HomeMy WebLinkAbout555 ANTON BLVD - Building PermitsCITY OF COSTA MESA
`C,�yTpMFy'q BUILDING DIVIS/ON
i�� 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • www costamesaca.aov
� `� � FOR INSPECTIONS CALL: (714) 754-5626
�°"°�°�fi PERMIT NUMBER: BC11-00508
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 10/20I2011
ISSUED BY: RMD
�os ,aooRess: 555 910 ANTON BL CM -.:. Suite/Unit: 910
APN: 41050110 . � Zoningi� , ', : ��_ . — _
Vicinity: 910
Canst Type: I-A
Primary Occ:
SQ. FT: 2804 Valuation: $73,750.00
SCOPE OF WORK: 2,804 SF INTERIOR TI FOR SPEC SUIT 910. WORK TO INCLUDE THE REMOVAL AND REPLACEMENT OF
EXISTING CEILING, INTERIOR NON-LOAD BEARING WALLS IN ORDER TO CREATE RECEPTIONIST AREA, CONFERENCE
ROOM, OFFICES AND BREAK ROOM WITH 1 SINK, ALTER/REPAIR COOLING/HEAT IN 5 ZONES, 35 LIGHT FIXTS„ 29
OUTLETS, AND � - . . ' ' , _
9 SWITCHES. � � . - � ' �
OWNER: RREEF
Phone:
APPLICANT: SALERNO,SCOTT
Phone: 949-993-9220
Address: PO BOX 4900
City/State/Zip: SCO7TSDALE, AZ �
Address:
City/State/zZip:
CON7RAC70R: AMARON CONSTRUCTION CORPORATION License No. 674301
Phone: 714-993-9220 � Address: 1565 N HARMONY ClUnit:
Cell: � - City/State:� � ANAHEIM HILLS, CA-
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees: �
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
License No.
License No.
$131.91
$811.75
$94.92
$140.65
$43.10
$0.00
$15.36
$3.00
$1,240.69
Unit: DEPT 207
Unit:
ZipCode 92807
PHONE:
PHONE:
^Refer to fee recei ts tor all fees aitl for ro'ect
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/7812010 - PER CMMC Sec. 13-279
Monday thru Friday -7:00 am thru 7:00 pm. Saturtlays-9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holiday5:
New Years Dav. Memorial Dav, Independence Dav. Labor Dav. Thanksqivinq Dav and Christmas Dav
NOTICE: The work authorized by lhis permit shall comply with all applicable handicap access requirements under Califarnia statutes and related
regulations. (Ord. No. 92-28, § 7, 12-27-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all appliwble codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
oee ixsaEcnonTrre
1616 Fixed System Final Fire Prevention
1266 Poo1 Spa Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
pgg x ni co� iNsrecnoNTrre
206 Final Mechanical
208
210
212
220
Final Plumbing
Final ElecViwl
Final Fire Prevention
Final Planning Approval
222 Final Sile
250 Final Builtling/Occupancy
i s. i�! DP� N pL
� �. • � � � �
l�• •1��
WORKERS' COMPENSA7IpN DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certifiwte of consent to self-Insure for workers'
compensation, as provided for by section 3700 ot the Labor Code, for the
performance of the work for Which ihis permit is issued.
❑ I have and will maintain workers' compensalion insurance, as required by
section 3700 0( the Labor Cqde, for the perfortnance of the work for which Ihis
permit is issued. My workers' compensation Insurance carrier and policy
number are:
tcarf,e? �/L'�ZC-�s'/ n��fzoN.o-t_
(This secfron need not Oa romp'eletl � Me pe�mrt is valuetl af ona �untlred dol�ars ($f00) orkss )
Polic� y�Number: %%0000 D / 3 �9 // /
❑ I certiry that in the p6Aormance of the vrork for which this pertnit is
issued, I shall not emplay any person in any manner so as to become subject
to the workers' compensation laws of Califomia, and agree that if I should �
become subjecl to the workers' compensation Drovisions of Section 3700 of
the Lab ode, I shal hWith compry vnth these pmvisions.
Applicanl'sSipnaWre O Oae
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CNIL FIN�S UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO 7HE 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 that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 ot the Business and Pm(essions Code, and
my license is in full force antl eftect.
u�.r Y3 � ssu %3
_ C�SIHGof9'SignAwre / F9���00�'
CONSTRUCTION LENDING AGENCY:
❑ I �ereby affirtn Ihat (here is a wnstruclion lending agency for the
perfortnance of the vrork for which Ihis pertnii is issuetl. (Sec. 3097, Civil Code).
Lendels Name:
Lenders Adtlress:
SignaNra Date
OW NER-BUILDER DECLARqTiONS:
I here�y aHirm that untler penalry of perjury that 1 am EXEMP7 FROM THE
CONTRACTORS LICENSE LqW tor the following reason (Sec. 7031.5,
Business and Professions Code: Any ciry or county which requires a permit to
construct, alter, improve, demolish, or repair any simcture, Drior to its
issuance, also requires the applicant for such permit to file a signed statement
ihat he or she is licensed pursuant ro the pmvisions o( the Contractors
License Law (Chapler 9(commencing vrith Section 7000) of Division 3 of Ihe
Business and Pro(essions Code) or that he or she is exempt therefrom and
the basis for ihe alleged ehemption. Any violalion of Section 7031.5 by any
applicant for a permit subjeMs lhe appliwnt to a civil penalry o( not more than
five huntlretl dollars ($500).):
❑ I, as ovmer of lhe pmperty, or my employees with wages as their sole
wmpensation, WILL DO THE WORK, and t�e siructure is not inlended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner ot Oroperty who builds or improves
thereon, and who does such vrork himself or herself or thmugh his or her own
employees, pmvitled that such impmvements are not intended or oNered tor
sale. If, hovrever, Ihe builtling or improvement is sold wiihin one year of
completion, the owner-buil0er will have ihe burden of pmving tha[ he or she
did not �uild or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED GONTRACTORS to wnstruct the project (Sec. 7044, Business antl
Professions Code: The contractors License Law dces not appy to an owner of
propeM who builtls or improves thereon, antl who wntrac�s for such pmject vnth
a contractor(s) license pursuant to �he Contractors License Lavrs.).
❑ I am exempt u�nder sec. •
Business antl Professions Code for this reason:
'Slgnawre Data
305)<6(3ro])
Owner ID verifed by driver's license. ❑ Yes ❑ No
Driver's License No. Expires: '
Verification ot Ownership by (rype of document, i.e. - property tax bill or tleed):
DIVISION OF INDUS?RIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certiry that no excavation fve (5) or more feei in depth into which a
person is required to descend, will be matle in connection with vrork authonzetl
by this pertnit, and Ihat no building strucWre, scaRolding, falsevrork, or demolition
or dismant(ing Ihereo(, will be more than thirty-six (36) feet high, (Chap. 32, Grp
2, Art 2, Sec. 341, Title B, Califomia Administralive Cotle).
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit from the Division of Intluslrial Sa(ery, as noted above, unless
such person has a permit lo do such work from the division.
Appliram's SiB�aWre
Division o( Industnal Safery Pertnii Numher: _
HAZARDOUS MATERIALS AND EMISSIONS GERTIFICATION:
1. Will the applicanl or present or fuNre building occupant neeA ro fle and
certiry a Business Plan for emergency response to release or threatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the Califomia Heallh and Safery Code requires, with some
exceptions, tha[ a Business Plan 6e filed with the Costa Mesa Fire
Depariment by every busine55 whiCh has at any one time during a reportetl
year a quantity of hazardous materials equal lo or greater than a weight of
500 pountls, or a volume of 55 gallons, or 200 cuDic fee[ of wmpressed gas
at standard temperaWre and pressure).
2. Does or will the applicant or present or (uWre building occupant need to file
a registration fortn for acutety hazardous materials? ❑ Yes ❑ No
(Section 25533 of ihe Califomia Health antl Satery Code, with some
exceptions, requires regisiration vrith the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry ot aculety
hazardous matenals equal to or greater t�an a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas al standartl
temperature antl pressure).
3. Does or will the applicant or present or future building occuDant need to
prepare an RMPP (Risk Management and Prevention Proprem for acutety
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safery Code provides that the
Costa Mesa Fire Department may require Ihe preparalion, certifcation antl
filing with the Fire Department of an RMPP by businesses which are required
to register aculety hazaraous materials with t�e Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuWre building occupant require for
Ihe work which is the subjecl o( lhis application a permit for such construction
or modifica�ion fmm Ihe South Coast Air Qualiry Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires lhal lhe requested
infortnation be fumishetl on applica[ions for non-residential builtling pertnits).
6. WII any part of the faciliry to be consWcted under ihis permi� be within
1000 feet from �he outer boundanes of a school? ❑ Ves ❑ No
Qf yes', the faciliry must meet the requirement of Sections 25534 antl 42303
o( Ne Califomia Health antl Sa(ery Code).
7. I( a permit from the Soulh Coast Air Qualiry Management District or other
air polWtion control disirict or agency is required for the work which is lhe
subject of this application, have all of the disclosures prescnbed by Califomia
Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No
8. (If'yes', attach certificate of compliance tmm t�e appmpriate air polNtion
wntrol officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Matenals antl Emissions.
CER7IFICATE OF COMPLIANCE AND AU7HORIZ/1TION OF ENTRY: I
certiry under penalry of perjury that I �ave read this applicalion and slate that
the in(ormalion given is correcL I agree to wmply with all slate laws and ciry
ordinances relating to building consWction, antl authorize representatives o(
the Ciry of Cosla Mesa to enter upon ihe above-0escribed property for
inspeclion purposes. I agree not lo occupy or allow octupancy ot any building
aulhorized by this permit until final inspection.
SlgnaWr ol�¢g mer�s) Dale
�— —1 � �
An e�Xi1f onze0 Applicenf �� eY
CITY OF COSTA MESA
oSTp"' Q B!/ILDING DIVISION
i�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.costamesaw.aov
� `� FOR INSPECTIONS CALL: (714) 754-5626
'`�"°^°^°'"' PERMIT NUMBER: BC11-00507
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 10/20/2011
ISSUED BY: RMD
JOB ao�ResS: 555 850 ANTON BL CM
APN: 41050110
Vicinity: SPEC SUITE
Const Type: I-A
Zoning: , ,
SQ. FT: 2562
Suite/Unit: S50
Primary Occ: '
Valuation: 566,880.00
SCOPE OF WORK: 2,562 SF INTERIOR TI FOR SPEC SUIT, 850. WORK TO INCLUDE THE REMOVAL AND REPLACEMENT OF
EXISTING CEILING AND INTERIOR NON-LOAD BEARING WALLS TO CREATE NEW OFFICES, STROAGE AREAS AND BREAK
ROOM WITH 1 SINK, ALTER/REPAIR COOLING HEAT IN 5 ZONES AND 28 LIGHT FIXTS, 23 OUTLETS, 10 SWITCHES.
OWNER: RREEF
Phone:
APPLICANT: SALERNO, SCOTT
Phone: 949-993-9220
Address: PO BOX 4900
City/State2ip: SCOI'TSDALE, AZ
Address:
City/State/z2ip:
CON7ftnC70ft: AMARON CONSTRUCTION CORPORATION license No. 674301
Phone: 714•993-9220 Address: 1565 N HARMONY ClUnit:
Cell: CitylState: ANAHEIM HILLS, CA
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees: ��
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
License No.
License No.
$123.95
$762.75
$86.53
$187.85
$43.10
$0.00
$14.04
$3.00
$1,221.22
"Re(er to (oo recel ts for all loes aid lor ro ecl
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3I1612010 -
Montlay thru Friday � 7:00 am thru 7:00 pm. Saturtlays- 9:00 am t�ru 6:00 pm. Prohibited all houi
New Years Dav. Memor(al Dav. Indeoendence Dav. Labor Dav. Thanksaivir
Unit: DEPT 207
Unit: :
ZipCode 92807
PHONE:
PHONE:
and the following Fetleral hotidays:
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, § 7. 12-21•92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF IAST INSPECTION.
INSPECTIONS: In order for the work authorized under this pertnit 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.
CODE t, V+sncnoH Trre
1fi16 Fbcetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Rool
201 Final8lock/Retaining Wall
202 Final Factory Fire Place
2�3 Final Sign
204 Final Demolition
QLi¢, INiffIALS GOOE� �NSGEC710NTYPE
206 Final Mechanical
208 Final Plum6ing
210 Final Eleclriwl
212
220
222
250
Final Fire Prevention
Final Planning Approval
Final Site
Final Building/Oaupancy
� ,' �
. • � �
��
WDRKERS' COMPENSA710N DECLARA710N:
I hereby aFfrm untler Denalry of perjury one of the follovring declaralions:
❑ I have and vnll maintain a certificate of wnsent ro self-Insure for workers'
compensalion, as provided for by section 3700 of the Labor Code, for the
pertormance of the vrork for which this permil is issued.
❑ I have and vrill maintain vrorkers' wmpensation insurance, as required by
section 3700 0( t�e LaDor CoAe, Por the peAortnance ol the work for which this
permit is i55ued. My vrorkers' compensation Insurence carrier and policy
number are:
•arrier� G1/ e+��v� N 4'f'i ar� �
(TM1.a secGon iketl nof De twnpefM allre peimt a vahrtH arpw nurdrtAGMars (irODl akss)
��aumbei: i (nfir7(k`i}7 / �. 7"f /� /
❑ I certiry that in the peAortnance of the vrork (or which fhis pertnif is
ISSued, I shall not employ any person in any menner so as to become su6ject
to the workers' compensation laws of Califomia, and agree t�at if I should �
becof—�he vrorkers' wmpensation Provisions of Section 3700 of
lhe L r Code I fa hvrith comply with these provisions.
� O %/
� np� s�61g'n'awra e�
l� /
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADDITION TO TNE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
A7TORNEY'S FEES.
LIGENSED CONTRACTORS DECLARATION:
I hereDy affirm that I am licensed under provisions of Chapter 9(commencing
�ih Section )000) of Division 3 of the Business and Pmfessions Code, and
my license is in tull tome and e((ect.
Li . � ti Gass ft� �
/D
�eleY.sSignar �e ��Jd
CON57RUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a construdion lending agency for the
p@r(ortnance of the �+vrk for which �his permit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
L@ndeYs Atltlress:
signaWre oate
OW NER-BUILDER DECLARATIONS:
I hereby affrm that untler penalry of perjury that 1 am EXEMPT FROM TME
CON7R4C70RS UCENSE LAW for ihe lollowing reawn (Sec. 7031.5,
Business and Pro(essions Code: Any ciry or t0unry which requires a permil to
construct, alter, improve, tlemolish, or repair any sWCNre, prior ro its
issuance, also requires Ihe apPlicant for such Dermit to file a signed statement
that ha or she is licensed pursuant to the provisions of the Cont2ctors
Li�nse Law (Chapter 9(wmmencing with Secfion 7000) o( Division 3 of the
Business antl Professions Cotle) or that he or she is exempt therefrom and
�he basis (or Ihe alleged exemption. Any violation of Section 7031.5 by any
applicant (or a permit subjects the applicant to a civil Denalry of not more than
Flye hundretl tlollars (5500).):
❑ I, as owner of t0e property or my employees with wages as their sole
compensation, WILL DO THE WORK, and ihe structure is not intended or
o((ered for sale (Sec. 7044, Business and Professions CoOe: The Contractors
License Law does nm appty to an owner of properry who builds or improves
ihereon, and who Aoes such vrork himself or herself or lhrough his or her own
employees, provided that such improvements are not intended or oHered for
sale. It, however, the building or improvemen� is sold within one year of
comDletion, the owner-builder will have the burtlen of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner o1 the property, am E%CLUSIVELY CONTRACTING WITH
LICENSED CON7RAC70RS to constmct lhe project (Sec. 7044, Business and
Professions Code: The cont2ctors LiCense Law does not appy to an ovmer of
pmperty who builds or improves thereon, antl who contracis for such Droject with
a contractor(s) license pursuant to the Contractors license LawS.).
[� I am exempt under sec.
8usiness and Pmtessions Code tor Ihis reason:
SiB^aWra
3059�46 (YJ])
Owner ID �erifietl by driver'S license. ❑ Ves ❑ No
Dnver'S Litense No. Expires:
Venfcation of Ownership by (rype of tlocument, i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION;
❑ I hereby certily that no exravation fve (5) or more (eet in depih inm which a
person is required to descend, will be made in wnnecUon with work auihorizetl
by this pertnit, and that no building strucNre, scaHolding, (afsework, or demolition
or tlismanUing thereof, will be more than thirty-s& (36) (eet high. (Chap. 3.2, Grp
2. Art 2, Sec. 341, Title 8, Califomia Administ2tive Catle�.
❑ As owner-builtler, I will not employ anyone lo do work which vroultl
reQuire a pertnit from the Division of Induslnal Safety, as noled above. unless
such person has a permil lo do such work from the divi5ion.
MpliunCa sipnawr.
Division of Intlustrial Safery Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
7. WII the applicant or present or fuNre building occupant neetl [o file antl
certify a Business Ptan (or emergency response to release or Ihreatenetl
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 ot Ihe Califomia Health and Salery Code requires, with same
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Depatlment by every business whicA has at any one time during a �eportetl
year a quantiry of hazardous materials equal to or greater than a weight of
500 pounAs, or a volume ol 55 gallons. or 200 cubic feet of compressed Bas
al standard temperaWre antl p�essure).
2. Does or will Ihe applicant or present or fuWre builtling occupant need ro file
a registration form for acutely hazardous matenals? ❑ Ves ❑ No
(Section 25533 of lhe Cali(omia Health and Sa(ety Code, with some
exceptions, requires registration with the Cosla Mesa Fire Oepartment by
each business which al any one time has on hantl a quantity of acutely
hazardous matenals equal to or 9reater than a weight ot 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of wmpressed gas at standard
temperaWre antl pressure).
3. Does or will the applicant or presen[ or future 6uilding occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutey
hazartlous malerials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health anE Safety Code proviCes that the
Costa Mesa Fire Department may repuire the preparation, ceAification and
filing with the Fire Department of an RMPP by husinesses which are required
to register awtely hazartlous materials wiih the Fire Department.
4. If an RMPP is presenity required, has Section 25534 of the Califomia
Health and Sa(ery Cotle Deen fuly complietl wit�? ❑ Yes ❑ No
5. Does or will the applican� or present or tuWre Euilding occupanl requite (Or
the work which is the subjeCt ot ihis aOP���ion a permit tor such wnstruction
or modifcation from ihe Soulh Coast Air Oualiry Management District or from
any other air pollution control dislrict or agency? ❑ Yes ❑ No
(Section 65850.2 0l the Calitomia Govemment Cotle requires that ihe requestetl
in(ormation be fumished on applications for norvresideniial building permits).
6. Will any patt o( �he Faciliry to be constructeC untler this permit be wit�in
1000 feet from the outer bountlanes o( a school? ❑ Yes ❑ No
(I('yes', ihe faCility must meet the requirement of Sections 25534 and 42303
ot the Califomia Health and Satery Code).
7. If a pertnit fmm the South Coast Air �ualiry Management District or other
air pollution control disinct or agency is required br the work which is the
subject o( lhis application, have all of t�e disclosures prescnbed by Califomia
Health antl Safery Code Section 42303 been made? ❑ Yes ❑ No
8. Qf yes', attach certificate of compliance from lhe appropriate air DOIWtion
control offcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury lhe
infortnation given above is correcL I agree to comply with all state laws and
city ortlinances regarding Hazardous Malerials antl Emissions.
Date
CERTIFICATE OF COMPLIANCE AND AU7HORIZA710N OF ENTRY: I
certify under penalty of perjury lhat I have read this application antl state lhat
the informalion given is correcl. I agree to compty wiih all state laws and city
ordinances relating to building construction, and authonze representatives of
the City of Cosia Mesa to enter upon t�e above�escribetl proDerty for
inspection purposes. I agree rtot to occupy or allow occupancy of any Cuiltling
authorized by Ihis permit until final inspection.
SiB�aWra ol Legal pvmer�s) DatO
� / �
�_^-4ln t c4ZBaTpPLcii1�\ .--.Q IB
4l
CITY OF COSTA MESA .
BI/ILD/NG DIVISION
F` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • v�v.ci.costa-mesa.ca.us
�. ` FOR INSPECTIONS CALL: (714) 754-5626
��°"�� PERMIT NUMBER: BC09-00168
PERMITTYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 0612612009
ISSUED BY: BJK
�oa aDDREss: 555 400 ANTON BL CM
APN: 41050104 Zoning: , ,
Vicinity: SUITE 400 INTERNAP
Const Type: I-A SQ. FT: 6025
Suite/Unit: 400
Primary Occ: B
Valuation: $157,403.10
SCOPE OF WORK: 3026 SF INTERIOR OFFICE TI CONSISTING OF NONBEARING PARTITION WALLS, NEW FINISHES 8
FLOORING FOR "INTERNAP' IN SUITE 400. ELEC: RELOCATE 12 LIGHT, 2 EXIT SIGNS, 2 OUTLETS, 2 SWITCHES; MECH: 3
VAV BOXES
OWNER: PWREFIMCC-SOUTH COAST, LLC Address: 535 ANTON BL. Unit: COSTA MESA,
CA
Phone: City/State2ip: SUITE 150
APPLICANT: SALERNO, SCOTT
Phone: 7�4-9323137
Address:
Ciry/State/zZip:
CONTRACTOR: AMARON CONSTRUCTION CORPOR.4TION License No. 674301
Phone: 774-993-9220 Address: - 1565 N HARMONY ClUnit:
Cell: City/State: ANAHEIM HILLS, CA
ARCHITECT:
ENGINEER:
License No.
License No.
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $857.06
Building Fees: � , $1,318.55
Electrical Fees: $81.90
Mechanical Fees: $55.45
Plumbing Fees: $0.00
SMIP Residential: $0.00
SMIP Commercial: $33.05
Bidg Std Admin Fund $7.00
TOTAL FEES: $2,353.01
"Rofer to fee receipts (or all fees paid for pro7oct
Unit: :
ZipCode 92807
PHONE:
PHONE:
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Cali(ornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT E7(PIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 p it.
U/ INSPEC710NTYPE � INTITIALS C�UF,p INSPELiIONTVPE �1 p��(/o IN RL
1818 Fixed System Final Fire Prevention ZO6 Final Mechanical ( � l`'! ^
1288 Pool Spa Final 208 Final Plumbing � r �
200 Final Re-Root 210 Final Electncal
201 Final BIocWRetaining 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�Occupanc,y
�i �
WORKERS' COMPENSATION DECLARATION:
I hereby affirtn untler penalty of perjury one of the (ollowing declarations:
❑ I have and will maintain a certifcate ol consenl to self-Insure tor workers'
compensation, as providetl for by section 3700 0( the Labor Code, for the
pedormance ol the work for which this permit is i55ued.
C I have arid will maintain v.arkers' compensatbn insurance, as requiretl by
ec n 3700 of the Labor Code, for Ihe pedormance o! the work (w which Ihis
permit is issued. My vrorkers' compensation Insurance carrier and policy
number are:
ca�a�:� �Ve2e.Y ,�A:r. 7n�s2 C�
�i�is sM.on neednot Ge mmdeteOR tne parmrt u vahiM al me �untlre0 dalars (E100) w bsa )
Policy.Number: �IGO(�OOO ��3� �DR �
❑ I certily thal in the peAormance o( �he work lor which this permit is
issued, I shall not employ any person in any manner so as to hecome subjecl
to the workers' compensation laws of Calilomia, antl agree that i( I should
become uDjecl to Ihe vrorkers' compensation provisions of Section 3700 of
the La Code. I `shy�p foAhvn/�t/r�comply with these pmvisions. G
6..9� ll.�, �C..� �/�.�-�/� /
APpli�n_ ��s Si8^alure ��ar
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed untler provisions of Chapier 9(commencing
with Section 7000) of DiviSion 3 of the Busine55 antl Professions Code, antl
my license is in full force antl effect.
Cic]# � � Class # �7 l �
_ ._- �/z�/05
Gonlrad«sSignature�� �Oat�A-.
��...
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that the2 is a construction lending agency (w the
peAwmance of Ihe v.ork fa which this pertnit is issued. (Sec. 3097. Civil Code).
Lender's Name:
Lender's Address:
Signamre
OWNER-BUILDER DECLARATIONS:
I hBfOby affiRfl 1h0� UntlBf p0nally o( perjury Ihat 1 am E7(EMPT FROM THE
CONTRACTORS LICENSE LAW for the tollovring reason (Sec. 7031.5,
Business and Professions Code: Any Gity Or COUnIy whiCh requires a permit to
consWct, alter, improve, demoli5h, or repair any strucNre, pnor lo ils
issuance, also requires the applicant tor such permit to file a signed statement
Ihat he or she is licensed pursuant to the provisions of the Contractore
License Law (Chapter 9(commencing with Section 7000) of Division 3 of �he
Business and Professions Cotle) or mat he or she is exempl therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant loi a permit subjects the applicaN to a civil penalry ot not more than
five hundred tlollare (3500�.�:
❑ I, as owner of tha property, or my employees vrith wages as their sole
compensation, WILL DO THE WORK, anC Ihe struclure is not in[entletl or
oHered for sala (Sec. 7044. Business antl Professions Code: The Contractors
License Law tloes not apply to an owner of propeny who builds or improves
thereon, and who does such work himself or herself or Ihrough his or her ovm
employees, provided Ihat suc� improvements are not intended or oflered lor
sale. If, however, Ihe building or improvemeN is soltl within one year of
completion, the ownervbuilder will have the burden of proving that he or she
tlid not build or improve for purpose o( sale.).
❑ I, as owner of Ihe property, am E%CLUSIVELY CON7RACTING WI7H
LICENSED CONTRAC70RS to wnsWct the project (Sec. 7044, Business and
Professions Code: The con[raclors License Law dces not apply lo an owner of
propeny vfio builds or improves thereon, aM who wntracis tw such projecl vrith
a contraclor(s) license pursuant to the CoN2ctOr5 License Laws.).
❑ I am exempl untler sec.
Business and Professions Code (or this reason:
SlgnaWre Oaie
305�-46�JI0]�
Ovmer ID verifed by driver's license. ❑ Yes ❑ No
Dnver's License No. Expires:
Verification of Ownership by (type ol document, i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: .
❑ I hereby certi(y thal no excavation Me (5) w more feet in depth into wfiich a
person is required to tlescend, will be made in connecl'pn vrith work authonzed
by lhis permit, and tha[ no building sWCWre, scaffdding, (alsework, or demolition
or dismantling thereof, will be more Ihan thirty-sa (36) teet high. (C�ap. 9.2, Grp
2, Art 2, Sec. 341, Ttle 8, Califomia Atlministrative Code).
❑ As ovmer-builtler, I will nol employ anyone to do work which woultl
require a permit from Ihe Division ol Intlustnal Safety, as noted above, unless
such person has a pertnil to tlo such work from t�e division.
AppliWnl's SipiuWrO
Division of Intlustrial Safeiy Permil Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or luture builtling occupant need to fle and
certily a Business Plan for emergency response to release or threatenetl
release of a hazardous material� ❑ Yes ❑ No
(Section 25505 of Ihe California Health and Safety Cotle requires. wim some
exceptions. that a Business Plan be filetl with the Costa Mesa Fire
DepaAment by every business which has at any one time tluring a reported
year a quantity of hazartlous matedals equal to or greater lhan a weight o(
500 pounds, or a volume o( 55 gallons, or 200 cubic feel of compre55ed gas
at standard temperature and pressure).
2. Does or will the applicant or presenl or (uture building occupant need to file
a registralion (ortn !or awtely hazartlous materials? ❑ Yes ❑ No
(Section 25533 oF tha California Health antl Safe[y Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry o( acutey
hazardous materials equal to or grealer 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 Ihe applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Progrem for acutely
hazardous materials)? ❑ Ves � No
(Section 25534 of the California Heallh and Safety Cotle pmvitles that Ihe
Costa Mesa Fire Department may require �he preparation, certification and
filing with lhe Fire DepaM1men[ of an RMPP by businesses v+hich are requiretl
lo register acutely hazartlous materials with Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 of �he Califomia
Healtn antl Safety Code been fully complied with? ❑ Yes � No
5. Does or will the applicant or present or future building ceCupant require br
Ihe wOrk whiCh is lhe subject ol this applicalion a permit for such wnsWction
or motlifcation from the South Coast Air Quality Management District or (rom
any othar air pollution control district or agency7 ❑ Yes ❑ No
(Seubn 658502 of the Califomia Govemmem Cotle requires that ttre requested
inlortnation be (umishetl on applications for ron-resiAential building permils).
6. Will any part o( Ihe lacilily lo be con5tructeC untler Ihis permit be within
10001ee� from t�e outer bountlaries ol a school? ❑ Yes � No
(If yes", the (acility must meet the requiremenl of Sections 25534 and 42303
ol the Califomia Health antl Salety Cotle).
7. II a permit from the Soulh Coasl Air Quality Management District or other
air pollution wntrol district or a9ency is requiretl for the vrork which is the
subjecl of this application, have all of Ihe disclosures prescribed by Califomia
Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certifcate of compliance from the appropnale air polWtion
control officer). ,
CERTIFICATE OF COMPLIANCE: I certify Ihat untler penalty of perjury the
information given above is wrrecl. I agree to comply with all sUte laws antl
city ordinances regarding Hazardous Materials antl Emissions.
Signawre Date
CER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury thal I have reatl this application and state that
the information given is correcL I agree to comply with all state laws and ciry
orCinances relating to builtling conslmction, antl aumorize representatives o1
Ihe Ci�y of Costa Mesa to enter upon the above-described propeAy (or
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until fnal inspection.
i Aawre o1 �eBa vmer(s� oate
�`..�-�' o
! An0/W Aultl 0'ApplKd�l �_ Dal!—'`
CITY OF COSTA MESA
. ��MFq BUILDING DIVISION F09-00080
i� . . � 77 FAIR Df?IVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
:
�. � FOR INSPECTIONS CAIL: (714) 754-5626
��
JobAddress: 555 ANTON BL
Suite: 400
Viciniry:
Parcel Nunmber: 4105p104
Applicant: GONZALES, ALBERT
Address: 2503 MIRA-MAR AVENUE
LONG BEACH, CA
FIRE SUPRESSION PERMIT
Zoning: .
Phone: 800 247-6497 X2505
Zip: 90815
Owner: PWREF/MCC-SOUTH COAST, LLC
Address 535 ANTON BL. - -
COSTA MESA,CA Phone:
SUI7E 150 Zip: 92626
Status: ISSUED
Applied: O6/12/2009
Issued: O6I30/2009
Contractor: INTEGRATED PRODUCTS AND SERVICES INCORFORATED DBA CAL PROTECTION
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
Phone: 800.247-6497
Zip: 90815
License: 909573
SCOPE OF PERMIT
3026 SF INTERIOR OFFICE TI CONSISTING OF NONBEARING PARTITION WALLS, NEW FINISHES &
FLOORING FOR "WTERNA . � "
INS7ALL 2 SPEAKERS AND 3 STROBE LIGHTS
REF BC09-00168 �
FEE SUMMARY
Plan Check: $72.31
Permit: $111.25
Other: $0.00
Total: $183.56
Calc Valuation: $a,so5.00
Claimed Valuation: Sa,sos.00
NOTICE: The work authonzed by this permit shall comply vnth all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-g2)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must wmply 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 ihis permit.
CODEt. INSPEClIONTYPE DATE INTITIRL COOEp INSFECTIONME QRTF INPTIALS
1676 Fixed System Final Fire Prevention � � 206 Final Mechaniwl
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention �^/3�_ s�,'�
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Si�e
204 Final Demolition 250 Final Building/Occupancy
' ` . . 1 .
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty o( perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure !or vrorkers'
compensation, as providetl for by section 3700 0( the Labor Code, for Ihe
peAormance ot the work for which this permit is issued.
❑ I have anC will maintain workers' compensation insurance, as requiretl by
sectbn 3700 of the Labor Code, for the pedortnance of Me vrork Iw which this
pertnit is issued. My xvrkers' wmpensation Insurance carrier and policy
number are: /�,n nI t
Cartter� �J'S��9Z�F �� f'�1� Y1 \i�%�
�'�This sedqn neetl rwl Ee mmpefea �/t1he pe`im'R is velve0 a( one hundmtl �Ilars (Sf 00) w less )
Policy�N ber: ��72�-1
� I certily iha[ in the performance of Ihe vrork for which this permit is
issued, I s all not employ any person in any manner so as to become subject
to ihe wor ers' compensation laws of Califomia, and agree that if I should
bewme s ject to the workers' compensation provisions of Section 3700 of
Ihe labor ode. fo hwith comply with ihese provision .
AC�o�.'S. � a:�—'�rw�•� :DMe�y,.
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 DOLLARS
($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 aKrtn Ihat I am licensed untler provisions o! Chapter 9(commencing
with Section 7000) of Division 3 0( Ihe Business and Professions Cotle, antl
my licens is in full force and effect.
L�--' ' 7 CIa55'#�� .,_
- 2rof55 a � �e—� ..-.�
�'�u��
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a constmctbn lentling agency for the
pertortnance of the kork fa which this pertnil is issued. (Sec. 3097, Civil Code).
LenCer's Name:
Lender's Adtlress:
SignaWre Date
OW NER-BUILUER DECLARA710NS:
I hereby aKrm lhat untler penalty of perjury that I am EXEMPT FROM THE
CONTRAC70R5 LICENSE LAW for the following reason (Sec. 7031.5.
Business and Professions Code: Any city or county which requires a permit to
consiruct. alter, improve, demolish, or repair any structure, pnor to its
issuance. also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to lhe provisions of the Conlractors
License Law (Chapter 9(commencing vnth Section 7000) of Division 3 of the
Business and Protessions Code) or thal he or she is exempt Ihere�rom antl
the basis (or [he alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit suDjects �he applicant to a civil penally of not more Ihan
flve hundred dollars (5500).):
❑ I, as owner of Ihe property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the struclure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Conlractors
License Law does not apply lo an ovmer of property who builds or improves
t�ereon, and who does such work himsel( or herself or Ihrough his or her ovm
employees. provided ihat such improvements are not intended or offered (or
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have Ihe burden of proving ihat he or s�e
tlid not build or improve for purpose of sale.).
❑ I, as ovmer oi the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRAC70RS to construct the pmject (Sec. 7044, Business antl
Professbns Code: The contrectors License Law does not apply to an owner of
property who builds or improves �hereon, and who contracts for such project with
a contracta(s) license pureuant ro the Cont2clors License Laws.).
❑ I am exempt under sec.
Business and Pr6fessions Cotle (or this reason:
Owner ID verifietl by driver s license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (type o( tlocument, i.e. - pmperty tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby cerlify that no excavation (rve (5) or more feet in depth into which a
person is requiretl lo tlescen4 will be made in connectbn wi[h wurk authorized
by Ihis permit, and lhal no building strucNre, scaffdding, falsework, a demolition
or dismantling lhereof, will be more than Ihirty-sa (36) feet high. (Chap. 32, Gry
2, M 2, Sec. 341, Ttle 8, Calitomia Adminislrative Cotle).
❑ As owner-builder, I will not employ anyone to do vrork which would
require a permit (rom the Division of Intlustrial Safety, as noted above, unless
such person has a permit [o do such work from the division.
Appli W nl'S $ignalure
Division of Industrial Sa(e[y Pertnit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicanl or present or future Duiltling occupant need to file and
certi(y a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes � No
(Section 25505 of the California Health antl Safery Code requires, with some
exceptions, that a Business Plan be fled with lhe 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 weiqht ot
500 pounds, or a volume of 55 gallons, or 200 cubic feet ot compressed gas
at slandard temperature antl pressure).
2. Does or will the applicant or present or future building occupant need b file
a regisiration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Heallh antl Safery Code. with some
excep[ions, requires registration vrith Ihe Cosla Mesa Fire Depariment 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 compressetl gas at slantlartl
temperature and pressure).
3. Does or vnll Ihe appliwnt or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Progrem for awtely
haz2rdous materials)? ❑ Yes ❑ No
(Section 25534 of lhe Califomia Health and Safety Cotle provitles that the
Costa Mesa Fire Department may require the preparation, certification and
fling vnth the Fire Department o/ an RMPP by businesses which are requiretl
to regisler acutely hazardous materials with the Fire Department.
4. If an RMPP is preseMly required, has Section 25534 of the Cali(ornia
Health and Sa(ery Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or (uture builtlin9 occupant require for
Ihe work whith i5 Ihe subject of Ihis application a permit for such conslruclion
or modification from the SoNh Coas� Air Qualiry Managemenl District or trom
any other air pollution control dislrict or agency? ❑ Yes ❑ No
(Section 658502 of Ihe Califomia Govemment Code requires that the requestetl
intortnation be fumished on applications !or nomresitlential building permits�.
6. Will any part of lhe facility to �e constmctetl untler this permil be within
1000 feet from the outer boundanes o( a school? ❑ Ves ❑ No
(I( "yes", the (acility musl meel the requirement of Seclions 25534 and 42303
ot 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 appliwtion, have all of the disclosures prescribed by Cali(omia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach cenificate of compliance from the appropriate air pollution
controloKceQ.
CERTIFICA7E OF COMPLIANCE: I certify thal untler penalty of perjury the
infortnation given above is cortect. I agree to comply with all state laws and
city ortlinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPIIANCE AND AUTHORIZATION OF ENTRV: I
certify under penalry of perjury that I have read this application and state that
the in(ormation given is correcl I agree to comply with all state laws and ciry
ordinances relating to building construction, antl authorize representatives of
ihe Ci�y of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any 6uilding
authorizetl by this permit until final inspection.
S a�ureo! galOvmer(s� 3ie
Sgnawre Daie �O
345'!-4fi (]I01) —�� a:e .zBtl Appli 1 f'patpi�� -�
� ( f
,� ��� �u+v�... ..... �. ...� .�. . ...._._..
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
555 ANTON BL
400
41050110
Applicant: ROLANDO CHIFFER _
Address: _ � , -
�: i%' ' _
�
, �/. .
ELECTRICAL PERMIT
�Phone: 714-245-1600 X230
Zip:
Owner 8AKIOKA FARMS °/aMORGANS HOTEL LIMITED� �_-_ �`,�
Address, PARTNERSHIP A,T.TN�JOE CRAWFORD
, DENVER, CO r - � Phone:
1050 17TH ST,#1220 Zip:
' ,: ,.
Convactor: SEASHORE CONSTRUCTION INC.
Address: "1930 OLD TUSTIN AVE , � .
SANTA ANA, CA
�
�Phone: (714)245-1600
� Zip: 927051600
License: 469215
Status: ISSUED
.Applied: 06/10/2004
Issued: 07/14/2004
�i/,� : �� J�
� - SCOPE OF PERMIT '
� 1,500 S.F. INTERIOR TENANT IMPROVEMENT FOR "PEOPLESOFT" IN SUITES 400 AND 500. �
� ELECTRICAL AND MECHANICAL WORK. NO NEW PLUMBING. REF.: 804-01067 �
� � � ELECTRICAL TO INCLUDE: 18 OUTLETS, 1 MOTOR TO 50 HP, 1 SERVICE TO 1000 AMPS, AND 1 � '
�� , TRANSFORMER OVER�100 KVAIKW �� i, , � _ _
, . ' _ . . . � _ _ - � ' - - . , �
FEESUMMARY
Quantiry Quantiry" - ;
ISSUE FEE ' , $23.50 � .,, Temp Disl Syslem / Lighting $0.00 ,�0 ' ' � - � .
, Temp service test � $0.00 � H - ,: � Busway /100 ft $0. W , � �0 � `-, ,
Res. alc package - $0.00 � , ' Standing Seclion, 50.00' �i"-0 � .
New Res'(1-2 units) . ' ' $0.00 0 ' Misc Electd'cal �Equipment $0.00, ';� 0 - �
New Res (3+units) - � $0.00 ; � � 0 � , , , Transformers up to 1;kvalkw - ,� � $0.00, " 0 r , , -
Pool / Spa ` � $0.00 - � 0 : ....:...........up to 10 kJa/kw $0.00 , � 0 =
Lighting FixCs �, � � - ; ",� $0.00 � . � 0 � .................up to 50 kva/kw �". `$0.00' - - 0 , � '
ReceptOutlets V�" : ' �. $19.80 �-� 18; : � ° ^ .................uptot00kva/kw:-; $0.00� •-/.0� �"�
Switches ���� ` $0.00��� ��b '��-� " ^ .......:..........overt00�kvalkw ,$74.50,.A;-7 ,-�;�/
Non Res Appl V�- �- $0.00 � 0 -- _-�' = , _ =Low Volqge Equipment , � �.$0.00 ;- 0 = � i
Res Appl � � $0.00 � 0 _ Low Volt.Widng System / Ckt � $0.00� /i 0� �
\
Service to 200a � $0.00 �� � 0 � - Misc. Conduit �" , � �� $O.00�i "�0�
Service to 1000a '�� $0.00 0 ' � � • Misa Conductor �� � �. � $0.00 "j 0
Service over t000a $124.30 �� 1�� � Circus ( gen or ride) ' �.$0.00' 0
Motors to thp $0.00� �. -� � D - i, Ciras (mech ride or lights)' ." ;$0.00 0
�
Motors to tOhp $0.00 � �--- - ChrisVnas Tree Stand % j� $0.00 0
Motors to SOhp $24.60 1 � - ��_ ' - _ � . ;Fireworks Stand � � 50.00 0 �
Motors to 100hp $0.00 0 ��- ��- -- 01her Electrical Fee $0.00
Motors over t00hp $0.00 0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. Nb. 92-20, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced vnthin 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, end�all
required Inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (7/4) 7545626 //
WORKERS'COMPENSATON DECLARAPON:
I hereby eXirtn under penalry ot Derjury one ot the following tledaratlons:
❑ 1 �eve end will maintein e cerllficate of wnsent to setl-Insure for workers' compensatlon, es proNded for by sectlon 3700 ot the Lebor CoAe, for Ihe pertormence of the
rk tor which this pertnit Is Issued.
I have end will malMain woAcers' compensatlon insurance, as required by sectlon 3700 of the Lebor Code, for Ihe pedortnarice ol Ihe work fw which t�ls permit Is IssueG.
My w�ork�ers' c�omp� se�1' nA Insure e cerrJ e�r@ poll um6er re: / �J %�
CeMer. .�" / fYl O W u'1 �. ( �/�. �/A Policy Number: �(OC/ �[/( ��
(Thls secbon need nof comp/eted 1! e permlt �s value ei one huntlred tlWlars (5100) or leu.)
❑ I certity UaI in ihe
compansation law
comply with �hesp
Applicent Signeture: _
WARNING: FAILURE TO SF
TIIIXISAND DOl1AHE (510
LICENSEDCOHTRACTORS
I heraby attirtn that I am licem
Porce end BflecL Lia k�
Comrector's5lgnaWre: �
CONSTRUCTION LENOING AGEI
❑ I hereby aMirtn that there Is e
LentleYs Neme:
Signeture:
'br whiCh Ui9 permit i9 IssueQ I 5hell not employ eny Oerson in eny manner so es ro become 5ubl� �o the workers'
i thet II I shoul0 bewme sub�ect to Ihe workers' compensatlon pravlsions oi Section 3700 of Ihe Lebor CaOe, I shell forihwith
/� oe�a: _ �7{ L¢7i�
ISATIIXJ COVERAOE IS UNLAW FUL AND Sw1L1 SU&IECf PN EMPLOVER TO CR MII NJ PENALAES N D pVIL FlNES UP TO ONE NUNDRED
COST OF COIAPENSATION, DAMFGES AS PROVIDED FOR IN SECrION 3�06 OF THE UBOR CODE, INTEREST, AND ATTORNEI"S FEES.
9(commencing with Sectlon 7000) of DiNsion 3 of Ihe Bi
CI055 k
Date:
and my license is in iull
lending egency for the pedormance ot the work for which thls permit is issued. (Sec. 3097, CiWI Cotle).
LendeYs Atltlress:
DBIB:
OWNER•BUILDER OECLAFiATIONS:
I hereby attirtn thet under penalry of per�ury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Busineu end Protesslons
Cotle: Any ciry or county which requires a pertnit to consWct, alter, improve, tlemollsh, or repair any sWctum, pdor to its issuance, elso reduires Ihe epplicent for such permil
to file e sipned statemeN thet he or she Is IlcenseA pursuant to Ihe proNsions o1 the Contractors License law (Chepter 9(commendng with SecOon 7000) oi Divislon 3 01 the
Business end Prolessions Cotle) or thet he or she is exempt Iherefrom entl t�e basis lor the ellegeC exemptlon. Any vlolation of Seotion 7031.5 by any epplicant for a pertnit
subjecis the epplicant to e civil penalry of not more then tive hundred dollers ($500).):
❑ I, as owner of Ihe properry, or my emplayees with weges es their sole compenutlon, WILL DO THE WORK, and Iha strunura is nat IntenEetl or oHered for sale (Sec.
7044, Business and Professions Code: The Coniractors License Law tloes not apply to an owner oi property who builds or imprwes thereon, end who does such work
himselt ar herself or ihrough his or her own employees, provided Ihat such improvemenis are nm intentletl or oNered for sele. tl, however, the building or improvement is
sold within one year of cnmpletion, the ownervbulltler will have the burden of proving ihat ha or she did not build or improve for purpose of saleJ. '
❑ I, es owner of the properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct ihe prolect (Sec. 7044, Buslness end Professlons
Code: The contrectors License law does not eppy to en owner oi properry who Cuilds or improves theraon, antl who contracts lor such pro�ect wlih e conirector(s)
. license pursuant to Ihe Contractors License Laws.).
❑ I em exempt under sec. Business and Protessions Code tor this reason:
Siqnature: Date:
Owner ID vanlied by drivels Iicense. ❑ Ves ❑ No Drivels Licensa No. Expires:
Veriticatian of Ownership by (rype al tlocument, I.e. - property tax blll or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereDy cenily thet no excevatlon five (5) or mora feat in depth into which e person is requlred to Gescend, wlll be matle in connectlon with work authodzeG by this
permit, end thet no builtling structure, scaflolding, felsework, or demoliiion or dismantling thereoi, will be more ihen Ihiny-siz (36) feet high. (C�ep. 32, Gry 2, Ar12, Sec.
341, Title 8, Cellfomia AAminlstrative Cotle).
� As awner-builder, I will not employ anyone to do work which would require e permit Irom the Division of Industrlel Satety, es noted ebove, unless such pereon hes a
pertnit to do such work irom the divislon.
Signature: Date:
Divislon of Industrial Safery Pertnit Number:
CERi1FlCATE OF COMPLIANCE AND AIJTHORIZATON OF ENTRY: I cerlily untlar penelty of perjury that I heve read this epplication en0 siate �hat the information given is
wrrect. I egree to comply with all stete laws end ciry ordinances relating to building cons�ruc�ion, end euthodze representatives ot Ihe Ciry af Coste Mesa to enter upon Ihe
ebove-descdbed property la�ectionpurposes. I agree not to occupy or ellow occupancy ol eny builtling euthorized by ihis parmit until Ilnel inspection.
CODE 1. INSPECliONTYPE
1878 Fixetl System Final Fir Prevention
1266 Pwl Spa Final
200 Final Re-Rooi
201 Flnfll BIocWReteining Wall
202 Final Factory Fire Place
203 Flnal Sign
204 Final Demolition
Q�jF p71RIAL5 LOpEt INSPECTIONTYPE
206 Finel Mec�anicel
208 Final Plumbing
210 Final Electrical
212 Final Flre Preventlan
220 Final Plenning Approval
222 FinalSite
250 Finel Bulldinq/Occupency
Job Address: 555 ANTON BL
Suite: 400
Viciniry:
Parcel Number: 41050110
BUILDING PERMIT
Zoning:
Applicanc ROLANDO CHIFFER ,
Address: 1930 OLD TUSTIN AV �- � � �
� Phone: 714-2451600 X230
SANTAANA;�CA� - � Zip: 92705
Owner. SAKIOKA'FARMS %MORGANS HOTEL LIMITED �
Address ,� PARTNERSHIP ATTN JOE CRAWFORD . . . .
. � DENVER, CO � , � ' � Phone: � �
, 1050 17TH ST #1220 " Zip:
Contractor. SEASHORE CONSTRUCTION INC.
' Address: 1930 OLD TUSTIN AVE
, , . � Phone: (714)245-1600
SANTA�ANA, CA
Zip: 927051600 License: 469215
Arch : JIM BICKEL Eng:
Address: 3600 BIRCH ST � �� � . Address: -
SUITE 220 ` Phone: 943757-0411
NEWPORTBEACH "
Status: ISSUED
ApPlied: O6/10/2004
Issued: 07/14/2004
ISSUED BY: �
. .
„ ��� � �
, Phone:
Zip: 92660 , License: C20925 �icense:
� � � --. SCOPEOPPERMIT - .
ALT EXISTING 1;500 S.F. OFFICE, UPGRADE EXISTING INTERIOR FOR'PEOPLESOFT" IN �SUITES 400 AND 500. ELECTRICAL AND � �
MECHANICAL WORK. NO NEW PLUMBING. REF.: 804-01068� - "
Plan Check: $172.41
Permit: $265.25
SMIP Res: $0.00
SMIP Com: $3.29
Other: $0.00
Inspection:- $0.00
Total: $440.95
SETBACKS."' �
MAIN STRUCTURE� Fr�ont 0- 0
ACCESSORY Front 0-0
PARKING Existinq: o
Rear
Rear
FEESUMMARY
PLANNING & ZONING
0= 0 - Ceft 0- 0�� �
0- 0 . left 0- 0 , �
Calc Valuation:
Claim Valuation:
' `
,;; -
� i i:,
� ,� � �� "��
" -.A,i., j�i
Poght � .0. 0' � �
/
���
Righl � 0- 0 ��
Reouired: •0 . Proposed: 0 �
� _,
.j
ais,s75.00
515,000.00
NO710E: 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 it work is not commenced within 180 days, or if work Is suspended or abandonetl
for a period of 180 days.
INSPECTIONS: In order for the vrork authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inspectlona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
zuaae �avo�
WORKERS' COMPENSA71ON OECLARATON:
I nereby ettirm under pBnalry of perjury aw ot the followin0 tlodareUons:
❑ I heve entl will malni9in a certificete of consent to sell-Insure far workers' compensatian, es proNded for by sectbn 3700 oi the Labor Code, for ihe peAartnence ot the
�ork 1or w�ic� this pgrmfl Is iuued.
�ave entl wlll mainWn woticers' compensat�m Insurence, es reduired by sectlon 3700 oi the labor Cade. tor Ihe peAormance af ihe work fw whkh this permlt ls Iswed.
My vrorkers' compenest on In urence cartier entl policy nu r ere: / �j q�7 1
Cerir e�� �_� 011wn-� • �� I�� ' //l� Number: � l 107i 1 1/�! ��
(iT`�tlon need not be cwnpleteC If the pe rIn( Lv valued ef one hundred dollars ($100) w less.) �'
❑ I cerlity Ihet In the peAom nce,ol Ihe work for ihich thls pertnit is issuetl, I ahell not employ eny pereon in eny menner so es to become subject to Ihe workere'
compensatlon laws i ,�C e!Ae 1 1 II I ahoulO become subJect to the workers' compensetion provlslons of Section 3700 ot t�e Lebor CoEa, I shell lorthwlth
wmDly with th 's . / � � �/ ^ � „ A
cani5lgneture: � Oal—� �� y ��
� � {
ARNINp;.FAIWRE.TOSE OM SATIONCOVERAQEI$UMAWFULANDSWILLSUBJECfANEMPL'[EH,TO_CRIMIWILPENALTI M!D LFlNESUPTOONEHUNDRED
D OOLURE (5100,qJp), IN AODIT TO THE COST OF CAMPENSATION, OAMAGES AS PROVIDED FOR IN SECfIIXJ 310B OF THE LABOR CODE, INTEAEST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
lorce entl eflect. LJc.
❑ I hereby aflirm Ihet lhere is e
Lendels Neme:
s�goamre:
9(commencing with Section 7000) of Divlsion
Cless a
entl my Ilcense Is in lull
egoncy tor the peAormance ol lhe work tor whic� ihis pertnit Is issued. (Sec. 3097, CMI Cotle).
Lentlers Atlaress:
Dete:
OWNER-BUILDER DECLApATONS:
� hereby eHirm that untler penelry of Dehury Ihet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW fo� Ihe lollowing reeson (Sec. 7031.5, Business entl Prolesslons
Cotlo: Any ciry or counry which requires e permit to canstrucl, elter, improve, demollsh, or repair eny structuro, pdor to Ite Issuence, also requlres the ep011cent for such pertnit
to flle e eignad etetement thet he or she Is Iicensetl pursuent to the provlslons ot the Contraqors IJcense Lew (Chepter 9(commencing with Sectlon 7000) ai Dlvision 3 ot the
Business end Professians Code) or ihet he ar she is oxempt Iherefrom end Iho besis tor the elleged exemption. Any violatlon af Sodlon 7031.5 Dy eny ep011cant lor a pertnit
sub�ects tho epplicant to e civil penalry of not more then Ilve hunCretl Aollara (5500).):
❑ I, es owner at t�e D�Operry, or my emD�oYees with wages as t�eir sole compensetlon, WILL DO THE WORK, end the structure Is not Intended or ottered lor sale (Sec.
7044, Business and professions Cotle: Tha Conirectors License Lew does not appty lo en owner ot properry who builds or improves thereon, antl who does such work
himseli ar hersetl or Ihrough his or her awn employeas, provided Ihat such impmvemenis ere not Imended or oflere0 for sele. If, however, the building ar improvement Is
sold wlthln one yeer of completion, the owner-bullder wlll have ihe Durden of proving ihat he or she tlid not Duild or improve tor puryose ot sala.). �
❑ I, es owner o1 Ue prOperry. em EXCLUSIVELV CONTRACTING WRH LICENSED CONTRACTORS ta consWct the pro�ect (Sec. 7p46, gusiness entl Professions
COAe: The contraaors LJcense Law tloes not apDN �o en owner of property who builds or Imprwes thereon. enA who cantracts tor such pro�ect with a cantrector(s)
license pursuant lo the Comractors Ucense laws.).
❑ I em oxompt uMer sec. eusiness end Professions Cotle for t�ls reeson:
Slgnaluro: Dele:
Owner ID veritied by driveYs license. ❑ Ves ❑ No Orivers License No. Ezpires:
VeAflceUon of Ownership py (type oi document, i.e. - property lan bill ar deed):
DIVISION OF INOUSTRIqL SAFETY PEHMIT CERTIflCAT10N:
❑ I �ereby certly that no excevelion flve (5) or more leet In tlepih Into which e person Is requiretl Io tloscentl, wlll be made In connectlOn wlth work euthaAzed by Ihb
permll, antl �het no Cuiltlinp structure, scaMolding, lelsowork, or demalltion or dismantling thereoi, will be more ihan t�lrry-slx (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Titla B, Calilamla Adminisirative Cade).
❑ As ov.ner-builCer, I will not emplay enyone to tlo work which woultl require e permit irom Ue Oivision of Industriel Safery, as noted eDove. unless such person has e
permit ta do such work from the divislon.
Slgneture: Date:
D'Maion of Industriel Sefety permit Number:
CERTIFlCATE OF COMP�IpNCE AND AUTMORVATON OF ENiAY: I ceM1ify under penalty of perjury �hel I have reatl thfs flpp(icafion and siate �hef �he tn(ortnalion given is I
cortect. 1 egree to compty with ell state laws� nd dty ortllnances relating to builtling construc�ion, and emhodze representetives ot ihe Ciry of CoSta Mesa to anter upon the
ebove-descnbed properry lor inspQc(ion purq6ses. I egree not to acupy or ellow occupancy of eny building euthorized by ihis permit until linal inspectlon,
CQDE �. INSFECTON T'PE
i
1878 FI:eG System Final Fire �i
1288 Pool Spe Flnal
200 Finel Re-Rool
201 FInaI8locWRetelning Well
202 Final Fadory Fire Place
203 Flnel Sign
200 Flnel Demdlilon
Q� ��
COOEI INSPECTONTYPE
206 Flnal Mechanical
20B Finel PlumDing
270 Ftnel ElectAcel
212 Final Fire Prevention
220 Final Planning Approvel
222 Finel Slte
250 Finel Builtling/Occupency
PAIE It�LS
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 400
Vicinity:
Parcel Nunmber: 41050110
Applicant: ROLANDO CHIFFER
Address
/
PLUMBING PERMIT
s
Phone: 714-2451600 X230
Zip:
: � . � � � � " � -
Owner.� SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
� � DENVER, CO� Phone:
. � 1050-177H ST #1220 Zip:
Contractor: SEASHORE CONSTRUCTION INC.
Address: 1930 OLD TUSTIN AVE ��
SANTA ANA, CA .
Arch / Eng : � •
Address: '.
. Status: ISSUED
Applied: O6/10/2004
Issued: 07114/20
ISSUED BY:
Phone: (714)2451600
Zip: 927051600
License: 469215
i
�
Phone: . � - -
Zip:� � � . � ..
License: - -- - ,
SCOPE OF PERMIT -
� 1,500 S.F. INTERIOR TENANT IMPROVEMENT FOR'PEOPLESOFf" IN SUITES 400 AND 500. � �
ELECTRICAL AND MECHANICAL WORK,�NO NEW PLUMBING. REF.: B04-01067 j�' j, � � �
- ' - � i ; _ - ,.
PLUMBING TO INCLUDE: 1 FLOOR'DRAW (CONDENSATE) ,
ISSUE FEE
Backflow irtigation � � -
BackflowPreventer ��
Bathtub
Clarifier System
Connect Qce,Soda,etc)
Dental UniLs
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
AMT
$23.50
ao.00
$0.00
� $0.00
$0.00
$0.00
50.00
50.00
59.80
$0.00
$0.00
�N
0
0
0
0
0
0
U
1
0
0
FEE SUMMARY
, � AMT aTY ' �: � , � f, ,
i
_ Laundry Tub / Washer , $0.00 0 - ' �- � � Sump Pump�, � �-, j
Landscape Irrigatlon 30.00 - 0 � � �Swimming�Pool',� '
. P-Trap $0:00 --0 � � � � � Trap Primer - y� �
� . Pressure Reguiator $0.00 0 - � ��. Urinal � � �
Process Piping (per 10 ft) $0.00 0'� �� Vacuum Brkr Bkflow(t-4)
Receplors $0.00 � �0 Vacuum Brkr Bkflow(5+)
SepUc Tank $0.00 0' , Wash Basin
Sewer Cap foi Demo $0.00 0- �. �/ wash Basin Set
� �Sewer Connect -$0.00 �- 0� -' Waste and Vent System
SewerPrivate�Cine " ' '$0.00 - 0 Waterqoset(Toilet)
Shower - $0.00 0 Water Heater I vent
AMT
50.00
So.00
$0.00
so.00
ao.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
QTY
0
0
0
0
0
0
0
0
0
0
0
I' NOTICE: The work authodzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related ��.
regulations. (Ord. No. 92-28, § 1, 12-21-92) ��
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned I
for a period of 180 days.
/
INSPECTIONS: In order for the work authorized under this permlt to be considered legal, such work must comply with all applirable codes, and all
required Inepaetione and finel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626 ,J
zue-ae �eroo�
WORKERS' COMPENSATION D�CLARATION:
I hereby ettirm unCer penalry at per�ury one ot t�e tollowing tlecleretions: �
❑ I h end will malntain e certiflcete of consant lo sell�lnsure for woMers' compense9on, es provlded tor by seMlon 3700 of Ihe Lebor Code, for the pertormence of t�e
rk tor w�lch tNs pertnil Is Issuetl.
I have end will malntain workgrs' compensatlon Insurenco, as required hy sectim 3700 ot the letwr Codo, for Ne poAwmaxe of Ne wark tor whkh this pertnit Ls Issued.
My wo � ers' compensation/N( surence rder enC r are: '7
Certier. `�� �I_ ��. J _ Pollty Numbgr. ��� �G/U�
❑ I cenly that in the
compansallonlew
compty wiN IheBA
Applicant Slgneture: _
WpRMNG: fARUPETOSF
LICENSED CONTRACTORS
I hereby.eRirm that i am licem
torce aritl eHect: Lic. N�
Contredofs Signature:
CONSTRUCTON LENDING /IU'61
❑ I nereby ettirtn tnat Ihere is g
Lenders Neme:
Slgneture:
OWNER-BUILDER DECLARATIONS:
r w�ich thls pertnit is IssuoA, t shell not employ eny peraon in eny manner ao es to bocome sub�ec� to t�e worker6'
r Ihe� tl I shoulC become sub�ect to Ihe wOrkors' compensetlon proNsions o1 SecUon 3700 at l�e Lebor Code, I shall Iorthwith
.A� oa�a: —7�/L�%
EN T10N COVERAOE IS UMAWFUL AND SIULL SUBJECT AN EMPLOYER TO CRI P�L FlNES UP TO ONE HUNDPED
TME COST OF COMPENSRTIIXJ, DAMAGES /S FROVIOED FOR IN SECTIIXJ 37080F TME LABOR COOE, INiERE5T. AND ATTORNEV'S FEES.
9(commenpng vrith SecUon 7000) ot DlNsion 3 ot the Buslness
Cless q _�
Date:
and my license is in full
lending epenq for Ne paAortnance ot Ihe work tor wNch thls permil is Isaued. (Sec. 3097, CMI CaCej.
Lentlora Atldress:
Date:
I �ereby afFlrm thet under penalry ol perJury Ihet I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW lor the tollowing reason (Sec. 7031.5, Business flnd Protesslons
Cade: My dry or counry which requires a pertnit to cronslrucL alter, imprwe, demdish, or repair flny siructuro, prlor to Ita ISsuance, eiso reQuires the epplicant tar such pertnit
ro file e signed slatement Ihat he or aha Is Iicensed Dursuant to the provlsians ot the Contractors lJcense Lew (Chepter 8(commendng with Section 7000) of Dlvislon 3 01 Ne
Business antl Professions CoOe) or Ihet he or she is exempt Nerefrwn entl the basu for t�e allapetl e:emptlon. Any vidation of Section 7031.5 6y any epplicent tor e pertnit
sub�ects ihe applkent to a dvil pehalry af not more then live hundre0 tlollars (5500).):
❑ I, fls owner oi 1he property, Or my employees wlih weges as their sole wmpenselion, WILL DO THE WORK, entl the atnuture is not intendetl or oHere0lor sale (Sec.
7044, Business antl ProtesSions Code: The Contractors License Lew tloes not eppty to en owner ot property who builds or improves Ihereon, and who tloes such work
himsetl or herselt or t�rough his or her own employees, provi0etl thet such improvements ere not intendetl or ottereC br sale. tl, however, the bulltlinp or Improvement Is
sold wiihin one year ot completion, the owner-builder wlll have the burden of proWng ihat he or she did not build ar imprwe lor purpose ot sale.). �
❑ I, as owner oi the property, �m EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTOHS to construct the pro�ed (Set. 704d, Business end Professlons
Code: The camrectors License Lew tloes not appty to en owner at pmperty who bullds or Imprwes ihereon, antl who contracts lar such pm�ect wlth e crontredor(s)
. license pursuant to the Contradors License Lews.).
❑ I em exempt under sec. Business entl Professions Code tor thls reeson:
Signature: Date:
Owner ID venfietl by tlnvefs licenge. ❑ Yes ❑ No Drivets License No. Expires:
Vedficetian oi Ownership by (rype ot tlocumem, I.e. � property tex bill or deed):
DIVISION OF INDUSTFIAL SAFE7y PERMIT CERTIFICATION:
❑ I �ereby certlfy thet no excayatlon five (5) ar more feet In dept� into whlch e person Is requiretl to descend, wlll be mede in conneciion with work euthorized by Ihls
pertnit, and lhat no builtling strucWre, scefloltling, felsework, or Aemditlon or Elsmentlinp Ihereot, wlll ba more than thlrtyslx (38) tee� high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Calilomia Atlmlqlylrative Gode).
❑ As owner-bullder, I wlll not employ enyone to tlo work whic� woultl require e permit irom the Dlvlslon ot Intlusirial Sefery, es noted ebove, unless such person hes e
permit to do such wark from the division.
Signeture: Date:
Division of Intlustrial Satery Partnit NumDer:
CEHTIFlCATE OF COMPLIANCE qND AllTTIORIZA710N OF EMRY: I certity untler penalty at perJury t�at I have read Ihis epplicatlon flnd stele thet Ne Informellon given I9
wrtect. I agree to ty wlth all steta lews entl ciry ordinences relating lo builtling construcUon, end euthodze representatives of the Clry ol Coste Mesa to enter upon the
ebove-descri�lor InspecGqi p�rryoses. I agree rrot to accupy o� allow accupancy ot any building authaizetl Dy I/ris pe�mit until finel inspecUon.
� �� �
1616 Fixed System / al Fire Preventlon
7266 Pool Spa FI
200 Finel RaHoof
201 Finel BIocWReteining Well
202 Final Fedory Fire Place
203 FI�1 Sign
204 Flnal Demolitlon
pdg p� cooe. n+svecnoxme
_ 208 Finel Mecnaniwl
208 Final Plumbing
210 Final Electricel
212 Final Fire Preventlon
220 Finel Planning Approvel
222 Finel Site
250 Finel Bulltling/Occupenq
� I��
t+ • ��1
Job Add�ess: $SS ANTON BL
Suite No 400
Vicinity:
Parcel Number: 41050170
npp�icant: ROLANDO CHIFFER" /
Address: ��'- � �� �
MECHANICAL PERMIT
Phone: 714-2451600 X230 �� .
_.,..
�'� � �
Owner� �;SAKIOKA FARMS%MORGANS HOTEL LIMITED
Address: PARTNERSHIP ATTN JOE CRAWFORD
DENVER,CO� - Phone:
� - , 1050 17TH ST #1220 Zip: .
Contrector. SEASHORE CONSTRUCTION INC.
Address: -19300LDTUSTINAVE
SANTA ANA, CA
� Phone: p14)245-1600
Zip: 92705-1600 '
License: 469215
_:
Status: ISSUED
Applied: 06/10/2004
Issued: 07/14/2004
ISSUED BY:
SCOPE OF PERMIT
� � � 1,500 S.F. WTERIOR TENANT IMPROVEMENT FOR "PEOPLESOFT' IN SUITES 400 AND 500.
, ," , ELECTRICAL AND MECHANICAL' WORK. NO NEW FLUMBING. REF.: B04-01067 '
MECHANICAL TO INCLUDE: 2 SMOKE DAMPERS, 1 AIR HANDLER.< 10000 CFM AND 1
� ' COMPRESSOR/ABSORPTION UP TO 3 HP/t00K BTU. � �
� FEE SUMMARY
� Quantiry � � �/= " Quantity �
ISSUE FEE � $23.50 Repair / Alt Absorbtion Unit -� $0.00 0
Inst FAU <100 k BTU $0.00 0 Repair / Alt Refrigeration UniE ��$0.00 0 "
Inst FAU >100 k BTU '� $0.00 0 Ventillation-System ��; ' $0.00' 0� �
Repair % Alt Cooling/Heat � $0.00 0 �-.-Evaporative Cooler %� � ,� �$0.00 0
Inst / Rep. Recess Wall HV $0.00 0 � 'Commercial Incinerator '�> , $0.00 0
Refrig Sys <100 k BTU , $0.00 0 , , ��- , Domestialncinerator �" , � $0.00 � 0;
Refrig Sys >100 k BTU � � $0.00 0 , " - . Compressors�7 Absorption Svstems ,� �
Gas Pipinq � �; ' . $0.00 0 . � , Up to 3 hp / t00�k BTU �- � � ' . $0.00 '0
Factory Fireplace � $0.00 0 ,, � , . 3 To 15 hp / 500 k BTU .� j� �..� � 50.00� 0
Hood w/Mech Exhaust � i� $0.00 -�0 _ , 15 To 30.hp / 1,000 k BTU%- " -,�%� -�� a0.00 0
� �� /
VAV Box \ . $0.00 0 � � � � � 30 To 50 hp /�t 750 k BTU � ' ' � ;'/ , , $0.00 0
Vent Fan / Single Duct � � , $0.00 0 �-_ � .. � � � Over 50 hp 1-Over�1 �750 BTU, ��. � � ,� .'' ,30.00 0
Appliance � �,� $0.00 0 � � � � � �Boilers - . �C ' i ' '
Fire Dampers $0.00 , 0. :� Up to 3 hp � -',�� $1470 1
�
Smoke Dampers - $14.50 �2 , 3 To 15 hp . . ` � " �i $0.00 0
Inst or Relocate Appl Vent � $0.00 0 � � � � 15 to 30,tip- ` �� � , � � $0.00 0
Air Handlers < 10000cfm $10.65 .7 , 30 to 50'hp_.' � � ; j . -' $0.00 0
Air Handlers > 10000cfrn $0.00 0.' � - Over50 hp - _ - �' $0.00 0
Floor Fumace $0.00 �0 � , _ _ . Other MecFanical'Fee'� �
Flooror Suspend Heater $0.00 0 � � __ ,' ' � � �-Investigation Fee� $0.00 '
` �" PIan�Check Fee $0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and relatad
regulations. (Ord. No. 92-28, § 1, 1241-92]
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work Is suspentled or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be conside�ed legal, such work must comply with all applicable codes, and alI
requlred inepeetlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
/ %
saaws cemo) //
WORKERS'COMPENSAnON DECLARAnON: �
I hereby eHirm untler penalry oi perjury one oi ihe following declarations:
❑ I h ve and wlll maintain e centlicete of consent to selFlnsure tor workers' compenseGon, as proddetl for Dy section 3700 of Ihe Lebor Cada, for t�e pertortnance of ihe
ork for which this pertnit is issued.
I have and wlll maintaln workers' compensetlon insurance, es repuiretl by seclion 3700 of the Labor Gode, lor Ne perfortnance ot Ihe work tor which Ihis pe'mit is issued.
M wor�k -s—' w�� e s Ion urence rder tl n ber are� /-7G% �J
Carrier:Y 7 / /l / 6 � ��� �/� pollcy Number: /�/J /� [ / � D`
(7h/s secnon need not be mp/efed tl(he rmif is valued at one hundred dollars ($100) or less.)
❑ I CBrtity ihet In Ihe
compensation lew
comply with Ihesp
AppllcantSlgneWre: �
WARNINO: FAILURE TO E
THOUSAND DOLLARE 1510
LICENSED CONTRACTORS
I herehy eHirtn Ihat I am liten:
lorce end ettect. Llc. a `
Contrector'sSlgneWre: �
CONSTRUCTION LENDItlGJ
❑ I hereby aNirm thet Ihere
LentleYs Name:
Signature:
of ork for which this permit is iuued, I shell not employ any person in any menner so es to 6ecome suD�ect to the workers'
4 8ree Ihat it I should become suDJect to the workers' compensetlon provisions ol Sectlon 3700 0l the Lebor Cotle, I shall lorihwi�h
Dete: �/�¢I �
�
ENSATION COVERA�E IS UNUW FUL PND SHALL SUBIECT AN EMPLOYER TO CRIMI PENAL ES M1D dNL FlNES UP TO ONE HUNDRED
TO THE COST OF COMPENSATION, DMU�ES /5 PROVIOED f-0F IN SECTION 3'!OB OF THE IABOR CADE, IMEREST, AND ATTORNEI"S FEES.
9(commendng with Section 7000) of �Ivislon 3 ot the Business
Class p
Dete:��
entl my license is in full
lending agency for Ihe pertormence of Ihe work for which this pormit Is issuetl. (Sec. 3097, Civil CatleJ.
Lendefs Address:
Date:
OWNER-BUILDER DECLAFiATIONS:
I hereby aNirm [hal untler penalry of perjury ihat I em E%EMP7 FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry which requires e perynit to consiruct, elter, improve, demolish, or repalr eny structure, prlor lo its issuance, also requires lhe eppliwnt for such pertnit
to file e sipnetl statement that he or she is licensed pursuent to the provislons of Ihe Cont2ctors LJcense Lew (Chepter 8(commencin9 wit� SecUon 7000) of DMsion 3 of the
Business antl Professions Gode) or Ihat he or she is exempt therefrom and the Easis for the elleged exemptlon. Any violatlon a� Sectim 7031.5 by flny epplicent for e pertnit
subjects the eppllcant to a civil penalry ot not more then tive �undretl dollars (5500)J:
❑ I, es owner oi Iha properry, or my employees with weges es i�eir sole compensation, WILL DO THE WORK, and the structura Is not intended or oHeretl for sale (Sec.
7044, Business and Professions Code: The Coniredors license Law tloes not apply to an owner of properry who builds or improves thereon, antl who tloes such work
hlmseN or herseli or through �is or �er own employees, provitlad that such improvements ere not intentled or oNered for sale. If, however, the building or imprrnement is
sold within one year ot completion, the Owner-builder will have the burden of proving that he or she did not build or Improve for purpose ot sale.). �
❑ I, as owner of the pro0erry, em E%CLUSIVELY CONTRACTNG WfTH UCENSED CONTRACTORS to consWct the project (Sec. 7044, Business and Professions
Cotle: The conirectors LJcense Lew tloes not epply to en owner ot propeny w�o builds or improves Ihereon, end who wniracts for such project with a contracroqs)
. license pursuant to the Contractors License Laws.).
❑ I em ezempt under sec. Busineu ena Protessions Cotla tor this reason:
Signature: Data:
Owner ID verified by tlnvers Iicense. ❑ Yes ❑ No Drivefs License No.
Veriflcetion ai Ownership hy (rype of tlocumenL I.e. - pmperry teu bill or daed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMfT CERTIFlCA710N:
❑ I hereby certify thet no excavetion tNe (5) or mora teat In dept� Into which e person Is requlred to Oescenq will be ma0e In connectlon with work autharizetl by Ihis
permit, end that no building sirucWre, sr,eryolding, talsework, or demolition or dismantling I�ereoi, will be mora than Ihiry-six (39) faei high. (Chep. 3.2, Grp 2, Ar12, Sec.
341, Ttle B, Cellfomia Administretive COCe).
❑ As owner-builder, I will not emplay enyone to do work which wauld require e permit from the DiWsion oi Intlustdel Satery, es noted ebove, unless such person has e
permit to tlo suc� wark Irom t�e divislon.
Signature: Date:
DlNslon o1 Intlustdal Safary Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHOFiVATION OF ENTAY: I certify under penelty ot perjury that I heve read this apDlication and state that Ihe information given is
correct. I agrae to compty with all state ws end clry or0inences relating to building constructlon, end euthotlze representatives ot the Clry of Cosle Mesa Io enter upon the
ebove-descnbetl proper�t�r�nsp�tio�urpuses. I egree not to occupy ar allow occupancy ot eny building authonzed by this pertnit until final inspection.
COpE �. INSPEC110NTYVE / Q�g, �y$
7618 Fl:etl System Fin I Fire Prevention
1268 Pool Spe Finel
200 Finel Re-Roof
201 Finel Block/Heteining Well
202 Final Fectory Fire Place
203
Fi�Z!
Final Sign
Finel Demolitlon
COpEt INSPECTIONTYVE
206 Finel Mechanicel
208 Finel Plumbing
210 Final Electdcal
212 Final Flre Preventlon
220 Final Planning Approvel
222 Final Slte
250 Final BuildincyOccupancy
(714)754-5273 • Fax(714)754-4856
` CITY OF COSTA MESA ,_
BUILpING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 555 ANTON BL
Suite: 4
Vitinity: 4TH FLOOR
Parcel Nunmber: 41050110
Applicant: DEOCAMPO, RUDI
Address:
Owner: SAKIOKA FARMS
Address •
BUILDING PERMIT
Zoning:
Phone: (714)754-1197
Zip:
r �
PERMIT NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 0 312 2/1 9 99
Issued: 04I20/1999
Phone: � Y � IIO �l-
Zip: 94137 . �� c� (
Contreaor: ACCENT BUILDERS D�.
Address: 555 ANTON BLVD
� #100 � Phone: 714-5493150
C.M.
2ip: 92614 License: 397790
Arch : FARRINGTON DESIGN GROUP Eng:
Address: 230 PEACHTREE ST #2000 Address:
Phone: (404)83&3005 Phone:
ATALANTA,GA
Zip 30303 License:
TI - 4TH FLOOR (J.D. EDWARDS - TENANT).
20,433 SF COMPLETE FLOOR TI. (B99-00383).
Plan Check: $232.74
Permit: $1,432.25
SMIP Res: $0.00
SMIP Com: $43.89
Other: $0.00
Inspection: $0.00
Total: $1,708.88
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY front 0-0
PARKING Existinq: o
NOTES:
Rear 0. 0
Rear 0- 0
Re uired: 0
Zip:
SCOPE OF PERMIT
FEE SUMMARY
Calc Valuation:
Claim Valuation:
PLANNING & 20NING
_ Left 0- 0 Right
Left 0- 0 Right
PrOposed: 0
0.0
0.0
License:
szos,000.00
szoo,000.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: This pertnit 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 �he work authorized under this permit to be considered legal, such work must comply with e�l applicabla codes, and all
requlred Inspectlone end final epprovel must be obtained. Feilure to obtain inspections and final approval vnll result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPENSATION DECLARATION: . � . .
I hereby aHirtn untler penelry of per�ury one of �he lollowing deUarations:
❑ I heve and will malnteln e cenlllcate of consen� to selFlnsure tor workers' compensetion, es provided br by sectlon 3700 of t�e labor CaAe, for t�e peAortnance of Ihe
work for which this pertnit is Issued.
❑ i nave� vn�mei�wwkers� cqmpe non insurence, es raqulred Dy secUon 3700 0l Ne Lebor Cade, iw Ne CeAormsnce at the work fa whidi this permit b Lssuetl.
My wo ers' mpen uan InsupRce �nrtler ey¢ pdiry number are:
Gertler: �£ `/wfs�sc—L' . Pw�cyNumner. /.Jc 2 �GI-637 S/3 ��/B�
(lh/s sectlon need nqr be plet d I! the p�s velued et one hundred�01kr5 (SI00) or less.)
❑ I certily Ihel In (he peAormanCa
compensation lew of Calilomi
comply wlth Ih
Applicenl Slgnelure:
WAHMN3: FMURE TO SE WORKERS'
TiqUSrWDDOLLARERt . ),INADDRIOI
j�r which Ihis It Is IssueC, I shell nm employ eny person in eny manner so es to Oecome subJect to the workers'
kt if I s�oul ecam§ sub�ecl b Ihe workers' campensetlon provlslons of Section 3700 01 Ihe Lebor Catle, I shell lonhwlth
� ,�� oa�a: �s/—zo—y1
�
COVERAf3E IS UNUWFUL AND SW1LL SUBIECr Ml EMROVER TO CRIA4NAL PEWLLTIES AND CIVIL FlNE$ UP TO OHE HUNDRED
= WMPENSFTION, OAMA6E5 /S PROMDED FOR IN SECfION 3]W OF THE LRBOR CODE, IIREREST. AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATON:
1 hereby amnn that I em licen 0 untler visions ot C er 9( encing witb Section 7000) of Divislon 3 of the Business end Professlons Cotle, antl my Ilcense is in tull
farce end etlect. Lic. p � 7 g Cless p- %3
Con[rectoYs Slgnature: " Dele; � —ZO —l��
CONSTRUCTON LRNDIN AOENCV:
❑ I hereby ettirm thet Ihere is e construCllon lending apency for the paAortnance ol the work lor which Ihis pertnit Is IssueE. (Soc. 3097, CMI CoAej.
Lendefs Neme: Lentler's Address:
Signewre:
Date:
OWNER-BUILDER pEGLARATIONS:
� 1r�1
I hereby eHlrm that under penalry of perjury ihet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness end Protesslons
Code: Any ciry ar co�nry whichiequires a'permitto wnsWct, elter, Improve, demolish, or repeir eny sWcture, prior to Ils issuence, elso requlres the appllcant for such permit
to flle e signetl statement Ihet he or she Is�licensed pursuent to t�e provisions oi t�e Contrectors Llcensa Lew (Chapter 9(commendng wit� Secilan 7000) of DlNslon 3 af t�e
Business entl Prolessions Code) or thet ho'or she is�exempt Iheretram and the basis for ihe ellegetl exemption. Any Wolatlon of Seclbn 7031.5 by eny epplicenl lor e permit
subJects tha epplicant Io e civll penelry ol not more ihen five hundred dollars ($500).):
❑ I, as owner at (he property, or my emplayees with wages as their sde compensation, WILL DO TME WORK, and ihe atructure Is not intentletl or oNerad for sele (Sec.
7044, Busines5 and Profeasions Code: The Contrectors License Lew does not appy to en owner af properry who builds or improvos thereon, antl w�o tloes such work
himsell or hersalt or through his or her own employees, provided ihet such improvements are not intended ar oHered for sale. If, however, the building ar improvement is
sold wit�in one year of comDletlon, the owner-Gullder wlll heve the burden of proving Ihat he or she ditl not builtl or Improve tor purpose ot sale.).
❑ I, es owner of ihe property, em E%CWSIVEIV CON7AAC71NG WRM LICENSED CONTRAC70RS to cnnstruct t�e pmjecl (Sec. 7044, Buslness and Prolessions
CoAe: Tha wntrectors License Lew does not epPly to en owner ot properry who builds or improves Iherean, end who conirecls lor such pro�ect wit� e conirector(s)
�icense pursuant ro the Contrecron License taws.). .
❑ I am exampt under sec. Business and Pmfeubns Cada tor this reason:
5lgnature: Date:
Owner ID venfied by drivefs license. ❑ Ves ❑ No Drivers LJcense No. Expires:
Vedficalion of Ownership by (rype ol daumem, l.e. � property tex blll or deed):
DIVISION OF INDU$7pIAL SAFETV PERMIT CERTFICATION:
❑ I heraby cenity thet no excevetlon Ilve (5) ar more teet in Aepih inta whkh e person Is requiretl to descenC, wlll be mede in connectlon with work euthorized by Ihis
permiL entl Ihet no builtling structure, scaXoltling, teLsework, or demditlon or Alsmenlling Nereof, wlll be more Ihen Nlrty-slx (38) leet high. (Chep. 32, Grp 2, Ar12, Sec.
341, Title 8, Califomle AEmInISIre1Ne Cotle).
❑ As owner-bullder. I w0 not employ enyone lo do work w�ich woulE require a pertnit irom the Dlvision ot Indusiriel Satery, es notetl ebove, unless such person has a
permlt to do such work Irom Ihe tlivislon.
Slgnature: Date:
DiNsion o1 Industrial Selery Pertnit Number.
CEH7IFlCATE OF COMPLIANCE AND ORIZATION OF EMRY: 1 certity under penelry oi perjury that I heve read thls eppllcation antl state iha� Ue inlormatlon glven is
cortect. I egree to Nmpy with ell e laws entl ciy ordlnences r to building conshuction, and euthorize representetives of the Ciry of Coste Mesa to enter upon the
e6ovatlescdDetl property lar i ectlon purposes. I e8ree no� to py or e0ow occupancy oi any building authodzeC �y thls permit untll flnal Inspection.
CODE /. INSVECTqNME `
7616 Fiaed Syst9m Finel Fire Prevenilon
7266 Pool Spe Final
200 Final Re-Root
201 Final BIocWRetaining Well
202 Final Fectory Fire Place
203
204
2M64e
Final Sign
Final DemWlilon
�� ��
Date
�/—Zo—,�5'
oace
CAUE I INSPEC770N TYPE
206 Final Mechanicel
20B Finel Plumbinq
210 Final Electrical
212 Final Fire Preventlon
220 Final Plenning �Approvel
222 Flnel Site
250 . Flnel Bulltling/Occupency
(714) 754-5273 • Fex p14) 754-4856
_, _ , CITY OF COSTA MESA _
BI/ILDING p1VIS10N
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAdtlress: 555 ANTON BL _ _ .
Suite: 4
Vicinity: 4TH FLOOR
Parcel Nunmber: 41050110
Appliwnt: SMITH,DON
Address: 555 ANTON BLVD
#100
C.M.
owner: SAKIOKA FARMS
Address
Contractor: ACCENT BUILDERS
Address: 555 ANTON BLVD
#100 -
C.M.
Zip: 92614
Arch :
Address:
BUILDING PERMIT
Zoning:
Phone: 714-5493150
Zip: 92614
Phone:
Zip: 94137
Phone: 714-549-3150
License: 397790
Eng:
Address:
Phone:
Zip License: Zip:
SCOPE OF PERMIT
INTERIOR DEMOLITION FOR NON BEARING WALLS FOR FUTURE T.I.
FEE SUMMARY
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other.
Inspection:
Total:
$0.00
$493.75
$0.00
$0.00
$0.00
$o.00
$493.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existina: o
NOTES:
a
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Lefi 0- 0
Lefl 0- 0
Praposed: 0
PERMIT NUMBER
T7 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/O6/1999
Issued: 04/O6/1999
ISSUED BY: � C�
. a
S a ai��r�J�i
. , i;'„ Q y sS�"
� �'�I. f. ''
� a� l �
� �
� ..�"� ,
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0 '
Phone:
License:
$40,232.50
$38,500.00
� NOTICE: Tha work aulhorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
j regulations. (Ord. No. 92-28, § 1, 12-21•92)
I EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
� INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepeetione end finel epproval must be obteined. Failure to obtain inspections end final approval will result in tha expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628
�
WORKERS' COMPENSATION DECLAFiATON:
I hereby eXlrtn untler panelry of per�ury one of ihe lollowlnp tledaretlms:
❑ I lieve entl wlll maintein a cerUficete of consen� to selFlnsure tw workers' compenseUon, es proviAed lor hy eadlan 3700 of Ihe Lebor Code, lor the pertortnance ol Iha
work tor whlM tlib partNt ls Issued.
�I liave end w10 malnteN workers' pensation Insurence. as repWretl Dy section 3700 ot the Lebor CoCe, iw tha peAortnance W Me wofk for whic� Uds pertnit Ls issuetl.
My wwkers' tpmpenseUon I�, r capg r end poliry number are:
caMo�: �i�r..-�_ L/� .._L/ PaIlcyNumOer. �J�GL —�GI ii37S/3'O�
(Thls secNon need not b comp eted i! th e, t/s velued ef one nuiMred da/ars (S t00) or less.)
❑ I certlty thet In Iha
�
of wol tor w iC`�'this permlt is issued, I shell no1 employ eny person in any manner so as to become sub�ect to the warkere'
A e �e hat I ould became sub�ect to t�e workers' compensetlon s of Section 3700 of ihe Lebor Codo, I shell forihwlth
Dete: S� G — Jr/r
i COMP SATION COVEfiAOE IS UNUWFUL AND SMALL SU81ECf AN MI PENALTES AND pVIL FlNES UP TO IXJE HUNDRED
N$T E COST OF COMPENSATON, �FANGES AS Pip'JIOED WR IN SEGTION 3)p5 pF THE LABOR CODE, INiEREST, AND FTTORNEY'S FEES.
I I�A6y attirm that I em Iicen tl unde isions ap 9( mmencing vnN Section 7000) 01 Division
i�� aoa anec+. u�, a 3 aess x
Contrectore S re: Date:
CONSTRUCTION LEN ING AGENCY:
❑ I �ereby etlirtn ihet Ihere is e constructlon lending apenc/ tor the pertortnance of the w for whlch Ihis
Lenders Name: Lentlets Atldress:
Slgnaiure:
OWNER•BUILDER DECLAfiATIONS:
Code, and my Iicense Is In full
(Sec. 3097, Civll Cotle).
Date:
I hereby eHirm thet under Denelry of perjury thel I am E%EMPT FROM TNE CON7RACTORS LICENSE LAW lor the followinp reeson (Sac. 7031.5. Buslness end Prafesslons
CoOe: Any cIry or cqunty which requlres a permit to consiruct, eltar, Improve, tlemolish, or repair eny stmcture, prior to Ils issuance, elso raquires the applicant for such pertnit
to flle a signetl stai6menbthe� he or she is Iicensed pursuent to the provlsions oi the CantreMors LJcense Lew (Cheptar 9(commenGng wlih Section 7000) of DlNslon 3 of Ihe
Business entl ProlOssfons.Coda) or that he or she is exempt ��ereimm end tha basis 1or t�e alleged ezemptlon. Any Wolatlon of Sectlon 7031.5 Dy flny appllcant lor e pormit
sub�eds ihe eppllcant to',a civil penaly o1 not more than Ilve huntlretl Collars ($500).):
�t.� c �v. �t�._
❑ I, es owner of the property; or my employees with we8ea es their sde compensalion, WILL DO 7HE WORK, end the struclure I5 rwt intentled or oHeretl for sale (Sec.
7044, Business entl Pmlessions�Code: �The Comractors License Lew does not eppy to en owner ot property who builds or imprwes Ihereon, and who daes such work
himsetl or hersell or through his or her own employees, proNded Ihet suc� ImprovemenGs are not intentled or oHered for sale. II, however, the buildlnp or ImOrovement is
soltl wit�in ong year of completion; the owner-bullder will heve Ne burtlen oi proving lhat he or she did not �ulld or impmve for puryose ot saleJ.
❑ I, as owner of the property, am E%CWSIVELY CONTRACTING WITH LICENSED CON7RACTORS to construd Ne pro�ed (Sec. 7044, Business end Pmtesslons
Catle: The contrectors License Lew does not epply to en owner of praperry who builtls or impmves ihereon, and w�o contrec45 tor such pro�ect with a contrector(s)
license pursu9nt to tha Conirecrore License Lews.).
❑ I am exemp� yntler sec. Business antl Professians Cotla tor this reason:
Signeture: Date:
Owner ID verifled by tlrivels Iicense. ❑ �es ❑ No Dnvers License No. bcpires:
Verilicatlon of Owners�ip by (rype oi document, i.e. - property tav bill or deetl):
DIVISION OF INDUgTqIAL SAFETY PEPMIT CER7IFICA710N:
❑ I hereby certity t�ef no excevetlon five (5) ar more feet in UepM into whlch e person Is requlred fo desCend, wlll be mede In connectlon with xrork eufhadzed by thls
permlL entl Ihet no builtling structure, ecaXoldinp, felsework. or demolition or dismentling thereof, wlll bo more Ihen thirry•six (38) feet high. (Chep. 3.2, Grp 2, An 2, Sec.
341, Title 8, Celltomia AAmInISlrative Cotle).
� As owner-bulltler, I wlll not employ enyane to do work which woultl require e permit frwn the Divislon oi InAustrlel Safery, es noted ebove, unless such person �es e
permlt to tlo such woAc from Iha division.
Slgnature: Dete:
Division of Industrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLI CE AND AUTH ON OF ENffiV: I certify under penelry ol perjury that I heve read thls eppllcatlon and state Ihet iha informatlon given is
correcL I egree lo y with�ell state I entl clty ordinences relatlnp to huilding construdion, entl euthotlze representetives at �he Ciry of Casta Mese lo enter upon the
above-tlescAbad pr rry Ior Inspecjlo urposes. I ree not to occupy or ellow occupancy ol eny building authorized by Nls permit untll finel InsDecUon.
1616 FI:eO System Finel Fire Prevention
1268 Pool Spa Finel
200 Finel RaRoot
207 Finel Block/Retaining Wall
202 Finel FecYory Fire Place
203 Finel Sipn
204 FinelOert�dltlon
zae�s
ue� u�e�s
WOE I INSPECTION 7YPE
208 Final Mechanicel
208 Final Plumbing
210 Final ElecMcel
212 Flnal Fire Preventlon
220 Finel Plenning ADproval
222 Final Slte
250 Final Building/Ocapanq
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 9262s
MECHANICAL PERMIT
JobAddress: 555 ANTON BL
Suite No 400
Viciniry: 4TH FLOOR
Parcel Number: 41050110
npp�icant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE,CA
Owner. SAKIOKA FARMS
Address: � '
contrador. AIR CONDITIONING CO., INC
Address: 6265 SAN FERNANDO RD
Arch / Eng :
Address
GLENDALE,CA
Phone: (878)244-6571
. Zip: 91201
Phone:
Zip: 94137
Phone: (878) 244-6571
Zip: 91201
License: 120696
Phone:
Zip:
License:
/
ISSUED BY:
SCOPE OF PERMIT
MECHANICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "J.D. EDWARDS" (4TH FLOOR).
INSTALL 10 VAV BOXES, 4 FIRE DAMPERS, 8 ALTER 2 HEAT/COOL SYSTEMS.
REF:B00-01342
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heal�
Inst / Rep. Recess Wall Htr
Refrig Sys <700 k BTU
Refrig Sys >700 k BTU
Gas Piping ,
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 70000cfm
Floor Furnace
Floor or Suspend Heater
$23.50
$0.00
$0.00
$27.40
$0.00
50.00
50.00
50.00
50.00
50.00
5706.50
$0.00
$0.00
$29.00
50.00
50.00
$0.00
$0.00
so.00
so.00
Quantity
0
0
2
0
0
0
0
0
0
10
0
0
4
0
0
0
0
0
0
FEE SUMMARY
Repair I Alt Absorbtion Unit
Repair / AIt Refrigeration Unit
Ventillation System
Evaporative Cooler .. - -
Commerciallncinerator � -
Domestic Incinerator
Compressors / Absorotion SVstems
Up to 3 hp I 100 k BTU "
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU �
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU ,
Boilers
Upto3hp � . �
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee .
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: t013012000
Issued: 10/30I2000
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 ; 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
80.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00
50.00
$0.00
5186.40
NOTICE: The work aulhorized by ihis permit shall comply with all applicable handicap access requirements under Calilomia 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 ii work is suspendetl 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 Inspectlons and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626 �
WORKERS' COMPENSATION DECLARATION:
1 hereby attirm untler penelty o1 per�ury ana of the tWlowinq tledarations: '
❑ I heve end will maintein e certificate ai consent to selFlnsure for warkers' compensatlon, es proWded lor by sectlon 3700 at the Lebor Code, for Ihe peAortnence of Ue
work for which t�is pertnit is issued.
�_ I haye enC wlll maintain workers' compensation insurence, as require0 by secUon 3700 ot the Lebor Code, tor the peAortnence W Ne work fw which this pertnit is ISsueA.
My workers' compensetlon Insuranca carrier entl policy number ere: /�
Cartter.... ��/�/�. �/1 PoliqNumber:Y2L�7JrY
lThh'sectlonnse`drrotbemr�etAtl theneimitLaveluetletme�unCredOollerslS700)wless.) �«'
I��
of ihe work tor whkh Utis pertnil is Issued, I shall not employ eny person in eny menner so es to bocome subject to Ihe workers'
, en0 epree Net tl I shouW bemme Sub�oct to the workers' compensetlOn provLslon9 ot Sectlon 3700 0l Ihe Lebor Code, I shell forthwiN
TO SECUiiE WOPo(ERS COMPENSATI(
E(E100,000), IN ADDITION TO TME CQST
LICENSEDCONTRACTORSDECLARATON:
Dele J�= // ��i_`, i
U^ UMJ1W FLL AND SwLLL SUBJEGT AN EMROVER TO CRIMIN�L PENALTIES M1D pNL FWES UP TO ONE HUNDRED
�TION, DAFNGES 0.S PROVIDED fOH IN SECTION 3lfbOF TME UBOR NOE, INfEREST, AND ATfORNEYS FEE9.
I horeDy eHirm t�al I em.11censetl under provlslons of Chepter 9(commencing wlih Sectlon 7000) ot Dlvision
�o«o e�d eno��. �� .�. _ _—' ,�Gp�
CONS7RUCTON LENDING AGENCV:
entl Prafessions Code, and my license Is in lull
❑ I here�y aHirtn t�at there is a conslruction lentling apency br the peAormance of the work tor whic� Ihis permit is Issuotl. (Sec. 3097, Civil Code).
Lendels Neme: LenUefa AOtlress:
Sipnatura:
OWNER•BUILDER DECLARATIONS:
oa�e:
1 hereby eflirtn t�at under penelry ot pe�ury thet i em EXEMPT FPOM THE CONTRACTORS LICENSE LAW lor the tollowing reeson (Sec. 7031.5, Business enC Professions
Cale: My ciry or counry which requires e pertnit m construd, eller, impmve, tlemolish, or repair any strucWre, pnor �o Its issuance, elso raquires Ihe epplicant for suU pertnit
to tile e signed stetement that he ar she is licensed pursuant to the proNsions of Ne Contreclors License Lew (Chepter e(wmmencing with SecUon 7000) of DMsbn 3 of Ne
Business end Protesslons Cotle) ar Nat he or she is e:empt theretrom antl the Ea5i5 for t�e fllleged exemption. Any violation of Sectlon 7031.5 6y any epplicant for e pertNt
subfects t�e epplicent lo e civll penalry of not mwe Nan five hundred dollars (5500).):
❑ I, as owner o1 t�e properry, or my employees with weges es their sole compensation, WILL DO THE WORK, end Ihe struclura is not intendetl or oHered for sale (Sec.
7044, Business end Professions Cotle: The Contrectors Llcense Lew Coes not appty to an owner of properry who builds or improves thereon, and who tloes such work
hlmself or �erself or through his or her awn employees, provided Ihe� such improvements are no� inten0etl or oHeretl for sale. It, however, the building ar improvement Is
soltl wit�in one yeer ot completion, ihe ownerbuilder will heve the burtlen of proving that ha or she tlid not build or improve for purpase of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS to wnstruct the prolect (Sec. 70d4, Business and Protessions
COCe: 7Te coNractors llcense Law Coes not apply Io en owner of property who bullds or Improves ihareon, and who contrects lor such projed wlth a contractor(s)
license pursuant to lhe Coniractore License Lews.).
❑ I am evempt untler sec.
SlgneWre:
Owner ID veriliBtl Dy drivefs license. ❑ Ves ❑ No
Business and Pwiessions Code tor thls resson:
Verilicetlon o1 Owners�ip by (rype at tlocument, i.e. - properry tex bill or deetl):
Drivefs Liten9e No.
Date:
Expires:
DIVISION OF INDUSTpIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certlly t�a� no exravalion frve (5) or more leet In depth Into whic� e parson is required to descend, wlll be made In connectian with work euihorizetl by Nis
permlt, entl t�at no building siruclure, scaXoltlinp, falsework, or demolition or dismantling Nereof, will be more then t�irty-six (36) feet �igh. (Chep. 32, Carp 2, M 2, Sec.
341, Title 8, Celltomia Administrative CoCe). . .
❑ As owner-builtler, I will not employ enyone to tlo work which would raquire e pertnil from the Dlvislon ot Induslriel Selery, es noted above, unless such person hes e
permlt to do such work tram the divlsion.
Signeture: Data:
Divislon of Intlustdal Salely Permit Numbec
CEHTIFlCATE OF COMPLIANCE AND AUfHORQATION OP ENfRY: 1 certity untler penalry of perjury �hal I have read ihis eppliwtion and state Nat the infamatlon given Is
correct. I agree to campty wlth ell stete laws end Gry ordinances relatinp to bullding construction, end euthoriza representatives ot the Ciry ot Coste Mesa to enter upon Ne
ebove-descrlDetl property for inspection puryoses. I egree not to occupy or ellow occupancy of eny builtling euthanzed by this pertnit until fnal inspeclion.
CODE I. IxsPECfIoxTYVE
1818 Flxed System Flnal Fire Preventlon
7268 Pod Spe Final
200 Flnal RaRaof
201 Flnal BIocWHeteining Well
202 Flnal Fenory Fire Place
203 Final Sipn
206 Finnl DemdlUon
PAg II{�ELS
Date
/D—TD—w
� ('n411P � � -� � �.
�j IXSVECTONTYPE
208 Finel Mechenicel
20B Finel Plumbinp
210 Finel Eledrlcal
212 Finel Fire Prevenllon
220 Finel Planning Approvel
222 Finel Site
250 Finel Building/Occupe�y
(a I ti O 1 �
(714) 754-5273 • Fax (774) 75a-4856 • www.ci.costa-mesa��DING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
.lobAddress: 555 ANTON BL
Suite: 4
Vicinity: JD EDWARDS (4TH FLOOR)
Parcel Number: 41050110
Appliwnt SMITH, DON
Address:
Owner: SAKIOKA FARMS
Address �' � .
� �
Zoning:
Phone: 213-482-9832
Zip:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 08/30/2000
Issued: 10/26/2000
�
. - - Zip: 94137 _ � . �
Contracror. ACCENT BUILDERS � � �
Address: 555 ANTON BL: #100 ,
, � � - Phone:- (714)549-3150 , . . ,
,COSTA MESA, CA ' . �
Zip� 92626 �. License: �- 397790 � , , � , ,
nrch : PAUL LONIGRO -. eng: � -
Address: 70717TH ST � • Address:, � `
2900 . . Phone: 714-754-1197 � " Phone: -
DENVER,COLORADO . �
Zip: 80202 � License: C22255 � License:
_ SCOPE OF PERMIT. ,
� � INTERIOR 18637 SF OFFICE TI FOR JD EDWARDS ON ENTIRE 4TH FLOOR. �__ __, � � � '
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$563.31
$3,466.50
$0.00
$115.21
$0.00
$0.00
$4,145.02
SETBACKS �. � ' �
MAIN STRUCTURE�-Pront 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o _
NOTES:
Rear � � 0-0
Rear . 0-0
Reauired: 0
FEESUMMARY
PLANNING 8 ZONING
LeR 0- 0
Left 0- 0
Proposed: 0,
Calc Valuation:
Claim Valuation:
< �-
; .
i,
��- i
� Right " �0-0"� - /". %
� '- ,
Rlghl. ,".0- 0� - i
$548,625;00
$525,000.00 �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremants 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 1B0 days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlons and final epprovel musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CA4L: (714) 7545626
zmaas 1�aa) �/
WORKERS'COMPENSAnON DECLARAnON:
I hereby eNirm untler penalry o1 perp�ry one of Ue Idlowing declaratlons:
❑ I heve entl will maintain a cenificete of con5ent Io selbinsure for warkere' compensellon, as provitled tor by section 3700 at t�e Labor Code, for Ihe pertormence of Ihe
work tor which this pertnit is issued.
❑ I hava arW will malntan workers' oompensation insurence, es requlreU �y secUon 3700 of the Lebor Code, for Ne perfo�mance ol Ne work ta wNch thLv pertnit Is LssueE.
My w�ers' wmpe on Insurance carrier entl policy numEer re: O
Certier. fA�Rm� SiU4- �_--.� PolicyNumber. D�O�OBI SZ
(77ds secNon neetl not be canpleted if the 1 is a! e huntlretl tlollais (5700) or Ie55J
❑ I certiry t�at In ttie pertarmar�ce
compen56Uon le s of Gallto
compty with t�
AppllCanl Sipneturo: �
WARNIN(3: FNLURE TO S RE WORKE
THOUSAND OOLLAHE 00.0001. IN /�Df
LICENSED CONTRACTORS OECLARATION:
�kh�4�ts pertnil issued, I shall not employ eny person In eny manner so as to hocpne subl� �o the workers'
If I 6f,�ld e wb�ecf to tho workers' compensetlon provislons ot SecUon 3700 of 1he Lebor Catle, I shell Ionhwith
-�� oate: �� � yG - O o
COVEMOE IS UNUWFUL nND SHALL SU6IECT AN EMPLOYER TO CRIMINAL PENPLTIES AND GVIL FlNES UP TO ONE HUNORED
° ODMPENS/TION, �AMFGES PS PRWIOED FOR IN SECTIqJ 3]OB OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEE3.
I hareby eMirtn Ihet I am Iicensetl untler pr ns Che 8( men ' p with Sectlon 7000) of Divlslon 3 of the Business enU Professlons COOe, and my Iicense is In full
Porce ena eHect. uc. p — Class p/3
Comrectofs Slgnature: Dete: !O ^z6 — 00
CONSTRUCTION LENDING AGENCV:
❑ I heroby eMirm that there is e consiruction lending egenty tor the pertormence ol the work lor which this permit is issuetl. (Sec. 3087, Civil Coda).
Lontlefs Neme: Lentlefs AtlCress:
SigneWre:
Date:
OWNER-BUILDER DECLARATONS:
I hereby eilirtn Ihet under penally ot perjury lhal I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe fdlowing reason (Sec. 7031.5, Bu5ine55 end Professlons
Cotle: Any ciry or counry whlch requires e pertnli to const�uIX, elter, Imprwe, tlemolis�, ar repair eny structure, prior ro iis iuuance, also requires the epplicam tor such pertnit
to lile e slgne0 statement thal he or she is Iicensetl pursuent to Ihe prmdsions ol the Cantredors License Law (Chapter 9(commendng wit� Sectlon 7000) 01 DMslon 3 of Ne
Business entl Prolessions Code) or Ihat he or she is exempt t�eretrom anC t�e basls for the allegetl axemption. Any violation of Section 7031.5 by eny epplicent for e pertnit
subjecis Ihe aOD���em �o a cHii penalry ot not mora Ihan (rve huntlreE tldlers (5500).):
❑ I, as owner of Ihe properry, or my employees with weges es thelr wle compensetion, WILI DO THE WORK, entl the siructure is not IntentleC or ottaretl for sale (Sac.
7044, Business and Professions Code: The Contradors License Law Aoes not appy lo en owner ol property who builds or improves therean, entl who does suU work
himself or herseN or through his or her own emplqrees, provltled t�at such improvements ere not intentletl or otteretl for sale. If, however, the building or imprrnement is
sold within one year of completion, the owner-builtler will have tha burden ol proving I�at he or she did not builtl or im0��e for purpose ot sele.).
❑ I, as owner oi tha praperty, am E%CLUSIVELV CONTBACTNG WRH LICENSED CONTAACTORS to construct the prqect (Sec. 7046, Business end Professions
Cotle: The mntractors License Law tloes not apply to an owner ot properry who builds or improves thereon, antl who contracts for sucti pra�ect with e contrector(s)
license pureuant to ihe Cantractors License Lews.).
� I em exempt under sec. eusineu enA Professions Code far this reason:
Signatura: Date:
Owner ID verlfied by tlriver's license. ❑ Ves ❑ No DriveYs License No. Expires:
Verllication ot Ownership hy (rype ol document, i.e. - property ta: blll ar deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATON:
0 I hereby certity that no exwvation five (5) or more teet in tlepi� into wNch e person is requiretl to tlescend, will 6e matle in connecllon with work authodzetl by this
permil, entl that no 6uiltling swcture, scettolding, telsework, or demolition or dismantling Ihereol, will be mora then ihlrty-six (38J teel high. (Chap. 3.2, Grp 2, Atl 2, Sec.
341, Title e, Calllarnla AtlminisireGve Cotle).
❑ As owner-bullder, I will na� employ enyone to tlo work which woulA require e permil Irom Ihe Division ol Industriel Salery, es noted ebove, unless such peraon has e
permlt to do such work from ihe Oivision.
Sipneture: Date:
Division ot Industrial Salery Pertnit Number.
CEHTIFlCATE OF CAMPLIANCE AND AUfHOR¢ATON OF EMAY: I certify under penelry of perjury that 1 have read Ihis apOGwUon and state that Ihe intortnetion gNen is
conect. I egrea lo comply w s and tl i nces ralatlng to buildinp construction, eM euthorize representatives ot Iha Ciry of Coste Mesa to enier upon ihe
ebovadescribed prope or inspecti purposes. pree trot to ocwpy or ellow xwpancy ol eny builtling authorized by this permit uniil 11na1 inspeclbn.
CODE �/ INSPECTONTYPE
1616 Fiaetl System Finel Fire Preventlon
1268 Pool Spa Finel
200 Finel Re-Raof
201 Finel BIocWRetaiNng Well
� 202
I 203
-� zo<
Finel Factary Firo Place
Finel Sign
Finel DemdiUon
Deta
� -zG-oo
Dete
�jj �$ CO�E! INSPELTIONiYiE
208 Final Mechenical
208 ' Finel Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Appmval
222 Final Site
250 Final BuiltlingiOccupenty
PAIE It�LS
�.
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
4
4TH FLOOR
a�oeai�o
Appliwnt: FULFORD, TERRY
Addres4: 8749 SHIRLEY AV
NORTHRIDGE, CA
Owne�: "SAKIOKA FARMS
Address
comractor: O'BRYANT ELECTRIC
Addres5: 8749 SHIRLEY AV
NORTHRIDGE, CA
ISSUE FEE
Temp service test
Res. a/c packa9e
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts , � �
Recept Outlets
Switches � ,
Non Res Appl � .
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1hp
Motors to 10hp
Motors to 50hp
Mo[ors to t00hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Liqht Pkg
Sign Cirwits
Temp Pwr Pole
Inlermed Pole
ISSUED BY:
Phone: (818)407-1986
Zip: 91324
Phone:
Zip: 94137
Phone�. (818)4a7-1986
. " Zip: 91324 ,
license: 386619
Status: ISSUED
Applied: 10/30/2000
Issued: 10/30/2000
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "J.D. EDWARDS" (4TH FLOOR). INSTALL
253 LIGHTS, 83 OUTLETS, 141 SWITCHES, 1 ELEC SERVICE TO 200 AMP, 2 A/C CONDENSORS, 1
TRANSFORMER UP TO 7 KVA, 66 COMMUNICATION DROPS, 1. TRANSFORMER UP TO 100 KVA, 8 49
MISC CONDUIT.
REF: B00-01342
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$192.09
$67.99
'$110.33
$0.00
$0.00
$30.50
$0.00
$0.00
$0.00 .
$24.60
$0.00
$0.00
$0.00
$53.58
$0.00
so.00
$0.00
$0.00
$0.00
Quantity
0
0
0
253
83
147
0
0
1
0
0
0
2
0
0
0
66
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
, Busway /100 ft
� -� Stariding Section
' Misc Electrical Equipment
Transtormers up to 1 kva/kw
................up to 10 kva/kw -- �
.................up to 50 kva/kw
.................up to 100 kva/kw
� ..............._.over 100 kva/kw
Low Voltage Equipment -
Low Voll Wiring System / Ckt
Misa Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
,Christmas Tree Stand ,
Fireworks Stand .
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$4.75 1
$0.00 0
$0.00 0
$49.50 � 7
$0.00 ' - 0
so.00 o ,
$0.00 0
$891.80 49
$0.00 0
$O.W . 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCUTATED FEES E1.448.64
COMMENTS / SPECIAL CONDITIONS
NO710E: The work authonzed by this permit shall comply with all applicable handicap access requirements under California statutes and related I
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This parmit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a penod of 7 BO 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' �
reqWred Inapectlons and final epproval must be obtained. FaiWre to obtain inspections and final approval will result in the expiratlon ot lhis p�t�
FOR INSPECTION5 CALL: (714) 7545626
zaawa (eroo)
WORKERS' COMPENSATION DECLAfiAT10N: �
I heraby afllrm under penelry of perjury one ot the following tleUeretlons: •--
� I have entl wlll me(ntaln e ceNtirate of consent ro sell-Insure lor workers' canpensatlon, ea proNded for by sectlon 3700 of lhe LeDor Code, for the pertormance oi Ihe
wark tor which this pertnit is issued.
ve entl will mainttin wo compensetlon U�wrence, as required by secGm 3700 al Ihe Lebor Catle, for Ne pertortnance oi Na work tor whid� Utis pertnit is iswed.
worker5' comoen5ati0 uraoae certler.enA oollw number ere:
one
PolicyNumber. �%��'�" z �%�G �/300
or less.)
❑ I ceNfy Ihet in Ihe pertormance of Ne work lor whiU thla portnit is issued, I shell not employ eny person in any mennar so as to becwne sub�ect to t�e workers'
wmpensation laws of Celifomia, en ree Ihet It I s�ould becoma sub�ea ta the workere' compensatlon provlsions ot Sectlon 3700 of t�e Lebor Code, I ahan torthwiN
campry with these p ��
ApplkenCSignature: � patl a;� /o -j o � o u
� J
WARNING: FAILUPE TO SECURE WORKE PENSATION COVEMOE IS UNUWFUL ANO SHALL SUfl1ECT AN EMPLOYEP TO CRIMINAL PENALTIES M1D CML FlNES UP TO ONE MUNDRED
T/qUP.AN� DOLURE (5100.OW�, IN FDIXiION TO THE �ST OF OOMGENSATION, DAM4GES AS PFOVIUEU WR IN SECf10N 3708OF TNE LABOR CODE, IMERE5T, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I heraby eHirm the1�l.am.licensed un er provisions ol Chepter B(commencing wlth Section 7000) at Dlvlslon 3 o�•the.Business and Prolessions Code, entl my Ilcense is In tull
lorce ena ettec�.(ua a ) _G 6 iA�j CI899 M ��' "�`�
CONSTRUCTON LENDING AGENLY:
❑ I hereby eHirtn t�et there is e consimalon lending epenty tor the pertortnance of tha wark lor which Ihis pertnit is iuued. (Sec. 3W7, Civil COAe).
Lentlors Neme: _ _ . . . . . _ _ _ Lendars Address: .
Slpneture:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby eHlrm t�et under penalry ol perjury Ihet I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, Buslnass enA Professlons
Code: My city or counly which requiraz e permil to consiruct, elter, Improve, tlemolish, or repelr eny atructure, prior lo its issuance, elso raquires the epplicent 1or such permit
to file e signatl stetement that ha or she Is Iicensetl pursuent to Ihe provisions at the Contrectors Licenae Lew (Chepter 9(commencing with Sectlon 7000) of Divislon 3 of the
Business end Professions Code) or that he or she is exempt theretrom anC the basls for t�e ellepetl exemption. Any violation oi Sectlon 7031.5 by eny applicent for a pertnit
sub�ects the applicent to e civil penaly ol not more than tive hundred ddlars (5500).):
❑ I, es owner of t�e pmperry, or my employeas wlth wages as Iheir sda compensetlon, W ILL DO TXE WORK, enA Ihe siructura is not intentleE or ofleretl for sale (Sec.
7044, Business end Pra!essions Cade: The Contrectors License Lew does not eppty lo en owner of proparty who builds or imprwas thereon, an0 who tloes such work
himsetl or hersel( or ihrough his or her own employees, provided ihat such Improvemenis are not Intended or oXered tor sale. If, however, the builtling or Improvement is
sold within one year ot mmpletion, the owner-builder will heve �he burden ot proving Ihet he or she tlid not build or improve tor purpo5e ot sale.).
❑ I, as owner of the pmperry, am EXCLUSIVELV CONTFiACTNG Wf7H UCENSED CONTRACTOq3 to cansirua Ihe projed (Sec. 70aa, Business end Professions
Cade: The coniredors Llcense Law does not eppy to en owner ot pmperry who Duiltls or Imprmes thereon, and who coniracts for suc� pro�ect with a contractor(s)
Ilcense pursuant ro t�e Contractors Llcense Lews J.
❑ I em esempt under sec. Business and Professions Code for Ihis reason:
Signature: Date:
Ownar ID venfietl by tlrivefs license. ❑ Ves ❑ No Drivers License No.
Vedficetlan oi Ownership by (rype of documen�, i.e. - pmDerry taz bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON:
Expires:
❑ 1 hereDy certlly ihei no exravatlon live (5) or more feat In depth Into which a person Is requlred to descend, wlll be made in connectlon wit� work euthorizetl Dy this
pertnit, and that no buJding structure, scaNdtling, lalsawork, or demolitlon or Glsmanlling ihereof, wlll be more than thirty-six (38) feat hlph. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Ttle 8, Califomia AtlministratNe Cotle).
❑ As owner•builder, I will not empby enyone to do work which would require e pertnit Irwn the Dlvision at Industrial Sefery, es noteE ebove, unless such person hes e
pertnit to tlo suCh work irom the tlivision.
Signe�ure: Dete:
Dlvision of Industrial Safery Permit Number:
ICERTIFlCA7E OF COMPLIANCE AND AUIHORQATION OF ENTFiY: I certify under penelry of per�ury that I �ava read this eppliwtion enG siate ihat Ihe informetion given is I
cortect. I egree to compty with ell stete laws erM dry ordinances relating to builAi� constructlon, end euthorize reDresentatives of the Ciry of Coste Mesa to enter upon Ne
ebove-deurlDed properfy tor inspeclion purposes. I egree not to ocwpy or ellow o¢upency ol eny Ouilding authorized by thls permit until tinel Irepection.
L4QE_1,
1618
1288
200
201
202
203
20a
Fixetl System Final Flre Prevention
Pool Spe Finel
Finel RaRoof
Finel BIocWReteining Well
Pinel Factory Flre Place
Finel Sign
Flnal Demolition
COOEI INSPECTONTYPE
208 Finel Mechenical
208 Final Plumbing
210 Finel Electdcel
/O :.£o ^CG
�081e��,
QAIE II{I�LB
f�-�-� �
212 Finel Flre Prevention
220 Finel Plenning Approval
222 Finel Slte
250 Final Building/Oxupency
(714) 754-5273 • Fax (714) 754-4856 • wvnv.ci.costa-m�.�pRESSION PERMIT �� FAIR DRIVE, COSTA MESA, GA 92626
JobAddress: 555 ANTON BL
Suite: 4
Vicinity: 400
Parcel Number: 41050110
Applicant: RAYNER, MARC
Address: 2505 MIRA MAR �
LONG BEACH, CA
i
' i
Owner. ��SAKIOKA�FARMS
Address , , � � � �
Contractor CAL PROTECTION
Zoning:
Phone: (562) 496-6444
Zip: 90815
Phone:
Zip: 94137
Slatus: ISSUED
Applied: 09/26/2000
Issued: 10/12/2000
ISSUED BY:
� �
,� � ���,
�
� ' - � .,A�' .
� �
- Address: 2505 MIRA MAR � � _ , �
� � � � Phone:- (562) 498-6444 - �, . �, �
LONG BEACH, CA 'Zip: 90815 � � �
. " ,License:�327196 � � � �
SCOPE OF PERMIT
' REF B00-01342, SUITE 400. J D EDWARDS. ADD 164 NEW SP HEADS AND RELOCATE SP. � .
--FEI
Plan Check: $36624 . _
Permik ' $563.45 \
Other: $0.00 �
Total: $929.69
—� Calc Valuation: saz,000.00
Claimed Valuation: $az 000.00
� . ,
._ - .. . . � .
', ,'
� �.
. -. :. _ �
;:
. �:
. . . � - ��i' •, �
'
' � . . . �i, �.
��- _' � ��i
�/�
� � i�' �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. 7241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all
requlred Inspeetlons end finel epproval musl be obtained. Failure to obtain inspections and final approval will result in the expira[ion of this permi�.
FOR INSPECTIONS CALL: (714) 7545628
/
zaawe cemo� . U
WORKERS'COMVENSAnON DECLARAnON: '
I hereby affirm under ponalty oi per�ury one of the lollowing declarations:
❑ I heve entl will malntain a certlficete ot consent to sell-Insure lor workars' compensetion, as provided for by section 3700 of tha Labor Code, for the peAormance of the
work for which this permit Is Issuetl.
��� I have and wlll malntain workers' compensatlon insurence, as required by section 3700 of the Labor Cotle, for Ihe peAortnanca of the worlc for w�ich Uis pertnit is tssuetl.
My workers' compansetlon InsurenCe cerrier end policy number are:
Carner: Polity Number:
(Th/s sectlon need nof be compleled i! fhe permit is valuetl a! one hundred dollare ($100) or /e55.J
❑ I certity ihat in t�e pertormanca of lhe work tor which ihis permit is issuetl, I shell nol employ any person in eny menner 5o es to become subject to the workers'
compensatlon laws of Cellfomia, and egree thet Ii I should hecome sub�ect to Ihe workers' compensation provislons of Sectlon 3700 ot the Wbor Code, I shall torthwith
comply with these �p^rovlslons.
Applicant Signature: Y I�G ��� Data: �(1' / Z- CJU
WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNtAWFUL AND SHAIl SUBJECT PN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FWES UP TOONE HUNDRED
T/qU5AN0 WLLAHE (5100.0OO�.IN ADDRION TO THE COSi OF GY7MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31460F TNE IABOR CO�E, IMEREST, M!D ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under proNsions of Chapter B(commencing with Section 7000) oi Division 3 af the Business antl Professions Cotle, and my license Is in full
brce end eHect. Lic. a Class q
Cantractofs Signawre: {"1�- !i2 Date: �(� - 12- V �
CONSTRUCTION LENOING AGENCY:
❑ I hereby aXirtn Ihat Ihere is e consiruction lentling egency for Ihe pertormance of �he work tor which this pertnit is issued. (Sec. 3097, Civil CoCe).
Lentlers Neme: Lendefs Address:
Signature:
OWNER-BUILDER DECLARA710N5:
Date:
I hereby ettirm lhal untler penelty oi perjury thet I am EXEMPT FROM THE LONTRACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requires e permit to construct, alter, impmve, tlemolish, ar repair any structure, prior to its issuance, elso requiraz the apD����� �or such pertnit
to file a signed stetemant that he or she is Ilcensetl pureuant to the provisions of the Contrectors License Lew (Chapter 9(commencing with Section 7000) of Olvision 3 of ihe
BuSiness anA Prafessians Cade) or that he or she is exempt therefrom and Ihe basis for the alleged exemption. My vloletion of Seciion 7031.5 by eny epplicant for a pertnit
subjecis ihe applicant to a clvll penalry of not more than live hundretl dollers ($500).):
❑ I, as owner oi the properry, or my employees with weges es their sole compensation, WILL DO TME WORK, antl the struciure is not intentle0 or offered tor sele (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of propeny who builds or improves Ihereon, antl who does such work
�imselt or herseN or Ihrough hls or her own employees, provided ihat such improvemenis are not Intended or oHered for sale. I(, however, Ihe building or improvement is
sold within one yoar of comDletioq the ownerbuilder will have ihe burdan ol pwving Ihat he or she did not builtl or Improve for purpose ol sele.).
� I, es owner oi the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ne O�elect (Sec. 7044, Busineu end Protessions
Cotle: The contractors License Lew tloes not eppty to en owner ot pmperty who bullds or impmves Nereon, and who coniracts br such project with e contractor(s)
license pursuant to the Cantrectors Licensa Lews.).
❑ I am ezempt under sec.
Signature:
Owner ID verified by drlver's Ilcense. ❑ Ves
Venficetion ot Ownarship 6y (type ol daument, i.e.
Busine55 and Protession5 Code for �his re95on:
❑ No Drivefs LlCense No.
properry tBx 6111 ar deed):
DIVISION OF INUUS7RIAL SAFE7Y PERMIT CER7IFICATION:
Date:
ExO�res:
❑ I hereby cenity thet no exwvetion five (5) or more teet in Oepth into which a person Is required to descentl, will be metle In connection with work euthonzed by Ihis
pertnit, antl Ihat no builtling struc�ure, scaHolding, telsework, or demolition or tlismantling thereof, will be more then thirty�six (3fi) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celilornia Atlminisiretive Cotle).
❑ As owner-builder, I will no� employ enyone to do work whic� woultl require a permit from the Division of Intlusinel Setery, es noteA above, unleu such pereon hes a
permit to do such work Irom the division.
SignaWre: Date:
Division of Industnel Safery Pertnit NumDer:
CERi1FlCA7E OF COMPLIANCE AND AUiHORVA710N OF ENfTiY: I certify untler penalry of perjury ihat I have read this application and stata thet Ihe intormation given is
correcL I agree to comply with all stete laws end ciry orOinances relating to building consWction, antl authonze representetives ol ��e Clry of Coste Mese to enter upon Ihe
ebove-descnbed Droperty for inspection puryases. I egree not to occupy or allow occupancy of eny building auihorized by Ihis pertnit until linal inspection.
_ Sip,neNre Of Legel Owner(s) Date
rr nc Iv- �2-00
nNOr Aulhodzed Applicant Date
40oE r. INSFECTIONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Flnal BIocWRetaining Well
202 Finel Faciory Fire Place
203 Final Sign
204 Final Damolition
PA� IM �LS
� - 9 `o l uki.
' �� INSPECiIONTYPE
206 Final Mec�anical
208 Final Plumbing
21U Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 FinalBuildinglOccupani
PAg It�lLS
�i -c.Ot �_
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-m�s�.igUPRESSION PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 4
Vicinity: J D EDWARDS (4TH FLOOR)
Parcel Number: 41050110
Applicant: RAYNER, MARC
Address:
Owner.. �SAKIOKA FARMS-
Address '
Zoning:
Phone: 562-498•6444
Zip:
Phone:
Zip: 94137
Status: ISSUED
Applied: 10IO2I2000
Issued: 10I12/2000
ISSUED BV:
contreaor: CAL PROTECTION
Address: 2505 MIRA MAR : .
. - Phone:. (562)49&6444 � , �� .
, LONG BEACH, CA �Zip: 90815 � � , � ' �
License: 327196 � � - �
. SCOPE OF PERMIT
INSTALL FIREILIFE SAFETY SYSTEM FOR TENANT IMPROVEMENT FOR J D EDWARDS. 4TH FLOOR. .
REF:B00-01342 �
Plan Check: $359.68
Permit: $553.35
Other: $0.00
Total: $913.03
� ' - ' ,
, FEE SUMMARY '
_ Calc Valuation: 3ao,e�o.00
Claimed Valuation: gao,e�o.00 ,
NO710E: The work authorized by lhis permit shall comply with all applicable handicap access requirements under Calilornia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRA710N: This permit shall aUtomaticaly expire and become void il work is not commenced within 180 days, or if work is suspentled or abandoned
lor a period of 180 days. -
INSPECTIONS: In order for iha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapeetlone and final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of lhis pertnit.
FOR INSPECTIONS CALL: (714) 754-5626
�
aas�.e �aroo�
i. =�.:;,�.
WORKERS' COMPENSATION DECLAHATION: . "
I hereby eflirtn under penalty at perjury rne oi Ihe IWIowing dedaratbns: _ ..,.
❑ I have end will mainteln a certitiwte ot consent lo sell-Insure tw workers' compensetlon, es Orovided lor by section 3700 of the Labar Code, for Ne pertortnence of Ihe
work for which this permit Is issued.
�I �ave anA will maintein workers' campensation insurence, as required by section 3700 of the Lebor Cotle, lor Ihe pertortnance of Ihe work tor whic� this pertnit Is SsueE.
My workers' tompensatlon InSurance Cflrrier arM polity number are: . .
Carrier: PWicy NumDer.
(This sectlar need not be comp/efed i! the pemdt is valued ef one hundred dWlars (S I00) or /ess.)
❑ I cenity Ihat in the peAortnance ol ihe work for w�lch IMs pertnll Is IssueO, I shell not employ any pereon in any menner so es to hecome subject to Ihe workers'
compensatlon lews of Calllomie, enC epree t If I shoulE DBcome suE�ett lo t�e workers' Compen5elion proNslonS of Seclion 3700 a� the Labor Code, I 5he11 torlhwith
camply with ihese,�ir.�ovislons.
Applicant Signeture: / /'^� �� Date: �U- � `2 � U'V
WFqNINO: FAILURE TO SEIXIRE WORKERS' COMPENSATION COVEMGE IS UMAWFUL AND SHALL SUBJECT AN EMPl.OVER TO CRIMINAL PENALTIES PND CML FW ES UP TO ONE HUNDiiED
THOUSAND DOLIARE �E100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMnGES AS PHOVIDED FOR IN SECTION 3]Ofi OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATON:
I herehy aNirm ihat I am IlcenseU untler provislons ot Chapter 9(commencing with Section 7000) ol Division 3 of t�e 8usiness untl Professions Cotle, entl my Ilcense Is in full
lorce end ettecL Uc. a Class a
COn�rettor'9 $IgneWre: ��" Da�9: / V-/ Z� C/�
CONSTRUCTON LENDING AGENCY:
❑ I hereby effirm t�al Ihere is e consWctlon lentling agenry for I�e pertormance of tha work br w�ich ihis permit Is issued. (Sec. 309�, Civil Code).
Lentlefs NBme: Londer6 Adtlress:
SignaWre: Date:
OWNER-BUILDEP DECLARATONS:
I hereDy alfirm t�et untler penalty ot perjury thet I em EXEMP7 FROM 7HE CONTRAC70RS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business end Prolessions
Cotle: My dN ar counry which requires e pertnit to cOnsWct, elter, improve, tlemolis�, or repeir eny structure, pnor lo its issuance, elso requires the applicant for suCh pertnit
lo flle a signed 6tatement that �e or she is IlcenseE pursuent to the provlslons of Ne Contractors License Law (Chepter 9(commencing with Sectlon 7000) ot Dlvisian 3 ot ihe
Business and Professions Code) or that �e or she is esempt therefrwn and Ihe besis for Ihe elleged exem0�ion. Any violation of Sectbn 7037.5 by eny epplicant for e pertnit
subjecls the epplicant to e Uvll penalry ot not more than five huntlretl AWlars (5500).):
❑ I, es owner of ��e Oroperty. or my employees with weges es their sole compensetion, WILL DO TME WORK, antl the structure is nm intentleC or otteretl br ule (Sec.
70d4, Busineu antl Professions Code: Tha Coniractars Licensa Lew does not apply to an owner of properry who builds or imprrnes thereon, antl who Aoes such work
himself or �erselt or t�rough his or her own amplqrees, pmvided that such imprwements ere not intended or aflered for sale. If, however, the builaing or imprwement is
solA within one year of completion, the owner-builder will �ave the burden of pmving ihat na or she did not build or improve tor purpose oi sale.).
❑ I, as owner ol the D�oCeRY. am EXCLUSIVELY CONTHACi1NG WfTH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Professions
Cotle: The contractors LM.ense Lew does not appty to an owner of property who bulltls or Improves Ihareon, and who contracts tor such project with a contractoqs)
license pursuant to tha Conirapors License Law9.).
❑ I am axempt under set. Business antl Prolessions Coae for Ihis reason:
SignaNre: Date:
Owner ID veritietl by drlvefs license. ❑ Ves ❑ No Driver's LiCen9e No. E�ires:
Vedfca0on of Ownership by (rype ol document, i.e. - properry tex bill or Aeetl):
DIVISION OF INOUSTRIAL SAFETY PERMR CERTIflCATON:
❑ I hereby certity thet rw excavatlon INe (5) or more feet in depth into whiU e person Is required lo descenE, will be maGe in connection vrith work auihodzea by this
pertnit, end that no building sWCWre, scaNWtling, talsework, ar tlemolttion or dismantling Ihereot, will ba more than Ihirry-sia (36) leet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Title B, Celifomia AdministreWa Code).
❑ As owner-bulltler, I will not employ anyone to do work which would require e permil from ihe Division ot Industrial Satery, es noied e6ove, unless such person �es e
pertnit to tlo sucli work Irom ihe dlvision.
Signature: Date:
Division of InAustrial Salery Permit NumDer:
GERTIFlCA7E OF COMPLIANCE AND AUTHORPATION OF EMRY: I cenity under penelry of perjury that I have read this appliwtion entl siate that �he infortnaUon given I5
correcL I egree to compty wilh all stete laws e� dty wdinances rela�ing to builtling constructlon, and euthonze representatives of ihe Ciry of Casta Mesa to enter upon �he
ebove-descnbed D�aGeny for inspection purposes. I egree no� to acupy or ellow occupanry ol eny builtling authorized by this pertnit un�il tinel inspection.
SignaNre Of Legal Owner(s) r� Date
1�.�/'�- � l— � O� � L _ Ci O
MNOr Authorized ApPllcant Data
WOE �, INSPECTONTYFE
1618 Fixetl SyStem Final Fire PrevenNon
7266 Pod Spa Final
200 Final Re-Rool
201 FInaI BIaWRetaining Wali
202 Final Factory Fire Place
203 Final Sign
204 Finnl Demdition
CAg It�LB
COOE� INSPECTIONTYPE
206 Final Mechenicel
208 Final Plumbing
210 Final Electriwl
212 Final Fire Prevention
220 Finel Planning Approval
222 Final Slte
250 Final Builtling/Occupency
� II��
Ciry of Costa Mesa
Development Services Departmant
Buildin9 Safety Division
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No. OD��E'�
The Building located at 555 Anton Aoi�lPvat�i Fourth E`looY
has been inspected and found to comply wiih ihe provfsions of all City of Costa Mesa Ordinances applicable thereto
for a Group R9 OcCupanCy.
Use of Building Offirc
Legal Description 410-501-04
� ISee reveru side for Metes and Boundsf
Buildi�g Permit No A2 Electrical Permit No. E 37938 Plumbing Permit No. P 37971
Mechanical Permit No. M 37963 Number of apartments and/or guest rooms
Fire Prevention Permit No. F 37693
ISSUED T0:
Building Official William T. Howacd
er�.•„r; rv oari f i r Aank
600 �9ilshire Blvd., 4500 b`/
r.,c,nnno7�eu. rA
� Date .Tulv 17. 1989
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 Ciry of Costa Mesa under Sec. 307 �ei t1.B.C.
CMF 1015-46 rev. 1/83 White � Owner; Canary - Numerical File; Pink - Bldg. Permit File "
eoonessaew�w�o: 555 ANTON BL
°""E"e"""Ei°'w°"": SAKIOKA FARMS
' "D°"E"' PO HOX 2097
TERMINAL ANNEX
AVVL.YARRM ADDNES&
u"T: 4 TH
urcxnecton�+nr+�n: INTERIOR DESIGN 213623219'GND' 9378
�xa^�'s�0°"�� 550 S HOPE ST �NT� 1100
L.A. CA 90071
�a+TM��T�'s"� MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
����ag�u� 610 REYES ST
�op� WALNUT CA ��= 230813
91789 uM:
LICENSED COMFRGTOfl4 DECL�NATION: I Mreby Nim uMm pvWy M peejury Nei l em IieauM uMx ppiaons d GAaqar 9
(mmmmdiq xnh Seciion'l000) M Diroion 3 d tlr Bua'vnw rd P�dmdau COCs. end mY Gowve o m IuA brce end eMep.
cmuc.No.:006558c �°01'�8 C 10 uc.No.: z30813 EXP• 12/96
� /— ��— / �
Dem: � Gaqmda:
,. e
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1031.5 Ey e�ry app5uru la e permd ampRv Ne epp4aN lo e dN pmWy d nd mws �hm fxa hund�od da0an �SSO011.
� I.mawrordthepopenyormysnplyessWihv.aq»m�heiwbmmpemVion. 94othsxak,aMNe�Wctunenal'vueMeE
a dle�ad la eele (Seclian )Oaa. BuvmvvM Proleaawn Cade: The CaMreeva licema lewEaea na eGVNto an owrord MOWM
xta W1tla a inpwo ihe�aan. md wfio dom auN M! "vnsetl a Mnd w Wa� he a Mr own e^WuYa�. P��� ihet ach
impovemeMs ere nd in�eMad a tllerad la �els. tl. Mvever. tM bwtlinp a inpownaN e wld wi1Nn ana Y� d mmplelbn. Ns
o�«aw�..�o n.� ms n�a.� a w�u n. «.n. eu �a aaa «�ao.. �« m. a.00.. a.��.
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v.Neamm cca: m. coin�eua, L'cmn L.i. m.. nw ww b., o.,�. a ww>rr wno hdi. a nro�'« in«.m.iw wro
wnvecta lor aMi MM�a xM e mmrmMe) fcenaed Wnwn io tM CaMrma� Liceros lewl.
� I em esamq uMer Senian: B. d P.C.. br Nu reeam:
Dma: Owier:
I Eo IwebY �„M Net I em ewere d end wdrewd ths �Wu��b d Callarie IbNh W Se1sY Code Swbv T3505. 25iV. W
P5551. eM IMI I a enY Muro dnknq omqenl ll I wil ml (mcb ans) roed b comC�Y wih wid ptl0 codn eM IM n0�irtmaNO M
a pxme laouuwniona modfo�ion hontM�i�eroprivn Oivritl. WriC�NilmrutMun eDOkmioroenewnq hdn �Mu
No+uions.
om.: �oq�n:
WOPKER'S COMPOlSATq1 OKl�F1T10N: l Aeraby elf uds pwWy d prpry an� d Ne bOmwp Aetlumioro;
� IMweMWmamenacat!'ubdmoruwutliwobwh»'mmqronion.npwidMlaEyBwipi])ooNtMlans
CoM. la tM pMmnance d tlr wrk lu wlirl� Ne panw u m�ed.
n I hew vk xd meiiuen �.aken' campvamun i�m�uae. m ieW�� M Swion �]a0 d tM leEa COM. ta tha De�vmuwe d iM
� wak Iw w�iA tlis V� e e�uW. MY wwkaY mmpa�ttlbn vu�vercs miw mE D�Y mvnbw aro:
te�w: FTAFMANS F[7ND EXPIRES
P�^^�^� DWCB���F6Q� 07/01/96
(Thb axiian nesd nof M mnWusd f iM pam� u b as hwdredCdlua (SI001 n,ImJ
� I Cl11�Y �118� YI 1�10 �0lIM11C0 O� ��10 MpM �Of M�1C�1 IhY V� Y�1Y110�. � VIl� II41 !T�' / M/ pCl�l� �II MY TBIIt10f p tl �O
become wEjeu to �M wMwY mnpenWian lern d Cefdamie. end yeaa tlW i I 4vM psone �u4� �o tM warW�'
mnpauetion (p�ovucm d Sequn ]�OU d tM lebar CaM. I tlu010 rNh mmph wvh \�e pm.i�'vv.
Dets: / `I II — � �PO��: J
Wemlip: FiNun ro wcun rvoik�ri ro�t/on eavupl l� in4wM, uM � �/�e �n wrploy�r ro cMlnl pmtltla �IM
Nvll flnu �q h am M1UMrM tlwund Edbn �JIPqPPDA h�AfRbn ro tln t ol m ru�fbR surrp� p provkNC br In
Sxtlon JIGG o/ IM LeDorCoO�. /ntwp4 ��M �ttom�y� Iw.
coNsrnucnaN ��arw naewcr: i i.wr m� we. wreM a oaim� na e. w�a�a� ww�v .o.�.v ro. in.
PeAamerce d iM wwk tar MJrh Ihe D�� e'vwwd (SW ion �OB]. Cw. C).
LENOER'S N�11E
LENOEfl'S ADOXESS:
I cenity ihal I hsa read Nb eppfrsam eM tlab ihn tlr ebo.a'vdurtWion u canse.l ppw to ovnpfy w'vh e0 ay enE odvay ad'vienoes
end stme levn relmn0 ro Mddiq mnmuam rd AasbJ eWvrzs nps+mt�ws d UoW b omm Wm tM ebwa�mWionaO poperly
1w irepepion purpmes.
CHARLES JACOBI
(5151�6.WP)
o.,..�� �u'— / �
Sa1MY. G�eeMFb: C+�mY-�VG�M: Pink-Rwan»: Caokmmd-Aisem
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 076012 PLAN CHECK NO: N
PERM NO: E 076012
GOVT: N SUPP: Y
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS REF: H-74570 / SUP E-74578
***x�w�r*w*�r*��r*x�****�r*+r*�r�rr*+r��r�*�r*���rx�*xx�****+tx��rrxr***x�**�e�rx��rx��+r+r*�r***�r�**���r�*
Z O N I N G R E(j U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING Nf5'tES>
� �a
41E 1F 1F 1E iF 1k ik M 7E 1k 1F 1F 7F 1E if M ik %1E 1F It 1k 1F M IF 1E 1E 1E 1E 1k iF iF ik 1F 1E 1E 1E iE 1t 1k 1f iE 1E iE iE 1FiE1E'IF iF 1E 1i ik 1E 1E 1@ 1f iE 1f 1E iE 1f 1f if iE 1E 7E 1E iE 1E ik 1E 1E 1E fE 1E iE 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S /
ZONING APPROVED BY .
BUILDING APPROVED BY :
f�f����:` ��� 1���������f:�
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE:
�r�rD�+�r*w*�F�t� ��r
STAUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 18.15
502 SMIP/NON-RES
PLAN
ISSUE FEE 4.50
BUILDING-DIV-> PERMIT ISSUE PLAN-CAECK TOTAL PAID DUE
TOTALS----> 18.15 4,50 0.00 22.65 22.65 .00
REVENUE DIVISION TOTALS--> COLLECTED: 22.65 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
22.65
1f1liEMMKkikikilititkiEiEKiklkiklklkikiFikkliKiflfifkk/F1EiFMiFMIFiE1FItikIEiE1tM1F1F1kiFk1F1k1E1fi4iEkiElEikifM1E1E1fkifiF4iEiE1f1kiElf�iEiE
I N D I V I D U A L F E E B R E A K D O W N
TYPE (JTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 7 RECEPT/OUTLET ADDITIONAL EA. .45 3.15
END OF FEES
g 2 I�ar�C:ti:'�`;. _'.I��`i2 "��?- "- -
r.� -�
1d .�
CONSTRUGTION AND PLAF6NING , PG a SPA �-
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
i. Temporecy� E7ectrital Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ? 53. Steel Reinfarcement
i
��,.�.-,�lectriwl�on urL U ity-Undcgrnd. 54. Forms �
'�4F�Fei'ectrical�qbov�d��or�rgrnd. 55. Electrical Bonding
;: �5.''$Leel Reir fprce e�t' 56. Rough Plum6ing & Pressure Test
-:*6�Electrical EH'�;'md, 57. APPROVAL TO COVER�GUNITE -
�� rr' T <'
��' Footings `r'�yM �N ' 58. Electrical Cond�u,t�Jndrgrnd.
-i�8. Eoundati�rpN tuF :� 0 59. Gas Pipe, O Unnrgrnd., Test
t .,
9. Water Pip�Undrg3nd. � 60. Backwash Liness��ap, O Undrgmd. �
10. StructurakFloor'$ystem 67. APPROVAL TO DECK
11. Property 6�Wel.�ne� House=F.onnection 62. 8ackwash & Rec�jSfor•Final
12. Sewer Cap, �. , 63. Hea[er & VenFFinal
13. Roof DrainS j� 64. Plumbina System - Final
74. Rough Plumbicig_. � 65. Electrical•Final .
15. Rough Electrical-Coouit . 66. Solar SYstem�F�b
16. Rough Electric 1��+irin� � 67. Fencinc� & Accese Approval
'.77. Rough Wiriag Sign ' 68. APPROVED F�CtPLASTERING
78. Rough ElecMcz�" Bar Ceiling'' 69. POOL/SPA SYS�f�iNS FINAL
19. Rough Heat�ng & Air Conditioning Y � FI,�E DEPT. REQUIREMENT
«,a�. c .. mn:
20. �¢ug� F�tor�Fi �ace � `^,z; '°� r `� =' 'T'� � APPF�DV�' �nPec�'nit � � � �'-'
��. C. S'-+ S* r+F -6-^^ .�._
���,
21. uahm�tru�uren� .. .. -< r S�7 : s 70. 'tJnder§rliwn H ro *
.-. ,;
22. cty.Ver�t�I-'ngE"':•: ' ^` 'T S��`.:71. Produ�,n r�n C7�as C�OiI
� Ii .l� 1:� I f *C7 e'. r�-r �;7�P 9
23. Gas �iAe� u�h & Tajst ;�1�� •� m v� �,_,� i+72. Undergr�nd FIu.aF�i a r-
24. Fbof`-Fra�ing •� '�+* r`• "� *� =� �T' +, 7� Under r Stor.{STanky GasyOOi�
x R * � a: � x 9�• Ylig �
25. floo�he�thing _ t � '� v�p r; j c r. 7q^ Overhead�Hydrei? *
26. FBatTCeiiing (S[rUct�raU & f�ri�at * �, ' 7�'`�A 75� Dry Chemical F, � �-' „��
i� J •
# } ' } - Vi �� J • •
27. �ame.and,Flashing:* �-� a� - �. w* 76. Dry StanOjsipe =�w mb;
�....
-�28. LatNtAg &$iding �� �-: ja'4'„ � � E ..� ..r 77,7 FIXEO $�T�t,�t �'.INAIF �..� ii
'29. Insufaiiosi; ��K `� 5 • �� � jr 78i FIRE PREV. FINZCL '^ �' =�
T 30. Drywall Nailing �'�y, � � � �' ;: �EALT�e,€P�.4i'EQUiF�P(utENT
`37.PlasterBr@ivn;Coatny�; ����r a � w +79�FINALI P,ECT�pfV � �
� 32. Electriwl�Ap� M¢ter�in I• � N ��' SPHFOOD CERTIF1�i4Y� I�S�1,ED�
h �
.33. k9naLEle�iric� y:r r•, � S 8.�z� Notes `� ^y•.. a.. ._ c^
u34. Pina�tieaUng & AiF6onditionlnPS , i r• � -- X a' •^. •_': .1:.. � s s�
-, r.• o i-�a; :Y "'7
35. �`.tnaFTias�diPe�'es� fi �," : f: F, � ' ^.�:� O,r #� n:,-,.r
�
.-;, 36. Hoo�or QanoPY �±: '] � t;..y y � C, ' '. ._ �p ' �� - � �.. _ - =.
'x r M IT. �T. r'' t f �� ��l
�37. �jPa�fa�rV Fire�?Fe � [-c- �� �� ' � + � �cni ` � `-� -
-�38. FinaC8lumbing � . �S: `-� � i kt v H .r tD . .
Tf � T 1 �Y. H G X
� 39. Water $ervice�Final�� �' `' x G �r .,� y `: ��" "� ,r,r�. - .
i�40. Gas Service-Final ?�# m, e;-^;r S �♦ :T: '� " O•�� n:n� « • • ' '
� e.. � � �'� -� S' �:. �21
J41. Solar pomesticFirtal* � � ' * �' "' yr' - � x - '
� ;n "';fJ
�42. Backflow Preventer .� n K I y� cZ >:- _ � � •
-, -
43. Backflow Irrirja`�ion * ^. '^SS � � K �•`� � �� C. •
4y. Landscape'IrripationSystem tn:^n s. rh7 ' .' Ox N cu � �� � N n--
" _ v � �: S i-.
4b. �ound A nuetion * �-^~' :" 'K E F F� �-, r� rn�i , .
ItR ; � .... x m m� c+ ,: .:. • !-� �
46. Handicap Regulations� � x� #. ct S `�r� s a
11 r
47. FINq�C STRUeTURE & BUILDING K c � {� �"� S ^ x'
a: . i, FR C C'
48. �jNF�`i: P�ANNING + ;-r . �. • � m < t -
_ � � <- ,: �.
48. Electric Release to Edison ` ' p _ �
� �• Ct 'E •. � i: '^
5D. Gas Fdglease to Southern CaliforniaGas Co + � i � i: -., '• c;r � G ••
� ��:� %� N ..�-
61. CER FICATE OF OCCUPANCY^ x t_;� mo . . _.
No Da[e
,�-- --...- - - - -_----- -- -
�- t�it�p o f c�o�ta Z�e�a �
� Developmeni Servtces, Divtsion of Buiiding and Safety
CERTIFICATE AF OCCUPANCY
This cerrificate is issued pursuant to the iequirements of the Uniform Building Code, Secrion 308
adopted by the City of Costa Mesa certifies that at the time of its issuance the building structure herein
below described was inspected and approved for occupancy as follows:
Building Address S�YS ANTON BLW. Fi.00RS 1-12 Bldg. Pertnit No.keee Delw
Use urrlc�s
Group B-2 Type of•Cons�uction 1-FR Fire Zone Use Zone PnC
,r
Owner of Building Sakicka Farms ' Tenant "ma -A►•"
Address ` `'
�B7457d, B75356, B74572, 574571, Bi4573, 574633 �
, B74632, B74631, B74630, B]�006,�B77866, B74574 By
' ����� November 14, 1496
Date
: RICK BRO'dN, CEO
, REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
AGD����l�to fill In all
CITV OF COSTA MESA(� C N'S1T UCtT'ION PE/R�N�IT (��'
PrOject Addre�s SS Sr� �N �d /�' `y — r ` ' _
Applicant's Maili Address . �j/ ��
Owner's Name hone ].1Hi��%
Address Ssr V A!
Arch/Eng. License No.
Address �
Contracror's Name �AJGB S1jp.. 'V
T��' Phone
Addreu (mailing) .��,d yS..Z�C�Cf.r�iti -�b.•-f !-1 �-�t, '
City License No. �7�)slri � 3 ���
L•ICENSED CONTRACTOR D CLARATION
I hereby affi�m tha[ I am lic¢nsetl under provi510n5 of Chart¢r 9(commencing
�with section ]000� of Division 3 of t�e Business antl Pro(essions Cotle, antl
my license is in i II force antl ettect.
�
License ClaSsac � � LI o 0
Date��- o� Si9nature
WORKERS' COMPENSATION DECLARATION
1 hereby atfirm that I have a certificate of wnsent co s¢If-insure or a certi/itdte
ot Workers' Compensation Insurance, or a certifietl coOY thereof (Section
3800, Lab. C.) ^
aoiic r�o.Lsl p fr63 7 SR9S Comuanyl2�K �•�r7 �
ertitietl <opy is nere0y fumishea. �
C tifietl copy�c etl with the Ut ' m isio���'
Date�- 7 ' d � APPlicanl - ���..�- :•-l/�
EXEMPTION FROM WORKERS' COMGENSATION DECLARATION
(T�is sec[ion neetl not be <ompletetl if ihe permlt is for one huntlretl (5100) or
less).
I certi�y that in Ihe per(o�man<e ot the wO�k for which th15 Oe�m�t is ISsuetl I
shall not employ any person in any manner so as to become subject to [�e
Workers' CompensatiOn Laws of Califomia.
Date Signature
NOTICE: It, a(ter makin9 this tleclaration, you shoWA become zubject to [he
Worker5' Compensation provi5ions ot the tabor CoUe, you must lortnwith
comply with such provisions or tnis oermil shall be tleemetl revoketl.
CONSTRVCTION IENDING AGENCV
1 hereby attirm that there is a construction lentlin9 agency for the pertormance
of the work tor which Ihis permit is issuetl (Settion 309� Civ. CJ
Lentler's Name .
Lentler's Atltlre55
OWNER BUILDER DECLARATION
I he�¢by af�i�m lhat I am exempt trom the Con[�acto�'S LlcenSC Law fo� the
following reason (Section 7031.5 Business antl Vrotessional Coae: Any city or
COunty wbiGh requires a permit to Construct. alter, improve, aemolish or r¢palr
any sV ucture, prior to its issuance, also requires Ihe applicant for su<h permlt
to file d Signetl statem¢nt that he/she i5 IlcenseU pursuant to th0 provlsion5 of
the Contractor's License Law (Chapter 9(commencin9 with Section 7000) o/
'pivision 3 of the Bu5ine55 antl Professions Code) o� thdt h¢/She is ezempt
therefrom-antl the basis for Ihe alleqeC exemption. Any violatlon o( Section
7031.5 by any applicant fOr a permit Subjetts Ihe applicant t0 a civll
�endlty of not mor¢ than tiv¢ huntlretl tlollars (E500).
1, as owner of the prop¢rty or my employee5 with wage5 as thei� SolO
compensation, will Go Ihe wo�k, antl the st�utture IS not intentletl or ott¢�e0
fo� sale (SeGtion ]044, Business anE Profezsional Cotle: Tha Cont�acto�'S
Licenze Law tloes not appty to an owner ot a property who builtlz or improves
thereon, antl who Ooes such wo�k nimielf/nerselt or thrOugh his o� har Own
em0loyee5, providetl thal such improvements are not intentlea or offeretl tor
sale. If, however, the builtling or improvement Is soltl within one year of com-
pletion, tne owner wili have the burtlen o( proving he/she tlitl not builC or Im-
�rove torthe purpose o(sale).
I, as own¢r of the prOperty, am exclu5ively Cont�acting with IicenSed con-
tractorsto tonstruct the project (Sectlon 7044, Business antl Pro�essions Cotle:
The Contractor'z �icense Law aoes not apply to an owner of property who
builas or improves tnereon. antl who contratts tor such oroiecls wlth a con-
tractor(s1 Lcense pursuan[ m me Gontractor'S Litense Law). I am aware that
oroot of their Worker's Compenwtlon Insurance shoultl be provitletl to me,
❑ 1 am exempt untler Section � B. & P. C. tor this reason
Dace
I hereDy cerNry t
intormation is cori
ana state laws rel�
Sentatives of [his
Inspection �ET�
Signa[ure i� - �
Drivers' LScen�se a�r
0865-46, rev. 5/88
_ owner
I have reatl this applicatlon antl state tnat tne above
I agree to <omply with all city antl county ortlinances
to builtling construction, antl hereby authoriza repre-
��t?o enter upon tne above-mentlonetl property for
�',�,__�� 1� Da[e '2,_7��
pt %�/
except those within �eavy bOrtler Ilnef anG sign all apP�opriale tlaclantions.
TRACT Alfl 1(1T Nfl i �nut un
� Z/
TVPE OF CONSTRUCTION I�NEW LJ�ADD I'� ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCfiIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRADING LJ POUNDATION L`TSTRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION . F7. OCCUPANCV �
CONSTRUCTION TVPE�' 9,>_ r� NALUATION S�'�T
ZONE GRADINGCV.YDS. _ ACRES
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspaction Fee
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Outlets l4r Closet
Water Heater
� Water Service
Auto�Wash
$15
Boiler
Duct-UnderGround
Duct - Structural
Duct � Ventilating
Exhaust System ❑ Multiple
Firepl/Fact Blt. ICBO #
Heating System & Dutting
❑0.100,000 BTU 0100,000
Reinspection Fee � $15
White - Bulltling; Candry - Applicant: Pink - Accountinq; GDltlenrotl - A55055or
Isue Fee
Hood or Typel �
Cenopy Type II ❑
Refrigeration Syrtem
go-�oo,000eTu ❑ioo,000
System Repair/Alterotion
Fire Dampers
Registers
Issue Fea
$3I,
$ 3
A.P. �w �I U —
S Main Building:
E
T Front
A Rear
C Right
K
Ping. Ref. #
Planning Notes: —
Automatic Washer
Cooking Unit
Dishwasher
Dryers ❑Ga:
Fan
F.A,U.
Fixtures
Device Bozes
Outlets
� d
_ Zo�a D c_
Acceuory Building:
Z
O
N
I
N
G
R
Perking Req./Provided E
�
M
T
5.
L
r� Garbage Oisposal
:• Generator 00.5 KW �5-15 KW
i. .
' Reinspection•Fee $15
Trensformer LJ 15-50 KW
❑ 50+KW
Meter �up [0 100 amps
Meter ❑over 100 amps
Sub Panel :^
Motors 041 HP � V6�- 8
Inc.Solar 09-15 HP �1G15+
Pole Light
Range
Sign �
Standing Sectian5
Trash Compactor
Issue Fee
LOPMENT SERVICES REDUIREMENTS: �r a7„ ,
Approved By %�� ���1~'
�9 APProvad BY e . . ! �f�.
i-` r i ,� ,
�j BUILDING PERMIT $
�: PLAN CHECK $
PLUMBING �� $
� PLANCHECK-. 25% $
ELECTRICAL � $
— PLAN CHECK 50% $
MECHANICAL $
� PLAN CHECK 25% $
FEES
$ 3
SUMMARV OF_FEES' �
��,y� �SMIP $
=js-�p--rERM1T
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $
TOTAL FEE $�
' �.1R3
01 L002SC54-40029065 �'a�u'� 1'_+;;,'sj
PATE: 03/Z?!&? TiliEe 13�45
. . - e. : � . F�_' . . . , . ,�.r . ��s . .......... . . . " n, . l :y , . ti'. � c..
'2.v �1 � \�.'v b.'_�
� CONSTRUCTIOIV•AND PLANNING ) PUv� & SPA �
� APPROVALS Permit# Dat� Inspector AppROVALS Permit# Date Inspector
1� ,
1. Tempo/ary Electrical Service or Pole . �., V 52. Pool & Equipment Location �-�
J
2. �Soil Pipe-Undrgrnd. � _� f 53. Steel Reinforcement 1'�
N i v NJ r' '. (.±
3 ��Electrical Condui��Utili�ty-Undrgrnd. ,' ',' 54. Forms ��
4:1Electrjcal Condu�-Und grnd. � � 55. Electrical Bonding -��,
S.,Steel;�einforcemenf �� �' 56. Rough Plumbing & Pressure Test ����i
6) Electrical UFpR`Grndy ' ^ �� 57. APPROVAL TO COVER-GUNITE ��1��,
s i. i i '
'7� Footings ? � , � � i F'�; ' 58. Electrical Conduit-Undrgmd. �
� q8.�'Foun ation , - � �
_ :c� ��`i (.. ' � � � _ ,- ! 59. Gas Pipe, O Undrgrnd., Test �,:
r
"9. Wate`JPipe�Undrgr�ii.r � �� � 60. Backwash Lines, P-Trap, O Undrgrnd. -
10. Strucfural Floor System `�� -� ,. 61. APPROVAL TO DECK
11. •Property Sewer Line & House Connection � ,. �. 62. Backwash &.Receptor-Final
12. Sew�Cap �V �� �,�! . � 63. Heater & Vent-Final �
�.
13..Roof-Drains � '' � j � 64. Plumbing System - Final I
. i �
14. Rough Plumbing � � ��� 65. Electrical-Final ��
15. Rough Electri�l-Conduit 66. Solar SYstem-Final
�i6. Rough Electric Wiring 67. Fencing & Access Approval
1,T. Rough Wiring Sign . 68. APPROVED FOR PLASTERING -
�J
118: Rough Electrical-T Bar Ceili�g 69. POOL/SPA SYSTEMS FINAL
�19: Rough Heating.& Air Conditioning FIRE DEPT. REQUIREMENT
�20'. Rough Factory Fireplace y APPROVALS Permit #
���21� Duc[s, in Struccure , . 70. Underground Hydro
22. Ducts, Ventilating r � 71. Product Piping O Gas ❑ Oil
23.�Gas Pipe-Rough & Te �t �. 72. Underground Flush �
24- Roof Framing ��'%i �� 73.�Undergmd.StorageTank OGas ❑Oil -
25. -Roof Sheathing � � • � );� �� ' _ - 74. Overhead Hydro
26. T-Bar Ceiling (Str.uctuial) ;& Monocoat 75. ,Ory Chemical �
27-.�Frame and Flasliing� �, J_' 76. Dry Standpipe �
28. Latfiing &1Siqing '. ('_. 77. FIXED SYSTEM FINAL
29. insulation . 78. FIRE PREV. FINAL
� �
30- Drywall Nailing �� � - � l7 HEALTH DEPT. REQUIREMENT
31'. Plaster Brown Coat'�` �' 79. FINAL INSPECTION .
32'. Electrical Power Met r-Final' 80. FOOD CERTIFICATE ISSUED '.
� i �.
� 33: Final Electric � �- Notes: � O �+s�- £� � /
c
34. Final Heating & Air Condifioning ��� .J .
35. Final Gas Pipe-Test � • � . • ,
. 36. Hood or Canqpy '° ' � �' � �t � " , 7
. �e�ciTveXCwol �v ' �
�37. Finai Factory Fireplace ��"
N i ( �rv 7 '
38. Final P,lumbing ?` _
39. Water Service•Final _ , ,,.. .
� -
40. Gas Service-Final � � -j-
41. Solar pomestic-Final �� ; �� r, ,
42. Backflow Preventer �� iij��, ,�14.
r
43�Backflow Irrigation_� �? _ __. ' � �'�`�'
44. .Landscape Irrigation�System �!�' '��� 1'�
45. Sound Attenuation, . � , .-� �
46. Handica,p Regulations '�
47. FINALSTRUCTURE&BUILDING l
48. Special Requirements Completed
,
49. Elearic Release to Edison . ,_'��- �, �".� t�
�50. Gas Release to Southern California Gas Co �1 a'� ,�� ��� i
'51. CERTIFICATE OF OCCUPANCY ' "� - '
��� �• ��i
No. Date � •�/>'� •� :
\
AO011cant to 1111 In all spaees ezcept Ihose wit�ln haavy Eortlar Iines anE sign all appropriate Gaelarations.
Clry OF COS7A MrESA CONST{%� UCTION� !PERMIT
Project Address 7r5 S i�/YfOA� 7� �04� _
AppliCant's Mailing Addresz
Owner'sName —��' ��FI` Phone
Address
Arch/Eng. LiCenSe Na.
Address
Contractor's Nam Phone�3"� ��
Addresslma'i'�ol—_�.SS/� /3 �AQ/M�OU+�"
City License No. �� �2�
LICENSED CONTRACTOR DECLARATION
I hereby ailirm [hal 1 am Iicensetl untle� prOvislOni ot Charte� 9(comTe�Cing
With seCfiOn J000) OI DIvi510n 3 01 Ih0 BUSIn855 dntl PfOfe5510n5 COtle, dnA
my Iicense is in IWI or��ne ene<t. �� � Z9�6 L/
License Class �•e NO.
oatc3 ���� Signature
`NORKERS'COMPENSATION DECLARATION
h¢reby a/firm that I hav0 a Certifitdt0 Of ConSent lo SBIf-insure or a certiticate
of Workers' Compensation insurance, or a certifietl copy t�ereof (Sectlon
3800, Lab. CJ p
aoiicy r�o. �����o�� Compan r 4�'�`� "�"
C rtifietl copy it hereby furnishetl.
C�J ille�p oP,Y�S filetl wit� the tlty Buil Ing ' isl '
Ddte6'Lii�d7 Applicant ' •
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -
(Thls sectlon neetl not be completOtl ii the permit is tor one hUntlred (E300) or
less).
I certify that in tne pertormance of tne work tor which tnis pnrm�t is issuee I'
s�all not employ any parson In any manner so as to bacome suD�ect to t�e
Workers' Compensatlon Laws o( CalHornia.
Date Slgnature
NOTICE: If, atter making [his tletlaratlon, you ihoultl becoma sub7ect to the
Workers' Compensatlan provisions of the Labor Cotle, you must forthwith
comply wllh SUGh prOVl5ion5 Or [nls pOrTlt Thall DG OB<metl revoke�.
CONSTRVCTION LENDING AGENCV
I hereby alfirm that there is a<onstructlon lentling agency for the parformanca
01 iho work tor wnich this permlt Is Issuetl (Sectlon 3097 Civ. C.)
LenCer's Name
Lontlet's AtlOress
OWNER BUILDER DECLARATION
I hereby at(irm lhat I am axemDt f�om tha Contractor's Llcansa L.aw (or tho
tollowing rcason (Soction 7031.5 Buslnass antl Proiezslonal Cotle: Any city or
county which reQuires a pGrmlt l0 con5(ruGt, dlteq ImO�ove, tllmOliSh o� �epalr
any strucWra, prlor to Itz issuance, also reqWres [he appli<ant lor such pormit
b tila a signetl slatomont tbat ha/she is Iiconsetl pursuant to tho provi5lons of
�e Conlractor's Licanse law (Chapler 9(commen<in9 witn Sectlon ]000) ot
ivlsion 3 0! thc Bu5ino55 antl ProiCssions Cotle) Or [ha� ha/she is exompt
.neroirom anC [he basis !or tha alle9aG examption. AnY vlolatlon ot Sactlon
7031.5 by dny appliGdnt fOr a permll SUD�ects tha applltanl [O a Clvll
�enalty of not more lhan fiva nuntlretl tlollars (E500).
�J I, as ownor o! [ho Droparty or my omo�oyeos with wages as thelr sole
compensa[ion, will tlo lho work, antl tne itructure Is not Intontletl or oileretl
lor salc (Saction 7044, Businass antl Professional Cotle: The Contractor'S
Llcansa Law tloas nol apply to an owno� ol a proper�y wl�o Ouiltls or Improvas
thoroon, antl who tlons such wo�k hiTselt/hOr501f Or NrOugh his o� hBr Own
employecs, Orovitletl lhat such improvem¢nts are not In[entloE or offeratl Por
salo. II, nowevor, the bulltlin9 or improvoment is soltl withln one year of com-
plelion, the ownvr will nave tne burtlon of proving he/sho tlIC not bulltl or Im-
�rove lor tho purooso of salo).
I, as owner of tne Oroperry, am exUusively contracUng wlt� Iicensetl <on-
tractors lo construct th¢ pro7ecl (Secllon 7044, Buslness antl P�olesslons Coao:
The ConVactor's Llconse Law does nol apPry to an owner ot proporty who
builtls or improves lM1Ornon. antl who <Ont�acts to� such o�oiecli witn a ron-
traclor(s1 Lcenze parsuam to [ne Contractor•5 License Law). I am awaro tbat
proof oi tnelr Worker's CompensaHon Insurance shoultl be provltlatl to mn.
❑ I am enempt untler Sectlon B. & P. C. for lhis reason
Data Owner
I hareoy certity that I have reatl this applicatlon antl state that the abovo
in/ormation Is correct. I a9ree to comply wltn all clty antl county ortlinances
antl state laws relatl o bul ing conztructlon, antl horeby authorize repre-
sontatives o! t i y n r pon the aDovo-mentioneU Oroperty for
InSpecUon pur 5. � ����
Signature Da�
Drivers' License or 55 $
TYPE OF CONSTRUCTION LJ rvEw LJ ADD 13J ALTERATION
❑ CONVERSIpN ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRADING �LyJ FOUNDATION U STRUGTURAL
❑ TENANT ❑ EIECTRICAL e9 PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5q. FT. OCCUPANCv_
CONSTRUCTION TYPE VALUATION $
20NE GRADING CU. VDS. ACRE$_
Ramarkt:
Sink
Prevenrer
Irrigation
king Fountains
�r Drains
�r Sinks
Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drnins
Reinspection Fee � $15
eoiier
DuCt - Under Ground
Duct - Structural
Duct � Ventilating
Exhaust System ❑ Multiple
Firepl/Fect. Blt iCBO dE
Heating System & Ducting
00-100,000 BTU 0100,000
Reinspection Fee � $75
OB65-46, rev. 5/88 WM1i[e - Builtling; Canary - Applicanf; Pink - Ac<ounting; Goltlenrotl - A55es5or
$hoWers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundrv Treys
Issue Fee
Hood or 7ypel 0
Canopy Typell 0
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fea
A.P. vW
S Main Building:
a E
_ T Front
B Reer
— A
— I C Right
SLeft
_ Ping. Ref, qW
— Planninq Notes:
FEES
$ 3
$ 3
Zone
Accessory Building:
Parking Req.IProvided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. ❑ 50+ KW
Cooking Unit Meter ❑up to 100amp5
Dishwasher - Meter ❑over100amps
Dryers �Gas . .Electric Sub Panel
Fan � Motors �67 HP 01'f, - 8
F.A.U. . � Inc.Solar 09�75 HP 016-
Fiztures j
Microwave
Device Boxes �' Pole Light
Outlets Range
Switches g�y�
Garbage Disposal Standing Sections
Generator 00.5 KW �5-15 KW Trash Compactor
Fea �$15 � � luue Fae
DEVELOPMENT SERVICES REQUIREMENTS:
2oning APProved By
BuildinB APO�oved By
FEES
$ 3
N
I
N
G
R
E
U
M
T
S.
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ I�. DO ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTALPEE $ ��
PLAN CHECK 25% $
O1 C��Q29312-00029312 T�7�" 11.04
6AiE: p3/28/89 TIt1E: 09�26
G`\ \ ` . .
CONSTRUCTION AND PLANNING 7 P� & SPA
'APPROVALS Permit# DateJ Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Po�e � � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � � v 53. Steel Reinforcement �,�
3:JElectrical Conduit Utility-Undrglnd. �a � 54. Forms � �
4��lectiical Conduit-l9ndrgrnd. j /! 55. Electrical Bonding ��
/ 1 l .
5� SteeljReinforcemen[ �t . �/ 56. Rough Plumbing & Pressure Test �� �
6!,Electrical UFERyGindl V 57. APPROVAL TO COVEq-GUNI7E ����
,7,�Footings �-i �n �� 58. Electrical Conduit-Undrgmd. ��
8� Foundation � � �^i � � 59. Gas Pipe, O Undrgrnd., Test Gj
9. Water Pipe-Undrgrnd. � n�;�� 60. Backwash Lines, P�Trap, O Undrgrnd. U
10 � Structural Floor System :� � 61. APPROVAL TO DECK
11,.^ Property Sewer Lin� & House CQ�nection �1 62. Backwash & Receptor-Final �
a
� 12:� Sewer Cap �5 .7 �� 63. Heater & Vent-Final �
13. Roof Drains ,+� �� 64. Plum6ing SYstem � Final �
14. Rough Plumbing: Z � 65. Electrical-Final �
15. Rough.Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
G77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
�i'$. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
,19.. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20' Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rotigh & Test 72, ynderground Flush
24. Roof Framing • 73. Undergrnd. Storage Tank O Gas � Oil
- 25. Roof Sheathing � � 74. Overhead Hydro
26. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical � �
27. •Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding ,ij 77. FIXED SYSTEM FINAL
29. Insulation ��J 78. FIRE PREV. FINAL
3D: Drywall Nailing �, HEALTH DEPT. REQUIREMENT
�3�1. Plaster grown Coat �� 79. FINAL INSPECTION
'�32�. Electrical Power Meter-Final i� ,� �X BO.�fOOD CERTIFICATE ISSUED
3�. Final Electric b - ;�' Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing y��y��q �g0
.. 39.. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer : �
43. Backflow Irrigation �
i
44. �Landscape Irrigation SYstem
45. Sound Attenuation �
46. Handicap Regulations � ��
47. FINALSTRUCTURE&BUILDING
48. Specia� Requirements Completed •
49. ElectriC Release to Edison
.�
50. Gas Release to Southern California GasCo ,-�
r'
51. CERTIPICATEOFOCCUPANCY / _�
No. Date �
V
�
Apvlicant to fill in all'svaees exceot lhosa within neavy Eoreer Iines anO sign all approvriate aeclarations.
CITY oF COSTA MESa CONSTRUCTION PERMIT �
ProjrFt Addres3 s✓`_r .�iitlTl� �G �
Applitant's Mailing Addreu� �S6.0 �C.i(I.G.UOb
Owner's Nam��G� ���'+'� Phoi+o.�¢'���
Address
ArchlEng. , License No. �
Addres�s /� >
Contr�l'�/SN25m�� � ��� PhoneYy��7/
Address (m3lmgr r�-4.C/ �.P �f/d�f�LN .4� �iGNAL
�
Ciry License No. - �l /1-7
UCENSED CONTRACTOR DECLARATION '
I hereby affirm Nat �I' am licensetl untle� provislons of Charte� 9(commencing
with sectlon ]000) oi Division 3 of the Buslness antl Grotesilons Cotle, antl
my Iicense is In (ull force ana etfect , '
Cicense Class — License No�'/����
� Date � 1�7�� Si9p ur
WORKERS'COMPENSATIO� ECLARATION '
1 her¢by affirm thal I have a<ertitiGat¢ O( cons¢n[ l0 Selttin5ure or a certiflcate
ot Workers' Compensation InSurance, Or a certlfietl copY thereof (Seclion
3800, Lab. C.) - � ' ' ' -' " '
aor�v r+o2.�/P��CI� � ComPanY ���a � ,
�Certifiotl coDY is nereby furnisne
CertillCtl cOpy iz tiletl with [ ty Bu Iding DI 'zion.
Date — Ap icant �
E%EMPTION•�RKERS' VENSATION DECLARA
(Thissection neetl nol ba complefetl it the permi� IS for one huntl�etl 300) o�
less).
I certity �that ln fhe p¢r(ormance Ot the wOrk tOr which th15 pe�mR is i55uetl, I
Shall� no[ employ any person In any manne� so �as to become subjec[ to [he
Workers'-CompensatloniLaws ot California. �
Date Si9nature
'NOTICE: It, after making this tleclaration, you shoultl become subject to the
Worker5' Comp¢nsation provizion5 of [he Ldbor Cotle, y0u must for[hwith
comply with'such p�ovlsions ot this pe�mlt snall be aeemea �evoketl.
CONSTRVCTION LENDING AGENCV �
1 hereby afflrm lhat tnere ts a construcUon lentling agency for the�per(ormance
of lhe work for whith fhis permi[ is i55uetl (Section 309] Civ. CJ
lantler's� Name
Lentler's Atltlress
OWNER BUIIDER OECLARATION • � �
I he�eby affirm tnat I am exempt f�om th¢ Cont�actor's LicenSe Law to� tne
followinq reason (Section ]031.5 Business antl Profe55ional COUe: Any city or
county which requirez a permlt to construct, alter, improve, Eemolish or repair
any stru<ture, prbr to its issuance, alm reqWres the applicant for zuch Dermit
[o file a slqnetl Statement [hdt he/she Is licensetl purzuant to the provi5ion5 0/
tne Contractor'S.License Law (Chapter 9(commencing with Sectlon ]0�0) ot
Divislon 3 of the Buziness antl Prote55ions CoOe) or that he/she i5 exempl
thereirom antl the basis for.the alleqea exemption. Any violation of Section
]031:5 by any applicant fo� a pe�mit Subjects tlte applicant'to a Clvil
�endlty Of not more [han five huntlretl tlollars (E500).
I, as owner of [he p�operty o� my employee5 with wages as thei� sole
compensation, will tlo the work, antl the structure is not intentletl or offeretl
for Sal¢ ($ec�ion •]044, Business anU Professional Cotle: The Con[ractor's
Licenze law tloes not applY lo an �owner ot a property who builtls or Improves
thereon„ antl who tloes such work himseli/herself or tnrou9h hls or her own
employees, provitletl that such'imorovements are not inlentletl or offeretl (or
Sale. It, howav¢r, the builtling or imp�ovem¢nt is soltl within one year of COm-
pletlon, lhe owner will have tne burtlen of proving he/she tlitl not builtl or im-
prova (Or [be purpOSe ot sale). - � �
❑ I, as owner Of the pro0erty, aT exclu5ively contracting with Iicen5e0 con-
tractors to cons[ruct the project (Section 7044, Business antl Protezzions Cotle:
The Contractor's License Law does not apply [o an owner ot Oroperry who
builtls or improves thereon, antl who contracts forsuch projects wlth a con-
SldCIOI(5� IIC205C pU(SlldflL f0 II1C COOLIdCiO!'S License LdW�. � dT dW3lE IhdL
proot o tneir Worker's Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untler Section B. & P. C. for thlz reason
� Date Owner
TVPE OF CONSTRUCTION IJ NEW LJ ADD Ji,� ALTERATION LJ REPAI R
❑ CONVERSION ❑ DEMOLISH ❑ OT�H,�,R
DE�SC$J&TION OF WOR K/USE OF B LDG. /����� Y%i/.'/J
TVPE OF PERMIT LI GRADING LI FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ EIECTRICAL ❑ PLUMBING �ECHANICAL
❑ OTHER
PRQIECT DESCRIPTION SQ. FT. OCCUPANCv_
CONSTRUCTION TVPE VALUATION $
ZONE ' GRADING CU.YDS. ACRES_
Remarkx �//�� �l ._.� .�.�. i%� �� �
Bar Sink
Backflow Prevenrer
Backflow Irrigation
Bath W bs
Clarifiers �
Dishwasher �
Drinking fountains .
Floor Drains
Floor Sinks .
GasService OuUets�
InterceptOre , �
Kitchen Sink •
Trap
iof Droins
Reinspection Fee
0
Service Sink .
Sewer Cap
Sewer Connection
Solar Collectore
Solar Piping
Solar Tank
Swimming Pool w/Spa
FEES
Water"Closet .
Water Hearer
Wacer Service -
- Auto-Wash �
l.aundry Trays' ' �
$15 Isue Fee . �� $ 3
Duct- Under�Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU � 100,000 BT
ISignat�e � � Date � Z%�i
Drivers' nse or 55 � Reinspection Fee
GMF 0865-46, �ev. 10/04 White - Builtling; Canary - Appliwnt; Pink - Accounting; Goltlenrotl - A5se55or
St5
Hood or Typel ❑ .
CanoPY Typell ❑
Refrigeration System �
❑aioo,000aru ❑ioo,000sru
System Repair/Alteration
fire Dampers Ls�,� �
Registers �
Iswe Fea
A.P. #
S Main Building:
E
T Front
ARear
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Bozes
OuUets
Switches
Garbage Dispoul
Generator 065 KW C
ir�S9/ `
Zone
Accessory Building: '
2
� O
N
I
� N
G
" R
Parking Req./Provided � � E
a M
T
S �
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+ KW
Meter ❑up to 100 amps
Meter ❑over 100 amps,
Sub Panel .
Motors �0-1 HP �1'h - 8
. InaSolar �945 HP �16�15+
75 KW
Pole Light
Range
Si9n
; Standing Sections
Trash Compactor
I�Reinspection Fee �$15 I I Issue Fee
DEVELOPMENTSERVICESRE�UIREMENTS:
Zoning Approved By
Building Approved By
P�PY��mtion Issued By �"�
SUMMARV OF kE
BUILDING PERMIT $
PLAN CHECK $
PLUMBING $ -
� PLAN CHECK 25% $
ELECTRICAL $
� PLAN CHECK 50% $
MECHANICAL $ 2dO ��
' PV1N CHECK 25% g '
$ 3
SMIP $
PERMIT .
ISSUANCE , $
ENERGV P.C. $
GRADING $
MICROFILM '$ � �
TOTAL FEE $ 2D0. �.�
TIME: i3:53
.� .� _
CONSTRUCTION AND PLANNING ' hvOL & SPA .
� ' QPPROVALS Permit # � Date �-Inspector AppROVALS Permit # Date InspecTo� I
�
1.�Temporary Electrical Service or Poler , � 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 Gmd. - � 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
' 19:••Roof Drains 64. Plumbing System - Final
� i,
�14.�Rough Plumbing 65. Electrical-Final
15. Rough Electriral-Conduit - 66. Solar System-Final . �'
i6.' Rough Electric Wiring � 67. Fencing & Access Approval � --�'
�
17, Rough Wiring Sign 68. APPROVED FOR PLASTERING ,
18:� Rough Electrica,l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19: Rough Heating & Air Conditioning t��l�c+ (�� FIRE DEPT. REQUIREMENT - �
20. Rough Factor.y Fireplace APPROVALS Permit #
21'. DuC[s, in.Structure � 70. Underground Hydro
22. Ducts, Ventilating 71 �. Pioduct Piping O Gas ❑ Oil .
�23. Gas Pipe-Rough & Test . 72. Underground Flush �
� 24. Roof Framing , ' 73. Undergrnd. Storage Tank � Gas O Oil '
25. Roof Sheathing 74. Overhead Hydro -
26. T-Bar Ceiling (Strucmral) & 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 L' !KlbJ ��
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 pomestic-Final , - '��}�
42. Backflow Preventer , , � '
� 7
43. Backflow Irrigation -%��''
44. Landscape Irrigation SYstem - `� i
45. Sound Attenuation � ' • � .
46. Handicap Regulations � � , , 1
47. FINALSTRUCTURE&BUILDING �
� 48. Special Requirements Completed , ' � � �
49. Electric Release to Edison - , - � � ' ���
i'
50. Gas Release to Southern California Gas Co � , .
� 51. CERTIFICATE OF OCCUPANCY � • . . . . � "�� ��.
,\'o. � � Date „ � - � - - ` ' =
\
/
�T� AOP�icant to flll in all spaces axcept those within heavy �orCer Iines anA sign all approDriate tlaclarations.
CITY OF COSTA MESA ONSTRUCTION PERMI I
Project Address S.S'S , N7qN S!/�TE S��
Applicant's Mailing Address
Owner's Name -S�Cv � � �one
Addreu ,t-
Arch(Eng. ya�1 License No.
Address ��//��Y Q� Lo..r/�yG,CG�S o�/
Contractor's Name � �/�'�DF��E) �lGT,P/Cynone
Addreu (mailin9) �DD I�1 EiJ i-/�LG ��U7COS� Pfc�
City License No. d y y�� l
LICENSED CONTRACT00. DECLARATION
1 hereby af�i�m tM1at I am licensetl untler provisions of Charter 9(commencing
with section 7000) 01 Dlvision 3 ot the Buslneis antl Professions Cotle, antl
my license is in t WI Por antl eifect S�/Z�% �/
LicenS Cla 5 LlcyqS No.
�pa[e � � � S�9ndt r � ���✓
'NORKERS'COMPENSATION DECIARAT ON
hereDy affirm ihat I nave a certiflcate of consent to selt-insure or a cert7fiwte
ot Workers' Compensation InSurante, or a cartifietl copy theraot (Sectlon
3800, LaD. C.) e ' ,�/
Policy No.W��.� y�3�0�ompany���i-`��
�Certifietl copy Is hereby furnishetl.
Ce fie py 5 iletl with the city Buil {u�•�, D�l�vis�ion
q'Date�'�� �� Applicant �'w+'�"� F�
EXEMPTION FROM WORKER$' COMPENSATI DECLARATION
(Thissection neetl not be Complatetl it lhe pGrmit IS for one huntlretl (E300) or
iess).
I certify that in tne pertormance oi the work for which tnis permR Is issuea 1
shall not employ any person in any manner so as to become subject to t�e
Workers' Compensation Laws o( Calitornia.
Da[e Signature
NOTICE: It, after making lhi5 tleclaration, you shoultl become subject to the
Workers' Compensation provisions of Ihe Labor Code, you must forthwith
comply with zuch provisions or tnis permlt shall be aeemetl revokea.
CONSTRUCTION LENDING AGENCV
I I hereby atfirm that there is a construction lentling agency for the performance
'. of Ihe work for which tnis permit is issuetl (Section 3097 Civ. CJ
�I LPntler's Name
LentlerY AtlOress
OWNERBUILDER DECLARATION �
I hereby atfirm Ihat I am exempl from the Contractor's License Law for the
following reason (Section ]031.5 Business antl Professlonal Cotle: Any city or
county which requires a permit to conStruGt, alte�, ImOrove, tlemOlizh O� �epair
any s(ru<lure, prior to its issuance, also requlres the applicant for such permil
b(ile a signetl statement lhat he/she h licensetl pursuant to [he provisions ot
e Contractor'S License Law (C�apter 9,(commencing wilh Sectlon 7000) of
vision 3 of the Businass antl Protessions Cotle) or that he/she is exempt
..�erefrom antl the basis for [he allegetl ezemption. Any violatlon of Sectlon
7031.5 by any appliGant to� a permit subject5 th< applicant to a dvil
�enalty ot not more than five buntlre0 tlollars (E500).
I, as owner of the property or my em0�oyee5 wilh wages as Inel� sole
com0ensation, will Oo Ihe wo�k, ana the structure Is nOt int¢n0etl or_Off«Btl
tor sale (Sec[ion 7044, Business antl Professional Cotle: The Contractor'S
�icense law tloes not apply [o an owner ot a property w�o builtlz or improves
Ihereon, antl who does such work nim5elf/hers¢If o� tnrOugh his o� h¢r Own
employees, orovitletl thal such imorovements are not inlenaea or offeretl for
sale. If, nowever, Ihe builtling or improvement is soltl within one year of com-
pletion, the owner will have the burtlen oi provin9 ne/she tlitl not builtl or Im-
prove tor Ihe pu�pose of Tdle).
❑ I, as owner ot the property, am exclusively contracting wit� Iicensetl con-
tractorsto mnstruct Ihe project (Se<tion 7044, Businesz antl Pro(essions Cotle:
The Contractor'S License Law tloes not appty to an owner ot properry who
' builtls or improves thereon. antl who contracts tor such orolects witn a con-,
tractor(sl hcense pursuan[ ro me Gontractor's Licanse Law). I am aware that
proof of their WOrker's CompensatlOn inzuranGa shoultl be provitletl t0 Te.
❑ I am exempl untler Section B. & P. C. for this reason
Dale Owner .
1 hereby certify that I have reatl
intormation is correcL I agree to c
antl state laws relating to builtling
sentatives oi thiT city to enter
InSpection Our0a5e �
�Slgnature
Drivers' License or 55 9f
�...,,, .. ..... Q ....._...... __. .._. ..� ��yv, A.P.�
(J T1�
S Main Bi
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHEp+� "-- � T FrOnt
DESCRIPTIONOFWORK/USEOFBLDG. 1� A Rear
TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL � K Rlght
❑ TENANT �iI ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � g� Left
❑ �Oi'FiER Ping. flef. #
PROJECT DESCRIPTION 5�. FT. OCCUPANCY A� planning No
CONSTRUCTION TVPE VALUATION 5
ZONE GRADING CU. VDS. ACRES
Remarks: � % A 7 ��
PLUMBING
I Showers
Preventer Service Sink
IrrigatiOn Sewer Cao
Jishwasher
7rinkin9 Fountains �
=1oor Drains
"rloor Sinks
3as Service Outlets
Interceptors
Kitchen Sink
�3V0[0(ICS
P-Trep
Roof Drains
Reinepec[ion Fee $15
Duct - Under Ground
Duct - Structurel .
Duct - Ven[ilating
Ezhaust System ❑ Multiple
Firepl/Fact Blt. iC80 #
Heating SyStem & Ductin9
❑a100,000 BTU 0700,000
Reinspection Fea � $15
0865-46, rev. 5/BB White - Builtling; Canary - Appllcant; Plnk - Accounting; Goltlenrotl - Assessor
Se er Connection
olar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
laue Fee
or Typel ❑
ry Type II ❑
tefrigeration System
7aioo,000sru ❑ioo,000
System Repair/Alteration
Fire Dempers
Registers
Issue Fae
FEES Au[omatic Washer
Construction Pole Sub.
COoking Unit
Dishwasher
Dryers �Gas ❑Elec
Fan
F.A.U.
Device Baxes�
�Utl¢t5
Switche5
Garbage Dispoul
Generator �65 KW
Fee
a 3 DEVELOPMENTSERVICES
Zoning Approved By
FEES 6uilding APProved By�
APGliration Issued BY
S 3
�
Zone
Accessory Building:
2
O
N
1
N
G
R
Parking Req./Provided E
Q
T
S.
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Merer LJup to 100 amps
Meter ❑over100amps
Sub Panel
Motors O0.1 HP O 1 Y, - 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Fiange
Standing Sections
5 KW Trash Compactor
$15 Issue Fee
SUMMARV OF FEES
BUILDING PERMIT $ SM
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $ 2�� • �
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $ i�
$
FEES
P MIT
UANCE $
ENERGY P.C. $
GRADING $
�CROFILM $ ►�� �� 7�
TOTALFEE $ �
/
D7 OOD29069—U0029069 TC1'y' 2bb.,3C
DATE: 03/23/89 TIflE: 13:47
`;_rJ\\�` ,\.. .... .. _ - . . . , _ ..,
CONSTRUCTION AND PLANNING �C P( & SPA
� APPROVALS Permit # Dati, Inspector p�ppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location
2. $oil_Pipe-Undrgrnd. ' • 53. Steel Reinforcement
31 �Electrical Conduit Utility-Undrgrnii.' ''' 54. Forms ��
4'. Electrical Conduii-Undrgmd. -� . 55. Electrical Bonding
5.-Steel Reinforcement �� 56. Rough Plumbing & Pressure Test •
6.: Electrical UFER Grnd. � .�; 57. APPROVAL TO COVER-GUNITE ;���
7.'Footings '� " i 58. Electrical Conduit-Undrgrnd. ''
�
"8. Foundation ' I � �L� '� 59. Gas Pipe, O Undrgrnd., Test �. i
9. Water Pipe-Undrgrrid. ��� '� ;� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System �� - ' 61. APPROVAL TO DECK '�
i 1,,,Property Sewer Line'& House Connection `_ r, 62. Backwash & Receptor-Final •t
�
12;SewerCap _ - � � ' 63. Heater&Vent-Final ���
i
13. Roof Drains' �, � �� 64. Plumbing System - Final `', ��
14�.� Rough Plumbing; �, � � '' ` 65. Electrica6Final
15. Rough Electrical-Conduit " 66. Solar System-Final
;16, Rough Electric Wiring .�,1 � 67. Fencing & Access Approval
17! Rough Wiring Sign i , " . 68. APPROVED FOR PLASTERING
�J
18. Rough Electrical-T Bar Ceiling ,7��� . POOL/SPA SYSTEMS F�NAL
19" Rough Heat�g.& Air Conditioning FIRE DEPT. REQUIREMENT
20� Rough Factory Fireplace APPROVALS Permit #
21, Ducts, in Structure 70. Underground Hydro
IA
22.,Ducts,Ventilating �Y � � 71.ProductPipin9OGas ❑Oil
23. Gas Pipe-Rough & Test j� � 72. Underground Flush /
24. Roof Framing � , 73. Undergrnd.StorageTank OGas�00i1
25. Roof Sheathing �. � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) &iMonocoat 75. Dry Chemical �
27. Frame and Flashing I 76. Dry Standpipe
28. La ihing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai. 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � otes:
34. Final Heating & Air Conditioning .` � - I', � �
�e
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 pomestic-Final '1 � � !
42. Backflow Preventer -- �-' ?� i')
i
43. 8ackflow Irrigation �
44. Landscape Irrigation System ( s� �
45. Sound Attenuation " � �
.
46. Handicap Regulations r `
47. FINAL STRUCTURE & BUILDING i
48. Special Requirements Completed
49. Electric Release to Edison `' ��'i
.
50. Gas Release to Southem California Gas Cn - �� '
� -
51. CERTIFICATEOF OCCUPqNCY "� i{, ).� � a, � /� '
No. Date n � �. -�� r'j
%�
M
N
�,
ADG�ieant to /ill in all spaces axcept l�ose within heavy borEer Ilnes antl slgn all appropriale tleelara[ions.
CITV'OF COSTA MESA CONSTRUCTION PERMIT �"""'T ""' TA�rT tin i nT n�n ��.��r..�.,
ProjectAddrMS �• $55. t�NTUN� 4TH FLOOR
Applicant's Mailing Address 7540 �r .T T.ANR jn]$q'TM7TQGTER
Owner'srvame SECURITY PAC. BANKphone
Address �00 SVILSHIRE BLVD. #500� L.A.
Arch/Eng. License No.
Address
Contracmr'sNama KIMBLE & CO. � ahone 895-115
Addresslmailingl 754� SUZI LN. WE$TMINSTER
Ci ty License No. 0 3 8 5 0 3
LICENSED CONTRACTOR DEGLARATION
I �ereby affirm that 1 am Ilcensetl untler provi5ion5 6f Charter 9(commencin9
with uction 7000) ol Divislon 3 of the Business antl Profes5ion5 Cotle, antl
my licenze iz in fult forc§ afi0 elfect.
�icen�} Cla �-- 1 b ense tao. 4 6 0 9 2 3
��te O 519 t �
)RKERS'COMGENSATION D CLARAT ON
. nereDy atfirm that I have a certiticate ot conzent to �INnsure ar a certitiwte
01 Wark¢rs' Compensation Insuranca, or a cert7/7Qp copy [nereot (Sec[fon
aeoo, �e. �P88470897-0�
vo�icv No. mpany FREMONT IND.
�Cer[ifietl coOY is hereby fumisheU.
Cer ie o y i f tl with the dty B n9 iv' n. �;��
Date�� ApPlicant � LanL�r,�t
E%EMPTION FROM WORKERS' COMPENSAT ON DECLARATION
`(This section need not be completatl if Ihe permi[ Is fpr one huntlretl ($100) or
Iess).
I certity thdt in Ih¢ Pet�o�mance of the wo�k tor wh�Gh this plrrli�t 75 Issuetl, I
snall not employ any person In any manner zo as to become subject to the
Workers' Compensatlon Laws of California.
Date Signature
NOTICE: 11, after making this tleclaration, you snou�tl become 5ubject to the
Worker5' Compensation provi5iOn5 of the Labor COtle, you mu5t forthwith
comply wilh such provislons or tnis Oermit 5hall be tleemetl revoketl.
CONSTRUGTION LENDING AGENCV
I hereby afRrm that there is a mnstruction lentling a9¢ncy for the per(ormante
of the work for whicn this oermit is issuotl (Sectian . 3097 Civ. C.)
Lentler's Name
Lentler's AtlOress
OWNER BUILDER DECLARATION
I hereCy atiirm that I am axempt from the Contractor'z License Law for the
tollowing reason (Setlion 7031.5 Bu5lness antl ProfpStlonal Cotle: Any city or
<ounty which requires a permit lo cons[rucl, alter improve, tlemollsh or repair
'^structure, prior to its Issuance, also requires t�e apo��cant for such permit
ile a signeA statement lhat he/sne i5 Iicensetl pursuant to [he provisiont ot
Contractor'S License Law (Chapter 9(commencing with Section 7000) of
.aision 3 of lhe Business antl Profe55ions Cotle) or thal he/5he Is ezempt
th¢refrom antl the ba5i5 tOr Ihe alle9etl ex¢mptiOn. qny vloldtlon ot Section
�031.5 by any applican[ for a permit SUDjects (ha applicant to a civil
�enalty of not more than five huntlretl tlollars (E500�.
1, as owner of the property or my employeei �yith wa9es as their sole
-compensation, w111 tlo Ne work, anC the structure is not Intentletl or-ofteretl
tor wle (Section ]044, Businesz antl Pwfessional �otle: The Contractor'S
License law tloes not apply to an owner o/ a property who builtls or improves
thereon, antl who tloes such work himself/har5ell or through his or her own
emoloyeez, provitletl tnat such imorovements are not Intentletl or o(feretl for
sale. If, however, [he builtlln9 or improvement is 5oltl witnin one year ot com-
pletion, tne owner wlll have tne burAen of provin9 he/sne tlitl not bulltl or im-
prove torthe purooso ofsale).
❑ I, as'owner oi the property, am exclusively con(ractin9 �+'��h IlcenSetl con-
tractors to construct the prolect (Section 7044, 6usiness antl Professions Cotle:
The Coniractor•s License Law does nol app1Y to dn owner of property who
builtls or impmve5 [hereon. antl who cOnt�act5 �o� such orOlectS wRh a r.on-
tractor(s1 Lcense pursuam ro me Conuatror•5 Llcens¢ Lnw). I am aware tha[
proof o( thei� Worker'S COmpensatlon InSutanCe Should be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date � Owner
I hereGy certity'that I have rea�
intormallon is mrrecL I a9rae ta
Slgnature �
Drivers' Li ense or
OB65-46, rev. 5/B8
'.tate that th¢ above
a county ortlinances
eby authorize revre-
ionetl �pr/o�pefr�ty �for
Date�
��� �9 1 � � � �
TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PEFMIT LI GRADING LI FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION 54. FT. oCCUPANCv�.S��_
CONSTRVCTIONTYPE VALUATION$ �
20NE GRADINGCV.VDS. ACRES
Remarks: �
Bar Sink
Backflow Preventer
Backflow Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
lavatories
P—Trap
Roof Drains
Reinspection Fee
$15
Duct- Under Ground
Duct - Structurel
Duct - Ventilating
Exhaust System ❑ Multiple
FirepVFact. Blt. iC60 �
Heating System & Ducting
❑P700,000 BTU �700,000
� , I I Reinspection Fee
White - B�IIUin9; Candry - qpp���dnt; Pink - Accounting; GOltlen�oa - Assesso�
$15
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
SOlar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
Laundrv Trays
Isue Fee
Hood or Type I ❑
Canopy Type II ❑
Refrigeratian System
❑0-700,OOOBTU ❑100,0006T
System Repair/Alteration
FiFe Dempers
laue Fee
H.Y. 9F
S Main Buildir
E
T Front
B Rear
A
� Ri9ht
g . Left
Ping. Ref. #
,$lanning Notes: ,
FEES Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Oryers ❑Gas ❑Elec
Fan
F.A,U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generetor �0.5 KW C
$ 3
$ 3
zone
Atceuory Building:
Parking Req./Provided
ELECTRICAL
Transformer � 15-50 KW
❑ SO+KW
Meter �up io 700amps
Meter ❑over100amps
Sub Panel
Motors�0.1 HP 01'/.-8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole �ight
Range
Standing Sections
15 KW Trash Compactor
� Reinspection Fee �$15 � � laue Fee
DEVELOPMENT SERVICES RE�UIREMENTS:
Zonine APProved BY .
Building Apptoved 6y
Aoolication Issued Bv '
FEES
$ 3
1
N
G
R
E
�
M
7
S.
SU�y�FEES 7 2�f
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PIANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �
PLAN CHECK 25% $
01 �0027585-000216A6 7"07' ]6,,25
DATE: 03/03/89 7I11E: 14:47
. _ .- .- . . . . , .. .
� CONSTRUCTION AND PLANNWV %L ' L& SPA
� Date Inspector Date Inspectbr
+ APPROVALS Permit# APPROVALS Permit#
1. �Temporary Electrical Service or Pole ' 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. I �' S3. Steel Reinforcement �
F 3. Electrical Conduit Utility-Undrgrnd.' �:- 54. Forms ,
4y Elec[rical Conduit-Undrgrnd. 55. Electrical Bonding • ,
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test ��
(3: E�ectrical UFER Grnd. •. 57. APPROVAL TO COVER-GUNITE � �
7. Footings -; 58. Electrical Conduit-Undrgrnd. I'
8. Foundation ,, 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Struc[ural Floor System -,i ' 61. APPROVAL TO DECK
1 i. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final �
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' ' APPROVALS Permit #
�
21. Ducts, in Structure , 70. Underground Hydro
22. Ducts, Ventilating �.�,,, 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test _. � 72. Underground Flush
24. Roof Framing '� 73. Undergrnd.StorageTank OGas ❑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 6
29. Insulation � 78. FIRE PREV. FINAL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
, 31. Plaster Brown Coat �, 79. FINAL INSPECTION
32. Electrical Power Meter-Finai" 80. FOOD CERTIFICATE ISSUED
�
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy .
37. Final Faaory Fireplace
38. Final Plumbing •
39. Water Service-Final �
� 40. Gas Service-final
41. Solar pomestic-Final
42. Backflow Preventer �
43. Backflow Irrigation ' ' � `
44. .Landscape Irrigation System �� ,
45. Sound Attenuation
46.• Handicap Fegulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
, 49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co . ,
, 51. CERTIFICATE OF OCCUPANCY
No. Date
,t
Applicant to fill in ail spaces ezce0t those wit�in heavy EorEer Iines anE sign all
CITV OF COSY/j �s CONS,T] RUCTION PE MIT(^
Prolect Address � �•-� IO :� �'},h ,Y�
Applicant's Mailing Address `
Owner's Name � 2 n i-"Phone T—
Address SA �"'
J
Arch/Eng. License No.
Address
Convactor'S Namo���� c� P one ��� -��
Address (mailin9)
City License No. a 3�� 4�
LICENSED CONTRACTOR DECLARATION
I hereby af/irm that I am Iicensetl untler provisions of Charlar 9(commencing
wi[h 5ection 7000) of Olvislon 3 ot the Business antl Professions Cotle, antl
my license is in tu torce and eHect. ��� � D�
License Class ice
Dale���yT__�—�' Si9nature �
WORKERS' COMPENSATION DECLARATION
1 hereby aflirm that I have a cerHlicate ot wnsent ro selt-insure or a certificate
of Workers' Cqm atian In�u n or a certifietl copy thereo( ($ec; lon
3800, Lab. C.' � 4 � /0 P�_� '. c`�—
Policy No. Company�rG
8 Certi/ietl w is hereby furnishetl.
Ce tifietl apy Is filetl with the Ci��.Bu' in is
Oale�=%� AOP�icant � y�( _
E%EMVTION FROM WORKERS' COMGENSATION OECLARATION
(This setlion neee not be completetl if the permit is for one nuntlretl (5300) or
I¢55).
I certify tnat in the per(ormance ot Ne work for which this permR is Issuetl, I
snall not employ any person in any manner so as [o become subject to tha
Worker5' Compensa[ion Lawi o1 CalifOmia.
�ate Si9nature
NOTICE: If, atter making lhii tleclaratlon, you shoultl become subject to the
Workerz' Compensation prOvisionz of the Labor Cotle, you mu5t fOrthwith
comply witn such provisions or this permit shall be tleemetl revoketl.
CONSTRVCTION LENDING AGENCV
I hereby aHtrm that there iz a construction lentling agency /or the pertormanca
ot the work fOr which [hi5 permit i5 i55u¢tl (Sectlon 3097 qv. CJ
Lentler's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION '
1 hereby ailirm ihat I am ezempt from the GonVactorY �Icense Law for the
tollowing reason (Section 7031.5 Business antl Pro�essional Cotle: Any city or
county whith requires a permit to <onstruct, alteq ImOrove, tlemolish or repair
any sirutlure, prbr [o Its issuance, also requires the apP���ant lor such permlt
[o tile a signetl statemen[ Ihat he/she is licensetl pursuan[ to tne provisions of
tne Contractor's License Law (Chapter 9(commencin9 wi[M1 SecUon 7000) o(
Division 3 oi the Business antl Professions Cotle) or tnat ne/she is exempt
there/rom antl the basis for the alle9etl exemption. Any violation ot Se<tlon
]031.5 by any apPlican[ for a pe�mit SUbjects the appli<dnt to a civil
�enalty oi not more than five huntlretl tlollars ($500).
LJ I, as uwner o( the property or my amployees with wages as thelr sole
compensation, will tlo Ihe work, antl the structure i5 no[ inl¢ntletl O� o(fer¢tl
for sale (Section 7044, Business antl Pro�essional Cotle: Tha Contractor's
Lic¢nu Law tloes not apply to an owner of a properfy who builtls or improves
thereon, antl who tloes such work himsel(/herself or through hls or ner own
employ¢es, proviaea that suth Imo�ovementz are not Intentletl or otteretl for
saie. 11, nowever, the builtling or improvement is soltl wlthin one year of com-
pietion, the owner will nave the burtlen ot proving he/sh¢ a10 not bulltl or im-
�rove for the purpose at sale).
I, a5 OwnGr Of the prop¢rty, am exclu5ively contracting wlth Ilcenzea con-
traclors to <onstruct the project (Section �044, Businezs antl Professions Cotla:
The Coniractor'S License Law does not apPly to an owner of pro0erty wno
� builtlz or imOroves tM1ereon. antl who confracts for such oroiects with a r.on-
t�actor�s Lcenze putsuan[ ro[n¢ ConVa<to�'S License L.aw). I dm dware thdt
proof o� [heir Worker'S COmpensatlon Insurance Shoultl be provitletl [o me.
❑ I am exempt untler Sectlon B. & G. C. for this reaion
Date
I b¢/¢by certity t
information Is corr
dOtl Stdl¢ IdWS lEld
Senlative5 Ihis
insp¢ction
Signatur
Drivers' License or
0865-46, rev. 5/88
Owner
that the abova
mty ortlinances
mlhorize repre-
I orooertv tor
R�g��3 I �c�`��l�l
TYPE OF CONSTRUCTION NEW aDD
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLOG. —
TERATION
TVPE OF PERMIT LJ GRADING LJ FOVNDATION YLjI STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5(i. FT. OCCUPANCV
CONSTRUCTIONTVPE � ��TT��'L�=��^�-�LUATION$�[
��'_
ZONE GRA�INGCU.VDS. ACRES_
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Serviee
Interceptors
Kitchen Sink
Lavatories
P-Trep
Roof Drains
Reinspection Fee � $15
Duct - Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact Blt. ICBO #
Heating System & Ducting
06100,000 BTU 0100,OOOBT
Heinspection Fee � $15
Whi[e - Bulltling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Weter Service
Auto�Wash
W undry Tra'ys
Issue Fee
Hoodor Typel ❑
Canopy Type II ❑
Refrigeration System
06100,OOOBTU ❑100,000
System Repair/Alteretion
Fire Dampers
Registers
laue Fee
.P. �W •—
S Main Building:
n E
_ T Front
— A Rear
— I C Right
SLeit
� Ping. Ref. •#
Planning Notes;��
ES Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
- Switches
Garbage Dispoul
• Generator DO-5 KW C
0
��ri
- Zone
Accessory Building:
Z
O
�' N
I
� N
G
i R
Parkin Req./Provided � E
�
� M
T
S.
ELECTHICAL
Trensformer ❑ 15-50 KW
❑ 50+KW
5KW
I Heinspection Fee ! $15
$ 3 PEVELOPMENTSERVICESRE(y
Zoning,APVroved BY �i
FEES .Building Approved By
_ APPliration IssUed BY
$ 3
Meter LJup to 100 ampi
Meter ❑over 100 amps
Sub Panel '.
Motors00�1 HP�1'f.-8
Inc.Solar 09-15 HP �16-15+
Miaowdve ."� -
Pole Light '
Fange ,
Standing Sections
Trash Compactor
luue Fee
FEES
$ 3
SU�f�) VAEFEES
BUILDING PERMIT $ /'� •SMIP $ �-�
'-PLAN CHECK $ Z 4� PERMIT
PLUMBING § ISSUANCE $
� PLAN CHECK 25% $� ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ �.�Lj
MECHANICAL $ TOTALFEE $ �L 1=
PLAN CHECK 25% $
0100033912-0003391m TGl' S29.00
DRTE: OS/2b/89 TIME: Q3:59
•. . ., . .. . .. . _ . ..�.. . . , _ ... 4 � !, -� �. w: v , _ _ , . v - s.: , _...�- � .. , . .
' PO4� & SPA
�' CONSTRUCTION AND PLANNING
� APPROVALS Permit # Date,, Inspector qppROVALS Permit # Date Inspector
r'
�;� 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location '
I�. �. � n
! 2. Soil Fipe-Undrgrnd. ��; � 53. Steel Reinforcement ���
/ 3., Electrical Conduit Utility-Undrgmd. ,� 54. Forms -�
4. Electrical Conduit-Undigrnd. � 55. Electrical Bonding �
5.� Steel Reinforcertient :- �' 56. Rough Plumbing & Pressure Test i n� �
6. Electrical UFER Grnd. , 57. APPROVAL TO COVER-GUNITE �
7'. Footings ✓, � �� . 58. Electrical Conduit-Undrgrnd. �
8. Foundation ' '. � �� 59. Gas Pipe, O Undrgmd., Test ��� �
�
9. Watei Pipe�Undrgrnd. � . 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 1�1 i, 61. APPROVAL TO DECK
11 �Property Sewer��Line & House Connection • , 62. Backwash & Receptor-Final
12'. Sewer Cap �� -_ � _ 63. Heater & Vent-Final
13.-Roof Drains t 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
1�8! Rough Elec[rical-T Bar Ceiling � 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditionirig FIRE DEPT. REQUIREMENT
20. Rough Faaory Fireplace ' APPROVALS Permit #
21. Ducts, in Structure • 70. Underground Hydro
22. Ducts, Ventilating , ' 71.�Product Piping OGas ❑Oil
23: Gas Pipe-Rough & Test . �'� 72. Underground Flush
24. Roof Framing i73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structuial) & Monocoat 75. Dry Chemiral
27.. Fcame 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 lb to � �. •
35. Final Gas Pipe-Test )
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing
39. Water Seivice-Final ' - �
40. Gas Service-Final %�
41. Solar pomestic-Final �
�-
42. Backflow Preventer ' •� 1
43. Backflow Irrigation - � � ' ,'
44. �Landscape Irrigation System
45. Sound Attenuation • - , , �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 7 �
48. Spec�ial Requirements Completed
49. Electric Release to Edison � i
.�
I '50. Gas Release to Southem California Gas Co � ,��
{� 57. cEanFICATEOF_OCCUPANCY •
� No. Date L .. , .
- ' ! -
' p:
�
i-1
�oonessaem�mn: 555 ANTON BL
avxexsraw�eiriww/r+: SAKIOKA FARM5
•"p°�'', PO HOX 2097
, 'TERMINAL ANNEX
AYPL.1WIllW AODilE53:
uxr: q TH
�xcxn�cTox�aN�x: INTERIOR ARCH.2136232164 ��� C-9378
�op�'s�� 550 S AOPE ST �NT 1100
L.A. CA 90071
cor+m�aarswue CAL-PAC CONSTRUCTION ( 310 ) 645-3500
c������ 6076 BRISTOL PARKWAY
�o� CULVER CITY CA uara: 392102
90230 uxi: 106
LICENSED COHfRRCTOFS DECLAHATION: I laeeby tllim undm per�ely d pnjuy Ntl I un lim�mtl �mder prom'vis d Cheqm 9
(oommerwin0 xnh SacYan ]000) d 0"rvivun � W IM Buvirrom enC Pmleaaiom Cods, and mY fmme o in IM brca enE afled.
cmuc.No.: uacuss: H�°�' �^?1(`[ �:XPq z�/
Dma: �O/�3�7 � C �i�'
� WNEN BUIIUER �ECL�PRTION: I he�eby dfirm wder pe�ely M �Mt I em azsmq Imn ihe Cpuretlon licmes lew lar Me
bxig eaemn (Setlon ]031.5 Bueiq�s vd Rdwo�u Cada: AM uY w eavYY MiN n0�uu e De�u to mnNG. e4x.'vnpo+e.
.emd'sh. or npei my et�uciure, prior m ea eauence. ebo a�u"vm �te epplium ta wN pmnE lo fle a eq�wE etelematl Net M a she
�. i�e w�� m me v��«�+ w m. comrea«. ��.e �. �Cheqm B(cammendiq wil� Setlion JOW) d Owaion J d ih
Buvmm vd Prdeaum CaEel a ihel he a�he a uemq �Mrelmm enE �M bam Ia Uw elleped ssemplian. Mf'violdon d Satlon
)03�.5 by e�ry eppYunl la e permil eiApaa tM eppli�aru ta e ad peneXy W nol maa Ihen �Ha huMred AOWn �5500�.
� I.movmardlMpopeMamyanpbyeaewiAwepeeuiheiwbeompenaalbn.willEolM�wrk,eMNeneueiun'snd'mieMed
imP��Wa us nd weMstl a a11enE fa eeM. o. lawever. iM duW�q a in0�+��em u wtl x9Nn ona Ymr d mmD�ion. Na
ow�wrbuiNx MA heve iM WNm d pwiip M a dw diE ml WJE a impaa In �M purpwa W edsl.
(J �. m mvnm d �n. wweM. am a.tlutivN� mmreano �.nn �ioenmd cm�mcias ro mimvue ine wdea (ssnion lou. an'viess em
Z Pmleadw Code: TM Capream Lirorce law Eoes np yply b en oxm d popMy wM butls a inpwa ihseon ud r.fio
{ comreda M euN Y4ees wuh a�tretlor(e) 6cmaW WnueM lo IM CoMretlds limme Lew�.
Q I an exemq uMer Secuan: B. d P G.. br ihis reeeon:
DAa: Owrw
I do hareby cMM �hel I em awere d eM uMersleM IM reyuiremsMa W CelAomia Vbellh eM Selety Code Sediom 25505. 255�.1, erA
2553a. vM ihm I«eiry Mure Wikirp oowpent will / wil rid (arcb ore) need to comyy wIh eeiE dme ooEe� enE ihe rapuiremams for
e OamY lacan4uciion a moddrmionhwn ihsA'rawTiyl.iwpemeN Dipnd. ReeNerual mmvfun eGv�iomeraaasmq hom Ilwae
pwisiana.
Dms: ADd�:
WOFKEN'S COYPDIS�TION DKLARATION: 1 MrMy elfum wdar pxu4y d perjury ans W iM IOAow'uq dderei'nu:
❑ I heve aM xil maintan e cenifrate d mneeni to vall.inwre br xvrkers' compenutian. ea providad Iw by Seeion 3100 N �hs Lebor
Cotle.lw ttn pa�lamerce d tha xak la w1icA �hie paimn is IouM.
f] i n�.�a .a �m.:,.�o�+�a.'�w��, ��... �.a�we M sw� a�ao d me i.eo. cod.. ro. me o«ro�m.� a me
work Iw whitli Nis permil iv u�ued. My wokere compenealion iraurence wrix uM pdiry numEm ua:
pv�ier; FTRFMTit.j�c Fnntn EXPIRES
PdiryNumber. vuro Al1SQG.A77 02/01/96
�rnr: s«vron �eed na w�wno�ed � rn. o�R �+ ro. orie nunei»d ew�en Isim� w baa.l
� I cenh' �hm in Ihe pa�oimenca d �M xroA br v.fich Ihb pertnX n inued, I ehdl rot omplry e�ry peiron in eny menner n ea to
bewme wbpd to tM xahrs' wmpsnwion kvn d Cdilwnu, uM epree Ihel il I� M E ms eubjea io i xw/sa'
mmpenaetbn prwienm d Sedion 3]00 d Ihe lebor Code, I WI �tMmn xi�h o
/s� /' /
oeia:! ��c3�4 ts� nooikem: � -
�
Wemlrp: Fellun ro ue�ro woA'en' eon�vxu�tlon rowrap� Is un wNl, �ndLrll wb/�cl �n wmployw fo er/Mrul psnaMw eM
nvu nnu w ro on. n�mdr.a mouwr�e eai... (a�oa,orol, �n .eeiaon ro m. ewi or mmwrw�an, am.w+ o wov�wd ro. m
3wtlon J�OS o/ tlis LMor COW, InNrul, enJ ettornsy i ls�a.
CONSTRUCTION LENUINO �OENCY: I Mnpy dfrm �Mm penelly d perlNry �hq �M�e u e canY�ud'qn brtli�p epem.y la �he
pertormaKe d iM �w�k In x}iich �hc peimY h esued (Seaion �Ogl, C'v. C�.
LENDEN'S NAME:
LENDEF'S sDDRESS:
I eerliN IM1ai I hars roeE Ihia epplcetion eM etels ��et iM ebove inlame�ion ia eartd, l eprte lo eomPN �h NI fiy end evuny oNiewwee
arM ele�e bvn rele�in9 �o buildvq conalruclion ud heroby aNlwrize repreaemelivea d Ihia dly lo enla� upon �M ebove�menloned pioperly
�Of1119p0tlIO11pYfpMB9.
/1� i 3 �13
� � ���� ome: lD �3 �'i �
Sgralure d Ownu//penVRppf1nnLGmlrapa
(S�St46 WP) Whne-BuiNiq 8 Selery: GreerFb: Cerary-Appiran; Nnk-Rs.enue: (bldmmb-Na»v
CITY OE' CO5TA MESA - BUILUIN� PERMI:T
PERM NO: B 074571
PERMIT NO: B 0"i4571 PLA�1 CHECK NO: 03715-95 A GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 20,000
CLAIM VALUE: 360,000.00 CALC-VALUE: 986,400.00 GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS
3E iE 3E it 4 iE iE iE ir �E 1E aE iF � iE 3E iF iE tE k 3E fE 3E jE 3E aE iE �(-iF 3E �1F if iE iE iE aE 3E * aE iE iE # iF iE-IE iE �E it 3E if iE iE iE i: �E iE �t it±E iE ie iF iE tE tr iE iE iE iE;E k iE jE 1E iF�E iE iE jE
Z O N I N G R E Q U T A E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAF2: FT IN
LEFT: FT � IN RGHT; FT ZN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 9.1050104 ZNE: PDC REF NO:
PLANNING NOTES> T�NANT IMPROVEMENT TO 4TH FLOOR FOR 76 PRODUCTS COMPAI�Y
� i • i ' "
iE �E 1F iE �IE fE iE'rE �)E �IE iE 3E IE iE �lE �IE .+�, �)E iEic 3E iE iE iE iE iE-ii� iF if *�7f iE i(-?' if� if �k?f 3f iE iF ik iEx iE �)E iE �)E iE iE 1E IE 1E If iE ik # 9F 3E iE iE iE iE 9E �E �1! if 1E iF�f �)E �IE?E 3E 3't iE �E jE �!-
D E V E L;;Oip M E N:T S E R V I C E S R E Q U I R E M E DI T S
; ,.. �./
ZONING APPROVED HY : �.� DATE: �JI�S/Jls�
BUILDING APPP,UVEq� BL' : ��fI�G-�_ DATE: �O�l3�%S�
I � J�/�
APPLICATION I.S'Sf�-EDiBY; �, �i�v/ DATE: !� �3�/�..5�
*�cit+�***�*��ir**#' atxa:x**�i �r�";F��,:l.'.—�n-,��y,��T. ,�i�� �ra *x�**+t*****�'R� . * �*
LEGALIZATION:N F E E S U M.' A R Y STRUCTURAI, SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,644.00
,. SMIP/NON-RES
PLAN 267.15 81.14
ISSUE FEE �•
BUILDING-UIV-> PERMIT ISSUE PLAN�CHECK TOTAL PAIll DUE
TOTALS----> 1725.14 0.00 -267.15 1992.29 1.992.29 ,00
REVEDIUE DIVISION TOTALS--> COLLF.CTED: 1725.14 06'ER/SHORT: .OU
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
1644.00 � 81.14
�� w', i
iF iE iE' iF dF?F 1E iElE iE iE 3E iE 1F iE fE �F 3E j'r iE �E iE iE iE �E if ielE iE !E 1E if iF iE ff If if 3f.iF �f iE iE 3E 3k iE df dE iE jf #if iE iF iE jE if aE IE 9E 1E fF 1E iE aE jE 3E 3E iE if jf 3' if iE if if iE ik iE iE
I N D I V I D U A L -F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF-INT. ALTER TYPG�L;II F.R. -AVER 18.24 364,800.00
SFC 2.0000 EQU-ALT COMM. SPRINKL"ER SYS -AVER .36 7,200.00
SFC 20000 EQU-ALT COMM. AIR CO�ID, -AVER .72 14,400.OU
ENd� OF FEES
ll l'115- jt:ta��Eh Y._;T. :,— 1�
17.��f< .� . . '7.C; � .�
. . •�_
✓"
CONS7RUCTION AND PLANNING � w � -$ SPA
� APPROVALS Permit# � Date Inspecto� qppROVALS Permit�h Date Inspector
+1. Temporary Electrical Service or Pote 52. Pool & Equipment Location � •
2. Soil Pipe�Undrgrnd. _ 53. Steel Reintorcement .
3. Electrical Conduit Utility•Undrgrnd. 54. Forms • �
4. Electrical ConduibUndrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plum6ing & Pressure Test �
6. Electrical UFER Gmd. ' 57. APPROVAL TO COVER�GUNITE �
7. Footinqs 5B.- Electrical Conduit�Undrgmd.
8. Foundation . � - 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. � � 60. Backwash Lines, P�Trap, Q Undrgrnd.
10. Structural Floor System � 61. APPROVAL TO DECK �
17. Property Sewer Une & House Connection &2. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & VenbFinal �
73. Roof Drainz 64. Plumbing System � Final �
74. Rough Plumbing • 65. Electrical�Finai �' , ,
75. Rough ElectricabConduit 66. Solar SYstem�Final •
16. Rough Electric Wiring ,. - 67. Fencing & Access ApProval . '
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling � � 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditionin9 - FIRE DEPT. REQUIREMENT
2D. Rough Factory Fireplace APPROVAIS Permit #
27. Oucts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Unde.ground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead HYdro
26. T�Bar Ceiling (Structurell & Monocoat //J�//6 � 75. Dry Chemical
27. Frame and Flashing �/lf�� � 76. Dry Sta�dpipe �
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation ..' 78. FIRE PREV. FINAL
30. Drywall Nailing I/J i6 �. HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � ' 79. FINAL INSPECTION
32. Electrical Power MeterFinal ' ' 80. FDOD CERTIFICATE ISSUED
33. Finai E�ectric Notes/B �L`� ,��"
P�� 4r_ �� /���w''``'' .�De�70
34. Final Heating & Air Conditioning ���/ /L�is�'i��-�J •
SG� �`� �/
35. Final Gas Pipe-Test •
36. Hood or Canopy . •
37. Final FactorY Fireplace ,
38. Final Plumbing ' .
39. Water Service�Final ,
40. Gas Service-Final
47. Solar pomestic�Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
' 45. Sound Attenuation
46. Handicap Regu4ations .
47. FINAL STRUCTURE & BUILDING ��y �6 ;
48. FINAL PLANNING ,. �
49. Electrie Release to Edison � . . '
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
'��p��8��� 555 ANTON HL
ox'wu+'sr�F�F�aw": SAKIOKA FARMS
�op� PO BOX 2097
TERMINAL ANNEX
��� 4TH I CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 076189
PERMIT NO: B 076189 PLAN CHECK NO: N GOVT: N SUPP: N
����^10"0°"� CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
urcxRecrone+m��nn: INTERIOR DESZGN 213623218��= 9378 JOB DESCRIPTION . INTERIOR 200005F OFFICE T.I. SQ FT: 325,000
�xcx.onrw•s�no�ss: 550 5 HOPE ST ��+T 1100
L.A. CA 90071 CLAIM VALUE: 325,000.00 CALC-VALUE: 339,625.00 GROUP OCC: B /
wwrx.eTare ru�:
CWIP1CfOR8YYlCq *�***�a�**�*r***�*�r*���*�*****�******+t+it********��*k��t****B****��*�*�*+t*�*�***��*
�nonEss: uc. no_
uKr: Z O N I N G R E Q U I R E M E N T S
UCENSED COHfRRCTON4 DECL�N�TON: 1 MrWy allim vqx paeW y o1 pa�rty pp l en fcmud �mdr pwA�'vs d Cheqr 9 S E T B A C K S
(wmms^dM xnh S�ctim ]000) d Oniaion 3 d IM Bu�ss W Pmla�bm Cods. ud mY bmw u m fu0 Mca mtl dlxl.
emuc.No.: ue.euss: uc.No.: EXP: ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
ome: �� FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RG[{T: FT IN LEFT: FT IN RGHT: FT IN
VNEF BUILDER OECIAPATidI: I haaby Num ivds pauly d pmjvy IIW 1 cn avnp hun Na Cp�tntlon llw'r� Lew ta IM
ow�r�e�(sea��w+sewow�eaw�coes:/Nvrtv«miwywn��o�a�ei000iewn,aner.uopow, pARKING RE(j: PROV: PARCEL: 41050104 ZNE; PDC REF NO:
ouwwdW eni�iMp�ovuwam.c'�''ram.lmn.l:��c`0°�imp�rs(m��ma�y"wen's:a�mi000�w�.'e�'�on3�or��: PLANNING NOTES>
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WONKER'8 COYPENSATION DECLIN�TION: I MrW/ �M'm ukr pwW y W pMuy vr N Ow Io0ow4q dw�u�tbm:
❑ IhmuMx4melmen�a�nLhs�dmuwntoWl�Luunfarwk�n'comp�vetbn.mpwld�dlaby8�eiona]OOOI1Ml�bar
coa. �« ins o.N�. a m. »m i« w�n w. o� e ie�.a.
r] I hm eM MI mdnt�F wM�n' aomqiuuion inwru�o�. n rpW W by Swion noo d tM l�bw CoC�.lor iM pdormuw� N tM
work ta whirh Nb W� b b�wd. YY wabn' cvmW�ion Iwruic� urtMr atl W�Y wmbr a�:
Carr4r:
va..r r+�me.:
(m�,.enw� n..e iwr e. cm,WMW, u» a�r u a m. nunm.a em.n rsiaul a Ms.l
❑ I oenly Net In IM pMamuw d tM wk br r.fikh Ihb pem�b o h�uW. I Ne! np �mpq ury p�mn In ury memx c m Io
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canWNtlbn Drovbioru d SWbn 9]00 d IM lebor CaM. I tlull tanM1W� wmW Wh Ycw pewWau.
�ela: Aopfrsm:
Wemlrrp: Fdlun b�.eun wrtn�'rompxu�tlon rov�nq b unbMul, �nA�IWIWbJIct m�mplqr M ulMn�l p�n�Mu �n0
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9.cuon �ro9 0� n. tweor coa, �m«..t .ne.rtemy. r....
CON9TIIUC110N LENDINO 10ENCY: I hasby tlfi�m �ndx paneRy d pm�ury IAtl IMn u e meM'utlion IsMirp epenry br iM
parlorma� d IM wk M xAkA �h's D�i u iwsd (Swion 3W1. CM. CI.
LENDEfl'S NAME:
LENDEN'811DDNE99:
1 csNN Ilw I hm neE No eeWieetbn eM qns �An tlro ebow'udamNion e emw. I VM to eanVN xilh e0'YY end muirtV ad'vienw�
eM eleta laMe roWinO �o �iWip cotuVudion aM Mreby aNhot¢a npwnlevns d Iltia dly b�Nx upan IM �bwa�menlunaE propeny
IaimpeCion purpoeaa.
ERNIE VITUCCI
L Pnm Neme�} /y��
'�wrLJ.� �i • � J �t�.-�e�: Ome: i Z is
Sqrimurod /�penVAppiraWCaureqp
(515t.48.WP) WAn�BuildipdSefary:Oreer�Fb:Ceiwy-Appiranl:Rnk-Wnnus:�ddenro�Neeuor
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N.-T.S
ZONING APPROVED HY� DATE;
BUILDING APPROVED BY : DATE: ,I
APPLICATION ISSUED BY: V DATE: ��-�o r1ie
If1FIFiFiflFiFiFlFif7FiFikfEiE1E1E1EiF1l1EiE if1FlfifiEiEiFififif�iF�iE� iEiE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
f'
BLDG PMT PLUMBING ELECTRI�C MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,479.50
' SMIP/NON-RES
PLAN � , • 71.32
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 1550.82 0,00 . 0.00 1550.82 1550.82 .00
REVENUE DIVISION TOTALS--> COLLECTED; - 1550.82 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
1479,50 ' � . 71.32
iE ib 1E 1E iE iE iF if i! 1E 1E if if 1E iE ik IE 1k iE 1E 1F iE 1E 1E 1E iE iE 1! iE IE 1E IE k iE 1E 1E 1E 1E iE 1f 1F ib 1! iE 1E if 1E k IF �f ik iE if 1E If 1E k 1f 1F IE If fE 1E fE It iE 1E iE if 1f if 1E iE 1E �k if k i! �!
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N_ UNIT COST TOTAL COST
SFC 325000 T.I. OFFICE BY VALUE/$1 1.00 325,000.00
END OF FEES
� f l_.1 ' - - -
CONSTRUCTION AND PIANNING F _& SPA
APPROVALS Permit # Date Inspectoi qppROVALS Permit # Date InspeEtor
1. Temporary Electrical Service or Pole '52. Pool & Equipment Loca[ion
2. Soil Pipe•Undrgrnd. 53. Steei Reinforcement
-3,, Electricat Conduit UtilitV-Undrgrrtd. 54. Fu�ms
-4'.. Electrical,Conduit-Undrgrnd. 55. Electrical Bonding ' �
•:5. Steel Reinforcement 56. Fough Plumbing & Pressure Test '
"� s' Etectrical UPER Grnd. 57. APPROVAL TO COVER•GUNITE .'
•...�. F.00tings - 58. Electrical Conduit�Undrgmd. '
� 8. Fo�ndation 59. Gas P�pe, O Und�grnd., Test
9. Water Pipe•Undrgrnd. � 60. Backwash Lines, P-Trap, � U�drgrnd.
70. Structural Floor System 61. APPROVAL TO DECK '
i t. Property 5ewgr I.ine & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap. ' 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System � Final
74. Rough Plumbing � 65. Electrical•Final � -�•
15. Rough Electrical-Conduit 66. Solar SVstem-Final
16. Rough Eleciric Wiring 67. Fencinq & Access Approval
17. Fough Wiri�g Sign 68. APPROVED FOR P�AS7ERING j
78. Rou9h Electiiral�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Hea[ing & Air Conditioning �.. � FIRE DEPT..REQUIREMENT :,
20. Rough Factory Fireplace _ _ � �. � APP�jOVfZLS Permit # - _
21. Duc[s; in_Structure � -' �. «�� 70. Underground Hydro
22. Duc[s., Ventilatin9- �� ';- � �„ ' � r`� 71. Product Piping 06as ❑ Oii
23. Gas Ripe•Rough & Test � - � ,' ' �� 72. Undergroun� FIUsh ' _
24. Roof-Framin " ' - ,
9 � - 73- Undergrnd. StoiagQ 7anlaO Gas ❑ bil
25. Roo{ Sheathing _ ' � �� 74-: �verhead Hydro .
26. '��Bai Ceiling (StrqRuroq & Moiiocoat /a_�l_ � � 75_ -0ry Chemical _ . �
27. Frame and Flashi� �. .;., : ��� �,� 76. Dry StarMp�pe ,- - �
- 28. Lathmg $�.Siding ` ;. , , � �� 77. FIXED SYSTEM•FINAL �
29. InsuFation� � _ • � - 78, FiRE PREV. FIN71L '
' 30. DrywallNailing " ��fa y��� _ HEALTHDEPT.�REQUIREMENT
_ 31. Plaster Brown,Coat r �� �-� � • 79. FINAL INSPECTION
�
"- 32. Electrical.Powei Met�rFinal � '� B0.` FOOD CERTIFICATE ISSUED
33. r�nal,Electric,: _ + *. � � � Notes: - � � � . �'
' 34. Finaf�Heating� Air Conditioning , _ � '
_ � ��!? 9' �� ( �� `%_l� = _ -��
35. Final Gas Pipe��est . - _��� �
36. Hoodbr CanoPY :,: t " � - ' , �p�. � - ' _ -
�J•'�
- 37. Final�Factory Pireplace ;; . - � r: � - . .
' Y
'.38. FinaF'Plumbing . � _ �. ' , a� .-_ - '
39. Water Service-Finak,� . ' . ' � �
?40. GasService�Fihal � � � • - " �
41. Solar OomesticFina(� ' - ' `
42. Backflow PrevenSeF'> r„' _ - _ - •
�._ . .
43. Backflow Irrigation , ,: -' ' , . �� _ ,
44. Landscape IrriGatian'System - ' ` -� '= '� � �_ `_- �_ ; �
45. Sound Atienuation ` ' . r , ,-� . _ .
- r•
46. HandicapAegulations -� � / / _ � • =�
47. FINAL STRUCTURE & BUILDING �1�/O� _
��
48. FINAL PLANNING" - �
49. Electric Release to Et7ison , � -'�
50. Gas Release to Southam Califorrria Gas Cn '� - "•
, -
51. CERTIFICATEOFOCCUPANCY '
No. Date
�I
7I
noon�ssa eunaxa:
wme.asraYeiviwonm: S
AOOREA4: p
�vx. wuiwc,wo�ss:
ANTON BL
A FARMS
X 2097
AL ANNEX
uHr: 4 T H
�xcxirecron�ax�xx: INTERIOR ARCH.2136232164 uc.r+o: 9378
ApCII OX FNd'S �11DPE55: S S O S HOP E S T uxr: 1 10 0
L.A. CA 90071
wxm,�crarswu� SWINERTON 6 WALBERG ( 213 ) 896-3400
cartnecions�uva 865 S FIGUEROA ST
�oo�ss: L. A. CA �,�p, 9 2
90017 uxr: 3000
110EN5EU CONTNACTOflS DEC4flAT10N: I heieby aflim uMs pMe�y d pee"ryry Ihm I am IironvsE �mder po.nbm d Cheqm 9
lmmmena�q wil� Seclbn 1000) d Orvisian � W IM Bux�wae eM Prdmewne Code. eM mY �� b m tull lace enE eXetl.
cmuc.No.:U46279 uc.cuss: H u. . 2� + _' P: 1�/95
om, �, 0• 26 � g� ���
WNEF BUILDEP OECLAH4TION: I Meby elfrm uMr perely d et I em ewnq om i a Cam�rfon Licems la Ne
bvnq ianaon (5adian ]mtS Buims enE Raleasbm COEe: v.hiN �q o�Y lo aoramn. eAer. �mpa+.
nmdeh, a repei eny nrunure. qv �o Ga eauerce, alao reQuins IM ep imnt la wch pe�mn e ayrod otetemeM Nel M a�M
e licenad pmuw �o iM pror�io'u d Ne CaLLretlan Licmae law �CMpa 9(wmmenmp wuh SWion ]OpO) d Divuion 3 W Ib
a�. �e rra�o�o coe.l « inm �» «.ns m�ma �ne..i.om e�e in. mm i« m. m�e ��q:�. wrv .wmo� a sea�
)031.5 W eiy eppli ent lor e pmmit wbptla the epqiceM lo e dvJ peneAy d ml mas �Mn IHe hundmE Edlen �5500�.
❑ i.a,ox+.ea�neww�r«mr.mNw«+w�nwepmea�n:.d.mmw�wia+..a�eomexwx.enau,ea�uen,nem'vaeM.e
u oflareE /a sab Iser,iun )pu.8uaron erd Prdaarom Code: The Comrmon L'rrue lew doas ra epply io an oxm d peopMy
who WNe a inpone tAvaon. md Mn Eom eu� �oek Nmaetl a MnN a IMaph he a her mm+mNq+ss. qa'� �het wN
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ownariwtler will Mw ilw bu�den d G�'�Y M«+he did na buiN a impa+l« iM wmm� tl ubl.
❑ i. m o.,w. a m. aav«n. ���+N �mrea�a �•;in i�.ee �,v=w. ro w�aw me o�da cseao� �a�. ew�. �e
wn m
Pmis�aie Code: TM CaNretlaa L'can+e Lew tlw rwl appFy w en oxm d popMY � bwk� a impww Ihenm enE Wa
convecb f« wN nd�+ ruA a mmemMa) Icenxd wn� m �he Caqreene lic«ue lewl.
� I em uemp unEer Seaion: B. 8 P C.. br Ihn �aewn:
Daie: Owner:
I do IweW cenJv tlW I em ewere d ud �mde�aiaM ths ram�iremmb d CelldMe IlsaAh ud Sdatv Cods Sen'vu 2i505. 25i11 eM
WONKEfl'S COYPFNSATION OECLARATION: 1 Mreby elfum wdr pwXy d pejury w d Ns IaOowiep AWumom:
� IheveeMwilmdNv�acenifwadmroaniioedrnanlorwken'cpnpsnwian.mpwdeAtabybeaion3)OOdtAsleEv
Cotle, la iM perlmre�Ka W ihe wk in w1Ych Nn pe�mii n ivued.
r] � new ene.0 meimo�.Mn.� oomv�� ��,,.rcx.., i.car.a w seeian sroo d m.leeo, wa.. m. m. w�«m.iw. a m.
wwk iw whidi Mie paemil is iseued. My wvFen' ewnpenW bn inwrenee eertpr end pdic/ number ue:
c�«: ARGONAUT EXPIRES
PdiryNumEer: Wl. h7 70�L1V774 OS/01/95
�rne ma� �e �a a. amawsd r� w�� n ro. o� n��wroe em.,.lsioul w�,.�
❑ I emlh � in N� perlomienee d Ihe wM Iw xfikh I�o permn I ueuad. I 4WI mi emply� arry peevon in ury m�nr eo d lo
beconw aqaa to tM xorkme' canpnuiian lawe d C' ' erM O�es Net ! I�I� ul b onr wEjw io tM w�keis'
compense�un pl�miei n. o Setlion 3i00 d �M leEot COEe, I Mel �m u eionv.
Dme: / ' ApplirenC
WemLrp: Fellun ro s�c�nWortsn' eorrpwu�tlon rovuep� I� u I� I, M�lull /M an loyer ro ciMY p�n�ltlu �nC
clvll fl� ,q ro om hurJrW fhouamtl Oo/4n (S10qOP0), M• n • ro�l ol mp tbM1 0arrrpu � provMN br In
Sxtlon �]O6 0/ Ihs LeDoi Cods, Interu( m! ettomsy'� lsu.
CONSTNUC110N �ENDINO 1GENCY: I hereby �em uMe� penetly d parFNrY �he� Ihen o a eone�iupion bMiip epenry la �M
pertoima�m d m, xwx �« .nim ine w�� �. aww (swion �, crv. c1.
LENDER'S NAME:
LENOEH'S RDDPESS:
I cenity ihe� I heve read �hia epplcetion eM nma Ihet iha eEwe inlormaion ie rn'red. I egreo to mmpN �� �I cny arM caunry ordinencee
eM slate kxs mklnp W Wikvp wnetrutlion arq heraby aiRMriis npaeentuivee ol thu ary to omer upon iM eEove.menlionetl prapeM
IOf iR9Px�lOn VufPoses. .. � .. ........... •
(Si51
om.: l �� u-`1�
8 SefetY: ���-Fle: Cenery-Applrini: Rnk-Revenue: Ookenro�Aessvor
CZTY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 074700
PERMIT NO: B 074700 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLP.IM VALUE: 20,000.00 CALC—VALUE: 20,900.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS PREP FOR TI
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- — ------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING N TES>
' ; .
*�r��****�-�t�rtx�x-**�#ac!3�******•ita�**i�*****i�**�x-i�*******�*******�t�*****+�****+t��**f�*�x-�t**
D E V E L O P'M E Nj T S E R V I C E S R E Q U I R E M E N T S
�f r �T
ZONING APPROVE6 BY •" ' DATE:
BUILDING APPROVED-HY�:
APPLICATION ISSU�D.BY:
iE iE iE iE if iE iE �E fE �E iE iF iE # IE'1E�E �1E3E iE 3Ea1
DATE: �
DATE:10
LEGALIZATION:Y F E E S U M M A R Y STRUCTURP.L SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 932.00 �_ _
__ SMIP/NON-RES
PLAN , ` ._ 4.39
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE
TOTALS----> 436.39 0.00 Or,Q.O 436.39 436.39 .00
REVENUE DIVISION TOTALS--> COLLECTED: , 436.39 OVER/SHORT: .OU
BLDG PMT PLUMBING ELECTRIC MECHANLC FIRE SMIY/TOT GRADING PLAN-CHECK
432.00 ' , 4.39
iE if �E IE �f iE iE iF 1F iE *!E iklF fk �k iF iE 1f itl6 if iEl6 iE iElk jE k!E iElE iE iE dE iE �E iE 9E iE iE 1E fF�iE iE 1E iE 1E IE iE iE iElE iE if iE iE if iE i! 1E ih if ik iF fE !f j' fE 3f if iF it iE iElf 1E if if
I N D I V I D U A L .�F �E:E B R E A K D O W N
TYPE QTY D E S C R I P T I O N, i` ^ UNIT COST TOTAL COST
SFC 20000 DEMOLISH BY t,�ALUE COMMERCIA�L, NOZONE 1.00 20,000.00
END';OF . FEES
�. . i
. .+ 1
' 61 Op1S266:-�OI92670 'r+"1'6' a;S.�S
ns,T�: ia<<�,�-� rr��E: o;::::�
CONSTRUCTION AND PLANNING P' "& SPA
APPROVALS Permit # Date Inspeetor pppROVALS Permit # Date Inspector
`1. Temporary Electrical Service or Pote 52. Pool & Equipment Location � �
2. Soil Pipe•Undrgrnd. �: � - 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgmd. 54. Forms -
4. Electrical Conduit�Undrgrnd. ' 55. Elec[rical Bonding
5. Steel ReinforcemeM 56. flough Plumbi�g & Pressure Test _ _
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE -
7. Footingz 58, Electricai Conduit�Undrgrnd. "
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. " � 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Svuctural �loor System -'�. 61: APPROVAL TO DECK ,- ��
11. Property SeWer Line & House Conneccion . 62. Backwash & Receptor-Finalf
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - �_ _ 64. Plumbing System � Final "'
14, Rough Plumbing . "' 65. Electrica6Final �
15. Rough ElecvicabConduit '� 66. Solar SVstem-Final ; .
76. Rough Electric Wiring .� 67. Pencing & Access Approval '
� 17. Rough Wiring Sign -"� 68. APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ductt, in Sirutture 70. Underground Hydro
22. Ducts, Vent�iating 71. Product Piping OGas ❑Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) &�onocoat �3a/� � 75. Dry Chemicai
27. Frame and Flashing �/jp�� � 76. Dry Standpipe
!
28. Lathing & 5iding 77. FIXED SYSTEM FINAL
29. Insulation 78, fIRE PREV. FINAL
30. Drywatl Nai�ing ��6 � HEALTH DEPT. REQUIREMENT
/
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Ppwer Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Condiiioning I q �
!__ �_l. �� '
35. Final Gas PiPe-Test �( ��`1l ��, e
36. Hood or Canopy ' � t_ _I /lb ���
I "1
37. Final Factory Fireplace �
38. Final Plumbin9 .
39. LVater Servite•Final
40. Gas Service-Final
47. Soiar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45: Sound Attenuatipn
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING /�f ��/��
48. FINAL PLANNING -
49. Electric Release to Edison .
50. Gas Fielease to Southern Calitomia Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
�I
�oonasaemiaxa: 555 ANTON BL
ONNERSNiYEIFRlOWN: SAK IOKA FARMS
"00"� PO BOX 2097
TERMINAL ANNEX
�rr�. wmmo �no�ss:
UNT:
4TH CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 076190
PERMIT NO: E 076190 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1£R SP PERMIT TYPE: ELE PURPOSE: ALT
�xcxrtecron�awffnn: INTERIOR DESIGN 21362321B10N0 9378
�pCN.ONFNd'SAOOPE54: SSO S HOPE ST �M� 1100
L.A. CA 90071
WNIPACTqfS NA1�:
CONffl1CTORSY/JIMi
�OORESS IlG N0:
urar:
110EN5ED COMRACTOHS DECLAX�TION: I hereb� Nim wder perely d pamvy Nel I em IiroreeE udx prwtimv d Cheqw e
(commmarq v.nA Seciion )000) d Oiriaun � d the Buvm a eM Prdessona Gode. eM mY imnu o in lull lorce eM Ntw.
cmuc.no.: uc.cuss: uc.No.: EXP;
Deta: Corqbor.
' WNEN BUILDEN OECIARRTION: I hemby e�rm unEer penaly M perjury Ihal l em eRemq ham iM CaMretlrca Licaue law la tM
bx�q �sesm (5etlion lOJ1.5 Buanese and Adsesions Code: MyW a od+NY wfiitli �W Wd e G��! �o mmNcl. atlm. vnV�.
amds�, w repei mry roucwre, p'v io aa uwaMe, a6o repuina tM applicenl ta euch pm�M to Rb a agneE stetemem thei he a ehe
u �censea w�w �o ine wwtsvn d m. comrmon Lioame le. Icheps s(mmmmbno wun seaiu, �aao) a oi.eim a a �1r
Budrea eM Prdes�ian Coeel «�nm he v sM o e.emN in>elmm end �he beaa I« un e0eaed ssemqion. �m' videtion ai seeun
�wis W env mW�� io.. ro,mn w4�• me ecW�m m a ma v�n a na m«. men rHe nw,ared dmd. lssooll�
❑ i.mo.m«ameawamo.mr.maim��..�n�.�..ein.:.ae�,v��..adom..w�.�eme.wwn:mw�e
aMeradlorceb(Sectiani061.BusmuaM PmleesimsCode:ThaCamraGwslicereeLnwdoesnotapp�ytoenowiwrMpmpe�ry
wM W Wf a mpm'ea IMtam. md xM doas suei� xak Fimsetl a henN a tiva9� A'e a Mr awn emplWees. Pw'� �hel euc�
'unO��eMs aro na Wendetl a ollasd fm veb. tt. Irowawr. the buildiM rc inpmemem u vald xrhm aro Yeer d comddian. iM
��.�.,-nwd.,..ui nab in. n,� a o�w��ro na a.na eu oa w�e «�o�o.e i« me vwo�< a.ma).
i. m owb. a me ww«n. �, u��r mm�m:,u .an i:�.,a �o�wn w�nw ma waa �see� �a.. ew�,. �a
Piae.vm. coa: me comimo�s lsee�se la. me. �a wW w a� owner d a'waro wno wiw a�mpo.e+ ina.o� .�e who
canvcro tor wdi papda wuh a mNmtlar(a) �SemeE W�swM to tM Cawwas Liaue Lexj.
❑ i� �.�w �� e. a v.c.. i« ms �:
o�. �/ z 6%46 �„�, F,.��,i— 7, f, _
tlut 15m ewve d erd undwsiaM
a�.
W ONKER'9 COMFENS�TION DKL�H�TIOH: I Mreby alfirm under penel�y d psjury pw d IM Idbxi'p Eeifvelbm:
❑ I M1aw eM xi1 meiNen e caMicero W ootuenl �o aellimun la warkmi cqnpetuetbn, m ptwiEeE la by Satlian 3)00 d IM lnbor
CoM, fw tM pa�IwmeMa d tM work Iw wlich thia parmil u esued.
r] .in...�aw��ve:,,.�.•�o�mo������...�.m��enisaa�,aroowme�m,cod..ro.m.wr«�am.
wak lar w1iiM Ihis parmil u iaeued. My wwFere oomperumnn imursnce mrtbr vd pdiry numbar va:
c�«:
Policy Number:
(1A%4 4BttiOn MOC Mf W cOniP�ed / IIN O��t u M pp MIMIBd EOOBrs �%ICO� n MA.f
� I cenh � in iM perloimeMe d 1he wak lor v.i�c� Ihu permY o i»uad. I kWl m� empby aery penm in enY men�wr no m to
ber wljetl b the xakme' canqmeiion lehe d Cefdomie. aeM epiee ihel Y I ehaM Eecmie eubpn �o tM worlmie'
campar�v�ian po-nsuna d Setlpn 3)00 d �M LaDn CWe. I shell twlM1wn� mmpl� xilh iAoeo powwov.
Date: Appfram:
W�mMp: Nllun ro weuro worten'ro�oxwtlon eoverep� Is un4rNl, nM aNll aub/cf an wnylayer ro eAMnsl pxWtlu enG
c/HI 9nu'q N om h,nllN fhouuM tlo/Nn (SIOO,OWA M Ml/tlon b tM eaf ol mmpsiwWM1 tlamepi u prov/CW br In
Sxtlon 9RI6 0/ Ms L�6or Cor/e, Infensf, �ntl ettomey'� Irx
CONSTflUCiION LENDING �GEHCY: I hereby elfiim uMer penehy d parpiry ihet ihere o e conYvdion bMirp apericy br iM
oeno�merim m ino.vwk ror wnitl� �nc oa�� a aa�e (s.aun aos), civ. cl.
LENDEfl'S NMIE:
LENDEN'S ADDPE53:
I cenity thei 1 have reaE i�is eppiceiion eM pale Ihel �he ebove inlormetion ia wnect. I epree lo comply wnh ell rny enA oounty wdinenma
enC e�ele kws rMe�iq la Wik'vp wnsVuqion aed hereby eNhor¢e �eqeeen�e�ivea d Ihie vly b m�er upon Ihe abwe-mom'v�eE p�aperty
lar inape lion W/pvsaf.
ERNIE VITUCCI
r��� rv�e
�n.�oA�%-7 � i�..._• Dme � z 6 L
Sqnalwe W rl enVAppM1ranVConlmqa
(5151dd.WP) Whne-Buikinp 8 Se1My: Oreao-Fle: Cenery-Appirani; Fnk-Revenue: Ooldenro�Aaeeaor
JOB DESCRIPTION : INTERIOR 20000SF OFPICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
*�*���**�****�**��***�D*********x�*******rt*****��*�x�*�i�*H****���*B***a**�**�*�r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGAT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING N6TES>
i
iPlE 1E it if iE iE iE If iE IEiE if ik 1E iE if iE iE 1E iE 1E iE iE IE iE 1E 1E iE IE if 1E IE k 1E 1E iF If if 1f 1f if iE iE iE iE iE iE k rt 1E iF i61E 1E iE 1E iE 1E 1E iE 1E iF 1E if iE i6 iE 1E iE iE iE iE iE iE iE iE iF iE
D E V E L O P M E N T S E'�R V I C E S R E Q U I R E M E N T S
{
ZONING APPROVED BY '' DATE;
L:li�i�ll�l�li[�\ •l•l:Li1+1�M �� p►�7
DATE;
APPLICATION ISSUED BY: . �A— DATE: L 2� k.l��
��,�*�,��,��,�*������«�«��«**������������ � ���������*���,«*��*� **
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 110.40
SOS SMIP/NON-RES
PLAN �
ISSUE FEE 15.00 '
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 110.40 15.00 • 0.00 125.40 L25,40 .00
REVENUE DIVISION TOTALS--> COLLEC<TED:. 125.40 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
�25.40 �
iE 1E 1E IE 1E i(� 1E iE iE aE iE iE 1E iE IE 1E 1F 1E if iE 1k 14 iF iF fE ik 1E 41ElE 1E iElE iE iE iE 1f 141E 1E ib iF iF if iF iF iE iE IE i! iF �F iE 3E 1E I! if iE It i(� �E 1E �E iE iE IE iE jE ib iE iE 1E iE fE iE iE i(� if �lE
I N D I V I D U A L .F E'E H R E A K D O W N
TYPE QTY D E S C R I P T I O N�� 1 UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1�ST 20 EA. .75 15.00
ELE 212 RECEPT/OUTLET ADDITIONAL, EA. .45 95.40
END OF FEES
-I . ' , — A
11
�2 J41��. ;ui-'.^2S. YL,';r ;i` �rD
GATE. [Il -� ,� �li.�.. :.a�:,.
CONSTRUCTION AND PLANNING � � & SPp'
APPROVALS Permit# Date �Inspector qppROVALS Permit# Date Inspector
,t. Temporery Electrical Service or Pole '� 52. Pool & Equipment locacion
2. Soil Pipe•Undrgrnd. _ � 53. Steel Reinforcement
r3r Efectrical �fpnduit Utility-Undrqrnd. � 54. Forms
4-�Efectrical�CondUit�Undrgmd. � 55. Electricai 8onding �_ •-
;5.'Steel Reir.torcement 56. Rough Plum6ing & Pressure Test ��
-.6: �E�ectrical_UFER Grnd. 57. APPROVAL TO COVER�GUNITE
- n.es
-�➢`. Faotings i�; 58. Electrical Co�duirUndrgmd.
-`8. FoundatiQnt�' ' 59. Gas Pipe, O U�drgrnd., Test
9. Water Pipe�U�drgrnd. - 60. Backwash Lines, P�Trap, O Undrgrnd. .
70. Structural•Floor System 61. APPROVAL TO DECK
1 t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer CaP• . 63, Heater & Vent-Final
{3. Roof Drains 6A. Plumbinc� System � Final
74. Rough Ptumbing �• 65. Electrical�Final
15. Rough ElectricabConduit - ' 66. Solar SYstem-Final �
76. Rough El2ctric Wiring 67. Fencing & Access Approval '
-77. Rough Wiriig Sign � 68. APPROVED FOR PIASTERING :
18. Rough Electr�ca��T Bar Ceiling 69. POOUSPA SYSTEMS PINAL
79. Rough Heating & Air Conditioning � FIRE DEPT. F�EQUIREMENT ,,,�
2D. ROuqb Faclory:FirePlace "_n! �; ; __ _, Ta. • �APPROVALS.ip-Permit# '; ,:..,:-
27. DuttS, in StNCIure i � •• -_ : �� F� 70. Underyround HXdro �
� Y'
22. Ducts, VehtilaXing�'y ' '- ��-., ' -71, Produq'FPipjng OGas OOiI
23. Gas Ripe-RouBh & Test , - e-., _ � t� 7Z, Underground Plosh a <
24. Roof`-Framing" ���W -� ' *�' � 7��Undergrnd.Srorage�TankYOGas DOIf
25. Roof Sheathing i�:. � v•�� ' �� r;+ �74. Overhead Hydro,
26. T-Bar Ceiling (Strustural) & MoQoLbat � '�, �� 75: Dry Chemical ,. ' . ,
27. 6rame and_Flashing. , - .- > � w 76. Dry StandpiPe -o' �� �-
28. Lathinq &'Sidin9 .�;' . S= '., .. •. . . 77� FIXED �YSTEqA�INAI. �..
29. Insulation. �� � . • � 78� FIRE PREV. FIN'AL � ", - -
30. Drywall M17Siling '• x_ K_ :�. - HEALTH �DEP7f. REQUIREMENT
31. Plaster Brown Coat_ r� -� �� ! � 79.�FINAL INSPECTION- - `
�'32. Electrical�Pow"er Met�'r�pa� � `' '`80, FOOD CERTIFICATE IS�SUED
-� r _
33. 6ina�Eleei�ic� ��: �.. . � �3.r�/� �,.�� Notes; -• --.� �: -. ;_ �.
. f�"/�
'34. Final Heafing & Air'Cbnditioning � _ �'
;. r Y T- �����..�, �.���� �,,��
35. fipaF�as�ipe:Test„y � ' . � .. �
��G�������P
'36. Hood�_or CanOpY c :� = � �� � �" ` �� f,� ' ��
• a'r ' ,C __ ` r � 7 '
'-. . - p � � � �., -
:37. Final Pactory Firepta,ce ' �.; ' � z, F "r ` ... - c. I �
3S. Final Plumbing - ' . , ' Y - � '. � .'� _ ° q. -
� K H - F
T f r ^ Y IT . n�
'39. Water Service-Final:, :- �, � �. , - ._ ,- ,� -
40. Gas Service-Final e -, c� + �� � '- •' �
_ - % -
� 41. Solar �omestio-Final� � . . '�� �-' ; . _ .. �
42. Backflow Preventer.z � �� ' _
- . . '
43. Batkflow Irrigation' ; r`"` � �- � �' � .
_,
r �� * J �
44. LandscapalrripationSystem �*'ti� � c, - _ _ `� _ - � -
45. Sound AtSenuation `� ;. - F ` ' ' • : `'�"' � -" ^
- . r . < r. . r (-.. , v:
46. Handicap Regulations ,� �, ; ' � - •
47. F-INAL STRUCTURE & BUILDING ;_ _ ' �_ , �
48. FiNAL PLANNING • r�� - _� ' r. • r
. �
49. Electric Releese to Edison , �;� 4 ' � _
50. Gas Aelease m Southem CaliFornia Gas Co • -
r -
51. CERTIFICA7E OF OCCUPANCY . - ^ � � -
No Date
ewiou+o: 555 ANTON BL
11Q'°"" SAKIOKA FARMS
�oonesx p0 BOX 2097
TERMINAL ANNEX
�vr�.iuiuqo �oox�ss
UNT:
4TH I CITY OF COSTA MESA - BUILDING PERMIT
PERM D10: E 074578
PERMIT NO: E 074578 PLAN CHECK NO: N GOVT: N SUPP: N
urcxnECToe�ow¢n: INTERIOR DESIGN 213623216p0�N0•' 9378
MCN.ONE110.'SA7CXE59: SSO 5 HOPE ST � u"r: 1100
L.A. CA 90071
�"'""CT01�9NA1E MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
ca+m�croaeuuura 610 RF.YES ST
�op� WALNUT CA �G�� 230813
91789 UNT:
110EN9ED CONTRACTOHS DECLAFATION: I Mroby dlim untlar pene4y ol per�ury Ihet I em linmad under praWYov d Chapter H
(eommondrp wMh Ssaion ]OW) d Diviebn 3 d I�a Budnw enE Pedssslons Cade, W my lioeme b In lull lorcs aM �MaG.
cmuc.r+o.:0065/56 uc.cuss: C 10 uc.No.: z30813 EXP: 12/95
ete�. —/Q � � Ganlream /
�Wj! P BUILOER DECtANATON: I Mnby tlfirtn undar pe�W y d parjury �het un us q ham IM Conleeean lian�� law In Ns
5w'vq �laton (�� )�1.5 Bufiw�s eM Pmlmabna COCe: My e�y a m My v.Ai epuirN a pl�m4 b wnsW el. dlx. impoua.
♦ndeh. n rapi eiry eNclure. pior Io is eawms. ebo �syuim IM eppli la euc parmil lo fib a eqneE eutproM tlW M a�M
m lieemad W�+��� �o �M povisiam d �M Comeeaon Lieems Lew �Chaqm meneuq wu� Saaion )000) d Div'sion 3 W Ilw
Buei�wo eM PMesaioru Code� w ilw he a ehs b axemq iherehom ud tM bmv Iw IM elbpeE eaemqbn. My vidmion d Seqion
]W t.5 W enY eGW� for e permil suEjx4e the applicenllo e dvil penelry d na mors Ihan ive huMred Edlen �f500��.
� I,mowrera/tMpropenyormyempbyeeewlhwepmaviMiedammpomelion,willEolMxork.vMNeHru�MurocridintanAeA
a ollered br seb (Seciion )Wa, Buariaa erM PManaiona Cotle: The Conlrenon Licanaa lewdoea ml applyto en owmrd popery
wlp Wida a inpeovee iharean, eM w1a Eoes eueh wak NmaeX or Mne� a IMap� hu a her oxn ampbyr�, proviEad thm euN�
impm+emenla ara rw inteMed or atlenE lor eels. tl, lawever, tM buiNi�p w'vnprovemeM ie wid wi1Nn ana yeer d mmpbtion, tM
owror-0uitlar wi4 heve IM1e budm d pv+iip M w she d'q no1 WiM ar imqova ta �M purpwe d veb�.
❑ I. n ox�w d Ihe papanY. em e�tliui.eM cwreeM wuh 4oemad convaclm ro mWutl Ne M9� (5aaion ]01/. Bueiross md
rwesaim+ cade: m. caurmon I.iron. le« me, m mqv m.n own« a ww�r •ro auw « impw« in«.m .ne wno
eonvaeu la wdi prqMa x<h a menemoHe) ��%� R��M to �M Can'mm lioeeua Lex�.
�� I em vamq udx Senian: B. 8 P.C_ br Nb �emm�:
I do hereM �M��Y thei l em awere W enE uMenwtl tlw reCuiremeMa d CelAanie /leetlh ud Sdery Code Sediom R5505. Y55}�, eM
Z553a, eM t�ei I a ury Mure buikirq oocupent vnll / wil m� (arcb orre) reed io compy w1h eeiE etate wEm enE iM �epuiremams tar
apermnlareonstruclionormotlAraiionhwn�MA'r�ueC�y erepamantDianq.Reekenlielm�m�wioneppiratiwnareexampimmihpe
powiom.
DPoe: ApqiceN:
WOFKER'S COMPENSATION OECLAH�TION: I Mretry elfum uMx panNy d pe'jivy ans W iM b0ow'vp Eetlere�iom:
� Iheroerdrrilme'vnaneeendr�admneniioeatlieuuabrworkae'mnparoqion.m0�widadlnMS«fion3l00N�MleEa
coa.. i« m. wrt«�. d m..,aw �« wnu w. o� e m.�.e.
❑ inm»e�e.,ameinia:�.�.��,v�:M�,..�a.o�w�=.aMseec�a�ooan.i,eoced..amew�«m.a.am.
' work /a w1iM No P� o baued. AM1' wakae' can0�++�ion imurenca finiar end W�Y �wmber me:
carde.: FTRFMANS FrTNn ExPiRES
PdiryNumEr. nr.r(-un���Fo� 07/01/96
(This senion need rw( 6e cwnpbted l �M pemi! n br one hunCred Edlers �T/00) w lua./
❑ 1 earlYy ihe� in iM pe�lamenee d IM wak br whieh t�u peimtl b iuued. I dWl eM empry eiry peison M enY menrier eo m �o
Wcama wbpd �o tM �wrken' canpavmion lawa d CdE«riia. eM ep�ee ihel ! I e1wiM bacanw wbpc io �ha xarbn'
�ou�+m�m a�uro a seaon a�ao a me �m« cme. �.neu n.an mmn .nn ucee o�b�
,: — /G — �,q�,„: ''
nlnp: F�Yun ro wcuro wakw�'ronpwu�tlon covxaps l� unYrM, ntlWll �6/ct �n w�nplqw ro erlMiul pwuM�s �M
GNI Hros �q b ms huMieE Wuub Co/Yn (Sfaqp00A In sAfltlon t M� co� � rompru�tbn� dem�p� u provMM ror In
Sectlm J1P6 0l tlro laEor Cob, Intaut ���msy� Iset
CONSTHUGTON LENUING AGENCY: I Maby elfirtn uMer penelly d per'Fvy tM iMn u e mn9ruqion bnE'vp pmry ior ths
p,n�e„m a ma .«i� r« .n� m: o«m� m:.�.e �s«aion aw�. cw. q.
LENDEP'S NAME
LENDERS AODPESS:
I cenM �� I heva reed No appGcation eM ams ihat the ebv.a inlametian u cnrtsq, l eprea lo mnply Milh eA tlry enE coun7 adirorcae
ard.tm.lews reletM lo buiNnB wnmueian eM heraby euthar¢e �ww��eiivas a tke rnY �o.rum uv� tM ebow�meNianed MoroM
i« o»o� wm�.
CHARLES JACOBI
(515td8.WP)
Selery: GreemFb: Cenery-�ppireni; Rnk-Rv.enue: GddenivE.U»sv
CONSTRUCTION TYPE: 1FR SP
PERMIT TYPE: ELE
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I.
CLAIM VALUE: CALC-C'ALUE:
PURPOSE; ALT
SQ FT:
GROUP OCC: B-2 /
COMMENTS: 76 UNZON PRODUCTS REF: H-74570
**+t*************�**�+t***+�*x**�� *�x�**�**�x*�*��*���*�**+t**+�+t��***�+��+t*�t+�x�+�*�� **�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKSNG REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
9E 1E iE �E 1E IE iE jE fE iE 3E fE fE fE 1f 1f �F 1F iE iElf 3E IE iE iE jE iE 1E 3E iE 1E if 1E 1f �i iE 3F aE ik if if iF if 1! iE 3E 1(� iE iE if iE 1k 1E iE iElE 1E if !E iE iP dE 9E iE iE �E If �E �F if if if 3(-!E iElE iE fE iE
D E V E L 0 P M E N T S Er•R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
BUILDING APPROVED BY :
i '
LEGALIZATION;N F E�E S U M M A R Y
BLDG PMT PLUMBING ELECTRZC MECHANIC FIRE
PERMIT 206.20
SOa
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL
TOTALS----> 206.20 15.00 0.00 221.20
DATE:
DATE: IJ � I lg-��
�E fE iE 9E 3E 3E iE 1E 1(��F�F �it3F�iF3F3FiE 1f
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON-RES
PAZD DUE
221.20 .00
REVENUE DIVISION TOTALS--> COLLECTED: 221.20 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
221.20
!E iE 1E iF If iF iE dE iE �E 1E iE k iE if iE IE 1f iE IE 1E 1E jE �E fE 1E iE 1F iE k!F 1F if iE iE iE 3f iE 3E IF iE iE iE i6 �E if aE 3E iE iE iE iE iE IE 1E if it ik iF 1F M 1E 3E jE �E iE 1E �E 3E iE iE 3( iF 1E iE jE iE 3E iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE
ELE
ELE
ELE
ELE
ELE
20 FIXTURES, LIGHTING
202 FIXTURES, LIGHTING
20 RECEPT/OUTLET
104 RECEPT/OUTLET
22 RECEPT/SWITCFI
2 SUB-PANEL
1 ST 20 EA.
ADDITIONAL EA.
ADDITIONAL EA.
1 ST 2U EA.
END OF FEES
.75
.75
.75
11.00
01 0039?�"�-9'=19_�GF? TEaT
oa�e: iv_s��;, *r+;F: ;;�:_=
15.00
90.90
15.00
46.80
16.50
22.00
'�1.2�
:
.;�
�� NSTRUCTION AND PLANNING •� PC S SPA •�
� .APPROVALS Permit# Date Inspector qppROVALS Permit# � Date Inspector
t. Temporary Electrical Service or Pole 52. Pooi & Equipment Location � ,
2. Soil Pipe-Undrgrnd. 53. Steei Reinforcement
3. Electrical Conduit Utllity�Undrgmd. � 54. Forms
4. Electrical Condult•Und�grnd. � 55. Electrical 8onding •
5. Steel ReinforGement ' S6. Rough Piumbing & Pressure Test �
6. Electrical UFEfl Grnd. 57. APPROVAL TO COVER-GUNITE "
7. Footings 58. Electrical Conduii-Undrgmd. �
;_
8. Foundation 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe�Undrgrnd. 6p. Backwash Lines, P�Trap, O Undrgrnd. .
10. Structurai Floor System . 61. APPROVAL TO DECK ��
1 t. Property Sewer �ine & House Conqeccion 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains �, 64. Plumbing System � final
14. Rough Plumb�ng � 65. Electrical�Fina1 •
t
15. Rough ElectricabCondua 66. Solar SVstem�Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
i
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. RE�UIREMENT
20. Rough FaciorY Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Dutts. Ventil8ting 71. Product Piping O G. s D Oil
23. Gas Pipe�Rough & Test 72. Under9round Flush
24. Roof Framing . 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and F�ashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 7$, FIRE PREV. F�NAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�final � 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric �_ 9� Notes:
34. Final Heating & Air Conditioning ; �
35. Final Gas Pipe�Test .
36. Hood or CanoPY �
37. Final Factoiy Fireplace
38. Final Plumbing
39. Water Service^Final
40. Gas Service-Final
41. Solar pomestirFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation .
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -
48. FINAI PLANNING
49. Electric Release to Edison �
50. Gas Release t0 Southern California Gas Co .
51. CERTIFICATE OP OCCUPANCY �
No Date
�
y
�nnnEss a eu�owa: 5 5 5 ANTON B L
owxeasNweiv�ua�m: SAKIOKA FARMS
"DOPF� PO HOX 2097
TERMINAL ANNEX
AVDL.WVIIIlG ADDRES&
UNT:
4TH CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 074834 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
�xcxnEcrone�aw�n: INTERIOR ARCH 2136232164 "`'N0�` 9�78
'""` °" FN° g AD°"�' S 5 0 S HOP E S T ° 110 0
�M�� L.A. CA 90071
cwrn�croxs�u�o COMPEL CORPORATION (310)946-8321
10410 PIONEER HL
"°°"E55` SANTA FE SPRINGS CA 1CN0i 392693
90670 °NTi
LICENSEU COMNACfOflS DECUfl4TI0N: 1 Mreby ellnn uMm penely d pajury thei 1 em licenasd uMx pwieima d Cheqm 9
(oomme�q xith Sadion ]000) W Drvuion � d Ne Budroe ud Prafm�iw COEe. end mY fiowue u in futl bm ad diw.
CT' IJC. NO.: L14 QA55: IJC. NO.:
032059 C-10 392693 XP: 08/96
oma: /6-2G "9S c�v,a« %�%m.7�4�. �ps _^ �-
'1WNEN BUILDEP UECLARATION: I heieby elfirm uMer panely d perjury IMt I em me Imn tM Camrmoee Lieama Lew la Me
�bw+q �esron (Sepian ]W �.5 Buinea erd Rdea�bu CaAs: A Y cYY rt mun�Y Mud� nWires e V�L lo meWct. Ms.'vnVm*.
emdsM1. m repai eiry s��ucl�ve. p'v b tf eauvae. abo rpuum IM epp4rent la wch pemN to fJe e eqrqd tlatqMM Ne� M a eha
��. i�e w�u �o me a�. a N. wu,mo�. u�� �w Icneaa s(�d,a�u wnn sw� �000l a o:eo� s a iro
Buwnv erd Prdevbna Code� a �Iw he or Na u uemq �hael�wn vM Ilw buis fa ihs elbpeE exemqion. My volaion d Sequn
�mis M em aoc�� �« a v� �i�+�ne eopcw m a da ro�v d m mae in� r a n�M�aa ddian �ssoop.
� I.mowrerdiAepropenYamYamMW��nweppmiheiedemmpriaeiion.Yipdo�hsxork.endlhsrvuclunenoliruaiEeE
a Mared I« eeb (Seeiim l0aa. Bmreveed Prdeseiom Cods: The Conlretlon lioenee law Eom ml eCWY �oen ownerd poVeM
who Wltla n inpavea thereon. eM wfio Eom suN xwk NmsYl or hand p Nrpph he a hm own empb�aes. pwkeE ihet aN
Mwwemma..,. �a w.ndee «oneiee �« mie. e. ro..ever. me wudtrq «mwo�.�ea u.aa..nn� on. r� a aomNaon. ub
ow�whiker wi0 Mve �Iw buNm d poviip M m eha dN iM WiN w imqwe lor IM pivpoee W eele�.
� I. aa owrer d iM quW�H. an azduvwN contreqnY xiN IioenmE conuedm ro mnmuq Me pNb (SeCian Au.Bwv�w eM
Pmlesvwn Cade: TM Caqratlm Licons Law does nU aWN b en owner d PW�Y x1a b lffi v imqwr thasan end who
mntrens la audi pqem xiih e owretlor�e) IiceneaA punuem to the Goniraqan Limnse Law�.
❑ I em exemq urder Seclion: B. 8 P.C.. la Nb ieevon:
oma: o.,�«:
i ao nawr �M mm i em s.me a w wd..i.�a ms,w��mm«w a cm�omi. rbw, .�e smm cme swiore zssos. zssai. w
25531. eM iM� I a ury Mure buikvq mwpant xin I wil ml (ercb me� need to compy wYh uid eme mdo W tM �em�'vemanb br
a paimn IormmWclbnw moCifiution hwniM�i�epemsm Dinna. ReddeNiel wnelNqion eppfutiwm ero uemp /rom iheae
prwiaiom.
ome: nndc.m:
WORKEN'S CONPENSATION DECL1fl�TI0N: I hereby effirm uMer peraliy d pwjury ww M iha Idloxiiq Gdara�ions:
� I heve eM wil meimen e eenGieete W eonxnt m eeX�inwn br v.oeken' e�mpen�etion, m prwiEed lar by SeUian 9]00 d IM leEar
COAe, lor iM pe�iwmenca d �M v.wk Iw wNc� Ihie permit ie ioued.
� I have eM wil maintan woMae' mmperueiion inwrerce, n�eyuiesd by Sepim 3]00 d Ne LSEa COEe. M IM pe�iormenoe d IM
wpk la xfiidi ihis permil o meued. MY wvkma' cwnpenW ion ineurarKe urtix ud pdiry number ua:
ce"'°' FFt£l4AP1'�' 6AA4� EXPIRES
`a`Y Nuinb" 0 2/ O 1/ 9 6
(lhis settion neeC iaf de cande�ed / �M pemrit e la orie hun kn 100 w bse.
� I eeelAy IiW in Ihe pMoimenee M �M work la vfic� Ihu permit ie iuuetl, I�hdl rwl ampby vry penon in eiry menner o m to
bxmb wqea to �M xake�e' compe�ion low� d Cdilwnu. vM yrw tlw ! I Nou pecoms wbjee to ihe waMen'
compeGma�bn q/w�iaiom d Seaion 9)00 0l tM labor Code. I Mell lathr.nc ��p[np_N wM
Dele: �tl ��P ��� AGVlvnl: ��w �l � �.�rL�Oh
Wemirp: Fellun ro iec�n no�ken' mmprwtlon cov�rep� I� un/eMu( entl �IWI au6/�ct �n mplqw ro MMrul psiulflN enJ
nw ro,.. w ro on. nund..n mou..�w aaa.. proaaoal, M.eeiuon ro m. �o.r o� rnnrosn..�wn, am.w... vA�a.e ro. �n
Sxtlon 9106 0/ M� Lebor Cods, InMut, enJ ettomry'i I�ss.
CONSTHUCIION LENDINO AGENCY: I InreW elfi�m uMer penetly d perjury tlW iMn u a wnatiutlion MMiep apem.y la Ihe
oarto��� a me woa ro, .nkn me w�e u esuea lsee� aoe�, c�, q.
LENDEN'S NANE:
LENOEX'S 10DNE35:
I cenJy thm I heve reeE �hb applcetion ud tlds Ihel Ne eEwe'utlarmmion b conetl. I epme io compy Mtth eA aty erd muruy ad'mercm
eM s�ale lews �Nel�q W dnldnB oonWutlun aM MrebY eNhw've ieqaenlelnea d tM reY lo mlx uD� iM eEoue-menlianeE ptapsly
lorivpeaion purpoaes.
__.,____..,, MoNTT/ PE4RSon1
��% Pmq Nama
/—' aQQiR�'J.- Ome: �
� SproiunMOwner/RO��AGW���rma
(StStes.WP) Whna-Buidnp 6 Sdery:Onart-Fb: Cwry-App4anl: Pink-Revenua: Gddmro�Aemmr
PERM NO: E 074834
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCAIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
*�****�x *****rt***�*x�**�D****x��*****�r**it�t*�it*f�t*****ir*��*********�**�*****x�*x�x**�x�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NdTES>
i
���*�+r*+�+r+r**�r�r*+���r**+r*�rx�********�+ti�**�**��*��r�r�r�rx�***+�******x�*�*���*�r�**+r*x***�r�
D E V E L O P M E N T S E,".R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY .
BUILDING APPROVED BY ;
APPLICATION ISSUED HY:
x�*��+t�*�r�t�������rx���**■
�
DATE;
DATE:
DATE: 1b
***�x�***���*
LEGALIZATION:N F E EI S U M M A R Y STRUCTURAL SEGMENT:N
/ ..
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT SS.OS ' •
50$',, ' SMIP/NON-RES
PLAN "
ISSUE FEE 15.00 =-`
HUILDING-DIV-> PERMIT ISSUE PLAN-CHEGK TOTAL PAID DUE
TOTALS----> 55.05 15.00 � 0.00 70.05 70.05 .00
REVENUE DIVISION TOTALS--> COLLECTED:' 70.05 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC �1 FIAE SMIP/TOT GRADING PLAN-CHECK
%0.�05 )
�
1E ft 1E if IF iE if iE iE 1P IE i81E fE IE fE iE i818 iF iE 1E IE 1E 1f 1E 7E 1f if if IE If if �E if 1E IE iFlF Ik 1f if 1E 141f IF iF MiE if 1f IE IE 1F 1E 1E 1E IE 1E fE IE'k 1E 1E 1E 1f 1E ik iF 1E 1E 1E iE 1E 1E iE iE 1E if
I N D I V I D U A L _F;E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N.�._._ UNIT COST TOTAL COST
ELE 20 COMMUNICATION DROPS 1 ST �20 .75 15.00
ELE 89 COMMUNICATION DROPS ADDIT•IONAL .45 40.05
END_�OF FEES
N
ai Do1v;r�?-q�14;127 '� �r'� iC.45
oare. ioiaai�s 57�:E: .5:01
CONSTRUCTION ANO PIANNING PC .& SPA
APPROVALS Permit# Date Inspector pppROVALS Permit# Date inspector
t. Temporary Electric8l Service or Pole 52. Pool & Equipment Location - '�
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement :� .%v
,y7�ectrical �ondu{t�(�tiLity-Und�gru�d. 54. Forms �; .y. � .
ruF4AF]ectrical Cdndui2�l-}ndrgrnd. !'� 55. Elec[rical Bonding _�
�� '
;!
,�.�?$Seel Reinf4FeemeiZi.� � 56. Rough Plumbing & Pressure Test - y �
F-�CSUElectrical U�ER�.Grnd� 57. APPROVAL TO COVER-GUNITE �'
T�•f�•
S�:'�Aotings �S ;�MC '� 58. ElectricaiConduit�L'ndrgrnd. �
:. -�
=��. 5qundation:,; ��_ � 59. Gas Pipe, D Und[grnd., Test
9. Water Pip�?Undr�ih%Nrc' 60. Backwash Lines,'P'�frep, L� Undrgrnd.
v - �- i
�
10. Structural-6loor System � 67. APPROVAL TO;D.ECK
11. Property 5ei,ve(line & House6Non�ectio�� 62. Backwasfi & flece�tor-Finaf!�
12. Sewer Cap,i `' � ,_, _ 63. Heater & Vent-Pinai '.
73. Roof Drains o -'"' 64. PlumbingSystem-Final.�.
74. Rough Plumbi6g_, r; '. 65. Electrical-Final � �
15. Rough Eleuricai-Gonduit -"' 66. Solar SYstem-Final_, ��
16. Rough El�ttric W}rin§�, ,: 67. Fencing & Acceys�Approval . �
;17. Rough Wirincy5iqn � � 68. APPROVED FOR`PLASTERING �
.,
T18. Rough ElBctncal�T Bar Ceiling"' 69. POOUSPA SYSTEpAS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- -1 - - � . '� �., . p,
20. �,duq5Fa2ory�ir�pPace ' �,�" 4 ? "' � � ""; PPR�JVdLS„y,�-,Permit#��_
� �
��.. , ._ , . .�- : '
21. [��i'ict�n $SruqFyre.T r .. .. y _ n* _�70. tlndergrou�'d Hyaro x
22. Dytt�Ve�,tila€iqg ;A ' �- t�y r r"�� ?71. Product:P�7Ping-O'Gas Cl'Oil
23. as Pk7e-�ugM'&'ie;�t = py r s p:v �72, UndergroiihU Fla�ti % F
24. Rbot:�'rar�ng•• ��'% r"' �;� � � ��� ,73::,Undergmd.StoragayTank;DGas ❑�i`�
25. Aoof'_$hea`j �ng �; � �• � y t � �U �. 74:,,Overhead Hydro; *
- < .,
26. LBartCeifng (StrucrrJtal) & Morioi�at � � � �' � � 75�Dry Chemical =� .� '� ` ^ -
�
27. F�7j�meand.Flashin�,K jQx * � y�}� 76rDry Standpipe �w x. � � � �
�-�28. Lath� 8iY-�,SSiding `� F y ��4 ^ �� • � ••� '•' 71:y FIXED 5�„YSTE��9NALtr H .:ir,
� P, �' �. �,
> :S o>p ... > M�, r i �''
'29. Insulation-. ,�w _ • � I t 7g,-FIRE PREV. FIN�cL . �a'
�30. Drywall Ma+ling Nw , � �� � I ' � s �{EALTI-�pEPT' REQUIR,E�I�f�ENT
(�% =n C': � 5 I � 6 i J 1 � 'c -' +
.-,31. Plaster Brq,wn Eoat�-;; c . � �� 79. FINAL IN�PECTI�N. .
ti
�32. E7Ectrical Howe7Mett�v-Ei�al r �� ti•S'��FOOD CERTIFI,�,4'f'E IS�U�ED,� JC�
.;33. F�Tal�leci%ic j'": r•. i S�� /., �lr� f� • aiies� �. -��*; x-� :., r'���
0.34. F,fnal�eai7ngticAu-(,bnat'fioning;� � +- I .Y ./� /� - ��-n .� .= �: . 'A
'*' . . , � . � rt - ;t ^, I i. 17 � �%� � l/j r� 1 �M.•� • r � L
35. �al%a:�pe=J�,est�.; ;�m .� r �, I � � � , , ,
� h=•�= _�'Q%` �_ .
afl6. roodtor CanoPY •:�� ;� � �� •i , �"` I ' �� s: '1�. { ,_. i'n
v" J
'F`.,37. F�al'Fpc4VlY Fire Y�Ce�� ^ .-.:-. r.. �:•n 4 �. e d'�i
-38. Finali?lumbing r�,. �t� ;.% �-+ a'�
3
i v � R. S x
- 39. Water�ervice-FinaC,* : � �. � ; - ;y „ � � �" .
�
;40.GasService-Final C��� rm� S ,�,m, ' �;� ��c JN �� �
_ ,-e i 1 �x n , � �. q
T41. Solar porr�esticFin^ � � �� �' � '� ��� " f _
y � � ir7 � �. ,,_ r.� ! ^
42. Backflow Preventer-''._^�; �� � �. i t; '.: �H � G :--+
- i. � � � m �n ^, X c+
43. Backflow Irrigaiiorr,;x �S-' � r w.; '". r � ..
s.
- ' ... �., ._ �
44. LandscaP¢.�rriaation$Ystem ¢f!:'�C C: �t�t � C7 �= �. [J : .-id _� S cJ ,.� �
4�. S�und At�tenu'stionsa` "' � . :`. ` `� � Fj� ; , _� 4� „ J ,
� x
4b, Handicap egulatia�s, : � � x: „ _, - -_ :
� <- i � �. _
47. F7NA�STRUC�'URB&BUILC3WG ` • " - _
Y� �
T! r.. � x F �';e E
48. F�y9A�PI.ANNING � � rc. + w �+ , ?: j =�
w i -� - r,
49�. Eiectrid Release'to Ed�son � ` ' ' . ' - : �' -•
y. � y, zj i, ....0.
5�: Gas ReJeaseto Southem California6asCo . i � ��- � • o�=� i. C� •'•
- il 5 lJ �i�
5.i. CERTaFICATE OF OCCUPANCV ' x s � � ., • . •
No. Date
�oonEssaewiova: SSS ANTON BL
ar�Easx.�E�F�a"*+: SAKIOKA FARMS
�p� P0 BOX 2097
TERMINAL ANNEX
� 1 �cv�. �,uuxc �noxrss:
�I
�� 4TK CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 074734 PLAN CHECK NO:, N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: PLU
urcxnwronrr«u+rrn: INTERIOR ARCH.2136232164 uc.r».: C-9378
YiH A
u¢x.on�os�oox�ss: 550 S HOPE ST uNr: 1100
L.A. CA 90071
car+m�crarsru�e: CONTINENTAL PLUMBING INC ( 909 ) 360-8300
CONfPACTOF5MY1dM 11165 THURSTON LANE
eoo�ss: MIRA LOMA CA uera.: 399073
91752 uwr:
IJCENSED COMN�CrOPS UECLAXATION: I Aereby ellim uMee perely d pmjury Nel I em fcemed uMx pwiwau d Chaqm B
(oomme�ep w4h Setlion )000) d Division � d tha Budroae eed Prdeaeiona CoEe. enE mY lioeroe u in tWl Mes vd sHsp.
cmucy.No.:027563 uc.cuss: C 36 ,G���,/} 990 EXP: 09/96
oma: 1� - a4 �- `�SS can�.ao� � !
OWNEN BUILDEN DECLAFATION: I Mroby effirtn uMer panely d par�ury Ihat I em e�emq Imm iM CoMredon Littnes lew lar Ne
Jbw'eq �aefon (�bn ]OJI.S &nroas ud Adeeaione Cods: Am/ c1Y a oounry MAid� rpuims e permil to cqqWCY. Mer. improue.
amd'nh, ar repv any evuciuro, q'v io in ewenoe, ebo repuiroe tM epplimnl la auch pamX lo fib e egned umemeni thet M a sM
ie IicamM punuent lo iM pm+aiona d ihe Contrmore Liunae lew �CMqm 9(oommenu�p r.uh Seaion )OW) d Onobn ] d �he
Bwineea eM Rdawuna Code� or thm Iw w eM n ezemq iherelmm end iM basro la IM dbpeE exemqian. My videtbn M Seaion
]0]1.5 by enY aDilicen� la e permil wbjeds ths eppl'rant to e cnil Po�Y d nd mae Ihen IMa hwdrad ddWe �5500�).
� I, av ovmar W Ihe prope�y w my mmDbYaee wvh wepea as ihe'v ede compenaetion, will do ihe wwk, end iha eVupuro o irot intentled
w oNared Iw ala (Sacibn JO«, Butineu eM ProleaebnsCab: TM Lmlracion licenae Lew Eoes nM epplyto en ow�rd propary
wla b�tlEa or inpmves Ihereon, aM Wa doae euch work NmeeH or henetl a throuph he w her own emplv+eea, providetl Ihet ewh
imqovemeMa ere nd inieMeE a Wered lar vele, tl, lwwmer, IM Euikirp a inprv.amem a�oN wnhin wr yw d wmplMion, tlie
o.�«-wad« .ai na.� ma w�d«� a wa��o ne «� ew oa w�u o, �w� i« m. wm�e a.w�.
a«
� I. m ovmer d IM pWeM. am eaauvnN mntreaM xnh 4caiued mnlreclon ro cmmrua Ne pM� (Seaon ]OM. &n'vrs ud
Pmlevon� GoM: The Conirnaas licarus lew doee nd epply io en owiwr d propany who buika a impovr ihmaon ud x1a
cronirecb tar wtli qqep� Mit� e oaNreGor�e) Iceneetl W��� �o Ihe Comrmas Licenae Lew�.
� I em exemp uMm Seciion: B. 8 P.C., Im thh reeeon:
Dete: Owner:
1 do MroW cMiry ihtl I em ewere d ard uMenleM iha reQuiiemema d Cellomie Ileellh xM Salery CaEe Setliam 25505.2553'1, eM
255J1. eM ihm I ar eny M�n Wikiiq om�pent xill / wil rai (a�cb me) nsed to canply wYh eeid ueie oodn ud iha iapuiremems tor
eDs��lnmiat�uclionuinodi(rsibnhamiMAi u�ly -enepemenlD'ptiitl.Reeiden�ulmnel�utlunWpiraturoanmemq/mmlMas
pwieime.
om.� novi��
WOFKER'S COMPENS�TION DECLANRTION: I Mraby dR�m under penelty d perjury aa d ths lolbwinp dedue�iom:
❑ I heve and xip meimen e cerlilcab d conaeni lo aeM-ineuro la Mwkere' compenW ion, u praWded lar by Seqan J]00 d iM lebar
code, �« iAe wnamence d �ne wix �o. vAvon mia w�X le �..uee. ,
❑ i n.ve.�e Me meimen woMen� oomro��� i�wrenm. m ma��roa M seeion »oo d me �nn« cuee. �« me o�«menm a me
wak la wliich I�b perm� u susd. MY waMen' canpenution inwrerce femu enE pdiry numbm ue:
c�.,: CNA EXPIRES
ratiY r+�mua�: 0 7/ O 1/ 9 6
lmr. �w� ��d �w na �omoi�ee r m. ��a �a ro� o�. n��d,ad eare� nroo� w ro:,.�
� I cenAy thel in I�e pa�ormence M �M1e wwk Iw v.hbh Ihie po�mn b' eE, 1 ehell nd amploy p Po� �� Y menner �o n lo
became .uqed io �ne worke�: camronmiion kae d eaiii e, eaeee n I eno � «ome wqse io �ne waken'
cwnva'ns^nbn D�+sbnn a Seaio aloo dtMlebarCode,l Ilo xiin N wnn � r'uona.
Dele: �V ^ �� ��� Mdicenl: I
W�m/np: Fsllun ro�xun woheri romp�n�etlon coverep� l� un/awNl, Null sWNc! en �myloysi ro cNMnel p�n�ltl�� �rrtl
e/vll flros up ro om hunOrod flwuuM Coll�n (t100,000), M edE/Hon ro M� rn�t ol romp�iwfbn, Mmeq� �a provltlM br In
SxHon 9RI6 0l !hs LeDor COM, lnfns�( �nd eltomsy'i I�u.
CONSTFUCTION LENDINO AOENCY: I Mreby �rm wEer panelry al perjury iM1el Ihere ia e conb�udion bMiip epmcy In tM
peAorme�e d �M wA Iw which ihe pimY i� u�ued (�� �]. Civ. CI.
LENDER'S NRNE:
LENOEN'S ADUNE54:
1 ceniN �� I heve neE Ihie epplirmion uM nva thei ihe ebova inlpmation b oortea. I epree to canply wilh dl ary eM coun�Y adiwces
end etme lexa mleinp io builArp mnsVudion eM hereby eullwrae repreaemeiives W t�ie dry lo enlor upon IM ebova�memioned propeity
lorinapeaion purposes.
�� ,_R� THORNTON,_ ,
A
�� �
(StSt-�B.WP)
`\
Dme: Iv ^ �� �
Whne-Buildvq 8 Selary; Oroen-Fle; Cenery-�ppkram: Rnk-Revanue; (3ddeneo�Aeee�aw
PERM NO: P 074734
GOVT; N SUPP: N
PURPOSE: ALT
JOH DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS; 76 UNION pRODUCTS OFFICE TI/� RE:#B74571
1E i! 1f 1f IE k iE i! 1E 1F 1F 1k 1f iF IE 1E 1i IE IE fE IE 1E 1i 1f 1E iE IF 1k 1k 1E� iF 1@ 1F IE k ik 1k R 1E iElk 1@ 1E 1E iE Ik 1E iE 1E IE 7E 1E 1E iE 1E 1E iE 1F iE k 16 M 1f 1f 1@ 1k 1E It it 1E IE IF iE iE 1F ik 1f 1E IE
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; ,,, FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 2NE: REF NO:
PLANNING Nt71'ES>
� i
1k 1E iF 1E IF IE i8 iE 181f iE IE 1F 1f ik iE ik 1k if IE iE 1k 1E 1E 1E 1E M 1f fI' iF 1F 1E 1f iF iE iE if iE� iElE 1E IE 1E 1f Ik IE 1f iFif 1k 1E 7Eif k 1i 1E k iE �IF 1E 1E IE 1f 1E if iE iE 1E iF ik ik iF iE 1F 1E I(� iE ik 1f
D E V E L O p M E N T S E R V I.0 E S`'� R E Q U I R E M E N T S
iy
ZONING APPROVED BY �T DATE:
HUILDING APPROVED BY : �':.,� DATE:
APPLICATION ISSUED BY: �Y � DATE: 0 23�,�
i(�1EIFIEIFIEIf�lE1F1E1E9fiE1Eik1f1f1f�1E1F1E1(�iF7f7F7f�F�F7F�FiF�f7f7F7F7FiF7E7E�iiTF7FiFiF�iFiF iF7F7f7FiF7F7F1iifiElE�iflFifiFIE1E iE1E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING
PERMIT
PLAN
ISSUE FEE
HUILDING—DIV—>
TOTALS---->
4225t
2�.��
p42M00 20500
SMIP/NON—RES
PLAN—CHECK TOTAL PAID DUE
0.00 62.00 62.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 62.00 OVER/SHORT: 00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
iF iE iE 1F 1E iE IE iE iE 1E iF IE iE fE iF 1t iE iE if IE if iF If iE if iF if iE 1E iF IF iE iE iF iFiE 1E iE iP 1E if if ik iF if iE IF iFiE �F iE 1E iF iE 1F if 1E ik iF if K iE 1f iE iF iE iE i! 1F iE 1E iE iP iF * 1E ik iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYpE QTY_ , D E S C R I P T I O N UNIT COST TOTAL COST
PLU 2
PLU � 2
PLU 1
PLU 1
SINK KITCHEN
WATE�i HEATER AND/OR VENT
HACKFLOW PREVENTER
SINKS, FLOOR
END OF FEES
7.00 14.00
7.00 7.00
7.00 7,00
1�1 ��.i.i�'(�t!"'i.1i17�� eT'L7� :!.1fl
oarE: �e,1a � �: � tr.E: i��:;l
CONSTRUCTION ANO PLANNING
APPROVALS Permit# Date Inspector
1. Temporary Electncal SerJice or Pole
2. Soil Pipe-Undrgrnd. ��
L --
��,�lectrica(�l�f Ef�nd.
\U t 1
£7�Footings,-j� r,
8. Foundation�� `7S y '� .
�� �
9. Water Pipg�Undsg`(r3d. ; j :
70. Structurai'Fioor.$Y`ltem
c.� -
11. Property`Sewer�.Llnei,& House°(Jonnection .
12. Sewer Ca.a Ci ` tr '•
73. Roof Drains �� '
74. Rough Plumbin¢> n
15. Rough ElectricahLConduii �, �
16. Rough ElectricNjri2g �
• 17. Rough Wirin� SiCn �
i �, y
18. Rough Elecirica�i' Bar Ceiling`
19. Roug�h Heating & ?�� Conditioning
.:. ;. i-� � c� *
20 x2o . F F�� � :.,:: •
.
PG & SPA
APPROVALS Permit # Date Inspettor
52. Pool Si Equipment Location ,
53. Steel Reinforcement � �
54. Forms ' ' -
�55. Electricai Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Electrical Cond,'��tlJndrgrnd. " .
c
---•cw
59. Gas Pipe, O Undr�rnd., Test
60. Backwasfi lines, RsTrap, � Undrgmd.
I 61. APPflOVALTO��CK ..y
��, 62. Backwash & Receptor-Finai �
'�� 63. Heater & Vent-Final
��'�i 64, pl�mbing System � Finat'' .
�I. 65. Electrical�Pinal -
��� 66. So�ar System-Fifl�l,
� 67. Fencing & Acc�vApproval �-
68. APPROVED F�LASTE(i1NG ' '•
V�
69. POOVSPASYSTEMSFINAL
FtRE EPT.�EQUI EMEN `,-. .,..,.
C -� g �. R. T
. y u �toc�Fi ace i St*' �: � r ;T�r.:�APPt�V$�r �Pe,�rmit# * � . -
21. Bucir in'$triwiur�� � �" " "'� �' `� C ,�,� ' 70. �nder�r'c�� I-tptlro ;
r. :K �� H � �K
22. 6u� V til+�:ngv�r. � � �x p � (� F�� 71. Produea�ping��6as �Oil
23. 4Gas Pipe+flouF�A & Tasc '. �_ �.� +: �t C' tS G��� 72. Undergr�"'s5Qf1 FiTish _' �y
24. F"Foof`�'Fr�ing" �* �`+`" *"� y� Hx � 7� Undergrnd.Storoq¢Tank �Gas ❑Oil
25. Root�ShABthing S� K �.r. M l7 D ni* 7q? Overhead Hydr�� .
N # tD [*1* y 7 r� i.:r
26. ��BaMr„Ceiling (StriLt�irap &(v��aocoat y� � >, p;� 7y, Dry Cheprical ;_- r.�;-:r
,� ' .. -
27.�arneand:Flashirt��� �'Sc. .*•C' �+ ��' 76. DrySta '.. eFc�.n c� %;n.t7
- �-. r i' -, ,. r .:r, n
O x- u. `i �S � x t� 3. .. �• �p+ • r, 'y <- -. * .
-28. LatFi7�ng �Siding r�* �M�, p w � p 7ry FIXED SYSTEiVI'��iVAf r, .
29. Insuption+ n'fi -� ^ �` .
1 Y- �'
30. Drywall �diling �" �� ,� � F.,
"T_
"� 31. Plaster B[DwrC4;oa.'"'+� S � '"' '
Z 32. �ectricah�o��r ft�,e,c'p�r�-��al � ,�. c�
J �
33. �nah£le[nric> r tT: � R
� �. . . ,
� 34. �jnak�le�ng� Arf��c�litioniny `-� rti t _,
35. �inal Ga4-pipe Tesv; r JsW •• x r-i
36. tloo�;or �anopy F'r � ' �" `� "' �* n
:.:'K il 1 7'..r � K
�37. Final• aaory FiruP�ece �' i�[- r. �! ��
.�.
^38. FinatPlurtibing �,". ^'� � ' �
m i o' 1 �S
'39. Watei+Service�Finel�rr i . rF
T:40. Gas Service-Final ` T '¢�T"" `- '' m
> - CT7 fi
41 . Solar DOmeSticFinad� " �r K `
42. Backflow Prevente� '• '
(�� � cU �� �., �: ,. H
Y.
43. Backflow �rriqdtion * ;.i ;i M
n�n � a�����.:a t.���.:,,,�c��ra,., ��C? � n n:
45. 6ound Ftt�tenjrdtidn.-p 7.:�.. - .,� ..
"' ..._t::i
�6. Hand^icap•Regulatior� 5 n i S
r17. �1N�L STRUCTUfi� & BUICDING �.�: �..
48. F1NhLPLANNING* � E� x"
4�9. ��ec{[7c Release t0 E�ison x
60. �as Release to SoutM"em Califtlraj�as Co k
51. CERTIFICATE OF OCCUPANCY
o Date
ti
7$,`FIRE� EV.F'YL �;.' " ;._n,y
C�
;p�� p�ALT�DEP1�.'FiEQU1Fj�flqEhi;F
79.� FINAL Ir,':`�„�P�ECT�N ' - "`'
� J
8({�'.�' FOOD CERTI��ATE I�Se�E0.. �; �
N"les: 1� �� � . � �
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S 5 C'� T. � � G
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m -:o m �x o
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/ Y • • ' ' !
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ADUHESS OF BVILqNG:
pYME4N,eNAYEIFqqWN: SSS ANTON BL
.00xess: SAKIOKA FARMS
, PO BOX 2097
TERMINAL ANNEX
APPL.WJIlNO AUURESS:
UNT:
4TH
fXCXREtT ON ENOMEEfl: 11C. NO.:
�xcxonexa•swo�ss: INTERIOR ARCH.2136232164 CuAri378
SSO S AOPE ST 1100
COMPICTON'8 NAYE: L. A. CA 9 0 0 71
CRrtPACTORSMIRPlOAIR CONDITIONING COMPANY (818)244-6571
�co�ss 6265 SAN FERNANDO ROAD ��,;
GLENDALE q �q CA 1�N�696
LICENSED GOMflACTOR9 DECUPITION: I heraby M4m uQnd6r pfi9ty d pa�ury Net I em licenrod unEer proWNone N GMqx 9
(cpnmmtinp �Ih SecUon 1000) d Divieion 3 N Ns Butlnea and Pmhaaiana Cade, enE my lioenaa h In lull lpcs eM Mse.
CffY IJC. NO.: 11Q CLASS: lJt. NO.:
014403 C 36 1.20696 EXP: 07/96
Da1e:�/., i ._i. Conlred �
g WNEX BUILDEP DECIANATION: I Mnby df uiWr penaly d per�m/ ihN I am exemq Imn iM Cont m Lbeme taw la iM
i�Jowip �eaaon (Sseion )03t.5 Buairoee eM Rdmeiona COEe: �M eiY n muexv whid� nVuim s V�d lo mmoun. Ma. imD�w+.
�S: imd'oh, a repei eiry atiunuro, prior lo il� eeuenca, ebo requiree iM applimnl la euch permit to fib e eqMA eWament Net M or eM
''is liceroed W���I to tM qaiamm d Ihe Canlradors License Lew �Cliepta 9(oommmriip wnh Seaon )Opp) d DMnian � d tir
Binmea eM Rdea'ions COEeI a ihet he u+ln u xamq threlrwn vM �M leab fa Ne elbpeE ezempbn. My vidmion d Sed'an
imis W em �� ia• w�a .�ei�+ ine �di�m io e aw va+enr d �a mae ih.� r a nu�d�.d adie�s �Ssaop.
� I.avovmardlhapropanYwmyempbyeawYhweB�%+tMiedammpenee�bn.willEotMxwk.eMiheMruclurebrwlinleMeE
w dlared lor eele (Seciion'l041, Bwi�wsa end Prdessiona Cotle: The Con�redars Licensa Lew doea iw epply loan ownerd piopany
wM WiEs ar inpwea IMreon. vd Mn daes aucA xwk himaell «Mnetl a Wouph he or her ovm empbyees, povideE ihel euch
�nvm+emenu e.e oa �mmeea a. on..d �«.w. n. no.a.a,, �n. wueNa v:nwwanem b saa wamo on. rmr a canWab,. ub
o�,a�e., mn n... m. wb., a o��a ne «ene eu m wue « �mw� e« m. wm�e a..bl.
� I. sv ovmer d IM popeM. ��duarely canveaip wnh licenaed conVecton b cmtlrud �he qojetl (Sedan ]DaI. Busirima eM
Pmiessbn� Coda: TM Lamemon lieeree Lew does m� eGVh to en owmr al qW�Y who Euitle a imP�+m ihereon end wlw
ronvaero lu wM Wqa� wuh e eaprepMa) lieereed WnueN to iM Caueman lioeiue law�. ,
� I am ezamq urdx Seciion: B. 8 P.C., br Nia remon:
o�a: o.�,�:
i eo n,�nv �r �nu i� e..�a a.�w �ww ue �o��,�e a ceuo�:e �en .m smwv cod. see�. uws. zss�..m
255�4, eM ihel I a e�Y Mun Wld'vq omqem wi0 / wil �(orcb me) �.aa m cm+W .vn .ae am• mees ene ins.ea�ram«w mr
epemin/amavuctionamoCifrelionhaniheA'r e�iy 'erepementpietrip.HeaEm�ielconetrWioneppk�etumeneRemqfmmlMas
wwidw,s.
Daze: Appl�au:
WOFKEF'S COMPENS�TION OECLAN�TION: 1 heroEy effiim uMer paruXy d pcjury aw G tM blbxiip Exieratuna:
� IheuaerdMilmeieueneee�R'Wadmamitonatli�wnlav.vrken'comperualion.mpwideElabySetlion3100dtMlebar
com. ia me o���e a ma .m� �«.uom m� c� m m�a.
❑ � n�.�d .a �m:.�..«xe�s� om,w�wo� ��w�.�m. m�ea�we W sea:., a�ao d ine im« coe.. m, m. o�«�w�c. d m.
,v
. work fa xfiitl� i�ia permn ia iauad. My worMers compenselan inwrenu rartiar eM po4ry number va:
Carrix:
Pq;�yN,,,,,y,r �, rviirvc��ie�i, �.ea.� EXPIRES
�rn;,��,�..e�aa�cre�aaiww�r;,ra'ld�.n„ ' ew�is�oolmwy.> > 10/O1/96
❑ i mnN mn �� u» w�a��•A a ine w«x ia ..ncm m� w�n m�,.a. i anen m� emoM �r ro� �+ �v man�r eo m w
e�o� a4� �e �n..wn«s� �w �o� e.,. d c.mom tl Wme Yw tl I ehudd Eecmn n+4a �o tM wMa�'
«�*o�� wwea,. a smoo a�oo a ma �n« coaa. �onn m oomaN wn mm. po.�n.
Daie: /A _�.�..Gi Appl' :
�
W�ml�p: RUun ro a�cun wortws' compru+tlon coverap� li unl�wlu( �M sIWI r4Hct �n wrplo • cilMnl p�ntltlu urtl
GHI 9roi iq ro ms h,ntliN Moviuid AWI+n (S1LqOWA N�LCltbn ro IM roa( ol mnpw�ufb � povMW br In
Sxtlon 3]06 0l Ms LaDor COJr, lNenat � aRum�ys /�u.
CONSTfiUCT10N LENDINO �OENCY: I Mreby elfirm uMx penetly d perjury �het �hue e e mrW�udion NnEmp epeiwy br Ne
pename�m a �n..�n ro. wnw� ms v.�� a e�+e tseaun �os�. cr.. cl.
LENDEN'S NNIE:
LENUEN'S AOUHE55:
1 ceNly IM1e� I hca reai No appfr.alion ud mma thet tM ebv+e'vdartution u cornn. I qiae iocanpy r.rh dl oy eM mumy adinvcv�
erd elete lawf releing to bntliq m�uV Wim eM hereby aulhor¢a �epreaenlmrvp d Ihu uly lo eMer upon IM ebava�men�oneE paparly
1« impeeion w�W%��
De�e: �C/ /��i
(St5t�8.WP) WM1�s-�idiq85alelyGrwrFb.`Cenery-/�ppirani:Rnk-Re�anw:GOldenmFAsaeav
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: M 074596 PLAN CHECK N0: N
- --. .i �. � c o
GOCTT: N SUPP: N
CONSTRUCTION TYPE: LFR SP PERMIT TYPE: MEC PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 200005F OFFICE T.I, SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74571
*+�*+�*+�*+t�****�***�r***�*********����***�********��***�**�*�*�***x*�*�*�r�����****
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKSNG REQ: PROV: PARCE,L: 41050104 ZNE: REF NO:
PLANNING NOTES> �
>
�.iE 3E iE iE IE IE i(-iP IE 14 d4 iE 3E iE if if iE iE 9E 9t if� iF iE �)f� �)t iE iE iP iE ik it iE iE iE IE �E 1�9E �)E 3E iF 3t iE iE jf-if-if if iF ik if iE i(-ik it dt if� it ik it iF 3E 3F iF iE iE iE iE iE iE i6 iE k�l(-it it if if iE
. D E V E L O P M E N T S E R 4.V. I C E S R E Q U I R E•M E N T S
ZONING APPROVED HY . � DATE:
ILDING APPROVED BY :
LEGALIZATION:N F E E S U�M-t4 A R Y
� � �
BLDG PMT PLUMHING ELECTRIC ,MECHANIC
PERMIT % 73.00
;:, � .• 2 5 t
PLAN ��
ISSUE FEE :' � /'� ,' 15.00
BUILDING—DIV—> PERMIT ISSUE PI�ADL.CHECIC'
TOTALS----> 73.00 15.00 � 0.00
iyii��l
TOTAL
88.00
DATE:
� it * D * * *+F �t�*7E ir�°�F�YF * *
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
88A00 �00
REVENUE DIVISION TOTALS--> COLLECTED: 88.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANI•C „ FIRE SMIP/TOT GRADING PLAN—CHECK
� 88, 00 �
�
iF iE iE iF iE iEiE if 1F iE if iE if iE if ik aF jF K%iE iE jE iE iE 1E iE df iE iE iE iE iE iE iE iE iE if iF IE 1F %i�iF aE iE IE iE ik aE 1E iE iE jE iF if iE iF iE jE �E if 1F iF if 3f if 1E iF �E 1E IE iE if �E iF iE iE iF
I N D I V I D U A L: ,F 'E E B R E A K D O W N
TYPE QTY D E S C R I P T I O'N;� L� UNIT COST TOTAL COST
MEC 5 VAV BOX ;' 6.50 32,50 /
MEC 7 FIRE DAMPERS S�' 4,50 31.50
MEC 1 INST/REL HOIL/COMPR;, ��,0 — 3.0 HP 9.00 9.00 �
END"OF FEES �
rl' ; �� � � � � �
H , �
. .F . � 1,�
C� 0015�1�: �61S2t.41 Tc7F
DATE: F�/tai�; TIttE' 1���'�9
��.GP
,_;,, . -
�. CUNSTflUCTION ANO PLANNING P� .� SPa
'�'• '� �APPROVALS Permit # Date . Inspector pppROVALS - Permif�# � ""�� " Inspector
'i: - i
i. Temporary E�ectrical Service or Pole 52. Pool & Equipment Locacion '
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 Plum6i�g & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVEP-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd:
8. Foundation 59. Gas Pipe, Q Undrgrnd., Test �, -
9. Water Pipe-Undrgmd. �� 60. Backwash Lines, P-Trap, O Undrgmd.
10. Svuctural Pioor System � 61. APPROVAL TO DECK I
i t. Properiy Sewer Line & House Conrkction � 62. Backwash & Receptor-Final
72 Sewer Cap 63. Heater & Vent�Final �
13. Roof Orains 64. P4umbing System � Fina! �
74. Rough Plum6ing • 65. Electrical-Final �
15. Rough Elettrica�-Condwt � 66. Solar System-Fina1 �
16. Rough Electric Wiring 6�. Fencing & Access Approval
77. Rough Wiring $i9n . 68. APPROVED FOR PLASTERING '
18. Rough Electrica�•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rougb Heating & Air Conditioning L/_�9"c�S , FIRE DEPT. REQUIREMENT
20. Rou9h Factory Fireplace APPROVALS Permit #
27 �. Ducts, in Structure _ 70. Underground Hydro �
22. Ducts. Ventilating 71. Product Piping CGas ❑Oil
23. Gas Pipe-Rough & Test 72, Underground Flush
. 24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74, Overhead Hydro
26. T�Bar Ceiling (Structurel) & Monocoat 75. Dry Chemiwl
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. F1RE PREV. FINRL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster 8rown Coat 79, FINAL INSPECTION
32. Electrical Power Mecer�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: 6� V� _ S- n�, �,,_�
y� c.
34. Final Heating & Air Conditioning
�Z L?7�' � f=�-`LS �2/L�Z7C!_1�7� _
35. Final Gas Pipe�Test
l=ZC�iS �i_2-_c� �(�f-
36. Hood or GnoPY �� ���_r �L��� _
37. Final Factory FirePiace �.
38. Final Plumbing
V
39. Water Service-Final "�
�
40. Gas Service-Final
41. Solar pomesticFinal
42. Backfiow Prewenter .
43. Backflow Irrigation
44. Landscape Irripation System '
45. Sound Attenua[ion
46. Handicap Regulations __
47. FINAL STRUCTURE & BUILDING �
� 48. FINAL PLANNING '�
49. Electric Release to Edison "
50. Gas Release to Southern California GasCn
51. CEFiTIFICA7E OF OCCUPANCY
No Date
�oowEssaem�owo: 555 ANTON BL
ONNEASWIMEIFpAWN: SAICIOKA FARMS
• ' ADDPE55: PO HOX 2097
TERMINAL ANNEX
AFVL. WUIlN01DDflE5A
1RCNRECT OP FNf+NFEP:
ARCN.ONFNO.'8ADOflE55:
uc. xo.:
uNr: q TH
UNT:
comm�crarsru� SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
cartx�croxs�uimo 215 E EL SUR ST
mowEss: MONROVIA CA uc.xo.: 190173
91016 uNr:
UCEN9E� COMPACTOFS UECLAHAt10N: I hereby efl'vm unEar paneXy W psrjury Ihtl I em Icanead undm proviebm d Chepter 9
(mmmenanp wilh Section ]WO) d Oivieion 9 af ihe Burinen aM Proleseione Cade, eM my liomm is in /ull Nrce end eHM.
cmuc.No.:013054 uc.cuss: C 16 uc.No.: 9p173 EXP: 04/96
__p �
oete�.�0��— / S CaNrea«: ���
OWNEfl BUILDEH �ECLAPATION: I hereby elfi�m uMer penaly G parjury tAtl 1 em usmp /mm �M ConVepas Licanes Lew la iM
Jbwip roeaon (�� )�1.5 Bue'vwss mk Rdwuna Goda: Airy ciY a aouMy wfiitli nquim e permn lo oomvucl. Mor. imprv.e.
rmd'mh, ar npei any eVuctun, qor ro ue ewerce, eho rx�uiree tM applimnt Ia wch peimil to fib e epMd eWemeM thtl M or eM
rx
♦ liuneed Wnuent lo iM povisime d ihs ConireGon Licanee Lew �Cheqer 9(mmmenc�q wilh Satlion ]UW) W DNebn 3 d IFe
Bueineu end Prdeaiom Code� or ihm M a ehe ie ezemq ihsehom aM the besie fa 11w albped exemp�ion. My vide�ion ol Seaion
)031.5 by eny eppliranl for e permit eubjeds �he appliceM b e dvil perielly ot ml mora ihen f'Me huMred dol4n [SSOOf).
� I,eeownerdlheOroPaMormyempbyeeewilhweB�%+����lemmpeneetion,vAlldoihewwk.endihea�mdum4'wlin�anded
a ollereE br eele (Section ION, Budnen end Proheeione Code: The Contredore Limroe lewdoea nW applyto en owmerol proparry
wlw buida a inpeovea ihereon, end who Eoee euM waM NmseM or hene� or ihrwOh ho w har own empbyaee, pranded ihe� euch
imqwemems are mt inteMed ar dieied la eele. H, however, lha buildiip w'unpeovmmem ia sold wilhin aw yeer W comde�ian. Na
o.oe��ewa« �;n ne., ma e�m�� d wo.me na o, .ne ad �a wna a �myo� r« me W�a a��.
❑ �. m a.e�., d ine aw�r. � eRaw«Nr oomreaoe wnn �ioansee canrecwn m�mm�a u» wae+a cseaon �a.. am�ewea ana
Pmleaiwn Code: TM Camreean license Law does mi npply �o en owror tl peopeny xM builde a'vnpovea thereon eM wM
convecb lor wM propds wM e aaurmor(e) Iceraed W��� �o Ihe ContreGore lirome law).
� I em ezemq uMer Section: 8. b P G., br Nn reeean:
o�a: o..�,:
I tlo hereby cenity Ihm I em ewere d enE uMentend ihe requiramenls W Cellomu Neellh arM Sefery Cada Seeiona 25505, 25533, eM
255M, enE ihm I or eny Mure buildin9 �+0�� �II / wtll nd (d�ck ona) naed lo cwnply wIh eeid elala wEes enJ �he mQuiremenis fm
epartniiloroonsVudionormoEilraiionirwnthaR'v u i�iy.aregemm�Diatriq.ReeiJentieleonatrud'pnepplifaioroeraexemqtromlhese
yro�nsions.
oe�e: nodcem:
WOPKEH'S COYPENSATION OECLAF�TION: I Mreby effirm uMer panMy d pe'jury ma W Ma fdbvriiq Eetivetiora:
� I heve eM wil meinlan e ceMicele G mvent io eaMimure br xpken' compermlbn. m poviEeE lor by Setlion �)00 d tM labar
Code. la iM pMamav:e d IM xwk I« w1icA this psmu u muaJ.
❑ � nere ene wie meimen wwMen• oomro�.mio�, im�renm. m ma�uee M sm�m aroo a in. �em, coe.. m, me ronoimenca n me
work /« xhidi Nia peimn ia iaued. My workan' mmpansation imurarrw urtiee aM pdiry number ere:
c��: FR MONT EXPIRES
Poliry Number: W�7iC46� ' 0 6/ O S/ 9 6
(This senion rreeC na be mmpbteC A �ha pimrt h la one huiMreE dallars (S't00/ or lass.) , _
� I cerlAy Ilat in IM perlamer�ce W ihe vroM lor which this peimn is iaeued, I nhell ml employ eny penon in eny menewr m es Io
�me a�qm m me won�n• ca�oa�d�� ie� d CelAomia, enE epree ihm H I ahouk became wbjae io the xwkarm'
�o�sma� w�sA�. w see� a�oo a in, �co� coaa. i sn�i � wnn o�Wr .un m� wow,�,.
Dma: _ iQ�� Applirant' ���
i
W�mlrp: F�Nun ro ascun wortx�' conpwuatlon cov�rnps Is un/awNl, �ntl alvll rb/ect an emyloysr ro cr/Miul p�n�Mu �M
clvlr nna �p ro om h,nerotl tlrous�nC OO/Nn (sfoqaaoA �n Mtlltlon ro M. cwt ol rompxuatron O+�P� ++ P'o��dM ro.ln
Sxtlon JlP6 0l Ms Lebor Cob, Intrut, �ntl ettomsy's Isu.
CONSTRUCTION LENDING AGENCY: 1 Mreby elfirm uMer penelry W perlNry ihet �here ia a oonn�ion IeMinp epancy br the
�100l�OTI611CB 11� INB NOI�t (Of W�1N�1 �h6 �IBTI� H 981184 ($MUII 309�/, CiM. Ci�,
LENDER'S NAME:
LENOEfl'S ADDAE53:
�CBf11�y�hB1�h6VBfBBdl�119 9�I�ICBIIOIIBIId BIBIBIhB��hB 8�V01lI�q1116�1Of119C011y}.�BQfBBI000111p1Y W11�IB��C1`/8114 NUll�YOld111B11CB8
eMaletekusrelell^9 ��ame�,�,�a�.mne,aWew,«�,,,v�,,,me�n�wmn�r�oBo�a,�w��n,mo��memo�adworem
lorinspetlion purpos .,_� /
�W �
P'
oma >D �-3-3_�
SigneNre d Ovmer/�penuRppkanVConlrada
(5t51d6 WP) WhXe-Buildinp 8 Safely: Gree�le: Canery-Rpplrani; Pink-Rmenue; GobenroE-Asee�eor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: F 079752
PERMIT NO: F 074752 PLAN CHECK NO: 03948-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYpE: FIR PURPOSE: OTH
JOB DESCRIPTION : AELOCATE FIRE SP SQ FT:
CLAIM VALUE: 8,900.00 CALC—VALUE: GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS REF: H-74571
x x�*x�+r�r��r*x�*�+�+r*�x�**x x x�*x�*x x�x�*�x *x�x **�rx�x�x�*�r*x�+t�r+�+�x�*�r*x�*�r*x�****x�**�x�x�+t�r�+��x�+�*��r�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 41050104 ZNE: REF NO:
PLANNING Nt31'ES>
i
1f 1f 1@ 1f 1f 1E 7f 1E fE If If IF 1f 1P 1k 1E'k 1k ii if iF if 1F 1f 1f� If� IE iE iE 1I� 1E iF 1f if if 1E 1E IE 181E 1E iE fE 1E 1E IE 1E IE 1E 1E iEiE 1(� 1E 1@ 1E iE 1f iE iE 1E fE 1E IE �E 1f 1E 1E 1E 1E'1E iF 1E 1f ik iE IE IE if
D E V E L O P M E N T S E R V I C E S R E{J U I R E M E N T S
ZONING APPROVED HY DATE:
�:1��*A �Z��l�.»� �;�u�����i
APPLICATION ISSUED
iE IE1(� IE IE IE IF iE 1E iflE IF1E i(� IE IE 1f if 18
LEGALIZATION:N
BLDG PMT
PERMIT
F E E S U M M A R Y
PLUMBING ELECTRIC MECHANIC
DATE:
DATE: �� 23
iFlEifiEiEiFiFifif IEiE
STRUCTURAL SEGMENT:N
EIRE SMIP/RES GRADING
10855t
PLAN 70,z0 SMIP/NON—RES
ISSUE FEE
HUILDING—DIV—>. PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> � 108.00 0.00 70.20 178.20 178.20 .00
REVENUE DIVISION TOTALS--> COLLECTED: 108.00 OVER/SHORT; 00
BLDG PMT,PLUMBING ELECTAIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
a 108.00
iE iFM M iFM iF�IE'lE * iFiF iE iF iFiE�ik iFiF 1f�it 1F 1F1F�IE i[' iE it'k M'!k if'k 1Fi(�1E'IE if if iE �f k M'IF iF i{' iE'lE1f if 1kk IF i4iFikd4 M dE ikiE if 3E'IE 1k iE 1E iE iE 1E ik if �IE'K'�IE �IE'IE iE if
:I N D I V I D U A L F E E B A E A K D O W N
TYPE . QTY. D E S_C R I P T I O N UNIT COST TOTAL COST
FIR 108 . FIRE EQUIP FEE (FROM BLDG VAL TAHLE)
� END OF FEES
ro
r
�
_•j �
_./^
f•
�j..
• J
J �"
�
T'
1.00 108.00
0± OOii2"I03—GJ19:i0. T wc7 ;�3,�{
DATE: 10/27�9� 7Ii�F• 1I:3h
CONSTRUCTION AND PLANNING � PO� t SPA
.APPROVALS Permit # Date Inspector qppROVALS Permit # Date inspector
1. Temporery Electrical Service or Fole 52. Pooi & Equipment Loca[ion;: ,�'�
2. Soil Pipe•Undrgrnd. 4:� , 53. Steel Reinforcement � /_.,� f,
.c;;;;�iectrical CondtLh U fty•Undng�nd. 54. Forms � 1�
-�4��iectrical CondUItiv�drgmd. '�� 55. Electrical Bonding �
.�eel Reinforcemg(+(r. � 56. Rougfi Piumbing & Pressure Test
i
nb7 F�ectrical UFE�*�d. 57. APPROVAL TO COVER-GUNITE r
Z-'"7�.'�Do[ing5 _.�;� ' � 58, ElBctrical Cond��llnd�gmd. '
�� 8. 6bundation [*+�: c+ ,"0 59. Gas Pipe, L] UnSfe�rnd., Test
..,
9. Water Pipe�Und��. � 60. 8ackwash Lines,.F�Trap, O,4Jndrgrnd.
10. Structurel Floo�•`SYstem � 61. APPROVAL TO DECK ��
11. Property Sewer iine� House�onnection - 62. Backwash & Rece`gior-Final ,'
12. Sewer Cap rJ ` `;,,' 63. Heater & Vent-Final
13. Roof Drains 64. Plumbin� System • Final '
74. Rough Plumbing-; �:7 � 65. Electricai-Fina�
15. Rough Electrica�Coouit , C' 66. Solar SVstem�Final� '
76. f;ough Eiectric �,vj`���y • 67. Fencing & Access.Approval
17. Rough Wiring S�n � � 68. APPROVED F�PLASTERING �
� 18. Rough Electrica�',I- Bar Ceiling � 69. POOUSPA SYST€MS FINAL
19. Rough Heatin�& Air EondiTioning F�$E pF�PT.�$EQUIREMEf�T
. -n�-+, r r �c^ C .-+.J.. .r. !r
20. �pu� Fa,c�tor�Fi��lace � 5�; � ^. ���� ` APPR„'�OVA`LS;-� P�fnit#�
21. B�cCs; inStr�Iure'Ix � '.. .. '-i r 5 O �-�r' � . _ "-' } "
�, cx i c � '.. ,-� ' �0. ;TlndergroHad H�dro ,k
22. D.ucts� V¢�til�ng1*: i ��� �. d � -, F� � 71. Produci;(�jp`yng� as C�dOil
23. Gas �+pe,Roup� & To-st � ;rf � c+7 c� � O* . 7Z, Undergro�nd F{[1Sii � �' '
24. Roofi�ra�iin �� � �'�" � ` `� �' � `�c� � ` ^
,., 9' x t rJ; �* .7� Undergr�.Sto{@,�„cTanI�;OGas^O�il
J ♦
25. Roo �Shr,a,thing Sx d � K� O> ;v* � 7q'r Overhead "-;'-..� Dt,�.A(� jj.'J,�•�$
r ,� - J
26. �BaF?Ceiiing ($tr�ral) & fas.-Jt,o�.�oat * � � `� �;. 7'S-.,T Ory Che�airal r,� X ~ � F,
27. �ramea Flayhi `•,v
_ R� m'� DtC� r� c� i� �fi 76. Dry Star�sTpe E^tlo i r'
-28. latt�ig �Si�g �� y C�;-' G � E ..� ..�;, 7�, fIXED �,T�TE,�"�I�INAL �� �� ,m-�,� LZ.Lq•�
.
� 29. Insulatioi� �. l�!: S • #�� � 7� FIRE PREV. FI{�L �% �^ 2. �yb f��
• �=/ �
30. DrY�'"all Naili� "� �„� � i., I �' � �i�EALT�,'DEP�.`i�EQ�UIREMENT
, 31. Plaster BiewRC�oa� � � � r^ � 79.� FINAL IAISPECTt9N �' v J
., :,
; 32. ,,F]ecvicaf'Po "r M¢.�r�F�al � x n' ( •� 8Q� FOOD CERTIFI�dTE I��l E[�., �
pJ ` r - . � � �, i�
:33. �na�Eleesric; �* ,! i iy x � �r N6tes: ^ ^! t�': u ^n7
� ��
� 34. 4,inaRlieating�ic A4r�onditiorrir� � �' * I TT -, `�� �F � TC'
ry G .TJ .^•i A:.-`� H 1 i-+Q .F
� 35. K�naiZ'ias Pip�:Tesi.x; Q, .. :y'., �� wo cJr �� C': �
i �
-36. HoorPbrCanoPv "= � �"� a �:n ` � � �'-n + �r
c^ r n t�m �s �t :n za x-� 7:=7
" r.� r ,- _.. � �
_37. ��nal.FactoryFirePlxte �; ;.�., r� x. � kk � S --� K `]N
38. F-inaf�Plumbing � , N � � k ! �i S �'`� v � - -
rl � �T. ' A:
�: I r r' . 1 v.l
� 39. 1�jate�Service�Fina1 T � � * � ( �K ' � p � " `
r -, �r
40. Cias Service-Final �x T �:[T'•`•' S *[*: `�* O� o�� �� �-
, r, c. 'n '1'. t F' 6< s' '¢
y41. S'd�lar pomestic�Fina� = '�f.,.� � * "� � r � ' '-'
C+' C t� '= c= O' +' 7' 7
�. . �-
42. Beckflow Preventer *� PJ x r� S��� • DF < � '-�
w �r :- :% R', J tl� c� [:: O x, c.
X .T. S �• �'' � �. : � v
43. Backflow irriqetion �� y, * S * r ;� .
4R. LandscapB� Irr�atiori''System �-n;CJ �T: * m 0 O O� � N:u •-. Tf3 +'� ^ n� c
.- .-. ri t M �.k F, �. L- O � V: s
1 .x �. C. F :T' k 1. r :-� e-� ��� ry r+
d5. 5pund Atien_u�a,[ion, „ r. ?] ,7 M�, a� c' Z� >
- - "
46. Hendicap•Regnlationk � O r� M a: 5 Oo `" *
r c � Y"'^ v !: R
47. FNAL STRIJ�'LTUR� & BUILDING � � �% ' n' �
�K F i'� .T :ic
n
48. EINFCLPIANNING�' :-F• ":N � , m � * •
� C; N � %F �
49. �lect7;c Releaie to E�lison � � � ,� ' �
50. f,as �iklease to a`�outhem CalifdmiaGas Co * ( k'' � r+ •%.n A C�'
� � �� R s �o � x :v c
61. CERT7FICATE OF OCCUPA�JCY * T � �•' •��-� • � • -'
No. Da[e
�oonEssovew�ou+o: rjrjcj ANTC�PI BL
axxeasw.weivaawx: SAKIOKA FARMS
, . �noneu: p0 HOX 2097
TERMINAL ANNEX
dVPL. WIIlN0I0URE54:
uxr: 4 TH
�wcxnecronenaxvn: TR I— S I GNAL I NC . ��NOt 0
urce.onEr+a•s,�oox�ss: 1995 GARDENA AV 818-247-1194 �M
GLENDALE CA 91204
coam��rareiuMe: MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
carm�croaswuura p O BOX 509
,�nopEss: WALNUT CA �� 230813
91789 uxr:
LICENSEO COMflACTOP4 DECL�NATION: I Mnb/ dbm undar paroy d per'ryry Mtl I em Icwwtl uMer ynitlora W Ghaqx B
(mmmerKinO m�h SMion 1000) d Oivisian � d I�e Buai�roee uM PeWeeeqns Cods, enE my lieanw u in hll Ipcs arM eHep.
cmuc.No.:�65 uc.cuss: uc./No.,/y�3y0y8 3 EXP; ly�/96
Dele/ ` Comrufw: l ///
OWNEP BUIL�EP OECIAN�TION: I Mreby elfimi uMw pxWy ot perjuey t!W I em ham �M ConvWon Liwme Lew la Ihe
'�Ilowirp reemn (�� 1W1.5 Buaiieaa eM Prdeaiom Code: My c'ty or Y whidi r auiras e pmnd m mnatruct. eller. imDrova.
�mdsh. a repei eny sVuclu�e, pna lo ta ewe�Ke, ebo roQu'vm IM ta wrli N Io fik e aqrod eftlemeM OW M a sM
� IieenseE punwnt lo �M poviaiom d Na Convaq«e Lieenae lew [Chep 9( ixiep xilh Seqion ]000) d DHoion 3 M IM
Buaineo vd Prdaviom Code] a thet he a ehe e a<emq iherehwn eM tM ' a Ne +AeO� �emqion. AM vbW ion M Seaion
1031.5 by eny eppliraN fw e parmil suEjed� Ihe apd�� lo e anl pmelry d m� mors ihen frve huiMred Edbn �5500�).
� I.mox�rdlMpopenywmyempbyeeavAhwepesmlhaisdacompereaton.rvillEONexak.enElhen�uauroaridinleMad
«onerea ror eale Isecfen laa, emrea. a,d aiwesaon. coae: ine comraeon Lica,ee Leweoe, na woM�o en nwnera omoa�+v
who buida rc in0� �he�eon. eM Mn Eoea suM xwk Nmaetl «hersN a Waph h6 n her own amPMb+. o�a+daE thm euc�
imprwemenls ere ml inlaMed or dleeeE la eab. X. Mwaver, �M Wiltliip a inpovameM is eoM within aro yev d mmple�on, IM
o.�rcu�ax wi new me eumm� a ww��o na «ana tid �a dae w�ww. �v u�s w�v� a mel.
� I. ea ox�r d ihe propam�. em e�tluriely oonlrmnp MdA liceved camreclon io mMua tM P�W� (�� �. �+air�ma eM
rw..sm. code: Tn. camraau, ueeree �ew eom na mdv m.� o.ms a ww�r wno wua. «:npem�e. maeo� e�e mw
wnlrecb br eucM1 pmpda wu� a wmrmw(n) Icemad WB�� to tM Conned«a Lioanae lew).
� I em uamp urder Section: B. 8 P.C.. tar Ne �unn:
Dele: Owrcr.
I do MiaW cMlh iM1at I em ewere d eM wMaabM Me �M���b d Cdiarva Hsa4h aM SefMY CoEe Seabm 25505. 255]3. end
2553n, end Ihet I u erry hnuro Wik"vq oavpem wiA / wil rwi (mcb ar) neaC to mnp!/ Mh ub ame oodee vd Iha mpuimmenb lor
oe�e: �od�wn:
WONNER'SCOMPENS�TIONDECLAF�TON:IMeb�eif uderpenMydpryryardNeltlbx'vqdederpbu:
� I hava antl xil mainten e eenAceia d mwni to a Wr�uun la xvken' ewnpaenvion, n pro+idetl Iw by SeGbn 9]00 d Ihe lebor
caee. i« in. v.�+�. d m...m� i«.�n � c«ma o 4.�e.
fl in,w�e�;i�m�.ona�.��m�mo��w�...nwn.dMs.a���ooam.�e«cme.i«mewn«�,oeam.
1� wak la whiM ihie pwmn ie ieeueE. My worken' oompammion im�mrce wrier eM pafx.y number ue:
, c�.,: FIREMANS F NU D �E�PI�RE96
Pdicy Number: fl W f R(1 F. 7 fi q�—
(Thia esUhn nwJ mt M rnnpNtW i iM prmt u M ms hu�d eoeais /Staol a/mJ
❑ I eerlN Ilul in IM1e pmlameewe d IM work Iw wfich Ihu parmil e iewetl. I ehell eM smpby enY Db� in e�ry menna p a� to
becm. .u4aa m �ns .a+nre• oomo�cn xw. a carnmue. ena ro�se ina i.hw�d eemnr w4er„ u �n. .�vn.n'
com/�5^�xtion p's d 00 0/ iM leEa Cade. I ehel wi1M1 oomyy will Ihoee povivione. \.
Deie: / �� Appfram: �
Waminp: Fellun ro��cen roik�n'rompwu�tlon rovaap� b un/nvNl, entl tll wG Cf 1I1 Mlp/OyM t0 CtlMNI pN11MY 1OC
dv/I Hnsi up ro on� �urdM thauuM tlo1Nn (JlOqaoO), M sEJltbn ro M cwr ol „p.,wrron e+m.w... au�aw ro� in
Sxtlon J1P6 al tlrs LeDo� Cob, /nt�m4 Ntl �ttomry'� Iwa
coNSTnurnoN �wmra nceNcr: i namr ��w. o�mi a�� m.�, e,�n�w�, �� � ro� w,
perlormenro ol lhe xoh br xfii h ihe permY ia'swed (Sedion 309]. C'v. C�.
LENDEN'S NAME:
LENUEF'S ADDHE55:
I cerliy ihe� I heve reetl IM1is epplicetion eM e�me �het �he above iniwme�ion u wrteu. l pree to compN xmh ell tlly enE munly aEinencea
eM etaie lew rNet�re �o butld'v�e conm�rbm eM nereb' eNha¢e ropa�emmrvae W Ihis mY w enlx uv� �M ebova-mentioned o�oeM
�Of1119pBC�qllpUfpOS89.
CHOCK JACOHI JR
PmtName
, �'v� �zz�r �,' o�.�—f'— �
(St51d6.WP) � W�itle-B�ildvq 8 Sdery; GreemFle; Cenery-qppirant; Rnk-Rerenue; OddenmE-Asseamr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 075839
PLAN CHECK NO: 04812-95 L
PERM NO: F 075839
GOVT: N SUPP: N
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74571
�x��*��***�*x�x�**�*�**x x �*x�x��rx�x�*�x���***�*��**x��x�***��*��***+�+r+�*+�+�**x+r��+�x *�******
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
----------- MAIN BUILDING ----- ----
FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCESSORY BUILDING --------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE; REF NO:
PLANNING NOTES>
7
1E'If iE 1k 1f 1E iE 1ElhlE 9F 1ElElElE 1E iF 1f iE if �f 1E 1k if 1E iE iE �F i(-IE I(� 1E 1E iE iE iE fE 1E �lE'IE iE'1E 1E 1E �E �E k �E iF 1E �F i(� 1E IE 1E iE if �E fE 3E'1E �E!(� 1E iE 3E if �f iF iE 1f 1f 1E iE iF iE iE 1f 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: �C1
1E if 1E iF 1f iP 1f 1f 1E iE iE iF IE 1E 1f iE If� iF if 1E if 1f �IF iE iE iF iE if 1E 1f 1F iFirt��7F7F�."�iF if
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 90.00
65t SMIP/NON—RES
PLAN 58.50
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECI( TOTAL PAID DUE
TOTALS----> 90.00 0.00 58.50 148.50 148.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
iE iF iE iE iP iP jE iE iF iF iE aE 1E iE iE iE if 1E 1E iF k iE 1f 3f ik if if iE iE iF iF ik it if iF iE iE iE it if if if it if ik iE 1k if iE iE jE if ik 3E if 1E iE iF iF if ik iE it iF if iE ik 1E iE iE iE 1E iE iE 3E jf if if 1F
I N D I V I D U A L F E E H R E A K D O W N
TYPE
f�i:i
QTY
90
D E S C R I P T I O N
FIRE EQUIP FEE (FROM BLDG VAL TABLE)
END OF FEES
UNIT COST TOTAL COST
1.00 90.00
ni od1�,:,. n: i>791^ � �1:TM 9D.5•
17n1-F: .;:'(:� �� T��":.. �1::ir -
CONSTRUCTION AND PLANNING � POC . SPA_ _ .
4PPROVALS Permit # Date Inspector pppROVALS Pe.mit # Date Inspector
1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location "
2. Soil Pipe-Undrgr�d. 53. Steel Reinforcement .
_3. ElectricalrCond�VifUtility-Undrgre6. 54. Forms
4. �Electricai Condu(f Undrgrnd. � 55. Electrical Bonding .
5. Steel Feinforcement �� 56. Rough Plumbing & Pressure Test
'8•�ElectricaPUFER'Gr.nd. 57. APPROVALTOCOVER•GUNITE
.7.'Footings . ' � 56. Electricai Conduit-Undrgrnd.
� 8. Foundation. � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undr9rnd. • 60. Backwash Lines, R'Trap, � Undrgmd.
10. Strucwral Floor System 67. APPROVAL TO DECK
11. Property Sewer L'tne & House Connection 62. Backwash & Rece�tor-Final
12. Sewer Cap � . 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System • Final
14. Rough Plumbing-. • � 65. Electrical-Finai
15. Rough Electrical•Conduit •^ � 66. Solar SYstem-Final
16. Rough Elearic Wiring- _ 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PIASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPASYSTEMS FINAL
19. Rough Heating & Air Conditio�ing � FIRE DEPT. REQUIREMENT �
� - .
20. Rbugh FaFtory Firezplace _�' ' y J� ,APPROVALS �;'Permit #� ��
21. Ducts, in Structure*� �•• • ' -� 70. Undergrou}td Hydro
.
22. Ducls.Ve'ntilafjng` ' ' Y� �.`_`�' �71, ProducCPi,pingOGas OOiI
�
23. Gas Pipe•Rough & Test i :* 72. Underground FlusFi�
24. Roof Framing ' ' • • ' - �_� �. '7g';�ndergmtl. Storage Tank O Gas ❑ Oil .
25. Roof Sheathing :` • v pi �� 74; Overhead Hydro. �
26. T•Bar.Ceiling (Structural) & Mor�OCoat f • � ' _ F 75. Dry Chemical � ' ' '
-'.J R
27. Frame and Plashing , =, , - r 76. Dry Standptpe �- A >� �t
�-28. Lathing BrSiding i;- �:< ' 77. FIXED �VS'TENj �INAL
29. Insulation• -, t= � � . � 78', F�REPREV.FINH�L -• • Q"1I�(, iAl
30. Drywall N�iling ' ;,_ _' HEALTH`OEPT� REQUIREMENT
�,37. Plaster Brown CoatY - . - • 79. FINAL IP15P.ECTION . - �
32, Electrical�Powe� Met¢r•Fin�l �' ' 80. FOOD CERTIF�CATE I$S�JED _
33. Final Eleciric -� ' + ��� Notes: - I _ �
34. Final:kieating & Airi6onditioning . _ fi � - � • ' ��
35. Fipal"Gas Pipe-jest, . , ' -� ' - .
36. Hood or Canopy � _ : • ' •
_ � .
37. Final Faaory FireplaFe� � ' ' `
38. Final�.Plumbing - � �
39. Water'Service-Final , � ' ' � .
.40. Gas Service•Final • . _ • _ � ' • �M � ' �
'41. Solar pomesticPinali . ,.. _ - . .
42. Backflow Preventer + � � ' � • � -
,- ,
43. Backflow Irrigation ' � � � � ` , . � , J
4A. Landscape IrripationSystem ai.�.;, � � � : R _ ' - �
45. Sound Attenuation � ' , ., . ' ` ._ . . . ,- �
46. Handicap'ReguWtions s : � _ _ _
47. FINALSTRUCTUfiE&BUILDING ` � ,
48. F�NAL PLANNING - � -
49. Electric Release to Edison ' '
50. Gas Release to Southem Cali�ornia Gas Co - �� '
51. CERTIFICATE OF OCCUPANCY � �
7
No. Date
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA. CA 92626
BUILDING PERMIT
Job Address: 555 ANTON BL
Suite: 500
Vicinity:
Parcel Number; 41050110 Zoning:
Applicant: ROLANDO CHIFFER _ ISSUED BY:
' < ,. _
Address: . �..,` .' -
" . _�- Phone: 714-245-1600 X230 - � �-
- " Zip: � �
Owner: SAKIOKA"FARMS %MORGANS HOTEL LIMITED
Address ,�PARTNERSHIP ATTN JOE CRAWFORD . �
i; DENVER, CO : �� -" . Phone:
- ' 1050 17TH ST,#7220 - " Zip:
, � � ,
Contractor. SEASHORE CONSTRUCTION INC.
Address: 1930 OLD TUSTIN AVE
Slatus: ISSUED
Applied: O6/10/2004
Issued: 07/14/2004
� �
� � �. � : �
, 'n,� � �� ���.�\
, / .
� ,_, �: .
� � , � . Phone: p14)2457600
� � �� SANTA ANA, CA -
Zip: 92705-1600 . • License: � 469215 , ,
nrch : JIM BICKEL ' , Eng:
Address: 3600 BIRCH ST � � � � - Address:
� SUITE220 . �, �. Phone: 949-757-0411
NEWPORTBEACH "
� , , , . , Phone:
Zip: 92660 , License: C20925 , License:
� . � .� �y� -� SCOPE�OF PERMIT �. - � .
� UPGRADE EXISTING 1,500 S.F. INTERIOR FOR "PEOPLESOFf" IN SUITES 400 AND 500. ELECTRICAL AND MECHANICAL WORK. NO NEW
PLUMBING. UPGRADE SERVER ROOM IN SUITE 500 - , " �
Plan Check: $300.59
Permik' $462.45
SMIP Res: ' $0.00
SMIP Com> . $6.58
� � Other: � � $0.00
Inspection: - � $0.00
Total: $769.62
SETBACKS,',`,
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Existinq: o
d
� � � ^ FEE SUMMARY -
� ' � , �� � Calc Valuation:
' , Claim Valuation:
� ,
- - .. -
'�.y _ `i' ,
.. , _ ,
. ' .l .-✓, - ��� .
�- . � _ , �_ „ :'i � .
� PLANNING'&ZONING , - �'i ��-; i;-''
�,_ i
� ,' i
i.
- � Rear - 0= 0 �- _ " Left 0 �0 . Rlght � 0• 0 � y� '
, �',
� i � 'i
- Rear . 0-0 LeR 0.;0-y,� �� � Right � 0-'0 �j'
'
Reouired: 0 , _ Proposed: ��0
' '
$31,350.00
$30,000.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This parmit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period ot 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all
requfred inspeetions end flnel epproval must be obtained. Failure to obtain inspections and final approval vnll result in the expiration of �his permit.
FOR INSPECTIONS CALL: (714) 7545626
2446-a8(8/00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby effirm unCer penelty oi per�ury one of the tollowing tlecleretlons:
❑ I hev .and will mainteln e certiflcate ot consent to self-Insure br workers' compensetlon. es proNded tor by section 3700 ot the Lebor Code, br the peAortnencs ot the
tor which this permit is Issuatl.
I heve end wlll melntain workers' compensation insurance, es requlred sectlon 3700 of the Lebor Code, for the peAortnence of the work for which Ihis partnit is issuetl.
My workera' wmpensatiop�ln�urance �arner���o�Icy,r��4er eS9q: //_��G� 7/��
Cerder: ""rn'��v / (�•L�� /y � ./.� �!' Policy Num�er. �U � �i�
�--L.o_!—fG �
(Thls sec on naetl not be crompleted I! fh pe�velued ef one huntlre tlollers ($100) or less.)
❑ I ceRly thet in the pe enc of the or which ihis permlt is Issued, I shall not employ any person in any manner so as lo become sub�en ta iha warkers'
compen5allon lew eA' , an lhat If I shoultl become SUD�ect ro Ihe workers' compen5etlon pmWsionS oi Seclion 3700 of Ihe LeDor Code, I ahell forthwl(h
comO�Yw�ththe5 ovislon �� /��
Applicent Slgneture: ' Date: ��
WFRNINO: FAILURE TO E E W S' SAT10N COVERAGE I$ UNLFW FUL AND SMALL SUBIECT MI EMPLOYER TO CRIMI PENNLTIES AND GVIL FlNES UP TO ONE HUNDRED
THOUSANDDOILFRE(51 ),I _ LO CWTOFCOfdPENSRTION,DAA1hGESASPROVIDEDFORINSEGTION3lOfiOFTHELA80RCODE,INTEREST,ANDATTORNEI"SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy eillrm that I am
force enA ettect. Llc. A_
Gonlrectols Slgnature:
CONSTRUCTION LENDINC�
❑ I hereby attirtn Ihat there
Lendefs Neme:
Sipneture:
9(commencing with Sectlon 7000) ot Division 3 of Ihe Bi
Class a
Date: _
Iendinp egency br the peAormance of the work tor whic� Ihis permit i� issued. (
Lender's Address:
Date:
antl my license is in tull
3097, Civil Cotle).
OWNER-BUILDER DECLARATIONS:
I hereby eMirtn thet under penelry oi perjury thet I em EXEMPT FROM TME CONTFiAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professions
Code: Any clry or wunry which requires e Dermit to construct, eller, Improve, demolish, or repair eny siructure, prlor to its Issuance, elso requires the epplicant tor such pertnit
lo lile e slgned stetament thet he or she is Ilcensetl pursuant to Ihe provislons of the Con[ractors License Lew (Chepter 9(wmmencing wit� Sectlon 7000) o} DMsion 3 of t�e
Business end Professions Cade) ar that he or she Is exempt tharelrom end the besis lor the alleged axemption. Any violation of SecUon 7031.5 by eny epplicant for e pertnit
sub�ects the aDPllcant to e civil penelry oi not more ihen five hundred dollers ($500).):
❑ I, es owner of t�e properry, or my employees with wages es �helr sole compensetion, WILL DO TliE WORK, anE Ihe structure Is not Intended or oXereA for sele (Sec.
7044, Buslness and Pratessions Code: The Contractore License Lew does not appty to an owner of property who bullds or Improves thereon, and who does such work
himself or herself or Ihrough hIs or her own employees, providad thet such improvements ere not imended or oHered for sale. tl, however, the building or improvement is
sold within ona year af completion, ihe owner-builder will have Ihe burden of praving that he or she did not build or imprave for purpose ot sele.). '
❑ I, as owner of lhe properry, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to cnnstruct the pmject (Sec. 7044, Business end Pmfessions
Cotle: The contrecrors License Law does not epply to en owner of propeny who builds or Improves thereon, end who comrects br suc� pro�ect with e comractor(s)
. Iicense pursuent to the Coniractors License Lews.).
❑ I em exempt under sec.
SignaWro:
Owner ID veniied by dnver'Slicense. ❑ Yes
Verlflcatlon ol Ownership by (rype oi tlocumenL i.a.
Business end Professlons Code lor ihis reason:
❑ No Drivefa License No.
property ta% blll or tleea):
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certily Ihel no excevetion five (5) or more feet In depih into which e person Is requlretl to descend, will be made In connectlon wit� work euthorizeG by this
permit, end the� no bullding sirudure, swttolding, falsework, or demolitlon or dismantling theraot, will be more �han thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle B, Celifomia Adminisiretive CodeJ.
❑ As owner-bullder, I will not employ enyone to do work which would requlre a permit tmm the Dlvislon of Indusidel Satery, es noted ebove, unless such person has e
pertnit to do such work from the division.
Sipneture: Dete:
Division af IndustAel Safery Pertnit Number:
CERTFlCATE OF COMPLIANCE AND AIITHORIZATON OF ENTFiV: I certily under penalry ot perjury fiat I have reed this epplicetion entl state Ihet the information given is
correct. I agree to com �ly with ell st e laws en0 city ordinances releting to bulltling construction, and euthorize representetives of the City of Coste Mesa to enter upon the
ebove-descnbed D�9PgAY�Wr inspect�n purposes. I agree not to acupy or aliow wcupency ot eny building authorized by this Dermit until finel insDection.
COpE �. �
1616 Fixetl System I
1266 Paol Spe Final
Prevention
200 Final Re-Root -
201 Flnal BIocWRetaining Well
202 Finel Factory Fire Place
203 Flnel Slgn
20A Final Damolition
�g �
COpE• INSPECTIONTYVE
206 Finel Mechanical
208 Final Plumbing
210 Final Electriwl
272 Final Fire Preventlon
220 Final Planning Approvel
222 Finel Site
250 FinalBuilding/Oaupancy
Pdif. L�Lfl
(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
555 ANTON BL
500
ELECTRICAL PERMIT
Parcel Nunmber: 41050110
o.pp�icant: ROLANDO CHIFFER ISSUED BY:
_.� �-
Address: - . '<� .�. ._� - "
i
�",; � " �. ", , Phone: 7�4-2451600X230 � � �
/ �� ,
� = , " „ . ' Z�p' � � . .
� � � , i ' ' �- . '
' �%i . _ . � - . ' , ' , . � , . '�
% , ''-,. �,- / � ' t .. __ ' - -� � A
Owner:�'�SAKIOKAFARMS%MORGANS�HOTECLIMITED' , �=;�>�;� %���` � . �, ���
" ii - ' _ - . Ai � ;•.
Address ��PARTNERSHIP ATTN.JOE�CRAWFORD �� ' � � � � % � ��
. '� � ; ii i� �.�
DENVER, CO„'� - Phone: � . , . � � �
�
� 1050 77TH ST,#1220 Zip: �� ` �� : .
� "
� ,
� Contrector. SEASHORE CONSTRUCTION INC. - _ � �� ,
Address: �1930 OLD TUSTIN AVE " - ' - � .
Status: ISSUED
,Applied: O6/10/2004
Issued: 07/14/2004
�SANTA'ANA, CA. _
r
� . ;- , ���Pfione: (714)245-1800 :
�� . - Zip: 92705-7600 .
License: 469215
-•, n . y SCOPE
� ' 1,500 S.F. INTERIOR TENANT IMPROVEME�
. ELECTRICAL AND MECHANICAL WORK. NO
�
� �. /
.
��� `
_�r �t
iFT" IN SUITES�400 AND 500. �
;EF.:804-01068 ,
��� ��� � ELECTRICAL TO INCLUDE: 21 LIGHT FIXTURES, 9 OUTLETS, 9 SWITCHES, 1 COMMUNICATION ;.
� - DROP AND 1 SUB PANEL'TO 200 AMPS.- � -, " � , � � - -
- - -- - ----' ' - - � ,� _ -. .
, � . , � . � • � _ U_._ , _> >, -
,� _
,_
ti'
�
ISSUE FEE � $23.50
Tenip service test- • , � $0.0�
Re3. a/c package ��t �$0.00
New Res (1-2 units) � �;�$0.00
New Res (3lunits) �$0.00
Pool / Spa '� � �� $0.00= �
Lighting Fixts ` '- -� �, $22.73
Recept Outlets �� ��` '�� % , $9.90
Switches ����V `� $9.90 �
Non Res Appl �'� �� � �$0.00
Res Appl � � ' $0.00
Service to 200a �; $0.00'
Service to t000a � ,� $0.00.
Service over 1000a �$0.00
Mators to 1 hp $0.00 -.
Motors to 10hp $0.00
Motors to SOhp $0.00
Motors to 100hp $0.00
Motors over 100hp $0.00
FEE SUMMARY . '
Quantity • , „ �_ � Quantity���! , , ' .
.. 7emp Dist System / Lightlng $0.00 l %0'i � . � � '
=� �=� -Busway/100ft �$0.00 �; �0' � '
, ��+���!'� . � . Standing��Seclion $0 00� ; � 0 '
0 , �-, , Misc Electncal Eguipment $0.00�� � 0 �
�, ;_0 � . Transfortners,uptol;kva/kw�-- -$0.00,' 0;. ' �
�
. 0� ' ' ^ ' . .......up to 10 kva/kw " `$0,00 . - 0 '
� ........ ;,
21 � . - •" ....:'...........up to 50 kva/kw � '�$0.00��� 0,. � � /
� � .` 9 . � � � � .................up to`100 kva/kw = � - $0.00 �✓; 0' / ��
�9= � ` , " . ...:........over,t00kva/kw � : $000 }�i0 /�j �
0 � . � �Low Voltage EquipmeM � ' ^$0 00'�: 0' ; �
�0 . � Low Volt Winng System / Ckl �� -$0 00 �0�
- � � � 0'� � � � Misc. Conduit . , � , �� �. $0.0,0 � % `�,0
.,, 0 . , ' � , Misc. ConductoC�' \ $0.00'�j 0
0 . � � Circus(genornde) - .��$0.00' 0
�� 0 � .. Circus (mech ride or lights) �':.$0.00 0
. 0� � - ChristmasTree,Stantl�� �j� $0.00 0
0--- - . -� . FireworksStantl' � - " $0.00 0
0 ��� � - � -- 04herElechical�Fee $0.00
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRA710N: 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 Inspeetiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2d46d6(NW)
WORKERS'COMPENSATON DECLARATON:
I hereby etfirm under penalry ot perjury one oi the following decleretlons:
❑ 1 hev d will melntain e centliwte oi consent to salf-Insure for workars' compensetlon, es provided for by sectlon 3700 of the Lebor Cotle, for tha pertormence ai ihe
for which this permit is Issuetl.
I heve end will meintflin workere' compensation insurance, az requireu 6y section 3700 af the Lelwr Code, lor Ihe peAortnance of Ne work for which this pertnit is issuetl.
My workers' wmpe setp� Insuren cerd r eng,poli nmber ere� �% %
ceMa�: �/'Pl� f�,,l� ll�I'. �(d �6/��� Poliry Num�er: f�2L�� 1I.o`
((h13 SBCf/0!1 lIBBd /10f B BtBd l/jIe perrfiit is val�one hundred ddlars (5100) or less.)
❑ I certify �he� in the
compensellon law
compty with Ihese
Applicent Signature: _
WMNINO: FAILURE TO SE
TqUSANO DOLLARE (510
LICENSED CONTRACTORS DE
I hereby eHirm that I am licensed
torce end eHecl. Lic. M
Comreaofs SignaWre:�
CONSTRUCTION LENDI C�AG
❑ I hereby eMirtn �het �here is e
Lender's Neme:
Signewre:
�iich this permit is issued, I shall not employ eny pereon in any manner so as to become subJect to the workers'
It I shoultl hecome suD�ect ro the workeB' compensellon proNsions o1 Section 37D0 of the L!ebo� Cotle, I shall tort�wit�
!/ Dete: �L/(�/_ VY
NJ COVEMOE IS UNLAWFUL AND SlULL SUBJECT AN EMPLOVER TO CRIMI PENAL I AND C IL FlNES UP TOONE MUNDRED
OFCOMPENSATION,DAMAGESASPROVIDEDFIXiINSECT10N31080FTHE RCODE,IMEREST,ANDATTORNE'fSFEES.
9(commencing wit� Section 7000) of DlNsion 3 0l ihe B
cless a
and my license is in full
lending agenty for the peAormance of the work for whic� this pertnit is issued. (Sec. 3097, Clvil CodeJ.
Lendefs Atltlress:
Data:
OWNER-BUILDER DECLARAiIONS:
I hereby eHirtn thet untler penelry ot per�ury lhet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for tha tollowing reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry which requires e pertnit to constnict, elter, improve, demolish, or repair eny struMure, prlor to its issuance, also requires the epplicant for such pertnit
b tlle e signetl statement that he or she is Iicensed pursuant to ihe proNslons of tha Contractors License Lew (Chepter 9(commendnp with Section 7000) of DMsion 3 W t�e
Business enA Profeulons Cade) ar that he ar she is exempt therelrwn end the basis tor the alleged e:emption. Any vidation of Sedlon 7031.5 by any ep0���en� ior e pertnit
sub�ects the epplicant to e dvll penelry ot not more t�an tive �untlred tlollers ($500).):
❑ I, es owner of tha property, or my employees with wages as t�air sole compensetion, WILL DO THE WORK, an0 ihe structure Is not IntendeE or olferetl for sele (Sec.
7044, Business antl Professions Code: The Contractore License Lew does not eppty lo en owner of properTy who builds or improves Ihereon, and who does such work
himself or �erself or through his or her own employees, providetl Ihet such improvements are not IntenAetl or oHeretl tor sale. If, however, the building or improvement is
sold within one year of completion, the owner�builder will have the burden of proving t�at he or she did not bulld or Improve for purpose of sele.). '
❑ I, es owner of the property, am E%CLUSIVELV CON7RACTNG WITH LICENSED CONTRACTORS to construct the proJect (Sec. 7044, Business end Protessions
Code: The conirectors License Lew tloes not epply to en owner ol pmperty who builds or Improves thereon, end who contracis br such project wlth e contrector(s)
. license pursuant to the Gon�rectors License Laws.).
❑ I am axempt untler sec. Business antl Protessions Code lor this reasan:
Signeture: Date:
Ownar ID verifled by drivers Ilcense. � Ves ❑ No Drivefs License No.
Vedlication ot Ownershlp by (rype ot tlocument, I.a. - property tex bill or daed):
Expires:
DIVISION OF INDUSTRIAL SAFETY FERMIT CERTIFICATION:
� I hereby catlify ihet no excavetion tive (5) or more teet in depth into which e person Is requlred to tlescend, will be made in connection wlih work authonzed by Ihis
permit, and that no building strucWre, scaffolding, telsework, or demolltion or dismantling t�ereof, will be more then thirry-slx (36) feet hiqh. (Chap. 32, Grp 2, Art 2, Sec.
341, 71t1e B, Califomla AdminlsVative Code).
❑ As owner-builder, I will not employ enyone to do work which would require e pertnit irom the Dlvlsion oi Industnel Setery, as nated eDove, unless such person hee e
permil to do such work trom the divlslon.
Signeture: Date:
Division of Industnal Satery Permit Number:
CERi1FlCATE OF COMPLIANCE AND AUTliORVA710N OF ENTRY: I cenity under penalry of perjury that I heve read this application and stele that the iniormatlon given Is
correct. I egree to comply with ell state laws antl ciry ordinances releting to building consiruc�ion, end aulhorize representatives ol t�e Ciry ot Casta Mesa to enter upon the
ebove-tlescnbed properry for inspectioq puryases. I agree not to acupy or allow occupancy of eny building euthonzed by Ihis permi� until finel inspection.
cooe �.
1618
1266
200
201
202
203
Flzed System Fin�l FI�Pr
Pool Spe Finel i
Finel Re-Roof
Finel BIocWRelainin9 Well
Final Fectory Fire Place
Finel Sign
204 Finfll Demolition
o�TE It�LS
CO�E 1 INSPECTION TYPE
20fi Finel Mechenical
208 Flnal Plumbing
210 Final Elecirlcel
212 Finel Fire Prevention
220 Finel Planning Approval
222 Finel Site
250 Flnel Building/Occupency
pA� II�LS
� F�iL ��✓
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
5
5TH FL (J D POWERS)
«u�.��y���:
ELECTRICAL PERMIT
Applicanc FULFORD, TERRY
Address: 8749 SHIRLEY AV ' - � - �
� ,
� �"�� _ .Phone: (818)407-1986 ��
��,�-" �
NORTHRIDGE;CA,"- �, Zip: 91324
�� , '
, ` � /
/ -. ` . . , , _ . .
Owner: ��PWREFIMCC-SOUTH COAST, LLC ' �- �
� � ..
Address " �535�ANTON BL�: - "
, � , COSTA MESA; CA ��" � Phone:
� �, � .
� SUITE 15��'% Zip: 92628
�;.�
/r'if'
/ .
� Contracror: 'O'BRXANT ELECTRIC ' -
� Address: 8749 SHIR6EY AVE ' � �
' „ , ` � �.:Phone: (878) 407-1986 �
� NORTHRIDGE, CA`� �' ���" " ' � ' Zip: �91324 , "
. . ..
i
- � C, -� ' " License: 386619
' / _.��-
Status: I SS U E D
Applied: 11126/2001
Issued: 11/27/2001
ISSUED BY: �
' SCOPE OF PERMIT
, ADDITION OF ELECLIGHTING, INGLUDING TRACK.LIGHTS, FOR AN EXISTING OFFICE, "J D
POWERS" ON THE STH FLOOR. 30 LIGHT FIXTURES,-I-OUTLET-, 10�SWITCHES. �
NO OTHER WORK WITH THIS PERMIT. - � � -
�:.
. -�'f - _ , - i: .
'"� "- 'FEE SUMMARY � ' � ` '
ISSUE FEE
Temp service test
Res. alc package
New Res (1-2 units)
New Res (3+units)
Pool / Spa ,. �
Lighting Fixts� .
Recept Outlets '
Switches � A
Non Res Appl �
Res Appl � ,
Service to 200a �
Service to t000a
Service over 1000a
Molors to 1 hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
i
\
. i;.
Quantity
$23.50
$0.00
$0.00
$0.00 0
$0.00 0 �
$0.00 0 �?'" �
� $29.30 30 - ,
$1'10. �:.�..:�",.���,- �
� �$11.00:� � `10� � - ,
� . ao.00�� �:'- . o
� „- $0.00 -' 0� -
$0:00 0
$0.00 0
$0.00 0
� �$0.00� _"i.% 0� j'._
�$0.00�. ' 0 . ,' i �
so.00 0
$0.00-'�,.� "�0`.. � ..
$0.00 ��-0 � ' . - -
$0.00 0`�� - . " - �
$0.00 0 -- � -
$0.00 0
$0.00 0
$0.00 0
$0.00 0
Quantity
Temp Dist System / Lighting $0.00 0
Busway /100 ft � ' $0.00 0 '
Standin9 Section � $0.00 0
. �Misc Elecirical Equipment $0.00 � 0
Transfortners up to 1 kva/kw $0.00 '�� 0
_._..........�.up to 10 kva/kw $0.00 ;,: 0
.................up to 50 kva/kw _� $0.00 0
........._......upto100kva/kw��� $0.00' 0
_ .........:......over 100 kva/kw $0.00 . � �� 0
Low Voltage Equipment $0.00 0
Low Volt Wiring System / Ckt � $0.00 0
Misa Conduit " $0.00 0 �.
Misc. Conductor : $0.00 0
Circus ( gen or ride) �$0.00 �, 0
Circus,(mechride�orliqhts) .�' $0.00. ���0
Christmas Tree Stand , $0.00 � 0
FireworksStand�� �� �-'$OAO 0
��'Other Electrical Fee, ���' i 50.00
�i= ,
-Investigation Fee�� �� $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $64.90
COMMENTS / SPECIAL CONDITIONS
�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned
for a period of 180 days. _
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2ddBd8 (NW)
WORKERS' COMPENSATION DECLAflATION: ' , � . �
I hereby aHirtn under panelty of perjury one ot the following declarations:
❑ I heve entl will maintain e cenificate of consent to selt-Insure for workers' compensation, as provided tor by sectlon 3700 of Ihe Lebor Code, for ihe pertormance of ihe
�°'ork for w�ic� t�is permit is Issuetl.
ff I have end will maintain workers compensetion insurance, as requiretl by secUon 3700 of the Labor Code, for ihe peAortnance of the woAc for which Nis pertnit is issued.
My wor/ke�`rs' co�m,p,e�ns-etion In,�suran�ce,,cafr en0 policy number are:
Cartiec �(1{7y6 iZV1`" � PolicyNumber: ?i� � �i )
(Ihis sectlon need nofbe cromplet l/ fhe permif Is velued at one hundred dollare ($/00) oNess.) �� �—�
❑ I cetlify thet in the peAormence the work fo ich this pertnit is issued, I shall not employ any pereon in any manner so es to become sublecllo ihe workers'
compensation lews of Calif , en0 egre it I s�aultl become subjecl to the workers' compensation provislons ot Sectlon 3700 of ihe Labor Code, I shall forthwlth
„ comply with these provi i
ApPliwnt Signeture:"' � /a�: �r /( � Z 7--p �
(�.
WARNING: FFILURE TO SECURE WORKERS' COMP TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FlNES UP TO ONE HUNDREO
?lqUSqNppOLLARE�5100,000),INAODRIONTO ECOSTOFCOMPENSATION,DAMAGESASPROVIDEDWRINSECTION3)O60FTHElABOFCODE,INrEREST,ANOATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettlrm thet I em Ilcensed u r provisi
force end aNect. Lia N
ContrectoYs Signeture: �'
with Section 7000) of Division 3 of the Business antl PCr'ofe$s�ns Cotle, and my license is in lull
Cless p _ _ __ . _ (
CONSTRUCTION LENDING AGENCY:
❑ I hareby aftirm that ihere is a construction lending egency for the Derformance oi the work for which this pertnil is issued. (Sec. 3097, Civil Code).
Lenders Neme: . . . . __ Lenders Address:
Signeture:
OWNER-BUILDER DECLARA710N5:
Dete:
I hereby aflirm thet under penelry ot per�ury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or counry which requires e permit ro construct, alter, improve, tlemolish, or repalr eny structure, pdor to Its Issuance, also raquires the applicant for such permit
to file a signed statement thet he or she Is Ilcensed pursuent to the provisions of the Coniractore IJcense Lew (Chepter 9(commencing with Sectlon 7000) of Division 3 ot ihe
Business and Proteulons Code) or thet he or she is exempt Iherefmm and the basis tor the elleged exemption. Any violation of Seclion 7031.5 by eny applicant for e perrr+]
subjecis ihe epplicent to a civll penalry of not more then five hundrad dollars ($500).):
❑ I, as owner oF the properry, or my employaes with wages as iheir sola compensation, WILL DO THE WORK, and the structure is not intendetl or oHeretl for sale (Sec.
7044, Business and Professions Cotle: The Conirectors License Lsw does not apply to en owner of property who builds or improves thereon, and who does such work
him5elf or �ereelf or Ihrough hi5 of her own emplayees, provided lhat such improvemenls ere not Intended or offered lor sele. If, however, lhe building or improvement is
soltl within ona yeer ot completion, ihe owner-builder will have ihe hurden of proving that he or sha tlitl not builtl or improve for pu�pose of sale.).
❑ I, as owner of the property. am El(CLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to consiruct tha praject (Sec. 7044, eusiness antl Profeuions
Code: The coNrecrore Llcense Law does not appry ro an owner ot properry who bulids or Improves ihereon, and who contracts br such project with a comrector(s)
license pursuant to the Conirectors License Lews.).
❑ I am ezempt under sec. Business and Professions Code tor this reason:
Signature: Date:
Owner ID venfied by drivef5licen5e. ❑ Ves ❑ No Dnvefs License No. Expires:
Vedtication ol Ownership by (typa of tlwumem, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby certify thel na e:cavetion fiva (5) or more feet in depth inta which a person Is requlretl to descend, wlll be made in connection with wark euthonzed by Ihis
parmit, and thet no building sirucNre, scaHoltling, talsework, or demolition or tlismantling ihereof, will be more Ihan t�irty-six (36) faet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Californla Atlministwtive Code).
❑ As awner-bulltler, I wlll not employ anyone to tlo work which would require e permit irom the Division of Indusinal Sefety, es noted ebove, unless such person hes e
permit to do such work from Ihe division.
Signeture: Date:
Division of Intlusirlal Setety Permit Number:
CER7IFICATE OF COMPLIANCE AND AUTHORIZATON OF EMAY: I cehity under penalry of perjury ihat I have read ihis epplication and state that ihe information given is
correct. I egree to comply with all state laws end ciry ordinances relating to tuilding construction, and authorize representatives oi the City of Costa Mesa to enter upon ihe
above-descnbed property for Inspectior�urposes. I egree not to occupy or allow acupancy of eny building authorized by ihis permit until final inspection.
CQDE t. INSPECTONTYPE
1616 Fixed System Final Fire Prevention
1266 Paal Spe Final
200 Final Re-Rooi
201 Finel Block/Retaining Wall
202 Final Factory Fire Place
203
204
Finel Sign
Finel Demolition
Applicant
�.�7\��Iu111Lib9
COOE� INSFECTIONTYPE
206 Final MeChanlcal
208 Finel Plumbing
270 Flnel Electncal
272 Finel Fire Preventlon
220 Final Planning Apprwal
222 Final Site
250 Final Building/Occupency
Date
/l Z'I—O�
/ Date
BAIF ItiiIDE4fl .
� . �� -- ...
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Atldress:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
5
STH FLOOR
41050110
npplicant: FULFORD, TERRY
Address: Bi49 SHIRLEY AV
NORTHRIDGE, CA
owner: - SAKIOKA FARMS �
Address - ' ' - "
Contractor. O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
Phone: (818) 407-1986
Zip: 91324
Phone:
Zip: 94137
Phone: (818)407-1986
, Zip: 91324
License: 386619
ISSUED BY:
Status: ISSUED
Applied: 10/30/2000
Issued: 70/30/2000
SCOPE OF PERMIT
. EIECTRICAL PERMIT FOR INTERIOR OFFICE T.1. FOR "J.D. EDWARDS" (5TH FLOOR). INSTALL
238 LIGHTS, 98 OUTLETS; 88 SWITCHES, 71 COMMUNICATION DROPS, 8 11 MISC CONDUIT.
REF:800-01341 �
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets �
Switches � ' �
Non Res Appl
Res Appl
Service to 200a � �
Service to 1000a '
Service over t000a
Molors to thp .
Motors to 10hp
Motors to SOhp.
Motors to 100hp
Motors over t00hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$181.14
$78.94
$71.84
$0.00
� �� $0.00
� $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$57.23
$0.00
sa.00
$0.00
$0.00
$0.00
Quantity
0
0
0
238
98
, 88.
0
��0
0
0
0
0
0
0
0
0
71
0
0
0
0
0
FEE SUMMARY
�uantity
Temp Dist System / Lighting $0.00 0 �
Busway /100 fl � 50.00 0
Standin9 Section $0.00 0 �
, Misc Electrical Equipment $0.00 0
- Transfortners up to 1 kva/kw $0.00 0
.............:.�up to 10 kva/kw $0.00 0
..........:......up to 50.kva/kw $0.00 � 0 '
. .................up to 100 kva/kw � $0.00 � 0
� ..................over 100 kva/kw � � $0.00 0
Low Voltage Equipment $0.00 0
� Low Volt Wiring System / Ckt ,- $0:00 � � �0
Misc Conduit " _ � $200.20 " 11 ,'
Misc. Conductor � $0.00 0
Circus ( gen or ride) $0.00 " 0-
Circus (mech ride or lights) $0.00 0
Christmas Tree Stand $0.00 0
Fireworks Stand $0.00 0
� �� Other Electrical Fee $0.00
tnvestigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES 5612.65
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
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 orcl�r for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this perrnit.
FOR INSPECTIONS CAIL: (774) 754-5626
zasass �aao�
r
WORKERS'COMPENSAnON DECLARAnON:
I hereby aHirm under penalty W perjury one of Ihe tollawing decleretlons:
❑ I heve end wlll meintain e certilicate ol consent ro self-Insure br workers' compensation, as proNded Por by sectlon 3700 of the Lebar Code, tor the peAartnance ot the
�� ork for which this pertnit is Issuetl.
�y' I heve entl will mainteln workers' compensetion Insurance, as required by sectlon 3700 of the Labor Code, for the pertortnance of the work for whlch ihis pertnit is Lssuetl.
��MY WOfkBfS' CORIDB098t10l�In5uf9nCB CBfdBf Bpd DOIICV OUffIbB! 9fB:
+PoliCy N� u!�!✓a+A Z 7�G / I 3o c�
❑ 1 certiy ihet in the pertortnence of the work for which Ihis permit Is Issued, I ahell not employ any pereon In eny manner so es to become subject to the workers'
compensellon laws ai Calitomia, e egree that If I should becoma subject lo the warkers' compensetlon proN5ion5 of Section 3700 of the LaDor Code, I shall torthwith
comply with these pr�ov�' '°nsey�� �----�,
,A�ppllcen�Slgneture: f•:G�. � . Dl� ete:—� �o �30 - o-J
WARNING: FAILURE TO SECUR WORK COMPENSATION COVEMGE IS UNLAWFUL AND SWLLL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNORED
THOUSAND DOLIARE (5100,000�, IN ADDITION TO TNE COST OF COMPENSATION, OAMAOES AS PHOVIDED FOR IN SEGTIIXJ 3]Ofi OF THE IABOR CODE, INTEREST, AND ATTOiiNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby efllrm tAIaLl�emAkepsetl untler�pmvlsit
forceendettect.lLi_c_s l _�Y/�,�/_
CONS7RUCTION LENDING AGENCY:
Chapter 9(cammencing with Seaion 7000) oi
Pratessions Code, and my Iicense is in full
/o
❑ I hereby eflirtn thet there is a constructlon landing egency br the peAarmence of ihe work tor which this permit is Issuad. (Sec. 3097, Civil Cotle).
Lendefs Nema: LenAars Atltlress:
Signature:
OWNER-BUILDER DECLARATONS:
Date:
I hereby eHlrtn t�et untler penalry of perjury Ihet I flm E%EMP7 FROM THE CONTFiACTORS LICENSE LAW for tha following reflson (Sec. 7031.5, Busineu antl Protesslons
Cotle: Any ciry or counry whic� requires a Oermit to construct, alter, improve, demolish, or repair any structure, pnar to Its issuance, elso requires Ihe applicant for such pertnil
ta flle a signed atetement thet he or sha is Ilcensed pursuam to the pmvlslons of I�e Contrectore lJcense Law (Ghepter 9(commencing with Secllon 7000) oi Divislon 3 oi the
eusiness antl Protesslons Code) or that he or s�e Is exempt therefrom and the basis for Ihe elleged exemption. Any violation of Section 7031.5 6y eny applicant for a pertnit
subjecLs the eppllcant to a clvil penalty af not more then flve huntlretl tlollars (5500).):
❑ I, es owner of Ihe property, or my employees with weges es their sole compensetion, WILL DO THE WORK, and ihe structure is not intentled or oXered for sele (Sec.
7044, Business end Professions Code: The Contractors License Lew does not apply Io an owner ot properry w�o builds or improves Ihereon, entl who tloes such work
himselt ar hersefl ar Ihmugh hIs or her own employees, provided that such Improvements ere nat IntendeG or oHered tor sale. If, hawevar, the builtling or imprrnemenl is
sold within one year o1 completion, Ihe owner-builder will have tha burden ot pmving that he or she did not builtl or improve for purpose oi sale.).
❑ I, a5 owner oi Ihe property, em EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTOpS to construct the proJect (Sec. 7044, Business antl Profession5
Catle: The conirectors Licanse Law does not epply to en owner ot praperty who bulltls or Improves thereon, and who coniracls for such project wiih a contractor(s)
Iicense pursuant to ihe Cantractors License Lews.).
� I em ezempt untler sec.
Siqnature:
Owner ID veritletl by tlnvers license. ❑ Yes ❑ No
Bu51nes9 enA Profe55ion5 Code lor �his reason:
Vedficetlon ol Owners�ip by (rype oi tlocument, i.e. - pmperry tax bill or deed):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTFICATON:
Drlver's LJcense No.
Date:
Expo-es:
❑ I hereby certlfy thet no excavatlon flve (5) or more feet In depih into which e person Is requiretl to tlescenA, will be made In connection with work euthorizetl by this
permiL and that no Duilding structure, scatfoltling,lalsework, or demolilion or dismentling Ihereoi, will be more t�an �hirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celifomia atlministretive Cotle).
❑ As owner-Duiltler, I will noi employ enyane to do work which woultl require e pertnit trom [�e DlNsion of Industrial Satery, es noted ebove, unless such person hes a
pertnit to do such work irom Ihe tlivislon.
Signature: Date:
DivLslon of Indusirial Salery Pertnit Number:
CERTIFlCATE OF COMVLUWCE AND AUTHORIZATION OF ENTRV: I certify under penalry of perjury that I heve reatl Ihis appliwtion anC state that the Infortnation given is
conect. I agree to compy with ell stete laws and ciry ordinances relating to building consWctlon, antl auUotlze represenfatives of the Ciry of Cosfe Mese to enter upon the
above-tlescribed properry tor inspection puryoses. I egree not to occuDY or ellow xwpency of eny building authorized by Ihis pertnit until finel inspection.
COUE I, INSPECTIONT'VE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roo1
201 FIneI BIaWRetaining Wall
202 Finel FaCtOry Fire Plece
203 Finel Slpn
204 Final Demolition
Date
/0 30 - c c]
Qd¢ Jy�� j�Qpg� INSVECTIONTYPE
208 Finfll MBchenical
20B Finel Plumbing
210 Final Electncel
212 Flnel Fire Preventlon
220 Final Plenning Approval
222 Final Site
250 Final Building/Occupency
PAg
. a!'
.m�_ :
}
\_
(774) 754-5273 • Fe�c (714) 754-4056 • www.ci.costa-mese.Ce.us 77 FAIR DRIVE, COSTA MESA, GA 92626
Job Address: 555 ANTON BL
Suite No 5
Vicinity: STH FLOOR
Parcel Nunmber: 41050110
Applicant: SNENS, DON
Address:
�
�,
Owner:
Address
SAKIOKA FARMS
Contractor: MUIR-CHASE PLUMBING
Address: 7940 GARDENA
Arch / Eng :
Address:
GLENDA4E,CA
PLUMBING PERMIT
Phone: 949-833-9351
Zip:
Phone:
Zip: 94137
Phone: �(878)500-1940
Zip: 91204
License: 539835
Phone:
Zip:
License:
Status: ISSUED
Applied: 11IO2/2000
Issued: 11IO2/2000
ISSUED BV:
SCOPE OF PERMIT
MISC PLUMBING FOR TENANT IMPROVEMENT ON TH 5TH FLOOR. REF: B00-01341. J.D.EDWARDS.
1 DISHWASHER, 7 ICE MACHINE, 2 FLOOR SINKS, i�KITCHEN SINK, 2 TRAP PRIMERS, 1 WATER-
HEATER. ., .
AMT
ISSUE FEE $23.50
Backflow irrigation , 50.00
Backflow Preventer. $0.00,
Bathtub � � � �$0.00 '�
ClarifierSystem �. �_ $Q00,",�
Connect (Ice,Soda,etc) ; . ;$9.80-_ ��
Dental Units $0.00 '
Dishwasher $9:80
Drain, Floor $0.00
Drain, Rainwater $0.00
Drain, Roof $0.00
Drinking Fountain $0.00
Expansion Tank $0.00
Gas Earthquake Valve $0.00
Gas (1-a outlets) $0.00
Gas (Over 4 outlets) $0.00
Gas Repipe $U.OU
Gas Service 50.00
Interceptors (Grease, Oil) 50.00
Interceptors (Sand Auto ) 30.00
Qn
0
0
-0
'0
1
0
i
0
U
0
0
0
0
0
0
0
0
0
0
�FEESUMMARY'
AMT
Laundry Tub / Washer $0.00
Landswpe Irrigation � $0.00
P-Trep : $0.00
� " Pressure Regulator $0.00
' � Process Piping (per 10 fl)� $0.00
Receptors ' � ' �$0.00
Septic Tank $0.00
Sewer Cap for Demo, , . � $0.00
Sewer Connect � $0.00
Sewer Private Line $0.00
Shower � $0.00
Sink, bar $0.00
Sink, commercial � � ' "�$0.00
Sink, Floor � $19.60
Sink, kitchen $9.80
Sink, service/mop $0.00
Spa (private) 5�.00
Spa (public) 50.00
';�; �
, �TY. - . _ . -' � ' AMT
� 0 �. Sump Pump � � $0.00
0 Swimming Pool � � $0.00
0 . . -� �TrapPrimer�� � � ' $19.60
0 �� Urioal; -'� � i�� 50.00
0"�' � VacuurriBrkrBkflow(1-4) $0.00
0 � � ,�� Vacuurti Brk{�Bkflow(5+) $0.00
0 � �, Wash Basin � ; $0.00
0 . � � N/ash�Basin Set $0.00
� 0 , Waste and Vent System $9.60
0 -�--Watei Closet (Toilet) So.00
o - Water Heater / vent $0.00
0��. � Water Piping pnst or Rep.) $0.00
0 Water Re-pipe 50.00
2 Water Service 50.00
7 Water Softener 50.00
0 OTHER $0.00
0 VIOLATfON $0.00
0 PLAN CHECK 50.00
REINSPECTION 50.00
COMMENTS / SPECIAL CONDITIONS
TOTAL CALCULATED FEES: 5101.90
QTY
0
0
2
0
0
0
0
0
1
0
0
0
0
0
0
0
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ortl. No. 92-28, § 7, 12-27-92)
EXPIRATION: This permit shall aUtomatically explre and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and eil
requlred Inspections end ffnal approval must be obtained. Failure to obtain inspec�ions and final approval will result in the expiratlon of lhis pertnit.
fOR INSPECTIONS CALL: (714) 7545626
244&68 (6W)
WORKERS'COMPENSAnON DECLARAnON:
I hereby ettirtn under penalry oi perjury one at Ne idlowing tledaratlons:
❑ I heve entl wlll maintein e certificata ot consent to self-Insure Iw workars' compensallon, as prodtleA tor by section 3700 of the LeDor Code, for t�e pertortnance of the
W fof whiCh Ihis pBrmil is issuetl. /
I have antl will malnWin workers' com � Rs�ti iissurance, es roQuired by sectim 3700 of the Lebor Code, for the perfortnance of the work br wM t peimit is issuetl.
My woMers' comp9lmjyCylnsura cerri aCtl odk.y number are: /S^
Certler. � `� Policy Number: lP `
(This sec(ion nesd not be camp/etetl il permit is velued el one hundred dWlars ($100) or less.)
❑ I cortity that In the peAormance of tha work tor which this pertnic is IssueQ I shell not employ any peroon In eny manner so es to becom blect lo the warkers'
compensatlon lews of Celitomia, entl agree that If I should becomo subject to Ihe workers' compensation provislons oi Section 3700 ol t e Lebor Cadeil ahall lorihwitt
\Apptl�(Signature: !� �! �� Date: �
WAqNINOfFAICURE TO SEWRE wORKEBS' COMPENSATION COVERAGE IS UNIAWFUL AND SWHi 5UBIECT AN EMPLOVER TO CRIMINAL PENALTI S rWD G L FlNES UP TOONE HUNDRED
TFIOVSAND DOLLARE �5100,000), IN ADDRION TO TNE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE L480R CODE, INTEREST, ANO ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm thet I em licensed under provLslons ot Chapter 9(commencinp with Sectlon 7000) ol Divlslon 3 oi the Buslness antl Protessions Cotle, enA my Ilcense I5 in lull
lorce antl ettect. LJc. p � Class a . i �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm thei Ihere is e construcfion lending egency lor t�e peAormance of ihe work br which Ihis Oermit is issued. (Sec. 3097, Civil CaAe).
Lender9 Neme: Lentlefs Atltlress:
slgnature:
OWNER-BUILDER DECLARA710NS:
oece:
I hereby eXirm Ihat untler penalry of perjury thal I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business end Professions
Code: Any city or county which requires e permit to conswct, alter, Impmve, tlemolish, or repair any strucWre, prior to its issuance, also requires the appliwnt tor such pertnit
lo lile e sipne0 stetemem t�at he or she is licensetl Oursuant to the Orovisions ot ihe Contracrors License Law (Chapter 9(cammencing with Section 7000) ot DiWsion 3 of t�e
Business antl Prolessions Code) or Ihat he or she is exempt Itierefrwn and the hasis for the elleged ezemption. Any vidation of Sectlon 7037.5 by flny epplicant tor e permit
subjects Ihe epplicant to a civil penalry ot not more then five hunUretl tlollars (5500) J:
❑ I, as owner ol the property, or my employees with weges as their sole compensalion, WILL DO TME WORK, and Ihe structure is not intentletl or oHe�etl tor sale (Sec.
7044, Business and Protessions Cade: The Contractors License Lew does not appty to an owner ol pwperry who builds or impmves ihereon, antl who tloes such work
himselt or herself or through his or her own emplqrees, pmvided Ihat such imprwements are not intended or oflered for sale. II, however, the building or improvement is
soltl within one year ol complation, the owner-builder will have Ihe burden ot pmving that he or she did not build or improve tw purpose ol sale.).
❑ I, es owner ot the property, am E%CLUSIVELY CONTRACi1NG WITH LICENSED CONTRACTORS to construtt Ihe projecl (Sec. 70a4, Business and Proleuions
Cotle: The contrectors IJcense Law tloas not appty to en owner oi property who builds or improves ihereon, and who coniracts for such Droject wlih e coniractoqs)
license pursuent to ihe Contracwrs License LawsJ.
❑ I em ezempt under sac. Business antl Professions Cotle tor this reason:
Signeturo: Dele:
Owner ID verified by drivel5licen5e. � Y85 ❑ No Dnver's License No. Expire5:
Venfication ot Ownership by (type ot documeni, I.e. - property tex GIII or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cetlity ihat no exwve�ion tive (5) or more teet in tlepth Into whic� a person is requiretl to tlescenq will be meCe in connection wi�h work euthorizetl by this
pertnit, end Ihat no builtling siructure, scaMdtling, talsework, or demolltion or dismantling thereol, will be more Ihan Ihirry-six (36) leet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Tltle B, California Atlminisiretive Code).
❑ As owner•builtler, I will not emplq anyone to tlo work which would reQuire e permil Irom Ihe Division ot Industrlel Safery, es noted ebove, unless such persan hes e
permit co tlo such work tmm Ihe division.
Sipnature: Date:
Oivision ol Indusirial Safery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AllT}10RIZATION OF ENTRY: I certity untler penalty ot perjury thet I have read this epplication and state that Iha infortnation given is
cnrrecc I egree to comply wlih ell slate laws end ciry orClnances releting to Duiltling conswction, end amhodze representatives ot the Ciry ot Costa Mese to eNer upon ihe
ebove-descnbed property lor inspeciion purposes. I agree not to accupy or ellow occupanty ot any building eulhorized by this permi� until final inspection.
COOE �. INSiECTIONTYPE
7876 Fixetl System Finel Fire Pravention
1266 Pool Spe Flnel,
200 Final Re-Root
201 Finnl BIocWRetelning Wall
202 Finel Foctory Fire Place
203 Final Sign
204 Final Domolitlon
�� >..:
� /L
Qdjf, �$ �j INSVECTIONTYPE
206 Finel Mochanicel
20B
210
212
220
222
250
Finel Plumbing
Final Electdcal
Finel Fire Preventlon
Finel Planning Approvel
Finel Site
Final Building/Occupency
P� It��
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 500
Vicinity: STH FLOOR
Parcel Number: 41050110
Applicant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE,CA
Owner: SAKIOKA FARMS
Address:
Contractor.
Address:
Arch / Eng :
Address:
MECHANICAL PERMIT
AIR CONDITIONING CO., INC
6265 SAN FERNANDO RD
GLENDALE,CA
Phone: (818)244-6571
Zip: 91201
Phone:
Zip: 94137
Phone: (818)244-6571
"Zip: 91201
License: 720696
Phone:
Zip:
License:
ISSUED BY:
SCOPE OF PERMIT
MECHANICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "J.D. EDWARDS" (5TH FLOOR).
INSTALL 11 VAV BOXES, 4 FIRE DAMPERS, 8 ALTER 2 HEATICOOL SYSTEMS.
REF: B00-01341
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair / Alt CoolingMeat
Inst I Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Retrig Sys >100 k BTU
Gas Piping
Factory Fireplace �
Hood w/Mech Exhausl
VAV Box
Vent Fan / Single Dua
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 70000cfm
Air Handlers > 10000cfm
Floor Furnace
Floor or Suspend Heater
$23.50
$0.00
$0.00
$27.40
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$117.15
$0.00
50.00
529.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
�uantiry
0
0
2
0
0
0
0
0
0
11
0
0
4
0
0
0
0
0
0
FEESUMMARY
Repair / Alt Absorbtion Unit
Repair I Alt Refrigerelion Unit
Ventillation System
Evaporetive Cooler _
Commerciallncineretor �
Domestic Incinerator
Compressors I Absorption Systems
Upto3hpl100kBTU " �
3 To 15 hp ! 500 k BTU
15 To 30 hp / 1,000 k BTU , �
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 B7U .
soi�e�5
Up to 3 hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Status:
Applied:
Issued:
ISSUED
10I30I2000
t0130/2000
Quantity
E0:00 0
$0.00 0
$0.00 0
$0.00 0
SO.OD 0
50.00 0
30.00 0
$0.00 0
E0.00 0
$0.00 0
so.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00
$0.00
$0.00
5197.05
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ortl. No. 92•28, § 1, 72-21-92)
EXPIRA710N: This permit shall automatically expire and become void il work Is not commenced within 180 days, or it work is suspended or abandoned
for a period ot 180 days.
INSPECTIONS: In order for ihe work authorized under Ihis permlt to be considered legal, such work must comply vrith all eppllcable codes, and all
requlred inapeetlona antl tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of Ihis perm�
FOR INSPECTIONS CALL: (714) 754-5626 �
zaaaae �e�roo)
WORKERS'COMPENSAnON DECLARATON:
I hereby ettirtn under penelry of per�ury one of Ihe fdlowing tlederetions:
❑ I heve entl wlll mainteln e certiticate ot consent to selFlnsure for workere' compensetion, es praWdeA for by section 3700 of ihe Lflbor Cotle, tor the perfortnance of ihe
work for which this permit Is issued.
� I have end wlll meinteln workers' compensaUon insurance, es requlretl 6y secUon 3700 of the Lebor Cade, far tha pertartnance ot �he woAc for which this pertnit is issueC.
My workers' compensatlon Insu nce carrler end policy number ere:
Car�e�:. .-� �/l fj�� � POIIcy Number.� 9Z�� fi
(Tlils sectfon need n�'be cvrnpl e ll (he permlf !s ve/ued et one hundred dollers (S100J or Iess.J -'"
� I certiy t�et In I�e
TO
of t�e work lor which Ihis pertnit Is issuetl, I shell not employ eny person In any menner so es to become subject to the workers'
, entl egrea that If I shwld become sub�ect ta Ihe workero' compensatlon provlslans af Sectlon 3700 01 the Lebor Cotle, I shall forthvrit�
wowceas� ��snnorr �
iN nnomori ro n+e casr oF
LICENSED CONTRACTORS DECLARA710N:
I hereby eHirm thel I em Ilcensetl untler provisla
forco antl eHect�Lic. a 1 /-e�/J
_ Date: ��iJ '—� � _ ...
AND SHALL SUBIECT AN EMPLOYEH TO CRIMINAL PENALTIES FNO CML FlNES UP TO ONE HUNDRED
:S AS PROVIDED FOR IN SECTION �OB OF TME IABOR CODE, IMEREST, M!D ATfORNE1"5 FEES.
9(commencing with Sectlon 7000) of Dlvlslon 3 of t�e Buslness end Prolesslons Code, and my Ilcense is in full
CONSTRUCTION LENDING AGENCY: (/
❑ I hereDy ettirm that there Is e conslructlon lendinp epency for t�e performence of the work for whic� this permit is issued. (Sec. 3097, Civll Cotle).
Lenders Neme: Lendefs Atltlress:
SlpneNre:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettlrtn Ihet under penalry al per�ury thet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW ior tha tollowing reason (Sec. 7031.5, Business entl Professions
Code: Any clry or counry which requires e permil to consWc�, elter, improve, demolish, or repeir any structure, pdor to Its Issuance, also requires Ihe applicant for such pertnit
to file a signetl statement ihet he or s�e Is Iicensetl pursuent m the provisions of the Contrectors License Lew (Chapter 9(commendng wlih Section 7000) of Division 3 at ihe
Business end Professlons Cotle) or Uet he or she is exempt theretrom end the basb for t�e allegeO eaemption. Any Nalatlon ai Sectlon 7037.5 by eny applicent for e pertnit
sub�ects the epplicant ta e civil penelry of not more then Iive hundred dWlers ($500).):
❑ I, es owner ol the properry. or my employees wilh wages es their sole compensetion, WILL DO 7HE WORK, end the structure is not IntenEed or oMaretl for sale (Sec.
7044, Business end Pratessians Code: The Contrectors tJcense Lew does not apply to en owner ot pro0erry who builds ar improves �hereon, antl w�o does such work
hlmseN or herself or throug� his or her own employees, proNOed ihat such impmvements ere not intentletl or ottered far sele. If, however, �he Duilding or improvement is
sold within ona year of completion, Ihe owner-builtler will heve ��e burden ol Droving that �e ar she tlitl not Duiltl or Imprwe lor purpose ot sale.).
❑ I, es owner o1 the property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to construq the project (Sec. 7044, Business and Professbns
Gode: The contrectors Llcense Lew does not appty lo en owner ol propeny who builAs or Imprwes Iherean, and who wntracts for such prqect with e contreqor(s)
license pursuant to �he Contractors License Lews.�.
❑ I em exemp� untler sec. Business end Prolessions Cotle for thls reason:
Signature: Date:
Owner ID veritletl by tlnvers Ilcense. ❑ Yes ❑ No Drivels lJcense No.
Vedficetlon of Ownership by (type ol document, i.a. - property tex WII ar tleatl):
Expiraz:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICA710N:
❑ I hereDy ceNty that no excavetlon five (5) or more leet in tlepth into wNch e person is raqulred to descend, wlll be made in connecUon with xrork aulhaized Dy this
permlt, an0 tha� no builtling stn�IXure, sceNdOlnp, felsework, or demditlon or dismantling t�ereof, wlll be mare than thlrty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tille 8, Celltomla AdminisiratNe Catle).
❑ As ownar-bulltler, I will not employ enyone to Eo work whkh would requlre e permit irom t�e Divislon ol Industriel Selery, es noted ebove, unless such person �es e
permil lo do such wark tram the divislon. �
Signature: Dete:
Division of Intlustrial Safery Permit Number:
CEHTIFlCATE OF COMPLIANCE IWD AUfHORQATON OF EMAY: I certily under penelry ot perjury Ihat I hava read lhis epplicetion anA sWte thet Ne intortnatlon given 15
wrrect. I agree to compy with all stete lews end dry ordinences relatlnp to bullding Constructlon, end euthorize representatives of ihe Ciry of Cosfe Mese to enter upon Ne
ebovo-tloscriDed O�Wa�TY �or inspection purposes. I egrea not lo ocwpy or allow ocwpancy ol eny Ouiltling euthorizetl by Ihis pertnit until tinel inspecllon.
COOE �. MSFECfqNTPE
1818 FIxeE System Flnal Fire Preventbn
1268 Pool Spe Final
200 Finel Re-Root
201 Finel Block/Retelninp Well
202 Final Factory Fire Place
203 Final Slgn
204 Finel Demditlon
Qejf, �(� fBQf,j MSPECl10NTYPE
208 Flnal Mochenlcal
208 Flnal Plumbing
210 Finel Electrlcal
212 Finel Flre Preventlon
220 Finel Planning Approval
222 Final Slte
250 Final Bullding/Occupern.y
Date
G��D l �
.
(714) 754-5273 • Fax (714) 754•4856 • wvnv.ci.cosla-mesa��DING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 AN70N BL
Suite: 5
Vicinity: JD EDWARDS (5TH FLOOR/PARTIAL)
ParcelNumber: 41050110
Applicant SMITH, DON
Address:
Owner: SAKIOKA FARMS
Address
Contracror. ACCENT BUILDERS
Address: 555 ANTON BL. #100
Zoning:
Phone: 213-482-9832
Zip:
Phone:
Zip: 94137
Phone: '(714)549-3150
ISSUED BY:
Status: ISSUED
Applied: 08/30/2000
Issued: 10I26I2000
COSTA MESA, CA '
Zip: 92626 License: , 397790
Arch : PAUL LONIGRO Eng:
Address: 1000 W SUNSET BL Address:
SUITE 1000 Phone: 213-482-9832 - Phone: �
LA, CA
Zip: 90012 License: C22255 License:
SCOPE OF PERMIT
INTERIOR 18167SF OFFICE TI FOR JD EDWARDS ON THE 5TH FLOOR (PARTIAL FLOOR).. � �
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
� Total:
$563.31
$3,466.50
$0.00
$115.21
$0.00
$0.00
$4,145.02
SETBACKS�
MAIN STRUCTURE Front -0- 0
ACCESSORY Front 0.0
PARKING Existinq: o
NOTES:
Rear 0. 0
Rear 0. 0
Required: 0
FEE SUMMARY
Calc Valuation:
Claim Valuation
PLANNING 8 ZONING
�� .
Left 0. 0 �� Right � 0. 0 �-�
Left 0. 0 � Righ6 0• 0 i
Proposed: 0
$548,625.00
$525,000.00
/
NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relatetl
regulations. (Ord. No. 9248, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandonetl
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this pertnil to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
/
zaae-ae lama) i /
WORKERS'COMPENSAnON DECLARAnON: "
I hereby effirtn under penalry of perjury one oi the tNlowing dedarations:
❑ I have and wlll melnteln e certificaie of consent lo sell-Insure tor workers' campensetlon, es providetl for by sectlon 3700 of lhe Labor Code, lor Itie performflnCe a� NB
wark tor which Ihis permit Is issuetl.
� 1 heve arM wiA melntaln worke ' compen5alion inwrance, es required by SecUon 3700 af Ne Lebor Code, for ihe pertormance ot ihe work Iw whirh thts pertnit is Iswed.
My wo compensatlon 1 urence�rrler end policy number ere; �a ��
Cartier. � _//� � • Pdiry Number: a � �
(mis secfion need rrot be cwnp/eted i! Me pe � Is vaNed afyr�huTd, d/ers ($100) or less.)
❑ I cenity Ihet In t
compensation h
comply wilh the
Appllcant Signeture:
WARNING: FNLURE TO
LICENSED CONTRACTORS
I horeby eflirm thal I em IiCen;
brce entl ettacl Lic. x_�
Contractor's Signalure: _
not employ eny parson in any manner so es to Cecome subject to Ne workers'
�workers' compensation pravlsions o1 Section 3700 of t�e Lebor Cotla, I shall forthwlth
oe�e: �O � Z G— d d
IS UNUWFUL AND SW1LL SUBIECT AN EMPLOVER TO CRIMI W1L PENALTIES AND GVIL FlNES UP TO ONE HUNDRED
�TION, DAMAGES A$ Pf�VIDED WR IN SECTION 3]OB OF THE IABOR COOE. IMEREST, AND ATfORNE'f5 FEES.
with Sectlon 7000) ot DiWsion 3 0l tha Buslne nd Prolesslons Code, and my Ilcense Is in full
Cless M _�
oa�a: LD -2 — oG
CONSTRUCTION LENDING AGENCY: \J
❑ I hereCy ettirm Uat thore is a construnlon lentling eBency lor the peAormance of Ihe work for which Ihis Oermil Is issuetl. (Sec. 3097, CIWI Cotle).
Lentlels Name: Lentler's Adtlress:
Signature:
OWNER-BUILDER OECLARATIONS:
Date:
I hereby eHlrtn that under penalry o1 perjury thet 1 am EXEMPT FROM ME CONTFiACTORS LICENSE LAW far the lollowing reasan (Sec. 7031.5, Business entl Professions
CoCe: Any Ury or counry which requires e pertnit to construd, elter, improva, demdish, or rapeir eny structura, prior to Its issuance, also requires the epplicant for such pertnit
ta flle a signed statement that �e ar she Is Ikensed pursuam to the provLslons ot Ihe Gontrectors License Lew (Ghepter 8(commenang wltli SecUon 7000) of Dlvislon 3 of Ne
Business and Protessions Cade) or ttiat he or ahe Lq exempt lherefran antl the 6asis lor t�e alleged exemption. Any Wdation of SecGon 7031.5 hy eny applicent tor a pertnN
sub�ects the epplicant to a civll penalty of not more Ihan five hunAretl Eollars ($500).):
❑ I, es owner of the property, or my employees with weges es their sole compensatlon, WILL DO THE WORK, end the siructure Is not intendetl or oNeretl for sale (Sec.
7044, Business end Professions Code: The Contractors License Lew tloes not epply to en owner of property who builds or improves Ihereon, and who does such work
himselt or hersell or ihmugh his or har own employees, provided that such improvements are not intended or oHered for sale. Ii, however, the builtling or improvement is
sold within one year of comD�etian, Ihe owner-builder will have the burden of D�oving that �e or she did not build ar improve for purpose af sela.).
❑ 1, as owner ot the propetly, am E%CLUSIVELV CONTRACTING Wli}1 LICENSED CONTRAC70RS to construct Ue prqect (Sec. 7044, Business antl Professiore
Code: The contrectors License Law tloes not eppty to en owner ot properry wfw builAs or Improves thereon, end who mniracts for such pro�ect with a wntrectw(s)
license pursuant to ihe Contractors License Lews.).
❑ I am exempt untler sec. Business and Professions Coda tor this reason:
Signa�ure: Date:
Ownar ID venfied by driveYs licensa. O �es ❑ No Drivefs License No. Evpires:
VeriNcetlan oi Ownarship by (type of tlocumen6 I.a. - property tex bill or Aeetl):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFlCATON:
❑ I �ereby certlty that no excaveUon live (5) or more teet in Gepih into which a perwn Is requlretl to tlescentl, wlll be mede in connectlon with work euthorizetl by this
permit, entl that no building structure, scefldding, falsework, or tlemolition a tlismentling thereoi, will �e more Ihen ihirry-six (38) feet hiph. (Chap. 32, Grp 2, Ah 2, Sec.
341, Tule B, Calilomia AtlministwWe Code).
❑ As awner-6uiltler, I will not employ anyono to Co work whlch would requlre e permit trom the Division ol Industriel Sefery, as notetl ebove, unless such porewi has e
permit to Oo suc� work Irom the dMsion.
Sipneture: Date:
Division ot Intlustnal Salery Pertnit NumDer.
CERTIFlCATE OF COMPUANCE�4N6 AlJIT10 T10N OF �tfINY: I ceM1ity untler penelry of Derjury ihat 1 have read ihis epplication and state t�at iha iniormaUon gNen is
corcect I egree to comply wi�d'flll state I and dry o n�ces relating m builAing wnstructlon, antl authonze representatives of ihe Cly of Cos[a Mesa to enter upon Ihe
ebove-Aescribed properry joflnspec � rposes. I ee not lo ocapy or ellow occupancy of any building eu�horized by this pertnit until finel inspection.
CO�E I' INSPECTONTYPE "
1618 Fixetl Sysiem Flnal Fre Preventbn
1288 Pod Spa Final
200 Final RaRooi
201 Finel BIacWRetelninp Well
202 Final Fectory Fire Place
203 Final Sign
206 Finel Demolilion
Date
l0 -Z� -oG
Date
Qd¢, Q�$ �QQEa INSPECTIONTYVE
208 Flnel Methanital
208 Finel Plumbing
210 Finel Electdcal
212 Finel Fire Preventlon
220 Finel Planning Approval
222 FinalSite
250 Final Building/Occupency
(714) 754-5273 • Fe�c (714) 754-4856 • www.ci.costa-rt�eaa.GeSys.PRESSION PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
�'IKC U
/
.lob nddress: 555 ANTON BL
Suite: 5
Vicinity: JD EDWARDS (STH FLOOR)
Parcel Number: 41050110 ZOning:
App�icant: RAYNER, MARC
Address:
Phone: 562-098-6444
Zip:
Owner. SAKIOKA FARMS
Address
Phone:
Zip: 94137
Contractor. CAL PROTECTION
Address: 2505 MIRA MAR
LONG BEACH, CA
Phone: (562) 498-6444
Zip: 90875
License: 327196
SCOPE OF PERMIT
FIRElLIFE SAFETY SYSTEM FOR TENANT IMPROVEMENT. REF: 800-01341
FEE SUMMARY
Plan CheCk: $326.85
Permit: $502.85
Other: $0.00
Total: $829.70
Status: ISSUED
Applied: 10I04I2000
Issued: 1120/2000
c
ISSUED BY:
Calc Valuation: 535,ae3.00
Claimed Valuation: S35,ae3.00
NOTICE: The work authorized by this permit shall comply w�th afl appllcable handfcap access requiramants under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12•21•92)
EXPIRA710N: TMis permil shall automatically expire end become voitl If work Is not commenced withln 180 days, or if work Is suspended or abandoned
for a period ol 1 BO days.
INSPEC710NS: In order tor ihe work authorized under this permit to be considered legel, such work must comply with ell epplicable codes, and all
requlred inspectlona end tinal approvel must be obtflined. Fallure to obtain inspections and final approval wlll result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545628
zaeee �aoo�
WORKERS'COMPENSAnON DELLARAnON: �
I hereby eflirm under penalry ot perjury one of Ue fWlowing tledereLons:
❑ I have entl w10 mfllntain a cerlificate of consent to selt-Insure tor workers' compensation, as proviAed tor Dy sectlon 3700 oi Ihe LeDor Cotle, lor Ihe pertormance oi Ne
work for which this permll La I55ueC.
,� I heve end will malntain workers' compensation insurence, av requiretl Dy section 3700 oi Ue Labor Code. lor the peAomiance ot Ne work for whkh NLa pertNt is iswetl.
My workers' compensation InSurence carrier entl policy number ere:
Cerrier: Polity Number:
(Thls sectlon need not Ee comple(ed i! the pemtit ls veNed el one hwMred tlW/ers (S �00) or less.)
❑ I ceNiy that in lho peAormance ot the woAc lor w�ich this permit is Issued, I shell not employ any persan in eny menner so es lo Eecome sub�ect lo I�e workers'
compensetlon laws ol Celitomia, end egree that II I should become sub�ect ta I�e workers' compansetion proWslons of SocUon 3700 ot the Lebor Catle, I shall fonhwlth
comply with these provisions.
Applicant Signeture: T�� C�L Date: `\ - ZC� - CX�
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UMAW Fl1L PND SHALL SUBJECT AN EM�LOYER TO GRIMINAL PE W�LTIES AND CML FlNE$ UP TO ONE NUNDRED
T}IOUSMlD DOLLARE (f100,000�.IN ADDITIIXJ TO THE WST OF COMPENSATION, DAlMOES ilS PFOVIOED WR IN SECiION 3]OB OF THE LABOR CODE.IMEREST, AND ATTORNE`f3 FEES.
LICENSED CONTRACTORS DECLARATON:
I horeby aNirtn that I em Iicensed unCer D�ovisions ot Chapter 9(commenanp wlth Section 7000) ot Division 3 of Ihe Business end Prolessions Cotla, end my license Is In tull
torce anA eHect. Lic. q Class p
ContractoYs Signeture: �"�'—� ���— Dete: _ 1\-2.0 - uO
CONSTRUCTION LENDING AGENCY:
❑ I heroby eflirtn that Ihere is a construction lending egenry tor Ihe poAormence at t�e work for whic� t�ls permit is Issued. (Sec. 3097, Civil Code).
Lentler's Neme: Lentlers Address:
Signe�ure: Date:
OWNEP-BUILDER DECLARATIONS:
I hereby eHirtn t�et under penelry of perjury that I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for the follawing reason (Sec. 7031.5, Business entl Protessions
Catle: Any city or counry which reqWres e permlt to consWct, elter, improva, demolish, or repair any structure, prior to its luuenco, elso reQuires the applicant lor such permit
to flle e sipned stetement Ihet he or she is IlcenseO pursuant to the provislons of the Contredors License Lew (Chapter 9(commencing wlth Seccion 7000) of Divislon 3 0l the
eusiness entl Professbns Code) or that �e or she is exempt thereirom entl the Desis for the fllleged exemptlon. Any vloletlon of Section 7031.5 by eny epplicant tor e pertnit
sublects the epplicant to a civil penalry of not more Ihen five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages es thelr sole compensatlon, WILL DO THE WORK, and the structure Is not intentletl or oNeretl for sele (Sec.
70a4, Business and Prolessions Code: The Contractors LJcense law does not apply to en owner of pmpeny who bullds or improves thereon, end who tloes such work
hlmself or hersetl or Ihmugh hls or her own employees, pmddeC Ihal such Imprwements ere not intended or oHered lor sale. If, however, the builEing or imprwement is
soltl wi�hin one year of cnmpletion, the owner-builtler vrill have t�e burden of proWng ihat he or she did not build or improve for purpose ot sale.).
❑ I, e5 owner ot the propeM, am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to con5iru[7lhe pro�ect (SecJ044, Business end Professions
Coae: The wntrectas License Law does nat apply to en owner oi property who bulltls or impmves [�ereon, end who wntracts lor such pmject wlih a contrector(s)
licensa pur5uent lo �he Conlradors License Laws.).
❑ I am e:empt untler sec. Business antl Professions Code tor t�is raason:
Signature: Da�e:
Owner ID verilied by tlriver's Ilcense. ❑ Yes ❑ No Drivers License No.
Vedilcetion ot Ownership Dy (type ot tlocumen6 i.e. - property tem DIII or deetl):
DIVISION OF INDUSTRIAL SAFETY PEflMR CERTIFICATON:
E�Ires:
❑ I hereby certity thet no excavation tive (5) or more teet In depth Into whicli e person Is requiretl lo descend, will be made in connedlon wit� work fluNOAzetl by Nis
pertnit, entl t�at no building structure, scattdtling, falsework, or demolltlon or tlismantling ihereof, wlll be more ihen ihltly-slx (36) teet high. (Chep. 32, Gry 2, Atl 2, Sec.
341, Title B, Celllornia Atlministretive Cotle).
❑ As ownor�builder, I will not employ anyone to tlo work which woultl roquire e pormil lrom the Divislon of Industrlal Seley, as noted ebove, unless such person hes e
pertnit to do such work Irom tha division.
Signeture: Dete:
Division ot Induslrial Selery Permit Number:
CERTIFICATE OF COMPWINCE AND AUTHOHVATION OF EMRY: I cenity under penelry of perjury ihat I have reed t�is application enG siete ihat the information given Is
correct I egree lo compty wit� ell state laws end ciry ordinances rela�inp to bulltlinp cons�ruction, end euthodze represemetives ol tha Ciry of Gosta Mese to enter upon the
ebove-describetl property lor Inspection purposes. I egree not to occupy or ellow occupancy of eny building eu�horizotl by ihis permil until tinel Inspection.
SignaNre Oi Legel Owner(s)
V`�\-�- 2� ��-Z�-G7Q-�
And/Or Aut�oAzed Applicen�
COUE I. INSPECfIONTYPE
1618 FIxeC System Final Fire Prevention
1268 Pool SDe Finel
200 Flnal Re-Root ,
201 Final Block/Retalninp Wall
202 Final Fedory Fira Place
203 Finel Slpn
204 Flnal Demditlon
Pdg ItiT�lL&
eooe� ixsvecnoNnve
208 Finel Mec�anicel
20B Finel Plumbing
210 Flnal Electdcal
212 Flnal Flre PrevenUan
220 Flnal Plenning ADPrwal
222 Flnal Site
250 Final Bullding/Occupency
PAg �L8
r . �,
i
(714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-m�.u,�pRESSION PERMIT 77 FAIR DFIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite: 5
Vicinity: JD EDWARDS (STH FLOOR)
Parcel Number: 41050110
Applicane RAYNER, MARC
Address: 2505 MIRA MAR
LONG BEACH, CA
Owner: � SAKIOKA�FARMS
Address� , - � �
i ' ,
c t t CAL PROTECTION
Zoning:
Phone: (562)498-6444,�
Zip: 90815 ,
Phone:
Zip: 94137
Status: ISSUED
Applied: 09l26/2000
Issued: 70/12/2000
ISSUED BY:
on rac or.
�
Address: -� 2505 MIRA MAR � . ' - , `
- - Phone: - (562) 498-6444 _ , � � , - -, .
, LONG BEACH, CA . 'Zip: 90815 - � , .
. �, , Liceo'se: �327196 � -' �
� � - SCOPE OF PERMIT �
� REF B00-01341, SUITE 500, JDEDWARDS, ADD 92 HEADS AND RELOCATE OTHERS. � . �
� Plan Check: $313.72
Permit: $482.65
Other: $0.00
Total: $796.37
�
FEE SUMMARY .
- Calc Valuation: gsa,000.00,
� Claimed Valuation: s3a,000.00
;
� ; �,
, a..;.:_.. �s% • �
;�, �
� ;-
; ;, �
� ;�" �,
_ %
%�
, -i;�`.��'�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Caliiornia statutes and ralated
regulations. (Ord. No. 92•28, § 7, 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 Inspeetlons 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) 7545626
2MBd8 (8�W) �
WORKERS' COMPENSATION DECLARATION: � �
I hereby etlirtn under penalry at perJury one ol the fdlowing Oedarellons:
❑ I have end will maintain e certificate of cronsent ta salf-Insure for workers' compensation, es provitletl br by sacNon 3700 ot the Lehor Code, tor Ne peAortnence ot Ne
work br whlch ihis pertnit is i55ueC.
� I �ave and will mainlain workers' compensatlon insurenca, es required by sectim 3700 of the Lebor Cotle, tor Ne pertormance of the work tor wNc� this pertNt is Swetl.
My workers' compepsatlon Insurence carrier entl poliq number are: .
Cartiec Policy Num�er,
(Th/s soct/on need not be cwnpletetl i! the pemut is velued et one nuntlretl tlol/are ($100) or IessJ
❑ I tertity ihat In Ihe pertormance oi Ihe work for which lhi5 p8rtnit is issued, I 5hell not employ eny person In Bny manner so es to become SuDject to the workers'
compensatlon lews of Celllomla, entl epree that If I shaul0 became sub�ect to the workere' compensetion provlslons b Section 3700 0l the Lebor Cotle, I shall torthwith
comply wlih I�ese provlslons. n
Applicanl SlgneNre: ��-'" U' �—r_ Dele: �� " � Z— U�
WARNIN(i: FAILURE TO SECURE WORNEFiS' CAMPENSATION ODVERAOE IS UNIAWFUL MID SIULL SUBIECT AN EM�LOVER TO CRIMWAL PENr1LT1ES AND CIVIL FINES UP TO ONE HUNDRED
T/qUSAND DOl1ARE �5100,000), IN ADDIi1qJ TO THE CbS� OF fAMPEN5AT10N, DAAIFOES AS PROVIDED WR IN SECTION 7]OB OF TME UBOR CODE, IMEFEST, M1D ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy eHirm Ihat I am licensetl under provislons af Chepter 9(commencing with Sectlon 7000) of DlWslon 3 0l Ihe Buslness and Professions Code, entl my Ilcense is in lull
lorce entl Bflett. LiC. M GIasS k
Contrectors Slgnature: ��� �� Date: �,(7 ^ I Z— C�U
CONSTRUC710N LENDING AGENCY:
❑ I hereby affirm t�at �here is e con5truction lentling agency lor the OeAormence ot t�e work for which I�is permit Is issuod. (Sec. 3097, qvil Codo).
Lendefs Name: Lentler's AGtlress:
Signature:
OWNER•BUILDER DECLARATONS:
Date:
I hereby eMirtn Ihat untler penalry ot perjury that I em E%EMPT FROM THE CON7RACTORS LICENSE LAW lor the followirg reasan (Sec. 7031.5, Buslness anA Protessions
Code: Any ciry or counry which requires a pertnit to construct, alter, improve, tlemolish, or ropair any stmcWre, prlor lo its issuance, also requires the applicant for such pertnit
ro lile e signeE statement Ihat he or ahe is Iicensed pursuant m the provislons of Iha Contracrors lJcense Lew (Chepter B(commencing with Sectlon 7000) of D'Msion 3 oi ihe
Business end Pmlessiare Code) or thet he or she is esempi theretran antl t�e basis for the allegetl ezemptlon. Any violatlan of Sectlon 7031.5 by any applicant for a permit
subjects the applicant ro a civil penalty ol not more Ihan live hundred dollars (5500).):
❑ I, as owner of the propeny, ar my employees wlih wages as their sole compensation, WILL DO THE WOHK, entl the sWCWre is not intendetl or ofleretl br sele (Sec.
7044, Business end Professions Code: The Contractors License Lew does not appy to an owner ot properry who builds or improves Ihereon, entl who Aoes such work
himself or herselt or Ihrough his or her awn employees, proviAed that such improvements are not intentled or ollered lor sale. If, however, the building ar improvement is
soltl within one year ot completion, the ownerbuilder will heva t�e burden ol proving thet he or s�e did not Cuild or improve for purposa of sele.).
❑ I, es owner ol the properry, em EXCLUSIVELY CONTRACTING WI7H IIGENSED CONTRACTORS lo construct Ihe project (Sec. 7044, Business end Protessims
Cotle: 7Te coniractors License Law does not apply to an owner ol propetly who bulltls or improves thereon, end w�o contracts for such pro�ect vrit� e contracror(s)
license pursuant to lhe Contractors tJcense Laws.).
❑ I em exempi under sec. Business entl Prolessiau Code for Ihis reason:
Sfgnatme: �ate:
Owner ID venfietl by driveYs license. ❑ Yas ❑ No Drivefs llcen5e No. �cpires:
Verllicatlan of Ownership by (type ol tlaumenL i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certlly that no ezcaveilon tive (5) a more �ee� in depth Into which e person is requlretl to dexend, wlll be made In connection with work euthwlzed by this
permit, an0 ihat no building siructure, scaHoltling, falsework, or demoli�ion or tlismamling thareof, will be more Ihen thirry�six (36) feet high. (Chap. 32, Gry 2, M 2, Sec.
341, Title 8, Califomia Atlministrative Cotla).
❑ A5 owne�-builder, I wlll nol employ enyone to do work which woultl require a pertnit trom the DIWSIon ol IndusMel Sefery, as notetl abave, unless such person hes e
pertnit to do such work trom tha division.
Slgnature: Date:
Division of Intlusirial Sefery Permit Number:
CERTIFICATE OF COMPLIANCE AND AllT}iOHIZATON OF ENTFiV: I cenity unUer penalry of perjury Ihal I have read ihis epD�����on and stete that the Infortnation given Is
correct I egrea to comply wlth ell stete lews end ciry ordinances releling to builCing construction, end emhodze represen�atives of t�e Ciry ol Coste Mesa to enter upon the
ebove-describetl property for inspec�ion purposes. I egree not to oaupy or allow occupanty oi any building authonzed by this permil until final inspection.
Signature Of Legel Owner�s) Date
M!t- /� / U- � 7- Uc.�
Antl/Or Authorized AppliWnt Date
COUE �. INSPEGTIONTYPE
1818 Fixetl System Final Fire Preventlan
1268 Pool Spa Finel
200 Finel Re-Roof
201 Finel BIacWRetaining Well
202 Final Factory Fire Place
203 FinalSign
204 Final Demolition
QSjE �� �QQf„( INSPECTIONTYPE
� .1-�r]—bO (.� 206 Flnel Mechenlcel
20B Finel PlumDing
210 Finel ElociriCal
212 Final Fire Prevention
220 Final Plenning Approval
222 Finel SIIe
250 Final BuildingiOccupency
Pd� II�GS
�2..�s-w w�u
,;�:��
r.
� ,r��
i '.:...:3: i '
�,
��ia� �sa-sz�s • Fex (��a� �sa-aess
Job Address: 555 ANTON BL
Suite: 5
Viciniry: 5TH FLOOR
Parcel Nunmber: 41050110
Applicant: DEOCAMPO, RUDI
Address:
Owner: SAKIOKA FARMS
Address
CITY OF COSTA MESA
9UILD/N6 DIV/SION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Zoning:
Phone: (714)754-1197
Zip:
Phone:
Zip: 94137
contraaor: ACCENT BUILDERS
Address: 555 ANTON BLVD
#100 Phone: 714-54&3150
C.M.
2ip: 92614 License: 397790
N
Arch : FARRINGTON DESIGN GROUP Eng:
Address: 230 PEACHTREE ST #2000 Address:
Phone: (404)8363005
ATALANTA,GA
Zip 30303 License: Zip:
SCOPE OF PERMIT
TI - 5TH FLOOR. COMPLETE STH FLOOR TI. J.D. EDWARDS - TENANT.
20,433 SF TI (899-00384).
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$232.74
$1,432.25
$0.00
$43.89
$0.00
$0.00
51,708.88
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0. 0
PARKING Existina: o
NOTES:
Rear 0-0
Rear 0. 0
Reauired: 0
FEE SUMMARY
PLANNING 8 ZONING
LeR 0. 0
LeR 0. 0 '
Pr000sed: 0
PERMIT NUMBER
77 FAIR DRIVE, COST�MESA, CA 92626
Status: ISSUED
Applied: 0322/1999
Issued: 04/20/1999
ISSUED BY: �Y�
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0. 0
Phone:
License:
52os,000.00
5200,000.00
NOTICE: The work authorized by this permit shell comply with all epplicable handicap access requlrements under Celifomia stetutes and related
regulations. (OM. No. 92-28, § 1, 12-21•92)
EXPIRA710N: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a pe�iod of 180 deys.
INSPEC710NS: In order for the work euthorized under this permit to be considered legel, such work must comply with all epplicable codes, end all
requlred Inepeetlone end flnel epproval must be obtained. Failure to obtein Inspectlons end tinel epprovel will result in the expiration of this parmit.
FOR INSPECTIONS CALL: (714) 754-5828
WORKERS'COMPENSAnON DECLARAnON: � .
I hereby aHlrm under penelry ot per�ury one o1 the following deGarations: ' �
❑ I have and w10 maln�ein e certificate of consent to sell-Insure for workers' compensation, es provitle0 for by sectlon 3700 0l the Labor Code, for the pertortnance of tha
work fw wNU� Nis pertnll Is Issued.
❑� I heve eiM wm meintain wakers' canPensatbn inwrence, as raquired by section 3700 01 Ihe Labor Code� tw the peAortnence of Ihe work fw which ihis PartNt b Lssuetl.
My workers' com�nsatio nsr�yance c�yAer and poliq number are:
Cerrler. L/ �/L LVFwty Poliq NumDer. RIG Z—�GI— 03 iS,(� —�S
(Thfs sectlon need not mnpleted!! Ne lued et one hu Odlers (S100) or less.)
❑ I cerlity thet In the pertortnan of the wo wh ihis it is issue0, I ahall no1 employ any person in any mannor ao es to become sub�ect to the worken'
compensetlon lews of Cell ia, e r t t tl ahoultl a sub�ed to the workers' campensetlon proNsions ol Sectlo 3700 ot Ihe Labor Code, I shell lonhwlth
compty with t�es roN ' � /
Appllcant SIBneWre: �• Date: �'j7� L d��l
WARNIN�: FNLURE TO CURE WORI( S' OOMP TION COVERAGE IS UNUWFUL AND SMALL SUBIECT AN EMPLOVER TO CRIMINAL'ENPLTIES AND CML FlNE$ UP TO ONE HUNDRED
THOUSANDWLIARE /00,000),INADDfTI COSTOFCOMPENSATON,DAMAGE50.SPROVIDEDFOiiINSECTION3]OBOFTHELl�BORCODE,INTEflEST,ANOATTORNEY5FEE5.
LICENSED CONTRACTORS DECLARATION: /�
I hereby aHirtn thal I em
lOrce end eHeCt. lJc. M_
Conlreclors Signeture:
CONSTRUCTION LEN�ING AGENCY:
(commencing with Section 7000) of Divislon 3 of Ihe Business anC Profeulons Code, end my Ilcenso is In full
, / _ Gass « a , ,
� Date: _� z O �
❑ I �ereDy ettirm Ihat t�ere Is e mnsiructbn lendinp apenq for the peAartnance of the work tor which this permit is Lcquetl. (Sec. 3087, Clvll Cade).
Lentlers Neme: Lentlera Adtlress:
SipnaWre:
Dete:
OWNER-BUILDER OECLARATIONS:
I �ereDy eHirm Ihet untler penalry ol per�ury thet I em EXEMPT FROM TTiE CONTRACTORS IICENSE LAW for iha lollawing reason (Sec. 7031.5, Business entl Pratesslons
Cotle: Any ciry or counry which requires e pertnfl to consWct, elter, improve, tlemdlsh, or repair any structure, pdor to IL4 issuflnCe, elso requires Ne applicant for such permlt
to flle a signed atatement Ihet he or she is Ilcensed pursuant to Ihe provislons of the Conirectore LJcense Lew (Chepter 9(commencinB wlth Sectlon 7000) af DMslon 3 of Ue
Business en0 Prolessions Code) or �het he or she is axempt therefrwn antl t�e Desis tor lhe ellegetl exemppon. Any violetlon ot Seetlon 7031.5 by eny epplicant for a peimlt
s�n�ec�s �ne eppnwm m e wu pene�y m rw� mwe inen nve nu�wrea aouars �asoo�.�:
❑ I, es owner ot Ufe propeM• or my amployees wit� weges as their sde compensaUon, WILL DO THE WORK, end the stmcture Is not Intended w aHeretl Por aele (Sec.
7044, Business and Professions CaAa: The Coniractors License Lew tloes not eppy to an owner oi property who bulltla or ImOroves thereon, antl who tloes such work
himsetl or hersell ar through his ar her own employees, provided that such improvements are not intended ar otlered far sale. It, however, Ne building or improvement is
sold wit�ln one year oi compleUon, the owner-buildar will have Ihe hurden ol proving thet he or s�e tlid not bulltl or improve lor purpose ot sele.).
❑ I, as owner ol the properry, am E%CLUSIVELY CONTFiALTING WfTFI LICENSED CONTRACTORS to construct t�e proJect (Sec. 7044, Business anC Prolessions
Coda: The coNrectors Llcense Law tloes not eppty to en owner ot properry who bullAs or improves Ihereon, end who wmrects tor such prqect with e comractor(s)
Ilcense Oursuant lo the Contreciors lJcense LewsJ.
❑ I em Bxempi under sec. BuSiness entl Pfofe55ions Code tof ihl5 reason:
Sipnatura: Date:
Owner ID venfietl by drivers Iicense. ❑ Ves ❑ No Drivers Llcense No. Expires:
Veriticatlon of Ownership by (rype of document, i.e. - properry tex bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFlCATION:
❑ I hereby cerlify Uat no ezcavatlon tNe (5) or mare feei in tlepth Inio which e person is required to descend, will be mede in Cannecilon wiN work euttwrized by this
pertnit, antl thet ra builtling structure, sceflo101np, faLsewark, ar demdltlon or dismantling thereol, will be more than thirly-slx (36) leet high. (Chep. 32. Grp 2, Art 2, Sec.
341, Title B, Celifomle AGminislretive Code).
❑ As ownor-builder. I wlll nol employ enyone to tlo work whlch woulO require e permlt Ifom Ihe DiW51on ot IntluSiriel Sefery, a9 noted ebove, unless such person �es e
pertnit to do such work irom Ihe dMsion.
SignaWre: Deta:
Division of IndusMel Safety Permll Number:
CERTIFlCATE OF COMPLJAPlCE AND AUTHOR¢ATION OF Y: I cenify untler penalry ol perjury that I heve reatl thls eppliwtlon entl state that iha inlormation given is
correct. I egree to compry with e laws end dry ordin relatlnp to bulltling wnstruciion, and authodze representetives of t�e Ciry ot Coste Mesa to enter upon the
ebove�described property far speccion purpe�es. I agre o� to,occupy or ellow occupancy ol eny building authorized by thls pertnit untll Iinel Inspection.
CO�E I,
1816
1266
200
201
202
203
204
2MBee
Flxetl System Final Flre Prevenlion
Pool Spe Finel
Flnel Re-Rooi
Finel Block/Fleteining Well
Finel Fedory Flre Plece
Finel Sipn
Final Demolicion ,
PAIE Q�dl�
CODE� INSVECTIONTYPE
208 Finel Mechanicel
20B Finel PIum6ing
210 Finel ElectAcal
212 Finel Flra Preventlon
220 Finel Planning Approvel
222 Finel Site
250 � Finel BuIlding/Occupancy
h%�„'7-d�,y
Date
Pdg II�IS
�
�
(714) 754•5273 • Fex (714) 754-4856
JobAddress: 555 ANTON BL
Suite: 5
Vicinity: 5TH FLOOR
Parcel Nunmber: 41050710
npp�icant: SMITH, DON
Address: 555 ANTON BLVD
#100
C.M.
Owner: SAKIOKA FARMS
Address
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Contrector: ACCENT BUILDERS
Atldress: 555 ANTON BLVD
#100
C.M.
Zip: 92614
Arch :
Address:
Phone:
BUILDING PERMIT
Zoning:
Phone: 774-549•3150
Zip: 92614
Phone:
Zip: 94137 �
Phone: 774-5493150
License: 397790
Eng:
Address:
Zip License: Zip:
SCOPE OF PERMIT
INTERIOR NON BEARING DEMOLITIONFOR FUTURE T.I.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$493.75
$0.00
$0.00
$0.00
$0.00
$493.75
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0. 0
PARKING Existinq: o
NOTES:
Rear 0. 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & 20NING
Left 0. 0
Lefl 0- 0
Proposed: 0
PERMIT
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/O6/1999
Issuetl: 04I0611999
ISSUED BY: C �
Calc Valuation:
Claim Valuation:
Right 0. 0
Right a o
Phone:
License:
540,232.50
538,500.00
NOTiCE: The work aNhorized by this pertnit shall comply with ell epplicable handicep access requirements under Califomla statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shsll eutomatically e�ire end become void it work is not commenced within 180 days, or if work is suspended or abandoned
for e period of 180 deys.
INSPECTIONS: In crder for the work authorized under this permit to be canslderad legal, such work must comply with all applicable cndes, and all
requlred inepeetlone and flnel epprovel must be obteined. Feilure to obtain Inspectiona and final epproval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 754-5628 .
WORKERS'COMPENSATON DECLARATON: ,
I hereby eXirm untler penalry of pehury one af the followinp dedaretions:
❑ I heve entl will maintein e ceni0cete of conSen� ro self-Insure tor workers' compensellon, es O�4eC for by section 3700 of the LeDor Cade, tor Ihe peAormance oi Ne
work far whlch Nis pertnit is ltwed.
�have arM wil rtiaintaln wwke rtsetim Irtwrence. es reyuired by section 3700 oi tlie Labor Code. far the pertortnence of ihe woilc lor which Ws pertnit is issuetl.
wo e,' com nsauon I ce er arM pdky number ere:
Cartler. ��/ ���� Poliry Number: �Z —��i/ - 0 37 S/3 -�
(Thls sectlon need not e com leted!! fhey t!s velue�,et m�tlretl dollars ($100) or less.)
❑ I cetlity t�at In tha
w �e
wm t
cant SI n
: FAILURE TO SE(
THOUSMID OOl1AFE (f100
LICENSED CON
I he Ihat I em I
OrtB en0 HOC�. UC. k_
�he r w I t�ls pertnit Is Issued, I shall not employ eny person in eny manner so es to becrome sub�ect to the workers'
ree et tl oulC be ome sub�ecl to the workers' compensetlon r lons ot Section 3700 01 the Lebor Coda. I shall faMvrith
- -- �� ��-ss
PEN pN COVEqppE IS UMAWFUL AND SHFLL SUBJEGf AN EMPIAYEP TO CRIMINAL P TIES AND CML FlNES UP TO ONE HUNORED
fOTH OFGOMPENSATION,DAMAGESASPROVIDEDFIXiINSECfION3l080FTHELr1BORCDDE.INfERE5T,MIDATTORNEI"SFEES.
with Sectlon 7000) ot Divlslon
Date:
Code, antl my Iicense Is in full
CONSTAUCTON LENOING AGENCY: \�
❑ 1 hereby eNirm Nat Ihere Is a consiructbn Iending agenq for ihe peAortnance ot Ne work lor which this pertnit is Issuetl. (Sec. 3097, Clvll CoCe).
Lenders Name: Lenders Addreu:
Signeture:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby ettlrtn that untler penalry of perjury Ihat I em EXEMPT FROM THE COMRACTORS LICENSE LAW for Iha following reason (Sec. 7031.5. Business end Professions
Code: Any ciry or counry which requires a pertnit lo consWct, elter, Improve, demolish, or repair any sWcture, prior ta ils issuence, elso requires �he epplicaN tor such pertnit
to lile e signed atatemeN Ihat he or she Is Ilcen59A pursuenl to Ihe proNsions ot Ne Contraqors License Lew (Chepter 9(mmmencing wlt� Sectlon 7000j oi Divlsion 3 oi t�e
Business and Protesilons Cotle) or Ihet he or s�e is exemp� therefrom entl t�e basis tor the ellepetl exemptlon. Any violation of SeMlon 7031.5 by eny epplicent for e pertnit
subJecis the epplicent to e cMl penalry of not more Nen Me huntlretl dollars ($500).):
❑ I, es owner ol Ne property, or my employegs wlth weges es iheir sde compensetlon, WILL DO THE WORK, end the structure is not IntenEeE or otteretl for sale (Sec.
7040, Business and Professians Code: Th9 Contrectors Llcense Lew does no� eppty lo en owner ol properry w�o builds or improves Ihereon, enC w�o tloes such work
himseN or herseM or through his or �er own employees, pmNtletl Nat surh improvemants are nat intended or ottered for sale. N, however, the bWlding or imprwement is
sold within one year ot wmpletioq the ownerbulltler will �ave tha burden of pmving �he� he or ahe tlitl not builtl or imprrne for purpose ot sale.).
❑ I, es owner of t�e pmDeRy, am EXCLUSIVEIY CONTRACTING WfTH LICENSED CONTRACTORS to construct ihe projed (Sec. 7044, Business and Pmfessions
Gode: The contracrors License Ww tloes hot eppty to en axner of properry wM builds or impmves ihereon, end who coNrecis for such project vrith a contrector(s)
license pursuant to the Contractors License LawsJ.
❑ I em ozempt under sec. Business antl Professions Cade far this reason:
Slgnature: Date:
Owner ID verifletl Dy tlriveYs license. ❑ Yes ❑ No Drivels License No. Expires:
Vedflcatlon of Ownership by (rype of document, i.e. - property tex bill or deed):
DIVISION OF INOUSTRIAL SAFETV PERMIT CEpTIFICATON:
❑ I hereby cenity that no excavatlan five (5) or more feet In tlepih Into which e person is requlred to tleacend, will be ma0e in connection wit� work euthonzetl 6y this
permit, and thet no bulltling structure, scafl0ldinp, falsework, or demdltlon or tlismantling there0l, wlll be mare then ihirly-six (38) teet hlqh. (Chsp. 32, Grp 2, Art 2, Sec.
341, Title B, Celifomla Administretive Code).
❑ As owner-builder, I will not employ anyone to tlo work w�kh would repuire a permlt lrom the Division of Induslriel Satety, as noted ebove, unless such person has e
pertnit to tlo such work from Ihe dMSion.
SlgnaNre: Date:
Dlvision of Industrial Sefey Permlt NumDer.
CER7IFlCATE OF COMP CE'AND iZATI N OF EMAY: I cenify under penelry ol per�ury thet I heve reetl this epplicetlon and stete that the information given is
correct. I egrea lo com with e e I s entl dry rtlinences relating to building construction, entl euthoAze representatNes ot the Ciry of Costa Mese Io enter upon t�e
ebove-tlescdbed pr rty forjps� urpaaee. I gree not to occupy or ellow occupancy oi any 6viltling euthodzetl by Ihls pertnit untll flnel Inspectlon.
1816
1266
200
201
202
203
INSPECTION TYYE
Fixed System Final Fire Prevention
Pool Spa Finel
Finel Re-Rool
Finel BIocWReteining Well
Flnel Fectory Fire Place
Flnel Slgn
204 Finel Demolition
zana-s8
COOE I INSPECTION TYPE
208 Final Mechenicel
208 Final Plumbing
210 Final Elecidc8l
212 Finel Flra Preventlon
220 Finel Planning Approval
222 Final Sile
250 . Finel Building/OCcupenCy
Q� ��
�
���a� �sa-s2�s • Fax (�ia� �sa-aess
Job Address: 555 ANTON BL
Suite No
Vici�ity:
Parcel Nunmber.
Applicant:
Address:
Owner:
Address
CITY OF COSTA MESA
BDILDIN6 DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
ELECTRICAL PERMIT
�i
ENTIRE STH FLOOR/ STE 500 � f D E(��lJQ "
41050110
FULFORD,TERRY
8749 SHIRLEY AV
NORTHRIDGE, CA
SAKIOKA FARMS
Contractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
ISSUE FEE '
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool I Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Molors to 1hp
Molors to 10hp
Molors to SOhp
Molors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
NORTHRIDGE, CA
Phone: 818-407-1986
Zip: 91324
Phone:
Zip: 94137
Phone: 818-407-1986
Zip: 91324
License: 3886�9
PERMIT
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 04/2211999
Issued: 04@2/1999
SCOPE OF PERMIT
TI FOR J D EDWARD (TRAINING FACILITY): 294 FIXTURES, 151 OUTLETS, 51 SWITCHES 7 NON
RES APPL, 17 MOTORS TO 1 HP, 101 COMMUNICATION DROPS, 1 SUB PANEL TO 200 A, 7 LOW
VOLTAGE EQUIPMENT.
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
$198.10
$105.15
$40.15
$29.75
$0.00
$0.00
$0.00
$0.00
$72.25
$0.00
$0.00
$0.00
$0.00
$72.65
$27.25
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
294
151
51
7
0
0
0
0
17
0
0
0
0
101
7
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway I100 ft
Standing Sedion
Misc Electrical Equipment
Transformers up to 1 kva/kw
:...............up to 10 kva/kw
.................uP to 50 kva/kw
.................up to 100 kva/kw
..................over 700 kva/kw
Low Voltage Equipment
Low Volt Winng System / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Ch�istmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspeaion Fee
Quantlty
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$113.75 7
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
so.00
50.00
TOTAL CALCULATED FEES E681.05
COMMENTS I SPECIAL CONDITIONS
NOTICE: The work authorized by this partnit shall comply with all applicable handicep access requirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
El(PIRATION: This permit shall automatically expire and become void if xrork is not commenced within 180 days, or if work is suspended or abandoned
for a period af 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
requl�ed Inspections and 11na1 approvel must be obtained. Failure to obtain inspeclions and finel approval will result in the axpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628
WORKERS'COMPENSAnON DECLARATON: � , .
I hereby atfrtn under penalry of pe�ury one of Ue fdlowirg tledaretions:
❑ I have antl wlll mainteln e cert�cate of consenf to self-Insure for workers' compensetlon, es provided for by section 3700 oi the Lebor Code, for t�e peAortnance of the
�work for which ihis pertnit I5 issuetl.
I have and will malntain workers' compensatlon insurance, es requireC by section 3700 oi Ihe Lebor Code, for Ue pertortnarxe of Me work for which this pertnit is Issuetl.
My workers' compensellon Insurence ceMer entl policy number ere:
Cartler: � Policy Number:
(lhls secHon need not be completeC il fAe Oermlf Is velued ef one hundred dollers ($100) or less.)
❑ I certiy ihet In the parformence i the work hich ihis pertnit Is issued, I shell not employ eny persan in eny menner so es to become suD�ect lo Ihe workers'
compensation lews of Calilo ntl egre I shoultl became sub�ect to ihe workere' wmpensetlon Drovislons of Section 3700 of Ihe Lebar Cade, I shell fonhwith
comply with t�ese provi � ' /
Applicant Signature: �`'"L% �� Date: y' z Z �(' Q
WARNINO: FAILURE TO SEWRE WORN�i Wf.1PE1 dJ COVEPAGE IS UNLAW FUL AND SHALI SUBIECT PN EMPLOYER TO CRIh4NAL PENPLTIES AND GVIL FINES UP TO ONE HUNDRED
TIKKISANODOLIARE�Et00.W0),INAODITIIXJTOTH COSiOFCOMPENSATION,DAAIAGESASPROVIDEDFORINSECT10N7](150FTMElABORCO�E.INfEREST,ANDATTORNEI^SFEES.
LICENSED CONTRACTORS OECLARA710N:
I hereby a8irtn Ihat I am licensed under provlsic
forca entl eHect Lia M
Conirecrors SlgnetureT. � • -
Chapter 9(commencing with Sectian 7000) of Division 3 of Ihe Business and Protessions Cotle, antl my license is In full
CIeSs N
.,.p Dete: —Z Z —4 P
CONS7RUCTION LENDING AGENCV: `�
❑ I hereby aHirtn ��et ihere Is e consiructlon lentling egency tor t�e pertormence ol the work tor which this permlt Is issuetl. (Sec. 3097, Civil Cotle).
Lentlefs Neme: Lentlets Atltlress:
SignaWre:
OWNER-BUILDER DECLARA710N5:
Date:
I hereby aHirtn thet untler penalry of perjury that I am E%EMPT FROM THE CON7RACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Buslness entl Professions
Code: Any ciry or counry which requires e permit to wnstruct, elter, Improve, demolish, or repair any structure, pdor to ils Issuence, also requires the applicant for such parmit
to flle e signetl statement that he or she Is Iicensed pureuent to ihe provisions of tha Coniractors License Law (Chapter 9(commencing wlth Section 7000) ot Dlvislon 3 of ihe
Business end Professlons Codp) or thet he or she la exampt t�eretrom and the basis for the allegetl exemptlon. Any violetlon of Sedlon 7031.5 by eny epplicant for e permit
sub�ects the applicent to e clvll panelty o1 not mare than Ilve huntlred dollars ($500).):
❑ I, es ov+ner ot ihe properly, or my employees wilh weges es their sole compen5allan, WILL DO THE WORK, end Ihe alructure is not Intended or aHered for sale (Sec.
7044, Business entl Profqssions Cotle: 7Te Contractors License Law Ooes not epply to en owner ol property who builds or improves Ihereon, end who does such wark
himselt or harself or thraugh his or her own employees, provided thet such improvements are nol intended or oflered for sale. If, however, Ihe hulltling or improvement is
sold within one year of completion, ihe ownerbullder will have the burden of proving ihat he or sha tlitl not builtl or improve for purpose of sale.).
❑ I, es owner ot the propehy, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS t0 ConStNtt I�e proleCt (Sec. 7044, Bu91n835 end Profe55ion5
Cade: 71re coniracrors Ucense Law does rwt apply to an owner of propefty who bullds or improves ihereon, and who conirads for such project witb a contracta(s)
Ilcense pursuant to the COntrectore Llcense LewsJ.
0 I em exempt under sec. Business end Professlons Code for ihls reason:
Signature: Dete:
Owner ID verifietl �y dnvers license. ❑ Yes ❑ No Drivers LJcense No.
Verification of Ownership by (rype of document, i.e. - proparry tax blll or tleetl):
DIVISION OF INDUSTRIAL SqFETY PERMIT CERTIFICATION:
Expire5:
❑ I hereby cenity thet no ekcavation �ive (5) or more feet in depth Into whlch e person Is requlred to descand, wlll be me0e In connection wiih work authodzed by ihls
permit, antl thal no building strucWre, sceffoltling, telsework, or tlemolllion or dismentlinp thereoL wlll 6e more then thirry-sia (38) teet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Titla B, Gelltomia Adminlsiretive Code).
❑ As owner-bulltler. I will nOt employ enyone to do work w�lch would require e pertnit iram Ihe Division of Industriel Sefery, es noted ebove, unless such person has a
permit to do such work irom the tllNslon.
Signature: Dete:
Division ot Industnel Safery Permil Number:
ICERTIFICATE OF COMPLIANCE AND AUTMORIZATION OF ENfAY: I certify under penelry oi perJury that I heve read this epplication antl state that the information given is I
correcL I agree to comply wllh ell state laws end ciry ordinences relating to building consiructlon, end eulhodze represenletives of the Ciry of Coste Mesa to enter upon tha
above-tlescnbed proDerry far Inspection purposes. I egree not to occupy or allow occupancy of any bulltling aut�orizetl by this pertnit untll Ilnel Inspectlon.
CODE �. INSPECTIONTYVE
1�6 Fiaed System Finel Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Finel BIocWRetalning Wall
202 Finel Fectory Fire Plece
203 Final Sign
204 Final Demolilion
2d48d8
p9IE 1[�lLS
y-Zz��%P
COOE I INSPECTION TYPE
208 Final Mechenical
2(18 Final Plum6ing
210 Final Electdcal
212 Flnal Fire Prevention
220 Final Plenning Aoproval
222 Flnal Site
250 Final Building/Occupency
CITY OF COSTA MESA
BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714) 754-5273 • Fan (714) 754-0856
Job Address:
Suite No
Vicinity:
555 ANTON BL
COMPLETE 5TH FLOOR
Parcel Nunmber: 41050110
Applicant:
Address:
Owner:
Address
THORNTON,RAY
SAKIOKA FARMS
PLUMBING PERMIT
Phone:
Zip:
Phone:
Zip: 94137
Contractor: CONTINENTAL PLUMBING INC
Address: 11165 THURSTON LANE :
ArchlEng:
Address:
MiRA IOMA, CA
Phone: (909)360-8300
Zip: 91752
License: 399073
Phone:
Zip:
License:
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/23/1999
Issued: 04/23/1999
ISSUED BY:
SCOPE OF PERMIT
PLUMBING FOR THE 5TH FLOOR TI - J D EDWARDS. �
1 ICE MAKER, 1 DISHWASHER, 1 FLR
DRAIN, 2 EXP TANKS, 2 PRESSURE REGS, 1 FLR SINK, 3 KITCHEN SINKS, 1 TRAP PRIMER, 1
-WASH BASIN SET, 1 WASTNENT, 7 WATER CLOSETS, 2 ELEC WTR HTRS, 1 WATER PIPING & 2
� INSTA HOT HEATERS. "
899-00384.
ISSUE FEE
BackFlow irrigation �
Backflow Preventer
Bathtub
Clarifier System
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-0 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$22.00
$0.00
$0.00
$0.00
$0.00
$8.75
$0.00
$8.75
$8.75
$0.00
$0.00
$0.00
$17.50
so.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
Qn
0
0
0
0
1
0
1
1
0
0
0
2
0
0
0
0
0
0
0
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $77.50
Process Piping (per 10 ft) $0.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower � $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $8.75
Sink, kitchen $26.25
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
Qn
0
0
0
2
0
0
0
0
0
0
0
0
0
1
3
0
0
0
Sump Pump
Swimming Pool
Trep Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or RepJ
Water Re-pipe
Waler Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$8.75
$0.00
$0.00
$0.00
$0.00
$8.75
$8.75
$6125
$22.00
$8.75
$0.00
$0.00
$0.00
$17.50
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: $254.00
QTY
0
0
1
0
0
0
0
1
1
7
2
1
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 penod 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
requlred Inspectiona end final approval must be obtained. Feilure to obtain inspections and finel approval vnll result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARATON: '
I hareby aflirm under penalry o1 per�ury one of ihe following declaretions: �
❑ I have and will maintein a certiiicate of consen� to selt-Insure tor workers' compensetion, es provitletl for by section 3700 of Ihe Labor Cotle, for the pertortnence of Ihe
. wark tar which t�is pertnit is issued.
��I have antl will maintein workers' compensation insurance, as required 6y seclion 3700 of Ne Labor COUe, tor the peAormance of �he work for which this pertnit is issued.
My workers' crompensation Insurance carner entl policy number are: ] p ft
Carrier. � E� Aa ��T� ti � d`�JCP Pollcy Numbar: � C Z ���U O� ( Q
(Th/s sectlon need mt be complefed il the permit is velued af one hundred dollars ($100) or IessJ
❑ I certlfy ihet in the peAortn e of ihe work for which Ihis permit is issueQ I shall not employ any person in any mannar so es to become subJect to the workers'
compansation laws of C M orni , e egr (P ii I shoultl become subject to the workers' compensetion provisions of Section 3700 of Ihe Lebor Cotle, I shall forthwith
comply with these prov' ion (/ ^ (��
Applicant Signatuie: Date: 1� oC� "'l-1
WARNING: FAILURE TO SECURE W ER OMPENSATION COVERAQE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TOONE HUN�RED
THOUSANO�OIAARE($100.000�,1 DITIONTOTHEWSTOFpOMPENSATION,DAM14IGESASPROVIDEDFOfiINSECT10N3�O60FTHELABORCODE,IMEREST,ANDATfOPNEV'SFEES.
LICENSED CONTAACTORS DECLARATION:
I heraby aflirm ihat I am
iorce and eHect Uc. x_
Conirector's SignaWre:
CONS7RUCTION LENDING AGENCY:
ot Chepter 9(commencing with Section 7000) of Divlslon 3 ot the eusiness and rofe ions Cotle, and my li,c�epse is in �1yII
Classp C- 3�o C`�-3Y•GI 6 hi1.i��`1
- Dete: ��...�3 �
❑ 1 hereby affirtn ihet Ihere is a consiruction lending agency tor the pertortnance of the work for which ihis permlt Is Issued. (Sec. 3097, Civil Code).
Lendels Neme: Lender's Atldreu:
SlgnaNre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aMirm iha� under penalry of perjury ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: Any city or counry which requires e permit to consiruct, elter, improve, demolish, or repelr eny slrucwre, prior ro ifs issuance, also requires the applicant for such permit
to flle e signetl slarement Ihat he or she is licensed pursuem to the provisions of the Conirectors License Law (Chapter 9(Commencing wiM Section 7000) of Divlslon 3 of Ihe
Business an0 Professions Code) or that he or she Is exempl Meretrom and t�e basis tor the ellegetl exemption. Any violetlon of Sectlon 7031.5 6y any epplicant for e permit
subJects the epplicent to e civil penelry of not more Ihen five hundretl tlollers ($500).):
❑ I, es owner oF the propeM. or my employees with wages as their sola compansation, WILL DO TNE WOHK, and iha strudure is not intentletl or ofFered for sale (Sec.
7044, Business and Professions Coda: The Contreclore License Lew does not apply to en owner of proparty who builds or improves thereon, anC who tloes such work
himself or hersetl or through his or her own employees, provided ihet such Improvemanis are not Intended or ottered for sale. If, however, ihe building or improvemenl is
sold wlihin one yeer of completion, ihe owner-builder will heve Ihe burtlen of proving ihet he or she did not build or improve for purpose ot sele.).
❑ I, es owner of ihe prOperty, am E%CLUSIVELY CONTRAC71N6 WITH LICENSED CONTRACTORS to construct tha pro�ed (Sec. 7044, Business antl Prote551ons
Cotle: The contractors License Lew does not eppry to en owner oi property who bullds or improves ihereon, end who conirecis for such project with a contrector(s)
license pursuant to tha Coniradors License Laws.).
❑ I am exempt untler seC. Business and ProFesSions Code for ihis reason:
Signature: Date:
Owner ID verifietl by driver's license. ❑ Ves ❑ No Dnvels Licensa No. Expires:
Venfication ot Ownershlp by (type of daument, i.e. - property tez bill ar deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereDy certify that no ezcevation flve (5) or more teet In depih Into which a person Is requlred to descend, will be matle In connedlon with work authonzed by ihis
pertnit, end that no building siructure, scattolding, falsework, or demolition or dismantling Ihereot, wlll be more than ihirty-six (38) feet �Igh. (Chap. 32, Grp 2, Art 2, Sec.
341, TLLIe B, Cellfornia Atlminisirative Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require a permit trom the Division of Industriel Sefery, as noted above, unless such person has a
permit to do such work from Ihe division.
Signature: Dete:
Division of Industnal Safery Pertnit Number:
CERTiFICATE OF COMPLIANCE AND AUiHORVJITON OF ENTRV: I certify untler penalty of perjury that I have read ihis application and state that iha information given is
correct. I agree to comply with all state laws entl ciry ordinances relating ro �uiltling constructioq antl euthonze representetives of the Ciry of Costa Mesa to enter upon the
ahove-tlescribed propeny tor inspection puryoses. I agree not to occupy or allow occupancy ol any bullding authonzed hy this pertnit until final inspection.
cooe �. ixsreenonTrve
7616 Fiaetl Systam Final Flre Prevention
1266 Pwl Spa Final
200 Finel Re-Roof
201 Final BIocWReteining Well
202
203
204
2648.48
Final Fectory Fire Place
Final Sign
Final Demolition , , .
COOE 1 INSPEC710N TYPE
206 Final Mechenical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Finel Site
250 Final
Y-°�� �i
Date
� L�
(714) 754-5273 • Fau (714) 754-4856
Job Address: 555 ANTON BL
Suite: 5
Viciniry: STH FLOOR
Parcel Nunmber: 41050110
App�icant: ELLIS, MARK
Address: CIO CAL PROTECTION
LONG BEACH, CA
2505 MIRA MAR AVE.
Owner: SAKIOKA FARMS
Address
Contraaor. CAL PROTECTION
Address: 02505 MIRA MAR
CITY OF COSTA MESA
BUILDIN6 p1VIS10N
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
FIRE SUPRESSION PERMIT
Zoning:
Phone:
Zip: 90815 ;
Phone:
Zip: 94737
PERMIT
77 FAIR DRIVE, COSTA MESA, CA 92626
Slatus: ISSUED
Applied: OS/03/1999
Issued: OS/21/1999
ISSUED BY: �S�
562.498.6444
�` �
Phone: 562-498�6444
LONG BEACH CA � Zip: 90815
" License: 327196
SCOPE OF PERMIT
OFFICE TENANT IMPROVEMENT. FIRE ALARM SYSTEM FOR "J.D. EDWARDS" RE: B99-00384.
Plan Check: $467.03
Permit: $718.50
Other: $0.00
Total: $1,185.53
FEE SUMMARY
,�
. r�''
Calc Valuation: sn,E23.00
Claimed Valuation: S�z,a2s.00
NOTICE: The work euthorized by this pertnit shall wmply with all applicable handicap access requirements under Califomia stetutes and relatad
regulations. (Ord. No. 92-28, § 1, 12-21•92)
EXPIRATION: This pertnit shal� automaticelly eupire and become void if work is not commenced within 180 days, or if work is susperWed or abandoned
for a period of 780 days.
INSPEC710NS: In order tor the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeellone end 11na1 epprovel must be obteined. Failure to abtain Inspectiona and final approvel will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 754-5628
WORKERS'COMPENSA�ON DECLARAnON:
I hereby aXlrtn untler penalty M perjury one of Ue tollowing dedaretlons:
� I �eve antl vnll maintaln e certlllcate of consem ro setl-Insure tor workers' oompensetion, es proNtleO for Dy section 3700 of Ihe Lebor Code, tor Ihe pertortnance ot the
WOA( �Of Wlllt�l �III9 P8rtf11t 19 ISS11Bd.
Q I heve and wlll melntain workers' compensatlai insurance, as raquire0 by sectim 3700 of the Labor CoOe, for ihe peAortnence of Ue woAc for which Ws pertnit Is Lssuetl.
My workers' com nsatlon I rencece� e�r,,and pdiry,o`umber are:
caMer. �� ��GPJQLI.L 1.fJ�E1`-�tJ1Ty PoncyNumoer. '3�{i�C�—��
one nunareu uwiers (S�ov) or
0 I certly thet tn Me peAormence of the work lor whtch Ihis permit fs tssued, I shetl nol employ eny porson in eny menner ao es to become subJect la tha workers'
mmpensetion lews ol Celifomla, end epree �het it I shoulG Decome su�ject ro the workers' compensation proWslons of SecUon 370p of the laDor Code, 1 shall tonhwith
comply with Nese proWsions. �nn• C
ApPllcem Signeture: lX�^ Deta: U/� /�� `�
WqRMNG: FNLURE TO SECURE WpRI�RS' OOMPENS�TION COJERAGE IS UNUWFUL M1D SHALL SU9IECT AN EMPLOVER TO CRIlNNAI PENALTIES AND WIL FlNES UP TO ONE MUNDRED
TIIOUSW D OOLLME (5100.Opp1. W A�DfiION TO THE OOST OF CONPFMSATION. DMMGES 0.S PRWIDED FOR IN SECiION 3'/080F THE IABOR OODE, IMERESi. MID ATTORNEY'S FEES.
LICENSED CONTRACTOpS DECLARATION:
I hereby eNirtn Ihet I em Ilcensetl under provisions ot Chepter 9(commendng with Section 7000) of Divislon 3 ot the Business antl Professions Cotle, entl my Iicense Is In full
rorce ana enect. ua k 5a �l b ciass x C— I D� G—� �
Contraaars Signature: i�Q oate: 4/ 3C7/ cIO�J''
CONSTRUCTION LENOINO AOENCY:
❑ I hereby ettlrtn Nat there is e wnstruction Iending epenty for ihe peAortnanca ol iha work for which this permlt is Issued. (Sec. 3087, Clvil CoOe).
Lendele Neme: Lendefe Adtlress:
Signeture: Dete:
OWNER-BUILDER DECLpqpT10NS:
I hereby efllrtn ttiet unCer penalty of petjury ihat I em EXEMPT FROM TME CONTAACTORS LICENSE LAW lor t�e following reesan (Sec. 7031.5, Business antl Professlons
CoOe: Any ciry or counry which requlres e pertnit to consiruct, al�er, Imprwe, tlemWlsh, or repeir eny structure, prior to Its Issuance, also requlres the epplicenl tor such permit
to ille e signetl stetemen� thet ha w she is 6censed W rsuant to Ne prwisions of the Contreclors License Lew (Chepter 9(commenGng wiN Section 7000) of DMsion 3 ot Ne
Buslness entl Professions Code) or thet �e or she is exempt theretrom entl ihe besis tor ihe elleged eaemption. Any vloletlon of Section 7031.5 by eny epplicent tor e permit
sub�ects the epplicant ta e cMl penalry of oot more than five hundreA ddlars (5500).):
❑ I, es owner of the property, or my emplqrees wilh wages as Ihetr sole compansallon, WfLL DO TNE WORK, end fhe slructure I5 nol tnlentletl or oHered lor sale (Sec.
7044, Buslness end p�ofessions Cotle: The Contrectors tJcense Lew does not epply to en owner of property who bullAs or Improves thereon, entl who tloes such work
himself or herself or through his or her own employees, provided Nat suc� impravemenis ere not intended ar oHered tor sele. It, however, the building or improvement is
soltl within one year pf completion, the owner-buildar will have ihe burden ot proving that he ar she did not builtl or Improve for purposa of sele.).
❑ I, es owner of the propeM� am EXCLUSIVELV CONTRAC7ING WITH LICENSED CON7RACTORS to consiruct the pro�ect (Sec. 7044, Business and Protessions
Code: The contrectors License Law tloes not appty to an owner of property who builds or Improves Ihereon, and who conireds for such pro�ect wlih a contractor(s)
license pursuent to ihe Contractors License Laws.).
❑ I em ezempt under sec. Business end Professlons Cotle for Ihis reeson:
Signeture: Dete:
Owner ID veritied by tlriveNs Ilcense. ❑ Yes ❑ No DAvefs License No.
Vadlicatlon ot Ownership by (type ol document, i.e. - property ta:c blll or AeeA):
DIVISION OF INOUSTRIqL SAFETY PERMIT CERTIFICA710N:
Ezpires:
❑ I hereby cenly that no excavetlon tive (5) ar more teet In tlepth into whlch e person is requlred to descen0, wlll Oe metle in wnnectlon wit� wark euthodzed hy t�ls
permlt, end that no bulltling structure, scaHaltling, talsework, or tlemolltlon or dismantling thereot, wlll be more t�an Nlrty-slx (38) le9t high. (Chap. 3.2, Grp 2, Art 2, Sec.
361, Title 8, Celifomie Adminlsiretive Code).
❑ As owner-Dullder, I will not employ enyone to do work whlch woultl raquire e permit irom the Dlvision ol IndusMel Selery, es notetl ebove, unlesa such person hes a
pertnit to tlo such wqrk from Ihe division.
SipneWre:
Division o1 InCustrlel Satety Pertnit Number.
oace:
CODE t. �xsvecnoNrme
1816 Flaed System Fiqel Flre Preventlon
1268
200
201
202
203
20a
2M&de
Pool Spa Finel
FMeI Re-Raof �
Final BIocWRetelning Well
Finel Feclory Firp p�g�q
Finel Sign
Finel Domdition
PLIE Iti�65
COOEt INSVECTIONTYVE
20B � Finel Mechenical
20B Finel PlumDing
270 F'rnal Electdcel
212 Finel Fire Preventlon
220 Final Plenning Approvel
m Fi�ei sue
250 . Finel Buildlnp/Occupency
� Iti�
'��� "'
�jl:�!JvY.
L
� y�.
� •.:�::: ; :
�
(774)754-5273 • Fax(714)754-4856
� CITY OF COSTA MESA
BI/ILDING p1YISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 555 ANTON BL
Suite: 5
Vicinity: 5TH FLOOR
Parcel Nunmber: 41050110
Applicant: ELLIS, MARK
Address: CIO CAL PROTECTION
LONG BEACH, CA
2505 MIRA MAR AVE.
owner: SAKIOKA FARMS
Address
FIRE SUPRESSION PERMIT
Zoning:
Phone:
Zip: 90875 -
PERMIT
�P99-00103
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: OS/03/1999
Issued: 0521/1999
ISSUEDBY: �f��•`(
� ' ' � . ��.A�.�� ..
�'��; � _
Phone:
Zip: 94137 . .
562.498.6444
Contractor. CAL PROTECTION
Address: 02505 MIRA MAR
Phone:l 562-498-6444 �
LONG BEACH CA �� ; Zip: 90815
"�License: 327196" .
SCOPE OF PERMIT
OFFICE TENANT IMPROVEMENT. INSTALL FIRE SPRINKLER HEADS. RE: 899-003&0. FULL 5 TH
FLOOR, FOR "J.D. EDWARDS:'
�
Plan Check: $397.96
Permit: $612.25
Other: $0.00
Total: $1,010.21
FEE SUMMARY
_ _ 'i
— i �
�� ,
. , _ , .�-i . .
Calc Valuation: 556,000.00
Claimed Valuation: s5a,000.00
NOTICE: The work euthorized by this permit shall eompty with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21•92)
EXPIRATION: This pertnit shall automaticaily expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order tor the work authorized under this permit to be wnsidered legal, such work musl comply with all applicable crodes, and all
requlred Inepeetlons end final epprovel must be obfained. Failure to obtein inspections and tinal epproval will result In the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS'COMPENSATON DECLARATION:
I hereDy eXirtn under penelry ot perjury one ot Ne lallowing deUarations:
@ I heve entl wlll malntain e cenificate of consen� to selFlnsure for workers' compensetlon, as DroviGetl tor 6y sectlon 3700 of Ihe Lebor Cotle, for the pertormencs ot t�e
work for whlc� ihis pertnit Is Issued.
B I heve end will mainteln workers' oompensallo� �nwrence, as requirad by se�tion 3700 of Ne LeOor Code, 1or the pertortnarke ot Ne wo�lc iw wIJM Nis� `rmit lv Lswed.
My workers' mmpensatlon Insurance cartler end pdiry number ere: ULT�/ ^ 3 4 e�' —� ��
caMe�: C �Y ��• 2r=P��T�' s�u p�' policy Numher. 1
(Th/s sectlon neetl not De completed I! fhe pemYt Is veluetl et one huiMred tlollers (5100) or less.)
� I cently that In the peHomiance ot the work tor whkh this pertNt Is LssueO, I shall nat employ eny person in erry manner so es to bewma subJect ro 1he workers'
compensetbn laws of Calitwnie, erW egree thet If I shoulC become subjecl to the workere' compensetlan proNsions of Sectlon 3700 ot the Lebor Cotle, I s�all fort�wlN
comDly with those P�r '{= fns.� F
Appiicant Signamre: '/ ' G�'Vi (" ��,� oa�e: 5—a �—a9
WARNINO: FAILURE TO SECURp WpRICEq$' ppMPENSATION COVEMOE IS UMAWFUL AND SIIALL SUBIECf M! EMPLOVER TO CRIMINAL PENALTE$ iVlD CM� FlNES UP TO ONE HUNDRE�
THOUSAND DOLLARE (5100.00%, IN FODRION TO TNE Ca6T OF GOMPENSAT�ON. DAMACaES AS PROVIDED FOR IN SECTION 3]OB OF THE IABOR CODE, INfERESf, AND ATTORNEVS FEES.
LICENSED CONTHACTORS UECLARA710N:
1 hereDy ettirtn that 1 em Iicenye0 unCer provislons of �§pter 8(cammandnp with Sectlon 7000) of Division 3 0l t�e Buslness antl Professlons Cotle, anA my Ilcense is in full
lorce end ettect, uc. a `i o`Z % ��(n Cless a C I�o G I O
Contrectors S�e�emre: .� Date: �/ 30/dU00
CONSTRUCTON LENDINR ADENCV:
❑ I here�y eXirm ihet there is e construclion lending agency fa Ne peAormence oi Ne work for wNch �his permit Is bsuetl. (Sec. 3097, Clvil Code).
Lendefs Neme: Lendels AtlOress:
Signature: Dato:
OWNER-BUILDER DECLAqATONS:
I hereby eHirtn Ihet untler penelry of perjury thet I em El(EMPT FROM THE CONTAAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Buslness antl Professions
Code: Any ciry or counry which requires e pertnit to conswct, eltar, improve, tlemolis�, or repeir eny strudure, pnor to its Issuance, elso requires tAe applicaM for such pertnit
to flle e signed stetement that he or she is licensed pursuant m the provislons of Ne Contreccors Lkense Lew (Chepter 9(commencing wlth Sectlon 7000) of DlNslon 3 of the
Business end Professlons Code) or Nat he or s�e is exempt therelrom entl ihe besis for Ihe elleped exemptlon. Any Nolation of Sectlon 7031.5 by eny epplicent lor e pertnit
sub�ecis the applicant ro e ciNl penelry W not more than fNe hundretl tlollers ($500)J:
❑ I, es owner ol Ihe praperty. or my employees with wages es iheir sole compensetion, WILL DO TH6 WORK, entl the structure is not Intentle0 or otterad for sele (Sec.
7044, Business entl Prolessions Cotle: The Coniractoro License Lew does not appy to en owner oi praperty who builds or Improves t�ereon, end who does such work
hlmself or hereetl or Ihroug� his ar her own employees, provitled Nat such improvements ere not Intended or ofleretl tor sale. H, however, ihe hulltling or Improvement is
sold wlihin one yeer of completion, the owner-builder will have the burtlen of proving Ihet �e or s�e tlitl not build or improve tor pur{wse oi sala.).
❑ I, es owner of lhe propgr(y, em EXCLUSIVELV CONTRACTNG WfTN LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business end Prolassions
Cotle: The contreaars License Lew does not apply ta en owner of properry who builtls or improves thereon, end wha cromreds far such pmject with a coniractor(s)
license pursuant to the Cantractors Ucense Lews.).
❑ I am exempt unCer sec. Business and Professiore Cotle far this reeson:
SignaNre: Dete:
Owner 10 verllled by tlAvefs IicenSe. ❑ Ves � No DriveYs License No.
Vedlication af Owners�lp by (type ot CocumenL i.e. - property tvc bill or deed):
DIVISION OF INOUSTRIAL SAFETY PERMR CERTIFICATON:
Expires:
❑ I hereby certlty that no eacavatlon five (5) or more feet in tlepth Into whlch e person is requiretl to tlescend, wlll be meUe In connedlon with work euthoAzeC by this
permit, end t�e� no huiltling struclure, sceHaldinp, lelsework, or demolition or dlsmantling ihereof, will be more I�an thlrry-slz (38) feet high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Caftkmta AtlMNstretNe Code).
❑ As owner-builder, I will nat employ enyone lo do work which would require e permit from the Divlslon ot InGustAel Setery, es nated ebove, unless such person has e
permit to do such work tmm the CMsion.
Signeture:
Divlslon ot IrMus�Ael Safery Permit Number:
Date:
COOE �. INSPECTION TYPE
1616 Flxetl System Flnal Fire Preventlon
1268 Pool Spe Finel
200 Final R�Roof
201 FInaI8locWReteininp Well
202 Finel Fedary Fire Plece
203 Final Sipn
204 Finel Domolitlon
20<8-18
�� ��
COOE I INSPE�ON ME
206 Final Mechanicel
208 Final Plumbinq
210 Final Elecldcal
212 Flnal Flre Prevention
220 Final Planning Approvel
222 Final Site
250 Final Builtling�Occupency
PAff INRfIALg
!�P' �-�{Q l.s��,7_
(714) 754-5273 • Fax (714) �54-0856
Job Address:
Suite No
Vicinity:
555 ANTON BL
5
Parcel Nunmber: 41050110
ApplitanY.
Address:
Ownar:
Address
GILLMORE, DION
SAKIOKA FARMS
CITY OF COSTA MESA �,
Bl/ILDIN6 DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Contraaor: GTO COMMUNICATIONS
Address: 1582 N BATAVIA
#2
ORANGE,CA
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Poot / Spa
Lighting Fizts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over t00hp
Communication drops
Sub panel to 200a
Pole Lighl Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ELECTRICAL PERMIT
Phone:
Zip:
Phone:
Zip: 94137
Phone: p14)921-4200
Zip: 92867
License: 473383
SCOPE OF PERMIT
147 COMMUNICATION DROPS FOR COMPLETE STH FLOOR TI. 899-00384.
522.00
50.00
50.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
50.00
50.00
50.00
ao.00
$0.00
$0.00
$102.55
$0.00
$0.00
ao.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
147
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Sedion
Misc Eledrical Equipmenl
Trensfortners up to 1 kvalkw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kvalkw
..................over 100 kvalkw
Low Voltage Equipment
Low VOII Wiring System I Ckt
Misa Conduil
Misc. Conduc[or
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Eiectriwl Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
PERMIT NUMBER
�9-00420
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: OS/18/1999
Issued: OS/18/1999
ISSUED BY:
QuanUty
$0.00 0
$0.00 0
80.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.ao 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E124.55
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with ell epplicable handicap eccess requirements under Calitomia statutes and ralated
regulations. (Ord. No. 92-28, § 1, 12-21•92)
EXPIRATION: This permit shall aulomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abendoned
for e perlod of 780 days.
INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must compty with ell applicable codes, and all
required Inepeetlone end finel epproval must ba obteined. Failure to obtain inspections and final epproval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628
1
WORKERS'COMpENSATION DECLARATON: -
I hereby etfirtn under penalry of per�ury one ot the Idlaxing dedarations:
❑ I have erM will meinteln e ceNlkete af consem ro self•Insure fw wakers' canpensallon, es D�o�ded tor by sectlon 3700 oi the Lebor Code, fot Ne peAormance ot Ne
work far whiCh this pertnit i9 issuetl.
❑ 1 have end wi0 malnteln wwkers' mnpe�satbn Inwrarce� es require0 M sectbn 3700 of t�e Lebor Code� tor tlie DeAoimanca of Ne work for whidi Ws PertNt b issued.
My wy[kers'�Q mpensaGorr�p,surflnca cerrler iq number ere:
Cerrier. LTo � U cN .� �L <- . Policy Number:
(Thls sectian neep not De complete0ll Me pertnlf I5 veluetl et one hunOred tld/ers ($100) or less.)
❑ I certify lhat in (ha pertormance ol Ne work lor whiU this pertnil is IssueQ I shell not emplq eny person in eny manner so es to betome subJect to Ne workers'
compensetiqn lews ol Calilomla, entl epre Ihet it I should become su��ect to ihe workers' compensation proNslons at Sedian 3700 of Ihe Lebor Cotle, I ahell torthwith
compty with the o sions. C/
Applicant SignaNre: 1.✓�� Dete: �/ D— ��
WARNINO: FNLURE TO SEWRE WORKERS' W�.�FENSATION COVEMOE IS UNUWFUL ANO SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENFLTIE$ AND CML FlNES UP TO ONE HUNDRED
TKK15AN0 DOLLARE (E100,000). IN AODRION TO THE COST OF CQMPENSAT�ON. DAANGES AS PfqVIDEO FOR IN SECfION 3%OB OF THE LFBOR CODE, INfEREST, AND ATTORNEYS FEES.
LICENSED CONTqpCTORS DECLARATION;
I hereby eNirm the� I em Ilcens d under Qrovislon Chepter 8(commencing with Sectlon 7000) ot Divlslon 3 oi the Business entl Professions Code, end my Iicense Is In full
lorce end ettect. Llc. a _� % 1.3 �� Class a G' 7
Conirectols SIgn9Nre: �'n^' Date: �� � Fi' %
CONS7RUCTION LENDINO AGENCY:
❑ I here6y aHirm �het Ihere is e conslruction lending egency lar Ihe pertormence of the work for which this permit is Issued. (Sec. 3097, Civll Cotle).
Lenders Neme: lenders Address:
Signature: Date:
OWNER-BUILDEp DECLARATONS:
I hereby affirtn th4t under penalry o1 per�ury ihat I em E%EMPT FROM THE CONTFiACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Profeulons
Code: My dty or opunry which requlres e pefmit to cansiruc6 fllter, Improve, demdlsh, or repair any sirucW re, prior to Its issuance, elso requires ihe epplicant tor such permit
to file e signetl statement thet he or she is IicenseC pursuant [o Ihe prwisions of the Con7rectore License Lew (Chepter 8(commendng wit� Section 7000) of DMslon 3 of Ue
Business erM Protessions Cotle) or Nat he w slie Is exempt Neretran eiM Ne basls tor Ne alleged eaemptlon. My vlolallon of Section 7037.5 by eny epplicent for e permit
sub�ecls the epplipgnt to e civil penalry of not more ihen Me hundrad dollers (E500).):
❑ I, as owner oi ihe propeM. or my employees wIU wages es iheir sde compense0on, WILL DO THE WORK, ernl the struc[ure Is nm intentled or ottered for sele (Sec.
7044, Busin� end Professlons Code: The Contrectors License Lew does not epply to en owner of properry who bullds or improves thereon, entl who tloes auch work
himself or hprself or Ihrough hls or her own em0loyees, provided Uai such improvamen4s are not intended or oXered tor sale. If, however, the builAing or imprwement is
sold wit�in qne year o1 campleLon, Ihe owner-builder will have Ne 6urden of proving lhet he or she tlld not builtl or improve lor purpose ot sele.).
❑ I, as owner of the property. em EICCLUSIVELY CONiAACTING WR/I LICENSED CONTAACTORS to conswcl Ihe project (Sec. 70a4, Business and Protessions
Code: The eontrectors License Law tloes not eppty ta en awner ot properry who builds or Imprwes thereon, end who conireClS for such pro�ect vrith e contractor(s)
license pursuant lo lhe Contraclors Lice05e Lews.).
❑ I am exempl under sec. Business and Professions Code lar this reazon:
SignaNre: Dete:
bwner ID verifietl Dy tlrivefs license. ❑ Ves ❑ No Drivefs License No. Ezplres:
Verilicatlan oi Ownership by (type at document, I.6. - p�operty tex bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: �
❑ I hareby ceRity that no excevatlrn iNe (5) or rtwre feet In tlepth Into whlch e person is repuire0 to descend, wlll De matle In connectlon wiN work euthorizetl bj this
permit, en0 �hei no bullCing structure, sceHoltling, felsework, or tlemolitlon or tlismantling Ihereof, will 6e more then thlrty-slx (38) feet hig�. (C�flp. 32, Grp 2, Art 2, Sec.
341, Title e, Cellfomia Administretive Catle).
❑ As owner-bWltler, I wlll not employ enyone to Go work wh�ch would requlre e permi� trom the Divlsion ot Indusirlel Satery, es notetl ebove, unless such person hes e
permit to do suc� work iran t�e dlNslon.
SlgnaNre: Dete:
Dlvlsion at InOuslHal Selery Permil Number:
CERTIFlCATE OR COMPLIANCE AND AUTMORQATON OF EMAY: I Certily untler penally of perjury tha� ! have read Ihls application and state that ihe Intwmaiion given Is
cortect. I egree lo campty wIN all stete laws and dry ordlnances relaUng to Dullding constructlon, end euthorize representetNes ot Ihe Ciry of Costa Mesa to enter upon Ne
ebove-tlescdbed property tor InspecUon purposes. I agree not to oaupy or ellow occupency at eny building euthodzad by Ihis pertni� unUl final InspeMion.
�/ pnature OI Legal Owner(s) S— I�1e 7/
� � MNOr Authorized Appllcant Date
COpE �, INSVECTIONME Qd¢, �64
1818 Fised System Finel Fire Prevemlon
1268
200
201
202
203
Pool Spa Finel
Flnel Fe-Roof
Flnal BIppWRetelning Well
Final Fecrory Fire Plece
Flnel S10�
204 Finel Damolltlon
z.u8-as
COOEt INSPECTIONTYPE
208 Finel Mechenical
208 Finel Plumbing
210 Finel ElectAcal
212 Finel Fire Preventlon
220 Finel Planning Approval
222 Finel Site
250 Final Building/Occupency
Ciry of Coz[a Mesa
Developmmt Services Department
Building Safety Oivision
P.O.eox 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No.
l'he Building located at 555 AlltOil Blvd. UTilt �500 �
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B-2 Occupancy. .� , . .
Use of Building office
Legal Description 410-501-04
Building Permi[ No 556537
M56636
Mechanical Permit No.
ISSUED TO:
Security Pacific BanR
600 wisnire alva. a�
Los Angeles, CA 90017
(See reverse side for Meres and Boundsl
lectrical Permit No. E56554 Plumbing Permit No. P56616
Number of apartments and/or guest rooms
Building Official Tony C' De Baca
by _ r" ! ` > ; . .
Date ApLll 19, lyyL
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. 1/63 White -Owner, Canary - Numerical File: Pink - Bldg. Permit File
�
City of Costa Mesa
Development ServiceS Deperiment
Building Safeiy Division
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No.00317�
The Building located at 555 Anton eoulevard,. Suite 500
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
fora Group B2 _ Occupaniy. � 4'.
Use of Building Off10E '
Legal Description 410-501-04
(See reverse side for Metes and Bounds)
Building Permit No B 46695 Electrical Permit No. E 4671] Plumbing Permit No.
Mecpanical Permit No. Number of apartments and/or guest rooms
Fii� Prevention Pecmit No. P 46517
ISSUED TO: Building Official m,n� ��n> uana
Sec�it�itv Pacific National � � ��
555 Anton Blvd.,, Ste. 500 by /�,o� .�,.. — •
Costa Mesa. CA 92626 •-
� Date Jtute 6, ]990
, 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 Cona Mesa under Sec. 307 (e) U.B.C.
CMF 3015-46 rev. 1/83 White - Owner; Canary � Numerical File; Pink - Bldg. Permit File
r
I�
��I
City Of Costa Mesa
Development Services Department
. Buildin9 Safety Division
P.O.Box 1200
Costa Mesa, Cafifornia
CERTIFICATE OF OCCUPANCY No. gQ��,��j�
The Building located at 555 Anton Houlevard, Suite 500
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group BZ Occupancy.
Use of Building �ffice
Legal Description 410-501-04
� ISee reuerse side for Metes and Bounds)
Build_ing Permit No B 46695 Electrical Permit No. E 46711 Plumbing Permit No.
Mechanical permit No. Number of apartments and/or guest rooms
�'ire Prevention Permit No. F 46517
ISSUED T0: BuildingOfficial '�,�s. r�no a�.-=
Securitv Pacific National ; /
555 Antqn Blvd., Ste. 500 by �� i'-- — �
Costa [9asa, CA 92626
Date June 6. 1930
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 Cona Mesa under Sec. 307 (e) U.B.C.
CMF lols-4E rev. 1/83 White - Ownv ��nary - Numerical File; Pink - Bldg. Permit File
�,
Ciry of Costa Mesa
Development Services department C E R T I F I C A T E O F O C C U P A N C Y No.
Building Safety Division
P. O. Box 1200
Costa Mesa, California
The Building locared at 555 AN7'f1N ROIfl.F.VARD. STH FLOOR
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group A� Occupancy.
U5¢ of Building 117.'F7(;F
Legal Description 41f1—S(11—(14
(See reverse side for Meres and Bountlsl
Building Permit No. R co��a Electrical Permit No. Plumbing Permit No
Mechanicat Permit No. Number of apartments and/or guest rooms
iSSUEDTO: BuildingOfficial Tonv C'De Baca
BANK OF AMERICA
/ %O
555 ANTON BLVD. by.' l, _i !�'//.—_ �
COSTA F1ESA. CA 92626 � �
Date November 11. 1993
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 3015-46 rev. 1/83 Nlhite � Owner: Canary � Numerical File; Pink - Bldg. Permit File
'S
�f'..
City of Costa Mesa
-Development Services Department
Building Safety Division
P.O.Box 1200
Costa Meu, California
The Building located
CERTIFICATE OF OCCUPANCY No. ����j�
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances
for a Group R� � Occupancy.
�
Use of Buildin
icabie thereto
Legal Description Q10--501--04
(See reverse side for Metes and Bounds) �
Building Permit No R aA�RS � Electrical Permit No. E 38524 Plumbing Permit N
Mechanical Permit No. [a 38437 Numbcr ot apartments and/or guest rooms
Eico Prevention Permit No. E38255,, F37692
ISSUEDTO: BuildingOfficial GooCqe Ecl.ri�tOn _
Securitv Pacific Bank /
555 Anton eoulevard,. Ste. 500 by i,.. � -�',., � �
Costa Mesa, CA 92626 � �
' �ate October 18, 1989 ,
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NQ"i BE removed except by the
Building Official of the City of Costa Meu under Sec. 307 (e) U.B.C. . . � ,
CMF l015-46 rev. 1/83 White - Owner, Canary - Numerical File; Pink - Bldg. Perm�t File .
(714) 754-5273 • Fax (714) 754d856
Job Address:
Suite No
Vicinity:
555 ANTON BL
5
STH FLOOR
Parcel Number: 410501'10
Applicant: RODRIGUEZ, LOU
Address:
Owner. SAKIOKA FARMS
Address: ; �
CITY OF COSTA MESA
BUILpIN6 p1VISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�
77 FAIR DRIVE, COSTA MESA, CA 92626 .
MECHANICAL PERMIT
ISSUED BY:
Contractor: AIR CONDITIONING CO., INC
Address: 6265 SAN FERNANDO RD
ArehlEng:
Address:
GLENDALE GA
Phone:
Zip:
Phone:
Zip: 94137
Phone: 818-244E571
Zip: 91201
License: 120696
Phone:
Zip:
License:
SCOPE OF PERMIT
6 VAV BOXES, 12 FIRE DAMPERS 8 10 HEAT PUMPS < t00K BTU. 899-00384.
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
Repair I Alt Cooling/Heat
Inst I Rep. Recess Wall Htr
Refrig Sys <700 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace .
Hood wlMech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers �
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > 10000cfin
Floor Furnace
Floor or Suspend Healer
$22.00
$0.00
$0.00
$0.00
$0.00
$132.50
so.00
$0.00
$0.00
$0.00
$57.00
$0.00
$0.00
$78.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
10
0
0
0
0
6
0
0
12
0
0
0
0
0
0
� FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Venlillation System
Evaporalive Cooler
Commercia l Incinerator
Domestic Incinerator
Compressors / Absorplion Svslems
Up to 3 hp I 100 k BTU
3 To 15 hp / 500 k 8TU
15 To 30 hp I 1,000 k BTU
30 To 50 hp I 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Upto3hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Olher Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CA�CULATED FEES
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 04121/1999
Issued: 04121/1999
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
E289.50
NOTICE: The work authorized by this permit shall comply with all epplicable handicap access requlrements under Califomia stalutes and related
regulations. (Ord. No. 92-28, § i, i2-zi-sz)
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.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetlona and final approvel must he obtained. Faiiure to obtain inspections and final approval will result in ihe expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754'S628
WORKERS' COMPENSArON DECI.ARAnON: � .
I hereby affirtn under penetty of per�ury one at the foNowing Aec(aretlons: � "
❑ I have antl will maintein e cerlificete ot cansent to seH-Insure for workere' compensetion, as provided tor by sectlan 3700 of t�e Le6or Cotle, for Ihe peAortnence of the
work far which this pertnit Is Issued. -
� 1 have and will maintain wwkers' cpnpenseUon insurance. as required by section 3700 01 Ihe Lebor Cotle. tor tl1a peAormance of Ne work for wlild� U�Is pertnit Is iswetl.
My workers' compensatlon Insurance cartier and policy number ere:
(Th/sasecNo�eed not�b �m�etl i! fhe permit /s velued af one hundred dollers ($100J or /ess.) p�� Number: �� �� ���
❑ I certify Ihat in the peAormenca oi the work for which this permit is I55ueQ I s�ell not employ any person In eny menner so es to hecome sub�ect ta the workars'
compensetion laws af ornis, entl egrae �ha� If I shauld bacome subjecl ta ihe workere' compensetion provislans of Sectlon 3700 at the Le6or Code, I shell torthwlth
comptywiththe rovisions.
Applicant SlgnaNre: �-� Dete: +�
WARNING: FAILURE T SECURE�V� /MKER$' COMPENSATIpN COVERAGE IS UN UL AND SHALL SU6IECT AN EMttOYEP TO CRIMINAL PEWILTIE GVIL FlNES UP TO ONE HUN�RED
THOU$ANDDOLLAHE( ,OW);TNADDfTIONTOTHE�STOF�.IPEN$ATIO� GESASPfiOVIDEDFORINSECfIIXJ3N80FTHElABORCO�E,INTEREST,ANDATTORNEY'SFEES.
LICENSED CONTAACTORS DECLARA710N:
I here�y aRirm that I em licensed untler provisions of Chapter 9(commencirg wtth Sectbn 7000) ot Division 3 of the Buslness end Protessions Code, antl my ficense Is in full
lorce end eflect. Lia p Class p L�^..�..p
ContrectoYs Signature: Dete: ��,�/��. .
o�
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm that Ihere Is a construction lentling egency for tha pertortnence of ihe work tor which this pertnit Is iuuetl. (Sac. 3097, Civil Code).
LendBYs Neme:
Signature: _
OWNER-BUILDEH DECLARATIONS:
Lender's Address:
Date:
I her4hy atllrtn that under penelry of perjury ��e� I am EXEMPT FROM THE CONTHACTORS LICENSE LAW for t�e tollowing reason (Sec. �031.5, Business end Professions
Code; Any ciry or counry which repuires e pertnit ro consWcC alter, improve, demWish, or repair any strudure, pnor to Its luuence, also requlres the epplicant br such pertnit
lo tile e signetl sfetement that he or she is Iicensetl pursuent to the proNsions of the Cantractors Llcense Lew (Chepfer 9(commencing with Sedion 7000) W DlWsion 3 of the
Business antl Professions Cade) or Net he or she is exempt �heretrom antl Ihe besis tor the allegetl exemption. Any violetion of SecUon 7031.5 by any appllcent tor e pertnit
suDJecis the appliwnt to e civll penelry of not more than tNe hundred tlollers (5500)J:
❑ I, es owner of ihe D�operry, or my employees with wages es their sole compensatlon, WILL DO 7TIE WORK, end ihe structure is not intentletl or otferetl for sale (Sec.
7044, Business and Protessions Cotle: The Conirectars License Lew tloes not epply to en owner of properry who builAs or improves thereon, and who does such work
�Imsalf or hersalf or through hIs or her own employees, proNdetl that such impmvements ere not inientletl or ottered for sale. If, hov+ever, the hulltling or impmvement is
sold within ona year of completlon, the owner-Gullder will have ihe burden of proving thet he or she did not hulltl or Improve for purpase ot sele.).
❑ I, as owner ot the properry, em E%CLUSIVELV CONTRACTING WITM LICENSED CON7RAC70R5 to construct the pro�ect (Sec. 7044, Business antl Protesslons
Cotle: The comrectors License Lew tloes nol appty to en owner of propeny who bulltls or improves thereon, entl who contrects Por such proJect with e coNrector(s)
Ilcense pursuant to Ihe ConireCtoro License Lews.).
❑ I ain ezempt untler sec. Business end Professlons Code for this reason:
Signgture: Date:
Own�r ID verified hy tlnvels license. ❑ Ves ❑ No Drivers License No. Eapires:
Verifi��ion of Ownership by (type ot tlocumenL i.e. - property tax bill or tleed):
DIVI$ION OF INDUS7RIAL SAFETY PERMIT CERTFICA710N:
❑ 1 herehy certity that no excevatlon five (5) or more feet in tlepih into which a person Is requlretl to tlescentl, will be me0e In conneqlon with work aufhorizetl hy this
pertnit, antl that no Duiltling slNdure, scaHoltling, falsework, or tlemolitlon or dismantling thereof, wlll be more Ihen t�irty-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tl�la e, Califomie Administrative Cotle).
❑ As awner-builtler, I will not employ anyone to do work which would require e permit from ihe Divlsion ot Indusirial Safety, es noted ebove, unless such pereon has a
permit to do such work irom tha division.
Signeture: Date:
DINs1on of Indusirial Safery Permit Number:
CERTIFlCATE OF COMPIJANCE AND AllTHORIZATON OF EHTSiV: I cartify untler penalry of perjury that I have reatl this appllcation and state Ihat the information given is
corrqct. 1 egree to comply wit� all stete lews and ciry ordinances ralating to bullding consiructlon, end euthodze representallves oi the Ciry oi Coste Mesa to enter upon the
above-aescribetl property tor Inspection purposes. I agree not to accupy or ellow occupancy ot any Dullding authorized by ihis pertnit until finfll InsDection.
Se4DE1, WSPECTIONTYVE
161fl FI¢ed System Finel Fire Preventlon
1268 Pool Spa Final
200 Final Re-RooF
201 FInaI Block/Reta7ning Well
202 Flnal Fectory Fira Place
203 Flnal Slgn
204 Finel.Demdition
2u&�e
17.ri�
�
�Cf1iiI.1Fj
�'+ ��� �
D6(e �
FODEt INSGECTIONTYVE
206 Final Mechenical
20B Final Plumbing
210 Final Electricel
2/2 Finel Flre PrevenNan
220 Final Planning Approval
222 Finel Site
250. Final Building�Occupancy
�. i. .un..
• �Q L 1
�oonessa em�qno: S S S ANTON B L
°w"Eas"""E"'°'°�"": SAKIOKA FARMS
�^�54 PO BOX 2097
TERMINAL ANNEX
wri. �wuw �no�ss
uxT: 5 TH
ui5xrtecion�ran�nn: INTERIOR DESIGN 213623218k"�- 9378
�NtlLOPFNO:SNDXES: SSO S HOPE ST �N* 1100
L.A. CA 90071
�`�wNm�crarsw� MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
CpPN1CTOR5WJWq 610 REYES ST
woxcss WALNUT CA ucr+o.: 230813
91789 uwt:
110EN5E0 CONfN�CTONS OECL�flAT10N: I hweby ellim udx perely d pemuy tlet I em fcensaE uMx pewisoiu W Chepls 9
(oommaevin0 xilh Seeiwn )0001 M Oivebn 3 d Ihe B�riiww end PMeauona COEe. erd mY 4eeme o in Iu01an erd Marl.
cmuc.No.:00��6558 �°01A44 C 10 uc.No.: 2308 3 EXP: 12./96
D+m: / //l '— � Camaqa:
� 1WNER BUILDEF DEClAP�710N: I hpaby etfirtn uMx pnuly d perj�ry thm I eiam han �he Camreqaa Licenas lew /a the
�loxiip reeson (�ion )0��.5 8uenne eM Prdeaeione Cotle: Rrry c�Y a coun �Mitli puiree e pa�mu Io owutrucl. ellx. improva.
amd'o�, or repai eny sliucturo, pia lo ea'vwenoe, e6o repuiree the eppliwil f auch e �o fib e sqrod eWement ihel M a eM
' icanaed pum�ent io IM prwivians d iha Contrmon life�ee lew ICheqm (wmm ' xnh Seqion ]000) d D'viion J d tb
Bwirou ard AWeabm Codal a �Iw he a ahe b uemq iherelmm vM IM ' b eAepeE exemqion. My vidmon af Setlion
)031.5 by erry epplieeni la e permX aEjetle iM epplirem to e wil penaAy d nd hen (xa huMred EoOan �L500�.
� I. ee owror d �ha propeny or my mmployw �h wapea u �Mi eds mmpenea�bn, will do �M xwk, eM IM eVudun e ml inlendeE
w dtereE la mle (Seciion )00�. Buaimu enA Protestione Cods: The Comreaae Liuroa LewEoea iat epplyto an ownard piopany
wlw Wiaa a inprorm iheieon, aM Nn don euM xwk NmmX «Mnetl a Ihraph hb a Mr own emplvreee, prmidetl ihel wc�
impwemema era nal intended a Wxed trc eeb. tl, howawr, �M buitli'p a inpv.aneN u eold wnhin aw yaer al wmpblion, Ns
o..�er�w�a« �;n naw me w�d«� a wa+�o ne « ene eu na a,�a n�mwa* �� �ne w�vae a sd.l.
� I. as oxrrr d tM pmpeM. � exduervdy mniredin0 �h IicaneeE convacton to wn9rud tM v�9�11��^^ ��. &+siiwea erd
Proleeeione Codo: T�e Coniredon ikmu lew doee � epply to en owner d peopa�y x1w buiNa w imqovea iheroon vM vAw
convecb la wch prqem v.i�h e ooniredor(e) Icenaed punuenl �o iM Contrecton lioense Law�.
� I em axemp uMer Seciion: 8. 8 P.C., br Ihie �eesan:
De�a: O.mer:
I do �ere4y cenily thm I em ewere d enE undeniuM IAa �puiremenie d Celfanie Heellh aM Safety Catle Sed'wne 25505. ?55�3. eM
25531, eM Il�et I w eny Mura Wikiiq ampen� will / w11 rwl (crcb me) neeE io campy wYh eek uate mdae erd the repuiramann lor
ePormnlamuuuclionamoEifimionhwniMAi u�a�yememDixrid.ReudmtilmrW�uquneppkatiomenssamWimnihws
ymridms.
Deie: Aoolicent
WOflKEP'S COYPFMS�TION DECLAPATION: I Mreby elfiim under peratly d pa�uiy aw d tM IODox'vp dadarmiuv:
❑ IheveendWmeimen.cenRktl.am�eentioutli�uurshxv.wken'�ompenWian.nwwidediaMSwian3)OOatMLaEa
COEe.Ia �he psrlmmanca d IM r.wk la which Nn permi� u inued.
i'] i nm,. �e w�e �m� won�n o�o��v� ��.�,.�, � Aa��.ee nr s«a� o�ao a in. �mo� coea. i« me wno�m�. a m.
work lor whiN iAu pe�mn u iuued. My worFen' compenaelion inwraMs uiirier ud pdiry number era:
c�«: FIREM� FUND EXPIRES
� cwryN�w: nwrA�i � �§'� 07/O1/96
(Thk eecfun need rrof bs campbMC / IM pnnt u M aro huMred dd/era �f100J w Im.)
❑ I eenH � in Ne pMamviea d ihe wM M whkh Ihn p�mn b iaund. 1 Mell na empby erry peeaon in vry marvror m o to
becmie wbjep to �M v.aNan' compmaelian lewe d CelEamie. ud ap�ss IM� J 1 elpuq bacome utlryeG�toVM xaNe�a'
cm�pe�m�ion �'aa G 91W d iM Lebar CoM. I 4u0 1l�vilh oomW weh �e p�weime. �
Date: �� �Cl ��� ACdraN:
Wam/ip: F�llun b��cun workw.' co�vwu�tlon cov�rp� l� unNwNl, �M • I iu6/Ic en emplqw b MMnsl pn�Mu uM
nH� nnu w ro om nurn.M rnouune edrn lsioo.aaoA m.emaon ro m� � o� m.n..rron e.�.w. u pcvm.e ror in
Sxtlon JM6 0/ 1M Lebor Ca6, InnnsL ���mry's l�u.
CONSTHIICTION LENDINO RQENCY: I hwoby elfirtn uMm peneXy d parju u e mMiudian bnE'vp epen�.y br tlro
�rrom�enm a me ..on� iw .n�cn �nu am�� o ue�.e Isaao� aoe�, cr�. cl.
, LENOEN'SNUIE:
LENDEN'S MOflE44:
I cenily thm I hm roeE �hia eppficeiim enE tlate ihtl iM eGova iName�ion e cwrM. I epree to wmpy wilh ell rny enE ooumyadinence�
eM etele Iews �ela�iq Io W ildvq ronelrupion enE he�eEy eNMrixe npaeantelrvee d Ihia tilyto en�x upon ihe ebove-manluned prope�ly
forinspeuion Wrpoeee.
C�iARLES JACOBI
�5151i6.WP)
Dme: / / d / �
8 Sefety; Oroen-File; Cenery-�ppiceM; Pink-Revenue: 0oken�a�Aceemw
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 076U13
PERMIT NO: E 076013 PLAN CHECK NO; N GOVT: N SUPP: Y
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE; ALT
JOH DESCRIPTION : INTERIOR 20000SF OFFZCE T,I. S(j FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS REF: B-74570 / SUP E-74579
�rx��r�rx�*+r*��***x x ***�rx x�x�*+r�r+r*�r�t+rx��r��r*�rx�x�x�x�******w�r*��r�r�r�rx **�r*�r*�r�r+�x�+r*x�«����+r*��r�x��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKZNG REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES� { _
I
x'�ri�*x*�r**x*�*x'x'i�'ie«'�r*r'�r'�'x'x'iai{i�'r�{iE*i�'i{x'u'r'�x'�r*i��i���r**�'**r**r*�'�r�r�r*x'*i{x*ieirx'*i{� x'*�i%�'i%
D E V E L O P M E N T S E A V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY •
HUILDING APPAOVED BY ; .
APPLICATION ISSUED BY: '' �
ik 1f ik 1@ if 1f i!'k 1E 1E iE i! 1E 1E 1E IE iE iE 1E 1E 1f 1E
LEGALIZATION:N F E�E S U M M A A Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 1950$
FIRE
DATE;
DATE:
DATE: �I
x� rt x� �t it * x� fE7I'IFiF:i'7�it *
STRUCTURAL SEGMENT:N
�ISF � 7/ :i �.�H;1.•L7 � �Id
SMIP/NON—RES
PLAN
ISSUE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 19.50 4.50 0.00 24.00 24.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHOAT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
if iE 1E ik if iklE 1E 1E 1E 1ElE IE 1f IE 1E 1E 1E fk 1f 1F 1k 1E 1k 1k 1F 1f 1E 1E 1E1k 1E 1E iF 1f 1E 1E 1E if iE 1E 1E 1f iE if 1E iF 1E 1E 1! k 1E iF 1E fF 1E 1E iE 1f 1k iE 1f 1E 1E 1f 1E 1E �F 1F 1E 1E 1E IE 1E 1(� Ik 1E 1E 1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15,00
ELE 10 RECEPT/OUTLET ADDITIONAL EA. .45 4.50
END OF FEES
�j��� �(q bS.'( ,!>'�613 YiE Y
.�('"��1 t!!",'v� �it;E: L9,,5
t Y , I:l�
CONSTRUC710N AND PLANNING -• P. ,& SPA
APPROVA�S Permit # Date Inspector APPROVALS Permit # Date. " i�spector
1. Temporary E�ectrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steol Reinforcement
�,. _ � .
�'j�ectrical:Co�d�Q3 Uality-Undrgmd. 54. Forms
��D�ectrical�o�d[I�-7�'1�lrgmd.M � 55. ElectricalBonding .
�r,,5'' eel Rein`,pYcemerq� ' � � 56. Rough Plumbing & Pressure Test �
_�uectrica�ll,�E�nd. 57. APPROVALTOCOVER�GUNITE
f`"'Y. f�botingst ,-•1 �� � 58. Electrical Con igUndrgmd.
��8. Foundatio?i'J �v�- y c' 59. GasPipe,O UrCtl�7nd.,Test
R
9. Water Pipe�Undtg�nd. � , 60. Backwash Line�r�Trap, O Undrgmd.
10. StructuraFFloof�System 67. APPROVAL TO �ECK
17. Property Sewer,�ne,Ff Hous��onnection 62. Backwash & Rc�eptor-Final
�2_ SQ'^ie� Caa W'-� --". - 63. Heater & Vent-Final
�n
13. Roof Droins �_, 64. Piumbing System - Final
14. Rough Plumb��9-� ;-; ' 65. Eiectriral-Final
15. Rouqh ElecvicabCor'duic 66. Solar Svstem-Fi�a1
16. Rough Elec[ric Nliring . � 67. Fencing & AccrSS Approval
. 17. Rough Wirirtg Sign �; 68. APPROVED F�"PLASTERING
`78. RoughEtec�ical"_.TBarCeiling 69. POOLfSPASYSTt3MSFlNAI
19. Rough Heatin & Air Conditio�ing ,� p�p E.n FPT_R EQUIp EMENT
rn J � . m rn. r '✓.' Q � k '`"�H�DF V. �i. [� L*I:Ti
20. �ou� F�y'tor�Fi�(�1ace ' 5�.�'_„ �^ y � �;.� r APP�V��-r�, Pormit #�Y�,7
21. DucCr, inStruE2urF7M .. .. -� * '"' O r+. ' ^ - �"^ c r
F ,y H `. �. ,.; 70. 'FC)ndergro�.�l Fkydro r
22. Quctt�, Vgijtil�in� u* � .�� * C ,� S ��"�, 71. Produ��'jPing � as I�OiI
23. Gas P+pe-Ro�9h & Test m +� ?� �t � ° � � 7p, Undergra�nd FLtS�h '' �-
..
24. Roo�Fra�ing.. ,oc � Fe- ..c_ r � ,�� .._ � Y � �, . - y �Y
z y: � c; r�x :7� Undergrt"i,d.Sto�ejeTank,;OGas Qbi
25. Roo heglhing S* S � �* �� -' ?:ar 7� Overhead Hydr i� x
� T '�'v
26. �BaF�Ceiling (Str�ral) & f�"o�x�'oat K�, y� '� .`�-.�'. 7s; Dry Che�ical E.,,� x^ � r;�
m
27. � artwand,F�ashing� �x� �a 76. DryStanB�ipe;G' ;_ � T��*%
^ 28. Lathin9 �'Siding `��' c^ '�` = `� � E .. ..x 7�; FIXED �T�INA�,- �� ��
t•� Of� G.r'.[-+ l7 h' ..' ' �
��29. Insu�6tion- Cl� � S � r_ ir 7� FIRE PREV. FII�L T= � ��'
�30. Drywatl �iling t,�* H * �,,, j ` `'�t-1EALTk7L�EP'�.�FiE�U1R:F��ENT
37. Plaster Bmwrcfwa�� S m-� # ' �t c• 7g;� FINAL I�SDECTIDId � v • .
� �.
;32. �]ectricaF�'ower hil2t�r��al ; � !, �' � � `� 8d_: F000 CERTIP�AI'E I��UEQ..,
,� fi ,� / �
33. �jna�Eleetric� � �i^ � � �+'�.Z/ '' � N6tes: `? `_t^ � "" �� z
:•�34. F4nai�fieai�ng;&AR-�onditionings f� � � �: . �" ''L •S :�= x _. a:`7
� I-a [.+ J �11.� (*7 lT; Y � r' , -+UO tV i F�-* v -�r
35. Finaf�iai.P,ipe: es * � .. � ' " , � " .� -
* N j � .,xc C7r. x rar-iR-
- .; . e � �.c.
= 36. Hoo�or GtnoP4 -'* �`, i �� c r ^ I � ^ !"?c 'r. �t+'
-� i X � iTl x 7 '1' m, .r. Cl !*:
� 1T FI r V r . . , �-�
--37. Eina�.Fac ory Firepjate -. i � :v :r � � p. � 3- * vdN
-�
�38. Finaf Plumbing + " "� {'y! = '" r �` '
C' T., K,V Q % ,?: i H � -
�39. Waterr''Service-Fina,l � ' n. ^: � '.. ' "' . . - ..
w E i r c .l� 4• 1: �T�r ',f.�
�. T
,./i�
•.40. Gas Service-Final v� r•. C:rt-- ?!-: � � G� on� r. •• -
� c.. r� r .�� i-� o� M c, '
��-41. $olar pomest��•Firfal'� S `� " + `- r . =" __
i- M N • 'X iT+ ^; O Q° +. � ;�
42. Backflow Preventer * N �i: � t G 1e-� r G � _ .
r � �r � �.. « r > YI [�7 O 4 �- -
..i
^ f: u.
43. Backflow Irriga'�tion $ .,' `� ,r..� y ;' i � ` . . '_•.t�
Y
44. Landscape�lrr'iCatioraSystemi^7CJ �: �+�!� '- "' . r3 ;�. 'ZCJ K ' n'L
�-�^ r� . -� � m x C � � � O T ' -
45. b¢und F�ttenu2tion,' .�,��„•`„ '~ * .n Y �� = �' = i`. E..�, j^
Q6. Handicap RegulationK =-+ O * = r: S Oe S �
+ # 'r 'J
47. FINFtL STRUCTUR� & BUIL�ING * t., �; �t� `�' " c� , F
_,
48. EtNAL.PLANNING* ' E-= '� �� -.-i*'� ,� � � Y
49. E;[ecY�c Release to E�lison : . !�; ; ; r: . � }. ' _
�.
, . -
5fl. 6es Release to Southem CalifomirGasCo � ��' � ' • =�(' " � • �
� �� v '�c � on
51. CERTIFICA7E OF OCCUPANCY * • - � -'�
No. Date
PflOJECT AO�NESS: S S 7 AN i ON BIr
OWNEP'SNAME:BANK OF AMERICA
nooeess:20 N. RAYMOND AVE
PASADENA
CA 91105
uNir: STH
pfltHIENGINEEH:ROY HERBOLD flEG.NO.:C._� � n-73
noosess: uxir.
2522 AQUASANTA
PENMITTEE:TUSTIN CA 92653
aooxess:'�MSTRONG CONSTRUCTION ( 818 ) 967-8001
929 SPRING MEADOW DR
WEST COC�INA CA.91791
LICENSEO CONTflRC70P DEClAPA7lON: I nereby alfirm Ihat I am licensee unaer pronsions ol Cnapter 9(commenting witn Section
7 1 0� Divisfon 3 0l I�e Business ana Pmfessions CaAe, and my li nse is in lull lorce anU e��ecl.
iTr uc.: n i 6£ 7�Z� 1� $TpTE LIC.:4 3 d_ 0 4� -j�
Da�e: —1 � Signature: �i
WOflMEflS'COMPENSATIONOECIANATION: Ihere�yatlir hailhaveat¢Nlita�eO�ConSenilOsel' ur¢oracerliticaleOtWorker5'
Compensation Insurance, or a cenilie0 coOY ��ereot �Section 3800. Lab. C�.
� � hucrxo.:pWC2?0778-00 EXP.OATE:OlIOS�9�}
� �maaNv:GOLDEN EAG�
� J niliea cooY is hereby furnishea. Certilie� capy i vn�n city uilAinA Orvision.
Oate: � 2 3 ApDlican�: �� � —
E%EMPTIONFHOMWOBNEHS'COMPENSA710NOEqABATION. Qhissectionneeanotbecamplete� h rmi�islorone�untlre0�51Q0�orless).
I cetlily I�al in Ihe pedormance of I�e work for which Ihis permi� is issued, I shall not employ any person in any manner so as lo become
su�lecl lo Ihe Worker5' Compensalion laws ol Calibrnia.
Oaie: Signa�ure:
NOTICE: I1, after makfng Ihis declaration. you shoula become subject lo t�e WorkerS' Campensatian pmvisions al Ihe Labar
CoOe. you mUSt Iorihwiih Camply wilA SUCh pmNsions Or lhis permil S�ail De A¢emeA revOkeO.
CONSTflULTION LENOING AGENCY: I hereby atfirm ��a� Ihere is a constmction IenOing agency for t�e OeAormance o� IOe work tor
wAicA Ihis Oermii is issue0 (Setlion 3097. Civ. C�.
LENOEH:
FODNESS:
OWNEfl BUILOEfl OECLAflFTION: I hereby ailirm �hat I am exemp� imm Ihe Conirac�ors' S�ate Litense Law br �he �ollOwing reason
(Seclion 703t.5 Business and Pmfessional Code: Any city of county which reQuires a permil to consimct, alter, impmve. tlemolish, or
repair any slmc�ure, prior Io ils issuance. also re0uires the applican� �or such De�mi� lo lile a signetl Slalemeni Ihal helshe is licensetl
pursuam to the pwvisions of ihe Comranors' State License Law (ChaO�er 9(commencinp wiih Section 70W) oi Oivision 3 of Ihe Busineu
an0 Pm�essions Catle) ort�ai he/s�e is exemp� IAerelmm antl �he Gasis lor I�e alleAetl e�emption. My viola�ion of Seclion 703L5 by
any applicanl �ar a permit su�jecis lhe apDlitan� to a civil penalry o� noi more �han �ive huntlred Oollars (5500�.
�. as owner of ihe Dmpeny or my employees vnih wa0es as iheir sole compenution, vnll Oo t�e wark, anG t�e
❑ S�mtWre i5 no� intenJeA or o��er¢tl �or Sale (Sectian 70E4, BuSineu an0 PmIelSional CoOe: The COn(ra[�or5' Sla�e LiC¢nse Law
Goes nat apP% ta an owner af a pm0e�y who builtls or impmves I�ereon, an0 wAo Ooes such work hims¢IVhersell or I�wug�
. �is or �er own employees. provitle0 t�al such impmvemenis are not inlenEe4 or otlereA for sale. II, �awever Ihe building or
impmvement is so10 wilhin one year oi com0letion, ��e owner will �ave Ihe buraen o� D�oving he/s�e Ai0 no� Ouiltl or improve
�or Ihe Ourpase al sale�.
I, as owner ol the propeny, am exclusively coNracling with Iicensed conlractors lo consiNtt ihe orole�� (Seclion 7044, Business
❑ anG Pmiessions Cotle: ihe ConVaciws' S�a�e License Law tices nu� apply lo an avmei ol pmpetly w�o Euilas m improves ��ereon
and who cOnVat�s �or Suth D�ojetis wilh a tOnVattor�s�license DursUanl�o Ihe COnlraclor5' SiafE Lit¢n5e Law�.l am awdre
inai pmof ol t�eir Worker's ComDensation insurance shoultl Oe O�oviOetl to me.
� I am exemp� unCer Section: 8. 8 P. C.
lor t�is reasan:
Oaie: Ownei:
I Oo nere�y cenily Ihat I am aware ol and unEerstantl ihe requiremenis of Calilornia Heallh ana Safery Cade Sections 25505, 25533, an0
25534 anU Inai I or any �Wure building occupant will/will nol (circle one� need lo com0ly wiN said s�ate cotles antl ��e reQuirements �or a
permit �or cons�mction ar moetlicalion �mm ihe Air Ouabry Managemeni Di5Vic1. Fe5i0ential cons�mclion apDlicalions are e�emp� imm
I�¢SC pmvi5ion5.
�ale: FODlicanC.
I �ere�y cerlityiha� I�ave reatl��is applicaiion ana Siale
or^T�'ancesantl5�atelaw5rela�mgloDuildingconsimction�
�IpoQliy IOf - SOQCIi n ppfp05¢S.
i
Da�e: � Signature:
�river's License or Sonal Securiry x:
I agree to comply wit� all city and cawry
I�is cily Io enler upOn ��e ahOve�menlipne0
I6dba6 Wbite—Builtling', Green—Cotle EnlorcemenC Canary—Applican�; Pink—Revanue; Goltlenma—Assessor
CZTY OF COSTA MESA — BUILDING PERMIT P�RM NO: B 061875
PERMIT NO: H 061875 PLAN CHECR NO: 01125-93 A GOL�T: N SUPP; N
CONSTRUCTION TYPE; iFR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; COMMERCIAL T.I, (OFFICES) 5Q FT: 5,275
CLAZM VALUE: CALC—VALUE: 96,321,50 GROUP OCC: B-2 /
COMMENTS: GENERAL OPEN OFFICE SPACE / CONSOiZDATE SPACES 525 536 6 550,
+��*?�********�t**#icx��*�r*�+��*��e*+��t+�+r�r***�r�r�*�r�*x*�r����***�t*#*#+���r****�r�r#####��r#***
Z O N Z N G R E Q U i R E M E N T S
S E T H A C H S
`---------F— MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
:'RNT: .T _N REAR: FT IN FRNT: FT iN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKZNG RE�• PROV; PARCEL: 41050109 ZNE; PDC REF NO:
PLAIvNING N T'ES> TI i0 STH FLOOR OF EX. OFFICE BLDG.
1
iF iElE �f �ff it if iF if 1f fE if 9F 1f # iF-lf 1ElElE iE iE if if if 1f if �E'lE if if iE 1E iF iE iE 1E i! if # if !h iE �1F iE iE iF 1E ic if iF if !F iE# if # iF i! 1E if if X-iE :�E # iF iF it ## fE #### i!?E iE
D E V E L O P M E N T S E R V i C E S R E Q U I R E M E N T S
ZONING APPROVED BY S G��, ��. DATE; �
BUILDING APPROVED HY : Y�a-� DATE:
APPLICATION ISSUED BY: DATE• C�4�3'�
iE�lFiFiElEiEiEiEallEiEiFiEiliE%1E1filiEiEiE xx� ....... , �c �r1 xar�r trx t r iei �er r x�lfiEiE�kiEifiEifiE-1E�Fse iFx�e � x�lE?E
ifiEik3Eif�f�YiEi'tiE3eifiEi!�if�ikif��lfiFifif�ffflElff(-ifitiFltlEififiEiFiflfiflfilif E1EikiElEiEiE�1EiE�lEiEiE�iEiEiEiF�1FiE�7flEifiEiFfE1E###i(�#iEif3f�#fE3fif�iE
LEGALIZATiON:N F E E S LT M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTR _ MECHANIC FIRE SMIP/RES GRADING
PERMIT 626.00
SMIP/NON—RES
PLAN 102.73 20.23
ISSUE FEE
BUI�DZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ' PAID DtJE
TOTALS----> 646,23 0,00 101.73 797.96 797,96 .00
REVENUc DIVISION TOTALS--> COLLECTED: 646.23 OVER/SHORT: .00
BLDG PMT PLUMBZNG ELECTRIC M�CHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
626.00 20.23
iF 1k 3f if �F iE if iF'1F?f 3E if !f ik if if if 1f'IE if 1E if iF1i !F if 1F if if 1E 1E iElE iP iF iF iE 1E iF �lE #'lE iE 1E if iE iElE iE iE if'14 iE i4 # iE if 1E �)f if'1E iE'1f'1E if if ## 1f ik #### if # if !f 1f
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
SFC 5275 OFF—INT. ALTER TYPE I iI F.R. —AC�ER 17.24 90,991,00
SFC 5275 EQU—ALT COMM. SPRINKL�R SYS —AVER .33 1,740.75
SFC 5275 EQU—ALT COMM, AIR COND —AVER ,69 3,639.75
END OF FEES
EXPIRED
incwnplete !nspectia�
�� � �� � ��
D1 00137859-00137860 T O T 646.Y3
DATE� 04/23/93 TItIE: 14:32
\
<
CONSTRUCTION AND PLANNING • �
I APPROVALS Permit �7''r
t
� 1, Temporary Electrical Service oi Pole
2. Sod Pipe•Undrgmd. �
3. Eiccvical Conduit Urihty-Undrgrnd.
, 4. E!ec!ncci Cor.tlurt�Undrqrnd.
I 5. Stc:l R�in'o:cemenc
' U� Eiecuiea! UfER Grnd.
7. Footings
B. Foundation `
�J. �Vatcr P�pe�Undrgmd.
� 70. St�uctu�ai Fioor System %` '
11. Propc•.y S��vier L�ne & Ho�ce Connection
I 12. Se�ver Cap ,-
13. Root Drains
1� 4 qauqh Pwmh:ng ������
I 15 Rn�g�- Eectrical-COndwt
�---
?G. Rouqh Electric!"Jirinq
� 77. Rou9h �,�.nng Siyn
I
78. Rouyh E�ett�ical-T Bar Ceihnq
19. Rnuqh Hea[ing & Air Condiiionmg
70. R�-..7h Fectory Frep:ace
21. D�cU,ir Structure
�2 �utt,, VrntiiaLng
23. G.,s ��pe�Rough & Test
2h. Roo! Framing
Z5 Fcv` SFeaihing
� �E,, T�6.+� Ceil�ng IStruetu-all & .o^ocoat
27. F•<-rt� z �d Plash�ng ---
. ?�2$. Lsiivnq I4 Sld�g
u:at�on
�
! ��. D�v�•.all •yaihng -
� 31. ; •�stt�r Bro:.n Coat
r37. E':c:��c:.� Power :^eur�F�„al - --
�-
33. F����' Elcctric
� ,14. F�.�ci Nr,;Lng & Air Conditioning -
�5. Fm,.i G�,s Pipe�Test
�- -
� 3G. H^c.i m CanoPY
37 F�ra� factory Fireplace
38. rinal Plumbing
39. l'Vater Service�Fina�
GC. Gas Serroice-Final
41. Sa�ar �omesticFlnal
42. 9acicAow Preventer
�r3. Eadiflow Irngation
44. Landscape Irriqation System
45. Sound Attenuation
4S. Hand�wp Regulations
47. FINAL STRUCTURE & BUILDING
48. f-INAL PLANNING
49. Eleceric Release to Edison
50. Gas Release to Southern Califorms Gas
51. CERTIFICATE OF OCCUPANCY
Date
Date � I nspector
..'
iy
-.J' ✓
Pt, ._ & SPA
APPROVALS Permit ;�
52. � Pool & Equipment Locat�on
53..Stee1 Reinforcement
54. Forms
55. Elact��cal Bond�ng
56. Rau�h Piun,bing i5 Pressure Test
57 AP'ROVAL TO COVER�GU�VITE
58. Electrical Cpnduit�Undrgrnd.
59. Gas P�pe, � Undigrnd., Test
60. 3ac:cm•ash L�nes, P-Trap, r: Undrgrnd.
61. APPROVALTODECK -�
G2. Bac<riash & Recepror-P�nai
GS. Hcatcr & VenbFintl
64. Piumbing Syscem � F��al
65_ Etectrical-fi�al --�I
oG. So�Ut System�Finai �
i
67. Fenei�g & Acces, Anpro^ai
68. APPROVED FOR PLASTER�hG
G9. POOL/SPA SYSTEibiS F WAL
FIRE DEPT. REQUIREi�AEiV7
l�P2ROVA�_5 ?ermrt':
�
Daie �inspector
e
I � %D. Undzrg�o�nd H��dro � ,
71. P.uduct Plp;:�q' : G.�. . 7 Od �� .
72. Undcrground Flu,�� ' � ��'
----'--' =�-
73. Undergmd.5torau.: Tz�k '7 Gas = 0�' �I -
,I � 74 O�ert,ead Hyc�ro � �-
I -- --- � ,5. Ory l7�cmi.. -- -- -'--- - --�
i J-_ - �
�-- -- j 76. Dry Stz�-dp`ce � . '
--- '- ------- -- -
77. FIXEC SYSTE� : "r IP!AL ' _
�
78. FIRE PREV. F�hAi---- �--- I
�--- -
I I HEALTFIDEPT RLQUIRE'.1�c�:7
�4 _- __ -____ _ __'__'
ir�.. ���/ii_ I�SLE�.T �v t�
3G � OCU CERTIFIC'ATF '�SiLFD j I 1
- - / ---�---- -±
Noics: ��„� �/7^ I
-- -�--- �"--`--^---`--'-- �
� i;
Y
�
u
:�. �
Pfl0.1ECTA00XESS: SSS ANTON Bi,
OWNEP'SNAME:BANK OF AMERICA
RODPESS:'ZO N. RAYMOND AVE
PASADENA
CA 91105
uxir: 5 TH
ppCHIENGINEEH:ROY HERHOLD AEG.NO.:C_� � n-73
nooeess: z522 AQUASAI3TA uxrt:
TUSTIN CA 92653
'E"m'nEE:COMPETITiON ELECTRIC (818)331-5807
nooness: 635 STEPHORA
COVZNA CA 91729
LICENSEU CONTflpCTON OECLABATION: I tlere0y alfirm ��a� I am licensea unAer D�ovisions ol C�apter 9 �commencing wi�� Sectian
7000� o� �rvision 3 0l �ne Business and Pmiessions Cadec-an � license is in full lorce antl eltect.
�ry��c:056905 STRTELIC..jl fi8[]Z LLASS:C_�
�ate: �—�'3 � �3 � Signa�ure:
WOPNEBS' COMPENSRTION OECIAPAtION: 1 here affirm 1 t ve a cenilitate ol cansent lo seif-insure or a cenilitate of Woders'
Compensalion Insurance. or a cerlilieA copy Ihereol cii , Lab. C�.
� �oucvxo.:1085579 E%P.UATE:OL�OLI9Q
comenNr:STATE FUND
Cetli�iea tOpy is her¢by �umi5�e0- � Certilied c y i wM1h t�e ciry BuilCing Division.
G C
Wte: l �Zi � i3 . F�OIi�. � ��'.�
E%EMPTION iflOM WOflREflS' COMPENSRTION OELU ._� � sec�ion n¢ed nat Ue cample�e� il the perm� ¢ lor on¢ Aun4reU (5100) or less).
I tertity I�al in Ihe pedormante 0� Ihe wOrk lor whit� Ihis permil is issuetl. I Shall nol employ any perSon in any manner 5a a5 io betOme
subjec� Io I�e Woikers' Compensation Laws o� Calilomia.
Da�e: Signamre:
NO7ICE: II. after making ihis aecla�ation, you shoultl become su0ject to lhe worker5' ComDensation o�ovisions of ihe la6or
Cad¢. yau musi Iatlhvnih tomply vn�h 5uc� pmvi5i0n5 ar I�4 Oermil Shall Ee CeemeA revaked.
CONSTNUCTION LENOING PGENCY: I hereby affirm inat �nere is a conslmc�ion leneing agency lar ine pedormance ol tne wark lor
wnich i�is permi� is issued (Seclian 3097. Civ. C�.
LENOEP:
AOOflE55:
OWNEfl BUILDEB OECLABATION: I �ereUy aflirm Ihallam exempi hom I�e ConUa[�ars' Siate LicenSe Law lorlhe lollovnnp r¢ason
(Seclion 7031.5 Busine55 anA Prolessional Cotle: Any cily ol county which require5 a Dermit �a [ons�mcl, alter, impmve, 4emoliSA. o�
repair any simcWre, orior ta its issuance. also requires ihe avPlicant for sucn permil to file a signeA statement Ihat nelshe is licensetl
pursuam lo t�e pmvisions o� the Contracmrs' Slaie License Law �Chapter 9(commencinp with Section 7000� ol Division 7 of Ihe Business
ana Pmlessions Cotle) ar Inal nehhe Is exemo< <herefmm anA Ine hasis for Ihe allepea erem0��on. Any violatian ol Section 7031.5 oy
any applicanllor a permit subjecis ihe applicantto a civil penalty o� noi more I�an �ive AunUfeU tloltars (5500�.
I, as owner ol the provany or my employees wilh wages as ineir sole comDensation, wiil tlo ihe work, an0 the
❑ stmcWre is nol imenaetl or attereG lor sale (Secuon 704a. Business antl Pmlessional Cade: The Canlractors' State License Law
tloes na� apD�y to an owner of a propeny who Euiltls or improves Ihereon, and wAo does sucA work �imsell/�ersell or tAmugh
' his or her own emDloyees, pmuiaed Iha� such impmvemen�s are noi intentled or o�fere0 for 5ale. II, however ihe building or
im0�avement is SoIA wilhin one year ol compl¢�ion. I�e owner will �ave the Curtlen ol pmving he/s�e tliC nol GuiIE or impmve
lor �ne o�roose of salel.
I, as owner oi �he properly, am exclusively con�rac�ing witn licensea conlraclors to cons�mc� the pmlect (Seclion 70A4, Business
❑ and Pmlession5 CoOe: The Coniraclors' S�aie License Law does nol apply to an owner ol propehy wlw EuiIGS Or impmveSlhereon
antl w�o conlracl5 for suc� O�olec�5 vnih a conirador(s) li[¢nse pursuant lo Ihe ConVaclors' Slate �icense Law�. I am aware
that pmo� ot Iheir Worker'S Compensa�ion insurance s�ould be pmviaea to me.
� I am exemp� unaer Seclion: B. 8 P. C.
lor Inis reason:
Date: Owner.
100 hereby [etlify IM1aI l am aware of an0 uneers�anG Ihe reQuiremen�5 0l California Meal�h ana Sa�eiy Cotle SeCiionS 2550.5. 25533, ana
25534 antl Iha� I or any luture �uiltling occuDant will/will nol (circle one) neetl lo comply wi�h said slate codes ane I�e requiremenis fo� a
permii lor constmction or motlification �mm t�e Aii Oualily Managemen� Dislric�. Re5i0ential conslmdion apDlications are e�empt Imm
mese o�ovisions. �
oaie: nPvi�c�m,
I �ereCy ceriily�ha� I �ave reatl I�is aOPlicalion antl slate�Aa1 I�e abovein�armation is correcl. lagree lo comply wiih all city antl coun�y
orainancesantlslalelawsrelatinglobuilAinpconstmclio an Dyaut�arirerepresentativesall�iscit toen�erupont�eabove�mentioneE
papetly lor inspeclion purpases.
/ q �
Dale: Q'2'J'�3 Signal �e: ' �
�nvar's Licensa or Socim Securiiy p:
t6at�C6 W�ile—Boilaing; Green—Coae EnlorcemenL Canory—Applicam; Pmk—Revenue; GolOemotl—Assessor
CZTY OF CO5TA MESA — BUILDZNG PERN:IT P�RM NO: E 061876
PERMZT NO: E 061876 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTZON TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
SOB DESCRIPTION ; COMMERCIAL T.I. (OFFICES) SQ FT:
CLAZM VAi.,UE; CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: REF B 61875
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Z O N Z N G R E Q U I R E M E N T S
sEraAcxs
------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARRING RE • PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNZNG N ?'E5>
i
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D E V E L O P M E N T S E R�� I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BJILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: o Z
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LEGALIZATIOlV:N F E E S J M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRI� MECHANZC FIRE SPhZP/RES GRADING
PERMIT 59.�0
S 3 SMIP/NON—RES
PLAN
ISSUE FEE ';5.5 Oa
BUILDING—DIV—> PERMIT ISSUE PiA —CHECR TOTAL PAID DUE
TOTALS----> 59.60 15.00 �-��. 0.00 69.60 69.60 .00
REVENUE DIVSSION TOTALS--> COLLECTED: 69.60 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRiC MECHF)NIC FIRE SMIP/TOT GRADING PLAh—CHECit
69.60 �
ihlE �lE 3E if iE iE iElElE iE if Y� If iF # if'lElE iE �1f !E 1E iE #E iElF 1E if iE 1E if iE 1E if� if 1E iE iF iE iE # 1F iE 1flElE iElE 1(� ihlE�lE 7F it!! iE i! iE iF ?F iF if iElE iF if !f� # it fE if� 3E # i4 i! # iE?E
I N D I V I D U A,I,, F E E H R E A K D O W N
,/
TYPc QTY D E S C R Z P T I O,N UNST COST TOTAL COST
. , i
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15.00
ELE SO FIXTURES LZGHTZNG _ADDIiIONAL EA. .95 9.50
ELE ' 20 RECEPT/OfJTLET - Y• ST ,20 EA. ;75 15.00
ELE 28 RECEPT/OUTLET �.ADDiTIONAL EA. .'45 12.60
ELE � 10 RECEPT/SWITCH 1 ST 20 EA. ,75 7,50
. END Qi F1�.Ji Q 1 Fi E i�
..���5-�-----' �,o • ,,.
� ' � � / \ ,1 �.: '� ..
��{f �i��ii�i�w:� �`�fY� •��. . � .
C 3!!1 e x� "� 0013�853—OU137858 TOT b9.6D
�', : DATE� ON23/93 TItlE: 14:31
4'
l , . - -
CONSTRUCTION ANd Pl'ANNfNG -
APPROVALS Permif �;-
1. Temporary Elecv�cal Serv;ce or Pole
2. So�� Pipe-Undrgrnd.
3. E(ectricai Conduit Uulity•Undrgmd.
4. Electrica� Condwt•Undrgrnd. _
5. S:ee' Reinforcem.nt
6. Eiectncal UFER Grnd
7. Footings . �
8, Foundation '
9. lVater Pipe�Undrgmd.
10. Svuctural Floor System
71. Property Sc.•.er Line E� Houss Connectian
72. Sewer Cap
13. Roof Dia�ns
14 Rough P�umbilg
75. Rough Electrical-Condu�t
16. Rough Electric W�nng
17. flough t^.ilnng S�gn
1A. Rough Elecvical-T Bar Cell�ng
79. Rou�h Heat�ng & A�r Co�ditron�ng �
20. Ro�gh Facmry Firepface
21. Ducts,in Structure _
22. Ducts, Vent�lating _
23. Gas Rpe�Rou�h 8, Tesc
24. floof Framing
25. Roof Sheathing
26. T•Bar Ceihng �Struct��all 15 �doroco.�t
27. Frame and Flashing
28. Lathing & Sitliny
29. Insulation
30. D�y�vall Nailing __ _
31 . Plast r 6rown Cqat �
32. Elect,�wl Po���er Meter F�n„I __ _
33. Fin�l E�ettric
34. Fir.al Heatinq & Au ConLitipn.:�g
35. Fina� Gas Pice•Te;t �_
36. Nooil or Car.opy
37. Ff�at FsMory Fveplacs
3$. F�nai Plumbin9 -
38. R'ater Service�Final
40. Gas Service-Fina�
4i. Sola� DomesuoP�r.:.l
42. Backflov� Preventer
43. Backflow Irrigation
44. iandseape Irngatic� SYsterr.
45. Sound Attenuauon
46. Handlcap RegufaUons �
47. FINAL STRUCTURE �, BL'IIDIiJG
48. FINAL PLANNING _
48. Elevlric Re�ease to Edison
50. Gas Release to Southern California Gas Co
No. Date
Data
Inspector
P�...� & SPA
APPROVALS Permit $
52. Pool & Equ��ment Locat�on
53. Stee� Reinforcemrnt
54. Forms
55. Elect�ical8ondmg
56. Rough Plumhing & Pressure Test
57. APPROVAL "f0 COV[P GUn!�TE
58. Electncal Cor.durt�Undi;inr
59. Gas P�pe, O Undrnrntl., Tas:
60. 8ackwash (�:nes, P�Trap, O Und���nd
67. APPROVAL TO IJEGK
62. Backc;ssh& Rec�;-:c� `,..
63. Heater & VenbPinal
u4. Riumbing SYstem � F:cal
65. E!ectrical�F..^.al
66 Solar System�Fina!
67. Fendng & Access ApP�uv�l
68. APPROVEDFOR'LASfERIf,;G
69. PQOVSPASYS?EPASFtNAI
FIRE DEFT. RE�UIP,Etv�EfvT
APPROVALS 'arnul �-.
Date �lnspector
- � -
70. Undergrouna HyJ�o �
71. Product Plpinq u Gas �- Od �`
72. Und'�r r � � �-�
. q o•-�.. F�us^ �
I73. Urd�rgrnd. Smra^c Ta�k rJ G�s ='� G,: �
74 Ovonc�ad Hvc.ro _ I
F-
76. Dry Chemic,.i
�-- --� �
-- I
a
� .
76. Dry StandpiCe ',��, �
h �
77. FIXED SYSTE?.4 FINAL , �� �_'� 3,; ,
- r �::
7B. FIRE PREV. FI?:.�� _�
._-�- I
HEA�TH DEPT. REQUIREPAE��T .-
70. FINAL INSfECT10N- � ------� - � ,
e
30. FOOD ! EH'� �FICHi E ISSUEL- -��..�}- ---
Not�S: �l _�`Q3��a,_G�ea_` ���ar-`!�2 � '
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� - �itp o f �o�ta Z1� e�a �
� Development Services, Division of Building and Safety
CER'I�ICATE AF OCCUPANCY
This cerrificate is issued pursuant to the requirements of the Uniform Building Code, Section 308
adopted by the City of Costa Mesa ceriifies that at the rime of its issuance the buUding structure herein
below described was inspected and approved for occupancy as follows:
Building Address S�5 ANTON BL9D. FLOORS 1-12
Use OFFICES
Bldg. Pennit No.#gee belw
Group �-z Type oBConsnuction 1-FR Fire Zone Use Zone pDC
Owner of Building Sakioka Farms Tenant "►rN�c'et"
Address °
�B74S70, B75356, B74572, B745)1, Bi4573, 874633 i
b74632, fi74631, B74G30, j 006, B77S66, 574574 By �
�.�L�:�B"d��ffi����R
Date November I4, 1996
[tYGK BRO'.rtd, CL'0
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
�
Pfl01ECT AODflE53: S S J Ai4TOP1 � BI� � � uN�T: 50 U'=.
owxfe�sxeMe: SECURITY PACIFIC NATIONAL
nooeess:555 ANTO�I ,C,M.
9'S7-1489
ABCNIENGINEEB: It�]1�$jtTjj . NEG.NO.:C].�]QQZ
. nnoxeu: S PARK PLF�ZA uxrt:
�SRt�INF CA 92714
PEflMITfEE: jNNER SFAC� � ' �( 11 3) 771 -7.126
eoneess: 5057 CECF.LIA r •
iOUTH GATE ' CA 90280
11CFNSEO CONTMC70P DECIAMTION: I herehy atfirm t�at I am Iicense0 untler provisions of ChaD�er 9(commencinp wit� Sectian
7000) oi Oivision 3 ofthe Business anA Professions Cotle, an0 my license is in ful force an0 eflect.
cin uc.: U 3 214 4 ST�TE 11C.:O O s '
Oate: � ^ � % --� � Siqnatur � -
WOHNERS' COMPENSRTION �ECLAMTION: I hereEy aflirm ihat I tuve ertificate of consent to setl-insure or a certificate ot Workers'
Compensation losyraqcl, w� tertqied copy thereoi (Section 3800, Lab. L)2 � O i/�J 9, .
roucrxo.: GREA1' AMERICAN Exr.onTe: 1
J COMPRNY: � - ' -
❑ Cehi�ietl coDY is here0y Iumishe0.� `C� CPPifietl cop - i�wi�h t iry uilUi iWsio��
Daie: 3-27 — F'O q IicanP
E%EMPTION FBOM WOBKEBS' fAMPEN&1110N DECUMTION: (ihis seciion need not he cample[ed i� Ne permit is �or ane hunOreO (5100) or less�.
I certity ihat in Ihe De�ormance of the work tor whlch ihis pertnit is issueA, I shall nat employ any Dersan in any manner so as to become
' su�jec[ to the Workers' Compensation LaWs al Califomia. �
Oate: - � Sipnature: � � � � - ' � ` �
NOTICE: If, after making this aeclaration, you shaultl become sublect to t�e Workers' Compensation provisiani of tAe Lahor �
Coae, you must foMwith comply wit� such provisions or this'permit shall 6e JeemeA revokeA. '
CONSTRUCTION LENUING AGENCY: I herehy a(firm that there is'a constmc[ion IenOinp aqency for the peAormance al �he work tor '
w�ich tAis Dermitis issuetl (Section 3097, Civ. C�. , � ,
LFNUEfl: � ' '. �
nooeEss: - - ' � ,
OWNEB BUILOEN OECUMTION: 1 hereby atlirm tlwt I am exemDt from the Coniractors' State License Law tor ihe tollowinq reason
(Sec[ion 7031.5 Business anA Prohsslonal Cotle: - My city af caunry wNch requires a Oermit to construc[, atter, impmve, Eemolish, ar �
reDair any strucWre, pnor ro hs issuance, also repuires the apDlicant for such permlYro file a siAneA statemenbthat hUs�e is licensed
pursuant to t�e Drovisions ai the Contractors State License Law (C�aD�er 9(commencinq with Section 7000) of Division 3 of the Business
anU Professions CaUe) or [hat he/she is exempt t�erefrom an0 the Uasis for t�e alleqe0 exemD(ion. Any viala[ion ol Section 7031.5 by :
any aDPlicant tar a Oermit sublacts tAe applicant to a cNil penalry of not more than five hundre0 Oollars (SSOU)r , � -.
I, as owner of Ihe pmpehy �or' my employees with wapes es�their sole compensation, wlll tla t�e work,' antl the
❑ simcmre is nm imenEeE or ottered for sale (Section 7094, Business and Prohssional CoOe: The Contractors' State License Law
does not aDDN �o an owner oi a pmDeM w�o btiiltls or improves Ihereon, anE w�o tices such wod himself/herself or through .
his or �er awn employees. DroviOetl Ihat such impravemenis are not intenOeU ar allere7 for sale. II, Aowever ihe builOinA or .
imOrovement is soltl vnthm one year of completion, the owner will �ave t�e �ur0en of Oroving �e/s�e di0 nat UuiIC or impmJe ,
'.far ihe Ourpode oi sale). , . , � . . � ,
. I, as owner oi ihe proDerry. am exclusively contracting with Ilcensed contrectors ro consimd tAe project (Section 7004, Business
❑ anA Professions COE¢: The Cantactors' State License Law dces not appty to an own¢[oi D�operry wAo bwl0s or improves thereon '
and who contracts for such projects vntA a contractor�s) license pursuan� ro tha Contractors' Stata License Law)..I am aware
that pr0of of their WOMer's CAmpenSaiian insurance s11au10 Ue Dra'nQeO to me. � . .
� I am eMempi untler Secliore 9. 8 P. C. `. , :
tor this reason: . � '
� � . , �
Oate: � Ownec -
I Uo here0y ceniry t�at I am aware of and understanE t�e reduirements of Calitomia Healt� an0 Safery COEe Sections 25505, 25533, anA
2553C and t0at I or any fuNa Duilding occupant wilYwill not (circle one) nee0 to camply with saiU state co0es antl Me requiremenls for a
permit for canstmction or mo0ification /rom t�e Air Oualiry Management OisMct HeSiCential construction applications are exemDt fmm
ihese pmvisions. . � • • �• .
�ate: qpplicant: � �
I �ereby certiry IAat I have reaC t�is aDVliwtion an0 state that the aDove informanon is correct. I agrte to camply wilA ail ciry anA caunry
oNinances aM sWte laxs relating to buil0ing construnion arM Irereby autlwn repreuntatives of this ciry ta enter upon iha abwa-mentioned
properry lorinspection purposas. n
Date'3� 27^ ! 2— Sipnatu � ✓�X �
oever's license ar Sacial Securiry x: � '
1fi91i6 W�ite—Builtlin9: reen—Cotle Enlorcamen�; Canary—qpolicem; Pink—Revenue; GOltlenroE—Nssesmr
'� CITY OF'COSTA MF_SA, - AUTLLIING PERMIT PERM NO: B 046695
FERMIT PIO: I3 . 046695 ' ' PLAN •CIIF.CK �PdO: 03016-90 L GOVT: •N SfJPP;' N
CONS'PRUCTION TYPE:' I-I'R ' .� , PERMIT TYPE: STR � � PUF.PUS.E: �T�T'
.. � �
JOB DESCRIPTIODI : A232SF OFFICE T':I. , -'' , SQ FT:_ . 9,?.32 _
CI,AIM VALUE: 60,000,00 CFpLC-�ALUE: 71,112,£S3 GROt)P OCC: B-2 /, ,o
COMMENT i �: - • , ' - � •
**x+�*rt�ex**it**�x*+�*�+��c***��*�*�r*��cx�****�+r*�rt**����r-x�:�*�*�c�c�+t��**x�i��*****x ��-*���
� Z O N T N G R.E Q U I R E M E N'T S
, S E'T D A C K.S , , ;>
------------ MASN BUILDING -------- �-------'-- ACC�SSORY BUILDIDIG --------
FRNT: FT IN REAR: F'T IN FRN1': • FT' IN REAI2: F9' � IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGH1': FT IDl
1'�ARK.T.NG REQ: PROV: � PAItC�L: 4J.OSOIU4 ZNE: PDC REF �10:
PLANI�ID]G NOTES� TErlANT TMPROVI:MF.NT ON THr FTFTH FI,OUR OL•' EX. S�CURITY ,
. > .PACIPIC DLDG _ ' � •
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D E V F. I,�.���. P M F. N 1' S E R V I C E S R E Q U I R E M E I�I-=C�:�a . �
7.ONING APFROVEU HX� DATE: 6� 6
. �= �j=��6-- --�----- 3% .7_�� -
H�UILDTNG APPROVED J3Y _ c�I�' - £- l30S�=--- � DATE: ..�%Z�pG
� � • f`'.'7
APPLICA'TTOr! TSSUGI;�;� I?Y: %J ' ,DATE: �A'7 �
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L�EGALTZATIQt�I:N -� P E E, S. U M M A R. Y -STRUCTURAI� 'SEGMF'T.ITeY
, ; f,, . .. ,
� 1BI.,bG PMT PLOM$]:D]G F.I�ECTRIC':.MECHANIC or�� FIEiE �SMIP/RES" GRAL�IIqG
�PL'.Rf�1I.`P 51 3 . `.i0 ., � , . . - • ' �
� t - " �• SMIP/MUN-I2F.S
P[sAt4 ' 333.78 . f.`�. • y:� '.,�-'. 1.0.21
�ssoF cee ,: ' ,r„
BUILDSNG-LISV-> PEI2MIT ISSDF. PLAN-CIiECR e TOT.,AT, � FAID � D[]L
TOTALS'----> ' S23.7'1 0.00 ; 393.:7II /i ;, IIi7':'49 ' 857. A9 ' '.00
REVF'NUE DI?'ISION TOTALS--> � COLliE'CTF.D::'' ,a23. 7��`� OL�L•:R/$HORT: .OU
` BLDG PMT PLUMHING T:LECTRIC MECI3AAI3C FIRE-• SMIP/T01' GR7�DING PLADI-CHECK
5:13..50 , ,: 10.21 :
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� . v'. '.. . /Y I '
TY.PE QTY L! E S C R I.P 7' I Q`,Dl �' 1 ,? ,A,^' �� UAIIT C051' T07'AL COST
SFC 4232 UFF-INT. ALTGR TYPE`� I,I3�:I'.R. -AVE2t�`r 15.OA 6(1,U:i0.56
' END OE'• F£.�S �
' _ .. . . � � �1�'. 'a �: (-a. . . .
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D /
ATE"03/27 90 TIi1E' 0� _3'
i
CONSTRUCTION AND PLANNING P� -& SPA
Date Inspector Date Inspector
, APPROVALS Permit # ' � • ; - APPROVALS Permit # 1
1. Temporary Electrical Service�r Pole . � 52. Pool & Equipmenl Location � f
2. 6oil Pipe-Undrgrnd. ' , , '� . 53. Steel Reinforcement %
3. Electrical Conduit U[ility-Undrgrnd. ' � 54. Forms :���
4. �Elgctrical Conduit�Undrgrnd.�j �� 55. Electrical Bonding :/
. 5. Steel Reinforcement �� - 56. Rough.Plumbing & Pressure Test -
6. Electrical UFER Gmd. � � � 57. APPROVA� TO COVEfi�GUNITE
7. Footings � ' „_p � ! t � 58. Electrical Conduit-Undrgrnd. � �'�� .
��8. �Foundation �� ;� � � } 59. Gas Pipe, O Undrgrnd., Test i'�
9. Water Pipe�Undrgrnd. f; ��� t� � 60. Backwash Lines, P-Trap, O Undrgmd. /'•1
10. Structural Floor System '�� � ' 61. APPROVAL TO DECK �•�
11. Property Sewer Line & H�usEConnection, �^ 62. Backwash & ReceprorFinal v"�
4
12. Sewer Cap �-- �! .. 63. Heater & Vent-Final �"��
13. Roof Drains � ^.' F � 64. Plumbing System � Final ' '
�
14. Rough Plumbin9 � 1 65. Electrical-Final a`'
15. Rough Electrical-Conduit �� 66. Solar System-Final "�
16. Rough Electric Wiring � � 67. Fencing & Aceess Approval �
i7. 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 #�� S� 7
21. Ducts, in Stiucture . " 70. Underground Hydro
22. Ducts, Ventilating - � 71, Produc[ Piping O Gas ❑ Oil
, 23.� Gas Pipe�Rough & Test � 72. Underground Flush - �
24. Roof Framirig . - _ - 73. Undergrnd.StorageTank OGas �Oil
. R f Sheathing 74. Overhead FiYdre _ ��C.�U
26. -Bar Ceiling (Structural) & Monocoat ' a 75. Dry Chemical
27. Frame and Flashing � 76. Dry Standpipe
28. Lathing & Sidin9 � . � � 77. FIXED SYSTEM� FINAL
29. Insulation : ti✓'"�tJ� 76. FIRE PREV. FINAL
30. Drywall Nailing � � i� �, �HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat �. -' f!�f� - 79. FINAL INSPECTION
32. Electrical Power Meter�Final ' '� � 80. FOOD CERTIFICATE ISSUED
33r Final Electric � - ,;" '";.y`?f Notes:
.t� G- E�GC .
34. Final Heating & Air Conditioning L^� �" ' - �
,' 'r.' - �
35. Final Gas Pipe-Test _� � -� ,,; J�• . o
��
36. Hood or Canopy � }y
� � • ! /H'. bii Y
37. Final Factory Fireplace• � �'' ` •
38. Final Plumbing ' _' ' ' � ` � _ .S,
39. Water Service�Final . � . � � �` . � L pa
40. Gas Service-Final � ' .. ' �
41: Solar pomesticFinaP -,� � - .
42. Backflow Preventer ' � •
43. Backflow Irrigation . - �
44. Landscape Irripation System ' . ' �
45. Sound Attenuation � �
46. Handicap Regulations �
. 47. FINAL STRUCTURE & BUILDING � � A�� �
48. FINALPLANNING �" - �i`
,
49. Electric Release to Edison %;r i/�y", .
(, �Y
50. Gas Releas�.to Southern California Gas Co �
.c,
51. CERTIFICA7E OF OCCUPANCY
No. 1.� Date
rxaecTeooeess: 555 ANTON BL 0N1T` 500 CITY C1F COSTA MLSA —'BUILAT]�G PBRMIT PERM 1J0: E 04G791
OWNEHSN�ME: SCCURITY PAC. NAT'L �AANFC ' � � . � '
aooeess: ,pME AS AHOVE PERMIT NO: E 046711 PLAN CIIF_CK NO: � . Dl GOC'1': N SUPP: Dl
' � • . CODISTRUCTIODI TYYE: � PERMIT TYP�: L•:LE PURPOSE: (.�TFi
213/,345-7880 � � _
FNCH/ENOINFEp: � " NEG.NO.: � • , JUB DESCRIPTION ;� EL£CTRIC �FOR.OFFICE• T.I. � ' � SQ FT: � � � � �
nooxess: . - uniT: �
� � � CLAIM�VALUE: CALC-VALUE: � CROUP OCC: /
PEflMIREE: rIUTCIiTSON CORP � ( 21 3 ) 763-7991 � � � � �. � , � � • � -
�ooxess: , �Z50 S.CF•.NTRAL AV . ' COMMENTS: 8-46695 ' • '�
RANCHO� DOMINGEZ � CA' 90220 . **-x�+rx�,K���*�**��*x���*�t�x�****�t��+�**�t*+r��at*�c�t+r+r*�x-x�*�-+t*�t+�x-�x�*���t�ie��*i��*�x-+��-*�t-rxx�**��x��cY**�x�
UCENSEU CON7MCfOB OECIAMTtON: I �ereGy amrm that I am firensed unUer pravisions of ChaD�er 9(commencinA !��h Section , 7, ��l 1 i� G Fi � Q U I R F. i'i e i� �r $ . .
7000) ol DiWsion 3 of the Business an0 Professions CWe, anU my license a in full torce an0 elfect. , S B T B A C K S � - '
cirr uc.: 0. 2 7 f3 7 suTe uc.: 7. 6 9 512 /� cuss: 1 p ��. Q • . �
oate: � sipnawa:_� 7'.�i�- � �1 '-"'-""'--- MI:IN BUILDING --------- -----�------ ACCESSORY BUILDIDIG -----=-�- '
WOBNENS'� MPENS�TIOIOECIAMT10N: Ihere�yaKrmthatlhaveacertifcatea/consenitasel4insurearac ificaleolWorkers' FRNT': CT IN REAR: ' FT IN FRDIT': FT IDl REI,R: FT T.N �
Compensationlnsurance,oracenifieEcopythereo1�5ecUon3000,La0.C). � I,EPT: . FT l:iJ RGHT: � , FT IN .LEFT: FT, , IN RGHT: FT . IN . t
voucrxo.:WCP60774?.R ocv.o►h: 12/01/99 ' .
coMrexr: GREAT AMERICAN PARKING RF_Q: PRUV: PARCF.L: 4105Q104 ZNF: ' REP �10: '
❑ Cenitiee copy.is hereby tumishea. � CeNeea copy is neo witn tne ciry e' q DiNsion. PLANN I NG NOTES > • � . , � � �
//'��j �A � >
Oate: 2 ppDlicant:y_L /!�/ , iEifiEiFififihif�if3fi[#9FiEiE1EiE1[iEiEi[-1F�t3E3E3t3EiE3(il�iftE#3(-jE9E9Eif3EiEiE�iE3E3E9k%9E3EjfiEikjfiE3h�1E3fi(�x-iFiEiF3(3f�iEifiFif��74iEiEiE3E1F3E3(�if?E,Y:?6 .• '•
IXEMPf10N Fli01 WOflKEIi$' MPEIISATION OECIAMTION: (tt� sec6on neeC no� Oe complete0 0 tlre pemit a iw one rm j5im� a kn)! ; �' L: V� L U P M L• N T S E-.R V• I� C E S R C,Q U I R E'M E N T. 5 � � -�
I certiy that in the pertormance of tAe woM1 far wNch this permil ¢ issued, I slull not employ any person m any manner so az ta hecome ' - . ' . t ' � ; ' �
subjectrotheWorkers'CompenutionLawsolCatitomia. , ' ` , ' ZUNING, APPROVEU BY ���� _ ._______.__ �DP:TE: _ ' '
Date:' ' SipnaNre: . .• ' . -. . ' • . .. . .. . � _. - . .. . � - '
NOTICE: II, atler maMing Nis tleclaration, yrou slroulU Gecome suhlen to tAe WaMeri ComDensation pmvisions ol Ihe La�or A U I Lll I NG APPROV Ell BY : .___ ' ___�, DATF : '
Cade, you must forthwrt� compty witA SucA O��sons or tliis�permR shall De OeemeO revokeE. � � �- '�• ' —T � ry q
CONSTBUCTION 1EN01NG �GENCY: I �ere0y affrm tAat t�era is a consirudion IenEinO apency far the petlormance ol ihe work tar� ' AP FL I CAT I ON I5 i U 1?D B Y: �. �� ' � ' DATE : �//do �j �
which ��is permii is i5sue0 (Sec[ion 3097. Civ. CI. . . � r �. �. {� *. {E.7E* * {F * );. ��.�.� {E 3f {f i(..lf it 3f {{'�'�7���'����� y,-'��� {(�.� {E * �!. �4 3f {E af � �. r- �' 7E �'y"�"�.��aF �c .
lENOEfl: � ' . i. � � 9F±f�)fiEiflEiE�f�lfjfifiEdt3fif±fkifM-i(ifM�ifif�klE%�iE�if3tiEit%if'iEifitlE#E1E�IEdEiMiEiEif34df�%iEiEiEiFiflE3EkitiE�(�iEKif�ffifiF�3E3f�3E#Y�i6�Y?fu.0 �
nooness: — � . LEGALIZAT'ION:N " ` "' F E E. S U M M A R� Y S'TRUCTORAL—'SGGIdE1V1':IJ ,
OWNERBUIIDENUECtAIL1TI0N: I�ereDyamrmtlutlamexem0���omt�eContactors'SWteLicenseLawbrtAafollowinpreason � BLUG PMT PLUMDING ELECTRTC �MECHANIC � f'IRE. �SMIY/RES GRADIIJG
�Secllon 7031.5 Business an0 Profcssional Catle: My ciry af counry wAich repulres a permit to wnstmct, alhr, imDrave, tlemolisn, ar � r' ER i�i I f ' � �%�. 0 S � '
reDair any stmcture, pdor to its issuance. aLso requlres t�e apD���� �ar wc� permil to lile a siynetl sWtement Ihat hrJshe Is Ilcensad ' - '
pursuant to ihe O���ons of Ihe Cantractars' Sute License law ICnapter 91�ommencin9 ��h Section 7000) of Divisian 3 al me Business ' - S 0$ . � S M I P/ DION — R E S
anA Pmtessions Coae) or ttut hNshe is exemDt lherelmm antl ihe Oazis lor ihe alleOeE exemplian. My violaiion of Section 7031:5 by � P I. � ��� � - � . ,
any aDPlicant for a permit suDlects tAe appliwnt ta a civil penalry of nat more tlwn live �unOmtl Oollars (5500�. 1 S SUE FEE � � 1 5. 0 0 � � � �
i, as owner o� ine oropeM a� mY em Iryres with wa0es as inelr soie rnmpenutian, win no tne worx, and ma �UTLL TNG—D1V=> PLRMIT iSSUE PLAN—CAECK . TOTAI. � P�ID . UUG
❑ stmnure is not inteneee or ottered lor sale I�eecuon 70ae, Buvness ana Professlonal Cotle: iM Contrzcmrs' State license Law � TOT AL S----> 7 9. 0 5� 15 . 0 0� 0. 0 0� 9 A. 0 5 9 4. � S �. Q 0
Oaes not apDly to an owner oi a Dmperty wM EuilOs or Improves thereon, anE wM Eaes suc� work MmseltlAerselt ar tAmup� �, - � • � � ' • ' �
hisorherownemployees,pravitleEl�atsuchimprovemenlsarenotintendeGorollereElorSale.Il.howeverihehuiltlin0a�' [jF.��ENI)F. U1'VISION 'I'OTALS--> � COLLECTEll• � 99.05• OVI:R/SFInRT: .QO �
imDrovement is sold vnt�in one year oi completian, I�e owner will �ava tAe Eurden ol DroWnO �e/she Ei0 not builU or impmve . ,
mrtnapurposeo�uieJ. � BLDG PM7' PLUMBID7G EI;ECTR7C MGCHRtJIC F7RL SMIP/TOT 'GRADII�G PI�PNrC2iF..CIC
I, az awner al Ne pmperry, am exGusively contractinp with Ilcensea coninctors to consimct tne Drajecl (Section 70dA. 6usiness '9 4. 0 5 • ; �
❑ anG Professions CqEe: The Cantac�ors' State License Law Oces not appty to an owner oi DroOerry who UmIUs or imOmves t�eraon �� � � - ' �
anUwhocomract5lorsucADral�Swit�acontactar�s�license0ursuantrol�eControctor5'SlataLicenseLaw).lamaware � r i{%�3[��k�.i��t�M�ltitM3E�1f*ifirititjt�Eit�t##iE�f�7EiFifilkiFififi(itiE3E�tiFitfElEk�atif�iEif�ifi(iE�t�iEif�i(�ie��E#iEiEiFiEKiEiE�It7Eifi�*#i(-3f�?�1EiEiE
t�at proof ol Itrtir Worker's Compensation in5uance slpul0 �e proviCeA Io me. , , j hl D I V 1 D U A I. F' $ E D R E A I( D � T^1 hl�
� I am exempl unGar Secllon: • 8. 8 P. C. ' • ' '
fo��hisreason: � � , _ � T'YPB QTY U E S C R I P'1' ]�. O N ' ' � UNIT COST TOTIaL C05'l' .
oate: Owner: ELE 20 FIX1'C7RESr LIGHTING 7' ST ?.0 � EA. .7S � 15.00
1 tla nereoy ceniy mat I am aware of antl unoerstana me reeuirements ol Caiitomu Healm ann Safery Code Sections 2550.5, 25533, ana E L E �I 9 • F 1 X. T U R E S, • L I GH T I D] G AD D I T L O�IAL EA .. . 4 S 21 . 0 S
25534 anE Olat I ar any IUWre Cuiltlinp Otcupant vnll/wlll not (cirGe one) need to compry vnih SaiO sute wGes an0 the reQuirements lar a .
permit lor constmctian ar maUification tram t�e Nr Oualiry Manapement Distnct. qesitlential consimctian ap0licatians are exemD� ��om F.L E � i 0 HHCF.P T/0[ITI.rET 1 S"P 2 0 EA . • . 7 5 � 15 . U 0
inesevra�isia�s. F.LE: 90 RBCEPTIOUTliET ADDITIONAL EA. .45 13.50
' ELE � 18 RECEFT/SWITCH 1 ST 20 .2:A. .'75 13. SU
oa�e: npp�icant � GND OF FEES i �
� IIa Ih abo ' t I I ' . • . + .
I here6y certity Ihat I luve rea0 ilus aDD4w�on anE state 1 I e ve m orma�on a wrrect. a0ree lo camp y wrth all city an0 county ,
orCinances antl siate Wws reWUnp ro DuilNnq cortcwetion antl �ere6y autlnrire reDres¢n ' es ul this cny to enter.upon t ove-mentloneE �
proPerry far inspeition purpa . �
Date: Z� SiAnaNre:..�_
Onver's License or Sau Secunry d: � '
IG4td6 Wfiite—BuilOina: Green=Cotle Entmcemant: Canary—Apolicant: Pink—Revenue; Gobenrod—laessor � ��
e
��L
0! 00057212-00051212 "fr�T 94.05
� DATE: 03/28/9Q TIt1E� l0:li
_ ' �
CONSTRUCTION AND PLANNING . P� "& SPA
; APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector.
>,1. Temporary Electrical Service�or Pole, 52. Pool & Equipment Location /
.. �i
2. Soil Pipe�Undrgrnd. , - - �' ' � 53. Steel Reinforcemen[ � .
. 3.. Electrical Conduit Utility-U�drgrnd. � 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 ,.�� - � 67. APPROVAL TO DECK
1 t�. Property Sewer Line & House Connection �� � 62. Backwash & Receptor-Final
12. Sewer Cap • � j 63. Heater & Vent-Final ,
13. Roof Drains �- , �' " 64. Plumbing SYstem - Final "
14. Rough Plumbing � ��. . 65. Electrical�Final '
15. Rough Electrical-Conduit .�' _ - � � 6. Solar System•Pinal • .
i 6. Rough Electric Wiring ' "Z 67. Fencing & Access Approval '
17. Rough Wiring Sign - PROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling . POOL/SPA SYSTEMS FINAL
�19. Rough�Heating-&�Air Conditioning � �� FIRE DEPT. REQUIREMENT ,
20. Rough Factor:y Fireplace -, APPROVALS .. Permit # •
21. DuCts, in Strutture _ 70. Underground Hydro
22. Ducts, Ventilating ' 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test ' � 72. Underground Flush
24. Roof Framing . .. 73. Undergrnd.StorageTank OGas ❑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 - • 76. FIRE PREV. FINAL
� 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - � -79. FINAL INSPECTION
32. Electrical Power Meter�Final - 0. FOOD CERTIFICATE ISSUED
33. Final Electric tes:
34. Final Heating & Air Conditioning , � '
35. Final Gas Pipe�Test- _ ��� . . '
' 36. Hood or Canopy � - ' - ♦ A� ' - • '
� 37. Final Factory Fireplace �
38. Final Plumbing --
39. Water Service-Final - � � � '
40. Gas Service-Final - -
41. Solar pomesticFinal � � -.
42. Backflow Preventer � - - -
43. Backflow Irrigation . . '
44. Landscape Irriqation System ': ' • . �
45. Sound Attenuation . . - �. -
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING �i•y
48. FINALPLANNING ��t '
49. Elearic Release to Edison `➢`�
/
50. Gas Release to Southern California Gas Co �,�
51. CERTIFICATE OF OCCUPANCY
No. Dace
PN0.IECT RUDflEBS: S S S AN'1'O�l- BL '
OWNEIMSN�ME: SCCUR�ZTY PI�C AANK�
nooxes's: 5`�5 ANTON BL
C`OSTA i��SA , '
. ' CI�• 97.62a '
� uxiT:500
��flCNIENGINEEfl: jTjZ'EHj.�I ' ' i . . flEG.NO.: 9 ' .
RDONES3: ' S PARK � Y L� � � - ' uxir. 'y 5 0
IRVINE' CA 92714_
PENMITTEE: KZMBI,E AND COMYANY ( 714 ) 895-1 l SFi
- �ooxess: 75A0 SUZI LANE ;
WESTMIDISTER CA 92583
UCENSEO CONTMCfOB OECLAMTION: 1 AereOy aflirm that I am Iicense0 unEer provisions oi Chapler 9(commencinp with Section
7000) oi Uivision 3 of the Business and Pmfassions Code, and my Ilcense is in full torca anU eAect.
cirr uc.: 0 3 8 5 U 3 STATE LIC.: O 9 Z/_/j C1�6
�ate: 3�'� — SipnaNre: �� • �
WOPKEBS' COMPEXS�TION �ECIAMTION: I her¢hy aflirm that I Aave a c¢rtificate af consent to self-Insure oi a certlliwte of Wo ers'
ComDensation lnsurmc� pr a��erWi¢G c9py I�e�oi (Sxtion 3800. Lab. L)8 / 2 3/ 9 0 .�
POLICY NO.: W L' tl �4 ll tf 7 IJ �P. ORTE: U
wMrnxr: FREMONT INDEM.' •
❑ Cenifiea copy�is hereby fumisAetl.' � Certitietl caDY is filetl wit� ihe ciry BuilUinp Division. '
Date: � — � , ApDlicant � /�(iNL�'�!� /'
IXEMFf10N FiiDM WORIIERS' COMPENSRTION EGANITON: (iTis se�tion neeA iwl Ee complete0 R the D�it is far one Au�rN (5100) a le �.
I cenity t�at In Ne Oedormance oi tAe work Por which Nis permit is issue0, I shall not emDloy any Oe�san in any manne� so as to become
suDlect to the WaMers' Compenution Laws of Califomia. : . '
'Oate: - - Sipnamre: �
NOTICE: Ii, atler maNing this Oeclaration, you shoul0 Oecome suGjecf to the Workers' ComDensation Druvisions oi tAe LaEor
CoOe. you must fortliwith cumply witA such Omvisions or INs permit shall De AeemeO revake0. •
CONSTBUCTION 1FN01NG IIGENCY: I AereOy atlirm t�at �Aera is a tonstruction IenOinp aAency fonlAe pedormant0 oi I�e wOrk for
which this permitis issued (Secnon 3097, Civ. C�. �
IFNDER: � �
� �noeess: . . ` _ .. .. - — , . - . . .
, ,
�OWNEq 6UIlDEB DECLAMTION: I hereDy atfirm Na� I am exem0� ��am the Contactors' State License Law tor ihe followin0 �e�on
(Section 7031.5 Business and Professianal Cotle: My ciry oi counry which requires a Oermit ro constmct, alter„imDmva, Eemolish, or
repair any s[mcture, pdor ro its issuance, alm reQuias the apD�iwnt for suU permtl ta lile a sipnetl statement thal hrJs�e is licensed
pursuant to t�e provisions ol the Contractors' S�a�e License Law.�C�aD�er 9(commencing wit� Set[ion 7000) o� Divisian 3 0l Ihe Buslnes5
and Pmfessions COAe) ar that he/sAe is exempt Nerefmm an0 ihe Dasis far ihe allepe0 exemptian. My vialation of Section 7031.5 by
any appliwnt tor a Dermit su6jecls tAe "appliwm ta a civil penalry bl irot more ttun five AunEreE Dollars (5500). ' -
I, az owner ot the OropeM�or'my emyloyees vnt� wa0es az tAdr sole campenutan, vnll Uo the xrork,-an0 ttre
� StmcNre is not intenEeE or ott¢re0 for sale (Section 7094, Business anA Prbfessional CoOe: T�e Contactors' Sta�e License Law
tices wl aDDN ro an owner of a D�operty who Euiltls or improves t�ereon, anE who Aaes 5uch wod Aimself/Aersell or Ihrouph
'�is or �er own employees, Drm+tle0 tAat such imprmemenis ire not inten0ed ar ottered tor sale. II. Mwever tAe EuilGinp or
improvement is soltl vnihin one year oi completion, Ihe owner will have Ihe �ur0en ol Dmvinq �e/she tli0 not 6uild oi imOmve
' for [he Duryose ai salel. ' . . - . .
� I, as owner of the pmperty, am extlusively contractinp wlt� licensetl cont2ctors to consUuct the Omlect (Section 7044; Business
❑ anA Professions Cade: The Comrazlors' State License Law Oces not appN to an wmer of Orocerty wM Euilds or improves tAe2on
anU who coniracts for suc� prolec[s xith a contractor(s) license Dursuant ro[he Contractors' Stata Licensa Law). I am awara
IAat D��� of iheir Warker's Campensation insuranu s�oNd be OmviOetl to me. .
� 1 am exemD� unUer Section: ' - B. d P. C. . . '
forthk reason: . .
Date: � Q«ner. '
I Oa Aeaby certiry ihat 1 am aware oi antl unCerstan0 the 2quirements oi Califomia Healih antl Salery CaCe Sectiore 25505, 25533, an0
- 25534 and Wt I or any INure EuilUinp acupant vniVwill not (circle ona) neeG m compry witb ui0 state co0es m0 Ne requiamen6 lor a
permii for consiruttion or moEifiwti0n from Ihe Nr Oualiry ManaOemeni DislncL Re5i4eniial consimcti0n applicaiion5 are exempt 6om
t�ese Drovisions.
Date: ApD�icant ' �
I hereDy certity t�a� I �ave reaC this aDPlication and state that Ihe above informanon is correcL I a0�ee to comDh �h all ciry and counry
orGiriances aiN sute hws reWtlnq Io DuilOinp consWClion anE hertG/ aNhorve represenlaUws at Ihis aty lo enter upan the a0ore-men ne0
prapeM �orinspection Durposes. f/� • //" �
Date: �—l� 90 ` Signature:�?�/� �
oriver's ucense ar socia� seafiry x: � �
16a1�e W�ite—euiltlina: G�eeo—Cotle EnrorcemenC Canarv—Auo�icam: Pink—Revenue: GOIEenruE—Avseemr �
` r,ITY bF COSTA• MESA — HOILD.[DIG PERMZT � [�ERM IdO: F�,04651'1
PERMIT�NO: F 046517 PLAN CHECK NO: 03049-90 S GOVT: N SUPP: A1, '
�-CONSTRUCTION TYPE: 1 SPRINK ' PERMIT TYPE: FIR PURPUSG: UTH �
; .
JOI3`DESCRIPTION : FIRE SPAINKLERS (COMMERCIAL T.•I,) � SQ FT: � �'
CLAIM V,ALUE: �2,700.00 CALC—VALUE: ' ' GROOP OCC: B-2 /
COMMEN'TS: SUSTE 500 (STH FLOOR) -' � '
u*+��*�e�u*x*��ex�r�**�e�x�r*x****�*�*�r�r�r**��rx�e�a�x+r�*+e�-�e**�r��x**+r�r��r***x�*�r�*�r��+r*���c�
.. �. Z O N I• N G R E(,�' U I R E M E N T 5 ,
�, , ' S E T B A C K S '
--------•---- MAIhI BUILDING --�----'-•--- '--------- ACCFSSORY,BUILLING �--------
FRNT: , F1' ' TN REAR: F'T IN , FRN'T: FT IN AEAR: : CT .l'N�.
LEFT: . FT ' IAI RGHT': F'T IN• I,EF'1'; FT' IN RGHT: FT , � IN�_.
PARKING REQ: PROV: PARCEL: 4105010�4 7.NE: �REF NO:�
PLANNING NOTES> , � ' ,
. � i
iE'if iE iE dE 1f if iE iE ik iE if iE iE iE iE iE if if iE iE ik ih if 1F ik if IF 1E iE IE IE if iE iE i! if iE 1E * it if iE �%iF iE k ff iE 1E iE k iE,if iE iE iE i4.iE 1t iE iE iE �E iE it 1E iF ik iF ik i!-0k iE 3E iE%i6 �lE
, D E V E L O.P M E N T S E R V;S C G S �R.E Q U I R E M E N T,S.
ZONING APPROL'ED BY __ ; __ _ ____ _ pATL: ___ ._.
HUILDING• APPROVED BY �e_� _ ' DATE: =�
APPLICATION ISSUED�HY: ' f� llATEi �7��� '
ifiElFiFifiE'iflFiEikkklEiEikifMkkkiEif�iF3e�iF��3FiF�iFiFiFiFiF'�'fFiF�IF3Fif7FiFTF3F3F�F3F'TF�FiFikifkfEk3E'iE1E1EfF iFM�iF
1Ei(�iE1EiFikiElflEikiFiPlfiEkkiFiEikMiEkifkiEiF1ElfiflElEfElEiEfFlF1EltkiEiFiFiEifMiEklfMikiEifkikltikiElEiEifiEMiE�FfEiEiE3liflEiFiEiElf1E�1EiE�kiE �
LEGAI�IZATION:N � F E E, S U M M A'R`Y . STRUCTURAL SGGMEN'1':N '�
i
BLDG PMT' PLUMBING 'FLECTRIC MECFIANIC FIRE SMIP/RES GktAUING
PERMIT ' S4.00 i
PLAN • - � ., .
ISSUE F'EE
BUILDING—DIV—> ' PERMIT ISSUE PLAN—CHECK
TOTALS,-----> .; " 54.00 � 0.00 35.10
REVENUE LIVISION T'OTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECFiANIC
65E
35.1.0
T01'AL '
89.10
SMIP/NON—RES
' PAID DOE
89.10 .00
54.00 OVER/SHORT: 00
FZRE SMIP/TO'f GRADING PLAN'—CHF_CK
54.00
�k 1E if iE %� iE it k IF IF it iE # ik iElE iE �e iElf iF if if iE IF if if 3E k iE 3E iF if if if iE iE M dElF i(� iE �t iE iE iE IE iE d! iE iF iE �� iE �lE if iE �f if 1FiE M iF 1klt iF it fE,�7E 9E �E If iE 1Elf !f i( 1t 1F
I N D] V I D U A L. E E E H R E A R D O W N
�'TYPE QTY D E S C R'I� P T I O�N � UNIT COST 'POTAL COST
�
FIR 59.' FIRE GQUIP FEE (FROM DLDG VAL TABLE) 1.00 . 54.00
� END OF FEES
i
0
O100Q56065-00056065 TOT 54.00,
DATE: 03/14/90 TIME: 12�42
CONSTRUCTION AND PLANNING P� $ SPA � �
� Date Inspector Date �inspector
.APPROVALS . Permit# APPROVALS Permit# �
.� .J
1. Temporaiy Electrical Se.rvice�or Pole .� !. - 52. Pool & Equipment Location '
i'
�
-2.. Soil Pipe;Undrgrnd. ' • „- �. � 53. Steel Reinforcement
_3'�Electrical CohduiYUtility-Undrgrnd�. . ' � �� 54. Forms� . • �
�4:cElectrical.Conduit-Undrgrnd. �,_ - 55. Electrical6onding
�v
_�5�Stqel Reinforcement . '• 56. Rough Plumbing & Pressure Test �.
,.r6,. Electrical'UFEft�Grnd. _ 57. APPROVAL TO COVER-GUNITE '�'
'7. Footings =+ - _. �-� 56. Electrical Conduit-Undrgmd. _
`8. Foundation -'`• ' � '' 59. Gas Pipe, O Undrqrnd., Test -
�9. Water Pipe-Und�grnd. � ,{- /� � 60. Backwash Lines, P�Trap, O Undrgrnd. '��
i
10. Structural Floor System . '� '� 61.�APPROVALTO DECK � �
11. Property Sewer Line & House Connection '� � 62. Backwash & Receptor�Final
12. Sewer Cap �_ � -� 63. Heater & Vent�Final 't
13. Roof Drains. �. �, - 64. Plumbing System • Final
74. Rough Plumbing �. .. 65. Electrical-Fina�
15. Rough Electrica6Conduit -_ � 66. Solar SYstem-Final �
16. Rough Electric Wiring. _ 67. Fencing & Access Approvai
- 17. Rough Wi�ing 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 r�DuMs, iri Struct�re -' -- � � "70. Underground Hydro '
- � -
22_�Ducts, Ventilating � ` ' �, � � ' _ ' � , 77. Product,Piping OGas �Oil
23. -Gas Pipe•Rough &-Test � '� ', " :� y 72, Underground FIusM '
24��Roof Framirig ' � ._ - _ - . 73-Undergmd.Storage•TankDGas ❑Oil
25. Roof SFieathing � � ' � 74"'Overhead Hydro_� 7 Ct Q+ (
26.'T-Bar Ceiling (Stiucturap & Monocoat " " 75: Dry Chemical _�
27.- Frame and F.lashing - a� 76. Dry Staniipipe -'- --
�"28. Lathing,&Siding_' �''r� �� J " ' � 77., FIXEDSYSTEM�FINAL � .S�-���b ��
29. Insulation • � � �• � 7$,- FIRE PREV. FINAL �� ' � ' ���I � �(1; '�
�.
30. Drywall_Nailih9 _'' � ,-, ° ' i , ' :HEALTH�DEPT,. REQUIREMENT
�37. Plaster Brown Coat� �. .��+ < ' �. +, � 7g, FINAL INSPECTION �
32:. Electrical Power Meter�F.inal '`� 80._FOOD CERTIFICATE ISSUED_ �.
" �' .
_33;-Pinal Electric � n . •' x Notes: � = � -. . `T
- 34: Final Heating & Ai'r. Conditioning �J � , �� `' � . ' �- .
_ �. � . .
35r Final Gas Pipe�Test . -' � , - - � _ - -
�36.Hoodor.CanopY *� _. ..y - _ ~_ . -
� -r -
37.. Final Factory Fireplace- � - � - - � .
-�38: Final Plumbing . _ � . � • ' ' �
i•
39.,Water Service-Final .. ' � , . . _ _ �
.��40. Gas Service�Final • ' ' � � - � '
41. Solar pomesticFinal- .. � - - ,
42. Backflow Prevencer. � " • � -� ` - *
. - --
43. Backflow irrigation ' , " : . �
- 44. Landscape Irrigation SYstem ' "' �� _ . �
45. Sound Attenuation -.'.. ' _ . _ _.. . _. - _ - �_ . - .
46. �Handicap Regulations �-� � _ - � - � � '
47: FINAL STRUCTURE & BUfLDING ` ' - ,- '
. , ,
48: FINAL PLANNING - � ' ^ �'� - : -
49: Electric Release to`Edison _ '' . _ , _ ' ' .
� 50: Gas Release to Southem California Gas Co • - � � �
51. CERTIFICATEOFOCCUPANCY ^ ' - '
No. Oate
Pfl61FCT ROOflESS: S S S ANTON HL ' � � ux�T: 5 0 0
� owxea'sxnrne: SECURITY PACIFIC NATIONAL
nooxess: 555 ANTON ,C.M,
957-1489 '
:FRNCNIENOINEEH: IT]'1'�'Rt•]i ' HE6.NO.:C1'�0,4Z ,
�DOflE33: S PARK PLA2A � uxrt:
IRVINE CA 92714 '
"L vEpMitTEF: WESTERN SUPPLY CO: ( 213 ) 633-0511
�oneess: 15510 ILLINOIS AV
PARAMOUNT CA 90723 `
110ENSEO CONTMCTOB OECIAMTION: I herehy attirm ttut I am 4cenuA unAer Dmvitions of CtwO�e� 9(�ommencinq with Section
7000) ol OiWsion 3 of t�e Business antl Pmlessions COAe, an0 my license is in NII lorce antl ettect. .
cirruc.:046021 , $TpT�uc.:291621 §�36
Oate: U— ��-9Q_ Sipnature:��� '
WOHIfEHS' COMPEN&1TION OECUMTION: I �ereEy aRirm t�at 1 have a certifiwte ol consent m sNbinsure or a certifiwte ot Workers'
Compensation Insurance, or a certifieA copy thereal (Section 3800. LaO. C). � �
voucrxo.: HWC194625 exr. oen: O1 /O1 /91
COMPeNY: HIGHLANDS •
t] Cetlified caOY is hereby turnishetl. � fzrtitied copY �s �0 ' � the ciry Builainp Division. ' �
IDate: y' ` � d �v Applicant:
E%EMPfION FlIOM VlOBKEIIS' COMPEN&TIOX OELUMTION: (Ilus sectim �ree0 not 6e canplete0 ii tAe pemdt is /a one hunOreG �f100) a Iess�.
1 certity ihat in the Oertormance af the work lor wNch t�is permit is iSsueO. I s�all not employ any perwn in any manner so as ro become
su0le�t �o the Workers' ComDensation Laws ol Califomia.
Oate: SipnaNre: '
� NOTICE: II, atler maAinp Nis Eedaratkn, you shoul0 bewme sWject ro i�e Woders' Compenution�praNsbns oi Ne labor '
Cotle, you must fartAwith compty witA such proNsions or t�is permit shall Ca tleeme0 revoked. �„-
CON57NUCTION 1FN01NG IGENCY: 1 herehy affirm tlut there is a canstruction IenAinA agency lor I�e Derlormance ot t�e waM1 for .
w�ich [his permit Is isSueA (Section 3W7, Civ. C). '
lFNOEP:
AO�flESS: ' ' .. • • -
, , .
OWNFR BUILOEP OECWWTION: 1 Aereby atlirtn ihat I am exempt fmm t�e Convacrors' State License Law Por Ne followinB reason
(Section 7031.5 Business an0 Pmlesslonal COCe: My ciry al county wAich repuires a permil ro canstruct, alter, improve, Oemolish, or
repair any StmcWm, ptlor to its issuance, also reQuires Ihe aDa�n[ for suc� ce�mit to /ile a sipned statemem that hrls�e is IicenSeE
pursuant to ihe D�avisions ol ihe Contrzcmrs' State License Law (CAapter 9(commencinp with Section 7000) of Uivision 3 al ��e Business
an0 Prolessions CaOe) or tAat hdshe is exempt t�erefrom an0 t�e Dasis lor t�e allepeG exempUon. My violation ol Section 7031.5 by
any aDDlicant for a Oermit SuDlects t�e apDlicanl to a cNil cenalry ol nat more tAan INe �unOreO dollars (5500). ' � �
I, az owner of Ne property or rtry employees vnU xayes as [�elr sole comDensatlon, will tlo�t�e work, anA the
❑ simcture is not intenUeA ar atle�eA for sale (Secimn 704A, Busineu an0 Professlonal Code: The Contractors' State License Law
tloes not appty Io an owner ol a property wAo �WIQ4 or imDroves tAereon, �nO wlw Coes suc� work himsell/turself or t�mup�
his ar Aer own amDloyees, proNEeC tAat sucA imD�'ements aa not intentle0 ar attere0 lor sale. If, however Ihe 6uiltllnp o�
impmvement is SOIE vnt�in one year oi com0�etion, the awner will Iwve ihe Uurtlen ol pmNnp AUstro EiE not hui10 or im0�ove
for t�e purpose of sale). , � � �
I, as owner af t�e proceM. am exclusivery cantractinp wit� IicenseG coniractors Io conslmci I�0 pmlect (Section 7044, Business .
'❑ anC Pr01¢SSi0n5 COEl: The ConVactors' State Licerise law Oces not apDA' �o an mmer al properry who Dw105 or improves I�ereon
anU wno comraas lor sucn pmlects with a camraaoqs) licensa pursuant Io tne Comractars' State License Law). I am awara
I�al Drool bf �heir WorkCr's Compensatian insurance shoul0 Ge prwl0e0 la me. •
� 1 am exempt unOer Sectlan: B. 8 P. C. � ' � •
lor t�is reason: '
Date: ' Owner.
1 do heaby certiry ihat I am aware ol anC untlersWntl the requirements ol Calitomia Heatt� anE Safety Cotle Sec[ions 25505, 25533, and
25534 and t�at I or any fumre Guilainq occupant wilUwill nat (circle one) neeU to comO�Y ��� sai0 state codes anA tAe requirements for a
permit for wnstruction ar mo0ifiwtion imm IM Fir Uualiry Manaqement USMct. NesiOenlial constmcdon ap0licatians are exempt Imm
these Drovisions. �
Oa�e: , AppliwnC
I hareUy certiry tAat 1 Aave aad tAis apDliwtion antl state t�at t�e aEove infarmatlon is conect. 1 aAree to compty with all ciry and coun�y
or0inances anE state laxs relatin0 �a builEinA ��NCbn anE IxreP/ am�or¢e reD�ntatives af t�is dry lo enter upon the abovamentioned
praDerry forinspeciian vuryoses. � ��
Uala: ( —� � � ( � Sipnature:
Drivei s ticense or Sociai Secunry • '
1641-48 W�ite—BuilOing; Grean—CoOe Enlorcement; Canary—Applican�; Pink—Ravenue: Goldenroa—Assesaor
CITY OF COSTA MESA — BUILDING PERMIT PEAM NO: P 046897,•
PERMIT NO; P• 046897 . PLAN CHECK NO: N . GOVT: N SUPP: N `
CONSTRUCTION TYPE: I-FR ' PERMIT TYPE: pLU , PURPOSE; OTH
.70B DESCRIPTION ; 42325F OFFICE'T,I, , SQ FT: , •
CLAIM VALUE; CALC—VALUE: ' GROUP OCC: H-2 /
, , ,
COMMENTS; RE: B46695 PAIMARY BLDG. PERMIT. ��
x��e�exx*�x�e�**�rx*x*�x**xr*rr�*�r**�**�r*�x�*�r��e*�r+��r*r�r*�**x*�**�xw�***�*****x*xx**
' 2 O N I N GS ERTEB�AUCIXRSE'M E N T S. • ,'
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAA;. 'FT ' IN ' FRNT; ET IN REAR:' . FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT ' IN RGHT: - FT IN�
PARKING REQ • PROV; PARCEL; 41050104 2NE: REF NO: •
PLANNING NtSTES> • •
�. _
1f 1k if 3f 1f MlFif 1f 1kfF lkft iF if 1f ft iflklF iF iF iF iF it 1f iF k M iF iF if if k if 1f �f iflf !f fklflk �F iF iE iF if if iFM if if if 1Fif if 1f ikikif iE iF 1F if iF iflf ikff iflf iF 1F M if iF if iF
D,E V E L O P M E N T S E R V I C E S.� R E Q U I R E M E N T S
20NING APPROVED BY .r. DATE:
BUILDING APPROVED BY C '-' DATEi
APPLICATION ISSUED HY: � DATE: �� O
1k it 1t M it it N ff iflf 1f If if iF M �F iF M iF iF iF iF ��F'iFiF'i�{F!t �k iF M iF if 1k MlFif7���3f'k iF
k�FMNMifMMMlFMifitifMitifMiFiFifMMMitkifkMMlfltiFifkifkiFitlfik ikMifMikMiEiflFitlfkitikMMkMMMKiFMiFiFiFiEifMM%ifikMfkiE
LEGALIZATION:N 'F E E' S U M M A R Y' STRUCTUAAL SEGMENTdN
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/RES GRADING
PERMIT 4.00
25i' � �SMIP/NON—RES
PLAN
ZSSUE FEE ' 3.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL, PAID ` 'DUE
TOTALS=---> . 4.00 3.00 • 0,00 7.00 � 7,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 7.00 OVER/SHORT:. .00
BLDG PMT PLDMBING ELECTAZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
, ''t , ' %.,0� ' '
MMMlFiFiFlFMlFikif itiFif 1tklfMikkififMlfif kifMitkiflfikifiFiFlklfiklFkikilikMMlkif!lMikkit%M1fkMklFltifff itlFifiFififiFMiElfMkMiFMM
I N D I V I D U A L E E fi B R E A K D O W N
�TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1' SINK BAR : 2,00 2,00
PLU ,1 WATE{t AEATER AND/OR VENT 2,00 2.00
" END OF FEES
e
. 01 DOG58234—OU�58284 T �T
DATE� 0</10/90 TIflE: l5:53
7.�a
/�
�
CONST�UCTI AND PLANNING � PO � SPA
Date Inspector Date Inspector
.�APPROVALS Permit # .. � APPROVALS Permit # �
„ � ✓
1. Temporary Electrical Servrx br Pote7� ' . 52.. Pool & Equipment Location
� �
�,VSoil P�Un��rpSl�. N^ �x �+ 53. Steel Reinforcement �
� v�i3.^-Electr.icat�Co2fdUR�Otility-Undrgmd�.-'4 � 54. Forms ,�
�'v�s� ��p'�' ;, �`�
. lectr`i'� i drgrnd:^ � �v 55. Electrical Bonding �
� S�.CSteel �Reinfarcerrro� v X 56. Rough Plumbing & Pressure Test o
.+ c.
S�i• Flectrical'�7FE��rnd. ,.�'�„ ' 57. APPROVALTOCOVER�GUNITE y
p;`J�.� ootings y yH u 58. Electrical Conduit�Undrgrnd. o
y'�'. Foundatio� n� ^ �'l� 59. Gas Pipe, O Undrgmd., Test /�
r /
�. Water Pipe�Un cg'md. ( y. _ 60. Backwash Lines, P�Trap, O Undrgmd. � `
1�. Structural Floor System �� � ��:�� . 61. APPROVAL TO DECK ���
�1 . Property Se r Lir�& HO�se,Conrr4otion � 62. Backwash & Receptor�Final ��/ �
�, P8. Sewer Cap a� o� m�� y 63. Heater & Vent-Final
� 13. Roof Drains,�',,,� y 64. Plumbing Sys[em • Final
14. Rough Plumbirg ' n!{d L 65. Electrical-Final
75. Rough ETectrit�l-Conduit 66.- Solar System-Final
16. Rough ettri iring 67. Fencing & Access ApP�oval
�17�. Rough Wiring �Sr.gn 68. APPROVED FOR PLASTERING
18. Rough Electriw!-T Bar Ceilin9 69. POOL/SPA SYSTEMS FINAL
' 79. Rou�qh F�eating & Air Conditionin FIRT Q�PT. �QUIR�MENT
,: n nx � cr� ca +� r�: m.t� * c ��-. r r ac
20.`'�io h ctqfY gplace i St+' x� * S�-+ tr� # PPR�Vq�,�jH�.C.Pe�it #� ��Q
I 21F-Ou�s,i�Structu7�x i.... �-iS x S ��-'** -70. �dergro�r�Hy�ro x -
�. T x � s�-, � r �-, n* � . � *
o x � x � . �
22.SDu, ., nt tir�M i {� k C ,E CJ F„� * 71. Product�f'Jping d 6ys C3�9i1
23.•Ga9-Piper-�R h& Xest � mT [;S * C�7 T m O# # 72, Undergro�� FI fi� x F
24�todcf Fi,� in ITiK I FE ••F i> ,n,, C #�K tD r�C �-l�
i"�� 9 ••x B; x 7 cC �-,k *••73nUndergrn .Srorpq�Tank�Gas ❑Oil
' 25. Rooi StIDathing m� �S � 7� � C7 >^� * 74�Overhead Hydr � �
26`jT-� CG{ling (Str.`$�iural) &�coat x m � m� * 75PDry Che al �` �"� N3
ro � O >. O* * � � F� � �-,K
27aFrar�e amd Flashivg pcC� x c � b7x x 76. Dry Stan �e Fm� * �� x�'
�
:� c� �7Kz � x'E ••x * c� !-y k
FS' La,t�Sin�Sidin�* ��F O * � * 77.yFIXED�L�E�uy}sjl�Al*,...� n mT
29. Insulattbh E� S •• R�� �/�1 � 78EF�RE PREV. FI' � x> ��'Q
�
�30. Drywal(��ailing �* �' V � ��' ~'N k�E LT �Tn EPT" R�QUIRE NT
[s�" �# rr I 'N F I �K S O iv O. ..'� ' CT' x �
031. Plaster &o�nhl Cd�t* S i t�'R' * I ` s 79� FINAL IfQ$BECTI�N * V 4
i p_ i... r^� c
,E'"¢.32�lectric�al Pnwer m]�tcnr-Fanal� � N ���` * O�OOD CERTIFI�ATE IS��JEDi.,,i d
�� � . � •, ..
E33 irml Eieccrp> * cn i K � i; * Not�s: ti tim * y O Gm
m �'
.-Na,3d�fin�JHeaci`J&`��`�tAFmicion,F,qS m �> '�� H Si F¢ « s �a
�35� inal Gas Pipe-Tect* p� •• �c r, � * So GN * Ft*�
�• �i
�36�y�.{o�y or CanoPY •* � � �`� a * (1 '�' # i C10 * tr'
'J S'u'z i: Cl 10.'[z7 '� .X �,i '# p'7 7C0 #lT7 n:
.-� v � �
"y37.•Fina Factory Fireplace� i FF nl x - x x # N
v r
+-y$. Fi,,g� Plumbing �' � � �" y� /�, /,�� � * S �"'� '� 'm"
S '"7 x n � o W Tp V�' =Fic � r� � #
. Wa er Service�Fina g i �; q I 1� * � `` *�
[:.
[`k10. Gas Service�Final ��T1 '4lT':�' S � m I � OV pN �
k (� E-� =. t*7 :K �k F• O i .K K
f,41. Solar pomesticFin�l '`"
m x x t* "7o c� x x a
e-
� 42JBackflow Preventer� N x^ ; � �% � � � F x O .-i ,
k N irtf+ k: r� x Y IT; [+70 K e-�
43. Backflow Ir�igatior* �, * q ** ir Y [� ••
R'a4. Landsc e�iqacidfi Svsce m[J G * m o d ox * ru cv ^�J * r� o0
s # Q * X $ E O: x S F
�45�ound �{+,tte�uatio� .�~y� .. M * M �7 p7�: z a� a� �2 • E�+t7 x
C46.•Man„dicap Fegulatidhs *+ O ��, � � �* � S bo � �
�,47'FIfs�L STR�CTU�E & Blr1'LDING � F., (! � i p, * F
48�INAL PLANNIN(i. � FF' � N ���,� � N S '+�� Q
a49�,EleG}ric Rel�se to�dison � * I �, * •n *
x50�C'ia�Release to Southem Calii Gas Co � ! I��� '� � v• om * O ••
� x x�• s �c n * n� co
��51. CEFi71FICATE OF«OCCUPANCY ' � r"' "`�
, No. Date
�i
�ooness: 555 ANTON BL �"�T 500
rsx�Me: SECURITY PACZFIC NATIONAL
nooeess: 555 ANTON ,C.M,
957-1489
�fltN/ENOINEER: I �•]'j'ERN I ' REO.NO.: C 1"] � 4 2 '
/ �ooaess: 5 PARK PLAZA ' uert:
IRVINE CA 92714
PERMiTTEE: AIA CONDITIONING CO. INC (818).244-6571
� ROOflE88: 6ZES SAN FERNANDO R� "
GLENDALE CA 91201
LILENSED CONTMC70R DEC4MTION: I MreOy alfirm Wt I am &enSeE unEer Orovislons ol Ctwpter 9(commendnp wltA Sec�ion
7000) of �ivision 3 0l tne Busireu anC Protesslans COEe, m0 my license is in lull torce anE etleq. ,
cmuc.:014403 sT�huc.:120 cuss: C-20
Data: Lr=( $'_% O aiure: — � '
WONKEPS' CO�Mr�5PyE�NaS�RTIOpN� OEGCrUt�Ne�ITcIOpNqy: I Aere rm ttat I luve a certil'inte ol cansent to � or a certifiwte of WOMers
PoLICY N0� W C. 9�� /� 1 L 1/ b me�eo� secu� ��ae. �1� / O 1/ 9 0
coMv�xr: TRANSPORTATION
�� CeNtieE coDY a AueM tumislied. � Ce�OfiM cqp�5'll¢0 wiN Ua tltY &dlLinp Uirision. .
/ /�/
Dare: � —� $ � � Mol'��n�� /'� � a A��a� �
IXEMFfION FflOM VAHIRfl3' COMffNS1TI0N OEUAWj�ON: (Ilis uc6m m�0 not be mmpkte0 il � a one MmEreE (f100� a less�.
I certity ttut in the perlormance ol tM xork lar xluch Uus pemiit a iSwM. I 51ia0 not empby any person in any manner sa az ro hecome
sublati Io I�e Workere' CompenSalion Laws ol Calitomla. ,
Oaie: 5'rynature: � �
NOTICE: If, aher madnp tlus Eedaniion, you SMuIE Decome mEject Io Ne Wohers' Compensation provisims al t�e LaOor
CoEe. you must foMiAU amply w¢� such prmssions m tlis perrtit slull Oe EeemeC rewkeE.
CONSTNUCTION LENOINO �GENLY: I �ereN/ aKrm ttut Nem is a cantructipi lefMinp a0e�y lor the Detlormance of IAe vrork lar
wNc� IN5 Dermii a iswe0 (5ection 3097. Gv. CI. . , ,
IENDER:
AODflE58:
OWXER BUILOEN DECUMTIOM: 1 �ereDy aflirm ttat I am ezempt hom tlie Cmtrapors' State License law lor t�e tallowinp reawn
(Section 7631.5 Businm antl Prolesslonal CaOe: My cRy ol munry wAkO repuUes a pemtit m co�wct, alter„imOrove, Eemolish, or
repair a�ry sWctum. D�� �o its issuance. also reQums t�e aDd�� �or sucA permit ta file a sipne0 5tattrtrent ttat IWs�e is ficenseA
pursuant �o IAe D��� of tAe Contnctors State lkense Uw (CMpter 9(commentinp vnN Section 7000) ol ONivm 3 of ihe Business
antl Pmfassians CoOe) or ttwt lirJs�e h e�emp� t�eretrom anU Iha Cavs lor IM alle0� ewompiion. My NOWtion ol Section 7031.5 Uy
a(ry appUunt lar � pemut wDIKu ttw appGcant ro a dvil penally ol rot more tlun live I�unEreO Cdlars (S5W). ' � .
I. u axmr of ttro properry or my empIoyetl wIN wayR at Neir sde compensalion, vnT Eo Ne work. aM Itie
❑ slructum is not IntenOeE or otlere0 tor sale (Sec'uon 704a, Buvneu anE Pmlessianal CoAe: T�e Cantractors Suta license Law
Goes not aDON ro an wmer al a property wAo Mn1Es or improves t�ereon. an0 wM Eas 5uU work Mmull/hersell or t�roup�
�is ar �er own employeas, D��eO Itut wc� improvemenis are nat inten0e0 or attere0 Por sale. II. �owever tM �uA01n0 ar
"� ImD�ovemant is sol0 withn orre year ol mmpletion, tlre owner xiA tuw Uro DurUm ol provinp �dstie AiE not DwIG or imOrove
�or me ourpose a� sa�e1. �
I, az owner ol tna Droperty, am exUuvveN contracWp wltA YanseE contncton to mnswn tne projmt (SecUon 70CJ, Business
❑ an0 Pralessipn CoEe: The Cmirutars State Liceize Law �a rot apply �o an a.mar ol proporty wM buuEs a improves ttierean �
antl wM wmrac6 Im wc� prqects vAt� a contrattoqs) Ikense W�� �o t�e Contractars' &ute Ucense Law1. I am aware
tAat Drool al t�eir Worker'S Compenution irnuraxe StqulE De DrandeA to me.
� I am exempt un0er Sectbn: B. 8 P. C.
lar Inis mason:
Date: Ovmer.
I Oo �ereGy certity Rut I am awaro ol an0 uMerstartl the reQuiremenis ol Calilamia Health anG Salery CoOe Sections 25505, 25533, and
2553C ana tnat I or any lutura DuilEinp acupant wilUwlll nm (drtla one) neeO to camply xitn saiE state catles and t�e reQuirements lor a
permit lor mnstruciwn or mo0ilicmion Imm t�a Nr aliry Manapement Oairict. Residential canstruc6on aDP�iwtions aa eaemD� �mm
Inese provbions. ' . �
� I here6y certity thai I haro reaE th5 ap0liraUon anU state tlut Ue aEove Nlormation is mrtect. I apree la wmpry witn all pry anU caunry
�I orEinances anG Staie laws relaiinp Io builNnp consirudian a rt y aNM�ize represenUtiveS of I�¢ dry m enter upon I�e aGare-mentloneA
�� proOeM �or inspection Ourposes.
Date: y�% 4^ qD 5 ature:
Oriver's License ar Saial Secunty M:
t8s1-aB W�ila—BuilEinp; Green—COCe Enlorcamem: Cenary—ApplicanL Pink—Ravenue; GolOenroE—Assessor
�
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: M 047015
PERMIT NO: M 047015 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: I—FR SPAINK PERMIT TYPE: MEC . PUAPOSE:.OTH
,JOB DESCRIPTION : 4232SF OFFICE T.I. SQ FT;
� �
CLAIM VALUE: CALC—VALUE: '� GROUP OCC: B-2 /
COMMENTS: RE: B46695 PRIMARY HLDG. PERMIT. �'
*�rx �r**xxx***��t*+t**r***�r�r*****�r*�*�r�e**x ****�r+r*�wr******�*****w«�+t+r***��r�r�c***�e***�
Z O N I N G R E Q U I R E M E N T S �
� S E T B A C K S '
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAA: FT IN
LEFT: FT 'IN AGHT: FT IN LEFT: FT IN RGHT: FT IN
PAAKING REQ• PROV:, PARCEL; 41050104 ZNE: REF NO;
PLANNING N6TES>
7 ..
.�t �k ik iF ik if if 3k if iklf 1E if ik M 1! if iF ik 1F 1F 1k k k if 1f 1k i! iF M iE if iF k ik M ik 1E if !F iF if if iF ik i! 1k it M!E 1F M if iE iFlk 1F if 1f fF iF iF fk if ik if iE iE iE iE iF fklE if if ik iE ik if
• D E V E L O P M E N T S E R �1�I C E S R E Q U I R E M E N T S �
;.ZONING APPROVED HY �'`' DATE;
BUILDING APPROVED BY : " '� DATE:
'APPLICATION ISSUED HY• � ������ DATE: �/--���0
!if 1! it 1F 1t it ik it �F iE if it M k �t k if iFlt �f 1f 1f ik it k 1f ik if ik 1E 1k 1f��iFit it
lfikiEiFitftitMM�tikifikifiFikitif�fMitlkihftftffiflfMlFitifitititkMMififkif 1tlfiFkifkMlFifMlfifkMkifikiFifklk1k1f1tltiFMiFifkititkitiE
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
' HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES ' GRADING
PERMIT 54,50 ,
• 25i SMIP/NON—RES
PLAN ' •
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 54.50 15.00 0,00 69.50 69.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 69,50 OVER/SHORT; ,00
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CkIECK
69.50
�FiFitdtiFiF�kiEitikiElFiflfiFkkikMiEifMifiFitlEiflfMMiFMif�fMMifMMKMNMMMitifMiFiEiFkM�flfMifiFiFififMiFitM�FkMikififKMiEiFiEiFi4iF
I N D I V;I D U A L F E E B R E A K D O W N
TYPE � QTY , D E S C R�I P T I O N UNIT COST TOTAL COST
MEC �1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9,00 9.00
MEC 7 VAV BOX 6.50 45.50
� END OF FEES '
� .
01 00058931-00058931 Tl7 T 69.50
DATE: 04/18/90 TIflE: 09:22
� '
� ' - �
_� �""CONcrHUCTION AND PIANNING ' . � � POOL' & SPA -
�-'"^APPROVALS Permit # YDate Inspector AppROVALS Permit # Date Insp�ector
�•
1. Temporary Electrical ServYce or Pole�.., � 52. Pool & Equipment Location ,�.
42_�Soil P.ipe-Und`grnd �' C��� -�5 � 53. Steel Reinforcement `,
.. , . .�,
��(3^�ElectricalCondLitUtilitY�Undrgmd�,C �• 54. Forms ' -'�
'-'`�4±Electlical,Conduft��Undrgrnd -�^ � 55. Electrical Bonding
i-.S � �•:•.. �. •+F
S;5:Steel<ReinfOrce'mertt r F•x, ' • 56. Rough Plumbing & Pressure Test v
. � 8`,Electrical•UFER�(3md. � S 57. APPROVALTOCOVER•GUNITE a
_,.7,.` Footings :y �;�x � y 58. Electrical Cqndui[�Undrgrnd. -
��8 Foundatio-ajr' �S � � 59. Gas Pipe, � Undrgrnd., Test �
.i
.9. Wa[er Pipe�Undrgind. • 60. Backwash Lines, P•Trap, O Undrgrnd. �
� t0. Structural FloorX�ystem � 61. APPROVALTO�DECK.
U. Property Se�e�Lin� & House�Connection ��� � 62. Backwash & ReceptorFinal
1�2. Sewer Cap �,n o; o a, 63. Heater & Vent-Final
.�
13. Roof Orains� ;� '
�y..., 64. Plumbing System - Final
14. Rough Plumbiag ^ � 65. Electrical-Final
15. Rough Electripl�Conduit 66. Solar SYstem-Final
16. Rough ElectriiiWiring 67. Fencing & Access Approval �
^17. Rough Wiring�Sign 68. APPROVED FOR PLASTERING
18. Rough Electrice.l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioriing - FI,QE pEPT. REQUIREMENT
r- � n n r � m ti c ,. �] C �.a G t-� K + � i
20"..'Rough Factoty �r�place � S�_�'„ x� * s � ,Q'5.��. y ;.APPROVFALS,.�y�Ver"mit # * ' `''m
21t-Du"cts, iri Stiucture i �•• •• �-5 k " :� �� >": 70. �Underg7ouna Hydro �
G. IS t� cY � <�-a A' f /lY:a a R. r-�.0 '.] Y
22.-Du^c.ts, Vent`atin`�` � n� r S <� a t� m< � ^'
��' � �-� *p ¢ -� F,�..�77• Product7PipingLl�as �Oil
V C� � I • . �
23: {'ias-Pipe,Rarigh &xTest i c�S >;r C ¢ O'c x�+7Z, Undergro'und FFush ` c�
� � -. �- � , -. i� �.
24zRoof Fi'amiri �nx t-•p� ..�., r � .., - y. * . ,o �•• .�tr r�
" 9 ••M � y: j s�,,� ,; : 73.; Undergrrid. Storage Tank;,0 Gas O�Oii"
_ 25. Rnof Sheathing�r C v� k. � f'� � roK K� 74,1 Overhead Hydr�� Y
26�T�8ar Ceilin (St[�icturall & onocoat 3` � W �`'" ''' � ''� ""� �
9 �:: �� �; �„ ��: k 75�• Dry Chemical �,_,7 ,� ,_F,.,,,Q
27+,Frame and FlasMn� '� � �" � " " `�' �
9 pc�a � c^ m 4* 76. Dry Starxlpipe c-�m * ¢
J Y'I i T
:''28. La'LGing-& Siding.� G° ��x ^ �� ••�' X 7j � FIXED S STEM%FINAL � ^ °"�
�, s �»: o..H � * ..' .. t«, �'� .� � n �x
J! '.y � �l .. �r • . .i m
V � � 76� FIRE PREV. FIN'AL ''
29. Insulation <.* S •• K ' ' i �_ �C �-7
T30. Dr;ywall�NailingY;, H � � F„ ' � �-�� � � �HEALTFI�DEPZ.'REQUIREMENT
1 S m z , s ' , r r � � r+ . v taJ�.
j31. Plaster Brown Coak S t^?T � � y�� ti'•79. FINAL INSP.ECTtON r:
�32C'Electrical Po`wer'Meter-Finaf �' �� � ( � �` � ''80T' FOOD CERTIF�ICATE ISSUED �
7 .i [a�. (J � W .a:i' ] lJ
� � T � * d7 i 4 x ��� � i� 'M s � Notes: '�7 `7r:, X ^] �J �� '.n
33^Final Elect x
'�34;�Final Heatin`j &7�i� Conditioriing n *r I ' �: i S; S C:x'� k S , O
�f �-+ _. �:n [Cl T rJ -� �x x (7 :� i F<L:a� * 5
�x >
, 35�Fin'al Gas P"-pe�Te'sF G: .. K;.., � �.! �' x: ` `�o ti;:n� x� F- r
p36.�Hdod or CanoPY '' �` �;•.y 4 x r I '�',i: *.: � � o �- a r ca T
� C .� C� � C. [*: --, � � � �'�. � T yir [T: T. O y :q >. [�7
--37Uf�'1 x �--� .a :J # lT1
Final Factory Fireplace.� � p-.E. v t� I jl "�F Sv --� i ^�
9
'38. Final Plumbing * �n� - `" * ^ i!� W � ^ S'•'^ ^' "'� *'� �
c m �� rt? � � k I '-� � Y': `� �J'L� O S �: 'l
"39. Water Service-Fina� ' ` '�: � - � ' : •"" ". + -' �
E � k S. I �,,: . i '1• r' �.
?140. Gas Service-Final �[T) Kn'^ 5 � lT � * Oa� v�N *� v
t n c.:. r y: I I � x F• o S_ ��S
i r S Cl •• .�' :J� [K X Cr�J r-� s
41. Solar pomesticFi al
� --i u �. , [-^. A� v r * [*' , o ^ T * X �
142. Backflow Preventer� U + I � 'x x c'G 5f-� s• C3 �-.
. �r n: n.-.�-: � F. �� 1: [; [*]O s' F
43. Backflow Irygation �SS � 3* `� � � w��
.r X. G ! :. .. 1 / :1. ('.
?!44. Landscape Irtigation System'y��� Q 1' c'1 O O O* *•: n+ N �C� �' cv o0
+� �r,�... -i a: Q efY i� :) � r.i :]C. .�' S F
�• n > !--� G F [�" � F_ i^ F x 3: i i .r �r :u ."4: �
�45` Sound .Attenuation .y ,. .. �• �r, � M+ e � � C+ � . F.�, c
i4fi.•Handicap Reguiacions r� v �� *�*'C � S l7o S + �
c �r � � .i hc f� m (1 R
47�FINAL STR�UCTU�RE & BUPLDING � �,., I '� :* y �' '�' S �, * _
l. +� � % 1 .
48�FINAL PLANNING �:-F x cu ' �- h:. i; [*i rt = F
� � +� I �', r� � � n� x rt
^� ti �.0 cc u =
�49TElectric Release to�Edison � fi i '
s � , � l i ,��r�� � :, c �� . .�
�50sGas)Release to Southern Califomia GasCo K � i C' y: * i: i-, t� • oi=; r O ••
r � c'c� L k k C :]o ft M: LV D^_�
�!51.CERTIFICATEOFOCCUPANCY �* x�:- �� mc .. , v�
No Da[e
PPOJECT ADONESS T j S 5 ANTON BL
.OWNEB'SNAME: $ANK OF AMERICA
aooeess: ?0 N RAYMOND 3RD
PASADENA
uN�T: 5 THFL
818-578-7700
RPCN/ENGINEEH: RWH ARCH NEG.NO.: C 1 S O I 3
nooxess: 22072 CAMINNO VINO uxrt:
LAGUNA HILLS CA 92653
PEpmiTTEE: COMPETITION ELECTRIC ( 818 ) 331-5807
aooness: 635 STEPHORA
COVINA CA 91724
UCENSEO CONTNACTOP UECIABATION: I hereby affirm ihat I am licensed untler Dmvisions of C�aD�er 9(commencing with Sec�ion
7000� of �ivision 3 of ihe Business antl Pmiessions Code. a license is in lulliorce an0 elfect.
cirruc.: Q0�56905 sTnTeuc.:51684 u�ss: C—�
Dale: ( � �_-� Signalure: r—�'
WOPREBS' COMPENSpTION oECIANRTION: I AereUy af ve a cenificate ol conseni b self-insure or a cehi�icate oI Warkers'
ComDensatmn I s a c, r d c r�ilie py �hereoi (Seclion 3800. LaC.
ooucrxo.: ����4�1�—�� EXP.ORTE: L�UI/93
'OMPANY: STATE FUND
J Certitied coOY is here�y Iumishe0. � Ceni�ied ca�ylSYil vnt� l�e city BuilJinA Division.
�
Oate: � ��`�- � � � M�Iica P ' �
E%EMPiION FflOM WOflREBS' COMPENSATION OECUM ' sec�ion netd no1 Ee compk�e0 il Ne perrri� is fa one hundred (5100� or leu�.
I cehify Iha� in the perlormance o� t�e work far wAich this permit is issued, I sAall nai employ any person in any manner 5o as la become
suble�� ro the Workers' Compensaiion Laws al Calilomia. �
Da�e: - SignaWre:
NOTICE: II. aiter making ihis Aeclaration, you should Oecome su�le�� �o t�e Workers' Compensation provisions o1.I�e Labar
COAe. you must fonAwilA comply with such pmvisions or inis De�mii shall ee tleemeA revokeA. /�,
CONSTBOLTION LENUING �GENCV: I Aere�y affirm that there is a consimction IenOing agency lor the peAormance ai lhe woM1 for
which Ihis Dermit is issuetl (Section 3097. Civ. C�. ��
IFNDEfl: �" J�
FDOHESS:
/
,
,
OWNFB BUILDEB OECIABRtION: I herehy affirm I�al I am exempt imm the Coniractors' State License Law for ihe fallowing reason
(Seqion 7031.5 Business anA Pmlessional Cotle: Fny ciry of caunty whith requires a permit to consiNct, aller. impmve, tlemolisn, ar
repair any stmcture. prio� lo ils issuance, also requires �he ap0licani br 5uch permi� �a file a sipne0 slatemeni Ihal heR�e is Iicense0
pursuani �o ihe pmvisions oi Ihe Contraclors' State License Law (Chapier 9(wmmencing vni� Stttion 70W) al 0ivision 3 0l ��e Busines5
anA Pmlession5 CoOe) or Ihat he/s�e is e�empi ihereimm and �he basis lor Ihe allege0 exemp�ian. Any violatian o� Section 7031.5 Oy
any applicant Ior a Oe�mit subiecis the apDlicantto a civil penalty of not more ihan live AunUreO tlollars (55001.
I. as owner af ihe pwpeny or my employees vnih wages as their sole camDensation, will Eo ihe work, an0 tAe
� stmcmre is not inlen0etl or offereE lor sale (Section 7044. Business anE Professional Code: The Coniracrors' S�ate License Law
does not apvty to an owner of a proDe�Y who builds or improves ihereon, and who Joes such work �imself/herself or ihmuAh
his or her own employees. provi0etl I�al SUch imD�ovemen�5 are n0� int¢ntl¢d or oflerea �or Sale. I�, hOwever Ihe OUiltlinp Or
impmvement is solE within one year of completion. ihe owner vnll have Ihe burEen of proving he/she Aitl not Uuittl ar improve
lor ��e purpose of sale�.
I.as owneroithe propeny.am exclusively conVaciing wi�� IicenseJ conirac�ors�o cons�mdihe pmleci(Section 7044, BuSiness
❑ antl Pmiesvons Coee: The Coniractors' S�a�e LitenSe Law does n0i apply l0 an ownef 0� propeM who OmltlS or impmves t�Cr¢on
antl who wniracis for sucn Droiecis wi�h a coniractoqs) license pursuant to Ine Cantracmrs' State License Law). I am aware
ihat pmof ot ineir Worker's Compensation insumnce shoWA be pmvi0etl Io me.
� I am exemp� untler Semion'. B. 8 P. C.
lor Ihls reason:
Oate: Ownec
I tlo hereby cenify tha� I am aware oi ana untlerslanA ihe repuiremenis oi Califomia Heallh an0 Safety CoUe Sections 25505, 25533, antl
25534 and Iha� I or any �uture buil0inp occupan� will/will not (circle one) neetl �o comply wilh saiE state coJes antl �he reduirements tor a
permit for conslmction or moaification Imm Ine Air Oualiry Managemenl �isiricl. Nesitlential constmciion applications are exemD� ��om
Ihese provisi0n5.
Daie:
Applicanf.
I hereby cer�irythatl have reatlihis applica�ion antl state�hatthe aDove intormationis correcL I aAree lo comply wi�� allciiy antl counry
or0inancesantls�alelawsrelatingio�uildinpcons�mclionana authorizerepresema�iuesolthiscirytoemeruponihea6ove-mentione0
pmpetly �orinspection !p�urpases.
�a�e: �� I v � r�� Signa�ure'.
�nver'S L¢ense or Social Securi�y p: [�]
tfiat-46 White—Buildmg: Green—Gode EnlorcemenC Canary—Appli<anf, Plnk—Revenue: Goltlenrotl—Assessor
CI'fY OF COSTA MESA — HUILDING P^aRMIT
PERMIT NO; E: 059019 PLAN CHECK NO; N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE; ELE
JOB DESCRIPTION ; 25005F OFFICE T.I.
CLAIM VALUE: CALC—VALUE:
PERM NO; E U5y01y
GOVT; N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: B-2 /
COMMENTS; RE; B59018 PRIMARY BLUG, PERMIT,
x*�*�x�*�*xxx��*xx*x x x�-*u���-u�x*x�r�*����r� ��*��*�**��*xxft**��,r*�r�xx**�r�ir�rt�r�r**it*ft�r
Z O N I N G R E Q U I R E M E N T S
S E T H A C K 5
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: cT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ • PROV; PARCEL; 41050104 ZNE; REF NO;
PLAUNING N(5T'ES�
i �
if if 1E-1E iF �lE iElE 1E iE 1E if iE if iE-If iF If lE iflE 1E iEiF iElh IE �1E i(� �7E i4 i(� iF iF i(� iE i(� iE ih fFiE iE 3E dE i!� i(� 3E 3F 3E * iE iE 1E iE IE if 1F �F if if �1F fEiElf if iE ik Ik ft tf if iE ic iE if If iE # iE
D E V E L O P M E N T 5 E��R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY , t: DATE;
HUILDING APPRdVEll BY : ,' DATE;
APPLZCATION ISSUEI� HY; � DATE• /O f
�EiE3fiFiEifi(�iFiEikltiEiFj(�itiEiEiEkiFiEiE . r�r�t � f t t y it iFifiFifjE3FiEiE1EiE r r iE�k
ifiE�EiEiFiE-lEi(�iEfE!(•iEi(�1hiE3ElEi(�iEiEiF1E14iEiE�f-iEi(�ik�itikiEik3(-iF��lE�1EiEiFjEiE fEiE1F 3EjEiE�f�FX�ifiE�lElfifiE3FjE1F3EiFifiEiEjEiFifiEic3'r#�iFiFif3'riC
LEGALIZATION:N F E E S U, M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTR`IC MECHANIC FIRE SMIP/RES GRADING
PERMIT 17;75
.- 50� SMIP/NON—RES
PLAN ' '
ISSUE FEE Y5,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 17.75 15,00 ',• C 0,00 32,75 32,/5 .00
�, �
REVENUE DIVISION TOTALS--> COLLECTED; 32,75 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMSP/TOT GRAIJING PLAN—CHECK
32,75
;: �
IE 1E it iF 1E it �t iE 1E iFlF iF-)f iF iE fE fE iFlE iE iE it iF ik # iElF iFiFlF iF 1F 1f iF iF�ih iE iF iF iEiE iE iF iE iE �F �E 1f iE iF iE 3FlE iE dF ik iF iE 3!� iE 9f %� iF ib fE iF iE 3E !k ff iE 1f'fi iFiE iF if iE iF
I N D I V I D U A�P.. F � E B R E A K D O W N
TYPE
ELE
ELE
QTY D E S C R I P T I O N;.
3 FIXTURES LIGHT7NG.• 1 ST 20
6 RECEPT/OfJTLET - 1 ST 20
1 SUH—PANEL
ENIi.- OF FEES
UNIT COST
EA. , 75
11,�0
TOTAL COST
2,25
a.so
1 1 , � �
CONSTRUCTION AND PLANNING - P( & SPA -
APPROVA�S Permit # - Date Inspector pppROVALS Permit # Date Inspector
� 1. Temporary Electrical Servic� or Pole - 52. Pool & Equipment Location
� 2. Soil Pipe-Undrgrnd. . - 53. Steel'Reinforcement
3. Electrical Conduit UtititV-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. Pootings �-` 58. Etectrical Conduit•Undrgrnd. .
8. Foundation . '� 59. Gas Pipe, O Undrgrnd., Test �
8. Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap, O Undr9md.
10. Structural Floor System ' ' 61. APPROVAL TO DECK
7 t. Property Sewer Line & House ConneMion ; 62. Backwash & Receptor�Fina�
72. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains �� � 64. Plum6ing System � Final
14. Rough Plumbing 65. Electrical�Final
15. Rough Electrical-Conduit 6�. Iar System-Pinal
16. Rough Electric Wiring ��C�� _ 07. Fencing & Access ApProval
'sc7
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heaiing & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Pactory Fireplace APPROVAIS � Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducis, Venti�ating - � 71. Product Pipinq OGas OOiI
23. Gas Pipe�Rough & Tes[ � 72. Underground Flush
24: Roof Framing 73. Under9rnd. Stora9e Tank O Gas O OII �
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical
27. frame and Flashin9 - 76. Dry Standpipe
28. Lathing & Siding . _. �� 77. FIXED SYSTEM FINAL
:
29. Insulation � I � 7$, FIRE PREV. FINAL
30. Drywall Nailing � � � •i HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' I ' � 79. FINAL INSPECTION
32. Electrical Power Meter-Pinal � (���• 0. FOOD CERTIfICATE ISSUED
33. Final Electric _ ...6-('� � ' Notes: �[r�0-3 /!�,// �.aG}�jC r-r
i !'-iiwlq
34. Final Heating& Air Conditioning �I _ j iy��� i'1._ �r"n �n����/j
/•t� T�
35. Final Gas Pipe�Test ! � �
r
36. Hood or Canopy . � i', .
37. Final Faciory Firepiace � �
38. Final Plumbin9 � .
39. Water Service-Final
40. Gas Service�Final .
47. Solar pomesticPinal � �
I
42. Backflow Preventer � � �
43. Backflow Irrigation
44. Landscape irriqation System , . .
45. Sound Attenuation�
� 46. Handicap Regulations
47�. FINAL STRUCTURE & BUILDWG i '!��' � �
�, 48. FINAL PLANNING ' �� � �
- 49, Electric Release to Edison "
50. Gas Release to Southem California Gas Co � � �,
51. CERTIFICATE OF OCCUPANCY
No. Date
Pfl0.1ECTRDOflESS, cj�}J AiVTON BL uxiT: STHFL
OWNEfl'S NAME: BANK OF AMERICA
ADDPESS: �O N RAYMOND 3RD
PASADENA
818-578-7700
ANCHIENGINEEN: RWH ARCH NEG.NO.: C 1 1 O% 3
nooness: 2Z072 CAMINNO VINO uxir:
LAG[INA HI.LLS CA 92653
PEflMITTEE: �MSTRONG CONSTRUCTION ( 818 ) 96%-8001
nooness: 929 SPRING MEADOW DR
WEST COVINA CA 91791
LICENSEO CONTBRCTOP OECLABAiION: I hereby alfirm �hai I am licensed unAer pmvisions o� C�apier 9(commencinA with Sec�ion
7000) a� Oivision 3 of the Business antl Protessions Code, an m'cense is'n lull lorce antl ettem.
cirr uc.: 5 6 '71 sTaTe uc.: 4 3 4 0 4'�� s: B— —
�ate: .__� Signature: i,���
WOHNEflS' OMP SRTION DECLABRTIDN: I hereDy abirm �hai I have a certi�itaf¢ ol ton5en[ Io Sel � Sure or a tetli�ita�e ot Workers'
Compensation Wp e c ietl copy t�ereoi (Semion 3800, Lab.
POLICY NO.: �`� �4 �� �� EXP. UAiE: S I O S� 9 3
;�nrnxr: REPUHLIC I,�N{DEM
., Ceh� py i herehy fumishetl. L`] Ceriilietl copy is ile h �Ae pl Builtling iv sion.
� �✓.
Oa�e: � Npplicani: �; �^�
EXEMPTION FNOM WOBREBS' COMVENSATION DECLABATIO . Rhis seclian neetl nm �e completeA if �he permit i r one hundred��$700) or less).
I ce�ily Ihal in �he pedormance o� ihe work for whicA ihis permit is i55ueU, I shall not employ any Oenon in any mannerl5o as �o hecome
su�le�� �o ��e Workers' Compensa�ion laws of Cali�omia.
f
�a�e: Signamre-
NOTICE: It, after making Ihis Oeclaration, you shoul0 become subjeci lo Ihe Workers' Campensation pmvisionsLaYdhe La6or
Coae, you mu5i fotlhwi�h camply with such pmvisions or this Oermi[ shall be tleemed revoked. S'
CONSTBUCTION LEN�ING pGENCY: I �ereby altirm ihat ihere is a constmction IenOing agency tor ihe pedormance oYthe work for
which �his Dermi� is i=suetl (Section 3097. Civ. C�.
LENOEfl: �
AUONESS:
OWNEB BWIUEP UECIAFAiION: I hereby aflirm ��a� I am exempt �rom the ConVactors' S�a�e License Law for Ihe lollowing reason
�Section 7031.5 Business ana Professianal Code: Any ciry o� counry which requires a De�mii �o cons�mct, al�er, impmve, demolish, or
repair any slmcture, prior to ils issuance, alsa r¢Quires the applicani for such permit lo tile a 5igne0 s�a�ement tha� he/she is licensetl
pursuani to Ne provisfons ol Ihe ConVac�ars' State License Law (COapter 9(commencing with Section 7000) of Oivision 3 of tAe Business
an0 Professions Code) ar t�ai he/she is exemD� ��e�e��om antl the basis for t�e alleged exemption. Any violation of Section 70.3L5 by
any applicam lor a permit subjects ��e aD0licantlo a civil penalry ol not more than live �unOred tlollars (5500�.
I, as owner of ihe DmDe�y or my employees with wages as their sole comDensation, will tlo ihe work, antl the
� simcwre is not intenAeA or ofiered for sale (Section 70d4, Business antl Prolessional Code: The Conlracrors' State License Law
Ooes not apply to an owner o� a pmperty who 6uilas or improves ihereon, antl w�o does such work himseltlAerull or lhroupll
his or her own employees. Dmvidea Ihat such impmvements are not intentleC or oflerea tor sale. I( Aowever �he �uilUing or
improvemen� is sold within one year o� comDlelio0. �he owner vnll have Ihe burEen of pmvinA he/she Uia noi bui10 or improve
for Ihe purpose ol sale). .
I, as ownerolt�e propeny.am exclusively coniracting withlicense0 coniracbrs�o canstmctihe prolect(Section 70ad, Business
❑ andPwiessionsGoOe: T�eCOniraClOrs S�a�eLicenselawdoesno�apply�oanownerofO�opetlywhobwltlsorimpmve5ihereon
antl who wmracis for sucA pmlects with a coniracmr�s)license pursuant to the Coniracrors' State License Law),I am aware
�hal D�oo� of Iheir Worker'S Compensa�ion insurance shoultl be pmvitleA �a me.
� I am exemp� under Sec�ion: B. 8 P. C.
for Ihis reason:
Date: Owner
I Oa here0y cenily Iha� 1 am aware af anA untlerslantl Ihe requiremenls al Califomia Heal�h antl Sately Cade Sections 25505, 25533, and
25534 ana Ihal I or any fuNre 6uileing occupanl wilVwill nol (circle one� neetl �o comply wilh SaiA 5�aie coUes anU ihe requiremenis �or a
permn lor conslmc�ion or modilication tmm I�e Air Oualily Managemen� Oistric�. flesiJemial cons�mction applica�ions are exemp� fmm
me:e o�o��:�o�s.
Oa�e: AOPlicant:
I here�y cer�ily ihal I have reaU Ihis aDPlication antl Slate �hal lhe a0o � formaji is correcL 1 agree Io compty wit� all ciry antl county
ordinancesandsla�elawsrelatinglobuiltlingconslmclionantlherey ihoizerQre nlalives iscirytoenlerupontAea�ove�menlioneU
pmpetly lori'Speclio purpo5¢s
Oale'. / � Signature:
oriver's �irense o� soc�ai seadry q:
1641-a6 White—Builtlma�, Green—Cotle EnlarcemenC Canary—AoplicanC Plnk—Revenue; GOIGenrod—Assessor
CITY OF COSTA MESA — HUILDING PERMIT PERM U; t5�53Ui—I
PERMIT NO; H 059018 PLAN CHECK NO; 0278$-92 L U��, N^5 YY; I
CONSTRUCTION T'YPE; IFR SP PERMIT TYPE; STR PURPOSE: A1.1'
JOB DESCRIPTION ; 2500SF OF'FICE T.I. SQ FT: 7,500
CLAZM VALUE; 20,000,00 CALC—VALUE: 45,650,00 GROUP OCC; B-2 /
COMMENTS; T,I. 2500SF OF 4977SF SUITE
**�**x��***�*�**��*****�r*�***���r�***�**�***�***x*x*��t��t��*x�**�*�**�t**�****�****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING kEQ• PROV; PARCEI,; 4105U109 '`LNE; PDC REF' NO;
PLANNING N(ST'ES> INTERIOR AL�/rT.ERATION FOR AN OFFICE WITHIN AN OFFICE BU�LDING
i % ri11
'K' i%if i�"K"]i' i�' i�' *'K' i�"�i' i%�{' �' �"it * * �' * *'K' *"k"�{' �'K' �' �%'K"K"�'��"x"K-'� �' �{' *'� if'K' *' if j%'if'�'K'if �' i�"�i"K")% �' �F ii �"K' i�"if i�' i�' *' * �' � �' �' it' j%'� i%i�"X"�i' �('
D E V E L O P M E N��T S E}'R V I C E S R E Q U I R E M E N","t S /
ZONING APPROVED BY , ��.g _�vE DATE; �'.s9/�//`2
BUILDING APPROVED BY : "V%C�
APPLICATION ISSUED BY: S '
aEihiEi(iflhlfl4iF3FiEiEiEiElflPififlFiEifiE .. . � � . � .
iE iE 1E 3E if jE �k iE �f iE iE ik �E iE iE if iE iE iE iE i(� �E 3f iE iE iF 1E iFiE iF iE iF ff 1E lE!!� if iE iE 1F iE 3Fl�
LEGALI2ATION;N F E E� S U M
BLDG PMT PLUMBZNG ELECTRIC ME
PERMIT 388.50
PLAN 252.53 �_
I5SUE FEE
BUILDING—DIV—> �PERMIT ISSUE PLAN—CHECK
TOTALS----> 398.09 0,00 252.53
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
388.50
/
1E iF iE iE 1f if iF iF iE 1k iE iE �E
TYPE
SFC
SFC
i
(
1
I N D I V I D U A L F'E E i
� i.'
QTY D E S C R I P T I,�O N ,.',, '
r i,
2500 OFF—INT, ALTER TYP,E,I 3I"F.R.
2500 E U—ALT COMM, SPR�INKL�.R'..SYS �
2500 E�U—ALT COMM, AIk COND.'
END;',OF FEES
�j
F
�
R Y ,•
I' 1�
DATE; 7./r�/i2
c�
DATE; % �� %
�kiE�ltlt�kiEit�t�E e� �E
3f �E if iF if 3E iE-)f ie if%ltjE 3E if iE ie 3E 1E iE # aF
ST'RUCTDRAL SEGMENT:Y
" trIRE SMIP/RE5 �RADING
,`�.. �� SMIP/NON—R S,
, .��`, 9.59
�'`�'TO�'AL', PAID DUE
`650.62 650,62 .00
3�8,49 OVER/SHORT; 00
R,{,i'S�MIP91AT09 GRADING PLAN—CHECK
� **���r**�***�***+��*****�*�**#�**
�JEtiA K,D O W N
�,J UNIT COST TOTAL COST
—AVER•z � 17,24 43,100,U0
—A�IErR � ,33 825,00
—A�R �j .69 1,725,00
�
^ ��
�.
� Q1 `i��7��4,u-:,''i..�t,ih� _'
, t . DATE: n`_,, i _ '� :
_�"
I1_ l:. �_ i
'?S.L-
CONSTRUCTION AND PLANNING P� & SPA
�- Dace Inspector Date Inspector
APPROVALS Permit�P APPROVALS Permit#
t. Temporary Electrical Service oiPole . 52. Pool & Eduipment Location -
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement .-
3. Electricai Conduit Utility-Und[grnd. • 54. Forms
` 4. Electriwl Conduit-Undrgrnd. 55. ElecVical Bond�ng
5. �Steel Reinfo�cement 56. Rough Plumbing & Pressure Test
6. Electrical UFEfl Grnd. 57. APPROVAL TO COVEA�GUNITE
J. Footings � - 58. Electrical Conduit•Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test •
9. Water Pipe-Undrgrnd. � � I 60. Backwash Lines, P�Trap, O Undrgmd. '
10. Structural Fioor System �� ' 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final
12. Sewer Cap . 63. Heater & Vent-Final �
73. Roof Drains ' 64. Plumbing System � Final �
74. Rough Piumbing �� ' 65. Electrical�Final i,
i.-:
15. Rough Electrical-Conduit ' 66. Solar System-Final
16. Rough Electric Wiring Q��'�L B L�' 67. Fencing & Access ApProval
` I�P •
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPRpVALS -- Permit #
27. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventitating � 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test 72, Underground Flush -. ��
24. Roof Framing - 73. Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing '74. Overhead Hydro
26. T�Bar Ceiling (SvucturaQ & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry S[andpipe
28. Lathing & Siding �- � � 77. FIXED SYSTEM FINAL
29. Insulation I � � 78. FIRE PREV. FINAL �
30. Drywall Nailing ��?.� �� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � I �� . I 79. FINAL INSPECTION
32. Eiectrical Power Meter�Final � � i 80. FOOD CERTIFICATE ISSUEO
33. Final Electric �,.q=I �,�y�lotes: � � �f � /
R•� . �J'��1.�-��"'-`-f,.� ,7' �/ s.��
34. Final Heating & Air Conditioning I 'j '
� l�
35. Final Gas Pipe-Test �
! ���b
36. Hood or Canopy , �
37. Final Factory Fireplace � '
38. Final Plum6ing .- � �
39. Water Service-Final � � /�G� Q�� �. / !L S. � -
L z `�O �
40. Gas Service-Finai � � ��� �d,�,Y � G_ �
I ��/v
41. Solar pomestirFinal ' .
� i
42. 8ackflow Preventer ( � {
43. Backflow Irrigation .
44. Landscape Irrigation SYst¢m �
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �„�y �H�� '
48�. fINALPLANNING �. .
49. Electric Release to Edison � -
50. Gas Release to Southem California Gas Co '� ,� �, ^;
51. CERTIPICATE OF OCCUPANCY
No. Data
Applicant to itll in all spaces except lhoze wilhin �eavy borCer Iinas anE sign all appropriate tleclaralions.
CITY OF COSTA MESA CON�T`TR UCT ON�,j JP_E IT PERMIT NO. jRACT NO. � LOT NO. UNIT NO.
Project Address r5� ANT(1 L-� �5�1'� ���_
�Applicant's Mailing Adtlress /J
Owner's Name L7�phone
Address ��" � '—
�i
�,1rchlEng. License No.
Address
/
Contractor's Nam )'P1hone
Addresslmailing��s� a �- t�+ Se iYy ��...s t
Ciry License No. b�i 2�'f�
I.ICENSED CONTRACTOR DECLARATION
I �ereby affirm that 1 am licensetl untler provisions of Charter 9(commencing
with Section 7000) ol Oivislon 3 Of [he Bu5ine55 antl Vro(essions CotlG, antl
my Iicense is In u rorce ana ettect. � 3 O 1,
u�e��g�U- ���"�' c.x�
Dat�V SI9 t . L�r L}�_
''�0.KER5'COMPENSATION DECLARATION
creby attirm that I have a terti(icale of consent to selt-Insure or a<ertifiwte
� Workers' Compensalion Insurance, or a Vc I Q�pqy f e�� ,yt,($�S(ip] �
3800, �ab. C. � G7 � C 6� 1 CKr}��7
PolicY N�(�� 0 ComPan 4a !�'l��s �J
�Certi/ietl copy is hereby (urnishetl. �,n
Ceyj itietl copy tl etl with the dt ing `� slon
Date %�b�� � APPlicant��a�,X' f�6i���
E%EMPTION FROM WORKERS' COMPENSATION DECLARATIO— NT—
(Thissection neetl not be completetl il the permit is for one huntlretl (E300) or
IessJ.'
I certi�y Iha[ in the Oe�b�mance ot Ihe wo�k fOr which this p¢rm�t i5 ISSuetl, I
snall not employ any oerson In any manner so as to become subject to the
Workers' CompanSaUon Laws ot Callfornia.
Date Signature
NOTICE: If, after making thi5 tleclaration, you shoultl become subject to the
Workers' Compen5ation provisions of the Labor Cotle, you must forthwith
comply wi[h suGh p�ovlslons o� thls pGrmit Shdll b¢ tleemetl revokEtl.
CONSTRUCTION LENDING AGENCV
1 he�eby aftlrm that there Is a consVuction lenain9 a9ency for the performance
of the work for which this permlt Is issuetl (Section 3097 Civ. C.)
Lentler's Name
LentleYs ACtlress -
OWf�ER BUILDER DECLARATION
I hereby affirm lhal I am exemp[ from the Contractor's License Law (or the �
followin9 reason (Section 7031.5 Business antl Pro(essional Cotle: Any ci[y or
counly wnich �¢quir¢s a pe�mit to ConStrutt, altl�, Improva, tlemoli5h Or repai�
any sl�ucture, prlOr to Its IsSuanC¢, dlzo �equi�es the apD���ant tor such pe�mit
� lile a signetl ztalement thdt he/She Is Iicensetl pur5udnt to the p�ovi5ionz ot
Con(ractor'z License Law (Chapter 9,(mmmencing witn Section ]000) of
ision 3 01 [he Businass antl Protesswns Cotle) or that be/she is exempt
uefrom ane the basis for [ne allegetl exemption. Any violation of Section
7031.5 by any applicant for a permit subjects Iha aOP���ant to a civil
�enalty of not more [han five huntlretl tlollars (5500).
I, d5 Owne� of the 0/operty Or my employe¢5 with wages as th¢i� sole
compensation, will Co [he work, anC [he structure iz not Intentletl or of(eretl
for sale (Settion �046, Business antl Oroteszional Cotle: The Contractor'S
Llcense Law does not apply to an owner of a property who Ouiltls or improves
lhereOn, an0 who tlolS such work himselt/herself o� [��oug� his or he� own
employees, proviGea that such improvements are not Intentletl or offeretl tor
sale. If, however, the builtlin9 or improvement is soltl within one year of com-
pletion, the owner will have the burtlen of proving he/she AIC not builtl or Im-
p�ova lorthe purpOSe Ofsale).
❑ I, as owner oi lh¢ property, am excluTively Contracting with IicenSetl con-
��� tractors to con5truct tne project (Section 7064, Business antl Professlons Cotle:
' T�e Con[ractor's LI<en5e l.aw does not apply to an owner ot prop¢rry who
builtls or improvez tnereon. antl who contracts for suth oroie<Is with a ron-
tractor(s1 hcens¢ pursuant ro 2ne Conttactor�s Licanse Law). I am aware Ihat
proof o( Iheir Wo�ker's Compensatfon insurdnc¢ shoul0 bE provitletl to me,
❑ I am exempt untler Section B. & P. C. for this reason
Date - Owner
I here�y certHy tM1at I have reatl tbls appliwtlon antl state that the above
IMormatron rs correct. I agree to comD�Y �+��h all tlty antl county orGinances
an0 Stat¢ IawS reldting [O builtling conSVuction, antl he�eby autho�Ize repre-
sentative5 of Uty oP upon the above-mentionetl property (or
Inspettion es. �Q _��
Signature n � < Dat
Drivers' License or 55 � � �
TVPE OF CONSTRUCTION I_I NEWb.LI ADD QSl ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WOR�15E0�_F BLDG.
TVPEOFPENMIT GR DIN FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION $Q.FT. r OCCUPAN1G1V `
CONSTRVCTIONTVPE �Z�M'�VALUATION$ �-tC-FT6'L1
ZONE GRADING CU. VDS. ACRES
Remarks: � j
Bar Sink
Backflow Preventer
Backflow Irriga[ion
Bathtuhs
Clarifiers "
Dishurasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
Interceptor5
Kitchen Sink ✓
Lavatories
P-Trap
Roof Dreins
Showers
Service Sink
Sewer Cap
Sewer Connecti<
Solar Collectors
'$olar Tank •
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash �
Laundry Treys r�
9
A.P. �f` �-
S Main
E
T Front
8 Rear
A
C Right
K , ,_
Ping. Ref. #
Planning Notes:
FEES Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generetor �0.5 KW C
a
Reinspection Fee $15 laue Fee _ $ 3
Duct - Under Ground
Duct - Struc[urel
Duct - Ventilating
Exhaust System � Multiple
Firepl/Fact. Blt. ICBO �k
Heating System & Ductin
00.100,000 BTU O 100,000
Reinspec[ion Fae I $15
0865-46, rev. 5/88 White - Builtling; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor
Hood or Typel ❑
Canopy Typell ❑
iQf Qf8S100 $ySLCT
0.100,OOOBTU ❑100,000BTU
System Repair/Alteration
Fire Dampers
Registers
laue Fea
$ 3
Fee
�a
� Zone
Accessory Building:
EIECTRICAL
Transformer 0 15-50 K
❑ 50+KW
Merer ❑up to t00amps
Meter �over1�00amps
Sub Pan �
Mot ❑0.1 HP�dY.-'�
aSolar �9-15'HP Oli
Microwave • f
Pole Light �
Range
Standing Sections
5 KW Trash Compactor
$15 luue Fee
DEVELOPMENTSERVICESR
Zoning.Approved By
Buildin9 APProved BY _
$ 3
N
1
N
G
R
E
�
M
T
$.
" SUMMARV OF�F.,�jES � rt c-•
BUILDING PERMIT $ � S7S�+� SMIP $ (g r� .
�PLAN CHECK $ PERMIT
Pl.UM81NG $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
.�ELECTRICAL 5 GRADING $
PLANCHECK 50% $ MICROFILM $ �.�}[y,
'.MECHANICAL $ TOTAL FEE $ �
� PLAN CHECK 25% $ '
Oi OJ0320EG-OD032087 Fs.�"�- -'� ,;
DATE: OS/03/S9 TInE: 0'/::�
CORiSTRUL�`f'ION AND PLANNING PC & SPA
APPROVALS Permit # Date ' Inspector qppRO�/ALS Permit # Date Inspector
1.,-Temporary Electrical Service or Pole � . 52. Pool & Equipment Location
� 2. Soil Pipe-Undrgmd; .`� _ 53. Steel Reinforcement r'
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
4:. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding '. ,�
5.. Steel Reinforcement % 56. Rough Plumbing & Pressure Tesi
i
6. Elec4rical UFER Grnd. �� 57. APPROVAL TO COVER-GUNITE '_
.
7. �Footings ' .- � . ? ' 58. Electrical Conduit-Undrgrnd. -
8. Foundation � i � • f-I � 59. Gas Pipe, O Undrgmd., Test �
�9. Water Pipe-Undrgrnd: . � -� 60. Backwash Lines, P-Trap, O Undrgrnd.
10.'Structural Floor System '' 61. APPROVAL TO DECK
- , .
� 1�7:- Property Sewer Line,& House Connection�'` ' � 62. Backwash & Receptor-Final
12. �Sewer Cap , - "` � " 63. Heater & Vent-Final
73.'Roof Drains . �` ,_ 64. Plumbing System-Final
14. Rough Plumbing '� �� 65. Electrical-Final ' '
15. Rough Electrical-Conduit .66. Solar System-Final
16�. Rough Eleciric Wiring 67. Fencing & Access Approval
'17: Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18: Rough ElecYrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
i,
20: Rough Factory Fireplace _._,_ APPROVALS Permit #
21. DuCts, in Structure � 70:' Underground Hydro
22' Ducts,Nentilating . _ � ,•71. Product Piping � Gas ❑ Oil �
23. Gas Pipe-R�ugh & Te'9[ �l" �% 72, Underground Flush �
24'. Roof Framing '� �:.. �� 73. Undergrnd.StorageTank OGas ❑Oil�
25. Roof Sheathing `� _ � ./ 74. Overhead Hydro �
26. T-Bar Ceiling (Structuraq &�Monocoat �� Z 75. Dry Chemical
27. Frame and Flashing _� �� �Z� � 76. Dry Standpipe � �
28. lathing &$iding .; �; 77. FIXED SYSTEM FINAL
29. Insulation . ���' �' 78. FIRE PREV. FINAL
30� Drywall Nailing _, - $��' -� HEALTH DEPT. REQUIREMENT .
31? Plaster Brown Coat „ 79. FINAL INSPECTION �
32� Electrical Power Mete�-Final. ' 80. FOOD CERTIFICATE ISSUED
33. Final Electric v � Notes: '� ��'
1�io �B <
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test , ��
o-c` ,.7
.
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumhing � ( � �S
' 39. Water Service-Final �.
40. Gas Service-Final _�
41. Solar pomestic-Final �
42. BackflowPreventerJ �� �
�
43. Backflow Irrigation - ' �
44. Landscape Irrigation System � � �
45. Sound Attenuation �� �
46. Handicap Regulations �� � �
� .
47. FINAL STpUCTURE & BUILDING •
48. Special Reyuirements Completed
49. Electcic Release to Edison �'� �� j
��50. Gas Release to Southern California Gas Co �, ��'! �f
57. CERTIFICqTEOFOCCUPANCY �.�l�• � �'
No. Date
` l. �
Appl(c2nt [O fill In all spacas excapt t�ose within �eavy DorGer lines anE sign all aOPropriate tleclanlions.
CITV OF COSTA MESA CONSTRUCTION PERMIT �FA^^�r nin ranrT Nn i nr Nn �����T ..�.,
Project Address sss�-r %l+ �rQN �LVA
Applicant's Maili�Addreso-��%l 2/��4'.Upv 'U p!`'����/�,�o✓
Owner's Name '� ECU .��! PhonC'��
Address .�ft /�N7aN.%L(/b �UST .�lG..W
Arch/Eng. License No.
Address
AddresslmailinglN��bl ��s*ii'"s.c.vwcioe N ow"�"•'
City License No. _ �� ��3
LICENSED CONTRACTOR DECLARATION
1 her¢Oy aHirm thal I am licansotl untler provisions of Charter 9(commanCin9
wi[h 5ection 7000) Of Divi510n 3 Of Ihe Business antl Profes51on5 CotlO, antl
my license is in (ull torte antl eltect.
Licenze Class � License No �ZD�OpG
A Da[e � ��� Si9naty e
V� '�JRKER$' COMPENSATIO�fJ DB LARATION
� ere�y alfirm that I have a certi(icate of consent to sel(-insure or a mrtlficate
`.. Worken' Compensation Insurance, or a certifietl copy thereof (SecUon
3800, Lab. C.)
� Policy No2(�0���� Company ��r��
� �Certifietl copy Is nereby fumishea.
Certi/letl to 75 �iletl with the ci ui in Di Ion.
P 9 f�� �/
Date ���% APPIi t� �' /`-�� �"���
EXEMVTION FROM WORKE 'COINPENSATION DECLARA I�
(Thissection neetl not be completee'if the permit is for one huntlretl (5100) or
iess).
I ceriify ihat in the performance oi Ihe work !or whlch this perm�t is Issuetl I
snall not employ any person in any manne� so as to become subject to t�e
Workers' Compensation Laws of California.
Date 99nature
, NOTICE: It, atter making this tleclaratlon, You s�oultl become subject to lhe
Workers' Compensation provislons of the Labor Cotle, you must (orthwith
comply with such Orovlsions or this permit shall be tleemetl ravoketl.
CONSTRUCTION LENDING AGENCV
1 hereby aHirm tha[ there is a construction lentling a9ency tor the pertormance
ot the wOrk iOr whicn this permit is is5u¢tl (Section 309] Civ. C.)
Lentler's Name
Lender's Aaaress
OWNER BUILUER DECLARATION
I hereby aHirm l�at I am ¢xempt irom the Contraclor'S Llc¢nse L.aw tor the
followin9 reason (Settion 7031.5 Business antl Professlonal Cotle: Any clty or
munty whlcn requir¢5 a pe�mil t0 const�uct, alt¢r, Imp�ove, tlemOliSh o� �epai�
any structure, prior to its issuance, also requires [he applicant for such Oermit
r� file a signetl statement that he/she is licensetl oursuant to the orovlsions ot
Contractor's Licenze Law (Chapter 9(commencin9 witn Section ]000) of
Sion 3 of the Bu5ine55 antl Pro(e55iot15 Cotle) Or that Ile/stle is 8x¢ntpt
.elrom ana tne basis for the alle9etl exemption. Any violation of Section
7031.5 by any applicant for a permit subje<Is the applican[ to a civil
�enalty of not more tnan (ive huntlretl tlollars (E500).
1, as owner o( [he property or my employees with wa9e5 as thelr sole
compensation, will tlo the work, antl the structure is not in[entletl or offereC
lor sale (Section 7044, Business ana Professional Cotle: The Con[ractor'S
LicenS¢ Law tloes not appty to an owner of a property who bulitls or improves
lher20n, antl wh0 Uoes Zuch wo�k himzelf/herself or througn hi5 or h0� own
employee5, providetl tha[ such improvements are not intentletl or oHeretl for
sale. H, however, the Dulltling or improvement Is soltl within one year ot com-
pl¢tion, ihe owner will have the burtlen of proving M1e/she tlitl not bui1G or Im-
�rove tortne purpose oi sale).
I, a5 Owne/ 01 th¢ property, am exClusivety Cont�acting with lit¢n58tl Con-
[ractor5 to construtt the proj¢ct ($ection 7044, Buziness antl Profe55lon5 COtla:
The ConVa<[or's License !aw tloes not apply to an owner of property who
builtls m imowves thereon. antl who contracts �or such oroiects witn a r.on-
tractor(tl Lcense pursuani to me CantractoYs License Law). I am awara thac
proot o� lM1eir Worker'S COmpensation insurance ShOultl be prOvltletl to me.
❑ I am exempi untler Section B. & P. C. for this reason
Date � Owner
I hereby certity that 1 have reatl this apP�ication antl state that the above
Informatlon iz <orrect. 1 agree to comply with all tity antl county ortlinances
an0 state law -sa ting to bwltling constructlon, antl hereby authorize repre-
Sentativ05 this nty to ente� on the above-m¢ntiOnetl p�opeRy fo�
Inspect Pu� as .
Signat ra � «^' Dates���
Orivers' se or � �
0865-4fi, rev. 5/88
TYPE OF CONSTRUCTION U NEW LJ ADD L2Q ALTERATION IJ REPAI R
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. T���u%� 7%E�
TVPE OF PERMIT LJ GRADING LI FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAI ❑ PLUMBING �MECHANICAL
❑ OTHER
PROJECT DESCRIPTION S�.F7. oCCUaArvCV—
CONSTRVCTION TVPE VALUATION $
ZONE GRA�INGCU.YDS. ACRES—
Remarks: ���� G`�/�.�/i� �j �-����JS
Batktlow Preventer
Backflow Irrigation
Bathmbs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Servic.e Outlets
Interceptors
Kitchen Sink �
Lavamries
P-Trep
Roof Drains
Showers
Service Sink
Sewer Cap
Sewer Connectian
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
M.Y. iP
S Main Build
E
T Front
B Rear
A
C Right
K Lett
S
Ping. Ref. #
Accessory Building:
Parking Req./Provided
6vS�'il
2one
ELECTRICAL
FEES Automatic Washer � Transformer ❑ 15-50 KW
ConstructionPoleSub. � 50+KW
Cooking Unit Me[er ❑up to 100 amps
_. Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Electric Sub Panel
Fa� Motors�Pi HP �1Y.-8
F.A.U. Int.Solar 09-15 HP �16-15+
' Fixtures Microwave
Device Baxes Pole Light
Outlets Range
Switches Sign
Garbage Disposal Standing Sections
Generator �0.5 KW �5-15 KW Trash Compactor
Reinspection Fea � $15 � � Isue Fae � $ 3
Duct- Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System � Multiple
Firepl/Fact BIL ICBO #
Heating System & Ducting
❑6100;000 BTU 0700,000
Reinspection Fee � $75
White - guiltlin9: Canary - Applicant; Pink - AccounUng; Goltlenroa - Assessor
Hood or" Type I ❑
Canopy Type II ❑
Refrigeration System
❑aioo,000eru ❑ioo,000sT
System Repair/Alteration
FireDampers �(,SOEa
Registers
Issue Fee
Fea �$15 � � Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
Buildinp APProved By _
FEES
$ 3
O
N
I
N
G
R
E
�
M
T
S.
SUMAiARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERG�' P.C. $
ELECTRICAL 5 GRADING $
PLANCHECK 50% $ MICROFILM $ p�r ��
MECHANICAL $ �� TOTALFEE $ �
PLAN CHECK 25% $
oi 0003z4ao-aoo32440 TO�' ?�,OQ
ORTE: OS/03/S9 TIflE: i1�14
. . .r � 1�` V f .,. .. . :. . Y y . ..� . + . . t . .
.. . '�,ti\ , ,..
CONSTRUCTION AND PLANNING - �� PC & SPA
APPROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector
i. Tempo��ry Ele trical Service or Pole � l 52. Pool & Equipment Location
2. Soil Pipe-Undrg�nd. ''� � i` 53. Steel Reinforcement ,
r ,� i.
3.)Elect�ical Conduii Utillty-Undrgrnd. 54. Forms :�
d. Ele,ctiical Conduit-Uniirgrnd. . � 55. Electrical Bonding �
i
�'5� Stee� Reinforcemeni '�� ,' 56. Rough Plumbing & Pressure Test ' �
6� Electrical UFER�Grnd.� 57. APPROVALTO COVER-GUNITE . .'
7.`'�Footings ' �,. ' 58. Electrical Conduit-Undrgrnd. , �
n. �
8. �Foundation '- /, �� � � 59. Gas Pipe, O Undrgrnd., Test �
i. r
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 �
� '. � ' i � '
73. RooflDrains ' �. 64. Plumbing System - Final � ';
i
14. Rough Plumbing% ' 65. Electrical-Final ��
15. Rough Electrical-Conduit � 66. Solar System-Final
`6: Rough Electric Wiring 67. Fencing & Access Approval
�17' Rough Wiring Sign �''� 68. APPROVED FOR PLASTERING
� ��
1�8� Rough Electrical-T Bar Ceil,ing�' 69. POOUSPA SYSTEMS FINAL
1�9� Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20�� Rough Factory Fireplace ..��� APPROVALS Permit#
21�. Ducts, in:Structure �� , 70. Underground Hydro
22. Ducts, Uentilating ��� 71. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test ' i 72. Underground Flush /� ��1 '
24. Roof Framing , � 73. Undergrnd. Storage Tank O Gas ❑ Oil �
25. Roof Sheathing � � 74. Overhead Hydro
26. T-Bar,Ceiling (Structural) & Monocoat 75. Dry Chemical
27. � rame°�and F�shing �� 76. Dry Standpipe
s
28. Lathing"& Siding � �t� 77. FIXED SYSTEM FINAL
29. Insulaiion �_� � 78. FIRE PREV. FINAL �� S
30: Drywsll�Nailing � HEALTH DEPT. REQUIREMENT .. %�
.i.
�31. Plaster�Brown Coat � 79. FINAL INSPECTION �
n
32, Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �/ �' y ��
33. Final EI"ectric Notes: . ^ � '
�
34. Final Heating & Air Conditioning ,j //��Q (�!J �
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 pomestic-Final � �
�^i � �
42. Backflow Preventer �' : � � • •
l
43. Backflow Irrigation f"? �
44. �Landscape Irrigation System
45. Sound Attenuation i'
46. Handicap Regulations=�
47. FINALSTRUCTUR�,&BUILDING
48. Special Requirement'sT��ompleted
49. Electric Release to Edison _ �Zj
50. Gas Release to Southern California Gas Co -'�1 �
51. CERTIFICATE OF OCCUPANCY -�%;
No. Date •""
AOGlicant ta Iill in all spaees exeept those within �eavY Dortler Iinas antl sign all approprlate Goclarations.
cirvoFcoST,aMEsn: CONSTRUCTIONPERMIT
Project Address S,S�i RN% ON A VF ��� �Te 56�
Applicant'sMailingAddrez. 3y�D /RI�IAn/E /1VE NPrIfW
Owner'sName T �FL[.11��hone
Address /� ��'Jr�',s �_�N A-'�E
Arch/Eng. LycuyT�N f �}S$�OC License No.
Address �.�•� z�� QE�� /Q'�/E %n!!.i%/.V
Contractor's Nnma H( /%t/�/�id N LO�../- Phone 21r�S��
Address (mailing) 35�� [�Qv/NC /�'V$
C�cy �ice�se No. !� 3 2%S 7
LICENSED CONTRACTOR DECLARATION
1 M1creby alfirm that I am Iicensetl untlor provislons af Char[er 9(<ommencing
witn 5eclion ]000) 01 Olvlilon 3 of the Busineu antl Professlons CoOe, antl
my license is in full to ce ana eHect. �
License Class � _Licen e o. � S�Z
Date� '�s'�4 Si9nature
'ORKERS'COMPENSATION DECLARATIO
ereby aflirm that I have a certlficate of consent to selNnsure or a certificate
..i Workers' Compensation Insuranca, or a cerU(Ietl topY lhareoT (Sectlon
3800, Lab. C. i
PolicY No. P803918l3 ComPanYr/'�E�.� ��:I�
Certifietl copy Is �ereby (urnishatl.
Certif U co yiz ti�yd ith the tlty Buil g Oivision. Q
ate �'�/d' /��APPlicant_ A6y.�� 6}�,r��'
EXEMPTION FROM WORKERS' COMP NSATION�::ECLARATION
(This sec[ion neetl no[ De completetl if tne permit ii 1ar ane nuntlratl (5300) or
less)
I certify Iha[ in th¢ Pertormant! O� tne wo�k fo� whicn IhiS pe�m�t I5 Issuetl I
, shall not amploy any person In any manner so as to become subject to t�e
Workers' Compensatian Laws o! Calitornla.
Date Si9nature
NOTICE: If, al[er making t�is tleclara[lon, yau shoultl betoma subjecl to the
Workers' Compensation provislons of Ihe Labor Cotla, you must fort�with
tomply wil� sucn provi5ian5 or thi5 0¢rmit Shall DB d00TBtl revoked.
CONSTRUCTION LENDING AGENGV
I h¢reby a/llrm that there is a can5truction 1¢nEin9 dg¢ncy 10r Ih0 pnrfOrmance
of tho work tar which this parmit I5 iisuetl (Sectlon 3097 Civ. C.)
Lentler'S Name
Lenaer's Atlaress
OWNER BUILDER UECLARATION
I hereby dlfirm Iha[ I am Oxompt trom th0 ContrdttOr'S LlcBnse Law IOr the
tollowing reason (Settion 7031.5 Business antl Prol¢isional Cotle: Any clty or
county wblcb reqWres a permit to construtt, alter, ImDrove, tlemolisn ar rapair
any structure, prior to its issuanco, al5o requirns the appllcant for such parmit
�� lile a signetl statement Ihat he/she I5 Iicenmtl pursuanl to the provislons of
> a,Con[ractor's LI<ense L. w(Chapter 9(commencing with Sectlon ]000) of
��ision 3 of tho Business antl Professions Cotle) or that bo/she is oxompt
��'��-.Y>A-ereirom ana tne basis tor tbe alle9otl eaemptlon. AnY ��olatlon of Seetlon
-7031.5 by any applicant for a permlt sub)ects tha aoo����nt to a clvll
�enalty ol not more than tive hunOretl tlollars (E500).
I, a5 ownar o� tho property or my omployoas wllh wa9as as lhelr sole
wmoensation, w711 Oo tno work, antl the slructure I5 not intontletl or oHoretl
for sale (Section 7044, Businnss antl Protesslonal Cotlo: The Contraclor'S
�Icense Law tloes nol apply lo an owner ot a properly wno builtls or Improves
I thereon, ane wno 40¢s such wOrk himSelf/hnrsell or thrOugh hii Or hBr own
I emplOyees, provitletl [Ilat Such ImprovOmOnts ara nOt Intantletl Or Otteletl for
I sale. II, however, the builtling or Improvament Is soltl within one yoar o1 com-
pietlon, the ownor will have the burtlen of proving he/sho tlIE not bWltl or im-
prOve Iorthe pu�po5¢ Olsala).
❑ I, as owner of the O�operty, am exclu5ivery contracting with Ilcensetl con-
tractorsto construcl the projecl (Secllon 7044, BuSinezs antl Profesilons Cotla:
Tbe Contractor4 Licanse Law does not apply to an owner ot proparty who
builtls or imoroves thereon. antl who contracts lor such orolacts wit� a con-
lractor(s bcense pursuan[ to [ne CanVactor•s License l.aw). I am aware Ihac
proof o� tnel� Wo�ker's CompansaHon InSuranGO inoultl be D�ovltletl to me.
L7 I am exempt untler Sectlon B. & P. C. for this reason
Date
I he�eby ce�tify that
information is correct
antl stale lawt relatin
sen[atives of thi5
inspectlon pwpas¢
Signature
Oriverz' License or 55
\ 0865-46, rev. 5/88
— Owner
I have reatl this applicatlon antl state that Ihe above
I aqree to comply with all city antl county artlinances
to builtling construction, antl heraby authorize repre-
� to enter upo Ibe above-mmtlonBG Oroperty for
� Dat! ��S
� .
TYPE OF CONSTRUCTION faU NEW LJ AOD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRADING LJ FOUNDATION U STRUCTURAI
❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT OESCRIPTION 5�. F7. oCCUPANCv_
CONSTRVCTION TVPE VALUATION S
ZONE GRADING CU. VDS. ACRES_
Ramarkf: �3
Preventer
Floor Dreins
Roor Sinks
3as Service Outlets
Interceptors
Kitchen Sink
Lavatories �
P—Trap
RoOf Drains
Reinspection Fee . $15
Boiler
Dutt - Under Ground
Duct - Structurel
Duc[ - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt, iC80 dk
Heating System & Oucting
❑0700,000 BTU �100,000
Rainspec[ion Fee � $15
White - BuilUing; Ganary - ADOliwnt; Pink - Atcounting; Goltlenrotl - Assessor
ShOW¢rs
Service Sink �
Sewer Cap
Sewer Connxtion
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Urinat
Water pout
Water Heatei
Water Service
Auto-Wesh
laue Fee
Hoad or Typel ❑
Canopy Type I� ❑
Fefrigeration System
❑0�100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Re9irtas
laue Fee
$ 3
53
A.P. qW
S Main 8uilding:
E
T Front
B Rear
A
C Right �
K ,
g Leh
Ping. Ret. #
Planning No[es:
Automa[ic Washer
Construction Pole Sub.
Cooking Unit
Di5hwa5her
Dryers �Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generatar �0.5 KW �5-1
Fea
Zone
Atcessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter �over 100 amps
$ub Panel
Motors �61 HP � i X- 8
Int.Solar 0&75 HP �1G75+
Microvrave
Pole Light
Ran9e
Si9n
Standing Sections
� Trash Compacwr
$15 I I luue Fee
DEVELOPMENTSERVICESREUUIREMENTS:
2oning Approved By
Building ApO�oved By r
FEES
N
I
N
G
R
E
Q
M
T
$.
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. S
ELECTRICAL $ � GRADING $
PU1N CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �
PLAN CHECK 25% $
CI �0433079-ODG33U79 T�Y ?D.9J
DRT�: OS/16I89 TINE: 14:Ui
.. ,� .. . . _ . .. . . .
� -- - ., ,
CONSTRUCTION AND PLANNING � � & SPA .
APPROVALS Permit# Date Inspector qppROVALS Permit# Date � Inspector
��
1. Temporar�Electrical Service or PoR � �' 52. Pool & Equipment Location
2. Soil Pipe-Uhdrgrnd. ;a- .,f �+ 53. Steel Reinforcement
t. �.! ,..
3 �'.Elec{rical Conduii- Uti4ty-Undrgrnd. y 54. Forms ��
4:�ElpctricaJ Cortduit-Undigrnd. i �^ 55. Electrical Bonding
5.; Steel�Reinforcement ✓ s 56. Rough Plumbing & Pressure Test
6r Electr,ical IJFER Grndr 57. APPROVAL TO COVER-GUNITE �', �
7 jFootings �t ?, � �i `! ,� 58. Electrical Conduit-Undrgmd. - ,�
8: Foundation •• . 'i, f 59. Gas Pipe, O Undrgrnd., Test �
1-., r 4 �• / I -
9�Vyatey Pipe-Uniirgirid�. � �_, 60. Backwash Lines, P-Trep, � Undrgmd.
n�
r
70i!-S�rucFural Floor System � 61. APPROVAL TO DECK
11. Property Sewer �ine & House Connection �- ��.� 62. Backwash & Recepmr-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 . Solar SYstem-Final
16�. Rough Electric Wiring � . Fencing & Access Approval
17: Raugh Wiring Sign 8. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � . 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. Dycts, Ventilating 77. Product Piping � 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
3L. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED
33. Final Electric � otes:
� 34. Final Heating & Air Conditioniny n.• �� ^
�, ... •'.'.
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 pomestic-Final -
42. Backflow Preventer '
43. Backflow Irrigation -
44. Landscape Irrigation System
45. Sound Attenuation ' �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requiremen[s Completed
49. Electric Release to Edison �
50. Gas Release to Southem California Gas Co . �
51. CERTIFICATE OF OCCUPANCY ' " • • ' - �
No. Date .± � �
ADP���ant ta fill in all spaces axcept thosa wit�in �eavy borAer Iines anE slgn ail appropriata Ceclarations.
CITV OF COSTA MESA CONSTRUCTION PERMIT
Project Address 5 5 5 A n t o n, 5 t h F 10 o r �«��
Applicant'sMailingAddres! 7540 Suzi Ln., Westminster
owner•srvame " Securitv Pacific BankPnone
Address b00 Wilshire Blvd., 11500
Arch/Eng. Licenu No.
Address
Contracmr'sName KimblE & Co. PhOne895-I156
' Addresslmailing) 7540 Suzi Ln., Westminster, 92083
Ciry License No. � ` 038503
LICENSED CONTRACTOR DECLARATION
I herehy afiirm that I am licansetl untle� prOvi5iOn5 O( Chdrt¢� 9(Commencing
wilh SeCtion 7000) Of Divi5lon 3 Ot thG Bu51ne55 antl Plote55lon5 Cotle, anC
my license is in tWl torce a deHect.
Licenze Cla s C— rb ense rl 460923
Oale���— 5'9 at
P �RKERS'COMPENSATION DECLARATION
meby atfirm that I have a certiticate ot consenl to self-insure or a certifiwte
A_ or Workers' Compensation Inwrance, or a certitied mpy thereot (Sectlon
W 3800, Lab. C.)
vou�y rvo. WP884 7089 7-0 1 comoa�v Fremont Indemnity
�ertifietl copy is hereby turnishetl. �
NCer fi copy filetl with the city �y !Qi i)�i an��/,
Date� ��a� Applicant w���`"�"'v
EXEMPTION FROM WORKERS' CO PE�N DECLARATION
(This section neetl not be completetl if tne permit Is tor one huntlretl (y100) or
less).
I certify that in the pertormance of the work for which this permR is issuetl, I
shall not employ any perzon in any manner so as to become subject to tha
Workers' ComOenzation Laws of Califomia.
Date Signature
NOTICE: If, after making [his tleclaratlon, you snoultl become subject to lhe
Workers' Compen5ation provisions of [he Labor Cotle, you must (orthwlth
como�Y �+'��h such provisions or tnis oermit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby aHirm tha[ there h a constructbn lentling agency for the pertormance
of the wo�k for whlcn tnis permit is issuetl (Section 3097 Civ. G.)
LEntler's Name
�entler's Atltlress
OWNER BUILDEft OECLARATION
I here0y a(firm that I am exempt from the ConVactor's Llcense Law for the .
following reason (Seclion �031.5 euslnass antl Pro(essional COAe: Any clty or
munly which �epuire5 a pe�mit [o Conrt�uct, alter, imp�ove, tlemoliSh o� repair
any structure, prlor to Its issuance, also requires the applicant (or such permit
' file a slgnetl SfatCment that he/She IS IICtnS¢tl pulsuant to Ih¢ PfOVI51o05 Of
ContraC[or's Ucense Law (Chapter 9(commencin9 with Section 7000) of
ision 3 oi the Business antl Pro(essions Cotle) or that he/sne is ezempt
..�ere/rom antl tne basi5 (or the allegetl ¢xemptlon. Any viOla[ion ot Soction
7031.5 by any applican[ for a permi[ sub�ects Ihe applicant to a civil
�enalty of not more than five nuntlretl tlollars (5500�.
I, as owne� of tha p�ope�ty O/ my emplOy¢es wlth wage5 as [M1eir Sole
compensation, will tlo thn work, antl the slructure is not intentletl or o/feretl
for sale (Seclion 7044, Business antl Protessional Cotle: Tha Con[ractor's
�icense Law tloes not apply [o an owner o1 a proPerty who builCs or improves
thereon, antl who tloe5 such wOrk hlmself/hetselt o� IhrOugh �is o� her Own
employees, O�ovitletl titat Such ImO�ovaments are not intentletl or 01fereC fo�
sale. Ii, however, the builtlin9 or Improvement is sold within one Year of com-
pletioq the ownur will have Na burtlen ot proving he/she tlitl not bulltl or Im-
nrove forthe purpose olsale).
❑ I, as�owner oi tne property, am ezcluSWely conlrattin9 with Iicensed con-
tractorsto consVuct the Droject (Section �044, Businass antl Protessions Cotle:
The COntractor'S License Law tloes nOt apply t0 an owner o1 property wh0
builtls or Imoroves thereon, andwho contracts for suth oroiects with a r.on-
tractor(s1 license pursuan[ m me ConVactor•s Ucense Law). I am aware tnat
proof o{ [neir Worker's Compensation Insurance should be providetl to me.
❑ I dm ezempt untle� $ec[ion B. & 7. C. fo� th15 rea5on
Da[e
I hereby cerUry that
intormation is mrrect
antl�state laws relatin
5entatives ot thl tit
inspec[lon pur es.
Si9nature
Drivers' License or 55
0865-46,rev. 5/88
— Owner
I nave reaa thls appli<ation ana state that the above
I a9ree to comply with all clty antl couniy ortlinances
to builtlin9 constructlon, antl hereDy authorize repre-
to nter upon the above�mentioneE property for
Date ¢ 3 Flq
x -�
TVPE OF CONSTRUCTION LJ NEW_I.� ADD LJ ALTERATION U REPAIR
❑ CONVERSION ❑ DEMOLISH L�1�OTHER
DESCFIPTION OF WORIS/USE OF BLDG,
TVPE OF PERMIT LI GRij.OING LI FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PR0.IECT DESCRIPTION 5�. F. oCCUaANCV
CONSTRUCTIONTVPE r�, _ VALUATION$ 4�653.00
20NE GRADINGCU.VDS. ACRES
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Servic.e
Interceptors
Kitchen Sink
lavatories
P—Trep
Roof Drains
Reinspection Fee
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
S r Tank
Swimming Pool w/Spa
Urinal
Outlets Water Closet
Water Heater
Water Service
Auto-Wash
$15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Ezhaust System ❑ Multip�
Firepl/Fact. Blt. ICBO �k
Heating System & Ducting
❑ o-i oo,000 eru O i oo,000
peinspection Fee � $15
White - BuilOing; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Isue Fee
1ANICAL
Hood r Typel ❑
Ca py Type �I ❑
Retrigeration System
❑4100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers �
Registers '
Iwue Fee
A.P. qW
S Main Building:
E
T Front
B Rear
A
C Right
K Lett
S
Ping. Ref. #
FEES P.utomatic Washer
Construction Pole Sub.
Cooking Unit
Disnwasner
Dryers �Gas ❑Eleccric
Fan .
F.A,U.
Fix[ure5
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW �5-15
Zona
Accessory Building:
Parking Req./Provided
ELECTRICAL .
Trensformer ❑ 15-50 KW
❑50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
j0%tors �0-7 HP �i'f, - 8
Inc.Solar O9-t5 HP 016�75+
Microwave
Pole Li9ht
Range
Standing Sections
Trash Compactor
Fee �$15 I I Issue Fee
§ 3 DEVELOPMENTSERVICESREQUIREMENTS:
ZoninB APP�oved By
FEES Building APP�oved By
� Appliwtion Issued By
$ 3
BUILDING PERMIT $
PLAN CHECK $
PIUMBING $
P�AN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50°� $
MECHANICAL $
PLAN CHECK 25% $
N
I
N
G
R
E
Q
M
T
S.
FEES
$ 3
FEES
SMIP $ • �0
PERMIT
ISSUANCE $
ENERGY P.C. $
GRADING $
MICROFILM $ �7
TOTAL FEE $ �/„ 7�
Qi Q0031346-00031347 T4 T 72.70
"�?E= 04/25/E9 TItfE: ?3:39
. ., .. ...`'' ..\. \.�� ... . .. . . . . . . _
CONSTRUCTION AND PLANNING � P" & SPA
APPROVALS Permit # � Date Inspector pppROVALS Permit # Date Inspector
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement �
3. Electrical Conduit U[ility�Undrgrnd! / 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �r
�
5. Steel Feinforcement . 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, � Und�gmd., Test j
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
� Y
97'` Rough Wiring Sign 68. APPROVED FOR PLASTERING
„ r
18: Rough Electrical-T Bar Cei�ing 69. POOL/SPA SYSTEMS FINAL
1�9> Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
tv
70: Rough Factory Fireplace !E" APPROVALS Permit #
r�
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.StorageTank OGas 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 i� 78, FIRE PREV. FINAL
30. Drywall Nailing '� ' HEALTH DEPT. REQUIREM NT
31r Plaster Brown Coat 79. FINAL INSPECTION
i
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Tes[
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final �
40. Gas Service-Final ` `;
� '\
41. Solar pomestic-Final � - ' �.� � ;�
42. Backflow Preventer �� � �,� ; ��
. � •
43. Backflow Irrigation . � , �
.
44. Landscape Irrigation System �� � r,
45. Sound Attenuation � � �
A. )
46. Handicap Regulations y
47. FINAL STRUCTURE & BUILDING `'
48. Special Requirements Completed
49. Electric Release to Edison �-
�'.
50. Gas Release to Southern California Gas Co ,i• � �•;
51. CERTIFICATE OF OCCUPANCY "r_^ i ✓'
,
No. Date %'
l
�79rj9 Applicant to fill in all soaees except those within heavY �orEor Ilnes anA si9n all aocroDrlate aeelaratlons.
CITV OF COSTA MESA CONSTR UCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A P
Project Address SSS AN�ION BLVD. �$T�
• Applicant's Mailing Address 7540 SUZI. WESTirLiNSTER 92683
�OwneriName '3�'��'�RITY PACIFIC BAN�one
nddress 600 WILSHRIE� #500
n�cn/Eny. L.A. 90017 LicenseNo.
Address
Coniraccor'sNama KIMBLE & C0. ohone 9-115
Addresslmailing) 7540 SUZI LA[VE, VTES`IMINSTER
Cit� License No. 038503
LICENSED CONTRqCTOR DECLARATION
I M1aroby altirm Iha� I am Iicensetl under provisions of Charter 9(commoncing
with section 7000) ol Divislon 3 0l the Businass antl Professions Cotle, antl
my license is in full lorca antl etfect.
ucense iass — �ce ' . 460923
Dale � ^ S'9n t r �
VORKERS' COMPENSATION DECL RATION
hereby atfirm tbat I have a certitirate of consent to selNnsure or a certifiwte
..( workers' Compen5ation Insuranca, ar a terUfietl copy therea( (Sactlon
3800, Lab. CJ
vou�Y No. WP88470897—01 Company ��NP IND•
Cer[ifietl Copy i5 hereby furNshetl.
Cer�J{�etl�Q� y��J'letl witn tne city B in Qnvi on �
Date (����7—/ Applicant ���/�� ��
�%EMPTION FROM WORKEFS' COMPENSATION DECLARATION
(This seclion neetl not be com0letetl i( tne permit is for one huntlretl ($100) ar
Icsz).
I certity tnat in the pe�fa�mance ot lne wo�k fo� whlch t�ls pe�m�t Is IssUetl, 1
sltalt not employ any person in any manner so a5 to becoma subject [o the
Worklr5' CompGnSatiOn LawS of CalifOmid.
Date Si9nature
NOTICE: If, atter making this tle<Iaration, you 5houltl become sub7ect to tha
Worker5' Compen5alion provislon5 01 the Ldbor COCO, you musl forthwith
comply with suc� provislons or tnis pormit znall Ue Coemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereDy aftirm that there is a mnstruction tentling a9ency for tne performance
of the wark for w�ich this permit is issuetl (Sectlon 3097 Clv. C.)
Lentler's Nama
Lentler's Atlaress
OWNER BUILDER DECLARATION
I nereby aHirm lhat I am oxompt from tho Contraclor's Llcenso Law for tne
iollowin9 reason (Settlon 7031.5 Buslness antl Profeszlonal Cotle: Any city or
county which requlres a permit to tonstruct, alter, improve, tlomolisn or rupair
any struclure, prlor to Its issuanco, also requires the applicant for suth pormit
�n file d signetl stalemenl lhdt h0/she Is IlcenS¢O purzudnt to lhe O�ovlSiOns o/
� Con[ractor's U<ense L. w(Chapter 9(commoncin9 wiln Section 7000) of
�ision 3 of [ne Busin¢55 antl Professions Cotlo) or tnat no she iz axompt
erefrom antl lhe basis for [�e allogetl exomption. Any vlola�lon of Soctlon
7031.5 by any applicant tor a permil subjecti the appllcant to a civll
�enalty of not more tnan tiw huntlretl tlollars (E500�.
I, ds owner of tlle plopelty Ov my employe02 wltll waga5 a5 th0il sole
� compCnsa[ion, will tlo the work, dntl tM10 sVutturo IS not Intentl¢tl O/ of�eretl
i lor sala (Section 7044, Businezs antl Prolesslonal Cotlo: Tbe Contra<tor's
� Li<ense taw tloes not apply lo an owner ot a O�operry who bulltls or Improvos
' lhereon, and who Does such work hlmsoli/hOrs0lt o� through his o� her own
employ ees, provitletl that zuch Improvementz are not IntentleU or oHeretl tor
ule. Il, however, the Duiltling or Improvoment Is solE within one year oi <om-
pletion, tM1a awnor will hav¢ Ihe burtl¢n Oi P�oving hC/Sha tlltl nol buIIE o� Im-
�lova fOr [ho purp050 Of sale).
I, a5 Owne� ot tha propetty, am nxclu5ivaly cont�actl�g with IlcenSatl Co�-
tlactOrs lo conStruCl the projact ($Cctlon 7044, Buslne55 dntl AOfesSIo05 COtlO:
The Contractor's LlcenSa ldw doe5 nOt apply t0 an ownel of prop0/ty who
builtls or imo�ovez thermn. antl who contracts for such oroiects with a eon-
tractor(s1 Lcense pursuam m me Convactor�s License Law). i am aware thac
proot o( their Worker'S COmpensation InSurdnt¢ ShOultl be p�ovltlOtl to m¢.
❑ I am exempt untler Seclion B. & P. G. for this reason
Date Owner _
I M1erebvi certitv lhal I have r¢atl fhis
antl
$i9nd[ure "'
Drivers• Licen or 55 �
abova
� "1 2 . . `�
S Main Building:
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T FrOnt
DESCRIPTIONOFWORK/USEOFBLDG. B Rear
A
TVPE OF PERMIT GRADING FOVNDATION STRUCTURAL � C Rlght
❑ TENHNT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL S� Left
❑ OTHER . Ping. ReL 91E
9
PROJECT DESCRIPTION SQ. FT. OCCUaA /�y�� Planning Notes:
CONSTRUCTION TVPE VALUATION $ ��L[ '�
20NE GRADING CV. VDS. ACRE�
Remdrks: (� _ n .. l'� _ lSt] �. 1% __ �i % d? —1QQ
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher -
Drinking Fountains
Floor Drains
Floor Sinks "
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trep
Roof Drains
Reinspection Fea
UnderGround
Strucwral
$15
ExhaustSystem ❑ Multiple
Firepl/Fact.8lt iCBO dk
Heating System & Ducting
❑6100,000 BTU 0100,000
Reinspection Fee � $75
0865-46, rev. 5/88 White -� Builtling; Canary - Applicant: Pink - Accounting: Goltlenrotl - Assessor
PLUMBING
Service Sink
Sewer Cap
Sewer Cannection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Wa[er Heater
Water Service
Auto�Wash
Issue Fee
FEES Automatic Washer
Construction Pole Sub.
Cookirg Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Bozes
Outlets
Switches
Garbage Disposel
Generator �0�5 KW [
$ 3
1ANIGAL FEES
Hootl or Type I ❑
Canopy Typell ❑
Refrigeration System
❑aioo,000eTu ❑ioo,000eTu
System Repair/Alteration'
Fire Dampers "
Registeis .
Isue Fee $ 3
Accessory
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50 + KW
Meter LJup to 100 amps
Meter �over100amps
Sub Panel
Motors �41 HP � 1 h- 6
Inc.Solar 09-15 HP 07615+
Microwave
Pole Light
Range
I I Standing Sections
5-15 KW I Trash Compactor
� Reinspection Fae �$15 � � luue Fee
DEVELOCMENTSERVICESRE�UIREMENTS:
2oninp APProved By
BuildinB NPO/a`�ed By
Appliratian Issuad By
FEES
$ 3
N
i
N
G
R
E
�
M
T
S.
SUMMARY.Ob FEES Q
BUILDING PERMIT $ � �"V_ SMIP $ _��_
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ �
MECHANICAL $ TOTALFEE $ ��_
PLAN CHECK 25% $
�I OII�275$3—OQ0275�4 Tt�Y 72.b2
6ATE: 03/03/89 TItIE: 1�=47
CONSTRUCTION ANDPLANNING ' P� 'SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Sofl Pipe-Undrgrnd. , � 53. Steel Reinforcement '
3� Electrical Conduit Utility-Undrgrnd. � 54. Forms �
4. Elc4trical Conduit-Undrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE .' '
7. Footings ' � 56. Electrical Conduit-Undrgmd. �
6. 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 Elec[ric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20.�Rough Factory Fireplace , APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing �' 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathin9 • . � � 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. F�RE 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 pomestic-Final
42. Backflow Preventer -
43. Backflow Irrigation
44. landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co � �
51. CERTIFICATE OF OCCUPANCY
No. Date
r�
Pfl0.1ECT ROOflESS: S S J AN .�UN BL UNIT: S OO
OWNEWSNFME: SECURI�:Y PACIFiC BANK
RDONESS: 6OO WILSHIRE BL #400
LOS ANGELES
CA 9001%
AHLNIENGINEEN: � z13T) 345-4951 flEG.NO.:
�ooness: ROY d. HERHOTD, JR. C-�NRO"/3
�?.072 CAN;INI.O VINO
PENMITTEE: I,AGUNA HILLS CA 92653
nooeess:PACIFIC $UILDIVG IN3ER�OR (213)223-1124
5363 ALAAMBRA AV
LOS ANGELES CA 90037.
LICENSEO CONTflFCTON DECLAHATION: I �ere0y altirm I�al I am IicerocU unEer Orovisions ol Cnapter 9 �cammencinA w��h Section
7000� ol Divivon 3 0l tAe Buaneu antl Piol¢5sians Cotle. antl rtry license is in full brci an0 ellttt.
c�rr uc.: 017 n 7 5 srnTe uc.:18 8 6 � 9� �i`"�°S ��
oate: �• L I• 0/ Z 5ionamre: _ �i(�_�
WOBREBS'COMPENSRTIONOECUPATION: I�ere0ya11irmitut haveacenificateolconsenimseti-insur acertificatealWorkers'
Comoensation Inmrance, or a cenifieE copy tnereol ISec�bn 3800. LaD. q.
rouerxo.:�CAOi1828 exr.o�re: 07/01/92
COMPRNY: {J(`1CAFiE I� CO
❑ CertitieG wpY �s herc6y Iumis�e0. Certilietl fApy R IileG M I� ly B'Idinq Uivision.
.. � • � I " /Z Appliam:
.cMPIION Ff10M WOPIIEflS' COMPENSITION OECUMTION: ' uGCn MU ro� Ee m�k'� i� tic per is M one maqrtE 1510D� w kssl.
I cemty �ha1 in t�e pedormantt al t�e wwk iw whic� lNs permit i5 issue0, I slull not employ any pe n in any marvier 50 az lo �¢come
suGie[1 �o IAe Wo�kers' Campensa�ion LawS 01 CalitOmia.
Da�e: SiOnamre:
NOTICE: 11. after maMinA Riis Oeclaration, you SMWE Eewme suEject to ihe Warkers' Compe�avan D��s of IAe Whor
CoOe. yrou musl lonhwitn compy witn wcn Drmvsrorts or tltis perrtet shall Oe EeemeO revaked.
CONSTflUCTION LENOINC �GENCY: 1 �ere0y a��irm Ihai I�ere is a conitruqion I¢nGinp apenry for I�e pedormante ol tha work fOr
w�ich Ihis Dermil is issue0 (Section 3097, Civ. C�.
IFNUEfl:
aooness:
OWNEB BUILOEN �ECLABR710N: I here�y allirm Ihail am e�empilmm the Cantractors' State License Law forthe tollovnnp reason
(Seciron 703f.5 Business anG Prolessional CaEe: My city ol county wNc� repuires a permi� to construct, alter, imD�m'e, 4emolisA, or
re0ai� any SimcWre. O�ior la ils issuance. als0 repuires Ihe aOU��� �o� suCh Dermit to lile a 9pnetl statemenl that he/she is Iicense0
pursuam to �ne provisions ot me Comraclors' State License Law �Cnapter 9lcommencinq witA Section 7000� of �ivision 3 of tAe Business
antl Pwiessions Coae) ar iAal he/sAe is exempt t�erelmm an0 i�e 6asis lor Ihe alleqetl eeemption. My violation ol Sec�ion 7031.5 Oy
any aOVlican� lor a permil su�jecls Ihe aDO�icanl Io a civil penal�y ol nol more I�an live hunOretl Oollars (E500�.
I. as owner ol tAe pmDerty or my em loyees wilh wa0es as t�eir mle campensaiion, wiil Oo Ihe work, anU Ihe
❑ s�mcture is nol intenaed o� olhrea lor sale I�cuon 70aa, Business anA Pmfeuianal Cade: The Caniractors' Stale License Law
Ooes nol a001y lo an ownei of a pwcehY w� builOs or impmves i�e2on, antl wla Eoes SucA work himsell/henell or throuqh
nis or her oxm employees, pmti0e0 I�al such imOrovemenl5 are n0t int¢nGed or ofl¢r¢G for Sale. II, �owever I�a Guildinp or
impmvemenl ¢ 5a10 wil�in one year ol comple�i0n, I�B OwnBr xill luv2 t�e DurG¢n ol prOvinp �USIi¢ EiE nol 6uiIG Or improve
lor Ihe purpose ot salel.
I.as owner ofine propeny .am exclu5ively Cunirac�inp vritnlicenSeU mnlraclorsto wnsirucithe o�olect(Section 7044, Business
aM Prohsvaa CoOe: Tlre Canlactors Suta L'certu Law 0oa mt appry to an wmer ol D�DeM ���IOs or improves tAeaon
antl w�o coniracisfor wch D�qeps wit� a contocmqs�licenye Dursuanito ihe Comractors' State Lirense Law�.l am aware
I�al 0��� o� I�eir Workei's Compem2li0n inSunnCB 51UWE DC O�OviGCO Io m¢.
� I am eremD� unEer Section: B. a P. C.
for itus reason:
oate: Ovmer:
I eo nereey cenily tlul I am awaa af anG unGerstanOlM reQuiRmen6 of Glilomu Hallh ME Sahry COAe Setlion5 25505, 25533, anA
2553< aM ihat I or any lulure buEOing Ottupant wiNwdl not (�de One) n¢eC to wmply with 5ditl state WG¢5 anG the r¢puiremen451or a
permil for consimclion or rtw0iluaiion fmm Ihe Air ua0iy ManaAemen� qslricl. flesi0en�ul conslmciion apP����ions are e�empl Irom
Iheu prov6ians.
Date: ADGliwni:
I hereby terliiy Iha� I �av¢ rea0lAi5 appliCalion anG Slat¢ l�ai I�e a00ve in�Ormalian is LUrr¢0. I aARe Io fAmpty wi�p all Cily anG t0unty
orainarces anA state Wws relating ia OuilWny cmatnKtion an01rere0y autlprim reyesentatives of tlfa ary to � upon We a�m�o-menlione0
O�oOe��Y �o� inspection Durpose5. � _ /� , ��
n i �i i
Oale: �I•�� Signature:���i•���1
Oriver3 Llcense a� Sacial Secuniy K: .
1641�C6 WM1ne—Bmlding'. Green—Codo Enlorcement; Canary—Apphtanl: Pmk—Revenue; Goldenrotl—Assassor
CITY OF COS'PA M,ESA - BUILD�NG PERNilI PERN. \O; B 05653;
PEAMTT NO: H OS6537 Pi.AN CHECK NO; OOfi`,4-92 L GOVT: N SUPP: N
CONSTRUC.ION TYPE: 1PR SP PERMIT TYPE: STR PJRFOSa; ALT
JOB DESCRiPTION : CON"?ERCIAL T.I, (OFFICES) SQ FT: 37,500
CLAIM VALUE: 200,000,00 CALC-VALUE; 212,'750,00 GRO[JP OCC: B-2 /
CUMMENTS: 5TH FLOOR i.I./F1RST TENANT ON FLR
aE d6 iF if # iE iF if� �IF �4 3F # 3c it if !f ### X� if # iF li i61f i6 iF IF # iFli� iE # iE 3f if # 3E if ii� 3E 9E 3f IF if� iE # If IF k it N� 3e i'r lE�li� ii� 3e iF iE iE IE iF iF if ie i'r �E if iF i� i#F if ###F iF
'L O N i N G R E Q U I R E M E N T S
S F. T B A C K S
------------ MATN HUILDING ---------- --------- ACCESSORY BUIiDII.G ---------
rRNT; FT TN REAR• FT IN r'RNT: FT IN REAR: FT ZN
LcFT: FT ZN RGHT: FT IN i.EFT; FT Zh RGHT: rT iN
PARI(ZNG REQ• PROV: PARCEL: 41050109 2t�E: PDC REF NO•
PLANNING Nt5TE5> TENA\T I,yPROVEMENTS FOR THE SECIJRITY PACIFIC 3ANK BUZiDING
> S'f3-cLOOk ONLY. �
# iE R if ii i(� ie iE iE # ie ii !E iFlE iF 1E iFiFif jE if iE } if ii iE if !i # ii�iE 1f iE 3'r iE iE iF jE # iF ie # ie ii if # 4 3i�# # iF iE i'r if-k• ic if ie i't i!� iF 1F iE iF �F # iE i�ii �# ii iF iF if 3E iilh if
D E V E L O�P M E 1� T S E R V Z C E S R E Q iJ T R E M z F� ,.�,' S
ZONING APPROVED BY :• ;��� DATE: �/��I Z
BUILDING APPROVED 3Y• ;_ C _ DATE; 3/<!�2
APPLICATION ISSUED'BY;���������— - DAlE• '���%/�2
iEiFifdfN�iFiE3EiP##iFiE#�%%iEiFiF�3ElEi'r. Tr -£'kifiF< � ,.� C�F� � !iF#Ik►:#3i�3Ea:irYJ�'%. �kie
if if li iF #� #�ri� iF IE 7F ff Y� # if� 3f if aF #ff iF ie if� ie iE 1t iF if i(� iF �i!� 3f i£ if i'r ## it 1(� #'r # t� if iF 3{ ii� iF iE } ie le i(� iF 3c �)f if Ih if 3F 1t #} if� # iF if ## if lE ae 3i K k� ii Y• I[� #
LEGALIZATION:N F E E S � M M A R Y�- -STRUCTURAL StGN.BNT:Y
BLDG PMT PLUMBING ELECTR=fC'" MEC,tiANI�/ rIRE SMIP/RES GRr1DiNG
PERMIT I,03`,,00 " , SNIP/NON-RE�
PLAN 672.75 ,
L55L7E FEE
DUILDING-DIV-> PERN,IT ISSUE PLAN,-CF�'ECK
TOTALS----> 1079,68 0.00 672',75
REVENUE DIVISION TOTALS--> COLLECF,'CE1j :
BLDG PNT PLUMBING ELECTRIC Mr.CHANTC
1035.00 .
TOTAL PAID
7.757.,43 1752,43
1U79.68 OVER/SHORT:
FIRr, SNIP/TOT GRADING
44.68
D00
00
PLAN-CHECK
i'r # k�}'. if rt 3F if k*if !h 3h iF �� �#%� iE iF iE �IF 3e iE fF if iF li iM1 if R�lE if ii� ie'lh 3f if !f if # ibiE if iE iE IE if ii• ii�'c 3f iF if iF lf iE 1e }'} i(� iF iF # 3F iF 7f iE !P %� iE 3i �i ?f IK �- # if IE iE
I N D Z V I D'J A L%F�£ E b R E A K D O W N
TYFE QTY D E S C R I P T I O N- ' UNIT COST TO;AL COSi
SFC 17.500 OFF-ZNT, ALTER TYPE I IT FiR. -AVER 16,08 201,000,00
SFC 12500 EQO-ALT COMM, SPRINKI.�R SYS -AVER .30' 3,750.00
SFC 12500 nQU-ALT CO."dM, AiR COND �" -AVER ,64 8,000.00
END OF FEES
r� �^. ; .- _.
��i.'F, _„
�
CONSTRUCTIONAND�PLANNING , POOL& �
/ APPROVALS Permit#. � uate Inspector AppROVALS �Permit�k . Date Inspector
t..Temporary Eiectrical Service or Pole -- 52.. Pool & Equipment Location �
2. Soil Pipe�Undrgmd. • � 53. Steel Reinforcement • �
3. Electrical Conduit Utilitv�Undrgrnd. 54. forms '
4. Electrical ConduiFUndrgrnd. - 55. Electricai Bonding -
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electrical UPER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footin9s 58. Electrical Cqnduit-Undrgrnd.
S. Foundation " � 59. Gas Pipe, � Undrgrnd., Test _
9. Water Pipe�Undrgmd, , 60. Backwash Lines, P-Trap, O Undrgmd. -�
10. Structural Fioor Sysxem ,.� 67. APPROVAL TO DECK
it. Properiy Sewer Line & House Connection - 62. Backwash & fleceptorFinal
12. Sewer Cap " 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing . � 65. Electrical�Final �
75. Rough Electrical-Conduit 66. Solar System-Final -
i6. Rough Electric Wiring 67. Fencinc� & Access ApProvai
t�. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
Z7. 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 O Gas ❑ Oil
25. Roof Sheathin9 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monowat 75. Dry Chemical
27. Frame and Flashin9 '31�-� q �rv_G" 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 MeterFinal - 80. FOOD CERTIFICATE ISSUED
33. Final Electric - Notes:
34. Final Heating & Air Conditioning , � �, f- v
�_�v �iv/ //(k�%aei� .
35. Final Gas Pipe�Test � � ��� ��/S .3/rf/� �
36. Hood or Canopy
37. Finai Factory Fireplace
38. Final Plumbing
39. Water Service-Final �
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING �
48. FINALPLANNING �
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PHOJELT RODPESS: S S S ANTON BL
� owueesxame: SECURITY PACIFTC BANK
ADDflESS: 6OO WILSHIRE BL #400
CA 90017
APCH/ENGINEEfl: � Z 1 3� 3 4 5— q 9 51
RDONESS: ROY W, HERHOLD, JR.
22072 CAMINITO VINO
u"iT: 5 0 0
NEG.NO.: C— 073
��:
PEqMinEE: LAGUNA HILLS CA 92653
WESTERN SUPPLY CO. (213)633-0511
aooeess: 15510 ILLINOIS AV
PARAMOUNT CA 90723
❑CENSEU CONTNRCTOB UECNIIATION: I �¢reGy allirm IAai I am ticenseE under pmvi4ons o� Chapter 9(commencinp with Section
7000) ol Drvision 3 0l ihs Business anG Pmfessions CaGe. anU my Iicense is in tull fo¢e ana eflect.
cmuc.:046021 sTareuc.:Zg1621 �u C-36
Oate: ��—/ % �� SiAnamre:
WONRENS' COMPENSRTION OECLAMTION: I here6y aHirm Ihat I have a certilicate o� consenl �o selbinsure or a ceni�iwte ol Warkers'
Compensaiion insurance. or a cennie7 cop �nereof (Section 3800. Lan. q.
eoucrxo.:PWC5078246�9 E%P.ORTE: OLIO1�93
C�MPANY: CNA INSURANCE
�1 C¢tliiietl w0Y is her¢Uy �umi5�e4. W C¢rtilie0 mpy 6 �il t� ihe ciry Builaing DiNsion.
.Wte: �� ;�_A 2 RpplicanC �
i
E%EMP710N FflOM WUflHEFS' COMPENSRTION OECUMTION: QAis section neetl na� be complete0 il ihe permit is Wr one huMre� �E1W) a less�.
I cenify Inal in ine Dedorn�ance ol ine wOrk for wnich ihis Oe�mit is issuea. I sAall nat employ airy person in any mdnner so as Io become
SUGIec� ID ihe WOrkers' Compen5aiion Laws ol Califomia.
Oate: SipnaWre:
NOTICF: II, after mapinp Ihis Aeclaraiion. you should hemme subject to Ihe Workers' CampeMation provisions o1 ihe La6or
Code. you musl tonnwitn comoly witn such provisions or inis permit shall Oe tleemetl revokeA. ,.-
CONSTfl11C710N LENOING pGENCY: Illere�y affirm I�atlhere h a consiNction len�ing agency tor Ihe�pertarmance of ihe work lor
which Ihis Dermil is issuetl (Setlion 3097, Civ. C�.
LEN�EP:
RDOflESS:
OWNEB BUILOEP OECIAflAT10N: I �ere6y allirm ihat I am e�empt imm t�e Coniractors' Slale License Law for ihe tollovnng reason
�Set�wn 70.31.5 Business an0 PmieSS�onal COGe: Fny tiry o� toUn�y whiCh reQuireS a permi� m cons�mct, al�er, impmve, Oemoli5�, Or
repair any simcWre. prior �o ils issua��ce, also requires ifle apDlicant lor suc� permit to file a signetl statement ihat he/she is licensetl
pursuant to Ne pmvisions ol l�e Contracmrs' SIaIe License Law �C�aO�er 9(commencing with Section 7000) at Division 3 of IAe Business
ana Pmlessions Coae) or ihat ne/sne is exempt inerelrom anA �Ae Uasis for the allepee exemption. Any violation al Section 7031.5 Oy
any aDO�itanl lor a Dermil Suble��5 ihe applitanl l0 a tivil Oenaliy o� n0� more Ihan �ive huntlretl tloll3r5 (5500).
I, as awner ol ihe pmpeny or my emVloyees with wages as I�eir sole compensation. will do the work, antl Ihe
❑ stmcwre is not intenaea or oflerea for sale (Section 70aa. Business an0 Prolessianal Cotle: The Contractars' State License Law
Ooes nol aDDly Ia an owner ol a pwpehy w�o builJs or improves �hereon, antl who Ooes such vrork himsel�/hersel� or Ihrough
'Oi5 ar her own eMG�%'ee5. proviOeU �ha� SutA imprwements are no� intentle0 or oifere0 lOr 5ale. II, �Ow¢v¢r ihe bUilJinA or
imDmvemem is sold wiihin one year of wmpte�ion, ihe owner will have ��e burden al pmving he/s�e Oitl nol bui10 or imDmve
lor tne ourpOse al sEie�.
I, as owner ol ��e O�opetly, am eeclusively coniracting wi�� Iicense0 con(ractors to constmct the Gwlect (Section 70e4, Business
❑ antl Professians COC�: The Cantractars' State License Law Aou not apDN �o an owner of pmperrywlw bmlUs or imprmes Uereon
antl who caniracis �or sucA pmlecis wil� a caniracloqs�license pursuant to the Contractors' Stale L¢ense Law�.l am aware
��� 0��� ot tAeir Worker's CamOensatian insurance shoNA De pmvitletl to me.
� I am eeempl un00� Se[lion: B. 8 P. C.
�or ��is reason:
Oaie: Owner.
I ao nerebV �eNfy that I ain aware al anA understan0 Ihe reQuiremenis o1 Califomia HealtA anJ Safery COEe Sections 25505, 25533, aM
25531 and I�al 1 or any IWure �uiltlinp occupanl wilUwill no� (cucle one) nee0 io comply vn�h 5ai0 s�a�e ca0e5 anOlhe �equiremenis �or a
permil lor conslmclion or RwOiliqlion twm ihe Air Ouabry ManaAement Usinct. flesitlentidl consimction aDDlication5 are exempt Irom
I�ese prouisions.
Da�e: Fpplitant:
I �ereby cenily ��at I have reaa ��is aDPlicaiion antl sUte tAai the a�eve iniormation is correct. I agree to comDly with all city anE counry
or0inances anG stale lavrs re��ing to EuilEing conslmclion antl �ereby autlwrize representatives ol this ciry ro enter upon �he ahove�mentianeU
P�aPe��Y �orinspetlion pu�Pa5e5.
Da�e�. � Z Signamre: �
�ri�er's ucense or Sociai Securiiy x:
16aL46 W�ne-9uildinP: Green—Coae Enlorcement; Canarv—Aooliwnl: Pink—Revenue; Goldenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 05661
PERMIT NO: P 056616 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTZON TYPE: 1FR SP PERMIT TYPE; PLU PURPOSE: ALT
JOB DESCRIPTION ; COMMERCIAL T.I. (OFFICES) SQ FT;
CLAIM VALUE; CALC—VALUE; GROUP OCC; B-2 /
COMMENTS: REF B56537
�t�r��r�r�r*******�r*�r*�r*�**��r�t�t�t*�r�e*� �t�t�t*�r�*�t�t+t�t*�r**�t�t*�t�r �r*x *�*�e�r�x �t*�**x *�r*�r+t**�r**�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REO• PRO�T; FARCEL: 41050104 ZNE: REF NO:
PLANNING NiSTES>
>
k�t�r**�r�eit***k�rk*�it�rit***�t*�rit�rit*�t*it*�eit*�rr**rit�ekx*r*�e*�r�rit�tkk�r�e�rret�r�e**�tlt�r�t�r*�r�r�t*�rit�eit
D E V E L O P M E N T S E R V I C E S`�, R E Q U I R E M E N T S
i
ZONING APPROVED BY :, DATE:
BUILDING APPROVED HY ; � DATE:
APPLICATION ISSUED BY: /� --- DATE; �j 2�
if it if 3f 1! if iE 1f If jt it iE k ik k if k if iF �t if iE k i4 if iF k 1kiEiF k iFli�4ii?�F�1F 7k
1l�klFifikififkk�lFltifiF�IfkiFififif�F�flFiFkikMkifkif�fkifMiflfitififif fikiF�fikklflt�f�FifiFifiFlEkiEififiFlflFlfkikikifif�FitifltifiFlFiFiFk
LEGALI2ATION;N F E E S' M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECT C MECHANIC FIRE SMIP/RES GRADING
PERMIT 9 00
'15t SMIP/NON—RES
PLAN
ISSUE FEE 3,00
BUILDING—DIV—> PERMIT ISSUE P AN—CHECK TOTAL PAID DUE
TOTALS----> 4,00 3.00 0,00 7,00 7,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 7,00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
%,00
MiFMikkkkifkiFkfFk�titifik3kfFiflf�kkifkiFiEiFfEififk�ffkiFifif�FitkiklFltMlFiFkiFitlEkMMiF�lifiFlfiFltklfiEiFifiF3tiEitiFkif3FiFif3fitifiF
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 SZNK BAR 2,00 2,00
PLU 1 tiATE{t HEATER AND/OR VENT 2,00 2,00
END OF FEES
(�1 �Ji�i�'.:c-_s ��l'�{.:i ' _ ' i
ofi�e: �.. ,;,s. ,., _ ,:_,
��CONSTRUCTION AND PLANNING �
7 APPROVAIS Permit # Date Inspector
1. Temporary Electrical Service or Pole .
2. Soil Pipe-Undrgrnd._ � � " � - �
4.=Etpcirica
= 5. Stbel Re
�_ ,6. �Elgctrical t7FER 6md. ' � ��
, •7.'Footing�"- : � �:
1 8. -�oundation � -�
9. Water PiR€-tJndrgrnd.
1�. Structurai Ftoor 5Ystem , � •�
11 . Property Sewer Line & House Connecti�
r _.
12. Sewer Cap 1 T '
13. Roof Drains =
74. Rough Plumtii`ag .-
15. Rough Electrical-Conduit
i 6. Rough Eiectric Wiring
; 17. Rough Wiring Sign
18. Rough Electrical�7 Bar Ceiling
19. Rough Heating & A�r Conditio�ing
20.,`Rough Factory Fiieplace � T �
I 5 � � � i
21._Ducis, imStructure} i , .•
22. Ducts, Ventilatirig��� � �
er �
23.;Gas Pipe`-,flough & Test .
24. Roof Freming * .
25. Roof Sheathing . � '�
26. T�Bar Ceiling (Structural} & Monocoat
27.'Frame and Flashin� � y r
�-28. Lafding��$Siding � . _��_ K
'29. Insulati�n ' � �� ,
i30. Drywall Nailing � � �
-31. Plaster Biown Coat,' , �.r
�32. ElectricalPo�erMeter�Final: �
.33. �Finel Electrit, ;" _ 'T
u,
'�'34; Fin1 Heating & Air Conditionin@; �
'35.'Final Ga's Pipe�Test' , � -
Y
T36. NoOd ot�Canopy .e. - •
37.-Fin51 Factory FireClace^ ' • ' �
,- , " :. .
'38. Final Plumbin9 . � •
.;39. WaterService�Fin91- � .�
r i.
40: Gas Service-Final : ,� . ,. S
�F7. Solar pomestic-Final ••
n
42.`-Backflow Preventer` ,�
43. Backflow Irrigation- ' • �
�44. Landscape luigati"q"n Systemr. - , .r,
�45�'Sound Atteouation - 5 � �
_46. Handicap Regulations = �
47::fINAL STRUCTURE & BUILDING `
48.`�FINALPLANNING ' �"�
49 ,.EleMric Release t0�dison �
50.;Gas.Release to Souihem California Gas
51. CERTIPICATEOF'OCCUPANCY
Date
�
PO(- SPA
APPFOVALS Permit #
52. Pooi & Equipment Location
53. Steel Reintorcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, � Undrgmd.
61. APPROVAL TO DECK
62. Backwash & Receptor-Finai
63. Heater & Vent-Final
64. Piumbing SYstem • Final
65. Electrical�Finai
66. Solar System-Final
67. Fencing & Access Apuroval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
.� S � APPROVA`i�S; y=Perynit # • � .. -
n . � ,
�: ' - +. J0. Undergtound Hydro
S i_ r � z,;, �,t?71. Producf�P,iping O��Gas �Oil
� -! i, � � .72. Underground Fius� �i "
_ ` �' � s � � ' � 73.' UndergmB'. Storagey_l"ank O Gas ❑ (JII`'
i � �� - ��. t � �'74.-Overhead Hydro`' �
� �T •� 75SDry Chemical ,� � " -
„ : q 76: Dry Stand�ipe ' '-� � ' � ; -,'
- ' ' • ' � 77: FIXEDSY$JENFFI�GAL' � .
.
,� � �.. , 78:� FIRE PREV. FINAL �z i��
� ^ n • •HEALTH^DEPT+. R-EnUIRENIEN
ti ' i
,� • �:. ' 797`F'IN'AL'1NSBECTI�N � - ' �
� -: � � � . • -gO.rFOOD CERTIFI,CATE i55UED� _
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Date �Inspector
a
c
v.
PX0.IECT PODNESS:
OWNEN'S NAME:
aooeess:
RflCH/ENGINEEH:
aooxess:
ANTON BL
ITY PACIFIC`BANK
ILSHIRE BL #400
O1�LES
345-4951
, HERBOLD, JR.
CAMINITO VINO
uxiT: 5 0 0
NEG.NO.: C_ 073
�r�r:
PEqmiTTEE: LAGUNA HILLS CA 92653
aooness: AIR CONDITIONING CO.INC, (818)244-6571
6265 SAN FERNANDO RD
GLENDALE CA 91201
LILENSED CONTppCTOP OECLANATION: I �ere�y aifirm I�at I am lic¢ns¢a unAer Dmvisions of Chapter 9(cOmmencing wi�� Section
7000) ol Division 3 oi the Business antl Pmtessions Code, antl my license is in tull brce and eHecl.
ci�r uc.: 014 4 0 3 srare uc.: 1 Z p cuss: C— 2 0
�a�e: .� .�'�✓ �� /S' � �� ��
WOflKENS'LOMPENSATIONOECIABATIONLLherebya rtm�hatl veaceni�icaleolconSentloselFinsure ac ih eolWarkers'
Compensaiion Inmrance, or a cenilied coDY ��e�eaf (5ection 3800; Lao. C).
roucvxo.:WC207416259 E%P.ORTE: iOIOSI9Z
comrnxv: TRANSPORTATION
❑ Certifietl copy is hereby Iumis�eG. � C¢rli�ieG copy is IileO wi�A �he ci�y BuilCinq DiWsion.
"Daie-.? �—%'Z q licanr �
E%EMPTION FflOM WOflKEflS' fAMPEN5PTI0N9EC1ABRT10N: QM1is secuon necd not Ee completeE it Ihe permil' o n reU (51WI or less�.
I certity �hai in I�e pedormante ol Ihe wOrk br w�ith I�iS permit is i35ueQ I Shall no� employ any Derso n y r w as lo become
sub�ect �o I�e Workers' Compensation LawS of Calilomia.
Oate: Signature:
NOTICE: II. atter making IAis aeclaraiion. yau s�au10 became suble�� �o !he Workers Compensalion D�ovisions al lhe Lahor
Cotle, you mus� torlA�th comply wi�� such D�o�isions or lhis permi� s�all b¢ Geem¢E revokeA.
CONSTBIlCT10N LENOING AGFNCY: I here�y aifirm ��at there is a construction IenOinp agency lor ihe peAarmance ot ihe work foi
which Ihis permil is issuea (Seciion 3097, Civ. C�.
LENOEfl:
RODflESS:
OWNEB BOILDEfl OECUflFTION: I herehy aflirm Ihat I am exempt imm [�e Coniractors' Siate License Law lor Ihe lollowing reason
(Sxtion 70.37,5 Business antl Vrofessianal CaEe: Any uty of caunty which requires a De�mit to consimct, alter, improve. demolish, or
repair any simcWre. pnor to ils i55ua�ice. also repuires ihe ao7���nt lar such perrtut to file a signe0 statement ihat npJshe is licensed
pursuanl Io I�e O�ovisions a� �he Comracmrs' State Litense Law (Chapter 9(commencinp wilh SecOon 7000) ol �ivision 3 0l the BuSiness
anE Prolesvon5 CoGe) or Ihai �Us�e is evem0� ��erelrom anG ��e GasiS lor Ihe allepe0 exemDtian. My vioW�ion al 5¢ciian 7031.5 by
any applicani lor a permit 5u01eci5 Ihe apDlicant ta a ciNl p¢nalry 0� not mare IAan �ive �undre0 Oallaa (5500).
I. as owner ai Ihe Omperty or my employees with waAes as t�eir sole compensation, will tlo t�e work, antl Ihe
❑ stmcwre is not intendea or oHered lor sate (Section 7044, Business anE Pmlessional Cotle: T�e Coniradors' Stale License Law
Coes not appty tn an axner oi a pmperty who huilds or impmves Ihereon, an0 wlio Goes 5uc� xrork himstl�/herull ar thmuAh
Ns or �er awn employees. Orovi0e0 Out such impmvements am not intenEM or ofleretl lor ule. Ii, Aowever t�e Euilaing or
im0�ovement is solG vntAm one year of comD�etion. the owner will luve �he OurGen of pmvinp Ae/she Eid not 6ui10 or impmve
br I�¢ purpose a� sal¢).
I, as owner ol the pmp¢ny, am exclusively coniracting with licensetl coniractars la consiNct t�e pmiect ($¢ction 7044, Busines5
❑ antl Pmlessions CaAe: The Contractor5' State License Law Ooes nat appty �o an awnerof properry who Omltls onmprOveS i�er¢on
anJ wlq contracts lor such D�ojec�s m�h a wniracmqs) litense pursuani b I�e Contrac�ors' State license Law1. I am aware
thal prool of t�eir Worker's ComOensa�ian insuranw shoul0 be proviEeG Io m¢.
� I am exempl untler Section: B. 8 P. C.
lor ��is reason.-
Oate: Owner.
I Oo hereby cenify ihat I am awdre ol an0 undeRtanA the reQuiremenis of Californu Health antl Sdfety CoAe $e[tions 25505, 2553J, and
25534 aM tnat I or any fuwre Uuilaing acupant wiil/will not (cirGe one� need ro comply with saiE stare mEa and tAe requiaments lar a
permi� br constmction or moaili[alion imm Ihe Air OuaOry ManaAemeni District. flesitlen�ial cons�ruc�ion appliwiions are exempi �mm
inese D�ovisions.
Da1e: ApplieanL
I hereby cenily Iha� I �ave reaG I�a application an0 slate Itu� ��e a�ove in�ormation is carte[t. I agree lo comply with all city anU counry
arGna�es anU slaie Wws relaung to OuilEing cons�mclion a�M au�lwnze represeniatives a� INs dry ro¢nrer upon tlre aGove-mentioned
pmpehy brinspection purpose5. / '/ /
..__ �._ / L'� 0 7_ _'_..__. 6�/ Nc�/_.�L. �
Drivefs License a� Sacial Securiiy x:
0
i6aL46 W�ne—Buildina: Green—CoEe En�orremenC Canarv—Hnolican�: Pink—Revenue: GOICenrod—Assessor
CITY OF COSTA MESA — BUZLDING PERMIT PERM NO: M 05663
PERMIT NO: M 056636 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTZON TYPE: 1FR SP PERMIT TYPE: MEC PURPOSE: ALT
JOB DESCRIPTION ; COMMERCIAL T.I. (OFFICES) SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS; REF B56537
�r�r****** x �r�+r*****+r**�e**********+t*�*****�e*****�e*******�r*+�r**�****�r�**�r�r*�r*�*�r*�r
Z O N Z N G R E{J U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT 1rN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL; 41050104 2NE: REF NO:
PLANNING N(ST'ES> '
i
' itifkiFiEifMiFifiFiEfhiFiFlfiflF4iFiFkiFlfMiFifMiFiFiFifiFlkikifiF*ifiF�FiFifkifiFiFkiEiFiFikiFitilkiFiFkkkiFiFiFifiFiF3flklfMlf�flf�FiE�fM1F�E
D E V E L O P M E N T S E R,:V I C E S R E(j U I R E M E N T S
ZONING APPROVED BY �� DATE;
�BUILDING APPROVED HY : �' DATE;
.APPLICATION ISSUED B . - DATE• ��fi�'��89�Z�
�flFkififiFkiFifififiEiFKififiFk�fM ifk�kiFafifkMffk kiF
iFiEiFiFk�FiEkk�tiEklflFitftlEltiflElflEkiFifltklEklFlt�liflflf�llE If�FitikkkMlFkkkkkklEklEitkkitkifkiFkkkjfikiFiFMiFMikitifit3FiF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLOMHING ELE RIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 225.50 �- V
25! SMIP/NON—RES
PLAN "
ISSUE FEE ' 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 225,50 15.00 0,00 240,50 290.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 240,50 OVER/SHORT; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK
�240,50
ifklfkk�FiFMkiElEffltitklElfifiFiFkififikkMffiEkiFiEiFiF1klFIf3flEklf�k�F�FMIf�flE�fkMifikMihitifikkififiFitiEiFkifiFiFiFiFaFkiFikiEiF�fifik
I N D I V Z D U A"L F E E B R E A FC D O W N
TYPE QTY D E S C R I P T I�O N UNIT COST TOTAL COST
�,.
MEC 1 REPAIR/ALT HEATING UNIT/SYS W/CNTLS 9.00 9,00
MEC 25 VAV BOX 6.50 162,50
MEC 12 FIRE DAMPERS � 4.50 54,00
� �END OF FEES �
v
"� ','1. �s:,�—��):1'9', "_ . ^ .:�
�i �t: it' � ;�;:,., _T'.,- _ - -
CONSTRUCTION AND PLANNING � . PO.. _& SPA �
APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector
�
t. Temporary Electrical Serv�ce or Pole., 52. Pool & Equipment Location
�2., Soil„Pipe-Undrgrnd.., � `' - 53. Steel Reinforcement
3.-Electvica.l:�-oRduitU[iliTv-Ondrgmdl� � 54. Forms �
4.�ISct:ic31�G6i�uit-Undr9rnd. r'� 55. Electrical Bonding
.15. SteeJ.aeipf�rfe�nt� - � � .. � 56. Rough Plumbing & Pressure Test
�_ 6.� EtQctrfca9 UFER Gmd. �' S7. APPflOVAL TO COVER-GUNITE
: �,
` 9.YFootirtgr --� � { ,� 58. Electrical Conduit-Undrgrnd. .�
8.-foundation ,�; r 59. Gas Pipe, � Undrgrnd., Tes[
<
9.�iNater P�peUndrgrnd. �. 60. Backwash Lines, P-Trap, O Undrgrnd. �
lO�Structural �loor�sterr� . 61. APPROVAL TO DECK
71. Property Sewer;Lin"e & House Connection 62. Backwash & ReceptorFinai
V
12. Sewer Cap ' y :�, 63. Heater & Vent•Final
13. Roof Drains '- � 64. Plumbing SYstem - Final
74. Rough Plumbing _ 65. Electrical-Final
15. Rough Electri¢al-Conduit ,- - ' 66. Solar SVstem•Final
i6. Rough Electric,Wiring � 67. Fe�cing & Access ApProval �
�17. Rough V�liring Sjgn 68. APPROVED FOR PLASTERING
'18. Rough Electrical�T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL � �
19. Rough Heating &_Air Cpnditionin9 _ � '1 vuv1� FIRE DEPT. REQUIREMENT
- - r�
20.*Rough Factory Fireplaoe i r '�s h ` , , „ ' :APPRQVA'LS � Permit # ��^_- '��" `_'
21:.Ducis, in St�uctuie � . -� ' � J0. Undergr�oGhd Hydro �
22. Docts, Venti��ting • • ' C _ Z�' '•77, produc;Piping �Gas �,Oil
23 :GaS Pipe;Rough � fest i ,,;. � r ,�. _ - . : y72. UndergroUnd Flush •� �
24; Roof Framing • � ' - " - ' + 73f•Undergrnd.Srorage-Tank OGas ❑Oil
25. Roof Sheathing , ` � 'L � ` � �, ;'� . '74: Overhead Hydro� � �
26r�T�8ar Ceiling �Str.uctural) &�Monocoat � r 75; Dry Chemical - �'� - 1,.- r
�> V
27.��Frame aod Flashin9, �� •, � � ;. 76! Dry Standpipe "',` , �' . � ��
28.�Lathing:& Siding •- - :�:.; 'r i • ••" • 77" FIXED SYSTEM F.tNAL` y `^ ; T
�29. Ins5lation - � �� � � . 78rFIfiE PREV. FINAL �; �.c:
, >
�30. Drywall Nailing �� � � � HEALTH�DEPT� REQt�IREMENT
`-31. Plaster Brow� Coat;� ti �. � i' '� a r79: FINAL INSPECTION '" � ,
-�32rElectrical Power Meter-Final � , I �, p :80.� FOOD CER'fIFICFCTE ISSUED�
}33:'_�`Final Eleccric . ' ; �' ; , f, , `Notes:3 ��YL /�o1^}LZEa40_,�f=. L.� c�
_ , , �:
�•34� Final Heating�& Aic onditioning- ^ �IQZ �Y : . i - : y:y. .. , _
'35�Final G2s Pipe-Test° _ - -' +!" > - ''�CI' •' .'• _
.� _
,36.THood o� Cano ' � . , � � � '
r PY r, ,:+ .t ��"� �� c r t �� :l
�+37 =Fin�l FaQory FireP,lace^ `•' �i `� � � ," ` ` ,_ ' '
1 �L`.
-38. Final Plumbing � � .... -J+ r ' � ' � .�: � , . -
r
'39. Water Service•Finalt � � - ' � � �' �!. 1`- " =�� __ � ^ r � .
,
r40. Gas Service-Final ' _�, ,r ,� x �� � r '� , �_ - � .
,� - �
=41. Solar pomesticFinel: � •• " i � ' � +
n Y 1 ��+. .i� :O t' T:
� 42 ='Backflow PreventerA v * ` �+ �� �z. ' �� �' _ �
. 43. Backflow Irr�i'gatiom "5 S t �.. - a t" _ � c'
a i C�, .
i z � .�
,.44. Landscape Iciigation Systern j;= �x �t �r ' - '� �__-
- �.: �
�45:..Sound Attenuatian x[ � ' 2- �- � • - - "�
ti .�. �� rr . . .
_46�-Handicap Regulations � C ` • - • • • ; " , � .
�47.�FIPFAL STRUCTURE & OUILDING < ' � ' � �y = .0 = ��
, ' .
48.'FINAL PLANNING` ' 'P ` ' ! '- � K � ` .
i . + . . � � . � �q � r
�49.-£�e`ctric Release to Edison � - � � �- - �. � � ' . � -
.n ;: r
i50.,.Gas,Release to Southern Califqr,nia Gas Co � � ���(� ; . ,- • �' - '.' .
"'S1. CERTIPICATEOF,OCCUPQIVCY ' . �
a . ��- T- . �_
No. Date
�
�-
PflOJECT �DOXESS:
OWNEP'S NRME: �r
eoosess: e
AflLN/ENGINEEB:
aooness:
555 ANfiON BL
CURITY PACIFIC BANR
0 iiILSHIRE BL #400
S ANGELES
90017
13)345-4951
Y W, HERBOLD, JR.
072 CAMINITO VINO
UNIT: 5 Q Q
flFG.NO.: C _ Q'� j
b�:
LAGUNA HILLS CA 92653
PEflMITTEE: HUTCHISON CORP. ( 714 ) 756-0501
�DOflESS: 34ZO IRVINE AVENUE 101
NEWPORT HEACH CA 92660
UCENSEO CONTPRCTOP OECLABRTION: I Oe2Gy allirm Ilwl I am IicenSeE unEer prmdsions ol C�apler 9(commencinA w��� Sec�ion
7000� ol Division 3 al ��e OUSinesS anE PmteStions CaOe, anE my IicenSe is in Iu0 �o¢e anG e�leti.
cirruc.:p Z�g� sTnreuc.:269512 cuss���
Oate: �—� SignaW2:
WONNEN�PEN TIONOECLAflATION: Illere�ya��irmlha�l�aveat¢rliliWieO�tOnS¢nllo5el6in5ureoratetli�itai¢OIWOrk¢rs'
ComDensaiion Insurance. or a cenifieG cop t�erro� (Sectim 3800. LaO. CI.
POLICYNO.:WCP 667443�i E%P.ORTE: OSIOSI9Z "
�ameaxr: GREAT AMER INS
J Cenilietl copy a hereEy fumis�etl. � Certilie0 copy is iJeG xit� tAe ury BWOi g Diviswn.
-� e
oa�e: � i z �ao����:
E%EMPfION F OM WONNEflS' COMPENSRTION OECIAflAT10N: (ilos secuon nee0 rot Ee mmpletM il Ne pemil's lor m u W(5700) m less�.
I cerlify Iha� in ��e pedorman[e ai t�e work lor wtut� lN5 permii i5 i55u¢E. I 5hall na� employ a�ry person in ang er w aS t0 b¢tOme
suDle�� �o t�e Warkers' ComOensation LawS ol Caiifomia. �
Date: Signaiure:
NOTILE: It. alter making INs OeUaration, you ShwIE become wblK� �o Ihe Workers' Compenuiqn D��slons al Ihe Lahor
CoOe, you musl lorl�vnl� compN ��� such O�ovisions or �Ms pErmit stWll Ga G¢em¢G r¢vokeG.
CONSTflUCTION LENDING RGENCY: I �ere�y a��irm tlut �tcere 5 a mrtslruciion IenOinq a0e�' �or I�e putorm2nte ol IAe work �or
whicn inis permit is issuetl (Section 3097. Civ. C�. �
LENOEB: -/
ROOflESS: �
OWNEN BUIL�EFl DECUNRTION: I �ereGy allirm t�at I am exem0� ��om Ne Contractars' Siata license Law for the lollowing reason
(Seclion 7031.5 Business anU Prolesvonal Cuae: My dq of munty wliic� repuires a Oermil to constmct. alter, improve, Oertrolish, or
repair any slmclure. O��or lo it5 i55uance. al5o r0puires l�e a00�icani lor suc� permil Io lile a 5iqneE 51at¢ment thai �e/5ha is licensed
owsuant io tne provisions ol the Coniracmri State Limnse Law �Cnapmr 91�mmenrinp vnt� Sec�ion 7000) al Division 3 0l tha Business
and Prolessions COUe� or I�at n¢/sne is exemD� ��erelmm anU t�e Oasis lor ihe alle0� eKemplion. My violation ol Seclion 7Q31.5 hy
any apDlicanl loi a permil su0jttts t�e applitdnt lo a cidl Denalty of iql more IIWn liva �unOr¢E dotlars (5500�.
❑ I, as awner of iM pmDerty or my emyloyees wit� wapes as t�eir sole mmpensation, xiA do tAe wod, an0 Ne
simcmre is no� inienGed or allere0 tor sale (Seclion 70aa, Business antl Pmleuiawl Catle: Thn Coniractors' State Ucensa Law
eoes not aDDly to an owner ol a proce�Y � �uilas or imprOvlS tner¢on. anC wh0 Oces sucA w0A Oimselllner5¢II or tnrouph
his or n¢r own CmplOy¢es, Dmvi4eC ��ai SUCh improvem¢ni5 are n01 inl¢natA ar altereA for 5aI0. II, how¢ver ��0 Ouildinq or
im0�ovement is m10 wit�in one year ol cortplelion, t�e awner wiA tuve ��e GurGen of DmWnO M/she tli0 not bui10 or im0�ova
lor Ihe ourpose ol salel.
I,as ownerollhe pro0eny.am exclusively caniractinp withlicensetl mntraclorslo consimcithe D�oject4Section 704d, Business
'❑ and Prolessions CoGe: T�e Contractas' State Licenu Law tices not aODN lo an owner of DmperryvAw CwIEs or impraves tAeaon
antl who contracis �o� SucA D��Iec�s wil� a caniratloqs) license pursuanl to �he Canlractors' $taie Li[onse law). I am aware
! Itlal O�ool ol t�eir Worker's ComOensatian insurance slwulG DB OrodGeE to me.
I� I am aempt unGer Sectian: 8. 8 P. C.
tor this reason:
�ale: Owner.
I Do nereUy cenily I�ai I am aware ol and untlerstantl i�e repuirements al Caiilomia Healt� ana Safeiy Coae Sections 25505, 25533, an0
2553C an� ihal I or any lulure buil0ing acupanl wilUwitl nol (cirUe one� n¢eE IO compty wi1I1 uiU staie c00es antl tAe reQuiremenis lor a
permil lor conslmclion or motlilicalion Irom I�e Air Oualily ManaAement Oislrict. flesitlenlial consimclion apD��calions are eeempt irom
Ihese pmvisions.
Dale: Applicant:
I hereby tetlAy Inal I nave rea0lnis aDPlicatian ane state ihal ine aDOve inlormalion is Wrrect. I apree to comply witn all ciry ane counry
or0inance5 antl sta�e laws relaiing to CuilGing con5lruclion an0 he�¢by autlwrae rep�esentaliv¢5 0l �N5 city to en�er u0on Ihe a6ove�menlione0
pmpetly lar inspeclion pur ases. ^�fG^ � _ ��
'/ v � ;� �r-.
Date: � � Signamre: � ` ��
Driver's License or Social Security N:
1641�46 Whlto—Buildinp; Green—CoOe EnlorcemenL Canary—Aoolican�; Pink—Ravenue: Goleenmtl—Aazxesnr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 05655
PERMIT NO: E 056554 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION ; COMMERCIAL T,I, (OFFICES) SQ FT;
CLAIM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: RE: H56537 PRIMARY BLDG. PERMIT.
**r*rrr*rr*�*r*�r�r**+r*****�t+r�t�t**�r****�e�t*r�e*�r***r*r******r�t�t�rx*�er**�r**+r*�**r**�r�t�r
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL; 41050104 2NE; REF NO:
PLANNING NiST'ES>
>
��r�e�t**x�rx��r��r�r.*�r*�e*,e�t**��r**�r�t�r�r��rx�r:**�t*�e�t**�e*�t�t�t*�t�t**�t*�t�t�t�t�t�r�r�r�r�t�e�r�r�■�e�e�t*�r*
D E V E L O P M E N T S E R V I C E S R E(j D I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY ; � „ n � DATE:
APPLICATION ISSUED
MftMiFkiEkitltMltMiflEkklFlfM
MiFMMMKiFifiFitkMltMfEifiklEM
LEGALIZATION:N
BLDG PMT
PERMIT
PLAN
ISSUE FEE
MkfFifiFKMifMitiFkkffl�,tMifMlt
F E E S U M M A R Y
PLUMHING ELECTRIC MECHANIC
152�1�=
"15.00
DATE; �3�Z
iF'{FiFkMiFikiFiF�ItMkM iF�F1Fif�E
kMMiFMkitMMfffFMMlf1F�fMMMMklFifiFif
STRUCTURAL SEGNENT:N
FZRE SMIP/RES GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CNECK TOTAL PAID DUE
TOTALS----> 152,10 I5,00 ' 0,00 167,10 167.10 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 167.10 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN—CHECK
167,10
itMiFiFMMIF�fkifMMMMMMMMififlfififkiFlfMMMMifiFkif�FMMklFkifkk!lifiFkMltlflfiFM1FIF�liflFitiE�FM�FitkitMMiFihif�kMlhlfklFiFif
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15,00
ELE 138 FIXTURES LIGHTING ADDITIONAL EA. .45 62.10
ELE 20 RECEPT/OGTLET 1 ST 20 EA, ,75 15,00
ELE 94 AECEPT/OUTLET ADDITIONAL EA, ,45 42,30
ELE 20 R6CEPT/SWITCH 1 ST 20 EA. ,75 15.00
ELE 6 RECEPT/SWITCH ADDITIONAL EA. ,45 2,70
END OF FEES
�� Urila��—f_fl�';)U�i�. �.. � �. �L
iA'�F• ^r. :�. 97 � _, - .
CONSTRUCTION AND PLANNING . PC & SPA
APPROVA�S Permit �i-` Date Inspector qppROVALS Permit # Date Inspector
i. Temporary E�ectriwl Ser✓�ice•or Pole�.. 52.� Pool & Equipment Location
_2. �Soi� Pipe�Undrqrnd. '� : :�' 53. Steei Reinforcement
- .3.� •c nca'��pi�`�Itii$,L`�tiliry�Undtgmd�� ' 54. Forms
� �.
-'��iSaAidC6oi�Gi�l;I�drgrnd.- ' S_ 55. Electrical Bonding
.r � .i
`.Z j�:�7"�ein .'r�Q�i�rtt ;�'x� 56. Rough Plumbing & Pressure Test �
�8•�lEctrJ�aTUF'ER�6md. � c 57.APPROVALTOCOVER�GUNITE �
Mr .� � �
z•�'.''Footi��','�T�r� "-� 58. Electrical Conduit-Undrgmd. 2
�,&=Foundatien •,s � � 59. Gas Pipe, � Undrgmd., Test `
9. �Nater Pi¢e�lndrgsnd. 60. Backwash Lines, P�Trap, 0 Undrgmd.
ir�:
10.^Structurel �Floor �System 61. APPROVAL 70 DECK
17. Property Sew"�r LinE.& HoLse Connection 62. Backwash & Receptor�Final
a
12. Sewer Cap y , � • 63. Heater & Vent•Final
13. Roof Drains�* ,' 64. Plumbing System � Fina�
14. Rough PlumtlSng �" . 65. Electrical�Finai
15. Rough Electrical•Conduit , i,,,/f 3�?{,� � . 66. Solar SYstem-Final �
��W f%1s,
76. Rough �(ectriE'�jNiring '' . 67. Fencing & Access ApProval '
�
� 77. Rough Q�jring Sjg9 6$. APPROVED FOR PLASTERING
18. Ro�gh Electrica�-T Bar Ceiiing 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT
- - - - c-, � x ,� ,.�,;T
201rRou�h FDctoLY � eplace � �:T. S 7 a: .� � c r� �: � PPROVA�S' =�.Pefi'nit # :_ - ' ,
� I S'T' CL1 < S -� T.w ¢ � .0 - {t - ...>
2L:Du s, in-Strt;ctu ,r, ' � ' ,. "r'q �, �-' ,r ;�. .. .70. nde�g�ipun Hydro �
22� Duc[s, V3nt[�tirig � � �S � f - ¢� `�7�. product�cPin� Q�C{�r�s O*Oil
23.`-Gas Pipe�Ro h & �est � r '� -�` * " " ' _
� �S � �x . ,72. UndergrovPd FlusEr «
24:rRot9 Framing �I � -- J"n a � , X a�73?�UndergrncT. Sror�g'-fank _�O Gas ❑ Oil �`�� t
25. Roo�f Sheathin9 1 F �'^ '- ' �
,� _ *.
mv �;, v .� p '_T . 74=0verheadiiydro;�'~
26� T-Ber Ceiling (Strtuctural) &:Monocoat r' � -� ' �i+• • 75�Dry Chemical � � � � • �" �Ms ��
27' Frame aqd Flashm�' � ! � ' ° ; ' 76: Dry Stanc�l�,e " � � � - "Y ^ ~ ,'
'ti J%:�F A•' -•aJ *1i�.fTl�n
r28�La24ing�$Siding��t. _ ���ij r �f>' .. ' •••.. 77: FIXEDSi' TEM;tiINAL' � _ ' ' - V
'''29. Insiilation � • � ' . .. s -^ , x 7 � r ; � �._ .� ^
g� ST . �' ( �. 78�FIRE PREV. FINA� ,. �. s _•?�
,�30. Drywall�Nailing �+ � �� + ; c � - HEALTHI3EPT%ii�EQUIREMENT_. :
„ ��'
C31. Plasrer Biowp Coa,tF c Y,,, ;� � ���J9:�FINAL Ift�$P,ECTION: r- J'L;� •`'''
»
; �32.-ElectricalPovYer (vietec-Final� ` ���. ,ti i �. i 8 . FO00 CERTIFICR`YE IS6 �ED �
� 33�in� Elettri4 . � � 't ��l�� � : es. % �' /� � � � _ r �f.�"
� � � e. 2
rn r - • 3. . a. - . . � w
,34.�Fina1 Heeting;& Aii.Copdicioning; .� K j � :,. s� •.s ; s, . g �y� ^ "
35:''Finat Ga's PipE-Testr :' -� ` ' .* * � ' ��. o � �*� S y. 'r p -
� . +, b r � so - -_v.- .
�fi 1io�d of�:anOPY .. :7a : M - .. r ^ � � ' " c '•- - j <. - �- J�
�-,
,37:=Fin51 Fectory Firedlace^ � S r o .+� �*t 1 ��.: ; C': .K . . � �0 5 *i
�c �i x i � < .r +� �L
n .� : .. .. .' i, � c . . _ _ -
,�38. Fir�f Plumbin9 > t: i I � �r • S s x
i ..
c.39. Water Service-FinaM � � . �z x ! '� * _ T,'ri .f S
r . .� �: �s >, _ :� x � r�6; •,in
;40. GasService-Final ` � � ' , . . . .
t� [Ti St*' � 5 ?1 � I �.Y R '
5:41. Solar pomestic-FinelS •• � � e �i- �
� .� m . � ' ♦ .�C
--42.'Backfiow Preventey. - ;` �'� � ''' . .. , , ''
I :a n .z :ir -�
. �: .
43. Backflow Irrt�atiorn Q.s'S * + r� 'F� �_
`r n S s+ �; � x•_
Y \. � V � , 1
.� 44. Landsca�e f�Cigati� Systerp `K =' x ,', �, � - ' R + [ i� v " '_ ^ ' �,_ ' :,_
......... �
f45:'Sound Qttenuation - �- �+' •�a - - + %� - _+';.� tK�_ •
� . - ,• 'r • . c- +
•�46. ,Handicap Regulati�ns � 7 y, '� � � ���' .r C ^ ^a �� a
i
�47.;FINALSTRUCTURE&Btf7LDING • � f. � i :i i � �
� ♦ + � a
48�If�L PIAaNIN� , � ;. �_ ,l � 4: R ,; ;� ,i ; '
w : - .-_ .
�49::Electric Relgase to Edison � . I � j. . .� .
+ a • r. " x .1 �
;=50._Gas.Release to Sou�hem Calitornia Gas Co �. � �y !, S = , � ,�. � . . '.-.
J � • -
.51.�CE9TIFICA7E 0 ,OCCUPANCY � 4 � _ ; �, . '. � _�,�` ._.
No. Date
Pfl0.1ECT FDDHESS: j S J �r�N BL
OWNEfl'S NAME: SAKIOKA FARMS
aooeess: TENANT—TRANSPACIFIC
DEVELOPMENT
TORRANCE
FflCHIENGINEEN: 213 316-1000
nooness:
flEG.NO.:
UNIT: 6� 0
:!
ux�r:
PEXMITTEE: KIMHLE AND COMPANY ( 714 ) 895—i 156
noosess: 7540 SUZI LANE
WESTMINSTER CA.92683
LICENSEO CONTflFCTOfl OECNBATION: i �ere�y aliirm I�a� I am ticensed untler pmvainns ot Ghapter 9(commencing with SecGon
7000� o� �ivision 3 0� Ihe Business an0 Professions Cotle, and m ' ense is in Iullforce antl e��ec�.
CITY LIC.: a sTaTe uc.: q 609 2 3 � 16
jlaro` Signawre: _
WOBREfl COM ENSATION OECIABATION: I hereby aBirm Ihat I have a certifica�e o� consen� m sel4insure or a certifica�e of Workers'
ComDensa�ion Insurance. or a cetlilied copY �hereo� (Section 3800. �ab. C�.
voucvxo.:WCI00135854 EXP.OATE: OSIZ3I9Z�
'OMPANY: NAICC
� Cetlilied copy is hereby lurnishetl. � Cetli�ie0 coOY filed ith 1 e cii Gil ' �ivision.
�al ' � Applican��.
EXEMP�ION FPOM WOPKEHS' COMPENSATION oECUBRTIDN: (T�is seaian nee� irot be completetl il ihe permit is lar we �undred (5100� or less�.
I cehify Ihat in the pedormance o� Ihe work �or which Ihis permi� is i55ue0, I shall not employ any person in any manner so as �o become
subjec� b the Workers' Compensation Laws ol Calilomia.
Dale: Signa�ure:
NOTICE: II. afier making Ihis tleclaration, you s�oultl become subjecl to the Workers' ComDensation provisions oi I�e La6or
� Cotle. you mus� brihwi�h comply wi�h such provisions or �his permi� shall Ue OeemeO revoked.
CONSTNUC710N LENDING AGENCY: I �ereby aifirm iAat Ihere is a consimction IenAing agency for ihe De�ormance ai the work for
which this permit is issuetl (Section 3097. Civ. C�.
LENOEH:
AODflESS:
OWNEB BUILOFB OELNMTION: I hereby ailirm that I am e.empl iwm ihe Contractors' Stare License Law for t�e follovnng reawn
(Seciian 7031.5 Business antl Pmlessional Code: Any cily o� county which requires a permi� �o consimct, al�er, impmve, tlemolish, or
reoair any simcture. Orior to iis issuance. also requires ihe apDlicant for such permit to lile a signeU statement �nat he/sne is licensed
pursuanl lo �he provisians ol the Comramors' State license Law (Chapter 9(commencing vnth Section 7000) oi Division 3 oi the Business
antl Pmlessions CoOe� or �ha� helshe is e�emp� iherelmm and �he basis fo� �he allegeU exempiion Any viola�ion ol $ection 703L5 �y
any applicani lor a permit subjec�s Ihe ap0licant Io a civil penal�y o� no� more than �ive hunAreO dollars (5500�.
❑ I. as owner of ihe pmpeny or my employees with wages as iheir sole compensation, will tlo the work, an0 the
stmcmre is not intenaea or offered 1or sale �Section 7044, Business antl Protessional Coae: TAe ContractoK State License Law
tloes no� apply �o an Owner oi a OmOeny w�o bUiltls or impmve5 there0n, an0 wAo tloe5 Such work him5elf/hefsel� of Nfough
his or her own employees, proviUeO �hat suc� impmvemenis are nol inlentle0 or oflere0 for Sale. If, however Ihe builAing or
improvemen� is soltl wi��in one year oi completion, �he owner will �ave Ihe burden ol proving he/she Ditl not build or impmve
for ihe Durpose of sale).
I, as owner ol Ihe propetly, am exclusively conlrac�ing with licensetl contracmrs m cons�mc� �Ae D�olec� (Sec�ion 7044, Business
❑ ana Pmlessions CaAe: The Contraciors' Siate License Law Ooes not apPry lo an owner o� pmpeM w�o 6utlUs or impraves thereon
anE who cantrac�s for such projecis with a contractar(s�license Dursuant to t�e Coniracmrs' Stale License Law),I am aware
�ha� pmol of their Warker'S ComDensa�ion insurance shoultl �e pmvidetl to me.
� I am exempt untler Section: B. 8 P. C.
lor this reason:
Date: 6wnec
I do hereby cenity thal I am aware o� antl untlers�an0 ��e reQuiremen�s o� Cali�amia Healllt an0 Safery Cotle Seciions 25505, 25533, and
25534 antl ihat I or any IuWre 6uiltling occupant wilVwill not �circle one) nee0 to comply wit� saitl state Godes an� ihe reduiremenls for a
permit lor cons�mc�ion or motli�ication imm Ihe Air �ua6ty Managemen� DiSiricl. ReSideniial cons�mction applications are exemD� ��om
Ihese pmvisions.
�ale: Np0litanC
I hereby cetlity �hat I have reatl this ap0�icalion and s�ale at Ihe ve in�orm - i mrrec . I agree Io compty wilh all ciry antl coun�y
ortlinancesa tl5ia�e awsrelating�obuildingconslmclion ntlh yaul r¢e re en �ives i cirytoen�erupontheabove�men[ionetl
pmperly br insp¢c orLpurposes.
�)�
�ye: � Signature.
Driver's ticense Socia� Secun�y a:
1641d6 Whi�e—Builtling: Green—Code Enbrcemem; Canary—Applicanp Pink—Revenue; Goldenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 05665
PERMIT NO: F 056658 PLAN CHECK NO: 00897-92 L GOVT; N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : ALTER FIRE SPRINKLER SQ FT:
CLAIM VALUE: 6,500.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: ��—iFET— �e� �, (351�537
*�tx�*x�t**�r�r*� *�***�t�t**+��r�r**x��t**�t*��r*�r*�t�t******�t*�t*x*�e�r**�t****�*�*��-*���e**�t*****�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARRING REQ • PROV; PARCEL: 41050104 ZNE; REF NO:
PLANNING NtST'ES>
i
ik if iF if 1F ik if iElE if 1E iFiE iF�E iF iE iF i! iF jF iFlF iF if 1E iE if aE if If k ik iF iF if if if iE1E iF 1E iE iF iE 1f iF iE 1E k iE if �f iF 3E iE 3E if �f �f iF iE jE iE iFif if iF 1E 1f if iE �f iE iE iF ik aE iF
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; �' DATE: ��� '! 1--
iF ik iFlF iF iE �f iE jE if iF 1E iE if iE �k IF �k ft iE �k If ik if if i4 iE ik iE it if iETt"�F'{F'iF'iF'iF�iFif k
1t M iF if iF if if iF 1E iE ik iE iF if iF iF iEif iE iE if �E k �f iF iF iE iF iE ik ik if ak iF iF if 3F iE if if ik ik jk iF �flk �f fE it 3f if iFiE iF iF±f iE it iF �E iF iE 1F iE �F iE iE iF k kiF ik iF iE �E iF jf iF iF
LEGALIZATION:N F E E S D M M A R Y STRUCTURAL SEGMENT;N
PERMIT HLDG PMT PLUMBING ELECTRIC MECHANIC 9I�RE�o SMIP/RES GRADING
�i53 SMIP/NON—RES
PLAN 58,50
ZSSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 90,00 0.00 58,50 198.50 198,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 90,00 OVER/SHORT; .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90,00
if if iEif iEiFiF iF iE if iE if iF iFiEjkiF �E1F�f dkdEif if �E iE *�! 1E 1E 1f iE 1k iflf iF iEiEiFiF 3E 1F 3E jf iElti6iElf if �Fif if iEiE 1E itiE!!iE iE iFiE iE if iE iF if if if iEif �EiF9f iE iE iEiE
I N D I V Z D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T Z 0 N UNIT COST TOTAL COST
FIR 90 FIRE EQUIP FEE (FROM BLDG VA7, TABLE) 1.00 90,00
>:
END OF FEES
-''r ._,.
�
% r�
�— (�
cP 4r'
� ��
C'1 UOli1C54-OC31i454 0` �o�
DATE: 03/?0/�2 TItiE: i}E:;.7
L',Oi�
- � CONSTRUCTION AND PLANNING_ , . PC A SPA
= APPROVALS Permit #' ' t �Date Inspector AppROVALS Permit # Date Inspe�tor
t. Temporary Electrical ServiCe or-Pole. -- . 52. Pool & Eq�ipment Location '
2, Soif Pipe•Undrgmd... ' �� . � ' 53. Steel Reinforcement •
3l Elediical Conduif Utility-Undrgrnd. � 54. Forms '
4. Elect�ical Conduit�Undrgmd. _ 55. Electriwl Bonding
(�, 5:,5tee� Reintorcem'eni - . �q . 56. Rough Plumbing & Pressure Test �
_&: 'E�ectrical UFER�Grnd. � 57. APPROVAI TO COVER-GUNITE
. .r -
.�7;'.footings .` 58. Electricai Go�duit-Undrgmd.
8. foundation �� '� 59. Gas P�pe, � 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 & Hoese Connection 62. Backwash & Receptor-Final '
12. Sewer Cap � " � 63. Heater & Vent�Final �
- �`
13. Roof Drain5 ��� 64. Plumbing System � Final '�
14. Rough Plumbing � 65. ElecYrical-Final
15. Rough Electrical-Conduit '- 66. Solar System-Final
16. Rough EleMric Wiring � 67. Fencing & Access Approval
cJl7. Rough Wiring Sign ' 68. APPRQVED-FOR PLASTERING
18. Rough Electricil�T Bar Ceiiing 69. POOUSPA SYSTEMS FINAL
79. flough Heat�ng & Air Conditioning FIRE DEPT. REQUIREMENT
L Y � '
20.'Rough Factoay Fi?eplace '- * T ; • ' APPROVALS. -Permit #
21.�Duc£s,in-Structura' . . �_� . � - � �70. Underground.Hydro
22. Ducts, Ventilating•'. �•� `_ -. � _71, Product Pipipg OGas QOiI
23. Gas Pipe�Raugh & Tesc � , - , 72. Undergiout�d Flush= .
24. Roof�Framing ' - 73.`Undergrnd.StorageTank�Gas DOiI
25. Roo�Sheathing �" .� • � ' 74.�Overhead Hydro_
3-2,s1tZ w,�p.
26. T-Bar Ceiling IStructural� & Monocoat �_ � 75.; Dry Chemical �
ti.
27.'Frame and Flashing - i.. - � 76. Dry Standpipe � � =
2S. Lathing & 5iding � ' . . - • • 77,�FIXED SYSTEM'FINAL . _ �T-QI-[{ �i
�i,
29. Insulation ` i' � � .� � 78. FIRE PFEV. FIIVAL � � � �' '
��_ wn
'30. Drywall�Nailing �- } HEALTH_DEPT'tREQUIREMENT
r
31. Piaster Brow� Col�.�`, ` � .. , : � .. 79. FINAL INS,P.ECTION . ' :
-32.rElectricat Power M1tAeteGFinai �, �•�50. �FOOD CERTIFICATE ISSUED
33::final Electr�c, ' . ' _ _ '
u . K r . .
Notes: _
34. Final Heatin9 & Air�Conditioning; - �r - • ` �
- �
35. Final Gas PiP�-Test , _ ' • - ' � � .
�t
36. Hood or Canopy- �-� . � , , � o ,- � �- ; �� - • � ' .
"37. Final FactorY Firepjace . _ � - ' " "
38. Final Plumbing r �� � � � , ti � ..
-39. Water ServiGe�Final � ' •
4 \ - .
�40:,GasService-Final , , ' �,, , „ - s.�� - ' �
-41. Solar pomestioFinai _ ' • : � •
42. Backflow Preventer , ' �. ' �
43. Backflow Irrigation' ` - � � • `� ' _ "
; ,_ .
44. Landscaqe Irngation System� �' . . - � . • ;�i: • ..
45.-Sound Attenuation � � • - - - -- . "
.. '�i � 'r � . . _
46.,Handicap Regulations ' ' � � , , � ,
47. F�NAL STRUCTURE & BUILDING ' � -
48. FIN'AL PLANNING � ,. � � .; : .
_49. Electric Release to Edison � i �
� � . .
50. Gas Release to Southern Cali�ornia Ga: Co I , ;� ' .
51. CERTIFICATE OF OCCUPANCY � _
No. Date
ROOqE550GBNLqIq: SSS ANTON BL
OWNERSNWEIFIWOWN: SAK IOKA FARMS
. '�oon�ss: Pr� BOX 2097
TERMINAL ANNEX
�vv�. �uiwc �ooeess:
uwr: 5 TH
un.wnecToxe�x�n: INTERZOR ARCH 2136232164 °0N0 C-9378
AIMIIOHFl10.'SADDPE55: SSO S HOPE ST °NT� 1100
L.A. CA 90071
��"�T�g� CAL—PAC CONSTROCTION ( 310 ) 645-35Q0
CONiRACT01f8MIlUNO 6076 BRISTOL PARKWAY
eooeess: CULVER CITY CA ueao.: 392102
90230 UNT: ZO�
110EN5ED COMHACTOHS OECUNATION: I MnEy aI1Fm uvMr pnelly d pmjury tlW I un IieemeE uMx peovi�iona d Cheqx 9
(commennnp xit� Seclion ]000) d Diviaion 3 0/ �he B�eineee end PMeseione CoEa, eM my lironea ia in lull lorce entl eHM.
cm ua No.: uc. cuss: B u�1 p � :�
o�. ia�is/4 �— ��,
.
OWNEH BUILOEF DEClAq1TI0N: I hereby effirtn uMar peratly of rjury thel I am ezemq Irom �M Comreaaa Licenae Lew Iw Iha
'Nbw'vq renaon (`�� ��1.5 &n'vwss eM Profaesions CoEe: Airy cN a mumy v,fiid� nqui�ae e paimu b muvun. ellx. impova.
noloh, m repe'x any elmcWm, pnw m na 6waMe, ebo reQuiree ihe eppliran� for euch permtl to fb e eiB�� eletemenl tMl he or eM
icerued Wn�t io IM provisbm d IM COMreqwv Liceroe Lew (Cheper 9(commmidiq wilh SeAion )OW) d Owiion 3 d �In
' ea eM Prdesaona GoCej a �Iw he u she ie exemq ihaehom eM ihe bain far �he dbped ezemplion. My videlion ot Setlion
]031�5 by eiry epdie�ant la e parmn subpds IM epplicen� �o e civil penely IN rrot mwe then fve huMred dollen [$500�).
� I. a9 owrer d tM1e qapenY w mY �WW�%�^'�h wepes m tiwi ede rompensazion. will do the v.wk. eM �M evuclum w mi intaMed
«aHered fa sele (Section 1044. Busineas end Pmfeaenna Code: The ConVeaon License Lew Eoea nW eppyto en ownarol prapeM
wM WiEa a inDrovea iMreon. eM Ma do» suM wak NmseX or M�C a ihroiqh he a Mr own emVly*ea. povided thm wch
improvemeMs ere mi inleiMed or olleeed Iw ub. II. Mwever. tM buiMinp a imP�mem ie eaN xilhin pre Yeer d mmple�on. tM
owner-buiNer vAll heva iM buNen ol pravi�q M or ahe dk nm build w improve lar Ihe WN�e o/ seb).
� I. ea oxnar d iM popeny. em extluarvey mnlreqmp wilh IironxE mnlrenwe w wnmrud iM prqee (Sepun NM. Busiris� erd
Prolaesione Cotla: Tha Convmon Licenu Lew tloee � eppFylo en ownerd praparly who buiNa orimqweathereon aM wha
conirec�s lar wM WMeaa xilh e mmrmor(s) licemed punuent io ihe CaNrapan Liceme Lewl.
��I am uemq uMer Senion: B. 8 P.C., iw �his rearon:
D� O�xnr
�I do hereEy cenM � I em ewere W end uMersiuM Hre repuiimnenh d Calianie HeMh eM Selety COEe SeUiwa?5505.25533. eM
zs53 j. ena Mm I«eny Mun buildina aauV�t vnll / wYl na (drcb one) riead m ewnPH wen aaie atete mdee uM tM reVuinmame br
epeimnlawnsirutlionormodifralionhwnthaA'r a�y enepememDistnd.RevCeNialmn9iupionepp&e�imsereeiemqlmml�me
pfW1510119.
Deb: ApqieM:
WOHKEP'S CONPENSATION DECLARATION: I hereW aifirtn �Mer pe�y d pe�jury wn d iha lollawiiq dadvmons:
❑ in��a�immma:,a�nnsmea�iiosen;u�..m...o��w�v��,�wa,�d,diwWsaa�a�ooamaimo�
�
coEe. i« Ine paAwmence m iM waM br wNcn Inis permA is isvued.
� ❑ i n� �a.�� mdma:,.�,�,� �w�,.m� n,.�,.�. m�a���d M s«�� a�oo a u,a �m« coea. ro� ina ro�ro�md,� a ma
n work Iw which �hie parmil is isaueC. My wake�s' campenmtion innwence renbr eM pdiq number ere:
c�a: FTRFMAN'.S FfINT� E}CPIRES
PolbyNumbar. jCj,TD R(1SUFR'a7 02/01/96
'(This section need rat 6e mmpbteJ / fM1e perml'n /a om nuMrei ddlers (Stool a bv.)
� I mnJy ihel in Ihe parlormvwe d tM wark Iw whch thie peemii ia iae�eE. I ehell ml empby anY Pe� in enY men�wr eo av lo
nacm�a w4«� m �na ..onma• comro�+mion b.n d ca�aanie ene ee.m imm � � a n«a�. w4ea m mn wo�en•
mmpenaeiio�n p��mas /Ja oi Seaim 3)00 d tM Labor Coda. wn ////''' �/Ln/..
�_ De�e: ���L.lt '/ � AOdian� �d�"'
� WemAD� Fellun ro wcvn wortsri romp�nvtlon rownp� b vnbwNl, entl �lull �ub/�cf en �mployer ro ctlMixl pm�Mu aM
a mp
c/vll fim� W ro ais �unCrM fhovunC EWbn /S/0q000), In eAf/fbn ro ths cwt o/ rompwuetbrt demspp v qvNded br In
SxOon 3]O6 0/ Ma LeborCode, Intxuq entl attomsyY l�u.
CONSTFUCTON LENDINO RGENCY: I hereW effifm unEe� panelly ot parN�Y �� ��em ia a mnsVuqion kMinB epem.y Im tM
�IBIiOf111BlICB 0�1�10 Nq�l�O! W}IX/1�h9 Gef111Y19 69110��$BCIU11 �03). CiM.C�.
LENOEq'S NAME:
LENUEfl'S AUGHE55:
1 cerlity IM1et I heve reeE this eppliraiion end aele �hei tha ebova intormeiion ia mrtecl. I epree lo comDN ��� a�l cny eM munry oNinentts
end sime leMs reletiq to WiWvq conmutlion erd Mraby einlwrae eepraeenlelives d Ihiv aty lo entar upon iM ebove-mantpnad qoperry
forin=padpn purposee.
ZYJu i Z�i Ss�
—_ '� ' nn� Neme
om.:�b /3 F�
Signewre ol Ovmer/AgenVRppliranVConveqa
(5151d6WP) Whde-Buildiip 8 Selmy:Orear�-Flle: Cenery-Applicenl; Pink-Revenue;OOlEanrotl-Aeaesmr
CITY OF CUSTA ME5A — BUILDTNG PERMIT
PERM NO: B 074573
P£RMIT P�O: H 074573 FLAN CHECK NO: 0371�-95 A GUVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 20,000
CLAIM VALUE: 360,p00.00 CALC—VALUE: 386,400.00 GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS
*�*�t�**********�*****��***�************�x*��***��tx+��***�*******�t*+���********�*�
Z O N I N G R E t� U I R E M E N T S
S' E T B A C K S
------------ MAIN BOILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT': F'T IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 2NE: PDC REF NO:
PLANNIWG NOTES> TENANT IMPROVEMENT FOR STH FLOOR FOR 76 PRODUCTS COM$ANY
i � � /"
iE iE iF iE jE * iE IE if �E if jE iE iE 1E iE 3f jE iE�jE+�Y' 1E iE i!!E-N�"�,iE 9f if iE iE 1E iE jE 1E �E fE 3E iE �F iE iE 1E iE iE iE 1E �E iE if if iE iE iE 3E iE iE �1E 1E iE if iE iE 1E dF dE iF 1f-iE �E 9't 9E jE 9E iE jF iE iE
D E V E L/O P' M E N�T S E R V I C E S R E Q U I R E M E N�jF S
ZONZNG APPROVED BY r� : Q:� DATE: __9�S,J�',S—
BUILDING APPROCTED�HY • Gt�� UATE: 1d�3�_S`
% ,�/� � —
APPLICATION ISSUED%BY: ��� . DATE: ��O//,�9s"
iE iE iE iE �E �)E *�lE �1E �lE aE aE iF 1F 3E?�.�IE iFiE iE �E 1E3F'G;F3FiF3F3F'., i�7F�E x iEiFiF�F3E±FT. �'iFiF�f iE iE if 3E r, jt �F 3E ifiE 3Fir'iF x"'�Fi�iF"iFiFi4 it
LEGALIZATION:N � F E E S U M M �R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRAUING
PERMIT 1,644.00
SMIP/NON—RES
PLAN 267,15 81.14
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 1725.14 0.00 267.15
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECHANIC
1644.00
TOTAL PAID DUE
1992.29 1942.29 .00
1725.14 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
81.14
3E �E iE 3EdE 3E 3E 9E iE if iE iE iE fElE iElf iE iE if �E 3E 1E 1E iE iF iE iE iE iE jf iFlE iE iE 3E iE 3E iE �K iE �E �F �1E 3E 3E iE iE 3E iF 3E 1E 3E iE 1E iFlf iE iE �E iE if iE if if 1E jf iE 3f if iF if if iE 1E iF jf jf iE
I N D I C' I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I F T I O N UNIT COST TOTAL COST
SFC 20000 OFF-INT. ALTER TYPE I,II F.R. -AVEP. 18.24 364,800.00
SFC 20000 EQU-ALT COMM. SPRINKLER SYS -AVER .36 " 7,200.00
SFC 20000 EQU-ALT COMM. AIR COND -AVER ."/2 14,400.00
END OF FEES
OS D7?5'_'.,'�i-0014?062 gk7 Y
UATE: SO/13�+�`' ii,"rr� lo:�C
1'�?5, lY
�
" �
CONSTRUCTION AND PLANNING � POO SPA ,
APPR6VALS Permit# Date Inspec:�F I�.�ppROVALS Permit# Date Inspector
. . r
'. Temporary Electrical Service or Pote 52. Pool & Equipment Locatio� �/
2. Soil Pipe-Undrgrnd. � . 53. Steel Reinforcement .�
3. Electrical Conduit Utilitv�Undrgrnd. 54. Forms �
4. Electrical Conduit-Undr9rnd. ' � 55. Electrical Bonding �
5. Steel fteinforcement 56. Rough Plumbing & Pressure Test ,
6. Eiectrical UFER Grnd. 57. APPROVAI TO COVER-GUNITE
7. Footings 58. Etectrical ConduicUndrgrnd.
8. Foundation . 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgmd. ,' 60. Backwash �ines, P�Trap, C7 Undrgrnd.
10. Structural Floor 5Ystem 61. APPROVAL TO DECK '
F '
i t. Property Sewer L�ne & House Conriection 62. Backwash & Receptor-Final ,
12. $ewer Cap � 63, Heater & Vent•Final
i
13. Roof Drains � 64. Plumbing SVstem � Final � �
14. Rough Plumbing i' 65. Electrical-Fina�
.
75. Rough ElectricabConduit • . 66. Solar SVstem�Finai ' -
i 6. Rou9h Electric Wiring 67. Fencing & Access Approval •�'�
17. Rough Wiring Sign ' 68. APPROVED FOR PIASTERiNG
18. Rough Elecerical�'i" Bar Ceiling 69. POOUSPA SYSTEMS FINAL �
18. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT
20. Rough Pactory Firepiace � APPROVALS Permit #
2t. Qucts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72, Underground Flush
24: Roof Framing 73. Undergrnd. Storage Tank Q Gas ❑ Oit
25. Roof Sheathing 74. Qverhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat ,O ��j !J��J 75. Dry Chemical
� �, / ,
27. Frame and Flashing �� �j' 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINA�
29. Insulation / � 78. FIRE PREV. FINAL
30. Drywa�l Neiling �/� � HEAITH DEPT. REQUfflEMENT
!
37. Piaster Brown Coat �,� 79. FINAI INSPECTION
32. Electrical Power MeterFina! �� 80. FOOD CERTIFICATE ISSUED
33. Pfial Electcic . � Notes:
34. Final Heating & Air Conditioning '
35. Final Gas Pipe�Test - .
36. Hood or Canopy �
37. Final Factory Firepiace .
38. Final Plumbing �
39. �Mater Service-Finai ' � .
4Q, Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow irrigation
44. Landscape Irrigation System -
45. Sound Atienuation
46. Handicap Regulations
47. FINAL STRUCTURE & BU�LDING (/ �y (�
48. FINALPLANNING ' .' j
49. Electric Release t0 Edison , �
�
50. Gas Release to Southern California Gas Cn
.
57. CERTIFICATE OF OCCUPANCY -
No. Date
1
�
�
pUDNES50FBUILqNO: SSS ANTON HL
an+EasNWs�Fa+ox'": SAKIOKA FARMS
��x PO BOX 2097
TERMINAL ANNEX
�vr�. wuuxc,moncss:
uNr: 5 TH
nncxnecron�x�n: INTERIOR DESIGN 21362321&c� 9378
u�cxon�ras,�uow�ss: 550 S HOPE ST �NT 1100
L.A. CA 90071
ca+m�cTars wue:
CONIN�CTORS YYIII10
. AU�11E55: 11G NO.:
UNT:
LICENSEU COMXRCTOflS OECUIP�TION: 1 Mroby ellem uMx perely d pnjury Net I em Icen�eE uMer praieune d Chapx B
(oommenorq wuh Section ]000) d Oiviaun 3 d �hs Buainms vM Pmleavma Cade, uM my licanm e in hA Ipcs eM e%oq.
cmuc.ao.: uc.cuss: uc.No.: EXP:
oate: conumn:
OWNEP BUILDEF DEC4RR710N: I Iwmby etFrtn uMer penely d perN�Y �� I em exemq Imn tM Con�redm Licama Law /a pn
'+Ilowip reemn (Sapion )031.5 Buanae vM Pmlesaiana Cads: pny cpy a camry whiM �aqui�ee e permit to oon�Vun, elier, improva,
imolah, w repei any eliucWre, priar lo ib ba�ance. ebo repuim iM epplicen� lor euch permil to fib a eipmd elelamenl iMt M a eM
. �w,�„a w�,d,� m ine ao�.v� a ub c�veaa. ��,. �. Icnaa« e(oomm��o wnn seaoo �ooq a d.e�, a a�ro
Budmn end Prala»iwu Codel a tIW he rc ahs u wmq tMehan end IM Esw la ths �IbpM eamnqian. My violation d Sspion
)W 1.5 Dy eiry epplicem In e parms wEjed� iM eppliceM lo e tivil penely of np mas ihen INs �uMred Edlen �350011�
� I, m owner d Ihs popenyor my ampb�ma wi� we0� a+�� ��Da��. ��I Eo iha Mork, uM Ns �IrucYwe u rid intended
«Mxed fa mle (Seclbn ]Oad, BwiMv vM Prdesaiona Coda: The ContreAae L'we�ma lawdoea rW applytoen oxner d popery
who Wids a inprwn thereon, end hfa Ero� suM wwk NmqM n Mrael p Mrqqh ho a M own amployse�. panASE Ihet wch
impwememn ue ro� imeMeE a dlaied /or veb. tl, howewr, IM buitli�p a inpwanoN u�dd within ona ysv M mmplMion. tM
�ownm-0uddx will haw �he Cuedan d pmirq M a elre d'd rc� buiN a impws lar IM µnpwa d We).
I. u omiar d �he qopeM. � eRtlueively canlrad'vp xil� lican�ed mntrenan io wnetrup Ns prqW (�� �. �+�e uM
Prolesaana CaEe: The Canlradon Licerree Lew doee 1w1 epply W en ownar al popairy M1ro bultla p Lnpovw tMnon uM xfio
convecta 1« eutli qqena wnh e mmrmar�e) IcenaeE Wnuem �o �he GonVedae Lican�� lew�. '
� I am uemp u/Ma SscQiion: B. 8 P.c.. br No rsnvm: 1
De�s: �/�'b / ]� Owier: �� % � I J . .' �
, iw i em e.,e,e d w wWeialene ins �ea���«�n d celfomu Ile.m� .ne sealr coee saian. usos. zs3a..iw
a anY Mun Wikinp ompeni vriA / wil rw� (dreb un) � lo canpy x'v� �eiE ue�s tada� eM iM �epu'usmaw br
udid,«moeirmiono-om�ne�F ai�aimen.mwmria.asdd«aielwnaruaion.00fmian..i..umol�romm«.
a�,..
Dme: Rpplcuil:
WORKEF'S COMFENS�TION DKIAX�TION: I MreEy effim� under pe'ully W parjury ar d tM tdbwup datluuixn:
� I heva ud W meinten e mtCkNs d w�wit �o �eMina�s lor xpkan' cdnprvpim. o povidsd la by 9W'v� 3lW d tM leEar
COEe,toriM perlomiancs diM xorkl« wlicAthia parmu u 4aueE.
❑ � ncn..ne wie meim.:i won«.• comro�o� ��w„ze. m raa��roe M s.aw� a�ao a me �.ew code. �« �ne o.�k��w�c. a in.
work la xAidi i�ie pamN o usueE. MY wabn' oompenwbn iruurencs u�nx arM pdiry numEar ars:
c�.
Poliry Number:
(This ascTion mad rrot Ds mmplereC / �M pennt ia M me hundied ddleis �S1POl d hn.)
❑ � caNy inm in ine v�ameMa d ine wax ror wncn �nu w� b aeuea. � enw na empw �r ro� �n mrv menn.r n.a �o
beconr aibpd to iM xorkera' cmbenWion 4xs d Ce4fanie. end pree Ne ! I NwM bcm�s wbjq lo IM waYan'
canV�ion Op^siam d Seeion 9)00 d tM Lebar Coda. I NeA lonhw4h aomPN wEh Nm qwi�'vm.
Dme: Apqi�aru:
Wamlrp: F�Ilun ro�xuro MOM'eri eonpensstlon eoverp� h unlawNl. uM LWI �Nct �n �mp/oysr b cr/Miul P�rop end
nH� nn.s w ro ms nuwrae �rouaw ea�an (rtaqaaoA ����n ro m� co.r a� mmpxu.�an d+m.w• u povaw ror m
Sxtlon �1f16 01 tlp LeDor Cods, Infr�s4 Ne ��mryi Iw.
CONSTIiUCf10N LENOINO AGENCT: I haeW � uMer penelly d perjury that ihae u e wnneudion bMmp eyeM.y lur Ihs
parlmme� d the xak la whidi thu pamY is eaued (Seuion �091. Civ. CI.
LENOEN'S NAYE:
LENDEF'S AODNE55:
I cMily �het I heve reed Nc epp4eibn W aae �IW Ne eEoue Wametion e conq. I epree to comply wY� ell ay enE ooumy ordirwics
eM slete leMs releiiq b WJE'vg canYrutlion erd Iweby eulhwce iepesanla�ivee d Ihe tlty�o anlar upon IM ebv.e-men�onetl poperly
la irepetlion Wrpaaea.
ERNIE VITUCCI
_���• �P7evu Narnb��
/� Va.r+1t-G� Data: , ZL
Sqreture d //genVAppirenUCm�repa
(StStee.WP) MA�ae-Build�q d Sdety; �eaeMFle: Ce�ary-AppFaN: Pink-He�ien�s: (3alEeneo�Mamw
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 076191 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR
PERM NO: B 076191
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T,I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC-VALUE: 339,625.00 GROUP OCC: B /
���**+Nt**i���****��***+ftt�D�**�****�*��*****�**+Lt**+Tt*�*ft�*****8 **�* x ****�t�t**�r�***�*+�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING NOTES> ,
> .
iE fE 1E 1E iE iE 1E 1E 1E 1E 1h 1E iE iE iE IE iE iE �If 1E 1F iE 1E 1E 1E 1f� 1klE iE iF ik 1E iFlf IF fE �! If fE iE ff� ff iF 1E 1E iE 1f 1f iE 1E if iF 1E if ik if if 1Elf 1f 1E IElElI� 1F 1F iE ik iE.fF iE IE ft 3E iF 1E iE �f 1E
D E V E L O P M E N�T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY '� DATE:
BUILDING APPROVED.BY ; ! DATE; ,,/
APPLICATION ISSUED .BY: . W �L I �^T DATE: � �-� ��
LEGALIZATION:N �' � � F E E S U M M A R Y STRUCTURAL SEGMENT:Y
!1
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,479.50 -_. �
SMIP/NON-RES
PLAN '� ' 71.32
ISSUE FEE - ��
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DOE
TOTALS----> 1550.82 0.00 • 0..00 1550.82 1550.82 .00
REVENUE DIVISION TOTALS--> COLLECTED: ' 1550.82 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC• FIRE SMIP/TOT GRADING PLAN-CHECK
1479,50 _ 71.32
ik 1ElE 1E 1E if !E 1f 7E 1E iE 1k fE 1E 1E 1f 1E iF iklE �E iE iE iE 1E if 1E if 1E 1E IF7F iE iElE 1f 1E 1f k if 1F iE 1E iE iE fE 1E 1E if 1E 1E 1E 1E 1E 1E iE 1E 1E iE IE 1F 1E 1E 1f iElF 1E'1(� fE 1E 1h 1E 1E 4 fE �E fE 1E iE
I N D I V I D U A L =F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 325000 T.I, OFFICE . BY VALUE/$1 1.00 325,000.00
END OF FEES
� �
. )
j
t
i
�i'�': '. • �' ' TM' �
CONSTRUCTION AND P�ANNING � PO�.. d SPA
APPROVALS Permit # Date � Inspector AppqOVALS Permit # Daie Inspector
�
�t. Temporary Electrical Service or Pole � 52. Pool & Equipment Location �
�
2. Soil Pipe-Undrgmd. .-53. Steel Reinforcement
_3� �Iectrical•Conduit Utilitv-Undrgrnd. - 54. Forms -
`-4: Electricai.�onduit-Undrgrnd. 55. Electrical Bonding
-5.-S�eel Reintorcement 56. Rough Piumbing & Pressure Test -
:'�6=F,leclricaLUFERGrnd. 57. APPROVALTOCOVER�GUNITE '
=�7. Fbotings - _. 58. Elearical Conduit�Undrgrnd. �
" 8. F'oundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe:Undrgrnd. � , 60. Backwash Lines, P-Trap, O Undrgrnd.
70. StruMurai-floor Syttem 61. APPROVAL TO DECK
1 t. Property Sewer Line & House Connection ' 62. Backwash & Receptor•Final
12. Sewer Cap " 63. Heater & Ven[-Final
73. Roof Dreins � �
64. Piumbing System � Final
14. Rough Piumbing .: � 65. Electrica6Final � •.
15. Rough Electrical-Conduit � 66. Solar SYstem-Final ' .'
76. Rough Eiectric Wiring 67. Fencing & Acce:s Approval �
17. Rough Wiring Sign 66. APPROVED FOR PLASTERING
18. Rough Electiicai-T Bar Ce��ing 69. POOL/SPA SYSTEA9S FINAL
19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT
20. Hough Factory: FirEplace T _ �, �, :; - ' ' . ' �,APPROVQLS" � Permit #
21. Ducts;in•Structure� - � • - 70.,Undergrovnd HYdro
L - r �
22. Ducts; Ventilaling -„ - � �„. ,• 77, ProduCt Piping O Gas I� Oil
23. Gas Ripe-Rough & Tast � ""S • - _ -� " + 7Z, Underground Fiush �
24. Roof Framing � ° ` � ��~ `, " `' ; . ' . 73. �Undergmd. Storage Tank O Gas ❑ Oil
25. flooiSheathing _' - � �� � c' '� -'t 74. �Overhead HyArQ __
26. T.•Bai.Ceiling (Struetural) & Monocoat Q7`6��,� � 75-��Dry Cheinical ,` � .
� �-� ��/f
27. Frame and Flashing•* � . �_- ' � �s /�/ .A/ 76. Dry Star�dpipe - _ f �
_ . .. r- . � L� /r� ,
2$. Lathing & SidSng �_ � r:S� °' ` " "�' 77�:. F1XED SVSTEM FfNAL -
29. InsuFation ^ + _ � - � � < 78; fIRE PREV. FINAL � �'
30. Drywail Nailing ;. __ ���6 .� � HEAITH �EPt.REQUIREMENT
. , .
37. Plaster BrowroCoat*.� • �':= t ' 79� FINAL INSPECTION
32. Electrica(Fower NjeterFinal � ;"'' �*' 80:: FOOD CERTIFICATE ISS,UED_.
r ,. • .
33. FinaFEle4iric� �x . n • * � N6tes: � . -_ "
34. FinaFl-leatang;$iAe��ondttionir�� �n,' �� . i.; 1��"�n f,� '! 4---�� /�,,,v .�.,
-�, � i i l�N-i��/
35. �ina GasPipe,7est-+ •• r r +. , '�/--1,,� ji/
- �D � r' /_j}= y Y.�
" 36. Hood'or CSnoPY ' - . �' ^' i ' ;rt .' �: : � . �Dnn �'f� 0 . �
- � . �, c . '- [*. " s. a " 1��� ri�GC �f��
37. Final.Factory PirepJace = - + � r � � - • �
38. Final;Plumbing '' �'' ` �' � ' - - •
� f � •
39. YVatei Service��ina1= fi •� � ,: ' . •
40. Gas Service-Final - k � '
». . .
�:
'�41. Solar pomestic�Final�, - - � .
42. Backflow Prevente�'+ ' • * �
- 4 ' � •
( } �
43.Backflowlrrigation_,; y�'"' - � �. ' •
A4. Landscape Irrigation5ystem :=•'^ � . . r r �� _ { , ,: -
, � o.r:
45. Sound Attenuation t - . � " � =�,.' - .-�- . '. �
46. Handicap Regulations �' � _ � •
nt
47. FiNAI. STRUCTURE & BUILDING j� l/ q� " � � _ _,
. r
4$. EINAL PLANNING ' '' °� ' `; '
Y 1 ; ' Y '
49. Electric Release to Eiiison , - Y -
«' _
50. Gas Release to Southem California Gas Co
- i , .
51. CERTIFICATE OF OCGUPANCY * � -
No Oete
�.
�I
woxessaeunaxc: J77 AN-LVN tll,
axehxsruw�iFaa�vr+: SAKIOKA FARMS
' �oo�ss POI HOX 2097
TERMINAL ANNEX
IPtt. Y�IIIIIO �ODHESS:
UNT:
,wcxREcronu+ax�n: INTERIOR ARCH.2136232164 ucr+o: 9378
urcxon�•s�nox�ss: 550 S HOPE ST urar: 1100
L.A. CA 90071
canm�crarsru�' SWINERTON �& WALHERG ( 213 ) 896-3400
cam�croxe�uiwa 865 5 F'ZGUEROA ST
�oo�ss: L�.A. CA �,�, 92
90017 ��, 3000
LICENSED COMNRCTOfl4 OECUN�TION: I MnEy ellim uMs pe�uly d per'ryry Net I em licen»d uMar youieions d Cheqr B
c�.rom wan s:� �000) a uwo� a a ms e��.. �e v�da�. coae..�a mr � A� nm roRe.�a draa.
cmuc.No.:046279 uc.cuss: B uc. o.: 92 EXP: 10/95
ov,: I.v •Zo•9S ���a: i.
OWNEF BUILUEH UECl1N�TON: I IrWy e1Nm uMv pmNy perjiry het I em �emq Im Ihe Canretlo licame lerla Ne
�bvnq �esvan (SaCion )W1.5 Bufiieaf enE Prdmana Goda: A ciY mun�Y �V � e Ds�mC to bucl. edx.'vnG�ow.
moluh, ar rapei eny etmcNro, prior ia ds ueueMe, e6o rpuiiae I ep ' lor suc rmn file e eqrwd mem Me� M or eha
e lieeneed punuenl m t�e pwi�ioero W tM Convmon Lioenx law er B(�m ,.an saa� �000� a or.a� a d in�
Buainm end Prdeniam Codel a ihel M a Mw w eRamq ihsehom eM IM bue lor �he elbpeE naemqion. My voW ion d Se �ion
lW �.5 Cy arry appYreru lor a permil wbjw� �he epplium io a dW perolry d no1 man then � a hurdnd Edlve �SSOOp.
❑ i. m o�.,,er d me oraronv o, my nmWweee wn �.�eom m me:.d. oomw�w�. �;n do mo.�,on�..nd ub N�,a��e b �a �m.naea
a dtered br eele (Secibn ]M0, Buzmn end Proleeeione Code: The ConlreGon limnaa lewtloee'wl epptyloen ownerd qopeity
wln bulde ar inpmws Inereon. eM v.fio Eoa �uch xwk Nmwll n henetl a Waph he a her oxn omploywe, prwidad thm wch
impwainmu ue M inieMed> oflenE la seb. X.lawewr.lhe Witli�q a inpownem u wtl M'rhin anY� d mmpldion. Me
ow�wrbuiMx xill heve the WNen d prv+iiq M a eM Ek mi buiN or improve fa IM WN�a d eele�.
� 1, ea ovmer W Ihe OpGeM. � axNueHety mn�radinp xdlh IimneeE wnVeclon lo cmbrutl the prol� (�� �a0, Bueinroe aM
Vrolesaiane GoGe: TM Cmtrenon Licenes Law doea mi apply W en owner d piopeMy Mw buiNs or'unpovm ihnaon eM who
wnvacu lor urli pqetl� wiN a wmrma�e) IcmeeE Wnuenl to �M Caniraqon lManw law).
� I em eaemq urMar Sec�bn: B. 8 P.C.. M ihie rauan:
Deie: Owner:
I do hreby canM �� �� ewus d ard uMantend IM repNremmu d Cellomia Heellh eM Sdey Code Saeima T5505, 25St�, vd
YSS�a, eM tM1el I a eny Mura Wiki�q ¢apaM vnll / wil nd (arcb me) neeE lo wmply wi� eeid eW a cadee eM IM ipui�emxNs br
apsrtnnlammVuctionamadifiratbnhomi�eA'r u�8 eil�epemeM0ielnd.Reeidenlielconnrudioneppkrelbmenexemqimm�hese
�IUN9M118.
Dme: Appl"ram:
WORNER'S COMPEN4ITON DKL�H�T10N: I MreEy elfirm undx penMy d pe�jury aw d ihe blbxirp Eedueliom:
� I heva erd xil memten � arN'ral� d aonnnl to ��Iltinan tar �ken' oomp�roal'pn. ea porided ta b� Swwn ]�0 d �h� leEv ,
Code.la IM pRmvrc� d IM wak la wlich Ih4 pxiNl u Ioued.
❑ I Mrs ud wil mvmen Makae' oomperoelun irwranro. n nqui�eE by 6wim 3lOD d Ne lsbor Coda. b tM pMomwre d �he
wak ta w1iiM ihu pmm� o iwueC. MY wokere' mmpeneetion Inwranee �rier eM pdiry iwmbx aro:
c�..: AhGONAU'1' E}CPIRES
� Pd'ryNumba: w� o� JOJL1V774 08/O1/96
(TWs eMion md mt M mirOb�b 11M p^n1 u/a wn huiNisdOd4n (JIP01 ar Ims.)
� I wnA' � M IM pMameMe d IM wak M whrh INe pemin muad, I Mdl ml emplq eiry pa�n m ury manrcr n n �o
becam �ubjw m iM .ohere' mmp�nWbn 4xs d G ' anEep ne tlW Y 1• k Q e abjea o IM xalan'
epnp/e�vetion pwupiore d SaCian �]00 d �M lebor Cada, I JUA e1h ' F omph � oe� a' e
De�e: f V� ZG �/�/ AvWicem: /
W�minp: FWun ro weun wohln'rompuuatlon rovuap� l� uq� Y, J Mtll /�ef �n • Iryv ro ulm'iW ntlt/u uW
tlHI Mu'q ro aw h'ntlrM tlwua�M So/W (J10qOWA M Wltlon ro co�t o ronpw�u n�nW u bi ln
S�etlon 91G5 0/ fM l�6or COW. Inhns4 �W �Momry i l�u.
CONSTflUCiION LENDINO ROENCY: I MnEy elfm� �Mer peneAy d per'µy ihel IMn u e mnu�uaun Mndiip qprv.y lor the
paAamer� tl iM wak M whirA ihu M�^�i b eeueE (Setlion ]W'!. CM. CI.
LENDEN'S NM1E:
LENDEP'S �ODNESS:
I cenM �� �� ned Ne epq'r.elion and qtle tlw the ebove iMamvian e ca�etl. I ep�ee to canply wilh ell rSy enE oouMy adir�vioae
eM atete kxa rMmip m buJdvq conmueian end hmsby aulhw¢e iepee+ntmivu d �hia cry to enim upan �M ebwa.memcnad popery
�°`�°'pBd�W`0°°°' DAN CONROY
, � �
ow: d'�'9
�(St51de.WRLJ WM1Te�M'ep d Selely; aree�b; Ce/ary-�DD��4 R�k-Revenue; CaaldenmFAtaefaa
``l
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 074701 PLAN CHECK �10:
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR
N
PERM NO: B 074701
GOVT: N SUPP: N
PURPOSE: ALT
JOH DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC—VALUE: 20,900.00 GROUP OCC: B-2 /
COMhtENTS: 76 UNION PRODUCTS PREP FOR TI
*�c**x-*#+t*+c�u��ce*�c***�*****�**��-****-��-*****�*+t*�****u-�t�*#******+E�*+t************+�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAZN BUILDING --------- -------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NOTES>
i
�r�-**�*��*�*�****�w��f**�-*�,*�*****�*-�**#*��**�*******�r�*�r**�r�**-�*****#**��******�
D E V E L�Q'P� M E N T S E R V I C E S R E Q U,I R E M E N T S
/ '�� /;. - . .
ZONING APPROVED �Y ' DATE:
BUILDING APPROVED �BY� : DATE: .
/ i
APPLICATION ISSU�`D !BY: DATE: Ivr�� �
iflflElEiElEiE'IE1E3E1E1fiF1EiE1E}k�iEjf3fiEif 1E ' ��iEifif-'N�iE3ElfiflElE�iF`�,:�i�i%'�ii�ty�iFiE
LEGALIZATIOr1:Y F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMRING ELECTR'IC MECAANIC FIRE SMIP/RES GRADING
PERMIT 432.00 '
SMZP/NON—RES
PLAN - 4.39
ISSUG FEfi -
BUILDING—DIV—> PERMIT ISSUE PLAN—CH£CK TOTAL PAID DUE
TOTPLS----> 436.39 0.00 . 0.00 436.39 436.39 .00
REVENUE DIVISION TOTALS--> COLLECTED: - 436.39 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECAAIVPC FIRE SMIP/TOT GRADING PLAN—CHECK
432.00 4.39
�E �)F iE 1E ik IE iE fE iE #!E if 1E IE iE 3E lE # iE 1E 1f iE if # iE # �E 1E )E # �E �E jE 1E iE jf #!F iE IElE ik iE YNE if 1! 1E�f iF if if # �E # iE 3ElF �lE iF IE lE IE iE �E �E �)E iE iE iE iE')f iE iE iE'lE iElE-IE
I N D I V I D U A L F'E E B R E A K D O W N
TYPE QTY D E S C R I P T I O t3� � UNIT COST TOTAL COST
SFC 20000 DEMOLISH BY C'ALIIE COMMERCIAL NOZONE 1.00 20,000.00
END OF FEES
41 O�JL92t51-�'n1S2e5� 'C'c�r�r ,?d.39
L'ArE: S0.':�rc=. 7I�f�: G^�1�
CONSTRUCTION AND PLANNING � P�� b SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date I�spector
1. Temporary Electrical Service or Pole 52, Pool & Equipmeni Location ^ -
2. Soii Pipe�Undrgrnd. � 53. Steel Reinforcement ' .
3. Electrical Conduit Utility-Undr9rnd. 54. Forms �
4. Electriaal Conduit-Undrgrnd. 55. Electricai Bonding
5. Steel Re�nforcement � 56. Rough Plumbing & Pressure Test :�
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE _ :'
7. Footings 58. Electrical Conduit�Undrgrnd. '
S. Fo�ndation 59. Gas PiPe, O Undrgrnd.. Test
9. Water P�Ae�Uodagrnd. • 60. Backwash lines, P�Trap, Q Undrgrnd.
10. Structurai fioor SVstem • 67. APPROVAL TO DECK
11. Propertv Sewer Line & House Conqection 62. Backwash & fieceptor�Final
�Z• Se`^ie' GaP 63. Heater & Vent-Final .
13. Roof O�ains ' fi4. Plumbi�g System - Final .
14. Rough Plumbing � 65. Electrical-Finai • '
15. Rou9h Electrical-Conduit ,__ 66. Solar SYstem�Final .
76. Rough Electric Wiring 67. Fencing & Access Approval •
17. Rough Wiring Sign 68. 0.PPROVED FOR PLASTERWG �
78. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, in Structure 70. U�derground Hydro
22. Ducts, Ventilating 71. Product Piping OGas OOiI
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro '
26. T-Bar Geiling (Structural) & Monocoat //��/0�6 � 75. Dry Chemical
27. Frame and Flashing !/2�� � 76. Dry Standpipe
/�
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulat�on 78. FIRE PREV. FINAL
30. Drywall Nailing �� /� � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. fINAL INSPECTION
32. Electrital Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Finaf Electric Notes: /�
34. Pinal Heating & Air Conditioning '_ I /J`_ � / '� �� C �„�, ,,i
J `� Y� 1/u OI `•lT
35. Final Gas Pipe-Test �� ��L�� 1.
v�
36. Hood or Canopy �J
^ - -- - � _
la �1
v-
37. Finai FactorV Firepiace -
38. Final Plumbing �_•
39. Water Service•Final '
40. Gas Service-Final
41. Solar Oomestic•Final
42. Backflo'N Preventer
43. BackfloW Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handic0p Regulations
47. FINAL STRUCTUFE & BUILDING %/�y
48. FINAI PLANNING
49, Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIfICATEOFOCCUPANCY
No. Date
�ooness av emtario: S S S ANTON B L
°w"Eas"","E"'Q'°"": SAKIOKA FARMS
�noxcss: p0 BOX 2097
TERMINAL ANNEX
iwr�. xuuNc �ooxess:
UNT:
STH CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 076192 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE
IPCXRECTOHFllfiNFFA: INTEKIOR DESIGN 21362321610�1D' 9378
uuxonEr+n�s�oox�ss: 550 S HOPE ST �'+T� 1100
L,A. CA 90071
carm�ctars xu�:
cam�croas �uiwo
�oo�ss: uc xo.:
uxr:
IJCENSED CONTNRCTOFS DECLANATION: I heroby aAFm uMer penely d pe�ury thm I em licenead urider povieione d Cheqm 9
(mmmenarp wnh Ssnun )000) d Divieion 9 at iM Butiinv enE Prdeaeiona Code, and my liceme is in full brta vM Metl.
cmuc.No.: uc.cuss: uc.No.: EXP:
Oete: CaNreUor.
OWNEN BUILDEfl DECLAR4TION: I Mreby elfirm uMer penelry al parlNN �� I em memq from IM CanireGors llronu lew lor Ihs
lollowinp meson (Satlion ]091.5 Buenees and Prolesebne Coda: Any cily a munry which repuiree e psrmB lo mnaWct, aXer, lmpavs,
demoluh, or ropeir eny e�mcWm, qior io n� ueuenca, elao roquiroe Ihe applimnl lor euch peimil b file e ei0�� eWemenl I�et hs a�he
ie liceneed W nuenl to �M praneions W IM Conireaon Linnae Lew �Chep�e� 9(commendtp vrilh Satlon ]000) d UNISIOn 3 Ol lhs
Buaneae enE Pmleeeion+ Code� or ihet M a ehe ia exemq Ihxehom end �M bmie for ihe elbpeC ezempton. My voleton d Sed'an
]031.5 by eny ep01iun1 for e permB aubl�l+ iha epplkent to a dvil penelry M nW more Ihen Iwe huMred dollen [SSW�).
� I, es awrier o/iM prope�y or my mmployaee weh wepea m ihai eole compenselion, will do tM wwk, end �ha evuciuro w rwl intended
or oilered br eda (Sec�ion )010, Buei�cv end PMesaions Code: The Comreclon Limnse law Eoea nM epply lo en ownerd propery
wha builde or improvm iheroon, end who doea auch xwk Mmaell or herseL or thraqh hi a her oxn employeee, qwided ihet euch
impravemeMs ere ial inleMeE a oilered br eele. X, howavar, iM Wikirp a inpmvemeM ia soN vmhin pre yeer d mmda�b�. Uro
�owner-Wilder xill heve the buNen d provi'p he or eha did na build ar imprwe (w �M W�e d saN).
I. ea owner W iM propaM. � eRduewey mntreeirq wnh licemed conVaclas ro cmmua tM qojeq (Sepion 10a1. Buairw�s vM
PMaeaioro COEe: TM ConlraGon Lcenae Law doea �w appty b en owner d propeM ��iMa a imqo.•m Ihe�aon uM who
conVecla Iw wd� prqane wdh e oomreda(s) IicenseE W9�t to the ConUeqon Liceme lew).
� I em exem t uMer Sec' n: B. 8 P.C., br Uia reemn:
o�a � Z < < ��,,, ,—,�,�— �. c � —
�_—
i ao n<rew �nav u� i e...e a.�a ��.�,a me rea�+,�e�d d c�ao� �nn d,e �mr c«� sm�o�,. assos, zuaa, �d
nsaa. e�a inm i«env nnu�e w�b�m «wo�� �+n i.ai �w cd�cb o�l �eee m ca�pv w�n .w mma �..�d me �.wv�mmem. t«
e oe�a �amn�ruc�ion«�weirraion han�ne �.3u�"crv .�� oe,�e. aevdmid wm�uao� «op�e��+e�a e�e�w�� me�
povisaru. ,
De�e: Appfraeu:
WONKER'S COMPENSATION DKUfl�TON: I M1ereby elfiim untler pe�alry d px'ryry aw W the /dbxirp Eetluetiona:
❑ I hew eM wJ meinien e eMMieme W oonxnt lo aellimure M waekere wmpeireatbn, m povkeE la by Seuion 9]OU d tha labar
CoCa, la �M pa�lamerce d Ihe v.wk lor Mich �ho pemin ia iaued.
❑ i neva ene m� me�m.:�..aken mmv�u� mn,e�a... �c���ea M seaian a�ao a ub �ee« cce.. b, mo w�� a m.
wwk fa whiM Ilire pa�mil ia iwued. My workan' cpnpensaiion insuranca fimer eM pdiry number ere: .
ca,;s,:
vaKv ru�me,,:
�ml:.sai,+ion ne.d,wr ne conidaroe l fM o�a is roi orro n�nared ewlars Isfoul w �e.w.l
❑ I cenity the� in iM pMormerice d tAe woA la wTich t�ia peimn is iuued, I shell ml empby eny penon in eny menrwr eo d to
necoma wniea m ma .w�.�: c�w�.n�o� ie., m cdn�de, d,e earea mm n i anwu become wqm m me .wnvn•
mmpensalion qmiaione A$aebn 3]00 0l �he lebor Code, I nhell forlhwith oompN �h thoee qaviaione.
o�a: �ooiwem:
Wam/ny: F�Nun ro�x✓n wolken'rompxu�tlon eoverep� h unl�wNl, entl �Mll sub/ect m xnployw ro etlM�ul peneMu enG
civll flns� up ro ons huntlreJ tMuuM dollan (5/00,000), In eltlltlon M Ms roat ol rompmutbn, tlameps� a� provldsd b� ln
SwHon J�OS ol Ms Lebo� CORe, InNrs1( end ettomeyY bsa.
CONSTNUCTION LENDIN� AOENCY: I MreEy ��m unEer penelry ol perjury ihel Ihere e e conatrvaion IaMinp apency br tM
panormaMe d �na wak �or wnlch me va�� �s 9•�•d (s«�on ao91, cw. cl.
LENDEP'S NAME:
LENUEH'S RD�RE55:
1 cerlify Ihet I heve reed ihis epdk�� �e �me ihet IM ebova inlamelion is mrtea. I eprae to c«nply wilh all dty eM munry aEinenoee
aM nte�e lex5 releling lo Wildnq cm&rWim eM hereEy aulhaixa repeaenleuves d Ihc dlyto enlx upon Ihs ebme-mmibned popeM
forinspeaion purpoaea.
ERNIE VITUCCI
Pnm Neme
a� '7. l J «- oma: 1 26
�m�u�edo�.,,enne vnoW� reea
'(5t5t<6.WP) Whne�Ouikip85elely:Greerv-FIe:Cenery-Applram:Rnk-Revenue;GoldenmJ-Assmsor
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I.
PERM NO: E 076192
GOVT: N SUPP: N
SQ FT:
PURPOSE: ALT
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
*���***��*******�****�D**�*+t**+Rt**�***�t***�****�*�*%+t*+Et�+�tB******+6t+�B*****�*+��****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES>
i
if iE iE if 1E 1F 1f 1E iE �F![�!F 1E 3E IEi(� 3E * if it iF iE if f! if 1E �lE IE'lh 1(�'lf' 1E 1E 1E 1E 1E 1E'IE 1E 1E 1E 1E �E 1E 1f 1F iFlh1E 1E 1Elf 1E �h 1E 1E 1E 16'k iF iE 1f 1Elf�lF if 1E iElh fE 1h 1E IE 1E 1E'1E'lh fE 1E
D E V E L O P M E N T S ERR V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : " DATE:
APPLICATION ISSUED BY; '�' S—� DATE; ��I I,
*,���****��***���**��*������������������������ ,�������*��*�**** ��
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 126.60
508� SMIP/NON—RES
PLAN
ISSUE FEE 15.�00 �
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 126.60 15.00 • 0.00, 141.60 141.60 .00
REVENUE DIVISION TOTALS--> COLLECTED; ', 141.60 OVER/SHORT; .00
BLDG PMT PLUMHING ELECTRIC MECHANIC ' FIRE SMIP/TOT GRADING PLAN—CHECK
141.60 , . ,
.
1f iE iE iE 1t iE 1E iE IE iE iF iE iE iE iE 9F iE jE fE iE ik iE iE 1E 1f 1F iE iE iE 1ElE 1E 1E 1E iE if iE ik iF�iE if iE iE iE 1E iE iE 1E iE iE 1E iE IE iE iE 1E iE iE 1E iF iE 1E iE 1F ik �E iF iF iE iE iE 3f iE iE iE iF iE iE iE
I N D I V I D U A L'— F•E.E H R E A K D O W N
. i
TYPE QTY D E S C R I P T I O N, " UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1,ST��20 EA. .75 15.00
ELE 248 RECEPT/OUTLET ADDITIONAL EA. .45 111.60
END'OF FEES
�
e
ot it:ii, � :'•_I4a.%:t9 '�aqF '.4.,bu
DAT'c: Q:r�C�y:. ri'�, i¢.ia
�
CONSTRUCTION ANO PLANNING , - P�O� o� SPA
APPROVALS Permit # � Date Inspector qPPROVALS Permit # Date Inspector
1. Temporery Electrical Service or Pole � 52. Pool & Equipment Location .'.�
2. Soii Pipe•Undrgrnd. � .-' 53. Steei Reinforcement �
"3: Electrical:6onduitUti7itY�Undrgrnd.. ., _ ' 54: Forms
��4; Electrical £onduit-Undrgrnd. - 55. E{ectricat 8ond?ng
r�
;5.�SCeel fleinforcemeni 56. Rough Plumbing & Pressure Test
- n6t�Electrical I1�ER Grnd. 57. APPROVAL TO COVER-GUNITE _ ""
,
' .7. "Footings �`'',. ' 58. Electrical ConduirUndrgmd. �
-_ �8. F.oundatioa - 59. Gas Pipe, C� U�drgcnd., Test
9. Water Pipe�Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd. .
10. Struaurai-Floor System ' 61. APPROVAL TO DECK
15. Property Sewer Line & House Connection . 62. Backwash & Recepior�Final �
12. Sewer Cap, `i ^ 63. Heater & Vent•Finai
73. Roof Drains � ; 64. Plumbing Syscem - Fina1
14. Rough Plumbing �� � '' 65. Electrical�Final -
75. flough Electrica6Conduit ._ . � 66. Solar SVstem�Finai '
16. Rough Electric Wiring � 67. Fencing & Access Approval =
- 17. Rough Wiring Sign � � i. 68. APPROVED FOR PLASTERING �
78. Rough Elect�icaLT Bar Ceiling � � 69. P00�lSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning PIRE DEPT. REQUIREMENT
' ' � ' ' _. - - ' t �" r
20. xoug� Factor�Fir�P�.ace ' '' �� '? * �� F. -' } "AppRbVACS� ;='Peimic # � � �'
:. � � .z. '. _. , , .
21. �ucts; in Strucfur�:t r .•. .. k :5 '� -� ' 70. t�ndergrben'� Hy_dro �
�- y y .
Z2. DVct�;'Veqtila`tjngi.; � �' ^ � `�' �71, Produc P� in ❑Gas ❑Oil
i. x"- r� �2 .-�� f F.�P� 9
23. Gas Pipe-Rougti & 7est � i� i C, - y; r. ��' 72, Underground Rush'� - -
24. R"oof-Framing• "-* - " " '•' � " `,73: Undergrnd.StorageTank�OGas ❑Oif
25. Roof Sheathing s�� c; ,. � r r � c,' �� 74' Overhead Hydro`� x
26. T-6ar Ceiling (StrJcttiral) & Moi�,o.COat ;' I� - '�'.,�, 75� Dry Chemicai _ e'"� � "; _
+ . � J _. �. �• f.
27. �r,ame and Flashinq,,, - x- >� c.. 76. Dry Standpipe .� * -
'-7�,z' - � �: •• �'•�' S`Y,STEIt1.F�NAL' _ r�.
- 28. Lathing &-Siding ; R_ � 77.� FIXED
�•29. Insul Iion l} � .> .. . � .�* � f 78.-_ FIRE PREV. FINAL � -
� 30. Drywall Naili�g '�� _ � x�_ *` - HEALTH D.EPT, REQUIREMENT
- 37. Plaster Brown,Coat�.��. - .��- K � ^79`FINAL INSPECTION� �� �� � '
.32. ETectricahPower Meier�Final ' *'� i`SO;�f00D CERTIFIC�TE ISSUED
'-33. F;�nai'Electric � .�. � •� �," �. = � _ - -
� = ' . �' � ~ �-,3�� I ; ,� Notes: _ : . _ !,_
�.34. Finai'Heatin & AiY.Gonditionin" : ': "
- __ ,. 9 _ < Y 9 m > 1' �r-� �y Il'ls .� �ctv�. Q2C.A�
. 35. Fi�al`Gas Pipe';7esi� :: : � : r. ,_ ;� i ` �,�,_,;,/��--� '('� � ° - �
-- S/_•r�� -
36. Hood.or GanoPY : ' 'T' -- - .'� ' '�. • ' . ���. - ��
- . .s, ' i.:� .. K x - _ _
� 37. Final Factory Fireplace ' � � "= i � � � � x .. a �
�38. Final�Plumbing ^ ^� � x , ' - - ` �
r ,- ir , 7'
�'39. Water Service�Finai�� s• ' �' � ,; i K 4 ' __ -. - . '
�.40. GasService-Finai . �rrn� - . C - - •
' F
�41. Solar OomesticFinai�: ' � _ - " ' ��
r � _ �
_ a.... c - . .
- �42. Backflow Preventer, � �' - � � � ' -
l .
43. Backfiow Irrigeiion .k ^ � � S �: LL Y - "' ` . .
�, -
44. Landscape'IrrigationSystem :n;:� x �. . _ '.. _ r ' -+ s.': ' ' " •
- ' • � > >
45. Sound Attenuation , - , „ ' ; � �� � _ " : �.,;_ �
46. Randicap�Regulations: -• - h � � - "� _'c� �
- - - �� - �.
47. Fa'NA�L• STRUCTUFE & BUILOING " '' • � � �,
; - , x. i �
48. F{NA't PLANNING r �� x^, x*' - . �
49. Electne Release to Edison '. "- ,` �
• K c .
50. Gas Release to Southem California Gas Co t � �- �
. - . -
51. CERTfFICATEOFOCCUPANCY � _ •� - -
N0. Date
�I
�I
�I
,�pOXFSSOFBNLO�� SSS ANTON BL
p//NyR91UYEIFppMk SAKIOKA FARMS
10°"�` PO BOX 2097
TERMINAL ANNEX
�vYb. �u�+a.00HEsa
UNT:
STH CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 074833 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FA PERMIT TYPE: ELE
""""`�`�0p�'�"' INTERIOR ARCH 2136232164 �B'N0'` �378
urcx.oxee�o.•saoox�ss: 550 S HOPE ST "r� 1100
L.A. CA 90071
conmAcrarawwE: COMPEL CORPORATION ( 310 ) 946-8321
�"""Ci0R91"� 10410 PIONEER HL
�� SANTA FE 5PRINGS CA �� 392693
90670 �NT
IJCEN4ED COMNACTORS OECUHATION: I henby Akm uMer panely d parjury IMt I em Ikemetl uMm pMWone of Cheper >
(�nmaridrp vmh Section 1000) d Oiwun J d Ne Buviiwa enJ Prdaesiom CoEs. ard mY limnw b In /utl lacs enE ansp.
cmuc.no.: 032054p uc.ousa: C-lOuc.No.: 3J/9,/26�9�3r, EX : 08/96
Dme: �Q �26 ' / .� Comrwar: � �01�7�1{¢ . �PlVA�/)
p�yNER BUILDEN CECLARATION: 1 Mmb/ elfirm uMx ponety d qrN�Y �w I un eRom Imm iM CoMreCars Liurua lew ta tla
PERM NO: E 07483
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SP OFFICE TI SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
*Q�*��**ir**��***�***��p**+Tr**Q*****�r**�***i�*B*+4r**�(�**Q�*���***�*��***�**��+r*+r�*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCE550RY BUILDII3G --------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
�dnwno�se+o�(seaian�miseuenueenev.de�we�coes:�e�ywdoouniy»hkn'wwmepannn�oomewa.mr.�npas, pARKING REQ: PROV: PARCEL: 91050104 ZNE: REF NO:
�Mdu�, a rapei a�ry eWclure, prior b ila weuend, ebo rpuiiu Ihe appliuM lor auch peimil la fila a Npned etetamanl ihal M a sM
n li�� Wnuenl m �M qmA�bm allhe Conlreqon Licanu lew �Chepx B(oommemiip wit� esqbn ]000) d DNblon 3 0l tM pLANNING NOTES>
Busmsw uq Prdmiona CaEel a tIW he a�ha ia wmp therehwn enE Ihe buu for tM elbped uampion. My vbWion d 6aaion � '
)p�1.5 by enY eVC��� Iw a p�rmil WEjetl� IM epplYAnl �o e mil paiWly d nd mM Ihan Ms huMrod dollett �5500�). /'�
p i...�.,�«am.v�wem«�rv«�da«e�wn�..m.:.d.o�oa,.m�..,naow.w«k..�du».mmne�aw.�,eae **f�*�t�t�t*it�+t***r*�r�r*�t+t�t*x�**+t�ti�*�r+titit**x�*rt�t*�t**�r+t�t*��*�i��t��t**�r�t�tx�*x�it�t�r�r+t�t�t**�r�ti�+ti�i�
wollmMbreeb�Sacibn'101�.Buw�auaMPrtanm�Cods:ThaCONredaeLYm+�lewdoundepqytoenow*wdpropnry D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S
wM WId1 a inpvn� Ihwaan. W vRn Eom �uth xak Nm�atl p hanN a th�pNh he a!w PM MnC�Nw.O�'bb tM ac� �
impm�.ammbvanalinleMSCaallwedlaeeb.M,Aowawr,IMWlldi�pa'vnpowmW�dd�.A'w�n,msyuraleomWotion.iM ZONING APPROVED BY � DATE:
ownerbuildar Mill hew iha Eu�ds� N pwi�p he or 4r EN nd WiN or Imprws Id ihe
� I. m ovmer M ihe propoM. ��dueivey mniroqNp xXh lioensad eonVactan to eonsVud ih� pml^d (Setlbn ]OM, Bu�iriw� end
,Prdwmu COCe: TM Gonlredon liwms law Am nd apply Io en ovmw M qopMy xho buIIM a impwn IMwn W Ma B U I LD I NG AP PROV ED B Y : - DATE :
contract� la wdi projetl� wdh e mmrvaor(�) IicanpE punuem to t�a Convrfp� Wen�� Lexj.
p'i.,,�...,��w�e.'s.a�: e.ar.c.,i«u,s�: APPLICATION ISSUED BY: DAT£: �� �-� i�:
D�a� Owmr: IEififiF1f1E1EiFiF1f�1E1f1EitiElEMiEifiEiE�E iEfElfffiflElEfEiEif ifk
I Ao heroby cMiy �lul � em ewua W uM unGMend iM �puiromem' W CNAomle MeeXh enE &N�ty Cod� Srfion� 25505, 2663J, W L EGAL I Z AT I ON : N F E E'' S U M M A R Y S TR UC TURAL S EGMENT : N
�SJI, aM ihet I a ury hnun WlMirp oaupenl xill / wYl rid �arob am) rwed lo camply wih uid qata m0a and iM nqulnmenb br �
�p.rtnXtacamwctionormodiflmibnlromiMAr3u yeTT�enepemamDlsl�Id.RaIMMWcontl�utlion�pDO���N�M�Mimmlhw� BLDG PMT PLUMBING ELECTRIC�: MECHANIC FIRE SMIP/RES GRADING
Deu: �VW�:
WOAKEfl'8 GOMPENS�TION DECL�R�TION: 1 Mnby effim� undn piWy d pwjuy ons W IM Mbwlnp Mdudkw:
� I hm uM vril meint4� � twulktl� d aomenllo �NILmn fur wk�n' camp�nW bn. n provitlW la by BWim 9]Oo d iM leba
CaM.lw tM prtamenc� of UN wrk /or which �hl� permd i� IwuW.
❑ in.�..�ww�m.h.o�k«.��v��i��...Aaw�.aMsww�s�ooam.�.no,cod..r>m.wn«m.z.am.
wak lor xfiich Mu p�im� u IeuW. MY wawn' eampsruuun in�urar�c� uMer eM pdiry numpsr v�:
ce.�a.: �orunu�r !`l1MD EXPIRES
Pdiry Numbx: 0 2/ 0 1/ 9 6
(7)wpctqnnMmtMcompNME/tM�wmtblaomhu fOValm.J
� I ontly tIW In iM qrformenc� W IM wak la whkh �hb pemiN b lawd, I YWI ml xnpb/ any pxson In ury mMrw �o n m
baeom� wbjetl lo iM xoM1en' mnpuiWbn kw� al Calilamie. uM pne Ihtl p I Mwk peeome wb�q m IM v.orbn'
comp�nWion �pjrovbbm [ot1S/�dbn 3]ao ol �M Lebor CoG, I�hdl l%o�nhwN� em/mp/N A�h ih�/y/Q rovbloru.
��11: �QiG�� Z J AVdh�M: � NY • /" ����
w.m��ro: F.o�. ro..�w. w�.r: mmew+ono� n.•nw �. w�wru� .�a.wiWel.n.n.+wmw ro�mmrw v«wn...�,a
dvll nnu w ro on. h'nend rheua.na ewdn (nat000A m.ee�tlen ro m. ewr or nnw«weron d�w u aroHn.E ro. �n
9�etlon J�GN el IM Le6or COA, l�rtwt Nd �Rom�y'� fMa
CON9TNUCAON LENDINO AOENGY: I h�raby alflrtn uMo psn�lly d qrwry �htl IMn b� oontliudbn Mrdbq �p�ncy la IM
pertprmann ol �M xaA lar xhlM IhM pxml b Y�u�E (8eabn �OG]. GH. CI.
�ENOEP'B N4ME:
LQIOEWB AODNE49:
1 ca�lilf'rtW I Ma n�E Nh eGWkefvi ud tlw Ihet IM �bovs WomWion b oorrW.l qlne m oomp�y wH� e0 rny eM eourny adinws�
�y slma Isw nitliq m buildip canWwian end MraM �W�orha npewnteMa d ihe dry b�Mar upon iM abwa�mambmd pnpMy
tn IMpetlion W�W��
Mo�v ��eRso�l
qI,, JJ/ a�m wm.
/''( 0�..�(J�� P.,�.I�� om.: �u_�
��pntlun Owne�/ApenVAppfun4CONreqa
(5151�l�WP) W�h�ulldiq d SNaly; Orss�Fls; Cenery-ADDk��: Gink-Rlvenw; Oaldanro0-Msatror
PERMIT 57..30 �
50$ -1`:£' _ � SMIP/NON-RES
PLAN � � `
ISSUE EEE 15.00 `' -�'$ ,-1
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK� .; TOTAL PAID DUE
TOTALS----> 57.30 15.00 . 0;.00 �' 72.30 72.30 .00
'� 1
REVENUE DIVISION TOTALS--> COLLEC-.TED: '� i� 72.30 OVER/SHOAT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC�?--FIRE SMIP/TOT GRADING PLAN-CHECK
72.30 'J ,
_ ) i !
TYPE
ELE
1E 1f �F iE IE iE if if iE 1E 1F iE if 1f 1E it ik 1E 1E IE if 1E iE 1f if 1E iE iE iE41F 1E iF 1E 1E 1F 1F 1F iP if If 1E 1E 1E 1E iF iF iF 1E 1E ik 1E 1E 1F iF if iE iE IE IFlE 1E iE 1E IE 1F 9f If ik iE 1E if
I N D I V I D U A L �F -E E i� B R E A K D O W N
J 'r� �.=s'' � . l"
QTY D E S C R I P T I O N^��-` ;•�/' UNZT COST TOTAL COST
20 COMMUNICATION DROPS �li�ST 20 / .75 15.00
94 COMMUNICATION DROPS ADDITIONAL .45 42.30
END�.OF FEES
l �� /
T
�.
`. D7 DO1F"ii�'-rlufS�.ii2S �'0'!�' T2.3()
CRTE.� 1�/"dl5� ?:,�:: it:Gtl
��
CONSTRUCTION ANO PLANNING P00� & SPA
APPROVALS Permit# Date In:oeKo�. qppROVALS Permit# Date Inspector
t. Temporary Electrical Service or P.ole 52. Pooi & Equipment Location ` �
2. Soil Pipe-Undrgmd. " � 53. Steel Reinforcement -, ?�
��.3=,�NectricalEond'uit�jJti�ity-UndJr,grnd. 54. Forms � ; � -
!. 7: �v
��MREAecVical Co�kidni�'-�rgrnd. 55. Electrical Bonding '
- n •-, �
,;49?`Sf�el Reinfpticem��p � 56. Rough Plumbing & Pressure Test �� •
^:8�'Electriwl UFER:.` d; 57. APPROVAL TO COVER�GUNITE ^� .�
�j6,1,.: F�otings ��m `�� q 58. Electrical Condy+t�lndrgrnd. ''
�-+�8, �aundationN ¢�rv _ 59. Gas Pipe, O U�6i�r•nd., Test �
� �
9. Water PipgyUndrgrnd"�� 60. Backwash Lt�es�z°1'rap, O,Wndrqmd.
10. Structural.Floor Svstam ' 61. APPROVAL TO DECK ✓i
it. Property Sewe�_Unei& HouseGonnection 62. Backwash & ReC�aptor�Fina1 �
12. Sewer Cap_' `` ' "' ' � '
a�-"-. ' 63. Heater & Ven[-Final
�
73. Roof Drains �� -� 64. Plumbing Syscem - Final �- -
14. Rough Plumbing.`'., 65. Electrical-Finai ' �,'
15. Rough Elactricay oratluit ' - 66. Solar System-Fip�l, y�
76. Rough El�ctric V�i,rir`g; �` �; 67. Fencing & AcceSsApqroval , i;
-77. Rough WiringSig� � �, 68. APPROVE� F(�tPLASTERiNG �
-, • �
78. Rough ElectYcal_'( 8dr Ceiling` � 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIf�E �EPT. Q,qEQUIREMEN,T
., -. . �� -,. a r.� �+ F� x m:T:
20. Fj�u ^Fa ior Firg ^'M S .. - D o+# ••�•�.7 � ,' •�-'
9� � X_:; <�ace .5;,., .r � �x ,�PP�uQ�rSrrPek'mit#-s-...�.,,.
21. ct3�•in StrucLure�l.r � .. .. ;� S :i -+v� � . 70. �lnder97�p'a H�iiro F
22. Q4�s?Veatila`ng �,� ^` R r) r .t_�„i .'71. ProduqE�QiPing �6�az C$.Oil
23. �.�as Pipe- � ugh & Ter,x m ��n, c' �i:t . 7p. Undergro'und F{ri§R ''� �'
^. Y
24. R'oof�rariNng "•� f "F" !'t T' ,� �,y �, 7�j Undergrrid. Stor�,qgTank.d Gas � U�il`�
25. Roof�hea�ing S� C �*�� �. : c� m 7�i Overhead Hydro"� '�
26. F•Sar?Ceiling (StnF,c�tiraf) & NF-o��at � ~ � �''�i 7 MDr Chemical _ -� '� `� ` n��
s .� � �: C .7 +: `�E Y +c O'J
27. F�me,and�lashing,�r x� y y:a 76. Dry Standjiifle =� }� ��
r
-28. Lathil7g8FSidin9 �'S '� �,.'C._; ;-; ' F "�� 7T FIXED J � y ^• Sc
�. -7 ,�,TE�j�iNAL� " � , ,tir
"29. Insulation�- r�� ` j l � � { 7� FIRE PREV. FIN�L *= `^ `�'�
r
I �30. Drywall Nailing � �, _ ��' �. � �€ALTFtDEPT, R�EQbIR`E�ENT
- A:r' i . ii✓ v
� ;�31. Plaster 8rey,m Coa�r> - -;r , i --�9..FINAL Ip3PECTt�N� x� � J
._ ' -� , � -. �a. ', .. --ir.
-32. Efectrical'Powe� M�tA�F�pa� ; ' �� � � � a�._;FOOD CERTiF`Ci��-E IS�S�JED� �C
'_33.�hal;Eleck�ic� '��',� � �' e� il?• � -�.otes; -+^. ^m � � � -�i�7
�34. P.inal:F9eaL"ng &'Air0ond7tionin�S � y ti i I " � � V? j. ��• �JQ� c a�'�„n
, .�T'�' l- �. �
35.F�inalEGas��Pe�,TesiXtn.�� ^ vr� � . .+ -.�:. ��„ "�C���,Y�r
:'36. Hood:or (�oPv � :-!: ;� tr ^ �+ r �� i ; •. _ �-�" `_' �, ��
- � �w � - p . r�11Q�C�� .Q..�:�Q���
�j37. FYnal Facto�Y FirepJ�e �. "'C' � y � : 'v - � � ��� ,/
.� ���� �
�-'38. FinaltP.lumbing ' +. n� � " ' � !� =- r w �(/
, � r. o � r
`-39. Water�3ervice�Fina1',i � `' * �, i �{ `. ��`: w "�
r-:40. Gas Service-Final C�- �-, d,-�a- �' *^� i �: J�+ '.,n� �
. ; /�4' `I* ,X' �"� ' 06. 4 �v
r 41, Solar pomestic-Firs�l� � � * �' � �; n �-;c; � ;� x ,�
�42. Backflow Prevente��: �: r I '� c; ��-� s r_' �
.: i n ... ti .. .-� E [-� � :C '.
43. Backfiow Irrig�2iorZr* '^ =-' � * �•' � x "' �+ . .
a �'
� �: -� n�-1
44. Landscape�.IrriAation System ��7CJ '1: � T• y � ��i r ° 7G *:. F
45. Sou�d A tent7a,tior�r ��Gc-. r .r � c, _��- -. r. .i -
�. t . .. . 'r fr� ��e- T S <L %G
��
46. Handicap ReguJetio�a� :. a�� � C = %�� = '
r � �c � :r �� C�
47.. ���,�,'STRU�fU��.& BUILDING "� �., ; � r; � -. ' - r �
i �,
48. FiNAL PLANNING � E-�!- *.^� t �,, tl C + ��
� n; t �
49. EfOctric Release to Edison • ° `� a, � ''
. � . � .� > -,�
5fl. Cas Refease to Southern Cali(omia�GasCo � � �* ^� ' ' "���'_+ ' ^' !
� v.• a <' .=JJ . � k C ���:
51. CERT-IFICATE OF OCCUPANCY x " ' ' ' =' - °. "
Date I ' � '
�
AUDFESSOFBNLWC: SSS ANTON BL
axr+EasruuEiF�r+: SAKIOKA FARMS
�' ���k PO BOX 2097
TERMINAL ANNEX
APPI. NAIIJNG �UDRESS
u�T: STH / CITY OF CO.STA MESA - BUILDING PERMIT
/
PERMIT NO: E r074579 PLAN CHECK NO: N
� �..
CONSTRUCTION TYPE: 1FR SP �"� PERMIT TYPE: ELE
�xcxnec,on�n�n: INTERIOR DESIGN 21362321E���= 9378
ARCN.OXENG'SIWUIIE55: jSO S HOPE ST uNT: 1100
L.A. CA 90071
COMXACTqI'SNANE: MORKOW MEP.UOWS CORPOF.ATIO ( 714 ) 59$-7700
carn�crorcsxuuwa fj? 0 REYES ST
�ooxess: WALNUT CA uc.ra.: 230813
91789 orm
LICENSEO GONTqACTOFS OECLANATION: I Mmby ellim uMx penely d perjury ihet I em IcenxE uMer pationa d Cheqm 9
(mmme�m�p xilh Seclion ]000� d Division � W IM &ni�wv aM PMeeeiona Coda, eM my licance ia in full /ace eM ellecl.
c uc.no.:006558 uc.cuss: C 10 uc.No.: Z30/813 EXP; 12/95
Oele: — "'— Comreifoc ` �
NER BUILDEN OECLARATION: 1 Mreby elfirtn uMer penaly d perN�Y �� � emq �mm the Gontreqon Licems lnw fa ihe
olbw'vp reemn (�1ion ]W 1.5 &n'vwse eM Pmleuiona Code: RM cry or m Y iCi iequiree e peimil to owuun. el�or. imywe.
Eemols�, a repei eny nruclun, prior io iro uauerim, ebo reQuirae iM eppliren a¢h permn �o Rb a egmd elalamem Nm M a eM
ie licensetl W��en� �o �Aa W�+eion%d iM Coniraqors Licensa Lew �Chepr (mmmerciiq xrh Sepbn ]000) d ONebn 3 d Iha
Buainesa eiM Ptafeaions Code� or Ihel M a elw ia exemq thsehom arM Ihe bnsi5 ta Ne allepeE uemplion. My vnle�un oi Sed'an
]031.5 Dy eny eppliranl la e parmil subpee the epd� �o a avil penelry d iat mwa �hen 1've huMreJ Eollers �SSW�).
� I, es owner d Iha propa�y or my empbyeee wnh wegea ea Iheir eole oompanaetion, will do �he waA, end IM Hiucturo u nd intanded
or oflerad lar ale (Seetion ]OI6. Busineaa enC ProfessianaCode: Tha Conlrectoea Lieeme lewdoea nM epply�oen ownerd propery
wM bulda or'vnprovee Ihereon, vM h1w daea euch work MmnH a MneM a throuph he w �er own employeee, pmviAed thet euch
improvamenb ere not inleMad «dlered lor ede. H, however, �he buitlieq or'vnpwemem w eok wilhin aw yaer d mmplmbn, tM
o.�e,�ud., �;n ne�e ine w�den a wo+�re ne «sne eid na w�u � �mv,ove �« ine wma. a..bl.
� I. av oMner d IM pWeM. un azdm�+h oonvmM wnh I'xanaed mnhee�ae ro emueua �M pqeC (Setlun )Oaa. Buai�va eM
wmessiore code: Tne con�reea. �c.,u �ew eoea �a acMi �o en owner a ww�r wno wib. « hwo... �nmea, ena wno
canvacn Iw eutl� prqMs wXh e conlretloKa) IcenseE Wrsuent lo iha Conlreqore Licerroe Lew).
❑ I em axampt uMer Seciion: B. 8 P.C., Im thia reeeon:
Deta: Ovmar:
I do Mreby ceNly ihel I em ewere d eM uMemtvW �ha req�iremenH d CelAomie Haellh eM $elety COJe Setliona 25505, 255]3, erd
2553a, eM tlw I u ury hnure WiWiip ampeni will / wll na (arcY wre) neetl b comply wYh eaid mma codae eM �he rpuiremmb tar
e pertnu taomsVuclion a modifmionkantMAr�BueTiy7f—aiepament pislrir�. Rauden�iel mMiupion appimtipnenexemp Imm thma
wo�s�.
Dete: Appliceru:
WOflKER'S COMPENS�TION DECL/�RATION: I Mreby elfi�m wkx penelly W parjury me M tha lallowinp dedereliom:
❑ I heve end wil maniein a canEiute d mneam to eaMinaure /a vroMen' wmpenaetion, u W�detl lor by Sedion �]0p d Iha leEar
eod,, e« m. wno�.��. a ma �a i«..n�on m�. v�u �. ��,a.
Q ineVe�dm��m��,�wmro�����.e.�aw�eaMsea�a�oodin.tenacroe.rormero�«meno.dine
A work lor whi F mo pe�mM1 o issued. MY w�en' canGenae�bn inwrence rarriar vd pdiry numEer ara:
c,�,;e,: FTREMANS FUND EXPIRES
rawrN�mn� nwrRnF-�hr,4� 07/01/96
� lmr,:er�onrreed�acecomvrorea�rnev�a�sro�orrenunereddaie�.lsioqw�..e.�
� 1 eerlty IMI in Iha palormeeca d �ha wwk Iw v.fich Ihis peimX ie iouad, I ahell mt employ eiry pemn in eny menner w eo to
become aubl� lo Iha wohera' canoenmron iews d c�n��e, ene earee um n i eno�w cawma wMea io ms worxas�
mpaneation pmvieune d /S�eaion 3)00 W�MlaborCotle,le/hel'��Jpnhwnh cwn iM1oee provisbns/.J
u_. %/�� �� �`�.� .W....-.. / � %�YJ �/J �.vYht
1�Tllly: F�llun b u[un woikwa'rompm�atlen rowiap� bYpI�MIY( In Nll flCE N ITpIOyN f0 CIIMNI pM�PoN 1I'O
rclvll flros up h ons hunOrotl tlausuM tlo/Nr� (SfOq000A /n WL/tlon M• eoa ol rompaustbry Aamspu u provMeA br In
S�cXon Jlflb o/ tl�s Lebor COJe, Irrtenaf, �ntl �ttomsy'a /su.
CONSTHUC110N LENDINO AGENCY: I hareby alfi`m �ndar penelry ol perNN �� ihare o e mnstivaion bMiip e0encry br Ne
paAormenca oi iha xrork lor whiN Ihe peimY o eaueE (SeGian 309), Civ. C�.
LENDEP'S NAME
LENDEWS �DOflE55:
I cenih �� I hen reaE Ihu epd�ion eM date Ihet IM above informetbn ia corted. I eprae to comply wrh ell ary arM cwnry adinar�
enE sle�e lawa rebtiq la b�iking conatruCon end hereby eulMrae repreaentelivea olthis tiry ta anbr �pon iM ebova-menlioned proparly
brimpeUion Wrposes.
CHARLES SACOBI
Deie:/L/ �L'r��
(5151d6.WP) �/4Yhilo-BuiWcp d Sa/ely; Oreao-Fle; Cenery-AOPF�C Fink-Rewnue; OolCenrod-Aaseeaw
PERM NO: E 074579
GOVT: N SUPP: rl
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: H-74570
**** �****�****��***iE x **�**+�iEiF �*�***iF�iE*ar�*it*r, ******�*+E�**��**iF*iE**at*****�c iE�*itiE*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- ---------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT I�] REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT TN
PARKING REQ: PROV: PARCEL: 41050104 ZNE; REF NO:
PLANNING NOTES>
i I
3F iE iE 9f � 1E iF iF iE 1t 3E �F fE iE 3E 3E 1E iP iE 9E iE iE iE * dE if 3E jE IE iE 3E iE iE 3E jE iE,iF iF iE iF 1E iE iF if ib iE iE dE dE iE �F dE iF �E 3E iE 3E iE �E iElF 1E iE iE 1E 1ElE iF IF 1E iE dE �E 3E �E iE-)E 3E �E
D E V E L O P M E.N T 5 E;,R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: .�/'/�_ DATE: /�'" � �
*�-*�-*****�-+��-**�**�rx-*�r*�'7FCF�i'3F1�����. �#�Fi�#7e7F�F*-���ifi��3F�*****?�x�*x�***�-��'�iF'ia'-�*
LEGALIZATION:N F E,'E� S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 225.15
50& SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIC�-> PERMIT ISSUE PLAD]-CHECK TOTAL PAID DUE
TOTALS----> 225.15 15.00 0.00 240.15 240.15 ,00
REC'ENUE DIVISION TOTALS--> COLLECTED: 240,15 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
240.15
iE iE 1E 3E aE i't 9E iE iE iE iE iE if iE iE iE 9E ik if iE it �f aE 3E iE iE iE iE 9E 1E iE iE 3E 3E iE iE iE 3E iE 3', iE �)E iE iE jE if if iE * iE 1E 9E if �k 3E iE �E iE 3E if iE iE iE iE 3E �E iE iE iE iE 1E if iE iE iE iE iE i6 iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
ELE
ELE
ELE
ELE
ELE
ELE
ELE
QTY
2�
192
2�
12�
5
3
D E S C R I P T I O N
PIXTURES, LIGHTING 1 ST 20
FIXTURES, LIGHTING ADDITIONAL
RECEPT/OCTTLET 1 ST 20
RECEPT/OUTLET ADDITIONAL
RECEPT/SWITCA 1 ST 20
RECEPT/SWITCH ADDITIONAL
SUB-PANEL
END OF FEES
UNIT COST TOTAL COST
EA. ,45 86.40
EA, .75 15.00
EA. .45 SE.50
EA. .75 15.00
EA. ,45 2.25
11.00 33.00
tll 0019^117G-uL19210C T�T ?�U.1-�
6�TE= i0ii6:9S TIt�E: J9:�1 •
r
� CONSTRUCTION AND PLANNING -� f � � POOL & SPA ,
,�i�iPPROVALB Permit # Date Inspector AppROVALS Permit #� Date Iospector
i. Terr�Porary Electrical Service or Pole 52. Pool & Equipment Location '
2. Soil Pipe-Undrgmd. 53. S[eel Reinforcement
3. Electrica� Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
'
5. Steel Re�nforcement 56. Rough Piumbing & Pressure Test �
6. Electriwi UFER Grnd. 57. APPROVAL TO COVER-GUNITE ;
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Wat¢t Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
70. Structurel Floor System , 67. APPROVAI 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 Pfumbing � 65. Etectrical�Pinal
15. Rough ElectricabConduit �� 66. Solar SYstem-Final ,'
76. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. 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 � Gas � Oil
23. Gas Pipe-Rough & 7est 72. Underground Flush
24. Foo{ Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74, Overhead HVdro
26. T-Ba� Celing (Structural) & Monocoat 75. Dry Chemical
27. Fr�ne and Flashing 76. Dry Sta�dpipe
28. Lathing&Siding 77. FIXEDSYSTEMFINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning
35. Fina� Gas Pipe-Test -
36. Hood or Canopy
37. Final FactorY Fireplace
38. Finat Piumbing
39. Water Service-Final
40. Gas Se��ice-Finai
41. $olat Domestic-Finai
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation-System
45. Sound Attenuation
46. Hand�wp Regula[ions
47. FINAL STRUCTURE & BUILDING .- '
48. FINALPLANNtNG
49. Electric Release to Edison �
50. Gas Pelease to Southem Calitornia Gas Co -
51. CERTIFICATE OF OCCUPANCY
hSo Date
�oowFssaeu�ar+o: 555 ANTON HI�
w�x�war�wEiF�"ox'": SAKIOKA PARMS
�o�u: PO BOX 2097
TERMINAL ANNEX
� � ur�. �u�na �ss:
�
�
f.
�M�. 5 TH
uicxnccronaaw�n: INTERIOR ARCH 2136232164 ��= C-9378
ARCN�QAENO:gADORE54: SSO S HOPE ST uNr: 1100
L.A. CA 90071
caan�.crarswua CONTINENTAL PLUMBING INC (909)360-8300
ca+m�crom�uir/a 11165 THURSTON LANE
�no�ss: MIRA LOMA CA ucr�o: 399073
91752 uxT:
�CENSED COMNACTONS OECLAFAiION: I limeby tlfim �Ms pwiely d pxjury tlW I un IianeA uWer pvriopu pl CNqx H
(oommxorp wil� Sxlion ]OW) d Oivoian � d Ne Buunow eiA Pmlaaonu C.ode. uM my litm e in hll brta aM elled.
cmuc.no.:027563 ��,�� C 36 N 3 07 £XP: 9/96
o�a ►c� • a4 - � ��,d
pWNEP BUILOEN DECLIRATON: t l�eby dfi�n uM�r prWy d perjvy Y 1 em �xamq liam �M CaMMon tiwnae lew la Ne
fdbxip reamn (�� ]��.5 &enan erd Prd�an� Cab: �m vY a oavuy Miirli �puYx e peme lo aomwia, etla,'enpow.
ymdeh. u repu my �nucme. p"v b b vauem. e6o �e�ves iM app6mN Irc aurh pamm to fla a dprE ptlemem Na M a�M
u �b.�aed w+�+em w �ne awinms a me cmreeor. ucove law Icheqer e(camm«idm .'vn sed'nn l000) a Divcion s a �ro
BU�� eM Rdm'va Codel a Nel lr rc tlie 6 azsmP �herehan W �M be�u la tM eOepW sssmd'on. My vulmun d Seaian
1o3�.s M�v aoofifam �or e wrmn eubi.�+�na roNicem �o a d�+l o�M a na mas Nen �ws huMree dd�.n 155ooU.
� I, m awrer d IM pivpenyu my emplv�ees wth wqpa n Ihs We aompemmian. MiA Ao Mo xwk. erd ihe piw.Yun u roI WeriEaE
o. a�«ae w.w (swm �a.. euwe...�a aian.ion.caa.: nb cw,.eaa liun.. �nwma. �a mdv �oN o�n« d aw.m
wla ddde a inV�� IAnlm. md xfio EOes tuN wakliTaM a AafN a Urwph he u hm wn ampb�w�. P�+�d Ihel aiM
imP�+maE� va nd "vnended w aMaeE tar ub. tl. Aowever. tM bWtlinp a inpv.amem u wtl Mttkn ana Yw M mmdMbn. IM
o..�«a�ua. wm n..e u» wa.o a a�w n. o..n. ed m daa «m,a�+io, u» wmo.. d ae�.
� �. oa own« a�ne wawnv. an e.dui+.ry ooM�mYro.�6+. boe�md cmvmtu, m munw �e�e wdb Is.a;m rou. &,.x»,. m,e
Prdeaeima Code: The Con�rrfon li.ron�a Lew dom nd MM/ b en owxr d prtpeny who WiWs a impv+m IMeean uH who
convecie M euM Or4� � e carureew(a) IcenwA WrouaM to IM CwNretlae lkanee Lew).
� I am ssemN wda Sston: B. 8 P.C.. br Nu ns�m:
Ode: Ovnw:
I Eo MreW ceniN Uut I em ewve M end WenwM tha �apidiwnr4� W CeUomis IbeQh W 9tlMY Cods SWiom P5505. YSS�.t. eM
256JG, vM ihel l a eny Mun buikinp ompem will / wil nd (arcb me) neeE lo canply w1� eeN awa coEw end tM reQuiromanie br
eC^"^ulaouuwGionartaGfiWionhanilaNr�iy —eeupertiemDiarid.Rsudatl�mmrutlianWD�lanvsusmplromlMu
w�.
od.: �ao�.:
WORKEfl'4 COMPENSATION �EC WIATION: I hsrapy elfvm iptler pnutly d pspvy ar M As fa0owirp Asdertliom:
� I hero enA wlll maiNan s cMAiWe d mnsent io eaXr�mn tar workan' canpenWion. m prwideE ia by 9atlion 9100 d �M Lebor
coe.. �« in. nemneec, a u..oni �« w:a, w. wmm e e.�ea.
❑ �n...wwm.w�.,ak..•�o«�.mo��.ro...�wm.ewsw�araoaw�.nacua..a�m.w�.w.nu.
.ak�«»�w,m.w�ao�.e.w.m.w«.�C�cn:�w,.z.car�.,aoaiv�vnw,.,.: EXPIRES
c�.,: e
Pd'ryNumbr: Q%�Ql�9p
(iW, maim rrC ror b� mmpMnd r �M owml u b aw hwWSC �OLua f3ttnl a 4u.)
� 1 uniy Mq'm 1M pMarturcs d Ne wM la Mkh Nu penm b u�uW. l kW np � py a�ry pr�pn {n erty mww w n m
becams wl}n Io iM wa`as' anpenm�cn le+i d 0� �' il N Eca�w aAjtl lo iM wFon'
�omro�wno� ww^�.��. a s.e� smo a in. �eo. coa.. i � onn n h� n w�.�..
De�e: 1� ] � /l.�^�` � AVdicent:
W�minp: FaUun to ueun rOAxi eamp�ru�tlnn eov�rp� I/ un1�wN �d �NII utlNet �n xryloyx b MrtYNI PM��tlu �M
eidi n�.. w ro w,. n�.m�.a �ro�,w eow.' lr�aaaaoa m.maon ro n• oo.� oi mm���n w�+w .. ao.+e.e ro. in
9�ctlon JroB el M liborCob, Inf�nst ���mry'� !wa
coNsrnucnoN �Eaana �aeNcr: i n..ev .� �m.. oa+M� a owrar �nr w.. s. odm�,ua�, ww�o �wv a m.
y,aom,erKe d �n. xwM ro, wnich m: v�� :�a (s.aYn ]oal, civ. c).
tENDEP'S NUAE:
LENUEH'S �UDNE39:
I dniN �� I heva nM Nb eppliWian W reu tla� Ns ebwa'udomution u oomd. I p�r to oomply w4� e0 tiry end courqy md'uunm�
.nd.m. mr. Mq�q m Gdd�w �o-wsm w MroEr.wares naw+.Gn. e �n'u elr ro«n« wa+�n. mo�.�m«aian.a wew�v
lor invV�lion N�C^s^�� .. � .. ..................
Date: � �
Whila-Bu1Wnp d Selsly: O�em-Fls: Cerory-Appirant: Pink-Revanue: (3oldan nuor
CITY OE COSTA MESA — BUILDING PERMIT
_�. . . .__.- , . .. . .. PERM NO: P 074735
PERMIT NO:.P 074735 PLAN CHECK NO: „ N GOVT; N SUPP: N
CONSTRUCTION TYPE:.IFR SP . PERMIT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION : INTERIOFi 20000SF OFFICE T.I. S(j FT:
CLAIM VALUE: ,_ CALC—VALOE: GROUP OCC: B-2 /
��***��*+i�*��r*+Nr��***��D****w�****w**�%***i�*��**�*�r�r�r*�rrx��+�x��r�r+rx��*�r*�r�r�r*�r**+r***�r
, , Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEET: FT. IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 41050104 2NE; REF NO:
PLANNING NOTES> ,
i
1E ii 1E If� 1E� 1k 1f 1f iE iF if 7! 1f 1f if fElk iE if iE 1@ 1E 1E 1E 1E 1E 1k 1k 1k 1E 1F 1F M iE 1E ii iE 1E 1EiE 1E 1f if iE iE Ik 1h if IE 1f 1E 1[�i81F 141E ik 7E 1E dF if 18 iE iE if 1F fE IE 41k 1E 1E if iF ik 1E 1P 1F iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY� DATE:
BUILDING APPROVED HY :
APPLICATION ISSUED BY:
LEGALIZATION:td
BLDG PMT
PERMIT
F E E S O M M A R Y
PLUMBING ELECTRIC MECHANIC
42252
DATE:
DATE : lo �'L'3 �q /
�F{F1E M iE �E Ik K if iE iFiF�K�iiF1E 1h
STRUCTURAL SEGMENT:13
FIRE SMI2/RES GRADING
PLAN SMIP/NON—RES
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 42,00 20.00 0.00 62.00 62.00 .00
REVENOE DIVISION TOTALS--> COLLECTED: 62.00 OVER/SHORT: .00
BLDG,PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
1E 1E 181k 1F �E 1E 1E 1k Ik M/k /E 1k ik iF 1k 1k M K 1E 1E 1E 1f M K 1f 1f fE lEiE 1E M 1t 1f 1F 7E 1k 1k 1F 1F 1f If IE lf 1f IF 1f lf if k K 1E iF iF K/f lf 1f lk 1! K 1E IE 1k k IE 1k iF if k k ik 1k 41t if /E ik
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
PLU
PLU
PLU
PLU
2
2
1
1
D E S C R I P T I O N
SINK KITCHEN
WATEit HEATER AND/OR VENT
BACKFLOW PREVENTER
SINKS, FLOOA
END OF FEES
UNIT COST TOTAL COST
7,00 14.00
7.00 7.00
7.00 7,00
� = l. �.t^ - . _' _ L �� T 1'7 f �
oa��; i;i.�. �,� T,:; , ��
� .�_ _ .
� CONSTRUC710N AND PLANNIILG' ' � ' ' ' POOI & SPA
APPROVAL$ Permit# Oate Inspecior qPPROVALS Permit# Date Inspector
1. Temporary Electriwl Service or Bole 52. Pool & Equipmenc Location, i .. �
2. Soit Pipe•Undrgmd. r' 53. Sreel Reinforcement '
�1 Electrical_ ndwY�3^lityUnHTgrnd. 54. Forms .
.- r
,; C�' �ectrical� d�y �n�tirgmd. 55. Electrical Bonding F,
"�c5. Sfeel ReihSOeceaa *�ntC •� 56. Rough Plumbing & Pressure 7est O `
- -�r
�'"�,��,�Flectrica�yl�gE�nd. 57. APPROVALTOCOVER•GUNiTE �
g. � otings,-�n; F 58. Electriwl ConctIIi�Undrgrrxi. �
8. ?`oundati�r� _�� �' m 59. Gas Pipe, O Und�md., Test
9. Water Pipg-Und�gr�l. 1, � 60. Backwash �ines, �Trap, L' Undrgrnd.
70. Structur�t_'�Floor�tem .y . 61. APPROVAL TO $',�E.CK - •�
11. Property�w�y,ine�-& Hous nbection 62. Backwash & Receptor•PSnat �
72. Sewer Cap. !� � 63. Heater & VenbFinat _-�
J
13. Roof Drains o'. ' 64. Plumbing System � Final
• 74. Rough Plumbin T 66. Electrical�Final �
15, Rough E{eccrica�Co��itluit '", 66. Solar SVstem-Fnr;dj .
76. Rough ElactricS�iriag o . 67. Fencin� & AccessT+pproval -'
ll. Rough Wiri� �n y 6$. APPROVED F�g..PLAS7ERING �'
18. Rough Eleclrica:�T Bar Ceiling� 69. POOL/SPA SYSTEMS FINAL
19. Rou h Heatin & Air Co�ditioni
c' g1 :� (9� ;�a .:�j C�T r,. •r. a7 CT C' F���T,yREQUIqEMEI�IJ aC c^
„ � n7 -U O [T� �t } 7':-y^7
20. ou�,ti F�tocZ Fi,`��lace i ��. �G * _..i p+� APP�OUA��F P�mit #.y �-'�^ �
��
27. �uC� in�tru�tur�� ..... �� R r� nx ' 70.FJnde�`g}�ji�l f�dro �.
22. Duc(ii Vg�til3�ing1�* �;j t D � �� Fx 71. Prodi4+l�Biping O'ibas �Oil
23. Gas PiPe�RouF�,h & Tlst ' M t*1S � t* �� S: 72. Undergr�hd �h1� � �,
24. Root'frasjing� �k � yF ��R; * -. �r, .�* • 7� Undergmd.Stcv�2TTanFiOGas ❑Oil
25. RooDSheSthing =� : v v* G = N�F 7A Ovenc�ad H dh,�i �
' .K u r �Ti �� Y =.C' Y�
r ti:-1 4 � �F
26.'�•B�r'„Cei�ifig (Str-'-�ral) & .�onoEoat * ,r� j, qa 7�S Dry Chea�ical F•^ � 'J -,qV ,
27, Frame arx# Fiashir� � �a'G x C >� �y 76. Dry Sta�jilpe,Q m'^ K` �. x�; v
28. LatftTng �'"s,�$iding �'* �� r`�`= ^ � � . .•z . �'.
o: da[-• O a � � 7: FIXED6�LSTfe Ab�-+ n xx
y 29. InSuI@ti0 �"�� � S " �` � 7�j�IRE�REV. F�L �' x n� O
' 30. Drywall Niiling �t; � r F I Sou oct��A� DEP�'~RE��11
:31. Plaster Br�wn Co81^' S � T't* x � t+' �' 79. FINAL �PEC'I`,�N � J � S�
" 32. ,rFylectrica�o��r�r A�A"e�i�rrf�pal ; y �' I � 8�.y FOOD CERTI � TE I�S�ED. ir•
g x ^
33. £inai�fleu:ric> �• [*t i � � x � � " es: "� '��� x'= � x S
---•�
; 34. �na�rle3�ng� Aii,�4* `d"itioning`-� ,� � ti 1 r c r i F S r i*7
35. ina Gas-Dipe-`fesE;r v^� •� fi r+ I ` . =�' �"'� � `" r
i ••(i x[+y
' 36. �Ioo�or CsanoPY ���, "�, � a,� �`, ; n I �i t�*�, Fo � n c'
, 37. inal•�actory Fira,�lace :: =-t 'v + � * "' * ��
n �c' tr �
38. Fina�lum'6ing l'� f� ' ` ` � S ^ �
,-c. n J r. � ,. ..� .
- 39. Water Service-Fina7: F �� �: � � � �± a� � !
2 i ;::
Q^ �. S K' M I 'F t^ G .c
~ 40. Gas Servicp-Final �� M i �.� �, * � I � F• of ♦ C
� 41. Solar pomescicFinak �^ � � c* "1e * �^ -
� i^�i �
42. Backflow Preyenter .* �, t;�H * H � � s >F 2� - -+
x :*7 C1G t i-+
43, Backflow Irri�ation .� i ��z M � r; � pocc
�. Landscap"t�Irnaatior�Sys[ema,`��� � �.m � `¢ �� � �� ,;, .""jC *S y �
�
� und Mhen{tation r ^� ..� i t*; n t*;� �� a' ' Q• FO r
� � o ...., .
36. hhand�cap�Regalatior� S C * �. ..� ..� � p �' �j t
47. FSINgL STRLJ�TUR� & BUIL ING a r � V ^' �
� X. F-
f -1 +: C
48.�F,�N�.LP�ANNINGx ��•� �n� � � ��.:, :, � S r S
?i9. E�lecfr}c Relea'se to Edison • r � i. ;. <C Y "
> sa��
b0. 6as Ffelease to Soutft0rn CalifQr(fial',as Co � ��` R' �
� : s ,.o r cu ococ
b1. CER IFICATE OF OCCUPANCY ' " " '
No. Date
1�
aoon�ss oo eunnxa:
awrrtxswW�viuimvw; 555 ANTON BL
,�oo�ss SAKIOHA FARMS
PO BOX 2097
TERMINAL ANNE}C
MPL. WIIYki t0011E55:
UNT:
STH
�PCNRECT OP FNqNFEfl: IIC. NO.:
: mcxox��s�oon�ss: INTERIOR ARCH 2136232164 C�T'�378
550 S HOPE ST 1100
coxm�ctarsx�: L.A. CA 90071
ca+m�crarsuuuxa AIA CONDITIONING COMPANY ( 818 ) 244-6571
,�p�u; 6265 SAN FERNANDO ROAD ucxo:
GLENDALE [j� CA 1,��696
LICENSED COMflACTOq4 OECL4p�TI0N: I Mreby eAim �� p�e�y d pa�ury Nal 1 em licmaed uMer R�vaq d Cheqar 9
(canmenrirq wiih Section ]000) d Oiriabn � d the Butined ud Prolessions Code, erd my licarim ie in lull lorte aM elletl.
CRY LIC. NO.: 11C. CUSS: UQ NO.:
014403 C 36 120696 EXP: 07/96
, ome: L!'f�-i.� comreao,:
�WNEN BUILDEP DECIANATON: I Aeraby elfiim urqm penJy d Po�V�Y �M1ei � em eRemq �rom �In Com�eda+ Linnae Lew lu iha
��0 �eewn (Sauion l0]1.5 &ainaa end Rdeavaa Code: �M vY a oounlY `.hirh �eVuvea a Da^�u to mmvud. ellm. imMove.
Inmoloh, a repeir eny e4unure, pior �o ne usuence, ebo reQuiroe Ihe epplirenl I« auch pemiB to file a eipneE ewamem ihe� M tt eM
u IKeneed pmwani lo Iha pwieiau d iM Comredors limnee lew �Chaqer 9(ownmend�q xnh Seeion 10W) d D'vebn � d Ihe
Buainev eM Rdeaiona Cotlel � Ihei M a+he c eaemq �harehwn eed lM bmis la ihe elbpee naemqion. My violqicn d Sedion
)m�.5 W eny epp4eeni fa e permi wbpm �M epplkam �o e mY penehy W nq mon �Mn fxe hundrod Edla� �SSWp.
� I, m owro� d �he propehy or my empbye» wYh wepea av IM1ei We oompensetion, will do Ne wuh, eM ihe eVuclun o rq� iMenEed
CITY OF COSTA MESA — BUILDING PERMIT
iICD� Al M I�iqCOq
PERMIT NO: M 074598
PLAN CHECK �IO:
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: MEC
SOB DESCRIPTION : INTERIOR 200005F OFFZCE T.I.
N GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
CLAIM VALOE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74573
*�**�*x �*x ���+�*���**��*�***+���**�r***+�*****�*�*+�*��*�*�***��***+�*x �**�*�� �*+r*+r�+�
Z Q N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT It�l RGHT; FT IN LEFT: FT Ih1 RGHT: FT ZN
PARKING REQ; PROV: PARCEL; 41050104 ZNE: REF NO:
PLANNING NOTES>
�
iE 1E iE 1ElE fE iE �E dE iF aE if iE iE IElE fF 1E iF iE IE iE dE iElE iE dE 1Flf iE iE jf iE iE �E if iE if 1E iE 1E iE iElE iElE 1F iflE 1E 1E iE iF iE iEl6 �E iElE if �E dE �E 1E 1E iE iE iElE iE �k 1E iE jF 1E �If� �E iE iF
D E V E L d P M E N T S E R V T C E S R E Q U I R E M E N T S
�wwmm«+Y w mt we�aee«ottarea �« w.. r. na.a.«. ina nNn+�a «.�pw.nm+e.m.uron o�. rwa mmo�on. u,e
ow�«�iu«winne�mawide�wwwireneaanedbmwiao�imwo.<�«meW�edwe). ZONING APPROVED BY DATE:
� I, ea ovmei M IM1e PropeM. � e�tluervaN �ireaip wilh licensed wnveclon ro con¢Inw �he qqeU (�1un ]OH. Buairma e�W
PMsaqm Code: TM GaMretlon liuree law Eom nd eVOh w en owner d pW�Y vRro Wilds a imp^+m thmean uM who
�oov�.r.i«.w�pww...�nn.wmredw.)iw.�.ewn�.mwmsca�reca+u�+.te.>. BUILDING APPfZOVED BY : DATE;
� 1 em er.empt uMer Sacam: 8. 6 P.G.. M1x Mu iauon:
ode: o«�.': �*p**�**'*�**ir****D*B** ��'��F���r*D*�*+��t� � ��;�*
�imn.,my�.,w�wmi�a,.��sa.ee�+w�,aw.���«�,«wacw,,,�e�un.�esmmvwa.s,d�,zssas.zss�..�a LEGALIZATION:N F E E S U M M A R Y� STRUCTURAL SEGMENT':N
zseaa, a„e mm i« vn nnon w�uvro «wc�� mn i wn �a l�cb o�e) �eee io comNr w.n .e�d am. ooda..�e m. rea��.�ro br .
epeemtlfamnewenonamod�IfnVionhamtMAr e��eqemantOislna.RmNeMolaonn'ueanap0���iarowezemphomiheae $LDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/RES GRADING
proNeians.
DNe: Appfcem:
WOpKEP'4 COMPENS�TON DECUF�TON: I hereEy alfirtn uMer pand�y d yajury me d IM Idbwi�p detluetiom:
❑ I heva eM W mainten a unAiutla a mwnt lo vallrvun br Maken' com0�+mbn. m PmriEad Ia by Sedion 9100 d �M lnbor
coa. ia ms we«m�e a ms �n i« »n�n �nm w��m a w.�e.
� I I�ew eM wi1 maimen waken' comPsmetion inauro�o. m i^Vu'ved M Satlian 3)00 d IM lebor Coda. b tM PaAdmxKe d �he
x wpk (or x1ivA Mis pmmif ie iseued. MY wa'�n' mmpemefian inwren<a rartier eM poliry numEer era:
Gemer:
� pq�yµ�myp: �, t it t,�t L �. .� EXPIRES
�mm.«r;��...t�me„mmabreesm.�a��,,,�21i,n 'ewvd�,/s�'m/a�.n.�y 10/O1/96
❑ I ce�Ay tha� in iM palarmarce d �he wak for which thie peimn is eeueU. I ehell iM ampby ury peaon m eiry menmr p n lo
baeorte w4� to �he xurkeee' mmpenaYion lews d Calilania eM eYree tIW i I MouM beeonw wEjW �o tM wMn'
�w�� wwno�+ d sea� aroo d m. �e« cae wnn �dr •�m mme wwma,..
Daia: �O ...�/ � �! A e. .Lu+—
! /
WITIIIy: FiYIM b 4CYM1 MOIkn' MTpM1�tl0�1 pryN� rY/INMNI� �IW �IY�I YC�ICE N MWI ro nmlwp«umu ua
dvll Mu ap ro om M1�ndrW Ihouundlvl4n (J10qa00A In �tldltlon ro M� cost ol rompmutbn�m� w. u vroHe.e ro. m
SxHm J106 0l IM LeOor CoW, Inronat aM ertomq'� Iwa.
CONSTNUCTION LENDINO POENCY: I Mnby �em uMx perWry d perjury Ihe! �M'e u a mnYrutlion bMiep eperv.y lor IM
yenamenoe d ihe wn �« wnim �nro wmn o ewne (Seeun aW�. cM. cl. .
LENDER'S NAME:
IENDEN'4 AO�pESS:
I ce�ily tM I heve rood Nq eppliratqn eM aela thel �M abova iMarmetion is conaf. I epme io comyy wi1M1 ell ary eM oouny aQironcee
end �ima lexe NmM ro huYd'nV conmwion eM herahY eu�Mr¢e ie0�^�^�evwa d 1hb elY ro emr Wm Ns ebwe�meMiwiad poVeM
ta imqabn purpdes.
_ Ome:�Q�/1-G%.
�---.—y— � .
(5151 d8 WP) WtNCBulEiq 6 Sday: O�wrrFb: Cerory-�ppiceni: Hnk-Mbwr: C�eltlpnqeJ_/vy�p�
PERMIT I10.50
25�
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 110.50 15.00 0.00
RECTENUE DIVISION TOTALS--> COLLECTED: 12
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
125.50
SMZP/NON—R£5
TQTAL PAID DUE
125.50 125.50 ,00
5.50 OVER/SAORT: 00
SMZP/TOT GRADING PLAN—CHECK
3f iF iE 1E 3E 3f # 3E iE,�ElE k IE iE iE 3F 3c-# 3[� iE 3E iE iE 3f �1F 3E 3F 3E �t 8E iF 3E * 3E iE * 3E iE iF 3E,�t it 9F 3f ,H� 3E it 3E 3E it fE k iE ,`f iE iF * IE iE iF,� 1t 3E 3E if ,�f iE aE+E,�E �lE it�t *�E �tF iE iF#
I N D T V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 0 VAV BOX 6,50 52.00
MEC li FIRE DAMPERS 4,50 49.50
MEC 1 INST/REL BOIL/COMPR 0.0 — 3.0 HP 4.Q0 9,00
END OF FEES
;1� aoi921r: n�]lniis3 "p"e.�9'6 in5.5D
C:-iE: r0/iE,�� Tit"cti 1%,:3J
., .: .':'. . . - �d
� CONSTRUCTION AND PLANNING - P�'` -�` SQA
APPROVALS Permit# Date Inspector qppROVALS Permit� Date Inspector
' L Temporery Electriwl Service or Pole - 52. Pool & Equipment Location �
f
2. Soil Pipe-Und�g�nd. � 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms �
4. Electrical Conduit-Undrgmd. � - 55. Electrical Bonding �
5. Steei Reinforceme�t 56. Rough Plumbing & Pressure Test i
6. Electrical UF�R Grnd. 57. APPROVRL 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 Urldrgrnd.
10. Structural Floor System ; 67. APPROVAL TO DECK i
1 t. Property Sewe� Line & House Conr�ectio� 62. Backwash & Receptor-Final �
12. Sewer Cap � �
63. Heater & Vent•Final
13. Roof Drains 64. Plumbing Syscem - Final •
14. Rough Plumbing 65. Electrical-Final - • '
15. Rough Electrical-Conduft 66. Solar System-Final �-
i 6. Rough Electric Wiring 67. Fencing & Access Approval �
17. qough Wiring Sign 68. APPROVED FOR PLASTERING �
78. Rough ElectriCa��T Bar Ceifing � 69. POOUSPA $YSTEMS PINAL
19�. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducis, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas �Oil
23. Gas Pipe-Rough & Test 72. Undeiground Flush
24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil �
25. Roof Sheathin9 74. Overhead Hydro
26. T�Bar Ceiiing (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
Z8. Lathing & Siding 77. FIXED SYSTE�1 FINAL
29. Insutation 78. FIRE PREV. FINAL .
30. Orywall Nailing HEAITH DEPT. REQUIREMENT
31. Plaster Brokn Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Fina! 80. FOOD CERTIFICATE ISSUED
33. Finat Electric . Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
3fi. Hood or CanopY
37. Fina7 Factory FirePiace � 1
38. Final Plumbing � .
n
39. Water Service�Final �
40. Gas Service-Final
41. Solar pomesiic•Finai
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound AttenUation
46.� Handicap Regu�ations
47. FiNAL STRUCTURE & BUILDING �
48. FINAL PLANNING r
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cv
51. CEftTIFICATE OF OCCUPANCV
No Date
n
�
�
�nonEsssarem�w+o: , S.SS ANTON HL
s
owxeaswweiviawm: SAKIOKA FARMS
, . • �oonEsa: p0 HOX 2097
TERMINAL ANNEX
�vr�.�uiuxo �nox�ss:
APCNRECT OP ENtlNEFA:
�acx. on �o.�s �oo�ss:
. . . _ uNr: STH
uc. xo.:
uxr:
coxm�crarsruue: SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
CONiNACTOR5MYl1lq 215 E EL SUR ST
�oo�ss MONROVIA CA ucra.: 190173
91016 uxr:
LICENSE� CONTHRCTOPS DECL�flATION: I hereby dlim uiMs peiuly d peejury Nu I em lieensed uMer D��e d Cheqm 8
(mmmeruirq �mA &xtian )000) d Oivoian J d Ne Budnsa and Pnlea�om CaEe. ud mY ��» u in fu0 brta eM eMaa.
cmuc.no.:013054 ����g C 16 ��N 19��y173 EXP: 04/96
Dme: Ia'�'3 �S GonveCa: �� //l ���
OWNER BUILUEH OECLAfl1TI0N: I hereby effirm uMer pwuly d per'�ny thet I em eumq fmm iM Camerfon ik«ma Law fa �M
lolbwirp reeson (Saqion )031.5 Buanaea erd Prolmuona COEa: AM c'ry a counry wfiidi re�uiree a permA lo mmVuc1. Mer. imDrova.
md'eh, p repai eiry sleueiure. prior b 6 6sueMe, ebo nqwm IM eppl'xant lor wN pem�e �o f�a a eqred �blameN tlul M a�M
IieemeC W�+�� �a iM yovieum W IM Conlretlon Lioenee Lew IChaqer B(�merceq wilh Sapion ]000) d Divwion � d �he
�uinW eM Admeon� GOCeI a Ihtl M n ehe u lmmp �hrehpn end IM buia ta Na eYepaE exemqion. My violelion af $W un
)031.5 by e�ry epplirent ta e pa�m� eiAp6f IM eppficaM to e dhl paraly d MI mas Ihen (rvs huMred tldlen �5500�.
� I.mowiwrdtMpopenyamyampbyeeawihwupeaeaiheiobmmpenee�ion.wLdothewk.enLiMaVucYu�eenolinleMaC
«oilereE br sale (SeGion l0aa. Bunma uM PMmaianaCode: TheCaMretlon Lioenee lawdoee not eGW �o en ownerof rvroeM
who buldn a inV�*e IM�eon. ard who EoeS tuM v.otk limxtl a Iwee� a Wwqh he a hs own amPM�s. p�� IMI tuch
imO�meMe ve ro� imaMed or WaeA lar sab. X, lawewr, iM buiNirp a inprwemeM is wld wil�in ans yeer W mmOblion, ihe
owirrhuilder xill haw �M WNen d pwi�q he or eM did nd duk a"unpv.a b �he pupma d eeb).
❑ I. ea owiw d tM wWaM. em a�tluvMY aontred'n0 �N IimuW cmuacian to wnehutl ihe pol� (Sed'on ]ON. &ninme enE
Pmlaaam� Code: TM Coniraaan L'cros Lew tlou nol eGWY b en owrcr tl V�WeM who W�a a imP�+a �M�om uM who
caNrazt� br wrh pqada wdh e mmrmfor(e) Icanaed punuem to ths CoMreGon Lkeroe lawl.
� 1 em exemq unEer Sec1ion: B. 8 P.G., M �Au reewn:
Dete: Owner:
I do M2by <MiN � I em awve W ud urdenlW IM 2pui�amstle W Gelipnie Neetlh uM Se1My CaEs Setlbna 25505. 2553]. eM
25536, e�d tlw I or eny luturo EuiNirp ¢wpeN wJl / wil ml (e�cb me) nssd w canpy wY� �eid efns oodw W iM �puimnenb M
epertMlamiMructianamoEifratianhamiM�i�t enepameniD"utAq.Rseidarqalmml�uCioneppfulumenusmqlromNase
prwiwro.
Dms: Mdsxn:
WOflKER'8 COMVENSATION DEC WIATION: I Mroby aHum unda parWy d ps�ury ms d iM tolbxiiq dsdertlbne:
� I Mva anE wil mumen e canMraie d aoruen� lo �Nlimun br MaM1an' compsvetbn, n pwidad la by BWbn J]W d Iha Lebor
Code. la IM pa�loimenc� d IM wak Iw Mch Ihb pamN b bwG.
❑ � n.w ena wi� meim.Y� wonu� eomw��w, inwre_npo�e... �awne M s.ao, 9�ao a m. �,e« coe.. w m. w�rormenn d m.
wo��or�Knmmo«mnoivi»e.�.ry'worte�'FKEMONT '��"�d'o�.v�wmerae: EXPIRES
c.m..:
Pdiry Numbr. 0 6/ O S/ 9 6
/hia wnion mN.w� b mnONM / W 0�1 c Iw aw huMd doCan �51WI a Im.)
❑ I mrlN �het In �he p�lnmence d tM work M whc� �h'p pertnA u 6�uM. I Nell M ampby erry pxpn In enY mennar o m to
beeoma wbjed Io IM xwken' eomponWion bxs d Cefdomie, uk pn� tIW Y I Mwk baepw wb�aa to iM v.orteii
compenwlon D��jbne Co/ SaUion �]UO d �ha Lebor CaE�. I WII I h mm vMh `thu"s� q�MuIom.
�ete: �� ��`J � / � AGV�itanl: ��!li�i �+
W�minp: F�Nun ro��eun wMn'romp�nutlon eovnpl I� un/nHul, mtl �NII �u4/�el m�mp/oyx ro etlMnl p�n�Ulu mL
c�vn nnu w ro om h,ner.e trou,w earw lsfat000A ����n m m. co.t or mnp.ru.tan e+mq.' u provw.e ror �n
9xtlm ])OB ol N� L�Eor COM, InNn1t, ene �ttumry'� Iw.
CONSTRUCTION LENDINO ROENCY: I Mnby elfirm uMu pe�Wry tl perjury Ihtl Ihas 4 e eonNe�abn hMi�p apanry lur IM
perlormenca M iM xork far whid� �he paml b'swW (`�� �). Civ. CI.
LEN�EN'8 NMIE:
LRIOEfl'9 �UUNE59:
� CBflln' 1�1Y � hBW IlGd plb B[��ICB�1ql BIb {�8101�W 1�10lbP9 �IiIX1110�10110 CqIM1. � aQM �O Cp��/ 1111�1 BB WY � GOYIMI' 0l�MfKlO
end ete�e lawe rolelinp b buildvp conabuaion erd Mroby eWnrce repreasnteirva� ol �Na eryto eMer upon Ihe ebove�maMioned pmprry
la impedia urpwsa. /�/5�� �
% //lCl/ �
Pnn�Neme
�� � Dete: �Q ��S^
��—�q�� OwetlApen✓RWk+���retla �
(5151-48.WP) While-Buildvp 8 Sdety;4reemFle;Cenery-Rppfrant; Fnk-Revenua;0oldonrod-qeveaeor
, . CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: F 074753
PERMIT NO: F 074753 PLAN CHECK NO: 03949-95 L GOVT: N SUPP; N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: FIR „ PURPOSE: OTH
JOB DESCRIPTION : RELOCATE FIRE SP SQ FT:
CLAIM VALUE: 8,900.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74573
+r*x�x��it�x�*x�*�**�*�x�x�*�x�x�*x�*x�**x�+t+tx�x�+tx�x�**+t+t�x�*it�r�rx ***x *r*x *�****x����+r�r*+�+rx��*��r�*it
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: , FT IN RGHT: FT IN
PARRING RE4• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NfSTES>
i
ik IE 1E 7F 1E 1E iE 1E 1E IE'lf 1E 1E IE 1E 1E1f fE IF if 1E 1E 1E iE iE fh 4 iF 7E 1E IEfE fE 1f 1E 1E 1E iE if 1f if iE if iE 1f i! iE �1F k ik iE 1E iE IE if� 1k IE IE IE 1E fF iE i! IE 1E 1E ik iE iE if if ik 1E iE if fklf iF 1f
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY :
LEGALIZATION:N
HLDG PMT PLUMHING
PERMIT
F E E S U' M M A R Y
ELECTRIC MECHANIC
�
FIRE
108.00
652
DATE:
DATE:
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
PLAN � , M1 70.20
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECR TOTAL PAID DUE
TOTALS----> , 108.00 0.00 70.20 178.20 178,20 .00
L,
REVENUE DIVISION TOTALS--> COLI:ECTED: 108.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC �� FIRE SMIP/TOT GRADING PLAN—CHECK
, � _ � 1 � 8, � �
. '�
kkltififMkMkkkkifMiFif lfkkitikihMMMiF�IkiF1kMMMlfMkiFiflfMiFMM44ifikifMM�fiFifiFMlkit�lfiFififlfilMk'If�FiklkiEiEiE�k14iF1FiF�141E4
=% I N D Z V I D U A L F E,E, H R E A K D O W N
TYPE (�TY � D. E S C R I P T I O N�, "" UNIT COST TOTAL COST
FIR 108 FIRE EQUIP FEE (FROM HLDG,VAL TABLE) 1.00 108.00
END OF_FEES
�i� _
I "� e
', � � - I � ,
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ai oa.�z�as-oo�Q��R4 ��._ ���.on
oaiE= �aizafas ra�E: ii�ae
CONSTRUCTION AND PLANN�NG POO SPA
,aPPROVALS Permit# Date Inspector qPPROVALS Permit# Date Inspector
,
t. Temporery Electrical Service or Pole 52. Pool & Equipment Loca[iorv �
�
- 2, Soil Pipe�Undrgmd. " 53. Steel Reinforcement ` '�.
�;�FJectricai Conduu UIIlity-Undt9rn[J. 54. Forms �
�
� ,�,��ectrical Cond�i;�0�rgrnd. 55. Electricai Bonding
..
r„�5. S'Ieel Reinforcemeqt= 56. Rough Plumbing & Pressure Test
,�Q�Elearica{UFESi'�nd. 57. RPPROVALTOCOVER-GUNITE
'�'F'ootings :..�;t: 58. Eiectrical Condu�Undrgrnd.
� 8. Foundation T�� � �- 59. Gas Pipe, O U�StliHmd., Test
'-r V ��
9. Water Pipe�Und�r�rid...., . 60. Backwash LineS�P•Trap, O�hdrgrnd.
10. Structurai FIooF„�System - 61. APPROVALTO�ECK �
11. Property Seweryine�.� Hous6xonnection 62. Backwash & RecePtor-Final�
12. Sewer Cap C r 63. Heater & Ven[-Final
�
13. Roof Drains ,,, - 64. Plumbing System - Finai �
14. Rough Pium6ing ?t " 65. Electrical-Finai .
15. Rough Elecvicat-Co�duit „ 66. Solar SYstem-Fy;ta{
76. Rough Eleccric yiriqc -� 67. Fencing & Access?�pproval
17. Raugh Wiring Sgn ! 68. APPROVED F(�1fj:PLASTERING �
18. Rough ElectricaE7 Bar Ceiling 69. POOUSPA SYST'EMS FINAL
19. Rouqh Heatina & Ai� ConditionRn� C� � � ; � F�FWDE�T4REQUIR,EME�1„T �„
20.�ou�iF tor�Fi��lace < -� ', S,:., c,�' APPBa�1��H P�i•mit#� C
...-...
21. 9u ' in�truiiur@%� ,�.. .. '"�= t 5""* 70. �lndergi� 1�dro tt
� s- y r., ns: �
22.8u�V�rjtil�'in �p �";� *p ,Q ,j -,* 71, Product.Hiping^ as �Oil
23. Gas Pipe.RouFh & TLst :T1S * m � Q Gk 7p, Undergro d F `'J
... r � r. -i'�J "� �
24.�ooY`�'Fra�ing� �* ' � ��rFr,, y = q,..�* • 7 Underqrnd.St�n{gTan'n.OGas ❑Oif
� - . (- µ �
25. RoobSh2IIthing S* � � �; � = Nx 7p Overhead "..;..� `Q,( .�c��+.L�. tz•�( •9S
26. ��Ba4'�Cei�ing (Str��ral1 & hsto�nocoat * p � c' p; 7� Dry Chenoiaal �-.� �v
- - � . ..
27. •Frarna ar¢i: Flaahirtgt �=.Q � � =� �'� 76. Dry Sta��'i,Pe`� "^ , f`'
x �p H k C .J
, 28. Latt�uig �tSi�ng O" N ��` � y E .. .•� 7'1; FIXED�CSTE INAL.-i .'1 '�J+ IT• �
J i7R UCr+ � ts Z9�aT
29. Insulatiort; �' :�fi r, n �, c I � 7 FIRE PREV. F�Ih�QL "�'� �^ _� 7'7 `R(� ��
' 30. Drywall IQ�ailir�Tg N� H - *_ � I � � `,�}�AL'f�j DEP� . REQUIRrEMENT
�. 31. Plaster BrowrfCoat7i S ' :"T � ' ; 79. FINAL A�I�PECi�FDN ' ~ .
... . �}.y x ^ :-.
!: 32. rEiectricaf �owQr Met'�r-fMal � � � r 8� FOOD CERTIFi�CATE l6S�lE0:
" � „ .
•, 33. EinakElectric,> � t c, 1 � j � NFtes: �2 � ^^' r y n'�m
_ Y-'t-s�; ::���jjj£''' �<���,
� 34. �'naGieating� � $'itionirtt�= Y ; �Q ��f�,' wVCX-E�- � "pl�,�.�,�
.d .� �1v�4A t- u � � �. .�' Y�� n. . , '
, _, .: . � ! � � G✓i�rM-v:� �S �.N � � : sY2ls�- - �'J,�-
35. �inal Gas Pipe,. esLR ,,, ^
^ 36. }�{oo or CanoPY 'T ": a �'� � �r �' �' r
�r : "n � s-; , i , ,ttiwl- s�..� -� wo�=(� ,��_ c�u -� -
37. Final�kactory Pireplace � =ti ^� �� � � z o 4� "���
^ 38. FinaF Plumbing � �' ' - �' .� S 'J"�
�� �t o x � � ., -� c[ • > ' C
" 39. 4j(ater'Service-Final r g V * G .v� o r "
r I
• 40. Qas Service-Final #� �.� r,S w� i , �. r�' o� K a; •
� '. .. � , . .. �
' 41. Solar pomestioFina� " {n, y a f � 'x Tc .- -7e� o� +�- Y, -.
� .. rc �
42. Backflow Preventer'� �1i '� � I ! G • ' • ��'" ' -
n � w r,., a N x ;*�cn :n :r, ^. *'" E.
43. Backflow Irrigation : - � ,� x , . `� �v � v ` (� •
' L C1 O
A�4. LandscapolrFi.�a[ior��System���� � '''•'� � o `�* 'L v `" �� *u ;U e
. x r ,JC�. Y y Q:K £ <. i
5. u�ound P,Ftenuation; =! •:c. ` r ` ;:� rq !r�� � cr - .', • �. +
z.
S6. Handlcap•Regvlatioris - � * j �' � � = `�� S '�
:r �; m G r� *
47. F1NF,�L STRl1�TUR� & BUIl01NG :�. ; v ' c� v
- r i
48.�{NNIPLANNING� �r'f" �n' i �.� � � r ¢
��. Electdc ReleA'se to 'EC. ison � � � ., j s ' e
�r 1�
60. Cas Fielease to Soutl�ern Califor�i�GasCo � � F" '� "� ' ��" ' `� '
,• r a• s a o r < :�� c
�51. CER�IFICATE OF OCCUPANCY � • � � �
Date
9
RUDFESSOFBVILpNG: SSS ANTON BL
avxewsn.weiFaawr+: SAKIOKA FARMS
, , ."°o"Eu: PO BOX 2097
TERMINAL ANNEX
APPL. WUWlO ADDNESS:
u�T 5 TH
�ncxnecrox�m�n: TRI—SIGNAL INC. ��NO' 0
MCH ON FNQ'SIDDXE55: 1 9[� S GARD E NA AV 818 — 2 4 7-1 19 4 ��+T�
GLENDALE CA 91204
�o�mncTon'Sru�: MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
cam�croxs�uimo p O BOX 509
�ooxEss: WALNUT CA uc.ra.: 230813
917 8 9 urn:
LICENSE� COMRAttOPS OECIAXATION: I Mreby eflim uMm pa�aLy d pe�iury the� I an licerimd �Mm prwieions d Cheqm 9
(mmmeriarp vmh Sectian )000) ol0ivision � M ihe Buai�wss eM Prdasaiom Cade, eM my lioensa ie in full iwca eM eHec1.
cmuc.no.:0�0 j558 /uc.cuss: /ucy. �o� 230$13 EXP• 17�/96
ode: � "� �7 � �(O camraa«:C� 71 % �
�
OWNEN BUILDER UECLANATION: I hereby elfirm urMer paneYy d parN�Y �� ��emp /mm tM Contreeon licenae Lew t« Ne
Idbwig �easm (Setlion ]031.5 Buarosa erd Pro/msian Cade: AnY W a eo ry whieh ' uine e peemil lo ansNiel. ettm.'unprove.
'wnolsh, w repei eny evucwre, prior ro ils 6euenca, eba rtyui�ae Ihe eppli br wc� n lo fib e sgned s�etemant thm he w eM
'icensed pureuantmthe pwieiona dihe Conlreclore license lew [Chept 9(com ndng with Sedon 'lOW) M Diveion � d�he
minem enA Prdeseione COEe� or Ind ho w ehe n exemq therelmm aM 1 IM elbpeE exemqion. My voletion of Section
/W l.$ Ey eny eppliranl IIX B permn wbptlf IM epplicen110 8 rrvil paralry d Tors Ihen frv0 hVMrad dd4n �5500j).
❑ I. m axviar of iM P�PaM or mY �PMeea'Mh wepes sv Ihei eole oompenaeiion. will do iM work. vM �he avuclure w not inlendad
or oilereE br sele (Sedion )OGO, Buanece ar�d ProleesbnaCode: The Conlreclon License Lew Eaes nM eppyto en owner ol properry
who buide «vnv�� �ha�ean, eM xfio doen euch xork Nmmll or hanetl or tMaph ho or har own mmdWee+. P�� �� cuch
impwwnema era ea inteMeE a dleeU iw eeb. tl, Mwever, IM buiMi�p or inryaemem is sdd wnhin ore yur d complpun, Me
owner-WiMer will heve iM buNen d pmvin0 he ar eha EN nd build a imqove Iw iM WN�s d seb).
� I. es amer d Ihe propeMy. em udueively contraniq v.nh lioenead conVeclon b conahud iha prol� (Seeion ]OId. Bueirwes eiW
a,m...�. coee: rna comreaon 4.�.0 �.. ao.e �� io � ow�,« a ww�v wno w�u. « ��« m.,.o„ d,d wno
cronvecb la euN pojeea wdh e ooeuretlor�a) IicenseE W��� lo IM Wntredws L'xanae lew).
� I em exempt wEer Se�lion: B. 8 P.C., la this raaeon:
od.: o�:
I tlo heraW ce�iry ihet I em awme ol uM uiMenlenE tM requiromeme d Celdomie Heellh eM Sdety Code Sediom 25505, 255J3, eM
255�0, enE Iliel 1 or eny INure builEirp oxupem xill / wJl na (aRb one) neeE Io compty wIh aeiE elete catlm arA Ihe requiremenb br
epmnnlamnevuetionormodifimlionhomlMAi ue�iy enepemenlDisUitl.Reeidemalmeatrvr�ioneppiea�iwnwssomplmnNeae
�`lW9M119.
oaia: nooikem:
WOPKEN'S COMPENS�TIIXJ UECIAHATION: I MreEy elfirtn undar peeWiy d pxiury ms d IM Idbwirp Aetlerelnm:
� I hew end xill meiMan e cerlXice�e d coneem to eeH-inaun Iw wwken' compeneeibn, es prwkeE br by 6eaian ]]00 d �M Lebor
COEe, br Ihe peNortnence d �M xoA lor which thie pe�mn le iouad.
rl �nav..nexi�meimenworwn�cano�mioni�w,.rc...,rea��ebys.eiu,a)mMm.lab«coa.ar�nawdwmvw.a�n.
R wak tw which IM1ie pom�n ia ivued. My wakein' mmpenaetbn iruurencs mner uM paliry number era:
c�a�: FTRFMANS F[TNn EXPIRES
aawrN�mc�: nwr-an���Fq� 07/01/96
�is axYion need nIX bs romObfM % Na pamiA ia M one hundred ddler+(StOp) w ba.)
� I cerlity ihet in Ihe peAom�ence o/ tM work br whkh thie pe�mn ie inued, I shNl iwl emdW e�Y Oaiwn in vry mennx m m to
bxana w4� �o iM woMn' mmDaree�ion kxs d Celitomia. entl Wree Net il ehouk Exoma wM� the vroMe�e'
%�^iumion 3)00 d �M lebor Coda. I H&I�vith mmqy Mnl ImeyoNabre. ,J
Date:/ �'� �� Applicanl' � % %� C ✓
Wem/nD� F+Uun M Heuro wort�ri mn�oNuetlon eovwep� h unlawful, �nAa I udJ ef �n xnp/oya ro MMNI pmeMu e�M
cnn nM. up ro on. nund�sa rMmne ewwn (Sia0.000A in eeeiuon ro ms t ol . mpxuetbn, wmeys. u prov�tlM roi In
SseHm 3)O6 0l Ms LNor Cotl�, InNnst, entl ettomsyY Ns�.
CONSTRUCiION LENUING AOENCY: I MroEy elfirm unMr penely d pvj� �Iwm u a cvn9ruaion bMirq �qeM.y lur Up
�IBf�01T8MB a IhB WJf�t /M M�1IC�1 ��16 p!l111119 49YB4 ($Bd911'��J. I�iN. C�.
LENDEN'S NRME:
LENDENB AODRE55:
1 cenM �� ���e reeE Ihis epqkelbn end ale�e ihet tM above inlormation ia <aneG. I epiee lo mmON �h ell ory enE oounry adinenroa
enE slete lewa ralelin0 �o buiWing conetrutlion eM hereby eNhorize repreaentvivae al lhia dly m enter upan the abova-men�bned pmpeM
r« ��ac�u� w,�.
CHUCK JACOBI JR
/� Pnnl Neme p �
/ '� _ %�%4 `'� .� h� ova �T�
(5151dfi.WP) 1 �'hnaEuikiq 8 Se1ary: Grear�Fb: Cenary-Appifant: Rnk-fiavenue: (3aMmmd-Meava
��/
CITY OF COSTA MESA — BUILDING PERMIT
PEAMIT NO: F 075838 PLAN CHECK NO: 04813-95 L
PERM NO: F 075838
GOVT: N SUPP: N
CONSTRUCTION TYPE: iFR SP PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74573
*�r***�r+�***+t****���*�*x�*�***�*�**�****�*�r�****�*+�***��+t�**��*+t*�r*�+�**x *�***�rt��*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES>
7
!E!f 1E if-iE iE 1E �lE 3E iE 1E'lE fE iE �E �E iE 1E if if 1E if ik i8lE �F 3E 1f if iE 1f iF iE 1F'Ik K!E IE 1k 1ElE iE if 1ElE iE fE 1E 1E!(� iE 1E iE if iE �f 1E If �E if iF iE 1E 1E 1E 1E ff if 1E iF iF iE �E 1ElE iE iFlE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
HUILDING APPROC'ED BY :
APPLICATION ISSUED BY:
*x *x *+r+�x ��r�r*�***�***��
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE:
DATE: �
�x�*�*+�** ��*
STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 90.00
658 SMIP/NON—RES
PLAN 58.50
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 90.00 0.00 58.50 148.50 148.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 90,00 OVER/SHORTc .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
iE �IE if iE iE iE iF iE �IE iE iF fF �IE iF 1F �f �E iF �If iE iE iE fE �lE if�')f �IE 3E �1F i@ * iF jflf if iE iE jE if �f fF if iF 1E if aF 1f �f if 1f 1f iF if If iF iE if iE if iE 1E 1f 1E if if iE 1E 1F i(� �E if if iF 1f if if jf 1f iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 90 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 90.00
END OF FEES
�.
'ii1 (JQS,';•rL?'"CJ1J/8"S �: 1'fi��' /U..Jcl
Dnr_: l±.•es �:; T�-�E= GSaI3
CONSTRUCTION AND PLANNWG P��� 'PA '
{�.PPROYAIS Germit # Date inspector qppROVALS - Permit # Date Inspector
�
:
1. �Temporary Elect�ical Service or Po�e 52. Pool & Equipment Locatipn '
2. Soii Pipe-Undrgrnd. ,�� 53. Steei Reintorcement �
r3.�Eteccrical Condaii UiilitY-Undr9sad. ` 54. Forms � ':t
4: Electricai Conduif-Undrgrnd. 55. Electricai Bonding ,
.5. Steei Reinforcement 56. Rough Plambing & Pressure Test
^6;'ElectricalU,F.ER',Grnd. 57. APPflOVRLTOCOVER�GUNITE '
a _ ,
� �7: F.00tings -� .-�� . 58. Electrical Condui[Undrgrnd.
8. Foundation � ' 59. Gas Pipe, O Untlrgrnd., Test ,
9. Water Pipe�Undrgrnd. ` � 60. Backwash Lines, P�Trap, p Undrgrnd.
10. Structurai Ftopr Svstem � � , 67. APPROVAL TO �'ECK �
it. Property Sewer Line & House�;onnection 62. Backwash & Re'eeptor-Final -
72. Sewer Cap . . � 63. Heater & VenFFinal .. - '
73. Roof Drains- `. 64. Plumbing System - Final ,
14. Rough Plumbirig . � 65. Electrical-Final �
75. Rough Eiectricai-Conduit ' - 66. Solar SYstem-Final
76. Rough ElectricYt�iring . ' 67. Fencing & Access Approval
-•77. Rough Wiring Sign b8. APPROVED FOR PLASTERING
78. Rough Electricai�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning _ FIRE DEPT..REQUIREMENT
20. Rough Faetory�FirEqtace ' T x. � ,` � �._ �� AppRQVALS..',F PeKmit #� ��
27. Ducts, in Struaure : � � �• �� • � � ,--" 70. Underground Hydro '
22. Ducts,;V=ntilatingf,�� x, ,, _�.� 7�, Product�P.iping C7�Gas OOii
23. Gas Pipe-iiougF.i & Test }:T: � 72. Underground Flush
. ;r
24. Roof� Framing " � , -_ ." 73u Undergrnd. Sto ageTank Q Gas ❑ Oil
25. Roof.Sheathing .+ •'!� 74. Overhead HYdro; � *
26. �_Bar Ce�fing �SvuctQral) & N}o9dcoat ,;. , ' t' � 75. Dry Chemical ._, .
27. F�ame.and-Fiashinq.;: �����x .- . ��. 76. DryStancJpipe �
- 28. �athing &,SidJ09 =� c` �� �' ." . ' ` 7Z: FIXED SYST6MiPINAL �.
29. Insulatiom. '- _ ... '.. • 78: FIRE PREV. FIPFAL � ` 2;"� (D�V y��.
30. Drywall �failing '; F � � � HEALTH DEPT. REQUIREMENT
xr „`
�37. Piaster Brown�Coat,. -. .. _� �' 79.� PINAL INSPECTION ..
32. Electrical;�ower M�t�rPinal ; '&0. FO00 CERTIFICKTE I�SUED.
33.Fi�nalElectiic-' TA r - � Notes: � �
f
�� 34. Finai`Neaiing & �ir%Co�ditioning'" : ' �' �- ���� ° • r'
�
35. Final Gas Pipe-iest ; ,_ ' - ��': x� ` �•,;�
- 36. Hood or CanoPY ' -' _ ' - 't : . - • �
F . ' .1.
. ;37. finai Factory Fireplace „ ' '_ ' :r _ ^t .
38. Final�Plumbing w , , . - ' . .. -•
.r
39. Water Service-Final � , ' � ."'� � �
*40. GasService-Final - �"� r".- ^' ' '
,.
"41. Solar pomestio-Final� `� - t '� ' . - ' � - ,
1 rr� r •
42. Backflow Preventer i ., � ' . -
�
43. Backflow Irrigaiian � �� � " � ' ; � ,
44. Landscape Irri9ation SYstem • + ."_ • . = � _ -. - _ '
�.,r�. r a r,
A5. Sound Attenuation ., " " � ; � � , _ - ,
46. Handicap�RegulaUons � � - : ' -
47. PINA�L STRUCTURE & BUILDING , _ �j � � � . ;
4$. FINALPIANNiNG � � _ �T'
,
, 49.. ElectnC Release to Etliso� ' �
50. Gas Relaase to Southern Calitornia Gas Co • •
- , -
57. CERTIFICATE OF OCCUPANCY -
No. Qate
�
���a� �sa-s2�s • Fax (��a»sa-aess
.lob Address: 555 ANTON BL
Suite: 6
Vicinity: . , -
Parcel Number: 41050110
CITY OF COSTA MESA l
BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
Applicant: MICHAEL WILLEY
Address: 18001 COWAN #A
IRVINE, CA �� �
Owner. SAKIOKA FARMS -
Address
Contractoc ASSI SECURITY
FIRE SUPRESSION PERMIT
Zoning:
Phone: (949)955-0244
Zip: 92614
Phone:
Zip: 94137
NUMBER
�
l/� F00-00082
I
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/20/2000
. � Issued: 03/20/2000
ISSUED BY: `-"" "-�
Address:- 18001�COWAN #A ��
� � Phone� (949)955-0244 �
� IRVINE, CA � �Zip: � 92614 , , � � �
`
� ' . Cicense: 683831 �
' , SCOPE OF PERMIT
" PROVIDE AND INSTALL LOW VOLTAGE CARD ACCESS SYSTEM. INCLUDES LOCKING OF ELEVATOR
L068Y DOORS TO BE CONNECTED TO LIFE SAFETY SYSTEM. . �
REF:800-00258 � - �
Plan Check: $63.21
Permit: $97.25
Other: ' $0.00
Total: $160.46
FEE SUMMARY .
— -- - ✓�
,
Calc Valuation: $a,000.00
Claimed Valuation: sa,000.00 �
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Caiifomia 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 e period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considared legal, such work must comply with all epplicable codes, and all
requlred inapactlone and final epproval must be oblained. Failure to oblain inspections and tinal approval will result in Ihe expiration of this permil.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSATON DECLARAnON: '
I hereDy ettirm under penalry of pehury ane of tha following tleclaretions:
❑ I heve antl will maintain a cenificate ot consent to self-Insure br woAcers' compensatlon, es proNded for by sectlon 3700 of the Labor Cotla, for Ihe peAortnance oi the
j�ork for which Ihis parmit is issued.
� I heve end will mainfain workers' compensation insurance, es required by section 3700 0l Na Lebor Cotle, for t�e perfortnance of Ihe work for which this permit Is issuetl.
. My worke s' compense�ion Insurence carrier and policy number are: . , �p
Carriar: ���/6-I`� �NS . Co • Policy Number. �f/G � / 2 S��S /�
(This sectlon need not be completetl il the permit is veluetl e! one hundred dollere ($100) ar less.) '
❑ I certify ihat In iha peAortnence ot the work tor which this permlt is issued, I shall nol employ eny person in eny manner so as to become sublect lo the workers'
compensation laws of lifornia, and e e that If I s�oultl become subject to the workers' compensation provisions of Section 3700 of ihe Labor Code, I shell forihwith
comply with these pra sions. �
ApplicantSignaNre: �` Date: � — ( � ��
WARNING: FAILURE TO SECURE WORKERS' WMPENSATI OE IS UNL4WFUL AND SHALL SUBIECf AN EMROYEF TO CRIMINAL PENALilES AND dVIL FlNES UP TO ONE HUNDRED
TMOUSAND OOLIARE (5100.0OO�.IN ADDITIIXJ TO THE T OF MPENSATION, OPMAGES AS PROVIDED FOR IN SEC�ION 31O80F THE LABOR CODE.IMEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS OECLARATION:
I here6y attirm that I am
farce and eHect. Lic. q_
Comrectafs Slgnature:
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHirtn that t�ere Is e cons
Lender's Name:
Signeture:
oi Chepter 9(commencing with Section 7000) ol Division 3 of Ihe Buslness and Prof§�sions Coae, antl my license is in tull
Glass x C i A��d
Da�e: T �� Z- �d
agancy for the peAortnance of ihe work lor which this permit is issuetl. (Sec. 3097, Civil Code).
Lenders Atltlress:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby afllrtn Ihat under penalry of perjury Iha� I am EXEMPT FROM TME CONTfiACTORS LICENSE LAW for ihe followinq reason (Sec. 7031.5, 8usiness end Professions
Code: Any ciry or counry which requires a permit to construcL alter, improve, demolish, or repair any structure, prior ro its issuance, also requires the applicant tor such permit
to tile e slgned stetement Ihat he or she is licensed pureuant to ihe provislons of the Contrectors License Lew (Chapter 8(commencing with Section 7000) of Division 3 of the
Business entl Professlons Cotle) or that he or she is exempt Iherelrom flntl Ihe basis tor Ihe allegetl exemption. Any violation ot Section 7037.5 by eny epplicent lor a pertnit
suh�ecls Iha epplicant to a civil penelry oi not more lhan Iive hundretl tlWlers ($500).):
❑ I, es ov+ner oi the proparty, or my employees with wages as Iheir sole compensation, WILL DO THE WOfiK, end the structure is not intentletl or oXeretl lor sale (Sec.
7044, Business entl Professions CoGe: The Contractore License Lew dces not epply ro en owner of praperty who Duilas or improves ihereon, end who does such work
himself or hersell ar Ihrough his or her own emplayees, provlAetl thet such Improvements ere not Intended or oHered for sale. If, however, the building or improvement is
soltl within one year oi completioq the owner-builder will heva the burden of proving that he or she did not build or improve for puryose of sale.).
❑ I, as owner of t�e property, am E%CLUSIVELV CONTRACTING WITX LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business end Professions
Cade: The contrectors License Lew does not apply to an owner ot proDerty who bullds or improves ihereon, end who contracts tor such project with e coNrectoqs)
license pursuant to tha Gonirectors License Lews.).
❑ I am axempt untler sac. Business end Protessians Codo tor thls roason:
Signeture: �ate:
Owner I� venfied by drivels license. ❑ Ves ❑ No Drivels License No. Explres:
Verilicetion of Ownership by (rype ot tlaument, i.e. - property tex blll or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICA710N:
❑ 1 hereby cenity ihat no escavation five (5) or more fee� in depih into which a person Is requlred �o descend, will be mada in connection wilh work eu�horizetl by ihis
permit, entl that no building structure, scaflolding, felsework, or demolition or dismantling Ihereot, will be more then thirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Celitomia Administretive Gode).
❑ As owner�builder, I will noi employ enyone to do work which woultl require a permit irwn ihe Division oi Indusirial Safery, as noted above, unless such person has a
pertnit to do such work trom the division.
Signawre: �ate:
Division of Intlustnal Safety Permit Number:
CERTiFICATE OF COMPIJANCE AND AUTHORIZATON OF ENTAV: I cenify under penalry ot per�ury that I have read Ihis application and sWte that the Intormation given is
correct. I egree to comply with all stete laws and ciry ordinences releting to building constructlon, an0 euthonze representatives ot iha Ciry of Casta Mesa to enter upon the
e6ove-descnbed property br inspection puryoses. I agree not to occupy or ellow occupancy ol any bullding euthonzed by ihis pertnit until tinal inspectlon.
COOE �. INSFECTIONTYVE
1818. Fixetl System Finel Fire Pr
1266
200
201
202
203
204
26a646
Pool Spe Final '
Finel Re-Fool
Final BIocWRetaining Well
Finel Fedory Fire Place
Final Sign
Final Demolition
�g.
�
IMIfIALS tooe� ixsveenoxxve
206 Finel Mec�anical
20B Finel Plumbing
270 Final Electrical
212 Final Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final BuiltlinglOccuDancy
Date
— / Z —OG
Date
Q�g IMRI4LS
cd 17(
(714) 754-5273 • Fax (714) 754-4856
r-.
CITY OF COSTA MESA , r
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 555 ANTON BL
Suite: 6
Vicinity: 6TH THRU THE BTH FLOORS
Parcel Number: 41050110
Applicant: MC CABE, MIKE
Address: 2250 S. CENTRAL AV.
RANCHO DOMIGUEZ, CA.,
owner: SAKIOKA FARMS
Address
BUILDING PERMIT
PERMIT NUMBER
� soo-oo22a
77 FAIR DRIVE, COSTA MESA, CA 92626
Zoning:
ISSUED BY:
Phone: (310) 763-2112
Zip: 90220
Phone:
Zip: 94137
Contractor: INNER SPACE CONSTRUCTORS
Address: 2250 S. CENTRAL AV.
Arch :
Address:
Phone: (310) 7632112
RANCHO DOMIGUEZ, CA.,
Zip: 90220 License: 366309
Phone:
Eng:
Address:
Status: ISSUED
Applied: 02/18I2000
Issued: 02/18/2000
Phone:
Zip: License: License:
SCOPE OF PERMIT
INTERIOR DEMOLITION FOR FUTURE T.I. FOR -BMC SOFTWARE- (6TH THRU 8TH FLOORS). DEMO NON-BEARING
PARTITION WALLS, FLOORING, CEILING, & FINISHES.
Plan Check: $0.00
Permit: $512.95
SMIP Res: $0.00
SMIP Com: $7.68
Other: $0.00
Inspection: $0.00
Total: $520.63
SETBACKS
ACCESSORY
PARKING
Front 0. 0
Front 0. 0
Existinq: 0
Rear 0-0
Rear 0. 0
Re uired: 0
FEE SUMMARY
PLANNING 8 ZONING
Lefl 0- 0
LeR 0• 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Righl 0. 0
Right 0-0
$36,575.00
$35,000.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap eccess requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall eutomalically expire end become void if work is not commenced within 180 days, or i� work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapecllona end final approval must be obtained. Feilure to obtain inspections end final approvel will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS'COMPENSAnON DECLARAnON:
I hereby eHirm under penalry ot perjury one o1 the tollowing tlaclerellons:
❑ I have entl will malntain a csrtilicste of consent to setl-Insure lor workers' compensation, es proviaed for by section 3700 ot the Labor Catle, tor tha paAortnance of Ihe
work tor which Ihis pertnit is issued.
I �ave entl will maintain wwkars' compensatim insurance, ag required by secUon 3700 of Ne Labor Cotle, tor tha peAortnence of Ne work for which Nis pemtii is iswetl.
—�—Myvrorkers' compensa�ion Inwrence carrier antl pdiry number ere:
Cerrie .r22:oV��ta � �^� �7Q�"'� N t �'"�/ �Polfty Numtier�/ 3 � 3 � � — d %
((Th!_iseclion need not be comp/eted i/ the Dermit fs veluetl et one hundred dW/ers ($100) or /ess.) `
❑ I cenlly thet in the pertortnance ol Ihe work for w�ich t�ls permit is issued, I shall noi employ any person In eny manner So es t0 become subJect to t�e workere'
componsation laws ot Calitomia, entl egr a Ihat N 1 should 6ewma suO�ect to the workars' compensation provisions of Section 3700 of Ihe Lebor Code, I shall forthwith
comply wiih thesa pro io
Applicent�Signature:��%L ��—c. �S�— rDate: �,// y/�
WARNUJG:FAILURE-TO SECURE WOPo(ERS' COMPENSATON COVEMOE IS UNLAWFUL AND SHALL SUBJECT AN EA�LOVEH TO CiiIMINAL�PENALTES AN� qVll FlNES UP TO ONE MUNDRED
TIqUSM1D DOLLARE (510D,000). IN ADDfiION TO iHE 005T OF GOMPENS4TION, DAMAGES AS PROVIOE� WR IN SEGTION 3]O6 OF THE LABOR CODE.IMEiiEST, PND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby effirm that.l.am�lice etl under rovisions ol Chepter 9(commencing with Secilon 7000) of Division'3'of�Ihe�Business antl Professions Cotle, entl my license Is In full
force and ene �f . Lic. p Lclass.N.
Comre�gnature: ,( /. i /t� — r.Data. nZI/A OCS
CONSTRUCTION LENDING AGENCY:
❑ I hereby aNirtn thet there is a construc�lon lentling egency lor the peAormence of ihe work lor which ihis parmlt Is Issued. (Sec. 3097. Civil Code).
Landers Nume: Lentlers Atltlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereDy aNlrm t�at untler penelry of perjury thet I am E%EMGT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Busines9 and Profession5
Coda: Any ciry or counry which requires e pertnit to constmd, elter, improva, demolish, or repair eny sWcture, pnor to its issuance, also requires the applicenl lor suc� permit
to tile e signed statemem ihat he or she is Iicense0 pursuant to I�e provisions of tha Cantraccors IJcense Law (Chepier 9(commencing with Seciion 7000) of Division 3 of the
Business antl Profeuions Code) or that he or she is e:empt theralrom end tha basis for Ihe elleged exemptlon. Any violatlon ot SecUon 7031.5 Dy eny applicant br a pertnit
sub�ects the epplicant to e civil penalry ot not mare t�an (rve hundred ddlars ($500).):
❑ I, as ownar oi t�e property, or my employees with wages e5 Iheir sole compensation, WILL DO THE WORK, and the sWtture i9 noI intenCBtl or oflered lor 5ale (SeC.
7041, eusiness end Professions Cotle: Ti�e Contrectars License Lew tloes no� apply to an owner oi property who Duiltls or improves thereon, end wha tloes such work
himseli or herself or thmugh his or her own employaes, provided that such impmvemenis are not intended or ottered for sale. It, however, the building or imprcvement is
soltl within one year of comple6oq the owneo-6uilder will have Ihe burtlen of proving that he or she did not build or improve tor puryose ot saleJ.
❑ I, es owner of Ihe property, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business entl Protessions
Code: Tha coniredors License Law does not appty �o an owner af property who bullds or imprwes thereon, and who comrects tor such prqect with a comractor(s)
license pursuent to the Contractors License Lews.).
❑ I am exempt under sec.
Signature:
Ownar ID veritietl by Eriver's licensa. ❑ Yes ❑ No
Business enC Professions Cotle for this reason:
Verificatlon of Ownership by (rype of tlocumenL i.e. - property lax 6ill or deed�:
Driver's Licanse No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby certify thal no excavetion live (5) or more faet In deplh Into whic� e person is requl�e0 to descentl, wlll be mede in connection with work aulhorizetl by t�is
pormi6 entl Ihet no huiltling siructure, scafloltling, felsowork, or demolilion or dismentling lhereof, will be more Ihan ihirty-six (36) feet hlgh. (Chap. 32, C�ry 2, Art 2, Sec.
341, Title B, Calllomia Adminisiretive Cotle).
❑ As ownar-6uilder, I will not employ enyone to tlo work which would requlro n pormlt Irom the Division of Intlustrial Safety, es no�ed e6ove, unlass such person has e
pertnit to do such work Irom the diWsion.
Signeture: Date:
Dlvision ol Indusirial Salery PBrmit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZAl10N OF ENTAY: 1 ceNfy untler penalry ot perjury Ihat I have reatl this application end state Ihet ihe informa�ion given is
correcl. I agree lo comply vrith all state laws antl ciry ordinances relating ta huilaing wnstruction, an0 authorize representatives ol tha Ciry oi Cosia Mesa to enter upon the
ebove-descriGed properry tor Inspection puryoses. I agree not to occupy or allow occupanry ol any buliding euthorized by t�ls pertnit untll final inspection.
CODE �. INSVECTONTYPE Q� IISI�LS
7616 Fixod System Finel Fire Prevention
1266
200
201
202
203
204
2a4B-98
Poal Spe Finel
Final Re•Rooi
Final Block/Relaining Wall
Final Fectory Fire Plece
Final Sign
Final Damolltlan
COOE I INSPECTION TYPE
206 Finel Mechanicel
200 Final Plumhlnq
210 Finel Electdcal
212 Final Fire Prevenlian
220 Final Plenning Approval
222 Finel Site
250 Finel Builtling/Occupency
P� UIIIDEIS
(714) 754-5273 • Fex (714) 7543856
Jobnddress: 555 ANTON BL
Suite: 6
Vicinity: SIXTH FLOOR
Parcel Number: 41050110
'�v
CITY OF COSTA MESA
BUILDING DIVIS/ON
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
npp�icant: DE OCAMPO, RUDI
Address: 3080 BRISTOL ST.
COSTA MESA, CA
SUITE 105
owner: SAKIOKA FARMS
Address
BUILDING PERMIT
Zoning:
Phone: (714)754-1197
Zip: 92626
Phone:
Zip: 94137
Contractor: INNER SPACE CONSTRUCTORS
Address: 2250 S. CENTRAL AV.
Phone: (310)763-2112
RANCHO DOMIGUEZ, CA., �
Zip:- 90220 _ License:- 366309 .
NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 031012000
Issued: 03/292000
ISSUED BY: �
Arch : IA � " � Eng:
Address: 3080 BRISTOL ST. . Address:- �'
COSTA MESA, CA - Phone: (714) 754-1197 Phone:
, SUITE 105 .
Zip: 92626 � License: License:
SCOPE OF PERMIT
17,800 SQ FT OFFICE T.I. FOR -BMC SOFIWARE- (6TH FLOOR).
Plan Check: $356.23
Permit: $2,192.15
SMIP Res: $0.00
SMIP Com: $65.83
Other: $0.00
Inspection: $0.00
Total: $2,614.21
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0. 0
PARKING Existina: 0
NOTES:
Rear 0. 0
Rear 0. 0
Reavired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0. 0
Left 0. 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0. 0
Righb 0. 0
$313,500.00
$300,000.00
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIHATION: This permit shall automatically expire and become void if work is not�commenced within 180 days, or if work is suspended or abandoned
for a penod of 180 days.
��, INSPEC710NS: In order for the xrork authorized under this permit ro be considared legal, such work must comply with all applicable eodes, end eil
�. requlred Inepectlona end flnal approvel must ba obtained. FaiWre to obtain inspections and final approval will resul� in lhe expiration of this permit.
, FOR INSPECTIONS CALL: (714) 7545626
WOFKERS'COMVENSAnON DECLARAnON: ,
I hereby atlirtn untler penalry ot perjury ane o1 the following tledereNons:
❑ I have and will maintaln e ceNilcate at consant to self-Insure tor warkers' compensation, as pmvidetl tor by sectlon 3700 of Ihe Labor Cotle, lar the peAarmance oi the
work for which Ihis pertnit is iuued.
❑ I have antl vrill maintain workere' cwnpensaUon inwrance, as required by section 3700 of the Lelwr Code, for ihe pertormence of Ne work for wNc� t1Js pertnit is iswetl.
My workers' co� pennsalio9 Insurence tartier e �tl poliry number era: .
Carner. �-L2�--�s--�� �l�� ,(,�/ � _ _ PolicyNumber: I 3 / 3 �(� — 1` 7
(Thissecti eetlnotbecrompletedl/fheOertnl(l�l�eaeronenunnrecdarars�sioa�oriessj
❑ 1 certity thet in the peAortnenca of the work for whlU this permil is issued, I shell nol employ eny person in eny mflnner so es to becomo subject ro the workars'
compensation laws ol Calilomia, entl egree thet if I shoultl become subjett lo tho workers' compensetion provisions of Section 3700 of Ihe fabor Cade, I shail torthwith
compry witn m iore. �� e
ApplicantSignaWre:��-��,� .( i� oate: � 3— Sa cJ� - C 6
WARNING: FNLURE TO SECURE WORNERS COMPENS�T1pN pOVEMpE IS UMAW FUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE MUNDRED
TINkI$AND OOLURE (5100,000), IN ADORION TO THE Cp$T OF COMPENSATION, DAMAGES AS PROVIDED FOfi IN SECiION 31O80F THE LABOR CODE.INTEREST, AND ATTORNEYS FEES.
LICENSED CONTfiACTORS OECLARATION:
I herehy aXirm thet I am
torce and eHect. Llc. a_
Contrecmrs Signature:
Chepter B(commencing wlih Section 7000) ol Division 3 of 1he Business entl Pratessions Code, and my license Is In lull
aass a L3 - C�. - P• 4' - C i 6
..+ Dete: t� �- 9. �i - O 6
CONSTRUCTON LENOING AGENCY:
❑ I hereby eflirtn thet theru is a constructian leqding agency fo� the pedormance of the work tor which t�is permil is issued. (Soc. 3097, Civll Code).
Lender's Neme: LonOafs Address:
SlgneWre: Date:
OWNER•BUILDER DECLARATIONS:
I hereby aMirtn ihat untler penalty of perjury Ihat I am EXEMVT FROM TTIE CONTRAC70RS LICENSE LAW for the following reeson (SeC. 7031.5, Buslness and Protesslons
Cotle: Any ciry or counry which requires e pertnit tb consWct, alter, Impmve, demollsh, or repair eny structura, priar to its Issuence, elso requires the epplicant lor such permi�
to file a signed stetement thet he or she is licensetl pursuenl to the pmvisions of the Conirectors License Lew (C�apter 9(commencing with Section 7000) of Division 3 ot �he
Business entl Professions Code) or that �e ar ahe Is eaempt Iherelrom entl t�e basis tor t�e allegeA ezemption. Any vialaHon ol Sectlon 7037.5 by eny epplicant for e Oertnit
sub�ects ihe applicant to a aWl penalry of not more than Me �untlred tldlers (5500)J:
❑ 1, as owner of the property, or my employeeg xi(h weges es thelr sole compensetion, WILL DO TME WORK, end the structure is not Intended or oflered tor sale (Sec.
7044, Business and Protasslons CaAe: The �ntractors LJcense Lew tloes not epply to en ownar ot properry who Dulltls or impmves thereon, and who tloes such work
himselt or herseli or through hls or her own Bmployees, provlded that such improvemenis ere not Intended or oHered for sale. It, hawever, the builtling ar improvement is
sold within one year of complation, ihe owner-builtler wiil have the burden of proving Ihet he or she did not build or improve for purpase ol sale.).
❑ !, as owner of !he propelty, am EXCLU&YELY CONTRACTNG WfTH LICENSED CONTRAGTOAS to construd the p�oject (Sec. 704a, 8uslness and Pmtessiw�s
Code: The contractors Llcense Law does npt eppty to an owner ot pmperty who Duiltls ar imprrnes thereon, and who contrecis for such proJect wlih a contrector(s)
license pursuant to the Contraciors License l.ews.).
❑ I em ezempt untler sec. Businass flnd Professions Gode tor Ihis reason:
Signature: Date:
Owner ID veritied by tlrivers license. ❑ Yes ❑ No Drivers License No.
Vedlication of Ownership by (type of daumem, i.e. . properry tax blll or deed):
Explres:
DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICATON:
❑ I hereby certity �hat no excevation Me (5) or rtrore leet in tlept� Into which a person is requlretl to tlescend, will be made in connectlon with wotk euthorized Dy ihis
pertnit, and thet no building structure, scattolAing, lalsework, or tlemolition or Gismantling Mereof, will be more than thirry-six (36) loet Mgh. (Chep. 3.2, Grp 2, An 2, Sec.
341, Title e, Celifomia Administre�ve CoOe).
❑ As owner-builder, I wlll not employ enyone to do work which would requlre e permit trom the Divislon ot Indusirial Sefery, as noted above, unless suc� persan hes e
permit to tlo such wark Irom Ihe dlvision.
Signature: _ _ Deto:
Divlslon of Industrial Safery Permit Number:
CERTFICATE OF COMPLIANCE AND AUTHORI2pT10N OF ENTRV: I certity untler penelty ot perjury �hat I have read this application end state that the intormation given is
correcL I egree to comply with all stete laws and ciry ortlinances releting to building consiruction, and authonze representatives ot Ihe Ciry of Costa Mesa to enier upon Ihe
ebove-tlescnbatl properry for inspedian purposes. I agree not to occupy or allow occupency of eny builCing authorizetl by ihis pertnit until final inspectian.
IgneWra Of Legal Owner(s) Date
,�.� ��.z.',,,.,,�r� n�� a�-on
And/OrAutho z dAppllcant Date
COOE I, INSVELTIONTYGE
1618 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Finel BIocWReWining Well
202 Ffnel Fectory F(re Place
203 Flnel Sign
20a Final Demolitim
2HBi8
Q� �
COOEt INSVECTIONTYPE
208 Finel Mechanical
20B Final PlumDing
270 Final Electdcel
212 Final Fire PrevenUon
220 Ftnal Plannfng Approval
222 Final Site
250 Finel Builtling/Occupency
Q�¢ INf1fIAL3
(714) 754-5273 • Fex (714) 754-4856
.i
CITY OF COSTA MESA , ,
BUILDING DIYISION
DEVELOPMENTSERVICES DEPARTMENT,
PERMIT
Jobnddress: 555 ANTON BL
Suite: 6
Vicinity: ,
Parcel Number: 41050110
npp�icant: LORI LOPEZ
Address: 2505 MIRA MAR
CA
LONG BEACH � �
Owner: , SAKIOKA FARMS
Address ' ' . -
Contractor: CAL PROTECTION
. Address:, 2505 MIRA MAR
FIRE SUPRESSION PERMIT
Zoning:
Phone: (562) 498-6444
Zip: 90815
Phone:
Zip: 94137
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/29/2000
Issued: 04/27/2000
ISSUED BY: � / , /
_ ' , Phone: (562) 498-6444 . � ' -
� LONG BEACH, CA � � �Zip: �` 90815 � ' �
� ,License: 327196
` SCOPE OF PERMIT
' INSTALL FIRE ALARM SYSTEM FOR BMC SOFTWARE. � • �
REF:B00-00258�. � , ,
Plan Check: $333.42
Permit: $512.95
Other: ' $0.00
Total: $846.37
a
' FEE SUMMARY
� — ;
— � �.
, - �
m
Calc Valuation: $se,i�o.so
Claimed Valuation: Sss,no.so
�
NOTICE: The work authorized by this permit shall comply with ali applicable handicap access requirements under Califomia slalutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire end become void if work is not�commenced within 780 days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for ihe work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetlone antl flnel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828 �
WORKERS'COMPENSAnONDECLAHAnON:
I hereby eNirm under penfllry of per�ury one oi t�e lollowing declaratians: �
❑ I have entl wlll maintain e cenificate ot consent to setl-Insure br workers' compensetion, es pmvitletl tor by section 3700 of the Lebor Code, for [he pertormance ol Ihe
work for which this pertnit is issued.
I have end vNl maint 'n w rke compe uon insu nce, r qu�re0 by secUon 3700 0l the labor Code, br Ihe pertortnance of ihe work for w�ich this pertnit is issued.
M workers' en atlo Ins rance cer /\l'e�nd� num �I I�O I G�
Camer.Y �M���� �C�U�--(� -: PoliCyNumber. �� � �
(This section neetl nat be mplefod il the permitls valuetl al one hundred Ilers ($100) or less.)
❑ I certity that In the peAor ce ol the work forv�y ch is� e ilt is issued, I shell not employ eny person in any manner so es to hecome suDject to Me workere'
compensatlon laws of Calito end egrea th MI si� 4 ete sub�ect to ihe workers' compensetion provislons oi Section 3700 of the Lebor Cotle, I shall lonhwith
comply with these pmvisions. (,� � 7�/OU
Applicant Signeture: Dete:
WARNING: FAILURE TO SECURE WORKERS' CQMPENSATION 01[�RAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER i0 CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAN� DOl1ARE ($100,000), IN ADDfiION TO TME COST OF COMPENSATION, DAlMGES AS PROVIDED FOR IN SEC710N 3]OB OF TME LABOR CODE. IMEHEST, AND ATTORNE`fS FEES.
LICENSED CONTRAC70RS DECLARATON:
I hereby attirm that I em
Yorca and eHecL Lic. a_
Coniractofs Signature:
ol Chapter 9(commencing with Section 7000) of Dlvlsion 3 of t�e Business entl Prof i s Code. entl my license is in full
�,esg„ c � o cP�
�,� oa�e: �-U._, �
CONSTRUC710N LENDING AGENCV:
❑ I hereby eflirm thet there is a consiructlon lending agency tor the Dedortnence oi t�e work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lentlefs Name: �endels Address:
Signature: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm Iha� under penelry ot perjury ihat I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW tor ihe tollowing reason (Sec. 7037.5, Business and Professlons
Coda: Any ciry or counry w�ich requires e permit to construcl, alter, improve, demolish, or repeir eny strucNre, prior to Its Issuence, also requires the epplicant Por such pertnit
to file a signed stetement ihat he or she Is licensed pursuant to the pmvislons of ihe Canirectors Llcense Lew (Chapter 9(commencing wlth Sectlon 7000) ot Dlvision 3 ot the
Businass and Profeuions Code) or thet ha or ahe is axempt therelrom end the basis tor tha elleged e:emptlon. Any violatlon oi SecOon 7037.5 by eny applicant for e pertnit
sub�ects the epplicent to e dvll panelry of not more ihan five hundred dollars ($500).):
❑ I, es ownar of the property, or my employeas with wages es Iheir sole compensatlon, WILL DO THE WORK, end Ihe structure is not intendetl or offered for sale (Sec.
7044, Business and Professlons Cotle: The Contrectors License Lew doos not epply to an owner of property who builtls or improvas thereon, entl who does such work
himself or hereelf or ihrough his or her own employees, provltletl thet such improvements ere not intended or oMered tor sele. If, however, the building or improvement is
sold within one yeer of completion, the owner-6uilder will have the burden of proving thet he or she dld not build or impmve tor purpose of sale.).
❑ I, es owner oi the properry, am EXGLUSIVELY CONTRACTNO WI7H LICENSED CONTRAC70R5 to construct Iha pro�ed (Sac. 7044, Business antl Professions
Code: The contracrors License Lew does not epDly to en owner of propetly w�o 6uilds or Improves thereon, and who contracts for such project with a contracror(s)
license pursuant to Ihe Conirectors License LawsJ.
❑ I em ezempt under sec.
Signature:
Owner ID verified by drivefs Ilcense. ❑ Ves ❑ No
eusiness end Professions Cade (or ihis reeson:
Venfication oi Ownership by (rype ot document, i.e. - properry tex bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION:
Drlvor'S License No.
Date:
Expires:
❑ I hereby certity ihet no excevetion tiva (5) or more feet in depih Inlo which a person Is requlretl Io Oescen4 will he matle in connection with work euthorized by ihis
pertnit, end Ihat no Duilding structure, scaHOlding, telsework, ar demolitlon or dismentllnp Ihereot, will be more Ihen thirty-six (36) feet high. (Chap. 3.2, Grp 2, Ari 2, Sec.
347, Ttle 8. Celifomie Adminlsiretive Code).
❑ As owner-bullder, I will not employ enyone to tlo work whlch would requlre a permit Irom the Dlvlsion of IntlusMal Safary, es notetl ebove, unless such person has a
permit to do such work Irom Iha diWsion.
Signatura: Date:
DiviSion ot Industnal Sefety Pertnl� Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalry of perjury ihat I have reatl ihis application and state ihat Ihe infortnation given is
correct. I agree 10 comply wlth all state laws and dty ordinences relating to huilding wnswction, and authonze representatives oi Ihe Ciry ol Costa Mesa to enter upon the
above-descnbed p a arry lor inspec' n os . gree not to occupy or allow occupancy oi any building authonzed by Ihis pertnil until linal inspaction.
SlgneW tL Owner . ¢@��I
L �
AnNOr Auf nzed App i Date
COpE �. INSiECTONTYPE Q�, �$
1616 Fixed System Flnel Fire Preventlon
1266
200
201
202
203
206
Pool Spa Finel
Finel Re-Roof
Final BIocWReteining Well
Final Fectory Flre Plece
Final Sign
Finel Demolition
CODEt INSFECTIONTYPE
208 Finel Mechanical
208 Final Plumbing
210 Final ElecMcel
212 Final Fire Preventlon
220 Finel Planning Approvel
222
250
Finel Site
Final Builtling/Occupancy
�� �
� - 3 . CY� t�
2a4&48 � _
' y,�: .��'.
i :�.::�: ;
�.
(714)754-5273 • Fax(714)754-4856
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
555 ANTON BL
6
6TH FLOOR
41050110
npp�icant: FULFORD, TERRY
Address: 8749 SHIRLEY AV
NORTHRIDGE; CA' -
� �
Owner. . SAKIOKA FARMS
, . ,
Address -
- / ` :
Contractor:
Address:
i ` \
CITY OF COSTA MESA
BUILDIN6 DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
ELECTRICAL PERMIT
O'BRYANT ELECTRIC
.8749SHIRLEYAV ,
�, �
r ,,; �
'NORTHRIDGE, CA, �
i, .
\ ��
Phone: (818)407-1986
Zip: 91324 ' �
NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: I SS U E D
Applied: 03/30/2000
Issued: 03/30/2000
ISSUED BY:
Phone:
Zip: 94137
i
+- .
../;,
- Phone: (818) 407-1986 � ,
Zip: 91324
License: 386619
. '
�
t ,% ' �, " �-� SCOPE OF PERMIT ' � � �
ELECTRICAL PERMIT FOR OFFICE T.I. FOR."BMC SOFTNARE" (6TH.FLOOR). INSTALL 243 LIGHT
FIXTURES, 242 RECEPTACLE OUTLETS, 90 SWITCHES, 10 NON-RES APPLIANCES, 73 '
COMMUNICATION DROPS, & 3 CIRCUITS FOR MODULARS. , � .
✓.,
REF: 800-00258 , .. • ,a ^,. _ -' _ - - _ , _ ,• !� � , . �
. � - _
� " , � - _ ._- _ . � � - � . .
FEE SUMMARY . '
. � ', Quantity �- - � , Quantity
ISSUE FEE • $23.50 . .... � Temp Dist System / Lighting $0.00 0 � �
Temp service test � $0.00 � � � � Busway /100 ft $0.00 0
Res. a/c package �$0.00 . �� Standing Section $0.00 0
New Res (1-2 units) �$0.00 0 ' Misc Electrical Equipment � $0.00 0
New Res (3+units) $0.00 0 ,. � Transformers up to 1 kva/kw $0.00 0 -
Pool / Spa $0.00 .' p`... - ................up to 10 kva/kw,: $0.00 0
Lighting Fixts �� -$1827g 243 , � .................up l0 50 kva/kw $0.00 0
Recept Outlets � , � - $182.06 � 242 - . .:.......:.......up l0 700 kva/kw $0:00 0
Switches � $71.10 90 '� . . ..................overi00kva/kw $0.00 0 .
Non Res Appl $47.50 10 �' Low.Voltage Equipment $0.00 0
Res Appl . $0.00 0 Low Volt Wiring System / Ckt $0.00 0
Service [0 200a � . � $0.00 0 � Misc Conduit � $0.00 0
Service to 1000a �$0.00 0' �� Misa Conductor �$54.60' 3
Service over 1000a $0.00 0 , Circus ( gen or ride) $0.00 0 .
Motors to 1 hp $0.00 � 0 �� Circus (mech ride or lights) ' $0.00 0
Motors to 10hp � $0.00 0 " Chrislmas Tree Stand . $0.00 0
Motors to 50hp $0.00 0 , Fireworks Stand $0.00 0 '
Molors to 100hp $0.00 0 �� Other Electrical Fee $0.00
Motors over 100hp $0.00 0
� NOTICE: The work authorized by this permit shall comply vnth all applicable handicap access requirements under Califomia statutes and related
'. regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is noDcommenced wi�hin 7B0 days, or if work is suspended or abandoned
for a period of 180 days. -
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work mus� comply wi�h all applicable codes, and all
requlred Inspeetlona and flnal approval must be obtained. Failure to obtain inspactions and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATION DECLARATION:
I hereby eHlrm under penal�y of perjury one of lhe tollowing tleClere�ions:
❑ I have end will maintain e certificate of consent to seli-Insure tor workers' compensation, as provitletl for by section 3700 oi the LeDor Cotle, for tha performance of Ihe
/�'ork lar which ihis permit is issued.
fH� I have antl will malntain workere' compensation insurance, es required by section 3700 of Ihe Lebor Code, for �he pertortnance ot Ihe work for which this permit Is issuetl.
My workere' comp9 nsatlon In nc�ca rner entl policy number er�: . �
Cerrier. �.v�7��� Ac�� c' i.v.Sc..c.ai,.c � Policy Number. �w� Z 7�l01/,�3c o
(This secfion need not be wmpleted il the permif Is valuetl et one hunOred dW/ers ($100) or less.)
❑ I certlly Iha� in the peAortnanCe of ihe w rk tof Whith Ihis permit is i55ued, I 5hall no� employ eny per5on in eny menner w es lo become 5ubjecl Io the workers'
compensatlon laws oi Califomla, and a e that II I shoultl become subject to the workers' compensation provisions of Sectlon 3700 ot t�e Labor Code, I shall fonhwi�h
comply wl�h Ihese provisi �i J/ / ,
ApplicaniSlgneture: � �/ Date: .3c4o^ov
WARNING:FAILURETOSECUREWORKERS' ENSATIONOOVERAOEISUNLAWFULANDSHnLLSUBJEGTANEMPLOYERTOCRIMINALPENALTIESANDqVILFINESUPTOIXJEMUNDflED
THOUSAND DOLIARE (5/00,000), IN ADOffIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE IABOR CO�E, IMEREST. AND ATTORNEV'S FEES.
LICENSEO CON7RACTORS DECLARATION:
I here6y aNirm lhet I am Ilcensatl u er provislons of Chapter 9(commencing with Section 7000) ol Division 3 ot the Buslness antl Pmtessions Code, and my license is In full
force and eXea. Uc. a ��i �% Class a �—��'
ConUactar's Signeture: '�a� Dete: � :.3m ^��
L�
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHirm thet thare is a constmction lending agency for Ihe peAormance of Ihe work for which this permit Is issued. (Sec. 3097, Civil Cotle).
Lenders Neme: Lenaer's Atltlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aflirtn Ihat under penalry o1 perjury tha� I am EXEMPT FROM TF1E CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Busine55 and Professions
Code: Any ciry or counry which requires e pertnit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, elso requires ihe applicant for such permit
to tile e signed stetement t�at he or sha Is licensetl pursuem to the provisians ol Ihe Coniractors License Law (Chepter 9(commencing wi[h Section 7000) ot DlNsion 3 ot the
Bu5ine55 and Prote991on5 Code) or Iha� he or 5h8 15 Bxempt Iherefrom end �he hasis for �he elleged exemptlon. Any vlole�lon of Section 7031.5 by eny applicant for e permii
sub�ects Iha apPlicant to e ciNl penalry ot not more than Ilve huntlretl Collars ($500)J:
❑ I, es owner oi t�e property, or my employees with wages as thair sole compensetion, WILL DO TME WORK, entl lhe structure Is nat intentletl or oHeretl for sale (Sec.
7044, Busine99 end Profassians Code: ThB Conireciors LlcenSe Lew tloes no� epply to en owner of property wh0 Duiltls or improves thefeon, end who does SUCh work
himself or herself or through his or her own employeas, provided Ihat such improvements are not intendetl or oHered for sala. If, however, the builtling or Improvement is
sold wit�in one yeer oi complation, Ihe owner�builder will heve the burden ot proving ihat he or she dld not 6uild or improve for puryase ot sele.).
❑ I, as owner ol the properry, am EXCLUSIVELY CONTRACTING WITX LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business �anG Professlons
Coae: Tlie contrectors License Law does not apply to en owner of property who builds or improves ihereon, end who contrecis for such project with a coniractor(s)
Ilcense pursuant to the Contrectors License LewsJ.
❑ I am ezempt untler sec. Business end Prolessions Code for this reason:
Signature: Date:
Owner ID venfied by drivefs license. ❑ Ves ❑ No Drivets License No. Expires:
Veritica�ion of Ownership by (type of document, i.e. - property tas bill or deed):
DIVISION OF INDUSTRIAL SAFE7V PERMR CERTIFICATON:
❑ I hereby certity that no ezcavetion fNe (5) or more feet In tlepth into whic� a person is requiretl to descend, will �e matle in connection wiih work euihorizetl Dy this
permit, antl t�et no buil0ing SiNCture, ScaHolding, felseWork, or tlemolition or tli5mantling Ihereof, will be more Ihan ihirty-SiX (36) feet high. (Chap. 32. Gry 2, Art 2, SeC.
341, Tltla 8, Calilomia Adminisira[ive Coda).
❑ As owner-huiltler, 1 will not employ anyone to do wark which would require e pertnit irom ihe Division oi Intlustrial Setety, es notetl aDove, unless such pereon has a
permit to tlo such work from Ihe division.
Slgnewre: Date:
Division of Intlustdal Satery Pertnit Number:
CEFi71FICATE OF COMPLIANCE AND AUTHORVATION OF EMAV: I certity under penalry of perjury that I have read Ihis application and sWte ihat the information given is
correct. I agree to comply vnih all state laws and ciry ordinences relating to huildinq construdion, antl emhonze representatives at ihe CRy of Casta Mesa to emer upon Ihe
above-descnbed property for Inspection purposes. I egree not to occupy or allow occupancy of eny 6ullding authonzetl �y this permit until tinal inspection.
CQOE t. INSPECTIONTYPE
1816 Fined System Final Fire Prevention
1266 Pool Spe Final
200 Final RaRoot
201 Final BIocWRetalning Wall
202 Finel Fectory Fira Place
203 Finel Sign
204 Final Demalition
2usae
jl�jE INTRIALS
LODEt INSVECTIONTYPE
206 Finel Mechanical
20B Final Plumbing
210 Finel EleCtncel
212 Finel Fire Prevemion
220 Finel Planning Approval
222 Final Site
250 Finel Building/Occupanty
.-Cd
Date
DRTE IIIIIDAL9
� �
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CITY OF COSTA MESA -
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
(�ia)�sa-s2�s • Fax(�ia)�sa-aess
JobAddress: 555 ANTON BL
Suite No 6
Vicinity:
Parcel Nunmber: 41050170
App�icant: DON STEVENS
Address: 1940 GARDENA
GLENDALE,CA � �
� �
Owner: �SAKIOKA FARMS � -
Address � - �
PLUMBING PERMIT
Phone: (818) 500-1940, �
Zip: .91204 - .
Phone:
Zip: 94737
CoNradoc MUIR-CHASE PLUMBING -
Address: 1940 GARDENA � � " / - �
- , � � � Phone:- (818) 500-1940
GLENDALE, CA _ Zip: 91204
" ' . License: 539835
Amh I Eng : .
' Address:
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 03/29/2000
Issued: 03/29/2000
Phone:
Zip:
, --
� - ' � _. License: ' . - . , � � . .
SCOPE OF PERMIT
2 FLOOR SINKS, 1 KITCHEN SINK, 1 WATER HTR, 1 COFFE/ICE MAKER CONNECTION AND 1
BACKFLOW PREVENTOR FOR BMC SOFTWARE. -
REF:B00-00258 �
ISSUE FEE
Backflow Irngation � ,
Backflow Preventer
BathWb
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain �
Expansion Tank
AMT
$23.50
$0.00.
$9.80
so.00
$0.00
$19.60
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
QTY
1
0
0
0
2
0
0
0
0
0
0
0
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap � $0.00
Pressure Regulator $0.00
Process Piping (per 10 R) $0.00
Receptors $0.00
� Septic Tank . �. $0.00
� . Sewer Cap for Demo $0.00
Sewer Connect $0.00
- Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Qn , . ,
0
0
0
0
0
0 .
0
0
0
0
0
a
0
SumpPump
Swimming Pool
Trap Primer ,
Unnal
Vacuum BrkrBkFlow(1-0)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toileq
Water Heater / vent
Water Piping (Insl or Rep.)
Water Re-pipe
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
aTY
0
0
0
0
0
0
0
0
0
0
1
0
0
NOTICE: The work euthorized by ihis permit shall comply with all applicable handicap access requirements under Califomia 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 1B0 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must compty with all epplicable codes, and all
required Inapeetlone and Iinal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penalry of perjury one ot the lollowing declarations:
❑ 1 hava antl will maintein a cenificate of consent to self-Insure for workers' compensation, es provided for by section 3700 of the Labor Cotle, for the pertortnance of the
work for which ihis permit is issued.
[� I have antl will maintain workers' compensation insurance, es requiretl by sectlon 3700 0l the Lalwr Code, tor ihe peAortnance of Ih work fq� which Ihis permlt is issuetl.
My workers' co ensatbn insurance carner and policy number ere: . (p ,j � 0 —fi 0
Carner. �i9T[r ��f'�A1`{ �i . PollcyNumber. �
(This section need not be camp/eted I/ Me permit is velued at one hundred dollero (5100) or /ess.)
❑ I certify Ihat in Ihe pertortnence of Ihe work fOr which IhiS pertnii i5 issued, I 5hall not employ any person in eny manner 90 es to betome subject to the workers'
compensation laws of Calitomia, antl egree thet If I should become subject to the workers' compensation provisions of Section 3700 of the labor Cotle, I shell forthwith
compty with Ihese provi 2 �7
Appliwnt Signature: � � Date: ✓"" Z"/'� i�
WARNING: FAILURE TO SECURE WORKERS' dJMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOl1ARE (5100,000). W ADDfTION TO TME COST OF CAMPENSATION, OAMAGES AS PROVIOED FOR IN SEGTION 37080F THE LABOR CODE, INTEREST, AND FTTORNEV'S FEES.
LICENSED CONTRACTORS OECLARA710N:
I hereby attirtn thal I am licenud under proNsions of C�apter 9(commencing with Section 7000) oi Divislon 3 of the Business nd Protesslons Code, and my license is in full
force and eflect. Lic. a Class x�—��O
ComractoYs `ign,�ref � �,. ���—� Date: � '—�i '��Z%
CONSTRUCTON LENOING AGENLY:
❑ I hereby eflirm lhat there is e conSWction lendinq eqency lor Ihe peRormance of Ne work tor which �his permit is issued. (Sec. 3097, Civil Code).
lendefs Name: Lendefs Address:
Signeture:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirm that untler penalty ot perjury that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for Ne following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a permit to wnstruct, elter, improve, demolish, or repeir eny sWctura, prior Io its issuence, elso requires ihe appliwnt tor such permit
to file a signed statemeN that he or she is licensed pursuant to the provisions of the Contrectors License Lew (C�epter 9(wmmencing with Sectlon 7000) of DiNsion 3 ot the
Business and Professions Code) or t�at ha or she is exempt therefrom anA t�e basis for Ihe alle9ed eaemptlon. My vlWetion of Sectbn 7037.5 by any epplicant tor a pertnit
subjects the applicant to e civil penalty of not more than five huntlred tlollere (5500).):
❑ 1, as owner ot the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and the structura Is not intended or oMeretl for sale (Sec.
7046, Business and Professions Cotle: TTe Contrectors Llcense Law tloes noi apply to en owner of property w�o 6uilQs or improves t�ereon, antl who tloes such work
himselt or hersell or through his or her own employees, provided that such Improvements are nol intended or oflered for sale. II, however, Ihe building or improvement is
sold within ona year ot campletlon, ihe owner-builder will have ihe burtlen of Droving I�et he or she tlid not build or Improve for purposa of sale.).
❑ I, as owner of lhe property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conStruCt thB OrO�ect (Sec. 7044, Bu5in855 and Profession5
Cotle: The contractors Licensa Law tloes not eppty to an owner of property who builds or improves thereon, and who comrects tor such project with a contractoqs)
license pursuant to the Contractore License LawsJ.
�❑ I am exempt untler sec. Business end Professions Cotle lor ihis reason:
Signa[ure: Date:
Owner ID venfied by drivef5 licen5e. ❑ Ves ❑ No Dnvers License No. Expire9:
Venflcation ot Ownership by (type of documenL i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ 1 hereby cerlity thet no excavation tive (5) or more feet In depth Into whic� a person is required to descend, will be matle in connection with work authodzetl by this
pertnit, and that no buildirig siructure, scattolding, talsework, or demoliUon or dismantling thereot, wlll be more t�an thirty-six (36) leet high. (Chap. 32, Grp 2, An 2, Sec.
341, Tltle 8, Calitomia Atlministretive Code).
❑ As ownar�builder, I will not employ anyone to do work which would require a pertnit from ihe Division of Indusirial Sefery, as notetl above, unless such person has a
permit to do such work trom the tlivision.
Signeture: Deta:
Division of IndusMal Safery Permit Numbar:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certih/ untler penalty of perjury thel I have reed this epplication and state that the intormelion given is
correcl. I agree to comply with ell state lews end ciry ordinances relating to building wnswction, and authorize representatives ol the Ciry of Casia Mesa to enler upon the
above-descnbetl D�aPerry for inspection purposes. I egree not to occupy or ellow acupancy ot eny bullding euthorized by this pertnit until tinal inspection.
� W re Ot Legel Owner(s) �^ Z —� atOe
9
AnNOr Authorized Applicant Date
CODE t. INSPECTIONTYPE QSjE 7y�$
1678 Fined System Final Fire Prevention
1266
200
201
Pool Spa Final
Final Re-Roof
Finel BIocWRetelning Well
202 Finel Factory Fire Place
203 Final Sign
204 Final Demolition
244fi-46
COOE� INSPECTIONTYVE
208 Finel Mechenlcel
200 Finel Plumbing
210 Finel ElectAcel
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Finel Building�Occupency
QLg 1[�EL$
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- CITY OF COSTA MESA ..__
BlIILD/NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
(714) 754-5273 • Fa�c (714) 754-4856
JobAddress: 555 ANTON BL
Suite: 6
Vicinity: 6TH FLOOR
Parcel Number: 41050110
App�icant: HAGHIGHI, DAVID
Address: 2505 MIRA MAR
LONG BEACH, CA
Owner. SAKIOKA FARMS
Address
Contractor:
Address:
CAL PROTECTION
2505 MIRA MAR
FIRE SUPRESSION PERMIT
Zoning:
Phone: (562) 498-6444
Zip: 90815
Phone:
Zip: 94137
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04IO6I2000
ISSued: 04I27I2000
ISSUED BY: �/ //
— �—
Phone� (562)498-6444
� LONG BEACH, CA _ : � �2ip: , 90815 ;
� , _-License: 327196
, SCOPE OF PERMIT
" FIRE SPRINKLERPERMIT FOR T.I. FOR "BMC SOFTWARE" (6TH FLOOR). INSTALL OR RELOCATE
45 FIRE SPRINKLER HEADS: - . ' � �
REF: B00-00258 � -
FEESUMMARY
Plan Check: $254.31
Permit: ' $391.25
Other: " $0.00
Total: $645.56
Calc Valuation: 52a,ess.00
Claimed Valuation: 52a,s93.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not�commenced within 7B0 days, or if work is suspended or abandoned
for a period o� 180 days.
INSPECTIONS: In order tor �he work euthorized under this permit to be consideretl legal, such work must comply with all epplicable codes, and all
required Inspectlone and final approvel must be obtained. Failure to obtain inspec�ions and final approvel will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628 ,
WORKERS' COMVENSATION DECLARA710N:
I hereby aHirm untler penelty ot per�ury one a<<�B tollowing deClaretlons:
❑ I have end wlll melntain e certllicate d consent ro setldnsure tor workere' compensatlan, as pmvitletl tor by sectlon 3700 0l ihe Lebor Code, for Ihe partormence of iha
work lor wNch f�i9 pefmit is Issued.
�I have end wlll maintei xro ers' cam nsetion insurence, required by section 3700 ot the Lehor Cotle, for Ne pertortnarice of the work for wNM this pertnit is Issued.
M worker m ensat n urance erantl II fw rare: ��� 1�{
Cartier:Y v �� n.—��QNa�I� PoliryNumDer. ` \
(7hls section need no be omp/eted i/ Me peimit is velued al one huntlred (5/00) or Iess.J
❑ I certify Ihet in Ihe p o ence ol the work for whlch Ih' rtnit 1�, I shall not employ any person in any menner so es lo become subject to the workers'
rnmpensatlon lews oi lifo ia, antl d8ree Ih eco sublect to ihe workers' compensa�ion provlslons of Sectlan 3700 of th Labor Code, I shall torthwit�
comply wlth ihesa provisi � L�12.�� �
Applicent Siqneture: Date: �
WARNINO: F/JLURE TO SECUPE wORKE PENSATI $ UNIAWFUL PNO SHALL SU81ECf AN EMPLOYER TO CRIMINAL PENKTIES M10 CML FlNES UP TO QVE HUN�RED
TMOUSAND OOLLARE (S10D,000), IN ADDRION TO THE COST OF COMPENSqTIpN, DAMAGES AS PROVIDED FOR IN SECfIIXJ 3)OB OF TME LABOR CODE, IPREREST, AND ATTOHNEY'S FEES.
UCENSED CONTHACT S DE_�
I hereby aNirtn t�el I am lice under proNsl�
brce end ettect. Lic. q
Conirectora Slgneiure:
with Sectlon 7000) ol Division 3 of Ne Business andC��jessions Code, and my license Is in full
� Class a � <-��
oate: 2'3- Oo
CONSTRUCTION �ENDINa AGENCV:
❑ I here6y effirm thel there is a cronstructlon lentlinq agency lor Iha peAormence of the work for w�lch thls Dermi� is issued. (Sec. 3097, CINI Catle).
Lentlefs Nama: LenAels AtlCress:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby atfirtn ��e� untler penalty ol perfury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the tollOwing reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e pBrmlt m construct, elter, improve, demolish, or repeir any sWcture, pdor lo Its Issuence, fllso reqWres the eppliGant lor such permit
to Hle e signetl stetement Ihet he or she Is liCensetl pursuenl to the pmvisions of Ihe Contrectors LJcense Lew (Chapter 9(commencing wlth Sectlon 7000) of Divlsion 3 of Ihe
Businass entl Professions Cotle) or Ihat he or she is eaempt therefrom entl the basis tor Ne elleged ezemption. Any Ndation oi Section 7031.5 by eny epplicant for e Dertnit
suh�eds the appllcant to a civll penelry oi nol more than live hundretl ddlers ($500).):
❑ I, as owner ot the D�W�rtY• a my emp�oyees wilh wflges fls their sWe canpensaUon, WILL DO THE WOpK, eiM the sVucture is not inlenEetl or otferetl tor sale (Sec.
7044, Businass end Professions Code: The Contrenors lJcense Law does not appN to an owner of property who builds or improves ihereon, entl who does such work
himself or herself or ihrough his or har owA employees, proNdad thet such Improvements are not Imendetl or otteretl for sele. It, however, ihe builtling or Improvement is
soltl within ana year ot completlon, ihe owner-�uiltler will heve the burden of proving that �e or she did not build or improve far purpose of sele.J.
❑ I, as owner ol the property, em E%CLUSIVELV CONTRAC7ING WI7H LICENSED CONTRAC70RS to mnstruct Ihe pro�ect (Sec. 7044, eusiness and Pwfessions
Cotle: 7he contractors License Lew tloes not apply to en owner ot properry who builds or impmves Ihereon, anA w�o cantwcts tor wch project with a coNractor(s)
license pursuant to Iha Cantrectors LJcense Lews.). ,
❑ 1 am exempl under sec. Buslness entl Professions Code tor this raeson:
Slgnature: Date:
Owner ID veritied by tldVer's Iicenso. ❑ Ve9 ❑ No - Ddvefs License No. Expires:
Vedfication ol Ownership by (type oi�tlocument, i.e. - property tax blll or deetl):
DIVISION OF INDUSTRIAL SAFETY PERM�T CERTFICA710N:
❑ I herehy cetlity that no excavatlon tive (5) or more feel In depih inro whic� e person is requlretl to descend, will De matle in wnnedion with work authodzee by Ihis
pertnit, and Ihet no builtling struqure, gcattolding, teLsework, or demollilon or tlismantling Ihereot, will be more than tNrry-six (36) feel �Igh. (Chap. 3.2. Grp 2, Ar12, Sec.
341, Title 8, Celilomia Atlminisiretive Ca1e).
❑ As owner-hulltlor, I will not employ enyPne to Oo work which would require a pormit Irom the Dlvision of Indusirial Sefety, as noted above. unloss such person has a
permit to Go such work from Ihe divislon.
Signeture: Date:
Divlsion of Intlustnal Safery Pertnit Number:
CERTIFlCA7E OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I cartify under penalry of per�ury ihat I have read this epplication antl steta that the informaiion given is
correct I agree to comply with all stete lews entl city orAinances relating to bullding conswction, entl authorize representatives ol the City ot Cwsta Mesa lo enter upon the
ebove-descnbed �rapeny lor inspection puryoses. I a9ree not to occupy or ellow occupancy ot any builtling emhorized by Ihis pertnit until finel Inspectlon.
CODE �. INSPECTIONTYVE
1816 Fi:ed System Final Fire Preventlon
1266 Paol Spa Finel
200 Final RaRool
201 Finel BIocWRetelning Well
202 Finel Fectory Fire Placa
203 Final Sipn
204 Final DemoliUon
2a4&46
Qejf, �$ �d INSVECTONTYVE
� � � � �7 _(,[3� 206 Final Mechenicel
208 Final Plumbing
210 Final Electncal
212 Final Fira PrevenUon
220
222
250
Final Planning Approval
Finel Slte
Final Building/Occupan�y
z-1 7�a� a�
Data
pAIE 1t�ALS
lo -lo-vr� �
�
"` CITY OF COSTA MESA _.
BUILDING DIV/SION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
pia� �sa-s2�s • Fax pia� �ea-aass
Job Address: 555 ANTON BL
Suite No 6
Vicinity: 6TH FLOOR
Parcel Number: 41050170
Applicant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE,CA' .
owner: SAKIOKA FARMS
Address: ' � - .
MECHANICAL PERMIT
Phone: (818)244-6571
Zip: 97201 �
Phone:
Zip: 94137
Contractoc AIR CONDITIONING CO., INC `.
�
� Address: - 6265 SAN FERNANDO RD ' .
� . : - � Phone: � (818) 244-6571 '
GLENDALE,CA ' � . - ,Zip: 91201 _
,. ,
. � License:- 720696 ' � �
Arch / Eng :
Address:
Phone:
Zip:
Lioense:
NUMBER
31
T7 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
SCOPE OF PERMIT
MECHANICAL PERMIT FOR OFFICE T.I. FOR "BMC SOFTWARE" (6TH FLOOR). INSTALL 1
REFRIGERATION SYSTEM, 2 VAV BOXES, 6 SMOKE DAMPERS, 1 COMPRESSOR�UP T0�15 HP, &'
REPAIRlALT 1 HEAT/COOL SYSTEM. ��- ,
r
REF:B00-00258 •
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU -
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k 8TU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace �
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Dud
Appliance
Fire Dampere
Smoke Dampers
Inst or Relocate Appl Vent
$23.50
so.00
$0.00
$13.70
5o.ao
$14.80
$0.00
$0.00
$0.00
$0.00
$21.30
$0.00
$0.00
$0.00
$43.50
50.00
Quantity
0
0
1
0
1
0
0
0
0
2
0
0-.
0 .
6
0
FEE SUMMARY
Repair I Alt Absorbtion Unit
Repair I Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial I n cinerator
Domestic Incineretor � �
Comoressors / Absomtion Systems
Up to 3 hp I 100 k BTU
3To15hp/500kBTU
15 To 30 hp I 1,000 k BTU
30 To 50 hp I 1,750 k BTU .
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
-3To15hp� �
15to30hp
Status: ISSUED
Applied: 03/29I2000
Issued: 03/29/2000
Quantiry
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$27.15 7
so.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 penod of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlona and finel epproval must be obtained. Feilure to obtain inspections and final approval will result in the expiration of lhis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnONDECLARAnON:
I hereby altirtn under penalry of per�ury ana ol the tWlowing dedaretions:
❑ I heve antl will melntain a cenificate at consent to selFlnsure tor workers' compensetlon, es pmvided for by section 3700 oi the Lebor Code, for tha pertortnence ot the
work tor whiCh lhis p8rmil is issued. '
I have and wlll maintein workere' compensaUon insurence, az required by section 3700 of ihe Le6or Cotle, for the peAoimance oi Iha work for which this permit is issued.
--A/v �orkera' mm�rtsnlirn Insuranrn rartiar xnd nNirv �umbef are'
P IcyNumbec p2/%���
one hunaredOollers ($100) orlessJ
❑ I certify Ihet In Ihe performence of Ihe work for which this pertnit is iuuetl, 1 shall not employ eny persan in eny menner so es lo becoma subject to the warkers'
compensation lews alitomia, entl egree Ihet if I shoulA becrome sub�ect to the workers' compensetlon provisions of Sactian 3700 of the Lebor CoCe, I shall lonhwith
comply with thes rovi ons. � y
Applicent Slgna� � �`� w Det� .J — J� d—"<' ✓
�ARNIN�:FAIWRE T09�URE WORKEHS' COMPENSATKKJ CUV I UMAWRIL AND SHALL SUBJECT AN EMPLO�TO CRIMINAL PENAlT1E5 AND GVIL FlNES UP TOONE HUNDREO
TFKKISAND �OLIARE �5100,000). IN ADORION TO TME COSf OF COY ON, OAMAGES AS PROVIDED FOR IN SECf10N 3]OB OF THE IABOR CODE, INiEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Iha
lorce ena erceciL
.Coni[ectore�6ipne
CONSTRUCTION
under provlsions ot Chapter 9(commencinq wit� Sec�ion 7000) of Divislon 3
AGENCV:
antl Professlons Cotle, end my license is In lull
❑ I hereby eflirm that Ihere Is e constructlon lending egency tor ihe pedormence oi t�e work tor which this permit Is Issuetl. (Sec. 3087, CIWI CoOe).
Lentlefs Nama: Lender's Address:
Sipnaturo:
OWNER-BUILDER DECLARATIONS:
Dete:
I hereby eMirtn that under penalry oi per�ury thal I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Business and Professions
Code: Any clry or county whlch requires a permit to consWct, elter, Imprme, demWis�, or repair eny sWCWre, pdor to its Issuance, elso requlres the applicant tor such pertnit
to flle e signed statement that he or she Is Ilcensetl pursuent to the pmNsions of the Contractore IJcense Lew (Chapter 9(commencing wlth Secuon 7000) ot Division 3 of t�e
Business anA Proteuions Cotle) or Ihat he or s�e is exempt t�erefrom and the basis br the ellegad exemption. Any violation ot Section 7031.5 by any epplicant tor e permit
sublects the epplicent to e dvil penalry ot not more than Ma hunAretl tlWlars (5500).):
❑ I, es owner of the properry. or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the structure Is not iniendetl or oRered tor sflle (Sec.
7044, Busineu antl Professions Cotle: 71ie Conirectors license Law does not epply to an owner of properry who Duiltls or improvas t�ereon. and who does such work
himseN ar herself or through his or her own employees, provitled that such improvements are not Intended or oXered br sale. II, however. Ihe building or Improvement Is
soltl within one year of completion, the owner-builder will have ihe burden ot proWng Ihat he or she did not huild or improve for Ourpose of sale.).
❑ I, es awner oi the property, em EXCLUSIVELY CONTFiACTING WITH UCENSED CONTRACTORS to constmct the pmjact (Sec. 7044, Business and Protessions
Code: The contrectors License Law does not epply to en owner ot properry who hulltls or impmves ihereon, and who comracts for such project with a contractoqs)
license pursuant to the Contrectors License LewsJ.
❑ I am exempt untler sec. Business end Professions Code lor this reason:
Signature: Date:
Owner ID veritietl by AriverS license. ❑ Ye5 ❑ No DriverS LicenSe No.
Varificetion ot Ownership by (type of document, i.e. - properry tan bill or deetl):
OIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION:
Expires:
❑ I hereby certify that no ezwvatlon INe (5) or more teet In depih INo which a person is requlred ro descend, will be meCe In connecllon wit� work euNorized by Ihls
permit, flntl Ihat no building structure, scaMdding, lalsework, or demolition or dismentlinp thereol, will Ue more ihan Ihirry-slx (38) leet hig�. (Chap. 3.2, Grp 2, Ar12, Sec.
341, Title B, Califomla Atlministretive Cade).
❑ As owner•bullder, I will not employ anyone lo do work which woula require e pertnil from Ihe Divislon of Intlustnel Safery, es noted ebove, unless such person has e
permit to do such wark from Ihe tlivisian.
Signeture: Dele:
DiWsian of Industnal Safery Pertnil Number:
ICERTIFlCATE OF COMPLI/WCE AND AllTTIORQATON OF ENiAY: I ceM1ify unCer penelry o� perjury Ihat I have reatl this epplication and state that iha inlortnation given is I
corcecL I agree to comply with all state laws and dy orCinances releting to builtling con5iructlon, anG 9uthonze representetives ot Ihe Clly of Costa Mesa to enier upon t�e
above-described properry tor inspection purposes. I eprae nat ro occupy or allow occupanq ol any bulltling authonzed Dy Ihis pertnit untll ilnal Inspection.
COUE A. INSPECTIONTYPE
1618 Fixod System Finel Fire Preventlon
1288 Pool Spa Final
200 Final Re-Roof
201 FIneI BIocWRetalning Well
202 Flnal Fectory Fire Place
203 Flnel Slgn
204 Final Demolition
zae-oe
Q�¢ �$ �Qpj� INSPECTIONTYPE
208 Final MechaniCal
20B Final Plumbinq
210 Final Electdcel
212 Final Fire Preventlon
220 Final Plenning Approvel
222 Flnel Site
250 Final Buliding/Occupanry
� I�r .111�
aooxEssovem�ara: S55 ANTON BL
avxexsrw�eiciu�avx:SAKIOKA FARMS
"°o"Eu:pO BOX 2097
TERMINAL ANNEX
wr�. �uuxo �ooness:
uNT: 6 T H
wcxntcroxu+aN�x:INTERIOR ARCH 2136232164 ��•"� 9378
ARCN.OXEN6.'9AWPE53: SSO S HOPE ST �NT� LLOO
L.A. CA 90071
��T�a�CONTINENTAL PLUMBING INC (714)360-8300
cairn�oroxs�uuxai1165 THURSTON LANE
monessMIRA LOMA CA uew.: 399073
917 5 2 uNr:
LICEN9ED CONTFACTON9 DEC�ANATION: 1 MMy eRrm wdx p�rWy d per�ury ttW I un IkermA wMr prwi�bm of Cheqx D
(oommeniaq wMh SCUon ]000) a�a+ � d iM BiWnm uM PMn�bu Cod�. and my Ikara� b In hll law uM Nfw.
�c c.No.O 7563 uacuss:C 36 147 EXP: 09/96
.: cunvmor
OWJ1 P BW�DEN DECUPITION: I M�eby alfirm uMx pauly d ry ihn 1 em mmq hom �M Comreaon ama lew tw Ms
1�owiTO �wOn (5Mbn )W1S &piWt end Adaeeiw COM: �M' a aouniY xfiirh'Nu'up e M�d to can�Vud. Nx. imYwa.
�mdeh. or rape'r eny eWCWee, prior to m eauenee, ebo,apuirea iM epqirent lor weh psrtnq lo fila e spnd Mlamenl ihel M or �M
n lieenead W nueM lo IM povieion� d Ma CONretloea Lirome law �Chaqm 9(wmmaMiiq �rilh Sadion ]000) d Orv'vion � d �M
Buaiian ad Prafevian CaAel a ihet M a eM w ezemq thaaM1vm and iM betle ror iM eAeWd memqbn. AnY vbluion M Ssaion
]031.5 by any eppliranl far a pmmil wbpry tM eppl'raN to e tivJ peneYy d nal mas ihen fxe huikred tldlen �5500�.
❑ i.mo�„a.dmewownv«mr�da�+wnw.�+mm.:.aa�,w�+.w�oeou,ewax.m,eu,e.wn�An�aw�,e.e
or Mered lor veb (Seciian ]OM. Buvrou vM Prdesaiona Code: The Comraeon l'vanse law doea rot npply�o en ownerd D�M
wM10 budM a inpmves Iheieon. eM xM dme cutli xak h'vnmtl a MnM a Ihraqh he a her oxn empbyaee, panded thm wch
impowmema era nd'uneMed a dlaed la aeb. tl. howma. the duWinp a inpawnatl o mk wnNn ona Y� d mmpbion. the
o.��wue« wn ne.a m. n�,e.� a o���u na « mb eu m wue «�aw. �o. m. wmd. a w.l.
� I, u aw�w d iM yopeny. am udmwy mn�r ]iq wdh I'visod can4aclm b mrcV W Ihe poptl (Setlion IDIt. Buairma ard
Prolesaions COEe: The Conlredws licenae lew doee m� epply w en owwr d pape�ly wlw buiWe ar impoves IMreon end wla
comrecb M midi qopaa wiN e aNratlor(a) fcemM puauam to tM Conumore lirsme lew). .
� I em eRemq uMer $ection: B. 8 P.C., fa Nia raeaon: �
oma: o�.:
i ao ne.enr oenM uw � a� a�.s,a a.�e uwemane m. �ui�emaw a ceuo�:e wmn.�a smar coee s«a�wu rws. nva. d,a
255�a. vd Mei I u eny lulun WiN�^0 � wJl / wY rwi (acb me) need to comdY wlh eaid qde mEs.v enE iM rcVu'vemmn br
apeimnlamvwciionwmodifi�ionhamtMA� ui-6—ixiiy anapement0istrie.ReskaniidoonqrmioneppireiumeneumplmmNeee
yrwisione.
ow<: ncd�n:
WOHI(EN'S COMPENSATION DK4N�TON: I Meby elfum uMx penMy d prryry ane d Ns �dbvrirp Eadeiuuiuu:
� I heve vM xi1 memien a catifcas d canseN io soMimure br wakers' mmpmubn. m porided la Ey Saeion �]00 d �M lebor
Code. la �M pMamarce d Ne r.ark In xtich iM penro u iwwE.
.A in.,..�aw�.:�,.�,�o.���w�.�.m�.a�.esrs«,�,a�oonm.i.e«we..a,mso.dam.�.wins
wak la v.TiM IM1ie pom+n la foued. MY ��' �De�� �+rencs unier W pdiry number us:
c�«: CNA EXPIRES
aoiryN�mc.,: ���aqn� 07/01/96
(This mction nee0 iaf 6e cvmpbro0 f tM prmt u M ons hundmd CoWis /StGtlJ w Iw 1
� I mrlh � in iM pa�lamaree d Re wark br xfic� Ihn permu' ' n 0. I ehell mi e�ky erry peewn in anY menmr eo ea to
Aecome eubjed �o iM xaMen' compeneetun lews d CeGI e, en e th ' ouk onn eubje to �M waMn'
ampenwan prwiai na d Seaian �100 M �M labar Code, I lo ' omp � osa potiai
ele: � Appli�an:
C�
nlrp: F�llun ro uevn woMw�'ronpwuatlon eove�ep� Is vn4 urtl �IWI u0/�cf an rrplqw ro cNMiu pwraltlu �rM
clvll fln�� up ro on� I�isMrrE Nouaud Edbr� (fiP0,P00A M Mtllfb M� eost ol rompwu�tbry rlartipp u provkkJ br In
Sxtlm 31f16 0l M� LeborCo6, Infenaf, �ntl attomeyi /Iu.
CONSTNUCTION LENDINO AOENCY: 1 Iweby elfirm uMw penelry d per'µy that �Mee a a mia�ueion bMiiq eparcy Im IM
porlormanm W ihe woM la which Ihu pe'mY o eauM (Safun �Bl. Civ. C).
LENDEN'S NAME:
LENDER'S ADORE55:
i cenily Ihet I heve reatl Nu apd�� ��e �het Ne ebv.a iNametun u corteU. l q�ne to camply wilh all tlry enE oouMY �inences
enE eiete lexe relm'fg io building wnatrupion erd hereby eNlwrae repreaenietiwe d �hie ary to enier upon �ha ebwa-maniioned pmPoM
lorinapeabn purposes.
RAY THRONTON
� ^ � Pnm NameA %�
( �� l� � � �� Dffie: OO �
� ��wrelure d atlAae Ao iratl
WM1ua-Build�q 8 Selmf: Oreami�e.'�'-ADP��: Pink-Rewnue: GdEerua�Aa9esaor
CZTY OF COSTA MESA —�UILDING PERMIT
� ERM NO: P 077903
MIT NO: P 077903 PLAN CHECK NO: N GOVT: N SUPP: N
STRUCTION TYPE: 1—FR PERMIT TYPE: PLU PURPOSE: ALT
DESCRIPTION : 20000SF OFFICE T.I. SQ FT:
IM VALUE: CALC—VALUE: GROUP OCC: B /
MENTS: 76 UNION PRODUCTS, REF: H-77866
*+r�*�*�****�**�***�**x *� �� x+�**�*x � *�*****�r*�***x�*���*��*��*�+�+rx+�**x *x ��*****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
--------- MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
T: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
T: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
KING REQ:
NNING NOTES>
i
PROV: PARCEL; 91050104 ZNE: REF NO:
�•
1E iE 3E 1E 1E 1F fE iI� 3k iF fflE 1E ik iElE iE 1E iE IE �E iE iE 1E'� iE iE 1E 1E IE fE �E 1E 7E 1E 1E iElE 1E'lE jE iE iE 1E iF if iE iE 1f if if iF 1E 3f �E iE IE �E �f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ``� DATE:
BUILDING APPROVED HY : ���i DATE:
APPLICATION ISSUED BY; �� `'J DATE: � � /G
�t*�t**�tit***x�****x�*****�-3FiF�TF�F�#�Fit�F��F�t�F�FTFTF ��F�F�iF�'iFTEiFTFiFiF3F�-x�it*�t***** it�*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTR�C MECHANIC FIRE SMIP/RES GRADING
PERMIT 57.00
25t r„ � SMIP/NON—RES
PLAN , �
ISSUE FEE 22,00 �.
BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE
TOTALS----> 57.00 22.00 ;� 0.00 79.00 79.00 .00
i;
REVENUE DIVISION TOTALS--> COLLECTED: 79.00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
79.00 ,�
I/ �
ikiflEiFiE1El61kiFiElE1EiE1E1FlE1E1EfEfEiEikiEiEfF1E1E1E1ElFillElEfEfEiElEiEfElklEiEiFiEifiEiEiEiFif1E1E1fiEiElffE1k1k1E1E1FiF1E1EfEiElEfElEfEjE1E1E1EiEfFifiE
I N D I V I D U A L' F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
�
PLU 2 SINK, KITCHEN �� 8,75 17.50
PLU 2 WATER HEATER AND/ORFVENT 11.00 22,00
PLO 1 FLOOR DRAINS !�' 8.75 8.75
PLU i REPAIR/ALTER DRAINAGE/VENT PIPING 8.75 8.75
END OF FEES
,f
yfl
�..1��.-_. _l/h:. �l I.r I' .
. .a. . _. .�� . 1 :�. Y_:�f
� CONSTRUGTION AND PLANNING - � �' SP�'' �
APPROVALS Permit # ' Date Inspector qppROVALS Permit #- Date Inspector
" t. Temporary Electrical Service or Pole 52. Pool & Equipment Locatiori
2. Soil Pipe•U�drgrnd. . � 53. Steel Reinforcement -
_3. Electrical Conduit Utility�Undrgrnd. 54. Forms • '
-�� A. Electrical Cond�it•Undrgrnd. •- 55. Electrical Bonding
'� 5. Steei Reinforcement 56. Rough Plum6ing & 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. S[ructurol Floor Svstem - 61. APPROVAL TO DECK� �
17. Property Sewer �ine & House Conn�ction 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Healer & Vent-Final
73. Roof Drains ' � ' 64. Plumbing System � Pinal
14. Rough Plumbing � 3� S� 65. Electrical�Final � �
L
15. Rough Electrical-Conduit _ 66. Solar System-Finai �
16. Rough EleGtric Wiring ' 67. Fencing & Access ApProval � �-
- 77. fiough Wiring Sign _ f�$, AppqOVED FOR PLASTERING
18. Rough Electriwl-T Bar Celling 69. POOL/SPA SYSTEA4S FINAL
19. Rough Heating & Air Con�tioning - . � FIRE DEPT. REQUIR�EMENT •-
20. Rough F�ctory Fireplace _ ' • . - �, � APPROVACS' " , Permit # ' .
21. Ducts, in $truaure � . - 70. Underground Hydro �
22. Ducts, Ventilating . `71. Produet'Piping OL'ias �Oil
23. Gas Pipe-Rough & Tost � � 72. Underground Flush
24. RoofFraming 73. Undergrnd.StorageTank'OGas �Oil
25. Roof $heath��9 � � 74.� Overhead HydrO
Z6. 7�8ar.Ceiling (Strutturali & Motfocoat 75. Dry Chemical � .
27. Frame and. Flashing � � 76. Dry Standpipe _
_28. Lathing&Siding ' _ � � . 77, FIXEDSYSTEMFINAL �
29. Insulation • . � 78, fIRE PREV. FINAL
J
30. Drywall Ptailing ' "� �- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat " _ � 79. FINAL INSPECTION
32. Electrical Power Meter��inal � 80. FOOD CERTIFICATE ISSUED
,
33. Final Electric ' . Notes:
'3l'-��C:�. �j gz�4'b_� �
34. Final Heating & Air Conditioning �./� �/ �
�d- ��-,-� - -
35. Final Gas Pipe-Tert � - ,
r
36. HoodorCanopy . •- � • . �
:
37. Final'Factory Fireplacz .
38. Finai Plumping . _ �
" ��
39, Water Service-Final
. 40. Gas Service-Final - � . .� '
41. Solar pomesticFinal . � �
�
42. Backflow Preventer . � `
43. Backflow Irrigation
44. Landscape Irrigation System _ � � �_ . �. . . -
45. Sound Attenuation •
46. Handicap Regulacions . � �_
47. FINAL STRUCTUfiE & BUILDING '
48. FINAL PLANNING . � , �
49. Etectric Re�ease to Edison � � ,
50. Gas Release to Southern CaliforniaGasCo -
51. CERTIFICATE OF OCCUPANCV
No. Dare
�I
v
T
�oon�ssorem�ara: 555 ANTON BL
avr�easruY€iriaavx:SAKIOKA FARMS
�nopEu:pO BOX 2097
TERMINAL ANNEX
1PPL. YAIII�M d00NE59:
uN*: 6 T H
�ncxrrecron��n:INTERIOR ARCR 2136232164 �� 9378
usx.on�a.•s�ss: 550 S HOPE ST uNr: 1100
L.A, CA 90071
caran,�cTaraw� MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
carn�croas �uuxo P O B OX 5 0 9
�ssWALNUT CA uaxo: 230813
91789 uM:
LICENSED COH[P�CTOFS DECLAF�TION: I MMy elfim ivMr prW y ol psr'ryry ihtl I em IicausC uMx prwidma W Cheplx B
(eanmaxieq �mh Senbn )OW) d OHision 9 M Na Buvrou end Vrafauona Cods. eM mY 4ewue e m tW Idu end NIaA.
cmuc.No.�06558 quc.cuss:C 10 �S` �3081/3 EXP: 1/96
Ome: -S� �� 0 � / l� Coroeeor ,a�j�.(�y�
OWNEN BNLDEP OECLAFATION: I hereby elfimi ivkv penely d parj.vy tAn I em uanq Imm iM CaMretlon L'oms law In Ihe
lbwiq iaamn (Setlion 1W IS &nines md Rdseaaia Cods: A^f' ctf' w mwY Miidi'+0� e D�n w m�W�utl. atlx.'unprn.
emolu�, w repv eny oVuclun, p'v m Ca eauenro, e6o repuiree �M epplimN la ach pennC lo fJe a eqmE etalemeru Uut he or �M
n fimreee wrn,w io ihe n�e a me cavreaan lioen.e Is. �Chww a(mmm«�o wan saeo, �aoo) w oncim a a �n.
Bwimm vd Ndmiom COMI a tMt M a tlw b aemq iherdmn eM �M bsw ip Ne �Apsd sssmqion. Nry vbldion W Setlion
)mt s M+m row�� �a. w� ��n. eppGrau m. dva v�r a na ma. uw, M. mmei.e eomn �swop.
� I.eaoxnerdlheCW�Ya�rv�OMwwihweT+m�Misdswmpmmetion.wiTdotlrwM.uWNeamMusi�wltrqoMd
«dirad la eeb (Seciion'lou. ew'vew end Piatmacna Cods: Tha CwesCm liwius Law dou nd wON toanowiw a p'opery
who buiCa a inpwas �hnson. ad Ma don �utli Mwk h'vnaatl a hwaN a Uvdph he a Mr mm+mWnMe�. P�ed iM wcA
'unP�'a^aras ne m� iiveMed a tllred In eels. tl. Mwwer. �M duHinO a inP��w e wtl wnhin aro Ymr d wmdMian. IM
o�,,..a�,�e« w�n n� me wm«� a o�mo ne «.n. au ou wue «�mwo,+ ro, me wmwe a�e�.
p �. m cw.a. a in. wWem..m ssrha�w mnttaa:a �tn sc.u.a cono-epa. ro mnww m. wded (swun rou. a�.mr. w
viaeeam. coa.: m. comaaon uoen. �.w m.. na avN a m o.,,o a ww�r wro aew « inro�+« mr.m .w M,o
convecd la aMi prapda wiU a amtmf«(e) fcemeE punuent to �M Contream lkema lew�.
� I em uemp uMer Senian: 8. b P.C.. br Mu �mam:
Oele: Ow�er:
I do I+reb�' �afN tIW I em aware d utl ivda�sieM Ns �F���aM d CalfmJe IleslA ud Se1atY Coda Sepbro 25505. 255». eM
255J�, uM tlw I a M' Mun dald'vq amqeiC wi9 / wp no� (eeeb ane) �wed �o eomplY MA md qat� mEn W tM �puinmwro br
.o��«m.UucYm«nwaAaanhomtl,.�:�r +��wawiw.R.ria.miNmm�ueion•oP��..�.v�w���..
a�.
DNe: Mo�ceN:
WORKEF'S COYVEN9ATION UECWi�T10N: I MrWy Nvm uMr pruYy d paMvy ons M iM Idbwinp MrW�tbro:
❑ inm..newum.w.:�.e.w�.aoo�,.Nio.w;mWero..oh.:mmoa�umw�...wwte.ee«Meww�amoam.teeo.
coa.. �« �n. c.�a�wic. d m. wM1 b.rNa, Nu o�+: mu�a.
� �n....iwwm.im.�.aM«.�m�w�mb�ww.a..enmewMsniu,moam.Lmorcoe..au»o.tarm.no.a�n.
work la whiM Nu D��'s e�usJ. MY waken' ion iwuuic� urtlx entl W�Y numhr u�:
c.m« FI�EMANS FUND EXPIRES
Pofry Numlr. 0 7/ 01 / 9 6
�(7Ai..«vo, �.w nor e. mnpY�H l w v.m, v a. m. m,�a,e eoe.,. rs�oo� n w..�
❑ I oen'N Na in IM P�m'unc� d IM wak br xhicA Uuw D�e b�rE. I tlW nd MnVM �^V P��^ In �nf' mervw �o n lo
Mcv�na wbjeq lo iM xorYr�' mnp�nWbn lew� M CefdaNs. W epn� pw i I�IiaM Eecmr rib�w to tM worbrs'
eanpauuion prwd+n�. a swian mo a w taea. eod.. � � n oomAv /wn u�a. a/oJ.'vh+.
Dne: � � .Z a� g� Mvikr+: C� Sf«�
W�m/np: F�pun ro�Ieun woM�n'ronpru�tlon mwplls unl�wiul, uW �IW/ ulNcf �n �mplay�r ro plMrrl pr��ftlp �M
elvll I/iw �q ro am M1uWrW WuaW ddbn (f10qQ]OA N�trlllbn b IM rosl el eenpwu�4eM1 d�rrp� u prorMW br In
9�ctlon J�O6 0l M� L�Dor Cob, lnMuG ��ttem�Y'� f�p.
CONSTIIUCiION LENOINO AOENCY: I hweby Mirm unMr proAy nl pmWry Ihtl IMn u e mW�udion Nndnp ypncy M IM
psrlormanw N tM woek b w1iiN N"s prmi u uvwd (Ssqun 3W1, C'v. C�.
LENDEII'S NAME:
LENUEN'4 �DDXE94:
I caN1Y tI+Y I hm ned Ihu eoG�'� eM ewe ilut Ns eEow'vdwmticn u conart I Wns W canVN r.'uh s0 dY and mWY adir�ena�
ud etme bwe nWiq b dNd'n0 oonWuaion aM MrWY uNw¢a nP�d� dihe fif' b eMa uD� IM ebou��memionaA popany
�w �no� wao�. ,
DAVID MORTON
Peva Nenr �^ -q
` r� � f1.. �.i- _ Dme: S J�/ � /
Sp�� W retla
(S�St-16.WP) WMtiBuldiq85elery:Grm�Fb:Cenuy-AppFam:Rnk-Mamia:4dEe'voG-Mroev
CITY OF COSTA MESA — BUILDING PERMIT
ERM NO; E 0779L0
PERMIT NO: E 077910 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE POAPOSE: ALT
JOB DESCRIPTION : 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B77866
�x*x��***x**x**xx*�rt�***�***�*x***rt�r�r�r**�r��x�����+t�r***x�+�+r+r****���x��*�r�*****�****
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 41050104 ZNE: REF NO:
PLANNING NOTES>
� ..
1E 1ElE iElE 1E 1E iflf 1E iF iE 1E iE iE if iF 1ElE 1F 1E iE If iE 1E 1f iF iF 1E 16 iF iF if if 1F 1f iElE iE �E 1E ff iE iF fE 7E IElE iE iE 1E 1E fE iE fE If 1E iE iE iE iE �E 1E 1E IE 1E if 1E 1E iE 1E If ik iE fE iElE fE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY .
BUILDING APPROVED BY ;
DATE:
DATE:
APPLICATION ISSUED BY: DATE: � � ��
1E1E1E1EiEiliElEfE1E1E1E1E1f1E1E1kkfE1ElE1E ifiEiElfiEfEiE1E1E1E 1Ek
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 314.65
SOY SMIP/NON—RES
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 314,65 22.00 0.00 336.65 336.65 .00
REVENUE DIVISION TOTALS--> COLLECTED: 336.65 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
336.65
ik iE 1k ik 1F ik iE 7E iE 1E 1E IE 1E 1! iElE iE 1E if Ik iE iE 1! 1E 1f 1E 1E iE 1E i! iE fE IE 1E If iE IE Ih k IE 1E IE 1E iE iE IF 1t iE k 1E k iF IE 1E 1E IE IE IE �f 1f ik IF 1E 1f �E iF if 1E 1E if iF 1F it 1F if if 1E iE 1f
Z N D I V I D U A L F E E B R E A K D O W N
TYPE
ELE
ELE
ELE
ELE
ELE
ELE
ELE
ELE
QTY
2�
212
2�
10�
Z�
25
2�
24
D E S C R I P T I O N
FIXTURES, LIGHTING 1 ST 20
FIXTURES, LIGHTING ADDITIONAL
RECEPT/OUTLET 1 ST 20
RECEPT/OUTLET ADDITIONAL
AECEPT/SWITCH 1 ST 20
RECEPT/SWITCH ADDITIONAL
COMMUNICATION DROPS 1 ST 20
COMMUNICATION DROPS ADDITIONAL
END OF FEES
EA
EA
EA
EA
EA
EA
UNIT COST
1.00
.65
1.00
.65
1,65
1.00
.65
TOTAL COST
20,00
137.80
20.00
65.00
20.00
16.25
20.00
15.60
. , ' ".::�._ . �
m
CONSTRUCTION AND PLANNING , P� & SPA �
_ APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspettor
1. Temporary Electriwl 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
� 8, Electricai UF£R Grnd. 57. APPROVAL TO COVER�GUIVITE
- 7. Footings .' 58. Elearical Conduit�Undrgrnd. '
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test •
9. Water Pipe-Undrgrnd. ` .� , 60. Backwash Lines, P-Trap, ��tJhdrgmd. •
10. Structural Floor Syscem 67. APPROVAL TO DECK
11. Property Sewer line & Hou56 Co�nection 62. Backwash & Receptor-Finfll �
12. Sewer Cap 63. Heater & Vent-Final -
13. Roof Drains 64. Plumbing System � Final •
14. Rough Plumbing . 66. Electrical�Final
15. Raugh Etectrical-Conduic -� 66. Sofar Svstem�Final ' :
76. Rough Electric Wiring -� � 67. Fencing & Access Approval � •
77. Rough Wiring Sign . � 68. APPROVED FOR PLASTERING �. y
18. Rough Electricat-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning, . . � FfRE DEPT. REQUIREMENT �
- � - :-
20. jiou9h Factory Fi�,eplace - � �� ' � ' APPROVALS ,, Permit #._,.� '
21. Duc[s, in.�Structure. . . �� �� 70.-Underground Hydro '
22; �Ducts, Ventilating •Y 1 ' 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test � - , • � 72. Underg�ound Flush . -
24. Roof Framin9 73. Undergrnd.StorageTank OGas ❑0�1
25. Roof�She2ching ', 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Md'aocoat _ 75. D�y Chemical '�;
27. Frame and Flashing _�-_ .� 76. Dry Standpipe "
28. Lathing & Siding'_� - . 77. FIXED SYSTEM FINAL � �
29. Insulation � . � 76. FIRE PREV. FINAL
30. Drywail Nailing - � HEALTN DEPT. RE�UIREMEfVT _
37. Ptaster 8rown Coat �' . 79. FINAL INSPECTION . �
32. Electrical Power MeterFinal .� 80. FOOD CERTIFICATE ISSUE6
33. Pinal Electric _ � ~ . _ _ il /% 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 " , k
� 40. Gas Service-Final . .- , , � _
41. Solar pomestic-Final _' � .
42. Backtlow Preventer � - � �
43. Backflow Irrigation ' . " � '
44. Landscape Irrigation System' � • �` ' - • '
45. Sound Attenuation ` `
46. Handicap Regulations • • � �
47. FINAL STRUCTURE & BUILDING , _
48. FINAL PLANNING • "
49. Electric Release ro Ediso� � . - � '
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�oonessa emiw�c: 5 5 5 ANTON H L .
OWNEA9IUMEIFqqhN: SAKIOKA FARfdS'
, ' /,00ness: p0 BOX 2097
TERMINAL ANNEX
�VPL. MAlIJNO AUORE59:
uNr: 6 TH
�xcxnecTon�+ax�x: INTERIOR ARCH 2136232164 1GND' 9378
1RCX.OPENO.'SADOPE53: SSO S HOPE ST 0N7i 1100
camucTarsru�e L.A. CA 90071
AIR CONDITIONING COMPANY (818)244-6571
CpRN�Ci0R4YYlAlO 6265 SAN FERNANDO ROAD
�oo�u: GLENDALE CA �N0' 120696
91201 �M
LICENSEO COMX�CTOPS DECLAN�TION: I heraEy dlim wiMr peixly d pa�ury tIW I un licanssd uMx provleions d Cheqx e
(mmmaidiq vrilh Senbn )000) d Oiwion 9 M Ns Budrou W Pmim�bru Coda. and mY lians b in hA bm W aHed.
c uc.no.:019403 uc.cuu: C 3 ` 120696 EXP: 07/96
/ Dme: � � C oc .
OWN BUILDEA DECUflATION: 1 Mnby etfum perWy d porWry �he1 I un esemq Iran IM Camr � Lbma Lew /a Ne
inB �^ (�ion )031.5 Buanea� eM Proleamone Code: A'ry ciy a oounty wfiiM ispuirae e parmn neVUN. Mar. imprwe.
��.* �'�e^ mdoh, a rapai eny awcluro, pria w u eauvw, ebo nQaro �he applirsnt la ach peima m fik e dp elebment Mm M ar �M
� lioeneed Wnuent io IM potieiona d tlro CaNredas Licenes Lew �Cheqer 9(oommandip wilh Sedion )000� d DMinn 3 of Ihe
�ueiron ard Prdmevu Codel a ihet M w ahe u Qemq threlmn end tM bmo /a ihe+OW� memqion. MY videlon d Sedion
)031.5 by enY eW��t la a perm� wbjetlf IM epplicaM lo e dW penelly d nd mOre Ihen (ne huMred dollen �$SOpjl.
� I.mounerdtMpopenyormyempb�mavAhwapmmlheiwbmmpenae�ion.w�Ido�Irowk.endihs�tNCWreunolinteMeE
a ollared lor sele lSeeibn lO6a.8ueirov vd Prdeaooru Gode: TheConlrrlon lioenea Lew Eoes ra epplyto en ownx M qapeey
who WHa a inG�� �haaon. W Ma Eoro awh hak IvmxC a Mne� a Wwph hu a hm own emP�+�. 0�� Ihet wch
improvemeMs are not inteMed v dlend ta seb. M, lawerer, ihe buiNi�p a'vnprwemeM u eold wilhin an year al mmplMon, iha
ownerbuitler will heve IM buMsi d pwinp M a ahe did nal duk or impav b tM purywe d eW).
� I. m owner d �he pew7. em udu'wey' oontrmiq xiN fiuroed wntreao�� b m�Ww tla o�i� (Seeion ]osa. Bue'vime eM
Prdeavone Code: Tha Conirmaa licmm law Eoea nd ePWY �o en axnu d pW�Y who Wilda a imG�'�a ihaeon eM who
canvene lor wW Proppa will� e cauredar(s) IicenaeC quaueN �o IM CaNrauas l'xwa lawl.
� I em eaemq under Senim: B. 8 P C., M Nie raeaon:
Deie: Oxiwr:
I Eo MmW cenAy Nei I am ewme d enE uMentaM iM reQwremaro d Cellanu IbeXh ud Sdxy Gotle Sediom 25:A5, 2553J, aM
255�i. eM ihel I a uy Mwa buiMirp ampe'u will / wil m� (ercb orc) � ro camqy w1� xiE qme mdee enE IM nQuirtmenla br
e permn lacvnavuction or �roEififelionhvmlM �i�anepenwn� D'm�iitl. qssidemial oonarvuon appi'attidnere exempt Imm theee
pwisona.
oa�e: ���:
WORKEN'S COMPENS�TION DECLAN�TON: I Mraby alfirm un0ar penelly d pajury ane d �M Idbwiiq dedueiune:
� I hera end wil meinten e cenMicele d coneent lo e�llim�n br waken' canpevetion, o prwided In by Section 3)00 d ihe le�or
cod.. i« in� oert«�. a u» .�w ia .u�n aa. w�a 4 n.�a.
�I M1ew end wil meinten workers' oompena�ion inwrenca. n rpu'vad by Saqim �)00 d Vn lebor CoEe. la �Iw perlormence d IM
work fa whiN tliu D�� 6 usued. MY vaken' canG�ion inwranu wriar enE W�Y wmEer ue:
�^�^^= CC]I�LTINE�Tnr. rns EXPIRES
ra�v r+�mca: T�T6 3 9—� �� e a o c 10 / O 1/ 9 6
�m;., �n;a,,,..e �or ee oo,�o�w i u. w�+a ra, a,�. wm,.d am... R�ool w �ss.�
��
� I cenA' thel in IM1e perlwmvice ol iM wak la rfich iAn pemiu u mwd. I Wtl nol amqry a�ry penon in am� menner eo m to
e«ome .�d� w in. waw�.• canpenwon b.. a c.raoirc.. ene m�.. inn a �.nwu e.cmi. w4aa m ine wonen•
�compenxlion P�aona d Seabn 9)00 0l tM lebar COAe. I lanhr.nc �ompy w4h �e prwidma. .
m � - �>-,G� � �: �L' !/ti!�l�J
WernlnD: Fe/lun ro��cun woiRn�' mmpmutlon cov�rp� b unlMu( �nd �IWI �uE/�el en �mp/ryr <tlMi Pen�IH�� entl
clvll nnu'q ro om nuMrM rMuuM Ao/Yn fJIGq00UA a��n ro tM cwt ol romvwu�rbn �p� �� p�MOM ror /n
SeeHon ]106 0l Ms I.�Oor COW, Inhnal, antl ertomq'� Iwx �
CONSTflUCTION IENDING �QENCY: I hanby elfi�m uMer paiWiy d perjury IMt IMn ie e mn9rudion IeMinp epenry Iw IM
perlwmerca d tM �o�k M whiM th'v pnmi o ewH (Setlian �09). Cv. C).
LENDER'S NAME:
LENDEF'9 ADOflE54: '
I ceni7 �htl I heve reed i�u e0dication eM uma thm the ebwa'vdametion e wrn�f. I WnatocamdY �ith eA dty eM mun�Y adinenns
end eiete levn relelinB �o buildinB �mrutlim eetl M1ereby unhw've ieqesenteiivea d iho ary io enter upon tM ebove�mantionetl prope�ty
loriropetlipn purpasas.
. LOUIS RODRIGUEZ_ _. .
Dne: h r %?/�`
(5t5i-se.WP) Wh�a-8uikvp8 . eerFb: arery-ADG����:Pnk�-Perenue:GddenroE-Asaeaor
' .. .
CITY OF COSTA MESA - BUILDING PEAMIT
„ �ERM NO; M 078199
PERMIT NO: M 078199 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: MEC PUAPOSE: ALT
JOH DESCRIPTION : 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B /
COMMENTS; 76 UNION PRODUCTS REF:B-77B66
*x�x�*��r�***x *+e�r�r***�r**�r**x �r�rx���r*x�+rx�x�x��r�r**�r��**x �r*x �r***����rx�+r+r�**�r***�rx *�r**�r**�r+r
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN R£AR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES� ,,, ;Y
1Eil1EiF1F7F1E1E1F1E1k1F1E1EiE1FiEiF1EiE1EiEiE1E1EiEfEfF1E1EiEiEiElEiEiE1E.1EfEiEiEikiEiF1i1F1F.1kifiEifiElkiflflEiF1E1E�FiE1ElFikifiklEif1E1F1EfFMillEililifiE
D E V E L O P M E N T S E R�V I C E S�{ R E Q U I R E M E N T S
ZONING APPROVED BY � `'� DATE:
HUILDING APPROVED BY : �" f%;i DATE:
..., 6
APPLICATION ISSUED HY: 5 "" DATE:
x*x�****�e�r*****'*�*�r***�r x��x�*�r*�r*� ��
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL EGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 118.65
_'•i 252 SMIP/NON-RES
PLAN
ISSUE FEE 22,00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 118.65 22.00 0.00 140.65 140,65 .00
i•
REVENUE DIVISION TOTALS--> COLLECTED: 140.65 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CFIECK
140.65
f"'
iF K iE iF iE 1E iE 1E if 1E ik M i! iE 1E ik If M 1E 1E iE M if iE 1E 1E iE Ik IE 1E iE 1F ik 1E ik if if 1E ik iF 1k if if iE 1E if iF 1E 1F iE 1k iE 1f 1E k if iE 1E if if M iE if iE iF fE fE iE 1F if 1E iE iE 1E iE iE 1E 1E iE
I N D I V I D U A Lj F E E B R E A K D O W N
TYPE ,. QTY , D E S C R I P T I O.N C1NIT COST TOTAL COST
MEC
MEC
7 VAV BOX
6 FIRE DAMPERS
1 INST/REL BOIL/COMPR,1 0.0 - 3.0 HP
�END OF FEES
9.50 66.50
6.50 39,00
13.15 13.15
,2 - - -o•_ — - �- _ .. -
�,��4:';_ _ ;_' 'i. a. ..
CONSTRUCTION AfdD PLANNING
QPPROVALS Permit #
i. Temporary Electrical Service or Pole
2. $oil Pipe-Undrgrnd. �
-t: r�otings ��� "
^--8. R.eiundation^: `-�
c� F.
� 9. Water Pipe�lJndr�(i
10. StrutturaFfioor Sl
1 i . PropertY `�-,c�w6n�7
12. Sewer Cap� ';.�
13. Roof Drains =
14. Rough Plumbi�9"
i
ey
N
J
E9
P0�1 SPA
Date Inspector qppROVALS Permit # � Date Inspector
52. Pool & Equipment Loca[ion •
53. Steel Reinforcement �
54. Gorms
55. Electrical Booding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Condvii � � ndrgrnd.
59. Gas Pipe, � Unih{�rnd., Test
H
60. Backwash Lines;��'jrap, � Undrgrnd.
61. APPROVAL TO-D�ECK
�..
62. Backwash & Recepior-Fina�
63. Heater & Vent•�tifal
n�
64. Plumbinp System - Final �
65. Electrica��Final
15. Rough Eleotrical�ort�Lit t' •• 66. Solar SYstem-Fiva�, �
16. Rough Elec[ric rin�' p 67. Fencing & Access Approval '�
[-�17. Rough Wirir.�Sicin U 68. APPROVED FC�'PLASTERING '
*v
�78. Rough Electifa�� Bar Ceiling" 69. POOUSPA SYSTCTAS FINAL
79. Rough Heating & Air Conditioni'ng FI�E I�PT. �EQUIRF�MEPIT
r �. Y +^ t r� �� �-. -_ s-
20.F%ug�Fa�or�ir`��ace �Sr G c `- i-7, `p'k PPi�VA.irS��=,Pe�it# F "�"�'
21. Dntt4�in Slrua.i' reTl� .. •. - " _ " �-' = �70. I7hder roi-ih Hpilro `
a,
� i r� �._ � t
22. [j�ct�Ve�iiagng �y�* � �. .., -- � F. 71. ProductrFri,'Pin�� s d.0il
N
23. Gas F�pe�fdoug� & Tee[ � x m ¢ Ox 72. Undergrodnd FI�rsR r ti
24. .�"'eof�rai�ng•' • '" �
J v � F ��, �K ^ ti w.J3�Undergm8. SroraggTank�7 Gas ❑ Oil
25.Roof�he�hing S'!� C ��*� � D Ns 74C�OverheadHydrw�, x�
26. 'FHao-'TM�,eiling (Stru��a1) & Mo$��nat � � � 7 ; 75.`_.,-Dry Cherp�cal F.,� � � ��
a
27. amtan 10shinf �
Fif d�F �'� = c:�: r r r c�:� 76. Dry Stanit"¢F(�c �,!^ F� .. _ c*7 �
--28. Lath�g $�Siding d k � 7S4 (., � � . � ..� ..�. 77a FIXED SYFt,TE�,hINAIY �..� i', ;r : i
'�29. Insulatiorr� �f� � s • x� �� � � jc 7�'FIRE PREV. FIN��L `^ s
�"30. Drywall Na'ting '�'� '" j �� `'' dALTH�EP REQ�C11REtwF,�SJT
i i R�� �✓ F S ,Fi�.t. �, �
' p31. Plaster Brpwn�oatt�r g ��r- � ' � a•79. FINAL �Itt$P.ECTIDN ti J
'" �--- -
�32. E�'ectrical w^ Meie�-�-tnal ; �' V I r80�F000 CERTIF��TE IS$U_ED,r
g33. FK,;Jial�leotcic > ; K rt; . � r .. h� �Nacts: � �t* � -
' � - ( Si-��z-�iG�LQZ--
N34. Fi�ai73eating Aii-(',k�' ndhioniny 5 �� ~ � � F-r,�-` � 5
a� :-� c,r. r•. m���6 ._ 4 _
�
35. Fr�al'�,as Pipe� est`� Q, . R F. � n ' �_+t.r_ M� .=r
�'36. Hoodor CanoPY * - r � _ `s' x �' � %f � � " ' � -
� � n � c r � � .. r - � cr
,� . :r. �- .. _ � . .. . ...
y37. Ftnal`Eactory Fireplaee z; �- c. - c • �s �: y. ^�
. _ .: _ ' .r r. �r
�38. Finalk'lumbin9 ' '�• -' � ^ ' :t� � S •:.e � �-+ # ro .
c r.. Y '� C � ` � - '+ H LR: '-'Q'. *
� � T ' : .i- 1 �.v• . . �•� ...
``39. Watef$ervice�Final x. f . .R- � ' � .., `, *
m
i-�40. Gas Service-Final �-' C:T'-' S n;z: ' � Oo �na� ; -
k � X 1 � �« [� • ^J :� �A 'Q�i
��41. Solar Oomestic-Final�` � � ~ � '' � � � -
_ ,:, � � � � -irv a� r ;: �
., �-
42. Backflow Preventer ;: � _ � I �� �� � F � r '-
. = i-." � �-, x, m [+1 O :x e- -
C a: T M ` �J
43. Backflow Irrig�ion fi a- -' .. � ;� . � ,� ; ` '�
�.
44. Landscaplc�IrriqutionSystem �C+': w �!"% _ 0��., rt; �, r.(J rT �'i% �"'-L
'^ x a :k E a O x > 5 i-�
4J. SOund AttEn �on s r!�.F cT' / � . F. � � r. �-, ••.
. �� X k R R7 I'^ > O' C" �." • !-+C' P
4�. andicap �Regu�etionse '-+ C *�� < t� S vv S *
� 'r R7 C;, t
4z. FffVA� STRUETURE;& BUVL{SING r_ ` -�K � T ;: f•
L
48. F,tNAGPLANNING t FF Kn% � � r -i �' � h�
X �f � (J �V ' � d
4�J. ETectfT'e Release to E¢ison q � � � .� ,,. •�, ; ' ,. .�-
50. (las Ra7ease to Southem Califomia 6as Co +' ti= - C• c t^ + � �•
r M• S Do C. c: ',C �
51. CEFifbFICATE OF OCCUPANCY "' " = • �- ^ �- �
No. Date
i �i
PPOJECT PO�PESS: S S ON BL uNiT: 6 FLR
OWYER'SNqME:BANI'C AMERICA
AODNE55: 2 O N R YMONA AV
PASADENA, CA
818-578-7700
AHCNIENGINEEfl:ROY HERHOLD nec.No: C 1 1 0 7 3
AoopEss_TUSTINAQUA �;ANTA CA 92680 uxiT:
PEHMITTEE:HORIZON HEAT:NG b A/C (719)974-3702
noonessVIILA pp,�RKjAGO BL STECA�92667
IItEN5E0 CONTpAtTOP oELIAHATION: I nereGy allirm that I ' nse0 unaer pmvisions ol Cnapter 9 �commencing witn Senian
)IlUO� ol Orv��siun 3 ul �he Business and Pmlessions Cotle. ana .nse is in lull f e and etlec�.
cinuc,:056444 STPTELIC.6472Z4 s. 0
oa�e: _�— )— cJ3 SiBna _
WOflREqS' COMPENSqTION OECLAflATION: I �ereby alfirm t�al I have a cenilicate ol consent to sel4insure or a cenilicate oi Warkers'
Compen5a�ion Insuranc¢, or a[enilietl copy Ihereot �Seciion 3800, LaO. C).
POLICY NO.: EXP. OqTE:
LOMPqNY:
❑ Gertilied copy i5 hereby lumis�etl. ❑ CeN�ied copy is IileO wi�� I�e ciiy Building Oivisian.
Date- ApDlicant:
E%EMP�ION FBOM WUflNEBS' COMPENSATION OECUflpTION: R� s n ne G not Ee c �e0 il �Ae permii is for on¢ huMrM (5700� or lew�.
I c¢tlity Ihdl in �h¢ pedOrmanC¢ O( Ih¢ wo�k (0� w�iCh ��i5 ¢ Shdll E 10 any person in any manner So as �o become
sueject to he Wor4ers' mcensation Laws oi Calito .
`.�ale: � ' Signa
NO710E: II, afler making I�is tleclaration, you s�oultl Uecome suClect to t�e Wofker5' Campen5ation DrOvisions of Ihe LaUar
Cotle, you mus� Iorlhwii� comWy w'�Ib Such O�ovision5 a� I�iS pemx� shall 6e Oeemetl revakee.
CONSTflOCTION IENDING PCENCY: I �ereby a��irm t�a� ��ere iY a consimction lentlinq agenty �or ihe Oertormance ol Ihe work �or
wnich Ihis-De�mi1 is issuetl �Section 3097. Civ. C�.
LENOEN:
aooeess:
OWNEfl BUILOEB OECIAflATION: I �ere�y aifirm t�ai I am eaem0� �rom I�e Conlraciors' Siate LicenSe Law far IAe lollaxinq rea50n
(Section 7031,5 Business antl Pmlessional Code: Any ciiy o� coun�y w�ich requires a permi� �o construc�, alter, imprOve, aemolis�, or
repair any sttuc�ure. prior lo i�s i55uance. al5p reDuires t�e aOGlicant lor such permit �o �ile a signe0 s�atement that he/s�e is licensed
pursuant ta ine p�o�sions o7 t�e Contraciws S�are license Law (Chaaer 9 �commencinp with Secibn 7000) o� Oivisbn 3 0� tAe Business
antl Pro�cssians Cotle) or �hdl helsh¢ is exem0� Ihere�mm ana I�C basis lor the allegeG exempliaa Pny violati0n ol Sec�ion 7031.5 6y
any aDGlicani lor a Dermit SUble��s Ihe ap0liwni Io a tiNl penalry oi noI mare tAan five hUnCr¢d dWlars (SS110�.
I, as owner ol ine prooeny or my employees wi�n wages as iheir Sale comDensation, will tlo Ihe work, anA Ihe
❑ slmcWre is not imenEed or ol�eretl for sale (Section 7M4, Business anC ProfesSianal Code: The Conirat�ors' State License Law
Does noi aOP�Y lo an owner o( a O��Perty wtw bailtls ar im0�ove5 f�erean, antl who tlaes such work M1imself/herself of Mmugh
�is or her ovm employees. Dmvi0e0 �hal 5uc� impmvemenis are nol intenOeG or oflere0 far Sale. 11, however lhe �uil0ing or
imD�ovemenl is 5010 wi�hin One yea� o� complelion, Ihe owner will have Ihe burtlen ol proving �e/she did no� builtl or improve
lor �Ae purpose o( sale�.
I, as owner oi the pmpeny, am eKclusiuely coniracting with licensetl con�raclors lo constmct the pmjec� �Sec�ion 7044, Business
I❑ ane Pm�essians Coae: ihe Convacmrs' S�ate L¢ense Law aoes no� aOUN �o an owner ol propercy who ouiltls or improvts Nereon
antl who coniracis tor such pmiecis witn a contractor(s) license pursuant to Ine Caniiactors' State License Law�. I am aware
Ihat prool o� ��eir Warker's Compensalion insurance 5houlA be providetl to me.
� I am ezempt under Sectian; B. b P. C.
for ihis reason:
Date: Ownec
I ao nere�y CenAy that I am aware ol antl untleRtana Ine reQuirements oi Calibmia Healin antl Safety CoOe Sections 25505. 25533, ane
25534 an4 ihal I or any IUWr¢ builAing oaupanl wilVwill not (circl¢ on¢) neetl Io tomply vnih saitl staie Codes and Ihe �equiremenis fOr a
p¢rmil br conSVucUprt w mOdilicalipn IrtM IIM Air Oualily Managem¢n� pisVicL ResiOCntial eWstruclion appGcalbn5 are ex¢mpi 1/om
ihese provisions.
Date'. AVO�i�anl:
I �ere�y ceriify I�a� I have r¢ad I�is aDDlicalion antl slale �hal e a e iMormalio is orreci. I agree lo comply wii� ail ciry dntl counly
ortlinancesantlsla�elawsrela�ing�oOWlAingconsimctiona a hor er en �ivesoflhiscily�oenieruponlheabove�mentioned
properiy/lo� inspecuon purppses.
Oate: _ti—/ � � 3 Sign .
o��rs �rce�s� o� sodai s�o�d�r �:
t6at�a6 Wni�e—BuilOing�, Green—Cotle Entorcemenl: Canary—Apphcem: Pink—Revenue; Gol�enrotl—Asseswr
, CITY OF COSTA MESA — BUILDING PERMIT ,
PERMIT NO; M 062495 PLAN CHECK NO; N , ,
CONSTRUCTION TYPE: IFR SP PERMIT TYPE; MEC PURPOSE: OTH
JOH DESCRIPTION : UPGRADE EXISTING FILE STORAGE AREA SQ FT:
CLAIM VALUE; CALC—VALOE; GROUP OCC: B-2 /
COMMENTS: RE: B61893 PRIMARY BUILDING PERMIT.
�e�r�x�*�r�t�*�t+r��e�r�r*�t*+�***�r�t�r�r****x�x*x�t�t�r�r��r�r*�r*�t�e��t�r*�tr+t*�+r�t��**�e*�*x �e�e��e�r**+t***�
Z O N I N G R E Q U I R E M E N T S
ssraAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDTNG ---------
FRNT: FT ZN REAR: fiT ZN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE(� • PROV; PARCEL: 91050104 2NE; AEF NO:
PLANNING NOT'ES>
i
�r�x�r�r�r��r�r�r��t�xx******�t�r,r�r**�r�t+r**�r�r��*��*�t�*�r��rr*�t*x*�e�r�t�e�rx��r**�r�r,e*��r*****�e�+r***�r
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUZLDING APPROVED BY : DATE:
*****+Cr�*+Ir�*x*�***D�eB*i��i � *�t�r*D***�r�r�*�r
kikiffh�flFifififlklEMiEifiliklflEifklEiflfififiElf�flfifiEiElfifififififikMlk*�ififiElfiE�f fik�lfif�flkiflf�tlf�k�FififiFifikiF�kikiFlkiEiflkilkltiFiF
LEGALIZATION:N F E E S D M M.�A R Y{' � STRUCTURAL SEGMENT;N
r( l. /
HLDG PMT PLUMBING ELECTRIC MECHANI•C ;'.� FIRE��SMIP/RES GRADING
PERMIT ,!� . 8Y 00 .; ;7 ."
PLAN ��, � �SVi'�� , „ SMIP/NON—RES
ISSUE FEE � ,� ^� 15.0;0 '� �� �
BUILDiNG—DIV—> PERMIT TSSUE PL'AN—CHECK`., i:TOTAL i PAIb DUE
TOTALS----> 81,00 15.00 '� ,"0,00'.,;; •96.00 ` 9,6.00 ,00
REVENUE DIVISION TOTALS--> COLI;ECTED; �� �- ��96�,00`. OVEA/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC 'FIRE SMSP/TOT� GRADING PLAN—CHECK
, 96.00 : % ;, . .. . :
�e�r�r�e�e�r�r�r�t�e�t�r�r�r�r�r�t+r�x��r*�e�r*�r�r�t�**�t�e��r*�r+t**�t'�rr**�r*�r*�**�r�t�r��r��*�t�r**�**x **�r�t*�r�t*�r
I N D I V I D U A L �F E E � B;R �E � A K D O W N'
TYPE QTY D E S C R I P T I O•N.� ;;� UNIT COST TOTAL COST
MEC 18 FIRE DANPERS ' � � x 4,50;" 81,00
END OF FEES,�. ,
.I �� � (�'• i . .
i � � � ��� .
�. A
iA � ' i � '
!� � �r � r
. � �' � � � ' . '
i
. j.� oi a01<0517-001<OS17 TL7 T 96 00
—
- DATE: 06/.D719,3 TIttF: ID:30 �
• . � .;
% " r �
I - �
/ 'i
�
, CONS7RUCTION ANO PLANNING
� APPROVALS Permit �`r
1. TemPorary Electncal Senvice or Po{e
2. Soil,Pipe-U�dxgrnd, �
' •3. Eaectrical ConduT tJullty-Undrgrnd.
�� Elecirt�a( CQn�fur,-Und�g�r.d.
5. S^.�el Rcipjarcercient
,8_ klecu�Fat�i1F£R-C'itnd '
7. Foqtinqs'� -
�_-_� -
8, Foondation �
9. LNa[Br Pipe-Undrgrnd. '
70. Structural Plopr$ystem
1.7. Property S¢p�er �,hte & House Connection
12. Sewer Cap .. �, .
13. Roof Dra+ns _
14. Rou9h Pfumbing � •
15. Aough Etectrical-Condua
76. Rough Electric Wiring ,
77. Rough WinngSign
18. Rough Electrical-T Bar Ceilmg
19y Rough Heau�g & Air Conditiomng
�t' ^[ . . . � . *' r s
2�. R�4gh�ac�ry�i�eplace � � ` -
�i- n;,.�.� � cr.���,�,�„ � ... . -
23. Gas Pipe�Ruugh &�Test � tC
� s _ _ , '+'
2d= Fouf Fiaming �'� ' : �•.:_:,
�---^'---��"-�
25. floof Sheathing* . .
265 T-oar Ce�ling (S"v6cturall & p7onocoat
27,. F�ameand FlastijaB : cr
_.,__�.• -
28. Lathiri� & Sid�rS� , ., _ � _
29. Iniula[Lon ' � �
30. Dryv.^allNailingj;.
31. Plastcr�BrotV� Goat . i • .�
3�. EkctrlEat Powef�ece,�F����
33. F'r�+ai�ect;.r_ �=a r, i -
��: _ �
34' FGial HAatirig &�A'ir Condrtio'n'ira,� '
35x Final C,Bs Pipe�T.e i-��I :
------�� '`.
36. Hood isr Cartopy�' ' � _
+ C;
..-z•,_r t,.� _
3?, Final F.qciory �i�eplac, �- -
--�---c-,--�-.
38. FiAal F4umbing " � ' -
39. \'.Ster a
$ervice-Fina3 , .
40. Gas SeFmce�Pinai �- .� 2 r
.
41. Solar pomes2rcFinaP '-
42. 8ackflovi P.eventer .,
43. Backflow I�igatior ' . `
44. LandsO�oe hngacion System < <. �.
_ {�
A5� Sound.Attanuation -
46. Handidap Regulations �
47: FINAL STFiUCTt7RE � BUILDING
4$. FI�JAL PIANNING �
49. Etectrie Release to Edison
50, Gas Release to Sat�thern California Gas Co
No._ Date
PO� �-& SPA - -� - --�
Date Inspector Date Inspector �
m
APPROVALS Permit �k
�
52. Pool & Equ�pmeni Locai�on �
53. Steel Reinforcement
54. Forms � �
--i
55. Elactricel Bond�ng ,
_--�
56. Rough Plumbing & Pressura Tcst '
� 57. APPROVAI.TOCOVER�GUNiTE _� - �,
, t
58. Electncal Condurt�llntlrg�ntl. � �
! T�
59. Gas Pipa, � U�tlrgrnd , 7est
60. Backwash Lines, P�Trap, � t Undrg.nd. �
67. APPROVAL TO DFCK , �
62. 6aekwash & Receptor�Final ^ ;
63. Heamr & Vent•Fi�a� � !
60.. Pfumbing SYstem � F;�ml '
65. Electrical•Final �-
66. Sofar System-Fina� �
67. Fencing & Access Approval :
� 68. APPROVED FOR PLASTERING
69. POOUSPASYSTE^.7SPtNAL ^
x k_ Ft�E�EPT„f2EQUiREMEq�T . �
�' " r � APP.OV�i�'`.' PAunii fi- '--�_� `' �
PL .
~`_� � 70. _Unde�gr���ri H;dro �
- - t � 71. Produ i�P:ng':"1�.+s �Dil
�- - ,
- � 'F 72. Undergrfwnri Fio'si�, �� •
=-- y - - -- _ .
Y x'} 73i Undergrnd.Sta�'u�..Tank[1Gas �Od
. - � ___,y_-._{_- . _ �
� 74. Overheatl Hydrn �'
�� �
IG. Dry Chem;ca: � :
-•� ^ 76. Dry Stantlpipe J � � �
7➢. FIXED�,S�'$TEIti�INAl;•_ ,- ` !
" �' 78. FIRE PREV. FIN`AL " � ^ �` _ 1
" ; " }fEALTfi DEPj': REfIUIf�E�ENT
_ ; • � : . _ _ -.r---�=-
x r. 7g; FltVAL Ih�CCTJ;]N •:
� '� �� 80`; fOOD CERTfF,Ii",ATE t�SL'ED
- -� �_ --- - ;
"� niat�s:G_�=9�= ��'r,p-1�����`�/�/J` ���.r�� - - �
ti I� _ \.'�D I �J""�'�����-�` p�� 1 / r�✓ I
. �t���r`�-- :-[C�s7�yv�_i��� G �
4 _
.�Y ' ` ..� ^.. '_�_
-. G°'.?4,�93 _isiac!�sw .TiL cm_n9Z r J_N+` o,+_�-�
�M � T__�� /
.�:.G���....,_/�s� .v�,,vnv�/, v.�a_ u`s,ry.�f.. _ . ��n.as�s7
.
�.Z.�_�n._%�� yr�.•d y,v_s6 .r.v�r_ J_w_� r T s�., _4��C_
-�: . J � , .. � - �
-��9_"fi_v„�_�;Y�ar wi.lL co_%*'t�+l f �.�'.GC_�1
; � � �
=.,�-=--{r-'
"��iZ�.�C�Z�, _
. - -_�" ..
m �:�l� .-c-�.,�--,
a
;
�
� g�3�
• � /�vo�icant [o fill in all s0aees exeeol tnose witnin neavy boreer lines ana siqn all aoo�oD��ate Gaclaralions.
CITY OF COSTA MESA CON TRUCTION PERM� PE MIT NO. � TRACTcO LOT NO. UNIT N A P# a� � Zone G
Projeci Address Ss� �t�.1 �,J (, - . 3 � � ' 6 S Main Building: Accessory Building:
AppliCa�YS Mailing Addre55 —�. TVPE OF CONSTRUCTION ,-. _ NEW ADD ALTERATION REPAIR E Z
❑ CONVERSION ❑ DEMOL'ISH � OTHER T Ffont 0
Owner's Name hone DESCRIPTION OF WORK/USE OF BLDG. I A Rear N
Address
Arch/Eng. License No. TVPE OF PERMIT GRADIrvG FOUNDA710N S7RVCTVRAL I K Right N
Left G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUM6ING ❑ MECHANICAL �, $' . R
Convactor's Nam��^ Phone��.-'�.zL ��OTHER _ _ Ping. Ref. # Parking Req,/Provided E
� G� �� PRQIECT DESCRIPTION 5(d. FT. oCCUaANGv � a
Address Imailinglsn�`1— � , � p Planning Notes: I M
031/4f� CONSTRUCTIONTVPE VALUATIONS Z�)y��� T
�Ci�y License No. ZONE GRADING CU.YDS. ACRE� $,
LICENSED CONTRACTOR DECLARATION
I hereby afti�m thdt I am IitenSetl untla� provisions ot Chdrte� 9(comm¢OCin9 Remarks: � 3�
O with sec[ion 7000) of Divislon 3 0l the Buziness antl Protessions Cotle, anC
my license is in lu�i torce ana ef(ect. ELECTRICAL FEES
� License Class � No3GG5 0 `f�
�1 ate�-1(— '' Siq t �• ��!� PLUMBING . FEES Automatic Wesher Transformer ❑ 15�50 KW
RKERS' COMPENSATION DECLARATION ConstruCtiOn PaleSub. � 50+KW
reby aftirm ihat I hdv¢ a certilicate oi consent to self-insure or a certlticat¢ Bdr $ink $hOw¢ri -
1 Workerz' Compen5dtion InSurant0, Or d certlti¢tl cOpy thefe f(SeCtion COOki09 UOit MEt¢f ❑up LO 100 dTpS
] 3800, �ab. Backflow Preventer Service Sink
S ��p %1 '� S f f� �BQ,. �--;' Dishwasher Meter ❑over 100 amps
Poli y No. Gompany • Backflow Irrig2ti0n Sewer Cap .- .
a ertifietl copY is hereby furnished. Dryers ❑Gas ❑Electric Sub Pan21 '
J+ Ce �fie�tl"cop I`rfIletl wlth the clty�s�''Cf Ing ' isi � Bathtubs Sewer COnn¢ction' %
Oate� ery��l APPliean��"—�`�' � '�'-1� � - F2�
E%EMPTION F0.0M WORKERS' CO NSATION D CLARATION Cle�ifiefs Sola� ColleCtOfS' MotOrS OP7 HP �1�%'- 8
(This section neetl not be completed if lhe permit is far one huntlretl (SI00) or F.A.U.
less . Dishwasher Solar Piping Inc. Solar 9-15 MP 16-15+
• I certify [nal in Ihe Performance ot tbe work for which lhis perm�t is Issuetl, I + Fixtures �
shall not employ any person In any manner so as to become subjet[ to the Drinking Fountains Solar Tank MicroYVeve
Workers' Compensatlon LawS of Cali(omia. , .
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
� NOTICE: If, after making this tleclaratlon, you shoultl become subject to tne • Outlets RangC
Wo�kers' COmpenSatlon p�ovl5lon5 Ot thG LdbO� COtl¢, you must forthwith FIOOf$iflk5 Urinal
� comply with such p�ovlLOnS or [Itis pe�mlt snall be Ceemetl revoketl.
CONSTRVCTION LENDING AGENCV G2SSefviC2 OuL1Et5 Wa[efCloset Switch25 Sign -
I hereby a(tirm Ihal there is a construction lentling agency for the performance -
01 lh¢ work for whi<h this permil is issuetl (Saction 309] CIv. CJ ��(erCeptOrS Water Heater Gerbag2 Di5pO5al Standing Section5
Lentler's Name
Lender's aaaress Kitchen Sink Water Service . GenSlator 00.5 KW �515 KW Trash Compactor
OWNER BUILDER DECLARATION �
I hereby atfirm lhat I am exempt (rom the Contractor's License Law for the LevatO�ies AutO-Waih
f011owing reason (Section 7031.5 Bu5ine55 antl PrOfessional Cotl¢: Any city or
county which requires a vermit to construct, alter, Improve, tlemolish or repair P—Trap �aundry Tra'ys
any struc[ure, prlor to its issuance, also requires the apD���ant for such permit
file a signetl statement that he/she is Iicensetl vurzuant to the provizions of Roof Drains
Con(ractor's Ucenie Law (Chap[er 9(commencing with Section 7000) of
ision 3 Ot [he BUSin255 antl PrOfesslons Cotle) Of Ihat he/she i5 exempt ReI115pBCti0�1 FBB $1rJ ISSUB F80 $ 3
erefrom anG t�e basis for the alleged exemption. Any violation ot Seclion -
7031.5 by any applicant for a permit zubjacts tha applicant to a civil
enalty ot not more than tive nunaretl tloiiars (E500). ' DEVELOPMENT SERVICES REQUIREMENTS:
� I, as owner of tne property or my emo�oYees wilh waqes as their sole Reinspaction Fae $15 Issue Fee $ 3 Q{p '
com0ensation, will Co Ihe wo�k, dntl Ine st�uctut¢ I5 not intentletl O/ o(teretl ZOning App�OVed By DatB
tor sale (Section �04a, eusinesz antl Professional Cotle: The Contra<tor's MECHANICAL FEES •Building Approved By 'S '�
License law tloez not applY to an owner of a property who builtls or improves _ Date4
thereon, antl who tlaes zucM1 work �Imsclf/herself or through his or her own HOOd Of TypE I ❑ APP���tion Issued By ��=�et8�y' ���—�
employees, prOvlAetl that Such imprOvements are nOt Intentl¢tl or offe�etl for BOiICf
sale. If, noweveq Ihe Duiltling or improvement is soltl wlthin one year o( tom- Canopy Type I I ❑ UMMARV OF FEES ^/
pletlon, Ihe owner wlll bav¢ the bu�tlen 01 P�oving h¢/Sne Gitl not builtl or im- DuCt - Und2� GfOUfld �
prove tor tne purpose ot saie). . BUILDING PERMIT $ ad SMIP $ '/�'S
❑ I, az owner oi tne oroperty, am exclusivety contractin9 with licensetl con- Duct -Structural Refrigeration System PLAN CHECK $ PERMIT
IractOvs ro cOnstruct the project (S¢Ction 7044, Buslne55 antl Profe55ion5 Cotle:
The Con[ractor's License Law does not apply to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ �SSUANCE $
builtls or improves lhereon. antl wM10 contracts �or such oroiects with a can- �
tractor(s1 hcense pursuan� to �ne Convactors License �aw). 1 am aware that Exhaust System ❑ Multiple ❑ Sys[em Repair/Alteretion � P�N CHECK 25% $ ENEflGY P.C. $
proof ot their Worker's Companutlon insurance shoWtl be proviae0 to me: � ELECTRICAL $ GRADING $
� I am exempt untler Section B. & P. C. for this reason Firepl/Fact. BIL ICBO d`- Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date Owner Heating Sys[em & Ducting Registers • MECHANICAL $ TOTAL FEE $���' Z
I hereby'certify tnat' I have reatl this application antl state that the above ❑6100,000 BTU �100,OOOBT ' ' pLAN CHECK 25%
InPormation is correct.'I agree to comply with all clty antl county ortlinances $
antl state laws rolating to builtling con5truction, antl hereby authorize repre- ,
5entatives o�f �1'S U te� up^� the abOve-m¢ntlOn¢tl property (o� '
Inspectl�j�'Py�� �s. �� p �� '
Signatu:a'�/-.y Dat R ReinspectionFee 515 IsweFee $ 3 �� �OD3058`r-00[!30Sgg '�'Q�� �;}�'g���
D�Ivers' �icense or 55 �F -/ l�ATE: G4/ibi$9 j7�jE: 1jCQ�
0865-46, rev. 5/00 Whit¢ - Bulltling; Canary � Applicanh Pink - ACCOunLnq; GOltlenrOtl - Assessoi
, �! . , ta ..;\ l �� � „ ... . ._ . , _
.CONSTRUCTION AND PLANNING � P & SPA
' A�PROVALS Permit # �Date Inspector p�ppROVALS Permit �k Date Inspector
1. �Temporary Electrical Service or Pole _ f .r 52. Pool & Equipment Location . �^
2. Soil�Pipe-Undrgmd. �� � � , 53. Steel Reinforcement ��,f
3. �Elecf�ical Conduit Utility-Undrgrnd. �" ' 54. Forms ���
4. �Electrical ConduyrUndrgrnd. ( 55. Electrical Bonding ' :�-t.
' �- ' -
5! Steel.Reinforcemen� °' 56. Rough Plumbing & Pressure Test F�-�
�G. El;ecv.ical UFER�Gmd. � � 57. APPROVALTO COVER-GUNITE i��
� r n
7.;Footings -� . , � f�� ; 58. Electrical Conduit-Undrgrnd. .-: �
8.�Founiiation } y � ._'' 59. Gas Pipe, � Undrgrnd., Test ^
9. Wate�-Pipe�Undrgrnd. t� �� � 60. Backwash Lines, P-Trap, O Undrgrnd.
i _
10. Struc'tural Floor System � � j� �j� 61. APPROVAL TO DECK
11:�Property�Sewer Line & House Conriection `� �� 62. Backwash & Receptor-Final
7�2� Sewer Cap ,j� ;� � �� � 63. Heater & Vent-Final '
i
13. Roof Drains V �� , � ^ 64. Plumbing System - Final •i'
14. Rou h Plumbin � -�
9 gy � 65. Electrical-Final .
75. Rough Electrical-Conduit 66. Solar System-Final .
it6� Rough EleCtric Wiring 67. Fencing & Access Approval
� 1-�� flough Wiring Sign 68. APPROVED FOR PLASTERING
•18? Rough Electrical-T Bar Cei�ing 69. POOUSPA SYSTEMS FINAL
� 9. Rough Heating & Air Condi� oning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace 'f APPROVALS Permit #
'�-
21. Ducts, in Structure � �' 70. Underground Hydro
22. Ducts, Ventilating � � 71. Product Piping OGas ❑Oil �
23. Gas Pipe-Rough & Te�t � 72. Underground Flush
2�4�. Roof Framing �%� � � 73. Undergmd.StoregeTank OGas ❑Oil
25. Roof Sheathing 1�; �-'� 74. Overhead Hydro .
26. T-Bar Ceiling (Str�ctural) &�Monocoat 7� 75. Dry Chemical
27r Fra�ne�anii Flashing �v � ��' � 76. Dry Standpipe
28. Lathirig�& Siding �,a1 77. FIXED SYSTEM FINAL
.
29. InsulaYion 1/ 78. FIRE PREV. FINAL
� V1 y
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
3,1. Plaster Brown Coat� i ��' 79. FINAL INSPECTION
32. Electrical Power Meter-Fi)r a�� 80. FOOD CERTIFICATE ISSUED
33. Final Electric l�r� a �Notes:
34. Final Heating & Air�Conditioning
35. Final Gas Pipe-Test
. -'36. Nood or Canopy
37. Final FactOry Fireplace
38. Final Plumbing '
'39. Water §ervice-Final• ,_ _
40. Gas Service-Final � -'
�
41. Solsr pomesticfinal ''''� -"�
:� h•
�42. Backflow Preventer � ' t� y�� � . . �
� rL
43. Backflow Irrigation� � � `
44. Landscape lirigation System ��; � %;!
45. Sound Attenuation, .
46. Handicap pegulations � �
47. FINALSTRUCTURE&BUILDING Ly�
48. Special�Requirements Completed
49. Electrie Release to Edison `' �� -
50. Gas Releaseto Southern CaliforniaGasCo �"r�:� •
-51. CERTIFICATE OF OCCUPANCY ' 7 • -.
No. Date � - + �
City of Costa Meu
Development Services Department
Building Safety Division
P. O. Box 7200
Costa Mesa, Califomia '
�
CERT6FICATE OF OCCUPANCY No.
�
The Building located at S55 ANT(1N� AOULEVARD. 6TH FLOOR' �
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group ao Occupancy
Use of Buildi
Legal Description 6Zl1—SM—OG
� � (See reverse side for Metes and Bounds)
�Building Permit No. A 4R�9'i Electrical Permit No.E 48344 Plumbing Permit No.
Mechanical Pe'rmit No. Number of apartments and/or guest rooms
Ftre Prevention Permit No. F 59052
ISSUEDTO: BuildingOfficial Tonv C'De Baca
� Snni��'it�� Parifip �At�(1TA� �
555 ANTON BOULEVARD bY f��—� ����� h�
C(1GTA MAF4. CA �19Ai6 . . / — ' '
Date A8A&'fii*d8$R110.1�990
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 Pile; Pink - Bldg. Permit File � �
4
City of Costa Mesa
Uevelopment Services Department
Building Safety Division
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY . No. Q'a���`�
The Buildin9 located at SSS AnY.on Aoulevacr7. 6�h Floor
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable�thereto.,
for a Group R� Occupancy. �
Use of Building nffi�a �
Legal Description 41(}-501—(kl
(See reverse side for Metes and Bounds)
Building Permit No B 38154 Electrical Permit No. E 38167 Plumbing Permit No.
Mechanical Permit No. M 38257 Number of apartments and/or�guest rooms
ISSUED TO:
SecuriCy Pacific Bank '
555 Mton Boulevard, Ste. 500
Costa F�,esa, CA 92626
Building Official Georae Ec�niston
by _�,^.� � i'� �i�'..., -�-
October 18, 1989
This'.Certificate of Occupancy SHALL BE pos[ed 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. �
CNjF 3015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bld9. Permit File �
- �
�
PH0.1ECiR0�PE5S: SSS A��TON BL ' uxiT:6 FLR
. OWNEfl'SNAME:BANK OF AMERICA
nooecss:20 N RAYMOND AV
PASADENA, CA
8?8-578-7700
RPCHIENGINEEfl: R�Y i�ERHOiD flEG.NO.:C 1 IUNIT 3
aooxcss: 2522 AQUA SANTA
PEflMITTEE:'US1IN CA 92680
aooxess:ARMSTRONG CONSTRUCi ION ( 818 ) 967-8001
929 SPRING MEADOW DR
WEST COVINA CA 91791
LICENSEO CONTHRCTOP UFCLIMTION: I �ere�y allirm Ihat I am licensea under pmvisions ol ChaO�e� 91�ommencing with Section
70�0) o� Orvision 3 0l the Business and Pmleutons CoEe. anC my license is in Iuil force and e�fecl.
c�rruc.:��Fp�� sTnreuc.:43404� c s: .�
�ate: Z Signawre:
WOBRE85' OMPENSp710N OECtAPATION: I hereby a m Ihat I �ave a cenifica�e oi cansenl ro � sure or a certificate ol Workers'
Campensation Insurance, or a cenifietl cooY ��ereof (5edion 3Bq1. Lao. C�.
^nucvxo.:pWC210778-00 E%P.DRTE:OSIOSI9�i
�mraxv:GOLDEN EAG��
J Ce�ilie copy is �ere�y fumiSAetl. � Ceni�ietl coDY �s f �. vnlh t�e city � IlOing Oivision.
Daie' � ` Z1 Apv�ican
EXEMPTIONFflOMWOPI(EBS'fAMPEN5RTI0NOEQAMTI : (ihisseclionneeGnotDecomDletedil rml¢�oronehundretl�4100�orless�.
I cetlily tna� in Ihe petlormance of Ihe work br which this permit is issuea. I stull noi employ any person in any manner so as �o become
su�jeci lo the Workers' Compensation Laws a� Calitomia.
Dale: Signalure:
NOTICE: If. a�ier making this tleclara�ion. you shoula become su61e�� �o the Workers' ComDensa�ion Dmvisions ol �he Labor
Cotle, you mus� torihwi�h compry wit� suc� pmvi5ion5 or ��is permit shall be tleemeC revokeA.
LONSTPUCTION LENOING RGENCV: I here�y affirm Ihai ��ere is a conslmciion lentling agency tor ��e pedormance o� Ille work for
wnich Ihls permil is issued (Seaion 3097. Civ. C�.
LENOEfl:
noosess:
OWNEB BUILOEP oECLAHRTION: I hereby affirm that 1 am exempt Imm t�e Comraciors' State License Law lor ihe fallowinA �eason
�Sec�ion 7031.5 Business an0 Pwiessional Coae: Any dty ol wumy whic� repuires a Oermit to consimct, alter, im0�ove, tlemolish, or
repair any slmcture, prior to its issuance. also reauires ihe appliwnt for suth permit lo file a siAneO s�atemenl �nal he/sne is licensea
Oursuam to the pmvisions al Ihe Contractors' Slale Litense Law (ChaO�er 9(commencinq wilh Section 7000) ol Division 3 oi Ihe Business
and Prolessions Cotle) or iha� �e/S�e is ezempl Illerelrom an0 ��e basis �ar Ihe allegea ecempiion. Any violalion o� $ection 7031.5 �y
any apDticant for a permil su�jecls Ihe ap0licant to a civil Oenalty ol not more Ihan live AunAreA Oollars (5500).
I, as owner of ihe pmpeny or my employees wi�n waqes as ineir sole compensa�ion, will Oo Ihe work, ana ihe
❑ simcture is not intentlee or otterea lor sale (Sec�ion 7044, Busmess ana Pmtessional Code: TAe Comractors' Slate License law
Does not apDly to an owner of a pmpeny wM Guil�s or impmves i�ereon, anG w�o Goes suc11 woAc himself/herself or t�muAh
his or her own employees, O�oviCeE t�at suc� impmvemems are noI inlenUeO or ofierea lor sale. II, however the huiltlinp or
impmvement is SoIU wilhin one year ol complelia0. I�e owner will �ave the �urtlen ol pmving �e/s�e dia noi Duila or impmve
lor Ihe vurpose ol 5ale�.
I, as owner ol Ine Dmpeny, am e*clusivety conVactinq wi1� licensed comraciors m cons�mc� �he pmlect (Section 7044, Business
❑ an0 Pmfessions Caae: The Controclors' $Iate License Law Ooes nol apply 10 an owner ot pmpeM who Ouiltls or impmve5 lhere0n
antl w�o coniracis tor suc� prole«s vfi� a coniracmqs�license Oursuam lo the Contraclors' State License Law�. I am aware
I�al pmol ol �Aeir Warker'S Compensation insurance 5�au10 be Drouldetl to me.
� I am exempt under Setlion: B. 8 P. C.
for �nis reason'.
�ate: Owner:
I Oo �ereby cendy Ihat I am aware ol ana unAerslana Ine reQuiremems ol Cali�omia Healt� and Salery Code Sec�ions 25505. 25533, antl
2553d antl Ihat I or anylulure �uiltling occupaniwilllvnll noi �circle one) neetlto comply vrith SaiA s�a�e cotles and Ihe repuiremenis�ora
permi� lor cans�mction or modilicatian Imm �he Pir OuaOry ManaAemenl DiSlnci. Resitlenlial can5iru[Iion apDlications are eKempt Imm
ihese D�ovisions. �
Daie'. NO�IicanC
I nereby certitythal I have reaatnis apolication and state inat Ihe aboveinlormalionis fArrect. lagreeto compiy with all city and counly
ortlinancesantlstatelawsrelalingto�uilQingconstmdionandhere�y ulhorrzer �senta veso�l�iscityioenieruponlheabove-men�ionea
pi0p¢py�r specii n purp05¢5.
�aie: Z Signa�ure:
i �river's License or Social Securiry n'
t6eLa6 WM1ne—Bwlding; Green—Cotle Eniorcemem; Canary—ApplicanC Pink—Revenue; Goltlenratl—Assesmr
CIiY O� COSTA :�!ESA — BJI,',D:NG PERMiT P�RN VU: & 06i8�3
rERMIT NO: B 06?893 PLAN C?IECR NO: 01386-93 L GOVT: N SliPP: N
CONSTRUCTION TYPE: I FR ?ERN,T_T TYPE: STR PURPOSE; AL:
JOB DESCRiP?�ON : JYGRA�E EXZSTING PILE STORAGE AREA SQ FT: 30,000
CLAIM VAi,UE: 30,000.00 CALC—VALUE; 30,000.00 GROliP OCC: B-2 /
CON,M?NTS; INSTA�L 2 HR WAL�S AROUND EXiSTING FILE STORAGE AREA
1E jk+' 1E iE iE iE iF+f iE iE iE 1E?f i(� 1E aE if iF ib 3E iF 1E iF if # if if ?f i(� iE iE ie )f # ie if 3f if if iF iE tF?E iE if iE #�lE # iE �1F #�7E 3f # iE # iF jE iE# iE # iE-lE?f ## iE # iE 9E � u it ! ie u
Z O N I N G R � Q U I R E M E N T S
stTaAcxs
------------ Mr1�N BUiLDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT _N RHAR: c^T IN FRNT: FT Ii� REAR: FT IIC
L`Y1: YT IN RGHT; FT IN LEFT: FT IN RGHT: FT :N
PARKING REO• PROV: PARCEL; 41050109 'LNE• PDC REF NO:
PLANNI�G N6?'ES> _NTERSOR ALTERA?ION TO ADD A FIRE RATED WALL AROUND AN
> �N'rr�SOR STORAGE AREA.
x��+�******+�**±�**�*�***�*��#*#�r***�#+�*******�c*x�x*x#*u��+r#*+�#�#+�#���x*�#����.�����*�
D E C' E L O P M E N T S E R V_ C E 5 R E Q li I R E H E N T S
ZONiNG APPROC'ED BY :�' C— DATE; 2 3
BUILDING APPROVEU HY : DATE: �.L- --S
APPLICATiON ISSUED EY: L1.,L_ .� G�-t.yGL..—. DATE; 2
if'Y.�#if'1EjEifjFfflfiEiEdEdf#iEif#*iE'1Edf3P�*Ri�RRt.h' 1YtYthl�Yt-.R1fMnR�if��F;l';t�iki�ici["1FiI�iEiFlfiF?F#if£t1tAiY��ifiE
iE if iE if lElF if !F iE if if !f 1E } iE # 1F iE 1E �1E iE ## iF iE?E # i! 1FlF iE iFiEif jE iE+E 3E?E �E lE if # i���)f if fF 3E �lE 3h if iE iE iE *# i! # M## if iE ik # if ## ih # iE iF %� # iE it f:
LEGALIZATION:N F E E S J M M A R Y STRUCiURAL SEGN.ENT:Y
3LDG PMT PLUMBZNG ELECTRIG' MEG�IANIC FIRE SMIP/RcS GRAD;NG
DERMIT 284. 50 ,., �. •
� h r% SMIP/NON—RES
PLAN 184.93 ,� :��� . � 6.30
ISSUE F'EE � "
HUILDSNG—DIV—> PERMIT I55UE PLAN;CtiECH.� TOTAL PAID DUE
TOTALS----> 290,80 0,00 c•�89.93 .975.73 47�.73 .DO
REVENUE DIVZSiON TOTALS--> COLHECTED': �:29b:80 OVER/SHORT: .00
BLDG PMT PiUMBiNG ELECTR�C MECHANI-r •'•FIRE ,SMIP/TOT GRADiNG PLAN—CHECK
284. 50 . ;� ,., ' 6. 30
���*****f���;��r��r�*+c**��*#*#ce*#*#�**�x�"���*x**+���*#*#*#x#�r#�+��r*##*x�*x�#�#x�c����!*�
: N D I V I D li A L�.,-F,E E%H R E A R D O W N
TYPE QTY D E S C R I P T I U'N� •� � UNIT COST TOTAL COST
� .
SFC 30000 AL?ER BY VAL'JE CONMERC3Ai �°�10'ZQN� 1.00 30,000.00
ENI3� OF; fEES � '•
. �' � `�..
l�
. j-
EXPIRED ,,, `� ! -
� te�pections
' —..S.G1�.— ,
_� �i� � '
!✓
��'�' 01 D013747&-00137979 TR7 T 290.E4
DATE: 04J27/93 TItIE: 10�54
i
� CO\STRUCTION AND PIAfVNWG
� APPROVAIS Permit �- Date
1, Temporary Electncal Service o� Pole
�
� 2. Soil Pipe Undrgmd. � �
�3. Eiectrlwl Condult Uhhty�Urtdrgrrd. �
��t PIeC�ital Condwt•Undrq�nd.
. $t:a'� Hel��torW^1E�I __--
( 6. E:scv,c:'I.FERG•�d. .
7. Fooungs
8. Fo�ntldtion
�-- ---
I 9. V�atcr Pipe-Undrgrnd.
� 10. Sbuctura! Fluor SVstem �
, 7 t. Froperly Sev�er Line & Ho��c�: Connectinn
r-�--
I� 1?. Sz:;er C,&p
� 7�. Fiouf Drains �
tr. Fouq��, Pl�mb�.ng
�; --
� 7 Rc�3h Ete�tr�cai.Cond��.c
: lf�. Rough Electric\'Jirin3
1-.-___
� 17. Rouqn lV�.nng S�gn
� tE. Rouoh Eiectrica!-T 82r Ceil,ng
79 Rou�h Heat�ng & Air Cor.QiLoning
20, Ro�..�h Fatto•v P!repl:,ce
21, Oucts, in 5tructure
22. Ducts, Vantildttng �
_ t-
23. G�s'�po�Rough & l"c':
74. R �,,F Fram�ng
25 Fa•,' ihea;ning
26. T-E �r Crlmg (S:rutt��all R• : �nnCwe;
27. F :. �c ncd Fiushin�--- - --�
28. lat���cg � $�d'n�
%9. '��sulaLan __
�0. D�✓r.al! P(.nLrc
31. P�3ste� Qro::•�. C.�at
� ---- - - - - -- � ---
39 Electnc�� Poc.er i�ete�.F�na!--- -_�
33. Fir„I El;�ctr�c �
C34. Fin.,l iir.it.n � & /♦ir Cond��tionin� �
t--•- - -�--
35. Fi�:ia�, G.,: P�pe�Test
3fi. Hocc or Canopy
37. F nal FactorV F�replace
3$. Final Piumb�ng
39. `�.4ater Servica-Final
40. Gas Serv�ce-F�nal
41. Solar pomest!c-F��al '
42. Backflow Preventer
43. Hatkflow IrrgaU�n
4n. Landscane Irriqation System
45 Sound Attenuation
46. Handiwp Reguiations
47. FINA� S7RUCTURE & BUILDING
48. F;�;AL?LANNING
Q9. Electnc Release to Edison
50. Gas Reic�se [o Southern Cabforma Gas
51. CEFiT�FICATE OF OCCUPANCY
Date
i Pl & SPA
Inspector AppqOVALS Permit,$
52, Pool & Equipment Locat:on
53. Stoel Reinforcement
54, Forms
55. Electrical Bonding
__ 56. Rough Plumbing & Pressure Tast
57. APPFOVA� TO COVER�GUt�ITE
58. Electrical Condurt�Undrgmd.
_ 59. Gas P�pe, C7 Undrgrnd., Teit
I 60. Backwash Lines, P�Trap, l� Und�an d.
� 67. APPROVAL TO DECK
G2. Backviash & Receptor-Final
63. Heatcr & Vent�Final
64. Plumbing System - Final _
_ 65.,Eluctrical•Final
=` 66. Salar System�Finai
) 67. Fencmg & Access ApP�oval
_/ 68�. APPROVED PQR PLASTERI";G
�
69. POOL,�SPASYSTEMSFINA�
FIRE DEPT. R£QUIREAAENI"
APPROVALS Permit�
70. Underground Nydro
�� 71. Product Pipiny U Gas ❑ Od
^� 72. Under�round Flusii
_ 73. Undergrnd.. Storayc Tank C: Gos � J,.
Date � Inspector
14 Ovcrnead Hvdro �' -. ---- I--- l,
---- -� -- ---- ---�' - - -;
--- I i5. fJryCucmicai ------- -�t---__
� 76. �ry Star,dpiPe --� -- - � I -' � ;
_ i. _ J. --_- :'-i
--- -� i�XED SYSTEM FI':AL � _�_ __��;
-----'�-- - -- - -
• � 78. FIRE PREV. FINA� '
-. -- ' - -1-- - - --L-- - "�
•�� ' HFqLTH DEPT. REQUIft[ :M1E�;T �
� �INAL INSPECTIqN - - - ---- ' -- �- -�' 1 - ��--
-,-�-+-- ------ - --- - -t -�!
' � ' I 8�� FOODCERTIFICATPIStiUED L % '
-'--;--1----� i-� --- ----1--1- /�--"
�; Notes:/�•� /;•s L_ zdr. F��� ` o�-
Fd
/�/j-O ✓ l Q.L_ /�iN[ �I-'t �c.` � d�!'v� l
-i
Fr� o.r»i�n�- / Y�9'� -- - -
-�-- --- l -- - - - -- -�
-- ^-^----�---'--- '- -�-- --'
• I //.¢rY�.�
Ue
./; .,•�--
/�_ __'_'"_' ....__._
� �it�p o f �o�ta 21�Je5a �
Development Services, Division of Building and Safety
CERTIFICATE AF �CCUPANCY
This cerrificate is issued pursuant to the requirements of the Uniform Building Code, Secrion 308
adopted by the City of Costa Mesa certifies that at the ume of its issuance the building structure herein
below described was inspected and approved for occupancy as follows:
Building Address
Use
ANTON BLDD. FI.00RS 1-12
Bldg. P2r[iut N0.#Bee belw
Group B-Z Type of.Construction i-Fa Fire Zone Use Zone PnC
Owner of Building Saki oka Farms Tenant "+nv -ar."
•874570, B7S356, 874572, H74571, Bi45?3, 874633 �
B74632, B74631, B74630, � 666, B77866, 574574 BY �
�����������a November i4, 1996
Date
P.Y!.'K Bk0'wJk, CL�O
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
,
�i
1l
Il
PN0.IECTRODNESS: ���lP.NTON BL uxrt: 6TH
OWNEfl'SN�MF: SECURISY FACZFIC NATIONAL
�OONESS: SA,,�iE
957-1439
excxiexcixeex: INTERNZ DESIGN aea.xo.:COf1
RODflESE: S PAFK PLAZA �"R' 750
PEflMITTEF: IRVINE CA 92719
►ooeess: ZNNER SPACE ( 213 ) 7%i—"/126
50�2 CECELIA
SOUTH GATE CA 90280
LICENSEO CONTMCTOB OECUMTIDN: I hereby affirm ttut I am licensetl unAer pmvisions of ChaD�er 9(commencinp vnth Sectian
7000) oi Uivision 3 ot Ne Business anA Prolessions CoOe. anA my licensa is in lull lorce an0 flea.
cin uc.: U 3 219 4 STA7E IIC.: 0 p 'cuss: g
�are: _7_I+1p-46 /SiAnaWre: �pF`�� �� � l
WORKEIIS' COMPFN&1TION OELUMTION: I hereDy allirm that I have a certilicate al wnsent to selFinsu2 or a cetlitiwte al Workers'
Compensatmn Insurznce. or a ceNlieO wpY ��ereot (SecUon 3800, Lah. C�.
roucrxo.:�0392813 �Po�h� 12/O1/99
�ornr�Nr: GREAT AMERICAN •
� CeNt1eE wpy is hereCy tumiStieG. [� CertilieO capy is Ii1etl witn Ure dry BuilEinO/1y��sim.
Date: �— G.�e � 7 d � ppp6ant: ��G��ere[�"'-=-7
IXEMPfION FNOM WONNERS' COMPENS1710N OEWIRATON: (Ilns seefun neeO not Oa compkteE il ihe pemtit a fa ane AuntlrtC �5100) a less�.
I ceNiy tha� in the pedarmance oi t�e wark for which t�is De��� ��uu d, I shall nol emD�oy y person in any manner so u to become
5u0ject ta the Warkers' Compenutian Laws at Catifomu. �
Oate: � SiAnature: �
NOTICE: II, after makinp thi5 EecWatian, you shoulU bewma suEjacl to the Workers' ComDensation prwisions ol Ihe Labor
CoEe, yau must IortAwit� camDN ��h sucA DraNsions ar I�is permn shall Ee OeemeU rewke0.
CONSTBIICTION LENDINO �OENCY: I �ereEy attirm dAat Nere Is e conslmction landinp apency tor the petlormanca of t�e work lor
w�ich this Dermit is iuued (SecGon 3097, Civ. C). _
tfNOEfl:
�oox¢ss:
Hi m tha I am x m t Ir m Ihe Contractors' S[ate License Law for ihe fallowin reasan
OWNER BOIIDEP DFCWUTION: I Aereby a r t e e D o 0
(Sectlon 7031.5 Business anE Prolessbnal Cotle: My dry of wunry wNc� repulres a permit ro construcl, alter, improve, OertqtiSL, ar
rtpair am/ sWctura, priar to tts iswance, alw repuires �he apDlicant tor wch permR ro We a sqne0 sWtemem [hat �dshe is IlcensM
pursuant lo the D�ovisians ol t�e Contacrors' State Licenu Law (ChaD�er 9lcommencin0 ��� �ion 7000) ol Oivivon 3 oi iha Business
aM Protessions COCe) or ttut MJshe is e.empt Ne2from anL t�e �asis for Ihe ylepe0 exempnon. My violauon of Sectbn 7031.5 by
arry applkam far a permit whjects Ne appticant W a dn1 penalry of not moa tlun Me AunEreO Eonars (f500�.
I, as owner of t�e DmDerty or my employees wil� wapu u t�eir sola wmce�uon, will do Ne work, anE Ihe
� structure is not inttnEeO or otleretl tar sale (SeCWn 7011, Bumess aiM Prolarional Cade: Tne Canractors' Staro Licensa Law
�Coes not apDN �o an owner o/ a propeM �o UmIUs or imprwes tAereon. anE who tlou suc� vrork �imsett/�ersell or tAmuph
Ais or her awn employees, OroviOetl tAat such improvamenis are not IntenAeE or otlereA lor sale. 11, however Iha DuIlElnp or
improvementis salE wrthin ona year oi comD�etion, Ne owner willtwvat�a Ourden oi D��np he/she EiE not EuiIE orimprove
for Ne purpose of sale�.
� I, as awnar af tha Dmpe�ty, am exclusively contmctinp wll� IlcaneeE comrectors ro canswct Ihe Dmject (Section 70Cd, Business
LJ anE Pmlessions CoOe: Tha Contractars' State License Law does not appy to an owner oi OropeM'�o CUJds or Improves t�ereon
and who conirac�s lor such projecis wilh a contractoqs�license Dursuanito Ihe Contactors' State L¢enu Law�.l am axare
ihat prool of IAair Worker's Compensation insurance shoula be D�oW0e0 to me.
� I am exempt unEer Seceion: B. 8 P. C.
lor Ihis reawn:
Dare: Owner.
I Oo �¢re6y certiry t�at I am aware ot an0 w4erstan0 t�e requiremenis ot Califomia HealtA anE Safery COEe Sections 25505, 25533. anU
25531 arb that I or any future builtlinp occupant vnlVwill not (drGe one) neetl to comOh ��� � state wCu and Ne repui2ments for a
permil for cwSVuctqn or moEifwGon Irom Ihe Air Uudlity Manapemem UiStrkM. NeSiEential conswctlon appliwGms are exempt Irom
tAeu provisions.
Da�e: MWicanL
I hereby cehity that I Aave aaOlhis appliwtion antl state that Ihe a0ove inlormation is coract I aqree ta compty with all ciry anA counry
arOinanca ard state laws rtlaWq to 6uiWinp constructlon anE hereby �trs representatives tl¢c dry ro enhr upan the aEme�mmtione0
prOpeM �orinspectim Durposes.
oace: �� z� � 9��Sipnawre:
onver's Licensa or Saial Securiry x:
tBabCe W�ite—BuilEinp; Oreen—Cotle Entorcemani; Cenary—Applicem; Pink—Revenue; GOIEenroO—Asseasor '
rITY OF COSTA MESA — BUILDING PERMIT PERM NO: B Q4829J
PERMIT NO: $ 048293 PLAN CHECK NO: 0938i-90 S GOVT: N SUP?: N
CONSTRUCTZON TYPE: I—FR PERi�IIT TYPE: 5TR PURPO(SE: P_LT
JOB DESCRIPTION : T.I. 2660SF FROM OFFICE TO LOADING FILES SQ FT: 2,V,i60
CLAIM VALUE; 60,000.00 CALC—VALUE; 43,2C0.52 GROUP OCC: B-2 /
COMMENTS; .
*��***x��*��+�*�t�itr���rrt�t�t��+��t�*�***�***�*x�r.��c��t*��r*+�**i��t�t�'��x�*�-*****��x-�t�*+�**x��-�***?�*i�+a
2 O N Z N G Ft E Q U Z R E M E N T S
5 E T B A C IC S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT I23 REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT;. FT IN RGHT: FT IN
PARKING AEQ; PROV: PARCEL: 41050104 ZNE: PDC REF NO:
F'LANNING NOTES> INTERIOR ALTERATIONS ONLY y
> i^:.
if i! if if ik # dF ii iE iE iE f. iE?E if �t tE if iF 1E?t # if ±!�'.E'.k iE±f iF iE t iE if 1E 15 i'?E!E if 1t if'k if if # if� jE?E 1f # if iE ik iE iE # 9E if :E ik # it 1t iE #�If 1t iE-i'35'.i' iE # iE ik if if iE?F
D E V E L O P M E N T S E R V Z C E S R E Q 0 Z R E M E N v.S
ZONING APPROVED bY �P�' DATE: �— Z�o—�v
�•,
HUILDING APPROVED BY : DATE; J'�Y_
APPLICATION ISSUED BY: �LG� �I� DATE: �'�—T.�—�O
itit�fEfEiEffi(�i'?Eif?E±!iE�EffiFjtiFlEjEl4ik . it .i�iF;F�:�i�it-L�iflEiE#ifiE#fE#�'M1�E�?F�{�iFif#
�,x��*�t���t�t**x�#�tx-�itx�t�*����c-��-�t�r�-�-�t*�x*�±c�+r���r�*�t�t-*�it���t�-��t��itit*�t+�*�r*3r*�t .ayi��y**�?t*�c�**
LEGALIZATION:N F E E S• U N, M A A?Y STRUCTURAL jSEGMEtdT:Y
BLDC PMT PLUMBZNG ELECTRS� MECH�NFC FIRE SMIP/RES�, GRADING
PERMIT 375.50 '
, { ; 5@"ZP/NON—RES
PLAN 244.08 •`" 'l 6.42
.. p _
�
ISSUE FEE
BUILDIidG—DZV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 381.92 0,00 �.299.08 G25.00 62G.00 .00
/ '
REVENUE DIVISION TOTALS--> COI;I,"ECT,EU: 381.92 O��ER/SHORT: 00
BLDG PMT PLUh1BING ELECTF.IC MECHA�IIC FIR�E SMIP/TOT GRADING PLAN—CHECIC
375.50 � 6.92
<' /!
if iE k iE if iE iE iE dE ik iE iE if iF if # iE i6 if jE'�(-if iE if if iE 3F 3F jE jE iF iE 3E?f !f ?F iP iE jf iE iP iE iE iE iE iE iE iF-)f dE iF iE 3E 9E?f jk iE # 3( iF iFif iFlf iE iE iE 9t iF # 9F if ?(� iE jF iE iF # G
I N D I V 2 D U A I,,� - fj�' E E B Lt E A K U O W N
i
TYPE QTY D E S C R I P T I O� �i:� ' � UNIT COST TOTAL COST
SFC 2660 OFF—INT, ALTER TYPE:Z,II F.R. -AV.ER 16.08 42,772.i�0
� E�NUiOF FEES -" t �
. , �
�
r,' . ,
1' +
i �
cl Oi,Gc_;t`-C'�:,ha''<t T�=�'( :'eJ.?:
C,�TE: L�;,';;6,4f: TI�;E, r��:+4
CONSTRUCTION ANDPLANNING P 'A
APPROVALS Permit# pate Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service qr.Pole ; 52. Pool & Equipment Location � '
2. Soil Pipe•Undrgrnd. . � 53. S[eel fleinforcement '
�
3. Electrical Conduit UtilitY-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd.� � 55. Electrical Bonding •
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test '-
6. Electriwl UFER Grnd. 57. APPROVA� TO COVER�GUNITE
7. Footings , 58. Electrical Conduit-Undrgrnd. . �;
8. Foundation f • 59. Gas Pipe, O Undrgrnd., Test �},
i.
9. Water Pipe-Undrgrnd. !:�. �' 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System -�� '� ���' 61. APPROVALTO 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 � -
74. Rough Plumbing . ' 65. Electrical-Final ��l
15. Rough Electrical-Conduit � 66. Solar SYstem-Final
16. Rough Elettric Wiring 67. Fencing & Access ApP�oval
77. flough Wiring Sign 68. G,PPROVED FOR PLASTERING
18. Rough Electrical-T Bar Geiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT •
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. �athing & 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: N,
34. Final Heating & Air Conditioning L6���
1��� �
35. Final Gas Pipe�Test •
36. Hood or Canopy • •
37. Final Factory Fireplace �- �
38. Final Plumbing , r � �
39. Water Service�Final � �
40. Gas Service�Final .
41. Solar pomesticFinal ,
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
:^
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �� q� i
48. PINALPLANNING -, � •
49. Electric Felease to Edison .�
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECTRODHESB: � 555 ANTON BL uxir: 6TH
� owxea�sx�Me: SECURITY PACIFIC NATIONAL
RODHESS: $�$
957-1489
necxrtNcineea: INTERNI DESIGN xeo.no.:C00
` �RDONE83: S PARK PLAZA uxiT:750
IRVINE CA 92714
PEpMimE: HUTCHISON CORP ( 213 ) 763-7991
, �ooeess: 2250 S CENTRAL AV
RANCHO DOMINGEZ CA 90220
110ENSEO CONTMCTUB DECUMTION: I here�y attirm ihat I am licen5ed unEer pmvisions ot Chapter 9(wmmencinp wit� Section
70W) a� Division 3 of tAe Business an0 Professions Catle, anO my license is in lull lorce and ettec[. '
cinuc.:032�r787 sTaTeuc.:269512�cuss �
Oate: 7�Td �' �U SiqnaNre: � � ���
WOBNEBS' COMPENSRTION OEIXAMTION: I �ereby affirm at I have a ceNficate af consent m setl-insum or a certi/icate af Warkers'
ComDensa[ion �n�j 2nc � eA�Q py th¢reof (Sectlon 3800, La�. )
UCYNO.: ^�P�����`V IXP.ORTE: �IOl I99 ,
�aMraxr: GREAT AMERICAN
Certlfie0 copy is heraby fumisheC. � Certifie0 copy i51i1e0 wit� ihe ciry B'' Division. �'` �. �%
i L%y�� y i�
oate: 7 -� 3 O � �� pppliwnt �� % —G� %/
IXEMPf10N FIIOM V/OflNEH3' COMPENS/�TION OECUHIITION: (f0is seGtian nttC not be mmpl¢[¢E it ihe pormil i51or one hun0 (5100) ar lea�.
I certiry thai in tAe pertormance oi tAe xrork for w�ic� [his permit is iuueE, I sAall nq{rrtploy any person in any manner m u to becama
suGiect ro the WaMers' Comoenution �aws at Califomia. i� //Q ,., i i,
NOTICE: I/, atter maltinA �his tleclaration, yau s�oultl become SuEjed ro tAe Workers' Compensatlon D�sions ai t�e labor
Code, you must torthwith campry wi[� such pmNsions or this permit stutl he AeemeA rewke0.
CONSTHUCTION LENOING �GENCY: I AereUy atlirm that ihere is a constmction lendinp apency for the petlormance of t�e woM tor
whic� this permitis issuetl (Section 3097, Civ. C�.
LFNOFR:
�ooxess:
OWNEN BIIRDER OECIAMTION: I Aerehy affirm tAat I am exempt irom t�e Coniractors' State License Law lor Iha lollovnnp reason
(Sectbn 7037.5 8usine55 anE Professional CoOe: My dry ol counry xTich repuires a permit to constrvct, alter, imDrme, Demolish, or
repair any simcture, O�or to its issuance, aiso aquires t�e apDlicant lar such permit ro file a siAnetl sWtement tMt Ae/s�e is IicenuC
pursuant to tAe pmvisions of the Conir�ctors' S[ate Licenu Ww (C�aD�er 9(commenpn0 witA Sectlon 70W) of Oivision 3 at ttre Business
anG Pmhssions CoUe) or t�at he/she is exemD< <heretmm an0 t�e bazis tor ihe alleAeJ exemption. My Nolation oi Section 7031.5 Ey
any applicam lor a Dermit su0jects me applicant lo a dvll penalry oi nat more than frve AundreA OWlars (5500�.
I, as owner oi ihe DmDertY or my employees wit� wayes az t�eir mle campensation, wiil Oo the wad, anO ihe
�structum a notintenJetl oroiferetlforule(SeClron 7074. Bus�ness anE VmlessionalCaOe: The Cantactors'State Licensa Law
� tloes not apDly ro an owner al a OmDerty who builtls or imD�oves tAereon, an0 wAo Eoes such woM himselt/�erseli or thmu0h
Ns or Aer ovm emDloyees, proviUe� that suc� improvemenGs are wt intended w otlereA for sale. Ii. haxever the EuiWinp ar
improvement is wIU vnihin one year at camDletion, [he ov.mer will �ave I�e DurOen ol pravinp Ae/she diE not huilU or improve
lor Ue purpose oi ule).
I, az owner of the pmDerty, am ezclusively contractlnp wit� IicenseG contracrors m canstmct Ue prolect (Sectian 704a, Busineu
❑ and ProlesUms CaOe: The Contactors' Sute Liceme Law does rqt apvN ro an owmr ol propeM wM EuJEs or impmres ticerean
ana who conirac[s lor suc� Drolec(s tit� a contractor(s) license pursuant to IAe Comractors' State License law). I am aware
WI D��f ot I�eir Walkef's CAmpenrlian insurdnCe SAould Oe proviGeC Io me. '
� I am exemDt untler Section: B. 8 P. C.
for mis aazon:
�ate: Owner:
I Oo heaEy certiry ihat I am aware of anG unEerstanE the repuiremenis of Glitamu Health anE Sahry COJe SecGau 25505, 25533, an0
25534 anG tAat I or any tuture OuilOinp occupant wilUvrill not (circle one) neeU m compty xitA uiE state coEes anE tAa repuimments lor a
permtt iw canstruction or mo0i�wtion Imm Ne Air �ualiry Manapertrent OisUict NesiOential cwutructlon appticatlons are eMempt Irom
t�ese pmvisians.
Date: ApDlicam:
1 hereby ceroy tlwt I tim rea0 this applicafion an0 sfate thai ��e above inlormaGon is correcL I apree ro compty wit� atl dry and counry
orAinances an0 state Wws reWtinp ta �uilAing cansWcibn an0 Oe reD o� �bs citY lo enter upon Na mentione0
pmceMtorinspec�on purposes. f,� ��
o��e: �' 3 ° — l0 so�c��. /!/L
omer: u«�u o� saw sa��ry « �
v.aba�: Whi�e-6ulNino: Green—COEe Enbrcemenc Cenerv—AoolicanC Pink—Revenue: GdtlenroE—htsaseot
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 048344
PERMIT NO: E 098344 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: I-FR P£RMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION : T.I. 2660SF FROM OFFICE TO LOADZNG FILES SQ FT;
CLAIM VALUE: CALC-VALUE: GROUP OCC: H-2 /
COMMENTS: RE: H48293 PRIMARY BLDG. PERMIT.
**x�+r�+r��r*����*�*r*�������**r�*�**���r+r*�r+r*�x�r���*�******x*�***�**��*****���***'*
2 O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE; REF NO:
PLANNING Ni5'1'ES>
> -
it ik if if ik if iF jf af 7k ik iF it it if if ik ik �k 3F �t ik ik ik k 1! N 1E if �f 1t ik if iF it iF It iF k if M iE if 1E ik iF ik if it k iE±t ik ik iF k M iF if if iF 1E it it iF ik ik iE K%it iE k iF if M iF M if
D E V E L O P M E N T S EiR V I C E S R E Q U I R E M E N T S
i.
20NING APPROVED BY , _ _ DATE;
BUILDING APPROVED BY ,:
DATE:
',1
APPLICATION ISSUED BY: . v DATE:��S��d�
��r*x*****�*���r*�r+r+r�+r�� *�r�r��r+r�r*r �r�r
lkikiliF*iFiFiFifftlFiF�FiFiFihiFifkiFikiflkifiFiFMffiFjfMihiFilikiFiFififk iFiE ikikMikfklkitlliElfk%iE1FltiFitlFMiFiF3klkKlFiFiFikilitiFiFiF
LEGALIZATION:N �F E�E ! S U;M M A.R Y , STRUCTURAL SEGMENTiN
4
BLDG PMT PLUMHING ELECTRIC ,;.MECHANIC E�IRE SMIP/RES GRADING
PERMIT 26.25 '; ��, _� ' •
�SOY�yr ; .:� SMIP/NON-RES
PLAN '
. :. .�. �' 1
ISSUE FEE 15.0.0 ,.'"'' ' �
HUILDING-DIV-> PERMIT ISSUE PLANrCHECK� �', TOTAL PAID DUE
TOTALS----> 26.25 15,00 ' ,0.00'.,i, 41.25 41.25 00
REVENCiE DIVISION TOTALS--> COLLECTED; �� 41.25 OVER/SHORT: 00 (1
HLDG PMT PLUMBING ELECTRIC MECHANIC j.�FIRE SMIP/TOT GRADING PLAN-CHECK�._�
�ii.zs o , ,/ ., _
�ifiFifihMitkiFitiFiFiFfkiFiFikikihikikatilkikikMikklfkikilikikikitlFikfkflMlfikifikikitititiFkMkMitiFikkMMlkiFitiFltifMiEMiFiFlFflilfFiFMfkiE
I N D I V I D U A L� 'F�E E` `'.B R E A K D O W N
� � � i
TYPE QTY D E S C R I P T I O.�N ,_ ,,; � UNIT COST TOTAL COST
i i.
ELE 10 FIXTURES LIGHTING';;; -1- ST 2Q- EA, .75 7.50
ELE 23 RECEPT/O{TTLET 1 ST 20 EA. .75 17.25
ELE 2 RECEPT/SWITCH '� 1'SST -20 EA. '�.75 1.50
END,OF FEES
%' !'� ��
. ' _ �� : , ,
. �J, .
,/' " :
/ ' ' /�~
. �. �. •
� ,��; � OI OOOb634b-90De639G 7 n �
• �ATE: 07/3D/40 T?ME: 13:39
�1.1:�
CONSTRUCTION AND PLANNIN � P - SPA
i Date 'Inspector � � Date Inspector
APPROVALS Permit # , , - APPROVALS Permit # �
.
� 7. Temporary Electrical Service or Pole.q ' ''� � 52. Pool & Equipment Location
n:r L/
-2;,;Soil Pipe,-Undrgrnd_� ;_ : �;y `�� 53. Steel Reinforcement �
'-:3`Electrical ConduirUtility Undrgrnd� � 54. Forms
v�� ... � c--'n-- � � �.,,
- 4. Electricaf Conduit-Ondrgmd: _ / 55. Electrical Bonding _
>-5. Steel Reinforc¢inent �'< ' � 56. Rough Plumbing & Pressure Test
:r �;
;�;6. Electrical'UFER;_Gcnd. ` :-� 57. APPROVALTOCOVER�GUNITE
�.7, Footings)7 - � 58. Electrical Conduit-Undrgrnd. � --
i8. Foundati � �'�`'' . �� �� 59. Gas Pipe, O Undr9rnd., Test �-
�9. Water Pipe-Undrgrnd. � i� i 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Floor System' '� � � 61. APPROVAL TO DECK /�
1_1,. Property Sewer Line & House Connection � �•' 62. Backwash & ReceptorFinal ��
� i. i �' .
12. Sewer Cap '. � �='.,'„ ;J �;' � 63. Heater & Vent�Final � '
s �
13. Roof Drains-_ „ -2 � ��� 64. Plumbing SYstem • Final
14. Rough Plumbing - ' 65. Electrical-Final
75. Rough Electrical•Conduit : , 66. Solar SYstem-Final "
16. Rough Electric,Wiring , � i 67. Fencing & Access ApP�oval
_�17. Rough Wi[ing Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling � 69. POOI/SPA SYSTEMS FINAL
79._Ro�gh Heating &;Air Conditioning ,., ;*.� � �FIRE_DEP_T. REQUIFEMEN,T, �,_ -
. - .i ,.. ~ . . � _ _ _, .:.. _: J J bi * A �-; 7
20="Rough �Fecro'ry Fiieplace , 5;; c,� . - �� n ;APPROVA�LS � .. Pecmit # - - -
.., �. . - d
21:-DuCIs, in Structu�e�' " " "' � - � "� �` '70. Under round H �dro ��, "
e- �� � :.. � i �: N 1�: - 9 Y
22r;Dutis, Ventilet�ng�, "--' i," �,i -`,# �^77, Product�.Piping OGas O'Oil
23. GarPipe=Rough & Test �"S X''`� � ��: * j72. Undergrou,ntl Flu'sli "
24;'Roof F�a'min [: � . • -. ..h: .-, � •
9 •• i� c�• �a r� ��: +� �73.:Undergrnd. Storage_Tank�O Gas. � Oil�
25;_Roof Sheathing y �; � � � 1''. � :? ✓� �; 7q,+Overhead Hydrdrr ..
T J -� � " � U � � l� �.- �. ♦ i^ �� . � � �
26:_,T-6ar Celling (5tructurall &�Mortocoat c" ,. �:� . 75-Dry Chemical y-
27sprame and FlaShing �M ; � A '.^ ,'?k �; 76. Dry Standpipe i; � ,. � _
F- " �� r.. -: -'-r. � .% ,• � .. ..x �: ^ �1: -•�. ._ ...
��28. Laching & SidingS� C�c, r, � � re .r. 77i7 FIXED SYSTEM.FINALw �- !' t*i.- �
29. Insulation �,;; _ �' �: c � � l� �" 7g;:,FIRE PREV. FINAL ;� ' _ ?
� y ,. . � : ,, �� .c t-. -; x .. � ,'- -
30. Drywall=Nailing j;a� �i . �, I !1 •�y; ;, r HEALTH�D,EPTi�. REQUIREMENT
731. Plaster Btown Coar =� � i � �r�'� *"7g,+FINAL IN�S�ECTI6N� �. y
� -
-'32'_,Elecviea! Power,Met��-Final " ti � � .�i �: ' :�;FOOD CER FfGATE ISSUED.
:.33�Final Eiectrir _ ' � ' � 6'g �� ""` otes _ a � - -' '�
:34�Final Heating&'Aii Coriditioning• �; � ' � [� �` ` _ - " -'
, I i
�35^FinaIGaSPi�pe�TesC (J✓ � y'"� �� �Y � .. � _ - - -� a -, �0��- -
`�36._Hoaii or�CanoPY .` .,�' . '" � �i �•'`k � .' ' - - � -
:J �... . c V :' �!7 r .. � , /���'.` .?' ;, n
�-37.��Final Factory Pireplace: ' '-�E-F v * � � ; °� `,^�y '
�," r
- : � r n: II .'.3� / J���Ca��"_ _
n
'�38. FinalPlumbing ��N � � ! i �.�, =' i '
� .
� 39. Water Service�Final, �; :� x � i �'x � N � - � y D;r1r9
.. x m. Qn:C
;�40. Gas Service�Final , '� ��" u' �''- '. "� '
7(. � i 's- � • '..S :'$
_41.. Solar pomestirFinal'" �• �r �: - L.
✓
42^BackflowPrevente;' '�1� '' �* ���� ' - "
` 4 J � J I I--� H y ,_ \ A t� � . i-�
43. Backflow Irrigation r� � ;..: Y� - �3 • • •
;44.., Landscape liiiaation Systemj�C� � ' � `'7 � ; f: " # ' '' �'I '!
S r t x� r-..
`457Sound ,Attenu2tion J-`•` ' i � :7 :�7 �-t � � :^ Q T _ ,.
.rr- ,.
��46.•HandicapRegulations ^ - � , - " � ^ '�'" -� ?�
� � 1 � i 7` X a .a ,� f
-:,47:'FINAL STRUCTURE & BUI�LDING e e- � % .< ' � "i f �
' - w r' i r i. �l
48TFINQ,LPLANNING `"F' `' ' ��� ` ' ' `
/:a :t � i . r <
;,49"..Ele'c[ric Release to Edison ! '�``, y �, . ,.- � -�
ce� r
J'-
�50?-Gas=Release to Southem Califorriia Gas Co -� • A ; ^ � ` � ;r � " . .
451. CER�TIFICATE OF OCCUPANCY " - - "- '
No. Date
{ ciTv oF cosrq
Project A�dress
Applicant's Mai`l�g
Owner's Name.� C
Address ��
, Arch/Eng.
Aop���ant ta lill in all s0aces exeept lhose within heavy borGer lines anE sign all appropriate Geelaratlons.
ON PERMIT � �,��ty,o�S `� ,,...,...... ...,. ..... .,�.�� ���.
�GI/,6 J�
�� TVPE OFCONSTRUCTION NEW ADD LTERATION REPAIR
Ph Q�� ❑ CONVERSION ❑ DEMOLISH ❑ OT�/,.�T ���
_ d� �, _ DESCftIPTION OF WO�iK/USE OF BLDG. ��Ri1c i ,
�i[:l
Ciry License No. U� `t'�`'T'�1 -
LICENSED CONTRACTOR DEGLARATION
1 he�eby atfirm that 1 am Iicensetl untle� provi5ion5 0( Charte� 9(commencing
with section ]000) o( Division 3 ot the Business antl Professions Cotle, antl
my license is in full torce antl ettect.
' icense Class — Lice se Nc�2�J�L9�
��te� �� 5�g ature �
.IORKERS'COMPENSRTIO ECLARATION
I hereby aifirm that 1 have a certificate of mnsent to self-insure or a certlflcate
of Workers' Compenzation Insurance, or a certifietl cooY thereot (Section
380�j a (� /
Polify�i! �G�lra� Company ���/Q'+fiv
�Certifietl Copy is hereby fumishe
Certifietl copy is tiletl with th ity Bui ing Di 'z on. /�r�n
oate� Ap� t � � .
EXEMPTION FR M WORKE 5' C PENSATION DECLAR 1 N
(This section neetl not be completetl if th¢ permit i5 fa/ One huntl tl($300) o�
less).
I certify that in tbe performance of the work �or which thls Oerm�t is i55uetl, I
zhall'not employ any peRon in any manner So d5 t0 b¢Come SubjeGt to the
Workers' Compensation Laws o( Calitornia.
Dafe Signature
NOTICE: If, afte� making this tleclaraHOn, y0u snOultl become subject to tne
Workers' Compensation provisions of the Labor Gotle, you must forthwith
� comply with Such provi5ion5 or tM1is permit shall be tleemetl revoked.
CONSTRUCTION LEN�ING AGENCV
I hereby aftirm lhat there is a mnstruction lentling agency tor the Oerformance
of tne work for which this permit is issueA (Settion 309� Civ. C.) .
Lentler's Name
Lentler's Atltlress - ,
OWNER BUILDEF �ECLARATION
I hereby afiirm ihat I am exempt trom the Contractor's License Law for the
following reason (Section 7031.5 Business antl Protessional Cotle: Any city or
�unty which requires a p¢rmit to construC[, alteq improve, tlemolish o� �epai�
y structure, prior to its issuance, also requires the applicant for su<h permit
. file a signetl statement that he/she is licensetl pursuant to the provisions o(
. ihe Contractor's License Law (Cnapter 9(<ommencing with Section 7000) ot
Division 3 of the Business antl Protessions Cotle) or that he/she iz exempt �
therefrom antl ehe basis for the allegetl exemption. Any violation ot Section
7031.5 by any applicant tor a permit subjects the applicant to a civil
�enalty ot not more than five huntlretl tlollars ($500). •
LJ I, as owner of the properry or my employees wlth wages as Nelr sole
<ompen5ation, will Co th¢ wo�k, antl tM1e 5[ruc[ure is not intentletl o� offeretl
lor sale (Section 7044, Business and Pro(essional Cotle: The Contractor's
License Law tloes not apply to an owner of a property who builds or improves
thereon, antl who tloes such work himself/herself or through his or her own
employees, provided that such improvements are not intentletl or offered for
' sale. If, however, the bulltling or improvement is soltl wlthin one year of com-
pletion, the owner will have the burden of provin9 he/she tlitl not builtl or im-
prove for the purpose ot sale).
❑ I, as'owner of the oroperty, am exclusively wntracting with licensea mn-
tractorsto consV uct the project (Section 7044, Business antl Professions Cotle:
The Contractor's License Law tloes no[ apply to an owner of pro0erty who
Cuiltlsbr improves tnereon. antl who mntracts tor such oroiects with a con-
tractor(s license pursuant to tne Contractor's License Law). I am aware tnat
proof o� their Worker's Compensation Insurance shoula be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner
I hereby certi�y that I have reatl this application antl state that the above
Intormation is wrrect. I agree fo compry wrth all city antl county ortlinances
antl state law lating to builCing construction, antl hereby authorize repre- ,
sentatives [ s city to enter 71pon tM1e above-mentionetl property for
Inspecti pur ses. � , / �
Signa r _���Fy �'��- _ Date
' Drivers' <ense oF.6�}�
/� 0865-46, rev. 5/88
TVPE OF PERMIT LJ GRADING LJ FOVNDATION IJ STRUCTURAL
❑ TENANT � ELECTRICAL ❑ PLUMBING �MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5a. FT. oCCVaaNCV—
CONSTRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES—
Bar Sink
Backflow
Bathtubs
Clarifiers '
Dishwasher .
Drinking Fount
Floor Drains :�
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Dreins
Reinspeetion Fee
�
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal (
Outlets Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
�
$75 laue Fee
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. �CBO #
Heating $ystem & Ducting
❑ a� oo,000 aTu O i oo,000
Reinspection Fee � $15
White - Builtling; Canary - Applicanh Pink - Accouncing; Goltlenrotl - Assessor
Hood or Typel �
Canopy Type I I ❑
Refrigeretion System
❑0-100,OOOBTU ❑100,OOOBTU
System Repair/Alteration
Fire Damper� 6 � ��
Registers � , � _ , .r �
Issue Fee
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
EES Automatic Washer
Construction Pole Su6.
Cooking Unit
Dishwasher
_ Dryers ❑Gas ❑Electric
$ 3
FEES
✓OS9/
Zo�e
Bu
/Provided
ELECTRICAL ,
Transformer ❑ 15-50KW
❑ 50+KW
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 00.5 KW �5-15 KW
Meter LJup to 100 amps
Meter �over100amps
Sub Panel
Motors�0-1 HP 07'h-8
Inc.Solar 09-75 HP �16-15+
Microwave
Pole Light
Range.
Standing Sections
Trash Compactor
I Reinspection Fee !$15 I ' luue Fea
DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
Building Approved By
APoliption Issued BY - �
SUMMARV (SF FEES
BUILDING PERMIT $ SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PLAN CHECK 25% $- ENERGV P.C.
ELECTRICAL $ GRADING
P�ANCHECK 50% $ MICROFILM
MECHANICAL $ 2�2 n.� TOTALFEE
PLAN CHECK 25% $
$
FEES
$ 3
N
I
N
G
R
E
Q
M
T
S.
Q1 00031359-0�031359 Tr]T 272.Q�! �
, DA7E: 04/25/39 TIME� 14:42
-� �
�
�= . ��;� �\���
�. CONSTRUCTION AND PLANNIh_. ;J-
� �APPROVALS lPe�mit�# I' �Datel
�.
1.'Temporary ElectiicBl Service or Pole �;
� r, � �
� 2. Soil�Pipe-Undrgrnd! % ��
,a� ,� .. �
'�Electrical Condd
iElectrical Condu
../„v , ..,.,,..,,..,.,,.,I
6�Electrical UFER'G�nd� �
r i .
� 7� Footings , � �� �� � .
�
� 8� Foundation -
�
e
. 9.� Water Pipe-Undrgmil. _ � '/
10 � Struc[ural Floor. System � �
- i. i
7 7�.<Property Sewer Line & House Connection ��
ri, i _
92. Sev�ier C�p � '� �
13. Roof�Djains' ;, % �
14. Rough Plumbing- %�
15. Rough Electrical-Conduit
�fB. RoughElectncWiring �
17. Rough Wiring Sign ' �
i� i ri/
:1`B. Rough Electrical-T Bar Ceiling�. �
' 19. Rough Heating & Air Conditioning y i
.�
�20. Rough �ictory Fireplace �� J
21. Ducts,in Structure f �
22. Ducts, Ventilating � �
23. Gas Pipe-Rough & Test % �
24. Roof Framing ' '
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame�and Flashing - � �
28. Lathing & Siding � A^ �,
29. Insulation �l fl
i �
!,
30. Drywall Nailing �J
31 r Plaster Brown Coat ��/
32. Electiical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning s
35. Final Gas Pipe-Test
36. Hood or Canopy .
37. Final Factory Fireplace
38. Final Plumbing �,
39. Water Service-Final C`•? .
� .�
40. Gas Service-Final ft')
41. Solar pomestic-FinalCj�
42. Backflow Preventer �
43. Backflow Irrigation rx
44. .Landscape Irrigation.System
45. Sound Attenuation
46. Handicap Regulatioji�s
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
Date
0
OL & SPA
Inspector AppROVALS Permit #
52. Pool & Equipment Location .
. 53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. 8ackwash Lines, P-Trap, 0 Urtdrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor-Final ,
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
� 66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
� 69. POOL/SPASYSTEMSFINAL
LeI�J FIRE DEPT. REQUIREMENT
APPROVALS Permit#
��
Date � Inspector
70. Underground Hydro
71. Product Piping OGas OOiI
72. Underground Flush 0 C;�
73. Undergrnd. Storege Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe .��
77. FIXED SYSTEM FINAL �
78. FIRE PREV. FINAL ,
HEALTH DEPT. REQUIREMENT ,
79. FINAL INSPECTION �,�
80. FOOD CERTIFICATE ISSUED ��
r/ �.
Notes: • ,
! '.
��
i
AOV�icant to fill in all spaees except those wlenin heavy Ooraer lines anC si9n all appropriate Ceclarations.
PERMIT NO.' TRACT NO. LOT NO. UNIT NO.
CITV OF COSTA MESA CONSTRUCTION PERMnIT E- 38 /6 � Th A�P� #
ProjectAddress 5�-'r� A�T�� ,�pTh �"��p(` _
A�plicant'S Mailing Address
Owner'sName SP_cl�f`���P�G��(`_�phone
Address
Arch/Eng. �OK License No.
Address � e-
Contracror'sName�-U-n+Pcl 1eoTr���� ano�e`.]y'4���3
Addresslmailingl3�n� RPtiV'�1�, ika-\O� C�n51a Me._<n�
City License No. O1.1L1.9FS(n -
LICENSED CONTRACTOR DECLARATION
I h¢reby affirm lhat I am licensetl untle� provi5ions of Charter 9(mmmencin9
with section 7000) o( Dlvislon 3 of the BuSiness antl Protessions COAe, antl
my Iicense is in full force antl eifect.
'License Class [�- - � � �icenser o 5U'�.y, �
Date 4/� 189 Si9nature K(1�er.-. C_.Qi\L+v'�
WORKERS' COMVENSATION DECLARATION
nereby aftirm tnat I have a certifiGdte of wnsent to Sel(-in5ure o� a certiticate
�f Workers' Compensation Insurance, or a certi(ietl copy tltereot (Section
3800, Lab. CJ c 1 ,
Policy No. ��%���9 Company rr 7� eM�1� ��
❑ Certifietl copy is hereby furnishetl.
�1 CertiOq tl cQe y is filed with the city Buil� i99 �ivision. /���
Oate 4/li(84 Applicant___�`�eLy7_5=� �
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl if the permit is tor one hunAretl ($100) or
less).
I certi/y that in th¢ perfOrmance Of tit¢ work t0/ which Ihis p¢�m�t i5 issuetl, 1
shall not employ any person in any manner so as to become subject [o the
Workers' Compensation �aws of Galifomia. �
Date - Signature
NOTICE: If, atter making this tleclaration, you shoultl become subject to the �
Workers' Compenzation provisions of the Labor Cotle, you must forthwith .
comply with sucn provfsions or this permit shall be� tleemetl revoketl. '
CONSTRUCTION LENDING�AGENCV
1 hereby afBrm that there Is a construction lentling agency for the performance
of the work tar which thi5 p¢tmit is i55uetl (Section 309] Clv. C.)
lentler's Name
LentleYs AtltlreSs
OWNER BUILDER DECLARATION
I nereby affirm ihat I am exempt from Ihe Contractor'S License �aw for the
followin9 reason (Section 7031.5 Business anC Professional Cotle: Any city or
county wnith requires a oermit lo construct, alter, improve, tlemolish or repair
any slruclure, prior to its issuance, also requires tne aoPlicant tor sucn permit
to file a signetl s[atement [hat he/she is licensetl pursuant to the provisions of
�e Contractor's Litense Law (Chapter 9(commencing wlth Section 7000) of
vision 3 o( the Business antl Professions Code) or that he/She is exEmpt
,erefrom an0 the basis for the alleged exemption. Any violation ot Section
703L5 by any applicant (or a permit subjec[s tne applicant to a civil
�enalty of not more [han five huntlretl tlollars,(E500).
I, as owner of tne property or my employees with wages as their sole
compensation, wlll tlo the work, antl the structure is not intentletl or�otferetl
for sale (Section 7044, Businezs antl Professional Cotle: Tne Con[ractor's
License Law tloes no[ applY to an owner of a property who builtlz or improves
tbereon, antl who tloes such work himself/herself or through his or her own
employees, p�ovitletl tnat such imorovements are not intentletl or oiferetl for
sale. It, however, the builtling or improvemen[ is soltl wlthin one year of com-
pletion, the owner wi11 have the burtlen oi proving he/zhe aitl not bulltl or im-
�/Ove torthe pu�po5e of sale).
I, as owner of the prooerty, am exclusively contracting with licensetl con-
tractors t0 construct the projett ($e[tion 7044, Business antl Protessions Cotle:
7he Contractor's License Law does no[ appry to an owner of praperty who
builtls or improves thereon. an0-who contract5 for such oroiects with a con-
fractor�51 hcense pursuant 2o me Contractor's License Law). I am aware tnat
proof of tttei� Worker'S Compensation in5urance shoultl be provitletl ta me.
❑ I am exempt untler Section B. S P. C. for this reason
Date � - Owner
I hereby certify that I have�reatl [his application antl state that the above
Information iz correct. I a9ree to comply with all city antl county ortlinances '
antl state laws relating to builtling con5truction, antl hereby authorize repre-
sentatives of this city to enter upon the above-mentionetl property for
inspection purposes.
Signature (�U-/Yl IYv� l� rr. Date 4II�I I$9
orivers' License or 55 �
S Main Buildi
TVPE OFCONSTRUCTION EW ADD ALTERATION REPAIR E
, O CONVERSION ❑ DEM �ISH ❑ OTHER T FrOnt
DESCFiIPTION OF WORK/USE OF BLDG. A Rear
TVPEOFPEflMIT GRADING ❑ FOUNDATION STRUCTURAL C Right
�7- K . �eft
❑ TENANT �p.tLECTRIGAL ❑ PLUMBING ❑ MECHANICAL S
❑ OTHER �
Ping. Ref. #
PRQIECT DESCHIPTION 5�. FT. OCCUaANCv planning Notes:
CO N STRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow.lrrigation
Bathtubs -
..._"`'___i ".
Dish
Floor DrainS
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
�avatories�
P-Trap
Roof Drains
Reinspection Fee � $75
Duct- Under Ground
Duct - Structurel
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact.8lt. ICBO #
Heating System & Ducting �
❑ U 100,000 BTU � 100,000 8T'�
Rainspection Fee I $75
OB65-46, rev. 5/88 White - Bulltling; Canary - Applicant; Pink - Accountlng; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Wate! CIOSei
Water Heater
Water Service
Auto-Wash
Laundry Treys
Issue Fee
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System
04100,000 BTU ❑ 100,000
System Repair/Alteration
F ire Dampers
Registers .
luue Fee
$ 3
FEES
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
zone
ry Building: .
Z
O
N
I
N
G
� R
Req./Provided E
Q
M
T
S.
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
$WIiC�IQi
Garbage Disposal
Generator �0-5 KW 05-15 KW
Meter LJup to 100 amps
Metef ❑ovef1008mps
Sub Panel
Motors �61 HP O 1 F. - 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
Standing Sections
Trash Compactor
� Reinspection Fee !$15 I I Issue Fee
DEVELOPMENT SERVICES REQUIREMEN7S:
Zoning Approved By
Building APProved BY
Application luued BV
FEES
3
$
SUMMARV OF FEES
BUI�DING PERMIT $ SMIP $ '
PLAN CHECK $ PERMIT,
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ � GRADING $
PLANCHECK 50% $ MICROFILM $'
MECHANICAL $ TOTAL FEE $ 2�l• Z0
PLAN CHECK 25% $ _ ' �
$ 3 DR7Ep�04J17J89030it�1�: 3�55
---":1..�Q
, � . 1 .\ . . �.. r. . . � r
��, I\i
CONSiRUCTION AND FLANNING �k� P� �` SPA
. APPROVALS Permit# Date Inspector AppROVALS Permit# _ Date � Inspector
1.FTemporary Electrical Service or Pole 52. Pool & Equipment Location
2. �oil Pipe�Undrgrnd. „ `" 53. Steel Reinforcement
n n
"3'.'�Electr,ical Conduit Utility-Undrgrnd. `% 54. Forms
� 4.�Electrical Conduit-Und[grnd. �, , 55. Electrical Bonding '-
i
5.;Steel Reinforcement; �' t, 56. Rough Plumbing & Pressure Test '
:
6` Electrical UFER'Grnd'� � 57. APPROVALTO COVER-GUNITE �:]
7. Footings ' 58. Electrical Conduit-Undrgrnd.
$. Foundation `_ �' ��` � � _ 59. Gas Pipe, O Undrgrnd., Test
T
9. Wafer Pipe-Undrgrnd. ' � 60. Backwash Lines, P-Trap, O Undrgrnd. � ,
10:�SVucturel Floor System � ' 61. APPROVALTO DECK
11: Properiy Sewer Line & House Connection ', � 62. Backwash & Receptor-Final
12-Sewer CaP �� ' - .. �.
63. Heater & Vent-Final
73: Roof Dreins "� ' � ; �� 64. Plumbing System - Final -
14. Rough Ptumbing�: , 65. Elecirical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring �f 7. Fencing & Access Approval
d7. Rough Wiring Sign APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � 9. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conqitioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace �' APPROVALS Permit #
21. Ducts, in Structure �
^ ) 70. Underground Hydro
22. Ducts, Ventilating "1 � 77. Product Piping D Gas ❑ Oil
23. Gas Pipe-Rough & Test 72, Underground Flush
� 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. FrameandFlashin9 � 76. DryStandpipe
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 . FOOD CERTIFICATE ISSUED
33. Final Electric es:
34. Final Heatin9 & Air Conditioning ` j .�•'i �
/\ L•
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 pomestic-Final
42. Backflow Preventer .-
43. Backflow Irrigation �
44. Landscape Irrigation System ,
45. Sound Attenuation -
46. Handicap Regulations '
47. FINAI STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison ..
50. Gas Release to Southern Cylifornia Gas Co -
51. CERTIFICATE OF OCCUPANCY . � .
No. Date , . ' "
I
11 I 1789
CITY OF COSTA MESA CONSTRUCTION PERMIT
Project nddre�s 555 ANTON, 6TH FLOOR
Appiicant's.MailingAddress �540 SUZI LANE� WESTMINSTE[2
Owner's Name —$ECURITY PAC2FiC SANK phone
Address 600 WILSHIRE, �t500, L.A. 90017
Arch/Eng. License No.
Address
Contracmr's rvama KIMBLE & COMPANY Pho�e 895— I I 56
Addreulmailing) 1540 SUZI LANE, 41ESTMINSTER
City Licenu No. '0'�'�'3 � �S� �
LICENSED CONTRACT00. OECLARATION
1 hereby�a�fi�m tha� I am licensetl untllt prOvi510n5o( Chdrte� 9(commencing
with section ]000) oi Division 3 0( the Business antl Professions Cotle, antl
my Iicense is in tult force antl et/ect.
�icense �ass C—�6 � n;eNo. 460923
Date � Signature
`RKERS'COMPENSATION DECLARATION
reby affirm lhat I have a cerlHica[e oi consent to self-insure or a certlfltate
Workers' Compenzation Insuran<e, or a certifietl copy thereoT (Settion
3800, l.aG. CJ
aorcy rvo. WP88470897—IOcomPany FREMONT IND.
Certitietl copy is hereby Wmishetl.
Ce[ ietl is f.y'b'��u'r ith lhe titY in vi ��� � y�/�
Date �����[' , APPlicant� ��y'
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This se[[ian neetl not be COmD�Gtltl it Ihe permlt IS fOr One huntlr¢tl (E300) Or
lesz).
I certify that in the performance of tha work for which thls perm�t is Issuetl I
shall not employ any pe�5on In any manner So d5 to btGOme Subj<Cf to t�e
Workers' Compensation Laws ot Califomia.
Date Slgnature
NOTICE: Ii, afte� making thi5 tleGlardtlOn, y0u snOUIG become subject to the
Workers' Comp¢nsation provi510n5 Of the Iabor Cotle, you must forthwlth
compty with such prOviSiOns or tnis permit shall be tleemetl revoketl. ,
CONSTRUCTION LENOING AGENCV
1 nereby attirm that there is a cons[ruction lentling agency /or the performance
of the work fOr whicn tnls permit ii ISSUGtl, (SeCtion 309] Clv. CJ
Lentler's Name
Lentler's Atltlress '
OWNER BVILDEft DECIARATION
I hereby aHirm that I am exemp[ irom the Contractor's License Law tor Ihe �
(ollowing reason (Sectlon 7031.5 Businass antl Professional Cotle: Any city or
county which �equi�es a pe�Tlt to con5t�uct, alte�, ImprOve, tlemollsh or re0ai�
any structure, prior to its issuance, alzo requires the appllcant tor such permlt
�^ file a signetl statement that he/she is Ilcenutl pursuant to the provisions ot
Conlractor's License Law (Chapter 9,�commennng with Section 7000) of
sion 3 ot the Business antl Professions Coae) or Ihat he/she is ezempt
� .;e(rom antl the basis tor the allegetl exemption. Any violation of Sectlon
7031.5 by any applican[ for a permit sub�ects the applicant to a civil�
�enalty ot no[ more than five nuntlretl tlollars (5500�.
I, as owner of the property or my amo�oyees wlth wages as their sole
mm0ensation, will tlo Ihe wo�k, antl Ihe st�utturo is nol int<ntl¢tl O/ oft¢r¢tl
tor sale (Seclion ]044, Businesz anC Professional Cotle: Tha Contractor's
License 12w tlo¢s not apply to an own¢r Of a p�ope/ty who builtl5 Or Improv¢z
[he�eon, antl who tloes Such work hiTself/h¢r5llf o� thrOugh hi5 0� her Own
employees, provitletl that such improvements are nol IntenCetl or ofteretl for
sale. If, however, tne builtling or Improvament is soltl within one year of com-
pletion, the owner will have the burtlen o1 provin9 ne/she tlitl not bulltl or im-
�rovefor the purpose otsale).
1, as owner of the property, am ezcluslvely tontractln9 wlth Iicented con-
tractorsto constru<t the project (Section 7044, Business antl Protessions Cotle:
The Contractor's License law aoes not apply lo an owner o( property who
builtls or improves thereon. antl who contracts for sucn orolects with a con-
Iractor�sj I�cense pursuant co me ConVactor'i License L.aw). 1 am aware lhac
proof ol tnei� Wo�ker'S Compen5ation Insu�ance shoulG be p�OvltleO to me.
❑ I am ezemp[ unCer Sec[ion B. & P. C. for this reason
Applicant to fiil in all ipaces except t�oie wlthin �eavy EorGer Ilnes ana si9n all aoO�oDriate tleclarations.
Date
1 hereby certi
information is
dOtl Tldt¢ IdwS
untatives ot
inspection pur
Signature �
Drivers' Licens
_ owner
1 hdve �ea
I aaree to
or 55 3#
rev. 5/88
1 Niz application antl state that the above
camply with all city antl county ortlinances
g con5bu<tlOn, an0 h!/eCy autho/iz¢ repre-
upon the abova-menlionetl propert for
�Date 3-a.'�-89
.-.
� - 3�' � � '-'� Flk
TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH OTHER
DESCFJPTION Q�WORKNSE OF BLDG. � Y`L 1�i1 r
TVPE OF PEAMIT LJ GRADING LJ FOUNDATION U STRUCTURAL
❑^ /TENANT ❑ ErLECTRICAL LUMBING ❑ MECHANICAL
LT�OTHER '{�`�r•j l.Ld�I%`e.SS( O�
PROJECT DESCRIPTION 5�. F7._ OCCVPAN�y�
CONSTRUCTION TVPF� �A� • VALUATION S '� �
20NE GRA�INGCU.VDS. ACRES_
Remarks:
Sink
Preventer
Irrigation
Dishvrasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
InterceptOrs
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Water Closet
Water Heater
Water Service
Auto-Wash
Reinspection Fee � $15 � � Isiue Fee � g 3
Duct - Under Graund
Duct - Structural
Duct - Ventilating
Exheust System ❑ Multiple
Firepl/FacL BIL iCBO #
Heating System & Ducting
❑0700,000 BTU 0100,000
painspection Fee I 515
Wnite - Building; Canary - Applicant Pink - Acmuntin9: Goltlenrotl - Assessor
Hood or Typel ❑
Can py Type I I ❑
efrigera2ion System
❑0.700,OOOBTU ❑t00,0008TU
System Repair/Alteration'�
Pire:Dampers �
Reyirters •
. �
J.
laue Fee � y 3
A.P. #
S Main Buildi
E
T Frant
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers OGas ❑Elec'
Fan
F.A,U.
Fixtures
Device Boxes
OutletS
Switches
Garbage Dispoul
Generator �0-5 KW C
Fee
zo�e
Building: . ,
ELECTRICAL '
Transformer ❑ 15�50KW
❑ 50+KW
Meter LJup to 100 amps
Meter ❑over 100 amps
Sub Panel
Momrs �0-1 HP 01'h - 8
Inc.Solar 09-15 HP �i6-15+
Microwave
Pole Light
Range
Standing Sections
KW Trash Compactor
laue Fae
DEVELOPMENT SERVICES REQUIREMEN7S:
Zonin9 APProved By
Building Approved By
Appliistion laued By
FEES
$ 3
O
N
I
N
G
R
E
U
M
T
S.
SUM ARY OF FEES
BUILDING PERMIT $ !�i} � ov SMIP $ �• �
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ �Q.�Q'�
MECHANICAL S TOTAL FEE $ �
PLAN CHECK 25% $
t]! 0�02?662-00029663 TL'1Y 145.95
DATE: 03/31/89 TIHE= 12:49
/ \ p \ � i .` . . . . ,. ..
� . �� �.
'"` rc & sPa \
CONSTRUCTION AND PLANNING ;` �
APPROVALS Permit # . Date Inspector p�ppROVALS rermit # Date Inspector
,�� .��
� 1..Temporary Electrical Service or Pole . 52. Pool & Equipment Location
� ./
� - �
2. Soil Pipe-Undrgrnd. :r 53. Steel Reinforcement ,
3. Electrical Conduit Utility-Undrgrrid.. 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 , i :�, 58. Electrical Conduit-Undrgrnd. j^
8. Foundation •, . � 7' 59. Gas Pipe, O Undrgrnd., Test �'
9. Water Pipe-Undrgmd.' ';; 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor Syttem •� �- 61. APPROVAL TO DECK
17. Property Sewer Line & House ConnAction 62. Backwash & Receptor-Final
12. Sewer Cap � � � 63. Heater & VenrFinal ���
13. Roof Drains 64. Plumbing System - Final '
r'
14. Rough Plumbing 65. Electrical-Final -
15. Rough Electrical-Conduit 66. Solar System-Final �
�1�6. Rough EI2clric Wiring 67. Fencing & Access Approval
1`. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough�Electrical-TBarCeilin`g 69. POOL/SPASYSTEMSFINAL
}9. Rough Heating & Air Conilitioning FIRE DEPT. REQUIREMENT
20. Rough�Factory-F.ireplace( �} APPROVALS Permit#
21. Ducts, ii Struciure a � � 70. Underground Hydro
22. Duc[s, Ventilating i 71. Product Piping OGas ❑Oil
i
23. Gas Pipe-Rough & Tes`t T �72. Underground Flush
24. Roof Framing �� � ;n.� 73. Undergmd. Siorage Tank � Gas �.Oil
�
25. Roof Sheathing� . �I 74. Overhead Hydro C.f� �
26. T-Bar.Ceiling (Structuial) &�Monocoat . 75. Dry Chemical
27. Frame antl Flasf�ing --.., 76. Dry Standpipe
28. Lathing & Sidin� j 77. FIXED SYSTEM FINAL �Y Z$' �
�
29. Insulation '^ �'�� 78. FIRE PREV. FINAL �% 2& 9� ��
30! Drywall Nailin�� "��� HEALTH DEPT. REQUIREMENT
31. PlasIer'8rown Coa '�: 79. FINAL INSPECTION
32. Electiical Power Nleter-Final"" 80. FOOD CERTIFICATE ISSUED
,�
v i
$3. Finai 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 � f
41. Solar pomestic-Final _- ,' !
42. Backflow Preventer � � � ' ;"
.,..
43. Backflow Irrigation � ' ' � r
i.
44. Landscape Irrigation System ' --
45. Sound Attenuation � ,. �
46. Handicap Regulations • ^'r
47. FINALSTRUCTURE&BUILDING �
48. Special Requirements Completed
49. �Electric Release to Edison
50. Gas Release to Southern California GasCo ��- �� �;
� 51. CEflTIFICATE OF OCCUPANCY � � ' �
i'
I No. Date ', .. I� � �
I
m��aeimm+c: 555 ANTON BL
OAMER9NAYEIFIOdM�t SAKIOKA FARMS
�ooxEzs PO BOX 2097
TERMINAL ANNEX
�vr�. �una�o �no�
uxr: 6 TH
urcxrtEcraxera�me INTERIOR ARCH 2136232164 ueao: 9378
urcxoxwa�s�ooness: 550 S HOPE ST � uxr: 1100
L.A. CA 90071
wern�craxs x�:
ca+m�croRs�uiwc
wouss
ue xo:
uxr:
LICENSED CONfNACTOPS DECLANITION: I hereby aR'vm uMm penetly d perjury thet I em Iceraed �ndsr prwieione d Chepar 9
(mmmerviM vrilh Sx6on ]000) d Oirisun 9 d Ne Buai�rom end Pmlmabm COEe. end mY Ibenss b in IWl lam and Ww.
cmuc.No.: uc.cuss: uc.No.: EXP:
Dme: Cmtratla:
INEN BUILOEX �ECL�PATION: I hemby elfi�m under pendy d perNO' �� �� eomq Imm Ihe ConVetlan Lironee lew lar iM
�oxiq �aewn (Setlian ]W 1.5 Buairaa eM Prdenion Cade: RM ciY a oouMY xAid� nVu've� e Ve�mG to caubucl. eder. inPow.
bmde�, a repv ury at�unuro, prior b Ea emieMe, ebo rtQu'ue� iM epplimM lu wrli prmn io fiM s epnW �taamsm tlw M a Me
h �bemse wreueni m �n. wa�me a �ne conireawn Limnae �aw ICMqm s Immmencre wnn e.acn r000) a wr:on a a ��r
Biwrrov eM Rdmeione Codal a IIw he a ehe ia emmq ihsNmn end ihe besiv br IM dleped mmmqion. My Woletion W Hwion
)0�1.5 by vry epplwv 1« e permu eiAjetl� Ihe eppl'rsM lo e dvY pmNry d M maa tlun Ma huMred ddl�n �S,AO�.
� I.mowirordiMpoCeMoriroamWWeeswihwepeemlMisdaoom0��ion.vAllAotlroxM.vM�Mtiv.tuieeroliNaNeE
a ollerad M�ele (Secton'loN. Buvmv uM Prdmaioru Gada: TM Conireem Licmw lew Eam �wt epp!/loen ownxd popeny
wM W1Ea a inG��* �hnem. end wM Eo» autli �k!'aneetl ar Mne� a tivp� A'v a hor own w�Wlopw. pw'Idsd �hY e�ch
impwwnerm va nq immdW n atlaeC la sab. tl. howewr. �M dutlinp n inpwsnw u mtl wulw� pr yaar d mpMion. ths
�/ ownar-0uiNx wi0 heve IM buden d qwi�q M« Me dN rw� driN « imqws la IM puryws d�eb).
PI.roOv/nRNIMV�Wdi'.BTMWmwIYOM�RtlMvNh6p11sdCdIbBCld�bmewlWNlWeM�(SeW'v�1D14.BW'vr�lM
Raeeaa,e coae: m. co�umea. �cmu �.�. m.. na ewN m en orm. a o�r wno ewd. a npw. mr.o� a�a .m
cano-xb br aMi Ydada xdh e mnreaMa) IicenxA wnuem to iM Camradara Liwn�a Ler.1.
em vemq wder Sea/ion: p B. d P.C.. br No �auon: /A +
Dale: � ' � l� � i �-� Oxmr: � � � . 1 / ' f G�
� i ao anar mm i.m .�..,a a.m w��e me �a��m w cau�:.H..m� w se+r cod. sw�. uws. zsm..d
� eM tlw 1 a enY tNue dutlm0 �d w� / wY �(wde oro) rosE ro oomdY wi� uk peta m!u mM iM np�mamwW br
a�•.
ome: �wr�n:
wonKen�s couvv�s�nan oEcun�noN: i ne..M.� �.w. o�wy a�.y w�. a m. mm.vy e.awen.:
❑ �n.re.na.ammman.ewteweammm�m..n:mu.�«waks.•mmprutic�.on�e«Ma.�aonalaoa�n.le0a.
coae. �« �n. o«�amence a �ne wak �a..+:cn mo w�rml u ueu.e.
r] �n....�e.amem,.nwiwa.•mno.roeto�iw�.nce.mAa��.aMs.aas�aam.�.na.wa..au»w�«mercwau.
wak ta whirh tltie D� e mued. �M Mvkan' mm0�ion inwancs mrier mM O�Y num Wr ero:
Cerrier.
Pdicy Numbr
(nda ewiw+rew �u ae camde�� t me a�] b ro. ww hunana adws Is�ool n hv.)
❑ IPw�h ��� VaNa�� ^� �� � 1« whch Ihiv pemiA b beueE. I WII na ampby erry pnson in erry menew n n lo
b4min wbjsq to tM v.akero' conpemetion bw d CeWmJe, end pms tlW M I daM bacmM �upjW b �M wabn'
mmpevtlbn qwisiam d Sacion 3]00 d tM lebor Lods.l4utl lonhxil� canp�y xiN Now pio�re"vs.
Dele: App4canL
Wem/np: F�Uvn b sxun woA�sn'romparuetlon rovsrep� h unNMuA ��N/I aWJ�ct m wmplqw b alMn�l pmeltlp �nJ
elvll flMs tp b om huntlretllMuu�M Eollen /S10qOW1, In Walfbn b M� eo�t o/ romprwtbn, tlem�ps� u provMW br In
81ctlon ]106 0l Ms LaDor Cob. InMut, nM ettamay'a Iw.
CONSTNIICTION LENUINO AOENCY: I hereby tlfirm uMer penely d perjury ihm �hom is a wulruqbn bM'iip epa�wy M IM
pAameMa d the xvM la which Ihe partni ie bweC (SeGon 309], CM. G�.
LENOEfl'S NANE:
LENDEF'S AODPE55:
I cenily ihn I hew rtetl Nu epW'rmion eM q+ta ihe� �M ebae inlamdion b coned. I apn� lo canply wkh aA ory end wuNy pdineios
erd alete lexa relmiq �o brildiq cmWutlion eM heraby eWvixs iapevaMetHa d iAis ary io eNr upon tM eEow�meMioneE piapeny
�°""'°°"'°"0"'°°'°g ERNIE VITUCCI
' )-i6-96
Oeu:
(S15t J6.W P) �Ne�u3d�q d Se1My:Oraen-Fb: Cenery-AppF�am: Pink-Iisvan�s: OdAmmJ-Mmor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 078539
PERMIT NO: E 078539 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS FURNIYURE INSTALLATION RE: B-78538
itet��*atu�at�it*�t*at***���titx�**et*��*�it�tit*��ir*itx�it****itet****x *+r��+�*+�x �*itat�*�**�t�**at*+rat**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PAOV; PARCEL: 41050104 ZNE: REF NO;
PLANNING N TES>
>
if ik k f(� 1F iE iF ik 1k 1E if 1E 1k iE 1k 1f ik iE if 1f 1E iE if IE 1E IF 1k 1k ik 1F 1E 1E 1E fE 1ElE iE iE fE 1f 1E if i! 1E 1E fE 1E ff 3E iElf iE 1F 1E iE iE 1E IF iE iE 1E IE ik iE 1E fE fElE �E iE 1E iE 1E iF 1f if �E 1f iE
D E V E L O P M E N T S"E,R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY
BUILDING APPROVED BY : �
APPLICATION ISSUED BY: �//�/�
iF if iE!! 1E if iF if iE if ik i! if i! ik 1F ft 1E iE �E �E iEiF{FiF�F�3FiF�'1��FiF��TP�i��{f3f��F�F�F'iFiF3FTfTF�F�F3F iF
LEGALIZATION;N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PERMIT 261,Fi0
508
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 261.80 22,00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
283.80
DATE:
DATE:
DATE;
iF1EfE1klkikiElE IE1!
STRUCTURAL S GMENT:N
SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
283.80 283.80 .00
283.80 OVER/SHORT; .00
FIRE SMIP/TOT GRADING PLAN—CHECK
iEiE1ElEiflFiflEiflFiFiliElF1!lFfFIfIf1E1F1E1l1EiF1f1Efl�7FiE1FiFlEiE1E1k1E1ElE1E1EiflflkiFiElE1FiE1klEfEfEiE�E1E1FiE1EfF1EiE1EiflElEifiFiEfEiElElkfEiE1E1E1EfE
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE
ELE
20 FIXTURES, LIGHTING 1 ST 20 EA. 1.00
372 FIXTURES, LIGHTING ADDITIONAL EA, ,65
END OF FEES
�.
20.00
241.80
CONSTAUCTION AND PLANNIN+ f .& SPA '"'
APPROVAIS Permit# � Date 'Inspactor ; AppROVALS'� Pcrmit# " Data inspector
t, Temporary Elec2rical Service or Pole' 52. Pool & Equipment Location
2.� Soil Pipe�Undrgrnd, 53. Stee� Reinforcement
3. ElectricaPConduitUtility�Undrgmd. 54. Forms
4.-Electrical �Conduit-Undrgrnd. - 55. Elearical Bondiny
5. Steel Reinforcement - 56. Rovgh Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE , i
7. �Footings� - 58. Electricat Conduit-Undrgmd. �
� 8. Foundation 59. Gas Pipe, O Undrgrnd., Test
�
9. Water Pipe-l7ndr9snd. - 60. Backwash Lines, P-Trap, O Undrgmd. '
1�. Structural Fioor Svstem 61. APPROVAL TO DECK �
i t. Property Sewer line & House Connection _ ,62. Backwash & Receptor�Finat
12. Sewer Cap , 63. Heater & Vent-Pinal
13. Roof Drains _ 64. Plumbing System � Finai
74. Rough Plumbing , � 65. ElectricabFinai
15. Rough Eleccrical-Conduit � 66. Solar System-Final
16. Rou9h Electric N�iring � � . - � g7, Fencing & Access AnProval
77. RouyhWiringSign 68. APPROVEDFOR�PLASTERING �
18. Rough Electricai-T Bar Ceiling �� ' . �9, POOLlSPA SYSTEMS FINAL �
79. Rough Heating & Air Conditioni�g - PIRE DEPT. REQUIREMENT i
20. Rough Factory Fireplace . - _ � . �� APPROVALS Permit # �
21. Ducts, in StNctu�e � " - �. - � _ � 70: �Underground Hydro
22. O�cts, Ventilating � � � 71. Product Pipin9 Cl:Gas C Oil
23. Gas-Pipe•Raugh &`Test � ' : . � 7p, Unde�ground Flush _,
24. Roof. Framing �•. _ 73. Undergmd. Storage Tank � Gas O Qil
25. Roof Sheathing �_ ' _ . � 74. Overhead Hydro` -
26. T-Bar Ceiiing (Struct�rai) & Monocoat � ' r r 75. �ry Chemicai � `
27.'Frame and Flashing , ,. 76. Dry Standpipe_ '� '
28. Lathing'& Siding „�- � 77. FIXED SYSTEM FINAL �-
29. Insulation - ' � -. � ' �. 7.8. PIRE PREV. PINAL . �
30. Drywall Nailing � � - - -HEAITN DEP.T. RE�UIREMENT
37. Plaster B'r'own Coat __ � " ' 79. FINAL INSPECT_ION .
32. Electriwl Power h�eter-Final � 80. FOOD CER7IFICA�TE ISSUED
33. Pina! Electric _ ��/2� , Notes: � ' � . �
34. Final Heating & Air�Conditioning � , . �. ' -
35. Finai Gas Pipe�Test • o-^ -_
. 36. Hood or Canopy " , ' ,_ . - - � � - �.. �-�
37. Final FactorY Firep�ace ' ' • ' ''
38. Final Plumbing � ' �- " � � ,_ - : � , �'
_ ` ��
39. Water Service•Final � � � � + � - ,
40. Gas Service-Pinai_ ' � � , - � � ' �' �- '
_ _ � , ,;,,� ,
41. Solar pome:ticPinal - - �� • � '- "
� -
42. $ackflow Preven2er ' ' � �. ' �
43. BackElow irrigation � � �
44. Landscape irripation Sysiem . . � � � � � � ' _
45. Sound Attenuation �� � �- _ - • - - '
46. Handicap Regulations - � -� ' .
47. FINAL STRUCTURE & BUILDING � ' . - _
48.' FINAL PLANNING - � i � �
49. Eiectric Release to Edison -' � -.
50. Gas Release to Southern California Gas Co -� "- � ".
51. CERTIFICATE OF OCCUPANCY - , - �
No. Date
�
;rt
t
�
"`�' S55 ANTON BL
'"""' SAKIOKA FARMS
� �D° 'PO BOX 2097
TERMINAL ANNEX
�cv�. wmwo aooeess:
°Ni 6TH
�xcxrteerox�onivx:INTERIOR ARCH 2136232164 ��NOi 9378
dMNONFNO.'8.100flFA9: SSO S HOPE ST ��+T� 1100
L.A. CA 90071
C0N1P�T0�'"'�CAL PAC ( 310 ) 645-3500
COMPACTORBY4lRl0 6076 BRISTOL PKWY
���CULVER CITY CA uano: 392102
90230 uxr:
LICEN9ED COMRAttORH OECLANATION: I MM/ �ItFm urAx pvWy d p�Qury IA IbmM dr pwMbm ol Gluqa Y
(eommm8^Y wNh &cibn ]000) d Oiwbn e d iM Budnm ud VnM4aa Cod�� mY Eonu� I IuA Mc and NIw.
emuc.r+o.:06 - z uc.cusa:B uc.No.:3 2 E} : 09/96
our � �G co�vma:
OWNEP BIlILOER OECIANATON: I h�nby �Mrm wdv p�nety d ry Ihtl 1 un q hom IM irlm Udw lrw fa IM
bibwinv �on �e.alon �oai.a Bwi�n� W Aawion� Goa: ery a mumy ulm • M lo aon�buct. Nr, Impo-n,
d�molbh. ar r�Wk �ny �VUHun, pbr w u� b�u�na, Wa rpul th� �pplloun la �uch a e dvn�d �W�m�M IMI h� m �M
b Ilanpd W��I �o IM pov4biu d iM CaNretlan Llam law [CMpta Y(mmm�ndnp Bwbn 70001 at DNbbn 3 W IH
Bwimv uM Prdmbru Cad�l a tIW h� a Jw b wmp tAsdean uM IM Cnb la IM dMp�d u�mqbn. My vbW bn M Bwfbn
]W l.! bV N'/ WdbN la � W�m4 wbMa� �M epWFeM b� tlW V�Y d nd mon IMn (w� hunEnC OOA�n RSOOp.
� I, m owMr o1iM propany w my xnpb/M� wYh wepw n �Mt wb oomqruetlm, r,i�l Eo iM worlt, vb �h� �wnun Y M Im�nd�d
w oRareA br We (Sa�Mion 101�, eutlnm eM Pmh�Nm� Catls: Ths Comredan Lbnw Lew tlaa iwt eppym m ownerol pap�M
who buYd� a Ynprova IMmn, aM who doas suM wk Nm�eM a Mnatl n ihrouph hb a Mr own mmplo�e. prwldW Ihet wch
imprtnamom� va nd Imendad a afMod la Wa. M. howawr. �M buiklnp a YnpowmaM b �ak wMAln on Y� d camplYbn.IM
ownsr-0uitiv xill hew iM EUMm W prwinp M w kr Ak m� Eulld a Imprn la �M purym� d uM�. �
❑ �, n mww d �M wowM, em vduweN mmreaYw Mnh �kan..e cantrec�on a conmua Ms o� (saabn )a/� Bu.iiw. eiw
Pmlevaiom Cods: Ths Comrepon Lkenx lew does np eppty ro en owner M D�M � bu�Na a Impovx IMnan uM xho
conuecla lor wM prqad� Mil� e canlmtlor(�) IceneeE Wnuent to IM Coniretla� Lbn�s Lewl.
� I am uemq uMx Sscibn: 8. 8 P.C.. br Ihw resson:
Dais: O�*�er:
I Eo hereby ce�ily tlw I em ewve M eM urdenteM IM rpuiremame d CelLomu Hael�h enE Selery Code Seeiom 25505. 2551�, eM
25551, erd ihet I a e'ry Mun Wikinp owaqeni will / wil rwi (arcb an) nsed to canyy wih uid qala wMs eM iM npuimma�m br
e permn Iw mmvunionor moEifimionhamlM�i3ieTiyl.roropement Oiprid. Reekenliel oorct'W on eppireiidue�a exemq Irom Jrs
poviaione.
Dele: Applicanl:
WOFKER'S COYFEN4�TION DECL�PATON: I hareby etfvm uMer pnMy d psjwy one d IM blbrrirq datlaretivu: .
� I heve eM wil meimein e tt�Micete W aonnn� lo esMinwm br worken' compenwbn, m pwkM la by SeCion 3100 d iM Lebar
Code.la Ihs perlormenu d Ihe xoM lor whkh ihie pormn ie iavued.
f'1 i new �,e w�e �m� woMa.• oomo��, ��w.�.. e. �o���.e M saa� a�ao a m. �ee, coe.. b, ine o«ro.� a me
3� work la xiiidi Nn V�� u ueued. MY wFen' camDenaetion imuruica urmr aM Vd�' numDer era:
c�.,: FTRRMAN' S FfiNl) EXPIRES
PdwyN�mber: KWPA(1SQF.Aa7 QZ/ /�j7
(mia eenion need na be cromd�eE % �he o�/ ia ror ons hundred ddlen /S�ao/ w bas )
❑ I wnh' i� in Ue p Iwmeny d Re wak 1« wliic� ihis pertnn n ivuetl. I e1Wl emplo/ eiry penon n ury vo m to
become euEjea i M Mo �6rs' canpanwion lexs d Cdtlamie, vq epree A I sliwk a' I M worFert
canpenaetion eione cSs/qion 3)00 W iM1e Labor CoOe, l haIllMhwilh 'dme.
Dela: Z / (p Applcenl: �
W�mlrp: Fal n ro s�curo worbn'rnmpwu�tlon cm�np� 4 vn 1, mtl �lu/ en wlp/ ro MMrul p tlu uW
cr.n nl,., �.q ro on� nvre� rhouuM ennm /SfaqooOA In n ro m. or m.n..rro mp., o aovww ro• in
Swtlon J1P6 0l tiv La4or COM, Infwf, enG efrorney'a /wa. .
CONSTHUCTION LENDINO AOENCY: I MreEy elfimi under Po�eM b pe�N'Y �� �Mre ia mnalrudan NMinp epanry la Us
peAormarra d Ihe waN M whiN t�e peiml ie ia�ed (Sed'nn 909), Civ. C�.
LENDEP'S NMIE:
LENOEX'S �DONES3:
I ceniN �� I heva med Ihis epplcnbn eM slele �ha1 �he ebove in/ormetbn ia cortep. I eproe Io camply Milh dl ary uM munly adinenroe
arM eime kxe relelip io W' d cwutruaun vd Mreby tharua raprevenletrvea d thia ay ia emx upon iM ebwa.meMionad qaperry
iw inepeeien purpaae,
S TH
Pnnt N <
� Dme:
S RpenVRppti nlrepa
SdMY: ��rFla: CenW-AppMcenl: Rnk-Fevenua: (3oldenmd-bseera
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO; B 077866 PLAN CHECK NO: 03719-95 A
CONSTRUCTION TYPE: 1—FR PERMIT TYPE; STR
PERM NO: B 077866
GOVT; N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : 20000SF OFFICE T.I. SQ FT: 20,000
CLAIM VALUE: 360,000.00 CALC—VALUE: 403,788.00 GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS
iE 1f-!E')F iE iF iFlE iF 1f 1f if !E if iE if 1E if if i(� if 1E 1E 1E �E'IE'lE IE 1f If� iE iE �E IE iE iE fE 1E 1E �E 1E �f 1E �IElf iflE 1E iflE 1E 1E 1E �E 1E iE 1FlE iE 1E iElE if iE dE 1E �f-1F 1E iE ik iE iE iE 1F fE 1E 1E iF
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT SN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE; PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR 6TH FLOOR FOR 76 PRODUCTS COMPANY
i
**� **�*x�����**�*�*�r*�«�**��**+��+��+���****�� ��**x �*�**���****���*+�*���*� ********+�+�
D E V E L 0 P M E N T S E R V I C E S R E Q U I R E M E N T�S
ZONING APPROVED BY Q�JA DATE: �J�'/5—%S
HUILDING APPROVED BY :� ` DATE: J�—Z3��
APPLICATION ISSUED BY: DATE: J��J96
LEGALIZATION:N
iF iF iF iE iF iF iF iE iF iF 1E iF iF iE iF iF iE iF iF iE 1E 1f iE iE iE IE 3E IE IE fE iE IE iE if If if iF iF if 3f 1f iE iF iFiE if ifif iE iE
F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 2,407.25
SMIP/NON—RES
PLAN 391.18 89,80
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 2492.05 0.00 391.18 2883.23 2883,23 .00
REVENUE DIVISION TOTALS--> COLLECTED: 2492,05 OVER/SHORT: .00
HLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
2407,25 84.80
if 1E 1E 1k f! ik iE iE if fE 1E iE IE ik i! IE iE 1E iE iE ik 1E if !E iE 1E ik iF 1E 1E 1E 3E fE �E iE fE 1E fF �E IE k fE fE �f 1ElF iF 1F if IE iE �f 3E 1E iE if 1E iE IE 1E 1E iF 1E iF if if 1! 1E iE 1E �E aE k fE fElE iE iE iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF—INT. ALTER TYPE I,II F.R. —AVER 18,24 364,800,00
SFC 20000 EQU—ALT COMM. SPRINKLER SYS —AVER ,36 7,200.00
SFC 20000 EQU—ALT COMM. AIR COND —AVER .72 14,400.00
• END OF FEES
!
ICONSTRUCTION AND PLANNING
i�PPROVALS Permit #_ -
`7.- Temporary Electrical Service or Pole
� Soil Pipe-Und.grnd.
'3, Hectrical Condilft Ut:lity-Undrgrnd.
4'E1Bctrical Conduit-Undrgmd.
� 5. Steel Reinforcerrieni
. 6. Electrical UFER Grntl.
7. Footings . �
-8. Foundation� ,__ _
9. Water Pipe�Undrgritd.
� 70. Structural�Floor System
i t. Property Sewer Line & House�Connection
12. Sewer Cap ,
I73. Roof Drains _ •
� 14. Rough Plumbing- „
15. Rough ElectricaLConduit ',.
16. Rough Electric Wiring- _ •
'_ 17. Rough Wiring Sign �
18. Rough Elearical�T Bar Ceiling.
19. Rough Heating & Air Conditlonjng . _
20. Rough factory; Fireplace .. '
21. D�Octs, in Structure ,
22. Oucts, Ventilating � , � .
23. Gas Pipe•Rough � Test �
24. Root Praming � . �
\25. Roof�Sheath(ng _ _ '
26. T-Bar Ceiling (StrucwraU & Moraocpat ,
1 27. Frame�and Plashing - ,
28. Lathing & Siding � �
29. insulation.
30. Drywali Nailing �
37. P�aster Brown�Coat ' �
32. Electrical Power Meter-Finol
33. Fina( Electric -. ' .
34. fi�al Heating & Air CondiT�oning �
35. Final Gas Pipe-Test • �
36. Hood or Canopy . '
37. Final Factory Fireplace � _
38. Final�Plumbing � �
�39. Water Service-Final : '
v
_ 40. Gas Service-Final ' :
41. Solar pomestic-Final
42. Backflow Preventer �
43. Backflow Irrigation
44. Landswpe Irridation System - .
45. Sound Attenuation . '
46. Handicap Regulations - .
A7. P1NAL STRUCTURE & BU{LDING
48. FtNAL PLANNING �
49, Electric Release to Edison
50. Gas Release to Southern CaliforniaGas Cc
51. CEflTIFICATE OF OCCUPANCY
No Date
VOOL & SPA
Date Inspeetor pppROVALS Permit# _
52. Pool & Equipment Location -
53. Steel Reinforcement ,
54. Forms
55. Electriwl Bonding �
56. Rough Piumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Conduii-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Tesi
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Piumbing System � Pinal '.
65. Electrical�Final
66. Solar SYstem-Final
67. Fencing & Access Approval
� 68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
- FIRE DEPT. REQUIREMENT �
� �- ' APPROVALS' Permit #
�
n
70. Underground Hydro .
� ' •.71. PToductPipingOGas 00�� . �
� - 72. Unde�9round Flush , -
" 73. Undergrnd.StorayeTank�OGas ❑Oil
' � 74. Overhead Hydro
' 75�DryChemis0l ' � �
, 76. Dry Stantlpipe ,` ' - ..
7t FIXED SYSTEM FINAL � �
� 78, FIRE PflEV. FINAL
• � . HEALTH DEPT. REQUIREIVIENT
- 79. FINAL INSPECTION
. 80: FOOD CERTIFICATE ISSUED
Notes: -
a
t �
_i -
0
Date � Inspector
G
�
�
bl
�oopa3aeu�m�c': 555 ANTON BL
ox,�psru�EiF�a,*+:SAKIOKA FARMS `
�o�PO BOX 2097
� TERMINAL ANNEX ��
r
� �M 6TH
� 4 �
., -
.vx.�uura�ooness: '�. • � v �
�
uicxnEnonrr'm+�n:INTERIOR ARCH 2136232164 uexo, 9378
n
urcx.onua.•s�ooxEss: 550 S KOPE ST � urir: 1100
I,.A, CA 90071
corrrx�crarswu�CAL PAC (310)645-3500
Cdllq�Ci0R5YY1Pq 6076 BRISTOL PKWY
��uCULVER CITY CA ��, 392102
90230 �,R;
LICENSEO COMRACTONS DECUHATION: I MieEy ellkm ivMs pne�y d prpvy v�l' ^cmuld uds prai�i na M CAeqm 9
�oomm«�,a .'vn s«� �000� a uw� a d m. a� w v�a.n�. coe a �n �++. e� we e �w.
cirruc.No.�65824 uc.cuss:H uc.No.: 2102 E�X : 09/96
Dme: � �� � �% Cawmm
�
OWNEN BUILDEN �EttAR�TON: I hreby elfiem wMer pemly af Nq I nn q� tM m Lbeme lew In iM
Idbxiq �oman (5eabn l0]1.5 &niw» eM Rdesaiona CoEa: M' a mumY n0�� n �o oaaaun. M«. imcrws.
damd"eh, a repei mry aWctun. pia b b mreroe. eho npws ihs eppGant la ash pemW to ftla e dpneE Memem Nu M rc�M
u liowed WnueN �o Un P�s d Ihs Caueeena Lir<nae lew I��Nx 9lmmmer�0 �Kh Seeion ]UW) d Oimion J d the
B�airoa vd Rdwuro Cadal a �hm M a ehe b memN �Melmm uM tM bva la IM dbpod memqion. Nr/ videtion af Seaian
)mf.5 b� ury epp4um la a parme adje¢� ihe appfwa to a dvi pmeby d m� m«e Nn Ina Mmd'ed AOEeia �Ssaop.
� I.mowrratMpapMy«m�w�ly�eaewthwpmoihscbmm�.w�LdoRewM,udNeawpuneMWrdM
a aRmed br We (Swm ]Ou. Bu+irev end PmlmduuCOEe: The CaafeCm Liomn lew dw noleGdY W�noxiwd popxly
who WiM a inP�� the�ean. end x1n dros zwA r.ork 1'vneetl a MnN a Wdq� he a her am emWnMss. pb'� �IW aM
owrc�buitlm wJl Mva IM EUNm d D�'��0 M a Me Nd M dWE a vnpon la Ns P✓Wea af tebl.
� I. m oww d iM V WMY. am aduenelY mwraiq wdh fwu�d cm4ecbn m corcNw Ns pqw (9wun 1D11. &nLiwa eed
v�a«.�. cod.: n» w�ama. u�w �. do« m mar a.� oww a n�ro«�v wno wtu. «t�o.. m.�.o� .�e ..no
rowecu la wM pqeaa wh e mNrffiah�) �sa� p� to IM WamAs Llosw lex�.
❑ i.m..�a�sao�: a.av.c..ww,�:
Oeta: Oxiw:
I do hareby cenily tMl I em awere M eM ivW�ewd tM nyuimnWs d CaOaNe ileeEh enE Selely Cade Bwbro 25505, 255J3, eM
RSS'N. ud tlw I a e�H Mun MlEinp omQeM r.iT / vA nal (acb ane) need ro mnW1Y xtA qid qats aoda� uq �M nVu'vanwM� br
• W�mu Incarobuclbnamod�fimiontran�M�i3iuTyl.rwpamrv OwUid. MdhKW mM�utlbn VW�bm en a�wnp Imm Nrs
provubne.
od.: Mp�rem:
WORKEN'8 COYYFNSATION OECLAR�TION: 1 MrWy Num utlr prWy M prp�y on� d iM Ia4oWp btluetbm:
❑ I luv� ud xil mdNen s ealAha4 d odura �o WlJiuw� tar v.vM1�n' mnpwsubn. s V�b In W 6wbn �]CO al �M labar
Code, /n �M paApmuce d Ne xaM In wNc� Nu prmb h Wued.
� i n�..�w w�o �,.m�.:� wo�we� oa,�o.�o� �w�.�a. n�.aw�.a W s.a� a.��aea a m. iana coa. w in. o«+e�m.�w. d m.
�����'��'mmq����� LI�ERY tU UT AL'�'�m�a� EXPIRES
c.m«
a�rc, rn�nd — 0 2/ 01 / 9 9
(rm, ..nw� n«d �or a carw.w.e r w n�t u n,., e,�. n�,�d,.e em.�. piwl u� wn.
❑ I oMW Ihtl In U� psrlormeza d �M wak lar xhic� Ihb p'mu b mu�E. I np �mpby meivix w m lo
bcana wbjed to t�e nwYan' compmmmtlion 4w� d Cdibmb, uM na tlW Y 1' w �o IM worlwn'
mmpaneuion peawiora d Saaion �lW d �M Lebor CaM. I Yu01 h mm
Oeia: � �O .� 9�i+ AVMiuro:
W�m/np: Fd/un ro��eun �rortni mmp.nutlon eovxp� b I�wNI, md � ��.� mY.. �o �nm,�.� o.�.ro...�a
nro n�.. w ro w,. n�e..e �ro�,.�a edr.n frioaaooA m iw� ro m. i o �an a.m.w .. vA�row ro. ��
9«tlan J106 oI lA� L�bor Cotl�, IntwuS �� ��mq'� Hu.
CONSitiUGfiON LENOINO �6ENCY: I MnEy elfiim uMx pa�Wy d peejey �M �Mn h e mnrtrudian MMi�p epeney M IM
perlamerua M �M wk br whid� �he D�Y h e�ued (Swian �08]. CM. C).
LENDER'S NiUIE: '
lENOEfl'S AODHESS:
I <eMy Ihet I
i6.WP)
lo
to canqy xilh eA rny end muruy pdLwiwe
io emx upon ihs abow-membnetl poporry
Dme: 5 �/�� /`
Whue-Buddiq 85alaY. GieeMFJa: CenW-�DP���: Pink-Peranue: (3dAsnro�Meaewr
CITY OF COSTA MESA — BUILDING PERMIT
�.PERM NO: B 077642
PERMIT NO: H 077642 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRZPTION : INTERIOR DEMO OF OFFICE SPACE FOR T.I. S(j FT: 8,000
CLAIM VALUE: 8,000.00 CALC—VALUE: 8,360.00 GROUP OCC; B /
COMMENTS: 76 UNION PRODUCTS
�r*+tx�**���r*��r�**���x�x*�rxx��xx�x��*+�ftftxftx�**x�*x�x�*��r*�**x*�rt��*+r+r**ftftx***�r�*�r�r*��**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BDILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NCSTES>
i
1f 1E iE 1E 1E iE iE 1E ik if 1E iE if 1E if if iE 1E 1E 1E 1f 1E fE 1E if 1f if 1f 1E 1f if 1E 1F 1k if 1! if iF if if iF If if 1! 1f 1f if 1E 1E iE fE 1E 1! fE iE i! 1E 1E 1k fF 1E k IF 1E if 1f IF IE If iF iF IF fE fE iE if 1E ff iF
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
*itie�it*+rx it+r+�x x ie�ritie*it*+r�
LEGALIZATION:N
I��D=�Ilw�if:�C�9
BLDG PMT PLUMBING ELECTRIC MECHANIC
DATE:
DATE: ����'
****�x�*�r��**�r�t���t����
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
PERMIT 149.75
SMIP/NON—RES
PLAN 1.76
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 151,51 0,00 0.00 151.51 LS1.51 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 151,51 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
149.75 1,76
iE 441! i! 1E 1E 1E 1E 1E IE 1t if 1f 4 41E 1E 1E iE 1E 1E 1E IE M 4 fE 1E if 1E 1f 1f 1E Ik 1k 1k It 1f 1F iE �F IE IE 1E Ik 1k 1k 1f 1E if 1E it 7E 1f iE IE iE 161E 1f 1f 1F iE 1f if 1E 1E iE 1E 1E iE 1E 1E if 1E 1E ik IE 1F
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY _ D E S C R I P T I O N UNIT COST TOTAL COST
SFC 8000 DEMOLISH BY VALUE COMMERCIAL NOZONE 1.00 8,000.00
END OF FEES
�
�'
��
� �
CONSTRUCTION AND PLANNING POOL & SPA ��
APPROVALS Permit# Date Inspector pppROVALS Permit# Date inspecto�
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locatiori
� 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
`�3. Electrical=Conduit Ufiliry-Undrgmd. 54. Forms ^ �
� .4� Hectrical�ConduiNUndrgrnd. 55. Electrical Bonding � -
:� 5..�teel ReirttorceMent- 56. Raugh Plumbing & Pressure Test
�'���Electrical�UFERG<<+d. 57. APPROVALTOCOVER-GUNITE
r � �
�-7. Footings~'� ' 58. Electrical Cond,��,�'C�Undrgrntl.
8. FoundationJ 59. Gas Pipe, O Undrgrnd., Test • ,�
9. Water Pip,F�Undrg(nd. �' 60. Backwash Linec, �Trap, O Uodrgmd.
10. Structural�Fioor Svstem .. 61. APPROVAL TO �ECK
it. Property�Sew�r Line"& HouseConnection 62. Backwash & R�ceqtor-Final •
12. Sewer Ca�S : 63. Heater & Vent-Final •
13. Roof Drains = 64. Plumbing System - Final
74. Rough Plumbing _ , � 65. Electrical-Final
75. Rough Electrical-Conduit • 66. Solar SVscem-Fi�l .
16. Rough Electric Wiring 67. Fencine� & Access-Approval
ll. Rough Wirin9 Sign -. 68. APPROVED FOR�PLASTERING
18. Rough ElectricahT Bar Ceiiing 69. POOL/SPA SYSiEA45 FINAI
19. iiough Hgating & f�ir Cond�tioning - � r, t^� �� .- FIRE'DEPT;REQUIREMENT �
" '_ - �tL: C: '
20. Rou§fi Factory Fi�Qlace _'` "� " - ' ' •: APPEfOV,�LS'� Pe�mit # '�� '-
21. Duas, in Structure � r - - � 70.r{)nder�qrourid F�idro r
22. Ducts,VentilSting�: _ - ' '., c 7�, Produci'Piping�C,as bOil
23. Gas f��pe•Ro�gh &,Test - - � - ' - _� �. � 72, Undergroimd F.iush� � '- '
24. Roo`Framing � � ' _ ,;� � '' � :. 73., Undergrqd. Sto,[aggTank � Gas ❑ Oil
25. Roof $heathing '. �- � . -. � 74 :Overhead HydrQ =
26. T-Bar Ceiling (Structurall & Moaocoat -` 75., Dry Chemical '' ,. ,
27. frame and Fhashing' _ _ . " . .. 76. Dry Standpipe,4 � � ;� ^_
- 28. Lathing & Siding" • ' : ,�, � � 7T FIXEDSYSTEM PINA;L r .-
29. Insulation ��.,x _, J ��, i � 7�: FIRE PREV. FtNAL ' �
30. DrywallNailing �� '� - �HEALTHDEPT..RE4IUIREMENT
31. Plaster Brown,Coat ,� �' � _ � - 79. FINAL f.NSPECT�IDN � - .- �
�_, - -
32. •Electrical Po�erer MeterFinal � * 8Q; FOOD CERTIFiCATE ISSIJED r'
: 33. Final,Electri4 ;. -.�'� � . IJntes: �.;'= ' " -
34. FinaCHeating$ Air Ccmditioning � * : � � ^ - •�. _
r �r . _ j ^ i,
35. Final Gas_PipeTest ; ' .r ' �. "� " " `. : �, : � '
r
- 36. l�ood or C�anopy � .- v �� . '�� - - a -
t (` ♦ f: j�
.: 37. Pinal'Fa�[ory FireDlace. -- ' ' -
. . v � � -
38. Fina��Plumbing '7 � ' • � +� -•r, a'
- : ' ::
39. Water Se;vice-Final � �- ; °' � , �, • - `; _
; - r.. ' �
= 40. Gas Service-Pinal +: � - - �_ ^ > ��� � , _ • • �.
_ e •h,
41. Solar pomesticFina! ^ x ` • � � �' �
� • L ) � J/�' .
42. Backflow Preventer r , -.�-• r - - - .�7: '� � �
rv r: -
43. Backflow Irripation ` "� . r,, , _ :� �
44. -1.andscape Ircigation System � s a: r� S a -r r� � - .
_ - " " �'
y ... T K, ^ M- �� F '�
45. Sound ATtenuatio�.. � _ ,. _ ,, y.
46. Handicap�Regulationt � .: �� �_ � '.. - % -- '
�17. FINAL STRUCTURE & BUILOING ��� � ' _ . , ,r `_ ! .
48. FINALPLANNING� s • � '
r- -
49. Electric Release to Etlison " � ^ �' ,-
50. Gas Release to Southem Californi@.GasCo r �'
�V
57. CERTIFICATE OF OCCUPANCY
No. Date
1 ,
�oon:uaeu�oso: 555 ANTON HL
avxeasruxeivaa�m: $AKIOKA FARM5
��p� PO BOX 2097
� TERMINAL ANN6X
�vr�. Muuxo �no�ss:
uxr: 6 TH
.xcxnecTon�au+�nn: INTERIOR ARCH 2136232164 ��= 9378
urcx. on �a.•s �no�ss: S 5 0 S HOP E ��� 1 1 O O
L.A CA 90071
�n�� CAL PAC (310)645-3500
CONfPACTORSYNWq 6076 BRISTOL PKWY
�nox�ss CULCIER CITY CA ucr»: 392102
90230 urm
IICENSED COMRARONS DECLAP�TION: I As�aby dlfm iaNx pxWy d prpvy Nm I mn leamed ivqer ywub'u d CMqer 9
(wmmanciq wuh Swqn ]000) d �nbun � d Na &ti�sa mtl Pmhs�vu CaGs. ud mY Gorns o in hdl Ma eM Maa.
cmuc.No.:0658j"2�4 ����+ B uc.No.: g2 //p�J'}n!�� P; 09/96
Dme:// �_�J CamW . M'�/
OWNEflBUILDEPOECLAR�TION:IheWyelfumuiEwpeWYM '' NetlamaiemphpniMComMonli�pyslewlaNe
�dbvm0 reafon (Setlun )0�1.5 &eiass W Rdwiw Co�: MYW n mNY �fiiN �apwa e G��d lo mnbucY. W.'vnVova.
dsmd'oh, a repei arry amcme, p'v b b ewenoe, e6o rpi=�a+IM epp4mm Itt ach pxrtW to Ns e dpneE mbnrq tlW M a�M
e u�.ad w�v io ine aweov d m. wmreaa, uwn. �.w Icnaa� a t��ro wn seeoo mool a w.:o� 3 a n.
Busi�wae vN RNea'vu Coael a Uut M v Me b uemq �MMmn vtl Ne bem ta tM eAped sssmqun. MY vbletion d Seaion
]p3t.5 by enY eOW� lor e permn wEjea� iM eppfrsN to e�1 VeneM d ml mae �hen !x� IwnE�eA doAu� �SSOOp.
� I.mowrordlMpivperlyarmyempb�wxthwaps�tliheiwkmmpamtlbn.YipEotMv,pk,mdOp�yu,yunemlimandeA
a oMxad M aeb (SacWn )oa�. Buinow antl PmleawN Code: Ths Catlroeae liurue Lewdoaa na1 WdYto m owrw d peWM
who W iEa a mpovee Ihenan, end �fn Aow eu h xpk h'unaetl a Mne� a Waph he a her ovm empbyse�, qwkeE Ihel euch
impmvemenle ue nd inleMeE a dlenE Iw Wa. X, howTx. �M buiNi�q a inprwemeM is �old wilhin wq yw d aomdMon, IM
awner-Wilder MiA hew �he EuNm d proviiq M a eM Ab � b ld a impow lor tM purpose M We).
❑ 1. u m`ner d iM wwem. em utluwW aw'ee�o wun ksnew cavmms m cmmw ur w9� (swm rou, eua'vi.. ane
Proleevmv Cotle: TM CoNretlm Liniva Lew Em M epdY b en owner tl papMy wM buiN� a impova� tlrson and w}p
convecu M aM prqeea wM e mmrma(s) �ameE µnuem �o iM ConlreCm L'mua law).
❑ i.m ��a � s.n�: e. a v.e.. ea w�,:
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a
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De�e: AppliuN:
WOPNER'S COMPENS�TION DECLAR�TON; I Mrab� Wum uMr prieAy d pajuy ans M Ns IaOorrinp Merelum:
❑ �n...wwumeweo.c.Wuroaom.wu�o..tl-0mu.uorwaMaa•artpavnion.uwwkadla.MBwionarooa�Mleew
Coda.lv tM pMamanca d U�e wk la Wich fM pmft'u Mued.
n IhewWWmeiNe�wVm'mnD�uninwero.m�Wvi+dWSan�31WdIMleEaCoM.b�MW���dIM
�: wak la wh'xA Ne Wmm's iviwE. MY wvlun' mnpw�ion "vuueerce mrtwr xM D�/ mimEr va:
c.m«: FIREMANS FUND E}CPIRES
verKv r�me« i�A$�6S 0 2/ O 1/ 9 6
(iAia saction rreed nm M eanpbtM / tM pxm! b M wre hu�wM Ew'Ln /Srool a wa.)
❑ I canh � in iM pMmrorc� d IAs wak la whkA �Iw D�e e iuuM. I WY no1 ampb� eiry pa�on in �ny menrw w q to
bsr.ome wbjed lo IM xoM1an' mmpanWbn levn d �eNarve. aM epna �IW ' dwuW bxvn� w��y�aaaddtl lo IM xqken'
c/Iri�_��bn�]UOOIIM � II�l�bn�
De�e: •
wemrrp: F.flun ro ucw rvoAr�' nmWrwtlon eewnp� �+ ��'M. •ndWlr ueJM.n rrplqw ro cnMnl pwMu �M
nH� nnu w ro om nu,ene mouund edan ltio4000A m.m�aon ro m. ea.e o� w�row•uon d.mro.• u vrov�d.d ror in
S�ctlm �108 0/ tln l�Eer Cob. INwN4 ud �ttumry'� IW.
CONSTfiUC110N LFNOINO AOENCY: I Mnby tl(um uM✓ pwM d perjury thu thsrs u a amp�ueion Nndinp apancy lor Ne
pGIIIXTB11L0 a 1�1G MIXk �IX Mfil(JI IhY �TI� O OlIIM� ($W41� �.IUBi. CrN. Cri.
LENOER'S NA4E
LENDEN'S ADDFE99:
I cerNY �het I Mw'eed Nu eODrsd� �rk tltl� Rw tlr �bow'uJmmeiion u canetl. I ple� lo oomdY wuA �Y iYy W aduMY aE'uw�or
eM elale kvn ielmM w Wi7d^0 oombuclqn eM Mraby eWNas �epwwatiw d tM �N'b eNa Wm lM eEwe.mauipwd puDeM
fa impeeion purpwse.
DAVID DE SISTO
_� Dab:�� 3-9 �
Sqrotwa d Qww/I,penVAppiren/CWreea
(StStdB.WP1 Whue-BuJdvq d SeletY:O�eemFb: GeneiY-Mp4ent: Rnk-Reronue: (3ddenrod-Maavn
CI COSTA MESA - BUILDING PERMIT
PERM NO: B 075024
PERMIT NO: B 075024 PLAN CHECK NO: 04502-95 A GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : ALTERATION TO ELECT/CABLE/COMM ROOM SQ FT: 10,000
CLAIM VALUE: 10,000.00 CALC-VALUE: 10,450.00 GROUP OCC: B-2 /
COMMENTS: 76 UNIONPRODUCTS ELECT ROOM TI
�******+��x+�****�*���*���*��****�r*�**��***+r***+��x*�**�*�***�*+��****x���****��**�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: TC REF NO:
PLANNING NOTES> INTERIOR ALTERATIONS.TO EX. ELECTRICAL ROOM ON 6TH FLOOR OF
> UNOCAL BUILDING. - '
�t*+�********x�*****�*+t+�+��t+�+t� *�*�*�**�+� it�� �x x�*�r**�*�*�*�****�**�*�**+�+�**�t*+t�r****�*
D E V E L;O P M E N T- S E R.`.V I C E 5 R E Q U I R E M E N..T S
ZONING APPROVED BY � � DATE: ( �- 3"9�
BUILDING APPROVED�BY : I/i�(U-I.�1Q •� DATE: U�:c�J7s
/ '�'
APPLICATION ISSUED BY: • � DATE: �
iEiEaEiEitiEiE �-if+�itifi[�ititikiEit�tit�EiEiFiFiF'iFiFiFiF'iFiFiFiF'iF3F7i�iFiFfF7FiETFTFTF3F7F7i�7F7F 7FTF3F3F�F�FlF+�1E�tiFiEiEititifiE iE�t
LEGALIZATION:N F E E� S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 126.00 SMIP/NON-RES
PLAN 20.48 . 2.19
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 128.19 0.00 20.48 148.67 148.67 .00
REVENUE DIVISION TOTALS--> COLLECTED: 148.67 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
126.00 2.19 20.48
iE 1E k 1E 1E iE 1f 1E 1E 1E iElE iE 1E IF 1E 1E IE 1ElE k 1E 1E 1E 1E k 1E 1E 1E 1E iE 1F 1E iE 1E 1E 7E 1f iE 1f 1E 1E 1k 1E iE If fE 1E iE 1E �E 1E 1E if if ik iElE k iE i! 1f 1E 1E 1! 1E iE 1E f! fE iE 1f IE 1E ff fE 1E iE IE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 10000 T.I, OFFICE HY VALUE/$1 1.00 10,000,00
END OF FEES
_ '
CONSTRUCTIQN AND PLANNING POOL & SPA ,
- APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
, 1. Temporary Electrical Service or Pole 52. Pool & Equipment Locatiori
2. Soil Pipe�Undrgrnd. - 53. Steel Reinforcement
3. Electrical,Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforceme�t 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE •
' -7, Footinqs: - - 58. Electrical Condult•Undrgrnd. ' '
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. , 60. Backwash �ine5, P•Trap, q lindrgrnd.
10. Structural Floor SYstem 67. APPROVAL TO DECK ,"
11. Propercy Sewer Line.& House Connection 62. Backwash & Feceptor-Fina�
12. Sewer Cap � , 63. Heater & Vent-Final ' .�
13. Roof Dreins 64. Plumbing System - Final ��.
14. Rough Plumbiog �- 65. Electrical-Final -
15. Rough Electrical-Conduit - 66. Solar System-F.inal �
76. Rough Electric Wiring - 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FO,R PLASTERING i
18. Rough Electrica4-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. RouQh Heating & Air Conditioning _ FIRE DEPT. REQUIf}EMENT
20. fiouqh Factory Pireplace '.. APPROVALS .. Permit # �
21. Duces, in Structure •' _ " 70. Underground Hydro ,
22. Duc[s, Ventilating �. - _'� 71. Product Piping � Gas ❑ Oil -
23. Gas Pipe-Rough & Test �� - 72. Underground Flush
24. Roof-Framing ; � - , � ' 73. Undergrnd.SrorageTank OGas ❑Oil
25. Roof�Sheathing � �. � '� 74, pverhead Hydro -
26. T-Bar Ceiling (Structural) & Manocoat ��s�P�� 75�. Dry Chemical _ .
27. Frame and Flashing . �p�6 � 76. Dry StaiTClpipe
28. LatHing$j.Sidin9: ' ', �' ; 77: FIXEDSYSTEM�PINAL� �
. 29. Insulation - ' • . 76, fIRE PREV. FIPlAL '
30. Drywall Nailing � I��GL' , HEALTH DEPT. REQUIREMENT
��.
31. Plasrer 8rown Coat. � r 79. FINAL INSPECTION
32. Electrical Power Meter-Final ' � 8�: FOOD CERTIFICATE ISSUEO
33. Final Electr�c � � Notes: :' '
34. Finat Heating & Air Conditioning _ �9 O�� ' _ �_ - �
7
35. Final Gas Pipe:Test : : .: , . rv . : . . �
36. Hood or Cbnopy - - � � 'x , '
' h
37. Final Factory Fireplace - . - �•
38. Pinal Plumbing � � " ' � `"
�
39. Water Service�Final � ' - • . . � � �
- ' i ..
40. Gas Service•Pinal . - - � - ; - �
� 41. Solar OomesticFinal . - - ��
42. Backflow Preventer � � ' �
, �.
43. Backflow irriqation , '
44. Landscape irriqation System � , . ' _ . �
45. Sound Attenuation . . � � - �
46. Handicap Regulations '
47. FINAL STRUCTURE & BUILDING �
48. FINAL Pl•ANNING � , / � ' • �
<
49. Elearic Felease to Ediso� �
50. Gas Release to Southern California Gas Co
51. CERTIPICATE OF OCCUPANCY
No. Date
�oonasaeu�ocrp: »> [irv
avxexsruYeiv�aavN: SAKIOKA
.00ness: PO BOX 2
. TERMINAL
IPPL. WJIINIi i1WPE54:
L
UNT:
ApCXRECT OX FHIiNHA: llt. NQ:
WCN.OR FllG.'S ADDRESS: UNT:
caim�crarswu� SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
CRAqICTOR4YY1W0 21 S E EL SUR ST
eooeess MONROVIA CA uano: 190173
91016 �,R;
LICENSED CONfN�CTON4 OECUIPATION: I heroby Nim undee peroly d pmjury Nu I em Icansed uMs prwuiona A CMpter B
(m�m er¢iip wil� Seclion )000) d Diriaion � d iM Budroo uq PNmdma COAe. vy my liconn is in IUA Iwcs entl aNea.
d[tvuqNo.:013054 uc.cuss: C 16 uc.No.: 190173 EXP: 04/97
/na�.� 1 �// Z/fL c�,.dm � i
�P BUILDEfl UECLlN4TION: I he�sEy e1Nm uder prelyA perjry �NI I am eremq Imm iMT.w�rfm l.iwme Lew la ihe
wip reum (Setlun ]Qt1S Buainsa end Rdpennf Code: MY cYY a aqm�Y w1iiN nCum e Dam� lo mroW�1. NW. MWova.
demd'oh. a npei airy atructure, pior b b aauerce, aho ipwrea �M epplimni lu euch pmmn �o fb a vprod sWsment Ihal M m eM
u limneed purwent b �M pwmms d tla Catlratlas Liroroe lew IChepr 9(��q �A Satlion 1000) d Diveian 9 d tM
Bwinma and Prdma'vm Cadel rc thq he a ehe u aaemq �IvsM1om W 1!w bem In Ne ele0� urMion. My violatian d Setlbn
J031�.5 Ey enY ePO� la e pemW aubpGf IM appl'ratl lo e tlW penelly 01 np maa �Nn live I�untlretl tla0v� �5500�.
� I.cvwmrdiheP�Yamyamd�Jb+wihwqp�m�MiWemm�.rriOEONeMakendNs�IricWnum"vurdeE
or MereC ta We (Seciim ]as. Bmrev vd Pmfmma Code: Tha Caurmors liwua lnwdox na ewNto an oxnx d prapeny
wln buih a inOp+<e �herean. end rho dom �udi wvk IimM a henN a tlxaqh he a Mr oxn amWuYb�. V�'b� �Iw wch
inpwamm� ue ra ine�EeE a afleeE la ub. tl. Mr.wx. Na buk'vp a inpwanatl e wtl wGAm aw Y+� d mmpbtion. tM
ownerbuitler xitl hew Ne hudm d V�+�q M n+he d'd nol MiN a impaa la Ns PaGms N eWl.
� I. m ovma d Re pW�Y. am mtlm�M' aoNree^0 wtlh foeiuW mntredan b mmtrutl Ne M9� (5au'vn IOM. &s'vieu erd
Profeno'u COCe: TM CatlrerJm l'caw lew Joea nol eppl� b en wnw d papMy Mn duN� a'unpwa tlwaan ud wM
wnVem la edi p9� xi�n e ovemfMe) fcemeE P�uam io iM Canmeae lioeme lewl.
� I em e�emp undx Seclion: B. 8 P.G.. br Nis maaon:
Dale: Oww:
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25SL. vd tlw I a enY Mivs briMnO �+nM wil / wi ml (vcb one) neeE ro mrolY wN uid qete wda� eM tM �epimamem� br
e pe�mY Iamnwniona moddmion tromilw /v�s�yenru Gnnd. Raetlxtlwlamurwion eVGk'mioroen e�emp Imn Nws
a�•.
Dma: �ppRw:
WONKEF'S COYYENS�TION DECLAH�TION: 1 hrMy Nfim �vdr pwtly N{wjey pr d tlw b0ow'up Mtivethe:
❑ IM1aweMrAmeuvviemnCubdmrorvioWwuab�wkan'm�mqbn,nprwtledlab/9�monJlWdiMlebv
Gotle.lu �M perlmmuica d Ne wuk la MirJi Ne panro u ieusJ.
i n..�..�e w�.;v.:,.�«,� �o.�m�o.� �.M.. m�.am.e e� s.,� a�ao a a. �. eoa.. a u» o.a�. a in.
work lor xTiM Nu V� u muW. MY ra4en' mnW mN D�Y number ua:
ca,,;,,: ����'�`° EKPIRES
P,,;�,.,,,o,,,,,: 0 6/ O 1/ 9 7
�T�119 6NYM I100.� IW �O CPTIpbGd � IlM 0�'ml0 /01 Y�M �WIMO.�QCdVD �i1W� b.�LY.�
� I oenM Ntl w Ns D�mrenu tl Ne rM br uhic� tlw 0� b m�Ntl. I tlu0 mi �mM�/ M' V�� w�ny men�ar n o to
becmre wbjeu io tM xoM1an' campwvun lexs W CaNanu, en yres tlw 1 I 4wq ecoms aEjw to tM worken'
mnw�� ��. a n, Jloo a in.lmo. coa.. �.n.o � .vm m�oM •an uw» '�'
e: �v L �ppiraru:
Np: F�9u ro�cu woM1wti ronpwu�tlon mmp �rNl. uW NN ub/cl �n • yw ro eAMirl P�bu �M �
crvn nnu w ro m. mndrw unauro eaian pt W an wWwn ro m. co.r or n�.n..wn d+m.w u peva.e ror a
9xtlon 91t16 0l IM la4or Ca6. InMu4 ����Y1 M1a.
CONSTtiUCIION LENqNO �GENCY: I MW� eKum ivder psuhy d psjvy �!W Ihas u e amuwion Wdinp epenry lor Ns
pMamenm d iM wk M wNN Nu pemi u ewd (�� �1. Cw. C).
LENOEP'S N.W E
LENOEP'S ADpqE49:
I eenM �het I hm reei tnb eaG�ration eed ama tlw tla ebwa'vd«mmion u oana. I rona m eanWY xitn M enY eM aounb �nenme
eM ela�e kwf mWip b buddiq mvtrWian end MrebyaWhp¢e �epa�aNelivu d Ilv ely b aMx upon �M ebwa.menliaieE popaty
�a�mc«�:�wm�..J.IM.KENZ.._, _, r -- - -- �
Whne-BuiN:q a
Dem: L L �
�
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: F 078125
PERMIT NO: F. .078125 __ PLAN CHECK NO: 01857-96 L GOVT; N SUPP: N
'CONSTRUCTION.TYPE: 1,—FR PERMIT TYPE:_FIR PURPOSE: ALT
JOH DESCRIPTION : ALTER SPRZNKLER HEADS SQ FT:
CLAIM VALUE: . 8,900.00 CALC—VALUE: GROUP OCC: B /
COMMENTS:._7,6�UNION.PRODUCTS
kklFkikkikiFkiFiFiFiFkklFkkkiFkkififlfikififiEiFifikififlFMikikMiFifkiFiFiFkikkdFkkkilikkifkMifklFMMifMiFMMkkkMiF�tiflEiFlkiF
_�'_. __ Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------.MAIN.HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: . FT . IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT ___ IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV; PARCEL: 41050104 ZNE: REF NO:
PLANNING N TES>
�
il' i4 il' iF If iE ih 1f 1f iI' if ih iF i4 iF 1k 1E 1F fk 1k ik ih i%ih if ih 1ElE 1E 1k i! i%if 1f 1E if fE fE if iF IF ih ih if fE if ii'1E i%if 1E 1Ei%1E ii' 1E 1k ih i! 1k 1E ii' 1E ik 1flf if 1E Ik il' 1f iI' 1k 1t i! 1tlE 1Elf
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY: � _ _ (�j�,`
iE iE 1E 1E 1E 1E 1f 1E 1f 1E iElE IE iE fE if ff 1E iF iF iE iE
LEGALI'LATZON:N F E S U M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT
DATE: n
DATE: l
��f/flflklklEifltiflElk 1F1E�
STRUCTURAL EGMENT:N
FIRE SMIP/RES GRADING
137.00
65Y SMIP/NON—RES
PLAN 89,05
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> r 137.00 0.00 89.05 226.05 226.05 ,00
REVENOE OL�lLSIqN_TOTALS-->_ C�)LLECTED:_ _ 1.97,00 OVER/SHORT: 00
BLDG PMT,PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
137.00
************'***'�{'X'**'��'*X'****'K'*************�'***'**K'�'*'K'**********'�**********�'�***�'�'
_ I N D I V I D U A L F E E H R E A IC D O W N
TYPE
FIR
QTY
137
I►i���:��i1i��7�1
FIRE EQUIP FEE (FROM HLDG VAL TABLE)
END OF FEES
� �'�
i" '�..
4. �l M1I
— / 3
r - .
� J �
—�- �`
—,*'-
UNIT COST
1.00
TOTAL COST
137.00
CDNSTRUCTION ANp PLANtilING .� NOOL & SPA , �
APPROVALS Permit # Date Inspector qppROVALS {'ermit #'- ! Date Inspector
' t. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
ti 2. Soil Pipe-Undrgrnd. ,_, �� 53. Steei Reinforcement . ��, •
���tElectrical Cond�T U£llity•Untlrgrnd. 54. Forms �^
', ���f,flectrical Condt�l,�Undrqmd. , 55. Electrical Bonding , ��
'a;5. ✓3teei Reinforcecscenr-+ 56. Rough Plumbing & Pressure Test s �. �'�
,��,yElectrical UFEfi'Gnd. 57. APPROVAL TO COVER-GUNITE �!� ��
n�
�� E . �ootings i.yp� � � 58. Electrical ConduiS•Undrgmd. ' �
8. •l�oundation `�� �' `O 59. Gas Pipe, O Uncl�grnd., Test ' � �� '
-,
9. Water Pipe-Und�Fnd.-; �+ 60. Backwash Lines•�ATrap, O.t�ndrgmd. ,
� 70. Structural Floo� ystem ,y � 61. APPROVALT04�?ECK � �
.'
71. Property Sewer�;iner& Hous�onnection 62. Backwash & Fec@ptor-Final �
�2. Sewe� CaP �' � 63. Heater & Vent•Final
�
13. Roof Drains � •��
,/ 64. Plumbint� System � Finai � ,
14. Rough Plumbing� i.� 65. Electrical�Final � �� .
-. �.
15. Rough Electrica�Co�duit C' � 66. Solar System-F�i,� � .
16. Rough Electric�iripg 67. Fencing & Acc�is Approval '
` 17. Rough Wiring �n � 68. APPROVED FQ�FFPLASTERING '
18. Rough Electrica�.T Bar Ceiling � 69. POOIlSPA $YST£MS FINAL
19. Roug3h Heat+ng & Ais Conditioniny � FIREAEPT;;REQUtf�EME{VT
C t :'1> t;^ � O'l7` c V: z �* �-. T
�^ 1" � �+.'= Y_ J W �.� �'1 � r."` .� i.A Y i. r
20.-Ro� F`^tor,� Fi�place i SR. �t: �; S H r.* APPgOU�,l�,5-��-, Pecmit# � ,
21. �ButiS, iriStrl�tur'Eze. i .. .. r:� >, S � �.K y. ` --^•.J ~�, e:
�•a+ SK 5� * i-� H rr 70.�Jndergr�GirtJ HHdro y.
22. �Huc4�. V�til5�tinfi�. . .":J t q rj �.,* � 71. ProductcPiPing O-�,as N.�J. Oil
23. vfias�Pipe�fio�h & Test :T.'S � t� �t Oy ` 72. Undergro�nd F,iilsh F �`
24. �oosfr,F in ' ^ � �"H ••F a _ iJ c � 7 > �c-� a: w
yy� B `z m r ^+ c-;* • 7J; Under9rnd.Stw.agQTankOGas Oil
25. RooiyS+ShE3thing � r Q v v.,: C�? �Z+� 7N Overhead I��_,foi.cJl,� (�`lQ'Q(� ��
26. ��BaCCeiJin9 (Str�gural) & M`Eli�oat x� j; ��� 7� Dry Chetnicel i,� r, J �
27.;FrameandFl�hiqgX �x�: >b' - �^ 'D'� 76. DryStary'�piPeF`� �- c�
�'' 28. nLat�ing �SiBfng�,*. `'' �',x�,.�., � x`' I I r� 7�; FiXED�L�ST��INP.,Yi.N r �: .$��J� � 14'
29. Insulation • ^� S •• r � I ,��. 7�' FIRE PREV. F�,f}�AL �" �" � l�i�Q( {�ig--
, -, � �
� 30. Drywall Naili}�g �'v ., x p., � - S ,ikEALT�F{ DEP;T: REQUIREMENT
31. Plaster BCDwifCoai %. s" ^':T' �t: ' tr � 79�. FINAL [N�yP� N �, ':
;. 32. �lecirica�ow�r Me�r'P,i,�al � * N ,,.1_�,�' 8!T' FOOD CERTIFd;EATE F��I:IED, �
_ 33. �inat;ElectriG> �.k ?! ; � .R � �;* � N'ates: `= 7tT7 �'� O GG;
w ^ .� -
'� 34. �ina�He�in� Air.�(�Pultior4irtg� � �,' � ' i�k ^ tK,; i C'�2 * y -
; 35. �inal Ganpipe;Test � � y •• s � EK � ::v �+r� * C;T
:.r Xt m �'l
36. jJooa�or CanoPY ` �[r- w C� rt ., £ C'o * `.
FS+ . � (l r �'. b; .-. �r ��� rr :'�.i k '.�7 i[•7
iL ` '
37. :na�4�actory Fireplace x � i-[� r,; x' i i' �. •. s �'r�
�� �
�-�L -J: Rl r
� 38. �1na�,Plumbing i �' , C � ' t S , :� • � �
�.
� 39. ,3�ater Service�Final :-_ g , � s tC � 4 ; . � � ^ L,."„ * m �
. 40. �Gas Service-Final '� �=, ^ "'- = * r � N' C �� ^'n' '� "
:., x . � � �- a: r kx - � ' • f a� �C
c � .. i� �
� 4Y. `�SoYar pomesticFinal� �-n �r r• c.i m';r� m � �. ^
C
42. Backflow Preventer'' ��+� ^ I kr � C: •�0 • " i-� r � r
�: ;u -•1�; '�Y `-, x t*:C'1c I�70 � c-
43. Backflow Irri�tion < s r r r: V'� �� +� i� •
� n
�A'R. kandscap'�IrHbatiori'5Ystem��'� '^ y T! C o Gt . n: «: '.i,, x c� c
r � 2 � �6 'Q C, �" ^� i E x '" '= r"'
�. : � � -,; � r� r r �•
5. ��S'ound AFien6'ation� . .. E. �:, �,; n � v c� � ` � .r
96. I-Fandicap•Regulatior'i5 �'' O �'' ~ �' :'r, 5 rr� �• x
a: � S f: �: I R; O C�� �P
47. f'IN�L STRtJ`�CTU� & BUI�'bING ,�: E... � �' • ` i C+ M c-
l' �
48. ElNltI.PLANNING' � E-'`' t n: '�"�r t i. �t * ,
.,� x �I =}r � c u x r;
�9. �ectjje Rele�e to E�tlison � f; � �.• ' � •n �M :, ,�
fi0. Gas Release to SoutFiem Califpihfi as Co ` i' i� F � G• c?, r •
r ,* � �o n
51. CERfi1FICATE OF �CCUPANCY � <<' �' ^ ' • `�
No Date
,�non�sav,em�aeg: 555 ANTON BL
avwERsruyeiviu+oxN: SAKIOKA FARMS
�nnness PO BOX 2097
--;' TERMINAL ANNEX
uv�. �uiwa �oo�ss:
UNT:
6TH CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 078538 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE; STR
�acxrt�roaEr+omm+: INTERIOR ARCH 2136232164 ucw.: 9378
urcxonFra•s,�ss: 550 S HOPE ST urrt: 1100
L.A, CA 90071
mN�n�cTarsrw�:
ca+mAcrons xuiva
�oo�ss
uaw.:
unr:
LICRlSEO COHfNACTOFS DECL/�H4TION: I hereby ellim unEer parialy d perjury tlW I em IicerieeA uiMer prwiaone d Chaqx 9
(mmmenti�p xilh Seclion ]ODO) W Drviaion 3 d IM �einem enE Profeeaom CoEe, erM my limnae ia in lull lace eM eflxi.
cmuc.Ho.: uc.cuss: uc.No.: EXP:
OWNER BUILDEH DECIAR�TON: I lweby dfim� undsr pe�Wy d perpry Ihal I am exemq han tM Waraqon Llwm� lew la Ihs
IoOor.'n0 �wm (Smion'lm�s Buenms eM Rd�bm Cods: M/ UY a m+euY r.t�id� rpuvu a V�t to mmfrud. mr.'v�wm+.
bmd's�. a raWi eny sWtlive, prior ro Ia oauer�. ebo rtVuins Ihe eppliunl tor wch pemu to fJe e epnad �WamM tlul M a eM
e icmaee w�w� m �ne n��+ a me cm�reeas Licema lew Icnepx e(mmme�o wun awnn 1000) a Oiyeon a a ur
B�an eM Pedmun Codel n tAm he n aM u memq ihaehan erd �M bmu la tla elbpetl usmpion. �m'vioW ion W Swion
�mi.5 W.�r.odK.m Iv. rormn a�npa+�M ecd�m io e dw o�v a na mae inen rH• wm.ed eau. �sswp.
❑ i.mow�.�am.ww?�v«!m��dw�aw�n..�e...m.:.d.�w�o�!:.;neom.won�.�em.w�,�.n..:�aond,eae
im0�mmro ve M inleMeE a Mmed la een. n, twwaver, me Wipnq a mpwemen ie eatl wnM1in aw yam d canpbtun, tM
�owmr-0uWr will heva iM buNm d pwinp � a� did np buiN or imprma la Ihs µvpwe d Ws).
I, m oxner d iM popeily, am aRduervay eMlreaip wil� IiceneaE conVeelwe b emetrua IM pqea (9epion 1W/. Bw'uim� eM
Pmlauime Gade: The CoMrepma Liunae Vw doae M eoGN a en o�mer d p�apeny wfio dtitle a Mpwev Ihm�an entl who
mnieeeu In wM pioptls wdh a mmrouor(e) liuroed punuent to iM Com�mae lHanss tex�.
saemq uMr Sxtim:q B. 8 P.C.. b I�i� �uson:
e: ' �— / Owner:�' �• � ��-+-
deM /^wnilYUwlemerueMerdwWe�aW�dNe�W���sesd ' ' FWMendSdeYCadeSaCiau2550S,E.53].mW
� Nei I a enY Mun buiWiiq am�peni v�ll / wil rwi (�b aw) �+ed �o comply wih mid ptle mEs� eM IM npuirempqs br
a 'IamubucYanamodd�ral'anhamUeAi�ly.TanipemeNDiY�itl.RatidMNcaWruCuneGOb�b�asaumqhamYep
a�•.
Dme: _ �Op�:
WOXKER'S COYPpISATION OECWi�T10N: I M1uebY dfimi imtlar penetly d pxpry one d IM bCow'vp dedvei'un:
❑ IheweMxilmeiMeneceNfr�admm��losetlimursbrwvrken'cmipen�eybn,ypo�dedlabyBr.Ibn3]OOdiMlebar
cod.. �« ine c.��a d �n. xwk �«.n:�n ml. v�il u u.wd.
❑ I luw eM xil mdnten waken' canpenaeliMi ��enca, m nqu'vsd py Seebn 3M0 d Ne lebor Code. br Ihe paibrmence d iM
work In �MiM ihis permN u inueE. MY warb�e' mmpaneeiion Inwrarw rirtir vd pdiry numbw w:
Cemer
Poliry Numbr:
(n�is oalm msd nor as �w*Me�ee r uie w�� b rur ms rwndred emeis Isirol w bn.)
❑ I wr�W Uw in Ur peetormvwe N tM wak ��kl+ t�b permM1 b ewatl. I ehell nol empby ury peson F ury muuw e a W
Memw abpd to tM walmro' mr�penW� uM+ a Cefdmue, arM ap�ea tlw ! I JnWd beeoro �ubjW lo IM wrbn'
mmpeneetbn pwuiom d Ssaion 3]00 d IM1s �bw Code. I 4WI IMhwnh mmply xilh ihwa pwuipu.
Dtls: MW�:
w.mNa: acw. ro a.c�a..�onten� mm�•oon cov...o. n u�wnq ..a,mm�eN�+,n.ro�ow ro afm�wwo«wnr.ne
uw Mu w ro om ninand mou.w dwrn ls�00.aaoA er.ealdon ro m. cmt o� conprwwn �w u e+orw�e ror �n
91ctlan 9llA5 0/ 1M L�bor Code, IMw( eMY�m�I•� Iw.
CONSTIiUC710N LENOINO PGENCY: I MmEy �� uMm penNry d pmjury Ihet iMm u a(mnruqion bntlirp epancy br tlr
psAormuxa d iM wak M Mhitli �hc paml u of� (�� �B). Crv. CI.
LENDEN'S NAME:
LENOEN'S ADDqEA4:
I cerliy �hm I heve reeE iho epd�im enG pme tlw� the ebovo inlameiion i� rnrtatl. I apme Io compty wilh NI tlry enE mwty ordinvims
enE etels Isw� Mmiq to buitlip aonvrutlion end IKKsM' �Mrixa nqaeanie�rves d iks tly ro mter upon tM above-menioneE papMy
���°'°°"�°°�"0°'°°' ERNIE VITUCCI
�: (515t�6.WP)
t
Daa: i ^ �6 ^ 76
WlNs-BuldN 8 Selely; OreerFb: CuimV-�OV�d: Pink-Rere�uw: OatlanmA-#uqaa
PERM NO: A 078538
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : 20000SF OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC—VALUE: 339,625,00 GROUP OCC: B /
COMMENTS; 76 [JNION PRODUCTS FURNIYURE INSTALLATION RE; B-77866
*it*itititetatat�r*kiFio-**x���r�r�rit�ft�r�it�*�tie**itititit***�ieit+�***k+r*�xx�*k�r*it*et�r**�rif�riF*x**��rie�rftft
Z O N I N �S ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050104 ZNE: C1 REF NO;
PLANNING NOTES>
i '
it iE it if ik it if 1t iE 1F it iF it it it it ik iE IE it iE iE if ik it it k if it it ik it it iE iE i! ik iE iE iE iE iE iE it iE iE iE fE iE IE ir it iE it it it iE iE 1F ff if 1E iE iE iE 1E iE it iE it it if it if iE iE 4!E iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T 5
ZONING APPROVED BY DATE: '
BUILDING APPROVED BY : DATE:.'� (
APPLICATION ISSUED BY: �..- DATE: 0
iEiElEfffkifiklff4iElFklfiElfiflfiEiEiflklE lElfiffE1E1E1E�1EiE1E 1E�7F
LEGALIZATION;N F E E S U M M A R Y STRUCTURA SEG ENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 2,087.25
SMIP/NON—RES
PLAN 71.32
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 2158.57 0.00 0,00 2158.57 2158.57 ,00
REVENUE DIVISION TOTALS--> COLLECTED: � 2158,57 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
2087.25 71.32
�E Ik fF 1E iE 1f k�E fE!!!f 1k fE iE iF 1f fE 1E 1E fE ik fE ff 1E fE 1E 1E ik if 1E if !F iE iElk iE if !E 1f fE �E 1E iF iE 1f iE if iE df iE fE IE 3E 1E 1E �)E iElf !f iE iE If iE 1f !E fE �)E jf 3E fE 7f * 1k iE iE k iE k iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC J25000 T.I. OFFICE BY VALUE/$1 1.00 J25,000.00
END OF FEES
�
CONSTRUCTION AND PLANNING � P�`-`y SPA
t??�ROVAIS Permit # Date 'InspeUor APPROVALS Permit # Date Inspecmr
,� 1,. Temporary Electrical Se�vice or Pole 52. Pool & Equipment Locaiion �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Eiectrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Coniluit-Undrgrnd. � 55. Electricai Bonding
5. Steet Reinforcement , 56. Rough Plumbing & Pressure Test �.
6. Electrical UFER Grnd. 57. APPROVALTO COVER�GUNITE .'
� 7. Footings 58. Electrical Condui[-Undrgrnd. '
8. Foundation 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, O Undrgrnd. '
70. St�uctural Floor System 61. APPROVAL TO DECK i
71. Properry Sewer Line & House Connectio� . , �62. Backwash & Receptor�Pinal
12• SQ'Ne� CaP 63. Heater & Vent-Fina�
13. Roof Drains 64. Plumbing System � Final
14. Rough Plumbing � 65. Electrical�Final � .
75. Rough Electrical-Condu�t 66. Solar SYstem�Final . �
76. Rough E�ectricWiring � 67: Fencingr& Access ApProval . .
17. Rough Wiring Sign , . 68. APPROVED FOR PLASTERING •
78, Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
� 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � � APPROVALS Permit #
21. Ducts, in Struaure , ' 70. Underground Hydro
22. Ducts, Ventilating . - 71. Produtt.Piping OGas ❑Oil
23. Gas Pipe-Rough & Test . . 72. Underground Flush �
24. Roof Framing - 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. :Overhead Hydro
26. T�Bar Ceiling (Strucmraq &�Monocoat 75. Dry Chemical -
27. Frame and Flashing .. 76. Dry Standpipe -
28. Lathing & Siding � 77. f�XED SYSTEM.F�NAL
29. Insulation - . .' � 78. FIRE PREV. FINAL �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coet; _. � 79. FINAL INSPECTION
32. Electrical Power tv1eterFinal 80. FOOD CERTIFICATE ISSUED
I, 33. Final Electric " '' Notes:
34. Final Heating & Air�Conditioning .
35. FinaPGas Pipe-Test
36. Hood or Canopy - ,
37. Fina� Factory Firep�ace �
� , -
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final � �
• 47. Solar pomesticFinal .
42. Backflow Preventer - -
43. Backffow Irrigation
44. Landscape Ircigation System � .- � . -
45. Sound Attenuation � - - '
46. Handicap Regulations ,
47. FINAL STRUCTURE & BUILDWG /���YG �
48..FINAL PLANNING ,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICATEOFOCCUPANCY
tJo. � Date '
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� CITY OF COSTA MESA �
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.costamesaca.qov
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: BC12-00016
FERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 02/28/2012
� ISSUED BY: KJB
,r
�os ao�Ress: 555 700 ANTON BL CM Suite/Unit: 700
APN: 47050104 . Zoning:, ,
RI
Vicinity: 7TH FLOOR Primary Occ:
Const Type: . I-A SQ. FT: '- 5168 Valuation: $104,500.00
., ti -
SCOPE OF WORK: 5,168 SF INTERIOR TI FOR "HOLTHOUSE CARLIN AND VANTRIGT LLP", SPACE 700. WORK TO INCLUDE
THE EXPANSION OF AN EXISTING TENANT INTO EXISTING FLOOR; NEW NON-LOAD BEARING WALLS AND CEILINGS,
FINISHES TO CREATE NEW OFFICE ARES; STORAGE AREA; BREAK ROOM; CONFERENCE ROOMS AND COPY/FILING
ROOMS W ITH 42
LIGHT FIXTS, 31 OUTLETS, 12 SWITCHES, 17 COMUNICATION DROPS. NO ALTERATIONS TO EXISTING RESTROOMS.
PL'•UMBING TO INCLUDE: 1 BREAKROOM FOR KITCHEN �SINK. MECHANICAL TO INCLUDE: ALTER EXISTING DUCT WORK.
�
OWNER: PWREFlMCC-SOUTH COAST, LLC Address: 535 ANTON BL. - Unit: COSTA MESA
GA
Plione: City/State/Zip: SUITE 150
�4PPLICANT: SALERNO, SCOTT Address:
,Rlione: � ' City/State/zZip:
CONTRACTOR: AMARON CONSTRUCTION CORPORATION License No. 674301
Fhone: 714-993•9220 Address: 1565 N HARMONY ClUnit:
�eIL City/State: ANAHEIM HILLS, CA
,;i,
21.
ARCHITECT: KERRY P WILSON License No.C19204
ENGINEER: License No.
:i%i.
GOMBINATION PERMIT FEE SUMMARY
Building Plan Check: $166.04
Building Fees: � $1,021.75
Electrical Fees: , $123.49 •
Mechanical Fees: $78:30 '
Plumbing Fees: $33.30 •
�SMIP Residential: . $0.00
$MIP�Commercial: $21.95
Bfdg Std Admin Fund $5.00
TOTAL FEES: $1,496.86
_'Reter to fee raceiots for all (ees oaid for oroiect
1816
L'.l
3?,66
F'G
� '
Ptl3 -
4b4
4C
:�:G
C�=
Unit: :
ZipCode 92807
PHONE:949-851-3080
PHONE:
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3118/2010 - PER CMMC Sec. 13-279
thru Friday-7:oo am thru 7:0o pm. Saturtlays-9:oo am thru 6:0o pm. Prohibited all hours - Sundays and the following Federal holidays:
:: The work authorized by this pertnit shall comply with all applicable handicap access requirements under California statutes and related
ans. (Ord. No. 92-26, § 1, 72-21-92) �
1TION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
:TIONS: In order tor the work authorized under this permit to be wnsidered legal, such work must wmply with all applicable codes, and all
d inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
ixsvccnoxrne p9IE �x�.Li S9o�,p n+s�rnoHrme p�g (%� x n�
Fixetl System Final Fire Preveniion 206 Final Mechanical . � s��• �z F�
Pool Spa Final 208 Final Plumbing x 3L• �� —� �
Final Re-Rool 210 Final EleCtriwl �( 7' ��� � Z�
Final BlocklReWining Wall
Final Factory Fire Place
Final Sign
Final Demolition
T72 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuildinglOaupancy
�
WORKERS' COMPENSATION DECLARATION:
0 hereby aKrm under penalry of perjury one of the lollowing Ceclarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as pmvitletl for by section 3700 of the LaSor Coae. (or the
peAormance of Ihe work (or which this permil is issued.
❑ I have and will maintain uorkers' compensation insu2nce, as required by
section 3700 0l Ihe Labor Code, lor Ihe peAortnance of Ihe work tor which Ihis
pertnit is issuetl. My workers' compensation Insurance carrier antl policy
number are: � /
Carrier L� �l�e� � N�0"T . S'vsQ •
(Thk sed'nn need rwt be [nmpleted AMe peimrt is valuetl al one huntlred ddlars (E I00J or less )
Policy Numher �� 6 b�� / 2j ��// /
❑ I certify that in the peAormance of the vrork for which this permit Is
issued, I shall not employ any person in any manner so as lo become subjecl
to Ihe workers' compensation laws o( California, and agree that if I should
becom ubject to Ihe workers' compensalion provisions of Section 3700 of
Ihe L r Cotle, I s II forthwith comply with Ihese provisions.
28 /2
A00�����'s Si9nalure D e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL
PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEI^SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed untler provisions ot Chapter 9(commencing
with Section 7000) of Division 3 0! lhe Business and Pmfessions Code, and
my license is in full force antl e((ect.
Lic. # � �! Class # ��� /
�l2-�// �-
Comractor's SlgnaWre Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a consiruction lending agency for the
peAortnance of the �+ork forwhich Ittis pertnil is'ssued. (Sec. 3097, Civil Code�.
Lentler's Name:
Lender's Address:
SignaWre Date
OWNER-BUILDER DECLARATIONS:
I hereby affrm ihat under penal�y o/ perjury �hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the follovring reason (Sec. 703L5,
Business and Protessions Cotle: Any cily or county which requires a permit to
construct, alter, improve. demolish, or repair any sWcture, pnor to its
issuance, also requires the applicant for such pertnit [o file a signed statement
that he or she is licensetl pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing wiih Section 7000) of Division 3 of the
Business and Pro(essions Code) or Ihat he or she is exempt Iherefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant (or a permit subjec[s the applicant to a civil penalty of not more Ihan
fve hundred dollars ($500).):
❑ I, as owner of the propeny, or my employees vnth wages as t�eir sole
compensation, WILL DO THE WORK, and the swcture is not intended or
oKered for sale (Sec. 7044, Business and Pmfessions Code: The Contractors
License Law Coes not apply to an owner of property who builds or improves
thereon, and who does such work himsel( or herself or through his or her ovm
employees. pmvidetl lhat such improvemenis are not intended or oflered for
sale. If, however, the building or improvemen[ is sold vnthin one year of
complelion, the owner-builder will have lhe burden of provinq that he or she
tlia 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 contrac[as License Law does not appy to an owner of
property who bniltls or impmves thereon, and who cont2cts for such project with
a cont2cta(s) license pursuant ro the Contractors License Laws.).
❑ I am exempl under sec.
Business and Pro(essions Code tor this reason:
�
SignaWre Date
1059-a6 (3IW)
�
Ovmer ID verifed by driver'S license. ❑ Yes ❑ No
Driver's License No. � Expires:'
Venfcation of Ownership by (rype of document, i.e. - propeny tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certAy that no ezcavation frve (5) or more (eet in depth inro v,fiich a
person is required Io descend, will be made in connection with work au[horize0
by this permit, and that no huiltling sWcture, scaf(olding, falsework, a demolition
or dismantling thereol, will be more than thirty-six (36) feet high. (Chap. 32, Gry
2, M 2, Sec. 341, Ttla e, Califomia Atlministrative Cotle).
❑ As ovmer-builder, I will not employ anyone [o do work which vrou10
require a permil from Ihe Division of Industrial Safety, as noted above, unless
such person has a permit m tlo such work from the division.
Applirant's Signalure Date
Division of Industnal Safery Permi[ Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future builtling occupanl need to file and
certily a Business Plan for emergency response lo release or Ihreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed vrith the Costa Mesa Fire
Department Dy every Dusiness which has at any one lime tluring a reportetl
year a quantiry of hazardous matenals equal to or greater than a weight o(
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperaNre and pressure).
2. Does or will the applicanl or present or future builtling occupan[ need to fle
a registration fortn for acutely �azardous matenals? ❑ Yes ❑ No
(Section 25533 of the Califomia Heallh and Satety Cotle, vnth some
exceptions, reduires 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 o! compresse0 gas at standard
temperature and pressure).
3. Does or vnll the applicant or present or future building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acu[ely
hazardous matenals)7 ❑ Yes ❑ No
(Section 25534 of Ihe California Health and Safery Cotle provides Ihat the
Cos[a Mesa Fire Deparlment may require the preparalion, certificalion and
fling with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials v+ith the Fire Departmen[.
4. If an RMPP is presently require4 has Sec�ion 25534 0! Ihe Califomia
Health and Safely Code been fully complied with? ❑ Yes ❑ No
5. OoeS Or will �he applicant or present or fNure huiltling occupanl require for
the vrork which is the subject of [his application a permit (or such constmction
or modi�cation from Ihe Soulh Coast Air �uality Management District or from
any otfier air pollution control dislrict or agency9 � Yes ❑ No
(Section 65850.2 of the Califomia Govemment Code requires Ihat the requested
information be (umished on applications for non-residential building pertnits).
6. Will any part of the (acility [o be constructed under Ihis pertnit be vn[hin
1000 feet from the outer boundanes o! a school? ❑ Yes ❑ No
Qf "yes", the facility must meet the requiremenl of Sections 25534 and 42303
o( the California Heallh antl Sa(e[y Cotle).
7. I( a pertnil 6om Ihe South Coast Air Quality Management DisMct or other
air pollution control district or agency is required for the vrork which is the
subject of this appliwlion, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certificate of compliance from the appropriate air pollution
control offcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty o( perjury the
iniormation given above is comect. I agree to comply vnth all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SiBnawre Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and state that
the information given is correcL I agree ro comply with all slate laws and city
ortlinances relating to builtling construction, antl authorize representatives o(
the City of Costa Mesa to enter upon the above-Cescribetl property (or
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by Ihis permit until final inspection.
ignalureoi BaiOw s) �Daie 2—
�s
AnClorAui�wixeOAooli�anl Dale
CITY OF COSTA MESA ' "
BlIILDING DIYISION
77 FAIR ORIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (7�4) 754-5626 �
PERMIT NUMBER: BC08-00393
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 10/21/2008
ISSUED BY: RMD
Jog a.��aesS: 555 700 AN70N BL CM Suite/Untt.., 700
APN: 41050104 �' ' � `-, �Zoning� , , - "
s.
.,,. � �� ��� - . _�,... : ' �� ..,.�..
s. . s�_� ry , ,
Vicinity: UNIT700 ' ` �` .,�_� '�-�Prima Occ: B, ._
Const Type: I-A SQ. FT: ��'" 14755 . .-; Valuation: $73,150.00 �
SCOPE OF WORK: 14,755 SF INTERIOR T( FOR "HOLTHOUSE CARLIN & VAN TRIGHT LLP" WITH'S VAV BOX, 1 AIR HANDLER:
1-10K CFM, 255 LIGHT FIXTS; 89 OUTLETS, 71 OUTLETS, 2 ICE/COFFE CONNECT, 1 DISHWASHER, 2 KITCHEN SINK, 2
WATER HEATER. �='
OWNER: PWREF/MCC-50UTHYCOAST CLC �`� Adtl�ess:�' 535 ANTON BL.. �s Unit: COSTA MESA,
„ ,
CA � : .t - 1 �,. _ - _ .-
Phone: �, � .� : ��-�"City/State/2ip: SUITE 750 , ' � � - '- • � �
APPLICANT: SALERNO,�S�COTT ,; A � Address - , ; . - . . � ,-� Unit: :
. ,:: .. ...., , .. � . . : -� � .
Phone: 714-993-9220 ' . ' City/State/zZip : - �, , - - _ -
�;� ,x ,.,,; ,...,,-:. .-,, . ..,. . - � ... . '- ��., i�i
CONTRACTOR: AMARON-CONSTRUCTION CORPORATION � License No. 674301��. �' '
Phone: 714-993-9220` � �.'; • �:' s ' ' �' ` �Address: �-1565 N�HARMONY ClUniti ��" �- --' �� . ., c � „'; .
Cell: � City/State: � ANAHEIM,HILLS, CA .,, . - � �-. `ZipCode 92807 �
ARCHITECT: KERRY P WILSON -�� ,. License No.C19204 '� � PHONE:949-851-3080
ENGINEER: <''. r , License�No. - � - , . . ' � ,PHONE: �
COMBINATION PERMIT FEE SUMMARY., -
Building Plan Check: $527.64 `
Building Fees: x $811.75 ; �
Electrical Fees: , ; $366.85 � _ . ,. _ -- . - �
Mechanical Fees: _ `-$149.35 � „ . � �
Plumbing Fees: ' -:. $92�10' ' - .. � -
. ..,; �.,�. - . v
SMIP Residential: � � ,$0.00,. �� � '� � �� � ' ' � '
SMIP Commercial: $15:36'
TOTAL FEES: $1,933.05 �
"Refer to fee receipts for all fees paltl tor prqect � � �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements underCalifomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-2y-92) � . ' . �
EXPIRATION: PERMIT EXPIRES 780 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � � .
INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final apprpval must be obtained. Failure to obtain inspections and fnal approval will.result in the expiration of this permit.
00 .� iNsvecnoxme onre ixTRIALS r.0 Eo a ixuecnoNrrve � � p� na�
1616 Fixed System Final Fire Prevention 206 Final Mechanical � ���
126fi Pool SDa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Elec�rical . /2� �
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 BuiltlinyOccupancy
�
< '% �1t�
WORKERS' COMPENSATION DECLARATION: . .
I hereby aKrm under penalty of peryury one of the follovnng Cecla2tions: .
i' �'
❑ I have and will maintain a certificate of consent to self-Insure'for workers'
compensation, as provided for by seclion 3700 of the Labor Cotle, for the
peRormance of the work for which this permit is issued.
❑ I have and will maintain vqrkers' compensation insurance, as required by
sectbn 3700 of the Labor Code, for lhe performance of the wurk for which this
pertnit is issued. My workers' wmpensation Insurance carrier and policy
number are� � .
Ca�rier:l�� �U�G1� '�"lYe %��k��
�(Thaseannneeonvfbecwnpetedamepermaisvlueoatarenundred ars(SfoO)wless/
P,olicy Number ��� �i (�� � z✓ � �� �i �
❑ I certify Ihat in the peRormance o� the vrork for which this permit is
issued, I shall not employ any person in any manner so as lo become subject
to the vrorkers' compensation laws of Califomia, and agree ihat if I should
become su � ct �o ihe workers' compensation provisions of Section 3700 0(
the Labo ode, I shall 1� with comply with these provisions.
2/ Or�" �
�Appliran Signalure Da�e
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 DOLIARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby aKrtn �hat I am licensed under provisions of Chapler 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and eHect. 2
Licr#—� �% �'�" �(�� rClass # � \�
�—, -1-�li/ dl�JL_.-� � ac�-0 �
ConVactor's5ignalore (�-Da1e� �
CONS7RUCTION LENDING AGENCY:
❑ I hereby affirm that Mere is a cons[mction lending agency fw the
perfortnance o/ the work for wfiich Ihis permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender s Address:
OWNER-BUILDER DECLARATIONS:
I here0y aKrm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LIGENSE LAW for the follovring reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permil to
consiruct, alter, improve, tlemolish, or repair any structure, prior to its
issuance, also requires lhe applicant !or such permi[ [o 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 an0 Professions Code) or ihat he or she is exempt therefrom and
the basis tor Ihe alleged exemption. Any violation of Section 7031.5 by any
applican[ (or a pertnit subjects the applicanl to a civil penalty of not more lhan
five hundred tlollars ($500).): '
❑ I, as owner of the property, or my employees vrith wages as iheir sole
compensation, WILL DO THE WORK, and the stmcWre is not intended or
oHered for sale (Sec. 1044, 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 thmugh his or her own
employees, provided that such improvements are not intended or oflered for
sale. If, however, the builtling or improvemen[ is sold vrithin one year o(
completion, the owner-builder will have the burden of proving lhat he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
UCENSED CONTRACTORS to construct the projec[ (Sec. 7044, Business and
Profe55ions Cotle: The contrac[ors License Law dces not apply to an ovmer of
property vfio builds or improves thereon, and who contracis fw such project vrith
a con[2ctor(s) license pursuant to the Contrac[ors License Laws.). �
❑ I am exempt under sec.
Business and Professions Cotle tor this reason:
305]-46�3I0])
Owner ID verifietl by dme� ,, ncense. � Yes ❑ No -
Driver's License No. Ezpires:
Verificafion�of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: ^ �
❑ I �ereby ceAiFy [hat no excava[ion frve (5) w more feet in tlepth into wfiich a
person is required to descend, will be made in connecCan with work authorized
by this pertnit, and that no building strucNre, scal(dding, falsev.ork, or tlemolition
or tlismantling thereof, will be more than thirty-siz (36) feet high. (Chap. 32, Grp
2, Art 2, Sea 341, Ttle 8, Califomia Administ2tive Code�.
❑ As ovmer-builder, I will not employ anyone [o do work which would
require a permit from ihe Division of Indus[rial Safety, as noted above. unless
such person has a permit to tlo such work fmm the division.
Appitam's SignaWre
Division of Industrial Sa(ery Permi[ Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
t. Will the applicant or present or tuture building occupant need to file and
ceAity a Business Plan for emergency response to release or threatenetl
release of a hazardous matedal? ❑ Yes ❑ No
(Section 25505 of [he California Health and Safety Code requires, vnth some
exceptions, tha[ a Business Plan be filed with the Costa Mesa Fire
Department by every business vmich has at any one time during a reported
year a quan[iry of hazardous matenals equal to or grea[er 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 ihe applicant or present or fuWre building occupant need ro file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Heal�h and Safety Code, wi[h some
exceptions, requires registretion with the Costa Mesa Fire Department by
each business which at any one time has on hand a quanlily of acutely
hazardous materials equal to or qreater than a weight of 500 pounds. or a
volume of 55 gallons, or 200 cubic feet of compressed gas at slandartl
temperature and pressure).
3. Does or will the applicant or presenl or fuNre building occupaN need to
prepare an RMPP (Risk Management and Prevention Progrdm for acutely
hazardous materials)? ❑ Ves ❑ No
(Section 25534 of the Califomia Health antl Safety Code provides [ha[ lhe
Costa Mesa Fire Department may require the preparation, certi(cation and
filing vrith the Fire Departmen[ of an RMPP by businesses which are requiretl
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of ihe California
Health and SaFety Code been fully complied with? ❑ Yes ❑ No
5. Dces or will the applicant or present or (uture building occupant require for
the work which is the suhject of this application a permil (or such construction
or modification from the South Coast Air �uality Management District or from
any oNer air polWtion control distnct or agency? ❑ Ves ❑ No
(Section 65850.2 of the Califomia Govemment Code requires that the requestetl
intormation be fumishetl on applications fa non-resitlential building permits�.
6. Will any part of [he (acili[y to be consWcted under [his permit be wi[hin
1000 (ee[ from the outer boundaries of a school? ❑ Yes ❑ No
Qf yes", the facility mus[ meet the requirement of Sections 25534 and 42303
ot the Califomia Health and Sa(ety Code). '
7. 1( a permit fmm the South Coast Air Quality Management Disiric[ or other
air pollutlon control di5trict or agency is requiretl (or [he. work which is Ihe
subjec[ of this application, have all of the.disclosures prescnbetl by Calitornia
Health and Safety Code Section 42303 been madel ❑ Yes �❑ No
8. Qf '�jes", at[ach certificale o( compliance from �he appmpria[e air pollution
control oKcer). . � � �
CERTIEICATE OF.COMPLIANCE: I certify that under.penalty of perjury the
infortnation given above is covect I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions. -�
CERTIFICATE OF COMPLIANCE AND� AUTHORIZATION OF ENTRY:- I
certify under penally of perjury Ihat I have read this application and slate lha[
the information given is correct. I agree lo comply with all state laws and city
ortlinances relating to building consWction, and authorize representaGves of
the Ciry of Costa Mesa to enter upon the above-descdbed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
aufhorized by this permit until final inspection. .
SI Wreo(LegalO er�s) Dat
�%o� D k
AnElw.Aulhon tl Applira_ _n _t ---_ Da�e
�_____� ��-`.
(��a) �sa-s2�s • F� (��a) �sa-aess
� CITY OF COSTA MESA
BIIILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
7
7TH FLOOR
41050110
npplicant: FULFORD, TERRY
AddreSS: 8749 SHIRLEY AV
NORTHRIDGE, CA
Owner. � ,SAKIOKA� FARMS
Address
Contrador. O'BRYANT ELECTRIC
Address: 8749SHIRLEYAV � �
r
NORTHRIDGE, CA
Phone: (818) 407-1986
, Zip: 91324 .
Phone:
Zip: 94137
e
Phone: (818)407-1986
Zip: 91324 -
License: 386679
�
�
PERMIT NUMBER
E00-00281
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03I30I2000
Issued: 03/30/2000
ISSUED BY: .
, ' �SCOPE OF PERMIT �
ELECTRICAL PERMIT FOR OFFICE T.I. FOR "BMC SOFfWARE" (7TH FLOOR). INSTALL 338
LIGHTING FIXTURES, 197 RECEPTACLE OUTLETS, 123 SWITCHES, 16 NON-RES APPL, 78
COMMUNICATION DROPS, & 1 CIRCUIT FOFt MODULARS. . '
REF: B00-00260
ISSUE FEE
Temp,service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets �� :
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over t000a
Motors to ihp
Motors to 10hp
Motors to 50hp
Motors to 100hp �
Motors over 700hp
$23.50
$0.00
$0.00
$0.00
$0.00
$�.00
$252.14
$149.21
$95.19
$76.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
Quantity
0
0
0
338
197
123
16
0
0
0
0
0
0
0
0
0
�,.
� .
- ' ' �
FEE SUMMARY
. - Temp Disl Syslem / Lighting
� Busway /100 it
� � � Standing Section
� � Misc Electrical Equipment
. � Transformiers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kvalkw
. ' .................up to 100 kva/kw
" ..................over 100 kvalkw
' Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
" Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights) ,
Christmas Tree Stand �
Fireworks Stand
� Other Electrical Fee
� Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
30.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$1820 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia 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 780 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with ali applicable codes, and all
requlred Inapectlons end flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLARATIONi
I hereby etfirm untler penalty of perjury one ot the following declarations:
❑ I have and will maintain e certificate ot consent to selt-Insure tor workers' compensalion, as providetl for by section 3700 oi ihe Labor Cotle, tor iha pertormance of the
—/ work tor which this pertnit is issuetl.
�y' I have and will maintain workers' compensetion insurence, as required by section 3700 of Ihe Labor Code, for Ihe peAormence of the work tor which this permit is issuetl.
�My workers' compens tio Insurence ner/au� policy number ere: �. n
Gerrier:—� �ivi� �iof�e. �hc.5��[,a.vcP_ , �olicyNumber: /S�W.¢ Z7�16l��00
(This.secfion neetl not be comp/efeU i/ the permit is velued et one hundred dollers ($100) or /ess.)
❑ I certify thet In Ihe performance of the work for which this permit is issuetl, I shall not employ eny person in any manner so as to bacoma subject to the workers'
compensation laws of Calitornia, en gree ihat if I should become subject to the workers' compensation provisions of Section 3700 of the Lebor Code, I shall Forthwith
comply with these pr ions. '�
ApplicanCSlgn Nre: Oate: .J �.3� '��
WARNING:FAILURE TO SECUR KE MPENSATION CAVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AN� CIVIL FWES UP TOONE HUNDRED
THOUSAN� DOLLARE ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DMMGES AS PROVIDED FOR IN SECTION 37060F THE IABOF CODE, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby attirm ihaPl�em'llcense_dyt� der provisions of Chapter 9(commencing wiih Section 7000) of Division 3;of�the�Business antl Professlons Cotle, and my license is in full
torca and etfect. �i`. p. ��,�'i�G�9 7iy� (-c�ass.q� �'-��
ContrectorsSignatu�.T Y�y Date: �^.�O—OG
LONSTRUCTON LENDING AGENCY:
❑ I hereby attirm�that there Is a conSWction lending agency tor the pedortnance of the work For which this permit is issuetl. (Sec. 3097, Civil Code).
Lender's Neme: Lendefs Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirm Ihet under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW Por the tollowing reason (Sec. 7031.5, Business antl Pmtessions
Code: Any ciry or counry which requires a permi� to consiruct, alter, improve, tlemolish, or repair any strucWre, pnor to its issuance, also requires the epplicant for such permit
to file e signetl statement t�at �e or she is Iicensed pursuant to ihe provisions oi the Contractors License Law (Chepter 9(commencing wlth Section 7000) oi Division 3 of ihe
8usiness end Professions Code) or that he or she is ezempt Iherefrom antl ihe basis for the elleged exemption. Any violation oi Section 7031.5 by eny epplicant For a permit
subjects the applicant to a civll penalty of not mora then five hundred dollaro ($500)J:
❑ I, es owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, entl the structura is not intandetl or oNeretl tor sale (Sec.
7044, 8usiness and Professions Code: The Contractors License Law tloe5 not apply to an owner of property who huilds or improve5 thefeon, and who does such work
himself or herself or through his or her own employees, providetl t�at such improvements are not intended or oHered tor sala. If, however, the builtling or impmvement is
sold within one year oi completion, the owner-Duiltler will have tha burden of proving ihat he or she did not build or improve tor purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Buslness antl Professlons
Cotle: The contrectors License Lew does not epply to en owner of properry who builds or improves thereon, end who contraas for such projec[ with e coniractor(s)
license pursuant m the Con�ractors License Lews.).
❑ I am ezempt under sec.
Signature:
Owner ID verified by dnvef5 license. ❑ Ves ❑ No
Buslness antl Professions Cotla for this reason:
Venfication of Ownership by (rypa of document, i.e. - property tan bili or tleetl):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICA710N:
Dnvers License No.
Date:
Expires:
❑ I haraby certity ihat no excavation five (5) or more teet In tlepth into which a person is requiretl to descend, will be matle in connaction with work authonzed by this
permi�, and ihat no building structure, scafloltling, talsework, or Oemoli�ion or dismamling theraot, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title e, California Atlministretive Cotle).
❑ As owner-builder, I will not employ enyone to tlo work which woultl require a pertnit from the Division of Industnal Safery, as noted above, unless such person has a
pertni� �o da such work from the division.
Signature: oate:
Division at Indusirlal Setery Permit Numher:
CERTIFICATE OF COMPLIANCE AND AUiHORVA710N OF ENTRY: I certity under penalry of perjury that I hava read this application end state ihat Ihe information given is
correct I egree to comply with ell state laws and ciry ortlinances relating to building construction, end authorize representatives oi the Ciry oF Costa Mesa to emer upon the
aDove-described propehy for Inspaction purposes. I egree not to occupy or allow occupancy oi eny bullding authorized by this pertnit until finel inspection.
COOE �. INSPECiIONTYGE
1616 Fixed System Final Fire Preventlon
7266 Pool Spa Final
200 Final Re-Roa�
2011 Final BIocWRetaining Well
202 Final Fadory Fire Place
203 Flnal Sign
204 Final Demolition
a�
Owner(s)
p0jg INi yLIDE�, INSPECTIONTYPE
206 Final Mechanical
20B Finel Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
QBj� INTITI
00 LL°
;
-' '•�
(714) 754-5273 • Fex (714) 754-4856
Job Address: 555 ANTON BL
Suite: 7
Vicinity: ...
Parcel Number: 41050110
npp�icant: MICHAEL WILLEY
Address: 18001 COWAN #A
CITY OF COSTA MESA
BUILpING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
IRVINE, CA
owner . SAKIOKA FARMS �
Address . � . . �
Contractor: ASSI SECURIIY
FIRE SUPRESSION PERMIT
Zoning:
Phone: (949)955-0244
Zip: 92614
Phone:
Zip: 94137
NUMBER
"y I F00-00083
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 03/20/2000
Issued: OS/iZ2000
l� � v
Address:- 78007 COWAN #A .'
. - - Phone� (949)955,-0244 . � �
IRVINE, CA : Zip� �� 92614- - i �
' � . . License: 683831 �
�. � _ - �
' �/. SCOPE OF PERMIT
� PROVIDE AND INSTALL LOW VOLTAGE CARD ACCESS SYSTEM. INCLUDES LOCKING OF ELEVATOR
LOBBY DOORS TO BE CONNECTED TO LIFE SAFETY SYSTEM. �
REF:B00-00260
Plan Check: $63.21
Permit: $97.25
Other: $0.00
Total: $160.46
FEE SUMMARY
, , . - , '•�,'".
%
;
Calc Valuation: 5a,000.00
Claimed Valuation: $a,000.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automaticalty expire and become void if work is not�commenced within 1B0 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this partnit to be considered legal, such work must comply with all applicable codes, and all
requlred inapections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in tha expira�ion of this permil.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLARATION:
I �eraby eMirm untler penalry of perjury one at the Idlowing Aaderetlons:
❑'�I heve end will melntain e certllicete of cansent to self•Insure tor workers' compensation, as provided for by section 3700 ot ihe Lebor Code, tor the pertarmance of �he
work for which this pertnit is issued.
� I have end will melnteln workers' compensatbn insurence, as required by sedlon 3700 of Ne Lelwr Code, for Ihe peAormance of �he work for which Nls permit is issuetl.
My workers' compensetlon Insurance �car e.r�e.ntl poli number ere: . �
Cerrier. ���yi o�✓ L�"� - �� . . � POIIcyNumber. �Z/2��5� .
(Th/s sectlon need nat be completed i1 the permit Is valued ef one hundred dollers ($100J or less.) �
❑ I certity thet In tho Oertormence of the work tor whic� t�is permit I5 issued, I shall not employ eny pereon In eny manner so es to becoma sub�ect to ihe workers'
compensation laws t Celitomia, en grea Ihet i I shoul0 b mma subject to the workers' compensation provisions ot Sedlon 3700 ot the Lebor Cotle, I shall forthwit�
comply with these rovisl
Applicant Slgneture: Date: � � 2 ���
WARNINO: FAILURE TO SECURE WORNERS' COMPENSATV MQE IS UNLAW FUL AND SIMLL SUflIEGT AN EMPLOVER TO CPIMINAL PENPLTIES AND CML FlNES UP TO ONE HUNDRED
THOUSAND OOILARE (5100.000�. IN ADdTION TO THE C T 9 COMPENSATION, DAlMGES AS PROVIDED FOR IN SECfION 3]080F THE L4BOR CO�E, IMEREST, AND ATTORNEY'S PEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn Ihat I am licansed u er ro 51�
farce end eflect. Llc. a ..s
Conlrectors Slgneture:
CONSTRUCTION LENDING AGENCY:
❑ I hereby eflirtn that Ihere Is e cons
Lentlefs Name:
Slgnature:
OWNER-BUILOER DECLARATIONS:
Chapter 9(commenGng wlth Section 7000) of Dlvislon 3 at the Business and Profg�sbns Cotle, and my Iicense is in full
� , Classa C—%dC/V
oa�e: s�rz -�6
egenc,y tor t�e pertortnance ot t�e work tor which t�ls permit is issued. (Sec. 3097, Civil Cotle).
Lentlets Atltlress:
Date:
I hereby Bflirtn Ihet under pen0lly of perjury lhet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe }011owing r8a5on (SBc. 7031.5, Bu5in855 antl Profession5
Code: Any ciry or counry which requires e permit to construct, elter, imprwe, demolish, or ropair eny struaure, pnor to ils Issuance, also requires the applicant for such pertnit
to file e signed sfetemem that he w s�e Ls Ilcensed pursuant ro the provisions of t�e Contraaors Llcense Lew (Chapter 9(commencing wlth Section 7000) of Division 3 of the
Business antl Prolessions Code) or thet he or she Is exempl t�erefrom antl Ihe hasis lor the allegetl ezemptlon. Any violatian ot Sectlon 7031.5 Dy any epplicant tor e permit
subjects the epplicent to e civil pe�lry ol not more then fiva hunOretl tlollars (5500).):
❑ I, as owner af Ihe property, or my empbyees vnih wages as their sole compensetion, WILL 00 THE WOHK, en0 Ne structure is not intentletl or otteretl br sale (Sec.
7044, Business entl Profeubns Catle: The Cantrectors License Lew does not appy to en owner ol praperty who builtls or improves thereon, end who does such work
himsell or herselt or through his ar her owA employees, provitled Net such improvements are not IntendeC or oNered tor sale. If, havever, Ne builtling or impmvement is
sold within one year of completioq the ownerbuilder will heve t�e buNen of proWng that �e or she ditl not builA or improve for purposa ot saleJ.
� I, as owner oi the pmperty, am EXCLUSIVELV CONTRACTNG WfTH LICENSED CONTRACTORS to construct Ihe project (Sec. 7046, Business and Professions
Cotle: The contracrors License Lew does not appty to en owner of property who bulltls or improves thereon, entl who contrects for such prqect wlth a contractor(s)
license pursuant to the Contractors License Lews.).
❑ I am exempt under sac. Business end Prolessions Code for this reason:
Signeture: Date:
Owner ID verifled �y tlrivefs license. ❑ Yes ❑ No Drivefs lJcense No.
Verification of Ownership by (rypa of tlocumenL i.e. - property laz Dill or deed):
DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICATION:
Expires:
❑ I hereby cently t�et no excav;tlon flva (5) or more feet In Cepth into which a person is requlretl to tlescenq will be mede in connectlon with work authorized by this
permit. entl Ihat no bullding structure, scetfolding, lalsework, or tlemolition or alsmaniling t�ereof, wlll Ge more than �hirry-siz (38) teet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomia AtlminlslreUve Cotle).
❑ As owner-builder, I will not employ enyone to tlo work which wwlC requiro e Oermil tmm the Division ot Intlusidel Satety, as notetl ebove, unless such person has a
permit to do such work trom the tlivision.
Slgnature: Deie:
Division at Industdol Satery Pertnll Numbor:
CERTIFlCA7E OF COMPLJANCE AND AUfHORIZATON OF EMAY: I certity untler penalty ot per�ury Ihat I have reaG ihis epplication antl steta that the infortnation given is
correcL I egree to comply with ell stete lews end ciry ordinences relatlng to bulltling canstruction, entl euthorize represematives of the City of Coste Mese to enter upon the
above-descnbed properry lor Inspectlon purposes. I apree not to occupy or allow occupency ol eny bulldinp euthodzed by this permit umll flnel Inspectlon.
CODE I. INSPECTIONTYPE
1616 FIxeO System Final
1268 Pool Spa Final
200 Flnal Re-Roof
201 Final Block/Fleleining Well
202
203
Finel Fectory Flre Place
Finel Sign
204 Final Demolition
241818
�
�
- /2
GOOE� INSPEC710NTVPE
208 Finel Mechenical
20B Final Plumbing
210 Finel EleCiricel
212 Final Fire Preventlon
220 Flnel Planning Approval
222 Finel Site
250 FInelBuilding/Occupency
Q� II�e4S
u « �' H-
(714) 754-5273 • Fax (714) 754-4856
Job Address: 555 ANTON BL
Suite: 7
Vicinity: SEVENTH FLOOR
Parcel Number: 41050110
Applicant: OCAMPO, RUDI
Address: 3080 BRIS70L ST.
COSTA MESA, CA
SUITE 105
Owner: SAKIOKA'FARMS
Address , �, � �
CITY OF COSTA MESA `�
BDILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
BUILDING PERMIT
Zoning:
Phone: (774)754-1197
Zip: 92626
Phone:
, , , Zip: 94737
Contractor: INNER SFACE CONSTRUCTORS
Address: 2250 S. CENTRAL AV.
. RANCHO DOMIGUEZ, CA.,
Zip: 90220
Phone: (310) 7632172
License: � 366309
PERMIT NUMBER
I B00-00260
77 FAIR DRIVE, COSTA MESA. CA 92626
ISSUED BY:
Status: ISSUED
Applied: 03/01/2000
Issued: 03/29/2000
LM
Arch : IA _ � - Eng:
Address: 3080 BRISTOL ST. � � � � Address:
COSTA MESA, CA � . Phone: (714) 754-1197 Phone:
SUITE 105 � �
�Zip: 92626 � � � License: , License:
SCOPE OF PERMIT
' 17,800 SQ FT INTERIOR OFFICE T.I. FOR -BMC SOFTWARE- (7TH FLOOR). � -- _
' Plan Check: $356.23
Permit: $2,192.15
SMIP Res: $0.00
SMIP Com: $65.83
Other: $0.00
Inspection: $0.00
Total: $2,614.21
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
Rear 0- 0
Rear 0- 0
Reouired: 0
FEE SUMMARY
i
PLANNING & ZONING
Calc Valuation: s3i3,soo.00
Claim Valuation: asoo,000.00
Left 0- 0 Right 0. 0
Lefl 0- 0 Right 0- 0
Pr000sed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire end become void if work is not�commenced within 1 BO days, or if work is suspended or abandoned
for a penod of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlona and final approval must be obtained. Feilure to obtain inspeclions and final approval will result in Ihe ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I here6y attirm untler penalry of parjury one of the lollowing declarations:
❑ I heve and will malntain a certificate of consent to self-Insure for workers' compensation, es pmvitle0 for Dy saction 3700 ot ihe Labw Cotle, tor the pertormance oi the
work tor whiCh this permil is issued.
❑ I I have and wlll maintain workero' compensation insurance, as required by section 3700 ot ihe Labor Gode, for �he peAotmance oi Ihe work for which Ihis permit is issuetl.
� ' My wRrkers_' com� n/;,ation fnsurance arrier end p licy number are: .
Carrier. KtA_�.�XrK��. ����,�n � , PolicyNumber: � / � a.�C `�
(This section ed nat be campletea i�. the permit is veW f one hundred dollars ($700) or less.)
❑ I cenify ihat In ihe pedormance of Ihe work for w�ich this permit is issued, I shell not employ eny person in any manner so as lo become subJect to the workers'
compensation laws of Celifomla, antl agrea that if l shoultl become subject to ihe workers' compensetion provlslons ot Section 3700 of ihe Labor Code, I shall forthwith
comply with ihes ons. p/7
ApplicaM SigneWre: �� -. �f.( X Date: /4� � a. �% — Ci g
WARNING FAILURE TO SECUflE WORKERS' COMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVEF TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED
THOUSANO WLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECiION 3IO60F THE LABOR COpE, IMEREST, ANO ATTOPNEY'S FEES.
LICENSED CON7RAC70RS DECLARA710N:
I hareby aBirm ihat I am licensed under provisions of Chepter 9(commencing with Section 7000) of Divislon 3 of Ihe Business end Professions Code, and my license is in full
force antl ettect Lic. # 3'� L.3 L� i� C�ass x F3 - C'. 'J. - C 4' - C/ 6
ContrectorsSigneture: Date:(7 3— a. 9- /� h
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm ihat ihera is a construction lentling agency tor tha peAortnance of the work For which this permit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lendefs Address:
SigneNre: ' Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that untler penelty of perjury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business and Professions
Code: Any ciry or wunry which requires e permit to consWct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, elso requires the applicant for such permit
to tile a signetl statement that ha or she Is licensed pursuent to the provisions of ihe Contractors License Law (Chapter 9(commencMg with Section 7000) of Division 3 of the
Business antl Professions Code) or that he or she is exempt Ihereirom and ihe basis for tha allegetl exemption. Any violation oF Section 7031.5 Dy eny epplicant for a permit
subjecis the epplicent to a dvll penelty oi not more than five hundretl tlollers ($500).):
❑ I, es owner of the property, or my employees with wages as Iheir sole crompensation, WILL DO THE WORK, antl the structure is not intentletl or oNeretl tor sale (Sec.
7044, Business and Professions Coda: The Contractors License Lew tloes not epply to an owner ot property who builds or improves thereon, and who does such work
himseif or herself or through his or her own employees, provided ihat such improvements are not intended ar ottered for sele. If, howevar, the building or improvement is
sold within one year of complation, ihe owner-builtler will have Ihe burden ot proving that he or she tlitl not build or improve for purpose ot sale.).
❑ I, es owner ot ihe pmperty, am E%CLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business and Pmfessions
Code: The contractors License Law does not apply to en owner ot property who buiids or imp�oves thereon, antl who comrecis for such project with a contractor(s)
license pursuent to the Comrectors License Laws.).
❑ I am exempt under sec. Business end Pmfessions Code br ihis reason:
Signature: Date:
Owner ID veri}ietl by drivefs license. ❑ Ves ❑ No Driver's Licensa No. Expires:
Verification ot Ownership by (typa of document, i.e. - properry tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceNty that no excevetion tive (5) or mora teet in depih into whlch a person is requlred to tlescend, will be made in connection with work authorizetl by Ihis
pertnit, and that no builtling structure, scaHoltling, falsework, or demolition or dismantling thereof, wlll be more ihan ihirty-six (36) feet �igh. (Chap. 32, Grp 2, Art 2, Sec.
� 341, Ttle e, Calitornia Atlminlstrative Code). .
❑ As owner-builtler, I will not employ anyone to do work which would require a parmlt from ihe Division of Intlusirial Safery, as noted a6ove, uniess such person has a
permit to do such work trom the division.
Signature: Date:
Division ot Indusirial Sefety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 W ill Ihe applicam or presern or fuNre builtling acupant neetl to file end certiry a Business Plan for emergency response lo release or threatened release of a hazardous
matenal? ❑ Yes ❑ No
(Section 25505 of ihe California Health and Safery Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has et any one time during e reported year a Quantity of hezardous meteriels equal to or greater ihan e weight ot 500 pounds, or a volume ot 55 gailons,
, or 200 cubic feet oi compressed gas at standard temperature and pressure). _ __ _ _
2 Does or will the applicant or present or future building cecupant need ro file a regisiration form for acutely hezardous materlals? ❑ Yes ❑ No
(Section 25533 of ihe Califomia Health and Safety Code, with some exceptions, requires registration with Ihe Costa Mesa Fire Depahment by each business which at any
one tima has on hantl a queniiry of acutely haiartlous materials equal to or greater than a weight oF 500 pounds, or e volume oi 55 gallons, or 200 cubic feet of
compreued gas at standard temparature and pressure).
.._,._. ... ... . . ....... . ..... .. ........_.. . . . ...___. ..............
3 Does or will Ihe aDP�icant or present or future building occupant neetl ro prepare en RMPP (Risk Management end Prevennon Program for acutely hazartlous materiels)?
❑ ves ❑ No
l of ihe Califomia Health and Sefery Code Drovides that the Costa Mesa Fire Depanment may requira [he preparation, certification antl filing with the Fire
an RMPP by businesses which are requiretl to register ecutely hazardous materlals with ihe Fire Department.
4 If an RMPP is presently requlred, has Section 25534 ot the Calitomia H�
5 Does or will Iha applicant or present o� fuWre building occupeM �equire
tfom Ihe SoNh Coast Air Quellty Management Disirict or tmm eny ot�er
(Seciion 658502 of the California Government Code requires iha� ihe re
6 Will any part of the feciliry to be constructed under this pertnit be within '
ion control alsttict or agency? LJ Yes LJ No
information ba tumished on aDoliCatlons tor nomresitlential
(If "yes", ihe facility must meet �he requirement of Sections 25534 antl 42303 ot Ihe Californla Health entl
or
7 tl a pertnit from ihe South Coast Air Oualiry Management Disinct or other air pollution contml distnct or agency is required tor the work which is ihe sublect of ihis
application, heve all ot ihe disclosures prescribed by California Healih and Safety Cotle Section 42303 been matle? ❑ Ves ❑ No
e (It yes", ettach cenificate of com0�ience from ihe appropnate air polWtion control oHicer).
CERTIFICATE OF COMPLIANGE: I cenity ihel under penalry of perjury the infortnation given abova is correa. I agree to comD�Y with all state laws and city ordinances
regerding Hazartlous Materials and Emissions.
Signamre: Date:
CER7IFICATE OF COMPLIANCE AND AIJiHORVA710N OF EMRY: I certify under penalty of perjury ihat I heve read Ihis application and state that iha information given is
correct. I agree to comply with all state laws and city ordinances relating to builtling conswctlon, and authonze representatives of the City of Casta Mesa m enter upon the
above-described property for Inspection purpases. I egree not to occupy or allow occupancy oi any building authorized by this pertnit until tinal inspection.
_> S e Qf Legel 9wner(s) ci� Date ^
c �� � �tS-Li' X Q i�,� � ' .� / '- i� (J
`An�Or Authonzed Applicant Date
CQOE �, INSPEC710NTYPE
1616 Fixed System Final Fire Preventlon
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Plece
'� 203 Final Sign
204 Final Demolition
zaaa au
�
INTRIALS � &Q� INSPECTIONTVPE
206 Finel Mechenical
208 Final Plumbing
210 Final Elecincal
2tt Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
1(p� INfff1AL5
_^�
REF:
- y�^� `'.
� �.�.:_:/:�: � •
�"�; r
(714) 754-5273 • Fex (714) 754-4856
JobAddress: 555 ANTON BL
Suite: 7
Vicinity: 7TH FLOOR
Parcel Number: 41050110
CITY OF COSTA MESA
BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
FIRE SUPRESSION PERMIT
Zoning:
�
NUMBER
03
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/06/2000
Issued: 04/27/2000
ISSUED BY:
�
Applicant: HAGHIGHI, DAVID
Address: 2505 MIRA MAR - - � � ,
" � Phone: (562)498-6444," � � .
LONG BEACH, CA " - � Zip: _ 90815 , � -
Owner. -'-SAKIOKA FARMS" � � , � � � �
Address. ' , . � � - � .. � ' �
� , . - - " Phone: - - �
" . - , - ' � Zip: 94137 � _ -
, -��;.��� ,
Contracroc CAL PROTECTION
�
. �Address:� 2505�MIRA MAR �
- � . _� Phone:�, � (562) 498-6444 _
� . LONG BEACH, CA ; � Qip: _. 90815� . _ - , � �
� ' P - „�Cicense: 327198 �
, - . . i, _ �- .
.
' f SCOPE OF PERMIT . �
� ,� FIRE SPRINKLER��PERMIT FOR T.L FOR "BMC SOFTWARE" , ,
. , � � � . � � � .
, . � � �
. , � ,, . . � . . , . . �
`
' ' FEE SUMMARY
' Plan Check: $392.50 � � - Calc Valuation: , $a5,ssa.00
Permit:�' $603.85 '.� ___ ,,., ��" Claimed Valuation: Sas,eea.00
� Other: � � $0.00 � - �� c�z:' ', . . : ; � . . �
— — ` ,/ J . .
Total: $996.35
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
requlred Inapeetlona and ffnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOfl INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARAnON: `
I hereby aHirm under penalry ot perjury one of the followlnq declaretions:
❑ I hava antl wlll maintain a certificate ot consent to self-Insure for workers' compensation, as provided for by section 3700 of ihe Labor Code, ior the pertormance of ihe
work for which ihis permit Is Issued.
� I have and will main ei worke�s' compensation ins re as eqmr by section 3700 ot the Lebor Code, tor the performance of the work for which this permit is issued.
M workers' com e ion Insuran,p� c tler antl umt ara:. �� (' 1�
Cerrier:Y p �lf�- p�� �� Policy Number: �j� �
(This section need not be comp '! the pertnit is valued � hundred dallers 00J or /ess.J
❑ I certify ihat in the peAorma of ihe work r hic this per 't is issued, I shail not employ any person in eny manner so as to become subject ro the workers'
compensation laws of Californi and egree t t if hou acom subject to the workers' compensation provislons of Section 3700 ot the L or Code, I shall forthwith
' comply with ihese provisions. �(
Applicant Signature: Date: "1 Z� �
WARNING.FAILURETOSECUREWORKERS ENSATION EISUNLAWFULANDSFIALLSUBJECTANEMPLOVERTOCRIMINALPENALTIESANDLIVILFINESUPTOONEHUNDRED
THWSAND DOLLARE �5100,000�, IN ADDITIqJ TO THE COST OF COMPENSAiION, DAMAGES AS PROVIDED FOR IN SEGTION 31W OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DE RATION:
I hereby affirm that I am licensed u e rovisions$ f� Ch er 9(�c 4m encing with Section 7000) of Division 3 of ihe Business and Prote�slon5 Code, and my licensa is in full
torce antl ettect Lic. a 5 "� Class a C-�U' 1«�R
ContrecrorsSigneWre: Date: ��00
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm ihat there is a constmction lentling agency tor the pedormance ot the work for which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lender's Name: Lenders Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aHirm thet under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Code: Any city or counry which requires a permit to construct, alter, improve, tlemolish, or repair eny shucWre, prior to its issuance, also requires the applicant for such permit
to file a signetl stetement that he or she is licansed pursuent lo the provisions of the Coniractors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of Ihe
Business and Protessions Code) or Ihat he or she is e:empt thereirom and the basis for tha alleged exemption. Any vlolation of Section 7037.5 by any epplicent tor a permit
sub�ects tha applicent to e civil penelty ot not more than five huntlretl tlollars ($500).):
❑ I, as owner of Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, an0 t�e structure is not intentlad or oHeretl for sale (Sec.
7044, Business antl Professions Cotle: The Contractors License Law does not apply to an owner oi property who builds or improves ihereon, and who does such work
' himself or hersetl or ihrough his or her own employees, provided that such Improvements a�a not intendetl or otteretl for sale. If, however, the building or improvement is
, sold within one year of completioq the ownervbuiltler will have the burtlen oi proving that he or sha did not build or improve tor purpose of sale.).
❑ I, as owner of ihe property, em E%CLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Protessions
Cotle: The contractors License Lew does not apply to en owner of property who builtls or improves thereon, antl who contrects for such pro�ect with a contractor(s)
license pursuant to tha Contrectors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Oriver's License No.
Verification of Ownership by (type of document, i.e. - property tax bill or deetl):
DIVISION OF INOUSTRIAL SAFETY PERMIT CERTFICA710N:
Ezpires:
❑ I hereby certity ihat no ezcavation live (5) or more feet in depth into which a person is requlretl lo tlescentl, will be matle in connection with work authonzetl by this
permit, antl ihat no building structure, scattolding, falsework, or demolition or tlismantling thereoi, will be more ihan Ihirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title B, Celitomia Atlministrative Cotla).
❑ As owneo-builder, 1 will not employ enyona to do work which would require e permit from ihe Division of Intlustrial Safery, as notetl above, unless such person �as a
pertnit to do such work from ihe division.
Slgnature: Date:
Division of Intlustrial Safety Permit Number:
CER'TIFICATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: I certity under penalry of perjury ihat I have read this application and state that ihe information given is
correct. I agrae omply with all state laws and ciry ordinances relating to bulltling construction, and authorize representatives of Ihe City of Costa Mesa to enter upon the
above-descnbetl riy for inspection purposes. I a9ree not to occupy or allow occupancy oi any builtling authorizetl by this pertnit until tinal inspection.
CODE t. INSPECTIONTYVE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Finel BIaWReteininq Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolitian
2aaF46
p1TE INTRIALS f�Qp�a INSPECTONTYPE
�0' (-2'i%�i � 206 Final Mechanical
208 Final Plumbing
210 Final ElecMcal
212 Final Fira Preventlon
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
�f ��,� � o0
oate
�jTF INTRIpLS
. y �.,•
(714)754-5273 • Fax(714)754-4856
Job Address: 555 ANTON BL
Suite: 7
Vicinity:
Parcel Number: 41050110
.
�- CITY OF COSTA MESA ' �.�
BUILDING DIVIS/ON
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
Applicant: LORI LOPEZ
Address: 2505 MIRA MAR
CA
LONG BEACH '
Owner. � SAKIOKA FARMS"
Address. ', ' �
�.
Contractor. CAL PROTECTION
Address: 2505 MIRA MAR
LONG BEACH, CA
FIRE SUPRESSION PERMIT
Zoning:
Phone: (562)498•6444,
� Zip: 90875
Phone:
Zip: 94137
Phone �� � (562) 498-6444
;•�Zip: � 90815
,.�License: 327196
77 FAIR DRIVE, COSTA MESA, CA 92626
, SCOPE OF PERMIT
� � WSTALL F.IRE ALARM SYSTEM FOR BMC SOFTWARE.
REF:B00-00260. " � � - .
Plan Check:
Permit:
� Other.
Total:
$333.42
' $512.95
$0.00
$846.37
FEE SUMMARY
� _
_ _- � ,
F
Stalus: ISSUED
Applied: 03/29/2000
Issued: 04I27I2000
ISSUED BY:
Calc Valuation: sae,no.so
Claimed Valuation: Sss,no.so
NOTICE: The work authorized by this permit shall comply with ail applicable handicap access requirements under Califomia statutes and relatad
regulations. (Ord. No. 92Q8, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is noLcommenced within 180 days, or if vrork is suspended or abandoned
for a period of 180 days,
INSPECTIONS: In ordar for �he work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapeetlone 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) 7545626 �
WORKERS' COMPENSATION DECLARATION: "
I hereby eflirm under penelty oi per�ury one ot lhe lollowing tleCleretions: � - �
❑, I heve entl will melntain e certificate at consent ro self-Insure tor workers' compensa�ion, as provided for by section 3700 of the Labor Cotla, for the performanca of ihe
�work far w�ic� t�is permit Is issuetl.
I �eve end will ma t In worka mpensatl nsuranca, as e ved by sectlon 3700 ot Ihe Lahor Cotle, tor tha peAortnence of Ihe work for which this pertnit Is issued.
My workars' Comp n tlon Ins re te carder e oll umbe� �� ¢ r„ l!�
Cerrier. �-- �. C.1� Policy Number. V v �\
(This secfion need nof be campl ed I! fhe permit Is ve/uetl et one huntlretl tla s($100) or /ess.)
❑ I cenity ihet In the p rmance of the ic is permit Is issued, I shall not employ eny person in any manner so es to become subject to ihe workers'
compensation laws of Ifomle, end a ee t t i I ul ecome subject to the workers' compensation pmvisions of Section 3700 at the Labar Catle, I shell torthwith
comply with these pravisl I
Applicent Signeture: Date: � t �
WARNING: FAILURE TO SECURE WORKERS' OOMPENS TION COVERAOE IS UNLAWFUT AND SMALL SUBJEGT AN EMPLOYEfi TO CiiIMINAL PENALTIES AND CNIL FlNES UP TOONE HIINDREO
THOUSANO DOLLARE ($100,000), IN AODITIIXJ TO THE COST OF WMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3)O60F THE LABOR CODE, INTEREST, AND NTTORNEV'S FEES.
LICENSED CONTRACTORS OECLARATION:
I hereby aNirm that I am li�� ed ��unde""%%r p��rovi�`sic
torce ane eHect. Lic. p�
Contractofs Signature:
CONSTRUCTION LENDING AGENCY:
Chapter 9(commencing with Sectlon 7000) ot Division 3 ot the Business end Prof s�sio Cotle, antl my license is in full
aass x � l4 l',1�
� Date: Z
❑ I hereby eHirtn Ihat Ihere Is e cons�ruction lentling agenty for the DeAormance ot the work for which lhis permit is issued. (Sec. 3097, Civil Coda).
Lender's Name: Lenders Address:
Siqnature:
Date:
OWNER•BUILDER DEClARA710NS:
I hereby ettirm lhet under penelry ot parJury ihat I em E%EMPT FROM THE CON7RACTORS LICENSE LAW for the lollowing reeson (Sec. 7031.5, Business and Protessions
Code: Any ciry or counry which requires a pertnit to construct, alter, Improve, tlemolish, or repair any siructure, prior to its issuance, also requires the appliwnt tor such permit
to file a signed steiement ihei he or 5he Is Ilcansed pursuanl to Ihe provlslons of ihe Conirectors License Law (Chapter 9(commencing with Section 7000) 01 Division 3 of the
eusiness entl Protessions Cotle) or thet he or she Is ezempt Iherelrom end the basis for Ihe allegetl exemption. Any violation oi Section 7031.5 by any applicent for a permit
sub�ecis the applicant to a civll penalty of not more t�an tive huntlratl dollare ($500).):
❑ I, as owner oi Ihe property, or my employeas with weges es Iheir sole compensatlon, WILL DO THE WORK, end the structure is not intendetl or oNeretl tor sale (Sec.
7044, Business end Professions Cotle: The Contrectors Licanse Lew does not apply to an awner ol property who builds or improves thereon, and who does such work
himselt ar herself or through his or her own employees, proNdad thet such improvemenis are not Intentletl or ofleretl tor sale. It, however, t�e building ar improvement is
soltl within one year of complelion, ihe owner-bullder wlll have �he burtlen of proving �hel he or she did not bulltl or Improve tor purpose of sale.).
❑ I, as owne� of the property, em E%CLUSIVELV CONTRACTINO WITH LICENSED CONTHACTORS to consiruct ihe prqect (Sec. 7044. Business end Protessions
Cotle: The comrectors License Law does not epply to an owner ot property who builds or improves �hereon, antl who contrects for such pmject with a con[ractor(s)
license pursuant ta ihe Conirecrors Llcense Laws.).
❑ I am exempt untler SBt.
5iqnature:
Owner ID veritied by tlrivers Ilcense. ❑ Yes ❑ No
Buslness entl Professions Cade lor this reason:
Verificatlon of Ownership by (rype of tlocumeni, i.e. - D�oOerry tax blll or deed):
Dnvefs License No.
Date:
Expires:
DIVISION OF INUUSTRIAL SAFETY PERMIT CERTFICATION:
❑ I hereby certlly t�et no excavetlon five (5) or more feet In tlepih into which a person Is requlred �o descentl. wlll be metle in connection with work aut�orizetl by this
permil, end Ihat no bulltling sirucNre, scatfoltling, falsework, or demolition or dismemling Ihereot, will be more t�an Nirty-six (36) teet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Ticle e, Califomia Adminlslrelive Code).
❑ As owner-builder, I will not employ enyone to tlo work whlch would reduire e permit from the DlWsion of Intlustrial Safery, es noted ebove, unless such person has e
pertnit ta do such work tmm Ihe tllvlsion.
Signaiure: Date:
Division of Indu5Ma1 Sefety Permit Number:
CERTIFICATE OF COMPLJANCE AND AUTHORQATON OF ENTRV: I certify under penelry ot perjury Ihat I heva read this appliwtion and state thet the infortnation given is
correcL I agree to comply with ell state lews end clry ortlinences releting ro bullding consWctlon, entl authorize representatives of the Ciry af Costa Mese lo enter upon ihe
ebove-descdbed properry for inspectlan purposeg.Zagree not to occupy ar ellow occupanty of any builAing authorized by thls pertnit until final inspection.
CODE �. INSPECTIONTYVE
1676 Fixetl System Final Fire Prevention
1266 Pool Spa Flnel
200 Final Re-Rool
201 Finel BIxWReteining Well
202
203
Finel Fectary Fire Place
Final Sign
204 Final Demolilion
��
�
��i:
CODEt INSVECTIONTYPE
208 Finel Mechanical
20B Finel Plumbing
210 Final Elactrical
272 Final Fire Preventlon
220 Final Plenning Approvel
222 Final Sita
250 Final Building/Occupancy
U D te
Go
Date
PAIE Iwmia�s
zusas _
CITY OF COSTA MESA _ .
BUILDIN6 DIV/SION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
(714) 754-5273 • Fex (714) 754-4856
PLUMBING PERMIT
Job Address: 555 ANTON BL
Suite No 7
Vicinity:
Parcel Nunmber: 41050'110
Appliwnt: DON STEVENS
Address: 1940 GARDENA �
Owner:
Adifress
Contractor:
Address:
ArchlEng:
Address:
SOFTWARE.
REF:B00-00260
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifer System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drein, Rainwater
Orain, Roof
Drinking Fountain �
Expansion Tank
GLENDALE,CA
� i„ �
SAKIOKA FARMS
� �
MUIR-CHASE PLUMBING :
1940 GARDENA , '; '
•� �
GLENDALE,CA '�
Phone: (818)500-1940-
2ip: 91204
Phone:
Zip; . 94137
Phone: (818)500-1940
Zip: 91204
License: 539835
Phone:
,. , � ��P-� � .. . ' � �. ,
' -- Cicense:'
PERMIT UMBER
00-00155
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 03/29/2000
Issued: 0329/2000
SCOPE OF PERMIT
1 FLOOR SINK, 7 KITCHEN SINK, 1 WATER HTR, 1 COFFE/ICE MAKER CONNECTION FOR BMC
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$19.60
$0.00
50.00
50.00
$0.00
so.00
$0.00
50.00
QTr
FEE SUMMARY
AMT
Laundry Tub I Washer 50.00
Landswpe Irrigation 50.00
P-Trep $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connecl ' $0.00
Sewer Private Line $0.00
snowe� , , so.00
Sink, bar $0.00�
Sink, commercial $0.00
QTY
0
0
0
0
0
0
0
0
0
0 '
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Waler Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
80.00
$0.00
$0.00
$12.30
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
NOTICE: The work euthorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 7, 1241-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not�commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In ordar for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetlona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 A
WORKERS'COMPENSArON DECLARAnON:
I hereby affirm under penalry of perjury one of the following declarations:
❑ I I have antl will mainteln a certificate of consent to seli-Insure for workers' compensation, as provitled for by sectlon 3700 of Ihe Lebor Cotle, for Ihe pertortnence of ihe
work for which this permit is issued. .
� I have and will mainlain workere' compensation insurance, es raquired by sec[ion 3700 ot the Lebor Code, for ihe peAortnance ot Ihe work for which this pertnit Is issued.
My workers' compensation Insurance carner and policy number ere: .
Carrier. ��1"7.1 N n Policy Num6er: �n � F%300 �— � G
(This section need not be completed il fhe permif is valued et one huntlretl tlollars ($100) or less.)
❑ 1 certify ihal in ihe peAormence of the work for which �his permit is issued, I shall not employ any person in any manner so es to becoma suhject to the workers'
compensation laws of Calitomia, antl agree thet if I shoultl become subject to the workers' compansation provisions of Section 3700 of the Labor Code, I shall fonhwith
comply with ihesa pr�ovisi �
ApplicantSignature: C�4�--�—�� Dete: :� - Z�% —C7 O
WARNWG FAILURE TO SECURE WORKERS' CAMPENSATION COVEFiAGE IS UNLAWFUL AN� SHALL SUBIELT AN EMPLOYER TO CRIMINAL PENALTIES AND pVIL PWES UP TOONE HUNDRED
THOUSAND DOLL4RE ($100,000), IN ADOITION TO TME C0.5T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3)O60F TME LABOR COOE, INTEREST, ANO ATTOPNEY'S FEES.
LICENSEO CONTRACTORS DECLARATION:
I hereby attirm that I em licensed under�prov'�ns of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Cotle, antl my license is in tull
roroe ana enea. uo. s �i34 �d 3 S aess a C—� !p
Comracbr's Signature: _ t_.�. _ �->9 Date: �; � �J ���Z7
\ ♦ . —_�"
CONS7RUC710N LENDING AGENCY:
❑ 1 hereby attirm t�at there is a construction lending agency for ihe peAortnance of t�e woB for which this permit is issued. (Sec. 3097, Civil Cotle).
Lender's Neme: Lentlets Address:
Signature:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby aHirtn ihat unaer penalry of perjury that 1 am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for �he following reason (Sec. 7031.5. Business antl Protessions
Code: Any ciry or counry which requires a permit ro consWct, elter, improva, demolish, or repair any structure, pnor to its issuance, also requires the applicant tor such permit
to file e signed statement the� he or she is licensed pursuent to the pmvisions of the Comractors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of �he
Business antl Professlons Code) or ihat he or she is exempt Iherefrom and the basis for ihe alleged exemption. Any violatlon of Section 7031.5 by eny applicant tor a parmit
subjecls lhe appllcant to e civil penalty ot not mora �hen five huntlretl tl011ars ($500).):
❑ I, as owner ot t�e property, or my employaes with weges as iheir sole compensetion, WILL DO 7HE WORK, antl the swcture Is not intended or oHered for sale (Sec.
7044, Business antl Professions Code: The Contrectors License Law tloes not appty to an owner ot property who builds or improves thereon, and who tloes such work
himsetl or herself or through his or her owA employees, provided that such improvemenis are not intendetl ar aHered for sale. If, however, iha building or improvement is
, soltl within one year of completion, the owner-builder will have the burden of proving ihet he or she did not build or improve for puryose ot sale.).
❑ I, as owner oi the property. am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professlons
Code: The contrectors License Lew does not appry to en owner ot propetly who builds or Improves ihereon, and who contracis tor such projed with e contractor(s)
license pursuant to the Contractors License Lews.).
❑ I am exempt untler sec.
Signeture:
Business and Protessions Code for t�is reason:
Owner ID veritied by driver's license. ❑ Ves ❑ No Drivers License No.
Venfication of Ownership by (rype of document, i.e. - property tax 6ill or deed):
OP INDUSTRIAL SAPETY PERMIT CERTIFICATION:
Da�e:
Expires:
❑ I hareby certity that no excavation tive (5) or more feet In depih into which a person is reqNretl to tlescend, will he matle in connection with work authorized by this
permit, and that no builtling stmcture, scaHolding, falsework, or demolition or dismantling ihereof, will be more ihan thirry-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec.
347, Title 8, Californla AdminiSirellve Cotle).
❑ As owner-Duiltler, 1 will not employ anyone ro do work which woultl require e permit from Ihe Division of Industriel Safety, as notetl above, unless such person has a
permit to do such work fmm ihe tlivision.
Signature: Date:
Division of Industrial Safety Permlt Number:
CERTFICATE OF COMPIIANCE AND AUl}tORIZATION OF ENiAV: I certity under penalry of periury Ihat I have reatl this application and stata that the information given is
wrrect. I agree to comply wi�h all state laws and city ortlinances releting to building construdion, antl amhorize representstives of the Ciry oi Costa Mesa to enter upon the
above�descnbed properry for inspection purposes. I agree not to occupy or ellow occupency of any buildinq authorizetl by this permit until final inspection.
Si Of Legel Owner(s) Date
��. . �,—�— � •— 2 9 — O c�
AndlOrAuthonzad Applicant �ate �
COQE 1. INSVECTIONTYPE
7616 Fixed System Finel Fire Prevention
1266
200
201
202
203
Pool Spe Final
Final RB-Roof
Final BIocWRetaining Well
Finel Fectory Fire Place
Final Sign
204 Final Demolition
zaan<c -
: '�
P9IE
�
INTRULS
LOpEt INSPECTIONTYPE
206 Final Mechanical
200 Final Plumbing
210 Finel Electricel
212 Finel Fire Prevention
220 Finel Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
R�T INTRIALS
6'1- '�ra.�..t -b.111L
(714) 754-5273 • Fau (774) 754-4856
�,
11
, CITY OF COSTA MESA �_
BUILDING pIVIS10N
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
MECHANICAL PERMIT
NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
R
Job Address: 555 ANTON BL
Suite No 7
Yciniry: 7TH FLOOR
Parcel Number: 41050170
Applicant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE�,CA
Owner: � SAKIOKA FARMS. �
Address: �� .' � � � � " � . -
\ , _
Status: ISSUED
Applied: 03129/2000
Issued: 03I29I2000
ISSUED BY:
Phone: (818) 244$571
Zip: 91201 �
Phone:
2ip: 94137 � ..
Contractor: AIR CONDITIONING CO., INC
� Address: 6265 SAN FERNANDO RD �
GLENDALE,CA
. �''i
Arch I Eng :
Address:
� : ' Phone: � (818) 244-6571
' " .Zip: 91201
' � License:- 120696
Phone:
Zip:
License:
SCOPE OF PERMIT
MECHANICAL PERMIT FOR OFFICE T.1. FOR "BMC SOFTWARE" (7TH FLOOR). INSTALL 3 VAV
BOXES, �11 SMOKE DAMPERS, & REPAIR/ALT 1 HEATICOOCSYSTEM. ; ' ,' �
REF:800.00260 - !
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >700 k BTU
Repair I Alt CoolingMeat
Inst / Rep. Recess Wall Htr
Refrig Sys <700 k BTU ,
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace _
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
inst or Relocate App� Vent
Air Handlers < 10000cfm
$23.50
$0.00
$0.00
$13.70
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$31.95
$0.00
$0.00
$0.00
$79.75
$0.00
$0.00
Quantity
0
0
1
0
0
0
0
0
0
3
0
0
0
]1
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refngeretion Unit
Ventillation System
Evaporative Cooler
Commerciallncinerator '
Domestic Incinerator
Compressors / Absorotion Svstems
Upto3hp/100kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp '
3To15hp
15,to 30 hp
30 to 50 hp
Quantity
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) .
EXPIRATION: This permit shall automatically expire and become void if work is no��commenced within 1B0 days, or if work is suspended or abandonad
for a period of 180 days.
INSPECTIONS: In order for �he work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspeetlo�s and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS'COMPENSATON DECLARAnON: �
I hereby eNirm under Denelty of perJury one of ihe tollowing decleretions: �
❑ I heve entl will meintain e certllicate ot consent to self-Insure for workers' compensetion, as provlded for by sectlon 3700 of the Lebor Code, tor the peAormance oi the
work for which this permlt is issuad. .
�ve antl will maintain workers' compensa�ion insuranCe, es r6quired by section 3700 ot Ihe Labor Code, tor the peAormance oi the work tor which ihls permlt is issuetl.
My workers' compensation Insurence carrier antl poliry number are: .
� o�icy NuP mber: 1,92 777J' ���
Ihe permi( is veluetl et ane huntlretl tlollars ($100) or /ess.J
❑ I certify that in Ihe pertormence ol the work tor which this permit is issuetl, I shell not employ eny pereon in eny menner so es to become sub�ect to the workers'
compensetion lew�alitomia, antl agree that if I should become subject to the workers' compensetion provislons of Section 3700 of the Lebor Code, I shall fonhwith
i_�._ __.._
G oaia: � ^3 0��
� CUREWORKERS'COMPENSATIONCOV GEISUNLAWFULANDSHALLSUBIECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFlNESUPTOONEHIINDREO
($t00,000�,INA�DITIONTOTHECO$TOF NSATION,OAhNGE5A5PROVIDEDFOPINSECTIIXJ3]O60F?HEL480PfA0E,INrERE$T,ANDATTOPNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Iha1�l�em�Ncre sed under provisions of Chap�er 9(commencing with Sectlon 7000) ot Division �ot.the.Business end Professions Code, and my license is in tull
force antl effect. lic_x �,/� ' �Cless.Y.---� � 2 U
Comractofs'Stgneture:^�^ ���s�fil Date: �— O D� w
F, l� h i �1
� e
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm ihat there Is a construction lantling agency for the perlormance ot ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lendefs Address:
Signature:
OWNER•BUILDEF DECLARATIONS:
Da�B:
I hereby aHirm thet untler penelry ot parjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business an0 Professions
Code: Any ciry or counry which requires a pertnit �o construct, alter, improve, demolish, or repair eny sirucNre, prior to its issuence, also requires iha epplicant tor such pertnit
to file e signed stetement that he or she Is Ilcensetl pursuanl to ihe provislons ot ihe Conirectors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot Ihe
Business and Protessions Code) or t�et he or she Is exempt tharefrom enA the basis for t�e alleged exemption. Any violation oi Sectlan 7031.5 by any applicant for a permit
sub�ects the epplicant to e civll penelry of not more than tive hundred dollers ($500)J:
❑ I, es owner of the property, or my employees with wages as their sole compensation, WILL DO TME WORK, antl the structure is not Intended or oMeretl tor sale (Sec.
7044, Business antl Professions Code: The Contrectors License Lew does not apply to an owner ot property who 6uild5 or improves thereon, end who tloes such work
himsetl or hersell or Ihrough his or her own employees, proNded that such improvements ere nol intended or olfered for sale. If, however, Iha builtling or improvement is
sold within one year of completion, ihe owner-huiltler wlll have the burtlen of proving that he or she did not build or improve for purposa of sale.).
❑ I, es owner af Ihe properry, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to construd the project (Sec. 7044, Business and Pmfessions
Code: The contrectore License Lew tloes not epply to an owner of pmperry who builds or improves ihereon, and who contracts for such project with a contractor(s)
license pursuant to ihe Contractors License Lews.).
❑ 1 em exempt under sec. Business enA Prafessions Cade lor this reason:
Signature: Date:
Owner ID vedfietl by tldvBfs license. ❑ Ves ❑ No Ddver's LicenSe No. Expires:
Verification of Ownership by (type ot document, i.e. - propetly tex bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I �ereby certtly that no exwvatlon five (5) or more feet in depih Into which a person is requlred to descend, wlll be matle in connectlon with work authorized by ihis
pertnit, entl thet no Duilding structure, scaHolding, talsework, or demolition or dismantling I�ereot, will be mora than thirty-six (36) feet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Title 8, Celltomia Atlministretive Code).
❑ As owner-builder, I will not employ anyone to tlo work which woultl require e pertnit Irom the Division of Industrial Safety, es noted above, unless such person has a
permit to do such work irom the division.
Slgnaiure: Date:
Division ot Industnal Satety Pertnit Number:
CERTIFlCATE OF COMPUANCE AND AIJfliORIZATION OF EMRV: I certily untler penalry oi perjury that I heve read Ihis application entl s�ate t�at the infortnation given is
correct. I agree ro comply wlih all stete laws and city oMinences relatinq to 6uiltling wnstruction, end authodze representatives of Ihe Ciry of Casta Mesa to enter upon Ihe
ebove-descnbetl proparry lor Inspection Durpases. 1 eB�ee not to occupy or ellow occupancy oi any building authorized by Ihis permit until final inspectlon.
CODE �. INSGECTIONTYVE Q9¢ INTRLILS
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Flnel
200 Final RaRoof
201 Final BIocWReteining Wall
202 Finel Fectary Fire Plece
� 203 Final Sign
204 Final Demalition
seawa '
GOUE� INSPECTIONTYPE
206 Final MeChanical
208 Final Plumbing
210 Final Elecincal
212 Final Fire Preventlon
220 Final Plannin9 ApDroval
222 Final Site
250 Final BuildinglOaupancy
Data
�.1 tW .
� � �
�
\�
City of Costa Meu
Development Services Department
Buildin9 Safety Division
P. O. eox 1200
Costa Meu, California
CERTIFICATE OF OCCUPANCY No. ���'� j;iYy
Tne Building located at 555 Anton Boulevardd Suite 700
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances app�icab�e thereto
tor a Group � Occupancy.
Use of Building ��Pi1teC ROOm
Legal
410-501-04
(See reveise sitle for Metes and Bounds) .
Building Permit No B 46•`�33 Electrical Permit No.E47109.E46563 piumbing Permit No. D GF,AQA
Mechanical Permit No. M 47014 Number of apartments and/or guest rooms
ISSUED TO:
Axur.itv Pacifir. Nah'1. Rank
555 Mton eoulevard
Gsta MA.qa. (`A 92fi�Fi
Building Official mnm� r�r� w�a
by ,.-�„ �
Date June 19,1990
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CMF 3015-4fi rev. 1/B3 White -Owner; Canary � Numerical File; Pink - Bldg. Permit File
Ciry of Costa Mesa
Development Seroices Department
euilding Safety Division
P. O. Box 1200
Costa Meu, California
CERTIFICATE OF OCCUPANCY No. OOc�-P�P�
The Building located at 555 Anton BOUZ@II]L'di ith E'lOOC
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
�for a Group BZ Occupancy.
Use of Building
Legal Description 410-501-04
(See reveru side for Me[es and Bountlsl
Building Permit No B 3f3155 Electrical Permit No. R 3R15R Plumbing Permit No.P �186
Mechanical Permit No. � 38258 Number of apartments and/or guest rooms
ISSUED TO: Building Official �rne Edmiaton
Security Pacific Bank l /�
555 Anton Blvd., Ste. 500 by -/ -�. � ' / /f - '—
Costa A7asa, CA 92626 -�
Date Octol�sY 18� 1989
This Certificate of Occupancy SHAIL 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 __
0
. PflOJECTA00PF5E: SSS ANTON BL � � ". ' . ' ' "uxrt:-"jUO� -
OWNEP'SNAME: $ECURITY PACIFIC NA'Z'�L�'.HK , � �
. nooeess: 555 ANTON BL
- COSTA S�tESA . ' .
' . . CA .9262E . 4 •
• (-2131345-7880 ' ' � " .
�,RRCHIENGINEER:�.jj�j'j'$R�j� � � , . HEO.NO.:C-1�JQQZ
�oox�ta: 5 F�RK• I'LAZA • uxq:
� �� IRVINE ' CA 92714
REflMITTFF: YNNER SPACF. CON.STRUCI'ORS ( 213 ) 763-7.11%2
1Pjoxess: i 796 P.O. AOX . '.
• 50UTH�'GATE � •+ CA 90280
LICENSE� CONTMC70B OEClAl1ATi0N: � I Aere6y atlirm that I am IicenseA untler pmvisions of Chapter 9(commencinA wilh Section
-7000�-oi Division 3 0l I�e�Business and Pmte55ions CoAe, antl my license is in tull force an0 ettect , .
cm uc.: 0 3 2 h 4p� sure uc.:35 fi 3 ,
�Da�e:� I��' ! � � .Si9naN�����._¢�� .,...,... ,
WORKEBS' COMPENSRTION OECIAppTION: I hereby affirm that I Aave a certificate o� nt ro sell-insure or�a eetlificata o� Workers'
Compensation.�r�sy�apcp. pr�r,Gry'}ie� yopY ihereol (Section 3800,-Lah.�) - �
=oucr aa:: W C. Y b b L tl 7 IXP. a,re: 2/ 31 / 9 9
cornrnxr: GREAT AMERICAN ' �
❑ CeAifietl copy is �ere�y fumishe0. -� cemrea co '' nee �v/il�.� �iv euii � sa�i ,. , �
oate:�� / � — ��i ppplic�p(f.'�J�.J_5����.Y = �
IXEMPfION FBOM WORKEIIS' COMPEXSRTION OECIAMTION: nis sT-ecCion neeA not be com01ete0 il the pattntt is lor one hunAreO (5100) or leu�. �
I certiTy ihat in the pertormance o� t�e wod for which t�is permit is iuueQ I shall not employ any Oerson in any manner so as Io Decome
suDlect lo tha Wolners' Compensation Laxs M CaFiomia. � � ,
Date: � - � ' SignaWre: �� - � °
NOTICE: It, aiter making this Oeclaretion, yuu s�ou�tl �ecome su0ject to t�e Workers' Compensation provisions of Ihe Labor
CaUe, you musifotlhwitA comply with sucb Drovisions o� this permit sAall ba•tleemetl �evoketl:
�pM8TRUCTION lFNU1NG AGEMCY: 1 hereGy at/um Nat tMre is a conslrucUan lending apency far the peAormarice oi Ihe work for .
which ihis permft is issuea (Section 3097; Civ. C). . „ „,
� LENUEB: � .
' FOONESS: . . � .. . . .
�:. ,
OWNER BUILOEB OEIXAMTION: I Aere�y aXirm Ihat I am�exempt iram the Caniraciors' State License Law for the followinA �ason
(Section 7037.5 Business antl Pm�essional CoAe: My ciry of counry which requires a permit to consimct, alter, improve, tlemolish, ar
repai� any structure, pria to its issumce, also r¢quires the aDW�an< <w � Cermit to file a 5iyneU slatement thal Pelshe i5 ��censed
pursuant Io t�e D�ovisions of tAe Gantracrors' State �icense Law (C�aO�er 9(cammencing with Section 7000) af Division 3 of t�e Business
anC Protessions Cotle) or that helshe is exemD� Iherefmm and tAe Uasis for the alleAed exemDtion. My viola[ion af Section 7031'.5 Dy
any applicant for a Dermit sWlects the applicam lo a crvil penalry of not rtro�e than iNe hunMeE tlWlars (5500�. '�
' I, as owner oi Na DmOeM ar' my employees with waAes as ibeiY sole compensalion," will tlo the work, and ihe
❑ snucture is not mtentletl oi oflered fm Sale (Section 704b, Business antl Professiaial Cade�. The Contractors' Seate License Lsw
Ooes not aOPq ro an ownei al a properry wA6 builOs ar impmves thereon, antl wha EOes such woM nimsell/nersetl or throuA�
his or.Ae�,owo-employees, provide0 ihat such impmvemenis are not inten0e4 or otteretl for sale. II, however the builAinq or
� imprwement h sold within one year of complMfon, the owner will have ttie DutOen ot provinp hefshe tlitl not huiPo oi improve
far the pu�pose af ulel. � - . . .•. - . .
I, u owner ai the D�opeity, am exclusivel9 canlractin0 with Ncensed contractors lo conSWcZthe O�We�� (,�ction 7044, 8usi�ess
❑ anE Pmfessions Cotle: The Cont2ctors' State Licenu Law Gces not appty ro an owner oi3Oroperry who bmlQs or impmves tAereon
' anG wAo coniracts forsuch pmle�ts with a con[ractaqs)license Oursuant to Ihe Contractors' State Licensa Law�.l am aware
that piooi ot thei� Waker's Compensation,ii,u�ance slwuW be Drovidetl b me. : . . '
�, I am exem0� untler Section: . . B!6 P. C. . . ' -
tot this reason'. ' ' � F. . , �
Oate.` ` - '"Owner � '
I tla Aerehy certiry Ihat I am aware at anA unaerstanE tne repulrements of Califomia Heal�h antl Safery CoOe Sections 25505, 25533, ana
25534 an0 tAat I or any firture CuildinA owupant wilUwill noC�circle one) nee0 to comply witA saitl state codes anE t�e requirements lor a
permit tor consiructWn or. moditication irom 1fre�Ai� QuaNty Managemem District. ResiOential coivstruction applieatio� are exempt fran
IAese praNsions. � . . . • , � •
Dare: ADPlicanc _
I here�y ceh�y ihat I have �eaA this aODlication and st5te Ihat tAe
or0inancesandsWlelawsrelatinA�oOu➢dingconsimctio Eherel
DropeM �ori spectbn/pulposes. '
.oate: _�b _ � Q � giq t
is
i oriver's �icense a Socia� Securiry x: ' -
i6a148 Wlrite—Buibinq: Green—CaEe Entorcemenc Canarv-Apv�icant; Pink—Fe
zgree ro camply with all ciry anG counry
iis ciry ro enter upon Ihe above-menlione0
GOltlenroE—lusessor ..
�
, � CI'Ci OF COST'A MESA � IIUILDIDIG PERMI'I' PEkM D10 II''.046543 �._.
. . . c..
PERMTT NU: D�' 046543 " PL'AN•CHECK NO: 0.2781-90�L GOVT: Dl SUPP: N,.
. . , . � . „ , . . , ,
CONSTRUCTIUN TYPE:.1'FR SPRl'NK PERMZT`.TYPE: STR• PURPOSE: AL1'. `.
JOB DESCRIPTION :; COMMERCIAL_ T_.•I.• �(COMPUTER ROOM') ' .SQ F1': . 2;400 '. � '
CLAIM VALUE: ' CALC—�,rALUE: .. 4.0,�328..64 GROUP OCC:� B-2_ / ,
�COMMENTa: o � , • � ,'
'���r****�c�+�x�**�r*.**�****+���*�*�***��*�r�+�**�**�r*x*��***+��*+�**��*�****�xx��*���x***+�x ' . ,
I. , , ; Z O N I N G' . R E' Q U I R E M E N T S
. S' F. T H A C K S . • � .
� ----------- MAIDI HUILDING -------=- --=------ ACCF.S5URY�BUILDING---�------ ,
I ERNT: E'T IN REAR: FT. IN ; ;ERNT: FT IN R�AR: � : PT IN '
LEFT'i, FT LN RGHT: � FT IN LEFT: 'FT IN RGHT: '.' FT IA1
IFARKING REQ: PROV: PARCEL: 41050104 ZNF.:, PACi 'RGF NO: '
PLANNING NOTFS> REMODEL EX: COMPUTER ROOM ON 7TH FI�OOR OF EX: S�CURI,TY ;
' > PACTFIG DUILDING - . ' ..! -
I x�*���e*+c**�x��*��**���r*a��+��r**'�*�r�rx*��*x+�***�*��-��*�**a��**x+�*�******�**ic***,i�*i����c �
I• D E.. V, E L� O-" �; M E• N�T • S. E R V I, C F. S R E Q U I R E M E Tl ".T,' S� ' <
70NING �PPROVED���� ' �-_���_�__ DATE� �3','�G_'_�� '
� ^ '
BUILDIidG APPRUVED HY :Qj��_�'���� -- ... .___ � DATEi C�.3• �4`�.Q
APPLICATION ISSUED ,$Ys'� ' ' •DA'TE: ����
1E iE if �)E iE if iF IE if % ff !F #f 7f 3F 7(� �7F iF iF �lf"df iF �iE�f' E if�f ��{F� �FiF���3F�SF���1E 9E 1E �7E 3f iE �)f i( # lf 3f N�lE� �
IFiEiFiEiE�lE�1E�J(-if9EiEifiE�lC�iE�1E3f3F#.iE'ifiFiEi(-aEiEiEiElf3E.�fiEiE3EiEdf3E'iEiEiE ifiEiElfiEifiElFlFiEiE3EifiEif�Flf3hihifiFiEiEiEif�E�1E�7f�3EiFif9EiEiE3EiEiE'i(� ,
LEGAL'lZATION:N � -' F^,E E S. M M A R Y •-• ,� =-STRUCTURAL SEGMfiNT:Y
. � . �
" IBLDG PMT• �PLUMI3ING' ET.ECTRIC..r�"MECHANIC � FIRE SMIPIRGS : GRADING •
PERMIT --356.00':•. � :
I PLAN ?.3I.40.{ ' , .' , �f, � SMIP�NON�-RES; ' .
rssos e�e ^ `.t , :� a.�9 ,
I;BUILDING—UIV.->, PERMI'Y � ISSDE ,PLAN—CHECK 'POTAL PAID ',DDF.
TOTALS----> � 764.79, .D',60,.-. 231:,40 543,14 543.19 � .QO
.RE�'�DtU� UIVISTObI 'COTALS-->' CULLECTED: 361,79 UVER/SHORT: .00 :
DLUG•PMT PLUMBING ELECTRIC M�CHANIC F'IRE SMIP/TOT GRADING PLAN;-CHGCR
- . � `� ]56'.00 ' � , .. ; ,' .�, . ' , 5.79 ,
• . • ' , ' ' � i ,
�lf # iF iE 3F # iE 3E if �7E if it �7E �iE K iE 3E iE iE if K if 3E 1E if if iF #E it �lE # iE'3E if� if 3E if �lE iE 7f i�%if lE if �E iE �1E iE �lf # iE1E iE it �)E iE iE #F iE IE iE 3E iF iE 3(-# �)f iE iF if dE �lE iF iE iE iE iE iF
' I T3 D I V T D U�A L`. F;,E E. B R E A K D O W N , ; � .
TYPE QTY D' � S C R I P T I;O, �N � � UNIT COS'P, � TOTAL COS'1'
. :�'
SF'C' 24QQ ' OFF—IN'T, ALTER TYPE'I,SIiF.R. J-AVER 16.Q8 3fi,592,�Q
' END OF F'F.ES
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�J1 DDc75b214-00056215 TUT
OATE: Q3(,16/90 .TIt7E� Q8:10 ;
' . . . � �. �..._ �._
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3b1.79
. ''�
1 � '� �- i
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CONSTRUCTIONAND,PCANNING � . � • ' �'�P��L&SPA � ;j .- � �
Date �Inspector - + Date InspGctor
APPROVALS Permit�# �•^� �� . = APPROVALS Permit# . �RJ
�..�
• 1. Tiemporary Electrical Servic�or Po�eM .� 52, Pool & Equipment Location � .. �
� _2.,ySoil�Pipe:Undrgrnd.� ��1 �� � 53. Steel Reinforcement , �
�i3:.:Electrical Conduit Utility-Undrgrndc� � 54. Forms � _ �� '
!Y� - ' .",-...�..., � y..
''r4._Electrical ConduibUndrgrnd. ; _� -,� - 55. Electrical Bonding � � �- Q �
�;:5;Steel:Reinforcement � Lr+:: " ' 56. Rough Plumbing & Pressure Test . r��
..r �._.
'��-�6^.Electrical UFER G nd. �'� � - ' S7. APPROVAL TO COVER-GUNITE . t �a m
.�ti7. Footings � `� �' � , 58. Electrical Conduit-Undr rnd. � �
',e �Ti1 , /il s }_' 1,��.
' `�8. Foundatiori. '� '• �'`� `, \�� 59. Gas Pipe, O Undrgrnd., Test . �f,� '�
(� n,
�9. Water Pipe-Und`igrnd. �J� � ,�'� 60. Backwash Lines, P-Trap, O Undrgrnd. " �
, 10. Structural Floor SYstem ��!� u! R� � 61. APPROVAL TO DECK `1�
11?�Property Sewer'.Line & HouseiGonnection, �Y� ' " � �62. Backwash &� Receptor-Final � � %1 �1} -
' A
- 12. Sewer Cap � �� v - �� � � . . �'`�`d
� `% - � � ,� . 63. Heater & Vent-Final � � .,�,
� 13. Roof Drains ;,, � :} � �- 64. Plumbing System � Final . �
14. Rough Plumbing � �� ' G�) � 65. Electrical-Final �
15. Rough Electrical-Conduit i �'� �� 66. Solar System-Final �
' 1
_ '�16. Rou'gh Electric Wiring � 67. Fencing & Access ApProval �
�
'•=17. Rough Wiring�Sign � � _ 68. APPROVED FOR PLASTEflING �
�
18. Ro�gh Electrical�T Bar�Ceiling 69. POOL/SPA SYSTEMS FINAL
.19_ Rough Heating & Air Conditioning� �" �, FI.RE DEPT. REQUIREMENT
_ ^> > . - -�c� - x �
� 20.�Rough Facto'ry Fireplece � �� �' i.ie. ='�, ,APPROVA'L'$�"c:.Peimit# - - �
21': �Dutts, in Structu�e' ` ' '" ' "�� * • ' 70. Undergiound Hydro �"
-� •- .i
�
22.�Ducts, Ventilating"� � � ' ' • � - � •„77. ProducbPiping OGas �Oil
. 23. �GasiPipe�RoUgh & Test c" � � � tT _ _• � i 7z. Underground Flush"' _ `' _�
24`.'RoofFraming °''�.... ` "'-' -'t;; `' � . _ ;73:jUndergrn`d.Storag��Tank��OGas OOiI -
A;`25. Roof Sheathing ' " � . �" " _ 74.'Overhead Hydro . -
"�26. T-Bar Ceiling (Str�uctural�-&-Monocoat ---F� / � 75. Dry Chemical . � �
�
'' 27. Frame and FVauMirr�� - ' �`, �� ' 76. Dry Standpipe :; - � �
�
' 28. Lathing:& Siding � _ _ {,_ - `- �._.,,'� " ' �' " 77,�� FIXED S.Y;STEM.F,.INAG ~ • _
-:� ..�
� � � , <i; I �'a � t �-
29. Ins�lation � _ -'; ' ��� �,% f'�":. 7g� FIRE PREV. FINAL � .
'� 30. Dr�ywall�Nailing ^ H � ! : � d� �, �'' - �M,EALTH�DEPT. �REQUIREMENT �
`:31. Plaster Brown Coat. �� i�'�• C.�r ��� �t`1 i�t '79, FINAL INSPECTION "'
l r_:
",32:,Electrical Power Meter;F�inal �_`� ^ `� �� � � - �'. �80�L'FOOD CERTIF�ICATE ISSUED,_, - y� � �
',33�FinalElectric s.� r � �t.'-, � _� '�' � ?j y�'
� � �� Notes: `,_
" -"34f�Fin`al.Heating & Air Conditioning� ' 'T " ' � � 'r �;, �`. ^. - "�= �
; - ,. ��� x � i�.: '1� n�`'��.1 - "�. ;y .. .
• - :" _ I ( - _ _o.
� 35� Pinal'Gas Pipe-Test- a � ••`- `' � ' y- - / tj- = � �
`�u i L�. � •. "». � . o
'36 Hood or.Canopy x. ` .� i ;...-� a � i ^ i/; ���� �i .. � n�. :c � �M
n �:r. ..,r� s � �!!,.+'fi: > r: ��o > ;r .s-;
` 37 -Final Factory Fireplace,� = i� �� � � i � �' 4'` ' -r '� �'�
"_38�Final Plumbing �� ; `� ` � �,�''�' = " � a' '� '
- r : S ."' > _ Y: ^ �' : $ 1 . �1 i J `. 3i. ri
� �39�Water Service�Final; _ � ;,, � � � j � � ,�; ... �� ;y � �
- 40.' Gas'Service=Final � C' . •;."° 'i% ^ ^" � . ,'; � � �, -
y �: r.. :� �: �� t .* t . - . _
. y41.'Solar pome_sticFinal- ,r � � ' � . � � - � . ' :
42. Backflow Preventer � " - " � � -� --
* �:
43. Backflow Irrigation - -� - � • � � , � � . �
� 44. Landscape Irripation System` _ ._ � -� �� � : t ' � � . ' - �
` 45: Sound Attenuation �, :' � � � � � , � _ . �
� 46. Handicap Regulations ; _ ' � � - � � � - � �
... /l ,7.,
I_ 47.�FINALSTRUCTU,RE&BUILDING � ' 6-.%, '' , . �
46.. FINAL PLANNING " �,, : �, ; ^.; � - . _ . ,
�� 49.'Electric Release to�Edison `,. - -� - ' ' '
. .l , -
� � 50:� Gas:Release to Southem California Gas Co - `� ' � `- -' � � ' '
51. CERTIFICATE OF OCCUPANCY � �
No. Da[e
PflQIECf AUORE58: S S S ANTON HL uNR: 7 0 0
OWNEP'SN�ME: �p�U��yNppLI�rIC NAT'L BK
aooxeu: 5 8 g
� . .• COSTA MESA
• CA 92626
� necWexcixeex: INTERNIS_7880 C-17042
neo.xo.:
AOONESS: S PARK PLA2A uxR:
IRVINE CA 92714
r�pMm�E:WESTERN SUPPLY CO, (213)633—OS11
�ooeEss: 15510 ILLZNOIS AV '
PARAMOUNT CA 90723
LICENSED WNTMLTOB OECIAMTION: I �ereGy atlirm tIW� I am IicenseC unEer D�ov6ions oi CAaD�er 9(cammencinq with Section .
70W) of ONision 3 of Ihe Business an0 Prolexvons Code. uitl rtry Ikense is in IWlforce an0 eltect.
aTruc.:046021 sre�uc.:291621 36
Date: 4—/fJ�_� Sianaturt:�
WONNEHS' COMPEN311TIOH OECLAl1ATI0N: I hereGy affirm W� I twve a unifmate of misent to ulbinwra or a ceNfiate of WOAers'
Compensation copy thereol (Seqion 3gpp, LaD.
roucr xo.: ��i ���� �zr. onr�: �1 /01 791
coMr�Nr: HIGHLANDS
❑ Certified caOY �s Aere�y fumishe0. � Certitie0 copy is (IM ' e ciry BuildinA �sion. � '
Dala: ,�� l ��� � MDficani:
F%FMPIION FPOM WOPItEN3' COMPEMSIITIOM DECIdilATiON: (TIa seivm � not Ee mmyeteU d Ne prmit's fa me �wOred if70� a less�. ,
1 cenity that in Ne pertwmance al tM xroAc lor wttich Ihis perrm is icwe0, I shall irot empby my person in arry manner so az to hemme
SuDIK� �o t�e Workers' Compensaiion Laws oi Catifomia. '
Da�e: Sipnature:
NOTICE: If, after makin0 � a��rauon, you shoulG become subject to IM WOAers' Compenutlon.Drovisbns al the Labor
CaEe, you must forthwii� comDly wiN wc� proviUons Or iNs permR stall Oe OeemeC revoked. ' �
CON37PUCTION LENOtNO �OENCY: P hertEy atlirm ttut Nere is a comiructiao IenElnq apency lor Ure DeAormance of the work for
wAlch Nk permit L5 iuue0 (5ecllon 3W7. Civ. CI.
lFNOER:
AOOflE33: ' ' ' '
OWNEH BOILOEH OECUMTION: 1 heaCy atfirm tAat I am eMemOt irom t�e Convactors' State Liceme Law lar Iha I011owin0 aasan
(Section 7037.5 Business antl Ratessbnal COEe: My dry ol �nry which repWra a pemtit ta mnsimct; atter, ImOrove, tlemolish, or
aDalr any 5trucWm, O�r to�its Isswnce, also reqWres Ihe appliunt lor wc� pemut ro lile a 5i0�ed SWtement tlwl he/5Ae Is Ilcense0
pursuant to Ihe provblons ol itu CanVacrori State License Uw (CMpter 9(commendnp xiN SecUon 7000) of Dlvislan 3 0l t�a Busine95
anA Pmfesslons CoAe) ar tlut IvJshe o exempt IAemimm and t�e Eavs for t�e vlepe0 evemD�� �Y �u�on ol Sectlon 7N1.5 by
i any �pDliwnt lor a D��� su0jats the applinnt to a dvil p��Wry of ret more Wn IWe hunOrM Odlars (SSOU�. . ,
I, u awner'of tAe D�opeM or my empI�yMs wIN wa0� az NUr sole mmpensatlon, wi0 Oo t�e work, an0 the
❑ SwcNre Is not intenEeE or oflereE lor 5ale (SecOon 7py1, Businar m0 Nolessfo� CaOe: T1re Comrac�ori State licensa Law
Eoes nat apDN �o an owner al a pmperty wlq EWIUs or ImD�s iherean, an0 wlq Gas suc� xrod Mmsell/Aersell or tAmuq�
�is or Aer own amployees, 0��4 t�at such imD�wemmts am not IntaMM a oflereE lar sale. 11. Irow�ever iha OuilUinO or
improvemam is sol0 wit�m ona year ol completion, ttre pwner wiA luva ihe DUNm ol Drodnp IreJs�e EM not buil0 or improve
�or che ourpau ot sate�. � .
I, az owner ol �ne Droporry� am erGusively wntractinp �t� Gcense0 conlncmrs to wnsimcl tAe O�olect (Section 704A, Business
.❑ and Protessians CoOe: TM Cantractors Sute Liurtsp Law tloes mt eppry to an ovmer of pmpe�tywh0 EmlQt or improves t�ereon
' anG wlia contracb lor suc� pmjecis vnt� a comractOr(s) license pursuant m t�e Comactars Slale LicenS! Law). I am aware
tnat pr0of of t�eir worlttr's fAmpflRaliOn insurance slloWO Oe prWiElC l0 me.
� I am exemD� unOei SecUon: B. 8 P. C.
�w m6 rason: . ' .
oa�e: � o«ner. '
I Eo �ereEy cenity Ihat I am aware al anG unaerstan0 t�e reQUirements ol Calilomla HealO anE Safery CoGe Sections 25505, 25533, and
2553C anG t�at 1 or any futum OuilEinp occupant wilVwill nm (nrcle ane) neeG to comDly wit� uiC sute co0es an4l�e reQuirements for a
permit lor constmctwn or moAilication imm the Nr ualiry ManaO�ment Oisinp. FesiGmtial constmctlon aDPliwtlons aa exempt Imm
Ine50 provisiaB. .
Oate: - MV���
I �eaby ceniry tnat I Aave rmE tlus appGcation anE staro ttut tle a0ove informauon'S cortect. i apree ta compry witA all dry aiN counry
ordiriances anE state laws rUatinO �o builELp mmirucliun a�M 11e authar� reD�v� ol thi� tity to enter upon the ahovementlane0
praperry ,folr inspection Durpases.
Date: 7_�� � �O SiAnaWrc.� �
on.rer's �ianse or Soua� Sewriry x: '
t8at�a8 W�it�BuiMi�q; Groen—Cotle EnlorcemanL Cenerv—noclirant: Pink—Ravenue; GOWanroO—Assessor
CITY OF COSTA MESA — BUZLDING PERMIT PERM NO: P 046898
PERMIT NO: P 046898` PLAN CHECK NO; N GOVT: N SUPP; N
CONSTRUCTION TYPE: 1FR SPAINK PERMIT TYPE: PLU ' PUAPOSE; OTH
JOB DESCAIPTION ; COHMERCIAL T.I. (COMPUTER ROOM) SQ FT: . '
CLAIM VALUE: CALC—VALUEi • GROUP OCC; B-2 /
COMMENTS; RE: B46543 PRIMARY BLDG, PERMIT. ' �
x��r*�rx*rw*****�rx+t*rrkrr*�r*+r***�r�+e+�+�+r�r�r��r****r*xr*rr+t*+�+�**�r+rrr+rr+�r*r**r�e�rx*�r+t�r�
Z O N I N G R E Q U T A E M E N T S -
S E T B A C K S '
------------ MAIN BUILDING ---------- --�------- ACCESSORY BUILDING --------=
FANT: FT IN REAR: FT IN FRNT; FT IN REAR: FT �IN
LEET; FT IN RGAT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • PROV; PAACEL: 41050104 ZNE: REF NO:
PLANNING NtSTES>
i
�t*�t*�e�er,r.�e��ex,e�*�*«�r*,e�*���r*rx,r,r�e�rx*�x�t*�r*�r*«*,r.*'�r�t*�*�r**�r«***+r***�r�t*�+r***+t*��t��
D E V E L O P M E N T S E R V I C E S^. R E Q U I R E M E N T S
20NING APPROVED BY l DATE: '
BUILDING APPROVED BY.: �-,__ _ DATE: �
APPLICATION ISSUED BY;
Mkk1F1FiF1f1klFMMiFMiFlflt�FlfMMMM
DATE: LI—�O —,
i!klkiflflFlFfFflikMMMkitikMillkMMMlflkkifiFifMkMkMkifMMMMMMMiF iF1FifMMMiFMMifMifMMiFMNMiFlfifMMMMkKifMMMkMif
LEGALIZATION:N '•F E E. S U M A R Y STAUCTUAAL SEGMENT:N
�.
� BLDG PMT PLUMBING ELECTAIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 4ZSi - ' • � SMZP/NON—RES
PLAN _ '`-'
ISSUE FEE 3.00
BUZLDING—DIV—> PERMIT' ISSUE PI.AN;CHECK TOTAL PAZD DUE
TOTALS----> 4,00 •3,00 ,-� 0.00 7,00 7.00 .00
REVENUE DIVISION TOTALS--> COLLECTED; 7,00 OVER/SHORT: .00
. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADZNG PLAN—CHECK
' 7.00. �:
MMMiflflfKkMMMMifMMMMkilMMMMMifM1kMMMMM1kikMMM.MMikMMMififMMMMMMMMi1MkMKMMMifNMiFMMiFMNifiFMikkKkkif
I N D I V I D U A�L' �F E E, B R E A K D O W N
TYPE ' QTY D E S C R I P T I' O, N: UNIT• COST TOTAL COST
PLU 2 SINKS, FLOOR �� 2,00 4,00
END OF'FEES
' �
O1 00058290—OD058240 T GT
QATE: 0</10/90 TI14E: 15:54
0
1.00
CONSTRUCTION ANO PLANNING POOL & SPA .
� APPROVALS Permit # Date Inspector qppROVALS Permit #
�r'
. 1. Temporary Electrical Servj�e or PoLe� �, 52. Pool & Equipment Location
W���i1�P'y�e�Urld��r� � , ;y� ' 53. Steel Reinforcement -
, r�i9n.E7pctrietrFC�cftY�Vtltiliry-Undrgrnd:¢ ,� 54. Forms
'�$'�c't4���Rl�drgrnd =� �N ;� 55. Electrical Bonding �
, s 5.;�$t�rge�in�prcerrrelC x 56. Rough Plumbing & Pressure Test
Sq�E�%ct�r,�"calZiF��rnd. y 57. APPROVALTOCOVER�GUNITE
�� ooti,ggs y yry c,t 58. Electrical Conduit�Undrgrnd.
�Q�. Foundati ' n� �-� ,^ 59. Gas Pipe, O Undrgrnd., Test
n
�9. Water Pipe�Un §rnd. � � � 60.� B2ckwaSh Lin85, P�Trap, � Undrgrnd.
,i .,
� �
I k0. $tructural Floor System , ; " ;, . 67. APPROVAL TO DECK
ty1. Property Sev�er Lir�& HouseCon�rction� � 62. Backwash & ReceptorFinal
t. Sewer Cap y d m d 63. Heater & Vent�Final
13. Roof Drainsti.., N 64. Plumbing System � Final
74. Rough Plumbing y � G�Q (�/J 65. Electrical-Final •
�
75. Rough Ealectri�-Conduit � 66. Solar System-Final
16. ftough �ectrir,,�y.iring 67. Fencing & Access Approval
017. Rough �ring �gn 68.� APFROVED FOR PLASTERING
18. Rough Electrica�•T Bar Ceiling � 69. POOUSPA SYSTEMS FINAL ��
19.' Rouqh Heating & Air Conditioning �� FI$E f�PT.,�EQUIREMENT
m� /S J ]k I T Q'!^� f/� Q'i �C.k Y C^ �.: N fi F �
20�'Ro^ry�h ctQCy �n lace � G'�., ry* `J � �*�� y>PPR�VFLl.'S"�PeR it #* � y
y .Y G �F'" i S: �G -K S H .^,� Y X `.,,sy�. � �r-'T-i
21!-0ucts, w�StiEGCU1ex i'.•.• t-S * S d �-'* � 770. Tlnderg7i{�ri� H ro �
4 * 1 i-I f: 1-1 �l k x � h�l �C
� c• �K 1 CJ S 7:
225Du�s, F�nt�tatir�* � � * � ,¢ � F* *� 7�, produci��pjng LTl�y.as �Oil
23.•GarPipe,RoIIgh &�est t mS x R7 C' C O* y 72, Undergro'�nd F 9R '� F
24�ioosf Fi miri§ ''* � E"`-' "`" � � � ` �` * ,7�Under m'a.Stor i�"Tank�Gas OQiI
� •• �' [*f k > CC �-+, x * 9 (eA£: 7.
25. RoDf Stffathing a7c � v K�� O> cox * 74.�Overhead Hydr �'
f• m
.;p,k. ��h,y k d7 O [�Jx'1: T -' # i-+ � N
26.�T-EPer Ceiling (SKT3K•ural) _..Sscoat K O �, �x * 75EDry Chereical t...,a * �,.�
27yframe dnd Flashipg �qc¢ � c� r xx x 76. Dry Stan' '�ie Fa7tr * � �
n n•
F28. WtFiing�'& Sidin�x y j�F � � E ..� .•* � 77 y FIXED �'fE,l���'A4 �, n �
29. In�lat�h E# S •• x�� j„� * 7� FIRE PREV. FIN �L *> Q'y
"30. DrX`�'�al� ailing �M i„+ i � �, � �� * Sou otQwALTF�DEP�.�R�EQ'C�IR:2MI
�31. Plaster Brov[n Coau�.� S i t*tn x I •� * 79. FINAL I[QB�ECT�N :
.� � cJ
32„e',�Electrica� P4wer�l�te'7-F�nali k N /, ���8P,.��FOOD CERTIF�'1ATE I�S�EDH
�33 irtej Elecvm i n; i ¢ # ,{�`''� * Noies: ��� � *r�,�,,,� c:
p" U`L�V�Dli•
N34�Fina1 H ti & ��' oFltlitidnmg� "'
.�. � � `�' ��� M � � '� � .I �!D ' ��A�o� l.�D �
� 35nFin`a� G`�;" Pi`p •Tes� p�'� .. t H ���' z � .�o C7�+ :k � ;n
�36�Ho� o-�CanopY '* �'1 i �zi a x (1 � / * ' E C'�o � tr
•.. tc � �� . �. m �;o * m [�7
� y37�Fina Factory FireGlace„ � FF n: #� �.* "' � O�
"'38. Fir� P bing * R,-�' � o ^ � � * H � *'D
F39. WaY�r S�vice-Fina* � � ` * � ( � � , �`•' * "'
' m40. Gas Service-Final x� Q[�^n^ S # t*f I * O� oN s
.r �. � .t 8 H• o Y' K' d
,�,�47. Solar pomestiCFin�IS m '� * � �� R., •yo c *;� �
� 42. Backf�ow Prev&nte� CJ x � '* Q 7F * C H
Y + N i--i t�� �: .t [*] i'r � * c.
43. Backflow Ir 8tio�' 4SS * s s r v
� 'k �. * G *� a � y n
�744. Landsc e 2TigaticYn Systeri�'7�J ec x I'1 U 0 �s � cU Sv xCJ * n: o
m �x � s ox �s �.
n ^ K F� S F T k E F F i-� x# r. `-i r�" �
�45�Sound Atteauatioc� ,..� .. .. x � m�# M� �, Q, C• F�J M
- _
046.•+iandicap Regulatio�s N O � � i � #* � n c7o � *
47�FIf�L STRUCTU�iE & BIfFLDING � -* N s M
P ,,, x H � � a� � F
48�IM4L PLANNIN6 � t�F �`•L ��: W m �" � E�
n: � I�. "kR v: !J !li s a K
449�sEl�tric Rele"ase to�dison i * � x: �' '^ ,�'.� *
� �
x�50..aGGa£Release ro Souahem Calitonn,ia Gas Co � ! I�� � W. •• ~ �o A(h'� � N o
�51. CERTIFICATE OFxOCCUPANCY r *�' � � F r
Date
Date Inspector
.
.� i
Pfl0.1ECTR00RESS: SSS ANTON• BL • � � ; uNir: 700
OWNEB'SN�ME: SECURITY PACIFIC� NAT'L BR -
�ooxess: S55 ANTON BL
� COSTA MESA '
' CA 92626 � '
(213)345-7880 ''
�NCHIENGINEEH: i�.]'j'ER�•ji ' � NE6.NO.:C=1']OQz
, eonxess: S PARK PLAZA ' u"�T:.
IRVINE � " CA 92714 I
� PEflMITiEE: AIR CONDITIONING CO, INC (818)249-6571 �
nooxess: 6265 SAN FERNANDO R�
GLENDALE • CA 91201
11LEMSEO CONfMCT08 �ELL�IWTION: I �ere0y alfirm that I am Iicense0 unEer pmvLaions oi Chapter 9(camm¢ntlnp with Sec[ion
7000) ol Division 3 af the Buvness anE Pmtessions COEe, and rtry license is in full tarce antl eIIM.
cm uc.: 014 4 0 3' srn� uc.: l z p /6,g�) cuss: C— Z 9.
Date: � — j �—' � Sipna�G �/�' �, /,� �.C—.v . . �
WOBNEBS' COMPENSRTION OpCIAMTION: I here0ydltirtn t�at I Aave a certilicate of consanl U¢tl-i ure or a cartlAcate of Workers'
Compenution Insurance or a certifieE capy t�ereo/ (Sectlan 3800: LaE. CI.
�YICY NO.: WC �I d�% 4 S Z S 7 b �cr. o�r�: 10 /O 1/ 9 0 . -
nrnvexr: TAANSPORTATION
I J Certi/ieE coDY is AereOy IVmisAetl. � Certitie0 cop ' fle0 with Ihe ciry Buil0in0 Diuision. ,
Oate: 4��� �^ � d pPPI t: . .
' ENEMPfION FflOM WOflKEH3' COMPENSITIOX UECUM N:�(1Ab section nee0 not he campleteU tl rmit is for one AwEretl (5100) a less).
I cenity ihat in ihe pedormance of the work for w�ich s permit is issued, I s�all not employ an erson in any manner m as to become
suhlect ta I�e Workers' CamDensatian Laws o1 Califomla. .
Oate: � SiA�ature: •
NOTICE: II, afler makin0 ��is declaratlon, you 5hou10 become SUEject to the Workers' CumOenution pmvisions al I�e Labor
CaEe. you mu3t tartAwith �pmpy wRh wc� pmvisions or Itus permit shall be OeemeE awked. , • '
CONSiRUCTION 1FN01N0 �CpNCY: I hereEy affirm t�at them is a constmction lentlinp a0ency lor t�e performance ol tAe work for
whkn mis Oerrtut is isSueE (sectlon 3W7. Civ. C). ,
IENOEB: .
'ROOBESS: " ' . - . . . .
OWNEB BUIlOEB OECUI4ITIQN: I here0y aflirm Ihat I am exempt tmm the Caniractors' Stata License Law for Ihe tollowin0 �eawn
(Seciion 7031.5 Business antl Pmf¢ssional Cade: My ciry al counry whk� reQuires a permii m cansirucl, alteq im0�, demWisR or
reD�� any simcNa, O�or to �5 issuance, alm repuiru tAe aD7liunt lor sucA Oermit to lile a sqne0 statement that �ds�e is Iicense0
pursuam m the pmvisions ai itp �nVactors' State license Law (Chapter 9(commencin0 �th Sedim 7000) oi ONisqn 3 al Ne Business
and Pmtessions Cade) or t�at pUs�e is eeempt Neretrom an0 I�e Gasis for ihe allepe0 exemption. My violatbn of Saction 7031.5 by
any apWicant lar a perrtut wEj�u t�e applicant lo a civil penatty of not more Ilwn frve �uMretl Uollars (3500).; , -
� I, as owner af t�e propeM or my emVloyees with wayes as iheir 5ola compensaiion, vNl Oo t�e.work. �anE t�e
� stmcWre is not intenAeA or ofleaa far sale (Sectwn 7064, Business an0 Pmfeuional CoOe: The Contractors' State �icense Law
� aoes not apply to an owner of a O�operty wtw EuilUs ar impmves thereon, antl who Ooes such work himsell/hersell ar l�muA�
, M5 ar her own em0loy¢es, proviAeO ihat sucA imD�ovements are nohintenAeO ar ottereC lor sale. If, �owevertAe huildinA ar
impmvement is sold wppin ana year of completlon, t�e,ownar vnll have t�e �urtlan ol Droving �e/s�e Aitl not Ouild or imDrave
lor I�c Durpose al W!).. -, , �
.I, as owner al t�e D�Werty� am exclusively wntractin0 ��h Iicen5e0 contractors to constmct t�e pmjacl (Sectlan 7014. Business
❑ anE Protessiars CaOe: The Contractors State licertse Law Eces ipt appN ro an awnn ol pmperty who buJ0.5 or impmves Nerzan
anO w�o coniracis lor suc� Omlecis with a contractoqs) license pursuant to 1he Contractors' State Licensa Law�. I am awara
Itwt prooi of their Workeer's ComDensafion insurance s�oulE �e prwiUeE to me.
rk
� I am eeempt un0er 58ction: ' ' B. 6 P. C. ,
lar Inis aazon: • ' ;
Date: Pwner.
I Co Aereby ttrtity that l am aware ol an0 untlerstantl ihe reQuiremenis o1 Califamia Healt� antl Satery Cotle Secqons 25505. 25533, anE
25534 anA that I or any imure OuilEinp acupant vnlUwill not (circle one) need to camON w��� ��4 state co0es anA the rzQuiamenis for a
permh lor conswction ormoryiliwtlon fmm t�e Nr Oualiry ManaOement Oistnct. HeSiEenti9 canitruction aOP���Uons am exem0� �mm
�he5¢ pfOvisions. � �
Oate: Applicant:
I here�y certiTy Ihat I �ave reatl this aD7�ication anG state that l�e aEove infarmation is correct. I aA�ee to comply witA all city an0 counry
ordinances and state laws relatipp �o builtling constmction an0 hereby authorize representatives ol [his ciry ro enter uDon t�e a0ove�mantioned .
prOpeM �arinspe/clion Durpo4es. �/ ' .
Dare: ��( �_ �� Sig mre: � �' ��4 // .
Oriver's �icenu or Sacia� Secunry x:
t8nt�ae Wnile—Buibi'p: Qreen—Cotle Enlorcamant: Cenary—Applicent: Pink—Rarenue: GOIEenratl—Asseswr
-...�. - ---
_�
• CITY OF COSTA MESA — HUILDING PERMIT '� PERM NO: M' 047014 :
. � i .
PERMIT NO: M 047019 PLAN CHECK NO: N GOVTd N SUPP:'N'
CONSTRUCTION TYPE: 1FR SPRINK PERMIT.TYPE: MEC ' PURPOSE:,OTH
JOB DESCRIPTION : COMMERCIAL T.I. (COMPUTER ROOM) SQ FT:. ,. ',
CLAIM VALUE: f.CALC—VALUE�: GROUP OCC:.B-2 /
COMMENTS; RE: H46543 PRIMARY HLDG. PERMIT. '
' *�**�r**�r****x�*�r**�***x****�x*x�*�r�r*�r��rx�*****+�*��e��rr��*«��*�r�e«�e�*��+�**�*�**�***�r
' 2 O N I N G R E Q U I R E M E N T S ' � '
_ ' S. E T B A C K.S
------------ MAIN BUILDING ---------- --'------- ACCESSORY.BUILDING
FANT: ' FT IN REAR: £T IN FRNT: FT IN REAR: FT, IN
LEET; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PAACEL: 41050104 ZNE: REF NO: •
PLANNING NOTES> , '
> i
it if 1E iF M it �k ik k if iF ik ih it k 7k k iE iF if iE M M ik iF iF 1f 1t iE ik af iE M M if iF 1E if iF iE iF iF iF iE iF if iF if N iE 1t iE iF �f if k%k iF if it iE iE iF it iE 1E iF 1F iF iF iF it 1E ik ii %iE.it
I D E V E L O P M E N T S E R-�.V, I C E S � R; E Q U I R E M E N T• S;
ZONING APPROVED HY �•• 'DATE: �
BUILDING APPROVED HY : � • DATE:
APPLICATION ISSUED HY: DATE: �'^ l U
/iflfklkikikjf�fltifiEifklfiFiFlf�tikifkk ififiFkiEiFiEiEiFiF ikiF
`ifitiFiEiflEiE�fMkififiEitiFiFiFlkifiEifiFiFiFitikllikiEiE�FiE1fKM1k1f1fiflFifiE 1EMlfifk�flF�fiEkiElfNiEifiEiFMiFiFiEMiFiFiF�kiEiEaEiF�tifiEififif
LEGALI2ATION:N F:E E S'U.M M A R.Y "' 'j STRUCTUAAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE� SMIP/RES GRADING
PERMIT ? ,' ' . 31,00
� • ' 25Y , SMIP/NON—RES '
PLAN •
ISSUE FEE 15.00 '
BUILDING—DIV—i PERMIT ISSUE PLAN—CHECK: TOTAL PAID 'DUE
TOTALS----> , 31.00 15.00 �0:00 46.00 46.00 ,.00
REVENUE DIVISION TOTALS--> COLLECTED: 46.00 OVER/SHORT: .00
BLDG PMT PLUMBING'ELECTRIC'MECHANIC FIRE SMIP/TOT GRADING PLAN—CAECK
. 46.00 . •
if 3k i! if 1k ik ik �f 3Fk ik iF ik if 1F �f 1f iFik k ik ik ik if ik iF if !f it if iF ih k 1t �F �flk 1f iklf ik iF 1k ik ik ik M iFif 1F if �F ik k k ik if k if iF ik ik ik iF �k �k it it ik if !F �f ik 3F M ik k iE i!
I N D I V I D U A L F E E B R£ A K D O W N
TYPE QTY ' D E S C R I P T I O N � UNIT COST TOTAL COST
MEC 1 REPAIA/ALT COOLING UNIT/SYS W/CNTLS 9.00 � 9.00
MEC 2 REFRIGERATION SYSTEM >,100 K BTU/H 11.00 22.00
. END OF FEES, • . '
0
0
0
0
01 00058932—D0058g32 T'[7iT.
DATE: 04/13/90 TI11E: 09:22
0
�
A
'46.00 `
\ . CONSTRUC710N AND PLANNING f `& SPA
Date Inspector Date Inspector
APP�IOVALS Permit # � -' - . APPROVALS Permit # �
- - /
' L,Temporary Electrical Service or PoIgF �f � 52. Pool & Equipment Location �
n. �" !1 m
;2.�So�I�Fiqe;U�drgmd,' c`,�' US �}; � 53. Steel Reinforcement �'��
�-;3.'%E�leetri T{Co�duit!tl;ility-Undrgrndt� ' ' 54. Forms � ' ,y
•3C �n:.c�-�ti�a�-� r�t¢: 7 ' - . .:i
' .4�IecJnca��Condurt�Undrgrndr� ,,,i�,,, . 55. Electrical Bonding
� 55.^.S�e�'Fieinforce'shenn �E�-x � 56. Rough Plumbing & Pressure Test ^�
�m rr
J46�Elect�rieal'C7fFR�Grnd. � S , 57. APPROVAL TO COVER�GUNITE �-
v v, �� 4
��7.�Footings y S'R :� . � 58. Electrical Conduit-Undrgmd. c,�
�8. Foundatid�n .;�5 59. Gas Pipe, � Undrgrnd�., Test ' �`''
_9. Water Pipe-Undrgynd. 60. Backwash Lines,,P�Trap, O� Undrgrnd. '
10. Structural Floo; System � 61. APPROVAL TO DECK •
17. Property Se`,w.,er,Lin,`,e.'& House;Connection ' 62. Backwash & Receptor-Final
t2. Sewer Cap u!i a• o, n� . 63. Heater & Vent-Final
13. Roof Drains..�.�,. � . 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Efectrical-Final .
15. Rough Electri�l-Conduic � 66.-Solar System-Final �
16. Rough ElectriciWiring 67. Fencing & Access Approval
= 17. Rough Wiring �gn " 6S. APPROVED FOR PLASTERING
�
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL �
' 19. �Rough Heating & Air Conditioning - ` FIRE DEPT. qEQUIREMENT
�^ n J t� C1 a � m^� a� r �n .y ;-. S ,. F i. �
'�7 i � . t t �, f 'J'. (il `y'7 x � ,� :�. �, .: n � i� (` t �'J LT7 . �: �+ �T1 iT1
2Q:-RooghFact_„Y�eplace iSM S�L r. H trx:•'APPROVQ�LSNi...,Pe�mit#-� ,-,.
21 �Du�ts, in StFuctu're' � '.. .. �-''� * S r �-+y: :t � � `^-*'+�' - "
�s �� .>�� � �j ,� � �: * i70. Undergrou�d Hq�ro #
J � ni M i ! S R >` V..� x^. M'� i mw %
22�DJcts, Ventj�ati�y� � � * � � ;� F,a, * `77, product�P,iping OGes QOiI
'23:�Ga^Pipe�Ro�9h &-7est ' � � T �� � ^7 � � OY � �72, Undergro �na Fl�ifh� i �-'
�24�Roof Fiamirig `'`��� ' �'�E'• ••F w'' -
O l'r x.R � '� .-�o� * � �-i
••�: ,7 x � � H*.i ••73:7Undergrnd.Storag�Tank;L7Gas OOiI
25. Roof Sheathing �1 �: � `� + '� � 'J � [Ut� �� �74�Overhead Hydro`�, *
n. i�•• m x�x �
'' � ' ' * � 7 C*t:k �: "' '7 z r+ p •+^.G
26-T�Bar Ceiling (Swtturall &-Mon=ocoat i. C� O,� »� 75^Dry Chemical Ho !� mm
� 27�-Frame and Flashing j.r, n a� �� � m.� x' 76. Dry Stancl'p'ipe ^� ;' u '�M
r� �.. n �t� .. i� y� s �-f u i.;-t n i --i �-+
y28.� Lathing& Slding^*" Car � Y� "' "� ^"� * 77� FIXED $Y,STEM FINA�; r� i, � j
29. InSUlat dn �* � S •' * r, ( � �x * 78yFIRE PREV. FIN�L y, � -`�''` ��
' `-� 6'..P �K �' � r' H 1
' 30. Drywal�Nailing.tiy_r, � x:,, I f-"�' HEALTH�DEPT,�`�R�EQUIREMENT
i hfR # . 5 (.,.., t. �...
�31. Plaster Brow� Coaa 5 i r•+b' * I �� x �79��FINAL INSBECTION r�✓ ! G�
.I 4. -n/1 i`I
.'.32.T;Electrical Po'��'er�Meter.F�inal� *'''� � I 1�•�; ��', �80�yF00D CERTIF�ATE I$SUEDH S j
C` ^ ,i' ' 3� 1 - 9. �.� - ... � �.l t�
`335Final Electrio a- c�t � •S * � �I . � Notes: ^] `7n '� ^� O �:am
..� i.-. ..i� c.. .m m � �t� c
23Q�Fir`r`alH`ating&�AixCoisificioning• m ' � { �� � s ^�a a .> � o
� �� K' H � Faro r� S
, 35�.jFinal Gas Pi�pe�Tesl �j,y � * ;r I 4 ����� � � � � ;:o '7^o k � c+ [s'
�36. Hood or'Canopy'i � ^ � �""'� a +� n �ij 'K ' � �'tc r: - n��n•
.� m r n i cc c*� r � i 1�* c*� x o � tn r o cn
�V oi �+. m -� t .� - ...�..
37.-.Final Factory Fireplace� -.�-. �1 K�� I I G' .:k y .�:-., � i. D;
.n o �
38. Fir�al Pi�mbin '� �N � " � ^, � 1 :'�� x ^ S�� ^• i-+ '� m i
9 � m i o i: � 1 � *' �-+ocv o � � fl�
�39. Water Service�Final, d , ` : ,x I � � � „ "" " � r`o`•' k `�' F�
i t -n .-� .
'!40. Gas Service-Final � [�? �F� m �'� I I � �; O'o �c�% � ���
F• � � z: .t: K
y S i t •• .� V+ Ff 1• •.+
�'41. Solar pomesticFinal t,.� * I I x' p, .y.o p, y x a
42JBackflow Preventer' � r� � � � �' � =C >F x rJ �
h r ni n--� �-+ r r+. ## M ?7 G �x F '-+
G'. � �'. S' x a. � •.,. n x• U vi -�
43. Backflow Irngation. �„ w:,; * q� i �; n ..
;44. Landscape IfriqationSystem`��''» � �� � a "�� a� n3 N xr'� r� cu o�
� C m � �2 di,* � T£ a O� KS F
i `,� I^ ("l x H x F M �. E t^ N [. r'r : ;r r-� :. �� u ' C +t
45.,Sound �Attenuation .y .. .. a M P7 h7;; x. a T �?. • FC �
-,46:•Handicap Regulations � O a' *� tc S G� S �
< x t' I I+',�iF: w t t+i O !'J K
47SfINAL STRUCTU�RE & BUtLDING Y E., � I -�� {� y �, � E.,
� w
48 �FIN'AL PLANNING i E-FC-F � ro f ��� r a n? � � !-�
r, �r i i '. x' x'� �, r) s # �;, '
i i I �: � q: � �. I 4 " J
- 49:,Electric Release to�Edison , R � I,��. y. r� .n ,. _
-50SGa`ReleasetoSouthemCaliforc�aGasCo'' � ! -' ». r . � '� • o�T+ * `J • •
DO :'l :� :J .=o
s51. CERTIFICATEOFOCCUPANCY ` ' x � �� ��' ^ * . ��
No. Date
,
PflQIEtf pODflE38: S S S ANTON BL
awxea�sx�ME: SECURITY PACIF NAT'L BK
11DOflES3: SAME AS ABOVE
• 213/395-7880
IIflLWENGINEEH:
anoxess:
xca.xo.:
UNR: %QQ
uxrt:
rEwnmee: HUTCHISON CORP ( 213 ) 763-7991
�ooness: 2250 S CENTRAL AV
AANCHO DOMINGEZ CA 90220
�, IICFNSED CONTMCfOB OECIAMTION: I h¢reUy atfirm I�at I am Iicansa0 un0er Dmvisions al CAapter 9 �commencinp vnt� Sectlon
' 7000) of Oidsion 3 al the Businass anE Prolessions CoOe, and my Ilcensa is in lullforce anE eflecl.
� cm uc.: 0 2 7 8 7 sr�re uc.: 2 6 9 512 cuas: 0
.. D�ta: ��� � ��� SlOnature: �� �-`
� WONItF OMPEN311TI OEClAlU710N: I hereEy attirm t�at I Aave a uNlipte ol conunt to ulLi�re or iate ol Workers'
iComDensatipn Itmreal (Secnan 38p0. LaO. l.
voucr xo.: ��� ����� � E%P. DATE: � Z� O S I 9 9
roMn�xr: GREAT AMER.}I�CAN +
CENfeO CODY �5 Aeteby IumiSheE. L'] CetlilieE COOY is �ileA witA Ihe ub 9�f�E� Uivisin� �
� f. ) /J
�' Daro: 2 Rpplipm: � �Vi/ �
IXEMPhON FB N YAfl[FN8' COMPF113+17ION DELWUTION: (fFis seCian ree0 not De conpktm it tle D�� b la (S10D) N less).
I ceNiy ttat in ihe peAormanm ol tice wark tar wNc� IAis pemrit ¢ iswe0. I stWl mt empby a�ry persan in am� manner m as ro Eewme
wbject to Ne Wwkers fqmperisatian Laxs of CalitamW.
Data: Slpnamre:
Nq7��E: II. aher maknp IAis Oeclaatian, you shoulG Oecame su�lect ro tM Workers Camp¢nsatbn provislons of the Lahor
CeOe, you must IorlAwit� comDN ��h suc� proNslons or this permit SAatl Ee deemN rewkeE.
CONSTpUCTION IFNUINO �OENCV: I �ereEy atlirm Ilwt Uere is a wnsVuclion IenNnp aOe�Y �or Ihe DeAormance ol t�a work lor
wNcn Ilus Oermilis 55uetl ISecilon 3097. Civ. C1.
IFNDEfl:
ROOflE33:
� OWNEq BUIIDEB OECIAMTION: I �ereEy atlirm t�at 1 am exempt Imm t�a Contrapors SWte licensa Ww tor t�a lollovrinp reason
(Sectbp 7031.5 Business an0 Pmlessional COCe: My clry ol counry whic� reqWres a Dermil ta wnstruct, aller, impmve, tlemolis�, or
repalr i�y sWctum. D�w to 16 Ltsuance, alw repuims �he apDllcant for sucRDermlt to IPe a sipnM SUtement ihat �eJSAe is Ilcenu0
D�«� lo I�a Wo��s ol Na Coninctors' State License Uw (CMpter 9(cammenUnp wit� Section 70pp) ol DNislon 3 of Na Business
anE PrOfessb� CWe) or WI tr151ie k erempt Nerefrom an0 Ne Easis lor Ne allepeE exemption. My Wdaflon al Section 7031.5 Ey
any aDplwant Im a perrtdl zIDjects tlre apqkant lo a Uvil perWry al not mort Wn tive huMreE EoOars (f5W).
I. az owna ol tlro P�D�M ar rtry em oyees wit� wa0es as Ndr sda mmR�wibn. wW 0o Ne xroA. anE tAe
O structure is irot inkMM or ottered tor sale ( on 704/, BuUness aM ProfesUonal CoEe: T�a Contnctars State License Law
- Coes �mt apply ro an oxrnr ol a Woperty who bwMs a improves lherea+. arM xin Ooa sutli work Nmse1!/herset/ o� Ihroupl�
� his or her ovm empbyees, prouitleO tlat such ImDrovemenis aa nut IntentlW or atleretl for gye. If, Mwever t�e builElnp or
ImD�ment is soW wlMn we year oi comDletlan, I�e owner vnll �ave IM OurEen ol O�ovin0 ��s�e NE not Guiltl or Impmve
forthe purpose ol �le). . .
I, az owner of Ne D�opeM, am exGusiveN wnvacW 0�U ticenseG conV�tlors ro constNct W Drojecl (Secuon 70.71, Busineu
❑ aM Pratesian5 COEe: The ConUaclon' Strte Lkense law Oces no� appty b an wmer oi property who au14s a improves Nerean
anG wAo mnUxis Iw surli Drojec6 wiN a contactor�s) license Oursuant �o Ne Convactas' Sme llce�xe Law), I am aware
Wt yoof offluirWorker's Compensation insurance shauW be pronGeAlo me.
� I am exem0� ���� B. 8 P. C.
lor inis reason: •
Date: Owner. �
I Oo he�eby certity Ihat I am aware o1 an0 unOersian7 the reQuiremenis ol CalilwMa Health a�M Sa/ery CoOe Secuore 25505, 25533, aiM
25531 prW ltat I or any Iuiure EUIWinO occupant v�n�IU�wlll no (cirUe one) neetl to compy witn sab sute coEc antl Ne repuiremenb lor a
Derrtul lor wrtsfrucllon ar imOilkaUon Imm Vu FTr au�ry Manapement Di5Vk1. HMWmtial conslrucUon appkatlans ara exemD� ��am
IAae proviSMs.
oate: nppiicam:
I nere0y cenity tlut I Wve rca0 iWs appllutlon �n0 state tlut tAe aDove Inlorrtwtlon i� rqrrecL I apree to compy witn all Gy anE ravnry
ordina�ys aM sUro laws reWtlnp to �uilEinq construcllon an0 hereby auttiorha repreuntatives ol Na tiry to arter upon Ne a0ove�mentioned
praperry brinspectbn purposes. ^ �� ���
/ J
Date: � SipnaWre:l 71t __ i __._ ..
orivers �iu s¢ nr s«w sauen «: v
t8st�a8 W�ite—Bulbiep; Oreen--COCa Eniwromenq Canary—Fpplleeni; Pink—Revenue: GOWenraE—Avessor '
CZTY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 047109 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: EL$
JOB DESCRIPTION : ADDITION OF 40KV TRANSFORMER
CLAIM VALUE: CALC—VAI,UE:
PEAM NO: E 047109
GOVT: N SUPP: Y
PURPOSE: OTH
SQ FT:
GROUP OCC: /
COMMENTS: B-46543/E-46563
a��r***x**�ria+tx��r�r�**�r�r�r+t*+t*�r*��**�***�***�r�r**���x���+r*+r�**�+r*it�**r��r+t*�r�t��*�r**�r+r**�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN AEAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE(� • PAOV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NfSTES>
>
MiFifililitMifikltitkltifkltkkfkltiFititffiEififiklkitifikifiEkilititikitMifitiEkiEiliflEkikiEiffEMkitikitiFiEikiEiEitMitltiEiEiEikif�flfifitfkiE
D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY :
APPLICATZON ISSUED HY:
1f iE if 1f if if ik k it k If iE iE iE ff iE it it if 1f iE iE3F�iFif
M 1f 1! ft �k if 1f iF!!!t iE 1E 1F if k if 1f !F if !k M 1! 1Flt It 1k 1f !k ik if 1k it ik if
LEGALIZATION:N F E�E
DATE:
DATE:
�. DATE: �t,lD
lE1FiE1flfiFitik�kif Ifif
!f !f !E if R 1t M 1f 1t 1t ik if k!k it k M M ff 1k 1f 1f �i if iE if iE ik M iE 1E M iF if iE if M iF ff k!k if
S U M M A R Y STRUCTUAAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 15.00
502 SMIP/NON—RES
PLAN
ISSUE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15.00 4,50 0.00 19.50 19.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 19.50 OVER/SHORT; 00
HLDG PMT PLUMBING ELECTRIC M£CHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
19.50
if if �k it if if it if if ik iE iE it it if if if iE �t if ik M ik iF if iE k ik M k iE k if i! 1f if if M if it ik iE M ik M iE if M it iE if 3t if M it iE if M ik iF iF if ik ik ik if if if iE 1E 1E iE iE if IE 1E 3f if iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
ELE 1 MOTOR/POWR APPARATUS 10,1 — 50.0 HP I5.00 15.00
END OF FEES
Of 00059b31-OD054d31 Tu T 19.50
DA7E: 04/27/90 TI�E: i1�iD
� �
� �
CONSTRUCTION AND PLANNING P�� � SPA �
APPROVALS Permit # Date Inspector APpROVALS Permit # Date Inspector
1, Temporary Electrical Service or Pole � _� 52. Pool & Equipment Location �
� -.
2:;SoilPipe-Undrgrnd,, __ ' �% ' 53. SteelReinforcement
3:-Electrical ConduiYUtility�Undrgrnd. , 54. Forms
4.. Electr,ical Cond"uit�Undrgrnd � 55. Electrical Bonding �
'S`5�eel Reinforcemeni 56. Rough Plumbing & Pressure Test �-
.- ,.
6� �lectrical UFER.Gind. �, :� 57. APPROVAL TO COVER-GUNITE -
7-:Footings t.'t,_ . 58. Electrical Conduit-Undrgrnd. �
8. Foundation -• � �- � 59. Gas Pipe, O Undrgrnd., Test �-
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P�Trap, O Undrgrnd.
10. $cructural Floor System � � 67. APPROVAL TO DECK .
11. property Sewer Line & House Connection, ' 62. 8ackwash & Receptor-Final
12. 5ewer Cap - � � 63. Heater & Vent•Final �-
13. Roof Drains ' ' 64. Plumbing SYstem - Final
14. Rough Plumbing � 65. Electrical-Final .
15. Fough Electrical-Conduit , p 66. Solar SYstem�Final �
16. Rough Electric Wiring � �� g7. Fencing & Access ApProval
17. Fough WiringSign 68. APPROVEO FOR PLASTERING
18. Rough Electricel�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19._Fough Heating &,Air Conditioni� � � _ �: _ x , _ FIRE D.EPT. REQUIREMENT
t,
..,a 4_] .J _. _ n ., •J�J '�. . �' i
20: �Rough Facto'!y Fireplace - �r, � �. � �APPROVALS .•�Permit # - -
21. �Ducts, in Stiuctu}e � " " '' ' ' � =' "' 1 �; 70. Onderground, Hydro -'
. �. _� 1 ;
22,Ducts,Ventilating � ?j �-r Q `'� i ^7�, Producr.P.ipingOGas ❑Oil
23. Gas Pipe-Rough & Test �'�'� +'T� - � ��; i� _' 7y, Underground Flush� a �
24. Fioof Frami�g , � �� � ��" =; s '" .'.73 ;Undergrnd. Storage Tank O Gas. O Oif
25: Roof Sheathing •' k � r� ,r. 74:�Overhead Hydro:,,
, o �,;,.. _ _ . .. �.
26. �7-Bar Ceiling (Structural) &=Mpnocoat -„ _ 75r_Dry Chemical -._j -
27::Frameand Flashing : y�7 �. � >' m 76. DryStandpipe �"" � _
'28 l.athing & Siding ' " �;�" =`= ` T �� �� � 77� FIXED SYSTEM;�INAL J '. �-
29. I�sulation - " ' �;. � 78�,-;FIRE PREV. FINAL � �� �
� 30. Drywall Naiiing _ .� F., � r� � �HEALTH�DEPT. REQUIREMENT
?31. Plaster Btown Coat� s' :�^� �� , u r'7g.�FINAL INSRECTION• ='
�..� � �. v m' _r C
.32..�lectrical Power Metei;Final �'� ? r ' O:�FOOD CERTIFICATE ISSUED �,
.'33: Final Elecvfc . � � � N°.,' 7 �'T - ' _ '"
�'.34yFinal Heating & Air.Conditioning� �,� x � , ; -*�, � - � ��o v � � � � 6 ± �
35. �Final Gas Pipe-Test � •• �: � � � # � ...c � t � -^
_ i
-- 36._ HooH or CanoPY ' - I m ' ° ; . ', r �� .•
�. :l i Y... ', . a. �
;.. . .
-737.� Final Pactory Fireplace' v « -
n, v r �' a
_38. Fina�l Plumbing ' ' " i; ' ' ' �` '.
� u
39. Water Service•Final. - W ¢ q �. r^ � �4 �
:'40. Gas Service-Final ' " <" ' • � ` w ' � '� �
; l. - � - • :.: i * _
^41. Solar OomestioFinal� ;:j * ' � k � ?� 'i _ '- _
42. Backflow Preventei ^� " ^ � a t -7 = `- - ''
u ��..,� v. 9 t -� `C _ _ ._�
�r -
43. Batkflow Irrigation �^,' a . x � ; - ' �
-^44. LandscapelrripationSYSCem�^i� ,S f ` ' -� �-°+� � � V '��_� � " _
'-Z 4` Q� a S �J
,.45��Sound �Atten.uation �V:.. � � ` r,� � _ ��. : � �
;.46.•HandicapRegulations � '� - ' �' `
47.'FINALSTRUCTURE&BUILDWG � __ -= ,f ' ' " - '
_�
48; PINAL PLANNING � " ; ' J'1 � '. . _ ' �
49: Electric Release to.Edison � "� ;, � " .
50: Gas.Release to Southem Calitornia Gas Co �- � -'� -
s -
51. CEFiTIFICATE OF OCCUPANCY �
No. Date
I
�
`��
PflWER11DOflE38: SSS ANTON BL � u"rt: •T00� �
OWNER'SNRME: SECURITY PACIFIC NAT'L BK �� .
, �ooxess: 555 ANTON BL
, COSTA MESA •
.• ' CP. 92.62G
(?.13 ) 345--78A0 .
11fltNlENCINEEfl: IN•rERNi � REO.NO.:C-1�oq�
�ooxess: 5 PARK PLAZA �� R'
PEflMITTEE: IRVINF. CA 92714
�oopFss: HUTCHISON CORP ( 213 ) 763-7991
2250 S CENTRAL AV
RANCHO DOMINGEZ CA 90220
11tEN5E0 CONTMCTOH DECLAIWTION: I �ereDy amrm that I am AcmuG unGer DraNslans ol CMpter 9(commencinp rAth Sectlon
7000) ol Division 9 of tAe Business anC�Prolesslons CaCe. arM my Iicensa ¢ in lull lorce an0 effect.
aTr uc.: 0 —�� 2 6 9 S 12�uss:
Uate:� S�p�aNre:� � ��,�� (
�WOpKEB3' CO NSIIT N DELIAMTION: I �areEy atlirm IAat I lwro a certificate ol ton5enl [o xl6insure or a certifi ol Workers'
Compensatlon nsurance, or a certAieO copy Ihereof (Sectlon 3800. LaO. C�.
^wcrxo.:{�CPG07747.8 �xr.opTE: 12/O1/99
�P�xY' CREAT AMFR CAN
eninee wov is icereby �umisnee. � cennien�o. m ua ary �mmm ron��, �
�, �
.�e: Moi�
` F%EMYfION j OM WORKQt4' COMPENSAiION OEWIhITION: (Itit 5tttim rceN noi ha mmp�te0 il Itn pairil ¢ ta one rt0 (510� or les5�.
I ceNry Itwi in I�8 DeAormance al �he vrork lor wNU NLt permit is iuueE, I shall no� empby any person In any n¢r 5o as to CBrAme
su�lect ta Ine WaM1eri Compensation Lavrs of Calitamia. � ,
Date: ' - �9��+�:
NOtIGE: II, aher mriJnp Ws Oeclaratlon. you S�wW Eerome su�jM ta Ihe Workeis' CompenuGon D�oNslons of tM Labor •
CoOe, you must InrlMril� comDA' w�tA suU pmvLvons or INs Dermit slwll Oe EeemeO revokM. � i '.
CONSTPUC710N LENOIN� �GENCY: I �ere0y aflirm tAat t�em is a canstruction IenAinO a0ency lor fAe peAormance ol the work br'
which IAis Dermit is iuuetl (Sectlon 3097, CN. C). � .
� IENUEB: � . . �
�OOflESS: ' ' '
� ,
OWNER BIIILOEP OECUMTION: I �eieGy amrm t�at I am exempt trom the Cantractors' Stata License Law lor t�a lollowinp reasan
ISection 7031.5 Businass an0 Rofessional CaOe: My dry ol cuunry x1dc� requires a permil to canstruct, alter, imDrme, Aemolis�, ar
repair airy 51mcWm, D�or to its Lssuance. also reyuues t�e aDO��� �� sucA perrtut to lile a sipne0 statemmt that hUs�e u Ilcenutl
pursuant to the provisloru af tlie Contractars' Stata Lianse Ww (CMpter 9(commenun0 ��h Seclbn 7000) ol Olvisbn 3 0l Ine Business
antl Prolessions CaEe) ar t�at ANs�e is eMemO� ��emtrom anC ihe Eazis lor Ina allepe0 exomption. My violation of Section 7031.5 Uy
any applicant lor a permit su0ia�s Rro appllcant to � civil penatty ol not more IAan 1Fre nunGreO dollare (33001.
I, es ownar ol tAe O�opeM or my em loyees wiN wayes Ss Iheir wle compensatlon. xtill ao the woM, ena ihe
❑ s�runu�o �s no� �meneea or oneme ror sa�e ��eectlan 70Ad, Busineu'an0 Prolessional COCa: T�e Contactors State Lkense Law
tloes nol aODN �o an ovmer ol a D��MM. � �uilds or Impraves tAeaon, anE w�o Oas suc0 wurk himself/Aerself or Nroup�
his ar Aer own empbyees, proviGeE tAa1 wcn improvements am not IntenUeO or oneraE Ior sale. II, nowever tAa Oulldinp or
� imD�ovement Is SOIE wit�in one year ol wmplation. t�e owner wlll h�ve t0e Uurden of provinp hUs�e dltl not EuiIC or imOrove
for tne vurposa ol sale). � �
�
I, as owner ol t�e pmPorry, am exclusively contractln0 ��� Iicense0 conlraclors to constmct t�e Drolep ISectlon 704A, Business
❑ anU Pmlezsbns CoEa: Tha Con[ncton' SWte llce�5e Law Eoes nrn appry to an wmer ol Oroperry wtq bullEs ar Improves Merean
an0 who comncb tor such projects xil� a conVactoqs) Ilunse Dursuani to I�e Coninctors' SWte License Law�. I am awaro
Ihai pr001 at �Aeif Workei S CamOlnSailon Insufante SOoulO Oe proviOoO �0 me.
� I am eKempt under Sectlon: B. 8 P. C.
for �hls rla5on:
DdIO: QMOBf:
I Uo hereDy ceniy tAat I am aware al an0 unUerstanE tha repuiremen6 al Calilornu Healt� and Salery CoUe Sectlons 2550.5, 25533, and
25534 an0 t�at I or any luwre GuilEinp acupam vnllAHil noI (circle ane) neeU to comply wiiA saitl state co0as anE t�e mqWrements lor a
permit for wnstructian or rtw0ilicalbn Irom tM ar Oualiry Manapement Ustrict. Nesidential constmction aODlications are exempt Irom
tAese D�ovisions. .
Date: AppliWnt:
I nereEy certiry Inat I nava reatl tnis appliwUon an0 state tnat tne a0ove inforrtuipn ¢ wrtecl. I aprea Io comDy witA all city anyyrycounry
or0inance5 and state Wws relatin9 �0 6uil6np constructian anJ here0 aut�onze reD�� atives oi tNs ury to enter upon t� ve�mdnlionetl
proDerty lor insDe Iion purpoms. � !�/ l
Oate: 3 � SiOnature: �/a // 1
oriver's License or Social Secudry x:
1gp1.n9 WNte—BuIIEi�q; Oreen—COEe Enlorcement; Canary—Applkent: Pink—Fevanue: GOltlanro0—Aveuor
CITY OF COSTA MESA — HUII�DING PERMIT PERM NO: E 046563
PERMIT NO: E 046563 PLAN CFiECK NO: N GO��T: N Si7PP: N
CONSTRiICTION TYPE: iFR SPRINK PERMIT 'fYPE: EL,E•: � PURPOSE: ALT
JOB D�5CRIPTION : COMMERCIAL T.I. (COMPUTER ROOM) SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: A-2 /
COMMENTS: REFER TO k46543 �
���+r*�r�e���e���*�*x��e*���e*�r�r�*x�r*�r*�*���c*��r*x*�*����**��e**�r**�r�r****�****�**��****
� ,' Z O N I N GS E�TEII(aAUCIKRSE M E N T S '
----------- MAIN AUILDING --------- --------- ACCESiORY BUILDING ---------'
FRNT: FT IN REAR: FT IN FRNT: ' FT IN REAR: PT IN
I.EFT: FT IN RGHT: FT IN' LEF'T: FT IN RGHT: � FT IN
FAI2KING REq: E'ROV: PARC£L: 41050104 7.NE: REF NO:
PLANNING NdTES>
— > - - -
at**�r�atat��*�*����**�e�**�*�****+r***�+t+�*�ititit�**�rit*at*��ft�r*���**�at��*�**�*�r*at�*�it***
, U E V E L O P M E N T S� R V I C E S R E Q U I R E M� N T S
ZONING�APPROVFD BY DATE: �
BUILDING APPROVED DY :_ _ �' DATE:
APPI�TCATION ISSUF.D BY: ' '� ���� �DATE:�j� `__���_
iFiEiFiE�ifififiPdFiEififiEiEifitiE*ikiEiE��iFi��I�i�iF����� ���F�iFiF�iFif�lEiFifitiEM�9EiEi4iF�E�3Fh iliPiE
1! iE iE if N iF iE 3E if 1E iE iE iE iF if k if iE iE it 1E iE 16 ih ik it 3k iE iE 1E IE 1E iE iE iEiE fE iE iF if iE ik jE �(� it �E il- IE k 1F If iF it Ik iE if iE iE iE it R� 1E it fF iE iF 3t 3h ik 1E 1E 1E it if ikik * af 9E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT �FLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING
PERMIT 72.80 �
� , SOi SMIP/NON—RES
PLAN
ISSUE FEE 15.00 �
BUILDING—DIV—> PERMI'T ISSUF. PLAN—CI3ECK TOTAL ' PI�ZI� DUrs
TOTALS-----> 72.80 15.00 0.00 8'7.80 � 87.80 .00
REVENUE DIVISIOAI TOTALS—=> COI,LECTfiD: 87.80, OVER/SIiORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIHE SMIP/TOT GRADIDIG FLAN—CiiECK
87.80
if �E iE i( iE it if N ib iE K k if iE 3f iF IF IR M ff IE N 3f iE M ik if fE If 1F iF 1f iE k iE iF if iE If iE It 1E iE iE iE jF 1E 1EiF if iE IE iE if # if iE # f(� IE iE iE iF iF iE �E �E iE jE if if it 3t �E j! M iE 3f i(�
I N U I C�.I D U A L F E E B A E A K D O W N
TY[�E
EI.E
ELE
ELG
Ei,E
ELE
EI�T'
LLG
QTY
1 �l
2�
9
2
1
L
L
D E S C R I P 1' I O rl
FIX.TURES, LIGH1'ING 1 ST 20 EA.
RECEPT/OU'fI,E1' 1 ST 20 EA.
RECEPI'/OUTLET ADDITIONAL EP..
RF.CEPT/SWITCH 1 ST 20 F.1,.
SUB—PA�]EL
t401'OF�/POWI2 APPP.RATUS 1.1 — 10.0 HP
MOTOR/POWi2 APPARATUS 10.1 — 50.0 IiP
sNn or• FEES
_
UPlIT CUST TOTAL C05T
.75 11.7_S
, .75 15.00
.45 ' 4.05
."15 1.50
11 . 00 11' . 00
7.50 7.5.00
�.5.�� �.5.��
O1 00056348-00�56348 TO T P7.80
DATE: 03/19/90 TIhE: 10:5b
I! _ /��
~ CONSTRUCTION AND PLANNING� � � '- POO� SPA .
"-APPROVALS Permit # - Date Inspector AppROVALS Permit # Date Inspector
L� 7e5nporary Electrical Service or Pole- j' 52. Pool & Equipment Location - ��
2.�Soil�Pipe-Undrgrnd:- , 53. Steel Reinforcement
-, 3r��Electrical Conduit Utility-Undrgmd. 54. Forms
4:eEiectriial Conduit�Undrgrnd. '" 55. Electrical Bonding
�. 5:�YSteel Reinforcement' ' - 56. iiough Plumbing & Pressure Test •
;'6., .Electrical UFER Gmd. � 57. APPROVAL TO COVER�GUNITE
��7-. Footings � � 'a' - � - ', 58. Electrical Conduit�Undrgmd.
�' 8�. Foundation� `° .� . 59. Gas Pipe, O Undrgmd., Test '
9. Water Pipe�Undrgrnd. ' 60. Backwash Lines, P�Trap, O Undrgmd. ''
10. Structural Floor System 61. P;PPROVAL TO DECK �
11. Properry Sewer Line.& House Connection ' - - 62. Backwash & Receptor�Final
12. Sewer Cap '. : •' ' 63. Heater & Verit-Final ��
� f
13. Roof Drains: _ _ � 64. Plumbing System - Final
' 14. Rough Plumbing , ` 65. Electrical-Final �
. 15. Rough Electrical�Conduit � ` , .' Solar SYstem-Final . . .
16. Rough Elearic�Wiring , .� Q� , Fencing & Access Approval . �
'17. Rough Wiring S)gn � . APPROVED FOR PLASTERING
, 18. Rough Electriwl-T Bar Ceiling . OOL/SPA SYSTEMS FINAL
19., Rough Heating &,Air Conditioning ,__ , s � .,FIRE DEPT. REQUIREMENT _ _ ,. _
20 =Rough Factor,y Fireplace - . _ _ - � APPROVALS.:�_Per`rriit # - - � - ,-
21:- DuCts, i rStructure ' - - '"'�"'
, _ . 70. Underground Hydro
22: Ducts, Ventilating � - � � _77, ProducbPiping O�Gas ❑Oil
23.�Gas Pipe_Rough & Test '�-= '- - � -72. Underground Flush
24�Roof Framing -. ��-; . '-•73{,Undergrnd.Storage-Tank OGas ❑Oil
25. Roof Sheathing '- - � ' •� 7q' Overhead Hydro _�
26.yf�Ba'r Ceiling (Stiuctural) & Mon`ocoat . ._ . 75.=Dry Chemical - � � � � -
27. -Frame and Flashing�� � � � ' ' 76. Dry Standpipe '' ' ' -
28. Lathin &Sidin =.•- " ' - -
9` 9�• Y� , . � � f 77.- FIXED S.Y.STEM�FINAL� .
29. Insulation ' _ �" � - 78FFIRE PREV. FINAL � � - - _
30. Drywall IVailing . _ � -i FIEALTH DEPT. REQUIREMENT
�' 31. Plaster Brown Coat ` "^ ' 79. FINAL INSPECTION �
,-132._Electrical, Power Me�terFinal .�� 0: FOOD CERTIFICATE ISSUED -
ti33.sFinal Electric � - Gy�/�B otes: �•�; -" ' �' _ '. _
;;;34`_Final Heating & Air�Conditioning� , y , - _._ ,-,
i :a �'-
35:-Final Gai Pipe-Test • - • � � ' ' : � ' -
" .�: �
: 36. Hood or,Canopy ^ ' - - - ; „ ' . -
�37.�JFinal Factory Fireplace' � - - � � -- �
i n
:38. Final Plumbing - _ � - A _ , '
39. Water Se vice�Final; � �� , - �� ' ' � . .- � �
`40. Gas Service-Final - � - ' ., - � r�� ��.'. ; ' " ' �
=41. Solar pomesticFinal :, - •- _ � • . '
42. Backflow PreventerF ' - - - `
�. . � - .1. � � �
43. Backflow Irrigatiorn� , '� � . � , t � � � -
��44._ Landscape Irrigation System `` J _ ' �, � � _ � ., `�•_� _ _. � �
. .n':` ' - , -
`45`Sound Attenuation • .. :. � - , � <; - - ,
46. Handicap Regulations '- • . � `^' - - � - - �
� ' ' � +;
,.47.'FINALSTRUCTURE&BUILDING _ . -• r
48: FINALPLANNING ' - '-, _ ; �
':'49. Electric Release to Edison . ' . - - _ -
_ �:
-50 =Gas_Release to Southern California Gas Co , ' '. ,,. . , .
'51. CER�TIFICATE OF OCCUPANCY � - ' � '
No. Date
� ADPlicant to fill in all spaees except those within heavy bo�tl�r
CITYOF.COSTAMESA COI�STRUCTIONPEFtMIT�
.aroject Address 5 SS �' /� {�o-N : ' �'— �%� �
Applicant's Mailing Address S �-
Owner's Nam �'- Phone
Address ���
Arch/Eng. License No.
Address
/
Contracror's Name NQ ^ C Phone 7��� 7�iG
Address (ma��"�ol �SDS�CeG �i� �]e u �- aw�"�`i
CiryLicenseNo. D�Sa/1�
IICENSED CONTRACTOR DECLARATION
I he�eby affirm that 1 am licensetl untler provi5ion5 oT Chdrte� 9(commencing
with section ]000) oT DiviSion 3 0( the Business antl Profe55ions Cotle, antl
my Jicense is in t I torce antl etiect.
� LicenseClass � icen 3G1�3e9
Dat 3�L���� Si9nature
� 'NORKERS'COMPENSATION DECLARATION
iereDy affirm that I have a certificate of consent to self-insure or a certiticate
( Workers' Compensation Insurance, or a certlfietl copy thereot (Section
3800, Lab._ CY�8D3 1�4/� � � •
' �licy No.�Jli Company
Certitietl copy is hereby turnishetl.
Certi—fief� cp py i5 tiletl with Ihe cit�py �inq i5i
DateZ Nr�'�� Applitanf/ - �{ —'---� Q�
EXEMPTION�FROM WORKEftS•.CO ENSATION DEGLARATION
(This section neetl not be completetl if the permit is for one huntlretl ($100) or "
less)
� I ce�tify that in the pe�fo�mance ot th¢ work tor whiCh this p¢rm�t is i55uetl, 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 makin9 this tleclaration, you shoultl become subject to the
Workers' Compensation provisions o( the Labor Cotle, you must forthwith
tomply with sucM1 pwvisions or thi5 pe�mit shall be tleemetl revok¢tl. �
CONSTRUCTION LENDING AGENCV�
1 hereby affirm that there is a construction lentling agency tor the pertormance
of the work for which this permit,is issuetl (Section 309] Civ, C.)
Lender's Name
Lender's Atltlre55
OWNER BUILDER DEGIARATION
I he�eby affi�m�lhat 1 am exempt from the Gont�acto�'S license Law fo� th¢
followinq reason (Section 7031.5 Business anG Professional Cotle: Any city or
munty wM1ich requires a pe�mit to construct, alter, improve, tlemolish or repai�
any sV ucture, prior to its is5uance, also �equire5 the ap0�icant tor such pe�mit
to tile a si9netl statement that he/she i5 licensetl pu�suant ta the provision5 of
'+e Contractor's License Law (Chapter 9(mmmencing with Section �000) of
vision 3 of the Busines5 antl Profe55ions Cotle) o� that he/she is ex¢mpt
rerefrom antl the basis for the allegetl exemption. Any violation ot Section
]031.5 by any applicant for a permit subjects the applicant to a civil
�enalty of not more tnan tive huntlretl tlollars ($500).
I, as owner of the property or my employees with wages as their sole
compensation, will tlo the work, antl the structure is not intentletl or�otferetl
� for sale (Section �046, Business antl Professional Cotle: The Conbactor'S
License Law tloes not apply to an owner of a property who builtls ov improves
the�eon, antl who tloes such work himself/berself or through M1is or her own
employee5, provitletl that Su[h imOrovements are not intentletl o� otteretl for
sale. If, however, the builtling or improvement is soltl within one year of com-
pletion, the bwner will have the burden o( proving he/she ditl not builtl or im-
prove for the purpose of sale). . �
❑ I, as.owner oi the property, am exclusivery contractin9 with licensetl con-
tractorsto constructthe project (Section 7044, Business antl Professions Cotle:
The Contractor's License Law tloes not apply to an owner of property who
builtls or improves thereon. antl who contracts for such oroiects with a�on-
tractor(s license pursuan[ [0 2ne ConVacror'S License Law). I am aware that
p�oof o their Worker'S Compensation insurance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. tor tFfis reason
Date O,wner �
I nereby 'certify that I have reatl tnis application antl state that tne above
information is correct. I agree to comply with all city antl county ortlinances
antl:state laws relating to builtling construction, antl,hereby authorize repre-
sentatives f this' city t ent r n the above-mentionetl property for
inspe<tion p �- � /�
Signature Date
Drivers' �License or SS �
antl sign all appropriate tleclara[ions.
�_ UNIT Nbnl
TYPE OF CONSTRUCTION LI NEW LJ AD� LJ ALTERATION CJ REPAIR
❑ CONVERSION`❑.OEMOLISH ❑ OTHER
DESCRIPTIONOFWORK/USEOFBLDG. � +
��
TYPE OF PERMIT .cR.aoING
❑ TENANT ❑.ELECTRICAL
❑ OTHER
PROJECT DESCRIPTION S..Q}. �FT�.�
CONSTRUCTION TVPEi�_L
ZONE GRP
Remarks:
Sink
Preventer
I rrigation
Dishvuasher
Drinking fo�
Floor Drains
Floor Sinks
Gas Service �
Interceptors
Kitchen Sink
Lavatories�
P-Trap
Roof Drains
Reinspection Fee
JFOUNDATION LJSTRUCTURAL
PLUMBING ❑ MECHANICAL
� d `� OCCUPA.�N'CY'1
]��. VALUATION $ � r �
CU.VDS. ACRES-
Showers
Service Sink
Sewer Cap �
Sewer Connection
Solar Collectors
SolarPiping =?
Solar Tank
Swimming Pool w/Spa
Urinal
Outlets Water Closet �
Water Heater
Water Service
Auto-Wash �
$15
Boiler
Duct - Under Ground
Duct - Structurel
Duct-Ventilating �
Exhaust System ❑ Multiple ❑
Firepl/Pact. Blt. �CBO �
Heating System & Ducting
❑U700,000 BTU 0700,000BTI
peinspection Fee I $75•
0865-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting; Goldenrotl - Assessor
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Issue Fee
A.P. # V .�
S Main Building:
E
T Front
A Rear
C Right
K ' . ,.
Ping. Ref. #
Pianning No'
FEES Automatic Washer
Construction Pole Sub.
Cooking�Unit
Dishwasher
� Dryers ❑Gas ❑Eleci
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
: Garbage Disposal
� Generator �0-5 KW C
� Reinspection Fee
$ 3 DEVELOPMENTSER
Zoning Approved By-
FEES ' Building Approved By
��� : APPliwtion Issued BY_
$ 3
`G�t-3
Zone
Accessory euilding: 1
O
N
1
N
G
R
Parking Req./Provided E
Q
M
� T
� S.
ELECTRICAL �
Transformer ❑ 15-50 KW
0 50+KW
Meter ❑up to 100 amps
Meter ❑over700amps
Sub Panel �
Momrs OO-7', HP � 1,'/: - 8
InaSolar �9-15 HP �1645+
Microwave "
Pole Light
Range �
Standing Sections
15 KW Tresh Compacmr
$15 luue Fee
FEES
$ 3
� SUMMAR OF FEES . y! �
BUILDING PERMIT $ lt2s��� SMIP $
PLAN CHECK $ PERMIT
� PLUMBING $ " �SSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
. ELECTRICAL $ GRADING $
' PLANCHECK 50% $ ' MICROFILM $
MECHANICAL $ TOTAL FEE $ ! z��
. PLAN CHECK 25% $
�i ��SG3Q5°�-�pG30`gF� 7".i�7� _?i�.�.?S
�pT£. �4l14/39 i'I"E: 11.Qa
. _.. .. . . ' Z.\�O�s `��eal'l� . .. ,_. .
3CONSTRUCTION AND PLANNING �
_ APPRbVALS Permit # � �
�-�1. Temporary Electric8l Service or Pole �
2. Soil�Pipe-Undrgrnd. � �
��
3:yElectr,ical Conduil Utility-UncJrgrhd
' � 7..Footinqs `� �
k' �
8. Foundation- ! n_i
� 9. Water�Pipe-Undrgrnd. �
--r
. 10. Stru�ctural Floor System Y
�i„� . 11 . Property Sewer_Liri� & House Copi
�:w � . . . .L . .
y' 12� Sewer CaP. _,.; ti+ -
I' , 13!Roof Drains I � �
i .. : (L-
1,4�Rough Plumbing�.
15. Rough Electrical-Conduit
I' �Y6� Rough Electric Wiring ,
a17? Rough Wiring Sign
��
�,�j$: Rough Electrical-T Bar Ceii�ng
�� �19` Rough Heating & Air Cond*Iioning
20. Rough Factory Fireplace ��
i
�21�. Duc,ts, in Structure � �'�"
- 22: Ducts, Ventilating � � �
?� 23: Gas Pipe-Rough & Test �v
, � -
� 24 Roof Framing �%� '`f
- < i .
25. Roof Sheathin9 ��.c ��-.
\
, 26. T-Bar Ceiling (Str�ctural) &,Mono�
, 27. Frame and Flashing ' � � �
�" 28. Lathingj& Siding � r,�j
29. Insulation "`./
. +
�- 30. Drywall Nailing 4 /�
31/. Plaster Brown Coat �� �
t: r n
vy�
-32. Electrical Power Meter-Fin�l(
33. Final Electric �� �O
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Tesi �
�36. Hood or Ca�opy { �
�37. Final Fac[ory Firepla e
i �
- �,38. Final Plumbing � �' �
'39. Water Service-Final �� -
. . _ �.' ' J . L
' $0. Gas`Service-Final � � �
� ,41•. Solar pomestic-Final' =.
]
42.jBackflowPreventer:'� �'
43� Backflow Irrigation � �
i ' --�
44. Landscape Ir.rigation'��Sy"stem
�
a
45. Sound Attenuation�
46. Handicap Regulations �
�� 47. FINALSTRUCTURE&BUILDING
i
. � 48. Special Requiremenfs Compl�ted
� 49. Electrie Release to•Edison
�50. Gas Release to Souihern California Gas
51. CERTlFICATE OF OCCUPANCY
Date
J
Date � Inspector
�}
CA
PG y SPA
' APPROVALS Permit # �
52. Pool & Equipment Location .
53. Steel Reinforcement �
54. Forms
55. Electrical Bonding
56: Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical�Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, 0 Undrgrnd.
61. APPROVALTODECK
.62. Backwash & �Receptor-Final r .
63. Heater & Vent-Final �
64. Plumbing System - Final
65. Electrical-Final
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIREDEPT.REQUIREMENT
APPROVALS Permit#
70. Underground Hydro. .
71. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil .
74. Overhead Hydro
75. Dry Chemicalt 1 � ' � ' �
76. Dry Standpipe '� -
77. FIXED SYSTEM FINAL �
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION �
80. FOOD CERTIFICATE ISSUED
Notes:
Date � Inspector �
n t-m - .
'`_"I
_ 1
� ' c �,.
'����I.Y�. '' .
4�('� V�
:(�1 nl
�_ . �.�
�r
�� . 1� i �
- vi
y,
F�'
:
�
�
:'
a
3
ADD�icant to fill in all ipaces except those withln heavy EOrGe� Iines antl sign ali appropriala Eaclarations.
Ci7Y oF COS7a MESA CONr�(` T�RUCTION PERMIT
ProjER`Address 655 q.11fM/ #" 7� _
'�Ap�icant's f�Wiling Address
Owner's Name �� Phone
Address
Arch/Eng. License Na.
Address
Contractor's Nam ��-�� ���-. �o Phone ��
Addresslmailingl �55f� �,v��TS p��00..�1
Ciry License No. �%� � � �
LICENSED CONTRACTOR DECLARATION
1 hereby affi�m that 1 am licensetl untle� O�ovisions ot CbartO/ 9(commencing
with secllon 7000) of Dlvision 3 of tne Business antl Prote551ons Cotle, antl
my license is in t I i rce antl eHect. q �
Licensa CI 55 ���- Icensa No2/�E'
- ^ �ate � Si9nature
�� 1RK RS' COMPENSATION DECLARATION
� .ereby aifirm thal I have a certificate of consent to self-insure or a certlficate
� of Worker5' Compe/ns�ation Insurance, or a certl'/fietl /c'opy tnoreof (Section
3800. Lab.�•�IL 1sO��I� //�(�y�
1 PoliGy NO. , Company
ny�{ y,,�-rtilietl <opy iz hereby fumisnetl.
LK Cert' i tl s filetl with Ihe Uty Buil ' g m' . -
Date � � Applicant
EXEM TION-�iiKERS'COMPENSATION DECLARATION �
(This section neetl not b¢ <Ompl¢t¢tl if the permit is tOr OnG hundretl (S300j O�
less)
I certify Ihat In the perfo�mant<of th¢ work (or whi<h this p¢rT�t it ISSu¢tl� I
shall not employ dny p¢rsOn In any Tdnn¢r 50 az t0 become subjett to t�e
Workers' Compensation Laws of Califomia.
Date Si9nature -�
NOTICE: It, atter making this tleclaration, you shoultl become 5uE7ect to the
Workers' Compensa[ion provislons of the Labor CoCe, you must forlhwith
complY `�'��h such provisions or lhis permit shall be tleematl rBVOk¢tl.
CONSTRUCTION LENDING AGENCV
I nereby aitirm that there Is a constructlon lentling agency for the parformance
of lhe work tOr which t�15 Oermit is issuetl (SeGtlOn 3097 Civ. CJ
LPntler's Name
Lentler's Atltlress
OWNER BUILDER �ECLARATION
I hereby atfirm Inat I am exampt from the Gontractor's License Law for tlte
following reason (Section 7031�.5 BuSiness antl Pro(essional Code: Any city or
county which requires a permil [o construct, alter, improve, tlemolisn or repair
aay 5truciu�e, pri0/ to it5 i55udnce, also �equir¢5 the aOP���ant fOr such parTit
/ile a signatl s[atem¢nt -[hat he/she is licensetl pu�suant [o tne provl5lo05 of
Contractor's License Law (Chap[er 9(commencing witn Sectlon 7000) ot
dsion 3 Of the Bu5ine55 antl Protessions Cotle) or that he/she IS Bx<Tpt
tneretrom antl the basis for the alle9etl ezemption. Any violatlon of Sectlon
7031.5 by any applicanl for a permit subjects the appllcant to a clvil
�enalty ot not more than tive huntlretl tlollars (5500).
I, as owner of tne prope�tY or my employees with wa9es as their sole
comp¢nsation, will Ao IhG wotk, antl the st�uctu�e is not intentletl or Offe�etl
tor sdle (SeGtiOn 7046, Busin¢55 antl P�ote55ional Cotle: The Cont�acto�'S
LicenSe Law tloes not aoP�Y �o an owner of a prooerty who bulitls or improves
th¢reOn, antl who tloe5 Suth wo�k him5elf/herself or Ihrough h15 Or h¢� own
¢mployees, provitletl that such improvements are not intentletl or oHeretl for
sale. If, how¢vet, th¢ DUI1tlIng Or imp�oveTent is soltl within One year Of COm-
plltlon, tM1e Owner will �ave [ha burtlen of proving he/she tlIG not builG or im-
�rove torthe Ourpose of sale).
I, as own¢r ot the property, am exclusively contractlng with IiGensetl <on-
tractorsto construct tne project (Section 7044, Business antl Professions Cotle:
The Contrattor's License Law dOes not dPP1Y to an own¢r of Oroperty who
builtls or Imoroves thereon. antl who coniracts tor such orolects with a r.on-
tractor(s1 liwnse pursuant m me Contractor•s License Law). I am aware thac
oroof of their Worker's Compensation insu�ance Shoultl ba provitletl [o me.
❑ 1 am ezempt untler Section B. & P. C. for this reason
Date Owner
I �ereby certlty that I have reatl tnis appliwtion antl state that tne above
Information is mrrect. I agree to comply with all city antl county ortlinances
antl state laws reld[ing to builtling Construction, antl hereby aplhoriza r¢p/e-
sentatives of this� ty�► nter upon the above-mentione0 proper y for
inspection purpe �es.� � �
Signature / � �-CL � Dal
Orivars' LI -�'
,"..�' ��/86 � ....�...�. � --� --� I V'�as
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOlISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT GRADING�q� FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL L11 PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5ci. FT. oCCVPANCv
CONSTRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES
Remarks: %.� i';Q/S}
Bar Sink
Beckflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories
�-Tre{i
Roof Dreins
Reinspection Fee $15
Boiler
Duct - Under Ground
Dutt - Structural
Ouct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iCBO �
Heating System & Ducting
❑ ai oo,000 sru O i oo,000
Reinspection Fee � $15
0865-46, rev. 5/88 . White - Builtling; Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor
PLUMBING
Shower5
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
laue Fee
Hood or Typel ❑
Canapy Type I I ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteretion
Fire Dempers
Registers
Issue Fee
A.P. qW
S Main Building:
E
T Frant
B Rear
A
C Right
5 Left
Ping. Ref. #
Planning Notes:
Accessory Building:
Parking Req./Provided
2one
ELECTRICAL
FEES <lutomatic Washer Transtormer ❑ 15�50 KW
ConstructionPoleSub. � 50+KW
Cooking Unit Meter ❑up ro 100 amps
Dishwasher ���. Meter ❑over100amps
Dryers �Gas ��Electric Sub Panel
Fan Motars �0.1 HP � 1:4 - 8
F.A.U. Inc.Solar �9�15 HP �i6-15+
Fixtures - Microwave
Device Boxes 4' Pole Light
Outlets Range
Swi[ches Sign
� Garbage Dispoul Standing Sections
' n Generator 065 KW �5-15 KW Trash Compacror
$ 3
$ 3
flainspection Fee �$15 � � luue Fea
DEVELOPMENT SERVICES REQUIREMENTS:
Zoninq AOProved By
Building ApProved By
CY��.9
$ 3
SUMMARY OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ ��7� PERMIT �
PLUMBING $ ____/_y��!_ ISSUANCE $
PLAN CHECK , 25% $ ENEFGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $ � 7�
MECHANICAL $ TOTALFEE $ %_P%V
PLAN CHECK 25% $
N
I
N
G
R
E
Q
M
T
S.
oz onoaosaz-000aosa2 roT ?,�p
6AT�: t�4/18/P9 TItlE: 15:43
, . . �t �?- �.^' . ... . . a ,. . . . . . , . .
� F & SPA
. CONSTRUCTION AND PLANNING %
�' Date Inspector � Date lospector
'PPr'tOVALS Permit # y APPROVALS Permit #
'i .
; 1. Temporary Electrical Service or PoINe � �� 52. Pool & Equipment Location
2. Soil�Pipe-Undrgmd. / �� . ^ �' 53. Steel Reinforcement �il ,
3)� Electiical Conduit Utility-Undrg�nd � 54. Forms ��
41' ElecVical Condu 1-Und�grnd. " �L 55. Electrical Bonding I�{
�� i;
5�SteeF_Reinforcertjent � V � 56. Rough Plumbing & Pressure Test �
6� Eleutrical UFER`Gmd�� 57. APPROVAL TO COVER-GUNITE %il
�
7.' Fooiings �- .� � �� 58. Electrical Cortdu'ri-Undrgrnd. ��
8. Fou1dation �L� +� r 59. Gas Pipe, � Undrgrnd., Test f�
9� Water Pipe-Undigrnd. �� �1� 60. Backwash Lines, P-Trap, O Undrgrnd. �'`
lO�Structural Floor System � 61. APPROVAL TO DECK
11. Property Sewer Lini & House Co�nection �' 62f Backwash & Receptor-Final �,�
12. Sewer Cap /; � '^ 63. Heater & Vent-Final �/
il'� ^ in .�:
13. Roof Drains h � 64. Plumbing System - Final ��
i
14. Rough Plumbin� y�q q (��Q 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
�iB Rou h Electrical-T Bar Ceilin
r,,; 9 9 69. POOL/SPASYSTEMSFINAL
��9. 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 � Gas ❑ Oil
23. Gas Pipe-RoXgh & Test 72. l.jnderground Flush
24. RoofFraming 73. Undergrnd.StorageTankOGas OOiI
25. Roof Sheaihing �,, __ 74. Overhead Hydro .. � . ..
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical
27. F?ame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation Oj 78. FIRE PREV. FINAL
30. Drywall Nailing I HEALTH DEPT. REQUIREMENT
3L: Plaster Brown Coat (`� � 79. FINAL INSPECTION
32! Electrical Power Meter-Final� 80. �F,�OOD CERTIFICATE ISSUED
33. Final Electric � . Notes': Ci
� ,.-,
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 pomestic-Final �
42. Backflow Preventer ' �
43. Backflow Irrigation ��' ' )
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �'� .
•'�
51. CERTIFICATEOF OCCUPANCY � -�, � '
, No. Date .-
Aoolieant to fill in all svaces�exeeo1 tnose wlthin �eavy Doraer Iines ana sign all approvriate aeclarations.
CiiY OF COS7A MESA CONSTRUCTION PERMIT PER I N3ga �, TRACT NO. LOT NO. UNITDNQO A P�y
Project Address SS-� ANpO� �vQ . S Main Building:
Ap�iCapt'S �i in A dr��� - ��ysp�Q�y TVPE OF CONSTRUCTION NEW ADD ALTEI7ATION REPAIR E
l Gv� .yry �j 'f�r¢ Z�� ❑ CONVERSION ❑ DEMOLISH ❑ OT R T Ffont
Owner's Name .1.� ��� P1Sone � DESC$IPTIO�,FJdQR11 /USE OF BLDG���/��� B Rear
Address CS� /¢�✓�.�� ��LL//� �lJST f�C�CH
Arch/Eng. LicenSeNo. TVPEOFPERMIT LJGRADING LIFOVNDATION LJSTRUCTURAL
Addr ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING �MECHANICAL
- /�l(L O.UO/ l/«" . I.UG 2 � ❑ �OTHER
Cont �a tor �s �a-ma one f'YT% f7
AddiCs51rii3'illfig�����/�QL�.�.��'-� -L� �rL%J/.I�+� PROJECT DESCRIPTION Sq. FT. oCCUPANCV_
City License No. ��T-r�-� s%�Z4� CONSTRUCTION TYPE VAI.UATION $
ZONE GRHDING CU. VDS. ACRES_
I �ICENSEO CONTRACTOR OECLARATION
� 1 hereby aHirm [�a[ I am li<ensetl untler provislons o/ Charter 9(commencing
� wit� section 7000) of Oivislon 3 of t�e Business antl Professions Cotle, antl
I my Iicense is in full torce antl effect.
�N I.icense Class C 20 License No���
wl ^ate� ���� Signat e
� IRKERS'COMPENSATION CLARATION
\ .ereby a/firm that I have a certiticatn of consent to self-insure or a certlficate
� of Workers' Compensation InSurant0, Or d Certlfi¢tl cOpy�ther¢Ot (SeCtiOn
3800, Lae. C.) � l
PoliCy No»/pv�r_,. �o�r? Company �/4�A-�/
Certifiatl copy is hereby turnishea.
Certi ietl copy is tiletl with the " y B Itling dision.
Odte�_ Appl' nt
EXEMPTION FROM WORK 5' C PENSATIO DECLAR I
(This sectlon neetl not be wm letatl If the p¢rTlt is fOr One hun re $300) or
less)
I certify that in the perto�mance ot the wo�k fOr which this perm�t i5 i55uetl I
Shall no[ employ any pei5on in any mannGr To as l0 b¢come suEject to t�e
WO/ke�s' Comp¢n5ation� LawS o( CalifOmia. .
Date Si9nature
NOTICE: 1f, after making this tle<Iaration, you zhoWA become subjecl to the
Workers' Compenwtion provisiont of Ihe labor Cotle, you must forthwith
complY �+��h Such provi5iOn5 Or tnis petmlt ihall be tleem¢tl revOke�.
CONSTRUCTION IENDING AGENCV
I be�eby aifirm lhat there is a const�uctlon Ientling agenty tor the perfOrmance
of the work tor whicn tnis permit is isiuetl (Section 3097 Civ. C.)
Lentl¢r'S Name
Lentler's Atltlress
OWNER BUILDER DECLARATION
I hereby affirm lhat I am exempt from the Contractor's License Law for the
following reason (Section �031.5 Business antl Professional Cotle: Any city or
county whiCh require5 a pe�mit to con5truct, alter, imp�ove, tlemoli5h o� �epdir
�ny slructWe, prlor to its issuan<e, also reqWres Ne aoP�icant for such permit
�ile a signetl Stdt¢ment that he/Sbe Is IlCensetl pursudM to Ihe O�oviSions of
Contractor's Llcense Law (Chapter 9(commencing with Section 7000) ot
iision 3 of the Busines5 antl Protessions Cotle) or [hat he/she is exempt
ther¢f�om antl th¢ ba5i5 tor the all¢gGtl exemptiOn. Any violation ot $ectlon
]031.5 by any applicant for a permit subjects [he applicanl to a clvil
�enalty of not more than tive huntlretl tlollars (E500).
I, as Owner of the property or my employees with wa9¢z as thelr SOIe
compensalion, will tl0 tne wo�k, antl thG s[�ucture i5 n0[ intenGeC or otferetl
for sale (Section 7044, Business antl Professional Cotle: The Contractor'S
License Law tloGs not apply [o an owne� oi d ptOperty who builtls or improves
the�eon, antl who CoeS such work hlmSeH/herself or through his o� h¢r Own
emDloyecs, providetl that such improveman[s are no[ Intentlea or offereA for
sale. If, however, the builtling or imorovement is soltl wlthin one year ot com-
v�etion, tne owner will have the burtlen of proving he/she tlitl not builtl or Im-
provefor the purpose of sale).
❑ I, as owner of the property, am excluslvely contractinq with Iicensetl con-
tractors lo <onstruct tbe project (Sec[lon 7044, Buslness antl Protessions Cotle:
The Contractor4 License taw does mt appry to an owner of Property who
builtls or improves thereon. antl who COntract5 fOr such oroiecl5 wl[h a r.on-
tractor(sl licanse pursuan[ m�ne Conttactor'S Liconse L.aw). I am aware tnat
proof oi [hel� Wo�ker'S Compensatlon in5urance shoultl be prOvitletl to me.
❑ I am exempt unCer 5ection B. 6 P. C. for this reason
Date Owner
certify that I have reatl thls application antl state that tne above
m Is correcL I agree to compty with all Uty and county ortlinances
la la[ing to builtling construction, anU hereby authorize repre-
I 5 city t0 ente p0� Ihe above-mentionGd proplrty for
purp ses. �/ ��v
Date 'Y'��G �/
pemarks:
Bar Sink
Backflow Pre
Backflow Irr
Bathtubs
Clarifiers
Dish�vasher
Drinking Foi
Floor Drains
Floor Sinks
Gas Serviee
Outlets
Kitchen Sink
Lavatories,
7-Trap
Roof Drains
Reinspection� Fee S15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. iC80 �k
Heating System & Ducting
❑ ai oo,000 eTu o� oo,000 sT
Reinspaction Fee
� � I I
rev. 5/88 White � Builtlin9: Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor
sis
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wesh
Laundry Tra'ys
Isue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑o=ioo,00asTu ❑ioo,000
System Repair/Alteration
FireDamperSA�� f�
6�
Registers
laue Fee
A
C Right
g . Left
Ping. Ref. #
Planning Notes:
FEES Automatic Washer
Construction Pole Sub.
Cooking Unit
. • Dishwasher .
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
$WItCh25
Garbage Disposal
Generetor �65 KW
Reinspection Fee
��s�/!
Zo�a
Actessory Building:
Z
O
N
1
N
G
R
Perking Req./Provided E
�
M
T
S.
ELECTRICAL ��
Transformer ❑ 15-50 KW
❑ 50+KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel
Motors � 0.7 HP � 1 Y. - 8
Inc.Solar �9-15 HP �16-15+
Microwave �
Pole Light
Range
Standing Sections
5 KW Tresh Compactor
$15 laue Fee
$� DEVELOPMENTSERVICESREUUIREMENTS:
Zoning AOProvad By
FEES Buildinp Approved By --,G
APPlitetiOn ISSUBd BV �
FEES
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELEC7RICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ 2�—? -{O TOTAL FEE $ 2G3 SO
PIAN CHECK 25% $
�1 �G031360-00031380 7'�oT 263.�Q
DATE: 04/25/39 TIrE: 14:43
�
. ; ., . .
�;�\��..�
, CONSTRUCTION AND PLANNING � F .& SPA
APRiiOVALS /Permit # � Date. Inspector AppROVALS Permit # Date Inspector
, 1. Temporary Electrical Service or Pole ,� ' 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.� � 53. Steel Reinforcement ���
3.1 Electrical Conduit�'U�til�ty-Undrgrnd. .. ! 54. Forms .' �'
4VElectricalConduit-Undryrnd. '�� �" 55. ElectriralBonding �
i i� � �!
5��Steel Reinforcement, �• ,. . � ' 56. Rough Plumbing & Pressure Test
6! Electrical UFER Grnd�� • 57. APPROVAL TO COVER-GUNITE ''�
i �. . � �
7? Foot'ings ��( W � 58. Electrical Conduit-Undrgmd. 5
i
8.'Founilation ;! �n 59. Gas Pipe, O Undrgrnd., Test � /
r_
9.� Wate� Pipe-Undrgrnd. '�' � 60. Backwash Lines, P-Trap, O Undrgrnd. i
i
10�StructuralFloo�lSystem � 61. APPROVALTODECK
11. Property�Sewer'Line & House Co�nection 62. Backwash & Receptor-Final
12. Sewer Cap �� �` , ' ' -� '� 63. Heater & Vent-Final '�
13. Roof�D�ains '• ji �' /, � 64. Plumbing System - Final '
14. Rough Plumbingi � 65. Electrica6Final ��
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring � v 67. Fencing & Access Approval
•�.1.7., Rough Wiring Sign �, 68. APPROVED FOR PLASTERING
(1�8. Rough Electrical-T Bar Ceiling�� � 69. POOL/SPA SYSTEMS FINAL
;19. Rough�Heating & Air Conditionfng S dY L� FIRE DEPT. REQUIREMENT �
�
20. Rough Factory Fireplace �' APPROVALS Permit #
.,21. Ducts, ��Structure � 70. Underground Hydro
22. Ducts, Ventilating �. 71. Product Piping �Gas ❑Oil
23. Gas Pipe Rough & Test � 72. Underground Flush �/'� �, j 1
24. Roof Framing , r� 73. Undergrnd. Storage Tank' � Gas ❑ Oil � �
25. Roof,Sheathing- , ' .74. Overhead Hydro '�
• 26. T-Ba'r,Ceiling (Structurall & Monocoat 75. Dry Chemical � '�
27. •F�ame and Flashing '� 76. Dry Standpipe ,,' .�
28. Lathing & Siding �a �� 77. FIXED SYSTEM FINAL � '�
v.: .
29. Insulation Q% �� 78. FIRE PREV. FINAL ,, �'�
30. Drywall Nailing n! �� HEALTH DEPT. REQUIREMENT ` ��' ,�
31,� Plaster Brown Coat �'' 79. FINAL INSPECTION �
32�. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � �,�� �
i" ,� ! r• �I
� ;'
33. Final Electric Notes: I`t � . ,
34. Final Heating & Air Conditioning /� �Y (�(�
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Fac[ory Fireplace
38. Final Plumbing
39. Water Service-Flnal �
40. Gas Service-Final � '
41. Solar pomestio-Final ; � Li
42. Backflow Preventer � �^�
43. Backflow irrigation � � '
� .
44. Landscape Irrigation System '.-��
45. Sound Attenuation ��:
46. Handicap Regulations =-.
47. FINALSTRUCTURE�$e'BUILDING
48. Special Requirements Completed
49. Electric Release to Edison `
4.. � 1
50. Gas Release to Southern California Gas Co �v� r'
57. CERTIFICATE OF OCCUPANCY ,
. i •.
No. Date ;y ,
Applicant to fill in all spaces except those within heavv eortler Hnas antl siqn all aonropriata aeelarotions.
PER IT NO. TRACT NO. LOT NO. UNIT NO.
Ci7Y OF COSTA MESA CONSTRUCTION PERMIT A.P. qN zaoa
�" 38 /68 1Th 1 .
Project Address S-r7� Arccnn �T}1 '��Mf' . S Main Building: Accessory Building:
App�icant'S Nlailing Address f Q TVPE OF CONSTRUCTION EW ADD ALTERATION REPAIR
Ownef'sNamC (�r�� �T.�.—]�.i��Phone � �ONVERSION ❑ DEMOLISH ❑ OTHER 8 Front N
DESCRIPTION OF WORK/USE OF BLDG. A Rear �
Address
Arch/Eng. -H�K Licenu No. TVPE OF PERM17 . GRnOiNG FOUNOATioN STRUGTURAL I K Right G
Address ❑ TENANT yf,ELECTRICAL ❑ PLVMBING ❑ MECHANICAL g� Left R
❑ �OTHER Pln Ref. #` Parkin Re
Contractor's Nam Phone�Q1.13 9• 9 q./Provided E
Address Imailing) ��� R�Cj,'l�l � I *�' \�% �'f'LSTPI (Y�P.Fl PROJECT DESCRIPTION Sq. F7. oCCUPANCY Planning Notes: M
���qR� CONSTRUCTION TVPE VALUATION $ T
City License No. ZONE GRAOING CU. VDS. ACRES $.
LICENSED CONTRACTOfi DECLARATION
I hereby aftirm tha[ I am licensetl untler orovislons of Cnarter 9(commencing Remarks: T
with section ]000) of Division 3 ot the Business antl Protessions Cotle, antl
my license is in (ull torce antl effect. 1 ' ELECTRICAL FEES
�icense Ciass C- �� License No.5�! a�� PLUMBING Automatic Washer Transformer ❑ 15-50 KW
'iate 4/1'1 � A9 Signature Kp � o,r, Co-vil�� � ' FEES
Q �RKERS'COMPENSATIONDECLARATION Bar$ink ShOw2r5 ConStrUC[iOnPoleSUb. ❑50+KW
.ereby altirm that I nave a certificate of cons¢nt to seH-Insut¢ or a C¢rNfitate
of Workers' Compensation Insurance, or a certifietl copv thereot (Section gackflow Preventer . ServiceSink Cooking Unit Meter ❑up to 100amps
3800, Lab. C.) c -
aoiicy No. �1�pa��il�ivi�9 Companyf, PJ'^�'+�T T�eMf1\�/ Backflow I�rigation Sewer Cap Dishwasher Meter ❑over 100 amps
8 Certitietl wpy iz nereby fumisnea. �. � Dryers ❑Gas ❑Electric Sub Panel � 0
Certitie�j cooY is tile0 with tne city Bulltljqg Division C��, � � Bathtubs Sewer Connection
�a[e 4(1'�l__ a�_Q APPlicant Y\rtnn.-n -�-' Pan Motors�0.1HP�1'h-8
EXEMPTION FROM WORKERS' COMPENSATION DECIARATION Cld�i(iE�S' $018! COIIECIO�S
(Tbis section neetl not be completetl if the Oermit is for one huntlretl ($100) or - F.A.U. Ina Solar 09-15 HP 076�15+
less). Dishwasher Solar Piping
1 t¢rtity that in Ihe pe�lo�mance of the wo�k fo� which this pe�m�t is ISsuetl, I - ixtU�CS
shall mt employ any person in any manner so as to become subject to the �rinking Foun[ains Solar Tank i MicroWdve Z ^�
WO/ke�s' Compensalion LawS of Califo�nia. '
Date Signature ,' Floor Dreins Swimming Pool w/Spa � Device Boxes Pole Light
NOiICE: If, atter making lhis tleclaration, you shoultl become subje<t to the ' Outlets Ran e S
Workers' Compensation provisions ot Ihe Labor Cotle, you must forthwith Floor Sinks Urinal - � 3 9
comply with such proviSiOns O� ttli5 petTit shall D¢ tl<emetl levoketl. SWItCh25
CONSTRUCTION LENDING AGENCV GaiSerVice Outlet5 We[efCloSet � Sign '� 6
1 hereby aitlrm tnat there ii a constructiOn lentling agency tor thB performance Gdrbd e Di Osal
of tne work for which this permit is issuetl (Section 3097 Clv. C.) Inte�ceptors WatEr H23ter 9 � Standing $ections
Lentler's Name
�entlers Aatlress Kitchen Sink Water Service Generemr �0.5 KW �5-15 KW Trash Compacror
OWNER BUILDER DECLARATION
1 hereby attirm Ihat I am exempt irom the Contractor's License Law for tne Lavatories Auto-Wesh
following reason (Section �031.5 Business antl Protessional Cotle: Any city or
munty which requires a permit to construct, alter, imorove, tlemolisn or repair P—Trap Leundry Trays '
any structure, prior to its iszuance, also requires the appliwnt tor such permit
'ile a signetl sta(ement that he/zhe is licenzetl pursuant to tne provisions of ROOf DrainS ' � B
Contractor's License Law (Chapter 9(commencing witb Section 7000) of
.ision 3 ot the Business antl Protessions Cotle) or tnat ne/she is exempt Reinspection Fae $15 luue Fee $�
tnerefrom antl the Dasis tor the allegeE exemption. Any violation of Section
7031.5 by any applicant for a permit 5ubjeCts the aooncant to a civll
enaity of,not more than (ive nuntlretl tloiiars (ESoo). $ 3 DEVELOPMENT SERVICES REQUIREMENTS:
� 1, as owner o/ the prope�ty or my em0loyees with wa9es as their sOle Reinspection FBB $15 ISSUe FBB
comoensation, will tlo the work, anC the structure is not intentled or.offeretl Za�i�9 APp�oved By Date
for sale (Section 704a, eusiness antl Protessional Cotle: The Conlrattor's MECHANICAL FEES Building Approved By Dete
' License Law tlo¢5 not apply ro an Owner ot a properry wno builtl5 or improves T�
thereon, antl wM10 tloe5 Sucn work hiTself/herself o� th�ough hi5 or he� own BOiI¢� HOOd O� T 21 ❑ APP���t�on lauetl By pat
employees, provitletl tM1at such Improvement5 a�¢ not Intentletl o� Otferetl fo� �P �
sa1e. If, however, the builtling or improvement Is soltl within one year of com- Canopy Type II ❑ SUMMARV OF FEES
plGtion, the owner will hav¢ the bu�tlen Of Provin9 h¢/She aid not builtl o� fm- DuCt - UOd¢� G�OUnd .
�iove tor the purpose ot saie). _ BUILDING PERMIT $ SMIP $
LJ 1, as owner ot me property, am exclusively contracting with licensetl con- Duct -S[ruMural Refrigeration System P�qN CHECK $ PERMIT
tractors ro construct the project ISettion 7044, Business and PrOfessioni CotlO:
The Contractor's License Law does not apply to an owner of pmperty wno Duct � Ventila[ing �a100,000 BTU ❑100,000 BTU PLUMBING $ �SSUANCE $
� builtls o� improves thereon. antl who cont�act5 �or such o�oiect5 with a mn-
tractorg Imense pursuanc �o me Comractors License Law). I am aware thaa Ezhaust SyStem ❑ MWtiple ❑ System Repair/Altera[ion P�N CHECK 25% $ ENERGV P.C. $
proof o� their Worker's Compensation inmrance shoWtl be provitletl to me. ELECTRICAL § ��.7� GRADING $
❑ I am exempt untler Section B. & P. C. for this reason Firepl/Fact. Blt. ICBO # Fire Dampers MICROFI LM $
PLAN CHECK 50% $ r7
Date Owner Heating Sys[em & Ducting Re9isterz MECHANICAL S TOTAL FEE $ <3y.7.�
I �!r¢by tertity Inat I hav¢ reatl tnis applicdtiOn antl state that th¢ dbove ❑O1�,D� BTU �i0�,D008T
intormation is rorrect. I agree to comply with au city antl county ortllnances PLAN CHECK 25% $
antl'state laws relating to builtling consVuctlon, antl hereCy authorize repre-
untatives of thi5 city to ent¢r upon the above-m¢ntionetl property tor
i�zaectio� o�.aose:. Ol Oa030698-O�D30698 TOIf ?39.75
Slgnature oate 4/�� �$9._ qeinspection Fee $15 laue Fee $ 3 �FlT�� �4/1%/89 TIP�EC i3�Sb
Drivers' License or 55 �
0865-46, rev. 5/BB White � Builtling; Canary - Applicant; Plnk - Accountin9; Goleenrotl - ASsessor
, ,
. CONSTRUCTION AND PLANNING f '. & SPA
• APFtiiOVALS Permit# Date Inspector p�ppROVqLS Permit# Date � Inspector
4 !.
'� 1. Temporary Electrical Service or Pole S_ 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - � - 53. Steel Reinforcement
'
3.�Electrical Conduit Utility-Undrgrnd. �� � 54. Forms
�
4. �Electrical Condui[-Undrgrnd. �,� 55. Electrical Bonding �.
5=Steel Reinforcement 56. Rough Plumbing & Pressure Test
6?ElectricalUFER'Grnd.` 57. APPROVALTOCOVER-GUNITE .
7. Footings ',, 58. Electrical Conduit-Undrgmd. '
(r i
8. Foundation : ^ � _ ; 59. Gas Pipe, O Undrgrnd., Test =�
�i
9: Water Pipe-Undrgrnd. ' - � 60. Backwash Lines, P-Trap, O Undrgrnd. �� �
10..Structural Floor System � - 61. APPROVAL TO DECK '
11 rProperty Sewer LinQ & House Connection 62. 8ackwash & Receptor-Final
�
12:-Sewer Cap ,� ' � � � 63. Heater & Vent-Final '
13. Roof Dreins 'l � ' ' �
64. Plumbing System - Final
14. Rough Plumbing ;� . 65. Electrical-Final �
15. Rough Electrical-Cohduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
�, ,
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Elecirical-T Bar Ceiling ��_ ,�p g. POOL/SPA SYSTEMS FINAL
19. Rough Heating,& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' APPROVALS Permit # .
_ ,r
21. DuCts, in Structure • � 70. Underground Hydro
22. Ducts, Ventilating •� 71. Product Piping OGas ❑Oil
�
23. Gas Pipe-Rough & Test ' 72. Underground Flush
24. Roof Framing - 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & 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 . FOOD CERTIFICATE ISSUED
33. Final Electric � otes:
34. Final Heating & Air Conditioning ��ti � Y�'
✓'
35. Final Gas Pipe-Test � 1
36. Hood or Canopy ' .
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Final
42. Backflow Preventer - �
43. Backflow Irrigation �.
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requiremen[s Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY � ' � ;
� No � Date � ' ' • • '
�� 1 I 6a9 AOV�kant ta /ill in all spaces except those within neavy Gortler linas ana si9n all aooroDriate aeclantlons.
CITV OF COSTA MESA CONSTRUCTION PERMIT P �T NO�O�O TRACT NO. LOT NO. UNI_T nIp A P�y 2one
/ia
Project nddress — 555 ANTON 7TH FLOOR _ � S Main Building: Accessory Building:
Applicant'sMailingAddress _�540 SUZI LANE. WESTMINSTER TYPEOFCONSTRUCTION NEWm� DD ALTERATION REPAIR
SECURITY PACIFIC BANK � CONVERSION ❑ DEMOLISH LSOTHER T Front p
Owner's Name Phone DESC PTION WORK/U5E OF BLDG. Clr`� Pn` M. 'e-� B Rear N
Address 600 WILSHIRE 11500� L.A. 90017 ��5�"�'�- � �— A I
Arch/Eng. License No. TVPE OF PE IT GIJ RADING FOUNDATION STRUC7V RnL I K Right G
Addre55 ❑�� NANT ❑ ELECjjLIGAI ❑ PLUMBING ❑ MECHANICAL �$' �eft R
KIMBLE & COMPANY 895- I I 56 �WaTHER }�1 r't S a.a /1��!'o s�� � N Ping. Ref. # Parking Req./Provided E
Contrector's Nam Phone �
7540 SUZI LANE. YIESTMINSTER, 92683 PROJECT DESCRIPTION 5�. FT. OCCVPANCV� planning Notes:
Addffi5�mailing) 038503 CONSTRUCTIONTVPE VALUATION$ �3.���.0� M
City LiCense No. ZONE GRA�S. ACREi
LICENSED CONTRACTOR OECLARATION S�
1 hereby aftirm that 1 am Iicensetl untl¢r proN5ion5 ot Chartar 9(commencing Remarks: �' ,Lp � i
with section 7000) of Oivision 3 of the BuSiness antl Professions Cotle, antl �
my license is in 1WI f rc ntl effect. , ELECTRICAL FEES
Licens^� ��as �—f� nservo. 460923, �
Date ".L Sig t � PLUMBING FEES P.utomatic Washer Transformer ❑ 15-50 KW
�RKERS' COMVENSATION DECLARATION Construction PoleSub. � 50+KW
:reby atiirm that I have a cerlitiwte of consent to self-insure or a certifitate Bar Sink Showers
r Workers' Gompensation Inzurance, or a certifietl _copy thereo( (Sectlon Backflow Preventer Servite Sink � Cooking Unit Meter Qup to 100 amps
3800, Lab. C.
h Policy No. �$$470897-01 company FREMONT IND. Backflowlrrigation SewerCap Dishwasher Meter �over100amps
��ertifietl copy is heteby tumished. �"�'� Dry¢r5 �GdS ❑EI¢ctric Sub Pdn¢I
Cer ¢tl oyy is�y�y with fhe City qy�+my.yNv i Bdthtllb5 Sewer Connection
�Date �'��T'�6 7 Appiicant?>>uA ���d� Fan Motors �0.1 HP 01'6 - 8
EXEMGTION FROM WORKERS' GOMVENSATION DECLARATION Cld�ifi¢�5 S012f C0112Ct0�5
iessissection neetl not be completetl if the permit is tor one huntlretl (5300) or Dishwasher Solar Piping F�A�U� Inc. Solar �9-15 HP 016-75+
).
1 certiry that in the performance of Ihe work (or which this perm�t is issuetl I
snall not employ any person in any manner so as to become subiect to tRe Drinking Fountains Solar Tank Fixtures ,,.�a�e
Workers' Compensation Laws of Calitornia. Device Boxes Pole Li
oate Siqnature Floor Orains Swimming Pool w/Spa ght
NOTICE: Ii, aiter making this tleclaration, you shoul0 beGome subject to the Outlets
Work¢rs' Comp¢nsatlon provi5ion5 of the labor Cotle, y0u must for[hwitn FIOOr SinkS ' ' el Rdng¢
comply with suc� provisions or tnis permit s�all be tleemetl revoketl. Switch25
CONSTRUCTION LENDING AGENCV GaSService Outlets WetefClout Sign
I hereby a�tirm that Iher¢ Vs a const�uctlon Ientling agency (o� tha pe�fo�mance � Gefbe E Di5 0581 SLe�di�
of tho work for wnicn this permit is issuetl ($eclion 309] Civ. C.) InterCeptOrs Watef Heatef 9 P g SeCtionS
l.entler's Name
Lender�s nadress � Kitchen Sink . Water Service Generator DO-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
1 hereby aftirm Ihat I am ezempt from the Contractor's License Law for the Lavatories Auto-Wash
following reazon (Section 7031.5 Business antl Pro(e55lonal Cotle: Any dty or .
county which require5 a permit to construct, aller, imDrove, Gemolish or repalr p—Trap Laundry T�ayi
any slrucWre, priDr tOJls I55uant¢, also reqWreS tbe applicant for Suth permlt
��.,tile a signetl statement that he/she Is Iicensetl pursuant to Ihe provisions ot Roof Dreins
.'+x��`'.:Contractor'S License Law (Cnapter 9(commencing with Sectlon 7000) of
�?��,��ision 3 ot the Business antl Professions Cotlo) or thal he/she Is azemOt , _ Rainspectian Fee $15 luue Fee $ 3
°�a`Yewfrom antl the basl5 for the allegetl ¢x¢mplion. Any viOldtlOn of 5ettlOn . �
7031.5 by any applicant for a p¢rmii sub�ects thB applicant l0 d Clvil
enalty ot not more than tive huntlrea aollars (5500�. DEVELOPMENT SERVICES flEQUIREMENTS:
�� I, dz owne� ot [he propertyo� my employ¢¢5 with wage5 ds [hei� sole RBinSpBCtiOn PBe '$1$ ISSUB Fee � 3
compensation, will tlo tne work, antl the structure Is not InlentleC or otferetl Zoning Approved By �ate
for sale (Section 7044, Business .antl Professional Cotle: The Contractor's �� MECHANI L FEES Building Approvad By Uat�
License Law tloes not apply to an owner of a property who builtlz or improves
thereon, and who tloes such wOtk �ImSel�/�e�self or throuqh hls or ha. own gpiler � od o� T e I ❑ �1PP���tion Issued By Dat������
empioyaes, provitle� [nat sucb Improvemenis are not intentletl or offeretl tor VP
sale. Ii, nowever, the builtlln9 0� improvement is sola within one year ot com- � Canopy Type II ❑ SU ARY OF FEES
Oletion, the owner will have the burtlen ot proving he/she tlitl not builtl or im- Dutt � Under Ground �
prove for the purpose of sale). , BUILDING PERMIT $ •�� SMIP $ �' �
❑ I, as owner of the Oroperry, am exclusivery contracting with licenzetl con- Duct -Structurel Refrigeratfon System P�AN CHECK $ PERMIT
tractors to construct the project (Section ]034, Business an0 Professions Cotle:
The Contractor•s �icense Law does not apply to an owner of properly who Duct- Ventila[ing ' DO-100,OOOBTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builtls or improves tltereon, antl who coM�acts for Sutb oroiects with a con- �
tractor(s I�cense pursuane to me Convactors License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repalr/Alteration� PLAN CHECK 25°h $ ENERGV P.C. $
prool o� tneir Worker's Compensatlon insurance shoultl be provltletl to me. ELECTRICAL $ GRADING $
❑'I am exempt unaer Section B. & P. C. for thls reason Firepl/Fact. BIt. �CBO � Fire Dampers �l �
" . PLANCHECK 50°� $ MiCfiOFILM $
Date owner Heating System & Ducting Registers � "_ MECHANICAL $ /i�S9
I hareby certity Ihat I have reaE this application antl state that Ihe above � ❑4100,OOOBTU �100,OOOBT .-. TOTAL FEE $
iniormation is correct. I a9ree lo comply with all tity antl county ortlinances " � PLAN CHECK 25% $
antl state laws relating to builCin9 construction, antl hereby authorize repre- • .�
Sentatives of thi City ro enter upon the abOve-mentiOn¢tl property tor '
ISignatme Pur e5. oat��[ " 01'OQO?S66<-OOL'24665 l'4T 14],95
Rainspection Fee $15 laue Fea $ 3 OaTE: 03/31/89 TIfiF: 1�:5Q
Drivars' �Lic nze or SS �_ - � .
0865-46, rev. 5/88 White - 8uiltling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Hssezsor
i
@M�F�`. �.�.. .. _..
CONSTR{1CTION AND PLANNING - � P� & SPA
; APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
•t� :il
� 1. Temporary Electrical Service or Pole '� 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � �� 53. Steel Reinforcement �
3. ,Electrical Conduit Utility-Undrgmdr �> � 54. Forms �.'.
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •
•� _
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � ;';
6. Electrical UFER Gmd. '�� 57. APPROVAL TO COVER-GUNITE i' ��
, , i�
7. Footings j �'�1 58. ElectricalConduit-Undrgmd. �:�
8. Foundation • � 59. Gas Pipe, O Undrgrnd., Test �
. ;
9. Waier Pipe-Undrgrnd. �;� _; 60. 8ackwash 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 '
,t
13. Roof Drains 64. Plumbing System - Final ;�•
14. Rough Plumbing 65. Electrical-Final
75. Rough�Electrical-Conduit 66. Solar System-Final '
�1'G � Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring S'ign 68. APPROVED FOR PLASTERING
.
� 8: Rough�Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19� Rough Weating & Air Condi�oning FIRE DEPT. REQUIREMENT
20. Rough~F,actory Fireplace `�, APPROVALS Permit #
21. DuCts, in Structqre Fy i 70. Underground Hydro
22 Ductsx•Ventilating =- .,"��}� 71, ProductPipingOGas ❑Oil
�.
23. Gas Pipe-Rough;& Test � 72."�Underground Flush �'
n .�•'
24. Roof Framing �'-- ����� i73. Undergrnd. Storage Tank O Gas O Oil
25. Roof Sheathing I • /) � , �� 74. Overhead, Hydro � �
26. T-Ba�Ceiling (Srcuctuial) &'Monocoat . 75. Dry Chemical -
27. Framrand Flash�ng ,r 76. Dry Standpipe
28. Lathing & Siding -;� 77. FIXED SYSTEM FINAL �
, /,
29. Ins�a[ion ,,� ') 78. FIRE PREV. FINA� y'2b a E�� ,i
30. Drywall Nailing�'' /,,% HEALTH DEPT. REQUIREMENT
3�1�. Plaste�;Brown Coat �� 79. FINAL INSPECTION
132�_Elect`r.ical Powei M ter-Finalr 80. FOOD CERTIFICATE ISSUED
33`�'Final�Electric V; Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-7est
36. Hood or Canopy
37. Final FactorY Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
/
42. Backflow Preventer ` 'y
. , i-
43. Backflow Irrigation � �
44. �Landscape Irrigation System
.:
45. Sound Attenu8tion :�
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 /,� , ,%
t•
Np. Date ' f �
�oowessoremidnc: SSS ANTON BL
owr'exsxweiFro�ovm: gAKIOKA FARMS
A°o^�u: PO BOX 2097
TERMINAL ANNEX
AVPL.YNIPlC AWRE55:
UNT:
7TH CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: B 075023 PLAN CHECK NO: 04503-95 A
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR
u�cxnecron�N�n: INTERIOR ARCH 2136232164 ��� 9378
urcx.onexc�s�noa�ss: 550 S HOPE �r+* 1100
c�m.cTarsw� CAL PAC CA 900310)645-3500
CQAFRCTORSYYIklG 6076 BRISTOL PKWY
aooness: CULVER CITY CA uc.xo: 392102
90230 ��r:
IICEN5E0 CONTpRCTOFS OECL�HATION: I heraby eHvm under peneYy d pa�ury Uat 1 em Icenaetl uMar povisons of Chepter 9
(mmmemrip xi�h Seciiw� )OOU) d Oireion 3 d Ure Bueimv vd Pmlmaions Coda. yd mY licenae ia in (ull Iace antl elled.
cmuc.No.:065829 uc.cuss: B � 10 P• 0/96
o�a: //- 3-95� ��T� ��
OWNEN BUILDEP DECIAHRTION: I Mreby elfirm unEer panelly d pe� rjury �hm I em exemq /rom ihe ConVedore Licenee Lew la ihe
'uw'uq ree (Sapion ]031.5 Buairosn erd Roleasime Code: Any c1y a oounty xfiid� reyuirea e permn io mmWcl, eller, improva,
nd'ah, a repei eiry svucture. q'v m ns 6eueMa, abo �eyuiros iM epplicent fw euch permil to Rb e ag�wd eutemeni Met M a eM
icenseE W��� �o tM proviaiona W Ne Con�ranoro License lew �Cheplm B(oommendrp wilh Seaon )000) d Div'sion � ol ihe
tlusimsa eM Prolessons Code) or Ihel M or ahe ia ezamq �hereirom arM Ihe beeie iw the elleped exempion. Any vblelun d Sepion
)0]t.5 by enY eVWiuni for e permn eubpav iM epplicem ta e avtl parely d iwl mae then iMe huMred ddlvs �S;qpll.
❑ �,eso.mera�heaownv«mv«�vWee.wanweee�esm.:.dammroosation..;naom.wax..�d�,eaie�runbnaimeneee
a oMeretl br aele ($eclbn ]Oad, Buvreac end Pmiaseiann Gode: The Contrenois Limnae Lewdoes ral epplyto en owner ol prapeny
wM buiEs or inprovee �Mreon. arM who Eoes autli work NmseM or Mrsatl w ihraph he or her own empbysea, pim�ided ihel euc�
imqovemmu ere nol imanEeE a dleieAta sab. M. however. the buiMiip w inpovemenl e aoN wnhin areY� d oomplation. Ne
owner-buiMer will heva �he buNen N provi�q M or eha did nN builC w im0�+�a tha WR^sa W aele).
❑ �. m owiwr d ihe wovsM. am mausbeN emveu4ro wfln �ironsae eonv.eion ro caneo-ua me o� (seuia, �ou. aisle�s. erd
Proleviom Code: The CaNratlon L'eenee law tloea ml MW b en owmr d Mw�Y wtw Wiks a'unDp'�m tM�aon erd Mw
mnvecm lor wch Drol�a wnh a omtreaor(s) Iceneed Punuent ta tM Conlreaors Licenea lew).
❑ 1 em examq uMar Sectpn: B. 6 P.C., M Nb meaon:
oma: ow�«:
I do heraby canity tlw I em exrere M erd urdenteM tM requiremarua d Cel/omie Hmnh enE Setery Cade Seqiom 25505, 2553�, uM
2553a, eM IMt I a enY Mure buiMmp om�pani xill / wil ew� (oreb aw) nseA �o eanpy wih eaid ewa eodm eM iM rtquiremama br
epertniltwoonstrunimmmodifice�ionhan�IwAi u3ali��enepement0idna.PeaiEeMielwnqrudoneppFfatbmeranaamp�fromthero
provisione.
De�e: Appliunl:
WOPKEP'S CONGENSATION DECLARATION: I Mroby elfiim urder penelty d parjury ma d tln lolbxifp Cetleretione:
❑ I heve eM W meinlen e cenifcale d mnmm to eattJruun M xorken' cwnqnaybn. m pwidaE /a by Saabn �)00 d tM lebor
Cade, lor iM pa�foimv�ce al tM xoA lar whic� thie paimn ie iasuetl.
fl �newenewi�meimanworke�.�como��,��wmMe.avrwwneMseennalaoau,eLeb«cme.rorinev�m.�wa�n.
7C wak Ia xfiid� Ihis Germil o ieeueE. MY warYers com0�smian imurence ranbr ard VdkY mimMr ere:
, c�e,: FIREMANS FUN� EXPIRES
PdiyNumber: KWPAnSQFiA� 02/01/96
(mis san�, �a.d �w ee comdaree � ma w�x r: n. �e nu�e�ee dd�.�a f%iool a ias,.)
❑ I eaMRy ihet in IM peetormenee W�ha wak for whkh thie peimn ie iewad. I WII iwl empby anY Pa�n in eiry mennx eo m to
becortre wbjea m �M wka�s' cwnpnwian 4wa d Celilomie. eiM eprae ihet il 1 houk bswne abjee �o woNsn'
o�e / gw3 �m s<a:� a�w a me �, c«�.. i ` er�;y�o..���.
�`� � aW�� /�j�J/
!
Wemlrrp: Fallun b�ec�n woilrsr�'rompxuetlan cmxap� l� u lawNl, enJ �H/I iub/�ef en errpi/oyer ro cNMnel psneltlu eiW
errp
c/H/ nro. �p ro om nunerW eMUHrM ao/Mr.lstao,auVA m M1/tron ro th• eo,t o/ romp�rwr/on, enmep� a. arowCeJ ror /n
3wHon 9�06 0l tln Lebm Cotlr, Inhnsq and afbrnq's Ir�.
CONSTRUCTION LENDINO pGENCY: I hereby �im �ndm penelry d per'ryry ihel lheie u e mmlr�tlion kidiip epeMy br �M
periormance W tha work lor which tho peimd ie oeued (SeGon �OB), Civ. C�.
LENDEP'S NMIE:
LENUEH'3 �ODAE54:
I ceniy Ihm 1 heve reed Nis epplicelian eM ama Ihet �he ebove inlormetion ie wrted. I epme lo camply with dl ey eM couMy wdineMea
eM siete lews IeIvn0lo Wikrp wnatrutlbn and Aersby euUwr¢s reprevenletivee d thia my io emer upan IM ehow.men�br�eE O�PaM
forinapetlion Wrpoees.
DAVID DE SISTO
� e
. �_ o,�e: //-3-�i'f
Sgnn�ure d Omwt/ApenUApplfanUCon eqa
� (5151de.WP) Whno-Buildiq85alatY:Greer�-FIe:Canary-Applcenl:Pink-Aevenue:Gddenrod-Avaeamr
PERM NO: B 075023
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : ALTERATION TO ELECT/CABLE/COMM ROOM SQ FT: 10,000
CLAIM VALUE: 10,000.00 CALC—VALUE: 10,450.00 GROUP OCC: B-2 /
COMMENTS: 76 UNIONPRODUCTS ELECT ROOM TI
��******�*�x��*x****��************+t*x+a***�************�*�t*�+��x�****�*�+c**���****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: TC REF NO:
PLANNING NOTES> INTERIOR ALTERATIONS TO EX ELECTRICAL ROOM ON 7TH FLOOR OF
> THE UNOCAL BUILDING.
**�*****�**�r*****.�***�**��*�********�**�*�*+�*****x�x�*************x�**�*�***�*��**
D E V E L�O'P M E N.T S E R V I C E S R E Q U I R E M E N,T_ S
/. �
ZONING APPROVED BY :�,� DATE: "(( 3-9s
BUILDING APPROVEDiBY; : f /i� DATE: �I`3—�
lf�r ;G
APPLZCATION ISSUED/BY: -1 DATE: II`_���
*************i�*x�*i['*****TF3F e e e �TFTF�FiFTF7F7'FTFTFTFTf �* F7F�F�**x�*�*****T�iF�* t�*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTR'PC MECHANIC FIRE SMIP/RES GRADING
PERMIT 126.00 —
.� SMIP/NON—RES
PLAN 20.48 r� - 2.19
ISSUE FEE �',�,
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 128.19 0.00 20.48 148.67 148,67 .00
REVENUE DIVISION TOTALS--> COLLECT.ED? 148,67 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
126,00 ' ' 2.19 20.48
3E 1E iElE if 1k iE 1E 1E 1E fE iE 1E iE iE 3E 9f !F 1E * 1E af fE 1f jf 1E iE 1E iE iE 1E iE ik 1E iE jE iE iE 3E IE 1E fE ik iE iE IE �ElE 1E fE IE 1E iE 1E �1E 1E iE 1F �E 1E 1E 1E iE �E 1E'lFlE 1E if iElE 1E iE iE 1f iE iE 1k ih
I N D I V I D U A L %�F E E H R E A K D O W N
7
TYPE QTY D E S C R I P T I O N' 1 UNIT COST TOTAL COST
/ / .
SFC 10000 T.I. OFFICE �BY�VALUE/$1 1.00 10,000.00
END OF�, FEES
: ')
/ � ` �"�
_._�. , � /
" � � 1 �� �
G. .
� G �� .
'� " !'; Q�l��i'�7G:. ��J1S�i��' �".LS� . �3�_'
ya � G':'4t :L �!. i t 'iijc :i' ..
I.
�
CONSTRUCTION AND PLANNING . POOt & SPA
APPROVALS Permit# Date Inspector AppqOVALS Permit# Date Inspector
1. Temporary ElecVical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steol Reinforcement �
3. Electrical-Conduit•Uulity�Undrgrnd. � 54. Forms
� 4. Electrica�'Condu[t_U�}drgrnd. 55. Electricai Bonding
.�5.-Steei Relnforcement 56. Rough Plumbing & Pressure Test
-�T6. Electriwl U�ER G�rid. 57. APPROVAL TO COVER-GUNITE �
- �.
• 7. Footings �� - � 58. Elearical Conduit-Undrgrnd.
' 8. Foundation - . 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe Undrgrpd.'"� �, 60. Backwash �ines�.Q-Trap, � U�drgrnd.
10. Structural Floor System � � 67. APPROVAL TO DECK r
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap. � 63. Heater & Vent-Final '
��
13. Roof Drains �: � 64. Plumbing System - Final �
�
74. Rough Plumbing- �-, � ' 65. Electrical-Final
15. Rough Elettricat-Conduit " , 66. Solar System-Final
76. Rouqh EleCcric Wiring . 67. Fencing & AcceSs ApProyal I �
- 77. Fough Wiring Sign 68. APPftOVED FOR�P�ASTERING
78. Rou9h EleCtrical-T Bar Ceiling 69. POOUSPA SYSTEA9S FINAL
19. Rough Heating & Air Conditioning ,� _ � FIRE DEPT. REQUIREMENT
20. �Rough Factory Ficepiace " . �J � ��'APPfiOVy�LS � � Permit #
21. Outts, in Structure �� - � • � , ' 70. ;�)nderg'tountl Hydro
22. Dutts, Ventilatin - ` "
9- . r•, 71. ProduCt.Piping OGas 130i1
23. Gas Pipe•Rough & Test � ' � t�_ � 7z. Underground Flush
24. Roof Framing" r '' ��- �. ' 73�; Undergrnd. Sto�a�� ianlc..O Gas ❑ Oil
25. Roof•Sheashing = } ' _ . • 74: �verhead Hydrp�_ '
26. T-Bar. Ceiling (Structurell & Manocoat 75. Dry Chemicaf �
. . , '. �� �. _
27. frame and� Flashing �- _. : j/� � 76. Dry StanBpipe _' �
- 28. LathTng ep Siding ` �� �, �� � Q- ��� ��, 77: FIXED SYSTENI��FINAL '
29. Insulation � � ' %* �� � � - ' 78, fIRE PREV. fINAL , �'
30. DrywallNa��it�g ,�; ���f'��j �` -' �kEALTHDEPT.REDUIREMENT
�
31. Plaster Brown�Cozt �� --' - �" 79. FINAL INSPECTION
,_ . .
32. Electrical-Power Nleter�Final � - ' ' I� �' 80'.; FOOD CERTIFICATE ISSUED
33. �inal Electric - • - � Notes: �
34. Final Heating & Air CQnditioriing • ' '� �
I_� 2c� i o�� r. �o ��-
35. Final Gas Pipe-Test. � . - -. _ � . , ��
� •,. u(�,�q� � �i..,�e(.�_.
" 36. Hood,or Eanopy . • : , - ��. �� � _
•37. F.inal.Facto�v Fireplace :. -� � �� � ,� " •
38. Final Pivaip�ng _� � - � ' � r _"
39. Water Service�Final . _ � . ;1 : � - -
�40. GasService-Final ! P' t � � � � ' ^ '
t •
,
41. Solar pomesticFinat ` .. �� - � ' �i R _ • -
42. Backflow Preventer ' � ' ' "� � "
, Y. �..
43. Backflow Irrigation � , � � .� LL .
44. Landscape Irrigation Syscem-_ �- ' "'' - -` -
� .. �
45. Sound Attenuation � � .� - . . ���. � - , . ,. -
46. Handicap Regulations _ � ' ' - ,.
47. FINAL STRUCTURE & BUILDING ,_/��j,j f,6 `
`
48. fINAI PLANNING' � ' � .. ' " ' ,^ -r . '
49. Electric Release to E'dison � , ' ' '•} ' , .,, . �
50. Gat Retease to Southern California�Gas Co � � ' � ' '
�
51. CEFTIFICATE OF OCCUPANCY
No Date
•_
i w
CITY OF COSTA MESA �
BIIILDING DIVISION
;:. :
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER BC08-00137
PERMIT TYPE: B COMBO
Sub Type: COM_ALT
STATUS: ISSUED
DATE ISSUED: 04/28/2008
- ISSUED BY: YH
i ..:, . � °
Joe aooRess: 555 800 ANTON BL-CM `: .' Suite%Unit:�, 800
APN: 41050104 ;y',��.`-- '� � � Zoning: , �, - . "-
Vicinity: . -: ' � � �`� . . . -, Pnmary Occ �B��`,�_.:
Const Type: I-A i, ;' SQ[FT . � 0 , Valu.
/it;� 1 . � ;!,r.�%"'',�* ' -
SCOPE OF WORK: COMPLETE INTERIORTI FOR "BLUE SHIELD" - NEW PARTITIONS; CEILI
267 OUTLETS, 45 SWITCHES,2'MOTORS�TO 1 HP, 1 MOTOR TO 10 HP, 85 COMM DROP,S, 1
TRANSFORMERS UP TO ,1,KVA, 2LOW VOLTAGE E�UIP, 1 LOW VOLT WIRING,.1.MISG COI
BTU, 2 ,.'� � � � ��
i.:; ,
VAV BOX, 1 BACKFLOWFREVENTER; 1.DISHWASHER;:I-P-TRAP, 1 SEWER CAP,�1 SEN%ER
WASTE AND VENT 1 VJATER HEATER' 1 WATER PIPE .x `
$815,100.00
�OORS, 210 LIGHT FIXTS,
�EL EQUIP, 2
,��1'REFRIG SYST < 100 K
JECT, 1 KITCHE SINK, 1
r��� �'r�.J r�, � - ' �� 4 . , r' - ,'�:�'.
OWNER: PWREF/MCGSOUTH COAST, LCC, , •� Address: 535 ANTON BL ` . :`;�� Unit: COSTA MESA,
CA j,; ,. ' . .. � .
�Phone: �iu` .�.'� . � .. .City/St2l'e/Zip:.'SUITE�750 � .� �
..; "��� , '� ' . .-
j
APPLICANT: BANKSTON; CHERITA � � � Atld(ess t , . � � = Unit: '
Phone: 310-763-2112 � P."i �.. . '�-� Qity/State/zZip .... - '.- � ."' .
CON7RAC70R: INNER;SPACE CONSTRUCTORS "� License No. 366309 ��_,, �� '�
Phone: 310-763-2112�f-� � �" Address: 2250S�CENTRALAVUnit: -; � �
Cell: ,, �^ City/State: RANCHO DOMIGUEZ, CA ' , `� �ZipCode 90220
ARCHITECT: , ; � , License No. ' � . • ' � : . _ PHONE:
ENGWEER: � � LicenseNo. - � - PHONE:
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check: - -��� ' '. - $769,40
Building Fees: - $4,73475
Electrical Fees: -$625.31
Mechanical Fees: $59.60_
Plumbing Fees: $126.55
SMIP Residential: $0.00
SMIP Commercial: $171.17
TOTAL FEES: $6,486.78
"Refer to fee receipts for all fees paitl for project
_ i:,.
; f,:
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulatlons. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAVS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work auihorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspeclions and final approval must be obtained. Failure to obtain inspections and final approval wili result in the expiration of this permit.
COpEf. INSPEC710NTYPE �TF, IN7fM y00E7 I NTYPE OR ���IlIl�14�
1816 Fixed System Final Fire Prevention 208 �al Mechanical P/p.. -� i�
1288 Pool Spa Final . 208 inal Plumbing P/Q, �r
200 Final Re-Roof 210 Final Electncal �
207 Final8lxk/ReUining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
25o Final euildinryOccupancy p�µ
• ,�/♦ II/' iI I
� �
WORKERS' COMPENSATION DECLARA710N:�
I hereby aKrtn under penalty of Derjury one of the (ollowing declarations:
❑ I have and will maintain a certifcate of consent to self•Insure for workers'
compensation, as provitletl for by seclion 3700 of the Labor Cotle, for the
peAormance of Ihe vrork (or which lhis permit is issued. .
❑ I have and will maintain workers' compensation insurance, as required by
sectbn 3700 0( Iha Labor Code, for the peAormance of the work tor which this
permit is issuetl. My vrorkers' compensation Insurance cartier and policy
number are:
"Carcier: �7T�-Tt �(l/U D
(This sedon nea0 irol 0e cnmpkteA Alhe permrt is value0 at one huMretl Edlars (5/00) oi lessJ
�FolicyNumber: n0`d5�"-��'I—���
❑ I certify that In lhe pertormance of the work for which Ihis permi[ is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensalion laws of Califomia, antl agree thal if I should
become subject lo the workers' compensation provisions of Section J700 01
t �sbor6a e, I shall foAhwith comply wilh these provisi� ns. G
O �
`A IiWnl'SS�greWre Dale
WARNIN ' ILURE TO SECURE WORKERS' COMPENSATION COVERAGE
WFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN� DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensetl untler provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Professions Code, and
my license is in full force and eflect. �L �1
L' � � � - Class # ' "l L � D
_ � � b Fs
, nVanor'SSigriaWre '�_. Dat
CTION LENDING AGENCY:
❑ I hereby affvm lhat there is a cons[ruction lentling agency for lhe
peAortnance of tha work for which this pertnil is issued. (Sec. 3097, Gvil Code).
LenCer's Name:
Lender's Atldress:
Signalure
OWNER-BUILDER DECLARATIONS:
I hereby aKrm lhat un0er penalty of perjury Ihat I am E%EMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit to
construct, alter, improve, demolish, or repair any swcture, prior lo its
issuance, also requires the applicaN for such permit to file a signed s�atement
Ihat he or she is licensed pursuanl lo lhe provi5i0n5 of the ContraG[Ors
License Law (Chap[er 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or Ihat he or she is exempt Iherefrom and
the basis for t�e allegetl exemplion. Any violation of Section 7031.5 by any
applicant for a pertnit subjects the applicant to a civil penalty of not more than
five hundred tlollars ($500).):
❑ I, as ovmer of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offeretl for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law dces not apply to an ovmer of properry who builds or improves
lhereon, and who dces such work himself or herself or through his or her own
employees, provitled tFiat such improvements are nol intendetl or offered for
sale. If, however, ihe building or improvement is sold within one year of
completion, the owner-builder vrill have lhe 6urden of proving that he or she
did not build or improve for purpose of sale.). �
❑.I, as ovmer of the property, am E7(CLUSIVELY CONTRAC7ING WITH
LICENSED CONTRACTORS [o cons[ruc[ Ihe project (Sec. 7044, Business and
Professions Code: The contractas License Law dces not apply to an owner of
pmperry who builds or improves thereon, and who contracls tor such prqect vrith
a contracta(s) license pursuant to the Contractas License Lavs.).
❑ I am exempt untler sec.
Business and Professions Cotle for lhis reason:
Signaiore , �aie
JOS]�46(3/0])
� ,
c
Owner ID verifed by driv �ca ❑ Ves ❑ No
Driver's License No. Expires:
Verification o( Ownership by (type ot document, i.e. - propeRy tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certdy that no excavation frve (5) or more feet in tlepih into w4ic� a
person is required to descend, will be made in connection with work aulhonzetl
by this permit, and ihat no building structure, scaffdding, falsework, or demoli[ion
or tlismantling Ihereol, will be more than Ihirty-soc (36) (eet high. (Chap. 32, Grp
2. M 2, Sec. 341, Ttle 8, Cali(omia Adminisl2tive Code).
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit from the Division of Industrial Satety, as noted above, unless
such person has a permit to do such work from the division.
Applicam's SignaWre
Division of Industrial Safely Pertnil Numher: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
i. Will the applicant or present or tuture building occupant need to file anE
cerlify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Heallh and Sa(ely Code requires, vnth some
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantiry of hazartlous materials equal to or greater than a weight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at slandard temperature antl pressure). �
2 Does or vnll the applicant or preseN or fWure building occupant need to fle
a regislralion form for acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and SaFety Cotle, with some
exceptions. requires regisiralion with the Costa Mesa Fire Deparlment by
each business which at any one time has on hand a quantity of awtely
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 ihe applicaN or present or future building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazartlous materials)? ❑ Yes ❑ No
(Seclion 25534 of Ihe Califomia Health antl Safery Code pmvides that Ihe
Costa Mesa Fire� Departmenl may require the preparation, certificalion and
fling with the Fire Department of an RMPP by businesses which ara requiretl
to register acutety hazartlous materials vnth the Fire Department.
4. If an RMPP is presently required, has Section 25534 of Ihe Califomia
Heal[h and Safety Code been fully complied with? ❑ Yes ❑ No
5. Ooes or vnll the applicant or present or fuNre building occupant require tor
the vrork v+�ich is the subject of this application a Dermit (or such cons[mction
or modi(calion from the South Coast Air Quality Management Distdct or from
any other air polWtion control disMct or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires Ihat Ihe requested
intortnation be fumished on applications tor ran-residential building pertnits).
6. Will any part ot the taciliry to be constructed under this permit be within
1000 (ee[ from Ihe outer boundanes o( a school? ❑ Ves ❑ No
pf yes", [he faciliry must meet the requiremen[ of Sections 25534 and 42303
of the Cali(omia Heallh antl Sa(ety Cotle).
7. If a permit from the South Coast Air Quality Management Distnct or other
air pollution control district or agency is required for the work which is the
subject otthis application, have all ofthe disclosures prescnbed by California
Health and Safery Code Section 42303 been madel ❑ Yes ❑ No
8. Qf'j�es", a[tach certifica[e of compliance from the appropriate air pollution
control offcer�. ' . .
CERTIFICATE OF COMPLIANCE: I certify lhat under penalty of perjury the
information given above is' correct. �I agree�to bomply vritti all state laws and
city ordinances regarding Hazardous Materials and Emissions. �. ,
Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION.OF ENTRV: I
certify under penalty of peryury that I have read this applicalion and sUte that
the inlormation given is conecl I agree to comply with all sfate laws and ciry
ordinances relating to builtling construction, antl aWhorize 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 ot any builtling
authonzetl by lhis pertnit until final inspection.
�—S ature0lLegalOvmer(s) Dale
r � ..p�
Gt3
� MCI Aulhonze0 ApO����� � Date
CITY OF COSTA MESA
R���euu� e�v�s�e�u
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER BC08-00150
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 04110/2008
- " ISSUED BY: BJK
.los ADDREss: 555 800 ANTON BL;CM '� " ' ' � � Suite/Unit: ;._800
APN: 41050104 - ; . . Zoning:., ,' -� � �
Vicinity: SUITE 800 BLUE SHIECD OF CA'� � `� " � - ' ��Primary' Occ � �B,,: ` �.; �•
Const Type: I-A !�"�l� SQ'.FT "�� ' 15584 - �, Valuatio'n: $26,125.00
j.."�,_ � - - .
SCOPE OF WORK: INTERIOR�OFFICE�DEMOLITION OF NONBEARING PARTITION WALLS,-TILE,�CARPETING, FIXTURES IN
CONJUNCTION WITH THEiCOMPLETE INTERIOR OFFICE TI FOR "BLUE SHIELD" - NEWiPARTITIONS, CEILINGS, DOORS. REF:
BCOB-00137 � . ;�.' . - � ','.
OWNER:
CA
Phone:
APPLICANT:
Phone:
, . � , ,: ';. ' - -
�,`. ;
PWREF/MCGSOUTH COAST; LLC �' Address: •� 535 ANTON BL. � � � , UniL COSTA MESA,
i : >>`� �. ..; ;• '�. _
` �r i ;�` City/State/Zip: SUITE 150 . - � . . � ��t,.
'" 'y 'v :' ' , . . . .
BANKSTON,CNERITA�'����� � , Address: . . . � � '�"l ,- . t+i� Unit: :
310-763-2112? � ' . CitylState/zZip; . . . ' ' . .
CONrrtnCTOR: INNER SPACE CONSTRUCTORS License No.
Phone: 310-763-2112 u" � . --Address �'2250 S�CENTRAL AVUnit:
Cell: � � .' Ciry/State: RANCHO DOMIGUEZ, CA
ARCHITECT: INTERIOR� SPACE INTERNATIONAL--FRANK LIMAHELU
PHONE:310-473-5358 � _ , „ � � .
ENGINEER: � � . � License No. ,
366309 •
� ZipCode 90220
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check: � - $267.77 - ..
Building Fees: � .� $411.95 _ - �
Electrical Fees: . $0.00
Mechanical Fees: - $0.00
Plumbing Fees: = $0.00 ' � -
SMIP Residential: $0.00
SMIP Commercial: $5.49 � - --- � � - �
TOTAL FEES: $685.21
"Reter to tee receipts for aU faes palC tor proJect
� . � �
. License No.C14425
PHONE:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenLs under Califomia statutes and related
regulatlons. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such vrork 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 ezpiration of this permit.
cooe�, ixsrEcnoxttre
1816 Fizetl System Final Fire Prevention
1268 Pool Spa Final .
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
ZOa Final Demolition
QA g IN7IML5
� L�/ �/
� i
GOOEt INSPEC710NTYPE
206 Finai Mechanicai
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Sita
250 Final Building/OtCupancy
p� xl 7RIRL5
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the lollowing tleclarations:
❑ I have antl vrill maintain a certificale of consent to self-Insure for workers'
compensation, as provided for by section 3700 of Ihe Labor Code. (or the
peAo nce of the vrork for which Ihis permit is issued.
I have and will maintain v.orkers' compensation insurance, as required by
section 3700 of ihe Labor Code, fa the pertortnance of the v.ork fa which this
permit is issuetl. My workers' compensation Insurance carrier and policy
number are:
carrierSTRrEP()AAA-ilSkno.il til�uzAVCE���U�
(TNs seQm neetl not 6e mGip/ele04tne pemN is valuetl }ot o�ne nunOretl tbllars (S100J wless.)
Policy Numher ,�) (� �i}. )�" �� � � � "I
❑ I certify that in the performance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
ro the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Seclion 3700 ot
th a or e, I shall forthwith comply with these provi ions.
_ � �S'
Appll 1's Signalure D te
WARNING: FAILU TO SECURE WORKERS' COMPENSATION COVERP,GE
UNIAWF AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PE AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($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 aKrm lha� I am licensetl under provisions of Chapter 9(wmmencing
with Section 7000) of Division 3 of Ne Business antl Professions Code, and
my litense i5 in full fOrGe and efletl.
Class # ' 1
/i� o
— �
i�bN LENDING AGENCY:
y affum that lhere is a construction lending agency tw the
of Iha �wrk for wfiich tNs pertnil is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty o( perjury [hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sac. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, tlemolish, 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 licensetl pursuant lo the provisions o( the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or thal he or she is exempl therefrom and
the basis for the allegetl exemption. Any violation of Seclion 7031.5 by any
applicant fo� a permil subjects Ihe applicant to a civil penalty ot not more than
fve hundred dollars ($500�.):
❑ I, as ovmer of the property, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, antl ihe structure is not intended or
oRereO for sale (Sec. 7044, Business and Professions Code: The Coniractors
License Law does not apDly to an owner o( property who builtls or improves
thereon, and who dces such work himself or herself or through his or her own
employees, provitled that sucli improvements are not intended or oftered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner-builder will have the burden of provinq that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the proDertY• am EXCIUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS lo wnslmcl the project (Sec. 7044, Business and
Pro(essions Code: The contractars License Law dces rrot apply lo an ovmer of
properry who builds or improves thereon, and who contracts fw such project with
a contracta�s) license pursuant ro the Contractors License lav.s.).
❑ I am exempl under sec.
Business antl Professions CoCe for this reason:
SigriaWre Dale
305)46 (3/O))
Owner ID verifetl Dy driver s lic ❑ Yes ❑ No
Dnvers License No. Expires:
Verification of Owners�ip by (rype of documeN, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �
❑ I hereby cedify that no excavation (ve (5) or more feet in depth into wfiich a
person is required m descend, will be made in connection with work aulhorized
by lhis pertnil, and tha� no building structure, sc�fdding, (alsework, v demolition
or dismantling thereof, will be more than Ihiny-Six (36) feet high. (Chap. 32, Grp
2, Art 2, Sea 347, Title 8, Califomia Administ2tive Code).
❑ As owner-builder, I will not employ anyone lo do work which would
require a permit from the Division of Industrial Safety, as noted above, unlass
such person has a permit to do such work from the division.
ApPhcanl'S SignaWre
Division of Industrial Safery 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 hazarAous matenal? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safery Code requires, vnth some
exceptions, that a Business Plan be filed vrith the Costa Mesa Fire
Department by every business which has at any one lime tlurinq a reported
year a quantity of hazardous materials equal to oi greater than a weight ol
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standard lemperature antl pressure).
2. Dces or will Ihe applicant or present or future builtling occupant neetl lo file
a registration form for acutely hazar0ous malerials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safery Code, with some
exceplions, requires registration wiN lhe Cosla Mesa Fire Department 6y
each business which at any one lime has on hand a quanlity o( acutely
hazardous materials equal to or greatar than a weighl of 500 pounds, or a
volume of 55 gallons. or 200 cubic fee� o( compressed gas at slandartl
temperature and pressure).
3. Dces or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous matenals)? ❑ Ves ❑ No
(Sec[ion 25534 0( the California Heallh and Sa(ety Code provitles that the
Cos[a Mesa Fire Department may require ihe preparation, cerlification and
fling vrith the Fire Department of an RMPP by businesses which are required
to register aculely hazardous materials wilh the Fire DepaAmenl.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Safety Code been fully complieA with? ❑ Yes ❑ No
5. Does or will the applicant or present or fulure building occupanl require for
the vrork which is the subject of this application a permil (or such construction
or modifcalion from Ihe South Coast Air Quality Management District or from
any other air pollution control aislnct or agency? ❑ Ves ❑ No
(Sectbn 658502 of Ihe Califomia Govemment Code requires tha� the requested
information be fumishetl on applications fa non-residenlial building pertnits).
6. Will any part of the facility to be construcled under Ihis permil be within
1000 feet from Ihe outer boundaries ot a school? � Yes ❑ No
Qf yes", Ihe (aciliry must meet Ihe requiremenl of Sections 25534 and 42303
of the California Healih and Safery Code).
Z If a permit trom the South Coast Air Ouality Management DisMct or other
air pollution wntrol district or agency is required for ihe work which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health antl Safety Cotle Section 42303 been made? ❑ Yes ❑ No
8. pf'yes'. anach certificate of wmpliance from the appropriata air pollution
contmloKceq. .
CERTIFICATE OP COMPLIANCE: I certify that under penally of perjury the
infortnation given above is wnect. I agree to wmply with all state lavrs antl
ciry ordinances regarding Hazardous Materials and Emissions. '�
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certity under penalry o! perjury that I have reaC this appliwtion and state thal
the infortnation given is wvect. I agree to comply with all state lavrs and ciry
ortlinances relating to building construction, antl authorize representatives o(
the Ciry of Costa Mesa to enter upon ihe above-descri6etl properry for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorizetl by lhis permit until final inspection.
ignaWreolLegalOwner(s) Da�e
�e�'�_ �)� �
An �orAul�otlEeUAPW��n1 Dalp
(714) 754-5273 • Fax (7t4) 754-4856 • www.ci.coste-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
800
41050104.
Applicant: JAY SUTHERLAND
Address:
ELECTRICAL PERMIT
Phane: 909-596-7700
Zip:
Owner: -PWREFIMCC-SOUTH COAST, LLC
Address 535 ANTON BL.
COSTA MESA, CA Phone:
- SUITE 750 Zip: 92626
Contractor: MORROW MEADOWS CORPORATION
Address: 231 BENTON CT
CITY OF INDUSTRY, CA
Phone: 909-598-7700
Zip: 91789
License: 230813
SCOPE OF PERMIT
ELECTRICAI AND PLUMBING WORK ONLY FOR SUITE 800 FOR "NETIFICE"
ELECTRICAL TO INCLUDE: 5 OUTLETS, 1 SWITCH AND 1 SERVICE TO 200 AMPS.
• ISSUE FEE
Temp service tesl
Res. a/c package
' New Res (1-2 units) �
New Res (3+units) -
Pool / Spa � ' �
. Li9hting Fixts ,
Recept Outlets
Switches
Non Res Appl ,
Res Appl
Service to 200a . .
Service to 1000a
Service over �OOOa
Molors ta 7hp
Motors to 10hp
Motors to SOhp
Motors to t00hp
Motors over 100hp
Communication drops
Sub panel to 200a
Quantity
$23.50
$0.00
$0.00
$0.00
$0.00
80.00
55.50
$1.10
$0.00,
' '.- $0.00 � �
50.00 ' -
� $30.50 �.,
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 , .
50.00
$0.00
50.00
Status: ISSUED
Applied: 11/03/2004
Issued: 12/02/2004
'�i/
. _ I t�
FEE SUMMARY ,
Quantity "
Temp Disl System / Lighting $0.00 0�
Busway /100 ft ' .$0.00 0 �
Standing Section� . $0.00 0 ,
Misc Electrical Equipment $D.00 � 0
- . �Transformers up to 1 kva/kw �$0.00 ; � 0 •
.-,. 'u
-' �� .:.:..:up to 10 kva/kw $0.00 ; .� 0 '�
. . .........
�:� ..............:..up to 50 kva/kw 50.00 � 0
. .....:...........up to 100 kva/kw-; . $0.00 � 0
.................over 100 kva/kw ' . �$0.00 0
low Voltage EquipmeM - - �°$0�.00 , 0
Low Volt Wiring System / Ckt ���$0.00 0� �
Misc. Candui[ . ' S0.00 � „0 �
Misc. Conductor - . $0.00 � 0 -
Circus ( gen or ride) � $0.00 0
Circus (mech ride or lights) $0.00 - 0'
Chnstmas Tree Stand $0.00 0
Fireworks Stand $0.00 � 0
� � Other Electrical Fee - � ' $0.00
Inyestigation Fee � � � $0.00
Plan Check Fee $0.00
J
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or If work is suspendetl or abandoned
tor 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, end all
requlred Inepeetiona end flnel epproval must be abtainetl. Failure to oblain inspections and final approval will result In ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628
244&48 (8�00)
WORKERS'COMPENSAnON DECLARAnON: �/ �s .. . �f �
I hereby aHirtn under penelry ol perjury one oi the fallowing decleretions: �
❑ I heve end will malntain e ceniflcate ot consent to sell-Insure br workers' compensetlon, es pmvided for by sectlon 3700 ot the Lebor Catle, for t�e pertortnance at the
work for w�ic� t�is permit is Issuetl.
j]�i hava end will maintein workers' compensatlon Insurence, as reqWred by sectlon 3700 of ihe Lebor Cotle, for the peAortnance of 1he wwk lor whicti Ihls permit Is iswed.
My workers' comDen atlon Insurence carrier end pollty number ere:
caraer—�- S T ��vL �PdiqNumber. �vk G � BU��19
is sechon need nof Ee complefed if the pertnlf !s velued ef one hundred dollers ($100) or Iess.J
❑ 1 cartity that in ihe peAormance ol the work lor whicli this permit is issued, I shell not employ any pereon in eny manner so es to bocome subject to the workers'
compensation lews of Iitomia, en grea that It I s�aulA become sub�ect to the workers' compensetlon pmvislons of Sectlon 3700 of the Lebor Cotle, I shell toMwlih
comply wlth these p ions.
A�pliteM-3lgnefUie_ �. ��.lwl� rpelB:., � j" — Z— 0 y
WAqNIFIG: F RE TO 5 E WORKERS' COMPENS�TbN COVERAGE IS UMAWFUI M'D SHALL SIIBJEGT rW EMPtOYEfi'TO CRIAUNAL PENA�TIES AND CML FlNES UP TO ONE HUNDRED
Ti%%15AND OOLLARE (5 ,OW�, IN ADIX710N TO THE C06T OF COMPENSATKX{ DAMAGES �S PiqNDED FOH IN SECfION 31O60F THE LABOR CODE, INiEREST, M!D ATTORNEY'$ FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirtn that I em
of Chnpter 9(commendng wlth Seclion 7000) ot Division 3 oi Ihe Buslness and Prafessions Code, enA my Ilcense Is In lull
�„�e. r_ i a
CONS7AUCTION LENDING AOENCY:
❑ I hereby ettirm that there Is e construction lentlinp egenq lor the peAormence ot the work tor which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lenders Name: Lontlefs AAtlress:
Signature:
OWNER-BUILDEP DECLARAT10N3:
Dale:
I hereby effirm that unGer penalry at perjury Ihat I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Pratessions
Coda: Any ciry or counry which requires e permlt to consiruct, elter, Improva, tlemolish, or repair eny strucWre, pnor Io its issuance, elso requlres the epPliwm for suc� pertnil
to flle e signed atetement that he or she Is licensed pursuant to the pmvisions of ihe Contrectors License Lew (Chepter e(wmmencing with Secuon 7000) ot DMsion 3 of the
Business end Proteulons Code) or thflt he or she is exempt therelrom entl the Dflsb tor the ellegetl ezemption. Any violetion o1 Section 7031.5 by flny epplicent for a pertnil
subjecis ihe applicant to a clvil penalry oi not more t�an INe �untlretl tlollars ($500).): .
❑ i, as owner ot Ihe property, or my employees wit� wages es I�eir sole compensation. WILL DO THE WORK, and ihe strudure is not intanded or oMered lor sele (Sec.
7044, Business and Prolessions Code: The Contraciors License Lew tloes no1 apply to an owner ot propeny who builds or improves Ihereon, end who does such work
himselt or herself or Ihrough �is ar her own employees, provi0ed thet such impravements are not intanded or oHered for sele. II, however, the 6ullding or improvemen� is
sWtl within one year ot completion, the ownerbuilder will �ave the burden of proving t�at he or she did not build or improve for purpase ot sale.). '
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTAACTORS to constmc� �he pmject (Sec. 704a, Business and Professions
Cotle: The wntractors License Lew does not apply to en awner ot D�openy who builds or improves thereon, enC who contracts tor such project wilh a contractor(s)
license pursuant to lhe Contwdors LJcense Laws.).
❑ I em exempt under sec. Buslness an0 Protessions CoOe lor this reason:
Signatura: Date:
Ownar ID verified by drivafs licensa. ❑ Yes ❑ No Drivers License No. F�pires:
Veriticatlon oi Owners�ip by (type at tlocument, i.e. - property tex bill ar deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATION:
❑ I heraby certity Ihat no e:cevatlon INe (5) or more teet In depth into which e person is required to tlescen4 will De matle in wnnectlon with work euthorized by thls
permit, end t�at no builtling sWcture, scaMoltlinp, talsework, or Cemolition or tlismantling thereot, will be more than thirty-six (38) taet high. (Chep. 32, Gry 2, A� 2, Sec.
347, Title B, Caltlomla AtlminLslretNe Code).
❑ As owner-builder, I will rrot employ anyone to do work which would require a permit trom the Divislon ol Industrial SeteN. es notad ebove, unless such person hfls e
pertnit to tlo such work trom Ne didsion.
Signature: Date:
Divislon of Indusirial Satety Permit Number.
CERTIFlCATE OF COMPIIANCE AND AUTHORIZATION OF ENfRY: I certily untler penelry of perjury that I have reatl this application enC state that the infortnation given is
correct. I eyjee ta comply with ell slate laws end Gry ordinances relatinp to huilding cons(ructlon, end euthonze represenletives of Ne Ciry of Costa Mese to enter upon the
above-de�cfbed prapertXlar inspection purposes. I egree not to occuDY or allow accupanty of any building euthorizetl by this permit un�il tinel inspection.
GOOE I, INSPECTIONTYPE
1616 Fi:ed System Final Fire Preventlan
1286 . Pool Spa Flnal
200 Final Ra-Root
201 Finel BIocWRetaining Well
202 Final Fedory Fire Place
203 Final Sign
204 Finel DBmolition
�7.1iq
v
�� �f.! INSPELTIONTYPE
208 Final Mechanical
208 Finel Plumbing
210 Final Elecirical
212
220
Finel Fire Preventlon
Final Planning Approval
222 Final Site
250 Final Building/Occupenq
� v Y
�ate,.,,,
eeg u�e►s
�'-F�...— V
✓
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 800
Vicinity: STE 800 (NETIFICE)
Parcel Nunmber: 41050104
App�icant: STEVENS, DON
Address:
Owner:
i
Address
PLUMBING PERMIT
Phone: 81&500-1940 -
Zip:
PWREF/MCC-SOUTH COAST, LLC
'535 ANTON Bl. .
COSTA MESA, CA Phone:
SUITE 150 / Zip: 92626
Contractor: MUIR-CHASE PLUMBING
Address: 1940 GARDENA
GLENDALE,CA- �
Arch / Eng : � - .
� Address: � � � � � �
Status: ISSUED
Applied: 11/03/2004
Issued: 11/23/2004
ISSUED BY:
Phone: (818)500-1940
2ip: 91204
License: 539835
Phone:
' � � , . Zip: ,. . , .
�, � .% � License:. �- �. - - '
,"
SCOPE OF PERMIT
' ELECTRICAL AND PLUMBING WORK ONLY FOR SUITE800 "NETIFICE" �
� , PCUMBING TO INCLUDE: 1 COMMERCIAL SINK, 1 WATER HEATERNENT .� � � �
' . . . :- . . , , ,
� � ' �;� �, ; �FEE�SUMMARY <�• -� ,
- % AMT-. -,QTY � . . AMT ��QTY. , , ,. � , ' .AMT QTY
ISSUE FEE , $23.50 . . - � Laundry Tub / Washer - � $0.00 0 - -� �� ' � - Sump Pump .. $0.00 0
Backflow irrigaflom $0.00.-::; ,0�: Landscape Irrigation $0.00 0 . Swimming Pool , .$0.00 0
BackflowPreventer�. �30.00, 0� P-Trap � �� 50.00 0 �_. TrapPrimer, � $0.00 0
Bathtub � �� �50.00��; 0 � -_ P-ressure Regulator, � " $0.00 0 . - ,'�Uripal-:- �'. . , ,� , $0.00 0
Clarifier System \ , - 50.00 � j �0 -� � �Process Piping (per 10 R) � $0.00 , - 0 � , -Vacuum Brkr Bkflow(1=4) $0.00 0
Conned pce,Soda,etc) � _ $0.00 0 � �Receptprs -� $0.00 .". 0 � VacuurirBrkr Bkflow(5+) $0.00 0
Dental Units �.. 50.00 0� Septic Tank - 50.00 0 Wash Basin - $0.00 0
Dishwasher �$0.00 � 0 . ' Sewer Cap for Demo $0.00 � 0, � Wash Basin Set $0.00 0
Drain, Floor $0.00 0 � Sewe[Connect " $0.00 0 � Waste and Vent System $0.00 0
Drain, Rainwater 30.00 --. 0- � Sewer Private Line � -,$0.00 �'0 � Water Closet (Toilet) $0.00 0
Drain,Roof $0.00 0�-.� �- � -�Shower �- � � - � �� � $0.00 - 0 � .WaterHeater/vent 572.30 7
Drinking Fountain $0.00 0 � Sink, bar . $0.00 ,.0" _�-��" Water Piping (Inst or Rep.) 50.00 0
NOTICE: The work authorized by this permlt 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 automaticelly expire and become void if work Is not commenced wlthin 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 tonsidered legel, such work must comply with all epplicable codes, and all
requlred Inapectione and tinel epproval must be obtained. Failure to obtaln Inspections end final epproval will result in lhe expiration of this permlt.
FOR INSPECTIONS CALL: (714) 7545626
244&OB (B/W)
WORKERS'COMPENSAnON DECLAHATON:
I hereby aXirtn under penalry ot perjury one of the fdlowing deGaretions: -
❑ I heve end wlll mainteln e certilicate ot consem ta self-Insure for workers' compensation, es D�ovlded tor by section 3700 of tha Lebor Cade, tor the peAarmance of ihe
work for which t�is permit is issuetl.
� I heve entl will malntein workers' compensation insurence, as required by sectlon 3700 of the Lebor Cotle, tor the pertartnance ot the work for which UUs pertnit La issuetl.
My workera' compensation Insurance rrier antl policy number ere:
cama�: �i� or�.-� � srr�r;.5.r�� Po��� N�m��: LvG437 64Zo —o 0
(lhis secibn need nof be completeC if fhe pemtit ls valued e! one hundred dollars (5100) or less.)
� I ceNiy that In the perlarmence of the work lar which this pertnit is issued, I shall nol employ eny person In eny menner so es to Decome aub�ect to t�e workers'
compensatlan lews ot Califomle, end apree t�at it I s�oulC become sub�ect ro the workers' compensatlon provisions ot Saclian 3700 of the Lebor Code, I shell foMwlih
comply with Nese 5. /�,
ApPlicent SipneWr�n� —�7 L/�-r-- Date: j � J- z 3- o q
WARNING: FAILURE TO SEWRE WORKERS' COMPENSATION CDVERAGE IS VMAW R1L ANO SHAl1 SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNURED
T/IOUSlW D OOLLARE (5100.000). IN ADqTON TO TNE COST OF COMPENSATION, OAAMGES PS PROVIDED FOR IN SECiION 3]OB Of THE LABOR CODE, IMEREST, AND ATfORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm t�et I em Iicensetl under rovis(oaaol Chepter 9(commencinp with Seclion 7000) af Division 3 0l ihe Business end Prolessions Code, enE my license Is In full
rorce and ettect. uc. x-+ S'�9 �3 5 Cless p�� �.- 3�/
-ContracmfsSigneture: ��.�—.�— oaca: /7—'Z3—O 4
CONSTRUCTION LENDING AGENCY:
❑ I heroby eHirm t�et there Is e wnstruction lending egency for the peAortnance ot the work tor which Ihls permit Is issuetl. (Sec. 3097, Civil Cotlaj.
Lentler's Neme: ' Lentler's Atltlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
1 herehy eHirtn that under penalty ot per�ury Ihat I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW lor Ihe tollowing reewn (Sec. 7031.5, Buslness end Protessions
Code: Any ciry or counry which requires a permit to wnswct, alter, improve, demWish, or repeir eny sWCWra, pnor lo its Issuance, elso reQuires lhe epplicant br such pertnit
to file e siqnetl stetement t�at he ar she is Iicensad pursuant ro the pmvisions o1 the Camrecrors License Lew (Chapter 9(commenGng with Sectlon 7000) of DiNslon 3 of the
8usiness entl Professions Cade) ar Ihat he or she is exempt therelrom end the besis for t�e allegetl exemption. Any violation oi Sectian 7037.5 Cy eny appiicent lor e pertnit
subjects the eppllcant to e civil penalry ot not more than (ive hundred dollars (3500�.):
❑ I, es owner oi Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl ihe structure is noi intentletl or otteretl for sale (Sec.
7044, Business anO Prolessions Cotle: The Contractors License lew does not epply to an owner of properry who builds or improves thereon, antl w�o does such work
himself or herself or Ihrough his ar her own employees, proviOetl ihat suc� Improvements ere not Intended or oHered lor sale. If, however, the builtling or imprwement is
soltl within one year ol crompletian, the ownerbuilder will hava the burden ol Drovinp that he or she tli0 not build or improve Por purposa ol sale.). •
❑ I, es owner ot Ihe property, em E%CLUSIVELY CONTRACTING WIiH LICENSED CONTRACTORS to construct tha project (Sac. 7044, Business antl Professlons
Code: The contractors Llcense Law Coes not appty to an owner of property who bullds or improves thereon, end who contracts for such project wl�h e contractor(s)
license pursuant to ihe Con�rac�ors License Laws.).
❑ I am exempt under sec. Business end Professlons Cotle for t�is reason:
Signeture: Date:
Owner ID veritied by tlrivefs Ilcense. ❑ Yes ❑ No Drive(s License No.
Vedficatlon ot Ownership by (typa oi document, I.e. - pmperry tex bill or deeC):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I hereby certify t�at no excavation INe (5) or more leet in depth into which e person Is requiretl to Aescen4 will be matle In wnnection vrith work euthoAzed by thls
pertnll, and Ihat no building structure, scaHolding, lalsework, ar demditbn or dismentling thereoi, will De more ihan thirry-sis (38) feel high. (Chep. 3.2, Grp 2, An 2, Sec.
341, Title 8, Celltomia Adminlsiretive Cotle).
❑ As owner-builder, I will not employ enyone to do work which wwlA reQuire e permit irom the Division ol Intlustrial Setery, es nated ebove, unless such person has e
pertnit to do suc� work trom the tlMsion.
Signeture: Date:
Division ot Intlusidal Satery Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND A!!T}fORPATION OF ENiTiY: I cenity under penalry ot perjury ihat I heve reed ihis applica�ion and stete Ihat the Intormatlon given Is
correci. I agree to comply with ell stete laws end dry ortlinences relating to bullding construction, and eulhorize represenletives of the Ciry at Costa Mesa to enter upon the
ebove-described pmperty br inspection purposes. I agree not to acupy or ellow occupency oi any building euthorized by this permit until tinal inspectlon.
��Slgneture Ot Legal Owner(s) 7 D te
�L/�� `� � � � (/� � 4
AnNOr Authodzetl Applicant Date
�� . , ' m•. �'
1616
1268
Fixed SyStem Flnal Flre Preventlan
Pool Spa Final
200 Flnel Re-Root
201 Flnel BIocWReteining Well
202 Finel FeMory Fire PWce
203 Finel Slgn
206. Finel Damolllion
PdIE It�lLS
COOE I INSPECTION TYPE
208 Finel Mechanical
20B Finel Plumbing
210 Final Electdcal
212 Final Fire Prevention
220 Final Planning Approvel
222 Final Site
250 FinalBulltlingiOccupancy
➢dIE ItiiIDdl�
Z—l7,2� �
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
�ob Address: 555 AN70N BL
Suite: 802
Vidniry: 802
Parcel Number: 41050110
App�ipne ROT7, DEANNA
Address:
Zoning:
Phone: 714-43&2272
ISSUED BY:
Status: ISSUED
Applied: O6/08/2004
Issued: 08l16/2004
Zip:
Owner. SAKIOKA FARMS %MORGANS HOTEL LIMITED , " � ''��
Address PARTNERSHIP ATTN JOE CRAWFORD � �
DENVER, CO • � . � _ �Phone: . . , , . �
" � 1050 17TH 5T �#1220 �, � Zip: � . � ' � .
Convactor. HOWqRD BUILDING CORPORATION , , � �
Address: 3184 qIRWAY,AVE � � . �
. . STE K.: - .� Phone: (714) 43&2272 , "
' � COSTq MESA, CA � � � � `
� Zip: . 92626 License: 445804 �
Arch : MICHAEL BLOYD � Eng: , �
Address: 30808RISTQL ST # 105 � _ Address:
Phone: 774-754-1197X7224 � Phone:
CM,CA � � _� � �
Zip: 92626 , License: C260N License: .
SCOPE OF PERMIT . ,
INTETRIOR OFFICE TO TO UNIT 802 FOR BMC SOFfWARE SUBLEASE. �� �
Plan Check:
Permit:
SMIP Res:
� SMI_P Com:
Other:
Inspection:
�� Sotal:
$145.11
$223.25 _ -
$o.00
$2.63
$0.00
�$0.00
$370.99 � .
FEE SUMMARY
Calc Valuation:
- Claim Valuation
s�2,sao.00
si2,000.00'
�
PLANNING & ZONING �
SETBACKS �� :-:� � � � ,
/
MAIN STRUCTURE`Front 0-'0• ' `� Rear � 0- 0� ��Left 0- 0 �Right - 0. 0- �ti�' ��
��.., ' -� _ - • , � _ - -_ ,, . � ,- ' , !./'
_-
�_
ACCESSORY \ Fwnt _, 0- 0 ",� „� Rear. � 0- 0 Lefl 0- 0� , Right �:0. 0, ,"%
,- ' �
� ��
PARKING ' Existina: o RequiYed: - o � �Pr000sed: o� � � ; %
NOTES: . - . � . , -i'-j�:�
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)
EXPIRA710N: This permit shall automatically expire and become voitl if work is not commenced within 7B0 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 Inepectlons end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (71q) 7545628
zaas�ae �aroo�
WORKERS' COMPENSATION DECLARATION: ' � -
I hereby eflirtn er penalry of Oer�ury one ol lha following �dealaretlons: �
❑ I hev ntl wlll meintaln e certlflcete of conseN to selt-Insure tor warkers' compensetlon, es pravided for by sectian 3700 0l the Lebor Code, lor the pertormence at the
lor which this permlt Is Issuetl.
I heve end will maintaln workers' compensatlon Insurence, as requlretl by sectian 3700 ot the Lebor CoUe, for the peAortnence oi the wwk Iw wh�h 1hls pertnit Ls Issued.
My workers' oompensetlon Insurance cerrier end policy numDer ere:
Certler. . PWiry Number.
(Thls sectlon neetl nof be completed l! f�e pe�mitls veluea ef one �uiMred dW/ars ($f00) or lexa.) , .
� I certlly Ihat in Ihe peAortnance of Ihe work lor which this pertnit Is Issued, I shall not employ any pergon in any menner so es to ecome subject to Ne workers'
compen5etion laws o1 Celitomle, entl egrae that II I ahould Eecome suD�ect to Ihe workers' mmpensetlon provislons ol SecUon 00 of the Lebor Coda, I shall Iorthwith
comprywlththe Provisions. n � „
AppllcentSlgneture: �a/11�N.-��e--QR�T� oere: �
WARNINO:FAILURETOSEWREWORKERS'COMPENSATIONCOVEM�EISUNLAWFULANDSWILLSU6IECTMIEMPLOYERTOCRIMINALPE ALTESM pVILFlNESUPTOONEHUNDRED
THOUSAND DOLLARE (5100,000), IN ADDI?IqJ TO THE COST OF COMPENSFTON, DAMhGES AS PROVIDED fOR IN SECTIIXJ 31W OF TME tABOR CODE, INfEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby attirm that I em licensed under provisions of Chapter e(commencing with Section 7000) of Division 3 of the Business and Pratessions
torce end eXect. Lic. a Class a
Contreciors Signature: a-�1"1M..Q_ Date:
CONSTRUCTION LENDING AOENCY:
❑ I hereby eHirm that Ihere Is e coretructlon lending apency Por ihe pertormence of the work tor which ihis permlt Is issued. (Sec. 3097, Civil Cotle).
Lentlefs Neme: Lentlers AOaress:
Sipnature:
Date:
my license is in full
OWNER-BUILDER DECLARATIONS:
1 hereby eHirm thet under penalry ot per�ury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe follawing reason (Sec. 7031.5, Buslness entl Professlons
Cotle: Any Gry or counry whlGi reqWres a permit to consWct, elter, Improva, demWish, or repair eny atructure, prior to its issuance, elw requires Iha eppllcant tor such pertnit
to tile e slgnetl slatement that he or she Is Ilcensetl pursuent to Ihe pravislons of Ihe ContraMors License Lew (C�apter 8(commendng wit� Sectlon 7000) of Dlvision 3 of t�e
Businoss entl Pratessions Code) or thet he ar she is exempt tharalrom entl the Dasis lor Ihe ellegoa ezemption, Any vidation oi Sedlon 7031.5 by eny epplicent lor e Dartnit
sub�ects Ihe applicant co a civll penalry of not more then five hundred dollars (5500).):
❑ I, es owner of ihe properry, or my employees with weges es I�eir sole compensalion, WILL DO T1E WORK, anOlhe siructura Is not Intentled or oXere0lor sele (Sac.
7044, Business antl Pmfessions Cotle: The Contractore License Law does not apply to en owner of property who builtls or impmves iheraon, end who Goes suCh work
himself or herself or through his or her own employees, provlAetl thel suU improvements ere not Intended or ottered tor sale. If, however, the builCing or Improvement Is
sold wit�in one year o1 completion, the owner-bullder will have the burden of proving that he or she did not build or imprwe for purpose of ule.). •
❑ I, es owner of Ihe proparry, am E7CCLUSIVELV CONTRACTING WITH LICENSED CON7RACTORS to conswct the proJect (Sec. 70n4, eusiness end Professions
Catle: The contraaors Llcense Lew tloes not appty to an owner ol property who bulids or improves Ihereon, end who contracis br such pmjaq wlih e comrector(s)
Iicense Oursuant to the Cantrectors License Lews.).
❑ I em exempt unCer sec. Business antl Profassions Cotle lor ihis reason:
Signature: Date:
Owner ID verl9etl by tlrivefa Iicense. ❑ Ves ❑ No Drivefs Ucense No. Expiros:
Vedlicetlon ol Ownership Dy (type oi tlaument, I.e. - property tex blll or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereDy ceriify Ihat no exwvatlon Ilve (5) or more feet in de0th Into which e person b requlred to descend, will be mede In connectbn with work eulhoAzeC by Ihis
pormi6 and that no building struclure, scattolding, lalsawork, or demdilion or dismanilinp thereol. wlll he more than t�irty-six (38) leet hig�. (ChaO� 3.2, Grp 2, Ar12, Sec.
341, TiUa 8, CaGlomla AGminlsirative CoEe).
❑ As owner-Dulltler, I wlll not employ enyone to tlo work w�ich would require a pertnit Irom Ihe Dhrision ot Industrlal Sefery, es noted ebove, unless such person has e
permil to do such work Irom Ihe tllvislon.
SlgnaNre: Oate:
DlNsion oi Industnal Safery Permit NumDer.
CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF ENTAY: I Certiry under penalty of perjury thet I heve reatl thls epplication and state that the Inlormeilon given is
correct. I agree lo comply wilh ell stete lews end city ordinances releting to building construction, and euthodze representetives of the Clry ot Costa Mesa lo enter upon Ihe
ebove-descnbed properry tor Inspection puryoses. I egroe not to occupy ar ellrnv occupancy of eny building euthorizod by this permil until tinel inspectlon.
� " SI$� N^re O�f L,egal Owner(s)
pLxQ�i`i120�- �-�4-4�-
MNOr Aut�arizetl Appliwnt
COOE t. INSPECTIONTYPE
1616 Fi:ed System Final Fire Pravemion
1266 Pool Spa Finel
200 Final Re-Roof
201 FInaIBIocWReWiningWall
202 Final Factory Fire Place
203 Finel Sign
20a Final Demolitlon
QdjE �L�j �f„( INSPECTIONTYPE
_ 208 Final MBchanicel
208 Final Plumbing
210 Final Electnwl
272 Flnel Fire Preventlon
220 Finel Planning Apprwal
222 Final Site
250 FinalBuilding/Occupency
PAIE
���/�
Li/L/r�
�
(714) 754-5273 • Fex (714) 754-4856
JobAddress: 555 ANTON BL
Suite: 8
Vicinity: EIGHTH FLOOR
Parcel Number: 41050110
CITY OF COSTA MESA �__,+
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
Applicant: DE OCAMPO, RUDI
Address: 3080 BRISTOL ST.
COSTA MESA, CA
SUITE 105
Owner: SAKIOKA FARMS
Address �
BUILDING PERMIT
Zoning:
Phone: (714) 754-1197
Zip: 92626
Phone:
Zip: 94137
Contractor: INNER SPACE CONSTRUCTORS
Address: 2250 S. CENTR4L AV.
RANCHO DOMIGUEZ, CA.,
Zip: 90220
Phone: (370)763-2112
License: �� 366309 .
PEflMIT NUMBER
I B00-00261
77 FAIR DRIVE, COSTA MESA, CA 92626
2��ue�
Status: .�G
Applied: 03/Ot/2000
issued: 3/aG���
ISSUED BY: �"�" I
Arch : IA ' " � Eng:
Address: 3080 BRISTOL ST. ;" Address: �
COSTA MESA, CA '� �' Ptione: (714) 754-1197 Phone: '
SUITE 105 � ` � �
Zip: 92626 , ' License: �License:
� � � � � SCOPE OF PERMIT ,
' 17,800 SQ FT WTERIOR OFFICE T.I. FOR -BMC SOFTWARE- (EIGHTH FLOOR).
Plan Check: $356.23
Permit: $2,192.15
SMIP Res: $0.00
SMIP Com: $65.83
Other: $0.00
Inspection: $0.00
Total: $2,614.21
SETBACKS-
MAIN STRUCTURE �Front 0- 0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY -
_ �, .
PLANNING.B ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0. 0
�
$37 3,500.00 �
$300,000.00
NOTICE: The work authonzed by this permit shall compty with all applicable handicap access requirements under Ca�ifomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRA710N: 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 aulhorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectlona end final epproval musl be obtained. Failure to obtain inspections end final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 /
WORKEHS'COMPENSAnON DECLARAnON: �
I hereby eXirm under penalry oi perjury one ol the following AeUaretlons: �
❑ I heve and will malntein e cerUflcate af consent to self-Insure tor warkers campensetlan, as pmvided tor Dy sectlon 3700 01 t�e Labor Code, tor the petlormance oi Ihe
work for which thi5 pertnit Is issued.
❑ I heve enC witl meintaln workers' compensetion insurenca, as requiretl by sectlon 3700 of the Lebor Code, lor Ihe peAOrmance of Ihe work lor whiCh IhiS pertnit is issuBA.
My �wgrkers'� 9Btlon surence carrier an��° Ilcy number aro: .
CarAer. C[.L2.u�lr[.c�� � .,�.,.._ __ [r!_� 1 %w Policy Number ( �� / �3 � � � n ]
(This secNo need�lotod I! fhe permlNs velu el one undred dallers (S100J or /ess.)
❑ I cerUly that in the pertortnance of the work for which this pertnit is Issued, I shall not employ eny person in eny menner so es to becoma su6ject to the workers'
wmpensatlon lews ol Celilomla, end egree thet it I s�oulC hecome sublect to the workers' wmpensatlon provlslons ol Section 3700 0l the Lebor Cotle, I shall Fanhwith
compty wit� t�e�e� Islons. .
Applicem Signewre: �'�,.�. �..: .QIL Dere: 11 �'— o`� �'7�^ O'i
WARNINO: FNLUFE TO SECUFE WORKERS' �MPENSATION COVEMGE IS UNLAWFUL PND SHML SUBIECT AN EM%.OYER TO CRIMINAL PENALTIES AND CML FlNES UP TO IXJE HUNDRED
THW:.�1ND OOLLARE (5100,000). IN ADDITION TO THE CQST OF COMPENSAT70N, OAAIAGES AS PROVIOED WR IN SECfION 31060F THE IABOfl COAE.INTEREST. AND ATTORNEVS FEES.
LICENSED CONTHAC70RS DECLARATION:
I hereby aNirtn ihat I am Iice ed untler provisions of Chapter 9(commencing with Section 7000) ot Divislon 3 of ihe Business and Professions Coda, and my license is In tull
torce and eHecL Lic. k Class # Q- C}. - L� �- C 1('�
ContrectoTs Signature: �.,.��..-�1� � Date: 11 i ,Z 9- h(�
CONSTRUCTION LENDINO AGENCY: �
❑ I hereby ettirm thet Ihere is e construpion lontling epenty br Ihe peAortnence of �he work lor which this parmit is issueC. (Sx. 3097, Cidl Code).
Lentlels Name: Lendefs Address:
Signeture: Dete:
OWNER•BUILDER DECLARATIONS:
I hereby aHirtn Ihat under penalry ot Derfury ihat I em EXEMPT FROM TME COMRACTORS LICENSE LAW for the following reason (Sac. 7031.5, Businass entl Professions
Code: My ciry or counry w�ich requires e permit to construct, alter, Improve, demolish, ar repair eny sWcture, pdor to its Issuance, elso requires the epplicant for such permlt
to lile e slgnetl statement that he or she is Ilcensed pursuant to the provisions of the Contractors Llcense Lew (Chepter 9(wmmencing with Section 7000) ot Division 3 ot the
Business enA Professians Cotle) or t�at he or she Is exemp� therotrom and Ihe basis lor the ellepetl e:emption. Any vlolatlon ol Sectlon 7031.5 by eny applicant tor a pertnit
subl��g t�e applicant to e civil penelry oi mt more than five huntlretl Adlars (5500)J:
❑ I, as owner ot the properry, or my employees with wapas es Neir sola compensation, WILL DO THE WORK, antl the aWcture is not intended or oMeretl lor sale (Sec.
7044, Business antl Pmtessions Code: The Comractors License Law dces nof apply to an owner ot property who builds or impwves therean, anG who tloes such work
himseli or herself or Ihrough his or her own employees, provitled that such Improvemenis are not intended or offeretl tor sale. N, however, the bullding or improvement is
soltl within one year of completlon, the owneo-builtler will have Ihe burden of proving ihe� he or she did not build or improve tor purpose of sale.).
❑ I, as owner ot Ihe property, em EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRAC70R5 to construct the project (Sec. 7044, Business antl Professions
Code: The conirectars License Lew does nol epPly to en owner of property w�o builds or improves thereon, end who comracts tor such prolect with e contrector(s)
Ilcense pursuant to Ihe Conirecmrs License Laws.). �
❑ I am eaempt under sec. Business and Prolessions Cotle for this reason:
Signeture: Date:
Owner ID verified �y drivers license. ❑ Ves ❑ No DrNers LJcense No.
Venllcatlon ot Ownership by (type ol dxument, i.e. - property taz bill or deed):
OIVISION OF INDUS7RIAL SAFETY VERMIT CERTIFICATION:
6cpires:
❑ I hereDy certify Ihat no excevetlon five (5) or more feet In tlepth Into which a person Is requlretl lo descend, will 6e mede in connection with work euthorizetl by Ihls
permit, end t�at no building slructure, scattolding, falsework, or tlemolition or tlismentling Ihereof, will be more Ihan thiny�siz (3fi) feet hlgh. (Chap. 32, Grp 2, An 2, Sec.
341, Tule B, Califomia Administrative Code).
❑ As owner-buildar, I will not employ enyone to tlo work which would require a pertnil trom Ihe Division of Indusirlal Safery, as noteG flbove, unless such person has a
permit to tlo such wark tmm t�e tlivl5ion.
5ignature: Date:
Dlvision af Industnal Satery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTMOPRATON OF EMRY: I cenity under penalty ot perjury that I have read this applicetion end state Uat Iha inlortnation given is
correct. I egree to compty wit� all state laws and ciry ortlinances relating to builtling consWttlon, end euthodze representatives of the Ciry ot Casts Mese to enter upon t�e
above-tlescribed property for InsDedlon purposes. I egree not to occupy or allow occupancy ol eny �uiltling euthoAzod by t�ls pertnit until finel Inspectlon.
�� %� Slgneture Of Legal Owner(s) Date
� w.l . . �-l._„ , .� .P I% (�1 � ' � % — � ��
AndOr Aut�onzetl Applicant Dete
['�'7d��L`Fi9itiS�L'KI'77
1616 Fi:etl System Final Fire Prevention
7266 Pool Spa Final
200 Final RaRoot
201 Flnal BIocWRetaining Well
202 Final Factory Fire Place
203 Flnal Slgn
204 Final Demditlon
p]\i�.u�ill4j
LODE 1 INSPECTION TYPE
208 Final Methanital
20B Final Plumbing
210 Finel Electncal
212 Final Fire Prevenlion
220 Final Plenning Approvel
222 Final Site
250 Finel Builtling�OCCupancy
PAff. lIi�1AL5
�
(714) 754-5273 • Fax (714) 754-4856 • vr.vw.ci.coste-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
555 ANTON BL
� �02
4y050104
Applicant: O'BRYANT ELECTRIC
Address: 8�49 SHIRLEY AVE.
NpRTHRIDGE, CA-
/ . _
ELECTRICAL PERMIT
Phone: (818)407-1986
Zip: 91324
�
Owner.' , PWREF/MCGSOUTH-COAST, LLC
�
Address, 535 ANTON BL �' - �
, - -. COSTA MESA, CA � Phone:
' � _ SUITE-150 . , Zip: 92626
Coniracror.
Address:
: Phone:
Zip:
� ; License:
ISSUED
� �
Status:
Applied:
Issued:
ISSUED
OA�23I2004
08123/2004
SCOPE OF PERMIT
REF: 604-01052-INTETRIOR OFFICE TO TO UNIT 802 FOR BMC SOFTWARE SUBLEASE.
ELECT. IS FOR RELOCATION OF 1 LIGHT FIXTURE, 2 SWITCHES, RELOCATE 1 EXIT SIGN 8 ADD
2 NEW EXIT SIGNS. �
ISSUE FEE � � $23.50
Temp servlce les4 �' . $0.00
Res: a/c package . � 50.00
New Res (1-2 units) E0.00
New Res (3+units) ' � '$0.00
Pool / Spa �. � � �50.00
Lighfing Fixls $4.40
Recept Outlets � . $0.00
Switches ��� � � ". '_ $220
Non Res Appl `� $0.00 �
ResAppl � ��� � $0.00
Serviceto200a ���� $0.00
Service to 1000a A� ���$0.00
Service over 1000a -\ $0.00 ,
Motors to 1 hp �30.00 i
Molors to 10hp $0.00�
Molors to SOhp $0.00
Motors to 100hp $0.00 ;
Motors over t00hp $0.00
Communicalion drops $0.00
Quantity
0
0
0
4
0
2,
,.p,
0 ,
� p,
� ,
0
0
0 _, .
p ,. ,
0
0
FEE SUMMARY
. - . ' . Quantity,�
Temp'DistSystem�/Lighting $0.00 ,0. ,
, Busway /100 fl $0.00 � �0 ,' _
....��.-� Standing Seclion 50.00 . � �-0" �
. - - Misc Electrical Equipment 50.00 �- . � 0 - �
" Transformers up to.1 kva/kw $0.00 ,�� 0
................up to 10 kva/kw_ �-- $0.00 0 .
.................up to 50 kva/kw 50.00 0 � '
.................up to 100 kva/kw ' $0.00 , 0
' ..................over100 kvalkw .- $0.00 � �- . 0 ,/, �
- ' �: Low Voltage Equipment%-= $0.00 � ��0 / ; ��
� � . ,. �Low Volt Wlring�Systerrf% Ckl ' -,$0.00" ' 0 - / �
Misc.Conduib " � � $0.00 -'�Oj�
Misa Conductor, � " � � ��$0.00!� ' 0
� Circus ( gen or ride) , �$0.00 "% 0
Circus (mech nde or lights) .�" � 50.00'� 0
ChrisVnas Tree Stand .- - �50.00 0
Fireworks Stand ;' j E0.00 0
. Ofher ElecMral Fee - 50.00
� InvesUgation Fee $0.00
/
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: This permh shall automatically expire anA become void tf work fs nof commenced with(n 180 days, or (( work fs suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order tor the work aulhorized untler �his permi� to be considered legal, such work must comply wi�h all epplicable codes, end ell
required Inspectlona anq Iinal approvel must be obtained. Failure to obtein inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CAIL: (714) 7545628
zanws laroo)
WORKERS'COMPENSAnON DECLARAnON:
I hereby aHirm under penalry of perjury one o1 the following tleclaretions:
❑ I have end will malntain e ceniticete o1 wnsent to self-Insure for workers' compensetlon, es providetl tor by sectlon 3700 0l the Lebor Code, far Iha paAortnance of Ihe
work for whlch lhls permil Is ISsuetl.
❑ I he wlll malntain workers' compensatlon Inwrerke, as require0 Dy sectlm 3700 ot 1�e r Code, for Ne peAortnance of the work for w1Ych this permit Is Issued.
My W ry tlon Insu nce �ceryr�qr per��-/}�II num r era� \` � r� �-/r��� �'�] �
C/rt(ier 11 �1�L� V"'h�'rr4ry ����1. . . Pdicy, umN ber: A J�1 b_
❑ I certity t�at In Ihe pertortn ot t�e
compenseUon lews ot ia, e'
comply wit� t�ese
Applli.SlgneNre: �
WARNINO: FAILURE TO SECURE WOPo(ERS'
TIqUSAND DOLLARE (E100,000). IN ADDfTI�
LICENSED CONTRACTORS DECLARATION:
I herebyerylrm lhel I em licens r o sio
torce end eitoct. Lic. a
Cgntreqofs Signeture:
is issue4 I shall
ne sub�ect lo the
es to become sub�ect lo Ne workers'
:j�qn.�700 or t4e Lebor CaCe, I ahell torthwitn
ISATION COVEMGE IS UNLAW RIL ANU SNALL SUBJECf Ml EMPLOYER TO CRIMINAL PENALTES MIDGVIL FlNES UP TO ONE NUNDRED
COST OF CpAPEN5ATI0N, DAAN6E5 AS PfiONDED FOR IN SECTION 37080F TME UBOR CODE, INfERE5T. M1D ATTORNEI"S fEES.
8(commendnp with Semion 7000) of Division 3 oi tno
Code, end my license Is in full
CONS7BUCTON LENDING AGENCY: � -
❑ I �ereby eHirtn t�et Ihere is e mnslruction lentling agen�y for t�e pertormance oi the work tor whic� ihis permil Is issued. (Sec. 3097, Civil CoCe).
Lentlele Neme: Lentler's AECross:
SlpnaNre:
OWNER•BUILDER DECLARATONS:
Date:
I hereby eHlrm thet under Denalry ol per�ury chet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the lallowing reeson (Sec. 7031.5, Business enC Protessions
Code: Any ciry or counry which requires e pertnil to consiruct, elter, improve, demolish, or reDeir eny siructure, pdor to its issuance, elso requires the applicant Por such pertnit
ta flle e sipned statement Ihet he or 6ha Is Ilcensed pursuent to ihe proNsions at the Cantrectors Llcense Law (Chapter 9(commendng with Seccion 7000) of OMslon 3 of t�e
eusiness entl Professions Cotle) or Nat he or she is eaempt Iherelrom erW the basls tor the ellaged examptlon. Any Ndetion oi Seclion 7031.5 by eny applkant tor a permit
subjects the epplicant to a chril penalry oi nal mwe than live hundretl ddlaw (5500).):
❑ I, es owner of ihe properry, or my employees with wages as t�eir sole compensetion, WILL DO THE WORK, and tha structure Is not intentletl or oflered lar sele (Sec.
7044, Business antl Professions Code: The Contrectors License Lew does not aDPh �o en owner of properry who builds or improves t�ereon, anC who doas such work
himselt or hersetl or through his ar her own employees, provided �hat such Imprwemenis are not intended or oMered lor sale. If, hov.ever, the bu9tling or imprwement is
sold within one year oi camp�etion, the owner�Dulider will have the burden ot proving that he or she did not builA or Imprwa tor purpose ot sale.). �
❑ 1, es owner oi the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to wnslruct the projecl (Sec. 7044, Business entl Prolessions
Cotle: The contractors License Lew tloes not apply to an owner of pmperty who huilds or impmves Ihereon, end who cantrects lor suc� pm�ect with e contractor(s)
license Dursuant to the Comractors License Laws.).
❑ I em eaempt untlar sec. Business antl Professions Code tor this reeson:
Signeiure: Date:
Owner ID venflBC Dy driver5litense. ❑ Yes ❑ No Drivefs Ucen9e No.
Verlfication ol Ownership by (rype oi tlacumeni, i.e. - property tex bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFlCATION:
❑ I hereby certify Uet no exravetim INe (5) w more feet in depN into which e person Is required to tlescend, wlll be mede Im m�nectlon wit� work authodzed by Ihls
pertnit, antl Ihat no buildinq strudure, scaHoltll�, ffllsework, or demdltlon or dbmantling Ihereol, will �e more t�an Nlrty-siz (36) feet high. (C�ap. 32, Ory 2, Art 2, Sec.
341, Title 8, Califamla Administretive Cotle).
❑ As owner-bulltler, I will not employ enyone to do work which woultl requlre e petmil Irom ihe Oivislon of Indusirial Snlery, es nated ebove, unless auch pereon has e
pertnit ta do such work fram t�e division,
Slgnature: Date:
Divlsion ol Industdel Sefery Permit Num6er:
CERTIFlCATE OF COMPLIANCE AND AU7HORVA7ION OF EMRY: 1 cehity untler penalry of perjury that I have reed this epplication and state ihat Ihe infortnation given is
wrrect. I egree lo comply wi�h ell state lews end clry ordinances relaUng to building consiruCtion, and euthorize representetives ol Ihe Ciry of C0.5Ia Mese Io enier upon Ihe
ebove-described property for inspectiyp�uryoses. I egree not to acupy or ellow accupancy of eny building euthonzed by lhis permil until finel inspection.
COUE I. INSPECTONTYPE
1618
1268
200
201
202
203
204
Fixed System Final Fire Prevenllon
Pool Spa Finel
Flnal Re-Roof
FInaI8locWReteining Well
Final Fedory Fire Place
Flnel Sign
Finel Demolition
eeg u�s
COOE 1 INSiECTION TYPE
206 Finel MeChanlcal
20B Finel Plumbinp
210 Final Electrlcel
2/2 Finel Fire Preventlon
220 Finel Planning ApOrwal
222 Finel Site
250 FInalBuilding/Oaupenc
�
• In ' �r.�
(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.�a,4�LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
. tlU
Job /+ddress: 555 ANTON BL Status: �SSUED
Suite: 800 Applied: OB/22/2002
Vicinity: Issued: 10/09/2002
Parcel Number: 41050104
Applicant: SMITH, DONALD
Address:
Zoning:
Phone: 714-412-2580
Zip:
Owner: PWREF/MCGSOUTH COAST, LLC
Address 535 ANTON BL. ' �
COSTA MESA,CA � - , Phone:
SUITE 150 � � � Zip: 92626 �
Contractor: HOWARD BUILDING CORPORATION
Address: 3184 AIRWAV AVE ��
� . , � Phone: (714) 43&2272
COSTA MESA, CA
Zip: 92626 ' License: �-445804 �
Arch : PAUL MORFORD / IA, INTERIOR ARCHITECTS Eng:
Address: 3080 BRISTOL ST • Address:
STE 105 Phone: 714/754-1197 Phone:
COSTA MESA, CA - - .
Zip: 92626 � License: C19058 License:
SCOPE OF PERMIT
200 S.F. INTERIOR TENANT IMPROVEMENT ONLY. MODIFY EXISTING AREA SEPARATION WALLS AND EXISTING EXIT CORRIDOR. SUITE'
800'BMC SOFTWARE" ' � �
Plan Check: $99.61
Permit: $15325
SMIP Res: $0.00
SMIP Com: $1.65
Other: $0.00
Inspection: $0.00
Total: $254.51
� _._ -. , .
SETBACKS
�\-
MAIN STRUCTURE Front � 0- 0 ����� Rear_ �0- 0
\ :;
ACCESSORY Eront � 0- 0" �Rear 0. 0
PARKING ExisQna: __ o., ,' Reau red:� a
.. -'.-� � _. , ,
�
c
FEE SUMMARY
PLANNING 8 ZONING
Calc Valuation: g7,a3�so
Claim Valuation: 3�,soo.00
LeR 0. 0 _ Right
Left 0. 0 -� - - Right
Pr000sed: 0 �
0- 0
0- 0
NOTICE: The work authorized by this permit shall comply with all applicabls handicap access requirements under California statutes and related
regulations. (Orcl. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order tor ihe work authonzed under this permit to be considered legal, such work must comply vrith all applicable codes, and all
required Inspeetlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this permit.
il FOR INSPECTIONS CALL: (714) 7545626 —
zeauas �erao�
WORKERS'COMPENSAnON DECLARAnON: � �
I hereby attirm untler penalty of perjury one o� the following deciarations:
❑ I heva and will maintein a certificate of consent lo sell-Insure for workers' compensation, as provitletl for by section 3700 of the Labor Code, tor ihe peAormance of ihe
for which this pertnit Is issued.
�)f have antl will maintain workers' compensation insurance, as requiretl Dy sectlon 3700 of ihe Labor Code, for Ihe pedortnance of the work for which this pertnit is issued.
My work�e �°mp nsation urence carrier end poll umber re: O
Cerner.� �31Y\�. �. 1„S• �IMn� .P,Wicy.Number. l�%/3�.30Z
�(TYiis section nee0 not be completed i! t /py mrt � valu et one h dollars ($100) or less.)
❑ I certity t�at in ihe peAortnance ol �fie woM f hic this rmit I ssued, I shall not employ eny pereon in eny manner so as to become subject lo the workers'
compensation laws of Galifomi nd agre at it shoul bec e subiect to tha workers' compensation provislons of Section 37 of (he Lebor Code, I shall fon�with
comply with these pra ' /
AP�cant.Signaf"� ure:—� � .�ete: �� 9 4 Z
WARNIN(3: FAILURE TO SECURE ORKERS' CA E ERAGE IS UNLAWFUL AND SHr1LL SU&IECT AN EMPLOYER TO CiiIMIW1L PENALT S PNO GVIL FINES UP TOONE HUNDRED
TFIOUSAND DdlARE (5100,000�, N ADDITION TO THE COST OF CAMPENSATION, OAMAGES AS PROVIDED FOR IN SECiION 31W OF THE IABOR CODE, IMEREST, AND ATTORNEY'S FEES.
L49�iF93�Zd�PYi.7_GSiiL•b973�1I_1:L�\iC7�A
I here6y eNirm that I am licensed un rovisi s of Ch�te (commencing with Sec�ion 7000) ot Division 3 ot Ihe Business and Prolessions Code, and my license Is in full
fOm :8➢A:B1fBCL'.I:fG_0� Q � p s� � � �
Contra�g�: _�-w-. Date: �O 9 e L
i
CONSTRUCTION LENDING AGENCV:
❑ I hereby alfirm Ihat there is a construction lending agency for ihe peAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lendets Name: Lender's Address:
Signature: _
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aMirtn Ihat under penalry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e permit to constmct, alter, improve, demolish, or repair any sWCNre, ptlor to its issuance, also requires the applicant for such pertnit
to file e signed statement that he or she Is licensed pursuant to Ihe provisions of lha Contrectors License Lew (Chapter 9(commencing with Section 7000) of Divislon 3 of t�e
Business and Professions Cotle) or that he or she is exempt theretrom antl the basis for the alleged e:emption. Any violation oi Section 7031.5 by any applicant br a pertnit
su6jects the applicant to e civil penalry of not more ihan five hundred dallers ($500).):
❑ I, as owner of Ihe property, or my employees with wages as ihelr sola compensation, WILL DO THE WORK. an0 Ne siructure Is not intended or oHeretl ior sale (Sec.
7044, Business antl Professions Code: The Coniractors License Law tices no� apply to an owner ot property who builds or ImD�oves thereon, antl who does such work
himself or hereelf or ihrough his or her own employees, provided thet such improvemenis are not intendetl or oHered for sala. If, howaver, the builtling or Improvement is
sold within one year of completion, the owner-builder will have ihe burdan of proving that he or she ditl not builtl or improve for purpose of sale.).
❑ I, as ownar of lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does no[ appty to an owner ot property who builOs or Improves thereon, and who coniracts br such prolact wlth a conirador(s)
license pursuant to the Contracmrs License Laws.).
❑ I am eaempt under sec. Business entl Professions Code tor this reason:
Signature: � Date:
Owner ID veritied by tlriver's license. ❑ Ves ❑ No Driver's License No.
Verification of Ownership by (type of tlocument, i.e. - properry tax bill or dead):
Ezpires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity that no exwvation tive (5) or more feet in depih into which e person Is requiretl to tlescend, will be made in connection with work authonzed by Ihis
permit, end that no building simcture, scattoltling, falsework, or tlemolition or dismantling thereol, will he more �hen ihirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, SeC.
341, Ttle 8, California AdminislraWe Code).
❑ As owner-buiider, I will not employ anyone to tlo work which would require a permit irom Ihe Division of Intlustriel Satety, es noted ebove, unlass such person hes a
permit to tlo such work irom the division.
Signature: Date:
Division of Intluslrial Safety Permit Numbec
CER7IFlCATE OF COMPLIANCE AND AIJfMORVATON OF EMAY: I cehify under penalty ot peryury that I have reatl this ap0lication and state that the infortnation given is
wnect. I egree to comply wl�h ate ws entl city ortlinences relating to building construction, end authorize representatives of Ihe Ciry ol Costa Mesa to enter upon Ihe
ebove-described property nspection urposes. I egreeyWio'ofcupy or allow occupancy of any building authonzed by Ihis permit until tinal inspection.
COOEI, INSPECTIONTYPE
1816 Fized System Final Fire Prevention
1266 Pool Spa Final
200 Flnel R8-Rooi
201 Final BIocWReteining Well
202 Final Faciory Fire Place
203 Finel Sign
204 - Final Damolition
1711�
�
icmir��
oa
/O e�
'�'Date � —�
LOOE� INSiEttIONTYPE
206 Final MeChaniCal
20B Final Plumbing
210 Flnal ElecMcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
I'1\I�I:Ihll,l!+�
(714) 754-5273 • Faz (774) 754-4856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Viciniry:
555 ANTON BL
800
Parcel Nunmber: 41050104 "
Applicanl
Address:
Owner:
SMITH, DON
Phone: 714-43&2272
Zip:
PWREF/MCC-SOUTH COAST, LLC
Address 535ANTONBL.
COSTA MESA, CA
SUITE 150
Contractor.
Address:
ISSUE FEE
Temp service lest
Res. a/c package
New Res (1-2 uniLs)
New Res (3+uniLs)
Pool I Spa
Lighting Fixts
Recept OWets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a�
Service over 1000a
Motors to 1hp
Motors to tOhp
Motors to 50hp
Motors ro t00hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Phone:
Zip: 92626
HOWARD BUILDING CORPORATION
3184 AIRWAY AVE
COSTA MESA, CA
Phone: (714) 43&2272
Zip: 92626
License: 445804
Status: ISSUED
Applied: OB122/2002
Issued: 70/09I2002
�-I� �
i, _ ___
SCOPE OF PERMIT
ELECTRICAL TO INCLUDE: 2 LIGHTING FIXTURES (EXIT SIGNS) AND 3 SWITCHES. REF.:
B02-01349 "BMC SOFTWARE' SUITE 800
$23.50
ao.00
ao.00
ao.00
$0.00
ao.00
az.zo
E0.00
E3.30
$0.00
$0.00
ao.00
ao.00
ao.00
$0.00 .
ao.00
ao.00
$0.00
$0.00
$0.00 -
$0.00
ao.00
Quantity
0
0
0
2
0
3
0
0
0
0
0
0
0
0
0
0
0 '
0
0
FEE SUMMARY
Temp Dist System / Lighling
s�s�y noo n
Standing SecUon
Misc Electrical Equipment
T2nsfortners up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kvalkw
.................up to 100 kva/kw
..................over 100 kva/kw
LOw Volt2ge Equipment
Low Volt Wiring System / Ckt
Misc. Conduil
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or liqhts)
Christmas Tree Stand
Fireworks Stand
Other ElecVical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
ao.00 0
$0.00 0
$0.00 0
ao.00 0
ao.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
ao.00 0
$0.00 0
ao.00 0
ao.00 0
E0.00 0
$0.00 0
$0.00
$0.00
$0.00
ao.00
NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92Q8, § 7, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void il work is not commenced within 180 days, or il work is suspended or abandoned
for a period of 1B0 days.
INSPECTIONS: In order for the work authorized under ihis permlt to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectiona and final epprovel must be obtained. Failure to obtein inspectlons end final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
za.asre �aroo)
WORKERS'COMPENSAnON DECLARAnON: �
I �ereby etfirm under penalry of peQury one of tne lollowing dedarations:
i
❑ 1 heve and wlll melntain a certificate ol consent to selbinsure tor workers' compensetion, es provided br by section 3700 at the Lebor Code, for ihe pedortnance of the
r fOrwhiCht�Is�pBrmiti5luued.
I have end wlll melntpin workers' Compen98tlon insurencB, as required by sectlon 3700 of Ihe Lebor Cotle, for the peAortnence ol the work lor whiCli �hi5 pertnit is LsSuetl.
My wo r' co pensellon Insurence carner entl pq�py numDe ere:
Certler. �.L Policy Number: ��% %C� �� Z
(TNs sec0on need nof be complefed i! e pelmit ' a ue et one hundre o/a ($100) or /ess.)
❑ I cenity Ihet in Ihe peAormence a� theJ ork tor I ich s pe i s Issu , I shell no[ employ eny Dereon in eny mennar so es to becoma sub�ect to the workers'
compansation laws ol elllomia, Q e et il ould e e workers' compensetion provislons ot Section 3700 al e Le r Cade, I shall forthwlth
comply with these pro � '
WARNINOt FALURE TO SECURE / RKE0.5' COMP SATION COV GE IS UNUWFUL AND SHnLL SUBJECT AN EMPLODYER TO CFIMINAL P��ES M1D GVI� NfS UP TO WE HUN�RED
T/qU$ANDDOLLAFE�f/00,000), ADDITIONTO OF PENSATION,DAMAGESASPROVIDEDFORINSEGTION3]OBOFTHEIABORCOOE,INfEREST,ANDAITORNEY'SFEES.
LICENSED CONTRACTORS DECLAFATION:
I �ereby afllrm Ihat I am
lorce end ettect. Lic. M_
Comrectofs Slgnature:
CONSTRUCTION LENDINO AGENCY:
with Section 7000) ol Division 3 0l ihe Business tl Pratesslons Catle, entl my Ilcense Is in full
— CI855 k � / / _ _
❑ I here�y aNirm Ihet thero is e construction lending agency lor Ihe peAarmenca ot t�o work for which ihis permit is issued. (Sec. 3097, Civil Code�.
LontleYg Nama: LenUer's Atltlress:
SigneNre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby afllrtn that under penelty at per�ury ihat I am E%EMPT FROM THE CONTRAC70RS LICENSE LAW lor ihe following reason (Sec. 7031.5, Buslness entl Professians
Code: Any city or county which requires a permit to construct, elter, improve, demolis�, or repair eny structure, prlor lo its issuance, also requires lhe epplicant lar such pertnit
to tile e signed statement Ihet he or she is Ilcense0 pursuant to the proWslons of Ihe Contraaore License Lew (C�flpter 8(commencing wit� Sectlon 7000) of Division 3 of Me
Buslness and Pratesslons COAe) or ihet he or sha is esempt therefrwn end the basis for Ihe alleged exemption. Any violation of SecUon 7031.5 by eny appllcent for e patmit
sub�ects tho epplicent to e clvll penalry ot not more than live huntlreA dollars ($500).):
❑ I, es owner ol the properry, or my employees with wages es thelr sole compensetion, WILL DO TME WORK, an01�e siructure is not Intanded or otleretl for sale (Sec.
7044, Business entl Professions Code: Tha Contrectors License Law does not apply to an owner of properry w�o builds or ImO�a�es theraon, and who tlaes such work
himsetl or hersetl or through his or her own employeas, pmvided Nat such improvemenls ere nm Intended or oMeretl tor sele. If, �owever, the bulding or improvement Is
sold within one year o1 complo�ioq the owner-builtler will heve the burtlen ot pmvinp ihet he or she did not build or improve for purpose of sale.).
❑ I, as owner oi iha properry, em E%CLUSIVELY CONTRACTING WITX LICENSED CONTRACTORS to conslruct the D�alect (Sec. 7044, Business end Professions
Gode: The contreaors License Law tloes nat apply to an owner o1 property who Cullds or Improves ihereon, anC who contracts for suU project with a contraclor(s)
license pureuant to fhe Coniractors License Lews.).
❑ I em ezempt under sec. Business end Professions Coae tor this reeson:
Slgneture: Date:
Owner ID veniietl by tlrivers license. ❑ ves ❑ No Drivefs License No. Er.pires:
VeAficetlon of Ownership by (type ol dxument, i.e. - property taa blll or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereCy certlty t�at no excevetlon Me (5) or more feet in de0� �nto which e person is requlretl to tlescend, wlll he mede In connecUon with work euNodzeA by ihis
permit, end that no 6uilding struGure, scettolding, feLsework, or tlemolitlon or tlismeNling t�ereol, will be more then ihirry-six (38) faet high. (Chep. 32, Orp 2. An 2, Sec.
341, T1tle 8, Celitomie Atlminislraliva Cotle).
0 As owner-tuilder, I wlll not employ anyone lo do work which would reduire e pertnit Irom the Divlslon ol Industrlal Sefety, es natetl ebove, unless such person �es e
permlt to tla such work Irom tha diNsion.
Signalure: Dale:
Dlvlsion oi Industrlel Satery Permit Number:
CER7IFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certify under penalry ot perjury thet I heve reatl I�is epplication and stata that the infarmetlon given is
conect I egree to compty wlt laws end nry ances releting to Dullding construqion, end authodze representaiives of Ihe Ciry of Casta Mesa to enter upon fhe
above-tlescribetl property mspeMion u�oses. gree o� to occupy or ellow occupanty ot any building euthonzed 6y Ihis permii until final inspectlon.
CO�EI. INSiECTIONTYPE —
1878 Flxetl System Finel Fire Pravention
1268 Pool Spa Finfll
200 Flnal Re-Roo1
201 Flnal Block/Retaining Well
202 Final Fectory Fire Place
203 Finel Sipn
204 Finel Demditlon
Pdffi IIf�dLi
' �. :
CO�E� INSPECTONTYVE
208 Finel Mechenical
208 Finel Plumbing
210 Finel Electdcal
212 Finel Fire Prevention
220 Finel Planning Appravel
222 Finel Site
250 Final Bulltling�Occupenc
PATE N�LB
��,
(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
555 ANTON BL
876
Parcel Number: 41050110
Applicant: JUWONO, GOEFFREY
Address:
MECHANICAL PERMIT
Phone:
Zip:
Owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address: PARTNERSHIP ATTN JOE CRAWFORD
DENVER, CO . Phone:
1050 17TH SY #1220 Zip:
Contractor:
Address:
WESTERN ALLIED
12046 E FLORENCE AV
SANTA FE SPRINGS, CA
Phone: 562-944-6341
Zip: 90670
License: 198821
Status:
Applied:
Issuad:
ISSUED
10I30/2002
10/30/2002
SCOPE OF PERMIT
INSTALL 3 TON A/C UNIT TO SERVE A COMPUTER ROOM (PROCESS LOAD). UNIT 876'BORM
ASSOCIATE5��
ISSUE FEE
Inst FAU <100 k BTU'
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent.
Air Handlers < 10000cfm
Air Handlers > 10000cfm
Floor fumace
Floor or Suspend Heater
Quantity
$23.50
$0.00 0
$0.00 0 ,
$0.00 0
$0.00 0
$0.00 0
$0.00 0
ao.00" o
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 � -' 0 �
50.00 0
so.00 0
$0.00 ��0
$0.00 0 -
$0.00 0
50.00 : .0 .
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler .
Commercial I n cinerator
Domeslic Incinerator
Compressors / Absomtion Systems
Upto3hp/700kBTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15to30hp
30 l0 50 hp
Over 50 hp
Other Mechanical Fee
Inves6gation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCUTATED FEES
Quantiry
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$14.70 1
$0.00 0
50.00 0
S0.o0 0
50.00 0
$0.00 0
ao.00 0
50.00 0
50.00 0
$0.00 0
50.00
$0.00
30.00
$3820
NOTICE: 7he work authorized by thts permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
E%PIRATION: This permit s�all automatically expire and become void ii work is not commenced within 780 days, or ii work Is suspendad or abandoned
for a period of 1 BO days.
INSPECTIONS: In orUer for ihe vrork au�horized under this pertnit �o be Considered Iegal, Such work must comply with all epplicable cotles, and all
requlred inspectlons and Iinal epproval must be obtained. Failure to obtaln inspections and final approval will result in the expiration of lhis permit.
FOR INSPECTIONS CALL: (714) 754�5626
zsaaae�aroo�
WORKEHS' COMPENSATION DEC�ATION: — �
I hereDy effirtn under penalry ot peryVry one of the tollowing tlederetions:
❑ I heva entl wlll melntein e ceni���ete of wnsent to self-Insure tor workers' campensetion, es providetl lor by section 3700 at the Labor Code, for t�e pertortnence of the
woB tor which this permit is issued.
,�' I �ave end will maintein workers' compe�set�w� ��wrencs, es requlred by section 3700 of I�e Labor Code, for Ihe peAOrtnance oi tha work lor whkh IhLs pqrtnit is IssueE,
My workers' �com�p�en�sa�tl�on, Insurence carder antl policy number era:
Cercler. [�L//KG UO: � POIIcyNumber. C/UT� OO�O ^OU
(7h/s aecr/on need no( be completed i7 MeOermi(!s valued et one hunEred dd/ers (5100) or less.)
❑ I cartity that in Ne performancB of Ue work lar whicli ihls pemut is issueq I shall not employ eny person in eny manner so es to become 6uDject la Ihe workers'
compensatlon laws af Calilomla, enA egree that it I shoultl become sub�ect to Ihe workers' compensatlon proNsions ol Section 3700 0l Ihe LeDor Code, I shall foMwlth
compty wit� t�ese provLsions.
Applicent Slpnature: �—�—^---�r —" Date: ��� /OZ
W ARNINO: FAILUFE TO SECURE WIXiNERS� COMPENSAiION CBVEMGE IS UNLAWFLL AND $HALL SUBJECT AN EMPLOVER TO CRIMINN. PENALTIES AND CML FlNES UP TOONE HUN�RED
TKKISAND DOLURE (5100,000), W ADO�T�ON TOTME W5T OF CpAPEN3AT10N, OAMnGES AS PROVI�ED FOR IN SEC7IIXJ 3'lOe OF iHE IABOq CODE, IMEREST. ANO �TTORNEYS FEES.
LICENSED CONTRACTORS DECLAAATION:
I hereby nNirm thet I em licansetl untler provlslpns ol Chepter e(commencing with Saction 7000) o� Division 3 of tha Business and Protes lons Code, entl my license Is in full
brco end ettect. Lic. M �g�y/ Cluss x C l0 �G� `
Cantrnctors Slgnature: -� -- -� Date: �S�_3c�'%: Z
i
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHirm thet there is a cn�sWction IenEing egency tor t�e peAortnanco ol the work lor which this permit Is issued. (Sec. 3087, ChAI Cotle).
Lendefs Name: Lendefs AtlOress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby etlirtn Ihet under penelry ot perjury thet i flm EXEMPT FROM THE CONTRACTORS LICENSE LAW lar the following reeson (Sec. 7031.5, Business antl Prolessions
CoAe: Any clry or counry which requires a pertnit to construct, elter, improve, demolish, or repeir eny slructure, pnor lo Its Issuance, elm requires the applicam tor suc� pertnit
to Ble e signetl statement ihat he or she Is Ilcensetl purouant to Ihe provisions ot Ne Conirecton License Law (Chepter 9(commenGng wit� Sectlon 7000) of Divlsbn 3 ot tlre
Business end Prafessions Code) or ihat he or she is exempt Iheroirom an0 Ihe basis for Iho alleged exemption. Any violetlon of SecUon 7031.5 by eny epplicanl for e pertnit
subJects Ihe eppllcent to a civll penalry of noI more Ihen Iive huntlretl tlollers ($500).):
❑ I, es owner of the properry, or my employees wlth wages es their sole compensatlon, WILL DO THE WORK, and the structure is not IniendeC or otleretl for sale (Sec.
7044, Business end Professions Code: The ConlraIXors License Law does noI apply lo an owner of property who builtls or improves lhereon, end who tloes such work
himself or herselt or through his or her own employees, Provided Ihet such improvements ere not Intended or oflered for sele. II, howeveq the bullding or improvement is
sold within one year of wmple6on, the owner-6uilder will �ave �he burden of proving that he or she did not build or improve tor purpase o1 sale.).
❑ I, as owner of the property, am E%CLUSIVELV CONTRACTNG WI7T1 UCENSED CONTRACTORS Io consiruct the project (Sec. 7044, Business end Professions
Cotle: Ttie contractors License L.ew tloes not epply to en owner of property w�o Cuilds or Improves thereon, and who contrects �or such pro�ect wit� e contradw(s)
license pursuant to the ContraG�o�s Ucense Lews.�.
❑ I em exempt under sec. Business and Professions Code tor lhb reason:
Signeture: Date:
Owner ID verlfletl by drivers license. ❑ Yes ❑ No Drivefs License No.
VedlirnUon ol Ownership by (rype af tlocumen�, i.e. - property tax DIII or Eeed):
Expiras:
DIVISION OF INDUSTRIAL SAPETV PERMR CERTIFICATON:
❑ I hereGy cerlity ihat no excavatlon flve (5) or more feat in depth Into which e person Is requlred to descenq will ba metle in connedlon wit� work euthoAzed by ihls
pertnil, entl Ihet no huilding stN�ture, sceHdding, lalsework, or Cemolitlon or dismantlinp Ihoreoi, wlll 6e more Ihen Ihirry-sla (38) teel high. (C�ep. 3.2, Grp 2, Art 2, Sec.
341, Tille B, Calilamla Adminis/retive Catle).
❑ As ownervbuiltler, I will not emp�oy enyone to do work which would require e permlt tmm t�e Division oi Intlustdel Setery, es notetl ebove, unless such person has e
permll to Eo such work tram iha dMslan.
SignaNre: Da�e:
DlWslon oi Industdal Satery Permit Number.
CEHTIFlCATE OF COMPUANCE AND AUTHORQATON OF ENiAY: I certity under penelry of perjury lha� I have read Nis flpplication end state thal Ne InfortnaUon given Is
wrrecL I egree to compty wit� all st61e laws entl city ortlinances relatlng m bulltling conslruction, anA eut�odze representeWes of Ihe Ciry ai Coste Mese to enter upon Ihe
ebove-descnbed property for inspeMion purposes. I egrea not lo occupy or ellow accupency oi any builOing eulhorizetl by Uis permit until tinel inspecUon.
Signature Of L el� Owner(s)_ Date
�— i�/3o /o z
And/OrAuihorized AppllcBnl Date
cooe �. INSPECTIONTYPE
1818 Fixetl System Final Fire Pre�entlon
1288 Pool Spa Finel
200 Flnal Re-Rooi
201 Flnal BIocWRetalning Well
202 Final Feciory Fire Place
203 Final Sign
204 Final Demoli�ion
QAg �L8
�QQ� INSPECTIONTYVE
206 Flnel Mec�anical
20B Finel Plumbing
210 Flnel Elec�ricel
212 Flnel Fire Preventlon
220 Final Plenning Approval
222 Finel Site
250 Finel Bulldina/Occuoen<
� I' I O:i �
pia� �sa-s2�a • Fa: (»a� �sa•aass
JobAddress: 555 ANTON BL
Suite: 8
Vitinily: • ' , ', •
Parcel Number: 41050110
, CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
Applicant: MICHAEL WILLEY
Address: 18001 COWAN #A
IRVINE, GA . '
Owner: SAKIOKA FARMS
Address , � � �
Contractor: ASSI SECURITY
Address: 18001 COWAN #A
FIRE SUPRESSION PERMIT .
Zoning:
Phone: (949)955-0244 �
Zip: 92614 -
Phone:
Zip: 94137
�
i'
NUMBER
' ' � . 1 - .,L .,..-.
T7 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/20/2000
`• . - ; Issued: OS/12/2000
ISSUED BY: �./� ry �/
. Phone: (949)9550244
IRVWE, GA � Zip: . 92674 . .
- � . -License: 683831 -
SCOPE OF PERMIT
' PROVIDE AND INSTALL LOW VOLTAGE CARD ACCESS SYSTEM. INCLUDES LOCKING OF ELEVATOR
LOBBY DOORS TO BE CONNECTED 70 LIFE SAFETY SYSTEM.
REF:B00-00261
Plan Check: $63.21
Permit: $97.25
Other: $0.00
Total: $160.Q6
FEE SUMMARY
6
Calc Valuation: sa,000.00
Claimed Valuation: sa,000.00
NOTICE: The work aulhorized by this permit shall compty with all appiiceble handicap access requiremerrts under Califomia statutes and related
regulations. (Ord. No. 92-28, § t, 72•21•92)
EXPIRATION: This permit shell automaticalty expire and become void if work is not�commenced within 180 deys, or if vrork is suspended or abandoned
tor e period of 180 days.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply wfih ali applicable codes, and ail
requlred Inspectlona end flnel epproval must be obtained. Feilura to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) i54-5628 �
WORKERS' COMPENSATON DECL.AFiAnON: �, "
I hereDy aHirm untler penelry of perjury one o1 the tollowing tledaretlons:
❑' I have and will maintain e certilkate ot oonsem ro self-Insure tor warkers' compensetlan, es provitletl far Dy section 3700 ot tha Lebor Cade, lor the peAormance ol Ne
rk lor whlch Ihis pertnit is issued.
I hava entl will maintein workers' canpensation insuranca, as requiratl by section 3700 of the Lebor Code, for Ne peAortnance of tha work fa which Nis pertnit Is issuaA.
My,workars' mmpensatlon Insurance carner end poli number ere: . �+ �j �(
Carrier: � �71 Di� ���L��1 � � • Policy Number: �_WCi2 � [..'T � � ��
(Thls section need no( be wmplefed 1! Ibe peimit Is ve/ued et one huntlred tlollers ($100J or less.)
e�y ��et In I�e perlormance of ihe work tor which Ihis pertnit is issuetl, I shell not employ eny parson in eny manner so es to become subJect to the workers'
c p nsatlon laws of Calllamia, and agrp that tl I sh uld be ub�ecl to ihe workers' compensetlon provisions o1 Section 3700 ot t�e Lebor Code, I shall torthwith
comply with ihese provis' ns.
� Applicenl Slgneture: - Daie: � �� �' ��
WARNING: FAILURE TO SECURE WORI(E8S' ENSATON UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND qVIL FlNES UP TOONE HUN�RED
THOUSANDDOILARE(5100,000),INADDITIIXJTOTNECOSTO PE ATION,DAMAGESASPROVIDEDFORINSECTION390BOFTHELABORCA�E,IIJrEREST,ANDATTORNEV'SFEES.
LICENSED CONTFiAC70RS DECLARA710N:
I hereby eflirm thet I am
+orce ana enec�. uc. » _
CantracroYs SigneWre:
CONSTRUC710N LENDING AGENCV:
❑ I hereby eflirm Ihet t�ere is e cons'
Lendels Name: �
Signaiure:
OWNER-BUILDER DECLARA710NS:
9(commencing with Sectlon 7000) of DlNsion 3 of t�e, Business enC P fesslons Cotle, and my IiCense is in tull
ae:g» G? � Gl4
' Date: �l� T�
pedortnance oi t�e work for wNch Ihis permll Is issuetl. (Sec. 3097, CMI Code).
Lendef s Address:
Date:
I hereby atfirm thet unGer penelry of perJury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Buslness end Professions
Code: Any ciry or county which requires a pertnit to consWct, elter, impmve, demolish, or repair eny strucWre, pnor to Its issuance, also requires Ihe epplicant for such permlt
to Hle a signetl stetemeN that he or she Is Iicensed pursuant to [he provisiow ol Ihe Contreciors Llcense Lew (Chepter 9(commencing wiih Sectian 7000) of DiWsion 3 of Ne
Business antl Pmtessions CoCe) or lhat he or she is eaempt therefram antl the besis br the elleged eaemD�ion. Any vlolation of Section 7031.5 by eny epplicant tor e permll
sub�ecis Ihe appllcant to e clNl penalry ol not more than five hundred dollars (5500).):
❑ I, es owner o11he property, or my amployees wlth wages as their sole compensetlon, WILL DO THE WOqK, antl the structure Is not intended or otteretl for sele (Sec.
7044, Business entl Professions Gotle: The Cantrectors License Lew does not apply to en owner ot propeny who 6uilds or improves theroon, end w�o tloes such work
himseli or hereelt or through �is or her own employees, providetl Nat such improvements ere not intendetl or oHared for sale. If, however, the building or Impmvemem is
sold withln one year o� completlon, the ownerbullder will heve the burUen of pmving that he or she did not builtl or improve for purpase of saleJ.
❑ I, as owner oi lhe property, em EXCWSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct ihe pwject (Sec. 7044, Bu5in855 and Prota551on5
Cotle: The contractors Llcense Lew does not apply to en owner of properry who huilds or Improves ihareon, end who croniracts for such pmject wlth a contrector(5)
license pursuant to the Contractors License Wws.).
❑ I am exempi under sac.
Signeture:
Owner ID venfietl by tlriveYs Ilcense. ❑ Yes ❑ No
Buslness antl Professions Cotle tor this reeson:
Vedflcetlon ot Ownership by (rype oi document, i.e. - pmperry tex blll or deed):
Ddver9 LlcenSe No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICA710N:
❑ I hereby tertity that no ezcavatirn iNa (5) or more teet in tle01h �nto w�ich e person is repulreO to tlescend, will be made in connection wit� work euthoAzetl by thLq
permii, entl thal no bulltling siructure, scattdding, falsework, or demolilion or dlsmanlling Ihereot, wlll be more than thirry-s�C (38) feet hlgh. (Chap. 32, Grp 2, Art 2, Sec.
347, Title B, Gellfomla Atlminisirfl�Ne CoOa).
❑ As owner-bullder, I will not employ enyone to tlo work whic� woultl requlre a permil trom the Division ot Indusinal Salery, es noted ebova, unless suc� percon has e
permit to Oo such work Irom Ne tlivision.
SignaWre: Date:
Divislon of Induslnal Safary Pertnit Number.
CER7IFICATE OF COMPLIANCE AND AUTHORQATION OF ENTAY: I Certily under penelly ot perjury Ihet I heve read this application ana state Ihal ihe intormetion givan is
correcL I agree to comply with all stete laws end ciry ordinances relatinp to bullding construction, end euthorize rapresentatives ot Iha City of Cos1e Mesa to enter upon the
ebova-descdbed propeny tor Inspection purposes. l agree not to occupy or ellow occupancy ol eny �ulltling euthorized by this permit untll ilnel Inspectlon.
COpE �, INSiECiIONTYPE �
1618 FixoC System F al Fire P
1268 Pod Spe Flnal
200 Finel Re-Roof
201 Finel BIocWRetelning Weli
202 Finel Factory Fire Place
203 Finel Slgn
204 Final Demdition
2a4&a8
�g
Dete
� � O�
�� Date
��$ 4Qp�( INSVECTIONTYPE
208 Finel MeChanical
208 Finel PlumDing
210 Final ElecMcal
212 Final Fire Prevention
220 Final Plenning Approval
222 Final Siie
250 Finel Builtling/Occupancy
�g �
:\ ,.
(714) 754-5273 • Fax (714) 754-4856
.� CITY OF COSTA MESA _
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
t.:.'
ELECTRICAL PERMIT
Job Address: 555 ANTON BL
Suite No 8
Vicinity: BTH FLOOR
Parcel Nunmber:
Applicank
Address:
Owner:
Address
41050110 .
FULFORD,TERRY
8749 SHIRLEY AV
NORTHRIDGE, CA
SAKIOKA FARMS
Contractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
Phone: (818) 407•1986
Zip: 91324 ,
Phone:
Zip: 94137
Phone: (818)407-1986
Zip: 91324
License: 386619
NUMBER
,, ,
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 03I30/2000
Issued: 03/30l2000
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR OFFICE T.I. FOR "BMC SOFNJARE" (BTH FLOOR). INSTALL 394 LIGHT
FIXTURES, 203 RECEPTACLE OUTLETS, 121 SWITCHES, 22 NON-RES APPL, 92 COMMUNICATION
DROPS, & 1 CIRCUIT FOR MODULAR PARTIYIONS.
REF: 800.00261
ISSUE FEE
Temp servica test
Res. a/c package
New Res (1-2 unils)
New Res (3+units)
Pool / Spa
Lighting Fixts �
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t 000a
Service over t000a
Motors to 1 hp
Motors to tOhp
Motors l0 50hp
Motors to t00hp �
Morors over 100hp
E23.50
50.00
$0.00
$0.00
50.00
50.00
$293.02
$153.59
893.73
$104.50
$0.00
$0.00
$0.00
30.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
394
203
121
22
0
0
0
0
0
0
0
0
0
FEE SUMMARY
7emp Dist System I Lighting
Busway/100 R
Standing Section
Misc E�edriwl Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Voll wring System I Ckl
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lighls)
ChrisVnas Tree Stand
Fireworks Stand
Other Eledrical Fee
Quantity
50.00 0
50.00 0
ao.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
81820 1
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and refated
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: This permit shall automatically expire end become void if work is no4commenced within 180 days, or it work is suspended or abandoned
for a penod at 180 days. .
INSPECTIONS: In order for the work authorized under ihis permi� to be considered legal, such work must comply with all applicable codes, and all
requlred Inapecliona end (Inel approval must be obtained. Feilure to obtain inspections and final approval will result in the ezpiretion of this pertnit.
FOR INSPECTIONS CALL: (714) 7545628 �
�
WORKERS'COMPENSAnON DECLARArON: ��
I hereby eMirtn under penalry of perjury one af Ne Idbwirp tleGaratlons:
� 1 heve end wlll maintain a cerlificata ol consent to selt-Insure tor workers' wmpensation, as provitled for by sectlon 3700 of the Labor Code, br Ihe petlormance ol t�e
�/ work lor which this pertnit is issuetl.
NJ I have entl will maintein workers' compensation insurenca, az requiretl by section�3700 of ihe Lebor Code, for ihe peAortnanca of Ne work for which Ihis pertnit Is issueA.
My workers' compensation Insurence caMer end poliq number are: �,. /^ ���! "��
carner. 111.1 t'(�.F �C� I PL �911 Q�j jC.F Policy Num6er: YU K ro
(TM1Is secNon need not be completed U the permlf Is veluetl e! one hundred dWlers ($700) or /ess.)
❑ I cetlity thel in the pedormence of the wo lor whlch this pertnit is issued, I shell not employ any porson in any manner so as to become suEjoct to Ihe workers'
compensetian laws ot Celifo ' end e �at it I shoul0 become sub�ect to the workers' compensetlon provislons oi Section 3700 of ihe Lebor Code, I shell forthwith
comply wlth t�eso proNsl
Applicen� Slgnelure: De�e: � �v ^��
WARNING:FFILURETOSEGUREWO CERS' SATIONODVEMOEISUNIAWFULANDSMALLSU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFlNESUPTOONEMUNOFED
TIKKISAND OOLURE (5100,000), IN ADDITION E CAST OF COMPENSATION, DMIFGES AS PROVIOED FOR IN SECfION 31080F THE U80R ODOE, INTEREST, M'D ATTOFiNEYS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aHlrtn Ihal I em Ilcensed und Nsl
lorce end ettecl. lic. a �����
ContrectoYa Signature:�
CONSTRUCTON LENDING AGENCV:
ol Chepter 9(commencing with Secllon 7000) ol Divlslan 3 ot Ihe Busineu and Protesslons Coda, antl my license ISIn tull
Glass N �-/�
�/ oate: 3-30. oe�
❑ I �ereby affirm thet Ihere is a consWction lendinq epency tor Ihe petlortnance ol iha work lor which Ihis permit is Issuetl. (Sec. 3097, Civil Code).
Londers Nema: LentleYs Atltlress:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby elfirtn thet under penalry ot perjury �hat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor lhe lollowing reason (Sec. 7031.5, Business entl Prolessions
Code: Any ciry or counry whlch requires e pertnit to construct, elter, improva, demolish, or repair any sWCWre, prior to Its Issuance, elso requires the applicaN lor such permit
to file a slgnetl statemenl ihat ha or she is Iicensed pursuent lo the prwlsions af the Comracrors License Lew (C�apter 9(commendng wlih Section 7000) ot Division 3 oi t�e
Business antl Profeuions Catle) or that he or she is e:empt therelrom and the besis tor the elleged exemptlon. Any violatlon of Sectlon 7031.5 by eny epplicant tor e permit
sub�ects the epplicent to e civil penalry of nol more than liva hundretl tloilars ($500).):
❑ I, as owner af the property, or my employrees with wapes es Ihelr sole compensation, WILL DO THE WORK, enC ihe structure is not intended or oHeretl for sale (Sec.
7064, Business end Pmtessions Code: The Contreaors License Lew tlaes not eppy to an owner ol property who Oulltls or impmves thereon, antl who tloes such work
�imseN or herself or through his or her own employees, provitled ihat such improvements are nat intended or oNeretl for sale. If, however, t�e building or ImpmvemeN is
soltl within one year of completion, the owner-buil0er will heve t�e hurden oi provin9 that he or she did not build or improve tor purpose of sale.).
❑ I, es owner of the property, am EXCWSIVELV CONTAACTING WITH LICENSED CON7RACTORS to construd Ihe pro�ea (Sec. 7044, Business antl Professions
Cotle: Tha contredors License Lew does not eppy to an owner oi Oroperty who Dulltls or improves thereon, end who comraqs for such project with e contrecror(s)
license pu�suent to Ihe Coniractors License Lews.).
❑ I am exempt under sec. Business and Professions Cotle for ��is reason:
Signature: Date:
Ownor ID verified by dnvef5 Ilcense. ❑ Ye5 ❑ No Driver's License No. E:pire9:
Verificatlon of Ownership by (type of tlocument, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON:
❑ I hereby cently that no excavation live (5) or mare Ieei In tlepih into whic� a perwn Is requlratl to descend, will be mede In connection with work euNOAzed by thls
perml6 entl Ihat no building structure, sceHolAing, felsework, or EomWipon or dismantling I�ereot, will ba more than thirry-six (36) leet high. (Chap, 32. Gry 2, A� 2, Sec.
341, Title 8, Celifomle AtlministratNa Cotle).
❑ As owner-builtler, I will not employ enyone to do wark which woultl requlre a permlt Irom the Division of Intlustrinl Safery, as noted ebove, unless wch person has a
permlt to tlo such work trom the d'Msion.
Signature: Oate:
DlWsion at Industriel Safety Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORPATION OF EMAY: I certify under penelry of per�ury Ihal I �eve reetl ihis epP�ication antl slate that tha intorma�ion given is
correct I agree to compty with all sWte laws and dty orCinances relating ro building construction, end euthodze representatives ot ihe Ciry ot Coste Mesa to enier upon the
ebove-tlescdbetl property for inspection puryoses. I agree rwt Io oaupy or ellow occupan�y ot eny builtling eut�odzed Dy this pertnit until tinal Inspection.
CODE �. INSPELTIONTYVE
1618 Fl:otl System Finel Fire Prevention
1268 Pool Spe Final
200 Final Re-Raol
201 FIneI BIocWRetelnlnp Wall
202 Final Fectory Fire Plece
203 Finel Sign
204 Final DemWition
214fii6
..�-3m , oc�
oate
Qd¢, �$ �QyEj INSPECTONTYVE
206 Finel Mochenical
20B Final Plumbing
210 Finel Electrlcal
212 Finel Fire Preventlon
220 Flnal Plenning Apprwel
222 Final Sl�e
250 Flnal Builtling/OauDanty
PSIE
i ��
Ui7ID�4S
_ y,��'
� •�:-::_ ; :
� , :
�»a� �sa-s2�s • Fax pia� �sa-aess
. �
. CITY OF COSTA MESA ��.._/
BI/ILDING DIV/SION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
JobAddress: 555 ANTON BL
Suite No 8
Vcinity:
Parcel Nunmber: 41050710
Applicant: DON STEVENS
Address: 7940 GARDENA
GLENDALE,CA
owner. SAKIOKA FARMS
i � �
Address
Contractor: MUIR-CHASE PLUMBING
Address: 1940 GARDENA ,
!
' GLENDALE,CA
Arch I Eng : .
Address:
SOFf WARE.
REF:B00-00261
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drein, Floor
Orain, Rainwater
Drain, Roof
Drinking Fountain �
Expansion Tank
PLUMBING PERMIT
Phone: (818)500-194Q
Zip: 91204
Phona:
Zip: 94137
Phone: (818) 500.7940
Zip: 91204
License: 539835
Phone:
Zip:
License:
NUMBER
P00-00156
77 FAIR ORIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 03/292000
Issued: 03I29/2000
SCOPE OF PERMIT
2 FlOOR SINKS, t KITCHEN SINK, 1 WATER HTR, 1 COFFE/ICE MAKER CONNECTION FOR BMC
AMT
$23.50
$0.00
50.00
50.00
$0.00
$19.60
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
FEE SUMMARY
QTY AMT
Laundry Tub / Washer $0.00
0 Landscape Irrigation $0.00,
0 P-Trap $0.00
0 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
2 Receptors $0.00
0 Septic Tank $0.00
0 Sewer Cap tor Demo $0.00
0 Sewer Connect $0.00
0 Sewer Private Line 50.00
0 Shower $0.00
0 Sink, bar $0.00
0 Sink, wmmercial $0.00
Qrr
0
0
0
0
0
0
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(7-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toileq
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
AMT
50.00
Eo.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
812.30
50.00
$0.00
Qn
0
0
0
0
0
0
0
0
0
0
1
0
0
NOTICE: The work authorized by this permit shall compty with all epplicable handicap eccess requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 7, 12•21•92)
EXPIRATION: This permit shall automaticalty expire and become void if work is not�commenced within 180 days, or if work is suspemfed or abandoned
for a period of 180 deys.
INSPECTIONS: In order lor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inepectlone end flnel epproval must be obtained. Feilura to ob�ain inspeclions and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628 /
WORKERS'COMPENSAnON DECLARAnON: '
I hereby ettirm under penelry oi perjury one ot Ne lollowing tledarations:
❑ I heve antl wlll mainteln e certfticata af consent to selFlnsure br workers' compensation, es proviCed for by sectlon 3700 0l the Lebor Cotle, for the pertortnance of iha
work tor which this pertnit is issued.
� I heva entl vn0 malntain wwkers' mmpensaUon Insurence, es requlretl by seclian 3700 of ihe Labor Code, for Ne peAortnance o1 Ihe work tw wh�h this pertnit is issuetl.
My workero' compensation Insurence carrier end policy number ere: .
Carder: �7�'�UN� . PolicyNumber: �0�0�3���0 '�O
❑ I cenify Ihet In the pedormance of the work for which this pertnit Is Issued, I shell not employ eny parson in eny menner so as to become subject to the workers'
compensation laws ol Califomia, antl agree that il I should become sub�ect to the workers' compensetion provislons of Sectlon 3700 of Ihe LeDor Code, I shall torthwith
comply wit� t�ese Orovi ���
ApplicentSignetura: �-ti_ —�r Dete: 3 "Z �—(`�d
WARNING: FAILURE TO SEWRE WORKERS' COMPENSATION COVEfU�E IS UM.AWiUL AND SHALL SIIBIECT Ml EMPLOYER TO CRIMI W1L PEWILTIES AND qVIL FlNES UP TO ONE NUNDRED
TMWSlWO DOLLARE (5100,000�, IN ADDfTION TO THE �ST OF CpAVEN$ATION, DAMAGES AS PROVIDED WR IN SEGTIIXJ 3]OB OF THE IABOR CODE, IMEFEST, AND ATfOHNEYS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aHirm tha� 1 am Iicensetl unCer rovisions of Chepter 9(oommendng wlih Section 7000) of Dhrision 3 ot Ihe Business antl Pratesslons CoAe, end my Iicense is in full
lorce entl eHect Lic. a 3�� ��� Class a (�—'�J �(f
Comrectofs SlpneWre: • i- ��v—�— Date: A^ 3! �O 0
\ �1�
CONSTRUCTION LENDING AGENCY:
❑ I horohy eflirtn thet Ihere is a conswctlon lending egenry lor the pedormence oi t�e work br w�ich Ihis pertnit Is issued. (Soc. 3097. CMI Code).
Lender's Neme: Lontlels Adtlress:
Signaturo:
Date:
OWNER-BUILDER DECLARATIONS:
I �ereDy eHirm that under penalry of perjury thal I am EXEMP7 FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or county which requires a pertni� to consWc�, alter, improve, demolish, or repair any sWCNre, prior to its issuence, also requires the eppliwnt tor such permit
to file e slgned statement that he or she is licensed pursuant ro the provlslans ot the Comwctors License Law (Chepter 9(commencing with Section 7000) of Division 3 of Ihe
Business end Professlons CaAe) or thet he or she is exempt I�erefrom and Ihe basis for the ellegeG e:emption. Any violation of Sectlon 7037.5 6y eny epplicant for a Dermit
sub)ects the apP����< <o e civil penalty o1 noi more than frve huntlreC ddlars (5500).):
❑ I, es owner af the property. or my employees with wages as their sde compensation, WILL DO THE WORK, and Ihe siructure is not intentletl or offered for sale (Sec.
7044, Business antl Professions Cotle: The Contrectors License Lew Coes not appty to en owner of property who builAs or Improves t�ereon, end who tlaes such work
himsetl or herself or Nrough his or her own employees, provided Ihat such improvements are not intended or ottered far sale. If, however. Ihe building or improvement is
soltl within one year ot completion, �he owner-Duilder wlll �eve the burden of proving that he or she ditl not builtl or Imprwe for purpose of sale.).
❑ I, as owner oi the property, am EXCLUSIVELY CONTAACTING WfTtl LICENSED CONTRAC70RS to cronstruct the pro�ect (Sec. 7040, Business antl Pmfessions
Catle: The contractors License Law tloes not apply ta en owner ot property who bullds or imprwes thereon, and who contrecls tor such prqect with a contracbr(sJ
license pursuant to ihe Contractors License LewsJ.
❑ I am exempl under sec. Business entl Professions Cada tor this reason:
SigneWre: Date:
Owner ID verified by dnvers licensa. ❑ Ves ❑ Na Dnvefs License No.
Veritication of Ownership by (rype ot tlocument, i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Eapires:
❑ I he�eby canity Ihet no ezcavetion flve (5) or more feet In Cepth into which e person Is required ro descena, wlll be metle in connectlon wlth work authorized 6y this
pertnit, entl �hat no Duiltling s�ructure, swffolCing, falsework, or tlemolition ar dismantling thereol, will De more then �hirty-six (38) leet hiph. (Chap. 3.2, Grp 2, An 2, Sec.
341, 71tla 8, Callfomia Administrative Cade).
❑ As owner-Dulltler, I wlll not employ anyone to do work which would roQuire e permit Irom Ihe Dlvision of Industrlel Safery, as notetl above, unleu such person has a
permil to Eo such work from the tlivision.
Signeture: Date:
Divlsion ol Industrial Selety Permit Number:
CER7IFICATE OF COMPLIANCE AND AIJfHOROATON OF EMAY: I ceM1ify untler penfllry oi perjury that I have read Ihis appliwtion antl sWte Ihat the infortnation given is
correcL I egrae to comply wlih all slate laws end Gry ordinances relaNng to builtlinp construction, and authodze represematives oi the City ol CaSta Mesa to enter upon the
ebova-Aescribetl propeny for inspection purpases. I egree not to occupy or allow occupency oi any builtling euthorized by this permit until Ilnal inspectian.
aNre Of Legal Owner�s) Dete
��•` i—�.�.— � --2 � —f�CJ
' AnNOrAuthorizedApplicent Date
['�•]�]31�RF19t�i161:i�YJ�
1618 Fixed System Finel Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Flnal BIocWReteining well
202 Finel Fectory Fire Plece
203 Flnel Sign
204 Finel Demdition
z+ae-.8
QAIE
s
�$ �� INSPECTIONTYVE
208 Final Met�enical
20B Finel Plumbing
210 Finel Eleciricel
212 Final Fire Preventlon
220 Final Planning Approvel
222 Final Site
250 Final Building�Occupenry
PAIE It�LS
�� .. r� 7,,_
(714)754-5273 • Fex(714)754-4856
Jobnddress: 555 ANTON BL
Suite: 8
Vicinity:
ParcelNumber: 41050110
CITY OF COSTA MESA _.
BUILDING DIYISION.
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
FIRE SUPRESSION PERMIT
Zoning:
npp�icant LORI LOPEZ �
Address: 2505 MIRA MAR �
CA Phone: (562) 498-6444
LONG BEACH � � Zip: 90815 .
Owner. i .SAKIOKA FARMS' -� "� • " " � � .
Address. �/�. . � _ -
. - ' � Phone:
, � � - Zip: 94137
,. �/ --'
Contractor CAL PROTECTION
77 FAIR DRIVE, COSTA MESA, CA 92626
StaWs: ISSUED
' Applied: 03/29/2000
Issued: 04/27/2000
ISSUED BY: � / Y /
., Address: 2505 MIRA MAR
' - Phone:� � (562) 498-6444 . � � �
. ,LONG BEACH, CA � ; • Qip: � � � 90815 � : ' ' , �
� - � " � ' • , � �Cicense: 327196 � .
�. ,
� � J SCOPE OF PERMIT
INSTALL FIRE ALARM SYSTEM FOR BMC SOFTWARE. --
REF:806-00281 �. � � -' .. ,� �� � , .
' Plan Check: ' $333.42
Permit: $512.95
' Ofher:. '' $0.00
Total: $846.37
- FEE SUMMARY
� � - —
,�� - . !.�_ �
- — ,
�
Calc Valuation: Sss,no.so
Claimed Valuation: Sss,i�o.so
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 7, 7241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not�commenced within 180 days, or if work is suspended or a6andoned
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
requlred inapectlons and Hnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this parmit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS'COMPENSAnON DECLARAnON: .
I hereby aftirm untler penalry oi perjury one of the following declarations:
❑ 1 have and will meintain a certiticate ot consenl to self-Insure for workers' compensatlon, es pmvided tor by saction 3700 of the Labor Cotla, for the peAormance of ihe
I work for which Ihis parmit is issuetl.
y` I have and wiil maintain worker ' compensat' insurance, as qmretl by section 3700 W the Lebor Cotle, for the pertortnance ot the work for which Ihis pertnit is issued.
My workers' campe a n Insu n�carrier poli numb are: . �t A�O, �Q
Gerrier: L PolicyNumber. —� �
(This section need not 6e complet il the permit is valued af one hundre ollars ($100) or less.)
❑ I ceniy ihat in the peA ance of the ork for h h ihi ertnit is issuetl, I shall not employ any person in any manner so es to become subject to iha workere'
compensation laws ot Celi nie, and ag e th t if s Id b ome subJect to the workers' compensation pmvisions of Section 3700 of th Labor Code, I shall fotlhwith
comply wiih these provisions.
Applicant SlgnaNre: Date: ��� � W
WAFNING: FAILURE TO SEGURE WORKERS' COMPENS COVERAGE IS UNLAWFUL AND SHALL Sl1BIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLL4RE ($100,000), IN AODITION TOTME COST OF COMPENSATION, OAMA6E$ AS PROVIOEO FOF IN SEGTIIXJ 3]Ofi OF THE LABOR Cq�E. INTEREST, ANO ATTORNEY'S FEES.
LICENSED CON7RACTORS O CLARATIi)N: (�
I hereby aflirm Ihat I am licensetl er pr�visiop� off� epte (c rii �ncing with Section 7000) of Division 3 oi the Business and Profe�siopy Code, and my license is in full
forceentlettectLic.a 3`Z `1�`1 Classu G�QI�-lb
Contrector's SignaWre: i Data 2�' -
CONSTRUCTION LENDING AGENCY:
❑ I hareby aflirm ihal lhere is a constmclion lending egency for the performance ot the work for which this permii is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lendefs Address:
Signature: Date:
OWNEFi-BUILDER DECLARATIONS:
I hereby affirm ihat under penalry of perjury ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sac. 7031.5, Business antl Protessions
Code: Any city or county which requires a permit to consimc�, alter, improva, demolish, or repair any simcture, prior ro its issuance, also requires the applicant for such permit
to tile e signed stetement Ihat he or she is licensetl pureuant to the provisions ot the Con�ractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 oi the
Business and Professions Cotle) or that he or she is exempt therefrom and the basis tor the alleged exemption. Any violation of Sedion 7031.5 by any applicant for a permit
subJects the applicant to a civil penalry ol not more ihen tive hundred dollers ($500).):
❑ I, as owner of Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the siructure is not intended or oflaretl for sale (Sec.
7044, Business end Protessions Code: The CONractors License Law does not apply to an owner of pmperry who builds or improves t�ereon, and who tloes such work
himselt or herself or through his or her own employees, provided ihat such Improvemenls are not intentled or offered for sale. If, however, the building or improvement is
sold within one year ot completlon, the owner-builder will have ihe burden of proving (het he or she ditl not build or improve for purpose of sale.).
❑ I, as owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Pmfasslons
Code: The coniractors License Law tloes not apply to an owner of propeny who builds or improves thereon, and who contrects for such pmject with a coniractor(s)
license pursuant to the Contractors License LewsJ.
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by dnvefs license. ❑ Yes ❑ No Driver5 License No.
Verification of Ownership by (type of dxument, i.e. - property tau bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Expires:
❑ I hereby certity ihat no excavatlon five (5) or more feet in depth inro w�ich a person is required to descend, will be meda In connection with work authonzed by ihis
permi�, and ihat no 6uilding stmcture, scaflolding, felsework, or demolition or tlismantling thereof, will be more than Ihirty-siz (36) ieat high. (Chap. 32, Grp 2, Art 2, Sec.
341, T�le 8, Calitomia Administrativa Code).
❑ As owner-builder, I wili not employ anyone to do work which would require e parmit irom ihe Division ol Indusiriel Safery, as noted above, unless such person has a
pertnit ta do such work from ihe division.
Signature: Date:
Division of Industriel Safety Permit Number:
CER'i1FICATE OF COMPLIANCE AND AUTNORIZATION OF ENTRY: I certify under penalry of perjury that I have reatl Ihis application and state that ihe intormation given is
correct. I agree b comply with all state lews and city ordinances relating to building construction, and authonze representatives ot the Ciry of Costa Mesa to enter upon Ihe
above-descnbed � erty for inspection puryoses. ree not to occupy or allow occupancy oi any bulldinq authonzetl by this permit until final inspection.
ignawreOlL g 10 er • R pl2.f;a��
� "�� f�
Or Autho he " nt Date
CODE M. MSPECTIONTYPE QpTg INTITIALS
1616 Fized System Finel Fire Prevention
1266 Pool Spa Final
200 Final Re-Raat
201 Final8locWRetaining Wall
202 Finel Fectory Fire Place
203 Final Sign
204 Pinal Demolition
COUEY INSVECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Finel Electncal
212 Final Fire Prevention
220 Final Plenning Approval
222 Final Site
250 Final Building/OccuDancy
PAIE INTRIALS
2446-6fi" � ,_
(714)754-5273 • Fax(714)754-4856
Job Address: 555 ANTON BL
Suite No 8
Vicinity: 8TH FLOOR
Parcel Number: 41050110
�
, . CITY OF COSTA MESA �_�
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
Applicant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE,CA
owner: � -SAKIOKA FARMS � �
Address: � � � . ,
Contractor:
Address:
Arch / Eng :
Address:
MECHANICAL PERMIT
Phone: (818)244-6571
Zip: 91201
Phone:
Zip: 94137
AIR"CONDITIONING CO., INC
6265 SAN FERNANDO RD
" �� Phone: (818)244-6571
GLENDALE , CA �. ' � . Zip: 97207
; ' � ' ' ' License: 120696 '
Phone:
Zip:
License:
NUMBER
33
77 FAIR DHIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03I29I2000
Issued: 03I29I2000
ISSUED BY: ,
. � SCOPE OF PERMIT
MECHANICAL PERMIT FOR OFFICE T.I. FOR"BMC SOFfWARE"� (8TH FLOOR). INSTALL 14
SMOKE DAMPERS & REPAIR/ALT 1 HEAT/COOC SYSTEM. _� ' � �
REF: B00-00261 �� �
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU �
Repair I Alt CoolinglHeat
Inst I Rep. Recess Wall Htr
Refrig Sys <100 k BTU ,
Refrig Sys >100 k BTU
Gas Piping
Fadory Fireplace
Hood wlMech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
$23.50
$0.00
$0.00
$13.70
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$101.50
$0.00
$0.00
Quantiry
0
0
1
0
0
0
0
0
0
0
0
0
0
14
0
0
FEE SUMMARY -
Repair I Alt Absorbtion Unit.
" � _ � Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercia l Incineretor
Domestic Incinerator
� Comoressors I Absomtion Systems
Upto3hp/100kBTU �
. 3 To 15 hp I 500 k BTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
1510 30 hp
30 to 50 hp
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241•92)
EXPIRATION: This permi� shall automatically expire and become void if work is no4commenced 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 Inapectlone and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 ,
WORKERS'COMPENSAnON DECLARATON: •
I hereby aHirtn under penalry of perjury one of the following tleclaretions:
❑ I have and wlll meintain a cetlificate of consent to self-Insure for workers' compensalion, as providetl for Dy sectlon 3700 oi the Lebor Cotle, tor the peAormence ot Ihe
work for which t�is permit Is issued.
�J�J�fM1a� and will main�ain workers' compensatlon insurance, es requiretl by section 3700 0l the Lebor Code, br Ihe peAormence of �he work for which this pertnit IS issued.
My workers' compensation Insurance carner antl policy number are:
'Cartiei: �� 2/�!L!v .� . PbpcyNumber:—��,,11'i7.� /�_
,.,_:""':"""."""'__,_.�.:..�'__—:.:_.._,.._�_"'_..._�._��_„__.a..�,��_„"'"' �
❑ I certify Ihet In the peAormence of the work far which this parmit is issue4 I shall no1 employ eny person in eny manner so es to become subject to the workers'
compensetion la alifornia, and egree ihet it I shoultl become subject to the workers' comDensetion provisions oi Section 3700 of the Lebor Code, I shell forthwith
complywith seprov ions. �---�
l�plicant�re:� Dal te:_—.� �'�.%d �U�
�ARNINCa'. A FE TO SECURE WORKERS' COMPENSATION C . IS UNUWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AN� CIVIL FlNES UP TOONE HUNDRED
THOUSANO E(5100,000),INMDfT10NTOTHE00.5TOF �MPENSATION,UMMGESASPROVIDEDFORINSECrION31080FTMELABORCOOE,IMEFEST,ANDATTOFNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby attirm the4Pem��icensed untler provisions of Chepter 9(commencing with Section 7000) of Division 3 oLthe,Business end Professlons Code, and my Ilcense is in full
lorce and eftec_t._u„c,.�a ��(Z��Q� -qass »� ,�'� 2 D
Co raa Sig� ��� _ . Date: _� o��, �w, �
��_r
CONSTRUCTON LENDING AGENCW. "
❑ I hereby aHirm that thera is a constmction lending agency for the partormance oi ihe work lor which ihis permit is Issued. (Sec. 3097, Civil Code).
Lender's Name:
Signature: _
OWNER-BUILDER DECLARA710NS:
Lendar's AddreSs:
Date:
I hereby aftirm that under penalry of perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he following reeson (Sec. 7031.5, Businass end Professians
Code: Any ciry or county which requires a permil to canstruct, elter, improve, demolish, or repelr any siructure, prlor to Its Issuence, also requires Ihe applicant tor such parmit
to file e signetl stetement that he or she is licensed pursuant to the provisions of ihe Comrectors IJcensa Lew (Chepter 9(commencing wlth Sectlon 7000) of Division 3 0l the
Business antl Protessions Code) or that he or she is exempt therefrom and the basis br the alleged exemption. Any Nolatlon ot Sectlon 7031.5 by any epplicant for e permit
sub�ects the apPlicant to e civil penalry ot not more than five hundred dollars ($500).):
❑ I, as owner of ihe property. or my employees with wages as thair sole compensation, WILL DO TME WORK, antl the structure is not intended or otterad for sale (Sec.
7044, Businass antl Protessions Cotle: The Conirectors Licensa Lew does not apply to en owner ot properry who 6uilds or improves thereon, entl who does such work
himself or harself or �hrough his or her own employees, providetl ihet such improvements ere no� In�ended or oHered tor sale. H, however, the builtling or improvemem is
soltl within one year ot completion, Ihe owner-builder will heve the burden of proving thet he or sha did not build or Improva tor purpose of sale.).
❑ I, as owner of �he property, em EXLLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cons�ruct �he prolecl (Soc. 7044, BuSiness and Professlons
Cotle: The conirectors License Lew does not epplY to en owner of property who bulltls or Improves ihereon, antl who contrecis for such project with e contrector(s)
license pursuant ro the Contractors License Laws.).
❑ I am exempt untler sec. Business entl Professions Code for this reason:
Signature: Date:
Owner ID venfietl Dy tlnvar's license. ❑ Ves ❑ No Drivers License No. Expires:
Venfication of Ownership by (rype of document, i.e. - property tex bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
� I hereby certity thet no excavetion Ilve (5) or more feet in depih into which e person Is requlred to descend, wlll be made in connectlon with work authorized by this
permit, antl that no Duiltling structure, scaHoltling, telsework, or tlemolition or dismantling �hereot, will be more then thirry-six (36) teel high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Title 8, Celitomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which woultl requlre e permit irom the Division of Intlustrial Sefety, es nated ebove, unless such person has e
pertnit to do such work fram ihe division.
Signature: Date:
DiNsion of Industriel Safety Pertnit Number.
CERTIFICATE OF COMPLJANCE AND AIITHORIZATON OF ENTFiV: I certity under penalry ol per�ury that I have read this application end steta that the inlormation given is
correct. I agree to comply wiih all state laws antl ciry ordinances relating to 6ulltlinp construction, entl authorize representatives ol Ihe City ol Costa Mesa to eniar upon the
ebove-0escnbed D�aGerry 1ar inspactlon purpases. I epree not ta accupy or allaw occupanty oi any builtling euthorizeA by this pertnit uniil linal inspection.
CODE �. INSVECTIONTYPE pd¢, f��$
1678 Fi:ed System Final Fire Preventlon
1266
200
201
202
203
Pool Spa Final
Finel Re-Roof
Finel BIocWRetelning Wall
Final Factory Fire Place
Final Sign
204 Final Demolition
2d48-48
COUE 1 INSVECTION TYPE
206 Final Mechanical
208 Finel Plumbing
210 Finel Elec�dcel
212 Finel Fire Prevention
220 Finel Planning Approval
222 Final Site
250 Finel Builtling�Occupancy
o �
> _
r
J
•��dP
(714)754-5273 • Fau(714)754-4856
REF:
JobAddress: 555 ANTON BL
Suite: 8
Vicinity: 8TH FLOOR
Parce� Number: 41050110
npp�icant: HAGHIGHI, DAVID
Address: 2505 MIRA MAR . '
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
FIRE SUPRESSION PERMIT
LONG BEACH, CA �. �
Owner. - SAKIOKA FARMS" �
Address, . , � � - �
Zoning:
Phone: (562)498-6444
Zip: 90815
Phone:
2ip: 94137
NUMBER
04 � '
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/O6/2000
Issued: 04/27I2000
ISSUED BY:
Contractor CAL PROTECTION
Address: � 2505 MIRA MAR �
" Phone.` (562)498-6444
� . IONG BEACH, CA . . . .Zip: �`� 90815� � � � . .
� � � „ � License: 327196 , � �
- � SCOPE OF PERMIT
' FIRE SPRINKLER�PERMIT FOR T.I. FOR "BMC SOFTVJARE" ,
` ,
Plan Check: $392.50
Permit: $603.85
Other: ' $0.00
�
Total: $996.35
m
FEE SUMMARY
Calc Valuation: sa5,eea.00
Claimed Valuation: 5as,ssa.00
,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIHATION: This permit shall automatically expire and become void it work is not�commenced within 180 days, or if work is suspended or abandoned
for a period of 780 days. .
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlons and final approvel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
POR INSPECTIONS CALL: (714) 754•5626 - ,
WORKERS' COMPENSATION DECLARATON: ` ' ""
I hereby aNirm under penalry of perjury ona ol the tollowinq declara�ions:
❑ I heve entl will maintain a cenificate ot consent ro setl-Insure tor workers' compensation, as provi0etl for by section 3700 0l the Lebor Code, for Ihe peAormance of the
work for which this permil is issued.
�� I have entl will eiMe'� workera' co pensetlon uranca, requir y section 3700 of Ne Lebor Code, for ihe padortnance of the work for which this pertnit Is issue0.
My workers' tom Ation In5 n aartier en iry nu r ere: Q� q+
Cerner: Policy Number. �� //U � \
(This sectlon need no! b mple ed il the permit /s valuetl ef one huntlred dollaro ( 00) or Iess.J
❑ I certity Ihet in the pe ance of Ihe work r hich is per 't is issued, 1 shell not employ eny person in any manner so as to become subject m ihe workers'
compensetion lews of Ca nie, and agree th t If I sh ecom ubject to the workers' compensation provisions of Sectlon 3700 of ihe 1ebor Code, I shall forihwith
comply with these pmvision ��^ �1 �
ApplicantSigneWre: Date: � \ U
WARNING PAILURE ID SECURE WORKERS' COMPENSATI ERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINA� PENALTIES M1D CIVIL FWES UP TOONE HIINDRED
THIXISAND DOLLARE (5100,OW), IN ADDITIIXJ TO THE COST OF COMPENSATION, OAMAGES AS PflOVIDED FOR IN SECTION 31060F THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
DECLARATION:
I hereby aMirtn Ihat I an
lorce entl eflecL Lic. # _
Coniractofs Signature:
wlih Section 7000) ot Divislon 3 ot the Business and Prole sions Code, antl my license is In tull
_ ClassN L���L � -
� Dare: � � - �U
CONSTRUCTION LENDING AGENCY:
❑� I hereby aNirm ihat there Is a constmction lentling agency for the pedormance of ihe work for which this permit is issuatl. (Sec. 3097, Clvil Code).
Lentlefs Name: Lendels Atltlress:
Signeture: Date:
OWNER-BUILDER DECLARA710NS:
I hereby eHirm Ihet under penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business and Professions
Code: Any city or counry which requires a pertnit to construct, al�er, imprwe, tlemdish, or repair any siructure, prior to its issuance, also requires the applicant tor such partnit
to file a signed stetement that he or she Is licensetl Dursuent to ihe provisions of Ihe Comrectore License Lsw (Chapter 9(commendng wlth Sectlon 7000) of Didsion 3 of Me
Business antl Professions Cotla) or Ihat he ar she Is exempt theretrom antl t�e Dasis for the alleged exemption. Any violatlon ot Sectlon 7031.5 by any applicant for a permit
sub�ecis the apD�lcant to a civil penelry ol not mora ihen five huntlretl tlollars ($500).):
❑ I, es owner of tha property, or my employees wi�h wa9es as iheir sole compensatlan, WILL DO TME WORK, antl the strucNre Is not intended or oflaretl for sale (Sec.
7044, Business end Professions Code: The Comrectors License Law tloes not epply to an owner of property who builtls or Improves Ihereon, antl who tloes such work
himsell or �erselt or through his or her own employees, pmvided that such improvemenis are not intended or oNered far sale. If, however, the builtling or impmvement is
soltl within one yeer of completion, �he owner-builder will have ihe burden ol proving that he or she ditl not bui10 or Improve for purpose of sale.).
❑ I, as owner of the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the pro�ect (Sac. 7044, Business and Prolessions
Code: 7he conirectors License Lew does not epDly to an owner of proparty who bulltls or improves Ihereon, antl who contrecis for such project with a contractor(s)
license pursuant to the Contrectors License LawsJ.
❑ I em exempt under sec. Business and Profeuions Code for this reason:
Signeture: Date:
Owner ID ventied by driver's license. ❑ Ves � No Drivefs License No.
Venfication of Ownership by (type of tlocument, i.e. - property tax till or deed):
Ezpiras:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIGICATION:
❑ I hereby certity ihat no excavetion tive (5) or more feet in depth imo which a person is requiretl �o tlescend, will be metle in connaction with work authorized by ihis
pertnit, and that no building stmcture, scaHolding, falsework, or demolitlon or tlismantling Ihereof, will be more than thirry-six (36) feet hlgh. (Chap. 32, Gry 2, Art 2, Sec.
341, Ttle B, Cell}omia Atlministrative Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which woultl require e permit irom the Division of Indusirial Safery, es noted ebove, unless such person �as a
permit to do such work from the tlivision.
Signeture: Dete:
Didslan of IndusMal Satery Permit Number.
CEqTIFlCATE OF COMPLIANCE AND AUTTIORVATON OF ENTRV: I certiry under penelty of perjury ihat I heve read this applicatlon antl state that the information given is
correct. I aqrae lo com,.Qly with all stete laws end ciry ordinances relating to building construction, antl authorize representatives at the Ciry oi Costa Mesa to enter upon ihe
aDove-0escnbetl prop0�lpr inspection purpysas� acyao.CQ!'IqoccuDY or allow occuDenq ot eny bulldinq authonzed by this permit unpl tinal inspection.
CODE t. INSPECTIONTYVE
1816 Fizotl System Finel Fire Preventlon
1266
200
201
202
203
204
Pool Spe Final
Final Re-Roof
Finel BIocWRetaining Wall
Final Fecrory Fire Place
Final Sign
Final Demolition
1 Q-dIEM, 1,.. �INT.t�RIALS
�0'�X�VV ��vV
�
COQEt INSGECTIONTYPE
208 Finel MBchaniCel
20B Final Plumbing
210 Finel Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuiltlinglOccupancy
���� «�
Date
QB?E INi1TIALS
• in �
_,
�— ------ -- ------_--
� �itp o f �o5ta 7Y�e�a C
Development Services, Division of Building and Safety
CERTIFICATE AF OCCUPANCY
This cerrificate is issued pursuani to the requirements of the Uniform Building Code, Section 308
adopted by the City of Costa Mesa certifies that at the time of its issuance the bullding structure herein
� below described was inspected and approved for occupancy as follows:
I...
� Building Address 595 ANTOH BLVD. FI.00RS 1-12 Bldg. Peinut No.*Bee belw
;
U52 urri�n�
Group B-2 Type of•ConsPruction 1-FR Fire Zone Use Zone PDC
;•., ;. .
Owner of Building Sakioka Farms Tenant "►��'�t-"
�B74570, 875356, B74572, B74571, Bi45?3, B74633 � ��-�-
B74632, A74631; B74630,�1 006, B77866, B74574 By p��_'
Date Novzmber i4, 1996
RICR Bk0'wTtd, CBJ
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
,
• City of Costa Mesa
y Development Services Department
� Buildinq Safety DiviSion
c P. O. Box 7200
, Costa Meu, California
CERTIFICATE OF OCCUPANCY No.
The Building located at 555. ANTON BOULEVARD ITNIT R75
r has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
�for a Group B-2 Occupancy.
Use of Building OFFICE
Legal Descr
ISee reverse side for Metes and Bounds)
Building Permit No 1�59854 Electrical Permit No.E$9855 Plumbing Permit No. P59860
Mechanical Permit No. Mh(11�4 Number of�apartments - and/or guest rooms
Fire Prevention Permit No.F60011
ISSUED T0:
BANK OF AMERICA
Building Official TONY C'"DE BACA
�
20 RAYtiOND AVENUE by '
PASADENA, CA 91103-3391 . � ��.��
• Date
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-a6 rev. 1/83 White -Owner, Canary - Numerical File; Pink - Bldg. Permit File
Ciry of Cosca Mesa
Development Services Department
Building Safety Division
P. O. Box 1200
Costa Mesa, Calitornia
CERTIFICATE OF OCCUPANCY No. QQ�%4d4
The Building located at 555 Anton BoleVardr Suite 800
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group BZ Occupancy. � ,
Use of Building Off].CE+
Legal Description 410-501-04
(See reveru side for Metes and Bounds)
Building Permit No B 37834 Electrical Permit No. F. �7R75 Plumbing Permit No. P�7R5f1
Mechanical Permit No. M 38012 Number of apartments and/or guest rooms
Fire Prevention Permit No. F 37943
ISSUED T0:
Securitv Pacific Bank
555 Anton elvd., Ste. 800
Costa Mesa, CA 92626
Building Official �eorqe Edmiaton
i
by /-��,.� //�_ `
Date �tobe[ 12i 1989
.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.
cn�tF 1o15-a6 rev. I/83 White • Owner; C�nary - Numerical File; Pink - Bldg. Permit File
� , .
City of Costa Mesa
Development Services Department
Building $afety Division
P. O. Box 1200 ,
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No.
The eui�ding located at 555 AntOn Blvd. Un�t #820
has been inspected and found to comply'with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a G�oup B-2 � Occupancy
Use of Building
Legal Description 410-501-04
ISee reverse side for Metes and Boundsl
Building Permit No. R535A(1 Electrical Permit No. FS�Fi] R Plumbing Permit No. pS3h�%
Mechanical Permit No. ^�^���� Number of apartments and/or guest rooms
ISSUED T0:
Security Pacific Bank
555 P:nton 81vd. #100
r`nata niac3a rA 97A9F
Building Official �a.,n.. r� na na�a
by
April 9, 1992
This Certificate of Occupancy SHAIL 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 3015�46 rev. 1/83 White -Owner' �anary � Numerical File; Pink - BId9. Permit File
Ciry of Costa Meu
Developmen[ Services Department
Building Safety Division
P. O. eox 1200
Costa Mesa, Caiitomia
CERTIFICATE OF OCCUPANCY No. OO��#6�.
The Building located at 555 Anton BOu1PVacr7, R�aitc AM
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B2 Occupancy.
Use of Building OfficP
Legal Description 410-501—OA.09
(See reverse side for Metes and Bounds)
Building Permit No B 35910 Electrical Permit No. F. '�Fi(N)R Plumbing Permit No. p�'�+�14n
Mechanical Permit No. M 3�� Number of apartments and/or guest rooms
ISSUED T0:
SP.CUri.t,�r Pacific $3qk
600 wilshire Blvd. �500
L.c�9 anaatac, rn Qrn17
Building Official William T. Howacd
' /
bY � , i_�_ !^,.'�/, . i
� Date April 4i 1989
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 Fiie; Pink - Bldg. Permit File
'°0P�0FB1A� 555 ANTON BL
omarrsru�Eica/wm: SAKIOKA FARMS
AD°"�' PO HOX 2097
TERMINAL ANNEX
�vc�. �,mu+o �oon�ss
1qCNIfECT Ofl FlqNfffl:
MCN.ON ENd'8100RF59:
EN
IIC. NO.:
unt:
UNT:
8TH CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: 6 076014 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE
COMRAttpf9NAYE: MORROW MEADOWS CORPORATIO ( 719 ) 598-7700
caxrn�cToxaw�o p p gOX 509
�5% WALNUT CA ��.: 230813
91789 u�:
UCEN9E0 COMH�CTOXS DECLAP�TION: I M�epy � uMr pmlly d qe"ryry Nu I am fiwnead �nder pro.mnu d Cheqx 9
(wmmenanp wn� Seciqn ]OW) d Di�riaqn ] W Ihe &nin� � ��ebm Cada, eM my lioenw u in lull lwcs eM elled.
cmuc.xo.:006558 uc.cuss: C 10 uc.No.: z308 3 EXP: 12/96
ome: /` � ��� �L camr.a«:
WNER BUILOEN UECUPRTION: I Mroby elfi�m uedlr penely d parN�Y �� � e zemq I om Ihe Comreaon licenaa Law la tlw
Ibw'vp reevon (Setlion J091.5 Buei�n� enE Pmleeeione Cods: Rrc� c1y a oounty hiM rp� m e pertnN to mnelrucl, ellx, improw,
demd'ah, a rpai eny tl�ucwn, pia b ps isuenoe, ebo nquirm IM epplimm Im � pen � m fib a aymd aWemem Mm M a�M
o IicamM W��t to iM prMwm W Ne CoMredon �� law �Chaplr 9( ma �mh Seaion ]000) d Diveion a af tte
Buainsee vM Prdseaione Coda� or Ihet he a ehe h exemq thsehom eM IM bevia e ellepeA aaemption. My violelion of Sepbn
)0�1.5 by eny eppliranl lor e permit eubjede Ihs eppliran� �o a civil penely d M mon ihen fve hund�ed ddkn �f500�).
❑ I. ea ovmor W iM propanY or my employaea wih wepm u IM'r eob oompenae�ion. will Eo ihe xoA. eM IM al�uclun u nd �tanded
a MereA la eela (SeMian ]PI<, Buamss eM ProlMeiana Code: The Conlreclae Lkenea lawdoea rwl epplyto en ownerd propeity
wlw buide a inqwm iMreon, aM who does suM � MmeaM or Mnal a Ihraph he a Mr own employaee, praridad �het wch
impvnmenU va mt imeMeC p Wmed lar ede. tl, M1�'�'��. ihe MnNirq «'vnqwemenl ia eok wnhin oere yaer G mmpbtun, tlw
ow�a��w�a« w�n ne�< ma e�m.o m aw�oa na «.n. a�a nd build or improve lor �ha puryove of eele).
❑ i. e. o.,�., d ine awem..m �a�N �v.c:ro ••nn tice,we wmm��a. �o c«�.ma ine woi� ls«au� �ou. a,.�. n,d
Profeaiwn Cade: The Coniradon L'cen» Lew doea M eppty lo en ownx d pope�Y ��ike ar impova tMraon uM who
conlrecb la suM prol�e wilh e ooMreclor�e) IkeneeE purauem io ihe Conlretlan lioenae lew).
❑ i� �.�a �,a.. s.a�: e. a r.c.. ia �n4 �:
Dele: O�ar
I do Mroby uniry thet I em ewere M erd wden�e�M tha rWuimnenb d Cellanu HaeXh vd Sdory Code Setlom 25505, 255�3, eM
Y553a, enE tlw 1 a eery lulura buildiip arvpent will / w11 �d (tlrcb one) naed io comply wlh aaM weie oods vd �he'pviromems la
eVamel«mni'uction«moGfiulionham�MAi u�y e�apememDiaritl.MeiAerealmnavfuneVP�iame�ee�emNhvmNeea
porisom.
Dale: AVdKen�:
WONKEN'S COMPENS�710N DKL�P�TION: I hereby elfirm uMw pmelly d perpry ons d tM blbniip dadve�iom:
� IheveeMxilmmrvenecen!'wedmromlloupinwrebxMen'mnpe�mmion.av��InpSeaima)WdiMLeEn
coee. ia ine ron�. a me .�x r« �n:�n �ms o«�*+� e�..�.d.
rj i ne.. �a.a ��i� wona. oomro��, mw,�... �w�e M sw� a�oo d m.l.eo. coea. i« ma ro��� d ina
� WOIk �p Mfilfjl I�Y VMIM U 4DIMd. MY W V�WB� WI�DOti�CII YWl811CB m11Nf Y10 �Y.% IIIIf11bBf BM:
c�.,: �R . AN' R F TPID EXPIRES
PdryNumber. nwranF�FFa� 07/OS/96
mllfiK{NMI/IN�/KKbI 'MT(I�I(!4I(�N�JlillfY/plVb�III/Idll.��Qt/t�ilCO�p�.�
❑ ��.nh �nm � ine o�am.rce d me ..a�x ia. wnen mo o�a u uurd. �.nen �a enmM d+r o«.� � drv m�• o n io
eeconie wbjee m �ne �.aFer.• mnpaumon mv+ u ceramue. end euns uw ! � anwM bsmn . i��o tne �wMen'
comJpaneiion pw[i�auro d`��/ io/n 3j 00 G tM LeE« Code. l nl� mmpA '� � p�b
De�e: / � / CJ � / (� AVG��:
Wemlrrp: HNun ro��e�n woik�ri compenwtlan ea��r+p� l� un/+wMl, an �lull !/ct en rrploy�r to eMMrW puuMu �M
dHl nnu �q ro om hvrend tnounM eddn (JfoqPDnA b�Itlon ro ros I rompmuWn d+nepi a pvHOM ror In
Ssetlon J1W ol tli� LNor Cotl�. Intens[ ���my i Isp.
CONSTHUCTION LFNDINO �OENCY: I MnW effiem under peneM d per�uy Ihet iMia u e oww�ueion Wdirp aperwY M Ihe
peAormence d �M xvrF M xfiidi Ilie D�i b ewed (5aun J08]. CH. Cl.
LENDER'S NAME:
LENOEH'S ADDRE%:
I ceniN thet I he�e reaE I�ia epd�� erd qme ihet ihe ebwe iMamelbn ie mrtaq. I epree lo romp�y xil� ell ary end munry ardi�w�ces
enE slele lewe �elalip lo buYEvq cwlrutlion and hareb/ Pu�Farixa npseeMetrvm d Ihia ay lo enter upan tM ebwe-meNbneE pmpany
Iw iroDeEion purpoaes.
CHUCK JACOBY
o�,/— i8—�!�
(5151<6 WP) W�n uilEip 8 Se1tly:OreaMFb; Cenery-RppYranl; Pink-fievenue; Gddenmd-Acww
JOB DESCRIPTION : 20000SF OFFICE T.I, /ELECTRICAL
PERM NO: E 076014
GOVT: N SUPP; Y
SQ FT:
PURPOSE: ALT
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS / REF H-74633 / SUP E-74682
:x�x��w�r�r*�r*x��rx��rx+��r**�*��r*��r�r+rx��r�r�r+r�r****�r�r*�r*��+r**x��r*�r�e�r****x�rx�x�x�x��rr*�r�r�**�+��rx��x
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NCSTES>
� � '
1E Ik 1k IE 1E 1E iE iE if 1{' if iF iE 1f K iE IE 1E IE 1E if M M 1f IE If iF iF 1E 1Eif iE if i! iE iE if If 1F IE Ik iE �IF If iE iE 1! IkiE 1k If iE 1E 1f iE 1E If ii iF if ik iE 1E 1E 1E 1k 1k 1k 1E 1E if iE if 1E iE 1F if if k
D E V E L O P M E N T S�E� R- V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . •'r DATE:
HUILDING APPROVED BY :
APPLICATION ISSUED BY: �
x�t*�t*itieititit+rititr***�rit*ir*
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 18.60
503
PLAN
ISSUE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 18.60 4.50 0.00
REVENUE DIVISION TOTALS--> COLLECTED: 2
BLDG PMT PLUMBING ELECTAIC MECHANIC FZRE
23.10
_ DATE:
DATE:
��iE 1E 1F 1f it 1f iE 1f �IE 1f��1E IE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIPINON—RES
TOTAL PAID DUE
23.10 23.10 .00
3.10 OVER/SHORT: .00
SMIP/TOT GRADING PLAN—CHECK
1k 1E 1E 1E M If' 1E 1F if 1E 1E 1E M 1F k k 1E if 1k 1k 1f 1f ik i! 1E IE 1f fF iF iE IE 1E 1E 1E 1E M 1E 1E 1E �E 1E iE IE 1E IE if 1E 1F iF iEiE k 1F 1E if iE iE 1E 1f 1E iF iE iE 1E 1E 1F M!k 1E 1E 1E 1E 1E 1f if 1k k 1f 1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20 EA, .75 15.00
ELE 8 RECEPT/OUTLET ADDITIONAL EA. .45 3.60
END OF FEES
'�. `+ ,' .; ','
/ \�� `' / �
CONSTRUCTION AND PLANNING P�. -& SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Temporory Electrical Service or Pole 52. Pooi & Equipment Location
2. Soil Pipe•Undrgrnd, 53. Steel Reinforcement
�3��I,ectrical Condu3 Ut ityUncl�grnd. � 54. Forms
��4rEZectricat Cond -'�U {g�nd. ' 55. Electricat Bond(ng �
��SxS�eel Reinforcert�ea.tF 56. Rough Plum6ing & Pressure Test
.'fi�ElecvicalUFER� cnd. � 57. APPROVALTOCOVER-GUNITE
'�si"`��aotings Ov n 58. Electricaf Cond�t iJndrgrnd.
u� 8. Eoundation � o+ 0 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe�Undr��. y 60: Backwash Lines�-P� rap, 4 Undrgrnd.
10. Structural Floor'�y6tem 61. APPROVAL TQ.QfCK ' �
11. Property Sewer C�ne � House�Eonnection 62. Backwash & Re�pior�Fina1
,i o
12. Sewer Cap ` � 63. Heater & Vent-�Jnal
13. Roof Drains � ' 64. Plumbing System - Finai �
14. Rough Plumbin� r - 65. Electricai-Finai
15. Rough Electrica{-Comduit 66. Solar SYstem�F' J,
76. Rough Electric�iriqg .�, 67. Fencing & Acc�iVApproval
�17. Ro�gh Wiring SiB� 66. APPflOVED F�PLASTERING
�
18. Rough Electrica`� Bar Celling 69. POOUSPA SYS��MS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEPfT
C� y��� C[:n CC R F iT1i*.
20. �~h u' F orp^Fir^��,#ace "'
'i!' � � �..^ £"t� S� •x x 5 .,.`.'y p,� ; APP�V��ti�Pe�it #�r" r ' 7
r. ..
21. �cip,in�Struffiurrnt .... --�- x S t7 -�K' 70. �Under§Fd+7fi,� H dro �
r c� -� � >
22. �utts Veotila?ng�"'.� ' � � S'�Y �77, Produ�ErTpjng�das �Oil
• i� M. � C � CJ F M
23. Gas I��ipe•�pugfi & l'�t ' p=; .f ;r; p� n; G Y +72. Undergrc�itnd FIdsS * =
24. Rbof-`Fia(rfing" �.� ��' � � � � �w .7�Undergrrt(�.Sro�a'�Tank�Gas ❑Oi!"
H
25. Roof hea,ihin '�� ' � - `�
y� 9 5* 4 vfi 7 Nx 7q70verheadHydr6J *
26. 7 BaC•Ceiling (StrJttirall & Mo at * u d'� m� 7r�-'Dr Che rai � ''� ' ��
:'+ "� � C* '2 Y � r' _i r l:7 C",
27. �arn¢,and�Flashinc�-x ,.��c a� m�r 76. DryStandpipe F� w�� mn
��28. Latha9&�y5iding :��� 'y4� C ig ..� .•�� 77�'FIXED�TEI�i�INA�',y �� Fh
29. Insulatio � x " �-• •. •• � * �T * � � ;. � �� V
�i; ,n� s �� v 78E FIRE PREV. FIN�L r-• � ��
• 30. Drywall Nailing N�` ''� � S �3�ALT�t��P�.�FiEQGIR�'�ENT
..'31. Plaster B� n�Coat � 5 � r- � � �.' 79. FINAL I ECT�N � , r•
G-! : -
32. 6lectricalFo�r/Bi N1�,tAY�F�n� i' i^� �� SOyF000 CERTIF "RTE I95�J,ED_�
�33. t�ina(cleeIjicj G:'�k ;� G; ��'�+�/F�(��jj,Y Nq(es: -y -7P7 , "y n ^
r_ "
•.34. Flna�-leat+ng•& Atc•�onclitionirt,�5 � 'r ir. •rt, •s !�� * j' �:, -
- X F'� I J H'00 �lJ I F'�,^ 'r, -•;�
35. �naFGas Pipe`�"esi' o * , • "' � ' "`
� i J%F C� 't H T.O C1 H 'r. � C3 ��r
�36. Fioo � nOPY W"� "^? �c. X i, � Fi i �t0 i: �� ^
� r^ m � ?7 :G i;� V�[r
-1 T ei -. � Y C� '!' �] � � S • t
y37. Finat',Fac�o�Y Firep!a€e �; _.:.., r� �x x f �»
�
-+38. Finata'lumbing ol't� � - *� � •i� � S � �' �
.-. � ' L _�e i-, x r
^'39. WateF'ti'uerCce�Finaf�.� � . G' * j � 1 % %* �' `.';� * ,rT ' '
� ' . �
=.40.GasService•final ;.s�: Gt<'^" S K.•, i s :.�- �n; +, •
-, � _ .,+ . o t � `
' 41. Solar pomestic•Fin��ly s ,-,^,� ' *� ;� i �c s � •
,. r r
��42. 8ackflow Preventer �: J �v � `� i � o^ Ci-� t: -. ' .
,. -, c,
43. Backflow IrriqaJtion ''� �7Sr * � ;_ t �_ � -
r '1: C� :Y J �� t C.
n' � e. � �...... . .. .-.
' 44. Landscapnalrrcpationdystem �:^� � *;-� CJ� :v n; �.n +: ^ o> >•" --. •-
M Y I, �'
$5. $ound A�eniiation * _ . .. ' * £ � � m R ` `' Q ,C`. E;K' M' � -
�,w r r
4B. HandicapRegulations ' �" r a; i,c s �
- c I T t Y,
4,7. �iNALSTRUGTUR�&BUIL�ING � � �� � `,�*. `�' � a, ` E„
Y•
48. F{NA,1 PLANNING �' �-�F� * a� "? * -
r
49. Elec[fic Release to Edison � '� .- "'' � � -
4. .� ' i* � .� ; ._,
50. �,as E�lease to Southern Califaraiatas Co t ; (x � - � • %�!=+ • •
^t !' r �i
5:1. CER�iFICATE OF OCCUPANCY~ : n _ : . - _ �
No. Date
/
,NOPESSOFBNIpNG: SSS ANTON HL
OWNEkSN�IAEIFp10WN: SAKIOKA FARMS
"°o"Eu PO BOX 2097
TERMINAL ANNEX
AVVL. YNIINO WDPESS
uNr: gTH
�xcxrtEcron�xux: INTERIOR ARCH 2136232164 °C'N0�` 9�78
urcx.oxerxiswo�ss: 550 S HOPE ST °` 1100
�m,��Tarsru� L.A. CA 90071
CQAN�CTORSYYIPlG COMPEL CORPORATION (310)946-8321
10410 PIONEER HL
"DOP�' SANTA FE SPRINGS CA °QND= 392693
90670 °Nio
LICEN9EU CONTHACTOfl4 DECLAPATION: I M1ereby dlrm uMx penelly d ps�ury the� I am licemad uMx paiwm d CMqar B
�oomme�np xi�A Sacuon )000) d Dhuion 3 d Ns Bu4nsee eed Profuuo1p CoEe. erd mY Iimms b in INI lau end aMW.
cmuc.r+o.:032054 uc.cuss: C-10 uc.No.: 3��3� EXP: 08/96
o�.: ln �2 G- F S ���a:
WNEN BUILOEF OECIANATION: I hereEy elfiim under penaly d pmlury ihel I i axemq Irum Ihs Comraqon Liums Law la iha
Ibv.vq �emon (&atlion ]0�1.5 Bus'vw� end Prdarobne CaEs: �iry c1y w aouMY whirA nVWm e PrtnY to awm�eL Ma. �mprn.
. aemd'e�, a repei vry sVuctun, pia b ila ea�eMs, ebo npu'va IM epplkaM la wch parm't lo fib a dpnad Mtamenl Net M a�M
N IicamM W�� la IM pwisiam d iM Conlredon Liwme Lew �CAepim 8(commmdnp wil� SWion'l000) d OM'sbn 9 d tlr
Bwi�was uW Prdewions Code� a IhN he a kr ie pomq iherehom eM iM buu la Ne Nbped axemqion. My viale�bn d Satlion
.)W t.5 b/ enY eOW� lor s permil abjeda Ihe appli aM to e wi pwWry W no1 mm ihen M� IwnEntl EOAen �55001).
� � I.movmertliMPWe�YamYamDMwev.ihwa0a+mihnedswn0a�ion.wiAAolMv.ork.udiM�wquroumlin�mMed
or MeraC br eele (Seclion ]Oaa, Busime+uM PrafeseiawCoEe: The Comreqore Licanss lew doac rwt epply lo en ow*wd proparty
�', wIn Wib a inpws� Iheieon. rd Wa daea euM wk himadl> henN a ihraqh he n M awn emplo�w�. pewNsd ihtl ach
�. impowmeNe ara m� inieMed n ollaed ta sab. tl. howaver. the bntlinp a inpwanera is eold vmhin pwYw d compblian. IM
. wrer-0uiMer wiA heve �M WrAen M pai'p M or ehe dtl na EuiN a impwe la IM Wmoae d aebl.
'i ❑ I, ea ox�w d IM puWM, am esd�mvelY mnlretl�q xah liunted con�racYm b cmmW Ne Vqa (5atlun ]Ol�. Bva'vwa eM
�. rie.avm. coae: m. cuw.cu. Licma. lew me. na ewN m.n oxn« a ww�v wno n�nN. o, umor« in«.o� .nd .a�o
�. mmrecp M euM 0�1�'� e caXrepw(e) fcenxE W��t to tM Canveqon Limme lewl.
'',. � I em mamq uMx Seciion: B. 8 P.C.. la Nu �uaon:
'�. De�¢ __. _ Oxna:
��, i ao n�nr �r �na i�..�< a�e �.�a u» ���o d ceuo�:. wmn.�e sm�v coes sea:.�. uws. usv. w
'� 25S3a, en0 tlut I a enV Mua Wikuq omrpeni xiA / wil rwi (ercb ore) iweE b ednON r�h eeid mts oodn md iM iew��emMs M
I WONKEfl'SCOYpEN3ATON0ECWiATION:IAeraEyelf wqerpe�WlydpxjwyardtMloAovnfqdsderatiom:
� IMeeMWme'vHanecMAkmedmnwnitosWimunbrv.pksa'mnpwna�on.uporidadlabySaaion910UW�MleEn
{�i0'�!. �Of ��1G De1�Of�11B11CG O/ 1�M NIXk �IX M�1IC�1 �hR Gs�114 �Ibd.
r] � nero.m hi� meinian.unen� aomw�mon i�.w.nce... �+w�� M swion aroo a n» Lwu. coCe. �« �ne o�«merca d in.
wak /a whirh M'v pwmii e iaueA. MY �a�' �Pa�� ��e�w m�ar end Pdiry wmEx ue:
c°""' —€'Lt6MG1tJT CObtF EXPIRES
Pofry Nwnber. 0 2/ 01 / 9 6
�T/16 5011p1 /IBJ� IKK �[YYI1CbIB.� I(�M pTl! O ipGVN 44�8/i IW p�JSl.
� I renh � in ihe pMamence d Rw wwk la wAkn Ihu pem�n b iuued. I ohN m� empby erry pereon in eiry mwier vo m to
becane abjetl lo iM xaYara' canpe'udian levn d CafJanu, W apne Ihm � I ahaM bcmw ribjee �o iM xaM1w�'
compe� wian pwiaom d Sepion 3]OD d the lebor Catls. I MM lanhv.i�h mmpy Ow» '' .
.� ov, �e —Zc � s �� m..�-� �
Waml�p: N�un ro wcun w'oilron'romvwetlan rovs�ay� I� unbrful, e�m�oloys ro cNMirl p�nsltlu �M
civll llnu'q ro om hintlM tMuu�d rbll�n (J�00,0001� M atltl/tlon b Ms ewt o/ rompsiuetbM1 damsp� u poH0a0 br In
S�ctlon 31(I6 0l IM laGor Cob, /nfx�s4 � efromry'� Iw�.
CONSTtiUC110N LENqNO �GENCY: I heraby �fi�m uMer penelly d perjury ihm �hra u e mwewion bMiiq apeM.y Iw Ihe
p,�� a m..�x i« wn� ine o�+� �<w�a �smo� aw�, ca. cl.
LENOEfi'S NAME:
LENUEP'S ADORE55:
I caMy ihm I have earl ihb eppicetan aM qeia �lut Ne ebwa iNarmetion u caned. l ep�se to mnyy w4n ap ery eM cwnty pdirorcae
end sta�e kws reW^Y m buddiq cawurmn eM hereh' einharca rep�eae�veti.ea W IM N7 ro enim Wm tM ebo�a-mav'wwd pWab
Iwirmpeaion purpwas.
�sxsGa�-g6aa A+ou'fy Pe4Rso�
//y✓/� �J�% DPrvu Neme —C..� �
/ �6k�I�V[ • / �LRw1 Dme: �
gneturedO�nerl/peeu/n reqa
(St51d6.WP) Whaa-Buiknp85afey.GneMFIe:Ceneiy-Appirenl:Pink-Revenue:GatlemmFMaesmr
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 074832
PERMIT NO: E 074832 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
*�***�**i��****w*�*�r**���*�**�**�**�r**ir**�ir*8�***��r�*���*+Nr�****�*x **��**��r*�r+�**�
Z O N I N G R E Q U T A E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARI(ING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i •
K ik iF K K K IE iF �F 1F if K iF 1E iE 1f M M Ik 1f 1E1E 1F 1F 1f 1F 7f 1E 1f 1E 1E iE if 1f M iF iF 1E iE IE 1f if 1f ik 1E 1E if 1f IE K If ii 1E 1f 1E 1E 1E iE 1E 1E 1E iE If� iF iF If iE 1E 1E iF if if ik 1EiF 1E iE 1E iE
D E V E L O P M E N T S E�_R-V I C E S R E Q U I R E M E N T S
ZONING APpROVED HY DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSOED BY: � DATE:��1�-�
iflflEiFif1E1@IFIiiEifiEifMl@iFlfMififl@k iE1E1F1E1EihlfiflflE 1EIE
LEGALIZATION:N F E E S[J M M A R Y STRQCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 56.85
502
PLAN
ISSUE FEE 15.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 56.85 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
71.85
FIRE SMIP/AES GRADING
SMIP/NON—RES
TOTAL PAID DUE
71.85 71.85 .00
71.85 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
IE iE IE 1E iF iF 1E iE IE iE iE IF iF 1E iE IE if iE iE 1E if IE IE iE iE 1E iF iE i81E if iE 1f 1F iE if IE IE 1E iE K K 1f iE K 1E 1f If if if iI� 1E IE 1F 1E 1(� 1E if 1F IE 1E iE if 1E iE iE 1E iE If dF K iE iF 1E 1F iE iE iE iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 COMMUNICATION DROPS 1 ST 20 .75 15.00
ELE 93 COMMUNICATION DROPS ADDITIONAL ,45 41.85
END OF FEES
��
f .�� 1�` ''
�
ni Onsv�•^�-_'G1q:iE?6 7'�i'S --
CpTE= 1^_� +5!'S lIi;c; :G;�i!
CONSTRUCTION AND PLANNING P• -& SPA
APPROVALS PBrmit# Date Inspector �qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Po�e 52. Pool & Equipment Locatio�. -�
2. Soil Pipe-Undrgmd. �--'- - 53. Steel Reinforcement ,' '
u,
``.��-�{gctrical Cj"ondu[rj4lj�ty-Und�rnd. 54. Forms �
vr4rt�ctrical Qdfhifuit'l4r+itrgrnd. '� 55. Eiectrical Bonding �' �{ , �
-in .. � rt+� -1
.',��?SiLeel Rein�cgemett.�„ 56. Rough Plumbing & Pressure Test j,
= r6.�Electrical U�ER�G�d, 57. APPROVAL TO COVER-GUNITE �G `
�-. . � n
S�!'F�otings �� �M�. `� 58. Electrical CoodI�?t ndrgrnd. y�
�1, �
-y �. P.o,undation v eC 5=� 0 59. Gas Pipe. O UndLgcnd., Test �'
�
9. Water PipE�Undr��f�"`O 60. Backwash linesN'�,.`T,rep, � Undrgmd.
10. Structural_Ffoor Svstem� 6t. APPROVALTIXflECK ',
17. Property SeWer_Line & House 6oDnection 62. Backwash &,Rec�tpr-FinaN •-"
12. Sewer Cap� '' �,�:, 63. Heater & Vent-Final ���
�
13. Roof Dreins o ! 64. Plumbing System � Final
G--
74. RoughPlumbi�g� -r,ro 65. Elecxrical�Final ' ,_^
15. Rough Elactrical�Gonduit cr ., 66. Solar SVstem•Fin Io �y.
16. Rouqh Electric W�tin� � t. 67. Fencing & Access �ipproval Y,
:-77. Rough WiringSigp i 68. APPROVED FdR`PLASTERING 'l
�18. Rough Electlical�'(1 Bar Ceiling `� � 69: POOUSPA SY57�S fINAL
19. Rough Heating & Air Co�ditioning FIRE DEPT. REQUIREMEf�fT
- O' r-� � F C; f f- !"" [':
20. yu h�Fa r ir! f�ce t�m 'Q � =� o'�K PPRyV '% �' �' �"'
� 9^ �Y� �* 5'T' S +k ra cs . � ��r�FPerinit#T.T. .,
21. q`".uctgin 5nu�yre�� � `.. .. � . rJ �_ .70. �fndergKS�'dH�7ro 2 ..
22. Q�yct�e�ila 9 N� ' � ;' d � F� '71. Produc�i�g C''J�G�yis �Oil
23. P[pe- -u9hJ& Te�� �:; w. R1 a; :�.r�. 72. UndergroQhd FlastF' � P�
24. RdofSrarNing ^''�a", ' F'F w= ��* 73�Undergmc� Sror�yaTank'(7Gas 0671"
25. Roof�eai�ing S* ¢ -vv:� > n;x 74,�UverheadHyAro� t
M '7 t*3:t I7� `• - e-� ` C'. C:
26. �-BarrLeiling (Stru�al) & N-iai��}at �� 75�Dry Chemipal �,_,� a �,J
27. Fram��ancj�lashin9� � ;G� K� �, m� 76. Dry Standpipe Fs .e: � Ef
:+28. LsthitR� 8c5iding ^- ' c: '�`�w r E ..�' 77� FIXED $V�EA~M1 �INAL,* , y�
rr 1x r: k !T r. .�, .
r nC axp �.... xv; .' , l:. ��.,
29. Insulationti n� S f � � �+ 78 "FIRE PREV. FIN,4�L +=-� 'x �'Q'
"30. Orywall N�iling n'* � � Y � � �'� S �'F,LALTFI�EPT� REQbIREATiENT � ' . ,
C37. Plaster Br�vn �pat�� � � „m * � 79��FINAL 1 ECTIS,iV � " . �
. 2- .
M32. ElPctrical P-^owE�Mece't-Finai � �' n+ h" O.t�`FOOD CERTIFf Al'E IS�S ED_, �� ' �•
�33. F�nal�lecuic ; �� �:, ! y ���� � - -'x. Nates:� •-,� �;n k ^ � i.;r,��. .'
c.;34. Ftnal eatIn98cAirt-Cbnd[tioning_s !', ��� � � ca �v •S ,�� s .- _rr . d-i, .
r:: Y i� � , Lfi t+Cu'J O I (-^ �:. ! .
35. PInaIFGas� e est « `� w c w c .� r .�� �� -.
� � JP � c,� � T * i-, �v- 'c o�-. - n;r�,m -.
r�8. Hoodbr 4anopy M � 'z"-y + n � �i: " � i'ee � � *' �.r•
��r II ,y� ,,; X c t; v: O h7
�7. P[�at?,�ct�v FireR�S�~x i -`-� c � �' � I � � ,.•¢c�
�_
� ,,. - -
'-38. FinaldNumbing �k: N . * I � � �i- 5 � Y G.
ti i 2 � t� Y.
�-39. LVater'Bervice�Final'"?x i 5' %� � � � "�r T '
ip0. Gas Service-Final ,-:� � �CM^+ S fi m ; i �r ��� m:� {�
.. � +:y r � �< F. . v r r a:
=47. Solar pomestirFin '� s �� x O� � -�r "�� �
t-� �'K !�7 f � � :�' •7v fi T. :'�
42. Backflow PreventerS� N x: � i i a '- r *' �
r n C . ;-
43. Backfiow IrrigHLion�# ySs A� #�'t: _ x�� C� ..
Q6�. Landscape��irriqatiowSystem ¢l[rjfj 7 x C7 O 7•a a: N r. .�C� + �J ��^
•.. v r •� ' �"t � k "
4�. Sc�Und A�tPnuationS> �--CCF �' K S F� F F� C` r� .. O' . ce� .
i. y.. ,. x h rr� ;,7:i, F C m Q• hC
Q.b. HandicapRegulstio+isr ::, �; � �,a � ^ c+.. - -
� I � � � r',
47. F�INA�STRUGTU�'�& BUILbING " i �� f y '� S J' .� F.,
r�
48. Fj{J,4�P�ANNING �� r�. rn+ I � � ^ ^ !n •; �� c
49. Eicctri�i ReYease'to Ed�son � "• ' � * � Q '� � _
i 4 I •r !*� d •C',
5`(}. C�s ReJease to Southern California 6as Co x i • �� = �• ; r w '� �•
- � . c �� v ^i _�
�. CERT�IFiCATE OF QECUPANCY r .� r_ �� + �
No.- .._ __ Date .
r
T
•AOOPESS Oi BUILqNG: J J J HIV 1 V lV D L
OWNERSNAMEIFRqWN: SAKIOKFi FAFtMS
ADURE53: P� B�X z�97
TERMINAL ANNEX
APPL.M/Jl1NG ADDNESS:
MCNRECT Ofl FHtlNEEX:
fNLX.OFENG.'S.100NE55:
UNT:
L1C. NO.:
UNT:
ca�m�,cTan.sN,u�: MORROW MEADOWS CORPORATIO ( 714 ) 593-77U0
CdNiX�tTOR3MNl1NG p o BOX 509
,�p�g, WALNUT CA ��,� 230813
917 & 9 uxr:
UCENSED COffrflPCTOHS DECL�NATION: I hereEy ert'vm uMm peneAy d pe�ury thv I em IcenaeE uMer povieions d CMqar 9
(camme�wip xilh Saclion 1000) o/0ivision 3 d Ihe &»imea end Proleseiona Code, eM my lioensa ia in hll brce eM ellen
crrruc.No.:00655N uc.cuss: C 10 u�.: l���l i EXP: 1�/95
o�e: lG —/ 9— 9.S �o�,�, '
WNER BUILDEN DECIANATION: I hereEy a/firm unEer penetly d parjury ihe� I ez q Imm iM CaMreUae Licenae Lew lor IM
:ow'vq �eeaon (�ion ]031.5 &nneas vd Proleoaiona Code: AnY cily a cou wh' mpuire9 a permil to canVun. ellx. imyove.
amdsh. a repe'r any sVucture. q'w to ns cauence, edo requiree ihe epplimnt i r wc pe�mX lo fib e epME elelemeM � M a aM
o IicenseE W�+�e�� b iM prwivone d tM Conireaore Liceme lew �Cheqar ( me�a�q wil� Setlian J000) al Oiveqn 3 d IM
Busiebsa vd Rdpa'a�s Cade� or �hel he or sha u e�emq iheralmm end Iha ' w Ihe dbpad ezemqion. My vide�ion al Sedion
)031.5 by eny epplirant for e permil abpqe tM eppl'ranl lo e wJ penelly d ml maa Ihen Me huM2E Edlen �5500�).
❑ i.�o�wmawoo�vwmr<mdm�wen��,eome:��,���.wuieoubwwk.�em.n�n,�.eoam�a�aae
«unerear«se�ats ,a��aa.eu.nmasenevrwesabmcme:rnecamreew.�iu�,s.�..ao..�wwch�oe�awrw,dpo0ery
who buWs ar inOro� �hmeon, eM wha doea+udi xvrk IimmH a MnM w IMap� hb a hm own ampb�eas. qovideA ihm euch
impwameMs ere nd intentleE a aHered la ceb. M, Mwe�+er, tM huiNiiq a'vnprtrvameM b add within one yeer d camplation. IM
owmrbuiNx xill luve tM buNen d proviip M or nha Ak ml WiM a im0� la tM W�e d Wa).
� I. av ovmer d IM PWeM. am e�chnrveN mntra.tM �mh 4unaed contraciwe ro mnsUW �he qqetl (5etlion )OH. Busi�s eM
Pro(msians CaCe: Tne Gontraqae L'cerue Lew Ewa na epply io an owror d prapeM ���a a'unpovm IMrean eM Ma
wntrecn for suuN prqetls xith a mNradw(e) 4cemetl pursuent ro Ihe Caniratlaro L'werea lew�.
❑ I am ecemq uMx Sedion: B. 8 P.C.. tar Ihb ieemn:
Dale: Ormer:
I do Mreby untly ihat I em ewere G eM �MenwM tlre equiremeMs d Cellanu Ibellh eM SeINy CaEa Saaum 25505, 2553J, erd
2553a, arM tl� I n enY �un buikieq ooaipeM vrill / wil ml (drtN ms) � to canply wih veid eWa wdo ud IM rp�inmenb lar
a pe�m0 trccomWcliona modifcetionhan�MAi�aeapemant Diarq. qeeiCeMiel conpiuCbn eppirelbmenexemp Irom tMee
a�.
Dete: Apqicem:
WOflKEN'S CONPENSATION DECLAR�TION: I Mreby eifirm uMer parW�y d psjury ww d ilw b0owi�p dedve�iam:
❑ I hew eM xJ meimm� e canJ�e d mneent lo salliruure br wMeea' compnealbn. n pwidod fa by Setlian �100 d tM Lebar .
Goda.la ihe perlmnv�ce d the wak la wkch I�ia permil ie ivuW.
[] i new ene wi� meime:�.�a.� �v�� ��,renc.. n na�v,ea M s.aion aroo a m. �en« coe.. r« m. w�o�m� a m.
.bn�i�..nw,mao�nn��a.Mr•�� t t�°'t(��`v°�`°��t'i�v°L'�nume«"•: EXPIRES
c�«: ------ 07/01/96
Pdicy Numbec L Vtl. U V O� V V J�
/m;s seaicn ireed na ae cm�deroE r us v�•;, ro. om nunaise dd�ers Is�ool a Ns..)
� I cenly �hm in IM pMormeMe d �M wwk lor whch �hie pem�Y u inwtl. I Mell �wl emplry em� pemn in ury meniror n n io
Eecam wbjad io tho xakre' campenmlbn lexv d Celibmie. eM eyrea Out tl I ehouk becan�e eubpct to IM xwken'
compensetbn pm.isipu W Seqion 3)OU d the lebor Cade. I ehall lo hwilh aompy wil Ilm piovieiona.
` i
oma: / �J "'�� A � � s Md'cem:
Wam/np: FaNun ro ascuro roMen' corrpsiu�tlon covenpe I� unMwNl, entl Ms/I imN •� en wnpioyn ro cmm�s�vM�u.ne
c/H/ flnu up b om hintlrM tMurntl aol/an (JfOq000A In etltlltlon ro lM cwt / ro xueflon, Wm�p� u praNtlM br In
Sectlon 3I06 0l fhs LaDorCOM, /nMs�t ena efromsyi Iw�.
CONSTtiUCTION LENDING AGENCY: I hareby eifirtn uMer penelry d perN�Y �� u e mritlivaion biMiep apercy b Ne
pe�lmneMe d �M xvek fa wTitli ihc permi o ce�ad (�bn 3091. CM. CI.
LENOEN'S NANE:
LENDEN'S AD�qESS:
� C8111h' 1� � h9VB RBd UI19 B�CB�Ml1 BII� dB�B ��101 �1B BbWB IfI�M110191119 MRB'y. � BQTO �O COIIIdY WII�I B�� CI)' BII� Cplll�' Ol�IIIMLas
aM siete bhs relalmB �o W ildvq canetrueun eM Mreby aulhor¢e repraeantetivae dihu tlty ro enler upon tM ebove�memionad propeety
�«��patl�°"'°°'°' CHUCK JACOBY
0
om,✓o -�9-i5
=�.i5151�46.WP) �WhnaAuildvp85efery;Oreert-FIa;Cenery-Appicv�t;Pink-Rewnw;Oddenrod-Avemwr
CITY OF COSTA MESP — BUILDID]G FERMIT
PERM NO: E U'7468�
PERMIT N0: E 074582 PLAN CHECK NO: Dl GOCrI': N SUPP: N
CONSTRUCTIODI TYPE: 1—FR PERMIT TYPE: ELE PUAPC�SE: ALT
J'OB DESCRIPTION : 20000SF OFFICE T.I. /ELECTRICAL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS / REF B-74633
***�**�***rt****�***��***�*���*��*�*�**�x*�*�***����*�**��**�c-*�c�**�****���r��**��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUZLDING -------
FRNT: PT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 `LNE: REF NO:
PLANNING NOTES>
% �" !'
iE if� 3E �k iE 1E IE'lE IE 3E 1(' 3E 3E iE iElE iE if iE iE IE # 1f i(� 9E 3F if ?E iE dE iE iE iE �lE iF iE if �N- iE dh fE -1E jE 1E 3E if iE �)E �k jF iF it iE 9F iE iF �lE i: iF i! iE 1E fF 9F?F �lE-k �E iF iE?F iF 1E jE 9E jt--%iE iE
D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DAT£:
BUILDING APPROVED BY : — /"' .�,�,� DATE:
APPLICATION ISSUED BY: ` ( ���5/� DATE: �Q—/9—/S
iF iE'IE IF iE IE iE iE iE iE IE iE 9E' iE if iE fE iE If iE fE iF h F 1E�iE iE iE'IE 3E'IE # iE'IE aE'1FiE �E-'h it i�'jE iF�i 3f iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRZC MECHANIC FIP.E SMIP/RES GRADING
PERMIT 209.95
SOk SMIP/NON—RES
PLAN •
ISSUE FEE 15.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 209.95 15,00 0,00 224,95 224.95 .00
REVENUE DIVISION TOTALS--> COLLECTED: 224.95 OVER/SHORT: :00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
224.95
if 1E iE iE 1F iF?E iE if iE iE 1E i(� iElf !k jE 1Elf iE iE �IE iF iE �I(' iE jE if 9k if 1ElE 9E iE iE # iE iE 1ElE iE if -SF df fE iE * iE iE 1E iE jE iF iE jE 3(- fE if �F 3E iF #'!E ##-� iE i(� 1E iE 3F fE jf 1E 3f 1f� 3E iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15.00
ELE 198 FIXTURES, LIGHTING ADDITIONAL EA. ,45 89.10
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 123 RECEPT/OUTLET ADDITIONAL EA. ,45 55.35
ELE 18 RECEPT/SWITCH i ST 20 EA. .75 13.50
ELE 2 SUB—PANEL 11.00 22_00
'� EES
D
D TE '
°.'.t OC19^4'.�n-L�?14�,Sr, -¢'r_a'9" �2,;.r:
DATE: i0;.g/Sc TrnE' :?:4i
t 1 ,•f '
♦
� CONSTRUCTION AND PLANNING P� "� Spp' 3
� Date Inspector Da2e Inspector
qpPROVA�S Permit # APPROVALS Permit # .
�l. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. $oil Pipe-Undrgrnd. 53. Steei Reinforcemenr ' -
3. Electrical Conduit Utitity-Undrgmd. 54. Forms � '
4. Electrical ConduiFUndrgrnd. ' , 55. Electrical Bonding _ �
5. Steel Reinfarcement � 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUN17E �
7. Faotings - 5&. Eiectrical Condu(t�Undrgrnd.
8. •Foundation-� - 59. Gas Pipe; O Undrgmd., Test
. Water Pipe�U�drgrnd. ' � 60. 8ackwash Lines, P-Trap, � Undrgrnd.
70. Structural Fioor System � 61.. APPROVAL TO DECK _ .,
7 t. Property Sewer Line & House Conpection - 62. Backwash & Receptor-Finai .
,
�2. Se''�e� CaP ' 63. Heater & Vent�Final "
13. Roof Drains � . 64. Plumtiing System - Finat •
14. Rpugh Plumbing � 65. Electrical�Final '
15. Rough Electrical-Conduit � 66. Solar SYstem-Final �
76. Rough Electric Wiring ; 67. Fencing & Access ApproVai
i7. Rough Wiring 5ign ' 68. APPROVED FOR PI.ASTERING
t - -
i,�.- Rough Eiectrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rou�h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Duccs, in Struciura 70. Underground Hydro
22. DuCt§, Ventilating ' 7L Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test . 72. Under9round Flush
24. RooP Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing . ' 74. Overhead Hydro
26. T�Ba� Ceiling (Struc4urap & Monocoat 75. Dry Chemical .
27. Frame and Fiashing 76. Dry Standpipe
28. Letfiing & Siding 77. FIXED SYSTEM FIf�AL
29. Insulation � 78. PIRE PflEV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIR�MENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Etectrical Paw2r Meter�Fina( 80. F�OD CERTIFICATE tSSUED
33. Final Electric � � Notes: �
34. Final Heating & Air Conditipning ��
35. Finai Gas Pipe-Test . '
36. Hood or Canopy �-
,� ' '
37. Final Factory Firepiace � � -
38. Finai Plumbing �
39. Water Service-Fina� '
40. Gas Service-Final '
4i. So�ar 6omesttc-Pinal '
42. Backflow Preventar
43. Backflow Irrigation � ,
44. Landscape IrriGation System �
45. Sound Attenuation
46. Handicap Regu�ations
47. FINAL STRUCTUflE & BUILDING
48, FINAL PLANNING
49. Electrie Release to Edison . �
50. Gas Release to Southern California Gas Co �� '
51. CERTIFlCATE OF OCCUPANCY
No. Da[e
AVDlicant to fill in all spaces exeept tnose within neavY borGer Ilnes ana sign all aDoravriate tleclaratlons.
IcITYOF,COSTAMES�p �C�eO.N�$$jT-R��UCTION PERM T O '`
.�I �Prolect'Address _a..a.2����� ��!"��a
�',�,�ApplicanYsMailingAddress 2Z�D (�(�1 JF•n-S/�7
�Owner'sName (-�-r� ��C/��'G Phone'�%`Tyf�
Address
SS.i- �1 u ,—o...: '�..� � `
Arch/Eng. �N� f%'e-u� LicenseNo.
Address ���� U'ul V+'.�'S1'l
Nl.c S p ��
Contractor's Nam�— /h�o�ne
Addresslmailingl �j� S2 G'�.1�_ C`� ,$�jufN �.n {,
City License No. D 3 1/4 f
LICENSED CONTRACTOR DECLARATION
\1 hereby affi�m that I am licensetl unde� p�Ovisions ot Charter 9(commencinq
with Section ]000) of DiviSion 3 oi the Bu5ine55 antl Professions Cotl¢, antl
mv rcense �s i u torce and e�tect. 3(� 6 3 a f
License Flass � se No.
^��e �/ � 5'9nat r Q�yQf�
3KER5' COI PENSATION DECLARATION `
.reby aftirm [hat I have a certificate of con5ent lo SEIf-in5ure or a certiticate
of Workers' Compensation Insurance, or a certifietl co y tnereof (Sectlon
� 3800, Lab.�fC.) �/
Poli y No.bb 3��-�/C� Company`� �✓
eri�tietl copy i5 hereby furni5hltl.
Certitietl copy is tiletl with tne city n"���^' isio ��
Date - APPlicant � `-� ��-' "" IA .
EXEMPTION�RKER$' COMPENSATION DECLARATION
1(Thi; seclion neetl not be complet¢tl if the p¢rmit IS tor one huntl�etl (5100) o�
� lessy.
I certify tM1at in the performance of the work for which this perm�t is issuetl, I
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws ot Calitornia.
Date Signature
NOTICE: If, after making this tletlaration, you shoultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must torthwith
comply with such provisions or thls permit shall be tleemetl revoketl.
CONSTRUCTION,LENDING AGENCV
I bereby affirm that there is a constructlon lentling agency for the performance
ot the work tor which this permlt is iszuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's Atltltess
OWNER BUILDER DECLARATION
� I hereby affirm Lhat I am exempt irom the ConVactor's License Law for tne
I� tollowing reason (Section 7031.5 Business antl Protessional Cotle: Any city or
county which requires a permit to construct, alter, improve, demolish or repair
��i any s[ructure, prior [a its issuance, also requires the applicant for such permit
f�le a signetl statement that he/she is licensetl pursuant to the provisions ot
! Contractor's License Law (Chapter 9(commencing with Section 7000) of
.vision. 3 0� the Business antl Protes5ion5 Cotle) or that he/she is exempt
there(rom dntl the ba5i5 for the allegetl ex¢mption. Any violatlOn o( $ection
7031.5 by any applicant for a permit zubjects the applicant to a civil
�enalty of not more than five huntlretl tlollars (E500).
I, as owner ot the p�operty O� my employe¢5 with wage5 a5 tltei� sole
compensation, will tlo the work, antl the structure is not intentled or ofteretl
for sale (Section �044, Business antl Professional Cotle: The Contractor's
License Law tlaes not apply to an owner o( a property who builtls or improves
tne�eon, antl who tloes sucn work himself/herself or through his or her own
emploYees, D�ovitletl that such Improv¢ments are not Intentletl o� o(f¢r¢tl �o�
sdle. If, however, the builtling o� imprOvement i5 Soltl within One yea� ot Com-
pletion, the owner will have tha burtlen oi provin9 he/she tlitl not builtl or im-
prove torthc Purpose oisaie).
❑ I, as owne� of the prOperty, am eztluSlvely cont�acting wifh licensetl con-
tractors to construct the project (Section 7044, Business antl Protessions Cotle:
The Contractor's License Law does not apply to an owner ot property wbo
builtls or imoroves thereon. antl who conVacts ior suth oroiects with a r.om
tractor(sl hcense pursuan[ to [ne ConVactor'S License Law). 1 am aware that
oroof of their Worker'S Compen5ation Insu�ance shoultl be provitletl to me.
❑ I am exempt untler Sec[ion B. & P. C. (or this reason
Date
Signa[ure ( ( a�.1�X
Drivers' License or SS ��
Owner
nave rea0 this application antl state that the above
a9ree to comply with all tlry antl county orAinances
o builtling con5truction; antl hereby authorize re0re-
� en�yepyn tna above-mentionetl property for
TYPE OF CONSTRUCTION LJ NEW L.J ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHE
� DESCRIPTION OF WORK/USE OF BLDG.
� �
TV�EOFPERMIT GRADING FOUNDATION STRUCTURAL
��'TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION SQ. FT. 3� y S OCCUPANCY �-2
CONSTRUCTIONTVPE .�.. VAlUAT10N$ � �DIi
ZONE GRADINGCU.VDS. ACRES
Remarks:
Sink
Preventer
Irrigation
rinking Fountains
loor Orains
loor Sinks,
25 $2fVICC �11212i5
Kitchen Sink
Lavatories
P-Trep
Roof Drains
Reinspection Fee
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhau# System ❑ Multi
Firepl/Fact.8lt �CBO dk
Heating System & Ducting
❑6100,000 BTU 0100,C
Reinspection Fee
0865-46, rev. 5/88 White - Builtling; Canary - Applitanh Pink - Accounting; Goltlenrotl - Assessor
$15
S�s
�n ti�-� i-tm l ��� [�
dBING �
Showers
Service Sink
Sewer Cap
Sewer Connection ,
SolarTank . ^
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
�Auto-Wesh
Laundry Trays
laue Fee
Hood or /T,'. �pe I ❑
Canopy/ Type I I ❑
�Efrigeration System
❑o-ioo,oaoeTu ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
FEES
$ 3
A.P. # y �
S Main Buildi
E
T Front
B Rear
A
C Right
SLeft
Ping. Ref. #
Planning Notes:
Aummatic Washer
Construction Pole Sub.
Caoking Unit
Dishwasher
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW
���
- �j zone
Accessory Building:
ELECTRICAL '
Transformer ❑ 75-50 KW
❑ 50+ KW
Meter LJup to 100amps
Meter ❑over100amps
Sub Panel '.
Motors �0-1 HP,�1�� � 8
I na Solar-� 9-15 HP, � 16-15+
Pole Light �
Range
Sign �
Standing Sections
15 KW Trash Compactor
I Reinspection Fee ! $15
DEVELOPMENT SERVICES REQi
.Zonin9 APProved By
Building Appraved By
Aootication laued Bv
Issue Fee
. SUMMARV OF F
�BUILDING PERMIT $ y,3 %• �
. PLAN CHECK $ %� �T
- PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50°.G $
MECHANICAL $ i
PLAN CHECK 25% $
O
N
i
N
G
R
E
Q
M
T
S.
FEES
$ 3
� �,
SMIP $ $ ' �
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $
TOTALFEE $ �
Ll.9G+128�44-��L�?8345 T�3T :L6.2e
DATE: 40'/!5/E9 ItME: t19:19
. .. . �_ .. . \ ..-. _. ti . . : . , . .
ti >-'�.�.r,.w.. N� ) /
' I _&SPA
�CONSTRUCTION AND PLANNINC
Daie .lnspector � Date Inspector
.'�APPROVALS Permit�_�_ y �.,� APPROVALS Permit#
i
jl. Temporary Electrical Service or Pole �.,, �' ., 52. Pool & Equipment Location F.
�2. Soil Pipe,Undigrnd. �•� J, �� 53. Steel Reinforcement y� �
�.� � �� • Ci
` 3. Electpical Conduit Utility-Undrgmd. 1 �! 54. Forms � ��.}
n, -"� .
4.,�Electr�ic�l Con�uit-Und�grnd. i" 55. Electrical Bonding % �_� �
� 5�Steel.Re`inforcemeni � 4 � - 56. Rough Plumbing & Pressure Test .�;y
I' 'J_ Y "
6�EleciricslUFER�Grnd. ��� 57. APPROVALTOCOVER-GUNITE ��;5�,
rFootings "�`+ � �f � 58. Electrical Conduit-Undrgrnd. y�
8�Fouridation �- �� n ^�� 59. Gas Pipe, O Undrgmd., Test h�'�
9�Water Pipe-Undrgrnd. U� ��� 60. Backwash Lines, P-Trap, � Undrgrnd, i1
ti
10. Structural Floor System � .,�� ti� ,i 61. APPROVAL TO DECK .
� 1,1. Property Sewer Line & Nouse Connection � , j�j� ! ��,5 � ' 62.. Backwash & �ReceptorFinal � � � �
t � ,
12. Sewe� Cap �! ;� � ' 63. Heater & Vent-Final
73:,�Roof�D'rains v 1 v� � 64. Plumbing System - Final !'�
� 14JRoug� PLumbingy � 65. Electrical-Final ,+�-
�15. Rough.Electrical-Conduit 66. SolarSystem-Final
�� �;tti6! Rough Electr� Wiring �', 67. Fencing & Access Approval
�i� Rough Wiring Sign � ����� 6S. APPROVED FOR PLASTERING
L8: Rough Electrical�-T Bar Ceiling �` 69. POOL/SPA SYSTEMS FINAL
�9. Rough Heating�& Air Condiiioniny , FIRE DEPT. REQUIREMENT
v
�0. Rough factory Fireplace �� Ly� APPROVALS Permit #
21. Ducts, in Structure i�'� �"'
{" _ :� J 70. Underground Hydro
2�. Duc[s, Ventilating ��,� f 71. Product Piping OGas OOiI `
23. Gas Pipe-Rou h& Test �' 4
9 � , _� / 72. Underground Flush � �
44. Roof Framing �,, f � � 73. Undergrnd.StorageTank OGas ❑Oil�
25. Roof Sheathing y '. . � _ _ 74. Overhead Hydro - • . -
r^� � }
26; T-Bar Ceiling (Structural) & Monocoat "i � 75. Dry Chemical
27. Frame and Flashin � ' �
9 ��, � 76. Dry Standpipe .
� 28: I:athing&JSiding j' .,i 77. FIXEDSYSTEMFINAL
F 29. Ins�ulation ; �, 78. FIRE PREV.�FINAL ..
�
,
30. Drywall Nailing �' � S .� , HEALTH DEPT. REQUIREMENT �
;�1? Plaster�BrownCoatlV w . 7g. FINALINSPECTION "
.� .. �
�32. Electrical Power Mete'r-Final � ; 80. �POOD CERTIFICATE ISSUED
33. Final Electric � '� �j � - Notes: ' ' •' '
r�
34. Final Heating & Air Conditionin ' �� �� .'2 " � n�
35. Final Gas Pipe-Test -- -- � � �� � �Q
r.� r
'y . Hood or Canopy (' I
�'37. Final Factory Fireplace � � -
,�
38. Final Plumbing s� " �
39. Water Service-Final - �
i. .
40. GasService-Final ,' . ���
� 41. Solar pomesticFinal � / 1�l ` ,i
42. Backflow Preventer � � �� �1'� v.i%•
� t� , .
'.43. Backflow Irrigation ,� �'�� 1 Y �
�
i-, ' .�
44. .Landscape'Irrigation System ' "
45. Sound Attenuation '� ��
� �
46. Handicap Regulations � � ��
47. FINALSTRUCTURE&BUILDWG � , �
48. Special Requirements Completed -
,49. Electric Releaseto Edisqn , ' [= lv �,;
� 50. Gas Release to Southern'�alifornia Gas Co , �' � �: ':9
51. CERTIFICATE OF OCCUPANCY � 't `�
- , ;�+: 1.>
No. Dace , . ' :���- ' � '.1
Aoo�icant to fill in ail soaces exce0t those within neavy boraer lines antl si9n xll aDV�oVriate aeclarations.
CITV OF COSTA MESA CONSTRUCTION PERMIT ' � iP MIT NO. TRACT NO. LOT NO. � UNIT NO. A P# 2one
, Project Address ';� �'.a/�0 �S �' R�D � � � S�
- S Main Building: Accessory Building:
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR E Z
, AppliCant'SMailingAddfe55 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T Front - p
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. A Rear - N
Address
Arch/Eng. License No. TVPE OF PERMIT GRADING ❑ FOUNDATION STRUCTV RAL K Right G
AddreSs . ❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL g� Left
/�� �� ❑ OTHER R
Contractor's Namn '��22D .S�1A�T �O Phone �2J2 �l]_� Ping. Fief. # Parking Req./Provided E
Address (mailing) �'f��� r[L�uniS PYkQR*!'1.i� �ROJECT DESCRIPTION 5(]. FT. oCCUPANCv Planning Notes: M
CONSTRUCTION TVPE VALUiITION $
Cfty License N0. � Ca O Z` ZONE GRADING CU.Y�S. ACRES $,
LICENSEO CONTRACTOR DEGLARATION
I hereby atfi�m that I am�licensetl untler provi51on5 of Cha�ter 9(commencinq Remarks:
with semon 1000� oi Divislon 3 ot the eusiness antl Professlons Cotle, antl ELECTRICAL FEES
my license is in full force antl effect.
License Clas � License No.Zq U Automatic Washer Transformer ❑ 15-50 KW
oatc�S'� -:l� 5'q t c 4- /� PLUMBING FEES .
RKERS' COMPENSATION DECLARATION Construction PoleSub. � 50+ KW
'e�y affifm tM1at I have a certificate O! con5ent t0 self-InSufe or d celtlticate gdf $ink $hOwQfS
workers' Compensation Insurance, or a certifietl cooY tnereot (Section Backflow Preventer Servite Sink Cooking Unit Meter ❑up to 100 amps
3800, Lab. �j) ��� / . . , '
Policy No. ow�-�qi�.��% Company �-�L�'=�%'�� Backflowlrrigation SewerCap Dishwasher •'. Meter ❑over100amps
� �, tifietl copy is hereby fumishetl. Dryers ❑Gas ,��Electric Sub Panel
�e ine copy �5�iietl wim tne city euiiq+ yR fi • - Bathtubs Sewer Connection -
Date ��6 -f�7 qpplicant [�/j � Pan "' Motors �0.1 HP �1•/:-8
EXEMPTION FROM WORKEFS' GOMVENSATION DECLARATION CId�IIi¢�5 5012� COIICct0�5
-(Thi55ection neetl not be comple[¢tl if the pE�mit i5 for one huntlretl ($100) o� Di5hv.35h2� F�A�U� Ina Solar 09-15 HP �1C-15+
less). Solar Piping
I certify tbat in the performance of the work for which this permi� is issuetl I Fixtures '� �
s�all not employ any person in any manner so as to become subject to t�e Drinking Fountains Solar Tank i+. Microwave
A Worker5' Compensation LawS of CdlifOrnia. � � D¢vic¢ BOxCS
Date Si9nature Floor Drains Swimming Pool w/Spa Pole Light
NOTICE: If, after making thi5 tleUaration, you ShOultl beGome subject to th¢ Outl2t5 (jdp ¢
. Worker5' Comp¢n5ation provisions of the Labor Cotle, y0u must forthwith FIOOr SinkS . Urinal 9
comply with such provisions or tnis permit shall be tleemetl revoketl.
' CONSTRUCTION LENDING AGENCV ' GaSServlce Outlet5 Wat¢fCbSet SWitCheS Sign
I hereby affirm that there Is a con5truction lentling agency to� the pe�fo�mance
iOf �he work fo� which tnis pe�mit is issuetl (Section 309] Clv. CJ IOt¢fC2Pt0�5 Water Heater '7 w Cid�bdgE Di5pO5dl $tanding S¢CLiOnS
Lentler's Name `
�enaers adaress � Kitchen Sink Water Service - Generator 065 KW �5-15 KW Trash Compactor
OWNER BUILDER DECLARATION
� I hereby affirm that I am exemp[ from the Contractor's License Law tor the Lavatofies AuiO-Wash
following reason (Section �031.5 Business antl Professional Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repair P-Trap � �aundry Trays
any st�ucture, priOr [o Its issuance, dl5o �eqWres th¢ applicant fo� such p¢�mit
�^ file a signetl statement that he/she is licensetl pursuant to the provisions of Roof Drains �
Contractor's License Law (Chapter 9(commencing with Section 7000) of
.sion 3 of fhe Business antl Protessions Cotle) or that he/she is exempt Reinipection Fee $15 Issue Fee $ 3
_refrom antl the basis Tor the allegetl exemption. Any violation of Section ,
7031.5 by any applicant tor a permit subjec[s the applicant to.a civil
enatty o[not more than /ive nuntlretl tlollars �E500). DEVELOPMENT SERVICES RE�UIREMENTS:
� I, as owner of the property or my employees with wages as tneir sole Reinspec[ion Fee $15 Issue Fee $ 3
compensation, will tlo tM1e work, antl the structure is not intentled o� offeretl Za�i�9 />PP�oved By DBtO
tor sale (Section �044, Business and Professional Cotle: Tne Contractor's MECHANICAL FEES Building Approved By Date
License Law tloes not appry to an owner of a proper[y who builtls or improves 3�T�S
thereon, antl who tloe5 Such work himselt/he�self o� th�ough his or h2/ own Applitltian ISSUBd By DatO�� ��b ���1
employees, provitletl that such improvements are not intentletl or ofteretl for BOiler HOod of Type I ❑
sale. 1f, nowever, Ihe builtling or Improvement is soltl wlthin one year ot com- Canopy Type II ❑ $UMMARV OF FEES
pletlon, lhe owner will have [he burtlen of proving he/she tliG not builtl or im- Duct - Under Ground
prove tor t�e purpose of sale). BUILDING PERMIT $ SMIP $
❑ I, as owner ot the prooertY. am ezclusively contracting wlth Ilcensetl con- Duct-Structural � Refrigeration System P�.AN CHECK $ PERMIT
lractors to ton5truct the prOject ($ection 7044, Businezs dntl Pro(ession5 Cotle:
The Contractor's License law tloes not apply to an owner of property who Duct- Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $� ISSUANCE $
builtls or imDrov¢5 thereon. antl who contracl5 tor such orolect5 with a mn- �
tractor(s1 I�%ense pursuanc to me Contractors License Law). I am aware that Exhaust SyStem ❑ MWtiple ❑ System Repair/Alteration PLAN CHECK 25% $ ENERGV P.C. $
O�oof of u�eir Worker's Compensation insuranre shoWtl be provitletl to me. ELECTRICAL $ GRADING $
❑ I am exempt unaer Section B. & P. C. for this reason Firepl/Fact. Blt. ICBO �k Fire Dampers MICROFILM $
PLAN CHECK 5096 $ �
Date owner Heating System & Ducting Registers MECHANICAL $ �
I hereby certify rnat I have reatl'tnis apP�ication antl state that the above ❑P100,000 BTU �100,0008T - . TOTAL FEE $
intorma[ion is correcL I a9ree to comply with all clry antl county ortlinances ' PLAN CHECK 25% $
anC state laws relati y }� oVyinq construction, antl hereby authorize reore-
sentatives ot thi5 y 'l entbr upon th¢ above-mentionetl property for ' ,
Inspection purpos . --� � �q (
Si9nature ' Date�o_L ,
�rivers' License ar 55 � _ Reinspection Fee $15 Issue Fee $ 3 Ot OOp38i,P.9- 2 �
noo ass9 Tt�-r �,p�
0865-46, rev. 5/88 Wnite - BuilCing; Canary - Applicant; Pink - Accountinq; Goltlenrotl - Assessor � ' DATE3 Q$/�(�/�� TIhE: I1.2L '
�. . ... ' . . r .., w� v. ; .. � � i.. .-.. � i T' f.. Y 9 � .� �aa. . . ... ^^
C I - I- I
CONSTRUCTION AND PLANNING 't � & SPA .
��APPROVALS . Permit # •�' Date Inspector AppROVAI.S Permit # Date Inspector
.. YJ
1: Temporary Electrical Service or Pole 1' 52. Pool & Equipment Location
;�
i. •e. rr
� 2. Soil Pipe-Undrgrnd. `,� � � 53. Steel Reinforcement �
� 3 JElec�trical Condoit Utility-Undrgr,nd. �) � 54 Forms jf��
� 4l�Electtical Condujt-Undrgrnd. } �1 55. Electrical Bonding '��,�'
5 jStee�,Reinforcemen� � � 56. Rough Plumbing & Pressure Test �,f .ij
65EleciricalUFER•Gmd^� 57. APPROVALTOCOVER-GUNITE :i
� 75 Footings ;� S n ��� 58. Electrical Conduit-Undrgrnd. , ��
V
� 8. Foundation �;.^,' �� �%} �` 59. Gas Pipe, 0 Undrgrnd., Test ^
9, Water Pipe-Undrgind.-� � !/ 60. Backwash Lines, P-Trap, � Undrgrnd.
10.� Structural Floor System % � 61. APPROVAL TO DECK
11!`Properry Sewer LinA& House Co�nection : , - 62. Backwash & Receptor-Final ,
>
12. Sewer Cap ,'% � '�+ ;; 63. Heater & Vent-Final ��
,.• � 'i
13. Roof Drains �� _ �' 64. Plumbing System - Final �A
= 14. Rou h Plumbin �� 3 Z`%�e L '�
g g, �% 65. Electrical-Final .,
15. Rough Electrical-Conduit - 66. Solar System-Final
q6: 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
79'. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace v APPROVALS Permit #
21. Ducts, in Structure `J 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 O Gas ❑ Oil
25. Roof Sheathing. � ' ' • 74� Overhead Hydro • e ,
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 7S. 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 S � �Q (,�
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer ..
43. Backflow Irrigation �
44. Landscape Irrigation System �
45. Sound Attenuation
46..Handicap Regulations
� 47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison = �
50. Gas Release to Southern California Gas Co -, .
51. CERTIF�CATE OF OCCUPANCY .
No. Date �
AODllcant to flll in all soaces ezeeot tM1ose witnin neavv eertler Iinea ane aion all aoorooriate tleelantiens. IDSY�
PEPMI NO. TRACT NO. LOT NO. UNIT NO.
� CITY OF COST`A MESA CONSTRUCTION PERMIT 8�o q.P, qi� 2one
.Project Address-�-r-�s' .� /' - �� O I �
AppliCOnt'S ��/ ddr¢Ss. �/ .F .!i l��c�s'el�r TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E Main BUilding: ACCe55ory Building: Z
Ownef's Nam2 ?������ �� G Ph0 p � CONVERSION ❑ DEMOLISH ❑ OTH T Front �
DES RIPT OF WO K/USE OF BIDG. �����T B Rear N
Address S.i�L� OiU �Gc�/ �Gl�T i(�61if �(�l�E �i!%U .�0:� U! !' . A I
Arch/Eng. LicenseNa. TYPEOFPE�GRADwG FOUNDA7lOra 57RVC7VRAL � K Right G
•�Address
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING �MECHANICAL g Left R
Contrac or s�m�o��' C�• ��� prya�YV-Gf")/ ❑ OTHER , Ping. Ref. # Perking Req./Provided E
PROJECT DESCRIPTION Sa. FT. oCCUaANCv �
Address (mailingl G�� � si►LJ /�.[.S�iftiao �+ Planning Notes: M
O/ A^� CONSTRUCTION TYGE VALUATION $ T
City Licenx No. �c`�� ZONE GRA�ING CU. VOS. ACRES
S.
LICENSED CONTRACTOR DECLARATION
I bereDy aHirm [hat 1 am IiCenSetl untle� prOvizlOnt 01 Charter 9(comm¢nCing Remark[: � �' �
with section 7000) ol Olvision 3 of l�e Business antl Vrofessions Cotle, antl
my ncense is In luu force antl Ntect. Q /O� J � ��OO ELECTRICAL FEES
, License Class C- zD Litense No������ L L'��'
oate� Sig ure � PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
7KER5'COMPENSATIONfDECLARATlO CqnSt�UctionPolfSub. �50+KW -
e�y aflirm Ihat I hava a cerHticate ot consent to sel -ms or a tertlficate Ba� Sink ShawE/S
. Workers' Compensation Insurance, or a certifletl copy tnereot (Sectlon Backflow Prevencer Servite Sink Cooking Unit Meter ❑up to 100 amps
3800, �b C.) -•
� Poiicy 1Goal�L✓• ���n� Company %�A..flf v Backflow Irrigation Sewer Cap • Dish�vasher Meter �over 100 amps
CJ �Certifietl copy is hereby furniitta ;� Dryefs ❑Gas ❑E12ctric Sub Pan21
Cert�etllcop I�e4wIN tn ty Bu'tlinq Di 'slon. Bathtubs . SewerConnection
Date d �—T- AP �a^� - ' , Fan
E%EMPTIONFROMWORKERS'C MPENSATIONDECLARAT Clarifiers $plarCOIICCtOrS MotOr5OP1HP�1'h-8
(Tnissection neetl not be completetl if Ihe permit I5 for one huntlre0 00) or �, F.A.U. Inc. Solai �9�15 HP 016�15+
less). Dishwasher / Soler Piping
I certity that in the pertormance oi lho work for wnlch this permrt is tssuetl, I Fixture5
shall no[ employ any person in any manner so as to become subject to the Drinking Fount9in5 Sol3r TBnk MicrOwavE
Workers' Compensation l.aws of Calitomia. Device Box¢s
Date Si9�ature Floor Drains Swimming Pool w/Spa Pole Light
NOTICE: If, after making this tlOClaraUOn, you Shoultl become subject to t�e
Workers' Compensation Orovlsions of the Labor Cotle, you must forthwith FIOOrSinks Urinal Outlets Reng¢
comply wilh suth O�ovlsions o� tnis pe�mlt Shall b¢ tleemetl r0voketl.
CONSTRUCTION LENDING AGENCV GeSSC�VICE OULIBLS W8l¢�CIOSEL SWItCh¢5 Sj9�
I hereby af/irm that there is a connruction lentling a9ancy for the performance
ot tne work ror wnicn this permlt is issued (Sectlon 3097 Civ. C.) Interceptors Weter Heater Garbage Dispoul Standing Sections
l.entler's NamO
�enacr's Atltlress Kitchen Sink Water Service Generator �0.5 KW �5�15 KW Trash Compactor
OWNER BUILDER DECLARATION
I nereDy aillrm lhat I am exompt irom tha Contractor'S Llcense Law !or the Lavato�ies Auto�Wash
lollowing reason (Section 7031.5 Business antl Professional Code: Any ci[y or
counry whiU requires a permit to cons(rucl, alter, improve, tlemolish or ropair P-T�ap Leundry T�sys
any slrutture, pNOf to Ils iSSudnCO, dlTO reqWr05lhe aDP���ant (or Suth pefmit
" file d SignGtl 5[alement thdt h0/ShU I5 IlcenSBtl pufSudOt 101h0 PfOVIslonS of ROOf DfdinS
COMractor's Litense Law �Cbapter 9(tommen<Ing with Section 7000) of
sion 3 ot the Busine55 ana Protessioni Cotla) or that he/ine is ezampt Reinspection Fee $15 Issue Fee $ 3
_-retrom anU tne basis for tne alle9etl axemptlon. Any vlolatlon of Sectlon
7031.5 by any ap011tdnt lor a permit Sub�ects Ihe appllcanl t0 d civil
ena�ty ot not mora than flva nuntlretl tloiiars (E500). DEVELOPMENT SERVICES REQUIREMENTS:
g] Reins ction Fee g 3 Zoning Appravad By Date
I, as owner ol th0 Prope�ty Or my employee5 with wag0s as Ihui� Sole Va $15 Isue F80
compenSalion, wiil tlo Iha wofk, dntl the slfuCtufB IS nOt Intlntletl a! otfBrCtl �
ior sale (Seclion 70a4, Business anU Professionai Gotlo: The Contractor's MECHANICAL FEES BuildinB APProved By Date
. License l.aw tloes not apD�Y �a an owner ol a property who builGs or improves
tnereon, ana who tloes iucn work himSeN/nerself or throug� his or her own Applimtion Issued By Dat
Cmployeei, prOviOCd lhat such ImprOVOmentS ar8 IIOt Int¢ntl80 of offafetl for BOiIEf HOOd Of Typ2 I ❑
sale. II, however, tne DUIItlin9 or improvament Is soltl witnin one year of com- Canopy Type II ❑ SUMMARV OF FEES
pletion, the owner will have tne burtlen of proving ha/sha tlitl not buile or im- Dutt � Under Ground
prova �or che purposo oi sale). BUILDING PERMIT $ SMIP $
❑ I, as owner ot the Droperty, am exclusively contracting witn Ilcenzetl con- Duct -Structural Refrigeration System PLAN CHECK $ PERMIT
lfacto6 t0 COnStrutt Ihe projeCt ($actlon 7044, Bu5In855 antl PrO/e551on5 Cotle:
bu'��Ids o��improvei�theroo�n�.anC who�contPaCt5t1or�5u<h oroieci�wltn�a wn� Duc[-Ventilating . �O�100,0008TU ❑100,WOBTU PLUMBING $ ISSUANCE $
tractor(s1 Lcense pursuan� ro ena ConVactors License Law�. I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteretion G,r P�N CHECK 25% $ ENERG�' P.C. $
proot o( tneir Worker's CompensaHon insurance shoula be proviaetl to me. ELECTRICAL $ GRADING $
❑ I am exempt untler Sectlon B. & P. C. for tniz reason Firepl/Fac�.81t. �C80 dk Fire Demper v O MICROFILM $
PLAN CHECK 50% $
Date owner Heating System & Ducting Registers MECHANICAL $�� �.n
I nereby certify that I have reatl this applitation anC ztate lhat the above ❑P100,O00 BTU �100,000BT TOTAL FEE $
Iniormatlon is correct. I agree to como�Y with all city antl county ortlinances T � PLAN CHECK 25% $
antl s[ate law lating lo builtling con5trucNon, antl hereby authorize repre-
5¢ntatives th 5 Uty IO enter on the abOv¢-menUonetl proplrty tor
i05pectl pulp SeS.
Slgna re ��-�. Date 7 ZGz��
� ' Reinspection Fee 515 Issue Fee .S-3. ,$.�a
or��ers� ense or 55 O 1 OOQ29507-00029507 TO �
0865-46, rev. 5/BB White - Builtling; Canary - Appllcant; Plnk � Accountinq; Goltlenrotl - Assessor - DAT�: 03!'sQ/89 TIKE: IQ:YO �
. . . , . . . ._ . ,�,. -. n-;. . .✓"-' .. ... _. . . ., y . . .
. �:�\;�,;.' _, � .
CONSTRUCTION AND PLANNING ,' � & SPA
APPROVALS Permit # • Date Inspector qpPROVALS Nermit # Date Inspector
� '
1. Temporary Electrical Service or Pole _ . 52. Pool & Equipment Location
•2.� Soil Pipe-Undrgrnd. 53. Steel Reinforcement ..
�.� Elecvical Conduit Utility-Undrgrnd. ' S4. Forms /
4� Elect�ital Conduit-Undrgrnd. � ! f �' S5. Electrical Bonding �
,5:+•Steel'Reinforcement� �!,. � 56. Rough Plumbing & Pressure Test , �
� ,
6� Electrical UFER Grndl � 57. APPROVAL TO COVER-GUNITE )
7. Foo[ings' � • 1' � � 58. Electrical Conduit-Undrgrnd. �j �
�
8�'Foundation "1 � �� �� � 59. Gas Pipe, O Undrgrnd., Test ��'
9.{Watei Pipe-Undrgrnti. ' � 60. Backwash Lines, P-Trap, O Undrgrnd.
10.�Structural Floor Sy tem �' . 61. APPROVAL TO DECK
11! Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final
'�: . t �
12. Sewer C5p . � - 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
c
16. Rough Electric Wiring 67. Fencing & Access Approval
•1.7.,Rough Wiring Sign � 68. APPROVED FOR PLASTERING
�1�8? Rough Electrical-T Bar Ceiling -� 69. POOL/SPA SYSTEMS FINAL
�19. Rough!Neating & Air Conditioning �ry� �,�() FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace '!I APPROVALS Permit#
,
�21. Ducts,�iri�Structure � �� 70. Underground Hydro
-22. Ducts, Ventilating '�� i 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test �� ` 72. Underground Flush � �� /
24. Roof Framing ` 73. Undergrnd. Storage Tank O Gas ❑ Oil �}'
25. Roof Sheathing . � 74. Overhead Hydro `i
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �
27.�F�amcandFlashing � . 76. DryStandpipe .
28. Lathing & Siding �� � 77. FIXED SYSTEM F�NAL • „
29. Insulation `,' n , 78. FIRE PREV. FINAL �
30. Drywall Nailing ��, � HEALTH DEPT. REQUIREMENT '�
31'. PlasCer Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Fina� 80. FOOD CERTIFICATE ISSUED ��'• j� /`� �
33. Final Electric Notes: � �' . '
34. Final Heating & Air Conditioning ��l�Q �v
35. Final Gas Pipe-Test
36. Hood or Canopy � �
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final FTS
40. Gas Service-Final (Tj
41. Solar pomestic-Final �
�
42. Backflow Preventer "� ' � ,
G r i� �,
43. Backf�ow Irrigation � ' ��
44. Landscape Irrigation S,y_tem
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 _�
ADG�Icant to flll in all spaces except tnose within neavy eortler Iines ana sign all aoCrooriata tleclantlons.
� PE�I 3��� TRAC7 NO. LOT NO. UNIT OD
CiTv oF COS7A MESA CONSTRUCTION PERMIT p A.P. qN zo�a
Project Address 555 An'f�T 5��� O�Zi ��
Applicant'S Mailing Add�255 (� TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR $ M2in Building: Acteisory Building:
Ownef'S Nam2 Sar�r�'�l Rl.C1Y�` Pdtl� � CONVERSION ❑ DEMOLISH ❑ OTHER T Ffont Q
Phone DESCRIPTIONOFWORK/USEOFBLOG. B Rear N
Address A �
Arch/Eng. HOK 1 _ Lic2n5¢NO. TVPEOFPERMIT^ GRADING FOUNDATION STRUCTURAL I C Right N
Address �1��V_r �� � ll)G I�l1(]P �PG ❑ TENANT �v ELECTRICAL ❑ PLUMBING ❑ MECHANICAL i g� Left G
❑ OTHER �
Convactor'sName��l, �-�PC'�rlC Phone�4���� PIng.Ref.# ParkingReq./Provided E
PROJECT DESCRIPTION 5(2. FT. oCCUPANCV �
Address (mailingl ��� �etlhll� �C�'1DT CLYS�C` (71CGfU Planning Notes:
CONSTRVCTION TVPE VALUATION S M
City LiCense No. �U'4486 ZONE GRADING CU. VDS. ACRES $.
LICENSED CONTRACTOR DECLARATION
I her¢by a/firm [ha[ I am IicenSetl unde� provislon50f Chart¢r 9(COmmancing Remarks:
with section 7000) of Dlvision 3 of the Business antl Protezslons Code, antl
my license is in fWl torceantl eftecL Jy - ELECTRICAL FEES
�icense Gass C— 10 �censp rvo.SU���—I 1 ��
Date`�I']�_ Signature ✓��.t�91'�1 �tY��u'n PLUMBING FEES Aummatic Washer Transformer ❑ 15-50 KW
7KER5' COMPENSATION DECLARATION Bar $ink ShOWers ConStrUction Pole SUb.
❑ 50+ KW
eby atfirm that 1 hdve d certifiCate of consent to selt-insur¢ or a C¢rtitltdt¢ '
o� Workers' Compensation Insurance, or a certifietl copY thereof (Section BackflOw Prevente� Service Sink Cooking Unit M¢ter ❑up co 100amp5
3800, t_ao. C.) r Dishwasher Merer ❑over 100am
Policy No.111PRR�1., �u� Company r�'PlhnnT T(1ri9rnl��i�1 Backflow Irrigation Sewer Cap �t PS
Certitietl copy is hereby furnishetl. Dryers OGas ❑Electric Sub Panel
Certifi tl c py is illetl with the city wlain9 Division. � Bathtubs Sewer Connec[ion
� ate0'�j17�$9 ApPlicant ��e.nC`rm1iM% - Fan Motors�0.1HP�1'h-8
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clafifiefs' ' Solar COIIe[tors �
(This sec[ion neetl no[ be completetl if the permit is for one huntlretl (5300) or F.A.U. Inc. Solar �9-15 HP � 16-15+
iess). ,� Oishwasher Solar Piping
I certity that in tne oerformance ot the work for which this vermlt is issuetl, I � 'J, Fixtures
snall not employ any perzon in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' ComOensation LawS ot California.
_� Date Signature Floor Diains Swimming Pool w/Spa �+ Device Boxes Pole Light
NOTICE: If, afte� making this tlecla�a[ion, you shoultl become Subject [O Ihe
Workers' Compensatlon provisions of the Labor Cotle, you must (orMwith Floo� Sinks U�inal Outlets Range �
tomply with zuch provislons or this permit 5hall be deemetl revoketl.
� CONSTRUCTION LENDING AGENCV G85SerViCe Outl2t5 WaterCloSCt , 6$Witche5 Sign
I hereby af(Irm [hat there is a conslructiOn IGntlin9 agenty fo� the pe�to�mance �
of the work �or wnicn tnis permit is izsuea (Section 3097 Clv. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lentler's Name
Lender's aadress - Kitchen Sink Wacer Service � Generator 065 KW �5-15 KW Trash Compactor
OWNER BUILDER DECIARATION �
I hereby affirm Lnat I am exempt from tbe Contractor'S License Law for the Lavato�ies Auto-Wash i 3 Kw war- � (�j9
tollowin9 reason (Sectlon 7031.5 Business antl Prote55ional Cotle: Any dty or
county which require5 a permit to construcl, alter, improve, tlemoli5h or ropair ' P—T�ap �und�y Trays
any 5t�ucWre, priOr lo its Issuance, a150 requir¢Slne appllcant tor SUGh pe�mit
' �ile a signed statement tnat he/she is �Icensea pursuant to the provisions of ' Roof Drains
Contra<tor'S License Law (Chap[er 9(commencin9 with SecUon 7000) ot
sion 3 of thC BuSiness antl Pro1lss�ons Cotle) o� thdt h¢/Slt¢ I5 exempt . RBI�SpeCtiOl1 FBB $15 ISSuO F88 �(%
.,ereirom antl the basis for the allegetl exemption. Any vlolation ot Sectlon
7031.5 by dny applicant fOr a permit Subjects Ihe apP�icant l0 a civil
�enalty o� not more than tive nunaretl tloiiars (5500). 3 DEVELOPMENT SERVICES REQUIREMENTS:
LJ I, as owner oi lhe property or my employees with wa9es as their sole Reinspaction Fea $15 lesue Fee a Zoning Approved By Oate
tompen5alion, will tlo IM1e work, antl the sVu<fu�e IS n0[ Int0n0etl o� 01fer0tl
for sale (Seclion 7044, eusiness antl Protessionai Cotla: The Contractor's MECHANICAL FEES Building Approved By Date
License Law tlo¢s not apO�Y f0 an own¢r O/ a p�ope�ty who bulltl5 O/ Imp�oves
[Fleleon, antl wllo tloe5 Su<h wolk hlm5ell/her5elt or thrOu9h h15 0l hef own AppIIWt10l1 IStUBd By � Ddt �
employces, pwvltletl that suth ImOrovemenl5 ar¢ nOt intentlBtl o� offeretl f0� BOi1Z� HOOd O� Type I ❑
sdl¢. II, M1owev¢r, the Dulltlin9 or im rovement is soltl within one y¢dr of com- �
p Canopy Type II ❑ SUMMARV OF FEE
pletlon, tbe owner wlll have Ihe burtlen of Proving he/she tlitl not �uiltl or im- Duct - Under Ground
erova for the purpose ot sa�e). BUI LDING PERMIT $ SMIP $
LI I, as owner of the property, am exclusively contracting with IlcenseC con- Duc[ -Structural Refrigeration System PLAN CHECK $ PEFMIT
tractors to construct thB project (SeGtlon 7044, BuSiness antl Profe551ons CoGe:
The Contractor's License Law does not apply to an owner of property who , Duct - Ventilating ❑6700,000 BTU ❑100,000 BTU ISSUANCE $
bulltls or Imoroves tnereon. antl who conVacts for such oroiects with a con- PLUMBING $
tractor(sl Lcense pursuani to me Contra<tors License Law). I am aware tnat Exhaust System � Multiple ❑ SyStem Repair/Alteration P�N CHECK 25% $ ENERGV P.C. $
proot o/ tneir Worker's Compensation insurance shoultl be oroviaetl to me, ELECTflICAL $�2. �5 GRADING $
❑ I am exempt untler Section B. & P. C. tor this reason Firepl/FacL Blt. �CBO # Pire Dampers
PLAN CHECK 50% $ MICROFI�M $ ,..,,� ��
Date owner HeatingSystem & Ducting Registers MECHANICAL $ Nr( •�D.�
1 hereby certity that I have reatl this aoP��cation antl state that the above ❑0-700,OOOBTU �100,0008T TOTALFEE $
Information Is mrrecL I aqree to comply with all tlty antl coun[y ortlinan<ez PLAN CHECK 25% $
antl State laws �elating to builtling const�uctiOn, antl h¢reby autho/Iie rep�e-
sen[atives of this tlty to enter upon the above-mentionetl property for
, inspec[Ion purpo5¢s.
Signature � �nnir(�Qr�9, 1 Date�%Ii�R9 �
Orivers' License or 55 9f � Reinspection Fee S75 laue Fee $ 3 Qi q00?8522-�D�J?Eb?2 Tb�i 7�.F5?
- DATR 113117/R9 TTMGt 12!rtS .
0865-46, rev. 5/BB W�ite - Buildinq; Ganary - Applicant; Pink - Accounting; GOIGenrotl - Assessor
. .�-� . � . � r -. . . ._ . �..�..-. -. . � . Y.r� J�.. .• .. �. • � �
PR-io-Ol
(:ONSTRUCTION AND PLANNING '' � & SPA
APPROVALS Permit# •.� Dateo Inspector �qppROVALS Permit# Date Inspector
� in
1�. Temporary Electrical Service or Po� � 52. Pool & Equipment Location
. 2. Soil��pe-�nii_rgrnd. V� t, q 53. Steel Reinforcement
3tlElectrical Eonduit�lJiility-Undrgrnd. _ 54. Forms �„
4�Eleciucal ConduiiUndrgrnd. Q 55. Electrical Bonding
5r Steel �teinforcemgnti n � 56. Rough Plumbing & Pressure Test
,. '
6.�Elect'ricalUFER�.Gmd� �-r 57.APPROVALTOCOVER-GUNITE ���
7. Footings �,; ��( q � 58. Electrical Conduit-Undrgrnd. �[r,
8. Foun'dation �„ �� v�D - 59. Gas Pipe, O Undrgrnd., Test ��u�
9. Water\Pipe-Unilrgrnd. �= i `� 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor System � �' .� 61. APPROVAL TO DECK
17�.'Property Sewer Line�& House Co_nnection . 62. Backwash & Receptor-Final `
12.',Sewer CaP '' � -. %-
- .i �. : 63. Heater & Vent-Final
L.-
13. Roof Drains U- � - 64. Plumbing Sys[em - Final a�
14. Rough Plumbing'`� ' 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
�•t6? Rough Elec[ric Wiring 3,31�� 67. Fencing & Access Approval
�i
17, Rough Wiring Sign 68. APPROVED FOR PLASTERING
i. '
18. Rough Electrical�T Bar Ceiling , fi• � 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. HEQUIREMENT
�
20. Rough Factory Fireplace j,� APPROVALS Permit#
r, ,
21. Ducts, in Structure � 70. Underground Hydro
22. D cts, Venti�ating v 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing iU 74: Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat '_ t. 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: Electriral Power MeterFinal 0. FOOD CERTIFICATE ISSUED
33. Final Electric es: ,
34. Final Heating & Air Conditioning ' ,
t� •:�7
35. Final Gas Pipe-Test ,_�
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final - _ "-
i I "
40. Gas Service-Final �' �
41. Solar pomestic-Final ; 1
.;
42. Backflow Prevenier ��•' � l.l
43. Backflow Irrigation . ��
44. Landscape Irrigation System � � �! �'
45. Sound Attenuation � �
�
46. Handicap Regulations � �
47. FINALSTRUCTURE & BUILDING '•
48. Special Requirements Completed ,
49. Electric Release to Edison ���:
50. Gas Release to Southern California Gas Co � t, ; _ _ �� �.�
51tiCERTIFICATEOFOCCUPANCY „ !� \ i; ,
- .� ✓
No. Date • ' • �
:� � , �. �
' ,#QZ$$$ AOV��cant to flll In all spaces exceo� lnose within neavy boraer nnes and siyn all appropriale tleclantions.
PERMIT NO. TRACT NO. LOT NO. UNIT N0.
CiTVO�COS7AMESA CONSTRUCTIONPERMIT A.P.�W zo�a
"Froject Address 555 A�TInN� $ITI`� #8�� � �� � OO S Main Building: Accessory Building:
Applicant's Mailing Address TYPE OF CONSTRUCTION t�lEw qoo ALTERATION RE7AIR Front
7540 SUZI LN. WES�7INSTER �/ e z
Ownef'SName SECURITY PACIFIC BANK PhOne � CONVERSION ❑ DEMOLISH LTOTHER C.O Mi�"le✓GIQ I T O
DES TION OF WORK/USE OF BLD 8 Rear N
Address 6�� WI�$iii�'� #5��, L.A. 90017 , q I
�✓' 3 P—rt �t,b�c �� v-S� E' �`1 � Right N
Arch/Eng. License No. TVPE OF PERMI�GRADING LJ FOUrJDATION LI S7RVCTV RnL K G
Address �+
❑ T NANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g� Left R
Contractor's Nama K�''E $�' Phone $95-1156 �oTHEa _ F� 1�"�� c�KJD1� �'e == 1 OI/� _ p�ng. Ref. # Parking Req./Provided E
PRQIECT DESCRIPTION Sq. FT. oCCUPANC n
Address (mailing) 754� $�ZI �1�,', �1TES�NS`I'IIi 926$3 � Planning Notes:
CONSTRVCTIONTYPE ��'R�r!�ATION$ �iOOO.00 M
City License No.Q38503 '
T
LICENSED CONTRACTOR DECLA0.ATION ZONE GRAOING CU. VDS. ACRES
S.
I hereby a1(irm that I am licensetl untle� provi5ion50f Charter 9(comm0nUp9 Remarki: C 'j
with section 7000) ot DlvisiOn 3 of the Buslness antl ProfeSsions Cotle, antl
my license is in fun force antl eHecL ELECTRICAL FEES
License,yia s C-16 ense N. 460923 �
�-ie - S� — 5�q � - PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW .
� • - ConstructionPoleSub. �SO+KW
_ RNERS' COMPENSATION D CIARATION Ba1 Sink $hOWErs
,reby at(irm Ihdt I have a certilica[e of consent to TeIT-ip5ure o� a Certlficate - '
Mof Workers' Compensation Insurance, or a certifietl cooY tnereof (Section Backflow Preventer Service Sink Cooking Uni[ Meter ❑up to 100 amps
^ ' 3800, Lab.
4�$$470$97—01 FRFSIONT IND. Dishwasher Meter ❑over100amps
�� Poii<y No. comoany Backflow Irrigation Sewer Cap
Certitietl copy is hereby rurnisnea. Dryers �Gas ❑Electric Sub Panel
e� etlpfl� y i�.fyq 0 with the city tli�q�p i n. BdthtUbs Sewer Connection
� ate �/ /`�`1' Appii<ant��-�✓T q w�0 Fan Motors �0.1 HP �1:5-6
EXEMPTION FROM WORKERS' COMPENSA�ECLARATION Clarifi2r5 $plar Collectof5
(Thissection neetl not be completetl if fhe pGrmit is fo� one nuntl�etl ($300 Or � InC. SOId� 09-15 HP �1615+
less). � Dishwasher Solar Piping F.A.U.
I certify that in the pertormance ot the work for which thls permh is issuetl I Fixtures
shall not employ any person in any manner so as to become suDject to tf�e Drinking Foun[ains Solar Tank Microwave
Workers' Compensation Laws of Calitornia. Device BOxes
oate 5ignature Floor Drains Swimming Pool w/Spa Pole light
NOTICE: H, a(te� making this tleGlardtlOn, y0u Shoultl become subject to the
Wo�ke�s' Compensation provlsions o/ the Labor COtle, you must (orthwltn FI00� SinkS U�in21 OutICIS RBflg¢
comply wilh such p�oviiions o� tnis pe�mlt shall bG tlaematl rGvokltl.
CONSTRUCTION LENDING AGENCV GasSerVice Out12t5 Switches Si n
1 nereby affirm that tnere is a construction lentling agency for the performante - Water GOu[ 9
ot tne work ror wnicn this oermit is issuad (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lentler's Name
Lentler's Atlaress Kitchen Sink Water Service Generetor 00.5 KW �5-15 KW Trash Compacror
OWNER BUILDER DECLARATION
I hereEy affirm Ihat I am exempt from the Conlractor'S Licenze Law for the Lava[o�ies Auto-Wesh
following reaion ($CcllOn 7031.5 Bu5Ine55 antl ProfCSSiOnal COde: Any Uty or
county which requires a permit to construct, alter, improve, demolish or repair P—Tre
•ny Structure, pfiof to Il5 IsSuanca, d150 I¢qWfes the applicant for SUGh pefmit P LBufldly Tf8Y5
'ile a si9netl statement that he/zM1e is Iicensetl pursuant to the provisions of Roof Drains
Contractor's Li<ense Law (Cnapter 9(commen<ing with Section 7000) of
,ision 3 of the Business antl Professions Cotla) or that he/she is ezempl � Reinspeetion Fee $15 ISSue Fee $ 3
merefrom antl the basis for the allegetl exemption. Any violatlon ot Settion
7031.5 by any applicant for a permit subjec[s [he applicant to a civil
eenalty ot not more tnan live huntlretl tloiiars (E500). DEVELOPMENT SERVICES RE�UIREMENTS:
LJ I, az owner of tne property or my employees with wages as tneir sole Reinspec[ion Fee $15 laue Fee $ 3 2oning Approvad By Dete
comp¢nsa�ion, will tl0 [he work, antl thc structure is not intentleA o� o/}eretl
� lor sale (Setlion 7044, Business antl Protessional Cotle: The Contrattor's MECHANICAL FEES Buildin8 APV�oved By Date /
License Law Ooes nol apply to an owner of a property who bulltls or improves Z I�
lhereon, anC who tloes sucn work himselt/herself or through his or her own Appllcati 1 d By Q 8"-Q?- Datn,,,-j �.-4-p�
employees, provitletl tbat such improvemenfs are not intentletl or offeretl for Boiler HoOd or Typ21 ❑
saie. It, however, tne builtling or improvement is soltl withln one year of com- CanOpy Type I I ❑ SUMM RV OF FEES� �
pletlon, the owner will have the burtlen ot Proving he/she tlltl not Dulltl or im- Duct � Undef Gfound
erove ror the purposeot sale). BUILDING PERMIT $ �� SMIP $ ./���
LJ I, as owner o/ the oroverry, am exclusively contracting wlth Iicensetl <on- Duct -Structurel Refrigeration System P�AN CHECK
iractorsto construct tha project (Section �044, eusiness antl Professions Cotle: $ PERMIT
Tha ConVactor's License Law does not apply to an owner oi property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU ISSUANCE $
builtls or improves thereon. antl wno contracts for such oroiects with a ron- � . P�UMBING $
tractor(s1 hcense pursuant ro ene Convactors Llcense Law). � am aware thax Exhaust System ❑ Multiple ❑ System Repair/AlteratiOn' PLAN CHECK 25% $ ENERGV P.C. $
prOof o( their Worker's Compensation insuranca shoultl oe provitlea to me. - �., ELECTRICAI $ GFADING $
❑ 1 am exempt untler Sectlon B. 6 P. C. for this reason Firepl/Fact BIL ICBO # Fire Dampers — MICROFILM $
PLAN CHECK 50% $ �-y�
Date owner Heating System & Ducting Registers " '_ MECHANICAL $ TOTAL FEE $ sy•J �/
I �ere�y certify tnat I have reaa thit application antl state that tne above ❑a700,0008TU �100,OOOBT
. Information is mrrect. I a9ree to comply with a1l city antl county ortlinances � � i: PLAN CHECK 25h $
antl state laws relating to �uiltling construction, antl hereby authorize repre- �
sentatives of th' city t enter upon tne above-men[ionetl property for , � "
' InSpection Ou Se5 Q{ ,
Signature �dte 0 /
Drivers' Li ense or 55 � Reinspection Fee $15 Issue Fea $ 3
OS 00024125-OOD29126 T4T 54.Su
UMb�-9b.lCV. ]/tlC wmte - tluuding; Canary - ApO��cant; Pink - Accounting; GOltlenrOtl - Assesso� Uii1C� UJ/Lt/b7 11iIG� 12�U1
.r. , � � \ �.. �.� `�' . . . , _ _. -
�
;CONSTRUCTION AND PLANNING i'P .P & SPA • '
•APPROVALS Permit # Date ' Inspecior AppROVALS Permit # Date Inspector.
1. Temporary Electrical $ervice or Pole� � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. . ' 53. Steel Reinforcement , �.
3. �Electrical Conduit Utility-Undrgrnd. � .� 54. Forms �-
4. Electrical Conduit-Undrgmd. 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. ,
6. 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 ,i
15. Rough Electrical-Conduit 66. Solsr SYstem-Final
1;6; Rough Electric Wiring 67. Fencing & Access Approval
,
ti7�.'Rough Wiring $ign 68. APPROVED FOR PLASTERING
lJ
18'Rough Electrical-T Bar Ceiliug 69. POOUSPA SYSTEMS FINAL
19 -'Rough Heating & Air Condittoning FIRE DEPT. REQUIREMENT
Z0, Rough Factory Eireplace � APPROVALS Permit #
21�� Ducts, in�Structu7e 70. Underground Hydro
22. Ducts, Ven[ilatirig ;' � 71, Product Piping �O Gas ❑ Oil
23. Gas Pipe=Rough & Test , 72. Underground Flush
24. Roof Framing �� �,� .` 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing •' � ',74. Overhead Hydro �{
26. T-Bar Ceiling (Structuial) & Monocoat 75. Dry Chemical
27. Frame and.Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL ���
29. Insulation �� 78. FIRE PREV. FINAL
341Drywall Nailing r HEALTH DEPT. REQUIREMENT
�31:'.Plaster Brown Coat 79. FINAL INSPECTION
32 � Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final -
. ,�
40. Gas Service-Final ' ��
41. Solar pomestic-Finai � �
•r.'`
42. Backflow Preventer �`� t
43. Backflow Irrigation
44. Landscape Irrigation System ` - -
45. Sound A[tenuation ��
46. Handicap Regulations .
47. FINALSTRUCTURE & BUILDING \
48. Special Requirements Completed
49. Electric Release to Edison � y
r
50. Gas Release to Southern California Gas Co � '"
51:_ CERTIFICATE OF OCCUPANCY � � ,,� -�
No. Date � � '
�� �
� �t
Applicant to flll In all spaees exeao� ihosa
c�TY OF COS7A G$�p CON`$iTR�U,,,C`T�IO,N PERMIT
,�roject Address �✓ ry '�-��✓y _
ApplitJr'Ss Mailing Address 11aFt��i� ��Y �__�_�__ _ f
�'� �� -�' ' �w - ,
- Owner's Name �Phone
Address
' Arch�Eng. License NLo�.
Address Z i-L ��� �r.��"��{��
Contractor'sNam �� � ��_�,jly ��/�'�r-ne77�� ���
4.
Addresslmailingl 7 6 -05 1
r City Licenu No. 32 ��
A LICENSED CONTRACTOR DECLARATION
�� � I hereby affirm that I am Ilcensetl untl¢r provl510n5 Ot Cba�te� 9(cOmminCing
Qd with section �000) of Division 3 ot the Buslness antl Professions Cotle, antl
my license is In tull rce antl efiect.
I License iass censa ' b b O
Oale� Si9nature
WORKERS' COMPENSATION DECL RA ION
1 hereby a/firm that I nave a certHicate of consenl to self-insure or a certlfiwte
� ol Workers' Compenzation Insurance, or a certitietl copy thereof (Section
3800, Lab. C.) '
- aoiicy rvo.WLPbL �I �b rcomoanv G�T ���� �'�
ertitietl copy iz hereby fumishea.
Cert' ' d op (i tl with the city Bu �n D vis' .
Date_�a�G�� APPlicant
E%EMPTION FROM WORKEfiS' COM N ION DECLARATION
(This mction neetl not b¢ compleletl it Iha pe i[ I5 fOr One hu0tlretl (5300) Or
less�.
I c¢rtify iha[ in the perto�mance of the wo tor w Ch thit_7�(m�t IS ISSuetl I
sM1all no[ em0loy any pe�5on i� dny mdn r SO a t0 b¢�,o rtiq SubjeGt [O (�g
Workers_Comnensalion,l.aws of Calito[ni .�. /'. / / /� . w inn /'/
comply with �sucn provisions or tnis permit sna�l �be tleemetl ravoketl.
CONSTRUCTION LENDING AGENCV . �
I nereby a/flrm that Nere iz a consVuction lentling a9ency for the oer(ormance
of the wOrk fOr whic� Ihis permit is issu¢tl (SeCtion 3097 CIv.,CJ
LRnOer'z Name
Lenaer's Atltlress
OWNER BUILDER DECLARATION '
I hereby aftirm tM1at I am exempt from the Contractor's License Law fo� the
following reason (Section 7031.5 Buslnass antl Professional Cotle: Any clty or
�����r� wn�cn •enuires a oermit to construct. alter. imorove. tlemolish or re0ai
. Division 3 0( the Business and vrmessions
-there(rom and Ihe ba5i5 fOr Ihe allegetl ex<�
� 7031.5 by any aOP��cant for a permit su
��enalty of not more than five huntlretl dollars
I;' as owne� o( lhe p�operty Or my em{
�I
or ma� ne/sne is ar
Any violation of Se
the aDPlicant to a
I.
with wa9es as theh
Is not Intentle0 or ol
Gotle: Tlie Conlra
tv who builtls or imC
thereon, ana who tloes iuch work himself/herself or tnrou9n hi5 or her own
employees, provitled Ihat Su<h ImprOvements dre not intentletl O/ offeretl to�
sale. If, however, the builain9 or improvement Is soltl within one year ot com-
pletion, the owner will have the burtlen of provin9 he/she tlitl not builtl or Im-
�rov< ta� the purpo5e of sale).
I, as owner ot-.the prop¢rty, am exclusivety rontracting with Ilcensetl con-
tractors.to construcitna pro�ect ($ection 7044, Buziness antl PrOfe55ion5 Cotle:
The Con[ractor's'License Law tloes n0t apP�Y �o dn Own¢t of property wbo
builtls o� imprOves�thereon. antl who conVdc[5 for such oroieCts with a r.on-
tractor(s) hcense pursuant to tne Contractor•s Llcense Law). I am aware tha[
proat o( meir Worker'S CompensaHon Insurance shoultl be provitletl [o me.
❑ I am exempt under Sectlon B. & P. C. for this reason
Oate � Owner
I hereby certify that I nave reatl [his application antl state lhat the aGove
information is corracL 1 aqree to comply wi[h all ciry antl county orAinances
antl 5[ate laws rela ing to builGing construction, antl hereDy autnorize repre-
sentatives of (his city to enter uPp the above-mentionetl property tor
Inspettion purp 's�. .0 /� ✓f 1
Signature �3/� i _/[���//���Date/D •77 •£C'
A - �
I� I peinspectionFea , I $15
OB65-46, rev. 5/BB WM1ite - Builtling; Canary - Appllcani; Pink - Accountin9; Goltlenrotl - A55essor
Showers
Service Sink .-
Sewer Cap. '
Sewer Connection �
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spe
Urinal
W�ter Closet
Water Heater
Water Service
Au[O-Wash �
Laundry Treys
laue Fee
� :
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System � -
Oaioo,000eTu ❑ioo,000eTu
System Repair/Alteration
F ire Dampers
a
Issue Fae � I $ 3
�. ��
A.a. # p �
S Main Building:
E
T Front
A Rear
C Right
g Left
Ping. Ref. #
Planning Notes: /'�
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electr
Fan
F,A.U.
Fixtures
Device Boxes '
Outlets � ---
SWItf.�1P.5 � � .
GaFbage Dispoul�
Generatoq �0.5�K
�
Zone
Bui
ELECTRICAL , ,
Transformer �� 15�50 KW
❑ 50+KW ,
Meter ❑up m 100 amps '
Mecer ❑over 100amps' �
� Sub Panel . �
Motors O0. 7 HP � 1 Y, - 8
Inc.Solar 09-15 HP �16-15+
Pole Light �
Range
Sign '
Standing Sections
5 KW Trash Compactor
7•
:Reinspection Fee •, $15 luue Fee
DEVELOPMENTSERVICES EQU EMENT : -
ZoninB APProved By-_�
Buildin9 ApProved By 5
4pPlicatiOn IaUBd ey � �
� . SUMMARVO F
BUILDING PEfiMiT $ �; L S���O
• PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
, ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL ' $
� PLAN CHECK ' 25% $
�
fEES
$
0
N
I
N
G
R
E
U
M
T
$.
��
-�,�f' �' $ y.:3L
P.ERMIT
ISSUANCE $ ,
ENERGY P.C. $
GRADING $ � v
MICROFILM $.
TOTAL FEE $ Z � ' 32
�� �oai�oo�-ooa�a�o4 -rnT as�ra2
- DkTE:.10/:7/&8 tI11E: 12:01. .
.. _ . �\ � -- 7 . . . - v
! �.ONSTRUCTION AND PLANNING . PL-� & SPA �
' APPROVALS Permit# Date Inspecior qppROVALS Permit# Date Inspector
T: Ta�iporary.Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe,Und,�grnd. ' r " , 53. Steel Reinforcement , _ ;.�r'
�i
,3. Electrical�Conduit Utlliry-Undrg�nd�. ,� ' ' 54. Forms � J"75
�4. Electrical�Conduit-Uridigrnd. �' 55. Electrical Bonding ��
5. Steel Reinfo cr �meM �- 56. Rough Plumbing & Pressure Test l, �
6. �Electrical UFER�Grnd~ ,"' 57. APPROVAL TO COVER-GUNITE �'. �
,
' 7. Footings `t -' ' - .� 58. Electrical Conduit-Undrgrnd. � .'�._�
' 8. Fou�dai ion Yr � � . ' 59. Gas Pipe, O Undrgrnd., Test ,�q �
9. Weter�Pipe-UnHrgrnd. i �; i; 60. Backwash Lines, P-Trap, O Undrgrnd. '�
,�.
. 10: St[uctural Floor System ' �,: � . : 61. APPROVAL TO DECK �� -
� 11'. Property Sewei`Line &:House Connection !,'� , � 62.� Backwash & ReceptorFinal � �� ,
� 72.'Sewer Cap �' � - . . 63. Heater & Vent-Final �
t_ v �
�
13. Roof Drains ; G-� �� . 64. Plumbing System - Final ,
14: Rou h Plumbin " . �
9 � � - �� -� l, , � 65. Electrical-Final _i
15. Rough Electrical�Conduit 66. Solar System-Final �-
ji6� Rough Electric Wiring 67. Fencing & Access Approval
�7�. Raugh Wiring Sign 68. APPROVED FOR PLASTERING
�18. Rough Electrical-T Bar Ceil�rig f 69. POOL/SPA SYSTEMS FINAL
"�19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. RoughlF.actoryFireplace ��l� APPROVALS Permit#
21. Ducts, io Struc[ure �� 70. Underground Hydro
�..
22. Ducts, Ventilating ��� P, 71. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough &.Test �';'� �1 . 72. Underground Flush � � �
rv
�24. Roof Framing i �� � �' � 73:`Undergmd.SmrageTank OGas ❑Oil �
� �: J ..l
25: Roof Slieathing �� ' �� � 74. Overhead Hydro . J,
26. T-Bar Ceiling (Structural) & Monocoat i J�y 75. Dry Chemical -
27. Frame and Flashing .SKc. �/�r1 ,�� �� i 76. Dry Standpipe �
28.� LatFiing^&iSiding �'�� � 77. FIXED SYSTEM FINAL ''
29. Insulation ',f 78. FIRE PREV. FINAL
(�.30: Drywall Nailing ('1 n. ' 1! � ,8 HEALTH DEPT. REQUIREMENT .
� 31.'Plaster,Brown Coat� .�=' "' 79. FINAL INSPECTION
32. Elect�ical Power`MeterFioa,l�� 80. FOOD CERTIFICATE ISSUED
33. Final Electric ��` � Notes: � - �, �� s�
� • 34. Final Heating & Air Conditioning ` , � � ,�
N i � � o....
35. Final Gas Pipe-Test .
, �N-
36. Hood or Canopy
-37. Final Factory Fireplace e � W d� a � ��
a�
. 38. Final Plumbing ��^ "� Sorn� ' �
39. Water Service-Final �� '
40. Gas Service-Final � � „ . . - �
41. Solar pomestio-Final / .�(`_ ;�.
42. Backflow Preventer / ��� ��'
43. Backflow Irrigation / � � _ , ��
44. Landscape Irrigation System �'�' � C'
i• ,
45. Sound Attenuation �=.�=
46. Handicap Regulations� �,
� 47. FINALSTRUCTURE�&BUILDING
4A. Sner.ial Requirements Completed •
49. Electric Release to Edison ,.�' � t
' r. i
50. Gas Release to Southem Californla Gas Co � �`' . '�
i V ,.'�
51. CERTIFICATE OF OCCUPANCY "
� ., �; '.
No. Date • �;. �.� i�;
I� �
� Applicant to fill in all spaces except t�ose wit�in heavy EorEer Iines antl Sign all app�oD��ate Geclarations.
• PERM NO TRACT NO. LOT NO. �U IT O.
Ci7vOFCOSraMESA CONSTRUCT.I2ONPERMIT l��. 3�O/�(v � ��� A'P'#
Project Address .¢.S-S Ai✓%b'�� �/�1� gf� 7�-�' _
Applicant's Mailin(Jp,�q ddress
Owner's Name � � ��G`uS Phone
Address
Arch/Eng. License No.
. Address 1
Convactor's Nama ��1�'-�V �� y�► Phone s'9-n�
Addreulmailing) /���� O/d ��RVL�+N�
City License No. u�pnZ�
LICENSED CONTRACTOR DECIARATION
I hereby at(irm [hat I dT IICBOSEO UlICBI pfOVI5IOf15O} CbdII81 9(comm¢ncin9
with sectlon 7000) of Division 3 of the Busineu antl Professlons Cotle, antl
my license is in /1yII fp��{ c/e ana effect. %� �
�.IC2052 �I 55 `�—"� icanse NOY�/�
Dat¢���5� 5�9 [
, P/ORKERS'COMPENSATION DECLARATION
'I here�y aitirm that I have a certi(Icate ot consent to se11-insure or a certifitate
� o( Worke�s' Compensation Insu�ance, o� a ce�ti�letl copy tne�eof ($ectlon
3800, Lab. ) '
aor�v No. . �Y-60-�%Y comaa�vii/!�/1tA��- -
�rtitie0 copy is her y turnishetl.
r ']{¢ op i tl wi[h the ciry Builtling Ivl
\ Date " APplicant ��
EXEM ION-�RKERS' COMPENSATION DECLARATION
(This section neetl not be comple[etl if the permit Is for one hundre0 (5100) or
less). '
I cerlity that in (he performance Of Ih0 wo�k /0� which this pe�m�t I5 Issuetl' f
shall not employ any person in any manner so as to become subject to t{re
Workers' Compensatlon Laws o( California. �"
�ate Si9nature
� NOTICE: If, after makin9 this tleclarapon. You shoultl become subject to the
Workers' Compensatlon provisions ot lhe Labor Cotle, you must forthwith
[omply wilh such p�ovi5ion5 or thi5 p¢rmit Shall be tl¢emetl �evoketl.
CONSTRUCTION LENDING AGENCV
1 nereby aftirm that there is a construttion lentlin9 a9ency tor the performance
Ot the work for which this permit is IssueO (Seclion 3097 Qv. C.)
Lentler's Name
LentleYs AOtlress
OWNER BUILDER DECLARATION �
I hereby aftirm lhat I am exemot from the Contractor's License L.aw for Ihe
followinq reason (Section 7031.5 Business antl Pro(essional Cotle: Any city or
' county whicb requirez a pe�mit f0 COnst�uct, dlt¢r, improve, tlemoll5h O/ repai�
any structure, prior to it5 ISSuanGe, alio requir<Slhe applicant /Or sucn permit
� to (ile a signetl statement that he/she Is licensea pursuant to the orovisions oi
tne Contractor's License L.aw (Chapter 9(commencin9 with Section 7000) of
�Division 3 of the Business antl ProfG55ions Cotle) or thdt he/ihe IS ¢xempt
theretrom antl tne basis tor the alle9e0 exemption. Any violatlon of Section
703L5 � by any applicant (or d Permit Subjecls tM1e applicant [o a civil
�enalty of not more Ihan (ive huntltetl tlolldri (E500).
I, as Owner ot Ihe O�oper[y o� my <TPloyees with wagez as their SOIe
� comoensation, will �o the work, antl the structure is not in[entletl or-otferetl
tor ule (Seclion 7044, BuSiness antl Prolessional Cotlo: The Con[raclor's
License Law Does not apply to an owner o/ a proparty who builEs or lmproves
the�eon, antl who tloes such wOrk hlm5¢If/nertelf or through his o� h¢r Own
employees, o�ovitlea that such Improvements are not intentletl or offere0 for
sale. I(, however, tne building or improvement is solC within one year of com-
pletion, the owner will have tha burtlan ot Proving he/sha tlitl not builtl or im-
prove for the purpose of sale).
❑ I, as owner of the property, am axcluslvely contractlng witn licensetl con-
trattOrsto con5truclllte pro�ect (Section 7064, Business antl Professlons Cotle:
Tne Con(ractor's License Law dOes no[ applY t0 dn owner of Pwperty who
builtls or imoroves tnereon. antl who conlracts for such oroiects witn a con-
tractor(s1 hcense pursuam w me Contra<for•s Llcense �aw). I am awara thac
proof o( their Worke�'S ComOensation Insuranca Shoultl be provitletl to me.
❑ I am exemo� untler Section B. & P. C. (or Ihis reason
Date Owner
I hereby certity that .I have rea
information is correct. I agree to
ana state laws relatin9 to
sentatives of this c !nt
intpection purpos
$Igpdture
Drivers' License S � _�
=\ 865-46, rev. 5/88
a
upon
TYPE OF CONSTRUCTION LJ NEW LJ ADD LCJ ALTERATION Ll REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTIONOFWORK/USEOFBLDG. CYj���'"
TVPE OF PERMIT LI GRADING LJ FOUNDATION LJ STRUCTVRAL
❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sq.FT. oCCUaANCv
CONSTRUCTION TVPF VALUATION $
20NE GRADINGCU.VDS. ACRES
Remarks: � �? �q�
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Servic.e Outlets
�Citchen Sink
Lavatories
?—Trap
Roof Drains �
Reinspeetion Fee $15
Dutt - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO dk
Heating System & Ducting
❑6100,000 BTU �100,000
Reinzpection Fee � $15
White - Builtlin9: Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service �
Auto�Wash
Leundry Tre'Vs
laue Fee
Hood or Typel ❑
CanOpy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers �
Registers
laue Fee
FEES
$ 3
$ 3
5 Main Building:
E
T Front
ARear
C Right
K
g . Left
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher .
zo�a
Accessory Building:
Parking Req./Provided
ELECTRICAL �'
Transformer ❑ 15-50 KW
❑ 50+ KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Dryers LJGas LJEIec[ric
Fan
F.A.U.
Fixtures ,.
Device Boxes -
OuUets
Switch¢5
Garbage Disposal
Generator �0.5 KW �5�15 KW
Sub Panel
Morors �41 HP � 1 X- 8
IncSolar �9�75 HP �76-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compacror
Fee �$15 � I luue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved By
Buildine APP�oved By
f7�Xc!
$ 3
N
I
N
G
R
E
Q
M
T
S.
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ �
PLAN CHECK 25% $
O1 OOOIII702-D001870i T'�JT 7.00
DATE: 11/OS/SE TII1E: 12:07 �—
!
.,.. ..-. tti� \� .. . .
�,,�j•.,CONSTRUCTION AND PLANNING 'r ' • POvL & SPA
�' . Date Inspector Date Inspector
APPROVALS Permit # ^ ' / APPROVALS Permit #
7: Temporary Electrical Service or Pple '�� �� 52. Pool & Equipment Location
'2. Soil Pipe-Undrgrnd. V •.� i'" 53. Steel Reinforcement
�!� .i : •.
' 3. Elec�rical Conduif Utility-Undrgynd: � '�� 54. Forms %� �r
4�,JElectrical Conduiy.Undrgrnd. ', � � 55. Electrical Bonding ;�. ��
,5v SteeliReinforcemeni %1 � � �� 56. Rough Plumbing & Pressure Test �� ���
� 2 1 F�n . 57. APPROVAL TO COVER-GUNITE ��
� Elecvical UFER G�T dt �
7� Footings �� ��� 58. Electrical Condui[-Undrgmd. �
� ��
. Foundation �.�, �' � � . 59. Gas Pipe, O Undrgrnd., Test ��;
�
,? Water Pipe-Undrgmd. �� 60. Backwash Lines, P•Trap, O Undr rnd. �I
�'�j .; �I' �i� 9 �=
10� Structural Floor SYstem � �i �� 61. APPROVAL TO DECK i�
� 1�'Property Sewer-Lin� & House'Co�nnection � � 62. Backwash & Receptor-Final �
12! Sewer Cap ��i .� U � 63. Heater & Vent-Final /�`
1 _. N
1�� Roof Drains O � 64. Plumbing System � Final i�.'
i
14. Rough Plumbing: ��n.�� (�f� 65. Electrical-Final ��
75. Rough Electrical-Conduit . 66. Solar System-Final . i.
16. Rough Electric Wiring 67. Fencing & Access Approval �
j17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
��1,8. Rou9h Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
-N2D. Rough Factory Fireplace APPROVALS Permit # _
,.�
��21. Du�ts, in Structure p,� 70. Underground Hydro
22. Ducts, Ventilating U 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test ` , 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil -
25. Roof Sheathing � . 74. Overhead Hydro �
26. T-Qar�Ceiling (Structural) & Monocoat 75. Dry Chemical
27,•Frame and Flashing � 76. Dry Standpipe
28. Lath'ing & 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 Cond'rtioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ��.Zq,.yj' �,�I .
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer �.--
43. Backflow Irrigation �'� �
;�
44. Landscape Irripation System � ,; ; i�
45. Sound Attenuation
46. Handicap Regulations , �
47. FINAL STRUCTURE & BUILDING
4R. Sper,ial Requirements Completed
49. Elactric Release to Edison
�
50. Gas Release to Southern California Gas Co , f.-
51. CERTIFICATE OF OCCUPANCY '- '
_ " I
No. Date '`�
.'� �
�
�
�
to S�l
CrrY oF COSTA MESa, • CONSTRUCTION PERMIT
Project Address S���k�T^l9�!�/' .' 4(/.�i
A�SplicanYs Mailin�Address6����+�/���L.d".
AOP�icant to fill in all soaces except tnose within heavy Gortler linez anO. sign all appro0��ate tleclantions.
PERN}tTjVO.����� TRACTNO. � LOTNO. �v���QO'
I `�l CJ
Aildress �ir ��=T/i (L �'iLtiP' � �n.I%� dlGlN:
Arch/Eng. ' ry License No. �
Address -
Contractor's Na �� �'ud ��«� 'v Phon��"� r��
Address (mailing�6� ���� .��'��'� ��✓� �`
City License No. � �� � ' -
LICENSED CONTRACTOR DECLARATION '
I herebyi atfirm that-I am�licensetl untler provisions ot Charfer 9(commencing
with section �000) of Division 3 of the Businezs antl Protessions Cotle, antl
my license.is in tull torce ntl�e fect. � S�a i��
License �C�lass �� ��� � L ense No. <S
Date�Sf—�a -SV Si9nat e • '
WORKERS' COMPENSATION D LARATION '
; hereby affirm that I have a certificate of consent to selt-insure or a rHficate .
ot Workers' Compensation Insurance,. or a certifietll copy thereofy(Section
3800, Lyab. CJ.. . .. _. _. . - w- - �
Policy4YA���%�O� Com any ��y �� v
�ny. Certifietl coOY is hereby turnishetl �
fP Certifjep coDY is �ep with th y Bu' ing DivjRon. �� �
EXEMPTION FROM WORKERS GW7IPENSATION DECLARATIOW
(TM1isseclion neetl not be camplete�frt the permit is for one huntlretl�(5100) or
lezs). '
I certify that in the performance ot the wo�k to� wM1ich this pe�m�t is Bsuetl, I
snall� not employ any person in any manner so.as to become subject to the
Workerz' Compensation�LawS ot Cali(omia. '
Date- � Signature �
'NOLICE: If, atter making this tleclaration, you shoultl. become subject to the
Workers'' Compensation provisions of the Labor Cotle, you must forthwith '
comply .with' such p�ovisions o� thi5 permit shall be tleemetl' �evoketl.
CONSTRUCTION IENDINGnAGENCV _ �
I hereby attirm that there i5a�construction lendin9 a9ency�for the performance
ot the work far which'this permit is,issuetl (Section 309] Civ. CJ
Lentler'S Name _ � _ � ,
Lentler's�Atltlress �
OWNER BUILDER OECLARATION �
I hereby; atfirm th5t I am exempt trom the Contractor's License Law for the
tollowing reason (Secfion ]�31:5 Business antl Professional Cotle: Any tlty or
county whicn requires a Dermitlo construct, alter, improve, aemolisn or repair
any structure, prior to its issuance, also requires the applicant tor such permit
to tile a signetl statement Ihat he/she is licensetl pu�suant to lhe p/ovisions ot
the Contractor's License Law (Chapter 9(commencin9 with Section 7000) of
theretrom antl the basis for [h¢ allege0 exempUon. Hny vio�auon or peaion �
]031.5 by any applicant' for' a permit subjects the aOP�icant to a civil ,
��penalty ofmt more than five huntlretl tlollars ($500). -
❑ I,'as.owner of the propertY or my employees'witn wages as their sole
compensation, will tlo the work, antl the structure is not intentled or otteretl
for sale� (Section 7044, Business antl Professional Cotle:�. The Contractor's
license Law tloes not apOb �o an owner ot a property who builtls o� improves ,
thereon, an0 who tloes Sucit work himself/he�selt or through his o� he� own
employees, provitleE that such Improvement5 are mt intentletl or oReretl,to�
sale. If, however, the builtling or improvement is.soltl within one yea� ot com- .
pletion, tM1e owne� will have the burtlen ot provin9 he/she tlitl not builtl or im-
prove tor the'purpose of sale). � '
❑ I, as owner ot the property, am exclusively cbntracting with licensetl con-
tractors to construct the p�oject ($ection 7044, Business antl Professions Cotle: �
The Cont�acto�'s License Law tloes not apply to an owne� of pwpe�ry who '�
.builtls or improves thereon, antl who wntracts for such prqects with a con-
tractor(5} license puiivan[�to the Cont�actoi'S License Law). I am aware tnat
' proot of thei� Worker'S Compen5ation insuran[e should be provitletl to me.
❑ 1 am exempt untler Section B. & P. C. to� this reason �
Date owner
7YPE OF CDNSTRUCTION ' LJ NEW � LJ AD� Vdl ALTERATION IJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT�ER
DESCRIPTIONOF� ORKy�SEOFBLD
:���� v.
� f'Ecv,Gi7✓ /.tcrl'� �:[��t�.�� .S'� .r
TVPEOFPERMIT GRADING ' FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAI_ ❑ PLUMBING ❑ MECHANIGAL
❑ OTHER'
PROJECT DESCRIPTION SO.FT. �
-CONSTRVCTION TVPE
ZONE GRADING
Remarkz: �J///_S i�/i / .
Sink
<flow Preventer
<flow Irrigation �
rtubs
ifiers
iwasher
iking Fountains
>r Orains
�r Sinks _ �
Service; Outlets
Intercepmrs � �
, Kitchen Sink '
Lavatories ' ' � _ � ;
P-Trap
Roof Drains .
Reinspection Fee� $15
certify that I have reatl this application antl state that the above
m is correct. � a9ree to comply with all city ana county ortlinances
laws r atin9 to builtling construction, antl hereby authorize repre- �
of' i city to enter pon the above-mentionetl Oroperty for
rp es. , ���
�- Date
Drivers nse or6� ���
Reinspection Fee S75
\ CMF 0865-46, rev. 10/84 Whiie - Builtlin9; Canary - Applitant; Pink - Fidountinq; Goltlenrotl - Assessor
Boiler
Duct : Under Ground
Duct-Structural "
Duct - Ventilating �
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating.System & Ducting
❑o-ioo,000 aTu Oioo,000
OCCUPAIVCV
_ VALUATION$_
VDS. CRES-
L': 6 e!�
Showers
Service Sink � � �
Sewer Cap- '
Sewer Connection
Solar Collectors ,
Solar Piping � '
Solar Tank
Swimming Pool w/Spa '
Urinal .
Water Closet " �, -
Water Heater.
Water Service ' �
Auto-Wash -
'Laundry Trays ' �
i '
laue Fee -
Hood or Typel ❑
Canopy Type I I ❑ .
Refrigeration System ,
❑0.100,OOOBTU ❑100,000
System Repair/Alteration '
F ire Dampers
Registers ' '
IaUe Fee
�
�
$ 3
A.P. #
S Main Building:
E
T Front
6 Fear
A
C Flf9ht
gLeft
Ping. Ref. # '
Planning Notes:
Automatic Washer. _ '
Construction Pole_Sub.
Cooking Unit ; - �
Dishwasher �
Dryers ❑Gas ❑Electric
Fan �j
F.A.U. �
Fixtures
Oevice Boxes �
Outlets
Switches
Garbage Dispoul
Generator OO-5 KW 05-15 KW
� , " _ _
I • , t
i��
. Zone _
Accessory Building:
Z
O
N
1
' N
.. G
R
Parking Req./Provided � ' E
Q
� M
T
S
�
JGAL �
Transformer ❑ 15-50 KW
❑ 50+KW
I
Meter ❑up ro 100 amps
Mecer ❑over 100 amps
Sub Panel
Momrs OO-1 HP O1'/: - 8
Inc.Solar 09-15 HP �16�75+
Microwave
Pole Light .
nanye
Sign
; Standing Sections
Trash Compactor
�
�'Reinspection Fee �$15 � ��luue Fee
DEVELOPMENT SERVICES REQUIREMENTS:�
Zonin9 APProved BY . .
Building Appraved By
Application laued By �
FEES
$ 3
- SUMMARV OF FEES � �
BUILDINGPERMIT $ SMIP� �
I$
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $ ����
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL � $ GRADING $ '
PLAN CHECK 50% $ MICROFILM $
MECHANICAL TO7ALFEE $ 26,,a.f
PLAN CHECK 25% $ Z
0± 000188S6-OU018E57 TC1T :6.2g
n�Tr. ��im ion rimc. �i.��
,
CONSTRUCTION AND PLANNING ' - PUvL & SPA � �
APPROVALS Permit# Date Inspector �'APPROVALS Permit# Date �Inspv.cmr
. J,� 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-Undrgmd. ' - ° 55. Electrical Bonding .
5. Steel Reinforcement � . " • . � 56. Rough.Plumbing�& Pressure Test
�- 6�� Electrical UFER Gmd: � 57. APPROVAL TO COVER-GUNITE
-7"Footings � ' � � 58.- Electrical Conduit-Undrgmd.
8. -Foundation ., _ 59. Gas Pipe, O_Undrgrnd., Test �
9. Water Pipe-Undrgrnd. , ' � � ' 60. Backwash Lines, P-Trap, O Undrgmd.
• 10. �Structural Floor System ' �� 61. APPROVAL TO DECK �
�11. �Property-Sewer Line & Houss Connection . 62. Backwash & Receptor-Final � ,
� 12. Sewer Cap � ' . 63. Heater & Vent-Final
13. Roof Drains ' � 64. Plum6ing System -�Final _ , .
� 14. Rough Plumbing- 65. Electrical=Final � �
15. Rough Electrical-Conduit -,- 66. Solar System-Final � �
16. Rough Electric Wiring �� 67. Fencing & Access Approval - �
�:1�7.,Rough Wiring Sign+ � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL
�l9> Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '"
20. Rough Factory Fireplace APPROVALS Permit # �
2b: Ducts,'in Structure 70. Underground Hydro, " -
-�22.=.Ducts, Ventilating 71. Product Piping � Gas ❑ Oil '��
23. Gas Pipe-Rough & Test _ 72. Underground Flush
24.-Roof Freming � 73. Undergrnd.StorageTank�OGas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �
� 27. F�ame 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. F�INAL 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 Canbpy �
37. Final Factory Fireplace _ � - �
38. Final Plumbing �yY L� � �
39. Water Service-Final � �.
40. Gas Service-Final T��7 ;�?
41. Solar pomesticFinal , _. . _ _' ;r',
42. Backflow Preventer � �
�;
43. Backflow Irrigation . _ ' _ s�
44. .Landscape Irrigation System'�� � . .')
45. Sound Attenuation ' � - .
46. Handicap Regulations � � ' . -
47. FINAL STRUCTURE & BUF4DING�� � . . � � � �
48. Special Requirements Completed , , � -
49. Electric Release to Edison . � -- - --- '- � •
<} %
50. Gas Release to Southem Califamia Gas�Co � ' . �. %��'
_ r', �
51. CERTIFICATE OFOCCUPANCY, _ . . , _ � _ _ _ . '-'
� Nn. - � � Date ' � - • . �' - - ' ' .
�
1
�
AGO�ieant to fill in all spaces except tltose within heavy bortler linet and sign all aDOrapriate tleclaratians.
CITY OF COSTrQ MESA CONSTRUCT`ION PERMI „�� PFR�41T Nfl TR�CT Nn I OT NO. . i iniiT_nin
ProjectAddressJ-�5��� L3I✓V �ZO CVS
ApplicanYs Mailing Address �.$�% I; o
SfL�+�r �
Owner's Name ��� v�� �' PhOne
Address '(�1�L I�� L• �
Arch/Eng. �ni,F'A �fi/� License No.
Address �!�—y� ��ibC/J� ��_�p
Contractor's Name k f��Cu�OoD E�eGiY�L Phone7lyY2d'SiG�
Addresslmailing1�7Z3 E �LGf~ �Nn'�� :� Q070/
City License No. �%OsZ�
LICENSED CONTRACTOR DECLARATION
I M1ereby affirm that I am licensetl untler provisions ot Charter 9(commencing
WIIh 5¢CSIOfI JO��) Oi �IVISIOII 3 of the Business dOtl Professions Cotle,'an0 ,
my license is in full torce antl f(ect.
LicenSe IaSi� �� �� L ense Novo3qZ9SS
na[e Siqnature
RKERS' COMPENSATION D LA TIO
.reby atfirm tnat I have a certificat f cons nt to seli-insure or a certificate
� Workers' Compensation Insuran , or a certitietl copy thereof (Section
3800, Lab. C.)
Policy No. �C �-;S�O Companye.�su 4/►���ngn
�J certifietl copy is hereby fumishetl.
❑ CertiTetl coj y� �is filetl with Ihe City B' ng `��j5i n.
Date �� .�—�'jS Applicant
EXEMPTION FROM WORKEFS' GO P N 10 ECLARATION
"(ThiS section neetl nat be completetl if the mit i5 or one huntlretl ($300) or
Iess).
I certity that,in the performance ot the wo�k for which thi5 pe�mR is i55uetl, I
shall not employ any person in any manner so as to b¢Come Subject to the
Workers' Compensation Laws ot California. �
—Date Si9nature '
NOTICE: If, after makin9 this tleclaration, you shoultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply with such provisions or this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby affirm that tnere is a construction lentling agency tor the performance
of the wark for which this permit is issuetl (Sectiom 309� Civ. C.)
Lentler's Name
Lentler'S Atltlress �
OWNER BUILDER DECLARATION
I hereby afiirm ihat I am exempt trom the Contractor's License Law Tor the
followin9 reason (Sectlod 7031.5 Business and Professianal COGe: Any city or
county whith requires a Oe�mit to const�uct, alter, improve, Oemolish o� �epair
-any structure, prior to its issuance, also requires tne applicant for,such permit
� file a'signetl statement that he/she is licensed pursuant to tne provisions of
� Contractor'S License Law (Chapter 9,(commencing witn Section ]000) of
,vision 3 of the' Business antl Professions Cotle) or that ne/she is exempt
merefrom antl the basis for the allegeC exemption. Any violation ot Section
]031.5 by any applicant for a permit subjects the applicant to a�civil
���enalty of not more than five huntlretl tlollars ($500).
I, as owner of the property or my employees with wages as their sole
�. �compensation, will tlo the work, antl the�structure is not intentletl or-offeretl
i for sale (Section �044, Business antl Professional Cotle: The Contractor's
� License Law tloes not apply to an owner of a property who builds or improves
' thereon, antl who tloes such work.himself/herself or through his or her own
Iemployees, p�ovitletl tM1at sucn improvements are not intentletl or offeretl tor
sale. If, however, the builtling or improvement is soltl within one year oi com-
pletioq the owner will have the burtlen of proving he/she tlitl not builtl or im-
prove forthe purpose of sale).
❑ I, as owner of the property, am ezclusively contracting with licensetl con-
Vactors to construct roe project (Section �044, Business antl Profassions Cotle: �
The Coniractor's License Law does mt apply to an owner ot property who
builds or imoroves thereon. antl who contracts for such oroiects witn a con-
tractor(s) license pursuani ro me Canttactor's License Law). I am aware Mat
proof of tneir Worker's Compensation insurance shoultl be provitletl to me.
❑ I am exempt untler Section . B. & P. C. fo� this �eason
Date
I hereby certify t
information �s corr
antl 5tate laws reli.
Sentdtives ot thi
in5pection purp .
Signature
Drivers' Lic nse �
0865-46, rev. 5/88
Owner
upon
tate that the above
tl county ortlinances
aby autho�ize �ep�e-
ionetl property tor
Date �// 3 ��
E 3�aot� I I IKb/
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
�❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TYPE OFPERMIT ❑ GRAOING ❑ FOUNDATION STRUCTURAI. �
❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL .
❑ OTHER
PROJECT DESCRIPTION 5Q. FT. OCCUaArvCV
CONSTRUCTION TVPE VALUATION $
20NE GRADINGCU.YDS. ACRES
Remarks:
Bar $ink
Backflow Preventer
Backflow Irrigation
Bathtubs .;".
Clarifiers �
Drinking Foun'
Floor Dreins
Floor Sinks
Gas Service �
Intercep?ors
Kitchen Sink -
LaV3LOf125
P—Trap
Roof Drains
peinspection Fea
OUiletS
$75
6oiler
Duct-UnderGround
Duct - Structural
Duct-Ventilating .
Exhaust SyStem ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting �
❑0-100,000 BTU 0100,000 BTI
Reinspection Fee I $15
White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Showers
'Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping '
Solar Tank '
Swimming Pool w/Spa
Urinal
Water Closet
Water Heate�
� Water Service
Auto-Wash
Isue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeretion System
❑0.100,000 BTU .0100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
A.P. #
S Main Building:
E'
T Front
ARear
C Right
SLeft
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher �
DrYers ❑Gas ❑Electric
Fan
F.A.U.
Fixtu�es
,� Device Boxes
_ ' Outlet5 �
Switches
� Garbage Disposal
� ' Generetor �0-5 KW C
Zone
Accessory Building:
` � Parking Req./Provided
ELECTRICAL �
Transtormer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors �0.1 HP �1Y�-8
Inc.Solar �9-75 HP �16-15+
Microwave
Pale Light
Gennn - .
Sign
Standing Sections
5-15 KW Trash Compactor
ReinspeMion Fee ' !$15 � � Issue Fee
�' �
DEVELOPMENTSERVICESREQUIREMENTS:
$ 3 �%!� Zoning APProved By
FEES :� Building Approved By
� QOOIICdkl00 �AOBf� BV
$
N
I
N
G
R
E
Q
M
T
S.
FEES
SUMMARV OF FEES "'�uJr�8 !jj 4��
BUILOING PERMIT $ SMIP $
%
PLAN CHECK $ PERMIT -
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ ���� GRADING $ �
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ �
PLANCHECK. Z5% $ _
'i 1 '�
oi ^002F548-OQO1°54F raT : ya.?t �
DATE: i?!(3313$ TIPIE: t��;34 '
` 1.�
� CONSTRUCTION AND PLANNING P� & SPA � _
APPROVALS Permit# Date Inspector AppROVALS Permit# � Date Inspector�
i
1. Temporary Electric8l Service or Pole � , � 52. Pool & Equipment Location ;
� �Soil Pipe-U�digrnd. , .�� ;; r' }� -53. Steel Reinforcement � ��� .
3.'�Elect'r'�ic"al Condyii U[ilify-Undrgrrid. .q - � 54. Forms � .� �?� �
., �.. ., ..� '�' �-, .
4.�Electi;icaPCorld.uit{l'llid�grnd. '` ,ti, 55. Electrical Bonding � '�ti .i '
5'�Steel%R�einforcerrtBnLF „�`., = ' � - 56. Rough Plumbing & Pressure Test � � +�n
.6;j�Elec�rical UF.�R Gmd. .��` R� 57. APPROVAL TO COVER-GUNITE �- i,�i
:,
rb r� :o
7..Fo {ings ��� ii . {+� i� / _�.�� 58. Electrical Conduit-Undrgmd.
�xh i!
8:vFoundaiion : rt l;;, , .'� �J, 59. Gas Pipe, O Undrgrnd., Test "'
,Z.
9.�Wa�er Pipe-Undrgrnd. �� �rt �•'^ !; 60. Backwash Lines, P-Trap, � Undigrnd. � �
;"r
i....- �;� �"
10:;..$fr.uctural Floor Sys'tem i �: � 61. APPROVAL TO DECK '
17:.Pcoperty Sewer Linet& House Connection „ 62. Backwash & Receptor-Final
�� v .p.
12.'Sewer Cap � r^ `w ,, � " 63. Heater & Vent-Final �-
'1'3..'.Roof Drains '.e �� �j � 64. Plumbing System - Final ,�'�
!r
13. Rdugh Plumbing'; � �. �� - ' 65. Electrical-Final '
15. Rough Electriral=Conduit 66. Solar System-Final � -
i6:� Rough Electric Wiring . 67. Fencing & Access Approval '
17: Rough Wiring.Sign � 8. APPROVED FOR PLASTERING �
183 Rough Electrical-T Bar Ceiling `Z 9. POOUSPA SYSTEMS FINAL '
19�. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
20.' Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure � � 70. Underground Hydro - '
n-
22. Ducts, Ventilating 4f" � . 71. Product Piping O Gas ❑ Oil ' �
23. GasiPipe-Rough & Test � 72. Underground Flush , ' �
24. Roof Framing ��� -' . _ 73. Undergmd.StorageTank �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 �
$0�.; Drywall Nailing HEALTH DEPT. REQUIREMENT
3U.� Plaster Brown Coat � 79. FINAL INSPECTION '
32. Electrical Power Meter-Final . FOOD CER ICATE ISSUED �
33. Final Electric u f� otes:
34. Final Heating & Air Conditioning G+4' -
�',j P;n
35. Final Gas Pipe-Test �
36. Hood or Canopy -
37. Final Factory Fireplace �
38. Final Plumbing
39. Wafec Service-Final � . .
40. Gas Service-Final �
41. Solar pomestic-Final -
42. Backflow Preventer � - "
�
43. Backflow Irrigation � i ��
�,
44. �Landscape Irrigation System �
45. Sound Attenuation . �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed :;� ,
49. Electric Releaieto Edison �-'!:
,r
50. Gas Release to Southem California Gas Co ; �•,L ��
51. CERTIFICATEOFOCCUPANCY �i �_. ��_i_y. �; j .
No. Date '_ i . ,t"i�
i
�� #31988 '
._ _ . Aoolicant to till in all soaces exceo� tnose within heavy Dortler Iinas ana s(9n all avProOrlate tleclantions.
CITV OF�COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. � U T N0.
555 ANit�N BLVD. 8TH FL. CGRRIDOR � 3.�v03 2 'f' � co�cy
Project Address -
%ZSS—D Garden Grove BIVCI TVPEOFCONSTRUCTION�/,� NEW. ADD A�TERATION REPAIR
Appl2ant s Mailing Address
Owner's Name SECURITY PACIFIC BANK ph ne
Address 600 WILSHIRE BLVD. � 9L,.A.�6�7
Arch/Eng. License No.
Address - -
Contractor'snlame KiIilbl2 dlld CO. pho�e 895-1156
Addresslmailingl 7211—D Garden Grove, Garden Gr.
Cit� License tvo. 0 3 S 5 0 3 �
LICENSED CONTRACTOR DECLARATION
1 hereby affirm that I am li�ensetl untler provislons of CM1arter 9(commencing
�j with section 7000) ot olvision 3 ot the Business,antl Protessions Cotle, antl
� my license is in full for�,e a��etiect. 4 6 O� z 3
License ass � Lice e N
� Oa/ � 5'g t .s An// � i��
_1 � SRK RS' OMPENSATION DECLA TION
�� ereby affirm tbat I have a certificate o ronsent to 5eH- nsure or a certiticate
1 _� Workevs' Co�m'pen tio_rL n r nc , o� a certitied Copy tM1e�eof (Sectlon
A_ 3800, Lab. r j�+j��lifllb���-al
v PoIicY No. p 4ti1(�t11 comoa�v -RSPu�7�-.Lbe—�.33d.
Certifietl mpy is hereby tutnlshetl. ��Q �I'FY
� Certifi cp� y lsff1¢p with the city Buil � Division.
Date J —(i/— y`( AOP�icant _
EXE PTION�II� FRO �WORKERS' MPEN IONDECIAR ION
(This section neetl not be comple[etl it the per it is tor one hu tlreA (5300) or
less)
I certify thal in the'per(ormance ot th¢ work fOr which this perm�t i5155uetl, I
snall not employ any person in any manne� so as t0 become zubjec[ to the
Workers' Compensation Laws of California.
Date Signature
NOTICE: It, atte� making this tleGlaration, you Shoultl bewme Subj¢CI to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply with such p�ovisions o� this Oe�mlt shall be deeme0 �evokeC.
CONSTRVCTION LENOING AGENCV
I herety affi�m tM1a[ there is a conSVuction lentling agency fo� t�e Oerto�mance
of lhe work fo� which thi5 permi[ is i55uetl (Secfion 309] Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER �ECLARATION
I hereby affirm that I am exempt (rom the ConVac(or'S License Law for the
followinq reason (Section ]031.5 Busine5s antl Professional Cotle: Any city or
couniy which requires a permlt to construct, alter; improve, tlemolish or repair
any structure, prior to ils issuance, also requlres the applicant for such permit
to file a siqnetl slatem¢nl that he/she i5 IicenSetl pu�suant to Me provisions o1
1e.Contractor'S License Law (Chapter 9(commencing with SeCtion 7000) ot
ivision 3 ot the Business antl Professions Cotle) o� that h¢/She is exempt
.nerefrom antl the basis tor [he alleqetl exemption. Any violatlon of Section
7031.5 by any applicant tor a pe�mit Subjects the applicant to a civil
penalty of not more than five huntlretl tlollars (SS00).
LJ I, as owner of the oroperty or my employees with wa9es as tneir sole
compensation, will tlo the work, antl Ue structure Is not intentletl or oiferetl
tor sale (Section ]044, Business antl Grofessional Cotle: The Contraclor'S
License Law tloes not appty to an owner oi a properry who builtls or Improves
thereon, antl wno tloes sucn work himself/herself or through his or her own
employees, provitletl tM1at such �mprovemenfs are no[ in[entletl or otteretl tor
sale. It, hOweveq [he builtling or improvement is soltl within one y¢ar ot com-
pletion, tne owner will have the burtlen of proving he/she tlitl not bulltl or im-
p�ove for [he purpose of sale).
❑ 1, as owner o/ the property, am excluzively contraGting wilh licensed con-
Iractors to consvuct the project f5ection 7044, Buziness antl Professions Cotle:
The Contractor's License Law does not apply to an owner of property who
- builtls or improves thereon, antl who conVacts for such projects with a con-
tractor(5I license pursuan[ to the Contracfor'S License Law). I am aware that
ptoof o( [heir WOrke�Y Compensation insurance shoultl be provitletl to me.
L7 I am exemD� untler Section B. a P. C. for this reason
Oale owner
I hereby certity tha[ I have rea�
intormation is correct. I agree to
antl state laws relating to b il
sentatives of jhR city to r
inspection {y1fpyS�s. _ �
LDrivers' Licens3 !r 55 �
f-
CMF 0865-46, rev. 10/84 �
tnis
upon
above
iances
re0re-
rv fOr
❑ CONVERSION ❑ DEMOL'ISH ❑ OTHER q,p.#
DESCRIPTION OF WORK)USE.OF BLDG. ^'
- - w: S Main Buildi
E
TVPE OF PERMIT GRADING FOUNDATION STRUCTV RAl T Front
❑ TENANT ❑ ELECTRICAL ��PWMBING ❑ MECHANICAL B Rear
❑ OTHER .. ' ' " � %+
PROJECT DESCRIPTION 5q. F7. oCCVPAN�}C�v .� � C Right
CONSTRUCTIONTYPE VALUATION$�(/./�VV g Left
20NE GRA�ING CU. VDS. ACRES ping. Ref. # '
Remarks: �� (''�y�- , �,�. �� � ( `L1 �/y� �(� _') p Planning Notes:
Sink
Preventer
Irrigation
Drinking Founroins
Floor Oreins
Floor Sinks
GasService Outlets
IncerCeprors
Kitchen Sink
Lavatories
P-Trep
Roo( Drains
Reinspection Fae � $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Bit. ICBO #
Heating System & Ducting
❑0.100,000 BTU 0100,000
Reinspection Fee � $15
Builtlin9; Canary - APPi�cant; Pink - Accounting; Goltlenrotl - Assesror
Service Sink
Sewer Cap
Sewer Connecti<
Solar Collecmrs
Solar Pipin9
Solar Tank
Swimming Pool
Urinal
Water Closet
Water Heater
Wacer Service
AUtO�WB5I1
Laundty Trays
Issue Fea
Hood or Typel ❑
Canopy Typell ❑
Refrigeretion Sys[em
❑aiao,000sru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
i
Zone
Accessory 8uilding:
Z
O
N
I
N
G
R
Parking Feq./Provided E
Q
M
T
S
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � � 50 + KW
Cooking Unit
Dishwasher
Dryers OGas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 00.5 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over100amps
Su6 Panel
MororsOO-1 HP OtX-B
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Li9ht
Range
Sign
Standing Sections
Trash Compactor
$ 3 I
� Rainspection Fea $15 Issue Fee
FEES
�DEVELOPMENT SERVICES REQUIREMENTS:
Zaning Approvad By
Building Approved By
Aoolication Issued BY �r—
$ 3
FEES
$ 3
� SUMMARV OF FEES .
BUILDING PERMIT $ '�-.�. oJ SMIP $ • .�
PLAN CHECK $ PERMIT
P�UMBING 5 ISSUANCE. $
PLAN CHECK 25% S •ENERGV P.C. $
ELEC7RICAL $. GRADING 5
PLANCHECK 50%� $ � MICROFILM $ r f1
MECHANICAL $ TOTALFEE $ �J"J"
PLAN CHECK 25% $
e
�CONSTRUCTION AND PLANNING � � POOL & SPA _ - , ,
APPROVALS Permit# � Date Inspector pppROVALS Permit# � Date' Inspector
1,, Temporary Electrical�$ervice or Pole 52. Pool & Equipment Location �
�
2. Soil Pipe-Undrgrnd. '" 53. Steel Reinforcement
3. Elec[rical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit-Unt)rgrnd. 55. Electrical Bonding �
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.' � 57. APPROVAL TO COVER-GUNITE
7. Footings , - 58. Electrical Condui[-Undrgrnd.
8. Foundation - ' 59. Gas Pipe, � Undrgrnd., Test � '
9. Water Pipe-Uniirgrnd. 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 ElecVic Wiring 67. Fencing & Access Approval' " -
17. Rough Wiring Sign . ' 68.'APPROVED FOR PLASTERING - �
18. Rough Electrica6T 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. Uniierground Hydro ' � '
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil � '
23. Gas Pipe-Rough & Test � 72. Underground Flush t�
24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil �
25. Roof Sheathing 74. Overhead� � �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical _
27. Frame and Flashing 76. DrV Standpipe �z � .
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 ! ' : �
I
38. Final Plumhing �
39. Water Service-Final `'' � . �
�40. Gas Service-Final � � � �� �'y ,; - .� � � �
�41. Solar pomestic-Final � ' � � •
�42. Backflow Preventer , • ' �
�� �`
-43. Backflow Irrigation , I � ' .
�44. Landscape Irrigation System � '��%' ' .
_ }
�45. Sound Attenuation - ' �
.. %
� 46. Handicap Regulations . ' � �
47. FINALSTRUCTURE&BUILDING � ,
.48.,Specia� Requirements Completed � , � `�
49. Electric Release to Edison � -• ��
50. Gas Release to Southern California Gas Co .. � � �
,
51. CERTIFICATE OF OCCUPANCY � - . - .
No. Date l � ' - �
` � . - �.
X
x
i
' _ ____- '
AVD�icant to flll in all spaces except those within heavy boraer lines ana si9n all approo��ate aeelarations.
CITY OF COSTq�I CO ST UCTION PERMI
Prd�cf Ado�ess � �1J�-'�p %ftiLEb!
Applicant's Mailin Address ��� q�,...�j� ar(�'��� �
Owner's Name _ ' � � �' �Phone
Atldreu � �'��%b ,
Arch/Eng. � � �License No.
Address � � - � � ,
Convacto 's Na e �-� PhonE� �%��'7/��L
Address Imailing) -r�'�'� ��F�✓�u%� ST Sr% G/��r
Ciry License No. 32- ���
LICENSED CONTRACTOR OECLARATION
I hereby affirm t�al I am IicenseU unUer provizions of Charter 9(commBncing
with section 7000) of Division 3 of the Business anU Professions Cotle, anU
my Iicense is in full tortg antl effecL � I��v�
License Class �� LI nse Ny ��
"�ate/.2...2 S�B t �_�^ jt, .
JRKERS' COMPENSATION DECLARATION
, nereby affirm ihat I have a certificate of consent to self-insure or a tertifiwte
of Warkers' Gompensation Inwrance, or a certifietl mpy thereof (Sectlon
3800, Lab. C.j '
PoliGy No.������7%i%2g Comvanv�.C�%� AmE.�
Certifietl copy I5 hereby turnisnetl.
Datee��e?cqpy Is filetl with the Uty By7lqlnq pivisq�9.�
1�'K qpplicant 7 c.NallN 4t
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl if the permit is for one huntlretl (§100) or
less)
I C¢rtify [hat in Ihe perlOrman<e Of the work for whlCh thi5 pe�mit Is I55UeQ I
znall not employ any person in any manner so as to become subject to the
Workers' Compensatlon Laws at Califotnia.
Da[¢ Si9na[uro
NOTICE: If, after making this tleclaration, you shoultl become subje<t to the
Workers' Compensa[lon provisions of the Labor Cotle, you must tortbwith
comply with such provisions or thts Dermit shall be Ceemetl revokeU.
CONSTRUCTION LENDING AGENCV
I hereby affirm lhat lhera is a construction lentling agency for the performance
of the work for whith this permit iz iz5uetl (Section 3097 Civ. CJ
Lender'S Name
Lender's Atldress
OWNER BUILDER DECIARATION
1 bereby a(firm lhat I am exempt from the Contractor'S License Law tor the
lollowing reasOn (Section 7031.5 eusiness and P�o(e55lonal CoOe: Any <Ity o�
county which requires a permit to construct, alter, improve, tlemolish or repair
�oy slructu�e, prlor to i[5 issuance, al5o rGqui�es tne aOP�icant for Such pe�mit
tile a signetl ztat¢ment Ihat he/sh¢ is Ilcensetl pur5udnt to the provlsion5 of
e Contractor's License Law (Chapter 9(commencing witn SecHon �000) of
ivision 3 of thc Business antl Protess�ons COGe) or that he/she is exempt
thereirom an0 the basis for the allegetl ezemption. Any vlolation of $ection
7031.5 by any ap0�kant for a permit Subjects lhe aOPlicant to a civil
��enalty of nat mora than five huntlretl tlollars (E500).
I, as owner of Ihe p�operty Or my em0loyee5 with wa9¢5 as thei� sole
<ompensation, will tlo the work, antl the structure Is not intentletl or.ofteretl
for sale (Se<[ion ]044, Business antl Professional Cotle: The Contrdc[o/'S
Li<ense Law tlo¢5 not ap01y to an owna� of a property wno builCs or Improve5
thereon, antl who tloes such wOrk himselt/hers¢It Or tnrouqh his or he� own .
employees, orovitletl thal zuch Improvements are not IntenCetl or offeretl for
sdle. H, nowever, the Duiltlin9 or improvement is soltl wRhin one year of com-
pletlon, the ownor wlll have the burtlen of proving he/she tlitl not builtl or im-
�rove for the purposc of sale).
I, as owner of the property, am excWsively contracting with licensetl con-
traCtors to con5truct tM1e project ($ectlOn 7044, Busine55 and Protesslons Cotle:
Tne Contractor's license Law does not apply to an owner of properly who
builtls or improves thereon. antl wM10 contracts for such oroiects with a con-
tractor(s) lmense purtuant to me Con[ractor•5 Licansa Law). I am aware that
proot o( their WOrk¢r'S COmpensatlon Insu�ance zhoultl be provltletl t0 me.
❑ I am exempt untler 5ection B. & P. C. for [his reason
Date Owner
I hereby certi/y that I have reatl this aOP�ication and state tbat the above
information is <orrect. 1 agree to complY with all city antl county orGlnances
antl state laws relalin9 �o builtling construction, antl here�y authorize repre-
sentatives of this Uly [o eoter upon the above-mentioneG property for
inipection purpos¢s. f �I�_� �
Signature � i Date
Drivers' �itense or 55 � � �
TYPE OF CONSTRUCTION IjY rvE
❑ CONVERSION ❑ DEMOLISH
DESCpIPT10N OF WORK/US� OF
TVPE OF PERMIT LJ GaqDirvG
❑ TENANT ❑ ELECTRICAL
❑ OTHER
PROJECT DESCRIPTION 5c2. FT._
CONSTRUCTION TVPF
20NE GRA
Remarks: , C�_ FF� �
3ar Sink
3ackflow Preventer
3ackflow Ir�igation
3athtubs .
�larifiers
�ishwasher
Jrinking Fountains
Floor Drains �
�laor Sinks
�as Servic.e Outlets
Intercepmrs
Kitchen Sink
Lavatories
'—Trep
ROOf Drains �
Reinzpection �Fee , $15
Duct - $tructural
Duct - Ventilating
Exhauzt System ❑ Multiple
Firepl/Fxt. BIt. iC80 #
Heating System & Ducting
❑ ai ao,000 eru O i oo,oao
Reinspection Fee � $15
0865-46, rev. 5/88 White - Builtling: Canary - Applican[; Pink - Accounting; Goltlenrotl - Assa55or
JADD LJ ALTERATION LJ REPAIR
OTHER
� i—�F��
y
YFOVNDATION LJSTRUCTURAL
PLVMBING ❑ MECHANICAL
_ VALUATION S �%+QT� � ��
CU. VDS. ACRES
Showers
Service Sink
Sewer Cap '
Sewer Connection
Solac Collectors �
Solar Pipin9
Solar Tank �
Swimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service
Auto-Wash
laue Fee
Hood or Typel ❑
CanopY Tvoell ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Regizters �
Issue Fee
A.P. # �
S Main Building:
E
T Front
A Rear
C Right
g Left �
Ping. Ref. #
Plannin9 Notes: ,
/" ^0 /' Q� V 2one
Accessory Building:
Parking Req./Provided
�i .
Automatic Washer
Construction�Pole Sub.
Cooking Unit �
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlet5
Switches
Garbage Dispoul
Generator 00.5 KW �5�15
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW '
Meter �up to 700 amps
� Meter �over100amps
Sub Panel
Motors 00�1 HP O1 h- 6
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light •
I Reinspection Fee ! $15 I
$ 3 ' DEVELOPMENTSERVICESRE�UIR
Zoning Approved By
FEES ' Buildine APProvad By
TT AppliptiOn Issued BY�
$ 3
Standing Sections
Trash Compactor
laue Fee
I
N
G
R
E
Q
M
T
S.
FEES
$ 3
L�� : "�
�• SU ARV OF FEES
BUILDING PERMIT $ ��� SMIP $ � Z�
PLAN CHECK $ �� ' PERMIT
'� �! PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL . $ GRADING $
� PLAN CHECK 50% $ MICROFILM $
MECHANICAI $ TOTAL FEE $ �
PLAN CHECK 25% $ �DD • �I
oi aoozos9s-enoziono �oT ioo.2o
DATE: 12/02/8II TIRf: 10:51 '
CONSTRUCTION AND PLANNING � _ & SPA
FZPPROVAIS. Permit # Dat Inspector � APPROVALS Permit # Date Inspector
� �
1. Temporary Electrical Service or Pole , 52. Pool & Equipment Location
2. Soil,Pipe�Undrgrnd. �, � .� 53. Steel Reinforcement
3. Elect�ical Conduif Utility-Undrgrnd. � 54. Forms �
,4. �Electrical Conduit�Undrgmd. . 55. Electrical Bonding .
5�Steel"Reinforcement � � 56. Rough Plumbing & Pressure Test �
• 6.�.Electr,ical IIPER�Grnd: •� . 57. APPROVAL TO COVER-GUNITE
7. �Footings'�' , , . ' 58. Electrical Conduit-Undrgmd.
8. Foundation ','�� i .; � � 59. Gas Pipe, O Undrgmd., Test
9.�Wate��Pipe-Undrgrnd. , ' 60. Backwash Lines, P-Trap, � Undrgrnd.
10. rStructural 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
i
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
n �.
22. Ducts, Ventilating �'� ,. 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Tesf ' 72. Underground Flush
24. Roof Framing �� �� ��� 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing ��' 74. Cjverhead 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. Drywa,l Nailing �_ y HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat,..,� •�� 79. FINAL INSPECTION
32. Electrical Power M�ter; Final� � 80. FOOD CERTIFICATE ISSUED
33. Final Electric �� ` Notes:"Fj{a � '
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test _ �,i� � (� �
36. Hood or Canopy .. �� L
37. Final Factory Fireplace�
38. Final Plumbing "
39. Water Service-Final (
40. Gas Service-Final
,
41. Solar pomestic-Final � � . � .
>
42. Backflow Preventer .� � • � �
� •
43. Backflow Irrigation _ �
i�
44: Landscape Irrigation System �:0 �
45. Sound Attenuation �
46. Handicap Regulations 1 � ,� �'
r.�
47. FINAL STRUCTURE & BUILDING 7� �
48. Special Requirements Completed ,
49. Electric �Release to Edison ' ' '
• . �
50. Gas Release to Southern California Gas Co . `� i y, .'ti
51. CERTIFICATE OF OCCUPANCY . . ' • • � � ,
No � Date � � �
i
Applicant to till in all spaees exce0< those wiihin heavy �orEer Iines anA
c;TY•OF�COS7n MESA CO STR�U)CTION PjERMI > G,,,�
Project Address � SS �TON �''� /s `� � �"'
Applicant's Mailing Address L% £�� Ct��� DS
Owner's Name �� � .�t�4.—Phone
Address
� ✓
Arch/Eng. • j License No.
Address �T'�A f��1i1.(�/5,-'F� '��"n�`
Contractor'sName .l��Q��/o �,/ P onecr,zufr—'�
Address (mailing11L7�-� ` �{r6��
City License NO. ��asL �
LICENSEU CONTRACTOR DECLARATION
I heteby afti�m that I am IicenSetl unde� p�ovi51on5 oi Cha�te� 9(commencing
with section 7000) of Division 3 of the BuSiness antl Professions Cotle, antl
my license iz in / orc a�d et�ect. �79
License CI ss Li ense No
9ale Si9nature �
WORKERS' COMPENSATION D R ION
hereGy attirm that I have a certifi<ate tonsen to selbinsure or a certiticate
oi Workers' Compensation Insurance, or a certifietl copy thereot (Section
3800, Lab. C.) n�tJn-- �J�/ _ / /J_ / _�
PolicY No. !./�L��J71W ComPanY /�/q'���/1 /KJL//
+� Certifietl copy is hereby furnishetl.
❑ Certit" tl cp p i$�fi�letl with the city Bu g Dlv' �
Date �2/�X Applicant " ��
EXEMCTION FROM WORKERS' CO ENSA N DE RATION
(This section need not be completetl i( tha pe� Is for e huntlretl ($100) or
less).
I ce�ti(y that in the pe�fo�mance ot the wotk for which this pe�m�t is issuetl, I
shall not employ any person In any manner so az to become subject to the -.
Workers' Compen5ation LawS ot California.
Date Si9nature
NOTICE: If, after making this tleclaration, you 5houltl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must tortnwitn
comply with such provislons or tM1is permit shall be Aeemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby a�(irm that ehere is a construction lentlin9 agency tor the performance
ot the work for which tnis permlt is issuetl (SectiOn 309] Civ. CJ
�entler's Name
Len�er's AtlOress
OWNER BUILDER DECLARATION -
I hereby atfirm Lhat I am exemp[ from the Contractor's License Law for the
followin9 reason (SecUon �033.5 Business antl Professional CoOe: Any city or
county which requiras a permlt to construct, alter, improve, tlemolish or repair
ny slructure, priOr t0 its is�ance, dl5o r¢quires the applicant tor such permit
o file a signetl statement that he/she Is licensetl pursuant to the provisions ot
. the Coneractor's License Law (Chapter 9(commen<in9 with Section �000) of
-Division 3 ot [he Bu5ine55 antl Professions Cotle) or tha[ he/she is exempt
tM1erefrom ana tne basis tor [he allegetl exempfion. Any violation of Section
7031.5 by any applicant to� a permlt su�jectz the a0�licant to a civil
�enalty of not more than (ive huntlretl tlollars (5500).
I, as owner of th! propertY Or my emploYeeS with wages as their Sol¢
compensation, will ao t�e work, antl the structure is not intentletl or-otferetl
tor sale (Section 7044, Business antl Pwtessional Cotle: The Contractor's
License Law tloes nol apply to an owner ot a property who builtls or improves
tnereon, antl wno aoes sucn work nimseli/nerselt or tnrougn his or her own
emo�oyees, provitletl thal such improvements are not intentletl or otferetl for
sa�e. If, howeveq Ihe builtling or improvement is soltl within one year ot oom-
pletion, ttte owner will have th¢ bu�Uen of p�oving h¢/She tlitl not builtl or im-
�rove for the purpose of sale).
I, a5 own¢r of tM1e D�operty, am ezclu5ively contracting with lic¢nsetl con- �
tractorsto construct the project (5lction 7064, Businez5 antl Profe55ions Cotle:
The Contractor's License Law dOes not.apply to dn owner of property who
builtls or improves thereon. antl who contracts tor such oroiects with a con-'
tractor(s} Lcense pursuani to [ne Contractor's License Law). I am aware that
proof oi tneir Worker's Compen5atlon insurance shoultl be provitleE to me.
❑ I am ezempt unaer Section B. & P. C. for this reason
Date Owner
I herebvi certiiv thal L have reatl this aoolication antl state that the above
Signature �
Drivers' Licei
0865-66,rev.
the
E 3� 4so I I
TYPE OFCONSTRUCTION NEw aoo
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. —
all apD/oDriate Geclarations.
UNITOIO,�C, q,P.#
� f3
S Main Buildi
ALTERATION REPAIR E
TVPEOFPERMIT LJGRADING LJ�FOUNDATION LJSTRUCTURAL
❑ TENANT �ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION S�.FT. Z oCCUaANCV—
CONSTRUCTION TVPE VALUATION $
ZONE GRAOING CV. VDS. ACRES_
Remarks: �� ���
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Founteins
Floor DrainS
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fea
Under Ground
Structural
$15
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU 0100,000
Reinspection Fee � $15
White - Builtling; Canary - Applicant: Pink - A�counting; Goltlenrotl - Azsessor
G
Showers
Service Sink
Sewer Cap .
Sewer Connection
Solar Collectors _
Solar Pipin9
Solar Tank
Swpiming Pool w/Spa
Water Closet
Wate� Heater
Water Service
Auta-Wash
Isue Fee
Hood or Typel ❑
Canopy Typell ❑
9efrigera -on System
�0- ,OOOBTU ❑100,000
ystem RepaidAlteretion
Fire Dampers
Registers
laue Fee
$ 3
FEES
$ 3
T Front
8 Rear
A
C Right
5 . Left
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Su6.
Cookin9 Unit .
Dishwasher
Dryers �Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW C
zo�e
Accessory
Parking Req./Provided
ELECTRICAL
Trenstormer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors OO-1 HP O1 %�- 8
Ina Solar �9-75 HP �16-15+
Microwave
Pole Light
Sign
Standing Sections
ICW ' Trash Compactor
� Reinspection Fea �$15 � � Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By
Application Issued ev - - - � - /
SUMMARY OF�FEES �
BUILDING PEflMIT $ SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PLAN�CHECK 25% $ ENERGY P.C.
ELECTRICAL � �$� 2 .00 GRADING
PLAN CHECK 0% MICROFILM
MECHANICAL $ TOTAL FEE
PLAN CHECK 25% $
$
oi oeoaa327-000���as zuT
DATE: iilsQJ28 TitlE: Q8�4?
I
N
G
R
E
�
M
T
S.
FEES
24,00
. `''b� �� c, � .. ,
t, CONSTRUCTION AND PLANNING- ' J .OL & SPA .
j Date Inspector Date Inspector��
�,APPROVALS Permit# APPROVALS Permit#
t�'1. Temporary Electrical Service or Pol� � 52. Pool & Equipment Location ;
2. Sail Pipe�Un�yrnd. �„ t, �� ,� 53. Steel Reinforcement ., r� .,� �
a i. - ✓' il-.. "• �'L'
3:��lectr ca� C6nduit UtiliYry-Undrgrr�d. �r � 54. Forms '� �% �
�V
4�Elect�ica�.CiinduiY-Ur�d�grnd. �� 55. Electrical Bonding �%.f �i
5.'Steel Reinfq'rcen5ent '� '~ r 56. Rough Plumbing & Pressure Test . .`:hj} �
M
f 6�E��ct�ica� UFER�G'rndr I)�y� � � 57. APPROVAL TO COVER-GUNITE !��
.7 �Fob'tings� 4� � ~ �� � %+� '� l ;" 58. Electrical Conduit-Undrgrnd. � � �
� i '�. n; :.1 f . � ,�.�
8.'�FoLridation %� �j � � tl % 59. Gas Pipe, O Undrgrnd., Test i��
9�.Wa[erlPipe-Undrgrn¢� '����r f', /'�� 60. Backwash Lines, P-Trap, O Undrgrnd. . `j„ ,
10:�$tructuia1 Floor System �' i) rj 61. APPROVAL TO DECK ✓
11. P�,operty Sewer Line�.& House Corin� ction �y,� '�/ 62. Backwash & Receptor-Final .
1,2: Sewer Cap �� ; � % 63. Fleater & Vent-Final f I
..
13.''Ruof Drains i� ,��, �� � 64. Plumbing System - Final �
14.7Rough Plumbing� /� � 65. Electrical-Final :�
15':iRough ElectricalrGonduit 6. Solar System-Final
1�6^ Rough Elec[ric Wiring ��$ 67. Fencing & Access Approval �
iu
�17,, Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18'� Rough Electrical-T Bar Ceiling }' � 69. POOL/SPA SYSTEMS FINAL �
79.-Rough HeatinQ & Air Conditioning FIRE DEPT. REQUIREMENT -
20. Rough Factory Fireplace ', 1� APPROVALS Permit #
21�. Ducts, in Structure �' _ 70. Underground Hydro
� �
. 22. Ducts, Ventilating � 71. Product Piping � Gas ❑ Oil
23.GasPipe-Rough&�est ^ . 72rUndergroundFlush - �� , .�-
24. Roof Framing w1 �� � �73. Undergrnd. Storage Tank O Gas ❑ Oil �� .
r ., "i
25.'lioof Sheathing ,�• „ � 74. Overhead Hydro . �
26. T-Bar Ceiling (Structuraq & 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 v. . FOOD CERTIFICATE ISSUED �
33. Final Electric � Notes:
34. Final Heating & Air Conditioning �:f' %
_�, , i�. y
35. Final Gas Pipe-Test
36. Hood or Canopy � �
37. Final Factory Fireplace . �
38. Final Plumbing ' ' �
39. Water Service-Final �j
,c'
� 40. Gas Service-Final ' «'� �
41. Solar pomestic-Final �
r� 1
42. Backflow Preventer � i�y _•. �;
43. Backflow Irrigation ✓. ^,
/.P
44. ,Landscape Irrigation System �; i i '
45. Sound Attenuation � � � � .
.�
46. Handicap Regulations . '�
i
47. FINAL STRUCTURE & BUILDING 7
L
48. Special Requirements Completed -
49. Electric Release to Edison • j
"� -
50. Gas Release to Southern California Gas Co `� ��{
�' �
51. CERTIFICATE OF OCCUPANCY � � ' � "
No.��� Date � � � �
- ��i �,
ADP���ant to till In all spaces except thosa wit�in neavy DorCar Iines anA si9n all approDriate tlaclantions.
CITY OF COSTA MESA TRUCT ON PE MIT�$
Project Addr
Applicant's Mailing Address �
Owner's Name �L hon �
Address �� �NTL71J
Arch/Eng. ���R� � _' License No.��
Address 22���7�`���'�I.����VEP(�S��V ���vC �,�"'In
Contrector's Nar11�rJ��'�4�` -t vhone`1.s�/-i rn�
Addresslmailing)�SZ CoC �iCA ,��.%�%�-.`
City �icense No. �3 ��/ 4y'
�LICENSED CONTRACTOR DECLARATION
I hereby affirm Ihat I am licensetl untle� provi51on5 ot Cha�ter 9(commencing
� witn section 7000) of Division 3 of the Business antl Professions Cotle, antl
my license is in �I�rce antl ette<L 3� � s b�
ticense Class _� ic
'+ate�+`�t_Tn�T Si9�ature
)RKE0.5' COMPENSATION DECLARATION
.�ereby aftirm that I have a certifiwte of consent to salftinsure or a certificate
ol Workers' Compensation Insurance, or a certifietl copy thereot (Sectlon
3800, Lab. )
aoi�cr No.�63-.759� f" ComPanY�`�' � �-� S
�y'{�,er:ifieA copy is hereby furnishetl. �7
L9 Certitietl co y is filetl with the city�9�lin9 q v/Siol90 � �
Date �- / APPlicant /'� �T ��i " ""���- �
E%EMPTION�RKERS' COMPENSATION DEGLA0.ATION
(Tnis section need not be completetl it t�e permit is tor one huntlretl (E300) or
less)'.
�'I certity [hat in the pertormance O7 the wo�k to� which this p¢rm�t is is5uetl, 1
shall mt employ any person in any manner so as to become subject to the
Worke�s' Compensation Laws ot California.
Date Signature
NOTICE: If, after making this tleclaration, you 5houltl become subject to the
Workers' Compenwtlon provisions ot lhe Labor Cotle, you must torthwith
comply with Suth provi5ion5 or this p¢rmit Shall be tle¢metl revOketl.
CONSTRUCTION LENDING AGENCV
1 nereby affirm that tnere is a construction lentling agency Tor the performance
ot Ihe work (or which this permit is issuetl (SectiOn 3097 Civ. Cj
Lentler'z Name
Lentler's Atltlress
OWNER BUILOER DECLARATION
I hereby aftirm lhat I am exempt from the Contractor's Llcense Law for the
fol�owing reason (Seccion ]031.5 Business antl Protessional Cotle: Any city or
county whicM1 require5 a permit to constru<t, alter, improve, tlemolisb or repair
a^v structure, prior to its Issuance, also requires the applicani for such permit
��le a signetl statement that he/She is licensetl pur5udnt to the p�ovi5ions Of
..on(ractor's License Law (Chapter 9(commencing with Section �000) of
.sion 3 of tne Business antl Professions Cotle) or that ne/she is exempt
tnerefrom antl [ne basis for the allegetl exemption. Any vlolation of Section
7031.5 by any ap0���anf for a permit subjects the apPlicant to a civil
�enalty of not more Ihan tive nuntlretl tlollars (g500).
I, as owne� ot the p�opei'ty or my em0loyee5 witn wages as [heir sole
<ompensation, will tlo lne work, antl the structure is not intentletl or.otferetl
for sale (Section 7044, Business antl Professional Cotle: The Contrattor's
Licenu Law Coes not apply to�an owner of a property who builtls or improves
thereon, an0 who tloes such work nimsel!/herself or through his or her own
employees, 0/ovitletl that such improvements are not intentletl or otteretl for
sale. It, nowev¢r, the Ouiltlin9 0� ImOrOvemenl IS Soltl wi[hin On¢ yea� o( <om-
pletion, the owner will have the burtlen ot provin9 M1e/she tlltl not builtl or im-
prove tor the�purpose of sale). �
❑ I, as owner of the property, am ex<luzively contracting with Iicensetl con-
traGtors to construct the Oroject ($ection 7044, BuSin¢55 antl Pro(e55ion5 Coae:
TM1e Contractor's License I_aw does not apply to an owner of property who
builtls or imo�oves thereon. antl who contracts for zuch oroiects wltn a con-
tfactol�51 Lcerhe pursuani ro Ine ConVaCtor'S licenSC Law�. I am awarG tha[
proof o( their Worker's Compensation insurance shoultl bo provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner �
I- nereby certity that I have reatl this application antl stata that the above
iniormation is correct. I agree to comply with all city antl county orGinances
antl state laws relating to builtling ConStructlOn; antl hereby authO�ize �eD�e-
sentatives of this ci to �ent upon the above-mantioneC property for
Intpectla�a s. .�.� ���C ..
Signature � Date�
Orivers' License or 55 9f � �
PE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER•
DESCRIPTIONOFWORK/USEOFBLDG. � �
T_VP^E OF PERMIT LJ GRADING LJ FOUNOATION L35TRUCTV RAL
�+TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5�. FT.����-�7 OCCVPANC �
CONSTRVCTIONTVPE I • VALUATION$�
20NE GRADINGCU.V�S. ACRES
Remarks:� �' �
�c r_,.. n_7RU�� �_�., io-it-_,� G[ �I-4SR�
Sink
Preventer
Irrigation
iking Fountains
x Drains
�r Sinks
Service Outle�s
Kitchen Sink
Lavarories
P-Trap
Roof Drains
Reinspec[ion Fee
Showers
Service Sink
Sewer Cap
Sewer Connectian
Solar Collectors
Soler Piping
Solar Tarik •
wimming Pool w/Spa
Urinal
water pout
Water Heater
Water Service
Auto-Wash
Laundry Trays
$75 Issue Fee
Boiler
Dutt- UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact BIL iC80 # �
Hea2ing SVstem & Ducting
❑aiao,000 aru Oioo,000an
Reinspection Fae � $15
0865-46, rev. 5/88 Wnite - Bulltling; Canary - Applican[; Pink - Actounting� Goltlenrotl - Assessor
Hood or Type I ❑
CanoPY TYPeII ❑
iefriger Cfon System
� 00,000 BTU ❑ 100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
A.P. qW �
S Main Building:
E
T Front
ARear
C Right
S . Left
Ping. Ref. #
Planning Notes:
&y- iS�
- Zone
Actessory Building: '
. Z
O
N
1
N
G
R
Parking Req./Provided E
Q
M
��A_ T
S.
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit Meter �up to 100 amps
Dishvrasher Meter �over100amps
Oryers �Gas ❑Electric SubPanel ' ��'
Fan Motors �0.1 HP �1'/� - 8
F.A.U. Inc. Soiar �9-15 HP �16-15+
Fixtures
Device Boxes
Outlets �
Switches
Garbage Disposal
Generatar �0.5 KW �5-15 KW
� Rainspection Fee � $15
$ 3 DEVELOPMENTSERVICESREQI
2oning APProved By�]�'
FEES 8uilding Approved By �� �•
�i� Aoolication Issued Bv � 1a
$ 3
Pole Light
fiange
Si9n
Standing Sections
Trash Compacror
luue Fee
� -- SUMMARV OF
' BUILDING PEFMIT $ �( �7. oe
PLAN CHECK 5 7�• ��
'PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
FEES
ES `� . Q ' �� '
SMIP $ �
PERMIT '
ISSUANCE $.
ENERGY P.C. $
GRADING $
MICROFILM $
TOTALFEE $ ���
�710G0Y8349-D00233�1 TtroT 516.26
i:t1T'c. 03/i5lE4 TIME': 49:23 ��—
r . , ... ` . • .
� �.�'.a-.�.r,��. ,rr,�.
, CONSTRUCTION AND PLANNING . P '. & SPA .
• D ie :lnspector Date Inspector
%.F qPPROVALS Permit # ;L � '� APPROVALS Permit #
���1�'Tempor_ary_Electrical Service or Po'e �_ � 52. Pool & Equipment Location + rt
• - � i � � -- -,...� •�.
�.;�Soil`Pipe-Undrgrnd. � � � . �y � 53. Steel Reinforcement , ' ;�
3;�jElectyical �Con " . .vY- 91 .�
[�uit Utilit Undr rnd. ;;, . 54. Forms ,/�
�
.'�, " .• _.. .i_� 4 . � ,
4:� Electrcal Conduit-U`nd�grnd. � p � . 55. Electrical Bonding �i
6�Steel-Reinforcemerit� ,� 56. Rough Plumbing & Pressure Test ��,;
• �6�ElectricalUFER;Gmd. i� 57. APPROVALTOCOVER-GUNITE �.;.
7S�Pobtings ,� �i �� �' �' �'!� 58. Electrical Conduit-Undrgrnd. � :.
i'
�Q_Foundation ��^� y ,r..�� , � 59. Gas Pipe, O Undrgrnd., Test `��
�..,Wate� Pipe-Ui�rg`rnd. � +� 60. Backwash Lines, P-Trap, � Undrgrnd.
10 �Structural Floor System _� '. � 61. APPROVAL TO DECK
�
11 �Property Sew"er Line & House Cor�nection -• -� , 62. Backwash & Receptor-Fina� �
12:-Sewer, Cap ' ' �• � � 63. Heater & Vent-Final
�
.]3. Roof �Draip'S1_� i, � '����• 64. Plumbing System - Final _r
; 74�JRough Plumbing- 65� Electrical-Final �
- 15. Reugh Electrical-Conduit 66. Solar System-Final .
`�6i Rough Electr;c Wiring �', 67. Fencing & Access Approval
. �7i Rough Wiring Sign �- 68. APPROVED FOR PLASTERING
�18 � Rough Electrical-T Bar Ceilin`g ^+ 69. POOUSPA SYSTEMS FINAL
19�. Rough Heating & Air Conditioriing' FIRE DEPT. REQUIREMENT
20�. Rough Factory Fireplace `, `� APPROVALS Permit #
�21: Ducts, in Struc[ure �,^ 70. Underground Hydro
22. Ducts, Ventilating __ ��`� � F71. Product Piping OGas ❑Oil � � �
23. Gas Pipe-Rough &'Test ." � � � 72. Underground Flush �%
24. Roof Framing �� -' r2 % 73. Undergrnd.StorageTank OGas ❑Oil . �
25 � Roof Sheathin9 , �- 74. Overhead Hydro
26. T-Bar Ceiling �Structural) & Monocoat � 75. Dr.y Chemical
- 27:' frame and Flashing , ' u$ 76. Dry Standpipe
28. Lathing &7Siding "�� 77. FIXED SYSTEM FINAL
- i � .
29. Insulation �"� 78, FIRE PREV. FINAL
30. Drywall Nailing n� �,�,» 7� HEALTH DEPT. REQUIREMENT
31 Plaster Brown Coat�-.' ✓ 79. FINAL INSPECTION � t
a. :J
32. Electrical Power Me�r-Final � 80. FOOD CERTIFICATE ISSUED � � ;
33. Final Electric � �� � Notes: � �
�
34. Final Heating & qir Conditioning �� � � �,
35. Final Gas Pipe-7est C��C
36. Hood or Canopy� '
-37. Final Factory Fireplace ^
. �38. Final Plumbing �
'39. Water Service-�inal .
� r
44. Gas Service-Final . � . � � ` �
41. Solar pomestic-Final � ` � �
42. Backflo'w Preventer � .! ' �� � -
, 1 .
_ /
;�43. Backffow Irrigation � �� 1 � �. � �
.. ( _ -� _
�' �i � r.
44. ,Landsc8pe Irrigation System �
45. Sound Attenuation ' � �� ��
'' /�
46. Handicap Regulations �� � � �� O �S�
j 47. FINAL STRUCTURE & BUILDING � �`
�
ri 48. Special Requirements Completed � E M�L(� -��� Cl ��
�
�' 49. Electric Felease to Edison . ���'� _
',� �50. Gas Release to Southern California Gas Co �� ��� � ��
`� 51. CERTIFICATE OF OCCUPANCY - -" • I
No. � Date �_ I�/ ^. -'� �� /
� � ��> �
, . L � �-v/ ) � � (
%A' i
Applieant to fill tn all spaces except t�ose within heavy Cortler Iines anO sign all aDVrapriate tleclantlons.
CITV OF CO�TA MESA CON^ST�R,UCTIONpP�ERMIT �"�'�"� S I '"��' '"". "" '"". """ NU. A P�p
Project Address �.�.� `�'� ti3 �- o.J� S Main Buildin9:
Applicant's Mailing Address TYPE OF CONSTRUCTION NEW aDD ALTERqTiOrv REPAIR E
Ownef'S Name (i ❑ CONVERSION ❑ DEMOLISN ❑ OTHER 7 FfOnt
Phone DESCRIPTION OF WORK/USE OF BLDG. 8 Fear
Address A
Arch/Eng. License No. TVPE OF PERMIT GRADING�OVrvDATION STRUCTVRAL I K Right
Address ❑ TENANT ❑ ELECTRICAL PLVMBING ❑ MECHANICAL , S' L¢ft
COntracLOr'SNam as hone�t'�%� �'OTHER PIng.R2f.#
PROJECT DESCRIPTION SQ.FT. oCCUaANCV
Address (mailingl �S_T/O 2U/�b�i(}' �iqsl4.�r.Soah Planning Notes:
�/ Q �l CONSTRVCTIONTYGE VALUATION$
City License No. h
20NE GRADING CV VOS
LICENSED CONTRACTOR OECLARATION
I hereby aHi�m that I am lic¢nzetl untler O�ovisiOn50f Charte� 9(comm¢ncin9
with Section ]000) of Oivi5lon 3 of tha Busine55 antl Prof¢SSionS Cotle, antl
my iicense is in tuu �orce ana ettect. 29/� u
Licens�e1 Class � License No.,
. Date y��� Signature
NORKERS'GOMPENSATION OECLARATION
' I hereby a/tirm that I have a certiticate oi consent to selt-insure or a certlticate
ot Wotkers' Compensation Insu�ance, o� a ce�tltietl mpy Ihereot (5¢Ction
3800, LaD. C.)
aorcr rvo. i3�i1/• !__r_ S�L37� 7 comaa�y �Y�
�ertifietl copy is hereby (umishetl.
Certifietl copy is filetl with tne ciry Builtliq� D' ision.
oate3-/(o Z('� qppiicant!
EXEMPTION FROM WORKERS' COMPENSATI ECLARATION
(This section neetl not be completetl it �he Oe�mi[ is fo� one huntlr¢tl (E300) or
less).
I c¢rti(y Ihat in the pe�formance ot the wo�k tor which this pe�m�t i5 i55u¢tl, �I
M zhall nol em0�oy any pe�son in any manne� so as to become subject to the
� Workers' Compensation Laws o( California. '
i Date Si9nature
NOTICE: If, atter making t�is tleclaration, you shoultl become suGject to tne
Workers' Compensation provisions ot the Labor Cotle, you must (orthwith
' comply with such provi5ion5 or thi5 pe�mit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby a(firm that there is a conztrucUon lentling agency for the per(ormance
�� of llte wOrk (or whith thi5 permit is i55ultl (Se<tion 309] Civ. CJ
Lentler's Name
Lentler's Atltlress �
OWNER BUILDER DECLARATION
I hereDy aftirm Ihat I am exempt trom the Contractor's License Law for the
tollowing reazon (Section 7031.5 Businesz antl Professional Cotle: Any city or
county which requires a pe�mit t0 const�uct, alter, improve, tlemolish O� repal�
any slruGture, ptlo� to it5 i55Uance, also requireSlbe ap0�icant for Such pe�mit
• to file a slqnetl statement that ne/she 151icensetl Oursuant to the provision5 ot
the Contracror's License law (Chapter 9(commencing with Section �000) af
DiviSion 3 of the Business antl Pro(e551ons Cotle) Or that he/she is ex¢mpt
lherefrom antl the Dasis for the alle9etl exemption. Any violation of Section
�031.5 by any applicant for a permit subjects the applicant to a civil
�enalty of not more than five nuntlretl tlollars (5500).
I, as owner of the property or my employees with wa9es as their sole
mmpenSation, will tlo th2 wo�k, antl Ine structur< is not intenCetl or offeretl
for sale (Section 7044, Busmezs antl Protezzional Cotle: The Contraclor'S
�icense Law aoes nol apply to an owner of a pwperty vmo bulltls or improves
the�eon, antl who tloes sucb work himselt/herself or tM1rou9h his on c�r own
employ¢es, p�ovitletl that such imOrovemenl5 ar¢ not intentletl or otfetetl to�
sale. I/, M1owever, tM1e builtling or improvement is soltl within one year o( com-
pleiioq tbe owner will have the burtlen of proving he/she tlitl not builtl or im-
prova �orthe purpose ofsale).
❑ I, as owner ot the proper[y, am exclusively contracting with licensetl con-
tractors to construct the project (Section 7044, Business antl Professions Cotle:
The Contractor's License Law tloes not apply to an owner of property who
builtls or improves thereon. antl who conVacts tor such oroiects with a con-
tractor(sl hcense pursuan[ to me ConVactor•s License Law). I am aware that
pwof oi their WOrker's Compensation Insu�ance Shoultl be provi0etl to me.
❑ 1 am exempt�untler 5ection B. & P. C. for [hls reason
Date ��� 'J • - Owner
1 nereby certify that I have reatl this apP�ication antl state that the above
Intorma[ion iz•� rrect. I a9ree compty with all dty antl county ortlinances
antl slate laws�lati i tli conStruGtion, antl hereby autho�ize repre-
sentatives of thi ity upon the above-mentionetl �roperty for
Inspectlon purpo /
$ignature Date7 �G —S9
Drivers' Li «
. . ACRES
Remarks: �,t, '%�7 �
Sink
Preventer
Irrigation
Drinking Fountains
Floor Droins
Floor Sinks
Gas Service OuHets
Interceptors
Kitchen Sink
Lavatories
Roof Orains
Reinspec[ion Fee � $15
Boiler
Ouct � Under Graund
Duct - Structurel
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑b100,000 BTU �100,OOOBT
Reinspec[ion Fea � $15
0865-46, rev. 5/88 White - Builtlin9: Canary - Applicant; Pink - Accountlnq; Goltlenrotl - Assassor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectars
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service
Auto�Wesh
laue Fee
Hood or Typel ❑
Canopy Type II ❑
Refrigeration System
❑aioo,000eru Oioo,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fae
$ 3
FEES
$ 3
Automatic Washer
Construction PoleSu6.
Cooking Unit
Dishwaiher '
Dryers ❑Gay 0' Electric
Fan
F.A.U.
Fixtures
Device Baxes �
Outlets
Switches
Garbage Disposal
Generetor �0.5 KW C
zone
Building:
Parking Req./Provided
ELECTRICAL
Transformer � 15-50 KW
o so+Kw
Meter ❑up to 100 amps
Meter ❑over 100amps
Sub Panel
Motors�0.1HP�7X�8 �
Inc. Soiar �9-15 HP �16-15+
Microwave
Pole Ligh[
Standing Sec[ions
5�15 KW Trash Compactor
� Reinspection Fee �$75 � � laue Fea
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved By
Buildine APP�ovad By �
AppliWt1011 IAUBd BY
FEES
$ 3
N
1
N
G
R
E
Q
M
T
5.
SUMMARV OF FEES �
BUILDING PERMIT $ SMIP $
PLAN CHECK $ � PERMIT
PLUMBING $ �• ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ _�
MECHANICAL $ TOTALFEE $ �
PLAN CHECK 25% $ __
ai oaoz�ada-ooczs46o -t�T �,oa
OATE: �3/16/89 TIflE: 11:29 j
4i. .-. .. � . ,� . . ..�. .. �,p^_, .. ,tt . . • .. . : . r.�^-r � . .. .. . . , .
,0� -I ��
� CONSTRUCTION AND PLANNING J ��vL & SPA
�'APPROVALS Permit# Date1 Inspector qppROVALS Permit# Date Inspector
:u -
1•. Temporary Electrical Service or Pole m ,.� 52. Pool & Equipment Location
l
2. Soil Pipe-Undrgmd. �'� --� 'n 53. Steel Reinforcement �. �'i „
3. Eleci�ica7 Conciuii Utility-Undrgmd. y1 54. Forms , �
4JElectrical Conquit-Undrgrnd. � � 55. Electrical Bonding �'o"C~
� . r �
5�Steel_Reinforcement�:.� � 56. Rough Plumbing & Pressure Test �� `,� ,�
6:�ElectiicalUF�R'Gind:� 57. APPROVALTOCOVER-GUNITE �
4 P ih
J:-'Footings 'i � t�� r� . 58. Electrical Conduit-Undrgrnd. �'�
Y . � �t d
$.� Foundation �` � '�JJ /J 59. Gas Pipe, O Undrgrnd., Test `��
91 Water Pipe-Unqrgmd. j; �� i) 60. Backwash Lines, P-Trap, � Undrgrnd. �
n
10.�5[ructural Floor System =� 61. APPROVAL TO DECK '
11! Property Sewer Line & House Connection { 62. Backwash & Feceptor-Final � .!
12. Sewer Cap �/ � �; 63. Heater & Vent-Final '1r
13. Roof Drains '�� � '" 64. Plumbing System - Final '
.�
14. Rough Plumbing� ��BQ LrcO 65. Electricat-Final !�
75. Rough Electrical-Conduit 66. Solar System-Final
�1�6. Rough Electric Wiring � 67. Fencing & Access Approval
r�
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
�78. Rough ElectriCal-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
� 19. Rough Heatiny & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace •� APPROVALS Permit #
21. Duc[s, in Structure -;� 70. Underground Hydro
22. Ducts, VentilaYing " 71 . Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test �� 72. Underground Flush
24. Roof Framing � J 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical Power Meter-Final � BO.�FOOD CERTIFICATE ISSUED
33. Final Electric �� Notes:
34. Final Heating-$� Air Conditioning
35. Final Gas Pipe-Test
36. Nood or Canopy
37. Final Factory Fireplace
38. Final Plumbing � � LE��
39. Water Service-Final
_ i . .
40. Gas Service-Final
41. Solar pomestic-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 Relea3e to Edison - �
50. Gas Release to Southern Califomia Gas Co -, ��
51. CERTIFICATE OF OCCUPANCY '
1
No Date ti
Applican� to fill in all ipaces except those within heavy bortler lines antl si9� all approo��ate tleelarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT
Projec�t�A2ddGress �i U
APPii�'SnTSFAa in9�iesS" �--�� /t'� �7rQ���.,i�L��cr
Owner's Name /PhIIri2 L�
Address s�r /��� OlJ �f%GuiJ G-��%-'Q�L�`s�'
Q�
Arch/Eng. License No.
Address /�j
Contrac o /i N3'mG ���P `�• ��C _ hon��� �7�
Address (rYfdil�Tigr r �'v� ..ddi7.f/c6 .G�. �/_�.GD`G. ���
CiryLicenseNo. U��3 '
LICENSED CONTRACTOR DECLARATION
I hereby affirm [ha[ I am licensee untler provisions of Charter 9(commencing
with Section ]000) of DIVISion 3 of roe BuSiness antl Professlons Gotle, antl
my �icense is in tuu rorce ana ettect. �ZB�QG
License Class - License o
� Date'-�� Signat}� � ����-�-..*=
� W00.KER5' COMPENSFTIESN �CCLARATION � l�
� 1 hereby affirm that I have a certiticate ot consent to self-insure or a certiticate
of Workers' Compensatlon Insurance, or a certi(ietl copy thereof (Section
� 3800, lab. C.) ,' .
Q PoIiCY No.�[G� ComPany �� ��.��
� �Certifietl copy is hereby furnis
Certifietl copy is filetl w�th tlty iltlinq ision
DateJ 1� `�� plican
EXEMPTION FROM WORKERS"COMPENSATION DECLARAT
- (This section neetl not be completed if the permit is-tor one huntlretl ( 0) or
, less).
I c¢rtity tM1at in Ih¢ P¢rformance Ot the work for which thi5 pe�m�t is ISSuetl, I
- shall not employ any person in any manner so as to becorOe subject to the
Workers' Compensatlon Laws ot California.
Date Si9nature
NOTICE: It, after makin9 tnis tleclaration, you shoultl become subject to the
Workers' Compen5ation provisions ot the Labor Cotle, you must forthwith
comply �with such p�ovisions o� this pe�mit Shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirm tnat there is a construction lentling agency for the oerformance
of tne wark for which this permit is issuetl (Section 309� Civ. 0.)
Lentler's Name
Lentler's Htltlre55
OWNER BUILDER DECI.ARATION
I hereby at�i�m lhat I am ezem0t from the ConVacto�'S LicenSe Law to� the
following reason (Section 7031.5 Business antl Protesslonal Cotle: Any city or
county which requlres a permit to construct, alter, improve, tlemolish or repair
any sVucture, prior to its issuance, also requires the applicant tor such permit
to tile a Si9netl statement that he/she is li[ensetl pu�suant to lh¢ prOvisions o(
tne Contractor's License Law (Chapter 9(commencing with Sectlon 7000) ot
Division 3 of the Business antl Professions Cotle) or that he/she is exempt
tneretrom antl the basis for the allegetl exemption. Any violation of Section
7031.5 by any applicant tor a permit subjects the applicant to a civil
� ��enalty of not more than five huntlretl tlollars ($500).
I, as owner of the pro0erty or my employees with wages as their sole
<ompensation, will tlo the work, antl the st�uctu�e is not intentletl o� ofteretl
� for sale (Section 7044, Business antl Protessional Cotle: The Contractor's
License l.aw tloes not apply to an owner of a property who builtls or improves
the�eon', antl who tloes such wo�k him5elt/M1e�selt or through M1is or her own
employee5, provitletl tM1at Such imp�ovements a�e not Intentletl o� ofteretl tov
sale. If, however, the bwltling or Improvement is soltl wi[hin one year of mm-
plelion, the owner will have the burtlen oi provin9 he/she Oitl not builtl or im-
prove for the purpose of sale).
❑ I„as owner of [M1e property, dm ezclu5ively cont�acting with IicenSEtl COn-
tractors to construct the project (Section ]044, Business antl Pwfessions Cotle:
The ConVactor's License Law tloes not appry to an owner of property who
builtls or improves the�eon. antl wno contracts Po� such oroiects wlth d ron-
tractor(s1 Imense pursuan[ ro me ConVactor�s License Law). I am aware thax
proof of their Wo�ke�'s Compensation in5uranGe shoultl be Orovitl¢tl to me.
❑ 1 am exempt untler Section B. & P. C. for this reason
Date ' Owner —
1 hereby certity�that I M1ave reatl this
information is correct. I agree to tomp
antl'state laws relating to builtling con
5entafives �t�this citv to en(¢r upoi
or 55
tate [�at the above
d COUl1[Y OIdlfldflC25
:by authorize repre-
ionetl property tor
Date�9
_P'l 3$013 �
TVPE OF CONSTRUCTION NE
O CONVERS�ON ❑ OEMOLISH
OE$CRIPTION OE WORK/USE OF
ADO }SJ ALTERATION IJ REPAIR
TYPE OF PERMIT LJ GRADING LJ FOUNDA�ION U STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANICAI
❑ pTHER
PROJECT DESCHIPTION $Q.FT. OCCUPANCV—
CONSTRUCTION TYPE VALUATION $
ZONE GRADINGCU.V�S. ACRES_
Remarks: �%py /�Ai�iT� � �► 77� � �
Sar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs -,�
Clarifiers "
Dishuvasher
Drinking Founiains
Floor Drains
Floor Sinks
Gas Service Outiets '
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee $15
Boiler '
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Ezhaust System ❑ Multiple ❑
Firepl/Fact. Blt. iC80 #
Heating System & Ducting
❑0.100,000 BTU � 100,000 BT
Reinspection Fee � $15
_ _ -- _
0865-46, rev. 5/BB White - Builtling; Canary - Applicant; Pink - Accountinq; GOIGenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service '
Auto-Wash
laue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System �
❑0.100,OOOBTU ❑100,000
System Repair/Alteretion
FireDampers�6 Sv �
Registers
Issua Fee
A.P. vW
S Main Buildi
E
T Front
B Rear
A
C Right
S . Left
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers OGas ❑Electric
�� r�i
Zone .
Accessory Building:
Z
O
N
I
N
G
R
Parking fieq./Provided E
Q
M
T
S.
ELECTRICAL
Transformer ❑ 15-50 KW
'� 50+KW
Fan
F.A.U.�
Fixtures
Device Boxes
Outl¢t5
$WitChES
Garbage DispoSal '
Generator 00�5 KW �5-75 KW
Meter ❑up to 100 amps
Meter ❑over 100amps
Sub Panel
Morors �0.1 HP O1 X- 8
InaSolar �9-15 HP �16-15+
Microwave
Pole Light
Range
C�...
Standing Sections
Tresh Compactor
Fee � $15 � ( Issue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
FEES Building Approved By �
T� Application Issued By
FEES
$ '3
SUMMARY OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ � �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ � GRADING $ • ~�
PLANCHECK 50% $ MICROFILM $
MECHANICAL $��r ta - TOTAL FEE $ L S. �U
PLAN CHECK 25% $
ni oao2vsos-00029s03 Tr3T jy..5.5(j
DATE= 03/30/89 TICIE- 10:43
. . . .. . . \�;Gi • . .. , ...._,.. ,._ _.
CONSTRUCTION AND PLANNING • fu�L & SPA
APPROVALS Permit# Dafe .Inspector p�ppROVALS Permii# Date Inspector
1•. T�mporary Electrical Service or Pole � 52. Pool & Equipment Location ,
/ .I • '
2. Soil Fipe-Undrgrnd� --� !• �� 53. Steel Reinforcement ,� __ �� �
3��JE�ect�ical Conduit Utility-Undrg�.nd! - � 54. Forms r�
4C�Electrjca� Conduit-Undrgrnd. `� ;, 55. Electrical Bonding "
5�Steel ,Reinforcement�:�j � 56. Rough Plumbing & Pressure Test
6�'ElectricalUFERGrrid:� , � 57. APPROVALTOCOVER-GUNITE •
�:
7�Footings� ^ y!� � ' , 58. Electrical Conduit-Undrgrnd. �-
8� Fountlation� � � � �� 59. Gas Pipe, O Undrgrnd., Test
9.}Water pipe-Undrgrnd. , �� � 60. Backwash Lines, P-Trap, O Undrgrnd. . `�
10f'S{ructursl Floor Syst'em � -� 61. APPROVAL TO DECK ��..
11. P[operty�Sewer Linel& HouseConnection - 62. Backwash & Receptor-Final ��
��
72. Sewer Cap r � . ' � y � 63. Heater & VenbFinal ' � ; �
13. Roof��D�ains r�� / ' 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
�1�7•. Rough Wiring Sign '' 68. APPROVED FOR PLASTERING
i1'$. Rough Electrical-T Bar Ceiling� y 69. POOL/SPA SYSTEMS FINAL �
l9. Rough Heating & Air Conditioning a� y,xK C,Ej� FIRE DEPT. REQUIREMENT
24. Rough'Faaory Fireplace '�� APPROVALS Permit #
u
21. Ducts, inVStructure f. � � 70. Underground Hydro
22. Ducts, Ventilating '� 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test � 72. Underground Flush' // 0
24. Roof Framing " - 73. Undergmd. Storage Tank O Gas ❑ Oil y iJ
� , ,
25..Roof Sheathing � � •� 74. Overhead Hydro %5
, ' f
26. T-Ba:;Ceiting (Structural) & Monocoat ' � 75. Dry Chemical
27.'FramOand fleshing - ' " • 76. DryStandpipe � y,,, /� '
28. Lathing & Siding �� . 77. FIXED SYSTEM FINAL + �+
.
�
29. Insulation � `/'�� 78. FIRE PREV. FINAL r i
30. Drywall.Nailing ���� HEALTH DEPT. REQUIREMENT � �/
.
31�. P�Iaster.Brown Coat i� 79. FINAL INSPECTION ,.
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � � 1
✓' V. 1: la. I
33. Final Electric Notes: •i , !+ T�
34. Final Heating & Air Conditioning � gb L��
C
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing . .
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Fina � /
42. Backflow Preventer :,, i �"���
.,� • -- � /-,
43. Backflow Irrigation i� `�� ��
44. .Landscape Irrigation�S'ystem
• .,
45. Sound Attenuation ��
•.�
46. Handicap Regulations� '
47. FINALSTRUCTURE�BUILDING
48. Special Requirements'Compleied
49..Electric Releaseto Edison ��)
50. Gas Release to Southem California Gas Co , ✓ ��
n
51. �CER7IFICATE OF OCCUPANCY �ij � �
.�
No. Date -
i
AOp���ant lo fill in all spaces axeepl i�ose wilhin heavy Gortle� Ilnas antl sign a11 approoriate aeciarations.
CiTY OF COSTA MESA CONSTRUCTION PERMIT
ProjAct Address 5�5 �}�+�+n s�u � rF 8sa_
Applicant's Mailing Addreu r
Owner's Name �/'���'�T�G ��nrk Phone
Address
Arch/Eng. ��%k License No.
Address
Contractor's Nam Phone �+�0112
Address (mailing) �ml C2e.�F: \� �� � 1 D? i�bSta R�GSr�.I
City License No. 0�4�1q86
LICENSED CONTRACTOR DECLA0.ATION
I hereDy altirm tnat I am licensetl untler provisions of Charter 9(commencing
with 5eclion 7000) of DiviSion 3 0l the Busine55 antl Professions Code, antl
my Iicense is in (ull torce antl eftect.
�icenu ciasj ucense rvo. +��47 �
7atey17/ Si9�ahre
,400.KER5'COMPENSATION DECLARATION
I hereDy atflrm that 1 have a certHicate ot consent to 5¢ILinzure or a certi(itate
of Workers' Compensation Insuranca, or a certitietl coOY lhareot (Settion
3800, laD. C.) __\ , ,
PolicY rvo. I�IP$RU.1�,� ComPanv��r 1,UeMn� �
�Certifletl copy is hereby furnlshed. ,
Ce�ti�led cap i5 tiletl with th¢ tl[y Bulltling Dlvlston.
ate -� — 11 ' �� APP li<ant �.'�.A.CM C �. [N�l \ 11�
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(Tnis sectlon neetl not be wmpletetl H the permit is for one �untlretl ($100) or
less).
I C¢rtity that In the perto�mant0 of thG wo�k f0/ which NIs pe�m�t Is ISSuetl 1
shall not employ any person in any manner so as to become subject to t�e
workers' Compensation Laws o/ Callfamia.
Date Si9nature
NOTICE: H, after making this tleclaratlon, you shoultl become subject to the
Workers' Compensation provisions of tne Labor Cotla, you must torthwlth
comply with zuch provisions or this permit shall be aeemeC revoketl.
CONSTRUCTION LENDING AGENCV
I hereby aillrm that there is a construction lentlin9 agency for the performance
Of lha work for whicn, this Oermit I5 ISSuetl (Sec[ion 3097 Civ. CJ
Lentler's Name
Lentler's Atlaress
OWNER BUILDER DECLARATION
I hereby af(irm that 1 am ezempt from tne Contractor's Ucense Law for the
(ollowing reasOn (Seclion ]031.5 BUSiness antl Professlonal Cotle: Any <ity Or
munty which require5 a pe�mit l0 <Onst�uct, alt¢r, IntP�ove, tl¢molish or tepai�
•ny structure, prior to itz Issuance, also requires the apo���ant for su<h permil
� file a signetl statement that he/sne is ticensetl pursuan[ to the provisions of
ne Contractor's License Law (ChaD�er.9 �commen<in9 with Section 7000) of
Diviilon 3 oi the Business antl Pro(essions Cotle) or that he/she is exem0�
, in¢r¢/rom antl the ba5i5 for the all¢9etl axemp[iOn. Any viOldtion ot S¢<tlOn
i 7031.5 by any aov���ant for a permit subjects the applicant to a civll
�enalty oi not more than five huntlretl tlollars (E500).
I, as owne� o( the P�oOerty o� my em0�oye¢S with wage5 ds lhel� Sole
�mmoensation, will tlo tne work, antl the sVucture Is nol IntentleA or o(feretl
for sale (Section 7044, Business anA Professional Cotle: The Contractor'S
�icense Law does not apply to an owner of a property who builtls or improves
tnereon, ana who tloes such wo�k hlTselt/herselt o� th�ough his o� h¢r Own
employ¢es, provitletl that such ImOrov¢menl5 a�e not Intentletl O� oiteretl f0�
sale. II, nowever, the Guiltlin9 or Improvement is soltl within one year of com-
pletion, tne owner will have tne buraen of proving he/she tlIG not bulltl or im-
�rove tor the puroose ot sale).
I, as owner of the property, am ezclusively contractin9 N'ith Ilcensetl con-
lracto�s [o conStruGt the Oroje<t ($¢ctiOn 7044, Busines5 antl Profe55ions Cotle:
The Contractor's License Law does no[ apply t0 an owner of property wh0
, builds or Imoroves thereon. antl who contracts for sucn oroiects with a[on-
tratlor(5) Imense pursuan[ ro cne ConVa<to�'s License Law). I dm aware tha[
proof o! Iheir Worke�'s Compensation InsuranGe thOultl be p�ovitle� t0 me,
❑ I am�exempt untler Section B. & P. C. for thiz reason
Oate Owner
I nereby certify Nat t have reaa tnis application antl ztate that the above
Intormation Is correcL I agree to comply with all tity antl county ortlinantes
antl state laws relatin9 to builtling construction, antl hereby authorize repre-
sentatives o/ this city to enter upon Ihe above-mentlonetl property for
Inspectlon Ourposes. '
Slgnature Date3/Ji/�
Orivars' License or 55 �
� � / D ! �P � �.,.. � �..,. �... �..,. v�vi � rv�. A.P. lW
S Main Building:
TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Ffont
DESCRIPTION OF WORK/USE OF BLDG. A Rear
TVPEOFPERMIT GRADING ❑FOUNDATION STRUCTURAL IC Rlght
K Left
❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ,S'
❑ �OTHER Ping. Ref. #
PROJECT DESCRIPTION So. FT. OCCUPANGY Planning Notes:
CONSTRUCTION TVPE VALUATION $
20NE y GRADINGCU.VDS. ACRES
Remarks: � LL�Te f]
f
Bar Sink
Backflow Preventer
. Backflow Irrigation
Bathtubs
Clarifiers �'
Dishuvasher-�
Drinking Fountains
Floor Drains
Floor� Sinks
Gas Serviee Outlets
Interceptors
Kitchen Sink
lavatories •
P—Trep
Roof Drains
Reinspection Fee $15
Boiler
Duct - Under Ground
�uct - Structural
Duct - Ventilating
ExhaustSystem ❑ Multiple❑
Firepl/Fact. Blt. iCBO dk
Heating System & Ducting
❑ P7 00,000 BTU � 100,000 BT
Reinspec[ion Fee � $15
0065-46, rev. 5/88 Wnite - Bulltling: Canary - Applican[; Pink - Accounting; Goltlenrotl - Assezsor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closat
Water Hea[er
Water Service
Auto-Wash
Laundry Trays
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
RefrigeratiOn System
❑0-t00,0008TU ❑100,000
System Repair/Alteretion
Fire Dampers
Registers
laue Fee
$ 3
FEES
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
D ishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixture5
Device Boxes
Outl¢[5
Switches
Garbage Disposal
Generator �0.5 KW C
zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
� 50+KW
Meter ❑up to 700 amps
Meter ❑over100amps
Sub Panel
Motors O0.1 � HP O 1 Yo - 8
Inc.Solar �9-75 HP �16-15+
Microwave
Pole Light
Range
Standing Sections
5 KW Trash Compactor
� Reinspection Fee �$15 � � Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
8uilding Approved By
APolication lauad 8V d
SUMMARV OF
BUILDING PERMIT $
PLAN CHECK $
PLUMBING S
PLAN CHECK 25% $
ELECTRICAL $ _7�%,.so
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
N
I
N
G
R
E
Q
M
T
S.
FEES
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $
TOTAL FEE $ �9• �
01 U002E623-00023623 Y4T 74.50
6RTE: 03/17/89 TIHE: 7.3:05
., � PB-ip-Ol .. , . ,_ _ ..,.,- �... _ , . � _ ...:ti,�
CONSTRUCTION AND PLANNING • �L & SPA
APPROVALS Permit# i DateJ, Inspector p�ppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole L 52. Pool & Equipment Location
2. Soi ��ipe-Ur�d�grnd. `�� ^- �� 53. Steel Reinforcement
n�Elect��cal Conduit Uiility-Undrgrnd. �}' � 54. Forms T'
4.rElect�ical Conduii�Undrgrnd. n -�' 55. Electrical Bonding :
5�Steet��ieinforcement.. n � 56. Rough Plumbing & Pressure Test �..
6�ElectcicalUFER.Grnd+ � 57. APPROVALTOCOVER-GUNITE �"
7. Footings ��. ��: W' '. �� 58. Electrical Conduit-Undrgrnd. ��
8. Fouridation �• ;�� � • y 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd, - �i ' 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. StructuralFloorSystem , �� �, 61. APPROVALTODECK
11: Property Sewer Line'�& House Co=rinection 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 6. Solar System-Final
�1�6. Rough Elec[ric Wiring 67. Fencing & Access Approval
�t,: Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Ceiling ,ij' $��1 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating.& Air Conqitioning FIRE DEPT. REQUIREMENT
i
20. Rough Factory Fireplace � APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Dycts, Ventilating ' 71. Product Piping O Gas ❑ Oil
rn
23. Gas Pipe-Rough & Test ) 72. Underground Flush
�.
24.� Roof Framing � v 73. Undergrnd. Storage Tank O Gas ❑ Oil
1�
� 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. F�IRE PREV. FINAL
� 30.-Drywall Nailing HEALTH DEPT. REQUIREMENT
31�: Plas[er Brown Coat � 79. FINAL INSPECT�ON
32. Electrical Power Meter-Final FOOD CERTIF�CATE ISSUED
33. Final Electric otes:
34. Final Heating & Air Conditioning �t� , i' ii;
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 pomestic-Final �
r"
42. Backflow Preventer �% � .
.,
43. Backflow Irrigation
44. Landscape Irrigation SYstem �'�!
45. Sound Attenuation . , � � % �
46. Handicap Regulations � ?
47. FffYALSTRUCTURE&BUILDfNG � �
48. Special Requirements Completed
49. Electric Release to Edison
�
50..Gas Release to Southern California GasCo �. �, _ „' �
51. CERTIFICATE OF OCCUPANCY �- �� ! '� \ -'c `'
No. DatQ ^ '.. _ ` '
r,
�
\
42988 ADPiicant to fill In a11 spaces except those within heavY �ortler lines antl si9n all apvropriate aeclantions.
CITv oF COSTA MESA CONSTRUCTION PERMIT
Projact'Address 555 AN7.'ON, $UI� #85�
ApplicanYsMailingAddress %540 SUZI I.N., WES`IMIDi$7'IIi
Owner's�Name S�TRT'�' pA T B-AT� Phone
Address `�'�'• i #500� L.A. 90017
Arch/Eng. � � License No.
Address
Contrecmr'sName K�� & �'��Y Phonea9S-1156
Addrezs (mailing) 7540 SUZI LANh� 4VES�NINSTII2 92683
City License No. 038503
LICENSED CONTRACTOR DECLARATION
1 hereby affirm tnat I am licensetl untler provislons of Charter 9(commencing
with section 7000� of Divislon 3 of the Business antl Professlons Cotle, antl
my Iicense is in (ullLtprrle��d ar,a�t. 460923
Licenze lazs ense
�]a[e ���" y S19 t � � s
IppKERS'COMPENSATION O CLARA O�
. nereby afiirm tnat I nave a rerHticata of consent lo selLlnsure or a terUflwte
of Workers' Compen5ation Iniuranca, or a cartlfletl copy thereof (Sectlon
3eoo, �e. c.��88470897-01� FRN2�IONT IND.
Policy No. ompany
Certitied cOpy is h¢rlby fumlzh¢tl.
ateef�i�/�oPY151+�etl wAPPI cantY— Bu1161ng Divi I .�
T 2(7 �/-1... T
EXEMCTION FROM WORKERS' CO PEM NSATION DECLARATION
(Thisseclion neetl not be com0�atetl i( the permit�is for one huntlreU (E300) or
Icss�.
I certity thal in the pertormance of the work !or which Inis perm�t IS Is5ue0 I
Shdll not employ any p«Son in dny manne� so as to become subject to t�e
Workers' Compensatlon Ldws ot California.
Date Si9na[ure
NOTICE: If, atter makinq ihis tlaClaration, you 5houltl becoma 5ubjett to the
Workers• Compen5dtion provislOnS ot the Labor Cotle, you mu5t (orlhwith
comply wil� suc� Provislons or lnis permlt S�all Ue tleemeE revoketl.
CONSTRUCTION LENDING AGENCV
1 hereDy aHirm that Ihere i5 a constructlon Ientlinq a9enty for the performante
Ot lhe work for whlch lhis permit I5 issuetl (SectiOn 3097 Civ. C.)
Lentler's Name
Lentler's Atltlre55
OWNER BUIIDER DECLARATION
I hereoy affirm t0at I am enempt trom the Contra<tor's Ucense Law for the
following reason (Section 7033.5 Business antl Professlonal Cotle: Any city or
counly wnich reqWres a permlt lo tonstruct, alter, improve, tlemolisn or rapair
�ny struclure, prior to its fssuance, also requlres tha apP��<ant for such parmit
lile a Si9natl statement thd[ he/She Is Iicensetl pursuant to tne provi5ion5 of
e Contractor's License Law (Chapter 9(commencing with Sectlon 7000) ot
.ivision 3 of tne Businest antl P�ofessions Coae) or that ne/she is exempt
ther¢from antl tne ba5i5 for the allegetl ex¢mption. Any vlolatiOn Of Section
7031.5 by any applicant for a permlt sub�ects the apP���ant to a civil
�enalty ot not more tnan tive huntlretl tlollars (5500).
I, as owner o/ tlte p�operty O/ my emplOy¢es wltlt wages a5 their sole
compensation, will tlo the work, antl lhe structure Is nol Intentletl or otferetl
for sale (Seclion 7044, Business antl Professional Cotle: The Contractor•s
License Law tloez not apply to an owner of a property who builtlt or improves
[hereon, dntl who tloes SUCh wOtk ItImS¢If/harselt or ihrough his or her own
empioyees, proviaetl tnat such Improvements are not Intentletl or oHeretl (or
sale. If, however, the builtling or Improvement is soltl wlthin one year of tom-
pletion, ine owner will �ave the burtlen ol proving �e/she eitl not builtl or im-
prova torthe purpose of sale).
❑ I, as owner o1 the property, am excluslvely contracting with Iicensetl <on-
tlactor5 [o constluc[ the plojGtt ($ection 7044, BuSin¢55 dntl PrOfessiofl5 COtl¢:
The Contractor's Litense Law does not apply to an owner of Oroperty who
builtls or improves thereon. antl wM10 contract5 tor such oroiacts with a con-
tractor(51 license Vursuant to [ne ConVac[or'S Li<ense Law). I am aware that
prool of [hel� WOrker's CompensaHon InSu/ance ihoUltl be provitletl to me.
'❑ I am exempt untler Sectlon B. S P, C. for this reason
Date Owner
I hereby certity that I have reai
information Is correct. I a9ree to
antl s[ate laws relating to builtlin
sentatives of tn' city to nter
Inspaction p se
Signature
Orivars' L cense or 55 �
I[his application antl state that the above
Comply wi[h all city antl cOunty ortlinances
g construction, antl hereby authorize repre- •
upon t�e above-mentlonetl property for
�!
Date �
TVPE OF CONSTRUCTION LJ rvE�
❑ CONVERSION ❑ �EMOLISH
DESCRIPTION OF WQqK/USE OF,B
TYPE OF PERMIT LJGRAoiM
❑� �TENANT ❑ ELECTRICAL
LJ-OTHER _�
PROJECT DESCRIPTION 5c�. FT._
CONSTRUCTONTVPPT �
ZONE GR
Remarks:
Bar Sink
Backflow Preventer
BackflOw Irrigation
Bathtubs
Clarifiers
Drinkin9 Founteins
Floor Orains
Floor Sinks
Gas Service
Interceptors
Ki[chen Sink
Lavarories '
Roof Orains
Reinspection Fee
ADD LJ ALTERATION LJ REPAIR
fHER �� M': 'Q. V'Cl�
1 FOUNDATION L15TRUCTURAL
PLVMBING ❑ MECHANICAL
�� � � � OCCUCANGY_
'Ky1.1 VALUATION§ '��
CU.YDS. ACRES—
I�
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Outlets W er Closet
Water Heater
Water Service
Auto-Wash
$15
Duct- Under Ground
Duct - Structurel
Duct- Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Bit. ICBO #
Heating System & Ducting
❑ 0-100,000 BTU � 100,000
Reinspection Fee � $15
0865-46, rev. 5/88 Whlte - Bulltlin9: Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor
A.P. 9W
S Main Building:
E
T Front
B Rear
A
C Right
K
g Lett
Ping. Ref. #
Planning Notei:
FEES /lutomatic WaSher
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers OGas ❑Elec
Fen
F.A.U.
Fixtures
DEVICE BO%CS
Outlets
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer � 15-50 KW �
❑ 50+KW
Meter ❑up to 100amps
Meter �over100amps
Sub Panel
Motors O P 7 HP � 1 h- 8
InaSolar QB-15 HP �1645+
Garbage Dispoul
Genera[or O65 KW OS-15 KW
�
Range
Sign
Standing Sections
Tresh Compactor
Reinspaction Fee $15 Issue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
laue Fee ZoninB APP�oved By
FEES s��ia��e nnv�o�a aY � �--� ��
Hood or Type I ❑
Canopy Typell ❑
i igeration System
aioo,000aru ❑ioo,000,sru
System'Repair/Alteration �
Fire�Da'mpers �
Registers �'
(� ,
laue Fae $ 3
O
N
I
N
G
R
E
U
M
T
S.
FEES
$ 3
SUMMARV OF FEES
BUILDINGPERMIT $ S¢. Oa SMIP $ ' `�
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTA�FEE $ ��
PLAN CHECK 25% $
0100029144—OOQ29I45 Tt]T 54.50
UATE� 03/24/39 TIME: 14:10
. . . . . . , . �' .� ,�. f . C'�' `7 _ .. . . .. . . . . .. . . ,
CONSTRUCTION AND PLANNING - •Y F .& SPA .
� RYPROVALS - Permit # Date.' Inspector qppROVALS Permit # Date Inspector
1, Temporary Electrical Serviceor 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. Fbundation � r- 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
I
13. Roof Drains • 64. Plumbing System - Final '
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
1�6. Rough Electric Wiring 67. Fencing & Access Approval
,
17�.%Rough Wi�ing 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.�RoughF�toryFireplace ' �; APPROVALS Permit#
21. Ducts, in Structure �
70. Underground Hydro
22. Ducts, Veritilating.. . ' 71. Product Piping � Gas ❑ Oil
23. Gas PipeRough�& Test �. 72. Underground Flush �/ �
24. Roof Framing ,� .- -� 73. Undergrnd.StorageTank OGas ❑Oil�
25. Roof Sheathing .`_, 74. Overhead Hydro '
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashin'g ,' .'. „ .( _ 76. DrY Standpipe .
28. Lathing & Siding �t 77. FIXED SYSTEM FINAL �
29. Insulation � � 1 78. FIRE PREV. FINAL
30. D�ywall Nailing• �. HEALTH DEPT. REQUIREME T
31; Plaster Brown Co'ai,: - 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
3S. Final Plumbing
39. Water Service-Final
40. Gas Service-Final � � .
41. Solar pomestic-Final � �
l,
42. Backflow Preventer �'�' � �
,% a.-
43. Backflow Irrigation ��
44. .Landscape Irrigation System � '
45. Sound Attenuation r." �
46. Handicap Regulations � ��-`
r
47. FINALSTRUCTURE&BUILDING ' �
48. Special Requirements Completed -
49. Electric Release to Edison �' y�
50q Gas Release to Southern California Gas Co � �','
51. CERTIFICATE OF OCCUPANCY / �, ��
No. ' Date � �' _
�
Applicant to till in all sDatts exceot tnose witnin neavy eorEer lines ana sign all appropriate aeclarations.
PERMIT NO. � TRACT NO. ' LOT NO. _-UNIT-N0.
CITY OF COST.A.MESA_ _CO�/NSTR CTION PERMI I_ _.Q�, �.—. . � i r: . � r--- _ _�
Project Address, SS� f1i:��%� ��l�� �V � I
L_.___ _ _ ..
� Applicant's Mail`ing Addiess � ��•,�������
Owner's NamaJ `�'l'� �"Yg� Ph6n'e��
Address _i'S^� � [% ' �G.r%i. �i%� �+�{.a
Arch/Eng. � �LicenuNo. ,
Addrejs� � �-
Con ati�Y'cJ�'Na'IrrFd/U� .-G✓. lJJG. Phon�����I
Address (mailin9l�9�6'��s/�C��%Lt��la�� ��.�Lp-G6L��
City•License No. _�_���l3� � `���
LICENSED CONTRACTOR DECLARATION �
I hereby atfirm tnat I�am licensetl untler provisionsof Charter 9(commencin9
witM1 SeCtion ]000) ot DivisiOn 3 ot the Bu5ine55 ana Protessions Cotle, antl
my license�is in full'force antl eftect. . ' .,/
License CIaSs' —�O �icense No� 2G�s�
' oate y—�„_��� signah
� '�ORKERS' COMPENSATI N D LARATION
hereby afflrm tnat I have a certificate of consent to selt-insure or a certificate
of Workers' Compensation Insurance,�or a certitietl copy thereoi (Section
3BOQ-}� �b,: C. .,. �` _ . _ . - .. ' - . .
Polic�Ne'����v�/ii�l�T � ComPanY ��r�J . .
�Certifietl mpy is nereby furnish .
Certitietl copy is filetl with th city uiltling D Iision. ' '
Date �� % � —�.� Ap� ¢ant
EXEMPTION-FROM WORKERS' PENSATIOI DECLAR I I
(This sec[ion.neetl not be corrlpletetl if the permit is for one huntlre 5300) or �
Iess).
I certify ;that in tbe per(ormance O( th¢ work tor which [his p¢rmK is issuetl, 1
. shall;not employ any person in any manne� so as to become subject to the
� Wo�kers' Compensation,Laws of California. ,
. Da[e Signature
'NOTICE: If, after making Ihis tleUaration, you shoultl bemme subject to the
� Warkers' Compensation provisions oi the Lvbor Cotle, you must forthwith •
comply with such O�ovisio05 o� this pe�mit Shall be tleemetl revoketl.
CONSTRUCTION�LENDING AGENCV� �
iI hereby affirm that tM1ere is a construction lentling agency tor the performance
� ot the work tor. which this permit is issuetl (Section 3097 Civ. CJ
, Lentler's Name••
^ Len�er's Atltlress'� `
� OWNER BUILDER DECLARATION " �
� en.nnv afii.m.tnat I am exemot from the Cant�acto�'s License Law tor the �
to
ahere(rom antl the basis
]031.5 by� any applica�
�enalty of not more tnan
1, as owner ot the F
compen5ation, will Ao th
� f0� 531C ($CCiIOII %�44.
license Law tloes not ap�
ihereon, antl who.tloes !
employees, provitletl that
sale. If, however, the bui
Oletion, fhe owner will h
prove for the purpose of !
❑ I_ az owne� ot the orc
that be/she i5 I
aw (Chapter 9 i
5 antl Protessu
or Ihe allegetl i
tor� a. permil
ive huntlretl tlo
operry;or my
wo�k,antl the
3usine55 antl F
y ro an owner
¢h work hims�
such improveer
]inq or ImOrow
ve the burtlen �
Je).
>erty, am excli
-ojece (Section
law tloes not
DWlas or Improves inereon, ana w �
tractor(s) Ilcense pursuant'm the�Cont
proof of their Worker's Compensatio�
❑ 1 am exempt untler Section
Da[e � Owner �_
I hereby certity that I have reatl [his
inenrmatinn is conecL I aaree to como
Any vlolatlon oY Se
the applicant to a
•with wages as thei�
s not intentled or ot
it is 5oltl within one year of com-
�oviriq ne/she 01a not builtl or im- '
ly contratting with licensetl con-
4, Business ana Professionz Cotle: .
dy to an owne� ot pro0erty who �
cts for such projects with a con- '
'S License Law). I am aware Ihat ;
�ance shoultl be provltletl to me.
. B. & P. C. for this rea5on
wtion antl state that the above
h all Nty antl county ortlinanCes
ion, antl hereby authorize repre-
above-mentioneE property for
� ' oate����
TYPE OF CONSTRUCTION LJ NEW IJ ADD ALTERATION LI REPAIR —
❑ CONVERSION ❑ DEMOLISH ❑ OTHER !�f.G�� iSLTcr� A P#
DESCRIPTION OF WORK/�QE OF DG.
' f'���Ly.�'y %��jG��G r"c//lG� ' G S Main Building:
E
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front
❑ TENANT ❑ ELECTRICA� ❑ PLUMBING �MECHANICAL ' B Rear .
❑ OTHER A
PRWEC7 DESCRIPTION Sq. FT. ocCUPANGv C Right
K Left.
CONSTRUCTIONTVPE VALUATION$ $
ZONE GRADING CU. V�S. �ACRES p�ng. Ref. #
Remarks: �,y^'f',� �'/1 / � , �j �" ���{ � � Planning Notes:
Bar Sink
Backflow Preventer _
Backflow Irrigation
eathtubs � �
Clarifiers
Dishwasher
Drinking Fauntains
Floor Orains
Floor Sinks
GasSerJice Outlets,
Interceptors
Kitchen Sink � ' -
Lavatories - - -
P—Trap �
Roof Diains - '
. .. � :
'Reinspection:Pae , :$1
Boiler �
Duct: Under Ground
Duct - Sttuctural ' •
Duct - Ventila[ing � '
ExhaustSystem ❑ Multiple�
Firepl/Fact.Blt.ICBO# �
Heatin9 System & Ducting '
❑ ai oo,000 eru O i oo,000 a
I orivery nse or 55 /_�_ I I Reinspection Fee I $75
�
CMF OB65-46, rev. 30/84 White - Builtling; Canary - Applicanh Pink -�Accounting; Goltlenrotl - Assessor
FEES
Showers
ServiceSink -
Sewer Cap � '
Sewer Connection�
Solar Collectors
Solar Piping '
Solar Tank '
Swimmin9 Pool w/Spa
_ Urinal ' _
Water Closet
Water Heater .
WaterService �
oy,
�
Issue Fee - . � ' $ �3
Hood or Type I � ❑ �
Canopy Type I I ❑ � '
Refrigeration System �-,
❑0-100,OOOBTU ❑100,0008T
System Repair/Alteration �
Fire Dampers � ��sQ �f
Registers
Issue Fee
Automatic Washer' ' "
Construction Pole Sub.
Cooking Unit
Dishwasher ,
Dryers ❑Gas ❑Elect
Fan
F.A.U.
Fixtures , .
Device Boxes
Outlets
Switches '
Garbage Disposal
Generator �0.5KW ❑
� i
� Accessory.Building:
Zone
ELECTHICAL
- Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
'Meter ❑over 100 amps �
:Sub Panel � .
Mators �41 HP �1'/x-8
Inc.Solar 09-15 HP �16-15+
- 'Microwave �
Pole Light
Ran9e �
5KW
; Standing Section�
Trash Compactor
I� Reinspec[ion Fee I$15 I �. � luue Fee �
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By �
euilding Approved By '
2
O
N
1
N
G
R
E.
Q
M
T
S
F.EES
_l_
$ 3
, . SUMMARV OF FEES
BUILDING PERMIT $ SMIP $ ��
PLAN CHECK $ � PEFMIT . � -
PLUMBING � $ ISSUANCE - $ '
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $ _�_
MECHANICAL $ � TOTALFEE $ �f�t� —
PIAN CHECK 25% $ .
: 11/22!EE Ti17E: 13:56
• CONSTRUCTION AND PLANNING � �& SPA
APPROVALS Permit # Date � Inspector AppROVALS Permit # Date Inspec*or
�
� i. Temporary Electrical Service or Pole 52. Pool & Equipment Location -
,�2.�Soil Pipe-Undrgrnd. 53. Steel Reinforcement
� lectrical Conduit Utility�Undrgrnd. 54. Forms �
+ Electrical Conduit-Undrgmd. � 55. Electrical Bonding � .
I5 Steel Reinforcement ' � - 56. Rough Plumbing & Pressure Test � � �
i
� Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -
�
� Eootings , � 58. Electrical Conduit-llndrgrnd. .
• , ,
' �oundation � � 59..Gas Pipe,�O Undrgrnd., Test
�
9. VYater Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. '
�
1� ructural Floor System � 61. APPROVAL TO DECK �
t11�1Property Sewer Line & House Connection � 62. Backwash & ReceptorFinal '
iQ. Sewer Cap ' ' 63. Heater & Vent-Final
1 �
3. Roof.Drains 64. Plumbing SYstem - Final ' �
��Rough Plumbing 65. Electrical-Final
' -�'5-Rough Electriral-Conduit � 66. Solar SYstem-Final � �
]6.. 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 '
19i. Rough Heating & Air Conditioning ��,-�� �� �� FIRE DEPT. REQUIREMENT .
20. Rough�FactoryFireplace APPROVALS Permif# . '
21. Ducts, in Structure 70. Underground Hydro
22. �Ducts, Ventilating � 71. Product Piping � Gas ❑ Oil �
23. Gas.Pipe-Rough & Test ' 72. Underground Flush -
24. Roof Framing 73.�Undergrnd.StorageTank OGas ❑Oil. '
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structuraq &-Monocoat 75. Dry Chemical �
27. Frameand F,lashing 76. Dry Standpipe
28. Lathing & Siding �� 77. FIXED SYSTEM FINAL �
2�klnsulation � 78. FIRE PREV. FINAL
i���{Drywall Nailing � HEALTH DEPT. REQUIREMENT
j Plaster Brown Coat 79. FINAL INSPECTION ' -�
�, . Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning r�-LY y8' �L.�
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 pomestic-Final
42. Backflow Preventer .
43. Backflow Irrigation - - - . - .
44. Landscape Irrigation System �
45. Sound Attenuation � �
i � 46. Handicap Regulations ' -
� 47. FINALSTRUCTURE&BUILDING
I�
48. Special Requirements Completed � - � - �
�
49. Electrie Release to Edison - - � ..�-• -
50. Gas Release to Southern California Gas Co . : . �
, 51. CERTIFICATE OF OCCUPANCY . � . , ' ;. �. . . . _ � -
. i
7 No. � � Date � . •
f' - - - � - - ' .. - -- . .
rnaecraooxess: �55 ANTON yL
OWNEB'SNAME: SECURITY PACIFIC BANK
ROOHESS: SJS ANYON HL, ST100
C,M,
� 3 �54-A77A
un.. 800
AFCMIENGINEEfl: � 1 - ' NEC.NO.:
aoosess: iNTER1�TI DESIGN C1��^TA2
5 PARK PLA2A 750
PENMITTEE: r�VINt �-A 9271�i
aooRess: UI�ITED FIRE PkOTECTZUN ( 714 ) i50-0886
1736 = 30RC3ARU
Sa��Tz� A�A CA 92705
LILENSE� CONTPALTOA 0 LU�PA ON: e�eby aifirm t�at I am licensed unUer D�ovisions oi Chapter 9(commencing with Section
70W) ol Divsian 3 0l IAe Bus�neu an0 Prolessions o0e. antl my license is in lull lorce antl eltect. ^ /
CITY UC.: STFTE LIC.: Cy� S: +�/
P �?�''.E�9 9� � •/ 0 3 9 9 �0" . c 1�-----�-i /
Oate: �' ignalure:_
�
WOBNEPS' COMPENSATION DECIANlIT10N: I �¢r¢Ey allirm I�ai I �ave a t¢ ¢aie o1 consem m sel4insure or a cenilicate of warkers'
ComOensalion Insurance. or a certifieA coDY ��e�eol (Secuon 9800. Lah. C�.
ooucrNo.: pC9R�435 EXP.DATE: OS�OII��
COMPRNY: RF.PUBS ZC T,�:I�, i
❑ Cenitiea coDY �s here0y furmshea. Lt CeN caov �s niea�wQ;m mej iiy BuilAin Uihvon.
oate:U"Z'�� /� a�t: ��✓!"H'. � /
' EXEMPTIONFflOMWOflNEPS'COMPENSRTIONOECUIIATION: (Thisstttionnee t0ecompleteOiiNepermtisforwelmnGreG(S10Gorleu�.
I cerlily tha� in Ine Derlormance ol Ihe work for whic� Ihis permii i5 is5ue4. I shall not employ any person in any manner so a5 io 6ecome
su�l�� �o ihe Workers' ComOensation LavS o� Califamia.
�ale: Signaiure:
NO7ICE: II. after mdking inis tleclaration, you shoul� Uecome subiect to tne Workers' CAmpenSation O�ovisians of the Labar
CoGe, you mu5i ton�rnih comply wii� 5uc� O�ovisions or Ihis p¢rmit s�all Ue 4eeme0 revoketl.
CONSTBOCTION LENDING RGENCY: I hereby allirm �hai IAere is a constmtlion lending aBenty �or the pedormance ot �he woB tor
wnicn Inis pe�mit is issuee (Section 7W7. Civ. CI.
LENOEfl:
RODNESS:
OWNEB BUILOEB OELLAflRTION: I h¢reby aliirm �hal I am ¢Kempi Imm ��e Cantrat�ars' $lale LicenSe Law lor �he lollovnng reason
�Section 7031.5 Business and Pm�esSional Cotla Any ci�y ol county w�ic� repuires a permii to conslmc�, atler, improve, demoiish, or
repau any slmcture. prior to its issuance. also requires ihe aDDlicant lor such oermil to file a signeA slatement ihat he/she is IicenseU
Dursuam to �ne pmvisions oi iAe Convacmrs' S�ate License law (Chapter 9(commencinA wit� Sec�ion 7000) oi Oivision 3 ot tAe Business
and Pmtessions Code) or that he/s�e is exempt iherelmm and Ihe basis tor �he alleged exemp�ion. Any violation of Seciion 7031.5 by
any applicani lor a permit su�lec�s Ihe appli�ani lo a civil penatly ol noi more ihan live hundre0 Aollars (5500�. �
I, as owner ol roe propeny or my employees with waAes as ineir sole compensation, will Oo the work, antl the
� slmclure is nol inlentlea or offeretl lor sale (Section 70aa, Business an0 Professional Cotle: The ContractoR Stale License Law
tloes not apD�Y to an owner ol a Oropehy who builtls or impmves ihereon, anU who tloes such work himself/herselt or Ihrough
Ais or Aer own employees, pmvi4eU ihat such improvemenls are not inten4e0 ar oflereA for sale. If, however ihe 6uilJing or
impmvement is sold wilhin one year ol com0letion. ��e owner will have Ihe bu�0en of pwvinp he/she dia no� builtl or impmve
lor Ihe Durpose ol Sale�.
I, as ownerol��e propetly, am eaclusively coNractinp wilh IicenSeA conlrac�orslo consVuctlhe prolecl�Section 7044, Business
❑ an� Pmfessians Coee: T�e Conlraciors' Slale License Law tloe5 noi apply �o an owner ol pmpeny who 6uilAs or improves thereon
antl w�o coniratl5 lor SUCh Or01et�5 wiih a tonVador(5� IicenSe purivani Io I�e Conlrat�or5' Slate License Law). 1 am aware
Ihat pmo� o� Ineir Worker'S Compen5aiion insurance should �e pmvitled lo me.
� I am exempt unUer Section: B. 8 P. C.
lor Ihis reason: .
Date: Ownec
I do hereby cenity Iha� I am aware ol ana una¢rslantl ihe reQuir¢ments ol Calitomia Heall� ana Sa�eiy Code Setlions 2550.5, 25533, an0
2553� andtnallor anyfuWte Euilding o¢upanlvnlllwiil nal (circle one�neetlto comply wit� SaiU stale fAOes anOt�e reQuirementsfora
permi� lor constmction or moailicaiion Imm i�e Air Ouality ManaAement Uisvici. FesiAemial consimcuon apDlications are exemD� ��om
ihese D�ovisi0n5,
Oaie: ADP anl:
I he�eEy cetlilythal I�ave rea0t�is applicali0 nd 51ale1hali�e aEove inlormali0n is cOrrect.laqree lo comply vnih allcit aM counry
ordinances antl 5�a�elawsrelatingio budaing c 5irutlionan0 hereby aul�oriieie�en�atives ol�his cilyio enter u 1 e ab e-mentionea
pfOpCfiy �nr i050PC1i0fl pUf005P5.
�/t7� 'j /.�
�aie: � ` / � / Signaiure: �`�^'
flrivef< I ironao nr Sm�ial Seninro • _ . — _ _ _ _
t6a�<6 Whne—Butlamg; Gieen—Cotle Enlorcemenl Canary—Applicant: Pink—Revenue; GolOenroO—Asseswr
CI'�'Y QF COSTA NF.SA - BU1�iliNG PcRMIT t�E�N t�0: � OS1�59
PERMiT NO; F' 05J599 Pi,AN CHECK NO; 02714-91 S GOV''': N SJPP: N
CONSTRtiCfIOi TYPE: :-SP AERMIT TYPE: FIR PGAPOSE: ALT
JOB DESCRIPTF.ON ; 22SPRINFCLER HEADS FOR OFFIC� T,7. SQ FT:
CLAIM VAL(JE: 1,650.U0 CALC-VALUE: GROUP OCC: B-2 /
COMN,ENTS: NO sTRQCTURAL PERMIT 15SUED YnT
'r:'r�Ekif�fklPlFlElE#1E#fEie1E#iE�flE##iFif#iE�flEi'tR1E�FiciE*�!'1E?F14ifiEiEiE#If#if#Eif#iE#iEa.iiiF#i:�i?�lt�}ieif�iEfF3Eif'�E#3fif#iEfcR##i@#
Z O N Z N G R E Q U I R a N, E N T S
S E T B A C K S
""_—_'____ "__"___ 7 —"'_'_",
MA UI t G---------- C SSORY BL LDI1�G
cRNT: FT IN REAR; rT ZN FRNT; FT IN Rr.AR: :T IN
LEFT; FT IN RGHT: FT IN LEFT'; FT IN RGHT: cT :N
PARKZNG REt�-: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING N6TES>
i
ac M' iE if iE'1F ie if i%'li' if"3F' #' if If 1e if �E iF iE if i(-ic i� iF i(� # if'k iE if if lE i4' IE iEY ih if 3F # iE iF if 1i il' iE if i! iFi4'lE if if if iE �i' ?f if )f' il--k 3'f'-Y� 1'c iF'lf if iF !b?E +f 3E ii'i( iE ;1, ii� if�
D E V E L O P N, E N T S E R V I C E S R E Q U I R E M E N T S
20NIAIG APPROVEU dY DATE;
BtiILDInG APP�OVcD BY ; _ DAT�; /
APPLICAiION ISSUED BY; �S� — DATE: �� /�I
3'riEii-ih1EK#M1ieN�iP9P#?EliV�K-fEiEkIFY.�kit$$if��FiF'�tib�TriF4i3F�iF itY3F' ; Y.'tx.trrit r.�iHii'rY.�k#Eifd'tif#X�r�iFi�. i� a� edk
3f # a� !F i? 1E'4 �K 1F�E?e if aF �34 ii• if �E il• iE �%i�.. iF 3E it �lE iF iE ie ii� iE iE ih IE iE M� �f �IF if�lE 3f i?� �fr �E 3f'..� K-�E iE 1i IE i+.- K iF j(� 3� x. 3'r �;:?'r 14 � ie fe if if �16 iE +if+e iE 3e ii� 34i%ii• iF #
LBGALIZA';ION;N F E E S II �u N. A R Y STRLiCTliRAL S�G,MEtiT:N
&LDG PMT PLUNBING ELECTRIC MECHANZC FIRE SMIP/Ra� GRADING
PfiRMI't
PLAN
iSSt3E FEE
BUILDING-DIV-> PERMIT ISSUH FL,AN-CHECK
ro•rA�.s----> 3y.00 o.00 zs,_i�
REVENUE DIVISION 10TALS--> COLLECTED:
BLDG PMT PLUMBING zLECTRIC MECHANIC
35.00
658 SMIP/NON-�ES
25.35
TOTAL PAID DUE
64.35 64.35 .�0
39,00 OVERISHORT: .00
FIRE SMiP/TOT G�ADING PiA;�-CHECK
39.U0
iC�iE i( �lk �iE if iC �lF �IE 1E �IE �l( 3f # �K M� )F �N }'.� %� if k �lf # �k iE i( �%� �1E �k �7kle # �IE �� �k # iF jf �%� 1E �14 3f % )f �i! ik �IE�It �if i't ?E iE i:� �T�if �E iE3f �k iF # af �IE �� � �iE �i: dF iE �f, 1E AE �1E # If i:� �}c iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE �TY D E S C R T. P T Z O N UNI1' COST TOTAL COST
fiIA 39 £iRE EQUIP FEE (FROM HLDG VAL 1ABLE) 1.00 39.00
� �.
END OF FEE5
♦}
D1 00095829-tG645S?9 'P'o� ,� ;:,()
DATe: Q8/2���2 TIIiE: I2:46
CONSTRUCTION AND PLANNING P $ SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. �Pool & Equipment Location
2, Soil Pipe�Undrgmd. - 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-Undrgmd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test . �
9. Water Pipe�Undrgrnd. ' 60. Backwash �ines, 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. So�ar System-Final �
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVEO FOR PLASTERING
18. Rough Elettrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
.24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing . 74. Overhead �iydm g� l� � �YJ�
/1
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL Q.�,5�'
29. Insulation 78. FIRE PREV. FINAL �l..Z']-Lj� (N,
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
� 31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriwl 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 pomestic•Final '
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handiwp Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINALPLANNING
49. Elearic Release to Edison
50. Gas Release to Southern California Gas Co ,•
51.-CERTIFICATE OF OCCUPANCY
No. Date
PNOJECT,AOOflE55: � UNIT:
'' OWNEH'$ NAME: J-� J ANTOU 3L R� O
aooxess: SECURSTY PACIFSC BANK
555 ANTO,V BL, ST100
C,M,
Z73-354—II776
AflLH/ENGINEEN: _N,i,Y.RNI pGSjGi�l HEG.NO.: �.l�n4Z
AUOflESS: S PARK P:.A'LA ��' 750
PEPMITTEE: zRVINE CA 92714
ROUHE55: J J S. , INC. (714 ) 540-5177
3"/50 S. SUSAN 100
SANTA ANA CA 52709
UCENSEO CONTBACTOB OECIAflFT10N: I hereby alfirm �hai I am licensed untler pmvisions o� C�ap�er 9(commencinp wilh Sec�ion
7000) of �ivision 3 0l ihe Business and Pmfess�i ns Code,and my license is in lull �orce and eflect.
cirr uc.: � d.� � � S STATE LIC./j � i 8� y.�x cjns� /
Oa�e: � ' Signamre: �1y1.��—.
WOflKEHS'W ENSATIONOECIABRTION: IhereOya��irmiha��veaceni teotconsemmsel4insurearaceniiicateofwarkers'
CamOensation Insurance, or a certilieE copy t�ereoi (Section 3800, Lab. C�.
oucrxo.: ti*CN80509U00 E%P.O�TE: QEj�OGI92
� �COMPFNY: 7'�AI`jS�ERJSA /
1 �] Ceriilie copy is �e�reey lumisnea. L}f Cenifietl copy is fil � wil� Ih � uilAinA a�sion. /
Jaie: _ AOPlitanL �� �
EXEMPiIONFBOMW BREB$'COMPENSp IONOECLAHATION: Qhisseclionneetl c�nple�eUil�hepermi�isloroneAunOre0�310D�arless).
I certify ihal in Ine Derformance ot ine work for whiclllhis pe ' is issued I sl dll not moloy any person in any manner so as to become
su61e�� �o t�e arker ' Compensation Laws ol Calllornla-
Oate: SignaNre:
NO710E. If, after making IAis Geclaration, you should beco lett to tl orkers' Compen5alion Drovisions ol �he Labor
Co�e. you mu5i brtMvith tompty wit� SucA D�ovisions or �his p¢rmi� shall ae¢me0 r2voked.
CONSTBUCTION LEN�ING RGENCY: I �e�eby altirm that there is a consimction IenOing agency for I�e Derformance oi t�e woM lor
w�ic� ��is permii is i=sue0 �Section 3097. Civ. C�. '
LENUEfl:
aoosess:
OWNEfl BWLOEB OECLABRTION: I her¢Oy a��irm �hai I am e�emD� ��om Ihe Can�rat�or5' Stale License Law for ihe I011owinA �eason
(Seclion 7031.5 Business anU Professional COUe: Any tity of couniy w�ich r¢puire5 a permit �o conSWci. al�eL impmve, tlemolish, or
rtpair any stNcture. prior to ils issuance. also requires ihe aDPlicant for such Dermit lo lile a signetl statement I�al hUshe 6 IicenSM
pursuam m ��e Omv¢ions of I�e Contraclors' Slate license Law �Chapter 9(commencing with SecGon 7000) ot Divisian 3 0l t�e 0uvness
and Proiessions Caee) or ihat ne/sne is eKemO� iherefrom and ihe basis lar ihe alleqetl e�emption. Any violation of Section 7031.5 6y
any apDlicant lor a permit suble��5 Ihe applicani lo a ciNl penal�y ol noi more Ihan live �unGretl dollar5 (SS110�.
I, as owner ol Ihe propeny or my employees with waAes as Iheir sole compen5ation, will Oo ihe work, and the
� 5lmtiure is noI imenCeG or OtlereO br Sal¢ (Secnon 70aa, Businesi anU Protessional Cotle: The COnlratior5' S�aie LitenSe Law
Daes no� apply to an owner ol a pmpenY who builtls or impmves IM1ereon. an0 w�o tloes such work himself/herseli or thmuAh
� his or her Dwn employee5, pmvitlCO tha� SUch impmvements are noi inlen0etl or o�fefed for Sale. II, howev¢r Ihe builJing or
impmvemenl is soltl wil�in one year ol comple�ion, �he owner will have Ihe �ur0en oi DmvinA he/she Oid no� huiltl or impmve
lor ihe purpose ol salel. �
� I, as owner o� Ihe pmperiy. am exclusively conVac�ing wi�h IicenseE coniratlors �o conslmci �he pmjec� �Sec�ion 7044, Business
❑ ana Pwiessions Coae: ine Lomracmrs' Stare L¢ense Law does no� apD�y to an owner of propeny wno Eu ids or ImD�oves thereon
I and whn tamrads Ior SUC� pmletts wii� a COntrat�oq5) liten5e puf5uan�io I�e ConiraCtarS' $ta�e License Law�. I am aware
t�al D�aO� 0� I�eir Workei 5 COmp¢n5alian insurante 5�ould be DmvideA �o me.
� I am evempi un0er Section: B. 8 P. C.
for I�is reason:
Oate: Owner.
I tlo �ere�y cenily ihat I am aware ol ana unAers�and ihe reQuiremems ol Califomia HealtA anA Safery Cotle Sections 2550.5, 25533, antl
2553a and Ihal I or any IWure bWltlmg occupant will/will nol (circle one) nee0lo comply wilh saitl s�a�e cotle5 anJ Ihe repuirement5lor a
permil lor constmc�ion Or moailicaiion Imm I�e Air �uali�y Management Di5Vic1. FeSiUenlial constmc�ion applicalions are exempi imm
I�eSe provisi0n5.
i
Daie'. ppiicam:
I he�e0y cerlily thal I have reatl this applica n antl s�a�e lha� lhe a�ave inlormation is correcL I agree to comply wilh all ci�y an coun�y
ortlinancesantlsta�eWwsrelating�obuiltlin constmclio andherebyaul�ozere0�5enlalive5o�thisciry�oen�eruponlhea0ov enlioned
pmoeny qlor irj0eciion purooses.
Date: _(,L� Z��� � Signamre: _
�iivei's Lic¢nse or $otial Securiiy M: �
I6n1�Efi Whne—Bmlding; Green—CoOo EnlorcemenC Canary—Applicanl: Pink—Ravenue; Goltlenrotl—Asseswr
CITY OF COSTA N,ESA — BtIILDING FERMIT PERN. NO; B 0535$C
PB�MIT ;40: H 053580 PLAN C9ECK NO: 02165-91 S GOVT; N SJPP; N.
CONSTRUC�'iON TYPE: Z—SP FERMI'f ?YPE: STR PURPOSE: A:,':
JOB DESCRIP'iIOh : 21615F OFrICE T,I. SQ FT: 1,5:iU
CLAIM VAL'uE: 59,268.00 CALC—VAi.uE: 34,748.88 GROUP OCC; H-2 /
COMMENT5; ATHLETIC BUSINESS PUBLZCATZONS
��e*�cex�x�*a��*��**���+rx��*a�****x�a�*��!���*at*��#r�**e�*r.#�*x��!��ixx x*;;•��c��**�+��eu�**u+is:a#�
'L O N I N G R E� U I R E N, i N T S
S E T H A C: K S
------------ MAIN HliILDING --------- --------- ACCESSORY BUILDZNG --------
FRNT: rT IN REAR: YT IN FRId1; FT iN REA.�7: eT Iiv
LEFT: FT IN RGHT; FT I13 LEFT; FT IN RGHT: FT TN
PARKZNG RE • PROV: PARCEL• 41050104 Z1.E_ PDC kEF TO:
PLANNING N�TES> SNYERIOR ALTBRATION TO AN OFFICE US� iN THE EXISi2NG_,
> SECliRITY PACiFIC HIJILDi:IG -,
�*+*���#*���+���+���ex �r��k*�*� � ��cex��*#*#***�c�c �*�e���x�trr �e��+��x�*��*�*��.��i�*+�**�x.u.
D E V E L O P M E N T S E R V 1 C E S R E Q U I R E M E N•� i;..S
ZONING APPROV�D BY ��l_ DATE: ���2=(0'�
r7DIt�DING APPROVED HY : DAT :: l;="'
APPLICATZON I53UED BY• W� �il� DATE•''.�'��a
iEiFii�7t3eiEiF?E-lE�1f�%iEiFki(�aFi[•ififieiek . �rx tirx R . � �'%'�i1i'£R'RkififiiiFkiElfiEx. .�ir"�yr �xii�iF
iF if iE iF i!�'.i� 3F � iF iF #� i4 If %}: IP if R 1M1 iE iF iF iE iE iF 3f iE 3f if iF ii if # if 3(� if iF if+F.ff af #f ?f ?f .t'.4iE iF 3£ iE3e ie lY �N� �IE iE if if lE iE iE 3'r iF 3(� i'r ir k it #±i� � ii if if+� 3� �i� �K i�
LEGALIZATZOIQ:N F E E S U M M A R Y STRi7CTuRX,L S:::GME\T:Y
BLD� FMT PLU,HBING ELECT'RIC• MECHAI�IC FIRE SM3P/RES G2ADING
P£RMIT - 3i7.00
' S,�:IP /NOh—R�S
PLeIN 206.0� 7, 30
ISSUE FEE -
BUII,DTNG—DTV—> FERMIT ISSIIE PLAN—CfiECK iOTAL PAID DliE
TOTALS----> 324.30 0,00 206,05 530,35 �30,35 .00
i
REVENC7E nIVIS:iON TOTALS--> COZLEC'PEfJ: 37_4, 30 OVER/s'HOR7': .00
HLDG PA�T FLUMBING ELECTRIC ,+�ECIiAhI(: F3RE SMIP/T(�T GRADING PLAN—CHECI�;
317.00 %,30
IE 3f iF �i� 3's f(� 3E iF iF �f 3E 3F N� ## Y- ie iF iE if 3i iF iF iE iE if tf iF ii ii� it it Y if ti� if R ii� if�'r. 1! if # if iF if� 3e s� iE if iE it jf-!e i'r If iF IE 1E �lE :i'r iE 3E if iE iE #:� IF iF?f k K i: x� iE iE Y.� #�
I Ai D I V 1 D U A I� F, E E B R E A K D O W N
TYPE QTY D E S C R I P 1' I O N i7NI1 COST 7'OTAL COST
SFC 216f OFF—INT. ALTER TYPE Z,11 F.R, —AVER 16,08 34,748.R8
END OF FEE5
r
n
Ol �C09`ES$—CO'34�E34 �T. �cTi �:t.�:
UatE: oE/?6/91 "iiP�r= 'iC:-",
�T CONSTRUCTION AND PLANNIN6 ' . �� �P' �
APPROVALS Permic # � Date Inspector AppROVALS Permit # Date Inspector
t'1
1. Temporary Electrical Service,or Pole � r` 52. Pool & Equipment Location _.-�^
2. Soil Pipe-Undrgrnd. '.:j -�' � 53. Steel Reinforcement ".
�
3. Electrical Conduit Utility�Urithgrnd. ' 54. Forms �""
4. Electrical Conduit-Undrqrnd. 55. Electrical Bonding
5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO�COVER-GUNITE
7. Footings � 58. Electrical Co'nduit�Undrgrnd. �
�
8. Foundation � � 59. Gas Pipe, O Undrgrnd., Test \-� ;�
,\
9. Water Pipe-Undrgrnd. �� : .ri � , 1� 60. Backwash Lines, P-Trap, � Undrgrnd.
70. Strucmral Ploor System � :`.` - ' �-;� ; .. - 67. APPROVAL TO DECK � �
11. Property Sewer Line & House;Connection -,y 62. Backwash & Receptor-Final
Y
12. Sewer Cap ' 63. Heater & Vent-Final r
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 ApP�oval
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 StruMure 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.StorageTank OGas ❑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 PflEV. 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 & F.ir Conditioning .
35. Final Gas Pipe-Tesc ��
36. Hood or Canopy . .
37. Final Factory Fireplace '
38. Final Plumbing ,
39. Water Service-Final '
40. Gas Service�Final ��
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE�& BUILDING � ��
48. FINAL PLANNING
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Cn � ' �
51. CERTIFICATEOFOCCUPANCY
No. Date
P OJECT AODflESS: UNIT:
� POWNEH'SNAME: SSJ ANTON BL E120
aoosess: SECi1RITY PACIFIC BAIQH
�55 AhTON BL, ST100
C.N.
FflCH/ENGINEEH: ? I�— 3 S 4 —$ 7 �$ pEG.NO.:
aooness: INTEkNI pESIGN Cl��t42�
5 PARK PLAZA /�C
PEPMITTEE: TRVINF. CA 92714
noosess: E6N, MECHANICAL ( 714 ) 282-0165
2328 N, BATAVIA ill
oRANGE CA 92665
UCENSEO CONTNACTOB OECNflRTION: I here0y allirm IAat I am licensed un0er Orovisions of Chapier 9(commencing wil� Seciion
7000� ol �ivisi0n 3 oi !he Business an0 P�ptessions Cotle. ane my Ikense is in iWl Iwce an0 ellect.
arr uc.: �'7 � 5 � STRTE IIC.: r) q$-T ��cuss: r 6
Daie: zi7 �� SignaWre: — _ ��'"��
WOXKFflS'COMPENSPTIONOECLPBATION: I�erebyailirml�ailha [¢rlilitalealConSenllo5e14in5urearateM1iliCaleo�Worker5'
CamDensalion Insurance. or a cetlAied copy there0i (Section 9800. Lab. C�.
Poucrxo.: WC7793563 E%P.�ATE: O9IOZI9S
LOMPANY: Cj,j�
� Cenifietl coOY �s �ere�y fumis�ea. [�' Certilie0 copy�\1s lilea with ��e cit^y Bu�ilainA Oivision.
..ate: �'�7�g� Applicant: /"��v/�/'/�
E%EMVfION fflOM WOP8EB5' fAMPEN5AT10N OECUBRTION: Qhis seclan neM noi be wmpletcd il Ihe perm� is lor one hunOreO (5100) or less�.
I ce�ity �hai in Ihe Dedormance o� �he wor4lor w�ith IhiS permil i5 i55ue4, I S�all n0i emDloy any penon in any mann¢r 50 a510 betame
5u0jett �o Ihe Workers' Compensalion LaWS o� Cahlomia.
Date: Signa�ure:
NOTICE: II. after making this declaralion. you sAou10 �ecome suelect to tAe workers' CAmpensation D��sions of the la�or
Code. you must �at�witn comply m�h suc� p�ovisions or Ilus pernu� s1uA �e OeemeO revoke0.
CONSTflUCTION LENOING AGENCY: I here�y affirm I�at t�ere is a tonstNction IenOinA aAe��Y �or t�e DeMormance of ihe work for
which �his permit is is5uetl (Sec�ian 3W7, Civ. C�. �
LENDEN:
FODFE55:
C�iTY UF COSTA MESA — BUSLDZNC PERMIT PERN, NO: P U�360"i
PERNIT NO: P 053607 PLAN CHECK NO: N COVT: N SJPP: N
CONSTRiJCTiOiV ':YPE: I—SP PERNIT TYPE: PLU PURPOSo: OTH
JUB DESCRIPTION : 21615F OFr'iCE T.I. SQ FT:
CLAIM VALUE: 1,500.00 CALC—VALUE: GROUP OCC: 3-2 /
CnN,MEtv"5; R�P:B53580
�rxx����#�r*�i�x�*���*;r��x�*+�*�v*��*��*�fKfia���x�•�*���x*�***��*�� r±�##xa�x•f�� �*t��►��
Z O N I N G R E Q U I R E M E N T S
S e. T B A C K S
------------ N.AIN HUTLDING ---------- --------- ACCE.SSORY BUILDiNG ---------
FRNT: FT IN REAR• FT IN FRNT: iT IN REAR: rT TN
LaFT; ^'t' IN �GHT: FT IN LEFT: iT ZN RGHT: FT TN
PARKIIvG REO• PROV; PARCEL: 41050104 7.NE: REc NO:
PLANNING N6TE5>
�
i'r 1f iE �lf ie i(� if if #}.1i� iF ic'/E iF �F iFlf iF jf iF 3F �F aF !F i?- lE #>: # iE iF iF �lE iF d4�f �f if iF i(� iF if )F IE �* R# iF #!:' 1F iF iE 1F IE 1f �1't 1E ii ie iF � iF ic �. Y ii 3E �le 3'r ii�i4 ii� i!� ic #
D n V E L O P M 5 iV T S E R V I C E S=� R E Q U I R E M E N T S
ZONIUG APPROVED BY '' DATE:
HUII,DII�G APPrZOVED HY : "i DATn;
APPLICATION ISSUED BY•� ♦� DATE: ��/�
iE}�<?41fiFiFN�7eiE3FlfiE'r.1Ei(-IFiFii�N�1F1! . �?'iF'iF'F��r3C��tra� . �ire£iFiF#�1fiEiFikN-�li�ii�iEi4�'£�'�£"i'.3F. iFi:#
ii� 7f #�%� if 3E R### ac �1e iF iE 3E iF ie �e # 3i� 3F if �IE iE ic?t iF Y�1E if �IF if Y iE IF �! if iF if ii +r if ie K� iE iF i'r ii iE ih iE 3e if 1E if #f i%!t� ai ��)f IE if ii iF �1E iE R IF A: k# 3e �E 3!� �?E # fe
LEGALIZATION:N F E E 5 D M M A R Y STRTiCTURAL SHGM�N7'.N
OWNEHBUILOEBOECtABATION: IhereOyafiirmthatlame�emD���omt�eComracmrs'StateLicenuLawbn�etMlowingreason BLDG F�N.'t' PLUr:�lidG Ef.ECT�IC , P9$CHANIC CIIiE SMIP/tZ$S GRAn1Ni'i
ISection 703t.5 Business an0 Protessional Coae: Any cily of counry which repuires a permit to constmct. al�er, impmve, tlemolisA, or P�Riy I:j• 6, 0 U
repair any slmcture. orior m i�s issuance. also requires ��e applicam lor suc� Oermit io lile a sipned slatement ihat helshe is licensetl ? 5$ S � I P/NON—RES
pur5uan� to l0e provi5ion5 0� �he Contracio�s' Slate License Law (Chapter 9(cOmmencinq wit� Section 7IXq) aI Division 3 0l ihe Business +�
an0 Prolessions Cotle) at �hal hel5he is exemp� ��¢r¢Imm anU TAe ha5i5 iar lhe all¢Aed ecemp�ion. Any violalian ol S¢tlbn 7031.5 Gy y�i�].,�j
any aODlicani lor a permit su�jec�s �he applicani lo a Civil Denalry ot nol more IAan �ive hunUreC tlollar5 �5500). I � CJ`U ^�, F'�E �. Q Q
i. as owner oi me orooerty ar my empIoyees with wages as tneir mie comoenutian, win eo tne woM. antl ine 3UTLD2NG—DIV—> Pr.Fi2/i1T ISSU: PLAI4—Ci�£CK TOTAL PAZD DJE
❑ siructure is nat inten0e0 or ollereq lor ule 15ecoon 70aa: Business anC Pmle55ional Cade: The Conlraciors' Slate License Law TOTALS ----> 6. 00 3. 0 U 0. 0 � 9. 00 g, � � . � 0
tlDes nol apP�Y �o an owner o� a Gmperiy who Duilds ar improves IhereOn, antl who 4o2i SUCh wOfk �imSel�IherSel� Or �IlmUgh �
his or her own employees. pmviQed ��at SUt� impmvemen�s are noi in�entlea Or 011ered �of Sale. II, however Ihe huil4inA or
imD�ovement is soltl wiinin one year of campletion, tne owner will have Ihe GurUen oi providA ne/she tli� not builA or im0�a�e RF. VENIJE D Z V IS 1`ON TQTALS --> COLL ECTED • 9. 0 0 OVER /SHORT : � 0
mnheP��ooseoisa�e�. BLDG PNT PLU:�BI1��G ELc.CTRIC MtCiiANIC FIRE SMIP/TOT GRADING PiAN—CHECH
. i, as owner oi ine urooeny, am ex��usiveiy conlmcting wi�� licensed comrac�ors �o consimct the Omlec� (Sec�ion 704a, Business 9. U 0
❑- aM Piofessions CaOe: The Contrmctors' Siate License Law Caes not apply lo an owner of pmDeny who bwltls or improves therean
anU wha coniratt5 �or Sut� proleClS wiih a COniratlor�s) litense pur5uani lo I�e GOniratforS' Slaie LiCenSe Law). I am aware �* �.��.�.# ?FiE N�iFiFiE 3F # 3E�3F�k 1F�jej{ {(.{p {s a(.{E {(�* *{t {:*� {E �E ifiF if if ii i'tiE a6 li'3(' If if fhi('if ?i iE1f'ih 1f'it'R'1:' fC'iF i2 14ifif}:'7EiF #'iE ik 3E it 9i' ?E 3e 3FiF i4 #iF
mat proo� ol tneh Worker's Comoensation insurance snoWtl oe provmed io me. I N D 1 V I l� U A L i� E H R$ A K I) �� W bl
� I am exempt under Seclion: B. 8 P. C.
mr mis reason: TYP: C,�TY D E S C R I P T I O N (INIT COS 1 1 OTAL COST
oaie: ow�ec pLi] 1 SINK BAR 2.00 2.OU
I tlo here�y cenily �hal I am aware o� anG unOerslanOlhe requiremems o� Calilomia Healt� and Salety Cotle Sec�ions T5505. 25533, ana pLU 1 WA 1�� $EAT: R AND /OR VcNT .�. , � � 2. � 0
25534 ane inal I or any IUNre building occupant will/will not (circle one) neetl to camply with saia slale coees antl ihe requirements for a
permi� �or wnsimdion or momlicaiion trum �he nir Oua�ity Managemem oisvict. Resieemial consimction apD�ica�ions are eeemp� �mm PLI7 1 r 1}{ 1 UR$ S"T / TRAF W/ P I1? I NG & BACK c LOW z. n 0 2. � �
inese oro�isions. END OF PEES
Date: ApPlicam: _ /
1 �ereDy ceniry I�at I have rea0lhis applicalion and sla�e Ihal lhe above inlormalion is correct. I agree to tomply wilh all ci�y an0 couniy `
ortlinancesanOsialelawsiela�ing�o�uiltling�ansimclionanQ� rebyautfwriierepre5¢nlaliv}� ol�hisci�y�0en1¢ruponiheabove-mentionetl
plOpWty �OI in5peciion pWpO5e5. � L� ���
Daie: u 27��� Signaluie: "p'
�river's �¢ense or Social Securily u:
t6an46 W�ite—Bwlainq: Green—Caqa EniorcemonC Canary—Applicanl: Pink—Revenuo: GOIEenroO—Auessor
D1 00095$52—Q9095E52 �'�od
DATEa ps/27/92 TI!iE: i.'�4
�
�.17�
i � J �
� CONSTRUCTION AND PLANNING � P��A �
�j APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
� 1. Temporary Electrical Service or Pole . . 52. Pool & Equipment Location �
2. Soil Pipe-Undigrnd. 53. Steel Reinforcemen[
3. Electrical Conduit Utility•Undrgmd. . , 54. Forms
. 4. Electrical ConduibUndrgrnd. -� _ - 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 56. Electrical Conduit�Undrqrnd.
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
15. Property Sewer Line & House�Connection � 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final �'
13. Roof Drains � 64. Plumbing SYstem � Final
74. Rough Plumbing - 65. Electrical�Final
15. Rough Electrical-Conduit � 66. Solar SYstem-Final
� 16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil -
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
I 27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PflEV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat ` 79, FINAL INSPECTION
32. Electrica� Power Meter�Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' � Notes:
34. Final Heating & R,i� Conditioning �
`
35. Final Gas Pipe�Test %� �.'
36. Hood or Canopy �, ���-
37. Final Factorv Fireplace �`; �y
38. Final Plumbing . q (,/EQ
39. Water Service•Final
40. Gas Service�Final
41. Solar pomestic-Final
42. Backflow Preventer ' '
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Re9ulations
47. FINALSTRUCTURE&BUILDING ��
48. FINAL PLANNING �.A
49. Electric Release to Edison `"i �
50. Gas Release to Southern California Gas Co �� j e
• 51. CERTIFICATE OF OCCUPANCY
No. Date
- \_ _
PNOJECT RDONESS: UNIT:
` UWNEfl'S NAME: 5 j� AN i'UN B L� 8 2 �
ADDNFSS: S'ECURTTY PACIFIC: HANK
55S ANTON 3L, ST1U0
C.;!.
FflCH/ENGINEEfl: z S 3"�J S�) — S %%i� qEG.NO.:
aooeess: 1L�LRNi DESIGN C1uMT42
5 PARK Pi.A7.A 750
PEflMITTEE: 1RVII�E C.A 9Z%1�
aoon¢ss: AiR CONDTT.ONING CO. 3NC ( 818 ) 294-6.ri71
62}6�5n SAN rERNA1dD0 R�
ULENSED LONTNACTOA O�C'WHpT10NL �here6y allirm inat I am Iicense0 unEer po'visio9s oi Cn�aoler 9 I�ommencing wim Seciian
7000� ol Oivison 9 ot I�e Business antl Pmlessions Coae. ana my license is in lull lorte anA efleci.
CITY LIC.: STPTE LIC.: CLASS:
�14�03 120F h C-20
e: _�=�^ q— � _ SfA� e: _ .�_
WOpI(EBS'LOMPENSR710NOECLABRTION: I�ere yatfir tl�aveacertiliwiealwnsenlloselNnsumor tiliwteotWorkers'
;omDensation Insurance. or a certdiea cooY �hereol (Section 9800, La�. CI.
roucr eo.: �C6074136 i 7 E%P. DPTE: lO �O I I9I
COMPANY: r 7�
n� Certitied copy�is� fiN�i�QR dT� �O�N ' etl wi�h t�e ciiy 9uiltling Divivon.
r. �^27"�� 'can � 4
E%FMPTIONFFOMWOpKENS'COMPENSATIONOECLA : (IhissecuonneeGnolOecompleteC' = w - IwwenuMred13t001orless�.
1 Cetlity I�al fn I�e pertarmdnrR oh�e work lar wNth f�i5 p¢rmil is issuetl. I stlatl noI empby Dersan N any manner w az m oecome
5u0iect to ihe �M1'wkers' fAmce�sdiion Laws ol Caltlorn9.
Oai¢; Siqnamre:
NOTICE:II. atler makinq Ihis Oeclaraiion, you shoultl Oecome sublecl �o IA¢ Warkers' Campensation provisions ol��e La�or
Code. you mus� �orl�wil� cOm01y wit� such Omvisions or Ihis Oermit s�all Oe deemeE revoke0.
CONStBULTION LENDING �GENCY: I �ereEy aliirm t�al tAere is a constmction lentling agenty for �he petlormarrce ol ihe work lor
vinicn ihis oermn rs issuM 1���� 3097. Gv. C�.
LENDEH:
�DOflF55: �
OWNEP 6UIlOEP OECuf1AT10N: I nereoy aliirm ihat I am exempt imm Ine CAntraclors' Slate Lkense Law lor Ihe fallowinp reason
(Section 7Q37.5 Busineu anU Pmfessional COEe: Any city of county which repuir¢s a Dermi� lo conslmc�. alier, impmve, tlemalish, or
repair am/ slmtiurp, p�i0r lo ils iSSuante. ai50 requiRS ihe ap0liCanl lor 5ut� p¢�mii IO @¢ a 4gn¢O Slalemen111W1 �¢/SM1e i5licen5etl
pursuam m �he provisions ol t�e Convactors' State License Law (ChaD�er 9(tommencinq wit� Section 7000) ol Oivivon 3 0l the Business
antl Protesvans CoOe� o� I�at �Us�e is exempt Ihertimm and Ihe Easis fot ihe alleqeG ecemptiQn, Any violalion ol Section 70;{1.5 Oy
any applicant for a permit suGjecis ine appliwnt to a civil penalty oi not more than live hunEretl OOIWrs (5500�.
,� I, az Pxner ol ine Dropeny or my em loyees vrith wages d5 iheir Sole fAmppnSa�qn, wlll Oo ine work, anJ ine
strucmre ¢ frot intenAeO or oBereO fw sale (�uon 704a. Busuiess an0 Prafessional Cotle: Tne Contraqors' Sute License Law
I Oaes not appy to an ovmei of a pmperty wlw builds or imprwes ihereon. an0 w�o Goes such work Nmselflherself or Nmuph
IXS 0! hC! MM MIpWyCP3. (IfOVIeCC I7ld! SYCh IIIIp10VPIIM�(5 d!C Ibi MlElIUCC M On&Cd �M SdIE. I�. IpwCVC! th¢ bllddlflQ 0!
impmvem¢nl is solU within pne year o� tomplelion, Ihe owner vnll have Ue OUrEen ot pmNng �e/s�e Aitl n01 builC or improve
lor ine owpose ol Sale1.
� I, as owner ol Ine D�operty, am exclusively conlractinB K'iih Iicen5e0 mniratiors to construct the D�alecl (Section 7044, Business
Q anU Professions CoOe: TAe Contractors' State license Law aces no� ao4N to an owner af pmperry who OwICs or improves t�ereon
antl wM cuntraws for suc� pm)ects vAt� a comractor�s) license pu¢uant �o I�e Convapurs' Stam 4cense Law). I am aware
Ilul prao� ol t�Hr Wotker's CAmpensaiion insurance s�auld Oe O��4eE to me.
� 1 am erempl unGe� Seciion: B. 8 P. C.
lor Ihis reason:
�am: Ov+ncr:
i ao ncreDy cenity ihal I am aware ol anA untl¢rstan� I�e requiremenis ol Catilomia Heali� anG Saleiy CoOe Setiions 25505, 25593, and
255J<and ttW� I or any lulWe Euilainq occuDanl willlwill not (circle one) nee0 �o comD�Y �^�� ��4 slaie c00es antl t�e repuiremenis �or a
Oermil l0� tonstmclion a �w0l�icalian irom Ine Aii ualny Manapemem UisVict. q¢gaemul consvuctwn applicatians are exempt Imm
��pSB O�avisiorts.
Ddie: AppliCani: _
� �ereGy cetlily Inall navercaUlAis application ane slale Inal Ine
oitlinance5antls1alelawve�alingloDuilUingconsimclionan iel
OroOe��Y �or inspe[lion Ourpo5e5.
D'aic: " " Signatu
Oqvefs Gcense o� $otial S¢cunry �: �
� agtee to compN ��� all city an0 counry
I�iS diy l0 enier upOn Ihe above-mentione0
1 W b<6 �'Me—BWking: Gre¢n—COEe Enlorcement: Canary—ApplkanC Pmk—Fevenue; GoNenroE—Assessor
CITY Or COSiA NESA BU�LDING AERNIT'
PERkIT NO: N 053603 PLAN CHECK NO: N
CONS'iRTJCTION TYPE: I-SP , PERMIT TYPE: N.EC
J03 DESCRIPTiON : 2161SF OF:.'C� T,I,
CLAIM VA..UE: 1,500.00 CALC-VAY.UE;
PERN NO: M 0�36U?
GOVT: N SJPP; h
PU�POSr; OiH
SQ FT:
GROUP OCC: B-2 /
CO.v:!EN"'S: REF;BS356�
�F # 1E 3E 3f iE iP ## R iF # ib ff R if iE )f iF Y: 1E #� iF iE if li q� 3E 3E 7't iE if if if # K�1f k iE if if iM1 if i%1E i'r fi� # iS fE iF #� if iF #F #�/E 1f # 1F # 3F if 1h i'r iF 3k'r. R iE iE k i'v ih it ie i( #
'L O N S N G R E Q U Z R E�M E N': S
S E T y A C K S
------------ MA7N BUILDING ---------- ----.---- ACCESSORY BUY,.D:NG ---------
FR13T: FT 3N R�AR; FT �N FRI�T• FT "tN REAR: FT :N
LErT; eT iN RGHT; FT 1N ;.�rT; FT 1N RGHT; :T iv
t�ARKIn�G REQ• FROV: FARCEL; 4105010A 7Nc: RaF NO:
PLANNSNG NVTaS>
>
iF�F#�f3hfF�lEceififv<1F3�rtYiFM!f�f-i�*a 1F#�ifitieiti(�*ii�iE�#ie#k�ERie*iE�ifih!fiEifatiFitx-ititklF#ihiFi4ii�t#iEa;+�-irif IEiFiE�ii��x�r:��:
D E V E L O F M b' N T S E R,V T C E S R E Q U I R c M'r: N T 5
ZONING APPROV� BY • DA.E;
HGILDING APPROVED BY : DAT�;
APPLICATION ISSiJED BY; � ' DAT�• �-a7�
fflElf?fic-Y.�iFif4iE#?FiF3fRiE�ffEiffE�f7E�'�� +.�A-iF�cTtw -z x+f-ifM#EiFifii�ifY.�t .xi}{�
iF i'r iE iF �1� iF+e?f 1f iE ie+E iF 1E iF fF iF if fE ## ih # fF IE �%�I'r iE i'r �e.h if )f iF iE ie if �f 1F #F r if af +F K# ii� 1E #� !E iE if 3E iF ## aG:; # if �1F# rt 1f- iF i� #f #- iF i'r k iF +i # i� �E i4 �#
:.F.GALIZATION;N F E E S U A: M A R Y STRUCTURAL SBGMENT:N
BI�DG PM'f PLUMBING c�L�CTRiC MECHANIC FIRE S,'N'1P/RES GRADThG
PERMIT 20.50
7.SY SMIP/hON-RES
PLAN
ISSi7= FEF. 15.00
BUILDING-�IV-> PER,NST ISSUE ALAN-CHECK TOTAL PAID DUE
TO;ALS----> 28.50 15.U0 0,00 43.50 43.50 ,00
REVah'Un Dil�I5ZON TOTALS--> COLLECTED• 43,;50 OVER/SHORT• UO
BLDG PMT PLIINBING ELECTRZC i�:ECHANIC FIRE S.MIP/TOT GRr1DING PLAN-CHE�K
43.50
# iF 3E iE 3f �### jf 1F ii ii� 3E if iF R 3"r iF ii� 3c 3f if iF if R R-lE if ?f �E �>E x iE ih fF iE fF iF iE f# 3i Y� iF iF ik if iE iF �} }##f jE if iF iE 3F if iE ii iF �E 1E 343e �k ±F iF # le # if # lf IE ?F i
Z t3 D I V I D U A L F E E B R F� A K il O LJ N
TYPE QTY D E S C R I P T I O N I tiNIT COST TOTAL COST
MEC i REPAIR/ALT COOLING UNI'f/SYS W/CNT(,S 9,00 9,OU
MEC 3 VAV BOX 6,50 19,50
snjD oF : s�.s !
ci _^�s_ta3-�cc;sv�� '� Lr,� -
u;-;:: oar��;;1 -7��Ee .� �
I::u:
i �
� CONSTRUCTION AND PLANNING ..�OL `A �
APPROVALS Permit# Jate Inspeetor APpROVALS Perrmt# 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 Undrgmd.
10. Structure� Floor System 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains 64. Plumbinp SYstem - Final
14. Rough Plumbing ' 65. Electrical-Finai
15. Rough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriwl�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough HAating & Air Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventiiating 71. Product Piping O Gas OOiI
23. Gas Pipe-Rouqh & Tesc 72. Underground Flush
24. Roo( Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling 1Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 76. FIRE PREV. FINAL
30. Drywa�l Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat r 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning p (�
35. Final Gas Pipe-Test `� ��
36. Hood o� Canopy '
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final �
41. Solar pomesticFinal
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING ''�
; 48. FINALPLANNING �'
49. Elettric Release to Edison '
50. Gas Release to Southern California Gas Cn ��
51. CERTIFICATE OF OCCUPANCY
No. Date
PBOJECi �ODflE55:, S S S ANTON tJu UNIT� R Z O
.OWNEfl'SNAME: SECUfZITY PACIFIC BA1�K
aooness: 555 ANTON Hi., ST100
C.M.
FflCN/ENGINEEfl: z � 3— 3 S 4 — 8 7 7 S flEG.NO.:
RUONESS: I^I l GRN 1 �.`^.JC i�'ii� C Z J,^T:4 �
5 PARK PLA2A �' 750
PEflMITTEE: IRVI NE CP. 9.�. % 1 4
aooxEss: ��TCHI50N CORP ( 21 3) 763-7991
225U S CE:�iRAL AV
RA�CHO DO:�INGE7. CA 90220
LILENSED LONTNAC70N OECLAflRTION: I trere0y aHirm itut I dm Iiten5e0 utqer D«oirs of ChaD�e� 9lcammenting wilh Section
7000� ol Oivs�on 3 0l t�e eusiness anE Prolt5si0n5 COEe. anG my kense ¢ in iW lorce anG eflect.
CITY IIC.: TRTE LIC.: S5: /�
�,�0�787 2695i2 /�., C/jJ___y� �j�
.Dale: — Signature: —(_G�
WOBKEPS' MPENSai N �ECIABATION: I her¢Gy aflirm WI I lidve a cerii�i e ol consent �o seu-insure or a certilica workers'
�om0ensali n Insurance. or a ceNhetl copy t�ereaf ($ectian 7800. LaD. C�.
oucrxo.: WCP607792Ap� E%P.ORTE: SZIOZI9�
OMPPNY: GRGA1 AMG.}_,CAN
J Cenilietl capy is Aereby Wmishe0. LJ' Cenifietl coOY a��� w+t� the city B'' ing Divisian.
Oale: O Z � APD���anC � `
'.:A..
E%EMPTION qOM WONKEfl ' COMPENSNTION OECLAMTION: (ih5 SecWn neM not Ee tampkteE i� Ne permil6lo� d1e 1Wn llp) Of less).'
I cenily ihal in the Oe�ormance ot t�e work for w�ic� iNs permil is is5ue4. I shdll not employ any person in any man ,/as to �ecoi0e'.
suhlect lo I�e Workers COmpensatiUn Laws ot Catitom0. ,
Oaie: � Signawre:
NOTICE: II. alter making ihis tleclaration. you ShoulG 6ecome suEject to the Workers' Compensation provisionstol the Lahor %%�
CoOe. yau mu51 �otlhwith Comply wii� SUCh pmvisions o� Ihis perrttii Shdll Ue tleemed fevoke0. t��" t �' ,
CONSTflUtTION IENUING pGENLY: I �ereGy aifirm Wt there is a constmc6on IenGing aAency lor t�e Oedormance ot tAe work lor
wAicA I�is Oermil is i=suea (Seclion 3097. Gv. C�. �
LENOEfl: �! �' '� r
ROOflES$: .. �
OWNEB BWLOEB OECUMTION: I nereoy aflirm Ina� I am exem0� Imm tne Contracmrs' Sta�e Liunu Law lor ihe I011owinA reason
(Section 7031.5 Business antl Pmlessional Coae: Any city ot counry whicn r¢puires a Dermii to cOnstrup. alier, improve. Eemolish, or
reDair any stmcture. prior to its issuanu. also reQuires ihe a00��U�� �or suc� permit m ide a 5i0�eE statement tlut he/she is licensetl
pursuanitotne pmvisions alihe Cantractors' Slate Litense L]wlCliapter 9 Iwmmencinp with SeCtian 70001af�ivision 3 olihe Business
and Pmlessions Cotle) or that �e/she is eaempt ��eretrom anG the basis for Ine allepeE eremption. Rny violation oi Section 7031.5 Uy
anV apDlicant lor a permil Subl¢tl5 Ihe appliuni lo a pvil p¢nairy ot nol mort Ilun live hunEr¢0 dollars (SSW�.
I, as owner of ihe Droperty or my employees vnih waqes as iAeir sole comDensation, vnil Oo ihe work, ana tAe
� s�mclure is no1 inlenaetl or ollered lor sale (Sepion 704d, BuSiness antl PrO�essional Code: T�e Coniracmrs' Slaie LicenSe Law
� Does not aDOty Io an owner ol a O�operty who �uiltls or improve5 i�¢reon, anG wtro Eo¢5 Su[h work him5ell/her5ell Or Ihmuph
his or �er own employees, pmviCeE Rwl suc� im0�memen�5 ar¢ nol inlenOeE Or O��ereE �or SaIE. II, M1OwevBr Ih¢ Cuilding or
im0�ovemen� i5 SWa wiNin one year ol completian, Ihe owner will Mve Ilk burEen al provinp hNshe Eid noi builG or improv¢
lorlhe purpose of sale).
I, as owner ol IAe propeny. am evclusiveiy coniractinp with Iicense0 fAntractors to consimct tAe pmlect (Section 7U4a, Busineu
❑ antl Pmlessions Code: T�e Comracmrs' State License Law Does not apply io an owner ol pmpeny who Emlds or impmves �hereon
ana wno conlracls br such vmiecis witn a caniractorls) license pursuant to Ine Cantractors' State License Law�. I am'aware
inal pmof of Ineir Worker's Compensatbn insurante snoulA Ue DroviOee lo me.
� I am exem0� untler Setlion: B. 8 P. C.
lor Ihis reason:
Date: Owner.
do here�y cenily ��at I am aware oi antl untlersiana i�e re0uiremems oi Calilomia Heall� an0 Salery Cotle Sections 25505, 25533, antl
5534 anU I�at I or any Iulure huilaing occupani willlwill nol (circle one) neetl lo comply wi1� saiG siate code5 and Ihe reQuiremen�s lor a
il lor con5imclion or motlilicatian Imm I�e Air �uah�y Managemenl DiStric�. flesidential conslmciion applicalions are exemp� Imm
ApplicanC
Ihave read Ihis aDO�icaiion anG 5�alelhatihe a�ove in�otmatiUnis torrecL lagree lo comply wiih allcily
lavrs relatingio buibmg tonstmciion antl �ereby autlpnze representa�ives of�Ms tirylo enleruDonlhe abOvi
� � SignaWre: ( �l� i1/�(
r'—
'Y"�
�n—CoOe Enlorcemem: Canary—ApdicanL Pink—Revenue:
Ci'iY OF COSTA N.r.SA — BUiLD'ING PERN.IT PEHM NO: E 0�36iA,
PERMIi NO: c 0�3618 PLAN CHECK NQ; N GOV'i; N SUPP; N
CONSTRUCTION :YFt.; Z—SP PF.RNST TYPE; EL�E PURPUS :: O:H
JOH DESCRZPTIQK ; 2161SF OFciCE 7,I. SQ F..
CLAIM VALUE: 5,000.00 CALC—VALUE; GROUP OCC: B-2 /
COMMtNTS: REF:B53580
f4iFka��*iE�ce��7%3?Fi��f*I�it�*t�*7�+tvi:urtifv�x��u��ieif�iE#�E�i•it*xce�aF�it�iF*w���it#ie#3i�*x�#x-*iE#;E�i�?E#��tst�a7t���t�y�
Z O N T N G k E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDINC ---------- --------- ACCESSORY 3UILDING ---------
FRNT: FT IN REAR: FT IN FRNT: =.T IN Re.AR; FT 1N
LEFT; cT 1N RGAT: rT iN LEF1: FT IN �GAT; cT �N
PARKING REp : PROV: PARCEL: 41050104 7NE; REF VO:
PLANNING tJf5Tc5>
� "
# ic if if if !F #?f IF If fE fF iE if 3f i't if iF } iE if iE If !f ie #� aF'� a!� 3F if� #� iF 9i if �t4 ielf iF iF iE ff ie 1F iF # if iF iF 1E i� 1(� fe* # i� if #�E 1i� # if fE 3F ##iE -R �#f� #E ii ie ie %� if Y##
D E V E L O P M E N T S E R V I C E S R E Q U T R E M. E N T S
ZONING APPROVED HY DA':�:
BUII.DI�rG APFROVED BY : _ DATE: q
APFLICATION ISSUED BY: � DATE• �'2 �C �
3fif�Elf!4�fikiEiEiEibifl(-iF##7E1EiFiEiFir�'i�t$£�Fix �Ftki�iFx,.��iFi'�C. n.'£iF3FjFiFiEif#FaK�#aeir'£�r'�.£r�r'r.Tt��Y.�
i'rifiFii##IEiF1F7F#IflelfiF>:iF#3F3c1F-1:3f1Flf#iFa�Y.•ifiFaF�?:�#'#1FiFifiE%h.: �a'�MFieif#i'rKY�iii��a;�lelFiF#KIFY.�#i4lfif#�/F1E#iEiFiFfieiiiE#E
LEGALIZATION:N F E E S U N. N A R Y STc`ZUCTURAL SEGM£I�'::N
BLDG PMT PLUN.BING ELECTRIC MECHANIC FIRE SMIP/RES GRAD�NG
PERN,iT ' 47 85
�03 SMIP/NON—RHS
pLaN
ISSUE FEE 15.00
BUILDING—DIV-> PERN.IT ISSJE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 47.A5 15.00 U.00 62.85 62,85 ,00
REVENUE PIVISION TOTALS--> COLLECTED: 62,85 OVER/SHORT; .00
BLDG PMT PLUMHING ELECTRIC MECHANIC 'r'IRE SMIP/TOT GRAI�ING PLAiv—C:iECH
62.8J
Y# 1F fF # M i!� It If� It iE 1f +F i4 iF # if if iE i!� !F i4 # R if !t iFl4lf !h 3E d� # if IE # IF iE ie fEii� If ie iF iElF iF i4 iE if # i� ik if• ie iE le } X'%� P'� 1f iE i41( le !f 1c 16 R}:� # 1f iE iE if ic Y.� If
I N D 7 V I D U A L F E E B R E�A K D O W N
TYPE QTY D E S C R I P T i O N i UNIT COST TOTAL COST
6LE 20 FIXTURES, LTGHPZNG 1 ST 20 EA; ,75 15.00
ELE 14 =IXTURES LIGH.ING ADDITIUNAL EA; ,45 6,30
EL$ 20 RECBPT/OGTLET 1 ST 20 EA; .75 15.00
ELE 4 RECEPT/OUTLE9' ADDITIOivAL EA: .45 1.80
ELE 13 REC5P1/SWITCH 1 ST 20 r,A: .75 9.75
END OF F�t5
, G2 ^t.�S- -��,t , -...
„•H` . �i. .. ' :.i"E= ;G_.
� SPA
�, CONSTRUCTION AND PLANNIN� / �
APPROVALS Permit # Date Inspector pppROVALS Permit #
• 1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Stee� Reinforcement
3. Electriwl 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. Root Drains 64. Plumbing System � Final
14. Rough Plumbing . � 65. Elec[rical-Final
15. Rough Electrical-Cqnduit � 66. Solar System-Final
76. Rough Electric Wiring • ,��y � 67. Fencing & Access Approval �
!
77. Rough Wiring Sign , 68. APPROVED FOR PLASTERING
18. Rough Electriwl-T Bar Ceiling y99� 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # �
� 21. Ducts,in Structure 70. Underground Hydro
22. Duc[s, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Fl�sh
24. Roof Framing 73. Undergrnd. Stora9e Tank O 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. HEQUIREMENT
31. Plascer Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � �-Q'( Notes:
34. Final Heating & R.ir 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 pomesticFinal
42. Backflow Preventer ,
43. Backflow Irrigation
44. Landscape Irripation System, �
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ' � -,�,
48. FINAL PLANNING ��
49. Electric Release [o Edison "
50.� Gas Release to Southern California Gas Co i
51. CERTIPICATE OF OCCUPANCY
No. Date /•�
�
PflOJECTFODNESS: :�)� �,NTON BL
OWNEP'SNRME: BAVK OF AI'iEFtICA
aooness: z0 HAYMOND AV
PASADENA
PflCHIENGINEEfl: a1ii—��a—l��Q
rtOY ritRBOtiD
UNIT: $ 7 J
BEG.NO.: C 1� n 7 3
RDOflE55: 2zO%Z i'/�.i`�ii1TIT0 �%1i�0 NIT:
LAGUNA HZ�LS CA 92693
PENMITTEE: �MSTRONG CQNSTRUCTZON ( 818 ) 967-8001
aoosess: 92g SPdING MEADOW DR
ArST COVTNA CA 91791
LICENSEO CONTflACTOP UEClANR710N: I �ereGy allirm I�a1 I am ticense0 uMer pmvivOns ot ChaD�e� 9(cammencinp wii� Section
7000� ot Dmsion 3 of Ihe Business an0 Pmle55ions Coae. ana my liceme is in lull lorCe an0 efiect.
uTruc.:�5;871 sraTeuc.:43604"' ss �-1
Dale:.4T1p/ �� SignaWre: . — -
WONREBS' CO � PENSRTION OECLAMTION: I �¢r¢Oy firm Ilui I luve a ttM1ilicaie 01 consen to 5¢INnSure ar a tertiliwie ot Workers'
Compensalion Inswance, or a renilie0 copy t�ereoi �Section 3800, LaC. q.
roucrNo.: PC943935 E%P.ORTE: �S IOi I93
carnraxr:REPG�LIC 1tiDEM �
❑ CenifieC cypy is fereUy Iumishe0. � cemrea ww a ypn y�m me�eu�m� �� an.
Oate:
CY[M
Applicani:
1! (� secfion neea mi Ee mmOkteU il ine OP+�CL�ta ane hwtlreC (3t00) or lessl.
I certity I�at in Ihe petlormance ol t�e work for whic� Nis permit i5 issu¢E. I Stiall na� ¢mDloy any person in any manner So a5 �o become
su�l�� �o �he Workers' Compensation LavS ol CaM1bmi3.
Oate: Signawrt:
NOTICE: Ii. af�er matdng Ihis OeUaration, you slaub Oewme w6ject to ��e Workers' Compewtion pmvisions of Ihe Labor
CoOe. you musl Iori�wi�� Comply wii� suc� Omvisions or W5 Oermil shall Ge Eeemed revokeA.
CONSTPUCTION IENOING AGENCY: I nereoy aBirm tAat thert a a consvuctian lenainp agency tor tAe DeAormance of ihe wark for
whiCh Ihis permii is issu¢E (Setiion 3097. Gv. C�.
LENDFH:
p00XESS:
OWNEB BIlIWEB DELUN�TION: I �emby allirm Ilut I am exempt Imm tne Cantranors' Staie License Law lor the Ioilowing reason
�Section 703L5 Business ana Pmlessional COEu: Any ciiy of counly w�ich repuires a permit to consimct, alter, Impmve, tlemolish, or
iepair any simclure. Orioi to ils issuance. also repuires I�e aDd��nl lor such permit to lile a sipnetl sta�emeni Nat hpJshe i5license0
pursuant �o �ne piovisions ol the Comractors' Siate License Law ICnaptei 9lcommencinp witn Section 7000� oi �ivision 3 oi the Business
an0 Pmlessions CoOe� ar ihal he/sne is eeemp� t�e�elrom anG I�e Dasis lor Ihe altepe0 e�emplion. Any Wolalion ol Sectian 7031.5 by
any aDOlicanl for a oermit subjecls ine apoliWni to a crvil De�alty of not more ihan live nuntlred Oollars R500).
1. as owne� ol ��e OroDerlY or my emplayees wilh wd0es as Iheie sole compen5ation, will do ihe work, and Ihe
❑ s�mmure is not imentle0 or ollere0lor sale ISection 70aa, Business anA Pmlessional Cotle: T�e Contractors' State License Law
eoes not apply lo an owner ol a prop¢ny wlq euilas or impmves inereon, anJ w0o tlou such work nimselllhersell or ihmuph
� �is or �er own emyluYees, proviCcO t�at suc� imOrovemenis ue not intenAEa or oi�eretl lor sale. II, �owever iha builtling or
impmvemen� is SOIC vnl�in one year ol completion. I�e awner will have ��e burCen ol provinA ���e Gitl not builC or impmve
IOt II1C pU1005C 01 SdIE).
I, as owner ol IAe DmDe��y. am ehtlusiv¢Iy coniractin0 ��� licensea contracmrs to canslmci Ne pmlact (Section 7044, Business
❑ aM Pmleuions Coae: itie Conlrazlors' Slate LRense Law Goes iro1 apDN �o an ovmer ol Dmpertp wM �mltls or imprwes lhereon
antl w�o toniracls lor such prole��s wil� a Conlrac10r�5) IicenS¢ pursuanl lo I�E Conlraciars' Stale License Law�. I am aware
I�ai pr00� 01 III¢ir WOrkei 5 Compe�52li0n iM1Surante SIquIC OB prOviO¢0 Io m¢.
� I am exempl unJer Section: 8. E P. C.
�. lOr I�is reason:
Date: �rvner.
I ao nere0y cenily Ihat I am aware al an0 uMerstantl tne tepuirements ol Calilornia Healih anU $alety CoOe Sections 25505, 25533, an0
2553a ana t�at I or any imure Ouileing acupam wiM�All not (circle one) neea io compry wit� saiG state coGes ane t�e repuirements for a
0¢��u� �Oi Cansimclion Or rtqdtip�ion IrOm 1�0 Ai��udlity MdnapBmenl Di5iritl. P¢SiCenlNl wn5VUC60n aOVlitd�i0n5 ar¢ exempl �rom
Ihese oiovisions.
Da�e: Apptiwm: _
I hereby cetliiy �Oai I tuve r¢aa �NS appli[a�ion a�M 51a�e Ihai
ordinances anU 9ale Wvs relaiing io OmWmg construtlion ark n
pmpeny lar in, .�ec+im O��D�lS.
Oaie: _ V SigiuWrt: �
Driver s License or Saial Securny •:
I agree �o wmpty wii� all u�y an0 Counry
!'ti5 tiry Io enier upOn Ille abOve�men�ionetl
16a��c6 WMe—Bwldmg; Gre¢n—CoOe EnlorcemenC Canary—Applicanl; Pink—Revenue: GWdenroE—Nssessor
CITY OF COSTA MESA — BUILDTNG P�RMIT PERM NU; B 0593.�4
PERMIT NO: B 059854 PLAN CHECit NO; 04200-92 A GOV'i; N SOPP: N
CONSTRUCTION TYPE; i FR SP PERMIT TYP�: STH PIiriPUSE: ALT
JOB DESCRIPTION : 68505F OFr'ICE T.I. SQ F_': 20,550
CLAiM VAiUE: 90,000.00 CALC—VA�UE; 17.5,08..00 GrIOUP OCC; B-Z /
COMMENTS: HUILllINGRh'S'�'ACK STUDY
#iE#itil�ifiEf4iEff#iEiFi'rikiftfiErt#7(�iEil-iE3Fit#ki1�#1EiFiEY�1ki4#fffFit##sE�EiEitif##�7k#it�#iFihil K�###3F#ik##lEif�q�i:ff �#Yi:iFit»!EiE
Z O,U i N G R E Q U I t2 E M E N I' S
S E T B A C K S
------------ MAIN BJILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; F"C IN REAR; rT IN
LEFi: F1 IN RGHT; FT ZN iEFT; FT IN �tGti; ; FT SN
PARKiNG REQ• PROV: PARCEL; 41050104 2NE; PDC REF NO;
PLANNING NCiTES> TENAN'f IMPROV�:vENTS FOR THE 8TH cLOOR (UNI'1' 875) F011 OFr'IC�
> PURPOSES, � ;..
rt1E%iFiE#ikiEjEifiEif�if#ifiEiEri�3EiEititiEiE#iEiEit#1FihiEif##�JfiE#x-iFiFiP?t-k�ffiFiffki(�#iEiE3f7EiElfiFlEfE#�#####KR#ik'kiF##-1F##4
D E V E L O P M E N T S E R V I C E S R E Q U I k E M E Aj°�F- S
ZONING APPROVED 8Y �� �. DATE; �IL- � rL�-
HUILDING APPROVED BY : DATE;:: .
APPLICATION ISSUEA BY: 35� L� DAT'Et il'�:�1 S
iEifif#iEif�C'1E'1EiEifi('ih3%#ii�iF#iflEiElE7ifiR�R�-�ie!'FiF'liliiF3FT'��R'k%'itf{'T[1tfi�7Fltll'iti�arriF$ih?�'iflFiEiE'IFif#7f-'x� h H'1LiI'�'
if �1i iE ## i! iE it iE iF # fY iF 7E K iF iFl4 iE if # fF iF if i(� 3F # iE ih iE # i(� if ik i(� fE 1! �t ####}E iF �If iE �IF I( fE # iE iE iE 3F 3f ## iE #!E it ff ## X' if�'R'�lEiEit �Jf if ## K� tE iF?t
LEGALIZATION;N F E E S U�I M I� R Y STK(iCTUtif.T,`S�GM�N7';Y
BLDG PM.T PLUMBING ELECTRiC MECHANIC cIAB SM.I�'/RL•'S GttAD;.'�G
PERMIT 730.50 � '
PLAN 118.71 �� SMIP6N0�—R�;S
ISSUE FEE
HUILUING—UIV—> PERMZT ISSUE PLAN—CHECK '['OTAL PAID DUE
TOTALS----> 756,77 0.00 118,71 8 r,4R R7S,48 ,00
REVENUE DiVISIU� TOTALS--> COLLECT�:D;� 756,%7 OVE}t/SHORT: 00
BI,DG PMT PLUKBING tLECTrtIC M'r'CHANIC :"RE SM /TO'i' GHADING PLAN—CHECK
�3o,so a.6.z�
if ik IF if if #�1F !F if ?E if ?F iF # it 1f!i� il-it� ## iF iF Ik i(• i4 iF SF 3f iF # if fP if # iC Y< if iF il # ft k# iE H� # 1E iE N� k if fE 7l� if )f 1h 7E i( N� ik :i )F K#### iF tt # if if ## if ##?t
I N D i V I D I1 A I. F E E B H� A K D O W N
TYPE QTY D L S C R I P i I O N UNIT COST i0i.'AI, CUST
SFC 6850 Or'F—iNT, Ai,TzR �YPE I,II�F,R. —AVER 17,24 113,094.00
SFC 6850 E U—AiT CO?1M. SPRINKLER SYS —AVER ,33 2,260,:;0
SFC 6850 E�iU—Ai,:" COkM. AT_R COND —AVER ,69 4,726,�0
END OF r�.ES
t
/�
�
' ^ �-��
CONSTRUCTION AND PLANNING P� -- & SPA
f' , APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Temporary Electriwl Service 6lPole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. f'� " 53. Steel Reinforcement %
'v� n
3. Electrical Conduit Utility�Undrgrnd. f� 54. Forms ��
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPFOVAL TO COVER�GUNITE
7. Footings r� 58. Eiectrical Conduit-Undrgrnd.
8. Foundation j`' ^ 59. Gas Pipe, O Undrgrnd., Test ~
�•
9. Water Pipe-Undrgrnd. `�� � � 60. Backwash Lines, P-Trop, O Undrgrnd. �
10. St�uctural Floor System �.. � 61. APPROVAL TO DECK
./.�
11. Property Sewer Line & House,Ctonnection i 62. Backwash & ReceprorFina� �-. ., i �
12. Sewer Cap � : ti 63. Heater & Vent•Final
i �.
13. Roof Dreins r� � 64. Plumbing System - Final ��'
74. Fou9h Plumbing ���) 65. Electrical•Final ��
15. fiough Electrical-Conduit 66. Solar SYstem•Final � j�t..�
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriwl�T Bar Ceiling 69. POOI/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 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing , 73. Undergrnd. Storage Tank 0 Gas � Oil
25. Roof Sheathing . 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . �
27. frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � � 77. FIXED SYSTEM FINAL
29. Insulation � I � 78. FIRE PREV. FINAL
30. Drywall Nailing I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai 79. FINAL INSPECTION
32. Electrical Power Meter-Fina� ' ' 80. FOOD CERTIPICATE ISSUED
33. Final Electric � � �� Notes:
34. Final Heating & Air Conditioning I � I
35. Final Gas Pipe�Test I �
36. Hood or Canopy �-�' N/ j�,l� //���.
lm r�- W ' ,T
37. Final Factory Fireplace � I S�
38. Final Plumbing I I I
39. Water Service�Final ! �
� .
40. Gas Service�Final ' i
41. Solar pomestic-Final � ,
42. Backflow Preventer � ; '
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
1- -
47. FINAL STRUCTURE & BUILDING �_�/Q f�% �
( I
48. FINAL PI.ANNING .
49. Electric Release to Edison � �
50. Gas Re�ease to Southem California Gas Co ,
51. CERTIFICATE OF OCCUPANCY .
No. Date
��
PFOJECT AOOflESS: S S S ANTON BL UNIi: � 7,
OWNEn'SNAME: gANK OF AMr',RICA
aooxEss: ? 0 rlAYMOND AV
PASAU�lA
818-578-7700
RBLHIENGINEEfl: HOY H�.�ia�LD NEG.NO.: C S � n�T j
. aooness: 7.?.072 CA,'�iINI:O VItJO . u"iT:
, LAGliNA HTi.LS CA 92693
PEHMITTEE: LANUINGHANI PLUMBING, INC, (818)336-7206
aooness: 19839 PdOCTOR A�� D
INDUSTkY CA 91746
UCENSEU LONTPACTOP OECIAflATION: I �ere�y afiirm Ihai I am Iicense0 untler provisions ol Chapter 9(commencing with Section
7000) o� Oivisian 3 0l Ihe Business and Pm�essians Cotle, and my license is m full�orce antl efleci.
arvuc.:057032 srareuc.:272520 ��^� ('�r
Date: _�.� � � '� y�� Signature:. . _[L _ . _
'VOflREXS' COMPENSATION �ECLABpTION: I nerehy alii�m Ihat I h e a ceriificate oi consen� Io sel �insure or a certi�icate of Workers'
impensaiion Insurance. or a ceNlieO copy thEreo� (SeCtion 3800. La�. C�.
�OLICY NO.: [�j 2% �. �$ 1. � EXP. OATE: n%/ O I I S 3
COMPRNV: CA COMP
❑ Certifietl coDY is hereby furnished. � Cetlifietl copy is file i�h the ci�y Builtling �iv on. /�
Daie: _/� — � � / 2—' APPlicani A��E ����""`b�"��
E%EMPTION FflOM WOBREPS' COMPENSRTION OECIANATION: Qhis se don neeU no16e complete0 if tAe permi im ane hunEr�tl (3700) or less�.
I cetlity �nal in Ihe petlormante ot Ihe work br which ��is permit is issu , I s�all not employ any person in�any manner so as lo become
subjec� to �he WorkerY Compensalion Laws ol Califomia. � ���
NOTICE: If, afier making Ihis declaraiion, you shoultl become suo I Io ihe Workers Compensalion'pmvisions oi the Labor
Code. you musl �ohhwi�h comply with such provisions or �his rmi� shall be OeemeO revoketl. ;r
CONSTflOCT10N LENUING PGENCY: I �ereby af�irm Ihai Ihere is a constmc�ion IenOing agency lor lhe�petlormance o� the work lor
whic� �his Oermii is issuetl (Section 3W7, Civ. C�. '"
LENDEH:
AOOflES$:
OWNEN BIIILOEfl DECUNATION: I hereby aflirm �hai I am ezempl Irom Ihe Contratlors' Slaie License Law �or �he following reason
(Seciian 7031.5 Business anA Pmlessional Code: Any city at counry which requires a permit �o conslmci, alier, impmve. Oemolish, or
re0au any stmclure. prior lo its issuance, also requires lhe apDlican� �or suc� permit �o tile a signed statement thal hels�e is licensed
pursuam to Ihe pmvisians oi �he Cont�aclors' State License Law (Chapler 9(commencing with Section 7000) ol Division 3 ol lhe Business
antl Pmlessions Code) or tha� helshe is e�empl Ihereimm antl Ihe basis for �he allege0 exemption. Nny viola�ion o� Semion 7031.5 hy .
any applicani �or a permi� subjecis the apDlicantlo a civii penalry 01 noi more �han five AunOred tlollars (5500�.
I, as owner of ihe pmpeny or my employees witn wages as iheir sole comDensation, will Oo the work, antl ihe
� slmcture is no� intenUetl or ot�ered lor sale (Seclion 7044, 9usiness antl Pm�essional Coae: The ConVacbrs' State license Law
does no� apply �o an owner of a property who builds orimproves ��erean, antl w�a tlaes such work himselfl�erself or �hrou9h
his or her own emDloyees, Omvitle0 ihat such impmvemenls are not intendetl or oflered for sale. II, however Ne building ar
improvemen� is sold wiihin one year o� completian. Ihe owner will have �he burtlen o� pmving he/she Oi0 not bui10 or impwve
lor ihe purpose ot salel. �
I, as owner o� Ihe property. am erclusively conirac�ing wiih licensed contraclo�s lo con5imct ihe pmle�� ISec�ion 7044, Business
❑ an0 Prolessions COGe: The ConVactors' Stale License law a�ws no� appty ro an owner oi Oroperty who bui105 or impmves �hereon
and who con�rac�s �or such prole��s with a coniracbr(s�license pursuani b �he Contrac�ors' Sia�e License Law). I am aware
Iha� pmof of Iheir Warker's Compensa�ion insurance 5houlA be pmvide0 io me.
� I am exempi under Sec�ion: B. 8 P. C,
�, lor Ihis reason�.
�a�e: Ownec
I ao hereby ceniiy �nai I am aware ol antl untlersland ihe requiremenls of Calitornia Healih and Sa�ety Code Seclions 25505, 25533, antl
25534 and Ihal I or any fuNre 6uilAing occupant will/will no� (circle one) neetl �o comply with saiU state codes and the reQuiremenis for a
permit �or constmction or motli�ication Irom �he Air Ouab�y Managemen� �iSlricL Resitlenlial consimc�ion applications are exemp� fmm
IheSe pravi5ion5. �
Daie'. � Applican�:
I hereby certilythal I have reae this applicalion antl s�ale Ihat Ue above inlormation is correcL I agree ta comply with all city anU county
ortlinances antl siate laws relaiing to building constmdion antl hereby aWhorize representaiives of Ihis ci�y �o enter upon Ihe above-men�ionetl
pmpeny lor ins0ec�ion urposes.
�ate: /�� �� Signatur � �
oriver s License or Social Secunry p:
16at-a6 Whi�e—Bmlainq; Green—Cade EnlorcemenP, Canary—Applican�; Pink—Revenue: Goldenmtl—Assessor
CZTY OF COSTA MESA - 3UILDING PER,vSi
PERMIT NU; P OS9860 i�LAN CHECK NO; N
CONSTRGCTION 'TYPE: IFR 5P PERMIT TYPE; PLU
JOB UESCkIPTZON i COMNERCIAL T.I. (OFFICES)
CLASN, VALUE: CAiC-VALIIE:
PERM NO; F U59860
GOVT; N ST7PP; N
P URP OS E: OTFI
SQ rT:
GkOUP OCC; B-2 /
CUN,MENTS: RE; B59854 PRIN.ARY BLDG. PERM.TT,
?f iF i( iF k±i� if iF?E 9t+E iF If aE #� 3E # �E jE iF iF-IE �JE iE # lE 3k %#if� iE iE if 3E+F iE �E #-k� K� �% iF # if ih 3E 3E iE %�lE 9k iE lt iE iE k%# IE # if 9E iE ih 9F iE� 9E #dF # 1Flt it'k iE fF 3P ##
Z O N I N G R E Q U I R n M E N T S
sETBacKs
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDTNG ---------
FRNT; cT SN REAR: FT ZN fiRNT: FT IN AEAR: FT ZN
LEFi: F3 TN RGHT; FT IN LEFT; FT L� RGHT; FT II3
PARKING REQ• PROV; PARCEL; 41050104 ZNE; REF NO;
PLANNINC- NGTES%
i
iF iE i(� �%iE �lF fE 3E iF?f iE iF # 3f ik k-iF i(� iE iE 1F iF if iF If i'r iF it ih iE # k?e iE if-if?i�iE iE!t IP # fF N� # IE iF It f(� 3(� # dF iF �IE iE # fE it� # 3F 1F',S� if ib #�ff� iF 96 N� i'r �rt 1F fh i( M• iC # iF 7F
D E V E L O P M E N T S E R V I C E 5�: R E Q U I R E M r N i' S
ZONING APPROVED FiY :,�' DATE;
BUTLDING APP}tOVED BY : DATE:
APPlICATION SSSUED BY • /� �' DATE • I/�_'!�'�
'N-iFifi%#iEil'#1E'lE'�iFiFiC�1EM'#3('f(%'iEi%3FiFM�x�%']r1Cil"ltRiFt', fFr �'re�,e 'R1FYF*Af iejtitl�'Fif'n�i�FiF'IP'7FiFiF�fkiFi('iEitY.-'Jt'r'7tltil'k!t' T'#
7F iF if-iE# iF iE if 3f %# iF 3E �)(� if 3(-it K� �1E iE-k iE iE % 7F tE fE !f iE# # if iE 3f 1E #�%if-# �lE 3E �1E iF iE f(� iE iF 9E i. : fk 3E �1F i4 !E # i(� # fE iE 7Elf fE lE �IE iF iriF iE iE iE ft iI H�# 1f iFiE #
LEGALI7,ATION:N F E E S J M M A R Y STHUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRRI�ING
PERMIT 7.00
253 SMIF/NON-RE5
PI.AN
ISSUE FEE 2U,00
BUILDING-DIV-> FER,yIT ISSUE FLAN-CHECK T'OTAL PAID DI3E
30TALS----> 7,00 20,00 0.00 27,00 27.U0 .00
AEVENUE DIVISION TOTALS--> COLLECTED; 27,(�0 OVEH/SHORT; UO
BLUG PMT PLUM,BING ELECTRiC MECHANIC rIRE SMIP/Y'01' GRAUING PLAN-CHECK
27_0�
if iE if �7E #iE fE �t' if if if k# i(-!f fE #�lFlF if i! �lE iF �It iF # iE iE # iE If� iF t iF ## iE iE if if iF #:ti it # N-i( iE if� if iE 16 iE ih fk #!h ie if 74 iF'I4 iF # if 3E lElE iFil� #!E # i!� K�'fi H� #<
I N D i V I D U A L F E E B R c. A K D O W N
TYPE QTY U E S C R i P T I O N DNIT COST TOTAL COST
PLU 1 SINK, KITCHEN 7,U0 7,00
END Jr FEES
r. U, , � " . . .
, �T'.� . r � 1
CONSTRUCTION AND PLANNh.,, r JOL & SPA
' APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service%%Pole , 52. Pool & Equipment Location �
2, Soil Pipe-Undrgrnd. � ;� 53. Steel Reinforcement ;i
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�. Footin9s 58. Eiectrical Conduit-Undrgrnd. ��'
&. Foundation .' 59. Gas Pipe, O Undrgrnd., Test �r �
�, ;�
9. Water Pipe�Undrgrnd. �� • 1 'i � ���/ 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Floor System ,� ' � i 61. APPROVAL TO DECK ��
1 t. Property Sewer Line & House,Connection ��� �� 62. Backwash & Receptor�Final ;
12. Sewer Cap �' 63. Heater & Vent•Final �� ^
i� �
13. Roof Drains �'� ,? 64. Plumbing System - Final
�/-I ,�
14: Rough Plumbing ' �!�//yM (�� 65. Electrical•Final •,� �
Q�•Ttv i
15.� Rough ElectricabConduit .'� t
, 66. Solar SVstem-Final ;-��
16., Rough Electric Wiring 67. Fencing & Access AnP�oval �
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING �
18. Rough Electrical�T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning 'FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21.� Ducts, in Structure 70. Underground HYdro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23..Gas Pipe�Rough & Test . 72. Underground Flush
24. Roof Framing ' 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation i I 78. FIRE PREV. FINAL
30. Drywall Nailing I I I �HEALTH DEPT, REQUIREMENT
31. Plaster Brown Coat � �i��i 79. FINAL INSPECTION
32. Electrical Power Meter-Final I I `� S0. FOOD CERTIFICATE ISSUED
33. Final Electric I ' � Notes:
34. Final Heatinq & Air Conditioning � �� tf�, .
.. /y,
35. Final Gas PiprTest � I
36. Hood or Canopy �'� ,
37. Final Factory Fireplace � �
38. Final Plumbing Z z.Y, '(��
39. Water Service-Final I ";
40. Gas Service-Final � (' , r.
41. Solar pomesticFinal � �
I � �'
42. Backflow Preventer � , �
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING I � i_�
48. FINAL PLANNING I ! .'a
49. Electric Release to Edison I I'
�/on
50. Gas Release to Southem California Gas Co �:,��
51,. CERTIFICATE OF OCCUPANCY
No. Date
Pfl0.1ECT RDUXESS: S S S ANTON $1. �N�T� 8 7 5
OWNEfl'SNRME:BANR OF AMERICA �
aooness:20 RAYMOND AV
PASADENA
818-578-7700
AflCM1ENGINEEfl:Fi�Y HERBULD flEC.N0.:C1IO%3
•; noon¢ss: 22072 CAMINITO VINO uNiT:
LAGDNA HILLS CA 92693
PEflMITTEE;HORIZON HEATING S A/C (714)974-3702
nooxEss:l'7853 SANTIAGO BL STE�107-243
VIILA PARK CA 92667
ULENSEU LONTNACTOP OECUIBRTION: I �ere0y atlirm that I a �c e0 unaer pmvisio f Chapter 9(comme�inA ��h Senion
7000� ol Omvm 7 0l IAe Business antl Pmtessions Coee, anE m I¢ s in full force C if
�iTYu�/,:0526�9,4n STRTELIC.:647 ss:
'— Oate:.(�'s" " � 2' Signat _ _ _ ' _
ONNENS'COMPENSRTIONOECLABRTION: I�ere�yatfirmt�atlhaveace�ilicateofconsemtoselbinsureora�enilicate Workers'
Amoensation Insurance. ar a cerlilie0 caoY �nereol (Sepion 380D. Lab. C�.
�POLICY NO.: E%P. DFTE:
COMPFNY:
❑ Cenilie0 copy is nere�y lurnis�ea. ❑ CeqilieE CaOY �s liletl un�h l�e ciiy Building Division.
�— I
Date:
MpliwnC
ESEMPIION FflOM WOBMEII$' COMPENSATION DFCU�q�1TI0N: (Th' seNo fiecd not �e wm0leje d pumt is lor one NW rM �51 W) or less).
I ceriity �hai in I�e pehormance ol �h¢ wOrk �or wt1i�A Ihi s a nan not o� airy erson N any manner so as to Uecome
sua¢cl lo'I�/e V,rkers' mDensation LawS ai C31i1 �a. r
Daie: �Ll.��� Signature: e�,�,
NO71LE: II, atler makin0 ��� 4eclarali0n, you s�oWtl beCame SUGiet1 to tAe Wark¢r5' Comptlisd�wn prOvi5i0fL5 0l Ihe LaOm
Wpe. you muv IonlrnnA wmply wit� sucn p�ohsip� or tNs permn shall �e Oeem¢d rewke0.
CONSTBUCTION 1EN01NG RGENCV: 1 hereEy aliirm Ilwt I�ere's a mnstmclion IenOing aqenty lor IM perlormxnce o� IAe wark lor
which �tds Dermit is issueE (�tion 3097. Civ. C�.
lENOEfl:
aooncss:
OWNEfl BU�LOEB OECUflATION: . I �er¢�y allirm IAaI I am ¢eempi trOm IAe COn�fatioR' Sta�e Lkense Law lor the followinB reason
(Seclion 703t.5 9usineu an0 Pmiessionat Catle: Any uty ot counry wtiic� repuires a permH to wnstruct. alter. im0�ave. aemofsn, or
reoair am' structute, o�iw to ils issuance, also reGuires the aoVh�ant for sucA permit Io lile a 9gne0 statement tlWt hUstle is Iicense0
pursuam io t�e pmvisions al Ihe Caniramors' S�aie License �aw (Chapter 9 �commentinp wilh Sec�ion 7000) al Oivision 3 0l I�e BuSiness
ana Pmiesvons Codel or tnat he/she is exempt iqerelmm antl �ne basa for the alleAetl e�emption. Pny doWtbn ol Sectbn 7031.5 by
�ny appliWni lor a De�mil su�jecis ��e aDPlicant to a tivil Denalty af not more ihan live �unGrea Aotlars (550�.
I, as owner oi ine pmperty or rtry emplayees wit� waAes as iheir sole compensation, will tlo l�e wark, antl ihe
❑ stmpure is nol imenaea or ollereU for sale �Section 70a4, Business and Pmlessional Caae: Tne Comrac�ors' Sta�e License Law
Uo¢s nol a001y lo an owner ol a D�Opetly wM OuilUs Or im0�ove5 ��¢reon, antl w�o do¢5 Su[h xrork �im5elt/�ers¢If or IhmuAh
his or ner own emplayees, pmviUe� Ihat suc� imDmvemenis are noi imentleU or offered lor sale. It, however tha ouilAinA or
im0�avemenl is SOIC wiihin onc year ol [Ompl¢Iion. Ihe awner vnll have �he burtlen ol prOvinp Atls�e tlia noi builC Or impmve
for ine purpose ol salel.
I, as owner o� Ihe Dwpetly, am ehclu5iv¢ty COniraClinp vn�� Gcens¢G [onlratlors IO Con51mc1 �he proletl �5¢tlion ]OEd, Busines5
❑ aiM Pmlessqns Cotle: The Coniractors' S�ate Licenu Law Coes not apply to an ovmer ol properly wM bmWs w ImDroves t�ereon
and w�o contracls lor suc� Orole��5 �I� a canirac�or(5� lic¢nse pursuant lo Ihe Canlracl0r5' Sia�e Lkense law). I am aware
��i o��� ol tneir Worker's Compensdtion insurance snoul0 Ee pwviOeC lo me.
� I am eRempt uMer Section: g. 8 P. C.
lor Itit rWson:
Oate: Mmer
I Oo hete0y Rnify Itut I am awaee ol anG unaersldnU t�e reQuiremem5 of Califomia Health anA Safety COUe SEctip� 255115, 25533, ane
25534 aM inat I or any Wture buileing acupant w�Nviu not (drde anel �� to comDty with uiG state coGes ana ihe repuirements lar a
Derm�l �or CWIStruGliOn or mo4ilitaii0n �rOm I�e qir Wahty Managemeni Di5lriti. Fe5i0enlial COnSINtGOn apD��WtiWs are exempi hom
ineu prov6ions.
Oate: p00�icani:
1 �ere0y ceruly tnat I nave �ea0 tnis aDPGca�ion antl sta�e tlwt t�e' ove' lormation is corre . 1 pree ta comDN ��� all city anA counly
orGinan[e5 aM Slaie IawS relaling Io buileing tanSirlK�pn an i ¢e 0 se �e i r ai � is d�y la eni¢i upon IAe a�ove�menlioneG
pmp¢�IY �oi m� etlb/n Dwposes.
oate: ���( ! ?+ Siqnature:
orivei's License o� Socia� Securiiy x:
�64b46 Whne—Bwltling�, Green—Coae Enlorcemenl; Canary—Applicanf, Pink—Revmue; GolOenroE—Assessor
CITY OF COSTA MESA — BOILDING PERMIT I�, ,
PERMIT NO; M 060104 PLAN CHECK NO: N I �"'aVT�S'IIP�Ir—�"
CONSTAUCTZON TYPE; I FR SP PERMIT TYPE: MEC PURPOSE: ALT
JOB DESCRIPTION ; INSTALLING 12 VAV BOX SQ FT;
CLAIM VALUE: 10,000.00 CALC—VALUE; GROUP OCC; B-2 /
COMMENTS: T.I. FOR BANK OF AMERICA REF:B59854
�r***+r**�*x*�r*�er***�t*�r�r�e�r�r*******�e� x �r�r�t*�c***�r�t*�r*****�t******�r�r�*�*�r*+r�r�r*�r�r*�t+��t�r*
Z O N I N GS ERTEB�AUCIRRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT: �FT IN LEFT; FT IN RGHT; FT IN
PARRING REQ• PROV; � PARCEL: 41050104 ZNE; REF NO;
PLANNING NiSTES>
i
�r*�r�e�ex�*�r*�r*�r**�r*�e�r�r�*�r�**�r�r�*�r+e**r�+�w�e*��r��r�r�**�r��r�r**�r�e*�r��e***�*+r�r�r*�r�r�r*�*+r*�*+�
D E V E L O P M E N T S E R_V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY �i DATE:
BUILDING APPROVED BY : e� DATE: —/
APPLICATION ISSUED BY: . DATE; �.�� 'Y
�tiFkiFifiFifkMifMlf�flflfififiEifffiFiF ilkifififiEifiFikif iEM
ikit3FkiFiFititifikkkkMifkiFifihifMltkMkitifkMiFikififkififkk fFihifM!lMifjflEifififiEifikifiFikiFkikiFiFiEifilikifitiEifiFitiFifiFifitk
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
PERMIT BLDG PMT PLUMBING ELECTRIC MECA78 ��C FIRE SMIP/RES GRADING
'15i SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 78.00 15.00 0.00 93.00 93.00 .00
REVENUE DIVISION TOTALS--> COLLECTEDi 93,00 OVER/SHORT; .00
BLDG PMT PLUMHING ELECTRIC MECHANIC' FIRE SMIP/TOT GRADING PLAN—CHECK
93.00
if ih if if k i! M!E 1klE iF k if it if k ik ik ik It If ff 1Flf M M 1kiE 1F 1E ik �F �Eif %if iF ik if if 1f if If fF 1! 1k kif M iF if 1f k iF if if iF 1ElE IE 1E �F 1E ik iE iF iF iF iFlE if 1E ik M iklE IE iE iF
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 12 VAV BOX 6.50 78,00
END OF FEES
0
� . � r ;
CONSTRUCTION AND PLANt. -� POOL & SPA
APPROVALS Permit �h Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical SerJite or pole r 52. Pool & Equipment Location
, 2` Soil Pipe•Undrgrnd. 53. Steel Reintorcement
�`E�ECif(C2�'('iondPit �,Utility-Undrgmd. 54. Forms
4:�flectFica! Co�QuiE-t4ndrgrnd. 55. Electrical Bonding
�-r, rr
T'�;-Sieel ReiriforceMe�ii� � 56. Rough Plumbing & Pressure Test �
�-
:`S'�'ElectricelUF.ERG�nd, - 57. APPROVALTOCOVER�GUNITE �
,. -
_�'7;;Footirigs' '�i",�� � 58. £IectricalConduiFllndrgrnd. `1
'ti�8. Foundation �j - 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe:Undrgrnd. , � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Struaural�Floor,SYstem' � ' 61. APPROVAL TO DECK �
11. Prope�ty Se t r L'in� & Ho'Lse Connection ; 62. Backwash & Receptor-Final - �
12. Sewer Cap , � � '=' �.._ 63. Heater& Vent-Final -
13. Roof DrainS- � . 64. Plumbing Sys[em � Final
14. Rough Plumb�pg`'"� - 65. Electrical�Finai
15. Rough �Electrical•Conduit � 66. Solar SVstem-Final
16. Rough �IeCIriCWiring � 67. Fencing & Access ApProval
�17. Rough�/Viring�$ign • 68. APPROVED FOR PLASTERING
18. Rough Electri�I�T Bar Ceiling 69. POOUSPA SVSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
' ' l' U' .-. Y C� -
20TRou'gh�F.gct6fy �r'eplace � ��in ¢"- � � � �T'�i.'� . qppWOV'l�E�-�G peFmit #�-
� .n ST T.d. .�i� :iRr:l� T Q -�F ? ['�
21_Dycts, �n Stiuctuie .... ..:�� ,'; � j ��. n+ 70. �Undergr,oLnd Hydro >
22.Du-s.Uentlating* . ��S � ? a#�;�-71. Produ��P�ng{7;$�as QOiI .
23; Ga`s_Piqe; Ro�gh gixTesi j r� > r � p x.� ., 72. UndergrQynd FJuiF x �'S
24£RoYff Framing � � F-� � i x> C *� � 73, Undergrritl.StoYa""Tanlf`OGas O�OiI
.\ X 1 �� A i. I .�
.K i ��V �4 T� _SI "� �r \ � f 1-�f� 2
25. Rosf S�eathing x _r •� �� ,� � 7¢:j Overheac�Hydra� x
26LT�Bar Ceiling (StZvctural) 86Monocoat * � _ oT a 7� Dry Chemical = �- C �
� n � � ,� -
27y'Fr�meaad Flashir�g ��..4 y� '' Dx r 76. Dry StanQ�:pe _� � x'� �
_,28. l.athing.& 3idin�x �: r�`,.: _� �_ '� -t� 77- FIXED�SYSTEI¢f�FINA� � U
"29. Intulation � ; � �',' 'S. "'� '� �'� y i`• 7& FIRE PREV. F1NQL > } z
' 30. DrywalFNaitlng� x��` �� = ti = �HEALTM DEPF!RE�UIREMENT
�
� 31. Plaster'Brown C6a� � ' " � '� 79° FINAL 4i�lSPECTION � �� �� ^
J L. S . P� IT� K �} Y, J� •
� 32r Electrical Power MeterFinal `-�'� x tc � �. x t' 80a FOOD CERTIRiCATE 13SUED
33��� �-r � �' -� ;n . ''� ;t,� r T '=> y;
Final E�ectric r , _,S ' �f'r x' Nptes: _ t�.:. n� L
; 34� Firial Heating &,F,.ii Conditip�ajng ,^'�'i �f �L, � � ` y r,: o. .. �, q
' 35, Final WYs Pipe-T@sf �'� = � a�; _ ��' so �',� � �
36� Hood or Cano ` s � � � �'
L PY,.c" � 9 a .:,^ i�0 ' z� ,r
,37-FinatFaMoryFiYe)Slaee � Scr o � n a. ;? �. q
� • -, , � z�. - �� :�
� 38. Final Plumbing 4, lr,� i•..�. - y .' .{. >.,,, • - x 1.
�' 39. Weter Service�Fina1 � ' •� x z- r�c�- o �• s� -• �r
Ks �r .: 4 ti
.40. Gas $ervice-Final ,` ,q„ r .> F �n r �r ' : v �� �
' 41. $olar pomesticFinals ^ •� = ��t �� M �y : ^� *
< r .: r � Lt %< 'r J
' 42� Backflow Preventer � .� � '� �� t L �
43. Backflow Irrigation � fib' i ' x R r' u!= -
Y L .. [ Y �
� X ' J�
�44. LandscapedYrigatiOnSystemnr x r �r<.� ;�7 13 i'c� �x _
.��- "
`45: Sound Attenuation - - "S : �x=t - �S =
' `� s x x. r� -[� x� - Q� .
� 46; Handicap Regulations � L x � '; • � S : � � -`
'47.;FINALSTRUCTU�RE&BUILDING ��.x ;� . �
r 1 < � - r
48.'FINAL PLANNING � ;`_:� � .,, ��' � ;,: ,y' .- �
, . .
- 49. Electric Release io Edison * ��. - +� : , ^ .
� 50. Gas Release to Southem California Gas Co '. V`.�, ,` �•�'r c ` •
: 51. CERTIFICATE Oi OCCUPANC'Y i i � ,j t:j - , j- _
No. Date
�
�
PflOJECT AOUBE33: � J) S ANTON Bi,
OWNEfl'SN11ME: BAVK OF AMr'.RICA
AODflESS: 2O RAYyOND AV
PA5ADENA
818-578-7700
APCH/ENGINEEfl: -
aooeess:
HEG.NO.:
uxiT: 8 � �
UNIT:
PEflMITTEE: COMPF�I�I�f�LON EL�c•r�re ( 818 ) 331 - 5807
aoneess: 635 SiEPHORA
COVINA CA 917?.4
IICENSEO CONTHACTOB OECUIBATIUN: I here�y atlirm ��ai 1 am IitenSeA un0¢f O�ovisions af ChaD�e� 9 kammentinA wiN Set�ion
7000) ol Oiv��sion 3 ofihe Business antl Prolessians Coae. and my license is in full brce antl elfecl.
CITY LIC.: �$� ^Cj Q 7 STATE LIC.: j S�'! S•'1� CU1S5: (' _�p
���—/��Z. Y >
Dale: Signatu ��'�%�'���—
WBREXS' COMPENSATION DECIANpiION: I hereb ' al I have a certi�icale of consenl m sell�insure or a cerlilicate ol Workers'
�ompensalion Insurance. or a certi�ieU copy ihereol �Seciion 3800, Lab. C�.
roucrxo.:1085579-92 E%P.ORTE: OL�OS�9j
COMPANY: STATE FUND
❑ CeNiiea copY is here�y Wmishytl. � Cenifietl co'nv s� \�ile0 wiih IAe ci�y Building Oivision.
oaie. / !— `� -- 4 't-- APPlitarVT\ ) �i��--.� ' �-�'�
E%EMPfIONFBOMWOHKEBS'LOMPENSRTIONOECIAM sectianneeGiw�GecomDleteGillAepermnislorOnl�uMr��5lWlal�S�f �
I cetlily ��ai in the pedormance oi ��e work lor which ��is permi� is issued. I shall nol emDloy any Derson in any manner So A5 �o become
suqect lo �he Wor4erY ComOensation Laws a� Cali�omia. ' "'
t/j
Oa1e: Signature:
NOTICE: il, after making t�is Ceclaration, you shoul0 became sublect ta the Workers' Campensatian pravisipns aLt�e LaOor � g
CoAe. y0u must �otl�e+ith comDly wiU Suth pmvision5 ar �his p¢rmi� s�all he deemeA revOkeU. �•�'�:"�' � f
CONSTflULTION LENUING RGENCC 1 hereby a��irm IAaI �here is a COnSlNtliOn I¢nEing agenty lor IAe �oiman[0�a1 I�e wark IOr
which Ihis Dermit is i=suetl (Section 3097. Civ_ C�. •?� �<�
LENDEP: � �
AUOPESS:
OWNEB BUILOEfl DECIAMT10N: I hereby aflirm ihal I am exempl lmm Ue fAniractor5' Stale License Law lor Ihe followinp reasan
�. (Semion 70315 Business an0 Pmlessional Cotle: Any ciiy o� t0uniy wAicA rtquires a permil �o cons�mct, alter, imprOve, O¢mali5h, or
I repaii any struclure. o�ior to its issuance, also requires IAe apD�ican� lor sucn oermit ta lile a sipneA statertrent ihat he/s�e is licensetl
I� pursuant �o t�e pmvisions ol lhe Conlractors' State License law (Chapter 9(commencinA �+ih Section )000) ol Division 3 0l t�e Business
anG Pm�essions Cotle) or t�al �e/she is exempl lherefmm antl I�e 6asis br ��e alleged e�emplion. Any violalion af Seclion 70.31.5 by
any appliWnl for a Oermit suGlecLs I�e aOPliWnt to a civil Denally ol not rtrore t�an five �unGrM Oallars (55011�.
1, as awne� of the pmpeny or my emDloyees vntn wages as Iheir sole compen5ation, will Ao itle wafk, antl the
❑ simcmre is not intenCeE or ollered lor sale (Secuon 760a. Business an0 Pmlessional Cotle: TAe Contractari State Licenu Law
tloes not apply lo an owner ol a pmpeny who buitds or imD�oves ��ereon, ana w�o d0es such xrork himseli/Aersell or IhrouAh
�i5 Or �er awn ¢mDloyees. O�avitleE thai Such imprwemenl5 are nq intentletl or ofl¢r¢C lOr Saie. II, Aowever l�2 builaing or
imprwement is wIA vnthin one year ai cample�ion, t�e. owner vrill have ��e bur0en o� pmving Ae/sAe Aid nai buila or impmve
far Ihe Ourpose af salel.
I, as owner of t�e pmpeny, am exclusively comracling wilh licensetl contractors m consimc� �Ae Dmject (Section 70a4, Business
❑ an0 Prolessian5 Code: The Canlractors Siare License law tices no� aDDN �o an owner o� pmperry who hmlas or imDmves thereon
an0 �vho conlracis �or SucA Dmjecls wit� a contraqor�s�license Dursuanl�o t�e Canlrattor5' Siate L¢¢n5e law�. I am aware
Ihai O�oof of IAeir Worker's Compensation insurance s�ou10 be pmvi�e0 lo me.
� I am exempi under Secbon: B. d V. C.
�or ihis reason:
oate: Owner.
I ao hereby cenity Ihat 1 am aware ol and un0ersiantl ��e requiremenis ol Cab�ornia Healt� antl Sale�y Coae Seclion5 25505, 25537, anA
25534 antl Ihat I or any future �uilAing occupan� vnlUwill nol (circle one) neeC lo comply wilA 5ai0 state co0es anA I�e requiremenls br a
p¢rmit lor consimclion or mo4ilicaiion �tom �he Air �ualiiy Management Di9rici. ReSiAential tan5lmction aOPliWiions are eeemD� �ram
�hese provisions.
Oate'. Applicant:
I hereby certify ihat I nave rea0 Inis applicalion ane stali
ordinances antl 9atelawsrelaiing�o �utlding constmction
pmpeny lor inspec/ii�on purposes.
�ate: � �_� L_=! � Signatu�P
Dnver's License or Sacial Secunly .:
above informatian is correcl.laB�ee lo comply vnlh ailcily an� county
y aul�orire re0resen�atives o� �his ciry to enter uDon Ihe above�men�ionetl
16aL46 White—Builtling'. Green—Code Enlorcemanl; Canary—Fpplicanf, Pink—Ravenuo; Goltlenrotl—Assossor
CITY OF COSTA MESA — BUZi,DING PERMiT
PEkMIT NO; E 059855 PLAN CHdCK NO: N
CONSTRUCTION TYPc.; I FR SP PERMIT TYPE; ELE
JOH DESCRIPi'ION ; 6850Sr OFFICE T.I., Rn;#BS9854
CLAIM l'ALUE: CALC—VALUE:
PEkM NO: E 0598��
GOVT: N SUPP; N
PURPOSE; AI,T
SQ FT:
GRODP OCC: d-2 !
CUMMEN'TS: BUILDINGRES'iACK STWY
It 9FiF 9L 9E IE �k # 9F ]( k-% dt fF k� iF iklE �1f �ff �1F iF iE �1G �M i's Jt iE �%�IE iE %� �R if iE iF N%�If X.� i( ��� �1E �X� •k iF �k IE �k �K 9f iE iF It �k if dE �lf �1E �Y i! �Y If dE %�%jf �lE # i!� i! �lE i( �k i4 ## X
Z O N I N G R E Q U S R E M E N'f S
5 E T B Xt C K S
------------ NAIN BUILDING --------- --------- ACCESSdAY BUILDING ---------
FRN'T; FT tN REAR; FT ' IN FRNT; FT IN R�Ak: FT IN
LEFT: FT II3 RGHT'; rT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• FROV; PARCEL: 41050104 ZNE; REF NO;
PLANN3NG NGTES> �
i
�*�r**##�*�x#*�tx��rxt�*�**��r��t�*�t�t#x�,r�3�x*#,r�r*��x•�c#u x rt�x�x�tx•�tx x#�r#x���t�rce�r�t f� �r� x#x�*�#x�*
D E V E L O P M E N i S E R V I C E S R c; Q U I R r: M E N T S
ZONING APPRUC'ED HY �'�� DATE;
BUILDING APPROVED BY : •� DATE;
APPLICATION iSSUaD HY; !'J DATE; 1I�
ikitM�iklf�ititiEJE�E�)f�3E�1EiPIfiEiEiEittEi(�it3"r�t3�FirTr�r+r�es:yr�rF�F3F��xx'3Ez 'vrTriFi'rn—irxitiFir irxk##ifkiF#iE#itu xx�r x�irx �#iF
if iE iE iE fE # iF iF if -!E iE # 7f 3(� !F i6 iE # iF iE # iElFiE # if-3E �lE i(� iE k fE?Eii iE lE if ik iE ## if .Y iE # ih iE k if # ik %rt iE 3k )E iP 1E iP # iE iE iF if ## it iF i8 if N� iF if 1f ## i(� ##
LEGALIZATiON;N F E E S U M,K A k Y STKUCTURAL SEGMENT;N
BLUG P1�:T PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRAbING
PER,NFT 96, 20
SOY SMIP/NO,V—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERNIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 96,20 15,00 0.00 111,20 111,20 .00
REVENUE DIVISION TOTALS--> COLLECTED; 111..20 OVBR/SHORT: ,00
HLDG YM'I' PLUMHING £LECTRIC MECHANIC FIRE SMIP/TOT GRAUING PLAN—CHECR
111 , 2�
1F iE df iF it i! iE # iE iE # 1E iF # ik # if !E if!! iE iEit if iF 1E iE jf i@'lE # if if iE iF iF i(� ik1F iE iF 1FiE ff 31� ## 1E # ie # il�lf �1E 1E iE # fE if # 3F iE i4 #!F iE 16 7t!h iF !k # iE #!f'.f # if if
T N D I V I D U A i, F E E B R E A K D 0 W N
TYPE OTY D E S C R Z P T I O N UNIT COST TU�AL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. ,75 15.00
ELE 76 FIXTURES LIGHTING ADDIT'IONAL EA, ,45 34.20
ELE 20 RECEPT/O�T1;.ET 1 ST 20 EA, .75 15.00
ELE 30 RECEPT/OUT'LET ADDITIONAL EA. ,45 13,50
ELE 10 RECEPT/SWIT'CH 1 ST 20 EA, ,75 7,50
ELE 1 SUB—PAtdEL 11,00 11,00
END OF F£ES
CONSTRUCTION AND PLANNiNG POOI & SPA
APPROVALS Permit # Date Inspector pppROVAIS Permit # Date Inspector
1. Temporery Electrical Service or Pole 52. Pool & Equipment Location -
e
� 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
'` 3. Electrical Contluit Utility-Undrgmd. 54. Forms
1
4. Eiectrical Contluit�Undrgrnd. � 55. Electrical Bonding -
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrital UFFR Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Eiectrical Conduit-Undrgrnd.
8. Foundation _ - 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgmd. �
10. Structural Floor SYs[em � 67. APPROVAL TO DECK
11. Property Sewer Line & Hou;e Connection � 62. Backwash & ReceptorFinal
12. Sewer Cap � 63. Heater & Vent•Final '
13. Roof Drains . 64. Plumbing System � Fina� �
14. Rough Plumb(ng 65. Electrical-Final
15. Rough Electri�al-Conduit '� /p2 66. Solar System-Final
!i
16. Rough Electric Wiring ���� 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
16. Rough Electri�al�T Bar Ceiling �?/ �QZ 69. PQOL/SPA SYSTEMS FINAL
79. Rough Heating & qir Conditioning `3 ' FIRE DEPT, REQUIREMENT �
20. Rough Factory Fireplace ' • APPROVALS Permit #
21 . Dutts, in Structure � 70. Underground Hydro
22. Ducts, Ventildting �. 77. Product Piping OGas ❑Oil
' 23. Gas Pipe-Rough & Test . � 72. Undergrouod Flush
24. Foof Framing • 73. Undergrnd. Storage Tank O Gas � Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Fl�shing 76. Dry Standpipe
28. l.athing & Siqing � � � 77. FIXED SYSTEM FINAL
29. Insulation I � 78. FIRE PREV. FINAL
30. Drywall Nailing ' I � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . i ' 79. FINAL INSPECTION �
32. Electriwl Power Meter�Final I � I 80. FOOD CERTIFICATE iSSUED
33. Final Electric ��L' ID "`�IL %� Notes:
34. Final Heating & Air Conditionin9 � ' I
i
35. Final Gas Pipc-Test �
36. Hood or CanoPY � � �
37. Final Factory Fireplace � -r
38. Final Plumbing � � �
' 39. Water Service-Final ' � I
40. Gas Service-Final i � '
41. Solar pomesticFinal ' I (
i
42. Backflow Preventer � �
.43. Backflow�lrrigation
44. Landscape Ir�{pation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & SUILDlNG � � '
I I �
48. FINAL PI.ANNING � � , j
,49. Electric Release to Edison � � �
50. Gas Release to Southem Califomia Gas Co � � !
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�� I
CS
PF0.IECTAOUFESS: SSS ANTON BL 0N1T� 875
OWNEP'S NAME: BANK OF AMERICA
nooness: p0 RAYMOND AV
PASADENA
818-578-7700
AHCNIENGINEEfl: ROY HERBOLD REG.NO.:CSSO%3
aooxess: 22072 CAMINITO VINO uxir:
LAGUNA HILLS CA 92693
PEHMITTEE: GOLDEN STATE FIRE PROT ( 714 ) 356-5644
aooeess: 15777 SLOVER AV
FONTANA CA 92334
LICENSED CONTBACTOfl DFCL4flATI0N: I here6y aifirm that I am licensed untler provisions ol C�aD�er 9(commencing with Section
71100� ol Uivision 3 0� I�e Busine5s antl Prolessions CoOe. anU my license is in full force an0 effect.
ciTvuc.:007649 STRTELIL.:3SO�IZS cuss: 16
oa�e: //�l �%'y � Signawre:—���
WOHNEflS' LOMPENSATION OECIAflATION: I nereby affirm t�at I twve a cenificate ol consent Io self-insure or a certificaie af Workers'
Comoensaiion Ins rdnc , or a[ nilie o ereol (5¢ciion 3800. Lab. �
=oucr xo.: (� 2� PC� 9��'� � E%P. DRTE: 3 I O 1 I9 3 .
omvnxr: REPUBLIC IND
J C¢hdie0 toOY is h¢re�y IUmiSheO. �LG Cetli�ieG Wpy i5 �ilea wilh ��e tity BUiltling Division.
Oate: �` �� �� � � Applicanl � �
EXEMPTIONFPOMWOPKENS'COMPENSATIONOEClAM710N: RhissecUannettliqtbemmpletedilthepermtisiaonehunOm0�5t00�orless).
I cerlify Ihai in Ihe Oerformance ol Ihe work lor which Ihis permit is issuetl. I shall nol employ any person in any manner so as to �¢come
5u01ec� to �he Workers' Compensation Laws 01 Calilomia.
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; F 060011
PERMIT NO; F 060011 PLAN CHECK NO; 09427-92 L GOVT: N SUPP; N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE; FIR PURPOSE: OTH
JOB DESCRIPTION : 6850SF OFFICE T,I, (FIRE SPRINRLERS) SQ FT:
CLAIM VALUE; 8,300,00 CALC—VALUE; GROUP OCC: B-2 /
COMMENTS; RE; B59854 PRIMARY BLDG, PERMIT.
�t**�t�t�t�t**�t�t*�r�e*��r�r�r**�r***r*�r�r**��r�r*r�r�e�e�e�e*�t��t�r*r�t�t*�t�r�t�t�t�t�r�r*�r*�t�r�r�r+�*�t*�t*�r�t�r�t�r*�t
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ PROV; PARCEL: 41050109 ZNE; REF NO:
PLANNING NO'P'ES>
i
if ik M k IFlf k!f M k N if if �k if iklk Iflf kif iF �f if if ik if if 1f �f if if iF1k if iF ik it ik ikif iflF iF i! 1FiF k iE if iF If �f �k�F�f k ik �F k k if it if k if iF iF ik It �f �! 1f if �t it �f iklE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY . DATE;
Oale: Sipna�ure:
' NO7ICE: u. aner making ihis aeclara�ion, you snoul0 become su�iect io the Workers Compensation provisions ot tne Laoor BUILDING ApPROVED BY ,
Cotle. you musl fotlhwilh comply wilh such pwvisions or Ihis permi� shall 6e tleemed revoked.
CONSTHUCTION LENOING RGENCY: I nereby allirm Ihai I�ere is a cons�mction lentling aBency �or Ihe peAormante ol Ihe work for APPL ICAT ION Z SSUED $Y ;
which �his permi� is issue0 (Section 3097. Civ. C). i61tltiElklfififlklFifl6{EiF{f�lifiFltfFlf{E
LFNOEfl: iFMKKikItlf�fMikitMfkifiEMiFifiliflFk
aooxess: L EGAL I Z AT I ON : N
OWNEB BUILUEN DECLAPRTION: I here�y allirm tha� I am exempt Imm �Ae Conimctors' $late license Law �or t�e �ollowing reason
(Seciion 7031.5 Busine55 and Pmfeuional Cotle: Any tily Oi Counry whic� r0puires a permi� IO cans�mCl, al�¢L impmve, aemoli5h, Or
reDair any slrucWre. pnoi to its issuance. als0 requires Ine aDolicani for sucn Derm� �n hle a siAneA statemenl t0at hpJsne ¢ IicenSeA
pursuam to Ihe pmvisions ol Ihe Conlraclors' State litense Law (Chapler 9 �commencing wil� Seclion 7000) of Division 3 0l Ihe Busineu
an0 Pmfesvons Coae) or Ihai �e/Sne is ehempt IAertlmm aM I�e �asis �or th¢ allegetl exemO��On. Pny dola�ion al Se[Iian 703L5 by
any applicant lor a permit SUGIeCis Ille apD�icani to a tiWl p¢nally ol nol more IIWn �ive huntlre0 tlollars (fSW�.
1, as nvmer of t�e propeny or rtry emplayees wit� wages as tAeir sole comDensation, vnll do ihe work, and the
� slmcwre is no� intenGetl or altered lor sale (Section 70A4, Business anU Pmiessional Code: TAe Conlractors' State License Law
tloes nol a0�ly �o an owner ol a property who Ouiltls or impmves the�eon, an0 w�o Uaes su[h xrork him5¢II/�er5¢I� or thmug�
his or her own employees. pmvieea �nat sucn improvemenis are not inten0e0 ar olleretl lor Sale. If, trowever Ine euilding ar
I im0�ovemenl is sold wilhin one year of compleiion, ihe owner wili �ave �he bu�den oi proving he/s�e Oitl nol �uiltl or impmve
for ��e purpose ol sale�.
I, as awner ol Ine pmpen , am eMclusivelp conimcting with Iicense0 coniraclors to tonslNcl lhe o�olect (Section 7044, Business
❑ anG Pm�esSions Cotle: TKe Camracmrs' Slate License Law Ooes not apDly to an owner of pro0eny wt�a builtls ar improves ��ereon
antl who tonirac�5 lor Suc� project5 wil� a Coniractor(5) licen5e pur5uani �a IAe ConlraCiaR' Siale LiCenSe Law). 1 am awafe
thal pmof ol Ihelr Workei's Compansa�ion insurance s�ould he pmvidetl to me.
� 1 am exempt under Seclion: B. 8 P. C.
�or Ihis reason:
Date: Owner
I do �ere�y cenily inai I am aware ol anG untlerstan0 iAe requirements af Cahlornia Healih anU Safeiy COAe Sections 25505. 25533, an�
25534 ana @at I or any �uWre builtling occupani wiil/will no� (circle one� neea Io comply with sai0 slale coAes and Ihe repuiremen�s for a
permit �or cons�mclion or moUtlicalion Imm Ihe Air Ouali�y Managemen� �islritt. Revdenlial canslmtiion aODliwiions are exempt �mm
IhQSP O�OVI5i00S.
Oate: POVlicant:
I�ere�y cerli�ythat I havereaa��is aOVlicalion ana slale Ihait�e aboveinformalion i5 torrecL lagreeto comply wit� allCily antl couniy
orOmances antl s�a�e �avrs re�ating �o builOmg cwrsimctbn and hereby awhonxe reo�esenta�ives ol ih6 cily to enrer upon Ihe aUwe-mentionetl
pmpetlY �or inspection purpoLses. —�'7�
Oate: �/�� 9� / f.�— Signature: L ' _ —
oriver's ticense or Sociai $ecuriiy x:
16a�.a6 White—BmlOing: Green—Cotle Enlo¢emenL Canary—Applicanl: PinM—Rovenue; Goltlenrod—Assessm
.
DATE: �
IE �t �E if if iF k iFit iE if 1E �f iEik IE iE �E #W iE iF iF k iF iF if �Flf iFif It �flf 1E if iFiE 3f if ik 3E iF iF ikiE 1F 1F IE �F
F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 108 00
PLAN ' 70�20 SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—>. PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> ,: 108,00 0,00 70,20 178,20 178,20 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 108,00 OVER/SHORT; 00
BLDG PMi PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CNECK
108,00
itiFiF /k1Fik IElE iFiE if 1E 1E 7flE iE if iklE 1E 1E ikitlf iElf !f iflFlf fkitk ik1E 1E 1k 1t 1E it if iFik iE 1k ikikiEif lF1k�f k iE ikiElk ik1! 1FitiElE iE iE iF iElf 1F1E 1f if iElflElF ik iflf
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY �� D E S C R I P T I O N UNIT COST TOTAL COST
FIR 108 ' FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1,00 108,00
END OF FEES
, ,
. ; r
CONSTRUCTION AND PLANNING . P� & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
J
1� Temporary Electricaf Servrce 6r Pol� r ' 52. Pool & Equipment Location - j
�� �
2. Soil Pipe-Undr rn,d. 'L'•' ✓-'� . 53. Steel ReinTorcement �}.
.D✓.� f_ S4' .Y
:�: El�ctr� - Q uitl�ility-Undrgmd�D � 54. Forms
� 4: ElectFieaFE6"- Lii-lY`ridrgrnd y' =�n � 55. Electrical Bonding r
�i m
�'5?S�el Reiy�ij�rsemen`t= Q,S� 56. Rough Piumbing & Pressure Test �
_ E.�Electircab�t�1P£^Ft�md. - w 57. APPROVAL TO COVER�GUNITE a
' n ".i�,-n
��7..�footin�gs � `•'��"' N 58. Eiec[rical Conduit�Undrgrnd. °"
��$. Foundation i-j J 59. Gas Pipe, O Undrgrnd., Test �
i
9. Wa[er Pip�llnci'Ygmd. ,,,,� ' !�, 60. Backwash Lines, P�Trap, O Undrgrnd. '�
i
10. Structural IoacSystem ."�� ' 67. APPROVAL TO DECK i
i t. Property Sev'�i-Li �& Ho'�stConriBction �� 62. Backwash & Receptor-Final
12. Sewer Cap y �; ,r i d '1 63. Heater & Vent•Final ;q
13. Roof Drains'�• 64. Plumbing System - Final •
14. Rough Plumtii�g '� , ,� 65. Electrical-Final f
15. Rough �Iectioai�Conduit , 66. Solar System�Final �
16. Rough �ettric,'Lj'Niring � 67. Fencing & Access ApProval
,�17. Rcugh iring 5jgn 68. APPROVED FOR PLASTERING
I
18. Rough Electric�l�T Bar Ceiling - ' 69. POOUSPA SYSTEMS FINAL �
i
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - �
- .' tT�=sY S t: � -
20.rRo��h F�'ctoFy ^c� lace � xt'% d- x C=. o"x' * r ppR~VA ��Per7i�it #� =" `'' ��
.r � s �¢ �aP � 5?. ,S4 :ti S � v� M � ��..;-, > ��
21:.�u;sis, iV+ St�r,�qctucyac i`•.`.. -�S :a 5 t7 i-, x K ;70. FJndergro� Hy9ro >� � �
22. Du�is,'�ent�tirigx � r� �� � �x � r77_ Produci��irg C'F'C�s C�OiI �
23..'C,a$_Pip�;Ro�h $��est � zn � t��. m n• ¢ flx y a7Z, Undergin�d Fluah, : `S •-
24;�'Foa�f Ffamirtg �x ' t-F �4-+ x J G^ x*- 73a"Undergrn�' Stor'a'Q"G.ziank�] Gas O�1
r-, ..x ��:� .v. ^s Y �-:x�c .
25. Ro S athin Z fv ,r. , _� Z,x: x v �r � _
9� � 9 m��: �L v x ;> t7K x 74t�Overhead ��� -�'.Z,_� �
26rcT�Bar Ceiling (Srouei�ral) &.51Atlnocoat x � �' �'�* * 75=bry Che i ail � y�" �- =T'
27�Fr �me agd Flashjriq� � T� x�. }�� M 76yDry Stanc�t�e -�.r�'. �� � S "-
t-28. Lattling�& $ldin �+� r -�¢� +X % F ••� x 77� FIXED �TE, • INAC% � r, T ��'t,�]�5'
.. ..
T29. In ulat� n c ".,, .. .. ? �< ?l :� x i " .-�_/ �„[ r7Z W •
�, 0 . xx ,r. �:� : x 78SFIRE PREV. FIPI[tL, x7 �
J � �
*30. DrywalllVaiiing �� '� ^ M �-' iiEALTFFDEP'6: FtEQiiIREMENT
v ' { Y
'.�-37. Plaster �{ovpa CQ3t; S j�.._� ;; "�� x 79nFINAL If�ECTI,t�N .'�� � s
� C-
:-327EIectriCal Power�ete7•Final� x ni ��: �:80[aFOOD CERTIFCCCCfE ISSUED�
.-. , /I:
. `` 1 �% � �T :1f tL'� � �K #. T �T
�33SFir�l EteFtric x in f ti � _.K x N�E25: .� .:� % xR.
:•_34f�Firtgl Heatirtq & �ciaCoErditioriii�� C� :•: � ` '' x :� S ns 'z .5 ' �
-• . m . r � x �- c. s! 2
r C� Ti ': !K '� +: x (l Cl� ?:S 'K -
, 35;.�Fin`31 G� Pi�-Tes� C; •• � � i- r �. �� `,ti ,
•. :
.o36.�HoDd oqCanoPY^x � i m-'- x r '%> - x' S_ C�u ' Y�., *'r
r � i r �' � .� -r
_37CFin�,l Fa,$tory Fire(�lace� ��_� � z�`' x�x - y k sn;
-38cFi�ai Plmnbing ac ;u �.... � .r. ' y i: z 5 i-+z x x -
Y
39��,.VJater S€�vice-Finay � � `� ; � ! � n � ^C R'^ "�
��40.� Gas Sery�ce-Final K� ,ymCr y x;n 7� Y O�% cn� x� �-
�
�=41: �Solar D'omesticPir�IS �! .. x �"• ' " * i � � �o r x x
Y � t� �
�42.'Backflow Prevente� ji �; �" :: � c�'.T� . .y � v: ,;, '
43. Backflow Ir atiorf` �^yS '� �` � �`''� 7�' ' � `
� u } .w �C s ;: 't3 / r� •
- x A .. .c .r. - ,
�.44. Landscpge Ircipation Systerx����j �x w _q - �• .^x x „ �: v �-+ ^C'� ,�
�
's45:=Sound Att uatio�Y �'aE"' �r > S. 'r� - -�' M ' +- 7x �?� �
> 'r� � :c r �TI .*1 ?: x � 6 . +:
=46 „Handicap R�gulatiq�s '" G � " �� � ��i � � � S cJo S
'47:>FINAL STRGICTURE & BIfCLDING x �' - :'' S ?�
s � x x; �x* >•
'48:',�F1f3�L PI.A`NNING i= r �r n' �;� x.� _� .n v. x -
r. �
�=49� Electric Release to'fdison � r = � + R = �K i • -_ •-
x ..- =�' t. n y • c
'�50.�Gas,Release to Souihem Califo5nia Gas Co ,F �� � �: ' iv - :1;. �x �, •
..51. CERTIFICATE OF:OCCUPANCY ;: ; r- i: ;rc � x - o
No. Date
�
1
y
�oonEssaem�owa: S55 ANTON BL
owr+Easru�Ei�aa^*+: SAKIOKA FARMS
IDDRE55: PO B�}{ 2 � 9�]
TERMINAL ANNEX
„ �vci. wuiva �ooxFss:
uNT: 8 TH
�xcxReeroeu+owvn: INTERIOR ARCH 2136232164 ��� 9378
�xcx:one++o.•s�ooxess: SSO S HOPE ST uxr: 1100
L.A. CA `�0071
ca+m�marsw�ue CAL—PAC CONSTRUCTION (310)645-3500
CprtPACTON'BM411N0 6076 BRISTOL PARKWAY
moxFss CULVER CITY CA uaao.: 392102
90230 uNr: 106
LICENSED CONTPACTOHS OECL/�BATION: I hemby eHim unMr peneYy IN pe�jury �hel I am licensed uMer proviaione d Cheqer 9
(mmmendnp xilh 3ec�ion ]oo0) M OMeion 9 0l I�e Buainen enE Prutnebro Cods, uM my license u In lull bm uM eMea�
cm uc. No.: uc. cuss: g uc. No.: ;; �], r, , ^�{ p,
Dete: / Comr ar:
OW NEfl BUIL R UECLAPATION: I hereby eifirm wEer peneYy psrlury Ihet I em exemq Imm the Conlrepon Licenae lew lor I�a
lolbw'vg rmwn (SeGion ]031.5 Buaiiross end PMeeeiom Cade: Any ciry a caunty whidi iequirea e pertnX to oonsVucl, eller, improve,
� damoluh, or repai arry ewnure, priw w da uwarce, ebo requim ihe epplirant tw euch permil to file e ap�wd etalemanl IMt �a or sM
u IicenaeE purnien� lo IM pv+isme d Ne Conlretlaa Licame law IChaqm B(canme�iq xilh $ed'pn 1000) d DHeion 3 d Ib
Bu4rieas erd RManore CaEel a Ihel ha a Me n ummq ihereham eM tM bean la the elbped exemqion. My voW ion d$equn
103t.5 by enY eOPh�t t« e permn aubjew IM ep0licem to a civil panelry d'wl mae Ihen tive �uMretl CaAen �55WI1�
� 1, es owner d Ihe properly or my empbye» wIh wepea es tMi sole mmpenaelion, will Eo ihe woM, eM IM shunure e ral intendeE
a oflered br eele (Secibn ]oaa. Busnesa entl Profassions Code: Tha Contrecion License Lew daea nM epplylo an owner d WWaM
who bulda a inproves Ihereon, mM xTro doae auch wwk IimsaN w Mnell a ihraph he a Mr own empbyees, O�dad ihm auch
impewamenn ere nd in�eMed a dlered lor eab. tl, howevm, tM Wiqiiq a impovemem ia soM xilhin ma yeer d oompletion, the
owr�arAuiNx xill hew iM buNen d pwiip M1e a sM1e tlitl M Cuik or impewa la ihe q�ryoae d eeb�.
� I. m oxner W Iha V�W�Y. em ud�'M' contreaiq wnh licenaed wnlrecton lo wralrua Ma WMetl ISeaion lfH6. &nirisa eM
Pmlesaian Coda: The ContreCae t'xense Lew does mi epply b an owrwr d qopeM ��itla a imqwes ihereon eM xfio
' con�rene Iw euch Drol�s �h e conirapor�e) IicansaC punuent to ihe Conirenan Licanae Lew�.
.
� I am emmp uMer Sacfwn: B. 8 P.C., fa ihia reeaon:
�
Date: �� Owner
i eo nerd�"�anM �n� i� a+�e a�e ��i�e in, rea��reme�� a ceia�� H.enn.�e sman cod, saa� zsws, zssa�. �a
255�4. end Me� I or eny Mure buikirp ax�pent vnll / w11 nrn (arcb wre) naed b camqy w1� sek ete�e mEee eM iM repuiremanre br
e pertnn /ormneVuction or madifice�ionhwn ihaAir�6Tnyl.ianegament Dis�rid. RniEenliel mnst'ud'an epD��ione ere e�smq Irom theae
pransms.
oa�e: Avd���
WOHKEfl'S C04VENSATON DECLAHATON: I hereby dfiim uedx penelly d perjury aro d tlro lolbwirp detlaiuiaa:
� I heva eM wiG mainten e cerlXcele o/ canseni to neM-ineure lor xoMars mmpammion, m providad lor by Seqian 3]00 d the lebor
COEe, lor iM parlortnence oi �M �w�k la which thia permd ie inueE.
� i n..�. e�d m� �oian wake�s• canro�� me�ra�ca. m rca���ed M sea� a�ao d��no, code. ro. me wn«m.�ce a me
� work la xi�icM1 tM1ie permn ia mued. MY waMert oompensalbn insurerce cemer vM pdicy number us:
c�,: FIREMAN'S FUND EXPIRES
vwryN�mn�,: xwr nv5yoosi 02/O1/96
� f*�Is aeniw� n�d nw aa �awm � me Po�e �a ro, aro nu,�d„d dorbm �tiool w i.,..�
I� I cenN �� in ihe peAom�enw ol iM wak Irn xfich thin parmn ia iaeuetl, 1 ehell irot empby eny penon in eny menner ao m to
m�ome .�Mw io me .on«s• como��� iewa a cdno�,b. ena ea� mm n���• �,.,.,,.... wqaq.m m. y�yn�•
De�e: - App . . -
Wamine: Fellun ro iscuro workw�' compenuHon coverps b unlewlul, antlW/l �ubJwt an mrp/oyw ro ctlMiul pxultlu ena
dtll flms up ro one huntlrsrl fhouvrp tlollen (5100,000), M �Wltlon ro M� roaf ol rompsiueflon, tlarrMpu e� prov/tlN br In
SxHon 3]O6 0l M� I.�bar CaW, Inrorss4 antl �fromsy'a /ess.
CONSTFUCl10N LENDING AOENLY: I MreEy ellim urder pereM1y W perjury Ihel Ihen u e mnxivaion bdirq eparrcry for the
�IBf�IX111811CB O� 1118 NIXk iIX W�1M�11�16 GB�� B C9YBj ($BCIOf1 �i. CN. {�ii.
LENDER'S NAME:
LENUEN'S PDOpE45:
I eerlily �het I heve read this eppliemion eM sleb �hel ihe ebove in/wmetbn u mrtea.l peee to e«nply wilh ell tlty eM munly oMinenms
eM stma le� relelinB io buiWvp ownVwion eM Mreby eWr�¢e repreeenieiivee d Ihis irly to enler upon �M ehwo-mentioned peopaity
Iwincaudiow�pir�gs. / �
Data: �J�� ��] J
/—
(5151d6.WP) WhGo-Buildvq d Selety: OreemFle; Canery-Appicent: Rnk-Revenue; Goldenm�Asamsor
CITY OF COSTA MESA — BUILUING PERMIT
PERM NO: B 074633
PEP.MIT NO: B 074633 PLAN CHECK NO; 03720-95 A GOVT; N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 20,000
CLAIM VALUE: 360,000.00 CALC—VALUE: 3$6,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
�**�*�****�*�r*�r��u�***+��*�***�******�r+�**x*;�*�**�*�r�����******�**�**�c�*�**#��***
Z O N I N G R E Q U I R E M E N T S �
S E T B A C K S
------------ MAIN BUILDZNG ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: L�DC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR 8TH FLOOR FOR 76 PRODUCTS COMPANY
� .�. � /} _
if iE iE iE jElE it �1(- X' �lc if 3E 9E 3E 9FlE'7E9E �If !E iE 1f �)E 3E iE iF iFiE if if')E 3ElE 9E jE # if i(� 1E 3f iE �E 3E 9E'lE �E 3E iE iE �IE if �E 1E-1E �E iE'1E iF �lE 1E iE 1E iE dE iE i� iE 1E iF'1E i't if iE 1E if iE iE 1E if
D E V E L;�c.�.P�M E N�T S E R V I C E S R E Q U I R E M E N T, S
ZONING APPROVED HY � ICl� DATE: Cti LS�
/ •
HUILDING APPROVEL}/BY�� : d DATE: �� '
' , �
APPLICATION ISSU*ED BY
!E 3E 9E 9E dE iE if 3f 9E iE if j' 3f * iE ib5i jF�E 1E �)E
LEGALIZATION:N
BLDG PMT
PERMIT 1,644.00
PLAN 267.15
F E E S U M M A R Y
L � ---
PLUMBING ELECTRIC �MECHANIC FIRE
_ �.
i
�
DATE: ��. �,;
�EiEdEiF9E*3fjEiE it., i�F3E3Eif
STRUCTURAL SEGMENT:Y
SMIP/RES GRADING
SMIP/NON—RES
81.14
C
BUILDINGEDIV—> PERMIT ISSUE PLAN'—CHECK - TOTAL PAID DUE
TOTALS----> 1725,14 0.00 '�2.67>,15 ' 1992.29 1992.29 .00
� .
REC�ENUE DIVISION TOTALS--> COLLECTED�: 1725.14 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1644.00 ��; 81.14
1� —�
iE iE iE iE 3f iE iElk iE �E 3F if 1E aE if iE �E iE 1E 1E iE IE 3E 1E 1E �E if iElE �E �E 3E iE fE 3E �E 1E 1�F 1E �E iE 3f 9F �f fE �E 3E 3E if jf if dE 3E iE jE 3E iE iE fE iE iE iE fE iE iE iE iE iE 3E iF 3E iF jf ff iE iE fE 1Elf
I N D I V I D U A L rF E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N' ' UNIT COST TOTPL COST
- 71 7
SFC 20000 OFF—INT. ALTER TYPE 'I;SI'F.R. —Al'ER 18.24 364,&Q0.00
SFC 20000 EQU—ALT COMM. SPRINKL�R�8Y5 —AC'ER .36 7,200.U0
SFC 20000 EQU—ALT COMM. AIR COND; " —AVER .72 14,400.00
END ;GF FEES
1
/
�i �JU14�3?i-^,C119?.'.'?3 �-+�'Y' 1�:=.'
�A7C: !G,'73.'?; Tili�; li:10
:. `-S�S
CONSTRUCTION AND PLANNING ���'"'Pa
Date Inspector Date �Inspector
APPROVALS Permit # APPROVALS Permit # i,
� '� -► � .
1. Temporary Electrical Service or Eo'I� - 52. Pool & Equipment Location �.
2. Soil Pipe-Undrgrnd. .. 53. Steel Reinforcement � � r•
r
3. Electrical Conduit UtilitY-Undrgmd� 54. Forms ' ' .�
r
4. E!ectrical Conduit�Undrgrnd. ,� ' 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Piumbi�g & Pressure Test „
6. Eiectrical UFER Grnd. 57. APPROVAI TO COVER-GUNITE •
; �.
' 1. Footings � 58. Electrical Conduit�Undrgrnd. �� �
� 8. Poundation � 59. Gas Pipe, O Undrgrnd., Test � '�
9. Water Pipe-Undrgrnd. 60. Backwasb lines, P�Trap, C7 Uridrgrnd. �.�
10. S;ructural Floor $Ystem 1 � 67. APPROVAL TO DECK � ��
11. Property Sewer U�e & House Connection , 62. Backwash & Receptor-Fina` ,'
12. Sewer Cap . ' . 63. Heater & Vent-Finai '
13. Roof Drains t� 64. Plumbing System � Final '
74. Rough Plumbing ' � 65. Electrical-Final ' �
' 75. Rough ElectricabConduit • 66.'Solar System-Final �t �
i�
16. Rough Electric Wiring � � 67. Pencing & Access Approval � `
� 17. Rough Wiring Sign ',`�,' 68. RPPROVED FOR PLqSTERING �'
18. Rough Electriral�T Bar Ceiling 69. POOUSPA SYSTEMS F�NAL
' 79. Rough Heating & p�r Conditioning � - FIRE DEPT. REQUIREMENi
20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72, Underground Flush
24. Roof Framing 73. Under9rnd.StorageTank C7Gas ❑Oil
25. Roof Sheathing 74, Overhead Hydro
26. T�Bar Ceiling (StructuraU & Monocoat 30/p.d /iY 75. Dry Chemical
��.�
27. Frame and Flashing ��./�� � 76. Dry Sta�dpipe
28. lathing & Sidiog � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. DrVwall Nailing �/3��� HEALTH DEPT. REQUIREMENT
'31. Piaster 8rown Coat 79. FiNAL INSPECTION
32 Electrical Power MeterPinal 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes:
34. Finai Heating & Air Conditioning � ��
11 �D -
35. Final Gas Pipe-Test w�IL Gl.q�y -«Q----��
JYL
36. Hflod or Canopy (
37. Finai Faaory FireP�ace
38. Final Plumtring
39. Water Servica-Final
40. Gas Service-Finai
47. Soiar pomestic•Final
42. Backtlow Preventer
A3. Backflow Irrigation
R4. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulat�ons
47. FiNAL STRUCTURE & BUILDING �/�c� �/6
48. FINALPLANNING
49. Eisctrie Reiease to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
N0. Date
yl
�
J
wonessaemioue 555 ANTON BL
oxxexsruYeiFiwwm: SAKIOKA FARMS
i10DNE55: POI B�}t 209%
� --� TERMINAL ANNEX
�VPL. WUIIIIG iWOPE54
uur:
8TH CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 074702 PLAN CHECK NO: N
CO�ISTRUCTIO�1 TYPE: 1—FR PERMIT TYPE: STR
�xcx�one�ffn INTERIOP. ARCH.2136232164 uc.ao.: 9378
n
wcx.on�•seoonEw: 550 S HOPE ST urrt: 1100
L.A. CA 90071
coeimecTarsxu� SWINERTON 6 WALBERG ( 213 ) 896-3400
LONf1iAttOR5YN18lG 865 S FIGUEROA ST
wo�ss: L.A. CA ucea.: 92
90017 uM: 3000
110EN5ED COHrNRCTOflS OECLANATION: 1 Mnby dfim uMer peneiy d pepury �hM I am IironmE uMm porieims d Clapw 9
/comme�rg wnh SeMion 1000) d Oivisian J d Me &nimm vd Profesabne CoJe. enE mY licema o in 1 I laca erd eXep.
cmuc.No.:046279 uc.cuss: B uc o.: 97 XP: 0/95
o�a I nTz(� �9� ��� �
OWNER BUILOEN UECLANRTION: I Mreby elfiim urMx pera�y d N �� � em uen 1 Irm IM Camretlore lirona law lar IM
Idbw'eq �mvon (�ion ]031.5 Buaima eM Prdmsions Code: A cly countY �� � e pe'mG to ambucl. �Am, improw.
amdah, w repei eny mrucwre, qbr a Ea bwerce, ebo repuime IM irent lar auch pen ' le a egred etmement Net M a aM
ikemee w�� io ma a�• a m. comrmon unose iew Icnea� s(m�e�a�a �mn s.ao� �000) a o�.�ma� a a in.
ewmesa eM Profesvionv CaEal ar tlal ha a eha ia examq thareM1om eM ihe batls lar ihe elb9ed uemNion. MY videtion d Seaion
)031.5 by eiry epplimnt fw e parmu wbptla IM epplicenl lo e tihl parally W ml mae Ihen ive huMred dd4n �SSOOjI.
� I, az owiwr ol�M peopeM w my ampbieea wih wepes es ihai ede mmpereation, will Eo Ne xwk. eM Ne st�ueture 6 rwl iMeMeE
or oXared la sele I�tion ]OId. Busirwsa eM Prolea4msCode: The Contrmon Limnae lewdoea iw epply ioen ow�xd popeM
who buids a inprovea Ihmaon, ad xfw doea auch xak IvmeeX w Mne! or Nrap� he a Mr own empbyeee, prmiEeE Ihet auch
impmVemenls are nd inteMeE a dlered la sab. tl, howe�+er, ihe buJdinp a'vnpovemml ia edd wilhin an yeer d campbtion. IM
o.�,a�ua�, mn ne.e in. e�� a wd+�re na « mre eb �a w�u « �mw� �« ma wmo�. a w.1.
� I. es amx d ihe propary. em axd�nirey conveaip wil� licensed conveclae to conatrud Iha pojatl (�� ��. �i�sa end
Pmlessbna Coda: Tha Camredwa Licensa Lew doea M eppy to en aw�ar d propany who Wilda a impwm iheraon eM who
convacta Iw adi prqeas wilh e conVmw(e) I'r<nxd W��t b Ihe Conlraaon license law).
� I am exempt uMer Sxtiw: B. 8 P C., tar this reeaon:
o�a� o.,�a:
i ao n<reM canM mm i� e�.e a ane u�wersiena me reaw�amem a ce�eom� �.nn e�d smay cam s.a�. asws, zssaa..�e
2553C, end ihei I ar e�ry Mure builEiiq mvpent will / wil na (tlrcb ma) need to wmph/ wih aek elele wEae eM ihe rpuimmeMe br
a pamin/«muirvnion amodiffalbnhomthaA'e�y . erepamani Diatriq. RmiEemiel conaruction eppiralian ere �emp Imm Ihese
o�e: nod�c
WONKEF'S COMPENSATION DECL�NATION: I Mreby elfiim uMar penelly d perjury aro d ihe fdbxiiq Eederalions:
❑ I heva eM xitl meiniem e cenAiceb d conaent �o aeH-imure br v.a�ken' compe�un, es povkeE la by Seeion ]]00 d �ha lebor
cada, i« me weo��a m ub won io..w:�n m�a w�a g ���ee.
❑ InavaeMxiemeimar�xarken'oomPanealionimurame.avrWuiredMSaeiona)oodtneleb«Coda./«�n.PeAormenwdtM
work la whiM Ihn permn is isaued. MY walmn' mmpenamion imurvwe cenix eM pdic� number ue:
c�m: AkGONAUT EXFIRES
PolicyNumber: Wl.. bJ JbJL1.U774 OS/01/96
(This .section rieed rrot be compbteE / tM pemiR ia lor we hurMred tlollers /51001 a bss.J
❑ i�nny ma� �n me penormerce d �ne won� io. wncn m�a oemi � issuee. i anen � emqoy ariy par on in erry menner eo ro to
bacome wbpe to the xwkers' companselion lews o/ CalMom . end epn m il 1 e uk 1 p e euEjetl to iha xvM1en'
com sa�ion proviaona 310U M tha Lebor Cade, I nh mp wnh th NaB n.
o�a r� .zo � � � A��r�,
Wam/ng: FaNun ro aecvro wodwa'rompw�tlon roverp� 6 nd , mtl �Ivll • ect m mploysr ro ctlMn I p �Itlu entl
c/vll flma up ro ons hunJM Ilwua�nC tlall�n (Sf00,GW), /n • Itla a N� roaf o/ mo.�. �an e,m.o..., wn +� ror m
SxHon J106 0l tlle Lebor COJe, Inhrsaf, antl eMrnsy'a /sss.
CONSTPUCTION LENDING AGENCY: I hereby elfirm under penely d perryry tlat ihen ie e mnatiudion bMing epency 1« Ne
pB(�IX111811CB Ci1NB WMk�OfW�llt�l�h6 pBllll� 19 BBIIBd(.SBCIUII'.i09%, fiN.ri�.
LENDEfl'S NRME:
LENDEN'S A�ONE%:
I cerlity Ihe� I heve read ihis epplkalion and dete ihm the ebove inlwmelion is coned. I egree to rompN �h dl dry vk counry ortlinencee
end atete Ievn relelinB �o a+ilding cmwurnon end hereEy euthorize repeeanle�ivea d Ihe dly lo enler upon Ihe eEove�menlbned propeity
�°`�°�� �°°P°`P°�°' DAN CONROY
� �
oa�e: ��
,� (515t-a6 WP) Whno-�Bee9iip 8 Selely; Greeo-Fle; Cenary-Appfi�ant: Rnk-Ravenue; Goldenrod-Asxsmr
lZ�l:��1�Y�i��IliP�l
; LEGALIZE DEMOLITZON WORK
PERM NO: B 074702
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC—VALUE: 20,900.00 GROUP OCC; B-2 /
COMMENTS; 76 UNION PRODUCTS PREP FOR TI
�r+�i��-**�t**at�-�-****�***�at***************�-�tx�**+�-�x�****it*x�*x��****f�x***+�+��-**�t***�-*�-�+�-�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDTNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL; 41050104 2NE: REF NO:
PLANNING NOTES>
� „' i
iE')E �IE iE 8E iE 3E iE �E iE dE df iE iE 1E 1E'�if iE iYlE�if iE iE ff !E i�if iF iE 3E'I(-!E 1E iF iE if * iE iE iF iE iE jE #-IE if IE-1E 1E #'k'lE iE �lE �F iF 1E 3E iE 1E 3h 3E iE M' �1E �E 1f 1E"i�iE iE iE jE iE iE 1F iE if iE
D E V E L/'O' {�' M E N•'T S E R V I C E S R E Q U I R E M E N.T S
�r i'� '
ZONING APPROVED BY �' DATE: �
BUILDING APPROVED/B1.� : � DATE: •/'
�• P:
APPLICATION ISSU£D�.BY: DATE: IO ���
******rt**�*�*�*�x�*i�*** �,� .. **�******�3E3f?: tv+��r
LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC EIRE SMIP/RES GRADING
PERMIT 432.00
SMIP/NON—RES
PLAN - 4.39
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE
TOTALS----> 436.39 0,00 0.00 436.39 436.39 .00
REVENUE UIVISION TOTALS--> COLLECTED.: 436.39 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MEQIiANIC FIRE SMIP/TOT GRADING PLAN—CHECK
43�,00 . 4.39
�lE iF if iF �IE iE # IE �N� i(-3f iE it iE 1E �E iF �1F if iE 3E if if iE iE #�)f if �tf �E iE iE iEiE iE iE 3F iF iF �tE iE 3E iE iE if iE if if iE if 3E iE 1E 3E iE iE iE iFdE ik iE iE iE iE # iE iE it iE 3f %9E 3E 9t-34 iE �7E �7F 3'
I N D I 6� I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I 0 N � UNTT COST TOTAL COST
SPC 20000 DEMOLISH BY VALUE COMMERCIAL NOZONE � 1.00 20,000.00
END `OF FEES
01 0�142E�9—(�t3l9259i3 To�'Y
DATE: laJ^b/Q5 TIi�t: G°�2i
/
+SO.J�
I
CUNSTRUCTION ANDPLANNING POO SPA �
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector,
-� 1. Temporary Elearical Service or Pnle 52. Pool & Equipment Location -•
�-2. Soil Pipe-Undrgrnd. ...� _ 53. Steel Reinforcement .
3. Electric3l Conduit Utility-Undrgmd. 54. Forms �
4. Electricd� Conduit-Undrgmd. 55. Electrical Bonding � ,
5. Steel Reinforceme�t 56. Rough Plumbing & Pressure Test '
6. Electrical UFEfl Grnd. 57. APPROVAI TO COVER-GUNITE .�
7. Footings 58. Electrical Condui't-Undrgmd.
$. Foundation ' � 59. Gas Pipe, � Undrgrnd., Test •
9. Water Pipe�Undrgrnd. - 60. Backwash lines, P�TraP,'� Undrgmd.
70. Svuctural Floor SYstem '' 61. APPROVAL TO DECK ''
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �,
72. Sewer Cap � - 63. Heater & Vent-Final � �
� 13. Roof Drains ' 64. Plumbing Sysrem � Final � ' -
14. Rough Piumbing , �� 55. Eleetricaf�Fina1 .. '
.15. flough E�ectrica6Conduit 66. Solar System�Final •
7
i 6. Rough E�ectric 4viring � 67. Fencing & Access Approval ' � (
17. Rough VViring Sign 68. APPROVED FOR PLASTERING -
18. Rouqh Electrical-T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
`19. f?ough Heating & Air Conditioning FIRE pEPT. REQUIREMEN�T i
20. Rough Factory Firepiace APPROVALS Permit #
'27. Ducts, in Structure 70. Underground Hydro
22. Oucts, Ventilating 71. Product Piping OGas �Oil
23. Gas Pipe-Rough & Test 72. Underground Fiush
24. Roof Framing 73. Under9rnd.StorageTank OGas ��Oil
25. Roof Sheathin9 74. Overhead Hydro �
�� I
.26. T•Bar Ceiling (Svucturaif & Monocoat /JO�6 � 75. Dry Chemical
27. Frame and Flashing �l�/p,� � 76. Dry Standpipe
�28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insuiatipn 78. FIRE PREV. FINAL
�3Q. Drywall Nailing �,�f� � HEALTH DEPT. REQUIREMENT
37. Plaster grown Coat 79. FINAL INSPECTION f
32. Electrical Power Meter�Finai 80. FOOD CERTIFICATE ISSUED I
33. Final Electric Notes:
34. Pinal Hsating & Air Conditioning '���p„ r `�� S��.r'-
_� W
35. Final Gas Pipe-Test t. _�}�, �
36. Hood or Canopy �� � �
37. Final Factory Fireplace
38. Final Plumbing �
38. 4Vater Service�Final
40. Gas Service-Final
'41. Solar pomestioFina�
42. Backflo�v Preventer
R3. Backflo�+' Irrigation
i44. LandscaPe Irrigation System
A5. Sound Attenuation
�46. HandicaP Re9uiations
47. FINAL STRUCTURE & BUILOING II /�/ �l
48. FINAL PLANNING
49. Electrie Release to Edison �
�50. Gas Relsase to Southern Cali�ornia Gas Co
�51. CERTIFICATE OF OCCUPANCY
No. Date
/�
AD�XESSOiBU1LpNG: SSS ANTON BL
°"'"E"'s"^'"E"'Q'ox": SAKIOKA FARMS
nooxEss: p0 BOX 2097
' ' TERMZNAL ANNEX
APPL. W1111N0 AWHE55:
u"T: 8 TH
pqCNRECTOPENtlNFEN: IN���tI�Ei t�Lf3I�3N '.i�3r,i3:1�.N0.: 9:j7H
nxcx. on exc.�s �oon[ss: V S HOP E S T °NTi 1 1 O O
L.A. CA 90071
CONINACTOP'S NAME:
CONTIiACT0A5 MYIINC
AOUHES£ UC.NO.:
uNT:
110EN5ED COMHRCTONS DECLAPpTION: I hereby eilrm uMer paneXy al pa�vry �het I em Icansed under provisions o( Cheqer 9
(mmmanurg wi�h Seclion 1000) d DiNson 3 0( �he Bmine» end Proleasiona Code, and my licensa ia in full (arce enE eMed.
CITY LIC. NO.: LIC. CLASS: LIC. NO.: EXP ;
IDma: CaNreaor:
OW NEF BUILDEH DECL1flRT10N: I hereby affirtn ueMer peneXy of perN'Y �hel I em exemp from iha ConVedae License lew for Iha
�ollowing reeson (Sadion 1031.5 Buainesa e�k PMeasiona Code: Any cily a munty wfiich requirea e pe�mil to mrevun, eller, imprwre,
' mof h, a repeir any airvcwre, pior lo Bs beue�Me, also requirea ihe applirant lor such parmil to fib a eipned elelemant ihal he a she
,licansed pursuent m �he povisiana of Ihe Contredoro License Lew (Cheqer 9(cammendng wilh Sedpn )000) o( D'vaion 3 W Ihe
euaineas enE PrMessons COEe] or ihe� M or she is examq �herahom anE ihe beais iw tha elleped uemption. My violeton W Sequn
�as�.s M am eov���,� �o, e re,mu euqaas me ecv��� m e dn� re�eKr d na more inen �ive nuoarea eo��en Issao]).
� I, az owner oi �M1e prope�y w my emO�M'�a wAh wegea ea thei aole mmpanselion, will do tM woik, end the atrudure e nm intendeE
ar oHered im aele (Section )OIG, Businen enE Profassbns COEe: The ConveCom Liceme Lew does not epply�o en ownar oi properry
who buNEs w improvea Iheraon, end xfio does auch xrork himaeH or herse� m through h's a her oxn empbyeea, pmvided ihm auch
im0�a�menb ere mt in�enEeE or dlered br aele. H, howavar, tha buiking w'unOrovement is saN wnhin are yeer d mmplatun, tlre
ownar-buiNar will heve Ihe buMa� W proving he or she EiE rwt build or improve for �he WT�se ol eab).
«�
�] I. az owner a IM1e oropxry, em exdusirety mmrmmg wiln licemad conveMon ro canslrua iM pmi�= (seaion )01d, euai�sa eM
Profeuions Gotla: Tha Comreeon L'censa lew doea na epply to en ownar d pmpeMy who EuiWs a impovea Ihereon end who
canvana M wch D�al�%��h e roMrector(a) IkansaE Wrsuent to iha Convedwa Limnae Lew�.
❑ 1 em eae p under Sec�ion B. 8 P C., far Nia reewn:
I Dete: I Oxner: �
I Eo M cenity Nm I are d ard understaM IM reQuiremenb M CelAwnie HmXh eM Sefary oda Sediom 25505, 25533, arM
zssaa. a me� i or e�r nn�re d,�mma �v� ��i i wai �rn (d26 a,al ��a io comvN wnn seia e oodes ene ine reauireme�m ror
a parmn lorcroswnion ormoEiffslion homthaAi�epemant Disirid. Reaidentiel conmiueion eppGmianaeraaumpt Imm theae
pravisions.
oe�a: nooi�+c
WONKEH'S COMVENSATIIXJ DECIAXATION: I Mreby elfirm uMar panally d pe�jury me M the lolloxing dedere�iona:
� I heve end wip meinlain a ce�Micate d ronaent to eeM-inwre for wwkers campenamion, ea provked br by Semm 3)OO W ihe Lebor
Code,/orihe pertortnanca oflhe warkiorwhichthia parmniaisauatl.
� I have end witl meimen woMers compense�on insurarim. sv roquired by Seaim 3]00 d the Lebor Code, for tM peAormenca d tM
work iw which �his permn ia i�ued. My workero compensetion inaurence ramer vW poliq number ere:
ce„� .
� PolicyrNumbar:
(Thia senian need nw be complefeC l tM qrmx is /a one hundrai dollars ($�00j o� bss.)
� I cenly Ihat in ihe penormar�ce W tM woM lor whch ihie parmn ia ieeuetl, I shell nM empby arry persan in eny menner ao m to
Eecoma aubl� �o Ihe waAers' wmpemation lewe ol CalRania, anE agree ihet il I ehauld becama euDjecl to Ihe xnMers
compenmtion O�suna of Seabn 3]00 of Ihe Lebor Cale. I ahell fonhvmh mmOH �h ihoee pmWsione.
Dale: Applkenl:
Wam/ng: Fellvn ro sxuro wolken'rompsivatlon rovsreps b un/ewlul, enJ aMll sub/set en emp/oysr ro eAMro/ ponaMu en0
clvll flnea up b one huntlre0 tM1oua�ntl tloll�n (Sf00,00pJ, In aWlOon ro Ms eost ol rompenuflan, tlamepa as provitled lor In
Sxtlm 3106 0l Ms Lebor COCe, Intercat, entl atromsy'a /eea.
CONSTHUCTION LENUING AGENCY: I heraby elfirm under penalry W perjury ihe� �here ie e mnsindion bMing egancy fa IM
p,no��� � ma wo,� ror wn�u� ma ��� is �suea (saa� aos�, cr. c�. �
LENDEN'S NAME:
LEN�Eq'S AUDPESS:
I cenity thet I have reaE Ihis epplcmion and etste ihe� the above iMormetion ia coneq. I agrea to compy with ell dy eM ownry ordineMes
enJ stele lexe rele�ing m building conslrudion aM hereby emhor¢e represeMalives M ihia cnyto emer upan �he ehove-mamioned O�PaM
/arinspadion purposas.
ERNIE VITUCCI
Pnnl Nema
. £�/�lEST T� VrTvcr_� oe�<: � 26
sianmure W Ownedn9envAvali�anuCon�reaor
\
Whne-8uildip d Sefely; Greeo-Fle; Cenery-Applirant; Pink-Revenue: Go EenroFAasusor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 076194
PERMIT NO: B 076194 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: LFR SP PERMIT TYPE; STR PURPOSE; ALT
•JOB DE5CRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 325,Q00
CLAIM VALUE; 325,000,00 CALC—VALUE: 339,625.00 GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION RE;#B74633
'k iE �E 1E iE iE �E iE'lE 1E 1E'IE iE'N' iE'X' 1E iE'lE iE'lE 1E 1E if 1E 1E if 1E iElE iE if 1E iF 1E iF 3E iE �lE 1E 1E iE 1E'Ih iE 1F 1E'1(' iE iE �E iE'lE 1E i@ 1E 1FlE iE 1E 1F 1E iE iF iF iE 1E!(-!f 1F if 1E iE iE iE iF iF 3E if
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
�y��fic �� t{�j �i���'4 �''� Tid L��'T: �'T IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO;
PLANNING NOTES� .. -. --
if 1E iE 1ElE iE 1E 1E 1E iE iE iE fE iE 1E iE iElElE'lE.1E iE �E iE 1E iE�iE iE fE fE iE 9E iE iF 1E 1F jf iE 1E 1E 1E iE iE If iF iE i(� 1E �F 1f iE 1E 1E 1Eif �k iF if iE 1E iEiE 1FlF iE iE 1E if iE 1ElE iE �1E 1E iE * 1F iE iE
D E V E L,.' 0 4P M E. NyT S E R V I C E S R E Q U I R E M E N,,;T S
. , �.
ZONING APPROVED HY �; DATE• —
BUILDING APPROVEDrBY :
APPLICATION ISSUED'BY: �.' I�(� �
3FiE�lEifiEiE3E1(�1E3E1ElElEiEiE�7EfEiE�IhfE�1EiE�F3F3F3F3F3E�FiF3F�FiF�7F� 7F7f3F3FTf�F iF�F3F
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRICti MECHANIC
PERMIT 1,479.50
PLAN ' '
ISSUE FEE _.�
BUILDING—DIV—> PERMIT ISSUE PLAN;CHECR•
TOTALS----> 1550.82 0.00 0.00 1
REVENUE DIVISION TOTALS--> COLLECTED:� 155
BLDG PMT PLUMBING ELECTRIC MECAANIC • FIR
1479.50 <
f�Fi:i�l
DATE: �
_ _ -- ! � �
STRUCTURAL"�SEGMENT:Y
SMIP/RES GRADING
SMIP/NON—RES
71.32
TOTAL PAID DUE
550.82 1550.82 .00
0.82 OVER/SHORT: .00
E SMIP/TOT GRADING PLAN—CAECK
71.32
t
iE jE �E 3E 3E IE iE iE iE iE iE 3E 3E IE IE iE iE iE iE iE if� �E 3ElE'1F'�'1E'�F if 1E 1E iE iE'lE 1E 1f 1f i(� 1E if 9F 1E'1E'1E IE'If 1E iE iF if If 1E 1f iElE iE iEif ik * iF 1E iE 1F 1EiF iE if iEif iE iE iE 3E �E ik iE fE 1E
I N D I V I D U A L F'E iE B R E A K D O W N
TYPE QTY D E S C R I P T I O N� UNIT COST TOTAL COST
;g4"F` �`a��.����� T. T. f3�'�'Zf'� �ky �N�1LC�E3S1
END�OF FEES
, 'i
�..
`
1,00 325,000,00
qi q0's?9?:;].:-��Gld�30:, ?"�n'f
DR7E: O:ti�:�!�1` -r1.; , �i�
i
i
POG SPA
I G�NSTRUCTION ANDPLANNING " (
Date ins ecfor Date Inspector
! APPR4VALS Permit �# _ � ,APPROVALS Permit # ,
;� 1. Temparary Elearical Service or Poie ' .' 52. Pooi & Equipmert �ocation .
� 2. 3oi1 Pipe-Undrgrnd. � . 53. Steel Reinforcement •
: _�3�Electricai �Bonduit UtiirtY-Undrgrnd. % 54. Porms �
- - �� i
� �•4�Eiectrical Conduit-Undrgmd. � - � - 55. Eiectricat Bondmy (
.r ^. �
-��b.''S_t'ee! Reinforcement 56. Rough Plumbing & Pressure Test
-�n6:. Electricai UFER Gmd. � 57. APPROVAL TO COVER�GUNITE
='�'7�"`Footings ,.�� 58. Electrical Conduit-Undrgrnd. �
�����8. Founrlationr�� � �' 59. Gas PiPe, u Undrgrnd., 7est "
.-,_
. 9. Water Pipe-Undrgmd. ., $0. Backwash Lines, P�Trap, O Undre�md. �
10. Structural Plwr Svstem � - - 61. APPROVAL TO DECK ,
1 t. ProperYy Sewer �ine & House Conneetion - . 62. Backwash & Receptor-Final
�
,12. Setver Cap_ �' � . -� 63. Heater & Vent-�inal
''73. Rao# Drains 64. Plumbin� SYstem - Pinai
'14. Ro�9h PlumbSng pi � 65. Electricai�Finai -
I75. Rough Electrical-Conduit c �` - .
_�. 68. Soiar System�Finai
'io. Rough Eleciricl'Jirinr � - � 67. Fencing & Access A�proval " , j
���27. Raugh UViring Si9� .. � 68. APPROVED FOR PLASTERING '
�18. Rouah ElectricabT Bar Ceiling � . 69. Pq0�15PA SYSTEMS FINAL �
'�1H. Rough Heating & Air Condi.ioning - FiRE OEP7. REQUIREMENT
� n . . . - : i r-n � � � � . -, .. .-. : � �- '^ . . . �
�20. RoughFaGtary'Fir�place � c `"� .4..• � _ ? ; �;'APPf�,OVAt;S��''�'Pern�it# ' -� .
'27. bUcts; in Structure^��� � " ' � " � �' 'J � A .,� 70. Undergioi7 �d Hy'dro x
122. �ucu; Vei�2iiating:i, , • � � �, -� ..' 77. Produet PiPing G7Cas. ❑ Qii _,'
Q3. Gas P.i e-Bou h& Tesx � ' - �� _
P � t-��. X n7 ?: ;,%� � 72. Undergrdund FVusfi� ` `'
�2A. ftoofFrari�ing' �' � `" �• ! = ,- ' 73 �Undzrgrnd.5t�r�g�,T,ank;L�Gas �Oi( �
25. Roof-Sheathing `� = y �� r �� =r ^ � � r 7A:: Overhead HY�ro, � '
26. T�Bar?CeiGng `Struct*ra4) & Mo�o�oat J/f,01�=- �� 75�- Dry Chemicas _, � ;. - �
27. Frame and_ Flashing��: _ _ :, f'/jayyFj _ , % ;. 76. Dry Standpipe . �� _ �
. . ' � . ���� � � , _, �' ,
-�28. Lathi'ng 8i_Siding ,� j.. v�":4', r. �o_ �: '�. 77n �IXEO S\'S7E4.��F1NAL_ ..
�29. insutation.. � n> � _ ., .• 'l e ��. � +; 78;. FlRE PFiEV. FINRL * "� �T' ' � ,
;30. Dryt✓a!i Na`iGng ��y , �s-g' 6 K � �F"iEALTH;DEPT. REQUIREMENT �
, . � �_ l_,=z , � .. :
-.�31. Aiaster6ro�n�n;6oat_.�u,> � c�t+' *' � *, �79. FINA�IRSPECTfON o
'-�32. Electrical Pbwer Meie"r=��nai !� '� "'�80'�FO00 CERTIFtEATE IS,SUED__
'33. Finai-Elec#+'ic' �« ir � Y� - � ,c Notes: -� � m� ' ._ �
�.3A. Einel-Hsatin & Aii-'.vonditionin- C' i � _ � . _ .x • ` � .//���;� �''. //
�:- -. ' e � ." 9 r _. -- - 1 "�6� � 11X.(.�U(S,FJ`--'
�35. FinaCGas Pipe:Test-; . � , �� �,i - - : �-y� �t = �,
` 36. Nood-or CanoPY ^+, _ "' ` � '� . � - .`� _ `c � �,(� ' >
- - �-. � .. � _F �� - .
. � ' �' � � „ _ - --"_�, � �• - --
37. F,ina1 F.actorV Firepface ,. E. x� �� ,
-�38. FIna1:P{umbing, t-- e � ; - ': ' i a- '_' . . � �. ----}
�. � K :! �- iL i f �
:::39. 1Vater'5arvice-Final� f � , ` , . '„ „ . ._ -. " `� '
--�AO. Gas Service-Final =� �*-� ' . 1 t* -
r-.x � c r., e
'41. 5olar pomesticFinel; - _ ' �� ' . �, ` � -
_, x _ {. .
A2. Beckflow Prevanteo: • !L - � �K , Y�. - - � '
n
�43. Sackf(ow imig�tion,'" j 1 ' '. ; � `� ' x , � .
'dA. l.andscaPe Irri9ation�SYstem ' ': �'� e" * ,- _ _ -: c: ' '.i � �ti -
- ^. - - �a: `-
A5. Sound fittenuation " �, �,. � �r `" ` ;r �x , - � , ` t'- �
r c c^i �: � T
�46. Handicap R�egulationa: - �� ' _ (- - - � _ � h-
i- _ _. ,- - ; ' y_
47, f2NA{: STRUCTURF�,& BUiLDiNG /� �/Ob , `� - �
!
A&. FiNAI PLANNING �r � '� �� � r.; -�. n -- ! -
�49� EleaYri'v Re}ease to Ed�iso� ' " � x : ' �
. �: ci
�50. Gas Release to Sauthern Gaiifornia�Gas Co �- � x� � ' .�[^ '
�_. -- � '� = -
51. CERTIFICATEOFOCCUPANGY � _ � • � "• <.
Nq. Oate ,
-
�oonEssavem�wra: SSS ANTON BL
' o�,�aswwEiF�": SAKIOKA FARMS
' ' �0flE4A PO BOX 2097
• � TERMINAL ANNEX
�
��
�vv�.iuiurw �ooxess:
uxT: 8 TH
urcx�cron�+�n: INTERIOR ARCH 2136232164 �c�= 9378
�xcxoeu+a•e�oa�ss: 550 S HOPE ST uNr: 1100
L.A. CA 90071
coxm�craaexu� CONTINENTAL PLUMBING INC ( 909 ) 360-8300
cwm�eroxe�uuw 11165 THURSTON LANE
�ooxess MIRA LOMA CA uc.w: 399073
917 5 2 uMr:
IJCEN4ED COMRACfOP9 DECL�P�TON: 1 Mntr/ drm uMx p�roly tl p�r�ury Ntl I un Ikmwd undx pMYm� d Cluqp Y
(oommmdrq wllh 9�e11an 1W0) d OA4un � d Yr Bidrwe utl COM. ud mY Iwn 6 in hA lac� uM e Iw.
cmuc.No.:027563(� �Q�•�c�s C 36 c.No.' 90 EXP: � 9/96
Uma: lO _� 1� L J Cmueaa
OWNEF BUILOEN OEClAfl1T10N: I Mnby dkm undar prWy d ps' tAel I un �ramq Imm IM Canrmm Lkwu� lew la tM
�dM4q iwm issabn'!mf s&n:w. aid Aam.um cod.: Mr W n opvur.� na� � o�a �o muuw. eb«. bnww..
'emd'eh, a rpei erry �Uud�vs, piv b U"veuena, obo rpww IM eppOmN In wc� prmtl lo fJa e �ipnW �Imemani ihat M a �M
; 4crosed pwuwu m tM provmvu d tlM CaN�aCa� liame lew �Clupr B(oomme�q w'nh Swqn ]000) N Di/sion J tl �M
Busi�nas ud Prdn�'vn GoCal a Ilw Ir a aM e uemp tMrshpn and iM b��n la Ne eAspaG eaanpun. My vbleton W Swion
)03f.5 by eiry app4uY tp e qrmY adje6� IM eppfraN to a dvi pmsly af np mm IMn fxe huMnd dMxs �5500�.
� I.mmmerdiMRow�Yamympb�m�xt�wps+mlheiWemmD�u�.wTdotlrwak.mdlM�mcw�euna'vpeMeE
a dlared M aele (Seclion )Ou. Bu�ea eM P�daesunaCads: The CoN'eem lioeine LewEom �w WDhto en ow�w d pope�ly
vM Wias a inPa++Rsaon. end Mn Groa �uNN �wk Fhnstl n MnM a tlrw� he a Mr wm amPMM�. pw� �hx wrli
'vnprv.emwa ma m�'vuaded a WenE la ub. tl. howewr.IM dddinp a inpwwneN u wld WYkn ona Yev d oompbton. the
oww-0uiNv W Ma tM daden W D�q M a tlr did �n Witl a impa+ta tM pvOd+d obl.
❑ i. s, o..,.. a in. nw«n..m..amwr wu�.a�c wn w.,..e �ro.m, w�c m. o�aw �s.e4, �a.. a�.:,v. �e
Pmlavone Code: The Caprmm Licans lew dou nd MdY m en o�nwr tl PW�Y wtro Euld� a'vnpwx iMraon end wM
cau�ecu k. wai wdw• .w e mueaMe) rcwnw o��+b Ur taweevs lioen.• le+).
❑ I am eianq urAs Ss9on: B. d P.C.. tar Nu mm�:
Uate: Oww:
i ao r er �r w� i.m ..me a.�e �.d.+„m u» �.mm.m.e. a c.u�:. �..en.�d sew eod. s.a�. zssos. usa�..�a
45SN. eM itw I n enY Mun bultlin0 ��i41 wil na (mcb oro) �x W ro camM' wlh uiE pete mEe� end IM nVwmnm� br
epemmlaawbwfo+amodJrationhomtM�i�enapwnW piqriC.peeM�aielmwvaionappiwiauenaxemqlromthma
a�.
Dete: Mp�raN:
wonKen�s couv�s�nw oecun�nor+: i n«.w.� �.w� �.nr a�.y ,�. a m. imo.a�y a.d.m�.:
� I hevs eM xd mau�en e mnLiuis M aduaY lo �Mliroun br Morken' mmpanLLim. m prwiEM la Ey Seaion ])00 d �M leEor
coe.. i� m. v��. d me .m i«.r:d, me v«�m e�.e.
� I hevs uA vril me'vtlen whr�' oomD�iom m�vanoe. n rRd�d bV Saaim am0 d tlr leEor CoM. br �bW�a�� d iM
work la wl�itl� Ne 0�� u etwE. NY waken'CcomDMWbn'uwtence urtir md VdkY wmber ms: E}� p I R�.+JC
Cemx:
a� r�e« T6 £35 0 7/ O 1/ 9 6
(This esaiar roM raf 6s mriyMM /W prml 'n b ons Mv�M dotlen �S�pp� a Nnl
❑ I cMh YW in iM DMmrorce d tM vM br ehic� �hu O�a 6 mwE. I tlW nd an eny Oa� in anY menrwr c m to
baconr wbjea to �M warkere' miw�eaion Iew� d erM Nm ' I baconr aAjw tM worken'
cano«�wian o�+\� d SetllJ'+�� L��)00 d tM lebor CoM. lonh ' i .
Dete: I�� i�� — LJ �ppl'raiu:
WemMp: FW�n ro uevn woA�ri rompnutlon cov�rp� l� , uWWll u!/�cf �n rnplqw ta eilMiW qn�Mp �M
clvll Ilns �q b on� h,nM�J tlnuuM Aol4n lJIOq000A ���n b tM eo.l o/ romp�nxfbR a�p� �� p�M� br In
sscaon aros o� m. LeDo, cotl.. �,u.r�,l, .,w.mrmr: r».
CONSTIIUCiION LENqNO �GENCY: I hreby eRum wWar penepy d perjury �he thers e e amnrueian WEiip qprv.y br iM
peAormence W iAe wwk M whitl� Ihu pemi� u ow�ed (Saqion �09]. Cw. GI. \
� LENDEN'SNMIE: �
LFNOEP'S AD�FESS: �
I cenM �hm I hew naE Nu eDMra�ian and qW IM tlw ebv.e iNamuion e oonop. I qya� to oomON vN� eA mY vM wurMyadinenm�
e{Ma
end atma kws rMe�'vq to buikvq conmuaion end Mreby eiMar¢e �epwentetiva d Ihie ary to amar upon iM ebove.meniioned popeM
Dtla: V ��
(St51�6.WP) Whne-B�iWiq 8 Salery: Gmen-Fb: Cenery-Appirant; Rnk-Rewnue; Oddenrod-Aeaenor
I �
� ' CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 074736 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: PLU
JOH DESCRIPTION : INTERIOR 20000SF OFFICE T.I.
CLAIM VALUE: CALC—VALUE:
PERM NO: P 074736
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: B-2 /
*�*****�ir**�+r+�r*���***�D�*�*��*���*�*+It(�x�***+�r*****+�r+r+��r�r*�x�*x�***x�r��r��r*�r�r�*�r+r*x��r�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARICING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NiSTES>
i �
iF 1F If if 1f 1f if iE 1E 1E 1f iE If 1E 1E iE /F If 1E1E 1EIE 1E 1E IE 1Eif fE iE 1F IE 1F fE 1E 1F 1F iE 1f iE 1Elf 1E 1f IE 1E 1E iF 1E1E 1E 1EiF K 1E 1E 1E IE IF 1E IE K iE IE IE iE if 1E 1E if iE 1f If 1f if 1E K ik M 1E
D E V E L O P!t E N T S E R V I C E S�;" R E Q U I R E M E N T S
ZONING APPROVED HY ' DATE:
BUILDING APPROVED HY : '.r DATE:
APPLICATION ISSUED BY: ��� DATE: � Y�3 .6i
ifil�iFiFikiFiE1F1E1EiE1fiElEiEiE1E1E1FiE1fiF 1EIf1hk1EiE1f14KK 1EiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 42.00
252 SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 42.00 20.00 0.00 62.00 62,00 .00
REVENUE DIVISION TOTALS--> COLL'ECTED: 62.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
ik iF IF M 7f M M 1F IF K if if 1F iE 1i iE M if 1f 7f Ih IE 1k 1F 1F 1F iE iF iE 1E 1E If iE iF 1F.K If If 1F k K 1E 1f iF iE 1k iF If iE iF1F if 7E M it IE1F if 1k ih M 1F IE M 1f M iF 1f iE IE 14 ik 1f 1f 1E 1F 1f M 1F
I N D I V I D U A I:_ F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O,IN UNIT COST TOTAL COST
PLU 2 SINK KITCHEN 7.00 14.00
PLU 2 WATE�t HEATER AND/OR_VENT 7.00. 14.00
PLU 1 BACKFLOW PREVENTER � 7.00 7.00
PLU 1 SINKS, FLOOR ,: 7.00 7.00
END OF FEES
. � � �
i+
�,li ',r�� "_`' ,. . - .
�. . �1� �•. -
C�NSTRUCTION AND PLANNING POO� � SPA
APPROVALS Vermit # Date Inspector pppROVALS Permit #
� 1. Temporary Electl�cal Service or �ole 52. Pool & Equipment Locations
2. Soil Pipe-Und�grnd. V 53. Steel Reinforcement
a.� ectrical5onddit�klt;Mity-Undogrnd. 54. Forms >
��Q�ectrical��di�t�7r�drgrnd. 55. Electricai Bonding .
.'�eef Reirt,�wcerTieFiC _ 56. Rough Plumbing & Pressure Test
` vdFJectrical�l�ER,��. � 57. APPROVALTOCOVER-GUNITE
otings;�.-� � E-, � � 58. Electricai CondyjtUndrgrnd.
8. FbundationF ryS ,""y � . 59. Gas Pipe, O Undrgrnd., Test
9. Water Pi��Und g,d. U . 60. Backwash Lines, PyTrap, Gl Undrgrnd.
70. Structura�YFloor 93tem '� � 61. APPROVAL TO RECK
17. Property�gwei..L�ine.� Hous�Connection 62. Backwash & Recepior•Finel '
12. Sewer CaR 'Ci � �� , 63. Heater & Vent-Final �
1 J
13. Roof Drains �_, � 64. Plumbing System - Final �
74. Rough Plumb:a¢ ' 65. ElectricabPinal � r
15. Rough Electrica�CoQ uit �' 66. Solar SYstem�Pµ�al�
16. Rough Electric '�j�ing -� ��' 67. Fencing & Acce35-Appro`val
-' 17. Rough Wirin,g 5� � � 68. APPROVED F�pLASTERING
18. Rough Elec2rica Bar Ceiling" ' 69. POOLl5PA SYSTEMS FINAL
, 19. Rough Heating & Air Condittonin� ..y FIRE O�EPT..&EQUIF�EME ffu
,� , , ", . � tr s .� • >. , r. ... � c r
20. �bu� F3�tor�Fit�Race � 5�.� � � R,yb �Iy$��.`�., r * � �~ ,�
i r � r: T
� ._, a* 'APP v Pe�m�t# -
27. BuctYin�atruiiurF.+' �'.... S +� �� n* ' 70.'�nder92o���1 Fi�iro y
22. [5'uc�V�r?r3til�dn9� � i � � # � �Q p Fx : 71. Product'�PingF �6as Oil
23. ns Ripe+�ou� & TYst � T M f x m c' �Q G� � 72, Undergrou�d FT�isH x*. �
24. �oofSFra in .. `M . -F * 7 G e' � c� r ��� .-•
�� 9 < �� ; � �K •7�-.F,Undergrnd.StoCac�TankrOGas rJOil
25. Roo h�hing S r �2 � v x � �>^* 7q"J Overhead Hydr�C, '{
� � � m •� m► 7 . - ... .,.
26. GBa4`��eiling (Str�t�iral) & R�o�ocoat > � �, p* 7� Dry Che�nical F,� �: N� ;
27. ,�rarnaancl�Flashiry�* �G^ * a' r m* 76. Dry Star�'pipe �r�? *^ .L �� �h
� JF fil „7 `� �3�. y � .. * 'Q y .`- Y / •
28. LatF&M�tYg �Siding �� ��F,, �; ��� 7� FIXED �r�TE�iI���J�VAk:-� f� :.x
29. Insulatior^ n� S •� � c, 7'`('IRE aEV. F� 'L �'l � n'¢
' 30. DrriYali IEI'�iling �Y r, i i c., j SGN c;M�£ALTF,��DEP�. RE�UIFI�,�_ .!
� 31. Plaster Baawn'fw�.*'* s i�ro� � +. c)9. FINAL I]VSPECTfDN * � �� •
•-. • • r-t �. C� F ,�
32, qectrica�ov�r A�t�r`��al � r n' �� "8Q'7 FOOD CERTIF�1�,'A�TE IS�S4�Eq.. �; �
, 33. Eanal=Ele�ric� ��% LT: i � * I `y •: N�eyl� �S^�l, '� '" '� �
'� 34. F�jnaR-le�ng� Ah;�o�d'itionir� 5 � * r� x � �'S � = �'
.., N � ��� 'Y .`, . i H I r-.'4^ } T
i 35. jna�GasPipe.tes�t C,n • ��-, sc Dr 'a � ;-
36. F�poc�br C'anopy "' =� ` ' m- � �� � j r z. . ,p .
3C# ll �.'�!Y, �i .t �j i(.,`..: #:�:
37. �naf. actory FireWace � � ��+ � � � � :R
� �
r,;:k (L � -� x� S r A''�7
38. Fina�Iumbing � � � - �s � •* �_� T �
� 39. Water Service-Fina`i* E : Y� � y � �� �' y��
�40. GasService-Finat �` �`% 'Q`-"" => * �% ' K �.c' '-;^� �f
k r� c.. 4. ,^.3 F - . p F ... •C
41. Solar pomesticPina� " ' �
i LT; '+'. t*� -7o m e. ^�.
42. Backflow Preventer �� :v x� � cr, �• p- * p r
� i 4v i'-IH 'f r'� K T1 [[f� *
43. Backflow Irri�ti0n * j�--' � .- i ; i �r ^i ��. . .�.
r 000c,
4A. LandscapYlrrv'�ation'System���- Z �Y C G rx., ns N �:, ,� N�=c^
r tY. x C�7 t 'E Q`i:f:'` �:..' R; iJm R.�'�
T Y, H�n:" 6' .' . '�. P' . t 1 i-f i �
�f5. Y�und Aitenj�ation� ... ,� � � ;n�,�i T � � • F;- t
�-�- K
46. Handicap•Rega4at�onS '-� O * R M S Gc 5 *
* s � � :T: � n r
67. �iNl�Z STRIJCTUR� & BUIL'DING ;, �.. � �; � '; �, r F.
n k '�
48. F-1NA}'. PLANNING K ��'-' * �� � �M . �� a � �
r
�. ��ecir.(c Re�ease t0 E�iSon * I F 7 ,1 � ' ,,,�
1. ��. aa
60. Qs Fi�lease to South�rn CalitQr�ja�GasCo '� �` , S ;.;�, �- �? ;k N c•� �o
5;. CERTIFICATEOFOCCUPANCY � * • ��• -- � � -- -
N0, Date
Date Inspettor
T
e
a -
�I
�uoxasaemiara: 555 ANTON BL �
°''�"E"s"""E'°'°�`'": SAKIOKA FARMS
��"�% PO BOX 2097
• �• TERMINAL ANNEX
�vv�. Yuiwc aom+[ss:
UNT:
STH CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 076195 PLAN CHECK NO: N
CONSTRUCTION TYPE: iFR SP PERMIT TYPE: ELE
,wcxrtecTon�+Nffn: INTERIOR DESIGN 21362321&�"� 9378
wcxon�•s�oon�ss: 550 S HOPE ST �'+T� 1100
L.A. CA 90071
CONfRACTqI'SN�1�:
camucrorcs �uimc
�oowesx
uc. ra.:
UNT:
110EN5ED COMFACTOHS DECLAPATION: I henEy aflim under pane�y d pmjury IMt I em I'r.enseE wEx pmieions d Ghaqs 9
(mmmena�p wnh Section ]000) d Drvaion 9 d ihe Busimv enE PMeseiona Code, uM my licen» o in IWl laca arM aHad.
cm uc. No.: uc. cuss: uc. No.: EXP :
o�e: c�i�a«:
OWNEH BUILDEF DECl1RATI0N: I Mnby etfi'm uMer penely d perjury thet 1 em wemq hom Ihe CaMretlaa lieeeue lew la Ne
IWbw^9 �eesan (Setlion )0315 Butinesa enE RaleSfbns Cade: Rny �IY a coun�Y Mfidi nVu'vas e Ga�L �o owtrucl. Mx, impow.
ismolish, or ropei any Niuclure. prior b Ga eaueMe, deo reQuirm iM eppl"rin� lor euch pertnA lo file e egmE etetement Net M a sM
i licenaed pursuent to �M provisions d iM Conirepore Licenae law �Chapter 9(commenarp xilh Sedion ]000) d DNeion 3 W Iha
Bumriess eM Rdmaiom Coda� a Ihei ha or+he o uemq �herelmm eM iM Eaae ia iM dbped exemqion. My voW un d Sadion
)03t.5 by ury epp5renl la a partM aubpGf IM epplkeM to e tivY penehy ot ml mas Ihen Ms huMeeE EoOen �SSW�.
� I,eaovmarWiMpropeMamyempbyaeaxlhwapeeavtMiademmpemqion,Wldollwxork.eMlMaWnunbndimaMeA
w oMeretl br seb (Seciion l0aa. Buairoo uM PmMniona Coda: The Contretlas liunee law doas ml applyto en ownerd qopeM
who W1Es n inP�a �henm. eM Mn Cros suM xak Ivmrotl n henN a Wwy� he a her own emOb/eae. pa'tleE tM euc�
Mv�mam ar. na wawea «araee t« se�e. u. now««. me d�uim a mawemem ie.da wnnio on. vem a oomWnon. me
�owner-0uiNx xill ha�a tM burden d pwieq M or eha dd M build w impmre tor tM puryma d Wa�.
�. av own« a in. wwem. ��*auHwN wmrea�ro wnn umneee convecwi. w w�amia u» wd� lswon rou. auin....ne
aeaeu�are eoae: nb caureaoo �b«w �.. do.. �a ewh ro en own., a awenv wno wuaa « impw« meieon .iw xl,o
mxrecu la wdi P�4�s wnh e mmredMa) IkeraeA Wnueru to �ha Coniratlm Liceroa Lewl.
� I em eaemp �Mer Saclion: B. 8 P C., br ino reewn: /�
om.: / � �G /9ii o�« ...�--'%. i �.� s
� �
I Eo hereby cenity thei em ewere d enC uMentenE tM requiremama ot Callwnie INM� eM S My Coda Seaiare 25505,1553], ud
25551. eM Nel I a ury Mure buiWinp ocapam will / wll m� (crtb ww) neeE lo cpnply wih uid ue�a mdp uq IM'pu'vemeMs for
epe�melamuwnionnmaEifrationhamiMAi�iy ereyemru0iur'vf.RmidmtalmmtMioneppWtbmenezemqlmmNwa
wm,maa
Dale: Appfranl:
WONKEN'S COMPENSATION OECLAflPTON: I heraby dfirm under panMy d prjury ma d qs IoOow'vq Mda'eliom:
� I hava ud wJ meinian e cenilcma d coneenl lo eeX-imuia br waken' wmpemelbn, m povided lar by Seaian 9]00 cf tM labar
Code, lor tM peRamencs d Me wA la wFich �hie pmmG u iawd.
❑ �in�..mw�m.:�.on..•o�w����...�.a�aMs.ao,a�aoam.�nn«cros.ro�m.w�«�nm.
wak /a v.hid� ihb permil u iseued. My wakere mmpematian ireurence wrier end pok.y numEer w:
c�.:
Pdicy Numbar.
(ihis maian meL rnu be cmrP'afed l Na P�t ia b om M1�MrW do9en /ItW/ a Nn.)
❑ I ten�Y � in iM pMwmercs M iM wak Iw xfirF this peimil e iavued. I Mell ml enipby erry pnaon In enY meruie� eo n lo
baemie wbptl lo IM �weken' tanpmLLon lexe d CeNomie. uM pres Ntl E I dpuk beemis wbjW lo IM MaAen'
' compenulion pwuom G Seeion 3]00 d tM lebor Coda. I duA /alhw4h oomp�y with thoes pio�apa.
ome: ncd��:
wamllp: F.xun ro ueun wohen• ronqw�utlon eoveray� I. unNwNl, uW sh�ll s�DJeet en Nnplqw ro uIMrW p�n�Mr �nC
c/r/l 9rro� up ro aw ��nErM fM1ouauM Ec14rs (S1Qq000A N eeGltlon ro tli� cwf o/ rortpmutbn, C�mqp �s provlWd br /n
SxXon 3]O6 0/ the LaUorCode, Infxes( enJ ettomey� /eu.
CONSTtiUCTION LENMNG AGENCY: I hereby e1F'm uMr prutly d perjry Ilw Ihra e e odutvfion bndvp eypi�.y br tln
periwmerce d tM xork la whidi Ihu parmt'p'esuad (Seeion �OBI. Civ. CI.
LENDEH'S NAME:
LENUEN'S AOOPE55:
I ceNly Ihm I heve nM tho apqicetion eM qele tlai iM abma inlormetion i� conae. I apiea b canpF/ xilh M dly end cauny adinencea
uM state kws mletvp to buiW'vp canvvwion ud hereby euiharize repreaenlelivm dtho ctYto amer upon tM ebwe�moniia�atl popeM
�« i2vreeion wewsea.
ERNIE VITUCCI
Pnnt Name
£�At Es ��. V� Ttl c c f oma: � L
sro�m��a a ow�nro�nvd�+u�o-wo.
(5151�IB.WP) Whue-Buildnp 8 Selety: Greerv�Fb: Cere�y-Appiram: Hnk�bwnue: poNenmd-A�eamr
PERM NO: E 07619
GOVT; N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: H /
*�*�*��****�+�**����**��******�****�**�*��*�***���*4�***+#rB��***+�**B****��*�*****
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV:, PARCEL; 41050104 ZNE: REF NO:
PLANNING NOTES>
7 1
iF 7E 1E 1f iF 1F 1E 1E 1E 1E 1F IE 1E ik If 1E 1E iF iE 1E 1f� 1F 1E �lE 1E 1E 1E if 1E 1f 1f fE iE ik 1E 1t 1f iElE 1f if iE 1E 1E 1! 1E IE 1E ii 1E iE 1E 1F 1!'lE 1f 1E iE iF ff 1E IE 1k 1! iE 1! iE iE 1E IE if if 1E iE iF 1E iF 1k 1k
D E V E L O P M E N T S E.�R V I C E S R E Q U I R E M E N T S
-a
ZONING APPROVED BY ': DATE;
BUILDING APPROVED BY : +.' DATE:
APPLICATION ISSUED BY: " �� DATE: ��� a e
*�t�t*�r�t�tx�*it*****x��t�t****7FiFiFiF�7F7F3F�F3FiF�FiF7FiF7F'i'FiFTF3FiFiF3F iFi��F�FiFiF*x�*�t*x�*ititit i�x-
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 119.40
502 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUZLDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 119.40 15.00 0.00 134.40 134,40 .00
REVENUE DIVISION TOTALS--> COLLECTED: 134.40 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
134.40
1f 1E IE 1E 1E 1k 1f �E IE iE 1E iE iE iE iE 1E 1E iE ff 1! 1E 1E iE 1E 1E 1E 1E 1E iE 1Elf fE 1E 1E if if 1f 1E 1E 1f 1E if 1F iE iE iE 1k iE1f 1E iE 1E 1E 1E 1E 1E iE 1E iE 1E iE fElE 1E 1E 1k If 1E 1E fE jE iE 1E IE IElE iE IF 1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 232 RECEPT/OUTLET ADDITIONAL EA. .45 104.40
END OF FEES
Qi ��,^iJo- .:- . j:,':rt:) ��g ''i,.
C�Ais: C111t!9S I_T�!`: 1'r:Ul
Cf)NSTRUCTION AND PLANNING - ' POO� .,� SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. '(emporery Electric2l Service or Pole - 52. Pool & Equipment Location -
2. Soil Pipe-Undrgrnd, � 53. Steel Reinforcement �
y3'.Hectrical.Conduit UtilityUndrgrnd. 54. Forms
='„4i�ciectricat�Cbnduit-Undrgmd. 55. Elecirical Bonding '
y�
,�5. Steei Re�nforcement 56. Rough Plumbing & Pressure Test
^'T6; Electrical_UFER Grnd. � 57. APPROVAL TO COVER-GUNITE -
�=7: Fbotings; • � 58. Electrical Conduit�Undrgrnd.
_ 8. Foundatiort . 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. ` i� � 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Str�cturat-Floor Svscem 67. APPROVAL TO DECK
11. Property�S'ewer Line & House Connect�on 62. Backwash & Receptor�Final
12. Sewer Cap' ' 63. Heater & Vent•Final
13. Roof Dreins = 64. Plumbing System � Final
14, Rough Plumbing . . 65. Electrical-final '
15. Rough Electrical-Conduit � 66. Solar System�Finai
76. Rough Electric Wiring 67. Fencing & Access Approval �
17. Rou9h Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Elect?ical-T 6ar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & A�� Condrtion�ng ` FIRE DEPT. REQUIREMENT �,� ::
20. �nugh Factory Fi `e{�1ace � ;r I ; ` _ _ :'..� � AppaOVALS�'� Permit # � - - �
27. DucCs; in Strueture"y '• " _ �- . �Y "� 70.'Under rodn� HVdro ;
4
�-a x � � • �. c � . .
22. 0.ucts, Verititating�K ' ,� c - - • 77. ProduFt!Piping O�Gas �Oil
23. Gas Pipe-Rough & 7est 6('i � c�"' 72. Undergroiind Fiush ' -
24. Roof�Framin ` ' "` ,` - - �F - � '
9� ` R ,�n • 7�3.. Undergrnil.Storaye7ank�-OGas COiI
25. RoofSheathing . � v c�� 74v Overhead Hydr� '
26. T-Bar Ceiiing (Strt{ot�ral) & Mondcoai °" y'z, � �� 7'c$: Dry Chemical r-
27. F:rame and Flashiny � - n, x �.^ . c. f 76. Dry Standpipe - ' '
ti28. Lathing &:Siding _ , ` ` c:� � i x ' ' . 71.� FIXED SYSTEM:FINAL . .�.
�29. Insuletion Jx _ •� r� f 7ff; FIRE PREV. FtNAL � f' �
�30. Drywall fVailing ` r �, � E.,, ` �_ `HEAITH DEPT.�REQUIR��4ENT
37. Plaster Brown.Coal"• " ' .- " �� : 79� FINAL I.NSPECT90N �
' 32. Electricalj'ower Nje[�rFi{�al �'' '� BQ:,' FOOD CERTIFICATE ISSUED
-33. �Cinal-Ele�tric _ � . � � J_�� Notes: - - - -
.34. Final-�Heating'& Ai7Condhionirig: ' * ''T '' . - ' _
, _ � r _ �, � .� - .....a ri o � � -
. . F � -
35. Ffnal Gas.rPipe]Tesf}-? �,�� .� z .. n - � " - � o . -�
-' 36. Hood or CanoPY `"� = � ""�, a ; !' � ; • � r '
�.. e � � r.�-� - v �r r
' , �r. t �. . .- -
.37. Finaf:�actoryFireD�ace . _r. n, t � . ;�. r
.
' 38. PinaF'Plumbing ^ . - ' �� ' , - ._ " ' -
x .
39. Wate� Service�Final , r ` i� � � � • - r
i 40. Gas Service-Final . ' ' �• ' � ' �
� i.: , _. .
�-41. Solar pomestic-Finpl� - '� � ` , . _� • - _
42. Backflow Preventer�` �' ' '" ' t �
` t - --
43. Backflow Irrigation ;. � 1 s � . , .
I 44. Landscape IrriCation'System'�:"n "'" �� _ ��. �• - - - = •.
: c:f _
� 45. Sound Attenuatiori , � '.r M - r - J - �, `� • - ^' �
.'
� 46. Handicap Reguiatio�s � • , r �' - ' '
47. F�INAL STRUCTUR€ & BUILOING � -' '
48. FINAL PLANNING � - � "' - ` ' �
49. Electrie Release to Edison - .,,--
50. Gas Release to Southern Cali(omia{'ias Cn � - -
�
51. CERTIFICATE OF OCCUPANCY • ,
No Date
� �
�
�oonessoveu�ou+c: SSS ANTON BL
OWNEC9WWEIFpnYIll SAKIOKA FARMS
�ooxEss p0 HOX 2097
TERMINAL ANNEX
�vr�. wuura �ooweu:
UNT:
8TH CITY OF COSTA MESA - BUILDING PERh1IT
PERM NO: M 0'14660
PERMIT NO: M 074660 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: MEC PURPOSE: ALT
u�cxnecronuxm�a: INTERIOR ARCH 2136232164 �� 9378
�xcx.on�a:s�nox�ss: 550 S HOPE ST ��+T� 1100
L.A. CA 90071
cwm.<,arswu� AIR CONDITIGNING COMPANY (818t244-6571
CONINICTORSY4IPlG 5265 SAN FERNANDO ROAD
moxsss GLENDALE CA uara_ 120696
91201 uxr:
4CENSED COMRACTOfl4 OECL�PRTION: I Mreby dfrm uMar penelly d ps�jury Net I em liceneed uMx yovleiana at Cheqm 9
(mmmendiq wnh SeMbn 1000) d Drvuion 9 d I�e Buvmu vd PMesuon� COEe, eM my license is in lull law antl eHea.
cmuc.No.:014903 uc.cuss: C 36 No: 120696 EXP: 07/96
Dve: l6-y4 —C� rmm +�v
YNEfl BUILOEH'OECL�fl�710N: I IiaeEy etfi�m uMer penNy d pmjury Ihet I un eumq tmn �M Canr lipnes law Ip tM
.Ibxiq twm (Setlion )OJ1.5 &wiip� enE %defvma Cade: My M' G oouM/ M�idi n0ui�m e Ve�A 1 fYutl. Ms.'vnpow.
demdeR a repei mry aM1uctxs, prior m Ya'saerce, Wo npu"um IM epqiwn la ach permn lo fib e eqneE petomeM pW M a eM
o lioerwd pumum to �he prv,Nipu o11M Conlratlas lioe�ve law �Cheqr B(mmmeni'vp wGh Swion )OW) d piiebn 3 d tM
8uxinem md Raloelxu Goda� rc fhef M a d�e n exemq thsehart mxl tM betislp Me e9epW uampfiwr. Nry vpleficn d Ser�m
]OJ1.5 W em/ epp4c+ni 1« e pe�mry abjw� IM applicam b a onl peiWly d nol mm iMn (na hufd�od ddlen �SSOOp.
� I,mowmrWiheproperlyamysmpb�eeswilhwepmm�heiedaoompenWbn,willdo�hexwk.end�heMrucNroendinlended
w Mered la ale (SecWn ]ou, Buunov vM Profeeaona Cotle: The Con�repon Ucanee lew Eam not eppylo en owrwrd propMy
who Wida or'vnv�o�as �hemon, enE v.1w Eaev euch xork limeell or Mnell or throuph hb a her own empoyee�. �xovksd ihel wch
imprv.�emenb ere not inlqy� a dlenE la seb. H, Mwever, tM buiNirp or'unprovemeM o wid xilhin p�s yw d aompblion, Uw
owmrbuiker xiil heve tly Wiben d povi�p he or ehe Ek rwl Wild w improva la the WP�e d sels).
� I, m oxnor d tM prapeily, am utluA'dY aonVm�q xith IioenmE conVecYm b canetnW Ne MNee (8aaion t0u. &oiMn aM
Pmlxa'vu Code: TM Gaureem licenes law dau na1 eCM/ lo en owner d P�w�Y x1w bultls n imD�'a IMrwn end wM
eomrecb la eu� Pqaee wiN e aommaa(U �e�sad W�swm lo tM Gaurmm licwua Law�.
� I un azemq wMer SecuOn: B. 8 V.C..lar Nu �sam:
Deis: Ownr.
I tlo MnEy cMity tlut I am ewye d vd uMsnWM Ihe �sVui�wnmua d Celyomis HeMh enE Setely Cads 8eplau Y5'A5.25593. aM
uSN, vW ihat I or eny Mun y�ilEmp awpem will / wil �(dreb one) iwod b comply wih saiA tlets mEm md IM iepuiremann br
a psimit fwmnsvunbn or modi(KqimfiomiM �4aw tyZl%enapamanl0fqnd. FwIESMieIm�Miupion eppimt(on�en examq(mm Ihne
povitmns.
Dals:. Applicam:
WOPKER'9 COMPENSATON DECLAPATION: I Mratry dNm undar psneM1y d prjwy ar d Ms idbvriiq doderNiau:
� IMwvdWme'vitenep�p��dwn�anitoeatlimwaMxaken'cpnp�nWion.oprwkaAlaEy&Wbn�lOpolMlaba
Gods. trc tM pMamvica d iM wak Ip wFirA Nu pamiY u u�usd.
Q � n.a. w.0 meimen.�ond+• mno�� ����•�w.... na��.a W s.ann a�ao a me �.bar coe.. ror m. a«�«menoe a u»
n work ta whidi Mw P�0 b umuad. MY waMn' comGeremion vuuranee mrier ud O�Y wmM en:
c�»,: CONTINENTAL CAS EXPIRES
Pd'ryNumbr: W�' i�� itii an vti 10/01/96
(Thla u�fion nesE riw be romdHSJ / fM prmr! i� M one huM�ed dolMr� �YfOJI w IsuJ
� I eMlly Uut in Ne perlohnanee d iM woek lar vfik� tMe psimn ls b�ustl, 1 eM1ell � empby eny pemn In eny mennar w u to
become subjad to tM �mrFye' rompenu�ion lexs d Calilanie, eM epros ihtl il 1 ehwtl become waaq b Ih� xorke�a'
compenution pmviaiona W$�pqn �)Op M Ihs Isbor Code. �ydlfin wllh oomp�y xilh tliws pim�isions.
i
oats: //7 /� i/ ApDN���
7
W�mlrp: F�Yun ro�cw woMw�i rompw�wtlon covMy� b w4wN{ �nJWll wDNcl �n �mplonr ro �ul pwltlu uM
nw nnu �y ro om h�nany u,ou,w dww. (sfaq000A M�i�n ro eh• eo.r oi mmo.nwwn d w u porw.a ror m
8�ctlon �]G6 0l tln LeDoi Ce6. Irrt�u4 �ntl �ttom�Y� fw�.
CON9TIIUGTON LFNDINO �pENC1': I IraEy elfi�m uMer pene4y d par�ury tAa tMn u a ww�uuion WHinp apam.y br Ur
qAoemuwe d Ihs v.ak la whitli Ihe ps�mY h iseued (Setlion 306/. Civ. C).
LENOEP'$ NAME:
LENUEF'4 �qpPE49:
1 ceniy Ihel I �eve read this epp�i�pion end pete Ihm iM ebove iMormelion Is mmd. I epise to aomply wllh all pry enE munty adinenoee
enE �We lews roletiq to builEqp ��W�pp� yy hxeby eWwraa �spreanlatiw� d Ihh dty �o entar upan iM ebove�mantioned qopsrry
r«��ewe�w�wbs. LQUIS RODRZGUEZ
�(5151JO.WP)
u�.: /� � S--Sr
Whue-Quild'vp 8 Sebty:OreemFle: Ganery-Appfum; %nk-Nevenue; Goldomo�Mtsewr
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 75 UNION PRODUCTS OFFICE TI, RE:#B74633
iF iE if iF 1E iF iE 3E iE iF iE iE �f If if iE 3E iE if if !f 3E iF iE iE 3f iE if iF jE if if iF iF 3E iE If IE iE 3F iE iF iF iE if ik iE iE iE if IE if If if 1E iF if iE if If iE'rE �E aE iE iE if iE if iE iE 9f if 3E iE aE iE iE #
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING -------- —
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 2NE: REF NO;
PLANNING NOTES>
� ' �,f
n
t.iE 1E 4 iF 1E if iE 3E 1F iE �k if �Elf iE �f iE k iE 3E if jf !F iE !E �f iE iE �E iE 1ElE 1E 3E if iE jE�E 3E iE iElE �E iE 3E fE 3E 3E iE iE iE iElE if iE if iEiE iE 3E �� iElE iE iE fE if i! iE iklf iE iE iF iE iE iE dE if
^ D E V E L O P M E N T S E R�J� I C E S R E Q U I R E M E N T S
���ONING APPROVED BY �' DATE:
HUILDING APPROVED BY : ��� DATE•
�********�*******D*B*�i
LEGALI2ATION;N
� �r.
.t '
F E E S U M M A R Y
DATE: l� I� ��
if3EifiEiE3E3Eif jE�1E
STRUCTURAL SEGMENT:N
'BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 117.00
25� SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CAECK TOTAL PAID DUE
TOTALS----> 117.00 15.00 0.00 132.00 132.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 132.00 OVER/SFiORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CH£CK
132.00
iF 1E ik dE iE jk 3E if if iE iE iE iE iE if if ik �E iE iE iE iE 3E dE 1f !E 9E dE 3E �E 1E df !E!f 9E * iE if �E iE iElF iE if !F 1F if iE 1E iF iE iE �76 iE jF # 1E iE iE iE �F �F �E iE 9E if jF 9E �E �E jk iE iE 1E iE �E dE iF 3E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 9 ��AV BOX 6.50 58.50
MEC 11 FIRE DAMPERS 4.50 49.50
MEC 1 INST/REL BOIL/COMPR 0.0 - 3.0 HP 9.00 9.00
END OF FEES
/
Q1 OQ192390-6D192390 'Y�3T ?32oQ0
DhTE: ;p1:4/4j iIi�E� Q9.°2
- -_- ,; r �
_ CONSTRUCTION AND PLANNING PUOL & SPA __
APPROV�LS�. Permit �k- _ Date �nspector qPPROVALS Permit # ' Date .� nspector
"t. Temporarv Electricai Service or Poie 52. Pooi & Equipment Location '
� 2. Soil Pipe-Undrgrnd. � 53. Steel fleinforcement • .
3. Electrical Conduit Utility-Undr9rnd. 54. Forms '
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test
fi. Electricai UFEft GrrttS. 57. APPROVAL TO COVER-GUIVlTE
7. Footings 58. Electrical Conduit-Undrgrnd. �-
8. Foundation 59. Gas Pipe, L� Undrgrnd., Test
9. Water Pips-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Struttural Fioor System 67. APPROVAL TO DECK
i i. Property Sevaer Line & House Connection 62. Backwash & Receptor-Finai
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains � 64. Plumbing System � Final �
14. Rough P�umbing 65. Electrical-Finai �
15. Rough Etectricai-Co�duit + � 66. Solar System-Final
76. Rough Eleccric Wiring � . 67. Fencing & Access Approval
t7. flough Wiring Sign . 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough He9ting & Air Conditioning L� FIRE DEPT. FEQUIREMENT
20. Rou9h Factory Fireplace APPHOVALS Permit #
27. Ducts, in Struaure 70. Underground Hydro
22. Ducts, Ventilaifng 71. Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Fram�n9 73. Undergmd.StorageTank OGas ❑0�1
25. Roof Sheathing 74. Overhead HYdro
26. T-Bar Ceiling (Structural) & Monocoat 75. D�y Chemical .
27, Frame and Fiashing 76. Dry Standpipe
28. Lathing&Sidin9 77. FIXEDSYSTEMFINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywa�l Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electr�cal Powzr Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Finaf Electric Notes:
34. Final Heat�ng & Air Conditioning �,���
35. Final Gas Pipe-Test
36. Hood or Canopy .
37. Final Factorv Pireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Final
42. 8ackfiow P*eventer
43. Backflow Irriqation
44. Landscape Irrigation System
45. Sound Atzenuation
46. Handicap Regulations
47. FINAL S7RUCTURE & BUILDING
48. FINALPLANNING
49. Elearic Release to Edison
50. Gas Release to Southern California Gas Co
5L CERTIRCATE OP OCWPANCY
No. Date
!
pUDPE550FBUILqNO: SSS ANTON HL
°�"'E'"s"""E'F'°'°'"": SAKIOKA FARMS
AD°"��' PO BOX 2097
' "` TERMINAL ANNEX
�PPL. MAllWO/iDDflE44:
u"T 8 TH
�xcxneaox�m�n: TRI-SIGNAL INC. °0N0i 0
1NCX.OHENO.'S�OOflE59: 19QS GARDENA AV 818-247-1194 uxr:
GLENDALE CA 91204
coxm�cTarsruuE: MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
cwm�croas wuuxa p O B OX 5 0 9
�oonEss: WALNUT CA ��� 230813
91789 uxT:
LICENSED COHfPACTONS DECL�XATION: I Mmby eRim uMm pa�aly d pe�ury ihm I em licenxd uMm pwiviau d Chaqm 9
(rommendrp xilh Section'l000� d Diviaun 3 M the Bininess anA Prd»aiona Code, erM my licenx o in full law e�W eHed.
cmuc.No.:O 655y/8� /��c.cuss: uc.No.: z3081 EXP: 2/�96
Dma:/ �'� �/ (/J COMrador: �
OWNEN BUIIDEN UECIANATION: I Mnby effi�m uMer penely d perN�Y �� �� amq om tha Comredaa L'xarue Lew /a tlre
folbw'xig reeaon �Sedion'l0�1.5 &remeae end Prdeaeiona Code: Any cily a ownly v ch re ires e permit to mnatrun, eller, impare,
emdnh, a mpev any etmcwra, qiar m iis esuence, eho repuires the epplicen� lor M1 pe n ta fb a eigiwd eie�ement Ihe� he or ehe
IicenseE W rsuan� to ihe provieiom d tM Conlreaore licenae Lew �Cheqm 9( ma 'iq wilh Saqion ]000) d Divwbn J d �he
dusrefa eM Rdxtiona Code� a Ihel M a sM ia e�emp ihxehom eM tM e eAapeE azamqon. My violelion d Setlion
'ladi.s M em evWirani �or a oermn wbjee. �ne evW�ram �o e dri� w�eM d na m«e ine� tve hwia�ea adws �Swop.
� I, es awner d Iha proparly or my empbyaea wdh wepea m �he'v eole mmpanaelion, vrill Eo IM wak. enE �he Mrudure o nM inlentled
«oneree r« we (s�im� �oaa. eumn� �e araessons Coaa: ma com.m� u��a. �w d� �o� �y�o � o�a,or p�
wM WJds w inprov» Ihereon, eM xfw daea auch wark MmceH w herseM a Nrouph hb w her own empbyeec. provketl iMl wch
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: F 075837 PLAN CHECK NO: 04814-95 L
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR
PERM NO: F 075837
GOVT; N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC-VALUE: GROUP OCC: H-2 /
COMMENTS; 76 UNION PRODUCTS REF: B-74633
�t*it*�tx�et*x��*�t*it�t**�i�x�+��t�+tit�tiex�i�+��+��+���tx�atit�*itat�r*x�*x�*it�r�x�*�-*�x�it*i��it***itit+t+�+�*et*x�x-et**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REp • PROV: PARCEL; 91050104 ZNE: RE£ NO;
PLANNING NOTES>
i
iE k df if iE it iE iE iE iE iF iE IE 1E i! 1E 1E iE 3E iE iE IE 1ElE iE if 1F iE aE iE iE iE iE if iF 1E iF iE 3f it iE if iE 3E iE if iE if if iFlE iF iE iE iEl6 iE iF iF iE if iE it �f iE 1E if it �E 9E if if iF it if iE iE IE IE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
imprwemenn ere nol imeMed a oHered la eeb. X, Mwever, iM huiNirp a'vnpwemem is eold wilhin aw yaer W mmpblion, iM Z ON I NG AP P ROV ED B Y DAT E:
owrorb�ildar xill heve tM WMm d proviiq M w sM1e ditl M Wik or'unprove la tha Wmosa W eeb).
� I. es owrrer d IM propaM. � e�d�irsM �nirenip ti�h linnxd cantreCpa to wnstrvq �M qojad (Sedion 10a4. Businse eM
Prolessions COEe�. The Ganveeon License law doec na eppy io en avmer of propaM �o WiNe a impavm thareon eM who B U I LD I NG AP PRO V ED B Y : DAT E:
eonlreela tw euN Drol� �Ih a eonlredor(e) lieeeread Punuenl lo Ihe Conlredora lironse lewl.
❑ i�,.,�,p��a„s��: e.av.c..i«m�.,�: APPLICATION ISSUED HY: DATE:
oaza� ow�.: 1EiEiEiE�tiEiaiEikifiFifiElElEiEIEiEiEiEiE1ETf7E7F3FiF'iF7F'iF3FiF7FiF3F7F'iFiF3F3F'i'FiF;F�f3F7F'iF7F iFi� 3F{F1EiEiE+EifiEiEifiEiE iEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
I do heraby cenlly thv I em ewera d erd uMersienE �he reQuiremenb d CalAomie Hml�h eM Selety Code Seclbne 25W5, 255�3, vM
25530, end ihm I a eny iNure buildiip rcapem xill / will na (tlrcb me) need to canpy wIh eak atale wdes eM �he repuiremenb far
,�aia�.wn�,��e���men:�v '�ea��omna.a<wa�i�������.a,.�.�,pr�in�. BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
aON9O1" P E RM I T
ome: naa�cenc
WONKER'S COMPEHS�TION DECI�flATON: I heraby elfiim uMer penelly d perjury aw W Ihe Idlowi�p Eetlermiom:
❑ � nme e�e w meim.n. �enncme a owvmi io.en;mum �« waxers canva+.mion. e awd.e �o, M swim aoo d m. �en«
coda �a �ne wno��<a ins wwx i«.w:�n in�. o�a 4�„�,a.
fl i n� �e �;� m�m�,.w�.n oomw�b� ��s����. � reawred �y sen�� aiao d ma �, cae., w, me va�ro,m�a d m.
� woM tw which ihis pe�mil s ieaued. My wakere compenmlion inaurenro umer eM pdiry number ere:
c�� F]REMANS FUND EXPIRES
ra�rmme��: nwrAnF�FFq� 07/01/96
�This sMion need nw Es compb�ed f fM pemit is br are hundred dolMn (Sf00J w Iess.1
� I ranity thet in �he pe�lormence ol tM woA la xfikh Ihia parmn ia iaued, I ehell nd amdW enY P�m� in eny mennar eo ac lo
becwna wbjea �o iha .wMn' mmpeneaiion lew d Cdilwnie. eM epree ihel H ehouk become wbjetl t� �s 1�ro�lmri
yemman�bnyo/ Seeyn �)00 d IM labor Coda. I �re hwn� ' Noro pewisnna.
Ci /'
oe�e: � f !� nnd�,c
WGMlily: FiINI� b�OCYR WWkMI'COmpMYltlOO roYNIQ! Il UOIIWNI� IIIO tl/ aub cf an xnp/oyx fo ctlM�xl pxuNu enG
elvll flMs up ro one hundreJ fMua�nJ OO/Nn (S10QP00/, In eetlltlon ro M� t ol mpxwtlor5 d�m�p+� �� poNdW br In
Sxtlon 9)OS ol tlro LaborCOW, IMen�t, and ettomeys /ess.
CONSTIiUCTION LENDIN4 AGENCY: I hereby �im uMer penaM1y d pxN Ihare u e mnArutlion bMinB Werwy tm iM
parlwmenee W iM xaek /w wfiieh iha pe�mi is ivwed (Seqion 309], CN. C).
LENpEH'S NAME:
LENDEH'S ADDfiE55:
1 cenM �� ��� �aed I�is applcmion end pme ihei the ebave in/ormetion is wnea. I pree io compy wnh ell my end coumy oNinenoae
arM siele lews reletng lo buildvg wnalrudion aM hereby eNhorae repreaentetivas W t�e dry io enter upon iha ebove-mentonetl pope1ly
for inspedion purpwes.
CHUCK JACOB JR
�� Pnnl Name
�� h o�,h� �/�
�gnet re oi Owner UR cenUConireaa
(5151-48.WP) I JNhna-Buildiq d Selery: arearFFb: Cenery-Rppirant: Nnk-Revanue: (3okanraa-Asaeaea
L/
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 90.00 0.00 58.50
REVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMBING ELECTRIC MECHANIC
90.00
652 SMIP/NON-RES
Se,So
TOTAL PAID DUE
148.50 148.50 .00
90.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
90,00
1E aE �E iE iE iE 9E 1E 1E iE iE �)E �1E 1F iE iF fE iE iE iE if iF iE iE iE'IF'IF iF'1F fE iF aE Ik-IE iF iF �E �lE'1F jt iF 1h iE 1E ik if �E if jf iF iE if 1E 1E iE iF �F 1ElE 1F 3E'IF 1E iE iF iE iE 1E 1E iE 9E 1F iE iE iE jE 1E'%1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 90 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 90.00
END OF FEES
��
.,
-=r
OZ �07975�7-CO't"r7E'r7 u a� T ?O.GO
oars- ax e_;�= rtt;. ..�:,a
� C4NSTRUCT�ON AND PLANNING PO,O. SPA !
APPROVALS Permit# Date Inspector pppROVALS Permit# Date inspector
- r
1. 'Lemporary Electrical Service or Pole 52. Pool & Equipment Location ' •
I
2: Soil Pipe-Undrgrnd. 53. Steei Reinforcement .
z
-,3� Electrical �Oond`uli Utirry-U�drgrnd. 54. Forms `
r
' 4�- @Iectrical Con�uif;Undrgmd. 55. Electrical Bonding /
� r� .-
�.; 5! Steel fteinforyement � 56. RougFi Piumbing & Pressure Test '
��6_ Electricai UF.Eft�GEnd. 57. APPROVAL TO COVER-GUNITE -
�.7: Footings -r�- 58. Electricat Conduit4lndrgrnd:
- 8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash LinesrA_Trap, O Undrgmd.
10. Structural Floor SYstem � 61. APPROVAL TO DECK
11.: Property Sew¢r Lihe & House Connection 62. Backwash & Receptor-Final
72.' Sewer Cap ` ' ' "' _ � 63. Heater & Vent-Final � -
13. Roof Oreins � 64. Ptumbing Syscem � Fi�al
14. Rough Plumbing" , 65. Elecxrica6Final
15. Rough Electrica6Conduit '� 66. Solar SYsiem-Fipa� - "
16.� Rough Eiectric Wiring _, 67. Fencing & Access Approval (
-77. RoughbViring5ign - 68. APPflOVEDFQRPLASTERING
18. Rou9h Electrical;T 8ar Ceiling�� � -• 69. POOUSPA SYSTEMS FINAL
19.� Rough Heating & Air Conditioning FIRE D�PT. REQUIREMENT
- + �.� _
20.RoughFactorY.'Firep�ace °',^t'�, a• � `;�''APPROVALS;;FPe%mit#_;_.-.. �
i
21. Ducts, in Struci,ure ; t ��• � - -+� � 70. Undergiound Hydro �
- T.
22..pucta�,Ventila?in9`-'.a, � � ,�, �� �71. ProducL�PipingOGas COiI
�- �
23. Gas Pipe-Rough & Test • ���� � ;_1+ 72. Underground Flusfi �
24. Roof Framing-' ' � ' " � "�, a �' � � H*, �;73'Undergmd.StoragLTank;OGas ❑Oii
25. Roof Sheathing � , •: s � � �� � � 74. •Overhead HYdro �� F' �
26. T�Bar Ceiling {Str�ctural} & Mon,qcoat ° �� ;'' k 75' �Ory Chemical � �^ ` ' _
27. Frameand Flashingr, ';Y�. � �� � � i 76 DryStandpipe' � • � '
28. Lathing &rSiding _ r • - -- ` � " "* 77` FIXED Sy,STEM�FiNAL' � -. �
29. Insulation� • .� �_ . � � � ' 78;fIRE PREV. F�Na'L � - `� 2I� �� ;�vj--
30. DrriVail Nailing � y - HEALTH.DEPTt REQUIREMENT
^,37. Plaster Brown Coat` � ���- +' i�79� FINAL INSPECTION T
32. Eiectrical'Powe7 Metet-Final '� '�80._,FOOD CERTIPICATE ISSUED
33. Finai�Eiectric�-• . - � � �� 'x +Notes: - '-? ' _ :. �
34. Fina��Heating&AirConditioning . - � '- . "' � _ � -
� t� r � �=+' i
35. FinaPGas Pipe:Test ;* � '� , �, � � � _ y -
�•
36. Hood or Canopy c �� F� � _ ' �
1 T
�37. Final�Factory Fireplace ! �� r� . r# yj • _- I
3&. Finai.Plum6ing � ` � - ' � -
� 39. Water Service�Finai " Y � " � � � •
r ,. - _ _ � ,
40. Gas Service-Fina� � � T � . ' - -
t- ,
41. Solar pomesticFinal, - - " , � �� ` f
. -� a � , ., _ i
42. Backflow Preventer . � � t�� • - • . �
s • ; • ' c.
43. Backfiow irrigation _ '�, • , � . � " �'�' �.
44. Landscape Irripation5yscem � - � • . " - ' xH �• '
_ ^� �
45. Sound Attenuation �- ' � -' - ' - . . - `' � �
. . �,; � �'
46. Handicap Regulations � J�� �
T
47. FINA� STRUCTURE & BUILDWG _ , � �f �� - ,
48. FINAL PLANNING > .. � '. , �
49. Electrie Release tp Edison � � �:� �� `�„ . '
5�. Gas Release ca Southecn Ca4ifosnia Gas Co - - _- •
4 Y '
5.1. CERTIFICATE OF OCCUPANCY� • ' -
No. Date
nooeEssaem�arw: SSS ANTON BL
ONNERSNAMEIFpqNN: SAKIOKA FARMS
ADDFE55: PO B �}{ Z � 9%
� �� TERMINAL ANNEX
AVPI. M41IINi ADDNE55:
�flCNRECT ON FNtlNEEX:
NMN OF ENO.'S ADORE55:
. uNT: BTH..._
UC NO.:
uNr:
coNm�cTarsw�ue SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
CRlfH1CTOR5YYNl0 215 E EL SUR ST
aooxEss: MONROVIA CA uexo.: 190173
91016 �,n,
LICENSED CONTXRCTOPS OECLRFRTION: I hereby ellim under pneYy of perjury Ihel I em liceneed uMx povivione ol Chepter 9.
(mmmenarp wi�h &aetion )000) W piviaion 3 d ihe Buai�se e�k Profseaiona Catls, W my lieeew Is in lull Iwce end eMed.
cmuc.No.:013054 uc.cuss: C 16 uc.No/�.: 190173 EXP: 04/96
ome: %O^i�3—S t ca,v.�o�:
�l'S • /�li�-y�
OWNEF BUILOEN �EC WRATION: I hereby eifirm unCer paneAy W perlury ihe� I em eicemq fwm IM Contredon licensa lew Ia Ihe
'dbxinB �e%+� l�bn 1W1.5 Bue'rreaa eM Prolpaiona Code: R'ry c1Y a muntY �ich �puirea a permA lo wnetruct. ellx. Impove.
kmdoh, w reper eiry avueture, pria io ue uewnea, ebo ea�uires �he epdimnt for weh pamiil lo fik a tlpriW efetamenl RW M m oM
��
m licenaed W�e�l �o �M pwiaiona d IM COnlretfaf Lipnsa Law �Chepim 9(�menii�p wnA Swbn )000) M Diiuion 9 d Ihe
Bueirbae eM Prdeaims CoEe1 or tMt M a Me is uemq Iherehom eM the buie fa Ns dbpad uemqion. MY videtion d Saeion
'/03t.5 by eny epplicent lor a permil wbjem Ihe eppiram io a dvil pnely of rw1 mas Ihen Ma hundraE Eollen �SSOOJ).
❑ I, m owner ol lhe pmpMY or my empbyeea Milh wepee u Iheb ede companee�ion, will Eo IM woA, Md �he sl�uMuro i nd Inlendad
or Mared la eela (Seclbn )OM, B�aine» end Prdeeeions CaM: TM Convecton Lkenes Lewdaee �wt epplyto en iwnerd Oroperty
who W ida w'vnprovea �hereon, uM Mn doee euM wah Nmrll w Mreetl ar tMap� Ae a har own employaee, prwidaE ihe� wch
impwemenu ve M imeMed a dlered fa eeb. tl, howwer, Ihe W iki�p a inprwamsM u wtl wilhin aa yw d campblian, tM
owner-0uikm will heve iM Eurden d pmnrp M or ehe d'k nd buik a impow fa �M Wmoee d We).
� I. u owror d tM popeM. ��tlua'rrely mnlMip wnh liqnead wnireclan to coneVutl iM pqaq (6eeion ]ON. Bu�iiwea aM
PMeaeione Code: Tha Conireclae licenes Lew tloee na appy lo an owner al propMy who buiMs or improvee therson eM wfio
comrmis Iw auch pml� ��h a mmreaor�s) licenasd pumuenl lo ��e ConVeaas Lipnae Lew).
� I em av.emp urMar Secibn: B. 8 P.C., lar ihb reeaon:
Deta: Owner
I Eo henby caniy Uw I em ewue W vM uMenwM iM reQuiremems ot Celfomu Heallh uM Sde1y Coda 3eaiom Y5505, 255�3. eM
25536, enE ihel 1 or eny /ut�ro Wikinp oaupaM wiil / will rwl (drcb one) rroad Io comply wIh uid tleta mEn uM IM repulramenb br
epermnlarmnel�uctionormadiAutionhomlheAk u3Tyl.repamomDletnp.ReeiEanlWconatr�wianeppYrellomwuemptimmihaes
proWaione.
Dete: Apd��
WOFKEN'S COMFENSATON DKLAflAtION: I haraby dfirtn uMer penelly W pxjury ms d Me Mlowlip dedermiom:
� I heve uW wiY manlen e ceMNiute d caneenl to �eM�ineure M waAen' compsnWbn, m pwidetl lor Ey Sarlim 3100 d Ihe lebor
Cods, lor �he pedortnenas d ih� woM lor which ihie permtl ie levued.
� I havs uM xitl meimen warken' mnpenalion Ineurems, u rpubed by Seclbn 3]00 d tM Lebm COEe, br IM pMamenw d IM
work Ia whkh ihb pormd b lausd. My wwbrt oompenamion Inwrar�cs umer yM pd'x.y numbx xa:
c.m..: FREMONT EXPIRES
Poi�r N�me« 0 6/ O 1/ 9 6
(This .vedion nsM rwt bs romplNSE llh� permk /e lor wrs hundrsdOdluv (f1oJ� a Iw.)
� I cerlity ihtl in Ihe peAormenw d IM wak la whkh Ihb prmil ls beued, I ehNl nd employ arry psnon in eny menmr ro u to
becoms eubl� to iM wwk�n' comp�nuiion Wxv d Celilamie, aM prse tlw J I ehouk E �ma aqaq io IM xoM1an'
mmpenaelion peuoviabns d Seaion 3]00 d iM lebor Cada. I JWI 1 h mm wMh IMea piwiabm.
Dele: ��i%''S� Applianl: �� �/�'���
Weminp: F�llun ro�xun wortx�'rompxueNen eov�np� l� �nl�wN( end �N/I �ubfM en �mployx ro crlMnsl pxi�ltl�� en0
C/Yll flM� up ro ons hundrM IMuwrM dollan ryfao,oaaA �� ��1d�tlon ro tM cwt o/ rompsiwnon, Wm�pes u provldM ror In
9xtlon �108 0l fh� Lebor Catlr, InM1n�S ��d etbmsy'a /wx
CONSTflUCTION IENDINO 40ENCY: I heiaby elfiim uMer penalry d per'ryry �hal iMn ro e eonsvuqbn ISMi�p aperwy for IM
peelamenee d IM v.oik br whirh ihi permi b ee�ed (�� �1. CH. Cl.
LENDEN'S NMIE:
LENOER'S R�ONES4:
I cerliy ihm I heve ned �hia epdbeiion end elete �hm Ne ebwe inlomu�ion ia mrted. I eyree to wmOM �h ell rily arA mumy oNiruncs
eM stete 4x+roletip lo Euik'up conatrutlbn eM hmeby eulhor¢s repeventetiwe d �hq ary to amer upon iM ebwe-mentionad papery
Iw insPa� W�w
' �
/�--�
Dtls:
Si neNro W Owrbr/ApenVRppYcenUConVedar
(515148.WP) Whns-Buildiip 8 Selety:Oreeri-Fle; Canery-ApPNun�: Pink-Revenw; Ookanm�Msspor
..., _, _ ,CITY OF COSTA MESA -,BUILDING..PERMIT
. .. „ _ . _. . _. PERM NO: F 079749
PERMIT NO: F 074749 PLAN CHECK NO: 04039-95 L GOVT: N SUPP: N
CONSTAUCTION TYPE: 1-FR, _ �. , PEAMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : RELOCATE FIRE SPAINKLERS SQ FT: ...
CLAIM VALUE: , 8,900.00 CALC-VALUE; GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74633
x�+rx�*�r**�r*+r*x�+�x��**�r+rx�*x�**�r**�r*�r***�r*+r�x �r�r*��r+��r�r+���*x *****�r*�r+r**�r**�r**+r*x��r**���rx�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
iE IE 1E1E 1[' If lhff 1E fE iE 1E1F IE IE 1E iE iE 1E iF iE iE 1E 1E 1F 1E 1E IE1Eii ii IE iE IE li iE if 1f if 1E 1E 1E iE if 1f iE iE 1E iE 1F iE iE 1E IElE IE iE 1EiE 1F 1F IE 1E iE iE iE 1E iF 1E iE iE 1E 141E 1E iE 1F i4 if
D E V E L O P M E N T S E R V I C E S R E Q CT I R E M E N T S
ZONING APPROVED.HY.
B.UILDING APPROVED_BY
LEGALIZATION:N.. � _ " .,
BLDG PMT PLUMBING
E E, . S U M M�A R Y
ELECTRLC MECHANIC FIRE,
1086��
70.20
�'�it�l i �'
PLAN
ISSUE FEE
BUILDING-DIV,-> PERMIT ISSUE PLAN-CHECK
TOTALS----> i 108.00 0.00 70.20
REVENUE DIVISION.TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTAIC MECHANIC
GATE:
DATE:
DATE • ����
1E 1El4iE iE 1E 1814 11� 1E
STRUCTURAL SEGMENT;N
SMIP/RES GRADING
SMIP/NON-AES
TOTAL PAID DUE
178.20 178.20 .00
108.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
1�8.��
1E iF k iFiFik iF if iF iFitit it iF iF if iF �)f k M kiFk 1E if if if if �kikiFik 1f ik 1F ik 1FMiFM if iE iE']F M iE �IF iE k'lE'If i! IF iik iFk N iE iF 1f iF if iE if iEiE ik iE iE'IE'IE iE k k iF if iE �F
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY �.D.E S C R.I P T I O N UNIT COST TOTAL COST
FIR 108 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 108.00
END OF FEES
r.i �'
.. �.
` ,�
i71 GG;9?7�5-0019279` T �tT t03.00�
�a��: ioi23f45 TdF1E: ii:;;a
- SONSTRUC'fl0(J�AND PLANNING P00� & SPA
RPPRO�/A-'L�Perm�t-#--�'- � Date Inspector pppROVAtS Pe�'fi,:���„_�s ."'�te' � Trtsuector
l
t.!Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion ':
2: Soil Pipe�Undrgrnd. ,,, 53. Steel Reinforcement ��
,
�a;�fiectrical CondGx UUlityUr�Plrgrnd. 54. Forms - • �
�
.�"4�€lectrical ConduiL�li"�1r9rnd. ,•,; 55. Electrical Bonding . ��
7 t' --
-d,5. �teel Reinforcernanr, 56. Rough Piumbing & Preesure Test
;"a,6,?�lectrical UFEft"�nd. 57. APPROVAL TO COVER-GUNITE
-�'7�Fvoting5. ,.�N � 58. ElectricalCon niT•Undrgrnd. •
� 8. foundation �'%x O1 �' S9. Gas Pipe, O Ur�F�,grnd.; Test
�,
9. 4Vater Pipe-Undrggnd." ' 60. Backwasfi lineb, R,Trap, �}Jndrgrnd.
10. Structurai Floo $Ystem ' 67. APPROVALTO�SECK ''
it�. Properry Sewer;l ine� Hous��..'onnection 62. Backwash & Receptor-Fina1 ' .
12. Sewer Ca0 G � i 63. Heater & Vent-Final !
�
13. Roof Drains �, � 64. Plumbing System � Final �
�
14. Rougn Plumbing+ Y 65. Electrical-final ��
15. Rough Electric3'�Co�duit 'r 66. Solar SYstem�Fi,rpa{
76. Rough Electric iripg e 67. Fencing & Accass P,pproval
17. Rough Wiri�g $�n � 68. APPROVED F,�l�PLASTERING
78. Rough Electri •T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & A%Cond�tionin� ,r� * � � �� �, , F�,F�q�PT�HEQUIF�EMEI�.IJ' �,
r ' y• '4 '1 �. J - � Ci C*7 > i�
20. �ou F to� Fi _'{�'lace �` z` �� � � i Cx r APPfjf�Ju,,,A��c., P�y:rnit #�� rr ^
-,-,
21. $uc(s in�tru�[u � ..�.. SH y r �� 70. !LJnder�j'i'�j�,�d F�dro "�
s�^ _ � . A
22. $uc(�, V�til�in .y. � �- y� p d . ��r. 71. Productl�iping w as � Oil
23. Gas Pipe+Rough & TxSt ��� MS r' m � c �r � 7y_ Undergrau d s'!1 r �, G
C �^
24. rHoo�Fr in " ��f � FF ..F: ,c ^. � - `a - -,a
�7 g * tr7 � r t.tir . k3. Under9rnd. Sto�.a� Tanlv � Gas ❑ Oil
25. RoobShe3ihing S» d � � r �; ' 7'g, Overhead t',�-=S:C,�JS....� /.1-/ 4'
26. �-Ba�r,r;Cei�ing (Stri��Urall & f�i�`q'�,oat Y�J ;,y c r . Dry CheZniea4 ;-.� �. ~ H
27.Fvarneare#Fishimg� =C� Ma • olx 76. DrySia� p�pet"'� x: `�
� r '�a �p� �-7 r�. 7 N
�� 28. Lath�ng�Si�qd� y C�F a K� .. .•# 7�. FIXED;SYSTt�Aq7-INAt�-� t"i G: ��S�r'/(p y(��_
29. Insulatiotf. _' f» r, S '" t � i �. PIRE PREV. F�QL �:� ". _ Z'-���( ��
' 30. Drywall f�ailir4g �'* ^. � x F, I ( t �ALT�1-1 DEP�:�EQUIktEMENT
l 31. Plaster Brown"Co8i1� S ' b"[" * � � �^ 79. FINA� ECIVi�N ' `•T'
M
" 32. ',Electrica�ow�r Me��'f�gal i *�� ' R B�; FOOD CERT�F�i�,�TE I,��fER0. t^
V. ' \'.l ' 1 V 1 . . _ ••.
33. ,'Fina,h.flectri� � x :�1 i 6 i � t� N'otes: '� '�r1 �`7 O OM
� 34. �naT=He�t"jng$ l���iiftionir�j= n ;' i { � S h,^. M 5
.., r. t M A� ,i • � r�: F� 7' Q1
35. ,�ina Ga ipe-�esL* U •• *� . �c 7H x� f.J?�
x m
36. �10o�.�or �BnoPY * � ' �y 'a' * '� ' E i i��+ i: , r
%� �l I �;r, :6 .^.6 # 'T7
i #
_ 37. Fina7•�actory FirePbce x i NE-� rv W�� , � �c � T� .K -.�
38. f5na�'lumbin �' N � `� x � `-", ` " ,y
a, 9 .: RJ i c *� i t Q � ._ V; ,-
` 39. �ater'Service-Final y� � , h �c � � rvj � x o �a� � -� �
� Ix K �'
•' 40. 6as Service-Final � M n�� ,s x n � � �� o� `� ,Q `�
:
_ 41. 'Solar pomestic-Fina� '�' �„ �r i m o � -70 � + z
_ ^,
42. Backf�ow Prev,enter'" R �` '� w ti' '' ' * r ''
A N ��-:i� n r -1 Oti:�` r� c
43. Backflow Irriqation � > �� r r � v a� ^ •
_ *
?F4. Landscap"� IrRGatior�SYStemD";��� S = m ^�7 �». a '3 N -+ xC) � N..
. `. t. �'+; rt c' . x � £ S O� v S `�-�
� •'1 , :.� �. � r. r - ' �
$5. �ound qttenpationx . .. s rn -. �-t < <� � S~ `^� >
- � 1 • -1
� � ),. T 'j: �" L•� • S !
36. hhndicap•Regulatioil3 t, * y , y. � V �, �
A7. �'INRL STRUCTUf� & BUI 'DING 7 F.. ! � ' '" � :: �-
- � : r� +� 1
48. EINFCL PLANNING* ' E"'� ` c� , w m � * `
r, # i � I tM . .^- i� S '� C
;j9. �]ec{[je Rele�e to d�son j , � rt � .;j * - � .
60. G'as R' lease to SoutFem CalifQ i�,t,asCo * '� `` ` � =• o�" +: C •
<- �o . �. .�
�51. CEFTIPICATE OF OCCUPANCY �' " ' • ' �
No. Date
Inc.
1000 E. Howell Ave. Suite B
Anaheim, CA 92805
Ph:�714) 937-5305
Fox: (714) 937-5307
TEST AND BALANCE ANALYSIS REPORT
... . . . :
��(� /"�_JI_a„�-a.�Y �����V� :, :�
� �N r.,,�'
� � /nYtl��..`:..�u '
. �
, -"""'4�^ � .,.s..-�+r : ..:it'---..3{'_�_ �'T�
�.... � f� � (��U11 i/j ll��I
U' � �� -:�
Y ..._�� .
�i
Cantrector:
H.V.A.C. Mechanical, Inc.
JOB# 5838
COMPIFTION DATE:
11j1j2012
Tech: Chris Miller
• UNLF,SS OTHERWISE NOTED, INDICATED CFM IS AT STANDARD CONDITIONS.
• FLOW HOOD USED ON ALL CEILING SUPPLY AYD RETURN TF,RMINAL U�ITS, ANU SIDEWALL RECISTERS ANU GRILI.ES
R'HERE APPLICABLE.
Page 1
.
csn
CEG
CER
CRG
CSR
CRR
EDO
EAR
FEG
FER
FRG
FSR
RAB
RAG
RDO
RLD
SAB
SDO
SLD
WE
WE
WR
WR
WS
WS
Mechanicai, Inc.
Connec�ofs Licrnse nf+R2IX/2
MASTER CODE SHEET
= CEILING SUPPLY DIFFUSER
= CEILING EXHAUST GRII.LE
= CEILING EXHAUST REGISTER
= CEILING RETURN GRILLE
= CEiLING SUPPLY REGISTER
= CEILING RETURN REGISTER
= EXHAUST DUCT OPENING
= EXHAUST AIR REGISTER
= FLOOR EXHAUST GRILLE
= FLOOR RETURN REGiSTER
= FLOOR RETURN REGISTER
= FLOOR SUPPLY REGISTER
= RETURN AIR BAR
= RETURN AIR GRILLE
= RETURN DUCT OPENING
= RETURN LiNEAR DIFFUSER
= SUPPLY AIR BAR
= SUPPLY DUCT OPENING
= SUPPLY LINEAR DIFFUSER
= WALL EXHAUST GRILLE
= WALL EXHAUST REGISTER
= WALL RETURN GRILLE
= WALL RETURN REGISTER
= WALL SUPPLY GRILLE
= WALL SUPPLY REGISTER
GENERAL REPORTING CODES
DNA
DNL
NA
NI
NS
NT
NVL
+
= DATE NOT AVAILABLE
= DATA NOT LICENSED
= NOT ACCESIBLE
= NOT INSTALLED
= NOT SPECIFIED
= NOT TESTED DUE TO ABNORMAL CONDiTIONS
= NO VALID LOCATION FOR ACCURATE TESTINC
= MEASURED WITH FLOW HOOD
Page 2
1000 E. Howell Ave. Suite B
Anaheim, CA 92805
Ph:�714) 937-5305
Fax: (714) 937-5307
Mechanical, Inc.
Conuac�o/s Littnu pG.qI0D2
FLOW HOOD
HOOD: A COLLECTORTYPE WHICH READS IN CFM
1000 E. Howell Ave. Suite B
Anaheim, CA 92805
Ph:�714) 937-5305
Fax: (714) 937-5307
METER: ALONOR VELOMETER WITH EIGHT RANGE SELECTIONS, THREE EACH FOR SUPPLY AND
RETURN. ONE POSITION SELECTOR IS ADIUSTABLE TO CORRECT FOR ALTITUDE
AND TEMPERATURE. THE OTHER TWO CALIBRATED AND SEALED TO READ OUT
DIRECTLY IN CUBIC FEET PER MINUTE AT CONSTANT VOLUME STANDARD
CONDITIONS,
RANGE
FLOW SENSOR:
30-500, 100-3000, 200-2000
0-500,200-1000,500-2000
DUAL Y." DIA. PIEZOMETER GRID SUSPENDED AT RADIUS OF AVERAGE VELOCITY.
Page 3
Mechanical, inc.
Contnno/s Limnc a6.C2W2
1000 E. Howell Ave. Suite B
Anaheim, CA 92805
Ph:(714) 937-5305
Fax: (714) 937-5307
DIFFUSER & GRILLE TEST SHEET
Page 4
'c-
(714) 754-5273 • Fax (714) 754d856 • wwvr.cl.costa- FIRE SUPRESSION PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite:
Viciniry:
555 ANTON BL
1000
STE 1000(BTE)
Parcel Number: 41050104
Applicant: SOUSA, MIKE
Address:
Zoning:
Phone: 323-582-5103
Zip:
Owner: PWREF/MCC-SOUTH COAST, LLC
,Address 535 ANTON BL. � ,
COSTA MESA, CA Phone:
SUITE 150 Zip: 92626
conuactor: KNESPLER, JOHN R
Address:
Phone:
Zip:
License: ` 160206
Status: ISSUED
Applied: 04f25/'1003
Issued: OS/12/2003
ISSUED BY:
SCOPE OF PERMIT
RELOCATE 26 FIRE SPRINKLER HEADS ON 10TH FLOOR. "BTE" IN STE 1000.
REF: 603-00553
Plan Check: $54.11
Permit: $83.25
Other: $0.00
Total: $137.36
FEE SUMMARY
Calc Valuation: sz,soo.00
Claimed Valuation: 32,soo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. Na. 92•28, § i, 12-21-92)
EXPIRATION: T�is permit shall automatically expire and become void it work is not commenced vnthin 180 days, or if work is suspendad or abandonetl
for a period of 180 days.
INSPECTIONS: In order for the work euthorfzed under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectione end final epproval must be obtained. Failure to obtain inspections end final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
z++e-ee �e�oo�
WORKERS'COMPENSAnON DECLAFiAnON: - - -
I hereby ettirtn under penalry oi per�ury one oi the following declarations:
❑ I heve entl wlll meinteln e certificate of consent to self-Insure for workors' compensetion, es provlded for by section 3700 oi the Le6or Cotle, for the peAortnance of Iha
�ork for whlCh (hi5 pBrtt�il IS i55Ued.
have end will maintein wwkers mmpensatbn Insurance. as requiretl by section 3700 0l the LeDor Code. br Ne peAortnance of Ihe vrork for which this pertnit is issuetl.
My wo ers' compensatlon In a carrler antl poliry number are: �1 I
Carrier. �� Pdicy NumDer. + I�/I 1~z-3�Z'
(lhis sect/on need not be cortrpleteOl! Ne Oertnif Is veluetl at me huiMred dollers (S100J or Iess.J
❑ I Certity Ihet in the
Canpensetlon law
comply wrth the
Applicant Slpnatur . �
WARNINO:FAILU TOSF
TIIOUSrWD E(S10
LICENSED CONTRAC'
I �ereby eHlrtn Ihat I am
torce and eilect. Lic. M
ConlrectoYs SI LL�pk
T7
CONSTRU ION LE
❑ I here eNi
Lender'9 Neme:
Slgnature:
is issued, I shall nm employ eny person In any manner ao es to becoma sub�ect to the workers'
ne sub�ecl to tha workers' compensellon provl91on5 of Sectlon 3700 01 the Lebor Code, I shall forthwit�
� Oeta: n � �z � J
ISATON COVEMGE IS UNLAWFUL AND SHNL SU91ECf rW EMPLOVER TO CRIMINAL PEWLLTIE$ AND CML FlNES UP TOONE HUNDRED
00ST OF COMPENSFTION, OAMAGES AS PR0I�DED FOR IN SECiION 3]OB OF THE UBOR CODE, INTEREST, AND ATTORNEYS FEES.
Chapter 9(commendng wlth Sectlon 7000) ol Divislon 3 oi t�e Busln§�s e � P� ssions Cade, and my license La In tull
CIas9 M C
. oo�a: � �z--o3
MG AGENCY:
t�ero Is e construction IenOing egency tor the pertormance ol the work tor which t�is pormil is Issued. (Sec. 3097, Civll Cotle).
Lentler's Adtlress:
Date:
OWNER-BUILDER DECLARATONS:
I hereby affirm t�et untler penalty of pequry thet I em E%EMPT FROM TNE CONTRAC70RS IICENSE LAW br the following reeson (Sec. 7031.5, Business end Pmfeulons
Cotle: Any dry or counry whith requires a permit to construct, elter, imprwe, demWish, or repair any aWcture, pnor to tls Issuance, also requires the applicant for such pertnit
to tile e signed sWtement thet he or she Ls Iicensetl punuant ro the provisions of Ue Contractors License Lew (Chepter 9(wmmendng with Sectlon 7000) of D'Msion 3 of Ne
Busineu entl Professions Code) or thet he or she is exempt therefrom and tha basis for t�e allegetl e:emptlon. Any viola��on ol Section 7031.5 by any epplicant for e pertnit
sub�eds the epplicent to e civil penelry oi not mare Ihan frva hunEretl tlollars (5500).):
❑ I, es ownar ol the property, or my employees with wages es their sole compensetion, WILL DO 7HE WORK, and Ihe struqure Is not intentletl or oflered for ule (Sec.
7044, Business antl Pmfessians Code: The Conira�lors License Law dces not appy to an owner ot pmperty who bullds or improves thereon, antl who does such wodc
himself or herself or Ihrough his or har own employees, provided that such impmvements era not Intendetl or oflered tor sale. If, howaver, the building or improvement Is
sold within one year of completioq t�e owner-builder wW have the Gurtlen of proving that ha ar she tlitl not build or improve for purpose ot saleJ. �
❑ I, as owner of Ihe properry. em E%CLUSIVELV COMRACTNG WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professions
Gotle: The contradors License lew tloes not appry ta an owner ot pmperry w�o builds or imprwes thareon, and who contracts for such project vrith a wmracior(s)
license pureuant to t�a Contractors Llcense Laws.).
❑ I em exempt untler sec. Business antl Prolessions Code lor this reeson:
Signature: Data:
Owner ID verilied by ddvefs liCenSe. ❑ Ves � No Drivefs LiCense No. F�pires:
Verificetlon ol Ownershlp Dy (rype of document, i.e. - propeM �%< Dill or Aeetl):
DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATION:
❑ I hereby ceNty ihat no excaveNon five (5) or more �eet In depth into which a pereon Is requlretl to tlescend, wlll be matle in connection with work authodzetl by this
permit, end ihet no buildlnp strudura. sceMoltling, telsework, or tlemWitlon or dismentling ihereoi, will bo more than Ihirry-slx (36) feet �igh. (Chap. 32, Gry 2, Art 2, Sec.
341, Tltle B, Celilomle ACmIniSlretNe Code).
❑ As owner-6uilder, I will not employ enyone to tlo work which would require e parmit Irom ihe Dlvislon of Indusirial Sefery, es noted above, unleas such person �as e
permit to do such work Irom Ihe tllWsion.
Signeture: peto:
DiNsion at Induslrial Salety Partnit Number:
CERTIFlCATE OF COMPLJANCE AND AUfHORVJ1T10N OF ENTRY: 1 cenity under penelry of perjury Ihet I heve reed this applicaiion ana slate that the infortnation given is
correcl. I egree to compy with ell steta laws entl dry wtlinances relating to bullding constructlon, entl euthodze representatives ot the Ciry ot Costa Mesa to enter upon ihe
ebove-descdbetl propycqr�or inspectian purposes. I egree not to accupy or ellow occupency of eny building euthonzetl by thls permit unW finel inspection.
�a,i�s�wr.n.i
1618 Fixetl System Finel Fire Prevention
1288 Pool Spa Final
200 Final Re-Roof
201 FIneI8locWRetelning Wall
202 Finel FeMory Fire Plece
203 Finel Slgn
204 Final Demolllion
COOE I INSYECTION TYPE
208 Flnel Mechenicel
20B
210
212
220
Final Plumbing
Final Eleciricel
Finel Fire Prevontlon
Finel Planning Approvel
222 Finel Site
250 Final Bullding/Occupency
ueg u�a
1� �
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.coste-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 555 ANTON BL
Suite: 1000
Viciniry: SUITE 1000
Parcel Number: 41050110
Applicant: DONALD SMITH
Address:
2oning:
Phone: 714-438-2272
Zip:
Owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
' DENVER, CO Phone:
7050 17TH ST #1220 Zip:
Contractor: HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE
COSTA MESA, CA
Zip: 92626
Arch :
Address:
Phone: (714) 43&2272
License: 445804
Eng:
Address:
Status: ISSUED
Applied: 04I04I2003
Issued: 04/22/2003
ISSUED BY: �
. Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TENANT IMPROVEMENT TO RECONFIGURE OFFICE SPACE AND REMODEL OF EXISTING SPACE. "BTE'
Plan Check: $147.84
Permit: $909.75
SMIP Res: $0.00
SMIP Com: $18.35
Other. $0.00
Inspection: $0.00
Total: $1,075.94
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
$87,362.00
$80,000.00
0
NOTICE: The work authorized by ihis permit shall compty with all applicable handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void if work Is not commenced within 180 days, or If work is suspended or abandoned
tor a period of 180 days. /� "
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable code �tl all
required Inapeetlona and flnal epproval must be obtalned. Failure to obtain Inspections and final approval will result in the expiratlon ot ihis pertnit.
FOR INSPECTIONS CALL: (714) 754-5626
204&48 (flN0)
WORKERS' COMPENSATION DECLAfiATIOh..
I hereby eXlrtn under penalry of perjury one oi Ihe lollowing decleretlons: �
❑ I heve antl wlll malntflin e ceNflcata ot conseN to sel4lnsure br workers' compensatlon, es provlded for by section 3700 at the Lebor Code, lar the p0rtortnance ot the
work lor which Ihis pertnit Is IssueU.
� I have end vNl meln�e�n workers' compensetbn U�wrance, as requiretl by sectbn 3700 oi the Lebor Code, for Ne pertomiance of the work for whkh Ws pertNt is lswe0.
M WO �p - rtoatlnn Inciimr�rn mrtlar wnA nMirv n�imlar ero� .
Certier.Y__L�
(Th13 58Ci10f1 nBBd itOf t
❑ I cerllty Ihef in NB
compansation I&w
comply wlih Ihes�
Applicanl SlpnaNre: ^
WARNINO: FAILURE TOSE
TMOUSMlD DOLL�RE (31�}
LICENSEU CONTRACTORS
I here6y etfirm that I Bm Ilcen:
force end eflecL Uc. P !�
Contrectola Slgnetura �
CONS7RUCTION LENDING AGENCY:
PolicyNumber: I �7�3d3� 3
Or (e9s.)
is issue4 I shell not employ eny person in eny menner so es to 6ecame su�ecl lo the workere'
e s �ecl to the workere' compensalion proWslons of Se�ctl/on �700 ot e Lebor Code, I shali forthwith
oe�a: � /z o3
UMAWFUL M1D SHALL SUBJEC! AN EMPLOYER TO CRIA9NAL. PENALTIE$ AND CML FlNES UP TOONE MINDRED
ON, DPMAGES A$ RqVIOED FOR IN SECTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES.
(commenUng with Sectlon 7000) ot DlWsion 3 0l the B
Class k
Dete:
end my Ilcense Is in full
❑ I �ereDy affirtn t�et Ihere is a construction IenOing epency tor the pertormanca ol the work tor which this permit is issued. (Sec. 3097, Civil Code).
Landers Neme: Lendafs Adtlress:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eNlrm Ihat under penalry ol per�ury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following resson (Sec. 7031.5, Buslness end Professions
Code: Any ciry or counry whtc� requlres e pertnit to wnsWct, alter, improve, tlemolish, or repelr eny slructure, pdor to its issuance, elso reqWres t�e epplicant tor such pertnit
to file e signed stetement t�et he or she is Ilcensad pursuent to the proNsions ol the Contrectoro LJcense Lew (Chapter 9(wmmencing with Section 7000) 01 Dlvislon 3 of Ne
Business end Protesslons Code) ar that he or she I5 exempt therefrom end the basls for Ihe ellegetl exempllon. Any viol6tlon of Saction 7031.5 by eny epplicant for e pertnit
su6jects Ihe epplicent ta e civil penalry af not more t�an tive �undred dollers ($500).):
❑ I, es owner ol the properry, or my employees wlih wages es their sole compensetlon, WILL DO THE WORK, end the structure is not Intendetl or otlered for ule (Sec.
7044, Buslness anA Professions Cotle: The Contractors lJcense Law does not flpply to an owner oi properry who builds or Improves theraon, flnC who does such work
himself ar herse�i or through his or her own emplayees, provitled thet such improvements ere not Intendetl or oNered for sale. I( however, the buliding or improvement is
sold within one yesr of wmpletion, the owneo-builder will have Ihe burtlen ot proving that he or she did not Cuild or im0�ove tor Ouryose of sele.). �
� I, es owner of Ihe praperty, am EXCLUSIVELY CONTRACTNG WfTH LICENSED CONTRACTORS to construct the Drojecl (Sec. 7044, Buslness antl Professions
Catle: The wntractors License Lew does not flppry ta en owner ot propeny wha builAs or Improves thereon, end who contracts for such pro�ed with a cantractw(s)
license pursuanl to the ConiractoB License Lews.).
❑ I am exempt under sec. Business antl Professions Cotle br ihis reason:
Slgnature: Date:
Owner ID veritietl by d��ers litense. ❑ Yes ❑ No DrNeYs License No. Expires:
Verificatlon of Owners�ip by (rype ot document, I.a. - property lex bill or deetl):
DIVISION OF INDUSYRIAL SAFETV PERMR CERTIFILATION:
❑ I hereby cenity t�at no excavatlon flve (5) or more leet In dept� into which e person Is requlretl to tlescend, will be matle in connection wlih work eutho�zetl by ihis
permit, antl ihat �o bullding sWdure, scattolding, lalsework, or demolilion or disman�ling lhereol, will Oe more then thirty-six (38) laet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Tltle B, Celibmia AOminlsirative Code).
❑ As owner-bull0e�, I will not employ enyone ta do work which wwld repulre e pertnit Irom the Dlvision of Intlustrial Sefery, es noteA eDove, unless suc� person has e
permit to tlo sucd wwk trom the dhAslon.
�Slanature: Date:
IntluStriel Se�ely PBrtnII Number:
CERTIFlCATE OF COMPLIANCE AND A OROJITON OF EHTAY: I certity under penelry oi perjury thet I heve read this applicetion entl state ihat the intormatlon given is
correct. I agree lo corripiy wlt� all s ews end Gry ordinence a ng lo builtlinp construction, end euthorize reDresenletives ot Ihe Ciry oi Costa Mesa lo enier upon t�e
ebove-described propehy �or ins ction puryoses.�ree no occupy or ellow occupancy oi eny building authorized by this permit until final inspecUon.
cooe �. ixsvecnoxTrve
7816 FIzeA System P�nel Flre PrevenNon
1288 Pool SOa Final
200 Finel Re-Rool
201 Flnel BIocWRe�elning Well
202 Final Fedory f�ra Place
203 Finel Sign
204 Finel Demolitlo�
QA¢. IMI�L$ LQQE! INSPECTIONiYPE
208 Finel Mec�anical
20B Finel Plumbing
210 Final ElectAcel
212 Flnel Fire Prevendon
220 Finel Planning Approvet
222 Flnal Slte
250 Final Bullding/Occupancy
PAIE It�45
(714) 754-5273 • Fax (714) 754d856 • www.G.eosta-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant
Address:
555 ANTON BL
1000
41050110
SMITH, DONALD
3184 AIRWAY AVE
COSTA MESA, CA
Phone: (714) 43&2272
Zip: 92626
owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
DENVER, CO Phone:
1050 17TH ST #1220 Zip:
Contractor: HOWARD BUILDING CORPORATION .
� Address: 3184 AIRWAY AVE
ISSUE FEE
Temp service test
Res. a/c package
New Res (1•2 unils)
New Res (3+units)
Pool / Spa
lighting Fixis
Recept Outle45
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to 1hp
Motors to tOhp
Motors to 50hp
Motors to 700hp
Motors over 100hp
COSTA MESA, CA
Phone: (714) 43&2272
Zip: 92626
License: 445804
ISSUED BY:
Status: ISSUED
Applied: 04YL2/2003
Issued: O4I22I2003
SCOPE OF PERMIT
TENANT IMPROVEMENT TO RECONFIGURE OFFICE SPACE�AND REMODEL OF EXISTING SPACE.
'BTE'
ELECTRICAL TO INCLUDE: 12 LIGHT FIXTURES, 6 SWITCHES, 5 COMMUNICATION DROPS, AND 1
MISC. CONDUIT. REF.: 803-00553
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$13.20
$0.00
$6.60
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
72
0
6
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway/100ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipmenl
Low Volt Winng System / Ckt
Misa Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electricai Fee
Quantiry
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$1820 1
so.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permlt shall automatically expira end become vaid if work is not commenced wlthin 1 BO days, or if work Is suspendetl or ebandoned
for a period ot 1B0 days.
INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply wlth all appllcable codes, antl all
requlred Inapecliona end finel approval must be obteined. Fallure to obtain inspections and final approval will result in the expiratlon of this�permit.
FOR INSPECTIONS CALL: (714) 754-5628
zasae (eroo)
WORKERS'COMPENSATON DECLARATION:
I hereby aNirtn under penalry at perjury one of the following tledareLons:
❑ I h entl will meimain e certillcate of consem to selt-Insure for workers' compensetlon, es pmvitled for by seaion 3700 0l Ihe Lebor Catle, for tha pedortnence of the
rk for wti�ch this perrnit is Issuetl.
1 hava end II m ntein ikers' compensatbn inwr , aa quiretl by 5ection 3700 of Ne Lebor Catle, for lhe pertortnance of Ne work for whk� Nb pemut I5 issuetl.
My wo co �pe n Insure rtier end y nu r ere: G
Cerrier. i pollcy Number. /� �j 30�0�
(Thls secNon need not be canW ed I/ the pe f� IueC ef one ntlietlOdlers (5100) or less J
❑ 1 certity t�at In Ihe OeAonnance o e work r which thls t is issued, I shell not employ any parson In any manner so as to becoma s ect to the woifcers'
campensetlon lews of Califom , and e that it I d ect to the warkers' compensetlon provisions ol Sectlon 3 of It Lebor Code, I shell tort�with
comply wlth these p 910 .
Applicent Signeture: Dete: �
WARMNO: FNLURE TO SE WOfi1�R5 COVEMGE I$ UtMWFUL AND SH�LL SUBJECT Ml EMRAYER TO CR�A9 PENAL ES AND CML FlNES UP TOONE HUNDRED
TIId1SAND DOl1ARE (5100, ), IN ADIXTI �T THE T OF QOMPENSATION, �AMpGES AS PiqVIDED FOR W SECTION 9108 OF TNE LRBOR CODE, IMERE5T. AND ATTOfiNEY'S FEES.
LICENSED CONTRACTORS DECLARA N:
I herehy aflirm thel I em Ilcensetl untl rONsl ns C te (commencing with Section 7000) of Divlslon 3 of the Business e Professlo Cotle, and my license Is in tull
force entl eNecL Uc. a Cless M
Contrectors SlgneWre: Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirtn thet there �S e conswcUon Ientlinp epency for the perfortnance ol Ne work for which ihis perml� b issuetl. (Sec. 3097, Civll Code).
Lenders Neme: Lenders Address:
SlpnaNre: Date:
OWNER-BUILOER DECIARAnONS:
I hereby eHlrtn Ihat untler Oend�ry of perjury that I em EXEMPT FROM 7ME CONTRACTORS LICENSE LAW lor the followinp reason (Sec. 7031.5, Business flnd Professlons
Cotle: Any ciry or counry wNch raquires a pertnit to construq, elter, Improve, demdlsh, or repeir eny atructure, pdor ro its luuence, also requlres the eppllGant for such pertnil
to tile e si8ned stetement Nat �e w she is licensed pursuant l01he pmNsions oi the ContreIXors lJcense Lew (C�epter 9(commencing wlth SecUon 7000) of Dlvisian 3 af Ue
Business end Pmtessions Cade) or that he or s�e is exempt Iherefrom entl tha basis br Ihe elleged exemptlon. Any Woletion of Section 7031.5 Dy eny appllcant for e pertnit
suD�ects the applicant to a dvll penalry of not more than INe hunCretl Adlars (5500).):
❑ I, as owner af �he propeAy, or my employees wIN weges as their sda compensation, WILL DO THE WORK, antl the siruqure is not InterMetl or oMeretl for sale (Sec.
7044, Business end Prolessions CoAe: The Coniractors Licensa Lew does noi aDPh �o en owner of property who builds or improves Ihereon, and who dces such wark
himself or �erself or Ihmugh his or her own emplqrees, proWded that such imprwemams are not iniended or ofleretl tor sale. Ii, however, t�e bullding or impmvement is
sold within one year of completion, Ihe owner-bulltler will �ave ihe burden ol proNng that ha or she did not builtl or Improve for purpose ol sale.). �
❑ I, es owner of the propeAY. em E%CLUSIVELV CONTRACTING WIiH LICENSED CONTRACTOiiS to constmct the pmject (Sec. 7044, Business end Professions
Code: The contractors U�ense Lsw does not apply to an ovmai W property who Dullds or fmproves Ihereon, end wtio coniraas for such pro�ecl with e contrac�or(s)
Ilcense pursuant to the C�«actars License Laws.).
❑ I am exempt under sec. Business ana Professions Code for Ihis reeson:
Signature: Date:
Owner ID verified by drNers IiCense. ❑ Ves ❑ No Drivels lJcenso No. Ezpires:
Vedticatlon o1 Ownere�ip by (rype af documem, (.e. - properry tax blll or deed):
DIVISION OF INDUSTRIAL SAFET' VERMR CERTIFICA710N:
❑ I hereby ceNfy ihat no excavetion live (S) or more Ieei In tlepth Inio which e person is requlretl to descend, wlll he metle In connection wllh work euthorizetl by Ihis
permit, end ihet no huiltling sWcture, scalloldinp, lelsework, or demolition or dismentlinp thereof, wlll be more Ihen thirty-siz (38) feet hlgh. (Chep. 32, Grp 2, Ar12, Sec.
341, Tltle B, Calilomie Adminlstretive Catle).
❑ As owner-builder, I will not employ enyane ta tlo work which would require e permit irom the DlNsion ot Intlusirial Sefery, es noteA aDove, unleu such person hes e
permlt to do such work tlom the OiNsbn.
Signature:
Divislon o1 Indusirial Sefety Pe�lt Num6er:
Dete:
:ARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WIII Ihe epplicenl or Dres �� or tuture bulltlinp occupent neetl to flle enC ceRify e Buslness Plen tor emerpency response to releese or threetenetl relaese of e hazertlous
meterlel7 ❑ Ves � No
(Sectlon 25505 of Iho Califomia Healih entl Sefery Code requires, with swne e:coptions, that e Business Plan be liletl with ihe Coste Mesa Fire Depertment by every
business which hes et eny wie time during e reported year e quantiry of hazardous materials equal to or greater Ihan e weight of 500 pounds, or a volume ot 55 gallons,
or 200 cuCic feet oi complesseA gas at standard tempereture end pressure).
._.._..._._ _...'_""'_.._.._..............."""_"'
Does or will t�e epplicant or present or future bui101np ocwpant nead to fila e registretlon lortn lor ecutaty hazartlous meterials7 ❑ Ves ❑ No
(Section 25533 of the Ce111omia Health anC Satery Gotle, wIU some exceptions, requires registretion with the Coste Mesa Fire Department by eecli Dusiness whlU at any
one tlme �as on hantl a quentlry ol awtety hezerdous meterlals equel to or preater then e weight ot 500 pounds, or e volume of 55 pellons, or 200 cubic leet of
compresseC ges et stentlBrd lempereWre entl pressure).
................................._..._......_.......,.................................._........................�.._........................_..._................................................................................................................._........................-._...................._.__.........._.__..........
Does or will the eGplicant or present or future building occupent need to prepere an RMPP (Risk Manegement entl Prevention Program lor ecutey �azartlous metedals)4
❑ Ves ❑ No
(Section 25534 of the Califomie Health and Sefety Code provides that the Costa Mese Fire Deperiment may ri
Departmem ol en RMPP tlY buslnesses whiU ere requlretl to reglster acutety hezeNaus materials wlih t�e Fire
........_ ........................_.....................................................................................�._...................__....................._................................................................
4 It en RMPP is presenty reQuired, has SecUan 25534 01 tha Califomia Health end Sefery Code been fully wmplie
..............'_".........._.__.._........_ ..."_'__ .. "'......_._..............___............._..'__'................
5 DoeS or wlll �he aDPllCant or present or tuNre bulWing oxupant raquire tor the work whicn is the sub�ecc of thls
fmm Ihe South Coast Air Qualiry Managemeni DlsMct or Irwn eny othe� 6I� pollutlon contrd Ci5[dq Of 9gBflt)?
(Section 658502 oi the Ca���omia Govemment Catle requlres that the requestad Informatlon De fumishetl on ap�
............................._............................................................_.........._...................__'......................_...._...................._..........................................................
6 W III flny parl of the taclliry lo be construdetl untler Uis pertnil be within t0001aet fmm the outer bountlades ot a
pl "yes", the feciliry must meet the requirement of Sections 25534 and 42303 0l the Celifamia Health and Safery
7
B
....................._................................._................_._......................_._................__.................................................
i Coest Air OuelitY Menegement Distdct or other eir pollution control dislricl or Bgency
disclwures orescnhetl W Califomia Heelth anC Saletv CoOe Section 42303 been meda7
the preparatlon, certilicetion end filing with the Fire
ment.
....................................................._......................—.........._..__..
7 ❑ Yes ❑ No
.................—._..._..._._..' —
'sUOn 8�e rmii �Or suGh Cd151NtU0n Or mOdlflCBifp(1
is �J No
ns for non-resitlentlal Duiltllno oermits).
Na
CEFTIFICATE OF COMP�IANCE: I certily that under penalty of per�ury Ihe Informatlon given above is correct. I epree to comply with ell stete laws and ciry ortlinances
regarding Harardous Ma[9��s and Emissions.
Signalure: Dale:
CERTIFlCAlE OF COMPLIANCE
wrrect I egree lo wmpy with
ebova-describetl properryf nsF
GOUE I, INSPECfIONTYPE
1816 Fixetl System Flnel FUe Prevention
1288 Pool Spe Flnel
200 Final Re-Roof
201 FIneI BIocWRetelnlnp Well
202 Flnal Factory Firo PIaGe
203 Final Si9n
204 Final Demolitlon
?tON OF EMRY: I certify unOer penalry ot perjury that I heve read this epplication and state that the infortnation ghren Ls
ty oMinances relating ro bulltling consWctlon, entl aut�odze representetives ot �he Clty ot Costa Mesa to enter upon t�e
egree nol to occupy or allow occupency af eny 6uilding authodzed by ihis permit until Ilnal inspectlon.
Q� �QQF,( INSPECTIONTYPE �
208 Finel Mechanicel
20B Finel Plumbing
210 Finel Electricel
212 Finel Flre Prevontion
220 Finel Plennin0 App�o�el
222 FIneI5lte
250 Finel Bulltling/Occupanry
�
�Ill�i�l
(714) 754-5273 • Fex (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 1000
Vicinity:
Parcel Nunmber: 410501�0
Applicant: SMITH, DONALD
Address: 3784 AIRWAY AVE
COSTA MESA, CA
PLUMBING PERMIT
Phone: (714) 438-2272
Zip: 92626
Owner: SAKIOKA FARMS °/aMORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
DENVER,CO,
1050 17TH ST #1220
Phone:
Zip:
Contractor: HOWARD BUILDING CORPORATION '
Address: 3184 AIRWAY AVE .
Arch / Eng :
Address:
ISSUE FEE
Backflow irrigation
BackFlow Preventer
Bathtub
Clarifier System
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
COSTA MESA, CA
Phone: (714) 43&2272
Zip: 92626
License: 445804
Phone:
Zip:
License:
Status: ISSUED
Applied: 04/22/2003
Issued: 04/22/2003
ISSUED BY: �
SCOPE OF PERMIT
TENANT IMPROVEMENT TO RECONFIGURE OFFICE SPACE AND REMODEL OF EXISTING SPACE.
'BTE'
PLUMBING TO INCLUDE: 1 DISHWASHER, 1 KITCHEN SINK, AND 1 GARBAGE DISPOSAL. REF.:
B03-00553 � .
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.80
$0.00
$0.00
FEE SUMMARY
QTY AMT
Laundry Tub / Washer $0.00
0 Landscape Irrigation $0.00
0 P-Trap $0.00
0 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
0 Receptors $0.00
0 Septic Tank $0.00
1 Sewer Cap for Demo $0.00
0 Sewer Connect - $0.00
0 Sewer Private Line $0.00
QTY
0
0
0
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes and all
requlred Inepections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration ot this permit.
FOR INSPECTIONS CALL: (714) 754-5626
r�...;�..;.(1J1
WORKERS'COMPENSAnON DECLARAnOh.-
I hereby aMirm u er penalry of perjury one of Iha iollowing deGeretions:
� I � entl wlll meintain e certificate ol cansent ro seli-Insure for workers' compensatlon, es provideG for by sectlon 3700 of the Labor Cotle, for the pertortnance ot the
rk lor which this pertnit is Issuetl.
I have entl wi mai tain workers' compensaU� Insuranca, ul by section 3700 of Ne Lebor Cotle, For ihe peAortnence oi the woAc for whlch this pertnit is issued.
My wa ensati4n Insurence carrid� end policy ber : /
Cerner. /1 ',./!�-S Policy Number. �(s 7�.�/ 3O 3
(Th/s secNon need no� i! the p it is va/ ef on untlretl tlollars ($f 00) or less.)
❑ I cartity �hat in t�e pertortnanCB 0 tl
compensetlon laws ot Celito ', er
compywiththese oNsio
Applicant Signature: Q""T�
WARNINO: FNLURE TO SECU WORKER�i
THOUSAND DOLURE �E100, ), IN NDDRION
LICENSEDCONTRACTORS
I heraby attirm ihat 1 am licen:
force entl eXect. LJc. x L
comreccors signemre:�
:h t pertnit is Issued, 1 shall not employ any person in eny manner so as lo be o ia sub�� �t to Ihe workero'
s Itl became sub�ecl to the worken' compensetlon pmvisions oi Section 37 of Ue or Cotle, I ahall forthwlth
Date:
Z
COVERAOE IS UNUWFUL PND SNALL SUBJECf AN EMGLOVER TO CRIMINAL PENALTI S AND CML FlNES UP TO ONE HUNORED
° COMPENSATION, DAM4GES AS PRWIDED FOF IN SEC710N 3]090F THE LABOR CODE, INTEREST, AND ATTORNEI"S FEES.
Sectlon 7000) ot Dlvision 3 oi ihe Bi
_ CI855 k
_ Date: _
CONSTRUCTION LENDING AGENCY:
❑ I hereDy ettirtn thet Ihere is a consiruction lending agency for Ihe pedortnance ot the work lor w�lch this pertnit is issued. (Sec. 3097, Civil Code).
Lender9 Neme: Lendels Adtlress:
Slgnatura:
OWNEP-BUILDER DECLARATIONS:
Date:
my Ilcense is in full
I hereby eMirm ihat under penelry af perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the Following reasan (Sec. 7037.5, Business antl Professions
Cotle: Any ciry or counry which requires e Dermil to construct, elter, Improva, demolish, or repair eny structure, prior to its Issuance, elso requires Ihe epplicant for such pertnit
to 111e e slgned stetement ihet he or she Is Iicensed pursuent to the pmvisions of ihe Contractors License Lew (Chapter 9(commendng wlth Sectlon 7000) of Division 3 oi the
Business end Professions Code) or thet he or she is ezempl therelrom end the basis lor t�e ellegeO e:emption. Any violation ol Section 70.31.5 Dy eny eppllcant for e peRnit
suD�ects ihe epplicant to e civil penelry ot not more than fNe hundred dollars ($500).):
❑ I, es owner ai Ihe properry, or my employees with weges es I�eir sole campensetion, WILL DO THE WORK, end ihe siructure Is not intentletl or offereC for sale (SeC.
7044, Busineu and Profeulons Cotle: The Contractors Licensa Law tloes no� apply to en awner af properry who bullds or Improves Iheraon, an0 who tloes such work
himsell or herself or through his or her own employaes, proNded that such improvemenis ere not Intendetl or oXered for sele. If, however, Ihe bullding ar improvement is
sold within one year of wmpletion, Ihe owner-bulltler wlll heve Ihe burden of proving that he or she did not build or improve lor purpose of sele.). �
❑ I, es ov.•ner of ihe property, am EXCIUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 70a4, Business entl Professians
Cotle: TTe contractors Llcense Lew tloes no� epply to an owner o/ property w�o bulltls or Improves Ihereon, enA who contreps tor such pro�ea with a contracror(s)
Ilcense pursuant to the Contwctors Ucense Lews J.
❑ I em e:empt under sec. Business antl Pmiessions Code br Ihis reason:
SignaWre: Date:
Owner ID veMtletl by dnveY5litense. ❑ Yes ❑ No Drivefs LiCense No.
Verlflcetlon of Ownershlp by (rype of tlocument, I.e. - properry tax bill or tleetl):
OIVISION OF INDUSTRIAL SAFE7V PERMI7 CEAnFICATION:
Expiras:
❑ I hereby cehify that no evcavetion tive (5) o� more teet In depth into which a person Is requlred to descend, wiil be made In connection with work euthonzetl by this
pertnit, and that no building siructure, scettolding, felsework, or demolition or dismantling thereof, will be mare than thirry-six (38) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomla Adminisiretive Code).
❑ As owner-builder, I will not employ enyone to da work whlch would require a pertnit Irom the Division of Indusinel Sefery, es noted ebove, unless such person has e
pertn0 to do such work from the division.
Signature: Date:
Didslon of IndusMel Safery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORIZAnON OF ENTAY: I certiy under penelry ol perjury that I have reatl this epplication and state thet Iha intortnation given is
corract. I egree to comply with tete lews and ci Inances relating to builtling constructlon, entl euthorize represantatives of the Ciry of Costa Mesa to enter upon the
ebove-descnbed property for'�r s�q ctian purposes eg� e not to occupy or allow occupancy oi any building euthonzed by this permit until finel inspectlon.
COOE�' INSVECTONTYPE �
1616 Fizetl System Final Fire Preventlon
1288 Pool Spa Final
200 Final RB-Roof
201 Finel Block/Retalninp Well
202 Final Faclory Fire Place
2Q3
204
Final Siqn
Finel Demolition
10.\I�CIItiLIti.
COOEI INSPECTONTYPE �
206 Finel Mechanical
20B Flnal Plumbing
210 Final Elecirical
212 Finel Fire Prevention
220 Flnal Planning Approval
222 Final Si�e
250 Final Building/Occupanq
-���
� r
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
555 ANTON BL
1000
Parcel Number 41050110
Applicant: SMITH, DONALD
Address: 3184 AIRWAY AVE
COSTA MESA, CA
MECHANICAL PERMIT
Phone: (714)438-2272
Zip: 92626 .
owner: SAKIOKA FARMS %MORG,4NS HOTEL LIMITED
Address: PARTNERSHIP ATTN JOE CRAWfORD
DENVER, CO ' Phone:
1050 17TH ST #1220 Zip:
Contractor: HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE ' � -
COSTA MESA, CA
P.hone: (714) 43&2272
Zip: . 92626
License: 445804
ISSUED BY:
Status: ISSUED
Applied: 04/22/2003
Issued: 04/22/2003
SCOPE OF PERMIT
TENANT IMPROVEMENT TO RECONFIGURE OFFICE SPACE AND REMODEL OF EXISTING SPACE.
��BTE" � .-. -,-., �- , �_ % --�'- / - . -. .
. ... _! .t : . �_ . -
MECHANICAL TO INCLUDE: 1 VAV BOX. REF:: B03-00553
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Re(rig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct �
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocale Appl Vent
Air Handlers < t0000dm
AirHandlers> t0000cfrn
Floor Fumace
Floor or Suspend Heater
$23.50
$o.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.65
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0 .
0
1
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorblion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial I nci nerator
-- �Domestic Incinerator
Compressors / Absamtion SVstems
Upto3hp7100kBTU
'3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Upto3hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
ONer Mechanical Fee .
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 1241-92)
EXPIpA710N: 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 penod 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 Inspeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2a4646 (NW)
WORKERS'COMPENSAnON DECLARAnON: �
I hereDy eNirm under penalry of perjury one of ihe following tleclarations:
❑ I1]�ve entl will maintain a certificate of consent to self-Insure tor workers' compensetion, es provided for by sectlon 3700 of Ihe Lebor Cotle, for Ihe pertortnance of the
aQork tor which this pertnit is issuetl.
[�]� I have and w'll m intain workers' compensatlon insuran as r quiretl by seclion 3700 of the Lebor Code, for the peAormance of the work for which this pertnit is issued.
My w co pensa Insurence carrier antl poli �u er are: /��7 7
Cartier: o ^�1 — POIIcyNumber: /�e // J03��
(This section need not be compl d i/ t e permi " ✓ed at one hundred tlollers ($100) or less.)
/
❑ I certly ihet in the pertortnence of th ork�for Ich ihi;qertnit is issueQ I ahall not employ any peBon in eny manner so es to become subJ to the workers'
compensetion lewa of Celibmia, d grae d I sh bld.tiecome subJect to the workere' compensatlon provislons ot Sectlon 3 ai the r Code, I shell forihwith
comply with these pro isi ns.
Applicant Signature: Lc—s." w� Date: /Z
WARNINO: FNLLIRE TO SECUR ORKERS' ENS ON COVEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINN. PENALTIES D CNIL FlNES UP TOONE HUNORED
THOUSANDDOLLARE�St00, �,INADDRIONTO TOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECfION3]O60FTHELABORWDE,IMEREST,PNDATTORNE`fSFEES.
UCENSEDCONTRACTORS
I �ere6y aHirtn that I am licen:
force end eHect Lic. N �
Conlredols Slgnatura: �
CONSTiiUCTION LENDING AGENCY:
with Sectlon 7000) ot Division 3 ot Ihe Busines�s�ntl Professions Cppe, and my license is in hll
Class # •C� i � //
Date: .. z O�
❑ I hereby eXlrm that there is a construction lending egency for the pertormance of the work for w�ich this permit is issued. (Sec. 3097, Givil Code).
Lentlefs Name: Lenders Atltlress:
Signeture:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby eHirtn ihet under penelry of perjury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe fallowing reason (Sec. 7031.5, Business end Prafesslons
Cotle: Any ciry or county whic� requires e permit to construct, alter, improve, demolish, or repelr eny struMure, pnor to Its Issuence, also requires the epplicant for such permit
to file a signed statement ihat he or she is licensetl pureuant to the provisions of ihe Coniradore License Lew (Chepter 9(commencing with Sectlon 7000) oi Divislon 3 oi the
Business end Professlons Code) or thet he or she is ezempt therefrom entl the besis for the elleged ezemptlon. Any vloletion of Sectlon 7031.5 by any epplicent for e permit
subJects the epplicent to a dvil penelry of not more ihen tive hundred tlollars ($500).):
❑ I, es owner oi the property, or my employees wl�h wages as Iheir sole compensation, WILL DO THE WORK, antl Ihe siructure Is not intentletl or oflered for sele (Sec.
7044, Business and Professions Cotle: The Contracmre License Law does not apply to an owner of D�operry who builds or improves thereon, antl who does such work
himself or herseN or ihrough his or har own employees, provided ihat such improvemenis are not Iniended or oflerad for sele. N, howaver, Ihe huiltling or improvement is
sold within one year ot completion, the owner-builder will heva the burden of provinq that he or she tliA not build or improve for purpose of sele.). �
❑ I, es owner ot Me property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consimct the project (Sec. 7044, Business and Professions
Cotla: The contrectors License Law tloes not apply to an owner ot property who builds or Improves ihereon, antl w�o contrects for such project with a contractor(s)
license pursuant to the Conirectors License Laws.).
❑ I am exempt under sec. Business and Professions Code for ihis reeson:
Slgneture: Dete:
Owner ID verifletl hy driver's Ilcense. ❑ Ves ❑ No DnveYs LicenSe No.
Verificetlon oi Ownership by (�ype of document, I.e. - property tex bill or deed):
DIVISION OF INDUSTRIAI SAFETY PERMIT CERTIFICATION:
Expires:
❑ I hereby certlty ihat no excavation five (5) or more faet in depih into which a person is required to descend, will Ge mede In connection with work euthoAzed by ihis
permit, antl ihat no builtling structure, scaHoltlinq, falsework, or demolition or dismantling thereof, will be more ihan thirty-six (36)leat hlgh. (Chap. 32, Gry 2, Atl 2, Sec.
341, Tl�le B, Calitornie Adminis�rative Code).
❑ As owner-builder, I will not employ enyane to do work which would requlre e permit from the Division of Intlusinel Sefety, as notetl ebove, unless such peroon hes e
pertnit to do such work irom Ihe division.
Signeture: Date:
Division of Industnal Safery Partnit Num6er:
CER7IFICATE OF COMPLIANCE AND A RIZA710N OF EN7HY: I cenity under penalry of perjury Ihat I have reatl Ihis epplication end stete thet ihe intormation given is
correcL I egree to comply wi�h ell stet ews and city ordi s relating to building consWction, end authorize representetives of Ihe Clty of Coste Mese to enter upan the
ebove-tlescribed properly tor inspe ' n purposes�-pgre �ot4o occupy or allow occupancy of eny building authonzed by ihis permit until finel inspection.
COOE �. INSPECTION TYPE
1616 Fizetl System Final Fire Prevention
1266 Pool Spa Finel
200 Finel Re-Rool
201 Flnel BIocWRetaining Wall
202
203
Final Fec�ory Fire Place
Final Sign
204 Finel Demolition
Pd7E inrmn�s
CODE 1 INSPECTION TYVE
206 Final Mechanical
208 Final Plumbing
210 Final ElecMcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Si�e
250 Final Builtling�Occupency�
�g
Z2
(�ia) �sa-sz�a • Fax pia� �sa-aass
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
10
10TH FLOOR
41050110
Applicant: FULFORD, TERRY
Address: 8749 SHIRLEY AV
--�
CITY OF COSTA MESA �-
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
NORTHRIDGE, CA� '. '
'
Owner. � "SAKIOKA FARMS"
Address �, , � . . � �
' Contractor:
Address:
O'BRYANT ELECTRIC
8749 SHIRLEY AV
NORTHRIDGE, CA �.
ELECTRICAL PERMIT
Phone: (818)407-1986
Zip: 91324
Phone:
Zip: 94137
/ .
� " _'Phone: (818)407-1986�
. � Zip: 91324
License: 386619
NUMBER
E00-00052
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01/24/2000
Issued: 01/24/2000
� SCOPE OF PERMIT
� ELECTRICAL PERMIT FOR T.I. FOR -EPOCH- (10TH FLOOR). INSTALL 100 LIGHT FIXTURES, 75
RECEPTACLE OUTLETS, 48 SWITCHES, & 52 COMMUNICATION DROPS. �
REF: B00-00027 '
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)-
New Res (3+units)
Pool / Spa
Lighting Fixts .
Recept Outlets --
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 7000a
Molors to 1 hp
Motors to 70hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communiwtion drops
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$78.40
ssa�s
$40.44
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$43.36
Quantity
0
0
0
100
75
48
0
0
0
0
0
0
0
0
0
0
52
FEE SUMMARY '
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc EleIXriwl Equipment
Transformers up to 1 kva/kw
................up l0 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System I Ckl
Misa Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Quantity
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regula�ions. (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 1 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectiona and flnel epproval must be obtained. Failure to obtain inspec�ions and final approval will result in the expiration of Ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
�
WORKERS'COMPENSAnON DECLARAnON:
I hereby aHirtn under penalty ot perjury one of the following declera�ions: ' . •
❑ I have end will maintein e ceMficete ot consent to seli-Insure tor workers' compensation, es providetl tor by section 3700 of the Labor Code, for the pertormance ot the
work tor which this permit is issued. '
�ve antl will maintain workers' compensation insurence, as requiretl by section 3700 of ihe Labor Cotle, for the pertortnance o6the work for which this permit is issued.
work rs' c ensation ren arrier a d policy nu er are:
�l�L� c4�/ � fe ¢ C/+�S _ � oli Numti'er:=llrL�/4- Z 7t31e i/3 Q O
need not be complefed il fhe pe�nit is valued a( one hundred dollars ($100) or less.)
❑ I certify that in the peAormance of the work for which this permit is iuued, I shall not amploy any person in any manner so as to become su6ject to Ihe workers'
compensation laws of Califo ia, and e Ihat ii I shoultl become subjed b lhe workers' compansation provisions of Seclion 3700 oi the Labor Cotla,-I shall Forthwith
comply with these provi ' . c�
�e�w�a�at�igna u � �� Dat�_ �—z ` �"�
WAqNIN(3t'FAINRE TO SECURE WORKERS' PENSATION �pVERAGE IS UNL4WFUL AND SIIALL SU&IEC� PN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF GOMPENSATION, OAMAGES AS PROVIOEO FOR IN SECTION 3106 OF THE LABOR CODE, IFREREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm Ihat I a I' �{se ntler proy,isions of Chapter 9(commencing wiih Section 7000) of Division siness antl Professions Cotle, antl my license is in full
force antl eHec �'a u=. -/�� � CX � x ���
mractofs�SignaNre� �T� � Date;+-� i-=^3r-�e —Z ^o�
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm that ihere Is e construdlon lentling agency for the peAormance of [he work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: __ _ Lendels Adtlress:
Slgnawre:
OWNER-BUILDER DECLARATIONS:
Date:
I herehy aNirtn Ihat under penalry of perjury Ihat I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 703t5, Business and Protessions
Code: Any ciry or counry w�ich requires a permit to construct, alter, improve, demolish, or repair eny strucWre, pnor to its issuance, also requires ihe applicant for such permit
to file e signed statement tha� he or she is licensed pursuant to the provisions ot ihe Contractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business and Pmfessions Code) or that he or she is exempt therefmm entl the basis for the alleged eaemption. Any vlolatlon of Section 7031.5 by any epplicant for a permit
sublacis ihe applicant to a civil penelty of not more than five hundred dollars ($500).): -
❑ I, as owner of ihe property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, antl the siruc�ure is not intentled or oHered for sale (Sec.
7044, Bu5ine55 antl Protessions Code: The Conirectors LicenSa Lew dce5 nOt apply to an owner of property who builds or improves ihereon, and who does such work
himself or herseN or through his or her own employees, provlded ihat such improvements are not intended or oNered for sale. If, however, ihe builtling or improvement is
sold within one year of completion, ihe owner-6uilder will have the burden of proving thet he or she did not builtl or improve for purpose ot sale.).
❑ I, as owner of ihe propehy, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS �o cons�rucl Ihe prajec� (Sec. 7044, Busine55 and Professions
Cotle: The contracrors Licensa Law tloes not apply to an owner of property who builds or improves thereon, antl who conirecis for such project with a contrector(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt untler sec. Business antl Professions Cotle for this reason:
Signa�ure: Dete:
Owner ID verified by tlnver's licanse. ❑ Ves ❑ No Dnver's License No. Expires:
Venfication ot Ownership by (rype oi document, i.e. - properiy �ax 6ill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cetlity ihat no excavetion five (5) or more feet in depth into which e person Is required to descend, will be mada in connection with work authonzed by ihis
pertnit, end ihat no building strucWre, scaHolding, falsework, or demolition or dismantling thereoi, wil� he more ihan thlrty-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec.
341, Title B, Calitornia Atlminisirative Cotle).
❑ As owner-builder, I will not employ anyone to do work whic� would require a permit from the Division of Intlusirial Safety, as noted ahove, unless such person has a
permit to do such work irom ihe division.
Signature: Date:
Division of Industrial Safery Permit Number.
CER7IFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certiy under penalry of perjury ihat I have read this application and state Ihai ihe information given is
correcL I agree to comply wi�h all state laws and ciry ordinances relating lo building consiruction, and authonze represen�atives of Ihe City of Costa Mesa to enter upon the
above-tlescribed property for inspection purposes. I agree not to occupy or allow occupancy ot any building authorizetl by this permit until final inspection.
COOE 1, INSPECTIONTYiE
1616 Fized System Final Fire Prevention
1266 Pool Spa Flnal
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Plece
203 Final Sign
204 Final Demolition
2446 46
AT ItIi1TIpL5
COpE I INSPECTION TYYE
206 Final Mechanical
208 Final Plumbing
210 Fina� Electricat
212 Final Fire Prevention
220 Final Planning Approvel
222 Final Site
250 Final Building/Occupency
—Z y�-m.¢�
• y�t . ,�--s,
�._
er� �. iwmin�s
�;��� �
�»a) �sa-sz�s • Fax pia� �sa-aess
�ob nddress: 555 ANTON BL
Suite No 10
Vicinity: 10TH FLOOR
Parcel Nunmber: 41050110
0
Applicant: STEVENS, DON
Address: 1940 GARDENA
�
CITY OF COSTA MESA
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
PLUMBING PERMIT
GLENDALE,�CA � , �
.
" .
�;� .. , ` .- :
Ownei:. � SAKIOKA FARMS �
�, , _ -
Address -
i .
Phone: (818)500-1940
� Zip_ 91204
� . _. . \
� - Phone:
, ' � - " Zip: 94137
<"
1 '. y
, Contractor.' .MUIR-CHASE PLUMBING .. .. /�`. J.
Address: 1940 GARDENA �. �* .. ,r"" ` � - �
, , - � f. �; � , � , �...' Phone:� (818) 500-1940 - .
� GLENDALE,CA.�--.' ' Zip: 91204
� .�' ' ���^ � License: 539835
r ,. Ai
Arch / Eng : � � - . .
. � Address, ' � �� � �.�.� , � ; , ,
Phone:
`• Zip:
_ ' � �t f'�"License
' PLUMBING PERMIT FOR OFFICE T.I. FOR
EIECTRIC WATER HEATER.
REF: B00-00021 ' � ' " l
r'
i
RMIT NUMBER
P00-00043
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01 /24/2000
Issued: 01/2a/2000
ISSUED BY:
INSTALL 1 KITCHEN SINK 8 1
�� FEE SUMMARY
� . AMT ' QTY . _ � � - � AMT QTY AMT QTY
ISSUE FEE � $23.50 .Laundry Tub / Washer $0.00 0 Sump Pump � $0.00 0
Backflow irrigation '$0.00 , 0 Landscape Irrigation � $0.00 0 � Swimming Pool $0.00 0
Backflow Preventer- � $0.00 0 P-Trap� - . � $0.00 0 Trap Primer � $0.00 0
Balhtub � $0.00 0 Pressure Regulator $0.00 0� Urinal $0.00 0
Clarifer System �- $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr BkFlow(1-4) $0.00 0
Connect (Ice,Soda,etc) �$0.00 0 Receptors $0.00 0 Vacuum Brkr BkFlow(5+) $0.00 0
Dental Units $0.00 0 � Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 - 0 Sewer Cap foi Demo $0.00 - 0 � Wash Basin Set $0.00 0
Drain, Floor $0.00 0 . Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line� - $0.00 0� ' Water Closet (Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0; 00, 0' Water Heater / vent $12.30 1
Drinking Fountain $0.00 0 Sink, bar � �$0.00 0 Water Piping (Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re-pipe $0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or a6andoned
for a period of 180 days.
INSPECTIONS: In order for the work aulhorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapectlone and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permif.
FOR INSPECTIONS CALL: (714) 7545626 , ���
WORKERS' COMPENSA710N DECLARATION:
I hereby aHirm under penalry of perjury one of ihe Following declarations: - � .
❑ I have and will maintain a certificate of consent to self-Insure for workers' compensetion, as provided for by section 3700 of t�a Labor Code, for tha peAormance of �he
work tor which ihis permit is issuetl. '
� I have antl will maintain workers' compensation insurance, as required by section 3700 of Ihe Lehor Code, for the peAortnance of lhe work for which this permit is issuetl.
My workers' compensation Insurance carrier and policy number are:
Camer. U%� � � Policy Number. �S�IIiS.3 g
(This section need not be completed il fhe permit is valued at ane hundred dollers ($100) or less.)
❑ I certify ihat in ihe pertortnance of the work for which ihis permit is issueQ I s�all not employ eny person in any manner so as to become subject to ihe workers'
compensation laws of Calitomia, antl agree ihat if I should 6ecome su6ject to Ihe workers' compensation provisions oi Section 3700 of the Wbor Cotle, I shall brthwith
comply with these pr �/
AppliwntSignaNre: „� _v��"�`"-- Date: �— zY'���
WARNING: FAILURE TO SECURE WOFKEFS' COMPENSATIQV CAVERAGE IS UNIAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TOIXJE MUNDRED
THOUSAND DOLLAFE ($100,000),IN ADDITION TO THE CqgT OF COMPENSNTIqV, DAhNGES AS PROVIDED FOP IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEYS FEES.
LICENSEDCONTRACTORSDECLARATON:
I here6y attirtn ihat I am licensed under�provi�sio s ot Chapter 9(commencing wlth Sectlon 7000) of Division 3 ot �he Business end Professions ode, end my license is in tull
rorce and ercect. �ic. u -Jr�i�Yl3 S C�ass p C-- 3
Conirecbrssignamre: C � Date:�/�-2t�—DU
�
CONSTRUC710N LENDING AGENCY:
❑ I hereby attirm ihat there is a construction lentling agency tor the performance oi Ihe work br which ihis pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address:
Signature: Date:
OWNER-BUILDER DECLARA710N5:
I hereby eFfirtn ihat under penalty of perjury that I am E7(EMPT FROM TME CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business ana Professions
Code: Any ciry or counry which requires a permit tp construct, alter, improva, demolish, or repair any siructure, pnor to its issuance, elso requlres ihe applicaN tor such permit
to tile a signed ste�ement that ha or she is licensetl pursuant to ihe provisions ot iha Comrac[ors License Law (C�apter 9(commencing wlth Saction 7000) of Division 3 ot the
eusiness and Pmfessions Cotle) or that he or sha is eaempt therefrom antl the basis tor the alleged exemptlon. Any violation of Section 7031.5 by any applicam for e permit
sublects the applicant to a civil penalry of not mor9 than tive hundred dollare ($500).):
❑ I, as owner of �he property, or my employees with wages as �heir sole compensation, WILL DO TME WORK, and ihe siructure is no� intentletl or oHeretl lor sale (Sec.
7044, Business and Professions Cotle: The Coniractors License Law does not apply to an owner of propeM �'�0 6uiltls or improves theraon, entl who does such work
himself or hersetl or through his or her own �mployees, provided tha[ such improvemenis ere no� Intantletl or oHared for sale. If, however, ihe bullding or Improvement is
sold within one year of wmpletion, ihe owner-builder will have ihe burden ot proving that he or she did not build or improve tor purpose ot sale.).
❑ I, as owner of the propetly, em EXCLUSNELV CONTRACTING WITH LICENSED CONTHACTORS to consimct the pmject (Sec. 7044, Business and Pmfessions
Cotle: The contwctors Licensa Law tloes not apply to an owner of property who builds or improves thereon, an� who contracts tor such project with a conirector(s)
license pursuant to the Contrectors License Laws.).
❑ I am exempt under sec. eusiness antl Professions Code for this reeson:
Signature: Date:
Owner ID verified hy driver's license. ❑ Ves ❑ No Dnvers License No. Expires:
Verification ot Ownership by (rype ot documen�, i.9.. property taz bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICA710N:
❑ I here6y certity thel no excavation tive (5) or more feet in tlepth into which a person is required to descenQ will be matle in connection with work authorizetl by ihis
permiL entl ihat no building siructure, scaHolding, talsework, or demolition or dismantling Ihereof, will be more than thiny-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, California Adminisiretive Code).
❑ As owner-builtler, I will not employ anyone to tlo work which woultl require a permit from ihe Division of Industrlal Safety, as noted above, unless such person has e
permit to do such work from ihe divisian. '
Signeture: Date:
Division of Intlustrial Safety Permit Number:
CER7IFICA7E OF COMPLIANCE AND AUTHORI7,A710N OF ENTRY: I certity under penalry of perjury that I have reed ihis application and state that ihe information given is
correct. I agree to comply with all state laws and ciry ordinances ralatinq to huiltling wnstmction, and authonze representatives ot iha City of Costa Mesa to enter upon the
above-tlescribetl property for inspection purposes. I agree not to occupy or allow occupancy of any building euthorized by this pertnit until final inspection.
�Sign LegalOwneqs) � Date
,,,� -�----- f _ zg-oo
AnNOr u�horized Applicant Date
COpE N, INSVECTIONTYPE
1676 Fized System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Finel Fac�ory Fire Place
203 Finel Sign
204 Final Demolition
• 2046 4fi
�„
ORTE INTRIALS
C �EN INSPECTIONTYGE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
PAL�
C���%��
INTJ � V
�»a� �sa-sz�s • Fax (»a) �sa-aess
Job Address: 555 ANTON BL
Suite No 10
Vicinity: TENTH FLOOR
Parcel Number: 41050110
CITY OF COSTA MESA � �
BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Applicant: LOU RODRIGUEZ
Address: 6265 SAN FERNANDO RD
MECHANICAL PERMIT
� � Phone: (818) 244-65�1
GLENDALE-„CA. - Zip: 91201
Owner: SAKIOKA FARMS '. - ' - � � � � �
Address: , � /.� . � �' �- . : � " � � . .
� ... . � % � �', '
� � Phone:
' ' . � • � � ' - " Zip: 94137
� �'�":
�.� �
Contrector: AIR CONDITIONING CO., INC
� . Address:� � , 6265SAN FERNANDO RD .
. � " . . . Phone:- (818) 244-6571
. . . GLENDALE , CA ` p°. , ,,..-" Zip:- 91201 � �
, . � . /..�, . f- " . Lcense:_ 120696 - .
Arch/Eng: , �- ��
NUMBER
M00-00045
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: Oi/26/2000
Issued: 01/26/2000
.� - Address: : - o'.-� ,
� . ' , � Phone: � '
, . � � . " Zip:
� � � � � , .. . .License:- . � . - - , ' �
` .' - � . " _ ' , � �
� SCOPE OF PERMIT
' INSTALL i VAV BOX , 1 REPAIR/ALT COOLING/HTG SYSTEM FOR "EPOCH INTERNET' TENTH
FLOOR ROOM TI. � - � - �- . . • �� � �
. � . ' _ _ , , - . . .-. . .
REF:B00-00021' . . , � . _ . . , � - -- �/ !
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU .
Repair / Alt� Cooling/HeaC
Inst / Rep. Recess Wall Htr
Refrig Sys <700 k BTU
Refrig Sys >100 k BTU .
Gas Piping
Factory Fireplace .
Hood w/Mech Exhaust -
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfrn
Quantity
$23.50
$0.00 0
$0.00 0
' � "$1370 1 �
$0.00 0
, �-$0.00 0 '�
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$10.65 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
FEE SUMMARY
Repair / Alt Absorbtion Unit �
Repair / Alt Refrigeration Unit
VentillatioqSystem .
Evaporetive Cooler
Commerci a l I ncinerator
Domestic Incineretor
Compressars / Absorption Svstems
Upto3hp/100kBTU
3To15hp/SOOkBTU �
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU�
Over 50 hp / Over 1,750 BTU
Boiiers
Up to 3 hp
3To15hp , ' �
75to30hp• �
30 to'S0 hp
` , Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
0
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, 12-27-92) '
EXPIRATION: This permit shall automatically expire and become void if woik 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 Inepectiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLAqqnON: .
I hereby aflirm under penalty of perlury one ot the following declarations:
❑ I have antl will maintain a certificate of consent ro 5elf-Insure for workers' compensetion, es pmWtletl for Dy section 3700 of lhe Lebor Cptle, for t�e peAortnance oi Ihe
wark tor which t�is permit is issued.
j� 1 have an0 will maintain workers' cqmpensation insurance, as requlretl by section 3700 oi the Le6or Code, br t�e perfortnance of tha work tor which this permit Is issuetl.
My workere' compensalion Insurance carnar and policy number era: �'
Cerrier: �(��/ d� Policy Numbar: �7 Z���7�
(This secfion need not be completetl it the permlt is velued et one huntlred dollere ($700� ar less.)
❑ I certity that in the peAormance oF the work for which this permit is Issued, I ahall not employ eny person in any menner so es to become sub�ect lo the workers'
compensation la i Calitornla, end egrae thal if I sh0uld beCome suhject to the workers' compensation provislons of Seclion 3700 oi the Le6or Cotle, I shall forthwith
complywith sep vi5ions.
ApplicamSig ure: � Dete: �l z�� —.-�J
WARNING: FAILURE T SECURE WORKEFS' 6MPENSATION E GE IS UNLAWFUL AND $MALL SUBJECT AN EMPLOVEP TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSANDDOILA �(3100.00D),INADOITIOryTOTHECOST NSATION,DAMAGESASPROVIDEDf-0RINSEGTION3]O60FTHELABORCODE.IFIrEREST.AN�ATfORNEV'SFEES.
LICENSED CONTRAC70RS DECLARqTION:
I hereby aflirtn that I am licensed under provislons ol Chapter 9(commencing wlth Saction 7000) of Divislon 3 0l the Businass and Professlons Code, ana my licanse is in full
force antl eRect. Lic. N 2 D Class k G 2�
Coniroctor's5ignaWr. /i .a_ _ _ Date: L2�
CONSTRUCTION LENDING AGENCV: �
❑ I heraby affirtn that there is a construction lending agency lor tho pertormance ot the work lor which ihis permit is Issued. (Sec. 3097, Civil Cotle).
Lender's Neme: Lender's Atldress:
Signature: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm ihat under penalry of perjury thet I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business and Protessions
Code: Any city or county which requires e permit to conswcf, alter, Improve, demolish, or repalr eny stmcture, prior to its issuence, also requires the applicant for such permit
to file a signed stetement thet he or she is licensed pursuant to the pmvisions of ihe Coniractors License Lew (Chapter 9(commencing with Seciion 7000) of Division 3 of the
Business end Pmtessions Code) or lhal he or s�e is ezempt Iherefram entl the Dasis tor the ellegetl exemption. Any Nolalion oi Section 7031,5 by eny eppllcanc tor e permit
sub�ecis the applicant to a civil penalry ot �ot more than fiva hundred dollars ($500).):
❑ I, a5 owner of tha Oroperry, or my Bmployee5 with wages as Iheir sole compensati0n, WILL DO TME WORK, antl ihe slruCiure is not intanded or offered for 5ale (Sec.
704a, Busineu end Professlons Code: The Contractors License Lew does not apply to en owner ol properry w�o builtls or improves ihereon, and who does such work
himself ar hersetl or ihrough hls or �er own employees, provitled ihat such imD�ovements ere nol intentletl ar aflered lor sela. If, however, Ihe building ar impmvameN is
sold within one year of completion, iha owner�bulltler will have Ihe burden of proving that ha or she dld not bulld or improve tor purpose ot sale.).
❑ I, as owner ot the properry• am EXCLUSIVELV CONTRACTING WITl7 LICENSED CONTRACTORS to construct the pro�ect (Sac. 7044, Business and Protessions
Code: The contractore Licensa Law daes not epply to en owner af pmperty who bullds or improves thereon, and who contracis for such project with a contractor(s)
license pursuan� to Ihe Conirec�ors License Lews.).
❑ I am exempt under sec. Business and Profeuions Code tor t�is reason:
Signamre: Date:
Owner ID venfietl by driver's licanse. ❑ Ves ❑ No Driver's License No. Ezpires:
Verification of Ownership by (rype of doqiment, i.e. - property ta: 6ill or tleed):
DIVISION OF INDUSTRIAL SAFETV PFpMIT LEP7IFICATION:
❑ I hereby certly thel no excavetion five (5) or more teet in tlep�h Inro whlch e parson is requiretl Io descend, will be matle In connection wi�h work authorizetl by �his
permit, and t�at no building slrucNre, scettolding, telsework, or tlemolitlon or dismantling thereot, will be more than t�irty-siz (36) feat high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title e, Celifomia Atlministrative Code).
❑ As owner-builtler, I will not employ anyone to do work which would require a Dermlt from ihe Division of Industrial Salery, as noted above. unless such person has a
permit to tlo such work trom Ihe division.
Signatura: Date:
Division of Intlustdal Safery Permit Number.
Will the appllcant or presem or fu[ure builtling occupant need to file antl certity a Business Plan for emergency response to releese or threatened release of a hazardous
matenel7 ❑ Ves ❑ No
(Section 25505 oi the Califomia Heatlh and Satery Code requires, with some eaceplions. that e Business Plan be filed wlih the Casta Mesa Fire Department by avery
business which has at any one time during a reportetl year e quentiry of hazardous materiels equal to or greater Ihen e weighl of 500 pounds, or a volume ot 55 gallons,
or 200 tubic teet oi compressed gag at slanderd temperaWre and pressure).
Does or will the applicant or presem or fuwre bullding occupant need b file e registration fortn br ecutaty hezartlous materials7 ❑ Yes ❑ No
(Section 25533 of �he Califomia Heal�h and Safery Code, with some exceptions, requires registre�ion vn�h t�e Costa Mese Fire Depanmem by each business which at any
one lime has on hand a quantiry 61 acutely hazardous materials eQuel to or greeter than a welght ol 500 Oountls, or a volume oi 55 gallons, or 200 cubic feet ot
comoressed oes at stanAard tempereture and oressurel.
an
or wni me appncant or presen� or
prepare an
25534 oi �he Califomia Healih and Salety Code provitles that the
ant oi en RMPP by bu5lnesses which are reGulred to replsler eculE
Health entl
�P (Risk Management
Fire Department may i
matenals with ihe Flre
acutely hezardous
certificetion end (iling wlth the Flre
Does ar will the applicent or presen� ar tuture bullding occupant require for t�e work which is Ihe subject ol this a plication a permii tor such construction or modificalion
irom Ihe Sout� Coast Air �ualiry Management Disirict or from eny other eir pollu�lon control tlistrict or agency7 � Yes LJ No
(SeCtion 658502 ot Ihe Califomia Government Code requlres ihat �he reduestetl Informetlon be furnishad on applicetions lor non-residentiel building Dermits).
Will eny patl oi the faciliry lo be constructetl untler this permit be within 1000 feel tmm the outer bountlades of e school7 ❑ Ves ❑ No
(If'yjes', the faciliry musl meet Ihe rpquirement ol Secilons 25534 end 62303 of ihe Calitomie Health and Safery Cotle).
It a permit irom the South Coast Air Dualiry Menegemeni Disirict or olher air pollution control tlistrict ar agenq is requiretl for the work which is Ihe sublect of ihis
application, heve all oi the tlisclasurgs prescnbetl by Calitornia Heelth antl Safety Code Section 42303 heen ma0e7 ❑ Yes ❑ No
(If'yes', aitech certifiw�e of complidnce trom the appropriate eir pollution control oHicer).
CERTIFICATE OF COMPLIANCE � certity that under penelry oi perjury Ihe inlOrmelion given above is correct. I agree to comply wit� ell siate laws and Ciry ordinance5
reqarding Hezardous Meterials end Emissions.
Signature: Date:
CERTIFlCATE OF COMPLIANCE AND qUTHORIZATION OF ENTRV: I cartity under penalry of parjury that I have read this application entl state t�at the infortnation given is
correct. I agree to comply with all state laws antl city ordinences relating to building consiruction, antl authodze representatives of Ihe City of Costa Mesa to entar upon the
above-tlescribed property for inspection purposes. I agree not to occupy or allow acupancy oi eny building au�honzetl �y ihis pertnit untll ilnal inspection.
COOE �' INSPECTONTYPE -
1616 Fizetl System Finel Fire Prevention
1266 Pool Spa Final
200 final Re�Roof
201 Final BIocWReWining Well
202 Finel Fectory Fire Place
203 Finel Sign
204 Finel Domolition
zansss
gAg, ��j �,I INSPECTIONTYPE
206 Finel MeChenical
20B
210
212
220
222
250
�/^2` �d J
Date
Final Plumbing
Finel Electrical
Finel Fire Preventlon
Final Plenning Approvel
Final Site
Final Building/Occupency
p 'M6
. yJy,�
`°��axmm'"`�
(714)754-5273 • Fex(714)754-4856
Job Address: 555 ANTON BL
Suite: 10
Vicinity: TENTH FLOOR
Parcel Number: 41050110
Appliwnt: WILSON, WALTER
Address: 2505 MIRA MAR AVE.
LONG BEACH, CA
Owner: SAKIOKA FARMS
Address
Contractor:
Address:
REF:B00-00027
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Zoning:
Phone: (562) 498-6444 EXT. 2205
Zip: 90875 �
Phone:
Zip: 94137
P��lPid�bER �
�
77 FAIR DRIVE, COSTA MESA, CA 92626
Phone:
Zip: .
� License:
SCOPE OF PERMIT
INSTALL 35 FIRE SPRINKLER-HEADS FOR -EPOCH INTERNET- (10TH FLOOR).
Plan Check: $117.81
Permit: $181.25
Other: $0.00
Total: $299.06
FEE SUMMARY
` , - , � � ,
. ,
Status: ISSUED
Applied: 07/10/2000
Issued: 02/03/2000
ISSUED BY:
Calc Valuation: 3�o,000.00
Claimed Valuation: sio,000.00
NOTICE: The work euthorized by ihis permit shell comply with all applicable handicap access requirements under California statutes and ralated
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if wark is suspended or abandoned
for e period of 180 days,
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlred inepeetlone end final epprovel must be obtained. Fellure to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 754-5626 .
WORKERS'COMPENSAnON DECLAFiATON:
I hereby elfirm untler penalry of perjury one oi tha tollowing decleretions:
❑ I have and wlll meintain a certificate of consem to setl-Insure for warkers' compensatlon, es provided for by sectlon 3700 at the Lebor Code, br the peAortnance ot the
wark tor which �his permit Is issued.
I h ve end will maintain wwhers' compensatlon insurance, as requiretl 6y section 3700 af Ihe Lebor Code, for tha peAormance of ihe work tor whlch Ihls pertnit Is Issuetl.
My wIorke�prs' compen5a0on Ir�urance carrier and licy number are: u f1 ^(
�ar[ierJ R.�/J�.v'� ���[_ lTi�t�E�2�uti.l-�-1 POIICYNum6er _� / ! � �
(Ihls section nee ot be complet� il the permiNs valuea af one huntlred ollers (5100) w IessJ
❑ I certify that in Ihe pedortnence ol the work tor which this pertnit is issuetl, I s�all not employ any person In eny manner so as to �ecoma su6jecl ta Na workers'
compensetlon laws ot Califomla, and agree ihat tl I should become sub�ect to Ihe workers' compensetion provisions oi Section 3700 af the Lebor Cotle. 1 shall tort�wit�
wmply wlth these provision8.
Appllcant SignaJa: Z-Ua�� .t� `�" ---�_ roeca: �'�• - 3� d'�
WqRNINO�FAINRE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNUWFUL MlD SW1LL SUBIECT AN EMF�.OYERTO�CRIMINAL PENPLTIES AND GVIL FlNES UP TOONE HUNOFED
TMOUSAND DOLURE (5100.00%.IN ADpRIpN TO THE CO6T OF COMPENSATION, �AMAGES AS PROVIOEO FOR IN SEGiIIXJ 3108OF THE LABOR WDE, INfEFlE5T. AND AT70RNEY'S FEES.
LICENSED CON7RACTORS DECLAFATION:
I hereby attirtn al I em GcBnsed under pmvisions ot Chapter 9(commencing with Sectlon 7000) ol Didslon 3yt Ihe BUsiness end
�orce end ercect. tk�.a� 3.2 i(`% ( b�esc.a� C—/
��
CONSTRUCTION LENDING AGHNLY:
❑ I hereby eMirtn that there is a consiruction lentling egency tor the peAortnance o1 the work br w�ich Ihis parmlt is Issuetl. (Sec. 3097, CINI Code).
LenOefs Name:
Signature: _
OWNER-BUILDER DECLARA71qN5:
Lendefs Adtlress:
Date:
my Iicense is in tull
I �ereby aftirm thet untler penalry af perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following raeson (Sec. 7037.5, Buslneu antl Profeuions
Code: Any ciry or counry which requires e permii to construct, elter, improve, demolish, or repair any structure, pdor to its issuance, elso requires the flpplicant tor such permit
to Nle e slgneA statement Ihet he or she is Iicense0 pursuanl to Ihe praNsions of the Contraciors License Lew (Chepter 9(commencing wich Sactlon 7000) of Divlsion 3 ot Ihe
Business antl Protesslons Cotla) or that he or she is exempt t�eretrom end tha hasis for the elleped exemptlon. Any Wolation of Section 7031.5 by eny epplicant for e pertnit
sublecis ihe applicant to a civil penalry of not mora than five huntlretl tlollars ($500).):
❑ I, as owner of the property, or my employees with wages as their 5ole compensalion, WILL DO TT1E WORK, end the structure is not intentled or ottered for 5ale (SeC.
7044, Business end Professions Cade: The Contractore License Lew does not epply to en owner of property who bullds or Mprwes thereon, entl who does such work
himself or herself or through his or her own amployees, provi0ed �hat such improvements are not intended or oHered lor sale. It, however, the building or Improvement is
sold within one year of completion, the owner-builder will have the burden ol proving that he or she did not build or Imprwe for purpwe of sale.).
❑ I, as owner ot Ihe pmperty, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to Constmct the pro�eCt (Sec. 7044, Business antl Professions
Code: The contractors License Ww does not appty to an owner ol pmperry who builds or improves thereon, and who conirecis lor such pmjeci with a contractoqs)
license pursuant to the Contrac�ors License Laws.).
❑ I am exempt under sec. Busineu antl Professions Cotle for this reasOn:
Signature: Date:
Owner ID venfied by drivers license. ❑ Ves ❑ No Driver's License No. Ezpires:
Vedticatlon of Ownership by (type of daument, i.e. - propeny te�c bill or tleed):
DIVISION OF INDUSTRIAL SAF�7y pERM1T CERTIFICATION:
❑ I hereby certly t�at no excdvetion tive (5) or more feet In tlepth into which e person is reqWreO to tlescentl, wlll be made in connection wlth work euthonzea 6y tNs
permit, end thet no builtling structure, scaHoltling, talsework, or tlemolition or tlismantling Ihereof, wlll be moro Ihan thirty-si: (38) feet hlgh. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Calilomia Admiryistrative Code).
❑ As owner-builder, I wlll not employ anyone to do work which would requlre a pertnit from the Division ol IntlusMal Safety, as nated ebove, unless such person has e
permit to tla such work from the division.
Signature: Date:
DiWsion of Industrial Selery Permit Number:
CERTIFlCATE OF COMPLIANCE qND Al7T}IORIZATION OF ENTRV: I certity untler penalry of perjury ihat I have reatl Ihis application end state that Ihe information given is
correct. I egree to wmpty with all steta laws and dry ortlinances relating to building wnsiruction, entl authodze representetives ol the City ot Cwta Mese to enrer upon the
above-descnbed p�openy fw inspettbn purposes. I agree no1 !o occupy or aAow occupency ol eny buildinp euthorizetl by lhis permit until flnel Inspection.
COpE �. INSPECTIONTYPE Q/y¢, _ �$
1616 Flzod System Final fire prevention z�''�— Ob �,
1266
200
201
202
203
Pool Spe Final
Final Re-Roof
Final BIocWReteining Wpll
Final Fectory Fire Plece
Flnal Sign
204 Final Demalition
2d4&d6
� S �
CO�E I INSPECTION TYVE
206 Final Mechenital
200 Final PIum6ing
210 Finel Electrical
212 Final Fire Proventlon
220 Final Plenning Approval
222 Final Sito
250 Final Building/Occupancy
�g ��
2- r-/�- ca �_
(714) 754-5273 • Fe�c (714) 754-4856
JobAddress: 555 ANTON BL
Suite: 10
Vicinity:
Parcel Number: 41050110
� - CITY OF COSTA MESA `�
BI/ILDING DIVIS/ON
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
App�icane JEREMY COLLINS
Address: 2505 MIRA MAR
LONG BEACH, CA -
Owner. SAKIOKA FARMS
Address
Contractor: CAL PROTECTION
Address: 2505 MIRA MAR
Zoning:
PAone: (562)498-6444
Zip: 90815
Phone:
Zip: 94137
. .�li �i� . � = .
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/10/2000
Issued: 02/03l2000
ISSUED BY: �^-
� CA . - Phone:` (562) 498-6444
� � LONG BEACH Zip: � 90815
- � License: 327196
' _� SCOPE OF PERMIT
�INSTALL FIRE ALARM SYSTEM FOR THE TENTH FLOOR TI FOR "EPOCH INTERNET".
REF:B00-00021 � �
i -"
�
' Plan Check: $72.31
` Permit: $111.25
Other. � $0.00
Total: $183.56
_ FEE SUMMARY
_ Calc Valuation: 3s,000.00
Claimed Valuation: ss,000.00
'` -
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92) �
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 poriod 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
�equlred Inepeetlona and flnal approvel must be obtained. Feilure to obtain inspec�ions and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
V
WORKERS'COMPENSAnON DECLARATON:
I here4y aftircn under penelry of Oerjury one af Ne (ollaving tlecla2tiong:
❑ � have and will malntain a cenificete ol conseni to selFlnsure for workers' compensation, as provitletl far by sectlon 3700 oi the Lebor CoOe. for the peAortnanca of ihe
�/ Work tor which ihis pertnit is Issued.
IQ � �ave and will maintain workers' compensa0m insurence, as reqWrad by section 3700 of the LaDor Cotle, for the pertortnance ot the vrork far whkA Ihis pertnit is issued.
My workere' crompensatlon Insu �nce cartier erM pdi�y nymber are: p� �
Gerrier. 2FPi/ ��i � Cysu�F'�wnsl: i-4 POIicyNumher: �YO O' I
(This sect on ne not be cwnpletetl I/ the permit is veluetl et huntlred tlWlers ($100) or /e55.J
❑ � cenify ihet in t�e pedormance ot the work tor w�ich t�ls pertnit is issued, I shall not employ eny person In eny menner so as to become eubject to the workers'
compensation laws ol Calitomia, and egrea that If I should become subjed to the workers' compensation provisions of Sectlon 3700 0l the Lebor Code, I shall fotthwith
compty with t�ese pr°�% ians. ,�(� �� �� � � -1 �^
AppllcentSigneWra: ��/ in.l�CL2 L�'- �u7`�t Date: i1 -�" v�
WARNIA�; FNLURE TO SECURE WORI(ERS COMPENSATION OOVEMGE IS UNLAW R1L AND SHFLL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES ANO GVIL FlNES UP TO ONE HUNDRED
TIqUSqryD Op1NRE (5100,OW), IN ADDf710N TO THE CO6T OF COMPENSnT1pN, pAA44GE5 0.5 PROVIDED FOR IN SEC710N 3108OF THE IABOR CODE, IMERESi, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby eNirm thet I em licensed untlar �visioGng of hapter 9(commencing wlth Seclion 7000) ot Division 3 ot the Business antl Protessio/❑s COEe, end my Iicense is In full
f0lCB dntl BHeCL UC. M � Z �/ CI855 k / Q / C -(.�.
ConiractoYs Signature: Q ,/ _ Date: �' Z? 8-Fi
CONSTRUCTION LENDING AGENCV:
❑ 1 hereby aRirm thet there Is e construct7on Iending epency lor the peAormence o! the work for which this permrt is Issued. (Sec. 3097, CIWI Cotlej.
LentleYs Name: LenOors AOdress:
Signature: Date:
OWN�p-BUILDER DECLARATONS:
I hereby affirtn ihat unCer penalry at perJury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he tollowing raeson (Sec. 7031.5, Business and Professlons
Code: Any ciry or county which requires a pertnit to construct, alter, improve, demolish, or reDeir any sWciure, O�ior to its Issuance, elso reqWres the applicent tor such pertnit
Io file a signetl statemem ihat he or s�e is licensetl pursuant to ihe provisions of Ihe Contractors License Lew (Chepier 9(commencing with Section 7000) of Dlvision 3 of the
Busineu and Pmfessions Cotle) or thei he or she is exempt theretrom entl Ihe basis br Ue alleged exemptlon. Any violation ol Sectlon 7037.5 by eny appllcsnt tor e permii
suhjec�s iha applicant to a civil penalry ol not mora Ihan tWe hunAred tlollars (3500).):
❑ �, as owner of tha pwperty. or my employees with wages es their sWe compensetion, WILL DO TME WORK, entl the sWcture is not Intentletl ar oHared tor sale �Sec.
7p44, Business entl Protessions Cotle: 7Te Conirectors License Lew does not appty to en owner of property who builds or Improves theraon, entl who does such work
himsetl or herself or through his or her own employaes, proWtled that such improvements are not intended or ofleretl for sale. If, however, t�e builtling or improvement is
Sold within one year oi completlon, t�e owner-builder vrill have the burden of Oroving ihat he or she tlitl not builtl or improve lor pur{wse ot sale.).
❑ �, as owner of the property, am EXCLUSIVELY CONTAACTiNG WITFI LICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business antl Professions
Code: 7Te comractors License Law does not appry to en owner of properry who bulltls or improves thereon, and who comrects for suc� pmject vrith a contractor(s)
�icense pursuant to the Contractors License Lews.�.
❑ I am exempt untler sec. Business end Pmfessions Code tar this reason:
Signature: Date:
Owner ID verifie0 by tlrivefs license. ❑ Ves ❑ No Drivers license No. Expires:
Vedflcation of OwnershlD by (rype of tlocumeni, i.e. � property �at bill or deed):
DIVISION OF INDUS7RIAL SAFE7V PERMIT CERTIFICATION:
❑ I hereby certity that no excavetion five (5) or more teet In depth into whic� a person Is requiretl to descend, will ba made in connection with work fluthonzed hy this
permit, and the� no Duilding structure, sceffoltling, telsework, or tlemolltlon or tlismantling thereot, will be more Ihan Ihirry-six (36) teei high. (Chep. 32, Grp 2, Art 2, Sec.
341, Ttle e, Celibmia Atlministrative Cotle).
❑ As owner-buikler, ! will not employ anyone ro do work which woultl requ'ue a perm'rt trom the Divtsion o� Industnal Setety, as notetl ebove, onless such person has e
permit to da such work tram the divlsion.
Siqneture: Date:
DiviSiqn of Industnal Sefery Pertnit Number:
CERTIFICATE OF COMPIJANCE AND AUiNOfil7ATiON OF ENTRY: I certify under penairy of perJury (hat 1 heve read this appfication and state thet the infortnation given is
correct. I agree to comply with ell state laws and ciry ortlinances relatlng to builtling constmc�ion, antl authorize representetives of Ihe Ciry ot Cosla Mesa to enter upon the
abova-tlescnbed propeny lor inspection purposes. I eqree not to occupy or allow occupancy ol eny bullding authorized by Ihis permlt until ilnal inspection.
� � Signetur Of LeQeI Owner(s) �_ �^ Pr� te
�c,lilOO-�—z V C/
AnNOr Au�horized Applicant Date
GODE Y. INSPECtIONTYVE QAjf, ��S
1618 Flaetl Sysiem Final Fire Prevenilon
1266
200
201
202
203
20a
�++o+n
Paol Spe Finel
Final Re-Root
Final 81ocWReteining Well
Finel Fectory Fire Place
Finel Sign
Finel Demolition
CODE� INSPECTIONTYPE
206 Finel Mechanical
208 Finel PiumDing
210 Finel Electricel
212 Final Fire Preventlon
220 Finel Planning Approval
222 Final Site
250 Final Builtling/Oaupancy
QdTF INi1i1pL5
44�yte MFs9
o, �
> _
:
J
�+�mm'A
(714)754-5273 • Fax(774)754-4856
Job nddress: 555 ANTON BL
Suite: 10
Vicinity: TENTH FLOOR
Parcel Number: 41050110
Appliwnt: DON SMITH
Address:
� CITY OF COSTA MESA = �
BUILDING DIY/SION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Zoning:
-Phone:
Zip:
Owner: SAKIOKA FARMS
Address , � � - ,
�� ' � . _ ' Phone: � , . ,
� -�"
� . . - Zip: 94137
Contractor: ACCENT BUILDERS
Address: 555 ANTON BL. #100
' �
� Phone:- (714) 5493150
COSTA MESA, CA
� Zip: 92626 License: 397790 �
Amh : IA � , �. �' � � Eng'
NUMBER
10021
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/06/2000
Issued: 01 /21 /2000
ISSUED BY: / �
��
Address: 3080 BRISTOL ST #105 ,- '� "� •, ' ' Address: -
� � � � _ Phone: (714)754-1197 Phone:
� COSTA'MESA, CA , -
' � Zip: 92626 � � � ' , License: License:
SCOPE OF PERMIT
• ,� 3,410 SF TI ON THE TENTH FLOOR FOR;'EPOCH INTERNET". � �� �
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Othe�:
Inspection:
Total:
$110.30
$678.75
$0.00
$11.52
$0.00
$0.00
$800.57
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existina: o
NOTES:
� FEE SUMMARY
� - ,- ' .�,� Calc Valuation:
-- , Claim Valuation:
_ " /�
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Lefl 0- 0 Right 0- 0
Left 0- 0 Right 0- 0
Proposed: 0
$54,862.50
$52,500.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is nol commenced within 780 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In ordar for the work authorized undar this permi� to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetlone and (inel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAhON DECLARArON: -
I hereby aHirtn untler penalty o� perjury one oi the tollowing dedarations:
� 1 heve antl will maintein e cenllicate of cronsent to setl-Insure for workers' compensation, es provieetl tor by section 3700 ot the Labor CoOe, far the peAortnance ot lhe
wark for which this p9rtnit is issuetl. �
� I hava and will mainiain wwkers'���ppp mpppaaansati� Insu2nce, as required by secUm 3700 ot Ihe Lebor Cotle, for the pertormance of Na work lor which Ws pemtit Ls issueC.
Myworke ' mpeng ionl �caM ntlpo' numberare:
Cerrier: � Policy Number: �% ��e�Q3 is/ 3—Q��
(lhissectionneednotbe� mplefetli!! permifis- lae nehunOretltlW/ars($f00)orless.)
❑ I certity that in the p¢Aorm ce oi the w i ic�/this pertnit is issued, I shall not employ eny person in eny manner so as to become subject to the workeB'
compensetion I s oi C' mia, and e t i s uld hecome subject to the workers' compensetion provislons oi Section 7�he Lebor COOe, I shall tort�with
comp with t .
A ignat e: __ ete: _ � �� /i�J
WAFNING' RE TO WRE WORKE ' COMPE TION COVE E IS UMAWFUL AND SMALL SU6IECT AN E PLOYEP TO IhUNP1 PENALTIES AND CNIL FlNES UP TO ONE HUNDRED
D OOLLARE ( OO.00p�, IN /�D TO COST OF COMPENSATKKJ, OAMAGES AS PROVIDED FOR IN SE THE IABOR CADE, INrEREST. AND ATTORNEYS FEES.
LICENSED
with Section 7000) of Divlslon 3 of the
uo. s
Date:
CONSTRUCTON LENDING AGENCY:
Professlons Code, enC my Ilcense is In full
❑ I hereDy ettirtn ihat t�ere is a consiruction Ientling egenq for the peAortnence of the work tw which thls Dermit Is issued. (Sec. 3097, CIWI Cotle).
Lentlefs Name:
Signature: _
OWNER-BUILDER DECLqqpTIONS:
Lenders ACtlress:
Da�e:
I hereby aflirm that under penalry ot perJury that I em EXEMP7 FqOM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons
Cotle: Any ciry or counry which requires e pertnit to construct, alter, improve, Aemolish, or repalr eny strucmre, pnor to its issuance, also reqWres the applicent tor such pertnit
to tile a signed statemeni that he or she Is IicenseC pursuant to Ihe provisions of Ihe Contractors License Law (Chapter 9(commencing wlth Section 7000) ol Division 3 0l Ihe
Business and Protessions Cotla) or ihet ho or she is exempt theretrom antl the basis for Ihe ellogetl ezemptlon. Any vlolatlon of Sectlon 7037.5 Dy any e0�licant tor e pertnit
sub�ects the applicant to e�ivil penalry ot not more then five hunCreO tlollars (3500).):
❑ I, as owner ot the prpperty. or my employees with wages as their sole compensetion, WILL OO 7HE WORK, end ihe sWdure is not intentletl or oflered lor sele (Sec.
7044, Business and P�ofessions Cotle: The Contractors License Law tloes not epply to en owner of property who builtls or improves ihereon, and who does such work
himself or herself or through his or her ov+n employees, provided ihat such improvements are not intenaetl or oflered for ule. If, however, the builtling or improvement is
sold within one year Of completion, t�e ownerbuilder will heve Me burden of proving thet he or she dld not build or Impmve tor purpose of saleJ.
❑ I, es owner of the property, am E%CLUSIVELV CONTRqCT1NG WITN LICENSED CONTRACTORS to construct the pro�ecl (Sec. 7044, Business antl Pmfesslons
Code: The coniractors License Lew does not epply to an owner of properry who builds or impmves thereon, end who contracts tor such project with a contracroqs)
license pursuani to tha Contrectors License Lews.).
❑ I am axempt under sec.
Signeture:
Owner ID veritietl by drivefs license. ❑ Ves ❑ No
Business and Professions Code for this reason:
Venfication ot Ownership by (type oi daument, i.e. - property tan bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMR CER7IFICATION:
Drivefs License No.
Da�e:
Ezpires:
❑ I hereby certih/ lhat no excevetion live (5) or more teet in tlepth into which a persan Is required to descend, will be made in connectlon wit� work aulhodzetl by Ihls
pertnit, and that no Duiltling strudure, sceHolding, talsework, or demWitlon or dismentling thereot, wlll he more then thirty-six (36) feet high. (Chep. 32, Grp 2. Art 2, Sec.
341, lllle B, Califomig AdministralNe Cotle).
❑ A5 owner-huiltler, I will not employ anyone to tlo work w�ich would require a permit from the Divislon of Intlustnal Sefety, as notetl above, unless such perwn hes e
permii to do such wark from the tlivision.
Signe�ure: Date:
Divislon of Intlustrlal Safety permit Num6er:
CERTIFlCATE OF COMP4ANCE AND AUTHOROATION OF EMAY: rtify under penalry of per�ury thal I �eve reed this application and siate that the information given is
correct. I agrae to comply with all stat w and d ortlinences ating to building construction, end auihorize representetrves ot iha Ciry of Casta Mesa to enter upon ihe
above-descnbetl property tor inspe n p as gree no� t upy or ellow accupancy ot any Duiltling authodzetl 6y this pertnit until Tinal inspeciion.
COpE �, INSPECTONTYiE Q�
t616 Fixetl System Final Fire Prevention
1266 Pool Spe Finel
200 Finel Re-Roof
201 Final BIocWRatelning Wall
202 Finel Fectary Fire Place
203 Final Sign
204 Final Demolitian
2aa&a6
�f$LA� �f,,,( INSVECTIONTYPE
206 Final Mochanical
20B Finul Plumbing
210 Finel Electdcel
212 Finel Fire Prevontion
220 Finel Planning Approvel
222 Flnel Slte
250 Final Building/Occupancy
PAIE INi1TIALS
\
.,
City of Costa Meu
Development Serv�ces Depar[ment
BuilAing Sa�ety Division
P. O. Box 7200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No.
The Building located at 555 ANTON R(11TA,F.VARD lOTH AT.(10R
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable there[o
for a Group B-2 Occupancy.
Use of euilding OFPICn — BANK OF AMERICA
Legal Description 410-501 04
' (See reverse side for Metes and Boundsl
Building Permit No B5954A Electrical Permit No. E59779 Plumbing Permit No.P59731
Mechanical Permit No. M59776 Number of apartments • and/or guest rooms
ISSUED TO:
dANK OF AI�RICA
20 N. RAYftOND AVENUE
Building Official TONY C'DE BACA
bj ' -
Y . .,r;�.
PASADENA, CA 91103-3931 � �/', �
Date
This Certificat¢ 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 Fi�e; Pink - BId9. Permit File
��
� `,
i �.
City of Cosia Meu
Development Services Department
a Building Sateiy Division
� P. O. Box 1200
Costa Mesa, Celifomia
CERTIFICATE OP OCCUPANCY No. OO��.O�
The Building located at 555 Anton Boulevatd. lOth Rloor
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
tor a Group B2 Occupancy.
Use of Buitding Office
Legal Description 410-501-p4
(See reverse side for Me[es and Bounds)
Building Permit No B 4�1863 Electrical Permit No. F. MRR7 Plumbing Permit No. p 4�ARA
Mechanical Permit No. M�91! Number of apartments and/or guest rooms
Fire Prevention Permit izo. E 45419
ISSUED 70: BuildingOfficial 7bnv C'Re Baca
Sacurity pacific Banlc '
555 Mton Houlevard, lOth floor by �, � i� •
Costa Masa, CA 92626
' Date June 5, 1�i40
�� 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 Meu under Sec. 307 (e) U.B.C.
� CMF 1o15-a6 rev. i/83 White -Owner, Canary - Numerical File; Pink - Bldg. Permit File
4�.
�
�
\
City of Costa Mesa
Development Services Department
Building Safety Division
P.O.Boz 1200
Costd Mesa, California
CERTIFICATE OF OCCUPANCY No.003���
The Building located at 555 Anton BlVd.. Tenth Fl[x�r
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Grpup B2 Occupancy.
Use of Bui�ding OffiCe
Legal Description 410-501-04
(See .euerse side for Metes and Bountls)
Building Permit No. R�7Q�d Electrical Permit No. E 37939 Plumbing Permit No._
Mechanical Permit No. � 37� Number of apartments and/or guest rooms
Eire Prevention Pecmit Iw. F 37689
ISSUED TO:
SecuritY Pacific Bank
600 P7ilshire Blvd.. ¢500
I:as Anqeles. CA
Building Official wi 11 iam m_ Wrn..a.+a
by — "` - �
Dace Julv �7, 1989
This Certificate of Occupancy SHAIL 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.
CnnF 1o15•a6 rev. I/83 White -Ownec �anary - Numerical File; Pink � Bldg. Permit File
�oonessaea�wa: 555 ANTON HL
OMNER9NWEIFIWOYM: SAKIOKA FARMS
"0°^E54 PO BOX 2097
TERMINAL ANNEX
r :;w•nm:si,aa:�i�e
�ncxrtEcr ax �m�n:
�PCX.OP EN4.'4 �OOXESS:
uc w,
uMr:
UNT:
lOTH I CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 076009 PLAN CHECK NO: N
��T�"� MORROW MEADOWS CORPORATIO (714)598-7700
carm�ctoas�uiu+a p O BOX 509
�no�ss: WALNUT CA uc.no: 230813
91789 uHr:
110EN5EU CONTHACTONS DECL�fl�TON: I he�sby Nim ivqs penely tl psrpvy Ntl I am IimaeE uMs pw'v'vu tl Chepla 9
lcommar+M wu� Sectim )000) M DNnian � d Ne Bus'v�ea and Pmlmmu Coda. W mY Gonse o m Iu0 ta�ca erd Waa.
cmuc.No.:00�/6/�5.58 �/�/��� C 10 uc.No zy3y0/8 3 EXP; 12/96
Dma: / / U � � t0 CoroaCa: - / / �
`WNEF BUILDEF DEttAXATION: I Mreb�� efirm wiEer peWy al par'�vy tlW I eumq mm �he Camrtdon liranea l.aw Iv Ne
bwiq eamm� (Setlbn ]WtS &niwaa aM Adeanm Cotle: �rt� eiy n mun Nif� n • e permE lo awWel. eder. imqova.
.emd'¢h. a reper ary struciu�e. pior w b cbw✓.a, eho �epuca iM �pGra01 wch ' �o Na e nprod efmm�wiq tlW M a eM
y i�e w�+ �o ub wo�s a m. con,mo� � i.. �cnaqa l� wuA Saeian ]0001 d Oi+eian 9 d tM
Busifca ud Rdaasiau Codel a �het he a Ms e ezemq iMrahwn eM ths ' ta ebpeE memqion. My vdmion d Swion
�mt s W em Aoo�u �«. cmmi akjee.� rtn eac� to. dH pmeuy a na hm R.a hmwed daCan �SSaop.
❑ i.mo..,�«ainswaw�r��n«�c�w�+..n�..me:.a.�ro�..arou»..o�..mu».v�eanaw�a
n ollmad I«aeb (Secum lou. emroa eM PiatmsianaCaEe: Tha Cauredan L'vne lsY Eom rot ePdJtoen oward propeny
W�q b11�9IX RIWP'N INBfl01. Yld Mp dCM tYdl Ylbfk b119p�i IX�IMOl� IX �IIWjh �1G Of �Nf bMl BIII[�pJpO�. P�� �� MlC�
'unD�+<meNs ve nd'waded o alleeed la eab. tl. howaw. iM do'tivq a inpws�w e eotl wnhm ans Yw d eamCMiun. iM
ownarhuddw r,illla�s iM diNen d o�0^^0 he a aM 6d no1 ddd n'unP� Iv tM wrDaa d Wel.
❑ I. n owrw d �M D�MM. em eadivwy mvradn0 �A for�d mmaclan m mrcmw tlr pWa (Swm mu. Bvabna end
PMwaan Code: The Caaraum lierca Lew Aow ra +ONY m an oxnx d PW�Y Mw d�L a'uripwr ihsrson ud xM
eaNneta la wrh Wqab xvh e arcaemp(e) IcsnaA punuaq to �M Corvrrme liosoe lew).
� I am ammq uMx SMion: B. d P.G.. tor tlie resron:
Dms: OYnw:
1 Eo hseW eMlY Met I am eware tl vd �vWeeuM tM'p�namW d Caliortis IIeeGA eM Sde�Y Cods Satlioro R5505.255�.t. eM
Y55�. md tlw I a en1' Mus WiNviO �+9^^� wi I rA m� (dcb one) rosE W mmdY w[h oid qtla mM� mM tlr npWramras br
e P� Iacvmvud'ona moAdwion hvmNe N� Oiuntl. R�riCe�W mm'ueion WO�iom ena`omq ham iMw
Vv+eions.
om.: .oa�n:
woncep�s co�vexs�non oEcuw�nor+: i n«ee�.rc� �.w.� �ey a o«b.y a,e a u» aoo..;ro aw.�moo.:
❑ IhawaMxJmevuanecaRSra�edmuetltoWawaslaxwken'mnpa�suion.mpwidtllaEySwion�)ootlilwtnGa
coa.. �o, in. wnan,.M. d m. bn w..?icn w. o� : s,�e.
�'� � nm eM x�t menwn wM1ers' omio«umun umnnoe. n �+m+oed W swion aroo d ma len« coee. w ine w�«muKa a ins
work la wAiM Ne D�e b uaued. M' wMwY wmM�bn'vnurencs ran'w eM pofv.y number ua:
c� F7ARMAN'S FUND E}CPIRES
var,m�e., nwrAnF�FF � 07/O1/96
(TAia eMim rrosd mt M mnd+�� /�MW+mt u b am IwndM ddhn If�W/ a/sn.l
� I oenN � in Ne pafamurw W Ne waM la which iAu prme b enwd. l Netl nd empby a�ry ps�on In eiry m n n to
Cecmw wbjed b iM xaMn' mnpanWian larn d Cefdamie. erd prs Net ' I NdYC Ecoms aas o� xaken'
ca/m%� wio/nf�y�'^�°oim� d,��/y�fQ J d tM faEn Code. l an�rril� aomPM Uwss pv+abm. (
Dele: / � / C/ �� AppliceM:
Weminp: F�flun ro��cun woMwry'rompm��tlon eov�rp� h unlawNl, �M • fl �uDJ f III MIplO/p f0 Cl/MN/ pMINN II1G
�iMr n,.. w ro w» n�.�a�.e �m�,.�a eww. (t�oq000l, M���� ro m. t ol wuafbM1 Wrrrpu u provpM br In
sxtlon J106 0l fM LeOor Cab. Inhnst ��rtomryl M1u.
CONSTNUCTON LENqNO �OENCY: I IwaE�y elfiem uMx prulry d Ih u e oonn�uqion 4rqiip pericy lur IM
DaAarmariw W �M wh b wTiM ihe V✓mY u ewd (Setlion �041. fw�r. CI.
LENDEfl'S NAME:
LENDEP'S 4DDPE39:
I cerlM �he� I hew reed No ePG�ceum vd um� ihet ths ebwe iMamvion u conetl, l eprw lo canGN wilM1 M �LY erd aountY oMironw
ene eime kwa nletin9 b W ikm9 crosvwion and M1ereM eWwce repamie�ivm W thu raY ro emx uD� �M eEovs.msmioned woroM
Imirupeqion purpoeea.
CHUCK JACOBY
Oma:� / � Y
(5t5�d6.WP) F4Ane-�uildvqdSdey;Omao-Fle:CanW-Appirani;Rnk-Bwmw;(loldomod-Neeemr
l�
PERM NO: E 0760U
GOVT: N SUPP: Y
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : 200005F OFFICE T.I. /ELECTRICAL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS / REF 8-74631 ��� �+ ���
*it*��titft�rit**�ratie�r�r��ritrr**��*�rx�**it�rit*it**ititie�* it� � x�*x��rx��tit�rie��r*�r+�**it��t*�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKZNG REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
� ,.
M ii ik 1E 1E 1E 1F 1E 1E 1f 1! ik 7E 1E 1! ik 1E i! ii 1k iE iE if ik i! if if ik 1! if 1E iE if if iE 1f 1E 1E 1E 1E 1E IE ik 1k 1E 1E iE1F 1E 1E 1E 1E iF 1E 1k ff ff fE iE iE'k 1f iF 1f 1f 1E 1E 1E 1E 1E 1k 1! 1k 1F if k 1Elk IE
D E V E L O P M E N T S E R V I C E S R E{J U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY
�t�t�t�tx��t�***x�x�*�r�r�rx�r*�t*
LEGALIZATION:N
BLDG PMT
PEAMIT
PLAN
ISSUE FEE
HUILDING—DIV—>
TOTALS---->
F E E' S U M M A A Y
PLUMBING ELECTRIC MECHANIC FIRE
21502
4.50
DATE:
DATE: ��
�r+� �r x� * * * *���F* �
STAUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
21.30 4.50 0,00 25.80 25.80 .00
REVENUE DIVISION TOTALS--> COLLECTED: 25.80 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
25.80
1EilfliklfllklElfMiFlk1l1E1E1l1f 1F1EMflMlkif 1E1E1kiF1E1E1E1EfF141F1E1kiEMikiE1f1E1EilM1l1E1f1FifiF1t7E7t1F7EK4M1f Ik1Fik1k1E1f 1Ek1f 1f 1l1F1EiFiklElElf
I N D I V I D U A L E E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20
ELE 14 RECEPT/OUTLET ADDITIONAL
END OF FEES
EA. .75 I5.00
EA. .45 6.30
E�
� � �
L�: �i'�_t; .1�,.`�"} �'�_� '
[-1f' l�, li•c 'i�� '.'p`
�
CQNSTRUCTION AND PLANNWG F. .& SPA
APPROVALS Permit # Date Inspector APPROVA4S Permit # Date Inspector
1. Temporary Etectrical Service or Pole 52. Pooi & Equipment tocation
2. Soil Pipe-Undrgrnd. ;0 53. Sceel Reintorcement
�V :.6lectricat Condult Ua)itv-Undegrnd. 54, forms ,
- :4�e��lectrical Condyi-U`�drgmd.' 55. Electrical Bonding ' �
•ti5£ Sbeel Reinforcemeot`� 56. Rough Plumbing & Pressure Test -
',6n Fjectrical UFEA�iiid. 57. APPROVAL TO COVER-GUNITE
r7" �oocings ;��, ' 58. Hectricaf Conc�uit,•Undrgrnd. �
� 8. FLundation '� � 1� 0 59. Gas Pipe, O U��Fll�rnd., 7est
ti�
9. Water Pipe�Und���d. � � 60. Backwash Line�p-Trap, O Undrgrnd.
10. Structural Floo�ysrem 67. APPROVAL TO� ECK
i t. PropertV Sewer �ne_& Hous¢�Connection 62. Backwath & R�i eptorFinal
72. Sewer Cap � -a 63. Heater & Vant-�nal
13. Roof Drains 64. Plumbing System � Fina3
14. flough Plumbing-. -� 65. Electrical-Final
15. Rough ElectricaNConduit �" 66. Solar System�Final
16. Ro�gh E�ectric �4iring � � 67. Fencing & AcccsS�ApProvaf
' 77. Rough Wiring Sign � � 68. APPROVED F�.��LASTER WG
V �
� 78. Rough Eiecvica�7' Bar Ceiling 69. POOL7SPA SYST�EA4S FVNAL
79. Rough Heatin & Air Conditio�Ing �, F]pE$�Pi„SEQUIREMENT
r', x T k fn t" �^ � H' - l.� Y
`'. 1 '1 S.^•, 'Q f v � 6' R' � (i �' 4 "�' �
20. �Ougg�i FaCtor�fi�{�tate ch. � S-a C� APPFf,OVj�t�F Per�nit #��_
21. �uCfs: in'SIru21urE*fk . '. •• `1V '� c � �-'• 70.:Under�7&�J F{,Sdro # .
�. n ��r c a -�v.�
22. �ucu' Ve�ti��Iing�,'�.y `: � * v ,� �j F* : 71. Produe9}jRing as �Oil
23. Gxs Eipe�souqh & Test � v: n r ¢ O r 72, UndergrSund FLGsN `� '
tiV k
24. Rbof=Fraisting" �� • ;' � � r.,�, .73; Undergrhd.StoipgeTank*OGas ❑Oi4
25. Roo heaching �� c`, v v �� G;� co� �� 7q1 pvenc�ad Hydr�r� +�
26. F•BairCeiling (Sa'(�;ral) & MUnacoat �+ '� -� �'`� x 'T ^ r . n �-;�
j� K O :. -i� 75_ Dry CheF�pical c.;, a: ��. '
27. Frameand Flashi � � � -
i ^9�a ��� kc r c�a 76. DryStark�Pi'Pei-�� �� �''.,
' _ . r� ��
'' 28. Lathy"'1i g �Sidin9 �,'-1j� �' �µ� x M �' �� ���r 7J�., FIXED,6�`'jSTC;¢1,�INA� _
-� O .' � H .. .. / � i � . ,
29. Insulation� ��+ _ •• +� ' � 7 " FIRE PREV. FIfJ„�.l " � c �-' .
30. Drywall Nailing '�� ^ k�,,, ' � S �EALT�B,EP�'."�tEQUIREN1Ef1T
-� .r � . ,
31. Plaster Brewn,Coat . r. - �. � �x !• 79. FINAI YN3PECT'TON �a
„32. EJectrica>Power N�t�r�%�ai � «^' i �'� 8� FOOD CER71p�ATE I�SUEQ.
r ' � � �- - . -r-:r---
33. �inaC-Elect�ic, �ze r . < ' N6tes: �. "iT; "'. C �.
�__ _- . ,.
. 34. FinaCFieating'& AN Eonditionid� + �' � v cC ^v .5 ,�w * `" �'�
(' N 6 t T Y, '� I- ) M'JO f�} 1 F1'!ti �� �
K � � .
35. Fina�T.,asPipA:7es�w 1. .. �::� � fk.• '� xo C+�� < -t-
� 36. Hoo&or CanoPY r = � ' "� '� � l � �"` � �'� * `"�'
s�� x c•: � � '+ ;- x c s-
='37. Finat Factory FirePl;}ce � - ` K' � . --
' � .
✓ 3$_ Finat�Plumbing � " - " * ^ � 1t �� '"' ` �
--+ •' c � � O k !: H S �.
�39. WaterSec�ice-Final r � y * � �' " ' -
;r: � x rz � � : ., y: � .;.
�.
�..40. GasService-Final o-'T 4-tr - t r�, ';f Cv xR �' ••
H" Y 1: � ii t+ � `�S � Q
41.SolarpomestiaFiral`� � " X'l "
! STi K �' �1'. M ']O C' " x
�42. BackflowPreventet'a N .t� � �N �k : F _ ��
., -, .., -. t .-. a -i m o . ~ F.
43: Hackflow Irrigation T y';S� w Q R• � r ••
- :-
44. LandscaRe�Irrtgation+SYstem W!'i�� n �-1 � C 7Y: � n' ^' x� F ^� L' �
E� c.: O G r-
45. So�nd Attenuation ; `c'F' • � E `" F' F'* " `� "
n.. .. R; .. R1 �.. T 7 ry . F. II
A6. Handipp Regulations � ' T � � z� • � ?o S �� • �^ .
e- . c i : «
47. F1NP�L STRUCTUR� & BUI�DING : I ; r + ' " � � , •
I 1_' �
t'
48. EINFU.PLANNING � :�� +'� � 'r . - �' a� .
a : � S :' -
49. Electric Release to EBison ' � ��'` '� _
� ;- .�F � t - ,
�i0. Gas RElease to Southem Califomia�GasCo * ' X- H '7 • ot*: � � •• -
`O'� � S DG fl o. • -
51. CERFIFICATE OP OCCUPANCY x . _ .. ..
No Date
�I
Aoonessaam�ncio: 555 ANTON BL
OWNEN'SNAYEIFpqYIN: SAKIOKA FARMS
eooncss: p0 HOX 2097
TEAMINAL ANNEX
APPL. Y/JI1N0 AOOIIESA
�RCMRECT Ofl FNdNFFA:
IJiCIL OP FNO.'4 AOONE55:
uNr: lOTH
11C. NO.:
UNi:
`°"`""`T°"5""'E` COMPEL CORPORATION ( 310 ) 946-8 321
CONfP�CTORSYYWq 10410 PIONEER BL
"0°"� SANTA EE SPRINGS CA °°N°° 392693
90670 °Hf
LICENSED COMFACTOflS DECLAP�TON: I hareby eRnn �Me� perely d pe�jwy Nm I em licenasd under pwniona d CMqm e
(mmme�np xi�h Seciim )000) d ONieion 3 d �he Busnew Md Fmleaebns Code, anp my 4cenro o in IWI laca erd eHae.
cmuc.No.: 032054 �`'CA55` C-10 uc.r+o.: 392�,9 3 /� EXP: 08/96
o�e: io -a4- �c �o�a %'�L�(�, Y�.�..��--
`WNEN BUILDEN OECLANATION: I lieeby elf�m wdar pandY d perjury Ihm I em ssemq tmn tM Comreqps Licame lew la IM
Ilox+q reawn (Sedion 1W 1.5 Bu+iioa ard Rdme'vu Code: AnY uY a cauM' whirh ieW"ves e O�n io mmm�ct. Mx. imWwe.
nmW'nh. or ropei vry auuc�we. pnar lo Ca'sw�vm, ebo repUins �he epp4mn� tp wch peimY to fib e sqned �letamanl ihet M or eM
m rcensee wrs�a,� ie n» a��ma a me ca,�reaas umme ie. Icnapv e(mmmenaro wnn seaun �aaol a oi�o�� a d�b
Busirea ard Prdessions Wdel or IM1e� he n ehe u examq thaehan eM iM beao la Na albY� ssemqbn. AnY violation M Sedian
)031.5 by any applicen� Iw e parmn aubpe� iM eppfcam io e� pendiY d �wl mae Ran Ma huMred Edlen R500�.
� I.svovmardlMVW�Y«mY�NoY�9v.ihwageamthadamm0a��.MTEONeMwk.eMtheatruciureum�inleMed
a dteradtar eele (��>�. Bumma uM Pro/esaans �: TM1s �treewe Licenee Lewtlom not epplyto en oxnard pmpery
who WiAs a inpaee therean. ud Ma doas autl� Mak h'cnaetl n henM a WouAh hu or har am emWMa. pa'� �he� wch
improvemeMe are rot imeMed «oHaed lor sab. tl, hows�er. iM buiHinp or inpovemeN b eoltl wnhin an yev ol mmpbtion, iM1e
�,�,-w�u« �;n neb me w� a o�+'ro n, «.na We oa wae «�w� �o. ub wmo.. a��.
❑ i.do�„e.am.ww.ro.���.+�r��:a.�n`m,,.ewm,na.wcasso-wubwqa�tsw�rou.a,s�.,�e
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: E 07482
PERMIT NO: E 074829 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PEAMIT TYPE: ELE PUAPOSE: ALT
JOH DESCRIPTION : 20000SF OFFICE T.I. /ELECTRICAL SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
*���*�**+i�x�*�x�*�*�+Nr+�**�D****�r*****xB****�*�**�****�****���*�***�***x�+r*****��r****
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NOTES>
> !.�_
iE iE 3E i(�!E fE �E IE iE1E 1E 1f iE 1f 1E 1E 1ElE iE 3f if if 1f iE IE 1E IE iE if 1E 1E iE iE.iE iE if if 1f� if 1E iE ik iE iE iE IE iE fE 1E 1f iF if iE 1E iE�E IE1E 1E iF if if 1f iE iE fE 1f fE if iE 1f iE iE if 1E iE IE 3E iE
D E V E L O P M E N T S E;R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY �" DATE:
PrWeasiona Coda: The Cantrectaa L'cwee law doae M eppN a en oxne� al papeny wM WiMa n impwae ihereon erd wha B U I LD I NG AP P RO V ED B Y : DAT E:
convecu lar wtli G�M�9 wiN a mureeMa) licems0 p+�sueM to iM Can�emrs liu�me lawl. _.
❑ i�,�.,mp��.s«i�: e.aPc..wmm�: ApPLICATION ISSUED HY; �' ��TF DATE: �C`� � r1 ✓
o�.: o�«: ieieieft�f[�**itieiEx��tx�x�ft�t*itx�itieit7FlFiFTF7FlF7F7F±F3F'iFiF7FiF3FiFif3F7F7F'iF 7F iFifTF7F'�F'iF**itie�ritiEit*it **
I ao hereby canily ihet I em ewere d ard uMantad iha �epuiromx�b d Cellanu Ibtlh eM Sdery CoEe Seebre u505. 25533. eM L EGAL I Z AT ION : N F E E S U M M A R Y S T RUCT URAL S EGM ENT : N
255�4. eM Oat I a+nY Mun dnMi�q oo¢qeni will / r.il na (ercb orc) need ro canOM xt� aeid pme oodea end tAe mGuimnenn lur
apa�mulormretiw.MianarmoGfiWionhwniAe�r ue�iy ar�eiemomDatrirJ.RmidemidmmtvaioneppicviaaenezamqlmmNme BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provrswne.
Dale: Rppfirsb�
WOHKEfl'S COMPFNS�TON DECLAFATON: I Mraby effim� �kx penMy al prjW ar d iM IOAoxiiq dadumiom:
❑ inb»�e�;���w:�e�ena�weaoo�.wio+en;�,w.i«w�d;�w�.mo�.owwd.di„Ws.a�,a�ooam.�n«
Cotle. fa tM pMamonce d 1M wak In wtvch thia pmna a iwuM. '
�'�'j i ne.. a�d w�e �m� won.n oomo�o� ��re�. m�w��.d M s.a:,� ��oo a ine �n« com. ro� me wn�� a m.
work la xfiich Iltis permn c'vsusd. MY wd�n' oompeMm� �rencs uriw mA pdiry number ua:
0e11eC F-R�xP4A?I'£ 69AM1� EXPIRES
' °a� ""m"°" 0 2/ O 1/ 9 6
�mr:,.nnrw��..e,wre.�Wm.ermew�+�+om.w�en i dwo.
❑ I eeelAy Nm in ihe pe�lamviee d Ihe work M xfich �hia permE b uwW. I WY mi emplvy vry penm in enY men'ror eo d to
bscoma wbjed to iM �wM�e' mnWenwion le'.h d CeGlarve. uM ap�os iM G I ahatlA bacartp abjod io �M r.orkeis'
compenee�bn proviaion� W Seaion �)OU d iM labor Code. I dWl IMhwil� oompty �N�
ode: /a-Z4 �S.S �wa�: %7.+r.'�'%�. /'',p�9„ne....--
Waminp: Felluis ro��cun woMni ronpxu�tlon eov�rep� /s unl�rNl, �n! I�uDJcf en wnp/oyp roWMrW p�naMu entl
c/WI flnu up ro wro hindM IMuunJ tlw'Mn (J�OQPPDA M Mil/tlon b M� rosf oI romprwtbn, J�nupp �s poHtlM br In
Sxtlon 9)OS ol tlrs labor Cods, Inf�uf, eM �ttomey'� ISM
CONSTRUCTON LENDIN(i ROENCT: I Mraby �rm uMe� GuxM d per'µy ihet Ihas u a mrut�ueinn IyWi�p epmKy M iM
p,n�� a in. � ia..n� me vmm� a ew�e (sea�+ aw�. cH. c�.
LENDEN'S NNIE:
LENDEN'S 1DOFESS:
I cenity Ihet I heve read Ihia eppliceum eM vma �het Na ebava iNumation ia wrtaC. l epree lo wmyy wnh all �y enC oounty ordirencm
enC siata lexe reletire �o builtln0 camwbn eM nxetr/ aNMae �eV��eiivaa d �Im mYto misr uo� �M ebova�memionetl MooeM
forinspedqn W�W��
�r�v cmnnmvnrx� MDN�T`� ���ON
�W ' //— J/..n.QY� Dme:fO —TC�'(S
5 un d IgvNRpp&anVCaN�a
I15t-a8 WP) Whne-BuilEvq 8 Seiery: Greeo-Fle: GereiY-ACDk'a�C Rnk-Avrenue; Ooldenmd-Aaxawr
PERMIT 64.05
SOt SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 64.05 15.00 0.00 79.05 79.05 .00
REVENUE DIVISION TOTALS--> COLLECTED: 79,05 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
79.05
1E IE If� 181E 1k iE fE IE 1E 1E 1f iE iF IE 1E 1F 1f iE ik iF f! 1E 1E 41E iE 1E Ik if iE 1E 1E 1f if if iE 1E iE IE 1E 1F 1F If M 1E �l'i{' 1E if 1f 1F iE iE iF if 1klE K ik Ik fE 1E iE 1k iE iE iF if iE 1E �F 1t M M if if� iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 COMMUNICATION DROPS 1 ST 20
ELE 109 COMMUNICATION DROPS ADDITIONAL
END OF FEES
45
EXPIRED
DATE �' I Z•
U2 qGt!,it'1-f.0293Y31 Ta�g
OpT£: i:1,'yi.�q rjt�c° .c:33
15.00
49.05
/
;9.Q5
�
CONSTRUCTION AND PLANNING P., & SPA
APPROVALS Permit # Date Inspeetor qppROVALS Permit # Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe•Undrgrnd. '- ' 53. Steei Reinforcement � "
v! -
���{gctrical Conduit,.di�'�ity-Un�egmd. 54. Forms � " '
v-4�'Qactrical ConduR•tlridrgrnd. � 55. Electrical Bonding �" �.
r�. T-�.�
��,��`�el Reinforcemer�;.�. 56. Rough Piumbing & Pressure Test
Fr6�Electricxl UFER�fAd. 5T. APPROVAL TO COVER�GUNITE
s�:'�otinqs C�� r 56. Electriwl Condu�itr'�ndrgrnd.
� � .
� 8. F,Qundation ��Sc� 0 59. Gas Pipe, O Un�qcnd., Test •
i
9. Water Pipe�UndrryridN� 60. Backwash L.inesr=P-`,TraP. O tlndrgrnd.
10. Structural Floor�S`ystem ' 61. APPROVALTOfO.@CK �.
17. Property Sewer Line & House+".onnection 62. Backwash & Re�pior•Final '�
12. Sewer Cap _,- 63. Heater & Vent-FinB� ' :�
13. Foof Draint � 64. Plumbing System � Final ,
14. Rough Plumbing�,' ,� . 65. Electrical�Final .` �-
15. Rough Electrical.�onduit 66. Solar System-Final_,
i 6. Rough Electric 6�rin� �� 67. Fencing & Acce �Approval
-77. flough Wiring Sigp � i 68. APPROVED FOR'PLASTERING �
.,,
�'^18. Rough Electrical T Bar Ceilinj° 69. POOL/SPA SYST6�yIS PINAI
19. Rough Hea[ing & Air �onditio�ing FIRE DEPT. REQUIREMENT
_ � � ' Y �. , � ... ,: ;�
20. �ugmFa�or� ire'�hace z � " - = '"�� PPROVlCLS,�`-�Per'tnit# ' " '_�
x ry -" � r , --r---
21. [riicts,.inS�iru�ra,`'.-�r �..�. .�- r r'+ -:,r 70. Undergroun�H�)ro t�
22. D�ct�Vef�lila� g �� ' : � � _`• '°�' 71. Produc�.T,.�P�irig O Gy�s C�,OiI
23. (?ns PjDe-f�u�,& l e�t .,j. � �� � � � � rj K �72, UndergroQhd FlnsYl� +' -
24. Roof�raifiin9" `O� � •`'`' "•, � � 4 �r �_73�Undergrna:Stora�GTank�lGas1�0i1'
25. Roof�'hea,jhing .�`'..�: � ' �� � C ': ',; �� 74%Overhead �HYdro^ 'r
26. LBartSeiling (Strudmall & Mcn�gc�at ' `' `°' ` 75� Dry CherQj,cal ;� ".� " ' � -
'r - `. -
27. �'amgyand,�lashing,,; ��a. � C. . �� � 76. Dry Stanutpi.pe r W � � � � �F
i-28. Lath6:g&�iding Or�� -7¢� � •T " "k 77Q'FIXED31'STENYf1NAl.;_ �, �",
�'29. Insulati0� �7: � � .• •• '' �� „ � = M,
Ru r t S r 78`•FIRE PREV. FIN,tt'L �: <:K
P�J30. DrywallNailing r�t � �z � � • HE'ALTHT�QEPT�REQ'piRE�[ENT
J37. Plaster 8r�ivn.6paf �r � .�..T. �; , � � i� .79�'FINAL I` �CTIBN. r -
� E,_ ._ ..
�32. C-t2ctrical�Powee Mc^-,,d�F.Snal , � +� ' n ti BO��FOOD CERTIFI' �.4i'p 15�U D•y S�
s-33. F�t�al�le ric ' ' �' � r� - :., �� � J
� C g /%//
, �- � m�n :T i d p�� ' �C/(s� Notes:, «�� :r -, O c�a'r:
,� . _ d i" `
;i34. Final eatingBCAir.Oond'Fi+onin{s,- ', � a� cr. •r� .< ��� � S ��C
m r k .,.- ' O � ��^. -.n
�35. F�halfGas Pipe�es �'• �,y : ` ~ x ; ���,, or^, . � . �. �
� I..r • -+ t :.G �r-� t :J-. �
�6. Nood;er �PoP4 •�: � i m.^ c , r � ;._ ' E %-;o '� ^r
_. � I �: x^ • m :G:�7
., _..
"�7. Final�i2ccoJY Firec�W'�e..� � F � •� �r f-� � _ } �;�:
r-38. Final Plurnbing : r V�(ti • "•'f" � S �' #�
r. . �- t
��39. Water�5erbice•FinaN} � � a A i * � � 'LL "� R "'
,�-,j30. Gas Service-Final � c �r; q�. � S - n C�� �:� x��
i L T K C
,. = • . �� r� ; r +
341. SolarpomesticFinal F� , ,f ,., ,�,2, ,.. � ^
�-� �. * . ,
F"42. Batkflow Preventer'� '� v _ � ? c: >'r ' �7 �+ ,� "..
•r, n, n c c-.
43. Backflow Irrigdzior�'� X=�� °� K 'r * O _ �
w. ., R . � x
qq,. LandscaP?Jrripatiqp£Ystem �;�!� G + �. t'� . c.: ' * ti '-^- .
- g' ' w
4b. SoLnd Att nu tion � `''�' � "= ' r` ' ~" "Q' F� '�
\ �. } �-�1 .. .• iT TI T X T �ii ' N� i
�@. Hzndicap Regulacions� � . `• . ...� � � .^ ��_ 5 !'
� � �
47, F1NAL STRUOTURE�& BUILt�ING t, ' � f n' S ��
, + n
48. P+'�!lA:,PLANt1�NG � �-- 'K : � d *� F
�. ri c v
49.. Etectriu Release to Edison x " G * '
� > � C .t --i._
�y0: Gas R@lease to South'arn Calilornia Gas Co � i z i 7• c a� * ^ ••
� -�� • i uc
5]. CERT:1fICATE OP OCCUPANC^ .� �; � x' ' �^ '�'=
No. Date
�n
I�
�� �itp o f�o5ta 21� e5a �
Development Services, Division of Building and Safery
CERTIFICATE AF OCCUPANCY
This certificate is issued pursuant to the requirements of the Uniform Building Code, Secrion 308
adopted by the City of Costa Mesa certifies that at the time of its issuance the buffding structure herein
below described was inspected and approved for occupancy as follows:
Building Address 5�5 ANTON BLVD. F[AORS 1-12
n�o OFFICES
Bldg. Permit No.*aee belw
Group B-Z Type of•Consavction 1-FR Fire Zone Use Zone PDC
Owner of Building Saki eka Farms Tenant "►nrocn[."
Address ` ' '
*B74S7G, B7S356, B74572, B74571, Bi45?3, B74633 :
B74632, 574631, B74G30, 7 006, B77866, B74574 By
%}�.IHI�Q:��OSb�+.�.�a
Date November 14. 1996
P.Z�'K Bk0'a*!, CL'0
�
i....._ ..._._- --- ------___.--
REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
�
'�
�.r
�
�noncss a ew�oun: 5 5 5 AM 1 ON B L
wmcirsru�eiv�v�axx: SAKIOKA FARMS
.00xess: PO BOX 2097
TERMINAL ANNEX
,�vx. �uiwo,�no�sa
UNT:
ia TH
urcxrtECT oe v+mi�n: uc. ra_
MCN.OP FMi'4100RE55: UM:
ca+m�cranwu¢ MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
cam�croas Wuia+o P O B OX 5 0 9
�oox�ss: WALNUT CA ��.: 230813
91789 uM:
LICENSED CONfFACfORS DECL1P�710N:1 hsaby tlfim uder penely d peipvy tlW I em hemsE udr prwbbm ol Gheqr B
(mmmanrin0 xilh Soetion ]000) d OWieion ] d Ne Butlnsp eed Pmlu�om CoEe. eM mY liosme h N IW brcs and aHotl.
cmuc.No.:0065q58 uo.cuss: C 10 uc.N^o.: 230813 EXP: 12/95
Dets: �'l7 � � / '— 9 � GameCa: ( _ / ' '� \[� �i �% :
'W NEP BUILDEN DEC4PATION: I Iwaby eRum uMo prWy d pa�ury IIW I un ¢ q tmm Gppratlm Lkam� lew In iM
tlow4ro reevon (Seaion loJts &une» end Rdmnvoo�u CaAr /�MW a m+M' xtii nV� Mm�i �o oomwn. Mx. imV�ove.
wmd'uh, or rope'r eiry ewctun, prior b b bauuws, abo npwm the eppYreN ta ach amY Io e�Ipned Netement IIW M a �M
u lieeneed W�� �o �M pem'v"vu d IM GaV�tlar� linma lew �Chepp B(aomm ' Satlun IOWI d Di+ibn J W iM
Bunrim ud Grdaaiona Codsl a IM M u Ms u azemp �hsshan uM tM b�tls la ths �AWed ssanqion. MY vbW un d SW ion
J031.5 Ey enY aVd� la e pumu � ihe eppfwu lo e tlN peiW�y W np man Ihm fxe hwMntl EOAen �SSW�.
� I.moxnerd�MRWNYamY�d�MSWhreW+nNeicbwmpamtlion.wiTEOlMwkerdNe�mmn'sndWeMad
«Merad la eeb I�� ]Ou. Bvainew ard Prdeason�GoEe: Tha Contreqon liqnas lew dom not applyto en ownmal piapeny
W �10 �Il�f IX�II V�S 1�MIlpl. Yd M}p Qp!! tIN}I Mtlk hCllfp�i Of �MM� M I�llWih �0IX hG! OWII YII[�IVM�. PA'�'� ��1tl WC�1
impovemenp vs mt inteMed a dleraE la eeb. tl, howwer, �M WiIC'uq a inrywxnem b wtl wnhin ar yw d wmplpun, iM
owror-0uiNw wYl hew IM EUNm W Va'm0 M a�he Ek nd bWJ a imR� 1> Ua Pupwe M Wel.
❑ �. ro own.r a �n. nowM. em e.tluweH awr.ero .un 6o.�.d cano-ecia. m mmina w wqw (s«au, �ou. ewn.. ana
riaeaion. code: m. coin,maa limro �a. me. na mvN ro.n own« a woo�v wno wib. « impw.. mei.o� .�a .no
crnvecu fa wN pqeCa wB� e mrtlrmoHal fcemod qvauem to the Caa�adwa Licams lewl.
� I em eaemq uedr Senion: B. 8 P.C., br Nu �uaon:
om._ o..,�«:
I tlo heraby cenily Ow I em ewve d enE Wenbnd Ne reQwromaw d Celfomie IbeM W SNdy Cods Sanbm P55p5, 2553J, vd
25St4, eM IM I a arry Mva buikinp m�uu MII / wA m� (ecb ane) nse! ro compl� wiA �eid eeis ade� aM IM �puimmmla br
a pertnn lormroi�uctian ar modiRmtionhwn�M Iir�ity�enpman pinrid. ReYdruid conqnqion epp{utipyye eymp Irom thas
a��.
Oeia: �pplirsm:
WORKEfl'SCOMPENS�TIOMOECIANATON:llseb�df wqxpsWiydprpvypwdtMloOoxnqEsderqbm:
� IhevevMxJmeinteneuMiuledaornsr4loestlinwabrwaken'companWion,mprwitlWlabySauion9llpdiMlebor
caee, i« ine �nwm�a d ine ..m i« .+:�n ma �.,n n n.�e.
�] I hero vM xd meinun waken' mmpemmion imuranro. m ipu'vsd by SeGion 9'!Op W tM LaEu Code. b iM paAmmeMe d Ihe
wak la xl�itli il�is Wrmn b baued. MY woken' aanV^^wion inwrerce ud i�Y wmbsr ve:
�,,,;„: F1R�MAN 5�"�`UtvU EXPIRES
PafryNumCx: LYVl.OVO/00]/ 07/O1/96
(mis asnian nee0 ria Dv canpWeC E Ns pmmt u b me MnMrW Eatlen /Sim/ a boJ
� I co�Ey �Mt in Ne peAomunce d iM wark la wfich ��u pemiY u itwetl, 1 tlull nq ampby arry perwn in erry mennx w u to
bscame wbjea io Ile waMm�' mmpenwian bws d CaNarce, uN yne il� ! I�Muk becoms Mjee to tM xvrken'
compenaeilon pwnbna M Seaion 9]00 d iM labor COEa. I h.rim� mmp �IN thove pwiuoro.
/a-�9'�- gS ,w �
Dele: A riM'
Weminp: HNun b peun woh�ri rompwwtlon coverp� U unNwNl, �n �IWI • ¢t m wqo/oyw ro ctlMiul pxultlu mtl
c�vn nn.. w ro m. nu�d.w rnouub edrn R+aq000A ����n ro n co.i o� mo.n..�ron ��w. u puv�e.e ror �n
s.cnon 9�os o� as L.no. coa, mra..c .�e.m,m.y. r....
CONSTNUCTON LENDINO AUENCY: I hereEy eHim uMm peiWy d per'�uy �Mt Ihers n e oonnewfion bMLp epeMy br iM
perlarmarim d �M xaM1 In xfiiM Ihe peeml a ewad (�� �). Giv. CI.
LENDEF'S NYIE:
LENDEH'4 ADOHESS:
I cMity Ihet I heve reed Uia epplicelian eM pe�e thei Na ebwe iMmration u cortau. I apree io oomply wnh ell dly enE county ordineroes
BM e�01e lewa nlPoeq b dIYA�q CMfV W�T� dM M�GbJ GI11hOfFs �ppepiMlpMt d IhY Cly b N11M IIpTI lh! Gb0.�f.m!lllOnld pOpB1A'
10rin9petl�°�`D°'°'' CIIUCK JACOBY
(5151dfi.WP)
o��0—/9— S
8 Selery: Oewr�Fb: Cenery-Appifait: Pink-Rerenue: Oddenro�/usewor
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 074685 FLAN CHECK NO:
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
N
PERM NO: E U14G85
GOVT: N SUPP: M
PURPOSE: ALT
JOH DESCRIPTION : 20000SF OFFICE T.I. /ELECTRICAL SQ FT:
CLAIM I�ALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS / REF B-74631
**+���****����r***�*�+�*���+�****�**�****+��x���*,�***�«*�*����*+��+��*��*�+�x�+�***�#�����
Z O N I N G R E Q U I R E M E N T S �
S E T B A C K S
------------ MAIN HOILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REp PROV: PARCEL: �I1t�j����F>Q 'ZISSSL 4���' 1;�'k '
PLANNING NO'�ES>
� 'X�i�
iF-1!')�9FJL:LjLxJ[{ciiii3F'3Fi�i4#ii#�?fiEiflE'kfticiriSit''t'iiit'R> �!!#ir'ItiE'kfkttiEiE'k##iriEiEk'i:iEillr#ifif'itiF'lE?'iEipit#i%iF'iric�i�t'x"xf�'ifuiE
D E V E L O P M E N T S E� V I C E S R E Q U I R E M E N T 5
ZONING APPROVED BY ^�' DP.TE:
BUILDING APPROVED BY : '� DATE:
APPLICATION ISSUED�BY: � DATE: ��I-'�/�/,5'
iliEiEiEiE*iEif3fiElfiEif3E7FifiEiEiQ�lEiElE ., �t�t iE3EiElE1E9EiE3f-iEiEfF?F7'�iF��fiFii�iF3F#iE
LEGALIZATION:N F E E S U M M A R Y* STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 203.35
508 SMIP/NON-RES
PLAN
IS^"— _E 15.00
BUILUING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 203.35 15.00 0.00 218.35 218.35 .00
REVENUE DIVISION TOTALS--> COLLECTED: 218.35 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
218.35
if ik iE # iE if iE'1! iE iE 1E iE # iE iE af IE If' I6 iE 1E 9F �%if iE ii"K iE af if iE if 1E iI-iE ik if K' iF iE if if 14 # if'k' if iE'1E if ih iE'N' iF'lE !E'IE ih IF ik if iF iE iE'�E if iF iE ik i<' if -0f i%i('!F iF'1f if iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE
ELE
ELE
ELE
ELE
ELE
ELE.
ELG
QTY
20
189
20
L12
2�
2
2
D E S C R I P T I O N UNIT COST
FI}{TURES, LIGHTING 1 ST 20 EA. .75
FIXTURES, LIGHTING ADDITIONAL EA. .45
RECEPT/OUTLET 1 ST 20 EA, .75
RECEPT/OUTLET ADDITIONAL EA. .45
RECEPT/SWITCH 1 ST 20 EA. .75
RECEPT/SWITCH ADDIT ��� EA. ,45
SUB-PANEL �]"� 11.00
END OF . ,(�
D TE ^1 oe+.,.,,_ :is.�Y45
"' — �u7� .. : .�
TOTAL COST
15.00
85.05
15.00
50,40
]5.00
.90
22.00 /
i- - - 'f` :5
r�
9S� CONSTRUCTION AND PIANNING P & SPA
SAPPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspeetor
t
4. Temporary Electrical Service or Pole 52. Pool & Equipment �ocation
2. Soil Pipe•Undrgrnd. . 53. Steel Reinforcement
3. Elettrical Conduit Utility�Undrgrnd. 54. Forms '
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. �EleCtrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footingz 58. Electricai Conduit�Undrgrnd.
8. �Foundation 59. Gas Pipe, � Undrgmd., Test
��.:'Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, Ca Undrgrnd.
1�. Structural Floor SVstem 61. APPROVAL TO DECK .
11. Property Sewe� 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. Elearical�Final �
15. Rough Electrical-Conduit , 66. Solar System-Final
16. Rough Electric Wiring . 67. Fencing & Access Approvai
17. Rough Wiiing Sign 66. APPROVED FOR PLASTERING
18. Rough ElectriCal�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Cond�tioning � FIRE DEPT. REQUIREMENT
2U. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof framing 73. Undergrnd. Storage Tank � 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
3Q. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Etectrical Power Mecer�Final / 80. FOOD CERTIFICATE ISSUED
33. Final Electric ��U�j a Notes:
� /-
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or CanopY .
37. Final Pactory Fireplace
38. Final Plumbing
39. Water Service-final -
40. Gas Service•Final
41. Solar pomestic•Final .
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System .
45. Sound Attenuation
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDiNG �
48. FINAL PLANNING .
49. Electric ReleaSe to Edison '
50. Gas Release to Southern California Gas Co
57. CEFiTIFICATE OF OCCUPANCY
No. Date
PN0.IECT ROUflESB: S S S ANTON BL ' uxiT:
�. OWNEB'SNIIME: SECURITY PAC BANK
� aooeess: 555 ANTON HL
i COSTA MESA
il CA 92626 ,
I RflClIIENGINEEfl: INT�RNI IIEO.N0.:7
�ooxEss: 5 PARK PL ux�T:750 .
IRVINE . CA 92714
PE"MiTTEE: IMPERIAL INSTALLATIONS ( 213 ) 722-3634
aooeEss: p,p,BOX 59148 NONE
NORWALK CA 90650
�. IICENSED CONTMCfOP OELUMTION: I here0y af14m tlut I am I¢ense0 unOer provitions of Chapter 9(mmmmdnp with Section
� 70W) ol-Uivision 3 of tha'BUUness antl Prolessiau CoOe, aM rtry Icense is in full force antl elfeci.
cmuc.:047006 �T�hu . p c s: /
� Date: SiO�tum:
� WDNNENS' COMPEN �TION OECIAMTION: I MreEy aKrm Ihat I Aaw a xNficate ot corismt ro utlinsure m a ceNOw[e oi Work rs'
I Compenution Insurance, or a cenilieO mpy thereol (Section 3800, Lab. C�.
i mucvNo.:WC804843 ¢xv.o�Te: O1/23/90
Mrexr: SAFECO
. Certife0 coOY is here0y tumis�00_ � Cenitied copy is ( e 'Ih th 'ry Bu� 'sio� /
Date: �lpplicant:
IXEMPf10N FflOM WOBI p$' COMPENSA710M FpAWITON: (Ra setfim IieeE roI Ee tdnpklM if tl1e pertlil LS fa dle AuINreE (5700) a �.
I certiy [hai in t�e performance ot the work lor wltich Ws pemtit is ixwe0, I shall nat empby any person In airy manner m u ro become
subjetl ta ihe Warken Campen5a0on L�ws of Calilomia.
Date: Sipnature: ' � �
NOTICE: Ii, alter maltin0 N¢ OeclaraUon, you shwltl Gecome suOjM ta ihe Workers' Compensation provisions oi Ne LaOor
CoOe, y0u must Iorihwilh wmpy vnt� suc� prOv¢ions or Vd5 pemu[ SIWI �0 drem¢E avokEE. .
fANSTRUCTION IFNDING �GENLY: I Aereby aKrm Wt t�ere is a cwutruction lentlinp apen�y lor Na ce�ormance ol l�e vrork lor
wNCA lha permil ¢ iuuetl (��n 3W7. LYv. CI.
lFNOEfl: !
ROOPESB: ' ' '
OWNEfl BUILOEP OELUMTION: I AereEy a1fUm ttat I am uemD� ��m Ne Comactors' State License Law lor t�e I011awin0 �eazon
(Section 7031.5 Business an0 Prolessianal CoEe: Nr/ cry of counry xTicO reQWres a perMt ro caratrvp, atler, fmD�'e, Oemalis�. ar
repair any structura, prior ro its issuance, also repWres I�e �ppAcant for sucli pemtit m file a sipneE sutement tAat �e/sAe is IicenseU
pursuant io the D�adsions al IM Cantactors' State Liceine L�w (CMpter 9(commendnp witn Section 70W� of qWsion 3 of Ina Business
an0 Pmfes5on5 COEe) or ihat �USM h exempt t0emlrom aM the Easis lor t�e aAepeE exemptian. My violatPon ol Section 7031.5 Ey
any aD7liwnt lor a permit subab tAe applkMi ta a ChA pmally ol irot mOre IAan Me �uMreE AOIWrs (f50�.
I, u ovmer of the oropeM a� m'/ employees witn wapa u Ntlr sole compensaLan, wiu eo ine work, ane ine
� slmcWre is not IntenGeE or ottem0lar �ale (SeCllon 707d, Buvness an0 Prafessional Code: T�e Conlraclors' Stata License law
Oaes not aDPly ro an ovmer ot a O�opeM �0 6uilOs ar ImO�oves t�ereon, antl wtio Ooes suc� woM �imsell/�arselt or t�roup�
Ais ar �er own employees, praviEeE IAat sucA ImD�ovements are not inten0ed ar atlere0 lor sale. 11, �awever t�e Duildinp or
impmvement Is wIU wit�in one year ol campletlon, IAe awner will hrve t�e UUNen ol DrovinO �Ushe tliU not OuilU ar impwva
' lor tAe�Durpose of sale�.
I, u mimer ol t�e D�a7eM. am exGuvveN contncMp witn Ikense0 contncmrs to canstmct the Dml�� (�ctlon 70Ad, Business
❑ ana Pmfessions Cotla: Tha Contanon' State Liunse Law Eces �ro1 apON �o an w.mr of pmce�ty w�o owl0s or imo�s tnaraon
anE who coniracu for such Drojects wlt� a contrzctar(s) license Dursuanl to ttw Caniractors' Staro Licanse Law�. I am aware
�Aat pmal of tfreir Workei s Campenatbn insurance sliouM De proviOeE to me.
� I am exempt unUer Sectlon: . B. 8 P. C.
for this reason: •
1 ao nere0y ceNry IAat I am aware ol antl uMersuna tM reQuirertrents ol Calitomia Heatt� aM Salery CoGe Sectidu 25505, 25533, an0
25534 anA tnat I or airy lulure EuiWhry aapant w�+Nwin iro �drde mel mN to campry wtt� sala sute mdn �nE Ne requlremenu tor a
permil fOr wnsVul.Yion or moEilkation trom Itq Ni �Ory Man�pement OaYnp. NaiEenual cansi�uqim �p0��ibn5 are ex8mpi Irom
meu Dravisbns.
Oate: ppptiani:
I AereEq uniry Inat I luw reaE tAis appfiratkn an0 sWte tMt tne a0ave inlormation ¢ rnrrect. I aqree ro rnmDN ��� �I ciry an0 counry
arOmances aiM stata Wws alatin0 �o UuilCinp croswction anE Icere6y autAw� apresmtatrvxs ol tltis pry ro emer upan tne aEovcmem� .
O��VQ�Y �orinspeciion purpase5. '
Od10: � � Sipnature: �
Onver's License or Social Securiry ,r:
, 1841J6 Whlte—BuiIEiM1: GreerCpCO Entortement: Canery—RColiwnt Pink—Ravenue: GolEenrotl_Asaeaw�
CITY OF COSTA MESA - HUILDING PERMIT PERM NO: M 044990
PERMIT NO: M 044990 PLAN CHECK NO; , N GOVT: N.SUPP: N
CONSTRUCTION TYPE: 7. SPRINK" PERMIT TYPE: MEC . PURPOSE: ALT
JOB DESCRIPTION :�TENANT IMP
SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: ALL WORK ON THIS PERMIT ON THE lOTH FL.
��r*****xx�r**+�**+�r***�txir�t�t�t***�r*x�*******�r**�tx�*�r+r*�itit�t�t*�r*�r�r**x-�t***�r**�t�r�t�t�r*+�it�t*�t
Z O N I N G R E(j U I R E M fi N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN�
LEFT: FT IN.RGHT: FT IN , LEFT: FT IN RGHT: FT IN
PARKING AEQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
. . > - - - .
���r*��**�*+r��r****�r+r*�r+�*�r�r*�r�r�**��x�����r*+r��r�****�r��r�r�x��**�r**�r*�r**�r****�**+��**�r�*
D E V E L O P M E N T S E R V. I C E S R E Q U I R E M E N T S. .
ZONING APPROVED BY ~ �DATE:
HUILDING APPROVED BY : � DATE:
APPLICATION ISSUED BY: '? DATE: � I'-'I �`U`l
ik i! ik iF 1! if if 3F iE �f iE iE k iE if if iE k k it �t iF
iF �k i!!k 4 i! �f iE �E if if k if iE if if k k k ik k iF iF iF if iF Ik iF iE iF if iE if if if it if iF iF 3F iF iF if if iE iE fF k M k 1E ik if k if iF
LEGALIZATION:N F E'E S U M M A R Y ' STROCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
BLDG PMT PLUMDING ELECTRIC MECHANIC
PERMIT ' 6.50
' 25Y
PLAN SMIP/NON-RES
ISSUE FEE • 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL ' PAID DUE
TOTALS-----> 6.50, 15.00 0,00 21.50 21.59 -.09
REVENUE DIVISTON TOTAL'S--> COLLECTED: 21.59 OVER/SHORT: .09
HLDG PMT PLUMBING ELECTRIC MECHANIC EIRE SMIP/TOT ,GRADING PLAN-CHECK
21,50 .
1f M ik 1E 1f 1E it k iE iE iE if iE iE iE if N M it If It 1E if if iF it if iE iE if k 1F�iE if i! 1Elt k if if k if if ik i! iF 1! 1f iF ff N� 4 iE il M fE 1E if k if iE 1E ib if k iE iE iE iE i6 iE �lf iF iE k k if it iE
I N D I V I D U A L F E E D R E A K D O W N
'tYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 INST HOOD W/DUCTS FED BY MEC EXHAUST 6.50
END OF FEES
0
6.50
0
1 JI VuOY: :/: 'JL•�' �J_ -•—-' T'
D,1T"t: 11'15?:4 E`:= ... _ �
0
CONSTRUCTION AND PLANNING Pl & SPA �
APPROVALS Permit # - Date Inspector p�ppROVALS Permit # Dafe Inspector
t. Temporary Electrical Service or Pole: •, 52. Pool & Equipment Location �'
2., Soil•Pipe,Undrgmd:- "'� - 53. Steel Reinforcement
`��3:'�Electrical�Conduit Uiility-Undrgrnd� - . 54. Forms '-I
n ... r-� r
�.�4:�EI ciiical_Conduit-Undrgrnd. ' 55._ Electrical Bonding
C.'S.:Stee6Reinforcemeni �� r _ . 56. Rough Plumbing & Pressure Test -'-�
r. i >
�'�6.,_Electrical UFER�Grnd. '� 57. APPAOVAL TO COVER�GUNITE �,;
c� 7. Footings -! -.r�i _ 56. Electrical Conduit-Undrgmd. _
'6. Foundation __ '�� i 59. Gas Pipe, O Undrgrnd., Test ' �
9. Water Pipe�Undigcnd. � ', 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Structural FloouSvstem �`^� � �-i� 61. APPROVALTO DECK �)
1 7. Property Sewer Lirie�& House Connection I 62. Backwash & Receptor-Final "�
12. Sewer Cap " �+ _ g 63. Heater & Vent-Final '�
c
73. RoofDreins�, z � �
�; 64. Plumbing SYstem - Final 1
14. Rough Plumbing � ' 65. Electrical-Final �
75. Rough ElectricVl-Conduit 66. Solar Sysiem-Final �
16. Rough Electric Wiring ' 67. Fencing & Access Approval
17. Rough Wiiing Sig� � 68. APPROVED FOR PLASTERING �
.� .
76. Rough Electrical�T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL
79._Rough Heating & Air Conditioning ^, �, � � s., . FIRE DEPT. REQUIREMENT � �
20 -�Ro gh factory F�ieplace _=�' _ . �, , ApPROVALS . =�Permit #
21 '�Duc[s, in Structu`[e�� "" _H t; - y � _�70. Upderg�ound Hydro �
22 �Ducis, Ventilating x• !� ;� C =-� +�� '.71. Product'Piping O Gas O�OiI
23 'GasPipe=Rou`gh &,Test - t�.= * "� � �' _ ` • �, 74, Undergrou_nd Flush� � '"'
Ci T rt� n.A' � e.�r+ l r^ `�i l •.
24'`Roof Framing y t ^� %ct X". _ '" '-1Y M%%3 �Undergrnd. Siorage Tank.O Gas�� Oil
25..Robf Slieathing ;�; ,� � ` � _� r ?�` ` 7q?Overhead Hydro�.. ;,
26 �T-Bai Ceiling (StP.uct�ral) &'Monocoat * _• , - _ � �� 75:;Dry Chemical . �
27 Frame �nd Flashing� � ti� + " '�� ' 76. Dry Standpipe `" � � ^ "'
M Wmr. T 1��� A''+ '
;�28. LatFiing:& Siding_.''y � }_,:� - �. ' " ' ��.j r 77=-�� FIXED SYSTEM F.INAL. �- �i
29. Ins�lation ��i', h " y' „ � � A;_ 78�FIREPREV.FINAL `' ��'
30. Drywall�Nailing �� �_ , � �� � :� FiEALTH DEPT,. REQUIREMENT
_'37. Plaster Browo Coat� 5 ":�' � � � � ;* � ' 79 FINAL INSPECTION � `
K .+� c_G.. v i t-i.-'r "
X'1 Jc C] ^" a. " r -.
.'32�Electrical Power;N,leter-F�nal ,; � , 4.,- '80.7FOOD CERTIFICATE ISSUED.� .-�
�-33YFin31 Elettriq� O+'� F7 7 c •�, � �� �' • •• � .��7 �. "' - r'.T.
�: r- rr : e Notes: G• n-� t r c
� 34 JFinal Heating& �i�`Conditioning- : � 81 .(�I � L�. ;. .• ,� � :,;�:, � - ""
35.'Final Gas Pipe�Test� C •• k � �r �� � ' -�'� � '-�^
:r e- ..nr^ r�
��36�Hood or CanoPYo� '":, � :S.-�' a' ?: � � ' •. ' * ,' hi ~� : ;r.
-37.�Final Factory Ficeplace%: � ��cJ .v � � ! :�t� t ^ -' ' ��
r .s e� r d- �•
r38. Final Plumbing �f' . "' �" , "'' � �� � � t `� X
' : i: 1-� � � x ,5: r 'r
�39. Water Service�Finalc -; . . ` '� n �� y -. ' � -
� ; .
,t40. Gas Service-Final � � �` _ � fi �" 1 :� �: , ;�� � '
C�
`41. Solar pomesticFinal"' �;j � " � . . •;: �� . � o �r �r• �_ �
i
42.�BackflowPreventel: �� : ^ , �'' :� � ' ; . .
�J �...�� .6 �, .�: a i 1 :*'.-. .0
43. Backflow Irrigation� . " { ^ � a. •� � i• �� r �
i. � - .,
r44.. Landsca"pe I�rigatio,n System�Qn � `�''� � � ,� � � � 4 � � h �' S �- �
,. c
45.=Sound Attenuation �`.... ' -� .-� r _ `� y`• -
ti .
_ ,� `�
46. Handicap Regulations � . _ � r. �. S ..� � !'
w •- x ••s ,� -� �.
-47-FINAL STRUCTURE & BUILDING •• t; F. � j. e i� ��� " �: r
' a� r
48rFINAL P�ANNING r:� �^' i '-•'t" !• t'� � ^
t. �i ' .J �J 5 p:
�49.'.Electric Release to.,Edison . "� � �, :;; V -; ' '
7 • �'. t
� 50.`Gas'Release to $ouihem California Gas Co ;` � `* " r • "M � �? •
-a p � 1 v
5i. CER7IFICA7E OF OCCl1PANCY " ' - " ` • '
No Date
Pfl0.1ECT ROOflESB: S S S ANTON B L
OWNEH'SNRME: SECURITY PAC BANK
• , aooeess:555 ANTON BL
COSTA MESA
CA 92626
-. ,oxir: ���irh
rl�1c
pqCMIEN0INEEN: INTERNI • • NE6.X0.: y �'
nooxess:' S PARK PL u"R: 7 5 0
PEpMrt�E. IRVINE CA 92714
INNER SPACE (213)771-7126
RDOflE38; . SOSZ CECILIA - NONE
SOUTH GATE CA'90280
LICENSED CONTMLTOP OECUMTION: I AereUy atfirm ihat I am Iicense0 un0er Dravisians al Chapter 9(wmmencinB ��h Seclian
70W) al OiWvon 3 of the Business antl Pmleuions CaOe, an0 rtry license Is in tull lorce anE ellect.
cm uc.: 0 3 214 4 sT�h uc.:3 6 6 3��—qq%__....��..�..-- �j
Uate: � Siqnature: (�� � � �,X
WOBNEBS' COMPENLITION OEC MTIDN: I hereDy aflirm that I have a tenillu�e ol con5ent io 5etl-InSure tir a ceN�itate of WOrkers
ComOe�ation Insurance, or a certitie0 coDY ���� (����on 3800, LaO. C�. • -
-�ucreo.:WCP6672865 �xr.o�r�: 12/31/99
iMvenr: GREAT AMER.
J CertifeC fApY �5 AErlGy tumlSAlE. � fRRi/1B 0 witph t��g)ciry B ilUin
Oata: �( � 7� o/ ApDllan� c� �tw0�—n
IXEMPfION FNOM WONI�PS' COMPENSATION DECWUTON: (Rtis secoon reM ml be mmD�� �� Rmm � br pre hwqreA �5700) a lus�.
I cenity �tut in lhe pertormance ol l�e vrork tOr whic� Ihis permit is ISsued. I shall noi employ any perwn in any manrMr W a5 to b¢COme
SIIOICCt IO II�O WO�klR' fAt�IpE1153GOfl L2w5 Of GIIIOrtli2. . . �
Date: Siqnamre:
NOTItE: II, atler maNinp I�iS declaaiion, you 5Aou10 Oecoma 5uhjap t0 Ihe Woders' Comp¢nutbn pmvision5 ot IAB LaDor
Code, you mu51 torthwit� rAmply wll� 5uth proNsronS or this permit SAall Ge GeemeE rewkeE.
CONSTBUCfION 1EN01N0 �GENCY: � I �ere0y aflirm fAat IAere is a wnstruction IenOinB a0encyJoi Ihe peAarmance at Ihe work Iar
whic� I�is permit IS i55u¢G (SetllOn 3097. Gv. C).
LENDEP: . ' ,
R�OBESB: - � ' � '� � � '
OWXEP BUIIDEP DECIAMTION: I hea6y aKrtn ihat I am eMemD� ��m tAe Cantapors' State License Law lar the tollawinq reasan
�SecUon 7031.5 Buslness anE Prolesslonal Coae: My ciry ol counry w�ich apuires a permit m construtt, alror, improve, EemoliSA. ar
repair any sirudum, prior to hs iuumce, aLso repuiru t�e aDDliwnt lar suc� De�mit to lila � sipnetl statemem that �e/s�e is licensed
pursuaN ro the provisions al the Contractoro' Staro License Law �C�apter 9(commencinp vnN Section 7000) of Oivision 3 of the Business
an0 Pmlessbns Cotle) ar Itwt he/she ¢ exempt t�erelrom antl t�e bazis lar t�e allepe0 elemptian. My Nolation ot SecGw 7037.5 by
any aDP��nt lor a permlt suUjeds t�e apDlicant to a civil penalry al not mma Ihan INe �unCreO Oollars (5500�. -
I, as awner of I�e D�aperty or my employea wit� wapes as t�eir sole compensallon. wiil Ao Ne work, antl the
rJ strudure is nat imenaeC or aHemtl tar sale (Section 7044, Busineu an0 Prolessional Code: T�e Comractors' Stata Licenu Law
Oaes not apD�Y�o an ownerota D�oDerry who builtls arimproves I�ereon, anE who does suc� work himseli/Aerseltorthroupli
. Ais ar her own employees, pradtleO lAat such improvemenis are not intenOeO or ollere0 iar sate. It, however Iha Ouildinp or
. ImD�a'/ement is so10 wii�m one year ot comple�ioq fhe awner will have IAe �urtlen of proving �e/she ditl noi Cuiltl or improve
for tM ouN� ol sale�. • - .
I, as owner ol ihe Dmperry, am exclusively contractinp wit� licensea wntractors to consiruct the D�olect (Sectlon 7074, Business
�❑ and Pralessions CaOe: The Coniractors' Stata Lkense Law tices not apOM �a an owner of Oroperry wAo �ud0.s w impmves therean
an0 w�o caniracts tor sucA prolects with a contractor�s) license pursuant to Ihe Coniractors Stata License Law�. I am aware
, that D�ool of iheir Worker's CampensaGon insurance shoWA Ue pmvlAeE to me. .,
� I am exemD� under Seclion: B. 8 P. C. ' � :
� lar t�is reasan:
Date: � � Ownec � � -
1 Ao Aereby cetliy IAat I am aware of antl untlerstanA the reQuiremenis of Califomia Health anA Safery CoOa Sections 25505, 25533, and
2553A anE that 1 or any luture builCinp occupant vnlVwill wl (circle one) neeE to camply wii� said state ca0es anE ihe requiremenls lor a
permit for cansimctlon or modification Irom Ihe Fi�ry Manaqement OisMct. NesiUential consimctian apDlications are exemOt irom
Itiese Drovisions. . '
Oate: FpO�icant: � �
� 1 �ereby cetlity tAat I Aave reaU t�is aDPlicalion and stata that the a�ove iniormation is cortact I aprae Io campty wit� all city anU counry
oNinances anE state laws relatinp ro builAinp consimction anA �ereby amMnze representau rs ciry to enter upan it�e a6ove-mentioneA
propeM �orinspectlon purposes. % � �y Q '
oate: �J - 7 — i' � SiOnawra=/2�:GZ1d-a � �"-�-/ � ^
�
orivefs License ar Sacia� Secunry x:. � - � . � �
' iealJe W�Ite—Bu110iiy; Groen—CoEa Enlorcemant; Canery—Fpplicanl; Pink—Revanue; GolEenrotl—Assessor �
`1_�/.
.CITY OF COSTA MESA - BOILDING PERMIT PERM NO: B. 044863
PERMIT NO: B 044863 PLAN CHECK NO: 01378-89 L � GOVT: N SUPP: N
CONSTRUCTION TYPE: 1 SPRINK PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : TENANT ZMP S(] FT: 250,000
CLAIM VALUE: 250,000.00 CALC-VALUE: 261,250.00 GROUP OCC: B-2 /.
COMMENTS: ALL WORK ON THIS PERMIT ON THE lOTH FL. •
�*x **+�**xx **�x �e�e***�x+r�r��***�r***��r***�e*x �x**+r�+r�rr�r�r**�r*****�r�r*******�*�r��+�*�r**�e
Z O N I N G R E.Q U I R E M E N T S
S E T.B A C K S
----------- MAIN BUILDING ---------- --------- ACCESSORY HUILDING ------=--
FRNT: FT IN RFAR: FT IN FRNT: FT IN REAR; FT . IN
LEFT: FT IN RGHT: FT IN LEFT: FT , IN RGHT; FT IN
PARKING RE • PROV: PARCEL: 41050104 ZNE: PDC REF NOe" P
PLANNING N�TES> TENANT IMPROVEMENTS ONLY �'- �
� �
if if if ik iF iE 1F if iE ik iF 1F iE iElF iF IE ft iF it 1E if iE iF iF IE It iF1k ff iE 1E IE 1E 1E ik iF iF ii ik k iF iF iF iE iE iE k k if 1t iF M iE 1E 1f !f 1t iE MiE ik iE IE iE iE iE ik if M�F iE iE iF if iF 1E iFlE
D E V E L O P M E N T S E R I C E S R E Q U I R E M E N T'S
20NING APPROVED BY C� . T, �������� . DATE: 1C %�
HUILDING APFROVED BY : J C' DATE: //'
APPLICATION ISSUED DY: ��� DATE: _I[/�
ikififiFiEiFiEifiFltkiE�fiEiEifikl!lEik1Elf ikiFltklFMiEifiEiE 3EiE
jFiEiFiflEiEififitiEifiEiflEifiFiF3FiF3FiFikifMMiFkiFNitltlklFiEifiEitkMiEMiEififiEillkiki EikififlfMikiEftiElfiEKMMiEiEif�iPiEM.lFifiElEiE1E1EifM
LEGALZZATION:N F E E S;D.M M A R Y STRUCTURAL'�SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC`;MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,206.50 � s.. ,'.•
�i SMIP/NON-RES
ISS[NIE EEE 784.23 i,; �',l�.j 37.50
BUILDING-DI��-> PERMIT ISSUE PLAN-CHECK � TOTAL PAID �DUE
TOTALS----> 1244.00 0.00 .�"- 78'4.23: 2028.23 2028.23 .00
ii..
REVENUE DIVISION TOTALS--> COLI;EC"LED;' � 1244,00 OVER/SHORT: � 00
BLDG PMT PLUMBING ELECTRZC MECHANI� FIRE SMIP/TOT GRADING PLAN-CHECK
1206.'S0 !, , ,�' � , �j 37. 50 ,
, . y..,• ..�
iE k if �f 1F if if iE 1f iE �f !E IE if iE �k if �f iE k ik iE iF iE i! if fE i! if iklF M 1P if iF iF iE ik It if�1k 1klf 1f 1E i! IE It 1k if k ak fE it 1f If if If iE i!!E IE IE 1E M!F jF it iE iF 1FiF ik 1k if M� it 3f 1F
I N D I V I D 0 A L'� � F' H� E� B R E A K D O W N' '
TYPE QTY, D E S.0 R I P T I O N��' '� UNZT COST TOTAL COST
. `
SFC 250000. ALTER BY VALUE COMMERCIAL •NOZONE 1.00 . 250,0OO.OQ
. � END OFl FEES`
� �! ,
. . � ' ' % � t�,. ' .
. . � ' � ' �� . i,f. ' '
- . . '.� ' (r, .
� � . .
.... j: � i��,.
.� �.Y�
P: !1'?C;t"•G„GilL('S94' 7L�'� _�...G9
n�t7�� _ ' 1i��:�,'L4 T."7: }3;,�� �
� t
� . `�' _.: " Pi:..�t:& SPA
CONSTRUCTION AND PLANNING-� �
' APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
�
1. Temporary Electriwl Service or Poten � ',., 52. Pool & Equipment Location ,
�:
;2.-i,$oil-Pipe_Undrgr,nd.� t,'; ;�a; � � � 53. Steel Reinforcement �
--�3.'�Eleutrica,yCondui,j?l�iility-Undrgmd^� � � 54. Forms , ,L
� '',�4t.E ecirica7��.-�Conduit Undrgrnd=� �� Q-c � 55. Electrical Bonding � .
_ ,
� S.�S,teel-Reinforce�'�n� �X �`� � 56. Rough Plumbing & Pressure Test -
��'�6.�Efectrical UFER.~G.rnd. m � 57. APPROVAL TO COVER�GUNITE �
r�7. Footings �-7 :, O . � _l �`� � • 58.- Electrical ConduibUndrgrnd. - .� �
� �.: �
�8. Foundation , �� i � 59. Gas Pipe',,O .Undrgrnd., Test � �
9. Water Pipe�Undrgrnd. � `^ ;� ' ���., 60. Backwash �ines, P-Trap, O Undrgmd. ��"�
� 10. Structurel Floor System �"�-J � '� � 61. APPROVAL TO DECK �` �
11. Property Sewer Line�& Hous�Connection , � ��- •• 62. Backwash & ReceptorFinal - � - f��
12. Sewer Cap � a ,� c� -�j � � 63. Heater & Vent�Final '
� v� O • ::v f t'':( .
' 13: Roof Drains�.. � ' L' `� �' 64. Piumbing SYstem � Final '
!, ��
14. Rough�Plumbing ( � 65. Electrical-Final ' ;�
15. Rough Electriw`I�Conduit '� '`) 66. Solar System-Final " ��
16. Rough Electric-Wiring f 67. Fencing &�Access ApP�oval
�
-'77. Rough Wir�ng Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling • �. �' 69. POOL/SPA SYSTEMS FINAL
�19. Rough Heating &.Air Conditio�iny � � FIRE_DEPT. REQUIREMENT
` .. ^,.-N i� ��x .• tr�. �c r� �. Qxx 7 r, . N
I i� J- , , .�.i. ,. v � ,.�.n, . :.�n.�C� r. >+ �-
20:xRough Facto�y Fi,ieplace „�. S� �i- c�.., �.�; :;; -APPR�OVALS�Hr-Per,mit #
�-., «J t- .�. � � �. ;,�
21!'DuCts, in Structu[e" " " `'� �' � � H* * ^ + "�'�" � '^ �
i� . S�, y. �;� ny: _� 70. U�dergrourd Hydro ,�
22.;Duc`{s, Ventilatiri�� � `''-' �' �`'.,. � .� ' `.-' "' ':
9�A: . �j :% ^v C C� i-�8� x 277. ProducGP.iping O Gus+ OIOiI ��
23. Gas,PipCRo�gh &:;Test M�. �? * i �� O* rt�7Y, Undergro nd Flu`sh�� �' '"' � �
24.�Ro"of Framin ^%� . f"� ••,=, �"� �� C^ q: K � lJ--� ' �-1� '+� ` -J
9 ,� �., � � - r+x�i: ••73`;Undergrnd.Stora9ej'Fank:OGas ❑Oil
25. Roof Sheathing �':� '� ``'' � C � v* ? 7q �'OverFiead Hydro`� �'
.� r. n c ti x�7 r., � a x � rn
'-t G'. . .�-+ :-• '4 G3 � ': i' % C"'i • --� '7 � r-t V C'
26'.�T-Bar Ceiling;IStcucturall &`Monocoat- y � _ =i ;. y 75s'Dry Chemical � s: -y •
.27�Frameand Fiashing '�G� �. '•' 7 u �'+: �. 76. Dry Standpipe `-w ' ,:;
- �.,�;.+ -. � �,�.. �� a ;-.
�CW Y�1 ],� r .�,�" i: iT '�1'1 � Y. �
-'28. Lattiing:& Sidingy�; �� r,��r, p �; ��I ��� n; r 77., FIXED SYS7EM �F�INALs r; ;� -
29. Insulation � ;;�� ,�, � �"� ?' � I ; f � * 7g�FIRE PREV. FINAi ;; � ^ .�
30. Drywall�Nailing � X � • p '��...� %?i �v `�c u < ,HEALTH-DEPTi REQUIREMENT �
. �. - - -' ° : - - -
'u31. Plaster Brown CAet� 5 '�4 r y. 'I �-� Z�. Y, r7g,�FINAL INS�ECTION #� � ••
� �� " �I.�' � n '� ^' v �'�I � x` r80 yFOOD CERTIFICATE 1S6UED�., r; '
T32 ,Electrical Power yter.Final: � � -� �: �;
� _ .. v C.
i33 =Fi tal Electr� O�� �lT; i F:N � r i I ��� �Notes: 'tir' '"'y •� Y`
�'34� 'Final Heating & Ai Con`ditiorting n0 * ,� I V `,�'� � �.�5 n: � �c
rC w �- � [s15 *�-�V 71� ' �A: i: � I- a. _4.
� 35�:Final Gas Pipe-TestR p�r � r � � �����K w ^ '�� /,``•v �� �,"
.,
�36�Hood or Canopy�v aC� ��n �-1 Y, (i i I � 't n r t�.-, . �5��+, z: � ~"r;
7�:,
T . _ _ _.
'-+37vFina�l Factory Ficeplacex i HE+ �� W H �': h: �
� n- r� x n'�.i �:c :
� i-5 O �' ^ �7� N � '� � ��'J�.• �nq: R � . '�H 7� O Ci
38. Final Plumbing -y 4�
5 -� r- . Y[n I O L'1.A L t� n � N N�n fi1 �
W ... • . �. + . . . -.. -, �- ... ,
39 �Water ServicerFinali � i s: ��y %�j L�: H o a S� S
w 'in n' ir- i c..e; Y^� :-�
'740~Gas Service=Final ^� •T� ""r'�. �' * C'• " + •`�`l, %i�; x O� oc� �
;Y, � t: : 1 F i-� :'7 '% . ✓% � 41. C F. • O 3'.�. ;' !'
�i. x. � �
� ;,41.`�Solar pomesticFinal r �� �; �" � y ���� ; ,_, ;: - �
i ,�. �. � � ,.
42. Backflow Preventer' C� �' �' I � ti. r a '.,p-� , -= r'
! : , rJ ^ .».+ �l �4 r. - _^7 C• v -, i-
R: � . .J a. . .�, „� � . ... .,� .
43. Backflow Irrigation� y�" �r e: �. i � •
Y � •A . ]Y ti f
( ��44. Landscape lirigation System"� ''r '� �J � � C� x: " �' c.: c. �^ ^ .�: N c
c: � Y C +S {: t � i! C�
_ : , .. _. �.: r � � � e, r r � •. -- -
'`45�Sound,Attenuation ... m �;, - �*�; � � -,,,,, ,;," l.;rj �,'
K
� C'46: •Handicap Regulations ` ` ^ '� " � ^ _' ,'-' - `
z S .r S � .:1: �r• ^ rf -
�y47' FINALSTRUCTURE & BUI'LDIN Z� 9rQ •"�� i���� ��i .� '"� i n i .
48�'.FINALPLANNING `�t' ' =•'� � �' `�� � ' r. 6 r '
- c. � y' ii`. ii i:: x C?. [.: �
�49 .Electric�Release to'Edison � �`� �-"� � . ' '
i :% / 1 y. ��jR J� l� .
�50:�Gas��Release to $outhern California Gas Cn * ' �'� '� - �� �" '- ' -
r, X �✓ a, s: `]:_ � � -
-51. CERTIFICATE OF OCCUPANCY ' '� ' �'•� " " �
No. Date
Pfl0.1ECf AOORESS: S S S ANTON HL
owxex�sx�re: SECURITY PAC BANK
eooness:555 ANTON HL
COSTA MESA
CA 92626
� uxrt:
ex`xiexoixeen: I NTERN I NEO.NO.: ?
. IIODPESb: ' S PARK PL . ' � uxR:750
IRVINE CA 92714
�PEflMiTTEE: WESTEAN SUPPLY PLUMBING ( 213 ) 633-0511
nooness: 15 510 I L L I NO I S NON E
PARAMOUNT CA 90723
LICENSE� CONTMCTOP OELUMTION: I �ereGy aflirm thal I am Iicense0 un0er DmWsions oi Cnapter 9(commencinp with Sectlon
70W� ol DiWsion 7,01 1Ae Businas ana hotessions COEe, anE iic�l lorce anU effep.
cm uc.: p 4 "l 1 srn� uc.: 3 6
Date: i �7� Sipnamre: - � �
WOHIIEBS COMPFN311TION OEClAMT10N: I AereEy allirm 1Aat I have � urUtica[e ot corisent ro ull-in5ure or a ceNilrate of Wnhers'
�ompensalinn Insuranca, ar a ceN�etl mpy Itrereoi 1Section 3800. LaU. C).
,:raucrxo.:BWC686817 ocr.o�a: O1/O1/90
�coMr�Nr: HIGHLAND
❑ CeNfieO copy is hereCy �umisAed. � CenifieE copy' NE« yp'IA �Ne ary BuilEmq DNoion.
oate: /L /�/d' / � �0.ppGcanc �/f� /
IXEMPf10N FHOM WOIIKENS' COMPENSITRIN OEUAMiION: (flis secrim reeE nm he mnqkteE M tlre pmM i51a are huMaE (5100) w kss�.
I ceNty that In the pertormance ai tle wark fw wNcli tltis permlt is LssueE. I stu0 not empby any ce� �n arry manner sa az ro Cewme
subiect to tne Workers' Compenutiw Laws ot Califomia. �
Oate: Siqnaturo:
NOTILE: II, aRer maldn0 �h¢ tleGara[wn, you shoulE Oecome wEl�� �o t0a Warkers' Compensatlon D�m'islons ol t�e LaCor
GaAe, yrou must IonAwith compry vntA suc� D�sions or tNs Dermit shall Ee OeemeE revokeE.
CONSTBUCTION LENOINO �GENCY: I Aereby affirm t�at f�em is a constructian IenAinO apency for t�a DeAormance ol Ihe vroM for
whic� t�is permil is issueE (Sectian 3097, Civ. C). . -
�
LFNDEfl:
RODflE55: " . '
OWNEN BUIIDEN DECIAIWTION: I liereby al@m Wt 1 am eaem0� ��m tlre Contactors State �ke�ue Law lor the Idlm.in0 reawn
(Seclion 7031.5 Businas anE Pro1c551orW Caae: My tity oi munry wtdc0 repWres a permlt to mwwp, al[er. improva. Oemolish, or
reDair any stru[tura. pdor to IIS LSSudnCe, aW repuir¢5 Ne appGtazlt Iw sucA Dermil lo lile a SIpnM sGttmenl lllat hpJ5tle a IiunsBO
pursuant to Ine prmisiorts ai Ine Convanors' State License L�w (Clupter 9(comme�rp wit� Sectun 70W) a101vision 3 ot ttre BusNess
anE Prolessims COEe) w tlut le/slu's e�empt Nerelrom aM Ne Wsu lar tM allepW exemptlon. My vidation ol Saction 7037.5 W
any aDDlicant lor a perMt w6jects Ne appliant to a civll penalry ol mt mara tlun live �wUreE Gollars (5500�. '
I, az awner al Ihe properly or rtry emWtyees vAN wa7a u Neir mle compe�ation. wiA Co t�e work, and tAe
❑ structure Is not IntendeU w atlerztl lar sale ISectlon 70ad, Business an0 Molesaonal Coda: The Contradora' Suta Ucense Law
tlom nal appty ro an mmer of a pmperty wM OWIGS or im0� �Mreon, an0 wlw Oces 5uc� work himsell/Aarsell or I�mupA
hLt or Aer ovm emD�%'�s. 7���� �ti� wcli unprovements are not inteiMeO or ollere0 lor sah. II. Aowaver tM GUIIEinp or
ImO�ovement is SOIG MtNn one year of camDletlon. t�e owner wlll luve Ne Eurden of pmNnp �e/s�e EIO not Duiltl or imD�ove
lor tne purpase ol saleL . ,
I, as owner ot t�a O�operty� am exclusively contractinp with IlcensaC coniractors to constmct the D�alect (Sectlon 704C, Business
❑ anE Prolessions CaAe: The Cant2Rors Stata Lice�Se �aw Coes not apply to an ovmer oi prope�tywiw 6mIUs or imOrares Ihemon
antl wlw wmrect+lor such Drojects wiN a conVactoqs)Iiunse Dursuantto Ihe Controctors' State Ucense Law�.l am awan
' that D�ool ol tAelr Worker's Compenutian insurance s�oulG Oe pmvlde0 to me.
I� I am exempt unEer Section: B. 8 P. C. ,
lor Inis reason:
Oate: 0«ner.
I ao �em�y ceniry ttwt I am aware oi anE un0erstaM tne requirtmen6 ot Calilomu Heatln anE Salery CoEe Saceions 25505, 25573, anE
25534 ana itut I or any hiMe OW6no a��7�� �T �(tlrde om) nee0 �o comply witn uiE sute coOes antl ttw reQWremems lor a
pemtit lar mnstruction or moEilicatbn Irom Ne !w Oualiry Manapement qSUkt. HesEential conswction applica6on5 are e�empt trom
tAese pmvi5i0n5.
Date: M0�1�
I nere0y cenity tAat I twre reaE th¢ appfiwlian anE stah [hat t�e ahwe mlormation is mrtect. I a0ree to mmpry wiin all ciry ane counry
ordinances aM sute laws reqUnp to EuilEinp castnxtion arN �ereDy autlpi@e �epreunUiivts ol tlris dry to enter upon t�e aUow�mentione0
propeM �OriaSpetibn pufpo5e5. /�'�ii� �
Daie: SipnaNre:
onver's icensa or SocW� Secur�ty w: �'
t8ana6 W�i�e-BuilOing; Grean-COEa Enlomertron�; CenSry-ApO���C Pmk-Revenue; Goltlanro0-Asaosaor
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: P 04488£i PLAN CHECK NO: N
CONSTRUCTION TYPE: 1 SPRINK PERMZT TYPE: PLU
PERM NO: P 044888 '
GOVT: N SUPP: N
PURPOSE: ALT
JOH DESCRIPTION : TENANT IMP SQ ET:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: ALL WORK ON lOTH FL ,REFER TO ItB4486] ' '
r�x���***�******�e�e*�r*r�***�r�e�e�rr�r**�r*�r�r�r�r�r**�r+r�r�r�rx � *�r*�ex *x �r�r*�e�r*��r��**+r***r�e+e*��e�
� Z O N I N G R E Q U I R E M E N T Fi
� S E T D A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
rRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES> ' '
> _ '
k!F!F i! if k ik if ik iE if iF iF ik k 1E if if it k iF iF i! iElf iE 3E ikfE iE it k k k if iF iE M ik if 1E 1E M iE i! k k iE iEiE i! iF k iE 4!f fE if fE 1E if if iE 3f ik k iElf it ik iE ik ik 3E if iE iF ik ik
D E�V E L O P M E N T S E R V I C E S'� R E Q U I R•E M E N T�S
ZONING APPROVED HY '� ' DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:II-- a 8'
IfifltiElfiEitiFMlflEfkMlkllik�fliikkMlF ftlFifkitiFMiEitiE MiE
iF iF K �f 1f if if ik 1k 1E iE ff f! M IE M M k k i! ik if if if if if if iE %ik M k if 1F if iE if iP k if iF K ik M iF iE ik it 1f if if iF k if k if iF iF iF iE If iF iF iF iE fE iE iF iE iE iE iE 1! i! iF iF 1f IF iE
LEGALIZATION:N F E E S U M M A R,Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 46.00
•25i � SMIP/NON-RES
�PLAN , � �
ZSSUE FEE 3.00
HUILDING-DIV-> PERMIT ISSUE .PLAN-CHECK TOTAL PAID DUE
TOTALS----> 46.00 3.00 0.00 49.00 49.00 .00
REVENUE DIVISION TOTALS--�> COLLECTED: 49.00 OVER/SHORT: .00
DLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
49.00
kkifkMifik%kiflfiElfMifffMitftififk4lfiflfiEiEififkkkkiFMMififklffEitfkitfklkkiEikifkMkiEikkikiEiEikkiEllkikifkikiEkif3fititlFitkk
I N D I V I D U A L F E E B R E A K�D O W N
TYPE
PLU
PLU
PLU
PLU
PLU
PLU
PLU
/PLU
PLU
QTY
3
2
2
9
1
2
1
2.
D E S C R I P T I O N
DISHWASHER
F,LOOR DRAINS
SINK, BAR
SINK, KITCHEN
SINKS, FLOOR
SINKS, SER��ICE
WASH BASIN
WATER CLOSET (TOILGT)
WATER HEATER AND/OR I�EN'T
END OF FEES
UNIT COST TOTAL COST
z.00 z.00
2.00 6.00
i.00 a.00
2.�� 4.��
2.�� 18.0�
2.0� 2.��
2.00 4.00
z,oa i.00
2.00 4.00
01 G00�.7r,a�.-'�LD4iQ28 'fiC�" .
6 ;TE� il/OiS%°9 TS�!�: tSriz
�
0
0
CONSTRUCTION AND PLANNING - h�Ol & SPA
APPROV}�LS "Fermit # !� Date Inspector qppROVAIS Permit # Date Inspector
/ i . �� �
• 1. Temporary Eiectriwl $ervite oc Pol� _ •�G 52. Pool & Equipment Location /v .
2,�So,ilPipe.,Undrgmd-. a,;� ��-,� �^ 53. SteelReinforcement - �=!.
�
i '3:�El�ectricar,N�Conduiiy-l'1(ility-Undrgrnd�� � 54. Forms �
•L:';C''9:V.. Z���._.-.. . .'�, .
;1,_Electnca�Condurt=U�drgrnd. � 55. Eleclrical8onding
S 5.CSt&ei'Reinfbrcem�n"t: = X ... . 56. Rough Plumbing & Pressure Test � '
r �+•• - n
5 6.�Electrical UFER`Grnd. 57. APPROVAI. TO COVER-GUNITE -
��7. Footings =: ^::-, . � � 58. Electrical Conduit-Undrgmd. -
. � '
y 8�. Foundation �, �' % ^!, 59. Gas Pipe, � Undrgrnd., Test �
i
�9�. Water Pipe-Undrgrnd. �` �'�+ ` i 60. Backwash Lines, P�Trap, O Undrqmd. !�,
10. Structural FIoo�System ( � � I �� 61. APPROVAL TO DECK � �.
11. Properry Sewe(-Line�& House Connection 62. Backwash & ReceptorFinal �
12. Sewer Cap =� a ^' d 63. Heater & Vent-Final
r4 U O
13. Roof Drains�.-. � 64. Plumbing System � Final
14. Rough Plumbing � (0�� f/�( Lli� 65. Electrical-Final
15. Rough ElectricaJl•Conduit � 66. Solar System-Final
16. Rough Elettric.Wcring . - 67. Fencin9 & Access Approval
17. Rough Wi� g S�g� � 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling _ 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating &_Air Conditioning �� x: :� m Cr r 7 ,-,FIRE DEPT. REQUIREMENT _._ _ �
20�Aou�h Factoi Fiie lace � c`-�'� `' w " `� "�'� �� ~ J��� Permit# Y = - - -y�'�
z 8 ..Y P �. qc, S F-+ t�i: x:APPROVALS;H _ ___
H
21.'"DucCs, in Structu[eX " " ""�s '� = J �"y: M � + �'-'h'y ::
:-, _,a: 5�� 't. CJ i-, ;��: � ��0. �lndergroundyHydro *
22.cDucts, Venti�ating�,� ���p ic q ti f� :;x Y 571. Product'Piping O�Gas O�OiI '
23.•Gai-Pipe'Rough & Test "� * n �' '°� Gw � �7z, Underground Flu`sA� ' ^
n r.� �� a:r nr � �n � � r s>. t• � x
24.`�Roof Framin� r;C. -i�+ r+ K � `1 n ?:'y. •- ci �C` _ .._ . • �:
9 s: ,r, x S!-ix r::73=_Undergrnd.StorageTank OGas ❑Oil
25._Roof Sheathing � +� a. `� "'" f � � R�> � 7q��Overhead Hydro-��.,,, .. �;
`ix, 1� 1 '-' _'1 `.X.r
26.;T-Bar Ceiling (Stiucturaq &"Monocoat ` � �' �� x � - � '"� ' - "'••
� r „ � �; >: 75 �Dry Chemical �...� � .,-� _ _ �
27YFrameand Flashin9' ym� ", .� " �' ��r �1 76. Dry Standpipe N�� ; ..., . � . =,?C;
�'28. Latfiin & Sidin ^�r. o' yq:�^, ^ 'Y. < .•' • ••;::;: �^ " _ - _�' : h•-•
r 9L 9-,;. �.�F � �; � !� � 77�y FIXED SYSTEM F1NAL- -- �.�. r- n,� .,--
� 29. Insulatioh „�� �, n ' h ^ � � t�. r 76 �F1RE PREV. FINAL 'x ' ` ' 'f"� ' '
R � a: � N •c•� . . . t' ` •- - _
�'30.Drywall�Nailingr,x•, +'r, � � '�#. 5�;�, ,�HEALTH=DEPT�.REQUIREMENT;-�� __
_^31. Plaster Brown Coatx � � �"�' "� I '? > ^7g, FINAL INSPECTION x . ' r.
.i� _c., 1 i� i: .a e ^
• L,. .r r" c(`. . r, [U '�: n � l r. � r ^ _
�32.,Electrical Power�Meter�F�nal� ��; � t�; *. 80.-�FOOD CERTIFIEATE �SSU,ED� -
�
z33...Final Electrir �^ r T. �y W � i !i� ; Notes: '? "3" ;' ' � " "'
�"'�' • � ' :k Y Ln <. M/` 'Y
a34SFin�l Heating�& Air:ConHitioning � r � ' !� � ' � . , n= i� _ • -.
� ;�
35: �Final Gas Pipe-Test: Q� •• r • � ;: a: � � :.o ' �. � - =�
�� � N� rt- r. -n
;�.,36.�HooB or CanoPYa.,��. � � .,r^,� a � i , i , .r � �.c � ; �-
�
^37`�Final Factory Ficeplacex i ^� � � � � � � .�� � � � � > �'
.-. .• � i
'38. Final Plumbin �''� U -• �• x S ^� ?� ^+
�� 9 r., n o • ��% irC :�i� : R Y: ^ -1 C .
�.'39. WaterService-Finalf � . 'c„ •1 ; �i�;y s. •-. c.��• �� �
f. i i �t Y 'y6 Y' -w
+"'40. Gas Service-Final > �"' 'Q�'"m => � M I � � ° � �c' �.= ":
C1 F r ['7 x. i � �: x � C' A: C,
.+ •• � . .. ,. _ . ..
'�41 _Solar pomesticFinal- �„ '� -� � �j. � ; -:p _ :` ,. -
� 42. Backflow Prevente "r �- ^' ^ ' � �'�' t � ''�-' a� -� '
t',7 O ti �-. .l: r� fi.e: :'i t':.-, r
l: �. - J L. •. �. y , - n . . . . . _ . .
43. Backflow Irrigation: j+ K C� Y; J r. �
= , ,. ... _
�,�,",44.. Landscape 17rigation Sysrem�J`d ^ �` �- C J Vfi �F� � �+ �' �.�� + .- - - � � - - '
.i r 1. T' I: C� v. i� ;Y G. � �'T. #� '
_ . � . V ♦ H V t` - 4 �� r' `4 • -.
"45.�Sound Attenuation �-; •... . , ,T � - • -C
_ • ;.
�46.•Ha,dicap Regulatid'ns '� - ` ^ ' • `� �' � �' �� - � �
. • s --�c r. r n
�47`FINAL STRUCTURE & BUfLDING y� .. � i ; !h i ' " ' ..
- _ _ ;-�
48rFINAL PLANNING ^r' '• �� � � i'�� * ? � - „ �,
`i49'Electric Release to;Ediso� .,: � � z r � ' .
�.
�50�GarRelease to Southem California Gas Co 1; ' --��; � ^ �' �� ' • � . � ^ . _ _ ; �
°�51. CERTIFICATEOF`OCCUPANCY ' `- � ' � - �" -� �-
No. Date
,PNOJELf ROORESB: S S S ANTON B 1+
OWNER'SN�ME: SECURITY PACIFIC
RDONESS: SSS ANTON
CM. CA
►NCNIENUINEEP:
�ouxess:
uxiT: CITY OF COSTA MESA = BUILDING PERMIT PfiRM NO: M 044917
� PERMIT NU: M 044917 PLAN CHECI< NO: N' �GOVT: N SUPP: N
CONSTRUCTION TY.PE: _ PERMIT TYPE: MEC PURPOSE: NEW
NEO.NO.: I JOB DESCRIPTION : NEW WATER SERVZCE
UXIT:
PENMITTEE: AIR CONDITIONING INC. f 812 ) 244-6571
eousess: (�Z65 SAN FERNANDO RD
GLENDALE CA 91201
LICENSEO COMMCTOB UECLAM7ION: I hereEy aHirm tlat I am Ilcense0 unOer pmNsions ol CMpler 9(commencln0 ��� �ctian
7000� ol Oivision 3 0l l�e Business an0 Pralessions CoOe, an0 my Ikense 5 in lull lorw en0 etlect.
cinuc.:014403 sT�reuc.:12 6 ���C-20
Oate: ��— /, 7 —� ' nature -- ,�% �/f�"�� �
WONNENS' COMPEN311TION OFCIAMTION: I lrtre irm Wt I Aave a unificate ol corismi ro sall- e o ertiikata aI WOMers'
Compensation I�uurance, ar a anifieE copy thereo ' 3800, LaG. C).
raucrxo.:407412'176 exr.oAn: 11/10/90
coMvaxr: C . N . A .
❑ CeNfied copy is Aerehy tumishe0. � Ce�etl a fAetl � Ne dry &ril0inp D'Msbn. �
ns� eoaeexs�Tro� o�auurrox:`Tms secnm �en �m te anm�eted a an oemn'x ra one
ma�xe o� me work tw wttich ws ce� ���. � slWl no� emqoy airy cerson m am� m
Compen�ation Laws ol CaUtwNa.
Oate: 9qnaWm: ��
NOTILE: II, alter maWnq tlus UecWatlon, you sMulU Eewme wEject ro Ihe Warkers' Campensation provisiau ol tAe L�Eor
CoOe. Wu must forttmiN comVN wiN such P�ovitiau ar tlis Demtit shall Ee EeemeO rewkeE. �
fAxS7HutTION LFNOIxG �cExCY: I hereEy amrm Nat Nere B a co�tructqn ImEinO aperity �w tha penormance al Ne work lar
whicA tA¢ Dermit b lswed (�ctiM 3097. Gv. Q.
lENOER: �
FDONE88: � - � ,
OWNEP BUItDER OECIAMTION: I hertEy amrm tlut I am enempt from Na Contractors State Llcerea Law lor t�a toAaMnp reason
(Sectian 7631.5 Business an0 ProleSslonal COUe: My dry ol tounry wNch repWrtt a�pemtil to rAnSVucY, alter, improve. Oemolls�, or
repair airy strutture, D�r to it5 issuance. aLso repuires t�e �ppOwit tar wcli pemut to lile a si0�� sta�emmt tAat �elsha is Ilcenu0
pursuam ta IAe pmvisions of iM ConVanars' Staro Ucensv Uw (Clapier 9(cammenpnp xiN Sectlon 70(10� ol DMslon 3 ot tne Business
an0 Pralessions COGe) w Wt MlsAe B eaempt Neahom anE Ne has¢ tor ihe aDepeE eaemD�n. My NaUGan al Sec(ron 7031.5 Uy
any aDV�icant lor a pemut suDjects t�e appficant �o a chril panalry oi not more Wn Iive AunEreE Eallars (550�.
�, az awner ot me Droperty or rtry emplayees wtt� rraan az tAeir sole campensalion, wiT Uo Ihe waM, an0 t�a
❑ siructure a no� inimded or ollere0lor sale (Sectbn 70an. Busl�cess aM Protessimal CoEe: TAe Cmt2ctors' Slate Lianse Law
aaes not appy ro an awner al a WopeM �� w Improves ttiereon, aM who Eon suU work ttimulimersell or Inmuoh
his w Aer own empbyees. prm4Ued tnat a�n Imp�msmenu are rot InttMeO ar ottereE tor ule. II. Mwzver tna huuelnp or
ImOrovemmt e wW xifNn dro year al mmpetbn. Ue owner x10 tuve t�e Durden ol D�0 �� OW rqt DuiM or ImDrove
lar the Durpose of sale�.
I, u awner al Ue Droperty� am exUusiveIy convaciln0 wIU IlunseE cmtru2ws to mnsuuct Ne O�oiect (Secllon 70a4, Business
❑ ana Pralessions CaOe: The Contrsaws' Stam Llcense law Eoes rwt appty to an owner oi orottrty� huil6t a improves t�ereon
anG wli0 wniracis Nr sucA D�oject5 xiiti a ca�rtrattOr(5) Ikense pursuanl to t�e Contrzctors' SWIe Litense Law). I am aware
tnat proof of iMlr Worker's fAmpeW2ibn in5u2M0 stqWO 08 proulC80 to me.
� I am exempt un0er Sectlon: B. d P. C.
for ihis rtason: .
Date: � Pener. �
I tlo MreGy urUry ihat 1 am aware ol anE unOerstaM Ue reqWremems al Calitorma HeattA an0 Safery CoOe Sectiau 25505, 25533, aiN
25531 an0 tMt t w any Mua OuilOmp acupant •iMM�I mt (tirtle pie) meE to comply witn u1E sute coGes anE t�e requiremmts tor a
ce��� �or con5irucfion or moEifiration hom Ne rAT�'ry Manapement DMncL flui0ential mnsiruction apptiatlons ara dempt Irom
mcu vrm�sians. .
Oate: AV7Gcant:
I �ere�y certify Vut I Aave rwd tNs appEcatlon an0 state ttut Ihe a6ove NtormaGm a corrxt. I apree to compty wi�A all pry anA cowry
or0iiunce5 azW sUk Idws relaiinq to GuiWiflq mtttrutllm anG aWqriR repreSenUiiveS ol �h6 tlry lo Glier upon Ne abov8�men6oneC
property lor inspecuon Ourposes.
Uate: Spiutu .
oriver's �icense w Sodai Sewdry x:
18ate8 W�ita—BuiWirg: Green—CoEe Enlorcement: Canary—Appticant: Pink—Revenue: GWEenraE—hssessor
SQ FT:
CLAIM VALUE: 30Q.00 CALC—VALUE: . GROUP OCC: H-2 /
COMMENTS: lOT[i FLOOR KITCHEN REF:844863
�**�*�**�r*****+�***�r*****�*�r*********�**��*��r**�r****�**x *�*���r���**�*****�+r*�r�**
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
—'----------- MAIN BUILDING ---------- --------- ACCESSORY BUILD1fNG ------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: �--FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: F3^��IN .
PARKING REp • PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NCSTES> ,
> . .
iE M iF ik iF iF iE IF iE iE M�f if if iF 1f if iE if 1E if iE 1E iE iE ik k IF iE k iE iE iE iE jE iE iF iF�E if ik iF i(� iE 1F 1k k iE iE iE if k iE if 1! iF 1E iE iE iE k k iElE it ik iEiE fE if -Ik if iF �E iE IE iE iE iE
� D E V E L O P M E N T S E R V I C„'E S R E Q U I R E M E N T S
,., .
�ZONING APPROVED HY ' � DATE: •
r
BUILDING APP[tOVED BY : — � DATE: �
�APPLICATION ISSUED BY: DATE;
�t*�r+�*�t**i�*i�x�*�t*+tf�*rr+t* • F�'��iF�+t*�tit+��t�t�t* ���R��x*
�r+��r*x*+r�r**�r*����e**r�e*�*x�*x***�** r�r** *�r�***x���***+��r�r***+r*�e**����*�r****�****
LEGALIZATION:N F E E S� M M A R Y STRUCTURAL SEGMENT:N '
BLDG PMT PLUMBING ELECTR MECHANIC i FIRE SMIP/RES GRADING
PERMIT' 67.50
25Y SMIP/NON—RES
PLAN ' .
ISSUE FE6 15.00 • �
BUILDING—DIV—> PERMIT ,ISSUE 'PLAN—CHECK TOTAL PAID DUE '
TOTALS----> 67.50 15.00 0.00 62.50 82.50 .00
REVENUE DIVISION TOTALS--.> COLLECTED: 82.50 OVER/SHORT: .00
DLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHGCK
. , 8z.5� .
iE 3k k if �k ik it if if M if if iE it iF it ik it k k iE If iE iE 1t f! M IF 1F if 1E k iE If ik M iE iF iE k iE if iE k M ik iE !f ik %M iF IF iE i! iE iE ik if M iF iE iE ik iE iE M if if if 1F iF 1k it if 1F iF iF ik
� I N D I V I D U A li" F E E H R E A K D O W N .
TYPE QTY D E S C R I P T I O N • UNIT,COST TOTAL COST �
MEC 1 REPAIR/ALT HEATING`_UNIT/SYS W/CNTLS 9.00 9.00
MEC 1 INST AIR HANDL UNIT 0-10000 CFM 6.50 6.50
MEC 1 VENTILATION SYS NOT'UNDER PERMIT,EA. 6.50 6.50
MEC 2 INST HOOD W/DUCTS FED BY MEC EXHAUST 6.50 13.00
MEC' S EACH APPL NOT IN OTHER CAT UNDER EEE ' 6.50 32.50
� END OF FEES '
.�
�!�. �Z�t}$/�`/'�'J��y;./ � _` �: ��
� ar.. :i; :3�:ry i7..,r, �5
vh�_ . . .. __
n
• i 1 �
•J� .1 � . . Y .
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Poie ti 52. Pool & Equipment Location
�2,:;Soil Pipe•Undrgrnd;� . _ ,�,': � 53. Steel Reinforcemen[ '
-- 3' ElOctrical Conduit'Uiility-Undrgmd� v � 54. Forms
� 45Electrical Conduit"Undrgrnd. ' 55. Electrical Bonding
'_:5 �Steel Reinforceme,nt' - 56. Rough Plumbing & Pressure Test l
_,6. Electrical UFER Grnd. ' , 57. APPROVAL TO COVER�GUNITE _
t�7. Footings ��.� o, 58. Elec[rical Conduit�Undrgrnd. _
^�;8. Foundation =Q • , � 59. Gas Pipe, O Undrgmd., Test j
9. Water Pipe-Undvg�nd. 60. Backwash Lines, P-Trap. O Undrgrnd. �
10. Structural Floor,System - i ` 61. APPROVALTO DECK
11. Property Sewer Line�& House Connection 62. Backwash & Receptor�Final
12. Sewer Cap . c ' 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 ,,,� (u.� c(�/� � ,...,FIRE_DEPT. REQUIREMENT _ _
-�. �� .g c_ x>: - �<
20-Roci h Facto� Fiie lace =:�;' v _ • �+ � - - -'r��• y+ n � :�= �r�±r
_9 Y , P .�:a � c#; �: :APPROVA�LS�; Permit# .
y�. . �. .. . �� c � y _ >,: r ` `r.,'-�-• � .A
21"Ducts, i,n Structure ` ;70. UPderground Hydro
S H 8 •"l i'
22�Ducts,Ventilating;; �;j _�+ �-� �: t77. ProducitFiping�Gas O�OiI
23 ��Gas Pipe-Rough & 5esc � X - �" '�� - r � :'72. Undergror�'u,nd Flush� �
- "� ^ 1 �. - Y: :i: I .K
24`Roof F aming = �� �i-� v " c �� ;: 73:,Undergrnd. Storage:Tank•�O Gas ❑ Oil �
25. Roof Sheathing ���� �z: `� ' ' `� -' �'' '' 74^Overhead Hydroi ��'
H I: Q
`..
26iT-0ar Ceiling (Structural) &'Monocoat �, -� _�., _�� Jc 75 �Dry Chemical :-, n � � q_ ti
27-�Frame and Flashing� '� � y r. �-' r � r_, 76. Dry Stand"pipe � w` _ �. - -_
: 28. Lathing'& Siding. ; '� pw �, � '� ` , t "� �; 77,y FIXED SYSTEM.F,INAL. - ' ^ =
29. Insulatio'n r, �* � = • ; ' � ,�.,'"!' 78.PIRE PREV. FINA'L � � ^ ' '
30. DrywaliNailing _''n ^ . � �i, �; x �- ;HEALTH;DEPT�. REQUIR�EMENT•L
�31. Plaster Biown Coat� � +, ' � � •' *� "79._FINAL INSPECTION � u - �%''-
r � ,-i n e- �- ^. t-
;:32 yElectriral Power Mgter�Final �� '' ' `'" j: �80�`-;FOOD CERTIFICATE ISSIjED.., ry ^'
.J`
_33_Final Elecirtc � '7 a; a- � �� k`r�� Notes:��_((�e 'pp �OK�--�QR..L�
�
'''34lJFinal Heating & AicConditioning� � � '?`.�:� � - ���r "0 ' : - � � -
¢ ,. :�� ! �L GH . � c-�:� r _
• 35C Final Gas Pipe�Test� •i� •• r _, � � 'r ri _ •. : G�-±" 'e: f "-+ ." '
�Y I nt ^ Y• F"
;36.yHood or CanoPY � " 'T�� " � ^: ^- 1� ��: n:� �r
, ^. � .; r � '�{ i.�Y.�� a: n xc �: , .
^37.-Final Factory Firepiac¢: � %+�- ": + �. f* � '"'.'� `+ � �� �
- /� Y. v A e^�� 41 �i�^' r.
�38. Final Plumbing ^ ' _, ' "'' S '� � ' 'r "` � .=,� �
: r .�: -ti :� -.•t =, r.
� - . �. .� , .,. . . _ - . . . '
39. Water Service-Finab ^ . �.; � � :- r, . .. • - -
- :fl r CI:
�40. Gas Service-Final � ' �"�' - ` �7 i ��' � ==� ���� '� ••- " -
- r• - s. �K .r' �- : i . C
;41. Solar pomesticFinal- �-' � r ' � r�: :i, [r -`.:o � i: ;c
�
42 Backflow Preventer f: r :* � �- 7: C ""
w C 1 'Y "a i; � Y: �'
43. Backflow Irrigation� �--� �. ` < ;: i ,r �- r � .. .... .
- � -' n c-n - �
'44._ Landscape li?igation SYstem��'� � ��: � ;� Q :-''- �' : �' , "�� ` :; ". ` • .
+ : c ,.
45?.Sound �Attenuation ''� � � ' - ryi � -- , a . =�1 �
'46.•�Handicap Regulations C' " _ ^' ?� '� _ -� �=1 �� , ,
� i ' Y, v
-•47�FINAL STRUCTU�RE & BUI'LDING ' � " � -
_ r _ � �.
'� -y
48.�;FINAL PLANNING ; �'t' �� ; "Jy, ; f - i t
.�49''ElectricReleaseto,Edison i � ;;-� �, - �, p " „ �
i.
-'SO�: Ga�Release to Southem Calitornia GasCo ' ' �-�` ' ,;,," � � ''9 � - _'_' '
� , �:
51. CERTIFICATE OF�OCCUPANCY • '' ' ' � � � � ' ' - �� - -
No. Date
PN0.1EC710DflE33: SSS ANTON HL � , °N1T`bmR
, OV/NEN'SNRME: SECURITY PAC HANK �'[Gf{Ei�
aooeess:.555 ANTON BL
' COSTA MESA , " .
CA 92626
IIflLM/ENCINEEfl: INTERNI ' HEU.NO.:-7 '
� �DONE88: S PARK PL �� � uxrt: �50
IRVINE CA 92714
PEXMITTEE:'IiUTCHISON CORP . � (714�)'756-�0501
�ooeess: 34 20 IRV INE NONE
N.B. CA 92660
� OCENSED fANTMLTOB DECUIWTION: I here0y amrm Ita� I am 4cemeE unEer proN5ion5 of C�aD�ar 9(camrtcendnp with Section
70W� ol Division 3 ot ihe Buvness antl Pmtessions COEe, an0 my licensa is in lull force anC eflect.
cm uc.: 0 3 2 7�8 7 STah uc.: cuss: C 10 � j
Data: � /� '� k 9 ��O�arore: �
WONNEflS' COMPENSATION DELIAMTION: I h¢reDy allirm ihat I have a certifwte of consent to ull-insur or a cMifiwte ai Workers
ComDensation Irnurance, or a cetli/ietl copy iKereoi (Satlon 3800, Lah. C�. .
� roucrxo.:WCA0392813 ' ezr.o�Te: OS/O1/90 •
wMv�xr: FIREMAN FUND
❑ CetlifieC caDY �5 here�y lumis�etl. � Cetlitie0 coOY Is tiied with Ihe ciry Buil01n9 Divisian. . �
Oate: � �� d � � 5 /Appliwnt: � ���� � ��
IXFMFf10N it10M V10HNEfl5' COMPFNSITION �CIAlUT10N: (iNs section nttC not Ee mmD�� �� 7e�n is �a we red (5100) or less):
� I cetlity that in the petlormance of the vrork tor w�ich IMs permit is issueE, I shall not emDlny any person in any manner so as lo Uecame
suEiect to tAe Warkere' Compensation Laws ot CaGtamu.
Oate: Sipnamre:
NOTICE: If, atler maldnA tha Ueclaatlon, you shoulE Oecome su6ject to tAe Workers' Compensalion D«sions at t�e Labor ��'
CaUe, you must to�Mnt� camply wit� suc� provisio�5 or tlus permil shall be tleeme0 rewkeE. ' C�
CONSTBUCTION 1FN01NG �GENCY: I AereUy alfirm IAat t�em is a construction IenOinA aAency lor I�e pedormance at I�e work Im'�
wNCA Nis permit is iuue0 (��on 3097, Gv. C). � �
LENOER: , � .
FDOBE8S: � . • • . . ...
• . '> . .
. o �' . ; .� � , . . .
OWNER BULLDEP OECLANITION: I �ereby_aHirm f�at I am exempt Irom ihe Coniractors Stata License Law tar tlre fallowin0 �easan
(Saclion 70.71.5 Business anG Protessional CoOe: Any city oi counry wAic� requires a permit ta construct,�altar, imprme, Eemolish„ar
apair zny semcture, D�or to IB issumce, also rtyuires t�e aOPlicant for such permit ro tile a si0�� statement Ihat he/she is IicenseA
pursuant to tAe D�ovisions ol the Cont2ctors' State Liunsa Law (CAaO�er 9(cammencinp xit� Sectbn 7000�bt ONision 3 at t�e Busineu
antl Pmlessiws Cade) or tlwt twJshe is�exem0� ��erelmm an0 t�e Gavs lor ��e a11e0e4 exemptlon. My dolation oi Section 70.71.5 6y
any aDa�� �or a Derrttit suqects IAe xpplicant �o a cNil penalry ol not more ttun five Aundred �allars (5500).'
I, u owner oi tAa properey or�my empbyees vritn wapes as their sole compensitron, will,do the work,�an0 Ne
❑ strvcturo ¢ not intenGed or olfereE for sale (Sectlon 704/, Busuiess anE Pmfessional CaOe: The Coni2qors' State License Law
� Ooes not aDPN �o an owner oi a OropeM �o EuilOs or impmves thereon, anE wAo Aoes wc� xroM himsetl/Aersell or tAmuOh
-nis or her own employees. vrovide0 WI such improvemenis are no1 intendeE or oflereE tar ule. It, hpwever IAe buildinp or
impmvement is solC mi�in one year ol completlon, the awner will,have the GurEen.oi OrodnO �e/she Uitl no� Cuiltl or impmve
1ar Iha OurpOSB at Sale�. ' . �
' I, as owner ot tAe pmperty, am exclusively conlractin0 w��� licensaE contracrors ro consimct IAe projacl (Sectlon 7044, Business
❑ an0 Pmfessions CaOe: The Contactors' State License Law Ooa nat appy �o an owner of Dmperty who OmIEs or imD��s therean
antl wAo controcts far such pralecis with a contractar(s)license Dursuantto Ihe Contacrors' State License Law),I am aware
that prool of Ihelr Woilcer's Compensation in5urance shoulC be proviUed Io me. ' • ,
� I am exempt untler Section: , , B. 8 P. C. ,
for mis reason: � . .
Oate: � Oanec �
1 do hereEy cenity Ihat I am aware ol anE untlerstanG the requimmenis of Calilamia Meali� anG Sahry COAe Sections 25505, 25533. anE
- 25534 anOlhat I or any INure EUEOinB occuVant wilWrill frot (cirUe one) neeC ro compty w,t� saitl state caUes anE Ne apuiremenGs tor a
permit tor consGuctwn or mo0ifiwtion from Ihe Nr Oualiry ManaOement Oistrict. flesi0ential constmction aDDliwtions are exempt Imm
ihesa provisions. � ' �
Daie: ApPliwnt:
I hereby certity tAat I Aave reaOlhis application and state t�at the a�we iniormation is correct. I aAree ro compty with all ciry and caunry
orGlnances anU state laws reWtinO �o builtlinq consimction antl �ereby authoritt reD��nWtives of tAk ciry to enter uDon Ihe a6ove-mentione0
D�DeM1y lor in5pection'�Orposes. , �
. �
Date: � � Signature:
�, oriver's �icense or Saciai Securiry x:
` 1601J8 W�iro—BuiWlnp; Orean—COEe Enlorcamenl: Cenary—Applicanl: Pink—Revenue: Gobanrotl—Asieswr
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 044887 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1 SPRINK. PERMIT TYPE: ELE '
JOD DESCRIPTION :�TENANT IMP '
CLAIM ��ALUE: CALC-VALUE:,
PERM NO: E 04488"7 '
GOVT: N SUPP: N
P[IRPOSE: ALT '
SQ FT: ' ' ,
GROUP OCC: H-2 i /
COMMENTS:'ALL WORK'ON lOTH FI, REFF.R TO #D448G3 �
�r�r�r**�**�*****��**���r****��r�rr*i��r�r�e*x��r�******x�**�r�r��*�r*�r**�rx�**�r*�r*�r**�r**��rx***�
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
-----------'- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ----------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: � FT IN�
LEFT: . FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL:'41050104 ZNE; REF NU: "
PLANNING NOTES> � �
� ' . '
1F iE iF k i6 ik 3k iF it if if 1! ik if iE it it �f if iE if if if i@ iF iE if� ik if if �If iF fklk fE 1F iE if 1f 1F1f 1E i! 1E i! iF I! 1E iE 1E IEfE iF iE iF �k # it fE IF * iF M if ik iE iE If� i6 �]E iF iE if 1E ih 1E if IE iE
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : • _ DATE: '
APPLICATION ISSOED I3Y: r �l'A DATE: '8 —�
***�r�r***�**+�**�r*�r�*�*x� iF'F�F��*�r�r***x�x��r��7F�**
ik iE ik if iE iE 1E 1E iE �E �FlF if iE if if ik if ik ik if if iE 1E iE iE iE if k 3f ik 1E i! ii 1k iE iF i! i! iF iE ik if iF iF if k ik M if iFiF iE if 1E ik k iE ik if iE i! if if iF if ik k iE if iEiFlb it dF iF ib ik 3E
LEGALIZATION:N F E E1 S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RF..�'i GRADING
PERMIT • • 79.90
' �' • ,SOi SMIP/NON—RES
PLAN ; .
ISSUE FEE 15.00
BUILDING—DIV—> PEAMIT ISSUG' PLAN—CHECK TOTAL PAID DUE
TOTALS----> 79.90 15.00 0.00 94.90. 94,90 ,00
AEVENUE DIVISION TOTALS--> COLLECTED: 94.'90 OVER/SHORT:. .00
' HLDG FMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
94.90 ,
if iE it iE iE iE M iE if iE N iE ff iE if it if iE iF ik if if iE 3f iE �lE 1E 1E ff iE if iE If iE If 1f IE k iE iE iE 1E 1E iF if 1E IE Mk 1k iE if iF ik iE iF iE i! iF if iE %ik if if ik iP if if iE iE if df iE iE 1F iE M�f
� I N D I V I D U A L F E E B R E A K D O W N �
TYPE QTY D,E S C,R I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .'IS � 15.00
ELE, 3 FIXTURES, LIGHTING ADDITIONAL EA. .45 1.�5
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
�LE 4 RECEPT/OOTLET ADDITIONAL EA. .45 1.F30
ELE� 13 RECEPT/SWITCH 1 ST 20 EA. .75 9.75
ELE 1 MOTOR/POWR APPARATUS 10.�1 - 50,0 HP � 15.00 15.00
ELE 2 MISC APPARATUS NOT LISTED REQ PERMIT 11.00 22.00
� - END OF FEES �
� , Us DDU47024-GIl0y7d24 �"-�-n '•,.-�� �
Bn7E� 11/03/39 5'Ii;E: '.' -� `,
CONSTRUCTION AND PLANNING � � . POOL & SPA _
APPROVALS Permit #� Date Inspector qppROVALS Permit # Date Inspector '
1: Temporary Electrical Service or PoIB:��- � 52. Pool & Equipment Location �.
..�
-2.,_Soil•Pipe;Undrgrnd_ �,•= G�-j 1 53. Steel.Reinforcement '
'•�3'ElectricaPCo'ndurt'Uiility-Undrgmd%;; . 54. Forms � -+
-� m
JC't^":(L!. C"�'CT..^ 1� ,
,.4.<Electncal;Coridwt=Undrgmd" ` - 55. Electrical Bonding
��;5 �Steeb Reiniorcement � -~ �=`' . 56. Rough Plumbinq & Pressure Test . -"�
'c : � r - r,
� 6.aElectrical UFER�Grnd. 57. APPROVAL TO COVER�GUNITE '
r�7. Footings �. �� � 58. Electrical Conduit-Undrgrnd.
^ �8. Foundation - , V , � � , 59. Gas Pipe, � Undrgmd.,.Test � ' -
8. Water Pipe�Undrgrnd. .� 60. Backwash Lines, P•Trap,�0 Undrgrnd. ,���
70. Structural Floor System �f '` 61. APPROVAL TO DECK � �
�
11. Property Sewer Line�& House�Conriection �� � 62. Backwash & Receptor-Firial �
^, 1
12. Sewer Cap L W �^�� �'-- ,� 63. Heater & Vent-Fihal �
13. Roof Drains.- , :, � ' � �
� � 64. Plumbing System - Final �
14. Rough Plumbina _ • :�, � 65. Electrical-Final �� � �
15. Rough ElectricaJ-Conduit �, 66. So.lar System-Final � �
1
l�fi, Rough Electric;Wiring !l 7. Fencing & Access ApProval
�
�' 1�� Rough Wii.ing Sign � - 68. APPROVED FOR PLASTERING
- 1',8'. Rough Electrical�T 8ar Ceiling . OOUSPA SYSTEMS FINAL
_ ,
+� 19eRough Heating St_Air Conditioning ...,i � e. . A: � ..,FIRE DEPT. REQUIREMENrT„ �. �.r_,
i v .� �rv� v.'� .�y�... -i ir r.1DC.' I^. a y -•-••-�ti
20..Rough Facto'_ry Fi,Feplace gr �r �.. c}'x -APPROVALS;i..�rPermrt # - -- ��r;!^r
�_ � y
. �;-�r, .
21 _OuCts, in Str`uctu[e�' •• '• M� "` � �ry'i" - �70. UpdergroUnd; Hydro
I�i �� Sr n: �J �K
22._Duets, Ventilating, y �'%; �': ^+ -.� , �71. Product�P,iping O Gas QOiI
23.'GarPipe'Ro'�u`gh & Ten _,�^ nn t�, lt-_' r � r. o i72• Underground Flush' �, '-
��: ...�.. ..�-+ x =. ,. .. .. . � e �� ._,-.
24�Roof Framing �,; C_ x = c� ��•; -73r,Undergmd.Storage,Tank.OGas ❑Oil �
25. Roof Sheathing s�" � ' ' r' - ����Y 74'�Overhead Hydr ;,_,,, F
r� . � ♦ i-+ k '] -�'r, Y.
26�T-Bar Ceiling (St;uctural) &'Monocoat �, � j, ' - :, �,. 75 _Dry Chemical ' i � �-� �• - �i-
�27.=Frame a�d Flashing' " � - - >' v� � ` 76. Dry Standpipe �,y � r << `_ '•'?� ` '�
'-28. Lattiin & Sidin y . � • e � 'T ���' �,� � - ��_ � _
9� 9-� y� �x�: p � ` .. . . �� 77�-, FIXED SYSTEM�F,INAL=..+ � ;,-7 , --
29. Insulation ,- �' ,r ;� " x �'., � • '� � 7$.;�FIRE PREV. FINAt � ' ' _'F;� �
��30. Drywall�Nailing -,;. � � � 'a �.- ,�'-� HEALTH�DEPT�: REQUIREMENT�%'�. r,
"�37. Plaster Brown Coat� == �"�T' 1 . (x '� °79.�FINAL INSPECTION' ' `� "�'
.�' �C.. .t * ,`.�G' -a_. I• ^ II.
�32�Electrical Power�Meter�Final, �' �' � �: + '80`�FOOD CERTIFICATE ISSUED_ � � �j`
�:33 ��Final Electric r, +� t'i "' � 1� � � Noies: -"� ""'7 "_ ^ .. . - �
♦ r,� r� � �-.,. r..� n� s�
�'34rFinal Heating & Aii Co`nilitioning`� �� � � , P" {' s �'v �S ""' '� " `�` : �
a � -� .. ., �: � '_� �.:. c c � F.¢ c r- �.
35'Final Gas Pipe-Test _ ~ .. r --� � r , ;+ d: � � C'�-^ + -:Jl-L'+^�'�' =
+� � e �,• .v c.. r..: . r
`-36�Hood or CanoPY,_, .�� �:�.. � ; t� � ..y a: r -• .7o a. -: �.F . .- -- .^
D t�Cl 4^.- C7 ^o r.r; __.r�. cr
:37.��Pinal Factory Fireplacex �-�- v zc � � 'r. � � r � ' �
., i_. � �. _ �
�a3$. Final Plumbing '" T ` ^ � �' c � ^ = -
• Is] � O `i r. I'. •.-•. A: ^
� 39. Water Service-Finali: F � .. :,; t i �: � � a.� � t � : n-�: � -
..2 .-i r a.. �. w.
"40. Gas Service-Final �*, r� �,C"t- _ �: ` ; ;�, * N� ��� * � • � '
�r.41. Solar pomesticFinal" .. - � I :�: i: c- ^7G e^ , _
��
42 Backflow Prevente�� �° T ^ ' � ° `* � = E"' ^' � "'�
��: n: p��.. �� -+ '1: a' :'" n C� M F .-. -,
43. Backflow Ir yation� - ' x G r i: � � 't� ' � - � • • • �
- v ;• .. r,l 'Y ! �l
�44, LandscaPe irri9ation SYstern,`� ; �fi � � � -•�. .� � C`' :�'. _.� •' -. � " � .' _
� 1 r Cl. r .1: ,� �i A i ��.J � h .i' C
� � t; �. - - . �- < r a-' � .,. _.
��45nSound •Attenuation �- •. .. x ;� h �:-�a� ;. � 4! ;-� �
Y
py '� {: X � I": � l.0 ..a +1:
_46.•�Handicap Regulatipns � {: S '__a * r T .
.�.47:-FINALSTRUCTURE&BUfLDING �� - �� � � ��
' ._�a : c� ;
w w r
48:FINAL PLANNING r" K n: � ��. '` �� h: � & r"
T I H� %n" � CJ � S '4,
�49°Electric Release toxEdison , 1 ' " � ' ��' ` " - ... - '
� �.,. r �- rr, •r: ;:
-�50`Gas�Release to $outhem Califor;nia Gas Co ��� � �{� * - �' ' �^ ' � _ _
- �* : _ o i. x . - . , _.
� ,51. CERTIFICATE OP`OCCUPANCY ` " - '� ' •" ^ ' "
No. Date
'
YXQIECT RODPES8: S S S ANTON D L
��lNEN'SN�ME: SE.CURI.TY PACIFIC BANR �
�ooaess: �00'WILSHIRE EtL, #500
L.�1. .
�
1BCH/ENCINEEfl: ..
IIDOflE38:
E
UNIT:
NEC.NO.:
� UNrt:
PEHMITTEE: KIMBI�E 6 CO �( 714 ) 895—'11 56
�ooeess: 7540 SUZT LDl -
' - WESTMINSTER CA 9000U '
tICENSEU CONiflACTOfl OFCIAMTION: I hereUy affirm lhat I am Iicense0 un0¢r D��ons at CtuO�e� 9(�mmendnp xi[� Secuon
7000� ol DNisan 3 0l Ihe Business anE Prolessions CaEe, anA my Ikense is in tull tarce anE eifect. , '
cmuc.:�3P�',•3 1nr�uc.:q�092—S�N="�s��_ .
Date: _ _�OnaNre: � -
WOH EPS' COMPEN311TION OELlAMT10N: I hereU attum Ihat I luve a cenlikate oi wnsent to ulN�rsure ar a ceNficate ol Workers' �
Compensatbn Insuance or a ceeili py t�ereol �SecGon 3800, La�. C).
•rxo.:WPB$4108��7-01 exr.o�n: 08/23/90
r�xr: FREMON'f 'INDEM � ,
IJ cenitiea wpy is nereoy Wmishee. m Cenilie0 copy is lilee v� n t�ry 9u� DrviSjp� '
Daro: i'L� �� b 4 Appliwnt: G �
IXFMPIION FlIOM WORItEl13' COMPENSITIOX DELUI111710N: (fhis secUon neeG nm Ee mmDleteE ii Ne pemet is for one huidred �S7 a less).
I certiry ihat in I�e peAormance ol the work lor whic� I�is permit is iSsueE, I s�all not emDloy any person in any manner so u to 6ewme
sublect ta the Warkers' Compensation laws ol CalifoMa.
Oate: ' " ' ' Sipnatum: � � � - � -
NOTICE: Ii, atter makinp this Eeclaralion, you shoultl became suble�� �o the Workers' ComDensation Orovisions al the Labor
COCe, you must fortAwit� comDly wit� such provisions or [his Dermit SAall 6e UeemeO ravoke0.
CONSTPUCTION IENUINO IIGENCY: I Aereby allirm that tAem is a consiruc[ion IenEinO apency tar Ne Detlormance of Ihe work for
wlnch�t�is permit is issue0 (Section 3W7, CN. C�. � , �
lFNOER: �
RUOBESS: '1 � ' -• .
.
OWNFR BUIL�EN DECUMTION: I �era�y atlirm Uat 1 am exempt from the Contractors' State License Law lar t�e tallowinp reason �
(Section 7031.5 Business anE Professional Code: My ciry oi wunty wAic� requires a Dermit Io constmct, alter, improve, Eemolish, ar
repair any stmcture, Orior to its issuance, alsa mQuires t�e aDPlicant for such Dermlt ta�Ble a si0netl sta�ament ihat ha/;Ae is IicenseE
pursuant to Ihe pmvislons of Ihe Contracrors' State License Law (C�epter 9(cammencinp with Section 7000) of Oivision 3 oi iha Business
antl Prolessions Cotle) or Itut �e/she is exempt I�erelmm anE t�e Oasis for the allepe0 exemD��an. My Wolation af Section 7031.5 6y
any aODlicant lar a Dermit suGl�ts tAe aDUlicant to a civil penalry al nut more t�an five Auntlretl Oallars (f500).'
. � I, as owner oi ��e piapeM ar my employees with wapes as t�eir wle compensation, vnll Eo t�e wark, an0 the
slmcWre is not IntenUed or otteretl lor sale (Section 7044, Business anA Vrolessional Cotle: TAe Contractors � State License Law
Ooes not apply to an ovmer of a Dmperty who UuilQs or Improves thereon, ana wM Eoes suc� wark himultlhersell or throug�
his or her own employees, provitleJ that such imprmemenls are not intenEeE or ottereE.tar sale. If, iwwever the Guiltlinq or
imOrovement is 5a10 within one year al comDletian. IAe awner will Aave the GuNen al pmWng tre/s�e OiU not builtl ar imD�%'e
tor Ihe puryose ol sale�. . ' � ,
�l, as own¢r of t�e pro0e�ty� am exclusively wnlnctlnA ��� IicenSeU contractors to construct ��e prolect (Section 7041,�Business '
❑ � an0 Professions CoOe: TM Caniractors' State Licenu �aw Aoes not appty ro an ovmer ol pmpeity who huJGs or improves thereon
anC who mninc6 iw wc� pmjects wit� a mnVatroqs) IIC¢n50 Dursuant ta fAe Caniractors' Sute License Law). I am aware
tAat 0�� of Neir Worker's ComDensatbn insurance s�oultl Oe D��deO lo me. '
� 1 am exempt unAer Section: .- B. 8 P. C. , -
lor Inis reason: '
CITY uF COST� MESA --�BUILD'ING FERMIT PERM NO: F' 04541�
PERM.TT NO: F 045A19 PLAN•CHECK NO: O1i290—Ci9 S . GOVT: N SUPP: N,
CpNSTRUCTI.ON TYPL•:: PERMIT TYPE: FIR' _YURPOSB: OTH
JOB DESCRIPTION :� KTTCFi�N HOOD 10TH FL � SQ F1':
CLAiM VAI,UE: 8,000.00 CALC—VIaLUE: GROUP OCC: /
CUMMENTS:��' g��� � - .
it�t*�e*�t-�titif i�x i�rt-F�.� �r �clt +r *��+e**�t********�r***�t��t�t**?t*�eit�t�*i�ls�t.�ti:�*�x��it**��t**�t�ki:�i�i�it*x��x-
'L O N I N G H F. Q U 2 R� M'E N T S ""
� E T B A C K S
--------�--- MATN iIUILDING ---------- — — ----- ACCESSORY BUILDING =--------:
FRN'I': FT IN REAR: FT IN FRNT: FT IN REAR: I'T IN �.
LEFT; ET IN RGHT: FT 'LN I,EFT: FT IN RGHT: , FT . TN.
PAFtKING REQ: , PROV: PARCEI,: 41050104 ZNE: ' REF NO: '
PLAAINTNG NOTES> • • '
� � _ . .
x��-i:;eat****x�***jtit���**�c*at*x�rit���c��-�•it*-�-�x-�tx�*#�t�t�x��-�-*�it***�t**�rt**x�x������itatr.it*it�r�r��t**�ieu�r�c**
D E V E L Q,P M E N T S E R V T C E S R E Q U I R E M I? N T•5
Z�ONIN<"� APPROVED BY DATE:
BUILllI�1G� APPROVED BY : p� ��? __ _` DATE; IZ.` I,$~'�
APPL'IGATION ISSUED IIX: 1� J DATE: � Z' I�'�
jEiF3EiEiEi6dE1f1EififiEibiEaElF1ElkMik3flf3�E.:1Eif�if���� ?f���E3FihTE�3F��iE�3F�?EiEiFjE3EfEdEiEiE��3��{F��F3Eii
i:�iEiEiEif�ififiE3EikiFiFlEiEiF�lEiEkikitititiFiF�kiflF'kikiliEiE�tifitit�F rtdfitfEibiF�EiFitiEi'iEiEdllEiEjFitifltitjfikifitiFiF�)EjF�fikjEkkiEiEk�lliEik�7E
LE:GALT�ZA'PION.�I " L� E E S`U'M M A R Y `S'fRUCTURAL SEGMENT:N
� '���,DLDG PMT PLUMBING ;ELECTRIC ,MECHANIC FIRE SMTP/RF•.S GRADING
YERMIT ' ,-', ' ', . 99.00 �
- � .. � .. 658 SMSP/NON—RES
�L��n`i . � � . : ' 64 . 35
i.ssar_ F•r•.r•. .
BUILUSNG—DI;V=> PERMIT ISSUE PLAD1—CHECK TOTAL PAID DUF_'
'TOTALS----? ;99.00 0.00 6�.35 ' 183.75 1F,3.35 '.00
, , �
REVF.NUE DIPISION T'OTALS--> COLI�ECTED: 99.00 OVER/SHURT: .00
BLUG PMT PLUMBING ELECTRZC MECHANIC FIRE ,SMIP/TOT GRAllING PLAN—CHECH
. � 99.OU �
�l6 k JE !E iF iF iE iE iE iE iE �lE iE 3t iE %� �)f iE it 3E jt # k i6 iF iE k if iE if iE iE iE -0f # iE i(�ir if if i! if # iF k iF iE iE i(� 3E if iE # iE if� if� iE �3(�?E df #iE if dF iE k if iE�i(� if if iF1E?t iE iF 1E!6 iE
: i N D I V I D U P. L F i: E B R E A K D O W N
1'YPE QTY U E S C R I P T I O N UNTT COS'P T01'AL COS'P
Date: ' P+mer: `I L•Ix
I Aa herehy ceniry �that I am awam al anE unAerstanE tM requirements of Californu Healih antl Salery CoOe Seclions 25505, 25533. anU
�25534 anE Itwt I or any lutua GuilOinp acupant wilUwill not (drele one) nee0 to comDN ��h uiG staie coEes anC the repuirements for a
permit for toRSiNLMion or m00ifiWtlon from Ne N'�r uality Manapement D'6lntt, qesitlen�ial cOnslNttlon apDliWtions a2 exempt from
t�ese PmNsions. i i
Dah: Applicant:
. I hereEy certity ttut I Aave reaOlhis appliqtion an0 stata that tAe a0ove information is wrreM. I a0ree ro camDM ��� ��M anE wunry
', aNmanca ard sia[e laws relavnp ro EuilEinO �T������ � heatry authome a resen ot thk py to emer upon Ne aDove�mentioneU
� D�ttM tar inspectiopn purposes. , ��j���/J
oate ! L / r�� SignaNre: T/T `/���
oriver's �icenu or Sacim Secudry x: � '
1601-46 WN�e-8uil0ino; GreerCatle Enlorcamen�; Cenary—Applicenl; Plnk—Revanue; GolEenmO—Assessor -
99• FIRE EQUIP FEE (FROM BLUG VAL TABLE)
;ENU UF FEES .
a
0
1.00 99.00
0100049872-00049872 TOT 99.�0
UATE: 12/18/89 TIME: 03:19
�
I
�ri �;� " 1�,•
.-t' �CONSTRUCTION AND PLANNWC � . . . � �' �' SPA
APPROVALS Permit #"� � /Date Inspector qppROVALS Permit # �Date Inspector.
L' VI
', 1. -Temporary Electrical Service or Pole �, . 52. Pool & Equipment Location ��
_�
�2. Soil Pipe-Undrgmd. -. . 53. Steel Reinforcemen[ . '`
.
3. Electrical Conduit Utility-Unc{rgrnd. ' � 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 Cond�it-Undrgrnd. ;� ,
8. Foundation � {���' 59. Gas Pipe, O Undrgrnd., Test ���'
v .
9. Water Pipe�Undrgrnd. �j �"= 60. Backwash Lines, P�Trap, O Undrgrnd. "'
, `
70. Structural Floor System �� � l 61. APPROVAL TO DECK f;n
11. Property.5ewer Line & House�Connection i�' _ 62. Backwash & Receptor-Final . i�
/
12. Sewer CaP . . - .�
) f 63. Heater& Vent-Final • /
13. Roof Drains � � 7 � 64. Plumbing System � Final � 9
i
14. Rough Plumbing , � �� I 65. Electrical-Final � � ,�
15. Rough Electrical-Conduit � ` 66. Solar SYstem-Final �
16. Rough Electric Wiring� ` 67: Fencing & Access�Approval ,
�
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING ,
18. Rough Electrical�T Bar Ceiling ' � 69. POOL/SPA SYSTEMS FINAL
19. Rough�Heating�& Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rouqh Factory Fireplace � APPROVALS Permit #
27. Duc[s, in Structure 70. Underground Hydro ,
22. Ducts, Ventilating 77, product Piping OGas ❑Oil
23. Gas Pipe-Rou9h &�Test _ 72. Underground Flush
24. Roof Framing ��1 ' 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing -'. 74. Overhead Hydro
26. T-Bar Ceiling (S[�ctural) & Monocoat ', 75.�iea� '�K%- �. � � �a ' �
27. Frame and Flash�ng 76. Ory Standpipe �
28. Lathing & Siding,.. - � ' �; 77. FIXED SYSTEM FINAL (� c '�
29. Insulation ✓J �.) +%" 78. FIRE PREV. FINAL .�• j �
30. Drywall Nailing �.�� HEALTH DEPT. REQUIREMEN
31. Plaster Brown Coat 79. FINAL INSPECTtON ��
32..Electrical Power MeterFinal `,' 80. FOOD CERTIFICATE ISSUED
33. Final Electric `� � � � Notes: '
34. Final Heating & Air Conditioning ��!� r��,i� , ��
�u
35. Final Gas Pipe�Test � � �� "_ .', - �
+ ,4f
36. Hood or Canopy , �' �
i
37. Final Factory Fireplace �� � �
38. Final Plumbing
39. Water Service-Final .
40. Gas Service-Final ,
41. Solar pomesticFinal ' -
42. Backflow Preventer - � '
43. Batkflow Irrigation � -
�
44. Landscape Irriqation SYstem � �
45. Sound Attenuation - ' �
46. Handicap Regulations '. '
47. FINAL STRUCTURE & BUILDING -' ✓1 "- ' :
48. FINAL PLANNING -� n .
49. Electric Release to Edison ' '
,� fi �
50. Gas Release to Southern California Gas Co "
,; 51. CERTIFICATE OF OCCUPANCY
No. Date
-
�
rRw�F,nooness: ��5 ANTON BL uxit: FL 10
OWNEH'SNAME: SA�CIORA FARMS
* nooRess: pACIPIC SOUTH WEST REALTY
PO 2047
TERMINAI� ANNEX, CA
8185787700
AflCH/ENGINEEfl: R�Y W. HERBOLD JR, flEc.xo.: C-11073
R�OflESS: ZZO%% CAMINO V`INO uxiT:
PEflMITTEE: Z'AGUNA HILZ,S CA 92653
aoosess: '��STkONG CONSTRUCTION ( 818 ) 967-8001
929 SPRING MEADOW DR
WEST COVI;�A CA 91791
I LICENSEO CONTBACTOB UECUIBATION: I hereby a�lirm �hai 1 am licensetl under pmvi5ions o� Chap�er 9(commencing wiih Section
��. 7000� ol Division 3 0l the Business an0 Pmicssions Cotle, antl my 'cense is in tull fome antl e��ect.
nTr uc.: 0 S 6 71 STFTE LIC. 4 9 q p��
Date: Si naWre:
WOflREB$' OMVEN RTION OELLABRTION: I �er¢Gy a m �hat I have a ceriilicate of consen� �0 4insure or a cehi�icate o� Workers'
I Compensation Insurance, or a cenifieA coDY thereof (Section 3800. Lah. C).
aoucvxo.: PC943935 EXP.OATE: OZIOS�93
COMPRNY: }�EPUBL'1C INDEM
❑ Cetlilietl copy is �ereby lumishetl. � CertifieA caDY i li wit� �h ,iry Bu' OinA Oivision.
Daie- Applicam: _
EXEMPTIONF OMWOBNEBS'COMPENSRTIONOECIABATIO Qhisseclianneetlna�becomDleletlitihepermtlis�oronehunOreA�5100)oiless�.
I ceriily ��a� in ihe petlormance oi I�e work for whic� �his permii is issued. I shall no� employ any person in any manner so as to become
sublec� �o ihe Workers' Compensalion Laws ol Califomia.
Oa�e: Signa�ure:
NOTICE: Ii. alier making ihis Geclara�ion, you 5hoW4 become sublecl to the Workers' CamDensa�ion pmvisions o� Ihe LabOr
Coae. you musl lonhwitn comply witM1 such D�ovisions or �nis permit snall he deemed revokeU.
CONSTflUCTION LENOING FGENCY: I hereby a��irm �hat there is a cons�mction lentling agency �or �he peAormance ol Ihe work �or
w0ich Ihis Dermil is iuuee (Sec[ian 3097. Civ. q.
lENOEfl:
AODflE55:
OWNEfl BIIILOEN DECU�BATION: I hereby allirm Ihai I am exemp� imm ��e ConVactors' S[ate License Law �or Ihe tollowing reason
�Sec�ion 70.31.5 6usiness antl Pmfessional Code: Nny ci�y o� wunry which require5 a Dermi� (o cons�mct, aiter. impmve, demalish, ar
repair any simcture. Orior �o i1s Issuance. also requires Ihe applicant lor such permit b file a signeA statement ihat helshe is licensed
pursuanl to Ihe pmvisions ol ihe Con�ractors' S�ale License Law (Chap�er 9lcommencing wilA Sec�ion 7000) of Divisian 3 af �he Business
anG PmleSsions COAe) or t�al he/she is exempl therelmm an0 �Ae basis for �he allegetl exemption Hny violaiion of Sec�ion 703L5 by
any applicani for a Oetmit subjects t�e applicant to a civil Denalty of not more ihan five �undre0 Aollars (5500).
I, as owner of ihe pmpeny or my employees wit� wages as iheir sole compensation, will tlo t�e woB, and ihe
7 s�mciure is no� intenEed or o�feretl �or sale �Sectian 70a4; Business an0 Pmfessional Cotle: The ConUactors' $�a�e License Law
tlaes nol apDly lo an owner oi a property who builas or impmves thereon. and who tloes such work himseli/her5elf or Nroug�
his ar her own employees, pwvi0ed �ha� such improvemen�s are nal in�ended or oifere0 for sale. If, however �he UuilOing or
impmvement is so10 within one year ol complelion. ihe owner will have Ihe burden of proving he/she Eitl not huild or imD�ove
br �he purpose oi sale�.
I, as owner o� the property, am eKclusively conUacting with licensetl coniracbrs �o constmm �he prolect (Section 7044, Business
❑ anU Professions CoCe: ihe ConVacbrS' S�a�e LiCense Law Aoes noi apply lo an ovmer 0� pmpeM �o �uilds or improv¢S ihereon
and wh0 COn�ratisfor Suth pwletls wiih a canimCloqs)liCenSe pursUan� Io Ihe Contractors' Sia�e LiCense Law�.l am aware
�ha� pmol of �heir Worker'S Compensation insurance should Oe OmviOed lo me.
� I am evemp� unaer Setlion: B. 8 P. C.
for Ihis reason:
Oa�e' Ownec
I tla �ereUy certify ihat I am aware o� and unUers�and ihe requiremen�s o� Califomia Healih antl $afery Code Sec�ions 25505. 25533, ana
25534 antl Ihat I or any fuWre Duiltling occupant willlwill not (circle one) neetl to comply wi�h saiA state codes and the requirements for a
permii lor consimclion o� moAifica�ion �mm Ihe Nir Ouality Managemeni DiSVicL Nesiaemial con5imction applications are exemD� ��om
Ihese provisian5. �
Oate: App�itanl:
I �ereby cetli�y�hat I have reatl��is appl¢aiion and s�ale Ihat the a�ove in�ormaiion is correct I agree�o comply wi�h all ciry and coun�y
oremancesandstatelawsrelalingtobuilaingconsimctionandher yau i¢erepresentative thiscitytoenteruDonlheabove�mentionetl
pmpetly lor ins ction Durposes.
�ate: / Signawre:�— � ^ -
oriver's License or Social Securi�y a:
�6<t-<6 Wni�e—Bvtlaing; Green—Cotle EniorcemmL Canary—Appl¢ant: Pink—Fevenue: GOltlenraE—Assessor
CITY OF COSTA MESA - BUILDING PER�NIT
PERMIT NO: B 059548 PLAN CHECR NO: 03649-92 A
CONSTRUCTION TYPE: iFR SP PERMIT TYPE: STR
JOH DHSCRIPTION : COMMERCIAL T.Z. (OFFICES)
PEkM NO: B 0�9548
GOVT; N SUP^; N
PURPOSE: ALT
SQ FT: 19,360
CLAIM VALUE: 280,000.00 CALC-VALUE: 247,566.40 GROUP OCC: B-2 /
COMMENTS; "BANIC OF AMERICA" IS iHE TENANT
*x�xx***x*�sr***��t**�xu****�*x*��x�rx+��t��r�*�*�r*�t*�x�e�tx��x�***+r*x*x�*�*�-��**�r�c*x-��*�x*
Z O N I N G R E Q U I R E: M E N T S
5 E T B A C K S
----------- MAIN BUILDING ---------- --------- ACCESSVRY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT' IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; F'T IN
PARKING REG• PROV: PARCEL; 43050104 'LNE; PDC REF NO;
PLANNING NZST'ES> INTERIOR ALTERATION FOR BANK Or AME;RICA OFrICr':S ON THE
> l OTH,. FLOOR,• ' ✓
�r�r��t�t***�r*****�*-x-+�*�******x-x��xx�*x*��r��r*�r***�r*x�t�r**xxx*�****�*��t�rx,*�c��***�*u�r��
D E V E L.O F M E N:,T S E R V I C E 5 R E Q U I R E M E N; T S
ZONING APPROVED BY •: LcJ�I\ DATE: �0 6 �
BUILDING APPROVEA'HY ; s r ,�A/ DATE;��(o /3
APPLICATION ISSUED �HY� .- v(/�/IU-t� w DATE'e �1�:., /�r'� /4n
# 1f iE 1E k iF iE iE if iE iE iE if if
it if iF iE if it if jt i! if 3f iE 3F if
LEGALIZATION:N
�)E iE �lE �IE fE iE ft iF iE iE iE iFiE # if �.l:f ik'ef fE i(�lFiElk iE fk �1Elk 1F iF i(� �7F iC� iE If If•i(��iE �FiE iE jFlE #iF�E # i(� it
F E E S U M M A R Y STRUCTijl'tAL SE�',ME,N'f; Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RE�S ��URAI?ING
PERMIT 1,157.50 ! " '
SN IP /NONi2E5
PLAN 188. 10 •�� 51 , 99 , !'
ISSUE FEE � i
BUILDING-DIV-> FERMIT ISSUE PL'ANcCHECK TOTAL PAID ,_�) %,� �i DUE
TOTALS----> 1209,49 0,00 � d88,10 139%.59 1397,59 '. k;.,OU
REVENUE DIVISION TOTALS--> COLu�6TED; 1209,99 OVER/SHORT; f: '00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRAAING P3,`AN.-�C/�fiECR
1157.50 + ; 51.99 �. ��---�-
` � Y_
�76iEiEiEifiEiFlEiEifiEiE�)f-1ElE�lE9(�ifi(�iEikiflFifiEiE1E1FlhlE�lE#ifillPlF �1f7hiElfiFiE�F1EiEiE�lhiEklEiEiFiE1EiElfifiE�lEfFiFiFiEiF�1(-If1EYriFiE"3Ej&iFlFihiEiEi't
I N D I V I D U A�L�'��F E E B R E A R D O W N "�"'�.}"
/� � r�
TYPE QTY D E S C R I P T I' O,} N� UNIT COST �`OTAL' COST
'1 �
SFC 19360 OFF-INT, ALTER TYPE�Z;II fi,R. -AVEA 17,24 /�247,.56,6,4�0
�.'ND.� OF' FEES /
� i ' � �,
f]
l� S i �'/ • �-�"�1
\ ti � � ' j� "
r � I •'
� ' , /
, I 1
�'I f-: � 1. i .... !. _
' G*JNSTRUCTION AND PLANNING - � F -& SPA
Date 'Inspector Date Inspector
'� APPROVALS Permit # ._ � . APPROVAIS Permit #
- 7.-Temporary�Electrical Service-o�,'Pole i -, 52. Pooi & Equipment Location � -'
� 2. Soil Pipe-Undr9md. --^- _,.. � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undr,grnd. " 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 � 56. Electrical Conduit�Undrgrnd.
�6. Fo�ndation � ' . 59. Gas Pipe, O Undrgmd., Test
9. Watpr Pipe-Undrgmd. � � 60. Backwash Lines, P-Trap, O Undrgrnd. I
70. Structural Floor SYstem ;' ' � 67. APPROVAL TO DECK �
71. Property Sewer Line & House,Connection �-� 62. Backwash & Re.ceptor�Finai '
72. Sewer Cap •�' � 63. Heater & Vent-Finai �-
13. Roof Drains t�, 64. Plumbing System � Final �
14. Rou9h Plumbing � 65. Electricai�Final
15. Rough ElectricabConduit , 66. Solar System-Final ..
16. Rouqh Electric Wiring 67. Fencing & Access ApProvai
77. Rough 4Niring Sign 68. APPROVEO FOR PIASTERING
18. Rough Electricai�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Atr Condtioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' APPROVALS Permit #
21. Ducts, in Structure .� 70. Underground Hydro
22. Ducts, Ventilating � 7t. Product Piping OGas �Oil
23. Gas Pipe�Rough &'Test •. . 72. Underground Flush .
24. Roof Framing 73. Undergrnd. S[orage Tal�k � Gas ❑ Oil
25. Roof Sheathing . 74. Overhead Hydro
26. T-Bar Ceiling (Structuraq & Monocoat ��Q� ' 75. Dry Chemical ..
27. Frame and Flashing f,� � 76. Dry Standpipe �
28. Lything & Siding � � 77. FIXED SYSTEM FINAL
29. Insulation i � 78. FIRE PREV. FINAL
30. Drywell Nailin9 %� T��' � . j HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat �' � �' 79. 'FINAL INSPECTION �
32. Electrical Power Meter-Final � � � 80. FOOD CERTIFICATE ISSUED
� �
33. Fina� Electric � I- � Notes:�, � �
� e
34. Final Heatin9 & Air Condluoning � I � �� ��`���
35. Final Gas Pipe-Test � �- ��
36. Hood or Canopy � i- I
37. Final Pactory Fireplace � � -
38. Finai Plumbing
39. Water Service-Pinai � �
40. Gas Service-Final I
47. Solar pomestioFinal �
42. Backflow Preventer � �
t �
43. Backflow Irrigation
'44'. Landscape Irrigation SYsiem
45. Sound Attenuation
46. Handicap Regulations
47. FtNALSTRUCTURE&BUIIDING 9� ` . /�
�! C _ `� `-/ ��� _.
48. FINALPLANNING �' �. j F� � /�
. � � mx.f uu�t_" _%� �-._.�� i
49. Electrie Release to Edison : � �
. ; : L�.�-,��' �.-�
50. Gas Release to Southern California Gas Co � , � ;�
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�
PflOJECT RDOflE55: S S S ANTON BL UNIT: F•L 1 �
OWNEP'S NqME: SAFClOKA FARMS
RDUflESS: PACIFLC SOUTH WEST REALTY
PO 2047
TERMINAL ANNEX, CA
8185787700
FNCHIENGINEEH: ROY W. HERBOLD 7R, eec.No.: �_1 ] 073
nooness: z2072 CAMINO VfNO uxiT:
LAGUNA HIiLS CA 92653
PFpMiTTEE: LANDINGHA,N PiUMBING ( 818 ) 336-7206
PUOPESS: S9S39 PROCTOR AV H
INDUSTRY CA 91746
LICENSED LONTflACTOP OECLABATION: 1 hereby aliirm Iha� I am IicenseA under Orovisions ol ChaO�er 9(commencing wiih Seciion
7000) oi Oivision 9 0l Ihe Business antl Proie55ian5 CaOe, anE my IicenSe ¢ in lulllorce an0 e�fec�.
ciTruc.://057032 STRTELIC.:z]'1SZ��uss:�Cq36�L/ � /
Oate: (S] ` Z�' �Z Signalure: — __6J :�..p'G.�/`���
WOPNEPS' COMPENSpTION OECIAPATION: I �ereUy aHirm Ihal I �avi cenilicate of consem ro seu-inmre or a ceeificate of workers'
ComDenuiion Insurance. or a cenifietl copy t�ereoi (Section 3800, laD. C�.
roucr Na.: W?. 710 815 exr. oate: 0 7/ O 1/ 9 3 '
comvnxr: CA COMP
❑ Certitied wpy is here6y lumistcetl. � Cenilied wpY is file/E witA �he ciry Builtling Division.
�ate: u — 7��9ti qpplicant��iL.N /�p��/'^'�--�'
E7IEMPiION FPOM WOHKEflS' COMPENSIITIOX OEUAIiATiON: (ilus secmn etl mt be campleitd il the permil is for one hu�re0 (5100) or less).
I cetliry �hat in I�e pedormance oi ��e wark br whic� ihis permit is rssueJ, I 5hall noi emD�oY any person in any manner so as fo become
su0lect lo �e Workers' ComOensation Laws of Califomia. / ^ _ / / �
�ale: �"' T��'� Signamre:.
7 v/ Y
NOTICE: If. afler making ��is Eeclaration, yau s�oWa become subj c� b �he Warkers' Compensation 0 isions ol �he Labor
CoOe. you must fonhwii� camply wii� such D�ovisions or lhis permi� s�ail Ge tleemed revoke0.
CONSTflUtTION LENOING �GENCY: I hereby atlirm Nai IAere o a constmction IenUing apency for t�e pedormance a� �he work for
whic� this Oermii is issue0 (Seciion 3097. Civ. C).
LFNOEfl:
ADONESS:
OWNEB BUILUEB OECIAflATION: I AereOy aliirm �Aal I am ¢xemp� �wm lhe Conlraciors' State License Law for ine Pollowing reason
(Section 7031.5 Business an0 Pmlessional CoCe: My city ol counry w0ic� repuires a permit to conslmci, alter, improve, demolish, or
repair any simcture. prior to its issuance. also reQuires Ihe aD�licant for such permil to lile a 5iqneC statement that helshe is Iicense0
pursuam Io I�e pmvisions al �Ae Cantraciors' State License Law (Cluprer 9(commencing vnt� Sec�bn 7000) af �ivision 9 of t�e Business
anU Prolessions Code) or I�al ne/she is erempt tllerefmm an0 I�e bazis lor ihe allegeG exemp�ioa Any violaiion ol Sec�ion 7031.5 by
any ap0�icam br a permi� su�lects tAe a001iunt ta a civil penalry ot not more ttun live hunUreE Uollars (5500�.
1, as ovmer ol iAe pmperty or my employees with wages as iheir sole compenution, will do Ihe woA, antl ��e
❑ slmcWre is nol imenaetl or olleretl lor sale (Secuon 70a4, Buvness antl Pmfessional Code: The Contractors Stale License Law
aoes noi aDV�Y �o an owner ol a pmpeny wllo Uullds or impmves ttlereon, anU who Aoes suc� work �imsell/Aersel� or IAmugll
Ois or her own employees, pmviGeO IM1ai sucA impmvements are not intenAetl or olleretl �or sale. II, however �he builtlinp or
impmvemenl is solG wiNin one year ot comDletion. I�e owner will have Ihe DurUen ol provinp �Plstle EiA nol huil� or impmve
for Ihe Durpose ot sale).
I, as owner oi tne pm0eriy. am ewclusiveN comractinq with Iicense0 comracmrs m consimct ihe prolect (Section 7044, Business
�❑ anC Pmlessions CoAe: TAe Cantacmrs State License Law aces no� appy ia an owner o1 pmcerry � bmlds ar improves Ihereon
antl wha [oNraCls �Or SUc� pmle[IS wilA a Coniratlof�s�licen5e Dur5uan110 ihe ConVadors' Slale Litense law),I am aware
�' ��al proo� o�l�eir Workei 5 Compensati0n insulance Shou10 be D«4� l0 me.
I, � I am exemp� unEer Section: 8. 8 P. C.
I lor Ihis reason:
�ate: Qwner.
I Oo here�y cenity Ihat I am aware ol an0 unGerstand t�e repuiremenis ol Califomia Healtll an0 Safety Co�e Sections 255P5. 25533, antl
255Ja an0 t�al I o� any lumre Ouilaing occupanl vnNxill noi (drde one) nreJ m wmpty wi�� uid staie coUes and Ihe reQuiremenl5 for a
permit for cansimc�ion or modilica�ion imm Ihe Nir �uali�y Managemenl DisVicl. Re5i0enlial cons�mction appliw�ions are exempt Irom
ihese O�ovisions.
�ate: p001icant:
I �ere0y cetlity �Aal I �av¢ read tAis appliwtion and Slale I�at Ihe above informaiion is correci. I agree �o comON ��h all ci�y an0 counry
or0inancesanasta�elawsrelalinp�obuil0ingcons�mctionanahereDyaui r¢erepresenlativeso�iti cirytoenteruponthea�ove-men�ioneU
pmpetly lar inspec�ion purpo5es. /�
oaie�. LG ''t-Y �s'L Signalure:!��� � �
Driver's License or Social Security a: .
I60t-a6 W�ile—BuJtlmG; Green—Cope Entorcemenl: Canarv—Aoolicanl; Pink—Revenue: Goldenrotl—Assesmr
CITY OF COSTA NESA — BOILDING PERMIT PERM NO; P OS9731
PER,IIT NO; P 059731 PLAN CHECH NO: N GOCrT: N SUPP: N
CONSTRUCTION TYPE: 1rR SP PERMIT TYPE: PLU PURPOSE; ALT
JOB DESCRIP3ION ; COMMERCIAL T.I. (OFFICES), RE;#tB59548 SQ FT:
CLAIM VALGE; CALC—VALUE: GROUP OCC; B-2 /
COMMENTS: "HANK OF AMERICA" IS THE TENANT
�r***�,�xx+�*+��*�***##*�#********+e�#*#*�*#**�*#��c*��rx�*�*xu*#*�rt*��**uxce**��##x##*
Z O N I N G R E Q 0 I ft E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT ZN FRNT; FT iN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGAT; FT IN
PARRING REQ• PROV; PAACEL; 41050104 ZNE; REF NO;
PLANNING NGTES>
>
iE iE iE 1f iE �3t iF iF 1E if 1E fE if iF # iE iE iE it #iE iE iE # iE ik iE# iE iE it if iF 3F if iF #�1f� iF �lE tE iF it # iF i(;i6 iE if iFit # iE #�1t-# ## 3E iE %iE 3Ei(� fEib it IE if if iF iF iE # i6 # iE # iE
D E V E L O P M E N'P S E R V I C E S-- R E Q U I R E M E N T S
ZONING APPROVED BY ' DATE:
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED BY: S�—" DATE; '�O��r�
iEiE-%iFititiP�%iFifif3EiEifiEiEiF�1FiElfifkx�iF�irie3FiriE3rfiit�iF%�iF'�it %� �iF'R�3ei"FiF'itit�i�x��Ftr3ElhkitiFfFiE�E#iF�t f�ic �x��r xf �-
-%iE iE iF iE iE iE i(� 3F iE iE if iE if iE iE if #### iF if iE lE IE iE ###�ElE it iE �1F �lE �f fP iE iE lf # if 1F 1f �Eit if 3(•lkif �lt IE iE ih iE #� f(� 7ElE 1h ih �4*ii� tE i! if # iE iE iE if !t 1F 1(� iE iElE
LEGALIZATZON;N F E E S I] M M A R Y STRUCTURAL SEGMENT:N
BLDG PM'f PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES G22AD LVG
PERMST �35Y SMIP/NON—RES
PLAN
iSSUE FEE 20,00
BUILDING—DFC�—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7.00 20.00 0.00 27,00 27,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SAORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/T'OT GRADING PLAN—CHECH
2%.��
iE if if 1F 1E iF 1F iElF iE if ?k 1t if it k M if IE fE Ik i4 if IF it 1f f(� iE # IE IE �IE if• !E # iF 1f if 1f iE iE i!�-lE 1F 1E �lE if if iE �IE 1F !F iF iElf �If iF 7f iE 1E # if iF# )t %� Ik iF iElf if !E iflF* i(� IE !f iE
I N D I V Z D U A L F E E B k E A X D O W N
TYPE QTY D E 5 C R I P T I O N UNIT' COST TOTAL COST
PLU 1 SINK, KITCHEN 7.00 7,00
END OF FEES
�L C: : _ -lf� •�.,. _ ' "
.'n',F: ��,_%o. . �_ .. .
CONSTRUCTION AND PLANNING P� & SPA '
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary E�earical Service or Poie 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Elec[riwl 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. Alumbing System � Finaf '
74. Rough Plumb��9 - 65. Electrical-Finai
75. Rough Electrical-Conduit ' 66. Solar System-Final '
76�. Rough Electr�c Wiring � 67. Fencing & Access Approval f
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Condi:ioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, in Structure 70. Undergiound Hydro
22. Dutts, Ventilating 71. Product Piping O Gas � Oil
23. Gas Pipe�Rou9h & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Ory Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding , 77. FIXED SYSTEM FINAL
29. Insulation i � 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat � � � 79. FINAL INSPECTION
32. Electrical Power Meter•Final � ' 80. F000 CERTIFICATE ISSUED
33. Final Elecirit i , Notes:
34. Final Heating & Air Conditioning � �
35. Finai7'ias Pipe-Test � � �
36. Hood or Canopy j
� i
37. Final Factory Pireplace � �
38. Final Plumbing q� ��
39. Water Service�Final 1 � I
40. Gas Service-Final � � I
i �
41. $olar pomesticFinal ' '
I
42. Backflow Pre�enter � � i
43. Backflow irri9ation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap fiegulations
47. FINAL STRUCTURE & BUILDING I �� �
48. FINALPLANNING I ' ,
49. Electric Release to Edison ' �
50. Gas Retease to Southern Catiiornia Gas Co � ,�
51. CERTIFICATE OF OCCUPANCY
No. Date
PNQIECTROOflE55: SSJ ANTON F!L �+ uxiT: FL 10
OWNEH'SNAME: [J`AItlOKA FARMS '
nooeEss: pACIFSC SOUTH WEST REAL'PY
PO 2047
TERMINAL ANNEX, r_A
8185787700
ANCMIENGINEEH: �OY W, HERBOLD JR. REc.xo.: �_a 1073
aoosess: z2072'CAMINO VfNO uxiT:
I.AGUNA HIF�LS CA 92653
PEHMITTEE:HORjZON HEATZNG 6 A/C (719)974-37U2
aooxess: 17853 SANTIAG� B7, STE#107-243
VIILA PARH CA 92667
LICENSEO CONTNALTOB OECLANRTION: I hereby affirm t�a� I I' se0 untl p ovisions ot Chapier 9(commencing wiih Section
7000� of Uirsion 3 0l �he Business aib Pmfeuions COtle. an I e se is in I rce and eifeci.
c�Truc.: 56944 sTaTeuc.:6477."4 � s —:0
�ie- � Z-- L Signaiure: _ _ —
OBKEPS'COMPENSFTIONUE0.ANRTION: InereOyallirmtna naveacertiliwteofconsemtoseli-insureoracenilicateolWorkers'
COmp¢nsalion Insurance. or a cerOfied copy I�ereol �Seclion 3800. La�. C).
POLILY NO.: E%P. DpTE: �
LOMPANY:
❑ Cenilie0 copY is hereGy Iwnis�ea. ❑ Cenilied copy is fileO vnt� t�e ci+ BuilGing Division.
Oale: p001icanl: � � yq
ESEMPTIONFflOMWOBHEBS'COMPENSIITIONOFCUflRiION: i5 4n Jn ec OletrOifNeperm�¢foronehunErttl�5100�a1ess�.
I Cetlily Ihal in Ihe peAormanc¢ oi �he work lor w�ic per ui i , Sh I'o pV y a person i ny manner 5o a510 UeCome
suDiecl to �he Warkers' QfAmpensalion Laws ol C' mia.
a�e: /�— Z— r Z� Signamre�
NOTILE: II, alier making I�is declara�ion, you shoultl Gecome su�lect Io I�e Wofkers' Compensation Orovisions ot �Ae LaCOr
CoOe. you must lorthwRh Comply wii� Suc� pmvisions or Itlis Dermi� shall be Oeemetl revokeE.
CONSTflULTION LENOING AGENCY: I �ereby allirm I�at t�ere is a convmclion lending agency for Ihe pedormance ol I�e work �or
wnicn inis Dermit is issuetl (Setlion 3097. Civ. C�.
LENDEN:
AUONESS:
OWNEfl BUILOEfl OECli1NAT10N: I hereby alhrm t�al I am eeempl Imm I�e Coniramors' Slaie License Law br ��e following reason
(Sec�ion 7o31.5 Business and Pmlessional COUe: Any cily ol county w�ich requires a permii to construct, alier, impmve, Aemolish, o�
repair any slmclure. prior to its issuance. also requires t�e apPlicanl for such permil to file a signed statement that he/s�e is licensetl
pursuam to I�e pmvisions of Ihe Contracmrs' State License Law �C�ap�er 9(commencing with Section 7000) of Division 3 oi Ihe Business
anU Pmlessions Code) or t�at �e/she is e�empt thereimm anA �ne �asis for �he allege� exemption, pny violation ol Section 7031.5 Gy
any applitani for a p¢rmil SUEj¢c�s �he applitant l0 a Civil penal�y oi no� mOfe lhan �ive hundfed tlollars (8500�.
I, as owner ol the pwoeny or my employees wilh wages as iheir sole compensation, will tlo me work, an0 the
❑ 9mcture is not inlentlea ar ollere0lor sale �Section 7614, Business anA Prote55ional Coae: 7he CAntractors' SWte License Law
Ooes not aOPly to an owner ol a D�oDe�y w�o �uiltls or impwves lhereon, and who does such woM1 himsell/herself of ItlmuAh
his or �er awn employees. O�Ovi4e0 Iha� SUch imD�ovemen�s are not in�enaed or o�fere0 for sale. II, hOw¢ver the builtlinA of
imprOv¢m¢ni is sola wil�in one year ol completion. ��e owner will have Ihe buraen of pmving he/sh¢ tli0 no� Uuiltl oi impmve
lorlhe pUrpoSe 0� Sale�.
1. as owner oi tAe pmpetly am exclusively Conlraning wiN IicenseG canirac�ors to constmq ��e prolect (Sepion 70C4. Business
❑ ane Pm�e55ims CoOe: Tt�e fAntrapars' Stai¢ L'¢en5e Law aoes nol appty Io an awner at O�Operry wtro OuilQs or improv¢5 thereDn
and w�a camratls lor suc� D�olecls wi�� a conVactoqs�license pursuani m ��e Coniractors' State License Law�.l am aware
Ihat pma� ol lheir Worker'S Compen5atbn insuranC¢ Shoultl �e pmvitletl �o me.
� I am exempl untler Sectian: B. 8 P. C. -
tor Inis reaSOn:
Ua�e- Owner.
i Oo here�y cenily iha� I am aware ol and unGerstanU tne reQuirements oi Califomia Healih an0 Safeiy CoOe Sections 25505, 255�3, antl
2553< antl�Aal lor anyluturt 6uiltling occupanivnll/willnoi(circle one�nee0to comply wi�h saitl slate codes anOth¢r¢puirem¢nI5 br a
permii lor conslmction or motlilication Imm I�e Air uah�y Managemenl OislricL RenOen�ial consttuction aODlica�ion5 are ¢xemp� irom
Ihese O�ovisions. .
�a�e: ADP�icant:
I �ere0y cenily Ihal I �ave i¢aa t�is ap0licalion antl Slale Iha� �tr ab in�or aiion' rr¢d. I agree �o comply xAth all tiiy an0 Coun�y
ortlinancesanaslatelaw5relaunglobuilAingconstmclion er hori rpB vesolhi5ci�yloen rupon��eabove�menlioned�
pmOenY �orin50eclion pur0ose5.
Oate: // � 1"— / � SignaWre:
�rivefs License ar Sacial Securiiy p.� �
I\ t64L46 Wnne—Bmltling�, Greon—Cotle Eniarcemenl', Canary—Applicanf. Pink—Revenue: Goltlenmtl—Assessor
CITY OF COSTA MESA — BUiLDiNG PERMIT P:ERM NO: N. 0597%5
PEHhiIT NO; M 059776 PLAN CHECK NO; N GOVT; N SUPP; N
CGNSTRUCi?ON TYPE: 1FR SP PER�I'l TXPE; MEC PURPOSE; ALT
JOB DESCRIPTION : COMN,ERCIAL T.I. (OFFICES) SQ FT:
C�AIM nALUE: 10,000.00 CALC—VALUE: GROUP OCC; B-2 /
�
COMMENTS; "BANK OF AMEkICA" AEF;B59548
�e+c���c;�� ��***�*�r� **�x*���r*�K�u**x ��x*�***�r*�x xx�x�**�x**x*,��e*x*�x�-*u,��**�-*�*�#�x�*
Z� I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ ,viAIN HUiLDING ---------- --- ACCESSORY HUZLDING ---------
FRtJT: FT IN REAR; FT IN FRNT; FT IN REAR; , iT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGAT; FT IN
PLANNINGRN6�'ES> �ROV; PARCEL; 41050104 2NE; REF NO;
>
�lF �F # if !!!F iE iE�IE if !E iE �7E'7ElE iE �E 7f ih ik iE iElE if 1E if iE 1E �IF # iE 3E �1f 1E !F iE iF 9E.# 1h iF N-iE if # iF iE iE iElEiElE IF i(-ih �IE 1E iF 3E 3E # 1E iElF ## �F ie # 1E iE iE iF 16 iE iF iC� # iE
D E V E L O P M E N T S E R';i� I C E S R E Q li I R E M E N T S
ZONING APPROVED SY '� DATE;
BUILDING APPROVED BY ; �� — DATE;
APPLICATION ISSUED HY; — DATE; i a''9 Z—
lFiF'lEi(-if1E'IEiEifiEiEiFifiE�EiFiEiFiEi6iEiF ft 1t . lt:. �'!t ' ftlt - Yf1E f! tl'x�+�' 1tRiEiEiF'IEif%ii'#iE#Yf1t ft 1lR * iFiF
3fK1fiElEiF#IEiFIFX��ItifiFiE3F�IfiF�IfiEjFi41fiF1EiE3kiFfE343flfili(if�lEiE�lEifN•if . '�iEif�iEifi(�#iFiflfi2.tF�1FiE3f3(�3fiEiffE#lE�EiFiEiflfiflfiEif•iEiFiF#iE
LEGALIZATION:N P E E S U M M A R Y STRUCTUAAL SEGMEN?;U
HLDG PMT PLUMBING EiECTRIC MECHA�IIC FIRE SMiP/RES GRADING
PERMIT 126�5& SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERN,IT iSStiE PLAN—CHECK TOTAL PAID DUE
TOTAI.S----> 126.00 15,00 0.00 141,00 141,00 ,00
REVENUE DIVISION T�TALS--> COLLECTED; 141,00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR
191,00
k K� 1Fi(� iF jF if iC� iE if �lE iE �f it # if !f if �1F iE #f if�iF �1F iE fE iF if if �lf i41E i(� 3E jF if # IE IElf iE if # IF 3F iF?( iF 3E �lF iE if 3E iE iEiE iE iE it iE iF if if lEiF tE iE iE iP N� 1F iE�lf iF df iE if iE �
Z N D S V I D li A L F E E B R E A K D O W N
iYPE QTY D E S C R I P T I O N CiNIT COST TOTAI. COST
MEC 1 REPAIR/AL'1' COOLING (Jt3IT/SYS W/CNTLS 9.00 9,00
MEC 18 VAV BOX 6,50 117,00
END OF FEES �
.�
�
CONSTRUCTION AND PIANNING P� �& SPA
APPROVALS Permit # Date . Inspector p�ppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipmen[ Location
2. Soil Pipe-Undrgrnd. , 53. Steel Reinforcement
3. Electrical Conduit UtilityUndrgrnd. � 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement . 56. Rough Pfumbing & Pressure Test
. 6. Electrical UFER Grnd. 57. APPROVAL 70 COVER�GUNITE
7. Footings - 58. Eiectrical Conduit�Undrgmd.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
�9. Water Pipe-Undrgmd. �� 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
i i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final �
12. Sewer Cap 63. Heater & Ven[�Final '
13. Roof D�ains 64. Plumbing System - Final
14. RoughPlumbing ! 65. Electrical�Final __
15. Rough Elect� ical•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. POOUSPA SYSTEMS FINAL
7'9. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, VentNating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test . 72. Underground Flush �
24. Roof Framing 73. Undergrnd. Storaye Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & 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 I � � 79. FINAL INSPECTION
32. ElectricahPower Meter�Final i i I S0. FOOD CERTIFICATE ISSUED
33. Final Electric � � Notes:
34. Final Heatinq & Air Conditioning Nl.f.wpL! {
lv+� �
35. Final Gas Pipe-Test I �
36. Hood or Canopy � �' �
37. Pinal Factory Fireplace � � I
t ,
38. Final Plumbing � � •
�
39. Water Service-Final ' � �
40. Gas Service-Final � �
41. Solar pomesticFinal � ' ' �
42. Backflow Preventer '
43. Backflow Irrigation .
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING I I
i
48. FINAL PLANNING � (
i
49. Electric Release to Edison ! � '
50. Gas Release to Southem California Gas Co � � ' �
51. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECT ADOBESS: j S J A.NTON BL UNIT: FL S O
OWNEfl'S NAME: SAKIOKA FARMS
aooness: �ACiFIC SOliTH WEST REALTY
PO 2097
TERMINAL ANNEX, CA
8185787700
AflCHIENGINEEfl: ROY W. HERBOLD SR, NEC.NO.:C—�� O%3
nooncss: z2077. CAN.INO VfNO "�r:
LAGII,IA HILLS CA 92653
PEBMITTEE `�� C
PETITION E' CTRIC (810)331—.,807
aooness: 635 STnPHO
COVINA CA 91724
❑CENSED CONTflACTOP OECIAflpTION: I hereGy alli tnai I am licensea unuer Dmvisions of Cnapter 9(commencing witn Secnon
7000� of Oivision 3 0l I�e eusiness antl Pmlessions Cotle. a my license is in lull farte anA eflect.
arruc.:076905 STRTEIIC.:S1E]8h: ��SS C—]^
-9ate: ��"' 2 —�j2 - Signatur'
W08KEH5'COMPENSp710NUEClAMTION: IAer aHir aveacertilicaiealcansenitoull-insurearacertiliwteotWorkers'
Compensaiion Insurance. or a cerii�ietl copy I�Ereo� ( ettion 3800. La�. C).
POLICYN0.:1��i579-97. EXP.OPTE: OLIOII9j
comraxr:STATE FUND
❑ Certilied topy i5 �ere0y Wmishetl. � Certilie opy i vnl� �he ciry BuilEing Divi5i0n.
.aate: � � 2-9 2 APVlicanP �'-�•. '� �
1 �.
ESEMPTIONFPOMWOflNEflS'LOMPENSATIONOECUPA ON: (T' ionnee0na�becampleleGi�tAepermitisbraneAundred�3100�orless��.
I certify �hat in Ihe pedormante ol �he woB lor which ��is rmil is issueq I 5�all no� employ any Derson in any manner3o as �o hecome .
su�leci lo Ihe Workers' Compensation Laws of Calitomia. � F %
♦
Dale-. Signamre: �
NOTICE II. atler making Ihis aeclaraiion. you shoultl hecome sublec� lo �he Workers' Compensa�ion pmvisions ot ihe Labor; y�'-�
fqtle. you mus� lorlhwith comply wiih such pmvisions o� �his permi� shall be Geemed revoketl.
CONSTHUCTION LEN�ING AGENCY: I �ere0y a��irm �hai Ihere is a ConSimClion lending agency for tAe Detlormantepf t�e work fov
whic� �his permil is issuea (Sec�ion 3097, Civ. C). ,.
LENOEfl:
FODflESS: .
OWNEB BWLDEB oECUBRTION: I nereoy aHirm tfui I am eKemO� ��om iAe Comractors' Slate License Law tor ihe following reason
(Section 7031.5 Business anA Pm�essional Cotle: Any ciry o� counry whic� requires a permii to tonstmct, alter, impmve, demalish, or
repair any slrucWre. priar to ils issuance. also requires ihe aDDlicant lor suc� permit to lile a signetl statement Ihat he/s�e is licensetl
pursuam to Ihe pmvisions o� �he Coniractors' S�a�e license Law (Chapter 9(tOmmencinp wiih Seclion 7000) ol Division 9 nf Ihe Business
and ProleSSionS Coae) or ��al heh�e i5 exempi Ihereimm antl Ihe basis fOf Ihe alleAeO evemD�ion. Any violalian ol SetliDn 7031.5 by
any applicant lor a permit suhlecls Ihe apDlicanito a civil penal�y ol nol more I�an live hunA�eO tlollars (5500).
I. as owner of the O�aVeny or my employees with waAes as ineir sole comoensation, will tlo ihe work, ane the
❑ simc�ure is no� intenEeE oi otter¢E lor ule (Section 70aa. Business anA Pmleuional CoUe: 7he Coniractors' State License Law
does not apply to an owner of a propeny wh0 Euiltls or improves ihereon, anA who tloes such work tlimseltlAerself or ihrough
his or her own employees, providee Nat such impmvemenis are not intenAea or olleretl for sale. If, however the buil0ing or
improvemenl is sold vnNin one year of wmpletion. ihe owner will have I�e burden ol proving he/she tlitl not builtl ar improve
lor t�e purp05e ol sale�.
I, as owne� ol I�e propetly, am exclusively conliaclin8 wi�h licensetl conirac�ors �o canslmc� iha prolect (Seclion 70Gd. Business
❑ ana Pmlesvons CaOe: The Contractors' Siaie License Law aoes not aOWY �o an owner oi pm0erry wtw huJOs or imDroves thereon
anE wM convacis for suc� D��ec�s mi� a coniracmqs)license Ourswnt m ��e Contracrors' State license �aw),I am aware
t�at prooi oi t�eir Worker's Compensation insurance s�oulE �e O�ohtletl to me.
� I am ezem0� unGer Section: � 8. 6 P. C.
lor Ihis reazon:
Date: Urner.
I Uo nereby cenify Ihat I am aware oi ana un0erstana Ine repuiremenis of Calilornu Meatt� and Shcery CoJe SeCtbns 25505. 25533. antl
2553C ana I�al I or any lulu�e bmleing acupanl wilVwill noi �circle ane) nee0 lo comply vn�h SaiE Slaie cotles antl lhe requirem¢n�s �or a
permi� tor conslmciion or mo0dicalion Imm Ihe Air Oualily ManaAement �iSlricL Resitlential con5im[tion apDlications are exem0� «om
these D�avisions.
�a�e: ApPlicant:.
I�ere�y cerlify IAai I �ave reatl t�is apDlicalion antl slale
orAinances ane sialelavrs rela�mglo buileing constmction;
pmoerry lor ins0eC6on pur0oses
� Daie: f�' 2�— S Z-- Signamre:
Dnver's License ar Social Securily x:
is tOrreci. I agree to wmply vnih all ciry and COunry
ntatives Of INS City �o enler Upon Ihe above-rtcen(iOneC
16<L46 Whne—Bmlding; Green—Coee Enlo¢emen�: Canary—AOP���enl: Pink—Revenue: Goldenrotl—Assassor
CITY OF COSTA MESA — BUILDIIJG PERMIT
PERMiT NO; E 059779 PLAN CHECSC NO: N
CONSTRUCTZON TYPE; 1FA SP PERMIT TYPE: ELE
JOB DESCRIPTION ; COMMERCIAL T.I, (OFFICES)
CLAIM VALUE; 80,000,00 CALC—VALUE:
PF.RM NO; E OS9779
GOVT; N SUPP; N
PURPOSE; ALT
SQ FT;
GROUP OCC: B-2 /
COMMENTS• "BANK OF AMERICA" REF;B59548
**�x**�r******x***�-**+t�*itfr��r*##x*x�x�it*t�if+�+rk�*tr�t*±t*���#x+t�tu!rir�t*itrt�itit*#it**�tfcit*itu��
Z O N Z N G R E Q U I R� M E N T S
5 E T B A C K S
--------'---- NAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT; Fi IN REAR; FT IN FRNT; FT iN REAR: rT iN
LEFT; FT ZN RGHT: FT IN I,EFT; cT iN RGHT: rT IN
PARRING REQ� PROV; PARCEL; 41050104 ZNE; RcF NO;
PLANNiNG NUTES>
i
iF iF iF�)f iFlE-1( !E if # 7F #f iE if iE .Y 1f� 16 if iE iE 1f iE iflE 1E if 1(� iE 1E iF iE jElc !F iFlE iE # iE iE fE �k !E #!f iE 1! M- if 1F #!E �E if 1FiE ##ih # if 1E i(� ik i(� iF iF IE iE if iF ##E # iFlE # iE
D E V E L O P M E N T S E�R V I C E S R E Q U Z R E M E N T S
ZON�NG APPROVED BY ''- DATE:
BUILDZNG APPROVED BY ;_ � , DATE:
APPLICATION ISSUED BY; �/ G DATE: ������
iE3Efk3k3tx�iE�lE�f3E*�7t�ifif�#M�iPiEiEiEx��x� � . �.<f�•, .,. o � , .,. . r it'iiir'�SF3E�f�iF#iF3(�x�i(-�%�it- � x�. x�3E3(�
#iFibiEif�ififiE%�XitifiE3fiEif�iEiF7EihiEiEifiE�I(�iEiFiF##1E1Fif�SEiF1EiF9klE3E1 h�)f <�iE1EiEiEiEiFiE#i(iE?E�lEif#itiElM1lEiEif#ififiEifi(iFiE#%!f1(�#iFlF
LEGALZZATION;N F E E S U, M A R Y STRUCTURAL ScGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE S,NIP/RES GAADING
PERMIT 187 00
:' �0� SMIP/NqN—RES
PLAN '
ISSiiE FEE -1•5,:00
BUILDiNG—DIV—> PERMIT ISSUE PLARP=CHECK TOTAL PASD DUE
TOTALS----> 187,00 15,00 >•, 0,00 202,00 202.00 ,00
REVENUE DIVISION TOTALS--> COLI;ECT�D; 202.00 OVER/SHORT; ,00
BLDG PMT PLOMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECH
2�2,�0 � -
jE if �f 3E iF �F # if if� i(� iE iF iFiF iE if- X� iF if iF iF aE-7(- fE iE 3E if-iF if 3f iF 3f if-%iEi( iF# �F iE dE 3E 3EiE iC� 3F iF 7f iF # it # if jh iF# iE ik �f� i(� # 3E if'.f if-if iE iF 3E i'� iE iE if iE fF i4 ## iE
I N D I V I D[] A L"�. F E E H R E A K D 0 W N
TYPE QTY D E S C R i P T I O N' UtiIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTZN�?`', 1. ST 20 EA, , 75 15. 00
ELE 178 FIXTURES LIGHTING;.�AbDITIUNAL EA, ,45 80,10
ELE 20 RECEPT/Of7TLET •�I ST 20 EA, ,75 15.00
=LE 62 RECEPT/OUTLET ��~ ADDITIONAL EA. .45 27,90
ELE 20 RECEPT/SWiTCH �: ��'. ST 20 EA, ,75 15,00
ELE 10 RECEPT/SWITCH ' ADDITIONAL EA, ,45 4,50
ELE 2 SUB—PANEL �� 11,00 22,00
ELE 1 TEMP DIST SYS/LZGHT�ING EA, 7,50 7,50
-�P]I}' OF FEES
�°�, ��r�
r �,
/%
i
CONSTRUCTION AND PLANNING PG & SPA �
APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
� 7. Temporary Electricai Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -'
3. Electrical Conduit Utility•Undrgrnd. 54. Forms
4. Electrical Conduit�Undr9rnd. - 55. Eiectrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFEF Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings - 58. Eiectrical Conduit-Undrgmd. �
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 & HousO Connection 62. Backwash & Receptor�Final
12. Sewer Cap t 63. Heater & Vent•Final
73. Roof Drains 64. Plumbing System - Final
14. flough Plumbing . 65. Electrical�Fina�
15. Rough Elecvical•Conduit . � 66. Solar System-Final
16. Rough Electric Wiring /Q`3 gZ /,( p.,,/� 67. Fencing & Access ApP�oval
� `Y
17. Rough Wiring Sign ' � 68. APPROVED FOR PLASTERING
18. Rough Electrica6T Bar Ceiling �//��� /� 69. POOUSPA SYSTEMS FINA�
%
19. Rough Heating & Air Conditioning � ' FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure �70. Underground Hydro
22. Ducts, Ventilating . 71. Product Piping OGas- OOiI
23. Gas Pipe�Rough & Test , 72. Underground Flush
24. Roof Framing ' ' 73. Undergrnd.StorageTank OGas ❑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 t I 78. FIRE PREV. FINAL
30. Drywall Nailin9 � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. ElectricahPower MeterFinal � �'' 80. FOOD CERTIFICATE ISSUED
33. Final Electric �G`p�% ��r� Notes:� --�j-QZ �. jq,( ,�
34. Ftnal Heating & Air Conditioning j.�
f/-Z3-SZ'�w���'q,_i _�3_a��_
35. Final Gas Pipe-Test �•• �
36. Hood or Canopy �'�
37. Final Factory Fireplace � �
38. Final Plumbing � 1
39. Water Service�Final �
40. Gas Service�Final
i �
41. Solar pomestic-Final • � �
�
42. Backflow Preventer � �
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STflUCTURE & BUILDING I �
48. FINALPI.ANNING I � �+
49. Elec[ric Release to Edison I � '
50. Gas Release to Southern California Gas Co � '
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�
^JJ �
PflQIECT ADOHESS: S S S ANTON BL UNIT: F^L 1 �
OWNEfl'SNFME: SAFCIOKA fi):t`jNJ
nooxess: pACIFIC SOUTH WEST REALTY
PO 2647
TERMINAL ANNEX, CA
8185787700
PNCN/ENCINEEH: �OY W, HERBOLD .TR. REG.NO.:C—S1O%3
aooness: z�072 CAMINO VfNO uxir:
LAGUNA HILLS CA 92653
PENMITfEE: GOLDEN STATE FIRE PROT ( 714 ) 923-9060
aooxEss: 936 E FRANCIS b
ONTARIO � CA 91761
UCENSEO CONiflACTOfl OECLRflATION: I hereby aiiirm [ha1 I am IicenseU unUer pmvisions o� Chapter 9(commencing wi�� Section
7000� of �ivision 3 0� ��e Business a`Pro�essions Cotle. antl my license is in �ull torce antl eflec�.
cirruc.:007649 srar�uc.:3507.25/� cuss:C-1��
�a�e.. �V'26'i1L Signatirce�' � (.q%'✓�'�'C. t.�
WOPNEHS' COMPENSPTION DELNPa7lON: I hereby aihrmihat I have a cenificate of consent Io sell-insure or a cetlilicate of WOMefS'
Compensaiion Ins rance. or a c£rtitied copy 1�ereof (Sectio`n 9800. Lah. C).
POLICYNO.: ��2J�C79�i.j`JS E%P.DRTE: U3IOZI93
COMPANV: RF,PUBL1'C IND
,] Cerlitie0 coOY is hereby fumiSheG. � CertifieA CODY �5 �ile0 wiN [he city BuilCing Oivision.
oate: ib—Z6^�% ppplicanf� H/.fV
E%EMPTIONFflOMWOflNEflS'COMPENSATIONOECIAPPT10N: Qhissectionnee0nol�ecampleteUilthepermitisioronehunArea�8100�arless�.
I ce�ily Ihat in Ihe pedormance ol �he work tor which this permil i5 isSueQ I shall no� employ any Oerson in any manne� so as to 6ecome
su�le�� �o ��e Workers' ComOensation laws ul Calitomia.
�a�e'. Signaiure:
NO710E: Ii, alter making t�is tleclaration. you shoula h'ecome subject to the WOM1ers' Compensation pmvisions ot ihe Labor
Code, you mus� fort�wi�h compry with suc� pmvisions ar �Ais permii shall be deemed revoked.
CONSTBUCTION LENDINC AGENCY: I here�y aifirm that there is a cons�mc�ion lentling a9ency �or Ihe pedormance ot �he work for
which mis permil is issuetl �Se[lion 3097. Ci¢ C�. '
LENOEX:
RDDHE55:
OWNEB BUILOEfl DELUPRTION: I here�y allirm thal I am exempt imm IAe Conirac�ars' Stale license Law lor ihe following reasan
(Section 7031.5 Business antl Pm�essianal CoOe'. Any city of counry whicA requires a permi� Io cOnstmct, alte�, impmve, demolish, or
repau any stmc�ure. Drior �o i1s issuance. also requires 1he aDPlicani lor sucA permi� �o �ile a signed stalemeni �hat he/she is IicenseU
pursuam �o ��e D�ovisions a� ��¢ Comracmrs' Slaie License Law (Chap�er 9(commencing wi�� Seciian 7000) o( Oivision 3 of �he Business
and Professions Cotle) or tha� �e/s�e is exempl Ihere�mm antl Ihe basis �or �he alleged exemption. Fny violation o� Sec�ion 7031.5 hy
any apPl¢an� �or a permii subjects t�e applicanl �o a civil penalry oi no� more ��an five hundretl tlollars (8500).
I, as owner ol �he Droperty or my employees wi�h wages as �heir sole compensation, will ao �he wark, an0 �he
� slrucNre is nat intenOeA or oifereA for sale (SecUon 7044, Business anJ Pmiessional Cotle: The Comractors' Slate License Law
does noi apPly Io an owner ol a pmDeny w�o Ouilds or impmves [hereon, an0 who tloes suc� work �imself/herself ar tAmuAh
his or her own employees, pmvitled Ihai suc� imD�ovemen�s are not intentleJ or ofiere0 for sale. If, however ihe 6uilding or
impmvemen� is solG wilhin one year ol comple�ioq �he owner will �ave �he hurden of provinp he/she ditl no� builtl or impmve
. br Ne purpose of sale�.
I, as owner ot �he pmperty, am exclusively contracling wi�h licensed coniractors lo cons�mc� the pro�ect (Section 7044, Business
❑ and Professions Code: The ConUacloa' S�ate License Law does nof apply ro an ownef of DmDeRY who bui105 or improves ihereon
and who comracts lor suc� pmlects witA a coniractoqs)license pursuant m ihe Coniracmrs' State License Law�.l am aware
Ihat pmo� o� Iheir Worker's Compensation insurance shoultl be providetl to me.
� I am exempi under Sec�ion: B. 8 P. C.
for �his reason:
oate: owner.
I do hereby ceriify iha� I am aware o� and unders�antl �he reQuiremen�s oi Califomia Heal�h antl Sa�ery Cotle Sec�ions 25505. 25533. antl
2553d ane �ha� l or any lulure builtling ocwpanl wilYwill noi (circle one) neetl to comply un�� saitl state codes an4 ihe reQuiremenis for a
permR for conslmclion or modilication �rom Ihe Air �uabry Managemen� �i5iricL Re5i0ential consimc�ian applica�ians are exempt �mm
Ihese pmvisions.
oate�. apvlicanC
I here0y certily Ihat 1 have read I�is apPl¢ation and s�ate lhal t�e above inbrmation is correc�. I agree lo comD�Y w�th all ciry antl counry
ortlinances and stalelawsrelalingio builtling conslmdion and hereby aNhorizerepresentatives o��his ci�yto enterupon�he above-meniioned
pmper�y lar inspection purposes.
oate: �� — Z b-9 2 Signawre�. ���
�river's License or Socia� Security a:
1601-46 WM1ite—BuilOmg; Green—Cotle Enlorcement; Canary—Applicanl; Pink—Revenue; Goltlenrotl—Assessor
CITY OF COSYA MESA — BUILDING FERMIT PERM NO: F 059692
PERMIT NO: F 059692 PLAN CHECK NO: 04099-92 L GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE: OTH
JOB DESCRZPTION : COMMERCIAL T.I.(OFFICES—FIRE SPRINKLERS) SQ FY';
CLAIM VALUE: 11,800,U0 CALC—VAZUE: GROUP OCC; B-2 /
COMMENTS; "BANK OF AMERICA" / RE: B59546
*�*�r*#�t�**#�**�-x-�c ��rxxx*�-**�**�r**����r�+t�x+r**i�***��t*�*�t*x�***x��**s�**t���t�*#�r*x###� �t
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY bUI1,DING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; rT IN
LEFT; FT IN RGHT; FT ZN LEFT; FT IN RGHT; F`T IN
PARRING kEQ • PROV; PARCEL; 41050104 ZNE; REF NO;
PLANNING NGTES>
i
iF 1FiE if iE �lE iP iE iE if 1f if• iE iE1E iE iFiF iE 1E 1E i(� fh 1P iEiE i(�iE iE if� �1E if if d� if iE if iEif iF i6 if # iF if if if if ik# 3E iE IF if # lElf� if # iF #�1FiF 1E iE-1F iklF iP i4 ib iE ieiE if 3FlE iflE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY DATE;
BUILDING AI�PROVED BY ; �c,r DATE:
APPLICATION ISSUED BY; �NL � �-pt DATE: � � �'v
iFiF1("lE')FiF1FiE3EiEiFiElfiEiFiEiE'IfIEiE1E'1Fi'Fl�FiF1—F t%1riF�FiF�F�Fi�F7F�F�FiF itRitiFTFitR1t*1tT�i'F��YF'A'1Z�iE#iEiEifiF#iFih1l' iFilftiFiF*Rft �#3t
i(� iE 3f �lf i(� iElE iE 1F �lf jF iE 3t �)t i(� �3F iE iE 3E iE 1f 1tiF 3E jt �iE * iE # �F iE iElf iFjf # 3flE 3E�1E �IF if-3E iF 3F iE �3E iEi/� iF 3f �1f iE i(• iE if jt if i4 �?F!F jf iFiE iF i(� lE it-0E lE 3f #� ihj( iE i( i(� iE #
LEGALIZATION:N F E E- S U M M A R Y STRUCTURAL SEGMENT:N
n
BLDG PMT PLUMBING ELECTAIC MECHANIC FIkE SMIP/RES GRADING
PERMIT ^ �
� � � 65Y SMIP/NON—RES
PLAN � . � ` 87.75
ISSUE F'EE � ^ �
BUILDING—DZV—> PERMIT ISSUH PLAN=CHECK TOTAL PAID DUE
TOTALS----> 135,00 0.00 .87.7,,� 222.75 222.75 .00
RE��ENUE DIVISION TOTALS--> COLLECTED• , 135.00 OVER/SHORT; 00
BLDG PMT PLUMHING ELECTRIC MECHAN2Cr• 135R00 SMIP/TOT GRADZNG PLAN—CHECK
/.
i
iE� iE 94 3E'lF iE dE �7E �lF iF iE 9E dE if 3ElFlF�1(� �7f i(� ie-IE�If� if �%iFiFi!� 1E if i(-9E �JF iE 9E �'�E-IF-0e ie iFif iE iEit �1E if �7E itdE�1F lf X 9F iE d(� �)f%�%iF# iE �1E �%iE-%� �iE-1E �%-IF iF if dE iE iF if #iE
I N D I V I D U A L F"E E H R E A K U O W N
, ' ^.
TYPE QTY A E S C R S P T I O N•, ':-�..' UNIT COST TOTAL COST
FIR 135 � FIRE EQUIP FEE (FROM`HLDG�VAL TAHLE) 1..00 135.00
• , END� OE' EEES
. s •^ � .
."� . -
" _ � . .a
-i � . .
� �.' Ll�� � f, �� •
.� , -'!' ` `' /,- �.11 ��i'r': �i2°_4: ,- . "- :.�i_
♦ i � y . .r� L-:�L� �.I ��.. � �ii'_ �.�Jt..�i.
•. ` i
CONSTRUCTION AND PLANNING - • - P� �` SPA
APPROVALS Pe�mit # Date Inspector APpROVALS Permit # Date Inspecior
; 1.-7emporery�Electriwl Service or Pole ' 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steet Reinforcement
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms
4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Steel Reinfo�cement 56. Rough Plumbing & Pressure Test
6. Eiectrical UPER Grnd. � 57. APPROVAL TO COVER-GUNITE
7. Footings . 58. Electrical Conduit�Undrgrnd.
8. Fo�ndation • � 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. �Plum6ing System � Final
14. Rough Ptumbing 65. Electrical�Final
15. Rough Electrical-Conduit � 66. Solar System-Final
16. Rough E�ectric Wiring 67. Fencin9 & Access ApProval
1�. Rough Wiring Sign 68. APPROVED FOR PLAS7ERING
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #��a'
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing ' 74. Overhead Y,��p„ pj �'J� �/Q ��
,� �z/_!r�- Qd
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & S�ding i 77. FIXED SYSTEM FINAL /o)- ,!�'�
29. Insulation . � � � 78. fIRE PREV. F�NAL ��/�
30. Drywall Nailing � � i HEALTH DEPT. REQU�REMENT f
37. Plaster Brown Coat � � 79. FINAL INSPECTION
32. Electricai Power Meter�Final � 80. FOOD CERTIFICATE ISSUED
�
33. Final Eleciric ' i � � Notes:
34. Pinal Heating & Air Conditioning , I 7y� 3 a-�.e� ,�.�.e Me� ev��-io.e�-�
35. Final Gas PiPe•Test � � �
� a� Cu,'C,2�d rn-� yola-.�v ✓Y��-,
36. Hood or Canopy `
a,-, ..,.,� � ������
37. Final Factory Fireplace �
� �
38. Final Plumb�ng � I
I
39. Water Service-Final � I
40. Gas Service•Final � j �
41. Sola� DomesticFinal � '
I
42. Backf�ow Preventer i i ,
43. Backflow Irrigation
44. Landscape irrigation System
45. Sound Attenuation
46. Handicav Regulations
47. FINAL STRUCTURE & BUILOING I ' �
i '
46. FINAL PLANNING � ;
49. Electric Reiease to Edison � �
i i
50. Gas Release to Southem California Gas Co ���
51. CERTIFICATE OF OCCUPANCY
No. Date
ADp�icant to /111 (n all sptces except �hose within heavy bortler lines anC sign all appropriate Eaclanlions.
CITV• OF COSfA MESA C�O�Nj��STRUCTION PE IT r PERMIT NO. TRACT NO. LOT NO. U T NO. A P,�y
Project Address 35.1 �LI-K� � �d� TL � � O� �� O S Main Buildin�
App;icant'S Malling Add�25� TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R E FrOnt
❑ CONVERSION ❑ DEMOLISH ❑ OTHER � T
Owner's Name '; ✓ Phone4��% DESCRIPTION OF WORK/USE OF BLDG. � - y- A Rear
Addreu �
� C Right
Arch/Eng. ' LicenSC No. TVPE OF PERMIT ❑ GRADING FOUrvDATIOrv STRUC7URAL � K�
Addre55 � ' ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL g� Lef
Contractor's Name���`� ����p���. Phone, ' ' �'�THER ' Ping. Ref. #
Addresslm���'�g��OiZGAC,�/% Sb �� L PROJECTDESCRIPTION 5�.F7. oCCVaA CvOM g oter. -
a CONSTRUCTION TVVE�-� � VALUATION S�i {/() _ Plannln N
City License No. b 3!� 49 � 20NE GRADIN CU. VDS. ACRES
LICENSEO CONTRHCT00. DECLARATION
I Itereby aHi�m IhSt I am Ilcen5e0 untllr prOvi5lons of Chdrter 9(commencing
wlth SCCtIOn JOOOj Ot DIVI51011 3 07 IhB BIISIfI¢55 dfltl PfOt¢SSIOf15 COtlB� d(Id
my license is in I force antl etfect.
LIC¢OS¢CId55 L f158 ��
Date `1-`' % � 519 t �-�1�
1RKER5'COMPENSATION DECL RATION
:re�y aHirm that I hdve a cef[iflcat0 Of cOnSent [0 58B-Inzufe Of a Ceftltltat8
. Workers' Compenutlon Insuranca, or a cartifietl cop t ereot (Settion
saoo. No.��803�tf9� ComPanY ����P'+'��-
r
Certifietl copy is hereby lurnishetl. `
Datee�ti4ie�copYJS�etl wAVPI cani✓�9�Siori��' t ' ,
X / �J � ��lw
EXEMPTION FROM WORKERS' C PENSATION DFCLARATION
(T�is section neetl not Ee completetl if Iha permil is for one huntlretl (E300) or
iess).
I certity that in the periormance of the work for whi<h this perm�t is issuetl I
shall not employ any person in any manner so as to betome subject to t�e
Workers' Compensatlon Laws of Califomia.
Date Signature '
NOTICE: If, a(ter making this tleclaration, you snoultl bemme subject to tne
Workers' Compensation provizions of the labor Code, you must forthwith
comply with such provislons or tnls permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby at(irm that there is a constructlon lentling agency for the performance
ot the work for which this vermlt is Issuetl (Se<tion 3097 Civ. C.)
LenCer's Name
Lenaer's Atleress
OWNER BUILDER DECLARATION
I hereby atfirm Ihat I am exempt from the Contractor'S Licenie �aw for the
following reason (Section 7031.5. Buslness antl Profe55ional Cotle: Any <i[y or
county which requires a permit to construcq alter {mprove, tlemolish or rapalr
any struchre, prior [0 9ts issuance, also requires t�e applicant for sucb permit
t^ �ile a signetl Statement thdt he/she IS Iic¢n5¢tl puisuant to IhB p�ovi5ion5 of
:ontra<tor's License Law (Chapter 9(<ommencin9 with Sectlon ]000) of
,ion' 3 ot the Business antl Pro(essions Cotle) or that he/she is exempt
,.etrom antl the basis for tbe allegetl eaemptlon. Any vlolatlon ot Section
7031.5 by any applitant for a permit subjects the applican[ to a civil
�enalty ot not more Ihan five huntlretl tlollars (5500).
I, as owner of tha property or my employees with wa9es as their sole
comoensatlon, will tlo the work, antl tne sVucture Is not Intantletl or�otteraa
tor sale (Section �044, Business antl Protessional CoCe: The Contractor'S
License Law tloes not apply to an owner ot a pro0erty wno bulltls or improves
Ihereon, antl who tloe5 such work hlm5elt/her5¢It Or thrOugh hiz o� h« own
employees, provitletl that suth'improvements are not Intentletl or oHeretl tor
sale. 1f, nowever, the bulltlin9 or improvement is soltl within one year ot com-
pletion, lhe owner will have the burtlen of proving ha/she tlitl not builtl or Im-
�rove tortne purpose of sale).
1, as owner of the property, am exclusively contracling with Ilcensetl con-
[ractOrs to con5[ruct the O�oject (SeCtiOn 7046, Bu51ne55 dfltl Prot¢TSIonS COUe:
The Canlractor's Licens¢ law tloes no[ apply to an owner of property who
Cuiltls or ImDroves thereon. antl who contrdCts fo� such orolect5 wltn d ton-
tractor(51 license Oursuanc ro me Contractors �icanse Law). I am aware tnat
proof of their Wo�ker'S CompensatiOn Insu�an<B ShOultl b0 prOvlCetl to me.
❑ I am exempt untler Section B. & P. C. tor this reason
Oate Owner
I hereby certi(y that I nave reatl thls applicatlon ana state that the above
In(orma[ion is correct. I agree to comply with all city an0 tounty ortlinances
antl state laws relating [o bullGin9 construction, antl hereby authorize repre-
5entatives t po upOn tne above�m¢ntionetl p�op¢/ty for
Inspection n
Signatur - Gy Dat�
Remarkf: �� (
Bar Sink
Backflow Preven[er
Backflow Irrigation
Jrinking Fountains
Floor Drains
Floor Sinks
u05$CfVICC �I1L�EL5
Interceptors /
Kitchen Sink
Lavamries
P-Trep
Roof Drains
Reinspection Fee $15
Boiler
Duct� Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multi
Firepl/Fact. Blt. iC80 #
Heating System & Ducting
❑6100,000 BTU �100,C
Reinspection Fee
Driverz' Llcense or 55 � � � �
0865-46, rev. 5/88 White - Builtling: Canary - Applicant: Pink - Accounting: Goltlenrotl - Assessor
$15
PLUMBING
Service Sink
Sewer Cap � -'
Sewer Connection "
Solar Collxtors -
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet •
Water Heater
Water Service -
Auto�Wash
Leundry Tra'ys
Isue Fea
Hood or Typel ❑
_ Canapy Type I I ❑
lefrigerat-on System
7a ,000sru ❑�oo,000
iystem Repair/Alteration
Fire Dampers
Registers
Iswe Fee
FEES
$ 3
§ 3
Automatit Washer
Construction Pole
Cooking Unit
Dishwasher
Dryers ❑Gas ❑
Fen
F.A.U.
Fixtures
Device Boxes
OUL12L5
- (� G} 2one �/(/
Actessory Building:
Z
O
N
I
N
G
R
Parking Req./Provided E
Q
M
T
S.
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel ` `-'�
Motors DO-1 HP �1 h� 8
InaSolar �9-15�HP 016-15+
Microwave � •�
Pol� � 'rY:
� Garbage Disposel
�-; Genere2or �0.5 KW �5-15 KW
^ �_"
Range
Sign � 't �
Standing Sec[ions
Tresh Compacror
r
Reinspection Fee $15 Issue Fee
�EVELOPMENTSERVICESRE�UIREMENTS:
Zoning Approved By _�=
euilding Approvad e P/I.���
�+ %i
�.BUILDING PERMIT $
�; i- ' VLAN CHECK s
/� PLUMBING $
' % i -'P.LAN CHECK 25% $
n ' �ELECTfiICAL $ -
(:^ �PLAN CHECK 50% $
'% NIECHANICAL $
' ' � ~'PLAN CHECK 25% $
� ��
FEES
$ 3
OF FEES V / n�
�� SMIP $ �
�ERMIT
ISSUANCE $.
_ ENERGY P.C. $
_ GRADING $
MICROFIIM $.
— TOTAL FEE $ �
W
01 Q�029065—QOU29U6; '➢"CJ'� :°3,i`
DATE: 03/23/E9 TI�iE: ?3:46
r .
' ? \.�J'1 .. \� � '_ ' � ' .. . . .., . ... ..
- CONSTRUCTION AND PLANNING '�- PC & SPA
' APPROVALS Permit #.�_ Date Inspector p�ppROVALS rermit # Date Inspector
1. Tempor@ry�Electrical Service or Pole ...� � 52. Pool & Equipment Location , i
�
e2. Soil�Pipe-Undrgrnd. i�"j„} r 53. Steel Reinforcement " -� �
3; Electnical Conduit Otiliyy-Undrgrnd. �� �" • 54. Forms �, -{
�
4. Electrical Conduif-U�drgrnd. •'; 55. Electrical Bonding "��_�
5:.�Ste �I.Reinforceme�f' �; � 56. Rough Plumbing & Pressure Test J;
6.;-Electrical UFER Grrid. � �� 57. APPROVAL TO COVER-GUNITE ^; ,•
r!' •
7! Footings �� �� �r� r`^ 58. Electrical Conduit-Undrgmd. ��,
8. Fouridation • � � �r � 59. Gas Pipe, 0 Undrgrnd., Test I
9. Water Pipe-Undrgrnd. �^ �,T - 60. Backwash Lines, P-Trap, � Undrgrnd.
10-.-.Structural Floor Sy'stem ��,i � J' �,�� 67. APPROVAL TO DECK
1-1, Property Sewer Line%& House Conn ction /.• � � 62. Backwash & ReceptorFinal
;
12. Sew�'rCap ' ' �
� 63. Heater & Vent-Final ,
13�Roof Drains ,� � � � J .�� 64. Plumbing SYstem - Final
14. Roug�i Plumbing,� •� ��� 65. Electrical-Final
15. Rough Electrical-Conduit '• 66. Solar System-Final
,16� Rough Electric Wirin9 67. Fencing & Access Approval - -
17,� Rough Wiring Sign 68. APPROVED FOR PLASTERING
J6. Rough Electrical-T Bar Ceiling� 69. POOL/SPA SYSTEMS FINAL
i19. Rough Heating & Air Conqitioning � FIRE DEPT. REQUIREMENT
t�
20.. Rough Factory Fireplace -.. APPROVALS Permit #
21. Ducts, in Structure, , ; � 70. Underground Hydro
22. Ducts, Ventilating �;. ' 71. Product Piping �Gas ❑Oil �
23:�Gas Pipe-Rough & Test -. 72. ,Underground Flush
24: Roof Framing . - � 73., Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing �' � 74. Overhead Hydro
i
26. T-Bar Ceiling (Structural) �coat Z 75. Dry Chemical
27. Freme and Flashing .. � 76. Dry Standpipe
:
28. Lathing &1Siding ��{ �� 77. FIXED SYSTEM FINAL -
,f
29. Insula�ion ."� 3� 78. FIRE PREV. FINAL
30: Drywall Nailing . ., HEALTH DEPT. REQUIREMENT �
31; Plaster Brown Coat �� i„ 79. FINAL INSPECTION '
, .
32. Electrical Power�Meter-Final 80. FOOD CERTIFICATE ISSUED
33: Final Electric � ... Notes: � � /��' �
!%-i+9�,rf/ o�G � ...-
34. Final Heating & Air Conditioning ' '
. .div sc c�� oyr Si
35. Final Gas Pipe-Test � ` n Z
36. Hood or Canopy u �
t
37. Final Factory Fireplace
38. Final Plumbing �
39. Water�Service-Ffnal .; ' `
40. Gas Service-Final y ` ��
41. Solar pomestic-Final� � �� � (��
n..-� �"�.
42. BackflowPreventer . _� �' " �,{' � �„t
43. Backflow Irrigation ; �.! , . �--� �
� _-,
44. .Landscape Ir�igation�System , / � "�
_, ��
45. Sound Attenuation:� �^ -� .� ��� T�
46. Handicap Regulation� `�
�
47. FINAL�STAUCTURE & 8UlLDING � ` '
48. Special Requirements Completed
49. Electric Release to Edison '�� ��,�. `�a"-
r,
.•50. Gas Release to Southern California Gas Co `� � � . ' �' 'V �
,_ ,_ ,
-51. CERTIFICATE OF OCCUPANCY " ' ;,�
.. i., �; - �..:.
Nti Date .r. j � ,. J
i
AOD���ant to fiil in all spaces except lhose within heavy borEe� Iinas antl sign all appropriata aeeiaratians. ' ' - '� �" -� •
CI7Y oF cOSra MESA CONSTRTUCTION PERMIT
Project Add�ess � ,v �'y�
Apblicant's Mailing Addrrcc ����of_.SJ—.C/ ��i?,rf/�DJ .L �
Owner's Name -S GA� � ��G��'� phone�� ¢��
Address ��lYu � �G✓� �� k�'��
Arch/Eng. License No.
Address
Addresslmailinglh�� �A.L�f"�F.�efC'���� �/L'�����
CiryLicenseNo. ��,�^��� �
LICENSED CONTRACTOR DECLARATION �
I hereby aftirm tha[ I am Iicensetl untler provi51on5 of Cbarte�'9 (commencing .
wlt� section 7000) of Division 3 of the Business antl Professions COUe, and
my Iicense is in tull torce antl effect. ' ' '
License Class � Licrense' �✓N2/ZO��
Datu�?? 5� 5'iD � �v6 '� V
+WORKERS'COMVENSATIO ECLARATI N.
�1 hereby aHirm that I have a certtticate oi conSGnt to SBINnsure or a certificate
of Workers' Compensation InSuranca, or d<ertitietl' copY the�eof (Section
' 3800��{1a' b1., C. "�' �/ ' /_ '
Policf�YOC ���� �.c_,�a � Company ��,d �
ertifietl mpy is hereUy furnisne
CmHfietl copy is filetl with [h city B Itling vision
V 1
Date A Icant i
O E%EMPTION�R RS' O MPENSATION DECLARA� I 1
J (Tbis section neetl not be complatetl il the permit B(or one huntlretl E100) or
iesz).
I certify that in the performanca oi the work tor which this perm�t is issuetl I
ShalGnot employ any person In any manne� so as to Decome subject to t�e
Workers"Compensatlon Laws of Callfornia.
. Date ' Signature
'NOTICE: It, afte� making this tleclaralion, y0u shoultl become Subject to the
Workers'' Compensation, provisiOns 01 [he Labor Cotle, y0u must forthwith
comply with, sucn proWsions or this permit shall be deemetl revoked.
CONSTRUCTION.LENDING AGENCV
1 hereby affirm tbat tnere is a construction Ientlin9 agency for the pertormance
of the 'work for which this permit Is issuetl (Section 3097 Civ. CJ
LentlerY� Name � �
LenEer's HOtlreSz
OWNERBUILDER DECLARATION i
I nereby afflrm that I am exempt from the ConVactor's License Law for the '
following reasori (Section 7031.S,Buslness antl Profezsional Cotle: Any city or
counly which requires a pe�ml[ to conStruCt, alt¢�, Improve, tlemoli5h or repai�
any structure, p`ior to Its issuance, also reqWres the appllcant (or such permit
fn /ilw a cinn tl tafeme.nt ihdt hOhhe IS IIC¢!IS¢tl OWSOdlIf LO Lh0 OfOV1510f15 O}
therCtrom antl the basis for
'�, 7031.5 by any. applicant 1
; eendlry of not more than tiv�
LJ I, u�owncr ot the prop
com0en5ation will tlo the w
for sale (Sec�ion 7044, Bu
License Law tloes not apPly
thereon, antl who [loes suc
em0loyees, provi0e0 that su
� sdle. I/, hOweveq the bulltli
pletion, tM1e owne� will have
prova for the pur0o5e o� sale
❑ I, a5 ownet of the p�o0e
tractOrs lo conslruct t0e proj
The Conlractor's'License L:
builtlz o� improves lhereon,
tractor(sl IicenSe pursuant�t<
proof o( lhel� Worker'S Coi
❑ 1 am exempt untler Seclio
Date O
I hereby certify that. I' havE
inbrmatlon I5 corr¢cL I agr!
antl stata laws�relating to b�
sentativesiot this city t i
inspecy6 n purposes.
Sig�ure
Drivers' ' ¢nse or 55 � �
CMF 0865�46, rev: 1OJ84 �Whit
a p
ntlre
V ov
to an o
h work
Ch Imp
ng orin
Ihe bu
rtv. am
ot Section
to a civil
o� a properry wno.owws or
,elt/herself or through his oi
nents are not intentlatl or o
�ement is soltl witnln one ye:
Of proving he/she tlitl nOt b�
usively contratting wllh lice
7044, Business antl Professi
; avPly to an owner ot pro[
�ntracts tor sucn projects witn a con-
ie Law�. I am aware that
oultl be provltletl to me.
B. & P. C. tor this reason
icom-
orim-
�ep�e-
Y f0� '
/V 'J-l—; - . , Q/v
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION O DEMOLISH ❑ OT
DESCFIP ION OF WOg K�/USE OF B G�u��T1�
.l�i ��;�A�,,�G'1(/�����„i—%� � ��/� �
TVPE OF PERMIT U GRADING �FOUN�ATI�OyN STRVCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING IOIMECHANICAL
❑ OTHER
PRQIECT DESCRIP710N SQ. FT. OCCUPANCV
CONSTRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES �
Remarkz: �/ r/ _ . . _ _ / — i7r%7�
ar Sink
ackflow Preventer
ackflow Irrigation
athtubs -
larifieis � �
ishwasher -�
rinking Fountains
loor Dreins
loor Sinks . _
asService �Outl
Kitchen'Sink " �� •
Lavatories ' '
P—Trap :
Roof Drairis - - �
� .i
.Reinspection Fae $15
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Mul
Firepl/Fact. Blt. IC80 #
Heacing System & Ductin
❑aioo,000 sTu oioo
�� I I Reinspection Fee I S75
Builtling; Canary - Appllwnt: Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink �
Sewer Cap
Sewer Connection �
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
4�ater Closet '
Water Heater -
Water Service
Auto-Wash
laundry Trays
laue Fee
Hood or Typel- ❑ '
CanoPY TYPeII•❑ � .
Refrigeration System
❑aioo,000eTu ❑ioo,000er
System Repair/Alteration �
Fire Dampers G �
Registers
laue Fee
N /
$ 3
0
A.P. ,ie
S Main Building:
E
T Front
A Rear
C Pig�t
g Left
Ping. Ref. #
Planning Notes: .
' I Zone
Acceuory Building:
0
ELECTRICAL
Automatic Washer -"� '� Transformer ❑ 15-50 KW "
Construction Pole Sub. � ❑ 50+ KW
Cooking Unit ; . Meter ❑up to 100 amps
Dishwasher ' Meter ❑over 100 amps •
Dryers �Gas ❑Electric . Sub Panel �
Fan Motors �0.1 HP �1 :5 - 8
F.A.U. � Inc.Solar �9-15 HP �16�15+
Fixtures - Microwave ' ' " "-'
Device Boxes
Outlets �
Switches
Garbage Disposal
Generator �0.5 KW �5-15 KW
Range
Sign '
; Standing Sections
Trash Compactor
� Rainspaction Fee '$15 ' ' Issue Fee
DEVELOPMEN7SERVICESREQUIHEMENTS:
Zoning Approved By
Building Approved By �>
n
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FEES
$ 3
SUMMARV OF FEES v
BUILDING PERMIT � $ SMIP � $ '
PLAN CHECK $ PERMIT
PLUMBING $ ��UANCE � $ �
PLAN CHECK 25% $ ENERGV P.C. $
ELECTFiICAL $ � GRADING $
PLANCHECK 50% $ � MICROFILM $
MECHANICAL $ Q�• t0 � TOTAL FEE $ 9/�v
PLAN CHECK 25% $ '
� �eiTE: 03%27/89 TIFiE: 13:54 ��•VV
v
CONSTRUCTION ANO PLANNING POOL & SPA
' APPROVALS Petmit # Date Inspector AppROVALS Permit # Date Inspectnr
. 1. Temporary Electrical Service�or Pole 52. Pool & Equipment Location _ �
-2. Soil Pipe-Undrgrnd. ' 53. Steel.Reinforcement
«-3. Electrical Conduit Utility�Undrgmd. 54. Forms
`4. Electrical Conduit-Undrgmd. . . �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 -
78. Rough Electrical-T Bat Ceiling � 69. POOUSPA SYSTEMS FINAL� � �
19. Rough Heating & Air Gonditioning 3 Yl� L� FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplece APPROVALS Permit # �
2�1.-Duc[s, in Struc[ure 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.StorageTank OGas ❑Oil �
25. Roof Sheathing 74: Overhead Hydro �
r
� 26. T-Bar Ceiling �Structurap & Monocoat 75; Dry Chemical -
� 27. Frame and Flashing 76. Dry Standpipe
�28. Lathing & Siding � �77. FIXED SYSTEM FINAL
29.,�Insulation �78. FIRE PREV. F,INAL
�, 30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT
� 31. Plaster Brown Coat ' 79. FINAL INSPECTION
�It 32. Electrical Power MeterFinal ' 80. FOOD CERTIFICATE ISSUED '
' 33. Final Electric • Notes:
34. FinalHeating�&AirCtlnditioning S� GE�
. 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 pomesticFinal ' � . ' . ' .
42. Backflow Preventer � '
,
43. Backflow Irrigation �
44. �Landscape Irrigation SYstem ' �
45. Sound Attenuation . � %
i
46. Handicap Regulations � � - �
�� 47. FINALSTRUCTURE&BUILDING
�
I 48. Special Requirements Completed, � ' , , � '
� I
49. Electric Release to EdiSon -�
• 50. Gas Release to Southern California Gas Co � :� `
51. CERTIFICATE OF OCCUPANCY � � • '
1Jo. � Date� � � ' �
� - - -
' - -- -
P
\
(�/% AOPi��ant to fill in all spacas excapt enose within �eavy Doraer lines ana si9n all aDo�oo��ate tleclantions.
CITY OF COSTA MESA CONSTRUCTION PERMIT
ProjectAddres5 SSS N?oN $1�/T%/��O
Applitant's Mailing Address
Owner's Name S�� Phone
Address
Arch/Eng. �/ License No.
Add�ess �U��! � 4.SAN�E�
ConVactor's Nama «✓ME/I� EL�G%,P/�'ahone d���
Address (mailing) �OD1J'iPE�Np�/LL �iST'2'/�% �oS�t (Q
City License No. '� 7��o p
LICENSED CONTRACTOR DECLA0.ATION
I hereby at(i�m [ha[ I am licensetl untllr provlslOni ot Charte� 9(Comrltencing
with 5ection 7000) of DlviSion 3 07 Ihe Bu5ine55 antl Prote5510n5 Cotle, antl
my license is in (ull tprce antl eftect. _ , , _ , , _ ,
!^atPS'GJ �i`� Si9nature f%�%T'�"�
RKERS'COMPENSATION OECLARATIO
ere0y afiirm tnat I nave a certiflcate of conzent to ulNnsura or a certifiwte
oi Workerz' Compenution Insuranca, or a certifletl copy tnereof (Sectlon
3800. Lab. C.) D v � D� ��L' ��/� ^ r
Policy No. �/ v� �36 Company� c�d ���c•
❑ Certifietl copy is hereDy 1UrN5�Ga. � n Y/O �/ �p 7
1�� Certitie py f tl with the city Builping Oivision,�- /1
YDate APPlicant Q/lµ�_ f11041�ri
E%EMPTION FROM WORKERS' COMPENSATI DECLARATION
(This Section neetl no[ b¢ COmplatetl if the p¢rmit is /or One hunCr00 (5300) Or
less).
I certify t�at in the pertormance oi lhe wo�k 1ot wnlcb [his p�rmR ii IStuOtl 1
snal� not employ any peRon in any manner so as to became sub�ect to t�e
Workers' Compensation Laws of Calltornia.
Oate Si9nature
NOTICE: It, atter making this tleUaration, you 5houltl become suDject to tne
Workers' ComOensation provisions oi the Labor Cotle, you must fartnwith
Comply with such 0/ovlsiOns o� IhiS pOrmlt Shall DG tla¢mG0 r9voketl.
CONSTRUCTION LENDING AGENCV
I hereby afflrm Ihat [htre Is a const�uctlon IenOing agency br the performdnCB
Of [h¢ work fo� wliich thls permit is Issuetl ($ectlOn 3097 Clv. C.)
Lentler's Name
Lentler•s Atleress
OWNER BUILDER DECLARATION
I bereby aftirm lhat I am exempt irom the ConVattor's Llcanso L.aw for lhe
followin9 reazon (Section 7031.5 Business antl Profonional Cotle: Any dty or
county whicn requires a permit to <onslrucl, alter, Improve, tlemolish or mpalr
�ny structure, prior to its issuance, also requires [he apolicant for suth permit
tile a signetl statement that he/5he is Iicunsetl p�rivant lo the provisions o!
Contraclor'i License Law (Cnapter 9(commenting with Soctian 7000) 01
aision 3 0( lh¢ BuSinesS antl Pr0ltssions Cotla) or lhdl h0/She Is exampt
[here�rom dntl lht basi5 for the allegetl axemptlOn. Any v101dtlon of SOClion
703L5 by dny ap0���ant IOr a permit Sub�ec[s [ne appliwnt t0 a clvil
�¢ndlty oi nOt mo�e thdn tivC huntl�etl t1011a�s (5500).
I, as owne� ol lhe pmperty Or my employea5 wlth wa985 as Ihelr So10
CompenSdtiOn, will Uo lM1e work, antl lho ilructure IS nOt IntBn00tl ol OHBfOtl
lor sale (Section 70C4, Business an0 Profe55ional Cotlo: The Contraclor's
License Law tloes not apP�Y �o an owner ol a property who builtli or improvei
ihereon, ana who Eoes suc� work hlmsell/herself or through his or ner own
employees, provitletl tnat such improvaments aro not IntontloE or offere0 for
ule. 11, however, t�e builtlin9 or Improvement is soltl wi[hin one year of com-
pletlon, ihe owner will have the burtlen of proving he/she tlltl nol Duiltl or im-
��Ove for the purpo5e 01 sale).
I, as owner of ihe proPerty, am exclu5ively coniracting wit� Iicensetl con-
Ifacto6 [O cOnSlrucl the ploje<t �58clion 7044, Buslnes5 antl Plotes5ions Cotle:
The Con��actOr'S LicenS¢ Ldw o¢s nat apply t0 an Owne� o( Droperty wh0
builtls or improve5 thereon. antl who contrdttz to� such orollCts wit� a con-
tra<tor(tl license pursuan[ ro[ne ConVactor•s License Law). I am aware that
prool 01 [heir Worker'S COmpensation Insuranca ShOultl be provlCetl to me.
❑ I am exempt untler SetNon B. & P. C. tar th6 reason
Date
I hereby cer[ify tnat
information rs correct
antl state laws relatin
sentatives of tnis
inspection purposes
�Siqnature
Orivers' License or 55
0865-46,rev.5/BB
Owner
I ha
I ag
to
m
._.._....--' �j -------� --- -- ,,... ...,
� % J C�� A.P. 5W
S Main Buildi
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Ffont
DESCflIPT10N OF WORK/USE OF BLDG. A Rear
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL C Right
�5 K
❑ TENANT 'AJ ELECTRICAL ❑ PLUMBWG ❑ MECHANICAL . g- Lfft
❑ �OTHER � Ping. Ref. dk
VROJECT DESCRIPTION 5�. FT. OCCUPANCV Planning Notes:
CONSTRVCTION TVPE VALUATION $
ZONE GRADINGCU.VDS. ACRES
Remarks: , � � C% 7 �y
Bar Sink
Backtlow Preventer
Backflow I'rrigation
Bathtubs'�
Claritiers; �
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
18v8tOfieS
P—Trap
Roof DrainS ,
Reinspaction Fee � $15
Boiier
Duct - Under Ground
Duct - Svuc[ural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fect.8lt. �CBO �
Heating System & Ductin
❑0�100,000 BTU 0100,OOOBT
Rainspection Fee � $15
Wnite - Builtling; Canary - Applicant; Pink - Attounting; Goltlenrotl - Assessor
Showers
Service Sink
sewe, wP
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Water Closet
Water Heater
Water Service
Auto-Wesh
Leundry Tray
Isue Fee
Hood or Typel ❑
Canopy Typell ❑
�Refri eration System
OO,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
FEES
5 3
Au[oma[ic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Oryers ❑Gas ❑Elec[ric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generetor �P5 KW �5-1
Zone
Parking Feq./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors O67 HP O1'f. - 8
Inc. Solar 09�15 HP �16-15+
MicrOwave
Pole Light
Sign
Standing Sec[ions
5 KW Tresh Compactor
I Reinspection Fee �$15 I � laue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2oning APProved By
Building Approved By
Aoolimtion IQued Bv —. �i
FEES
$
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SUMMARV OF FEES (�
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENEHGV P.C. $�
ELECTFiICAL $ /07• �b GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ r�7. �o
PLAN CHECK 25% $
O 1 OOD2907D-00029070 T� Y 1Q7.10
DATE: 03/23/89 TIt1E: 13:48
. , . .. . . \.�/ �\� U,� � ` ., . . ...i . . . , _ .
�f
CONSTRUCTION AND PLANNING %+ � .& SPA �
APPROVALS Permit# Date Inspector qpPROVALS Permit# Date Inspector
7. Temporary Electrical Service or Pole � 52. Pool & Equipment Location
2.'Soil Pipe-Wndrgrnd. . � 53. Steel Reinforcement
3.�Electrical Conduit U[ility-Undrgrnd. 54. Forms r�
4. �Electrical Conduit-Undigrnd. � 55. Electrical Bonding
5. Steei �Reinforcemenn " 56. Rough Plumbing & Pressure Test .�
6.�ElectricalUFERGrnd� • 57. APPROVALTOCOVER-GUNITE �
7.,Footings • ' ,-: ; . 1 ,,� 56. Electrical Conduit-Undrgrnd. . �
8. Foundation { �. , �� 59. Gas Pipe, 0 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 Corinection 62. Backwash & Receptor-Final �
� 12. Sewer Cap � • ' ' . . 63. Hea[er & VenbFinal
13.• Roof Drains ' � � 64. Plumbing System - Final
14.'. Rough Plumbing'��_ " � 65. Electrical•Final '
15. Rough Electrical-Conduit ' 66. Solar System-Final
1'6i Rough Electric Wiring 67. Fencing & Access Approvat
17. Rough Wiring Sign 8. APPROVED FOR PLASTERING
r
18; � Rough Electricat-T Bar Ceiling �� 9. POOUSPA 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 t'U 71.�ProductPipingOGas ❑Oil
23. Gas Pipe�Rough & Test �, 72. Underground Flush �
24. Roof Framing 'J! ,� 73. Undergrnd. Storage Tank O 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. Lathi�g & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
; �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31�? Plaster Brown C9at. 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
'33. Final Electric �. /f�/ �4 'Notes:
'34. Final Heating & Air Conditioning ' � ,
i
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Fac[ory Fireplace
38. Final Plumbing
39. Water Service-Final � '
r
40. Gas Service-Final ,
47. Solar pomestic-Final
42. Backflow Preventer f%; �
43. Backflow Irrigation _ .-� �
44. Landscape Irrigation System ,- �
45. Sound Attenuation �
;; /
46. Handicap Regulations � -�
i,
47. FINAL STRUCTURE & BUIIDING �
48. Special Requirements Completed
49. Electric Release to Edison � '
50. Gas Release to Southern California Gas Co �� � ,_�. (/
57. CERTIFICATE OF OCCUPANCY `i � } .;� ,
No. Date •'l • f"• � .. �'i - '
. , ,.
�
Applicant to fill in all spaees ex<ept those wit�in �eavy CorCer Iines anE sign all appropriate Eeclarations.
CI7Y OF COSTA MESA CONSTRUCTION PERMIT
ProjectAddress 555 ANTON� 10TH FLOOR
Applicant'sMailingAddress 7540 SUZI LANE� WESTMINS
owner'sName —SECURITY PAC. BANK pnone
Address 600 WILSHIRE BLVD. #500� L.A.
Arch/Eng. License No.
Address -
Contracror'sNama KIMBLE &�'n Phone 8 S—> > 5
Addresslmailingl 7540 R[T7.T 7.N_� WESTMTNSTER
CiryLicenseNo. ` 038503
LICENSED CONTRACTOR DECLARATION
I hereby af(irm that I am licensetl untler provislons ot Charter 9(commencin9
with sectian 7000) ot Division 3 of the Business antl Protesslons Cotle, antl
my �icense is in rw� �arcelasd ettect. 4609 23
�icens Cla s ceo e o.
",te� y S'9 t !fy}
RKERS'COMPENSATION DECLARATION
areby affirm that I have a certificate of consent to selLinsure or a certiticate
of Workerz' Compenzatlon Insurance, or a certitietl coDY thereof (Sectlon
3eoo, �ao.,�.>P88470897-0� FREMONT IND.
Policy No. mpany
� Ce�rt{itietl co�p�Y�+i�s heetl withrthehcitY 8�� In..$�DI i n..
�Date�` �T'�J APPlicant �//iM�/ �in�G
EXEMPTION FROM WORKE0.5' COfJIPENSATION DEGLARATION
(This seclion neetl not be completetl If the permit is for one huntlretl (5300) or
lesz).
I certity that in the perfOrmdnte Ot th¢ work fOr whlth thi5 p¢rT�t is ISTu¢tl I
sball not employ any perzon in any manner so as [o become subject to [�e
Workers' Compensa[ion Laws of Califomia.
Date Signature
NOTICE: If, after makin9 this tleclaration, you shoultl become 5uE7ect to the
Workers' Compensation provisions of tne Labor Cotle, you musl forthwith
tomply with such provisions or this permit shall be tleemetl revoketl.
GONSTRUCTION LENDING AGENCV -
I hereby affirm tnat there is a construttion lentling a9enty for Ihe performance
o( [he work (or which this permit is issueE (Section 3097 Clv. C.)
L.entler's Name.
l_¢ntler'S Atltlre55
OWNER BUILDER DECLARATION
I hereby affirm-ihat I am exempt trom the Contraclor'S License Law for the'
followin9 reason (Sec[lon 7031.5 Business antl Profe55ional Cotle: Any city or
County wlticM1 requires a permit to cOnst�uct, alter, imp/ove, tlemOliSM1 o� �epair'
•�y sVucture, prior to its.issuance, alzo requires the applicant for such permit
'ile a si9netl stalem¢n[ that tte/sh¢ i5 licensetl pursuant l0 the p�ovl5lons of
Contractor's Li<ense Law (Chap[er 9(commencin9 wlth Section �000) o(
�ision 3 of tne Business antl Pro(essions Cotle) or Ihat ne/she is enempt
theretrom antl the basis for the alle9ea exemption. Any vlolalion of Section
7031.5 by any appliwnt for a permit SUDjectz tne aOP��cant ro a civil
�enalty of not more t�an (ive huntlretl tlollars (E500).
I, as owner o} the p�op¢rty o� my ¢rn010yee5 with wages as thei� sole
compensation, will tlo the work, ana tne riructure h not Intentletl or otferetl
for sale (Section 7044, Business antl oro(essional Cotle: The Contractor'S
License Law tloes not apply to an owner of a property wno builtls or improves
[hereOn. an0 who tlaes such wo�k himSelt/h¢rSGlt or th�oug� his or he� own
¢mplOyees, plOvitletl that Su[h Improvement5 a!e not Intentletl or Otfeletl tOr
Sale. If, however, tne builtling or improvement is soltl within one year ot com-
pletion, the owner will have the bu�tlen Of P�ovin9 h0/She tlitl not builtl o� IT-
prova for tne vurpose of sale).
❑ I, as owner of [he property, am ezclusively contracting with licensetl con-
tracton to con5truct the pro�ect (Sec[lon �044, Business antl Protessions Cotle:
T�e Contractor's License Law tloes mt appry to an owner ot property who
builtls or imOroves thereon. antl who contracts for Such oroi¢CIS wlth a con-
tractor(sl hcense pursuan[ m me ConVactor's License Law). I am aware that
proof o� their WOrke�'s Compen5ation InSurance snoultl be p�ovitletl to rl�e.
❑ bam exempt untler Section . B. b P. C, for thlt reason
Date Owner -
I hereby certify that I have reatl Ihis application antl state [hat the above
Information is correct. I agree to complY �+ith all city antl county ordinances
antl state IawS relating to building COnStrucUOn, dntl hereby authoriie repre-
sentatives of tn' city t enter upon the aDove-mentlonetl property for
Insve�tlon p �es
Signature ,�� Date aa�-�i
Drivers'�License or 5 �
._........._. ....._..._. __..__. .,... A.P.#
C�8 /o " /o
S Main Buildi
�PE OF CUNSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER � 7 Front
DESCRIPTION OF WORK/USE OF BLDG. A Pear
TVPEOFPERMIT GRAOING FOUNDATION STRVCTURA� I C Right
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ', $ � Left
❑ �OTHER Ping. R¢f. #
PpOJECT DESCRIPTION 5�3. FT. OCCUPANCV Planning Notes:
CONSTRVCTIONTVPE VALUATION$ 4,330.00
ZONE GRADINGCV.YDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Drinking Fountains �
Floor Drains
Floor Sinks
GasService Outlets
Inrerceptars
Kitchen Sink
Lavatories
P—Trap
Roof Orains
ReinzpeRion Fee
$15
Duct- Under Ground
Duct - Strucaral
Duct - Ventilating
Exhaust SVstem ❑ Multiple ❑
Firepl/Fact. Blt. iC80 dk
Heating System & Ducting
❑o-100;000 BTU 0100,OOOBT
fleinspection Fee � $15
0865-46, rev. 5/88 WM1ite - Builtling; Canary - APPlicant; Pink - A<counting: Goltlenrotl - Assessor
Showers
Service Sink
Sewer (:ap ,
Sewer Connection
Solar Collecmrs
Solar Pipin9
Solar Tank
Swimming Poo� w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
Laundry Trays
' Isue Fee
Hood or Typel ❑
Canopy Type il ❑
Refrigeratlon Syscem
04100,000 BTU ❑ 100,000
System fiepair/Alteration �
Fire Dampers � �
Registers '
� IsSue Fee ^
$ 3
FEES
$ 3
Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Zone
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �Q5 KW �5-15 KW
Meter LJup [0 100 amps
Meter ❑over100amps
Sub Panel
Motars O0.1 HP O1 :5 - 8
Inc.Solar �9-15 HP �16-75+
Microwave
Pole Light
Range
Standing Sectioni
Trash Compactor
' Reinspection Fea �$15 � I laue Fee
DEVELOPMENT SER VICES REQUIREMENTS:
Zonine APP�oved By
BuildinB NPP/o�d By
Appliration IAued By
FEES
$ 3
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SUMMAjiV�OFFEES , �,�
1 1 L
BUILDING PERMIT $ � � SMIP $ _ j��
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PVaN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �
PLAN CHECK 25% $ .
0100027577-0002757E TOT ?44.62
6pTE: 03/03/89 TThE: 14:45
.. .. . ^ YJi. l . � . ., ._
CONSTRUCTION AND PLANNING •a F '. & SPA
- APPROVALS Permit # Date � Inspector ppPROVALS Permit # Date Inspector
1. Temporary Electric8l Service or Pole �.+� 52. Pool & Equipment Location
2.�Soil Pipe-Undrgrnd. ,� .,,� 53. Steel Reinforcement ��
3. Electrical Conduit UtilitY-Untlrgrnd� � 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. ElectricalConduit-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
71. Property Sewer Line & House �onnection , ��
_ 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final "
73. Roof Drains � 64. Plumbing System - Final '"
14. Rough Plumbing 65. Electrical-Final '
15. RoughElectrical-Conduit 66.�SolarSystem-Final
16.• Rough Electric Wiring 67. Fencing & Access Approval
17. Fough Wiring Sign 68. APPROVED FOR PLASTERING
18r Rough Electrical-T Bar Ceiling 69. POOUSPA 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 t_ 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Aoof Framing '1 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing . . 74. Overhead Hydro% 3a.8 e9
i
26. T-Bar Ceiling (Structural) & Monocoat � � � 75. Dry�Chemical'� '
27. Frame and Flashing , ��, 76. Dry Standpipe
28., Lathing & Siding -� � 77. FIXED SYSTEM FINAL g yy �
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 pomestic-Final
42. Backflow Preventer ,' �
43. Backflow Irrigation .
44. ,Landscape Irrigation System ,
45. Sound Attenuation `
46. Handicap Regulations
47. FINAL STRUCTURE & BUI�DING
48. Special Requirements Completed ,
49. Electric Release to Edison
50. Gas Release to Southern CaliFornia Gas Co . ;
51. CERTI FICATE OF OCCUPANCY
No Date �
�onncssaeumm� 555 ANTU:�I BL
1. o�vr,�as�+WE�Fa,w�m: SAI(IOkA FARMS
��% POI HOX 2097
l TERMINAL ANNEX
�vtt. Yuiv�+.00xEss:
�
�
y
uxr.
IOTH . CITY OF COSTA MESA - BUiLDING PEFtMIT
PEP,MIT NO: B 074631 PLAN CHECK NO: 03'72"1-95 A
CONSTRUCTiON TYPE: 1-FR PERMIT TYPE; STR
urcxnecron�ar+c�n: INTERIOR ARCH.2136232164 uc.ra: 9378
uaw.onu+as�oox�ss: S50 S HOPE ST uar: 1100
L.A. CA 90071
coxm.c,arsx.uE CAL-PAC CONSTRUCTION (310)645-35U0
CONf11ACTORSMAIIMG 6076 BRISTOL PARKWAY
.00�ss CULVER CITY CA ucra, 392102
90230 uNr: 106
LICENSE� COHfRRCTORS OECLAN�TON: I MmEy e11im wder penaly M pee'µy Np l em IcannG urder yovi�b�n d Cheqn 9
lcmimeiaq xilh SxYian 10001 d Dnuian � d Ihs B�wn md Adw+P� CoAs. ud mf' fiwms o in hm bw Nlw.
cm uc. No.: n uc. cuss: B � : q 21 �' = K P
Oale: / ` C �
OWNEP BUILDEP OECIAP�iION: I IwWy tllum vMs pxWy perjvy ihel I am eremq Imn iM Cauradm Limme lew la Ns
'4bv.+�9 reeaon (Seaion'lOJ�.S Bueina� vd Roleesons Goda: MV W a muM' Yhirh iWw� e De�mu to mmwn. ads. impove.
mdsh. a repei vry sWchve, p'w b n eaierce. a6o nawu �M eppliratl ttt pch pxme to fle a dpneE palamxu Ne� he a�M
&ereee w�M io �ne ao.mau d m. caarmae l;o.ns ler �cMqr s(oomm•nano .an seaun'l000) w oi.ebn s a �ne
a�� em naw4o coal o. mm n. o..ne m�q md� dd �ne n� ior m. an�.e �.�w:�. Mr •wmo� a sea�
)W 1.5 by mry epp4reru la a permu abpas �M eppfran io a cwi penehy d na mps Ihm frve himEmE AOAen �SS00�.
� I.eaoxrorMiMpW�YamYaMM��n� apnnUs�obmmO�.rTtloNeva�kudtlnevucYvewnd"v4entled
w dlereE la seb (�i� )�. Bumwv ud Pmfmaiana Code: Tlp Caqretlan liom�e lawdox not epply lo en owMr d propercy
..no wu. � m�o... m«�. w.m eo�.w,.on� m�,w d n.n., o, e.o� ne «ne, w„�.m�q.e.. ww�aw mm .Kn
impovemema va nd "mteMed a d1enE la aab. tl, howwer, iM WYdinp a inpwemM u�otl wnhm ur year d camqetbn, ihe
ow�wrbuiHw x{u Mw un Gvden d pw'vp M a kw Eid in Wdd a'vnprma la Na pvpma d aW).
❑ I. aa o�.ner d IM D�OeM. em urF�wM/ mmmfvq wuh fi estl mWecun b rmWutl IM PMa (Seaun ]OM. Bwiroes end
PIOI!l91M! COEl: TII! r.W 2tlM LiClltff LIw AtN M 4{�Y b N O'w�M N PWM�Y v/!D WOI�f Of NPD'/M IIsYn elld wh0
mrueecu la axS� prqws xnh e mmfmoHa) IiconaM Wnuem to Ihs CoNraCp� limva lew).
❑ I em uemq unEer Seclian: B. a P.C.. la Nw rwson:
Data: Owiw:
I do M�eW cMM IM1et I em awvs d aM WasWM IM nNenmeMa tl CeWarie IbN� ud SdalY Goda SWom �5505.25SV. erd
25SL. enE Net I a M' M1nura buiMvq 000�pem xi4 / wil no� (rscb ans) naeE io mmGh wih uid qete mAs� W ihs nVuirsmsm� br
eV�lamrevudionanwdifmiontrom�M�i e�t enepanamDivria.RaudMmlmmwunmofwiwouse�omdlmmNwa
Dda: �ppliwu:
WOFKEF'S COMPENSATION OECL�N�TION: I hweby elfimi xqor peiWy N pe�ivy py y iM IoOovriip detleretqna:
❑ inw.�a.a�n�.ane�.aoo�mio.w.�.i«.m�a:��,..awb.disas.a:,�s�aoam.�.e«
COG.Ia �he peAamencs d Ne rM la wlirJi ihia prmE u IsueA.
Q I hma eM xil maimen v.vM1en' oompenW ion im�renoe. m reywrsd py Senion �)p0 tl Ns LeEm CoUe.lor iM penormeroe d IM
W������pm���FIREMAN S UPPD ��u� EXPIRES
c.m.,:
Paerrnme« wN nu�ynuii 02/O1/96
(Thr1 senim nssd m� be mmpWd / rM n�'mr u b w nunNs� daPen �Si WI aW.)
� I cenN �hd in Jw pMormeree d iM wak la r.ficA ihu pem�C b�ueE. I WII nol amqoy erry pe�pn In em� memar p m to
become aEjetl to IM xarYen' mipe'umion lexi d C�W�� �o t wkw�'
c mpaneet pwi� d Seaion J]W d tM Lebor � �.
oe„ %a%/�ly'� �� .
Wem/n0� F�llun ro��cun NOMa�' mrryewtlon cavwap� I� Iaw�Nl, �M �lull µCJIc� �n Nnploy�r to cNMns/ p�n�l0u �nJ
clvll IInN ap b on� �uWrM fho�untl JMNn (JIQq000A F��n b N� ewf ol wrrpw�ufbM1 Lam�p�i u povldM lor In
Sxflon.111A6 0l M� LeDorCOW, Inhnaf. uM �ttom�Y'� /�u.
CONSiIiUCIION LENqNO AOENCI': I M1noby elfi�m uMr pmelry W perjry iMt �Mn u e eonpiud'pn bMiep epmey br IM
perlorme� tl �M xak la xfiid� �he P�Y u c�ued (Sadion �09]. Civ. C).
IEN�EN'9 NMIE:
LENOEF'S ADDFE39:
I cenih �hm I he�a naE thia WWiation eM aab ihet Ne ebova idormelian u omod. I qpe+io camdY wn� M mY eM couny adwnova
enC eiste lewe nle�mp �o Wikip conmuaion vtl twraEy aNlv've repeeenta�rvae d �Au ury �o amm upon ihe above�memionod poporry
�a��� �l/ / /J "7�Y S� 5 n�
- � �� oa�,: � d !� S
Sq�ure d Owixl�penVAppiranVCwreea
(St5Fa8.WP) W�ne-Buildvq85dery;Oeeeo-Fle;Cenery-Appirani;Nnk-Revenue;CaldenmG-Aexwr
PERM NO: B 074631
GOVT: N SJPP: id
PURPUSE: ALT
SOB UESCRTPTION : INTERIOR 20000SF OFFICE TI SQ FT: 20,000
CLAIM VALUE: 36,000.00 CALC-VALUE: 386,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
if 3E iE 1E fE E if if ih iE if iE if v'r iE iE # �f iF iE if �E ik 1E"iE ie iFlf iF iE iE if if 1E 1E 1E iE iE iE if ft� If 3f� iE iR IF 16 if IE if iE 1tlf if 1E # iE if fE iE iE # fE 3F iE iF 3E IE # �E if iE if iE # if 1E if
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING — -------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARI(ING REQ: PROV: PARCEL: 91050104 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR lOTH FLOOR FOR 76 PRODUCTS COMPANY
i __',
�E iE iE if it it� if iE ih ic� i4 iE iE iE iE if iF�f ir� f iE 9E iE fE iE 7F iP ii iE i[� �IE �If iE 3f iE �1F k iE iE �IE iE �1E iE �lb ib iE �E if IE iE IE iE 3E it 3E iE iE if iE * if i'r it 3t if �h it * iFif iE iE tt-�lt IE # if i(-�
D E V E L�� P M E�1•.T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ' • kC p DATE: S.b �_(���
BUILDING APPROVED�BY : ��) � DATE:
� /
APPLICATION ISSU�DjSY: �� lNl�- �� DATE: �� �(�
jfjfif�'�'if'jfi�'iF*�*jfifif�f{�'i�Yfifif�' �iF�ii� 1�1�i�{!if�'3fif3fjf'�iF?�* h �F i'%i!
LEGALIZATION:N F E E S U M M A hi Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 1,644.00
SMIP/NON-RES
PLAN 267.15 81.14
ISSUE FEE
BUILDING-DIV-> PERMIT ISSOE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 1725.14 0.00 267.15 1992.29 1992,29 ,00
REVENUE DIVISZON TOTALS--> COLLECTED: 1725.14 OVER/SAORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
1644,00 81.14
if iF 3F iE iE 1F IE �E 3E iE iE iE aE IE iE i(� 3E aE if IE iE iE iE iE 1E 1E iF iE iF Ik IF 1E iE iE iF if iF iF Y.� If iF i4 iE IF iE iE �E iE if 3E iE 3E iE 34 jE 1E if fE 1ElE jf iE 1f 1E �E iE iE it if 1E 1Elf iE iE 1E i� if if iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFC
SFC
SFC
QTY
2�0�0
20000
2�0��
I_�1���7 :i � ; �i ii ��7 d i
OFF-INT. ALTER TYPE I,II F,R. -AVEA
EQU-ALT COMM. SPRINKLER SYS -AVER
E�jU-ALT COMM. AIR COND -AVER
END OF FEES
UNIT COST TOTAL COST
18:36 367,200.00
.72 14,400.00
0 ,^"='-`` t:'.9?3''t �"a- ` - -
L,.,:. i0�'.S.'v: .- .. __
< � �. _ - _ -
C6NSTRUCTION ANO PLANNING ' .. �• POC SPA � �
% APPROVAIS Permit # Date Inspector qppROVALS Permit # Date -�Ins'pector
. �. �
1. Te�nporary Electrical Service or Pol.e 52. Poql & Equipment Location • "
2. Sqil Pipe-Undrgmd. , � 53. Steel Reinforcement .�
3. Electrical Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit�Undrgrnd. 55. Electriwl Bonding �
5. Steel fleinforcement 56. Rough Plumbing & Pressure Test t'
6. Electriwl UFER Grnd. 57. APPROVAL TO COVER�GUNITE 1
7. Footinqs 58. Electrital Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test '
9. Water Pipe-Undrgrnd. ��� 60. Backwash �ines, P�Trap, � Undrg.nd. .
70. Structural Floor Svstem � � 61. APPROVAL TO DECK '
11. Property Sewer Line & House Connection 62. Backwash & fiecepior-Final �
12. Sewer Cap • 63. Heater & Vent•Final
73. Roof Orains 64. Plumbing System - Final , �
74. Rough Plumbing . 65. Electrical�Final ''
15. flough Electrical-Condu�t 66. Solar SYstem�Final •
16. Rough Electric Wiring � 67. Fencing & Access Approval ..
17. ftough Wiring Sign 66. APPROVED FOR PL'ASTERiNG �
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning " FIRE DEPT. REQUIREMENT �
20. Rough Factory Firepiace APPROVALS Permit #
27. Ducts, ih Structure 70. Underground Hydro
22. Duets, Ventilaiing . 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Rocf Framing . 73. Undergrnd. Storage Tank O Gas ❑ Oil
.
25., Roof Sheathing � � 74. Overhead Hydro
� 26.,4T_.Bar Ceiling (Structurall & Monocoat I/J�� � 75. Dry Chemical
27 ,:�Frame and Flashing �/,�'Gii � 76. Dry Standpipe
-,�.: /y
1
28:ii„ thing'&-S-'.ding :" 77. FIXED SYSTEM PINAL
29. -Insulation 7$, FIRE PREV. FINAL
30. Drywall Nailing ��� � HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
�32. Electrical Power Meterf�nal 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Fina� Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Finai Factory Fireplace
38. Finai Plumbing
39. Water Service�Final
40. Gas Service-Finai
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landswpe Irriqation System
45. Sound Atten�ation
46. Handicap Regulations
47. FINAL STRUCTUftE & BUILDING // ��'6 /
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
1
�
�oonessa ew�axo: S 5 5 ANTON B L
o�vneRswweiv�u+avr+: SAKIOKA FARMS
�ooxEss pOI BOX 2097
TERMINAL ANNEX
MPL. M/JIWO �WPESS:
VNi:
�xcxnecroxe+aw�n: INTERIOR ARCH.2136232164 ucxo.: 9378
ARCN.ON ENO.'4 ADOIiE55: S S O S HOP E S'T uxr: 1 10 0
L.A. CA 90071
carm�cTaraxu�: SWINERTON 6 WALBERG ( 213 ) 896-3400
cam�craas�uiaa 865 S FIGUEROA ST
�ooxEss: L. A. CA ue, ao.: 9 2
90017 uM: 3000
110ENSED COMNAC70N4 UECL�fl�TION: I Mraby Nim uMx parWy d prjury Nq 1 am licensed wqer pwnb'u d CMpm e
(ewnmerc eq wii� Seeum 1000) d Orviaion � d tln &mima mtl PNa ' Code. uM mY fmnee u m IUA lacs eM allw.
cmuc.no.:04627� uc.cuss: B uc. : �z :XP: 0/95
�
o�a:��'� �1J ���
OWNERBUILDENDEC4flRT10N:lhsatr/dfumivdxpaWyd t lemaxemqmnl Caqeedmliee olewlattro
b0owiq �eefon (5eclion R1tS &uiw� W%Wudmf COM: W a MJrli VM�G IomroWcl. s.'vnpa+.
�md'sh. v repei em� aWLm. prior b tf e�ue'ae. abo �apio�m ihe lor weh pe�mC to e e'ryprd ptlsnatl Met M a�he
. ticensW W�� �o Na N�� W Ne Catlratla� limne lew� I�tiWx 9(mrvnmvq rrilh Satlion ]000) d Diveion 9 tl tb
Buf'vru eM Rdmaiom Codal ^r IIW M v tlr u ssemp IhaaM1am antl IM bafu la Ne eOepeE eaenplion. My vulelon d SW ian
)W 1.5 by eiy epWirani 1> e permn ubjw Ihe eppfirsm to e tlN pe'a!y d nal mas ihen fwa IwnNatl EaOer� jS500�.
❑ I.mowneed�MPWhYamY�WbY�rA�'.ape+ntheiWewmD��.MGAONeMvk.eMtMN'udursend"vurdeE
«dlaeE br reb ISecYon )Ou. Bu�mm md Rdsadms CoG�: TM Coruiafm lidue lnw�dou na nVDNto en oxwd pw�Y
.no ww. s mw� �n.eon. w.ro me..urn wn i:n.e «n«+N «waqn �a «n.r oM, «nWa�«. o� �na .ucn
imG�*mam ue �v iesded a aRSM la We. �. howwv. Ne hvlEi'q a inpow�M u wtl wvlim awYser d m�plaion. Ne
onrrWJdr wi0 Mn us butlon d pw"vq M a eAs d'd nd Nutl a'unpow la Ns pivpo�e d v41.
❑ I. n owror tl IM qWMY. em mAaalY mNrC'rq wbh 6canM MMapm b mibW IM P�olb 1Seaion ]OU. Buames� eM
PMemne COAe: The Caemaan L'cww ler Aoe� na eDMY b en ow�w d wW�Y Wc WY� a'viq�wm iha�on end wM
mnvacn iv arF p9a� w�0i e mvsaMU liwwd P�� b Ila Camrmu� liowa lew).
� I un exemq unEr Ssivi: B. 8 P.C.. br Nu �am�:
Dale: Owwr:
i ao nwenr �nM Nn i.m ....�. a w �,d..ww me �mm«m a c.uome wmn.�d sd+r ced. sec�. uws. zss�..�e
255�. vd Mm I a eM Mus dn'Idoq omqeM xN I wp nal (acb ons) �wd b canWY wi� uid Wta mEs� W iM �puinmama br
•W�IammUuctianamod&miontromtMAi�iy mepei�avGantl.RadJruWmmvaion�ppMm'vuraeaemqhanNe�s
a�.
Dvs: ApqiceN:
WOflKEN'S COYVp14AT10N DECUR�iION: I IwWy el(�m �Mr peuEy d pnjuy ons d IM to0or.irp Esdvalum:
� I heve eM xil meuuen � canfw d odusu to utlrvw br wvken' m�panmion. m pwitlad la by Saaion �lW M �M leEu
COM.Ia �M pMmnmica tl Ns M la Mirf� tiv panib h Wuad.
❑ � ne.�..ne xi� meimen.�wwn.• mnw�on:w,eenw. n mry'v.a M s.nim noo a u,e �m« caC.. eor ine w�+a�wn. d in.
wak fa whirA Ne 0�4 6 mued. My �mrFen' ion maverca wris W W&Y wmber ms:
�„,:,; AFTGONAOT EXPIRES
awryre„�w w� e� ]b]L1V774 08/O1/96
�Tnn .«ro, �.ea �or e. romderoe r rn. p„�i ;, ro. �. n�d..e eon... Rrool a�w.�
❑ 1 cMh tMt in ihe G�ormeres d �M �oM lor wt�itli Oiu W� b mwd. 1 tlWl nal amOM en Va+� in anY manror n m �a
becwne wbl� lo iM xoM1n�' canpaiueiion Isx+ d Callom aM eprm iAq E 1 �o come wEjw �o IM hoiMn'
riaeiian ylfid Sopion �1W d �M leEw Cab. I 1 t A wElp o 'i ms.
o�. `�6 -z6"w"� ��.
z
Wem/np: Fillun ro��cun woibri mmpwwtlon rovn�p� b mE �N/l •/cf �myloy�r ro etln vl p�n�ltln m0
nvu nn.. w ro on. nurer.e mouune ewrn (iralomA a iwn m. co.� o� ran am.o.. , pvHad ro• �n
S�etlan J�05 0l /M lMor Cob. In(wut ���mryY Iws.
CONSTNUCTION LENDINO AUENCY: I hanby effum uMv pwully d perjury ihet tMro u e conprvqion NMi�p apmcy lor IM
perlormenm d IM r.vrk M whiM t�e pem�� ie eweE (Sadion JOB], CM. C).
LENUEfl'S NMIE:
LENOEH'S A�UPESS:
I ceniN IM1et 1 heve reeC Nia Wdiwion W pms ihet iM ebo.a inlame�bn w oonaa. I Wies io mmON wnA M tltY vd munry wdinenoee
arM smta kwe Melvp b brildep cona4ucEon end heraby au1hW¢e reprmaNNivn d Iho cry lo aNer upon Ihe eDova.menloned pmperly
�« ��'P�" F ""°°'"' DAN CONROY
Dma: � L� N
8 Se1Ny:Green-Fb:Cenery-Appfcent;Pink-Revenue:GokavoE-Aseeeeor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 074704
PERMIT NO: B 074704 PLAD] CHECK NO: N GO�'T: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: ALT
JOB AESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC—VALUE: 20,900.00 CROUP OCC: B-2 /
COMMENTS: 76 ONION PRODUCTS PREP FOR TI
*�ar*at�x�**��*�*�****arft*�tit�tftat«��at*at�*�*****xx���ititir***it�*��ar***�t**#it���r#ae�**x*i4*ir*#
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: F'T IN
LEFT: FT IN RGHT: FT IN LEFT: F1' IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NaT'ES>
� . .
1E iE iE iC- iE �E 1E 1F # iE �)F iE if 1E iE iE �)F iE 3E ?F3E iE 9E iE 9E'1f -0E 3E 1E iE fE �lE �E 1E 1E iF �(-iE 3E �E'.E �E �F 3E 1E'lE fE'1E iE iE �f �)f �E �If �IE iF �IE iF iE i61E iF iE 1E i(-iE 1E iE # iE iE iE �lf if �)E # 3F if if
D E V E L,O P M E N 3� S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED'BY : DATE: �
APPLICATION ISSUED BY: �- DATE: ����1�,/�
iE 1E if !E 3FlE if if iE if iE 1ElElf if iE IEifi1E if IF iE �TF�FiFi��iF16 iE iE iE k 1E 1F 1E k if7��i�;tic�k !- �E iE
LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 432.00
PLAN SMIPqN09-RES
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 436.39 0.00 0.00 436.39 436.39 .00
REVENUE DIVISION TOTALS--> COLLECTED: 436.39 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FSRE SMIP/TOT GRADING PLAN-CHECK
432.00 4.39
'14 if IE if iF IF if if !F IE 1F iE iF iE iE iF IE iE �lElf if 3f 1E 1E 1f 1E 1F 1E iE iF iE iF IE 3F 3E 1E IE 1E 11-1E iF iElE iE!(� N� iF i41f� if 1E iE 1f 1E 1FlElElk it ik iE iE iF iE iE iE If 1E iE �f iE # iE 1E iE !E iE iE 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S,C R I P T I O N UNIT COST TOTAL COST
SFC 20000 DEMOLISH BY C'ALUE COMMERCIAL NOZONE 1.00 20,000.00
END OF FEES
07 0019�o,i�-i 019266E Te��'
DATE: iC!/2�'?5 i;FiE: '�7t?,i
CONSTRUCTION AND PLANNING PO(. . SPA
• APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector
1. Temporary Electrical Service or PDIe 52. Pool & Equipment Location ,
2. Soil Pipe-Undrgrnd. �- 53. Steel Reinforcement - ''
3. Electrical Conduit Utilitv-Undrgcnd. 54. Forms
4. EI¢ctrical ConduibUndrgmd. � � 55. Elec[rical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -
6. Elecvical UFER Grnd. 57. APPROVAL TO COVER�GUNITE ".'
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., 7est
9. Water Pipe�Undrgmd. 60. Backwash Lines, P-Trap, O Undrg�nd.
10. Structurel Floor System � 61. APPROVAL TO DECK ;
}1. ProPe�ty Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & VenFFinai
13. iioot Drains . - 64. Plumbinq System � Final �
14. Rough Plumbing `, I 65. Electrica6Finu1 - ---'
15. Rough Electrical-Conduit 66. $olar SYstem-Final _ -�
16. Rough Efectric 4Viring ' . 6). Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rouqh Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in Structure � - 70. Underground Hvdro
22. OuMs, Ven[i�ating 77. Product Piping OGas ❑Oii
23. Gas Pipe-Rough & Test . 72. Underground Flush
24. Roof Freming 73. Undergrnd. S[oraye Tank � Gas ❑ Oil
25. Roof Sheathing 74, Overhead HYdro
26. T�Bar Ceiling (Structurall & Monocoat ��%� � 75. Dry Chemical
�r�
27. Frame and Flashing I�p�� 76. Dry Standpipe
28. Lathing & Siding ,• 77, FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing / fC��'6 y� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Elactrical 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. Fina1 Factory Firepiace
38. Final Plumbing -
39. Water Service-Final
4�. Gas Service-Final
41. Solar pomestic-Final �
42. BaGkflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sou�d Attenuation
46. Handicap Regulations
47. FINAI STRUCTURE & BUILDING ri �y%Y6
48. FINALPLANNING
49. Eleccrie Release to Edison �
50. Gas Release co Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No Da[e
�
�I
ADOPESSOFBIIILpNO: SSS ANTON HL
°"'"EPs",wE"'°+ox": SAKIOKA FARMS
�oox�u: p0 BOX 2097
TERMINAL ANNE7C
���. �uiwo �oox�as:
u"T 10TH
,�xeNrtEcrox�+anun: INTERIOR DESIGN 213623218�� 9378
1qCHONFNO.'8/i00PE54: SSO S HOPE ST �r+T� 1100
L.A. CA 90071
CONIIUCTORB NYIE
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LENDER'S NAYE
�ENUEN'4 AODNE99:
I untly �Atl I hm neC Nu appfcmion W w4 tlW Ne �ba+4damd� u cartw. I pns lo mnply w�qh N ay ud oouMy pd'vuMw
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la'unD�N MD�s.
ERNIE VITUCCI
Pntl Nem�
�QNEST �- � sTr 9G�! om.: i��_
spiwwe d ormer��a«NAo�u�enor
,�(5151d6.WP) Wlwa-Buildvp d SefMY.O�samFJe: CenM'-�`�"�: Rnk�kwnus:0okorvod-Nn�mr
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 076181
PERMIT NO: B 076181 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
SOH DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC-VALUE: 339,625.00 GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION RE:1iB74631
*+�****x�*********��x ***x ***�*�*+t�r*+t+t**x ******x **�*�4*��r�+t+t*+�*+�*�rrt�r��*��*+�*������
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO;
PLANNING NOTES>
i
***�****����+r**+r+��c�*��r�r�r**�r**�***x�*�*��*��«��****�**�+r*�*�r*�+�**��*���+�*�r�r�***+�*�
D E V E L:+0 p,M E NjT S E R V I C E S R E Q U I R E M E N T. S
' � .i. .
ZONING APPROVED BY�" DATE:
BUILDING APPROVED;'BY�: L DATE: r�
I �'J
APPLICATION ISSUED BY: IiUIL � DATE: � ZG ��
it�t�rx��tit�ritititi�+�it+�x�f�itf��r*it*TF3F7F3F'iF'iF�F7F"iF"iF'i�"iFiF{FTF'iF'i�iF'{F47FRF'lFfF7FiF7F7F3F7F"iFTF3F�Fx�it**x��t**f�it *it
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,479.50 -
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 1550.82 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECHANIC
1479.50
SMIP/NON-RES
71.32
TOTAL PAID DUE
1550,82 1550.82 .00
1550.82 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
71.32
+r**iert*x x itit**�*it**�*itit**���t***x��x�+tx���r�*��tat*��*�r�*it**ie**�r+��*+�+r+t��it**�*�tet�t���rititit�*
I N D I V I D U A L • F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N` UNIT COST TOTAL COST
SFC 325000 T.I. OFFICE BY VALUE/$1 1.00 325,000.00
END OF FEES
CS C":; _-_ .i'.p7 ;-- ,
6a E'•�bt � •�' Tt{.-: _ :.
CONSTRUCTION AND PLANNING � _ POOL & SPA
• APPROVALS Permit # Date 'Inspector APPROVALS Permit # Date Inspector
i. Temporary Electrical Service or Pole .� 52. Pool & Equipmenc Location �
2. Soil Pipe-Undrgind. 53. Steel Reinforcement �
3: Electrical:Conduit Utility•Undrgrnd. • 54. Forms . �
4'�:�Iectrical�Conduit-Undrqrpd. 55. Electrical Bonding -
..5`�5teel Reinforcement 56. Rough Plumbing & Pressure Test
:�6� Electrica4ll�ER Grnd. 57. APPROVAL TO COVER-GUNITE �
"--��Footings ���. 58. ElectricalConduit�Undrgrnd.
8. Foundation = 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. • 60. Backwash Li�es,P-Trap,� Undrgrnd.
10. Structuran,Floor Syscem 61. APPROVAL TO DECK
11. Property'Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap. ' ' 63. Heater & Ven[-Final
13. Roof Dreins ', • 64. P�umbing System � Final
74. Rough Plumbing [*! . , 65. Electrical-Final ' � • �
15. Rough E�ectriral-Conduit ;, � 66. Solar SYstem-Final �
76. Rough Electric Wiring 67. Fencin� & Access Approval .
" 17. Rough Wirirrg Sign � 66. APPROVED FOR PLASTERING '
i
- 78. Rough Electriral�T Bar Ce'tling � 69. POOLISPA SYSTEMS F�NAL
19. Rough Heating & Ai� Conditionin� o c, r� , �. F`RE GEPT.�.REQUIREMENT -
20. �ough Pacto;�Pi�ace ;ir xf �- : p ; �'APP�ROUf�LS-.i� Permit # � � �
21. Dvcts� in'StruEturF; , " � . _ ,' - - � ,' - 70. �Undergr�und li��dro �
22. Ducts', Vi'rStil3tin9`-�> ,� _, r. �+�. 71. ProductPiping O�Pae �OIt
23. Ges PIpe�Rough & Test �� _ '�� _;* �± 7p. UndergrOvnd F,1'ush; . .
24. Roof�-fra�riing '� y�" - - ._,,`.73yl�ndergrnd.Storaq¢Tank:OGas ❑Oil
25. RoobSheaShing _ -" � ' �� - :` i��� 7�'�verhead Hydrn �_ "
-. . � .. _ � y � � . .
v - - -
26. i`Bai .Ceiling (Str�ct�ral) & Mn`aocoat !•J�/r'6+. 75:. Dry Chemical �� .
- " /-r- � . -- '- _ -
27. Frame and� Flashing• � '.-' r �%3S� 76. Dry Staridpipe r m x;,
� -r
-28. l.athing�'Siding a,.�' - '' ' �� ��� 77. FIXEDSYSTEIVipINAL � .
'r +
^29. Insulation� �• :.� l -. • 1_. ' 7�i, FIRE PREV. FIP}!�L i' ,
30. Drywall Rlailin� ' i_, ��� �f .- rHEALTff DEPT. REQUIF�EMENT
v.
; 31. Plaster B�waCoaL- > ' • y 79. FINAL I,N$PECTION r�
' 32. Electrical�Power Metgr�F�nal . � ' ��'. �� 8Q' FOOD CERTIFF�CATE I$SUED
�33. �inahEleci�ic � rv - � � - � Notes: � `�"; �� ' _
�-
_ ., _ _ ' ,� �.. � •, ,�i' -�
�34. Fina��,fie�ting'& A(i��o,nT,ditionirg ` r; � ' �� � , :'� , .
35. Final Gas Pipe.Test c 7 y • �' � : ', ♦. �
_ i� � �P _��r�,- ti iUQ�.�:�� '�.c�
36. Hood or CanoPY "'* �' ,; �' a r , �, - ,� , .. ; :,
- _ �_ �,_ - �-,-
� 37. F.inal Eaciory FirepJace .� �•'-� * ' � -
_ _ + -
-38. PinaF'Plumbing �"',. .• �� � , � - ..
39. Water Service�Final i � � � •�� ' � .
�F
: 40. Gas Service-Final * �^ _ - ^" : -�' -`:-'. '
- ' > .�
_�41. Solar pomestic=FinAl; , Y -:c. .. ,
42. Backflow Preventec' r - � x � '`- �!
� �; iH i K�- i• .w ^ _
43. Backflow Irrigetion;x r' , a; � � .
44. �andscape Irriqation'System �"��� ' *'� �" - ;� « �, ` ;: ; ,
r .7C- -i e C,.r �- i e. -
45. Snund Attenuation r -�4... + ` � r-� T���: r' . . • . •
46. Handicap Regulation5 �_ - '� .�, - ' ' "
47. PINALSTRUCTUR &BUILD)NG ^ +� . � •
� - `��/ �6 � -
48. FINAL PLANNING " " "?� >f � '�` ;
• �. :� ,; _ .
49. Elearic Release to Edison '� = .
50. Gas Release to Southem Caii(om'raGasCo � -' -'n? �
'l _ � Y i
51. CERTIFICATE OF OCCUPANCY ' � '
No. Dace
��
�oox�ssaeu�m�o: S55 ANTON BL
°""E�s"""E'°'a�w^': SAKIOKA FARMS
�oo�sa p0 HOX 2097
TERMINAL ANNEX
�vr�. �uwa �ooxess:
01f' 10 TH
uicxrtecTon�awvn: INTERIOR DESIGN 213623216��"� 9378
��"�'g"�"�� 550 S HOPE ST �"� 1100
L.A. CA 90071
wam.crars wua:
CQlRUCTORSYYIWO
,�no�ss: uc. ra.:
uNr:
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cm uc. no.: uc. cuss: uc. No.: EXP :
Dme: Cammor.
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c�«:
. Pdicy Number:
�m;s aecrro� �e.d �or ee cu*a�mee i rns w�� %+ ro. w�e nu�ema ediars Riaol w i..,..�
❑ i�nh mm �� in. v�om�vwe w m..on� ro, ��,ntn mm w�n re�uee. i.ndi �a emoM �r o� m arv m.��..o m m
beeoma wbl� lo ihe xoAwe' eanpnambn lewe d Ce4lanie. eeM epree ihet J I elwk baeonie aup�en to tM worlmn'
mmpameiun pmisbm d Sseion 3]W d tM labor Code. I dWl IUhwil� oomp�y xith tMn pwoiwu.
Dete: Appficeru:
W�minp: FiNun ro ucun workai �o�e.�wnon ro.e..o. �, �ml,.nn, .,�e.w� «npa.�.,,�yroy., ro�w p.�.ro..:m
nvn nnu w ro on. nuw.w rrou,.ro eorr.n (s�at000A M.m�aon ro m. eo.� or rnmp.n..nnn �+� u pora.d ror in
s«non aros or m. lmo. coa, �nrei.sc +�e.rcemwl �....
CONSTNUCiION LENqNO RDENCY: I MnW dfirm uMer panally d per'Fmy ihel Ihae v e miwwfion Imdiip epeM.y lor the
pOI�OTIBfICB d 1�18 Mqk �p W�IIC�1 I�1Y Veflll� M 6WB� ($BCIIGI'.109J. �iM. (�r�.
LENDER'S NAME:
LENUEN'S RUORE55:
I cenily Ihel I lave reeE I�ia epplcelim aM aela Ihet Ihe above inlormetion is cwretl. I eprea b comply v.iih ell ay eM muMy adinenoes
end eima lexe reW iq io W ildip ronmunbn erd hereby eNhorrza repreaentetivaa d iNa ary io enix upon iM ebove.memuried popeM
la impedion Durpwea.
ERNIE VITUCCI
E�t'ntEst— T\/i�c�� o�a: � Z6
sre�+��,e a o.,bdroaovnvn�ucem�a«
(5151�ae.WV) White-BuilEinp 8 Se1My: preen-Fle; Canery-RDM�C R�k-Ravenue: Gddenrob-bxemr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 076182 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE
PERM NO: E 076182
GOVT; N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION ; INTERIOR 20000SF OFFICE T,I. SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION RE:#874631 6 B76181
1F iE 1f 1f k 1E 1k fk 1k iE 1E 1k 1E ik 1ElF 1! 1E 1E 1f ik iE 1E iE i! fE IE 1E k 1f iE 1! 1E 1t iF 1E iE iE iE ii if 1E if iE IE 1E 1E 41E 1E �E 1E 1E 1E fE 1E 1E if 1FlE 1E 1E 1E iE 1f 1F ik 1f If 1E 1E 1E fE iE iklE iE 1E 1E
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i "�
1E 1E 1E 1E 1f' 1F iE iE'IE iE 1E 1E iF 1f 1k if 1I� IF iE 1f iE 1E 1E 1F iE 1E iE iE iE iE 1(� 1E 1E iE 1f iE iE i(� iE 1E 1E 1E iE 1F 1E 1f IElk 1E 1E 1ElE 1F �F1E 1E 1f' 1f iE 1E IE IE 1E 1E if iE 1E 1E if 1E IE IE 1E f! iElE iE fE iE
D E V E L O P M E N T S E-,R V I C E S R E Q U I R E M E N T S
1� .
ZONZNG APPROVED BY DATE:
BUILDING APPROVED BY : � DATE:
APPLICATION ISSUED BY: .1 DATE: � 2Co ��
iEik1E*1E1EiE1ElElEfE3EiklEiEiEiEiE1EiE1E1i IEiE1E1EiElflElEifiF iEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 139.20 ,
SOt� SMIP/NON—RES
PLAN ' �
ISSUE FEE 15.0'0
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 139.20 15.00 0.00 , 154.20 154.20 .00
REVENUE DI�'ISION TOTALS--> COLLECTED.: ' 154.20 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC•.. FIRE SMIP/TOT GRADING PLAN—CHECK
154,20 �
iF iE IE IE 1E if if 1E iE 1E if 1E iE iE iF i61f 1E iE iE iP iF iE iE iE iFiF iF iF it iE ik if iEik iE iE iE iE ik iE ik it i! 1F if it iF 1F iF iE it iF iE iF iF k iF fF IF iF 1F �1F iF iF iE iF iF iF iE if iF iF iF 7E if R 1F 4
I N D I V I D U A L F,E E B R E A K D O W N
TYPE
ELE
ELE
QTY D E S C R I P T I O N UNIT COST TOTAL COST
20 RECEPT/OUTLET 1'ST 20 EA. .75 15.00
276 RECEPT/OUTLET ADDIT:IONAL EA. .45 124.20
END :OF FEES
D1 aDi�9: =�- v2Fr�29� T�T I.?a.20
6A1�: U1%_�/�.5 rjr.c� i�:�3
/
CONSTRUCTION AND PLANNING POO� s SPA
� APPROVA�S Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporery Electrical Service or Pole . 52. Pool & Equipment Location . .
2. Soil Pipe-Undrgrnd. i ,53, Steel Reinforcement •
3. Electrical:Conduit Utility�Undrgrnd. , 54. Forms .
' 4.,Qlectrical?Cond'uit�Undrgmd. 55. Electrical Bonding ' '
5. �Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd, 57. APPROVAL TO COVER�GUNITE .
=7. Pootin9s :�- 58. Electrical Coaduit�Undrgrnd. ` �,
_ 8. Foundation:' 59. Gas Pipe, � Undrgmd., Test �
9. Water Pipe�Undrgrnd. 60. Backwash lines, P�Trap, 0 Undrgrnd. "
10. Struttural Floor SYstem 61. APPROVAL TO DECK
t t. Property SewCt Line & House Connection 62. Backwash & Receptor-Fina�
12. Sewer Cap.. 63. Heater & Vent•Finai
13. Roof Drains � 64. Plumbing System - Final
14. Rough Plumb�ng 65. Electricai�Final �
15. flough Electrical-Conduit - - 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Appro�al �'
. 17. Rough Wiri:ig Sign 68. APPROVED FOR PLASTERING �
18. Rough Eleci?ical�T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rough Hea[ing & Air Conditioning _ , PI�iE�DEPT.�EjEQUIREMEPtT
�Tl.�
20.�ioughFauoryPir�pJace ��r' � : �� � �,_.t;APPRdVALS';.,Pekmit# � ^.
.- '-
21. Ducts, in STrubture^. ' . .. - • .' '-' T � . 70. 'U�dergroun� Hvdro ��
22.Ducts,'Verttil0ting:�• � ' : � , L,�,�77,ProductPiping�lGas �Oii
23. Gas Fipe-Rough & Tost - _ . �T+ y ¢ :� � � � 72, Undergrd6nd FW4h' ' ` -^
� � .� >
24. Rbof�Fra�itingn' � , '� - ; � r .�x 73�.;Undergrnd.Storag_eTank�LlGas ❑Oil.
25. Roof SheaShing �� a` � v � -> ����Y � 74:� Overhead Hydro-. �
26. F�Ba� Ceiling fStru�t�ra1) & Mohocoat W,. T-' �`'* " "`�`'
. „ ��,, 7r:•DryChemical ;•:i.,
27. Preme and. Flzshing• �� ��':� e � •r ?� ^� 'I6. Dry Standpipe � "�''
i
28. Lathing&.Siding � �, � r;�,-' `; ,�. ` " "�. 77,:.� FIXEDSYSTEAAFINAL _ ��
29. Insulatiom � .r � = ;.� , ` 7 - PIRE PREV. FINAL ` ,�'
30. Drywali N�ailing �,, r_ , K `� �HEALTW�DEP7,. REQUIREMENT
37. Plaster Brawn;Coat �- ' � 'r i�-79JFINAL INSPECTIDN• y y -�
32. Electriwl.Powe} Met�jt•Final ;`� � � B0.'''+'FOOD CERTIFfCATE IS�,�,S�FED_,
• 33. Final Electric, : r -�! i 1_3r-� Notes: �c �7 i- _ -
�� �,�
•34. FinalFHeaYrng & Air�C'onditioning =� � � � v � ,� j� i ' ,.'=� , '
�T
�=N-� �; ( (�._ � D._ - - - - �
135. �nafG`as_Fipe:Testrg - . F ti � � , - ,
- - -.��'��,4��i - -(/�� � -
- 36. Hoodor C�noPY _: � .' � . ' t r � ��� ��"` J_l�elJ-1'4��C� '__7�
r�
_ -� � -
37. Flnal'Fac}ory FfrePface � . �_ r ,,, �i� . � . 'ru �
38. Final�Plumbin9 �_; � - . f -' H ' -
'39. Water Service-F�nal; � -. ° � ' � _ .�_ ' �
_' 1 " � . F [T1�_
40. Gas Service-Final • T ^'c*' ' �'� C� .�
m . -�: ?
�41. Solar OomestiaPinal� � ,. � � ,F , - ;, _ -
42. Backflow Preventer c� • - �
.�-.r- « + 'r-
43. Backfiow irrigation , � "` � - a � � � � � .
_ ,-
44. Landscap8-Irri9ation System �� `• '� + ��� �- � ' ' � ?��� ' �•' �
-a� C Ct - v. .}r-
45. Sound AttenUation '� ,�T �. ~ F R° ' n . F� K
s
46. Handicap Reguiations�� � �� . + • u, S . �� S �
x - '
47. F1N/tL STRUCTURE & BUIL'D4NG . ,' � �.
9
48. F.INAL PLANNING � ' ' - * ' � �
x
49. Electric Release to Edison � *;~ :i .�- X .
50. Oas Release to Southern California Gas Co ' -� -
- . . �
51. CERTIFICATE OF OCCUPANCY r � � �• � • ' -
No Date
�
�
�
�noxEssaeu�w+a: 555 ANTON HL
m�m�qsxu�EiF�w: SAKIOKA FAAMS
��Eu POI HOX 2097
TERMINAL ANNEX
li]PL. WUIING 1DOXE54:
�� lOTH CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 074730 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: PLU
�N��Tape+@+� INTERIOR ARCH.2136232164 �� 9378
urcxon�++c•s�oox�ss: 550 S HOPE ST urar: 1100
L.A. CA 90071
���T�g� CONTINENTAL PLUMBING INC f909)360-8300
CONf11�ttOR3N41➢l0 11165 THURSTON LANE
�noxess: MIRA LOMA CA uc.ra: 399073
917 5 2 uxr:
LICENSED COHfNRCTONS OECLAXATION: I M�eEy eRim uMs peepuy tlW 1 am fo ed ivdm poririan d Ghapr 9
(oomme�vmg vrilh Seclion ]000) d R.'nion 3 d Ne BUYneu enE P de. aM my li ene i in 1� brte eM eXetl.
cmuc.No.:027563 �� ��% C 36 N 3 07 EXP, 9 96
o�, �d � ay� �.� ��,�a
OWNEN BUILDEN �ECIANATON: I MnEy etfirm uMer penNy d per'�vy I em eump tmm ihe Coruieaon L"oenae law t« tln
Idbxiq rsamn (Satlun lWls &niwaa md Prdmeu�u Cade: My vy a wuM' xliidi iW��M e M�A to arntrucl. eCa. inpore.
lemdoh. n rapei mry aWCYuee. pia w u u�uence. ebo reQu'um Ihe epp4rem fa wNi pa�mu io file e vpned swemeni the� M a ahe
m IiwruW punueN to iM pv+uiom d Ns Can�mas L'xeme !aw IClupv 9laommenmq rMh 5�
BuimfS eM Holmidv Cadel or Ihel M n the o e�emq Iherehan enE IM be�ie In Ihe eOepeE u�
]OJ1.5 by ury epplreM la a permG eubpf� �he epplirem to e tlH perWry d np mae �hen fxs huMn
❑ �,eaown.raineo�v«mremdw.e.wAnweae*..ine:.d.comwnealion.winaom.woni.
or oflered la ede (Saaion )01d, Buiroa eM PMevvma Code: The Comredon l'rarua lew doea
who buiEa n inpwes �Mmm. eM Mn does vuM xvrk himnell «Mnel a ihrouph he a Mr ow
mlinlendetl
PERM NO: P 074730
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H-2 /
*�+Mr+Mr**�+Sr�x�*****����**��****r�*�***w**ir***+'t**�****�r*�r�r*�*�r*�x�r�r���***�r*�*x*�rx�***
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REA� PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNZNG Ni51'ES>
i
IE iFiE iE iE If� 1F iE IE IE If 1E IE 1E iEk 1F M 1F iE iE iF N 1@ II� 1f 1E 1E �E iE 1F IFiE If 1f 1E 1k 1F iF if 1f 1E If 1f 1F1f iE 1E1E 1iM iF 141E 1F iE 1F iEiE iF 1@ 1k 1f 1f iF i! iE iE iE K M iE if iEM I@ 1F M Ik
D E V E L O P M E N T S E R V I C E S w R E Q U I R E M E N T S
impwemewuendimentledadlaedfaveb.X,howawr,tMbuikiipainqwemeMiswNwilNnaroyeerdcanpblbn,Ne ZONING APPROVED BY �� DATE:
owner-0inNx xiY Aeva tM duden d pwinp M or ehe Ek nd duk m"unpova la Ne purywe d eeb).
❑�. e. u.n« a �ne ww.m..m..�v�dY odnrau:n M;�n 4oruea mw.�+a. b canww �n. wd.d (seaion 1a.. ai.ine...na .'�('\
rwu�.cas:rn,caro.aa.u�,»�wme.�aawN�o��.anw.�r..�wm,«�,c.>...m..�.m..m BUILDING APPROVED BY : 1 DATE:
mnlrecb tor autli ptqeUf wGh e wM�epor(e) lironeetl Wnuanl lo Ihe Conlrodon lironee lew). 7 '-/
❑ i�a.����a«s.c��: e.av.c..�«m�.�,: ApPLICATION ISSUED BY: ' DATE;�O '1-�I
oe�e: om,a.: +�x��+rx�x�x�+rx�x�+r�rx�x�*�r�tx�x�*��t x��r*x�x��r�r**x� r*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
I do heraby cMity IMt I em ewera d ud uMeratarM �M �puiremend d CelAomie HaeAh uM Selery Code Sed'ana 25505, 255]3, eM
255JO,erdMetlarenylulunbuiNi�pomqeniwill/wllrwi�tlrcbam�neediowmptywiheeidewecodnvdthem�uinmmbbr BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GAADING
.n.nn�rn.ra...rn�n:.�nmMRrwtimMmiMAr u�eiv.Tareoemen�Oiew.Mui�n�ialmn<nrfnna�nFiaivuaww�wmnlmm�Mvn
oma: noa�c
WOFKEF'S COMPENS�TION DECL�NpTION: I hemby elfiim undar porie„y W pe1jury aw d �he tollowi�p Eecbretone:
� I heve end wil meintein e cerlGicele d mnaent io �aHinauro lor xaken' wmpenation, m 0�� �a by Setlion 3)00 d tM labar
code, iw in. rodo��� d in� �n m,.w�n m�, v.�,�u �, �..�ee.
❑ � neve ena me meime:i won�en• canw�mo� imureze. m�.a�b.e M s«�i�n a�ao a �ne �ee« coee. ror me w�«mence a me
work fa w1iiN Mie pamn u inued. MY waken' mmpenambn inwraMe rarier ud pdiry number ua:
c�,: CNA EXPIRES
Pary N�me«: �(S'�T9"36T3T— . 0 7/ O 1/ 9 6
(This eection neeE na be cwnWeroG f tM pemiAie M orrs nurrdred ddl.n Riool w bag.)
� I cen'ty ihel in tha pMwmer¢e d tM wak la rfikh ��ia pe�mn n ed. I e1Wl rwi ampby siwn in y mannr ao s9 ia
become eubjw io Ihe woM1aa campeneetion kvn d Cel , en aprea t J I eb� k E come wbjw io �M warken'
compenulian qwiaum d Seeion Ji00 d iM leEor CaEe. I I with w x4h 1�los o aiwu.
o�.: (�9 �r�y —�� ���:
Wamlip: Feflun ro ucun wo�lren'romp�u�tlon rov�rp� Is un1�rN1, e ilull uE/�cf en Mnplqw ro a/Miul p�n�ltlu �rM
clv/I flnss up ro om �1nsrstl fhouxnJ EWNn (JIOq000J, M Wtlltlon b• ew! o/ ro�lbR denup� u proHdW br In
Sxtlm 9]P6ol M� LeborCoM. Intxs�f, �M�ttom�y� Iww
CONSTflUCTON LENOINO AGENCY: I MraW �mi uMer penNry d perjury �het �Mie o e connruqion IeMmp eyenry br Ihe
peAormema d tM hak la xhirh thm p'mY o iaued (�� �]. C'v. C).
LENDER'S NRYE:
LENDER'S �ODRESS:
I eenJy tAm I hew rteE No eppl'raiion eed uNe �lul ihe ebwa iNamelion o oonad. I epna io eamply wuh N rmy ud owvay ad'varcm
end aW e lewe reWiq W buikiq cansYud'nn e�d Mreby eulhp¢a iap��entNivp d Ihe dly lo eNa upon tM ebo.e�memonetl piopMy
�«��'�°�� RP�Y�THORNTO� . .
fi
� � �
� 1 � a— otl. j���
mn,redo.,bn.bew�ppimn e.e«
(5151<6.WP7 Whna-Buikip 8 Seley:OraerFle: Ganery-�ppireni; Fnk-Hrnnue; Ooken�o�Rsnvor
PEAMIT 42.00
25t SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 42.00 20.00 0.00 62.00 62.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 62,00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
iEiFiflfiflfiFiFlfiEiflFiEiEiFiEiF1EiE18MK1E1F1FMIfKKKiEiEKKK1E1FiE1FiflFifiFlfl@1E1@IEiEiEiflflFiFiFiEiF1E1E1FiEiE1@IflfiEiElEfFMiEiE1EiE1Eif11�ikK
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
PLU
PLU
PLU
2
2
1
1
D E S C R I P T I O N
SINK .KITCHEN
WATE�t HEATER AND/OR VENT_
BACKFLOW PREVENTER
SINKS, FLOOR
END OF FEES
UNIT COST TOTAL COST
7.00 14.00
7,00 7.00
7.00 7.00
oi acis�-,s.�ni?z�as r „-a- a2.,0
DA?E: ?:�,:0!'+5 Tii'�: d.".:2; ,
CONSTRUCTION AND PLANNING POO� & SPA
� APPflOVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporery Electrical Service or Pole 52. Pool & Equipment Loca[ion, � --
1
2. Soil Pipe�Undrgrnd. V 53. Steel Reinforcement
,
, � . ..
a;�'iEfectricai�ond�GPHtility�Undrgmd. 54. Forms -` • < '
,:��ectrical�d���drgrnd. 55. Electrical8onding . F .
, eel Rei�accerrtetx0 � 56. Rough Plumbing & P�essure Test C -
'`Q'�.�^,�Iactrica�Ef�'n"ti. 57. APPROVAITOCOVER-GUNITE
g'�Footingsnp; p. 56. Electrical Cond�eUndrgrnd. �- .
�' 8. �'oundatio,t� jS °y' � 59. Gas Pipe, O Undr�rnd.; Test
9. Water Pip:g�UndtS�l�g,d. r� ' . 60. Backwash Lines, �Trap, L, Undrgmd.
- �.
10. Structura.Y�'Floo �tem '� " 61. APPROVAL TO �CK - �
11. Property�wo���ne� Hous�Connection 62. Backwash & Receptor-Fin�i �
12. Sewer Cap. C� t� � 63. Heater & Vent-Pinal �
.y
13. RoofDrains o,., . � 64. PlumbingSys[em-Final"`
14. Rough Plumben9 ?; - 65. Electrical-Final - -
75. fiough Ef`ectrical�Co�uit 'J' � 66. Solar SYstem�Fj,��4 • '
16. Rough E ectric ��rin;� � 67. Fencing & Acc6S2�pproval
17. flough Wiriny 5�� y- 68. APPROVED F�PLASTERWG _
� 18. Rough Electric�FiT Bar Ceiling � 69. POOL/SPA SYSTEMS F1NAL �
19. Rough Heatin & Air Conditionin F E T. EQUI MEN
,::, y n. i csi ao� r u o r a��� � � � crc* m
20. �� -y �C r•. � >+ •:^- 7
ou�ii F tor Fi qlace i SM x .- S F:, p�# App�V(fi��$.y_ Pe,�mit#_z���
21. 9uct^ in�tru�tur�'� �..�.. � Y S O �"�* 70. �,inderg �{� Fi�dr° r
:� ., n*
22. ~uc� V til in -�r � fi
,� r�� 9rox � �i O S� E•t , 71. ProduWP,ipin9 �8as CZlOiI
23. �res Ripe•Rou� & TOst ' � [* *^: � '�: C* F' 72. Undergr� 1u1 FLSsiI � �
24. �oo�Fr ��n .• rox � F•-+ s? O a, * .. t,c fi -
�� g a �•[n � �-y� . 7. Under9rt�i. Stoca�� Tank•O Gas ❑ Oil
25. Roof�6h�thing =* 'Q vvY'� p:> :vX 7.�?OverheadHydr�p, %
26. �y�BAi„Ceiling (Str�t�iral) & IC��x[�aoat * � � '�; � � ~ "' `;
t. p r p. 7 Dry Che�ical E,-• � �,� .
27. Frame an�: Fiashirg�r �xcC x a� >+ �* 76. Dry Star Ffpe Fmcn fi� ;V ��. .�
28. Latf�'ng �Siding �R" p��x., O �� N 7r� FiXED¢1�STEc��rKyawAk r, n zx
� 29. Insulation+ n' S '• * � �* 7 9�IRE iiEV. Fj�L *'' � `�`� �
�' r+ta K Cl F G
30. Orywail i$Biling 'Lx �..� � k p., � Soti oci5t'sAIT�,DEP�.�RE�UI _
� 37. Plaster BGown'Y'waF'• S �[^t*� * � 79. FINAL I�I�PECTAIN * �^�
ra x
" 32. �lectrica�pov�r �rrF�ai � � �' I x' 8(!,j F000 CERTIf��,'l�TE I�S�IE4.1
i .., � �'
' 33. na�Eleptric� t !Tf i r: � 'x � N'�tes: `? `:m * "� O Q �
�� 34. �FSna��-le�jng� Afi�oy�dtioriirt;S C� � � S C�Z * S _
�*; C : ! ; H i F �2 [n
� 35. �nal Gas`3ipe.Te�. p; .. # r-i �� xo �..-. *~ F t*'
am
� 36. �ooT�'or P'hnoPY a s �Cl � �c�C�,-y.7 ,6. �.KK C'� �Y' i*1 no � � ;mri
37. �Finai:Fa�ory F�replace �x i,��'-= r� s�� x x a%
T �
38. Fina�lumbing � K "� � `. '� """" ��'�� > ~' � �
wx (r7 1 O t�� �� r :[ '%
x �- .
39. Wat�Service�Final �- g � * tr :n � i
. in xc m
X[*1 '4 i" C*' S * R7 '{. Q'�t .^. li r
�.40. Gas Service-Final }. ��� � � � F• oE �c e;
41. $olar Oomestic-Fina� ;,; �� * � � -yo * � �
42. 8ackflow Preventer r !v � � � %F * `� "i
* n; ��; �-; x. r-, � m tn O t. r-.
�43. Backflow Irri�qtion M y- * rx * � i s ;� • • • •
. . � coGc
Ai3. Landsca�'�Ir�ation�ystem'��`"•n x �R m `� " O � �' �: `t' xr � �� 000c.
+ D T. !'7 # 6�C � x i: E � O� * S i^
�5. `_'.ep� und P.iten�2tion x y..�. r: m m m r. .� m o' Q�• FO *
..r
48. Flandicap•RegalatiorS ^-� 'J K # a S Oc S r
Y' S I [Tl O f: �*
67. hINF,�1. STRUCTUR� & BUIL ING * f,
48. EINKL PLANNING.' � "�' y "�
'' �jeci�c Relea"se to E�ison
. 4�9. i i.
50. GSs R'elease to South'�rn Califor��,as Co .*
51. CERfi'IFICATE OP QCCUPANCY -
No. Date
�� �
' !' I
m
; r n:
t a �;
� �K �
r • S
.7 • O
pC
-,:-'
aa'vV�
OU00
�
i.
'I
�
�ooxEssoveunm'c: 55S ANTON BL
«mEasx.uE�Faa�m: SAKIOKA FARMS
�� POI HOX 2097
TERMINAL ANNEX
uv�. �www �oox�ss:
uNr:
10TH CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: M 074658
PERMIT NO: M 074658 PLAN CHECK NO: N GOVT: N SUPP: tJ
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: MEC PURPOSE: AL3'
�xcxnecTonvaw�x: INTERIOR ARCA.2136232164 �� 9378
MCN.OP EW:.'S IDDNE55: S S O S HOP E S T �M� 110 0
L.A. CA 90071
ca�m,�crarsruwE AIR CONDITIONING COMPANY ( 818 ) 244-6571
CONIPACTORSYNNA 5265 SAN FERNANUO ROAA
�noxcss: GLENDALE CA uc.no.: 120696
91201 uxT:
LICENSED COMfflACTOq4 DECLAPATION: I heieby ellim uMm penelly W pe�jury thet I em Icavad uMw pwisms d Chaqm 9
(mmmendiq xilh Section l000) d Dirision � d Ihe B�aiirea eM Protmaima Code, ard my licenae b in /uA law eM aHaa.
cmuc.No.:0149U3 uc.cuss: C 3(yFNo.: 120696 EXP: 07/96.
Dme: �/1 /11�9i treaa: ) /
OWNER BIIILDEX �ECIARRTION: I hereby elFrm er penetly d perWrv �� �+m esemq /mm iM Conlreda iun e lew la iM
Idbwip �aawn (Setlbn )W 1.5 Busmss vM PMesaiwu Gode: Airy ciy a ooumy v.fi'rA requiree e parmn ta eo t . Mx. impove.
�mdoh, ar repei eny �vuclure, pia io ire uweMe, ebo rapuirm IM epplicant la vuc� pamM1 lo file e upneE �lelemem I�et M a eM
licerreed 0���� �o �he proviaione d ihe Conireeon Licensa Lew [Chepter 9(commend'p wBh Setlon l(p0) IN DNbion 9 0l ib
.ueinw eiM RMeaeiona Coda� a ihel M w eha ie ezemq ihsehom enA ihe basu la tha elbped ssempian. My violelion d Sed'nn
]W 1.5 by eny apqiceni la e permn aubpan ihe eppl'rau io e avil perelry o1 M moro ihen Ma hundred ddbn �55W��.
❑ I.eaowiwrdlMproperlYamY�VM��hwepeamNxwlemmpenselion.willdolMwork.anAtheevuctunemiiniandW
a ollereE br ade (Senion )Oa<, Busirwu eM Prolaesions Code: Tha Comreaan Lixnee Lew daee nM eppy�o en ownerd propery
wlw Wlda a inpwa iharean, ud vAa doas euch xah himceX w heneY a ihraqh h6 a her own empbyxe, providW tAm euch
impwcnmU ue nd inbMad a aH«ed ta seb. tl, lawe�wr, the buitlinp a inpwernem b eoM rmNn pr yeer d mmprion, tM
owMrpuiMx will heve IM burEen W qwiiq M or eM EiE nol buik or improva la the W�+s d pb).
❑ I. es ownw d ihe popeny. em ewtlueivMy oonireeirp wnh licenaed canbac�on Io wnetrud �he pmjetl (Seeion )WI. Buainro� eM
Pmloduu Cade: TM Comrmaa licenae lew does nd epply to en oxw d poperly xfio Wilda or'vnpovm iherean end Mho
canvecla la wdi popda wM a awqeadw�s) licoiwd quaueN to iM CanVanus licenea lewl.
� I em axamp unEer Senion: B. 8 P.C., br Ne �eeaom �
I do hereby uNry ihe� 1 em ewars d eM uMv+taM tM rpuirema� d Cellanu FbeXh eM Sdny Cade Seeiom 255p5, 255]J, vd
255J1, eM thel I n ury IWure dukmp oxupaM xill / wil nd (ercb me) neeA lo canply wih eaid qala codes xd IM isyuiremenU Iw
eD�lawntruclionamodScmionhwntMAiZ�y enayenimtOiYrid.HeddaNidame�MionePO�bmenaremqhom�hete
po�irioen.
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNIODI PRODUCTS OFFICE TI, RE:#B74631
���*�t+F******x�**�**#************�*****�*�****-�it�t�*******jtat**��x-�***�t+��x-**�**�-**�*�
Z O N I N G R E Q U I R E M E N'C S
S E T H A C K S
------------ MAIN BUILDING --------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT' IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
yPLANNING NOTES>
v � ✓
� iF fE iFlE jE iF iE 3E iE 1E 1F iE iE iE �E IE fE 3E iE 1E 1E 3E iE �E 3E fE iE 1F 3E 3E iE IE iE 3E iE i(-fE 1E if iF iE 1F iE3(' if iE 3E 1f 3E if ff 3E iElE 1E 1E iF 1f 1E iE iE iE 1E if it iklFlf iE iE 9E iE iE k!E iF jE 3E
� D E V E L O P M E N T S E R�V I C E S R E Q U I R E M E N T S
.✓
{4�ONING APPROVED BY �� DATE:
�HUILDING APPROVED 8Y : �` UATE:
/� ,
�APPLICATION ISSUED BY: T � DATE: �DI�q �✓
3E%3EIPiEiEiEiFiEiE3f3EiE1E1fdE161f�E�FlfkiF�E��iE�f�E7F3EiFiFiE����EiF1Z-�E�3F�FiF�F i��f��f�i�i�{F��3ElEif3EiEiEjElEiE3E 1E�E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
ov.: �vw�:
wonKens eowras�non oEcun�noN: i n,..er �, ��a« o«eey w��. a m. rom.;�y a.d.�m:M.: PLAN
ISSUE FEE
❑ in,�..�em��m.:�.�.nn�c.doo�im..n;�.ro�won�.:���.a,awdea�«o-is.ema�oodm.�.n« BUILDING-DIC�-> PERMIT ISSUE
coae,�«rt»�n«�Kedua��«w�nmao�un��d. TOTALS----> 106.00 15.00
Q �M1m.udwJmmmen.a.a,�mmV�iomm�„e�.e�Gwredbl'Sar,ian�,UOarta�.ba,CaA..bJwG�«m.ro.d�lr
.. waF Iw x�id� Ilw V�n u iaaued. My wvken' canP�%mbn inwirenca wrw ud paGry wmber ms:
106.00
25�
15.00
PLAN-CHECK TOTAL
0.00 121.00
SMIP/NON-RES
PAID DUE
121.00 _00
c.�,: CONTINENTAL CAS EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 121.00 OVER/SHORT: .00
� ranrwmn,r wr tu iti� ax vti LO/O1/96 BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN-CHECK
rrn�, �;.,,� �.e,�w e. �,w.�ee i� v.+�e a ro. a,. n��mw am� Is+ro� a w..� 121 . 0 0
❑ i cenh u� �o ine rono�,n.00a a ina .on� r« .,n�n mm o.�a n�.a. i.wi �n «�ww Yn v� ��v m��« .o m m
n«o�Wq«+�om.wd�,•��m..ac.rao�„�...m�,mmei.rowew�o��..�.�iom.wna.� rt*i�***�t**x��t�*i�******it****�-*�ti�**x�i�**x-*i�i�-ic-i�*�-�*x��t*�tiE�t?E*�t***it*�*�t-*�-*iE**i�*��-itiEiE�tiei��tt
�a«m��, o�� a s�:., amo m me �no. coe., i ..an �yi.nm mw �. I N D I C� I D U A L F E E B R E A K D O W N
Dme:��A-'/� �r A ' t: �/l/�-t
w.mi�:F.e�,.ro..��,...,on�.,:ro„o«wm���nuniawrui.ne�nnlre/.c�.n«yra�wro ,�.lo«wn..w TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
clHl flnu ap ro om hurtllsOWuuM CdMn (S/OqOWA N r�Glfbn ro tli� cwf ol ronp�nutbR d�p� �i pA�� br In
s�cdon�ro6o�meworcoar,mronsteiwercomq��w. MEC 8 V V BOX 6 5
CONSTIiUGTON LENDING �QENCY: I MreOy effi�m wEar penelry d pmj,ry iha Ilwe u e mut�ueion bnEinp epency lar Ne MEC
yenama,oe d iha .,ak ror wnidi me ve�� u csued Iswon 3oe�. cw. cl. M EC
LENDEN'S NMIE:
LENDEfl'S ADDXE%:
I ce�ily Rat I heva reeE No eppficelion e�d aeb ihel Ne ebova iNpmetion u conae. l pree ta comply xnh M ery erd oouruy ad'muKes
end etale lewe mlmn9 �e �ildvp connrudan ud hareby evlhorize ropreaenteiivp d Ihis dly to amar �pon Ihe abow�menlioned pmpeM
la inapmian purposae. .
LOUIS RODRIGUE2
(5t5t<e.WP) WM1nsEuildiq85e/ery;
om.: /o ^���
Rnk-lio-ronw: (blEm sav
A
10 FIRE DAMPERS
1 INST/REL BOIL/COMPR 0.0 - 3.0 HP
END OF FEES
, 0
4.50
9.00
01 00192b^,E-Q719?.3�E firJ'F'
OA7E: 10/i'Y,�,E� 7T,CEr pg:51
52.00
45.00
9.00
/
=:L�J"u,
CONSTRUCTION ANDPLANNING POO. .SPA •
'APPROVAIS Permit # Date I�spector qppROVALS Permit # Date I�spector
1. Temporary Electrital Service or Pole 52. Pooi & Equipment Location • �
2. Soil Pipe�Undrgrnd. - ' 53. Steel Reinforcement
3. Electrical Conduit Utility•Undrgrnd. 54. Forms �
4. Electricai Conduit-Undrgrnd. 55. Electricai Bonding �
5. Steel Reinforcement 56. Rough Ptumbing & Pressure Test
6. E�ectrical 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 �ines, P�Trap, O Undrymd.
70. Structural Floor System � 67. APPROVAL TO DECK
i t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
92. Sewer Cap � � 63. Heater & Vent-Pinal
73. Roof Drains 64. Plumbing System - Finai
74. Rough Plumbin9 65. Electrical-Final
15. Rough ElectricabConduit � 66. Solar Svstem�Final , .
76. Rough E�ec[riG Wiring � 67. Fencing & Aecess Approval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough EleciriGal�T Bar Ce.iling � 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning ,L„L� FIRE DEPT. REQUIREMENT
20. Rough Pactory Fireplace APPROVALS Permit #
2L ��cts, in StruGture 70. Undergrouncl HVdro
22. Ducts, Ventilating 77. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Tes2 72. Underground Fiush
24. Roof Framing 73. Undergrnd.5toraye Tank O Gas ❑ Oil
25. Roof Sheath'ing 7d. Overhead Hydro
26. T-8ar Ceiling �Svucturaq & Monocoat 75. Dry Chemical
27. Frame and Fiashing 76. Dry Standpipe
28. Lathing & Siding 77. fIXEp SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywail NaiGng HEALTH DEPT. REQUIREMENT
31. Piaster Brown Coat 79. FINAI INSPECTION
32. Electrical Power Meter-Finai &0. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
3A. Final Heating & Air Conditioning '�s�.�
35. Final Gas Pipe-Test
36. Hood or CanopY
37. Final Factory Fireplace ' .
38. Finai Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
A2. Backflow Preventer
�43. Backflow irrigation
44. Landscape Irri9ation System
45. Sound Attenuation
46. Handicap Regu�ations
47. F1NAL STRUCTURE & BU4t01tVG
48. FINAL PLANNING
49. Elactric Release to Edison
50. Gas Release to Southern California Gas Cn
51. CERTIFICATE OF OCCUPANCY
No. Date
, /
/'
wnnasaemiowo: S55 ANTON BL �.
IXINERSNAMEIFplOYM: SAKIOKA FARMS ��
� I�OOPESk PO HOX ZO9%
TERMINAL ANNEX
�vr�. rwuxo �ooxess:
MCXIfECTOFFNCdlFfA:
�xcx a+e++a�s �ooxEss:
_ - • - -, „ --- uxr:. _ lOTH
IIC. N0:
uxr:
caxm�crarsw,� SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
cam�crorcs�uiwc 215 E EL SUR ST
anox�ss.MONROVIA CA �c�; 190173
91016 uNr:
LICENSEO COMNACTOXS OECLRNRTION: I Mmby Nim uMm pene�y d per'ryry iMt I em licenaed uMn qan�ian ol CMqm B
(commerwiq rm� Seciion ]WO) d Oiviaion � d IM Buaineva eiq Prolaeebna Coda, vd my lin�ua u in /ull lwp enE allq.
cmuc.r+o.:013054 uc.cuss: C 16 uc.No.: 90173 EXP: 04/96
ome /� aa-�'� ��� f� /�s�--� I
OW NEN BUIL�EX OECIANATION: 1 Meeby dfiem uda p«Wy d prN�Y �� ����q M1� �M CaMmtlon Lieama Lew la ihe �
foGowiq �ee�m (Sedion 1N1.5 &ni�eae erd Rdmvma Code: AMW a odwY �fii3i re0u'va e D�u io mrnwc4 eEx. imVm*.
iemdon, a nW� �' mrunun, P� b tls :�uvKe, ebo reaares IM MN��n11or wch 0�! to fib e epME elelemeN WI M n.he
a licensad Wrvunl to Ne Pawiaa W Ne CoMredwe License lew �Chequ B(mmmend�q Milh Setlion ]000) M ON'vian Y d tb
Buaimn enC Rdma'au Cotle� or Ihv M n Me ie axamq therehom vM Ihe beau Iw Ne dbpsd memqion. My violetion d Seaian
lmt s M anv avd�,� �w e vennn eubjeae �ne aodiem �o e avY aerWir d na mara �nen M. wmrae ed�en Issooll.
� I, m ovmar dtM proparry or my empbyeee w'vh wepea es Ihei eob mmpeme�ion, xilldo Iha Mwk, end tM ewnuro e m� imeMW
a dlereC lor eale (�� ��. B�diru ud PMaaiana Code: TM CaNrepm Limn�s lewtlom not npplytoan ow�wr d p�apMy
ww d,u. «mw� �ne..on. w.no aoee.ucn wwk hm..n «nen.e a m.wan nc «nx om, «�Wm+.•, wo.idw inm wcn
impwanmb are �w imerdad a atlaeE la aab. tl.Iwwmm.IMluildirp a inpovemem u edd wnhm pw Y� d mmpluun. the
ow�wr-0u�der vNl heve IM bu�dm d povieq M a eAe did na duk a impow la IM Wryme d eW).
❑ I. m owirr d tM PW�Y. em e�tlimMY evnlM^Y wGh kw�wE conl�e[tm b m'uVutl Ne p9s� (Satlion 1011. But"uwe eed
rra«:am coae: ma cww.ea. �.«w i.. aoee �a wwr m� o.,w a wwMr wno wue. a u�,« ma.00 .oe wro
comracb br axh PGeCs r.M a ooniaeMs) GcemW Wn�uu �o tM WMrapar� lloxne leM.
❑ I em azemq uMar Saeion: B. 8 P.C., br Nis reman:
Dve: O+mer:
I do heroEq uNy ihet I em awue d ard wdweteM the repuiramams d Cellpn4lWM end SdNy Code 9W ian 25505.255J3. end
255J0, aM thet I a any Mun Wiki�p ocwpem will / wll �(orcb aw) need ro comply wlh aeiE tlala codw ud IM isquimmanb br
epermillacaaWclionamodi&etionhamlMAi w�y enepementDialiia.Na�kaniielm�nrueioneppica�qrouaexemplmniAna
pw�w.
om.: �op�:
WOPKEfl'S COYPENS�TIIX/ OWL/�P�TON: I Mreby dHm under pndly d prpvy ar d IM bbwinp Estluelum:
� �nm.w.amwm.�.c.ndm.aoom«,��o.w;v�u.wwoix.:mmv��...awid.e�orMs.e�onarooam.�.nor
coae. t« ihe w�omwic. a u» .ax �«.rr:u� mb o� A m�.e.
❑ � nm..ne.0 maw.:� xwtr.� oomw�� �,reno.... na�� M s.aian aloo a m.l.nc. cod.. a. in. wR«menc. a �n.
w��«��'�p'�p��MY�'•Fi�EMONT •��'�'�m�u• EXPIRES
c.�»,
Pdiry Numbw: 0 6/ 0 1/ 9 6
(ihu aMim me! rwt bs romdNb / fMW^^t u/a ans hund�si dol4re �S100I a Iw.)
❑ I eenN �hm m �he P�artnercs W iM wak t« wlicn inu Wemn h WuaA. I ehdl na emqw em' ro� In em' manrwr o n �o
became wbjact �o IM xorkere' camoanWcn k�w d Ce4lanu, epns Nn ! 1 Noukbycm� wEjeq �o �M xoM1an'
campe,m(mb.n� p�vm�'v/n d� Satlion 3)00 d iM lebor Cods. I eAeO t 9h/my.�pjy,�w�Oh �Nws 'pduw' r.
Dete: �C� ��'-7S� AGdraN:� ' //l��'�\�
w.mlip: Fwun ro slcun woik�n• romo�tlon rovxp� l� un/aMul, aW wll ub/ct �n wrplqw ro cNNirl pwuftlp uM
c/Hl Anu �p ro om h�ntlrM ffauuM EWhn (ffIX{PPOA N N1/fbn b M ewt ol ronpwefbM1 d,rtypu u provMM fer In
S�ctlon J)O6 0l IM /abor Cod, lrrtwu4 uM �ttumry'� Iw.
CON9TIiUCf10N LENOINO AOENC�: I Mnby dfirm uMu pwlry d perjury Ihtl �Mn u a cvnCrWian IWi'p eparwy br tlro
pa�amvw d IM v.oM br whid� ihw psmii n ewW (Sedion �O9]. Civ. C).
LENDEN'S NM1E:
LENpEfl'S ROOFE44:
1 ceMy ihtl I haw feed Ne appliralion uM pde ihm IM above iNarmetian o oonaq. I pne to romply rm� ell tiry ud ownly qdinenoes
ukMPoelewen iqbWOEipmmbWionutllwrabyeNhv¢a�aptWntNi�mdlhb'YyloeMoruponlMebw��mamon�EpapMy
�uimpspc v �
Nama q
— Dets:'�� �.3 �/s�
qrunr W ar/IpeMAppfun4CanVtln
(5151J6.WP) Whue-BuiMnp 8&tlqy; Orserl-Rb; Canuy-Applunl; Plnk-Rmnw; Oddemod-Nwnar
_ ,�_ , „ ,_..,_,.,r. , ._. CITY.OF COSTA.MESA -, BUILDING PERMIT
PERMIT NO: F 074745 PLAN CHECK NO: 04041-95 L
PERM NO: F 074745
GOVT:.N SUPP: N
CONSTRUCTION TYPE: 1-FR .... PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : RELOCATE FIRE SPRINKLERS SQ FT:
CLAIM VALUE: _ 8,900.00 CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PKODUCTS REF: B-74631
*+t*��r*�x�*x�x*�rx �r+r�x�x�x�r�r�r��r�rr�x��r�x��r�r+��*+rx�x��r*x�*�r�r*�r*��x�*xx�**x�*x�**�****x******x�+r+r*�
_.._ Z O N I N G R E Q U I R E M E N T S
S E T 8 A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: .FT, IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NdTES>
i
1f 1f 1E iE 1f iE I@1E 1E M 1k IF k 1k M 1E 1f 1F iF il' 1F 1k IF 1f 1f iF 1F M M' 1t 1k It 1E ik1E 1E 1F IE 1E 1F 1E 1E 1h 1E 1E IE 1E 1f 1F 1E 1E 1E 1f 1E 1E 1F 1flE /E IE iE 1E IE 1E 1E IE 1F 1E Ik 161E 1E 1E 1E IE iflf ff 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:
IE 1k 1F 1F K/E 1k /E /k 1FiE 1E 1F 1FIE 1F iE 1E fF fE 1E 1E If 1F 1F iF IE IE 1(�if IE if�iFiFiE IE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
ioe.00
65Y SMIP/NON-RES
70.20
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> , 108.00 0.00 70,20 178.20 178.20 .00
REVENUE DIVISION TOTALS--> COLLECTED; 108.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN-CHECK
' 1�8.0�
�t IF1E'lf k'If if iE M 1F iF iE iE �f k iF M it if k if iE if iFiF if k 1F k if 1E 1F if iF k if iE 1kk if iE if if if iE if if if af iF M1F it 1f iF 1E iF �FiE if if 1F iE iE'1I' k 3f iF iF iF iE'1I�1F iF lkif if iE if
_ I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY , rD E S C R I P T I O N UNIT COST TOTAL COST
FIR 108_ FIRE EQUIP FEE (FROM BLDG VAL TABLE)
END OF FEES
1.00 108.00
O1 C0:92705-QJiS27Q6 Y'�Ce"@' 108.00,
DATE: lOi33f9� ilitE% 1�:3'
� CONSTRUCTION AND PLANNING •� POOL & SPA
� APPROVALS Permit # Date, Inspector qppqOVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location' ..
., .
2. Soil Pipe-Undrgrnd. �. 53. Steel Reinforcement i�• ��""�
�3ii9ectriwl CondGrt U�llity-Un¢irgind. 54. Forms �`
����ectrical Cond�-1`�'J�drgrnd. ' � 55. Electrical Bonding ' , .;
ta$. 6teel Reintorcement-� 56. Rough Plumbing & Pressure Tes[ . •�?�
���.,tiElearical UFER''6'md. 57. APPROVAL TO COVER�GUNITE
'�Footings `,-,pt � 58. Electrical Con a�Undrgrnd. .
7 8. �Fuundation 'T� � 'D � 59. Gas Pipe, O U�igrnd., Test '
9. Water Pipe-Und�giqd.�. . 6p. Backwash LineSyR,Trap, Q Undrgrnd.
10. Structurel floo� ystem �' 67. APPROVALTO,fSECK +,
11. Property Sewer�,ine,-& Hous�unnection 62. Backwash & Recgptor-Final-'
12. Sewer Cap p v�:. � 63. Heater & Vent-Final �
13. Roof Dreins � � 64. Plumbing System � final �
14, Rough Plumbir�ry� :*1 i 65, Electrical•Final �+
iry
� �
15. fiough Electric3w�Co8duit ?; � 66. Solar SYstem�FinpJ .
i 6. Rough Electric,�iri�yy o ' 67. Fencing & Acc�s�ApproVal '
= 17. Rough Wiring 3�i n a ' 68. APPPOVED F�Fj,PLASTERiNG
y 18. Rough Electrica�T Bar Ceiling 69. POOL/SPA SYST'EMS FINAL
79. sough Heatin,g & A� ConditioRny� b,C * �� �o d�' tr, F1�F�E�TQREQUIREME 1�J .r
20. `�ou F�to� Fi � lace i S!*� GC + S N o� *: APP��^�F PyY.mit #% � -~
�
21.'Bu ir�tru�tufi�* .... '-�5 � S O -+x T ^ yt
�. S� S�» � C� !- Cl: �0.�)ndergt�ujd 13ydro ,
22. �ucT�, V [i �tin�� � �;� * C; d q c. �* V 71. Prodaui(Biping as tt�".J Oii
23. 6asFpeHiou� & Test ��T tT7S M m T � v* • 72, Undergr�d P7ysh ;; � �
24. `t3ooYFr T in "� �� ..�'" �' � * ~
� 9 x M t t� r.M • 7 Undergmd. Stcua�P Tank i7 Gas ❑ Oil
25. Roof�Sht:�thing sx �c," vv� O> cu* 7p'�, OverheadV:,.'�Q,�o..ic�ti� 12-��jj
26. `,'��Ba`i!Cei�jng tStrtFc�Lral) &(v��c`i�coat � � � �� 7 Dry Chep�isai r,� x� �
27..Erameand Flashiegs DMtC * o' ��*- 76. Dry Sta �PeE"� ; J�, "�
"28.^Lac��9�Si.�.J�9�xN ��F O �� ..: 7�h FIXEDtSY�T~~ INAt�, n Q ��S��I(a �'J-
y 29. Insulatio� ,� :�* r, S •• ��, 7 FIRE PREV. F`U�L '�'' ��" �'��(� �
r 30. Drywall t�aili�(g ��* ,� *:� � �ALI� DEP�. RE�JIIt�EMENT
'. 37. Plaster Brown Coanr. S � c�'t* M I 79� FINAL '�PEC'f�N � ••
>
� 32..rElectrica[`�Po��r Me�r`F�i�al � � N S�j FOOD CERTIF�CATE ISS�IED, �
']� �V !
; 33..Einai7El�ctri� � * m � C * � Notes: '7 ^,t*7 :�'"y O ��:*!
� A
Z 34. !�ina�He�n es� ftitioriir�jS n '� �: S n" "
�` "%n���'i ?f � � n ., i [�K x m
i 35. �,inal Gai-,pipe=Tesi,x v •� *`-� I � xo a.; .r Oi^
° 36. �{oo�'or �anoPY * '� � � `7 a s: c1 E nvi :v � !-
� c� � cam x m �o + r >r
y 37. FJna �'Factory Pireplece � � i-+F- r� �: � � r z - � "']:�
� c c r
� 38. anal'�iumbing � mCli i j * S ��� k �
" 39. �atei Service-Final .�, i * � �, c}' p �
K +1
�40. GasService-Final ''r•; 6t^'!-' S stn Cim cN = --
r � Cl F F� '*. 7 I [-� • o E o d;
y 41. �~S'olar pomestio-Final iy fi. ! � �np _ �p a. p� ,�
- � a
42. Backflow Preventer � � a i I q� �•� • � F �� � `:
CJ 'kN OH�-: a:� * i70Nv1 ITI� �' i-+
43. Backflow Irrtgation * ;i �r � x `� � �� i �� .
- 4 2 7 '
oi'4. �.andsca�e Iriipa[io�SYstem�'�� � * ��, O .7 C7�� N i�.; -• .:t� � N ..�
+ ��: � t>] �F ':." 1 C* � �: L Q O'. * S r
� �15. Sound !}Henuation,j � �:u �� a. �`�n, R; m* � ;.^ m Q � !-+O *
1 ..�-1 Y
�&6. liandicap•Regulatiods =� k ~ * � '" 7� ' -
,�, ,. � s I ' t* m G �
�J. FIN1�L STRIYCTUf�E & BUIL`DING � F, � � � i P �_
� I � -�
48. EINQIPLANNINGx � • *`v � �;; �„ N � � c
'- �
�49. �}ecttjc Rele�e to Exdison � * i � !,: � : � - ,
i:: r-, - - �
b0. Ga: Release to Soutl�em Califor��Gas Co * � � �' �' "'' �o �: ; n c
Y . <'
51. CERB'IFICATE OF OCCUPANCY � � �� •- • �
No. Date
���
�nonEssaea�omc: 555 ANTON BL
am�"s"'"'E"a,w� SAKIOKA FARMS
� "0°"E� PO BOX 2097
TERMINAL ANNEX
,wri. �uimc �nnaEsa
urr: 10TH
urcxnEcrox�x�n: TRI—SIGNAL INC. �0�N0�' 0
""CX0"�'91D°^�� 1945 GARDENA AV 818-247-1194 �M�
GLENDALE CA 91204
C0N1P"CT01f8NA1� MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
CONIHACTWI9YYIW0 p O HOX 509
�o� WALNUT CA �� 230813
91789 u�:
4CEN9E0 COMNACTOR4 UECLAN�TION: I MrMy Mvm uMm pe'Wy d perjury ihN I am Ikamad uiMar prMkma d Cheqm B
(camm>neM wu� Secibn'1000) W Diwion 9 d Na Bud�ws aM Pm(osion� Coda. W mY Goenn b In IuA /au end akee.
emuc.No.:00655�8"' /UC.ClAS9: LJC.NO.: z3O 13 EXP• 12/96
Dms: /— �—" / (O ContrerJw: �
OWNER BUILDER OECI�R�TION: I MMy eMvm urkx perWy M perjiry Ihtl I e 1 tmm IM CaNntlm Liosiva lew ta iM
IOYowip iwm (&etlon ]W1.5 Bwiim� eM Prdmiona Cods: AM ��Y a mun M�i qWm e pemin io oauWct. Mx.'vnprow.
�moleh, a npai eny evucluro, priv io m usuenro, ebo rp�im �M appliunt r pertnu lo fib e dpmd �Iebmanl rtw M w�M
IioenaeE W��a�l to iM pwuions d iM ConirWps Lipnsa Lnw ICMqm mendrq wilh Satlbn 1000) d Ore'vvlon a d the
eunMsa end Rdwbro Coda� a tMt M a ehe u eumq IherNmm eM iM bam la Ihs dlpd s�amqion. My videtion d Saaion
)0]t.5 � eiry eppGrent lor e permY abp6e iM applicaN to a dni peneMy d nd mors Ihen Me hundnA EdW� R500p.
� I.mowroroltMpropenY�mY�VbY��hwpmulMiedemmpsneetion.willdolMxwk.eMtMtlNCWniMinlsMed
w MeraE lar veb (SeGbn ]Ou, Bwiew wd Prdeeabna Cada: The Conirmae lioenu Lewdma nd eppyto en ownm o/ proparty
who buide « inpone tlwreon, end Ma Eoe� auch xwk Ivmsell a Mne� a tivuph he a Mr oxn mmpbiee�. pwided �hel ach
impmmnems era rot'vurded v dlereE la �ab. tl. Mwe.m.Ihe buitlinp a inpwwnmt o wN wilhin awYw d canpblian. IM
owiwr-buiNa wi4 hew tlw buNm d pai�q M a eM did M Wtld a improve lor tM W�a d eeb).
� I. m oxner M iM piapeM. � extlu�ivey mnlrM'vp xilh limnaed canvenwn to conmua iM pol� (Sepion 10u. Buai�a aM
PMevima Code: TM Canirmon Lkense Lew tloes ml epply b en owrwr d peopany wlw builie a impww Ihe�ean uM who
tomratla Ia v�N pqWf wiN e cwvatlor(el4camed Wnuenl to iM Canlmlm Limfe Lew).
� I un memp uMx Section: B. 8 P.C.. br ihu �eeaon:
Dale: O�mer:
I da haeM �MM thet I em ewue M erd wdenieM Ns reGwremoms d Cellanu Haetl� enE Se1M' Cods Saaiau 25505.2SS].t. aM
255N. eM OW I a erry Mun Wikiiq ompenl will / wil ml (ercb one) naed b romply xYh vaitl eWa wdp ud IM �syu'vemaMs M
epermitlaconetruclionamodifiWionhamthe�i �e-Oi .�iy erepement0imrip.RmMeMielconsliuGGioneppirelbneersnaempiromlheae
provisiona.
Dma: AppGceM:
WONKEN'S COMPENS�TION DECL�RATION: I Mroby elfimi uMer penelty d pa�ury me d Ihe Idbvnrp Exiereliana:
❑ I M1ew eM xi1 meinten e cenE'rma d mment io eep��uuro br xarksn' oompemelun, n prwideE la by Swion �]W d �M leba
Coda. la tM pwlmiw�ca d Na work lar wlich Nb pamu u hsued.
n I Mw enE wil meimen worken' wmpemmun inwre�. u rpuiretl by Sad'pn �)(Ip d Ne leEor Cade. M the peAamuae M tM
]S" w� lor which ihie pormtl ia iesueJ. My warM�e' compeneatian ineurenca umer uM pdiry number ve:
c�»�: FTREMANS FUND EXPIRES
i PdicyNumEr nwranF�FFa� 07/O1/96
(TAia senion med rrot bs cands�ed i tM P�x n M mro h�Mred EdMra ISi00� w beeJ
� I cerlAy iMl in IM pMormence M tlro work lor wlich t�ia pmmil is imueE. I ehdl m� employ enY De� in enY menner o u io
bxo�ro euCjeq io iM xorkme' mnperoe�bn ler.t al Geltlarrue. uW apree Ihp tl I haulE become wEjetl t� � e�aken'
comD��bn Ma+�bn� d$bam � d Iln lebar Cotls. I a1Wl yvii� candY xi�l i oea Pm'au
� � / /
Dele: / �' � � n Aod�: i
W�m/np: Ftl/un ro pcun woMrpi comp�nutlon rov�wp� b unl�wN( �nd • I ab/ 11II MIpIOyN fp MMN/ pIM/tlM �IIA
clvll flnu �q ro om h,nGiN IMuunC tld/an (f1PD,00dA M M1/tlon ro tM t oI mpwu�fbR tlam�p� �� povleW br In
Sxtlon JlP6 0l Ms LMor Coln, /nMul, entl �rtomsy'� Irx
CONSTNUCTION LENDINO �OENCY; I Mraby ellirm uMer penely d parWry �het Ihem ia e conNrvaion bMinp epency la iM
qAamerKe d iM wah la �MiM Ihn prm� u ewed (�nn 3081. C'v. C).
LENOEN'S NAME:'
LENDEfl'S ADDPE55:
I ceniN �� I heva rteE Nu epWcation uM qete ihet IM ebove inlarmeiion u coried. I epree io canply wn� ell ay ud w�nry pdinenma
vM atele kxs relaliq lo Wikip consltWion end hareby eNlprue �speeentetim d Ihb dly lo mter upon IM aEwe.menlioneE poperty
lor iropeabn purpoees.
CHUCK JACOHI JR
o�e �-8' �
(S151d6 WP) ' 4�M1ne-Buildip 8 Sdey; Ormo-Fle; Cenery-Appf'ant: Rnk-Rerenw; (3oldenmd-Nempr
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: F 075835
PERMIT NO: F 075835 PLAN CHECK NO; 04816-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS REF: H-74631
+t+�****+t*****�****+t***x�**�t����r��rx���*��*���x �**********x�**��t�r+�+t+��**��***��***�*�*
Z O N I N G R E Q U T A E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDZNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
iE 1F 1F if 1E iElE ff af 1F 1E 1E IElE 1E IE fE iE fE fE 1E 1f fE iF 1E 1E 3E 1E Ik 1E 1E 1E 1E 1E 1E iE iE ik 1E 1E iE 1f if IF 1E if if 1f ik 1F 1F ik if if iF iE iF fE iFif 1F 1ElF iF 1F iE iE 1E iE 3E if 1f if 1E 3k iE if if iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY .
BUILDING APPROVED BY :
LEGALIZATION:N F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT
PLAN
ISSUE FEE
DATE:
DATE:
DATE:
ifiFiEiF�fiEiEiEiF iEiEiEiElE Ifif iEiE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
90.00
652 SMIP/NON—RES
58.50
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 90.00 0.00 58.50 148.50 148.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
ik it ik 1k 1E iF 1f if if if iE ik 1E 1F 1EiE iF'lE iF iF M iE i(' �16 �Ih �k 1E 1E iE fF IF i! iF iE iF iF iE 1F ik iF if 1f iE ik ik ik if iE1f iE iE iE 1E 1E ik iE iF if if iE iE 1E'k iF 1E iE iE 1E 1F iE �E iE iE 1E iE fE fE'IF iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
FIR
QTY
90
D E S C R I P T I O N
FIRE EQUIP FEE (FROM BLDG VAL TABLE)
END OF FEES
i
UNIT COST
1.00
TOTAL COST
Ol n�)d'i&!'� ..01'i�'15 :"os�'i
CRfEr i�• pr •.. , ?:�,:.: n�:17
�
- ,CONSTRUCTION AND PLANNING
�APPROVALS Permit#
1. Temporary Electrical Service or Pole
2. Soil PiPe•Undrgrnd. .
3. �Electricai Conduit;Ufihty-Undrgmd.
4. Efectrica� ConduibUndrgrnd. '
5.'Steel Reinforcemem
-&. Electrical UFER Gcnd.
7."Fooiings • , ,
8. Foundation '
9. Water Pipe-Undrgrnd. ;
10. Structural Floor System
t t. Property Sewer L-'ine & House Connection
72. Sewer Cap . � ,-'
13. Roof Dreins '
14. (iough Plumbing
15. fiough Electrical•Conduit - �
76. RoughElectricW�ring'
77. Rough Wiring Sign .
18. Rough Electricai�T Bar Ceiling -
19. Rough Heating & Air Conditfoning
20. Rough Factory.'Fir�piace .
21. Ducts, in Structure`-. z .. ^ ,"
22. Duccs. Ventilating �'."
23. Gas Pipe-Rough & Te;t
24. Roof Framing " - ` � - '�'t
25. Roof Sheaihi�9 - ,
26. T•Bar'Ceiling (Si�uctJral) & Monocoat
27. Frame and Fiashing . _ - _ _
28. Lathing &'Siding y ` '' .
29. Insulation � _ •
• 30. Drywall Naiiing r ,
37. Plaster Brown Coat;, ,
32. Eiectrical Power Meter-Final
33. Finai Electric
34. FinaPNeaUng & AirConditioning,.' � �
35. Final Gas Pipe-TesY-,; • �.
.36. Hood or Canopy � - -
37. Finai Factory Firepla�e . - ,
38. Final Plumbing
39. Water Service�Final ` ^ �
40. Gas Service-Final • - .
47. Solar pomesticFinai' � _ '
� 42. Backflow Preventer ,
43. Backfiow Irriqat�on � -.� � -
44. Landscape Irrig2tion System ' • �;;
45. Sound Attenuation � '
46. Handicap Regulations � �
47. FINAL STRUC7URc & BUILDWG
48. FINAL PLANNING • :
49. Electrie Release to Edison
50. Gas Release to Southem California Gas Cc
57. CERTIFICATE OF OCCUPANCY
No Date
Date
e
n
POO.__ SPA
Inspector qppROVALS Permit #
52. Pool & Equipment Location �
53. Steel Reinforcement •
54. Forms
55. Electrical Bonding
56. Rough Plumbi�g & Pressure Test
� 57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash lines,'P�Trap, O Undrgmd.
61. APPiiOVAL TO DECK
62. Backwash & Receptor-Finai
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar SYstem-Final
6�. Fencing & Access Approvai
� 68. APPROVED FOR PLASTER�NG
69. POOL/SPASYSTEMSFINAL
_ FIRE DEPT. REQUIREMEMT
.- � t APPROVAL•3`��'Pecmit# • .
+y 70. tlnderg7'o�nd H�dro �
'.r �'71. ProduciPipingQGas C�OiI
<. 72. Unde.ground Flush �
' ' 73. Undergmd. Storzge 7ank � Gas ❑ Oil
74. Overhead Hydro.
75. Dry Chemical ..
76. Dry Standpipe -
� ; 77. FIXED SYSTEM FINAL. ,
78: FIRE PREV. FINqL - �Zf,
' ' HEALTH DEPT. REQUIREMENT
. 79. FINAL INSPECTIflN ��
. SO..�FOOD CERTIFf.CATE ISSUED
' Notes: � .
_ 2 t�.
Y . ,
r _ .. ' - .
r • _
I � 4 . . _
' F
r iall
! - • ' .
it _ -
Date � Inspector
L
�
� CITY- JF COSTA MES�. :_ C
Development Services, Division of Building and Safety
CERTIFICATE OF OCCUPANCY
This cerHficate is issued pursuant to the requirements of the Uniform Building Code, Section 308 adopted by the City
of Costa Mesa certifies that at the time of its issuance the building structure herein below described was inspected and
approved foroccupancy as follows:
BuildingAddress 555 925.AnEon-Bl. B1dg:PermitNumber 806-00345
Use Comr.�ercial � � � � � �
p B yP ' 1-FR � �' ���j�� �� � .�'� UseZone PDR-HD
Grou T e of Construction
Sakioka Farms c/o�Moraans o�e LimitedJ.Ptnrshp
OwnerofBuilding Attn: Joe Crawford , Tenant �So. .925
Address
BUILDIN
�
1050 17th St. �#1220, Denver�.. CO
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE ��
�
• - , � . . - ^ . . . . . �1.: ..H:,-. .. . � - -: � . .. " . • _ _ _ . . '
� � CITY��F COSTAr MES�. �: �
, Development Services, Division of Building and Safety
� �``�....
CERTIFICATE OF OCCUPANCY �
This cerHficate is issued pursuant to the requirements of the Uniform Building Code, Section 308 adopted by the City
of Costa Mesa certifies that at the Hme of its issuance the building struclure herein below described was inspected and
approved foroccupancy as follows:
. r� � ' • . .
BuildingAddress 555 925 Anton.Bl. BIdg.PermitNumber B06-00345
Use Commercial '
B � ' � 1=FR � ". � � ' UseZone PDR-HD
Group Type of Conshuction „'1�i��#
Sakioka Farms c/o Moi�ans Ao e L m ti e�nrsho
OwnerofBuilding Attn: Joe Cra�ford . Tenant Sp. 925
Address 1050 17th St..#1220, Denver,,CO ^
BUILDIn
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
Cily of Costa Mesa
Developmen� Services Department
Building Satety Division
P. O. eox 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No.
The Building located at 555 ANTON [TNIT 9
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B-2
Use oi Building OI'FICE
pancy.
Legal Description 410-501-04
ISee reverse side for Metes and Bounds)
Building Permit No B59015 Electrical Permit No. E59016 Plumbing Permit No._
Mechanical Permit No. MS9549 Number of apartments and/or guest rooms
ISSUED T0:
Bank Of America
20 N. Raymond Ave
.._, � r
Building Official Tanv C°DP Bacn
by � 1 r
""""""••", "�y"• Date October 26.1992
This Certificate of Occupancy SHALL BE posted in a conspicuous place o� 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 - Bld9. Permit File
City of Costa Meu
Development Services Depar[ment
Building SafetV Division
P. O. eox 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No. ��'�'���E�.j
The Building located at 555 Anton Boulovard. Ninth Floor
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B7_ Occupancy.
Use of Buildin
Legal Description 41�501-04
(See reverse side for Metes and Bounds)
Building Permit No BSi99i Electrical Permit No. E 38031 Plumbing Permit No. P�Ol�
Mechanical Permit No. M 3�82 Number of apartments and/or guest rooms
iSSUEo To: BuildingOfficial William T. Howacd
Securitv Pacific Bfahk
•600 Wilshire Blvd., $500 by --
��03 Allq?�.CBi CA
• Date Julv 17� 1989
Tfiis Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE
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
removed except by the
,
�✓�
CITY OF COSTA MESA
o "' = BYILDING DIVIS/ON F09-00082
i�� 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
: ,c
� FOR INSPECTIONS CALL: (714) 754-5626
4q�a.mw fi
FIRE SUPRESSION PERMIT
JobAddress: 5$$�AIVTON BL
Suite: �866°�
Vicinity: SUITE 900 COMPUWARE
Parcel Nunmber: 41050110
App�icant: MORENO, ANNA '
Address: 31912 CYPRESS GLEN,
LAKE ELSINORE, CA
owner. RREEF �
Address PO BOX 4900 "
DEPT 207
SCOTTSDALE,AZ
Comrador: ALL PRO FIRE PROTECTION
Address: 31912 CYPRESS GLEN
Plan Check:
Permit:
Other:
Total:
LAKE ELSINORE, CA
Zoning:
Phone: 951-244-9836
Zip: 92532
Phone:
Zip: 85261-0900
Phone: 951-244-9836
2ip: 92532
License: 629993
Status: ISSUED
Applied: O6112/2009
Issued: O6Y242009
SCOPE OF PERMIT
RELOCATION OF 11 OVERHEAD SPRINKLERS IN CONJUNCTION WITH THE 5000 SF INTERIOR OFFICE
TI CONSISTING OF NONBEARING PARTITION WALLS, NEW FINISHES & FLOORING FOR "COMPUWARE"
IN SUITE 900. REF: BC09-00169 �
$27.17
$41.80
$0.00
$68.97
FEE SUMMARY
Calc Valuation: St,ioo.00
Claimed Valuation: $i,ioo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and Tinal approval must be obWined. Failure to obtain inspections and fnal approval will result in the expiration ot this permit.
C�DE �, INSPELTION TYPE DRTE IN� OOE! INSPELiION TYiE DpTE INTIiIRLS
1816 Fixetl System Final Fire Prevention 206 Final Mechanical
7266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 270 Final Electriwl
201 Final BIocWRetaining Wall 272 Final Fire Prevention �'�1� �
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Si�e
204 Final Demolition 250 Final Building/OccuOancy
WORKERS' COMPENSATION DECLARp710N:
I hereby affrm untler penalty o( perjury one o( Ihe lollowing tleclarations:
❑ I have antl will maintain a certifcate of consent to self-Insure for workers'
compensation, as provitletl for by section 3700 of Ihe Labor Code, tor the
pedormance of Ihe work for which Ihis permit i5 issued.
❑ I have and will maintain v.orkers' compensation insu2nce, as required by
section 3700 of Ihe Labor Code, for the peAortnance of the v.�rk Iw which this
pertnit is issuetl. My vrorkers' wmpensation Insurance carrier and policy
number are: �J e
Cartier.ln...(��19 �ll�c../
�Th�se[timneeC�f!WI/b�e�pV'P de��dth pe rs lu/etl�al enviM/re�VdS�V a1rs(Syt010)orless.)
Policy�Number: IiW V'W � � �/ ��UN �V �
�_�a.�
❑ I certify that in Ihe peAortnance 6f Ihe work for which this permit is
issued, ! shall not employ any person in gny manner s� as to becane subject
to the workers' compensation laws o( California, an0 agree that if I should
bew subjeG to the workers' compensation provisions of Sec[ion 3700 of
Ihe or Code, I Ishal "� fp� �tlhG mply �' these proviyon ��
�i/ � �
V
tpfy�n[s SignaWre �,'a�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNL4WFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVII. FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION �706 OF 7HE LABOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby affrtn that I am licensetl under pmvisions of Chapter 9(commencing
with Section 7000) of Division 3 of I�e 9usines5 antl Professions Code, antl
my license is in full force and effect.
�.u�-n�: - ���— _c�'"�' ��P
�.� r'sSiB�aWre oaie� •
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that Ihere is a Construction lentling agency for Ihe
perfortnance oi the wurk for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atldress:
Sipnature Daie
OWNER•BUILDER DECLARATIONS:
I hereby a(frm that under penalry o! pery'ury lhat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the bllowing 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 Io its
issuance, also requires Ne applicaN for kuch pertnit b fle a signed statement
that he or she is licensed pursuant tb the provisions of Ihe Contractore
License Law (Chapter 9(commencing with Section 7000) of Division 3 0( Ihe
Business antl Professions Cotle) or thal he or she is eaempt therelrom and
the basis for the alleged exemption. Any violalion of Section 7037.5 by any
applicant tor a permit subjects the applicant to a civil penally of not more than
fve huntlred dollars ($500).):
❑ I, as ovmer of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, antl Ihe struclure is not intended or
oRered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or oNered for
sale. It, however, t�e building or improvement is soltl within one year of
completioq the ovmer-builder will have the burden of pmving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property. am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CON7RACTORS to conslruU the project (Sec. 7044, Business antl
Professbns Cotle: The contraclors License Law dces not appty to an owner of
pmperty who builds or improves thereon, gnd who contracls fa such project with
a con(rac(«(s) license pursuant to the Contraclors Ucense Lavrs.�.
❑ I am exempt under sec.
Business and Professions Code for this reason:
SiB^aWre Da�e
]OA-dfi �3/0])
Ovmer ID veri�ed by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Venfication of Ownership by (type of document, i.e. - property tax bill or aeed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certAy that no excavation (rve (5) or more fee[ in tlepth into wfiich a
person is requiretl lo descend, will be made in connection with work autMrized
by lhis pertni�, antl tha[ no building structure, scaf(dding, falsework, or demolition
or tlismantling lhereof, will be more than [hirty-s& (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Califomia Administ2tive Code�.
❑ As ovmer-builder, I will not employ anyone to tlo work which vrould
require a pertnit lrom Ihe Division oi Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
ADOlicanfs Signalure
Division o( Industrial Sa(ety Permil Numher: _
HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION:
1. Will lhe applicant or present orluNre building occupant neetl to file anC
ceAity a Business Plan tor emergency response to release or Nreatened
release of a hazardous matenal? ❑ Ves ❑ No
(Section 25505 of the Calitomia Health and Safety Code requires, with some
exceptions, that a Business Plan be filed vrith the Cosla Mesa Fire
Department by every business which has at any one time dunng a reported
year a quantily of hazardous matenals equal to or greater than a weighl o(
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
al standartl temperature and pressure).
2. Does or will the applicant or preseM or future builCing occupant need to file
a regislration fortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safery Code, with some
exceptions, requires registration with Ihe Costa Mesa Fi2 Departmen[ by
each business which at any one time has on hand a quantity of acutely
hazar0ous malerials equal to or grea�er than a weight of 500 pounds, or a
volume ot 55 gallons, or 200 cubic feet of compressed gas at s�andard
temperature and pressure).
3. Does or will the applicant or present or fuNre building occupant need to
prepare an RMPP (Risk Management and Preven�ion Pmgram for awtely
hazardous materials)? ❑ Yes ❑ No
(Seclion 25534 of the Califomia Health an0 Safety Code provides Ihat Ihe
Costa Mesa Fire Departmen[ may require [he preparation, certification and
fling with the Fire Department of an RMPP by businesses which are required
[o register awtety hazardous malerials vrilh the Fire Depatlmenl.
4. If an RMPP i5 presenUy requiretl, has Sec[ion 25534 of the Califomia
Health antl Safety Code 6een fully complied wilh7 ❑ Ves ❑ No
5. Does or will the applicanl ot present or future building occupant require for
the vrork which is the subjec[ of this applicalion a permit (or such construction
or motlification from the Soulh Coas[ Air Quality Management Dislnct or (rom
any other air polWtion control district or agency? ❑ Ves ❑ No
(Section 658502 of the CalAomia Govemment Code requires that the requested
information be (umished on applications fa non-resitlenlial builtling permits).
6. Will any part of the faciliry to be construcletl under this permit be within
1000 feet (rom the outer boundanes of a school? ❑ Yes ❑ No
Qf yes", the (aciliry musl meet the requiremen[ of SecGons 25534 and 42303
of the Califomia Heal[h and Satery Code).
7. If a pertnit from the South Coast Air Quality Management DisMcl or other
air polWtion control district or agency is required for the work which is [he
subject of this applicatioq have all of the disclosures prescnbetl by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certifiwte of compliance trom the appropriate air polWtion
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information qiven above is wrrecc I agree to comply with all state lavrs and
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application antl state that
the information given is correct. I agree to comply vnth all state laws and ciry
ordinances relating to huilding construction, and authonze representatives of
the Ciry of Costa Mesa to enter upon the above-Uescnbetl property for
inspection purposes. I agree not to occupy or allow occupancy ot any buildinq
authorized by this permit until final inspection.
Signature er�s)� Dat
� �
AnNon� OMiCO'Pppli�'ant�T. De�G�...�..��?
�"._.�.
CITY OF COSTA MESA
� , BlIILDING DIVISION
> � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856
:
�.�m� FOR INSPECTIONS CALL, (714) 754-5626
JobAtldress: 555 ANTON BL
Suite: 900
Vicinity: SUITE 900 COMPUWARE
Parcel Nunmber: 41050110
npp�icanr. GONZALES, ALBERT
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
owner: RREEF
Address PO BOX 4900
DEPT 207
SCOTTSDALE,AZ
FIRE SUPRESSION PERMIT
Zoning:
Phone: 800 247-6497
Zip: 90815
Phone:
Zip: 85261-4900
t
0
F09-00090
wv✓w.ci costa-mesa.w.us
Stalus: ISSUED
Applied: 06242009
Issued: 07/102009
Contracior: INTEGRATED PRODUCTS AND SERVICES INCORPORATED DBA CAL PROTECTION
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
Phone: 800-247-6497
Zip: 90815
License: 909573
SCOPE OF PERMIT
UPDATE EXISTING FIRE AND LIFE SAFTEY ALARM SYSTEM IN CONJUNCTION WITHTHE 5000 SF
INTERIOR OFFICE TI CONSISTING OF NONBEARING PARTITION WALLS, NEW FINISHES & FLOORING
FOR "COMPUWARE" IN SUITE 900. REF: BC09-00169
FEE SUMMARY
Plan Check: $81.41
Permit: $12525
Other: $0.00
Total: $206.66
Calc Valuation: ss,esa.00
Claimed Valuation: ss,s9s.00
NOTICE: The work authorized by this permil shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work aufhorized under this permit to be considered legal, such work must comply vnth 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 ot this pertnit.
CODE/. �NSPEC710NTYPE DRTE INTRIAL DEI 1_N$PEGTIONIYPE DRTF IN7I71pL5
1818 Fixed System Final Fire Preven6on 206 Final Mechanical
1288 Pool Spa Final 208 Final Plumbing
200 Final Re-Root 210 Final Electriwl
201 FinalBlock/RetainingWall 212 FinalFirePrevention ,���i�09 ��
202 Final Factory Pire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 FinalOemolition � 250 FinalOuiiding/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalty ot perjury one of the following tlecla2tions:
❑ I have and will maintain a certificate o( consent to sel4lnsure for workers'
compensation, as providetl foi by section 3700 0( the Labor Code, tor the
pertormance of the vrork for which this permit is issued.
❑ I have antl will maintain workers' compensation insurance, as requiretl by
sectbn 3700 of the Labor Code, for Ihe peAormance of the wurk for which this
permit is issuetl. My workars' compensation Insurance carrier antl policy
numberare: ��/ � n �
Ca"'mer�� ` Ip Li
(IDrssec(ionncetlrMtOeWmdo(M�f eppim}isvaW¢dafOne�und�Mtl0llers(f10pJaless)
Poliry.Numtier: �PC�r� �)��
❑ I certify that in Ihe peAortnance of the work lor which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
to the workers' compensation laws of Cali(omia, antl agree that if I shoultl
becoma subjecl to the workers' compensation provisions ol Section 3700 0(
the La or o I sha forthwith Comply Wilh these provis'ons.
in
� '�� iyuwre � a:.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSP,TION, DAMAGES AS
PROVI�ED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
A7TORNEY'S FEES.
LICENSED CONTRAC70RS DECLARATION:
I hereby aKrm thal I am licensed under provisions of Chapter 9(wmmencing
with Section 7000) of Division 3 ot the Business and Professions CoEe, and
my license is in full force and eflect.
❑c-"��-_� '! 3 Cewu.tt� _C Ip 1
I 3 _IO
l, n�i�aWre ���i
�
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm Ihal Ihere is a consWction lending agency for Ihe
pertortnance of the work fa vfiich this permil "s issued. (Sec. 3097, Civil Coae).
Lender's Name:
Lender'S Atltlress:
OWNER-BUILDER DECLARATIONS:
I hereby aKrm thal Undef penally of perjUry lhal I am EXEMPT FROM THE
CONTRACTORS LICENSE lAW lor Ihe (ollowing rea5on (Sec. 7037.5.
Business and Professions Code: Any ciry or county which requires a permit to
construcl, aller, impmve, demolish, or repair any structure, prior to its
issuance. also requires the applicant lor such permit to file a signed statement
that he of She i5 liCenSetl pufsuanl lo the Drovi5iOn5 0( lhe ConlraCrors
License Law (Chapler 9(commencing wilh Seclion 7000) o( Division 3 0l the
Business and Prolessions CoOe) or thal he ar she is exemDt therefrom antl
the Dasis for the allegetl exemption. Any violalion ol Section 7031.5 by any
applicaN for a permit subjecls the applicant to a civil penally of not more than
five huntlretl Oollar5 ($500).):
❑ I, as owner ol lhe property, or my employees with wages as lheir sole
compensation, WILL DO THE WORK, antl ihe structure is not intended or
offered for sale (Set. 7044, Busines5 and Prole55ion5 Code: The Contractors
License Law does not apply to an owner of property who builds ar improves
thereon, and who does such work himselt or herself or through his or her ovm
employees, provitleC that suc� improvements are not intended or offered for
sale. If, however, the building or improvement is sold wit�in one year of
completion, the ovmerDuilder will have the burtlen 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 CONTRAC70RS to consWct lhe project (Sec. 7044. Business and
Pm(essions Code: The cont2clds License Law dces rrot appty ro an ovmer o(
property who builds w improves Ihereon, and who conlra[ts for suth project wilh
a cmtracta(s) license pursuant to the Cont2ctors License Laws.).
❑ I am exempt under sec.
Business and Professions Code /or this reason:
345'l�A6 (1W )
Owner ID venfietl by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION: �
❑ I hereby certify that no excavation (rve (5) w more feel in depth into which a
person is required to descend, will be made in connecl'an v+ith wvrk authodzetl
by this permit, and that no building structure, scalloltling, lalsewurk, a demolition
or dismantling thereol, will be more than thirty-six (36) feel high. (Chap. 32, Gry
2, M 2, Sec. 341, Title 8, Califomia AdministraMe Cade).
❑ As ovmer-builder, I will not employ anyone to do work which v,ould
require a permit from the Division ol Industnal Satery, as notetl above. unless
such person has a permit to tlo such work Irom the division.
/oo�icanfs SlBnawm Wte
Division o( Industrial Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or presem or fuNre builtling occupanl neetl ro fle and
certity a Business Plan lor emergency response lo release or lhreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 0! the Califomia Health antl Safely CoGe requires, wit� some
exceptions, lhal a Business Plan be fletl vnth the Costa Mesa Fire
Department Dy every business which has at any one time tluring a reponed
year a quantity of hazartlous matenals equal to or greater Ihan a weight of
500 pounds, or a volume ol 55 9allons, or 200 cubic feet of wmpressed gas
at stantlartl temperature and pressure).
2. Does or will the applicant or present or tuture builtling occupant neetl m file
a registration fortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( Ihe Califomia Heallh anA Safery Cotle, with some
exceptions, requires registration with the Costa Mesa Fire Departmenl by
eaCh busine55 which at any one lime ha5 on hantl a qUantity 0f awlely
hazartlous materials equal to or qreater than a wxigh� of 500 pounds, or a
volume of 55 gallons. or 200 cubic feet ol compressed gas at stanCartl
temperature and pressure).
3. Ooes or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health antl Sa(ety Code provides thal the
Costa Mesa Fire DepartmeN may require me preparation, cenifcation and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous materials with the Fire DepartmeN.
4. II an RMPP is presently required, has Seclion 25534 0l lha Califomia
Health antl Safely Cotle been fully complied with? ❑ Yes ❑ No
s. Does or will iha applicant or present or future building Occupant require for
lhe work which is [he suhjecl of Ihis application a permil !or such conslruction
or modification from Ihe South Coast Air �uality Management District orlrom
any other air pollution control tlistric� or agency7 ❑ Ye5 ❑ No
(Sectbn 65850.2 0( Ihe Califomia Govemment Cotle raquires thal the requested
information be fumished on applications (or ran-residential building pertnits).
6. Will any part o/ the facilily to be constructetl under this permit De within
1000 feel from tha outer boundaries o( a school? ❑ Yes ❑ No
(If'yes", the tacility musl meet Ihe requirement of Sections 25534 and 42303
o( Ihe Cali(omia Heallh an0 Sa(ery Cotle).
7. If a permit from tha South Coast Air Quality Management Dislric[ or olher
air pollWion control districl or agency is requiretl for Ihe v.ork which is the
subject of this application, have all ol the disclosures prescriGetl by Calilomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. Qf'Yes", attach certificate of wmpliance from the appmpriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certily that untler penalty o( perjury lhe
inlormation given above is correcl. I agrea to wmply with all state lavrs and
city ordinances regartling Hazartlous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty o( perjury that I have read this appliwGon antl sta[e thal
the information given is correct I agree to wmply with all sWte laws and city
ordinances relating to building construction, antl authorize representatives of
the Ciry of Costa Mesa m enter upon the above-tlescnbed property for
inspection purposes. I agree not Io occupy or allow occupancy ot any Duiltling
au[honzed by ihis permit until final inspection.
SignaWre egalOwner�s) Daie
,�,.,(�-- 0� o O
l � NM�I2�0APW1[9n1—"'� �UNs.—J
� CITY OF COSTA MESA
BUILDING DIVISION
�
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
PERMIT TYPE: B COMBO
Sub Type: COM_ALT
FOR INSPECTIONS CALL: (7�4) 754-5626
Jos aooReSS: 555 900 ANTON BL CM
nPN: a1o50110 , Zoning: , ,
Vicinity: SUI7E 900 COMPUWARE
Const Type: I-A SQ. FT: 5000
PERMIT NUMBER: BC09-00169
STATUS: ISSUED
DATE ISSUED: 06/17/2009
ISSUED BY: RMD
Suite/Unit: 900
Primary Occ: 8
Valuation: $130,625.00
SCOPE OF WORK: 5000 SF INTERIOR OFFICE TI CONSISTING OF NONBEARING PARTITION WALLS, NEW FINISHES 8
FLOORING FOR "COMPUWARE" IN SUITE 900. 47 LIGHT FIXTS, 35 OUTLETS, 10 SWITCHES, 1 ALTER/REPAIR
COOLING/HEAT, 1 REFRIG < 100 K BTU.
OWNER: RREEF - Address: PO BOX 4900 Unit: DEPT 207
Phone: � , -City/State/Zip: SCOTTSDALE, AZ
APPLICANT: GILBERT, CHARLES - Address:
Phone: 77q381-4N5 Ciry/State/zZip:
CONTRAC70R: KPRS CONSTRUCTION SERVICES INC. License No. 751130
Phone: 714-672-0800 Address: 2850 SATURN STUnit:
Cell: City/State: BREA, CA
ARCHITECT:
ENGINEER:
License No.
License No.
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: • $758.78
Building Fees: $1,167.35
Electrical Fees: . $109.16
Mechanical Feas: $52.00
Plumbing Fees: $0.00
SMIP Residential: $0.00
SMIP Commercial: $27.43
Bldg Std Admin Fund $6.00
TOTAL FEES: $2,120.72
^Refer to fea receip(s for all fees paltl for project
Unit: :
ZipCode 92821
PHONE:
PHONE:
NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and relaled
regulations. (Ord. No. 92-28, § 1, 12-21-92) .
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
CO�Et INSPECTIONTy�
0
1616 Fixed SySt@m Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Raof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demqlition
ORjF� IN7171AL5 � / INSPEL710NME
__ 206 Finai Mechaniw�
208 Final Plumbinq
210 Final Electncal
212 Final Fite Prevention
220 Final Planning Approval
222 FinalSite
250 Final Building/Occupancy
D^ _ Are L� IN7171R15
_L�{7�e� '�L
�J/{ '�
/17i%� ��
�/
WORKERS' COMpENSATION DECLARATIO�
I hereby affirm untler penal�y of perjury one of the following tleclarelions:
❑ I have and will maintain a cerlifcale of consent to sel(-Insure for vrorkers'
compensation, as providetl for �y section 3700 of ihe Labor Cotle, for the
pedormance of lh� work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
sectbn 3700 0/ the Labor Code, for the peAortnance o( the wurk tor which lhis
pertnil is issued. My workers' compensation Insurance carrier antl policy
Ci�number are:n' ( //n/ r //�///
/V.a'J�/�M I�M/4'ti r//�.f�/��ILCM..////
(This SeIXion neep no( De cvmplele� tl Me permAis valuetl al one huntlr tlollars ($100) w kssJ
(,nli`c�y�Number, y ��(, o /
❑ I cerlify that in the performance ot the work for which [his permit is
issued, I shall not employ any person in any manner so as to become subject
lo Ihe vrorkers' compensation laws of Cali(omia, and agree that if I should
become su6ject to the workers' compensation provisions of Section 3700 0(
the L b/p'y'Code�,JI shall ,f�ojrthwith /9�� pl�yjw�}�h —the�se pmvisions.
�/L' �ic�...—(. /w"�/ �`—+T ' lP//7�B'�
NPw"-,.�5'^_=�nva I iD�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNL4WFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRqCTORS DECLARATION:
I hereby aKrm Ihal I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, antl
m�y li�ce'nse is in tull force and effect.
�— � 61� ass'N���
.�,�.�. � ,.��- G / / � / a-�
lGno4a`ctar's'Sw�iaw`e / '�
GONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a consiruction lending agency fw the
peAortnance ol the wvrk (or wfiich this permit is issued. (Sec. 3097. Civil Code).
Lender's Name:
Lender's Address;
SiB�alure Dale
OWNER-BUIIDER DECLARATIONS:
I hereby aKrm thal under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for ihe (ollowing reason (Sec. 7037.5,
Business antl Professions Code: Any city or county which requires a permit to
wnstruct, alter, improve, demolish, or repair any strucWre, prior to its
issuance, also reyuires the applicant for such permil b fle a signed statement
that he or she is licensed purouant to the provisions of Ihe Conhactore
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pr0(essions Code) or that he or she is exempt therefrom and
Ihe basis (or the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penally of nol more than
five hundretl tlollars (5500).):
❑ I, as ovmer ol the propeAy, or my employees with wages as their sole
compensalion, WILL DO THE WORK, and the structure is not intended or
oRered for sale (Sec. 7044. Business and Professions Code: The Coniractors
License Law tloes not apply to an owner of property who builds or improves
thereon, and who does such vrork himself or herself or thmug� his or her own
employees, provitled 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 lhe burden of proving that he or she
did not build or improve for purpose of sale.).
❑!, as owner o! the property, am EXCLUSIVELY CONTR4CTING WITH
LICENSED CONTRACTORS ro construct lhe project (Sec. 7044. Business and
Professions Code: The cont2ctors License law dces no[ apply [o an ovmer o(
property who builds or improves thereon, and who conlracts fw such projecl with
a contracta�s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Pro(essions Code for this reason:
Signawre �aie
305]Jt6(]MI)�
�
Owner ID verifed by tlri s license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ownership by (type of tlocument, i.e. - property tax bill or deed):
DIVISlON OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certi(y tha[ no excavation (rve (5) or more leet in depM inro which a
person is requiretl to descend, will be made in conneclion with work authonzed
by Ihis pertnit, and that no building sWcture, scaHWding, falsevrork, or demolition
or dismantling lhereof, will be more than thirty-six (36) feel high. (Chap. 32, Grp
2, Art 2. Sec. 341, Tlle 8, California Administ2tive Cotle).
❑ As owner-builder, I will not employ anyone to do work which wpuld
require a permit from the Division of Industrial Satety, as noted above, unless
such person has a permit m do such work from lhe division.
ApplitanCs S�gnaWre oale
Division of IndusVial Sa(ety Permi� Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certity a Business Plan for emergency response to release or threatened
release o( a hazartlous material7 ❑ Yes ❑ No
(Section 25505 ot the California Health and Sa�ety Code requires, with some
excep�ions, that a Business Plan be filetl wi�h the Cos[a Mesa Fire
Department by every business whicA Aas at any one time during a reported
year a quantiry 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 lemperature and pressure).
2. Does or will the applicant or present or fuWre building occupant need to fle
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safery Code, with some
exceptions, requires registration with Ihe Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous ma[enals equal to or greater than a weight of 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas at stantlard
temperaWre and pressure�.
3. Does or will Ihe applicanl or present or fuWre building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazartlous maleAals�? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certifcation antl
fling with the Fire Departmen[ of an RMPP by businesses which are requiretl
lo register acutely hazartlous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Heallh and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or vnll lhe appliW n[ or preseni or future 6uiltling occupant require for
the work which is the subject of Ihis application a permit for such consWction
or modification from the South Coasl Air Quality Management District or from
any olher air pollution control district or agency7 ❑ Yes ❑ No
(Section 65850.2 0( the Califomia Govemmenl Code requires tha[ the requested
infortnation be fumished on applications fa non-residential building permits).
6. Will any part of Ihe lacili�y to be constmctetl under [his permit he within
1000 leet (rom the outer boundaries of a school? ❑ Yes ❑ No
(I('yes", the facilily must meet the requiremenl o( Sections 25534 antl 42303
o! the Califomia Healih and Safery Cotle).
7. If a permit from lhe Sou[h Coast Air �vality Management Dis[rict or other
air polWtion control disMct or agency is required (or the work which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safely Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", allach certificate of compliance from the appropriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is correct I agree to comply with all state lavn antl
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1
certify under penalty o( perjury that I have read this application and state that
the infortnation given is correcL I agree to comply with all state laws and ciry
ordinances relating to building construction, and authorize represenlatives of
Ihe City of Costa Mesa to enter upon the above-0escnbed property (or
inspection purposes. I agree nol to occupy or allow occupancy of any building
authorized by_Nis permit until fnal inspection.
�
/,7 $s aWre�alOwyer{Sy Da�e
l� ��lL ilil/Z—
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(714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
JobAddress: 555 ANTON BL
Suite: 925
Vicinity: SPACE 925
Parcel Nunmber: 41050110
npp�icant: , MAITREJEAN, JOHN
Address: 15531 CONTAINER LANE
Owner:
Address
Contrador:
Address:
Zoning:
� Phone: 714-902-8000
HUNTINGTONBEACH,-CA Zip: 92649 � �
SAKIOKA FARMS %MORGANS HOTEL LIMITED
PARTNERSHIP ATTN JOE CR4WFORD � � -
DENVER, CO � . Phone:
1050 17TH ST #1220 ` " Zip: '
CEDENO, OTTO
75531 CONTAINER LANE ,
,,. Phone: 714-902-8000
HUNTINGTON BEACH, CA Zip: 92649
' � ° License: -612153 � _
. SCOPE OF PERMIT
FIRE ALARM PERMIT FOR 685SF T.I. FOR SPEC SUITE 925.
REF#:�BO6-00345
77 PAIF DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 0321/2006
Issued: 04/20/2006
ISSUc _"O'H7'�—'—�—�
� = FEE SUMMARY
Plan Check: $54.11 - � Calc Valuation: s2,aso.00
Permit: $83.25 . � Claimed Valuation: S2,aso.00
Other. $0.00
Total: ` "$137.36
`i' �•c� n l�,ao�c � � , , '�i !� Q�� 1—�in�
f"
(�•?�06 �ha:�e �.: �-1a.✓h-+ ��vnh��� D�- !?��/�
� ,� �
, �
��� � : �� �:� � � � — ��
. ,.
�� - .
� � _. ,a _ , , .
,.
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulatlons. (Ord. No. 92-28, § t, 12-21-92) .
EXPIRATION: This permi[ shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned
for a pedod of 180 days. � ,
INSPECTIONS: In order for the work authorized under this pertnit to be conside�ed legal, such work must comply witA all applirabte codes, and all
requlred Inapeetiona end flnel epproval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5628 �
2446�6818/00)
WOHKERS'COMPENSAnON DECLAflAnON: .
I �ereDy ettirm under penalty,of perjury one of the following declarations: •� �
❑ I heve and will maintein a cartifiwte ot consem to seN-Insure tor workers' compensatlon, es provided tor by sectlon 3700 0l the Lebor Code, lar the peAortnence of Ue
wark tor w�ich ihis permit 15 issued.
ensation insurance, es repuiretl by section 3700 of t�e Lebor Cade, tor the peAortnence ol the work �or which this pertnit is issuetl.
carrier and poCllty number ere: ^�
Z.Ocr]GE l.0 � POGcyNumbec �-1�o�(��t033i2
permit is velued et one bundred do�lars (S �00) or less.)
❑ I ce�ify that in the peAormance of tha work tor which this pertnit is issueQ I shall not employ eny person in eny menner so es to become sublect to the workers'
compensatlon laws ot Califomia, and agree t ' I should become subjacllo the warkers' compensation provisions ot Sectlon 3700 of t�e Lebor Catle, I shall fonhwiih
complywiththese�pmvisi� s.
Applice�rt�Signature� s'� v Deta: �� 2d d�n
WAqIJIN6�FAM1URE TO SEW ORKERS' C0�.IPENSAJ� WVERAGE IS UNLAWFUL M1D SMALL SUBIECT Ml EMPLOYEF70 CRIMINAL GE TI AND CML FlNES UP TO ONE HUNDRED
TTIOUSAND DOl1.AFE (5100 �. IN qDDITIIXJ TO THE QO T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3�OB OF THE LABOR CODE, IMEREST, M1D ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm that I am
CONSTRUCTION LENOING AGE
❑ 1 hereby attlrtn Ihat Ihere is a
LenOers Name:
Signature:
OWNER-BUILDER DECLARATIONS:
of C�apter 9(commencing with Sectian 7000) ot Division
entl my license is in full
pertortnance ol Ihe work tor which this pertnit is issuetl. (Sec. 30W. CiNI Cotle).
Lenders Address: �
Date:
I hereby attlrtn thet under penalry oi perjury that I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the follawing reeson (Sec. 7037.5, Business and Prafession:
Cotle: Any ciry or counry which raquires e pertnit to consiruct, elter, improve, demolis�, or repair enysWcture, ptlor to Its issuence, elso requires ihe epD�lcent for such permil
to ille e signed statement the� he or she Is Iicensed pursuant to ihe provislons ot ihe Contractore License Lew (Chepter 9(commencing with Sectlon 7000) oi Divislon 3 ot ihe
Business end Professions Code) ar ihat he ar she is exempt Ihereirom end the basis br the alleged exemption. Any violetion ol Sectlon 7031.5 Dy any eppliceN for a pertnli
subjects ihe applicant to e civil penally of not more Ihan five hundre0 dollars ($500).):
� I, es owner ot the properry, or my employees wi�h wages es t�elr sole compensetlon, WILL DO THE WORK, end the structure is not intended or ottered tor sele (Sec.
7044, Business end Pmfessions Cotle: The Contracmrs License Law does not apply to an owner of property who bulids or improves Ihereon, and who does such work
himself or herself or through his or her own employees, providetl Ihat such improvaments ere not Intended or oHered for sele. II, however, the bullding or improvement is
sold within one year oi completion, the owner-builtler wlll have the burden of proving ihat he or she did no� build or improve tor purpose of sale.). �
❑ I, es owner ot the pmperry, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to constmct the profect (Sec. 7044, Business entl Professlons
Cotle: The conirectors License Lew Does not eppty to en owner of pmparty who bullds or Improves Ihereon, end who coniracts for such pro�ect wlih e conirector(s)
license pursuant to ihe Contrectors License Laws.). .
❑ I am e:empt undar sec.
Signature:
Ownar ID verified by driver'Slicense. ❑ Ves ❑ No
Business and Professlons Cotle for thls reason:
Verificatlon ol Ownarship by (rype of tlaument, i.a. - property taz bill or tleed):
Driver's License No.
Data:
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CEFTIFICATION:
❑ I hereby certify that no excavetion five (5) or more feet in depth Into which a person is requiretl Io descend, wlll be made in connection with work authodzed by ihis
permit, and thet no building slmcNre, scalloltling, talsework, or demolition or dismanNing thereot, will be more than thirty-sla (38) feet high. (C�ep. 32, Gry 2, Art 2, Sec.
341, Title B, Calltomia Atlministrative Coaa).
❑ As owner-6ulltler, I will not employ enyone to do work which would require a permit irom t�e Division of Intlustnel Setety, es noted ebove, unless such person has e
pertnit to do such work irom the division.
Signature: Date:
Division of Intlusirial Safery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND A17T?IORVATION OF ENiAV: I certify un0er penalry of perjury thet I heve reed this appliwtion end siate thet the inlortnatlon given is
correct. I egree to comply with ell stete laws antl ciry ordinances relating �o building cons�ruc�lon, antl euthorize representetives of the Ciry of Costa Mese to enter upon the
ebove-tlescribed property for inspection purposes. I egree not to occupy or allow oaupency ot eny building euthorized by this permit until finel inspection.
1616 Fixed System Flnal Fire Prevention
1266 Paol Spe Final
200 Final Re-Rool
201 Finel BIocWReteining wall
202 Final Factory Fire Place .
203
204
Final Sign
Flnel Domoli�ion , ,
PSIE I[LTQ191fl COOE�
� 208
208
Finel Mechanical
Finel Plumbing
210 ' Finel ElBcincal
212 Finel Flre Pravenllon
. 220 ' Final Planning Approval '
222 � Final Site
, 250 Final Building/Occupency
��.��riiM/.147
G- I -06 �
(714) 754-5273 • F2x (774) 754-4856 • www.ci.costa-mesa��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL �J.� /,� Z�p Status: ISSUED
Suite: 925 ��P `v"� Applied: 03/01/2006
Vicinity: SPACE 925 Issued: 04/10/2006
Primary Occ: B Eat<50/ OKce/ Bar<50 Type of Construction: I-FR
Parcel Number: 41050110 Zoning:
Applicant: DEREK BEYLER
Address: 1565 N HARMONY CIR
Phone: 714-932-3131
ANAHEIM, CA . Zip: 92807
ownec SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP Al"iN JOE CRAWFORD
DENVER,CO Phone:
1050 17TH ST #1220 Zip:
Contractor. AMARON CONSTRUCTION CORPORATION
Address: 1565 N HARMONY CI� �
- . � � � Phone: 714-993-922C
� � ANAHEIM HILLS; CA
Zip: 92807 � - License: 674301
Arch : , . Eng:
Address: . Address:
ISSUED BY:
� Phone: � Phone:
. Zip: � , License: '. , License:
" _ � SCOPE OF PERMIT
685SF T.I. FOR SPEC SUITE 925. WORK TO INCLUDE: REMOVAL OF 1(E) NON-LOAD BEARING PARTITION WALL, NEW CEILING GRID AND
MINOR ELECT. WORK. ' .
i
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:..
I nspection:
� Total:
$163.31
$251.25
$0.00
$3.01
$0.00
$0.00
$417.57
FEE SUMMARY
PLANNING & ZONING
SETBACKS ' �
MAINSTRUCTURE Front 0-0 Rear 0-0 Left 0-0
� S r�= � � �
� �_ � � �
ACCESSORY Fronh 0= 0A . Rear 0- 0 � Left 0- 0
�' � �. �
�
PARKING � �, ' Existina':' , o ���� �'Required: o � . � Pr000sed: o "
Calc Valuation:
Claim Valuation:
Right 0-0
Righ� . 0-0
$14,316.50
$13,700.00
NOTICE: The work authorized by ihis permit shall comply with all applicable hantlicap access raquirements under Califomia statutes and rel ed
regulations (Ord. No. 9248, § 1, 1241-92)
EXPIRATION: This psrmit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or aba doned
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 codas, and all
required Inspections end final approval must be oBtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zawac �sroo�
WORKERS' COMPENSATION DECLARA710N:
1 hereby aflirm under penalty of perjury one of Ihe tollowing declarations:
❑ I have end will mainiain a cenificate of consent to seif-Insure for workers' compensation, as provided fo� by section 3700 ot the Labor Code, tor the perfortnance o1 Ihe
work for which this permit is issuetl.
❑ I have and will maintain workers' compansation insurance, as requiretl by section 3700 of the Labor Code, for the peAormance of ihe work for which this pertnit is issuetl.
�My workecfa mp nsation I r7ance c rier and poiicy number are: /�
Carner._. 7�� �/�� PolicyNumber. /�7��� �ZvO�
;(This'sec(ion need not be completed il (he permit is valuetl e( one hundreO dollars ($100) or less.)
�ertity that in the pertormance of the work for which this permit is issued, I shall not employ eny person in any manner so as to become subject to Ihe workers'
compensation law5 oi Celifo ' d agree thet i� I shoultl come subjec� �o Ihe workers' compensation provisions oi Section 3700 of the Labor Cotle, I shall forthwilh
comply with these provision f �---�- �( � /
Applicant SignaNre:, � �_Date:� %� Q E a�
�---
WARNING FAILURE TO SECURE WOFKERS' C01dPENSATION ERNGE IS UNLAWFUL AND SHALL SUBJECT PN EMPLOYER t0 CRIMINAL PENPLTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSANDOOLLARE�5100,000),INF�DRIONTOTHECOSTOF PENSATION,DPNAGESASPPOVIOEDWRINSECilON3�O60FTHELABORCODE,IMEREST,ANDATTORNEYSFEES.
LICENSED CONTRACTORS DECLARA710N:
1 hereby aHirm that I am lican�ed u9d�rprovisic
CONSTRUCTION LENDING AGENCV:
Chapter 9(commencing with Sedion 7000) of Division 3 ot Ihe Busine� antl Professions Code, and my Iicense is in full
�Ctass �( ,
_ Date: �' 9 yQ 0 /
� _�� �.�._
❑ 1 hereby aHirm ihat there is e consimction lending agency for the pedormance ot the work tor which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: Lentler's Address:
SignaNre:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby attirm ihat under penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or county which requires e permit to consiruct, alter, improve, demolish, or repair any simcture, prior to its issuance, also requires the applicam tor such permit
to tile a signed statement that he or she Is licensed pursuant to ihe provisions ot ihe Con(ractors license Lew (Chapter 9(commencing with Section 7000) of Division 3 oi the
Business antl Professions Code) or that he or sha is exempt therefrom and Me basis for the allegad exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more Ihan five hundred dollars ($500).):
❑ I, as owner ot the propeny, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the stmcture is not Intended or oHered tor sale (Sec.
7044, Business and Professions Code: The Contradors License Law does not appty to an owner ot properry who builds or improves �hereon, and who does such work
himself or herself or ihrough hls or her own employees, pmvided Ihat such improvements are not imendad or oHeretl for sale. If, however, ihe building or improvement is
sold within one year of completion, ihe owner-builder will have ihe burden ot pmving ihat 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 constmct the project (Sec. 7044, Business and Pmtessions
Code: The coniractors License Law does not eppty to an owner ot pmpetly who builds or Improves ihereon, and who conlrecis for such project with a contractor(s)
license pursuant to the Contractors License laws.).
❑ I am exempt under sec. Business and Professions Cotle for this reason:
Signature: Date:
Owner ID venfied by dnvers licen5a. ❑ Ves � No Driver5 License No.
Veritication of Ownership by (type of document, i.e. - property taa bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify ihat no excavation five (5) or more feet in tlepth into which a person is requlretl to descend, will be mede in connection with work authonzad by this
permit, and t�at no building simcNre, scaHolding, felsework, or demolition or tlismantling thereot, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, California Adminlstrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from ihe Division of Industrial Safety, as noted above, unless such person hes a
pertnit to do such work Irom �he division.
Signature: Date:
Division of Industrial Safety Permit Number:
CER7IFICATE OP COMPLIANCE AND AUiHORIZA710N OF ENfAY: I certiry under penalry of peryury that I have read this appliration antl state that ihe information given is
correct I agree to comply with all stata laws end city ordinances relating to building consiruction, antl authorize representatives oi the Ciry ot Cos�a Mesa to enter upon Ihe
above-described property for in5pection puryoses. I agree not to occupy or allow occupancy of any building authorized by ihis permil unlil final inspection.
COOE t. INSPECTONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roat
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 � Finel Demolition
o"re IMRIr1L5
� /� C��Date
�Dat�
400E� INSGELTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Efectrical
212 Final Fira Prevention
220 Final Planning Approval
222 FinalSite
250 Finai Building/Occupancy
A�F INTRIpLS
\
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa,Ca��TRICAL PERMIT �� FAtR DRIVE, COSTA MESA, CA 92626
tL
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
555 ANTON BL
925
41050110
WOLFE, ERIK
10 HUGHES
SUITE A105
IRVINE, CA
Phone: 949-768-5807
Zip 92618
Owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
DENVER,CO Phone:
7050 17TH ST #1220 Zip:
Contractor:
Address:
THOMAS ELECTRIC
10 HUGHES
SUITE A105
IRVINE, CA
Phone:.949-768-5807
Zip: 92678
� License:625798 -
ISSUED BY:
Status: ISSUED
Applied:, 04/26/2006
Issued: 04/262006
' � SCOPE OF PERMIT
� 68SSF T.I. FOR SPEC SUITE 925. WORK TO INCLUDE: REMOVAL OF 1(E) NON-LOAD BEARING
PARTITION WALL, NEW CEILING GRID AND MINOR ELECT. WORK. REF.: BO6-00345 '
. ELECTRICAL TO INCLUDE� 10 LIGHT FIXTURES, 4 OUTLETS, 1 SWITCH�AND 6 COMMUNICATION
DROPS. � . - - ' �
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighling Fixts, . �
Recepl Oullets '
Switches ' � ,
Non Res Appl
Res Appl
Service ro 200a �
Service to 1000a
Service over t000a
Motors l0 1hp
Motors to 10hp �
Motors l0 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
Quanlity
$23.50
so.00
50.00
$0.00 0
$0.00 0
$0.00 0
811.00 10
$4.40 4
$1.10 1
50.00 0
50.00 0
� $0.00.: d-<�Oc- ��
', $0.00.; . _ �;., .,
�!i 50.00 � : 0 "-
� - 50.00 ��' j0� ._ �_
. 50.00� �-0-� '
� � $0.00 �. . , 0 � �'
�` �.-�50.00 . •0�-
- '� $Q00 - - , ' 0' '
' . $6.60. � �6
�$0.00-- 0�.- (-
50.00 � . � �� 0
$0.00 ' 0
$0.00 ' 0� � �
$0.00 0
FEE SUMMARY
Temp Dist System / lighting
Busway/100ft - �-
Standing Seclion
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
................:up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misa Conduit � '. � [ ' • ,-
Misc. Conductor �
Circus ( gen or ride)
Circus (mech ride or lighis) - �,
Christmas Tree Stand - "
Fireworks Stand � �
Other Electrical Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0"
$0.00 0
$0.00 0
$0.00 ., 0
$0.00 0
$0.00 0
$0.00� 0:
$0.00 0 �
"80.00 .' 0
$0.00 '. ,0
$0.00 0
$0.00 0
$0.00 ,
� Investigation Fee � . $0.00
Plan Check Fee , �$0.00� �
�;ReinspectionFee - . �.�,$0.00
TOTAL�CALCULATED FEES E4fi.60
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiramants under Califomia statutes and related I�
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: Thls permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspentled or
for a penod of 7 BO days. � •
INSPECTIONS: In order for the work eulhorized undar this permit to be considered legal, such work must comply with all applicable co�
requlred Inspectione and flnal epproval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this
FOR INSPECTIONS CALL: (714) 7545626
2M&<8 (fl�00)
all
WORKERS'COMPENSAnON DECLqqATON: � �
I hereby aHirm under penalry of perjury one of Ihe Idlowing dedaratlons: -� � � � , .
❑ I have and will mainWin a ceNticate of consent to selt-Insure tor workers' compensetion, es pmvided for by sectlon 3700 of the Lebor Code, for the pertortnance ot the
work for which Ihis pertnit is luued. '
will maintain workers' compensatlon Inwrence, az requirad
s' compensatlon InsUrence cerrier enA policy numDer are:
!Ae perMf /5 vaNed et me huntlretl
3700 of Ihe Lebor Code, tor Ihe pertortnence ot Ihe work for whbh thLs pertnit l9 ksued.
P.oIltyNumber._ �� ��S���U
wless.) �
❑ I cenity �hat in t�e pertormance ot t�e work lar w�ich Ihls pertnit is issue4 I shall noI employ any person in eny manner so es to become sub�ect to Ihe xrorkers'
compensation laws of Calitomig, d a ee mat Ii I s�oultl become sub�ect to t�e warkers' compensetian pmWsions ol Sectlon 3700 0l the Lebor Cotle, I shall forthwlN
compy wit� t�ese provisio�s/
Appitcan ist pnamre: - ' oate: �%/� 06
WMNfM3: FAILURE TO SECUF OMPENStT10N COVERA(3E IS UNLAWFUT ANO $HN.L SU61ECr fN EMHDVER Tq C(UMINN: PENp671E5 M10 qVil FlNES UP TOONE NUNOiiED
TMOUSAND DOLLARE (f100, iN TO THE COST OF COMPENSATON, DAANGES AS PROVIDED WR IN SECTION 3IOB OF TME LABOR CO�E, INfEREST, M10 AITORNEY'S FEES.
LICENSED CONTRACTORS DECLqqAT10N:
I hereby eflirtn Ihat I em Iicen5�0 ur�erpr�W�ns oi Chepter 9(cwnmencing with Sectlon 7000) ol DMSIon 3 of
end my Ikense Is in lull
CONSTRUCTION LENDIbO'AG�ie{':
❑ I hereby aMirtn that ihere is e consiruction lendinp epenry lor the peAormance ot the work lor which this pertnit Is issued. (Sec. 3097, Civil Code).
Lender's Neme: _ .. _ Lendefs Address:
SlgneNre:
OWNER•BUILDER DECLARATONS:
Dete:
I hereby ettirm Ihet under penalry ol Der�ury thet I am E7(EMPT FROM TME CONTNACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry whic� requires a pertnit to construct, elter, improve, demdis�, or repair eny structure, pdor to Its issuance, elso requires the epplicant for such pertnil
to iile e signeA stetement thet he or g�e Is Iicensetl pursuant ta the proNsions ol the Contrectors License Lew (Chepter 9(wmmencing with Sectlon 7000) of Dlvision 3 of the
Busineu and ProFessions Cotla) or Ihet he ot she Is exempt t�eretran entl the basls br the alleped exemption. Any vblatlon o1 Sectlon 7031.5 by eny epplicant for e pertnit
subjects the epplicant to e dvll panalry p� �ot more then fNe hundred ddlaro ($500).�:
❑ I, as owner oi Ihe properry, or rny employaes wlth wepes as ihelr sole wmpensation, WILL DO 7ME WORK, and the structure is no� Intentletl or oHeretl tor sale (Sec.
7044, Business and Professbns Cotle: Tha Coniractors License Lew Ooes not appty to en owner of property who builds or Improves Ihereon, end who does such work
himselt or hersetl or Ihmug� hL9 or �er own employees, pmWtleO t�et such improvements ere nat intended or oflered tor sale. If, however, �he huilding or ImprwemeM Is
soltl within one year o1 comqetion, lhe ownerbuilder vrill have the burtlen of proving that he or she did not builC or improve for purpose oi sale.). �
❑ 1, es owner oi Iha propeM. em E%CLUSIVELV CONTRACTING WtTH LICENSED CONTRACTORS lo wnsiruct the project (Sec. 7064, Bu5ine55 end Pmfessbns
Cotle: The wntrecmrs Licertse Lew tlaes not epply to en owner ol propeny wha builds or improves thereon, and who contrects br such pro�ect with e contratta(s)
license pursuant to t�e ContraMors License Laws J.
❑ I am ezempt untler sec. Business and Professions Code iw ihis reason:
Signature: �ate:
Owner ID ventied by driver5license. ❑ Yes ❑ No Dnvera Llcense No.
Vertlication of Ownership 6y (rype o1 tlocument, i.a. � praperty ta: blll or deetl): '
Expires:
DIVISION OF INDUSTRIAL SAFETV PEHMR CERTIFlCATON:
❑ I hereby cenify Ihat no excavatlon tNe (5) w more feet In tlepih Into which e person Is requlred to tlescen4 will he made in wnnection with work euthorized by ihls
permit, antl that no bullding strUcwre, scafloltling, falsework, or demolition or tllsmantlinp I�ereof, will Ce more then thirry•six (38) Ieel hiph. (Chep. 32, Orp 2, Ah 2, Sec.
341, 71t1e 8, Celitomia AdminlstreWe CoEe).
❑ As owner-builder, I will noI employ enyone to do work wNch woultl require a pertnit trom the DiNsion ot Indusiriel Safoty, es noted ebove, unless such person �as a
pertnit to do such wark trom Ihg tlivision.
Signature: Date:
Division oi Industnal Safery Permit Num6er:
CERTIFlCA7E OF COMPLIANCE AND AUTHORVA710N OF ENTAV: I certify under penalry of perjury that 1 �ave read ihis applicetion enC state Ihat the inlarmation given is
correct. I egree to compty wl�h ell stete lews end dry arClnances relating to bullding construction, end authorize representatives oi the Ciry ol Costa Mesa lo enter upon the
ebove-descdbetl D�operly for inspection purposes. I agree no� to occupy or ellow occupency ot eny building euthorized by Ihis permit until finel inspection.
COOE �. � �
1616 Fixed System Final Fire PrOventlon
1266 Pool Spa Final
200 Final RaRoof
201 Final Block/Reteinirg Well
202 Final Fectary Fire Place
203
204
Final Sign
Finel Domdition
COQE1 RISPECiIONTYPE
206 � Final Mechanical
20B Finel Plumbing
210 Finel Electdcal
212 FIneI Fire Preventlon
220 Final Planning Approval
222 Finel SIIe
250 Final Building�Occupflnty
Pdff ItiIl�4
�%i, ; �J!I!�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-m FIRE SUPRESSION PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suile:
Viciniry:
Parcel Number:
555 ANTON BL
900
STE 900 (BLOODGOOD, SHARP AND BUSTER)
41050110 Zoning:
Status: ISSUED
Applied: 06/21I2005
Issued: 07/21/2005
ISSUED B
Applicant: MORENO, ANNA % -
Address: 30060 SILVER SADDLE CT' �. � � � �
i
- . . � , , . � Phone: (951)244-9836"� ���� .
CANYON�LAKE,CA. - � ' Zip:- 92570 � � � � - -
i _
Owner. �� SAKIOKA FARMS%MORGANS HOTEL LIMITED ` �
Address' . PARTNERSHIP�ATTN JOE�CRAWFORD . � '
DENVER, CO ' Phone: ,� ,
1050 17TH SL #1220 Zip: � , �
� � �
IContredor. ' ALL`PRO�FIRE PROTECTION '� ��
-Address: �7 30060 SILVER SADDLE CT �
, , ,-. Phone:' .(951) 244-9836 • - ,
' CANYON LAKE; CA - : Zip: _� - -.92570 � � ,
, .. , � ,' � - ucense: tizyas� � � , � ,
� � � SCOPE OF PERMIT
RELOCATION OF 3 FIRE SPRINKLER HEADS IN CONJUNCTION WITH THE 2.121 SF INTERIOR
TENANT IMPROVEMENT FOR "BLOODGOOD, SHARP AND BUSTER" IN SUITE 900�WHICH WAS FORMERLY
TWO SUITES (7280 SF). �
REF: BOS-00877 ' ' , .
FEE SUMMARY
Plan Check: $15.28
Permit: $23.50
Other: $0.00
� .Total: $38.78 " • �
r�w��� d�.., . �-�� � ���� j� � ,
. ,.
�� � � ' �� �,
�,
�,� �_ .. ." - _
� ` .�
, �; -
Calc Valuation: '
Claimed Valuation:
,` �," ,
$500.00
asoo.00
I, NO7ICE: The work authodzed by this pertnit shall comply with all applicable handi6ap access requirements under Califomfa 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 wlthin 1 BO days, or ii work is suspended or abandoned
for a period of 180 days.
�. INSPECTIONS: In order for the work eNhodzed under this permit to be considered legal, such work must comply with all applicable codes, and all
I requlretl Inepeetlona end finel epproval must be obtained. Fallure to obtaln inspectlons and final approval will result in the expiration of ihis pertnit.
FOR INSPECTIONS CALL: (7/4) 754-5628
2448d8 (BI00)
J
WORKERS'COMPENSAnON DECLAflAnON: �
I hereby aHirm under penelry of perjury one of Ne Idlowing tledaratlons:
❑ I e entl wlll meinteln e ceNticate of consent to aell-Insure for workera' compensallon, es provlded for by sectlon 3700 of the Lebor Code, for Ihe peAortnence of the
oflt iof whlCh �hi9 pertni� Is is5ued.
I have arW 11 melntein wwkers' oompense0on insurence, as reQulretl by &ecUon 3700 ot Ihe Lebor Cotle, for the peAortnance oi the work for whldi Ws pertnit Lv issuetl.
My worker �satlan Ins nce ca r end pdicy number are: /� �/� /'/^��
Certlor. / .� Policy Numbgr; � y � �� �`�
(7hls secNon eed not be cnmplet I/ the pe�mlt Is velue0 et one huntlred tloners (5100) or �ess.) !
❑ I certlly t�a� in ihe pertortn nce ol Uie Work lor whlCh ��ig pBrtni� 19 199ued, I 6hell nOt employ eny pBreon In eny manner eo as to became subjec� �o Ihe wwkere'
wmpensetlon lawa of mla, enE epreg thet II I sh id becwne wb�ect to Ihe workers' campenselion proNslona of Sectlon�700 ot a LeDor Cade, I shell forthwlih
complY with these pr ' o. f—�//{'^/ n
Applicent SlgneNre: ✓'' e�0 Date: _ � L � D�
WMNIN(3: FAILUiiE TO SECU WORKERS' COMPENSATION COVERAOE IS UNUWFl1L AND SHALL SUBIEGT AN EMPLOYER TO CNMINAL PENALTIES AND CML FlNES UP TO ONE MINDRE�
TMd1SAN� DOLLARE ($100,000), IN ADqTION TO THE C0.ST OF LOMPENS4TION, UAM4�E5 hS PROVIOED WR IN SECTION 3108OF THE IABOR OpOE, IMEREST, AND ATfORNE`!'S FEES.
LICENSED CONTRACTORS UECLAHATON:
I �ereb eflirtn Ihat I em Ilcense0 un er C ter 9 twnmend with Seclion 7000 of Divlslon 3 af Ihe Buslness e�Pro��s�wns Code, entl my license Is In fu0
�o«a aene��. ��. « Pe �'�°��i..�° ` � ' ��a�» �
convaaors sianawre: ;1.f .,n,f✓ „��,= oeie:
CONSTRUCTION LENOING AGENCV:
❑ I hereby eHirtn t�at Nere Is e wnstrucNon lendinp epenty for Ihe peAortnance of Ihe work tor which this pormit is issuad. (Sec. 3097, Civll Code). .
Lentlore Neme: LenAer's AAtlress:
SlgnaNre: Date:
OWNER-BUILDER DECLARA710NS:
I hereby eHlrm Ihst under penelry W per�ury Uat I em EXEMPT FROM THE CONTRALTORS LICENSE LAW ta the iWlowing reasan (SeC. 7031.5, Business entl Professbns
Cotle: My dry or counry which requlres e permu to cronstruct, elter, improve, demdish, or repalr eny structure, prior lo Its issuance, elso requires the applicent lor such permit
to file a signed stetement tha� �e w she Is Iicensetl pursuent to the praWsloru o1 the Contrflnors License Lew (Chepter B(commendng wlih Sedion 7000) ol Division 3 ot the
Business entl Professlons Code) or Ihet he or s�e L9 exempt t�eretrom antl the besU for the elle8etl evemptlon. Any Wolation of Section 7031.5 by eny epplirant for e pertnit
subjec4s the epplicent to e dvil penalry of not rtwre than Iiva huntlred dollers ($500).J:
❑ I, es owner ol Ne D�aPeM. or my employees wit� wages es their sde compensallm, WILL DO THE WORK, end the siructure is not InterWed or oflered fa sale (Sec.
7044, Business end Professions Code: The Coniractors Lkense Lew tloes not eppty lo en owner oi property who builtls or improves Ihereon, and who Coes such work
himself or hersell or through hls or her own employees, provlded that such improvements ere not intended or oftered tor sele. If, however, Ne building or improvement is
sUtl wilhin one year of com0�e���. ��e owner-builtler vrill have the burden ot proving Ihe� he or s�e dId nol build or improve lor purpose of uleJ. '
❑ 1, as owner oi ihe praperry, am E%CLUSIVELY CONTAACTING WRH LICENSED CONTflACTORS to construct ihe pro�ect (Sec. 70M14, Business antl Professlons
Coda: The con[redors Llcense Law does nat eppty ro en owner of pmDerry who builds or improves Ihereon, enA w�o contraas for such project with a contrac[or(s)
license pursuant m tha Contranors Ucense Lews.).
❑ I em exempt under sec. Business end Professiwu Code br this reason:
SignaWre: Dete:
Owner ID veritietl by drivers license. ❑ Yes ❑ No Drivers License No.
Verllicallon of Ownership by (type of Ooament. I.e. - properry tex bill or daedj:
E�ires:
DIVISION OF INDUSTRIAL SAFETV VERMR CERTFICATION:
❑ I hereby certity Uiet no excevetlon Me (5) ar more feat In depih Into whic� e person L5 requiretl to tlescentl, wlll be matle in wnne�Mion wilh work euthoAzetl by �his
permit, flnC t�at no bulldinp 5tructure, scaHdtling, laLsework, or demdilirn or dlsmentling Ihereof, will ba more than thirty-sIz (38) feet hip�. (Chep. 32, Grp 2, M 2, Sec.
341, 71t1e e, Celitomia AdministraUve CoCe).
❑ As owner-builtler, I will not employ enyone to Oo work w�ich would reQuire e partnit trom ihe Division ot Industrial Setery, es notetl ebove, unless such pemon hm e
pertnit to tlo such work trom t�e dlvision.
Signeture: �ate:
Division ol Indusirial Safety Permit NumOer.
CERTIFlCATE OF COMPLUWCE AND AUiXOR¢AT10N OF EMiiY: I certity unCer penelry ol perjury Nat I have read thls epplicatlon entl stete Nat the InfortneUon gNen is
correct. I egree to comply wlt� ell stete lews end dry ortlinences relating to 6uildinp conswctlon, end authodze representatives of t�e City ot Costa Mesa to enter upon [he
ebove-describad property tor inspection Durywes. I epree not to occupy or ellow occupency of eny building euthorized by this permit uniil tinal inspectian.
i e alOwner(s) -� �� afeD,�—
�
— And/Or Authorized Applicant Date
sooe �, ixsvecnoNrve
1618 Fixed System Flnel Fire Preventlan
1268 Pool Spa Final
200 Flnal Re•Roof
201 FIneI BIocWReteininp Well
202 Flnal Fectory Fire Place
203
204
Flnel Sign
Finel Demolltlon
QAIC It�ELB
CO�E� INSVECTIONTYPE
208 Finel Mechanicel
208 Finel Plumbinp
210 Finel Eloctricel
212 Flnel Fire Preventlon
x2o
222
250
Final Plenninp Approvel
Final SIIe
Finel Bulidinp�Occupancy
� It��
(774) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Jobnddress: 555 ANTON BL
Suite: 900
Viciniry: UNIT 900
Parcel Nunmber: 41_050110
Zoning:
Applicant: KNUSTGRAICHEN, ERNIE
Address: 15531 CONTAINER LN . . � . ,
� � Phone[ 714-902-8000� �
HUNTINGTON BEACH, CA �,F� � .. Zip: 92649 �-
Owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD ,
DENVER, CO. , r-� - Phone � .
105017TH.ST #1220 � - _ ' -.Zip .. ..� . .
Stalus: ISSUED
Applied: 08/03I2005
Issued: 0823YL005
ISSUED BY: 1//_ ✓�_!�
Contrector. , AMICAY, SAM
Address:� . � . - . . . - �
� � Phone: 714-902-8000 � - � `
. . ' 2ip: .. - .
�. x
� - ' � License'- 612153 - � � " ' -
. ' � -�' ' � � SCOPE OF�PERMIT . �
� � f INSTALI 8 STROBES AND DEVICE FOR �THE 2,721 SF INTERIOR TENANT IMPROVEMENT FOR �
. ' "BLOODGOOD; SHARP AND,BUSTER" IN SUITE900._ � � - �
, ; � "3'. . - � � �_ . . . � ' - " �
. . _ � REF #BOS-00877 - -� „ . . = is... . ..
� � � � � -_FEE SUMMARY �,-
Flan Check , � $72.31 . r �' b �; i �
' Permd: `' $119.25
Other. `,t�, $0.00 � -
,- � ; �, �
`-.
�, . : � ._. " . .. , . .� k
. ___� .. - .. - - _. ...
.. _ . � _. � � . . '
. ' _.. i � .. ; ...: . S ... �.... .: .' .z -.
Total: 5783.56 � �
;Galc Valuation ; ,; $n rs oo . �
Claimed Valuation: $n,iz5.00' :
, �: � �s
a . . ! 3
� - - .� ' i
, . _
,. �
uv;
�- �
? , � � � �4. ,
� �
• • r ^n,. Sx;Y +t . tT ' F':
, wl: E �4 � . .
� � �n � � �
Y 1fi� �
�`_.. �; u� 't i` ;a � � �� ��'�
. � � re».�-.; �� "
E' — �^ �
3�
� �� � S Y
� y ,.,�
f �t� �m 7�t
3' ;� y i :� 1 � ; �,� �
� . '� ' "���,�"','•,
� r,_,-�; ^, ., g'... ''�
� �
' " _' ...... . ��� ., �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241•92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period oi 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and eli
requlred Inspeetlons and final approvel must be obtained. Failure to obtain Inspectlons and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
:{�:�Fil•�J]
WORKERS'COMPENSAnON DECLARAnON: . �
I heieby eHirm under penalry oi perjury one ot the following declaretions: �
❑ I have and will meintaln e certificete of consant to self-Insure for workers' compensation, es providad for by sedion 3700 of Ihe Lebor Code, for the peAortnance of Ihe
wark for which Ihis permit is Issued.
.^=1�h va e and will maintain workers cwnpensatlon Insurance, as required by sectlon 3700 of the lebor Code, for ihe peAortnance ot the work for which this pertnit is issued.
My workers' compensatlon Insurence carrier end policy number are:
CR61icy.Nu`mber:_'�"•-�
(77�Is section need not be completed il the permit 15 veluetl af one hundred dollars ($f 00) o� IessJ
❑ I certity ihat in t�e pertortnanca of the work for which this ermit is issued, I shall not employ eny person in any manner so as to become subject to the workere'
compensatlon laws of Iifomia, end eg /t s iould ome sub�ect ro the wo�icers crompensa[ion provisions of Section 3700 of the LaDor Code, I shall toRhwith
comply with ihese p v io�ns�. /-/ �j/�7
ApPlirant�Signetur� e:-����'GG� Date:^P'/!-!i�/Q�
�WARMNG. A URETOSECUREWORKERS'WMPENSATIIXJCOVEMGEISUNLAWFULANDSWLLLSlIB1ECrANEMPLOVERTOCRIMINALPENALTIESANDCIVILFlNESUPTOONEHUNDRED
T)10USAND DOLLARE (5100,000). IN A�DITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PRWIDED FOR IN SEGTION 3706 OF THE LABOR CADE, INTEREST, AND ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hareby effirtn that I am
torca�end eNecli`�L'Ic. # _
�_ r'
6ontiactoYs Slgnature:
�._....�..--- i
of Chaptar 9(commencing with Section 7000) of DiWsion 3 of Ihe eusiness and Protessions Code, end my license is in lull
— � Cless x�� � �
� DAFie:"��s•�'`r f��Qj �.
CONSTRUCTION LENDING AGENCV:
❑ I hereby effirm that thera is a consiruction lending agency tor the padormance ot ihe work Por which ihis pertnit is issued. (Sec. 3097, Civil Code).
LentleYs Name: Lentler's Atldress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirtn that under penelty of Derjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business enA Protessions
Code: Any ciry or counry which reQuires a permit to construct, alter, impmve, demolish, or repair eny sWCWre, pnor to its issuance, also requires the applicant (or such pertnit
b file e signed stetement thet he or she is Ilcensed pursuent to the proNslons of Ihe Contrectors License Law (Chepter 9(commencing with Section 7000) af �ivision 3 01 the
Busineu antl Protesslons Cotla) or lhat he or she Is exempt therefrom entl Ihe besis for the allepetl exemption. Any violatlon o� Section 7031.5 by eny applicant for e permit
subjects the epplicant to a civil penalry of no� more than five hundred dollers ($500).):
❑ I, as owner ot ihe properry, or my employees with wages as thelr sole compensatlon, WILL DO TNE WORK, antl the siructure Is not intended or ofleretl tor sele (Sec.
7044, Business and Professions Cotle: The Contractors License Lew does not appty to an owner af pmperry w�o bulltls or impmves thereon, and who does such work
himself ar herself or ihrough his or her own emplayees, provided thet such Improvemenis ere not intentletl or oNered for sele. It, howaver, tha huilding or impravement is
sold within one year of complation, the ownar-builder will heve the bwden of proving that he or she ditl not huild or Improve for purposa of sale.). �
❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSEU CONTRACTORS to construct the project (Sec. 7044, Business antl Protessions
Cotle: The contradors License Law tloes not epply to an owner oi propeny who bullds or Improves thareon, and who contrads for such project with a contracror(s)
license pursuant to ihe Coniractors License Lews.).
❑ I em exempt under sec. Business end Professions Code for this reason:
Signature: Date:
Owner ID venfied by tlrivers Iicense. ❑ Vas ❑ No DriveYs License No.
Vedficetion oi Ownership by (rype of dacumant, i.e. - property tax blll or tlaetl):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMI7 CEHTIFICATION:
❑ I hareby certity that no excavetion five (5) or more feet in depth into which a person Is requlred to descend, will be mede In connectlon with work authorized by Ihis
pertnit, antl that no building struMure, scattolding, falsework, or demolitlon or tlismantling thereoi, wlll be more than ihirty-six (36) feet high. (Chep. 3.2, Gry 2, AA 2, Sec.
341, Title 8, Celifomia Administrativa Code).
❑ As owner-builder, I will not employ enyone to do work w�ich would require e pertnit From the Divislon oi Industnel Safety, es notetl ebove, unless such person has e
permit to tlo such work from ihe divislon. �
SignaNre: Date:
Division oi Industnel Safery Permit Number.
CERTFlCATE OF COMPLIANCE AND AIfT}IORIZA710N OF ENTFiY: I cetlity under penelry of perjury that I heve read this epplication and steta Ihet the informatlon given is
correct I agree to comply with ell stete laws and city ordinences relating to building constructlon, and euthodze representatives of the Ciry of Coste Mesa to enter upon the
ebove-described property for inspection purpases. I egree not to occupy or ellow occupancy of any building authorized by ihis permit untii fnal inspection.
CODE I, INSPECTIONTYVE
1616 Fixed Sysiem Final Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Final 81ocWRetaining Wall
202
203
Final Fadory Fire Placa
Final Si9n
204 Finel �emolltion ..
Owner(s) � 7�a�
!/
'An��rant DB B
PA1F INTITIRLS
COUEf INSPELTIONTYPE
206 Final Met�aniCal
20B Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 Finel BuildincyOccupancy
PAg MI�L3
(714) 754-5273 • Fax (714) 754•4&58 • vnvw.ci.costa-mese.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
900
BLOODGOODSHARPBUSTER
41050110
,appiicant: TIM FYKE
Address: 1250 E GENE AUTRY WY
ANAHEIM,CA
.Phone: (714)712-0744
Zip 92805-6716
Ovmer: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP�ATTN JOE CRAWFORD - '
DENVER, CO � � Phone: �
1050 17TH ST #1220 Zip:
Contractor. NAZZARENO ELECTRIC CO INC
Address: 1250 E GENE AUTRY WY � '
' Phone: (714)712-0744
� Zip: ' � � 92805-6716� .
License:681792 µ
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+unlls)
Pool I Spa
Lighting Fixts
Recept OWets
Switches
Non Res Appl
Res Appl
Service l0 200a
Service to 1000a
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors lo SOhp
Motors to 100hp
Motors over 100hp
ANAHEIM,CA
Status: ISSUED
Applied: 07I21I2005
Issued: 07121/2005
ISSUED BY: �
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR 2,121 SF INTERIOR TENANT IMPROVEMENT:FOR'BLOODGOOD. SHARP AND
BUSTER' IN SUITE 900. . � . �
REF #805-00877 �� '
WORK TO INCLUDE: 8 LIGHTING FIXTS, 27 RECEPT OUTLETS AND2 SWITCHES.
523.50
$0.00
$0.00
50.00
$0.00
$0.00
$8.80
a2zii
$220
$0.00
50.00
$0.00
$0.00
So.00
$0.00
E0.00
$0.00
$0.00
E0.00
Quantity
0
... ., 0. , � .
0'
8
y�
2
0
0'.
0
Q
0.
k. ��_
p
0
0
0
FEE SUMMARY
Quantity
Temp Dist System I Lighting 50.00 � 0
.. . Busway /100 ft $0.00� 0
.- ' Standing Section $0.00 0
- Misc E�ectrical Equipment $0.00, 0
Transformers up to 1 k4a/kw� "�$0.00 0
� .........:......up to 10 kva/kw $0.00 0
.................up to 50 kva/kw 30.00 0
................:uP l0 100 kva/kw� $0.00 0
' ..........:..::...overd00 kva/kw $0.00 0
. Low.Voltage Equipment $0.00 . 0.
� Low Voit Wiring System / Ckt '$0.00 ' 0
- Misa Conduit �� - ° ' � - ' � $0.00 � 0
- ��Misc. Conductor � - � $0.00 0
, Circus ( gen or�ride) . 30.00 0
�'"'Circus (mech ride or lights)� - 50.00 0
. . Christmas-Tree Stand �•� � $0.00 0
. _ -.Pireworks SWnd � $0.00 0
Other ElecViral Fee $0.00
NOTICE: The work euthorizad by this permit shall camply w0h all applicable handicap access requlrements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: Thls permit shall automatically expire and become vold if work Is not commenced wlthln 180 days, or il work is suspended or abandoned
tor a perlod of 1 BO days.
INSPECTIONS: In order for the work euthorizetl under this permlt to be considered legal, such work must comply wlth all applicable codes, and all
requlred Inepectlone end flnel epproval must be obtalned. Failure to obtain Inspectlons end final epproval wlll result In the expfration of lhis permit.
FOR INSPECTIONS CALL: (714) 7545848
yJ�.� �.�31�J:
WORKERS'COMPENSAnON DECLARAnON:
1 hereby aHirm under penelry of perjury one of the tollowing declarations:
❑ I heve and wlll maintain e certlliwte of consent to seli-Insure for workers' compensation, es providetl tor by sedion 3700 of the Lebor Coda, for the pertortnance of ihe
work for which this permit is issuetl.
��na�e flntl will maintain workars' cwnpensation Insurance, as requlred by section 3700 of ihe lebor Code, tor the peRormance of Ihe work for which this permit is issuetl.
My workers' compensatlon Insurence carrier en0 policy number are:
CpMer.--+r �-.�.n�..rc/ Policy�Number.�—_.y�D l�os 33 -o�
(fhls�aecM'�r need no be canp/etetll! fhe permif /s va/ued et one hundred dollare ($700) ar less.) � _
❑ I certiy ihet in the pertortnance of the work tor which this permit Is issued, I shell not employ any pereon In eny menner so es to becoma sub�ect to Iha workars'
compensation laws of ' anQQQAAAgggrororo��� t�at it I should become sub�ect to the workers' compensatlon proNslons af Sectlon 3700 of Ihe Lebor Cotle, I shall forthwith
complyw�ese visions. / \ r
Ap�licerrt'Sf9netu : � � � Date"'^�� �'� 1U J y
v
WARMNG.`FAILURE TO SECURE W BfJJSATION COVERAGE IS UMAWFUL M1D SHALL SUBIECT AN EMPLOYEHTO CRI � INAL PENALTIES nND CNIL FlNES UP TO ONE HUNDRED
hKK15rW D DOLURE (5100.0OO�.IN ADDRION TO THE WSt OF COMPENSAnON, DANAOES AS PROVIDED FOR IN SECTION 3�O60F THE LABOR COOE, IMEREST, M1D ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm thet I am Ilcensed under rovisions of C�epter 9(commencing with Section 7000) of Division 3 of the Business end Professions Code, and my Ilcense Is in lull
farce and.ettecL-Lic: p��-- ��� �' Z iCtass'p � J
CmractofsSlgnaNre_� . , �DaI�. Zt 1 Ju
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm that ihere is a conslruction lentlinp apency lor ihe pedormence ot Ihe work for which this permit Is Issued. (Sec. 3097, Civil Code).
LentleYs Neme: Lendels Address:
Signeture:
OWNER-BUILDER DECLARATONS:
Date:
I hereby ettirm thet under penaliy ot perjury that I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Prafesslons
Cotle: Any city or county whic� requires a pertnit to consiruct, alter, improve, demolish, or re0eir eny strucNre, prior to Its issuance, also requires the apD�iwnt tor such permit
to file a signed statement ihet ha or she is licensed pursuant to the provisions oi Ue Contractors Licensa Lew (Chepter 9(commencing with Section 7000) of Division 3 oi ihe
Business and Pmfassions Cotle) or that �e or she is ezempt therefwm and the basis for the ellegatl exemptlon. Any violetlon of Section 7031.5 by eny eppllcant for a pertnN
subjects the applicant to a civll penalty of not more Ihan frve hundred dollars (5500).):
❑ I, es owner oi Iha property, or my employees with weges es their sole compensation, WILL DO TTIE WORK, end the sirucWre Is not intended or afleretl for sale (Sec.
7044, Business and Professions Code: TTa Contractore License Lew does not apply to en owner of property who builtls or impmves Ihereon, and who does such work
himself or herself or thraugh his or her own employees, providad that such imprwements are not intendetl or offered lor sale. It, however, the building or improvement is
sold within one year ol complelion, the owner-Cullder will have Ihe burden ot proving lhat he or she did not build o� imp�ove tor purposa ot sale.). '
❑ I, as owner of the properry, em E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the proJect (Sec. 7044, Business and Professions
Code: The contractors License Law does not appty to an owner ot property who builtls or Improves thereon, and who contracts tor such pmject vrith a contractor(s)
license pursuanl to the Contractors License Laws.).
❑ I am exempt undar sec. Business end Professions Code tor this reeson:
Signature: Date:
Owner ID venfied by drivers license. ❑ Yes ❑ No Dnvers Litense No. Expires:
Verificatlan of Ownership by (type of document, i.e. - property lex hill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby canify Ihat no excavatlon flve (5) or more teet in depth iNo which e pereon Is required to tlescend, wlll be metle in connection with work authorized by ihis
pertnit, entl Ihat no bullding structure, scaXolding, talsework, or tlemUltlon or tlismantlinp ihereot, will be more than thirty-six (36) feet hlgh. (Chap. 3.2, Grp 2, Art 2, Sec.
347, 71t1e B. California Adminisirative Cotle).
❑ As ownervbulltler, I will not employ anyone to do work whic� woultl require a permit from the Divlslon ot Indusirial Sefery, es noted ebove, unless such person hes e
permil lo tlo such woAc from Ihe division.
Signature: Date:
Division o1 Industrial Salery Pertnit Number.
CERTIFlCA7E OF COMPLIANCE AND AIJTTI0RVA710N OF ENfAY: I certity under penelty of perjury i�et I have reatl this applica�ion and state that the infortnation given is
correct. I egree to comply with ell state laws enC city ortlinances relating �o bulltling construction, entl euthodze representatives ot the Ciry ol Cosla Mesa lo enter upon ihe
above-descnbed proDerty for inspection Duryoses. I agree not to occupy or ellow occupancy of any building euthonzed by this permit until final inspection.
COUE I, INSPECTIONTYPE �/f
1616 Fi:ed System Final Fire Prevention
1268 Pool Spa Flnal
200 Finel Re-Roof
201 FInaI BIocWRetaining Well
202 Final Fedory Fire Place
203
204
Final Sign
Final Damalltion
neia u�meii
CODE� INSPECTIONiYVE
206 Final Mechenical
20B
210
212
220
222
250
Finel Plumhing
Final Elecldcel
Finel Flre Preventian
Final Plenninp Approvel
Final Slte
Final Building/Occupency
�
� 11 • C.►
(714) 754-5273 • Fex (714) 754-4a56 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Adtlress: 555 ANTON BL
Suite: 900
Viciniry: SUITE 900
Pnmary Occ: B Eat<50l OKce/ Bar<50 Type of ConsWction: I-FR
Parcel Number: 41050110 � Zoning:
Applicant: ERB, LYLE
Address:
SWlus: ISSUED
Applied: O6/01/2005
Issued: 07121/2005
� � � Phone: 714-9323137
, , � Zip: . ..
Owner. SAKIOKA FARMS%MORGANS HOT_EL LIMITED_ - �; � �
Address = PARTNERSHIP ATTN JOE CRAWFORD � � � - � � . -� _ � �
- DENVER; CO� � - ' — Phone: , � _ - ;
. � 1050 77TH ST #1220' � � Zip: �
contractor: AMARON CONSTRUCTION CORPORATION
� Address:" 1565 N HARMONY CI
� .., '� Phone: (714)993-9220
- , , ANAHEIM HILLS, CA . - ,
Zip: � 92807' . . License:.. 874301 ' .
Arch :
Address:
Zip:
Phone:
� - " License:
Eng:,
� - , Address:� �
- - �� " � . Phone:
� � ' � "i ; " SCOPE OF BERMIT ; - �� �' ' �
2,121 SF INTERIOR TENANT IMPROVEMENT FOR'BLOODGOOD, SHARP AND'BUSTER' IN SUITE 900.
License:
FEE SUMMARY
Plan Check: $441.19 Calc Valuation:
Permit: $678.75 Claim Valuation:
SMIP Res: $0.00
SMIP Com: $11.47
Other. , $0.00 -
Inspection: �' � $0.00 �i,.� ��� ,
� � .. , � - '�
Total: $1,131�.41 ' .
� , � PLANNING & ZONING � :�; �
SETBACKS. . � � � - ' � � � � " . '%'
MAIN STRUCTURE Front �0. 0 � �Rear— � �0= 0 � , . _Left 0- 0 - � Righl�� �0. 0 " � � �
':;� �`�.. � _ . _ . � _�— ,., �;,�
ACCESSORY Front��;Oc 0'�� � j' Rear 0. 0 Left 0. 0 Right� '-'0. 0�" �
, . .
PARKING Existin :�' �0� _ Requiretl: .0 Proposed: 0� . � � , =
NOTES:
asa,so,.zs
E50,000.00
NOTICE: The work aulhorized by this permit shall comp�y wflh all applicable handicap access requirements under Califomia statules and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 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 consldered legal, such work must comply with ell appiicable codea, e�efl
requlred inspectlone end final epprovel must be oblalned. Fallure to obtain Inspections and final approval will result In the expiration of this t.
FOR INSPECTIONS CALL: (714) 754-5828
2MBd8 (8�W)
WORKERS' COMPENSATION DECLARATION: — �
1 hereby atlirtn under penalry of perjury one ol tha tollowing tledarations:
❑ I heve end will malnteln e ceNfkate of consent to selt-Insure tor waMers' compensetlon, es proWtled for by section 3700 oi ihe Lebor Cotle, lor ihe peAartnence M ihe
�ork tor whlch thi9 permil Is issuetl.
�ihe�e arW wlll melntein wwkers' compenseUon insurance. as required by sectlon 3700 of the Lebor Cafe. tor Ihe peAortnance ot Ure work Iw whkh thls permit is IsweE.
F1y WaFkera' wmpensatlon Insurence carder en9yollry nup ber ere: �/^h / qp �
ca,rim--.�. _ S `,�-��"�!� ,--�.' .U'� �..u�y,_•w,�mue` �.;- { �l G T G 6 �- ' ��.5
(r�s.seclion�need nor ee comp�erea �r the pemllr �s va�uea ef one nunarea da�ers (atoo) or �ess.J
❑ I cenly that In the peAormence
mmpensetlon laws ol CelllomR
SEWRE
LICENSED CONTRACTORS DECLARATION:
I5 issuod, I s11a11 not employ any person In eny manner so es lo beqome subject to ihe workeB'
ne sub�ect to the vrorken' compensetlan praNsions oi Sectlon 37%0 of�% Lebor COEe, I shell forthwith
Dete: �il Ll / QS �
�j-0.GWFLL M!D SHALL SUBIECf AN PLOVE�NAL PENAL ES A! 6 CML FlNES UP TOONE MUN�RED
7N, DAAN�ES AS VROVIDED FOH W SECTION 3]OB OF THE UBOR CODE, INiEREST, PND ATTpVJEYS FFES.
I hereby afllrtn Ihel I em Ilcens n r r on�ayCh ng w' S tlon 7000) ai Dlvision 3 01 Ihe Busines ntl P ofess ns Cotle, antl my license ls in lull
faree' eHect. Lic.� M `�"' � �
6ontr rSlpnalure- � .'"—� Dete �
�� c
CONSTRUCTON LENDING AGENCV:
❑ I hereby ettirtn Ihet there is e construcllon lending egonry tor the pertormanca ol Ihe work for wNth thls permlt is Issued. (Sec. 3097, Civll Coae).
LenCer's Neme:
Signetura: _
OWNER•BUILDER DECLARAT10N3:
Lentler9 Atlaress:
Date:
I hereby ettirtn thet untler penalry of perjury that I em EXEMPT FHOM THE CONTRACTORS LICENSE LAW tor t�e lollowinp reeson (Sec. 70.31.5, Buslness entl Protessirns
Codo: Any ciry or cwnry which requires e pertnit to construd, eltor, imprwe, Cemolish, or mpair any strucWre, ptlor m its issuance, elw reQuires t�e appllcant lor such permit
to file e algnetl stetement Ihet he or she U IkenseA pursuant ro Ihe proNslons at Ne Contrectorm lJcense Lew (Chapter 9(commexing with Section 7000) af DMsim 3 of Me
Business end Professlons Code) ar Ihet he w she ia exempt Nerefrom eM Ue besU lor Ne allegeA eaemptlon. Any Noletlon of SecUon 7031.5 by erry applkant for e pertnN
subjecis Ue appllcant to e dvil penalry of not more than Me huntlred tldlars ($500).):
❑ I, as owner oi the properry, ar my employees with wepes es Neir sde compensetlon, WILL DO THE WORK, end the structura is not Intendetl or oflered tor saie (Sec.
7044, Business and Prolessians Cotle: The Cantrectors Lkense Lew does not eppty to an owner of properry who builds or improves Nereon, antl who does such work
himself ar hersetl or Urough hLs or �er own employees, providetl ihe� such Improvemenis are not Intendetl or oXeretl for sele. Ii, howevar, Ihe buiitlinq or ImDrovement is
sold wit�ln one year ot completion, ihe owner-builtler will heve Ihe burAen of provirp that �e or s�e did not �uild or imprwe far purpose of sale.). �
❑ I, es owner of the property, am El(CLUSIVELY CON7RALTING WfT}1 LICENSED CONTRACTORS to consiruct the Oro�ec1(Sec. 7004, Business and Professions
Code: The contractors License Lew daes not eppy to an owner of properry w�o builds or Improves t�areon, antl who comrects br wch project with a coniractoqs)
license pursuant to the Canirectors License Lews.).
❑ I am asempt unAer sec. Business antl Prolessians Coda tor t�is reason:
Slgnalure: Date:
Owner ID verilied by drivers Ilcense. ❑ Ves ❑ No Orivers License No.
Vediicetlon ol Owners�lp Dy (type oi tlowment, i.e. - properry t� DIII or deed):
Expires:
DIVISION OF IN�USTAIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certify ihat no ezravation INe (5) or more feet In deD�� into whlch e person is requlred to tlescend, wlll be mede In connectlon wlth work authorized by Ih(s
permit, and Ihat no building structure, scattdtling, taisework, or tlemdltlon or dismantling thereof, wlll be more Ihen thirty-six (38) fee� Mgh. (C�ap. 32, Grp 2, M 2, Sec.
341, TIIIe 8, Calitomia AtlminislreiNe Code).
� As owner-bulltler, I will not employ enyone lo tlo work which ww1U reQuire e permit Iran Ihe Divlslon ol Industrial Sefery, es noteG eDove, unlesa such person hes e
pertnit to do such work Irom Ihe tlivision.
Signeture: Da1e:
DiNsbn of Industdal Setery Pertnil NumEer.
CERTIFlCATE OF COMPLIANCE AND AUfMOROJ1T10N OF ENTRY: I certify unCer penelry of perjury that I have read �his epDlicetlon enC state tha� �he intortnatlon given (s
cortect. I egree to compy wilh ell stete lewa and dry orcfinances relating to buildinp constructlon, enA eut�aAze representeUves of the Ciry ol Coste Mesa lo enter upon ihe
ebove�described propeM �a� �^9Pection Putposes. I egree rrot to awpy or ellow oxupenry of erry bullOing euthorized by Ihb pertnil until finel inspection.
GOOE1. �Nsvernoxirve
7618 Fixed System Finel Fire Preventlon
1268 Pool Spa Finel
200 Flnal Re�Root
201 Flnel Block/Retelninp Well
202 Flnal Faclory Fire Placo
203 Finel SIBn
204 Flnel Demalltlon
Qe� u�ui
�QQf,j INSPECTIONTYVE
208 Finel Mechenlcal
208 Finel Plumbinp
210 Finel Electrical
212
220
Finel Flre Preventlon
Final Planninp Approvel
222 Flnal Slte
250 Flnel Building/OCcupency
Dei6�
PAg II�L$
(714) 754-5273 • Fax (714) 754-4856 • www.ei.costa-mesa.ca.us P FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite No 900
Vicinity:
Parcel Number: 41050170
Applicant: JOHN ANDERSON
Address: 1550 S SUNKIST ST
SUITE E
ANAHEIM,CA
MECHANICAL PERMIT
Phone: (714) 937-5305
Zip: 92806
owner: . SAKIOKA FARMS %MORGANS HOTEL LINIITED
Address: PARTNERSHIP ATTN JOE CRAWFORD . -
� � DENVER, CO , Phone:
1050 17TH ST #1220 Zip:
Contwcior: HVAC MECHANICAL INC
Address: 1550 S SUNKIST ST
SUITE E
� � ANAHEIM, CA . ,
Phone: (774)937-5305
Zip: 92806
License: 682002
Status: ISSUED
Applied: 07/27I2005
Issued: 07/27I2005
ISSUED BY:
SCOPE OF PERMIT
- . 2;121 SF INTERIOR TENANT IMPROVEMENT FOR�"BLOODGOOD, SHARP AND BUSTER" IN SU,ITE
. 900. REF.: BOS-00877 � � . .i . �. . � . '
�� MECHANICAL TO INCLUDE: 1 REPAIR/ALT COOLING/HEATING. SUBJECT TO FIELD
� '� - � INSPECTION. - . �
- FEESUMMARY: �
� Quantity � � �uantity
ISSUE FEE. � 523.50 Repair / Alt Absorbtion Unit
Inst FAU <100 k BTU � • $0.00 0 Repair / All Re(rigeralion Unit
Inst FAU >100 k BTU • . $0.00 0 Ventillation System
Repair/Alt Cooling/Heat $1370 1 � ` EvaporetiveCooler
Inst / Rep. Recess Wall Htr , $0.00 0 ��� ' Commercial Incinerator ,
Refrig Sys <700 k BTU �.' , 50.00 0 , . Domestic Incineretor
Refrig Sys >100 k BTU �� 50.00� -� 0,� , . , , Compressors'I Absorptian Svstems
Gas Piping ' $0.00 . 0 � �, .. � . , " , Up to 3 hp / 100�k BTU �
Factory Fireplace � � . � � � • 30.00 . "0• � .. � �� -'3 To �15 hp / 500 k BTU .
Hood w/Mech Exhaust ��� -� $0.00 �0� '. � � �. ' 15?0 30-hp'1,1,000 k�BTU
VAV Box � � -$0.00- 0�� � � 30?o SO�hPl� 1{750 k BTU �-
Vent Fan / Single Duct � � � $0.00 � " 0. � - � � - - � � ���. Over50 hp / Over 1,750 BTU- '.
Appliance ` - 30.00 � b _ � ,,, � � � � `Boilers ' ��� . � ,
Fire Dampers - � 30.06� ;0 � � Up,to 3,hp' ;�', .; �
Smoke Dampers �� ., 50,00 ,. 0 -. „ . . - - � � , � 3 To 15.6p ., � ;;
Inst or Relocate Appl Vent $0.00'... 0,,,� � ,;, ��-, 15 to 30.hp"" .,
Air Handlers < t0000cfm 50.00- � �- 0 ��. � 30 to 50 hp �, .�> ��c � ",: �
AirHandlers> t0000cfm 50.00 0 -�� � � . , .-0ver-50'hp._;.---
Floor Fumace 50.00 0 -� ��- --. ' Other Mechanical Fee
Floor or Suspend Heater 50.00 0 Investigation Fee
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
ao.00 0
50.00 0
$0.00 0
$0.00 0
$0.00
50.00
$0.00
$0.00
$0.00
50.00
0
0
0
0
0
NOTICE: Tha work authorized by ihis permit shall compty wlth all applicable handicap access requirements under Califomla statules and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This pertnit shall automaticalty expire and become void il work Is not commenced within 180 days, or If work is suspended or ebandoned
�� tor a pedod of 180 days.
INSPECTIONS: In order for the work authorized under this rmit to be considered le al, such wark must com I with eil a '�_ ��
pe g p y pp�kxibte eoEes, and all
requlred Inapeetlona end flnal epproval must ba obtalned. Failure to obtain Inspections antl final approval will result in tltb'.'e piietbn•ol this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
zaas+e �e�oo)
WORKERS'COMPENSArON DECLARAnON:
I hereby eHirtn under penalty of perjury one of the follOwing deClara�on9: '
❑ I heve end wlll maintein e certificate ot consent to self-Insure for workers' compensetion, as pmvidetl tor by sectlon 3700 0l tha LaDor Code, for the pertormenca of the
w or whlch t�is pertnit is iuuetl.
�� i Ffave aritl will maintain wwkers' compensatlon Insurence, as requiretl by section 3700 of the Lebor Code, for ihe pertwmance of the work fw which Nis pertnit Is IssueA.
�My worke m satlan�ca carrier end poliry numDer are:
� artl� er-�. v�— Policy N mtier: �l ri —// 9
(Jhhsection neetlr�not �eted i! the permitls velued a( one �untlred dol/ers ($100) or /ess.)
❑ I certify Ihet in t�e pertormance ot t�e work far which this pertnit Is issue4 I s�all not employ eny person in any menner so es to hecome sub�ect to the workers'
compensatlon laws of Califomia, end egree that If I should become sub�ect to the workers' compensetion provislons of Sectlon 3700 of the Lebar CoAe, I shall forthwit�
compl�with ihese provisions.
A cantSigneture:"`" �� Dfl�B: ����DqVILFlNESUPTOONEHUNDRED
W�FWING!FAIL ERUiTOSEWREW ENS�TIONCOVEMGEISUNLAWFULANDSNALLSUBJECTANEMN.CYERiOCRIMI
TIqUSAND DOLLAFE (5100,000). IN ADDRION TO THE COST OF COMPEN54TION, UAMAOES AS PROVIOE� FOF IN SECTION 3]OB OF THE LABOR CODE, INfEREST, AND ATTORNEVS FEES.
LICENSED CONTRAC70RS DECLARATION:
ol Chapter 9(commencing with Section 7000) ol
Prolessions Cotle, end my license is in tull
CONSTRUC710N LENDING AGENCY:
❑ 1 hereby eHirtn that there is a consiruction lendinp egency br the pedormenca ot ihe work lor which Ihis parmit is issuetl. (Sec. 3097, Civil Code).
Lender9 Neme: LendefS Address:
Signatura:
OWNER•BUILDER DECLARA710N5:
Date:
I herehy ettirm Ihat under penalry ol 0e�ury that I am EXEMPT FROM THE CONTFiACTORS LICENSE LAW for Ihe lollowing reesan (Sec. 7031.5, Buslness antl Professions
Cotle: Any ciry or county w�ich requires a permit to construct, elter, improve, demalish, or repair any structure, pdor to its issuanca, also raquires the epDlicant tor such pertnit
to flle e signeC stetemant thet he or she Is Iicensed pursuent to the pmvislons af the Contractors Ucense Lew (Chapter 9(wmmencing with Sectlon 7000) ot DNLsion 3 of the
Business and Profes5ions Code) or lhet he or she is exempt therefrom antl tha Desis for the elleged exemptlon. Any vlolation of Section 7031.5 by eny epplicant for e pertnit
subjecis ihe applicant to e civil penalry af not more than tive hundred dollars ($500).):
❑ I, as owner ot the properry, or my employees wi�h wages es Iheir sole wmpensatlon, WILI DO THE WORK, antl the strudure is not Intended or otteretl Por sale (Sec.
7044, Buslness end Professions Code: The Contractors License Law tloes not apply to an owner oi proDerry who bullds or improves thereon, entl who does such work
himself or herselt or Ihrough his or her own employees, provided Ihel such imprwements ere not intended or oNered for sele. If, howaver, the 6uiltling ar improvement is
sold within one year oi completion, t�e owneo-builder will have the burden of proving thet he or she did not build or improve tor puryose of sale.). �
❑ I, as owner of Ihe property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe projact (Sec. 7044, Business entl Profeuions
Code: The contraqors Licanse Lew aoes not epply to an owner ol property who bulltls or Improves thereon, antl who contrects for such project wlih a contrector(s)
licanse pursuant to the Contradors License LewsJ.
❑ I am exempt under sec. Business antl Professions Code for Ihis reason:
Signature: Date:
Owner ID verified by drivers Iicense. ❑ Ves ❑ No Drivers License No.
Veritication of Ownership by (type of daumenL i.e. - properry tex bill or deetl):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby ceNty that no azcavation flve (5) or more feet in depth into whlch e person Is required to descend, wlll be made in wnnedlon with work authorized by this
permit, and that no building structure, scaHoltling, telsework, or tlemoli�lon or tlismantling thereof, will ba more than Ihirty-six (38) feet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Tltla 8, Celifornie Atlminisiretive Cotle).
❑ As ownerbuilder, I will not employ anyone m do work which would require e pertnit trom the Division of Indusirial Safery, es noteC aDrne, unless such pereon hes e
permit to do such work Irom ihe division.
Signature: Date:
Division of Industnal Selery Pertnit Number:
CERTIFICA7E OF COMPLIANCE AND AlliHOROATION OF ENTHY: I certify untler penelty ot perjury Ihat I have reatl ihis epplication antl state that the infortnalion given is
correct. I egree to wmply wlih ell state laws end Gry ortlinences ralating to building conslruclion, end auihorize representatives of the CIty ol Coste Mesa to enter upon the
ebove-descnbed property for inspection puryoses. I agree not to occupy or ellow occupancy ot any building eutharized by this permil until finel inspection.
CODE �. INSPELTIONTYPE
1676 Fixed System Final Fire Preveniion
1266 Pool Spa Finel
200 Final Re-Roof
201 Final BIocWRe�eining Well
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demolilion
QdjF � �QQ$,( INSPECTIONTVPE
t
206 Flnal Mechanical
20B Final Plumbing
210 Flnal Electdcal
212 Final Fire Preventlon
220 Flnal Planning Approval
222 Flnal Slte
250 Final Builtling/Occupency
ueg r �u�ej�°t
'• '� JJ
T
CITY OF COSTA MESA ,
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
��ia� �sa-sz�s • Fax (�ia� �sa-aess • www.ci.costa-mesa.ca.us
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
ApplicanL•
Address:
Owner:
Address
�
Contractor:
Address:
• ISSUE FEE
• Temp'service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Ligh�ing FixLs '
Recept OuOets
Switches ��
Non Res Appl �
Res Appl
Service to 200a
Service to t000a� �-�
Service over 7000a
Motors to 1hp
Motors to 10hp
Motors to SOhp
Motore to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
POIe Lighl Pkg
Sign Circuits
Temp Pwr Pole
Inlertned Pole
555 ANTON BL
900
41050110
A
PERMIT NUMBER
E02-00688
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 07/22/2002
Issued: 07/29/2002
D' AGOSTARO, SAL ISSUED BY:
730 FAIRMONT AV � , � %� � � � � � � ' , � ,
�i�����- - �Phone: 81&241�009 ` -
GLENDALE, CA �!�� - Zip: 91203 � �
i". , � . , _ ��,� •�
/ . '.. . . ' � - � " i
, '. - _ , �. � _.
� ,�
SAKIOKA FARMS %MORGANS HOTEL LIMITED--,. _ �
�PARTNERSHIPATTNJOECRAWFORD � ' ��`
_ �� � _
. DENVER, CO-"� - � Phone:
� . �-;, - ,�� ��;� �: � , ,/
1050 17TH ST�#1220 Zip: � ' '
i: � �..
�=/
PINNACLE COMMUNICATION SERVICES
.730FAIRMONTAVE • - . � � ' � -�
� ; - . '.�Phone: (878)24i-8009 _, � , � .
GLENDALE, CA � - � � � Zip: 91203 - - ,
- � - License: 708192 - �� � . .�"
SCOPE OF PERMIT �
REF: B02-01008. TFiE MEYERS�GROUP'. 90 COMMUNICATION DROPS FOR WORKSTATIONS.
, _ , . � .. . :� _�.. . . . � .
$23.50
$0.00
50.00
50.00
30.00
$0.00
ao.00
�.'�.;50.00
�� �. $0.00 .
$0.00 '
, $0.00 �
30.00
so:oo .
� 50.00
30.00 "
$0.00
$0.00
$0.00
$0:00
571.10 ����.
50.00
50.00
$0.00
$0.00
$0.00
Quanlity �
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
90
0
0
0
0
0
FEE SUMMARY , .
. ." � Temp Dist System /•Lighting
Busway /100 ft, �
Standing Section
Misc ElectnCal Equipmenl
Transformers up to 1 kva/kw
: . . . ; ................up to 10 kva/kw
= � �" ...........:.....up to 50 kva/kw
; .............:...up to,100 kva/kw
..................over 100 kva/kw .
� . Low Voltage Equipment '
Low Volt Wiring System / Ckl
Misa Conduil
Misc. Conductor -
Circus ( gen or ride)
� Circus (mech ride or lighis) � �
Christmas Tree Stand
� . Fireworks Stand - �
� �Other Eleclrical Fee
� Investigation Fee
Plan Check Fee, ,_
Reinspection Fee
` Quantity
$0.00 0
$0.00 0 '
$0.00 0
$0.00 0
$0.00 0
50.00 0;
$0.00 0
$0.00 ,. i"0
$0.00�=� 0,
50.00 0
$0.00 , 0
- $0.00�- " .0
� $0.00 ���'�0
. $0.00� - 0 �-
$0.00 ' -0 "
$0.00 0 '
� � $0.00 /0
$0.00
' $0.00
$0.00
30.00
TOTAL CALCULATED FEES $94.60
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (OM. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shail automatically expire and become void if work is not commenced within 180 days, or ii work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order tor the work authoAzed under this permit to be consitleretl legal, such work must comply with all applicable codes, end ell
requlred Inepectlona end final epproval must be obtained. Failure to obtain inspections end final approval wlll result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
zasee �a�oo�
� � �
WORKERS' COMPENSATION DECLARATION: �
I hereby eHirm untler penalry ot perjury one of the tollowing declarations: - . -
❑ I have entl will maintain a certilicate oi cansent to sell-Insure for workers' compensetion, es provided for by section 3700 ot Ihe Lebor Cotla, for the pedormence ol ihe
_— work forwhich �his pertnii is issuetl. . '
❑ I��ave antl will maintain workers' compensatlon Insurance, es required by sectlon 3700 ot the Lebor Code, lor the peAortnance of the work fw which Nis pemut is issuetl.
_My workers' compensatlon I urence carder e poll numbe�r raref: �l _ � ,
Cartier: � '�_� '� ��i✓'+ �-. -/�"� . P,dlcy Number: �
(TNs secNon need nof be completetl i! 1he perMl ls ve/ued ef ine hundred dWlars ($100) or less.) `' 3 y'06�� �p � ��QO �
❑ I cenity t�at in t�e performance ot the work lor which ihis pertnit Is issued, I shall not emplq eny parson in any manner so es to became subJed lo �he workeB'
cwnpensetlon laws oi Calit Wla, e tl e ree t 11 I shaul�6ecome subject to the workers' compensatlon proNsions of Sectlon 3700 ot the Lebor Code, I shell foMwlih
wmply with these provisio /
Applicant Signaturei t
TIqUSAND DOLIARE (E100.00OI.IN ADDRION
LICENSED CONTRACTORS DECLARATON:
I hereby eHirm ihabbem licensetl untler praWsians ol
•---- --� -�--. , ._ ., ? � „ a .
,�� C�oa�a—� 7 — 2�—o Z
N COVERAGE IS UMAWFUL PND SHALL SlIB1ECT Ml EMPLOVER TO CRIMINPL PENALTIES AND CNIL FlNES UP TO dJE HUNDRED
OF COMPENSATION, OM.NGES PS PFIOVIDED FIXi IN SECf10N 37080F TME UBOR CODE, INfEREST, AND ATTORNEVS FEES.
with SecUon 7000) of Dlvislon 3 0l ihe Buslne59 and Profe551on5 Co06, and my licen5e Is In full
class a 7 (i I U
ooia: ^ � — �- 9 — � '� -
CONSTRUCTION LENDING AGENCV:
❑ I hereby eflirtn that ihere is a wnstruction lending egenty lor the pedormance oi t�e work tor which ihls pertnit is iuued. (Sec. 3097, Civll Cotle).
LonCels Name: Lentlefs Address:
SigneNre:
OWNER•BUILDER DECLARA710N5:
Date:
I �ereby eHirm t�at under penfllry oi Der�ury Ihet I em EXEMPT FROM TME CONTAACTORS LICENSE LAW tor the tollowing reason (Sec. 7037.5, Buslness en0 Professions
CoCe: Any ciry or counry which requires a pertnit to canstruM, etler, improve, tlemdish, or reDair any simcture, prior to its iuuance, elso requires the epplicant for such pertnit
to Ille a signed statement that he w she is Ikensed pursuant to 1he pmvisions of Ne Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) of DlNsim 3 of the
Business end Professions Code) or Net he or she is ezempt Nerafran and Ne besis for the alleged e:emptlon. Any vloletion of Section 7031.5 6y any eppllrant for e pertnit
subjects the eppliwni to a crvil penelry of not more then live �untlred tlollers ($500).):
❑ I, es owner oi Ihe property, or my employees with wages es I�eir sole compensation, WILL DO T1E WORK, end the structure Is not intended or otleretl lor sale (Sec.
7044, Businass end Professions CoOe: TTio Cantractors License Lew does not appty to an axner of pmperry who builds or improves t�ereon, entl who tloes sucli work
himsetl or herself or Ihrough his or her own employees, providad that such improvemems ere not intendetl or oHered for sale. tl, however, ihe builtling or impmvemeni is
sold within one year ot completion, the owner-builder will have the burden of proving ihet he or she did not build or improve for purpose ot sale.).
❑ I, as owner ol the pwperty, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business antl Professlons
Code: The contractors License Law does not eppty to en owner of propeny who builtls or improves Ihereon, and who contracis tor such prolect with a croniractor(s)
licensa pursuant to the Contraqors License LawsJ.
❑ I am ezempt under sec. Business end Professions Code for ihis reason:
Signeture: Date:
Ownar ID verlfietl Dy drivefs Ilcense. ❑ Yes ❑ No Drivefs License No.
Verificetion of Ownership by (type oi documeni, i.e. - property te:� biil or deetl):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I hereby certlly ihet no excavatlon five (5) or more leet in Aept� inta w�ich a person is requlred to descend, will be matle in conneclion with work authoAzetl by Ihis
pertnit, end t�at no builAing struaure, scattdding, lalsework, or demolition or tlismantling t�ereol, will Oe more than thirry-siz (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Tltle B, Califomia AdminlsiretNe Cotle).
❑ As owner-builtler, I will not employ anyone to tla wark whic� would reQuire e pertnil Irom Ihe Division ol Intlustrial Setery, es notetl above, unless such person hes e
pertnit to tlo suc� work trom the division.
SlpneNre: Date:
DiWsion ol Industrial Sefary Pertnit Number:
ICERTIFlCATE OF COMPLIIWCE AND AUiHOROA710N OF EMAY: I cenity under penalry ot perjury thet I have read this epplication and state thet the iniormatlon gNen is I
cortect. I egree to cwnpy with ell sate laws end dry oWinances releting to Duilding construcilon, and authodze representetives of Ue Gry ot Costa Mesa to enter upon the
ebove-descri6ed property lor inspeciion purpaaes. I egrae not to occupy or allow occupancy ot any building authorized by this permi� until tinal inspection.
COOE �. INSPECTIONTYPE
7616 Fisetl System Finel Fire Preventlon
1286 Pool Spa Final
200 Final Re-Root
201 Flnal BIotWRetaining Well
202 Flnal Fectory Fire Place
203 Final Sign
204 Final Demolition
Q�¢, �$ �g,( INSPECiIONiYPE
206 Finel Machenicel
20B Finel Plumbinp
210 Finel Elec�dcal
212 Finel Fire Prevention
220 Finel Planninp Approvel
222 Final Site
250, Final Builtling/Occupanq
Date
.i y•�, �.
—Data-7
PAIE It�EL9
� �
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
��ia) �sa-sz�s • Fax (�ia) �sa-aess • www.c�.cosca-mesa.ce.us
ELECTRICAL PERMIT
Jobnddress: 555 ANTON BL
Suite No 900
Vicinily: STE 900 (BLOODGOOD SHARP BUSTER)
rr r.
PERMIT NUMBER
E02-01066
77 FAIR DRIVE, COSTA MESA, CA 92626
Parcel Nunmber: 41050110
Applicant D' AGOSTARO, SAL ISSUED BY:
Address: 730 FAIRMONT AVE . ' � "
Status: ISSUED
Applied: 12/03/2002
Issued: 12/03/2002
Phone: (818)241-6009 � .
GLENDALE;.CA �,�' Zip: 97203 � ' �- �
� , , . . , i i . ��
'i
. � , � . ' . � - - ` �> . � � ; �
Owner.' SAKIOKA�FARMS %MORGANS HOTEL LIMITED � � � � � ` �
Address �; , PARTNERSHIP ATTN JOE CRAWFORD - / �
�
" , DENVER,CO �' � Phone: _-���� �,� � _ ,
- . � 105017TH-ST #1220 Zip: � ' �
, . . �i: �' � - , . , ,
� `
' ��' ,
Contractor.
Address:
M1 � \
�
PINNACLE COMMUNICATION SERVIGES
730FAIRMONTAVE � �� ` �
� . . �Phone: (818)241-6009:_�
GLENDALE, CA; ' " 2ip: '91203 �
�- ..
' - License: 708192
�
� � „-, •,- - SCOPE OF PERMIT , - - - - , . � � �
i - ELEC PERMIT FOR 22 COMMUNICATION�DROP F,OR INTERIOR�OFFICE�TI FOR "BLOODGOOD, SHARP 8 �
BUSTER"INSTE900" � ����"� "-'---'-' `��`�" � "� �
REF: B02-01921 �, � - " '
/�., �
`' � Quantity
�ISSUE FEE . $23.50
Temp service lest 30.00 .
Res. a/c package , 50.00
New Res (14 units) � $0.00 0
New Res (3+unils)-' � � 30.00 0
Pool / Spa �� ' � �� �$0.00 0
Lighting Fixis� ' 50.00 � 0
Recept Outlets �' ., 50.00 � 0
3witches �- � % � � 50.00' ` � 0
Non Res Appl `� �. � = j � 50.00 ' ; �0
ResAppl � -� �� $0.00 _ ��0;
Service to 200a �- � $0.00 '�� 0
Service to 1000a A �� �� $0.00, , ' 0
Service over 1000a � = $0.00 �, 0 -
Motors to 1hp ,. $0.00 " 0 �
Molars to 10hp � 50.00 0
Motorsto50hp $0.00,� - 0
Molors to 100hp $0.00 �� �. - 0� �,
Motors over 700hp $0.00 � 0
Communication drops $27.46 22
Sub panel to 200a $0.00 0
EE SUMMARY ,j ` _ �
��� ' Quantiry,' �
Temp Oist System,/ Lighting -� .50.00 0� ,
Busway /100 k � $0.00 0 �
Standing Section 50.00 0 �.
�- - ` Misc ElecUical Equipment 50.00 , " 0' - - ,
.�� Transfortners up to t kva/kw $0.00�,��.= 0 _
.............:..up to 10 kva/kw $0.00 ' 0
.................up to 50 kva/kw- � _� - $0.00 " 0 ; � ,
, ................up l0 100 kva/kw $0.00 0 �� , � �
- - ' ....over 100 kva/kw �. $0.00- � � 0 � '
Low Voltage Equipment - , .�� $0.00�"�/ 0 ;
Low Volt Widng System /�Ckt $0 00 � 0-"
, � MisaConduit , " " -$0.00� 0'; %
Misa Conductor ', � � _ $0.00' i 0 , �
Circus ( gen or ride) � $0.00 -� ;� 0"
. Circus (mech ride or liqhts) � $0.00 �' 0
ChrisVnas Tree Stand , . $O.W �" 0
"Fireworks Shand � �' � $0.00 0
� � � �ONer ElecVical Fee ; � . � " $0.00
� Imestlgation-Fee- $0.00
Plan Check Fee $0.00
NOTICE: The work authorized by this permit shall compty wilh all applicable handicap access requirements under Calilornla statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This perm0 shall automatically expire and become void if work Is not commenced withln 1B0 days, or if work Is suspended or abandoned
for a period of 180 days. ,
INSPECTIONS: In order for the work authorized under ihis permit to be consldered legal, such work must comply with all applicaGla cotles, and eil
raquired Inapeetlons and final approvel must be obtained. Failure to obtain inspections and final epproval will result in tha expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5628
zaaaae �eiao�
a
WORKERS' COMPENSATION DECLARATION:
I hereby eNirm under penalty af parjury one ol the tollowing tledaratlons:
❑ I heve entl wlll melntein e certifwte oi consent to selt-Insure tor workers' compensetion, es providetl br by sectlon 3700 0l the Lebor CaAe, for Ihe peAortnence af the
��ork tor which Nls pertnit Is IssueE.
�f I have entl will malntain workers' compensation Inwrence, as required by sectim 3700 of NB La6or Gotle, tor the peRortnenco of the wwk for whlUi Ws pertnit is Ls.wetl.
My workers'tOmpen98tlon InSurente terder end polity number are� �/ a^ D D� /��
Cerrler: �l��Zf�%��h!I6lJIG'i. SnIS • LZJ - PolicyNumber. �/
(ihis secriar need not be canplefed!! fhe pertnll !s va��ed et one hunared dalars (StoO) or �ess.)
❑ I certiry t�et in the pertortn rice at Ihe work lo( which Ihis per il is Issued, I s�all not employ eny pereon in eny menner so os to become sublecl lo tha workers'
compensetbn lews of Cellt nia n eprae Set II I shwld come sub�ect ro the workers' compensetion provislons ot Sectlon 3700 ot the Lebor CaEe, I shell tonhwlth
comply with these provisl'
ApplicanlSlpneWre: / Dete: � � � � � 6 �
WARNINQ: FAILUPE TO SEWRE WORNERS' C�OMPEN�4 TION COVEM6E I$ UNLAWFUL AND SHP115U61ECT AN EMPLOYER TO CRIMIIUL PENAlT1E5 AND CM� FlNES UP TO ONE HUNDRED
TIIOVSPNDOOLURE(5100,000),INADDRIONTOTHE OFCOMPENSATION,DAMAGESASPI70VIDEDFORINSECTION3]OBOFTHEUBORCOOE.IHTEREST,MlDATTORNEVSFEES.
LICENSED CONTAACTORS DECLARATON:
I hereby aHirtn thet 1 em Ilcensetl untler provlsions of Chapter 9
lorce entl eHect. LJc. M O a— .
Contrectors Signeture: �
with Sectlon 7000) oi DlNsion 3 0l Ihe Business an� Pr � nions Catle, entl my Ilcense is In tull
Cless p �. l 1
oa�e: i2� 3 —0 7
GONS7RUCTON LENDING AGENCV:
❑ I hereby eNirtn thet Ihere Is e conswcilon Ientlinp epency br the peAormance of t�e work tor which Ihis permit is iuuetl. (Sec. 3097, Civll Cotle).
Lentlefa Name: LenCefs AdAress:
Sipnature:
Date:
OWNER•BUILDER OECLARATONS:
I hereby aHirtn thet under penelry ol per�ury Ihet I em EXEMPT FROM TNE CONTRACTORS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business antl Professlons
Code: Any city or counry whlch reqWres e permil to consiruct, elter, Improve, demolish, or repelr eny structure, pdor lo its issuance, elso requires the epplicam for such pertnit
to file e signed atatemem t�at �e or she Is Iicensetl pursuent to the provislons o1 the Contradors LJcense Lew (Chepter 8(commencing with Sectlon 7000) ot Dlvlsion 3 ot the
Business entl Professlons Cotle) or thet he or she Is exempt therelrom end the besis for ihe elleped exemption. Any violetlon oi Sectlon 7031.5 by flny epplicent for a pertnit
subjects Ihe applicent to e civil penelry of not more t�an flve �untlretl tlollars ($500).):
❑ I, es owner ol ihe property, or my employees wit� wages as t�eir sole compensatlon, WILL DO T}fE WORK, end the structure Is not intendetl or ottered tor sale (Sec.
7044, 8usiness enC Protesslons CoOe: The Cantrectors License Lew does not apply to an owner of property who builds or improves thereon, entl who does such work
himself or hersell or through his or her awn employees, provitletl Ihei such improvements are not Intended or ottered lar sele. If, however, Ihe buildinp or Improvement Is
soltl wit�in one year ot completion, the awner-builder will heva the burden of proving that he or she did noi bui10 or Improve for purpose ot sale.). �
❑ I, as owner o1 the O�operty, em E%CLUSIVELY CONTRACTINC WITH LICENSED CONTRACTOpS to construct the project (Sec. 7044, Business end Professlon5
Cotle: T�e contrecrors lJcense Lew tloes not eppty lo en owner o1 property who bullds or Impmves ihereon, and who contrects tor such pro�ect with a comrector(s)
licensa pursuant to ihe Conirectors License Laws.).
❑ I am exempl under sec. Business anE Professions Code for this reason:
Slgnature: Daie:
Owner ID veriTied by drlvers Ilcensa. ❑ Ves ❑ No Drivers License No. Explres:
Vedflcetlon ol Ownershlp Dy (rype of Cocument, i.e. - properry taz bill or Oeetl):
DIVISION OF INDUSTRIAL SAFETV VERMR CERTIFICATION:
❑ I hereby cenify that no excevetion tive (5) or more teet In depth into which a person is required ta dascand, will be meEe In connecilon wit� work eutho�izetl by ihis
permit, antl ihat no bulltling siructure, scaflWdinp, talsework, or demdltlon or dismantling thereoi, will he more Ihen thirry-six (38) feel high. (C�flp. 32, �rp 2, Art 2, Sec.
341, Tille B, Celitomia ACministretive Catle).
❑ As owner-bullder, I wlll rrot employ enyone to do work whith would requlre e permil from the Divisian of Industrial Sefety, es notetl ebove, unless such pereon hes e
permii to tlo such work Irom the division.
Signeture: Dete:
Dlvision ot InOusirial Selery Permit NumDer.
CERTIFlCATE OF COMPLIANCE ANU AUIHOR¢ATION OF EMRY: I certify under penalty of perjury ihat 1 have read Nis epplicaUon flnd state that Ihe intortnatlon given is
correct. I egree to camply with ell slate laws entl Ury ortlinances relating ro bullding construction, anU aut�odze representeUves ot the Giry of Gosta Mese to enter upon Ue
eDove-described properry lar inspection Durposes. I agree not to occupy or ellow occupancy oi eny building aulhorized by this permit un�il finel inspection.
COOE I. IHSYFCTONTYPE
1816 Fixed System Finel Fire Prevenqon
1266 Paol Spe Final
200 Flnal Re-Roaf
201 Final BIocWRetelning Well
202 Final Feqary Flra Place
203 Finel Sign
204 Finel Demolition
Qajg �� �j INSGECTIONTYPE
206 Final Mechenical
20B Final Plumbing
210 Finel Eladdcal
212 Finel Fire Prevention
220 Finel Planning Approval
222 Final Site
250 Finel Building/Occupency
Date
/2- 3-D?�
Date
Pdff Itii��l6
/� �/ �
/v� % `�.r7
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
555 ANTON BL
9
9TH FLOOR
41050110
FULFORD,TERRY
8749 SHIRLEY AV
NORTHRIDGE, CA
SAKIOKA FARMS
�
Contrector: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts �
Recept Outlets
SwitChes � �-
Non Res Appl �, ,
Res Appl
Service to 200a �
Service to 1000a
Service over 7000a
Motors to 1 hp
Motors to 10hp
Motors to SOhp
Morors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ISSUED BY:
Phone: (818)407-1986
Zip: 91324
Phone:
Zip: 94137
Phone: (818) 407-7986
- �Zip: 91324
License: 386619
Status: ISSUED
Applied: 0926/2000
Issued: 09126/2000
SCOPE OF PERMIT �
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "CENTRECOM" (9TH FLOOR). INSTALL 60
LIGHTS, 35 OUTLETS,�6 SWITCHES, 20 COMMUNICATION DROPS, & 21 MISC CONDUIT.
REF: B00-01208 �
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$57.20
$32.95
$26.60
$0.00
� $Q00
$0.00
$0.00
" $0.00
$28.50 ,
$0.00,
$0.00
$0.00
$0.00
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
- - . FEE SUMMARY
Quantity
0
0
0
60
35
'' g..
0
� ��0.
0.�
0'
0
6
0
0
0
0
20
0
0
0
0
0
Quantity
Temp Dist System / Lighting $0.00 0�
Busway /100 R . $0.00 0 -
Standing Section $0.00 0 ""
Misc Eleclrical Equipment $0.00 �0 -
��� .. Transformers up to 1 kva/kw $0.00 ,' 0�'
. ...........`...up,to 10 kva/kw $0.00 . 0
..............::.up`to�50,kva/kw $0.00 ., ; 0 .
.................up to 100 kva/kw:: _ . $0.00 � 0 ,
.. .....:............over 100 kva/kw�� � ' $0.00 0 �
- Low Voltage Equipment - $0.00, � - 0
_ Low Volt Wiring System / Ckt �� �.'$0.00� �,� 0
- Misc. Conduit " ' $382.20 ' <21 .
Misc. Conductor � ' $0.00 - 0�
Circus ( gen or ride) ,`$0.00 � 0
Circus (mech ride or lights) $0:00 .� 0-
Christmas Tree Stand � � - $0.00 � �0
Fireworks Stand ' , $0.00 � 0
Other Electrical Fee , "$0.00
Investigation Fee 50.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES E566.95
COMMENTS / SPECIAL CONDITIONS
NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 780 days, or it work is suspended or abandoned
for a penod of 780 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 Inspeetiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration oi this permit.
FOR INSPECTIONS CALL: (714) 7545626 j�,
2408d8 (fl�00)
WORKERS' COMPENSATION DECLARATION: �
I hereby affirm untler penalry of perjury one of Ihe following dedarations:
❑ I have end will mflinlein a certiliCate ol ConSent to self-Insure tor workers' compensation, es provided tOr by 5etlion 3700 of Ihe Lflbor Cade, for Ne peAortnente of �he
yrork tor which this pertnit Is issued.
maintain
as required by sectlon 3700 of ihe Lebor Code, for ihe peAormance of Ma work tor which thLs pertnit is Iswed.
�mber ere:
[Poliry.Number.- l✓w9 Z 7c�6 / /300
or less.)
et one
❑ I certity ihat in tha peAortnence oi Ne work lor which this pertnit is issued, I shall not employ any person in any manner so as lo become subject to the workers'
compensation lews ol Galifomla, gnd egre �� at It I s�ould become su6ject to t�e workero' compensation prodsions of Sectlon 3700 ot t�e La6or Code, I shell lotlhwith
Comply with 1h85e O�oNsions /
ApPlicam Signature:- — rDete: �-l6 ! a"
WqRNiNG FAIIURE TO SEWRE WORKERS' SAT10N COVEMGE IS UNUWFUL ANO SHALL SU6IECT AN EMPLOYEP TO CRIMIWIL PENALTIES rVJD GVIL FlNES lIP TOIXJE HUNDRED
TMOUSAND DOLLAFE (E100,000). IN ADDRION TO THE C0.ST OF COMFENSATION, DAM4GE5 AS GROVIDED FOR IN SECfION 3�OB OF THE IABOR COOE, INTEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihaCl.am.11rsnsed under rovisions of C�aptar 9(commencing with Saction 7000) of Division 3 oi the.Business antl Protessions Cotle, end my license is in tull
force anC eHect Lic.-a--�"� /o/i� � ss�M—�-� �'-� �
Co�tractaYs'Slg=ature_ Date:-"- -rZC -�...
CONSTRUC710N LENDING AGENCV:
❑ 1 �ereby affrtn that thera is a constructlon lending agenty tor the pedormance ot t�e work for which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lantlers Nama:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lendefs Address:
Date:
I hereby atfrtn �hat untler penalry of per�ury Ihel I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor ihe tollowing reeson (Sec. 7�37.5, Busineu antl Professlons
Cotle: Any ciry or county which requires e permit to wnslruct, elter, improve, damolish, or repeir eny simcwre, Onor to its issuance, elso requires the applicant for such permil
to Ne e signed sWtemem thet he or s�e Is IlcenseA pursuent to the provisions of the Contradors License Lew (Chepter 9(commendng with Sectlon 7000) oi Divisian 3 ai the
Business and Protesslons Code) or Ihet ha or she Is eaempt Iherelrom and ihe besis Por the elleged exemption. Any violation oi Section 7031.5 6y any applicent for a pertnit
sub�ects the applicant to e civil penalty of no� more than Ilve hundretl tloilars (3500).):
❑ I, as owner of the pmperty, or my employees with wages es their sole compensatlon, WILL DO THE WORK, antl ihe siructure is not intended or oHered for sala (Sec.
7044, Business and Professlons Cotle: The Contractore License Law does not apply to en owner of properiy w�o builds or Improves ihereon, and who does such work
himself or herself or t�roug� his ar her own employees, provided ihat such improvements ara not intentletl or aHeretl for sale. If, however, ihe building or improvement is
sold within one year ot completion, ihe owneo-builder will have the burden ot proving ihat he or she did not build or improve tor puryose oi sele.).
❑ I, as owner of Ihe proDerty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the projeci (Sac. 7044, Business antl Professions
Code: The contraciors License Lew does not epply to an owner of property who buiitls or Improves ihereon, and who conirects lor such project with a contrector(s)
license pureuent to the ConiractOrs LicenSe Laws.).
❑ I em exempt under sec. eusiness antl Professions Cotle tor this reason:
SignaWre: Date:
Owner ID verifled by dnvers license. ❑ Yes ❑ No Oriver's Llcense No. Eapires:
Venfication ot Ownership by (rype ot daumenl, i.e. - property teu bill or tleetlJ:
OIVISION OF INDUSTFiIAL SAFETY PERMIT CERTFICATON:
❑ I hereby certity �hat no e:cavation fne (5) or more leet in depth into which e person is required to descend, will be made in connection with work aulhorizeC by �his
permit, and thai no building slructure, scattoltling, lalsework, or demolition or dismantling thereoi, wlll be more �han �hirty-sia (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Title B, Califomia Adminisiretive Code).
❑ As owner-builtler, I will not employ enyone to do work which would require a permi� trom t�e Division ol IndusMel Satery, as notetl e6ove, unleu such person has e
pertnit to do such work irom Ihe Givision.
SignaWre: Date:
Division of Indusirial Safery Permit Number:
CERTIFlCATE OF COMPIJANCE AND AIfTHOfiIZATION OF ENfAY: I certify untler penalry of perjury that 1 �ave reatl t�is application and state Ihat the information given is
correct. 1 aqree to comply with ell stete laws end ciry ordinances releting to builaing conswction, entl authonze representetives ot ihe Ciry oi Costa Mesa to enter upon Ihe
above-described property for inspection purposes. I egree not to occupy or ellov.• occupency ol any building authorized by t�is permit until finel inspection.
COUE I, INSPECTIONTYPE
1616 Fixetl System Final Fira Prevemion
1286 Pool Spa Finel
200 Final Re-Roof
201 Finel BIocWRetaining Well
202
203
Final Factory Fire Place
Final Sign
,nt-r-- .. .-_-._.r�
QAIE 1[ffiIELS
„ oate
cooe� iNsreenoxTrve
206 Finel Mec�anital
208 Finel Plumbing
210 Final Elec�ricel
212 Finel Fira Prevention
220 Finel Planning Appraval
222 Finel Sile
204 Final Demolilion 250 Final Building/Occupency
Pdg It�LS
„ v
�
i
(714) 754-5273 • Faz (714) 754-4856 • www.Ci.Costa-meSa.Ca.uS 77 FAIR DRIVE, GOSTA MhSA, GA 92626
BUILDING PERMIT
i
Jobnddress: 555 ANTON BL
Suite: 9
Vicinity: 9TH FLOOR
Parcel Number: 41050110
Applicant: RUDI DE OCAMPO
Address: 3080 BRISTOL ST
COSTA MESA, CA
SUI7E 105
Owner: SAKIOKA FARMS
Address
Contrador: ACCENT BUILDERS
Address: 555 qNTON BL. #100
Zoning:
ISSUED BY:
Phone: (714)754-1197
Zip: 92626
Status: ISSUED
Applied: 06/22/2000
Issued: 09I082000
Phone: � D
Zip: 94137
�� a9 03
Phone: (714) 5493150
COSTA MESA, CA
Zip: 92626 License:- 397790 ��
Arch : IA " � Eng:
Address: 3080 BRISTOL ST � Address: .
� COSTA MESA, CA _ Phone: (714) 754-7197 � - Phone: �
SUITE 105
Zip: 92626 License: License: .
SCOPE OF PERMIT
865 SQ Ff INTERIOR OFFICE T.L TO CREATE NEW DATA CENTER FOR "CENTRECOM" (9TH FLOOR). �
Plan Check: $91.56
Permit: $563.45
SMIP Res: $0.00
SMIP Com: $8.78
Other: $0.00
Inspection: $0.00
Total: $663.79
SETBACKS '� � ,
MAIN STRUCTURE Front 0- 0�' �, Rear - 0- 0
�
ACCESSORY �FrOnt 0=0 � Rear 0-0
PARKING Ezisting; � 0 - �Required: 0
NOTES:
FEE SUMMARY
Calc Valuation:
Claim Valuation:
PLANNING & ZONING
Lefl 0-0 _ , - Right. �0-0-; ' '. �
Laft " 0- 0 Righl �0- 0, �
� Pr000sed: 0 � � , ,
sai,eoo.00
sao,000.00
NO710E: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calilornia statutes antl related
regulations. (Ortl. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permlt shall automatically expire and become void if work is not commenced within 1 BO days, or iF work is suspended or abandoned
for a period of 180 days. '
INSPECTIONS: In order for the work authorized under this permN to be considered legal, such work must comply with all applicable codes, and all
required inapectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot thls permit.
FOR INSPEC710NS CALL; (714) 7545626 /
zaaae �aroo�
v
WORKERS' COMVENSATON PECLAFiATION:
I hereby aHirm under penalry of peQury one of the following tleUaretions:
❑ I have end will maintain a Gerti��cete ol consent to self-Insure for workers' compensatlon, es provided lor by section 3700 oi the Lehor Code, tor the pertortnence ot Ne
work tor w�ich this rtnit is �ssuetl.
I have aritl will " in woA�ers' compensation fnsurance, as requiretl �y secUon 3700 ot the Labor Code, for the perfortnance ol t�e xrork for whkh Nis pertrtlt ls IsweC.
My workers' ensation Insu �.r�aier entl poli umber ere: Q� /
Car r: PoliCy Numher: !4/��O �� �
(ihls secN eed not be comp/Bted /l e pe ' s ve/u et ndred tldl ($100J o� /essJ
❑ I ce iry thet in Ue performd��e a work to�fii this it is I A,1 shell not employ eny person in eny menner so es to bewme sublec� lo ihe workers'
DOLLARE (fKiO,OW). IN
�m Ihet I �rn Iicensetl
enac�. uq�p
ub ect to the wo tlon provisions of Secllon 3700 of the Lebor Code, I shall forthwith
D : �� 8'�Q O
IS UNLAWFUL rWD SNALL SUBJE YER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED
1TIp1. DAlMGES nS PpWIOED WR IN SECfIIXJ 3108OF THE IABOR CODE, IMEREST, AND ATTORNEV'S FEES.
9 (commenGng wlih Sectian 7000)
CIo59 M
Code, entl my Iicense is in full
CONSTRUC710N LENDING AGENCV:
❑ 1 �ereby efflrtn Ihat there i9 B consVuction IenCing egency for the peAortnance ot Ihe wark lor whic� this pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lentlers Name: Lendefs Atltlress:
SignaWre: Dato:
OWNER-BUILDER DECIARATONS: �
I hereby aflirtn,thet under penalry oi pehury thet 1 em EXEMPT FROM TME CONTflACTORS LICENSE LAW Por the tWlowing reawn (Sec. 7037.5, Business entl Pro}essions
Cotle: My,Ciry,ar'counry.which raqulres e pertnit to construct, elter, Improve, damolis�, or,repelr eny strucWm, pdor ro its Issuance, elso requires the eppliwnt for such pertnit
to file e signetl s�etement thethe ocshe Is IlcenseA pursuent to Ihe pmvisions of Ihe Contrectors License Lew (Ghep[er 8(commencing wilh Sectlan 7000) ol DMslon 3 of Ne
Business end�Piota'ssion's Cbde) or Ihat he or she is ezempt Iherefmm end Ihe basis br Ihe alleged ezemption. Any violation at Sedlon 7031.5 by any appllcant for a permN
sub�ec[s the eppllcan� to e dvil pBnelry ot not mare than iNe hundred dollers (5500).):
"
❑ I, as owner of the propeny, or my employees wIN wages as their sde compenseUon, WIL� DO THE WORK, entl the structure is nat Intentletl or oRerad far sale (Sec.
7044, Business end Profe55�oro Code: The Contraqors License Lew does not appty to en owner oi property who builAs or Imprmes thereon, an0 who Eaes sud� woAc
himself or herseN ar througP hi4 a her own employees, providetl Ihat such impmvemems ere not Intendad or otteretl br sflle. If, however, ihe �uilding or improvement Is
sold withln one year oi completion, Uie owner-builder will have ihe Durden ol proving that he or she did not build or improve for puryose of sale.).
❑ I, a5 owner ot Ihe property, em E%CLUSIVELV CON7RACTNG WI7H LICENSEO CONTRACTORS to Consiruct Ihe pmject (Sea 7044, Business and Pmfesslons
Cotle: 7Te contrectors License Law tloes not eppty to an awner of properry wha builds or Impmves mereon, entl who wnirects lor such project wlth e contractar(s)
license pursuant to the Con��actors License Laws.).
❑ I am exempt under sec. _ Business antl Professions Code tor Ihis reewn:
Signature: - Date:
Owner ID venfied by drivers Iicense. ❑ Yes ❑ No Drivefs Llcense No. Expires:
Venficatlon of Ownership by (ryp9 01 tlaument, i.e. - proparty tex bill ar tleetl):
CERTiFlGATE OF COMPLIANCE �1D ORQATION OF EMRV: I certify untler penalry of perjury t�at I have reatl thls epplication and state that the iniwmatlon given is
conecc I egree lo compy vrith el �e laws erM dry ordlnan ela�ing to building conswdion, and euthodze representetNes of the Ciry of Costa Mesa to enter upon ihe
ebove-described properry br 'onyarpo�vs I egree no o r py or ellow occupency ot eny building euthorized by this permi� until final inspec4on.
GOQE �. INSFECTONTYPE "
1616 Fixetl System Final Fire Pravemion
1286 Pool Spa Finel
200 Finel Re-Roof
201 Finel BIocWRetaining Well
202 Final Faclary Fira Place
203 Finel Sign
204 Final Demolition
�$ �( INSPECTIONTYPE
206 Flnal Mechenical
20B Finel Plumbing
210 Flnel Electrical
272 Finel Flre Preventlon
220 Flnel Plenning Approvel
222 FIneI5lte
250 Flnal Building/Occupenty
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa�_DING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
Job nddress: 555 ANTON BL
Suite: 9
Vicinity: 9TH FLOOR
Parcel Number: 41050110
Applicant: SMITH, DON
Address: 555 ANTON BL
3RD FLOOR
COSTA MESA, CA
Owner: SAKIOKA FARMS
Address
Contracror. ACCENT BUILDERS
Address: 555 ANTON BL. #100
COSTA MESA, CA
Zip: 92626
Zoning:
Phone: (714) 754-1197
Zip: 92626
Status: ISSUED
Applied: 08I09/2000
Issued: 09/20/2000
ISSUED BY: �
Phone: �rK Lr7.T
Zip: 94137 . �� i■i�L
DATE �`3
Phone: (714) 549-3150
License: . 397790
Arch : IA Eng: - �
Address: 3080 BRISTOL ST � - Address: �
SUITE 105 Phone: (714) 754-1197 Phone: � ,
COSTA MESA, CA
Zip: 92626 License: License:
SCOPE OF PERMIT
16,622 SQ FT INTERIOR OFFICE T.I. FOR "CENTRECOM" (9TH FLOOR). ADD NEW NON-BEARING PARTITION WALLS,
DOORS, & CEILING. ' � � .
Plan Check: $332.57
Permit: $2,046.55
SMIP Res: $0.00
SMIP Com: $60.35
Other: $0.00
Inspection: , $0.00
Total: $2,439.47
SETBACKS ' '
MAIN STRUCTURE Front 0�0 -
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0. 0
Rear 0- 0
Reauired: 0
FEE SUMMARY
PLANNING & ZONING
LeR 0- 0
LeR 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0-0� .
Right . 0-0 -
5287,375.00
$275,000.00
NOTICE: The work authonzad by this permit shall comply with all applicable handicap access requiremenis under Califomia 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 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of this permit.
FOR INSPECTIONS CALL: (714) 7545626
?aaere (N0�)
WORKERS'COMVENSAnON DECLARATON:
I hereby aXirtn under penalty of per�ury one o1 iha tdlowing tledarations:
❑ I �eve entl will meintaln e cartitkete of consent to selFlnsure for workers' compensetion, es provitleA tor by section 3700 of the Labor Cotle, tor the peAortnence o1 the
work tor wMch Ihisoartnit is issued.
��Z
WARNING: FAILURE
THOUSFND
n insurance, es requiretl by sectlon 3700 af the lebor Code, for the pertortnance ol [he wolk for whidi this parmi( is issuetl.
end pdic/ number ere:
one
Policy Numbar.��1S(X/ �/SZ_
orless.)
in Iha perfortnany �of the 6rl 6r whic� ihisy 9�rnit is' ueQ I s�all not employ eny parson in any manner so as to becoma sub�ect to lhe workeB'
m I s oi Cal�rnle, e e that It I Ultl De e sub�aci to IOe warkers' compen5aiion pravlsions of SetliOn 3700 oi Ne Lebor Cotle, I 5hell fotlhwii�
1� provi 16n
re_�— cf--.--�++ • %`Date:��a•� ?L� ^j�lJG"D
TO WRE WOHKE ' O P ATION COVEMQE IS UNLAW FUL AND SNALL SUBJECT AN EMPCOVEF TO CRIMINAL PENA�TIES M!D GVIL FlNES UP TO ONE HUNDRED
DOLLARE (�.�1. W��T� TO WST OF COMPENSATION, DMNQE50.5 PROVIOEO FOR IN SECf10N 3]O60F THE LABOR CODE.INTEREST. M1D ATfORNEI"S FEE9.
LICENSED CONTRACTORS
I hereby aflirm Ihal'bem.licen:
torce end eHect. Lk..tl. �
Comractofs SlanaWre: Lf-
wl�h Sectlon 7000) ot Divislon 3 0l Ihe Business� Professlans Code, antl my license Is in tull
Cless p� e
Date: - ti 20 _ Zd 0
�
CONSTRUCTON LE9ICING AGENCV: \�
❑ I hereby ettirtn thet there is e conswction IenAing egancy tor tha pertormance ol Ihe work lor which this permit Is Issuod. (Sec. 3097, Civil Code).
Lendels Name: Lentlers Atltlress:
Sipnature:
OWNER-BUILDER OECLARATIONS:
Date:
I hereby aHirm,t�et untler penalry ot perjury Net I am EXEMPT FROM iHE CONTRACTOHS LICENSE LAW lor ihe tollowing reason (Sec. 7031.5, Buslness end Professions
Cotle: My,Gry ar,counry w�ich requires a permit to consWct, elter, improve, tlemolish, or repair eny strucwre. pnor l014v Issuance, elso requires Ihe epplicant br such pertnit
to flle e signeE steteinent ihat he oi.she Is Ilcensed purauant to the pmvisions ot I�e Contrectore License Lew (Chepter 9(commencing wit� Sectlon 7000) of Divislon 3 of the
Business entl'Pmfesslans Cotle) oCNat he o� she is exempt thereirom and ihe basis lor the ellegetl ezemption. Any violetlon of Sectlon 7031.5 by any epplicant for e pertnit
su6jects Ihe epplicent lo a civil penalry of not more Ihan (Iva huntlred dollars (5500).):
❑ I, es owner of tha praparty, or my employees with weges as their sde compensauon, WILL DO 7HE WORK, and the strucWre is not iniended or oHereG for sele (Sec.
704a, Business end Professions Code: The Coniractors Llcense Lew does noi eppty to en owner of property who bullds or improves thereon, and who tloes auch wark
himselt or herself ar throug� his or her own employees, pmvided that such impmvemen4s ere nat imendeC or ottered lor sele. II, hawever, Ue building or Imprwement is
sold within one year of wmpletion, the owner-Euilder will have Ihe burden ol proving ihat he or she did not build or improve for purpose of sale.).
❑ I, as owner oi the property. am E%CLUSIVELV GONTRACTNG WITM LICENSEO CONTflALTORS to conslmct t�e pro�ect (Sec. 7066, Business and Pmtessions
Code: The contractors Ucense Lew tloes not eppty to en owner ot pmpeny who 6ullds or Impmves thereon, end who comracts for suc� project with e coniractor(s)
license pursuant to the Conirectors License Laws.).
❑ � am exempt under sec. Business and Pmlessions Code for Ihis reason:
Signeture: Date:
Owner ID verified by drivers license. ❑ Ves ❑ No DriveYs Licensa No. Expires:
Vedficetion of Ownership by (rype ot tlocument, I.e. - prcqerry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ 1 hereDy ceNty ihat no excavatlon five (5) or more teet in Eepth Into w�irh e person is requiretl to descerW, will be mede in connection with work euthorized by Ihls
permit, and thet rro building struqure, scattdding, talsevrork, or demolition or tlismantling ��ereol, will be more then thirty-six (3fi) feet �iph. (Chap. 32, Grp 2, An 2, Sec.
341, 71t1a B, Calilomla AdministretNe Cotle).
❑ As ownervbuiltler, I will not employ flnyone to da wark whic� woultl requlre e parmit irom Ihe DINsIan of IndusMal Setery, es noted above, unless such person �as e
permit to tlo such work trom the d'Msbn.
Slgnawre: Date:
Di�dsbn of Intlustdal Safety Permit Numher.
CERTIFlCA7E OF CO E AND AUTMOROATON OF ENfAY: I certity under penalry of perjury that 1 �ave reatl �his apD����� antl state that the infortnation given is
conect. I egree lo mpty with all st�1e lews and ortlinflnces relating lo bulldirg constructian, end euthanze representatives of the City of Cosia Mesa to enter upon the
ebove-descnbe roperty for insp�Ehon pu I agree not to oaupy or ellow occupancy of eny building authorizetl by Uis permit unGl tinel inspectlon.
COtlE I. INSPECfIONME \J
1818 Fixetl System Final Fire Preventlon
1266 Pool Spa Finel
200 Finel Re-R0o1
201 Flnal BbcWReteining Wall
202 Final Fectory Fire Place
203 Final Sign
204 FinelOemolilion
Qe¢, �^ �j MSPECfIONTYVE
_ _. _ .. 208 Flnal MechaNcal
20B Final Plumbing
210 Finel Electdcal
212 Final Fire Prevention
220 Finel Planning Appravel
222 Finel Site
250 Final euiltlingiOccupancy
(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite No 9
Vicinity: 9TH FLOOR DATA ROOM
Parcel Number: 41050110
App�icant: WALKER, TERRELL
Address: 1606 E CARSON ST
CARSON,CA
Owner: SAKIOKA FARMS
Address: �
Contrecror: AIR-TEC
Address: 1606 E CARSON ST
Arch I Eng :
Address:
CARSON,CA
MECHANICAL PERMIT
Phone: (310)549•1698
2ip: 90745
Phone:
Zip: 94137
Phone: (370)549•1698
. - Zip: 90745
License: 420650
Phone:
Zip:
License:
.. `.. _ _ �••.
StaWs: ISSUED
Applied: 09I25/2000
Issued: 09I25/2000
ISSUED BY:
� � �
�•' . �/ ��
SCOPE OF PERMIT
INSTALL TWO 5 TON A/C UNITS IN DATA ROOM FOR "CENTRECOM" (9TH FLOOR).
REF: B00.00924
'. ISSUE PEE � �
Inst FAU <700 k BTU
Inst FAU >700 k BTU
RepairlAlt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refng Sys >700 k BTU
Gas Piping �� '
Factory Fireplace �� /.�
Hood w/Mech Exhaust �
VAV Box
Vent Fan / Single Duct �
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers c 10000cfm
AirHandlers> 10000cfm
FloorFurnace
Floor or Suspend Heater
Quantity
$23.50
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
= . $0.00' _ 0 �
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
ao.00 0
:�
FEE SUMMARY
Repair / Alt Absorbtion Unit
�Repair / Alt Refrigerelion Unit
Ventillation System
Evaporative Cooler
Commercia l I ncinerator
Domestic Incineiator
Compressors / Absorption Systems
Up to 3 hp I 100 k BTU ,
3To15hp/SOOkBTU �
15 To 30 hp / 1,000 k BTU �
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 8TU
Boilers
Up to 3 hp
3To15hp
15to30hp .-
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
ReinspeIXion Fee
�uantity
$0.00 0
$0.00 0
E0.00 0
80.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
ao.00
$54.30
$0.00
50.00
$0.00
ao.00
80.00
50.00
TOTAL CALCULATED FEES E77.80
COMMENTS / SPECIAL CONDITIONS
0
2
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 1241•92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or ii work is suspended or abandoned
for a period ot 780 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable_codea-a�
requlred Inepections end (inal epproval must be obtained. Failure to obtain inspections and tinal approval will result in the /e/xpiratwn�o( ihis permfl.
FOR INSPECTIONS CALL: (714) 754-5626 v
24a8d8 (8�00)
�
WORKERS' COMPENSAnON DECLAFiAnON:
1 hereDy afFirtn untler penalty ot perjury rne oi Ne tdbvring tledara�ions:
❑ I heve end will melntein e cenllicata ot consent to self-Insure lar workars' compensation, es provltled tor by sectlon 3700 ot the Labor Code, for ihe pertormance of Ihe
wofk for which I�IS pefmit Is i55uetl.
'0—I'have entl will maintain workere' compensetion insurance. as requiretl by sectlon 3700 0l Ihe Lebor Code. lor Ne peAormance ot t�e work for which Ihis pertnit lv IsweO.
_My workers' co pensatiorn,J�ncuranc�rartier an ol4 number are: �'���� �
Certfe�%//�/ 7 ti �� . Polity NumDer. �,�
(This-secffon ne ot be canpleted i! fhe permit Is'va ued et one hundred dollen (5100) oi lessJ
❑ I certity Ihat In t eAormenc of +e work t� hich tNs pertnit is iuueU, I shell not employ eny person in any mennar so es to 6ewme su6�ec1 to Ue workers'
Compensetlon I w af CalNor� , tl a ree i N I should beCome Sub�eCt to �he workere' crompensetlOn provislons ot Sedion 3700yyy f Ihe Lebor Code, I shall torthwl(h
comply with th pmNsion � /_ / /�
Appikant SignaWre � Detei /r1i77 �
WARNINCi: FAI�UR ECURE W RS' TION COVERAOE IS UNLAW FUL AND SWLLL SUBIECT AN EMPLOVER TO CRIMI PE TIES PND CNIL FlNES UP TO ONE MUNDRED
THOUSAND �5100,000), IN AOOITION TO THE GUST OF G1�lAPENSnTION, DFMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, IMEREST, ANO ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHlrm�haLl.am�l n r r sions Ch er 9(commencing wilh Sectlon 7000) ol Oivlslom3�ohthe�Business en0 Professions Code, entl my license Is in tull
rorce end enectyc_r. Lc�esa:a—G�ZE]
Comrectofs SlpnaNre: _ � Caie:, � �6
CONSTRUCTION LENDING AGENCY:
❑ I hereDy aHirtn Ihet Ihere is a canstrudion lending egency tor Ne peAormance ot t�e wark for which Ihis pertnit Is issued. (Sec. 3097, Civil Code).
Lender's Neme: Lentlers AtlOress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby atlirtn f�el unCer penalty ot per(ury that I am EXEMPT FROM THE CONiAACTORS LICENSE LAW lor the tWlowing reason (Sec. 7031.5, Buslness flntl Professbns
Coda: My Uty or counry which requires a permit ro construct, elter, impmve, demolish, or repelr eny strucWro, Pdor to its issuance, elso requires the eppllcan� for wch pertnit
to tile a signed stetement that he or she is licensad pursuent ro the O�oNsions of Ihe Contractore IJcensa Lew (Cheprer 9(wmmencing with Sectlan 7000) of DMsion 3 of Ne
Business end Protessions Code) or ihat �e or she is exempt therefrom end the basis lor Ue elleged ezemptlon. Any violation ot Section 7031.5 Cy eny applkant for e pertNt
sublects Ihe epplicant lo a Gvil penelry ot not mora Uen fve huntlretl tlollars (5500)J:
❑ I, es owner ol the property, or my employees wit� wages es t�eir sole compensetlon, WILL DO TME WORK, and ihe siructura Is not intended or oHered lar sale (Sec.
7044, Business end Professions CoAe: The Contractors License Law does not apply to en awner of properry who builds or improves thereon, end who does such work
himsell or hersetl or through his or her own emplqrees, providetl thet such improvements ere not Intended or ofleretl tor sale. It, however, t�e bulitling or Improvement Is
sald within ane year ol completion, the ov+ner-builtler will heve the burtlen of proWng that he or she did not build or improve for purpose of sale.).
❑ I, as awner of the property, em EXCLUSIVELV CONTRACTING WITH UCENSED CONTRACTORS to construct the prolect (Sec. 704d, Business an0 Pmfesslons
Cotle: The contrectors License Lew does not appty to en owner ol property who bulltls or improves Ihereon, end who coniracts for such projact wlth a wniractor(s)
IiCBnse pur5uenl lo lhe CAntreclors LiCBn38 WwS.).
❑ I em a�empt under sec. Business end Professions Cade for ihis reeson:
Siqneture: Date:
Owner ID verlfled 6y tlrivers Ilcensa. ❑ Ves ❑ No Drlvers LJcense No. Expires:
Ven�ication of Owners�Ip by (type a� Cocumen, i a�p�operry tex bill or deetl):
DIVISION OF INDUSTRIAL'SAFETY PERMR CERTIFlCATON:
❑ I hereby certily that no excevetion frve (5)pr rtwra teet In tlept� Into which a person is required to deuend, will be made in connectlon with work euthwlzed by thls
pertnit, end that no building siruclura, scattdCing, taLsework, or tlemditlon or dismentling thareof, vrill be mora t�en Nirty-siz (36) feet �igR (C�ap. 32, Grp 2, Art 2, Sec.
341, Title 8, Gallfomia AdminblreWe Cotle).
❑ As axner-builder, I wlll not employ enyone to do wark whlch would requlre a pormit Irom I�e Divislon of InAusinel Safery, es noted ebove, unless such person hes e
permit to tlo such wark imm the dlNsbn.
Slpnature: Date:
Division ot Intlustrial Selery Permit Numbar:
CERTIFICATE OF COMPLIANCE AND AUTHOR¢ATON OF ENfAY: I certify untler penalry ol perjury ihat 1 have read this epplication flnC state that the Infortnetion given L5
wrract I egree to wmply wlth ell state laws end dry oNinances relating m bulldinp constructlon, end authodze representatives of ihe Clry of Caata Mesa to enter upon the
ebove-described property lor inspection purpaaes. I agree not to occupY or ellow occupency of eny building eut�orized by this permit until finel inspection.
woe i. ixsveenoxrrve
1818 Fixed System Final Fire Prevention
1268 Pod SOe Flnal
200 Finel Re-Rooi
201 Finol BIocWRetalning Well
202 Final Fectory Fire Place
203 Finel Slgn �
204 Final Demditlon
CODE� INSPECTIONTYVE
208 Flnel Mechenical
208 Finel Plumbing
210 Final Electdcal
212 Finel Flre Prevention
220 Final Plenning Approval
222 Final Sita
250 Final Bullding�Occupancy
ua�a - —
� It��
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 92626
Job Address:
Suite No
� Vicinity:
555 ANTON BL
9
9TH FLOOR
Parcel Number: 41050110
Applicant: WALKER, TERRELL
Address: 1606 E CARSON ST
CARSON;�CA
/ .�
Owner: -�.SAKIOKA FARMS
Address: ' ' � �� � �
Contractor: AIR-TEC
Address: 1606 E CARSON ST
Arch / Eng : ,
Address:
CARSON,CA
MECHANICAL PERMIT
Phone: (3t0)549-1698
Zip: 90745 .
Phone:
Zip: 94137
Phone: (310)549-1698
_ Zip: 90745
License: 420650
Stalus: ISSUED
Applied: 09/28/2000
Issued: 09/28/2000
ISSUED BV:
� A
�
. �
. .� ..�� ��\
EXpiRED �
oa'� 3 ` � ,
Phone:
Zip:
, � , License:• - , � � -
SCOPE OF PERMIT � '
MECHANICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "CENTRECOM" (9TH FLOOR). INSTALL
1 VAV BOX, 4 COMPRESSORS, 8 ALTER 1 HEAT/COOL SYSTEM.
REF:B00-001208
ISSUE FEE
Inst FAU <100 k BTU �
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU ,
Gas Piping �
Factory Fireplace . ,
Hood w/Mech Exhaust �
VAV Box
Vent Fan I Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHantllers> t0000cfm
Floor Furnace
Floor or Suspend Heater
$23.50
$0.00
$0.00
$13.70
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$10.65
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
FEE SUMMARY
Repair/AltAbsorbtionUnit " � �
Repair/AltRefnqerationUnit , �
Ventillation System
Evaporative Cooler , , "" " -
Commerciallncinerator � �
Domestic Incineretor ' - '
Compressors I Absorption Systems' "�'
Upto3hplt00k8TU = , � ��,
3To15hp/500kBTU - .
15 To 30 hp / 1,000 k BTU � .
30 To 50 hp / 7,750 k BTU .
Over 50 hp / Over 7,750 BTU , '
Boilers
Up to 3 hp � - .
3To15hp
15 to 30 hp
3010 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
� Quantiry
$0.00 0
50.00 0
$0.00, 0
$0.00 0
$0.00 b
$0.00: 0
�"� $0.00 0
$0.00 0
80.00 0
$0.00 0
$0.00 0
$58.80 4
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES 5106.65
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 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
tor a period of 180 days. ,
INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all
requlred InapecHona and final epproval must be ob�ained. Failure to ob[ain Inspections and tinal approval will result in ihe expiration of this pertnit!.
FOR INSPECTIONS CALL: (714) 7545626 �
^_.
WORKERS' COMPENSATION DECLARA710N: '
I hereby aflirtn under penalry of perjury one of Ihe following decleretions:
❑ I have antl will maintain a cerlificate of consent to self-Insure tor workers' compansation, es provitletl tor hy section 3700 of the Lebor Code, tor the performence of Ihe
work for which lhis pertnit is issuatl.
❑ I ha`ve end will maintain workers' compensetion insurence, es required by sectlon 3700 of tha Labor Code, tor Iha perfortnence oi Ihe work for which this pertnit Is issuetl.
--My workers' c9m�nsa . s c me tl pof m r are: � �/, ��� /�� I
�1v�f�J� `l���il/�l�i .'�,�}'�. /U/Al � -{��
Cartier. Poliry Number. �:�,�� �
(This sectiw need not be comn/ated i! the oermit is ve/uetl at one hundretl tlollars /3100) oi less. )
❑ I certiy t�et in the d rtnance of ihe rk whi ihis is IuueA, I shall not employ eny person in eny menner so as to bocoma ub�ect ro the workers'
compensation la s Callfomia, a gr t ii I ho b ome sublect to Ihe workers' compensetion provisions of Sec Ibn 3700 0l e Lebor Code, I shell fort�with
comply with thes rovisions. n o, /7
Applicant Signeture: i rDete:--
• �� (%(/
WARNING:�FAIL ~ CURE WORI�RS' PENSATION COVERAGE IS UNUW FUL M!D SMN.L SUBIECT PN EMPLOYER TO CRIMINFL PENALTI S M1D CNIL FlNES UP TO ONE HUNDRED
T}KX15AN� DOLLAPE (5100.000), IN FDqTION TO THE 00ST OF COMPENSATION, OAhUGES AS PROVIDED FON IN SECTION 31W OF THE UBOfl CODE, IN7ERE5T, AN� ATiORNENS FEES.
LICENSED CON7RACTORS DECWRA710N:
I hereby aNirm that I am li uf� er o t Ch pter (c mmencing with Section 7000) ot Division 3 0l ihe Busine�5 s, antl rof slons Code, end my Ilcense Is in full
force and eNacLr c. N � V�� � �� Cless p=(� `, ��
DontraqoYsSigneWre: ✓ / �,,,D- a[e: � �i-
' �
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm that ihere is a constniction lending egenty for the peAormance of Ihe work tor which this pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lendafs Name: ' LenAeYs Atldress:
Signature:
OWNER-BUILDER DECLAFiATIONS:
Date:
I hereby ettirtn that under penalry oi Derjury that 1 em E%EMPT FROM TME CONTFiACTORS LICENSE LAW lor the tollowing reeson (Sec. 7031.5, Business end Professlons
Cotle: Any ciry or counry which requires a pertnit to construc4 elter, improve, tlemolish, or repair any siructure, prior to its issuance, elso requires the epplicent for such pertnit
ta file a signed sWtemem that he ar she Is licensetl pursuent lo the provisions of the Contradors lJcense Lew (Chepter 9(commendng with Secllan 7000) oi Divislon 3 ot the
Business and Professi0n5 Code) or thet he or 5h8 i5 exempt iherelrom end Ihe besis tor ihe fllleged exemplion. Any vidation of Section 7031.5 by eny epplicent for a pertnit
subjecls the applicent to a civil penalty of not more than flve �untlretl tlollars ($500)J: .
❑ I, as owner ot the property, or my amployees with wages es t�eir sole compensa�lon, WILL DO THE WORK. anC ihe siructure is not intentlatl or otferetl 1or sale (Sec.
7044, Business antl Protessions Coda: The Comractors License Law does not apPly to en owner of properry who huiltls or improves thereon, and who does such work
himselt or hersalbor.ihrough his or her own employees, provided Ihat such improvements are not inientletl or afleretl tor sale. If, howevar, ihe building or imprwement is
sold within one year of iompletion, the owner-6uiltler will have I�e burCen oi proving that �e or she Ci0 not 6uild or improve for purposa of sale.).
❑ 1, as owner ot tlie�property, em EXCLUSIVELV CONTRACTING wI7M LIGENSED CON7RACTORS to canstruct the project (Sec. 7044. Business end Profeuions
Code: The comrecmrs Llcense Law'does not epply to an owner of pmparty who builCs or Improves thereon, and who cornrecis lor such pro�ect wit� e contrector(s)
license pursuant to the Contractors Liiense laws.).
❑ I am exempt unde`r sea - Business and Pwlessions Code tor Ihis raeson:
Signatura: � `4" � Date:
Owner ID verified by drivers license. ❑ Ves ❑ No Drivefs LicenSe No. Expires:
Verification ot Ownership by (rype at document, i.e. - pmperry tam blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CEHTIFICATON:
❑ I hereby ceniy that no e:cavation iNe (5) or mora leet In de0�h Into w�iU e person is require0 to tlescend, will Ee matle in connection with work authorizad by lhis
pertnit, antl t�al no building siructure, scaHolding, falsework, or tlemolilion or dismemling Ihereot, will be more than t�irty-six (36) teet high. (Chep. 32, Grp 2, An 2, Sec.
341, Ttle B, Califomia Administretive Code).
❑ As owner-builder, I will nol employ enyone to do work which would require e permii Irom the Divislon ol Indusirial Sefety, as noted ebove, unless such person hes e
pertnit ro tlo such work trom the tlivision. �
Signature: Date:
Division oi Indus�nal Satery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OP ENTRY: I cenity untler penalry ot perjury that I have read this application and state t�at ihe iniormation given is
correct I egrae to comply with all stete laws entl city ortlinances relating to builtling construction, and aulhorize re0�esemelives of the Cily ol Costa Mesa to emer upon the
ebove-descnbed properry lor inspedion purposes. I eyreejiot to occupy or allow occupenty ot eny building authorized by this pertnit until finel inspection.
CODE t. INSPECTONTYPE
1678 Fixetl System Final Fire Prevention
1266 Paol Spe Final
200 Final Re-Root
201 Final BIocWRetainin9 Well
202 Final Fadory Fire Placa
203 Final Sign
204 Final Demolilion
COUE 1 INSPECfION iYFE
206 Final Mechenlcal
20B Finel Plumbing
210 FinalElatiriWl
212 Final Fire Prevention
220 Final Plenning Approval
222 Final Si�e
250 Finel Building/Occupency
GAg VifIDELfl
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-rt1aSB�a,u�PRESSION PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
hIK a
JobAddress: 555 ANTON BL
Suite: 900
Viciniry: STE 900 (BLOODGOOD SHARP BUSTER)
Parcel Number: 41050110 Zoning: _
Status: ISSUED
Applied: 12/09/2002
Issued: 12/16/2002
ISSUED BY:
. - � -,i.�- -, _ _ ' -
Applicant: HENKE, TOM ��`- ` . ' . ~
_� _
iG�.� _ .} . . ..__, .
Address �' l - � � � . ``� \
,� ,
� �,�i .' � � Phone:, 909-592-0151� � / �� ., �
/, . : � �- �
% � i j' \ _ .` '_ Zp: ` - . / l � � �-'-' �
�
i�, � /� ���� �
/,, _. - - , ��.
Owner./, SAKIOKA`FARMS%MORGANS HOTEL LIMITED - �>„ � � ���
Address' � PARTNERSHIPAT7N�JOECRAWFORD � � ,� � � �-' �� � ����.
\= • �
� i j ��DENVER. CO;��: %;�:: ' Phone: �:\\ � %/ �, ��� ,�'•
%�i �' 'V 050�17TH SP�#1220 Zip: � �� �� ^ ` ' '� \
� - i i `/ �`� � � VtV`�
Contr ctor . OGLE & SON GENERAL CONTRACTORS \ \ ``� - �, � �`��
" Address:�, 580�E'ARROW HWY �, . A�, �;� ��,
��, � �
, % SUITE�B - Phone g 909-592-0151 -- - \�� ` \ � ,� `
� f �3ANTADIMAS,CA �`Zip.,, �� "gt773`%,':` ,� � � . � � � A
, - �= - — .� +. � _ ' � � .
, ' : „ � , � �,;..License: 426222� ' •. 1 �. _.. � ,� .
ii; � : i '\/r' __ ,_ '�. , " ��
, ' � � � - SCOPE OF PERMIT ':<� �' ; i/ `� r " , `.�.
BUSTER .�� � � ��i�
IN STE 900: REF B02 01921
� __'
�
i./ �J . ,
�\
��. �, Plan Cfieck: `�
Permit:
- Other ', :
� �
li�
`t,'. _
�� +Total:• �
,,`
�� ,. .���/ ,
� �r, -r� ^� r �r� -
� I , i ��.
$99.61 \
�$15325
$0.00
� �.
� \
r i'-;7jr�. :�r4 �; �\
� � � �
�`I_._i ��L��:l
FEE SUMMARY ; �j
.^'� � �1
"� ,� -.�,� -- _ "-� _ I �^ i' l
, ��, %
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, �� �
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Calc Vaivation: ; $a;000.00' � ;
-��Claimed Valuation: �, $a,000.00 �
-- u� ' � �
ir , .
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NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permlt shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a,penod of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required inspectlons and finel approval must be obtainad. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2448-66 (N00)
WORKERS'COMPENSA710N DECLARATON: �
I hereby ettirm under penalty of perjury one of Ihe tollowing declaratians:
❑ I have antl will maintain e rsrtificate of wnsent to self-Insure 1or workers' compensetlon, es provitletl for 6y section 3700 of tha LeDor Code, for the pertormence of the
work for whiCh this pertni� is issued.
I have and will
My workers' c
i insurance, es reQuiretl by secGon 3700 oi ihe Labor Code, tor the pertortnanca ot the work tor wNch this pertnit is issued.
end policy number ere:
one
�ew�y.Nem�oe�- o�o�i/oo —�bo �
orless.)
❑ I certity ihet in the partormance of the work for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensatlon laws oi Califomia, end egree Ihat it I shoultl Decome suD�ect ro Ihe workers' crompansetion provisions of Section 3700 of Ihe Lebor Cotle, I shell forthwith
Comply with Ihese pr ' ions. ( /
�ncanC:signewre:-,�.....,. Q �ac ./�e�.ru�dcr�. ,�oa�e:� B�L/�Z
WARNINO:FAILUFETOSECUREWORKERS'COMPEN IONCOV ISUNLAWFULANDSHALLSU6JEGTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFlNESUPTOpJEHUNDRED
TKKl$AND DOLLAHE ($100,000), IN ADDRION TO THE COST OF CO�dPENSATION, DAMAGES AS PROVIDED FOR IN SECTIdJ 3]O60F THE IABOF CODE, IDIrEqEST, AND ATTORNEVS FEES.
LICENSED CONTRAC70RS DECLARATION:
I hereby aHirm that I am licensed undar provision5 of Chapter 9(commencing with Section 7000) ot Division 3 of the
Force�antl-�'�effect.'Lic # 2 02�%- �Cl,�ass
i
Contrectofs Signature: ` ris...J. ,� � � Date:
Code, end my license Is In tull
CONSTRUCTION LENDING AGENCV:
❑ I hereby attirm ihat there is a construction lentling egency for the peAormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lender's Name: Lentler's Atltlres5:
Signelure:
OWNER-BUILDER DECLARATIONS:
Da�e:
I hereby aHirtn thel untler penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business anC Professlons
Cotle: Any ciry or counry which requires a permit to construct, alter, improve, demollsh, or repair eny strucmre, pnor to its issuance, also requires the epplicant tor such pe�it
to flle a signatl statement that he or she is licensetl pursuant to the provisions oi Ihe Contradore License Law (Chapter 9(commencing with Section 7000) of Dlvision 3 ot the
Business and Protessions Code) or that �e or she is exempt therefrom end the hasis for the alleged ezemption. Any violation oi Sectlon 7031.5 by eny epplicem for e pertnit
subJects t�e epplicant to a civil penalty of not mord than iive hundred dollars ($500).):
❑ I, es owner of the properry, or my employee5 with weges es Iheir sole compensation, WILL DO THE WORK, and ihe structure is not intentletl or ottered for sele (Sec.
7044, Business and Professions Code: The Contractors Llcense Law does noi epply Io an owner ot properry who builds or improves Ihereon, end who tloes such work
himsetl or hersetl or through his or her own employees, provided ihet such improvements are not Intended or oHered for sale. If, however, the building or improvement is
sold within one year of completion, the ownB�-builder will hava the burden of proving that he or she ditl not build or improve for purpose oi sale.). �
❑ 1, as avne� ot the property, am EXCLUSIYE�Y CONTRACT{NG WITH LICENSED CONTRACTORS to constmct ihe D�o)ect (SacJOAA, Business and PrMewlons
Cotle: Tha contractors License Law does no� epply lo an owner of propeny who bullds or Improves Ihareon, and who contracis tor such projeci wlth e contractor(s)
license pursuant ro the Contractore Licanse Laws.).
❑ I am exempt under sec. Business end Professions Code for this reason:
Signeiure: Date:
Owner ID venfietl by drivers license. ❑ Ves ❑ No DriveYs License No.
Vedfication ot Ownership by (rype of tlocument, i.�. - propetly lex blll or tleetl):
DIVISION OF INDUS7RIAL SAFETY PERMIT C�A7IFICATION:
Expires:
� I hareby certify thet no excaveNon fiva (5) or more feet In tlepih Into which a person is requiretl to descend, will be made in connectlon with work euthorizatl by ihis
permit, end that no 6uilding structure, scaflolding, talsework, or demolition or dismentling thereof, will be more ihan thirry-six (36) feet high. (Chep. 32, Grp 2, An 2, Sec.
341, Tltle 8, Cellfornla Administrativa Cotle).
❑ As owner-bullder, I will not employ anyone to do work which would require e permit from ihe Division oi Industrial Safety, es noted ebove, unless such person hes e
permit to do such work irom the division.
Signature: Date:
Divislon o1 Indusinal Safety Permit Number:
CEHTIFlCATE OF COMPIJANCE AND AIJfFiOR17A7�ON OP ENTRV: I certity under penalty ot perjury that I have reatl this application anC siate that t�e Intortnetlon qiven is
correct. I egree to comply with all slate laws and ciry ordinances relating to bullding construction, end authorize representatives ot the Ciry of Costa Mesa to enter upon the
ebove-described properry for inspection purposes. I agree not to acupy or allow occu0ancy of eny building authonzed by Ihis Dermit until final inspection.
GOUE �. INSPECTONTYiE
1616 Fixetl System Final Fire Preven[ion
1268 Pool Spe Final
200 Final Re-Rool
201 Flnel BIocWRetelning Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolilion
Pdg I[QIDlLfi
COOEt INSiEtTONTYPE
206 Finel Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Finel Planning Approval
222 Final Site
250 Finel Building/OCcupancy
P�IF II�ELfl
/.i -/9: � �"
CITY OF COSTA MESA _,
BlIILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714) 754-5273 • Fax (�ia) �Sa-a856 • www.cl.costa-rr��PRESSION PERMIT
Job Address: 555 ANTON BL
Suite: 900
Vicinity: STE 900 (BLOODGOOD SHARP BUSTER)
NUMBER
77 FAIR DFiIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 12/04/2002
Issued: 12/12/2002
Parcel Number: 41050110 ZOning:
_ - ISSUED BY:
Applirant: KNESPLER,JOHN_,i,'�� � �", • �
.� _ � � _ ,� �
Address: 2532 E 49TH ST.� �� � ". -,( _ , -
� .� � ' ,
�; � �� , - ' Phone: 323-582-5103 � ��`�,� �
VERNON;CA � � � � Zip: 90058 � � ! � � ����; <
. ��
' /%, _ ��`:_ i , • \i/ ��A,���
owner:/� SAKIOKA`FARMS9/oMORGANS HOTEL LIMITED-;�, , _ ` �� � -� �� �
/ � �,� _� ��_,��:
Address- - PARTNERSHIP ATTN JOE CRAWPORD ,�_� �
� '- ��DENVER CO� % -` Phone: �-`����� ,- �' � i � �` � �
�.
' \1050 17TH ST: #1220 �� Zip: �� �� �� , � � � ' : �� \
� � �� '� �. / .�
- / .._� � � � �. � � . .
Contiactor:-, KNESPLER, JOHN R ��� '
;:\ ��
, �:�� , �� _
. Address: '%- / ,c�� , ,
i i `�
' � Phone:... - � -� �
. _ ;�' . �.Z�p; -, ^'`- . ' , . _ ' �. �
' � � � Cicense� 180206-�' -
, - , , . ,. ., � " , ,. . `� �
� � _ �
' - � _ SCOPE OF PERMIT - �_ �%.� -=� , /j �� �
? RELOCAtION^OF 16 FIRE SPRINKLERS HEADS FOR INTERIQR 5033 SF OFFICE AREA TI FOR
JUCiUUU. SFIAKF'�tlUS I tK" IN 51 t�yUU. Fltt: t3U'L-019Z1 \`�� , ; �,.�.
/�, . , " - - - --� � ' , ��
� ' .....� . � .,:�.:`�PEESUMMARY,.�i ._:�� `� �
'� Plan Check: " � $39.07 � � ;, � Calc Valuation: � S�,ioo.00� ' �
Pe�mit; $60.10 �� �-;' Claimed Vaivation: 3i,�oo.00 �;
�� � 04he�: $0.00 . � _ � _ � �:� �.: _ _ , � � ,
, �� : � � i ,
� --- --_ . / __ '
,� �_ � / -- - , . ,
r�� �
, '� , � �� � ,
� _. ,
. , � .. /' ,�' �:
Total. $99.17 � �
. `� ,
� �i
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�- �:� <./� � i' �- . . . � : -„ � ,
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/
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. �� , . ,. �, . -.�i%- , .
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
�� EXPIRA710N: This permit shall automatically expire and become void it work is not commenced within 180 days, or it work is suspended or abandonetl
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
requlred inapectiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ol this permit.
FOR INSPECTIONS CALL: (714) 7545626
�
WORKERS'COMPENSAnON DECLARAnON: -
I hereby affirtn under penalry ol per�ury one oi the following decleratlans: �
❑ I heve end will meiNaln a certlficate of consent lo sell-Insure lor workers' compensetlon, as provided for by sactlon 3700 0l ihe Lebor Coda, for ihe peAartnanca of the
—/ work for which lhi5 permit 19 i55uetl.
�[_�hhave flnd will maintain workere' compensation Insurence, as required by sectlon 3700 of Ihe Lebor Cotle, tor the paAortnence ot the work br which this pertnit Is issuetl.
/�-My work rs' compensatlon Ins�nce cerner entl pollcy number ere: —1
Cerner:__7�7�'T, i U h1�7 � pollcy Numbe'r�d �� I^J. �'�i b�-
�(Ih15 sectlon need wt be cromp/e(ed U(he perm/t /s ve/ued ef one hundred dollers ($f 00) or /ess.)
❑ I certify that in ing pe ortnance of the work for which ihis pertnit is IssueO, 1 shall not employ eny person in any manner sa as to become subject to the workers'
compensation IaW�oi elifom , and egree Ihat II I shoultl hecome sublect to the workere' compansation provisions o1 Section 3700 oi the Lebor Code, I shall torthwith
comply with these isions.
App cant SiB� ' Date: � I�- �' —Cl1
WARNINO: FAILURE TO S E WORKEPS' OOMPENSAT P� COVERAGE IS UNLAWFUL M1D SHALL SUBIEC� AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED
TlIOUSAND DOIJ.ARE ($t , ), IN ADDITION TO THE COST OF COMPENSATION, DMIAGES AS PiqVIDED WR IN SECTION 3%OB OF THE UBOR CODE, INiEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARA710N:
9(commencing wlth Sectlon 7000) ol Division 3 oCihe.Business and Professlons Code, entl my license is in full
Gass.N.� C — ( �
CONSTRUCTON LENDING AGENCY:
❑ I hereby eflirtn that there is a consiruction lending epency br Ihe pedormance of the work br which Ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentlefs Name: Lendefs Address:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn that un0er Denalry of perjury that I em E7(EMPT FROM THE CONTRACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business and Professions
Cotle: My ciry or counry which requires a pertnit to cronswct, elter, Improve, tlemolish, or re0air eny struqure, prior to its issuance, also requires Ihe apD����t for such permit
to file a signetl stetement thet he or ahe is Iicensetl pursuent to Ihe pmvisions of Ihe Contreqors LJcense Lew (Chepter 9(commendng with Section 7000) ot Division 3 ot the
Business end Pmfessions Code) ar thet �e or she Is exempt therefrom end the basis br the alleged ezemption. Any Woletion o1 Secuon 7031.5 by any aDP����t far a pertnit
sublects t�e epplicant to e ciWl penelry of nol more than tNe �untlreG dollars (5500)J:
� I, es owner oi the D�operry, or my employees with wages as t�eir sWe campensetion, WILL DO THE WORK, antl the sW cNre is not intendad or otterad tor sele (Sec.
7044, Business and Profeulons Cotle: The Contracrors lJcense Law tloes not epply to en owner oi pmperry who huilds or improves thereon, and who does such work
hlmself or herself or through his or her own employees, pravitled thet such improvements ere nat intentled or aflered tor sale. N, hov.ever, the building or improvement is
soltl within one year of completion, the owner-builtler wlll have tha burden of proving t�at he or she did not builtl or ImO�ove lor purpose of sale.). �
❑ I, as owner of the property, em E%CLUSIVELY CONTRACTING WITN LICENSED CONTRACTORS to construct the pra�ect (Sec. 7046, Business and Professions
Code: The contrecrors Licanse Lew tloes not apply to en owner ot property who builds or Improves thareon, and who contracts for such project wlth e crontractor(s)
license pursuant to the Contractors License Lews.).
❑ I am exempt untler sec. Business end Prolessians Coae tor this reason:
SlgneWre: Dere:
Ownar ID venfied by dnvefs license. ❑ Ves ❑ No Drivers License No. Ezpires:
Verificetlon at Ownership by (rype of tlaumenL i.e. - praperry tex bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity that no excevetlon five (5) or more feet In dapth Into which e person Is requlred to descend, will be metle in connection with wark authorizetl by this
permi6 antl ihat no building structure, scafloltlinq, talsework, or demolition or tlismantling ihereof, will be more ihan thirty-six (36) feet hiqh. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltle B, Calitarnia AtlminlStrallve Code).
❑ As owner-builder, 1 will not employ enyone to do work which wauld require a permit trom ihe Division ol Industriel Sefery, as notad above, unleu such parson has e
pertnit to do such work trom the tlivision.
Signature: Date:
Division of Indusinal Satary Permit Number:
CERTIFlCATE OF COMPW�NCE AND AUTHORVA710N OF ENTAY: I certify untler penalry ol perjury that I have read this epplication antl state that the information given is
cor ct. I egree to compry with ell stete laws an0 city orAlnences relating to building constructlon, enA euthonze represematives of the Ciry ol Costa Mesa to enter upon the
e ve descnbed property for inspection purpases. I egree not to occupy or allow occupancy ol eny buildin9 authorized by this permit until final insDection.
� INSPELTIONTYPE
1618 Fixetl System Final Fire Preventlon
1266 Pool Spa Final
200 Finel Re-Rooi
201 FInaI BIxWRetaining Well
202 Final Fectory Fire Plece
203
204
Finel Sign
Finel Demolition
�g. ��
COUE� INSPECTIONTYGE
208 Final Mechanical
20B Finel Plumbing
210 Final ElecMcal
212 Final Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
— 11.--t3 t
t Date ^���
�g �
_i� 79-az �
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 fAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 555 ANTON BL
Suite: 900
Vicinity: 9TH FLOOR (MEYERS GROUP)
Parcel Number:. 41050110 Zoning:
� ' '
Applicant: SMITH, DON
Address: ' � � � - � � " � �
ISSUED BY:
Status: ISSUED
Applied: 07/03/2002
Issued: 07/23/2002
. „ . � Phone: 714-012-2580 ' � '
� Zipi� .
� � �
Owner. SAKIOKA FARMS%MORGANS HOTEL LIMITED ," ��- .
Address -�PARTNERSHIF ATTN JOE CRAWFORD ,
.' DENVER,CO ; , , , � Phone: � � ; , '
,-- 1050 17TH ST #1220 = : � - - Zip: � - � - - �
, �i. . , �
Coritractoc HOWARD�BUILDINGCORPORATION �
� Address: 3184 AIRWAY-AVE � ,� �,�,. �
� - � � Phone:- (714)436-2272 _ ' -
� . • ' , COSTA'MESA, CA � � � � � ' ,
Zip: , 92626 � . License:-. 445804 �_ � � , �
Arch : PAUL MORFORD / IA, INTERIOR ARCHITECTS Eng:
Address: 3080 BRISTOL ST . � � � � . Address:� - ,
STE 105 - � l" Phone: 774/754-1197 � - � � � . � Phone: �
� COSTA MESA, CA � - � � ' ' ��
-Zip: 92626 - . ,' license: C19058 � �License: �
. � SCOPE OF PERMIT _ . _
;
" INTERIOR 9347 SF OFFICE TI FOR "MEYERS GROUP" ON THE 9TH FLOOR. - '
Plan Check: $213.36
Permit: $1,312.95
SMIP Res: $0.00
SMIP Com: $32.92
Other: $0.00
Inspection: $0.00
�- �Total: ' $1,559.23
. � � � i ���. : ._ -
�, .
FEE SUMMARY
SETBACKS
MAWSTRUCTURE-Front 0-0 Rear 0-0
ACCESSORY Front 0-0 � Rear 0-0
PARKING Ezistin : 0 Required: 0
NOTES:
Calc Valuation: Siss,�so.00
� Claim Valuation: S�eo,000.00
PLANNING & ZONING
LeR 0- 0
Left 0- 0
Proposed: 0
Right 0- 0
Right 0- 0
,
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
I for a period of 180 days.
I INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspections and flnal 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 _ �
244fi-46(fi/00)
WORKERS'COMPENSAnON DECLARAPON:
I hereby eflirtn untler penalty of perJury one ot Ihe following deGeretlons:
❑ I heve end will meintaln e certilkata of consent ro setl-Insure for workers' compensatlon, es provided for Dy section 3700 ot the Labor Code, for the pertortnence of tha
work for which Ihis permlt Is issuetl. .
❑ I heve end will maintain workers' compensation insurance, es required by secGon 3700 of the Lebor Code, for iha partortnence of the work tor which Ihls pertnit is issuetl.
My workere' compensatlon Insurance cerrler antl pollcy number ere:
Cerner: Policy Numbar:
(Th/s section need nor be comp/eted Il th erm/t ued et one huntl� llars ($700) ar less.)
/ �
❑ I certily thet in Ihe pertormen ol the wo or which fsge (mit i ssued, I shell not employ eny person in eny manner so es to become sub�act to the workers'
wmpensetlon laws oi Calll �la, end eq e that N o 10 b e sub�ea to [he workers' compensation pmvislons af Sectlon 3777bbb0 ot theII��eebor Gode, I shall forthwith
Comptywith lhese ovl5 9. r� /�� /��
ApplicantSignature: Date: �� �a�
WARNINO: FNLURE TO SEC E WORI(ERS'GO�A SATI COVERACE IS UNUWFUL rWD SHALL SUBIECT AN EMPLOYER TO CRIMINAL PE iIES AND VIL FlNES UP TO ONE HUNDRED
T}IOUSANDDOILARE(5100 ),INADDfiIOKTOTME OFCOMPENSAiION,DAM4GE5ASPROVI�EDFORINSEGTION3�OfiOFTHELABOFCODE,IMEREST.ANDATTORNEI"SFEES.
LICENSED CONTRACTORS
I hereb eNirtn t�at I am license u e sio o Ch r(commencin with Section 7000 of DNision 3 ot t�e Busi end Profe sions Cotle, and m Ilcense is in tull
Y � 9 I � — � Y
torce end eflect. Lic. # _ Class q�
Conirectors Signature: - Date: � �
/ � /
7��
CONSTRULTION LENDING AGENCV: �
❑ I hereby atfirtn that there is e consiruction lending agency tor the peAortnance of tha work for whlch this pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
I �ereby etfirtn that under penalry ol per�ury Ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, Business antl ProFessions
Cotle: Any d�y or county which repuires a pertnit to construct, elter, improve, demdish, or repelr eny StruMure, pnor Io ILs issuance, elso requires the epplicant tor suc� pertnit
to file a signed statement Ihet he or she is Ilcensetl pursuanl ta the provisions of the Cantrectors License Lew (Chepier 9(commendng wiU SecUon 7000) 01 DMsion 3 at ihe
Business end Protessions Coda) or that he or she is exem0� ��erefrom end the besis for Ihe allepetl exemption. My violation oi Sectlon 7037.5 by eny epplicent for a pertnit
subjecis Ihe appliwni to e clvll penelry oi not more than five hundred dollars ($500).):
� I, es owner oi iha property, or my employees with weges es thelr sole compensallon, WILL DO THE WORK, and ihe siructure I5 not intentled or aHeretl tor sale (Sac.
7044, Business and Professlons Code: The Contradors License Law dces not apply ro en owner ot Droperty who builds or ImOroves thereon, end who does such work
himselt or hersetl or �hrough his or her own employees, provitletl that such improvements ere not intendatl or aHeretl tor sale. Ii, however, the building or improvement is
sold within one year ol completion, the owner-6uilder will have the 6urden ot proving that he or she did not build or improve for purpose ot sale.).
❑ I, e9 owner oi Ihe property, am E%CLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to Construct ihe project (Sec. 7044, Business end PrOfe55ions
Code: The conirectors License Lew does not epply to en owner of property w�o builtls or Improves thereon, antl who contrects lor such project wlih a contractor(s)
license pursuant lo Ihe Conirectors License LawsJ.
❑ I em exempt under sec. Business antl Professions Code tor Ihis reason:
SignaNre: Date:
Owner ID verifiad by dnvefs Ilcensa. ❑ Ves ❑ No Dnver'S Licensa No. Expires:
Vedficetlon ot Owners�ip by (Iype of documenl, i.e. - property tax bill ar deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICA710N:
❑ I hereby certity ihet no excavetlon five (5) or more feet In depth Into which a pereon is required to descend, will be meda in connection wi�h work euthorized by this
permi�, antl t�at no building slructure, scaHolding, lalsework, or demolition or dismanlling �hereoi, will be more lhan thitly-sla (38) feet high. (Chep. 32, Gry 2, Art 2, Set.
341, Title 8, Calitornla Atlministretive Cotle).
❑ As owner-builder, I will not employ anyona to tlo work which would require a permit from Ihe Division of Indusirial Sefety, es noted ebove, unless such person has e
permii to tla such wark irom the division.
Signeture: Date:
Didslon of Intlusinal Safery Pertnit Number.
CERi1FlCATE OF C LlA1�CE ANU AUTHORVA710N OF EHTAY: I certify under penalry of perjury Ihat I �ave read this epplication antl state Ihat the information given is
correct. I agree t ompty w{h el te laws iry orGinances relating to building wnstruction, and authorize representetives ol the City ot Coste Mese to enter upon the
above-describ properry t� i e ion p os . I egree not to occupy or allow occupency of eny building authorized by this pertnit until final inspection.
COOE I, INSPECTWNTYPE��
1676 Fixed System Final Fire Prevention
1266 Pool Spe Flnel
200 Final Re-Roof
201 Final BIacWRetelning Well
202 Final Fectory Fire Plece
203 Final Sign
204 Final Demolition
�.:'� � G
..-
Qeg � �gppt ixsvecrwnnae
206 Final Mechanical
208 Finel Plumbing
210 Finel Electdcal
212 Finel Fire Preventlon
220 Final Planning Approval
222 Final Site
250 FinalBuiltling/Occupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
suite No
Viciniry:
Parcel Nunmber:
555 ANTON BL
9UU
STE 900 (MEYER'S GROUP)
41050110
Applicant: FULFORD, TERRY
Address: 8749 SHIRLEY AVE
, . ' Phone: (818)407-1986
NORTHRIDGE; CA - Zip: 91324
�'
Owner: � SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
, DENVER, CO- , �, . Phone:
� 1050 17TH ST, #1220 Zip:
Contractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AVE
. - Phone: (818) 407-1986
,NORTHRIDGE, CA . . Zip: 91324
� � � License: 386619
Status: ISSUED
Applied: 07/24/2002
Issued: 07/24/2002
ISSUED BY:
. SCOPE OF PERMIT .
ELEC PERMIT FOR INTERIOR 9347 SF OFFICE TI FOR "MEYERS GROUP" ON THE 9TH FLOOR. 92
LIGHT FIXTURES, 60 OUTLETS, 25 SWITCHES, 1 MOTOR TO�1 HP: REF: B02-01008
� Quantity
ISSUE FEE $23.50
Temp service test $0.00
Res. a/c package $0.00
New Res (1-2 units) $0.00 0
New Res (3+units) . $0.00 0
Pool / Spa $0.00 0
Lighting Fixts, /� �, $74.56 92
Recept Ou[lets , � $51.20 60
Switches ' ' $29.30 �� `' "� `30'�
Non Res Appl ' ., $0.00 � � ' , 0
Res Appl . , $0.00 , 0
Service to 200a $0.00 � 0
Service to 1000a $0.00 0
Service over t000a . $0.00 0
Motors to 1hp $475 7
Motors to 10hp $0.00 0
Motars to SOhp $0.00 0
Motors to 100hp $0.00 0
MOtors over 100hp $0.00 � � 0
Communication drops $0.00 0
Sub panel to 200a $0.00 0
Pole Light Pkg $0.00 0
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0
Intermed Pole $0.00 0
FEESUMMARY
Temp Dist System / Lighting
Busway/100ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
: � ................up to 10 kva/kw
.................up to 50 kva/kw
................:up,to 100 kva/kw. ;
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Winng System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lighls)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigalion Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES f183.31
COMMENTS / SPECIAL CONDITIONS
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 1 BO days, or if work is suspentletl or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be consideretl legal, such work must comply with all applicable codes, and all
requlred inapeotlons and flnal 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 .
zsaaae �aroo� / '
�
WORKERS'COMPENSAnON DECLARATON:
I hereby ettirtn under penelry of perjury one of the following declarations:
� I have entl will mainteln e certllicate of consent to selt-Insure tor workers' compensetlon, es provided for by section 3700 oi the Labor Cotle, for the peAortnence of the
�/ work tor whic� t�is Dermit is luued. .
.YJ I have and vrill maintain workere' compensatian insurance, as required by section 3700 of Ihe Lebor Cade, for Ihe peAormance of the work for which Ihis pertnit is issuetl.
My workars' compensetlan Insurence carner entl poli�cft,ln-umber �ar�/ / �/�
Cerrier �L[!� .ewa�.u�w.: ��'� `�� �—�f�C �^'� PolicyNumber: 7L'8.23�0 /
(This secNon need not be camplefed i/ (he permif is velued af one hundred dollers ($f00J or Iess.J
❑ I certity that in the peAormenca oi the work for which this permit is issueQ I s�all not employ eny person in any manner so as to become subject to t�e workers'
wmpensetion lews of CelNomia, end e that it I should become sub�ect to ihe workers' campensetion provisions of Sectlon 3700 of Ihe Lebor Code, I shell forthwith
comply with these D�ovislo �
Apv���em Signeture: � �.. � Date: 7— z j� oZ
WARNINO:FAILUFETOSECUFEWORKER$' ENSATIONCAVERAGEISUNLAWFULANDSH�l15UB1ECTANEMPLOVERTOCRIMINqLPENALTIESANDGVILFlNESIIPTOONEHUNDRED
TM(%1SAND DOUARE (E100,000�. IN ADDITION TO THE CQST OF GOMPENSATIIXJ, DAMAGES AS PROVIDED WR IN SECTION 3106OF THE LABOR COOE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION: �.
I �ereby eflirm that I em Iicensed under ovisions of Chapter 9(commencing with Sectlon 7000) of DlNsion 3 of the Business and Professions Code, end my license is In tull �
force and eflect. Lla a ( Class M � � �
ContreaolsSignaNre: Date: 7 2�—o Z
CONSTiiUCTION LENDING AGENCY: �
❑ I hereby affirm ihat ihere is e construction lentling agency for the perfortnance oi the work tor which this pertnit is issuetl. (Sec. 3097, Civil Coda).
Lenders Name: Lenders Address:
Signature: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby altirm that untler penalry ol perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Buslneu end Protessions
Code: Any ciry or county whic� requires a pertnit to consiruct, eltar, improve, demolish, or repair eny strudure, pdor to Its luuance, also requlres ihe ep011cant for such permit
to �ile e signetl stetement ihet he or she Is licensed pursuent to the proNsions of the Contractors LJcense Lew (Chepter 9(commencing with Section 7000) of Divlslon 3 ot the
Business end Professions CoOe) or Ihet he or sha is exempt therefrom end tha basis far Ihe elleged exemption. Any violation of Section 7037.5 hy eny epplicant for a permN
sub�ecis the eppllcant to e civil penelry af not more Ihan tive hundred dollers ($500).):
❑ I, es ownar oi Ihe properry, or my employeas with weges es Ihelr sole compensetlon, WILL DO TME WORK, end the structure is not intended or oflered for sale (Sec.
7044, Business and Professions Code: The Contractors License Lew does not apply to en owner of property who builds or improves thereon, end who does such work
hlmself or harself ar ihrough hls or her own employees, provlGed ihat such improvements ere not Intended or oftered lor sele. It, however, the bullding or Improvement Is
sold within one year oi wmpletion, the owner-builtler wlll have the burtlen of proving ihet ha or she did not build or improve for purpose of sele.).
❑ I, es owner at the pmperty, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTOHS lo construd Ihe project (Sec. 7044, Business entl Professions
Code: The contreCtors lJcense Lew tloes noI epply Io an owner ol property who bullds or Improves lhereon, antl wha wnlrecis for such pro�ect wlth a contrector(5)
license pursuant to the ContreClorS LitenSe LawS.).
❑ I em azempt undar sac. Business and Professions CaAe far this reason:
Signe W re: Date:
Owner ID verified by drivels license. ❑ Ves ❑ No Driver's License No. Expires:
Veriticetlon ol Ownership Dy (type of aocument, i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cetlify that no excavatlon five (5) or more feet in depih into which e person is requiretl to descend, will be metle in connection with work euthonzed by this
pertnit, end that no building structure, scaHolding, falsework, or demolition or dismantling thereol, will be more Ihan Ihim/-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Califomia Atlminlsirative Cotle).
❑ As owner-builder, I will not employ enyone to do work whic� woultl require e pertnit Irom Ihe Division oi Intlusinel Satery, as notetl above, unless such person has a
permit to tlo such work Irom the divisian.
Signeture: Date:
Division of Intlusirial SefeN Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AIJfHORVATION OF EMRY: I cenify untler panelty of perjury thet I have reed this application ana state that the Intormetlon given is
correct. I agrea lo camply wlih all stete laws end ciry oNlnences relaling to building conslrucllon, end eu�hodze representatives uf the Ciry of Coste Mese to enter upon ihe
ebove-describetl property fo�inspection puryoses. I agree not to acupy or ellow occupency ot eny building euthorized by this permit until final inspection.
COpE 1. INSVEGTONTYPE �¢, IMtMLS
1616 Fl:etl System Finel Fire Prevention
1266
200
201
202
203
Pool SOe Finel
Finel Re-Roof
Finel BIocWRetaining Well
Finel Factory Fire Place
Finel Sign
204 Final Demalition
COUE I INSPECTION T1PE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
2tt Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtliny0aupency
7-z:7� pz
Date
� It�
D1�"� �<<Gttd.
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
555 ANTON BL
900
STE900(MEYERS GROUP)
Parcel Number: 41050110
npplicant: JUWONO, GEOFFI2EY
Address: 12046 E FLORENCE AVE
SANTA FE SPRINGS, CA
MECHANICAL PERMIT
Status: ISSUED
Applied: 07/23/2002
Issued: 07/23/2002
ISSUED BY:
Phone: (562)944-6341
Zip: 90670
Owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Atltlress: PARTNERSHIP ATTN JOE CRAWFORD
. � DENVER,CO Phone:
1050 17TH ST #1220 Zip:
Coniractor: WESTERN ALLIED CORPORATION
Address: 12046 E FLORENCE AVE
'Phone: (562)944-6341
SANTA FE SPRINGS, CA Zip: 90670
License: 198827
SCOPE OF PERMIT
MECH PERMIT FOR INTERIOR 9347 SF OFFICE TI FOR "MEYERS GROUP" ON THE 9TH FLOOR.
15 REPAIRIALT COOLING/HEAT, 2 VENT FANS/SINGLE DUCT, 10 SMOKE DAMPERS.
REF: 802-01008 .
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >700 k BTU
Repair I Alt CoolingMeat
Inst I Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan I Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > 10000cfm
Floor Fumace
Floor or Suspend Heater
Quaritity
$23.50
$0.00 0
$0.00 0
$205.50 15
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
�. $0.00,_-�.0 ,. -
so.00 0
$14.50 2
50.00 0
50.00 0
$72.50 10
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refnge2tion Unit
Ven611ation System
Evaporative Cooler
Commercial I nci nerator
Domestic Incinewtor
Compressors / Absomtion SVstems
Upto3hp/100kBTU
3 To 15 hp / SOO k BTU
15 To 30 hp / 1,000 k BTU "
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU�
Boilers
Uplo3hp
3Tot5hp
15 to 30 hp
30 to 50 hp
Over 50 hp
ONer Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Quantity
50.00 0
$0.00 0
50.00 0
50.00 0
ao.00 0
50.00 0
so.00 0
50.00 0
so.00 0
50.00 0
50.00 0
so.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
50.00
$0.00
$0.00
5316.00
NOTICE: The work authorized by ihis 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 780 days, or if work is suspended or abandoned
for a pariod of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all epplicabla codes, and all
requlred inspeetlona and (inal approvel must ba obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 , , /
... „ �,. ,
WORKERS'COMPENSAnON DECLARAnON:
I hereby ettirm under penalry of perjury one oi Ihe Iollawinp tledareLons:
❑ I heve antl wlll meintaln e certllicata of cansent to selt-Insure for workers' compensatlan, es provitletl for by sectlon 3700 oi the Lebor Cotle, for the peAortnence of Ihe
work ior which t�is permii is Issued. .
� I have end wlll me�ntan workers' compenseGon Uisurence. az raqulretl by sectlon 3700 of the Labor Code. for Ihe peAartnance of the woAc fw wluch this pertnit is Issuea.
My workara' compensstion Insurence carrier end polity numDer are: c p
Cartier. ST�J� �N'Q PdiryNumDer. �%�Z/O%—��
(Tlr/s secfion need nof be completetl if fhe peimitls ve/ued et one huntlretl tld/ers ($f00) w Iess.J
❑ I certity ihel In the pertortnance ol the work for which thls pertnit is issued, I shell not emplq eny pereon In eny manner so es to become suDlact to Ihe workers'
compensatlon lews of Calllomle, end egree ihat tl I should become sub�ect to t�e workars' compensetlon provislons af Sedlon 3700 of Ihe Lebor Cotle, I ahell lorihwith
comDN w��h these proNsions.
npp�kant Slpnemre: _' �-- Dete: 7,7i3�� 2
WARNING: FAILURE TO SEWRE WORNERS' COMPENSATIIXJ W VEMOE IS UNLAW FUL AND SWLLL SUBIECT AN EMPLOYER TO CPoMIN�L PENALTIES AND CML FlNES UP TO ONE HUNDRED
TIIOUSrWD DOLURE (f100,000), IN ADIXiION TO THE WST OF COMPENSqT10N, OAM1LIGES AS PRONDED FOR IN SECTION 3)O60F THE IABOR OODE. INfEREST, AND ATTORNEYS FEES.
IICENSEU CONTRACTORS DECLARATION:
I hereby aflirtn Ihet I em licensetl untler provlslons at Chepter 9(commenGnO wlth Section 7000) ot Divislon 3 ot t�e Business antl Professions Code, and my license Is in tull
tarce end efleq. Lia M �988 Zl Class p �'ZO
COnirector's Sipneture: ��-- �' Date: 7�YS 02.
CONSTAUCTION LENDING AGENCY: �
❑ I �ereby eNlrm that ihere is a constructlon lenaing agonty lor the performence of t�e work tor whic� this pertnil is issuetl. (Sec. 3097, Civll Code).
Lendefs Name: Lentler's Address:
SlgnaNre: Date:
OWNEFi-BUILDER DECLARATONS:
I �ereby eHlrtn t�at untler penalry of per�ury thel I em E%EMPT FROM THE CONTRACTORS LICENSE LAW far the tWlowing reason (Sec. 7031.5, Business entl Pmtesslons
Cade: Any clry or counry which repuires a Dertnit to tonstrucl, elter, improve, demolish, or repair eny siructure, pnor lo Ita Issuenca, elso requires t�e epplicant for such permlt
to ille a signed aletement Ihet he or a�e I5 Iiconsed pursueni to the provisions o1 the Contractore Lkense Lew (Chepter 8(wmmencing with Sectlon 7000) ot Divislon 3 of the
Business end Pmfesslons Code) or Ihet he or she is exempt thorefrom and the basb for the ellegetl exomption. My Nolatlon of Sectlon 7031.5 by any epplicent for a pertnit
sub�ecLs the epplicent to e cfvil penalry ol not more than Me hundred dollars ($500).):
❑ I, as owner of l�e praparry, or my employees wiih weges es t�eir sole compenselion, WILL DO T1E WORK, antl the struaure is not IntenCeO or otteretl tor sele (Sec.
7044, Business and Professions Code: 7Te Conireclas License Lew does not appty to an owner oi property who 6uilOs or improves thereon, flnd who does such work
himsetl or herselt ar Ihrough his or her own employees, provided thet such improvements ere not intendetl or oNered for sele. If, however, the Duiiding or improvement is
sold within one year ot completion, the owner-builtler will have Ihe burden ol pwving that he or she did not builtl or improve tor Ourpose of sale.).
❑ I, es owner of the properry, em E%CLUSIVELV CONTRAC7ING WITVi LICENSED CONTRACTORS to construct the prolecl (Sec. 7044, Business and Professions
Gotle: The contractars License Law tloes not eppty to an owner ot propeny wha builtls or imprrnes I�ereon, end who contrects for such pro�ect with a contrectar(s)
licensa pursuBnl lo the CONrattors LlCense LewsJ.
❑ I am exempt under sec. Business entl Prolessions Gode tor IhLv reeson:
Sipnature: Data:
Owner ID verlfletl by tlrivers Ilcense. 0 Yes ❑ No Driver's License No.
Venfication ol Owners�ip by (type of tlxument, I.e. - property tez blll or Ceed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ 1 hereDy rarttly ihat no axcavailon Me (5) or more teet in depth imo which e person is required to descentl, wlll be made in connection with work euthodzetl Dy Ihis
permlt, antl Ihet no building siructure, scaNOlEing, falsework, or demolltion or tlismantlirig ihareof, will be more t�an t�irty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, 71t1e 8, Celliomla Administretive Cotla).
❑ As owner-bullder, I will not employ enyone to tlo work which wauld roqulre e permil Irom the Dlvision of Intlusirial Salery, es notetl ebove, unless such porson has e
pertnit to Do such work from the tlivl9lon.
Slgnature: Date:
Division ot Industrial Sefery Permii Number.
CERTIFlCATE OF COMPLIANCE ANU AUiHOR¢ATON OF EMRV: I cetlity under penalry ot perjury that I have read lhis flpplication and siate that Ihe infortnelion given is
wrtect I agree ro comply wilh ell stete laws end ciry ordinances rela[ing to 6uIl01ng consWction, end euthorize representatives of the Ciry of Costa Mesa to enter upon ihe
ebova-described proDerty for inspection purposes. I egree not to acupy or allow occupancy of eny 6uiltling au�horized by this pertnit until finel inspection.
� Signeture OI Legal Owner(s) Date
T ����lo,_
AnNOr Authorizod Applicenl Dato
COOE �. INSPECTONTYPE
7616 Fiaed System Final Fira Prevention
1266 Pool Spe Finel
200 Flnel Re-Root �
201 FIneI BIocWRetalning Wall
202 Flnel Fectory Fire Place \
203 Final Sign �
204 Final Demolition
Qe¢. QQjAEL4 �i4�F,a INSPECTIONTYFE
206 Final Mechanical
208 Final Plumbing
210 Finel ElecNncel
212 Final Fire Prevention
220 Flnal Plenning Approval
222 Finel Slte
250 Finel Building/Occupency
�. I 1111. :
V /
r • • �
(714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla•mese.ca.us 77 FAIR DRIVE, CASTA MESA, CA 92626
Job Address:
Suite No
5$5 ANTON BL
900
Vicinity: S7E 900 (MYERS GROUP)
Parcel Nunmber: 41050110
Applicant: STEVENS, DON
Address: 1940 GARDENA
GLENDALE,CA
PLUMBING PERMIT
Phone: (818)500•1940
Zip: 91204
Owner: SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address PARTNERSHIP ATTN JOE CRAWFORD
DENVER, CO Phone:
1050 17TH ST #1220 Zip:
Contractor: MUIR-CHASE PLUMBING
Address: 1940 GARDENA
Arch / Eng :
Address:
GLENDALE,CA
Phone: (818) 500-1940
Zip: 91204
License: 539835
Phone:
Zip:
License:
ISSUED BY:
Status: ISSUED
Applied: 08/27/2002
Issued: 0&27Y2002
SCOPE OF PERMIT
PLUMBING PERMIT FOR INTERIOR 9347 SF OFFICE TI FOR'MEYERS GROUP' IN SUITE 900. 1
DISHWASHER, 1 KITCHEN SINK (GARBAGE DISP), 1 WATER HEATERNENT (FOR INSTA-HOT).
REF: B02-01008
ISSUE FEE
Backflow irrigalion
BackFlow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental UniLs
Dishwasher
Drain, Floor
Drain, Rainwater
Drein, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 ouUets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
aN
NOTICE: The work aulhorized by this pertnit
regulatlons. (Ord. No. 92-28, § 1, 12-21-92)
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 k) $0.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower 50.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen $9.80
Sink, service/mop $0.00
Spa (private) 50.00
Spa (public) $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-0)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Wasle and Vent System
Water Closet (foilet)
Waler Heater / vent
Water Piping (Inst or Rep.)
Water Re•pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: 555.40
orv
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
access requirements under Califomia statutes and related
EXPIRATION: This pertnit shall automaticaity expire and become void if work Is not commenced within 180 days, or il work is suspended or ebandone0
for e period of 180 days.
INSPEC7IONS: In order for the work aulhorized under this permit lo be considered legal, such work must comply with all applicable codes, and all
requlred lnapectiona and Onal approval must be obtained. Failure to obtain inspections end final approval wiil result in the expiration ot this pertnft.
FOR INSPECTIONS CALL: (714) 7545828 �';
zua+e (erool
WORKERS'COMPENSAnON DECLARAnON: � �
I hereby attirm under penelry of perJury one ot the tdlowinp tledarations: �
❑ I have end will meintein e cenificate o1 consent ta self-Insura tor workera' campensetlon, es proNtleA for by sedlon 3700 of Ihe Lebor Code, lor tha peAarmance ol the
—/ wark tor which tliis pertnit is luuetl.
� I have end wlll malntein workers' compensatbn insurance, es reduiretl by sectlon 3700 of Ihe Lebor Cotle, fo� Ne peAortnance of Ihe vrork lor which this pertnit is issuetl.
"�ty workers' compensation Insurance certier and policy number ere:
caMa�: I/�-/G O aa��rN�moe�: �/GS /OD /OZ —Oo
(TAfs sectlon need nof De cornpletetl i/ the pem'lf /s velued ef one hundred ddlers (5100) a less.)
❑ I certily t�a� in ihe peAormence of 1he work fw whlch thLs pertnit Lv issuetl, I shell not emplq eny person In eny manner eo es to become sub�ect to the workers'
canpenseUon laws of Cellfomia, entl egrea that il I ahoulA become sub�ect to Ne workers' compensatlon proNsions ol Section 3700 01 Ihe LeDor Code, I s�eli torNwlih
camply with Ihese pro ns. cA�
Applicem SigneWre: � �/� Date: `� �Z�—� �
WARNING: FAILIIRE i0 SECURE WOPKERS' COMPEN^aATION COVEMGE IS UMAWFUL AN� SHALL SUBIECf AN EMPLOYER TO CRIMINnL PENALTIES AND CML FlNES UP TOONE HUNDFED
TIIOUSAND OOLLARE (5100,000), IN ADDRION TO THE COST OF COMPENSATION, DAAMGES PS PROVI�ED FOR IN SECTION 3108OF THE IABOR CODE.IPREflEST, AND ATTOHNE`fS FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby aNirm t�et I em licensetl untler DroNsions ol C�apter 9(wmmenGrp wit� Section 7000) ot Divlsion 3 ot the Business enG Professions Code, end my lice2se is in tull
IOrCB 9nE BflBC�. Lk. M � CIa53 p C' �p
ContracrofsSignaWre: Date: �3s I —n7i
�i'��--•
CONSTRUCTION LENDINO AGENCY:
❑ I �ereCy effirtn Ihat there is e constructian lendinp egency for t�e pcAortnance of Iha work lor whlch Ihls permi� is issuetl. (Sec. 3097, Civil Catle).
Lendels Nflme: Lenders Atldress:
Sipnaiuro: Dete:
OWNEP-BUILDER DECLARATIONS:
I hereby ettirm Ihet under penalry of pehury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Business and Professions
Cade: Any city or counry which requires e pertnil ta construct, elter, improve, tlemolish, or repelr eny struCture, pnor to its issuanco, elso reduires �he appllcant for such pertnit
to lile e slpned stetemenl ihat he or she is Ilcensed pursuent ta Ihe proWsions ol Ihe Coniractors Ucense Lew (Chepter B(tammenclnp wiN Sectlon 7000) of Ohrislon 3 of the
Business end Professlons Cotle) or t�at �e or she is oxompt therefrom and t�e besis for the ellogetl ezemptlon. My vlolatlon of SecOon 7031.5 by eny appllcant tor e pertnit
subjecb Ne epPlicent to e civil penalty of nat more t�an fivo huntlretl dWlere (5500).):
❑ I, es owner ot the property, or my employees wlth weges es Ihelr sde compensatlon, WILL DO 7HE WORK, anC Ihe siructure Is not InterMed or aHeretl for ule (Sec.
7044, Business end Protessions Code: The Cantrectors LJcense Lew does rrol appy to en owner at property who �ulltls or Improves thereon, antl who does such work
�imself or hersetl or Ihrough his or �er own employees, provided Ihat such imprwements ere not intendetl or oHered tor sale. If, howaver, the builtling or improvement is
sWtl wNhin ane year of wmpletion, Ne ownerhuiltler wlll have ihe hurCen ot proving ihat he or she tlid not Duild or improve for purpose ot sale.).
❑ I, es owner of Ihe property, em EXCWSIVELV CON7RACTNG WITH LICENSED CONTRACTORS to construct the proJoct (Sx. J04d, Business antl Professlons
Cotle: The comrectors Llcense Law tloes not apply to en owner ol property w�o builtls or Improves t�ereon, and who conirecis lor such prqect wit� e contractoqs)
Ilcense pursuent to the Comrectas tJcense LewsJ.
❑ I em exempt under soc. 8usiness end Prolesslons Code tor thls reason:
Slgnature: Date:
Owner ID veri9etl by tlrivefs Iicensa. ❑ Ves ❑ No Drivor's License No. Expiros:
VenficaUon of Ownership by (lype of document, i.e. - praperry tez bil� or tleetlJ:
DIVISION OF INUUSTRIAL SAFETY PERMRCERTIFICA710N:
❑ I hereby certlfy Ihat no excevetion Ilve (5) or more leet in depth Into which e person is required lo tlescend, wiil be me0e In connecilon wiN work euthonzed by Nis
pertni�, an0 ihat no builtllnp structure, acaHolElnp,lelsowork, or tlemolltion or tllsmentling I�oreot, wlll be more then thirty-six (38) feet high. (CheD� 3.2, Grp 2, Art 2, Sec.
341, Title 8, Calllomia Administretive Cotle).
❑ As owner-builder, I wlll no� employ enyone to do work which woultl require e permit Irom the DlWsion ol Indusirlfll Sefery, as noted ebove, unless suc� person �es e
permll lo do such work trom Ihe division.
Signature: Date:
DlWslon ol Industrial Safery Pertnit Number:
CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF EMAY: I cenify untler penalty of perjury �hal I have read lhis epplication and stata that the intortnation given is
conecL I agree to comply with all state laws end city ordinances relatlng to builtling consiruaion, entl auihorize representatives ot t�e Ciry o1 Coste Mesa to enier upon ihe
ebove-described pmperty tor inspection purposes. I epree not to occupy or allow occupanry of eny buildirig euthorized by INs permit until final inspeMion.
�IgneWre Of Lepel Ownar(s) /� Date
— ;O (.i+�� k5 ' 2%— � �
� AnNOr Aulhodzed Applicanl Date
WDE �, INSPEC710NTYPE ' Qej: Qj[��j
1616 Fixetl System Flnal Fire Prevention
1268 Pool Spe Finel
200 Final Re-Roo1
201 Flnel Block/Retaining Well
202 Final Fettory Fire Plece
203 Finel Sign
204 Final Demolitlon
fAUF,� INSPECTIONME
206 Flnal Mechanicel
208 Finel Plumbing
210 Finel Electrlcal
212 Finel Fire Preventlon
220 Final Planning Approval
222 Flnal Site
250 FinalBuilding/Occupancy ,
�g ��
�
� . fi r -_ •
(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa�DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: S$S ANTON BL
Suite: 900
Vicinity: STE 900 (BLOODGOOD SHARP BUSTER)
Parcel Number: 41050110
Zonin9:
Applicanr. SMITH DON
Address: , - � ,, . - � ' _ � ' � ,-�
� - � Ph ' 714-0 2272 . . .. -
ISSUED BY:
--�i . one. 3& - -
'. �-''. - � � . .
�i : � . Zip: �� �
� �, �
/� 7�= , �' "� � • � , �'��. � --�.
Owner. SAKIOKA�FARMS�%MORGANS HOTEL LIMITED �� �' ��' ��� ' � �
� ., , � � ��� � �-�_ .'_
Address �PARTNERSHIP ATTN JOE CRAWFORD - _ _ - � � �/ - �, ��
� DENVER, CO - � . - Bhone: � � _ - ; - , �
� - 1050 17TH ST� #1220. � Zip: � '
' � %` � � .
. _ i . - " �- ' �. /� / ,A\
Contractor. �HOWARD'BUICDING CORPORATION ��` ��,�A,'� �� � ��
.'Address:, 3184 AIRWAY AVE �'�' ��' � / �
i � � . �\ .
, . , .-, ��% Phone:���(714)43&2272 �.
. �
i � \ � .
- COSTA-MESA, CA - . , � �� �
. i _ . �'�' ���
- Zip: ' 92626% ' License:c; 445804 ' � �. . � . �� ��, .
Arch .. - - - �, , ' � Eng: .. � . �
. Address: . - � / Z�� ' Address:�- �, � ' �
� ,
�
� � �a. �� � l� Phone:_ _ ' '. . _ ' .��� . � :,: %. Phone: = - .� .
, ,, . . . - _ / i . �� �
��Zip: . ". ' ��� i License: � � .:License: = _ .-� �.
" �\
' , � SCOPE OF PERMIT '
'; INTERIOR 5033 SF OFFICE AREA TI POR'BLOODGOOD, SHARP�BUSTER':IN STE 900.' WORK TO INCLUDE NONBEARING WALLS, CEILINGS,
,DOORSANDFINISHES. , -'� -- �- -- � -- '-' 6��' `-•-�t" � � �
i
.` - � _ - . .' _. '�
Sfatus: ISSUED
Applied: 11/25/2002
Issued: 12/03/2002
; Plan Check: $468.49
Permit: $720J5
SMIP Res: $0.00
��SMIP Com: � � $12.61
Other: , , $0.00
Inspection: ,$0.00
,�,. ..
';:
� TotaL• . � $1,201i85.
, ���_ .
,—�; � ,, FEE SUMMARY .� ,..
-- ' � _ Calc Valuation:
� � � � � � �," �� ; �' - Claim Valuation: �
/
' �' 360;061.38-
sss,000.00
<' ;
"�� %'�, ,�- PLANNING&ZONING ,,.���
� � i
SETBACKS ��'' � � � " � ': � �
. . ,
'„ � / . ; \ . /,
MAIN STRUCTURE-Front - 0- 0,.� Rear � 0. 0- �- _ Left � 0= 0 Right � 0-�0, `/'
.�., � ,
ACCESSORY Front �,0 �0 ` Rear 0. 0 Lefl , 0- 0• Right. � 0- 0:, j�
�: ,
PARKING Exisuna: �o= �' Re uired: o Pr000sed: o-� ��� �
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, 1241-92)
EXPIRA710N: This permfl 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 tlays.
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 inspeetlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626
244&68 (BI00)
WORKERS'COMPENSATON DECLAHATION:
1 here6y eHirtn untler penalry of perlury one of the lollowing daclaretions:
❑ I have ntl wlll maintflin a ceniticate ot cansent to selt-Insure for workers' compensetlon, es O�ovldetl for by secUon 3700 oi Ihe Lebor Cotle, lor the peAormence ol the
for whith Ihis pertnit is ISsueE.
I have and will mantein workers' compensation insurance, as reQuiretl by section 3700 0l ihe LeDor COde, for Ue peAortnance ot the work for which INs pertnit is issuetl.
Mv warkers:comoensetion Insumnce certier entl oollcYnumbar ere:
Cartier. „�,j
(Thls seclion need r
Policy Number. / (�'� �' ��O Z
❑ I certity t�et In t�e pertortnence ol �wa� 1� �is 0��� �ssued, I shell not employ eny person In eny menner so es to Decome aub�ect to Ihe workers'
compensatlon lews ai Califomla n0 p e 1 tl houl � me sub�ect to Ihe workers' compensetlon pmvlsions oi Sectlon 370 of t�9 Lebor Cotle, I shell foM1�with
comply with these 0�sions. � � 9� 1,.�/)
ApPlicant Signeture: Date: I� �—. ��[ �
WARNINGFAIWRETOSECUR ORKERS' IPENS/TIO! OVEMGEISUNLAWFULANDSHAILSUBJECTANEMPLOYERTOCPohllNALPENALTESrW CMLFlNESUPTOIXJEMUNDRED
THOUSAND DOLIARE (f100, . IN ADDITION THE COS F COMPENSATION, UAMAGES AS PROVIDED WR IN SECTION 3]OB OF THE LABOR COOE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS UECLARATION:
I hereby aMirm thet I em Ilce sed un r pr vislon C apt 9 ommendng with Sectlon 7000) ot Dlvision 3 0l the Busingv�nntl PmlesSions Code, antl my Ilcense is In full
force end eNect. Llc. a Class a <S
Conirectofs SlgnaWre: Date:
CONSTRUCTION LENDIN AGENCY:
❑ I hereby eHirtn thet there Is e consWctlon lentling egency for the peAormence ol the work lor whlch 1�Is permit is luuetl. (Sec. 3097, Clvil Cotle).
Lentlefs Name: Lentlar's Atltlress:
Signeture:
OWNER-BUILDER DECLARA710N5:
Date:
I �ereby aNirm that under penalry of per�ury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW lor Ihe following reeson (Sec. 7031.5, Business and Professlons
Coda: Any ciry or counry w�ic� requlros e permil to construct, elter, Improve, tlemolish, or repair eny structure, pdor to its issuence, elso requires t�e epplicant tor such permlt
to file e sipne0 stetement that he ar she is Ilcensed pursuont to Ihe pmNsions oi Ihe ContreIXors LJcense Lew (C�apter 9(commenGng with Sectlon 7000) of DlNsion 3 0l Ihe
Business entl Professlons Cotle) or that he or she is exempt therefrom end the besis lor Ihe allegad exemplion. Any Wolation of Sectlon 7031.5 Dy eny epplicent lor e pertnil
sub�ects Iha epplicent ta a civil penalry of not more than Iive hundred Aollara ($500).):
❑ I, es owner ol the property, or my employees with wages es their sole compensetion, WILL DO 7HE WORK, end Ihe structure Is nat Intendetl or aNered tor sale (Sec.
7044, Buslness and Prolessions Cotle: The Conirectors lJcense Law dons not epply to en owner ot praperty who builds or impraves thereon, and who tloes such work
himsell or herseli ar Urough his or her own employees, pravided that such ImprovemenLv ere not Intendetl or oNered for sele. Ii, however, the bullding or improvement is
sold within one year o1 completion, the owner-builder will �ave Ihe burden ol proving t�at he or she did not builtl or Improve lor purpose oF sala.). �
O I, es owner o1 Ihe properry, em E%CLUSIVELV CONTRAC7ING WRH LICENSED CONTRACTORS to conSlruct the pra�ett (Sec. 7044, Buslness and Prolessions
Cada: The cantreaors License Lew does not eppty to an owner at propeny w�o builEs or ImO�oves t�ereon, end who conirects for such pro�ect with e contrector(s)
license pursuem to the Comrectors License Lews.).
❑ I em e:empt under sec. Buslnasa antl Pmlessions COEo tor thls roeson:
Siqnature: Date:
Owner ID veriiletl by tlrivers Iicensa. ❑ Yes ❑ No Oriver's License No.
Verilicatlon of OwnershiD by (typa of tlocument, i.e. - properry tax blll or Oeetl):
Expires:
DIVISION OF INDUSTFiIAL SAFETY PERMR CERTFICATION:
❑ I hereby certify thal no excevetlon IWe (5) or mora taet In tlepch Into whlch e person Is require0 to Eescend, will be meEe In connectlon with work euthoAzetl by lhis
permit, entl thet no buiWing swcture, sceHWtling, talsework, or Cemdltlon or dismentling Ihereof, will be more than tNrty-six (38)leet �Iph. (Chep. 3.2, Grp 2, Art 2, Sec.
341, lltle 8, Celltomie AAmInlStretNe Code).
❑ As awner-builder, 1 will not employ enyone to do work whkh would requlre e permit Irom the Dlvlsion ot Industrlel Sefety, es noted ebove, unless such person hes e
pertnit to tla such wark from the tlivislon.
Signature: Date:
Dlvision ol InAusinal Satery Pertnit Number:
CEHfIFlCAiE OF COMPIJAN AND AUTHOR¢A710N OF ENTAV: I certity untler penalry ot perjury that I have read this epplication enG state that the information given is
correct. I eqree to wmpty ell state laws end dry ordinences ralating to 6vil0ing constmction, antl eut�odze represenletives oi tha Clry ot Costa Mesa to enier upon the
eDove-tlescribed prope ar Inspectior�.pQ3poses. I agr o 0 occupy or ellow occupanry ol eny building euthorized by ihis permit un�il Iinel inspection.
COUE �.
7618
1266
Fisetl System Final Flre Preventlon
Pool SDa Final
200 Flnel Re-Roof
201 Finel BIocWReteining Well
202
203
204
Final Fat�ory Fife PlaCe
Final Sign
Final Demolltlon
I�7.�1� �IIII/14'
CODE� INSPECTIONTYPE
208 Final Mechenical
20B Flnal PlumEing
270 Flnel Electdcal
212 Finel Fire Preventlon
220 Final Planning Apprwal
222 Flnel Si�e
250 Finel BuildingiOccupanry
1�7.11 .IUI. fl
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
555 ANTON BL
900
Parcel Nunmber: 41050110
Applicant: FULFORD, TERRY
Address: 8749 SHIRLEY AVE - �� � �
ISSUED B .
Stams: ISSUED
Applied: 12/OS/2002
Issued: 12/OS/2002
� �:i � . _. , .. . �
, " .� %% � . Phone: (818) 407-1988 - � �
` � _
NORTHRIDGE,-CA', � -� � Zip: 91324 - .��,�
- � = . � � , ; ;,�
„
%/��'��. .. � � � �_' / ��-.\�
- - - ' . i .I! �
�
Owner:% SAKIOKA�FARMS_%MORGANS�HOTELlIM17ED����
�, - � ;': � ��� `
Address' PARTNERSHIPATTN�JOECRAWFORD � , � � '
, ' � - DENVER; CO/', -, Phone: ���� �\ �% �
;
" � 105017THST�#1220 2ip: ���: �' \' ��
i �
- , iG,�j ' ���,:�, �����
>,
- ,'i.',. ' �� ' . ��
Contractor: ' O'BRYANT ELECTRIC � �
, _ , . „�\
Address: � 8749 SHIRLEY AVE " � - ' ' � � � . ' " �
, .� _: �,��-� .. � .
, � �, � � ` ;,Phone: (818)407-1986„ .. � ,. - - �'� . �
� NORTHRIDGE, CA � - � - . Zip: 91324 ' _ ' . � � . ,
� �� � � � � � - � License: 386619 � � � . �� ��. �
, - � _ -�i � , �
�\ , , . - . � � ,
. . � �
' SCOPE OF PERMIT '
i� INTERIOR 5033 SF OFFICE AREA Tf FOR�BLOODGOOD; SHARP�BUSTER' IN.STE 900. WORK TO
INCLUDE NONBEARING WALCS, CEI�INGS. DOORSAND FINISHES: REF:'B02-01921. ELECTRICAL
TO INCLUDE: 23 LIGHT F�XTURES, 28 OUTLETSS, 4 SWICTHES,._ ; -
, ,✓ _ ,. , - _ ` .!� ._;!l�: ,
Quantity
ISSUE FEE , $23.50
Temp service test , $0.00
Res,�a/c package � 50.00
New Res (1-2 uniLs) . $0.00 - 0
NewRes�(3+units)- � � �� $0.00 0
Pool / Spa.��. �� $0.00 0
Lightlng Fixts �. � � $24.19 23 -
Recept Outlets � , � $27.84 , -� � 28 � -
Switches �� � � . �� $4:40'_-� 4
Non Res Appl� ;� �A i�;� $0.00 - ,.0 -
Res Appl � , A � ; $0.00_ � � - 0-`-
Service to 200a � � ,b0.00 � ��0 � '
Service to 1000a $0:00 � �, �-. � � 0 �
\ -
Service over 1000a ��.� � 50.00 � , 0
Motors to t hp $0.00 �.� 0�
Motors to 10hp ' �$0.00 �. 0
Motors to 50hp $0.00 � �- . 0
Motors to 100hp $0.00 �. 0
Motors over t00hp $0.00 � � .0 .
CommunicaUon drops $0.00 0 � �� -
.,;�
'EE'SUMMARY- ' C `
- � � -'��� Quantity/ �
Temp Disl Syslem / Lighting $0.00 0��
Busway/100�ft ' �$0.00 0'.
StandingSec6on ' $0.00 �05 '
� '.Misc ElecMcal Equipment $0.00 '� 0. � �
� �� Transformers up to 1 kva/kw $0.00 ��,` 0 �
� ................up to;10 kva/kw $0.00, „ �� 0
. .................up to�50kva/kw . 30.00 ' � 0 •
- .................up to 100 k'va/kw � � �. $0.00 0
: . ...........i......over 100 kva/kw . $0.00 . �. 0
� Low Voltage Equipment - . ��. $0.00 � ' ,0- �,
�.. Low Volt Wiring System LCkt�% $0:00 '. 0 '
Misd Conduit � $O.OD � ��0 " �,
' � Misa Conductor ' . . � $0.00= � , 0 ' i
Circus ( gen or ride). , �� '�; , � $0.00 - � Oj
.. Circus (mech ride or lighls) � �$0.00 �'� i 0
ChristmasTreeStand� -$O.Wj� 0
Fireworks Sfand ; � � , � 50.00 0
' '� Other Electrical Fee. - � $0.00
_ �InvestigaGon Fee� - � $0.00
:'
, �
NOTICE: The work authorized by this permit shall comply wilh all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become voitl if work is not commenced within 780 days, or it 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
requlred Inepections end final approvel must be obtalned. Failure to obtain inspections and final approval will result in the expiration ot ihis permit.
FOR INSPECTIONS CALL: (714) 754-5628
zaaaae (arool
WORKERS' COMPENSA710N DECIARATION:
I hareby eftirm untler penalry oi perjury one of the tWlowing dedaretions:
❑ I heve antl wlll malntein a ceNficate of consenl �o self-Insure for workers' compensatlon, es proWdeO for 6y section 3700 of ihe Lebor Code, for Ihe pertormance of the
work for which Ihis permit IS issued.
❑ I have end will melntein w ers' mmpensatlon Inw es requiretl by sectl 700 of tha Lebor Cotle, for Ihe peAortnance af the waM for which Nis pertnit Is issued.
My warkers' comdren tl n Insurence cerder entl Ilc n}��, b�er ere: q
Cartler. 1 � � �� .l7 i //lJ� � Poliry Number. �� .S � � � � r���
(fhls section neetl nof tie complef ll Me permif !s veluetl el one �unOretlOollers ($100) or eu.)
❑ I certity Ihet in Ihe pertortnanca at the work lor w�lch thls permlt is Issuetl, 1 shall not ploy eny porson in eny manner sa as lo become subJect to ihe workers'
wmpensetlon laws oi Calitomiggg���pp¢ntl agr et II I should become aublect to-therro era' compensatlon pravisions of Sectlon 3700 0l the Lebor Catle, I shall torthwlih
comply with the9e provlslong///
Applicen� Slpneture: �� Da�e: �Z ' S''� Z-
WARNIN(3: FNLUFE TO SEWRE WOfL ERS' COy SATION COVERAOE IS UNUWFUL M1U SHALL &UBJEGf AN EMPLOYEF TO CPIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
TIIOUSPND OOLL4RE (E100,OOO�.IN ADIXi1pJ ll5 E WST OF COMPENSATION, OAMAGES AS PROVIDED WR IN SECTIIXJ 3�OB OF THE IABOF CODE, IMEREST, AND ATTORNE`fS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eXirm Ihat I em
torce en0 eNect. Llc. a_
Contreclors SignaWre:
Chapter 9(commenUng wlih Sectian 7000) ot Dlvision 3 0l lhe Business an Professlons Code, and my license L5 in tull
Cless p �'' �
`o �•.` Dete: �Z — d '� �
CONSTRUC710N LENDING AGENCY:
❑ I hereby eilirtn thal there is e construction lentling agenty lor the pertormanca ol iha work lor w�ich this Dermit is luuad. (Set. 3097, Civil CaOe).
Lendefs Name: Lenders Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby atlirtn that un0er penelry of per�ury that I em EXEMPT FROM TIiE CONTfiACTORS LICENSE LAW lor the followin8 reason (Sec. 7031.5, Business anA Prafesslons
Code: Any dry or counry which requlres e pertnit to conswct, elter, Improva, tlemolish, or repair eny strucNre, D�ar to ils 15suanca, elso requires t�e apD���ent for such petmit
to file e signed atetement Ihet he ar s�e b Iicensed pursuent to Ihe pmNslons of the Contredors License Lew (Chepter 9(commendng with Section 7000) ot �ivision 3 of Ihe
Business enA Professions Code) or t�at he or she Is exemp� Iherefrom end tha basis Por the elleged exemption. Any NoleOan o1 Section 7031.5 by eny applicam far e pertnfl
subjects ihe applicant to e cMl penalry W no� more than fNe hunaretl Eollars ($500).):
❑ I, es owner of the property, or my employees wIN weges as their sde compenseLon, WILL DO 7ME WORK, end Ihe siructure Is not Inten0e0 or otterad tor sale (Sec.
70C4, Busineu and Professions CoAe: The Contractors License Lew Coes not apply lo en owner af properry who huilds or Improves Nereon, and who does such wark
himselt or herselt or Ihrough his or her own employees, provided tliat such improvements are not intended or oflerad for sele. tl, however, t�e butlding or improvement is
sold within one year ot complation, �he owner-builder will heve tha burden ol DroNng Ihat he or she tlitl not build or improve for purpose of sale.). �
❑ I, as owner of the properry, em E%CLUSIVELY CONTT7ACTNG WI7M LICENSED CONTRACTORS to construct the p�o�ect (Sec. 704d, Business and Professions
Code: The wntrectors Ucense Lew does not eppty to en owner ot property wha builds or Imprwes thareon, and w�o cantracts tor such project with a wntractor(s)
license pursuant ta the Contraqors License Lews.).
❑ I em axempt under sec. Business and Prolessions Coda tor this reeson:
Signature: Date:
Owner ID veniied hy tlnvefs Iicense. ❑ Yes ❑ Na Drivers Llcense No. Expires:
Verificetian ai Ownership by (type ot Oocument, I.e. - propeny tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby ceNty that no eacavetlon Ilve (5) or more teet in depth into which a person Is requlred to descentl, wlll be mede in connectlon wllh woM authodzed by Ihls
permit, antl thet no bullding structure, sceMdtling, telsework, or demolitlon or tlismentlinp thereat, will be more than thirry-six (36) feet �ig�. (Chap. 32, Grp 2, Art 2, Sec.
347, Title 8, Celifomla AdminlstretNe Cotle).
❑ As owner-bullEer, I wlll not emplay enyone to tlo work whlch woultl requlre e permil trom the DlWsion ol Industrlel Sefery, es noted above, unless such person �es e
permit to do such work tmm the tlivisbn.
Signature: Date:
Divislon o1 Industdel Setery Permlt Number.
CERTIFlCA7E OF COMPLUWCE AND AIJTHORQATON OF EHTTiV: I certity untler penalry ot pe�ury that I have reetl this epplication and state that the infortnatlon given i9
correct. I egree to wmpty wiih ell siete laws end Gry ordlnences relatinp to builtling consiruction, and authodze reprasent&tives of the Ciry of Costa Mese lo enter upon Ne
ebovo-descnbed property for i�pectlon purposes. I egre9 not to occupy or allow occupancy of eny building euthonzed by ihis pertni� unGl finel inspecGon.
400E r. INSPECfIONTYPE
1816 Pixetl System Final Fire Preventlon
1288 Paol Spa Final
200 Final Ra-Root
201 FIne181xWRetelning Well
202
203
204
Finel Fecrory Fire Place
Flnal Sign
Flnel Demolilion
�
�^� S,QQ�( INSPECTIONTYPE
206 Flnal Mechanical
208 Finel Plumbing
2t0 Finel Electrical
212 Finel Fire Preventlon
220 Finel Planning Approval
222 Final Site
250 Finel BullAing�Occupency
L
PAg P�ELS
/y� �
i C�J I��
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIFi DRIVE, COSTA MESA, CA 92626
dL
MECHANICAL PERMIT
Job Address: 555 ANTON BL
Suite No 900
Vicinity: 900
Parcel Number: 41050110
Appiicant: JUWNON,GEOFFREY':'
Address: 12048 E FLORENCE AV - %
�� �,, -. � " . . �, Phone: 562-944-6341 i .
SANTA FE SPRINGS, CA � .- ' Zip: 90670 � '� _
/ �
Ownec SAKIOKA FARMS %MORGANS HOTEL LIMITED
Address: �PARTNERSHIP ATTN JOE CRAWFORD
- DENVER; CO'� �� Phone:
i "
� 105017TH.ST'#1220 Zip:
� /
Contrector. ` WESTERN ALLIED
Address: 12046 E FLORENCE AV � - � _ ,
. � �� , P.hone: 562-944-6341
- ,
, SANTA FE SPRINGS, CA` �=. - �Zip: 90670
.. " ' . � " License:198821
' % �.
Status: ISSUED
Applied: 12/06/2002
Issued: 12/06/2002
ISSUED BY: 1/ 1 � �
e
< �
/ ,
� SCOPE OF PERMIT ` � ' � �
, �" REF: B02-0192L SUITE 900 BLOODGOOD SHARP BUSTER. ALTER 7 DUCT ; ,� . ,
��� ,�. �... - _ - f ; �; - - �
� " - `-"FEESUMMARY "�- �'•'
Quantiry � '; Quantiry
ISSUE FEE _, 523.50 "� Repair I Alt Absorbtion Unit � 50.00 0 �
InstFAU<100kBTU 50.00 0 � �� .- �- - , - ,� RepairlAlLRetnger`ationUnit ,� $0.00-� 0� �
Inst FAU >100 k BTU $0.00� - 0 - � - - , Venlillatiori System , , $0.00 0� . � �
Repair I Alt CoolinglHeat E95.90 - 7 � ' ' Evapora6ve Cooler $0.00 0 ,
Inst / Rep. Recess Wail HV $0.00 0 Commercial Incinerator �, $0.00 0 �
Retdg Sys <100 k BTU 50.00 0 Domestic Incinerator � ., ,:� $0.00 0
Refig Sys >100 k BTU 50.00 0 Comoressors I Absorption Svstems '
Gas Piping � 50.00 0 . . Up to 3 hp / 100 k BTU � .' 50.00. 0 ,
Factory Freplace � 30.00 0 .. '�"3 To 15 hp I 500 k BTU � -- 30.00 , 0 �
Hood wlMech Exhaust � $0.00 0 - 15 To 30 hp I 1,000 k BTU $0.00 ,� 0
VAV Box �` $0.00 0 '' � 30 To 50 hp /_1,750 k BTU - $0.00 ' 0
Vent Fan / Single Duct , �� � , � $0.00 . .0 . � Over 50 hp / Over ,1,750�BTU� � � � $0.00� �0
Appliance - � 50.00 0 , Boilers ' ' -
Fire Dampers -. � � �50.00� 0 Up to 3 hp " 50.00� 0
Smoke Dampers, . � � � . $0.00 �- - 0 � " 3 To 15 hp . � � , _ � ! y0.00 0
Inst or Relocate Appl Vent " . ,§0.00 � -0 � � , � .15 to 30 hp " , - � ; �0.00 0
Air Handlers < 10000cfm �, �$0:00 0- - 30 to 50 hp - �,' 50.00 0
Air Handlers > 10000cfm . `�_ �50.00 ; 0 Over 50 hp � � � - - � �� / E0.00 0
Floor Fumace . 50.00 - 0- Other Mechanicaf Fee , -
Floor or Suspend Heater , � - $0.00 � 0 � , ' , , - , Investigation Fee . " . 30.00
, � • , Plan Check Fee � � . $0.00
� � \ . Reinspection Fee _ , : � �. $0.00
' . . � TOTAL CALCULATED FEES 5119.40
NOTICE: The work authorized by this permit shall comply with all applicabte handicap access requirements under Calitomia statutes and related
regulations. (ord. No. sz-26, § 1, 12-zt-s2)
EXPIRATION: This permit shall eutomaticaily 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 authoAzed under this permlt to be considered legal, suc� work must compy with all applicabte codes, and all
requlred Inapeetlona and Iinal approval must be obtained. Failure to obtain inspections and final approval will result in tha ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626 •
zaas�es �e�oo)
WORKERS'COMVENSATON DECLARAnON:
I hereby eHlrtn undar penalty ol per�ury one of t�e lollowlnp tlecleretlons:
❑ I have entl wlll melntein e certilicate ot wnsent lo self-Insure for workers' compenseUon, es provided lor �y section 3700 0l Ihe Lebor Cotle, lor Ihe peAormence o1 Ue
L work for whiCh thl9 permlt Is 155uetl.
U I have and wlll melntaln workers' compensetlan insurance, es reqWred by sectlon 3700 of the Lebor Catle, for the pertortnance of No work lor which ihlq pertNt is issueA.
entl pollcy number ere:
_�o��: CNrM odz�o - c�
e velued el one huntlred dd/ers (5100) a IesS.)
❑ I cerUty Uet in the peAormance at che work for which this pertnit is Issued, I shall not employ eny peraon In eny manner so es to become sub�ect to the workere'
co ensation laws ol Celifomia. end aprae Ihet II t shoul0 become sub�ect to Ne workero' compensetlon pravisions of Section 3700 of the Lebor Code, I shall torNwith
mp th these provisions.
Appli Slg ature: � r^�� a� I�i/�o �O Z�
W LURE TO SECURE WORKERS' COMiENSAiION WVEMDE IS UNUwFUL M1D SHALL SUBIECf AN EMPIAV CfLMINAL PENALTIES M!0 GVIL FlNES UP TO ONE HUNDRED
TKKISAND OOLLARE (5100,000), IN ADDITION TO THE CQST OF COMPENSATION, �AANGES AS PROVIDED FOR IN SEGTON 3'lO60F THE UBOR CODE, INfEREST, aND ATTORNEY5 FEES.
LICENSED CONTAACTORS DECLARATION:
�Mem licensed under provisions of C�aO�er 9(commencing wllh Sectlon 7000) oi DlNsion siness an0 rotessio s Code, end my Ikense Is in full
��. « �L �� �za %a�
iewre: �� _ �� a��T G� m _
CONSTRUCTION LENDING AGENCY:
❑ I hereby eflirtn Ihat ihere is e construdion lentlinp epency for Ihe peAarmence oi Ne wark tor which ihis pertnit I5 issued. (Sec. 3097, Civil Code).
Lentlers Name: LentleYs AOtlress:
Signature:
OWNER•BUILDER DECLARA710NS:
Date:
1 hereby affirm t�at untler penelry of per�ury thet 1 em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the follaving reason (Sec. 7037.5, Business antl Professions
Cotle: My dty or counry which requlres e pertnit to conairud, altor, improve, Aemdis�, or repelr eny structure, prior lo Its iuuance, elso requlres the epplicant tor sudi permit
to lile e sipned stetement thet he ar s�e Is IkenaeE pursuent to the provlsions ol Ne Conirectora Ucense Lew (Chapter e(commendn0 wlih Sectlon 7000) of Dlvlsirn 3 ot �he
Buslneu enA Protesslons Cotle) or t�at ha or she is ezempt Iherotrom end the besLs for the elleped exempllon. Any Nolatlon of Senlan 7031.5 Gy eny epplicent for e pertnit
sub�ects the eppllcant m e clvll penalry of not mora thfln Ilva hundred tldlers ($500)J:
❑ I, as owner of 1ha properry, or my employees with weges es ihelr sole compensatlon, WILL DO TNE WORK, entl the sirudure is not intenOed or oXered for sele (Sec.
70a4, Business end Pmfessions Cotle: The ContraMors LJcense Lew tloes rro� appty to an owner ol property who builUs or improves ��ereon, enC who tloes such work
himself ar herseN or ihrough his or her own employees, providetl Ihet suU Improvemenis are not Intended or oNereC for sale. It, however, the bullCing or ImprwemenVis
sold vrithin one year of campletion, the owner-Dulltler will have t�e burden of proving Ihat he or she tlid not bulld or improva tor purposa ot sale J. �
❑ 1, as owner ot the propeM. am E%CLUSIVELV CONTRAC7ING WI7H LICENSED CONTHACTORS m construct the pro�ed (Sec. 7044, Business and Professions
Catle: The contrectors Llcense Lew tloes not eppty to an owner ol property who bulltls ar Improves t�ereon, and who contrects lor sutli pro�ect wl�h e contrecior(s)
license pursuent lo the Coniracton License Lews.).
❑ I em exempt untler sec. Business en0 Protessions Code lor Ihls raeson:
Signature: Date:
Owner ID veAfletl by Erivers Ilcense. � Yes ❑ No DrNers LJcenso No. • Expires:
Venficetlon ol Ownership by (rype ol tlaument, i.e. - property tex blll ar tleed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ 1 hereby cenity that no e:cava0on five (5) or mara feet In depth Into which e person is requlred to descend, will be matle In connectlon wilh work euthodzed by ihis
permil, and Ihat no building structure, scaHOltling, faLsework, or demolltlan or dismaniling t�ereof, wlll be more t�en thirty-sl: (38) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Titla B, Califomia Atlminisirative Coda).
❑ As owner-builder, I wlll not employ flnyone to do work which woulU requlra e permit Irom the DlNsion of Industrial Safety, es notetl above, unless such person hes e
pertnit to tlo such work from the division.
SlgnaWre: Dale:
Division ot Intlusirial Salery Permil Number:
CER71FlCA7E OF COMPIJANCE AND AIlTTIORVATON OF EMRY: I certify under penalry ot perjury Ihel I hava reatl thu epplicetion and stete Ihel ihe infortnation given I9
corract. I egree to comply with all state laws end ciry ordlnences relaiing to buil0ing consWdlon, entl au�hodze representetives ot t�e Clry ol Coste Mesa �o enter upon the
ebove-described pmperty far inspection Durposes. I egree not to occupy or ellow accupenry at eny builtling euthonzetl by t�is permli until finel insDection.
Legal
COOE t. MSPEC710NTYPE
1616 Fixed Syslem Finel Fire Prevention
1266 Pod Spe Finel
200 Finel RB-Roof
201 Final Block/Retelning Well
202
203
200
Finel Factory Fire Plece
Final Sign
Final Demolition
PdIE I[�l6
cooe. n+svecnoNnre
208 Finel Mechanical
208 Final Plumbing
210 Flnal Electdcal
212 Finel Fire Prevention
220 Finel Planning Appraval
222 Final Sile '
250 FinalBuilding/Occupency
Date _ .
� PAIE It�E64
�a•��.d� �nL
�
(714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE. COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 555 ANTON BL
Suite No 900
Vicinity:
Parcel Nunmber: 41050110
Status: ISSUED
Applied: 12/04/2002
Issued: 12I04/2002
ISSUED BY:
Applicant: STEVENS,.DON'� � ��� " � � , -�
Address: 1940 GARDENA ; � , " " � � �
/ �, .
�', �, ' ' � Phone: (8181500.1940; -� � �� - ' ���
GLENDACE, CA . " � � Zip: 91204 � . � ' '
, � - - �i �. �. �
/� - . - - . ``�
� ��� � .� . ' � �� - • ����� �/ ��A-,�
Owner: /�SAKIOKA FARMS:%MORGANS HOTEL LIMITED ;' � \ \ ! ` �
Address PARTNERSHIP"ATTNJOECRAWFORD . ���� , -
�'- �.
". .
� , DENVER;�CO' Phone:
' 7050,17TH�ST #1220 Zip:�
. - ' ", . ' . ' - , '
Contractor. MUIR-CHASE PLUMBING�' -. �i' '
, Address: 1340 GARDENA ; , ' , � - . , �
, " � - . '" � - Phone: (818) 500.1940
- GLENDALE �CA Zip' 91204
i
�Arch / Eng :
Address:
., �..
\ ����. ��
,
�
� _ . �� \:
� ' � �
� License: 539835 � ��
� �,-. - .- � -. . ' _ `, ' . , l . , , ' - . A
' �` � ��.
. � % �.
Phone:
. ZiP.,
� - � License:
��
%�'',
�i _
SCOPE OF PERMIT , �
, � . PLUMBING TO INCLUDE: 1 DISHWASHER, 1 KITCHEN SINK, AND�1 WATER HEATER. REF.: -
� � , � 802-01921, SUITE 900'BLOODGOOD, SHARP BUSTER' . , � , "
_ �
� - . � � , " � FEE SUMMARY � -- � . �
. ' . AMT� - QTY� .. , � . AML `-aTY _ , :.. _ . , . �- - . AMT
ISSUE FEE� � � $23.50 .� Laundry Tub l Washer $0.00 0 , Sump Pump - , 50.00
Backflowirrigation�� �-�30.00.� 0���;�; Landscapelrrigalion $0.00 0 -;�Swimming-Pool 30.00
Backflow Preventer � -50.00 ' 0 �� P•Trap � ' 50.00 � 0 � �-": Trap"Primer ; , � 50.00
Bathtub � � � $0.00 ; � 0� - �Pressure Regulator � ' $0,00 0 -.- - � -Urinai�, � ' . 50.00
Clarifier System :. �$0.00 � 0,- � �Process Piping (per 1D ft) $0.00 0 , Vacuurn Brkr Bkflow(1�4) 50.00
Connect pce,Soda,etc)� �$b.00 % 0 �RecepWrs $0.00 0. . ' Vawum Brkr Bkflow(5+) $0.00
Dental Units � -$0.00-�� �0 �� - SepUc Tank $0.00 '.�0 ', Wash Basiri,� � $0.00
Dishwasher $9.80� � 1 - Sewer.Cap for Demo ' $0.00 0� Wash Basin Set $0.00
Drain, Floor So.00 �.- 0' Sewer Connect $0.00 0� � �� Waste and Vent System 30.00
Drain, Rainwater $0.00 0 �; -. - Sewer Private Line � - $0.00 0 ..Water Clwet (Tdleq $0.00
Drain,Roof So.00 0 �- �Shower $0.00,�.0 ��_- WaterHeater/vent 512.30
Drinking Fountain $0.00 0 Sink,.bar �- � �$0.00 0 Water Piping (Inst or Rep.) 30.00
Expansion Tank $0.00 0 Sink, commercial �$0.00 0 Water Re-pipe $0.00
on
0
0
0
0
0
0
0
0
0
0
1
0
0
NOTICE: The work authorized by this permit shall comply with all epplicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIqA710N: This permit shall aulomatically expire and become void if work is not commenced wlthin 780 days, or if work Is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the vrork authorized under ihis pertnit to be consldered legal, such work must comply with all eppliceble codes, end eil
requlred inapaetlona and flnal approval musl be obtained. Fallure to obtain inspections and final approval will result in the expiretion of thls permi�
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSAnON DECLARATION: - -
I hereby ettirtn under penalry ot perjury ane ol Ne tWlowing tledaratlons:
❑ I heve end wlll maintain a cenificete ot consenl to self-Insure lor workers' compensailon, es provided tor by section 3700 0l the Lebor Code, far Ne pertofmance at Ne
.��,/ work for w�ith thi5 permil is IssueO.
yy1� 1 heve end will mainlain workers' compensetlon Insurance, es required by sectlon 3700 of Ihe La�or Code, lor the pertormance ot the work lor which this pertrtit Is iswea.
My workers' compensatlon Insurence carder entl policy number ere:
ceme� (/ � [_[' n . - — -awy.N�U/G� /DO /OZ 00
❑ I certify ihat In ihe peitoima�xe ot the wrnk for whkh tlris pemiit Is issue4 I sfia11 not employ erry Derson In any manner so as ro �eGoma sublecl to the workers'
campensetlon lews of Califomia, entl epree that II I shouW become sub�ect to the workere' wmpensetion provislons of Sectlon 3700 ot the Labor Code, I shall lanhwith
comply with Ihese p s.
�FPlcent.Sil gnaWre:! e/�^- Date:-+
WARNINO: FAILUHE TO SEC�IRE WORKERS COMPENSATION COVEMGE IS UNUWFUL uJD SHAl1 SUflIECT AN EMPLOYER TO CRIM�NPL PENA�TIES AND GVIL FlNES UP TO ONE HUNDREO
T1qUSM1D OOLIARE (5100,0�%.IN A�DRION TO THE COST OF COf.IPENSATION, UAMAGES AS PHO�AOED FOR IN SEGf1IXJ 31080F THE UBOR OODE, INrERE5T, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS OECLARATION:
I hereby eMirm ihat I em Ilcensetl untlerp,roNslon ot C�epter 9(mmmencing with SecUon 7000) af Division 3 of Ihe Business and Prafesslans Code, end my Iicense Is in lull
torce ana enect'Clc'A���' YS�i � ctess'n (�_ — 3 fp
c_reccor.bsia�ew�e: /�,^ ���— o�e_"�s J 7_ — 4— oZ—_
CONSTRUC710N LENDING AGENCY:
❑ I �ereby eflirtn that Nere is e consiruction Ientlinp epenty br ihe pedormence of the work for whlch t�is permit is issuod. (Sec. 3087, Clvll Cotle).
LendeYs Namo: Lenaers Address:
Signeture: Dete:
OWNER-BUILDER DECL�AnONS:
I �ereby eflirtn thet untler penalry of perjury thet I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business entl Protesslon9
Cotle: Any ciry or counry Which repuires a pertnll t0 consirucC alter, improva, demWish, or repeir eny structure, pnor lo Its iasuanco, also requiras the apP����� �or suth permil
ro Ille a sipnetl stetement �hat he or she b Iicensed pursuant to the D��sions oi the Contrectoro LJcense Lew (C�aptar 9(tommendng wllh SecUw 7000) of Divisim 3 ot Ihe
Business end Professions Code) or thal he or sha is exempt thereiran antl the Eesis lor Ihe ellegetl e:emptlon. Any violatlon of Sectbn 7031.5 Cy any applicant far e pertnit
sub�acts the eDPlicant to e cNil penalry oi not more Ihen Ova hunAretl dollars ($500).):
❑ 1, as owner ot ihe propertY. or my employees wtth weges as their sofa compenselion, W ILL DO THE WORK, and ihe svucture is no1 iMernfed or otteretl tor sale (Sec.
7044, Business end Professions Catle: The Contractors Ucense Law tloes not epply to an owner of properry who builds or improve9l�ereon, end who tloes such work
hlmself or herselt or Ihrough hls or her own emD�oyees, provitled that such Impravemenis are not Intendetl or oflered tor sale. If, however, the building or improvement is
sold within one year of completion, the awner�0ulltler will heve the 6urtlen ol proving thet he or she did not build or improve for purpose of sale.). �
❑ I, as owner ot the proPerty, am EXCLUSIVELV CONTRACTING WfTH LICENSED CONTRACTORS to constmct tha proJect (Sec. 7044. Business antl Profeuions
CoCe: 7he conirectors �cense Lew daes noi epDh �o en owner ol property who bullds or Improves ihereon, and who wntracis lor such projed with a wntractor(s)
licensa pursuant ro the Contractors License Lews.j.
❑ I am e:empt under sec. Business anA Professions Code lor this reason:
SigneWre: Date:
Owner ID venfied Dy dnvels license. ❑ Yes ❑ No DrivaYs Llcense No. Expires:
Vetllicatlon of Ownership by (rype oi tlocument, i.e. - properry tez bill or daed):
�1VI51�N OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I here6y ceNty ihat no excavetlon Ilve (5) or more teet in depth into whlch e peraon Is requlretl to tlescend, will be metle In connection wlth work autharized by ihls
pormll, and Ihat no buildinp siructure, sCettolding, felsework, ar demolition or tllsmentling Ihereoi, will be more then Ihihy-six (38) leet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, 17t1e B, Calllomla Adminlslretive Code).
❑ As owner�builder, I Will nal employ anyone to do work which would require a parmit from Ihe Division of Intlustriel Sefory, es noted ebove, unless such pereon hes e
pertnit to do such wo� �rom the tlMslon.
Signeture: Deta:
Dlvlslon o1 �ndusirial Safery Perrttit Number:
1 CERTIFlCATE OP COMPLNNCE 1WD AUIHORQATION OF ENTRY: I ceNty untler penalry o1 perryry that I hsva read this applicetion erM state ihat ihe intomiatfon given lq I
correct. I egree to compty w�ih ell state laws entl ciry ordlnances relating ro builtling consiructlon, anC eul�odze representetives ot the Ciry of Costa Mesa to enter upon the
ebove-OescriDed property for Inspectian purposes. I agree not to occupy or allow occupanry ol eny building au�horized by thls pertnit until linal inspeclion.
GOOE I. INSPECTION TYPE
1818 Fixetl System Final Fire Preventlon
1268 Pool Spa Finel
200 Flnaf Re-Root
201 FIneI8locWRetaininp Well
202
203
204
Final FeCtory Fire PIBce
Finel Sign
Final DemWition
PAIF 1[�919
' � — � Dat��
teJ
COOE 1 INSPECTION TVPE
208 Flnal MeChenical
20B Finel Plumbing
210 Flnal Elecirical
212 Finel Fire Prevenilon
220 Final Planning Approval
222 Final Site
250 FinalBuiltling/Occupency
QdIF. Iti�Al9
) :�a 3 -o'd �
(714) 754-5273 • F� (714) 754-4856 • www.ci.costa-r�e��a�s�PRESSION PERMIT » FAIR DRIVE, COSTA MESA, CA 92626
Jobnddress: 555 ANTON BL
Suite: 900
Vicinity: 9TH FLOOR
Parcel Number: 41050110 Zoning:
. - � - - - - ISSUED BY:
Applicanr. ROYER, REJEAN " � ' �� � � � � _ �
.�
Status: ISSUED
Applied: 07/18I2002
Issued: 08/02I2002
�� , _ ,
Address: � "- - . - � �-�- - '
� � ; '. � / A
� �; �� Phone: 909-592-0151 ,� ��
. % ' " ` Zip: . . . �\
/- `. . , . , �i .
,� i . - ,
�,
Owner:/ BiAKIOKA PARMB,MORGANS HOTEL LIMITED - � � � `��� A ��
Address., ,PARTNERSHIP AITN JOE CRAWFORD - � ` �
� �A; _ / -�A- ` �
��DENVER, CO , - - Phone: � `� �. ii��
�/ ,
_ � 1050 17TH ST� tt1220 Zip: , , - �
� �- �� � . , . . . .
Convacror. ARDENTTECHNOLOGIES
Address: 580 E ARROW HWY �. � �
i
� " SUITE.B . Phone: 903592-0151 „ , . , � ', �
, SANTA DIMAS, CA �' , Zip: , . 91773 •�,: -- - � _ . .
. " " ' _. � License:- 426222 . � - .
�
� .
� ` � . - SCOPE OF PERMIT � �. ,
� FIRE AIARM�FOR TENANT IMPROVEMENT FOR'THE MEYERS GROUP". REF: B02+01008: � , . �
< .
� FEE SUMMARY _ �
�-.a>�-
Plan Check: $217.91 � , _ .' . _ � � �_ _ _ �_ _ _', ,�_ '_ _ , � �; Calc Valuation: � ' Sz�.o0o.00 �
Permit: $335.25 Claimed Valuation: Szi.000.od
Other: � $0.00 � . �
� , ;•ti _ _ �` /�� � -. � ; �
� - Total: $553.16 .- . / - � <,�' (
�
' �.
�: .
� A '� i % - �,C
' � _"i� /- � .,
`
� �
_ , , ' �� - , �!
�,
� � �i
, �. 'j
�i�� "- "
NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access iequirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permil shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
lor a period of 180 days.
INSPECTIONS: In order for the work aNhorized under this pertnit to be considered legal, such work must comply with ell applicable codes, arW all
requlred Inapactlons and final approval must be oblained. Failure to obtain inspections end tinal epproval will result in tha expiration of this pertnit.
iy
FOR INSPECTIONS CALL: (714) 7545628 � /
z„&.e,�� v
WORKERS'COMPENSAnON DECLARAnON: �
I hereDy ettirm under penalry ot perjury ana of tha tollowing tledaretions: �
❑ I heve end will maintain e cerGlicete of consent ta selbinsura tor workers' compensetion, es providetl for by section 3700 ot the Labor Catle, tor Ihe pertortnence of ihe
wark tor which ihis permit is issuatl.
� I �ave anG w10 maintain woAcers' compensatlon insurance, as required by sectirn 3700 of the Lehor Code, br the peAortnance oi t�e work fw wlikh NIs permit is issued.
My warkars' compen;ation Insurance carrler antl pdiry num�er are:
ceMer: ��c�dr�2zcc�—c'.-o-r� -s"� __ [�a POIIcyNumber:
�rms secnw� �� ae�mp/eted il� Pem,tr is�emeo er one undred dollers (Sloo) or Iess.)
a�T� ,,,., aoY6o-ae�l
❑ I certify that in the pertortnance I Ihe wark tor w�lch this permit is IuueQ I shall not employ any person in eny menner so es �o become sub�ecf ro t�e warkers'
compensetlon laws ot Galifomla, end epree that il I should becoma sub�ect ro tha workers' wmpensetlon provisions ol Section 3700 of the Lebor CoOe, 1 shall forthwiih
comply with these provisions.� \
AppllcentSipneture: ���- Date: � ^ 02 —�2
WMNINO: FFI�URE TO SECURE WORK COMPENSAPON COVERAQE IS UNUW FUL AND SHr1LL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE NUNDRED
T/qUSAND DOLLARE (5100,OD0). IN AODfTiON TO THE COSi OF COMPENSATION, DAAMGES 0.S PROVIDED FOR IN SECiION 3NB OF THE LABOR CODE, IMEREST, M1D ATTORNEV u FEES.
LICENSED CONTRACTORS DECLARA710N:
. I hereby eMirm that I am licensed undar provisions ol C�apter 9(commendng wlih Section 7000) at Division 3 0l the Business end Professlans Cotle, an0 my Iicense is In tull
� lorce and eflect. Lic. a� �c 3 2 Z Closs q /3 - E T/Ci
� Contreclors Slgnature: ��.r. � � Date: •Q — O"� — � Z
CONSTRUCTION LENDING AGENCY:'
❑ I horeby ettirtn that there is e constructlon IenOing e9enq tor t�e portormence ot the work for which this pertnit is luuetl. (Sec. 3097, Civil Code).
Lenders Neme: Lendefs Atltlress:
Signawre: � Date:
OWNER-BUILDER DECLARATIONS:
I �ereDy eXirtn thet under penalry ol perjury Ihet I em EXEMPT FROM 7FIE CONTRAC70RS LICENSE LAW tor Ihe lollowing reason (Sec. 7031.5, Business antl Professions
Code: Any cily or counry which requlres a permit to consiruct, alter, Imprwe, demolish, or repalr any structure, prior to.its luuance, atso requlres Ihe epplicent for such pertnil
to Ille e signed statement that �e or she Is Ikensed punuant to the proWsions ol lhe Contrectors lJcense law (Chepter 9(commencing wlth SecUon 7000) of Division 3 of �he
Business end Protesslons Code) or lhet he or she is eaempt iherelrom entl t�e besb tor the allaged exemptlon. Any violation of Section 7031.5 by eny epplicent for a pertnit
subjects the applicant to e dvil penelry oi not more than five hundred dallers ($500).):
❑ I, es owner of the property, or my employees with wages es t�eir sole compensation, WILL DO THE WORK, end the stmcwre is not intendetl or oNered tor sale (Sec.
7044, eusiness an0 Protessions Cotle: The Contractors License Lew tloes not apply to an owner ot property who builds or Imprwes Ihereon, antl who does such work
himsetl or hersetl or Ihraugh hls or her own employees, provided Ihat such improvements are not Intended or oftered for sale. If, however, the buiMinq or Improvement Is
sold wit�in one year of completion, the owner-builder will have the burden of proving that �e or s�e ditl not builtl or improve for purpose of sale.).
❑ I, as owner of Ne properry, am E%CLUSIVELY CONTRACTING WITH UCENSEO CON7RACTORS to construct the project (Sea 7044, Business antl Protessions
Code: The contrectors License Lew tloes rwt appry to an owner of property w�o builAs or Improves thereon, entl wha caniracts far such prqect with a coniwctor(s)
Ilcense pursuant to the CantreMors Licensa Lews.).
❑ I am exempt under sec.
Signature:
Business end Professians Cotla for this raason:
Owner ID verilied by dnvets license. ❑ Ves ❑ No DrivetS License No.
Vedlicatlon of Ownership by pype ol daumenL i.e. � property tu blll or deed):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTFICATON:
Date:
Eapires:
❑ I hereby certify ihet no excavation five (5) or more feet in dept� inta w�ich e person is requiretl to tlescenq will be mede in connection w1I� work euthonzed by �his
pertnit, end that no building sirudure, scafidding, falsework, or tlemolitlon or dismantling Ihereol, will ba more then thirty-siz (36) leet hig�. (Chap. 32, Grp 2, M 2, Sec.
341, Tiile 8, Calitomia AdmInlSlretive Cotle).
❑ As owner-builder, I will not empl0y enyone to tlo work which would require e permit Irom Ihe Divislon ol Indusirial Sefety, e9 noted ebove, unless such per5on has e
pertnit to do such work trdn t�e division.
Signature: Date:
DiWblon Of Intluslrial Satery Pertnit Number:
CEHi1FlCATE OF COMPLIANCE AND AUTHOROATION OF ENTAY: I certity untler penalry of peryury Met I have rea0 this aD7liwtion end state that t�e infortnation given is
Correct. I egree to compty with all stete laws end dry ordinances releling to builtling construction, end aulhoAze representatives of Ihe Cly oi Coste Mese to enter upon Ihe
ebove-descrlbetl property ior inspection purposes. I egree not to accupy ar ellow accupancy at any building euthonzed by Ihis pertnit until tinel inspection.
`��� Sign ure Ot Legal Owner(s) Date
-P-�-��...- �i+�icti� �/i — d'.�l — Z% >.
AnNOr onzetl Applicant Date
CO�E 1. INSPELTIONTYPE
1618 Fixed System Final Fira Preventlon
1268 Pool Spa Finel
200 Final Ra-Rooi
201 Finel BIocWRetaining Well
202
203
204
Finel FaMory Fire Placa
Final Slgn
Final Demolitian .
PdIF It�LS
�qp� iNsveenoxnve
206 Finel Machenlcal
208
210
212
220
Finel Plumbing
Finel Electdcal
PInBI Fire Preventlon
Flnal Planning Approval
222 Final Site
250 Final Building/Occupancy
� Illl��
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-rn��S��a,�1�PRESSION PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Jobnddress: 555 ANTON BL
Suite: 9
Vicinity: 9TH FLOOR
Status: ISSUED
Applied: 07/18/2002
Issued: 08/02/2002
Parcel Number. 41050110 ZOning: /
_ �-- - - --- ISSUED BY:
Applicanr. ROYER, REJEAN "�>' .'��`'„�� � � � ,� , �
� ii -. � � �:.
Address: - ,- ' �
� ���.� ,
- � Phone: 909-592-0151 / � � -�
��%/� ._ . . Zip: ' .� � \� �\\ �\
j% �� ��.� = , ' __ . --,�� � V\�.�
Owner;% KIOKA�FARMS_%MORGANS HOTEC LIMITED,,, _ �� � � �j �� �A
Address. �, PARTNERSHIP AT-TN JOE CRAWFORD - � � �' �' �� �', � � �� - �
\ ..\
� %DENVER,CO-;� - � � � Phone: �A;� -�_ i�� � . --��
. - � ` 1050�17TH ST. #1220 Zip: ��� �� � � �� �
. ���� � � �� � �� ��
. ' ` / .� � /� ' ��� i ` ,�
�. � :
Contractor. ARDENTTECHNOLOGIES �, �. �� � �
. Address: 580 E;ARROW HWY � � " �
��
, � SUITE B . Phone: �- 909-592-0151 , _ � �
� , SANTA DIMAS. CA . .: � .Zip: � �- 91Z73 � ; • . _ . ,
. , . - �' � _License: -428222 � , _ ' ��� � " _ - ,
� - . .� , !i. � _ � � . �
� � � - SCOPE OF PERMIT _ , � �
' FIRE ALARM FOR FOR FUTURE TENANT. � - �
\
\
� Plan Check: � $117.81
� Permit: $181.25
Other: $0.00
Total: , $299.06
�,; _ -„ .;, .� FEE SUMMARY
� � �-^ ;_,,.�,;.,
:..�: - �;J.� --� - ... �:.-_..,_,�-
, � .. �,
_- ; � _
.� . - . �� .. -
Calc Valuation: � Ss,eoo.00 1
Claimed Valuation: Ss.aoo.00'
_' /'
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall aulomatically expire and become void if work is not commenced within 180 days, or it work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply vrith all applicable codes, and ell
required Inspectlons and finel approvel must be obtained. Failure to obtain inspections and final epproval will result in the expiration oi this permit.
POR INSPECTIONS CALL: (714) 7545626
x++aee (a'ool
WOPKERS'COMPENSArON DECLARAnON:
I hereby aftirtnvnder penalry of perjury one of the following declarations: ` �
❑ I have and �will maintain e certificate oi consent to selbinsure tor workers' compensatlon, es provided tor by section 3700 of the Le6or Code, for the pertortnance oi Ihe
' work tor which this pertnil is issuatl. .
� I have and vrill maintain workers' compensa6on insurance, es requiretl hy 5et0on 3700 ot Ihe LeUor Cotle, for the peAortnance of the work for which Ihis pertnif is lswetl.
My workere' compensation Insuranca carrier end poliry number are: n /
Cartier. �� OL�Q � lJ hi � Policy Number. IX O y F.� O� oZ ��
(This sectlon neea no( be comp/efed i! fhe pertnit is velued af one hundred dollars ($100) or /ess.)
❑ I certily ihat in the peAormance of the work for which this permit is IssueQ I shall not employ any person In eny manner so es to �ewme suhject to ihe workers'
compensatlon laws oi Califomia, antl egree Ihat if I shoultl become subiect to ihe workers' compenution provisions of Section 3700 ot the Lebor Catle, I shall tort�wit�
comply with these pr io�.
Applirant Signature: ,�.�r �'-� Dare: �`i �' � � — O �
WARNINfi: FAILURE TO SEWRE WORKERS' COMPENSAiION COVEMGE IS UMAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENnLTIES M1D CML FlNES UP TO ONE HUNDRED
TFIOUSAND DOILAfiE (3100,000),IN ADOITION TO THE COST OF CAMPENSATIIXJ, DMMOES AS PROVIOED WR IN SECTIOfJ 3IO60F THE LABOR CODE, IMEREST, AND AiTORNEI^5 FEES.
LICENSED CONTRACTORS DECLARA770N:
I hereby attirtn Ihat I em' liceLnse�d,untler provisions at Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business e d Professions Code, and my license is in full
torce entl e(fect. Lic. N�-]l'2 Class tl �- C�T! D
Conirectors SignaWre: Date: �•� Y) A-01
CONSTAUCTON LENDING AGENCV:
❑ I �ereby attirtn that there is a construction lenaing agency for Ihe peAortnance of Ihe work for which Ihis pertnit is issued. (Sec. 3097, Givil Code).
LendeJs Name: LentleYs Atltlress:
Signature: � Date:
OWNER-BUILDER DECLARATIONS:
I hereby aftirtn lhat untler penalry ot perjury that I em E%EMVT FROM THE CONTRACTORS LICENSE LAW for tha tollowing reason (Sec. 7031.5, Business antl Professlons
Code: Any ciry or counry which require5 a Oermit to construct, alter, improve, demolish, or repair any slruCture, O�ar to its i55uance, elso requlres lhe apD����t tor such pertnil
to fle a signed statement ihat he or she is licensed pursuant to the pmvislons of ihe Contractore License Law (Chapter 9(cammencing with Sectlon 7000) of DiWsion 3 oi the
Business antl Pmtessions Code) or that he or she is exempt theretrom and Ihe basis lor Ihe alleged exemption. My violation of Section 7031.5 by eny epplicent far e pertnit
subjects the epplicanl lo a civil penalry ot not more than five hundred dollars (5500).):
❑ I, as ownar of ihe property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the siruciure is not intended or ottered for sele (Sec.
7044, Business and Protessions Code: The Contractors License Lew does not appty to an owner of properry who builtls or improves thereon, antl who does such work
himself or hereelf or Ihrough his or her own employaes, provided ihet such impmvements ere not Intended or oflered for sale. IL however, the bullding or improvemem is
soltl wit�in one year ol completion, the owner-builaer will have ihe burden of pmving ihat he or she tlitl not 6uild or improve tor Durpase of sala.).
❑ I, as owner of the property. am EXCWSIVELY CONTRACTNG WITH LICENSED CONTRACTOHS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Lew Aoes not appy to en owner oi property who builds or impmves thareon, and who tontracts tor suCh project with a coniraclor(s)
license pursuant to ihe Contractors Licensa Lews.).
❑ I am exempt under sec. Business and Professions CoOe for this reason:
Signature: Date:
Owner ID veritietl by drivers license. � Yes ❑ No Drivefs License No. Expires:
Venfiwtion ot Ownership by (type of document, i.e. - pmperty lax bill or deed):
DIVISION OF IN�USTRIAL SAFETY PERMIT CEHTIFICATON:
❑ I hereby ceNfy that no exwvation five (5) or more fee� In depih Into w�ich e person is required to descend, will De made in connectlon with work euthodzed by Ihis
pertnit, end ihat no building siructure, scaftolding, falsework, or tlemolition or dismantling Ihereof, will be more ihan Ihirty-sl: (36) faet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomia Administrative Cotle).
❑ A5 owner-builtlar, I will not emD�oy enyone to tlo work which would require e pertnil from the Division of Industrial Safety, as notetl ebove, unless such person has e
pertnit to do such work fram Ihe division.
Signature: Date:
Division of IndusMal Safery Permit Number.
CERTIFICATE OF COMPLIANCE ANU AU7HORVJ1T10N OF ENTRY: I cenity under penelty ot perjury ihai I have read this application and state t�e� ihe iniortnation given is
cortect. I agree to compty wiN all state laws end ciry ortlinances relating lo builtling consiruction, and euthodze represenlatives ol the Ciry ot Coste Mesa to emer upon ihe
ebove-descnbed property for inspection purposes. I egree not to occupy or allow occupancy of eny building authorizetl by this pertnit until finel inspactlon.
cr$ignaWr LegalOwner(s) a� ate D
�{ — 1
And/Or Aulh zetl Applicant Date
COOE �. INSPECTIONTYVE
1616 Fixetl System Final Fire Prevention
1266
2��
207
202
203
204
Pool Spa Finel
Final Re-Roof
Final BIocWRetaining Wall
Final Fadory Fire Plars
Final Sign
Final Demolition. .
jl�¢, JNTIiI�LS �QpEj INSFECTIONTYPE
206 Final Mec�anical
20B Finfll Plumbing
210 Finel Eledncal
212 Final Fire Prevention
220 Flnel Planning Approval
222 Final Sile
. _ 250 Final Building/OCtupancy
aeie u�e�a
�a - -01.. �
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
FIRE SUPRESSION PERMIT
Job Address: S55 ANTON BL
Suite: 9
Vicinity:
Status: ISSUED
Applied: 07/19/2002
Issued: 07/31/2002
Parcel Number: 4105011 O Zoning:
_ . — - - -- . �_ _ ISSUED 8Y:
-'�- �:'�<.���i�i. _, ' -�
Applicant KNESPLER, JOHN ;,%' J"- ' - - • -
i
-,
Address: 2532 E 49TH,ST� � ��„ � `/. � �` ��
��-��� � ' Phone: 323-582-5103.� ��-�� � ��
i. �, ��
/.-" , i/ ,� ,�
VERNON;.CA �� ��� ! , Zip: ; _ 90058 - ,. r � '�� � �� � •
����� VA ... � � ._" �� �i .'�7� ���
Owne��SAKIOKA�FARMS%MORGANSHOTEt.LIMITED-,�_ �; � ,�� A ���V����
Address- ; PARTNERSHIP�ATTN JOE CRAWFORD � �� � �.i `
/ i -.. , .�, � � ��A\
� - DENVER,.CO j,,:'- = Phone: ,� �.�� �� % ��,� ����
. ` 1050 VTH ST. #1220 Zip: � � � � /� % ; � ��- '.
; ' � ' . /,� / � �, �\ � � �'.
Contractbr: � SCO.TP CAMPBELL COMPANY �' � �� V"� � , �� �����
. , \>�`_� , j . \ .
; - Address: 2532 E�49TH ST ,. �
� ' " " ; � . Phone: �- 323-582-5103 �' ` ���
� � \ ,
j�---i /.`; . � - •• _ � \\ ` � . :
, �--� .VERNON,CA ^� �Zip ,.,� 90058����^ � � � �� 'j� �
' ; � ,�� � ,"� ^ License?180206� , w - � `�
. � �
, , i ;v, - , �. '�i:��� _ c`�/`.•� _ � ' � � �, � A. ' . �� .
� - � .; ' ; L _; , - : - SCOPE OF PERMIT_ �,� '- ` , // � ,
� �, INSTALL 32FIRE SPRINKLER HEADS. "MEYER'S GROUP" REF.: B02-01008 (9TH FCOOR) ���'-� � , _ . �
' ���'i� � �� � , ..
' PEE SUMMARY- . � �� �
,-
� Plan Check: $54.11 � �� � r ' � � �" � - ' ", R/ ' ' � �"� Celc Valuation: � i $z,�eo.00
.�v:� . ...._. .�.X.�._L•, .
Permit: $83.25 � Claimed Valuation: 3z,iao.00'
� Other. $0.00 �� r-, � ,�� � '
• � n�� �,. ,. , ,-`,, �iS��,
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�, � ,� � � � � ' i
�� � �� - � - - - - - �� � j . . � �: r
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- TotaL• , , $137.36 � ' ;
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�� �:� �, � �`�� � . . � ' � ._ �/� , � � � =
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cali(ornia 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 suspentled or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be consideretl legal, such work must comply with all applirable codes, and all
required Inapectiona 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) 7545626
zuere �aroo�
WORKERS' COMPENSATION DECLARATION: . - .
I hereby aflirm under penalty of perjury one of the following declaretions: � � '� . .
❑ 1-have and will meintain a certificate of wnsent to self-Insure for workers' compensation, as provitled for by section 3700 of the Lebor Code, br the pertortnence oi the
work lor which this permit is issuetl.
❑ I have end will maintain workers' compensetion insurance, as requiretl by section 3700 oi Ne Lebor Cotle, For Ne peAortnance ol the work for which this pertnit Is Issued.
My workers' compansatlon Insurance carrler antl policy number ere: / -7
CaMer: .S 7��� � U/.-� �7 PoliCy Number: ��G � I�3� 0� �
(T)iis section need not be completed /l fhe permit Is veluetl af one hundred dollars ($100) or less.)
❑ I certify �hat in the peA ance at t�e work for x
compensation laws oi Ifomi , and agree that
comply with these pr isi ns.
Applicant SignaNre:
WARNING FAILURE TO SEC OFiKERS' CAMPEN If
THOUSANDDOLLARE(31 , )INADDITIONTOTHECOST
LICENSED CON7RAC70RS DECLARATION:
is issued, I shall not employ any person in eny manner so es to become subject to ihe workere'
ne subject to the workers' compansalion provisions of Seclion 3700 of Ihe Labor Code, I shall forthwith
oe�e: ? — 3 � —� z
CAVERAGE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAI. PENALTIES AND CIVIL FINES lIP TO ONE HUNDRED
° COMPENSATIIXJ, �AMAGES FS PROVIOED FOP IN SECTIIXJ 310fi OF THE LABOR COOE, IMEREST, AND ATTORNEYS FEES.
I hereby aNirm Ihat I am licensed under provlslons of Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Protessions Code, end my Ilcense I5 in full
forw antl eHecL Lia a 6 Class q C- ��o �
Contracmrs Signature: Date: 7- �i C- cJ'L
CONSTRUCTION LENDING AGENCV:
❑ I �ereby eHirtn that Ihere is a consiruction lending agency For ihe pertormance of �he work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lenders Neme: Lendefs Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I herehy aHirm that under penelry of perjury Ihet I em EXEMPT FROM THE CONTAACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business entl Protessions
Code: Any ciry or county which requires e pertnit to consiruct, alter, Improve, demolish, or repair any structure, prior m its issuante, also requires the applicant For such permit
to fila a signed statement thet ha or she is licensetl pursuent to the provisions of Ihe Conirectors License Law (Chapter 9(commencing with SecNon 7000) oi Division 3 of the
Business end Protessions Gotle) or ihat he or she is exempt thereFrom end the basis tor the alleged ezemption. Any violation of Section 7031.5 by eny applicent for e pertnit
suhjecis the applicant to e civil penalry of not more than five hundred tlollers ($500).):
❑ I, as owner of Ihe properry, or my employees wilh weges as iheir sola compensation, WILL DO THE WORK, end the strucWre Is not intentletl or oHeretl tor sale (Sec.
7044, Business and Professions Code: The Contractors License Lew dces not apply to an owner ot Droperty who builds or improves theraon, and who does such work
himself or herself or throug� his or her own employees, provided ihet such improvemenis are not Intended or oifered for sale. If, however, ihe bullding or improvement is
sold within one year of completion, ihe ownervhuilder will have ihe burden of proving that he or she tlitl not �uild or improve tor puryose of sale.).
❑ I, as owner of lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslruct the project (Sec. 7044, Business and Professions
Cotle: The contractors License Law does not epply to en owner ol pmperty w�o builtls or impmves thereon, ena who wntracis tor such project with a contractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am axempt under sec. Business end Professions Code for ihis reason:
Signa�ure: Date:
Owner ID venfied hy driver's licensa. ❑ Ves ❑ No Onvers License No.
Venfication oi Ownership 6y (rype of document, i.e. - properry tax bill or deed):
Expires:
DIVISION OF INDUSTHIAL SAFETV PERMIT CERTIFICATION:
❑ I hereDy certify that no excavation five (5) or more tee� in depih Inm which a person is required to descend, will be mada in connection with work authonzed by ihis
pertnit, end that no building siructure, scaHolding, talsework, or demolition or dismantling ihereof, will be more Ihen t�irry-six (38) feet high. (Chap. 32, Gry 2, Art 2, Sec.
347, Title 8, Calitomia Administrative Coda).
❑ As owner-builder, I will not employ anyone to tlo work which would require e permit from the Division of Industrial Safety, es noted above, unless such person hes e
permit to do such work from Ihe division.
Signature: Date:
Division oi Intlustrial Satery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF EMAV: I cetliry under penalry of perjury that I have read this application and state t�et the information given is
correct I agree to comply with all stete laws antl ciry ortlinances relating to building construction, and authonze representatives of the Ciry of Casta Mesa to enter upon the
ebov -de cnbed property for inspection purposes. I agree not to occupy or allow occupency of any building authorized by this permit until finel inspection.
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Flnel Re-Roof
201 Final BIacWRetalning Well
202
203
Final Fadory Fire Place
Finel Sign
204 Final Demolition
Date
�— 3 ( �c��
� -Dare— z
QArF 1�19L�a S�QpF�( INSYECTIONTYPE
� 206 �Final Mec�anical �
208 Final Plumbing �
270 Final Electrical
212 Final Fire Prevenlion
220 Final Planning Approval
222 Final Site .
. 250 . Finel Building/Occupency
PAg II�L@
.�
.t'i. �
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
dob Address: 555 ANTON BL
Suite: 9
Vicinity: 9TH FLOOR
Status: ISSUED
Applied: 07/09/2002
Issued: 07/09/2002
Parcel Number: 41050110 Zoning: . �� �
npplicant: SMITH, DON ISSUED 6Y:
Address: 3184AIRWAYAVE - � � ' ' � ', � .
, - �. � Phane: (774) 438-2272 �. .�
COSTA MESA, CA "� Zip: 92626 � / �'� ��`�
, . .�- ' � � , i �"`�. .,
Owner. SAKIOKA-FARMS�%MORGANS MOTEL LIMITED � � ' �" �
i� � � ,
Address /PARTNERSHIP ATTN JOE CRAWFORD. _ - � � � ` „i , � � , �
�,-DENVER,CO � ,, - �':Phone --- ,V`�'�"V�.
` /1050 17TH ST� #1220 - ZiP: � � � `�.��. � � � � �' �
��',;�'/ �`� �\�i:�.,� r ^ � ; � �\ _// \r ,�\oi:�
Contrac`tor: `HOWARD�BUILDING CORPORATION �\� ; ��,^� � �',,;.t�,
`Address: 3184AIRW,AY-AVE \ �,�.��
,
� "- > =,� Phone;>>(714) 438-2272 � � ��
. .. - , � �`� �� i' � .
COSTA�MESA, CA � - � � � .
r Zip: 92626- - License:, 445804 . � � � �
. .. Arch : � � - � , " ,,,, :, . Eng: .. : , � . .
�Address: � ' , ` �. -. � � . � Address: -, - , . �
, ,., . , , Phone: ' ' . . _ , , Phone: - �
e
i _. . .
Zip: - , � . License: � License: � ;
� SCOPE OF PERMIT . `
� % DEMOLITION OF WTERIOR"NON-BEARING'WALLS TO BE SUB-DIVIDED'FOR�TWO,FUTURE TENANTS. REF.: 602-01008. ��.
9TH FLOOR. � . _. . . _ . : _ . . . . _ . _ . . . _ ,. , � .
Plan Check: $0.00
Permit: $9725
SMIP Res: $0.00
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
��, -Total: � , �, $97.25,�
. ,' -
Galc Valuation:
Claim Valuation: ;
� $3,735.00
$3,000.00
� � %,
l
% %
� � � ' . . , � � . � . . r . �, , . � .
SETBACKS, '
MAIN STRUCTURE Fiont .0= 0
ACCESSORY FronY- -0- 0 �
PARKING Existinq: o �
NOTES:
= PLANNING & ZONING
� Rear ` 0- 0 _ Left 0- 0. � Right -- �0= 0�
-. Rear 0. 0 � Left 0- 0�- �� Right 0- 0.,= �
Re uired: 0 � Proposed: 0 �� �
e
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, 72-21-92)
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 inspeetions 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) 7545626 , ,
2aas�as (doo)
WORKERS'COMPENSAnONDECLARAnON: ' _ .. � "'
I hereby aHirtn under penalry of perjury one of the tollowing tleclarations: ""
❑ I heve entl will maintain a ceniticate of consent ro self-Insure tor workers' compensatlon, as provided Por by section 3700 of the Labor Code, for the performance of ihe
work foi which [his permit is issued. . _ �
��y h ve antl will maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Code, for the pedortnanca of the work for which this pertnit is issued.
My
(Tliis section need not be comp/9tetl i/ the permif is
❑ I certify Ihat in the pedormance
compensation laws of Californ'
comply with �hese prqvision�
WAi1NING:FAILURETOSECU WORKERS'
T/qUSAND OOLLAFE ($100, ), IN ADDITION
LICENSED CONTRACTORS DECLARATION:
Contractor's
Pd�cyNum6ai:� / l0 � 9 3d.30 Z
orless.J _ .
issued, I shall not employ any person in any manner so as to become subjact to the workers'
� subject to the workers' compensatlon provislons of Sedion 3700 of the Lebor Code, I shall forthwlth
�� ,«oa�� 7- �' — o Z
�!J CAVERAGE IS UNLAWFUL AN� SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
OF CAMPENSNTION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOii COOE, IfJrEREST, ANO AiTORNEPS FEES.
with Section 7000) oi Division 3 of ihe Busines nd Professions Code, end my license is in tull
CClassp�' �
n�.o. 7— �—/�Z
CONSTRUCTION LENDING AGENCY: '
❑ I hereby aflirtn ihat there is a consimction lending egency for the pedormance of the work for which Ihis permi� is issued. (Sec. 3097, Civil Code).
Lenders Neme:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lender's Address:
Date:
I hereby aHirtn Ihat under penelty of perjury �ha� I am EXEMPT FFiOM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Code: Any city or counry which requires e permit to construct, alter, improve, tlemolish, or repair any simcture, prior to its issuance, also requires the applicant for such parmit
to file a signed statement that he or she is lirsnsed pursuant to the provisions of the Conirectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business and Protessions Cotle) or thet he or she is e:empt iherefrom and the basis for the allegetl ezemption. Any violation of Section 7031.5 by eny applicant for a pertnit
suhjects ihe applicant to e clvll penelty of not more than five hundred dollare ($500).):
❑ I, as owner of Ihe property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe structure is not intendetl or oHeretl for sale (Sec.
7044, Business antl Professions Code: The Coniractors License Law does not apply �o an owner ot property who buitds or improves ihereon, and who does such work
himself or herealf or ihrough his or her own employees, provided Ihat such improvements are not intended or oNeretl for sale. If, however, tha building or improvement is
sold within one year of completion, ihe owner-builtler will have the burden of proving �hat he or she did not build or improve tor purpose of sale.).
❑ I, as owner of ihe properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Cotle: The contracrors License Law does not appry to an owner ot propeny who bullds or improves thereon, and who comrects for such pro�ect with e contredor(s)
license pursuent to tha Coniractors License Laws.).
❑ I am e:empt untler sec.
Signature:
Owner ID verified by drivers license. ❑ Ves ❑ No
Business antl Professions Cotle tor this reason:
Veritication of Ownership by (type of document, i.e. - property ia�c bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Driver's License No.
Dete:
Eapires:
❑ I hareby cehify that no excavation five (5) or more feat in dep�h into which a person is required to tlascentl, will be matle in connection with work aulhorized by �his
permi6 and that no building stmcNre, scaHolding, falsework, or demolition or dismantling theraof, will be more than thirty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, Califomia Atlministrative Code).
❑ As owner-6uiltler, 1 will not employ anyone to do work which would requlre a permit from the Division oi Intlustrial Satery, as notetl above, unless such Derson hes e
permit ta do such work irom ihe division.
Siqnature: Date:
Division of Intlustrial Safery Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORRATION OF ENTRV: I certity under penalry of perjury that I have reatl this application and state ihat the information given is
correct. I agree to comply with all state laws and c' ordinances relating ro huilding constmction, and authonze representatives uf the Ciry oi Costa Mesa to enter upon the
above-described proper}y.fe� inspec9erf�uryos . I a ee not to occupy or allow wcupancy of any building authorized by this permit until final inspection.
CODEN, INSPECTIONTYPE �J � Qaj[ � INTRIALS
1616 Fixed System Final Fire Prevention
1266
200
201
202
203
Pool Spa Finel
Final Re-Root
Final BIocWRetaining Wall
Final Factory Fire Place
Final Sign
204 Final Damolition
CO�ER INSPECTIONTYGE
206 Final Mechanical
208 Finai Plumbing
210 Final Electrical
212 Finel Fira Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
onTe INTILULS
,
(714) 754-5273 • Fax (774) 754-4056 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant
Address:
Owner:
Address
555 ANTON BL
9
NEW DATA CENTER
41050110
FULFORD,TERRY
8749 SHIRLEY AV
NORTHRIDGE,�CA' � " �
SAKIOKA FARMS
Contractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
Plione: (878) 407-1986
Zip: 91324
Phone:
Zip: 94137
,
Phone: (818) 4W-1986
-: �Zip: 91324 �
License: 386619
ISSUED BY:
Status: ISSUED
Applied: 09/26/2000
Issued: 09/26/2000
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR NEW DATA CENTER FOR "CENTRECOM" (9TH FLOOR). INSTALL 6 LIGHTS,
30 OUTLETS, 4 SWITCHES; 2 MOTORS TO 10HP, 2 COMMUNICATION DROPS, 2 SUB PANELS, & 1
TRANSFORMER UP TO 50 KVA. _ _ _ � , _ �" . " _ , �
REF:B00-00924 �
9
� � FEE SUMMARY , � -- ; � �
� Quantity � Quantity �, - - �
ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0-' . � -
Temp service test $0.00 Busway /100 ft � . $0.00 0 � . �
Res. a/c package $0.00 Standing Section $0.00 �A . � ,' .
New Res (1-2�units) . , $0.00 0 ,- . Misc'Electrical Equipment $0.00 �..0- �
New Res (3+units) $0.00 0 ".. •� Trensformers up to 1 kva/kw $0.00 �-. 0 �� �
Pool / Spa , � � $0.00 0 . _.. .:�.up to'-10 kva/kw $0.00 �' 0 - ' -
Lighting Fixts: ' $26.60 ; . _ _6 � � , .....up to 50��kva/kw::.�.- $24.60�;' 1 � � ' � �
Recept Outlets �, , . $29.30 �' - 30'" �" ' � � ....._..:.......up to 100 kva/kw� '- $0.00� 0 - � -
Switches , , � $24.40 � _ - 4 � ..____._.....over 100 kva/kw „-$0.00 � � 0 � ;
Non Res Appl , ��, _ � $0.00 "� � ��0 � _ Low Voltage Equipment = � $0.00� -� 0 � � "
Res Appl ' $Q00' _ 0.;; , _ - Low VOIt W ring System / Ckt �� $0.00 ; : 0 � %
Serviceto200a �. $0.00 ' �0 � � MiscConduit . -� $0:00� 0- � ,
Service to 1000a - . $0.00 � � �. � 0.. ' � Misc. Conductor � � ' � . $0.00 � "0- ,
Service over 1000a � $Q00 -„ 0 � - Circus ( gen or ride) � . � $0.00. ''0-
Motors to 1hp $0.00 . 0 Circus (mech ride or lights) $0.00 ,'0
Motors to 10hp $24.60 _'� 2 , Christmas Tree Stand .� . $0.00 � 0
Motors to 50hp $0.00 �, 0 . , Fireworks Stand ' -='$0:00 0
Motors to t00hp $0.00 . 0 � Other ElecVical Fee -', �$0.00
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits �
Temp Pwr Pole
Intermed Pole
$0.00 0
$2.20 2 Investigation Fee $0.00
$61.00 2 Plan Check Fee $0.00
$0.00 0 Reinspection Fee $0.00
$0.00 0
$0.00 0 TOTAL CALCULATED FEES b216.20
$0.00 0
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-26, § 7, 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
tor 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 la I
�equired Inspeetlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit./�
FOR INSPECTIONS CALL: (714) 7545626 //
2446d6�N00)
WORKERS' COMPENSA710N DECLARATION: --
I �ereby etllrm untler penalry of perjury one of the following tlaclaretions:
❑ I heve end will meintain e certificate of consent to self-Insure tor workers' compensatian, es pravitletl for Cy sedion 3700 of the Lebor Code, for Ihe pertormance of the
�work for w�ich lhl5 permit is issued.
��
I lieve flnd vrill malntein workers' compensatlon insurence, as reQuired by sectim 3700 of the Lebor Code, tor Ne perfortnance ot Ne work for which this peimit is issuetl.
My workers' compepseUon In�nceperrier and policyAumber are:
PolicyNumber.- il/�..�A Z 7 J�G //3ac�
oNess.J �---.. .^
❑ I certity t�at in [�e peAormance of Ihe work for which Ihis pertnit is issueQ 1 shell not employ flny person in any manner so es lo become sub�ect to the workers'
compenseiion laws of Calll la, end agree Ihat N I sh IC became sub�ect to the workers' compensatlon proWslons ot Saction 3700 of iha Lebor Gode, I shall tort�wlN
comply with these pro
r�r��� sis�aw�a: -- Q ,..,/ oe�-_� -2G -� c�
WRRNINO� FAIWRE TO SEIXIRE WORKERS' OOMPENSFT1dJ RAGE IS UNLAW FUL M1D SIULL SU&lECf AN EMPLOVER TO CflIMiNAL PENALTIES AND GVIL FlNES UP TO ONE HIINDRED
TTIOUSAND OqlARE (5100,000). IN ADDfiIIXJ TO THE COST PENS4TION, DPMAGES AS PROVIDED FOR IN SECiION �W OF THE LABOR COOE, WTEREST, PNO ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
of Chapter 9(commencing wIN Sectlon 7000) of Division 3 ot t�e
entl
Professions Cotle, antl my license is in tull
G-a�,
CONSTRUCTION LENDING AGENCV:
❑ I hereby aflirtn that there is a construction lending agency for the peAormance ol ihe work lor which Ihis permit is issuetl. (Sec. 3097, Civil Code).
Lentlers Name: lendefs Address:
Signeture:
OWNER-BUILDER DECLARATONS:
Date:
I hereby eMirtn that untler penalry ot per�ury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Pmiessions
Cotle: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also reduires the applicant for such pertnit
to file e signed atetement Ihet he or she is licensed pursuam ta the prodsions of the Cantrectors License Law (Chapter 9(commencing wit� Section 7000) of Divlsion 3 of the
Business antl Professions Cotle) or that he or she is exempt theretrom end the basls for the allegetl eaemption. Any violation of Section 7031.5 by eny applicent lor e permit
subjects the applicant ro e civil penalty ot not more than tive huntlretl tlollers (5500).):
❑ I, as owner oi the properry, or my employees wi�h wages az their sole wmpensation, WILL DO TIiE WORK, antl the structure is not intended or ottereG for sale (Sec.
7044, Business and Professions Code: The Contraciors License Lew does noI eOPly to en owner ot properry who builtls or improves thereon, and who does such work
himself or herself ar Ihrough his ar her own employees, provitletl that such improvements are not intended or ottered for sale. If, however, ihe building or improvement is
sold within one year ot completion, ihe owner-builder will have the burden of proving that he or s�e did not build or improve tor purpose of sale.).
❑ 1, a5 owner of t�e property, am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct Ihe project (Sac. 7004, Business entl Professions
Catle: The comrectors License Lew does not epply to en owner ol propeny w�o builtls or imprwes thereon, end who contrects lor such project with a contrectar(s)
liten5e pursuant to the ConVettors LitenSe WwSJ.
❑ I em exempt under sec. Business entl Professions Code for Ihis reason:
Signature: Date:
Owner ID verllled by ddver's license. ❑ Yes ❑ No Dnver's License No. Expires:
Verificetion ol Ownership by (rype oi tlocumeni, i.e. - properry tan bill or dead):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION:
❑ 1 hareby certify thet no excavation five (5) or more fael in dep�h Into which e person Is require0 to descend, will be made in connection with work euthodzed Dy this
pertnit, end ihat no 6uilding siructure, scaHolding, felsework, or demolition or tlisman�ling ihereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Celifomla Atlmini5lralNe Cotle).
❑ As owner-builtler, I will not employ enyone to tlo work which would require a permil from ihe Division of Indusirial Selery, es notetl aDove, unless such person has a
permit to do such work from the division.
SignaWre: Date:
Divisi0n ot InduS�rial Sefety Permi� NumDer:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMAY: I certify under penalry of perjury that I have read this application and state Ihet the inlormation given is
wrrect. I egree to comply with all stete laws antl ciry ortlinances relating to building consWction, antl authodze representatives of t�e Ciry ot Costa Mesa to enter upon Ihe
ebove-described property for inspection purpases. I egree not to occupy or allow occuDency of any builtling authorized by this permit until finel inspection.
COOE t. INSPECTIONTYPE
1676 FIzeA System Final Fire Preventlon
1266 Pad Spe Final
200 Finel RB-Root
201 FInaI BIocWRetaining Wall
202 Final Fadory Fire Place
203 Final Sign
204 Finel Demolition
n[ -' -
Q�¢, � �f�j INSiECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electrical
212 Final Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
Date
-O U
I:ii�il.1R]
lr �
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-m��Ep.�1PRESSION PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 9
Vitinity: 9TH FLOOR
Parcel Number: 41 �5�� � �
Applicant: GARCIA, JOHNNY.
Address
Zoning:
ISSUED BY:
Status: ISSUED
Applied: 10/23/2000
Issued: 11/14/2000
_ Phone: (562) 496-6444 -" � � . \ 1
�,. � � . z�p: �
v
� :� �
�'�
Owner /SAKIOKA_FARMS . _ � _ � � �
Adtlress� � �� � ' � � � ' ' � �
i . . . _ � . �A� �
, �
- . " Phone: - , � � ,
, � � � � . � Zip: 94137 `; � . � ' ��
. �� \
Contracroi:' CAL PROTECTION � �`,�� \
�
� , Atldress: � 2505 MIRA MAR ' �� �� - '
� , Phone: . (562)498-6444 � ', \�'�
, � LONG BEACH, CA � Zip: 90815 - � � , � � - �, � i,
` � " � Licenae: 327196 , �. . -
. ,
SCOPE OF PERMIT
� . RELOCATE 12HEADS AND INSTALL 4NEW HEADS FOR OFFICE "DATA CENTER"�FOR "CENTERCOM", ' �� .
RE:B00-00924' �
Plan Check: $90.51
Permit: $139.25
� Other: $0.00
` Total: $229.76
- _;FEE SUMMARY
\ ,
� � ' � .
` Calc Valuation: $e,soa.00 �
Claimed Valuation: gs,sos.00
I
/
�; _ '
o, � � �
� -_ , ..�' , � �; �
— �
;",
,.
�
,
� , _, �
i �;
; �; -
�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access -requirements untler Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIflATION: 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 penod 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 Inspeetlona and final approvel must be oblained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
244fi38 (fl�00) //
WORKERS'COMPENSAnONDECLAHATON:
I hereby eHirm under penalry ot perjury one of the tollowing tleclarations: �
❑ I have entl wlll maimaln e cenlficate of cowent to self-Insure for workers' compensation, as provltled for by section 3700 of the Labor Code, for ihe pertormence of ihe
�__wotk tor whic� t�is Dermit is issued.
My
� Insurence, as requiretl by SeMion 3700 of the Lebor Code, lor the Oedortnance of the work for which this pertnit ia issuetl.
entl policy n ber ere: �/
� � ,�, Po� � � so-�y
; velued ef one undred tlollars ($700) or less.)
❑ I cenily that in the petlartnance ot t�e work for which this pertnil is issueQ I shall not employ any person in eny manner so as to become subject to the workers'
compensatlon laws of omia egree Ihat if T,should become subjacl to the workere' compensetlon provisions of Sectlon 700 of t Labor Code, I shell farthwith
wmplywiththesa vis ns. /
ApplicantSigneWre: ��h Date: <� �y�li
�7�"� �
WARNIIJC� FAILURE TO SEBURE WORKERS' ODAIPENSATION WVERAGE IS UNLAWFUL AND SWLL1 SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND dVIL FlNES UP TOONE HUNORED
1HOU,SAND DOLURE (5100,000). IN ADOITION TO TME COST OF COMPENSATION, DNMAGES 0.S PROVIDEO FOR IN SECTION 3]O60F THE LABOR CODE, INTEflE$T, AND ATTORNE`f$ FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby aNirm IhaFLam IIcw��ed un er{yox'sio9� of Chapter 9(commencing with Section 7000) ot DiNsion 3 ol.the Busin$ss an� Profe,� 6ions CoOe, and my license is in full
larce entl ettect..Lic..x, i,7i'�� ( SC /o iCless x C�/(� /�-- r�o
CONSTRUCTION LENDING AGENCV:
❑ I hereby aNirm that there is e consiruction lending agency tor the pertormance ot the work br which this permit is issued. (Sec. 3097, Civil Code).
Lendels Nama: Lenders Address:
Signamre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereDy aMirm thet under penalty ol perjury that I em EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions
Cotle: Any ciy or county which requires e permi� to consiruct, alter, improve, tlemolish, or repair any siructure, prior to its issuance, also requires the applicant for such permit
to file a slgned sletement thet he or she is licensad pursuant to ihe provisions ol ihe Contrectars Llcense Law (Chepter 9(commencing with Seclion 7000) of Division 3 of Ihe
Business and Pmfessions Code) or thet ha or she is exempt therefrom and tha Casis tor the elleged eremptian. Any violation of Section 7031.5 by any epplicant lor e partnit
subjects the epplicant to e civil penelty of not more than five hundred dollers ($500).):
❑ I, as owner ol Ihe property, or my employees with wages as their sole compensatlon, WILL DO THE WORK, end �he structure is not intentled or otteretl for sele (Sac.
7044, Business and Professions Coda: The Coniractors License Law tloes not apply to en owner of propeny who 6uilds or Improves Nereon, antl who does such work
himsetl or �ereeli or through his or �er own employees, provided that such improvements ere not Intentled or otfered tor sele. If, however, ihe building or improvement Is
sold within one year ot comple�ion, the owner-6uilder will heve the burden of proving that he or she tlid not build or improve for purpose of sale.).
❑ I, as owner 01 lhe property, am EXGLUSIVELV CONTRACTINC WITH LICENSED CONTRACTORS ro con5truct Ihe prol�� (Sec. 7044, Business end Protessirns
Cotle: The coniractors LJcense Law does not appty to an owner ol proparty w�o bullAs or Improves Ihereon, and who contrects for such project with a conirector(5)
license pursuant to the Contractors License Laws.).
❑ I em exempt under sec. Business antl Protessions Code tor this reason:
Signatura: Date:
Owner ID verified by tlnvers Ilcense. ❑ Yes ❑ No Driver's License No.
Veniication ot Ownership by (rype ol document, i.e. - property tax 6ill or tleea): �
Expiras:
OIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby cerlity that no ezcevation five (5) or more feet in tlepth into which a person Is requiratl to Aescend, will be mede in connection with woM authorized by Ihis
permit, and Ihat no building structure, scattolding, falsework, or tlemolitlon or Oismantling thereof, will be more ihen Ihirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomle Atlminl5iretive Code).
❑ As owneo-huiltler, I will not employ anyone to do work which would require a permit from the Divlsion oi Industnel Sefery, es noted ebave, unless such poraon hes e
permit lo do suth work from Ihe divi5i0n.
Signature: Date:
Division oi IndusMel Safery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF EMAY: I cenity under penalty ol Derjury ihat I have reatl this application and siate that ihe information given is
correct I egree Io compry with ell stete laws end ciry ordinances releting to builUing consWction, antl euthorize representelives of the City ot Costa Mesa to enter upon Ihe
ebove-described property for Inspection purposes. I egree not to occupy or allow occupency ol eny building authonzed by this permit until finel inspeclion.
COOE I. INSPECTIONTYVE
1616
1266
Fizetl System Finel Fire Preveniion
Pool Spe Final
200 Final RaRoof
201 Flnel BIocWRelaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
�
o"�l .I�t��`ELfl
�'�'�` WT
CODEt INSPECTIONTYPE
206 Flnal Mechanlcal
20B Final Plumbing
210 Final Electriwl
212 Final Fire Preventi0n
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
P�IE Q�lL$
IE
�•v•o� �
, � ,.
_ � CITY OF COSTA MESA . __�
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(71a) 75a-5273 • Fax (71a) 754-4856 • www.ci.costa-mp}�Ee.gilpRESSION PERMIT
Job Address: 555 ANTON BL
Suite: 9
Vicinity: 9TH FLOOR
Parcel Number: 41050110
Applicant GARCIA, JOHNNY
Address: 2505 MIRA MAR �
LONG BEACH CA
Zoning:
Phone: (562) 498-6444
Zip' 90815
NUMBER
F00-00280
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 10/30/2000
Issued: 11/14/2000
�
� -" - - _ '� .� �; ��
owner: SAKIOKA FARMS � � ` � �� � � � � �
Address� � . �- � � . � � . �/. - � �- � ��
. - - - � - - - " •`
- � ' � Phone: � . _ _ , . ., �> ` .
� , � . Zlp: 94137 � � . � . � ��,
Contiactoc CAL PROTECTION �
Address: � 2505 MIRA MAR ` _ � - �
' - . - � � Phone: � (562) 498-6444 � � � , '� A ��,
� � LONG BEACH, CA . Zip: � 90815 � . � � � � ' � ,
� . = � - ���License:� 327796 . .� � :� � , �.�\,
SCOPE OF PERMIT
FIRE ALARM PERMIT�FOR INTERIOR OFFICE T.I. FOR "CENTRECOM" (9TH FLOOR)." � - ,
i.
REF: 800-0
_ _. . _ . _ � _ _ _ '
. _ _. FEE SUMMARY .. _ '
Plan Check: $136.01 Calc Valuation: s�i,soo.00
Permit: $209.25 Claimed Valuation,' $i�,5oo.00
Other. $0.00 � - � � "
- -- - - �
Total: $345.26 � � ' � .
NOTICE: The work authorized by this parmit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 7241-92)
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 tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspections and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
zaac�se (eroo)
WORKERS'COMPENSAnON DECLARATON: � �T-'
I hereby etfirtn under penaly af perjury one ot the following deGaretions:
❑ I have entl will maintain e certifiwte of consent to setl-Insure lor workers' compensation, es pmvided for by sectlon 3700 0l the Lebor Cotle, for Ihe pedortnance of Ne
,�work for which this Oarmit is issuetl.
�I �eve flnd will maintain vrorkers' cwnpensatlon insuranca, es required by secUon 3700 ot the Labor Cotle, iw the peAortnance of the work for which tttis pertni[ is issuetl.
=y � rkers'_compeqsation Insuren wrt,ie/r� entl policy number are: pn- /
Ceme�: � �,. ,K _ L�I�, �, Po�i�Y N�- �—�_ Y!/ O-[ y
(TJ�is�section n ed nof be camplefed i! the permit is vel etl et one �undred dollars ($100) or less.) l� —�
❑ I certify Ihat in the par�ormanca of the work for which Ihis permit is Issuetl, I ahall not employ eny person in eny manner so es to become subject to tha workers'
compensatlon laws ol ifomia, an egree Ihet it I shoultl become subject to Ihe workere' compensation pmvisions o1 Section 3700 t the Labor Cotle, I shall tort�with
comply with these pr isi ns.
Applicant Signawre: i-' ' 1t�r. D�ate: �//�/� O(�
WMNINO.'fAICURE TO SE E WORKEPS' COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SUBIEGT AN EMPCOVER TO CRIMINAL PE�TIES AND dVIL FlNES UP TOONE HUNpRED
THOUSAND DOLLARE (51 ,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]W OF THE LABOR CADE, IMEFEST, AN� ATTORNEI"5 FEES.
LICENSED CONTRACTORS DECLARATION:
IherebyeHirmttwid�emijcs25a�d� proyisio
force end eMecL�Lic :q. �-- ��O
CONSTRUCTION LENDING AGENCY:
of Chepler 9(cammencing with Section 7000) oi Division
and my license is in tull
❑ I hereby atfirtn that ihere is a consiruction lending agency for Ihe peAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lentlefs Nema: Lenders Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Da�9:
I hereby ettirm ihat untler penalry ot perlury that I em EXEMPT FROM THE CONTRACTORS LICENSE lAW for the following reason (Sec. 7031.5, Business entl Protesslons
Cotle: Any ciry or wunty which requires e permit to construcL alter, improve, tlemolis�, or repair any structure, pnor to its issuanca, also raquires the applicant for such permit
to file a signetl stetement that �e or she is licensetl pursuen� to ihe provlslons of Ihe Conirectors License Law (C�apter 9(commencing with Sectlon 7000) of Divislon 3 oi Ihe
Business and Prafessions Code) ar that he or she is ezempt theretrom antl t�e basis for Ihe alle9ed eaemption. Any vialation of Sectlon 7031.5 by any epplicant for a permlt
subjects Iha eppliwnt to e civil penalry oi not more than five hundred dollars ($500).):
❑ I, es owner of ihe D�operty, or my employees wlth weges as iheir sole compensation, WILL DO THE WORK, anG Ihe siructure is not intentletl or oHeretl for sale (Sec.
7044, Business and Professions Code: The Contractors Licensa Law does not appty lo an owner of property who bullds or Improves ihereon, entl who tloes such work
himsetl or herself or through his or her own employees, pmddetl t�et such improvemenis ere nat intentled ar offeretl tor sale. II, however, Ihe building or improvement is
sold within one year at completion, the owner-Duilder will have ihe burtlen of Droving that he or she did not builtl or improve for purpose af sale.).
❑ I, es owner of the property, am E%CLUSIVELV CONTfiAGTNG WITH LICENSED CONTiiACTORS to construct tha project (Sec. 7044, Business antl Professions
CoOe: The contrectors Llcense Ww does not appty to en owner of property who Dulltls ar improves thereon, end who contracts br suc� projeq wiih a contractor(s)
licanse pursuaN to the Contractors License Lews.).
� 1 em exempt untler sec. Business end Professions Code for this reason:
Signawre: Date:
Owner ID verltietl by dnveYs license. ❑ Yes ❑ No Dnvefs license No. Expires:
Venfication of Owners�ip 6y (rype oi document, i.e. - pmperry tax blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certily thel no axcavation five (5) or more Ieel in depih into which e peroon Is required to descend, will be mede in wnnection wl�h work authonzed by this
parmit, end thal no building structure, scaHolding, falsework, or demolition or dismamling thereof, will be more Ihen �hirry-siz (38) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Celitomla Atlministrative Cotle).
❑ As owner-builtler, I will not employ anyone to tlo work which would require e permit from the Division ot Industnel Setery, as noted e6ove, unless such person hes e
permit to do such work irom the division.
Signe�ure: � Daie:
DiviSion ot InduSMel Safety Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I ceniy under penelry of perjury that I have reatl this epplication and state that the information given is
wrted. I agree to comply wii� ell stete laws and ciry ordinances releting to bullding construction, and euthonze representatives ot the Ciry ol Coste Mesa to emer upon ihe
above-described property br inspection purposes. I egree not to acupy or allow occupancy ot any building authorized by ihis permit until final inspection.
COUE �. INSPECTIONTYPE
1676 Fixetl System Finel Fire Prevention
7266 Pool Spa Final
200 Finel Re-Rool
201 Finel BIocWRetaining Wall
202 Final Factory Fire Placa
203
204
Final Sign
Final Demolilion
�ff. I�
CODE� INSPECTIONTYGE
206 FInelMethaniWl
20B Final Plumbing
270 Final Elettrical
212 Final Fire Preventlon
220 Finel Planning Approval
222 Final Site
250 Final Building/Occupency
1'�r6-ia w�1'
PflOJECTROUBESS: jS�J ANTON BL uNir: g CITY OF COSTA MESA — BUILDING PERMIT PERM t�10; B � 1� \
OWNEN'SNRME: BANK OF AMERiCA
POOPESS: ZO N RAYMOND AV PERMIT NO; H 059015 PLAN CHECFC NO: 03341-92 A . GOVT: N S PP; N
PASADENA
818-578-7779
FflCH/ENGINEEN: ROY HERHOLD NEG.NO.: C S S O% 3
AOOflE$S: '1zO72 CAMINITO vINO UNIT:
LAGUNA HILLS CA 92653
PERmiTTEE: AkMSTRONG CONSTRUCTION ( 818 ) 967-8001
nooness: 9?9 SPRING MEADOW DR
WEST COC�INA CA 9179].
❑CENSEO CONTNRCTOfl OECIABATION: I �ereby aflirm �hal I am licensetl unaer pmvisions af Chap�er 9(commencinp wi�� Sec�ion
7000) al �ivision 3 of �he Business antl Pro�essians Code. anp�m�y ' ense is in lull�orce antl ettecl.
ciTruc 56 � 1 sTnreuc.:434047// J s: H
Oate: Signature',.�1���'�
WOBREBS' OMPEI ATION OECIAflRTION: I here6y �rm tha� I have a ceniliwte ot consent ro s ' ure or a cenilicate oi Workers'
Compensation s e c etl copy Ihereoi (Section 38011. Lab. .
iucrNo.: ���4���� exr.onre: 1/O1/93
ornraxv: REPUBLSC I,N�fDEM
❑ Ce�ifietl copy is hereby �umished. L9 Cetlifie0 copY � i with IA= ly Buildin �ivision.
' Date: a ADDlicanP.
E%EMPTIO FflOMW NEBS'COMPENSNTIONOECUflFT10 (Thisseclianneeanol�ecompleteaiitheperm' oronehunOreA($1W)orless�.
I cehily ��al in lhe pertormance ol �he work �or which Ihis permi� is issued, I shall no� employ any Oe�son in any manner so as tb become
subleci lo ��¢ Workers' Compensa�ion Laws Of Calilomia.
�ale: SignaNre:
NOTICE: II. al�er making Ihis Aeclaration, you shoultl become su6ject Io Ihe Workers' Compensa�ion provisions o� Ihe Labor
COAe; y0u mu5i �orthvnih tOmDly wi�h Sut� D�Ovisions or lhis permi� 5hall 6e AeemeO revoketl.
CONSTBUCTION LENDING RGENCY: I �ereby atlirm that Ihere is a constmc�ion lentling agency for ihe pedormance ol I�e work for
whicA Ihis Oermii is i=suetl (Senion 3097. Civ. C).
LENOEfl:
aooeess:
OWNEfl BOILDEfl OECIABATION: I hereby a�firm Ihal I am exemp� imm the Contracmrs' S�a�e License Law for the lollowing reason
(Sedion 7031.5 Business an0 Pro�essional CoAe: Pny city at counry which requires a permil b cons�mc�, alter, impmve, demolish, o�
repair any simclure, prior to its issuance, also �equires �he applican� for sucA permii to �ile a 5igne0 s�atemen� �hat �elshe is licensetl
pursuant to �he pwvisions of the Contractors' State License Law (ChaD�er 9(commencinA wi�h Section 7000) at Oivision 3 of ihe Business
antl Prolession5 Code) or �ha� he/she is exempt Ihereimm an0 ihe Oasis �or ��e allegeG exempiian. Any violalion oi Sec�ion 7031.5 by
any ap0lican� lor a permii suhjecis Ihe apD�ican� lo a civil penalry o� noI more Ihan �ive AunOreJ Oallaa (5500).
I, as owner of the pmpeny or my employees with wdges as their sole compensation, wiil tlo ihe waB, an0 ihe
� simcwre is not intentled or oif¢re0 for sale (Seclion 7044, Business antl Prolessional Coae: The Coniracrors' State License Law
tloes no� apOty lo an owner o� a Dwperty who builtls or impmves Ihereon, anU who tloes such work �imsell/hersel� or Ihmugh
his Or her own employ¢e5, provi4e0 I�ai Suth impmvemen�s are n0i inlen0ed of offefe0 tor Sale. II, however ihe building or
improvement is SoIA within one year of comple�ion, �he owner will have I�e 6urden oi proving he/she ditl not builtl or impmve
for t�e purpase o� sale).
I, as awner of Ihe property. am exclusively conVaming wi�h IicenseU con�racbrs �o consimc� �he D�olect (Section 7074, Business
❑ antl Pm�essions Cotle: The ConVac�ors' S�a�e License Law does no� apply �o an owne� ot pmperry who CUAas or impmves thereon
antl who coniracts far sucn pmjecls with a coneractorls) license pursuant to Ihe Coniractors' State License law). I am aware
t�al proof of iheir Worker's Compensation insurance should �e pmvided to me.
� I am ecemp� weer Seclio¢ B. 8 P. C.
lor Ihis reason:
Oa�e: Owner.
I Oo Aereby cetlify Iha� I am aware ol antl untlerStanG the requiremems o� Cali�omia Healih and Sa�ery Co�e Sec�ions 2550.5, 25533. antl
25534 an0 iha� I ar any �uiure builtling occupan� will/will noi (circle one) neetl �o comply wi�h saitl sta�e waes and IAe requirements for a
permil �ar constmction ar mo0ilica�ion Irom �he Air dualiry Managemen� DistricL Resitlential cons�mction ap0lications are exemp� imm
�hese provisions.
Da�e: ApplicanP.
I �ereby cer�ity tha� I �ave read �his applicaiion anU sla�e that ��e a e inbrmalion is correc�. I agree �o comply wilh all ciiy anA counry
orAinancesantlslaielawsrela�ing�a�uiltlingcons�mc�ionantlhe b auhorixerep ma�iv o�thiscirytoemeruDonlheabove-mentionetl
propetly brins c�ian urposes.
Oa�e: Signa�ure-
od�er's �icense or ociai secunry a:
I6aba6 WM1�te—Builtlingl Green—Code Enlorcemenl', Canary—Applicanl: Pink—flevenue', Golaenmd—Assassor
CONSTRUCTION TYPE: SP PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION ; 4005F OFFICE T.I. SQ FT; 1,200
CLAIM VALUE: 7,000.00 CALC—VALUE; 7,304,00 GROUP OCC�-2 /
COMMENTS: 4005F OFFICE T,I,
*��r�c-**x*******�r***�***+�******��*****�*�x***�*x����**��*�r****������*+���x�***�r*��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------
FRNT: FT IN REAR; FT IN cRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARRING REp • PROV; PARCEL: 41050104 ZNE; TC REF NO;
PLANNING NCiTES> IN'�fiRIOR REMODEL TO 9TH AND i1TH FLOORS
i fi �
�IF 1E If if iE if 1E iE iE iEif iEif iF ik iE iF 1E 1EdF # iF iF iE # 1E 1E iE iE iF iE iF if iF �ElF if iE iE if fE If iE dE iFiE iflEiF if iE iE i't �lt iE if iE iE IE iE iE iF 3F-1E ih it if iE iE�E jE iF 3f iE 3E iE 3f IE �lE
D E V E L O E�P M E N' T, S E R V I C E S R E Q U I R E M E N �1' S
ZONING APPROVED HY ' f :�I�� DATE: �(D /�
HUILDING APPROVED ��' ;��^��� DATE; !O 2
APPLICATZON ISSUED �HY: ` ' !/ DATE: ;F��"'��
if3FifitiEiF�lEif3fjEiEiEiFiFifjFiEiF3F:ifiEi(� 3(�ififiE3EjFiE3EiFif if�k
iEiFiEikiEifiEifiE�hiEifjE�E3FiFiFiFiP}Elk1E�f*iE�EiFiEiEiFiPiEiEiEifiEjkiEifiEiEfF3f IklE1E1E3EiEiEltiFfEifi(�ItrlElfiEiE3EiEiEiEiEjG iFifiFiE3f�1E3F�EiEik
LEGALIZATION;N � F E E S U M M A R Y STRUCTURAL SEGMENT;Y
.4
BLDG PMT' PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 99,00 , ;"� �� SMIP/NON—RES
PLAN 16,09 ��� � ' ].,53
ISSUE FEE 't � � �
BUILDING—DIV—> PERMIT ISSUE PIiAN—CHECK ' TOT'AL PAID DUE
TOTALS----> 100,53 0,00 'i 16;09 ,? 116,62 116,62 ,00
REVENUE DIVISION TOTAL5--> COLliE6.TED; �� 100.53 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC/•Y.}FIRE SMIP1T03 GRADTNG PLAN—CHECK
99.00 , � `'
*��*xx*.*�x**�*��*****�*****+�*�***�a�**,*�*�***+��* *�-****��**��****��***�*********
I N D I V I D U A",L"�„ ;' F E E �R E A K D O W N
TYPE QTY D E S C R I P T I� O� N,.� ��' �,` r
��r UNIT COST TOTAL COST
SFC 400 OFF—INT. ALTER TYPB� Z� TI F;R.%.� AVER 17.24 6 896.00
SFC 400 EQU—ALT COMM, SPRINKL�R 5Y5 !• kAVER .33 �132,00
SFC 400 EQiJ—ALT COMM, AIR CONU °�%% —AVER ,69 276,00
END'-0F FEES
1 2`.� �..
(t�. /
1 . �,V
�� _��ii�5,���--'i�` "_ '�' -,.V
Uh�F: QR�"t7'�: . _- _. �
CONSTRUCTION AND PLANNING f _& SPA
APPROVALS Permit.# Date Inspector qpPROVAIS Permit # Date In:pector
t. Temporery Electrical Service o� Pole . 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. - -' 53. Steel Reinforcement �
3. Electrical Conduit Utillty-Undrgrnd. � 54. Forms
4. Electrical Cond�it�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement � 56. Rough Piumbing & Pressure Test
6. Electrical UFEF 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'Conneaion 62. Backwash & Receptor�Final
I
12. Sewer Cap � 63. Heater & Vent-Final �
13. Roof Drains � 64. Plumbing System - Final .
14. Rough Piumbing �!• 'Y : 65. Electrical�Final �
15. Rough Electrical-Conduit 66. Solar System•Final
16. Rough Electric Wiring 67. Fencing & Access Apqroval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough ElectriCal�T Bar Ceiting 69. POOI{SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rou9h FactorY Fireplace . APPROVALS -" Permit #
21. Dutts, in Structure 70. U�derground Hydro
22. Ducts, Ventilating �. 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test � � 72, Underground Flush
24. Roof Framing - 73. Undergrnd. Storage Tank O Gas ❑ Oil �
25. ftoof Sheathing . "- 74. Overhead Hydro
26. T�Bar Ceiling IStructural) & Monocoat 75. Dry Chemical
27. Frame and Flashing ��7..G1�(3L �Gy�i 76. Dry Standpipe
28. Lathing & Sid�ng � � � 77. FIXED SYSTEM� F�INAL
i
29. Insulation .�� ... ;. 76. FIRE PREV. FINAL
30. Drywall Nailing O�� f� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat .{ � . � 79. FINAL WSPECTION
i
�32. Electriwl Power Meter•Final �_� 80. FOOD CERTIFICATE ISSUED
33. Final Electric � _; Notes:�� ~ _ ��
s
34. Final Heating & Air Conditioning � � i �b �.�� 1 p
35. Final Gas Pipe-Test� _ I � � `�
i
36. Hood or CanopY , , �' � _ �
��(y �'� �.
37. Final Factory Fireplace �
10�2.z-�' 2- _
38. Final Plum6ing � � I . �
39. Water Service�Final I � i
t
40. Gas Service•Final ! '
i
41. Solar pomestic-Final
42. Backflow Preventer � � � �
43. Backflow Irrigation
44. l.andscape Irr�pation System , .
45. Sound Attenuation
46. Handicap Regulations .
47, FINAL STRUCTURE & BUILDING ���L��;,�[
48. FINALPLANNING - �:
49. Electric Release to Edison
50. Gas Release to Southem Califomia Gas Co ; i i i
51. CERTIFICATE OF OCCUPANCY
No. Date
PHOJiCT AOOXE55: j S S ANTON B L
OWNEfl'SNAME: BANK OF AMERICA
aooxess: ZO N RAYMOND AV
PASADENA
uxir 9
ANCHIENGINEEN: a1H—S%A—%�J79 NEG.NO.:
aooxess: ROY HE:RBOLD C1 �OT73
22072 CAMINITO VINO
PEXMITTEE: LAGUNA HILLS CA 92653
AUOXESS: HORIZON HEATING & A/C ( 719 ) 974-3702
17853 SANTIAGO H1 STE#107-243
VZILA PARK CA 92667
UCENSED CONTBACTOB DECLBflFTION: I �ereby afiirm �ha� I I' nsed n0er pmvisions oi Chap�er 9(commencing wi�h Section
7000� oi Dirsion 3 of Ihe Business antl Pmtessions Code. antl I' nse n full force antl 'e t.
cirr uc.: p � 6 q q STRTE LIC.: 6 z q s_�� p
� �a�e'. 6 �e 921� . ,J _ -
IWOflNEflS' COMPENSATION UECLABRTION: I hereby aHirm t�aU have a certiticale ot consent m seli-insure ar a certilicate of Workers'
Compensation Insurance. or a cenilietl copy �hereoi (Section 3800, Lab. C).
� pOUCY NO.: EXP.OATE:
COMPRNY:
❑ Cenihetl copy is hereby �urnishea. ❑ Cehified coDY is tiletl vn�� Ihe ciiy Building Division.
Oate: Applicanf
EXEMPTION FBOM WOBKEPS' COMPENSIITION OECIANATION' li cti ne n be c Ie�eO i� e ermi� is�or one huntlred ($140) or less).
I cenily tlta� in �he peAormance o� the work lor w�ic permit' is d, sh not em oy p rson in any ma ner so as to 6ecome
subjed Io Ih Work 5' Compensa�ion Laws oi C Aomia.
Date�, F �—Si9nature:
NOTI : II. after making t�is Aeclaration. you s�oultl become lect to ihe Wo ers' mpensation pmvisions o he Labor
CoOe. you must �orthwilh compty vnlh such O�ovisions or Ihis permil 5hall be OeemeA rewke0.
CONSTflULTION LENUING RGENCY: I hereCy aifirm Ihai ihere is a constmc�ion lentling agency for the pedormance oi Ihe work tor
wAicA I�is De�m�i Is issuetl (Section 3097. Civ. C�.
LENDEfl:
FODPE55:
OWNEfl BUIIDEB DECUIBRTION: I hereGy allirm �ha�lam exemp�irom the ConVac�ors' State License Law �or�he �ollowing reason
�Section 7031.5 Business antl Professional CoOe: Any ciry oi county which requires a permit ro consimcL alter, improve, tlemolish, or
repair any simclure. Orior lo its issuance. also requires [he aDPlicant for such permil lo lile a signed statement ihat he/she is licensed
pursuam to Ihe provisons oi ihe Coniracmrs' State License �aw (Chao�er 9(commencing with Section 7000) oi Oivision 3 0l ihe Business
and Pro�essions Coae) or Ihal �e/she is exemp� �herefmm an0 the hasis lor Ihe allege0 exemption. Nny violaiion 0� Seciion 7031.5 by
any applicant �or a De�mi� sublec�s Ihe appliWni to a civil penalry of no� more �han live hunOr¢0 tlollars �E500).
I. as owner of �he propeny or my employees wiih wages as Ihei/ sole campensa�ion, will Co the work, and the
❑ S�mtWre is not in�endetl or oll¢retl �or Sale (Section 7044, Bu5ine55 and Pmtessional CAde: The fAntratlors' State License Law
Ooes not apply to an owner of a D�oOerty who builds or impmves Ihereon, antl who Aoes such work himsell/Aersell or �hraugh
his or �er own employees, DmviOeU ��at such impmvemems are noi intentled or oflere0 �or sale. If. however �Ae �uilding or
imD�o�emen� is soltl within one year oi comple�ioq the owner will have �he burtlen a� pmving he/s�e Oi� nol 6uild or imDmve
�or Ihe purpose of sale).
I, as owner of ihe pmoehv. am e�clusively conimcting with licensetl coniractors to construct ihe proiect (Seciion I04a, Business
❑ and Pmfessions Cotle: The Comractors' Slate license Law does not aDPly to an owner of proOehY who bwl0s or impmves thereon
antl who con[rac(5 for such pmjed5 with a conVactoqs)license pursuan�to lhe ConVac�ors' S�ate License Law),I am aware
�hal pmo� o� their Worker'S Compensa�ion insurance shoula be O�ovitletl b me.
� I am eeempt under Seciion: 8. 8 P_ C. '
br ihis reason:
Date: �wnec
I eo hereby cenity ihat I am aware of anU un0ers�antl ihe requirements of Calilomia Healih and Safery Code Sections 25505, 25533, an0
2553E an0 �hal I or any �uWre builtling occupant will/will no� (circle one) need to comply wi�h 5ai0 s�ate cotles antl I�e fequifemen�s for a
permit lor wnsimction or motlificatian irom t�e Air Oualiry Management District. Besitlential consiruction applications are exempt irom
I�ese provisions.
Dale: ApplicanL
I hereby cer�ilytha� I havereatli�is appl¢alion antl staie tha info aiion is corre . I reeto comply wi�� allcily an0 coun�y
ortlinances and statelawsrelatingto buil4inA conslmctio he by thor' epre ntativ o t cityto enteruDo e ahove�mentioned
pmperly br ins Bction urposes.
�
Da�e: G �� S2� Signaw .
Driver's License or Sociai Searity a:
164td6 Whi�e-9wltling; Green—Code Enlorcemenl', Ganary—ApplicanC Pmk—Revenue; Goltlenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 059549
PERMIT NO: M 059549 PLAN CHECK N0; N GOVZ'; N SUPP; N
CONSTRUCTION TYPE: SP PERMIT TYPE: MEC PURPOSE; OTH
JOB DESCRIPTION : 400SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC; B-2 /
COMMENTS; RE: H59015 PRIMARY BLDG, PERMIT,
���x�*�**x-**�*�x��r� �*,����***�r**���� *��*�� xx+��*******��***x*��*x��x**�*x***�� �x��**�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAk: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT; - FT IN RGHT; FT SN
PARKING REO• PROV: PARCEL; 41050104 2NE: REF NO;
PLANNING NU1'ES>
1 �
i(� ik lf iE if il�iE iflE iE-lE 1E if iF ik 1k 3f• �1C� iE 1E i(� �1EiF iE if �41E if ik ik 3E iE if iE �M� iF jF�lf iElF iElE fE �1F iE iFiE iE lE 1E iE # 1f iE 1E iElE 1F !E �1FiF �%iF if ik i/� IF iElF iF �E if iE �1F �E iP1F iF �(-
D E C� E L O P M E N T S E�%:V I C E S k E Q U I R E M B N T S
..+.'r
ZONING APPROVED HY , �� ___ DATE;
HUILDZNG P.PPAOVED HY
APPLICATION ISSUED BY•
( �.:
*�r�r�r�r**�e�t*�*********�t*�r� �� �������i �r ,��
iF1tX�ifiEifllif�f3F1f*iEiFif�i(�iFiEiFiE3Fif�FiE1E1EiE3(•ififiEifjfit�EiEiEiEiFlE3FlE�iE9F3fi1 h3EiE
LEGALIZATION;N F E E S U M M;S R Y
BLDG PMS' PLUN,BING ELECTRIC MECHANIC
DATE;
if iE 36 ih-lE 3f iE iF�IE 3f 3F dF �F K� iE �%if iEiEiE i6 iE iE iE if iE iF
STRUCTURAL SEGMENT;N
FIRE SMIPlRES GRADTNG
PERMIT 9,00
25: SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15,00 0.00 29,00 24,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 24,00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/T'OT GRADING PLAN—CHECK
24.00
�1E iF if iE 1E iE �lf iF iE �lE iE 1h iE if iE iElF iE iE1E �lf 1f �lE �lf iE if !E if ik # 7E iF iEiE iFiE fi If if �k if iE %i@ if IE if !E iFiE lE iE if iFlE if iE iF %1E 9E iF iklPiE iF )f lf IE iE iE ik 1F i! iE �3h if # i!
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I 0 N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9,00 9,00
END OF FEES
c: �aiz�s�.s-�a:��.�e� � .� -: .
��lic: 1i7,'1L.'72 .nE: :):•;•: �
CONSTRUCTION AND PLANNING ' _ PG� _& SPA
APPROVALS Permit� Date Inspector AppROVALS Permit� Date Inspector
1. Temporary Electric3l Serviceor Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgmd. . � �53. Steel Reinforcement
3. Electricat Conduit Utility-Undrgmd. - 54. �Forms
4. Electriwl Conduit�Undrgrnd. , 55. Electricat Bonding
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electricai UFER Grnd. ' 57. APPROVAI TO COVER-GUNITE
7. Footings 58. Electrical Conduit•Undrgrrld. �
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.� ' ." 60. Backwash Lines, P-Trap, � Undrgrnd. �
70. Structural Floor System � � 67. APPROVAL TO DECK _
11. Properiy Sewer Line & Flouse Co�nection 62. Backwash & Receptor�Final -
12. Sewer Cap 63. Heater & Vent-Final '
73. Roof Drains • . �� 64. Plumbing System - Final i
14. Rough Plumbing �� 65. ElectricabFinal �
15. Rough Electrical-Conduit ' 66. Solar SYstem-Final ' •
76. Rough Electric Wiring � , 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED•FOR PLASTERING
18. Rough Electrical�T 9ar Ceiling 69. POOI/SPA SYSTEMS FINAL
19. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory FirePlace APPROVAIS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Dutts, Ventilating 71. Product Piping OGas OOiI
23. Gas Pipe�Rough & 7est ` 72. Underground Flush �
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Fioof Sheathing ' 74, Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Fla:hin9 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 � I 79. FINAL INSPECTION
32. Electrical Power Meter�Final I I,-� 80. FOOD CERTIFICATE ISSUED
33. final Electric � � Notes:
34. Final Heating & Air Conditioning /dl y/efL� �7.�1
b" �
35. Final Gas Pipe�Test � �
36. Hood or Canopy � ��
37. Fina� Factory Fireplace ' ;� �
�
38. Final Plumbing - � � ,
_l
39. Water Service�Final I I'
40. Gas Service-Final � , - �
41. Solar pomestic-Finai � �
i i
42. Backflow Preventer � ,
43. Backflow Irrigation
44. Landscape Irriqation System ,
45. Sound Attenuafion
46. Handicap Regulations
� 47. FINAL STRUCTURE & BUtIDING I I
48. FINAL PLANNING ' ' - I
49. E�ectric Release to Edison I I. .,
,�
50. Gas Release to Southem Cal(fornia Gas Co � ' i
51. CERTIFICATE OF OCCUPANCY
No. Date
PflOJEDT F��NE55: S S S ANTON BL uNir: q
OWNER'SNRME: BANK OF AMERICA
aooxess: z 0 N RAYMOND AV
PASADENA
81fl-578-7779
RNCHIENGINEEfl: �,QY HERH OLD REG.NO.: C 1 1 O I 3
ADONESS: 22O%Z CAMINITO VINO uxiT:
LAGUNA HILLS CA 92653
PEflMiTTEE: COMPETITION ELECTRIC ( 818 ) 331-5807
aooREss: 635 STEPHORA
COVINA CA 91724
LILENSEU CONTBACTOB OECIAflATION: I hereUy allirm IAaI I am licensetl un0er provisions o� C�apier 9(commencing with Seclion
7qq� ot Division J ol ��e Bu9ness ana Pro�¢Ssions CAAe, an0 my license is in �ull force an0 elled.
cirr� .: 6905 sTeTeuc.:5168 euss: C-10 ^
� �� '�.
Date: � `5 Signamr>� �
W08 MPENSpTIONOEClA8RTI0N: IAereby 'rmth veacenilicatealwnsenuoself-insureoracenifiwtealWaAers'
ComOensaiion I{�s}�{a c c ili py thereoi �Seciron 00. LaG.f� . � J
POLICYNO.:+V�����—�� E%P.ORTE: Vi�OS�93
coMraNr: STATE FUND�+.�
L� C¢tlilieG copy is �ere0y Wmi5he0. L'] Ce�ilietl Co is lile ' � I�e tM1y BuilAing Divisi0n.
Date: 1 �/� ^SYL MDlitani: �� ':� �.
1:
EXEMPTION fqOM WOPREBS' COMPENSATION �ECIAflAT10 . is seclion nee0 not Ue compkletl il �he permii is lor one hmkrM �5100) a kst�y
I cerlily I�al in Ihe periormance o� I�e work �or wllic� IhiS Oermil is isSueU. I s�all nol employ any person in any mann�'soa5 io 6ecome
Su0jecl �o tlie Worker5' Compen5aiion Laws 01 Calilomia. � �'
y; y
Daie: SiAna�ure: •
NOTICE: If. al�er makinq t�is aeclaralion, yau stroultl became subject l0 1�e Workers' ComOe��uon Dmvisions pf•ihe LaUar%
coee. you m�si ionnwne campW with suc� Dmdsions or Ihis permil shall Ge aeeme0 revoked. /r ��,�
fANSTBUCTION 1EN01NG 110ENCY: I �er¢Gy aflirm I�ai IAert ¢ a conSilUt�iOn 1¢ntling apency �Or Ihe p¢AOrma�te ot I�p wOrk'�or
wNch Ihis Dermil is iSsueE (Sttlion 3W7. Civ. C�. �{F
LENOEP: %� ` ' `
AODNESS:
OWNEP BUILDEB DECtANRT10N: I �ereby aflirm tAat I am exempt imm t�e Coniractors State License Law lor t�e iNlaxinp reason
(Section 7031.5 Busineu anE Pmleuional COAe: Rny city of wunty whic� requires a permit m constmct, alter, impmve. �emolis�, or
repair any simcture. D��or to its issuance. also requires t�e applicam lor sucA permit ta file a signe0 sta�ement I�ai �e/sAe is IicenseJ
pursuant to ihe pmvisions ol the Contraclors' Stale License Law (ChaO�er 91�mmencing wit� $eclion 7000) ol Uvision 3 al ��e Business
ana Pmlesvons CoOe) ar Ilu� he/slie is exempt t�erelmm anG tAe Oa5i5 tor t�e alleqe0 exemptian. My vioWtion ol SeCtion 7031.5 Gy
any apDtiqnt lor a petmit suGj¢Cts Ille appliUnt to a civil penalty of not more Itun /ive �unOretl Edlars (5500�.
I, as awne� ol t�e pmpeny or my employees wiRl wages as t�eir sale comp¢nsation, will Oo ihe work, antl the
❑ slmcture is nol inlen0etl or ollere0 br sale (SecliOn 7(Wd, Business an0 Pmlessional Cotle: T�e Conlraciors' S�ate License Law
aces not aDUly to an owne� of a o�oDenY who builes or improves thereon, and wtlo tloes sutn vrork nim5elf/hersell or Ihmugh
�is or �er own emDloyees. provi0e4 Itut such improvemenis are not intend¢d or offered far Sale. If, however I�e �uilding or
impmvemem is sola within ane year ol wmvletion, tne awner will tuve �ne DurEen oi DrovinA he/she Oi0 nat �ui10 ar improve
lor I�e purpose ol ule�.
I, az owner ol I�e pm0erty. am e�clu5ively coniracling wiih licens¢tl conirac�ors lo conslmci I�e pml¢cl (Section 70Ad, Business
❑ ana Pmlessions Coae: The Conlractors State License Law tices not aOPly lo an owner ot DmpeM � OUIWs or Impmves Inereon
anG who fAntra[IS �or Sut� pfqetls vrii� a COnVaClor�S) li[Brtt¢ puRWni lo Ihe fAnlrattaR' Siate LitOnse Law). I am awafe
Ilut prool ol t�eir Worker's Compenution insurance s�oulG he pmvideE la me.
� I am e�empt untler Semion: B. 8 P. C.
lor ��is reason:
Date: Owner:
I do nere�y cenify Inal I am aware ol anU unAerstantl ihe requiremems of Calilomia Healtn an0 Salery Coae Sections 2550.5, 25533, ane
255JA ana Iha� I ar any lulure builaing occupan� willlwill noi (circle one) neetl to comply wilh saie Slate cotles antl Ihe requiremenis �or a
permil �or constmc�ion or mo0ilicalion �mm Ihe Air OuaOry ManaBem¢ni Oislnc�. Fe5i0en�ial [onstruc�ion appliwtions a�e eKempt �mm
meu omvisions.
Date: ApPlicanl:
I hereby cetlily Ihal I have reatl Ihis apPlication and slale Iha�t�e above iniorma�ionis torrect. lapree lo comply wilh allcity an0 coun�y
orainancesanAstalelawsrelalingloDuilAingconslmcliona�E aulhor¢ereD�esenla�iveSOl�Aiscirytoenteruponlheabove-mentionea
D�operly lor /in�sDeclion purposes. \
Oate: _' � � �'— I 2 Signature:
�riuer's �icense or Sociai Secudiy x: .
16<646 While—Builtling: Green—Cotle Enbrcemem; Canary—FpPlicanC Pmk—Revenoe; Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMI7' PERM NO; E 059016
PERMIT NO: E 059016 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE; ELE PURPOSE; OTH
JOB DESCRIPTION ; 400SF OFFICE T.I. SQ FT;
CLAIM VALUE: , CALC—VALUE: GROUP OCC: B-7 /
COMMENTS: RE: B59015 PRIMARY BLDG, PERMIT,
iE �F 3f iE iE 1E iE iE iF 1E iE if iEiF iE 1E iF 3E jF iF iE jE iE iF iFlF iE iE 1f iF iF iF 1E iF if it�k if iE 1E iE iE if iF iF iF iF if k iF iE iE If k fE !f k iliE if iE iE iE iE k 1E ik 1E ik if iE it if iE 3E N� IE 1E 3f
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAFt; FT IN FRNT; FT IN REAA; FT IN
LEFT; FT ZN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARltING RE • PROV; PARCEL; 41050104 ZNE; REF NO:
PLANNING N TES>
>
ikiFiFiE3EiEiFif�iFiEififiElElEiEifiFiFiEiEikiEiEiElEif3EiEiEif�kiei�iflf�IfiEiElEiEfPifiFkiE�ElfiEiliEiEiEkififiEitiEiEiti(� ilif�kiEiFiEiEiEikiFifie�EffiF3f
D'E V E L O P M E N T S,�E,R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY i:+ ATE;
�
BOILDING APPROVED BY : � �� � „q � DATE;
APPLICATION ISSUED BY
iElE 1Eif if 1E iE1E fE it iF 3ElFiE iE 1f 1ElE iElE iE
if iE iE it iF iE iE iF �E �E iE iP iE if �t iE iE �F iE if !E
LEGALIZATION;N
HLDG PMT
PERMIT
1F �E iE IF �E iFlE IE it iE iklE if iE iE iE iF if ik if �lE iF it iE �t7fif if 1F k iE �t iF iFlE it IE iE ik if # 3E �E IE 3E iE tE 1E 3F 3E iE iF �E iE if ib IF iE
F E E S U M M A R Y STRUCTURAL SEGMENT;N
PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
39503
SMSP/NON—RES
PLAN
ISSUE FEE 15,00
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 39,00 15,00 0,00 54,00 54,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 54.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FZAE SMIP/TOT GRADING PLAN—CHECK
54,00
if iE iE iE 3F iE iFiE iE iE iflE if �F iE ik fE iE 3f fE iE iFiE iF iE 3E ik iFiF iF iE iF ik if iE iFlE iE if ik iE if �f if iE iF 3F 3E if it 1f iFif iE iF iE 1E iE if if 1E iFif If 3f iE iF iF iE if it if 3F iE iF if if iF 9E
I N p I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
ELE 18 FIXTURES LIGHTING 1 ST 20
ELE 20 RECEPT/OLITLET 1 ST 20
ELE 5 RECEPT/OUTLET ADDITIONAL
ELE 11 RECEPT/SWITCH 1 ST 20
END OF FEES
EA. .75 15,00
EA, .45 2,25
EA. .75 8,25
Y
�. �13�..7..:���i-i�'��iR�:l"� 'i•—•��- �,,4,
OATF: �9!IS/9� ?Ii'E' i�:w�
l,
CONSTRUCTION AND PLANNING P� & SPA
- APPROVALS Permit# Oate Inspector qppROVALS Permit� Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ,-
2. Soil Pipe-Undrgrnd. ~ 53. Steel Reinforcement
3. Electrical Conduit Utitity-Undrgrnd. . 54. Forms �
4. Eiectrical Conduit�Undrgrnd. - 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electricai UFER�Grnd. 57. APPROVAL TO COVER-GUNITE
7: Footings , 58. Electrical Conduit�Undrgrnd.
B. Fo�ndation _ ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgmd. �
70. Structural Floor System � 61. APPROVAL TO DECK
11. Property Sewer line & House Connection 62. Backwash & Receptor-Fina� '
12. Sewer Cap , 63. Heater & Vent-Final •
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Piumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Efectric Wiring �L� !� �,� 67. Fencing & Access Apuroval
77. Rough Wirin9 Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling Q/�4 QZ R� 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning /�� FIRE DEPT. REQUIREMENT
20. Rough Factocy Fireplace - - APPROVALS Permit # �
21. DuCts,in Structure 70. Underground Hydro
22. DuMs, Ventilating . � " 77. Product Pipin� O Gas � Oil
23. Gas Pipe�Rough &�Test • 72. Underground Flush
24. RoofFraming • � 73._Undergmd.StorageTankOGas ❑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
i I
�29. Insulation � �. 78. FIRE PREV. FINAL -
30. Drywall Nailing I ' � NEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat � � � 79. FINAL INSP.ECTION
32. Electrical Power MeterFinal I ;,,;,.. � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � z Q,&!� Notes:
34. Final Heating & Air Conditioning � � I I '� ��
35. Final Gas Pipe�Test - � •
36. Hood or Canopy . � •
i
37. Final Factory Fireplace ' ' ' �
38. Final Plumbing � �� ' , '
39. Water Service-Final
40. Gas Service-Final I � �
47. Solar pomestic-Final • �
42. Backflow Preventer � � � .
43. Batkfiow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING '' �
49�. Electric Release to Edison •�
50. Gas Release to Southern California Ga: Co I � f
5•1. CERTIFICATE OF OCCUPANCY ,
No. Date '
wEuaoosess: 555 ANTON BL
OWNEN'SNAME: BANK OF AMERIr_A
nooness: 20 N RAYMOND AV
PASADENA
uxrt: 9
$18-578-7779
RXCN/ENGINEEH: ROY HERBOLD flEG.NO.:CiSO%j
aooeess ��072 CAMINITO VINO u"�'
LAGUN:4 HILLS CA 92653
PEflMITTEE: GOLDEN STATE FIRE PROT ( 714 ) 923-4060
aooxess: 936 E FRANCIS B
ONTARIO CA 91761
LICENSE� CONTBRCTOP UECIABATION: I hereby a0irm ��at I am IicenSeU untler provisions of Chap�er 9(commencing with Sec�ion
7000) ol Oivision 3 0l �he Business antl Pmtessions Cotle. and my license is in full torce and effect.
ciTruc.:10/y0�7649G sT^TEuc.:350225 —16
Oate:�J���7� Signature:�— —
WOPREBS' COMPENSRTION OECIAflAT10N: I llere�y a�lifm Iha� I nave� ceni cate oi consem m seli-insure or a certilicate ot Workers'
ComDensa�ion Insurance. or a cenilieC cnp t�ereof �Sec�ion 3800, Lab. C).
Poucrxo.: (92)PC9943�8 eav.oaTe: 03/O1/93
•omeaNr: REPUBLIC IND
`] Certilied coDY is her/eb�y Iumis�e0. � Cenified copy is fileA ' /�uil0ing �ivision.
�a�e: /v�� ! / � AOOlicanL v'V:%���
E%EMPIIONiBOMWOBNEflS'COMVENSRTIONUECLABATION: (ThissectionnettlnotEecampleleAillhepermitisfaronehunOretl(3100�orless�.
I cenity ��a� in the pedormance ol I�e work lor whic� tAis permil is issued, I shall no� employ any persan in any manner so as �o hecome
sublect lo Ihe Workers' Compensation Laws o� Cali�omia.
Date�. Signature:
NO71tE: II. after making t�is Eeclaration, you shoul0 become suble�� �o t�e Workers' Compensation pmvisions ot ihe Lahor
CoOe. you mu5i lotlhwrth comply wi�h such pmvisions or �his De�mi� shall be aeemed r¢voked.
CONSTflUCT10N LENOING AGENCY: I hereby a��irm I�at ��ere is a coretmclion IenAing agency br the pertormance of �he work lor
which �his Dermi� is issued (Sec�ion 3097. Civ. C�.
LENOEH:
AODPESS:
OWNEP BUIlOEN OECIAXRTION: I herehy aHirm �hal I am exemp� irom Ihe Contrac�ors' Slaie License Law for lhe following reason
(Seciion 7031.5 Business anA Protessional Cotle: Any ciry of counry whicA repuires a permit �o cons�mct, al�er, improve, Oemolis0, or
reDair any simclure. prior lo ils issuance, also requires Ihe apDlican� lor such permil to file a SiAned s�a�emen� thai he/she is licens¢tl
pursuam Ia Ihe pmvisions ol Ue Conlraciors' S�a�e License Law (Chap�er 9(cammencing with Sec�ion 7000) o� Division 3 0� ihe Business
an0 Pro�essions Cotle) or that he/she is exemp� ��erefrom an0 I�e basis lor Ihe alleged exemDtion. Any violation of Seciion 703L5 by
any applicanlfor a permi� sublec�s Ihe apDlican�Io a civil penalty of no� more �han �ive hunOreO Jollafs (5500�.
I, as owner ot t�e pmpeny or my employees wit� wages as iheir sole compensation, vnll Oo tAe wark, antl lhe
❑ simcWre is not inten�ea or of�ere0 for sale (Seclion 7044, Business an0 Pm�essional Cotle: TAe Contrac�aro' Slaie License Law
Ooes not appty to an awner o� a pmperty who Ouilds or impwves tAereon, antl w�o does such work himsel�/�erself or tNough
his or her own employees. pmvided ��at such impmvemen�s are not inlendetl or oflered �or sale. Ii, however [he DuilOing or
impwuemen� is SoIU wi�hin one year of comple�ion, Ihe owner will have �he burtlen o� Dmving helshe Oitl no� build o� imD�ove
for I�e pur0ose of sale�.
I, as owner ol ihe pmDe�Y. am evclusivel9 coniracting with Iicense0 contraclors to consiNct ihe pmlect (Section 7044, Business
❑ ana Pmlessions Go�e: T�e Conlrac�ors' S�a�e License Law Aoes not appry to an awner of pmperry who builas or improves thereon
antl who coniracts lor suc� pmlec�s with a con�racloqs)license Dursua9I to t�e Contracmrs State License Law�.l am aware
t�al O�oof of Iheir WOBer's Compensatian insurance shoWd 6e provi; tl to me.
.� I am exempl un0er Section: B. 8 P. C. .
lor �his reason: �
Da�e: Ownec
I tlo hereby cetli�y Iha� I am aware ol an0 un0er51an0 ��e requirements oi Cabfomia Health anJ Sa�ery Cotle Sec�ions 25505, 25533, antl
25534 antl I�al I or any �Nure building occupant will/will not (circle one) neeA lo compty wilh saitl sia�e cotles antl lhe �equirements for a
permi� for consimclion or motlilicalion Irom ��e Air Qualiry Managemen� �isVicl. Residen�ial con5imction apDlications are exemp� imm
these provisions.
�ate: Applicant:
I �ereby certity IAaI ihavereatl�his aDPlica�ian antl slale t�a� Ihe aboveiniormaiion is correci. I agree�o comply wiih ail city antl counry
ortlinancesantlstalelawsrela�ing�o�uiltlmgconstmctionantlhereb authari ativeS011hiSCily�oen�efuponlheaUOve-men�i0ne0
pmpetly lar inspection purposes.
�ate: `Q��� �/ Signawre�
oriver's License or Sacia� Securiry a: �- ___ __
164La6 Whue—Builtlino: Green—Cotle Enlorcement: Canarv—Aoolicanl; Pink—Revenue: Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; F 059568
PERMIT NO; F 059568 PLAN CHECK NO: 03969-92 L GOVT: N SUPP; N
CONSTRUCTION TYPE: SP PERMIT' TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : ADD 5 FIRE SPRINKLER S RELOCATE 10 SQ FT:
CLAIM VALUE; 1,875.00 CALC—VALUE; GROUP OCC: H-2 /
COMMENTS: REF: H59015
�*�r+��r�r*x�*� x*�*�**��x*�#***�****�*�*��**#�**�*����r�� *x*�*+��r�r�*���r����***���r��rx�*�*
Z O N I N G R E Q U I R E M E P7 T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCES50RY BUTLDZNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARitING REp • PROV: PARCEL; 41050104 ZNE; REF NO;
PLANNING Nf7TES>
.�� i
if iFlFiF 1FiElF �IF 1k �F �lf lf if� if IE iE 3F iF �f ik iE ik # if� if 1E 1f if if'lE iE iF iF iE iF'lF iF if if # if #�1E 1F iE iF IE ik iE ik 1E iFlF �k iE iF iF iE # IF �iE iF 1E 1f� 1E 1F iEiElF il�lFlf iE iF iC� !E 1E # iE
D E V E L O P M E N T S E R V I C E S R E Q U I k E M E N T S
20NING APPkOVED HY
DATE;
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY: L� DATE: �� (�'�.
iEiEiFiFifiFiF�Ei61E3Fik3fiEiEiE3FIhiE3Fit3EftiFiF3FiFiF3Ff�FiFiFi't i�tu�iFicil�ii ie'iFiFit��riFiti'rxyFTt3FiFiE�FfEiEiEiEi(-tfiEte n it #�IF
iE 7E �1f �F-16�3E iE iF 3E iE iE 1E iE if iEiE 1E iF it iF If• #!E iElf iE if� jE iEiE iE 1E iE �E IE �lE if iF it iF fE iF iE 1E iF 3f iE 3F if if iF if if'lf �kiE if iE if� �)P # 1EiE iF 3h �E iF iF�1FiE iE if �If iF iE iF iflE �!E
LEGALI'LATION:N F E E S U M M A R Y STAUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIFtE SMIP/RES GRADING
PERMIT 43�SS SMIP/NON—RES
PLAN 27.95
ISSUE E'EE
BUILDING—DIV—>� PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> � 43.00 0.00 27.95 70.95 70.95 .00
REVENUE DZVISION TOTALS--> COLLECTED; 43,00 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC F'IRE SMIP/TOT GRADING PLAN—CHECK
, 93,00
iE if fE ii 1E iF'IE iE �IF-%iE �� �1F1E �IE9E iF�� �1E iE iE �%� it it 1F iE �lt �1f iF 1E if 9F iE !E dF iE iEiF-IE if �1!-%if�i(� iE �%� 3E iElE iF1E if 9E )Ej69(�#�If 1Eitik iF�7E iF 1f �7f �1f iE'%iFiE iE 9E9f �1FiFlE �k �%-
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N tlNTT COST TOTAL COST
FIR 43 F'IRE EQUIP FEE (FROM BLDG VAL 'tABLE) 1,00 43.00
END OF FEES
_�
/.
i�
�
0! Q012'.;,'"C'.,1�},.;'j '"'�+ r ,;1,_
^qT�: 19;"+;r.. �,:,..r. .,'.
� CONSTRUCTION AND PLANNING�` P� & SPA
� Date- Inspector Date Inspector
� APPROVAIS Permit #� . APPROVALS Permit # ;� �
i.�Temporary Electrical Service�or Pole 52. Poo� & Equipment Location � .
2. Soil Pipe-Undrgrnd. �� 53._Steel Reinforcement
3. Electrical Conduit Utiliiv-Undygrnd. ' 54. Forms �
4. Electrical Conduit-Undrgrnd. � � - 55. Electrical Bonding
5. Steet Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footingt 58. Electrical Conduii�Undrgrnd. �
8. Poundation 59. Gas Pipe, O Undrgrnd., Test . .,%�-`
9. Water Pipe-Undrgrnd. ' ' 60. Backwash Lines, P�Trap, � Undrgrnd. .
70. Structurel Floor SYstem � i,� � 61. APPROVAL TO DECK ���,
1 t. Property Sewer Line & House Connection�' -; 62. Backwash & ReceptorFinal �
12. Sewer Cap . ' ' � 63. Heater & Vent-Final '!
73. Roof Drains � � 64. Plumbing System - Final +
74. Rough Plumbing � � 65. Electricai�Final �
15. Rough Electrical-Conduit � � � 66. Solar System-Final �
16. Rough Electric Wirin9 ' � 67. Fencing & Access Approval !
77. Rough Wirinq Sign 68. APPROVED FOR PLASTERING �
18. Rough Electrical�T 8ar Ceiling 69. POOL/SPA SYSTEMS FINAL !
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace ' APPROVALS Permit # ,
21. Dutts,in Structure � . 70. Underground Hydro �
22. Ducts, Ventilating 71. Product Piping �Gas OOiI ,
23. Gas Pipe-Rough & Tesi ,�, . 72, Underground Flush.
24. Roof Freming 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof SFieathing � 74. Overhead :w:;.=+ ib-�l.� '�.1�
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL b-fl(•4 Wy�
30. Drywali Nailing I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � i � 79. FINAL INSPECTION
32 Elecirical Power Meter-Final I I f 80. FOOD CERTIFICATE ISSUED
33. Final Electric � I �' � Notes:
34. Final Heating & Air Conditioning - � I
35. Final Gas Pipe-Tes[ - � I
36. Hood or Canopy ' �
37. Final Factory Fireplace I . I
38. Finai Plumbin9 � I ��
i
39. Water Service-Final � � �
I .
40. Gas Service-Final � � �
41. Solar pomestic-Final � i I
i
42. Backflow Preventer � i �
43. Backflow Irrigation -
� 44. Landscape Irrigation System .
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING � I
46; FINAL PLANNING I I I
49. Electric Release to Edison . �
i
50. Gas Release to Southern Califom�a Ga: Co I � i .
5*. CERTIFICATE OF OCCUPANCY
No. Date
�
�
I ��I
PflOJECT AOUNESS: S S J AN'i ON BL u"�T: 9
OWNEH'SNAME: H'f:UI{ Qr AyiBRICIi
RDOPESS: ZO v RAYN,OND AV
PASADENA
818—�78-7774
RflCNIENGINEEH:RUY HERBOLU AEG.NO.:CI�O%3
nooeess:22072 CAMS�ZTO VIN4 uxiT:
LAGJNA AILLS CA 92653
Pexminee p}ZN,SfRO.'VG CONSTRUCi lON ( 818 ) 967-8001
aooaess: g?g SPRiVG NaADOW !lR
WEST COVIt3A CA 91791
LICENSED CONTflFCTOB DECIABATION: I he�eby atlirm Ihat I am li[ensetl untle� Dmvisions ol Chapler 9(commencing with Sec�ion
70D0� of Divsion 3 oi t�e Business antl PmleStions Cooe. antl my lirense is in iWl larce anA effect.
cirruc.:05I6877 sTpTEuc.:434047 cuss:B�i
Date: ��i�_.. 7 Signature: �"—� ���
wOBREBS'COMPENSATIONDEClAM7lON: Inerebyatlirmiha Ihaveacertificateolconse osell-insureoracen�ficateolWofners'
ComDensation Insurance. or a ttrufie0 coOY �nereof I��tion 3800. Lao. C�.
-v xo.: P C 9 4 3 9 3� El(P. ORTE: O 1 I O S I 9 3
nraxr:REPt7BLIC TNJEM
U Certitietl coDY is hereby lurnishetl. � Cehi�ietl copy is fileU ilA Ihe ciiy Builtlinp ivi5i0n.
oate: �/�iIG, r? naoiicam: ��
ENEMPTIONFNOMWOBI(EBS'COMPENSATIONOELLFBATION: (Thi55eclionneeEnotb¢comple�tdi�ih prmi�i5loronehunOrea�SlW�orless�.
I rerlity �ha� in (he Oerlormante al Ih¢ work lor whiCh Ihis permi� is issu¢E, I 5�all nol empl0y any rmn in any manner so as to become
subjecl lo t�e Workers' CAmDensalion Laws ol Galibmia.
Oaie: SignaWre:
NOTICE: II. alter making t�is aeclara�ion, yau shoultl become suGject m the Workers' CamOensatian Drovisions of the Labar
Code. you musl fonhwil� comO�Y �^�� sut� pmNsions or iNs permit sAdll 6e AeemeA revake0.
CONSTBUCTION IENUING RGENCY: 1 �erz0y affirm tlut tAere is a consimction IenOing agen�y br t�e pedormance of tAe xroA for
wnicn Ihls permitis issue0 �Setlion 3097. Civ. C).
LENDEH:
nooness:
OWNEfl BUIL�EB UECLl�BATION: I Aereby a��irm I�at I am exempiJmm ��e Conlrac�ors' $tate LicenSe Law lor �he following reason
�Seclion 7031.5 Business ana Pmlessional Code: Any ci�y ot counry which reQuires a permii to consimct, al�er, imprave, demolish, or
reoair any siNtture. priar lo Ils issuance. also requires the applicanl for such permil lo lile a signe0 statement ihat helshe is licensed
pursuani to the pmvisions oI 1he Coniraclor5' State License Law (Chapler 9 �commencinp wiih Sec�ion 7000) ol Division 3 0� Ihe Business
h r ir m n h ba i � r �� all G x m lion. An violaiion ol Sec�ion 7031.5 6
and Pmlessions Cotle) or Ihal he/she is enem0� � e e o a d t e 55 o e¢ge ¢¢ p y y
any apPlican� �or a permil Subleci5 Ihe apDlican� Io a civil penal�y ol not more Ihan liv¢ hun�reE Aolla¢ ($500).
. I. as awner ol Ihe pmpe�y or my employees wilh waAes as iheir sole compensatian, wiil Oa the work, an0 t�e
stmcWre is no� intenGeG or aflerea far sale (Section 70aa, Buvness antl Pmtessional CoEe: T�e Coniracmrs' State License Law
dces no� apPly Io an owner o� a O�oOerty who builEs or im0�ove5 ihefeon, anA w�o Oaes such work himselt/licrs¢II ar IAmupA
his or her own em0loyees. pmvi0e4 I�a� such impmvemenis are no� inlen0etl a� ollere0 br sale. II, however �h0 Guilding or
impmvemen� is SoIA vnlhin one year ol'completian, the owner will have the burden o� O�oving �e/she Eitl not builtl or impmve
Ior ine ourpose of Salel.
i, as owner ol t�e propeny, am excNsiveI� coniraainp vnth licensetl contractors to wnsimct tAe pml�� (,�cibn 70CJ, Business
❑ antl Pmlessions Co�e: The Contraciors' Stare License Law Ooes not aDPly io an owner ot pmpeM �o buJas or imD��es t�ereon
ana who contracls lor suth o�ojecis witn a coniractorls) Iicense pursuanl to �ne Conlraclor5' State L¢ense Law). I am aware
Ihat proof of their Worker's Comoensalmn insurance shoul0 De DmviAetl lo me. .
� I am eKempi untler Sec�ion: B. 8 P. C.
mr mis rcason:
Date: Ownec
I eo hereby cenily Ina� I am aware ot antl uneerstana ihe requiremenis al Caiiiomia HeallA an0 Salety Cotle Sections 2550.5, 25533, antl
25534 an0 Ihai I or any INure Guilding oCtuDanl will/will nol (tircle ane� need Io tOmpty wilh 5ai4 Slale WOes and Ihe requirem¢nI5 �or a
permii tar consimclion or modilicalion �mm Ihe Air Oualily Managemenl Oistricl. flesiden�ial construction applica�ions are exemp� Imm
I�ese pmvlsions.
Dale: Applicant:
I hereby certity Inal IhavereaU ihis applicalion antl stale ihalihe a0oveinlormation is correcl.lapreeta comply with allci�y antl couniy
or4inance5ana51alelavrsrelalingloOuiWingcanSlmctionan0�ereby uginorizerepresenitivesolihisci�ymenteruponiheabove-mentioned
pmperiy loi inspe[Iion DurpOs¢5. �
��i�
Uaie: Z Signamre: L �T �
���wnne-e6vua�,=�����rva;
i6e1.¢6 "
C=TY OF COS'PA MESA — BJiLllING PF.riuI'f PEit�� NO: d C��L�S
PERMIT NO: B 059819 PLAN CHECR NO; N GOV'�'; Y SGPP; U
CONSTRUC3ION TYPE; 5P PERMIT TYPE; S'TR FURPOSE; AL'"
JOB DESCRIPTION : 1500Sr OFFICE T,i., PHAS� II SQ FT; a,500
Ci,AIM VALUE: 30,000.00 CALC—VALUE: 27,39U,OU GROUP OCC; B-2 /
COMMENTS: FOR PLANS r�E;3341-92A
#x ��r*+�:�+r�r��x�,t#�#xx�*�#���t*�+����e�***��E±r�##�r�t�#�tt�*�+t�urtu#xa##,t*#*t�*r.�#�� x�xx�*+�
Z O N Z N G R� Q U I R� M B N T S
S E T B A C h S
------------ N,AIN BUILDZNG ---------- ---^----- ACCESSORY BUILDING ---------
FRNT; iT IN REAR: rT IN FRNT; FT IN REAR; eT .IN
LEFT: FT IN RGHT: FT IIv :,BFi ; FT iN RGHT; F;' / IN
PARRING REQ: PROV;. PARCEL; 41050?04 ZNc: C REF NO; /
PLANNZNG NLSTEs> 1
D - {
iE-lf�if iE if iF'.E 3E �1f iF'r. 3i if iE H� ##?!� i4 ## iE ic iE # if if 3,F.k� ##!f iE �IF #�#?k if Sf ti� 1F !E �lf iE 3E iE �IFiE �k iE iF1f # iF 1F 3k �F 3F ik k ih if 1t ;F # 14 iE �:a�`!t f£ X� ii #'h # if 1f ii
D E V E L O P M E`N'. ;T_ S E R V I C E 5 R� Q U I R�: M B N T S
ZONING APPROVED BY -':." DA'TE;
BUILDING APPROVED BY ; DATE;
:; �,
A?PLICATION ISSJED BY • `: PJSI �— ilATE • `� S� S L.
itlEif�lFiE�ikiFiE3E-IE�EiEiFii�#fEX�ki6#if1E�x��a�i, xxir�rr:a�3Fx�rxiryr�rirx%xuxxxi�+rirx�xtrfrrr ��tFiEiFft##tfiF##ar -irx ax�-wrtiE?E
i! <iE�l'r i(� iE ie if iF if iE Y�!f ii iF # af if i41f if fElf #!{,�k sE k it IF jE �li� 3E 1E iF # if ;4. ic # it �E iE lflt 3E iE # iE 3i it ik it ic #%� fe iE #!E ii� iE # ie ih if #��)f ## ih iF iE±f K if iE iF
LEGALIZATION:N � F E E ,,S' U M M A R Y STi2UC1UHA_. SEG,v�:�VT;Y
BLDG PMT PLUMBZNG ELECTATC .YECHANIC riRE SMIP/R �' �'iRA'�';;,N�
PERMIT ?.71.50 , � � �
" SMIP/Nhta=,}2t�'; ~'j
PiAN �i'� '',' S' 75:. � �
ISSUti �FEE � ''�
BUILDING_DT_V—> PERMIT ISSUE P�.AId:�CHECK TOTAL PAID�� y�„� 'r� DTJE
TOTAiS > 277.25 0.00 N' 0.00 277,25 277,25 rf,00
.�
� /
�
REVENUE DiV�SION TOTALS--> Co'L;r,'��1cD• 277 25 OVEt7/SHORT� �'O
BLDG Ph1T PL'JMHIUG EL�:CTRIC �EEdAAIIC FIRE �SMIP/i'OT GkAUINCy.�P;�A — CI<
z�i.so .'i; 5.�5 , ��'�
ik if X-IF if #<�f �E?t+t it f! iE # fE iE if• iE iE iE iE?E ie fE iF # x� # iF ik # 3f i�,�4;1E�kit �E lF # iF K• iE �IF ##±F#?e it if # iE # K x%� ## i4 #�t it iF m it �(� iL,'�' �/�,�# if� k±E �:s
Z N D I V I D U A'L� � F t E B H E A K D 0 W N ������ � T
TYPE QTY D E S C R I P T I O N UNI't' COST �eryAL ,etj5.
r 7�., ,
SFC 1500 OFF—INT, ALTER TYPfi.I II F,R, —AVER 17.2�i '2'J,8G0'�40
SFC 1500 e. U—ALT COMM, SPtt �}3CL�R SY6 —AVER ,33 49�,00
SrC 1500 E�iU—ALT COMM. A��4,,�.�'�"��ND —AVER .69 1,035,00
ayiy� 0� t E�5 �
.r.�1 �
EXPIRED s
,� �i P!ete 4nsP�t� �S
� � -�-~ r:
�
r�
F
`
/ ,
. _ �
,�- � -
�
�c.�ONSTRUCTION AND PLANNIN(
APPROVALS Permit # Date
1. Temporary Electriral Service or Pole
2. Soil Pipe-Undrgrnd. .
�3. Electrical Conduit Utility-Undrgrnd.
4. Electrical Conduit�Undrgrnd. �
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation
9. Water Pipe-Undrgrnd.
10. StruMural Floor System �
11. Property Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains -
14. Rough Plumbing . �
15. Fough Electrical�Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign
78. Rough Electrical-T Bar Ceiling �
79. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Structure .
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
�z /�/
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & F,ir Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Fireplace
39. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final -
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
Date
0
�
A
� '_ & SPA
Inspector AppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPFiOVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgmd.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar SYstem-Final
67. Fencing & Access ApProval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Under9round Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
�' 77. FIXED SYSTEM FINAL
�ry�• 78. FIRE PREV. FINAL _
� HEALTH OEPT. REQUIREM
� � 79. FINAL INSPECTION
i 80. FOOD CERTIFICATE ISSUED
,
� � Notes: .�,2�� �..�i �
8
e
0
� . _ t :
� �.
i .� �
i_ -- ' - � " � ,..- ' --- -
0
Date I I
— AOP�icant to fill in all spaces except tnose witnin �eavy bortler Iines antl sign all aporopriata aeclaretions. �R �o(�S
CITY OF COSTA Sg., CON TRUCTIO PERMIT PER�fQIT N�.D D�� Ti AC�NO._ LOT NO.� UNIT NO. A P*, _ Zo�e
�S A���7%i FLoo,� /� ��CI lY 7✓ lb — b
Project Address _ S Main Building: Accessory Building:
Applicant'S Mai ing Addres TYPE OF CONSTRUCTION NEW AOD ALTERATION REPAIR E Z
��� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T Ffont - � p
Owner's Nam �_ honrP e DESCRIPTION OF WQ�1�f USE OF LDG. A Rear N
Address l�/�Fi/L��-i �—%1(.
Arch/Eng. LicenseNo. ' TVPEOFPERMIT GRADirvG LJ FOVrvDA7lorv STRUCTURAL K Right � G
Addre55 ❑ TENANT ❑ ELECTRICAL ❑ PLUM8ING ❑ MECHANICAL g� Left . R
Contractor's Nam� A%« S�1ac � pryo � -/ ❑�oTHER Ping. Ref. ;Y- Parking Req./Provided E
PROJECT DESCRIPTION 5c?. FT. oCCUPA v n
Address (mailing) _S� s�% �C� i i� �0O Planning Notes: ry�
City License No. 03.� / S��" �ONSTRUCTION TVPE VALUATION $�_
S T
20NE GRADINGCU.VDS. ACRE$ $,
LICENSED CONTRACTOR DECLARATION .
I M1ereby aHirm that I am licensetl untler provisions ot Charter 9(commencin9 Remarks:
with section �000) ot Division 3 0� the Business antl Professions Cotle, and
my license is in fuu force antl eftect. � - ,/' ELECTRICAL FEES
License Ciass LI %�� T�O �� L OOE�UOf�H %
/� PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
Datra 5�(S�� Signature
`RKERS' COMPENSATION DECLARATION Construction PoleSub. � 50+KW
reby attirm that I have a certificate of consent to self-insure or a wrtlficafe Bar Sink Showers
JJorkers' Compensati9,�+ Inz 5� y� a certlfietl c py thereof (5ection Cooking Unit Meter ❑up to 100 amps
� 3800, Lab. C.)(q/C� 6 6 J /� ^ Backflow Preventer . Service Sink
� Policy N ' Comoan;,(�r�q �M+� �< < Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps �
n BCe�tifiea copy is hereby furnisheG. Dryers ❑Gas ❑Electric Sub Panel
Ce t�ti wyy ' tiled wltn the <I q Di n�`�� Bathtubs Sewer Connection ' ��!
;� Date �� Applicant % /
V EXEMPTION FROM WORKERS COMPENSATION DECLARATION Clarifi¢fi Solar ColleCtOrs FdO Motofs OQ7 HP O1"h-- 8
(Thissection neetl no[ be completetl if Ihe permit is for one huntlretl ($300) or F.A.U. Ina Sola� �9�15 HP �16�15+ �
iess). � Dishwasher Solar Piping
I certity that in the performince ot Ihe work tor which this oermi( is IssueQ I Fiztures �
shall not employ any perzon in any mdnner 50 as t0 become 5ubjeCt to the DfinkiOLJ FOuntdi05 $Oldf TdOk MiCfOw3v¢ f�,
Workers' Compensation Laws ot California.
oate Siqnature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light ��.
NOTICE: If, aRer makin9 this tleclaration, you shoultl become subject to t�e Outlets �
Workers' Compensation provisions ot tne Labor Cotle, you must forthwith Floor Sinks Urinal Range ��
comply witn such provisions or Ihis permit shall be tleemetl revoketl.
CONSTRUCTION IENDING AGENCV Ga55erviCe OUtlets - WatefClo52t Switches Slgn �
1 hereDy affl�m Ihat there is a con5truction lentling agency to� the pertormanc¢
of the work tor which this permit is issuetl (Section 309� Civ. CJ �nterceptors Water Heater Garbage Disposal Standing Sections
Lentler's Name
�entler•s aatlress � Kitchen Sink ` Water Service Generator �0-5 KW �5-15 KW Trash Compactor
OWNER BUILDER DECLARATION -
I he�eby dffirm lhat 1 am exempt trom the Cont�actor's LicEnse Law for th¢ Lavatories AUtO-WeSh
following reason (Section 7031.5 Business antl Protessional Cotle: Any ciry or ,
county whlch requires a permit to construct, alter, improve, tlemoiish or repalr P—Trap Laundry Trays
any structure, pri0/ to its i55uance, also �equire5 tlte applicant tor such pe�mit
tR file a signetl statemen[ that he/she i5 licensea pu�suant to the p�ovlsion5 of ROOf Dfd105
�"�,'�. Contractor's License �aw (Chapter 9(commencing with Section ]000) of ' ,
"`-' � sion 3 ot the Business antl Prote55ions Gotle) 01 that be/she is ¢x¢mpt - � � RBinSpeCtiOl1 FBB $15 ISSuO F¢8 $$
�+�� `"'9efrom an0 the basis for the alle9etl exemption. Any violatlon of Section . .. �
%�3L5 by any applicant for d Pe�mil Subje<ts the aDP���ant to a civil
� �enalty of not more tM1an tive huntlretl tlollars (E500�. , 3 DEVELOPMENT SERVICES REQUIREMF�Nj$: n,.
LJ I, as owner ot the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ '(f�/'(,L� ,
' Compensation. will tlo the work, antl tM1e structure is no[ Intentletl or offeretl ZOning AppfOVBtl By D3tB
for sale (Section 7044, Business antl Professionai Cotle: The Contractor's . MECHANICAL . FEES Building Approved By A�fEG AD Date ��
License l.aw tloes not apply to an owner of a property wbo builtls or improves �� / 7 /� p
. thereon, antl who tloes such work himself/herself or through nis or her own ' Application Ittued By_ Date_s�_�a__� V�
employees, provitletl thal such improvements are not IntenOetl or offaretl for Boiler HOod o� Type I ❑ ���
sale. If, however, the builtling or improvement is soltl within one year of com- Canopy Type I I ❑ S�FEES
pletion,�the owner will have the �uraen ot proving he/she tlia not builtl or im- Duct - Under Ground
' n�ove far the purpose ot saie). BUI LDING PERMIT $ / C� SMIP $ •�%
❑ I, as owner oi'the prooerty, am exclusively contractin9 with Iicensetl con- Duct-Structural Refrigeretion System PLAN CHECK $.[�, 4_t PERMIT
traGtors to construct the project (Settion 7044, Busine55 and PrOfesslon5 Cotle: '
Tne Con(ra<tor's License Law does not aoP�Y to an owner of property who Duct � Ventilating ❑0.100,000 BTU ❑700,000 BTU _ PLUMBING $ �SSUANCE $
builtls or impwves the�eon, antl who contracts fo� such o�oiect5 witn a con-
tractor(s) hcense pursuanc to me Contractors License Law). I am aware that ExhauSt $ystem ❑ MWtiple ❑ System Repair/Alteration . P�N CHECK 25% $ ' ENERGV P.C. $
prooi oi [heir Worker's Compensation Insurance shoule be provitletl ta me, ELECTRICAL $ GfiADING $
� i am exempt untler Section e. & P. C. for this reason FirepUFact. BIL iC80 # Fire Oampers MICROFILM $
Date Owner Heating System & Ducting � Registers PLAN CHECK 50% $-
� P hereby certify that I have reatl this application antl state that the above ❑0.100,000 BTU �100,0006T MECHANICAL $ TOTAL FEE $�73_4 �
information rs correct. I agree to compty with all city antl county ortlinances PLAN CHECK 25% $
antl State laws relatin9 builtlin con5truction, and her¢by authorize repre- . ,
Sentatives Of thi5 cit • on Ihe abOve-mentioned O�oLpe-rtyp �fo'� �
insaecuo� . I O1 QOA29723—QD0297:0 T�.�lg ¢7�.'%�
Signature ' oate�l�
�rivers',License or 55 �
Rainsveceion Fee St5 Issue Fee � S 3 DATE: 04I03/$4 TIIiE: 11:J5
� 0865-46, rev. 5/BB White - Builtling; Canary - Ap011cant; Plnk - Accounting: Goltlenrotl - Assessor
/ .� .. . . . . .H.� . ♦ .. \ . 1 • . ♦. . l• _ . ' ' :
� `1�/��iJ
PC g SPA j
CONSTRUCTION ANDPLANNING .
APPROVALS Permit# � Date Inspector p�ppROVALS Permit# i Date Inspector
1. Temporary Electriral Service or Pole � -, 52. Pool & Equipment Location �
2. Soil Pi e�Undr rnd. ��.. ' �� '
P g -,7� ?1�' 53. Steel Reinforcement !
,
3.�Elec[rical Cond t Utility-Undrgmd. �"�l 54. Forms i � i
4.�Electrical Conduit-Undigrnd. �� � 55. Electrical Bonding � � '
5.�Steel Reinforcement ✓ � j 56. Rough Plumbing & Pressure Test ''' �I-
- r :'"� n
6• Electrical UFER Grnd. � ; �� 57. APPROVAL TO COVER�GUNITE � � ;
'7:� Footings � �S � i, ; - 56. Electrical Conduit-Undrgmd. � '�'�
S..Foun�lation " .'� � - � � 59. Gas Pipe, O Undrgrnd., Test �� j.=•
9.�Water Pipe-Undrgrnd. , - � 60. Backwash Lines, P-Trap, O Undrgrnd.
lp.'Structural Floor System , `. � 61. APPROVAL TO DECK
11� Property Sewer Line & House Connection �"• � 62. Backwash & Receptor-Final �
12:i Sewer Cap �. •' , �� 63. Heater & Vent-Final I
,:
13:. Roof Drains � _� ,� 64. Plumbing System - Final ,
14.�RoughPlumbing. � 65. Electrical-Final �
-15. �Rough Electrical-Conduit 66. Solar System-Final ;
l,fi• 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
�.
Y9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firep�ace � APPROVALS Permit # I
.Y7
21. DuCts,�fi Structure �, 70. Underground Hydro I
22. Ducts, yentilating t �i 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Teit �� 72, Underground Flush
24. Roof Framing ""," 73. Undergrnd.StorageTank OGas ❑Oil
..
25. Roof Sheathing � 74! Overhead Hydro•
��)
26. T-Bar �eiling (Structural) & Mohocoat 75. Dry Chemical
27.��rame and Flashing �, 76. Dry Standpipe �
28. Lathing & Siding " 77. FIXED SYSTEM FINAL
29. Insulation ~�' � 78. FIRE PREV. FINAL
30. Drywall Nailing :':j HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat F� 79. FINAL INSPECTION
32. Electrical Power'Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric V� Notes: � � I�T O
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 pomestic-Final , � /
42. Backflow Preventer i'� � �y '
.- •1;
43. Backflow Irrigation � ' � �
L` 'L'
l� / '
44. Landscape irrigation System -
45. Sound Attenuation , �
46. Handicap Regulations ' , �
�'
47. FINAL STRUCTURE & BUILDING � Z� I
48. Special Requirements Completed '
49. Electric Release to Edison '
^/ i
50. Gas Release to Southern California Gas Co �� ' r =��
51. CERTIFICATEOFOCCUPANCY �-�
No. Date . . � %
— �
Pfl0.1ECT RDOPE55: S S S ANTON � BL
OWNEfl'S NAME: B�K OF AMERICA
aooness: ZO N RAYMOND AV
PASADENA
uNir. y
81B-578-7779
AflCMIENGINEEX: ROY HERBOLD HEG.NO.:CSLO%3
nooeess: zZ072 CAMINITO VINO uxir:
LAGUNA HILLS CA 92653
PENMIiTEE: �MSTRONG CONSTRUCTION ( 818 ) 967-8001
noowess: gZg SPRING MEADOW DR
WEST COVINA CA 91791
LICENSED CONTNACTOfl OECLAMTION: I �ereEy attirm ihai I am IicenseC unGer pmvisims oi ChaD�er 9(tommencinq with Seciion
7000) oi Division 3 of IAe Bu5ine5s antl Pmlessions Code. anA my license is in Iuli lorce anA eileci.
CITY LIt.: Q rj 6$ 71 STRTE UC.:4 3 � 4 CIASS: B— .
'r.0yte: � Z��' S 2 _ Signai .
! W08REP5' COMPENSRTION oECIAMTION: I �ere6y ve a cenifiwte of consent to sell-insure or a certifiwte ot Workers'
Compensalion Insurance or a cenifietl wpy thereol (Section 3800, LaG. C).
Poucreo.:PC943935 E%P.URTE: OS/OII93
•omraxv: REPUBLIC INDEM
..] Certifietl coDY is �ereby tumisAeA. � Certilieheee ' fileG wt� the ciry BuilOinA a��on.
Q \
Da : ' �-'� ` / Z-- Applicanr �— •
E%EMPTION FflOM WOflNEPS'COMPENSATION �ECIAflA ssttuon neeOiwlbecompktetlili�e permitisforone hunOred�5100�orless);
I ce�i�y �ha� in t�e pedorman[e ol �he work lor which t�is permit is issuea, I shall noi employ any person in any manne[so as �o become
subiect to Ine Workers' Comoensation LawS ot Califomia. '' �
Oate: SgnaNre:
NOTILE: If. aiter making this aeclaration. you shoul0 �ecome subjec� to t�e WOM1ers' Compensation D�ovisions af9he Labor, s'
Code. you musl lotlhwith camply with sucA Orovisions ar lhis Oermit stwll Ge Eeemed revoked. r �j; �
CONSTPUCTION LENDING RGENCY: I hereGy allirm ihat Ihere is a cons�mc�ion lentling agenry �or the pedormanceA� Ne work ur
which inis Dermit is issue0 (Section 3097. Civ. C). .. ,��/
LENOEH:
aooAEss:
OWNEB BUIL�FP DECUMTION: I hereby attirm ihat I am exempt Imm ihe Cantractars' State License Law lor the foltowinA �easan
(Section 7031.5 Business and Professi0nal Coae: Any ciiy af county w�ic� requires a permit to consimct, alter, impmve, tlemolish, or
reDair any slmcture. prior lo ils issuance. also re0uires ihe appliWnt for such Dermii to lile a signe0 statemenl I�at �e/5Ae is licensed
pursuant to tne pmvisions ol Ihe Contractari Sta�e License Law �ChaD�er 9(commencing with Section 7000) of Oivision 3 0l Ihe Business
anA Pmlessions CAee) or tlWt Ae/s�e is exemp� ��ereimm anG the basR for Ihe alleA� ecemption. Any violation of Seclion 7031.5 Ey
any apDlitani for a permii SuUlet�S Ihe applican� la a Civil p¢nalry o� nol mor¢ ��an five hUnUretl tlollar5 �5500).
I, as owner of ihe Ompeny or my emyloyees mlh wages as tAeir sole compensalion, will Uo �ne work, an� ihe
❑ stmcmre is not intend¢G or oflere0 for sale (Secuon 70a4, Busineu anG Pmiessional Code: The Cantractars' Slate License Law
Ooes not apply lo an owner oi a Dmpeny w�o Euilas or im0�oves thereon, ana who Ooes suc� work himsell/herseli or ihrouAh
his or �er own employees, proNGeG t�ai such imDmvemenis are not inten0etl or oflereG br sale. Ii, Aowever the huiltlinp ar
impmvemem is so10 within one year ol completion. ��e owner will have ihe burtlen of pmWng �e/sAe Eid not Duiia or impmve
far t�e purpose ol sale�.
I, as owner o� t�e pmDeny. am eKciusively conVaciinq wi�� licensea comracmrs to consimct Ihe pmject (Section 7044, Business
❑ an0 Pmlessions CoOe: Tne Lontratlor5' State License Law Oces nol aD7N ro an ovmer of DropeM � hmltls or imD�� �hereon
antl who conVacls for suc� O�ole��s with a wntractoqs) license pursuanl �o �he Contractors' Siaie License Law�. I am aware
' that praot ol t�eir Worker'S Compensation insuran[¢ ShoWJ �e D��4e0 to me. �
� I am exempt under Seciion: B. 8 P. C.
lor �nis reason:
Da�e: Q�er.
I tlo hereby cenily tnat I am aware oi ana unaersiand �ne repuiremems ot Califomia HealtA an0 Safery Cotle Sec�ions 25505, 25533, an0
2553a antl ��ai I or any fuWre builtling oaupam wilVvnll not (cirUe one) nee0 to comDN wiih sai0 state coEes ana �he reQuiremen�s lor a
permil �ar cons�mc�ion or moailicaiion Iwm �he Air Oualiiy Managemeni Oislnci. Pesidential constmciion applicaiions are exemD� ��om
Ihese pmvisians.
Date: ADPlicani:
I hereby cer�ity�ha� I havereatlihis application antl statet�att�e above in�ormalionis correci. I agree lo comply with allcity antl couniy
orUinances and state IawS reWting lo buil0ing ton9mc�i n�uthonze represenlatives ot this city to enter upon t�e above�mentionetl
pmpetly lor inspection purposes.
�Bme: �2'� /� '— `7 2— Sign � v. �
�—
�nver'S License or Social S¢curily a: �/ _ __
i6at�d6 Whi�e—Buildmq: Green—Code Enb�cement; Canary—Applicanl: Pink—Revenue: Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 060278
PEAMIT NO: E 060278 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE: SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : 1500SF OFFICE T,I„ PHASE II SQ FT;
CLAIM VALUE: CALC—VALUE; GROUP OCC; B-2 /
COMMENTS; REF; B59819
+��t�t��r�t�t��e�r��e�e�e�t�r�e�r�e�r�r�rr�r���r�r**�e*�r�rxxx�r��r�r��r�r�r�r+r*�r�r��rx�r���r�r�r���r*��r*�r�rx�t*�rx�r�r�*�r�r
Z O N I N G R E Q U I R E M E N T S
ssrsAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT ZN
PL�KNINGRNO�'ES> PROV: PARCEL: 41050104 2NE; REF NO;
i
1! if 1EM iElflk k iF k iF ik if iF iF iF iF i! i! iF if 1FiF 1f iFiE if iE iE iF if iF iF iFiF�if if �E iF if iE if if 1E iFlE ikiEiE iEif if iE if if M if �f 1f Il�f 3FiF iF if �F iF k iE iF iF iE ik iE k if �F 1E 1f
D E V E L O P M E N T S E.R V I C E S R E Q 0 I R E M E N T S
-'y��
20NING APPROVED BY ' DATE:
HUILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY: � DATE: I�Z�
iF k iF M ik if MiF if it it it if iF if it ikiF iF if 1F k itlt k it 1E iE k ih �E if�iF{Fif 3f
iF M M M if iE iF iE iF M iF k ik iE i! M M iF ik k%if iF it it iF iF ik ik iF if i! iFlF ik iE iE iE if iF iE iE �f if M iE It M if if Ik iF �F M if 1E k k if k it iE iF iF If �F iF iE 1! iF �k IF 3f �F �F iF IE �f �f
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 20,25
—� SOt SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERHIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 20,25 15.00 �v 0,00 35.25 35.25 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 35.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHEC}C
35,25
:: .:
iliF if if it it ik�t iF if it Mit iF if if ik M it if if 1f if if itif k!f k it 1t �h 1f �f k iflk k ik �f iklt �F if 3f kif if 1t iF it if ikiF if it iFit MiF if iF if if iF iF it if if k 1F if k if if i! iFiF �F
I N D I V I D U A.L. F E E H R E A K D O W N
TYPE QTY D E S C R I P T I 0 N UNIT COST TOTAL COST
ELE 9 FIXTURES LIGHTING 1 ST 20 EA, ,75 6,75
ELE 12 RECEPT/O{TTLET 1 ST 20 EA, .75 9,00
ELE 6 RECEPT/SWITCH � 1 ST 20 EA, ,75 4,50
END OF FEES
n r - — _ . ' -
v��'_ . . � _ .
J
CONSTRUCTION AND PLANNING • PC & SPA �.
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Elec[rical Serv�c2 or Po�e. . 52. Pool & Equipment Location � '
2. Soil Pipe�Undrgrnd. '�.r 53. Steel Reinforcement
� �'Elgctr�a,Y_�'g�jj���i�ty-Undrgrn� . 54. Forms
r_4. Elcctriwt�octiimtWndrgrnd. -'[ 55. E�ectriwl Bonding
� .'
� 5�`�[�el Reln{or�ec_,zieb,Y g.t 56. Rough Piumbing & Pressure Test �
`, .,:ElectricaCtiF@R Fir:m. * 57. APPROVAL TO COVEfl•GUNITE
�_��Footirigs ^•'�`� = � 58. ElectricalConduibUndrgrnd.
��oundation i� _.; " _ 59. Gas Pipe, O Undrgrnd., Test -
9. Water Pipe�jlnd'p'md. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural�Floo� �ystem 67. APPROVAL TO DECK
1 i. Property Sev��r-L:'AF'& House Connection 62. Backwash & Receptor�Final
12. Sewer Cap .y 1 �� 63. Heater & Vent-Final
13. Roof Drains'� 64. Plumbi�g System - Pinal '
14. Rough PIumEStnq ' 65. Elecvical�Final
75. Rough �cvica`bConduit 66. Solar System-Final
i6. Rough �ectric�Wliring �Z �j. � U 67. Fencing & Access ApProval
�V
77. Rough iring S'tgn ' 66. APPROVED FOR PLASTERING
18. Rough Electric�;-T Bar Ceiling " L� �jy 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Contli:ioning FIRE DEPT. FiEQUiREMENT
-- - � a r�-�n- x Y _ ..� s
20.'�Rough F.3cto7� F}leplace � -' ,- � :' �T C - T � , .� PPR(iU S���er'mit # ' �" - --
D '� r �4 K � G�a' X�c. 7 r ^,i'
.�. ^i H •' Y I : - - . - . r _.:J .
21.=DuCts, i�;Structura. i .... _ � . ,. =`j0. 4lnderg�aelnd7Hydro
22. Dut25. VBntilatiny's f: ' F � � Q� - i. Product�i�Ai�9 Q`�s ��il
23. ,"tias;pipE�`�iou�h 8i �est � � " �`' � - � "
r . ti ��: ,: �J2. Undergiot�ra� Fle'u!r �
24.:RootFraming• .�fi �.-= ••T %' � `S73.GlJndergmcPStor�c�rrTank�lGasOOil"�='
25.Roo],SfVu[hing ��� � 'y' � ' - ;xS74{�Qverhead�lydro� �
26.�7-Bar Ceiling (Stnrcturail &•[Olonocoat '- r 75: Dry Chemical ?� � -:� c�.�
. t
27:'Frame a Flashi ` �D .� � � � Tu° j�5 � S : , : :l:
� �K _.F,� - .h 76. DryStandq�Qe _.,L � ;...H,r�
F 8.`Lathing. Siding��:� �G�� � _; " 77?FIXEOSY�STEl�I;F1NAL� _ ,� ""'
'29. �nsulati�i � C �• •. .. ' •( - „ •. - � - ,; i;
� .. �' ; � 78y:FIRE PREV. FIN?i - F �
J �Y •
,T30. Drywall:Nailing * � HE�ALTHDEPT�REQUIREMENT
r
�31. Plaster Biowp Coat'� .� ; i. ;. ': � � `. J9�'FINAL INSPECTIfST}; ,; - � � �'
',�J.32._�£IectricaJ;Poner Metef•Final �: *.` .�SO..�FOOD CERTIFIC.AT6ISSUED
� .., " n - . �J
._33.SPina,ElectriS : . ' � /�S� � * "Not'es:,�� .,;,4 �Q �'y�� �_ /�//.�, ��'
� � � �/�--VIiV �_ - "i-\
:�34.,�Finai Heaziny_& Air:�Condition�g� . �: �s .��.:v � y r^ x � ti
_ ,�
35:`,FinaIGaTPip'e-Test",,�; • , I �R _"-"-� � y` JS t r `�
F +. . . ..� � �.� .- .
,�36. Hood or�sl',anopy i. y � ;�. � g
_ _ ,� � :,�
S.. o . ,� C' �: c � c
',_37.�FinaF Faciory Firep;ace_, ,,
`38. FinaFPlumbing . .'� �x , " i �- . _
.:39. Water Service-Final' ' �' T • - � =
f � s 'j 1 . M •
;40. Gas Service-Final '. . s - _ a ,, : - .. ' .
zAt. Solar pomesticFinal.� r'�� � •• . - 2c' °�
�J 'fI :I. " K
� 42.-�Backflow Preventer; '`� ` � �'' '_ �
_ � � J
43. Backflow Irrigation`� � - � S ' ' -' " "� _ ,
r .0 . + � �
. �
,44. Landscape IrF�gatiop System ���� ,z �-a � ,� � ,: _i , .
�•A5.;'Sound Attewatiom -�-' • ' !^ Y �" ��� *
.. - � t L
'k6. Handicap,Reg4lations . ' ' ` � , �r � � 4 _ � : +�
47.�fINALSTRl9CTURE&BWLDING � � :. •
Y �'J
48.'EIN3aLPLAFfNING; �; ,;. _� ,'` . .i;
cA9..EleCtric Release to Edison i s� 5. s ' x
x .� � r
50.,Gas Aelease to Soufhem Cafi}omia Gas Co , � ' ` - . - � `� �
Y �� �_
.51. CERTIFICATE OF OCCUPANCY , - , : „ „ �• _ , -
No. Date
AOD���ant to fill in all spaces ecceD� thase wilhin �eavy CorGer Iines antl sign all avVroO��ato Geclarotions.
CITY OF COSTA MESA CON TR CTION P RMIT PERMIT NO. � TRACT NO. LOT �. U IT NO q,p, # Q���O �
vi
Pro[ect Address, C✓� � � � _ S Main Building:
E
A�licant's Maili Addren � T Front
Owner's Name ' hone B Rear
Address �S� � u 4 A
I C Right
Arch/Eng. License No. K _
Address
Contractor'sNam�u►1P2, 21�C -G Phone��3 7�7�/�7
Addreulmailingl-�^O SZ�G��A.. .S' i�-�N Fs,L G
City License No. �3 3% �/�
LICENSED CONTRACTOR DECLARATION
I hereby affirm t�at t am licensetl untler provi51on5 of Charter 9(commencing
with 5¢ction 7000) of Dlvizion 3 Ot the Buslne55 antl PrOf¢SSionS Cotle, antl
my licenze is in II for<e antl eitect. �� l� �
Licen eI'CI � ' •—T� -.i Ic ` 6
Date �+� �- ] cianat . .�.,L la �pa��i�
�RKERS'COMPENSATION DECIARATION
ereby aftirm tnat I have a certl(icate of consent to sel(-Insure or a certitica[e
,.� Workers' Compensation Insurance, or a cerflfietl copy chereof (Set�lon
3800, Lab/. C �
Policy Nu�, ��C 3� f f��' Company ���� AM: L.C�KL
eCertifieC copy is �ereGy (umishetl.
Ce�ti(ie� y s tlletl with the cityr B, n9 p�yJsion� QD
Oate Applicant (��
E%EMPTION FROM WORKERS' CO SATION DECLARATION
'(This sec[ion neetl not be completatl if the permit Is for one huntlred (y100) or
less).
I certify tha[ in [h¢ perto/manCO Of th0 wo�k f0/ whlch this p¢rm�t I5Is5uetl I
shall'not employ any person in any manner so as to become subject to t{�e
Workers' Compensation Laws of Calitornla.
Oate Signature
NOTICE: If, at[er making this tleclaratlon, you shoultl become subject to lhe
Workers' Compensation provisions of lhe Labor Cotle, you mu5t forthwlth
tomply with such p�ovl5ion5 or thi5 p0rmit Shdll b0 tle¢metl �evoketl.
CONSTRUCTION LENDING AGENCV
1 hereDy atfirm that there is a construction lentling agency for Ihe performance
of the wark for which this permil Is Issuetl (Sectlon 3097 Civ. C.)
Lentler's Name
LenOer'S Atltlre55
OWNER BUILDER DECLARATION �
I hereby aftirm lhat I am ezempt from the Contractor'S License Law for tne
followinq reason (Section 7031.5 Business antl Profezsional Cotle: Any city or
county which requires a Oermit to construtt, alter, Improve, tlemolish or repair
any sVucture, prlor to its izsuance, also requires t�e app11<ant for such parmit
-:+ (il¢ a sign¢0 slatem¢nt Ihat he/Sh¢ Is IlcenSCtl puf5udnt to tFle plovi5ion5 Of
'� Contractor's License law (Chapter 9(commencing with Section 7000) of
'+���,��ision 3 of the Business antl Professions Cotle) or [hat ne/she is exempt
`s�:i5erefrom ana the Dasis for Ihe allegeE exemD��e�• Any violation of Section
7031.5 Dy any applicant for a permit SUDjects the applicant to a tivil
�enalty of not more tnan five nuntlretl tlollars (5500).
I, as owner of the property Or my nmployee5 with wages as th¢ir sole
compensation, will tlo tho work, antl the structuro is not inlentletl o��ofteretl
for wle (Seclion 7044, Businass antl Pro(e5sional Cotle: The Contractor'S
License l.aw tloes not apDly to an owner ot a property who builtls or improves
thereon, ana who tloes such work himself/herselt or throu9h nis or her own
employees, provitletl (hat such imprOvemenls are nOt IntenOetl or offeretl for
sale. II, however, the bulltling or improvement is soltl wlthin one year of com-
ple[ion, the owner will have tha burtlen of proving he/she tl10 not builtl or Im-
�rova M�the purpose olsale).
I, as qwner of the proPerty, am exclusivaly contracting with Ilcensetl ton-
tmctorsto construct the project (Section ]044, Buslness antl Protesslons Cotla:
The Contractor's License Law does no[ apO�Y lo an owner of property who
builtls ar'imoroves thereon. antl who contracts lor such oroiects wlth a con-
tractor(!�hcense pursuani to �ne ConVa<tor'S License Law). I am aware that
proof o their Worker's Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untler Saction B. & P. C. fOr tnls reason
Date Owner
1 hereby certity that I have read this application antl state tbat the above
information is correct. I agree [o comply wlth all city antl county ortlinances
antl state laws relating to builtling tonstruttion, antl bereby authoNze repre-
5lntdtives o1 thls t up0� th¢ dbOve-TentiOnetl ploperty fof
inspectlon
Signature Date ���
Drivers' License or 55 � �
r3�,-j� 2 I SO
TVPE OF CONSTRUCTION NEW AD� ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTIONOFWOtiK/USEOFBLDG. - -
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
( ❑ OTHER
PR0.IECT DESCRIPTION SQ. FT. � L OCCUPA Cv
CONSTRUCTIONTYPE�.a.tiN4�— VALUATIONS�
ZONE G ADINGCU.VDS. ACRES
Remarks: � `�.N-� L1� �
�rG
Bar Sink
Backflow Preventer
Backflow Irrigation
Drinking FOuntains
Floor Orains
Floor Sinks
Gas Service .Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspeaion Fee I $15
Boiler '
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFact. Blt. �CBO �k
Heating System & Ducting
❑6100,000 BTU � 100,000 BTI
Reinspectian Fee $15
0865-46, rev. 5/88 White - Builtlin9; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor
i
Showers
Service Sink _.
Sewer (:ap °�
Sewer Connection
Solar Collectors
Solar Pipina .
Solar Tank
Swimming Pool w
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
laue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
Sysrem Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
FEES
$ 3
e
Ping. Ref. #
Planning Notes:
� , , YW�lY��
— . : . • _
�
—
�'
� � � � � �
L��/���� //LJty�I�L�..�.��
i"G2�!�L' :._�,�1 [9C//.I.��,
ELECTRICAL
Automatic Washer Tiansformer ❑ 15-SO KW
Constructlon Pole Sub. � 50+ KW
Cooking Unit Meter ❑up to t00amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Electric Sub Panel �
Fan Motors �0.1 HP �1 h- 8
F.A.U. ' Inc.Solar �9-75 HP �16-15+
Fiztures Microwave
Device Boxes Pole Light .
Outlets Range '
Switches Sign
Garbage Dispoul Standing Sections
Generator 00.5 KW �5-15 KW Trash Compactor
, � Reinspection Fee � $15
DEVELOPMENTSERVICESHEUI
Loning Approved By
Building Approved By
Anolication laued Bv
laue Fee
FEES
$ 3
SUMMARV OF FEES
� BUILDING PERMIT $ , � I Z�c7 � SMIP $ ��
PLAN CHECK $ PERMIT
PLUMBiNG $ ISSUANCE $
. PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL 5 TOTAL FEE $ �
, PLAN CHECK 25% $
Q1 00029445-�0024446 T�'Y' . 12 a,25
GRiF: C31�9/E9 TIME: 23:1y
. . . . . . � . .. . . .. Y. Y�r1 1 . �.. V • ♦ • • ..n
.i t,1 `,:
� P & SPA
'.� • COpISTRUCTION AND PLANNING �.
� dPPROVALS Permit# Date� Inspector AppROVALS Permit# !Date Inspector
,1. Temporary Electrical Service or Pole � ,:� 52. Pool & Equipment Location '�� ��
2. ,Soil Pipe-Undrgmd. , ��.� � � ',� 53. Steel Reinfoxcement �5���
3� Electrica� Conduit�Utility-Undrgrnd� 54. Forms � �r"
�
4!Electrical Conduif�Undrgrnd. ' S5. Electrical Bonding ' ,�)
5� Steel-Reinforcement ,�. • 56. Rough Piumbing & Pressure Test �� ��
Y
6- Electricel UFER Grnd. �-� � 57. APPROVAL TO COVER�GUNITE � �i�i
7i� Footings �'_ � �,`� 58. Electrical Conduit-Undrgrnd. �
8: Foundation .� � '. � � 59. Gas Pipe, � Undrgrnd., Test i "'-?
9` Water� Pipe-Undrgrnd. n� -• 60. Backwash Lines, P-Trap, O Undrgrnd. �
10 Structural Floor System `: � � ,�1 61. APPROVAL TO DECK �'
11,� Property Sewer Line�& House Connection • - I 62. Backwash & Receptor-Final �
i
� 12. Sewer Cap �� _' � h �. . 63. Heater & Vent-Final
73r�Roof Drains !�'i ' , '.I 64. Plumbing System - Final � �
14. RoughPlumbing. •� � 65. Electrical-Final '
i
15. Rough Electrical=Conduit 66. Solar System-Final �
�6. Rough Electric Wiring 67. Fencing & Access Approval �
17. Rough Wiring Sign "- 68. APPROVED FOR P�ASTERING �
d8. Rough Electrical•T Bar CeiGng 69. POOL/SPA SYSTEMS FINAL �
79•. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace "' APPROVALS Permit �
s
� 21. DuC[s, in Structure . �� 70. Underground Hydro
--�22. Ducts, Ventilating �,� �;T 77. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Teit �� 72. Underground Flush
24. Roof. Framing � �� 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame�and Flasfrirtg ^ � � 76. Ory Standpipe
V2S. Lathing & Siding �,; ;� 77. FIXED SYSTEM FINAL
29. Insulaiion �' � 78. FIRE PREV. FINAL
.K
30. Drywall Nailing �, �, � 3 1i Q HEALTH DEPT. REQUIREMENT
3L Plaster 8rown CcjaI��^ -`--� ;,� 79. FINAL INSPECTION
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
.
^ J ��
33. Final Electric ti-� � Notes: � �� � 1�
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
� 36. Hood or C`iiopy
'37. Final Factory Fireplace
38. Final Plumbing � -
39. Water Service-Final ; , '
40. Gas Service-Final � ���
�41. Solar pomestioFinal ' - •
i '
42. �Backflow Preventer �� �
43. Backflow Irrigation_-' � � • '
44. Landscape`Irripation System �� �� �: ' �
45. Sound Attenuation ����
�
46. Handicap Regulations - � �
� 47. FINA�LSTRUCTURE&BUILDING � � i
48. Special Requirements' Completed �
� ,49. Electric Release to�.Edison '✓ �� I
� � i •
i .� ,. �
�50. Gas Release to Southem �alifornia Gas Co '. . �
r � � ,
51.iCERTIFICATEOFOCCUPANCY ,�, , ��
�
No. Date " .`
��
Applicant to fill in all spaces except those within heavy bortler linas anE sign all appropria[e Eeclaretions.
CITY oF Co�s!"n �MESA CONS'CR�CTIONPE�M�,T �
ProjectA�ress �55 Q�j�r� `� ���%a _
Applicant's Mailing Address � g S� U '��-%-�.� ��S %�f%4"
Owner'sName �L`q� ��2�P'� Phone
Address � ^-N�
Arch/Eng. License No.
Address y��
Contractor's Nam ��`� P/I/1,o�n�e� Z���� �� ��`�
Address (mailing) y � a u�r �. ^�
City Licenu No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm [hat I am licensetl untle� prOviSiOnz o( C�arte� 9(commentlnq
with section �000) o( Division 3 ot the Business antl Professions Cotle, antl
my license is in tu❑ rce tl f(ect. a`
license flass � �� ^ �se No.� 1 `Z' I
Date �"��I�RO� ce�ar ..
� �RK RE 5'COMPENSATION DE RATION
:reby affirm that I �ave a ce�tificate ot consenl to self-InSu�e o� a certificate
. Workers' Compensation Insurance, or a certlt tl copV tM1ereof (Sectlon
3800, Lab. CJ ` /� •/ � �/ f –,N „ y/-� -^
L�� � Fir O .r+aa KJFi..� � �,i�
Policy No.YG�" Comoany
nyp_C rtifie m isherebyfurnlshetl. (�
/� cer i cop 'letl with the city Bui�9 i .
Date � y Applicant - ' .
EXEMP ION ROM WORKERS' COMPENSATION DECLARATION �
(This sec[ion neeA not be completetl if the permit is tor one huntlretl ($100) or
less). :
I certi(y that in the pe�to�mance ot the wo�k for whlCh thl5 pe�mit i5 is5u¢tl d:
shall not employ any person in any manner so as to become subject to t{�e�
Workers' Compensation LawS of Califomia. `�
�ate Si9nature
NOTICE: If, after making this tleUaratlon, you shoultl become subject to the
Workers' Compensation provi5ian5 of the Labor Cotle, you must (orthwith
comply ,with such provisions or tnis permit shall be tleemetl revoketl.
CONSTRUCTION LENOING AGENCV
I hereby affirm that there is a constructlon lentling agenty for the performance
Of the work .for which this Oe�mit is issuetl (SeGtion 3097 Civ. C.)
Lentler's Name
LenGer's AtltlreSs �
OWNER BUILDER OECLARATION
I hereby affirm lhat I am exempt from the Contractor's Llcenze Law for the
followin9 reason (Section 7031.5 Business anG Protes5lonal Cotle: Any city or
county which r¢qui�es a permi[ to con5truc[, alteq ImprOv¢, Oemoli5h O� �epai�
any structure, prior to its issuance, also requires the applicant for such permit
� tile a siqnetl statement that he/she is licensetl pursuant to the provisions of
Contractor's License Law (Chapter 9(commencing with Sectlon 7000) of
ision 3 of tne Business antl Professions Cotle) or that he/she is exempt
.eretrom antl the basis for the allegetl exemption. Any violatlon of Section
�, 7031-.5 by any applican[ for a permit suDjecls the applicant to a civil
',I�enalty oi not more than �ive nuntlretl tlollars (5500).
�J I, as owner of the p.operty or my employees with wages as thelr'sole
compensation, will do the work, antl the structure is no[ intentletl or ofteretl
for sale (Section 7044, Business antl Protessional Cotle: The Contractor's
License Law tloes not applY t0 an owner Of a prope�ty who bulltl5 or imp�ove5
thereon, antl who tloes such work himself/herzelf or through his or ner own
emo�oyees, provitlea that such improvements are not intentletl or offered (or
sale. If, howev¢r, Ihe builtling or Im0/oveTent i5 SOItl within one year of Com-
pletion,.the owner will have the burtlen ot provin9 he/she ditl not builtl or im-
prOve for tne purpose of sale).
❑ I, as owner oi the property, am exclusively contratting with Ilcensetl con-
tractarsto construct the project (Section 7044, Busine55 antl Professions Cotle:
The Con[ractor's License Law tloes not appry ro an owner ot property who
builtls or impwves thereon. antl who contracts for Such oroieCtS witn a ron-
tractor�s) license pursuani to me Con[ractor•s LicenSe Law). I am aware that
proot oi their Worker's Compen5ation insurance shoultl be provitletl to me.
❑ I am exempt under Section B. & P. C. for this reason
_.._ _ g0 / C7 _" �
TYPEOFCONSTRUCTION NEW ADD ALTERATION R
❑ CONVERSION ❑ DEMOLISH OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LI GRA�ING LJ FjDUNDATION LJ STRVCTURAL
❑ TENANT ❑ ELECTRICAL jr; LUMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION Sc7. FT. oCCUaArvCV—
CONSTRVCTION TVPE VAIUATION $
ZONE GRADING CU. VOS. ACRES—
Remarks: � � qy�
Sink
Preventer
Irrigation
Drinking Fountains
Floor Orains
Floor Sinks . .
Gas Service Outlets
Interceptors
Kitchen Sink
Lavamries �
P–Trap
Roof Oreins
Reinspection Fee � $15
Duct - Under Ground
Duct - Structurel �
Duct - Ventilating
Exhaus[ System ❑ Multiple ❑
Firepl/Fact. BIt �CBO #
Date ' Owner � Heating System & Ducting
I hereby certity inat I have reatl tnis application antl state that the above ❑6100,000 BTU �100,0008T
information is wr ect. I agree to comply with all city antl county ortlinances
antl State laws r ti builtling con5tructlon, dntl h¢�¢by duthorize r �e-
sentatives Of t 5 c ter. u on the abOve-mentlonetl p� pe�t ,fo��
inspection purp s � p , , 5 p� Y XI ' ' . '
Signature Date `� � ,
Drivers',License or 55 � . � Reinspection Fee
0865-46, rev. 5/B8 White - Builtling; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Asse55or
$15
PLUMBING
Showers
Servite Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
YWater Heater
Water Service
Au[o-Wash
laue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeretion System
❑0.700,OOOBTU ❑100,OOOBT
SVstem Repair/Alteration
F ire Dampers
Registers
Iasua Fee
FEES
.P #
S Main Building:
E
T Front
A Rear,
C Right
S . Left
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction'Pole Sub.
Cooking Unit
�IS�IW25hEf ��;
Dryers ❑Gas._�Electric
Fan _��
F.A.U.
Fixtures �'�
Device Boxes
Outlets
Switches
Gar6age Disposal
Generamr OO-5 KW �5-75
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Trensformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Matars � 41 H P � 1%- 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light '
Range
Sign
Standing Sectionr
I Trash Compactor
Fee �$15 � � luue Fee
$� DEVELOPMENTSERVICESREQUIREMENTS:
Zaning Approved 6y
FEES BuildinB APProved By
Appliption Issued By
$ 3
. SUMMARV OF
BUILDING PERMIT $
PLAN CHECK $ —yc—
PLUMBING $ �� V V
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
FEES
$ 3
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $
TOTAL FEE $ �� ��
O
N
I
N
G
R
E
Q
M
T
$.
01 ORA24502-000295�2 7'OT . 7„�'j�?
DA7E: 03/30/89 TIME: 10:04
. ��� � \ / �
, COf�STRUCTION AND PLANNING e' . P� & SPA i
A`PPROVALS Permit# Date �Inspector ' p�ppROVALS Permit# � Date Inspector
' v_ �..
, 7'a Tempora�y Electrical Service or Pole` _ �� 52. Pool & Equipment Location ,
.
� �. �oil Pip�,-Undrgrnd. ` - � _� 53. Steel Reinforcement �'
�d Electlical Condu i Utility-Undrgmd. � f-- 54. Forms �. �
4'.lElectri�l Conduit-Un grnd. 4� n 55. Electrical Bonding %i
5� Stee� R�nforce�ent (� 7 � 56. Rough Plumbing & Pressure Test �
� Ele`c(rical UFER`G�rid. � 57. APPROVAL TO COVER-GUNITE � b
�_ �-. �.._. .2 .s. `
7� Foouangs _`-� � . 58. Electrical Conduit-Undrgrnd.
8. �ou` dation � j `� `�, 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undwgrnd. j -�3��� 60. Backwash Lines, P-Trep, � Undrgmd. ' !
10-S�iuctural Floor System ��`� 61. APPROVAL TO DECK
' 17. PropertySewer L�ine-& HouseCo'nnection �M �' � 62. Backwash�& Receptor-Final .
;- =� - r.-
1�2 �,Sewer�Cap �. `,� r ,7 63. Heater & Vent-Final j•
� u ic/
13' Roof Drains �� � .�'1 64. Plumbing System - Final �1'.'•
14. Rough Plumbing� � s� L� 65. Electrical-Final i �
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval I
�t�`/. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
I
j18� Rough Electrical-T Bar Cei�ny 69. POOUSPA SYSTEMS FINAL I
r9. Rough Heating & Air Condiiioning FIRE DEPT. REQUIREMENT �
n I20: flough Factory Fireplace �J.) APPROVALS Permit#
. �
�21. Ducts, in Structure `� � �
r,,, , 70. Underground Hydro �
22. Ducts, Ventilating p �71. Product Piping � Gas ❑ Oil �
23. Gas Pipe-Rough & Test � 72._Underground Flush i
� 24; Roof Framin� �- 73. Undergrnd.StoiageTank OGas OOiI
� .25�RoorSheathingf .. � . :X � � 74. Overhead Hydro ' � , �
'� ' �
26. T-Bar Ceiling (Struc4ural) & Monocoat,- ,� 75. Dry Chemical -
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding' 77. FIXED SYSTEM FINAL
29.�Insulation 78. FIREPREV.FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31�. Plaster Brown Coat � 79. FINAL INSPECTION
�132. Electrical Power Meter-Final �J 80.L,�OOD CERTIFICATE ISSUED
� ,
; 3� Final Electric � Not�s:
34. Final Heating & Air Conditioning
35. �Final Gas Pipe-Test �
36. Hood or Canopy ' „ j
37. Final�Factory Fireplace �
,
38. Final Plumbing (,�/�� �G�' �p '
i
39. Water Service-Final ._ , _ i.,_ _ _ _, . - � • � � - 1 ' '
.y _ . � .... :- .. . .
40. Gas Service-Final� !
41. Solar pomestic-Final � �� � �
42. Backflow Preventer �-f i
i i
43. Backflow Irrigation - � �� ;
44. �Landscape Irripation SYstem � �
45. Sound Attenuation �.�
;
46. Handicap Regulations -� ;
47. FINALSTRUCTURE&BUILDING '
i
48. Special Requirements Completed ' '
49. Electrie Release to Edison �
i� i�.
50. Gas Release to Southern California Gas Co �� � � �
51. CERTIFICATE OF OCCUPANCY � �•�• "
No. Date �"
�Y' .
AVVlicant to fill In a1l soaces exeeo� those within neavy eoraer Ilnes ana sign a1l appropriate tleclarations. /� S/ �
PE M T NO. TRACT NO. LOT NO. UNIT NO.
CI7v OF COSTA MESA CONSTRUCTION PERMIT 3 Q � A,P. qW Zoo,
Project Ad ress Ss� �NTO.0 .C�G(/.� _ S Main Building: Acceuory Building:
��f r TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
Applicant ST]f2Tfinj Addt25f-+ p� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � T Front �
Owner's Name �Gv 's"4' � PhoRt'� DESCRIPTIO WO K/USE OF BLDG.�����QS����'-'��_ B Rear N
Address ��f ,�� l%/. J,!�Gt/.6 CGtfr /,Y�/F i�'�/���l� , A I
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL C Right N
Arch/Eng. License No. I K. Left G
Add��Cv�/55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANICAL S
� f�� �.�L{/%lGil/`/� �j � �� ❑ �OTHER fl
Co t or s m ���� Pho y�S7/ , Ping. Ref. # Parking Req./Provided E
PROJECT �ESCRIPTION SO. FT. OCCUPANCV 4
Address (mailing) �zl ���AC�_ .4.!/��tJ .Gi �./�t! Planning Notes: M
CityLiCenSeNo. �� 5v/.3 �/2d� CONSTRUCTIONTYPE VAWATION$
ZONE GRADINGCU.VDS. ACRES '� T
LICENSED CONTRACTOR �ECLARATION S'
I nereby allirm that I am IlcePsetl untler provislons of Cnar[er 9(commencing Remarks: � �
with Section ]000) of DlvlSitln 3 0( the Bu5ine55 antl PrOfeS51on5 Cotle, antl
my Iicense is in tuu torte antl e«ect. ' _ `v/T � ELECTRICAI FEES
License Class � License No��O�%�� ' �
oateQ- 7�iCi 5iqna PLUM8ING FEES Automatic Washer Transformer ❑ 15-50 KW
RKERS' COMPENSATION D LARATION � ConitrUCtion PoleSub. � 50+ KW
reby a/tirm that I have a cCrtHicate oi consent to self-Insure or a certiTicate Bar Sink Showers
. Workers' Compensation Insurance, or a certifiea copy Ihareot (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
\ 3800, LaE. C.) //
Policy rvo � zD/'��/Y Q- Company 65.6✓ � Dishwasher Meter ❑over 100am s
� !{/ AT— r Backflow Irrigation Sewer Cap P
��Certifietl wpy i5 here�y fW��sheU � Dry¢lS ❑Gas ❑Elect�ic Sub P2nel
Cer�Ctie�tl cop is filetl with th ty B iltling � tsion. 82thtub5 Sewer Connecti0n
Date ""L ��' Ap �<ant -. Fan
Motors O0.1 HP � 7'f. - 6
EXEMPTION FROM WORKERS' COMPENSATION OECLARAT ClefifiEfS $olaf ColleCtofs
(This section neetl not b¢ COm{��et¢tl it the pe�mlt 15 to� One huntlred E 00) or F.A.U. Inc. Solar 09-75 HP �16-15+
. iess). Dishwasher Solar Piping
I certify that in th¢ performaPce of the wo�k fOr which thl5 pe�mR i5 issuetl, I ^ Fi%tu�ES
shall not employ any peROn �n eny manne� so as [O betOme Sublect to the Orinking Fountains $Old! Tdnk � MiC�OWdV¢
Workers' Compensation Laws o� California.
oate Signature Floor Dreins Swimming Pool w/Spa 'J Device Boxes Pole Light
NOTICE: 11, after making [his tleclaration, you shoultl become subject to the
Workers' Compensatlon O�ovisions of the Labor Cotle, you must forthwith FIOo� SinkS U�inal Outlets RangC
comply with sucn provlsions or tttis permit 5ha11 be tleemetl revoketl.
CONSTRVCTION�LENDING AGENCV '- Gas$2rvice Outlet5 WetelCloSet SWitCheS � Sign
I hereby aftirm tnat there is a Gonstruction lentling a9en<y for t�e pertormance
01 Ihe work tor which th�s Oermit is issuetl (SeGtlon 3097 Civ. CJ Interceptors Wat2r Heater GOrbage DispOsal Standing S2ction5'
Lenaer's rvame Generator 00.5 KW �5-15 KW Trash Com acror
Lentler's Atltlress Kitchen $ink Water Service P
OWNER BUILDER DECLARATION
I hereby alfi/m lhat I am e%empt trom the Contrdctor'S LiC8n5e Ldw f0f the LdVdtOfiCS AUtO�WdSh
tollowing reason (SecUon 7031.5 Busine55 antl Profe551onal Cotle: Any tlty or
county which requires a perm�t lo construct, alteq Improve, demolish or repair P—Trap Laundry T�e'ys
any structure, priOr to its is54ance; a150 require5 the applicant ior Such permit
^.file a si9nea statemenl tha� he/she is licensetl pursuant to the provisions of Roof Drains
"� Contractor's Litense Law (Cnap[er 9(commencing wi[h Sectlon �000) of
r�;�"Asion 3 o( tbe Business antl Professions Cotle) or that he/she is exempt . Reins eetion Fee
N��itiretrom antl the ba5is for [he allegetl exemption. Any vlolation of Section P $15 luue Fee $ 3
� 7031.5 by any applican[ Por a permit subjects tne applicant to a civil
eenalty oi not more tnan tive nuntlred tlonars (5500). � $ 3 DEVELOPMENT SERVICES REDUIREMENTS:
LJ I, a5 owner of [he prop8rty Or my employee5 wlth wagas a5 their sole RBinSpBttion f¢B $15 ISSUB FBe
compensation, will tlo the wbrk, antl the structure is not Inlentlad of offeretl 2oning AppfOved By DdtB
tor sale (Section 7044, Buzi�ess ana Pro(essional Cotle: The Contractor's MECHANICAL FEES Building APP�a"ed By Date��r_
License Law tloes not apply to an owner of a property who builtls or improves
� thereon, antl who Ooes such wo�k himzelt/he�581f or thrOugh hI5 or h¢r Own ApPlitltiOn ISSUed By ^ Det�iQ ��
¢mployees, provi0etl [nat SUGh �mprOvements are nOt intentl¢0 O/ offe�etl (o� Boiler HOOd 0� Typ2 I ❑
sale. If, �owever, [he builtling or Improvement is soltl within one year ot com- CanOpy Type 11 ❑
pletion, tne owner will have tne burtlen ot proving he/sha tlitl not builtl or im- Duct - Under Ground SUMMARV OF FEES
�rova tor the purpose of sale). . BUILDING PERMIT $ SMIP $
I, as owner of the prooertY, am exclusively contractin9 with Ilcensetl con- Dutt -Structural Refrigeration System PLAN CHECK $ PERMIT
tractorsto construct tne proje�t 15ection 7044, Business antl Professions Cotle:
Tne Contracmr's License Law doez not apply to an owner ot property who Duct - Ven[ilating ❑0-700,000 BTU ❑100,000 BTU ISSUANCE $
builtls or improves thereon. a�tl who contratts lor sucn oroietts wiN a mn- PLUMBING $
tractor�sl hcense pursuane to me Contractors License Law). I am aware that PLAN CHECK 25% $ ENEfiGV P.C. $
prooi ol tbeir Wo�ker's Cort�PenSafion insurance shoultl be provitled to me. Exh2u5t Sy5(¢M ❑ MultiplB ❑ � System Repaif/Alte�ation
ELECTRICAL $ GtiADING $
� 1 am exempt untler 5¢ctlon B. 6 P. C, tor this reason Firepl/Fact. Blt. �CBO � Fire Dampers � J E-b MICROFI LM $
PLAN CHECK 50% $ 7 �
oate owner Heating System & Ducting Registers MECHANICAL $�� Ga � /
I hereby ceriify that 1 have reatl tnis apo�icalion antl state that the above ❑0�100,000 BTU �100,0008T /, TOTAL FEE $�cTl¢ ��
Iniormation is correc[. I agree �o comply with all dty antl county ortlinances � � �T W PLAN CHECK 25% $
antl state IaWt-rc tin9 t0 builtling ConStruGtion, antl hereby autho�iz¢ repr¢-
Sentatives thi�dty to eP�Gr pon the abOve-mentiOn¢0 property tor �
i5lgnatt�fe Purpo s. Date� Z f'9 �.. 01 OOD30QII1—OOD30081 T�T ],�(7.Q0
on�a.�� ��e a, ss � Reinspee[ion Fae s�s i��e Fea s—a— �AiE: 0�/Ub/E? TIflE: 11:37 '
0865-46, rev. 5/88 Wnite - Building; Canary - Applitant; Plnk - Accouniin9; Goltlanrotl - Assessor
. U �; ,;�;;` . . . . . _
CONSTRUCTION/ AND PLANNING � P� & SPA �
APPROVALS GPermit# �Date Inspector p�ppROVALS Permit# Date Inspector
/
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location
2. Soil Pipe-Undrg�nd. "� .�� � 53. Steel Reinforcement '
�' 3.�Electrical Cond�it Utility-Untlrgrnd. � 54. Forms �,
� 4: Electiical Conduit-Undigrnd. 1 �. 55. Electrical Bonding %'
; . . .
5. �Steel'Reinforcemerit `�. �. � 56. Rough Plumbing & Pressure Test '
Y
6? Electrical UFER�Grnd� � 57. APPROVALTO COVER-GUNITE .�
�. .
7. Footings ��� + , 58. Electrical ConduirUndrgrnd. �
8. Foundation . A• j� ' 59. Gas Pipe, O Undrgrnd., Test �� �
�
9.1 Water Pipe-Undrgrnd. % � 60. Backwash Lines, P-Trap, � Undrgrnd. �
10. Structural FloonSYstem ' ' 61. APPROVAL TO DECK
11. Property Sewer Line & House �onnection "� 62. Backwash & Receptor-Final " '
i ._
12. Sewer Cap ' �, ' ,� 63. Heater & Vent-Final �
i t �
13. Roof �D�ains ;, � � � 64. Plumbing System - Final ' �
14. Rough Plumbing j� 65. Electrical-Final ' �
15. Rough Electrical-Conduit ,� 66. Solar System-Final ;
16. Rough Electric Wiring �� 67. Fencing & Access Approval
'17'f Rough Wiring Sign � `� . 68. APPROVED FOR PLASTERING
.
j8� Rough Electrical-T Bar Ceiliny � 69. POOL/SPA SYSTEMS FINAL �
19l Rough�H¢ating & Air Conditioning FIRE DEPT. REQUIREMENT
20:Rough'FactoryFireplace �fj APPROVALS Permit#
2T. DuCts, i� Structure l,� �,I 70. Underground Hydro
22. Ducts, Ventilating �' 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test ��� 72. Underground Flush � � N
. /
24. Roof Framing ' '�� , 73. Undergrnd. Storage Tank � Gas ❑ Oil ~� r�
25. Roof Sheathing � � , � � 74. Overhead Hydro �
26. T-Bar Geiling (Structural) &`Moryocoat 75. Dry Chemical
27. •F�ame.and F.fashing ��! � 76. Dry Standpipe
28. Lathing & Siding ��, i 77. FIXED SYSTEM FINAL ,�
29. Insulation f� 78. FIRE PREV. FINAL ',�
30C Drywall Nailing . j�i' HEALTH DEPT. REQUIREMENT ' ��'
31! Plascer Brown Coat �, 79. FINAL INSPECTION �
32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED �'r,t} f, �" ;
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 .m -
r
41. Solar pomestic-Final Cfj /
42. Backtlow Preventer � �'��
43. Backflow Irrigation �„
44. Landscape Irrigation System
45. Sound Attenuation ' j�
46. Handicap Regulations'�"
47. FINALSTRUCTURW BUILDING
48. Special Requirements Completed
�49. Electric Release to Edison
= r' '
50. Gas Release to Southem CaliPornia Gas Co . �
51. CERTIFICATE OF OCCUPANCY . �
No. Date -
ADP��C2nt lo flll In all s0aces azcept tho50 wlt�in �edvy Do�Cer Iinas an0 si9n all apOropriale EeClaritions.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A P
Proj¢ctAddressSSS An�ToN 9� F1(Y]R _
APplicant'S Mailing Address
Owner's Name SS.CdJ��7v ���i��- �nrk ohone
Address
Arch/Eng. N�%K License No.
Address
Contractor's Nam Phone� O\\�
Addresslmailingl�0` RP�}�1 �1 �A-10, i�nSTq MCv�J
Ciry License No. �%��qg6
LICENSED CONTRACTOR DECLAPATION
I hereDy altirm that I am ticensetl untler provislons of Cbarter 9(commanUng
with 5ection 7000) ot Dlvislon 3 of Ihe BuSiness antl Prof¢551ons Cotle, antl
my Iicense is in full force antl effe ^` `,�,
Licensec� ass • �- �� License No.^���J�J
nate 3/-'�1 f� S�9nat r m' \�4,i'(�-
`0.KER5'COMPENSATION DECLARATION
:reGy aflirm that I �ave a cerlifi�ate ot canient lo salf-insure or a certltiwta
of Workers' Compenution Insurance, or a certlBeC copy thereof (Sectlon
3800, �ab. G.j
aoiicy rvo. W�84i360Q Gompany�m'+�T 1 �'^���
Certitietl copy is nereby fumishea.
Datee�tjetl qop�y is filetl wilh tne tity�ip Itlin9 DiviSiQn. •
�����_T��-�-AOPlicant YYL1.!/Y+ ��
EXEMPTION FROM WORKERS' COMPENSATIO DECLARATION
(T�is sec[ion neetl nal Ce complatetl if the plrmit IS fOr One hu00reG (E300) o�
less).
I cCrtily [hat in the pe��otmance of the work fOr whith th15 pe�m�t ii ISSueC I
snaii not empioy any person in any manner so as to eecome sueject to the
Workers' Compensation Laws of California.
Date Si9nature
NOTICE: It, atter making this tleclaraUon, you zhoWU becoma suo7ecc ro me
Work¢r5' Compensation provi5ion5 O1 [h! Ldbo� Co00, y0u must fortltwilh
comply witn such provisions or tnis permit sna�l be tleematl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby attirm lhal t�ere is a<onstruction lentling agency for the parformance
of Ihe work for whiC� this permit ii iiiu@tl (SeCtiOn 3097 Civ. C[)
�entler's Name
LenAer's Atltlress
OWNER BUILDER DECLARATION
I hereby aifirm ihat I am exempt trom tha Contractor's License L.aw (or the
followin9 reason (Sectlon 7031.5 Businass an0 Professlonal COCe: Any dty or
county whi<h requires a permit to coMlruct, alter, ImOrove, tlamolish or ropalr
any sVucture, prlor to ils Issuance, also roquires the applicant Ior.Wcb Pormit
� ti�e a signe0 statement tnat he/she Is Ilcenietl pursuant to the provislons o/
e Contractor's LI<enze Law (Chapter 9(commenUng witb Sectlon 7000) of
,vision 3 of tne Bu5lness antl Professions Cotle) or tnat be/sho is axempt
�herefrom and the bails !or tha allegatl ezempUon. Any vlolatlon of Settlon
7031.5 by any applicant for a permit sub�ects [he aOP���ant to a civll
eenally ot not more tnan I�ve huntlretl tlollars (f500).
LJ I, as ownar ol the oroperty or my omo�oyees with wagas as ihalr solu
compensaUon, wiil ao lhe work, antl tne suucture Is not intentletl or oiferotl
for sale (Seclion 7044, Business antl Protessional Cotle: The Contraclor's
License Law tloes nol app1Y [o an owner of a property who builtlt or Improves
'� tnereon, ana who tl0ls such wOrk him5¢It/her581t Or Urou9lt nis or he� own
I� employees, provitica that su<h Improvemonts are not Intendetl or otteretl for
sale. Ii, �owever, the buileing or improvement is solG wllhln one year of com-
plo[ion, thu owner will �ave lha burtlen Ot p�ovin9 ha/Sho tlid not builtl o� Im-
prove lorthe purpose oiSale).
❑ I, as owner of the Property, am exclusively contracting with Ilcensetl con-
t�actOrs to const�uct Ihe prOj¢ct (5¢CtiOn 7044, Bu51nes5 antl Professlon5 COtle:
The ConlractoYs �icense Law dOes n0t apply to dn OwnCr oi prOperry who
builtls or imoroves thereon. antl who mnVacts lor such orolects witn a r.on-
tractor�sl hcense Oursuant w tne ConVactor•5 License Law). I am aware Ihac
proof of their WOrker'S Compensation insurance Shoultl be prOVlEetl to me.
❑ I am eaempt untler Section B. 6 P. C. for this reason
Date Owner
I nereby certity that I have reatl this appli<atlon antl state that Ihe above
in(ormation is correct. I agrea to comply with all tity antl county ortllnances
antl State IdwS I¢la[in9�t0 builtling conStruCtiOn, dnd h¢r8by duthOfize lepfe-
Sentativ¢s oi Ihis City to enter upOn Ihe abOve-mentiOneC pla0elty fOr
Inspettlon purpose5. '
Signature Date
Driver5' License or 55 �f
3 �031 ..�
S Main Bu
TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ OEMOLISH ❑ OTHER T FrOnt
DESCRIPTION OF WORK/USE OF BLDG. A Rear
TVPEOFPERMIT GRADiNG FOUNDATION STRUC7URAL I C Right
❑ TENHNT � ELECTFICAL ❑ PLUMBING ❑ MECHANICAL i g� Left
❑ OTNER Ping. Ref. #
PROJECT DESCRIPTION 5Q. FT. oCCUPANcv Planning No�
CON STRVCTION TVPE VALUATION $
ZONE GRADING CU. VOS. ACRES
Remarki:
Sink
Preventer
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories
Roof Dreins
Reinspaction Fee
Showers
Service Sink
Sewer Cap
Sewer Connec[ion
Solar Collectors
Solar Piping
Swimming Pool wlSpa
Urinal
Outlets Water Closet
Water Hearer
Wacer Service
Auto-Wash
$15
Dutt-UnderGround
Duct - Structural
Duct - Ventilating
Eahaust SyStem ❑ MW[ipl�
Firepl/Fact.8lt, iCBO;W
Heeting System & Ducting
❑ P100,O00 BTU � 100,000
Rainapeciion Fee � $15
0865-46,rev. 5/88 WM1ite � Builtlinq; Canary - Applicant; Pink - Accounting; Goltlanrotl • Assessor
laue Fee
Hoodor Typel ❑
Can Type II ❑
4efrigeration System
❑4700,OOOBTU ❑100,000
System Repair/Alteratian
Fire Dampers
Registers
laue Fee
$ 3
FEES
$ 3
Automatic Washer
Construction Pole Suh.
Cooking Unit
Dishwasher
Dryers �Gas ❑Eleci
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator O65 KW C
Accessory
Parking Req./Provided
ELECTRICAL
Transformer ❑ 75-50 KW
❑ 50+KW
Meter �up to 100 amps
Meter Daveri00a s
�. Sub Panel /
Motors�fai tiP O1 ;4 - 6
Inc.Solar 09-75 HP �16-15*
Miaowave
Pole Light
Range
Sign
Standing Sections
15 KW Trash Compacror
I Reinspection Fee �$15 ' I luue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By ^ /
Building Approved By �
AppliCdtiOn ISSUBd BY
,r' SUMI�RV OF kEES�
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
� PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
. ELECTRICAL $ �O� S GRADING $
PLAN CHECK 5096 $ MICROFILM $
MECHANICAL $ TOTALFEE $
PLAN CHECK 25% $
R
a1 OOG29656-+J062966b TPj'p'
DAiE: �3/31/84 TIltE: 12:57
N
I
N
G
R
E
O
M
T
$.
FEES
3�10.95
Palrolei . . ..
COIVSTRUCTION ANp pLANNING x P .& SPA _
lYPPROVALS Permic# Date(J Inspector qppROVALS Permit# Date � Inspector
W
1,. Temporary Electrical $ervice or Pole '� 52. Pool & Equipment Location
J
�
2. �Soi� Pipe-vnd��grnd. d � ir. 2. 53. Steel Reinforcement
3:,;Electrical Condui[ U4ility-Undrgrnd. i_ 54. Forms - � �
Y'
4�Elect�cal Conduit, U�tlrgmd. � 55. Electrical Bonding ,
5SStee�Reinforcement� � � 56. Rough Plumbing & Pressure Test '-
6�EleciricalUFER�Grnd?� �,� 57. APPROVALTOCOVER�GUNITE `!''�
� h � 1
7. Footings -�� ��_ "0 (J d �' 58. Electrical Conduit-Undrgrnd. j
8. Fou �dation ,� ��� - R `� 59. Gas Pipe, O Undrgrnd., Test �
9LWater Pipe�Undrgrrid. �� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Fldor Sys,tem _ � � 61. APPROVAL TO DECK
11.�Property Sewer Line & House Co�rinection ' 62. Backwash & Receptor-Final .
721`CSewer Cap �-I � �1 • 63. Heater & VenbFinal »
13. Roof Drains -� •� � ' 64. Plumbing System • Final ��i
14. Rough Plumbing'- • -- 65. Electrical-Final
15. Rough Electrical-Conduit 6. Solar System-Final
�16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign . APPROVED FOR PLASTERING
.�
18. Rough Electrical-T Bar �ei�in9 69. POOVSPA SYSTEMS FINAL
18. Rough Heating & Air Condnionin9 FIRE DEPT, REQUIREMENT
x
20�. Rough Factory Fireplace ��" APPROVALS Permit #
� T
21. Ducts, in Structure �'� 70. Underground Hydro
_ L
22. D'ucts, Ventilating r� 71. Product Piping � Gas ❑ Oil %�
23. Gas Pipe-Rough & Test "� � 72. Underground Flush �'
24. Roof Framing � 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical '
27. Frame and Flashing 76. Dry Standpipa
28. Lathing & Siding 77. FIXED SYSTEM FINAI
29. Insulation 78. fIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final . FOOD CER FICATE ISSUED
33. Final Electric ' otes:
34. Final Heating & Air Cbnditioning " �'
, J
35. Final Gas Pipe-Test '
36. Hood or Canopy
37. final Factory Fireplace
38. Final Plumbing
39. Water Service-Final �
�40.- Gas Service-Finai
41. Solar pomestic-Final ' , �
��
�� ,
42. Backflow Preventer -
.^
43. Backflow Irrigation , .. �
.'
44. Landscape Irrigation System � � �
45. Sound Attenuation � � �:
46. Handicap Regulations i -
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 ` � i•,1 �' �
No. Date � '' ! ` �� ' ' ' � ��
r. !� .�
0 6 8 8 9 Acv���ant to till In all soaces exeeD� tnasa within heavy EorCer Iines anE iign all appropriata Eeclantions.
CITY OF COSTA MESA CONSTRUCTION PERMIT P � NO. �� TRACT NO. LOT NO. U�T N P,�y 2one �•
ProjectAddress -S5S ANTON, 9TH FLOOR _ ypp S MainBuilding: AccessoryBuilding:
AppliCanY5MailingAddfe55 JS�iO SUZI LANE. WESTMIN T�i�OFCONSTRUCTION NEW^ A�D ALTERATION REPAIR
LJ CONVERSION ❑ DEMOLISH L'�'STHER T Front �
owner'sName SECURITY PAC. BANK Phone
DESCRIPTIO WORKIU OF BLD B Reer N
Address 60� WILSHIRE �C50�, L.A. ���r-�,� —�n--rr--�—s� �,a,a A �
Arch/Eng. License No. TYPE OF PEFMIT LJ GRADi G LJ FOVnDAT�ON STRUc7URAL I K Right G
Addreis ❑ TENFNT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL , S left R
KIMBLE S COMPANY p 89$- I I$ � aTHER Ping. Ref.�W Parking Req./Provided E
Contractor's Name hone
7540 SUZI LANE, WESTMINSTER PRaECTDESCRIPTION S�.FT. OCCUPANCV � PlanningNolES: �
oadresslroai�ingl - 038503 CONSTRVCTIONTVPE T VALUATION$ �3.� 0.�� M
City License NO. ZONE G�NG CU. VDS. ACRES
LICENSED CONTRACTOR DECLARATION S�
1 hereby a�firm l�at I am lic¢nsetl untlGr provi5iOn5 Of Chart!/ 9(COmmGnUng Rem]rks: � ° .� O
witn seclion ]000) of Division 3 of t�e Business antl Professions Cotle, antl
my Ilcense is in (ull orc �^d ettect. c� _ O ELECTRICAL FEES
l7
ticense Claz �-�`� cens No. 4 6 0 9 2 3 p�UMBING FEES %�utomatic Washer TransfOrmer ❑ 15-50 KW
Date ��� -%r 5"9n t Q
'�R KERS' COMPENSATION DECLARATION ConStructiOn Pole Sub. � 50 + KW
eDy aftirm Ihat 1 have a certificate of consent to seif-Insure o� a certiflcate 88f Slnk $hOW¢�5
aorkers' Compenution Insurance, or a certitiea copy tnereot (5ection Backilow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
3800, Lab. C.) Dishvrasher Meter �over t00am s
Poiicy no. WP88470897—Odompany FREMONT TND. Batktlowlrrigation SewerCap P
�Certifietl Copy is hereby futNs�e�. Dfy2f5 ❑Gas ❑EI¢Ct�iC SUb PenEl
Cecy fi�j oapy i�# iletl wilh the city tlin �iyjI �6n.. /- Bathtubs Sewer Connection
Date d�/ /" d 7 Av�licant ��^^"'�%'Y Fan MomrS �61 HP �1 X- 6
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clelifi¢!S $plar Coll¢tt0l5
/ (This section ne¢tl not be completetl it the permit iz fOr On¢ huntlr¢tl (EI00) or F,A,U. Inc. Solar 09-15 HP �16-15+
M iess). Dishwasher Solar Piping
V I<¢rtity that in t�e pe�(o�mance of the wOrk for whiGh thii p¢�m�t i5I55u¢tl I Fixtu�¢5
shall not employ any person in any manny r zo as t oecome suDje<t to t{�e Orinking Fountains Solar Tank Microwave
WOrkewJ C���e n LawS of CalifOrepy. �- /� �/. /_
Date p{_ Signature � SItiN /LIA�•�•5o Floor Orains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE: If, after making this tletlaration, you shoultl become suDject to tne Urinel Outlets 9
Workers' Compensation provizionz of [he La�or Cotle, you must fortnwilh Floo� Sinks Ran e
comply wilh zuc� provisions ot tnis permit shall be tleemetl revOkltl. $Wi[Ch¢5
CONSTRUCTION LENDING AGENCV G85SerViCe Outlets WetClCloiet Sign
I nereby aflirm that [here is a construction lentlin9 agency for the DerTormance ! GarbO e Di Osal
oi tne work for wnlcn tnis vermit is Issuea (Section 3097 Civ. C.) Interceptars Water Heater 9 � Standing $ections
LEntlGr'S Name
�enaer's Atlaress Kitchen Sink � Water Service Genera[or 00.5 KW �5�75 KW Trash Compactor
OWNER BUILOER DECLARATION .
I h¢reby aHirm lhal I am ¢xeTpt 1rom tha COntracto�'S LICGn50 Law to� thB �8v2tO�i¢S � AUtO-WeSh
tollowing reazon (Section ]031.5 Buslness and Professional Cotle: Any <ity or
county which �equira5 d pe�mit to <onzt�uct, alt¢r, ImD/ove, tlemoli5h Or repai� P-Tfep l�uftd�y Ttey3
any ztructure, priOr t0 Its issuan<¢, also requirei [he applicant tOr such pe�mil
lo file a signetl Statemen[ thdt he/St1e is IiCe�SGtl pUfsuant to IhG Pfovliloeli 01 ROOI D�8in5
ConlraGtOr'S License Law (Chapter 9(COmmencing with SeCtion ]000) Of /
[ion 3 of [�e Buslne55 antl Protession5 Cotle) or that h¢/Sne is axempt ' Rainspettion F80 $15 Issuo Fee $ 3
etrom anC the basis br the allegetl exemo��a�. A�Y ��olatlan ot Sectlon
31.5 by any aoolican[ fo� a permlt subjecti tite applicant f0 a tivll
enalty ot not more than live nuntlre0 Oollars (E500). 'DEVELOPMENT SERVICES RE�UIREMENTS:
� I, a5 Owne! ot th8 Plope�ty O/ my employees with wagez as thelr sola ROinspeCtlOfl FBB $1$ ISSUB FBB S 3
comoensation, will Oo tne work, antl the structure Is not Intentletl or oiferetl ZoninB %�PProved By Date
for saie (Section �044, Business antl Professlonal Cotle: The Contractor's MECHANICAI FEES 'Buildinp Approved By
License Law tloes not apply to an owner of a DropertY who bulltli or ImDroves Date��zt
t0ereon, ana who tloes such work �imselt/h¢rseli or through his or her own � ApPli�ation Issued By �1ate�L �� -U��
employces, provitletl [hat such improvemenls are not Intentletl or offeretl for BDiI¢f HoOd Or Type I ❑
saie. It, noweveq the bWIGln9 or Improvement is soltl witnin ona year of tom- Canopy Type 11 ❑ ,J V OF FEES
plelion, tne owner will have t�e burtlen o( Droving ne/she tlitl nol bulltl or im• Dutt - Under GrOund ,� /
prove �or thc purpose of sale). • BUILDING PERMIT $ �da SMIP $�/ • 9�
❑ I, as owner of lhe Oroperty, am exclusively contracting with Ilcensetl con- Duct -Structurel Refrigeretion System ,� p�,,qN CHECK $ PERMIT
Iraclor5 to conStruGt Ihe pfoject (SCctlon ]044, BuSin¢ss antl Prote55iOns CotlB:
The Contractor's License Law tloes not apo�Y to an owner ot properly who Duct - Ventilating ❑0.700,000 BTU ❑100,000 BTU � PLUMBING �SSUANCE $
builtls or imOwveS ther¢on. antl who conVatts for Such oroiects with a con-
tractor(sl license pursuani to me ConVacmrs L�unse Law). I am aware tna[ Ezhaust Sys[em ❑ Multiple ❑ System Repair/Alteration'�• ?LP.N CHECK 25% $ ENEFiGY P.C. $
proo/ of tbeir Worker's Compensation insurance snoultl be proviEetl to me. - � GRADING $
❑ I am exempt untler Section B. & P. C. for lhlz reason Firepl/Fact. BIt. ICBO �k Fire Damperf �' � � ELECTRICAL $
. PLANCHECK 50% $ MICROFILM $ �,�
Date owner Heating System & Ducting , Registers • _ �' ' -� {� q '� �
1 hereCy certiry'that I have reaa this aoo��catlon antl state that tha above _ � MECHANICAL $ TOTALPEE $ Je(,L_
� 04100,000 BTU 0100,0008T � pLAN CHECK 25% $ ~
Iniormatmn is correct. I a9ree to comply with all city antl county ordinances
antl State laws �elating to Duilaing con5t�uc[ion, dntl h¢rGby authoriie �ep�e- '
sentatives of Ihi "tlty to enter upon the aDove-mentione0 Property for ' q '
Inspection pur es . � Date �-�7-� . ! � � _1
Signature Reinspaetion Fee $15 Izwe Fea � $ 3 �
Orivers' License or 55 � � — ��+ �) .t'- Ol 0�0?7246-QU027247 TOT 2 4�
� .. 6ATE: 02/2E/89 TIME. y��
OB65-46, rev. 5/88 White - Builtling; Canary - Appllcanq Pink - A<countlng; Goltlenrotl - Assessor ;-� � � � i2:28
. . . _ .1 ... � , ` . . . , . . . . .
�` [ . [ ! � /-
CONSTRUCTION AND PLANNING ? PO� '� SPA ,
AP?ROVqLS Permit # Date Inspector pppROVALS Yermit # Date Inspector
{ ,�
1. l'emporary Electrical Service or Pole . 52. Pool & Equipment Location
r.
2. Soil Pipe-Undrgrnd. � !� ; � 53. Steel Reinforcement '
3. Electrical Conduit Utility-Undrgrnii. � �+� 54. Forms � •
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. S[eel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE -
�
7. Footings � , r 58. Electrical Conduit-Undrgrnd.
8. Foundation � • 59. Gas Pipe, � Undrgrnd., Test
,'
9. Water Pipe•Undrgrnd. � ' !� 60. Backwash Lines, P-Trap, O Undrgrnd. .
10. Structural Floor System . 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection "� � 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drdins 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 PLASTER�NG
18.• Rough Electrical-T Bar Ceiling _ 69. POOL/SPA SYSTEMS FINAL
79: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough`Fy�oryFireplace APPROVALS Permit#
r' . '
21. Ducts, iri Structure � � 70. Underground Hydro
22. Ducts,�Ventilating � 71. ProductPipingOGas ❑Oil
23. Gas PipeyFiough & Test� l � 72. Underground Flush
24. Roof Fra'ming �',. 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) &.Monocoat � 1� 75. Dry Chemical�, � "
27. Frame and Flashing - 76. Dry Standpipe
28. lathing & Siding �/ • 77. FIXED SYSTEM FINAL � 6
29. Insulation . 78. FIRE PREV. FINAL �f�
30�DrywallNailing '�� ' • HEALTHDEPT.REQUIREMENT
31,!Plaster Brown Coa[ � -' � 79. FINAL INSPECTION
32. Electrical Power fVleter-Final� ' � 80. FOOD CERTIFICATE ISSUED
33. Final Electric J� • Notes:
34. Final Heating & Air Conditioning � � L��
35. Final Gas Pipe-Test
36. Hood or Canopy (� �, r �� G�
37. Final Faccory Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final �
� 41. Solar pomesticFinal , -� /
42. Backflow preventer '
e; ,+
43. Backflow Irrigation + ..
44. .Landscape Irrigation SYstem �
45. Sound Attenuation
46. Handicap Regulations
47, FINAL $TRUCTURE & BUILDING
48. Special pequirements Completed
n
�W9. Electric Release to Edison �
50. Gas flelease to Southern California Gas Co ^•
51. CERTIFICATE OF OCCUPANCY ,
No. Date
n
0
�-- --- .._ _ . ..-
��itp o f�o�ta 2� esa �
Development Services, Division of Building and Safety
CERTIFICATE AF OCCUPANCY
This cerdficare is issued pursuant to .the requirements of the Uniform Building Code, Section 308
adopted by the Ciry of Costa Mesa certifies that at the time of its issuance the building structure herein
below described was inspected and approved for occupancy as follows:
Building Address 595 nNTON BI.vD. F[.o0[ts 1-12
rt�o OFFLCES
Bldg. Pertnit No.�eee belw
Group $-Z Type oF�Construction 1-FR Fire Zone Use Zone PDC
Otvner of Building Saki oka Farms ' Tenant "i1NOCet!'
Address `
•B74570, b7.5356, B74572, B74571, B74573, 574633
n74632, B74631g���B74G30,�j 006, B7�866, B74574 By '
�Q:
Date Novzmber 14, 1996
PSCK Bk0'�12d, CEO
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
•oonessaemiara: 555 ANTON BL
av�ERsny+EiFp+"^'": SAKIOKA FARMS
�op� PO BOX 2097
TERMINAL ANNEX
AFPL.WIWHi�00NE59:
AIiCNRECT ON FlNiNFER:
ARCN.ON FNO.'S ADUXE55:
u�+T: 9 TH
uc ra.:
UMT:
coxm�crarsru�: MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
�«rrx.�*onsw�ina P O HOx 509
�ooxEss: WALNUT CA ucno: 230813
91789 uxr:
LICENSED COMHACTOPS �ECLAHATION: 1 Mreby eflim untlr pmNy d perjuly Nq I em I'r.mxA wdm prowima IN Cheqar 9
(commeewi�q wnA Secibn ]000) W Oiviaion 3 W ihe Buvimn anE Pmleeeiom Cads, eM my fironae ie in hA bru enE Nlect.
cmuc.r+o.:006558 uc.cuss: C 10 uc.No.: z30813 EXP• 12/96
o�, i/� �i ti ��� r
W NEF BUILDEP UEC4N�TION: I ha�eby ellvm uMr peiWy d pe'ryry ih em ve p hom tAe CoMraCon Licenae lew la IM
.Ibw'vq reawn (Sepion ]NI.S Buanesa eM PMeasiona Cods: Any dy a c Ny whidi quirae e pe�mn to mrewcl, ellx, improva,
damol"sh, m repei any svucluro. qior b b iswaMa. abo eapuire+�ha ta wch ' to fib a epiwE etalemen� Met M a eM
A i�.�e w�� io ins v� a me cw,eeo.. uodne i.. �cn.a« (� end'q wuh Sedion lW0) d DN'sbn a d �M
Business enE Prdeeabre Cada� a Ihei he a Ma e e�emq iherNmm enE iM Ne albpad exampion. My vio4ion d Saeun
1031.5 by vry epplirant M e parmY abjeGa iM epp4eN to e ci pa�uXy d nal mae Ihen Me hundmE EOYen �SSWn.
❑ i.ee�,win.awanr«mr«oobre.•••n..�a..a,m«.de�o«,�a�+.�;nmm.wo�x.�a�.ww�:�a�m«,ew
or dlareE M aele ISocUon )M6. Budroaerd Prdesabu Code: TAeCaureaae licaus Lew dou not wGN�oan awnxd propeny
who buids a mpwea tMreon. e�W who does auch xwk h'unwtl v hereel a Nraup� hu a hx own employsee, qwitled ihet euch
mpwemew eee nd'wenEeE a atleed la eeb. tl, hows.er, iM britl'up a inpev.amaM u eak xilhm one ymr al mmpblion, Ne
owner-0uiker will heve iM buNen d proviip he a ehe dtl M Wik a imqove tw tM W�e d eele�.
� I. m owner M t�e C�WeM. em mdueiveN mntrari'rq wnA lidnaed eonvxion lo coneT�p ihe Moletl (Setlion 1041. Bwirwss arM
Prc/euio'u CoEs: The CanlreCae lice�w law dou m eGWY m an oxner d pcD�Y �1a bo'Ida a LnV�'u ihaeon end xho
convecta la eu�A prqw� with e mMretlar�e) licanead Wnuen� to IM Conlretlm limnaa Lev�.
� I em emmq uMer $ecYm: B. 8 P.C., br Nia �eewn:
Dms: �++r:
I do InieM uniM tlw I em ewera W end uMenWd Iha �w���am d Cdfartue Haell� end SdatY Cade Satliom 25505. 255�. erd
P55�/. enE Ihel I a any Mun Wlldiiq mvpenl will / wil rol (dreb aew) nseA io odnply wY� eeld aeta mdu ud ihs rpulromente /a
a psrmnlammmniona motlifwionhomtM �i�iuTyl.rwpamnv Oiurip. ReddoNwl mrmrupion e�tlwnan axomq Imm �hms
Dma: /�pWiasN:
W ONKEP'S COMP6lS�TION DECIAPATION: I hsraby e1Nm uMr psWiy d pa�ury aw d IM Idbwlip dduelum:
� IhevaeMwilmeiMeiiecMXktlodmneemio�allamuntorwken'mnpsnWbn.uproridaElaEySWim�)Wdlh�LeEw
COEa, lar iM peAamerce d Ihs xvM1 lu wNch iM pe�mii b hsued.
'] i n�..�e w�� �m.:, waxe� �o«�+mc� mwrd,os... �w�i�.a M s.ao� e�ao d m. �n« coa. ro� m. rortorm.�a a �n.
work la which Ihie parm� h MueA. MY wakar� oompanxlian m�urerics mrtier W pdiry numbsr ars:
c�;.� FIREMAH'S FUNTD EXPIRES
PdryNumbr. nW��i7RFi9 07/01/96
/mi, axvion nese rw n m*Ne�b r us v«m! h ro. ons MmenC ea�en �S�ool a ws.l
� 1 oNeY � in IM pMmnenca d iM .ak M wM1i� tl�i� pemiY b leueE, I Nell np smpby vry penon In ury meruiar �o u to
becoms �ubl� Io iM xwM�e' canpenwian Isvn al Calilanu, vW pn� thtl A I ehouk Eecwne wbjw b;he xdks�
�w�J+� ao+m[��+. a see��j /ao a' m. tee« coe.. i.iwi �n.nn eomcN wi uos. w�..
Dme: / � �Tl ` / C.. �cWiwa:
W�m/np: F�Nun ro�Ieun wortx�'rompxwtlon ronrap� l� unNwlW, nJaIWI • Mcf �n wnploy�r to crlMnl pwltlu �rM
Nvll llnu �q b om �urtliM tlpuNnd 4o/4n (ltOQIXlOA N M1Rbn lo fM awl rompwiutbM1 J�m�py u pvvleW bi In
9�ctlon JIfM o/ M� L�6or CwY, InNna4 �tl ertom�y i/ww
CON9THUCTION LENDINO ROENCY: I henby elfi�m under panetly M per Ihet IMn b a oona�upbn kMi�p eprrty tor �ha
oena�a�w w in..o� m� .,nw� mm ro�+ a:.�a �s«a� aoc�. ca. c�.
�ENOEP'S NRME:
LENDEWS AOOFES9:
I cerlily ihu I heve reed Nu epplictlion W pet� tIW �he ebove Wametion o cmw. I pne io oompy wnh N dry end ooumyadirunom
end �le�s kvn rtW ip b Wtldvq canahuqi0n e'd hvsbyeNhU¢e �apsfeNe�nas M Ihu dly b�Mx upon �M ebove.menlbned qopeM
br inao�+ion WrP�a.
CHUCR JACOBY
�—�ry� Pnm Neme /� � ✓/��
/�( / � ✓ DNe:
(5151i6.WP) Wh' ild�p 8 Setey; aresMFb: Cerory.�ppfum: Hnk-Rwanue:0oksnnE-Mww
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: E 07601
PERMIT NO: E 076015 PLAN CHECK NO: N GOVT: N SUPP: Y
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION ; 20000SF OFFICE T,Z, /ELECTRICAL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
Ct��(+��NTSt 76 UNION PRODUCTS / REF H-74632 / SUP E-74684
� *�t*x��t�t�t�t�t�t�tx��t�t�t**+t****+t�t**�tx�x��t�t�t�t*�t�t��t�t*�t**�t*x��t�t*�t****xx�x��t�t��r����*x�x��t��+t**
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDZNG ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR; FT IN FANT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i ��
1f 1f iE 1E if iF 1f 96'141k if iE 1E iE'k iE iE iE 1E iE 1E 1E ik iE �f' iE i! 1F iE 1E i! iE 1E iE'lE iE iE 1E iE 1E iE'k i! iF if if if 1E iF iE iE 141F fk 1E 1E iE iFlk 1k iE iE iE ft 1E iE iE ik iE 1E iE iE 1E i! iE iE k 1E 1E
D E V E L O P M E N T S�E�R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY �'�• DATE:
�:1�����%���:����;�����:���
APPLICATION ISSUED BY
1F 181k IF 1E iE iE fF 1E 1F iE if if 1f 1E k ik k lf 1@ If
LEGALIZATION:N
BLDG PMT
PEAMIT
PLAN
ISSUE FEE
F E• E S U M M A R Y
PLUMHING ELECTRIC MECHANIC
1950R
4.50
DATE: �
DATF.� /
If 1fiE1t iE iEif 1E 1k M ih 1t iE iE�itiF ff iE iF {FiE fE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 19.95 4.50 0.00 24.45 24.45 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24,45 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.45
iF iF IF ik iF 1E 11� 1f iE ik 1I� if 1F iF ik 1E 1E if IE 1E 1E 1E 1F iF ik Ik 1f Ik IE If 1E ik iF 1! 1F 1E ik 1E 1f 1F ff 1E 1f 1f k 1E 1! 1k iE i! k fE 1F 1E 1E i! 1F 1k If iE 1F 1E 1k 1E 1E 1E k if 1k 1k fE 1E IE 1k 1F 1F 1F'IE 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE
ELE
QTY
2�
11
D E S C R I P T I O N UNIT COST
RECEPT/OUTLET 1 ST 20 EA. .75
RECEPT/OUTLET ADDITIONAL EA. .45
END OF FEES
TOTAL COST
15.00
4.95
DA 3 ' •�
C11 i1Q19:51� -�UIG'v.ii7 TEe'N' ,`',$.�i=�
GAlE: Oi :?!4� T?�'tc: G.^:57
CONSTRUCTION AND PLANN�NG 1, �& SPA
- APPROVALS Permit# Date I�spector qPPROVALS Permit# Date Inspector
� 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soii Pipe-Und�grnd. � 53. Steel Reinforcement -
•� r :. � �
e,��ectrical Condu(t UWitY-Undr.grnd. 54. Forms
•"��C-~lectrical Cond�-U�irgrnd. 55. Electricai Bonding •
-��. eel Reinfortemept 56. Rough Plumbing & Pressuie Test
��FlectriwlUFER`Y'irnd. 57. APPflOVALTOCOVER-GUNITE
�vv �^
M
'`7.' otings pp ' 58. ElectricalCondu'rgUndrgrnd.
: 8. 6bundation �� � � 59. Gas Pipe, O Uistlr�qrnd., Test
r�
9. Water Pfpe�Und{�r�ii. � 60. Backwash Line��Trap, O Undrgmd.
10. Structural Floof?System � 67. APPROVAL Ti}QECK .�
71. Property Sewer �ne� House�onnection 62. Backwash & R�eptor-Final
12. Sewer Cap ^ � 63. Heater & Vant�'inal �
13. Roof Drains 64. Plumbing System � Fina�
74. Rough PlumbingV.� � 65. Electrical-Final
15. Rough Electrical�oaUduit -�' 66. Solar SYstem-Fipa� -
76. Rough Electric �irinaOg � � �67. Fencing & Acceas.ApProval
77. Rough Wiring Stgn y 66. APPROVED F�fiYLASTERING
78. Rough ElectricaFT Bar Ceiling 69. POOUSPA SYST�MS FINAL �
79. Rough Heating & Air Conditioning F�,RE�pEPT..BEQUIF�EMEf�iT
�, !- �,r - - - �, c . cr .. r t*.:Tt
20. �'Pugti F�tor� Fifis,�jace sr: �� � ^ H Q,� : APP�bV�A(�F Pen`c}nit #� '� �'�
21. �vctF�inStrt[�tur�l* � .... � * � 7 ^x 70.:lJnder�i�� �dro # .
�
22. `uces; VeJ ti13Un9�',y . " y� S * � 77. Produ' e
g „ ,'1 �C :� Fm P9�.�JP�ng �as Oil
23. Gas 2ioe-�.ou(ifi & Test � � S '� n7 cr � O�' 72. Undergro`'uiid Ptr�ST+ y
24. Fibo�Fra.`rNin ��ct �F. '� ^ p � x _. � '� '-�.' * ^° -
,� 9 y: x a: �-,x � �ag Undergrfid.Stnfa�,TankqOGas ��bil'
25. floo�Sh�hing s r � � �� k�� 7'� c��� 7G; Overhead NVdr� y
26. �BaF�Ceiling IStrt�rap & I�'qcoaT .y - j, �J �m.,,�`.' 7� Dry Cheylical •_ ♦ u � �r,�
Y
27. Eremearxi;Flashirp�x. s r r 2x 76. DryStar4N�5ipeE^p t' m�T:
.�
-28. Lathiiig 2�Sidin9 �* ' cMF, G *� .. ..� 77� F�XED��TF� INA� ri �. i,
�'29. Insulation: h'r � �" •• " � � � F« 7� FIRE PREV. FIf�L * � ' F`
30. Drywall N�ilin9 �`y. � .'� �,., � � c '�i,4EALT�D,yEP�.�E�UIR,fc�yENT
31. Plaster Bf�owR'Coai � S i r•'?' x' i � ',rx'� � 79� FINAL K615PECTtON �_ ��
� 32. Efectrica�'f?ow�r h�t�rfy�al � k� � �T � 8�% FOOD CERTIF.I��TE I��UEQ,
r. y � � �` ��,/ - �.
-33. �na�Electric;, mx�:�• • 4 8��/ NOtee: : '-1��. M'- G c�'
1�� � /. C
,34. FinaliHeating"B+Air�onditioning'- '� r � - � 'n� •S � '"' * - "�r
F. a fi^� [*7 �' " r: Cu0 �� 1 H� Y. '^ l�
r � 'D x . _ � i:.: � i .. � �a _
35. �inai Gas,Pip6::fesj��; G. .. . p::. xo Or-+ �� r�� c*'
� 36. 4{ood-�or CenoPY y s �: � � � � � � � { k - m �'.z�'.c + -r � G;
-737. Eina(.Eaa Dry FirePiace � _ .� q ��� ' � � x :k Mi�
_38. FinaC*?luhibin9 '„� =" : � �( � '� 5 � * a .
'39. Wate� Ser�ce-FinaL* Z : a � � i � . a � * � i�i..
�.� r
m
:;40. Gas Service-Pinal �.-* n 6rr�T- S -� . '' . �� G<- -�� * � �
n c.. ^. r .�; T '�� i-� . n: �' x'G
^41. Solar pomestic-Fi�� S f� " * �
D; � [� '7�L o' x :'
�42. Backflow Preventer K N � y , ' 't c ^H * � '-
n• �,-,.r s- 'r C] C1�� �f t+
43. Backflow Irrigation x j =-S * .; x ; �Y M `' �, . •'
', �
¢4. Landscape�IrllOation'$ystem�Ti: �' rtT' '7 C7 VM : tt% N SCJ * +t% 7%'t' - j., =
- �r r' �c: x' F. i :n G a: R S F
� �k '-: C �� . k� F � F xc r� i--�
45. Sound Attenuationx, y„„ r �_� h,.,�* C, 5• �^ . r.,G i� �
4b. HandicapRegulations :+ C� +� r. : Q 5 Ov S :Y. ,.
� �- r � Iv. : J '!:
4�. F`INP�. STRI�TUR� & BUIIaIIVG �. �„ � i '�,�` � N S �. Y E., "
�-.
48. EINA1PlANNING* =4+ Y:� '. �*: m � r - i`_
- ��--'te. ) :� S m � , .
49. Efect�ie Release to E�ison • t �' (� - � ' '-
x ! . t C •C'� x --�
50. Gas Release to Southem Calitorrr�Gas Co � � r- y r- . �,;-� . ..
-� � cc v � r s ;�!' (� Xt iJ _'L
51. CERTIFICATE OF OCCUPANCY x �' � '�" "-
No Date
�
�oox[ss a emimio: � 7 7 taiv i vri n L
OMNERSN.WEIFqAYM: SAKIOKA FARMS
i,00xEss PO BOX 2097
TERMINAL ANNE}C
�. uaiuxc �noxFss:
111CXRECT OR FNGWFEN:
uc xo.:
ur..: 9TIi CITY OF COSTA MESA BUII,DING PERRIIT
PEAMIT D10: E 074584 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
1PCIl OP ENQ'4 �WRES4: UNT:
mxmecrarsxu�: MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
��,,,,��,�r,�,,,,q P O BOX 509
,�� WALNUT 91789 CA ��, 230813
um:
IICEN4ED COMH�CTOFS OECLAF�TION: I MreEy ellFm unEa paiely tl pe'ryry tlut I am fcmuetl uMr pvmom d CNqa B
(oomme�ri�G �uh Sec�m "l000) tl 0ivnion 9 d ihe Bwiiwn erd Pmlaae'vu Cods. vtl mY liune b m Iu0 Ma mM Nlatl.
cmuc.no.:006558G uc.cuss: C 10 uc.No.: 230813 EXP: }2/95
Dme: /� — � / ' / � CanberJm � / J
� W NEN BUILOEF DECIAN�TION: 1 hasby dfum wdor paWy d porjwy IIW I em emq mn iM Corurenan lYrua lew Ip Ms
Ibwiq �aeaan (Setlun )o��S &niio� end Pralm�om Cada: MYW o mNY e D�i to mmhucl. edr.'vnpa+.
Eemdeh. a rqri arry Mw.Wa. priot M Ia uwenca. ab npuvm IM eppfineY Ip ' 10 fib a qpd qqamaN tlW hs p�M
o ti�.�d a� m m. a�v a u,a wmreao� ��.. te. lcnap�r s t �.an sea� �000l a o�w� a a in�
Buaimn vd Prdasioro CoCel a tlut M a tlr e uemq thaahvn and iM bem IM eOpeA mamqun. /M'vdmion d Saaun
]W t.5 by my eppfram la e pxmn rbjetl� IM eppleaM to e dH per�eQy d m� mm �Am fxs Iwnd�ed do0en �S.AOp.
� I.nawrordtMPWNYamYamdW�wY�wa0e9miheieobmmV�.wYdolMwA.entllMstrucWreenoliNmked
«mmea r« �el. cseqan )a.. e�ev w amb,.iom cua: TM cum'mm limro.lewm.. mi epplr�o.n e.,b.d popmn
.,m n�aa. «ma� �n�. �e ww ao�.�n �x �.�n «n«.r a wo�,on na o, n« o.,� «�aw.... v� �nr.�n
impwemena ere nd'wended aWeed ta eeb. tl.lrowmm. ihe buitlinp a inpawnW o wtl wENn ons Yar W mmqelion. Ne
awnerbuiNv wYl hew Ihe bueden d patiry he a tlw d'd na bwW a impo.a ta Ne qvpws d�dal.
� I. n axrr d iM papeny. em uMnMy mnlreq�q xdh fienmE mnireno�e p mmm�f Nn pyW ($pm �u. Buairan aM
Rawion, coe.: n,e comnaa. licm. l.r eoe. �a wwv �o en o.n« r1 w�r .m nWi. « iipw« �n..on w Ww
caNecb b ed� D�4✓++wN e mnmeM�) fcameA Wnuem io iM WMrx1a� liwrn� l�wl.
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Dtle: Ownsr:
i m nenM u�nr mm i e�,..re a m,e �.br.w,e u,e Aa���«m d wrm:. w.en w sd.n coa. swion. asws. xxsb. ene
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• pxmd IummweionamoEdwiontranlMN�w liaropmatl Diqrie. Rwid�aW oumNpion eppitAfwsm aaemqinm Nma
n�.
Dma: Applium:
WOPKER'S COYVENSATION UKWiATON: I Mreby elfum uds� ps�etly d pryry ar d Ns b0ow'vp Mve'vu:
❑ �n...w.am�v,:,.c«wm.am�wnio.eu;neunrs.Anc.n•caro«�wc�..,aw�a.dtaMs.aiona�ooam.�.n«
cod.. �« �n. oMmiwrt. M m. wk �w .licn inu wrmA u n,u.e.
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`�`"���"�'D�""����' FiHEM�1 �`"S�'l'�I'N°u �'"��'� EXPIRES
c�;.,
ra�.rns,w� ur+�ovoioo�r 07/Oi/96
�rnu .ep„�e.e na w camda.e � w c«m� i, r« a,. num�.d am�. rsiaol d w.1
❑ imnrymmnmeo.n�.au..on��«.nKnm�.wm+av�u.e.iwem.�w�w.roo.�n.m�.o.,m
bett�ne suhjen to tM wMw�' mmpametion lewe d CeWmue, ud p�w Ihtl L I�hwld becmr �upjW lo tM wYen'
canpenWion porisiaa d Setlian �]0� tl the labor COCs. I dWl rVh mmpy 'lh Yow pwitinu. �
om,:Jo—/9-95 ��:
WunNp: F�Hu� ro wcu� roikui rorryw�tlon rovwp� l� unNnN( �ntl • I wtl ct �n �mpbrr M erhNM pwftlu uW
uN� mr, w ro a» nwna wu,w eni.n (rfu4aroA m.wimn ro n. e i� er .n..uon w�.w u a�va.e ro. �n
Sctlon ]]O6 e/ IM lMer Cetl�, InMs4 ���mry%� Iw.
eoNsrnucnoH �v'awo �aeNer. i n..w .M� ��« w�.M a wbm me uw. u. m�m�wb, wwno wKv �« u.
pMamenw d Ne wak br Murh Ne ppmY u u�u�d (`�� �). CM. CI.
IENDEN'S NAME:
LOlDEF'S ADOFE59:
� cwN inn � n... nea u�u.cNwn+.id.w. �w �,. wo.. i��m�wim a c«,w. � ro'« m mmoN wn.n en.�d oaum� oid��.iwe.
vH �Ws laxe rdet�q m ddCM mmuueion W Aereh' euNares �eY��etiw tl Uw �Y ro wx upon IM �bwa�mwpbnW piapa1ry
J� �°'""0°°"""`D°�'' CHUCK JACOHY
P �
��St�6 WP)
o-i� 95
SeleN: G�eeMFib: Ce�W-+�c0�: Fnk-Rw�s�w: GatlxvoA-�swnr
PERf1 NO: E 074684
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : 200005F OFFICE T.I. /ELECTRICAL SQ FT:
CLAIh1 VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS / REF B-74632
�***�r�****�+r+�*i�**�***rtrt*i��i�*�*�-**�t*+r***�-�**it�-+�-*x�*****i��e+��****#****�t��t**�r*#**+f �ce
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S .
------------ MAIN BUILDING ---------- ---- ---- ACCE5SORY HUILDING --------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARICING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
> 'C
1E iE iE �E iE iE 3ElE iE 3E iE a(� �E iE k iE fE iE iE 1f iE iE iE if 1k iE ik 3f iE if iE iF 1E iEif 3f if �E if !E 7k iE if iF iE if 1F if iF iE ik iE 1E 1E if 3f if if �Y.1E ik iE �F 3E 1f if if If if 1f if iE iE if fk iE if k iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPRO�'ED BY ''� DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
# iE iE iE iE iE if iE iE i(� if iE iE ir iE 1E iE iF �)r iE iE Y
LEGALIZATZON:N
1����'311u1�'tC�S�
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 211.00
SOE
aLAr�
ISSOE FEE LS.00
BUZLDING-DIV-> PERMIT ISSUE PLAN-CHECR
TOTALS----> 211.00 15.00 0.00
REVENUE DIVISZON TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECFiANIC
226.00
DATE:
� DATE: ��I�%��s
iF'iF{Fi�1fiFlEiEiEiElE'kk'��iriFiF it�3Fi!'1E
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAZD DUE
226.00 226.00 .00
226.00 Ol'ER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
# ih iE 1E iE 1E k iE iE iF iE if iF # iE # 3f if iE iE jF iE iE iE �E �IE IE iE iE iE iF iE iE �lE iE ih iE iE iE iE iE iE d4 iE iE iE ih iE iE iE iE 3E iE IE iE iF iE it iE iE iE iF iF i� iE aE IE iE iE if fE �1E �IE iE iE iE # ik if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE
ELE
ELE
ELE
ELE
ELE
ELE
20 FIXTURES, LIGHTING 1 ST 20 EA.
198 FIXTURES, LIGHTING ADDITIONAL EA.
20 RECEPT/OUTLET 1 ST 20 EA.
117 RECEPT/OUTLET ADDITIONAL EA.
20 RECEPT/SWITCH 1 ST 20 EA.
5 RECEPT/SWITCH ADDITIONAL EA.
2 SUB—PANEL
V ( . E., i
Ax� 'J q �
.75
.45
,75
.45
.75
,45
11.0�
o: �ai=:,,•,--'.:,,��,;5c �2u�'
C6TE: ��i_a:':`i T7.-r; i-,- �
15.00
89.10
15.00
52.65
15.00
2.25
2 2 , � � /
=�a�t,=
.� - � .^
�\�
CONSTRUCTION AND PLANNING F -& SPA '
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location
,'[. Soil�Pipe-Undrgrnd. 53. Steel Reinforcement
I .
: 3. Electriwl Conduit Utility-Undrgrnd. 54. Forms
'4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test '
6. Electrical UPER Gmd. 57. APPROVAL TO COVER-GUNITE 1
�7. -Footings 58. Electrical Conduit�Undrgrnd. •
6. Foundauon 59. Gas Pipe, O Undrgrnd., Test
!9,-':Vater Pipe-Undrgmd. ' 60. Backwash Li�es, P�Trap, O Undrgrnd.
'��. Structural Fl�or System 61. APPROVAL TO DECK '
11, Property Sewer Line & House Connection 62. Backwash & Receptor-Final .
1. Sewer Cap 63. Heater & Vent-Finai
` _. 1
13. Roof Drains � 64. Plumbing System • Finai '.
14. Rough Plumbing 65, Electrical-Final
15. Rough Electrical•Conduit ' 66. Solar SYstem�Finai .
16. Rough Electric Wiring 67. Fencing & Access Approval �
17. Rough Wiring Sign 68. APPRpVED FOR PLASTERING i
18..Rough Electripl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
ti3.-R6��fiHea:ing & Air Conditioning FIRE DEPT. REQUIREMENT
2� . Rough Factory Fireplace APPROVALS Permit #
21. Oucts, �n Struaure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas � Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hvdro
26. T�Bar Ceiling (Str�ctural) & Monocoat 75. DrY Chemical
27. Frome and Flashing 76. Dry Standpipe
28. lathing&Siding 77. FIXEDSYSTEMFINAL �
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 8 Z/ Notes: �
34. Fina1 Heating & Air Conditioning ` . '
35. Final Gas Pipe-Test �
36. Hood or Canopy � , ,
37. Final Factory Pireplace '-"i�
38. Final Plumbing '
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINAI PLANNING '
49. Efectric Release to Edison
50. Gas Release to Southern Ca�ifornia Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date
11
�
��
�nonessaeu�m+a 555 ANTON BL
OfMERSNAYEIiRqWN: SAKIOKA FARMS
"�'' PO BOX 2097
TERMINAL ANNEX
�vx. �unaa.00�ss:
u"' 9TH
urcxnEcroeetxa+�nn: INTERIOR ARCH 2136232164 �'N0- 93r78
A1C10P�'°�SAO°"�'' S50 S HOPE ST °N 1100
L.A. CA 90071
CONf"1BT0H8Ni1� COMPEL CORPORATION (310)946-8321
C°"'"'0T0��""�0 10410 PIONEER BL
"0°� SANTA FE SPRINGS CA �G"�- 392693
90670 �NT
LICENSEO COMfl�CfOP4 DECLAP�TION: I haaby effim utlar pmely d peejury Nm I em Iiw�eW uMs po.avu ot CMqs e
(��0 w4� Serlion 1000) d ONuun 9 d IM Bmas rM P�dmsoro Cods. and my 4wma u n hA bru eM Mletl.
cmuc.wo.:032054 uc.cuss: C-10"`"o g26 3 �XP: 08/96
om.: /(7 �2� `� i camwo. �le..G A
v
�W NEN BUILDER DECIANATON: I hntly elfum wder pruly d pmj.ry Ihel I em eumq Imm tM Cav�rfm liosna lew la Ns
�bxi�0 �esfon (Satlion'!W t s&ni�et� eM Rdmabtn CoM: MY vY a opmly xM1idi mG�um a Vam� lo mtubucl. etlx. inpws.
demNeR a rWei rry �Iruelure. pia b ea'srvvo, e6o nQueu iM eppGu'u Iw oeA pwmu to fib e aped mameru Nm M a vM
b 4oruaE pvaueN lo Ns prawian� d Na CaLLraCa� li�we lew �Claqx 9(�m�q �h Seqion ]000) tl pwcbn J d iM
Bueinem end Peafanioro Codsl a Ilw M> eM e meemq Nsahan end iM bdm la IM NbpeC memplun. MV vbNtion d Saeion
J03t.5 by eiry epp6nnt la a p�mn �Wje6f IM epplkvtl lo a dW peneXy d nd more Ihen M� lwe�ed dolen �S.vWD.
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a aEarea fa vla (Saa'vi )ou. Buvwu eM PmlmsomCade:The Caa�aCae licenas LewEomm� eOMitoen anrrd propeny
�D bU�f IX TPwO=�hM0011. dl'� Yl�q d000 BIR�I Mq�. �VIIOGd IX �1Mfl� M ��11M9h hB Of �IOf OMl pll[�'MD. Mw�'%�bl tUCh
'unpwxnmb re no1 iroeMM a dfaW la We. tl. howewr. �M bo'tl'up a hnpmsnem e edd wuh'v� one yaar d cvmpMion. Ns
mmaaader.w nne ma w�d.n a o��a ne «.ns ed m� dae a �nww. �« me v�o�e a mel.
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a�»
Otla: Applran:
WONKEN'S COYVFNS�TION OEtt�PATION: 1 haraby effrtn wder pxu4y d pajury ons W IM b0vwiry detle�ioro:
� 1hawWwume'vvenacMEictlsdowneiv�outlLwvebwarke�s'canW�+�ion.eapaidedbMSaman3]00diMleba
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wwk ta Wii� Nu W�� b�uW. MY Waken' oomD��bn i�uurvica unisr vtl VdwY wmber w:
Oeniai �Rfib19NT COMP EXPIRES
°d`�' Nuin°" 0 2/ O 1/ 9 6
(i1Js ppion roM �wt b cu�np/�nd / tM perme u b aw 100 a Nn.)
❑ I wnly Nm In Ns pMmwcs d tM work tar wh� tM pe�md 'u inu�E. I Mell nd wnply� mry pr�on N em� mww o n �o
beconr wbpd �o Ihs v.oMre cmbanWion bws d CYdamie. uM eprse ihet il I e1wWd becmM vdjW to �M r.wken'
compenaation provuione d Seaion J]00 d iM lebar CaN. I NeA t np hxnh mm �� Nw��.
/ �A_ lL.
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oyw ro aMYlvl pwM/tlu aM
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S�ctlon J]G6 0l tln l�oi Cob. /ntw4 ���mqi Iw.
CONSTIIUCf10N LENDINO AOENCY: I hereby dfirm u'dm penelly d pmjury that �hera o e wnAfuCion WM'vp eperwry M IM
�rto�,�.z. d m..� ro, .n�� m: vs�� � e.�,.d (swo� aos�. cw. q.
LENDEP'S NRME:
LENDEF'4 AOOXE44:
I earuh ��a Iluw reeE I�u eDdiutian eM mme �hel Ne eErns iNoemetbn u mmd. I apna la eamdY wn� e0 mY rd oou�uY adineriea
YM tW! Isxf �aW�q b WJdY�i COnWutllOn 4d Mf06`/ elfi�wRf �4�� V� d ��p tYY IOONM uD� lh0 ObM�TMUYJtIlE plOplln'
b, ImoK+�, w�w�.. �K 1
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CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 074831
PERMIT NO: E 074831 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
*���*�*****�+r�*+It�*�+Pt*�D+Ut*���c�**�*****(��****H***�*%*��*+Mt*******�*�*�***it*�*�t�+r**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT ZN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NOTES> �,.,
� t"
% 1(' IE iF If iE If 1f 1E �f 1E 1k �E 1f 1E 1k 1E if 1E 1E iF 1E if iE If IF 1f 1F iE 1k iE 1E 1E�if 1h iF ih IE 1E 1f 1f 1f 1f if iF if iE IF 1h 1E iE If 1k /F iF 1E if iE iE 1E iF 1k 1E If If 1F IF 1F iE 1E iE IE iE iE 1E fF 1E iE 1F
D E V E L O P M E N T S E-R V I C E S R E Q U I R E M E N T S
� n�
ZONING APPROVED HY �'"' DATE:
BUILDING APPROVED HY : DATE;
APPLICATION ISSUED BY:
�r*x�*x�x��rx�x��rx�x��r**�*�r*�r�r* �
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 63�1�;
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CFIECK
TOTALS----> 63.15 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECHANIC
78.15
DATE: I��L�' ,�/�
��*�r«***�+r **
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
78.15 78.15 .00
78.15 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
iE iE 1E IE IE M IE IE 1E IE 1f ik 1E 1k 1E 1E M ik I! If if if iF iF M 1k If ik ik 1f� 1f 1E 1E 1f M if k iF 1F 1f 1E IE if IE IE IE 1E 1f 1F 1E M 1E k M 7f 1f M/E If 1i 1f IE 1f 1k 1f M iE 1f iE M 1F 1E 1E iE 1E 1F ik iE IF
I N D I V I D U A L F E E 8 R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 COMMUNICATION DROPS 1 ST 20 ,75 15.00
ELE 107 COMMUNICATION DROPS ADDITIONAL .45 48.15
END OF FEES
n 3 2
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� CONSTRUCTION AND PLANNING F _& SPA
� APPROVALS Permit # Date Inspector pppROVALS Permit #�- Date Inspector
. /
1. Temporary Electrical Service or Pole 52. Pooi & Equipmenc Locatiori; � i
2. Soil Pipe•Undrgrnd. ��' 53. Steel Reinfarcement -"T � a-
n�,,3�-�rigctrical �undu�,tfuc�,itv-Und`"igr�d. 54. Forms '� •
'� �4?N'earicai �d'rid0�' rgrnd. J 55. Electrical Bonding �
r. �-. o
-�4�'Eel Reinfp; cemer,.?�-� 56. Rough Piumbing & Pressure Test %,
-'8^Electriwl R" Fn�. 57. APPROVAL TO COVER-GUNITE r'
r -.y� c
''�"F�otings a.�j j�� " 58. Electrical Cond��-Elndrgrnd. �� �
-. 8. �oundation;� Q��o. � 59. Gas Pipe, O Un�t�cnd., Tesc
•�. r, ,
9. 4Vater Pipe�llndrgrnd:'�`� 60. Backwash Lines�rap, � Undrgmd.,
70. StrutturaY_81oorSyscem - 61. APPROVALTO-DECK �
11. Property $ewet Line &, House2onnection 62. Backwash & Re���orFinal ,_ �
72. Sewer Cap;, ` �% ; 63. Heater & Vent-Finol '
13. Roof Drains �� "' g4, Plumbing System - Final � . .
14. Rough Plumb ag 65. Electrical-Final .
15. Rough Eiectriwf-CorWuit 7' .C' 66. Solar SYstem�FinyL� . ',!.
16. Rough El�tric VQiriny� _ 67. Fencing & AcceSs Approval ' .i'
-�77. Rough WiringSign �-., 68. APPROVED FC�"PLASTERING
18. Rough Eiett7�pl� Bar Ceiling� 69. POOUSPA SYSTEA9S FINAL
19. Rough Heating & Air Conditioning `. FI��D�PT.�EQUIREMEt�T ��
r
20. i�ug�Fa'�oryrFir��ce i Sr ' * H c,� ' pPRDVAI:���G„Pe�it #�j.�:.'._.p,'�.:.
�
21. �ct�in 6tru�ure*��* .. .. �-! * S J r-�* 70. ilnderftlurl� HyTdro � .
22. Qucts?Ver�ila�ngR� ' '' ;� �., ��' �71. Produqk���ping�i�as tfOil
23. Gas �e�F�ougp& Tect b7 -� x m V S O>' 72. Undergro`und Fta, �i � H --
24. Foof�ram�ing" •�* • - �� Y � �,* '7�Under9m�.Stor,d9z•TankaDGas CQU�
25. Roof¢he��hing S* .Z ' v�� � N+ �7qr�OverheadHydro� *
s
� k� C' :.7 A' ^' c F+ p r1;1
26. T��Ba�eiling (Stru�t�ral) & 14Te��bat K G . ...� 75''.,_� Dry Chemical �,_; W � �C
27. F�ame.and..F�ashing,,� �x� �p� ;� c�s 76.�DryStan�ipe F:: ��� E�.
✓r -, ^
-28. Lath�8F�Sidin9 �#y �Q` � ,.'' "� 77' FIXED��,iE(�I�FINAL . n M'�
'29. Ins�latiofi-� � K V 5�� �. � r` � 4 7gv' FIRE PREV. FIN�}'L "= T. q�r,
c,
-30. Drywall Nai�ing C`•* H 'y ti I ,y. �' �?�ALTF�.�EPI�. R'EQLIR�'I�ENT
�31. Piaster Bra�vvn�Eoa(.�c S �?�s � � ^x 79. FINAL 1�6�.8gECTt9N• r. � � y
�, -fn
-32. F,tectrical w M' r�Gal � * �3 ' �T 80,k'�yF00D CERT�F�A�E i�'S�ED� vn
�v. � t*�:� , � �-' � ' Noies� -. �-f '-: m s � � U :.: [�� t^
-33. �fial�FlecH�c y * ;r, , � �'�� �� ,,
;-34. Fina173eamhgBPAii�bhitionin�S c� *:^ . �R �: '�'�+ •= f�= x S 7
-' I r� � H �+O O! !-+ �G ♦ '-i �
� : ' .}, . , • ..
.35. F.i�al�as�pe:7esiQx i, . ,� ti j � �� n:y Y� r.:rr•�
�.36. HOOd:of CHhopy .•' D� t*� `7 a x fl i j i i.: f�C + �-+6'
a :t� n i s:�! r. � �cc . m -.�r.,;
�37. Ftoal�aC{o!Y FireQ �2��' i Fc, r., �. � .•. - �: * v���.^,N
'-38. Final Plumbing m* m�� i � '. ' 4A _ � � * �. -
`.39. Water $ervice-Final';* £ i 6 + � � '� � '.' �
,•R0. Gas Service•Final f �_ [^ �¢t•";�' * n ^r O�^ •�� ?�
r'a n• r, r. � vE 'f' Q
�41. Solar Oomestic-Fin�x: �' n ' , V � f;e �;, .;n. * Z '
42. Backflow PreventeGx �: r y i 1 r '- >F x: Cl r�
� N .Y t:, r�r A: tJ
43. Backflow Irri * �SS * � -' � .
9�tior�.� �, '+ �. k- �� a- C'
� �
r
44. Landscap€7rrtG3tion�6ystem �T.^ � '�n � C Ort �� ;� s!; < �: r„n� _.
-. -, n�r -� . a r � : :� Gc `. `" -
r '� � '� a -� S F . t 2 r- F - � � r� � u - - ' -
45. Sowd Atcen�tion- r . .. * t: � ;..�� m _ � • F'_' _ `
48. Ha�dicap Reguletiona =, O � �' C 1. S x �•.,
v a '] •
4J. FINAiSTRUCTU�,F�`&BUILDING * ; ' t ' '" 'j ,r
48. FINAE PLANNING + '-F � n% = n m 'y y. ` ,
_ � ;.� ;� •� - k d
49. ETectri¢ Release to Edison ' K' ^ - ' •
x 1 r C, - a
� �
50. Gas Release to Southem Califorrt're�6asCo � '� H - �c'1 w �' ••
z. � - n ... �. .y.. .
51. CER�IfICATE OF OCCUPANCY � • •'+ ' -' �
No. Date
�
yl
woncssaeunmo: 775 Afl�1�UN UL
avH€r�i/+�cira�an+: SAKIOKA FARMS
.noxEs4 PO BOX 2097
TERMINAL ANNEX
�w�. �uuxo �ooa�ss:
uHr: 9 TH
urcxirectoneow�nn: INTERIOR ARCH 2136232164 uc.w: 9378
uux.oaua�saoo�ss: 550 S HOPE ST uxr: 1100
L.A. CA 90071
cw�m�crarswu� CAL—PAC CONSTRUCTION ( 310 ) 645-3500
�� CON111�CfORSYNNq 6076 BRISTOL PARKWAY
� wo�ss: CULVER CITY CA ��, 392102
i 90230 �M; 106
�I 110ENSED COMN�CTOHS OECL�NA710N: I Mraby M'rm uMm perely d prpiry Nn I em Icmmod ivdw pMvu d Cheqx 9
(mmmanrilq r.d� Soclion ]000) d Owiaian 9 d Ne Buv'wu arM Pmleeeons Cods. end mY Ywius u In lutl bm eM Wed.
cmuc.No.: uacuss: B /^u�p o.: 3921',c r{p;
Dme: / ConlmMn��/'
OWNEN BUILUEN OECIAN�TON: I hareby dfi�m uMx penety al perjury� q hpn Ns CaeraCon licaNe Lew la 1M
�Wo�iq raewn (Saeion )W t.5 &nir� erd Prolwbru Coda: �m dr a mmt�/ xliirh ispu"va� e D�u to mmwa. ebr. imwova.
Ad'eh. a �apei mry �t�ucuus. prior b C�'seueMa. e6o repuiree tM eppliam la ach pamu Io fib e a'rypwd qalemeM thtl M a aM
,�«,.ad wm�w m ma awi�am a me canrea«s uunx iew Icneq.. s(m��a .an swon �000l a oi+:im a a m.
ai�rimw and Rdmima Cotlel a thet M n eM u awamq therehan vq IM baw ta Iha eYapeE mamqion. My viduion d Ssqun
]W I.5 tr/ em� epp4cem In e parmv aibjetl� Ihe applicaM b e dvil penely d na mors �hen frve himdnd ddlan �5500�).
p I, m oxnar d iM papany a my empb/eee wih wepea av Ihe'v ede oomperae�ion, wlldo Ne work, eM IM sWduro e Iwt inlenEeE
a MareE br Ws (5ection )Ou. Budinu arM Pmfasuma Cade: The CoNraUon tim1ue Lew Ema nd apply lo en amr ol popeM
wM Wida n inD�+� IM2m. ud wla tlaee tuM woM NmeeM a MnN u WuNh he a Mr own emDbM�. O��sE IIW euch
"unpovamew ua nd'werdM n d1aeG fa eab. H, Irowever, lhe buitlirq ar inprmammt a aoN xrthin aa yeer d camplMion. ihe
ownarbuitler v.ill hew iM bu�den d povinp M or ehe did nd buik a impwa for iM purpoee a1 seb).
� I. m owiwr d IM o�wwtl, am udvwwly aonirea�v xilh GmroeE convectore m mu�ia tM Vq� (Sed'on 10u. &roi�ros� eM
PNstrim� Code: TM Canntlon Lioenn lew doae ml WdY lo en ohnx W V�W�Y who delM Or'vnpw'u IM�son uM x1a
mnue{.ta Ia wtli propea wnh � mmmGa(e) IcemeE Wnueni �o �M GoNrapws Licems Lew�.
� I am uanp uidr SocYan: B. 8 P.C..In this rsevon:
Deie: Oxrwr:
1 do hsrW�crWy tM I em eww d mtl udraWd Ihe nQuiiem Wa M Cel%ortde HeeM ud Sdary Coda Satlioro t5505. 25�.1�. W
PSSJ�. aM tlul I a M' hAu� dddinC �Pw wJl / wll r�d (arcb ar) rwetl b complY r1h oiC ms mdu md the nCW�emaw b
•P�+tamnwCionwmoEfwbnM1aniMlv ua�y uupamaYD'atnd.ReudseWmm�ueu�epD�iwnmawnqlnmNma
pwidau.
Dala: Applium:
WONKEP'9 COYipl4ATq1 DECWIATION: I hw�bJ dlum wGr pmupy d pa�ry ans d Na IaYow'vq drLrqiwa:
� I hm� eM wY meinien e c��G"ut� M aonwn� io ��Cineun W wakaa' mmpenaetion. o prwded I> py Sqbn ])W d iM LeEn
coe.. �« m. o.��. a u» .oM �a w+:�n w. c.�n 4 a,�se.
p � n.,v w vN me'vu.n.ab.• mno�mi�n'ueurerc.. m i.m�a.e br s.au� �oo a u.l.mr cod.. m. u» o�� w �n.
�����'�e���'FIR MAN S�FUIS�D ��� EXPIRES
c�«:
v,r�ra�e.r nwt� nu5ybn�i 02/O1/96
�ina re�m,..d �or w cm�Wm.n � w a�e a ro, one nune�.e dm.�.lsiool w wv.�
❑ � o.nN nn m in. v«�om�.K. a u..nn ror .,niU mu o«�a w ewee. �.neo na emqm� �r v� �.m mww .o ., �o
Eecam� wdj�e m Ns Moe1<n' mnqa�uYion law d CeW e. eM epeas Ne � v r�p to ty� wYen'
wmp�uti�/pj� {��+/ d��bg m 9)OU d IM lebor 1 )��y-�
Dtls: ��_��/�Y \ Mdiceiu:�� .. �`
w.mpro: c.ew. ro wcu. rertrn'rnma�aon cov..pl b unYwlN..M.M� uel<e.n urp�qw ro crtrYllwM n��tlr.w
aN� n�,.. w a oo. n�,e�.a mo�.w eai... rrioc000x m.mao� ro ar. ew� e� n�m«�•wn e.�.w .. ao�e ro, �n
s1etlm J10B ol fM l�0oi Cod, INwuc �ntl.tlom�Y. hu.
CONSTflUCl10N LENqNO �OENCY: I hsrWy dMn undar penetly d pujvy �!W IMn e e mut�uabn Mitl4p �puy,y Ip tM
qAamxre M tM wpk tor whM ih's W�i o ewtl (Seann ]091. CM. GI.
�ENOER'8 N�IIE:
LFNDEN'9 AODFESS:
I ceniN �� I hew �xE Nu epplicubn W atl� �hal �hs ebova in/ormNbn u corrwa. l pna to compty with N tay ud owntY oN4uro�
vM �W s lex+ialtliq b dtitlnp mutruCian W haraby eullwr¢e repamntelrvm d Iliu cly b Wx �pon IM ebo.a�meNidiad popsM
lar iiupatlbn
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D�te: �U I �J
(5i51�E.WG) Whne-�Ildiq85elery:0ieen-Fb:Cenary-Appiwit:Pink-Reram�e:GdCenmFMw�aor
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 074632 PLAN CHECK NO: 03721-95 A
PERM NO: B 074632
GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-ER PERMIT TYPE: STR PURPOS£;.ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT: 20,000
CLAIM VALUE: 360,000.00 CALC-VALUE: J86,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
***ir�*iE�E*s***********��iE**�****��r**���*?Ek**rt�+�*�*�**it�*�ac***+E*iE***+r****�**+�rt*srt
, Z O N Z N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDSNG ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN kGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR 9TH FLOOR FOR 76 PRODUCTS COMPANY
� � .
�c-*ir**x�**�-*****�t*�x�e�*'��i�*�r�r.+E�F�*��*********�-*****�+t-��***+r�*�+�*�*********i�**�r****�
D E V E L�O '� M E N�T S E R V I C E S R E Q U T A E M E N T S
l : �, �
ZONIDIG APPROVED B�Y " � kC.� DATE: lU I_I_��`'�l
HUILDING APPROVEDlB�IY/J�: J / DATE:
APPLICATION ISS�JEDI:BY: �% (nlll- 1�- DATE: lO�j��j I�j
LEGALIZATION:N
BLDG PMT
PERMIT 1,644.00
PLAN 267.15
ISSUE FEE
� F E E S U M M A R Y
PLUMBING ELECTRIC MECHANIC
iFiF�FifiFiElfikiEiklEifiE�� iF�e'iF �'iF1EiE
STRUCTURi�L SEGMENT:Y
FIRE SMIP/RES GRADING
SMIP/NON—RES
81.14
BUILDING—DI�'—> PERMZT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 1:/25.14 0.00 267.15 1992.29 1992.29 .00
REVENUE DIVISIO�I�TOTALS--> COLLECTED: 1725.14 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHPNIC FIRE SMIP/TOT GRADING PLAN—CHECK
1644.00 81.14
if IE ik iE iE iE jE i!� iE fE �E 3E if �)k �E �)h M# 1E iE jE 1E IE # if ie iE iE iE if iE 3f �7E 3f jE �1E iE if iE �E iE iE iE �7E 9E IE iE iE 1E 3E IE # 3F iE 1E iElf it iE 1F if iF iE IE if iE if if iE i(� iE�IE * 1E 3E 3f iE if iE
I N D Z V I D U A L F E E H R E A K D O W N
TYPE
SFC
SFC
SFC
QTY
2��0�
20000
Z00��
D E S C R I P T I O N
OFF—INT. ALTER I'YPE I,II F,R, —AVER
E(jU—ALT COMM. SPRINKLER SYS —AVER
EQU—ALT COMM. AIR COND —AVER
END OF FEES
�NIT COST TOTAL COST
18:36 3fi7;200.00
.72 14,400.00
/
O1 CJt4:=.:-7;15:'3', T"-�Y 1%�5.1•,
LAiE: 1".:;vc ';I"c: ;;:�.
,
._�--
3�CONSTRUCTION AND PLANNING " POC SPA -
�APPROVAIS Permit # Date Inspector qppROVALS Permit �`r Date s� I.nspeetor
�
1. Temporery EFectrical Service or Pole V 52. Pool & Eqvipment Location • '
2. Soil Pipe•Undrgrnd. ' , 53. Steel Reinforcement `�
3. Electriwt Conduit Utility-Undrgmd. 54. Forms
4. Electrical ConduibUndrgrnd. 55. Electrical Bonding ' i'
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test ,
6. Electrical UFER Grnd. 57. APPflOVAL TO COVER�GUNITE
7. Footings � 58. EleMrical Conduit�Undrgrnd. '
8. Fo�ndation ': 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgmd. I . 6p. Backwash Lines, P�Trap, E7 Uodrgrnd.
10. Struccural Floor SYstem 67. APPROVAL TO DECK I
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 Electriwl-Conduit � 66. Solar System-Final �
16. Rough Electric W��ing , 67. Fencing & Access Approval •
77. Rough Wiring Sign 66. APPRpVED FOR PLASTER WG � -
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ` �
19. Rough Heating & Air Conditioning FIRE DEP7. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Duc[s, in Structure 70. Underground Hydro
22. Outts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Freming 73. Undergrnd. Storage Tank L7 Gas ❑ Oil
25. Foof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Seructural) & Monocoat ��'✓/�j' � 75. Dry Chemical
��.�
27. frame and Flashing �f0/� � 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 7$, FIRE PREV. FINAL
30. Drywall Nai�ing //J � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriwl Power Meter�Final 80. FOOD CERTIFICATE �SSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Finai Factory Fireplace �
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final �
41. $olar pomesticFinal ,
42. Backflow Preventer
43. Backflow Irrigati0�
44. Landscape IrriAat�on System
45. Sound Attenuation
46. Handicap Regulat�ons
47. FINAL STRUCTURE & BUILDING l�ry �6
48. FINAL PLANNING
49. Electric flelease to Edison �
50. Gas Release ta Sauthern Calitornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No Dace - �
.
"0°"�S0iB1"L0"°' S55 ANTON BL
°a"E"s"""E"a�a� SAKIOKA FARMS
, '0°"�'k PO BOX 2097
TERMINAL ANNEX
/ippl. N4I1N01DDNE99:
u"T 9 T H
ApCNRKT0RO10°'� INTERIOR DESIGN 213623216'CNO� 9378
""�"�pFNO'°'0°"�p' S50 S HOP£ ST °Nf� 1100
L.A, CA 90071
caxm�crare xu�:
CQIfN�C10RB YNfIIq
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uNr:
IJCENSED COMRACTONS OECLAX�TON: I Mnby Mkm undar pwWy d pwpvy pW I em Icwind undx pwieoiu ol Gheqx B
(mmT�O wiih Sodim ]000) at Divbion 3 d tlw Burinw vM Pm1a�wN CoEa. ud mY fmrue u in hA b�ca uW aflq.
cm uc. No.: uc. ouas: uc. xo.: E X P;
Dms: Garureaa:
OWNEP BUILUEP pECLAR�TION: 1 hNeby a1Nm indx prW y M p�rjuy ihtl I em uemq Irom IM CanrMas licau� law la IM
Idbw�q �aewn (�ion )0�1.5 &anm� enE Prolu�ioni CoJe: AM c'ty a aoumy xfiid� iapuirm e permG to mrutruq. etler,'unDrove.
�leh, p r�pLL ury �I�ucluro, p'v b L�'sauerca, ebo ieVuim IM epplkeN ta wch pmnN lo file s slpMd �letanbm tlut M a�M
,m.a a+�w.n� �o m. vwhbn. a u. can�m«. uaMe �nw lcn.o�« e(mmmeiwno wan saaun �oacl a a.:ion 9 a ��v
.bn eM Prdvsiona COM� a �M M a 4r b azemp ihreham enA �Iw Wris lu Uw �k0� exunqian. MY videtbn d SW bn
Mt S by ury appliraM la a perm! �ubjea� �M epplicanl to e dril penelly d rid mm IMnlHe h�mdrsd Eopen �S,AOp.
� I.moxmrWtMpropMyamyampoywwYAwapwmlhei�dacdnpriWion,v�doUwxwk.eMtM�mvAvaendinisMeO
a dlydbr uM (Section ]oM. Businav W PmtaasonaCoM: Tha CaNreeaa liwroa lewEou na1 W W menorns d MWsM
wM Wih ar mMa'^^ �Mreon. md wM doee ��ch xak Hmwtl a henN a Waqh h'v a ha wm mmPbYMe. o�+deA ihm wch
fmwa+mew m. na �tenaee n an«ed �or.ds. d. nowevu. �n. w�d'uro a:nwwaoerv w.da wnnin a. vw a cand^�:�^. uw
owew�diNar xill heve IM burden d pewinp M a die did np dNE or hnpwa Ia iM purpws d eds).
� I. n ownor M Ihe proper�y. am e�tlumvely aonirenip wilh licenaed convactae b crosrtWf the piojeC (Seeon ]Ou. Bueinwe erM
Pmlwim� Code: TM Ga4reCm L'r.enae Ww droa rwl WWY b en oww d WW�Y Mw WiIG ar Inww'u �Iwaon end who
canvern b wdi pqee� wuh e odvraaor��) IicanuE Wnuuu lo iM Caureuore lioems Lexj.
� I em ve d uMn ': B. 8 P.C..Ia Nu mmon:
'� om.: � 2 6 ! o,,,�« �iS .,r.�.i" % - - -
I do cmW' Nel I n ews d entl �Mr�lend Ns roPiremWa tl Cdfartes VI�eM ud Cods Seabro 25505. RSSV. eM
Y55�e, eM Me� I a eiry Mun WBJirp aoowent wiA / wil �(arcb ww) need io camp�y xih eeid qete ooEse eM IM ispwninama Ia
aDertMlnmrovudionamalifimiontromiMM�y viepeme�uDiurid.WWa�admM�utlionePVkffibroueexemqtromlhue
DM: AoWicem:
WONKEP'S CONFDI9�TION DECWI�TION: 1 Iw�by NNm udx psWy W pa�vy dr d qa IdbWp dduet'an:
p in.Y..mwmrM.:�.ane�.a�..a�o.w;�neo..,n�..•e�uo,,..w�a.ai«Msw�,arooain.�.eo.
COM.Ia tM partamencs d tM wak la wlich �M1b pemiu u'neusE.
p �n...wwmeime:,wnd.•mn+o.rmnioniro�,�.M.....pui�eawswb,��wam.laba.cae..w,n.o.�armenr.d�n.
xak la whiN thM VMM w 6susE. My walun' mnV��ion innrtar�ca mn'wr uM V^kY numEn era:
c�,:
Pdicy Number.
, s«rim n.se ror o. romdmee � w n«mt u ror ar n��d�ea edte�. /Siao/ n 4u./
� 1 oertN tlw'v� Ns D+�artarca tl tM1s wak br �.ni t� ma Deimu u'veueA, l tlW mt emdW �Y w� e an'f mvvw m m m
yecmw wbjse io ilro waxaa' mmperouion laws d Cebomin. enA qpes pw A I Jwuld bxmie vAjee b �M waM1an'
�«roa.wia, w�o�. a swion noo d we �.nw cod.. � wu �onn.w canbr wnn mwe pwi:o�..
Ow: Appliceiu:
w.m/nD: F.nun ro.wur. wo�lrx.•roiro�non ewirew b unl�wnil, .iw M�II ueN�'r.n �rroloyr ro Mmlirl CMvro...ne
clvll ll�u W b au M1u�arM Mauwq do14n (f100,OWA M Wtlltbn M N� co�t a! compmutlaM1 Wrtrp� u poHAq br M
9�cH0� �1U6 0l tl�� LMor Cob, /nfwl. �M �ttomsY'I /wx
CONSTAUCTION LENqNO �GENCY: I hsaby eMrm unEer penMy y par'�ny Ihm iAre b e oorutruqbn bM'up q�srcy b the
wnom��.» a in..,on� io..nw� in: c�� ��ww �s«�p� xn. c:. c).
LENOEN'S NAME:
LENOEP'S ADDFE55:
1 cxWY �MI I heva rotl Nb epqiration ed nms Ihtl IM ebova iNpme�cn u cortaq. l ep��ae �o oomply x'rn ep cuy aM wisity ordiixriwe
�q ¢W a lewe �elelvp to W'ikiq con»Wian erd Mreby aullwrize'epeveni�i�m d Utia rey m anler upon tM ebv.e�membaE qopaM
ia ��.wa�oo w,o�.
ERNIE VITUCCI
.-�r—�:a wm.
�/1l 6s � `J ♦ ��/ %l..J G 'L � De�e: � '16
sro�w��do.,,e��✓ �ma
`(St5t�6.WP Whne-BuildnpdSelery;Omen-Fb:Cemry-�ppiranl;Pink-tievenua;GaWenro�b�aa�a
,I
CITY OF' COSTA MESA — BUILDING PERMIT
PERM NO: B 076196
PERMIT NO: B 076196 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC—VALUE: 339,625.00 GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION RE:ttH74632
iE 1F iE iE 1E iE dF it iF 1E iE iE IE iF 1F iE 3E if iE iE iE ik 1F iF �E 1E iE iE 1f 141E iE iE 1k iF ik 1E iE iE iE iE 1E 1E iE iE iF if iE iE 1F �E 1E if 1E if iF 1E 1E if 1E dF iF 1f 1E 1f iF iF iF iE iE iE 1E ik 1EiF iE 1F �E �k
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING N6TES>
j
dE 1F 1E iE iE 1E dE 1E if !E iE if 1E 1E 1f 1E IE 1f 1f if IE iE iE fE iE iF if fF iE �Elf 1E iE if 1E 1f fE 1E if 1F iF 1E IE 1E IE 1f 1E 141E fE IE If 1E iE dh k 1E iE fE 1E iE 1E 1f 1E iF 1E dE iE 1f iE 1k 1E dh IE iE 1E fE 1E dE
D E V E L O P, M E N� T S E R V I C E S R E Q U I R E M E N- T S
ZONING APPROVED BY DATE: �
BUILDING APPROVED BY : DATE:' ���
APPLICATION ISSUED BY: W � ��' DATE:
�t at x� �t * at * at �t at �t * it at �t ** at �t ** �tiFiF7f3fiF"iFiF3F'�iFSF3FiF iFif3F3F�iF�E'iF'iFiF3F�F3F'iF iFSFiFTF'iEiF x� qt ��t it at �t at � at _���F�t �t
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 1,479.50
' SMIP/NON—RES
PLAN • 71.32
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 1550.82 0,00 0.00 1550.82 1550,82 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 1550.82 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC� FIRE SMIP/TOT GRADING PLAN—CHECK
1479.50 ' 71,32
iF 1E 1E IE 1f 1E 1f 1E 1E 1E 1E 1E if if iE 1f iE fE iE 1E 1f IE 1! 1k fE iE 1E 1f If IE iE 1f fE iE 1E 1E fE IElE IE fE If 1E if 1F 1E 1t IE fE IE IE 1E 1t iE fE 1E 1f If 1E 1E IE 1E 1k 1E 4 iE 1E if ik fE 1E IE 1E 1k 1k if iE iE fE
I N D I V I D U A L F E 6 B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 325000 T.I, OFFICE 'BY VALUE/$1 1.00 325,000.00
END OF FEES
_: :1` . � - �� T� � � �
.'i.'.. , . " . . .. w.. f'
CONSTRUCTION AND PLANNING - POOI - SPA
APPROVA�S Permit# Date Inspector AppqOVALS Pe����it•# Date InsPeccor
1. Temporory Electrical Service or Pole � 52. Pool & Equipment Location
2. Soil Pipe•Undrgmd. 53. Steel Reintorcement �
3.-Electrical Gonduit Utility-Undrgmd. • 54. Forms '
�4. Electrical Conduit�Undrgmd. � 55. Electrica� Bonding
., 5: Steel Reir�forcement 56. Rough Plumbing & Pressure Test
�: •Electrical UF�ER Grnd. 57. APPROVAL TO COVER�GUNITE
-r
' '7' Footings ; ��., 56. Electrica� ConduiEUndrgrnd.
• 8. Foundati0�t�� 59. Gas Pipe, O Undrgcnd., Test
e
9. Water Pipe�Undrgrnd. ' ' 60. Backwash Lines, P-Trap, O Undrgrnd. '
10. Struttural Floor Svstem 61. APPROVAL TO DECK
i 1. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12. Sewer Cap, ` • " 63. Hearer & Vent•Final
73. Roof Drains r �� 64. Plumbing Syscem � Pinal
i4. Rough Plumbing � 65. Electrical�Finai
15. Rough Elecvical-Conduit ' ' 66. Solar SYstem•Final �
16. Rough Electric Wiring � 67. Fencing & Access Approval ,
r 77. Rough Wiriag Sign 68. APPROVED FOR PLASTERING '
18. Rough Electrical�T Bar Ceifing 69. POOLlSPA SYSTEMS FINAL
19. Rough H�ating & Air Conditioning FIRE DEPT. R,E�UIREMENT .
� o- �i
20. RoughFaitory�:Pire0lace , ^!'' : ' ,- � �APPROVALS�. Per'mit# ` � I
21. Ducts, in StruC(ure= . ••� ' - � 70. Undergrou!ld Hydro ''
22. Qucci„Ve`rt'tila�fing� � � '` _ 7�, ProduciPipingC76as. �Oil �
23. Gas Pipe-Rou�h'& Test � ��+_� � r <; � *' 72. Underground Flpsfi' - ' - •
24. Roof Framing" '"�T `•"r' ' " ' ;,, :_ _' `73:� Tlndergrri'd.Storag�ri7ank�OGas ❑Oil
r +
25. Roof-Sh@athing ! ♦ ' .. �� - - 74;.Overhead Hydro. -
� �/`,
26. �Bar Cefling (StructuralY & Mo�ibpbat p'3e�� � �Y 75',..Dry CherPica� _ ' �'
27. �'ameand Flashing- , - -• I ( i. J6^ Dry Stantlplpe =
- /_/�� .� -
28. Lathing&Siding '" � `4-� � ' •• '�' 77r FIXEDSYSTEM'fINAL` .
"r ;�r� r �
29. Insuf2tion `. ;" � �� � � � 78,' FIRE PREV. FIN�,L - - T
30. Drywall Nailing �' ��6/�` _ `I�EALTH DEPT. REQl7,Iq�AENT
� 31. Plaster Brown Eoat �� ;� - - ' �'� ��79. FINAL IN3PECTtflN � � ��
-'32. ETectriwl�Power MeierFinal ' '� ` 80: F000 CERTIFICY�TE ISSUED"
-�
-33. Final-E�fciric ` • �- �Notes: �- -- � "� -•
34. Final Heati� & Air �onditionin � r ' ���f'� � { � y...�
9 9 '-. '' . �' �aIO_ ,.. - Ld.� /�� {1.��1
35. Final�Gas Pipe�Test. ` r` � .. ls �' j�, I�T1� J.(��. 1�-� '
- 36. Hood or Canopy � . . • r .. .. � _I � �� ': �-� IV%%� � 1 �
_ _ a
-37. F�nal Fa�ory Fireplace _ '�'�-_ � : �A �� i �
38. Final Plumbing �" � ' -• _' _� ` `•� i
t �
39. Water`Service-�ina(' � � � , � ' - � � �
' tr
-.-40. Gas Service-Final � - , - " �
' 41. Solar pomestic�Final, � ' , X - , ,
42. 8ackflow Preventer - - � � • " ' • �
r� = t . t ' �.
. � � , �
43. Backflow Irrig�tion= � . - •- ; � , . - �
44. Landscape:Irrigacion�Sys[em �':.t� ' -' ' „� • ' - _ ' ' C" �
r' � .
-'.� . r `- t_ ' S; ' ; �
45. Sound Attenuation ' . „ , � - . ,
4�6. Handicap Regulations .- � � � " = • ` � : �
47. FINAI, 5TRUGTURE & BUILDING .// U/(f,b � - • �
48. FjNA2 pLqNNING � . • . ' ' ".
48, Electric Reiease to Edison : � _ �� , - � ' -
50. Gas Release to Southem California Gas Co ' '
51. CERTIFICATE OP OCCUPANCY • � � �
No Da2e
�
woncss a eu�uen � 7� eirv 1 vtv ts L
avrhmraueivaan+: SAKIOKA FARMS
.owcesx POI BOX 2097
TERMINAL ANNEX
�vv�. vuw+o wo�ss
VNT:
axcxnecronEtamvn: INTERIOR ARCH.21362321G4 uexo, 9378
I�NCN.ORFHO.'SIWflE54: SSO S HOPE ST urir: 1100
L.A. CA 90071
camucTarsx,u� SWINERTON 6 WALBERG ( 213 ) 896-3400
owm�crom��wio 865 S FIGUEROA ST
�onncss: L. A. CA uc ra.: 9 2
90017 uNr: 3000
LICENSEC COMP�CfOfl3 OECLAflATION: I hemEy elirm unEer perwly d perjury Ihet 1 em ficerwE urder pwidme d CMpim B
(mmmendn0 ��h Sectian )000) d Divnian 9 M �he Buineee enE PMaesum Cotle. end my liceiva u in IuA bres erd ellen.
cmuc.No.:046p27�9 uacuss: B uc. . 2 SP: 10/95
�i De�e��� �W � li� CoMreaa:
I OWNEP BUILDEN DECURITION: I hereby elf uMx panely d 1� I un e�emp han tAe Wmesqm Liean Lew la iM
Idbwip iaeeon (�� ��1.5 &niiaee aM Proimaione COAe: �M �Y a unry v.fiirl� �e �'m e imn io mn�vun. er. ImDrwe.
'emdeh, ar repv ury �bunve, prior w aa eaence, elao reQuirm Ihe tor wch pennd I a eqroC M�emoM Mm M or �M
. i��..e w�v �o me a�. a o,. comrmor. u��sa �w Icnep., a 1�«�,c »an seco� �000) a oHe� � a�b
Buwmn vd Hdw'vu CoOs� a t1W M a eM 6 uemq �haehom end IM beae b Ne eAepeE uampion. My vbW ion d Sopion
)W l.s by eiry eppYreN fa e pe�me uLjeiYa �he applicW �o e tivY penely d np mon Nm IMe hWiW AoOer� �5500�.
� I.eaowrordlMpopenynmyempb�eeswYhw�esavtMiedemmpevatan.w�EOlMxorkerdNe�wctunend'weMW
a oEe�ed be eeb (Seeim ]ou. Busimo aM Pmluvona Code: The Catlroam liorua lew� does nd wdY�o en ownard pwMY
wM buida a inpwea Riaeon. eM Mn do» auN xak IJmxtl ar hend a WwpM1 hu a Mr wn anplq�s�. pwkeE ihel wch
'vnprwemMa rs na'vesdtl a a11seE la ub. G. Iawever. iM b�itlinp p inpwwnW b wtl wilhn aw Y� d aomplwion. the
orrtw�ddder xiA hew the daden d pmvq M a eM d'd m ddd a'vnryv.a ta Ne qvpua tl aMl.
❑ �. u own« a u» nw.n..in ud��.ir mvi.anc xiln 4mmea cmv.,a, m mmic in. na.n (swbn la.. 9�.inm..iw
Pmlencm Code: TM CaYmm L'wve lew dw nal eroN b en rnnw tl PwNY Wa bu0d� a vnpw'm thaaon and wM
eameacu b adi popaa weA e mv�eeMa) IkeiwA P�uem m �M Canlradm Limma lew�.
❑ I em wmp ivWr Sstlion: B. d P.C.. In ihu �eem:
Dms: Qnar:
i eo n«.w c.mm �n i.m.�.,�. a w�w,a m. ��am w c.um:. wmn w snm coes sww�. sssas. zssv..�e
�
iM ��.�ro a
ow: �ow�:
WOflKEN'S fAYVENSATpI DKUH�iION: I hareb� e/fvm �udr pnMy d parpry ur d tlw IabwNp daWeiom:
❑ �n.v.wwme�u,n.c«wut.am�u.vio+.n;�wwm.whe.•mro.wia,.oawb.e�«Ms.aionarooam.�.ear
CoG�. ta iM prlamvice d Ns wM1 la wlirJi this perm4 u usueE.
❑ I Mro eM xil meiNan xarlwa' mmGui�etion ireurence. m nOwW M Satlion �IOD d IM leEa CaM. br �M V�amenm tl �M
�i«»nd,wo�ena,�.e.Mr.a�n'�G�V[�.�i��;..mww�e«.�.: EXPIRES
c�..
pW'ryry�yy: Wl. o� �o��iv»-� �8/O1/96
Imb .e�on �.ed �or ed =awbroe r w wme a ro, o�. nu�dna emas /Sioul o. w.1
❑ � oenri mm n W. Mem,.Ke a �ne work br .nch Ni. o�a o ewee. � e�w m� rroM mn a.m n�nr mem« o n m
Eecome wEjea to iM walss' canpe�uNian le�.a tl C , ud e pW i - Nd n» aiEj �o tM wakan'
Daie: � 6'�� y � 3]00 tl �M lebor Cads. I n��p�y t� �a
�� r; ,.�
Wiminp: FWun ro weun rurtw�i mmpwvetlon eoveraps � n NI. �M �IWI •/M rrplqw ro eNMn p�n�ltlu �n0
�nn no., w ro o�. n�e�.e rrow.ro eon.., (s�maool, � i � ro m. cw� o mn ..uon m�+.w . cro�aw ro. io
9�etlan ])05 0l tM (Mor Cob. IN.nsG uW �Mrnry'� lwx
CONSTHUCTION LENDIMO �DENC�: I Mreby dfirm under piWly d perjury �he �Mn o e mu�vaion MnE4p ypM.y lor �hs
pAamenu W tM work br v.TiN Ne W�i e eweE (Safion ]OB]. Cw. C).
LENOEN'S NMIE
LQIDEP'S ADDXE44:
I ceniry ilw I Mvs nW ub apqicdian eM nm. inm iM ebova imamalion is conae. I pns io compy wAn M tiry eM coumy adineriw�
anE siete lews nW'vq to buikiq conetrupbn eM MreDy eNhorize ropraeentativm d Ihie ay io amr upon tM ebv.e�meNimwA poperry
�°��°�D°"�°�°�`0°°°' DAN CONROY
om�,b •ZO �9J
6 SNdy: OreemFb: Cenery-Appirer�t; FnkJiew�w; Odde�vod-Anem
CZTY OF COSTA MESA — BOILDING PERMIT
PERM NO; B 074703
PERMIT NO: B 074703 PLAN CHECK NO: N GOVT: N SOPF: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PORPOSE: ALT
SOB DESCRIPTION : LEGALIZE DEMOLZTION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC—VALUE: 20,900,00 GROUP OCC: B-2 /
COMME�]TS: 75 UNION PRODUCTS PREP FOR TZ
*�-**x�*x�**x���t*****x�i�*at**�tat�at**��t**�t�**it**�*+�r**x��t�E�t*�t�t�it*it��t**�t***ftu-�-�**at�r*�-***�-
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
-------- --- MAIN BUILDING ---------- --------- ACCESSORY BUILDING,---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
I,EFT: FT IN RGHT: FT IN LEFT: F'T IN RGHT: FT IN
PARICING REQ: PROV: PARCEL: 9]050104 ZNE: REF NO:
PLANNING NOTES>
>
fE 1f !F # iE �lE iE 163f 1E if� �E fk *!E If� if 1Fif �If 1g 1ElE i6lE iF fE iE 3ElE iE 3E 1E -0F iE'lE 1E 1E fE 1E 1E �E 1k'lE'x'!E iE 1E iE iF 1(� 1f �E 1E IElf M� 1f fE 1E # fE iE iE'IE �E iE'lE9f !E'1E 1E 1f -)E iE iE 3E 1ElE
D E V E L O P• M E N,T S E R V I C E S R E Q U I R E M E N T- S
/ —
ZONING APPROVED 8Y ' DATE:
BUILDING APPROVED(BY : DATE:
*�****��*�*�****�D�B** �' �r, '��F*�+��t�+�c�**+�*��i��'3F!�**
LEGALIZATION:Y � F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 432.00 '
` SMIP/NON—RES
PLAN 4,39
ISSUE FEE •+ -
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 436.39 0.00 0.00 436.39 436.39 ,00
REVENUE DIVISION TOTALS--> COLLECTED: . 436.39 OVER/SEiORT: .00
BLDG PMT PLUMBING ELECTRIC MECHATIIC FIRE SMIP/TOT GRADING PLAN—CHECK
432.00 - 4.39
If M IE IE iE iE �f df 1F # 3E iE IE iE 9Elf 1E # iE iE 1f iF 1E 1F iE iE if 1E 3E iE # iE �IE # iE 1E If iE �lE IElE iE iF 1F 1E iE if iE 1E if iE if if if 1k 16lE IE iE �E # iE 1E IE iE # ib iE 1E ih # 3ElElf IE 1E �E iE 1E
I N D I V I D U A L . P'E E H-R E A K D O W N
TYPE QTY D E S C A I P T I O N , UNIT COST TOTAL COST
SFC 20000 DEMOLISH BY VALUE COMMERCIAL NOZONE 1.00 20,000.00
E�ID .OF FEES
/
I
O1 0017iEe's-��192064 Yo7"q`
6A?E: ic,_-:,�•; T�r��� ��:ia
/
J_.J
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# � Date Inspector qppROVALS Permit# Date Inspector
' i. Temporery Electrical Service or Pole - 52. Pool & Equipmeni Locatiori
2. Soil Pipe-Undrqrnd. ' 53. Steel Reinforcement
3. Eiectriwl Conduit UtilityUndrgrad. 54. Forms •
4. Electrical ConduibUndrgrnd. 55. Electrical Bonding !
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .'
6. Electrical UFER Gr�d. 57. APPROVAL TO COVER-GUNITE
7. Footings � 58. Electrical Conduit-Undrgrnd. ;,..
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgmd. . �_ 60. Backwash �ines, A-Trap, O Undrqrnd. �
70. Structurol Floor Svstem ' 61. APPROVAL TO DECK
11. Propertv Sewer Line & House Connection 62. 8ackwash & Receptor-Final ,
12. Sewer Cap • 63. Heater & Vent•Finai
13. Roof Drains � � 64. Plumbinq SYstem � Final • �
14. Rough Plumbing I 65. Electrical•Final ' � '
15. Rough Electrical-Conduit � 66. Solar SYstem-Final : -
16. Rough Electric Wiring '_ 67. Fencing & Access Approval '
17. Rough Wiring Sign 68. APPROVED FOR PIASTERING
18. Rough Electripl-T Bar Ceiling 69. POOL/SPA SYSTEA4S FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Strutture 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framin9 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & MonocOat �0�� /`J 75. D.y Chemical
��i
27. Frame and Flashing 'i/%JO/�6 I 76. Dry Standpipe
��
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insutation 78. PIRE PREV. RNA�
30. Drywall Nailing (jT���� NEALTH DEPT. REQUYREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriwl Power Meter�Final 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning f� I�� (�?(,o i� q �•� av�
` r v' ST -W���.- � Y4�1
35. final Gas Pipe•Test "`v
36. Hood or Canopy /���I,,� U
/ rWV vJ - - -��'Q��, •- -�
37. Final Faaory Fireplace . U;��(„
38. Final Plumbing � - _�n Q ������
39. Water Service-Final � �tr�_ �.
40. Gas Service-Finai
41. Solar pomestic•Final
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape Irriyation System
45. Sound A[tenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING � IY�� �
48. FINAL PLANNING
49. Electric Retease to Edlsoo -
' 50. Gas Retease to Southern Calitornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
yl
�oowEssaeuipwa: 555 ANTON BL
a�m�x9""�EiFp'o"w: SAKIOKA FARMS
�oox�ss: p0 BOX 2097
TERMINAL ANNEX
MPL. WUIING �OOXES4:
ur.T: 9 TH
��opE++�+�+ INTERIOR DESIGN 21362321b��� 9378
�+ap��g�� 550 S HOPE ST uxr: 1100
L.A. CA 90071
coMn�crars �:
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,�ooxEss:
ue w_
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UCENSED COMNICTOH9 OECI�flATION: I MiMy ellim uMar puWy W pujury tIW I un licansd uMs prwmnu d CMqu B
(cwnma�q rnA Sxtion �000) M Diveion 9 d Uw Bunrien eM Pmlmaiona Code. W mY fiaeme u In fuA brta end afletl.
cmue.ao.: uc.cuss: uc.No.: EXP:
ow: cmu.a«:
OW NEN BUILDEP DECIAHATION: I hanb/ tlNm iwlv pe�Wy d px�ury IIW 1 un �umq Imm IM Caunqon lfoww l�w Itt IM
:�',�Oowna iwon (Sedion �W 1.3 &uiN�� enC Rdutbru Cads: MY vY a opv4y whid� �Vuim e Wem! lo mmbuN. Nr.'vnYoh.
'�ind'sA p rapv vry �vueturo. prior m b'sauenea, Wo ipuim IM epplimm lu ax� pemin io RM e tlped Mt�mseq tlW M a�M
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c�«
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9ctlm l]08 el 1�� LMor Coh, IMwuL ��my� Iw�.
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pmlamuros d �M wk la wAiM th's prml e'sa»d (�� �). �'. CI.
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LENUEP'8 ADDRESS:
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fu'vupauion p�upo»�.
ERNIE VITUCCI
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 076197 PLAN CHECK NO:
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE:
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I.
PERM NO: E 07619-
N GOVT: N SUPP: N
ELE PURPOSE: ALT
SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
*�**�**�*x**�t***�***���**�*****�*�***+t*+Nt+�t*******��%*�*�*B*�*****�t***�����r*��r��*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT I"
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN
PARKING RE(j: PROV; PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES>
i '
1E 1f� k fE 1F 1k 1k 7E 1F IE ik 1E ik iE 1E i! iE 1F 1E iE 1(� 1F M 1! ik i! 1t 1f fh 1E 1E 1E iF 1E iF if 1E iE iE ik 1E IF 1E iF iE 1t iF 1f if 1E iE 1f 1f 1E iElf if �E 1E if iE 1E iE 1E IE iE IE 1f iE iE if if if if 1f' 1F �f if If
D E V E L O P M E N T S E,R V I C E S R E Q U I R E M E N T S
l
ZONING APPROVED HY . DATE:
HUILDING APPROVED BY :
APPLICATION ISSUED HY:
x�*������«�x�����������+r�r
LEGALIZATION:N F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 146.40 �
SOY
PLAN
ISSUE FEE 15:00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 146.40 15.00 0.00-
REVENUE DIVISION TOTALS--> COLLECTED: 16
BLDG PMT PLUMBING ELECTRIC MECHANIC � FIRE
161.40
DATE:
DATE:
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
161.40 161.40 .00
1.40 OVER/SHORT: ,00
SMIP/TOT GRADING PLAN—CHECK
fE fE 4 fE 1E 1E iE 1E iE iF M IE 1f 1E iE �E 1E iE iE 1E iE iE iE'k 1F 1f 1F 1k 1F iE iE 1f iE 1E 1E 1E 1E iE 1E 1f If 1E IE iE 1E 1E 1f IE iE 1E �lh M 1E iE iE ii 1E ik 1E iE 1f� iE �E 1p 1Flf iE �F ib fE 1E iF 141E 1k 1f 1k 1ElE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N '• UNIT COST TOTAL COST
/
ELE 20 RECEPT/OUTLET 1.ST 20 EA. ,75 15.00
ELE 292 AECEPT/OUTLET ADDITIONAL EA. .45 131.40
END OF EEES /
� �
� I GOC /�C.S� J� �i/ TtJ c r/ Dms: r � I �I Q�:� ,- _'v'[�� L..� �j .
Sq'uWndOnir/IGm✓AOO��Veaa QQfL: :'t�ic� :t ry �1 .�
L�
(515116.WP) Whns�BuldipBStlMy:Onarv-Fb:Guury-Appkam:Rnk-Rs.an�e:Odd�niod-Nmv
CONSTRUCTION AND PLANNING P�� � SPA
� APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector
1. Temporary Electricai Service or Pole � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd, �".-53. Steel Reinforcement
K3:.Electriwl Conduit Utility-Undrgrnd. 54. Forms
� 4,- Electricaf ConduibUndrgrnd. 55. Electrical Bonding -
,�5. Steel Reinforcement 56. Rough Plumbing & Pressure Tesc •
'6: Electrical_LIFERGrnd. 57. APPROVALTOCOVER�GUNITE `_
=7. F,botings -�;- 58. Electrical Conduit�Undrgrnd.
� 8. Foundation � 59. Gas Pipe. O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P�Trap, � Undrgrnd.
70. Struttural-Floor Syscem 61. APPROVAL TO DECK �
11. Property�Sewec Line & House Connection 62. Backwash & Receptor-Final .
12. Sewer Cap ' 63. Heater & Vent-Final
73. Roof Drains 'J � 64. Plumbing System � Finai
14. Rough Plumb��g - . �- 65. Electrical-Final
75. Rough Electrical•Conduit - 66. Solar SYstem�Final
76. ftough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 5$. APPROVED FOR PLASTERING -
78. Rough Electriql-T Bar Ceiling 69. POOL/SPA SYSTEMS F�NAL
19. Rough Heatiny & Ai: Conditioning _ y FIRE pEPT. REQUIqEMENT
20. �iough Fa�ttor,� Ficep�ace � "� � Y _ N �ApP�OVA(.S_ • Pecmit #
21. Ducir, in'Str�lEiur¢' ' •^ �- �� `� -' ` � 7p, tinder�tound Hydro
'. �t
22.Ductr.Ventil�fing�'. . ,,� � ,�. _ ^x� 71.ProductPipingOGas QOiI
Y
23. �'i�as Rroe-sough & Test t*' �- Y?' a' C�� 7Z, Underground F�osh � � �'_
24. Roof`�Frarnin9 . � .' 3, ,..;'.73; Undergrnd.StorageTankOGas OOiI
25. Roof Sheathing : x �: �� ' r�y 7q, Overhead HYdrg �_ �
26. T-Ba: Ceiling (Str�ctura1) & Monocoat �' � �., 75 Dry Chemical
27. Frame and Flashirg � = o, ; : - .� -" � 76. Dry Standp�pe �T •
,
28. Lathing&'Siding �, ' -' �?� : ` " " 7I, fIXEDSYSTEMFINAI .`
29. Insulation - - � * � 78. FIRE PREV. FINAL � - �
� 30. Drywall �dai�ing •` � ' } � . -' HEALTH.DEP'�. REQUIf;EMENT
31. PlasterBcownCoar.-_ � � . '� 79. PINALI'NSPECTION �
32. Electrical.Powzr Meter�Final }'' `�� 80:. F000 CERTIFICATE ISSU20_
33. FinalElectric� ^+ _ 2 �_ �-`.� _- � Notes: -�^ �. •� . _ -
� 34. Finai �Heaiing & Air Conditioning -• ' ' _ , �.' K
. ,- _ . _7 l�(o� �s%�_ � cv-
35. Final Gas'pipe:7est. - � . . - � c 7�
- 36. Hood�or CanoPY '-r - ^ - � I� 1V- �'� �
- - � t � [* • . ��l( �tiJ" �"/ '.�. I�
37. F.inal.Eactory Fireplace ; ; � - . � . . ,
- 38. Finai Plumbing ' ` ti ' - ' � ' - " � '-
- _r p a � e
39. Water Service-Finat-3 -- " •. C .o •. ' - - -,
�.40. Gas Service-Final .' " " ' t " �
i- , . - , = 1
� 41. Solar pomestic•Fina� " - � � �� - �
42. Backfiow Prevent8r'* c.. ` � - '� ' '
Il '�. y � �
43. Backflow irrigatioa�,�: -� �"''' -,`. � Y , : - � � •
�
44. Landscape�IrrJgation°SYstem_''"�' : - ` - r �� , ` ' .
_ ,
. . - . . .. r r' W
45. Sound Attenuation . , , �
46. Handicap Regulations � • . '
n M
.47. FINAl STRUCTUp€ & BUILOING � . ' � �
48. F�NAL PLANNiNG ` , , • • r :
49. Electn'e fteleaSe to E&ison ' � "-
. , � -
50. Gas Release to Southern CaliforniaGas Co ' ` =
51. CERTIFICATE OF OCCUPANCY^ * •
No Date
�I
�I
�noness ar sunowc:.
�ooxeu
❑e�w�ome.r ����;:���a
ANTON HL ._
A FARMS
2097
IAL ANNEX
uNr:_.9TH. CITY OE COSTA.MESA — BUILDING PERMIT
_. _, � ' - . . . PERM NO: P 074737
PERMIT.NO: P 074737 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTAUCTION TYPE: 1—FR PERMZT TYPE: PLU , PURPOSE: ALT..
I uvcN�MopF++m+�n: INTERIOR ARCH 2136232164 ���: 9378
�n
�,wcxon�o:s�ss: S50 S HOPE ST uNT: 1100
L.A. CA.90071
wNm�cr«rexu�: CONTINENTAL PI.UMBING INC ( 909 ) 360-8300
CONfHACTOR4MNIdlO 11165 THURSTON LANE
aooness MIAA LOMA CA ucr�o, 399073
917 5 2 ox,:
LICENSEU CONfNACTOPS DECLpPAT10N: I Mreby dlim uMm penee pe�ury �he1 I em lironad uMa potiebne d Cheqm 9
(oommeria�p wilh Seclbn ]000) d D'Ms'vn 3 0l Hre Buai�reu eiq Pml Aa, enE my Lceiue b in IWI a anA eMaa.
cmuc.No.:02756(3� (u1c�.�cuss: C 36 No.: 9907 : 09/9
o�a: �� � � i ' �lJ com�aa: '
OWNEP B111L0EN OECUN4TION: I haeEy elfirm uMer perialy d perN�Y �� I em emp fmm IM CaNrapav Licenve Lew la IM
'dlov.'vq rsesan (SeUion )0�I.5 9uema�a end PMeviona Coda: Any cEy a oounry requi�ea e pertnu to mmNtl, eM1x, imqwe,
'emoloh, or ropes eny alrucluro, prior io na asuence. ebo raquiree the epdiani la euc� pemul to file e eqrwtl ele�emenl ihel M a�he
n licenaed Wnuem lo Ihe povitiau d �M Comreaon Licensa law �Cheqm 9(cammendnp xil� Saaion laao) d D'v'vion a ol Ib
B��ineee and Prdenbm Cade� w �hm he or �he n exemq Iherelmm eM ihe bese /a tM Nbped eaamqion. My vioWion o/ Seqon
]OJ1.5 Ey eny eppliunl lw e permil wbpde �M epplceni �o e aril panelry d irot more ihen IMe hunCred Edlen �SSW]).
� I. ea owiwr d IM propenY a mY empbyeea wih wepee ea �ha'r eob ownpenselion _will Eo IM woM. enE Ne eVucluro e iat imenEeA
imqoremeNa ete ml iManEeE a ol�eia0la eab. tl, M1owevar, IM1e EwNi�p a'rnp�mmml b add wilhin ona yaar d rompbtion, the
awnubuiMer wJl heva �M buNen W provinp he w sM tiv! nal buik a imqaw Iw �M Wmoea d aele).
� I. m owror W iM popally. em ud�Ny oontreuiq wnh lixnaed mnireclore ro mn�hua Ne prqetl (�� ]OM. Bueinme enE
PrWeaebne Cotle: TM Conireaae L'eanse Lew doea iw epply m en ownx d pmpeity who Euilde w imprnee Iharsan eM who
mnvec�. �« cuM orqeaa wan a maraaMel �ka�aea wusuw w �ne comreav. um,.. Lewl.
❑ I em azemq uidar Sxtian: B. 8 P.C., la ihia reeaon:
Oeia: Ownx:
1 tlo hsebY cenM �hei l em ewere d W uMesivM Me reVuiramer�i W Cal/ania Hml�h enE SetetY COEa Seabm 25505. 2SVJ. enE
u51'. entl ihY 1 n ury Mun buiNirq arvpent vrill / wll ml (tlrcb ona) naed io canpFy tih eeid mta oodss vd �M rpuimmenb Iw
e psmii IaowuVucYona �roGif�ion kom��eA'e�iiy .�enpemen� Dimntl. RmiOeMiel amp�urlion eppimlian enexemq Imm thess
woNaon•.
Dme: Mqiwv:
WONKEfl'4 COMPENSATION DECLARATION: I MreEy effirm uMs pe�uhy d pxjwy me d ihs Idbwmp 0etluqbro:
❑ �nmeena.um���ei�.�.w�a.domw,�meen;nw,.r«xvkds•comw�em�an..spwiaea�«Mseeionarooaine�ee«
Code.lor IM pulmiance d Na wA fa wNc� �hb peimn ia iaued.
❑ in��aw�m.:,.,ww.•o�v�:+��.�...�w�a�rsaa�,arooam.�no.coe..wmeo«ia�,oedin.
work lu whirh Mo G�� o a�ued. MY workan' mm bn'unueanee fartier erd PdkY numbar ve:
c�«: CI�A EXPIRES
� Pd'ryNumbr. 07/O1/96
�rn;s s.a�,b.e,�a w�dm.e i m. v�� a b• a,• n�„�m.a edi.,9 moo� o. w,.�
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Wmne wbpf lo iM xorkma' con�pereetion lews d Cef�6mie, eqies Y I aEjw t M xoM1an'
ome: �CJ •- ec..� — �-7 �oprau:
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elHl flnu ,q b m� ��ntliW IhouunE ddl�n (JIPq000A M aLdlfbn ro 11 ew! ol rorrpxuatbrt d+�P+ u poHdW br In
S�ctlon ]]P6 0l M Le6orCo6, Infens( aM attomeys /su.
CONSTfiUCT10N LENDINO AOENCY: I haraEy effi�m uMer penetry d parjiry ihet �M1sra u e oorwrunian bM"vp epency br Ns
prlamerce d tM wik b whiW ihe Oeem� ia eeueE (Swion �091. CH. Cl.
LENDEH'S NRME:
LENOEP'S AOOHE53:
I ceniy ihm I heva meE Nb eppicetian vM ame tAm Na ebove "u�torme�ion o cana. I epias �o canply xilh M dry W oounry adimnws
uW eWe lawe mWnp to Euikmg cone�uGbn aM MrabyeNlror¢e repreaentetiwa d ihu Nty b aNer upon IM abova�meruunad pmperiy
i / / ^ ��I �I �+1� Dme: IO � OC`�1 1�
� sro����a oi aw�nM�unvoww�ucem�aa,
� 9�iWiq 8 Safery; Oreer�Fle; Carary-�pplwit: Rnk-Revenue; (ioldsnrod-Aeee�eor
�
JOH DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, AE:#B74632
**�r*x�**�r***�r*�*�*�r*�r*x�x�x�*�*�r**x *x�+r�r+tx�***�tx�**+r*x��r*�r�r*�r*x �r*�**�x�*�r*�r*�******�+r*x�*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: ,FT . IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT,;, _ FT_ . IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV; PARCEL: 41050104 2NE: REF NO:
PLANNING N TES>
i
1E iE if ik 1E 1E 1P if I@ 1f iE iE iE If 1E K 1@ 1F 1F 1E 1E iE 1f /f iE 1E 1E 1E iE if 1k lklk IE1E1E1E 1E iE N 1k 1f 141E 1E 1E 141F'k /k 1f if %ik 1E it 1E M 1E if 1F IE 14ii 1@ 1k 1f 1F K if 1kiF 1F if 1k 1F if k 1f
D E V E L O,P M E N T S E R V I C E S�;' R E Q U T A E M E N T S
ZONING APPROVED 8Y '� DATE:
HUILDING APPROVED BY : /.�'1 DATE:
% �
APPLICATION ISSUED HY: DATE: �Z'��`1�I
IEIliElkiFkifKMMK1iMiF1@ififiEifiEiEiE 1EiE1fiENi@K1@kIF ��fif1E
LEGALIZATION:N F E E S U M M A R Y � STRUCTORAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING
PERMIT 42.00
25t SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> _. 42.00 20.00 0.00 62.00 62.00 .00
AEVENUE DIVISION TOTALS--> COLLECTED: 62.00 OVER/SHORT: ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK
62.00
1FiE1FiFMMIFIF1EiE1F1F1k1fik1FlkIEfEIEiEfflEiElfil/kikikifiilFiEiflEK/k/k1k/k1EiE1FIf1ilklEiElkfElfiEIE1F1E1f lklffEil/kiEiEM/fiEIE1E1E1E1iM1f iF1f1F1E1EiE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 2 SINK KITCHEN 7,00 14.00
PLU 2 WATE�t HEATER AND/OR VENT 7.00 14.00
PLU 1 BACKFLOW PREVENTER 7.00 7.00
PLU 1 SINKS, FLOOR 7.00 7.00•
END OF FEES
oi oo�^a:zE ':�19_786 r+��e .�.��a
GP7£: 2i:�?,9, TIYF' i"v;:li
,,s_-= �
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # w Date Inspector AppROVALS Permit #
t. Temporary Electrical Service or eole 52. Pool & Equipment Location_
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement j
�:3�iEAectricaC`�ondwrthilityUn&gmd. - 54. Forms �_
c„
' � j��lectrical�d�}r`-�ntirgrnd. 55. Electrical Bonding '
'a;5. �aSeel Reid7otcea�nC' 56. Rough Piumbing & Pressure Test
; E�,filectrica�E�n�l. 57. APPROVALTOCOVER-GUNITE
, �..
t,7. _�-�ootings��p7 p, �� 58. Eiectrical Condfli�Undrgrnd.
��.,. �. ..�.-. , .. .
- 8. �Foundation� �= y `O 59. Gas Pipe, � Und�rnd., Test �
9. Water Pip,e,�Und�pr�d. r j . 60. Backwash Lines, H:Trap, � Undrgrnd.�
10. StructuraHFloor�tem - 61. APPROVAL TO �ECK �., ;
11. Property�5�ewe;F(.inet& Hous � n 1ection 62. Backwash & Receptor-Fi+rai "
72. Sewer Cag� `: � i- 63. Heater & Vent-Final ' .
n, �.+
73. Roof Drains p„ 64. Plumbing System - Final== �
i4. Rough Plumtrin� M � 65. Electrica6Final - �
15. Rough ELectric�YCo��Juit r 66. Solar System�F,ir,�i � �
i 6. Rough Electric iriag O 67. Fencing & Acc:i�Approval •�
57. Rough Wir� 5t4�'n a, . 68. APPROVED F�.R�,PIASTERING �
� � '
78. Rough ElectrifabT Bar Ceifing 69. POOVSPA SYS'i�M19S FINAL
-79. Rouy�iH�tfng&A.�i*Cond�ciqnin,g� ��,,, �� n m a� ,�, F��,F.PTQREQUI�,EMEf�,T;-
� � . � ..., w - � �• �*7� "' �„�^,.,C [*l * ?� ; J
20. ou�i F@gtoCY Fi�qlace ��:; �6 >, �'.., p�s C APPe}VU��,Sti[-, P�xmit # � a
Y
21. ��ui� in�tru�4ur�* t.. .. SS Y � b ^*. 70..c~..Unde�r�}�d F�dro �
22. 8u s, V til- in "
k^i ai 41:;� CJ * O � �J e^ �- V 77. Prodi221(3iping C7as OOiI
23. 6as Pspe�flou &L7'Ast � ��T1S * r•7 � 'G O* 7z, Undergr�d F?;� « j,.
cC rn S #
24.'Roof'Fr�ing� "'x `� ��p; :' � q,..�x • 79y Undergrnd.Stc��iTanW�Gas;�Oil
25. Rooi'Sho�ihing �> • a � Y Y �^ n%'� 7q'�, Overhead Hyd�' � �
f ""� H+ H Y; r'� Rj ,_^. { � �K I
26. '�„f•Ba�f„Cei�iPg {Str_{�ural) & CJr��oat y O � pM 7� Dry Che:tteical FD * y r-�e4 !-+
�
27. ;Erartte and Flashi � ��� *�' " p�` 76. Dry Sta }flpe�'�"' �� �m 't
< N h+ • � .7 [ll �C, N
" 28. Lattt±ng �Siding �X �' ��= r�j r .•� 7� FIXED�YSTfW,YSeNAt!-+ [� s.�
' 29. InsulatioQ' n� v S .. *• � � 7�`�fiRE�REV. F,�.tk'.�L r� � rF.,F O
� 30. Drywall f�ailing ��s ..., ! KE., � gon� o:J¢tAL � DEP+T�tEQ�ll, iVl�i�
�
37. Plaster 8�wn` �T`� S � L4 * 79, FINAL �VECI�JN ,k �! f„ 5`
� 32.:E}IeciricaC�ow�r .Ni"e,terrf�al j *"' 8l�-j FOOD CERTI , ATE � S�JEfiU �.
• 33. FinaB+'£le�trio'� "* tT] � '2 * � f�ices: '7 ��'' ' `� � x
- r -C i �- m:� M
� 34. �ina} eQ ng� Ai,}�np`di"tionir�� ' . �
� i>� i' : � � '.T1 x i M � F'Q a I*1
� 35. � inal GarPipe�Tesx+� O� •• 'i. � � r� xc O�-+ * F
..r. :«.
: 36. boo�or �;anoPY �x� ��t i �� -• * �� rh .Zo * tT3
-` .. ,. i
37. F{inal•Faotory Fire{�Itf�ce � �!�-�F �� ! � S �
'+ a� •^ I*' i '
' 38. FinaC�'� lumbing �* '�� � �" � ' ~ {
�., r r :� -T�iS `i6 � ^
39. 4Vatei Service-Final�r E i * G � w
1- :. �:� i
r I 1 �� sm
' 40. Gas Service-Final � �! ��''�T' S + n � �N � x
x !�.FF t^ t I I .�.£ . Q
�, '"
`41. Solar �omesticFina4 � • I �� [*� -�o � * � S
42. Backflow Preventer � N '^� ^ � �' Q � F'" * h
t� � Zi p:-� H * r-a '� m R! O +i _ F
43. Backflow Irriqation x >+ `� r c� * ; � t �� • • •
= cu » ^ 000c
^' « S-nfJ 'J'. * cT; G � O+K s1: iJ � -K •�
'�.�4. Landscap�lrngatior�System�;¢� m � �,, �i. - g g �v O�: ,� S �
,I i N�
5. $ound Atten$ation r -� •• •• � � i+; m n* �. c � y• Fv r
r- -�� � i :-tU ••r� Y
'46. �Hand�ap'RegUlatiorfs '- , � � r � � " '�`� `
x S J a_ I 1� .!�7 !J �J *
4J. FINlSi STRIfG�TU �& BUIL ING W t- � � �y y �' � t F�
- � r C
48. �NF�}L PLANNING" � rF *� I r, m ~ ;*
� r (i f� N S � •� ¢
�49. �Ele uc Release to Edison � � , � •:� � r �+--
r j da�(.
S0. �as E�eiease to Soutt�ern Califbr`��GGas Co � '"� O• � n � •••
� r• s �o n x sv coo�
51. CERTIFICATE OP CCUPANCY " "' " ' ' '
No. Date
-�
Date Inspecto
ADDFESSOFBNIWMl 555 ANTON HL �"T� 9TH CITY OF COSTA MESA — BUILDING PERMIT
�°""Eas"°"E"'°'°"": SAKIOKA FARMS PERM NU: M 074659
'D°"� PO BOX 2097
TERMINAL ANNEX PERMIT NO: M 074659 PLAN CHECFC NO: N GOVT: N SUPP: N
fil
�
!�
i �vv�. iumao �oo�sx
��
1NCXRECTOflQlCdlEER INTERIOR ARCH 213G23216�4 �"o�� 9370
urcx.oa�•s�ooe�ss: 550 S HOPE ST ��� 1100
L.A. CA 90071
���s� AIR CONDITIONING COMPANY (818)244-6571
CpfIq1CTOR5YNWq 6265 SAN FERNANDO ROAD
wontss GLENDALE CA uew.: 120696
91201 urR:
UCENSEU COMHRCTORS DECIAHATION: I Mnby elfrm uMs peretly M qr'ryry ihtl I am Icauad uMx proririme oi Cheqa B
(wmmxvsM wilh Sacnon )OW) d Oiwion � d Na Bud�ron eM Pmtaeaione Gotle. W mY Ibenm o in hA Mca eM Nletl.
cmuc.no.:019903 uc.cuss: C 36 uc.N ' 120696 EXP: 07/96
Dme:��D �y'�Y Comw .
i
OWNEP BUILDEP �EttAqAT10N: I Iweby e1Nm uMer d perjuy Ilut I em exmmpl imm IM CON'edm li � lew lor tM
Idbxip reason (�� ]091.5 Buaiwaa eM Rdeaions Code: My cry a oounry xfiich iryui�w a pamd lo eum c Ix.'vnyovs.
bmdsh. a repae any elruclura, prior b u eauarca, eleo reyuirp tAe epplimM Ia euch pemin to Rb e�qneC nm m tlW As a oM
e licensed W� m IM prwniam d iM Conveqws Licenas Lew �Gheqer 9lmvnantlnp wuh Swon )000) d Diveion � d iM
'Bumiwv eM Profmiona Code� a tnm he a Me ia exemq ihaehom eM �he beaie la tlro Mepetl naampion. My videlon d Seaian
�)031.5 by enY Wd�� In a permn w4� IM epplican� to e dvil penelry d na mva tAen IMs �uM�ed dd4n �5500p.
i � I.esowMrWlMpoPaM«mYamPM�xA�waBa°a��MiaobmmG��ion.xilldotMxoh.eMlM�IrudunenoliMeMed
or Mered la aeb (Seclion l0aa. Buaron ard PmMa'vu Code: The Conlreeon lioema lewEam mi appyto en owrorol pope�ry
who Wids ar inprovea Nareon, end xfio Eoes euM waM Ivmsetl or MeaeY a Ihraph he a her oxn empbyea�. pwidM Ilw euch
impwamew era na imeMed ar ollereE la seb. X. hows.er. �he Witlieq w'vnpwemeN u wltl wilMn one Y� a�mpleiion. Ne
owmr-0uiNm mll heve �M burJm d prwi�q M or ahe d'N ml WiW w impova la iM p�ryoae d eeb).
� I. ea oxner d IM MWeM. em udusiv^h oonirad'n0 vrith IkameA convec�on io cmmud Ne MMb ISeUion 10a1. Bua'uwa enA
Pmleaaiane Cotla: Tha Conlrmav L'r.ense law Coee rwl epply ro en oww d pvpsM � buiqs w impwo ihaaan uM wlw
cnnVect Iw av3� qojeqe wnh e mmrmor(s) Icarised Wn� �o IM Conlradae Liroiue law�.
� I em eumq urMer Section: B. 8 P.G.. Im I�ie reeaan:
Dele: Owner.
I do hareby urlM �� I em ewme M eM uMersta'M �M requimmema d Celfomu HeeXh eM Selety COAe Seuione 25505.255]3. ud
255�C, eM thei I a eny lulure Wikiip orapent will / wYl not (arcb aw) nsed io mmply wYh eeid ueia mdn vd iM mpuiremenb b
e permn fwcanvunion a modifirai'wn han IheAi�ue ITy .1�anapement Ois�na. RasidsnlW wiMrvdion eppfi�ioneen emmq Imm Ihese
pammns.
o.�a: aooi�i�
WOFKEN'S COMPENSRTIOII DECL�fl�iION: I hereby etfirm unAer penMy d perjury wp d �he IOIIoxAiq Aedarelione:
� I M1ew utl xil meinten e cenXicete d mnxnl lo eelliruure la warkwi canponWion. m pwided lor by Seabn 3)00 M tM LeEn
ccde, ta tM peNormen<e a Ne wak 1« wlicn Inie pmmX ia inued.
I lave uM xil mainten woeken' oompen�elun imurenu, ro rpuirad by Sepim 3100 d Ne Labor CaEe, la iha pa�lamerca d iM
�, wak Iw xfiich Mia parmn ia ivued. My wwken' wmpenaetion ineurence urrier eM pdiry number vs:
c�.,: C'(INTTNF.NTAi� CAS EXPIRES
PdbY Number: Gi/' 4O 'J ti Y d Y. 4`� 10 / 01 / 9 6
` rmrs �n� ,r�d �w en comv�ee � rne o�� n ro, o�a n��o,sa aam,. ts,aol w bs..l
� I mnh' � in iM pMamence d �he vroh lar wM1ich IM1is pe�mY ie iaeueE. I ehdl �wl ampby erry pe�eon in enY menrwr o m to
baconb eu4ea ta iM xwkue' cwnV�mian bwe d CalXorttie. eM roros tMl X I ehaiW Eecome wM� to �M wwken'
comVansation P�+siom d Sedion 3]00 M tM labor Code. I ahd hwil� canDN wiN Nor povucne.
Dme: � /iT�7 %'� Appl' � w � l'
Weminp: Hllun ro a�cun wwkeri rompwustlon rov� li unNwNl, �iM �lull �W/�c! �n �nQ�p to eAMnsl paultlu in0
��h� n,», w ro w�. n�e�.e mo�,w ewr� �s�ao.aaol, m,amrro� ro m. �o.r or �omv«w�ron n•m.a�• .. wa•ro.e ro. ��
Sxtlon 9]P6 0l fhs /iDorCUY, /nrsmt ��� ettomey i I�u.
CONSTflUCT10N LENDING �GENCY: I hanby etfirm ��w., o,�,iy a p«� inm ino�. m..o�m�,a�, i.�e�� ,o,zv rw m.
perlortnwa d tM v.vrk 1« whiM the pmml u ewW (Seqian �041, Cw. C�.
LENOEH'S NAYE:
LEN�ER'S ADDNE55:
I cenAy tAm I have reaC Nis epplrsiion enE deb thet Na ebwe iMmretron ro cantl. I epne to comWy vmh e0'nyeM cauny aNmenws
B�M 91818 lewc �BlNvq �O buiW�q CG1ffiWM Blld hGfBb/ 81N�wR0 �Oplb111B�fIM d �hq p1Y b M�N upOn IINl�'O�menlYnad pOpally
�a imvacion Anposas.
� LOUIS RODRIGUEZ
omei/// / i� ' 91/
� (515tefi.WP) WINe-Buildiq 8 Selery: GreerFb: Cenaey-Appirant: Fnk-Raenue: ()olderva�Mauv
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: MEC PURPOSE: ALT
JOB DESCRZPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74632
�t**+�**x**�********�***��r***�**�*�+�**��***��**�*x�c**�*x******�t*********�x�*****�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
---- ------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN
LEFT: FT IN RGHT: FT IN LEFT; FT ZN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 41050104 ZNE: REF NO:
,PLANNING NOTES> ,,.
I� % y
iE IElE 1E iE iE 3f 3E k iE 1E 1E iE IF 1E iE 1F iE if �E iE IE �E-YE iE if 9E if 3E iE 9f 9E 3E 3F 9E i! iE jE �E jE iE iE i' iE 1E 9E 9E iElf �k iE 3f iE 1E *!F 1F iE if iE 3E iE iE �E 1E iF IE 1E iE iE iE iF aF 1F jE iE 1E 3E iE
� D E V E L O P M E N T S E R V I C E S•, R E Q U I R E M E N T S
1ZONING APPROVED BY DATE;
,.BUILDING APPAOVED BY : �'�� DATE:
—APPLICATION ISSUED BY: � DATE: I,O � �,�
IflkiEiElEiEiEiE',E�EfEiE1EfE3EiFififiEiEikiEiF3F�FiFi��iFiFiF7F�FiFiFiFiF�iF3F7F�F�iFiF3FiF , iFiF7FiFiEiiii�iFiFifiEiFifibi(�iEiEdE x 7�3F�F�EiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 80,00
25� SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 80.00 15.00 0.00 95.00 95.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 95.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
95.00
�E �E iE iE IE iE 3E iE 1E �E iE 1E 3E iE 9E jE iE iE * aE iE iE iF 3F 3E if iF if * iE iE iE 1E jk 1F if if �E if 3E 1E iE Ik 1E iE dE �E if 3E �f jf iE if iE 1E 1E iE iE iE iE if 1E �E �lE iE iF iE �E 1E ib if j! iF 1E iF 94 �F jf iE
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 4 C�AV BOX 6.50 26.00
MEC 10 FIRE DAMPERS 4.50 45.00
MEC 1 INST/P,EL BOIL/COMPR 0.0 — 3.0 HP 9.00 9.00
END OF FEES /
�
�
�1 Q�J1933�7�]019:`s8i "io3 T �5.�7Q
DATE: ln;l+'l9i iFi�L: QE:�G
_ "; � „ ' ,
. ��_
57RUCTIQL�_AN� PLANNING . POOL a SPA � _ ,
� c- Date Inspector �" _�_�. J.,z, .; pate Inspector
' - APPROVALS Periiiit� APPROVALS Permit#"� - �
� :-1: .:�,.t<.,.� :.,...._---
•1. Temporary Electrical Service or Po�e 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Rei�torcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit�Undrgrnd. 55. E�ectrical Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. Elettrital UFER Grnd. 57. APPROVAL TO COVEfi-GUNITE
7. Footings , 58. Electncai Conduit•Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test �•
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgmd. �
10. Structural Floor System 67. APPROVAL TO DECK �
i t. Property Sewer Line & House Connection , 62. Backwash & Receptor-Final �
12. Sewer Cap ' . 63. Heater & VenrFinal �
13. Roof Orains 64. Plumbing System � Final
14. Rough Plumbing 65. Electrical�Final • �
15, Fough Electrical•Conduit . 66. Solar SVstem-Finai
76. Rough Electric Wiring ' 67. Fencing & Access Approval '
V. Rough Wiring Sign 68. APPROVED FOR P�ASTERING .
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19.�Rougfi Heatina & Air Conditioning tr�� � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas OOiI
23. Gas Pipe-Rough & Test 72, Underground Flush ,
Z4. Roof Framing 73. Undergrnd.StorageTank OGas QOiI
25. Foof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (S[ructural) & 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
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Fina� 80. FOO� CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Condiiioning '
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Pfnai Factory Fireplace �
38. Final Plumbing __�L�
G
39. Water Service-Final ,
40. Gas Service-Final
47. Solar pomestic�Final '
42. Backflow Preventer ,
43. Backflow Irrigation
44. Landscape Irriqation System .
45. Sound Attenuation
46. Handicap Regulations �
47. fiNAl STRUCTURE & BUILDING �
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OP OCCUPANCY
No Date '
monFssaeuuaa 555 ANTON HL
",""E"'g"wE�a,w�c SAKIOKA FARMS
��� PO BOX 2097
TERMINAL ANNEX
�vx. ��ua,e.00�sx
ANCXRECT OP F711I�1FFA
ANCX. OP QA'b dODRE54:
IlGl10.:
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UNf:
���T�� SOUTHWEST FIRE PROTECTION (818)359-0034
�p+TM���� 215 E EL SUR ST
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91016 uxr:
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Idbxip �eemn (`+b� �1.5 &oiw�� vd PMs�4on� God�: Arty ciy a awMy r.fiM IpWm e pemin to aonaUucl. Mer. Impan.
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who bdd� a inpwas tM1araon. eM Mw tlam �uM xak NmsMl a MnN a Nrprf� he a Iw wm amHT�. P�w'� tMt ach
impmanero ua m� ircaded a dlsaE ta We. tl.lrowwer. tM buitivq a inp�wamM w wN w4hm arYw d complation. Ne
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wak for r,hiN Ne D� o musd. MY vaFen' cwnGe�ian inwrvice wner ud D�Y riwnber ero:
c�.,: FREMONT EXPIRES
a�N�e�.: 06/O1/96
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4�ctlan ])fl6 0l IM {�4or Cah. InMut. uW ertomryl Iw.
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psrlormenm M iM wvk br xfiiN Ihe partnl h'vwad (�� �l. CH. CI.
LENDEN'9 N41E:
LENDEF'S �UDHESS:
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S' �aturo d Ownx/ApenVRppifenUCanlredor /�'
(5t51Je.WP) WM1�s-&+tld�p85dary:OreerFle:Canery-Rppfunt:Rnk-Rewrun:(iakeivoFMmme
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 074748 PLAN CHECK NO: 04040-95 L
PERM NO: F 074748
GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYp£: FIR PURPOSE: ALT
JOH DESCRIPTION : RELOCATE FIRE SPRINKLERS SQ FT:
CLAIM VALUE: 8,900.00 CALC—VALUE: GROUP OCC: B-2 /
COHMENTS: 76 UNION PRODUCTS REF: B-74632
�*�r�r�*x x�rw��r���r�r�rx�x�*���r�x���r*�r��r�r�r*�r�rx�wx �r�r�r���r�*x�x��r�x�x��r*�rx�+t+t+t+tx�+t*��r*+t*x�x��x�*+t�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ HAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050304 ZNE: REF NO:
PLANNING NiSTES>
i
ItIFM1E1E1ffEMIfMKfEMfEiEM1F1ElEfflEIEiEM1FK1E1ffEMiflFiFlflEiE1f1F1EM7F1kiEiFiElE7kifMifiE1liflEiElEiFiEiklEiFlFikM1E1E1E1EiflFikifiEiEiEiE1@ifiE
� E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: �— DATE: Io Z3��1✓
ifMIkIFNMiFMMiEiFiFiF1F7FKiFMMMif1F MIfMIFiEiFIFiElflf kK
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT
PLAN
ISSUE FEE
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 108.00 0.00 70.20
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT.PLUMBING ELECTRIC MECHANIC
FIRE
10865t
70.20
SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
178.20 216.00 —37.80
108.00 OVER/SHOAT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
108.00
MifiFiFiFMMMMkNiFifMiFMMif1fMMMiFiFMMMMMififiFMMMkMiF1kMMMifNiFMMMitMitMMifMNifMMMifMifMiFifMififk'IFiFiFMiEiFlEiFiE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY iD E S C R I P T I O N UNIT COST TOTAL COST
FIR 108
:�
FIRE EQUIP FEE (FROH BLDG VAL TAHLE)
END OF FEES
i.:
�._ r�
" `
I.
� 7
1.00 108.00
OI �II192l0':-;:?i9�709 T �� Y ;C5.4i
Dp7E: FO/13/95 'iZff$: 1:��8
' CONSTRUCTION AND PLANNING POO. ..SPA ,
� APPROVALS Permit # Date Inspector pppROVALS Permit �h � Date Inspector
1. Temporary Electrical Service or P.61e 52. Pool & Equipment Locatior. `
i
2. Soil Pipe•Undrgmd. w' 53. Sreel Reinforcement � °' � ��� ''
�,�'-{ectrical Conduh UL11iry•Undsgrn�f. 54. Forms � � r
.
� "��lectricaf CondUIT�7�1r9rnd. " 55. Electrical Bonding � "
., y,ii.` eel Reinforcemynyr+ 56. Rough Plumbing & Pressure Test ,✓'
"Rt?`ectriwl UFEFi'C}�d. 57. APPROVAL TO COVER�GUNITE �
a
'�.'�otings �:,n; � 58. Electricai Con ;�Undrgrnd.
� 8. 6bundation :*!� ^� 2 59. Gas Pipe, � Ur�]lijtnd., Test �
,,, .
9. Water Pipe-UndtRr�. � / 60. Backwash Lines;,�,Trap, O•FJDdrgr�d. �
10. Structural Floo � ystem � 61. APPROVAL TO �ECK ��'
11. Property Sewer �jne�& Hous�',onnection 62. Backwash & RecGgtor-Finat
�
12. Sewer Cap �j ��' 63. Heater & Vent-Final =
73. Roof Drains - 64. Plumbing Syscem - Final
14. Rough Plumbing. m 65. Electrical�Final � � �
15. Rough Electrica�Co�uit Q' 66. Solar SVstem�FEna�. � '
16. Rough Electric irir�q � 67. Fencing & AccA55-Approval
77. Rough Wiring Sic�T � 68. APPROVED F�LASTERING
� 18. Rough Electrica� Bar Ceiling 69. POOUSPA SYST6MS PINAL �
19. Rou h Heatin�& Air Conditlonin t � � ,� F�,2yE.aEr,PT.�EQUIR�MENT r
J
20. �u� F�cor�Fi�'lace i St*� oC s S r, o�* APPI�V�i�,� Permi2 #� g�_
21. 6ucr's in6trup3urc+1� � �•• •• `� • S � n. � 70. �nder�i��l K�dro '
.
22. Qu� Veljtil �ngF';� �` {
_`�Y, �, .. X i fi C7 Q p H�� 71. Produ�tj Ping as �Oil
23. Gas Ri�ae-Rouyh & Tost :*1 � m v' Q Oy � 7Z, Unde�gro�3ri�1 F�N i F J
24. 4�oo�ra�`rting" `�' � ��" � *� ^ Q r. �' • 7� Undergmtl. Sto�o� TankKO Gas ❑ dil
25. Roo heffihing S� 'Q �' x` 0> �%* 74� Overhead !��`� Qp �� ��� Q,S
26. 78a??Ceiling (Str�p��ral) & oat J
c 'S� � a O �� J* 7� Dry Che�+iral E..� * `_;
27. �ame anc; Flashirp�x pQ � # C >+ m� 76. Dry Sta �"+pe F� ,. u �. m
.y� Y �'1
28. LatFt�g �Si�g �� y d�F C *� .•� ..' 7� FIXED ��T�INAk v �� a � ��'y� /C�--
„29. Insulatiod •;�x v S � � � 7✓ FIRE PREV. F��L �� �" Z(� �Q(p U
' 30. Orywall �ilir� 'v� �..� � x F I S '�ALTb�,DEP�.�E(S�UIF�MENT
� ,. �
31. Plaster Brown"EoaT� S � t*t*� s 79. FINAL IPS�ECTt9N � !"
r 32. �ectrical`PouYer M�t�r�F�al i ; N � � I 8(�j' FOOD CERTIFr+�TE I�`�t Eq..� p-
- 33. na�lec+ricj i� m � k x� N6tes: "7[^ r. ^- O �^.:*:
�
� 34. ftna&}Ie�ng�F A'��oncttionirr�s n � a S nx �' < O
,:., r � [+7 C*1 #> r, � F 6 # '�
� 35. jnai �ias,ip .. esj"',�s � •• x r-� � xo Or� r. -'r
..� �
t � I II'^_ t. V: CI � k S f1cA � fC'
36. Hoodbr �"anopy � t ,�
s c� ,,. • .� � �n. s m �c � tr >:.
�
.37. �ina .Factory Fireplace r r(, r� *' x -� �. �n:
� 38. aina(`�Plumbinq � ��- c � � ' ,yQp �, y 6
` 39. 4s/ater Service-Final y g t # q ` �-. x� �o z�
Y .. 1.^.
':40. Gas Service-Final *�T% �T�*' S * c*� C� on, * �-
t Ct r-. t- X. F• O� +.' .�
'41. $blar pomesticFina� � ;r � I �..-, ��-yo � �. x �
�
42. Backflow Preventer x N t i �•�^ ?F � v -
•. � .•�- x�+ � mor�:r. m0 R
43. Backflow Irriqetion * >.V � a � , -�� �� >
'A0. Landscap Irrfga[io xBYstem a'd�� � }�`• T d Q� � � •.., OQ + S F �
T �. "
45. SO�nd /itien,�dtion; �..r . * :n m mr�. C Q . "r� *
��
46. Hendicap•Regclation5 Ci y� t: x s vo s •
.-� �- c bK R1 O CJ x
A7. FINAL STRUCTUR� & BUILDING � r, � ,# ' _ Y �
48. qNliLPLANNiNG� � -� " �� "y"'� `•'� ¢ " E"
h ' -Y .F ' l � f�i .� Q
;�J. �ecfiic Releafe to E�ison i x � l' � w •;-� # '
'` n
50. 6as Release to SoutKem Calitoririb�as Co t ' �•, � �' �T y �`
-x
51. CERTIFICATE OF OCCUPANCY x •- ���" ^ - ��
No _ _ Date
�oonessecem�axa: 555 ANTON gL
°ry"E"s"°YEi��u�o'"": SAKIOKA FARM5
�noness: p0 HOX 2097
TERMINAL ANNEX
APYL. YNIDq /i00flE51:
uHr: 9 TH
urcxneaow�+a��n: TRI—SIGNAL INC. ���= 0
�NCNONEN0.'81DOHES9: 1�JQS GARDENA AV 818-247-1194 ��:
c�rn��Tarer�.�: MORROWLMEADOWS CORPORATI01 f 909 ) 598-7700
CONfHALTOR4YNlW0 P O HOX 509
�ooncsa WALNUT CA ucw: 230813
917 8 9 uxr:
4CENSED COMRRCTOfl4 DECLAflRTION: I herMy Nim u� D�dY d peryvy Uut I em licrossd isds pw�om d CMpa 9
(mmme�w.i^V w4h 9ecibn 1000) d Oiwun 9 d �he Buvrou W Pminwns CaEe. eM mY Ycams b in IW torta enE ellea.
crrruc.No.:0�0j65GJ5/8' ���� uc.No.: 3081 EXP: 2[96
oae: � /'� / �O co�o-�«:
OWNER BUILOEN OECUqATION: 1 haeby dfim+ uMm ps�Y d perjury �htl I nmq fm iM Cam�rfoes lioeme lew Iv IM
'dbv.hq rsemn (SeUion )OJt.S &u�ae� eM Pmlenofn Cads: A^Y NY n mun xAid� nW'v e DermC W aombucl. Mer. hnMws.
'�mdih. w ropai enY �I�uctwe. p'nr b b'vsuene. ebo na�+ ih applimN 1 r arJi permd fJa a eqred wtsmeN tIW le or �M
, �icemee wrnum w ine n�� a Ne cwreem limN. �e. ICMq« mvm � wan seaun 1000) a U+:im a a ine
Businw erd Rdaaixu Code� a ihei Ir rc die c e emp II�Mrom e�d �M NepeE uemqvn. My voluion d SeGion
]031.5 M enY aDWKaM la e 0«� a4�+ihe eVO�wu �o s tlW V�Y d nd mas �Mn t"ive �u�dred doAvs �SSOOp.
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wM buiCe a inpv.aa ihe�ean. end Mn Eoea autli wM himaetl a haaA a tivaqh ha a Mr am amplryse�. pwideE ihet urJi
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I Eo heroby caniry �hel I em ewere d enJ urdenund tlr rpui�«n+ d CN/anu /bMA W Sday Code Sediom?5505. 255�, enA
255J1, enE thm I a ury Mws driki�q ovaqani wiA / wil m� (arcb me) naed io comply xvM1 eeid pete ooEm erd tM roqulmmeMs la
e pmnn Iammi�uctiona iroEifolion IramiM �i�l . e� �b. WritlMiN aonn�ueion eppirmian en wmq Imm I�me
>�,..
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WORNER'S CONPEN9ATON DECLAF�TION: I Mrab� dfirm uMa peruly d pr}vy me d Ne Idbw'up AwWmuns:
❑ 1 hew and wll mdnien � ow1liWs d m�wu to �atlLWn br'aakrY mmpa�ion. n qo.ideA t> by Sadion �)00 d IM lebar
GOM, fof �M pMmnu�ea d 1fis wakfa Wich fh» pemi 61sueA.
n I hew and W menten raFen' mm0�ion inwenu. n nwFad bY Sq'ai �]OG tl tlr LeEor Cods. br �M Du��K+M IM
7C .,aw i>.iw� w. o«mm e e.�.e. Mr.a�,� �:w�e�... oM..�d n,c�y �n« r.:
c.m. FI ��D 07%O1E96
aarryr�c., f1W("Hfl
(This uttim med irot M romdMd / �IwV�1 e b arn hVd�M EaOen 131P01 n hv.l
❑ 1 oenh ��� Ma�Ke d tM wak br MfiiM Ihb V� u muM. I Nel nd �mplv� airy prwn N ury menMr �o m to
becom� wastl to iM wM1as' cmwmWian Nw� d��. � apiw Nel d NnJd bamM wE�W lo M�Orlmri
eom/pmetb(ny�,roviviom M Seaio%n J]W d �M laEor C04�. I o m�� m�/m�pl� wnl Mr pewimro. /�
Dme: ` � /J � � / i. AGG�rJ�: / � ! ! '
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nvn nn.. w ro an nurer.e �rou,.ne edw, ls�ao,anoA �^ ���n ro ar• e r er m w.rron a.�w+., pvvro.e ror �n
3�etlon ]l08 0l M� L�6ar Cotl1, Infwt �� ���Y i/Mi.
CONSTflUCTON LENDINO �OENCY: I haeeby elfirm ueqar MnMy tl qr'µy iNl IMn u a oonalruqion MMi'p epeney br tM
perlmmeno W i�s v.ak br wliitli Ric MrmY u ewed (Saaion �oAl. C'v. CI.
LENOEN'8 NiW E:
LENOEF'S MUXE99:
I cently �MI I luw naE No epplkaYm W tlaU ihel iM eGwa �damelbn u oonw. I pn� lo canply xilh eG ay ud odmiy admviw�
uM.We lexs nbtn0 to buikw0 mmo-umon eM MrWy �Wva• �ethm a Ihn mY m rnu uG� iM �bon�momionod poP�M
la impeaian pu�poe��.
' CH K JACOBI JR
��, v�u N,m, h - � G/ �.6
_� Dets:
(515t�ds.WP)
8 Sefely:GreerrFila:�-MO�cen1: Pink-Rewnw: (3ddenrod-A�aauw
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 075836
PLAN CHECK NO: 04815-95 L
PERM NO: F 07583
GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE: ALT
SOB DESCRIPTION : FIRE ALARM ADDITION SQ FT;
CLAIM VALUE: 6,400,00 CALC—VALUE: GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS REF; H-74632
*******i�**+tir**x�**+t***x�*it**it*****at**�t*+t�t+�********�tx�t*�t��*+t**+t+t*�t**�t**at***x-�t*�**i�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
i(� 1E iF iE 1E iE iE iE 1E iE iE iE ii 1F 1E i! 4 ii if if k 1F aF If 1f iF iE 3F if ii iF if iE iE 1E iE il� IE iE iE iE ik iElE iE iElF 3f iF if ik fE if 1f� iE iE 7E If if 1f IE if 1E iF 1f iE if if iE iE 1E iE 3E �E IE 1E 1�' * 1E
D E V E L O P M E N T S E R V I C E S A E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : �� DATE:
APPLICATION ISSUED BY: ��
K iF K if 1F if K iE iF iF if� iF I(� If 1E 1E if fF 1F iF iF iF
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT
PLAN
ISSUE FEE
FIRE
90.00
652
58.50
DATE:
ififiEiFiflEifiE �Eif
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 90,00 0.00 58.50 148.50 148.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK
90.00
1E fE 1E �F iF IE ik 1E if iE ik it i(� 1k it ik ik k IF ik iF IF i! �IF ff iE iE iE iE iF i! �1! 41E iE k k iF iE k If k ik ff ik ik if ff 1E it 1E iE 1E i! iE k M k 1f iE iE 1k 1f k!f iE iF'IF�E iE iE iE iF iE �E it iE iE 1(�
I N D I V I D U A L F E E B R E A K D O W N
TYPE
FIR
QTY
90
D E S C R I P T I O N
FIRE EQUIP FEE (FROM HLDG VAL TABLE)
END OF FEES
UNIT COST TOTAL COST
1.00 90.00
U! �Di... . �Y�i.�� . l [' .,. ii
�t�l' h� ' .' T. ♦.
0
' CONSTRUCTION AND PLANNING P00_ ...SPA
� APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
t. Temporary Electrical Service or Pole 52. Pooi & Equipment Location i
2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement '
�3: Electrical Conduit Utility-Undrgrnd. 54. Forms
4: �Electrical Conduit-Undrgrnd. 55. Electrical Bonding '
i-
5. SEeeI Reinforcement 56. Rough Plumbing & Pressure Test
$�E,Iectrical'U.PERGmd. 57. APPROVALTOCOVER�GUNITE
'.7. Footings f, 58. Elettrical ConduibUndrgrnd. �
- 8. Foundation - 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrg�nd. " 60, Backwash Lines_, P�Trap, O Undrgrnd.
10. Structural Ftoor Svs[em � 67. APPROVAL TO DECK
1 i. Property Sewer L,ine & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap � .. -- . 63. Heater & Vent-Final
13. Roof Draini-'-. � 64. Plumbing System - Final
74. Rough Plumbfng -� 65. Electrical�Final
15. Rough Electricai•Conduit � � 66. Solar SYstem•Final
76. Rough Electric Wiring 67. Fencing & Access Approva�
- 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Cefling 69. POOL/SPA SYSTEMS FiNAL '
79. Rough Heating & Air Conditioning _ , y , FIRE DEPT. REQUIREMENT
20. kough Factory Fitep�ace � � � . � ' ; r � APPROVAL$. � Permit # �
21. Ducts, in Structure- � • �• _ � _ ' 70. �Underg'round HYdro
r -
22. Duc[s�Ventilating`:,' - �• - G', 71, Product Piping �Ll6as OOii
23. Gas Pipe•Rough & Tesc -_ '• T *� 72. Underground Flush
24. Roof Frarning �' � ";� �� ;. � 73.. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof.Sheathing - � �- r �+ 74, Overhead HYdro '
26. T-Bar Ceiling (Structural) & Monocoat ;` � - �- 4 75. Dry Chemical
27. Frame and Flashing w -._ - �• � 76. Dry Standpipe " '
,..
28. Lathing&Siding " '�` � � 77., FIXEDSYSTEMFINA� , ��
_� .
29. �nsulation, �. < _... � 7$: FIRE PFEV. FINAL ' Y' Zl�l G�(� la.,�,�
30. Drywall Nai�ing ';. � HEALTH DEPT. REQUIREMENT
" I
37. Plaster Brown Coat•ir •• r - 79. FINAL INSPECTION
32. E�ectrical�Power MAt@rFinal $- �'80'. F000 CERTIFICATE ISSUED ,
33. FinaFElecirir; �A e; . Notes: w� " "
.
34. Final Heating & Air Conditioniny - ' • • - � _
Y, - s
35. QinalrGas Pipe-Test�: - � , . � � . �
'- 36. Hoodror Canopy Y • � ' ' .� � • �
- t -- .
- 37. Final FactorV Firepla`ce - ,' _ - � � �
' 38. Finai Plumbing ' y � � . - - ,
39. Water Service�Final � � � ,, � ' � - " : �
40. Gas Service-Final � - - " ' ' •
� 41. Solar pomescicFinal � - - � .. . _
42. Backflow Preventer • �
43. Backtlow Irriqation � �, �" + - �
44. Landscape Irrigation SVsrem � - � , . . a �
45. Sound Attenuation . , , � " � � _
46. Handicap Regulations � � -
47. FINAL STRUCTURE & BUILOING F �� ,
48. F1NAL PLANNING
49. Electric Reiease to Eilison .
50. Gas Release to Southern California Gas Co �
51. CERTIPICATE OP OCCUPANCY
�
No. Date
i~ �
�- �i-�p o f�o5ta 21� e5a �
Developmenr Services, Division of Building and Safety
CERTIFICATE AF OCCUPANCY
; This cerrificate is issued pursuant to the requirements of the Uniform Building Code, Section 308
adopted by the City of Costa Mesa certifies that at the rime of its issuance the building structure herein
; below described was inspected and approved for occupancy as follows:
, _ .
Bullding Address 555 ANTON BLVD. FI.00RS 1-12 Bldg. Permit No.*eee belw
n..o QFFLCES
Group �-z Type of�Construction i-FR Fire Zone Use Zone PnC
�}'
Owner of Building Sakicka Farma '� Tenant "��'-AI•"
Address' ' ` m . • ^'
*87457C, 575356, B74572, B74571, Bi45?3, B74633
874632, &74631; B74G30, j 006, B7786b, 574574 By �
\ 7B{S�DATii:ID�+.'I�:":.��:i1$�,Z?�1�@i�ia 19 96
Date Novzmber 14,
PS.�'K Bk0'ah, CEO
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE �
- ---- - --- . _- - ---.._.. - ---- -- ---- --- --- ----�— -� —..�----__.�,.-- --_._— - --
�.w . . � . .. . . � 1` . _ . . . , . �..r . .. . f.. . � .- 1 ;:) .., ... ,
� CI"lY OF COSTA MI� �A �
Development Services, Division of Building and Safety �
CERTIFICATE OF OGCUPANCY
� �� z. �� � � � .:;� ,�
This certificate is issued pursuant to th"e requ�rements of t}ie Un�form Building Code, Section 308 adopted by the City
of Costa Mesa certifies that at the Nme of its issuance the building structure heiein below described was inspected and
approved foroccupancy as follows:' , �<� =`
� ��c
555 Anton�<81. ,� Ste �3�7Q0 � � � � � 807-00746
Building Address Bldg. Permit Number
, �� ... , k'�r, , . f.; - . .
Use Office (�18,39,3��;s:f.,) t;;
�`7 �,� g � "� �i � i v.�.� r � . . ,- ", _ ' "'§ 4�
Group B TypeofCo,nsfruchon 1-FR " F�reZone XXRX7�XXX UseZone PDI
rc� �_<t.. - � . -
RREEI'i,° �'� �� ' � � � ' �' �� '� 4IOODRUFF�, SPRADLIN & SMAF.7
Owner of Building Tenant
Address P'0. Box 4900, Dept. 207,.Sco'ttsdale, AZ 85261
� ' � � � �' By � �� � � �. �� ,
suiL�iNc oFFicinL-Khanh Q.�Nguyen, C B O. �-
� ' Date 10/�4
�
� REQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
7
�
Cicy oi Costa Meu
Development Service5 Department
Builtlin9 Safety Division
P. O. 8ox 1200
Costa Meu, California
CERTIFICATE OF OCCUPANCY No. ������
The Buildiag located at S�.S A_ntr�n E3ouleVaCd. Suite��('>�`%%
has been inspected and found to comply with the provisions of aVl City of Costa Mesa Ordinances applicable thereto
for a Group A9 Occupancy. ' � '
Use of BuiVding Ofif1C0
Legal Description 410-501-04
(See reverse side for Metes and Bounds)
Building Permit No A 37547 Electrical Permit No. E 37568 Plumbing Permit No. P 37562
Mechanical Permit No. M 376� IVumber of apartments and/or guest roomt
ISSUED T0:
Secucitv Pacific Bank
600 Wilshire Blvd., SSflO
Los Anaeles. CA
Building Official William T. Howard
by����� `�t �—'
� Date Ju1Y 17i 1989
Tfiis Certificate of Occupancy SHALL BE posted in a conspicuous place on the premius and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (ej U.B.C.
CmF 1o15-a6 rev. 1/B3 White - Dwner, Canary - Numerical File; Pink - Bldg. Permit File
. w . . w�r�� �.. y 1WY �. . .. ..��.. �.- . -•-- • -�•---�•�r.� . _ . ....- _. . --r-�w.�p�•. � � .
/
' � l
� � . ' �it�p o f �o�ta 21� e5a
, �
.' 'Development Services, Division of Building and Sa fety
• CERTIFICATE OF OCCUPANCY
�Y.�.« _,�=.�
This certlficate is issued pursuant to the?requirements of�the�Uniform Building Code, Section 308
adopted by the Ciry of Costa Mesa cernfies that at, the rime of its`issuance the buffding structure herein
below described was inspected an,d�'appr_ove3;foi-occupanCy�as follows:�
Building Address��
�
�`
Use Office
Group B-z
Owner of Building S�
Address P• 0. Box
BUQ,DING OFE7CIAL•�Otl''P
;
�
'�'i:��_r-�:L'��::3 i:i:�i�
�-- -Tena:
� �,� �:r: T.-�: ��
-_ ___ s_-1 --
Y/ `YY
REQUIRED TO BE
Pernut No. n �snn�
! Use Zone EDC
76' tJNION PRODIIC
%,l�==;i�l
�,�r� ���L`�
i
e b�r 13, 1996
%
;OUS PLACE
, CITY OF COSTA MESA e, �;
�
BI/ILDING DIVISION
i � 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754+5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.0
�.��� FOR INSPECTIONS CALL: (714) 754-5626 FO%-OOZLS
FIRE SUPRESSION PERMIT
JobAddress: 555 ANTON BL � � . - , �
Suite: 1200 � � ' ' " '
Vicinity: WOODRUFF, SPRADLIN 8 SMART� '� , . ' - � � �
, . . . . . . _,����,
Parcel Nunmber: 41050110 � ' . ZOning: ; '
, , . ,' � : � -
: �
Appliwm: GARCIA; JAMES ' , ,. •
Address: 2505 MIRA MAR AV -�. ^°'��•� '
� ' Phone: � 562-498-6444 '��," ,
LONG �BEACH, CA % � . Zip: 90815 - �
.� . � . ._ , � .
owner: RREEF ; '
Address PO BOX 4900 � � •
DEPT 207
SCOTTSDALE,AZ
f�
Phone:
Zip:" '- :85261-4900 ' �
a
e
Status: ISSUED
Applied: 06282007
Issued: 07/262007
Comracror: ACKERMAN; MAGGEY
Address: � � -- . - •- . ' . � -
� . - � Phone: �_ _ , . _ ._ . .. . � ..
. r.� ., ..i ZiP; ' . ` t_ -. , sr,
' � �' � License: 327196 ' . � :.`,, .. .,
� . .. . � � � �. � ... ,
. SCOPE OF PERMIT
FIRE SUPPRESS�ON PERMIT•TO INSTALL 25 STORBES, 2 FUNCTIONAL DEVICES, OUTPUT MODULES
AND 1 SPEAKER FOR A 18,393 SF INTERIOR TENANT IMPROVEMENT�FOR"WOODRUFF, SPRADLIN
AND SMART' IN SUITE 1200. REF#: B07-00746.� . ., - ; ,,"�,_:, � '�. '� -.
� " FEE SUMMARY : "
Plan Check: $217.91 � .` � � _ -' ` `� � � Calc Valuation: s2o,a52.00
Permit: $335.25 - • Claimed Valuation: szo,as2.00
Other. $0.00 ` �
Total: $553.16
NOTICE: 7he work authwized by this permit shall comply with all applicable handicap access requirements under Califomia sWtutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order tor the work authorized under this pertnit to be considered legal, such work must comply with all applicabla codes, and all
required inspeet(ons and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
WDE/, INSPEGiIONTYPE Q�jf, U$ S,QQF�a INSVEC710NTYPE � �T fN7IiI�LS
1818 Fixed System Final Fire Prevenfion ZOB Final Mechanical '
1288 Pool Spa Final ' 208 Final Plumbing
200 Pinal Re-Root ' 210 � Pina(Electnwl �
201 Final Block/Relaining Wall 212 Final Fire Prevention S�Zg� � ��"
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Dertrolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm untler penalty of perjury ona of the fonowing declarations:
❑ I have and vrill mainlain a certifwte of consent to sel4lnsure for workers'
compensalion, es provided for by section 3700 of the Labor Code, for the
p Aormance of Ihe work for which this perthit is issued.
I have and will �rtiainlain workers' compensa[ion insu2nce, as required by
eclion 3700 0l the Labor Code. fa the per(ormance o( lhe work fw�wliich Ihis
pertnit is issued. My vrorkers' wmpensation Insurance cartier antl policy
number are:
Carrier: �LflU�-i j� r_��PNL n/i %/
(ThisSeciionnee0�pfpacwndet`/ etMpertnla aNMafinenunOrM�Ia fStW)akss.)
Policy Number: �iy7JU — ��n
� I certily that in ihe peRormance of the work (or which ihis permit is
issued, I shall not employ any person in any manner so as to bewme subject
to Ihe workers' compensation laws ot Calitomia, and agree t�at if I should
bewme subject to lhe workers' wmpensation provisions of Section 3700 of
the Labor Cotle, I shall 1 h com with Ihese provisions.
Applion Sig le
WARNING: FAILUR TO SECURE WORK�RS' CAMPENSATION CAVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($100,000), IN ADDITION TO THE CAST OF CAMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF TF1E LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under prpvisions o1 Chapier 9(commencinq
with Section 7000) of Division 3 of the Businass and Professions Cotle, and
my license is in� 2full force and eftect.
Lic. # J2 Class # — U � —
v
COnV2Ct0i 5� a ure D21e
CONSTRUCTION NDING AGENCY:
❑ I hereby affirm that there is a constmc[ion lending agency fw the
peAortnance of the Nork (a wfiich this pertnit is issued. (Sec. 3097. Civil Code).
Lender's Name:
Lender's Adtlress:
SipnaWre Date
OW NER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalty of perjury Ihat I am EXEMPT FROM THE
CON7RAC70RS LICENSE LAW for Ihg following reason (Sec. 7031.5.
Businass and Profes5ion5 Cotle: Any city qr county which requires a permil to
conslrucl, alter, improve, tlemolish, or repair any structure, prior to its
issuance, also requires Ihe applicant for such permit lo file a signetl statemenl
Ihat he or she is licensed pureuant to the provisions of the Contractors
license Law (Chapter 9(commencing with Section 7000) o( Division 3 ot Ihe
Business and Professions Code) or Ihat he or she is exempt therefrom antl
Ihe basis. for the alleged exemption. Any violation o( Section 7031.5 by any
applicanl !or a permit subjects lhe applicant to a civil penalry of not more than
five hundretl dollars ($500).):
❑ I, as owner af the property, or my employees with wages as Neir sole
compensalion, WIIL DO TME WORK, and the structure is not intended or
oKered for sale (Sec. 7044, Business and prolessions Cotle: The Contractors
License Law tloes not apply to an ovmer bf proDerty who builds or improves
thereon, and who does such v,ark himself Or hersel( or lhrough his or her ovm
employees, provitled that such improvemanis are not intended or offered for
sale. If, however, the building or improvement is sold vrithin one year of
completion, t�e owner-builder will have thg burden of proving ihat he or she
tlid not build or improve for purpose ol sale.).
❑ I, as ovmer of the property, am EXCLUSIVELY CON7RACTING WITH
LICENSED CONTRACTORS ro consWct Ihe project (Sec. 7044, Bu5ine55 antl
Protessions Code: The contractors License Law dces rrot apply to an avner of
property who builds or improves Ihereon, arM vfio conVacts for such project with
a contracta(s) license W��nt to the Contrdctors License Laws.).
❑ I am ezempt under sec.
Business and Professions Cotle (or lhis redson:
305)�46�3I0])
Owner ID verified by drivt �se. ❑ Yes ❑ No
Driver's License No. Expires:
Venfication of Ownership by Qype of document, i.e. - property tax bill or tleeC):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cetldy Ihat no excavalion frve (5) w more feet in depth into wfiich a
person is requiretl to descend, v.ill be made in connection vrith xork author¢etl
by lhis pertnil, and that no building StrucWre, scaffdding, (alse.wrk, or Cemdition
w diSmanUing thereof, will be more Ihan thirty-six (36) feet hgh, (Chap. 32. Grp
2. Art 2, Sec. 341, Title 8, Califomia Administ2tive Code).
❑ As ovmer-builder, I will not employ anyane to do work vRiic� would
require a permil from the Division of Industrial Sa(ery, as notetl above, unless
such person has a permit to do such work from Ne tlivision.
Applir�nl's SipnaWre
Division of Industrial Safery Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will lhe applicant or present or fWure building occupant need to file antl
certily a Business Plan for emergency,response to releasa or threatened
release of a hazardous malenall ❑ Yes ❑ No
(Section 25505 of the Califomia Health antl Safety COCe reduires. with some
exceptions, that a Business Plan be (led with the Costa Mesa Fire
Department by every �usiness which has at any one lime during a reported
year a quantity of hazartlous malanals equal to or grealer ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas
at standard temperature and pressure).
2. Does or vrill the applicant or present or future building occupant need to file
a registration form for acutely hazardous matenals7 ❑ Yes ❑ No
(Section 25533 0( the Calilornia Health and Safety Code, with some
exceptions, requires registration with the Cosla Mesa Fire Department by
each business which at any orte time has on hand a quantiry of acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl
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 (or awtely
hazardous materials)? ❑ Ves ❑ No
(Section 25534 of the Califomia Health and Safery Code pmvitles that lhe
Costa Mesa Fire Departmant may require the preparetion, certifcation an0
fling with Ihe Fire Department of an RMPP Ey businesses which aie required
to register acutely hazardous materials with the Fire Depanment.
4. If an RMPP is presentry required, has Section 25534 of the Calitomia
Heallh and Safery Code been fully complietl wi�h? ❑ Ves ❑ No
5. Does or will Ihe applicant or present or IuWre huilding occupanl require lor
the work which is the subject o( this application a permit for such conslruclion
or modifcation from ihe SouN COasl Air Quality Managoment DiSMct or !rom
any other air pollution control tlistrict or agency� ❑ ves ❑ No
(Sectbn 65850.2 of the Calilomia Govemment Code requires that the raquested
inlortnalion De fumished on applications lar non-residential building pertnils).
6. Will any part o( tha facility lo be conslructed under �hi5 permit be vrithin
1000 teet Irom the outer bountlaries o( a school7 ❑ Yes ❑ No
(II'yes", the lacility must meel lhe requirement of Sections 25534 an0 42303
of the Calilornia Healtn and Safety Coae).
7. I( a permil from the South Coast Air Oualiry Management District or other
air pollution control districl or agency is requiretl (or the work which is Ihe
subject ol this application, have all o! the disclosures prescriheC by Califomia
Health antl Safety Code Section 42303 been made7 ❑ Ves ❑ No,
8. (If'yes", atlach certifcale ot compliance from the appropriate air pollution
CAntrol oKcer).
CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury ihe
information given above is correct. I agree lo wmply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have reaC this application anA state that
the in(ortnation given is corcecl I agree lo comply vrith all 5tate laws and city
ortlinances relating to building wnstruction, and authorize representatives of
the Ciry of Costa Mesa to enter upon t�e abovedescribed property tor
inspection purposes. I agree not to occupy or allow occupancy o( any builtling
authorized by this permit until final inspection.
Signature of legal ) Da�e y
Date � 26 7
MO/orAul�o - Da�
P.
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 1200
Vicinity: SUITE 1200
Primary Occ: B Eat<50/ Office/ Bar<50
Parcel Number: 41050110
npp�icant: AUSRA BAGDONAS
Address: 4770 CAMPUS DR
SUITE 100
NEWPORT BEACH, CA
Owner: RREEF
Address PO BOX 4900
DEPT 207
SCOTTSDALE,AZ
Type of Consiruction: I-FR /
Zoning: �Sl�.��
Y
Phone: 949-701-4685
Zip: 92660
Phone:
Zip: 85261-4900
Contracror. AMARON CONSTRUCTION CORPORATION
Address: � 7565 N HARMONY CI. "
ANAHEIM HILLS. CA
Zip: 92807 �
A¢n . KERRY P WILSON
Address: H HENDY ASSOCIATES
NEWPORTBEACH,CA;
' i Zip:-' i926124�', �
� �_l �ft/i: �1 �i
Phone: 714-993-9220
License: 674301
Eng:
' � � Address: ;
Phone: 949-857-3080�'{ " A 1(
' .�" �a '� �i
ioo ; �" -'"�a c: �. �y
,�Ucense�' C79204 � ' ,����h'_I
� � JT. c_ .. " � _. _
Status: ISSUED
Applied: OS/31/2007
Issued: 07I2312007
ISSUED BY:
- 'Phone: � • , �
. j �� L, �
� 1 � L�4�nse: _ 1 1\ �
. . .. , � �t � , .
� _< -� acvrt vr rtrcmi i
18,393 SF INTERIOR TENANT IMPROVEMENT FOR "WOODRUFF, SPRADLIN & SMART" IN SUITE 1200
• FEE:SUMMARY--___..:_:,- :
Plan Check:� ; : $2,494.05 `� /` � " '' r` '�,�%J �' ''r"'.Ir �'� � �'�"'^Calc Valuation:
. , , ` t $3,837.00 - ��' r/ " �` "� � L `��� �-'_,� �; �k` (�4 Claim Valuation
Permit:� i •
�SMIP,Res,,�� � $0.00 �� � � � �:�y ,
SMI_P�Com: ,,',,� $131.67 ��,,,�, �� �h^� �,y,
� Other:. �, � $0.00� �,�^��_'_�' �
Inspection: $0.00 '
Total: $6,462.72
SETBACKS
MAIN STRUCTURE FronY�• 0. 0
ACCESSORY Front 0-0 '
PARKING Existin : o
PLANNING & ZONING
Rear,. Ou�O c� Left "' 0- 0� � Right
�Rear 0- 0 Lefl 0- 0 �� � Right
Reauired: 0 � Pr000sed: 0 � � �
' _
' �� � ,
ssz�,000.00
5soo,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permlt shall autometically expire and become void if work is not commenced within 180 days, or II work Is suspentled or ebandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wlth all epplicabla codes, enA ell
requlred Inspectlons end finel approval must ba obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5628
2a4&481B100)
WORKERS'COMPENSAnONOECLARAnON:
I hereby effrtn under penalry of perJury one ot Ne following tledareLons:
❑ I heve entl wlll maintaln e certificate of consent to Self-Insure br workers' compensatlon, es provided for by secllon 3�00 ot Ne Lebor Cade, for the peAormance ot Ne
work for which ihis pertnit is issued.
I e enG vnll meintain wwkers compensation insurance, fls repuired by sectlon 3700 0l the Lebor Code, lor the peAormance of Ihe work for whiCh this pertnit Is Issuetl.
y w e co nsatl Insuren carrier erW pdiry number ere:
c Ma� s��-��}� —Pa�: /�to 7 9 5' 7— zo�
s section need not be oomplefed i! Me permlf fs ve/ued et me hundred dollers (8100) or Iess.J
❑ I certity �het in Ne OeAortna at the wwk tor whlch this pertnit Is IssueO, l shell not omploy eny person in any nner so es to become sub�ecl to Ne workers'
com ws af Ce la, end egree,ide f I shoulE ome sub�ect to the worken' wmpensetlon provlslons of Sectlan 3700 0l the Le6or Cotle, I shall torNwith
iy wim ma a c g• �- 3?Lc-L� 6 7
ApPIi t Signa �� � �_._.
WARNIN : FNLUR 'SECUiiE WORI(ERS' OOMPEN54TION COVEfUOE IS UNLAWFUL AND SINl1 SUflIECT� CRIMIN�L PENALTIES AN CML FlNES UP TO ONE HUNDRED
T ^uAND DOLURE (5100,000). IN ADDRION TO THE CQST OF COMPENSAT70N, OAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR WDE, INfEREST, AND ATTOFiNEYS PEES.
LICENSED CONT9ACTOHS DECLARA710N:
that I em
of Chgp(er 8(commencinp with Sectlon 7000) ol
Class p
Prolessions Catle, end my Iicense is In full
❑ I hareby eHlrtn thet there Is e consirucNon lending egency lor Ue peAormance ot t�e work Por which this pertnit Is issuetl. (Sec. 3097, Clvil Code).
Lender's Neme: Lentlefs Atltlress:
SignaNre:
OWNER-BUILDER DECLARA710NS:
Dete:
1 hereby eflirm thet under penalry ol perJury ihat I em EXEMPT FROM TME CONTRACTORS LICENSE LAW lor ihe following reason (Sec. 7031.5, Business end Proteuions
Code: Any ciry or counry whic� requires a permit to construct, elter, Imprwe, demWlsh, or repelr eny sirucWre, pdor lo its issuance, elso requires the applicant for such permit
to tlle e signed atetement ihel he or she is Ilcensetl pursuent ta Ne proWsions o1 the Contrectors Llcense Lew (Chapter 8(commencing wit� Sectlon 7000) of Divislon 3 0l the
Business en0 Professions Cotle) or Ihet �e ar she is exempt therefrom anOlha besis for ihe alleBed exemptlan. Any vialation a� Sedlon 7031.5 by eny ap0�lcant for e permit
sublecis t�e epplicant to e civil penelry W not more t�an flve hundrad dWlers ($500).):
❑ I, es owner of ihe properry, or my employees wlih weges es thelr sole compensatlon, WILL DO THE WORK, entl Ihe siructure Is not Intendetl or oflered for sale (Sec.
7044, Business end Professions Code: The Contractors LiCense Lew tloes not epply lo en owner of property who 6uilds or Improves t�ereon, and who does such work
himself or hersell or thraugh his or her own employees, provided that such impravements ere not intended or oHereG tor sale. If, however, ihe bullding or improvement is
sold wiihin ona year al wmD�etion, t�e owner-builder wlll heve iha burden al proving ihet he or she did not build or improve tor purpose of sele.). '
❑ I, es owner of the property, em E7(CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe projact (Sec. 7044, Buslness end Profeuions
Cade: The contractore License Law does not aOP�'to an owner oi property who bulltls or improves Ihereon, end who comrects for such project wlth e conirector(s)
license pursuant to the Contractors LJcense Lews.j.
❑ I am exempt under sec.
SipneNra:
Owner ID veritied by tlrlveYs Ilcense. ❑ Ves � No
Business and Protessions Cade lar ihis reeson:
Vetlflcatlon of Ownere�ip by (type af tlaument, i.e. - properry tex Dill or tleetl):
Drivets License No.
Date:
Eapires:
DIVISION OF INDUS7RIAL SAFETV PERMI7 CERTFICATION:
❑ I hereby certlty thet no ezcavation Ilve (5) or more feet In tlepth into which e pereon Is requlreA to tlescend, will be mede In connectlon with work authorized by thls
permit, end thet no Duiltling struclure, scettolding, telsework, or tlemdi�lon or dismantling thereof, will bo ^ore ihan thlrry-slx (38) feet high. (G�ep. 32, Grp 2, Art 2, Sec.
341, Title B, Caltlomle AdmiNstreiNe Cotle).
❑ As owner-6uilder, I will not employ enyone m do work which would requlre e pormlt Iram t�e Division ot Industdel Satery, es noted ebove, unless such person hes e
pertnit to Eo such work Irwn the Elvision.
Slgneture: � Date:
Dlvision ol Intlustrial Selery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHOROA710N OF EMAY: I certiy under penalty ol perjury thet I have read this flpplication en0 stete Ihat the informaGon given is
correct. I egree to compty wlth ell stete lews enC ciry oMinences relatinp to buil0inp wnswctlon, entl aut�odze representetives ol the Cly of Costa Mese to enter upon the
ebovs-descrlDetl Droperty for inspection purposes. I egrae not to occupy or allow occupenq ol eny 6uilding authorized by ihis permil until finel inspection.
GQUE I, INSPECTIONTI9E �
1618 Fixetl System Finel Fire Pravention
1268 Pool Spa Finel
200 Finel Re-Rool
201 Finel BIocWRetelning Well
202 Finel Fectory Flre Place
203 Finel Sign
204 Flnal Demolitlon
QAff. II�ELB
COOEI INSPECTIONTYVE
206 Finel Mechenicel
208 Final Plumbing
210 Final Electdcal
212 Final Fire Praventlon
220 Finel Plenning Approvel
222 Finel Site
�250 '� Finel Bulltling/Occupency
•
CITY OF COSTA MESA �
BUILDING D/VISION
s
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER.' E07-00711
:;:
n
PERMIT TYPE ELEC STATUS: ISSUED r
DATE ISSUED: 08101I2007
- - --. ISSUED BY: SOK
� ,- �:
��•1;;� s�
JOB ADDRESS: 555 1200 ANTON=xBL CM '� '; , "�Suite/Umt w1200
Vicinity: SUITE 1200 -_ , , � ' , ,,,
. . A ... . . ,_ .
'., i ; . .- _. -
SCOPE OF WORK: 18,393 SF INYERIOR TENANT IMPROVEMENT FOR "WOODRUFF.�, SPRADLIN & SMART' IN SUITE 7200. REF.:
607-00746 ELEC INCLUDES: 103�GGHTS; 155�OUTLETS AND 49 SWITCHES. -- -��- �
R�' t
OWNER: RREEFAddress ��;,.,�, �� . ,� PO BOX 4900 Umt:DEPT 207,. �.
PHONE: '`�� - �� ', City/S,tate/Zip:-. �� SCOTTSDALE AZ �' . ",
APPIICANT: ERIK WOLFE '�*�L -�� ='-�-� � Address: P O�BOX 1654 .Unit: ,- � . �
PHONE: 949-768-5807 ` , .-�� -� City/State/zZip: LAKE FOREST, CA .
CONTRACTOR: THOMAS ELEC7RIC � � • � � � � . � "License No.-��. 625798 � � � � �
Address: P O BOX 1654Unit: � � PHONE: 949-768-580T � - � ' � - � - '
City/State: LAKE.FOREST, CA �- - y ZipCode. 92609 . -- CELCi -. -- -
'r .�, , .. _ .
� �
.'^" . 4�.,.. a� ' . .. -��
�4 . ; . . ���, '..
ti. � j, t.
, ..,. ._ . . .
� . �. �� _:.... .... - � - .. .. . .
ELECTRICAL PERMIT FEES i ''` '
Electrical Plan Check Fee: , , : $0.00
Electrical Permit Fee: '$269 8�
Reinspection Fee $0.00 .
TOTAL FEES ': $269:81`-
� - _ .
•.i . .,.. � . .
�
�L, _
� i
i .`:: t
a
.�
1_ � 1
... . ,;,. ..; � -
� 't�. ..Y� .-, . ':'
NOTICE: The work authorized by thi5 permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21�92) ,
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 fnal approval will result in the expiration of this permit.
cooe r. ixsrecnoxTrve
1fi18 Fixed System Final Fire Prevention
1286 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
DAIE INTIMLS
�
CODEt INSPEG710NTYPE UpTE INTITIALS
208 Final Mechanical
2�B FinalPfumbing {/-�///j7
210 Final Electrical �� LYJ%(I/f / � � — „�%
/
272 Final Fire Prevention � 7i�— �
220 Final Planning Approval
222 Fina15ite
250 Final Builtling/Omupancy � �//
V
.
WORKERS' COMPENSATION DECLARATION• . �
� hereby affirm under penalry of perjury one of the tollowing.declara6ons: �
❑ I have and vnll maintain a certificate o( consent lo self-Insure for workers'
Compensation, as provided for by section 3700 of the Lahor Code, (or the
peAormance of [he work for which this permil is issued.
�have and will mainWin v.orkers' compensalion insurance, as requiretl by
�" �lion 3700 of [he Labor Code, tor the perfortnance of Ihe work for which this
pertnit is issued. My workers' compensation Insurance carrier ana policy
number are:
Carrier 'r2t�C,�' //LSr/�2AA.L'F' €�iCN�/l,ia�
(Tlis sMion need iaf be mmp'eted Jthe pertnQ is valuetl at rne �untlred W9ars (E1ppf a less )
Potil ty�Numbec- A/04444'�fZ/ �
❑ I certify that in the pertormance of the vrork !or which this permit is
issued. I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of Califomia, and agree thal if I should
become subject to the workers' compensation provisions of Section 3700 of
(he Labor Co y(t shall fortt�wi[h comply with these provisions.
__ �___ _. O/ GT
�'� -App- nfsSignaWre- -_ Date �
W : FAILURE TO SECURE WOftKERS' COMPENSA710N COVERAGE
�S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in tull force and effect.
lic 2S'�Q Qassit e�/�
S �� b
� o actor'S Signature Da�e _
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that there is a construclbn lentling agency fa the
peAortnance of lhe �+ork for which this pertnit is issued. (Sec. 3097, Gvil Code�.
Lender's Name:
Lender's Address:
Dale
OWNER-BUILDER DECLAR4TION5:
I hereby affrm that under penalty of perjury [hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business and Pmfessions Code: Any ciry or coun[y which requires a permil to
constmct, alter, improve, tlemolish, or repair any slructure, prior to its
issuance, also requires the applicant for such permi[ to 51e a signed sta[ement
that he or she is licensed pursuant to Ihe provisions o( the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or [hat he or she is ezempt iherefrom and
ihe basis for lhe allegetl exemption. Any violation o( Section 7031.5 by any
applicant for a permit suDjec[s the aDPlicant to a civil penally of not more Ihan
frve hundretl dollars ($500�.�:
❑ I, as ovmer of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the strucNre is not intentled or
oflered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law dces not apply to an ovmer of propeAy who builds or improves
lhereon, and who does such work himself or herself or throu9h his or her own
employees, provided that such improvements are not intentled or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer•builder vrill have the burtlen of proving Ihat he or she
ditl not bui10 or improve for purpose of sale.). , . .
❑ I, as owner of the property,-am EXCLUSIVELY CONTRAC7ING W17H
LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and
Pro(essions Code: The con[2ctors License Law dces not appty ro an owner o(
property who builds or improves thereon, antl who cont2cts for such project with
a contracla(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. - "
Business and Pro(essions Code for this reason:
305]-46(3/0])
% \.
Ovmer ID verifed by dri�nse. ❑ Yes ❑ NO
Driver's License No. Expires: �
Verification of Ownership by (rype of document, i.e. - property tax bill or tleetl�:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � �
❑ I hereby certHy that no excavation frve (5) Or more feet in deplh into wfiich a
person is requiretl to descend, will be made in connectbn v.ith vroik authonzed
by this permit, and that no buildi`g structure, sca((ddirty, �alsewnrk, or demolition
or dismantling thereo(, will be more than thirty-six (36) feet high. (Chap. 32, Gry
2, M 2, Sec. 341, Tpe 8, Calitomia Administrative Code). i
❑ As owner-builder, I wi0 not employ anyone to do vrork which vroWa
requfre a pertnit fmm the Division of IndusMal Satety, as noted above, unless
such person has a permi[ [o do such work from the division. j
i
ApplmanfsSignaWre Date �
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:�
1. WiU the applicant or present or luNre building occupant need to file and
certify a Business Plan for emergency response to release or threalened
release of a hazardous material? ❑ Yes ❑ No �
(Section 25505 of the California Heal[h and Safety Code requires. wi[h some
exceptions, tbat a Business Plan be (led with the Costa Mesa Fire
Department by every business which has at any one time tluring a reportetl
year a quantiry of hazardous ma[erials equal to or greater than a weig�t of
500 pounds, or a volume of 55 gallons, or 200 cu6ic feet of compressed gas
at slandard tempera[ure and pressure). '
2. Does or will the applicant or present or future building occupant need to file
a regis[ra[ion fortn for acutely hazardous materials? ❑ Yes .❑ No
(Section 25533 of the Califomia Health and Safety Cotle,- with some
exceptions, requires registration with the Cosla Mesa Fire Department by
each business vfiich a[ any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressetl gas.al standard
temperaWre and pressure). �
3. Does or will the applicant or. present or future building occupant need to
prepare an RMPP (Risk Managemen[ and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No �
(Section 25534 of lhe Califomia Health and Safety Code pmvitles that the
Costa Mesa Fire Department may require the preparation, certifcation antl
filing wi[h the Fire DepaRment of an RMPP by businesses whichiare required
lo register acutely hazardous materials with lhe Fire DepartmenL I
4. If an RMPP is presently required, has Section 25534 0( the California
Health and Safery Code been fully complietl with? ❑ Yes � No
5. Does or will the applicant or present or fuWra builtling occupan[ require for
the vrork which is the subject of this application a permit for such�'conslmction
or modifcation from the South Coast Air Qualiry Management District or from
any other air pollution control tlisMct or agency? ❑ Yes ❑ No
(Section 658502 of the Cal'rfomia Govemment Code requires tha[ the requested
information be (umished on applications ta ran-residential builtling pertnits).
6. Will any part of [he facility to be constructed under this permil be vnthin
7000 �eet lrom the outer bourWahes of a school? ❑ Yes ❑ No
Qf "yes", Ihe facility must meet the requirement o( Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from Ihe South Coast Air quality Managemenl DiSMct or other
air pollution contml district or agency is require0 for the vrork which is the
subject of this applicatioq have all of the disclosures prescnbed by Califomia
Heallh and Safety Code Sectio� 42303 been made? ❑ Yes ❑ No
8. (If yes", altach certifcate of compliance trom the appropnate air polN(ion
control officer}.
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury lhe
information given above is correct. I agree to comply with all slate laws antl
city ordinances regarding Hazardous Materials and Emissions. .
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
cerli�y under penalty of perjury that I have read this application and sWte that
the information given is correct I agree to comply with all state laws and ciry
ordinances relating to building construction, and authorize representatives of
the Ciry o( Cos[a Mesa to enter upon the above-described;property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by Ihis permit until final inspection. � ,
��e Leqal Ovmeqs) te I
l/� O/ 0
/— An _Aut�otixe0 AOGliwnl `�Da e ' .
l___ __ . . _.
CITY OF COSTA MESA
BYILpING DIVISION
i` � 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax p14) 754-0856 • ww�v.ci.costa-mesa.ra.us
".��� , FOR INSPECTIONS CALL: (774) 754-5626 . 07-��,2,2$
FIRE SUPRESSION PERMIT
Job Address:
Suite:
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner
Address
Contrector
Address
r., .—,... ,
555 ANTON BL "` ""' � �,
�, ,r, � Status: ISSUED
1200 _,�rr` ��" I ; -- Applied: 07/112007
WOODRUFF, SPRADLW�B�SMART }... � r�� �`` -'-"*� Issued: 08/01/2007
y _ ,' -
S � F i }
41050110 ` `� `Zoning
.'f .� /� � = 1 � �F a }. .
ANNA MORENO , �+' �`c' � �, `
. r� r� .. �;aH7 ' S .a .i �5 ' "
�i
' �e 11''�{ Phone �.:951-244-9836 . a�.. "�. � .
�
�� ,�, �� Zip . 6
�
.
RREEF '; ��'' Y ' ' � " �
�,
Po eox asoo ' ° � '= '
DEPT207. � �� Phone: - - - . � �
�.
SCOTTSDALE,AZ ..'�;�� .-`."Zip�',",�.`85261-4900 ;�:- ��•�. �- - ,-'-.� [�,
- , _ — _ � � _ i'1'I �
. ;�. _ ,. .. � _ _ . .
ALL PRO FIRE PROTECTION
30060 SI WER SADDLE CT. ; _-� i_., r.. ,
_��- �.;,�; Phone:- 951-244-9836. . ,.
CANYON LAKE;'CA �I t:.� ` Zip: 92570 f ��� � -
i ��
" � a ��'� License 629993 � ... .. '� +'�:
�a , .
ii y � r ��f � ,�. ;,
.tL,.�.���; ... � ��,,.. .., , , .,Y.
ti'ry'
RELOCATE 99 FIRE SPR�INK
. RE:807-00746. �r ,
� 4 t �:
�y„�,;`��;
Plan Check: $99.61
Permit: $153.25 '
Other:' $0.00
Total:. $252.86
,� '�i'.
�%� ': _
FEESUMMARY��
:;(, . ,�-., ; ; _�.
TI,
f:;.
. , .��.
Calc Valuation: $a,000.00
Claimed Valuation: $s,000.00
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) . . .
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the wo�k 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.
4ppEt, INSPECl10NTYPE A�F, IN1171RL CODE/ INSPEG110N7YPE . Q�]TF, INnnn�s
1818 � Fized System Final Fire Prevention 208 Final Mechanical �
1266 Pool Spa Final �, � 208 Final Plumbing
200 Final Re-Roof ' . 210 Final Electnwl
201 Final Block/ReWining Wall
202 Final Fadory Fire Place
203 Final Sign
204 Final Demolition
212 Final Fire Prevention
220 Final Planning Approval
222
250
Final Site
Final BuildinglOccupancy
7. O'1 C�--'
��
WORKERS' COMPENSATION DECLARATION:
I her y affirm under penalry of perjury one of the fou�wing declarations: '
1 have and w,ill maintain a certifcate of consent to selt-Insure for workers'�
compensation, as provided for by section 3700 of Ihe labor Code, for Iha
peAormance of Ihe work (or which this permit is issued: .. . �
❑ I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, fa ihe peAortnance of the v.ork for which Ihis
pertnit is issued. My workers' wm e` p nsation Insurance cartier antl policy
numberare: n�' �' � `
/Ca e�� �� � ui r"� �'�
�/� (i�is sttlwr nee0 �rof pa tnm�etl �Ihe p�mmrt� v�uN�t one hundred 0a9ars (S100J w kssJ
Policy Number:
� Yi i, `� �iv �
❑ I certify that in the performance o( [he vrork for which [his permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws ot California, and agree that if I shoultl
become ubject to the workers' compensa[ion provisions of Section 3700 of
theLa" Code.lshallfqr�ppi(l���ryplywj(hJfieseprovi�n^1 O�
- / l' ! 'I�YLu ti
App(rcanfs SignaWre ^ Date
�1�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION ER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOlLARS
($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 aKrm that I am licensetl under provisions of Chapter 9(wmmencing
with Section 7000) ot Division 3 of the Business and Professions Cotle, and
my license is in full force and eftect. I�1'
l:i�tr#—_-, � Class�#� `� �
, M p"IYI,OM�,(,� y ol 0'7
Coniranor's Sipnawre Oar ,�_
i
CONSTRUCTION LENDING AGENCY: �
❑ I hereby affirtn that there is a constructbn lending agency for ihe
pertortnance of lhe Kork fa which this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lendeis Address:
OWNER-BUILDER DECLARATIONS:
I hereby aKrm Ihat untler penalry of perjury Ihat I am EXEMPT FROM TME
CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5,
Business antl Professions Cotle: Any ciry or county which requires a permit to
construct, alter, improve. demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such permit to fle a signed sWtement
that he or she is licensetl pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing vrith Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis (or 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 hundretl dollare ($500).):
❑ I, as ovmer of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and ihe 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, antl who does such work himself or herself or through his or her own
employees, provided�ihal such improvements are nofintentletl�or offeied tor
sale. If, however, the building or improvement is sold within one year of
completion, the ownervbuilder will have the burden,of proving,that he or she
did not build or improve for purpose of sale.). -
❑ 1, as owner of the.property, am El(CLUSIVELY CON7RACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professbns Code: 7he contractors License Law dces not apply to an ovmer of
property who builds or improves thereon, and who contracts for such project with
a contrac[a(s) license pursuant to the Contractas License Laws.).
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
SiB�alure � Date
305>-46(3/0]) '
Owner ID verifed by drive se. ❑ Yes ❑ No �
Driver's License No. Expires:
Verification of Ovmership by ([ype of document, i.e. - properly tax bill or deed):
DIVISION �OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby ceAAy that no excavation frve (5) or more feet in depth into wfiich a
person is required to descend, will be made in conneclion with Hork authorized
by ihis permit, and that no building strucNre, scaFfdding, falsev.ark, v demolition
or dismantling thereof, will be more [han lhirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, CalAomia Adminisirative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the Division of Intlustrial Safety, as noted above, unless
such person has a permit to do such work from the division. .
Applicanfs SignaNre 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 8usiness Plan for emergency response to releasa or threatened
release ot a hazardous material? ❑ Ves ❑ No �
(Section 25505 ot Ihe California Health and Safety Code requires, vrith some
exceplions, lhat a Business Plan be filed with the CosW Mesa Fire
Depariment by every business which has at any one time dunng a reported
year a quantity o� hazardous matenals equal to or greater than a weight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard tempereWre antl pressure).
2. Does or will the applicanl or present or future building occupant need to file
a regislration (ortn for acutely hazartlous materials? ❑ Ves � No
(Section 25533 of the Califomia Health and Safety Code, with some
exceptions, requires registration with [he Costa Mesa Fire DepaAment by
each business which at any one time has on hand a quantity of acu[ely
hazartlous materials equal to or greater than a vreight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at� stantlartl
temperature and pressure).
3. Does or will the applicant or present or future building occupant neetl to
prepare an RMPP (Risk Management and Preven[ion Progrem for acu[ely
hazardous materials)? ❑ Yes ❑ No �
(Section 25534 0( the California Heal[h and Satety Cotla provides that the
Cosla Mesa Fire Department may require the preparation, certification and
fling with the Fire Department of an RMPP by businesses which are requiretl
to register acutely hazardous materials with the Fire Depariment.
4. If an RMPP is presently required, has Section 25534 of [he Cali(ornia
Health and Safety Code been fully complied with7 ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre building occupant require for
the work which is the subject oT this apDliwtion a Oermit for such wnsWction
or modifica[ion from the South Coast Air Qualiry Managemenl District or from
any other air pollution control tlistrict or agency? ❑ Ves ❑ No
(Seclion 658502 of ihe Calrfomia Govemmenl Code requires that the requested
information be fumished on apPlications fa non-residential building pertnits).
6. Will any part of the �acility to be construc[ed under this permit be within
1000 feet from lhe outer boundaries of a school? ❑ Yes ❑ No
pf'yes", the tacility must meet the requiremen[ of Sections 25534 anC 42303
of Ne Calitomia Health and Safety Code).
7. If a permi[ !mm the Sou[h Coast Air �uality Management District or other
air pollution conhol district or agency is required (or the work which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No.
�B. Qf "yes", attach certifcate of compliance from the appropriate air polWtion
control oflicer�. - � �
CERTIFICATE OF COMPLIANCE: I certi�y that under penalry of perjury the
information �given above is covect I agree�to compty with all state laws and
ciry ordinances regarding Hazardous Materials and Emissions. �
. .. Signalure Dale .
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury Ihat I have read Ihis application and state Ihat
the information given is correct. I agree to comply with all state law's and ciry
ordinances relating to building construction, and authorize representatives of
ihe City of Costa Mesa ro enter upon the above-described property for
inspeclion purposes. I agree not to occupy or allow occupancy of any builtling
authonzed by this permit until fnal inspection.
' S aWreof�� �%� ��
Pn 0/.Au1�OnxMAO-LcaN r'pe�e l'�
_ � 1__=`` \
—��__ —_ �� \
� w
CITY OF COSTA MESA
BUILDING DIVIS/ON
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBE�07-00445
PERMIT TYPE MECH STATUS: ISSUED "•
DATE ISSUED: 08/02/2007
ISSUED BY: RMD
JOB ADDRESS: 5551200 ANTON BL'CM ' Suite/Unit:� ,_._:1200
Vicinity: WOODRUFF, SPRADLIN AND SMART .,: "'- ��
SQ. FT: 0 . -_
,`,.::; . � - � ,
SCOPE OF WORK: MECHANICAL PERMIS FOR�A 18,393 SF INTERIOR TENANT IMPROVEMENT FOR "WOODRUFF,
SPRADLIN & SMART' IN SUITE 1200. REF#: 607-00746 WORK TO INCLUDE:
PLAN REVISED TO ADD 1�VAV BOX AND�1 FIRE DAMPER. �� � -� �- �.
., �.. >. _..... __ _ . � � � 4 .
OWNER: RREEFAddress - " � PO BOX 4900 Unit:DEPT 207 � �-
PHONE: "� City/State/Zip: SCOTTSDALE AZ �
APPLICANT: PROCTOR,�:JOHN. `� ,� � Address: 25108 MARGUERITE PKVJY 'Unit:UNIT 58
PHONE: 949-586-5894� ' -l�;:, � �'n." ."��; "��`:".City/State/zZip:-„ MISSIONVIEJO,CA "�� � ��'
, .." �� . .. . . � .. � � .
CONTRACTOR: JP AIRSPECIALTIES INC ' � � License No. 776459
Address: 25108 MARGUERITE PKWYUnit: UNIT 58 , —_ . PHONE: 949-586-5894 -
City/State: MISSION VIEJO, CA ZipCode.'92692-- ���- ._ � � , � ,� CELL: - .:
MECHANICAL PERMIT FEE SUMMARY " ' _
MECH ITEM FEE: - � :$275.80.', � - ' .� � � ' .
PLAN CHECK FEE: ' � � �: $0.00. , , , � � . _ - �
INVESTIGATION FEE: , -. �$0.00,-� '� ' - - ', �.
REINSPECTION FEE: , , $0.00 � � . .. . • �
� '' ;f,,, � . � ..
TOTAL FEES: $325.30 �� � �� _ � ' '�"�E � �
- , . _ �.,
���- �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
C0� IN$PECTIONTYPE
7816 Pixed Sys�em Final Fire Prevenlion
1266 Pool Spa Final
200 Final Re-Roo(
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
0� INTIlIALS CODEp INSGECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Eleciriwl
212 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 Final euilding/Occupancy
DRT� INTITIRLS
l�l �(J U7 r�
l]
�
WORKERS' COMPENSATION DECLARATION: .
I hereby aKrm under penalty ot perjury one of the loifowing declarations:
[] I have and will maintain a certifcate o! consent to self-Insure for workers'
compensation, as provided for by section 3700 of Ihe, Labor Coda, for the
pert rmance o( the work for which this permit is issuetl.
I have antl will maintain v.orkers' compensation insurance, as requiretl by
ec ion 3700 ot lhe Labor Code, for the peAortnance of the vrork for which this
pe ued. My workers' compensation Insurance carrier antl policy
mber ar (�
Ca ' . � 9'f/i`-�
(Tli nne d�rofL0Jem/mdetetlAfn'epIeimrtiGsraluetlafonehuntliedtbNars(Sf00)wleuJ
P �. Num : -1 l, — � �/ � ( �
certity that in the performance of the vrork for which [his permit is
issued, I shall not employ any person in any manner so as to become subject
b the worker ' compensation laws ot California, and agree that if I shoultl
become sy � t ro t� rkers' compensation provisions of Section 3700 of
Ihe LaD /C e, I liall f hvnth comply with these ptovision !
pliwnl' - alure
WA ING FAIWRE TO SEWRE WORKERS' COMPENSATION COVERAGE
�S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
pENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000j of Oivision 3 of the Business and Professions Code, antl
/�y' T/iCey/se��s in (ull force and eHect.
(� l� 7 Class # 2 �
_.7 � ! G
only dor'sSl aWre Oate
CO TRUCTION L NOING AGENCY:
❑ I hereby aKrm that there is a construcibn lending agency (or the
peAortnance of the v.ork for which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Adtlress:
OWNER-BUILDER DECLARA710NS:
I hereby aKrm that untler penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business antl Professions Cotle: Any city or county which requires a permil to
tonstruct, alter, improve, demolish, or repair any sUucture, prior to its
issuance, also requires the applicant for such permit to file a signetl slatement
thal he or she is licensetl pursuant to lhe provisions of the Contractors
License Law (Chap[er 9(commencing wi[h Section 7000) of Division 3 of lhe
6usiness antl Professions Code) or that he or she is ezempt therefrom and
the basis lor the alleged ezemption. Any violation of Section 703L5 by any
applicant for a pertnit subjects Ihe applicant [o a civil penalry of nol more [han
fve hundred dollars ($500).):
❑ I, as owner o( the property, or my empioyees with wages as their sole
compensation, WILL DO 7HE WORK, and tt�e stracture is not inlended or
oHered 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, antl who does such �vrork himself or herself or [hmugh his or her own
employees, providetl that such improvements are not intended or offered tor
sale. If, however, the buildinq or impmvement 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 ovmer of the property, am EXCLUSIVELY CONTRAC7ING WITH
LICEN5ED CONTRACTORS ro construct the project (Sec. 7044, Business and
Professbns Code: The cont2ctas License Law dces no[ apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a conlracta(s) license pursuant to the Contractas License Laws.).
❑ I am exempt under sec. �
Business and Professions Code for this reason:
Signature Da�e -
305]�46(3/0])
Owner ID verifed 6y dnver .ise. ❑ Yes ❑ No �
Driver's license No. Expires: �
Venfication of Ownership by (type of document, i.e. - property [ax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � �
❑ I hereby certdy that no excavation fNe (5) or more feet in depth into v.hich a
person is required to descend, will be made in connection with vrork authonzeU
by this permit, antl t1�at no building structure, scaffdding, lalsewnrk, a demWition
or dismantling thereof, will be more �han Ihiriy-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Atlminist2tive Code).
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit from the Division of Induslrial Safety, as noted a6ove, unless
such person has a permit to tlo such vrork from the division. '
i
ApPI¢anfs5ignaWre Dale ,
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: ,
i. Will the applicant or present or tuture builtling occupant neetl to file antl
cerlify a Business Plan for emergency response to release or threatenetl
release o( a hazardous matenal? ❑ Yes ❑ No . �
(Seclion 25505 of the Califomia Health and Safety Code requires, with some
exceptions, that a Business Plan be fled wiM [he Costa .Mesa Fire
Department by every business which has a[ any one time during a reportetl
year a quantily of hazartlous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas
at standard temperature and pressure). '
2. Ooes or will the applicant or preseN or fuW re building occupant neetl to fle
a registration form (or acutely hazardous materials? ❑ Yes ❑ No
(Sec[ion 25533 of the Califomia Health and Safety Code, with some
exceptions, requires registration with ihe Costa Masa Fire DepaAment by
each business which at any one fime has on hand a quantity of acutely
hazartlous materials equal to or greater Ihan a weight of 500 pounds, or a
volume ot 55 gallons, or 200 cubic feet of compressed gas at standard
temperaWre and pressure). �
3. Does o� will the applicant or presen[ or future builtling occupant need to
prepare an RMPP (Risk Management and Prevention Pmgram for acutely
hazardous ma[erials)? ❑ Yes ❑ No ,
(Section 25534 0( the Califomia Health and Safery Code provides that the
Costa Mesa Fire Department may require the preparation, certifcation and
filing with the Fire Department of an RMPP by businesses which 2re required
to register acutely hazardous materials wilh ihe Fire Department ;
4. If an RMPP is presenHy require4 has Section 25534 of the Califomia
Health and Safely Code been fully complied with? ❑ Yes ❑ No
5. Does or will Ihe applicant or present or fuWre builtling occupant require for
Ihe wo�k which is Ihe subject of this applicacion a permit for such �constmclion
or modificalion fmm the South Coast Air Quality Mana9ement Disirict or from
any other air polNtion control district or agency? � Yes ❑ No
(Section 658502 of the Calitomia Govemment Cotle requires that the requestatl
information be fumished on applications fv nornresidential building permits).
6. W ill any part of the faciliry to be constructed untler this permit be within
7000 feet Gom tbe outer boundaries of a school? ❑ Yes Q No
(If yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Heal[h and Safety Code). �
7. If a permil from the South Coast Air Dualiry Management DisMcl or other
air pollution control distnct or agency is required for [he vrork which is the
subject ot this application, have all of the disclosures prescribed by California
Healih antl Safery Code Sec[ion 42303 been made? ❑ Yes �❑ No
8. Qf "yes", attach certifcate of compliance from the�appropriate air pollution
contral oKcer). �
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is conecL I agree to comply with all state laws antl
city ordinances regarding Hazardous�Matenals and Emissions. � .
i
SignaWre Da�e '
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
cehi(y under penalry of perjury Ihat I have reatl this application antl state that
Ihe informalion given is correcL I agree to compty with all state laws and city
ordinances relating to building construction, and authorize representatives of
�he City of Costa Mesa to enter upon the above-described jproperty for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
author'rzed byt �� permit nalinspecHon. .
Si na e er(s) _/ a�e i
O� [ �
Analo� iretl Ap I 1
CITY OF COSTA MESA _.
BUILDING DIV/SION
�7 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754•5626
i
PERMIT NUMBER: M07-00445
PERMIT TYPE MECH STATUS: ISSUED
DATE ISSUED: 08/02/2007
- � = = ISSUED BY: RMD
i' '
JOB ADDRESS: 555 1200 ANTON.BL-CM �' ;, Suite/Unit: :-__-1200
Vicinity: WOODRUFF, SPRADLIN AND SMART � _ ';' '
SQ. FT: 0 _
iz
SCOPE OF WORK: MECHANICAL'?ERMIT.-FOR A 18,393 SF INTERIOR TENANT IMPROVEMENL•F,OR "WOODRUFF,
SPRADLIN & SMART" IN SUITE �1200. REF#i'B07-00746 WORK TO INCLUDE: �.. " -
.%ri
a
i ,. _ . : , .' .
f �*
OWNER: RREEFAddress � • . - � POBOX4900� Unit:DEPT207 �
PHONE: � .- - City/State/Zip:� - $COTSSDALE,AZ, --
APPLICANT: PROCTOR,�JOHN �`�._' ''`� °� � Address: 25108�MARGUERITE PKWY l�Unit:UNIT 58
.....
PHONE: 949-586-5894 . . � ,., '•> City/State/zZip: MIS$ION VIEJO;�CA �� �
CONTRACTOR: JP AIR SPECIALTIES INC �,� � - - ' � ' ' -�' License No. 776459 �
Address: 25108 MARGUERITE PKWYUnit: UNIT 58 ��- � �� - ' PHONE: �949•586-5894
City/State: MISSION VIEJO, CA _ ZipCode 92692,, ; _.. � , , �, _ . CELL: � " ,
��a. � . _.. . _. . . - _
� ' . � -.. '�i=.
� , '('
MECHANICAL PERMIT:FEE SUMMARY
MECH ITEM FEE: $257.90 . ' . '
PLANCHECKFEE: ',`.. �.,.. .:�� ",$0.00. �;:.- � �' � :� ., . :;-..� , .
INVESTIGATION FEE: ' - � � '� $0.00 -� � � � � � � � -
REINSPECTION FEE: ' , - . � $0.00�; -_ �� �. , . . . _ .. .
TOTAL PEES: $257.90
;-_ � �
- � . . , _ _ �i .
NOTICE: The vrork authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § t, 72-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
COOE i. INSPEG710N TYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
INTITIqLS COOE!
201 Final Block/Retaining Wall �� 212 Pinal Fire revention
202 Final Fadory Fire Place Final Plan ' g Approva
203 Final Sign 222 Final Site
204 Final Demolition 250 FinalBuilding/Occupancy
DATE INTI71pL5
WORKERS' COMPENSATION DECL4RA770N: �
I hereby a(firm under penalty of perjury one of the following tleclarations: .
❑ I have and will maintain a ceAifcate of consent ro sel(-Insure for vrorkers'
Compensation, as provitletl for by section 3700 of the Labor Code, for the
performance o( Ihe work for which this permft is issued. �
❑ I have and vrill main[ain vrorkers' compensa[ion insurance, as �equired by�
aection 3700 ot the Labor Code, fw the pertortnance of [he work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are: t�r �
Carriei: 5,�'fi I vi`i
" nas sertbn need' � mmpet�the pennrt �syaluetl at one nuntlretl tlonars (5100) w less J
U�`�'
P lic�'� Nu`mb�r. E� � �
❑ I certify that in the performance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compens tion laws of California, and agree that if I should
6ecome su� c to th i cers' compensation provisioyns o( Section 3700 of
the Labor od . I s II fo with comply with these provi fbns��-7
t�%/ � d /
A pliwnl'S'Signature � —�ia{e<: _
�� ..
WAR G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AMD SHALL SUBJECT AN EMPLOYER TO CRIM7NA�
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
AT70RNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I am licensed under provisions o( Chapter 9(commencing
with Section 7000) Of Division 3 of the Business and Pro(essions Cotle, and
my license is in full force and effect.
� G c�Sz:C ' O
d
afS�aWTe '� ,^ ;Oat _r� t'
'1
CON CTION LENDING AGENCY:
❑ hereby aHirtn that [here is a constmction lending agency for ihe
peAormance of the vrork fa which this permit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: _
Lentlers Address:
OWNER-BUILDER OECLARATIONS:
I hereby affrm that under penalty of perjury that I am ExEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 703i.5.
Business and Professions Code: Any city or county which requires a permit to
construct, alter. improve, demolish, or repair any stmcmre, prior ro its
issuante, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuan� to the provisions ot the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 0( t�e
Business and Professions Cotle) or thal he or she is exempt there(rom antl
the basis for Ihe alleged exemplion. Any violalion of Section 7037.5 by any
applicanl for a permit subjects the applicant [o a civil penalry of not more than
fve huntlred dollars ($500).):
❑ 1, 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
o(feretl !or sale (Sec. 7044, Business and Professions Code: 7he Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who dces such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or offered for
sale. If, however, the bu'AO'irig or improvement is sold within one year o!
completion, the owner-builder vnll have the burden of proving that he or she
did not build or improve for puryose of sale.).
❑ I, as ovmer of ihe pmperty, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to consWct the project (Sec. 7044, Business and
Professbns Code: The wn[ractors License Law dces not apply to an ovmer of
property who builds or improves Ihereon, and who contracts for such project with
a coniractor(s) Gce�se pursuant to tbe Contractors License Laws.).
❑ I am exempt under sec. �
Business and Professions Cotle for this reason:
SignaWre Date
3051-G6�3I0�)
Owner ID verified by drive. ,rtse. Q Yes ❑ No
Dnver's License No. Expires:
Verification ot Ownership 6y (type of document, i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby ceAAy that no excavation (rve (5) or more feet in depth into wfiich a
person is required to descend, will be made in connection vrith work authorizetl
by this pertnit, and that no builtling swcture, scaFfdding, falsework, a tlemolition
or dismantling ihereof, will be more than Ihidy-six (36) (ee[ high. (Chap. 32, Gry
2, Art 2, Sec. 341, Title 8, Califomia Administ2tive Code).
i
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permil from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division. i
Appl¢anCs Siqnalure bate �
Division o( Indusirial Safery Permi[ Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: .
i. Will the applicant or present or future building occupant need to fle and
certify a Business Plan (or emergency response to release or threatened
release o( a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Heallh and Safety Cotle requires, wi[h some
exceptions, that a Business Plan 6e fled with the Cosla; Mesa Fire
Department by every business which has at any one time dunng a reported
year a quantity of hazartlous materials equal [o or greater than a weighl of
500 pounds, or a volume of 55 gallons, or 200 cubic leet of compressed gas
at slandard IemperaWre and pressure). -
2. Does or will the appliwnt or present or future building occupant need to file
a registration form for acutely hazardous ma[erials? ❑ Yes ❑ No
(Section 25533 of the Califomia Healt� and Sa(ety Cotle; wilh some
exceptions, requires regis[ration with the Costa Mesa Fire Department by
each business which al any one time has on hand a quantity of aculely
hazardous matenals equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cu6ic feet of compressed gas, at standartl
temperature and pressure).
3. Does or will the applicant or present or future building occupant need m
prepare an RMPP (Risk Management and Prevention Program for aculely
hazartlous matenals)? ❑ Yes ❑ No �
(Section 25534 of [he Califomia Health and Safety Code provides that the
Cosla Mesa Fire Department may require the preparation, certifcation and
fling wiM the Fire Department of an RMPP by businesses which are requiretl
to register awlely hazardous materials with lhe Fire Department!
4. f! an RMPP is presenily required, f�as Section Z5534 of the Califomia
Heal[h and Safety Code been fully complietl vrith? ❑ Yes �❑ No
5. Does or will the applicant or present or future building occupaN require for
the work which is the subject of this application a permi[ (or such construction
or modifcation fmm the South Coast Air Qualiry Management Disirict or fmm
any other air polWtion control tlistrict or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires Ihat the requested
in/ormatron be lumished on applications fa rron-resideniial buflding permits�.
6. Will any part of Ihe tacility to be consVuc�ed under Ihis permit 6e within
1000 feet from the outer bountlaries of a school? ❑ Ves iO No
p('yes", the faciliry must meet [he requirement of Sec[io�s 25534 and 42303
o( the Califomia Heal[h and Safery Code).
7. If a permit from the South Coast Air Quality Management Dislrict or other
air pollution control district or agency is required for Ihe vrork which is the
subjecl of Ihis appfication, have all of the disclosures prescribed by Califomia
Health and Safe[y Code Section 42303 been matle? ❑ Ye5 ❑ No
8. Qf'yes", attach certi(cate of compliance trom the appropriate air pollution
control offcer). -
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. �, �
Signalure Date
CERTIFICATE OF COMPCIANCE AND AUTHORIZATION'OF ENTRV: I
certify under penalty of perjury tAat 1 have read this appticatiori and stace tfiat
Ihe information given is correct. I agree to comply with all state laws and city
ordinances relating to building consWction, and authonze representatives of
l�e Ciry of Costa Mesa to enter upon the above-described property (or
inspection purpos I�Qr�e rrot to occupy or allow occuparicy of any 6u'tld'ing
authorized by t' r(nit htil final inspection.
G
ig reo LegalOwner(s) le
� �; Xlld/orAU1l�p�yMAPplifanl �dlC1
1
CITY OF COSTA MESA
� "' BUILDING DIVISION
F � 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv,�w.ci.cos[a-mesa.ca.us
�•,��� FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER! P07-00480
PERMIT TYPE PLUM
STATUS:
DATE ISSUED:
- ISSUED BY:
ISSUED
08102/2007
RMD
JOB ADDRESS: 555 1200 ANTON BL CM Suite/Unit: . 1200
Vicinity: WOODRUFF, SPRADLIN AND SMART
SCOPE OF WORK: PLUMBING PERMI'f FOR A 18,393 SF INTERIOR TENANT IMPROVEMENT FOR "WOODRUFF, SPRADLIN &
SMART' IN SU�TE 1200. REF#: B07-00746. WORK TO INCLUDE: 1 COMMERCIAL KITCHEN�SINKS. '
OWNER: RREEFAddress:
PHONE:
APPLICANT: VASQUEZ, JUAN
PHONE: 6263363882
CONTRACTOR: VAS MECHANICAL PLUMBING COMPANY
Address: 16035 CHELLA DRIVE
City/State: HACIENDAHEIGHTS,CAZipCode:_91745
PLUMBING PERMIT FEE S.UMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $43.10
TOTAL FEES: $43.10
PO BOX 4900 DEPT 207 �
CitylState/Zip: SCOTTSDALE, AZ
Address: 16035 CHELLA DRIVE� :
City/State/zZip: HACIENDA HEIGHTS, CA
License No. 803288
� - PHONE: 626-336-3882
� .. � CELL: -
NOTICE: The work authonzed by lhis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for lhe 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 inspectlons and final approval will result in the expiration of this permit.
CppE1, INSPEClIONTYPE D�TF INTRIpL' 00 INSPECTIONME �7� ��
1818 Fired System Final Fire Prevention 206 Final Mechanical ^
1266 Pool Spa Final 208 Final Plumbing —(—d
200 Final Re-Root 210 Final Electriwl
201 Final BIocWRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Si9� 222 Final Site
204 Final Oertrolition 250 Final BuildinglOccupancy
WORKERS' COMPENSATION DECIARATION: .
I �ereby affirm untler penalty ot perjury one of l�e following tleclaretions:.
❑ I have and will maintain a certificate of wnsent lo self-Insure (or v.arkers'
compensa!'ron, as providetl tor by section 3700 of the Labor Code, �or the
performance ot the vrork foi which this pertnit is issued.
❑ I have and vrill mainWin workers' wmpensatbn insurance. as required by
section 3700 of Ihe Labor CoOe, tor the performance of Ihe work fw which ihis
pertnit is issued. My vrorkers' wmpensation Insurence cartier and policy
�n-umher are: �/
�.Carrieri � (Li�../ �/y�i�
�(T�issacAbnneeoirotbemmdet Jlheptm�riquvaNMa me�w�M�/MOMa�S(5100)orlessJ
lPolicy�Number. � (L7 5 Z (� �- i/Jn -f-
❑ I certity that in the pedormance ot the vrork lor which this permit is
issued, I shall mt employ any person in any manner so as to beCome subject
ro the vrorkers' compensation laws of Califomia, and agree that if I should
6ecome subject lo lhe workers' compensation provisions of Section 3700 of
ihe Labor Code, I shall foAhwith comply with these provisions.
y-z-o�-
d� �9^oWre `,____Date�3
�___ ��
WA ING: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE
IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLAFtS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm thal I am licensed untler provisions of Chapter 9(commencing
vnth Section 7000) of Division 3 of the Business an0 Professions Code. antl
my license is in full (orce and effect.
���.#-' _ ��-#� c -3 6
�Con4acto' 9�Wre �Dat�'D�
CONS UCTION LENDING AGENCY:
❑ I hereby atfmn that there is a crosWction lendifg agency (a the
per(ortnance of the v.ork for v.fiich this permit is issued. (Sec. 3097. Civil Cotle).
Lender's Name:
Lender's Address:
SignaNre Qale
OW NER•BUILDER DECLARATIONS:
I hereby affrm that under penalry of perjury Nat I am EXEMPT FROM TME
CONTRACTORS LICENSE UlW for the following reason (Sac. 7031.5,
Business antl Pro(essions CoOe: Any city or counry which requires a permit to
construct, alter, improve, demolish, or repair any SWCWre, prior lo its
issuance, also requires the applicant for such permit to file a signed starement
that he or she is licensed pureuant to the provisions of Ihe Contractors
License Law (Chapter 9(commencing with Section 7000) ot Division 3 of the
Business antl Pro(essions Code) or that he or she is exempt therefrom anC
the basis tor the alleged exemplbn. Any violation o/ Sect'ron 7031.5 by any
applicanl for a pertnit suDjects the applicant to a civil penalry o( not more than
five hundred dollars (5500).):
❑ I, as owner of !ha property, or my employees wilh wages as �heir sole
compensation, WILL DO THE WORK, antl lhe strucWre is not intended or
offered for sale (Sec. 7044, Business antl Professions Cotle: The Contractors
License Law dces not apply to an owner of property vfia builtls or improves
thereon, and who does suth wv(k himset� or hersel� or through his or her ovm
employees, provided ihat such improvements are not intendetl or otteretl for
sale. If, however, the buildinq or improvement is sold within one year of
wmpletion, the owner-builtler will have the burden of proving that he or she
did not build or improve (or purpose of sate.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WI7H
LICEN3ED CONTRACTORS to construct the projecl (Sec. 7044, Business and
Professions Ca1e: The contractors License Law does rwt aDPN �o an ovmer of
proDerty wfio builtls or improves Ihereon, and who cont2U5 for such project vrith
a contractor(s) license pursuant tothe Contractas License LawsJ.
❑ I am exempt under sec. -
Business and Pmfessions Code tor lhis reason:
]O5�<6(YO])
Owner I� venfied by drive� nse. ❑ Yes ❑ No
Dnvers License No. Expires:
Verification of Ownership by (type o� dxument, i.e. - property tax Dill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihat no excavation frve (5) or more feet in depth inlo which a
person is require0 to descentl, vrill be made in connectbn vrith work authorized
by this pertnit, and that no builtling swcture, scaftdEing, false�wrk. a demolition
or dismantGng Ihereol, will be more than thirty-su (36) feet high. (Chap. 32, Grp
2. M 2. Sec. 341, Title 8, Califomia Administrative Code).
❑ As ovmer-builtler, I will not employ anyone to do work which would
require a perm'it /rom the Division ot Intluslrial Safety, as Iwted aDove, unless
such person has a permit to do such vrork from the division.
Appliwm's Sipnalwe
Division o( Industrial Safely Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CER7IFICATION:
1. Will the applicant or present or future building occupant need ro file and
certify a Business Plan tor emergency response ro release or threatened
release of a hazardous material7 ❑ Yes ❑ No
(Section 25505 0l t�e Califomia Health and Safery Cotle requires, with some
ezceptions, ihat a Business Plan be filed wit� lhe Costa Mesa Fire
Department by every business which has at any one time tluring a reported
year a quaMity ot hazardous mater'rals equal !o or greater than a vreght of
500 pountls, or a volume of 55 gallons, or 200 cuGic leel o( compressetl gas
al standartl temperalure and pressure).
2. Does or will tha applicant or present or future building occupant need lo file
a registralion form for acutely hazardous materials7 ❑ Ves ❑ No
(Section 25533 of the California Health antl Safery Cotle, with some
exceptions, requires registralion vnN the CosW Mesa Fire Departmem �y
each business wfiich at any one time has on hand a quantiry of acutely
hazartlous materials equal to or greater than a weight o( 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet o( wmpressed gas at standard
temperature and pressure�.
3. Does or will the applicant or present or future builtling occupant neetl to
prepare an RMPP (Risk Management antl Prevention Program (or acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 0( the Califomia Health and Sa(ery Code provides that the
Costa Mesa Fire Qepartment may require [he prepardtion, ceAificatlon and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials wiN the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health antl Safely Code been lully complied with? ❑ Yes ❑ No
5. Does or will the applicanl or present or future building occupant require for
the vrork which is tho subject of this application a Dermit fo� such COnSWGlion
or modifcation from the South Coast Air duality Managemenl District or from
any other air pollution control dislrict or agency? ❑ Yes ❑ No
(Sectbn 658502 0( the Califomia Govemment Code requires Ihat [he reque5ted
informatbn be lumished on applications lor non-resi�ential building permits).
6. Will any part of the faciliry to De consWcted under this pertnit De within
1000 feet from Ihe outer boundaries of a school? � Yes ❑ No
Qf yes", lhe faciliry must maet the requirement o( Sections 25534 and 42303
of the Cali(omia Health and Sa(ery Cotle).
7. It a permit Irom the South Coast Air Ouality ManagemeM District or other
air pollution coNrol dislrict or agency is required for t�e vrork which is the
subject ot this application, have all of the disGosures prescribetl Cy Califomia
Health antl Salety Coda Section 42303 been made? ❑ Yes ❑ No
8. Qf yes", atWch cenifcals ot wmpliance (rom Ne appropriate air pollulion
wntrol oMcer�. �
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury Ihe
in(ormation given above is conecL I agree to comply with ail state laws antl
city ordinances regarding Hazardous Materials and Emissions.
Signawre �aie
CERTIFICATE Of COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certiry untler penalty o! perjury that I have read this aDPlicalion antl stale lhat
the intormation qiven is conecL 1 agree to comply with all staie laws arW ciry
or0inances relating to building construction, and auNorize repre5entaUveS of
the Ciry of Cosla Mesa to enter upon lhe above-0escribed property for
inspection purposes. I agrea not to occupy or allow occupancy o( any builtling
authoirzetl by Ihis pertnit until final inspection.
SgnawreofleBalOwntt(s) Date
R� 7 -/J�-
r ' n01WFu�M1anxeEApplipM--'— pale- . T
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v
• v�. •.
� •.:._::� ; :
�
(714)754-5273 • Fax(714)754-4856
JobAdtlress: 555 ANTON BL
Suite: 12
Vicinity:
. - -.
CIN OF COSTA MESA
BI/ILDIN6 DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
PERMIT NUMBER
' � 699-�1137
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 07/20/1999
Issued: 07/20/1999
Parcel Nunmber: 41050110 Zoning: .
Applicant: WARREN PARCHAN ' �SSUED Bv: _
Address: ' � " � ` - • � . -
/ ,'
�'�.�;�.%'- . ,Phone: 714-99&3790 - _ _-
'i �%i/)�.�' � � ZiPt � �- ; �' �-;
� � . .
. ,�. �
�
Owner. SAKIOKA�FARMS- ' � %� � _ � ��
�/i \\i� �,. - �. ���.
Address � ��� �� , - - .1 i .� ��
� ��
���/� �\ � � f /,�, � - -- Phone. _` -�., _._ -� � -: ` , .A
�ii�/�/// \���//-„� 2ip' 94137 �_-��� , /-����
/�' \ \.,�i %/ \��\\ �� / j �\,�
Contracror: �DE�LA SECURA'INC �� � � � / ; " i �. �A
i .���,�
�� dress: 01975 N BATAVIA ST ������ �� � � ���� �
1� � ,, � %� Phone:,- 998 3790 � � �
_� ,/� /ii, . . �-.�
� i✓, i � ORAN6E CA , � , . ' � '- ��
i,�
, . ��� ��Zip. ; 92 65 . . . License: 467925 . . �� _ ` �
. �, .Arch : � . � � _ , - ' � � , Eng: . , . - � - \ .
-- i. - - � , . . �
i, Address: � - '� � � Address:, , �
� � � - _ . /� �� � �Phone: � " . . /� Phone. • :�'
I ' ; � ^ _ . " _ . _ ,
-!i � �� ' �, i
� � I � � _ - . . � - i
,,� Zip � �, � � � Ucense: Zip: License: �
, ,�� � � �� � . / � ��> ,A
� � / !- ' ' - SCOPE OP PERMIT �
� � MINOR DEMOLITION IN pREP FOR "TICKETS.COM" OFFICE TI FOR 11TH AND 12TH FLOORS, RE:899-01068. � �
�
' � � FEE SUMMARY ' -' • �
� Plan Check: „� $0.00 . -�, � — - . �'t� Calc Valuation: � ' Sto,asoioo
�� , Permd ;,� $174.75 � ``� �`� � � � i � � �� ClaimValuation: � �- sio,000.00�
� SMIP_Res ' • � $0.00 " - _ � ` j j , , �
��SMIP Com: ����, � $2.19 _ % . ,';
t � � �Other. �,.' $0.00 � " � ''
��Inspection:� �;���$0.00 • -- � - �
�
���`, ��� / � � � . � . , . ,
�A �Total � $176.94 � � �
.
�.�� ��. •
V"�, . ��.`� = � � � PLANNING & ZONING - � � �
�
.
��� �. - �' %
SETBACKS,� � /% ,'� �, , � � � � '
MAIN STRUCTURE`Front , 0•'0 �� - Rear� � 0. 0 Left ' 0- 0 � Right � 0. 0 . �"
_ i
ACCESSORY �'Front, 0- 0 Rear 0- 0 Left 0- 0 Right, 0- 0-' �
PARKING Exlstintt:, 0'-, �Reui'red: ��0 Proposed: 0
NOTES: _ � : - � . , � � �.
- ' - ,. - . �"- ' -
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes end related
regulations. (Ord. No. 92-28, § t, 72-21-92)
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 penod of 180 days. ,
INSPECTIONS: In orcler for the work authorized under this parmi� to be considered legal, such work must comply with all epplicable codes, and all
required Inapectlona entl flnel epprovdl must be obtained. Failure to obtain inspections end final epproval will result in ihe axpiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626 �
7 I
WORKERS'COMPENSATIONDECLARATION: ��
I hereby aHirtn untler penalry o1 per�ury ane of t�e lollowing tleUareUons:
❑ I have entl wiil maintain a cenificete af cronsent to self-Insure for workers' compensation, es provitled lor by sedlon 3700 of Ne Lebor Cotle, Por the pedortnence ot the
work for which this pertnil Is issued.
❑ I have erW will maintain workers' pensatlon insurance, as requireA Dy section 3700 0 1he Lebor Coda, for t�e pertormance of the work lor which NIs permit is Issued.
My workers' cortpensatlon In� ca ce ribi re�tl pol number ere: �/ ��y�
Cerrier: -�i � �1 PollcyNumber. ��s/�/�9��VW
(Tltls sectlon nesd nat be compl e/ N e permlf Is e one huntlred dollars (5100) or IessJ •
❑ I ceNiy thel in the OeAor ce 1 Ihe i w' h this permit is issued, I shall not employ eny porson In eny menner so es to became subject to the workere'
compensetion laws ot C mi nd a r f houltl become sub�ect to Ihe workers' mmpensatlon provisions ot SecUon 3700 of ihe Lebor Gode, I shall lorihwlih
compy wlth these provls' s.
Appllcen� Signalure:
WARNING: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNl
THOUSAND OOLLARE (5100,000). IN ADORION TO THE (YJST OF COMPENSATIIXJ,
Date: �
ECT AN EMPLOVER TO CRIMII
f-0R IN SECfION 3]O60F THE
Ur..i
fiNE$ UP TO ONE HUN
WDATTORNEY'S FEES.
LICENSED CONTAACTORS DECLARA710N: �
I hereby aRirm �hat I am Iicens ntler pro ' ions � pler 9(co e ng with SecUon 7000) of Division 3 ot the Business and Prof ons Code, and my license is in
force an0 eHecL Lic. a � Clau k
Contrettofs Signature: Dale:
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHifm thet there is e construciion Iending egenty lor Ihe pertormance of the work for wMch thls permN Is IssueA. (Sec. 3097, CMI Code).
Lentlels Name: Lentlefs Address:
SlgneWre: Daie:
OWNER-BUILDER DECLARATIONS:
I hereby aHlrtn t�ai untler Denalry ol perjury Ihet I em El(EMPT FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Protesslons
Code: Any ciry or wunry which requires e permil to construct, elter, impmve, demolish, or repeir eny sWCluro, prior to Its issuance, elso requires the appllcan� for such permit
to file e signetl stetement thet he or she is Ilcensed pursuaN to ihe provisions af the Contrectors Llcense Lew (Chepter 9(wmmencing with SecOon 700% ot Dlvislon 3 of ihe
Business end Prafeuions Code) or Ihat he or ahe Is exempt theretrom and Iha basis tor the alleged exemptlon. Any vloletlan ot Sedion 7037.5 by any epplicant for e permit
sub�ects the apP���nt to e cMl penelry of not more t�an five hundretl tlollars ($500).):
❑ I, es ownar oi iha propeny, ar my employees with wages as Iheir sole compensation, WILL DO THE WORK, entl the siructure Is not intended or oHeretl for sale (Sec.
7044, Business and Professions Catla: The Contrectore License Law does not eppry to en owner of property who Ouilds or Impmves thereon, entl who tloes suc� work
himself or herself or through his or her own employees, provided thai such improvements are not intended or oHered for sale. If, however, the building or improvement is
sold within one year oi completioq the owner-builtler will have the burden oi provinq t�at he or she tlitl not build or improve for puryose of sale.).
❑ I, as owner of the properry, am E%CLUSIVELY CONTRACTING WfTH LICENSED CONTRACTORS to construd the projec[ (Sec. 7044, Business entl Prolesslons
Code: The contractors License Lew does nol appty to en owner of property who builEs or impmves thereon, and wha cantrects tor such pro)ect with e cantractoqs)
license pursuant to the Gontrectors License Lews.).
❑ I em eaempt under sec. Business and Professions Cotle lor this reeson:
Signature: Date:
Owner ID venfietl by tlrivefs license. ❑ Ves ❑ Na Drivers Licensa No. Fxpires:
Veriticetion of Ownershlp by (rype oi document, I.e. - properry t� bill or tleeO):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTFICATION:
❑ 1 �ereby ceNfy that no e:cevetbn five (5) or more feet in tlepth Into whic� e person is reQWretl to descen4 wlll be mede in connection with work euthodzetl by this
pertniL entl ihet no Ouiltling struqure, scattolding, lelsework, or demolition or Eismantling thereol, wlll be more than thirry-six (36) teef high. (Chep. 3.2, Gry 2, Art 2, Sec.
341, Title 8, Celitomia AtlmInlSlrBilve Cotle).
❑ As owner-builder, 1 will not employ anyone to tlo work which would requlre e pertnit Irom t�e Divlslon of Intlusinal Safety, as noted above, unless such person has a
permit to tlo such work tram tha dlNslon.
Signature:
Divlsion of Intlustrial Safery Pertnit Number:
oa�e:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATON:
1 WIII the appliwnt or preseN or fuWre building occupent need b file antl certiry a Business Plen for emergenty responsa to releasa or Nreatened relaase ol e �azartlous
material7 ❑ Yes ❑ No
(Section 25505 of Ihe Calilomla Heelth entl Safety Code requires, with some ezceptions, that a Business Plan be filed with Ihe Costa Mesa Fire Department Dy every
business whicli �as ai eny one time dunnp e reported year a quantiry oF hazartlous materiels eQuel lo or greater then e welght oF 500 pounds, or e wlume ol 55 gellons,
or 200 cu�ic teet of cwnpressed ges at stentlartl temperaWre end pressure).
2 Does or will Ne ap0liwnt or present or future building accupenl need to tile a registration fortn lar ecutely hezertlous materials9 ❑ Yes ❑ No
(Section 25533 of Ne Califomia Heallh end Sefety Code, wlth some excepilons, reQuires registretlon wlih Ihe Cwte Mese Fire Department by each business which et flny
one tlme has on hand a quentlry ot acuteN �ezer0ous matetlals equal to or greeter then e welght ol 500 pounAs, or a volume of 55 gallons, or 200 w�ic leet ot
compressetl ga5 flt standartl tempereture entl pressure).
3 Does or will the appliwnt or presem or tuWre bullding occupant nee0 to Orepare en RMPP (Risk MenaBement and Preventlon Progrem for ecutely hazerdaus metedels)7
(Secllon 25534 ot the Califomle Health entl Sefety Code pmWdes thet the Coste Mesa Fire DeOeriment may requlre the Oreparetlon, cenlfication end liling with the Fire
Depertment ot en RMPP by businesses which are requlreA to register acutey hazar0ous meterlals wl�h the Fire Depanment.
a II en RMPP is presently requlred, hes Section 25534 ot the Celifomia Heelth entl Safery Code 6een lully complled withl ❑ Yes ❑ No
5 Does or will Ihe epplicanl or present or futum buliding occupent require tor ihe work which is iha subJect of ihl5 ,e,ppllcatlon e germi� for Such cons�ruction or motli�ication
fmm ihe Soulh Coast Air Oualiiy Menagement DlsidCt ar irom any ot�er air pollutlon control distdCt or egenCy7 �J V89 �J No
(Section 658502 oi �he Califomia Govemment Cotle requires that the repuested Infortnatlon be tumishetl on applicatlons tor noo-resitlentlal building permits).
e WIII eny pae oi the facillry to be wnslmcteC untler this permlt be wiNin 7000 feei from the outer bountlades of e schod4 ❑ Ves ❑ No
(II �jes , the faciliry must meet the requirement of Sectlons 25534 antl 42303 oi Ihe Califomla Heelth anA Safery Code).
7 tl a pertnit from the South Coast Air Quellry Management Distnct ar other air pdWtlon control tlistnct or egency is requiretl for Ihe work which is the sub�ect ot this
flpplication, have all of the disclasures D�escrlbad by Califomia HeaIN antl Safery Code Sectlon a2303 been made7 ❑ Yes ❑ No
B (II yes', anach cenificate oi wmplian m ihe epPropdate eIr polulion control otticer).
CER7IFICATE OF COMPLIANCE� certi t�at untler penalry of pe�ury tha intofmation gNen ebove is cortecL I egree to compy with all state laws end ciry ortlinences
regertling Hasardous Materials e Emis ns.
Signature: . „ Date:
correct. I q(jree y6 compty
COOE I. INSPECTIONttPE
1876 Fized System Final Fre Prevention
1266
200
201
202
203
204
Yue-s8
Pool Spa Final
Final RaRoot
Finel BIocWReteining Wall
Finel FeMory Fire Place
Finel Sign
Finel Demdltion
7RIZATON OF ENTRV: I certity under penalry ol perjury thet I heve read Ihis application and state that t�e informatlon givan is
end ciry ardinences relatlng to builtling conswction, end euthonze representetives ot the Ciry of Costa Mese to emer upon Iha
�sos. I agree not to occupy or allow occupancy oi any builtlinp au�horizetl by thls pertnit until Ilnal inspecilan.
�ff.
�
�$ �a INSPECTIONTYFE
206 Final Mechenical
20B Finel Plumbing
210 Finel Electricfll
212 Final Fire Prevention
220 Final Plenning Approval
222 Flnal Site
250 Flnal eulltling/Occupency
��LI��I:IhIF.7Fj
t CITY OF COSTA MESA �_,
° BUILD/NG DIYISION �
> �
� DEVELOPMENT SERVICES DEPARTMENT
J `
�� PERMIT PERMIT NUMBER
F98-00161
(714j 754-5273 • Fa�c (774) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
.IobAddress: 555 ANTON BL
Suite: 12
vcinity:
Parcel Nunmber: 41050110
FIRE SUPRESSION PERMIT
Zoning:
Status: ISSUED
ApPlied: WI14/1998
Issued: OB/03I7998
Applicant: UNK ,— - „ ,r - - - - '
Address: ' �'"��� �- ' � � -
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TROFIT oM s^ SCti.�io ro s^ scOPo OFPERMIT ' '. �` /' `
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NOT OCCUPIED AT THIS TIME. / � � � ''� ',
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� �Plan'Check � $154.21
� - Permit. . $237.25
�i �, ', , Other,.,�,. $0.00
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� � ,Total: ���'��,$391.46
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�, = FEE SUMMARY � , � ' �
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S ;��G° �. �. , ( ;� ' � Calc Valuation: - So.00 �
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EXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 1 BO days, or if woAc is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authodzed under this permit to be considered legal, such work must wmply with all applicable codes, and all i
requlred inepeetlone and flnel approvel must be obtsined. Failure to obtain inspections end final epproval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPEN$ATION DECLARATION:
I hereby effim� under penelry of per�ury ane ot the fdlowing dedaretlons:
❑ I liave end wpl melntain a ceNficate ot consem ro self-Insure tor workers' compenseUon, as provitled br by aectlon 3700 of t�e Lebor Code, tor the pertormence ol the
wo ich Nie petmil ls Issuetl.
heve arM wN rriainfflU� worlcers' canpensatim Insurence. as requlretl by seetbn 3700 oi Ne Lehor Code, lor Ihe peAWmence ot the work for whk� Nis pertnil Is IssueG.
My workers' nsailon I ur nce cartier e pollcy -n/um6er ere: /`�` �/X ^�
Cerrler, ���� � ��/�[ �l�W Poliry Number. w� C r'/� � l /
(fhlssecflonneednot �amp/eteC!/Ihepe�m�Prsve/uedetonehundreddollers(5100/oilessJ
❑ I certlty that in the peAo ence oi the rk lor � Ich this pertntl Is Issued, I s�ell not employ eny persan in eny manner so as to became sub�ect to the workera'
compensetion lews o all mie, e gre Ihel l s�oulA Eecome sub�ect lo Ihe workera' compensetlan proNslons ol Section 3700 of the labor Cotle, I shell fonhwith
�, wm wi� lhese pr I s. _. � �_�jQ
ce eWre: _ � Dete: � C, .
WARNI LURE TO SECURE WOPKERS' COMPENSATIIXJ �OVEMGE IS UNLAWFUL AND SFULL SU81ECf PN EMPLOYEfl TO CRIMINAL PENALTIES AND CMl FlNES UP TO ONE HUNDRED
D DOLLARE (E10p,pppJ, IN AOORION TO THE COST OF COMPENSATON, OAAN�ES AS PROVIDED FOR IN SECrION 3lOB OF THE LRBOR CODE, INiERE5T, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aHirtn that i em licensed un�tl f,Gj� on/sP f,C.�apter 9(cammendng wiih Sectlon 7000) of DMsion 3 of ihe Business entl Pratessions d my Iicense Is in tull
f9ocsertCN(ect. Lic. a _ A �55 �/ �l 'Ll � / Class N _ —
Contrect�s S�nature: . / Daie:
CONSTRUC710N LENDING AGENCV:
❑ I hereby afflrm thet thera is e constmction lentlinp egency lor t�e pedortnance ol the work Por w�ich Ihis pertnit Is issueG. (Sec. 3097, Civil Code).
Lenders Neme:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lantlers Adtlross:
Date:
I hereby eltirm thet under penelry ot perJury thet I em E%EMPT FROM THE CON7RACTORS UCENSE LAW for ihe Idlowing reeson {Sec. 7037.5, Business entl Pmtessions
Code: My dry or county whlch requires e pertnit to conslruct, elter, Improve, demdis�, or repair eny structure, O�or to Its Lasuance, also requlres the applicant for suc� permlt
to !le a sipneC stetement t�at �e or she Is Ilcensed pursuent ro Ihe provisions of the Contreaors License Lew (Chepter 8(commenclnp wit� Sectbn 7000) of DlNslon 3 af the
Buslness and Professiqns Codej or Ihet �e ar she Is exempt �herefrom and Ihe Oasis lor the ellegetl ezemptlon. My NoleUon ol SeMim 7037.5 by any epplicant 1or e pertnit
subjecLa the eppllcant to e dvil penalry o1 not more Ihan Me hundred dWlars (.5500�.):
❑ I, es owner oF Iha property, or my employees with weges as their sde compensetlon. WILL DO 7HE WORK, end ihe struMure is not intended or oflereG ior sale (Sec.
7044, Business and Professions Code: The Goniractors IJcense Lew does not eppty lo en owner of propeM who builds or imprwes theraon, and who does such work
himself or �erself or Ihrough �Is or her own employees, provided lhet such ImD�'emenLa ere not intended or otterad for sele. If, hov.•ever, [he building or Improvement is
solC wii�in one y0ar o1 completlon, Ihe owner-Dulitler will have Ihe bur0en oi praving Ihet he or she tlitl not hulld or Improve for purpa5e of sale.).
❑ I, as owner W the properry, em EXCLUSIVELY CONTBACTNG WfTH LICENSED CONTRACTORS to conswcl tha project (Sec. 7044, Business end Pmtessions
Code: The cantr4ctors License Law tloes nat epply to en owner of property who builtls or Improves thereon, end who cantrects for wch pro�ect with e contrector(s)
license Dursuant to t�e Convecrors Licensa Lews.).
❑ 1 am exempt under sec. Business end Prolesslons Code for Ihis reason:
Signeture: Date:
Owner ID verlfied by dtivers Ilcense. ❑ Yes ❑ No Drivefs License No. E:pires:
Vedflcatlon W banership Dy (rype ol Eocument, I.e. • pmperty tav �III or deetl�:
DIVISION OF INDUSTqIpL SAFETY PERMR CERTIFICATION:
❑ I hereby certiy that no a:tavetlon 1Ne (5) or mor0 feet in tlepth into wMch e person is repuired to descenQ will ba matle In connectlon wit� work euthodzed by Ihls
permit, end Nat �o bulitlinp Slructure, ecettolding, felsework, or demolition or tllsmenUing Ihareof, wlll be more t�an thirty-sia (38) fee� Ngh. (C�ep. 32, Grp 2, Art 2, Sec.
341, Title 8, Caltlomia AdminlstretNe Cade).
❑ As owner-bulltler, I wlll not employ enyone to tlo work which would require e pertnit Iram Ihe DlNsion ot InCusiriel Setery, es noted eDove, unless such person hes e
pertnit to do such work Iram the tlivislon.
Signeture: Date:
Division of Industnal SBfery Permit Number.
ICERTIFlCATE OF COMPLIANCE IWD AUTHORVJITON OF EMRY: I certity untler penalty of per�ury that I have reatl this epplication entl stete thet the informetlon given is I
conect. I egree ro wmpty with all slete laws end ciry ortlinences reletinp to bullding consiructlon, end euthodze representetives ot Ihe Ciry o1 Costa Mesa to enter upon the �
ebove�UexnDed praparty tor Inspectlon purpqees. 1 egree not to occupy or allow occu0enq al eny bulltling authonzed by thls pertnit untll linal Inspection. �
COOE �. MSGFCIroNTYPt
1616 Flzed System final Fire Prevention
1268 Pool SOa Final
200 Flnal RaRoof
201 Finel Block/Flgtaining Well
202 Final Fectory Flre Place
203
204
2a4&e8
Final Sign
Flnel Demditlon
�g ��
�� �!S ��
CODEI MSPECTONME
206 Flnel Mechenicel
208 Finel Plumbing
210 finel EleMncal
212 Flnel Fire Prevention
220 Final Plenning Approval
222 Flnal Site
250 Flnal BuIldingKlccupenry
� Da� �
� It��
6 f9 �
�._y�
•oonessaem�dra: SSS ANTON BL •
�i,""�'E���'"�^' SAKIOKA FARMS
""a+E� PO BOX 2097
TERMINAL ANNEX
�rv�. �uimo �oo�ss:
uxr:
12TH CITY OF COSTA MESA - HUILDING PERMIT
PERMIT NO: E 075856 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
�N1E°TON�"n'�"' INTERIOR ARCH 2136232164 �"�- 9378
�wap�'s�� 550 S HOPE ��+T 1100
L.A CA 90071
�amu�Tar+ru� CAL PAC ( 310 ) 645-3500
eam.crorrs�uia+a 6076 HRISTOL PKWY
�oo�ss CULVER CITY CA ucw: 392102
90230 urr:
LICENSED COMP�CTONS DECUP�TION: I MrW� Nim uder pxiJy d psrpvy Me 1 sn Irvnre ineer powim� d Cheqs 9
(mmm�rkr�p xiin Sectian )OW) a�� a d Ne &mrwn aM Pmfeaaiau Code. eM mY �� b In IWI bru uM aXetl.
��065824 uc.cuss: uc.No.: 392102 EXP: 09/96
,: /� s—f G ���,�: �.,�E-� - �e�.oa._
NEN BUILUEH UECUfl1TI0N: I hareb/ elfi�m unEer paWy W perj.uy thm I aumq tmm �M Gomradon Liceme lew la Ihe
bxnY reefon (Sapion R11.5 &pirot� eM Prdamiona ('.ods: Airy c1y a cauniY wftiN n9u'um e Dertna lo mmVun. elltt. MGrove.
.mWeh, a ropei eny evucture. pior b en oauenca. eho npure+tAe eppl"ran� la wch pmnil lo fib s sipmd eWemeM �hel M w eM
ie liwnaed W��t io iha pwisiana d ihe Gontrmas liuma law �GMqer 9(commendrp wilh Satlion ]OW) � DMnbn 9 d ihs
Busima arW Prateeebm Codel a ihm he a ehe u ezemq OwMmm eM tM beaa la ths eAepd mamqian. Nry vioWion d Seaian
>03t.5 by enY aVWirani lor e parmX eubjMe Iln epplcam io a cvd pe�alry d nol moro ihen Ma hurdrad ddlan �SSW�).
� I.00vmerMiMpWeMnmY�W�rMwihweppn�hx�dammO�.wAEONer.ak.endNe�wcfuroem�mtenEeE
a oflereC Ia We (Sxtion )pu. Bminn eM Pmtaeaiw Code: The Camaeps Limnea Law Eox nd applyloan owrier d popMy
who Eui]a n inP�'�� �henm. end Wc doea s A xak h'vnaetl a hesM a Wdqh hu a Mr orm amMsM�. 0�'� �hei ach
imqwemema era nd imenEed ar dlme! la eela. tl, hvxw«, IM buiWinp a inpio.ammm is wld hi1Nn aro ymr d compMun, i�e
ow�w-0uBdar xill hew �M dudon d pwiry M a tlr did,w buld a'unpo.e la Ur pupose N Ws�.
� I. ea o�.ner d IM G�W�Y. am wduen+�Y mnime�q �mh luved contraclae ro mmtrutl Ne p9b (9edion 10u. &ains� and
a�a«:�. caee: n» caanem u w,,. i... ro.. �a mdr m.� �« a aw.�v .ro aaa. o.:�ro�w.. m«.� .�a wno
mnvern In wM prqeaa v.iN e mvrapor(s) fcemed punuu4 to �M CaM�euas lioerua Ler�.
� I em aasmp uedx Seaian: B. 8 P.C.. br Ne nsaon:
Dms: Oe+wr.
i m n..ev c.nar ma i.m ...�. d.oa �.�a..wd me �.m a c,uo�:. �..en .1,e sew coes s.a�. um. usz+..m
255�. anJ Ntl I a any Mun dikuq omip W wT / wil na (acb om) nseE b camNV wih uid ptle mM� eM IM nCui�wnM br
Deie: Appfram:
WONKEN'9 COMPENS�TION DECL�RATION: I IwWy el(um �Mr prWy d pwpry w d Ms bOOWnp Esdutlum:
❑ � n... w i,u mdMaii. a.imictl. a m�.em m..uJmw. ro�.ak.n• mmpe�ue�m... wwia.a �a M s.aion aloo d �n.l.n«
COM, la �M prlm�unu d Ns xak la Mvch Nu pemd u mued.
I� in..�.w.um.w.�wo�x..•oomc.���..,�.aw.eMs.a�,�roodu,.i.e«coe..wm.o�m.�.d�n.
wak la whiN pio D�'s owE. M' wcAen' wmW�ian'vnurenu miw ad G�Y wmEx v�:
� c.�w: FIREM NS FUND EXPIRES
aa�r re,mw: xwa 'i'�- 0 2/ O 1/ 9 6
(This pcfion mW � M cwndM�d / Jw O�i u br o» hwMrW CdWi ISIOOf a 4qJ
� I ,Y �� In �he pMormenre tl �M wark la r.fiFli Ihe permtl b WueA, I tlutl iw rnpby ury panon In eny menn�r n u to
wEjae �o tM Maken' wmp��unbn 4�n M GaGlanu. anE epn� tlpWy, il 1I�AIowpk bcm� wbptl lo IM xwFen'
//-' co �II_n o� _�� � 9)aOdiM ��.I Nelllm'-�OC�IW �/^'I ��.aG.L
D e
.mi�a: v.uw. m.«�� .o�x.n• rn�nw.no� �.�.w �, �rwnn..�e.n.n.�elK�.� «ro�or« ro onm,�.i a.�.ro...�a
vu nn.. w ro om n�ndne trwuune eann lt�alaooA N WGltlon ro m. co.r o� mmyr,utan am.p. u pavw.e ror �n
tlon J]06 0l M� Wor Cob. Infw4 �� ��m�Y's ha.
CON4TIiUGTtON LENDINO AQENCI: I Mntr� e1Nm ivMr penetly d pr'Fry tAa tMn w� mru�eudbn Nid'uq yaty la Uw
peAormeme d �ha MwM br whitli Ihe parml u ewed (Seaion �p81. Civ. CI.
LENDEP'S NIW E
LENUER'9 AOOXE9S:
I eaniN tM I hew rteE Nu epplcaYm uk ptl� tlw tM eEas iNoemNbn o �motl. I epn� to mnpy wk� eA rtiy enE aouMy adi�wwe�
uk �ma 4w� nW^i ro dAdM mivuwion uk MraDY uNvca npeaametA++d UuetYb anr upm iM abwsmrqiawE DAWb
tw impmion qvpm�.
DAVID DE SISTO
Das: /'� �N
(St51d6.WP) WINFBuJdip85e1W:�rasmFlie:Guum4PPk'�:Hnk-Re�enie:(3dEsimE-Mwua
PERM NO: E 07585G
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE; CALC-VALUE: GROUP OCC: B /
COMMENTS: 76 UNIONPRODUCTS " VOICE, DATA 6 FIBER OPTIC CABLING"
**�*�*��**� � ** *x ���***rt***+�*��+�**+tx **+�**+�+�***x *���+t*+�*+�+r***+t**x *****+�+��*���*+�*�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 41050104 ZNE: REF NO:
PLANNING NOTES>
, ,r
iE fE 1E if �E IE iE dE 9f !f iE aE 3E it 1t iE fE iF iE iE iE 1E if iE ff iE 1k if 1Flf if iE iE iE IF if iE iF iE iF 1E jF iE iE if 1f IE 1f ib 1E if 1f �lf� 1f iF iE iF iElF 1f iE iF iF iE iE ik iE iF iE �f 1f if jf iE iE iE iE if iF
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY '
BUILDING APPROVED BY :
APPLICATION ISSUED BY: � r ��
iElEifiElEiE18iE�fiElEiElEiFiFiElf1E1E1fiE1EiF�iF£iF�F�F3f3f���3F� �3F�����F
LEGALIZATION;N F E E S U M M A R Y
BLDG PMT PLUMHING ELECTRIC MECHANIC
PERMIT 39502
PLAN
ISSUE FEE 15.00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 39.75 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
54.75
DATE:
DATE;
S
ENT:N
FIRE SMZP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
54.75 54.75 .00
54.75 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
if iE iE 1E iE if 1E �ElE jE 1E iE 1E 1f �E if iE M 1E 1F iE iE 1F iE iE 1E 1f ik 1f 1E if if iE it iE If 16 iF iE if 1E if 1f 1f 1E 1E 1E 16 iE 7f ib 1F ik if 1f ik iF iE 1f iE 1E 1f iFlF iF ik if 1F 1E iF 1E iE iE IE 9k iE iE iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20
ELE 55 RECEPT/OUTLET ADDITIONAL
END OF FEES
EA. .75 15.00
EA, .45 24.75
E
PI C'' _ ^l: ��,• -� �r .
C,i?_. �L... - .`�.__ J.. _.
� CONSTRUCTION AND PLANNWG P� & SPA I__
��APPROVALS Permit # Date Inspector qppROVALS Permit # Date I.nspector
}'. Temporary Electrical Service or Pole 52. Pooi & Equipment Location� - •.
�. .
2. Soil Pipe-Und�grnd. �, 53. Steel Reinforcement • '
3. Electrical Conduit Utility-Undrgrnd. 54. Forms r
4.� Electrical Conduit-Undrgrnd. � 55. Electrica� Bonding , �
`�. Steel Reinforcement 56. Rough Plumbing & Pressure Test --
'6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
.
7. Footinqs , 58. Electrical Conduit-Undrgmd. ��
8. Foundation 59. Gas Pipe, � Undrgrnd., Test ,
9. Water Pipe�Undrgrnd. 60. 8ackwash Lines, P;Trap, O� bndrgrnd.
id. �5tructural Floor System 67. APPROVAL TO DECK �_
1.-Property Sewer Line � House Connection 62. Backwash & Recepror-Final
12. Sewer Cap -,- 63. Healer & Vent-Finai .�
13. F±oof Oreins .. 64. Plumbing SYstem � Fina1 �
14. Rough Plumbing ' 65. Electrical-Fina� �
15. Rough Electrical-Conduit ^ 66. Solar $Ystem�Final . �•
�s
i6. Rough E�earic Wiring 67. Fencin� & Access Approval
17. Rough Wiring Sign 66. APPROVED FOR PLASTER�NG ��
18. Rough Electrical•T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning . _ FIRE DEPT. REQUIREMENT .
20. Rouqh Factory Fireplace " ' � APPROVALS . Permit #
27. Ducts, in StruCture � - ' 70. Underground Hydro
22. Ducts, Ventil8ting " � . 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rou9h & Test - 72. Underground Fiush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing ' � � 74. Overhead HVdro:
26. T�Bar Cei�ing (Scructural) & Monocoat ' 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe �
28. Lathjng & Siding 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing _ �H,EALTH DEPT. REQUIREMENT
31. Plaster Brown Coat. 79. FINAL INSPECTION
32. Electrical Power Meter•Final ' 80. FOOD CERTIF�CATE I$SUED
33. Final Electric _ 8 Notes: -
34. Final Heating & Air Conditioning = '. ,� � , �
35. Final Gas Pipz-Test . � . -
36. Hood or CanOPv ' �_� - _ _ . - . . .
�37. Final Factory Pireplace � _ � , � ,. �
- 38. Final Plumbing - �
- 39. Water�Service�Final .. �
40. Gas Service•Final � . � .'
41. Solar pomesu�-Final � , . �
42. Backflow Preventer � - .
. 43. Backflow Irrigation � � �
44. Landscape Irrigation System . � . •
45. Sound Attenuation ., , � • - � � , . •
46. Handicap Regulations . •
47. FINAL STRUCTURE & BUILDING � -' � -
48. FINALPLANNING 'i `
49. Elett�ic Release to Edison �
50. Gas Release to Soutfiern Calitornia Gas Co ,.
51. CERTIFICA7E OF OCCUPANCY '
No Date
, � .>GO��cant to /ill In all s0aees exeept t�osa within �eavy Eortler ilnas anE sign all apnrapriate tlaclantions. 8q /3 �
CIT`rOF CQSTA MESA CONSTRUCTION PERMIT PERMIT NO. ', TRACT NO. LUT NO. UNIT 0. A P,�
Pro'ect Address' ��� �-iNr(rv ST � Zi7L7 3 � � � '_ � _ � 2one � .ti
1 , / "�� �/ D � � O S Main Building: Accessory Building:
' AppliC2nl'S Mailing Address p�� Yn l�n UN� dFn 5�rr TVPE OF CONSTRUCTION NEW ADD AITERATION REPAIR E Z
' Owner'S Name — 5�(� �'9'� �NTti✓� pryo�e ��4 -�Nia •� CONVERSION ❑ DEMOLISH ❑ OTHER B FrOn[ N
DESCRIPTION OF WORK/USE OF BLDG. Rear
Addreu SS r %�✓T�O^� - A �
Arch/En . �TF-/+-�/V C Right � N
g I �/ Lic¢n52 No. TVPE F PERMIT GRADING FOUNDATION STRVCTVRAL
Address 7 D U AJ fhS f �TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g Le(t R
Contractor's Nam hone ��oTHER P1ng. Ref. # r q.IProvided � E
Addresslmailingl��S.�. CeCa:. LA, Qo��'i�� PRaECTDESCFIPTION 5� F7 r•,Oz OCGUPA V 8 �� M
� _ 7 �p r� Plannin Notes:
CrtyL�cenuNo. d$aZ/4�L CONSTRUCTIQNTyPF_ VALUATION,V
ZONE GRA '�5. ACRES � $,
LICEfJSED CONTRACTOR DECLARATION -
I hereby aHi�m Ihat I am licensetl untler prov151on5 of Chdrt¢r 9(COTmGnCing Remarks: ''z�
with section 7000) ot Divislon 3 ot tha Business and Pro(e551ons Cotle, antl � -
my Iicense is in t f ce antl effect. O� e �,pQ, �— ELECTRICAL FEES
License Class — _ � � v
oate �.� 12��" Si9nature �� PLUMBING FEES Automatic Washer Transformer � 75�50 KW
4KER5' COMVENSATION DECLA RATION ConSlruttiOn POIe SUb. ❑$O + KW
reby af(irm thal I have a cer(ifiwte of consent to selttinsure or a certifiwte Bar Sink ShOw2r5
or Workers' Compensation Insurance, or a certifiee copY thereof (Section Backflow Preventer Servite Sink Cooking Unit Meter ❑up to 100 amps
3800, Lab. C.)
Poiicy No.wPSosaSs9t' Comoany Backflowlrrigation �we��P Dishwasher Meter ❑over100amps
BCertitietl copy is hereby furnishetl. Dry2�5 �Gas ❑Electric $ub Panel .
Ger 'fietl co y is 'ie�wrth the cit Div ' n. Bathtubs Sewer Conn¢Ction
� oa�e�. =2p+-_- ��_ APPlitant� I,d'� '� � d'� - Fan Motors O67 HP �1.X - 8
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clafifi2f5 $plar Coll¢ttors
(ThissettiOn need not bG COmpletetl If ihe pe�mit Is fot OnG hunCrBd (5300) ot DiihN25h2f F�A��� Inc. Soiar 0�-15 HP �1G75+
less). Salar Piping
I certity Ihat in th! performance O7 th¢ wo�k tor whith this perm�t IS i55uetl I FiXtU�¢5 , MICroWdv¢
zha11 not employ any person in any manner so as to become suDject to t�e Drinking FOuntains SOlar Tank , i
Workers' Compensation Laws of Cali(ornia. �
Date Si9nature Floor DreinS Swimming Pool w/Spa � Device Boxes Pole Lighi .
NOTICE: It, atter making�this tleclaration, you shoultl become subject to the Ou[I2t5 '
Workers' Compensation provisions of the Labor Cotle, yau must forthwilh Floo� Sinks Urinet Range
compry with such p�ovi5ion5. or IhiS plrTlt Shall be tl!¢mGtl revoketl. SwItCh25
CONSTRUCTION LENDING AGENCV, G85ServiC.e Ou[I2I5 WetCtCloS¢t � 5�9�
� I nereby aHlrm tbat tnere is a mnilructlon Ientlin9 a9ency for Ihe per/ormance
oi the work tor wnicn tnis permit Is Issuee ($ectlon 3097 Civ. C.) Interceptors Water�Heater Garbege Di5pa581 Stending $ections
Lentler'S Name
Lentler's adtlress Kitthen Sink Water Service Generetor �0.5 KW �5-15 KW Trash Compactor
OWNER BVILDER DECLARATION - .
I he�eby-afti�m lhat 1 am exempl irOm [tte ConlydtlOr's Licenie Law fOr lhe �evet011¢5 AUtO�WBSh �
/ollowing reason (Section 7031.5 Busineis antl Professional Cotle: Any city or .
counry whiCh requires a permit t0 cOnStrutt, alt¢q Imp�ove, tllmOlish o� �apdir P—Tlep LBuOdry T�8y5
any structure, prior to its issuance, also requlres tha applicant for such permit
tile a zi9notl statement that he/5�e Is licensetl Dursuant to the provi5ion5 0/ Roof Drains
Contractor's L4c¢nse Law (Chapter 9(commen<in9 witb Section 7000) of
,ision 3 ot the Business antl Professions Cotla) or that ne/s�e IS Bxempt ReinspeCtion Fee $15 Ittue Fee $ 3
.��erefrom antl the ba51s /or Ihe allegetl exemptlon. Any vlolation of Section
7031.5 by any applicant tor a permit subjects the applicant lo a<Ivll
�enairy of not more tnan �ive huntlretl tlouars (E500). DEVELOPMENT SEHVICES REOUIREMENTS: � 1 R
�J I, as owner ot the prOp¢rty or my ¢mployee5 with wage5 a5 thBir sole ReinSpectiOn FaB $15 IauO FBB $ 3 /� —/� _v
CompenSdtiOn, will Co the wotk, anU the it�u<lu�e ii nOt inlentletl O/ ofte�etl Zo^in8 APProved By�}� Dete
lor sale (Section �044, Business antl Professional Catle: The Contractor's MECHANICAL FEES Building AOProved BY —f:l'L
Date
License Law tloes not aO��Y to an owner of a property who builtls or improves Lrdtion Issued B �
theleon, antl who tloe5 Such work himselt/hers8lt af tllrough h15 Or hel own BOiI¢f HOOd Of T 0 I ❑ APP Y— D8t
employees, provitl¢tl that such i�nprovements are no[ Intentl¢G Ot offeratl fOr VP
salo. If, nowever, tne builtlin9 or improvement is soltl within one year of com- (;anopy Type II ❑ ' SU M RV OF FEES ...sss���
pletlon, the owne� will have the bur0an ot provin9 he/sha dltl not bui1G o� Im• DUCt - UndC� GlOufld $�
proverortne.purposeofsaie). BUILDINGPERMIT $ � SMIP
❑ I, as owner ot the property, am exclusively contracting with Ilcensetl ton- Duct- Structural Refrigeration System PLAN CHECK $ PEflM1T
Iractors to construct the project ($ectiOn 7044, Buslne55 dntl PrOfesslon5 COtla:
The ConvactOr's License law does nol appty to an owner ot oroperty who Duc[ - Ventileting ❑0.100,000 BTU ❑100,000 BTU ISSUANCE $
builtls ar Improves thereon. antl who contracts for such oroiacts wlth a r.on- PWMBING $
tractm�sl Lcer.se pursuane to me Contracror's License Law). i am aware thac Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGV P.C. $
proo/ ol their Worker's Compensation Insurance shoula bn provitle0 to me. ELECTRICAL $ GRADING $
❑ I am exempt untler Section B. & P. C. (or tnis reason Firepl/Fact.6lt. ICBO �`- Fire Dampers ' MICROFILM $
PLAfV CHECK 50% $ _l'1 9
Date Owner HeOting System & Ducting Regirters MECHANICAL $
I nereby certify that I nave reatl tniz applicatlon antl ztate that the above ❑P100,000 BTU �100,OOOBT TOTAL FEE $
Information is correcL I a9ree to comply with all city antl county ortlinances PLAN CHECK 25% $
dntl state laws relating to iltlin Construction, antl hereby autho�Iie repr¢-
sentative5 f[hiz 'ty pOn th< dbovG-mentioned propGrry for .
i59 attuo�nPu . �1e� � .
,� ." ' flainspec[ian Fee St5 �ss�e Fee S 3 DATE�00;/`�/8�D2TI�5 4Cy� 2��9.SC
Drivers' License or 55 # � C•
0865-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting; GOICenroG - Assessor
. . . �j '\rl\�t.\ 1 ' U :" �i . '
.. � CONSTRUCTION AND PLANNING P' & SVA
�" APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
� ;i
i 1•.� T�mporary Electrical Service or Pole ,_, '� 52. Pool & Equipment Location �
2,', Soil Pipe-Undr§rnd. .r F .� '� 53. Steel Reinforcement ' �'F
3. Electrical�Conduit Utitity-Undrgind. � � 54. Forms r•.�j
4`. IElec[r,ical ConduibUnil�grnd. '� � 55. Electrical Bonding .r '�
� .r . �v �
�5: �S[ee�'Reiriforcement, � �� 56. Rough Plumbing & Pressure Test �r ;%'
6. Electrical UFER Grnd. �,;; � 57. APPROVAL TO COVER�GUNITE N?
7:"Footings _ I� � � 56. Electrical ConduirUndrgmd. � n�
.
8!� Foundation � , 4 -% �� 59. Gas Pipe, O Undrgmd., Test ;.,,
.,9. Water Pipe-Undrgind. .�� �' 60. Backwash Lines, P-Trap, O Undrgrnd. r
10. Stiuctural Floor System ` j ,.M 61. APPROVAL TO DECK
11:�P,roperty Sewer Line'.& House Connection .° 62. Backwash & ReceptorFinal
� e. �
12,�Sewer' Cap � �:,� � � ,� 63. Heater & Vent-Final� . �
73.�Roof�Drains ,. �-�, • 64. Plumbing System - Final '
r'1 ' ii
14. RougR Plumbing i '�� 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
�1.6• Rough Elect;ic Wiring 67. Fencing & Access Approval
�17: Rough Wiring Sign 68. APPROVED FOR PLASTERING
1.8:. Rough Electri�l-T Bar Ceil�g 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning �FIRE DEPT. REQUIREMENT
� 20: Rough Factory Fireplace �`- APPROVALS Permit #
27. Ducts, in Structure � �
��, �'� 70. Underground Hydro
22. Ducts, Ventileting � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Tes�t `'' ` 72. Underground Flush
24, Roof Framing -,i, _�; �.� :1 0 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing �, `! �.�- "+ 74. Overhead Hydro
26.. T-Bar Ceiling (Structu a4 �& A4e.9ecoat � 27 75. Dry Chemical
27. Frame and Flmshing � • � 76. Dry Standpipe �
28. Lathing & Siding , �'� 77. FIXED SYSTEM FINAL
29. Insulation �� � 7$. FIRE PREV. FINAL
30. Drywall Nailing +' ' 'f Z7 HEALTH DEPT. REQUIREMENT
31�. Plaster Brown Coat , � 79. FINAL INSPECTION
,
32. Electrical Power MeterFin51� 80. FOOD CERTIFICATE ISSUED
33. Final Electric %' Notes: r / �
.,.,
34. Final Heating & Air Conditioning /%ly� � ��L Z �
35. Final Gas Pipe-Test �
36. Hood or Canqpy f � ' �+ �, � .
:37. Final Factory Fireplace
�38. Final Plumbing •
�'39. Water Service-Final
��
'40. Gas Service-Final �
i
41. Solar pom�sticFinal ' -
42. Backflow P,reventer -
_ ' �
43. Backflow'Irrigation - � -'
44. Landscape Irr'�qation System ;�
45. Sound Attenuation '
46. Handicap Regulations ., �
47. FINAL STRUCTURE & BUILDING � �
48. Special Requirements Completed
49. Electric Release to Edison . • ,.
�50. Gas Release io Southern Calitornia Gas Co ' ' __,
51. CERTIFICA7E OF OCCUPANCY � "'
No. Date� f � ' •
1
�
I
�
Appllcant to fill In all soaces exceo� ihose within heavy oortler Ilnes antl sign all apvropriate aeclarations.
c�7Y oF�cOSTA MESa CO�N.tST�/R- UCTION PERMIT
. Projec; Address �JSS /t�%7DN � lZ�� _
Applicant's Mailing Address r�
Owner's Name ��+�� TM.«(�-- Phone
Address ss� Al�p
Arch/Eng. License No.
Address � q
Contractor'sName��e—'�"C_ 3�P�4 PhoneG✓3�` � ��
nddresslmai�ingl-15,$/'O Z'1Ll�y�LS
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensetl untle� ptovi5lon5 ot Cha�te� 9(commenting
with section 7000) of OlviSion 3 of thG Business antl ProTe55ion5 Cotle, antl
my license is in full torce antl effect. Z�`��
Licensg�Ciass G 3 �icenze No
^ate!/ � 5'9 t J
iRKERS'COM ENSATION OECLARATION
.�ereby aifirm that I have a certificate oi wnsent lo selPinsure or a certificate
oi Workers' Compensation Insurance, or a certifietl copy thereof (Sectlon
3800, ,,' -✓ ,.� � %
Policy •I �7 Company-6���^"
� Certifietl copy is hereby fumishetl. - _ y
�Certitietl tqpy 5 etl with [he city Builtlin 'sion. .
Da[e Z �LG� � Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl it the permit is for one huntlretl (E300) or
less).
I certify thal in the performance of tne work for which this perm�t is issuetl,.l
shall not employ any pe�son in any manne� so as to become subject to the
Workers' Compensation Laws of Calitornia. -)
Da[e Signature
NOTICE: If,after making this tleclaration, you shoultl become subject to tna
Workers' Compensation provisions ot the Labor Cotle, you must forthwitn
comply with such provisions or this permit shall be tleemetl revoketl.
CONSTRUCTION LENOING AGENCV
I hereby afflrT that thG/¢ is a Copstrut[ion lentling agency tor the Oe�to�mance
of the work for wn�cn this permit is issuetl (Section 309� Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION
I hereby afTirm Lhat I am exempt from the Contractor's License Law for the
following reason (Sectlon ]031.5 Bu5ine55 antl Profe55iOnal Cotle: Any City or
county whicn requires a permit to constru<t, alter, improve, aemolish or repair.
any structure, prbr to its issuance, al5o r¢quires the applicant (or Such permit
� file a signetl statement thdt he/She I5 Ilcense0 pursuant to th¢ provisions of
e Con[ractor's.License Law (Chapter 9(commencing with Section 7000) ot
�ivision 3 of the Bu5ine55 antl Professions Cotle) o� that he/she is exempt
therefrom antl ihe basis tor the allegetl exemption. Any violation of Section
]031.5 by any applicant for a permit subjects the applicant [O a civil
�enalty of not more than five huntlretl dollars ($500). '
1, as owner of the property or my employees with wages as their sole
compensation, will tlo the wo�k, antl the st�ucture is not intenGetl or ofteretl
for sale (SeGtion 7044, BuSin¢55 anC Pro(essional Cotle: The COntractor's
License Law tloes not apply to an owner of a property who builtls or improves
[hereon, antl who tloes such work himself/herself or tnrough his or her own .
employees, provitletl that such Improvements are not intendetl or offeretl for
sale. If, however, the builtling or improvement is soltl within one year of com-
pletion, the owner will M1ave the burtlen ot proving he/she tlitl not builtl or im-
prove forthe purpose of sale). '
❑ I, az owner of the property, am exclusively contractin9 wlth licensetl con-
tractors to construct the project (Section �044, Business antl Protessions Cotle:
The Contractor's License Law does nOt appty to an owner o( property who
builtli or imOroves thereon. and wM10 contratts fo� such'oroiects with a r.nn-
tractbr(s) hcense pursuan[ to me ConVactor's Llcense Law). I am aware that
proot ot their Worker's Compensation Insurance shoultl be provitle0 to me.
❑�I am exempt untler Section B. & P. C. tor this reason
Date Owner -
'I nereby certity that�l have reatl tnis application antl state that the above
information is correct. I agree to comply wrth all tlty antl munry ortlinantes
antl state laws relatin builtling construction, antl hereby authoriza repre-
s¢nfatives of Ihis y t upon the above-mentiOn¢d O�operty for
InspeCtion pu�pos . Gs
Signature Date Z �ZZ- � /
Drivers' License o 55 qk
�� J / S �GZ ._ _- __. - -. ., . �1 A.P.#
�/
S Main Building:
TVPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOlISH ❑ OTHER ' T Ffont
DESCRIPTION OF WORK/USE OF BLDG. A Rear
TVPEOFPERMIT GRADING❑—y. FOVNDATION STRVCTURAL I C Right
❑ TENANT ❑ ELECTRIGAL LJ PLUMBING ❑ MECHANICAL ' g� Left
❑ �OTHER Ping. Ref. �
PROJECT DESCRIPTION 54. F7. OCCUPANCV Pianning Notes:
CONSTRUCTION TYGE VALUATION $
ZONE GRADINGGU.VDS. ACRES
Remarks:
� . % � �%
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers �
�IShWdShE!
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
�avamries
Roof Drains
Reinspection Fee � $75
Boiler
Duct - Under Giound
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
F,irepVFact. BIL ICBO # �
Heating System & Ducting
❑ O 100,000 BTU � 100,000 BT
peinspection Fee � $15
0865-46, rev. 5/88 White - Builtling: Canary - qpplicant; Pink - Accountin9: Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
$012L COIIQCtOfS
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet '
Water Heater
Water Service
A uto-W ash
Laundry Trays
Issue Fee
Hood or Type I ❑
Canopy, Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System �Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
FEES
$ 3
Zona
Accessory
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 75-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit � Meter ❑up to 100 amps
Dishwasher " �,. Meter ❑over 100 amps
Dryers ❑Gas ❑Electric Sub Panel
Fan � Motors 00.1 HP 01'f, - B
F.A.U. Inc. Soiar �9-15 HP 016-15+
Fixtures� ;� Microwave
Device BOzes �j Pole Li9ht
Outlets Range
Switches Si9n
Garbage Disposal
Generator �0.5 KW 05-15 KW
�
��
Standirig Section5
Trash Compactor
� Reinspection Fee '$15 ' I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approvad By
Building Approved By
APoliratian Iwued Bv __ .
� SUMMARV OP FEES
BUILDING PERMIT $ SMIP
PLAN CHECK $ �%BO pERMIT
PLUMBING $ � ISSUANCE
PLAN CHECK 25% $ ENERGV P.C:
ELECTRICAL � $ GRADING
PLANCHECK 50% $ MICROFILM
MECHANICAL $ TOTALFEE
PLAN CHECK 25% $ _ . .
N
I
N
G
H
E
Q
M
T
S.
FEES
$ 3
�a ano2�sb6-000���bb �ra�-r ±�.eo
QATE: 02122!89 TII1E: 15-?5
J' • CONS7RUCTION AND PLANNIN(�.
�p,APPROVALS Permit# •
ei
G,�i�'iemporary Electrical Service or Poli
r.9
e. Soil,Pipe-Undrgrnd. � _.p
4) E
Elect'rical UFE
8:" Fou"ntlation c- � `�J
9. Water pipe-Undrg ntl.
u
10:�Structurel Floor System
11�� Property Sewer Line & House C�onnectio
12. Sewer CaP �� 'G
t_
73. Roof Drains
�v �
14. Rough Plumbing
15. Rough Electrical-Conduit
,1�6. Rough Electric Wiring
i
17. Rough Wiring Sign
�8. Rough Electrical-T Bar Ceiling
d,9. Rough Heating & Air Conditioning
'10. Rough Factory Fireplace '
i.i :i
21. Ducts, in Strucmre �
22. Ducts, Ventilating �`� �
�
23. Gas Pipe-Rough & Test ,
� i
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structuraq & Monocoat
27. ,Frame and Flashing
28. Wthing & Siding
29. Insulation
30.. Drywall Nailing
31. Plaster Brown Coat
32. Electrical Power Meter-Final i�,'.
33. Final Electric r'
n
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 $ervice-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Lanqscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49` Electric Release to Edison
50. Gas qelease to Southern California Gas C
51. CER7IFICATE OF OCCUPANCY
�o. Date
-\-\
Daie
1�1
�n �I�
�n
rn .�
Gj `
�
• � L & SPA
Inspector qppROVALS Permit#
52. Pool & Equipment Location
53. Steel Reinforcement
. 54. Forms -
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPFOVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, � Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor-Final '
63. Neate'r & Vent-Final
64. Plumbing System - Final
(�,() 65. Electrical-Final
66. So��System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
71. Product Piping OGas ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank 0 Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical � �
76. Dry Standpipe ,
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
� ���180. FOOD�CERTIFICATE ISSUED
) � Nntest G ('
L �D
�i
�j
i
Date I Inspector I
/,
8���(
AVo���ant to tlil In all soaces except tnose witnin neavy bortle� Il�es ane sign a11 apvropriata Eeelarations.
CiTY OF Co�Ta MESA CONSTR UCTION PERMIT � 1 Z.�
Proj2ct !{{ldress � S"SS /��vTo�v .BLf/.o
Applicant's Mailing Address � �4'U f L
Owner's Name 'a'«��� PhoneZS�
Add"ress S'S� �.C/%.0 �C!/� COS%/F iC/EYA
Arch/Eng. License No.
Address -
� zYY-�c7
Contractor's Nam � � � � � Phone �
Address�mailing)�L��'_S�fL/�/L�✓4.GKb .4 �./•��
City Cicense No. _��d-3 � , 9/�/
LICENSED CONTRACTOR DECLARATION '
I+hereby atfirm tM1at I am Ilcensetl un�er provi5ion5 of Charte� 9(commencing
with section ]000) of Division 3 ot the Businezs antl Professions Cotle, antl
my Iicense is in tull force antl effect.
License Class - ice e No �
�ate 2'Zf-'�%� Si9na ure "-� �
�ORKERS'COMPENSATIO ECLARATION
1 here�y affirm that I have a certi/icate oi consent to zelt-i sure r a certiticate
of Workers' Compensation Insurance, or a certitietl cooY tnereof �(Section
'3800, LaG. C.) ' ' �
Policy No Company ��/F-S�v
❑ ter[ifietl coov is herebv tumis ied. �� � �
ThE�section neetl�not be�R mEpletedit the permit�rtor.one hund�ed-(E300) o�
less).
I ce�tlfy [hal in th¢ pe�to�mance OT the work tor which this pe�m�t Is issuetl, 1
snall not employ any person In any manner zo as to bemme subject to the
Workers• Compensatfon.Laws of California.
�ate Signature �
'NOTICE: If, after making tM1is tleclaration, you shoultl become subject to lhe
Workers' Compen5ation provisions of the Labor Cotle, you must forthwlth
comply with such provisions o� this permil shall be tleeme0 tevoketl.
CONSTRUCTION�LENDING AGENCV '
1 hereby atflrm tnat tnere Is a construction lentling a9ency for the performance'
ot the work for which t�ls permit is issuetl (Section 309] Civ. C.)
I,.entler's Name �
enalty
� I. as
as
BUILDEH �ECLARATIOfJ- � -
afilrm that I am exempt irom tha Contractor•s License Law tor the
reason (SecHon 7031.5 Business and Professional Cotle: Any tlty or '
�nich requires a permit to conStruCl, alter, ImO�ove, aemolish or repair
ture; prlor to its issuance, also requires tne apolicanl for su<h permit
pgnetl statemenl that he/she is Iicensetl oursuant to the provisions of
'actor's License Law (GnaDter 9(commencing witn Sectlon ]000) ot
3 of the,Business antl Protessions Cotle) or that he/she is exempt
i antl [he basis tor.[ha allegetl exemption. Any violatlon of Sectlon
ry any applicanl for a p¢rmlt subjects the appli<ant to a<ivll �
f not more than five huntlretl tlollars (E500).
owner of the�property o� my ¢mployeos with wage5 a5 [heir sole �
ition, wi11 tlo the work, antl the structure is not IntentleG or offeretl
(Section 7044. Bu5ine55 anU' Prote55ional Cotle: The ContractOr'S �
2w tloe5 nOl apply to an owner of a propertY '�'ho builtls O� im0/oves �
antl who,tloes such work himself/herselt or through his or har own '
s, provitletl thal Suth improvemen[5 a�e not IntenCetl Or offeretl fo�
iowever, [he CUIltling or improvement i5 SOItl within ona yeat of com-
ha owner wlll have'Iha burtlen of provin9 he/sM1e tlltl not bulltl or iT-
the purpose o(sale).
owne� ot the Oroperty, am exclusively cont�acting with licensed con-
o constru<t [he project (Sec[ion 7044, Bu5ine55 antl Protessloni Cotle: �
traclo�'s Licenze Law does nOt apply to an owner of properly who
bullds or improves tnereon, ana wM10 conVacts tor zuch pro�ects-wrtn a con-
traclor(51 ➢cense pursuan[ to [he Cont�acto�'z LiGenze Law). I am aware Ihat
proof o( their Wo�ker's Compensation insurance shoultl be provitletl [o me.
❑ I am ¢xempt untle� Seclion B. & P. C. fOr thi5 reason
Date Owner -
I hereby certity tbat 1 have reatl tnis appliwtion antl state thaf the above
intormalion is mrrect. I agree to comply with all city antl county ortlinances
antl state laws relating to builtling construction, antl here�y au[horize repre-
s¢nta[iv¢s of ty�to enter u on the above-mentionetl property for
Ins9pection pose . . �
51 natur�_ �'�" Date
TVPE OF CONSTRUCTION LJ NEW LJ ADD J�J ALTERATION LJ REPAI0.
❑ CONVERSION ❑ DEMOLISH ❑ OTHER� � �
�DESCRIPTION OF WJdRK/USE OF 81DG. Ti�'U.F,U ��Y� -
TYPE'OF PERMIT LJ GRADING.LJ FOUNDATIO�N• LJ STRUCTURAL
' ❑ TENANT ❑ ELECTRICAL ❑ Pl.VM81NG Jd.fNECHANICAL
� OTHER
PROJECT DESCRIPTION $Q�.FT. OCCUPANCV_
CONSTRVCTION TVPE VALVATION $
ZONE _ GRADING CU. VDS. � ACRES—
Remarks:��/ '
�2 • 3+ �, •^"
Bar Sink '
Backflow�Preventer
Backflow Irrigation
Bathtubs '�
' Clarifiers �
Floor Drains ' �
Floor Sinks .
Gas SerJice Outlets
In[erceptors
Kitchen Sink �
Lavatories . '
P-Trap
Roof Drains -
Reinspection Fea �
• r.
Boilei
Duct= UnderGround
Duct-Structural � �
Duct-Ventilating '
PLUMBING i
Showers
Service Sink � .
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping�-
Solar Tank
Swimming Pool w/Spa
Urinal
� Warer Closet ,
Water Heater
Water Service
Auto-Wash '
$15
Exhaust Sysiem ❑ Multiple
FirepVFact. Blt. ICBO # �
Heating System & Ducting
❑P700,000 BTU �100,000
Reinspec[ian Fae
orivers' L'c�a, e B?yp � � -
CMF OB65-46, rev. 10/84 White - Builtling; Canary - Applicant; Pink - Actoun[ing; Goltlenrotl - Assessor
Et5
Isue Fee
Hoodor Typel ❑
Canopy � Type 11 � ❑
FEES
A.P. �W -
S Main Building: .
E .
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
' ; Automatic Washer
� ',i ConstructionPoleSub.
� Cooking Unit .
Dishwasher
Dryers �Gas ❑Electric
F '
an
F.A.U.
- Pixtures , � -
Device Boxes
Outlets
Switches
Garbage Disposal
. � . . Generator �0.5 KW 0545
Refrigeration System
❑6100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers 6, �a . r.�
Registers �, Q�d
Isue Fee
/oS9/
,. � , _
Zone
Accessory Buildin9:. - ,
• Parking Req.�/Provided - '
� ' . ! �
ELECTRICAL � � FEES
Traniformer�� 15-50KW� � ,"
❑ 50 + KW
Meter LJup to 100 amps
��Meter ❑overt00amps
Sub Panel
'Motors�Ot HP 01'h-8
Inc.Solar �9-15 HP �16-15+
'Microwave' � � "
Pole Light
Range
Sign
; Standing Sections
Trash Compacror •
$ 3 I �-
�- Reinspection Fee $75 luue Fee
FEES �
DEVELOPMENT SERVICES REQUIqEMENTS:
Zoning APProved BY .
Building Approved By —�
_ Appliption Issued 8y
$ 3
SUMMARV OF FEES �
BUILDING PERMIT $ � ' SMIP � $
PLAN CHECK $ PERMIT � 1( .,e'
PWMBING $ - �SSUANCE • $ �=��
PLAN CHECK 25% $� ENERGY P.C. $
ELECTRICAL '$ GRADING $
PLAN CHECK 50°� $ MICROFILM , $
MECHANICAL $ � TOTAL FEE , $ �-� �
PLAN CHECK ZS% $ � , . .
ui no
neTce
TC1i" is'3.
no.^n
Z
O
N
I
N
G
R
M
T
S
� �CONSTRUCTION AND PLANNWG � � � rvOL & SPA -
:,,APPROVALS Permit# - Date Inspector pppROVALS Permit# � Date Inspettnr
�
- 1.'Tempo�ary Electrical Service or Pole , 52. Pool & Equipment Location
�-2. Soil Pipe-Undrgrnd. 53. Steel-Reinforcemen[ �
3.� Electrical Conduit Utility-Undrgrnd. " 54. Forms '
. i
4. Electrical Conduit-Undrgrnd. 55. Electrical`Bonding
. 5.� Steel Reinforcement ' 56. Rough Plumbing & Pressure Test
6 Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
i
7. Footings � 58. _Electrical Conduit-Undrgrnd. -
�. '8. Foundation � � � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgmd.
10.-Structural Floor System ' 61. APPROVALTO 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
75. Rough Electrical-Conduit 66. Solar System-Finaf � �-
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 Con ' i�� 3 d`�A FIRE DEPT. REQUIREMENT _ � �,
20. Rough Factory Fireplace , � APPROVALS Permit # �
� 27. 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 O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �
27. Frame and F,lashing .. 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. FINR1 INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
33. Final Electric Notes:3`Ct dJ� p�4'p �pVq2, {(.qQ,p (,�u,y�, (�j0
34. Final Heating & Air Conditioning ZD � �� '
� . - `-. ....._.., �
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 pomesticFinal ' � ' ' ,
42. Backflow Preventer' .
43. Backflow Irrigation . , � � .
44. Landscape Irrigation SYstem � - . .
45. Sound� Attenuation . ' � , '
46. Handicap Regulations . � � , ' �
47. FI�NAL STRUCTURE & BUILDING �
48. �,�ecial Requirements Completed � � .
�
49. Electric Release to Edison • � - -' ��
50. Gas Release to Southem Califomia Gas Co � ' � �
51. CERTIFICATE OF.00CUPANCY . . . _ . �
�No. Date' . ',' � . .
AVO���ant to /ill In all spaces excaD� ��osa wlt�ln heavY DorGer Iines anE sign all app�a0riale Geelarations.
PERMIT 0. TRACT NO. LOT NO.
CiTY oF COS7A MESA CONSTRUCTION PERMIT � 3�, p iNij�N„On q,P, qW zooe
Project.C.tidress SF� A�+nn �aTh F1oor �av . `�"' S Main Building: Accessory Building:
Appli"can"t's Mailing Address (� TVPE OF CONSTRUCTION NEW ADD ALTERqTlora aEPaIR E Front �• Z
.Owndr'SName �1-Lr'�i"�� �nC- ��hone � CONVERSION ❑ DEM LISH ❑ OTHER T O
T DESCRIPTION OF WORK/USE OF BLDG. A Rear N
Address
Arch/Eng. ��K LicCnSC NO. TVPE OF PERMIT GRADING FOUNDATION STRUCTVRAL I K Right G
Address ��-�r'd���2 • L�S Qn� t�C� ❑ TENANT � ELECTRICAL ❑ PLVMBING ❑ MECHANICAL g� Lefl
R
Canvactor's NamP ��! ^+en ���-"�'�' �� Phone g�� ��oTHER Ping. Ref. # Parking Req.�Pravided E
PRQIECT DESCRIPTION 5a. FT. oCCUPANCv �
Addreu (mailingl �� � Rtrlhl 1� QV P dR e'1- 10-! �ocrp (i1L� Planning Notes: M
City Lke�sc No. (XitLq R(o CONSTRUCTION TVPE VALUATION $
T
ZONE GRA�INGCU.YDS. ACRES g,
LICENSEO CONTRACTOR DECLARATION
I hereby a11i�m Ihat I am liceniatl untler p�ON5iOn501 Chd/te� 9(commOnCing pemarki: r
with section ]000) of Divislon 3 ot tne Buslness antl Professlons COGa, anC
my Iicense is in (ull force ana eHect. EIECTRICAL FEES
ucense Ctass C- - � O Llcensa rvo. 5ua`a� ( 3� �,
p� Date O�'�3-�i Signature 'KK+�ni+-; L�n`�LLir; PWMBING FEES
Automatic Washer Transformer ❑ 15�50 KW
� '0.KER5' COMPENSATION DECLARATION ConstrUCtion Pole $Ub. � SO+ KW
eby atfirm that I nave a certHicate ot consent to selt-0nsure or a tertl(Icate Bar Sink Showers
O Norkers' Compenution Insurance, or a cartifietl copy tnereof (Section gackflow Preventer Service Sink Cooking Unit Meter �up to 100amps
3800, Lab. C.)
OPoiicy No. U�Pgg��13�o°� Company 1�rnM'S `f Mn�,'1� Backflow�lrrigation Sewer Cap Dishurasher Meter ❑over 100amps
Certitietl coDr �s hereby (umishea. Dryers ❑Gas ❑Electric Sub Panel O
— Certitietl coD is tiletl ith tne city Bulltli g Division. ` Bethtubs Sewer Connettion
ate n�— ��' �APPlicanl �=L�y1`^ ^� \"� F2n
' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clefifiefs Solaf CollectOrs otofS OQl HP O1 R- 8
. (Tbis section need not be comple[etl H the perml[ Ii (or one buntlretl (E300) or Dishwasher F�A•U� S. olar 09-15 HP 016-15+
Iess). Solar Piping
1 certify [hat in [he performance ot Ibe wotk t0/ wNc� Nis pGrmR IS I55ueG I FixtU�CS
snall not employ any person in any manner so as to become sub7ect to the Drinking Fountains Solar Tank � (drowave
WOrke�s' Compensation Lawi ot Califo�nid.
Date Signature � Floor Drains Swimming Pool w/Spa Device Boxes o��e Light
NOTICE: 11, aiter making this tleclaration, you shoultl become sub�act to lhe Outl2t5 4
Workers' Compensation provlsioni o( Ihe Labor Cotle, yau musl forlhwlth FIOot Sinks U�inal ( rj a.� eng2
comply with suCh prOVI5iOn5 or (bi5 permlt Thall be CelmGtl r9vOk0O.
CONSTRVCTION LENDING AGENCV Switches 1 Si n
1 bereby aHitm ihat lhere I5 a<onstruttlon Ientlin9 a9ency for the performanto Ges S2rvit2 OUtletS Wetef ClOset �7 9
ol tne work tor wnicn this permlt Is Issued �Sectlon 3097 Civ. CJ Interceptors Water Heater Garbege Di5po5al Standing $ections �
l.entler's Name -
�entler•s Aatlress Kitchen Sink Water Service Generator 00.5 KW �5�15 KW Trash Compactor
OWNER BUILDER DECLARATION
I her¢by aHi�m lhat I am exempt IrOm IItO ConVactor'S LICOnin I..aw lor tho LeVOtO�iCS A�[O-W85h 3Kw �N$�1 i�� lV�
lollowin9 reason (Section 7031.5 Buiiness antl Profeisional Cotle: Any city or
<ounty whith requires a pErmil t0 cOnsl�utt, dltGr, iTprove, tlem011S� Or mpal� P—Trep LeuOdry heyi
any stru<lur¢, Prlor to its iSSUance, also reqWrti the apPllcant IOr Such parmil
ip.l�le a signetl statement that ne/she I5 Iicensetl purivanl to tho provisloni ot ROOf Dlains -
,�,i:.rontractor's License Law (ChaD�er 9(cammenUnq wilh Sectlon ]000) of -
��;ion 3 of [he BuSin�ss antl ProfG55ions Cotle) O! thdt h8/She Is BxBmpt fZBinS BCtion F88 $1�J ISSUB FBB 1S a
�?`�.�'�/rom antl the Dasis tor the alle9e0 exemptlon. Any vlolatlon o1 Sectlon -' P
7d31.5 by any applicant for d Permil suD�atti Ihe applicant t0 d civll -
�enalb ot not more than iive huntlrutl tlouars (f500). $ 3 - DEVELOPMENT SERVICES REQUIREMENTS:
Reins ction Fee Zoning; Approved By �ate
LJ I, as own¢r oi Ihe OrOpOrty or my omployoes wilh wag05 as thalr So10 Pe $'IS IaUe FBB
<ompensalion, will tlo the work, antl th¢ struttura is not IntenCetl or otfereC
I br sale (Section 7044, Business ana Professional Cotln: Tho Contracmr's MECHANICAL FEES ' Building APProved By Dat�
License Law tloes not apDly to an owner of a property who builCs or improves
thc.von, antl who aoes such work himsell/harselt or tnrou9h nis or her own Boiler Hood or T e I ❑ �APPliration Issued By Dat
emplOyees, prOvitletl tnat SUGn Improvomen[s ara not Intuntletl or OHOretl to� VP
sale. It, however, the Dullaing or Improvemant is soltl wlthin ona yoar ot com- CanopV Type I I ❑ "� SUMMARV OF FEES
pletlon, tha owner wlll nave the burtlen o1 Proving ha/shu dIG nol build or Im- DuCt - Under G�ound �'
nrova for the purpose ot tale). �� �BUILDING PERMIT $ SMIP $
❑ I, as owner ol tne provertY. am excluslvaty contractlng witn Iicensetl con- Duct -S[ructural Refrigeration System ,�pLAN CHECK $ PERMIT
lractors to con5truct tne proj¢ct (Se<tlon ]044, Businoss antl Professions Cotle: :
. The Coneractor's License Law does not apply ro an owner ol property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU ..' pLUMBING $ ISSUANCE $
builtls or improves [Ilereon. antl wh0 conVactS �or Such orOiBctS wlth a ron-
tractor(sl licensa pursuan� ro me ConVattors License Law). I am aware tna[ Exhaust System ❑ Multiple � SyStem Repair/Alteration ' /: ''P�N CHECK 25% $ ENERGV P.C. $
proof o1 tneir Worker's Compensatlon insurance shoWa ba proviaetl to mo, p 'ELECTRICAL $ 3� • GRADING $
� ❑ I am exempt unaer 5ection e. 6 P. C. lor thls reason Firepl/Fact. BIL ICBO # Fire Oampers -� ' MICROfI LM $
, PLAN CHECK 50% $
Date owner Heating System & Ducting Registers %MECHANICAI $
I hereby certify that'1 have reaa mis application anE state mat the above ❑0700,000 BTU 0100,OOOBT TOTAL FEE $ �
information is correct. I agree to <omply with all city antl toun[y ortllnances ' �PLAN CHECK 25% $
antl s[ate laws relating to builtling constructlon, ane hereby authorize repre•
sentatives of [nis city to enter upon the above-mentionetl property for
inspectian purposes.
Signature �]woM(�[v.��t.�_� DateOa- - .
o.wers� �icense o. ss � - Rainspeetion Pee $15 laae Fee S s . O1 00026403-�D02b903 T�J3' 3R1.05
0865-46, rev. 5/88 • White - Builtling; Canary - Applitant Pink - Accounting; Goltlenrotl - AsseSsor DATE: �2/�J��9 TIt7E: -i1�J�
�
.. . .. • -. ..q . . . . . . , i.
. � I ^ _ '
CONSTRUCTION AND PLANNING • PC �& SPA
APp�OVq�S Permit # - Date Inspector qPPROVALS rermit # Date Inspector
1: :e porary Electrical Service or Pole ��� 52. Pool & Equipment Location
,
2: Soil Pipe-Undrgrnd. �� � 53. Steel Reinforcement .
�� 3:;Electrical Condui[ Utility-Undrgrnd. . � 54. Forms
4. �Elect[ical Conduit�Undrgrnd. - 55. Electrical Bonding '
,
5. Steel�Reinforcem¢nt� 56. Rough Plumbing & Pressure Test �
6. �Electrical UFER Grnd.^ � 57. APPROVAL TO COVER-GUNITE •�
7. �Footings �i ' ,�� i � 58. Electrical Conduit-Undrgrnd. �' �
8. Poundation - i�; ' - 59. Gas Pipe, � Undrgmd., Test � �
9..Water� Pipe-Undrgrnd. , i j 60. Backwash Lines, P-Trap, O Undrgrnd. ' i.
10. Structur�l Floor Syitem � - : 67. APPFOVAL TO DECK
11. Property Sewei Line & House Conriection �
_ � 62. Backwash & Receptor-Final
12. Sewer Cap , � � - 63. Heater & Vent-Final
13. Roof Drgins � - " 64. Plumbing System - Final �
. 4
14. Rough Plumbing � --- � 65. ElecVica6Final -
15. Rough Electrical-Conduit 6. Solar Sys[em-Final
16. Rough �Iectric Wiring 3�p� 67. Fencing & Access Approval
�1�� Rough Wiring Sign . APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � 9. POOL/SPA SYSTEMS FINAL
i
19. Rough Heating & Air Condiiioning FIRE DEPT. REQUIREMENT
�,
20. Rough Factory Fireplace �` t�: APPROVALS Permit #
'21�. Ducts, in Struc[ure �?" �� 70. Underground Hydro
22. Ducts, Ventilating �� �, � 71. Product Piping � Gas • OOiI
23. Gas Pipe-Rough & Test '''� 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O 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 6rown Coat 79. FINAL INSPECTION
32. Electricdl Power Meter-Final 0. FOOD CERTIFICATE ISSUED
i
33. Final Electric tes: l
34. Pinal Heating & Air Conditioning � r'�� �� . 2�
LL � '. .
35. Final Gas Pipe-Test ; ��
36. Hood or �nopy �
37. Final Factory Fireplace �
i
38. Final Plumbing ��� �j ;. '
39. Water SErvice-Final " ` - "
• fA i
40. GasService-Final. ` 4 -1 �
41. Solar pomestic-Final • �� " . .
,,
42. Backflow Preventer _ i ,� � �Z �' `` - � � , -�� ,tit
�
43. Backflow Irrigation � �' -`��; i • '
�r; , /
44. Landscape Irrigation System .
45. Sound Attenuation
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING ' .
48. Special Requirements Completed
� 49. I�lectric Release to Edison � y . �
50. G�s Release to Southem California Gas Co - _
51. CERTIFICATE OF OCCUPANCY sL {U �! . 't� -
No. Date � �� '4 � '� ��� ,.� �
� r� ��
AOONES�Oi91GLWl�: ]>] HN1UN tlL
axr+exeNu.ieivp+o�rn: SAKIOKA FARMS
wonesa PO HOX 2097
' TERMINAL ANNEX
MPl.1WIPlG i100flE54:
UNi:
urcxirECTonu+axan: INTERIOR ARCH 2136232164 uc.xo.: 9378
urcx.onu+c.�s�om+�ss: 550 S HOPE urar: 1100
L.A CA 90071
coxm�naxsw� CAL PAC (310)645-3500
cwm�ctorcs�uimc 6076 BRISTOL PKWY
,�p�; CULVER CITY CA �G�, 392102
90230 uM:
LICENSEU COMF�CTOFS OECL�X�TION: I Mreby ellim uMer pmely d perjury Net I em Icenaed uMx prwisioru d Chaqx 9
(mmmenmi6 wuh Sxion ]000) d Oivaun 3 d Ua Busron eM Pedeae'vm CaEe. W mY lioeroe u m 1u0 taw uM tl�ee.
cm�.:065824 uc.cuss: u �: P: U9/96
o /� Z-9 � ��
WNEfl BUILOEP DECIARRTION: 1 hen�y elfiim uMer peiuly d rNrY �� I em eaanq tmm iM Cam�edae Lironea lew la Ne
bx*q isemn lSauian ]W 1.5 Bueiwsa aM Pralamona Code: ArtY UY a mu�uY xfiidi mVu'vea e M�i �o wnsWc�. e4m.'vnpow.
wmd'nh. a reper eny sWtlue: piu b ia enwice. eho npwe� iM epplirant la wch pamu Io fJe e eqneE pmemem Nm he a eAe
u IicenaW punuent to Ihe pwivau d tlr Conlrmoro lioen�e lew �Chaqm 9(mmmerc'vp vAh Serlion ]000) d Gvuion J d the
Buv�wsa eM Rdea'vn Cadal a�� � a Me o ewemq iMelian end iM Wau la Uw elbped ezemqbn. My vio4lian af SeUbn
lW �.5 by eiry epplireN fa e perma wbjWs �M eppl'rsm to a aN pwu4y d nol maa then /Na hunNad doAen �L•W�.
❑ i.mo..,wainew�v«mr«�Ww...an.ao...sin.:.decanoemmo�..maouawnn�..�em..we�ns�wmimded
n oflereElw eeb lSeciim )OM. BusMu erd Prole�uma Code: The Caniredwe liceiue Lew Eoea not eppyto en ownerd prope�ly
who buid� a inY� �twiean. eM wno doee e�cn xork FimaeX a henM or Nrwph he a Mr am emGMM=. Vr�aC tM a�ch
� poremmn ue nw wenaee «onaea �a.w. a. no.ws. ine nWuino «:nw��em u edd.mn:, an vw d mmpmun. u.
owror-0uiNr xill heve tM buNen W pwiip M or ehe d'd na dtiM a improw lor ihe purpoee M We).
� I. m ovmer d IM G�WMY. am udus�eN mrurm�q wnh 4cenaed oontreclae �o muvue tM WMa (Sequn ]OM. &aiima eM
Pmlassona Code: TM Catl�apm L'crw lsw dom nd WWV b en wmar M pW�Y who Eu�lda a imPa'ee tAaaon ud who
conirecb lu wM prqeee rmh e aMreda(v) IicemeE Wnuem lo iha Com�eqae Uceme Lew�.
� 1 am uamp undm Seciion: B. 8 P.C.. la Nro ieuon:
Ua1e: O.mer: .
I Eo heieb/ cen�y itW I em ewve d ud iWe'eunE iM nQuiremw tl Callomie Ilsetl� enE SNety Code Setloro 25.5p5, 25593, enE
255J6. eM Net 1 a ury Mun brikinp owaqent will / wll rw (rnc4 aro) �d to odnply wih eeid neie mdn eM tha �puuemanb lur
e parmn lormmvuciion a modifireiion hwn IM A'r-0-a ITyl�enepemenl Dinria. RaekoMW mmirvdion appicelionsere aaemd imm ihme
oma: nad�em:
WONKER'S COMPEN5ITION �ECL�P�TION: I hareby elfi�m �Mer penelly d parjury me d tM lolloxi�q dedvetuen:
� I hme e�d wil meimen e cenificete d coneen� lo oM�inwn br Makeri canpmdion, m pw�ded fa by SWian 3]00 d IM leCor
coee. lw �ne wnormeMe o� �n. wwk �o, whicn mie pe�mA I. fuuee. ,
� 1 hm uM wil meiman waken' oompeneelion iruurerce. m royuirod by Soqion �lOp d IM Labor Cotle. br tln pM«mence d IM
.�x i«.mKn inn w�n 9 ro.�,ee. Mv.,ow.n ���{.�� �[�°a�v ��mna� ae: EX P I R ES
ca.�.,:
ratiY n�mn�.: 0 2/ O 1/ 9 6
�mr: senron nese � ea canWeree i �� v�+� a ro. w�e nu�e�ea ediers Riool o, rw./
❑ � cenM mv in �ne penoimence a iM .vark �w wnkn �nl. w�n ro ieeuea, �.nen mi emWor eny o� �� .�y m��e, eo ea �o
becanb w4b ia tM xakere' wmrometion lexs d Celibmi eM e ree Uat ' d �o iM1e xwYwe'
mmDenseiian pm+ewa d Secion �)00 d �M Lebor CaAe ^�I ,r.r �Im V�+� « ��"%%
ove: //" Z— 9 � •ow 1r- /: .C�i
Wamlrq: F�Nvn ro ixun woMen'romperwtlon eoverep� I��IawN( endWll �uD(�ef �n �mploysr fo cAMrul psiultlw an0
clHl fllaa up ro on� hunOrsd thouund LNI�n lSt00,000A � e�G/Hon ro M� ewl ol eampewtbn, tlamepu u pnvltletl ror In
Sxtlon 3M6 0l M�Wor COGr, Infwuf, end ertomry'i Iwi.
CONS?NUGTON LENOINO AGENCY: I hereby �rm uMer pnelly d perjury Ilut IMn u e conqnqian bMiry eperwy lor Ihe
�no,m�� m in� woa ro, wn�u� ine o��i n a.�a tsaa�w, aoc�. c:. cl.
LENDEP'4 NNIE:
LENOEP'S AOUflESS:
I ceMy Ihm I heve neE �he eppiceiim vd qms IAe� tM ebv.e'vdormetbn u mma. I epme lo canpty rmh ell tlry eM muruy ardinux.ee
ard sWe 4wa rtW�q b buJd'nB cmfbu�ion eM Iweb/ eNlwixa nqeesaelrvea d Ihu uly IO eMm UV� Ihe eEwe-menlionetl piopa�y
�«��0°"�°°""°°`°' DAVID DE SISTO
'./ � ,.n�. Dme: �� ��� / �
� J c:...r���. ti n..�..��,..� ie�.s...x�'m
(S�Sty6.WP) WM1ds-BuiNip85eley:G�ar�FJe:Cvury-Appiram:Rnk-Revmue:(3oldervo�M�smr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 075006 PLAN CHECK NO: 03724-95 A
/
PERM NO: 8 � 075006
GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: ALT
SOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT: 20,000
CLAIM VALUE: 360,000.00 CALC—VALUE: 386,400.00 GROUP OCC: H-2 /
COMMENTS: 76 UNIONPRODUCTS
*�***�***+��**�rt**�**��x��rx�*�*�***x�*x�*�r��*��***��****x�x*****�*���**��****���x�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ � PROV; PARCEL; 41050104 2NE: PDC REF NO:
PLANNING N6TES> TENANT IMPROVEMENT FOR 12TH FLOOR FOR 76 PRODUCTS COMPANY
i :
iE iE iE IE iE iE iE iE IE iE 1E iE iE iE iE 1f iE iE iE IF iE IE iflF iF iE iE 1E if fE iE iE iE iE iE iE IE iE IE iE iE iE IE IE IE iE iF 1E IE'IF IE iE iE aEih �E if if iF K iE 1F iE iE 9E iE iElE 1E'IF 1F iF if if iF IE iE iE K
D E V E L O P M E N�T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY :�' -°�.�. DATE; ��=1.: gS
BUILDING APPROVED BY,: W L�.�A�._ DATE: �'�`Z—�,
� �i-Z-qs
APPLICATION ISSOED BY: � DATE:
iEiE+E1EiEiEiefeit*iEitiE+tiEiE*it+E.iEiEK�TFiF7F3F3FiF3F3F�F7F7F1FiFiF'{F'{FiF7F7F1FiF'{F'iFiF7F F iFlFlF�FiF*�EielEiEiFifieiEie�'i�'iF"�iF**
LEGALIZATION:N- � : F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,644.00
SMIP/NON—RES
PLAN 267.15 81.14
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 1725.14 0.00 267.15 1992.29 1992,29 .00
REVENUE DIVISION TOTALS--> COLLECTED: 1725.14 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1644,00 81.14
if iF 1f if iE 1E if 1E 1f iE iE ik 1E if 1E 1E iE 1E 1k 1E iF iE fE 1E i! 1f 1f ik 1F 1E 1E iE 1E 1F 1k iF 1E 1E 1E 1E if 1E 1! iE 1E iE fE 1E iE 1E 1E iE ik iE aE iE iE 1E 1E 1E iE iE 1E iE 1f 1E iE iE fE fE fE iE iE iE IE iE iE iE If
I N D I V I D U A L F E E 8 R E A K D O W N
��T���
SFC
SFC
SFC
QTY
2���0
20000
2�0��
D E S C R I P T I O N
OFF—INT. ALTER TYPE I,II F.R. —AVER
EQU—ALT COMM. SPRINKLER SYS —AVER
EQU—ALT COMM. AIR COND —AVER
END OF FEES
UNIT COST
18.24
.72
TOTAL COST
364,800.00
7,200.00
14,400.00
L�i 0`_°i . i2-'�G`i �'-:�" � .',.
�%TF- :i'`'__ _ ';+�. _� .:J
/ .
CONSTRUCTION ANDPLANNING F .&SPA �
APPROVALS Permit# �� Date Inspector AppROVALS Permit# Date Inspector
�
1.,Temporory 6lectric8l Service or Pole 52. Pool & Equipment Locacion �
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � .
-�3. Electriwl Co�duit Utility�Undrgrnd. 54. Forms �
_. ., ~ i
M4�. �lectrical Co�dVibUridr9rnd. 55. Elec[rical Bonding �
5. Steel Reinforcement �� 56. Rough Plumbing & Pressure Test �
'-6. Electrfcal,UFERGrnd. 57. APPROVAITOCOVER�GUNITE � ;
: 7. �Foo[ings, , - 58. Electrical Conduit•Undrgmd. �
8. Foundation ,-i 59. Gas Pipe, O Undrgrnd., Test; �
9. Water Pipe�Undrgmd. ��_. � 60. Backwash �ines, P,Trap, O Uridrgmd.
t0.5tructural�FloorSystem ,;' ��� � 61. APPROVALTODECK ;�
17. Property Sewer Line & House�Conrfection 62. Backwash & Receptor•Final '
12. Sewer Cap 63. Heater & Vent-Final i
13. Root Drains �' y � 64. Plumbinq Sys2em � Pinal %
14. Rough Plumbing� �. � 65. Electrical�Final �-
15. Aough ElectricabConduit ' 66. Solar System-Final � '
16. Rough Electric Wiring �- -! 6J. Fencing & Access Approval .
• 77. Rough Wiring Si9n - 68. APPflOVED FOR'PLASTERING ,'
18. Rough Electric.a6T Bar Ceiling' 69. POOL/SPA SYSTEMS FINAL �
- 79. Rough Heating & Air Conditioning PIRE DEPT. REQUIREMEIVT ,
20.'.Rough Factory Fireplace _ .. . - ' APPROV,AIS', Pecmit# ,
21.-Ducts, in.Structure � � � ^ - ' ' ' 70.�Underground Hydro '
22. Ducts,Ventilating,' ,-, .. 71. Product,PipingOGas �Oil
23. Gas�Ripe•RoUgh & Test _ ' 72. Undergro�und FIusA '� -"
24. Roof Framing � ' - - _.j ' ' ' - . . . 73. Undergrnd. Storage Tank 0 Gas ❑ Oil
25. Roof Sheathing = � 74'. DvePhead Hydrp .
�.
26. T�Bar�Ceilin IStrueturaii & Monocoat %Z'•/4 � ` "� � � ' '�
- 9 , . ^�/�� i 75.�Dry �hemical � . -.
27. �F,rame and Plashing. ``'.�_ -. � '� ,, x - " -
/Z�jq 96i�=�'`�76. Dry Starid'pipe
28. Lathing & Siding _ , ' - � � 7j. FIXED-SY.•STEM FINAL . � ' _
29. Insulation _ _ ':. z � -?�• 3 ' � > ' . "-
78. FIRE PREV. F.INAL
' � 30. Drywall �I�ailing _ ; �Z'�J.��. 'i��� = HEALTH DEPT.'REQUIRE7VIENT
31. Plaster Brown Coat +-- � r . 'r 79. FINAL INSPECTtON �
�-
� 32. Electrica) Power MeterFinal " -� . 80, FOOD CEfiTIFJCATE ISSUED. -
33. Fina6Elecvit � � , ' ;';1 Notes: � ' _
� 34. .Final"Heating & Air Conditioning � � '� }i ' " •" _ , � � ' _
, � - -
- 35.'F,inal Gas Pipe�Test • ` . . � : - � �� � � �-
� 36. Hood or CanopY ' � � ' = T � ' ` - + -_
�,
. 37. Fina'I'Factory Fireplace ' . . - . � � .
38. Fina7 Plumhing ." � �` ` . ,
x
39. Water Service-Final . � . � . . ' . � ' ' � -
40. Gas Service-Ptnal • �+'��• � . � � ' '� - �
�' , • -
41. Solar pomesncFinal _ " � - � , . . � • • �
�
42. Backflow Pre�enter> - - . � ' ' � - "
.. s -.
43. Backflow Irri9ation , - - ' � , � � � , � .
44. �andscape Irrigation System • ' " � '� - '-' � • . � `
�'
45. Sound Attenuation• ' - � t � ` - � , :� ,
� . e . , _
46. Handicap Regulations -- " c - : ;- - - `
� �'
47. FINAL STRUCTURE & BUILDING �i, 6 . ,� '
_
48: FINALPIANN�NG' ._- - �� ' • , ! i''' . . , '.- .
49. Eiec(ric Release to Edison �i i �; : '_. �� : e. ' : ; "
50. Gas Release to Southem Calitornia Gas Cn •� � '- _ . ' .�
51. CEFiTIFICA7E OF OCCUPANCY • '
N0. Date
�
/
T
�oon�syaemiaw: 555 ANTON HL
qtt1ER4N41E1FI0pWk SAKIOKA FARMS
moxess: POI BOX 2097
' TERMINAL ANNEX
_.. __R"wm;r.^.��
u�: 12TH CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 074706 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR
uiexnecton��x: INTERIOR ARCH,2136232164 ucao.: 9378
1RCN.OqENO.'9MDRE34: SSO S HOP£ ST ur�r: 1100
L.A. CA 90071
eartn�crarsrun SWINERTON 6 WALHERG ( 213 ) 896-3400
cartnncronsxuuxa 865 S FIGUEROA ST
�oo�ss L. A. CA uc. r�o.: 9 2
90017 �NT, 3000
LICENSEO CONfPACTOflS UECLAN1ilON: I Mroby ellim uMx pe�Wy ol pm�ury tlxt I em licsnsad uMu paneb�u N Gheqa 9
(rommendnp wilh 6enion'l000) d Dimion 3 d the Bueinsn eM Proleseion� CoEa, eM my Ilanse ie in lull iwce eM eHed.
cmuc.jeo.:0462(J7/° uacuss: B uc : Z X�P--.��/95
Dete: 1 11�� � N Conveaa:
WNEN BUILOEP DECIARRTION: I heieby eifiim uMer penely d Ihm 1 un au q han M Contretlae Licens /a Ne
bwiq renvan (Satlion )W 1.5 &uiwa uid Prolaeom COEa: My W aouM' whidi Wure� V�n to mnmw. el r. imVa+.
aemd'oh, or repai eny miucWn, qior io ba ueuenca, eho m�uirm �he aiunt br such il �o e a eqnad elelemeM ihel M m sM
u IioemeE WmwY �o IM V�e d iM CaNredns licanee lew �CMper B(Oomm � Satlian ]OW) M ONeun 3 M Ilw
Busnma ud Prdmbre Codal a �het M a e!w u eRemq tMahan end Ihe bem ta Ne eAeOM usmqion. /�m videtbn d Ssqion
)03t.5 by eiry eppYcent lor e permn abjeUs �ha epWicaM lo e dril peiulry d ml mpe Ihan fxa hu�W�eE tldlen �5500�.
❑ Lno.wa�nen�o�r«mramdm�winwaymm�nei.dsmmw�+Vcn.wa�domsxwk.eneu»viununenaunmAae
«on«ea a sda (s«tion �a..6u��.., ene v,ae..iau caa.: m, can�reea.lio.,» le.ma. �w epdr�oN ow+,« d nweM
W�p �! IX TpIWM 1�MtBC11. Nb M}U dOM tYC�I Mqk fY111G� IX �WfG� IX 1�V W�I �1V IX�Nf OWII MIpO�'W. pIOY�.♦G� I�IY tW�l
imP�'amema ero nd iniedeE a aHseJ ta seb. p. lwwewr. tM buildiiq a inpwpnM o�dd vmhin one Yaer d mmdMion. tlr
ownerbuikW wJl hcre the buiden d P�'�0 he a'hs did m� buJd a imYa+trc Re wTaa d vab).
❑ �. m ow�« a me uwaro. e� ��'dr ��redro �•;�n wa,be ainrev+o�. ro wnmw in. wd� (sauon �ou. a�.i�m. d,e
Prolovma Code: Tha Caqrepae limae law doee nol WNY ro en owror d V We�Y who Wiltl� or'vnpw'm Ihereon eM xfio
wnvrt+br atli p9�* vmh e mureuMel licemed O�uem m �M Cammfas Lioena lew).
❑ I em eaemq wdar Saciion: B. 8 P.C., la Nu redon:
Dme: Ormer
I Eo M�eM ��M Ubt I em ewua d eM imdenieM tlro nWimmmb d CelCamie Iluth ud Se1M' CaOe Setliam R5505. Y553J. end
255�0, eM Net I or eny Mure buibinp omipenl will / w11 nW (drcb me) naed lo comply w1� eeiE gle�e mEet eM IM reQuimnenm lu
apermulawuwction«modifraianhomiMRi ue3i�.ty eropemseDiqrip.RmiAantieloonnwuneppfutqmenezemqfromNpe
ww+s�..
PERM NO: B 074706
GOC'T: N SUPP: N
C:Iil:l',Z�FY��rY11
JOB DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC-VALUE: 20,900.00 GROUP OCC: B-2 /
COMMENTS; 76 UNION PRODUCTS
**********�**�*�t***�*�*�***��**x+�*�*�t�t***�t**x**�t*+�**�r********�r*+�+t�c+�***#****�t��*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUSLDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNZNG NCiTES>
� • .
+�******�-*�-*�r**��-+F�c*�#**�*�**#****�x�***�**�-�********�*****�*�*��*#�-**is+�*�-*rt***rtx�*
D E V E L•O R'M E N: T S E R V I C E S R E Q U I R E M E N r S
ZONING APPROVED BY . DATE:
BUILDING APPROVED.BY ; ! DATE:
APPLICATION ISSUED'BY: '%� �h�� DATE:
iEifiFiEiElEiEifiEif1E1E1E�lE1Ei��IFifiFrlfiFiF E F 3E1E�E3E3FlE#iEiE14�1� #��iF�iF{F3EiE
LEGALZZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 432,00
om.: n°d�"�"` PLAN
WORKEP'S COMPENSATION DECLAPATION: I hmeby �rm uMr pondiy d peijury one d IM Idbxin0 ddueforo: I S S U F, F E E
� IheveeiMxiomeinie'vecenilcmedmnxnnoaeX�inarelwworken•wmpenwun,mpwkedlwbySeqion3l00diMlebor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
cade.�an»veno��ewms�oix�«w�nmia��ni�m�ed. TOTALS----> 436.39 0.00 0.00
'] � ne�e e�e �ae meimar� .mkere wnv�� ��,�e. o nawne M s.eim a�ao a ua �.no. coee. �ar me vu�«menm a me
work lor which Ihie parmil ia iaeueJ. My warkere' peneeli imu ence cemer eM poliq number ere�
FIRE SMIP/RES GRADING
SMIP/NON-RES
4.39
TOTAL PAID DUE
436.39 436.39 .00
�„�,,; �TiGUF�At�'L EX.PIRES REVENUE DIVISION TOTALS--> COLLECTED: 436.39 OC'ER/SHORT: .OU
GWiryNumEec wl. o.� .�GLv »•t OB/01/96 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
�rnm �e;,� ,..e,�n a, �„p.rae r rne �� a m. a,. n��e edw /siw� a�,.� 4 3 2. 0 0 4. 3 9
� I cer1A' � in Na pe�lamente W iM work tor xfic� Ihb peimB i ivuad. I Mell ml emplvy enY penm in erry manrier w ea io
becarovublealo�haxaken'cmWMse�ionla�xdCeNanie. Ca�esietG I b omew�bpd�o�Mxwkna' #if�)fifillEfEiE!(�il7Eif##fFiE*iElf%3f*iEif*3E�fiEfEiEif3EfEiElE1E�E9E1EiEjEiFiEiElEiEifiElElEiEiElFiE3EiEiEifiFl6iEiElf9fif9EdEiEiE3EiE1EiEiEiEiE�lEfFaE
��p^(��^^.����ajo„i 3]0o M i�e labor Coda, I enell 1 ' omp th ee I N D I V I D U A L F E E B R E A K D 0 W N
Dvs:l � C--�/ � � Mdcam: /
w.mbp:F.sunroixunwoMwinn�vwatloncov�rap�liun t m�nai• K �«�o�o�wro�nmry �i:mm�.w TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
dHl flnu �q ro om MnEisO thoua�ld Jo/l�n /JIOq000A b�l n h • cal o/ HOM1 Jem�pu u proHtlstl br In
s.�a�s�osorm.i.,eo,coe.,��r.,..c.�a.rcom.r.r«. SFC ZOOOO DEMOLISH HY VALUE COMMERCIAL NOZONE 1.00 2O, UOO.00
CONSTRIlClION LENOINO AGENCY: I Mmby elf wdar pmelry d perjuy tMt �Mn e e mrut�ueon bMiiq epeM.y lor Ihe
penormenoa a �na xorx �or wuw me rom�i u uwee (seeon aw]. cM. cl.
LENOEN'S NAYE:
LQlOEP'S 1UDFESS:
I cen'ily �I�el 1 heva reaE No epd�� eM pme �hm IM1e ebova inlame�ion ia corrtp. l epree to comOM �� � MY ��M'/ ordir�vwo
vM atet! laws �ele(uq b WJEni CMYrWion W Mfab/ GWIwaG iepeeemBlntl d Ih'v mY M eMN Y0.'� lh! 9bM�111BIYbnitl pOpN!/
�°`��pBtl�""D°�°' DAN C(�NROY
� ^ 1/ N��, Dme: � ,� / 1
While-Buikiip 8 Se1My: OrearFle: Carary-AOGken�: FinN-Ravenue; Ooldenrod-Asae�or
END OF FEES
/
01 GD7936��-��14'sh7;; u ���-P' .3i.a4
eF�E: ±n,z�r�s �,re• _ :s
�-� -- ...
.1;ONSTRUCTION AN6 PLANNING - F _ & SPA �
APPHOVALS Germit# . Date Inspector � AppROVAL$ Permit# Date Inspector-
1��`TEmporary Eiect��cal Service or Pote 52. Pool & Equipment Location . ' '.
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement '
3.. Electrical Conduit UtilitY-Undrgmi3. 54. Forms -
4. Electrical Conduit-Undrgrnd. • 55. Electricai Bonding '
5: Steel Reinforcem�nt , � 56. Rough Pium6ing & Pressure Test �� �'
6. Electrical UFEfl Grnd. 57. APPROVAL70 COVER-GUNITE -
7. Footings -� . 58. Electrical Conduit=Undrgmd. ,
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. lMater Pipe-Undrgrnd. ' 60. Backwash Lines, P�Trap, O Undegmd.
10. Structural Floor SYstem . '� 61. APPROVALTO DECK t �' ,
17. Property-Sewer Une & House Connection 62. Backwaeh & ReceptorFinal
12. Sewer Cap � �-" 63. Heater & Vent-Final . ,
13. Roof Drains •- 64. Plumbing Syscem � Final -_
14. Rough Plumbing ._ ' 65. Electrical�Final � • �
15. flough ElectricabConduit , - 66. Solar SYstem-Final • �-' �
i 6. Rough Electric W�ring . � 67, Fencing & Access Approval -
77. Freugh Wiring Sign . � 68. APPflOVED FOR P�ASTERlNG- '
18. Rough Electiical-T Bar Ceiling 69.� POOUSPA SYSTEMS PINAL '
1Xi:==ovgh��Heating & Air Conditioning " FIRE DEPT. REQUIREMENT
2p� Rough Factory Fireplace ' APPROVALS Permit,�-` �
i---
27. Duces, in Struciure � 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping � Gas L� Oil
23. Gas Pipe-Rough & Tesi - • 72. Underground Flush
2A. Roofi �Framing � ' 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roo€.Sheaihing � • 74, Overhead Hydro
26. T-Bar CeiVin9 (Structurall & Monocoat �/fO�p'� /"�' 75. Ory Chemicat �
��ii
2,�.'�: �Frame and Flashing � 76. Dry Standpipe �
%/l6 .e`A _
2���Lathing & Siding " � 77. FIXED SYSTEh1 FINAL
29. Insulation � � ��f- 78. FIRE PREV. FINAL
30. Drywali Nailing � /��� iyl" HEALTH DEPT. REQUIREMENT
/r�/
31. Plaster Brown Coa; � � • 79. FINAL INSPECTION
32. Electrical Power MeterFinal 80. F000 CERTIFICATE ISSUED
33. Final Electric � . � � Notes: � �
34. Final Heating & Air Conditioning -
35. Final Gas Pipe�Tesi - -
36. Hood or Canopy �
37. F�nai Factory Fireplace . �
38. Final Plumbing -
39. Water Service-Pinai
40. Gas Service-Finai
41. Solar pomesticFinai
42. Backfiow PrevenTer
43. Backfiow Irrigation
44. �andscape Irrigation System
45. Sound Attenuation
4b. Handicap Regulations
47. FiNAL STRUCTURE & BUILDING / /Y �
48. PtNAL PLANNING �
49. Electric Release to Edison
50. Gas Release to Southern Califomia Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
� I
�AOONKSOiBNLqNO: SSS ANTON BL
°""Ea°""'E"'Q'°'"": SAKIOKA FARMS
, '°0"Eu' PO BOX 2097
TERMINAL ANNEX
,wr�. �uuno mo�ss
uNr: 12TH
j"1KN1Kf0PFfm'�"' INTERIOR ARCH 2136232164 "�NOi 9378
urcxonu+a•s�noxEa: 550 S HOPE °NT' 1100
L.A CA 90071
�1tT0"8NA1� MORROW MEADOWS ( 714 ) 598-7700
cwm�croxs�uiwo p O BOX 509
��5% WALNUT CA ��- 230813
91789 uNT:
UCENSED COHfP�CTON4 OECI�N�T10N: I M�oby Nim �vdr penNy tl perpvy Nq I am IicansM undp pwiuon� d Gheqx 9
��,«,dro �+�n s.n� �000� a a�.:M a a u» a� d,e v�r�,. ceae. w mv u�.. o m i�u m2..�a wea.
cmuc.'No.:006558 �°0�g C 10 uc.No.: 230813 EXP• �12/95
/'m i�- s� - 9S �«�«
YNEH BUILDEF DECUNATION: I haeby eM'm uMm penNy af per'Fvy iha 1 ue � Irom tM ConVauae liuma lew la ihe
qwiq rseaon (Setlion )0�1.5 &»iwt� end PMWiana CoOa: MY ��Y a cau iY wfi nW'vp a Vam! lo mnsVucl. Mx. imPove.
aemolah, n ropeir eny elr�v.Mun. pia io [a ceuance. e6o �eqimm ihe appfxxnt permil to fib a eipned �Wemem �hN he a ohe
u licenasd Wnuent io IM Pwitiom d Na Comrmaa limnae law IChaqm enmq wd� Seaion ]000) d Oi+'vion J d IM
Buainea eM Prdeuuna Coda� w thel he a tlro o uamq tharalmm erd iM baa /a Ne albped exempion. My vidmion d Satlon
)091.5 by ury epplirant lu e p��mil abjaea tM eppfcva to e cvi pe�etly d nd mon Ihen Ms hwWtl EOAu� �5500�).
❑ I.moxwdihepopenyamyampb�eaaxihwpseutheiadocompsreetion.r�EONewpl�ertltM�Nqunenal'vilentleE
or dlmeE Ia We (Section ]OM. Buurou enE PmlmwnaCOEe: The Com�Wm timua tew dw� np epplyta en ownerd qoperry
who Euids a inP�+� �hwean. end xM doas e A work h"vnaetl a MnN a Wwph Io a har an mmplv�se�. pm'idatl �M wch
impo.amem ma nd'unxdeE a aMmM fa ede. tl. bvwa. tM W�tl'uq a inpw�matl u wN xqhin an yaer d mmplelbn. Ns
owiw-0uiNa win hm IM WNm d 0�'��0 M«qe Sd nd deld a"vnPa+ tn tM wmde W eele).
� I.mownarM�MpW�Y.emmdwndYmrcrrf�qw'n�formdmitracbnbom�uCiMPNbISWianlOu.&m'vanmd
PMes�ims COM: TM CaNratlm lirue lew dom m� eGVM b m owns d P�W�Y wb bdld� a uMu'u �hason and x1n
comrects for awl� 0�4✓�� �N e mMMa(e) WmsO w�sueN Io tM Camromn Lisua taw�.
� I em uemq uMa Sx�m: B. 8 P.C.. br Ne iem�:
Dme: �+�
i eo naeM �v wi i.m ..,.,e d.ne �we�.w�e me �.md«n«as a c.vo�rc. w.en.�e snw com swim, zssas. zs�. m,e
255],. eM tlut I IX M' Mu� b ld�q ov�Wv w�T / wi nd (mcb ar) nesd ro canW�Y Hh uid tltl� aoEe� aM ihs �opuinmaqa br
eW�lammuuctionrcnaESretionhamNSAi�y m�mwaD'u�ntl.PaeEWWmuttWiona00kdiomenuemNtmmlhne
Oma�. Appfcen:
WOPKEF'9 CONPEN4ATON DECI.�PATON: I Mraby eKum wder pe�Wy d parpuy ons d Ns Idbwinp dsderWion�:
� I Mva eM MI mein�en s cM�itla d miuem io �aMarowa M worksn' wmpemdion. m pwideE la Ey BWlon �)00 d ih� Lebar
coe.. �« in. nn�. a m. wn i� wi:m e:. o«+� n w�ed.
'1 � n..s.�e wu me'uu.n.o�sY mmcmwon mw,renw. o nQu'v.e W s.acn amo a m. �.e« coe.. ro� m. oe�a� a m.
wwF lor wliicM1 �hi� permn 1� iuueA. MY warMen' mmpenutbn imuranca eertir W pdky n�mp�r vs:
c.m«: FTRFMAN' S FflNfl EXPIRES
Pd'ryNumbr. L1W('8067��Q� 07/O1/96
(mb mnion rwM IrotW canP'kM I tM w'm] u �n ms lumdsd dNlua RtoO/ a hoJ
� I wrlh � In IM pMmnenca d iM wak br wh'rh IM pamu b uu»tl. I WY M wnpb� erry perwn in e�ry mennu n u �o
e.ccm. aa.a m m. wakn.• canpam�o� m.. a c.rao�:.. .�a ap�w m,�a(yp� ��.houu e«an. wqw m in. wwM.n
`�comD+��ion G�+�iom� py�)00 d iM lebor Cob.14��rlhMtl� mm'_'17-� ���% /
r.. ro cnmw nwna.�ro
ANIq�� 4 VAYICIO f0/ �ll
CONSTIIUCiION LENDINO AQENCY: I hreby Mum urder peneQy tl perryry IIW tMn u e wnNrvCion krMi�p eQenry lor Me
psrlpmvqe d tM rdk la whirh tN psmi e'vwad (SWion �09]. Civ. CI.
LENOEP'4 NAME
LENOEN'S �ODPES4:
I cenih �hm I Aeva roeE N'v eGWiralian W tlW IIW Na elwa iNomietion e mriw. I aPM w canNV wh �Y aY uW mumY adinuau
eM �Ime Nw� �eW^Y b buJd�q miquqm W MMYainAoe¢e eaP�beNm dihe �YY b aNx uD� �M Nw�.meMionad V W�M
i� �.c«vm auw....
CHUCK JACOBY
Dtls//`� /�
(5151d6.WP) �J��a-BuiM�qBSdaY�areer.-File:CenW-APO��:Rnk-Rewnw:(iddanro�Nrovsw
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 075088 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
PERM NO: E 075088
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC; B-2 /
COMMENTS: 76 UNION PRODUCTS REF: 8-75006
��+e��*at��titat�rxrt***�r�c***�tit**+tat����*�it+eatat****�*+t���*rtft*atrtx*it**�**�**atx��*�*�at�*****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
1E if if 1E iF 3E iE 1E fE iE iE IF 1E iE fE fE 1E 1E IE iE 1ElE 1E 1E ik 1E iF 1f if 1E iE if 1E 1E if iE IE 1E fE iE iE 1E iE 1Elt 1E 1E 7E 1E iE 1E iE 1E iE 1E iE if iE iFlE 1E 1E if 1E iF iElF 1!!F 1f 1F iE iF iE k if �f 1E iE
D E V E L O P M E N T S E R V S C E S R E Q U T A E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED HY : - . DATE:
APPLICATION ISSUED BY: ^ ��'� DATE: ( �j�
�tx��t********f[�***i�*i�it�t*�tTf7FiF7FiF'iFiFiF'3F7F7FiF'iF7FiFiFif �FiF'iFiF7FiFiFTF�FiF3F7FiFiF*x�**+�***+ti� *+t
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 269.45
SOR SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 269.45 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECIiANIC
284.45
TOTAL PAID DUE
284.45 284.45 .00
284.45 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
iE iE fE 1E iE iF �E iF iE iE iE 1E 1E fF iF ik 1E iF it IE M 1f IE 1f fE 1! i! k it iF it iE it if 1E iF if iE it 1E iF ii 1E iF if k 1E if iE 1E 1E iE iE iE iE it it iE it iE iE iF i! iE iE iE iE it if iE 1E it iE iF iE 1t ik 1F 1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N ONIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15.00
ELE 342 FIXTURES, LIGHTING ADDITIONAL EA. .45 153.90
ELE 10 RECEPT/OUTLET 1 ST 20 EA. .75 7.50
ELE 140 RECEPT/OUTLET ADDITIONAL EA. .45 63.00
ELE 20 RECEPT/SWITCH L ST 20 EA. .75 15.00
ELE 9 RECEPT/SWITCH ADDITIONAL EA. .45 4.05
ELE 1 SUB-PANEL 11.00 11.00
END OF FEES
OI �Jy�_"_�-.rP:i;:,�5 � e.��
JATE: !:,�.j�,..� Tj•'t• ; r...1
.�
' �C6NSTRUCTION�ANO PIANNING � � & SPA ,
�
APPROVALS Permit # Date Inspector pppROVALS Permit # Date I�spector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steei Reinforcement
3. Electriwl Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Coriduit�Undrgrnd. 55. Eiectrical Bonding
3
5. �Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electric3l UFER Grnd. 57. APPROVAL TO COVER-GUNITE
J. Footings , 58. Electrical Conduit�Undrgrnd.
- 8. Poundation - � 59. Gas Pipe, O Undrgmd., Test
9. Water P�pe�Undrgrnd. i - 60. Backwash Lines,P•Trap, O Undrgrnd.
10. StrucwraF Floor Svstem 61. APPROVAL TO DECK
7 7. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer CaP 63. Heater & Ven[�Final -
13. Roof Drains 64. Plumbing System - Final
74. Rough Plumbing ' . � 65. Electrical-Pinal
15. Rough Electrical=Conduit 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. FoughElectriwf�T 8ar Ceiting 69. POOUSPASYSTEMS FINAI
19, Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT . .
20. Rouqh Gactory Fireplace - . �, ' . � AppROVALS. � PermiY# � . ,
27. Ducts, in Structure , � ., � 70. Underground Hydro
22. Ducts,Ventitating ' � 71, ProducTPipingOGas 004�
23. Gas Pipe-Rough & Test ' • , - ' ' 72, Undergrovnd Fiush ' . .
24. floot-Framing �� - � 73. Undergrnd. Storege Tank � Gas ❑ Oil
25. Roof Sheathing . � ,� 74, Overhead Hydro
26. T-Bar,Ce�ting (Structural) & Monocoat . 75.. Dry Chemical
27. Frame and Flashing � . •- 76. Dry Staridpipe ` -
28. Lattiing & Siding ' � 77,, FIXED SYSTEMfINAL .
29. Insulation- � ' 78. FIRE PREV. FIPIAL
�30. Drywall Nailing : � HEALTH DEPT. RE�UIREMENT
37. Plasrer Brown Coat � � � 79, FINA� INSPECTION .
32. Electric2l.Power Meter-Final ' �80'�FOOD CERTIFICATE ISSUED
33. Final Electric y �.,� Notes: _
34. Fina(' Heating & Air Conditioning ' '�� � `�
35. Final Gas Pipe�Test • � � '
36. Hood or Canopy � , ' - - ._� � � . r ' ,
37. Final Factory Firepiace - - � � � �
' 38. Pinal Plumbing - �,
39. Water $ervice-Finai � � � , � � _ - -
40. Gas Service-Final � ' - ' • � � ' '
�41. Solar pomesticFinal: • � . � _ . . _
42. Backflow Preventer ' - �
43. Backflow Irrigation ' . • . � � �
44. LandscaPe irrigation System � • . ' . - �
45. Sound Attenuation " , -
46. Handicap Regulations ' , . � �.
47. FINAC SiRUCTUAE & BUiLDING �
48. FINAL PLANNING ' ' * � � ' ,
49. Electric Release to Edison " �
50. 6as Release to Southern Califomia Gas Co ` . � � ' ' � . �
51. CERTIHCATE OF OCCUPANCY
No. Date
�ooxessaem�ara: SSS ANTON BL 01Ti 12TH CITY OF COSTA MESA — BUZLDING PERMIT
°""E�xs""'E"'wor'": SAKIOKA FARMS PERM NO: P 075073
�oo�ss: p0 HOX 2097
�� TERMINAL ANNEX PERMIT NO: P 075073 PLAN CHECK NO: N GOVT: N SUPP: N
��vr�.wuuxo�ooxeu: CONSTRUCTION TYPE: 1—FR PERMIT TYPE: PLU PURPOSE: ALT
APCNRECTORFNtlNEEN: INTERIOR ARCH 2136232164 "`�N0' 9378
�, MCX.OPFlq'S�OOHESS: SSO S HOPE °� 1100
L.A CA 90071
C01^^�TOR'g""� CONTINENTAL PLUMBING INC ( 909 ) 360-8300
caxmacraxsMuuno 11165 TAURSTON LANE
�� MIRA LOMA CA ��� 399073
91752 uNr:
LICENSED CONfRACTOXS UECL�XATON: I hereby eflnn unEs paroly W perjury �htl I em IceiueE uMer prwieions W Chep�ar 9
(mmmeridip xiih SecYon IOW) a�+aion 3 d Ihs B�sirom vd Prolxeiona Code. eM mY �s u in lull brca eM ellatl.
cmuc.no.:027563 10Q� C 36 3 0 P: 09/96
��e ' � — �' — �.�] c«�o-w ' -
'�Efl BUILDEN DECLAFATION: I Mmby af(rtn under penety d pa' �IW I un ewnq Imn the ConireGon liroroa lew la Ma
.lawvq roeson (Seaion 10�1.5 &reiwsa vd Pm/eeaione Cotle: rliry c counry xhid re�uirea e pemin io mnawcl. eller. impare.
IEemd'nh. or repei vry aWcwn, pria b n awenn, eho mqwes tM apqimm 1« aud� penM �o Ne e eq�wd eWareN thm he a ehe
is IicemeE WnuaM lo Ihe pwisiona d ihe Convmora �imme Lew �Cheqer 9(cpnmeiviiq xilh Satlion IOW) d DNiion 3 W �he
Buainen vd Prdeabu Codel ar ihm M n ahe b exemq therelmn arM the bm� b Na elka� �emq'vn. qm' violalian d Seeion
]031.5 by enY aPWicent fa e perm4 wbpds tM epplicarq �o e tivd pe�ulry d M more Ihen (ne hurMreE Eollen ISSW�.
� I. es ovmer W �he poperly a my emWryees wih xapaa m ihai We mmpsnaetion. w� Eo IM wwk. enE the munuie e ria iMeMed
who WiM a mprwea tne�em. eM Mn tlo� sucn xak IvveO a henell « Wwph hc
improvemenM ere nol in�eiMeE a Werad la aeb. tl, howewr, IM buikirq a anprwemer
owrorauuex rno neve ine eumm u pwup ne « ene aa mi dw « unpmro �« u�e purpoas a ub).
❑ �. e. owm, w �ne vwaM..m ��h �ver,:y .w uron.sa oo�uma. io wnow ub c'wsa (s«,in, �a.. a,.�r�. d,a
Pmleabm GoOa: The Camrada+ l"smm law doea ia epply b en owner d popeny wM buiids a impwm Iheiaon ud x1a
mmrecn M wrh pqeda wiN e mMretlor�el Iicen�eE punuem to tM Contretlm Lioeme fewl.
❑ I am memq under °wciion: 8. 8 P.C.. tor tha �sum:
Dele: . ... Ownx:
I da Mroby ceniy Ilw I em ewere d erA �MenteM
z553,.enE uWla eny Mura Wikiiq oou�peeu will,
WOflKER'8 CONPQlSATION DECLAP�TON: I Mroby eMum u�dr penelly d per�ury ma d �hs followiip Eetluelbn�:
� I Mw uW wil maim�n � cMil'sets d meem to �eMtimun br v.a�kri eomqnWbn, m pwidsd lar by 6auion 3)00 d Ih� leEa
JCoM. la �M pMmvrca W N� wk la wlich Nis pemE u IeueE.
�A I hev� eM wiE meinlem waM�i mmp�melian inwrerca. n rapuind by SWion a)00 d iha LaEor Code.lor tM peAormeMs d Ih�
\wwk /a whid� Nis pamin u muW. My walwn' mmpwwlion imurerca raeelar end pW.y wm Wr ua:
c�.,: rnin EXPIRES
°di�'"°'""" 103�1940235 07/O1/96
�tn;, ..e� �e.e �or n�d.�w, w w�+�* o ro. o�e n�m�w dood.ls,00l o. iwa
� I ce�ty NN in Ihe perlmiunc� d iM work la xhk� �hb '' , I tlWl rw� �mpby ury psirin in �ny menner o u to
becoms �ubpq �o iM Mo�Mr�' mnpwaion law d C ' p thu ! I k becpn� ubjoq �o �M xoM1ari
mmpenW bn pim�iebn�c -d �Setlion �10p d iM Lebar CoE� hell l �wn '
�oe�e�.� i, ��" —1.-7 noW�m.
�W�w�p: F�llun ro��cun wort�ri mn�oxwtlon cov�np� l� unl ,�ntl �N/I �ubHct en �mployx fo eHMrwl p�nslUu entl
eroa nn.. w ro m. nindr.e enou,.M do�l�n fJioo,aaoA h.m�don ro m. eo,t o� ronp«u.tkn wn.w. u poHe.e ror �n
SxHon 9)p5 0l M� Le6or Cotls, /nNns4 antl ettom�y'� /�u.
CONSTIiUC710N LENOIN4 ROENCY: I hmaby elfiim �nder penelry d perjury ihel ihae o e conel�udion bMi�p par�cy br Iha
p.eo�meno. a �n. woM �« wnidi ma rom,� a eauae (s.e:xi a081. civ. c�.
LENDEN'9 NMIE:
LRlOEP'4 AUDNE54:
I cenMtAm I heva mad ihe eodice�bn eM ams �Mt �he ebwa "udamwian o mrtee.l rone io romPN wnn e� ci1Y eM couMy aEmenoes
uM slele lews relelinp to Wikap wnMrutlbn eM AueEy eNhorrzs reyauntelivp d Ihia c1Y a m�er upon IM eEo.•a.menluned popeM
la iropedan purpmea. �
/ �
`(5t51i6.WP)
Dme I � —
While-B�ilCip d Sffiery; GreerFJa; Cerury-ADV��: Pink-Revenue; OOltlanroFNunn
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI
CLAIM VALUE:
CALC—VALUE:
SQ FT:
GROUP OCC: H-2 /
COMMENTS: 76 UNIONPRODUCTS REF: 8-75006 " THREE ELECTRIC WATER HEATERS"
****+�+��****+�*+�**�*�+�*+�*� **�� ��+�x+�+�+��r��*��*�**�**�**+�**+��****��*��***�x �*��***�*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES> tf�
i
1E iE iE Ik 1F iE if if if iE iE if ik iE 1ElE 1k iElE iF iF iE jF if if iE if if !f iE 1E 1E if iE 1Elf iE 1E IF if !f iE 1E 1E 3E iE 3E,fEfE aE iE iE 3E iE fF iE 1E 1F iF 1E iF iflf if iF �E iE iE �E IE fE jE IE 1E fE 1E �E 1E 1F
D E V E L O P M E N T S E R V I C E S �� R E Q U I R E M E N T S
ZONING APPROVED BY � DATE:
BUILDING APPROVED BY : % .�i DATE:
APPLICATION ISSUED BY: �'. f��' DATE: �
iF�EfElEiE1ElE1E�ElEiE�E3EfElE3EIEIEIEIE3E3EiFifi%�3FifiFiFiFiF�if7f3fiF �f�f3F�f3f��f��f'i����F7F�f�FifiEifiEjfiElEiE3EiE iFif
LEGALIZATION:N F E E S O M M% R�� STRUCTURAL S GMENT:N
BLDG PMT PLUMBING ELECTRI,C MECHP;NIC' FIRE SMIP/RES GRADING
PERMIT 70.00 " '� r�
25$ .r^ ^ -ti N �-" � SMIP/NON—RES
PLAN `%j ,!` ; � " .'"
ISSUE FEE 20.00 " -�" �� •�
BUILDING—DIV—> PERMIT ISSUE PL'AN=CHECK� TOTAL PAID DUE
TOTALS----> 70.00 20.00 ��,0'.00� ' 90.00 90.00 .00
�,+
REVENUE DIVISION TOTALS--> COLI;ECTED,: � 90.00 OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC i F,IRE �^SMIP/TOT GRADING PLAN—CHECK
90.00 : � ^ '/°1 -�.
., ^
� '1
iE 1E �E 1E IE iE jE 1E 1E 1E 1! IE iF iF 1F iE iF 1E 1E 1f 1F 1F iE fElf !E if If if iF 1E 1F if fF iF 1f iE IF 1F 1E �E iE IE.1f if�lF 1E ikl6 if.lE 1E ik 1E * 1E 1E if �F iE iE iE if 1E 1E iElElF dE iE iE iE 3E iE 1E iF iE ik iE
I N D I V I D U A L� yF •E �— B R E A K D O W N
n
TYPE QTY D E S C R I P T I O�N � � UNIT COST TOTAL COST
PLU 1 SHOWER ,' � Y 7,00 7.00
PLU 2 SINK, KITCHEN ' �^ 7.00 14.00
PLU 1 WASH HASIN ��, � 7.00 7.00
PLU 1 WATER CLOSET (TOILET) � 7.00 7.00
PLU 3 WATER HEATEA AND/ORj.VENT� �� 7.00 21.00
PLU 1 SINKS, FLOOR ^ 7.00 7.00
PLU 1 REPAIR/ALTER DRAINAGE/VENT PIPING 7.00 7.00 /
END 'OF� FEES
•� n
/l �� / /�
�� ! � �i� �c:�s --_ -.3v� � _��' '>c.�a
�i i , Ca'�e �i'��, S'� .r:r".__ — .
"_�,.: I
�
���.CO`NSTRUCTION AND PLANNING
APPROVALS Permit # �
1. TemDorary Electrical $ervice or Pole
2. Soi� Pipe�Undrgrnd. - � -
3.` Electrical Conduit-Utility-Undrgmd.
A. Eiectrical GonduibUndrgrnd. -
5.'Steel Reinforcement
'"6. Electriwl UFER�Grnd.
" 7. Footings � .
i
8. Foundation �
9. Water Pipe;Undrgmd. , �
70. Struttural Floor Syscem
17. Property Sewer Line & House Connection
12. Sewer Cap . � �
13. Roof Drains ' -
74. Rou9h Plumbing -
15. Rough Electrical-Coriduit %
76. Rou9hElectricWiring �
17. Rough Wiring Sign
18. Rough Eiect�ical�T Bar Ceiling�
79. Rough Heating & Air Conditioning
i -
20. Rougti Factory Ficeplace •
21. Ducts; in Structure . � � ��
22. Ducts, VentilaYing . -
23. Gas Pipe-Rough & Tost '
24. Roof� Framing" � '
25. Roof Sheathing '
26. T•Bar'Ceiling (Structurol) & Monocoat
27. Frame and Flashing . .
'28. Lathing & Siding � ' �
, - ,.�
29. Insulation . . . •�
30. Drywall Nailing �
31. Plaster Brown Coat.
- 32. Electrical�Power MeterPinal
33. Final Electric - .•
� 34. Finat Heating & Air Conditioning ��
35. Finai Gas Pipe�Test � �
"36. Hood or Canopy ° - ._
,37. Pinal Factory Fireplace .- � -
' 38. Pina(Plumbing � - � �
39. Water Service�Final.�
.40. Gas Service-Final - ' -
' 41. Solar pomestic-Final' '
42. Backflow Preventer
0
43. Backflow Irrigetion , . � '
44. Landscape Irripation•$Ystem . � _
45. Sound Attenuation „ � :. .
46. Handicap Regulations _ �
47. FINRi STRUCTURE & BUILDING
48. F1NAt�. PLANNING ,
49. Electric Release to Edison
50. Gas Release to Southern Cali(orniaGas Co
51. CERTIFICATE OF OCCUPANCY
Date
Date
� � & sPa ,
Inspector �
APPROVALS Permit # '
52. Pooi & Equipment Location"
53. Steel Reinforcement
54. Forms •
55. Electrical Bondi�g
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, C) Und�grnd.
67. APPROVALTODECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final .
64. Plumbing System - Final �.
y
65. Electrical-Final �
,
66. Solar System�Final '
67. Fencing & Access Approval
66. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFtNAL
. FIRE QEPT. REQUIREMENT .
. - � APPROVALS� , Permit #
Date � Inspector
70. Underg�ound Hydro
77. Product Piping C1�Gas COiI
72. Underground Fiush '
73. Undergrnd. Storage Tank �O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical � � , �
76. Dry StandpiPe -
77., FIXED SYSTEM FINAL ��
78. -FIRE PREV. FINf1L � � '
' HEALTH DEPT. REQUIREMENT �
79. F�NAL INSPECTION
80. F000 CERTIFICATE ISSUED �
Notes:6�.-% -9< � i .,,,. ,,,----_-. ,-.,
r �
.
�
�
�ooxessa em�dxc: S S S ANTON B L
NERSNWEIFRYMM: SAKIOKA FARMS
. "°OflE�' POI BOX 2097
TERMINAL ANNEX
�. �uiwc �sf
UNT:
12TH CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: M 075070 PLAN CHECK NO: N
CONSTRUCTION TYPE; 1-FR PERMIT TYPE: MEC
""�""�T0"B"a'�'` INTERIOR ARCH.2136232164 �BNO= 9378
�xatoxe+�•smoxEss: 550 S HOPE ST °Ni' 1100
L.A. CA 90071
���T�"� AIR CONDITIONING COMPANY (818)244-6571
cam�ctoxs�uiwc 6265 SAN FERNANDO ROAD
�o�� GLENDALE CA ��= 120696
91201 ��:
ucwseo conrnacrons occunenor+: i ne�.M .n:m aw.r �wy d� mn i.m rwn„e �o,ee, awie�a„ d cn.qa s
(�mer�q wilh Seclian 1000) W Oivoion � al i�e Bupmee enE Pmlaeeom Code. vM mY �� a in lull lace vd eHea.
cmuc.No.:0149c03 "�"^gg C 3 N0 12/0/§�-/6� EXP; 07/96
Dme: �� � � /r �qem�� /�•%�.�.1
VNEP BUILDEfl OECIANATON: I hareby elfirm uMer pwly M Po�N�Y �� � em e�emp tmn i on liceme Lew /a Na
nv.n9 reamn (Setlion )W 1.5 &nnefa enE AWeffimf CaEs: MyW a opmly r.hidi n0u'um e Oe�G lo mnWtl. eQar. nWa*.
.,emdsh, a repei eny elriwYure, pria to ne eaerce, e6o iequim� Ihe epplimnt lar euch pemin io file e vyned e�etemenl Nal M a aM
b licensed punuenl Io IM prwisime d tlw Conveqas limme lew ICheqr 9(oommand�q wnh Saqion'l000) d Orveion a d Ihe
Buzrbss enE Rdeaiwu Cadal a ihet M a eM u eaemp �herMmm end ihe beam la IM elbWd ewmmqion. �m'vioW on N Sea'vi
1031.5 b/ eny epplifant la e permil wbjeqe Iha epplicanl �o e civil penelry d na m«s Ihen /Hs hurdreE do14n �fSW�.
� I. ea awrnr d IM propMYa my empb/w x'vh wapm n iMi wN mmpe�ueiion. Wldo Ns wvk. end �Ip at�ucfun e na iMeMaE
or oMered Iw e+la (Section )000, Busiiwm end Protenbne Cade: The Con�repon Liomea lew Ewe not epplyta en ownar ol popeM
who bulEs a inV� IMrtm. eM who daee such v.wk h'vneell a MnM n Waqh hif Or Mr own smDbY�a, pa'� Ihe� vuch
improvemmp ere not imerded w dlned la ede. M, howe�er, iM Witlirp ar inprv.emem u eoN wnhin aw yeer d complMion, iM
owror-buiWar will heva IM Wrden d provinp �e or ehe dM nd build or impm.e la iM puryosa W eele).
� I. d amer d Ine prapeM. ��duvrey mnireaiq wilh li�anesd oonlrecton m cauvua tM propq (Seqion ]Oa�. Buei�wea arM
Pralessione Cotla: The Contrenwe License lew doee na apply to en owner d properly who bulNa or Impovm �heraon arM wlw
�{ wnlrecla la wM yqMf wilh e conlrada(e) IceneeE p�nueM lo IM Con�retlors Litsnse lew).
u I am exempl under Senion: 8. 8 P.C., lor �his roeaon:
Deie: Ownx:
I�o hareby cenM � I em ewua al vW uMeniuM iM ��iremanb ol Cellanu HSMh uM Sebiy CoEs Seeiom 25so5. usv. enE
25594, enE Ihet I m eny Mura builEiip ampen� will / wYl na (drcle me) nsed lo comply wIh eeiE ate�e mEp eM �M requinmenb 1«
epeminlormneVucUonamodifimiionhwniMA'r ue�0i�iy enapemsniDiYrid.FwiAentielm�wrvr�ionappicetiwroarswmqlromtlrove
povivone.
Dele: MplceM:
WONKEfl'S CONPEN9�TION DECLAP�TION: I Mroby elfirm uMar pa�uXy W pe1jury ms d Ne Idlowi�p EaWations:
� IheweMwilma'v�tanecenifinedmneeruioeeMimurolorworksn'cpnpanwbn.nprovidedtabySecamJ]OOdiMlebar
Cotla, la iM parlamarca ot iM wak Iw wNch thi� parmn i� iuusd.
'7 � nm. ene .0 m.im.� w�en� mmw�mo� �ro��.iw... �.a�h.a W swo� mo a m. taee. eode. e> �ro o.dom+.nm a m.
work lor whitli �hn permil is iauM. MY waknri compenulion in�urenca unbr an0 policy numM ere:
c,m..: rnn�TrtiFtiTnr. rna EXPIRES
PdicyNumbr: IdS 30 a52 ^Q QS 10/01/96
(ihu xtlibn nas0 rwf bs cam0�� ) Ns 0'M�T u M w» /wnd�s.i dtlWf �SIOV) b leasl
❑ i mnh mm m u» vMmnenc. a me w«x i« wnicn mu w�n i. u.u.a. i.nw �a .mWw �r v� m.�r m�., .o a. ��
beconr wbjetl lo iM xakmJ wmpauetion ler.i d CeGmiis, erq epis Ihet Y I e1nWA Eecpm abjq to iM xaM1ae'
cwnpeneetion porisioro d Setlion 9]00 d IM lebor C/ode. �I )IIlo�hrril� mmpy xiN t/lcp qwbbro.
Deta: ��� — C�' J� /Aµ7wp: � � �f/����
W�n/ip: F�Nun ro Wcun woArw�'rompwu�tlon c�V�rap� l� unhwNl, �ntl �IWI u!/cf �n rriployw roYi/M�ul paWtlu uM
e/Hl flw ,p ro an MntliW MousuW tldlvs ftICqG00A M�ddltlun ro M� cost ol ro�doA d+rryp� u provMM br In
S�ctlan �1P6 0l Ms l�Dor COW. InM1nst. �nC �ttumry'� Iww
CONSTIIUCf10N LENDINO �OENCY: I hweby tlfi�m �me, c.�.ny a p«wy in.� m.. o.�mNeo�, i.oa� ,a,My r« m,
paAortnawa d �ha woA iw xfiiW Ihe permi u eweE (�� �]. CM. GI.
LENDEX'S NAYE:
LENOEP'S ADDPES9:
I carlily �hq I heve meC �hia epplcvion uM etms ihai Ne ebove inlamdun la conap. I ep�sa lo camply wilh all tlly eM oounry adi�Kae
eM etale bws mlei'vq to buJEip mnwueion end Mreby eWprhs repmantetivae d tAu tlty io eeux uµm IM ebow-meMiuwtl pmpxy
fpinspatlion ptrcpoaea.
LOUIS RODRIGIIEZ
Ume; ��� � �!
(5151��a WP) WhnrBuildip d Sdey; OreerrFle; Cenery-AOM�l Pink-Ravenue; aWdenmd-6eveeeor
JOB DESCRIPTION : LEGALIZE DEMOLITION WORK
CLAIM VALUE:
CALC-VALUE:
PERM NO: M 07507
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT;
GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74706
*x�***�i�*******+�**+t*f�x�+r*�rx��-+tao-+t*******x���*************��*�x�******x�+�***�r****�*�+�ic-*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
� ' /
1E 1E iE 1E 1E fE 1F if 1f if 1E iElE fE 1E iE iE 1E fEl6lFlFlf 1f 1E if iE iF iF iE iFlk 1E 1E 1E i! 1f f(� 1ElElE 1ElE 1E iE IF 1E 1E IE 1Flf 1f IE 1E 1E 1E 1E 1E fE iE iE iE iE iE 1E iE if if 1E 1F fE 1E iE iE if �E fE fE IF
�;� D E V E L O P M E N T S E R�V I C E S R E Q U I R E M E N T S
rZONING APPROVED BY /1, DATE;
;BUILDING APPROVED BY : i,�'! DATE:
-}� � ' �/ 1
�kPPLICATION ISSUED BY: �� DATE: �� l C(�
1E�IEiE1EiEiE1E1E1E1EfEiEiElElEiEiE1E1EiE1ElE�3F7F7F�F�F�{�if�fTfTf���i����� 3F�3F3F'��{FjEiE1f'IEiflfif181E iElE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 'f 88.50
� ,{ 258 SMIP/NON-RES
PLAN
ISSUE FEE �` i .� 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE
TOTALS----> 88.50 15,00 •'0.00 103.50 103.50 .00
l\
REVENUE DIVISION TOTALS--> COLLECTED: 103.50 OVER/SHORT: ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
L;09,. 50
3E iE iE iE iE IE IE k 1E k 1E iE fE fE if if iElE iE 1E 1E 1F 1f 1E iE iE 1E iE k if iF �F iE tF iEJt it iE iE it 1E ik iE iE if it iE k ff �E 1E if iE iE k dE iE i6 it if 1F iE iE iE 1E �)F iE iE 1E 1E k iE iE iE if if iE iE iE
I N D Z V I D U A L� F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O,�N UNIT COST TOTAL COST
MEC 6 VAV BOX n 6.50 39.00
MEC 9 FZRE DAMPERS -� 4.50 40,50
MEC 1 INST/REL BOIL/COMPR' 0.0 - 3.0 HP 9.00 9.00
END OF FEES
���' .
ol Uaiy,ME-c:iQe�ba -�;la� •17J,5U
DpT'c� 11;n.r�� Tj�;,L� �(�.:YU
m . . . - .v . . J .
. T' '__'-�s.�..... 'y'
� t . :'� -... �y .:w
CON5TRUCTION AND PLANNING - � F _ -$ SPA '�- ' '-" � _ � � -
APPROVALS Permit# - Date Inspector �� AppROVALS Permit# Date fnspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' .
3.- Efectrical'Conduk Utility-Undrgrnd. 54. Forms
4. Electrical�onduit:Undrgrnd. 55. Electrical Bonding .
5. Sieei Reinfo�cement 56. Rough Plumbing & Pressure Test
6. Eiectriwl UF,ER Grnd. 57. APPROVAL TO COVER-GUN�TE
7. Footings �� ' 58. Electrica� Conduit�Undrgrnd.
8. Foundation - 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � . 60. Backwash Llnes, P Trap, O Undrgmd.
70. StruMural Floor�SYsrem � 61. APPROVAL TO DECK �
t t. Property Sewei Lin� & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap �. - 63. Heater & Vent�Finel
13. Roof Drains , 64. Plumbing System � Finai
74. Rough Plumbing- ' 65. Electrica6Final
15. Rougb ElettriwbConduit �� 66. Solar System-Final �
76. Rough Electric Wiri�g � 67. Fencing & Access Approval
� 77. Rough Wiring Sign � 68. APPROVED FQR-PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOI/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning �,y�p _ FIRE DEPT. REQUIREMENT .
// 4 �
20. Rou9h F�dory Ficeplace .�,' - . ; APPROVAIS � Permit # _
21. Ducts, in Structure ' � �• ' ' � ` ' 70. Underground H3�dro �
22. Dutts, Ventilating - '- V�. 77, product Piping � Gas .('-".i Oil
23. Gas Pipe-Rough & Test . - • , 72. Underground F�,Osh
24. Roof Fram�ng ' `" � . .: 73.� Underqrnd `Storage Tank O Gas ❑ Qil
25. Roof Sheathing � _� ' 74 Overhead HVdro
26. T-Bar"Ceiling (Structural) & Monocoat + , � -` �. 75. DrV Chemicat � , � _
27. Frame and,Flashing - • c+ 76. Dry Standpipe �- �'
28. Lathing & Siding ,�, _ ' � , � • ' '�' 77. FIXED SYSTEM FINAL . . ,.�� �
29. Insulation ' 7$, FIRE PREV. FINAL �
30. Drywall Nailing � ;� � . . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat� �' + -, 79. FINAL INSPECTION
32. Electrical Power MetAr�Pinal .� �� 80. FOOD CERTIFICATE ISSUED
33. Final-Electric, � �� _ , Notes: /-�?_�T � � 8.7j-G�.-
34. Final Heaiing & Air Conditioning � =��c, �`��- ,�J�Bj, � '
/ sl:�"
35. Final Gas Pipe�Test �� � • � -•� ,. - -
36. Hood or Canopy ' - •
- 37. Final Factory Fireplace ' � � � + �
.
38. Final Plumpinq � ' _ - � � , . , _ '. ;
` 39. Water Service-Final � � � � � , �
40. Gas Service-Final ' - • ' - " -
41. Solar pomBstioFinal - . ' �
42. Backfiow Preventer '
, - .
43. Backflow irrigation - '" , - �
44. Landscape Irriqation System � "' � e;, . ' ' , � '
45. Sound Attenuation �, . � � , � � . �_
46. Handicap Regulations • _ • � - .
47. FINALSTRUCTURE&BUICDING . � � , ,
48. FINAI PLANNING " � '
49. Electric Release to Edison . • , y. _
50. Gas Release to Southern Calitornia Gas Co - ' '
51. CERTIFICATE OF OCCUPANCY ' `
No. Date
_
�I
�
�
�nnxcssaew�oo+o: 555 ANTON HL
axxEaswu�eica�wm: SAKIOKA FARMS
. , mox�u: p0 BOX 2097
TERMINAL ANNEX
n.sw•nnizn,�r.���a
IqCNIfECT ON FNfINffA:
1NCH OH FNO.'4100RE53:
��T 12TH
11G N0:
UNf:
cam�crars�: SOOTHWEST FIRE PROTECTION ( 818 ) 359-0034
cam�croxs�uia+o 215 E EL SUA ST
�oo�ss MONROVZA CA uc.wo: 190173
91016 urn:
LICEN4ED COMP�CTOpS UECL�FATION: I hemby ellim uMw peiuly d pv'ryry tlW I em licensed uMm pw'vcne d Cheqx 9
(oommenarq wilh Seclion ]000) d Divieion � d ihe Buei�wn eM Pmimeime Code. eM my limme ia in IuA /wcs vM aMed.
cmuc.No.:013054 uacuss: C 16 uc.No.- 19(Y17, EXP: 04/96
od,: //-/3 - 9s ��,�� � ��
WNEN BUILDEN OECIARATION: I MreEy ��m uMer penely d perN�Y �� I am emmq Irom iM Comreaan Licenes lew la Ms
Abwiiq rseeon (SeUion ]091.5 Buavwss end PMeasbne Code: Airy cN a counry which requiree e pmmN lo awutiucl, eller, impove.
dsmd'n�, n repai eny ev�cNn, pia w ba ewence, ebo rt�uirm ihe applirant la wNi parmu �o fib a sqnad eiatemeni HW M a�M
ia licanaed W��� �a �he yavian d �M Conlredore limnae law �Cheqer 9(mmmeminp ��n� Senion ]OW) d �Muion 3 M tb
Busineve end Proleuona Code� or Ihel he a eM ie examq therehan enE �he Ea9c la Iha dlepeE ezempton. My v'olelon W Sepon
]031.5 by enY aDG�� �w e permn wbpae IM epplieenl to e mN panelly d nd mwa then fna hurdrad ddlaee �55W7).
� I, ee ovmer W Ihe properly or my empbyeee wYh wepee ai Ihei eale mmpemmian, xill do tM xwk, end the evunuro 6 m� intardW
a oMered lor aela (Seclion ]0<6. Bueineea end Praleneiom Coda: The Coniredon Lioeme lewtloea iwl epply lo en owrw d propMy
wla WIAe or inM� Iheieon. md Ww Eoee euch work NmaNl a Mner or NrouW ho ar M oxn emVbr+. V�b �hm wrli
impmvemeM� ere nN inierdM a oflaeA la eab. tl, Mwever. �he WiMiip or inpwwnam ie edd wi�Ain aw yaer d mmplui�n, tM
owner-buiWer will heve ihe WNen d proviip he w ehe dk not build w im0� �a Ihe WT�e d eele�.
� I. n o�wwr d ihe V�waM. em atluwelY aoMrednO xM licm�etl canlrecias ro camua Ow pula (Swion loU. &ninr� eM
PMevion. Code: The Contrmm L'cenx Lew dose iwl appy ro an owrror a prapeny wM buld. n impov« Ihrwn enE who
convecn lor wM prqeds xilh a awuretlor(e) liceneed Wnuw to tha Conireqon Liienea lew�.
� 1 em uemq uMar Senion: B. d P.G.. tar Ihia ieemn:
I po h«aEy cruly tlW I am awus d vd wMenuM Or npui�emema d Caliamia HWIh and Sdary CoEa Ssqiom 25505, 255JJ, md
2555a, anC Nq I a ury Muro Wikinp ampam xill / wil ewi (tirtb wr) need to eamply w1� eotl eWs ooEas aM �M �puimmanb br
eVe�/amruWctiannmodifiWionhomNeAi e�y anepemaMD'atrie.Re�Eeeuielmm�ueioneOVkmiomuse�emphomNre
>a,�.�,..
Dele: ApWiuN:
WOFKEN'4 COYiFNSATION DECLIR�TION: I hersby aHum uMm penelly M pajury ane d ihe Idbwiiq Esde�etbm:
� IhevaaMWmeiruenecanfiutedmroenlb��tlimu�aMwahen'compeneuion,nprwidWlnb�SaeqnJlGOMtMlebar
COM.Ia iM palm�anca d Ns wik Iv wHch Ihie pemE e ivueC.
� in�..�e�;��m.�..o�w.n•�v��,���..mna�o-sabrs.a�a�ooam.i.no.cm..r«m.w�wm.�o.am.
. woh lu MiirA Ne W�� u mud. MY wabn' mmW��ion ifwrancs umer end W�/ rwmber vs:
c.m.�: FREMONT EXPIRES
aa� N�mw: 0 6/ 01 / 9 6
(iNn veGion meG rrot M candmed / tM O�X b iw orn hurMred ddWe /JtP01 ar bn.)
� I anAy Nq in Ihs p�immerce d IAe work la whch thro Po�a is ipuetl, I ehell M employ any preon in eny mennu �o m �o
beemia wbpr io iM xoM1se' eampenwbn �ew d Ce4tomie. peee Net ' I Nouk beeam vibjrf io �M xvbn'
compen�elion pwiviam ol Seubn 3100 d ihe leEar Coda, I ahdl h h 1�,o�'� viom.
od.: // /3�'iS �op�: � //�!/���
WeminO� Ftllun ro�wun wodx�' comp�metlon rovsrp� b unlawN( antl ilWl �ub�scf en �mplayvr ro ctlMiul pxuMu mtl
e/v/l nriu w ro on. nunarM rhouHna EWYn (St00,0001, �•���n ro M. ewr or compwwtbn, Wrrup� u proHtlW ror In
Sxtlon J106 0l tlro L�DorCOW, InlxuS end ettom�yi /su.
CONSTNUCTION LENDINO �OENCY: I hereby eHrm uMx penelry d perjury ihei IMre u e conatiudion IaMiip epaMry la Uw
perlormeMa d �M wM la Miich ��e pmmi u'vaued (Seqion �091, Crv. C).
LENOER'9 N�ME:
LENDEN'S AUDflE53:
I cenih �� I heve reeE Ihia epplicmion end me�e ihei tha ebave inlpmelion is mrtac. I egrea to canpty wnh ell ay eM ooumy oMinemee
erdslnbkx+m O�oWiqipwnavuepneMherebyeuUaraarepreeaniaiivead�NadlybeMmuponiMebo.e-mentionsdqoperly
la impeaun �
2
i vnv wm.
� /fii--r-�- o�,: i/-i3=9�
pmturo d Ow�w/Pqeru/�ppiranUCmlrqa
(515t<fi.WP) WMa-BuJdip 6 Sdety. GresrFb: Cuw���ppfra�: Rnk-Revenue:OotlenmE-Asmm
CITY OF COSTA MESA — BUILDZNG PERMIT
PERM NO: F 075149
PERMIT NO: F 075149 PLAN CHECK NO: 04043-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: i—FR PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : RELOCATE FIRE SPRINKLERS SQ FT:
CLAIM VALUE: 12,400.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF; B-75006
x�*i��-*rt***�****x�**�***+r************��*****�**��*�**�*****x�*�t*****+�*+t********�***
Z O N I N G R E Q U 2 R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 91050109 ZNE: REF NO:
PLANNING NOTES>
i
!f iE 1f 1E iE iElE 1E 1E 1F 1E IE fFlE 1E 1E k 1E iE 1ElE 1ElE 1E 1k iE fE iE iE 1E iE 1E 1E �E iE 1E iE iE �E IE fE 1E 1E iE iE 1E jE 1E fE iE �ElF iE 1E 1E k IF fk 1E iE fE iE fE iE iE IE 1E iF iE iE iE 1E 1k 1E if if ik 1ElE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: VT�L DATE: �I �J �-1
if 1f 1E if 1E 1E if �f iE iF if ±E IE 1E iE'lf' 1E 3E'� �E IE 1E�F3FiF�iFTF3FiF7FTF�F3FiFiF 3F3F�FTF TF7F�F 3F iF3FiF �F�F iFTFSf3F iE 1E'1F'1E �E 1E IE 1E iE 1E �IE iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
�� ��
HLDG PMT PLUMHING ELECTRIC•�MECHANIC FIRE SMIP/RES GRADING
PERMIT �„ 144,00
65t SMIP/NON—RES
PLAN � ,.;� 93.60
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAZD DUE
TOTALS----> � 144.00 0.00 _93�60 237.60 237.60 .00
REVENUE DIVISION TOTALS--> COLLECTED: 144.00 OVER/SHORT; .00
BLDG PMT,PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
. , , 144.00
v
1f if iE ik iE iE 1E 1F iE iE if jE iE if aE if if iE iE iE 1E 1E IE iE if 1E ik if 1f it 1f iE if iE 1E if if 1E 1E 1E 1E if 1E if 1E 1E IE iE fE iE iF 1f fE iE jF jf !E if if it 1F iF dE iE 1E If if iE iE iF if �f IE iF �E iE �E IE iE
`� I N D I V I D U A L 'F �E E P A E A K P 0 W I�7
TYPE QTY D E S C R I P T I O N r• UNIT COST TOTAL COST
FIR 149 FZRE EQDIP FEE (FROM HLDG VAL TABLE) 1.00 144.00
END OF FEES
�: .
�
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I� '
01 ^.?.5,"�,-;.{i1v,:7P'• �'c�e�' '44.��
DAiE' :;.'�0.5•5 iT;-r�' ? i:l?
�CONSTRUC710N AND PLANNWG � �& SPA
APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pooi & Equipment locacion � �,
2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement
3.� �Etectrical Conduii UtilitV-Undrgrnd. 54. Forms ��-
.4. Electrica� Conduit-Unilrgrnd. 55. Electrical Bonding
� 5. Steel Reinforcement 56. Rough Piumbing & Pressure Test �
' 6.' Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
• 7. F'ootings 58, Electrical Conduit-Undrgrnd.
B. Foundation ' 59. Gas Pipe, O Undrgrnd., Test �
9. 4Va[er Pipe�Undrgmd. ' 60. Backwash UneS,�P-Trap, O Undrgrnd.
10. Structural floor SYscem - 67. APPROVAL TO DECK � .'
1 t. Property Sewer Line & House Con�ection 62. Backwash & Receptor-Fina�
12. Sewer Cap . ' 63. Heater & Vent-Final
73. Roof Drains 64. Plumbinq System - Final `
14. Rough Plumbing ' . 65. Electrica�•Final �
15. Rough Electricat-Conduit 66. Solar System�Final
�
16. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign 66. APPROVED FOR PLASTERING
78. Rough &lectrical•T Bar Ceiiing 69. POOUSPA SYSTEMS PINAL
79. Rou9h Heating & Air Conditioning FI.RQAEPT. REQUIREMENT
20. �Rough Factory Fi�eplace . � AppROVALS � Permit #
21. Ducts, in-Struaure • � - ' 70. Undergrpund Hydro ,
22. Dutts, Ventifating . . 7i. Product Piping O Ga: ❑ Oit
23. Gas Pipe•Rough & Test "; 72. Undergraund Fiush .
24. Roof Framing - � _ 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing _ ' -' 7q: pverhead 1�-_= ro-�.e�.,,. 1/(8`� �/,�
�� -'J
26. T�Bar', Ce��jng (Structural! & Monocoat 75. Dry Chemical �
27. Frame and Flashing � 76. Dry StandPiVe
28. Lathing &�Siding : ; � `'r" " - � � 77. FIXED SYSTEM-FINA�� • , j�iy`�6
29. Insulatipn � 78. FIRE PREV. FINAL '
- - 3�j!�4c �-6f-
30. Drywall Nailing , ,. � � HEALTH DEPT. REQUIREMENT
37. Plaster 9rown Coat ' 79. FiNAL INSPECTION
32. Electric2l'Power Meter-Final 80. FOOD CERTIPICATE ISSUED
33. final Eletiric � � � Notes:
= 34. Final Heatin9 & Ai[ Conditioning � ' _ L. � A. I C � �/J� J
/LOJl.Li.t:lA � ��Q� '
35. FinalGasPiPe-Sest • _ . /� /' ��g,Q� ' "
36. Hood.or CanoPY . . _ - ���'-�c� -
37. Final Factory Firepiace ' � •
�
.'38. FinalPlumbing , � �
' 39. Water Service�Final • • �
� 40. Gas Serv�ce-Final ' � ' '" _ '
41. Solar �omestic•Final � �
42. Backflow Preventer , � - ' �
43. Backflow Irrigation � . -
44. Landscaoe Irrigation'System , � , • " . �_-
45. Sound A2tenuation � '
46. Handicap Regulations ' - � � _ .
47. FINAL STRUCTUflE & BUILDING
48. FINALPLANNING "
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co ' . . .
51. CERTIFICATE OF OCCUPANCY ,
No. Date
�oon�ssaem�dra: 555 ANTON BL
°""Eps"""Ei`a'°"": SAK IOKA FARMS
"°OPE� PO HOX 2097
'� TERMINAL ANNEX
APPL.WULQlO M�RESA
u"' 12TH
�xcxrtecTonum+�+: TRI—SIGNAL INC. �NO�' 0
�xcxon�a�saooncss: 1945 GARDENA AV 818-247-1194 ��
GLENDALE CA 91204
��T�""� MORROW MEADOWS CORPORATIO (909)598-7700
CWiNACi0R4Y11tdl0 p O BOX 509
�� WALNUT CA ucra: 230813
91789 uM:
LJCENSED COHfRACTOR9 DECUN�TION: I hereby eRim uMer penely d pe�jury thm I em liceiued uMm ywiuoru M Cheqer B
(commenanp wilh Sec4m 1000) d D'meun 3 d Ne Buvnev eed Prdmaiom Cotle. eM mY lioense a in full Mu aik eHed.
cmuc.No.:006556 uc.cuss: uc.No.: p308 3 EXP: 2,/96
om,: / — � — � � �o��a: m
`W NEX BUILDER OECIAR�TION: I Mmby �'m unJer peneAy W perlury thet I xemq / om ihs Comrarfae liroma l.ew lor ihe
Ibwvp reeaon (�� ]OJ1.5 Buenme eM Prdeeziona Cade: AnY cIY a coun whiM req ree e pertnit m ownbucl. eller. imparo.
nmol'ah, p npei eiry eVucturo. priar io da ueuence, e6o repuirea ihe epplimnt such pe ta file e aqmd eWement tlut M w eM
iw,�d w�d,� io me aom�. d in. coovm«. uo�o.a �w Icn.a� (canm xilh Sedion ]000) d DHeion 9 d Ihe
Budmc enE Pralembm Coeel a iAet te a ehe b uemq inxehan eM �M ' 1 elbpeA uemqion. My voW ion d Seuion
lVlt.S by env eGV��� 1« e permil wbjw+tM epplicem io e wil parely d M mora Ihen IHe huiMretl Edlen RSW�).
� I, m oxmmr W tM propenY or my empbyeae wAh wepn ea thei ada mmpevalian. wiil Co IM vroM, enE IM Hruc1uro e nd intentleE
w oHerod lor eele (Section )OdO, Bueiners enA Professions COEa: TM Comrenan License Lew doea rwl epplytoen owmr d poperry
wM Wilde ar improvee ��orean, and x1w doee vuch wark IimaeH w henep a ihraqh he a her own em0loyeee. pmriEeE Ihet euch
improvememe me na in�eMaA aWerad lar eeb. X. haweYer. ihe buitli�p a mpiviemeM a satl wNhin ms Y� d campblion. lhe
o.�«�wue« wn n.w in. w,ea, a o���o n. « ena ab na w�b «�mwa+�« �n. wma• a.d.l.
❑ L m owiw d ine pweM. em utluaweN mmreeYre wnn 4c.mee wno-m�on ro ooneo-ua u�e wd� (Seann 1ou. Busb�ws.oa
Prdsoioru COEe: The Con�redon L'senee law Eaea nd epply io en owiar d properry wM10 Wilds a impwo thenon ud xfio
conlrecb Iw vud� pojxte wilh e coMredoKs) licen�d punuenl lo �M Comretlaf Lioensa lew).
❑ i� �.«np ��ae, s«�: e. a v.c.. i« me �:
I do hareby coNry IIW 1 am awva d eM wWenleM Ne reQiivemmb d Celimie HaeEh eM Sdery Cods SMoo 25505. 2553J. W
255Je, eM Na I n mry Mun WiNvp omipeni will / wil m� (orcb an) nead W cpnqy wIh eek pqa m!w eM IM repui�emwW M
ePartnYlamvvuc�im«madifwunhanlM�i�Oiu iyiT�e^e0emen�Dislrid.ReakentielcamivaionWV�iaroenexemplmmtheea
q�.
Dme: �pp4rent:
W OpKEN'S COYPENS�TIpI DKL�N�TON: I Mreby elf wder prutly of pemvy ons W IM hGowiep Mdue�nna:
❑ I M1ew vd W meimen a cMilictle d owwnt �o velli�n la wkere' mnpenemion. e� qaideE ia by Seaim �]OD W IM LeEn
Coda, la �M pMortnarce d IM xwk 1« wlich ihis permn ia mued.
r] i n..�..�w xi� meimew wwwn� oomwmmm ��w�.�m. a, ma���a M seao� aroo a me �ee« cme. nr me o�«menoe a m.
� wak la xM1ich Nia Vmmn n eeueE. MY waken' camPetietbn'umrerce urtar aM VdkY rvun Wr ua:
c.m«: FTRFMANS F(1Nn EXPIRES
vw�vN�mn.: Dylranc.��Fa� 07/O1/96
(This axtion rieM rid be completeE I tM pemit ia lw one hunCre! Cdlvs (f1W1 w lese.)
� I cenly ihel in Ihe peAormence W the woek la xA'rh ihie Po�M ia aeueE. I shell iwl employ enY Oe� in eiry meniwr w as lo
bacome vubjea to iM warkare' campeneelion kwa d CeNomu. eM apree ihm il I ehwM Eecana wbpa o iM waMen'
comJpen�etion �pjwiaom d Seaioy a)ao a �ne �� , �.neu � h�iln canoN'�^ �� w��� �
Deta: / ` tj—� Ly �� i
Wem/nD: F�Ilun ro s�eun rorken' compmuHon covsnp� b unbwN{ mtl i wD/ cf an �mployx fo ctlMru/ pxuMu nW
clvll 11� W ro ons hunarM fMuwnd do/bn (S10QOOOA In eddlHon ro Ms ��f oI c rWsiwf/oq d�m�pi u proNdM br /n
SwXon J1P6 0l fh� LaEor COM, InM1resq mtl �ttomeyl /ssi.
CONSTiIUCTION �ENDINO 10ENCY: I Aereby �im uMer peraRy d paeju t u e wnvrud'pn bMirp pmcy M the
qriormenoe d IM v.vrk M whiM ihe perml b uausd (Secon J08J. C'v. CI.
LENDEH'S NAME:
LENUEfl'3 ADDRE53:
1 ceNty IM1et I hew reed ihia epplice�ian eM e�Ye thai ihe ehwe informe�ion c coiree. I peee �o comply wiih dl my eed muMy advunne
vd ate�e lews roleleq lo WiMiq conaYWion eM Mroby eulbce npreaenlnlives d Ihia cly b mtm upon iM aEwe-meMonad popaR/
la inspetlun purposas.
CHUCK JACOHI JR
///j /ry Pnm Neme }� / �� /
/ . � C iC� / � Dtla. �o
(StS�<6 WP) Wh4 Bdwp d$eldy:Orean-Fle: Cerery-AppFanl: Rnk-Reronue: GOIEenrob-Nuaw
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: F 075833
PLAN CHECK NO: 04818-95 L
PERM NO: F 075833
GOVT: N SOPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74630
if iE iF iE iFlFlElE'lE jE 1E ih iE �E fE 1E 1E �E 4 if 1F IE 1E iE if iE if ik iE iF i! k 1E 1E �F 1E iE 1E 1F 1E 1E �E jE �E Ik iE �E �kiElE iE iE iE iF 1E iE iE iE fElE 1E iE iE �E il� iE 1E 3E fE ik 1E iE if iF 1E ik It if 1E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
14 iE iE iE iE 1F iE 1f if if if 1E ib if-�ElE �IF iE iE iE 41E 1E 1E IE i! iE if iE iF fE if 1E 1k 1E 1E 1F 1E 1F 1E �Ih jE fE iE 1E iE iE iE 1E iE iE 1E iE 1F if iF 1f if iE if if iE 1E jE if 1E 1E IE'IE'IE 1F 1ElE 9E IE iE iE if ik
D E V E L O P M E N T S E R V I C E S R E Q U T A E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : � DATE;
DATE:
APPLICATION ISSUED BY
**���r�x�*�*��x****�***
LEGALIZATION:N
i 7�f�Z�a3Il��411Li:1�.[tl
PERMIT
F E E S U M M A R Y
ELECTRIC MECHANIC
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 90.00 0.00 58.50
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
FIRE
90.00
65Y
58.50
x *�*�it� it+�**�t�**iE*iFiFif
STRUCTURAL SEGMENT:N
SMIP/RES GRADZNG
SMIP/NON—RES
TOTAL PAID DUE
148.50 148.50 .00
90,00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECR
90.00
iF if 1F �1F �IE �lt if 3E if ib if 3F iE iE if 1E if 3E if iF'IF iE IF �IE ih 1t it iE �1! �If� iF if if iF iE iE 1F 1f� if iE iE aE iF iE iE iF 7F if �`f 1E if iF iF iE 1E 1F iE if iE iF 1E iE If if ii ih iE iE iE �E �E �IF 1E iF IF iE ik if iF
I N D I V I D U A L F E E H R E A I( D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 90 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00 90,00
END OF FEES
��
�.
,
_ ' :'�c,. - ' _. "
�n '
CQNSTRUCTION AND PLANNING P & SPA
A?PROVALS Petmit# �f Date Inspector qppROVALS � Permit# - -Date Inspector
1. Temporery E�ectricBl Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. - - r- 53. Steet Reinforcement
3. Electrical Conduit Utility•Undrgmd. . 54. Forms �-.`
•4. Electrical ConduibUndrgrnd. � 55. Electrical 8onding
5. Steel Reinforceme�t 56. Rough Plumbing & Pressure Test
� 6. Electrical UFER�Grnd. - 57. APPROVAL TO COVER�GUNITE
7. F.00tinqs 58. Electrical Conduit,Undrgrnd.
8. Foundation -.. � .� 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ` , 60. Backwash Lines,'P-Trap, O Undrgrnd.
10. S2ructoral Ffoor SYstem 61. APPROVRL TO DECK •
i i. Property Sewer Cine & House Connection 62. Backwash & Feceptor-Final '
12. Sewer Cap , 63. Heater & Vent•Finat -
13. Roof Drains '- ' 64. Plumbing System � Final
74. Rough Plum5in9 65. Electrical-Final
15. Rough Electrica�-Conduit � ' 66. Solar SYstem-Final �
76. Rough Electric Wirin9 67. Fencing & Access Approval
77. Rough Wiring $ign ' 68. APPROVED FOR PLASTERWG ,
18. Rough Electrical-T Bar Ceilin9 69. POOL/SPA SYST�MS FINAL
19. Rough Heating & Air Conditioning FIRE �EPT. REQUIREMENT
' 'e .
20. Rough Pactory PirePlace ' , APPROVALS �.- Permit #, �
27. Duces, in Structure • •��•• " 70. Underg�ound Hydro
22. Dutts, Ventilating - _ 71. Product Ri'ping OGas ❑ Oil
23. Gas Qipe-Rough & Test - . - � 72. Underground Plush� �
24. Roof Framing - '- - _' 73. Undergrnd.SroTgeTank.�Gas ❑Oil
25. Roof•Sheathing - 74.` Overhead Hydro. R
26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical '- '� '
27. Frame and Flashing- � - � � 76. Dry Standpipe � �� �
28. Lathing & Siding � " . :_ . '_ � ' ' � 77:. FIXED SYSTEM F�N%aL . �
�29. Insulation � - • � 78., FIRE PREV. FINAL ' -� ,,�j � �� (J-�
30. Drywall Nailing ' .: HEALTH DEPT. REQUIREMENT
31. Plaster Brown.Coat � � . 79.' PWAL INSPECTION , �
32. Electrical Power Meter�Pinal �, 80._ FOOD CERTIFICATE ISSUED
� 33. Pinal?Electric- " � , �� Notes: ^ �� �
34. Final Heating & Ai! Conditioning - + �� . �. . • _ - .
_ , � r
35. Final Gas Pipe-Test � � � � - : -
36. Hood or Canopy � � •� . . _ ' � "
37. Ffnal Fac[ory Fireplace , ' . � - � f '
-38. Final�Plurtibing /l' -• ' ' '
r..* c
39. Water Service�Final ' � ' ' ' , � ' -
.i
40. Gas Service-Final � � � - , • -
�41. Solar pomesticFinal - �� . - .
♦ F
42. 8ackflow Preventer � =i � � - ' 4�
�
43. Backflow Irrigation , � , _ � �
44. Landscape.lrripation Sy:tem �:.� � � � ' � �
� 4
45. Sound Attenuation ' ;_. ` , � _' '
46. Handicap Regulations - , � •
� 47. FINAL STRUCTURE & BUILDING , � � �� �
- �.� .
48. FINAL PLANNING - � � - � -
49. Etectrie Release to Edison , �%" .
r
50. Gas Release to Southern California Gas Co . � .
51. CERTIFICATE OF OCCUPANCY
No. Date
�
,.
�-- ---- - - -- - --- - - - ---- ----- - - - - - -.. .. . .
�- c�i��p o f�o�ta 21�e�a �
� Development Services, Division o f Building and Safery
'.. -
CERTIFICATE AF OCCUPANCY
This cerrificate is issued pursuant to the requirements of the Uniform Building Code, Section 308
adopted by the City of Costa Mesa certifies that at the rime of its issuance the buffding structure herein
below described was inspected and approved for occupancy as follows:
Building Address
Use
ANfON BLVD. FI.00RS 1-12
Group �-2 Type of•Consuvction 1-FR Fire 2one
Bldg. Pemut No.*�ee belw
UseZone PnC
Owner of Building Sakioka Fazms Tenant ���AT ��
Address ` - " F '
*B74570, B75356, B74572, B74571, B745?3, B74633 i_(%
B74632, 574631; B74�630��06,�B�7666, B74574 BY �•��� �
?�SNXrX?t#:�I$L�i�csi iP,�r
Date Novamber i4. 1996
RI!.'F, BkOwRQ, Cf.'0
��
REQUIRED TO BE POSTED IN A CONSPTCOUS PLACE /� �
I ( —
�
�
CITY OF COSTA MESA
BUILDING D/VIS/ON
� 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww.v.costamesaca.00v
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: M11-00083
PERMIT TYPE MECH
APN: 41050110
JOB ADDRESS: 555 1100 ANTON BL CM
Vicinity: - �
SQ. FT: 0
STATUS: ISSUED
DATE ISSUED: 10/26/2011
ISSUED BY: RMD
Suite/Unit: 7100
SCOPE OF WORK: ADD 1 INTERIOR CEILING MOUNTED COOLING UNIT, 1 VAV BOX AND 2 REGISTERS FOR
"TICKETS.COM", SPACE 1100. NO STRUCTURAL WORK.
OWNER: RREEFAddress: PO BOX 4900 Unit:DEPT 207
PHONE: City/State/Zip: SCOTfSDALE, AZ
APPLICAN7: HEIMSTRA, BEN Address: 767 N MAIN ST Unit:
PHONE: 714-516-9970 Ciry/State/zZip: ORANGE, CA
CONTRACTOR: SELECT HEATING AND AIR CONDITIONING INC License No. 445205
Address: 767 N MAIN STUnit: PHONE: 714-516-9970
City/State: ORANGE, CA ZipCode: 92868 CELL:
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $62.65
PLAN CHECK FEE: $47.00
INVESTIGATION FEE: - $0.00
REINSPECTION FEE: - $0.00
TOTAL FEES: $709.65
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order tor 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 lo obtain inspections and f nal approval will result in lhe expiration of this permit.
COOE�, INSPEC710NME Q0¢, LN�A1S GQpfp INSPELPONTYPE ,/ QSjF N R
1616 Fbcetl System Final Fire Prevention 206 Final Mechanical /� �—�2� �a— �
1268 Pool Spa Final 208 Final PlumDing
200 Final Re-Roof 270 Final ElecMcal
201 Final BIocWReWining Wall 272 Final Fire Prevention
202 Final Fadory Fire Place 220 Final Planninq Approval
203 Final Sign 222 Final Site
204 Final Demolition ' 250 Final Builtling/Occupancy
/
tNORKERS' GOMPENSA710N DECLARATION:
� hereby aKrm un0er Denalty of pelury one of the following declarations:
[] I have and vrill maintain a certificate of consent to selt-Insure tor workers'
compensation, as pmvided for Dy section 3700 0( the Labor Cotle, br the
pertormance of the work (or which this permit is issued.
CJ I have antl vrill maintain workers' compensation insurance, as rcyuired by
section 3700 of the Labor Cotle, for the peAormance of ihe vrork tor which this
pertnil is issued. My vrorkers' compensation Insurence wrrier antl policy
number are:
carrier: N°"�" o rw.l Uti: a.ti �; re � n5 � Lo.
(rnrs secfqn ncatl ral Da compbled a fne permA �s valuetl at one hurpredtbllars (5100) a ku )
PolicyNumbe�: W<<���7��8�
❑ I certify that in Ne peAortnance of the work for which this permii is
issued, I shall noi employ any person in any manner so as to become subject
to the workers' compensation laws of California, antl agree that if I should �
Decome subject to ihe vrorkers' wmpensation provisions of Seclion 3700 of
lhe Labor C e. I pall forthwith comply with lhese pmvisions.
���� 10/26/11
—� Aypliranfa5ignaNre Oate
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAN/FUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($100,000), IN A00t710N TO THE COS7 OF COMPENSATION, OAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS �ECLARAiION:
I hereby aKrm that I am licensed untler provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Pro(essions Code, antl
my license is in tull lorce and eRect.
Lic. # Y�'lS 2 � S Class tt C—�
/ //d� �i—� 10�26�11
Cm'raaaYe Signatwe Data
CONSTRUCTION LENDING AGENCY:
[] I �ereby a�rm lhat there is a wnsWction lending agency tor the
peAortnance of [�e work for which this pertnit is issued. (Sec. 3097, Civil Coae).
�entleYs Name:
lenders Address:
S'pnalun �ats
OW NER-BUILDER DECLARATIONS:
� hereby afTrm that under penalry ol perjury t�at I am EXEMP7 FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5,
9usiness and Professions Code: Any ciry or counry which reQuires a permit to
ConsWct, alter, improve, demolish, or repair any sWCWre, prior to i�s
issuance, also requires the applicant for such permit to file a signetl stalement
tha[ he or she is licensed pursuant Io the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pm(essions Cotle) or Ihat he or she is ezempt lherefrom and
Ihe basis for the alleged exemption. Any violation of Section 7031.5 by any
eppliwnt (or a pertnit subjects the applicant to a civil penalry of not more than
fve hundretl dollars (ES00).):
❑ I, as owner of the property, or my employees wilh wages as their sole
Compensation, WILL p0 THE WORK, and the structure is not intended or
OffereC for sale (Sec. 7044, Business antl Professions Code: Ttie Contractors
License Law Aoes not appy to an owner ol property who builds or improves
thereon, and who does such vrork himsell or herself or ihrough his or her own
employees, provided t�at such improvemenls are not intenAeC or oHered tor
Sale. It, however, the buil0ing or improvemenl is soltl within one year of
tompletion, the ownenbuilder will have the burtlen of proving that he or she
tlid not builtl or improve for purpose ol sale.).
❑ I, as owner ot ihe proDerty. am E%CLUSIVELY GONTRAC7ING WITH
LICENSED CONTRACTORS to wnstruct the project (Sec. 7044. Business and
Pro�essions Code: The contractors license Law dces not aOWY to an owner ot
property who builds or improves thereon, and who contracts tor such project with
a wntractor(s) license pursuant to the Contraclors License Laws.).
❑ I am exempt under sec.
Business antl Professions Code for this reason:
SiB�eiwo
3051.46(3�01)
Owner ID verified by driver�nse. ❑ Yes ❑ No
Drivers l.icense No. Expires:
Verification of Ownership by (rype of document, i.e. - property tax bil�r deetl):
r `
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby certify Ihat no ezcavation five (5) or more feet in depth into which a
person is required to descentl, wifl 6e matle in connec(ion with work authonzed
by this pertnit, and Ihat no Duilding sWcture, scaHolding, falsevrork, ordemolition
or dismantlin9 thereof, vnll be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, AA 2. Sec. 341, Title 8, Califomia Atlministrative Code).
❑ As owner-builtler, I will not employ anyone to do vrork which vrould
require a permit from the Division of Industrial Safety, as noled above, unless
such person has a permit to do such vrork from the division.
Applicenfs Sigrumre Date
Division of IndusMal Safety Pertnit Number.
HA2ARDOUS MATERIALS ANO EMISSIOHS CERTIFICpT10N:
7. Will Ihe applicant or preseni or tuture building occupant need to fle and
certiry a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Seclion 25505 0( the Caiifornia Health and Safery Code requires, wilh some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time dunng a reported
year a quantiry of hazardous materials equal to or greater than a wei8ht of
500 pounds, or a volume o! 55 galtons, or 200 cubic (eet o( compressed gas
al standard temperaWre antl pressure).
2. Does or vrill the applicant or present or future builGing occupant need to file
a regislration form lor acutely �azartlous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Healt� and Sa(ery Cotle, with some
exceplions, requires regislration with the Costa Mesa Fire Department by
each business which at any one lime has on hand a quantiry ot acutety
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume ot 55 gallons, or 200 cubic feet of compressed gas at stantlard
temperaWre and pressure).
3. Does or will the applicant or present or (uture building occupant need to
prepare an RMPP (Risk Managemen� and Prevention Pro9ram for acu�ely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safery Code provitles ihat the
Costa Mesa Fire DepaAment may require the preparotion, certifcation and
filing wilh the Fire Department o1 an RMPP by businesses which are required
m register acutely hazardous materials with Ihe Fire Department.
4. If an RMPP is presentty reqWretl, has Section 25534 of the Califomia
Health and Satety Cotle been Wlty wmplied vrith? ❑ Yes ❑ No
5. Does or will the applicant or present or future builtling occupant require for
the vrork which is the subject o1 Ihis ap0�����on a petmit for such constmction
or modifcation from the Souih Coast Air pualiry Management District or from
any oth0r air pollution conlrol tlislrict or agency? ❑ Yes ❑ No
(SecUon 658502 of the California Govemment Code reduires thal the requestetl
infortnation be fumished on applitations for non-resideniial building permits).
6. Will any part of the (aciliry to be consWctetl under this permit be within
1000 feet from the outer bountlaries ol a school? ❑ Yes ❑ No
Qf'yes', the faciliry must meet Ihe requiremen� of Sections 25534 and 42303
of Me Califomia Heafth and Safery Code),
7. If a permit from the South Coast Air Qualiry Management Districl or other
air pollution contml tlistrict or agency is required for Ihe work which is ihe
suDject of this application, �ave all ot the disclosures prescribed by California
Health and Sa(ery Code Section 42303 been made? ❑ Yes ❑ No
8. (If yes', attach certificate of compliance from �he appropriate air pollution
wntrol offcer).
CERTIFICATE OF COMPLIANCE: I certiy that untler penalty of perjury the
intormation given above is correcL I agree to compty vrith all state laws antl
ciry ordinances regartling Hazartlous Matenals and Emissions.
sie^a�we Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I
certiry under penalty of perjury that I have reatl ihis application and state ihat
the infortnation given is correct I agree to compy with all state laws and ciry
ordinances relating to building conshuction, and auihorize representatives o�
the Ciry of Costa Mesa to enter upon the above-Aescribed property tor
inspecUon purposes. I agree not to occupy or allow occupancy of any Duiltling
authorized by this pertnit until final inspection.
� t�legal Owner(s) D te
��(% Z�O �� .
rzeC AppLcan� Oa�e
/
CITY OF COSTA MESA
o�*""'Fs, BI/ILDING DIVISION
. �
r.. .� 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax p14) 754-4856 • www.ci.wsta-mesa.ca.us
r
FOR INSPECTIONS CALL: (714) 754-5626
'''b^m"` PERMIT NUMBER: E11-00197
�
PERMIT TYPE ELEC STATUS: - ISSUED, `
APN: 41050110 DATE ISSUED: 08131/2011 �
ISSUED BY: f2MD
JOB ADDRESS: 555 1100 ANTON BL CM
Vicinity: SPACE 1100 TICKETS.COM
Suite/Unit: 1100
SCOPE OF WORK: ELECTRICAL PERMIT FOR THE ADDITION OF 8 LIGHT FIXTS, 32 OUTLETS, AND 2 SWITCHES LOCATED AT OPFICE
AREA FOR "TICKETS.COM", SPACE 1100. ELECTRICAL WORK ONLY; NO TI INVOLVED.
OWNER: RREEFAddress:
PHONE:
APPLICANT: HECTOR, TODD
PHONE: 714-323-2734
CONTRACTOR: IRONWOOD ELECTRIC INC
Address: 1239 N TUSTINUnit: PHONE: 714-998-6580
City/State: ANAHEIM, CA ZipCode: 92807
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $65.26
Reinspection Fee $0.00
TOTAL FEES $174.26
PO BOX 4900 Unit:DEPT 207
Ciry/State/Zip: SCOTTSDALE, AZ
Add25s: Unit:
Ciry/StatehZip:
License No. 617971
CELL:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenls under Califomia statules antl related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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. FaiWre to obtain inspections and fnal approval will resWt in the expiration of lhis permit.
COOEI. INSPEC110NttPE �ATE INTI11R15 CODEt INSPECiIONTYPE UAIE IN1111RL5
1616 PixeA System Final Fire Prevention 206 Finai Mechanical
12fi6 Pool Spa Final 208 Final Plum�ing �—
200 Final Re-Roof 210 Final Eiectncal � �-�ol -��
201 Final BIOck/Re�aining Wall 212 Final Fire Prevenlion
202 Pinal Factory Firy p�ace 220 Final Planning Approval
203 Final Sign 222 FinalSile
204 � Final Demoli�ion -� 250 Final Building/Occupancy
N�ORNERS' COMPENSATION DECLARA710N:
I hereby aHirm under penalry ol perjury one of the (ollowing declarations:
❑ I have and will maintain a certificate of consent to self-Insure lor workers'
compensation, as pmvidetl lor by section J700 of the Labor Code, for the
peAormance of the vrork for which ihis permit is issued.
❑ t have antl will maintain workers' compensation insurance, as requireC by
section 3700 0( Ihe Labor Code, fa the pedortnance of the �+ork !w which this
permit is issuetl. My workers' compensation Insurance cartier and policy
number are: /' /�1�
Carrier: i f Ar`C %_�}[,S! rA n G✓ L.V
(mrssedronneed oewmpe�MemepermarsvaWedarwenundieddonais(E1o0)wiess)
POlicy Number; �� �'� ���% 7��0 �
❑ I certily that in ihe performance o/ Ihe work lor which this permit is
isgued. I shall no! employ any person in any manner so as to become subject
to the vrorkers' compensation laws of Califomia, and agree that if I should
become subject lo the workers' wmpensation provisions o( Section 3700 of
!hp �abor Code, 15ha17 forthwith tomply vdth the5e pfovi5ion / ���
% ��^— (-/�L
AooLwnfe 99���e Dale (
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENqLTIES AND CIVIL FINES UP TO ONE HUNORED THOUSAND DOLLARS
(5100,0001, IN ADDITION 70 THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND
ATTORNEV'S FEES.
��CENSED CONTRACTORS DECLARATION:
I hereby affrm that I am Iicensed untler provisions of Chapter 9(commencing
ti++t� Seclion 7000) of Division 3 0/ ihe Business and Protessions Code, and
my license i in lull lorOce a�n7tl effect. ��O
Lic. # � � � L / � ' �Class #
_ � � � �� �
�ConVa�ars��sgnalure Date
�ONS7RUCTION LENDING AGENCY:
[] I hereby aKrm that there is a wnsWction lending agency for the
pEAormance of the �wrk /a xfiich tltis peimi! is 'asued. ISec. 3D97. Civil Code).
L@nder 5 Name:
LOnder's Adtlress:
SignaWre Daie
�WNER-BUILDER DECLARATIONS:
I here6y aKrm thal under penalty ot perjury that I am EXEMP7 FROM THE
CONTRACTORS LICENSE LAW tor Ihe following reason �Sec. 7031.5,
Business antl Prolessions Code: Any ciry or county which requires a permil to
�OnsWct, aleer, improve. demolish, or repair any swcWre, prior lo its
issuance, als0 requires the applicant lor such pertnit lo fila a signed slatement
that he or she is licensed pursuant ro the provisions of �ne Contractors
Li�ense Law (Chapler 9(commencing wiih Seclion 7000) of Division 3 of the
Business antl Professions Code) or that he or she is exempt Iherefrom antl
��e basis for Ne allegee exemption, Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant ro a civil penalry ot not more t�an
five hundred tlollars (£500).):
❑ I, as ovmer ol the property, or my employees with v2ge5 as their sole
Wmpensation, WILL DO THE WORK, and Ihe SWcture is not intentletl or
oHered for sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law does not apply Io an ovmer of propeny who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, providetl Ihat such improvements are not intentled or oflered for
sgle. If, however, ihe building or improvement is sold within one year of
wmpletion, the owner-6uilder will have the burtlen 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 ro consWct the project (Sec. 7p44, Business and
Protessions Code: 7he contractps License Law tices noi apply to an ovmer d
property who builds or improves thereon, and who contracts Iw such project with
d fp0�f3ClOf(5) IitC058 {RIfSUdnl b 111E (�,Onlf2CIIX5 �JGCf15C L2\K.�.
[� I am ezempt under sec.
Business and Professions Code for this reason:
SiB���urc Wte
305"l�a6 (YO]�
OLvner ID veri(�ed hy dirva. _.�cense. ❑ Yes ❑ Mo
Driver's License No. Expires:
Verification of Ovmers�ip Dy (type of document, i.e. - propeny tax bill or tleed�:
. � ��
DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICA710N:
❑ I hereby certify that no exwvation frve (5) or more (eel in depth into vfiich a
person is required ro descen4 will be made in connectbn vrith work authorizetl
by this pertnit, antl fhai no bullding strUcture, scafldding, falsework, or Oemolition
or tlismantling Ihereof, vnll De more than thitly-siz (36) feet high. (Chap. 3.2, Grp
2, Ari 2, Sec. 341, Title 8, Califomia Atlminist2live Code�.
❑ As ownervbuilder. I will not employ anyone to do work which woultl
require a permit from the Division of Intlustrial Safery, as notetl above, unless
such person has a permit to do such work from the division.
APd��nfs Sigrnwee Date
Division of Intlusirial Safely Permit Number.
HAZARDOUS MATERIA�S AND EMISSIONS CERTIFICATION:
1. Will the applicaN or present or tuWre building occupanl need to file and
certify a Business Plan lor emergency response to release or threatened
release of a hazartlous matenal? ❑ Ves ❑ No
(Section 25505 of the California Heallh and Safery Code requires, with some
ezceptions, that a Business Plan be fled vrith the Costa Mesa Fire
Department hy every business which has a[ any one time tluring a reportetl
year a quantiry of hazartlous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feel ot compressed gas
at stantlar0 temperature and pressure).
2. Does or wilf Ihe applicaM or present or fufure builtling occupant need to f1e
a registration (orm for awtety hazardous materia157 ❑ Ves ❑ No
(Section 25533 0l the California Health and Safety Code, with some
exceptions, requires registration wilh the Costa Mesa Fire De'pariment by
each business which at any one lime has on han0 a quanlity o! awtely
hazardous materials equal to or greater than a weig�i of 500 pounds, or a
volume o( 55 gallons, or 200 cubic teet of compressetl gas at standard
temperature and pressure).
3. Does or will Ihe applicant or present or (uture building occupant need to
prepare an RMPP (Risk ManagemeM anE Prevention Prpgram (or acutely
hazardous materials)? ❑ Ves ❑ No
(Section 25534 of the Califomia Health an0 Salery Cotle provides that the
Costa Mesa Fire DepartmeN may require �he preparation, certi�cation and
fling with the Fire Departmem o! an RMPP by businesses which are requiretl
to regisler acWely hazardous malerials with the Pire Department.
4. If an RMPP is presently requiretl, has Section 25534 of the Califomia
Healih and Sa(ety Code 6een tully complietl wilh? ❑ Ves 0 No
5. Does or will the apP���n! o� present or /uWre building occupanl require for
Ue work which is Ihe subject of this application a permit for such construction
or modificaliOn Irom Ihe South COasI Air �ualiry Manaqemen( DiStriCt or (rom
any other air polWtion wntrol district or agency? ❑ Yes ❑ No
(Section 65850.2 o! the Calilomia Govemment Cotle requires t7iat the requestetl
infortnation De fumishetl on applications la rmn-residential twildirg permits).
6. Will any part of the taciliry to be wnsWcted under this permit be wiihin
1000 feet (rom Ihe outer boundanes of a school? ❑ Yes ❑ No
(If yes'. �he facility musl meet the requirement of Sections 25534 and 42303
of the Cali(omia Health and Salety Code).
7. If a pettnit (rom Ihe South Coast Air Qualiry ManagemeM District or other
air pollution control districl or agency is required (or the work which is ihe
suDject of this appliwtion, have all o( Ihe disclosures prescribed by California
Health antl Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. pf "yes", attach cetlifcate ot compliance from the appmpriate air polWtion
contml officer).
CERTIFICA7E OF COMPUANCE: I certify thaR under penalty ot perjury the
infortnation given above is covecL I agree to compty with all state laws and
cily ordinances regarding Hazardou5 Materials and Emissions.
Da�e
CERTIFICATE OF GOMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have reaC this appliwtion and state thal
the infortnation given is cortect I agree to comply with all state laws and ciry
ortlinances relating to builtling conswdion, antl authorize represenlatives of
the Ciry o( Costa Mesa to enter upon the above-tlescnbed property for
inspection purposes. 1 agree not lo occupy or allow occupancy of any builtling
authorized by this permit until final inspection.
Srgnamre al Legal Owner(5� a�e
�"�' / �I
� MNdAutPMxPOAppIiWn1 _ pat!
CITY OF COSTA MESA
BUILD/NG DIVISION
7� FAIR DRIVE, COS7A MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.w.us
FOR INSPECTIONS CALL: (714) 754-5628
PERMIT TYPE: B COMBO
Sub Type: COM_ALT
JOB ADDRESS: 555 1100 ANTON BC CM �
�
.
PERMIT NUMBER: BC08-00280
STATUS: ISSUED
DATE ISSUED: 07/11/2008
ISSUED BY: YH
Suite/Unit: 1100
APN: a705o7to . Zoning: , ,
Vicinity: SUITE 1100 ' ", � .: . - Primary Occ: B
Const Type: I-A � SQ. FT: �" 0 . -� Valuation: $267,250.00
;',.;�� � :>`,i .
SCOPE OF WORK: REVISION TO PERMIT;ON 09/16/08 TO INCLUDE COFFEE/ICE CONNECT, 1 DISHWASHER, 1 KITCHEN
SINK, 1 WATER HEATER .'� � � ' �- � - - ' � �
REMODEL EXIS17NG SUITE. REMODEL CONFERENCE ROOM, ADD WALLS TO 2 OFFICES FOR "TICKETS.COM". 100 LIGHTS,
42 OUT�ETS, 30 SWITCHES, t SUBPANEL, 1 VAV BOX, 1 TRAP PRIMER 8 1 WATER SOFTNER.
OWNER: RR�EF ' � '�Address: POBOX4900 - „ � Unit: DEPT207 •
Phone: ,' _ � `CitylState2ip: SCOTTSOALE, AZ � -
APPLICANT: SALERMO, SCOTT L , Address: _ .
Phone: 714 9323137 � City/StatelzZip: � . -
CONTrtnC7oR: AMARON CONSTRUCTION CORPORATION _.. License No. 674301
Phone: 714-993-9220- � - ' �._� Address: -1565 N HARMONY ClUnit:
Cell: . ,� City/State: ANAHEIM HILLS, CA .
ARCHITECT: . - License No.
ENGINEER: � Lltense No.
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: ' $308:90
Building Fees: � " . '$1,900.95
Electrical Fees: , ' $20176 �
Mechanical Fees: - $34i.15 .
Plumbing Fees: �.�; $82�:30-"�;
SMIP Residential; �-.' $0:00.
SMIP Commercial: $54:86-
TOTAL FEES: $2,582.92
••Refer to fee recelptg for all fees pald for project
UNt: :
_ ZipCode 92807 .
PHONE:
PHONE:
NOTICE: The worlc authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) .
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � ,
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspadions and final approval musl be obtained. Failure to obtain inspections and final approval will iesult in the expiration of this Dermit. �
COUEt. �xarcrroxmmc P�Ii LNIDl�i 44PE! iNsvecnoHirve PAIE l�kH
1818 Fixed System Final Fire PrevenGon ZUB Final Mechaniwl ,
1288 Pool Spa Fingl 208 Final Plumbing '
2(10 Final Ro-Roo( 210 Final Eletlrical
207 Final Blo�k/Retaining Wall 212 Final Fire Prevention
202 Final FaUory Fire Place 220 Final Planning Approv2l
203 Final Sign 222 Final Site �
204 Final DemoliGon 250 Final Building/Ottupancy
WORKERS' COIYIPENSATION DECLARATION: � •
I hereby aHirm under penalty of perjury one of Ihe following declarations:
❑ I have and will maintain a certifiw[e ol wnsent to sell-Insure tor workers'
wmpensation, as provitletl for Cy section 3700 of the Lebor Code. tor the
peAormance of t�e work lor wliich lhis permit Is issued. �
❑ I have and will maintain wwkers' compensatbn insurence; as required by
section 3700 0( Ne Labor Code, for lhe peAortnance of tlre work fa which Ws
permil is issued. My workers' wmpensation Insurance carrier and policy
numberare:�-f
Cartier. K�EUWOo�
— (Tl�secibnneeanaIeLecwnpleted/t�reµrmtsvanxda�manurMiMewlarslEfoo/mless)
Policy Number: �7 � 3 �D 7$�(p'L-6 g(
❑ I certify Ihat in the pertormance o( the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
lo the workers' compensation laws of California, and agree ihat if I should
become suhject to lhe wor ers' compensation provisions of Section 3700 0(
Ihe Labor Cod qll f � omply vrit� these provisions.
`�///n /D 8
AppliWnl'sSigndlure ' D31e
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 DOLLP,RS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I herehy affirm Ihat I am licensed under provi5ions of Chapler 9(commencing
with Section 7000) o� Division 3 0( Ine Business and Professions Code, and
my license is in f'urll force and effect.
�ic. u �O'T3� � � C�ass n �
.. �/lh o�
. Contacmr'sSignaWre Oale �
CONSTRUCTION LENDING AGENCY:
❑ I hereby affmn that there is a construction lendinq agency fa the
peRormance W the v.ork ta which tNs pertnit's issued. (Sec. 3097, Civil Code�.
LenAer's Name:
Lentler'S AtlCre55:
OWNER•BUILDER DECLARATIONS:
I hereby affirm that under penalry of perjury that I am EXEMPT FROM THE
CON7RACTORS LICENSE LAW (or the toliowing reason (Sec. 7031.5,
Business anC Professions Code: Any ciry or counry which requires a permit to
construct, alter, impmve, demolish, or repair any strucWre, pnor ro its
issuance, also requires the applicant tor such pertnit to fle a signed statement
lhal he or she is Iicense0 pursuant lo the pmvisions of lhe Contractors
Litense Law (Chapter 9(commencing with Section 7000) of Division 3 0( lhe
Business and Pro(ession5 Code) Or that he Or She is exempt Iherefrom an0
lhe ba5i5 lor lhe alleged exemption. Any violation ol Seclion 7031.5 by any
appliwnt (or a pertnit subjects the appliwnt to a civil penally of not more man
five huntlretl tlollars ($500).):
❑ I, as ovmer ol the property. or my employees with wages as their sole
compensation, WILL DO THE WORK, and the slructure is not intended or
oKered for sale (Sec. 7044, Business and Professions CoAe: The Contractors
License Law dces not apply to an ovmer of property who builds or improves
l�ereon. and who dces such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or offered tor
sale. If, however, the building or improvement is sold within one year of
completion, lhe owner-builder will have the burden of proving that he or she
Cid not builtl or improve for purpose o( sale.�. _ ,
❑ I, as ovmer of the property, am E%CLUSIVELY CONTRACTING WI7H
LICENSED CONTRACTORS to construtt the projecl (Sec. 7044, Business and
Profess'ans Cotle: The contrectors License Law tices not apply to an owner ot
property who builds or improves Ihereon, and who contracis for sucb project with
a contractor(s) (cense pursuant to the Coniractas License Laws.)..
❑ I am ezempt under sec.
Busine55 and Pro(essions Code (or lhis reason:
Ovmer ID verifieC Dy Arivei .....:ense. ❑ Yes ❑ No � • �
Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - properly tax bill ar tleetl�:
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �
❑ I he2by Cetlify thal rro exCavation five (5) a more feel n tleplh into wfiith a
persm i5 required f0 destentl, will be matle in connecl'qn with rorlc autMi¢ed
by this pertnil, and that no building strucWre, scaffdding, false�wrk, or tlemolition
or tlismantling thereof, will be more than thiAy-s& (36) (eet high. (Chap. 32, Grp
2. M 2. S¢t. 341. Title 8. Califomia Atlminist2tive Code).
❑ As owner•builder, I will not employ anyone to do wnrk which vroultl
require a permit from the Division O( Industrial Sa(ety, as noled above, unless
such person has a permit Io do such work from the division.
nooiirnm's Sip^awre Daie
Division of Intlustrial Salety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will lhe applicant or present or fuWre building occupant neetl to file antl
certify a Business Plan for emergency response to release or threatened
re�ease of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Cotle requires, with some
exteptions, thal a Business Plan be filed with the CoSW Mesa Fire
Department Dy every business which has at any one lime tlunng a reported
year a quanlity of hazartlous materials equal lo or greater ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet ol compressed gas
at 5tandard �emperature and pressure).
2. Does or will the applicanl or present or WWre building occupant naetl to file
a registration form for acutely hazartlous materials7 ❑ Yes ❑ No
(Section 25533 0! the Calilomia Health and Salety Code, with soma
exceptions, requires registration vrith the Costa Mesa Fire Department by
eaC� bu5ine55 whiCh at any one time ha5 on hantl a quantity of atuiely
hazartlous materials equal to or greater than a weight o1 500 pountls, or a
volume ot 55 gallons, or 200 cubic feet ot compressetl gas at standard
tempereture anA pressurel�
3. Does or will the appliwN or present or future builaing occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous materials)? ❑ Ves ❑ No
(Section 25534 of the Califomia Health and Safety Code provides lhat Ihe
Costa Mesa Fire Department may require lhe preparation, ceAificalion anC
filing wilh 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 requiretl, has Section 25534 ot Ihe Calilomia
Health and Safety Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or tuture building occupant require for
the work which is the subject of this application a permit for such wnsWclion
or modification trom the South Coast Air Qualiry Management District or from
any other air polWtion control tlistrict or agency? ❑ Ves ❑ No
(Seclion 65850.2 of the Califpnia Govemment Cotle requires that the requestetl
infwmatbn be (umished on applications for rarnresbential building pertnits).
6. Will any part of the (aciliry to be tOnstrucletl under Ihis pertnit be vnthin
10001eet from the outer boundaries of a sc�ool7 ❑ Yes ❑ No
(If yes', the facility must meet lhe requirement of Sections 25534 and 42303
of t�e Califomia Health antl Safety Code).
7. II a permit from Ihe South Coast Air �uality Management District or other
air pollution control districl or agency is required for Ihe vrork which is the
subject ot this appliwtion, have all of ihe disclosures prescribed by Calitomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. pf yes", attach certificate of wmpliance from the appmpriate air pollution
control oKcer). - �
CERTIFICATE OF COMPLIANCE: I certify lhat undenpenalry of perjury�the
infortnalion given above is correct. I agree to comply with all,state laws anC
city ordinances regarding Hazardous Materials and Emissions.
Sipnalure - oale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry o( perjury that 1 have read this application and state that
Ne infortnalion given is correct. I agree to wmply with all state laws and city
oMinances relating lo building wnsWction, antl authorize representaUves o(
the Ciry of Costa Mesa to enter upon the above-described property (or
inspection purposes. I agree not to occupy or allow occupancy of any building
authonzetl Dy this permit until final inspection. . ,
Signa����y/u�� Lpgai (/s� ate
Sipiuwre '' Daie ' /Y/��/� /_ G,r G p�
005)�a613N]7 !A/!/ %
MOIw Nu1f10nz AppIKD D3t
�
! CITY OF COSTA MESA �
BYILDING DIVISION
77 FAIR �RIVE, COS7A MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�4856 • www a.costa-mesa.ca.us
FOR INSPECTIONS CALL: (716) 754-5626
PERMIT 7YPE: B COMBO
Sub Type: COM_ALT
�os AooREss: 555 ANTON BL CM� ��V�
APN: 41050110 . � � Zoning: , ,
PERMIT NUMBER: BC08-00280
STATUS: ISSUED
DATE ISSUED: 07111I2008
ISSUED BY: YH
Suite/Unit: �;
Vicinity: SUITE 1100- - . � - '� Primary Occ: B,
Const Type: t-A .- SQ. FTi. 0 • Valuation: � 5261,250.00
SCOPE OF WORK: REMODEL' EXISITNG SUITE. REMODEL CONFERENCE ROOM, ADD WALLS T0�2 OFFICES FOR
"TICKETS.COM".
ELECT - 100 LIGHTS, 42 OUTLETS', 30 SW ITCHES, 1 SUBPANEL. .
MECH. - 1 VAV BOX. . � � � . � � �, �
PLUMB - 1 TRAP PRIMER & 1�WATER SOFTNER. � - , � � . �
OWNER: RREEF ' .. � Address: PO BOX 4900 � -
Pha�e� - City/State2ip: SCOTTSDALE, AZ
APPLICAN7; SALERMO, SCOTT L � Address: �
Phone: 714 932-3137. City/SUtelzZip:
CON7rtacrors: AMARON CONSTRUCTION CORPORATION License No. 67430t
Phone: 714•993-9220 - - � Address: 1565 N HARMONY ClUnit:
CeIL `, - Ciry/State: ANAHEIM HILLS, CA
ARCHITEC7:
ENGINEER;
License No.
License No.
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check: $308.90
Building Fees: $1,900.95
Electrical Fees: - . _ ' $201�.76
Mechanical Fees: �� ': $34.15 ' �
Plumbing Fees: �' -$43.10
SMIP Residential: $0.00
SMIP Commercial: $54.86
TOTAL FEES: $2,543.72
•'Rafor to fea racalpts for ail (eos pald for proJoct
' UMt: DEPT 207 G
.' , :11i)C7d
Unit: :
ZipCode 92807 .
PHONE:
PHONE:
,,,
:.,�'�-� � �
�.
NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92) � ' � � �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. .
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 Ihspections and Flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
cooe�. �xsr�cnoxirne
1818 Fiz9d System Final Fire Prevenlion
1288 Po01 Spa Final
200 Final Re-Roof
201 Final BIoWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
peg ixmu�s �gp�a ixsvecnoxttre
208 Final Mechanical
208 Final Plumbinp
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
2T2 Final Site
250 Final Building/Octupanry
pSIE !_llD�kS
Iil1R�'.,�, - 'l .�
WORKERS'COMPENSATON DECLARATION�
1 hereDy aftirtn uMer penalry M perjury rnre of the followirg deGarations: ,
� I have an0 will maintain a certificate of consent to self-Insure for workers'
wmpensatlon, as provideG lor by section 3700 of the Labor Cotle, for t�e
peAortnance of the work for whic� this permit is issued.
�❑�1 have arid will mainlain Horkers' compensation insurance; as required by
sectiwi 3700 of Ue Labor Code, lor the periormance of ttre work fa vfiich tNs
permit is issued. My v.orkers' compensation Insurance carrier and policy
r numDer are: C
�carrier ,21i�i W(L17 �lrP C �IqEQJ�ti
(TnitseCmrreedn'o`te'e!mnpeteaavrepemvis�¢hlcaatarenundiedoo¢a (Sloo)akss/
Policy Number: K N �� U 0��—� ��S �
C
❑.�I"certity that in lhe pedormanca o( ihe work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to ihe wnrkers' compensation laws o( Califomia, antl agree ihal i( I should
bewme subj ct to Ihe vror4 (s' compensaUon provisions of Section 3700 0l
the Labo e, I shall f wilh comp, '1� these provisions.
� 1/ �c-�y D �'
applionfs Signalure Da�e
L. �
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDfTION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensetl untler provisions ot Chapter 9(wmmencing
with Seclion 7000) o( Division 3 of ihe Business an0 Prolessions CoOe, an0
my license is in full lorce and e(fect. N�
Lic. # r Class # i. ) �
� �� � �
-�, vaUor's ip aWre `" ale
CONSTRUC710N LENDING AGENCY:
❑ I hereby aKrtn lhal there is a conslruction lending agency for the
peAormance of the v.ork for wfiich Ihis pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lendefs Address:
OWNER-BUILDER OECLARATIONS:
1 hereby a�rm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5.
Business and Professions Code: My ciry or county which requires a permit ro
wnsWcC alter, Impmve, demolish, or repair any structure, prior to its
issuance, also requires lhe applicant for such pertnit to file a signed s�atement
that he or she is licensed Dursuant lo the provisions of the Contractors
License Law (Chapter 9(commencing with Seclion 7000) of Division 3 0( lhe
Business antl Professions Code) or that he or she is exempt therefrom an0
ihe Dasis lor the alleged exemption. My violation of Section 7031.5 Dy any
applicant for a permit subjects 1he applicant lo a civil penalry of not more than
five hundred dollars ($500).):
❑ I, as owner of ihe property, or my employees with wages as their sole
wmpensation, WILL DO 7HE WORK, and the swcture is not inlended or
oRered tor sale (Sec. 7044, Business and Professions Code: The Contractore
License Law Cces not apply lo an owner of property who builds or improves
thereon. and who dces such work himself or herself or through his or her own
employees, provided ihat such improvements are not intended or o(teretl for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have lhe burtlen of �proving that he or she
ditl not Duiltl or improve for purpose of sale.).
❑ 1, as ovmer o1 lhe property, am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CONTRACTORS lo construcl the project (Sec. 7044, Business antl
Professions Coda: The contractors License Law tices not apPN �o an rnmer of
property who builds or improve5 thereon, arM wfio con[racls tor such project vrith
a canUactor(s) ticense pursuant lo the Cont2Uors License Laws.).
❑ 1 am exempt under sec.
Business and Professions Code lor Ihis reason:
SignaWm Date
305)�a6�3/0])
Owner ID verified by driv�ense. ❑ Ves ❑ No `
Driver's License No. Expires:
Verification of Ownership by (ype of document, i.e. - properry taz bill or dee0):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �
❑ I hereby certify that fin ezcavation five (5) or more (eet m tleplh inlo wfiich a
persm is required to descerM. v.ill be made in connection wiN work author¢ed
by Ihis pertnil, and Ihat no buildirg s[ructu2, scaHdding, (�sework, a demdition
w dismantling thereof, vrill be more than [hirty-s& (36) feet �igh. (Chap. 32, Grp
2, iN 2, $2C. 341, TII�Q $, (�,3�1(OR112 AdR11f115I21N8 COdE�.
❑ As owner-builder, I will not employ anyone lo do work which would
require a permit from the Division of Industrial Satety, as note0 above. unless
such person has a permit to do such vrork from lhe division.
�� � '�;.,:•
• Appli�'anl's Si9�lure
Division of IndusUial Salety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or (uture building occupant need lo file antl
certify a Business Plan for emergency response lo release or Ihreatened
release o( a hazardous material? ❑ Yes ❑ No
(Section 25505 of ine Cali(omia Health and Sa(ety Coda requires, with some
ezceptions, thal a Business Plan be filed vrith lhe Costa Mesa Fire
Department by every husiness which has al any one tlme tluring a reportetl
year a quantity ol hazardous materiais equal lo or greater Ihan a weighl of
500 pounOs, or a volume of 55 gallons, or 200 cubic feet ot compressed gas
al standard tempe2ture and pressure�.
2. Dces or will Ihe applicaN or present or fuNre building occupant neetl to file
a registration lorm (or acutety hazarEous materials? ❑ Yes ❑ No
(Section 25533 ot the Calitomia Health antl Safety Cotle, vnth some
exceptions, requires registration with the Costa Mesa Fire Department by
each Dusiness which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight o( 500 pounCs, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperawre antl pressure).
3. Does or will the applicant or present or Future building occupant need lo
prepare an RMPP (Risk Management antl Prevemion Program lor acutely
hazarCous materials)? ❑ Yes ❑ No
(Seclion 25534 of lhe Califomia Heall� antl Sa(e�y Code prOvides lhal tha
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department o( an RMPP by businesses which are required
to register awtely hazardous materials with Ihe Fira Deparimen�.
4. If an RMPP is presently requiretl, has Seclion 25534 0l Ne Cali(omia
Health and Safery Code been fulty complied with7 ❑ Yes ❑ No
5. Does or vnn the appliwnt or present or (uture builtling occupant require tor
t�e vroB which is the subject of Ihis appliwtion a pertnit (or suc� consWction
or modifiwlion fmm the South Coast Air Qualiry Management DisMcl or (rom
any other air pollution wntrol distnct or agency? ❑ Yes ❑ No
(Settion 65850.2 0( the Califania Govemment Code 2quires that the requeste0
intormation ba fumished on applications for rron-residential builtli� pertnils).
6. Will any part of Ihe. facility to be con5tructed under this permit bo wilhin
1000 (eel from Ihe outer boundaries of a school? � Yes ❑ No
(If yes'. Ihe lacilily must meet Ihe requirement of Sections 25534 and 42303
of lhe Calilomia Health and Safely Code�.
7. If a permit from the South Coast Air Oualily Management Districl or other
air pollulion conlrol dislnct or agency is required for lhe work which is the
subject of this application, have ali of the disclosures prescribed Dy Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If yes", attach certificate of compliance from the appropriate air pollution
wntrol oKcer).
CERTIFICATE OF COMPLIANCE: I certify lhal under penalry of perjury lhe
inlortnation given above is wrtecL I agree to comply with all sWte laws and
city ortlinances regarding Hazardous Materials and Emissions.� '
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION�OF ENTRV: I
certify under penally of perjury �hat I have reatl this application and s131e ihat
Ne inlormalion given is correct. I agree to comply wiN all state lavs and ciry
ordinances relating lo building wnstruction, and authorize representatives of
the Ciry of Costa Mesa [o en[er upon Ne above-described properry for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by Ihis permit until final inspection. �
ignalur of. al eqs) Ddte
G
(AM/IX. AuthonzeE_Applipnl Dale
`�
� C._.TY OF COSTA 1V`�SA �
Development Services, Division of Building and Safet�
CERTIFICATE OF OCCUPANCY
This cerHficate is issued pursuant to the requirements of the Uniform Building Code, SecHon 308 adopted by the City
of Costa Mesa cerHfies that at the Hme of its issuance the building structure herein below described was inspected and
approvedforoccupancyasfollows: '
555 Anton B1, 1100 - BC08-00280
Building Address Bldg. Permit Number
Use Office (4,OU0 s:f.1
Group B Type of Construction � 7—A Fire Zone �xxX �": Use Zone• PpC
Owner of Building RREEF � '. Tenant TICKETS . COM
Address P� Box 4900� SCOttBdale� A2
BUILDING OFFICIAL-Klldrill Q. NgUyeri, C.B.O.
By
Date ���Z��
ItEQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
�
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(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us . 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
11
TICKETS.COM ON THE 11TH FLOOR
41050110
Applicant: FULFORD, TERRY
Address: 8749 SHIRLEY AV -
NORTHRIDGE. CA
i
Ownec " �SAKIOKA FARMS
Address . � - �
",. _- � ,_ �
- . ' Phone: (818)407-1986
" , Zip: 91324
� i , .
i�
Contracroi:�; � O'BRYANT ELECTRIC
� Address: � 8749 SHIRLEY'AV-� . ,
' �
i � j . � ,
NORTHRIDGE. CA - � ' -
r
Phone:
Zip: 94137
i
�- Phone: (818) 4W-1966 ,. �� .
Zip: 91324 ' - -- .
License: 386679
Status: ISSUED
Applied: 03/15/2007
Issued: 03/15/2001
ISSUED 8Y:
/�
- - • � ' , • �. . . '�� �.
� -_� .. . . ���.
"• �'�' "v SCOPE OF PERMIT j ��, �"� � '� ;
-"PHASE 1 INTERIOR OFFICE TI FOR'.TICKETS.COM" ON THE�.117H.FLOOR. 47 FIXTURES, 27
; OUTLETS, 28 SWITCHES, 1 MOTORTO 1�HP, 12 COMMUNICATION�DROPS.
' i REF: B00-01795 ` ' �': i
,, , ` , ✓. -
� � � a � � ;.
, � � � - �� ��FEE SUMMARY �� �- --"
..� � �� � � Quantiry � ,5' ' � Quanti�,
ISSUE FEE ^' � $23.50 � Temp DistSystem�/ Lighting �$0.00 0
Temp eervice test � �. $0.00 Busway'/{OO�ft -- $0.00 0
Res: a/c package - �.�:� � $0.00 ;,.,Standmg Sedion $0.00 /0
New Res (1=2 units) � �$0.00 0 -�?-'�,', Misc Electrical Equipment $0.00 �/0
New Res (3+units)� ��,��$0,00 � 0 � �n` �`- - � � Transformers up,to 1 kva/kw $0.00
Pool/Spa���V ' ��$O.OD 0 : � '�=�� � �.,`
• ..uptot0,kva/kw $0.00
Lighting Fixte����� � $41 71, �-. � -" 47 a�' ,r, � � .up.to 50 kva/kw � � '" � $0,00
Recept Outlete` �� � /�$27�1.7� � - 27 `'� � --� .. .up to 100 kva/kw ���'$0�00
Switches �;, /i�$2784` ��` 28 �� � ' �.�%� �over100kva/kw `%$0.00
Non Res Appl ��� « $0.00 ��0� � � ; � Lou%Voltage Equipmenh'� �� $0.00
ResAppl �1�� $0.00� �0��.,�\� �� L'ow,VokWinngSygfem/;Ckt $0.00
�
Service to 200a �- � �$00� � 0�`"�� . �`� � Niisa Condud--=='i'"� '$0:00
Service to 7000a �� ��, $0.00 � � 0 �� � - �Mis¢ Conductor� � -$0.00
Service over t000a `�, $O.OD \ , i 0�< � Circus � ��
Motors to 1h �\$q��g� � „j ' � ,- ( gen or rlde),-� V � $0.00
p ; � �Circus (mech ride,or lights) $0:00
Motorstol0h /r-��/� '� �
p $0.00 �A 0�^�'-; , ChristmasTree�Stand-�� �i� $0.00
Motorsto50hp $0.00A�,��0--_ `����. A�FireworksStand� �:;.�"�$0.00
Motors to 100hp $O.OD ��,0� =` �,, - Other Electrical Fee=, ' ',.-! $0.00
Motors over 100hp $0.00 0 - � - � _ ,_ � - i � �% - �
Communication drops $1320 12 � - - -- �-Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES E738.11
IntermedPole $0.00 _0
COMMENTS I SPECIAL CONDITIONS
.. ',l;
0��
0 � v�
��
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall au[omatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectiona antl final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration.of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626 ,
2468d8 (N00)
WORKERS' COMPENSATION DECLARATION: � �
1 hereby ettirm under penelry of perjury one of the lollowing decleretions:
❑ I have end will maintein e cenificate of consent lo sell-Insure for workers' compensatlon, as provitled tor by section 3700 of Ihe Labor Cotle, tor tha pertormence of the
work bt whic� Ihis permit Is issued. .
� I �ave antl will meiniain workers' compensation insurence, es required by section 3700 ot ihe Lebor Code, for Ihe pertortnance of the work for which this permit is issued.
My workere' compensallon Insurence cerrier and policy number ere:
Cerner: Policy NumCer.
(This secllon need not be crompleted /l fhe permit is velued et one hundred dollers ($ f00) or IessJ
❑ I certlfy Ihet in the DOAortnence of lhe work for which Ihis pertnit is issued, I shell not employ eny person in any menner so as to become subject to the workers'
compensetlon laws oi Celifomia, entl � t�et ii I should become sublect to the workars' compensetion provisions oi Sectlon 3700 0l the Labor Cotle, I shall forthwith
Comply with t�ese provl
AppllcantSlgnetura: �� — � Dete: �—�s�� �
WMNING: FAILURE TO SECURE WOi0iER5' NSATION COVEMGE IS UNUWPUL PN� SHALL SU6IECT AN EMFLOVEF TO CRIMINAI PENALTIES AND GVIL FlNES UP TOONE HUNDRED
T/qUSAND00LLARE(E100.000),INADOITION TMECOSTOFCOA9PENSATION,DAMAGESASPROVIOEOFORINSECilON3]O60FTHElA80RCODE,INTEREST,ANDAiTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Ihet I em Ilcensed under provislons ol Chapter 9(commencing with Section 7000) of Division 3 of t�e Business and Professions Code, end my license is in full
lorce entl eHect. Lic. » Class a
ContrecrorsSigneWre: , , ,�.j� Date: _9�'S—o/
GONSTRUCTION LENDING AGENCV:
❑ I �ereby aNirm thec Ihere is a conswctlon lending agency tor the pertormance ol Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lenders Neme: Lentler'S Atltlress:
SigneNre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby afllrm ihet untler penalry of perjury Ihet I em EXEMP7 FROM THE CON7RACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business end Protessions
Code: Any ciry or county which requlres e permit to consWct, alter, improve, tlemolish, or repair any strucwre, pdor to Its issuance, elso requires Ihe epplicant br such pertnit
to tile e signed sletement thet he or she Is IlcenseA pursuant to the proWsions oi lhe Conirectors LJcense Lew (Chapter 9(commencing with Sectlan 7000) oi Division 3 of the
Business entl Prolessions Code) or Ihel ha or she Is exempt therefrom end tha besis for the ellegeA a:amption. Any Wolation a� Saction 7031.5 by any applicant for a pertnit
sub�ects Ihe epplicant to e ciNl penalry oi not more Ihen ilve hundred tlollers ($500).):
❑ I, es owner ot Ihe Droperty, or my employees with weges as their sole compensa�lon, WIL� DO THE WORK, and Ihe s�ructure Is not Intended or oHeretl for sale (Sec.
7044, Business and Protessions Code: The Contractors License Lew does not apply Io an owner ot O�operry who builds or improves thereon, and who tloes such work
�Imself or hereelf or through his or her own employees, proNded thet such improvements are not intended or oXered for snle. It, however, ihe building or improvement is
soltl wilhin ane year af completion, the owner-builder will have the burden of pmving that he or s�e tlitl not build or improve for purpose of sele.).
❑ I, as owner ol lhe properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to wnstruct the project (Sec. 704d, 8usiness and Professions
Cotle: 7Te contrectors License Lew tloes not epply to en owner ol property who Uuiltls or impmves thareon, and who comracts tor such project with e contraaor(s)
license pursuant to ihe Contractor5 LiCense Lews.).
❑ I em exempt under sec. Business anA Professions Code for this reason:
Signature: Date:
Owner ID verilietl by tlriver's license. ❑ Ves ❑ No Dnvers Licensa No.
Vedlicatlon ol Ownership by (type ol dwument, i.e. - pmperry taa blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Expires:
❑ I here0y cehify that no axcavation live (5) or more feet in depih into which a pereon is requiretl to tlescend, will be mede in canneciion with work authorizetl by ihis
permit, and that no building siructure, scattolding, talsework, or demolition or dlsmamling thereof, will 6e more than thirty-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec.
34 i, Tltle 8, Califomla ACminisirative Cotle).
❑ As owner-�uilder, I will not employ enyane to do work which would require e pertnit Irom Ihe Division of Industrial Safery, es noted above, unleu such person has a
pertnit to do such work irom the division.
Signeture: Data:
Division ol InAusirial Sefery Pertnit Number:
CER71FlCA7E OF COMPLIANCE AND AIJTHORVATO110F ENTRY: I certify untler penalty ot perjury that I have read this epD�ication antl state that the inlormation given is
correct. I agree to compty with ell sWte laws end city ordinances relating to bullding construction, end euthodze representatives of ihe Ciry of Costa Mesa to enter upon the
above-descnbed D�oOerty for inspection purposes. I egree not to occupY or allow occupancy ot any building au�horizetl by ihis permit until finel inspection.
CO�E I, INSYELTIONTYPE
1616 Fixetl System Finel Fire Preventlon
1266 Pool Spe Finel
200 Finel Re-Root
201 Finel BIocWReteining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
eeie'
�
IIIIIDdLi
COOE 1 INSPECfION TYGE
206 Finel Mechenical
20B Finel Plumbing
210 Final Eleciriwl
212 Finel Fire Prevention
220 Final Planning Approval
222
250
Finel Site
Final Bullding/Occupency
Date
•i —/,� ^ O /
Date
P�I& II�A4S
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(714) 754-5273 • Fex (714) 756-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Jobnddress: 555 ANTON BL
Suite: 11
Vicinity: TICKETS.COM (11TH FLOOR)
Parcel Number: 41050110
npp�icant: THOMPSON, CHRIS
AddrBss:
Owner. SAKIOKA FARMS
Addtess � �� ,
Zoning:
. ISSUED BY:
Phona: 626-303-3883 ��
Zip:
Phone:
Zip: 94137
Contractor: SHELDON STEVENS CONSTRUCTION CO INC
Address: - 733 W LEMON AVE
� ' Phone: 626303-3883
- � MONROVIA, CA
Zip: ' 91016 • License: � 513414
Status: ISSUED
Applied: 7 7/08/2000
Issued: 02/212001
�
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- ,, . _ �
Arch : LORING CRUZ DESIGN & CONSULTING Eng:,
Address: 260 REDONDO AV Address:
, Phone: 562-439-5335 .Phone: �
, LONG BEACH, CA .
Zip: 90803 License: � - License:
�
SCOPE OP PERMIT . �
� PHASE I: INTERIOR OFFICE TI FOR'TICKETS.COM" ON THE 11TH FLOOR. �`- � , � l
Plan Check:
Permit:
SMIP Res:
� SMIP Com:.
Other.
Irispection: j
, �Total:
� .,.
$550.39
$846.75
$0.00
$16.46
$0.00
$0.00
$1,413:60
\`'\ /� � �� �� � -,
SETBACKS��A<<✓ �",�,� � ���:
MAIN STRUCTURE Front � 0- 0 ��� Rear ��0= 0
. .��� �., _ ,
ACCESSORY Front�,_0-0 � �� Rear 0-0
PARKING existinqy ,o - ` - ,Required: � o
�`_�
NOTES:
FEE SUMMARY
�- �
_ � CalcValuation: „�. � s�e,3�s.�oo,�
- Claim Valuation: �,� , ' S�s,000.00�
, ,, I
; r�
� i� ;�' � % �� /
� i %. (� �-� ' /;' i
,%ii! � � ; i, � l
� %/i �.��� /��/
��%
�,.. �,' � �i, /
a- -
�
/�� ���
�� '�
PLANNING & ZONING � ; ,/ j, /
� . �
-� V �
,, Lefl 0- 0, -_'� Right ^ 0- 0'� �
� ` � //,� �
Left 0-0 � -�� Right� '0-0� �' '
Proposed:
, . !
i
5.
�
� ,j
0; �
_ ,�
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regula�ions. (OrU. No. 92-28, § 1, 12-21-92)
EXPIRATION: Thls permit shall automaticelly expire and become void it work is not commenced wlthin 180 days, or if work Is suspended or abandoned
tar a period of 780 days.
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlred inapeeClona and tinet approval must be obtained. Failure to obtain inspaclions and final approval will resull in the expiratfonot thts permN.
FOR INSPECTIONS CALL: (714) 7545626 �
zaae�ae (erool
WORKERS'COMPENSAnONDECLABArON: .
I �ereCy eNirm unAar penalry of per�ury ona ot the fdlowing dedaretiwu:
❑ I he nd will maintein a certificele of �nsent to self-InSure for workers' crompensation, es provitled for 6y 5action 3700 oi Ihe Lebor Code, tor the pehormance ot Ihe
br whlch this pertnit is issuetl.
I heve end wlll maiMain workers' comp9�setb� Inwrance, as requireA Dy section 3700 of the Labor Cotle, for the performence of I�e work lor which Nis pertnit is issuetl.
My workers' wmpensaUon Insurence Certier entl policy number are:
Carder: Policy Number.
(Thls secNon need not De comp/eted I! (he permi! Is valuea ef one hundred dollars (S I00) or Iess.J
❑ I certify thet in tha peAortnence at t�e work lor w�i this pertnit is issued, I shall nat employ eny person In eny menner so es to become subject to the workers'
compensetlon laws ol Celi nia, en e t oultl Decome sub�ect lo the workers' compensatlon provislons ol Sec'lon 37' �'Ihe Le �otle, I shall forthwith
comply with these p
Appllcant Slgneture: ` .� � Date: ,� �
WARNINO: FNWRE TO SECURE WORKERS' OOMPFN3AT1 EMGE IS UNLAW RIL AND 51ULL SU&IECf AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED
THOUSAND OOLURE (5100,000), IN ADDITION TO n7E WST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 31O80F THE UBOR COOE, IMEREST, AND ATTORNEI^S FEES.
LICENSED CONTRALTORS DECLARA71tlN:
I hereby aHirtn Iha1 I am licensetl u r prov�s�wi � pter 9(commencing with Section 7000) of Dldsian 3 0l ihe Busineu antl Prq{assians C e, and my licensa Is In full
lorce end eflact. Lic. a Class a �/� . �i
Comrectals Slgnature: Date: �
o /
CONSTRUCTION LENDING AGENCV:
❑ I hereby eMirm that there is e constructlon lending agency tor the peAormance ol I�o work for which this permll Is issued. (Sec. 3097, Civil Code).
Lontlers Name: Lendets Adtlress:
Slgneture:
Date:
OWNER•BUILDER DECLAHATIONS:
I hereby eHirm that under penalry ol perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, Business entl Professions
Cotle: My dry or counry which requires e p9�i� lo consiruct, elter, imprwe, demolish, w repair eny strucWre, pnor to its issuance, elso requires �he epplicam for such peimit
ta Nle e signed sietemeni that �e or s�e I5 IlGensed Dur5uanl ro Ne provisions ol ihe Contrectors Lkense Lew (Ghepter B(commencing with Sectlon 7000) ot Divisbn 3 of the
Business end Protessions Code) or that he or she is exempt therefrom end Ne basls tor the alleged exemptlon. Any violatlon ol Section 7031.5 by eny applicant for e pertnil
sub�ects the epplicant to a civil penelry ol not more then flve huntlretl tlollars ($500)J:
❑ V, as owner oi the Oroperry. o� my employees with weges as thei� sWe compensaUon. WILL DO TME WORK, antl the sindure is noi intendatl or oflared tor sale (Sec.
' 7044, Businass antl Profeuions Code: The Contractors License Lew does not apply to an owner ot propeny who builds or improves Ihereon, and who tloes such work
himselt or herself or Ihroug� his or her own emD�oyees, provided ihet such Improvements ere nat Intendetl or oNeretl lor sale. If, however, ihe builtling ar improvement is
soltl within one year of complation, the owner�0uiltler will have the burden of proving that he or she did not builtl or impmve lor puryose oi sale.).
❑ I, as owner of the property. am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to Consimct the prolect (Sec. 7044, Business an0 Profeuions
Cotle: The contrectors License Law does not epply to an owner of property who builds or Improves thereon, and who contracis for such projec[ with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sac.
SlgnBiure:
Business and Professions Cotle for this reason:
Owner ID verilied by drivers IlcenSe. ❑ �es ❑ No Drivers License No.
Vedflcation of Ownership by (type of tlocume��. �.e. - property taz bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON:
Deie:
Expires:
❑ I hereby certity that no eacavetbn INe (5) or rtwre leet In tlepth Into which e person Is required to descentl, wlll be made in wnnection with work authorized by this
pertnit, and Ihat no building sirudure, s��oltling, lalsework, or demolltlon or tlismantling thereoi, will be more ihan thirty-six (38) leet high. (Chap. 3.2, Grp 2, Ar12, Sec.
34i, Tltle B, Calilomle Adminl9lretive Cade).
❑ As owner-Duilder, I will not employ enyona to do work which would require e permit Irom the Division ol Intlus�nol Selety, as notad e6ove, unless such person hes e
permit to do such work trom the division.
Signeture: Date:
DlWsion of Industrial Salery Permit Number:
CERTIFlCA7E OF COMPIJANCE AND AUTTIORVATOt10F EMfiY: I cehity untler penalry ot perjury Ihat I have read �his apD����an end state that the informatlon given is
wrrect I egree lo compty with ell 51ate laws end ciry ordinances relating to builtlinp wnsWctlon, antl euthonze representatives ot the City ot Costa Mesa to entar upon Ihe
ebova-descnbed property for inspection purpOses. I agree not to occupy or ellow occupency ol eny builtling euthonzed by this permit until linal inspectian.
n Of Legal Owner(s)
AntllOr hodzeA Appltcanl
COOE 1. INSPECTIONTYPE
1818 FIxeA SyStem Final Fire Preventlon
1268 Pool Spa Finel
200 Flnel R8-Root
201 FIneI8locWRetaining Well
202 Final Feciory Fira Place
203 Finel Sign
204 Final Demolition
�.:
•
i� I/
.. :
QdjE' �$ j�Qj�j INSVECTIONTYPE
206 Flnal Mechanlcal
20B Finel Plumbing
210 Flnal EIBc�rlCel
212 Final Fire Preventlon
220 Finel Planning Approval
222 Final Site
250 Final Building/Occupanty
�g
�
U�L6
.
(714) 754-5273 � Fax (714) 754•4856 • www.ci.costa-mesa.ra.us 77 FAIR DRIVE, CASTA MESA, CA 92626
BUILDING PERMIT
.lobAddress: 555 ANTON BL
Suite: 11
Vicinity: TICKETS.COM (11TH FLOOR)
Parcel Number: 41050110
npp�icant THOMPSON, CHRIS
Address:
Ownec SAKIOKA FARMS
i
Address
Zoning:
Phone: 6263033883�
Zip:
Phone:
Zip: 94137
ISSUED BY:
StaWs: ISSUED
Applied: 11/08/2000
Issued: 02/21/2001
� � .
� �
Contracror. SHELDON STEVENS CONSTRUCTION CO INC
Address: - 133 W LEMON AVE , '��,���
" � Phone: 626303-3883 - � �� �',
' � MONROVIA, CA � ' ���\ ,
Zip:' 91016. �License: 513414 . � ",,� �`�" ���� A�� ��
r
Arch : LORING CURZ DESIGN & CONSULTING Eng: „ `
Address: 260 REDONDO AV � � � ,Address: � � ,
� , �Phone: 562�39-5335 . � ' ,Phone:
LONG BEACH, CA , - � � �
Zip: 90803 License: � License: :
�- r� - �� t
� , -�. , SCOPE OF PERMIT - . � . ' ; �! i
� PHASE II>INTERIOR OFFICE TfFOR-"TICKETS.COM"ON THE 11TH�FLOOR: � - � �� '' � , � � � �
: Plan Check.
� � Permit ,
SMIP Res:
�. SMI�P Com:,
, Other:
�Inspection, �
� �Total:
$700.54
$1, 077.75
$0.00
$24.14
�, $0.00
$0.00
$1,802:43 _
FEE SUMMARY
. :.'` - ..
� _ i � �i
� ,'� �
� _- -. . �.� �
� � Calc Valuation %�;� � Siia,s o�oo �
-- ClaimValuation ��'/ $iio,000.00�
�, �f � ,.� %j��
� i
� %�/% (��:�. i, (
�� ;��
/i� � <-'; ✓
:/� \ '�' /'//
,: .
,i
�;i t� %�; /
. . - _ - ,`,- � ji ���. �'J�
� � ` (// \/�' � � � � PLANNING & ZONING � '� Ci' �� �/�
\ �l "/ // \\\ C _ . � � . l / �
SETBACKS��� / i —. � , _ �� � �� J �
</
MAIN STRUGTURE� Front 0 0 �� �, � R ar� 0= 0� _„ Left 0= 0 - �� Right i�0 �0� �,. ��
' �� A� / , _ � VA � ' 1 � '-
. . � � , ,� . J� i, �
ACCESSORY Front,�0;0 ��� !� Rear� 0-0 Left 0-0 ,���� Right�`�0-0!;;/
PARKING Existinq:' :0 ,�` � Rehuiied: � o pronosetl: 0, ' ;�///
�� _�, � . . - � �,:. /
i
NOTES: � ��` -- . - ' - �
� � - � � � - %' �'
NOT{CE: The work aNtwnzed by this permit shall comply with all applicable handicap access requirements under California statutes aad related
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or it work is suspended or abandoned
for a penod of 180 days.
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepectiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration.of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 �
2408d8 (8�00)
WORKERS' COMPENSATION DECLARA710N: . , .
1 hereby eHirm under penalry of perjury ona ol ihe following declarations:
❑ I h ve end will maintain e certificate of consent �o self�lnsure for workars' compensetlon, es provided for by section 3700 0l the Lebor Code, lor the pedormance of the
rk tor whlch Ihis pertnit is issued.
I have and will mainteln wwkers' compensation insurance, es requlred by sectlon 3700 oi the Lebor Cotle, for the perfortnance of the work for which ihis pertnit is issuetl.
My workerL' tompen5etion Insurence cerrie� entl policy number ere:
Cerner: Policy Number:
(This sectlon need nol be complefed il Ihe permit 1s velued af one huntlretl tlollers (5100) or less.)
❑ I certity Ihat in Ihe pertortnence of the work for whic I5 pertnit is luued, I shall not employ any person In any manner so es to becoma suD�act to ihe workers'
compansatlon laws of Califo i, end ey he I s ould become sublect to t�e workers' compensation provisions ot Sectlon 37 0l the L or Cotle, I shall lorihwith
tomply wlth these provi I'o� . U n / !
ApplicaniSlgnature: � r Date: d/� 0/
WARNINO: FAILURE TO SEWRE WORKERS' COMPENSATION ERAGE IS UNUWFUL M'� SFIALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVII FlNES UP TOIXJE HUNURED
T/%%1SAND OplARE (5100,000J, IN qDINiION TO THE COST OF COMPENSAiION, DMNGES AS PROVIDED FOR IN SEGTON 3IW OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I here6y effirm t�ei l em licensed un r provisio�n ol pter 9(commencing wit� Sectlon 7000) ot Division 3 oi ihe Business and Professions Cotle, and my license is in full
force and ettecL Lic. a /1 � ///7/� � __ Class a
Con[raaofsSigneWre:�/�/�� Date: ..? /i
/J i c"' 7
CONS7HUC710N LENDING AGENCY:
❑ I here6y aflirm ihat there is a construction Ientling agency for the pedormance ol the work for which ihis Dermit is issued. (Sec. 3097, Civil Code).
Lender's Neme: Lender's Address:
Signewre:
OWNER•BUILDER DECLARAT10N5:
Dete:
I hereby eMirm that untler penalry ot perjury that I flm E7(EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business end Professions
Code: Any ciry or county which reQuires a pertnit to construct, elter, improve, demolish, or repeir any structure, pnor to its issuance, elso requlres ihe epplicant for such permit
to ille a signed stetement �het he or she is licens�d Pursuflnt to Ihe proWslons oi I�e Contrectors LJcense Lew (Chapier 9(commencing with Sectlon 7000) oi Divislon 3 of Ihe
Business antl Pmlessions Cotle) or that he or she is exempt therelrom and the basis lor the allegetl exemptioa Any violation of Section 7031.5 by any applicant for e pertnit
sub�ects the apD�icant to e civil penalry ot not mora lhan five hundred dollars (5500).):
❑ I, as owner ot the properry, or my employees with wages as their sole compensetlon, WILL DO THE WOHK, an0 the siructure Is not inten0ed or oHeretl lor sale (Sec.
7044, Business end Professions Code: The Coniractors License Law does not aDPly to en owner of property who builds or Improves thereon, and who Aoes such work
himself or herself or through his or her own emplayees, pravided that such improvemanis ara not intendeA ar oNered lor sule. It, however, the building or improvement is
sold within ona yeer of completion, ihe ownor-builder will have the �urtlen of proving that ha or she did not builtl ar improve lor purpose ol sale.).
❑ I, es owner ol the property, em EXCLUSIVHLY CONTRAC7ING WITH LICENSED GONTRACTORS to construct the project (Sac. 7004, Business and Pmtessions
Code: The conlractors License Lew tloes n0� apply to an owner of pro0erty who builds or improves Ihereon, antl who coniracls /or such pmject with a contrector(s)
license pursuant to the Contrectors License Laws.).
❑ I em evempt untler sec. Business end Pwlessions Code for this reason:
Signeture: Dare:
Owner ID veriiletl by tlriver's license. ❑ Ves ❑ No Driver's Licensa No.
Verillce�ion of OwnerShip 6y (type of daument, i.d. - property tax bill or daed):
Ezpires:
DIVISION OF INDUSTflIAL SAFETY PERMIT CEAnFICATION:
❑ I hereby cartify Ihat no excavation five (5) or more feet in tlepih into whlch e person is required to tlescend, will be made in connection wlih work authorized by Ihis
permit, and Ihat no building structure, scaHolding, falsework, or demolition or tlismantling ihereot, will be more ihan ihirry-siz (36) feet high. (Chap. 32, Grp 2, Ar12, Sec.
3a i, Title B, Calllomla Administretive Goda),
❑ A5 owner-bullder, I will no� employ anyone to tlo work which would requira e permit from ihe Division ol Industnal Safety, es noted ebova, unless such person hes a
pertnic to do such work from ihe division.
Signature: Date:
Division oi Industnal Safery Permit Number:
CERTFlCATE OF COMPLIANCE AND AIJTHORIZA710N.OF EMRY: I certity under penalry of perjury that I hava read this application antl state thet lhe infortnation given is
correct I egree to comply with ell state laws end clry ordinances releting to bullding conslruciion, entl au�hoMze representetives of ihe City ol Cos�a Mesa to enter upon the
ebove-descn6ed property tor inspection purposes. I agree not to occupy or ellow occupancy of eny building euthorizetl by this permit until finel inspection.
neture Of Legal Owner(s)
C'
d/Or Authonzetl Applicant
COOE 1. INSPECTIONTYPE PeIE' U�EL$
7676 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Final Re-Rool
201 Flnal Block/Retaining Well
202 Final Fectory Fire Place -
203 Finel Sign
204 Final Demolition
1
� �/
° Date
COpE I INSPECTION TYPE
206 Final Mechanical
20B Finel Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupency
2AIF
�v
iw .
\
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1
Cicy of Costa Mesa
Development Services Department
Building Safety Division
P. O: Box 1200
Costa Mesa, California
CERTIPICATE OF OCCUPANCY No. �Oaa^`,�9
The Building located at 555 Anton Boult+Varrl Rlavanth Rlnnr
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
�or a Group B2 Occupancy.
f
�Use of Building Ofifice
Legal Description 410-501-04
. � (See reverse side for Metes and Boundsl -
Building Permit No R 37Q3A Electrical Permit No. E 37937 Plumbing Permit No. p 3i972
Mechanical Permit No. M 37965 Number of apartments and/or guest rooms
Pire Pr2vention Permit No.F35905,F37627,F35906 William T. Howard
ISSUED T0: BuildingOfficial
Securitv Pacific Bank .
600 Wilshire Blvd., #500 by � "'
Los Anaeles. CA
Date July 17i 1989
This Certificate of Occupancy SHqLL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Cogta Mesa under Sec. 307 (e) U.B.C.
CMF 1015-46 rev. 1/83 Whi[e - Owner, C�nary - Numerical File; Pink - Bldg. Permit File �
Ciry of Costa Mesa
�evelopment Services Departmenc C E R T I F I C A T E O F O C C U P A N C Y No.
Building Safety DiviSion
P. O. Box 1200
Cos�a Mem, Califom�a
The Building located at _ �55 ANTl1N Rf1ULP.VARD 1 iTH FLOf1R
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
tora Group n_� � Occupancy. � , . ,
Use of Building OFFICE — BANK OF AhfERICA
Legal Description 410-501-04
(See reverse side tor Metes and Bounds)
Building Permit No R59(I1'i Electrical Permit NoR59(117 Plumbing Permit No. P5074�
Mechanical Permit No. Number of apartments and/or guest rooms
Fize Prevention Permit No. F59569
ISSUEDTO: BuildingOfficial Tf1NY l'�nF. RA(:A
SANK OF AhiERICA '
20 N. RAYMOND AV�NIJE by
PASADENA. CA 91103-3931
Date �` /!/ / � ��
This Certificate of Occupancy SHALL BE ported 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�a6 rev. 1/83 Nlhite -Ownn�' Canary - Numerical File; Pink - Bld9. Permit File
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address: 5SS ANTON BL
Suite No 11
Vicinity: 11TH FLOOR
IFR'L7��[Ri177�iUI.Lif G]
npp�icant: DEDONA, PAUC, :
Address: 12046 E ELORENCE AV -
j �. ,
ISSUED BY:
,
� / ,, j j - � �- � - � , �� Phone: 562-944-6341 . � .
� �. ,
SANTA,FE SPRINGS, CA � - .Zip: 90670 � �
��'��� �`�� � . ' � � . ,
� `" � \� - . _ _
owner i SAKIOKA:FARMS � � �
; , ��� <
Address: � �� ��� �; ��'� � s
�.j � ,
� / i./,.
_ � , � , , Phone: �
� i � . `� `
� �ii �i
. � -�_ �i��% Zip: 94137
� . .,' � � / �.; � :
„'� �;�
Contrector � - WESTERN ALLIED CORPORATION '
-� Address � ,12048�E�FLORENCE AVE , � � .
% ; - _ � �` , " - - � "Phone: (562) 944-6341
- J � - SANTA FE SPRINGS; �CA - ' - Zip: 90670 '
� . ! �: " - License: 798821
� Aroh/Eng -',� �,
1 ` �. _ .
� � � �Address � . � , ,, ,
. 1 � � � . , - ' r .. . r- _
i � , � Ph'one. '
I , '�I' ' �J_' ._ . _/..,
I ' _ . .Z�P'�
�l' i � /l`. � - License�-
t l. — Ib�
� i ,
�� � '� ; �_" ��', �•_ - �., ��. SCOPE O
� l ;� �� INTERIOR OFFICE TI ON THE 11TH FLOORFOF
j � _ - ' � `� ��9 SMOKE DAMPERS AND 1 VAV BOX. � � "
� .�� �� J ' ��REF: B00-01795 & B00-01796
� '�` � �� '� .
.. -� .
�
i% �
,
Status: ISSUED
Applied: 03/02/2001
Issued: 03/08/2001
� �� C'V � � =�'� � FEE SUMMARY � ��
' \\ � � � •� : = Quantity .-.aiJ :�: . . . �.; , �/
ISSUE FEE. , � _���� $23.50 .� ��f:%�� � RepairY�AltAbsorblion Unit � ! %'�
Inst FAU 2{OO�k BTU ��- � ; �$0 00 0 �. . ' Repair / Alt'Refngeration Uml �. - %
<
InstFAU>100�kBTU���-S ���$0.00.-�0_., � ,��VentillationSystertm`a�'';�` � j
Repair/Alt Coohng/Heat � ��$000 �0''- -- - '�EvaporativeCooler �� -��
Ins[ / Rep. Recess Wall Htr �'�' ; $0 00\�0 ; � � � Commercial Inaneretor��%% '/ �� �
Refrig Sys <100 k.BTU ��� /� $0 OO�O�C � � � " Domestic Incineiator� �� � ��%%
� � � i�
RefrigSys>100kBTU� �//$000 0.�:;`�\�� ' -� ,Compre'ssors/Absoro'honSvstems��v
GasPiping �-���� � �'$000��0 �" �` _y ,_>Up�to3hp/100KBTU�1 '� V��
Factory Fireplace \� \ �$0�00 0 �� � _. - 3 To� 15 hp / 500 k BTU� �\ ' �% �
Hood w/Mech Exhaust ���� $0 00��.0, ��� - _ 15 To 30 hp�/ �1,000 k BTU_� � �� �%
VAV Boz ��$10 85 �.1 ��,\1 - . �' 30-To 50 hp�l 1,750�k BTU �/�/
Vent Fan / Single Duct ��$0.00�0 .� Over 50 hp I.Over1-,750 BTU- ��
Appliance $0.00� � 0.: -_ ` � ,A � . �Boilers ' ` -�� ���j�
Fire Dampers $Q00'�� 0�� �� .- Up to 3 hp�„ �%�' �'
Smoke Dampers $6525 9 � � , - - . �.- � -� .3 To 15-hp _ -
Inst or Relocale Appl Vent $0.00 0 ---- --- �� - 15 to 30 hp
Air Handlers < t0000cfm $0.00 0 30 to 50 hp
Air Handlers > t0000cfm $0.00 0 Over 50 hp
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee
. Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS I SPECIAL CONDITIONS
/`/���
\ i
$0.00
� $0.00
� � $0.00
$0;00
s9.00
� � 00
l, ��$0.00
� $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
599.40
u�
�
�
�
�
0
0
0
0
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: 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 inspeetlona and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration.of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
2446d6 (BI00)
WORKERS' COMPENSATION DECLARA710N: ' -
I hereby aXirtn undar penalty of perjury one of ihe following declarations: '
❑ I have and will mainWin e certificate ol consent to selt-Insure tor workers' compensetion, es provitlad for by sedion 3700 ot the Labor Code, lor the pertormance of Ihe
work for which Ihis permit is iuuetl.
� I heve end will maintain workers' crompensetion insurance, as requiretl by section 3700 ol the Lahor Code, for the pedortnance of the work for which this permit is issued.
My workere' compensation Insurence carrier antl policy num�er are:
Carrier: Policy Numher:
(This sectlon need no(be cromplefed il the permit /s veluetl af one hundretl tlollars ($100) or /ess.)
❑ I certily Ihat in the peAormanca of t�e work for which this permit is Issuetl, I shell not employ eny person in any menner ao as l0 6ecome suhject to the workers'
compensetion lews of Callfomia, and egree that if I should become sub�act lo the workers' compensation provisions ot Section 3700 of Ihe Labor Cotle, I shall torihwith
complywilh�hese ions. � p� m
Applicant Signature: ��, d-�^"'� Date: � O-� �
WARNINO: FAI�URE TO SECIIRE WOfiKEFiS' COAIPENSATION CAVERAGE IS UNLAWFUL AND SNALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GIVIL FINES UP TOONE NUNDRED
THOUSPND OOLURE ($100,000). IN ADDITION TO THE COST OF COMPENSRTION, DAMAGES AS PROVIDED FOR IN SECTION 310fi OF THE UBOR CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aHirtn that I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 oi the Businass and Professions Code, and my license is in full
forca and ettect Lic. a Class a
Contractor's Signature: �.y.w.Q� Date: 3-7Y- 7e� i
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm that there is a consimction lending aqency for the pedormence ot ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lendefs Neme:
Signatura: _
OWNER-BUILDER DECLARATIONS:
Lentlar's Atltlress:
Dare:
I hereby aHirtn that under penalry of perjury that I em EXEMPT FROM THE CONTiiACTORS LICENSE LAW tor ihe followinq reason (Sec. 7031.5, Business antl Professions
Gode: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any slrucNre, prior to its issuance, also requires the aDP���nt tor suc� permit
to tlle a signetl statement that he or she is Ilcensed pursuant to the pravisions oi Ihe Contractors License Lew (Chapter 9(commencing wi[h Section 7000) of Division 3 af ihe
Business end Protessions Cade) or thet he or she is exempt Iherefrom end ihe basis for Ihe alleged exemption. Any violetion of Section 7031.5 by eny applicant for e pertnit
subjecis ihe applicent to a civil penalry ot not more than five hundretl tlollars ($500).):
❑ I, as owner of ihe property, or my employees with wages as iheir sole compensa�lon, WILL DO THE WORK, and ihe siructure is not intentletl or oHered tor sale (Sec.
7044, Business and Professions Code: The Contractors License Lew does not apply to an owner o� propeny who builds or improves ihereon, and who does such work
himself or hereelf or through his or her own employees, provided ihat such improvements are not intentlatl or oHeretl for sale. tl, however, ihe builtling or improvement is
sold within one year of completion, Ihe owner-huilder will have ihe burtlen ot proving ihat he or she did not build or improve for purposa of sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions
Code: The contrecrore Licensa Lew tloes not epply to an owner ol property who �uiltls or improves thereon, entl who contracts tor such pmject with a contractor(s)
license pursuant to ihe Coniractors License Lews.).
❑ I am e:empt under sec. Business antl Professions Code for ihis reason:
SiqnaNre: Date:
Owner ID verified by tlnvers license. ❑ Yes ❑ No Drivefs License No.
Verification of Ownership by (type of tlaument, I.e. - properry Wx 6iil or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Expires:
❑ I hereby certify that no excavetion five (5) or more feet in depih into which a person is raquired to descend, will be matle in connaction with work authorized by Ihis
permit, and thet no building sirucNre, sceRolding, talsework, or demolition or dismantling ihereof, will be more than ihirty-six (36) teet hiqh. (Chap. 32, Grp 2, Art 2, Sec.
34i, Title B, Calitomia Atlministretive Cotle).
❑ As awner-builder, I will not employ enyona to tlo work which would require e permit trom tha Division of Industnel Safety, as noted abave, unless such person has a
permit to do such work from ihe tlivislon.
Signature: Date:
Division oi Indusinal Satery Pertnit Number.
CERTFICATE OF COMPLIANCE AND AUTMORIZATION,OF ENTHV: I cetlity under penalry of periury that I have reatl this appiication and state ihat the information given is
correct. I egree to comply with atl state lews and city ordinances relating to bullding construction, and authorize representatives ot ihe City of Costa Mesa to enter upon the
above-descnbed property for inspeclion puryoses. I egree not to occupy or ellow occupancy of any building authorized by ihis permit until finel inspection.
^� ignature Ot Legal Ownar(s) �_ ; ate
( �/ �'�G
AnNOr Authonzed Applicant Date
CODE t. INSVECTIONTYPE
1616 Fixetl System Final Fire Prevention
.1266 Pool Spe Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
o"h- f�$ fQpEt INSGEC110NTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electricel
272 Final Fire Preventlon
220 ' Final Planning Approval
222 Final Site
250 FinalBuiltling/Occupency
S-iG�or ��v
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(714) 754-5273 • F� (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
11
TICKETS.COM ON THE �11TH FLOOR
41050110
Applicant: FULFORD, TERRY
Address: 8749 SHIRLEY AV . . . .
NORTHRIDGE.�CA
/ �,
/
Owner:-' SAKIOKAFARMS, .
,
Address ;-�' . - "
,
qontractor �- O'BRYANTELECTRIC
� Addre`ss: 8749�SHIRLEYAV'
� �
" �NORTHRIDGE, CA �
Status: ISSUED
Applied: 03/15/2001
issued: 03N 5/2001
- :; ;' . ISSUEDBY:
Phone: . (818) 407-1986 = �� - -
Zip: 91324 ' . � . .
�
\
, .\ �
. ' �-
Phone:
Zip: 94137
� Phone: (818)407-1986 ��
Zip: 91324 ' .- .
License: 386619
� � - -. "i• SCOPE OF PERMIT .' - - - � � � ' ''
" �. PHASE 1 INTERIOR OFFICE TI FOR'TICKETS.COM" ON THE"14TH FLOOR. 72 FIXTURES, 7 I� . i ��'
^ ;, OUTLETS, 10 SWITCHES; 1 COMMUNICATION DROP. -- -- -- 1
�� '__-• �I�Ai
� - _ , � REF: B00-01795 ` ! . �
� ._ ' ', ; '� '� <; 1 , ;� I
� � ' , . , � - � � -- �� ,� : '�'i � _ l-� ��_'� � (1 �,
, , - - FEE SUMMARY. j ' v- -�
„ .: 'i
� ,- .;
� . . � � Quantiry �: ,
ISSUE �FEE � $23.50 � Temp Dist System�/ Lighting �"$0.00
Teinp,service tesl � $0.00 Busway /100�ft � =�� r $0.00
Res'a/cpackage�, ��,' $0.00 . ,..StandingSection $0.00
New Res (1'-2 unds)/ �` $0.00 0 - ', 'Misc�Electrical Equipment $0.00
New Res,(3+units)' ,$0 00 0 �"�' � � Transfortners up to 1 kva/kw $0 00
Pool / Spa. �• � �� � �$0 00 0 � up to 10 kva/kw $0 00
LighhngFoRs��` $59�96.,� �.,,,72��j, , , i ..� - .upto50kva/kw' �" $000
Recept OuUets�\ � $770 �� � 7 . � - � � .. .up to 100 Nva/kw ` $0:00
Switches \� // $11 00 � 70 �, � � = ? Covgr 100 kva/kw /$0.00
Non Res Appl \\V� $0.00\��0� � � �, L Low Voltage Equipmenl�- ��$0.00
Res Appl �V� $0.00�� 0���, �� � Low,Vott _Wiring System'I Ckt $0.00
Service to 200a �.� � $0.00 � A 0 � - _ �-`�-" -,�Misa Conduit, -� =� (� �$0:00
Service to 1000a � ,$0.00 � � �, 0�� -- Misa Conductor� � l`, $0.00
Service over 1000a � � �_ $0.00 ` �� 0�% � - Circus � � � t
( gen or ride); - � $0.00
Motors to 1hp �� $0.00� <f0 �� ' ; - , • � _ Circus�(m,ech ride,or�lights) $0;00
Motors to tOhp $0.00��, ;,� 0� ��, Christmas Tree Stand! �� $0,-00
Motors to SOhp $0.00\ � � 0� �.. � � � � � ,�• �Fireworks Standf "'� $0.00
Motorsto 100hp $0.00 �-.,0� %� ,�,- . OtherElectrical Fee�. �='J" �%� $0.00
Motorsover100hp $0.00 0`' � � .-.._�,� y_��i��"', -
Communication drops $1.00 1 � -� ---- - Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES 5103.16
Intermed Pole $0.00 .0
COMMENTS / SPECIAL CONDITIONS
/i
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handirap 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 1 BO 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
requlred Inspeetlone and flnal approval musl be obtained. Failure to obtain inspections and tinal approval will result in the ezpiration.of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 ,l
2448-48I8/00)
WORKERS' COMPENSATION DECLMA710N: - `
I hereby ettirtn under penalry of perjury one of ihe following declarations: �� � �
❑ I have end will maintain e cenificate of consent to self-Insure tor workers' compensation, as providetl for by saction 3700 oi the Labor Cotle, for the pertortnance ol ihe
rk for whith �hi5 pertnii is issuetl.
I have and will maintain workers' compensa�ion insurence, as required by section 3700 of Ihe LaDor Cotle, for the perfortnance of t�e work for which this permit is i55ued.
My workers' campensa�ion Insurance carner antl policy num6er ere:
Carner: Policy Number:
(Tliis sect/on need not be completetl il the permit is valued at one huntlretl tlollars.($100) or less.)
❑ I certify thet in the performance of Ihe wo tor which Ihis pertnit Is Issuetl, I shell not employ eny pereon in any manner so es to 6ecome subjed to the workers'
compensation laws ot Ca�rnie, anC �e ihat N I sl ould become sublect to ihe workers' compensation provisions of Section 3700 of Ihe Labor Code, I shall forthwith
comply with these proyi s.
ApplicentSignature: � .L� Date: 3-�S �� �
WARNING: FAILUF±E TO SECUiiE W RS' ENSATION COVERAGE IS UNLAWFUL AND SHALL SU8IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVII FINES UP TOONE HUNDRED
T/IOUSANDOd1ARE(E100,000),INAODRI THECAiTOFCqMPEN$ATION,DAMAGESASPFOVI�EDFORINSECTION3lWOFTHELABOflCOOE,IMEREST,ANDATiORNEV'SFEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aHirm that I am licensed under provisigis of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Protessions Code, antl my license is in full
torce end ettect Lic. k ,n /�� / Class N
ContrectoYs Signature: _T n Da�e: —� S�+ �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that there is a consWction lending agency for the pedormance of the work tor which ihis pertnit is issued. (Sec. 3097, Civil Cotle).
Lendefs Name: Lenders Adtlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Da�e:
I hereby eNlrm Ihat under penalty oi perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professlons
Code: Any city or county which raquires a permit to constma, alter, improve, demolish, or repair any stmcWre, prior to its issuance, also requires Ihe applicant for such permit
b file a signed stetement Ihet he or she is licensed pursuent to the provisions of Ihe Contractors Llcense Lew (Chapter 9(commencing with Section 7000) of Division 3 ot Ihe
Business end Professions Code) or thet he or she is ezempt thereirom end the basis tor the allegetl ezemption. Any violation of Sectlon 7037.5 by any applicant for a permit
subJects the epplicant to a civll penelty of not more ihan five hundred dollars ($500).):
❑ I, es owner ot the property, or my employees with wages as iheir sole compensation, WILL DO TME WORK, antl the strucWre Is not intentletl or ottered tor sale (Sec.
7064, Business and Protessions 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, providetl that such improvements ara noi Intendetl or oHered for sale. If, however, ihe building or improvemen� is
soltl within one year ot completion, ihe owner-builder will �ave ihe burden ot proving lhat he or she did not build or improve tor purpose of sale.).
❑ I, es owner of the property, em E%CLUSIVELV CONTRACTING WIIH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Protessions
Code: The contractors License Law tloes not appty ro an owner of pmperty who builtls or Improves thereon, and who contracts br such project with a comractor(s)
license pursuant to the Contrectors License Laws.).
❑ I em exempt under sec. Business antl Professions Cotle for this reason:
SignaNre: Date:
Owner ID verifietl by tlriveYs license. ❑ Ves ❑ No Driver's License No.
Veriflcation of Ownership by (type of tlocument, i.e. - proper�y tax blll or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Expires:
❑ I here6y certity ihat no excavetion five (5) or more teet in depih into which a person is required to descend, will be matle in conneciion with work authorized by Ihis
permit, and that no building structura, scaflolding, falsework, or demolition or dismantling ihereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec.
345, Title B, Calitornia Administretive Cotle).
❑ As owner-builder, I will not employ enyone to do work which wouid require a permit from the Division oi Industrial Safey, es noted above, unless such person has e
permit to do such work from ihe division.
Signa�ure: Date:
Division ot Intlusirial Safery Permit Number.
CERTFICA7E OF COMPLIANCE AND AIfiHORIZATIONOP ENTRY: I certily under penalty of perjury that I have read Ihis application and state that �he intormation given is
correct. I agrae to comply wlth ell state laws end ciry ortlinances releting to builtling constmction, ena authonze representatives of the Ciry of Costa Mesa to amer upon the
ebove-described property for inspection puryoses. I agree not to occupy or allow occupancy ol eny building authorized by this permit un�il tinal inspection.
CODE I, INSPECTIONTYPE
1616 Fised System Final Fire Prevention
1266 Pool Spa Final
200 Final Ra-Roof
201 FIneI Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
3-!.S^O /
Date
o�re' �Ry$ f�Qpf�( INSPECTIONTYPE
206 Final Mechanical
208 Finel Plumbing
210 Final Elecincal
212 Final Fire Prevention
220 Final Planning Approvel
222 Final Site
250 Final BuilAinryOccupancy
I�I:\��I:Ilil/.1�'j
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa- FIREaSUPRESSION PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite: 11
Vicinity: TICKETS.COM ON THE 11TH FLOOR
ParcelNumber: 41050110
Applicant: BARRON, DAMIAN�. ' '
Address: 2505 MIRA MAR . � -
LONG BEACH, CA ,
�
Zoning: _ . _
Phone: (562) 498-6444 " '
Zip: � 90815 .
Status: ISSUED
Applied: 03/21/2001
Issued: 04/05/2007
ISSUED BY:
� . . .
Owner. ��-SAKIOKA FARMS � � � � � � .
Address ' �� � � � � �
��� . , Phone: - . .� .
� � � � , . Zip: 94137 - .
i r , �i, " - ' ,�
Con'tractor: CAL,PROTECTION �� `
,
Address: �� 2505 MIR4 MAR " � � � � \'�'���
, � ��- ' 'V A��
. Phone: �. 562 498-6444
„ `,�, �,, .�' ( ) ' ' , a� �� � _•` \�''�.
. ' � ��, � LONG-BEACH;.CA' �Zip: 90875��- ' " ���, ' � � �, ��� �
� ' ; �' .� , . . � . � _ License: 327196 - . . � � � " `, �, � �
��
SCOPE OF PERMIT � � � ; '
. , INT IOR OFFICE TI FOR'TICKETS.COM" FOR 21 FIRE SPRINKLER HEADS. ." , -
� �F: B00-01795 8 B00-17
F01-OOB _ . . � � �. - . - ; �.f
- in �
, , � . , _ , _, .. _ � _ _ ' . �. , ._ , � ,
� � ' � � FEE SUMMARY - �='-_ : � � �
�:'Plan Check: - $154.21 � � �.J Calc Valuation: ' $13,275.00� I��'
1
�' Permit , $237.25 , - � . r Claimed Valuation`. ,Si3;2�s.om �,�% �
�_,; _
, 1 Other^ � $0.00 — - -- — ! - — , � � � �� �
, , ' � �; ��i
�' i. - 1�;
.= �;; �r ''r
� � " / ,' �
� . Total � �� $391.46 ,. '_ / j ," ��% `,'
� �
� �r��� /.5�� / ��
; � � �, o � - i
�� � � � � �'
�� ; ,�' � t `,>_ ,;�i
,�<� � ... � �� _ >x.. j�,
J ' 1 R. �, . � i .3r /
�-�� � A � ��� ' ��� %/
�A � - 1 .. i . �� /� �
VA � � ,� A���.,,� c: '<} v ,. . r-! / ��� `
���� �!,/ ✓�i � �, ���\ , , , �� /' L�,-\��
v:V (//,�� `� ;� � '/�, ',��..� /,
_
� �:��, � ' : � _ _ . (��� " � v /, ,�
��� i � -� V`./ i!ii
. ;.� � � _
. ; , `, i ,�
��,r���. �::� ,�� _ ��' � `. %%� '
_ i % �
� V' �� � -- =,C% ,
_ " ' . . ... � -J�/' �- � : . ,�
�
2. �
`
%�
NOTICE: The work authorized by ihis 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 voitl If work is not commenced within 180 days, or it 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 Inapeetlons and flnel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon. of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aas-as (s�oo)
WORKERS'. COMPENSATION DECLANATION: , �
I hereby ettirm untler penalry of perjurytine ot fhe following tleclarations: '�
❑ I have end will maintain e certifiwte oi consent to self-Insure for workers' compensation, as provided for by sedlon 3700 ot the Lebor Code, for the pertormance of the
work for which ihis permit is issued.
❑ I have antl wlll maintain workers' canpensetion insurenca, as required by section 3700 of the Labor Cotle, for the peRormance of the work for which this pertnit is issuetl.
My workers' compensation Insuraxe caMer antl policy number ere:
Certier: Policy Number:
(This section need na( be cromp/etetl i/ the permit is valuetl et one hundre0 dollers ($100) or IessJ . ,
❑ I certify that in the p�N6rman e of ihe work for which this pertnit is iuued, I shall not employ any person in any manner so as to become subject ro the workers'
co�la� f Califor ia, a;d agree �ry if I shoultl become sub�ect to ihe workers' compensation provi5ions of Sectio�� ot ihe I,ab�r Code, I shall forthwith
comply with the p ovision . /Q
�Applicant Slgpet�r .(///l///�� Date: �
WqRNING: AI R UREWORKEFS'COMPENSAiIONCOVEfiACaEISUNLAWFULANDSHALL511B1ECTANEMPLOVERTOCRIMINALPENATSA OCIVILFlNESUPTOONEHUNDRED
THOUSAND OOLLARE �E100,000), IN AODITIIXJ TO THE COST OF CpAPENSATION, DAMAGES AS PROVIDED FOR IN SECTIdJ 3]O60F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirm thei l em licensed under provisions of Chapter 9(commancing with Section 7000) of Division 3 of the Business end Professions Cotle, and my license is in full
force entl ette¢L Lic. .� , /.S Class A
Eantre�ctorls.&lanetur :�� /'i.1�6ba �/�/�at.� Dete: .S C�
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm that Ihere is a construction lending agency for the peAormance of ihe work for which ihis permit is issuad. (Sec. 3097, Civil Code).
Lendefs Nama: Lendefs Adtlress:
Signawre: Date:
OWNER-BUILDER DECLARATONS:
I hereDy aHirtn t�et untler penalry of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Busineu and Professions
Cotle: Any ciry or counry which requires a pertnit to conswct, alter, improve, demolish, or repair any strucWre, pnor to its Issuance, also requires the applicant for such permit
to file e signed stetement that he or she is licensed pursuant ta the prodslons of tha Contrectors License Law (Chepter 9(commencing with Section 7000) of Divislon 3 of the
Business entl Professions Gode) or that he or she is ezempt therefrom and Ihe basis for the alleged exemption. Any violetion of Section 7031.5 by any applicant for e parmit
subjects the epplicent to a civil penalty of not more then tive hundred dollars ($500).):
❑ I, es owner ot tha propeny, or my amployees with weges es their sole compensation, WILL DO THE WORK, end iha strucWre Is not intended or otteretl for sale (Sec.
7044, Businass and P�ofessions Code: The Contradors License Law does not apply to an owner of property who buiids or improves ihereon, and who does such work
himselt or herseli or ihrough his or her own employeas, provided ihat such improvements are not intended or oNered for sale. If, however, the building or improvement is
sold within one year of completion, Ihe owner-builder will have the burden ot proving ihat ha or she did not build or improve for purpose of sale.).
❑ I, as owner of ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professions
Cotle: The camractars Licensa Law tloes not epply to en owner of property who builds or Improves thereon, end who contrects for such project with a contrectoqs)
license pur5uen� �o ihe Con�ractor5 LicenSe Laws.).
❑ I em exempt under sec. Business and Professions Code for ihis reeson:
Signature: Date:
Owner ID veritiad by dnvefs license. ❑ Ves ❑ No Driver's License No. Expires:
Verificetion at Or.nership by (rype ot documenL i.e. - properry tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihat no excavation five (5) or more feet in tlepth into which a person is required to descend, will 6e matle in connection with work authonzetl by this
permi6 and that no building strucWre, scaffolding, talsework, or demolition or dismanNing thereof, will be more ihan thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
34i, Title B, Calitomia Adminisirativa Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division ol Industrial Setety, es noted above, unless such person has e
permit to do such work fmm ihe division.
Signature: Date:
Division oi Industrial Safety Permit Number:
CERTIFICATE OF COMPLIANCE AND AIffHORIZATON.OF ENTRV: I certiy under penalry of perjury that I have reatl this application antl state that the information given is
correct. I egree to comply with ell state laws and city ordinances relating to building consiruction, and authonze representatives of ihe City of Costa Mesa to enter upon ihe
above-described property for inspection purposes. I egree not to occuDY or allow occupancy of any building authorized by Ihis permi� until final inspection.
CODE t. INSPECTIONTYPE
1616
1266
Fixed System Final Fire Prevention
Poal Spa Final
200 Finel Re-Root
201 Finel BIocWRetaininq Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
PAIE' INTITIRLS
•! {JI �_
� S� �o�,a
/ ate
CODE� INSPECTIONTYPE
206 Final Mechenical
20B Final Plumbing
210 Final Elecirical
212 Final Fire Prevention
220 Final Planninq Approval
222
250
Final Site
Final BuiltlinyOccupancy
OATE INTR11L5
�{.�v_n� c�+.�
�
(714) 754-5273 • Fax ��ia� �sa-aees
�
� CITY OF COSTA MESA
svao�N� ��v�s�oN
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 555 ANTON BL
Suite: 11
Vicinity: 11TH & 12TH FLOORS
Parcel Number: 41050110
BUILDING PERMIT
Zoning:
,4pp�icant: PARCHAN, WARREN
Address: 1975 N. BATAVIA RD.
CA ,- Phone:r.(714)9983790
ORANGE - - . _ , , - Zip: - 92865 -
Owner. SAKIOKA FAI�MS%��� �� � �
r ., t ', � �
Address � = � � : --- �
"'.�r, -. 1 - ; .. � - -- .
� . ,'. � - . Phone - . .
i r�� ' `. `', .� Zip.��'94137 - �.�.;, �.:- .
t
� ,/� � � . ..c,,
�
Contracto`r'%AMARON CONSTRUCTION
Address: A 4214 E LA�PALMA�'
,�:
' `� _ -. ,t% j Phone: 714-993-9220
. ANAHEIM; CA „�
�, ,
� , � Zip:' 90807,�F' License:�, 674301
'1, :
NUMBER
B99-01930
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 12/7/7999
Issued: 12/7/1999
ISSUED BY: �
.,Arch : IA" ... �"�" � Enq: ; .
Address: � 3080 BRISTOL ST. #105 p`:� , y;,.�'" " ' Address: �
' - . , _ . . �'" ,` �,,,,Phone:��.(7,14)754-1197 ->
_ ' �,,. � , , . _ .- �.
1 - . COSTA MESA, CA ; ; � -' � � � � . - .
.*'
� Zip: 92626 �' ; �. ,��, • � - License: `
Phone:
License:
�". . <�. :� .. - ,'
. - ` � �' ��' ' SCOPE OF PERMIT � � �'�
�`
. � OFFICElfI FOR THE 11TH & 12TH FLOORS: 10;400'SF TI ON THE 11TH FLOOR &"3000 SF TI ON THE 12TH
FLOOR."TICKETS.COM"�TENANT. � "-� '-t �� ti-�r--- - � �.`� . � � ���
� � � � '� .. ,.. . , _ . . . . . , . r , t . ,_ ,. �
APPROVALS AND PERMIT ARE FOR REVISIONS�5,6,7 & 8 TO'ORIGINAL DRAWINGS. NEW CONTRACTOR DOING THIS
SCOPE OF WORK.-• , r , . ,
, _ , _ '��1�.,. .—_--, ��'��n ,i!_; .
. . _..._._ —._ i„ r�- . ..
`.'�• - — FEESUMMARY"j' . - :°-
;Plan Check , ; ���$174.24 ' � � -' ` �� ,� t Calc Valuation: � g�3s,sss.00
Permit: $1,072.25 - � Claim Valuation: gis�,000.00
•:SMIP Res: ' `- $0.00 � __ -- _ � . �
SMIP,Com:� ';,$28.75 � � t -
� �� , Otherr �-,$0:00 � •� � - �
Inspection: �$000 � � �•n� -�� � � �
�y �, �
Total: �� �$1,275.24', �, . _ �. , .��,':� ��"'� , � � . �
� . ' _PLANNING'& ZONING , � � �
SETBACKS , �- � , . � � '. �
MAIN STRUCTURE Front 0- 0 � Rear � 0- 0 Left 0- 0- Right 0- 0
ACCESSORY Front, 0-0
PARKING Ez�sn"a: o
Rear 0-0
�_"Required: '0
� _. Left 0-0 - Right 0-0
� . Proposed: 0 .
.'
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 br ihe work authorized uodar this permit to be consitlered legal, such work musl comply wiih all applicable codes, and all
required inspectiona and tinal approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION: . �
I hereby aNirtn untler penaliy oi p&�jury one ot ihe following declarations: ' - � '
❑ I heve and will maintain e cghificate of consent to self-Insure for workers' compansation, as provided tor by section 3700 ot Ihe Labor Code, tor the peAortnance ot the
I work far which this parmit is issuetl.
fi I have antl will maintain workers' cwnpensation insurance, as required by section 3700 oi ihe Labor Code, for the partortnance of the work tor which this permit is issuetl.
My worker;��orppensatio nsyrgnce carner and policy num6er are: ^
Carrier �� �M ��U Policy Number. .n.o/. C�i ��i 1J%�UU
(This secfion neetl not be complet� the permit is valued af one hundred dollers ($700) or Iess�J
❑ I cetlity that in the pedormence of ihe work for which this permit is issued, I shall not employ any person in any menner so as to become subject to Ihe workers'
compensation lews of Calitomia, and agree ihat it I should become sub�act to ihe workers' compensation provisions of Section 3700 of tha Labor Cotle, I shall torihwith
comply with Ihese provision's,.,^
Applicant Signature: ✓��F�/ Date: 1 o�i/ �
WARNING FAILURE TO SECURE WOp ' COMPENSATION CqVERAGE IS UNL4WFUL ANO SHALL SUBJEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL PINES UP TOONE HUNDRED
THOUSAND DOLLARE (8100,000), IN AbDITION TO THE COST OF COMPENSATION, DFMAGES AS PROVIDED FOR IN SECTION 3706 OF THE L4BOR fADE, IMEREST, AN� ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Ihal I am licensed nder provisions ot Chaptar 9(commancing with Saction 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and ettec�. Lic. N . N 30� � Class k
Coniractors Signature: __. Date: � 1 Jn,(n
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn that Ihere is � consWdion lentling agency tor Ihe peAormance of Ihe work for which this permit is issuatl. (Sec. 3097, Civil Code).
Lentler's Name:
Signature: _
OWNER-BUILDER DECLAFA710NS:
Lender's Atldress:
Date:
I hereby aHirm Ihat under penalty of perjury ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business and Professions
Code: Any city or counry which requires a permit to constmct, alter, improve, demolish, or repair any siructure, prior to its issuance, also requires Ihe applicant for such permit
m file a signed stetement Ihat he or she is licensed pursuent to ihe provisions ot ihe Comrectors License Law (Chapter 9(commencing with Sedion 7000) of Division 3 of ihe
Business and Protessions Code) or that he or she is ezempt ihereFrom antl the basis for the alleged exemption. Any violation of Section 7031.5 by any epplicant for a permit
sublects the applicant to e civil pe�alry of not more than five hundred Oollars ($500).):
❑ I, as owner of ihe property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business antl Profesgions Code: The Coniraclors License Law tloes not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or ihrough his or her own employees, provitled thet such impmvements are not intended or oRered for sale. If, however, the builtling or improvement is
sold within one year of completion, the owner-builder will have the burden ot proving ihat he or she tlitl not build or improva tor purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRAC7ING WITN LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Cotle: The contractors License Law dces not apply to en owner of property who builds or improves ihereon, and who comracts for such project with a conirador(s)
license pursuant to the Contrac[ors License Laws.).
❑ I am exempt untler sec. Business and Professions Code for this reason:
SignaWre: Date:
Owner ID venfietl by tlrivers licensa. ❑ Ves ❑ No Dnvets License No. Expires:
Verification of Ownership by (type o} document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICATION:
❑ I hereby certity lhal no ezcavation five (5) or more feet in depih into which a person is required to tlescend, will 6e mede in connection with work authorizad by this
permi6 entl ihet no building stmcture, scattolding, falsework, or demolition or tlismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title B, Celifornia Administretive Code).
❑ As owner-builtler, I will not Bmploy anyone to do work which would require a permit fmm the Division of Induslrial Satety, as noted above, unless such person has a
permit to do such work from tha division.
SignaWre: Date:
Division of Indusinal Safery Permi� Number:
CERTIFICA7E OF COMPLIANCE pND AllT}IORIZATION OF EN7RY: I cenity under penalty of perjury Ihat I have read this application antl stata that the information given is
correct. I agrae to comply with all state laws and city ortlinances relating to building consimction, antl authorize representatives of Iha City of Costa Mesa m enter upon the
above-descrihetl property for inspection purposes. I agreo not to occupy or allow ocapancy of any building authorizetl by ihis permit until iinal inspection.
�v�(�ture Of Legal Owner(s) Date
i � i-- �al� � �.
�tl/ r Authorized Applicant Date
CODE Y. INSPEC710NTVGE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Finel Demolition
oATE
INTRIALS LOOEY INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electriwl
272 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
OpTE INTI71RL5
(714) 754-5273 • Fax (714) 754-4856
.lob Address: 555 ANTON BL
Suite: 11
Vicinity: 11TH & 12TH FLOORS
Parcel Nunmber: 41050110
Applicant:
Address:
Owner:
Address
CITY OF COSTA MESA
BI/ILDING DIVISION �
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
PARCHAN, WARREN
BUILDING PERMIT
Zoning:
NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
1975 N. BATAVIA RD. - -- " - ,; y�-� . _� :_'- -�
'� /?�C -- '�
CA �� i� Phone: p14) 99&3790 ;C-t��
ORANGE � �/�'� �� � '�Zip: 92865� � A r� ,�
C 1 � `�
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Contr�c�t�� DE�L
�Addiess: 01975
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n..� �,Z�P� 92665
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Status: ISSUED
Applied: 07/1211999
Issued: 08/18/1999
CA'EARMS�-�, � ; �, ; �-' i' �'. �!J � ! �A> �� ��
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� Address ; 3080�BRISTOLST.#105 F �. ..��� Address: ` � � ' " "
- � � ; � � , t\ /� � � -, i,-V, � , �� �
; ,.�.. � _ _ � '�t' � � �� Phone: � (7-14j754-1197' � - _ ?_ � �� �_� ��� Phone: . . �� `
; ��i COSTA'MESA,CAr�`��i' " � - i. i- r�- _.
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'� � .�i- .� ��� �A_ ', . . .��
�'� � SCOP-E OF PERMIT
j _ _ � ,
/ OFFICE/TI FOR THE 11TH 8� 12TH FLOORS.;10,400 SF TI;ON THE?11TH FLOOR & 3000 SF TI ON THE 12TH�
FLOOR.'TICKETS.COM"-TENANT.'J "' ' �-�.- � �«��� i��� �--_��� �- � �
i. . . � _ - - - - - - ` �- - - - - - - - -
� � ' �� �, ^ �� �`^ FEE SUMMARY � �
\ � Plan Cfieck '�'s � $165.30 � � �`! ��+ � `� /�-�� �� �" �' ���� ��_ _Galc Valuation
� �i �. i Permd ��� $1,017.25 , - � ' � �� � -_ _ Claim Valuation
� � � SMIP Res'�� �; $0.00 � � �
` V�SMIP�Com: � �, $26.33 - �� ��
� ' / ;.--�� � �,
��ti\ Othe�: ���$0.00 — - __ � ' �' ✓6
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� Inspection�_ A�$0.00 .� � - '�'�'
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�� 'T�t I• 120888 -�`' �' ' �. �:�„
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ai 20 000`.00
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SETBACKS . � ���' % �� `�. i />' C� � ,
MAIN STRUCTURE'Front� 0-'0 �%, � Rear �0 0�\ �- -�, �Left- 0. 0�- �, Right -- � 0 0� �� �/
����� ��.i��il^ ' __ _ �.�.� i,i/
ACCESSORY Front= ' 0- 0�����; �- Rear - 0- 0 Lefl 0. 0 , Right� " 0; 0�� �
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.. � •_ , , �� � : "-.% �'
PARKING Existin :��,0='- Required: 0 Pr000sed: 0�� ' "%� �� .
. ,. _ / . � . ., ' - ���
NOTES: '�; �� ::�,%.r,_' -.
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e
NOTICE: The work authorized by this permit shall comply with all applicable hendicap access requirements under California statutes and related
regulatlons. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: 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 tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
raqulred inapectlona and flnal approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this pe�mit.
FOR INSPECTIONS CALL: (714) 7545626
WORKEHS'COMPENSAnON DECLARAnON: �
I hereby eHirm untler penelry of per�ury one ot Ue following tleGarelions: � '
❑ I have and will meintain a cenificate of consent to self-Insure for workere' compensetian, es provitleA tor Dy sectlon 3700 ot Iha Labor Code, for the pertortnance of the
�work for which ihi5 p8rmi� 19 i55ued.
I have end will maintein workers' compensation insurance, as required by section 3700 of tha Lebor Code, for Ihe peAormence of the work tor which this permit is issued.
My workers' c�omrp�ensatlon In .�nce'c/arriar and policy n�u%!�b�er are: �%�� �y/� �f Q �
Cerner: �%I�/i� .IC �i!' _ //" J. POIIcyNumber. /�«4 �/ �CJ //E,QG�
(Th/s sec(ion need not be com�perm/t!s valued et ane hundred dollars ($100) or less.)
❑ I certily that in the peAortnence ot ihe work for which this permit is issuetl, I shall nat emplay any pereon In eny manner so es to become subject to the workers'
compensation laws of Celitomia, end agree that ii I should become subject to the workers' compensation provisions ot Sectlon 3700 of Ihe Labor Cotle, I shall torthwiih
comply with these proNsions.
Applicant Signature: Date:
WFRNING: FAILUPE TO SECURE WORNERS' COMPENSATIIXJ COVERAGE IS UNL4WFUL AND SMALL SUBJECr AN EMPLOYER TO CRI PEI TIES AND CNIL FlNES UP TOONE HUNORED
TMOUSAN� OOLLARE (5100.000). IN ADDRION TO iHE W5T OF COMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 310fi OF E LAB CODE, INrEREST. AND ATTORNEY'S FEES.
LICENSED CONTRACTORS
I here6y ettirm ihat I am Ilcen:
force antl eHect Lic. # �
Conlreciofs Signe�ure: _
CONSTRUCTION LENDING AGENCY:
with Section 7000) ot Division 3 ot the Business er�j=ro�sions Coae, and my license is in tull
_ Class a Jf
—� Da�a: _� _�
❑ I hereby ettirm thet Ihere is e constmction lending agency for the peAortnance ot Ihe work tor which this permit Is Issuea. (Sec. 3097, Civil Cotle).
Lender's Neme: Lendets Address:
Signeture:
OWNER-BUILDER DECLARATIONS:
Dete:
I hereby atlirtn t�at untler penalry of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e pertnit to construct, elter, improve, demolish, or repair any strucWre, pnor to its issuance, also requires the applicant for such permit
to tile e signed statement ihat he or she is licensed pursuant to the provisions of tha Contraqore Llcense Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the
Business and Proteuions Code) or Ihet he or she is e:empt lherafrom antl the basis for Ihe ellegetl exemption. Any vloletlon of Section 7031.5 by eny applicant for a permit
sub�eds the applicant to e civll penelry ol not more than tive huntlretl tlollars (5500).):
❑ I, as owner of t�e propeM. or my employees with wages es Iheir sola compensatlon, WILL DO T/1E W08K, antl t�e structure is not intendad or oXered for sale (Sec.
7044, Business antl Protessions Cotle: The Contracbrs License Law dces not epply to en owner ot properry who builds or impmves Ihereon, and who tloes such work
himselt ar hersell or Ihrough his or her own employeas, provitletl that such improvements ere not intended ar oHered far sale. If, howaver, the building or improvement is
sold within one year ot completlon, the owner-builtler will have ihe burden of proving thet he or she did not builtl or improve for purpose ot sale.).
❑ I, as owner oi lhe propeRy, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct lhe pwject (Sec. 7044, Business antl Professions
Cotle: TTe contractare License Lew tloes not apply to an owner of pmperty who hullds or improves thereon, enC who contracis for such project with a contrectoQs)
license pursuant to Ihe Contractors License Laws.).
❑ I em exempt under sec. Business antl Pmfessions Cotle for this reason:
Signature: ' Date:
Owner ID verified by tlrivefs license. ❑ Yes ❑ No Dnvefs License No. Expires:
Ventication of Ownership by (type ol tlaumeni, i.e. - property tau bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify thet no aacevation flve (5) or mora feet In depih into which a person Is requlred to descend, will Ge made in connection with work authorized by this
permi6 end that no builtling sirucWre, scaHolding, talsework, or tlemolition or dismantling thereof, wlll be more Ihen thlrty-sis (36) feet hiqh. (Chap. 32, Gry 2, Art 2, Sec.
341, Title B, Celifomle Atlministrative Cotle).
❑ As owner-builde�, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, es notetl above, unless such pereon has a
permit to do such work irom Ihe tlivision.
Signeture: . Date:
Divislon of Intlustnal Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will ihe epplicant or present or luture building occupent need to file and certity a Buslness Plen for emergency response to release or ihreatenetl release ot a hazartlous
matenel? ❑ Yes ❑ No
(SecUon 25505 ot the Celilomia Health and Safery Coda requires, with some exceptions, thet e Business Plen ba filed with the Casta Mesa Fire DeparimeM by every
business which hes at eny one time during a reported year a quantiry oi hazardous meterlals equal to or greaier Ihen e weight ot 500 pounds, or a voluma of 55 gallons,
or 200 cu6ic teet oi compressetl gas at stantlartl tempereture and pressure).
2 Does or will the applicant or present or future building occupant need to file a regisiretion form tor acutely �azartlous metenals7 ❑ Yes ❑ No
(Section 25533 ot the Califomia Heellh and Safery Code, with some exceptions, requlres registretion with the Costa Mesa Fire Department by each business which at any
one time has on hend a quantiry ot acutety hazaraous materlals equal to or greater than e weig�t oi 500 pountls, or e volume of 55 gallons, or 200 cubic feet ot
COmpfessetl p85 815t8ntl8ftl �empBfBWfa 8nd pf855ulB).
3 Daes or will the eF
❑ Ves ❑ Ni
(Section 25534 of
Depanmentotan
4 If an RMPP is pre:
ent or tuture building occupant need lo prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)?
Health antl Safery Cotle provitles that iha Costa Mesa Fire Department may require the preparetion, cenification antl filing with the Fire
iesses which are required w register aatety hazartlous matedals with the Flre DeDartment.
�es Section 25534 oi the
Does or wlll �he applicant or preseni or tuture builtling ottupant repuire for �he work whlch Is ihe sub�ect of
trom t�e Sauth Coast Alr Ouelity Manegement District or irom any other air polWtion cnntrol tlisttict or egency
(Section fi58502 ot the Califarnla Govemment Code requires that lhe requasted information be fumished on
or
br nornresidential building partnits).
8 W ill Bny pert ot tlle teclllty �a be conSINC�80 Untlef ItllS perml� be wllbin 10W feBi ifOm IbB OUIBr OOUntl3rIB5 Ol 9 SC110017 �J YBS �J NO
(If'yes", the tacility must meet ihe requirement of Sectlons 25534 entl 42303 of the Califomla Health antl Safery Code).
7 If a permit from ihe South Coast Air Oualiry Management Disirict or other eir pollution control district or egency is required tor ihe work which is ihe subject ot Ihis
epplicatlon, have ell of the tlisclosures prescribed by Californie Heelih and Safety Code Sectlon 42303 been medel ❑ Yes ❑ No
_.......__....._...._'_..__...'__""".._...'_......—_.._—_..__...._.__—_.— ..— _ —._--
8 (It "yes", ettach certificete of complience from ihe appropriate eir pollution control oNicer).
CERTIFICATE OF COMPLIANGE: I certity t�at under penelry of perjury Ihe intormelion given e6ove is correC�. I egree to comply with all state laws end ciry ordinances
regerding Hezardous Meterlals and Emissions.
Signeture:
CERTIFICATE
carrect.l eare
GODE �. INSPECTIONTYPE
1676
1266
Date:
117THORIZATION OF ENTRY: I certity under penelty of per�ury that I have read this application and state that the informalion given is
laws end ciry ortlinances relating to builtling constructlon, end euthorize representatives of the Ciry of Costa Mesa to enter upon the
puryoses. I agree not to acupy or allow occupency ol eny 6uilding euthorized by this pertnit until final inspection.
Of Legel Owner(s)
Fi:ed Sysiem Final Fire Prevention
Pool SOa Finel
200 Final Re-Root
201 Final Block/Retaining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
2a4Bd6
DpTE IMIiIRlS
CODE♦ INSiECT10NTYVE
208 FinaIMBChaniWl
208 Final Plumbing
210 Final ElecMcal
212 Final Fire Prevention
220 FInalPlanning Approvel
222 Finel Site
250 Finel Building/OCtupenCy
pBg INTITIALS
(714) 754-5273 • Fax (714) 754-4856
. CITY OF COSTA MESA ,
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
MECHANICAL PERMIT
Job Address: 555 ANTON BL
Suite No 11
Vlcinity: 11TH & 12TH FLOORS
Parcel Number: 4�050110
NUMBER
M99-00394
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Applicant: RODRIGUEZ, LOU , �� s.� , �. -. ,
/�,. -:_ -
Address: 6265 SAN FERNANDO RD � � - � � -�C �.� _.�
CA /%' =,�'- � � �hone: (818) 244-6571 '�-. �� ;�\
SWtus: ISSUED
Applied: 08/19/1999
Issued: OB/19/1999
GLENDA���� `'J l` 1'� �Zlp: 91201- / � r�\'\� �,\ .
�� �l � �.
�� , �
��i-� ,-� , � - � , � �•; ���
Owner. SAKIOKfi FARMS �� _- � "= ,�� � � '� ��"� \
./ �' / \ \ � 4 �I S _ 4' S "^ ti?. � .`.`�"` � � ` J ~�i\\�\
\
..ddress. // � -- - \ �� �J � �� � �
� /7� \ �.�' � %�'`.- `�".- ��. � �� �
�}i7/ � � i%j %� Ph 2ie� 94137 ��\ � \� �<i/ /� j\ ����
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/ � ✓� � � � ��,�� l i � ���
Contractor: AIR-CONDITIONING CO., INC ����� ✓ r
j / i ii„%r � A - , - V \ � �
rAddrees:, 8285�SAN�FERNANDO RD _� � > A r,,1� �AA ,
,i, ; <i/ �i/,%j w, �> >,V �-��
�i ' ! � CA-� � Phone:' (818) 244-6571 � �� �.
����� � GC NDALE „ Zip 1 91207 �.. ' � ' � ��'"�� _ � ���`
/. � �! - � ! � ; _ � �� <` V ��
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/ � Arch I Eng I/�� y � t .s"'��../�". r..�-�� "� _�� ,_ �\��. � ` 7�. . � �.�i
i � �� � ,
� �4 . ..Address � i"� / �-�(. ��� � .� ' -✓/� . � �A� A y \� � • t �,
`-�� , ��_�� �'�' , Phone: - _ ;�. , ��� v,n\ - �A��i.
'a; ,� ;�_, ,/-� Zip: . Y %`' ,_ .
��� �
,� �A f � �% , License: � � `, F � -_ - �� i
i � ��
Li ,i' ' ---- - - - - - - -- - `l
�' ;'� y - , ,�r . � i � � ::,`�' `SCOPE OF.PERMIT � �� , � _ `, �,�; r � � +
!, , ,�,� MECHANICALPERMITFORT.I..FOR'TICKETS_COM"(11TH-812TH�FCOOR),INSTALL2-VAV ' �.�� . - .... ;�`1 ;
- BOXES, 1-COMPRESSOR UP TO 3HP, &REPAIR/ALT 2-REFR. UNITS. � 1. _ ��
� \ ,.
�
����-REF:B99-01068 N" ������y, �_�� �_.�l �.=1t ���� -�i, ;' ��� , i� `�
' l .1'�' _ _ _'� _ -t/ .f, . 7:��.'
� � � � +�,; _ � �FEE�SUMMARY.� f _ - -- �r ,. � - ��; 1
�� t� � ,_� ✓ 1 ._ i ! ' r l
�, � ��, � 'Quantity �_�_ ..-, � ,' , , Quantity
ISSUE FEE " �� $23.50 � • RepaiU AICAbsorbtion Unit� /� ($0.00 - � 0 �����
Inst FAU�<100 k BTl'1 �` �'�� $0.00 0 - RepairlAlt Refrigeration Unit /�' j$29.60i 2'���
Inst FAU ?100 k-BTU �'�� $O.00i 0 � i ��, Ventillatlon System ; � � \.$0.00 �Oi /
Rapav /'�AlhCooling/Heat ��`�� $0.00- 0 . � ' S `;� Evaporative Cooler / "�� $0.00 %, 0�
Inst / Rep: Recess Wall Htr ��` � $0.00 0 � � , � � Commercial Incinerator . ti j � � $0.00 ' � 0
Refrig Sys,<7�00 k BTU _� ����� $0.00 0 ,.,, F � : ,��� . _ =i Domestic Incineretor - -�'�.Li/ ' % �' $0,00 � i0
Re(rig Sys ?100 k BTU� �, � ; $0.00 0. � � ` , Compressors / Absorotion�Systems -
Gas Piping � / i-. �-$0 00 "0"' - � "� �' Up to 3�hp / 100 k�BTU- - �.;';% � '- � ,$0.00 0
Factory Fireplace� �, (� / �� $0.00 �, 0, ' � � ' -.3 To 15'hp / 500 k BTl'1-� � �� � �. i �;.� $0:00 0
Hoodw/MechEzhaust, �l '� � $0.00 0����,ti' - �:.15.To30�hp/;7,OOOk�BTU � ""� �,��$0.00 0
VAV Box � �� ��� '!, $21 30 _ 2 �•-' _�- '��� . � " '�.30�To 50-fip I 7,750 k BTU - ��'' ��' ' " i $0.00 0
Vent Fan / Single Duct� � A�$0.00�.` 0_ _ '` Over 50 hp / Over 7,750 BTU�,' �`� �i �$0.00 0
Appliance A ���:A � � $0.00� �,0 -_ • _ � Boilers , � � �. � ; j '- �
Fire Dampers �,: � .._$0.00�; 0��"-� � �- �` � --� � - Up to 3 hP, . i . ` •, %, `"/� $14.70 1
Smoke Dampers �-� : $0.00 0 . A r � �' 3 To 75 hp ' "� = �� `� � $0.00 0
Inst or Relocate Appl Vent �-$0:00 ��0 " _ � '�; , - 15 to 30 hp� � � -- %. � � $0.00 0
Air Handlers < 10000cfm $0.00.,' 0« �` 30 to 50 hp -: � $0.00 0
Air Handlers > 10000cfin $0.00 0 � . Over 50 hp-' _� �� � $0.00 0
Floor Furnace $0.00 0 - '� �'� � Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES E89.70
COMMENTS / SPECIAL CONDITIONS
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, § t, 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 1 BO 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
requlred inspectlona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALI: (714) 7545626
WORKERS'COMPENSAnON DECLARATON: - ,_
I hereby aHirtn untler penalry of perjury one ot the following declaretions: 4 `
�] I have end will meintain a certificete of wnsent to self-Insure for workers' compensation, as p�ovided for by section 3700 of ihe Labor Code, for iha peAormanca of ihe
work for which ihis permil is issued.
❑ I have end will mainlain workers' canpensation insurence, as requiretl by seMion 3700 of the Lebor Code, for the performance of the work for which �his pertnit is issuetl.
My workers' compensation Insurance cartier antl policy number are:
Carner. 2 ��" �� Policy Number: '�i7 �%f�
(This section neetl nat be crompleteO il the permit is velued et one hundretl dallers ($100) or less.)
❑ I certify that in the paRo�manca oi the work for which ihis permit is issuaq I shall not employ any person in eny manner so es to become subject to Ihe workers'
compansetlon f Celifornia, end agree lhat ii I should become subject to Ihe workers' compensetion provisions of Section 3700 of ihe Labor Code, I shall forthwith
comply with ese pr visions.
Applicant Sign ure: Date: � -�L�f'7%�f
WARNING FAILURE TO 'CURE WORKERS' COtdPENSATION COVEF� I JLAWPUL AN� SHAIL SU&IEGT AN EMPLOYER TO CRIMINAL PENALTIES AND dVIL flNES UP TO ONE HUNDRED
TFIOUSANDOOLLARE($100.000),INADDITIONTOTHECOSTOFCOWF SA ON,DAMAGESASPROVIDEDFORINSEGTION3lO60FTHELABORCOOE,IMERESi,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions ot Chapter 9(commencing wlih Saction 7000) ot Division 3 oi the Business and Professions Code, and my license is in tull
farce and eHect. Lic. #
Coniractots SiqnaNre:
Class N
Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm ihat ihere is a constmction lendinq a9ency for the pedormance of Ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lentler's Name: Lender's Atltlress:
Signawre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirm ihat under penalty oi perjury �ha� I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry which requires a permit to constmct, elter, improve, demolish, or repair any stmcWre, prior to its issuance, also requires the applicant for such parmit
to tile a signetl statemeN Ihat he or she is licensetl pursuant to the provisions oi Ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business antl Protessions Cotle) or Ihet he or she is exempt theretrom antl t�e basis for ihe allegetl ezemption. Any violatlon of Section 7031.5 by any epplicent for a permit
subjects [he applicant to e civil penalry of not more than tive hundred dollars ($500)J:
❑ I, es owner of the proparty, or my employees with wages as their sole compensalion, WILL DO THE WORK, antl the structure is not intended or oHered for sale (Sec.
7044, Business entl Professions Code: The Contrectors License Law does not apply to an owner of properry who builds or improves thereon, and who does such work
himseli or herself or through his or her own employeas, provided Ihat such improvemenis eie not intendetl or oNered for sale. If, however, Ihe building or improvement is
soltl within ona year ot completion, the owner-builder will have the burden of proving ihat he or she did not build or improve for purpose of sale.).
❑ I, as owner of lhe property, am E%CLUSIVELY CONTRACTING WITH UCENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The contrectors Licensa Law does not aOP�Y �o en owner of property who builds or improves thereon, and who contrects for such project with a contracror(s)
license Oursuant to Ihe Con�ractors Licensa Laws.).
❑ I am exempt under sec. Business antl Protessions Cotle tor this reason:
SignaNre: Da�e:
Owner ID veritietl by tlnvar's license. ❑ Yes ❑ No Driver's License No.
Verificalion ot Ownership by (type ot tlocument, i.e. - property tes bill or desd):
OIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I hereby certity that no excavation five (5) or more feet In depih into which a person is required to descend, will be matle in connection with work authorized by ihis
permit, and thal no building stmcture, scaHolding, falsework, or demolition or dismantling ihereoi, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, 7itle 8, Cellfomia Atlministrative Code).
❑ As ownervbuilder, I will not employ enyone to tlo work which wouid require a permit from the Division of Indusirial Safety, as notetl above, unless such person has a
permit to da such work fmm ihe division.
SignaWre: Date:
Division oi Indusirial Safery Pertnit Number:
CERTFICATE OF COMPLIANCE AND AU7HOflIZATON OF ENiAY: 1 cetlity under penalty of perjury that I have read this application and stata that Ihe iniormation given is
correct. I agree to coinply with all state laws and city ordinances relating to huilding construction, antl authorize representalives of the City of Costa Mesa m entar upon ihe
above-describetl property tor inspection purposes. I agree not to occupy or ellow occupancy ot any building authorizetl by this pertnit until tinal inspection.
COOE �, INSPECTIONTVPE
1616 Fixed System Final Fire Preven�ion
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
2A66 46
Qeie
(ic. � ����
ate
INTRIALS C�y�� INSPECTIONTYGE ,� IN ,
206 Final Mechanical '
208 Final Plumbing ,
210 Final Etectrical
272 Final Fire Pravention
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
(714)754-5273 • Fax(714)754-4856
Job Address:
Suite:
Vicinity:
Parcel Number:
Applicant:
Address:
Owner:
Address
_ CITY OF COSTA MESA �
BUILDING DIYISION �
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
555 ' ANTON BL
11
11TH FLOOR
41050110
ELLIS, MARK
2505 MIRAMAR AVE./ i-�
ONG BEACH/���/f /����
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Check l: $81.41
Permif;�1� $125.25
Othe� `r � �' $0.00
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Zoning:
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Zip
PERMIT N ER
F9 204
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: OB/1911999
Issued: 09/0311999
� ISSUED BY: '
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�n ^�1) �('°i� �i�,'^1.Oi('J(b� i � �- � �(�y81CV81U8110f1���.�'$5,643.00
,: t �J ��� ��ti ` �� s:; ���'� r.. � � � �S �. r�' Claimed Valuat�oni � 5s,sas.00�
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�,ti�, �1 Total,��+�'r�$206.66 �<<-_� - �j__.. �� =__<'` „'--- �'� ��' _
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relatad
regulations. (Ord. No. 92-28, § 1, 72-21-92)
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 penod ot 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicabla codes, and all
requlred inepectlone end flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLAfiAT10N:
I hereby ettirm under penalry of perjury one of the tollowing tlecleretians: � `
❑ I heve end wlll mainlein fl certificete of consent to seli-Insure tor workers' compensation, es provitletl for by sectlon 3700 oi the Lebor Code, for Ihe peAormance of the
work for which t�is pertnit is issuetl.
� I have antl will'intain workers' compensa0on insurance, az reqWred by section 3700 of Ihe Lebor Code, tw ihe perfortnance oi the work br which this pertnit is i55ueO.
My wortk�ers' co�libensa�on Insurance carrier and poll number ara: /�
Cerrier. R�P(iQI�C. LN�Ef`�AJ�'�'Y PolicyNumber. 3�'{7S�—� �
(Thls sec0on need nat be wmp/etetl il fhe permit is ve/ued ef one hunCretl dollers ($700) or less.)
❑ I certlty ihat In Ihe performanca of the work far w�lch thl5 pertnit Is Issued, I shell no� employ eny per5on in any manner 50 85 t0 betOme 5ub�eCt to �he worker5'
compansation laws of Celifomia, and agrae that It I should become sub�ect to ihe workers' compensation provisions of Section 3700 of Ihe Labor Code, I shell forthwith
comply wlth these provision/sy��� /�/�� G}
AppliCent SlgnaNre: /��� T'JC1� Data: Y^�� 9 C1 ,
WARNING: FAILURE TO SECURE WORKERS' CqAPEN5ATI0N COVERAGE IS UNLAW FUL ANO SMAIL SU&IECT AN EMPIOVER TO CRIMINPL PENALTIES AND CNIL FINES UP TO ONE HUNDRED
TiqUSAND DqlARE (5100,000�, IN ADDRION TO THE COST OF COMPENSATIIXJ, �MNGES AS PROVIDED FOF IN SECTION 3]W OF iHE LABOR ODDE, INTEREST, M!D ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm thet I am licensed under provisions of Chepter 9(commencing with Section 7000) of Division 3 of ihe Business and Protesslons Code, antl my Ilcense is in tull
�orce end eHect. Lic. p 3�'l 1 9(e c�ass a C. ^ I U� G^I �n
ConiractoYsSignatura: Date: �'"1'�ig,
CONSTRUCTION LENDING AGENCY:
❑ I hereby eflirm that there is e construction lending egency for the pedormance ot the work for which this permit is issuetl. (Sec. 3097, Clvll Cotle).
Lender's Name: Lendefs Address:
Signature: Date:
OWNER-BUILDER DECLAfiA710NS:
I hereby affirm ihat untler penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Buslness and Professions
Code: Any ciry or counry w�ich requires a pertnit to construct, elter, improve, demolish, or repeir eny structure, pnor to its issuance, also requires the applicent tor such permit
to tile e signetl stetement t�at he or she is licensed pureuant to the provisions oi t�e Coniractors License Lew (Chaptar 9(commencing wlth Sectlon 7000) of Division 3 of Ihe
Business antl Pratessions Cotle) or that ha or she is exempt theretrom antl the basis for the allaged exemption. Any Wolation ot Section 7031.5 by any applicant for e pertnit
suD�ads Ihe applicant to e dvil penalty of not more Ihan five hundred dollarg ($500).):
� I, as owner ol Ihe properry, or my employees with wages as iheir sole compensetion, WILL DO THE WOHK, antl ihe structure is not Intended or ottered for sele (Sec.
7044, Business entl Professions Cotle: The Contrectors License Lew Goes not appry to en owner of property who builds or improves ihereon, and who does such work
himself or hersetl or ihrough his or her own employees, pmvided thet such Improvements ere not Intentletl or oHeretl for sale. It, however, the building or Improvement is
sold within one year of complation, tha awner-builder will hava the burden ot proving Ihet he or she did nol build or improve for purpose oi sale.).
❑ I, as owner at the property, am EXCLUSIVELY CONTRAC7ING WITN LICENSED CON7RACTORS to construct the project (Sec. 7044, Business end Protessions
Code: Tha contrectors License Law does not apply to en owner of property who builCs or improves thereon, end who cronirecls lor such project with a contractor(s)
license pursuant to the Contracmrs Licanse LawsJ.
❑ I am exempt under 5ac. BuSineu end PrOfessions Cotle tor this reason:
SignaWre: Date:
Owner ID verified by tlriver's license. ❑ Ves ❑ No Driver's License No. Expires:
Veriflcatlon of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
❑ I �erehy cenily that no ezcavation five (5) or more leet in depth into which a person is required to descend, will be made in connection with work euthonzetl 6y this
permit, entl that no building sirucfure, scaflolding, felsework, o� demolltlon or tlismantling t�ereof, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Celilarnie Adminisiretive Code).
❑ As ownervbulltler, I will not employ anyone to do work which would requlre e permit irom ihe Dlvision of Industrial Safery, as noted above, unless such person has a
permit to do such work from Ne division.
Slgneiure: Date:
Division oi Industrlal Sefery Pertnit Number:
CERTFlCATE OF COMPLJANCE AND AUTHORQATON OF ENfTiY: I certify under penalty of per�ury Ihat 1 hava read Ihis application and state Ihat ihe intormetion given is
correa. I agree to comply with ell slate lews and ciry ortlinances relating to bullding consiruction, antl amhorize represemaWes of the Ciry of Casta Mesa to enter upon Ihe
above-tlescribetl property for inspaction purposes. I agrea not to acupy or ellow occupancy ot eny bullding aut�orized by this pertnit uNil linal inspection.
Signa u e Ot Legal r(s) Date
� a-3 - 99
AnNOr Authorized Applicant Date
GOUE I. INSPECTIONTYVE
1616 Fixed System Final Fire Prevention
1266 Pool Spe Finel
200 Final Re-Roo�
201 Final Block/Retaining Well
202
203
204
2d48-46
Finel FaCtory Flre Place
Final Sign
Final Demolition
P9g I[�LS
� ��' � �_
GO�E I INSPECTION TYPE
206 Final Mechanical
208 Final Plumbing
210 Final EleCirical
212 Final Fire Prevention
220 Finel Planning Approvel
222 Final Site
250 Final Building/Occupancy
DpTE
N R
1-�•� �
(714) 754-5273 • Fax (714)
__ CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 555 ANTON BL
Suite: 11
Vicinity: 11TH & 12TH FLOORS
ParcelNumber: 41050110
Applicant: ELLIS, MARK
Address: 2505 MIRA MAR
CA
LONG BEACH!
Owner. SHKIVKH"rAl
Address�N\ �, �
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FIRE Ati1RM8YS
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��'� Plan Check:�� $108.71
� ^ Permit:�, $167.25
\ Other ., $0.00
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Zoning:
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?hone:�—(562) 498-8444-,,- \`
'Zip: i 90815 1
77 FAIR DRIVE, COSTA MESA, CA 92626
. ; .
� ISSUED BY:
Stalus: ISSUED
Appliad: 08/19/1999
Issued: 09/03/1999
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a penod of 180 days.
INSPECTIONS: �In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlona and flnel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARAnON: �
1 here6y effl �untler penelry ai perJury one oi the tollowing tleGeretlons: '�� -
❑ I have entl,will meintein e certificete of consent to seli-Insure for workers' compensetlan, es pmvided tor by section 3700 of the Lebor Code, for ihe peAormance ot the
wark tor which ihis permit Is issued.
l� I have and will tain woAcers' compensation insurence, as requlrad by section 3700 oi Ihe labor Cade, for tha peAortnence af tha wark lor which this pertnit is issued.
My work�jf� nsatlon Insuranca carder end palicy number ere: —J �j
Cerrler: '�+'— V al�+� 5-1�7 �E^'N�T �' Policy Number. O�'I iPO ^� 6
(Thls sectlon need nat be cromplefed!l fhe permif Is valued et one hundred dollers ($f 00) or less.)
❑ I certiFy that in ihe peAartnance of the work for which this pertnit is issued, I shell not employ eny parson in eny manner so as to bacome subJect to the workers'
compensation lews of Celifomla, and agree Ihat If I should become su6ject to the warkers' compensetion proNsions of Sectlon 3700 of the Lebor Code, I shall forthwith
comply with these provision�sy.y/� ��/� p�
Applicem Signawre: �/' rv� CXY. Dete: `'��� �i �
WARNING: FAILUFE TO SECURE WORKERS' ODMPENSATION ODVERAOE IS UNUW FUl AND SHRLL SUBJECT AN EMPLOVER TO CRIMINAL PENPLTIES AND CNIL FlNES UP TO ONE HUNDFED
THOUSAND OOLLARE (5100,000), IN A�DRION TO THE COST OF COMPENSATION, DAA4IGES AS PROVIDEO FOq M SECiION 31W OF THE IABOR CODE, IMEREST, AND ATTORNE`f5 FEES.
LICENSED CONTRACTORS DECLARATION:
I �ereby attirm that I am licensed und r p `ovisions of C apter 9(commencinq wit� Sectlon 7000) of Division 3 0l the Business and Professions Code, end my license is in full
rorca and enect �ic. a �d 7 1 4�o ciass a G^!O / G—� (e
Contracmr's Slgnature: �Y �� oate: 4� 3—Q q
CONSTRUCTION LENDING AGENCY:
❑ I hereby aRrtn t�at there is a construction lending egency lor the pertormance ol the work lor whic� this pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Neme: Lendafs Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereDy ettirm ihat untler penalry of perjury that I am EXEMPT FHOM THE CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7037.5, Business end Professions
Code: Any ciry or counry which requires a pertnit ro consWd, alter, improve, demolish, or repalr eny sWCNre, prior to Its luuance, fllso requires the appliwnt for such permit
to tile e signetl statemem that he or she is licensed pursuent to the pmNslons ot Ihe Conirectors LJcense Lew (Chapter 9(wmmencing with Section 7000) of DiNsion 3 of Ihe
Business antl Professions Code) or thet he or she is exempt therelrom end Ihe besis for t�e ellegetl exempiion. Any vloletion o1 Section 7031.5 by any epplicant tor a permit
subJects Ihe eppliwnt to e civil panalry of not more Ihan flve huntlretl tlollars ($500).):
❑ I, es owner of the pmperty, or my employees with weges es their sole wmpensation, WILL DO TME WORK, antl the sirucWre is not intentletl or oNeretl for sale (Sec.
7044, Business and Professions Code: The Contrectors Licensa Lew does not apply to en ownar at propeny who builds or impmves thereon, end who tloes such work
himself or herself or through his or her own employees, provitlad that such Improvements ere not intended or ofleretl tor sale. If, however, ihe bullding or improvement is
sold within one year at completion, the owner-builder will heve Ihe burdan ol proving thet he or she tliA not huiltl or improve tor purpose ot sale.).
❑ I, es owner oi the property, em E%CLUSIVELV CONTRACTING WITFi LICENSED CONTRAGTORS to construct the project (Sec. 7044, Business antl Professians
Code: The contracmrs License Lew tloes not apply to en owner af properry who bullds or improves thereon, antl who contracts for such project with e contractoqs)
license pursuam to the Contrectors License Lews.).
❑ I am exempt under sec.
Signeture:
Owner ID verified by drivels license. ❑ Yes ❑ No
eusiness entl Profeuions Cade tor this reason:
Venfication ot Ownership by (type ot document, i.e. - properry tex bill or deed):
DnveYs License No.
Date:
E¢plres:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cerlity ihat no excevetion tive (5) or more teet In tlep�h Into which a person Is requlred to descend, will be mede in connectlon wi�h work authonzed by ihis
permit, antl that no �uiltling siructure, scaHolding, falsework, or tlemolition or dismentlinp ihereoi, will be more then thirry-siz (36) feet high. (Chep. 3.2, Grp 2, An 2, Sec.
347, Title 8, Celitomia Atlministretive Code).
❑ As owner-builder, I will not employ anyone to tlo work which wauld require e permit Irom the Division ot Industrlal Safery, as notetl ebove, unless such person has a
permit to tlo such work from ihe division.
Signature: Dete:
Divislan oi Intlustrial Salety Pertnit Number:
CERTIFlCATE OP COMPLIANCE AND AUTHORVATION OF ENfRY: I certify under penelty of per�ury that I have reatl this application and state that the intormation given is
correct. I agree to comply with all state laws and ciry oMinances relating to building construction, and euthorize representatives ol the Ciry ot Costa Mesa to enter upon Ihe
above-described property for inspection puryoses. I egree nat to occupy or ellow ocaDancy of any bullding authorized by thls permit untll final inspectian.
wre Of L�ga� ner(s) q� oat q 9
L� � '
AnNOr Authorized Applicant Date
COpE �. INSiECTIONiYPE
1616 Fixetl Sysrem Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2C48 96
OpTE 1i�43`
COOE� INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Finel Eleciricel
212 Finel Fire Preventlon
220 Final Planning ApDrovel
222 Final Site
250 Final Building/Oaupenq
PAg L�
�"%'� �
(�ia� �sa-sz�s • Fa: (»a) �sa-aess
- CITY OF COSTA MESA
BUILDING D/VISION `
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
.lob Address: 555 ANTON BL
Suite No 11
Vicinity:
Parcel Number: 4�050� 10
FLOORS.
Applicant: LOU RODRIGUEZ
Address:
.r
MECHANICAL PERMIT
�Phone: 818-244-6571
Zip:
Owner: SAKIOKA FARMS �
��' '
Address:� -� � ' . _
„ � _
' `, � -
, � � . ,_.,_ -
Contractor: AIR CONDITIONING CO., INC
Add 626 SAN FERNANDO RD
Phone:
Zip: 94137
ress. 5 .
' CA� ; Phonei �. (818) 244-6571
� , GLENDALE Zip: ; 91201
1 . - . � - � � � License: 120696 - .
Arch / Eng : � �f - �''� .
= . � � . � �\ , . " . ' � „ ,
Address: - '�� � - -
� �.. - Phone:
Zip:
, , , � License:
PERMIT NUMBER (
M99-00549 v
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED i
Applied: 12/9/1999
Issued: 12/9/1999
� .
ISSUED BY:
' t �SCOPE OF PERMIT
' 11 & 12TH FLOOR "-TICKET.COM" OFFICE TI, RE:699-01930, ALTER A/C SYSTEM IN BOTH
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep.,Recess Wall Htr
Refrig Sys <100 k BTU ,
Refrig Sys >100 k BTU, �
Gas Piping � .
Factory Fireplace �
Hood w/Mech Ezhaust
VAV Box
Vent Fan / Single Duct
Appliance - ,
Fire Dampers
Smoke Dampers .
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfrn
Floor Furnace
Floor or Suspend Heater
$23.50
so.00
$0.00
$27.40
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0:00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
� ��
Quantity - -
0
0
2
0'
0
0
0
0
0 �
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY - ' '
- - - . / ,; .
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeretion Unit
Ventillation System
� Evaporative Cooler
' � � Commerciallncinerator .
� � Domeslic Incinerator
- Compressors / Absorption Systems
Upto3hp/100kBTU
3 To 15 hp / 500 k.BTU
� 15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
� �Boilers �
Upto3hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
� � � Other Mechanical Fee
Investigation Fee
• � Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS I SPECIAL CONDITIONS
�
Quantity
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$50.90
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 tha work authonzed under this permit �0 6e considered legal, such work must comply with all applicable codes, and all
requlred Inapeetione 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 �
WORKERS' COMPENSATION DECLARATION: ..
I hereby aftirm under penalty of perjury one of the following declerations: •
❑ I have and will maintain a certificate ot consent to seN-Insure tor workers' compensation, es providetl tor by section 3700 of the Labor Cotle, for Ihe paAormance of the
work tor which t�is permil is issued. , '
� I have antl will maintain workers' compensation insurance, as requiretl by sedion 3700 of ihe Labor Code, for ihe peAormance ot the work for which this pertnit is issuad.
. My workers' compensation Insurance wrrier and policy number are:
Carner. Z//h�o%1 / PolicyNumber. 11Z�%7U/
(This section neetl not be comp/ered it (he permit is valued et one hundred dollars ($100) or /ess.)
❑ I certify that in the performence ot the work for w�ich this permit is issued, I shall not amploy any person in any manner so as to become subject to the workers'
compensation laws of Califomia, and agree ihat it I should become subject to the workers' compensation provisions ot Section 3700 of ihe Lebor Code, I shall torihwith
comply with Ihe visions.
�Applicant Signat : Date: �/ Z ^;�—�6'9 /
WARNING: FAI TO$ CURE WORKERS' WMPENSATION Cp GE IS UNLAWFUL ANO SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAN� OOLLARE (S10D,000), IN ADDRION TO THE COST OF ENSATION, DAMAGES AS PROVIDED FOR IN SECiION 31060F THE L4BOF CODE, IfJrEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aftirm that I am licensed under provisions of Chapter 9(commencing with Secii�00) of Division 3 of �he Business and Professions Cotle, antl my license is in full
force antl etteci. Lia lf " / Class a_��— 2 �� /
� Comractor's Signalure'�� / ��� ,/ Date: _
CONSTRUC710N LENDING AGENCV: �
0 I hereby attirm ihat there is a constmclion lentling agency for iha performance oi the work tor which this permit is issued. (Sec. 3097, Civil Code).
Lender s Name: Lendefs Address:
SignaNre:
OWNER-BUILDER DECLARATONS:
Date:
I hereby aHirm that under Oenalty oF perjury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business end Professions
Cotle: Any city or counry which requires a permit to constmct, elter, improve, demolish, or repair any strucWre, prior ro its issuance, also requires ihe applicant for such permit
to tile e signetl statement ihat he or she is licensed pursuant to ihe provisions of ihe Contractors License Law (Chapter 9(Commencing with Section 7000) of Division 3 ot Ihe
Business and Pwfessions Code) or that he or she is exempt Iherefrom antl the basis tor t�e allegetl exemption. Any violation of Section 7031.5 by any applicent tor a permit
subiects ihe applicant to e civil penalty oi not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, antl the struciure is not intended or oReretl for sale (Sec.
7044, Business and Professions Cotle: The Contractors License Law tloes not apply to an owner of property who builds or improves Ihereon, and who does such work
himself or herseH or ihrough his o� her own employees, provided thet such improvemenis are not intentletl or offered for sale. If, however, the building or improvement is
soltl within one year oF completion, Ihe owner-buildar will have the burden of proving that he or she did not build or improve for purpose ot sale.).
❑ I, as owner ot the property, am E%CLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to consimct the project (Sec. 7044, Business and Pmtessions
Cotle: The contractors License Law does not apply to en owner of property who 6uilds or improves ihereon, antl who contracts for such project with a contractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am exempt untler sec. Business and Professions Code for this reason:
SignaWre: Dare:
Owner ID ventietl by tlriver's license. ❑ Ves ❑ No Driver's License No.
Verification ot Ownership by (type of document, i.e. - property �ax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I hereby certity that no excavation live (5) or more feet in tlepth into which a person is required to tlescenQ will be made in connection with work authonzetl 6y ihis
permit, and tha� no huilding stmcture, scafFoltling, talsework, or demolition or dismantling thereof, will be more than thlrty-six (36) fee� high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomia Administrative Cotle).
❑ As owner-Duilder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safery, as noted above, unless such parson has a
permit to tlo such work from ihe division. .
Signature: Dare:
Division of Industrial Safety Permit Number
CER7IFICA7E OF COMPLIANCE AND AU7HORIZA710N OF EN7RY: I certify under penalty of perjury �ha� I have read this application and sta�e that [he information given is
corred. I agree to comply with all state laws and ciry ortlinances relating �o building conswction, and authonze represen�atives of the City of Costa Mesa to enter upon the
above-descnbetl pmperty tor inspection puryosas. I egree not to occupy or allow occupancy oi any builtling authorized by this permit until final inspection.
CODE t. INSGECTIONTYPE �
1616 Fixed System Final Fire Prevention
7266
200
201
202
203
204
244s a6
Pool Spa Final
Final Re-Root
Final Block/Rataining Wall
Final Factory Fire Place
Final Sign
Final Demolition
ixrrtia�s
CODE� INSPECTIONTYPE
206 final Mechaniwl
208 Final Plum6ing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
Final Builtling/Occupancy
0
e
�
�
� RDOPFSSOFBUIlaNO: SSS ANTON BL
avxeasru�eira+avx: SAKIOKA FARMS
�ooeess: p0 BOX 2097
TERMINAL ANNEX
�vv�. �uimo,�uoxess�
UNi:
�xcxrt�cr ox ��n: uc. xo.:
�xcx. on u+c.�s �oon[ss: uxr:
ca+m�crarswu� MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
CONfX�CTOR5M1111NG P O BOX 504
��ss WALNUT CA �r,o: 230813
91789 unr:
' 4CENSED COMH�LTOHS UECL�NIITION: I heraEy ellkm uMer pene�y d parjury tMt I em IceneeE uMar qovieione d Chopler 9
'� (mmme�np wilh Seclion ]W0) d piviaion � d Na Buvroa W Vrdestima Code, eM my lin�ua ia in tu0lorca enE afletl.
cRruc.No.:0065('�58 uc.cu,ss: C 10 uc. : 23�013 EXP• �12/95
oete: �'7 — � l '—' �' S comreaoc
W NEH 6UIl0EN OECLANATION: I Mm�y dfi�m uMer penNy M perjiry Ihe n ue p/mn iM CaMredm Lironee Lew la Ihe
Imhnp ieewn (SeUbn ]0]1.5 Bue'uwee eed Prolaeeiom Code: Any eYy or e nry xfiic rpuiree e permn to wuvuet. Mer, improva,
emols�, or mpei eny elmcwra, pmr m Xe enuence, abo reQuiree �he eppli t lor wc em�il lo fila e eyrwE eletemenl ihel he a she
ia licenasd Wnuenl lo Ihe powiwn d �M Conlredwe Licenu Lew �Chept r 9( entl�p wuh Setlion ]OW) al Oivebn ] ol lhe
Buv�wa eM Prdeasuro Cod�l a Ihel he a ahe u vemq tMehan arM t la Na dbpeE exemqian. My vidtlion d Soaion
lW t.5 b/ ury eppliranl for e permu wbpas tM epplirsnl lo e wil penany d m� mwa �han I'wa hurdred ddWa �SSW�.
� I.mowxrd�MpropenYormYempbyaeswYhwep»av�heiedemmpenaetion.WldoNowork.eMNeevunuroumtimeMeE
a oRered M eeb (Seclion )016. BuaireaeM PMmaiona CoUe: TM COMretlors Lkaue lew Ems �wl epyy loen owiwr d qope�ly
WM iMl�f IX TpM6t ��ICIBCII. Yld Y�}q dOBf tU(31 MN{', hY11bM M �IBf90+IX dif.OUi� hC IX �1Of ONTlTVbYM]. M��d ��1Y Wf�l
�w�ma. m. nd'wenasa «d�.ma �« wa. n. nowewr. �ne duNuw «o,w�+.m u.w wanin ar rav d omiW+un. �ne
owmr-0uiNer xi0 hew ihe buedm d pwinp M a eM ditl np buitE a impwe In Ne qrtpms d ub).
� 1, ea axTMr d IM piopeR/. em utlueiwy ooniredip wilh Ibmaed eontrec�ore ro rnmrue ihe piojee (Smnn �10. Buainme enA
Prdeseiom COEe: The Conieedon lieeme Lew Aom nal MdY ro an owner d G�W�Y r.fio buiM� or inpwa tlw�ean uM wM
cvn�rac�a /a vrh pqw� wuh e mureea(n) licmaed pveuem to tha ConVaCora �iwoe Lawl.
� I am azemq uMs Secwn: B. 8 P.C„ br Ihia reasm:
Dale: �
1 do MreW uNH tlw I em ewe tl eM wtlmsieM Ma �Ww�mb d Ge@anie HaeM end 9efM' Cotle Setlbm 25505. 25SV. end
25531. vd tlut I IX ury Mwe Wildiiq omipent will / Wil rw� (tlacb me) need b cwnply wiA oN mts mdae ad IM mpwromMb tar
epaimillaconavuctionormoE'ifitalbnhamlMA'r uaTeiy.IrerepemamDis�rip.RmkeMielwW�uqionepqiratiproanwanptimmthw
proW.ion..
De�a: Appliran:
WOHKEN'S COMVENSATION DECLANATION: I Mreby eMum unEer per�elty d perj�vy pre A tM IdlowinB �vnone:
� I hera eM wJ meinien e cMilictle W mroent io vetlirtwn br xwken' wmpanselbn, u povided IaW Sed'an �100 d ihs lebor
Cade. la iM pMame�we d tln wwk In wNch I�u pamn is isuad.
r] I heve eiM wil meiniein waekeA aompenaeion inararKe. u repuired by $epim 910p d Ilw Lebw CoEe. br IM pe�ormexe d iM
workro..nknim,p,�n�.re.�e.Myw«��Fl�REMAN S FON�D��um�r�� EXPIRES
ce„�«:
vd:.vN�mw.: uw�aun ioby i 07/01/96
(lhis seaion neeE rat 6e comdN� d �ns pmmd ia ror are huMred Edlars (S�ao/ a Iese.J
� I cerlAy Nd in IM peAormenca d tM wak la whkh Ihis peimX b baued. I ahdl mi empby eny parwn in eny menner eo m to
bevwno eubjm to tM v.vhss' mmpemmion laws d CalJmve. vd aprea I A 1 dpuN barome wbjq io �M xaM1na'
com bn paiaum d Saeion 2l00 M tM Lebor GoEe. I �hmlh oom wEh Nwe povc'vy �
o�, %/�—�9--9� A��
W�ml �� un ro ucun woil[wi rompnutlon rovxap Is unlew�M, �n ahs/l � fM M wnylqN ro Glm4ul qMlllu �/M
u.ri n�., w ro w�. n�a..c mo�,w eaws �sioo,aaoi m.eaao� m oo.� o ro�owwtbr� Glnpu u povMM br In
sxaw, s)a o� m. lYmo. coa, �m«..t .�a.rrom�y', rw..
CONSTHUC110N LENOINO AGENCY: I hraby elfirm uMa peneXy d ry Ihwa u a mutiutlion WWinp eperwy br iha
partormarice a �ne worx �« .MNi �nc v«m� e aw.e (secion ]p8'/. cw. cI.
LENUEN'S NAYE
LENOEN'S �UOPEA4:
I eeMy thet I heva eeW No eppl'r.elion ud nme ihm IM above iNormetion ia earred. I epne lo eampy wn� eA rny enE rouniy ud'uwieea
eM atme lews reWip lo Wiidfq camuuim end herebY eNlv¢e iepresmimwm d Ihu ay io eru> upon tM abv.a�maniiansd propany
r«��oaa�,wm�. CEiUCK �JACOBY
� �
� = �� �5�5�<fi.WP)
D�/O'I�7��'I �
Selory: O�aemFb: Cenery-AVPke�l: Pink-Revanue: Galdenmd-beeapr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 074686 PLAN CHECK NO: N
CONSTRUCTZON TYPE: 1—FR PERMIT TYPE: ELE
JOH DESCRIPTION : 200005F OFFICE T.I. /ELECTRICAL
CLAIM VALUE: CALC—CrALUE:
PERM NO: E 074686
GOVT: N SUPP: N
PURPOSE; ALT
SQ FT:
GROUP OCC: B-2 /
COMMED]TS: 76 UNION PRODUCTS / REF B-74630
# 3E iE �f if if:E 3E 1f �)E IE !F 1E �(-iF if iE k�)E 9E fE IE �E �F iE iE 3E 3E 9E iElE iE-1E IF iE iE iElE jE if 1E iE iF 1E iE iE iF iF iE �1E 3E # 1F iE �IE iE iF iE iE # iE iE # 1E ## iE # if # fElE ## iElf iE iE iE
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUZLDING ----------
FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCESSORY BUILDING ----------
FRNT: FT IN REAR: FT IN
LEFTt FT IN it�HTt FT IN
PARKIhI% REn: FRt�Nt I�!��F?ELF $?(���1F�'4 %3N�r R��' N�t
PLAbIhlrpar, NnTES� `�.
���;���f�;��#���#���#��bk�:�f�rtf��i������(r�icr4�il���r�#t�S���k��'i�fri�t�>a����s sKkx��*#�c�*
v E V E L v P M E N T � E�Ft V I�_ E S R E C1 U I k E M E N T S
ZONING APPROVED BY '' DP.TE:
BUILDING APPROVED BY ; � DATE:
APPLICATION ISSUED BY: ' G
if 3f iE if if #'- iF �f 1E �E 3E iE 1ElF dF fE �E 3f 3F �E iE 3E
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLOMBING ELECTRIC MECHANIC
PERMIT 193503
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 193,25 15.00 0.00
REVENOE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
208.25
�� DATE: �Z�-19—%S
sk3Fic'i6if if if iFiEif 1ElF iE3F�iF�iF if iE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
208.25 20i1.25 .00
208.25 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
!E IE 1E 3E �)E-)E 1ElE iE iE if �1E jf iE �E iF iElE !E dE k 1E if if 1E if M-iE if'1(-1E �(- IE iE �f iE IE iE 14 iE 3E �E iE �lE iE �E �IE'IE iE �1F 1E iE iE 3E iE iElE ie 3ElE if iE iE 3E iE �E �E # 3E iE fE �E iE 1E j(- if # IE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
ELE
ELE
ELE
ELE
ELE
ELE
ELE
QTY
z0
120
120
2
1
D E 5 C R I P T I O N
FIXTURES, LIGHTING i ST 20
FIXTURES, LIGHTING ADDITIONAL
RECEPT/OUTLET 1 ST 20
RECEPT/OUTLET ADDITIONAL
RECEPT/SWITCH 1 ST 20
RECEPT/SWITCH ADDITIONAL
SUB—PANEL
END OF FEES
UNIT COST TOTAL COST
EA. .75 15.00
EA, ,45 85,05
EA. .75 15.00
EA, .95 51.30
EA. .75 15.00
EA. .4� .90
�1 . f � T 11 � �� /
TE ��
+,� �01:id:;1—„�1424`I T�C+T 2fJ5�''=�
LATz= _7-.9��°� 7;"�'• 1';5,; '
r�
% i
CONSTRUCTION AND PLANNING F _$ SPA
' �qPPflOVA�S Permit# Date Inspector qppROVALS Permit# Date Inspector
�`. Temporery Eiectrical Service or Pole 52. Pooi & Equ�pment location
2.� $oil Pipe�Undrgmd. � 53. Steel Rei�forcement
3. Elecirical Conduit Uiifity-Undrgmd. . 54. Forms �
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcemeni 56. Rough Plum6ing & Pressure Test �
6. E�ectrical UFEfl Grod. 57. APPROVAL TO COVER-GUNiTE
7. Footings 58. Electrical Conduit-Undrgrnd. '
B, Foundation 59. Gas Pipe, O U�drgrnd., Test
9. Water Pipe�Undr9rnd. ' - 60. 8ackwash Lines, P�Trap, Q Undrqrnd.
10. S�ructural Floor Svstem � .- 61. APPROVAL TO DECK
71. Property Sewer Line & House Connection � 62. Backwash & Receptor•Final '
S2. Se`^�e° CaP _ 63. Neatar & Vent-Finai ',
13. Roof Drains ; 64. Plumbing System - Final �
74. Rough Plumbing � 65. Electrical-Final
15. flough Electsical-Conduit • 66. Solar System-Finat '
16. Rough Electric Wiring ' ' 67. Pencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
1:-Ro�gh Electrica6T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
i
tf1.-Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit #
27. Ducts, in Structure 70. Underground Hydro
22. Dutts, Ventilating 77. Product Piping � Gas OOii
23. �Gas Pipe•Rough & Test 72. Underground Flush
24. Roof�Framing 73. Undergrnd.StorageTankdGas �Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Diy Chemical
27. Prame and Flashing 76. Dry Standpipe
Z8. Lething & Siding ' 7�. FIXED SYSTEhA FINAL
29. Insu�ation 78. FIRE PREV. FINAL
30. DrYWalt Na�iting HEALTH DEPT. REQUTAEMENT
31. Plester Brown Coat 79. FINAL INSPECTION
32.'Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Finat. Electric f(�/� � Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final FactorY Firepiace
38. Final Plumbing
39. Water Service-Finaf
40. Gas Service-Final '
41. Solar pomestic�Finai � .
42. BackfVow Preventer
43. Backflow Irriqation _
� 44. Landscape Irrigation System ,-�: -
45. Sound Attenuatio� '
.
46. Handicap Regulations �
47. fINALSTRUCTURE&BU�LDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. C�RT1FfCATE OF OCCUPANCY
No Date �
�nnrssaemiwa: SSS ANTON BL
°""ERs"u'E"'aow": SAKIOKA FARMS
"°o"E"' PO BOX 2097
TEAMINAL ANNEX
MPL. WUWlO /i00flE59:
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COHi""C0k4N'�` COMPEL CORPORATION ( 310 ) 946-8321
CONfPACfOR9YY1Wfi 10410 PIONEER BL
A0°"� SANTA FE SPAINGS CA 1CN0.` 392693
90670 °Hfi
LICENSED COMN�CtORB DECLAPATION: I MmEy eflim uMx puuJy al perjwy tMt I em Itansed uMm paviam d GMps 9
�oomm«,oro .cn s.�� �aaol d aw�, a d� e��...�d am...� coe...�e my � m� mc m2e �d ,xea.
cm uc. No.: uc. cuss: uc. No.:
032054 C-30 9269 .�7tP: OB/96
/r� -Z� - fS �.�
om.: co�mm«: - J rivsGoti
W NER BUILOEF OECLAN�TION: I haeby �im uMm penNy W perjury Ihet I� tM Comreaon licema lew Iw Ne
bxiq �anton (Setlbn ]O�1S &nima eed PeWeeaiona Coda: AT' ciY a aounlY vAiN iWu'um a DumG lo mteWcl. Ma.'vnYwe.
.BT0�9�1. IX fl�0f 011y 81NCINl. p1�.T b b�OfU011CO. 0�f0 Aj111Rt 1�1G G�YbY IOf plCh pMM lo �1�8 e pjlqd EWBIIIBN I�W �1! IX i�1B
m u em.e w�+w�� �o m. wwmu,. a w. comrmon �imrce �ew Icnw., s I�.�c .an seao� �0001 d w.:on 3 a ub
Buwie�s end Rdeae'vn CaMI a IMI M a aha u e�emq �hsehom aM ihe Eme la tlr eAepeE uamqion. MY vWmion tl Seain
]W 1.5 by enY aDWKe�I la e pxme wbpaa tM eppliram io e dvd penMy d nd man �Mn frvs huMreC Edleia �SSWp.
❑ �.moxn.ra�neo�ronv«mv�cM+e.,�n.reaa.e.�n.:.dewmvame�ion.wineomewoix.eneubswnu�ewnaimmwee
or oflereE la eeb (Sanion )01I. Buvro» enE PMeseiona CaEe: TM Comrmon licarue lew doee ra eppF� toen oxnx d poperry
who Wida n inpovea IMreon, aM xfio doea euch xdk IimesH a MnN a Nrouph he a Mr ovm empb/ees. pwitleE Ihet wM
imV�TM�eNa ma not iNendetl a Werad lu eab. tl. Aowa�mm. iM briNinp a in0�'�ep is wIC witNn me Yeer W oom0�ion. iha
ow�«am., �:u n.v. in. w� a aw�m ne «.ne ma m wua «�aa+�« ine wm� or..b).
❑ �. e. o.nm a ine awem..m ..a�elr oom.eena wan �iwwe oo�v.nn. w wnava the wq� (s.aiu, �w.. a,.ins. ena
PMeaeions CoEa: The Conirecon licenu Lew Eom iwl eGWY w en owrcr G pW�Y who buJds a unV�'�m tlw�eon ard wM10
conirecta Iw euU prqede wil� e coMredor�e) licenwd punuani �o IM1e Conlreaon lironse lew).
� I em eaemq uMer Sxiion: B. 8 P C., br Ihis reeaon:
one: am,..:
I Eo Mreby canity ihat I em ewere d W uMen�eM tln reQursmems d Cellomie HeMh ud Sefery Code Swioro 25505, u533, eM
25530, arW t�el I a eny Mure buildiip ovupeni xill / wJl na (arck «ro) naed �o compty w1� eeid pele wCee eM IM myuiramenb br
epamiil/wmnawciionormoEAicelionhomt�eRr ue�iy enepemen�Dipnd.ResiEenlielconelrud'aneppkralioneereexemqlromtMae
warisin,..
Deia: ADWKeru.
WONKER'S COYPEN311TION DEClAN1TION: I hereEy elfirm uMer perehy d pe�jury aw d �M /Wbwirp Ee�iereliona:
� I hew vM wil manlen e cerlMcela M ronwni to saN.inwm Ia vrorken' wmpenwbn. m poviEeA la by Seaan 3)00 of �he Lebor
Code, lor t�e pa�iamenca o/ ihe xark lor which ihie perm� ie Inued.
r] I heve eM witl manlen waMert campeneeiion Inarvee. u rpuireE by Seclion �]UO d the lebar Cada. br the perlwmence M iM
wark Iw r.fiid� ihia pmmn n iaueA. My waNert wmpen�bn inwrence wnar uq pdiry number ve:
P�'N m� F�6P42�1T 6Ai4� EXPIRES
(ThissecfionneednMbecanpb�MitM1spxmxislaarohu kn f wbu. �z�01�96
� I ceMity IM1eI in iM parlwmerica M iM xroA la v.1�kh Ihia pamin ia iewW, I ahell � ampby any pemn in eny mennm eo av to
becwna wEjatl to IM xorkere' canpeneeiion levn ol Cdilomie. uq ep�ee ihet il I eMUH Decame aubjeU to IM haMn'
compenaetion pwieoro d Seeion �]00 d IM Lebor CoEe. I Mell 1 nhwuh mmp�y xith tlime
oma: �D "ZI` — �j ��p�m: �'��_aite�s+-.
Wem/np: F llun ro sxun woikx�'rompwrutlon covsrp� b unlewNl, m0 ��II �uEpcf en �mploya fo MM�uI paultlu uM
e/v/l flMs up ro one M1undred fMuunC tloll�n (SfOQ000A M�tldlHon b M� mst ol eompewtbM1 Wmepss u povltled br In
Sxtlon 9]O6 0l M� LeEo� Cods. Intsnaf. �nL �ttom�Y'� Iws.
CONSTIiUC110N LENDINO RGENCT: 1 hseby �rm uMu peneRy d perjvy �IW IMn o e wnq�upion bM'uq pon�.y b ths
pMamerce d IM wA M wM1irh th"v pami u uwM (Seaion �041, Civ. C).
LENDEF'S NANE:
LENOEH'S 10DPE39:
��Y iAet � heve med Nn �DN� uq Xd. ilw ihe.bw. iMamman m mnetl. �� b oomPN �ith eA �Y end rdvn,.ordv�enon
enE slate Iex+eaWiq to huddip emmumm erd Mratr/ eWhor¢� �eprxmteiiwa d ihu edy io «ux upan iM WwsmemivwE popeny
la'vapmian Wm�s. ,
RICK STRATFORD /hp gqQSp�J
�J/J /P9)'^ leme
________'���� f/ ��� Dme� ��
Sq��ws d OwebdAqenVApplrenVContmqp
(5151d6.WP) WAne-Buiknp 8 Se1my: Graen-Fle: Canery-�ppican�: Rnk-Rewnue: GaNenmd-A�aeawr
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 074830
PERMIT NO: E 074830 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYpE: 1—FR PERMIT TYPE; ELE PURPOSE: ALT
JOB DESCRIPTION : 20000SF OFFICE T.I. /ELECTRICAL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS / REF B-74630 COMMUNCATION LINES
x�**�*�**+r***�r***�r�rx x��r��r****�****�r***�r*x�x�fr�r�r*�r****x�*�r+�*�*�r+rx �*+r**+�+rx�+�x�+r�r�x���x��x
Z O N I N G A E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 2NE: REF NO:
PLANNING NOTES> �'".
i
iE 1E iE 1k If 1i Ik 1E 1f� IEfE Ik 1F iE I(� iE IE IE 1E If iE if 1f 1F ik 1k iF 141f 1! ik 7E ik ik 1f.ik It If 1F IE i! 1EiE iE iF 1k 1E iE 1E iE IF 1E It iE iE 1E IE 1E it 1E 1E 1E 1i iF iE 1E if if IF iE iE 1k iE 1E iE k �k if iE
D E V E L O P M E N T S E•R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : �'• DATE:
DATE: ��?����
x�x���r+r�it�r *rt
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
APPLICATION ISSUED BY:
�t�t*x *�t�tx *�t�r�t�t�t�t�r***�r�t�t�iF
LEGALI2ATION:N
BLDG PMT PLUMHING
PERMIT
F E E S U M M A R Y
ELECTRIC MECHANIC
61502
FIRE
SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 61.80 15.00 0.00 76.80 76.80 .00
REVENUE DIVISION TOTALS--> COLLECTED: 76.80 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
76,80
it iF 3E 7E 7E 1E if' 7E IE iE 7F k 1k 7E If 7E if iE 1E 1k iF 1F iF ik 1E 1k iE M if i(� iE iF IE iF 1F ik iE 1! IE IE IE IF iE IE IEiE iEiE 1E iEM M IE if iE if 1f iE ii ii if 14 if iF 1E� if if 1E iE 1F 1f 16Ik iE iE iF if 1E iE
I N'D I V I D U A L F E E B R E A K D O W N
TYPE
ELE
QTY D E S C R I P T I O N
20 COMMUNICATION DROPS 1 ST 20
104 COMMUNICATION DROPS ADDITIONAL
END OF FEES
UNIT COST TOTAL COST
.45 46.80
D�3i2 4
QS �Q:S?�,S—f�719:fi2� 'B'Te'� 7, C
DaiE-• iC;.6�l5 7I�E: 1u%Gi
CONSTRUCTION AND PIANNING . P & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
7. Temporary Elec[rical Service or Cole 52. Pool & Equipment Location� �'
2. Soil Pipe•Undrgrnd. �� . 53. Steel Reinforcement "n
��� ���. � .
`�ectrical Condw �!T"t�+ty•Un rgtnd. 54. Porms ' �'
�'
���-0.aETctrical Condutt"Hr(drgrnd. � 55. Electricaf Bonding '
,..� -.<-.
,� 5?S�el Reinforcemen�r,;T, 56. Rough Pium6ing & Pressure Test -� "
[--�6cElectrical UFERTeci�cl� � 57. APPROVAL TO COVER�GUNITE
rc '
��:-F��otings ��C, '�' , 58. Electrical Cond�'�t-y�Jnd�grnd. � �
„ �
y' �. Fqundation � rK o � 59. Gas Pipe, O Undffiind., Test �' 'L
9. Water Pipe-Undr�4id�"� 60. Backwash Lines�'�'rap, � Untlrg.nd. �
10. Structural Floor�ystem 61. APPROVALTO;IIECK ',!`
i i. Property Sewer Line � House�oqnection 62. Backwash & Re�nr-Final�-'
12. Sewer Cap ;�� ` 63. Heater & VenFFinet ' ,
13. Roof Drains � 64. Plumbing System � Final
74. Rough Plumbing� �� � 65. Electricaf-Final ��
. i �,
15. Rough ElectricabConduit ,^ � . 66. Solar SVstem�Fi ral �
16. Rough ElectricV�in� p I 67. Fencing & Acce�'s'�jipproval �'
--17. Rough Wiring $ign i�' 6$. qPPRQVED FO'R'PLASTER�NG '
==78. Rough Electrical`7 Bar Ceiling� 69. POOLlSPA SYSI'�UiS FINAL
19. Rough Heating & Ai� Condiiioning f1RE DEPT. REQUIREME4V7
c a�,m� c[ + i- .a,�.
20. Ftdugb?FaFzory^� vgp79ce ��`� '� * C a �'�"f � pp V�j �CPery� it# �` " y�
.+^. rL Q %7 1 S h' C'. 'A: r. Q' c J �'Y't � r+� 3' ��
21. �ucts�.'.in StruGf,vre�`.�y� i'..'.. �, * O r-�r ��0. tlnderg�TburiT H�ro ` .
..
22. D�ct�Ver��tila g �"" ' •� '� � �� 77. Produc��ing �Gat �Oil
r.. �� �r c� c r.� t-•.�
23. Gzs P`',tpe-F�ug?�& Te�.t � �:; « m ¢ Ot •72. Under9roQhd FIa�tU � F-
24. Raof.Frar�ng •• �'� ' F'F' �> q �� .73�Undergrnd Stor�y�'fank�lGas ❑Qfii
25. Roof;�he ing S�f � •�v# � ' c�= 74.r�'.OverheadHydroj �'
26. LBar[Qeiling (StrusikXali &(t��M1gc�at � n C j+ 75�Dry Chemical HM Y`" `'' ��
27. �mg.�n�lashin�.� =�A,.- xcr � mx 75.�DryStanc'�iine ��m ~�ey � ��
.-28. lath'� &�idin9 nr •� 'y�^ � :� £ . ..� -..� 77:7 FIXED '�,4�TEN�jj�iNAly � �., .,-,Sar
"19. insulatio o �* C ��~~• * `�" I � � "�
�h; :�s S ,- �« 78EFIRE PREV. FINRL * � % Q4
�'30. Drywall N iling ��N �✓ * � � t{gALTF�EPT�REQCiiREMENT
�31. Plaster BrAwn Cpat� t c i;r�r. ,y � I I:« 79.�FINAL Ity.S2ECTI�N. "
,,. .. . . . -:�- - � .
.A�32. 6fectrical�Pow^dMJilsl`-E7nal ; t N j�',.ta O�DODCERTIFf�QY� IS��IED�, ^�
y33. Fynal�lec�[,ic �. �# tn i K��� � , �k N4te�ser •-. i '"�?f t h � :JNM
�
n34. Final:►�eatingBdAi�.Condi:tioning; ,,'i > r,: �•rv �•�' f'�x �: S �"7
,,.' t' m m x'� I H�AG O I r-�Q X. -+C�
.35. Pina1�C'ias Pipe��esY�O# x ,� * � � ' " -� �' ,� ` `'
i w'� C? # r 'x.. ...� Gr+ �JrilT
r_-36. Hood'13r CanoPv •i� a� � tr`: c t�� I I . s Cio : �� .. .�•�
n I �s a� -o + r•. �Oi*i
�- •' ^ i S?^ o # a! � � � �. .> >
��. F�nal{3�cr�}y Fired��e ,� � r,r rv fi + �c-
J � v � �
�ti8. Final9lumbing 5��: �ti � ` I I �{ _ � '" ^ ".
H S. �
�39. Water'Ser�e•Fina1S� � i a ' M ' , ,.� � �' �:; .a.
�{30. Gas Service-Final �-: x tr, �;+^E*� S x n � '�'� ('� � s v y.
.�t �� I 4+ J" t C
�41. Solar pomestioFin�# � -,.� t a � y; �y� T �- 7
. r , •• ' �
' 42. Backflow Preventeny� N ! � i� x ?� ! C� �-+
+- r m r. F
43. Batkflow Irrig�onm.: ^ T�S y. a. .�, ;� �H � `� `-. . .
4,9j. LandscapeJrripation $ystem cfn[j c� x tn _+ Oa c �� n: xCJ �: :u �-
�. y r n m c.
�' H�-. l" L� x� f-' !-- k:l H `-1 Q'rJ lT. CL T
4�. �und A�nuation � .y .. .. �. ,� �* � �, � � . e.,� „ .`
4b, Handicap Regulationsi. �. p � r c� c; s o� � -
.-, .-. .
47. F�NA�CSTRUCs��URC'& BUILiyING K F i�*�' -'• S �,. ; �, .:s� �•_
m
48. F1�lA,�PIANS�7ING t i�-,. * c� �,� c+: m �S .� E- .
- . .- n x
49�. Et€ctrt"�c Release�to Ed[son x j '� E � ..: ` '� _ � � ,
i: -' w
54'L Ges FieJease to Southein California6as Co z: j �a = • cn * :� ••
- �.o « r} or
5b. CERTaFICATE OP OCCUPANCY ^ x • s �� �c .. r , �:�_
No. Date
noon�ssorem�axa: S55 ANTON BL
°""E"e"""E'°'w°w": SAKIOKA FARMS
"°0"�'' PO B OX 2 0 9 7
TERMINAL ANNEX
.vv�. �uiwo �ooxEsx
MCNRECTOPFiXiNFEN:
urcx. ox e++a•s �oonEss:
uxr: 11TH
uc. r�o.:
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coxm�erarsru�: MORROW MEADOWS CORPORATIO ( 719 ) 598-7700
Cd1INACi0R4YY1II10 P O BOX SO9
�p�+ WALNUT CA uaxo.: 230813
91789 u�:
ueviseo cor'rnaerons oEeua�now: i ne�eer .n:m �,�w ce,wy w� uw i� r�..d �.b., aomm� a cn�q. e
��.�re wnn ��000� a oi.+.o� s a m. e�� w r�a«.:M, coa..m my ib.�.. e�� mo roR. �e .ma.
cmuc.no.:006�5�j58 uc.cuas: C 10 uc.No.: 3081 EXP: /9/�G
Dma: /— /r� ` �� Cameaa:
WNEN BUILDEN DEttAN�TION: 1 Mnby elfilm unAsr psnaly M pvpry thet 1 em �emq Im � IM Convrlm Liorue lew for tlr
bwip �wqn (Saqbn )W1.5 &niia� eM PMwebn� CaEa: Airy ciy p wuntY ��+Vuir � e pmnB to mrmbwl. Mm. improua.
wmdsh, p rapv eiry �buctun, pia ro G�'swa�ws, ebo rpuim IM applimnt tor h psrm5 Rb e eiproA'wemsm tlW M w sM
a i�..a w�� m m. w�� w u» cam�.e«. u�.n,. V. Icn.a« e � �..�n s.a� roro� a oN:� � a m.
Bueiere uN AAmiau Coda� a IM M a shs b wmp �Asahpn uW iM eOpaE �emqion. Nry vulmion W bwion
lm1S M M' ecc�wu lu e vxmu ndi+d tM VMirsm to e wi M�M' a na mas �hen five huMnd do0en �S.i00p.
� I.uowwrdiMpoperlYamyamployeae�tihwepeeuiheinbcompevalbn.wipEo�hswwk.eMiM�huclununainleMed
a dlaad br eW (6aciion ]ou. Bud�ww eM PmleaeimaCode: The Comreaaslicenae lewdow rot wWvban owwr d pwaM
`M�p bll�f IX TMwM ��1MBpl. plb 11ip dMf �Ydl MIXk fY11f0M Of �1l90� IX IfYWyI �b IX �IM OY/11 BIIIVb/ed. �b� I�1d Wf�l
impwemeNa us nd'upentlM a aflred ta eels. tl. Mw�aw. ths W�tlinp a in0�'d�em u wld wuhin ona Yser d mmP�ion. tha
ownarbuider wi0 heva �M WMm M Pa'��0 M w eM did nol dek a"vnPb+ln �ha W Wss d ada).
� 1. ea owrier W Ihe pW�Y. am e�d�'eN ooniraaM xnh 4onaed wnVaclors b canstrwJ IM PW� (Saaion 1W6. Bueinma ard
PMesaiane Code: TM Conirepae L'smsa lew doea nd epply io an owwr W popMy Mw Wiks a impwm �Mrean eM who
convecie 1« wtli prqeae r.dh a caqmtlm(a) Icemed WnueM Io IM Convaeon limue law).
❑ i.�,� �+�a ww� s«�: e. a v.c.. w w�,:
o�a: w.,,.:
i eo nmeM �r �nm i em e..m. d m,e unemsm,a ub rea���.�n a cd��y He.m� �d sd�r code seaom uws. usaa. e�a
t55v. uM Ne� I a ury heun Euiki�q amqw will / wil mi (ae4 aa) �d to eanply wY� eek pme ooda eM the nqwiemeeaa br
. w� �nom.weim«maedwiono-amin.�PaueTiyxranev.mem omria. Aeud.. W mmwvn.w�m..n ss«�w �mm ume
wo.m«u.
oam: �oaF.m:
WORKEP'9 CONPENSATION OECLMATON: I heraby dfmm uMm pmdly W pejury oro d the IaOohinp detlaretioro:
� IhmeMWmeirue�ecmW'�edaonwntlovaEimweMxvken'compmvt'vn.opovidedtrchrySWun3)Wd�Mlebm
coe.. i« me ronom,�. a u» w� ia .+:on inm wmw a b.�e.
r] I hevs eiW wil meimen waken' aompenution imurerce. m nQuirod by Sacim 3)00 d tM lebor Code. lw tM pmlormerce d IM1e
work la xhid� ihu parm� ia usued. MY worMn' compenwbn iruurerce carrier eM pdicy number ere:
c�..: FIREMAN' S FCTND EXPIRES
rwryrn,mna.: nwranF��Fq7 07/01/96
(This sMbn nesJ rwf 6e comWetN I Us pmr! ie br ars hundiad ddlers �StW/ a bn.)
❑ I cMaY � in ihs peAormerice d ihe work la whch t�ia pem�n u ieeueC. I WWI M empby erry ysmn in erry mannpp%�� eo av to
becmw wEjed to �Iw xaken' canpammian ler.a d Ldilomu. eM epne Nq il I a ouk Exome wEjen �o ih� waAmn'
ca/nQ_�� ionypy� au[j�Sp/�� nn 00 d �M lebor Code. I Mell lo mmpl� wuh N e p�ovmwu. \
Oe1e: / — // / � / � RDdium: �
W�minp: F�Nun ro��cun workri roniperu�tlon rowiap� l� unl�wlul, end �NII /x� �mproyer ro crlMmlpenaluu uM
cM� nn. w ro on. nurer.e rnou..ro aaw. (s�a[4oro1, m eee�Gon ro m. ca. or rnmp tan d•Mw o wnvmee ro. �n
Sectlon J]06 0l IM LeDoi Cob, /nMuf, �ns �ttomry%� /�ea.
CONSTRUCTION LENDINO �UENCY: I Mroby eff'm �Mer penelry d perjury � o e mruiivaion bMi�q epexy M tlre
perlormance N iha xork lor wfiiW ihe peimM ia esued (Sed'nn 308), Civ. C�.
LENDEH'S NMIE:
LENOEN'S ADDFE%:
1 ronily �t�ei 1 heve ieeC �hb epDlicetion eM pete Ilul ihe ebwe iMamdion n coma. I eprea lo canqy with eA my eM couMY adireMea
eM etaie lewe relminp to buildvq conaruaion enE heroby unhorize npraeen�etivae d Ihis alyto enler upon tM ebova�meruioned properry
forinapaclion purpmas.
l—/�i��
Dete:
(5151 de W P) — W �de-Buildiq 6 Sdety; Qieen-Fb: Cenery-Aookenl Pink-Revenua; addenro�Avaevor
CITY OF COSTA MESA — BUILDING pERMIT
PERM NO: E 076010
PERMIT NO: E 076010 PLAN CHECK NO: N GOVT: N SUPP: Y
CONSTAUCTION TYPE: 1—FR PEAMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : 20000SF OFFICE T.I. /ELECTRICAL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS / REF B-74630 SUP E-74686
x�*�*x�*x��*x�*�r***x��x�**�x *****�r��**�r�rx��*�x�x *x��*x�x��r*+�x��**x�r*x x�***�rx�x�x�+r�r��+t�*x��tx��«�x��r�
Z O N I N G R E Q U Z R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT ZN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 41050104 2NE: REF NO;
PLANNING NdTES� �.;�
1E iE fE �E 1F iE IE IF 1E 1E 1F IF 1E 1E 1E 1f if iE fE IE1E 1k 1E iE IE 1E 1E 1E 1E 1f 1E 7! 1F 1E1E�1E 1f 1E 1E if k 1f 1F k ik K 1FMIf if 1E k iE iF 1E iE 1f iE 1E 1F iE 1E 1E IE iE Ik 1F M 1f 1E if if iE i! if 1F iE 1E if
D E V E L O P M E N T S,E-R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY � DATE:
BUILDING APPROVED HY : 'i
APPLICATION ISSUED HY: �'
�r**itit*�r�rieitie�r*�r+�**+�*itit+e
LEGALIZATION:N F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 1950t
DATE:
DATE: ����
STAUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
PLAN
ISSUE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 19.95 4.50 0.00 24.45 24.45 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24.45 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.45
1E �E 1F 1E iE 1F 1f� 1E 1E 1E 1E Ik iE 1E K 1k ik IE 1k ik iF iE 7E Ik iE M iE iF iE 1E If iE 1F iE if 1E iE 1F 1E 1E 1t i(' 4 ik iE ik 1E If 1f ik 1E 1k 1f if 1E 1E if iE 1E 1k K if if iklE 1E 1E M ik 1E 1f 1E 1E iE 1E 1k 1E 1E 1E
I N D I V I D U A L F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET
ELE il RECEPT/OUTLET
ADDITIONAL EA
END OF FEES
M�. `��' �l•,`�\_. ,
�� ���`�\' �
45
�: r��..:i�[ �y' � 4n! 1') �4.�-r
cA*E:"a.,�. �r' ����: .
�/ J� ��V
15.00
4.95
CONSTRUCTION AND PLANNING P� & SPA -
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporery Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. � 53. Steel Reintorcement ,
;,3p�j�lectrical Condur`� Utility-Un�rgrnd. 54. Forms
'• 4i'ETectrical Condu"'�Ur�rgrnd. � 55. Electrical Bonding �
i�r,',u
� s5.''S?eel Reinforcemewt' S6. Rough Plum6ing & Pressure Test
�^6.= EJectr�cal UFERTG2od. 57. APPROVAL TO COVER-GUNITE .
• z7' �ootings ; �� " 58. Electrical Condtyt�Jndrgmd.
�� 9. Foundation f.; .� 59. Gas Pipe, O Unt#tgrnd., Test
9. Water Pipe-Undrg�a��tl. � . 60. Backwash lines��Trap, � Undrgmd.
v
70. Structural Floor�ystem 61. APPROVAL TO�OfCK
�
11. Property Sewer �ne� House£onnection 62. Backwash & Re's'"ebior-Final
12. Sewer Cap ;i ' .� 63. Hea[er & Vent•Ffial �
13. Roof Drains � . 64. Plumbing System � Final �
74. Rough Plumbing T 65. Electrical-Fina�
15. Rough ElectricaF-UConduit '�' � 66. Solar System-Fipa,JL
76. Rough Electric 1�riny� ,ti 67. Fencing & Accr�siAPProval
-•77. Rough Wiring Sign �' 66. APPROVED F `PLASTERING
� p
'18. RoughElectricai'j"BarCeilinj� 69. POOUSPASYST�iV1SFINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- .� -. r� � lZ' C r. �.h. E• T. • - f•� f'
20. �ug� Fa�tory:Fir�lace ' �m Q� '" C' � �"* '�APPR;OV� =�� Pee�it # * � �^
:J A i S C" � X_ .-. r+ C� i i �., �-f. �-. .�7i-
27. �uct'S��.in�jtruk ure�> •• �• Y,5 � S 7 rx � 70. tlndergro3h� H� � ro �
c .. -� s ♦t
22. pyct'-'Ve tii ngH* � � fi S �` 71. Produ[^ B+' L�JC�..,,as G+OiI
_. � �� � fU �. i � � l7 `2 iJ F� GF,,P��9
23. t`ias P�pe•�'pu & 7'est ;,� _ * r1 C e; O* a 7p. Undergra�i nd FFush� � r
� .
24. ftbof=Freming" ^�� `'` 'Y x� G ° �,�. ;73�Undergrri�.Sto�g�TankAQGasM00il�
25. floof$he�thing s� 6 � v�i` c: ^ cor 7K: Overhead�Hydr6� K
� `Y -'' .-. '_1
26. T,BafTCeiling (Stru��iral� & MFor,�pat * r � d d y 7y'�',. Dry Chemical .� � �, ' �.�,.���
27. ,F"yame,an�Flashin�,x ';x� �c p� � �* 76. Dry Sta�Cpipe r7, K J 'T'!*:
28. Lathing B�Siding O* r; �r;2 s; * E .. ..* 7T'.:y FIXED �TEf��INA� ,_, ��
��
J29. Insulation� �,-�,y ` � �� � . � " � �z 7g��,-FIRE PREV. FINFL �� = - =�
'30. Orywall f�2iling -� � �;: F i .,# `i �FLALTFTD�P7x.'REQUIRP�ENT
31. Plasier Br,emivn-E;oai : S - # � q: -^79JFINAL I�SEECTiBN k`� J `-
� 32. ETectricaRPow'g'r MglAt kinal �17 i � 8d�'FOOD CERTIF�Ci4TE I�SUED ,
.33. �na�`,,Elee ic_ .r � �r � �q���x . tTl `� .`" ; .
, _. V -r -, � '4 � Z kv Y � Notes; ^ -yn e. - � t*t
��,.•�
� � � x i x CC •�J •S Clx 7'. 5 'c:.-'.• �n .
��34. Finat�ieacing�&Air-G�oncE3ionir�s .
a..r xi T:� ik r+�.:'� -J F��.* ' ^G -
� Y rl !' -i 'y, I .R . V S � a ,� � • V V
35. F�mal'GasPip�:�"esy,.e C" • .r.-. �: � ^o �;r„ a Nr,�,• ', �
36. Hoo�Dor anoPY JJ=- t*'-' .+. � ' kK - T- no h� H�" - .
c �-r� �� '� rt^ k, I* ?7 �C O 'Y ,'7 '.:O r i
F� t1 '4' 4y � � � i-. r k[-.� '. : 1
'37. r�PalF,actpryFirep�e �` N �r ( ,�� „ x ���n� , �
-+38. Final-Rlumbin 7'i+ c� : � '� � S - `� � ✓--� �r'
9 H i i� H T * �
� 7
^ 39. WateFSer.v.�ce�Fina'�`� � ` , �' a' � ' K .' `°'' � '
x � ' .....; (r . [*, -.
r,40. Gas Service-Final .:.k � �[^cY S K Tl �, �T 04 •-N r� ••
^ ��. � r �. . i �v F. . p� r
�41. Solar OomesticFirlal* � �� ' '' � � ' E* "" `~
-, � v: � i y; t*� '^ v c' •..:.
� 42. BackflowPreventer k :i * : `X :� �!-+ . O r-�
' ' n : � ...+ x . C r
43. Backflow lrrigation ` ��� � M �-' "�� ^ .
* � � a� � :r n
..�.
.q. Landscapp:lrr pation.�System v!*:!� a: ��. n C' �# ^� a+ wCJ � V 'u ���'
:n r: `- M �
d6. Spund A^en�i�tion r :;^� � * F F F r �� �� �., x.
i,� -� . .. * ,: M �; x .• c r < • �- t7 �
46. Flandicap Regulations. v "' t�� *- S _. S �x
- ' W v 1 !} ^ �. •]
47. FI'NF�L STRUC?URE� & BUILDING " � � � -' �' "
•�l Y �F ^ � .;K V �' r
48. FiNA�� PLANNING +� � - M !U � ` � '.' ¢ * �
' r ( � ii - '1 r c
49. Elect�ie Releas� to Edson � * � � -� .� � _� � _ �
�'-�=.
50. Ga: Release to Southem Calilornia�Gas Cn �� ; i +-� • o; i + � •
«- �Y c `lG ' CG.
51. CERTiFICATEOFOCCUPANCY � ♦. T� �, '" � J:_
No. Date
�i
PflQIECTR00flESS: SSS ANTON BL
OWNEfl'SNRME: HANK OF'AMERICA
nooxess: 20 N RAYMOND AV
PASADENA
unrt: 11
� 81A-57A-7779 qEc.xo.: C11073
APCHIENGINEEfl: ROY HERBOLD
aooxess: �z072 CAMZNITO VINO uNiT:
LAGUNA HILLS CA 92653
PERMinEE: ARMSTRONG CONSTRUCTION ( 818 ) 967-8001
nonxess: 929 SPRING MEADOW DR
. WEST COVINA CA 91791
tICENSEO CONTBqCTOB OECIAMTION: I hereby atlirm tha� I am Iicense0 untler D�a�sians ol CIwD�er 9(commencing with Section
7000) ot Oivision 3 0l I�e Business antl Professions CoEe. anE my ' en5e is in tull farce an0 efiect.
cin uc.:--�1 s.ere uc.: 4 3 4 0 4 7 �� 6eeA
�a�e: �� SignaNre:
WOflKEflS' C PENS� ION OECIAMTION: I Aereby a rm itat I tuve a cenilicale ol consent 1 �insure or a certificare ot Warkers'
comPensa�ion �s�tp�e4o��ce�t t�iea mpy mereol ISection 3800, �ao. ��S / O 7/ 9 3
roucvxo.: kEPUBLIC INDEM E%P.DRTE:
COMPANY: ,-y
L7 Cerlilie0 Co0 is here y tUrnished. L? Certilie0 taDY is i wylfl e CViy l Itling i isi0n.
Oa�e: 0 PpplicanC /
E%EMPTIONFPO WONNENS'COMVfNSFTI0N0EC1ABRTION: hissecti�nneetln�ibecompleteAillheper ronehunAreU�$100)orless).
I certity ��al in �M1e pedormance ol Ihe woB for whic� �his permi� is is5ue4 I s�all not employ any person in any manner so a5 io become
suble�� �o I�e Workers' Compensa�ion Laws ol Califomia.
Date�. Signalure:
NOTILE: Ii, alter making ihis 7eclaration. you shoWd �ecome sublec� �o the Workers' Compensation provisions af t�e Labor
Cade. y0u must IOrihwilh tOmply wifh SUCh O�Ovisi0n5 Or �his permit 5hall be tleemetl r¢vok¢�.
CONSTBUCTION LENOING pGENCY: I nereby afiirm t�at inere is a consimction lenainp apency lor tAe Oerlarmance of tne work for
w�icli I�is permi� is issueG (Setlion 3097. Civ. C�.
LENOEfl:
RD�NESS:
OWNEP BWLOEB OECIABRT10N: I �ereGy aflirm ihai I am exempt Irom t�e Coniractors' State License Law lar ihe tolbwinq reasan
�Sectian 7037.5 Business an0 Pmiessianal Cotle: Any ciry al wunry whic� repuires a Oe�mit to wnstmct, alter, improve, Oertwlish, or
repair any 5lrutlure. prior Ioiis issuance. als0 require5 lhe ap0�icanl fOr Suc� p¢rmii Io �ile a SigneO S�a�emen� �ha� he/S�e i5 litensed
pursuant lo tAe Omvisions ol Ihe Contraclors' State license Law (ChaD�e� 9lcommencinq vnih Seclian 7000) of Divisian 3 of t�e 9usiness
anU Pmlessions Code) or �na� he/sne is e.empt inerelrom antl ine Oasis for tne alleqe0 exemption. My violalion ol Section 70.71.5 Dy
any a001icant for a p¢rmil SUEjecis the apD�itant to a tiWl penally of not more Ihdn live hunOreU Uallars (E500).
I, as owner of Ihe proDeny or my employees with wages as iheir sole comDensation, will tlo Ihe work, anJ ihe
❑ simcture is nal imentled or a0ered �or sale (Section 7044, eusmess antl Pmlessional Code: TAe ConUactors' $�d�C LICCIISC L2W
tloes nol apply lo an owner af a pmperiy who builtls orimD�oves thereon, antl who does such wo�k AimSelVAersell or Urough
his or her own employees. pmviaed thai such improvemenls are nol inlentleE ar ollereG �or sale. II, howeve� Ihe UuilOing or
impmvemen� is soitl wiihin one year of completion, �he owner vnll have Ihe burden o� pmving �e/she AiA na� hui10 or impmve
lor �ne puroose of sale).
I, as owner ol ihe pmpetly, am exclusively contracting with Iicense0 contractors to consimct ihe Drole�� (Section 7044, Business
❑ anG Pmiessions CaOe: Tne Coniractors' State License law does not aDDly lo an owner of OroOerry �o EmIOs or improves ihereon
anU who mnlraCl5lor Su[A O�ole��s wittl a COnlrattor(5) liC¢nse pur5uani lo Ih¢ COnlfatiof5' S�a�e Lkense Law�. I am aware
Ua� 0��� ol their Warker'S Compensation insurance siwultl be provitleE 10 m¢.
� I am exemp� untler Sepion: B. 8 P. C.
farlhis 2ason:
Oate: Ownec
1 do nere0y cenity Ihat I am aware af antl untlerstand tAe repuiremenls of Califomia Healih anA Salery COde Sections 25505, 25533. anU
2553A ana l�al I or any Iuiur¢ �uilaing oCtuDan� will/will not (ti¢le one) neeG l0 tompty wilh SaiO 51a1e coAeS antl lhe requirem¢ni5 for a
permit lor constmc�ion or moailicalion tmm Ihe Air Ouality Management Oislnp. fleaGeniial consiruclion aDDlications are exemp� imm
�nese pmvisions.
�ale'. ppplicant:
I here�y cetlity IAaI I �ave rea0ihi5 ap0�icaiion antl sta�e�hat��e aboveinlorma�ion is correci. I agreeta compty with all ciry an0 counry
or0inancu an0 slale laws relaling to Gwltling cons�mction antl �ereby ' e repr �ative i Ihis city to enlei upon �he abov¢-mentionetl
pmpetly lar in pe[tio Ourpases.
Date: �fl Signawre:
orivers �icense or Soc�ai securiry a:
'I�Y_�,tf��A6 W�il2—BuiltlinQ: Gr22n—CoEe En�orC2m2nL Cdnary—ApoliCdnl;�Pink—Rev00u0: GOIEenlod—Aitesxnr
PERMIT NO; H
CITY OF COSTA MESA — BUILDING PERMIT P�:KM NU; it �y l�
059013 PLAN CHECK NO; 03342-92 A �c� , S YY; N
CONSTRUCTION TYPE: SP PERMIT TYPE; STR PURPOSE; ALT
JOB DESCRIPTION ; 3800SF OFFICE T,I. S� FT; 11,400
CLAIM VALUE: 50,000,00 CALC—VALt]E: 69,388,00 GROUP OCC; B-2 /
COMMENTS: 3800SF OFFICE T.I,
+r�**+r*x**�r�**�r*�r�x***+�***� �r*�r�r�r**+t*�t*�r+r***�x*�r***��*****�*+�**�c�t***�r�x******+t+tx�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARRING REp • PROV; PARCEL; 41050104 ZNE: PDC REF NO:
PLANNING NOTES> liTH FLOOR TI.
� '
�k ik k i! IE iF i! if� if ik f! it if iE ik iF 3f jE k it iFit iE ik iE i!!E if it it 1E It 1E ik iklF iF �E 1F iE k iE iE iE kiE iE iF if iE !E if IE if iE iF k 1E iF ik fFiE iF iF 3f �1f if 3F� it* iF iE iE iE ik if iE if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T S
ZONING APPROVED BY ;�{��.� DA"PE; � /0 2
BUII�DING APPROVED BY :
APPLICATION ISSUED BY:
1f',EiEiEififffiElfjElkiEiEiEiEiEififiFillfiE x iE
iFiflFiFifitlfiElEiFfFiEifiFffiEiFiEifjFiEibiEiEifiFifiEiEiE1E1EKiEiEiE3EifiE-IEiE iEiFiEiEiklfiE*�EK-iFiEik*ik
LEGALI'I.ATION;N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PERMIT 509.50
DATE;
iE if if iE �1F if iE !F if #
SEGMENT;Y
SMIP/RES GRADING
� SN,IP'/NON—RES
PLAN 81.98 i\1 14.5'7
ISSUF. FEE ,
BUZLDING—DIV—> PERMIT ISSUE PL-AN—CHECK TOTAL PAID DUE
TOTAI.S----> 519,07 0,00 �_+1 81.98 601.05 601,05 .00
REVENUE: DIVTSION TOTALS--> COLP�ECTED; 519,07 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
504,50 �' 14,57
ti�
iE if �k if 1(� iE iF iE il�1F iE iElf dE iF iE if iF iE 1t i! if if iE ik iF �)f iF 3h if k iF 3F ik 1F'�lE iE �lE 3ElE iE �1F iF �E ih rt iE �lE fk iE iE iE IE �IF iE �IE �lt �7E iE iF iE iE 1E IF iE iF if it iE �ilE iE iF iE iE iE # 1F�lE
I N D I V I D i1 A�li � F E E B R E A K D O W N
� �
TYPE QTY D E S C R I P T I O�N; UNIT COST TOTAL COST
SFC 3800 OFF—INT, ALTER TYPE L II F,R, —AVER 17,24 65,512,00
SFC 3800 EQU—ALT COMM. SPRINKL�R SYS —AVER .33 1,254.00
SFC 3800 EQU—ALT COMM. AIR GOND —AVER ,69 2,622.00
END.� OF FEES
� �
*
1
Z , ,. _,1. • � ' . .� i�.
�.
CONSTRUCTION AND PLANNING . - P� _& SPA
APPROVALS Permit # Date Inspector pppROVAIS Permit # Date Inspector
1. Temporary Electrical Serviceorpole 52. Poof & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement -
3. Electrical Conduit Utility-Und�grnd. 54. Forms
4. Electrical Conduit�UndrgrntJ. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. Electrical UFEF Gmd. 57. APPflOVAL 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, Q Undrgrnd. ,
10. Structural�Floor System �: 61. APPROVAL TO DECK -
11. Property Sewer Line & Hoyse Connection � 62. Backwash & ReceptorFinal . � ' -
12. Sewer Cap � 63. Heater & Vent-Final �
13. Roof Drains " 64. Piumbing System - Final
14. Rough Plumbin9 ; �': 65. Electrical�Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencinq & Access ApProval
17. Rough VJiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriral-T Bar Ceiling 69. POOL/SPASYSTEMS FINAL
19. Rough Haating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - � APPROVALS � Permit #
21. DuCts, in Structure 70. Underground Hydro
22. DuMs, Ventilating . 71. Product Piping �Gas OOiI
23. Gas Pipe-Rough & Test . 72. Underground Flush
24. Root Framing � - 73. Undergmd.StorageTank OGas OOiI
25. Roof Sheathing �� ' 74. Overhead Hydro � -
26. T�Bar Ceiling (Structuroq & Monocoat 75. Dry Chemical �
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding - � 77. FIXED SYSTEM FINAL
29. Insulation _ I_� i 78, FIRE PREV. FINAL
30. Drywall Nailing � !� i HEALTH DEPT. REQUIFEMENT
37. Plaster Brown Coat � ��� � 79. FINAL INSPECTION
32. Electrical Power MeterFinal - ;� • 80. FOOD CERTIFICATE ISSUED
33. Final Electric � � Notes: � - �
34. Final Heating & Air Conditioning •�"( t�� 1a��p ���,
\ �
35. Final Gas Pipe�Test � �" �� �
36. Hood or Canopy ,
37. Final Factory Fireplace '
38. Final Plumbing �
39. WaterService�Final . .� _.. __ . �� . • .....a;'y;.,..�;i . . .. �•.. .. • , '.
40. Gas Service�Finai � . . �- - �� � �
41. Solar pomestic•Final ' I
42. Backflow Preventer I � �
i
43. Batkflow Irrigation , �
44. Landscape Irrigation System _
45. Sound Attenuation
46. Handicap Regulations / - _) _
� 47. FINAL S7RUCTURE & BUILDING 4/� p,��
1 �
48. FINAL PLANNING
49. EleMric Release to Edison �� '
.v
50. Gas Release to Southern California Gas Co i �
51. CERTIFICATE OF OCCUPANCY
No. Date '
/
�
PN6IECTAOONE55: SSS ANTON BL UNIT: SI
OWNEX'SNRME: BANK OF AMERICA
RDONESS: zO N RAYMOND AV
PASADENA
818-578-7779
AXCN/ENGINEEfl: ROY HERBOLD REG.NO.: C 1 I O% 3
aooeess: zz072 CAMINITO VINO uNiT:
LAGUNA HILLS CA 92653
PEpmiTTEE: COMPETITION ELECTRIC ( 818 ) 331-5807
nooxess: 635 STEPHORA
COVINA CA 91724
' UCENSEU CONTqRCTOB OECNIUTION: I �ereUy aHirm tAat I am licensee untler D�ovisions ol CAaD�e� 9 kommencing wiih Sectian
7pq) of Div6ion 3 of I�e Business antl Professions Coae. a my litense 6 in lull larce anA effeci.
urruc.: 0q56905 srnreuc.:516842 uss: C-1
Date�. /'��—S2" Signaiure:
WOBREflS' COMPENSATION UECLABATION: I hereby 'rm e a certilica�e ol consen� lo sel4insure or a cehificale al Workers'
POLICY N0. n ��s�a�esq�a��ure�c�y IAere01 (SeCt�E%P. ORTEab � 1 I O S I 9 3
, cornrnxx: STATE FUND,y
❑ Cenified cooy is �ereEy lumished. U' Ceniliea caDY is�\�\�\fffi' jjje���yyyy�\A Ihe ciry BuilAing Division.
Date: ! �/� ' ��— Applicam: �T"� —_�-
E%EMPTION FROM WOPNEBS' COMPENSATION OECUPNTION: is xction neetl not be completeE ii t�e permit is tor one hunOreO (5100) or less�.
I cerlity iha� in I�e Dertormante 0� lhe work for w�iCh Ihis permi� is iSSueG, I Shall noi employ any DersOn In any manner so a5 i0 beCom¢
subjetl lo ihe Workeri Compensation laws o� Calitomia.
Date: Sgnaturt:
NOTICE: I�. atl¢r making lhis Eeclaration. y0u S�ouIG Detome SuEjett �a �tle WOrke(5' ComDensatlon pmNvons al IAe Labor
COEe, you musl lorthwiih mmON `m�h sucn Omvision5 or INs permit Shall b¢ UeemeO revokeG. �'
CONSTBOCTION LENOING RGENCY: I her¢by a��irm IAai Ihere i5 a tOnSlmCiion lending aAenc/ �or lhe petlOrmante,ol �he work �or
w�ich ��is permi� is issued (Seciion 3097. Civ. C�. �'9
LENOEN: '
RODflE55:
OWNEB BUILOEB DECLAIUTION: I �ere�y allirm tlwt 1 am e.empt Imm ihe Coniractors' Staie license Law lor t�e lollowinp reason
�Seciion 7031.5 Business anG Pmtessionat Cotle: Any ciry ol county w�icA requires a permit m eonstmc�, al�er, impmve, Oemolish, or
repair any s�mc�ure, prior lo ils issuante, a150 reQUires �he aDDlitanl for SUch Oarmit �o lile a SipneE Siatement tlut �e/She is lic¢nSed
pursuam m the proviswns ol lhe ConVacmrs' Siaie License Law �Chapter 9(commencing with Section 7000) of Division 3 0l t�e Business
antl Professions Cotle) or ihat ne/she is exempi Iherefrom anU Ihe �asis lor �ne alleged exemption. Any violation of Section 7031.5 hy
any aDPlican� for a permi� 5u01e��5 ��e apPlicanl �o a civil penally ol not more than �ive hundred dollars (55(10�.
I, as ovmer ol the propetlY or my employees with wages as Iheir sole compensation, will do the work, anA the
❑ slmc�ure i5 nol inlentletl ar offeretl for sale (Section 7044, Business antl Prolessional Cotle: The Contractors' Slate License Law
Aoes not apply to an owner ol a Dmpetly wlq Ouiltls ar imOroves t�ereon, an0 who does such woM1 himsel�/�ersell or IAroug�
�is or her own employees. pmNtleO Ihai SUth impmvemen�s are not in�endetl or Ot�ere0/or 5aie. It, �owever t�¢ GuilEing or
impmvemen� is solA wi��in one year al com0le�ion, ��e owner will have Ihe burUen oi proving �e/s�e tli0 not �uild or improve
. forlhe purDase of sale�.
I, as owner of t�e property, am eKclusively coniracting with IicenseU coniractors to cansiruct Ihe prolect (Section 70ad, Business
❑ antl Pmfessions Code: The Contractors' State license Law aoes not appy to an ovmer of DroOenY �o �uilAs or im0�oves therean
antl w�o contracls lor such O�ole��s wit� a conVacior�s�license pursuan��o I�e Cqn[ractors' State Lic¢nse Law�. lam awarp
thai D��� of I�eir Worker's Compensation insuranre shoul0 Ce pmviEetl to me.
� I am exemD� unUer Senion: B. 8 P. C.
for t�is reason:
Dale: Ownec
I tlo �ereEy certily ��at I am aware ol an0 untl¢rslan0 t�e requir¢menls al Calilornia Heal�� antl Sa�e�y Catle Sec�ions 25505, 25533, an0
25534 antl �hal I or any IUWre �uiltling occu0ani vnlUvnll nol (circle one) nee0lo compry vnttl uiA slaie codes and Ihe rtpuiremenis �or a
peemil �or constmction or moEilication Irom Ihe Air ualily Management Oisirict. flesftlential [on5iruction appliwtions are exempi Imm
Inese pmvisions.
Oate: ADOlicani:
I �ereby cetlityihal I have reatl this application ana state Iha�ihe aboveiniormation is correct. I agreeto comply wil� allci�y antl couNy
or�inances antl s�alelawsrelatinglo building conslmclion antl aulhorize representa�ives oi�his ciryio enler upon��e a�ove�mentionetl
pmpetly for inspection purposes. �
Dale: ���� � � 2-- SignaWre:
Oriver's Liwnse ar Social Seari�y x:
i6at�a6 W�ne—Buil0lna: Green—CoOe Enbrcemem; Canarv—Aoolicanl; Plnk—Revenue: Goltlenroa—Assassor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 7
PERMIT' NO: E 059017 PLAN CHECK NO: N GOVT; N f:
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE; ELE PURPOSE: OTH
JOB DESCRZPTION : 3800SF OFFICE T,I, SQ F'T;
CLAIM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS; RE: B59013 PRIMARY BLDG. PERMIT.
���r*�r�+r*x�x��r*�r***�r*�+t�r�r��rx*�x *�*�+r�t�r+t+r**�r**�t*��r*�***+��t*x**+tx*�t�r*x *****�*�**�*�r�r�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MASN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEF'C; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 41050104 ZNE: REF NO;
PLANNING Nf51'ES>
i
*�*�**�+��+���*��*�r**�*�rx�***x��***x�;x*�*�*�r*��r*�x�*�****�r**�r*�***+�******�*x��***+�**
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY• DATE; l0
ikiEkiflEiElEiEifiElfifiFiEifiFfEfp�blFifif � �� � tr �3FlflElkiF1E1E1EiElE�F iFiF
iEifiEltiE1ElFiFIEiEfElkiEifiEiFiEiEikiFifiEi!lflEiEiflfiElElFiEiEikikiEiElFiflE�lEi(�1fiFtt�i EIEiElflEfE#�IEiFK�iEiElflflElElEiF.iFi(-iEiEiEiFiEiFil�IEififlFiE
LEGALIZATZON:N F E E 5 U M M A A Y STRUCTURAL SzGMENT;N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PI.AN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
PERMIT ZSSUE
12.75 15.00
12�02
15,00
PLAN—CHECK
0,00
SMIP/NON—RES
TOTAL PAID DUE
27.75 27,75 ,00
REVENUE DIVISION TUTALS--> COLLECTED: 27,75 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECT'RZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
2%.%5
iF iE iE 1E itlE iF iF iE IE iE iE if iE iE if iF iE iF iF iFiE iE iE iE ih if ib iE iE iE 1E if iE if iF iE iE 3E iF 3F iE jE * if iF iF IE iE it if fF iE iF iFiE iE fE iE iE iE if iF if iE iF ik iP if iE 3f iF 1E iF if iF iE iE �E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 9 FIXTURES LIGHTING 1 ST 20 EA, ,75 6.75
ELE 7 RECEPT/OiITLET 1 ST 20 EA, ,75 5,25
ELE 1 RECEPT/SWITCH 1 ST 20 EA, ,75 ,75
END OF FEES
� 'l7,' _'� '_ _,
�l.v'_ __ _
, c; �� . , ' _ .. �.
,
�
���
��� CONSTRUCTION AND PLANNI G - POL_ 6 SPA -
• AGPROVA�S Permit # Date inspector p�ppROVALS Permit # _ Date Inspector
1. Temporary Electricai Service or Pole - 52. Pool & Equipment Locauon . �
2. Soil Pipe-Undrgrnd. � - 53. Steel Reinforcement �
3. Eiectrical Conduit Utiiity-Undrgrnd. 54. Forms �
4. Electrical Conduit-Undr9rnd. , 55. Electrical Bonding �
5. Steei Reintorcement - 56. Rough Plumbing & Pressure Test
6. Electriwt UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings � � 58. Electrical Conduit�Undrgrnd.
� 8. Foundation ' � 59. Gas Pipe, � Undrgrnd., Test ..
9. Water Pipe�Undrgrnd. • 60. Backwash Lines, P�Trap, � Undrgrnd. -
10. Structural F�oor System � � 61. APPROVAL TO DECK
it. Property Sewer Line & House•Connection 62. Backwash & Receptor-Final
12. Sewer Cap � 63. Heater & Vent•Final
13. Roof Drains � 64. Plumbing System � Final
14. flough Plumbing 65. Electrical�Finai
I
15. Rough ElectricabConduit ' 66. Solar System•Final
i 6. Rough Eiectric Wirin9 ��6 � 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 Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace , APPROVALS Permit #
21. DuCts, in Structure . � 70. Under9round Hydro
22. DuMs, Ventitating - -71. Product Pipin9 O Gas 0 Oil
23. Gas Pipe-Rough & Tesc , � 72. Underground Flush .
24. Roof Framing � � '73. Undergrnd.StorageTankOGas OOiI
25, fioof Sheathing � 74: Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and F�ashing - 76. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM fINAL
29. Insu�ation � � 78. FIRE PREV. FINAL
30. Drywall Nailing I � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat _ � �' I 79. FINAL INSPECTION
32. Electrical Power Meter-Finai � � � 80. FOOD CERTIFICATE ISSUED
33. Pinal Electric „(y0"'� .f Notes:
34. Final Heating & Air Conditioning �� � � ��
�
35. Final Gas Pipe�Test ' � f �
36. Hood or Canopy r ' �
37. Final Factory Fireplace -� � -
38. Final Plumbing �
39. Water Service•Final � � ' -
i i
40. Gas Service•Final i � � �
41. Solar pomes[icFinal • '
42. Backflow Preventer. ; �
.43. Backflow Irrigation � �
44. Landscape Irripation SYstem - -
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING �
49. Electric Release to Edison ' �
.50. Gas Release to Southern California Gas Co � , ,
51. CERTIFICATEOFOCCUPANCY
No. Date
�
�
�I
PHOJECT RODHE55: S� S ANTON $L UNR: 1 I FI.
OWNEN'SNFME: BANK OF AMERICA
noaeess: 20 N RAYMOND AV
PASADENA
pPCH/ENGINEEfl: 8 S B— S% S —%%% 9 flEG.NO.:
nooness: ROY HERBOLD C1 ��73
22072 CAMINITO VINO
PEflMIiTEE: LAGUNA HILLS CA 92653
eoosess: LANDZNGHAM PLUMBiNG ( 818 ) 336-7206
19839 PROCTOR AV B
INDUSTRY CA 91796
❑CENSEO LONTIIALTOfl DECNMTION: I hereby aflirm ihal I am licensetl unUer pmvivons ol C�aD�e� 9(�ommencing wiih Section
7000) ol DiviSion 3 0l Ine Business ane Pmfessions CoGe. an0 my licenu is in lull lorce ana elfect.
cmuc.:0�7032 sTnreuc.:272520 cuss/:�(/'' ac
Oate: �O – 2�—`/'i_ Signalure: _ _V —_
WOBREBS' COMPENSATION OECIAflRTION: I �ereby affirm that 1 �ave cenificaie ol consent io sel4insure o a certiliwte of workers'
ComDensation Insurance. or a cerldietl capY �hereof (Section 3800, lab. C�.
PoLICYNO.: j+j�%1Q$l�j E%P.DRTE: O7IOLI93
COMPANW. CA COMF�
❑ Cerli�ietl copy is hereby fumi5hed. � Ce�i�ietl copey is filetly+iih the cily Builtlinp Div' ���
J /J �
oate: ��' ' Q-� ' �Z Applicant: � -��LLoY
E%EMPTIONFpOMWOPHEBS'fAMPEN5ATI0NDEClABATION: (Thisseclionnee0nol�ecomple�e0iithepermitis� onehun4retl�8lW�orless�.
I cetlify �hal in �he peAormance of Ihe work for w�icA �his permi� is issueq I shall nol employ any person in any manner so as �o hecome
SU61e�� �0 Ihe Workers' Compen5aiion Laws o� Cali�ornia.
Oate: �G • QSr' g L SiqnaWre:
NOTICE: I1. alter making ihis aeclaration, you snoule become suDiect to tne Workers' Compensdtion D�ovisions o1 ine Labor
COde. yoU muSi Iahhwiih tomply wiih such pmvision5 or I�iS permil Shall Ue OeemeA r¢vok¢d.
CONSTBUCTION LENDING �GENCY: I here�y affirm t�al there is a wnsimction IenGing apenq for the DeAormance of ihe work for
wnich �nis permit is issuea ISection JW7. Gv. CI.
IENDEfl:
ADDPESS:
CITY OF COSTA MESA — BUILDING PERMIT PERN NO: P 059732
PERMIT N0; P 059732 PLAN CHECR NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE: iFR SP PERMZT TYPE: PT.0 PURPOSE; OTH
JOB DESCRIPTION ; 3800SF OFrICE T,Z. SQ FT;
CLAIM VALUE: CALC—C�ALGE: GROUP OCC; B-2 /
COMMENTS: RE: B59013 PRIMARY BLDG, �ERMIT.
�*��r�r+���*x**���*�#*#�r�r***#�r��r�t*#��t*�*****x**�**x��-�*n*x�*#�#*##**#�**�r**�-##x n##ttu�
Z O N I N G R a Q U I k E M E N T S
ssTsacxs
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR; FT IN E`RNT; FT IN REAk: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARItING REQ• PROV; PARCEL: 41050104 ZNc: NEr NO;
PLANNING NV'I'ES>
>
iE iE iE 1E if if iF iF iE if iF it� iF i! iE fE iE iE it il� iE iE if iE ibiF iE i! it )t iE 1E iE iE iF iE iP iE iE iE #jE jt # it iP il' it if iE iF iE iF ik iE iE # iE iE iE ih fE 3E iF # iE 1f� iE 3F # iE # i! fE il� ## iE iE
D E V E L O P M E N T S E R V I C E S'. R E Q U I R E M E N T S
ZONING APPROVED BY �� DATE;
BUILDING APPftOVED HY : DATE:
APPLICATION ISSUED BY• �—, DATE• ����
ifiEifiEiFiFiEiEiElEiFi6iEiFifiEiE�lEiEietFif�eir+tfe�'e�3r�iF3F3Fn'�iF�rir�rux�e x"3Fi�z�f't3i-TFttiririFiE�lE3Eit#iPiEiF#i!� xx r raew� x iE
1E iE �(-iF iE iE iE iElt i(�!F iE if �lE iE iE if iF iE if if iF if iF 161E iE if i4 iE �1E iE iE 3E 1f �lE iE 3E �1E iF�IE iF iE i4 iklf # if �?E if%# IE # iE iP M� iF # i(� iE iE iE ff iE �F if -!f iF iE iE 3E iFiF i( iF iF �F iF
LEGALIZATION;N F E E 5 U M M A R Y STRUCTURAL SEGMENT;N
OWNEPBUILOEflOECUMTION: I�ere6yaHirmttutlameKempUrom��eConVaclars'StateLicenseLawforthetollowingreazon BLDG Ph1'1' PLUMBING ELECZ'RIC MECHANIC FIRE SMII�/RES GRI�IN(�i
�Section 703f.5 Business an0 Pmfessional CoEe: Any ciry ot counry which reQuires a Oermit ta wnsiruct, alter, imprme, Uemalis0, or pERM I T 7. 0 0
repair any slmciure, D�ior Io iis issuance. also reQuires �he aDDlicanl �or suc� Dermi� �o file a signetl siatemem tha� he/she is licensetl z 5= SM I P/ NO
pursuam to t�e pwvisions oi ihe Comracmrs' State License Law �ChaO�er 9(commencinA with Seclion 7000) of Divisian 3 of tAe Business ��—t� E$
an0 Pmlessions COAe� ar IAai �e/s�e is exemp� iherefmm anA Ihe �asis �or t�e alleqeE exemp�ion. Pny Wolation ot Setlion 703L5 6y PLAN
any aDPlican� for a Oermi� suble��s �he a001icanf �o a pvil penaliy of not rtqre ihan live hunGr¢d tlollars (5500). I SSUE FEE 2 0, 0 0
i, as owner oi me prooenv or my emPioyees wilh wapes as tneir soie compensatian, wi�� ao me work, ana ihe B�IILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ s�mcmre is noi imenoed or onerea ror saie �Seaion �oaa, susiness and Pmiessionai Coae: rne Coniracmrs' state �icense �aw 1 OTALS ---- > 7. 0 0 2 �, � 0 0, 00 2 7, � 0 2 7. 0 0 , U 0
Uoes not apply Io an owner of a D�oPeny w�o huilas or impmves tAereaq and wAo tloes such work �imself/�ersell or thmugh
hmDar�ememssolalwn�none�yea� tdcompetionrtheowoeravnllhave1lhe�hur0eno'I�pmhngSAe/shedtlnotbuil0arilmpmve REVENUE DIVZSZON TOTAZ.S--> COLLECTED; 27,00 �VER/S'HORT; ��
mrinec�rPaseo��ie�. HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADSNG PLAN—CHECK
I, as owner of the pro0erty, am e�clusively conVacting wi�h licensetl comractors to consimct the pmlec� (Section 7044, Business Z 7� 0 Q
❑ and Pmiesvons Cotle: The Conlraclors' S�ate Lirense Law Goes no� apply t0 an owner of pmperry wAo Guilds or impmves thereon
andwhoconlraclslarsuchprojectswit�aconVactor�s�licensepursuanl�o�heContractors'StateLicenselaw).lamaware ***#1EiEifiEiEiEieiliEitiElEiEiEiEiF#3EifitiElEiElEitikifiEiEiEiEiEiEftifiEit3EiEiEiE1ElFiCiEiEiFiEiE#ifitiElEiFiFifififiEiEiFiEiFiF�1E1E�l�ifiEiEK�tE#�f
I�al D��� ol ��eir Worker'S Compensatian insurance 5hou10 be prwi0etl to me. I N D I V 1 D U A L F E E B R E A R D O W N
� I am exempi under Seciian: B. 8 P. C.
�or mis mason: TYPE QTY
oa�e: ownec I PLU
I Go Aere�y cenily ihat I am aware of anU unaerslanU Ihe repuiremenls of Calilomia Healih anA Sdiery CAOe Sections 25505, 25533, ana
2553a and I�ai I or any lu�ure Ouiltling occupan� will/will noi (circle one) neea Io com0ly wilh saia state cotles antl the requiremen�s �or a
permit lor consimclion or mo0ilicaiion fmm �he Air Ouabry ManaAemenl DiSinct. flesitleniul conslruclion aDVlications are exemp� Imm
inese provisians.
oate: Applicanl
I �ereGy cetlity Ihat I Aaue reaU this applica�ion antl slale �hat t�e aLave in�orma�ion is wrrec�, I agree to comply wilh all city an0 county
orAinances anA slaie laws relating �o Duileing conslmction an0 �ereby au��onze reDresenla�ives o� Ihis ciry �o enter upon [he above�mentionetl
pmpetly lor insp¢ction purpases.C. /�
Oa�e', �U _ 2 � " / 1� SignaWre: �, i/ �
Oriver's Lirense or Sociai Securiry ro: �;
i6ai.a6 Whi�e—Buildmg; Green—Code Enlorcemen�; Canary—AOo�itenl: Pink—Revenue; GolQenrod—Assessor
D E S C R I P T I O N
1 SINK, KITCiIEN
END OF FEES
UNIT COST TOTAL COST
7.00 7,00
�t � •�:�'� ': �" ' " ' '
��„ r _.i_u, � _.il• - �
�
CONSTRUCTION AND PLANNING � P�� ' SPA
APPROVALS Permit# Date Inspector p.ppROVALS Permit# Date Inspector
� t..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. Elecvical Bonding '
5. Steel Reinforcement 56. �Rough Plumbing & Pressure Test
6. Electrftal UFER Grnd. 57. APPFOVAL 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, � Undrgmd. � ,
10. Structurai Floor System 61. APPROVAL �O DECK �
1 t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap '.'� 63. Heater & Vent•Final , �
13. Roof Drains � 64. Plumbing System - Final
14. tiough Piumbing � 65. Electrical�Final
15. Rough Elect�iwl-Conduit , � 66. Solar System-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval ,'
7�. Ro�gh Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA 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 � 77. Product Pipin� � Gas L70i1
23. Gas Pipe�Rough & Test 72, Underground Flush �
24. Roof Framing � 73. Undergmd. Storaye Tank L7 Gas ❑ Oil
25. Roof Sheathinq 74. Overhead Hydro
26. T-Bar Ceiling IStructural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � � � 77.. F�XED SYSTEM FINAL
29. Insulation � � � 78. FIRE PREV. FINA�
. I
30. Drywal� Nailing � � �HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat I � 79. FINAL INSPECTION
32. Electrical Power Meter�Final � � 80. FO00 CERTIFICATE ISSUED
33. Pinal Electric � � I Notes:
34. Final Heating & Air Condiiioning I �
35. Final Gas Pipe-Test , � (
36. Hood or Canopy ; � �
37. Final Factory Fireplace �
38. Final Piumbing $ ��vf I�/� '
39. Water Service-Final I
40. Gas Service-Final ' �
41. Soiar pomesticFinal ! �
� �
42. Backflow Preventer � �
43. Backflow Irrigation
44. �andscape Irriqation SYstem
45. Sound Attenuation
46. Handicap Regulations
. 47. FINAL STRUCTURE & BUILDING � �� I
i
48. FINAL PLANNING � �
49��. Electric Release to Edison � � I
50. Gas Release to Southern California Gas Co � � I
51. CERTIFICATE OF OCCUPANCY
No. Date
�
/
�
PNOJELT RDDflE55: S S S ANTON BIr �N�T. 1 1
OWNEB'SNRME: BANK OF AMERICA
nooness: 20 N RAYMOND AV
PASADENA
AflLH/ENGINEEN: 8 1 8— 5 7 8-7 7 7 9 PEG.NO.:
nooxess: xOY HERBOLD C1��T73
22072 CAMINITO VINO
PEqmmEE: LAGUNA HILLS CA 92653
aooaess: GOLDEN STATE FIRE PROT ( 714 ) 423-4060
936 E FRANCZS B
ONTARIO CA 91761
LICENSED CONTNRCTOP UEClABl1TI0N: I hereUy allirm IAai I am Iicen5e0 unaer pmvisions o� COaO�e� 9 kammencing with Section
7000� o� Oivlsion 3 ol Ihe Business anA Pmlessions Coae, an0 my license is in lull �orce antl efleci.
cirruc.:007649G srnTeuc.:35022.` t�U$$'�C-16
�ate: �(,�'� S� 7 � Signamre: _ L�(
�� WONREBS' COMPENSRTION OECLABFTION: I hereUy allirm Ihat I have a cenilicate of consent m sell-insure or a certificate ol Workers'
ComDensation Insurance, or a cenifiea copy Ihereol (Section 3800, Lab. C�.
i roucvxo.: (92)PC994398 EXP.ORTE: O3IOS�93
cornrnNr: REPUBLIC IND
❑ Certi�ietl coOY is hereby Wmishetl. � Cetlilied copy is ' � Ihe � il0in0 Oivision.
Oaie: /L1� � � y � Applican�: �
E%EMPTION FpDM WONIIEXS' COMPENSATIDN OECU�fl,ITION: (INs seclion nee0 iw10e comDletetl I� Ne permii is iw one hurMred (E700) or less�.
I cetlily Ihat in Ihe petlormance ol the work lor whic� IhiS Oermit is i55ue0, I shall noi ¢mploy any Oersun in any manner so as �o became
su�jeci Io Ihe Workers' Compen5dtion Laws of Calilomia.
Daie: Signalure:
NO7ICE: if. alter making this Oeclaralion. you snoultl become subject lo Ine Workers' CamDensalion provisions of Ihe LaCor
Latle. you mu5ilo�hwil� comply vn�� suth O���sions orl�i5 p¢rmit Shall Ue AeemeU revoke0.
CONSTPUCTION LENOING RGENCY: I �ereGy affirm Ihat I�ere is a wnstmciion lentlinq agency for lhe pedormance af Ihe wnrk tar
w�ich Ihis permii is i<sueU �Section 3097, Civ. C�.
�noee:
ROOXESS:
OWNEB BUILOEP oECLAPATION: I �erehy allirm ihat I am exempt irom t�e Coniractors' State license Law for ihe �oilowing reason
�Sec�ion 7031.5 Business an0 Prolessional Cotle: Any cily ol county whic� requires a permi� �o cons�Nct, al�eL improve, tlemolish, or
repair any stmcture. prior to ils issuance, also reQuires Ihe aDPlicam lor suc� permit to file a siqnetl statemeni ihat Aelshe is Iicense0
pursuam m ihe pmvisions ol ihe Comractors' S�ale License Law �Chapter 9(commencing with Section 7000) of Division 3 of the Business
antl Pmlessions Catle) or �hal he/she is exemp� Iherelrom anJ Ihe 6asi5 lor Ihe allegetl exemp�ion. Any viola�ion o� Sec�ion 7031.5 6y
any apPlicant lor a permii su6jects t�e applicant lo a civil penaliy ol no� more Ihan live hunare0 dollars ($500�.
I. as owner of ihe pmpeny or my employees witA wages as iheir sole Compensation, will do the wark, an0 Ihe
❑ slmcWre is no� inten0ed or oflered �or sale (Seciion 70a4. Business and Pmtessional Cotle: 7he Contractors' State License Law
Uoes not a0�ly to an awner ol a pmperty who builtls or impmves �hereon, antl who Ooes such woM himsel�/hersel� or Ihmugh
his Or her own empl0y¢es, O�o�itle0 ihal SUCh improvem¢n�s are no� inientled Or oifere0 �of sale. I( hawever �he bUiltling or
impmvement is Soltl vnthin one year oi compl¢lion, I�e owner vnll have IAe GurAen of pmving he/she Oid no� build or improve
lor ihe puryase ol sale).
I, as owner of the pmpeny, am eKclusively coniracting wilh licensetl conirac�ors �o consiNtl ihe pmiect (Section 7044, Business
❑ anA Pmfessions Cotle: The Coniractors' Siate Licenu Law tices not apO�Y to an owner ot properry wfio builds onmprwes tAemon
and who coniracis for such pmjects wit� a coniracmqs�license Oursuant m ihe Coniractors' State License Law),I am aware
�ha� pmol ol Iheir Worker's Campenution insurance sMNA be pmviUeJ Io me.
� I am exem0� unAer Seclion: 8. 6 P. C.
far�nit rtason:
oaie: Qanec
I aa nere6y tenity ihat I am aware of anA unAerstan0lhe ceQuirements of Calilomia Healin antl Sa1ety Catle $¢qions 25505, 25533, and
2553d antl�hai lo�anylulure building OCCupan�wilVvnllnol(cir[le One�neeClO compty vni� said slaie coaes anA Ne r¢quiremenis�ora
permi�lorcon5imction or motldica�ion Imm ��e Air Oualiry ManapBment Uistrici. fle5i0entulconSVuttion applications a�e ex¢mptlmm
inese o�ovisions.
Daie: PppliCani:
I �ereAy ceriity I�ai I �ave reatl �his aOVli[aiion antl slate ttul l�e aGOve inbrma�ion is carr¢ct. I agree Io comply with all ciiy ana counry
or0inancesanaslatelawSrelalinglobuilQingconslmclionanOherebyauiho' pt�enla�ivesof�hiscilyloenteruDon�heabove�mentionetl
pwperty loi insp¢ctian pur0ose5. �� ]
Da�e: ��� � Sign�re �' / / /���
oriver's �icense or Socia� Seariiy x: .
16<La6 W�ite—Builtling: Green—Code Enbrcemom; Canary—Applicanl: Rnk—Revenoe; GOlaenroG—Assessar
CITY OF COSTA MESA — BOILDING PERMIT
PERMIT NO: F 059569 PLAN CHECK NO; 03968-92 L
CONSTAUCTION TYPE; SP PERMIT TYPE; FIR
JOB DESCRIPTION : ADD 3 FIRE SPRINKLERS AND RELOCATE 4
PERM NO: F 059569
GOVT; N SUPP; N
PURPOSE; ALT
SQ FT:
CLAIM VALUE; 1,100,00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: REF; B59013
**�e*�***r�t*�r*�r***�*�t��tx�x�•�r���r�r*�t*�t�tx*�rx �r*�r�r��r**�rft�r****x�*�*�t*#�**�*�u*���r�x�x�x���r
Z O N I N G R E Q U I R E M E N T S _
sETaAcxs
j,.
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FR'NT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ� PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOT'ES�
i
IE 1E 1F iF k!F # iE 1E iE 1E 1E iE iFlE 1ElF 1E 1f if 1E if 1E if 1f !E iE 1E iE iE iE iF if ik ik if'lE if fE fE # Ik if if 1E 1P iF iE iE iF �lE �lE iE #!f ik iF iE #1E 1F1E iklE ik if�iFlklF 3E
E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY ,
BUILDING APPROVED BY :
DATE:
DATE;
APPLICATION ISSUED BY: ��i�'}�� I�--� DATE: ����.��L
i�***rtifi�-�t�i�*�tit*rt***i�-x�**itiF�FiF'iF3F��riFir�rTr#iF 7F ieiFGFiF�r it 3FiF3FiF�e�F�F�riE*i��tit*iti�*i� x it��-
�r�r�r*�*x x�+�,r�x �r�r**�r*x ��*****+�**��r�*�r�**x �t**�*� �r*�r*�rx�***�**�*******+�x� *******�r*x �r**
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 27,00
658 SMIP/NON—RES
PLAN
ISSUE EEE
BUILDING—DIV—>, PERMIT ISSUE PLAN—CHECK
TOTALS----> 27.00 0.00 1�.55
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
1%,55
TOTAL PAID DUE
44,55 44.55 .00
z�.00 ovExisxox�r; .00
FIRE SMIP/TOT GRADING PLAN—CHECK
z%.oa
1E �F iE �7F �Ik �)E iE iF iE %� �lE �1E �� 1F �lE ihif IFiE �IE 3E iE �IF iFiF iE3F 7F if� if �1F it iE lt if-i(� i(� 3t 3t if 1E iFiE �t k# iF�� �%�lF ih iE 3f jf if 3E �IE lf 9E iE iF 3k iE �lE iE�%iE-lE it IE �Ik iE 1E �1F iE iE if iE if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R F P T I O N UNTT COST TOTAL C051'
FIR 27 FIRE EQUTP FEE: (FROM BLDG VAL TABLE) 1,00 27,00
END OF FEES
_.' '_J
1�
�'i .
. �
=�1 J1�`-�-0t'i���l��fi: ' � . �i�
G='Tc� !�I��"_�,'�rt_ � �. ':. .�
CONSTRUCTION AND PLANNING PO. 9 SPA
APPROVALS Permit # Date Inspector qppROVAIS Permit # Oate Inspector
t. Temporary Electrical Service 4r Pole 52. Pool & Equipment �ocation �.
2. Soil Pipe•Undrgrnd. �. � 53. Steel Feinforcement
3. Electricat Cpnduit UtilitY-Uodrgrnd.� • 54. Forms �
�
4. Electrical Conduit�Undrgrnd.'. 55. Electrital Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6• Electrical UFER Gmd. 57. APPROVAL TO COVEft-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. �
�8. Foundation �,, •,,f-' 59. Gas Pipe, � Undrgrnd., Test ;`
9. Water Pipe•Undrgrnd. �/ !! 60. Backwash Lines, P�Trap, O Undrgmd. � i
10. Scructural Floor SYstem ' 67. APPROVAL TO DECK ?
17. Property Sewer Line & House Connectiori_ .' 62. Backwash & Receptor�Final ��
12. Sewer Cap � 63. Heater & Ve�t•Final �
13. Roof Dreins •� ' 64. Plum6ing System - Final '
74. Rough Plumbing 65. Electrical-Final 1
15. Rough Eleccrical•Conduit � 66. Solar System-Final �
i 6. Rough Electric Wiring � 67. Fencing & Access Approva� �
17. Rough Wiring Si9^ � 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 #
27. Ducts, in Structufe � .. � 70. Underground Hydro �
22. Ducts, Venti�ating , � 71, Product Piping OGas OOiI
23. Gas Pipe-Rough & Test , 72. Underground Flush �
24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead-,-::.a
�:9-/��� tt)+�.
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. FIFiE PREV. FINAL �b•J�(.C�j„ lV��
30. Drywall Nailing j � ' HEALTH DEPT. REQUIREMENT
' 31. Plaster Brown,Coat � � � � � 79. FINAL IfVSPECTION
32. Electrical Power.Meter-Final • � � 80. F000 CERTIFICATE ISSUED
33. Pinal Electric � � Notes: ,
34. Final Heating & Air Conditioning � � •
35..Final Gas Pipe-Test - � I �
36. Hood o� Canopy � � �
37. Final factory Fireplace � ' � I�"
i
38. Final Plumbing I �
� i
39. Water Service�Final I ,
40. Gas Service-Final �
i ;
41. Solar pomestic-Final �
� 42. Backflow Preventer . I ,
93. Backflow Irrigati0�
44. Landscape Irrigation System .
45. Sound Attenuation
46. Handicap Regulations
47. FINA� STRUCTURE & BUILDING ! �
48. FINALPLANNING I
49. Electric Release to Edison (
�
50. Gas Reiease to Southern California Gas Co i � �
51'. CERTIFICATE OF OCCUPANCY
No. Date
�'� Applicant to till in all spaees eacept thosa wil�in heary borEer lines antl zi9n all appropriate Eeclarations.
/
CITY OF COS CONSTRUCTI N PERMIT PERMIT NO. TRACT NO. LOT IT NO.
►'
TA MESA /� O }-.����
ProjectRddress ��S /-�-��iT�fit.i (-R.PTI_�� � � _
A�plicant's Mailin Addreu � O�� .�� �
Owner's Name C �! � �Pho eli.t-Oi-%
Address sii'.%� ��15 c /.i,
Arch/Eng. License No.
Address
Contractor's Nam ,;r�� �� -5��. l-� Phong ¢G�� 1�
Address Imailing) �S.Z �pc�. tJ1 S a,i-�'4-i- �'��
� City License No. O 3a. /49
LICENSED CONTRACTOR DECLARATION
I h¢reby af/irm lhat I am IicenSetl untle� p�ovlslons of Clta�te� 9(commencing
WILh SCCIIOfI i��0) 01 �IVI51011 3 OI LIIB B115Il1855 dllU PlO�QSSIOnS COtlE� dlld
my Iicense is in full force antl eHecL 3 0
Licensc Class c Icen
�` �%� 6E Signature
tKERS COMPENSATION DECLARATION
1 nereby affirm that I have a cer[ilicate of consent to zelf-inmre or a cartlfica[e
of Workers' Compensa[ion Insurance, or a certifietl topY thereof (Sectlon
� 3800, Lab.�C�Jq �� �Sf4 S� �-� 4YN
Pnol� cy No. WJ Compan L.r 0.?
�..yCertifietl copy is hereUy furnisnetl.
Id Certirietl c� ^%witn the Uty-G�yj�in9 p�qn. 7�
Date APPlicant /J. C J ( i1_ ._�il
E%EMPTION FR M WORKERS' COf�E J�9ATION DECLARATION
(This section neetl not be completetl it Ihe Dermil is for one huntlretl (5300) or
less).
I certify that in the pertormance of the work for which thls perm�t is issuetl I
shall not employ any person in any manner so as to be<oma subject to t{�e
Workers' Compensation Laws of Calitornia.
Date Signature
NOTICE: If, after makin9 Mis tleclaration, you shoultl become subject to the
Workers' Compensation provisions of the labor Cotle, you must forthwith
comply wi[n suc� provisions or tnis permit shall be deemetl revoked.
CONSTRUCTION LENDING AGENCV
I hereDy affirm that there is a construction IenCing agency for the pertormance
of tha work for wnich tnis permit is issuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's AtlOress
OWNER BUILDER DECLARATION
I hereby affirm lhat I am exemp[ from the Contractor's License Law for tha
followin9 reason (Section 7031.5 Business antl Professlonal Cotle: Any city or
counry wbich requires a permit to construct, alter, improve, tlemolish or repair
� y struclure, prior to Ils issuance, also requires lhe applicant for such permit
file a signetl statemen[ roat he/she Is Ilcensetl pursuant to [he provisions of
e Contractor's Licenze Law (Chapter 9,�commencing with Sectlon 7000) of
UiviSion 3 Of the Business antl Prof¢SSions COtlO) oI that he/Sh¢ I5 exempt
there/rom anU tne basis tor the allegetl exemption. Any vlolatlon of Section
703].5 by any appliwn[ for a p¢tmit subject5 the apP�icant to a Civll
�en0lty of not more than tive huntlretl tlollars (y500).
I, ds owne� of th2 pro0erty or my empl0y0e5 with wage5 as th¢i� sole
compensation, will do the work, antl the s[ructure is not Intentletl or ot(eretl
lor sale (Section 7044, Business anC Professional Cotle: The Contrac[or's
Licenie Ldw CoeS no[ appty to an own¢r Of a property wh0 bui105 0� improv¢5
thereon, antl wha tloes such work NmseH/herselt or throu9h his or her own
employee5, prOvitletl that such Improvements are not In[entletl or offeretl for
sal¢. If, howeveq the builtling or Imp�ovement is soltl within on¢ year ot com-
pletlon, the owner wi11 have the Durtlen ol provin9 he/she tlitl not builtl or Im-
prove for the purpose of sale).
❑ I, as owner oi the property, am exclusively contracting with Iitensetl con-
lractors to construct tne pro�ect (Sec[ion 7044, Buziness antl Professlons Cotle:
I The Contractor's License Law does not apPly to an owner of property who
builtls or improves tnereon. antl who contracts �or sucn oraiects with a con-
tractor(s1 hcenze pursuam m[ne ConVattor•s License L.aw�. I am aware that
proot o( their Wotke�'s Compensation Insu�ance Shoultl be prOVICeU to me.
❑ I am exemo� untler Section 8. & P. C. tor this reason
Date
I hereby certity t
intormation is corr
antl stafe laws relz
sentatives of this
inspectlo��
Signature
Drivers' License or
0865-46, rev. 5/88
Owner
have reatl this aooiication an0 stale tbat the above
agree to como�Y with all tity antl county ortlinances
o builtlinq constructlon, antl hereby authorize repre-
ei� pOn the above-mantlonetl property fOr
Dated-�
�..-. �..
3 � •I Y� �1 D
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑.DEMOlISH ❑ OTHER
OESCRIPTION OF WORK/USE�OF BLOG. —�. � �
TVPEOFPERMIT GRADING FOVNDATION' STRUCTURAL
❑ TENANT ❑ ELECTRICAI ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PR0.IECT DESCRIPTION 5�. FT. OCCUPANCv '
GONSTRUCTIONTVPE VALUATIONS�7S �VO
20NE GRADINGCU.VDS. ACRES
Remarks 0/� .,,� Pl 1Q'��'� � �.,� �� Q_2�f{Q
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
Interceptors
Ki[chen Sink
Lavatories
P-Trap
Roof Drains
Reinspec[ion Fee
ShoWerS
Service Sink
Sewer Cap
Sewer Connection
Solar CAllectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Outlets Water Closet
Water Heater
Wa[er Service
Auto�Wesh
Lsundry Tra'ys
$15
Boiler
Duct- Under Ground �
DUCt - $tructUrel
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact Blt. IC80 #
Heating System & Ducting
❑0-100,000 BTU �100,000
Reinspectian Fee � $15
White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
laue Fae
Hoodor Typel ❑
Cenopy Typqll ❑
iefri ion System
100,OOOBTU ❑700,000
System Fepair/Alteration
Fire Dampers
Regiscers
Issue Fee
A.P. # 'O �
S Main Building:
E
T Front
ARear
C Ri9ht
K
Ping. Ref. #
Planning Notes:
FEES Nutomatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers �Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlet5
• Garbage Disposal
' Generator 00.5 KW
Fee
�i�L'i�Jl�
—
� • — •
—_
—
— '. � •.. . . ., '
�J�� / �J���'��I/�`1���i�,
�Q�!J/���'� _ � �
ELECTRICAL �
Trensfarmer ❑ 15-50KW
❑ 50+KW .
Meter ❑up to 100amps
Meter ❑over100amps
Sub Panel
Motors �61 HP �1.:4-8
Inc. Solar 09-75 HP 016-15+
Microwave
Pole Liaht .
Sign
Standing Sections
15 KW Trash Compactor
$15 luue Fee
DEVELOPMENTSERVICESREQUIR
$ 3 2oning Approved By
FEES , Building Approved B�
r
. Aooliption Iss�ed Bv
r
, ' SUMMARV OF FEES
BUILDING PERMIT $ ' � SMIP
PLAN CHECK $ �
y PLUMBING $
PLAN CHECK 25% $ �
� ELECTRICAL $ �
PLAN CHECK 50% $ �
" MECHANICAL $
� PLAN CHECK 25% $
$
FEES
$ 3
fERM1T
ISSUANCE $
ENERGY P.C. $
GRADING $
MICROFILM $
TOTALFEE $
/. 3,
oi OOa2vD62-00029063 TCoT 1:�3,�$
CAiE- 03/23f89 7I�E: 13:45
. . �� � G � l`� � \ � r �7 , _ - . . . . , . ,
�'..' EQ�VSTRUCTION AND PCANNIN� ,J �.. , . � -"��=L & SPA •
.�t�'AP.PROVqLS Permit# �.�. Date� Inspector AppROVALS Permlt#�'a Date Inspector
�
-. 1.`Tempor�ry Electrical Service or Pole ..� ,� 52. Pool & Equipment Location f^�
2. Soil`PipE-Undrgrnd. YJ° �� � 53. Steel Reinforcement g �I
f
3?�ElectEical�ConduiTUtilijy-Undrgmd. a� �� 54. Forms 1
� - .• .� n � i-..
4�Elect�ical Condui[-Und�grnd. N 55: Electrical Bonding ��.�/
5� Steel �Reinforcement G �* 56. Rough Plumbing & Pressure Test `�'�,� ��
. � ��
� l 57. APPROVALTOCOVER-GUNITE �J � �
6. Elect'rical UFER Grnd. �,�; � � �;
r..
� �7� -FooUngs� � �• - Y �� f� 58. Electrical Cqnduit-Undrgrnd. �n
�
�- 8:-Foundataon % � �,; i 59. Gas Pipe, O Undrgmd., Test �' y
ti
' 9. Wate�Pipe-Undrg�nd. � n I� � 60. Backwash Lines, P-Trap, � Undrgmd.
/'�'
10.rtStructurgl Floor System ��' �� � 61. APPROVAL TO DECK
11. �Pro erty Sewer Lin��& House Corin�ction • �
P 1 , � f, : rt j 62. Backwash & Receptor-Final
12. Sewe'r.CaP . �;;, .', + � � �
. 1.� .� 63. Heater & Vent-Final
�i
13.,_Roof�Drains , �� � -� � � � - 64. Plumbing System - Final � �
14^Rough Plumbing.� "` � '� 65. Electrical-Final �'�
15. Rough Electriral-Conduit 66. Solar System�Final
�� Rough Electric Wiring 67. Fencing & Access Approval
�.7! Rough Wiring Sign 68. APPROVED FOR PLASTERING
�8. Rough Electrical-T Bar Ceili�g. • 69. �POOL/SPA SYSTEMS FINAL
'�. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace �� APPROVALS Permit# '
� i;
21.'Ducts, in Structure ^! � 70. Underground Hydro
�
22. Ducts, Ventilating -� 71. Product Piping �Gas ❑Oil
23.-Gas Pipe-Rough & Test �" ' 72lUnderground Flush
.
24. Roof Framing r._ � � � � 73. Undergrnd. Storage Tank � Gas ❑ Oil �'
25. Roof Sheathing �� ,r � .' 74. Overhead Hydro � �, .
26. T-Bar,Ceiling (Structural)'& fWes+esoat � f 75. Dry Chemical .
�
27, Frame ahd Flashing � - � 76. Dry Standpipe '
28. Lathirig &�Siding v� � � 77. FIXED SYSTEM FINAL �
29. Insulation 78. FIRE PREV. FINAL ' J
30. DrywalJ Nailing '1 j � HEALTH DEPT. REQUIREMENT
31.�., Plaster Brown Coat�- �' � v� 79. FINAL INSPECTION
32� Electrical Power Meter-Finel� ' 80. FOOD CFRTIFICATE ISSUED
-!
i
33 Final ElCctric � � Notes: �i ����� o-� �
, GG v
34. Final Heating & Air Conditioning ' �� �-Z_Y -�9,
35. Final Gas Pipe-Test �� r�+ � ty , y
36. Hood or Ca�opy , . S� Q��
-� .
�37. Final Fac[dry Fireplace � ' .
.� .
38. Final Plumbing 1 �
i
' 39. Wate �Service-Final �� ' ,�
-40. Gas Service-Final � � ' � .
�
4�. Solar Dqmestic-Final � � - ' � �. : �. j
42. Backflow Preventer , �J�, � � �
J
43. Backflow trrigation' , '.� ) - � �;� ���
, ', .. '� �.
44. .Landscape Irrigation,System i ,' �' •�/
y
45. Sound Attenuation ��� 1• ./�,� E
46. Handicap Regulations "� r��
9
47. FINAL STRUCTURE & Bl11LDING � L `
48. Special Requirements Completed �
i i
49. Electric Release to Edison -
r. �.' i.. i.:"�
'50. 6as Release to Southern Califomia Gas Co •� , �. �, .�'.� �
-51. CERTIFICATEOF_OCCUPANCY • .; '%. �,I �
' � - ''-�! :v �.,
No ��- Date . � '�!' �
�
�'
' .� ApO���ant to fill In all ipaees ex<e0t ��ose within heavy bortler lines antl sign all aOV�opriate tleclarations.
CITY r COSTA MESA CON$TRUCTIO PERMIT PER NQs �^ � TRACT NO. LOT NO. UNIT 19n A P# Zone �
Pr ect Address'
555 laNdaa 1\� �k�ti- a u z��
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR S Main Building: Accessory Building:
Applicant's Mailing Address ' �
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T FrOnt p
Owner's Name �`� ����—� Phone DESCRIPTION OF WORK/USE OF BIDG. A Rear N
Atldress
Arch/Eng. License No. TVPE OF PERMIT GRADINGf�Y FOUNDATION STRUCTURAL I K Right G
Address ❑ TENANT ❑ ELEGTRICAL f�J PLUMBING ❑ MECHANICAL � g� Left - R
/�T�, ❑ �o7HeR Pln Ref. # Parkin Re
Contractor's Nam �� o Phone � 9� 9. Q.�P�°°ided E
c� PROJECT DESCRIPTION 54. FT. OCCUPANCv �
Address (mailing���-.+7� ���/�x% �� CONSTRUCTION TVPE VALUATION $ P�anning Notes: M
City LiCenSe No. �� � 2.� ZONE GRADING CU. V�S. ACRES— T
S.
LICENSED CONTRACTOR DECLARATION
I hereby a�/irm tba[ I am licensetl untle� provi5ion5 of Chd/te� 9(commencing Rema�ks:
with sectlon ]000) of Divlsion 3 of [he Busine55 antl ProT¢S51on5 COAe, antl
my license is in full torce antl effect. - 7 � ELECTRICAL FEES
�'-//L 2I <�
License Ciass ense No p�UMeING FEES Automatic Washer Transformer ❑ 75-50 KW
(J Date?��� Signature
n RKERS' COMPENSATION �ECLARATION ConStruCtiOn Pole Sub. ❑ SO + KW
~ ,reby attirm that I have a certlfitate Ot con5ent to self-in5ur¢ o� a certlficate Bar Sink $hOW¢�5 � �
ot Workers' Compensation InSurance, or a certifietl copy thereot (Sectlon Cooking Unit Me[e� ❑up t0100amp5
� 3800, Lab. c� _ � � r Backflow Preventer Service Sink
Policy No.���VC-��ii% Company /-iWf+-A`�'� Backflowirrigation SewerCap Dishwasher Meter ❑over700amps
� � C¢rtifietl mpy is hereby furnishetl. Dryers ❑Gas i'• Electric Sub Panel
� �(,YCertitietl co�yy�3{ ilea wkn the city Bui ng vis" Bathtubs • Sewer Connection
Date_� � Za -o / AOP��cant - Fan Motors �0.1 HP � 1 h- 8 .
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clafifiel5 $plar Coll¢ctOfS
(This section neetl not be completetl it the pe�mit IS fo� one huntl�ed ($300) o�, � F.A.U. � InC. 5012� 09-15 HP 016-15+
less). Dishwasher . Solar Piping "
I certiry that in tne performance of tne work tor which this permk is issuetl 9 Fixtures Microwave
shall not employ any person in any manner so as to become subject to t�e Drinking Fountains Solar Tank
Workers' Compensation Laws ot California. Device Bozes �• Pole Li ht
Oate Si9nature Floor Drains Swimming Pool w/Spa 9
NOTICE: If, after making this tleclaration, you shoultl become subject to the Out10[5 '
Workers' Compensation provi5ion5 0( the Labor Cotle, you must torthwith FIoo�Sinks Urinel Range
mmply with Such provisions or [Itis pevmit shall b¢ tleemea revoketl. SwitCh¢5
CONSTRUCTION LENDIN6 AGENCV GasSefviCe OutIEtS WatelCloSet $ign
1 hereby af(irm that there is a construction lentling aqency tor the pertormanre /�/� Gai6a e Dis 0581 Standin
of Ihe work for which this pe�mit is i55uetl ($ection 3097 Civ. C.) Int2�C2pLOI5 Wdt¢� H¢dt2f ' � yv 9 P 9$et[iOnS
, LRnaer's Name �
Lentler's Atltlress Kitchen Sink Water Service - Generator 00.5 KW 05-15 KW Trash Compactor
- OWNER BUILDER DECLARATION . .
I Flefeby at(irm lhat I am exempt troT the ContraCtor's License Law for the L2v3tOfi25 - AUtO-W85h
following reason (Section 7031.5 Business antl Professional Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repair P—Trap �undty Trays
any strucWre, prio� to i[5 issuance, a150 requires the applicant tOr such permit
`ile a si9netl Statement that he/she I5 licensetl pur5udnt to tlle provi5ions ot ROOf DfdipS
�ontractor's LI<ense Law (Chapter 9(commencing with Section ]000) oi
.sion 3 of the Business antl Protessions Cotle) or that ne/she is ezempt Reinspection Fee $15 laue Fee $ 3
meretrom antl the basis for the alle9etl exemption. Any violation of Sectlon -
]031.5 by any applicant for a permit subjects the aOP�icant to a civil
.�enalty of not more than five nuntlretl tlouars (g500). � - DEVELOPMENT SERVICES REQUIREMENTS:
LJ I, as owner of lhe property or my employees with wa9es as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By Date
compen5ation, will tlo the wo�k, antl the st�uctura i5 not Intentletl o��otfEretl .
for sale (Section 7044, Business antl Protessional Cotle: The Contractor's . . MECHANICAL FEES Buildin8 APP�oved By Date_���
License l.aw tloes not apply to an own¢r of a property wtio Ouiltls or improves
Ihereon, antl who tloe5 suc� work hiTselt/hers¢If o� th�ough his or h¢r own goiler HOOd Of T ¢ I ❑ APP���tion ISSUBd By DOtA_r���.���
employees, provitletl that such improvements are not intendetl or offaretl for VP
sale. I�, however, the builtlin9 or improvement is soltl within one year oT com- Canopy, Type II ❑ SUMMARY OF FEES �
pletion, the owner will have lhe burtlen of proving M1e/she tlitl mt bulltl or Im- DUct - Und¢f GfOUOd
prove tor the purpose oi saie). BUILDING PERMIT $ SMIP $
❑ I, as owner ot l�e property, am exclusively <ontracting with licensetl con- Duct -Strucmral Refrigeration System P�AN CHECK $ PERMIT
l�actor5 [o const�uct the project (Section 7044, Business antl Professions Cotle: �
The Contractor's License Law does not apply to an owner of oroperty who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU PLUMBING $ J- V v ISSUANCE $
builds or improves thereon. antl.who contract5 for such oroiect5 with a ron-
tractor�sl Lcense pursuan� m rne Coniractors License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENEPGV P.C. $
proof of tneir Worker's Compensation insurance shaula be provi0etl to me. ELECTRICAL $ GRADING $
❑ I am exempt untler Section B. & P. C. for tnis reason Firepl/Fact. BIL IC80 # Fire Dampers MICROFI LM $
PLAN CHECK 50% $
Date Owner Heating System & Ducting RegiSters MECHANICAL $ ���
I nereby certify that I have reatl chis application antl state that tne above ❑0.100,000 BTU �100,OOOBT TOTAL FEE $
information is mrrect. I agree to comply with au ciry antl county ortlinances P�AN CHECK 25% $
dntl State laws rela[in iltl' construction, antl hereCy duthoriie repre-
sen[atives of this t y Y er pon tne above-mentionetl Oroperty for �
Inspectlon purpose . � ' � ;
sie�at��e oat� �r% � Ql O�L1293t1-O�G2931i T� "9 7 �
Orivers' License or 55 � Reins e[ion Fee $15 Issue Fee $ 3 f �
OB65-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accountin9; Goldenrotl - Assessor � �ATE� ��J2g�g9 TInE% [��l:�.'7 ' •�
� G `� .; \.; _ . .. . . .
' w & sPn
CONSTRUCTION AND PLANNING
�' DaYe Inspector
APPROVALS Permit� u�' � APPROVALS �Permit# Date Inspector
� 1. Temporary Electrical Service or Pole � �� 52. Pool & Equipment Location
.a
2. Soil Pipe-Undrgrnd. n�� .^ N 53. Steel Reinforcement
�� Elec4iical Condwi l'Itility-Undrgund. �;� �' 54. Forms �%�
4�.iElectFical Condurt-Undrgrnd. �� q 55. Electrical Bonding (�`�
, .�
5�SteeL Reinforcement � . �' 56. Rough Plumbing & Pressure Test ������
6.1 Elecikical UFER�Grnd`; 57. APPROVAL TO COVER-GUNITE �--� �J�
r
7� Footings �t� � j�� /� 58. Electrical Conduit-Undrgrnd. �'
8V Foundation �'� � ` 59. Gas Pipe, � Undrgrnd., Test �
9�'Water Pipe-Undrgrn�d. V� i��� 60. Backwash Lines, P-Trap, O Undrgrnd. Q
10� Structural Floor Sy;tem � � 61. APPROVAL TO DECK �
� t taProperty Sewer Lin� & Nouse Co�nection �yt -� 62. Backwash & Receptor-Final i,�
12j Sewer Cap !(f �p 63. Heater & Vent-Final ,i�
nr i,
73. Roof Drains (j. �- 64. Plumbing SYstem - Final '
��
14. Rough Plumbing ZY�"( G� 65. Electrical-Final "�
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring . 67. Fencing & Access Approval
.'l
�-17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
�18. Rough Elearical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
r19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory FireplacC APPROVALS Permit #
L'i
21. Duc[s, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72..Underground Flush
24. RoofFraming 73. Undergrnd.StorageTankOGas ❑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 j� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat �f 79. FINAL INSPECTION
'32.�Electrical Power MeterFinal � ��1 80. 100D CERTIFICATE ISSUED
33. Final Electric J Notes:
� n �.
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing L1_� �'(��
„ 39. Water.Service-Final -- � - - -- � �
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer '
��
43. Backflow Irrigation ��
44. Landscape Irrigation System
45. Sound Attenuation '
.-.
46. Handirap Regulations '�;
47. FINALSTRUCTURE & BUILDING
48. Special Requirements COmpleted
49. Electric Release to Edisqn _ _ :�
50. Gas Release to Southern �ylifornia Gas Co ' �
51. CERTIFICATEOFOCCUPANCY /� ,
No. Date ' �'"
, , h�. . _ . . ...., . �
�
AOG���anl to fill In ail spacei exceD� tnose wit�in �eavy OorAer Iines anG sign all aovrooriate aeelaretions.
CITY OP COSTA MESa CONSTRUCTION PERMIT
ProjectAddrQss ��,�//i/T� �l!/.!'1
Applicant'sMailingAddresqo � ��o LlQ .r.
Owner's Name �/-`C-J�Y O/1 �/Fi+G fi6ne2fY-/ � 7/
Address
Arch/Eng; � � License No.
Address /�
Contracto s�me G���� Cu !R!G � Phon�YY-6�j�
Address (mailing) �Z� � s�� ��✓���+U�a ��` ���
City License No. �� ¢�'�%-� � '
LICENSED CONTRACTOR DECLARATION
1 hereby,afiirm that Pam.licensetl untler provisionsot Charter 9(commencln9
with section ]000) of Division 3 of the Business and Professlons Cotle, antl
my license is in full torce antl eftect. '
Utense�Class_�� '�% menseN�zD��.�'l
Oa[e�=�� �� 5'an�a rn�� � ��
'ORKERS'COMPENSATION D CLARE ATION
hereby atfirm that I have a cer[iflca[e of consent [o self-insu or a�
of Workers' Compensaiion InsurSnce, or a certlfiea copy thereoi (Sectlon
3800, 1_ab. C�:p)� ' ' "' ' ' ' �
Policy No.�iC:.._,��dd�� Company �/���
❑_ Certifietl mpy fs hereby fumisne �l ' ,
kr ce,t„�ed �oPY �s n�ed w�th the tY a�� (nne oi�p�on. fi�/�In/
Date�'��7-�� AOP � an� �C/
EXEMPTION FROM WORKE C ENSHTION DECLAFtATI
(Tltis section neetl not be completetl if the permif I5 (O/ one huntlr (S 00) or '
less). -
I certify t�at in the pertormance O1 the work fOr which this perm�t I5I55ueQ I
sball not employ any person in any manner so as to become subjec[ to lhe
Workers' Compensation Laws ot California. ,
Date Si9�ature
`N0T10E: It, after making this tleUaration, you shoultl become subject to the
Workers' Compensation provi5ion5 ot the Labo� CoOe, you must forthwith
comply with such.provisions or this permit shall be tleemetl revoketl."
CONSTBUCTION LENDING^AGENCV �
I hereby a(firm that there is a construction lentling agenty tor the performan<e'
ot the work fo� which this permit is'i5suetl (Sectlon 3097 Civ. C.)
l.en0er's Name -
LenUer's A�Oress �
OWNER BUIL�ER OECLARATIOfi ' �
1 hereby affirm that I am.exempt (rom tne ConVactor's'License Law tor the
following reason (Section ]031.5 Business antl Piofessional Cotle: Any tlty or '�
county whicn requires a permit to construct, alter, Improve, Bemollsn or.repair
any structure, prior to its issuance, also requlres Ne applicant for such permit
b(iie a signea statement that he/she is licensetl pursuant to the proWsions of '
ie Contracror'S License law (Chapter 9.(commencing with,5ectlon 7000) of-
.IviSion 3 of lhe Buziness antl Profe55mn5 Code) o� lhat he/She Is exem0�
�hetefrom antl the basis to� lhe alleged exemption. Any violation Of SettiOn
7031-.5 by any ap0�icanP tor a permil subjects the ap0���anl to a civil
��enalty of not more than five M1untl�etl tlollar5 (5500�.
I, as owner o� the, pro0erty or,my em0loyees wiro wa9es as iheir sole
,Compensation, will tlo the WOIk� dfld LbC'SIIUCIUfC�15 not intenCeE or otferetl
lor sale' (Section 7044, Buziness antl orofessional Cotle: Th¢ Contractor'S
l.icense Law tloez not apO�Y to an owner ot a pm0erry who builtls or improves
thereon; antl who Aoes such work himzelf/herseli or through his or her own
employees, provltletl thai such Improvements are not intentletl or otteretl tor
sale. If, howev¢r, tne builtling or Improvement is�soltl within one year ot com-
pletion, the owner will have tM1e burtlen ot proving he/she tlitl not builtl or im-
ptave tor Ihe pu�po5e o( sale). . -
❑ I, az owner of the property, am exclusively contracling with Iicensetl con- '
traGtors to construct the project (Section 7044, Busine65 antl Professions Cotle:
The Con[ractor's �icense Law tloes not apply to an owner of property wM10
builtls or improves Ihereon, antl who contracts tor such p�ojeCts wlth a�con-
tractor(s) license pursuant to tne Contractor's License Law). I am aware [bat
proof of their Worker's'Compensation insurance shoultl be provltle0 [o me. �
❑ I am exemD� untler Section B. h P. C. for this reason
Date Owner
I hereby certity that P have reatl thls application antl 5[dte that the above
Information is correct. I aqree to comply witn all city antl county ortlinances
antl state laws relating to builtling tonstruction, antl hereby�autnorize repre-
sentatives of M�city to enter upon the above-mentionetl property for
Inspectio urpo �5. � ,
Si9na e DateJ 27�
TYPE OF CONSTRUCTION LI NEW U ADD J29 ALTERAT.ION LJ" REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTH R q p. #
DESCRIP I NOF ORK/USEOFBLD ��,e(C��l-
���� ��d� ��C. / � - . S Main Buildi
TYPEOFPERMIT GRAOING FOUNDATION ❑STRVCTURAL T Front
O TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANICAL B Reef
. 0 �OTliER � %� �
y�gOJECT DESCRIPTION 5c]. FT: ' oCCUaArvCV ' K Right �
CONSTRUCTIONTVPE � VALUATION$ � g Left
ZONE � GRADINGCU.V�S. ACftES p�ng.Ref.#
Remarks: �j /y r� � ��'j^ �.���7%' � Planning Notes:
Bar Sink
Backflow Preventer
Backflow Irrigetion
Bathtubs
Clarifiers �
=1oor Drains i '
=1oor Sinks . . . .
3as Service ,Outlets
Interceptors
Kitchen Sink
Lavarories , - ' � .
P-Trap�
Roof Orains
Reinspaction Fae - $15
Duct- Under Ground
Duct-SVuctural '
Duct - Ventilating '
Exhaust System ❑ Multiple ❑
Firepl/Pact. Blt. IC80 #
Heating System & Ducting
❑aioo,000'eTu �ioo,000eT�
F^=
Driv¢rs' 1' se or 55 � � �'- �"""'
=MF 0865-46, rev. 30/04 White - Builtling; Canary - A�Pllcant; Pink - A<counting; Goltlenrod - Atsessor
$15
Showers '
ServiceSink. . -
Sewer Cap � �
Sewer Connection
Solar Collectors
Solar Pipin9 �
Solar Tank
Swimming Pool w/Spa
Water Closet "
Water Heater �
Water Service �
Auto-Wash . ' �
laue Fee
iANICAL
Hood or Type I ❑
Canopy Typell ❑
Fiefrigeretion System
❑0.700,OOOBTU ❑100,
System Repair/Alteration
Fire Dampers �G �
Registers
S/,l�/,GtJ/!/c��'�rir
Issue Fee
FEES
r
AutUmatic Washer
�Construction Pole Si
Cooking Unit �
�IShW35f1Ef
Dryers ❑Gas ❑EI
Fan �
F.A.U.
Fixtures
Device Boxes
Ou[lets
Switches
Garbage Dispoul
Generetor �0.5 K W
ic
s�spi
. Zone
Parkin9 Req./Provided
I
ELECTRICAL •
Transformer � 15�50 KW'
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑overi00amps
Sub Panel '
Motors 00.7 HP 07 h- 8
Inc.Solar �9-15 HP �16-15+
Microwave � � '
ole �ight
� Range
I ' I; Standing Sections
5 KW Trash Compactor
$ 3
Reinspeetion Fee $15 luue Fee
FEES
DEVELOPMENT SER VICES REUUIREMENTS:
2oning Approvad By
_ _ Building Approved By ��—i A
t�
Z
O
N
I
N
G
R
E
Q
M
T
S ,
SUMMARV OF FERS� '
BUILDING PEFMIT ' $ � SMIP� $
PLAN CHECK $ PERMIT . .
PLUMBING $ � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
E�ECTRICAL $ � GRADING $
PLANCHECK 50% $ MICROFILM $���//� �' �
MECHANICAL $ � TOTALPEE $ LzL��
PLAN CHECK Z5% $ .
: D3/?7/8? TIf1E: 13
- •CONSTRUCTION AND PLANNING - � E � & SPA
APPROVALS . Permit#' ' � Date , Inspector qppROVALS Permit# Date Inspecror
-,7, Temporery 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. Elect�ical Bonding : �
5.,Steel� Reinforcement � - 56. Rough Plumbing & Pressure Test "
6.,ElectricalUFERGrnd. 57. APPROVALTOCOVER-GUNITE -
� 7t. Footings . � 58. Electrical Conduit-Undrgmd. - �
�8. Foundation . . 59..Gas Pipe, O Undrgmd., Test �
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgrnd. -
10. Structurel Floor System - ' , 61.� APPROVAL TO DECK .. � .
�11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final ,
' 12. Sewer Cap - � '� . 63. Heater & VenrFinal
1 73. Roof Drains -' 64. Plumbing System - Final '
14. Rough Plumbing ' � 65. Electrical-Final '
-15..Rough Electrical-Conduit � ' 66. Solar System=Final � " " -��
7�6. 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 � �
i
19. � Rough Heating & Air,Conditioning 3�/�+.�' (�/) FIRE DEPT. REQUIREMENT ' �
20' �Rough Factory Fireplace � APPROVALS ' Permit # ' �
21' Ducts, in Structure ' 70. Underground Hydro � � �
22. Ducts, Ventilating � �71. Product Piping OGas ❑Oil .
23. Gas Pipe-Rough & Test 72. Underground Flush ' �
� 24. Roof Framing� , 73. Undergrnd. Storage Tank�O Gas ❑ Oil �� ����
25. Roof Sh�eathing 74, Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical '
27. Frame and Flashing � � �� 76. Dry Standpipe � -
28. �Lathing�& Siding ' � � ' �771 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 � �O ��
l
35. Final Gas'Pipe-Test- - � � � � �
36. Hood or Canopy , � � � �
37. Final Faaory Fireplace - -
38. Final Plumbing ' ,
39. Water Service-Final � - � '
'�
40. Gas Service-Final .
41. Solar pomestic-Final , . ' . -���'`
42. Backflow Preventer � � � � . �
43. Backflow Irrigation � � �
.. i% .
44. �Landscape Irrigation System . - .
45. Sound Attenuation ' � ' ' � � � �
46. Handicap Regulations � • � ' . �
47. FINALSTRUCTURE&BUILDWG , ' . . , _ �
48. Special Requirements Completed � � � �� �
49. Electric Releaseto Edison, - - - ` • •' � '
� � � '.�
50. Gas Release fo Soufhern Califprnia Gas Co � � �
57. CERTIFICATE OF OCCUPANCY . � � _ ,. _ . ' . ' /
.�ii
� �n. ' ' Date , : ' ' �
(� �� ADD���ant to /III In all spaces eKeept tnose within �eavy Eo�Oer Iines anG sign all appropriate tlaclarotions.
CiTv oF COSTA MESA CONSTRUCTION PERMIT
Project Addtess' SSS I�NTOAI .$�(�/ iG �% �, o� -
Applicant's Mailing Address -
Owner's Name SELu%�/ rV �i� gi�/.�,(�^phone
Address
Arch/Eng. Hli'� License Na.
Address — L�J�[ne� u p/2 LD S H'r) (i-ELc S ��p
Convactor's Nama (�i M t n/ t C EGTR! G phone S7J D//3
Address Imailing) -?/70� RrnNi// �d 2-n�7 r.�s7'� MFs�i
Ciry License No. — — ��%�f ��
LICENSED CONTRACTOR DECLFRATION
1 M1oreDy affirm thal I am Iicensetl untler provislons of C�arter 9(comTGnCiO9
with section 7000) of Diviilon 3 0/ t�e Business antl Professlons Cotle, antl
my Iicense is in tull torce antl effect. �/
LJcense Glau �� Lice se o.��1 7 Z�
(� ^ate 3'33-89 Signature
'��� �RKER$' COMPENSATION DECLARAT N
AV .ereGy af(irm ihat I have a certitiwte ot consent to self-insure or a certiflcate
� ol Workers' Compensa[ion Insurance, or a certiffetl topy lhereof (Section
3800, Lab. C.) T
�� wPdR�i 36D9 F MoN INDfM
Policy No. � Company �E /
(O ❑ Ce�tifietl copy I5 he�eby fUtnls�etl. EXF IO `I ' 89
� �I Cer'fie copy i f letl with the city Buii ng Division �7 �
Oate ' Applicant F(�/r'1Pti
EXEMPTION FROM WORKERS' COMPENSATI DECIARATION
(Thiz section neetl not be completetl I( the permlt I5 for one huntlretl (§100) or
less).
I certiry that in [he performance oi Ihe work for whlch [his perm�t is issuetl I
shall nol employ any OerSon In any manner so a5 to become subject to t�e
Workers' Compensatlon Laws of California.
Date Si9nature
NOTICE: Ii, aiter making this tletlaration, you shoultl becoma sub7ect to the
Workers' COmpenSation provi5iOn5 ot the Labor Cotle, you mu5t forthwilh
comply witn sucn provislons or tnis permit snall be tleemetl revoketl.
CONSTRUCTION LENOING AGENCV
1 hereby af9rm lhat there is a<onsVuctlon lentling agency for the performan<e
of the wOrk iov which Ihis permlt Is ISsuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION
1 hereby a(firm that I am ezampt trom the Contrattor'S Llcense I..aw for the
� following reason (Section ]031.5 Busineis antl Profe55ional CoCe: Any city or
counTy whiclt �equires a pe�Tit to ConStru<t, dl[B/, ITp�ove, tlemollSh o� repai�
any structure, prior to Its issuance, also requires the aoo�icant �or such permit
(ile a Signetl 5[atemenl that h¢/She Is Iicensetl pur5ud�t t0 the p�ovi5io�5 Of
� i Con[ractor's License Law (Chapter 9(commencing with Section 7000) of
.vision 3 of the Business antl Professions Cotle) or [ha[ he/she is ezempt
there�rom antl the basis for the allegetl exemption. Any vlolation ot Section
]031.5 by any ap0licdnt fo� a permlt Sub�eGts tna appliGant to a clvil
�enalty of not more than five huntlretl tlollars (E500).
I, as owner of the property or my employeas with wa9es as their sole
compensation, will tl0 tne work, antl the st�uctu/B IS nOt intentletl O� ofter¢tl
for sale (Se<tion 7044, Busmess antl Professional Cotle: The Contractor's
LicenSe Law tloes not apply to an owner of a property w�o builtls or improves
lhereon, and who tloes su<h work himselt/herself or througb bis or her own
employees, provitletl tnat such Improvements are not intentletl or offeretl for
sale. If, however, the builtlin9 or Improvement is soltl within one year of com-
plation, Ihe owner will have [he burtlen o/ provin9 he/she tlltl n0[ bulltl o� Irt�-
prom forthe purpose oisale).
❑ 1, as owner of Ihe Oroperry, am ezclusively mntracting with Ilcansetl con-
tlaclors t0 conslfuct [he pfoject (Sec[ion 7040, Busine55 antl Ffot¢StlOns Cotle:
' The ConVactor's License Ldw doe5 not appty l0 dn owner Of p�operty wh0
builtls or improve5 thereon. antl who contracts lor such orolects with a con-
tractor(5) Lcense pursuan[ to [ne Conttactor�s Llcense L.aw�. I am aware that
proof of (neir Worker's Compensatlon Insurante shoultl be provitleC to me,
❑ I am exempt untler Section B. S P. C. for this reason
Date Owner
I hereby certity tnat I have reatl this applicatlon antl state tnat the above
information is torrect. 1 a9ree to comply with all <ity antl coun[y ortlinancez
antl state laws relatinq�[o builtling construc[lon, anA hereby authorize re0re-
5antdtive5 0/ this tlty to enter upon the above-mentiOnBtl Prop¢rty tOr
nspectlon 0 oses.
Ignature oate 3-13 -89
Drivers' Licanse or 5 �
�r�...3_ �� ...._..'_' __. __. '��Y• A.P.�W
'G
S Main Building:
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEM LISH ❑ OTHER T Flont
DESCRIPTION OF WORK/USE OF BLDG. A Rear
TVPE OF PERMIT�y GRADING FOUNDATION STRUCTURAL I C Right
K Left
❑ TENANT OCJ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $'
❑ �OTHER ( ` . Ping. Ref. #
PRQIECT DESCRIPTION SQ. F7. OCCUaANCv planning Notes:
CONSTRUCTION TVPE VALUATION $
ZONE GRADINGCV.YDS. ACRES
Remarks: '2 .?� 7 Q 2 _
3ar Sink
3ackflow Preventer
3ackflow Irrigation �
3athtubs '
�larifiers
Jishwasher
Jrinking Fountains
=1oor Drains
�loor Sinks
.iasService Outlets /
I ntercepror5
Kitchen Sink
Lavatories
P—Trap
Roof Drains �
Reinspec[ion Fee $15
Duct - Under Ground
Duct - Strucmral
Duct-Ventilating �
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iCBO �k
Heating System & Ducting
❑ ai oo,oaa eTu O � oo,00a
Reinspection Fee � $15
0865-46, rev. 5/88 White - gulltling; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assa55or
Showers
Service Sink
Sewer Cap
Sewer Connectian
Solar Collecrors
SOlar Piping
Solar Tank
Swimming Pool w/Spa
Wetef ClOset
Water Heater
Water Service
Auto�Wash
laue Fea
Hood or ypel ❑
Ca y Tyue I I ❑
Refrigeration Sys[em
❑0-100,OOOBTU ❑100,OOOBTU
System Repair/Alteration
Fire Dempers
Registers
Issue Fee
FEES
$ 3
Zone
AccessOry Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-SO KW
Construction Pole Sub. � 50 + KW
Cooking Unit Meter ❑up to t00amps
Dishwasher Meter ❑over100amps
Dryers OGas ❑Electric � Sub Panel
Fan Momrs 00.1 HP � 1 R- 8
F,A,U. Inc.Solar 09�15 HP �i6-15+
Fixtures Microwave
Device Boxes Pole Light
Outlets Range
Switches g�y� �
Garbage Disposal Standing Sections
Generator OP5 KW �5-15 KW Trash Compactor
Heinspection Fee �$15 � � luue Fee
DEVELOPMENTSERVICESREUUIREMENTS:
Zoning APPtoved By
Buildine APProvad By � q� k
FEES
N
1
N
G
R
E
Q
M
T
S.
SUMMARV OF FEES V
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ 2.�$ • ��D GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ Z6g , �o
PLAN CHECK 25% $ '
5�O1 00029068-QQQ24Q68 TCl�" 2b8.1�
y DATE: 03/23<E9 7I11c': 13:47 -
� ; .\ 1'.' C'` . .-.-. . .. . � ..-�. ,� -- .. .. ..,..
CONSTRUCT14N AND PLANNING \ � - & SPA � � �
APPROVALS Permit# Date Inspector qppROVALS Permit# � Date � Inspector
�' ,.i
7. Temporary Electrical Service or Powe ,'�, 52. Pool & Equipment Location
2i Soil Pipe-Undrgrnd. ?� f 53. Steel Reinforcement ��
3. �Electrical ContluiF Uiility-Undrgmd. �� ?� . 54. Forms "�'
4. Electrical Concluit-Undrgrnd. '� �y 55. Electrical Bonding �'
5' Steel �Reinforcemenf ;, 56. Rough Plumbing & Pressure Test
6. Electrical UF�R Grnd � ^ . 57. APPROVAL TO COVER-GUNITE �' "�
7' Footings �' , - � 58. Electrical Conduit-Undrgrnd. 4i
' 8. Founilation ��; : 'r=" ' � 59. Gas Pipe, � Undrgrnd., Test /�
9., Wate� Pipe-Undrgrnd. �' ', . �� 60. Backwash Lines, P-Trap, O Undrgrnd. �
10��Structural Floor Sysfem �� ' 61. APPROVALTO DECK i
11. Property Sewer Lin�& HouseConnection i� '" 62. Backwash & Receptor-Final
12 �Sewer Cap �ti' : ', 63. Heater & Vent-Final r'; ��
13 �Roof Drains - � � � � } 64. Plumbing System - Final .
]4. Rough Plumbing,• '� � . � � � . . � 65. Electrical-Final
15. Rough Electrical-Conduit . Solar System-Final
18; Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign �68. APPROVED FOfl PLASTERING
18. Rough Electrical-T Bar Ceiling 3,�_� 69. POOL/SPA SYSTEMS FINAL
�19. Rough Heatiny & Air Conditioning FIRE DEPT. REQUIREMENT
20: Rough Factory Fireplace APPROVALS Permit # -
i
21. Ducts, in Structure [•J 70. Underground Hydro
22. Ducts, Ventilating 7�1. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough & Test ` 1 %72. Underground Flush �
24. Roof Framing ' � 73. Undergrnd. Storage Tank � 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. Drywefll Nailing � HEALTH DEPT. REQUIREMENT
,31. Plaster Brown �oat� 79. FINAL INSPECTION
32' Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED
33r.. Final Electric � � �3 N .
34. Final Heating & Air Conditioning �� � %
N_ ., a
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final �
. �-
40. GasService-Final ��`
41. Solar pomestic-Final { �
�
42. Backflow Preventer - . � ��;
43. Backflow Irrigation '
44. .Landscape Irrigation System - �
45. Sound Attenuation � 7�
46. Handicap Regulations "�
47. FIfJAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison � '. �
:�
50. Gas Release tq $outhern California Gas Co � �' y
. r 1 • � �1 w :�
51. CERTIFICATEOFOCCUPANCY =� ;.� �;'• !ti ;�'� / '
No. Date ! h ''! •� � ' ?% ;
` i.,
•::
AGO�icant to fill in all spaees except those within heavy bortler lines antl sign all apOropriate tleclarations.
CITY oF cOS7a MESA CONSTRUCTION PERMIT
Projectnddre;s 555 ANTON� 11TH FL CORRIDOR
Applicant'sMailingAddress �z11—D G.G. BLVD. GARDEN GRC
owner's Name SEC2TRITY PACIFIC NAT' L�y
Addres5 - EOO WILSHIRE BLVD. �.S�S'. tt�J��
Arch/Eng. License No.
Address '
Contractor's NamP KTM6LE & OD Phone g95-1156
Address lmau�nyl 7211—D G.G. BLVD. � GARDIN GROVE� 926
City License No. 03R503
LICENSEO CONTRACTOR DECLARATION
I hereby affirm [hat 1 am licensetl untle� provi5lon5 of Charte� 9(CommenCin9
with section ]o00) of Division 3 of the Business antl Professions Cotle, antl
my license is in tu1 o and eitect.
.:----- ^,--- —`f� �-, . r. ,_�__ .._ 460923
, "'ate I V � ��T Si9nature �-�-- ` � (�.
_v-
'a'JRKERS'COMPENSATION DECLAHATION
'�'�`nereby affirm that I nave a certificate of consent to self�insure or a certiiicate
of Workers' Compensation Insurance, or a ceriitietl copy thereo( (Section
3aoo, �ao.�8�470897—01 FRFMONT INDH3�AITIY
Policy No. Company
�Certifi¢tl copy is,h¢reby furnishetl.
Cer rtietl$ ,ap�+� filed with the <ity�; iltli rvisi
Datc �n � f 'a ^ APplicant �`11U��
E%EMPTION FROM WORKERS' COMPENSATION ECLARATION
(Tnis section need not be completetl it the permit is for one huntlretl ($100) or
less).
1 certify [hat in the p¢rtormance of tbe work for wnich this OermR is izsuetl, I
shall not employ any pe�son in any manner So a5 to becom¢ subjeCt to the
Wo�kers' Compensation Laws ot Calitomia.
oate ` Signature
NOTICE: �F, alter makiny this tleclaration, you shoultl become �subject ro the
Workers' Compensation O�o��sions ot tne Labor Cotle, you must torthwith
comply with Such p�ovisions or thi5 permit Shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV
I hereCy affirm that there.is a'conztruciion Ientlin9 a9ency tor the perPormance
' of the work for �which this permit is issuetl (Section 309� Civ. C.)
lentler's Name
LentleYs AtldreSs
OWNER BUILDEN DECLARATION
II hereby affirm that 1 am exempt from the Contractor's License Lsw for the
following reason (Section ]031.5 Business antl Professional Cotle: Any city or
counry which requires a permit to wns[ruct, alter, improve, tlemolish or repair
anv-=�'^�h'c o�lor to itsi55uanc¢, also reqWres the appllcant tor zuch pe�mit
1 tile a 5igneO staternent that he/she i5 licensetl pu�5uant to the provisions ot
ie Con[ractor's License Law (Chapter 9(commencinq with Secilon ]000) ot
Jivision 3 of the Business antl Professions Cotle) or that ne/she is exempt
tM1erefrom antl the basis for fhe alle9etl exemption. Any violation of Section
7031.5 by any applican[ for a permit subjects the apP��<ant to a civil
�enalty of noi more than five nuntlretl tlollars �5500).
I, a5 owner of th¢ PtoOerty or my employees witn wages a5 fhei� sole
compensation, will tlo cne work, antl the structure Is not intentletl or otteretl
fOr sale (Section 7044, Busine55 antl Prote55ional Cotle: The Contrac[or's
LitenSe Law tloes not apply to an owner of a property wM10 builEs o� imOrovez
thereon, antl who tloes such work himselt/herselt or throu9h nis or her own
employees, prOvitletl that such improvemen[5 are not intenCed or offeretl for
sale. If, howeveq tne builtlinq o� imprOvement iz zoltl within one year ot Com-
pletion, tM1e owner will have the burtlen o( proving he/she tlitl not builtl Or im-
prove for the pur0ose of sale).
❑ 1, az owner of the Oroperty, am extlusively contra<ting with Ilcenzetl wn-
Vactors 16 consVuct [he Oroject (Section 7044, Business ane Profezsionz Cotle:
The Contractor's License Law does not apply to an owner of property who
builtls or imD�ovez Ihereon, antl who contracts fo� such projec[5 with a con-
tractor(s) iicenze Oursuant to the Con[rac[or's �icense Law). I am aware that
proof o( their Worker'S Compensation insurance shOultl b! Provitletl to me.
❑ I am exem0t unde� Section B. & P. C. fo� this �eason
Date
1 hereby certify Ihat
informa[ion is correc[
antl state la relatin
Sentatives i hi
inspe<tion pos .
Signature
Drivers' License or 55
Owner
have reatl this application antl state inat th¢ above
agree to comply with all city antl cOunty OrtlinanCes
o builtling construction, antl hereby autnorize re0�e-
enter upon the above-mentionetl propert tor
Date I� ��
TYPE OF CONSTRUCTION � LI NEW LJ ADD LJ ALTERATION LJ 1�'4MM
❑ CONVERSION ❑ DEMOLISH ❑ OTH R qp,#
DES�j RIPTIONQF WOR O/F� BLDG. ��Y•'— w
�Ifi. 1 l� ��'� l��rsar ' 1rr � S Main Bu
E
TVPEOFPERMIT GRADING FOVNDATIOr�N STRUCTURAL T FfOnt
❑�yTENANT ❑ f�TRICAL ❑ PLUMBINGy �LJ MECHANICAL B qeer
IJOTHER .�1�� SCrI�/1\ • A
PROJECT DESCRIPTION 5Q. FT. oCCUaarvCV �� � Right
CONSTRUCTION TVPE VALUATION $�I16O � g �eft
ZONE GRADING CU. VDS. ACRES p�ng. ReL #
Remarks: /' � � .��/ . ']�_ �,� . � �A �FK Planning No�
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
7rinking Fountains
Floor Drains �
�loor Sinks
�as Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains '
Reinspaction Fee $75
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact BIL ICBO �
Heating System & Ducting
❑ ai aa,000 eru � i oo,000
Reinspection Fee � $15
GMF 0865-46, rev. 10/04 Wnite - Builtling; Canary - Appliwnt; Pink - Accountin9: Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
Laundrv Travs
Issue Fee
Hood or Type I ❑
Canopy Type II ❑
Refrigeration System
❑0-100,0008TU ❑100,OOOBTU
System Repair/Alteration
Fire Dampers
Registers
Issue Fae
FEES
$ 3
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit .
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
OuUets
Switches
Garbage Dispoul
Generator �0-5 KW 05-'.
Zone
Accessory Building:
Parking
ELECTRICAL ,
- Transformer ❑� 15�50 KW
❑SO+KW.
Meter ❑up to 100 amps
Meter' �over 100 amps
Sub Panel
Motors DO1 HP �t Yh: 6
Inc.Solar 09�15 HP �76-75+
Microwave
Pole Light
' Range
Standing Sections
KW Trash COmpactor
I Reinspection Fea �$15 I I luue Fae
DEVELOPMENT SERVICES REDUIREMENTS:
Zoning Approved By
Building Approved By
FEES
$ 3
Z
O
N
I
N
G
R
E
�
M
T
s
SUMMARV OF FEES
BUILDING PERMIT $ �,,,� • �� SMIP $ •��
PLAN CHECK $ PER�
PLUMBING S �SSUANCE $
PWNCHECK 25% 3 ENERGVP.C. $
ELECTRICAI 5 GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL S TOTAL FEE $ DZ' 'S ��
PLAN CHECK 25% $
: 10/27/88 TIME: 1�
CONSTRUCTION AND PLANNING , POOL & SPA
APPROVALS rPermit # Date Inspector AppROVALS Permit # Date Inspector
.. '
1:•,Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion
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. Structurel Floor System 61. APPROVAL TO DECK
"1�1. -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
i6. Rough Elearic Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
:'A' n
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �� ��'��
y
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT V'�
��
20. Rough Factory Fireplace APPROVALS Permit # ��
21. Ducts, in Structure 70. Underground Hydro -
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oi4' -�
f-
23. Gas Pipe-Rough & Test 72. Underground Flush � '
�
24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil .�.. •
� .'.
25. Roof Sheathing � 74. Overhead Hydro �,Qo _.�, .3 Zg �� �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ^) � •�
27. Frame and Flashing .l�i 76. Dry Standpipe �� �,� `
28. Lathing & Siding 77. FIXED SYSTEM FINAL !'� 2� �rc�
29. Insulation 78. FIRE PREV. FINAL �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
i
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 pomestic-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 i
49.: Electrie Release to Edison
''/
50. Gas Release to Southern California Gas Co . ,
51. CERTIFICATE OF OCCUPANCY � � �
No. Date �
.� .
ADo���ant to till in all soaces eacept those within neavy eoraer Itnes ana sign all aDo�opriate aeclarations.
Ci7Y oF COSrA MESA CONSTRUCTION PERMITf`�+� PERMIT NO TRACT NO. LOT NO: UNIT N
Project,4ddress SSS ANTON BLVD. � 11TH FLOOR
ApplicanYsMail' gAddress -�211-D G.G. BLVD., GARDIIV GP
Owner's Name-�Mfi�j[J�LL:3� M6MT�P. phone
Address -S-'S-S �f11
Arch/Eng. Licenu No.
Address
Contractor's Name K�� &���Y Phone 6
Address Imai�inql 7211—D GARDEN GROVE BLVD. , GG. 92641
City License No. ��a' 3$ SO3
LICENSED CONTRACTOR �ECLARATION '
1 hereby af/irm that I am licensetl untler provislons of Charter 9(commencing
with section 7000) of Dlvision 3 of the Business antl Professlons Cotle, antl
my license is in tull torc ana effect. �
�icens c� C-1� � e:a No. 460923
♦te e�m.x��+`-
JRKERS'COMPENSATION DECLARATION
� hereby aftirm tnat I have a certifitate oi tonsent to SelLinsure or a certificate
ot workers' compensation Insurance, or a certifletl <ooY thereot (Section
3800, Lab. C. \
voucv No. i�P884-79897=D �v EMNTIY
�Certifietl copy is hereby fumlihetl. .
Cer itietl c y' tiletl with the Uty� uiltli DI en
Dat � - JReeni�SL -
E%EMGTION FROM WORKERS' COMPENSATI N DECLARATION
(ThiS section neetl no[ be completetl If Ihe D¢rmll IS for One huntlretl ($300) or
lesz).
I certify that in the performance of the wo�k tor whi�h th15 pe�m�t is issuetl, I
shall nOt employ any pe�son in any nnGr O t0 ecOm¢ SUDject to the
WOrket{jCoy�yPt�j�n 519 attur¢II- Ia. �e y s�
Date �� (L!'� /��--
NOTICE: If, aiter makin9 this aeclaration, you shoultl become subject to the
Workers' Compensation provlsions of lhe Labor Cotle, you mu5t (orthwith
comply with such provisions or this permit zhall be tleemetl revokea.
CONSTRUCTION LENDING AGENCV
1 M1ereby affirm that there is a construction lentlin9 agency tor tbe performance
of the work for which this permit is issuetl (Sectlon 309] Civ. C.)
LPntler's Name
Lentler's Atldress
OWNER BUILDER �ECLARATION
1 nereby affirm ihat I am exempt from the Cantractor's License Law for the
tollowin9 reason (Section 7031.5 Buslness antl Protessional Cotle: Any ciry or
counry which requires a permit lo cOnst�uct, alter, ImprOve, tlemolish or repair
any structure, orior to its issuance, also requires the applicant for such permit
� file a slgnetl s[atement that he/Sh¢ IS licPnsetl pursuant to the provisions of
ie Contractor's License Law (Chapter 9(commencing witM1 Section 7000) of
Jivlsion 3 0! the Business antl Profess�ons Cotle) or that ho/she is exempt
therefrom antl the basis for Ihe allegetl exemption. Any vlolation of Section
7031.5 by any applicant for a permi[ Subjects lhe applicant to a civil
'� enalty of not more than five huntlretl tlollars ($500).
I, as owner ot the p�operty or my employees wi[M1 wages as their Sole
compensa[ion, will tlo the work, antl the structure is not intentletl or offeretl
for.sale (Section �044, Busine5s an� Professional Cotle: The Contracior's
License Law tloes not apply lo an owne� o( a Oropa�ty who builtls o� imp�oves
t�ereon, antl who tloes such work hlmself/her5elf or (hrough his o� �er own
¢mployeei, provitletl [�at such Improvem¢n[s a�e not Intentled or offeretl fo�
sale. 1f, however, the builtling or ImOrovement IS Soltl within One yea� of com-
pletion, the Owner will have the burtlen of proving h¢/she tlIG not builtl or im-
prova fOr the purpose oi sale).
❑'1, as owner of the Oroperty, am exclusively contracting wi[h Iicensetl con-
tractors to construct the project ISection 7044, Business antl Professions Cotle:
Tha ConVactofs License Law does nOt appry to an owne� of pmperty who
' builtls or imD�o�es thereon, antl wlto conVactS tor Such prOjects with a con-
' tracmr(z) iicense pursuant to the Contractor's License l.aw�. I am aware that
I prooi o( Iheir Warker's Compensation insurance shoultl be provitletl to me.
I❑ I am exempt untler Section B. & P. C. for this reason
Oate Owner
I hereby certity ihat I have reatl this application antl slale that the above
informa[ion is mrrecL I agree l4, comply wlth all city dntl countY Ortlinancei
antl state laws relating to bwitlin9 construGtion, dntl hercby authonze �e0/e-
sentatives�o tnis city o e ter upon the above-mentlonatl property tor
Insoect�on u oses. �f c
Signa[ure Da[e �%' [ "O
Driver5' License or 55 �
35�os'� o/ .�- "'
7fYPE OF CONSTRUCTION ' NEW P.DD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ A.p.*,
DESCRIPTION OF WORK/USE OF BLDG.
FIRE SPRINIQ.ER, INSTALSII'1'ION S Main Buildi
7VPE OF PERMIT GRHDING FourvoArlorv ❑ STRVcrURAL T Front
❑^ �T ANT ❑ ELECTRICA' ❑ PLUMBING ❑ MECHANICAL B Rear
LTOTHER F: 1'�C. � Ar� w�.' . .. _ A
PRQIECT DESCRIPTION Sa. Fr. oCCUPANCov w� C Right
CONSTRUCTIONTVPE VALUATION$ ]� g Left
ZONE GRADING CU.YDS. ACRES Ping. Ref, #
Remarks: }n� �y� ��.�� _ ,� /0�7�Qyj PlanningNotes:
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Dreins
Floor Sinks
GasService Outlets
Interceptor5
Kitchen Sink
Lavatories
P-Trap
Roof Drains '
Reinspectian Fee � $15
Dutt - Under Ground
Duct - Sttuctural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑6700,000 BTU 0100,000BT
Reinspec[ion Fee � $15
CMF OB65-46, rev. 30/86 Whit¢ - BUIltling; Canary - AOP��cant Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink
SewerCap
Sewer Connection
Solar Collecrors
Solar Pipin9 �
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
Laundrv Treys
Issue Fee
Hood or Type I ❑
Canopy Typell ❑
Refrigeration System
❑aioo,oaosru ❑ioo,000eTu
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES
$ 3
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Oryers �Gas ❑Elec�
Fan
F.A.U.
Fixtures
Device Boxes •
Outlets
Switches
Garbage Disposal
Generator �0�5 KW C
Fee
Zone
Accessory Building:
Req./Pravided
ELEC7RICAL
Trensformer � 75-50 KW
❑ 50+KW
Meter LJup to 100 amps '
Meter ❑over 100 amps
Suh Panel
Motors �0.7 HP � 1 h- 8
Inc.Solar �9-15 HP �16-75+
Microwave
Pole Light '
Range
Standing Sections
5 KW Trash Compactor
$15 Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
ZoninB APProved By
Building Approved 9y
FEES
.$ 3
2
O
N
I
N
G
R
E
Q
M
T
S
SUMMARV OF FEES �
BUILDINGPERMIT $ 2.f�'� SMIP $ •�_�
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $ .
PLAN CHECK 25% $
ELECTRICAL § GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ � `�
PLAN CHECK 25% $
2 00017980-Q00179E1 TUT ?5.50
OTF: 1!1l�7iafl rtNc• m.z7
CONSTRUCTION AND PLANNING � POOL & SPA
APPROVAIS Permit# Date Inspector qppROVALS Permit# Date Inspector
('
1.�Temporary Electrical Service or Pole 52. Pool & Equipment Location �
�i
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. APPROVALTO COVER-GUNITE
7. Footings � 5S. Electrical Conduit-Undrgrnd.
8. Foundation ' � 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
r.
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 "
iS. 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 ❑ Oil'
23. Gas Pipe-Rough & Test !� 72. Underground Flush s
24. Roof Framing 73. Undergrnd. Storege Tank � Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro '"L 1 �� �' J
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � �
27. Frame and Flashing F�. 76. Dry Standpipe �- �
28. Lathing & Siding 77. FIXED SYSTEM FINAL �'-- �
29. Insulation - 78. FIRE PREV. FINAL �J �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �
.. '
31. Plaster Brown Coat 79. FINAL INSPECTION �� '`'� /
32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED ., �
33. Final Electric Notes: ' �
34. Final Heating & Air Conditioning ' � �
i�
35. Final Gas Pipe-Test -��
36. Hood or Canopy ,
37. Final Factory Fireplace ,
38. Final Plumbing • - - .
39. Water Service-Final �, . �
40. Gas Service-Final � � � �
41. Solar pomesticFinal . � � �.�
42. Backflow Preventer • � � - , �
�.
' �43. Backflow Irrigation � � „ � � �
i.
' 44. Landscape Irrigation System - _ - � _
45. Sound Attenuation � "
46. Handicap Regulations � �
47. FINALSTRUCTURE&BUILDING '
48. Special Requirements Completed - , _ ' , '
49.. Electric Release to Edison ' . � .�
50. Gas Release to Southern California Gas Co : ._ ,�
51. CERTIFICATE OF OCCUPANCY � ,
No. Date ' �� � �'
06589 Aop���ant to fill in all sDaces excev� those witnin heavy Gortler lines antl sign all aDVropriate Eeelarations.
CITY�OF-COSTAMESA CONSTRUCTIONPERMIT PE�iIT O. TRACTNO. LOTNO. UNl�fjl0. AP# � . � Zone
Pro'ect wress'S55 ANTON� 11TH FLOOR !— �� bZ- Z�f
1 j+ � "�� S Main Building: Accessory Building:
Applicant'S Mailing Address � 54 � SU7+I LANE TYPE OF CONSTRUCTION NEW 'yuu ALTERATION EPAIR E . Z
❑ CONVERSION ❑ DEMOLISH � oTHER T Front p
Owner's Name SECURITY PAC. NAT � L �e _ DESCRIPTION OF WOR USE OF BL G. B Rear N
nddress 600 WILSHIRE BLVD. #500 (^ n � �� v� p' �
. Arch/Eng. License No. TVPE OF PERM�T GRA iNG FOUNDanorv ST UC7URAL K Right G
Addf255 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � g� �-eft �
R
Contractor's Name KTMRT.F. & Q7MP n1V phone $95-1156 ��OTHeR Ping. fief. # Parking Req./Provided E
PROJECT DESCRIPTION 54. FT. oCCUPANCv � n
Address Imailingl 7540 ST77.T T.ANH'.� WF:R'IMTNSTER 92683 -y-• 1 � 11 �. � � Planning Notes: ry�
CiLyLiCenSeNo. n�iRSn3 CONSTRUCTIONTVPE y VALUATION$ i .
T
ZONE GRA�INGCU.VDS. ACRES S.
LICENSED CONTRACTOR OECLARATION -
1 here0y affirm that 1 am licensetl untler provisions of Charter 9(commenGng Remarks: �_ �
with section 7000� of Division 3 ot the Business antl Professioni Cotle, antl '
my license is in Iu11 forc lr ELECTRICAL FEES
��'0q'2�� �'� c-16 c�(�.R�� . Z�c l�i --
Licens Class cens o.
''e�E�'C� 5iqnature � PLUM8ING FEES Automatic Washer Transformer ❑ 75-50 KW
2KER5' COMPENSATION DECLARATION ConStrUCtion PoleSub. � 50+ KW �
_re�y a(firm that I have a celtificate of consenl to self-Insufe or a Cefti(iGdt2 Ba� $iOk $hOW¢f5 �
of Workers' Compensation Insurance, or a-certlfietl copy thereof (Section BackflowPreventer ServiceSink � CookingUnit Meter ❑upto100amps
3800, La�. C.) Dishwasher Meter ❑over t00amps '
voiicy rvo. WPRR470897-��pany FRF.MnNT TN1IF.MN TY Backflowirrigation SewerCap ,
eCer[ifietl wpy is hereby furnl5hetl. - � DryCfS ❑Gas ❑EI¢Ct�ic Sub P80¢I
CerY 'etl59p y' tl with tne city e i m vi�)�� �� % �� Bathtubs Sewer Connection
Date �"�/-�� ApPlicant �/3ti+"_'��^tiv � Fan Motors�0.1HP�1'h-8
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers SOId/ COIICctOfS
�Tnis section neetl not be completetl ii the permit is for one huntlretl ($300) or Dishwdsher F.A.U. Inc. So ❑9-75 HP �i6-15+
less). � Solar Piping
I cer[i}y that in tM1e perto�mance ot the work for which thl5 pe�m�t is issuetl I FixtUfES
shall not employ any person in any mann so as to betome subject to t�e Drinking Fountains Solar Tank � rowave
Wo�kera� C an�,{ Laws of CdlifOr i �
DeviceBoxes PoleLi ht
Date d� ��6 � Si9nature �� Floor Drains Swi ing Pool w/Spa 9
NOTICE: If, a(te� making this tleGlaration, y0u ShOWtl become Subject to the � Out12t5 R2ngC �
Wo�ke�s' ComO¢nsalion provi5iOn5 of Ihe Labo� Cotle, you must (orthwlth FIOOf $iflk5 U�iOdl
complY wi[h Such p�ovi5iOn5 or tnis pe�mit shall Ge tleemetl �evoketl.
CONSTRVCTION LENDING AGENCV ' Ga55¢rvicE OUtI¢ti WaterCloSet SWitChes Sign
� I hereby a(firm that there is a tonstructlon lentling agency for the performance Garba e Dis osal Standin
of tbe work for which this permit. is. issuetl �(Section 309] Civ. C.) Intercepto�s Water Heater 9 P g Sections
Lentler'S Name
�entler's Aearess � - Kitchen Sink Water Service Generator �0.5 KW OS-15 KW Trash Compactor �
OWNER BUILDER OECIARATION � ' -
1 hereby affirm lhat I am exempt from the ConVactor's License Law for the ' LavatOries � Auto-WaSh '� �
followin9 reasOn (Section ]031.5 Bu5Ine55 antl P�otessional Cotle: Any City o� '
county which requi�es a pe�mil to construct, alte�, improve, tlemolish or repai� P—Tf2p Laundry T�ayS '
�^v s[ructure, prior to i[s issuance, also requires the applican[ tor such permlt ,
'ile a signetl statement that h¢/She is IicenS¢tl pu�suant to the provi5ion5 ot Roof Drains - �
� Contractor's License Law (Chapter 9(commencing with Sectlon 7000) of -
.Ision 3. ot the Buziness antl Professions Cotle) or that he/she is exempt Reinspection Fee $15 luue Fee $ 3
the�ef�om'antl the basis for thE allegetl ¢xemption. Any viOldtion o( SCctlon . '
7031.5 by any applicant for a permit subjects the applicanti to a civil . -
enalty oi not more than tive huntlretl aollars ($500). - - � - $ 3 DEVELOPMENT SERVICES RE�UIREMENTS:
� I, as owner of the property or my employees with wages as their sole ReinspeCtion F¢e .$15 � ISSue Fee
compensation, will tlo the work, antl the sVucture is not in[entletl or�ot�eretl , Zaning Approved By �ate
for sale (Seclion 7044, Business antl Professional Cotle: The Contractor's � MECHANICAL PEES Buildin9 Approved By
License Law tloes not apply to an owner of a property who builtls or improves , Date �{ y
thereon, antl wllo tloe5 such w0/k hiin5elf/helself or through his o� her Own � Applicdtion ISSUed By ndte � LP! O
emplOyees, provitletl that such Improvements a/e nOt Intentletl or offeretl tor BOi12I HOOd O� Typ¢ I ❑
sale. If,�however, tne builtling or improvement is 5oltl within one year of com- Canop Type II ❑ � SUMMARV OF FEES
pleUon, the owner will nave tne burtlen of provin9 he/sne tlitl not bwltl or im- Duct - Under Ground � �
prove �or the purpose oi saie). BUILDING PERMIT SMIP $
❑ I, as'owner of the property, am exclusivety tontracting with Iicensetl con- Duct- Structural efrigeration System pLAN CHECK �� PERMIT
tractors to construct the project (Section 7044, Business antl Professions Cotle:
The Contractor's License Law does not applY to an owner ot property who Ouct- Ventilating ❑0-700,000 BTU ❑100,000 BTU PLUMBING $ �SSUANCE $'
builtls or improves [hereon. antl'who conVactS fo� sucn oroiects wrth a mn- '
tractor�sl license pursuanx to cne Contrattors License Law). I am aware tha� Exhaust System ❑ Multiple ❑ System Repair/Alteration '' PLAN CHECK 25% $ ENERGV P.C. $
proof of tbeir WorkeYs Compensation Insurance shoultl be provitletl to me. - GRADING $ '
� ❑ I am exempt untler Section e. & P. C. for this reason Firepl/Fact. Blt. ICBO �k � Fire Dempers �• ELECTRICAL $�
• � PLAN CHECK 50% $ � MICROFILM $. �,�
Date owner Heating System & Ducting Registers . _ MECHANICAL $ - $��Q ^
f-hereby certlfy that I have reatl this appliwtion antl state that the above' ❑0-100,OOOBTU �100,OOOBT TOTALFEE
information is <ortect. I agree to comply with all city antl county ortlinances ' � PLAN CHECK 25% $
antl state laws relating to builtling construction, antl�hereby authorize repre- .
senidtives ot this ity to e er upOn the above-menlionetl prope�rt/y fo� , ,
Inspection purp . �� Date �/ ��
s�ynature . ,� ReinspectionFea -$75� IssueFee $ 3 Ol 00027244-0002724$ Ti_�T 3�`�,$�
Drivers' License or SS � � —
QATE: �2/98tgq TTMFa f9e97
0865-46, rev. 5/88 White - BWltling; Canary - Appllcant; Plnk - Accouniing; �oioenroa - tassesso�
. . , . y.. . . . . . .. -� v._ . �- . _. . ... . . �
.\ =t ` .
. CONSTRUCTION AND PLANNINC F '. & SPA
!� Date Inspector Date Inspector
:i APPROVAIS Permit# APPROVALS Permit#
��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 Undrgmd. ��
10. Structural Floor System . -� ' ' 61. APPROVAL TO DECK � F
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
`b6' 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 Conditionirig FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ,� APPROVALS Permit #
21. Ducts, in�Structure 70. Underground Hydro
ri
22. Ducts, Verrtilating l��i -� �. 7�7: Product Piping O Gas ❑ Oil
23. Gas Pipe:IRough & Test �/ ' �72. Underground Flush f
24. Roof F.raming ,; � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing j�� � 74, Overhead H'ydro f!� ��, � ,3/� (�j `(�,
26. T-Bar Ceiling �Structural) & Monocoat � 75. Dry Chemical
27. Frame and Flashing 1; 76. Dry Standpipe
28. Lathing & Siding 'r,- . 77. FIXED SYSTEM FINAL 2q ��
29. Insulation• � 78. FIRE PREV. FINAL �
30. Drywall�Nailing �� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
r•
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 F(replace
38. Final Plumbing
39. Water Service-Final � �
40. Gas Service-Final r ,
41. Solar pomestic-Final �� .�
42. Backflow Preventer � �,��,�'
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 �� ,
.
51. CERTIFICATE OF OCCUPANCY '
� J�
No. Date �
�
�ooneuaam�owc: 555 ADJTON BL
'avriExsru�Eiva+mvr+: SAKIOKA FARMS
• �ooxEss: PO BOX 2097
� � TERMINAL A�1NEX
y
(
�
y
y
�w�. uuuNo �oon[ss:
uur:
11TH CITY OF COSTA MESA — BUILDING PERMZT
PERMIT NO: B 074630 PLAN CHECK NO: 03']23-95 A
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR
urcx�rEcrox�ar+vn: INTERIOR ARCH 2136232164 uc.ra: 9378
urcx.onexo.•s�ooxess: 555 S HOPE ST uNr: 1100
L.A. CA 90017
coxmecrarsxu� CAL—PAC CONSTRUCTION ( 310 ) 645-3500
carm�croxs�uiu'c 6076 BRISTOL PARKWAY
�ooness: CULVER CITY CA ue.ea.: 392102
90230 uxr: 106
LICENSED COHfFACTOq3 DECLAHA710N: I Mreby eliim uMer peneYy ol perjury iMt I em Icer�eed uMx prwnion� G Clup« 9
(mmmeminp hil� Secibn 1000) d Oiviaon 3 W I�e BuaiMu enE Frolmeiau Code, uq my liceva b in lull lau enE elle .
cm uc. No.: uc. cuss: B uc. N 'i 4 21 �.� � XF :
o�, � /�� ����
OWNEN BUILDER DECUNATION: I heaby dfirm uMer peeWy d rjury Ihet 1 em awamp Iran tM Conlrapwa liewe law Iw Ihe
�Idbwiq rsemn 1�� J�1.5 Buaineaa enE Rdevabna COEe: My tiy a counlY �✓� �Ouirts e partnG to cantrucY. ellel. imyovs.
femd"eh. a repei vry al1uctun, par b Ra isuerca. eho �puim IM epplium la wc� pa�mu �o fib � dpMd �itlomml qtl M a�he
u liwnaed Wmienl m 1he pwi�ims d Ihe Canlrapon licenae lew IClupr 9loommentiq wah Sanion ]000) d Drv'sion 9 d �he
Busiiwa eM Prdaubm Godel a �M Ir a Na n uemq tharahan and iM beaw la Ne eMOaE awemqion. My viduion d bseion
)m1.5 by eiry epplimm i« e parmp wbjeaa iM eppliw to e dvtl peroAy d nd mm ihen I'xe huM�sU Edlen �5500p.
� I, m ownar d Ihe propeny or my ampb�eae wIh wepm m iMi ede mmpemetion, xill do Ihs xork, eM tlw etriMure u �at iMeMeA
a dtmetl br veb (Section'lOu. B�arwe end PMnaons Gods: Ths ConVedae 4oerus lew daae nd epyym en owMr d popa�y
wb Euide or inpmres �Mnm. vM wM10 Eom �utli wak Nmsell a MnN a Mraph he a Mr oxn amplv�ea�. qwkaE IM wch
impovamatls me nd imendW a dlmeE la ub. p. howenr. iM Euitluq a inpownw u wk xil�in on Yw d canOMbn. iM
ow�w-0�Jdx wi9 hm �M buNm d pw'vq M u tlr d'd nq ddid > impm� In iM puryas d uM�.
� I. u ormar M iM poWM. em e�dusn+N wnireanY wiN liwnrod canvsbn ro ommue tln qqsp (9adion 10u. Bw'uw� uM
Prdmiam COEe: TM Cantratlm Liwnw lew doss np �pply to en owner d popany r.fa puitL a 4npovx IMmn vd xfio
cnnVacie far wM prqem wnh e mmretlar�sl IicenseE W nueM to IM Contrapm� Liwnaa lew).
❑ I em aaemq uMer Seclion: B. 8 P.C., b Nu ieeaon:
Dme: Oxnw
i m n.,wr �.nay mu i� aw.�. w�e ��w�.wd m. �w��«m a c.uomr w�u.�a sdwr coa. s.atoo. zssos, nsa�..m
2553s, aM UW I a vry Mun buiki�p oavpem r.ill / wil mt (orcb oro) nssd ro oomply wih eeiE aeta mAn W �M rpulrom�w lur
e WrtnillormruVuctionamodifiutionhan�MAi�e�memeMOipntl. RuidsmW emnrupionmolmlbmanusmdlnmiMw
Dtla: Appfram:
YpflKEfl'S COYVENS�TION OECUNATION: I MroEy elfirm wEv psnelly d pwjivy w W IM blbrNq dMumioro:
❑ I hevs aM xil memleh e urlifctls d oaaani io uMimun for xaksn' oompenWbn. n providaA Ip py 9etlim J]00 tl �he LnEor
Cods, la �M parlarmarics d tM wdk la w1Ych ihu pemin h ksuad.
p in.V..�e���i.�.ak.r�c.�w��..�...,�.a��.awsww�aroowm.i.nacee..ro.m.v.w.m.z.am.
•• �.�xta�n�,w.'.�aqm�.e.My�w.�.'F�REMAN�S�E'UN°Loi'll�m�"� EXPIRES
c�«:
� va�rmmn. nwr nv�yoo�i 02/O1/96
�: ,.n;� �..e,�w n. c�W.ne r w n�r;. ro. �. wmroe eaw. Rrool «,w..�
H� I oenh � in tM pMmnviea d tM �k br v.fic� Ihu paemn b Wusd. I Mell ml wnpI�� em/ perNxi in°°°���%%% m w n lo
b�ecaPw��j� to IqMm xMse' campnWion Iews tl CaGbmyl W rea Nm tl IM �'(l.8m M W WkM��
Oeia: /CY /��/ ' �,� d iM �Cotla�YWY I�ndAT o�i p xi (Ih • pr lo `��
r 1� �
ranT`�I
WamMp: �F llun b aseuf� wo�kx�'romv�nutlon rov�np� l� u I�wN( �nGaNll utlfcf �n wyleyx ro crlMivlOwltly m0
c�H� nnu w ro wn nina�.d tnouuro ecuWn lt�o4oaoA M.m�non ro rh. eo.r o� rnmv.�wthn e.mpu •• obvw.a ror �n
9�ctlon i108 0/ Ih� La6oi Cob. Infwt anA�ttomry'� M,.
CONSTiIUCTION LENDINO AOENCY: I haraby elf uMx panNy d par'�uy Ow tAan b e oonq�uttbn 4M'up pw.y br iM
peefamenoe d tM wk lar whkh the parmi b ewtl (Sed"on 3081. CM. C).
LENDEP'S NMIE:
�v�oen•s �ooness:
I cenily �lut 1 hew reW Ihia epqicNion ud ame Ow Ne ebovs'udormetM u mnsp. I pias to oompty with NI �Yy enE cauMy adNuiou
eM steta levn MtlM lo buikM mvVWian W harabY auUw¢a,V��atnm d �Itiw aY b emu u0� tM ebora�meNian�d P�WM
ta impeai
�,Q✓/1i S��
� De1a: � �
SqneWn d Qner//�panVAppiranVCani'een
, (S151ie.WV) Whna-Buikip85e1Ny:OrsamFb:CenW-�ppiunl:Pink�lavanue:Clddenod-A�wsor
PERM NO: B 074630
GOC'T: N SUPP: t�l
FURPOSE: ALT
JOB DESCRIPTION' ; INTERIOR 20000SF OFFICE TI SQ E'T: 20,000
CLAIM VALUE: 360,000,00 CALC—VALUE: 386,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
r��*****�*****x-**rtx-�*�-*+�**rt**�**�t**+�x��r******x�**********���*�***te**�***�-+�****�*��
Z O N I N G R E Q U I ft E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 91050109 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR 11TH FLOOR FOR 76 PRODUCTS COMPANY
� " i
if iE if iE iE ik iF iE if if �E iE iE iE �! iE`iF�1E if"iFlf� iE iE iE iE iFi `'jE if !E if if iE iE iE iE ik iE fE ik iE 1E iE if if iE �)F iE iE if if if �E iElF iE if !E iE iE 1E iE 9E iE iE iF?E iE iE iC-iE if iE iE if ?� 3E i� IE
D E V E L;O P M E N.T S E R V I C E S R E Q U I R E M E N T S
�- - •. -�. �[��1.�
ZONING APPROVED BY " I� C..� DATE: lo FS
�
HUILDING APPROVED BY�: i DATE:
�.
APPLICATZON ISSUED •BY: �%� ��FA�F3F�£���'£iF DATE: 1�����
�****�r*x�x-�**rtx-*iE*x�-k-*�r* x *�**�**�**� ,� **
LEGALIZATION:N F E E S U M M A R Y STRUCTORAL SEGMEDIT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,644.00
SMIP/NON—RES
PLAN 267.15 81.14
ISSUE FEE
HUILDING—DIV—> FERMIT ISSUE PLAN—CHECK TOTAL FAID DUE
TOTAL5----> 1725.14 0.00 2b7.15 1992,29 1992.29 .00
REC'ENUE DIVISION TOTALS--> COLLECTED: 1725.14 OVER/SHORT: ..00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1644.00 81.14
/
3f iF iE iF aE 1E?E �f iF iE iElE iE iE 1E 1E iE 1E IE iE �E �E �E iE fE iF �E iE aE iE fE k iE if iF iE �E 1E jE * i(� if 3E 3E 1k 4 if iE �E iE 1f �)E iE fE 3E � fE iE iEjE iE �E 9ElE iE 3E iE � �E iE jE-)F iE 9F 1E iE jE iE fE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF—INT. ALTER TYPE I,II F.R. —AVER 18.24 364,8U0.00
SFC 20000 EQU—ALT COMM. SPRINKLER SYS —Al'ER .36 7,200.00
SFC 20000 EQU—ALT COMM. AIR COND —Al'ER .72 14,400.00
END OF FEES
]1 QC1"'_319—".�7?33'_`0 �"cy T ."<5.:-
4AiE: iD/.,;�9° TIrE: :,r2c
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CONSTRUCTION AND PLANNING , � POI._�b SPA ,r
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
� r
1. Temporary Elactrical Service or Pole 52. Pool & Equipment Location � '
2. Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement " '�
�� I
3. Electrical Conduit Utility-Undrgr.nd. 54. Forms �• �
4. Electrica� Conduit-Undrgmd. 55. Electrical Bonding � �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �'�
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE �� I
7. Footinqs 58. Electrical Conduit�Undrgrnd. �,
8. Poundation 59. Gas Pipe, � Undrgmd., Tesh
9. Water Pipe�Undrgmd. . � 60. Backwash Lines, P�Trap, O Undrqrnd. �
10. Structurai Floor Svstem ✓, �' 61. APP,ROVAL TO DECK ;
71. Property Sewe� Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final
13. floof Orains � 6A. Plumbing System � Final-��
14. Rough Piumbing � , 65. Electrical-Final _
15. Rough Electrica6Conduit , � 66. Solar SYstem�Final • '
16. Rough E�eciric Wiring ' � 67. Fencing & Access Apprnval -
17. Fough Wiring Sign 6$. APPROVED FOR PLASTERING .
78. 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, Ventilatfng 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Freming 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ce(ling �Structuraq & Monocoat �j�d /Jy 75. Dry Chemical
%`��
27. Frame and Flashing �,d��' � 76. Dry Standpipe
28. Lathing & Sid�ng 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing /fe % HEALTH DEGT. RE�UIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Powe. Meter-Final 80. FOOD CERTIfICATE ISSUED
33. Final Eleciric Notes:
34. Final Heating & Air Conditioning
35. Finai Gas Pipe-Test
36. Hood or CanoPY
37. Final FaMory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service�Pinal
41. Solar pomestic-Final
42. Backflow Preventer
43. Backtlow Irriqation
44: Landscape Irrigation System
45. Sound AttenUation
46. Handicap Regulations
47. F1NAL STRUCTURE & BUILDING IJ/r�/pd
��
48. FINAIPLANNING
49. Electric Release to Edison
50. Gat Release to Southern California Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
��
noonEssocew�aric: S55 ANTON BL uNr: 11TH CITY OF COSTA MESA — BUILDING PERMIT
a'^+Easn"�E�F�+w`": SAKIOKA FARMS PERM NO: B 0761II3
• �pE�: PO BOX 2097
TERMINAL ANNEX PERMIT NO: B 076183 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.IWtIIlG �DOPESS:
�ncxrreaoeaau�nn: INTERIOR DESIGN 21362321810N0i 9378
�pCX.OF FNQ'S ADOflE55: S S O S HOP E S T �NT� 110 0
L.A. CA 90071
CONIPACTqfSNAYE:
cam�cToxs �uia�c
�oox�sx uc. xo.:
UNT:
LICRISEU COMHACTOHS OECLAflRTiON: I MmEy ellim uMr perory tl paijury thm 1 em licenaed wder pwisims d Claqx 9
(mmmend�q wn� Sec�wn ]000) M Oiviaun � M iha Buainam end Pmfeasima CoEe. eM my licenae is in lull brte enE eMen.
cm uc. Ho.: uc. cuss: uc. No.: EXP :
Dale: Caroaaa:
OWNER BUILUEN OECLAHATION: I haraby effirm uMer panaly d perjury thm I em ezemq Irom IM Conlrapwe Licenee Lew fa iM
�Idbxiq rensa� (Seaion 1W 1.5 &niiesa uM Rdassiona Cade: R�ry cry a counry whidi royuim e pe'mn to oorevuci. aXa. imprwe.
femdaM1, ar rapeir eny e�ruciure, pmr ro ila ewar�m, abo reQ�ires iM epplifani tm euch permil lo file e epmd eWemenl ihet ha a oM
n licensed punuent �o iM prvritima d Ihe Caniredon Limnx lew ICheqr e(commmoip xilh Seqion )00p) d Orvebn 3 d Ihe
Buaireav erd Rdessiona GOCe� a IIW he v ehe is uamq ihaelran eM �he bexe lor the ellaped mempion. My volmion G Seqion
J031.5 W eny applirent br e parmn wbpcte IM epplicanl �o e civil qnelry o/ rw� mare ihen fve hurdred ddkn �55W�).
❑ I.movmardthapoP�Y«myemNW�wl�wepe?ea�heiademmGaree�ion.xiOdo�M1exwk.vMlMNiucNnbiwliMaMeE
w Mered lor sab �SeGan>Oaa, Buvma+eM Praleonwna Cada: Tha Conlreclon licenaa lewdoea m� epply toen oxner W propeity
who buih a inpearea theieon. eM Ma Eoae euM xvk IJmaetl a heise� « Wouph he a har ovm empbyee�. pwitleE Ihet eue�
impwamema are rot imsMed a ofiaeC la aeb. II, however, iM Widinp or'vnpwemeM ia eok wilhin oro yeer M completon, Ihe
�oxTer�Wider vnll heve ihe buNen d pavinq M or eha d'd rw� buiN w impove la IM WN�e d eele).
i. � e.,,a, a ma rwaro. ��awrvdr ���vro �n i��a �ireno�. w�m„d m. wa.a tseao� �oa. a�.�,e.�a
PMassiane COEe: Tha CaniraGae t'emm law doee rol appy b en owiwr d qapany xfio Witle w impewm thaeem uM xfio
mnVads 1« ad� pqeee xeh e mmrotlor(�) IieraeE punuaru to the C«ueeqoea Li�ensa lew).
❑ i��.e� i��ae,s«r� e.avc..m,aC o: �. U�
Dme: � Z � � Owner: �
i ro n,�,nv �r �n.� i� a.�a a�e �rsw,a ma ���n a c��o�,:. H„im .�d sm coee sae� uws. zss�. �a
25534, eM ihel I a eny Mure buiNi�q a¢vpent will / w�l na (arcb me� neatl Io campy wM� aeiE elme oodee eM iM raquiromenie tor
aPomMlumm��upionamoERm�ianhamlMAi�1 e^e9e^�tDalna.ReadxuielemaeWmeGDkdiamenvemqlromNae
Mv+iaiona.
Dme: Applkam:
W OHKEH'S COYPEN9ATION DECLAX�TON: 1 hereby etfiim wdn penelly ot pe�jury me d the blbwirp datlermuru:
� I heve end wil meiman a mNlictle W mnaent io aaX�inaun tor xaken' compammion, u prwiEed /a by Samon 3)00 d �hs Lebor
Code, la �M pMmrenu d iM xwk lor wNch ihia parmn ie uaued.
❑ in��a�;��m�w�a.•�oe�.m����...�a���ews«,�,aiaodm.�coa..wm.c.n«m.�a�n�
wwk /a whiM ihia pe�mil ia iasueE. My worke�e' mmpenae�bn inaurence umar eM pdiry numDer ve:
c�«
� PdicyNumber:
(TN4 SBCYttn nMC /pf 6s mn�Cb�� / lheGM�1 u hM M! AuM�tld dPYas �%I W� p b.n.f
❑ I eenaf' � in ihe pMmnenea d iM woA br whoh Ihb peemu u muad. I WII no� empq erry panm in enY menner eo u a
beeome wM� to �M xakxe' mnperumbn lewe d Calilwnu. aM Nme Net ! I ala�tlA Eemnw aMa io �M MveYe�s'
compameton pomone d SeGion 3100 d �ha Lehar LoOs. I ahell fathxith mmp�y xi�h thow proviaione.
Deb: Mq�ceM:
Wem4p: Faqw ro Ncurs wohwi ronp�rostlon rovwp� l� wbwNl, anG�M/I sW/�ct �n �mplayx ro crlMrW p�n�l0u �M
HHI fiiws up N aro huMrM fhouunE tlu/len (SfOq000A Mi etl0ltlon ro tln cwl o/ ronpmutbM1 Jsnups' � proNtlM br In
S�ctlon J1P6 0l tl�e LeEor Cods, lnM1nat, �ntl afromsy i Iws.
CONSTIIUCiION LENDINO AGENCY: I Mreby etfifm u�kar pandry d parN'Y �� �Mn e e mrutwun Ixdiip epmcy la Ne
performerce d iha xak b whiM the pannl o ewed (Sedan �09). CM. C).
LENOEN'S NMIE:
LENDEP'S AOOFESS:
I cenily thet I heve neA ihc epdKe�� eM tlme thm Na ebova iMormmbn u mrtad. I epiee lo camply wilh ell tily eM cauMy adinences
ud swa kws Maz�q to buJdvq ammurmn end hmeM' einM¢e �epaaen�mivea d ihc u�Y �o xua uD� tAe eEova�mentivrd propany
fw impaebn purposea.
ERNIE VITUCCI
�
L�eNES � J• 1/i � Gc / ome:/��
SigneNm d UvneNRBen ApplcenVConVepp
` (StStJe.WP) WAna-Buikip65e1&y;GneerWe:Ce�y-Rppirani:Rnk-Rewnue:OoNenroQAieearor
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC-VALUE: 339,625.00 GROUP OCC: B /
���*���*�*******�**�*�D***��*�*�***�***��**�**�*�*%*****B�*�*�**��r�**�*��r*��**�r
Z 0 N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE; PDC REF NO:
PLANNING NOTES>
i i
iE 1E k i4 i(� iE 1E 1E 1E IE iE 4 i4 iE iE 1E IE iF i8 iE 1E 1E f@ iF 1E i! i6�IF 1! i! 1! 4 i(' 1E iE 1E M ih k 1E 1E IE 1E iE'Ik ik 94 if IE if 1f If 1f iE iF iE i! iE iE 1k 1E'Ih fE i! iE 1E IE aE 1t iE 1f ih 1E 1E If if 1k 1E 1E
D E V E L;; O P. M E N, T S E R V I C E S R E Q U I R E M E N.T S
' ♦�
ZONING APPROVED BY � DATE: �
BUILDING APPROVED"-BY, ; f DATE: �'
�.� �r
APPLICATION ISSUfiDr'BY: ' l.- DATE: � 2-te
***ie**�r�r+r*+�*+t+�**ieieitit** *�*rt�r�tat*�x� x��
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL�SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,479.50
SMIP/NON-RES
PLAN 71,32
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 1550.82 0.00 0,00 1550.82 1550.82 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 1550.82 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CIiECK
1479.50 71.32
fI' iE 1E k fE 1E 1E 1ElE 1F IF 1E 1! 1E'1f'!E fE fE 1E iE iE 1Ek fE 1E iE 1E 1E IE fE'lE 7(� �E 1E'lE 1E i! 1E 1E IE iE 1E 1E 1E 1E 1E 1E fE fE 1E k'lF if 1k k 1E 1f iE IE if IE 1f 1f 1E 1f 1E 1E 1f 1E 141E iE iE 1E fE 1E iF 1F if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 325000 T.I. OFFICE BY VALUE/$1 1.00 325,000.00
END OF FEES
': .;Jl;r. �,: _��7 i'- -
C::�.- �_ . - , .' _
CONSTRUCTION AND PLANNING ' POG� cL SPA
APPROVAIS Permit # Date i�spector � qppROVA�S Permit # Date inspector
t. Temporary Electrical Service or Pole _' 52. Pooi & Equipment Location _
2. Soil Pipe-Undrgmd. _ � 53. Steei Reinforcement
c.3: Etectrical'Conduit UtilitV-Undrgrnd. -. - 54. Forms
��"4x'Eiectricai,CoAduit-Undrqrnd. - - 55. ElectricalBonding ,
: er,i. $teel Reinfar.cement 56. Rough Plumbing & Pressure Test -
"�,�lectrical_UFER Gmd. 57. APPftOVAL TO COVER-GUNITE
� ;47�Footings`-,;:, 58. E�ectrical ConduirUndrgmd. �
-� 8. F`oundation'. 59. Gas Pipe, O Undrgrnd., Test -
r
9. Water Pipe:Undrgmd. 60. Backwash �ines, P-Trap, � Undrgmd.
70. Struccure� Floor Svstem � 67. APPROVAL TO DECK
t t. Property Sewec Line & House Connectlon - . 62. Backwash & Recepto��Final
12. Sewer Cap� 63. Heater & Vent-Final
73. Roof Drains � ' 64. Plumbing System - Final
14. Rough Plumbing [*: - 65. Electrical-Final � `
Y
15. Rough E[ectricabConduit - � 66. Solar System-Final -�
.. �-
76. Rough Electric Wiring . - 67. Fencing & Access Approval �
` 17. Rough Wiring Sign . ' 68. APPROVED FOR PLASTERING .
18. Rough Elecirical-T Bar Ceiling � 69. POOUSPASYSTEMS FWAL
79. Rough Heating & Air Contlitioning _ ` C, F`RE�EPT.,REQUIFjEMENT
20. Rou h Factor. Fira lace ..-�"' �`-�-' 1' ` - ;y '�::: r.� rt �n -; « . ��
g N q r.. '•' �; �.APPROVdG�.F, Permit #
21 . Qucts, in �Struciure_ ; . ' •- "''= = ' ""�'� � � 70. 'ZJnder 7o A� � y.
��. i. .-i�:. 9 ,y, Fh.dro
22. Dutt's-, Ventil82ing�; r � �'� " `� f ;� x�' 71. ProductPiping Q-Ggs GOiI
23. Ges Fipe-Rough & Test : _ T' ` * � � _ '�l� :i k 7z, UndergrXed F,lush�' " ' '
F
24. RooPFraming.. , � �'` �`F Y �" C, a �. -�. � - �' r�n~� r
�z r� � 73; Under9rnd. Storage �ank-�7 Gas ❑ Oil
25. RoobSheathing J� "` � � =� T N. 7q, Overhead Hydro:.., '
26. ;L.Bai Ceiling {Structyroll & Mo�ocoat ./ � '' '� �
'9'���+ � 7r1-',A�Y Cher�'rcai , �
27. £rame and Flashing� Y -»r_; ��t�` �� �-�'� 76. Dry Sta4dpiPe -' * � '
I
� 28. Lathing&.Siding ,='.� , -�c'- tc � .. ..,. ,�: ' _ z .
'j�- V ` ,,, 7}, PIXEDSYSTER1=PINAI -� ,
29. insutatior �� k • � ��'� 7�; FIRE PREV. FINAL n' �` „
^ 30. Drywall Nailing �\l /�� i�; - �NEALTH pEPT. REQUIREMENT
_ 31. Plaster grow�'Coat. �� r• . � � f-x ' 79. FINAL INSPECTIO�
-� 32. Electrical Power Met�r`F�nai �, `'� , ��� SO'.: FOOD CERTIFICATE ISSUED
J'33. Finai��Electric� �r r: CC +�� j'�" Notes: - ':"[i � " . •
L 34. FinaRliea�ing�& AiT•�o�ditioning 5 �,_,' ' y ��, ', � � �� r �
-. �. U� � ,,u�c;,, - _ r.a
±.35. Flnai�Gas P,ipe�7esry. .^J�y * �� - �, ' i ��;. - �� �(-,. . ,r,�_ �
r •- _ x. fl ' -.A . [". : r�•--.-
'=36. Hood�or Canopy ' :� ,� ,�,� r
- 37. Final.FacYorY Firepiace �. , t-�:-� r� # � � � .+' � G � � �
- N
38. Final Plumbing .` , � � `f . . ." = _`_ �' ." ; --
:tiz ' Y R Fti �
39. LVater`Service-Fina'1=� ',; � ¢ � �.�; , . • . . -
,. .
40. Gas Service-Final '' � :' r"' " * `"� . .' �� =, '
..: i. "1 c � t'7 F� . - t�
:41. Solar pomeSticFinal� '" a; � ' �� p. , r�� < •� -.
42. Backflow Prevent��+' � �� J � ' ` `1 = -"
-r. C���.-. - ,r, r -.�
� � � r.:.> � :, _ r _ �� .
43. Backfiow Irrigetion a }, a. � .� [ 3 �r 4 � '
- n� � ,
44. landscapE Irrigation�SyStem ' ' % "'� _ t-' •. ; ; -` N ; ��- � " �
� r: * a .:. r . � F. < C' `
- r, y.:r (T ' '. ;-� r. t.' ' r '.
45. Sound Ajienuation ��_ �. .. �� ;-� � ;.y;�� - r -� • �-�i .
46. Nand(cap Regulation5 - � ' ' -� '
� i ..�. '�., .
47. FWAt STRUCTUR� & BUIL`DING �1,�.//�� � ' . ` .,
T r•� r r
48. F.1NAL P�ANNING x `•- * r� 'fi ; ' - i7 `y ' ' -
�
49. Elecirie Release to Edtsd� � y �
, -
50. Gas Relea"se to Southern Califomia-Gas Co - � ' " ` '-' ' - `� " '
� � _ J
59. CERTIFiCATE pF OCCUPANCY ' � - � "
No. Date
�
�
/ I
�
aoonFssovea�wx+: 555 ANTON HL
OWNENSN�WEIiplq�N: SAKIOKA FARMS
• ww�ss POZ HOX 2097
TERMINAL ANNEX
�vtt. Yuiwo woxEss:
ur�r: 1 1 T H
uicxirEcroxu+r+x¢n: INTERIOR ARCH.2136232164 ucwo: 9378
�xcx.onu+a�s�wxea: 550 S HOPE ST uxr: 1100
L.A. CA 90071
coNm�ctarsxua SWINERTON 6 WALHERG (213)896-3400
cam�cTars�aumo 865 S FIGUEROA ST
�ooxess: L. A. CA �. �p.: 9 2
90017 �M, 3000
LICENSEU COHrN�CTOPS DECL�N<TION: I M1ereby � we. �� a�,.y mm i,,,, im.,m ,e,d„ ao.�n a cn.qe. s
��ma�� .an sxi� �aao� a o�,s� a a� a,.m�., w v�d vma CoEe. eM mY 4oame o m hA brce vd eHec.
cmuc.No/.�:0'4�6^2^79 cuss: B uc. . 92•/'� 'XP: 10/95
Dae: � ll ,Lll / � Capfaeor. V
OWNER BUILDEP DECLARITION: I IaeeEy effi�m uMx penely pmjury hm I em uem I ham e CoNretlua Liron Lew la Ihe
Idbwiq iaeaon (Satlion ]0313 &uimn eM PrNasooiu Cada: dY ���Y wfiidi ivem P�e to mubud. etl«.'vnYow.
bmd'nh, > ropei eny strucwre. prior ro u� u�uenu. ebo rqu'vm Ihe irau t« wch e spneE etalemaN the� he a eM
n licensed WA��� lo �M pmieiani d Ne Canl�adaro Liceme lew �Cheqr 9(commmoip wilh Setlon 1000) d Oiiebn � d Iln
BiniM» uk AWeubm Codel a Ihet M a ehe w eumq �herehan and IM beae la Ne eleped ssemqian. qm/ videtion d Seeion
1W1.5 b/ vry eppiraru Ia e permu � Ihe epplium to e ai paretly d np mps ihen tNe hund�eL EaOen �5500�.
❑ I.mowrrrdiMVW�Y«mYamWeY�w'chwepesmihaiedecomVemalion.riAEOlMxark.eMNemuctweeridimaMed
or dlmeE la xb (SecUon 10u. Busiroa+ud Prdsae'vreCode: The Corurmon Linrua lawdoae �weVWY�a en owiwd popery
wM Wida n inpovea thsaon. ard Mn dros auM wak limselt u MnN a WapM1 hc a Mr own empo�m. pw'iEeE thm wM
imppATaNa Ma MI iNndld Uf 4XMBA IOf 9818. tl.IpWBYG1. �M GridiM IX�IIP��Mtl O t011� W1111N qM y]Bf d CTP�YM, IM
owrierWiltler �wll Mw ihe bnden d pwifq M a eha did m� driq a impova lar iha puryoee tl eWl.
❑ i. m o.�.� a in. wow�v. ��a�wr ��rea�a wn uo��e �u.omn w��a u» wdea (sea� �a.. a,.�,. �e
Rolauians COEa: TM Coru'mrca Liuns law Eam nal MNY b an ows d pW�Y wlw bWds a wwa'm IM�ean end Ma
mnleecb Irc adi G�leq� wuh a mmreeMa) ficemaE Wnuem �o tha CoMerlan Liceme lewl.
� I em exemq uMer Sec�ion: B. 8 PC., la �ha reewn:
Dtls: Owner:
I Eo hereW anity ihet I em ewen d eM uMenuM Ns iequimmmb d Celfomie Meellh eM Selay Coda Swbrre 25505, 2553J, erd
255�0. enE thel l a enY Mwe WJdvp ocapam will / wil ewi (�b aro) � to canply wih aeid mme codes eM �he �pu'uemmb tar
eW�elammmx�onamodfWianhantM/v�t a�pemwuDim�itl.RmidWWwM�utlioneOVkm'vuenexemqhomNw
a�.
Dda: Appfram:
WOPKER'S COMGENS�TION DEC WIATON: I Mrob/ dfiem wda pm�My W perpvy an d Ms 1o0or.iip dxlmq'vn:
� I heva enE vril meinien e cerlilicela W ooneen� b seM�inwn br Mwkere' compenWion. m pwided /a Cy SeUian 9)00 d iha lebar
CaEe, la iM pMwmence d IM wk I> xtich Ihu peemil u bsueE.
❑ in.».�w.���me:,.,onen��o«nmo���.m�.a��arrs.e�a�ooau,.tmacm..wm.o.no��.wma
work /a xfiich ihis pemid is ivued My wake'e' mmpemetbn imurencs fertis eM pdiry numbar ua�
CITY OF COSTA MESA - BUSLDING PERt4IT
PERMIT NO: B 074705 PLAN CHECK NO: N
PERM �IO: B U74"105
GOVT: N SUPP; N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR PURPOSE: ALT
SOB DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC-VALUE: 20,900.00 GROUP OCC; B-2 /
COMMENTS: 76 UNION PRODUCTS PREP FOR TI
**�*i�****x�**�r*********�***��*x��***�rx��*�***x�****rt+Ert�t*at�**�r***at**+�*x�*�***�*�t-***�t*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; F'T IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES>
% i // •'
iE if if iE IE'Ik iI' iE K' ii' # iE if if iE iE.'� iF1EiF�f 1f if if iE iE i�'If i4 if iE iE iE iE-0f 1E iE'IE 1E iE iE iE 1f iE'IE if if'N' if iE If if iE'lE iF i4 iI' if 1I' iE if'If �f' iE #'1E iEiE iE iF'lf if �4-0E iE iE 1E'lf iI'
D£ V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
'
ZONING APPROVED �Y i' ' DATE: �
BUILDING APPROVED�BY/,: / DATE: _
i �.
APPLICATION ISSUED 'BY: �{ � DATE; ( O l�� �i✓
IE iFlFlE iE if !E iE IE if ik 1E 1E 3! !k 1f 1E 141d iF IE 1f �'�'k i(� �f 1k R iE 9E lt 3E iE�it'�iE�FiF� �3E #
LEGALIZATION:Y.: � " F E E S U M M A R Y STRUCTURA'L SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RE$ GRADING
PERMIT 432.00
PLAN SMIPqN09-RE5
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 436.39 0.00 0,00 436.39 436.39 .00
�,m,,. AKGONAU"L' EXPIRES REC'ENUE DIVISION TOTALS--> COLLECTED: 436.39 OVER/SHORT: .00
PofcyNumber. w� o »��iv 7K 08/O1/96 BLDG PMT PLUMBIDIG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
�rnv �a� ��e �a w�o+.�� � u. a«m+a ro. �. n�e�.a aaw� �s�aol w rw l 4 3 2. 0 0 4. 3 9
❑ I ceNY thet in IM pMomunu d tM wwk far whch ihu prmn ia baiwJ. I Mell ml empbf � e on in vry mennu ao n io
becanaw4amlla •mnro�ionkxaa end al e , eeubjwmihexvrkee• #fE�EfE�IE�FjE3hiEiElfiE�E3E�1E#iEiEiElEkfFjE�ffElElEiEiE�)EfElE�lfiE1ElfihiE9FiFfFlflkil�iEikifiEififiEif3E1EfE9EiE�EiEff�M-#fEiE1flE�EiEiEiEiElfiflEifiEfk3F3F
`°"'°°"°"g�/°/'°('"'(g��J�'°" 30° a'"' Lb� °o°°��, "�' °• '°" I N D Z V I D U A L F E E H R E A K D O W N
De1e: � � � G` [ ' / APW'ran:
T� TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
W�mlrq: F�Nvn m ueur+rohwry'rnr�vwu�tlon eov�rep� l� uMWll • ecf en mplqr ro olm�Nl, mNtlq errtl
mm �nu w ro w�. n�nerse �rou,.ne edun fsia4aaoA m iuon n• cwr or rron wmew... v�� ror m
9�cflon3)Ofio/M�LMmCOW,lnfsnsl,eiMettornryl/ns. SFC 2���� DEMOLISfi BY VALUE COMMERCIAL NOZONE 7..00 20����.�0
CONSTtiUC110N LENDINO �OENCY: I hereEy elfirm �� �ny w o«� mm m«e o.�w�w� ww� ,o,zy ro, m. END OF F E ES
perlormaMe d Iha xwk fw which ihe Vsrmi is owed (Saeion JVd]. Giv. CI.
LENDEN'S NANE:
�ENDEN'S RODPE55:
I cerlify IMt I heve reed ihia epplcetim eiM nele Ihet tM ebove iMormetion u wrtw. I epree io canpN �h eA ary uM mumy mdimr�ee
end eieta leMe relminp lo buiWing conslrudim e�d hereby eWhor¢e repreaentmivea d Ihia dly lo enler upon iM ebove�mentioned poperry
i«ms�a�w�w�. DAN CONROY
P i Nem /7
��_ .. _ .��..'_'""" Dme � �.'/�
8 Salery: GreerFle: Ganery-Appimnl: Rnk-Revenue: CioldamoaNaem
01 0�1.9^5;.-JG19�675 ao��r i?6.39
�ATE: 10/'.'i1�8 7IP�E: ui:.:
CONSTRUCTIQN ANO PLANNING � POG.. d SPA
APPROVALS Permit# Date Inspector � qppROVALS Permit# _ Date Inspector
1. Temporary Electrical Service or PoYe 52. Pool & Equipment Location � �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �>
3, Electricat Condult UtiiitY-Undrgrnd. � 54. Forms ' .
4. Electrical Conduit-Undrgmd. � - 55. Electrical Bonding
5. Sieel Reinforcement � � 56. Rough Plumbing & Pressure Test .•
6. ElectricalUFERGrnd. 57. APPROVALTOCOVER-GUNITE -
7. Footinqs � 58. Electrical Conduit-Undrgrnd. "
8. Foundation � 59. Gas Pipe, � Undrgmd., Test �
9. Wa[er Pipe�Undsprnd. _ • � 60. Backwash Lines, P•Trap; (7 Uno7gmd.
10. Strucwral Floor SYstem 61. APPROVAL TO DECK ��-'�
17. Property Sewer 4ine & House Con`nection . 62. Backwash & Receptor�Final �
12. Sewer Cap � 63. Heater & Vent-Finai
73. Roof Drains ' ' 64. Piumbing System - Pina( . "
74. Rough Piumbing �_ 65, Electricai�Final �-� .' '
75. Rough Eleccricai-Conduit ' 66. Sotar System�Final � �
16. Rough Electric Wiring � 67. Fencing & Access Approval ,
77. Rough Wiring Sign � 68. APBROVED FOR PLASTERING
18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Unde�ground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas ❑Oii
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Uoder9rnd. Storaye T&nk O Gas ❑ Oil
25. Roof Sheathing 74. Overhead HVdro
26. T-Bar Ceiling (Structurap & Monocoat �p0�6 � 75. Dry Chemical
27. Frame and Flashing ��% �� 76. Dry Standpipe
28. �athing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FlRE PREV. FINAL
30. Drywall Nailing //�0�� �� HEALTH DEPT. REQUIREMENT
ir.
31. Piaster Brown Coat 79. FINAL INSPECTION
32. Electricai Power Meter-Final 80. FO00 CERTiFiCATE ISSUED
.33. Final Eiectric Notes:
34. Final Heating & Air Conditioning- i
35. Final Gas Pipe-Test 1� ����
36. Hood or Canopy �
37. Final FactorY Fireplace �
38. Fi�al Plumbing '
39. Water Service-Final _ '
40, Gas Service-Final -
41. $olar Oomestic-Finai �
42. Backflow Preventer ,
43. Backflow Irrigation
' 44. Landscape Irri9ation System .
45. Sound Attenuation
46. Handicap Regutatio�s
47. FtNAL STRUCTURE & BUILDING I�� �.6
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No._ Date
r
�
`j �
nnonrssaem�wia: S55 ANTON HL
°""Eas"""E"'war": SAKIOKA FARMS
. "p0"�s PO BOX 2097
TERMINAL ANNEX
�er�. wuuxc �ooness:
UNT:
11TH CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 076184
PERMIT NO: E 076184 PZAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
umxnecroa�axQn: INTERIOR DESIGN 213623216�N0= 9378
uicxoxwa�s�nox�ss: 550 S HOPE ST uxr: 1100
L.A, CA 90071
CONf11ACTOR'S N/iME:
owm�croxawuuNo
,�uon�ss: ua no.:
uxT:
LICENSED COHfPACfOP4 DECLAX�TION: I ha�aby dlim uMx p��Y d par'ryry Ntl I am Ikanrd iaMor prwoiau d Clupr 9
(mmmsiwM wilh 6xMion )000) d Civieion 3 W Ns Buu�rop uM Prol»Nan Code� uM mY Ibsnro h in lull loru ,nE Nletl.
cmuc.No.: uc.cuss: uc.r+o.: EXP;
Dtle� Comrepm:
OWNEF BUILDEN �EGIANATION: 1 hxaby aMrm uMx pnNy M p�b.W OW I un wmp Imm IM Canlraaas llaro� lew la IM
Idbwiq �uean (�� ]�1S Bwi�x� eM Pro/wbm CoEe: MyW � oouMy MfiirA nyulm e pemiE to muwcl. Mp. Imprors.
demofe�, a�apv eiry �uucMa, pria b ua uv�uvM. Nw nQui�x tM wW� lor pth qfmA ta Na s dp�ed Nwt�neat UW M a�M
b GceroH pu�aw m �M pabians d iM Cam�emn llanse Lew ICluqa B(�mentirp wXA Bwion ]000) M DHibn a af tM
Buainm W Protmiom Code� a Ihe1 M a dw u uemq Ihrelmm �d �As bsau lor iM NIpW memqion. Nry violYion ol9wbn
]W 1.5 by enY WP��I lw a pxmG eubpL ihs appliceM �o a dW ps�Y a� mps tAen IM hurrJnd Edlen �5500n.
� I, es ow�r at IM qope�y or my employeaa vnlh wepm ea ihei e01a mmpenWbn, xill do ihs xoM, aM Ihe nruclun e iat IntardeA
w Mxed br sels (Saetion ]066, Bmrcu end Prdaasioru Cods: TM CoNreGon lieama lewdoea eM apyy Io en oxna d pope'ly
who Wlds a inpmae �Mreon, uW Mn Aam �uN xvk Nmmell � Mnsl a Ihrouph he a Mr own empb�ae�. pwkaA ihet wN
impovemeNa me nol inieMeE a a11xeE Im veb. p, howa.er. tM buitluq a inpwemaM n wld �Ihin ar yaerW mmpbton, tM
owmrLuJder wJl hara tM bwden tl pmvinp M a tlre did nq buiN a impwa lar �M pupms M eW�.
�] I. m o�.ner d IM P�W�Y. em eRtlu�iMY mMreq^0 wCh FcwuM contrenas b mmtrutl IM V�9� (5mun JWI. &sinw W
vraeswn. coae: rne wnraeo� �san» �.. aom nw ewN w en oxn. a wwem �,o wia. « impw« mr.n, .iw wro
wnvaeta br m�M w4ws r.rh a mmemMe) I'v:emed a�uem �o ihe Contrmon liowue lewl.
� I em e�emq uMer SMio � B. 8 P.C.. br Ihb rae+ui:
ov.: I zG 6 0«�., � '7. ( -_ .
i m nxenr enM mm i e.,.e d e�a �d..w�d m. �.a�,aw a c.vom�e �ww w s m coa s.a'vn uws. zssaa. ene
2553/. erd Nm I a eiry hawe drik'vq ommenl vnll / wa �(ercM aM) �+ed lo canpy �.t� uid mte mdu ad tM ipu�amrrcs b
s V� farmuv�iona moddmunhvntM �i�anq�mwm Uqntl. Reeideravlmwvfun eVV��cre en easmq Imm Nua
Yo+isona.
ome: �oa�:
WOXKER'S COMPENS�TION DECLAXATION: 1 hereby aKim under p�ehY a parjury me d iM Idbwieq dedvetiom:
❑ in��aw�m.:�.�naw.doo�nemio.w:m�ni«wkm:mnw«�uo�.uaw�d.dr«Ms«a:�s�aoamei.n«
Cade.la iM qr1«manca d Ne xvF la wNch Nu pamu u us�ed.
❑ in..e�awm.ar.:,.m�.��w�:M�,�.o�.awwMs.u:na�oodm.i.nscaee.a.m.wnv�w,c.am.
wark ta whidi tl6e V� 0 6suetl. MY wvkm' comouiseiian'v��ence mr'w aM D�Y wmber me:
c.m«:
Pdiry Number.
(�M1is sedim rreed mv be cana'arod i tMW�! ie b me hundred ddW 13i0u1 a Im J
❑ I cenAy Nei in the perlameMe W IM wpk for xfich iM pemie u mued. I Mep np emqq airy pa�em in ury mermx w m �o
baeann wbpe io tM wMes' mmpenwbn lewe W CalJmw. uN epna Net ! I elaWd beaM wbpp to tM wlwis'
cwnpensetbn pwuure d Seeion J]00 d tM lebor COEa. I NeA lat�Mah mmpy wuh Nw pwiebro.
ome: �vo��v:
W�m/ip: Fe9un ro s�cun wilreri romMN�tlon eoreraq I� unl�'�. ��tl �IWI ue}e� �n «rplayw �e cMNiul qvMr mE
e/Nl fims �q ro ar� IrvWnE NouuN JWMn (f100,000A b�1Wn ro fM cwf o/ rompmufbM1 Wrispn u prvHtlM br In
Sxtlon J1P6 a/ Ms Le4or COAr. Irrtwut ���mry's Np.
CONSTFUCTION LENDINO AGENCY: I MeEy elfirtn uMx pareM d pe�jury �hm IMre o e oonm�ion b�diiq epmry lor tM
DSNormaMe d Ihe wak br whidi �he Dem�i u uaed (Sedion 90B). CN. CI.
LENDEN'S NIW E:
LOlOEP'S �OOXE55:
I eMJy tM1q 1 hew iaaE No epplrstcn eed ame �het Ur ebv+e iMamM� e oonW. I epiee lo eomply rrith M ory eM muMy udirontte
md 9tatB leMa releliq b Wikip crosV Wbn entl hmaEyeWiorca �epfdsniati�'et d Ihe r'Sy IO eMu Upon IM ebava�memcnad popsrry
la impetlion quqrees.
ERNIE VITUCCI
vNu r�
� Q�i E S'�� � 1/I �/S�' G/ Dme: � Z 6
sqnmure d o.,wi.be�unv �av
�5151-IB.WP) While-Build'ip 8 Selery: GreerFle: Cenery-Appirent; Fnk-Revenue; Cioltlen�otl-bmeor
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T,I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B /
*���****i�x��*�***�***��D*�*�**�*�*�*�*x�*+Nt*****+At**�rt4x****B***+e�**�t*��******�****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
ERNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NdTES>
i �
1F 1E 1f iE 1E iE IE 1E IE 1f 1k fE 1E 1E 1E 1E iE 1E 1E fE 1E iE iE!(� IE 1E 1E 1E if IE 1E 7E 1! 1f' 1! 1F 1E 1E 1E 1E iE iE 1E 1f 1k 1E 1E if 1E 1f IF ff 1f 1k 1E 1E 1E 1E 1E 1E fE IE 1E �f' 1E 1ElElE iF ik 1k fE 1f 1E 1E 1E iE iF 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY � DATE:
BUILDING APPROVED HY : DATE:
APPLICATION ISSUED BY: � � DATE: (,.� �L
*�,�+�,�******,�,�,�*��*�«�����������-r�������s�� ����**,«�,«�*��* ��
LEGALIZATION:N F E E S U M M A A Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 141.00
502 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 141.00 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED;
HLDG PMT PLUMBING ELECTRIC MECHANIC
156.00
TOTAL PAID DUE
156.00 156.00 .00
156.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
�k 1E fE fE IE 1E IE iE if 1f 1E if 1E if iE 1E if 1f iE iE iE 1E iF 1E iE 7E iE 1F iE 1E 1E 1E IE 1E 1E 1E M ik if fE iE �E if 1E 1E iE 1E if If 1E 1EiE 1f if iE iE iE 1E IE IE 1E IE IE!(� 1E 3E 1E iE 1E 1E if 1f ih 1f �f 1E if iE iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET L ST 20 EA. .75 15.00
ELE 280 RECEPT/OUTLET ADDITIONAL EA. .45 126,00
END OF FEES
OS �rliv '' t iYJS[i v Lr1 � :�h.ij�
CATE: C1 , ° rt� �: .r Cu
•CONSTRUCTION AND PIANNING ''• �G� y SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date inspector
1• Temporery Electrical Service or Pole �' 52. Pool & Equipment �ocation ,
Z. Soil Pipe•Undrgrnd. ' 53. Steel Reinforcement '
�3.,Electrical�Conduit Utility-Undrgrnd.� . .' 54. forms . �
4; �Electrical �ondoit�Undrgrnd. � ' 55. Electricai Bonding _
.�5: SCeel Reinforcemen2 S6. Rough Plum6ing & Preswre Test
� 6. Electrical.UFER G�nd. 57. APPROVAL TO COVEfl�GUNITE
� 7. Footings - � 58. Electrical Conduii-Undrgrnd. �
8. Foundation�� 59. Gas Pipe, C� Undrgrnd., Test
9. Water Pipe�Undrgrnd. - �� 60. Backwash Lines, RTrap, O Undrgmd.
10. Structurol�Floor Svstem 65. APPROVAL TO DECK
11. Property Sewec Line & House Connection , 62. Backwash & Receptor-Final
12. Sewer Cap; 63. Heater & Vent-Pinal
13. Roof Drains � , j 64. Plumbing Syscem � Final
14. Rough Plumbing ,� � � 65. Electrical�Finai � �•� r'
15. Rough Electrical•Conduir - � 66. Solar SYsxem�Final �/
,
i 6. Rough Electric Wiring 67. Fencing & Access Approval '
77. Rough Wirir� Sign � 68. APPROVED FOR PLASTERING .
,18. RoughElectricai-76arCeiling 69. POOLlSPA5YSTEMSFINAL
19. Rough Hea[ing & AiraConditioning r ` _ FI,�E�OE�T. REQUIREMENT ��
20. RoughFactory,Filrtz�ace �.�,�'.c r.� , ` �;, � `�•�APPROVAt�S��`..�,Pekmit# � - - ,
27.Ducts;,inStrucCure-�� � ^ - _ ' � � ���4_=70. �UndergionndHq`�ro �
22. Duct��Ventilat�tngJ', � `� ;.•J i'� -„� �77. Produq PipjngOGas O�OiI
23. Gas Pipe-Rough & Test .� �� k m _ �+ ��' 72, Undergroe'n'd F�vsB� • '
v
24. Roof Freining'� ' " '- ' ` � � �,y ;73�Undergrnd.Storiagg:Tank.�Gas OOiI
25. Roof Sheathing �< �t �.� �. y l' .- ^��+. 74. Overhead Hydr6: � r
26. T�Bar Ceiling (S[ru,ctYrap & AAonnFoat + � �; 7�'-.Dry Chemical `- : i p:
27. Frame-and F�ashing i: � _ - . - 76. Dry StanTpipe F;'� '
-Z8. Lathing&Siding .�-'� �';;�� _ � � ";' 77�,� FIXEDSYSTE,NJ;FINAL. . '
29. Insulation S � +� !� 7S" FIRE PREV. FINAL � ^ �'�
30. Dryevall Nailing t�} + y, r y �J IiEALTH�,CfEPT,. REQUIfjEMENT
31. Plaster 8rawn Coaf ; �-s !, ' +� •79'FINAL INSPECTION• * �
M!`
32. Electrical �owe'r M�ie�r�Final r"� ' k�`•80.7FOOD CERTIF�CATE I�SIJED
33. F.%nal.Electric� '�= i: �._7ZI-Q( l�� �Notes: - `� -- � _ � ^_ .^
� . _ � �,,, L l r �.. ti
" 34. FinailHeating&Air.Conditioning �� �� r'' � ' r��Ji ,(�� .-�
. , , r _ �\�� '
35. Final'Gas`Pipe:Test;�. ^ : , ,- � � � - 8�,�
36. Hood or Canopy � � i- - ' +- , '+� ' � - � •
+. �' i•• - K k ;�,' �� �i a � '' •.�
Q�L�_
37. PinafF.aMory FirePtace � - _ _ _ � ��; ' yc
, � ./4- 12 1� (o �
�38. Final.Plumbing '� ` � " T ^ � _ ` �' - -
C s M
39. Wate'r5ervice�Fina�,'+ _, ' � 'y . � _���
�-40. Gas Service-Final . •T!T �� - * `" ' °' ,=,2 ' �, *
- . t-� -. � •• c
� 41. Solar pomestic-Firi$I: � � �� �, - � -
z� _
42. Backflow Preventer' � +,. ;- < ��F- • - ��
z�. -� ,:7 C r
43. Backflow Irrigatior� : � � 5 y „ * ,; �� • �
44. Landscape Irrigation System �" "' � ��, * '? ^' � "� "• - ='r T �} �
f�.� G S• • T •`7 l'
. . -. r_; - � ?_ p r• • _ -� . e. �
45. So'und A�tenuation " ,; „ . ,.,, _ . ..r ;
46. Handicap Regulations � i: i. ; a' s =_ ' '
t C �
47. FINALSTRUCTUR�&BUICOING y � "' ' � '
s :- �
48. F�INAL PLANNING . � ' ' -
�
� A9. Electric Release to ECison ` "' - ^ . -
.. r � • �' -
50. Gas Release to Southern California Gas Co � � ' r -
�r
51. CERTIFICATEOFOCCUPANCY • -- �
No. Date
�
1
r
�oon¢saauaooa: ,SSS ANTON BL
owr+Ea9ru�Ei�aa�m: SAKIOKA FARMS
� . �o�s% PO BOX 2097
TERMINAL ANNEX
�vx. YuuNo �ooxEss
uNr:. 11TH
urcxnecTon�awun: INTERIOR ARCH 2136232164 uuno: 9378
iu�cx.oeer+o:a�oon�ss: 555 S HOPE ST um: 1100
' L.A. CA 90017
coam�crarexu� CONTINENTAL PLUMBING INC ( 909 ) 360-8300
cartn�crara�u�na 11165 THURSTON LANE
�ss: MIRA LOMA 'CA ucr�o, 399073
91752 u�:
UCENSED COMP�CfONS DECLAHATION: I Araby Nim utls pnYy M ps�vy Ne I em licaa�d uMw pwirima d Cheqx B
�mmmeMirq xM1h Seclan 1000) d Di+ision J d Ne &miwu W V a Cads d my Y en u in full lorte vM a%ad.
cmuc.r+o.:0275 3 ����s C 36 c.No 3 90 EXP: 09 96
Dme:�� Carmw �
OWNEN BUILOEP UEC�AN�TION: I Mraby tlfimi uMa paWy tl pxjvy et 1 em �remq han tM Can�eem lioems law Ia tM
Idbv.iq reuon (�� )��S &enaaa and Aoiemm� CoOe: My cty a wwy xhidi rpuup a pwme lo coroWCY. Ner. impovs.
femde�. a rpv emy �vucWra. pbr ro b eaieroe. e6o rpu'vu iM epqium la vrA pemn to fJe e eproE swama�n Nm M a�M
u IiceneeE W�em �e �he pw�iaione M Ihe Corureaas Linme lew �CMqer g(mmmenunp wnh Sedion ]OpO) d Divoion 3 d ihe
Binircu eM Ralmom COMI a thet Ir a�he u mnmp iMehan aM IM bam la tle e4epeE m�mplion. Nry vioW ion d Seeion
)031.5 M�Y eVd�unl lor e Dermil wibpqe ihe WVrcaM io e cni V�eMY M nd mm iMn /ve AuMied do0us �5500f�.
� I.mowrorWIMV�We�YamY�VMMrnhwapsao�MidsmmP�.wiTdotlwwh.xdNesNxtunenol'vqeMaE
«Mered ro, eeb (Saeiion )01'. ew",nee� W Pmlmam.Code: The Caueeam Lieens� Leweom no1 e00N lo en owrierd popany
who Wlda v inD�'e� 1lwean. W Mn d0s� ��ch rMk 1'vnaNl a henN a Waqhlo a Mr Own anpowp. Pmrkop IAtl wc�
imqwemmM1 ere nd inleMM a Mae01a eW, tl, hvxwm, iM WiIG�p a inpovrnem w�old xiihin om yw d mmplotion, t�e
owrorbuiNw MiA Mvs �Ae dnden d pwin0 M a Ne Nd nd ddd a impwe la ihe o�W�a M uM). '
� I, u ox+ar d IM popxry. em udiuiva!/ mntreenp Mah YoenNC contrmlon �o muvud Ns po�w (�� ]OM. Bualms� vd
Prolamn� Code: TM Caurwon licams lew Aou m� WvN b an ownar d pW+�Y Ma deYb a MPa'r iMrson �nd wM
contrecia lw wW prqad� wnh e mMreda(s) IcomsE pun�mp to tM Comrtqore licwe Lexj.
� I em azemq uMr Setlon: B. 8 P.C..lor Ne �seaon:
Oeie: Ox+w:
i m narenr �«iM uw i.m .r.ue a ena md..w�a u» �.m�.m«m a c.uo�w ween.�d sd.n caae s.aon. zsws. zss3a..�w
255N. vM tlw 1 u eny.Mwa buiMiiq omqeni win / wil rw� (mcb aw) nsed ro oomply wIn uiE qns mda vd tM rpWromenro Iw
epemiillamml�uclionamaGdratianhomiM�r�y �enyememDiprirJ.quidamWOdmrvqcn�ppi�byy�axamqtmmNw
prwinms.
DNe: �pqium:
WORKEN'8 COYVp14ATON DECIAR�TION: I MrWy elfvm uNr pwtly d pw'ryy w d N� IaOow'up Mtivuidn:
❑ � new.na Wu meim,n. cennw. d oonwn �o..nam�. ro..nh.n cano�u�. m maw.d �o, M seao� s�oo a m. �.no.
coae. �« �n. v.narmv�c. d u..wk �« M:u� �k. o+� a b.uea.
❑ � new w�e meiw:,.ak«Y m�v�on vo�..M.... �.a�.e M sww� aroo a ur �mo. cod.. m. in. wnvmenw d ine
work lar xAich ihu W� u ivwE. M' waFsn' canOM�ion vuurerca mniar W G�Y numEv ero:
c.,�«: CNA EXPIRES
• Pdry N�me��: 0 7/ O L/ 9 6
(Thia uCion m�0 mf M cande�M / tiv W'mt u b ar �uN�d (StPO� a Ns.)
� I nnA' �� In iM pelormenea d iM wak la v.hie� IM pmJt �usd. I NW I wnqry nY ron in ury menna o ea to
Eecan� wEjetl lo iM w4mJ oompwuion lew� d W epna i tl I�Ao E m� wbjop b �h xpkan'
wmpanmli `n ��� d Ss�jq� i)00 d II�� lebor CaEa. I IonAwilh w wXh Iho • n�.
�`� _ � �5
omo: v l �aq�u:
W�m/np: Hllun M�1eun wortwi ronpwu�tlon covwq� l� wbwNA �� uGl<� �� �+qlqw ro cnMrul p�n�Mu �n0
�nrr nnu w ro on. n�ner.e rnou..ro edun fri W oaoA m.eeidon ro m i o� ro�n«+.��an am.w .. ao�a.a ro. ��
9�ctlon ]106 el tlr� LWor Codr, Int�L �� ��m�V� IMa.
CON9TNUCIION LENOINO ��ENCY: I IwWy elfrm uMa peneCy d per'�ury �Ae �hpe o e wnp�udion kMi'p apericy M IM
performenro W Ihe v.ak Ia v.fiicA tAe pemii u e�ueE (Saaion ]061. CM. GI� '
LENDER'S NUI E:
LENOEfl'S AUDflES4:
1 cerlity tlai I heve reed thb eppliWion vd pme Ilw Ne ebovs inlameiion Is conoC. I epias lo camply wnh ell rny end cwmy oNiriozee
414 t181! �6W!!l�BI�IQ �O �IIIbI1Q MWYCUII YIE �IOfO�`/ Olfi�qfZO fOPpl111G�NY d I� pA' b ONH up011 ��IO Gbql.IIIMIUf1ld �IOpYIY
brinepadion W�o � �.
R Y " RNTON
n r+.�. r
Dais: � ^ ` i
grature d Owner/�penVAppfunLCaMreua
(5151�a8.WP) Whds-BuilEip 8 Satery; OreemFle; Canery-Appirenl: Pink-Revenue; �ddenioF�vaeaaw
C
,,..... _,. �- CITY.OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 074731 PLAN CHECK NO:
CONSTRUCTION TYPE: 1—FR PEAMIT TYpE: PLU
W
PERM NO: P 0747311
GOVT: N SUPP: N
PURPOSE: ALT.,
'JOB DESCRIPTION : INTERIOR 20000SE OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74630
x�x��t*x�****�**���r�r**x�x x�+r**x�+r�r*x��r�*x�**+r�+r+�*�rx��r+r�r*r�r�r***r***�r�*+r**�w***�r**x�x�*�**�*
_ Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT,:. FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
x��r**x*w«�r*�r********x **�r�rx***x***x�*****x�***�x�,rx�*±r*�r*x***�r*�*«�r**x�x�x��r*��*�r�r*��+�**
D E V E L O P M E N T S E R V I C E S� R E Q U I R E M E N T S
,ZONING AppROVED BY !^ DATE:
�'.
BUILDING APPROVED BY : r%' DATE:
APPLICATION ISSUED BY: �' DATE: �d �Z3iG
IEIF1ffElEfElElfMif1E1E1E1EifMiFfElflEfElE M1EIf1f1E1FiFiFif1E 1Eli
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 42.00
25f SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 42.00 20,00 0.00 62.00 62.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 62.00 OVER/SHOAT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
ltkihlkfklfiFlflEMiFiFiF1E1I'1fiEiklflFMM1EMiF1f1E1E1f1EiF1@1EfEM/kIEK1E1t1E1E1t/f1EfflflkiElFM1F1Eif1EMiE1f1F1fM1fiEM1kif1F4/E1E1E1f1EiE1fMlFMif
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 2 SINK KITCHEN 7,00 14.00
PLU 2 WATE{2 HEATER AND/OR VENT 7.00 14,00
PLU 1 HACKFLOW PREVENTER 7.00 7.00
PLU 1 SINKS, FLOOR 7.00 7.00
END OF FEES
a� an�s����-o��y.;aa �s..��- �^.uo
�:i:E� i���i`t74J 711'Gi �.C�:.S
•CONSTRUCTION AND PLANNING P��'` �` SPA
APPROVALS Permit # Oate Inspector qppROVALS Permit # Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location.�
--t
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement � ..
�Electrica�on � lity-Undrgrnd. 54. Forms � � � �
...
�,ao �
�y�,tiectrica��dN�tt"Y,Intlrgrnd. , 55. Electrical Bonding �
.�¢5. Sleel Reia'Idicetrninr� � 56. Rough Plumbing & Pressure 7est C
c
, ��,�„�6lectrica�E�"�ntl. 57. APPROVALTOCOVER•GU4VITE
E� otingsi it*7 F 58. Electrical ConctH'rCUndrgrnd. 5
� 8. �oundat'� ? S �„' - 59. Gas Pipe, O Und�rnd., Tes[ .
9. Water Pi�pg�Undcpqd.n� ' 60. Backwash Lines, �Trap,�O Undrgrnd.
10. Structur�Floo�stem `� 61. APPROVAL TO DECK � _
11. PropertySewes,lin�-& Hous�Connection 62. Backwash & fieceptor-Final t�' �
12. Sewer Ca9 w�� � N • 63. Heater & Vent-Final
ti
13. Roof Owins p,_ t 64. Plumbing SYstem -�Final-_
14. Rough Plumtiirr� "" 65. Electrical�Final ` - - .
..� u
15. Rough E�ctric�Col�luit ;, 88. Sofar System-F�rai �" .
16. Rough E�ectric�5liriog � 67. Fencinc� & Acc��lpproval •.
'/7. Rough WinBg S�n ' '� 68. APPROVED F�(j.PLASTERING �-
78. flough ElectricabT Bar Ceiling 69. POOL/SPA SYSYEMS FINAL
19. �ou H�tin & ir Conditioni Ta, � N m a r c^ �� C�
4� A� �, _(19. FLFj.F,�€fT�?EQUI�;EME4fJ Cp, �,
�.. ...- - v ... [n� '" N :� U '.*7 � :�+ ^7'7 "f'7
20. 'Qiouc�+ FgetocY Fit,rplace �� c^.�( r S `+ '^ �� APPF30�1$ts."r+i-� Pp+mit #= rn r+'+"'��
... c- .-� t .-�
� � iTl • �-+.S M � � Hi H (�70'7 $ 'A
21, u in trti�tur�?# �"' S.r; .� � r, ��# 70.F:lndergrpyr�l F�dro �
22. Du s�, V�til2'=in�� � fj .k G Q �7 !-+* 77, pwduL�'1t9iping� µ as �Oil
23. Cias P pe+r„flou� <�st ,,..,,�, �S � m q� S* 7z, Undergr��d Ft��3� � j�
24. Roo r�ing � � '' ��;,; -. ^ � Q;-+r • 731 Undergrnd. StcPl� Tank � Gas ❑ Oil
25. � o�'Shoathin9 �s � v�*,..� m�* 7#�. Overhead HVdr�e �
26.'Y�Ba4:Ceiting (Str�;pral) & hio;�coat i C y - O* 7S Dry Chemical :� r v-�v:y �-+
� �
27. �ramearr3 Flashi • �G� � � " m* 76. Dry Star�p?peF"m�^ * �'� �
�' x :+� 6H • * C7 fu 'Q N
'� 28. lat -^ :• . ..� .
t�ng�Sidingp*�� 7�F. p r ' 7� FIXEDt�S�CSTEUT5r,1VAt�-+ (� :t'z
29. Insulatiap' �1�� � " � S 7o�IRE�?REV. F�`, L t'� � F,�,.�.._ p
,i
30. Drywall �ailing v* H !� t-• � x Son, on ALT DEPT. RE�UIRBiNfiiuT
F-
�' 31. Plaster Brown"�(;o3T,t'�R = �";T' * 79. FINAL ��EC7�N ; J F �'-�'
�. 32. Elecrciw[�o�+,�"r Met�r f;pai �� � N ' R gfcy F000 CERTI � ATE IfiS17E6i i,
' 33. Sna�T,..£IeEtri�� • r" � x cc I � 't Pkaces: '� '�c+7 k`� O � a;
r C C7:� x S
',; 34. �ina�ie'�{'`jng� Ay�q,?�icionirig^ �„ ��, I+ f .-� i FK t T' �
. �
� 35. �inal GatPiprTei�x ��� •• s � � bc � �o Or-i s f- !+'
-� rr � • - w m
36. Hoo�or QnoPY �* ��, x��-, a e `+ � ' � " ` � V
,, n xc a r•,
37. Final•Fa6tory Fir§�IFce 7C ' FE^ `v y� i I jr � x (L'
m r.
"38. Fina�lum6in9 V� �;r. � � � b P.* H � y
� Z%!(I
� 39. Wate� Service-Final t E � � ec ;� =� W^
• F�D + [*1
� 40. Gas Service-Finai �'' r FF t*' f� � F� oS • Q
41. Solar pomesticFinaF y t�7 x � t*� `�o c � �; D
n ri i ? S
42. Backflow Preventer � N G�y ,K F y� cr!O w F
43. Backflow irrigation a: ?� y Y� �, N x� � �occ
�4. Landsca '� Irrlaatior�.Sys[em �a �� „ � m � fi �L c.: Y � -.�
.� �Js L" �2 Sa a E ro Gt� a s F
�5. $ound Attenaationa ^'.�^ .. x� t, i�t t*1� c*' Q. 2- x
c i m ..f / / NO -•.-1 x
46. W2ndjFap'RegUlatior%t T� .. Rr. S I � t*, O p �d � �
47. F1Nqi STR TU �& BUILDING � F. � i � i c �i� �
x k O
48. �jN�L PLANNING�; ' : �� ' � { � � ;� v S S
?19. Elecfric Releaie to Eclison r ' M,� •n x ~��+
I p^` k [1 a....yL
'S0. �as �elease to $outt(ern Californi$:Gas Co � • o" x -
� r . s �o n* N JGG'
3'1. CERTIFICATE OF CCUPANCY " "
No. Date
�
�
�
�nonrssa ew�dno: 5 5 5 AN TON B L
°wr+�Re""°Ei°p'°"'": SAY.IOKA FARMS
. . "��+� PO BOX 2097
TERMINAL ANNEX
�vv�. muwa �ooweu:
uNT: 11TH
u�cxnecronuaw�n: INTERIOR ARCH 2136232169 ���= 9378
ApCMORENQ'4�OONE54: SSS S HOPE ST uNT: 1100
L.A. CA 90017
��T�g� AIR CONDITIONING COMPANY (818)244-6571
����ro�� 6265 SAN FERNANDO ROAD
�no�ss: GLENDALE CA ucxo: 120696
91201 uNr:
LICENSED COMF�RORS OECIAR�TION: I Mrab/ tllim udar pmrly d pmjry Ntl 1 am fmmod udw prwuiuu d Gheqw B
�o�«�c •Mn s«� �000l a on�o� a a u» a�w .m a�a.:�. con...oe mr uo�o. o m mu mRe.m ww.
crrruc.No.:014403 �CO� C 36�� 120696 EXP: 07/96
OWNER BUILDEfl OECUH�TON; I lrab� tlfimi utls pexly d per"�vy Ne 1 mn a�emp hpn tM Caaea�on LirbGa leM ta rtr
Idbh*q reuon (Swion )W t 5&enn� rN PNovw Code: A 1 NY w mw1Y MJdi npum e pamY to mmvucl. etlar. "vnYm+.
femdaA, m repv ury awaure. piv ro b'ev�e�ae, e6o rpiem �M eppGm�a Iv wcA prmn lo fib a qppd Mlemsru tIW he p ahe
A r��d w� m m. w�+• a m. wm�.aa+ uo.n. �. wn.a. e c�o .ae saaoo �000) a or,� a a m.
B�iae end Rdev'am Codel a �M te a eM e eaamq IMahan W iM bem la tlr NepW eaemPion. Nry wW on d Senion
)03t.5 by ary epWvaiu la e parmY aiDjad� �Ir eppfram io a ad pruEy d nal man Uunlxe IwMmd EaAar� �5500�.
❑ �.nox+..a�nea�roe�+v«mv.�aa��..nwqp+u�ne:.a.wn,o��..Nmu»�aekemu..��u[Lueemweneae
a dtereE br veb (Seciian Mu. Bu�isv enE Pmlearioro CaEe: The Cavmfaslimme lnwdoee rot eGPNto en owmrd P�WeM
wM bdde n inP� �Mrwn. aM Mo dow eW� wh h'vnrtl a MnN aWwph he a Mr orm emVMa�. p�� ihtl mich
'unpwanw ma noi ineded adlaad 1> Ws. tl.Im�e.ar.IM buV'vp a inpvwinW n wd vrilhin ane Y� d aomplelion. Ne
owner-0uiNm xi0 hera tM Gu�ds� tl pv.•'uq M a Ya GN na dik a impow In Na pvpoea d We).
❑ i... ow�+r u m. oAwnr..m .��w ��:a .a, sa�,.a cow.eu. ro can.we u» wdea tsw� �a+. a�.�...�d
Peolauians Code: TM Capradan liemr law dou rc� eVdY b en oxw d PW�Y xfio bum a impm'o thsson vd who
canVact+ In vrh D�IN� MN e mNttlMt) liwvod Pn� b Ile CaKrotlds l3omfs la�.
� 1 am uemq uMx SMian: B. a P.C.. b tlis reeaon:
Dele: Olnw:
i ro n«.ev �«wv um i.m...n a�e �.d.,w�e u» �«.. a c.uw,:. �wan .m sdw cod. swo�. um. zss�a..�a
PS.U1. eM Na I n enY Mun Eutltlin0 ompmi_vn0 / vA rid (u�cb ww) nsad ro camW WIh oN aW e mM� eM iM rsCui�omonls br
epamnlamnsviMionamodifrmianhomiMAr�u iy7.f�ervpemem0iqrie.RuiJemielownt�ioneppireibneereeumpimmtheee
aa;�,..
Da�a: Mp«
WONKEN'S COYPEN9ATON OECLAN�TOM: I Mrab� elfmm udsr p�nMy d pwpvy ans d Na bMwinp Mutlum:
❑ I Mro vM xJ me"vpen e unAiuu d mm4 �o �W+iwv� br rakmi mmpe�umion. m Pa'� la A' 8wion �]00 W iM leEn
Cads.la �M pMwnwics d IM xaF lu wlicA th'v prme u iwiwE.
� nme.�a wi� m.w.�.wke.� mnv�4, ��.�,oe.., nQu'v+e M sw�m a�ao a me �enor cod.. w me w��ww. d ine
A woM tor whiM I�is permh ia iaaued. MY ��n �OM�� imurerca feniar eM pd4y numbar ve:
c�..: f'('1NTTNRNTAT. C'AS EXPIRES
va�� r�,mn«: t.rr a n •� ti�� a K v ti 10 / 01 / 9 6
(m;, ewria+n.nd nw be cann�e�ee r rM v�t u ro. om hunane adwslJrool w I�u.l
� I unN �� in iM pa�ormerca M IM1e wwk Iw wh'rh ��ia pmmn b ievuetl. I 4W1 mi emqvy onY Po� in anY mennar ro m io
become vuEjed b tM xwkers' mmpenxtion 4vn d CNilomu, uM epree Nn A I ehouM become wEjetl lo IM waMen'
cpnpensvbn V�++iom d Ssqion ]]W d �M laEn Coda. I JUY Ian�xXA camDM wiN Nas pm'frimv.
ome:�.s /9—S` �vd����--li�
Waminp: F�Ilun ro��cun woik�n'romp�ru�tlon rowrap� l� unMwNl. �ntlYWl �ulhcf ur w�pJs J crlMnl pwNu �rW
c/vll flMa up ro ons MntliW tMUYid dolbn (SIIX{OWI. In M)Itlon ro tl,1 ro�f ol rompNY�ttlM��p� �� p/ovMW bi In
Sxtlon 9106 0l M� LtlorCOW. Inlru4 �Ird �rtom�y'� Iw.
CON9TFUCTION LENDINQ �OENCY: 1 AreEy atfirtn unAer peiuM1y N perj.vy Ihtl Ilws b s canM�udion bMirp epency lor iM
perlameriw d tM xwk la whiM iAu pemil u ewad (Sopion �091. Crv. C).
LENOER'S NMIE:
LENDEN'4 �ODRE54:
I eerlity IM1eI I M1eve eeed Ihu epp4ra4an enA pW Ihe11M abws iNpmelion u eanatl. I pns lo eamply xilh etl Wy and eounlY ordirenm
Bnd 916�! kwD AI81RN M WIkM CMYNtliM CM MIBb/ GNMCG ApltMlplw [11M qIY IO MIN Up011 �Ib GbWl.IIIlIIIU11lE PAWhY
�IX IMVMp�I qrtVwm.
^ LOUIS RODRIGUEZ
Pemi Nems
(5151�de.WP) W�s��diq85efdy:O�er�Fb:
om.: �6-��i �S J�
�
CZTY OF COSTA MESA - BUILDING PERMIT
c'ERM NO: M 074657
PERMIT NO: M 074657 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTZON TYPE: 1-FR PERMIT TYPE: MEC PURPOSE: ALT
SOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM C'ALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFZCE TI, RE:#B74630
*f�*�***�t-*�x�*+��er**i�**i�**itit�tu-i�*+�i�-***************��r��r*rr�r�t*it**x�***i�*�t*it�**it�*+e�*�i�*itit
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- -------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
�LANNING NOTES>
i
'�1E IE 3E 3E 3E fE 1E iE iE !E iE �F 3E !f !E 3E dE 1E fF iE dF iElE dE iE iE �E 3f tiE iF iE iE ik 1F iE iE i�{E # if 14 if !E 1E � �E iE7E 3E 3E if 3EjE If 3E iE iE iE IE 3E iE if iE?F iF iE 3E if iF aE iE �E iE 3E 3f iE iE iE iF
�i D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
�ONING APPROVED BY � DATE:
B[JILDING APPROVED BY : �i; DATE:
i' • �
'rA�PPLICATION ZSSUED HY: �� S� DATE: �Q�(��t�
iF 1E iE 1f� iE if 1E if iE iElE iE iE if 3F #!E �E if if if iETf�fif3i�if� iF� iFiF iF'iFi�-'��f��iFTFiF iF�� ifiFiF�Tf3FiF3FiF if iE # 3F iE iE iE iF iE iE !E iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 84.50
25$ SMIP/NON—RES
PLAN
ISSUE FEE ].5.00
BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 84.50 15.00 0.00 99.50 99.50 .00
REVENOE DIVISION TOTALS--> COLLECTED: 99.50 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
99.50
iE iE if !E iE iF iFlF 1E iE 3Elb iklf iE 1E iF 1f 1f 1f 361E iE it iE 3E if iF iE 1F �E 1F i4 �F if k IE 1f �f IE �E iE ik iE IE �F 1E If 1E 1E �E 1E �E 3E df k 1F i6lE iE if ik iF iE iF iE iE 3! 1E i6 iE iE If iE it 1E iF iE iF
Z N D I C' I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 4 VAV BOX 6.50 26.00
MEC li FIRE DAMPERS ' 4.50 49.50
MEC i INST/REL BOIL/COMPR 0.0 — 3.0 FIP 9.00 9,00
EtID OF FEES
✓
O1 �91!'2T�S-C�19�389 To� 4 99��.
OPTE: 1�/�%i45 1'!iy£: �8:5i
�. --
CONSTRUCTION AND PLANNING P00.. � SPA
APPROVALS Permit# Date Inspec4or qppROVALS Permit# Date Inspector
1. Temporary Electrica� Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgmd. 54. Forms
4. Electrica� Conduit-Undrgrnd. 55. Electrical Bonding
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test •
6. Electr�cai UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Tes[
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structuraf Floor SYstem � 61. APPROVAL TO DECK •
51 . Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Droins 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Final �
15. flough Electrical�Conduit 66. Solar SYstem�Final
16. Rough Electric Wirin9 • 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning r�� � FIRE DEPT. REQUIREMENT
20. Rou9h Factory Fireplacz APPROVALS Permit #
21. Ducts, in 52ructure 70. Underground Hydro
22. Ducts, Ventilatln4 71 . Producl Piping O Gas O Oil
23. Gas Pipe-Rough & Test 72, Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•Bar Ceiling (Strucrural) & Monocoat 75. Dry Chemical
27. Frame and Flashin9 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FiRE PREV. FINAL
30. Dryevall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-F�nal 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning /�/S�
!C
35. Final Gas Pipe•Test
36. Hood or Canopy
37. Final Fac[ory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem
45. Sound Attertuatio�
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �`
48. FINALPLANNING
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�nonessaew�wx+: SSS ANTON BL
opx�
o,vr+�asru�eiva�an+: SAKIOKA FARMS
�+� PO BOX 2097
' - TERMINAL ANNE7C
i1VVL. YAIIING AUURE55:
�qCNIfECT ON FN�lEEN:
ANCN.OHENG'SIDDXE55:
�M 11TH
uc.xo:
UNi:
coNm�crarsruue SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
cwm�croxs�uiwa 215 E EL SUR ST
wo�ss MONROVIA CA uc.rw: 190173
91016 uNr:
110EN5E0 CONTfl�CTOPS DECLGN�TION: I Iwelry all�m iNer perely tl ps�uy tlut I am f wd uda pwidwn d Clupr 0
(cartunervn9 MAA Seciion )OW) d Oniaun � d the Buunen ud PMasfions Cotle. arA mY Yoemse u m tW tau eM atlee.
cmuc.No.:013054 ����5 C 16 uc.No.: 9p 73 EXP: 04/96
oaa: /O�a3�YS c�vm�:_
OWNEP BUILOEN DECIAR�TON: I hereby effi�m undar penaly d perjury �Mt I em memq hwn iM Conveqon L.icanes lew Iw iM
Idbwip ieaaan (Sedion ]W t.5 &srou enE Pralaeeiom Code: �M cry o munry xhiA rpu'ves e pemi! lo mmuucY. Ner.'vnprova.
eemdon, «,w� �rv.�Nnwe. wb. w aa :wa,oe, d.o �.can. �n. rod�� �«.0 A c� �o N.. ap�.a naemem mm n. «.na
is licenaed pummni io iM pransian W Ihe Convaqon licome lew �CMqm 9(mmmew'vq xnh Seqion )000� d Div'sion 9 d ihe
Budrieav eM Adeabna Cotlal w ihet he n ehe u memq iherelrom vk �M besa la IM eAeO� memqion. My vide�ion M Sedian
]oa� s M e�r aod�,� �a e rormA wd�s ine apd�ceni io e rni� oeneM d �a mae �he� 1'xe hmMred dotlen l35001).
� I, m ownar dthe propeny or my empbyeee wih wepee av IMk ede mmpeneation, will do IM vrork, end IM aVucturo c ral immEeE �
or allered br mle (Seclion )OaO, Bueimea end Proleesions Code: The Conlreclore Licanse lew doee not eppty io en awmrd propeM
wM10 bulda w'unprovee I�erean, enA who doee such xwk NmeeM a MneM w Mrouph he a her own employeee, pmriEeE Ihel wch
impmvemema are mt inlendeC a ollmeE for eab. M, however, lhe buiHi�q a'vnpwament b wN xiihin aro yeer d mmplMian, ihe
owrier-0uilaer xill heve iha buiden d potirp M or eha d'd rid WiN w impove lar IM W�P�a d mlel.
� I. n awiar d �Aa MOMM. em utivawy' oonirW�q wiU IicensM canireclon io mnmw tha V9a (Setlian ]Oa�. Buainsa arq
a�d.ss�. coae: rn. comreaon uo.,e. �. do.. �a wwr a.� ow�w a wa�r wno w�d. a�ww.. ine� .�d ..no
conUacts f« vxi� piqeea wdh e mmreCor��) IicenaaA W nueru to tM Conlreqon Limme lew).
� I em examq uMer Sectim: B. 8 P C.,1« ihis neeon:
Deie: Ownx:
i eo namv �v �nm i� ew�e a�a �m�wm w. �a��,«,u d cd�o� �mn �e smm coae saaoo. zssos. zss.v. d,e
25511. enE Nel I a ury Mun build'up omqeeu r.iA / wil m� (web aro) meE lo ea�ply wih eeid mta mdw eM �he rpWrsmanU lor
eD�fameo-unionamoEfratonhamlM�r e�u iiy.am�enwil0ierid.RdavilmnpMioneDV�cromaexemdhanRr�s
Pori+ioru.
Dme: Appl'ram:
WONKEfl'S COMVEN4�TION OECL�PATON: I MreEy dfirm uMer qnelly W perjury dr d iM blbwi�q deduvum:
� I heva eM wil meinten e ceM'We d wwni to Wlineius Ior xpken' cpnpenv�ion. n pwided 1« by Seqion 3]00 d IM LeEa
Cade. fa �he perlamucs d Me xark la xticA th'v pumA u baued.
� I he.e e�d vnl meinten wMxv' canV��ion imurenca. n r+W'usC M Seim J]00 d Me Lebor Code. b �M D��� M IM
w«k In xtuch Mu V� e inued. My warken' oom0�+mian imurarcs onier end OdKY number ero:
c�« FREMONT EXPIRES
PdiryNumber 0 6/ 0 1/ 9 6
(Tlris sxYion neeC iro16e comdefe0 7(M permd'u la aie huMled ddlan /St00J w bss.)
❑ i cenry ina� in �he palormence d iM woA 1« which ihia peimii Ic Iewed, I ehdl iwl emqoy ury penm in eny mennar eo ea to
bacome wbl� io iM v.orkere' compenea�ion levn o1 Cdibmie. enE epree Mm il 1 MaulA became eubjea m �M xwken'
compeneeiion �proJnaiona d `Seabn �]OU W Ihs Lebar COEa, I ehell 1 h camply ilh tMes pmvidona.
Dete: i���oJ�S Mdium:� . .
w.m�m: c.n�� ro..�m. wort..r eomv�+wuon em«�w �. ��N»�n,r, .ne wn.�el.n.�.iro�m� ro<nmhv� pm.ro...ne
elHl flnu up ro m� hinCiW Movautl eai/w (S1P4000). M WUfbn b M� ewt ol rompxwWM1 tlemep� u provltlM br In
$KtlWI J%� OI (�IO {2�10! (�.0l�J� �IIIM/1� III✓ IiMT1✓� INl.
CONSTPUCTION LENDINO AOENCY: I heroby elfirm uMer paneXy d qrlNry �hel �M1era u e mmtiudion bndi�p eyency M �hs
perlameMa W IM xoek Iw whidi thi D�Y Is'vwed (Saeion 308�. Cx. CJ.
LENUEN'S NNIE:
LEN�EN'S ADUNESS:
I<MJY thet 1 hew rtad Nu eVG�raiion W aue ihel Ne ebwe'vdwmetion o cmetl. I yrea w com�N x'nh eA mY eM m+mY ad"uwm
ardewalexereW' obuiltlnOcanstruabneMMrWeulhareslepeeenutiwnd�hbclYromqauD�iheabo.e-meMionodpapery
�IX IMpBC1IX1 pll! �
Ponl Nen,
om.: ^/� �3-�
SymWn d Pnnr//ipenVAppirenuCwreeu
(5t51deWP) W�no-Buik'vp85dery:4reerFb:CanW-Appicem:Pink-lievenw:0obenraE-Avmaa
CITY OF COSTA MESA - BUILDZNG PERMIT
PERM NO: F 074747
PERMIT NO: F 074747 PLAN CHECK NO: 04042-95 L GOVT: N SUPP: N
C��S''f'��5�"f'���N TYP�: 1-F'R %�AR�1�I§' �fYtY'�E= �E'iR0 �'URPOSE: ALT
JOH DESCRIPTION : RELOCATE FIRE SPAINKLERS SQ FT;
CLAIM VALUE: 8,900.00 CALC-VALUE: GROUP OCC: 8-2 /
COMMENTS: 76 UNION PRODUCTS REF: 8-74630
+r+r�r�rxx�rx�**x��r+r***�r*x��r�r�r�r�rx���r*�r*x�x�x��**x�*x�+r+rx�+r�r+��r*x �r�r�*�r�r�rx��x�*�x��r�*�r**+��r+�+r+�+�*�r��
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT. IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT _ IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
i
1k 1E iE iF 1F 1F if if iE IE1E iE 1i /f fEiEiE 1F fE 1E ff if 1E 1E1E 1F IF 7f 1F 1k 1FiE 1F iE iE 1k if if if if iF iE iF iE iE 1E IE if 1E iE IE 1E 1E 1f M iF i! 1f iE iE if if iE if 1ElE1E 1E 1E 1E iE 1E 1f 1F 1E ik M iE 1t
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: �;���5� DATE: lb 2'3 �Iy
IFiFiF1FIF1EiE1FiFiFiFIFiFiFiFIEiFiE1FIFiFiF F�F1�f�E� �i����iE1E1k1E1E1E1E1E1E1F a'FiF'47F�tit
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
gi,l��3 PM'C HLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING
t��li4�t4� i4fl :44
PLAN ��6§a SMIP/NON-RES
ZSSUE FEE
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 108.00 0.00 70.20 178.20 178.20 .00
REVENUE DIVISION TOTALS--> COLLECTED: 108.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
108.00
Mifk�llfMiFif�fif�k�FikiFitifiFifiFiFiFMif�Fa4iFkifikiEiflFiFiFiFkififMifMMikifMiFifMifiFififMiFMifMiFitikitKikiEiE3Fikifikif ifitififififkifif
Z N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 108 FIRE EQUIP FEE (FROM HLDG VAL TAHLE) 1.00 108.00
•r 1 END OF FEES
�1 CO?92707-f,,192i07 Tl"1iT 10°,Oi'•
CnT�• [0/?3!"5 TICF: i1:�i
CONSTRUCTION AND PLANNING POOL ., SPA
AQPROVALS Permit # Date Inspector APPROVRLS Permit # � Date i�spector
t. Temporary Electrical Service or pole � 52. Pool & Equipment Location ,
2. Soil Pipe-Undrgrnd. � �' 53. Steel Reinforcement -
e;.��Etectrical Cond�t L1c�ItV-Und�gr.nd. 54. Forms � �
"'dntTectrical ConduilTJ�drgrnd. , 55. Electrica� Bonding � � •
Ci� �-I ...i . �. � �
. Ieel Reinforce�FenF-+ 56. Pough Plumbing & Pressure Test
,�u,lectriwl UFEFt'�nd. 57. APPflOVAL TO COVER-GUNITE •
�;i �ootings �,n; � 58. Electrical Conc�iTUndrgmd. '
� 8. �"oundation ^� �°ti '� 59. Gas Pipe, O Ur�f�rnd., Test
9. Water Pipe�Undr,gc[Ld. � . 60. Backwash LineS; F Trap, �.Updrgmd.
19. Structural Floo Ystem �� 81. APPROVRL TO �ECK '
1 i. Property Sewer�(;in4-� Housd�,Connection 62. Backwash & Rec�ptor�Final• �
72. Sewer Cap O � 63. Heater & Vent-Final
73. Foof Drains � ' 64. Plumbing System - Final �
14. Rough Plumbing� tT1 �, 65. Electrical�Final �
:
15. Rough Elec[ric81'Co�luit ? � 66. Solar SYstem�F;iF�I . �
16. Rough Electric�iripg e 67. Fencing & AccSis Approval
��
17. Rough Wiring S�n y 6$, qPPROVED Fl��PLASTERING �
78. Rough Electrica6.T Bar Ceiting 69. POOL/SPA SYST�MS FINAL
19. Rough He tin & Air Conditionin� FJ�R�F�EPT0.REQUIHEME&,T ...,
c• , ..� � C� � �^ _ �r a x :� a ¢ �s� - -�. � �
, . +.:. x V .. �• ^N�G :TI �t �+ r-�
20. �ougt��- tor,�Fi�;�lace , S�„ � x S,..� �K,. APPF{�V�,i��,F Pelmit# � �-^
m
21.6ucts�in�5'tru�;tur � ��"" �''� * S O r.a� r�-��7� �'
-ts� �* I S-� �a f1 r-� (1M. 70..�1f�dertJ^�,hzFt'S' �dro x
22. DQucCl�.V�ntil�{�inglyx i �Jj aG � CJ F,x V 71. Prodiu:I:�iWing�]'6as +OOiI
23. Gas Pi�ae-�ou & Ttst � � c*:S � [+7 ^ � O � � 7Z, Undergr��d (�us'`� � �, o
24. �oof'FTa^in .. �* � `"F" .." * � c ■ _ n, r a
� 9 � � * > � .y � • 73r Undergmd. St�a$ Tank+O Gas ❑ Oil
25. Roof•She32hing Sy� !C v v Y J> n: X 74:' Overhead Hydf�Q, � `�` 4 f ��`
26. LT,Ba{,freiljPg (Scr��ral) & fSo�"'r+c"3soat � � y Ci< 75,; Dry Che�isal ' r. - :y
i-.^
27. Ereme�arttl:Flazhiri4.'� DQx * �' >' �+ 76. Dry Sta piPeFm ¢� r� ?!
28. Lathin�`A'�e�Si�'g Q* � b�F � x� ..� ..� .•% 77.i FIXEDkSY3Tht17�f-INP:L-� C: a�
y29. Insulationt • n* = ,. ,�;.• � I M 7�;FIREPREV.EI�L *'� � ""' I�l�'��. �G
�. • � � a ��
' 30. Drywall tl�ilin9 ��x r� � r E I � -r S �ALT� DEP,�'.`�iE�11R,�EMENT�2�? jgb
31. Plaster Bra,vn"Coai7* S � c*t- w � I IK 7g. FINAL 0.�tlZ4PECi�JN M^ F r
. 32. �ectricaf$owgr Me(��f��al ; x� � � � 80'.j FOOD CERTIFL;CATE F6Sg1ED- t:
33. F.SnahElectric� � `' ?7 < � y, Notes: '"y �� * "7 � �'S
"34. na�Fle�Sln � �q. �6hioni`�S :� �` ' � � a: S Cl� x
� ��.. 9... '-iY� �� � [+t x : � . C• r-{ � F C * �
� 35. nal�GasEipe-. ezU+ p,V� •• x r. ix � xo O� �� O�T
I-� -r� t `'
3�0. �{OD[�A� �dnOPY 'F J I T�'7 G 'I ("t I �M " !'I['1 � Cr'
s n i �cn 'x m �o :m >r-:
'37. �tnal-Factory Firep�ace T � F-F- v M�� �.t x -� v .•-
i r1' O v
�38. �inal'Plumbi�g * ��� i � � I �. ,yQS �; ` �
�
� 39. atei'Service•Final �, g i �g z; I �a. ' -. � o fi '-
x -7
�40. Gas Service-Final ��`� �� •r S v r•; I �,fi O� o[u x "
:� 4 r-. [-. ;*j K � Ii i-. . O i ic C,
i �
� 47. Solar OomesticFina� - ;,j �� * i � r;; V -io a� M x -
�
. .42. Backflow Prev�nter ; . C� ` ^ ' � '�.''�`° • >�"" �r O `
x N Q H H M H '1 lT; ='.M1GrI R17 M
43. Backflow Irripatio� t N x G X� '�' i �r !1 •
� x^. o
�4%3. andscap�lrfi."qatio*System���? h *n �� Q�-, � �' '� �� ' ti r'
?S F
�5. �ound ALQenNdtion. y�� . x f� [*7 T7�' cr C b;� Fl� �
.. r�
36. Handicap Regulatiprfs H Q 'k F � U; S �-o S �A
!' S 'r S � K r; (:7 �7 id ��
47. �1NA;l STRIFE�TUR� & BUIL' �NG * F � � a �-
- - c
48. � N � PIANNING� `'•`' ' n' ' � '� * °"
.i t �: � F{ .- �; „ S s ri
'A�9. �ect4'ic Release to �dison � � - '^ �` � '
k b . . ..^, . � � � o
t` � r.�;
S0. �ias Wplease to SoutNMem Cali(q�y7j�Gas Co � � �: F; y �� �n Y v�
51. CERTIFICATE OF OCCUPANCY �� � � " -
No. Date
anonrssaem�awc: 555 ANTON HL
"""E"'s""YEi��v�o"": SAKIOKA FARMS
moxEss: p0 HOX 2097
•^ TEAMINAL ANNEX
I�YPL. WIl1N0 ADURE55:
UNT:
11TH CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 075834 PLAN CHECK NO: 04817-95 L
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FZR
urcxnEcron�mtsn: TRI—SIGNAL INC. ���� 0
�xcxoa�c•si,00n�ss: 1945 GARDENA AV 818-247-1194 ��:
GLENDALE CA 91204
c«+m�crarsru� MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
camucraxs�uwx� P O HOX 509
aoo�ss: WALNUT CA ucxo: 230813
91789 urar:
LICENSEU CONTPACTOH9 OECLAq�TION: I haroby NFm uMm penely d pmjury thet I em liceued uMm prwiuma d Cheqw 9
(commuidrq wn� Section ]000) d Diwun � d Ne Bumrov eM Proleeebu CnEe, end my 4miue u in lull brta enE Nlae.
cmuc.No.:006558 uc.cuss: uc.No.: 2308�13 EXP: 12/96
�� I�
o.�.: c�nwa:
OW NEF BUILOEN DEC I4TON: I Mreby etfum uMx paiWy tl pse�uy IIW I eRsm hom iM Comream lioema lew la iM
Io0owT0 �eeaan (Saeion'l031.5 &nnaat end Pralxebna CaEe: IvryW a oou Wirli Vuim e Mem� to wrmWct. edx.'v^Vwe.
Esmd'vh, n rapei ary sVudve, pror b Is'swups, e6o rpuuae �M w W lo Ne e eqroA �wemw tlw M a sM
b liumad punuem to tM powiam d Ihs Coniraqas Licws lew �CMplm enery wtlh Setlion )OW) d�+ebn 3 d �he
BuzMee uW Rabaviom CoMI a thet M a Me is mamq Nerelmn end iM bnu la Ihe dbped ssemqion. Nry videtion d Setlion
)W 1.5 by anY WW�� lor e pe'm! umjsq� IM applieaM to e�'n+l penelry d nd mors ihenlHe hunAred Adlen �550pU.
❑ I, n owror d IM prapeny n my empbyeee w1� wepea n Ihei sob canperueiion, will do Uq wak, vd Na neucNn u mI iMeMad
a dlareE br eeb (SeGbn �M. BuYrou and Prdnebne Cade: TM ConVapon Lioerus Lew doee ml epqyto en ownerd popery
wlw Wids a inprnee tlwsan. W who Ew �utli xwk HmvNl a MnM n thrwpl� I�e n Mr own ampbyss�. pwidsd tIW such
imqwwnmp ua mt interdad a dlad la uk. tl, howwar, �M WiNiip n inpavmam u sold wnhin on� yw d oompbtion, Ma
ow�w�waa« .;n nw. in. wedn a w�+�o n. «.n. em m wue «imwo.+ ta m. wmo» a.w�.
❑ �... o.,.. a �n. ww.M. em ..ausNlr omiraenu .ah 4wmod con�mcta. m muaw u. adetl (seuion roM. a,.ins.,.�,e
Profauun Code: Ths CoMrtlm Licrw lew doee mi eGVN b an owrw d V'WMY who bui1C� a imG�'a tlraon erd Ma
mntrecta la adi pqaaa wu� e mNrtlorp) fwm�tl punueN lo �M Camrrfm lbma lex�.
� 1 em eRamq uMer SecYm: B. 8 P.C.. b Ws �mson:
Dtle: O�nw:
I do hereby ceniy Nn I am ewme W eM undenieM �M iepuiremenb d Cellanu HmXh eM Sahty Cods 9splom 25505.255�3, eed
I u5�0. enE Ihel I a any Mun buildiip oocupent will / wil na (rircY orie) med b oamply wMh uid peb aodx uM Iha �epuirommb M
aparmnlormrol�uctionamodMralionhom�haA'v �u�iy �epemmlDislnd.RuiAaMisloonYiutlonepp4Wion�eroeomqiromMesa
provieions.
Dele: AppliuN:
WONKEN'4 COMPENS�TON DECLAPATON: I Mraby alfimi uMr pruAy d pa��vy ons d tlw b4orrinp Mde'elba:
� IhevsenCWmeintenaweYfcrosMmriw�tioutlimunforxvrkan'compamaten.nprwitl�Elaby8wLm9MOd�Mlebor
CoM, la �M pAamarce M Ne waM1 lor wNch Nu pamiu b Ivued.
C] in...ww���m.�wnen�v�o�i�,..�,�e.a.m���eaMs.a�,erooam.�e«cae..�«m.wi«�w,udm.
R work la whidi i�ie permil u iwusd. My worka��' comPo��� inwrentt urrMr erd pdky num Wr ue:
c�.: FTRRMANS F��7+����- EXPIRES
PdiryNumbr: i1W(�RnF�%��/ 07/01/96
(Thia eMion nse0 nIX be romON�M I fhs pemil Is br ons hurrdrsE EWkn RI00) oi Nas 1
� I qntly Ihet in �he pMormenoa d Ihe work Ia which ihie permB I� hsuM, I NNI np ompoy enY W� In any mennor m ee to
become �ubl� �a �hs xurlan' companwion levn d Colibmle, eM pras Ihel tl I�hould became �ubjwf �o ��s vrorke�e'
� penuibn pmn'sione d Ssdiwl�]OO W tho lebor Coda, I MNI 1 wNh mmply xi IMee pmvi�ioru. �
o c, i
Dvs: O / l0 npdicem:
W�m/np: F�Ilun ro ucun woilrwti rompxwtlam m�r�p� Is undwNl. �nC �M uDl ef �n wnploy�r b MMn�I p�n�ltlu �M
clvll 11rw� �p ro em h�ndid tMuuM ooll�n (tI00,P00), M Walfbn ro M� 1 aI mpriutbn ��P� �� P'DVIEtl br In
Sxtlon J106 0/ Ilu L�Dor Cod, InMuf, �ntl �ttomry i/ww
CON9TRUCIION LENOINO 16ENCY: I heroby ��m uMer peneMy d per�u tMn ia e canx�utlbn kndvq epanry br IM
Po�ormenm W Ihe xork Iw xfiitli ihc pemiY n esuaE (Sed'nn 309], CN. C).
LENOEN'S NAME:
LENOEF'S ADDPE39:
I cerlity Ihe� I lieve ned thia eppicelion enE slels iMl Ihe ebora inlorme�bn la rorrep. I epres to compN �h dl ary eM ooumy ordineMee
eM eteie leMe releing to Wildvq wnaVuaqn vd haraby eulhorixa repraoentelive� d Ihu olyto enler upon IM ebova�meMiorwtl pmpary
br inepeaion W �w%��
i CHUCK JACOBI JR
w
Date: / � �
(5151-10.WP) WR�sGaiWiq 8 SNery; Oreen-Fb; Canery-Appirani; Pink-Reranw; Ookenio��awemr
PERM NO: F 075834
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74630
*�+t+��**�**x�*x�**+��r*�r*x�xx�rtrt+t*��r�*�*+c*+r�+t*�r�**�����**�***+t���*���**�x���**�x x**x
Z O N I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ MAIN HUZLDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN
--------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
1E 1E iE if iE if 1E 1E 1ElE iF if if if IE 1F iF 1E iE IE 1f If iE 1f !E 1E 1E 1E 1k 1E 1ElF 1E 1f 1E IE 1E 1Elf 1E iE 1E IE 1E fE 1E 1f 1E iE 1ElE iE ik iE iF ik 7F 1flF if 1F iF 1f 1f if 1E 1f !E 1F iF IElE iF 1E 1E �E i(� Ik 3E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: �
iEiEiElEiE1EfE1E3E1EiFififlEiEiEiflEiElEIEiEif�f�{Fif�3f�iF��iF�{F{FiFi��FiF iF�FiEiE7tiElE�E1(�iE1FiE iEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 90.00
658 SMIP/NON—RES
PLAN 58,50
ISSUE FEE
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 90,00 0,00 58.50 148.50 148.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
iF iF ik fk iF if� iE �If� dF iE 1E iF if iF ik jE iE 1F 1E iE 1h if iE it 1E 3E iE 1E IE 1E if �k iFiF iF 1F iE 1E iF iF iE �lE if iF if if if iF iE ik if 1E 1E if iF if if ih iF if if 1E 1E 1E if 1E �E if 3E 1E if iF 1E aE IE af 1E iF iF
I N D I V I D 0 A L F E E H R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR
90 FIRE EQUZP FEE (FROM BLDG VAL TABLE) 1.00
END OF FEES
♦ •
:-� -
•1 �1
'a L�y ..l � �::.Y i v ' � ''
1%.!IC� l�. . ' �. _ .Je�i
CONSTRUCTIpN AND PLRNRf1NG POOI _, aPA _
APPROVALS Permit # "- Date Inspector qppROVAIS Permit # _ Date inspector
�
i. 7emporary Electrical Service or Pole 52. Pool & Equipment �ocation .
2. Soil Pipe-Undrgrnd. t' � 53. Steel Reinforcement ;
-3: Electrical Conrl.uit Ufi�itv�Undrgrnd. 54. Forms '
� 4`�lectrical Conduit-Undrgrnd. � 55. Electrical Bonding
. 5. Steel Re�nforcefnent 56. Rough Piumbing & Pressure Test
6. Electrical UFER'Grnd. 57: APPROVALTO COVER�GUNITE .
. 7. Footings ' =�' 58. Electriral Conduit-Undrgmd.
- H. fou�datio� � '- ' 59. 6as Pipe, O UnGrgr�d., Test _
9. Water Pipe-UndrgPnd. " � 60. Backwash Lines,_P-Trap, � Undrgrnd.
10. Structurol Floor System , 61. APPROVAL TO DECK �
11. Property Sewer 1; ne & House Connection 62. Backwash & Receptor-Finai �
12. Sewer Cap �- - 63. Heater & Vent-Final ' � .
13. Roof Drains _ , � 64. Plumbing System � Final � .
14. Rough Plumbing � ,. . 65. Electrical-Pinai
15. Rough Electrieal-Conduit � 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access Approval . '
il. Rough W�ring Sign 68. APPROVED FOR PLASTERING
� 16. Rough Electrical�T Bar Ceiling� 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT
_ r. .
20. Rough Factory� Pir,eplace - ; e° .. '. �APPROVALS,-�� Permit #
21. Dutts, in Structure� •� ' _ ` 70. Underground Hydro
22. Ducts, Ventilating ��i �-. `�',� 71. Produci ~i in ❑�as ❑Oil
P�P 9
23. Gas Pipe-R'ough & Test � • ,r - � � . � 72, Underground Fldsh -
_`
24. RoofFraming'� � • " ' �r ��;-�7�`,:Undergrnd.StoracyeTank,OGas �Oil
25. Roof Sheathing �� t - ti • ^' " 74. Overhead HVdro�_
26. T�Bar Ceiling (Str�tGra1) & Monocoat � � �- r: `. 75; Dry Chemical '
27. Frame and Flashing , �� - 76. Dry Standpipe ',' +
28. Lathing&;Siding,_ � •"�T . � ' "�� 7f;� FIXEDSYSTEM�FINAL .
29. Insulation y i+ . _ 78; FIRE PREV. FIfVAI. - �24rLlb
� 30. Drywall Nailin9 ;,_ r - `HEAITH DEPT. REQUIREMENT
�x
,
- 31. Plaster Brown�Coae +• . a - 79. FINAL INSPECTION
32. Electrical_powe� MetArFinal � � �' 8p; FOOD CERTIPICATE ISSUED .
33. Final EleEtric - - � . � �. � � - Notes: - � �
34. Final' Neating & AiY� Conditioning _ * _ ' � - " �
35. Fina� Gas Pipe•Test � - � , . ' . .
' 36. Hood or CanoDY "_ � ' - � ' � .
37. Einal�Factory Fireplace . `'.�. � - � .
38. FinaF Plumbing �� � , r
r
39. Water Service•final ,` n �� � _ , - '
, r :,
40. Gas Service-Final � - _ ' -
41. Solar pomestiG-FinaY . _ _ - .
42. Backflow Preventer � � .
i .
43. Backfiow Irrigation �,;�- ; � ' : �
44. Landscape IrriBation•System .'.G� .. � ^ r �� � � � - '
F.
45.SoundAttenuation' ",;, � � �.°�' . �.` .
46. Handicap Regu�a[ions � _. .
47. PINAL STRUCTURE & BUItDING ' , ' �
48. FINAL PLANNING • �� + �' • '
49. Electri'c Release to Edison � ''.' :; �
, �
50. Gas Release to Southern California Gas Co � _� "' �
51. CERTIFICATEOFOCCUPANCY �
No. Date
0
• -- � _ , • , 6
(714) 754-5273 • Fa<(71C) 754-4856
Job Adtlress: 555 ANTON BL
Suite:
Vicinity:
Parcel Nunmber: 41050110
Applicant: JIM BARNETf
Address: 2727 ORANGE ST.
ALHAMBRA,CA
Owner: SAKIOKA FARMS
Address
SIGN PERMIT
Zoning:
Phone: (626) 4573000 x240
Zip: 91803
Phone:
Zip: 94137
Contractor: HEATH OPERATING COMPANY
Address: 2121 OR4NGE ST
ALHAMBRA,CA
Arch ! Eng :
Adtlress:
Phone: , (626} 457-3000
Zip: 91803
License: 73�013
Phone:
2ip:
License:
i i rn�n univc, t;va � n mtos�, cn a[o[u
Status: ISSUED
Applied: 06/2712000
IssueO; 06129/2000
ISSUED BY: ��.
EXPI��
�(� �r �
b �h^�''�"� � �
�
SCOPE OF PERMIT
TND 227 SQ. FT. INTERIOR ILLU MINATED PENTNOUSE TOWER SIGNS FOR BMC SOFNIARE
INCLUDING LOGO FOR'BMC SOF7WARE".
Plan Check: $163.31
$0.00
Permit: $251.25
SMIP Com: $3.15
Other; $0.00
$0.00
Inspection: $0.00
$0.00
$0.00
Totat: $417.71
NOTES:
FEE SUMMARY
PLANNING & ZONING
Calc Valuation:
Cleimed Vatuation;
$15,000.00
$75,000.00
��, NOTICE: The work authorized by ihis permit shall comply with aII applicabie hantlicap access requirements under Calitomia statutes and related ��,
� regulations. (Ord. No. 92-28, § 1, 12-2i-92) �,
• i
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspentled or abandoned
fo� a period of 180 days.
INSPECTIONS: I� order to� the work authorized under this permit to be consideretl legal, such work must comply wilh all applicable cotles, and all
reqWred inspeetions end finai epprorrel must be ohteined Failure to obtein inspectians and tinal approvet will result in the e�cpiration of this permit.
I FOR INSPECTIONS CALI: (714} 7545628
0
�
WORKERS' COMPENSATION DECLARATON:
1 here6yaHirm under pena�ty of pe�ury one of the tollow'mg deciaratlons:
❑ � have antl will maiMain a cenKcata of mnsam fo selidnsure for workers' compensation, as providetl for by sealon 3700 of ihe Lebor Code, for the pertormanCe of Ihe
woAc for which this permif ls Issuetl. .
� 1 have antl will maintain worlcers' compensatlon GwrerKe, as required by seclipn 3700 of the Labor Code, fw tFre peAormariCe ol the work 1w which Ihis pgmrit is issueC.
My workers' compenseHon Insurence cartier atW policy number ere:
cerner. �Wt EP IC�F,ti/ _�(.�(ZX7-.��-�oi l�A15 � Policy Number. � CJ `T�Fl2 ?7/ D(
(fits secrron need not be comp/eted�i! (ne pertnir rs ve/ued et one hunCred dWters (St00) orless.)
i ceril ihet In Ihe Rormence of Ihe work for whlch Nis �
❑ ly pe pertnit is issued, I shell noi play any person in any manner so es to �ecome subject to tt�e workers'
cpmpensetion iaw9 ! Celi�omia, en ee �he� if i sh0u1C bBCome su6ject to the wo 3' compensetlpn prodsions af Sectlon 3700 of il�e laDor Code, 1 ShaA farthwit�
comO�Y w�m lhes r 'sions, / j /
Applicam Signature: �.i .��� Date: _T/Z �f(xh '
WARNINp: FNLURE TO SE E WOflKERS' COMAPENSAT%7N CAVERAGE IS UMAW FI1L ANO SHALL SUBJECf AN EM%.OYEfl TO CRIMINAI, PENALTiES ANU qVIL FlNES UP TO ONE MUNDRED
TMOUSAND DOl1ARE (E1a0,000), IN AODITION TO iME WST OF COMPFNSATNJN, OAMAGES A$ PROYIDED FOR IN SECi10N 9]060F THE IABOH CODE.IMEREST. AND ATiORNEYS F£ES.
LICENSED CONTRACTORS DECLARATION:
i heieby eNfrm ihat 1 am
force antl eHect. Lk. k_
Coatractofs SlgnaMre:
of Chaptar 9(commendng w0h SecliqrY/000) M Division 3 of IOe Business antl P�fessians Cade, entl my iicense Is In
l Class a — b
Oate:. ____ ���-.rY Ct1 ._ .
C�NSTRUCTON �ENDING AGENCY:
❑ I hereby a�rtn that there Is a co�struction lendlnq 89e�o7 tar the pedortnance u( the work lor whlUi this permit Is Issuetl. (Sec. 3097, qvil Cotla).
lflnders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATONS:
I hereby attirtn that under penalry ot pe�ury Ihat 1 am EXEMPt FROM 7HE CONTRACTORS LICENSE lAW tor the tallowing reason (Sec. 7031.5, Busfness entl Professions
Cade: Any Ciry w cou�ry which requires a partnit to construct, altar, improve, demolish, or repair any structure, ptior to its issuance, elso requlres the applicam for suc� pertnit
to tile fl signed statement that he or she is licensed pursuant to the provisions of the Cantracrors License Law (Chapter g(commencing with Section 7000) of Division 3 of Ne
6usinass and Pmlessions Cotle) or that he or s�e is ezem0� theretrom antl the basis tw the allegetl ezemption, Any vbletlon ol Sectlon 7037.5 by eny applicent for e permif
sub)ects t�e appficant to e civil penalty ot not more than INe �untlretl dallare (350o) J:
❑ 1, as owner at Ihe property, ar my empioyees wilM1 wages es Iheh sde compensauon, W ILL DO THE W ORK, en0 the strucwre �s not intended or a8eretl ior sale (Sec.
7044, Business entl Professions Cafe: The ContractPrs License Law tloes nat sppiy to en owner af property who buitds or improves t�erepn, and who tloes such work
himseit or hersetl or through his or her awn empioyaes, providetl ihat such improvemenGs are not inten0ed or otlered for sale. it, however, the buildng or improvemant is
sotd within one year of comD�Btion, fhe owner-buiider will have fhe hurden M proving Ihat he or she �Id not 6uiltl or imp�ave for purpose af sala.).
❑ I, es owner of the propeny, am.EXCIUSIVELY CONiitACTNG WITH LICENSED CONTRACTORS to constmq the project (Sec. 7004, BuSiness and Profes5ions
Code: The(wn�reqor3�llcenge;L'aw does not apply to en owner of DropeAy who builtls or imprwas Ihereon, antl who contracts tor such project with a coniractor(s)
licensa pursuaht�to,lhe"CoritrsCtorS�IJcense Laws.).
c`a
❑ 1 am ezempt under sec. Business aM Protessions Cotle fw this reeson:
Signature: '�� �ale:
Ownar ID verifiad by drNers ticanse. ❑ Ve5 ❑ No Drivary License Na. F�cpites;
Verification ot Ownership by (type oi documem, i.e. - properry fax bill or deed):
DIVISIQN OF INOUSTRIAI. SAFETY PERMR CERTIFICATION:
❑ 1 here6y cenity lhet no ezcavation tive (5) or more feet in depth imo whic� a person is reqWretl m tle9centl, will 6e matle in cnnnectfan with work authorized by this
portnit, and ��at no 6uiltling sUucture, scattdding, ialsewc�k, or tlemditioo ar tl4sman0ing thereot, wlll be mere t�an thirty�siz (36) �eet higb. (Chap. 32, Grp 2, Art 2, Sec.
347, Title 8, Celitomia Atlmioistrative Code).
� As owner-builder, 1 wlll not emplay enyone to do work wAlch would repulre e permtl from t�e Divislon o� IntluStriel Safery, as noletl ebove, unless such person hes e
permit to do such work frwn tne divisfon.
S�gna[ure: Date:
OiWsion al IntlustAal Safery Permit NumOer.
CERTiFlCAiE OF COMPLIANCE AND AUiNORQATION OF EMAY: I certiry urMer panalry of pe�ury that I have reatl this application and state ihat tha information given is
correcl. 1 agrae ta comply wilh all s7ate laws and dry ordinances raWUng io buliding wnstruction, and authorize representatives of the Ciry oi CaSta Mese to enter upon Ihe
above-tlescribed property tor lnspection purposes, l eg�ee nat to occupy or allow otcupency of any builtling authorizad 6y thls permit ua41 final inspection.
i Signature Ot Leget Ownar(s� Date
,,� c�t,r�.t-�" � G/,z41ao f
i--- AnNOrAul�ori2edApplicam �— Date
GOpE I, MSPECTtONTViE
i� 7878 Flxnd System Final Fire Prevention
I 7266 Poof Spa final
200 Final Re�Roof �
201 Final BIocWRetaining Wall
202 Final Fadory Fire Piaca
2�3 Finai S�gn
204 Finel DemOliiion
24GB d6
Pih 119IDdk5
CODEt INSVECi10N�YPE
206 Fina� Machanical
208 Finel Plumbing
210 Finai Elootricsl
272 Final Flre Preventbn
22D final Pianning Approval
222 Fi�al Site
250 FinalBuiltling70ccupancy
Pdg l�5
�
. � � CITY OF COSTA MESA �: �
� BUILDING DIVISION
� � DEVELOPMENT SERVICES DEPARTMENT //�''-�'
� PERMIT PERMI�T NUMBER
'� `A'
F98-00162
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite:
Vicinity:
555 ANTON BL
1ST LEVEL THROUGH LEVEL.
Parcel Nunmber: 41050110
FIRE SUPRESSION PERMIT
Zoning:
App�icant COLLINS, JERMEY - ' "
- . �. �r� -+< , -_ .-
Address: /��X � " - - - : _ ' - - .
Owner SAKIOKA-I
Addresa � ��� � �
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iPlan Check. ± $297.54
,' .-Permit: ;,$457.75
� ��� � �Qt�12f ,��1, $�.��
a.
�� { ,Total ` '�;$755.29
��� t , '.:�
Slatus: ISSUED
Applied: 07/74/1998
Issued: 08/OS/7998
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%� . Zip: 94137 \ . . < _ " '
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� �� ��_ �,.Lice�se:„327186� .. .i ,, - , - ��\
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� �_!,_„? _ ` - -' SCOPE OF PERMIT ' . ; �,--� ,.', . �
FITING TO STAIRCASE RISERS FROM 1ST LEVEL THROUGH �12TN LEVEL::•� � -��� ���
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� r, FEE SUMMARY ; � : . \� „'
/ � r,. � _ ;> >� �
� � ��.. ��.� �� �;��,,, �"� �- ; Galc Valuation: % go.00
� � - - - Ciaimed Valuation: 3s�,000.00 `
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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
requlred Inapeetiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of Ihis permit.
FOR INSPECTIONS CALL: (714) 7545826
WORKERS' COMPENSATION DECLAHAT14N: �
I hereby affirm undar penalry of perjury one of the follovnng declarations:
❑ I heve end will meintain e cartificete of consent to self-Insure for workers' compensation, es provided tor by section 3700 of ihe Lebor Code, tor the pertortnence oi iha
work for which ihis pefmit is issued.
�I have end will mainlflin workers' compensation insurance, as required by section 3700 of ihe Labor Code, for the perfortnance of iha work for which this pertnit is issuetl.
My wor��e�r/s comp�\p\sallon-�Insurance carrier and policy mber ere: Q �7
Cerrier. [ot�..`J.�j�nc r` _�_�----. � PollcyNumber 3�(1Q�� T
(fhls sectlon need no�mp/etetl i/ the permi( is velued at one hu �red tllr ollars ($100) or /ess.J
❑ I ceAify that in ihe ormence of ihe w f hich Ihis permit is issued, I shell not employ eny person in any menner so as to became sublect to the workers'
compensetion lews o lifomla, and eyr e th I sha�tl become suEject to Ihe workers' compenselion provisions of Secct�lon.370 oo�f the Lebor Code, I shall torthwith
cm SigneWre� / P�lo �� // Dete: ) u`� �`v
T710USANDWLLARE SS00,000),INOADDIiIONTOMTHECOSTOF'CaMPENSATIqJ DAM4G SASPFlOVIDEDFORINSEGTION3]O60FiHE�LA90RCODE,IMERESTLANDATTORNEVSFEESDRED
LICENSED CON7RACTORS DECLAPA710N:
I hereby eNi untler rovisions of Chapter 9(commencing with Section 7000) ot D' ion the B siness antl Professions Code, and my licensa is in full
e ect. Lic. A �a � 1 �( las C l l
Contrecrors Signatu � �
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that ihere is e construction lendinq egency for the perfartnance oi the work for which Ihis parmit is issuetl. (Sec. 3097, Civll Catle).
Lentlefs Name: Lendefs Adtlress:
Signeture: Deta:
OWNER-BUILDER DECLARATIONS:
I hereby a�firm ihet under panalty of perJury ihet I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, 8uslness and Protessions
Code: Any city or counry which requires a pertnit to consimct, elter, improve, demolish, or repelr eny structure, pdor to ils Issuance, also requires ihe epplicant for such permit
to tila a signed stetement that he or she is Ilcensed pursuant to the provislons at the Canirectors License Lew (Chepter 9(wmmencing wit� Section 7000) oi Division 3 of the
Business antl Professions Code) or Ihat he or she is exempt thareFrom and the besis for Ihe alleged axemption. Any violation of Section 7031.5 by any epplicant fo� a pertnit
subJecis Ihe epplicant to e civil penelry ot not more then five hundred dollars ($500).):
❑ I, es owner o( the property, or my employees wfih wages as iheir sole compansafion, WILL DO iHE WOHK, and Ihe structure is not intended or ottered for sale (Sec.
7044, Business and Professions Code: The Contrectors License Law does not apply to en owner of property who builds or improves thereon, antl who tloes such work
himself or herself or through his or har o�y� employees, provided Ihat such Improvemenis ere not intended or oflered for sale. tl, however, Ihe bullding or improvement Is
sold within one year of completion, �he qwner-builtler will heve Ihe burden oi proving thet he or she did not build or improve tor purpose of sale.).
❑ I, es owner of Ihe properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTAACTORS to construc� iha project (Sec. 7044, Business and Professions
Coae: The conirectore License Law Ooes not epply to en owner oi property who 6uilds or improves Ihereon, antl who contracts for such project with a coniractor(s)
license pursuant to t�e Contrectors License Laws.). .
❑ I am exempt under sec. Business antl Protessions Cade tor ihis reason:
SlgnaNre: Date:
Owner ID verified by driver's license. ❑ Ves ❑ No Dnver's License No. Expires:
Vedflcetion of Ownership by (rype of tlocument, i.e. - pmperty tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERM17 CERTIFICATION:
❑ I hereby certify Ihet no excevetlon tive (5) or more feet In depth into whic� a person Is required to descend, will be matle in connection with work authorized by this
pertnit, enA ihat no building structure, s�ryolding, falsework, or demolition or dismantling ihereot, will be mora than thirty-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, THIe e, Celifomia Atlministrative Cqde).
❑ As owner-builtler, I will not employ enyone to do work which woultl require e pertnit from Ihe Divislon of Industrial Setery, es noted above, unless such person hes a
pertnit ta do such work from the division.
Signeture: � �ate:
Division of IndusMal Satety Permit Number.
Will Ihe eppllcant or present or fuNre bullding occupant neetl to fila end certity a Business Plan tor emergency response to release or threatened release ot a hazartlous
meterial? ❑ Yes ❑ No
(Sec[ion 25505 of ihe Californie Heelih qnd Satery Code requires, with some exceptions, lhat e Business Plen be tiled with ihe Costa Mesa Fire Department by every
business which has at eny one time dunng a reponetl year a quantity ot hazertlous meterials equel to or greeter than e weight oi 500 pounds, or a volume of 55 qallons,
or 200 cubic feet oi compreuetl 9as at slandard tempereture and pressure).
.........................................................................................................................................................................................................................................................................
Does or will ihe eDD�icent or present or tuture builtling occupent nead to tile a regisiration fo�m for acutely hezertlous matenals? ❑ Ves ❑ No
(Section 25533 of the Celitomia Healih ehd Sefety Cotle, with some exceptlons, requires registratlon with the Casta Mese Fire Depariment by each business which at any
one time hes on hend a Quantiry of ecUtely hazardous metenels equel to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cuDic feet oi
comoressed qas at stantlard tempereture antl oressure).
or wlll Ine eppllCent or
prepare an RMPP (Risk Menagement antl
25534 of the Calitomia Healt� dntl Safery Code O�ovides that tha
ant of en RMPP by businesses which ere repuired to register ecute
en RMPP is presently required,
and
Fire Depenment may require the preparatlon, certification end filing with Ihe Fire
'� materials with ihe Fire Depatlment.
�es or wlll Ihe epplicent or present or tUture bullding occupant requira tor the work whlcb Is t110 Sub�eC[ of [015 ap�
im the Swth Coast Air Queliry Manegement District or Irom any other air polWtion cnntroi Cisirict or egency9 ❑
ection 658502 oi �he California Goverryment Code requires Ihat the requested infortnation 6e tumished on applica
..................................................................................................................................................................................
ill any pert of ihe faciliry to be construc�etl under this parmit be within 1000 feet trom ihe outer boundaries of a sch
yes", ihe faciliq must meet the requir�ment oi Sections 25534 and 42303 of the Califomia Healih and SaFery Ca
..................................................................................................................................................................................
e pertnit irom the South Coast Alr QUaliry Menagement District or other elr pollution control dlsirict or egenc�r
�Olicetion, have ell of the tlisclosures prascribetl by Calitornia Haelth antl SeteN Code Section 42303 been mede.
❑ No
fornon-residential
No
`�
(If'yes", attach cetlificate o� compliance irom ihe appropriete air polWtion wnirol officer).
CERTIFICATE OF COMPLIANCE: I certify Ihat under penalry of perlury ihe intormation given ahove is correct I aqree to comply with ell stete laws entl ciry ortlinances
regardinq Hezardous Matedals entl Emissions.
Signature: Date:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENiHY: I cehity under penalry of perlury ihat I have read Ihis application and state Iha� ihe infortnetion given is
conect. I agree to comply with ell state laws and ciry ordinances relating to building construCtion, end authonze representatives of lhe Ciry of Costa Mesa to enter upon ihe
above-tlescnbed property for inspection purposes. I egree nol lo occupy or allow occupancy of any building authorized by this pertnit until final inspedion.
CO�E I. INSPECTIONTYPE
1616 Fized System Finel Fi�e Prevention 1 't .�a �,
1266 Pool Spa Final ,
200 Fnel Re-Roof
207 Final BIocWRetelning Well
202 Finel Factory Fire Place
203 Final Sign
20d Final Demolition
2449<fi
S4➢Et
208
208
210
212
220
222
250
8��@�
� Date
IHSPECTIONTYPE
Finel Mechanical
Final Plumbing
Final Electricel
Final Fire Prevenllon
Finel Planning Approval
Flnel Site
Final euiltling/Occupency
S 17 4 � ,� f
(714) 754-5273 • Fa�c (714) 754-4856 • w�vw.ci.costa•mese.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Appliwnt:
Address:
Owner.
Address
555 ANTON BL
41050110
FULFORD,TERRY
SAKIOKA FARMS
Comractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outle[s �
Switches
Non Res Appl
Res Appl
Service to 200a
Senice to 7000a
Servite over 7000a
Motors to 1 hp
Motors to 10hp
Motors to SOhp
Morors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Rvr Pole
Intermed Pole
NORTHRIDGE, CA
Phone: 818-540-5884
Zip:
Phone:
Zip: 94137
Phone: (818) 407-1986
Zip: 91324
License: 386619
ISSUED BY:
Status: I SS U E D
Applied: 12/27/2000
Issued: 12/27/2000
SCOPE OF PERMIT
ELECTRICAL FOR SWITCHROOM, GENERATOR PAD AND AUX. COOLING TOWER. REFF:B00-00925. 80
OUTLETS, 3 SWITCHES, 1- 1600 AMP SERVICE, 1 MOTOR OVER 100 HP, 6 SUBPANELS, 8
STANDING SECTIONSS, 1 TRANSFORMER 100 KVA/KW, 3 TRANSFORMERS OVER 100 KVA/KVJ.
523.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$65.80
$3.30
$0.00
$0.00
$0.00
$0.00
5124.30
$0.00
$0.00
$0.00
549.50
$0.00
$0.00
$183.00
$0.00
$0.00
$0.00
50.00
Quantity
0
0
0
0
80
3
0
0
0
0
1
0
0
0
1
0
0
6
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................uP to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misa Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights) �
Chrisimas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
$130.00 8
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$49.50 1
$223.50 3
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E852.40
COMMENTS I SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 1241-92)
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 Inapectlons and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
zao-ae �aroo�
WORKERS' COMPENSATON DECLARATION:
I hereby aHirm under penalry of perjury one of the followinq tleclarations:
❑ I heve and will maintain a cenificate of consent to self-Insure tor workers' compensation, as providatl for hy sectlon 3700 ot ihe Lebor Code, lor ihe peAormance of Ihe
work for which ihis permil is issued.
❑ I have and will mainlain workers' compensation insurance, es requiratl by sectlon 3700 of ihe LeOor Code, tor tha pedormance of the work for which this pertnit Is Issued.
My workers' compensation Insurence carder and policy number are:
Carner. Policy Numbec
(Thls sect/on need not be completed i/ fhe permit is valued et one hundred dollare ($100) ar less.)
❑ I certity �hat in �he performance of the work for which ihis permit is issued, I shall not employ any person in any manner so es to become subjecl to the workere'
compensation laws ot Calilornla, entl egree �ha� if I should Decome sub�ect to ihe workers' compensation provisions oi Sectlon 3700 of the Labor Code, I shall foMhwith
comply with these D�ovisions.
Applicent Signeture: Date:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UMAWFUL AND SHALL SUBIECT AN EMMOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOIXJE HUNDRED
THOUSAND DOLLARE (E100,OW), IN FDDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED WR IN SECTION 31O60F TME LABOR CODE, IFIrEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm that I am licensed under provisions ot Chapter 9(commencing with Section 7000) of Division 3 ot ihe Business antl Professions Code, and my Ilcense is in tull
torce end eftect. Llc. q Class N
Contractofs Signeture:
Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby eHirtn that thera is a conswction lending agency tor t�e peAortnance of �he work for which �his permit is issued. (Sec. 3097, Civil Code).
LentleYs Neme: Lentler's Adtlress:
SigneWre:
OWNER-BUILDER DECLARATIONS:
Dete:
I herehy affirtn t�at under penalry oi per�ury that I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any sWCNre, pnor to its issuance, also requires the epplicant tor suc� permit
to file e signetl statement Ihet he or she is Ilcansed pursuant to the proWsions of the Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of DiviSion 3 of ihe
Business end Protessions Coda) or thet he ar she is exampt cheretrom and the basis for the allegeA exemption. Any violation of Section 7031.5 by any epplicant far a pertnit
sublects Ihe applicant to e civil penelry of not more Ihan five hundred dollars ($500).):
❑ I, es owner of the property, or my employees with wages es �heir sola compensation, WILL DO 7HE WORK, and the structure Is not intentletl or offered for sele (Sec.
7044, Business and Professions Code: The Contractors Licensa Law dces not apply to an ownar of property who builtls or improves Ihereon, entl who does such work
himself or herself or through his or her own employees, provided that such improvemems ere not imentled or oNeretl for sela. It, however, the building or Improvement is
soltl within one year oi completion, the owner-builder will have the burtlen of proving that ho or she did not build or improve for purpose of sale.).
❑ I, as owner of the DroOarty, am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business end Professions
Gotle: Tha contraqors Llcense Law does not apply to an owner of pmpeny who huilds or Impmves thereon, and who contracis tor such project with a comrector(s)
license pursuant to the Contreclors License Laws.).
❑ I em exempt under 58c. Bu5in855 and Profession5 Code for ihi5 reason:
Signature: Date:
Owner ID verifie0 by tlnver's license. ❑ Ves ❑ No Drivefs License No.
Vanficetion at Ownership by (type oi documem, i.e. - properry tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I hereby certify ihat no excavetion five (5) or more faet In tlepih into which a person is requiretl to tlascentl, will be metle In connection with work authodzed by Ihis
permit, and ihat no building simcture, scattolding, talsework, or tlemolition or dismantling thereot, wili be more ihan ihltly-six (38) feet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Titla 8, Calitornia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would reduire a Dermit from Ihe Division of Industrial Safety, es noted above, unless such pereon has a
pertnit to tlo such work irom t�e tlivision.
SignaWre: Date:
Division af Industrial Safety Permit Number:
CER71FlCA7E OF COMPUANCE AND AUTHORIZA710N OF ENTRV: I certify under penalry of perjury that I have read this epplication and state that Ihe information given is
correct. I egree to comply with ell state laws entl city ordinances relating to builtling conswction, end authorize representa�ives ot the Ciry ot Cosia Mese to enter upon the
above-described properry tor inspection purposes. I agree not to acupy or allow occupancy of any building authorized by Ihis permit until finel inspection.
Ot Legal Owner(s) Date
AnNOr Authorized Applicant Date
CO�E I, INSPECTIONTYPE
1616 Flxetl System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Final
Final Re-Roof
Finel BIocWRetaining Well
Final Factory Fire Place
Final Sign
Final Oemolition
Qd¢, U �Qj�.j INSPECTIONiYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 Flnel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Buildin<yOccupancy
d`�
lt{�AL@
(714) 754-5273 • Fax (714) 754-A856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
Contrector:
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1hp
Motors to 70hp
Motors to 50hp
Motors to 100hp
Motors over t00hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circui[s
Temp Pwr Pole
Intermed Pole
555 ANTON BL
41050110
JIM BARNETT
SAKIOKA FARMS
ELECTRICAL PERMIT
Phone: 626-4573000X240
Zip:
Phone:
Zip: 94137
HEATH OPERATING COMPANY
2127 ORANGE ST
� - Phone: (626) 4573000
ALHAMBftA, CA . Zip: 91803
� License: 737013
SCOPE OF PERMIT
2SIGN CIRCUITS FOR "BMC SOFTWARE"., RE:SB00-00075.
$23.50
$0.00
$0.00
$0.00
go.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
g0.00
$0.00
$o.00
$0.00
$0.00
$0.00
$0.00
g0.00
$0.00
$49.20
$0.00
$0.00
�uantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
FEE SUMMARY
Temp Dist System I Lighting
Busway/100ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to t0�kvalkw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Voll Wiring System / Ckt
Misa Conduit
Misc. Conductor
Circus ( gen or ntle)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Eledrical Fee '
Investigation Fee
Plan Check Fee
Reinspection Fee
Status: ISSUED
Applied: 06/29/2000
Issued: O6/29/2000
ISSUED BY:
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
80.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E72.70
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is nol commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order tor Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all
requlred Inspections end tlnal epproval musl be obtained. Failure to obtain inspections arM final approval will result in 1he expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARATON:
I hereby aHirtn untler penelry of perjury one ot the following Ceclarations:
❑ I have and wlll meintain a certificate of consent lo sell-Insure for workers' compensation, es provitlad for by sectlon 3700 of the Labor Cotla, for the paAormence of the
—/ work for which this permit is issued. .
L� I have and wlll meinWin workers' compensatlon insurance, es required by section 3700 oi tha Lebor Cotle, for the peAormanca of the work for which this pertnit Is issued.
My w/o�rkers' compensation Insunnrence carrier and policy num6er ere: /�
Cerrier: H� ��'��n7���/�.�J /.� � / PoliCy Number: ��. U 7SZ Z%I DI /
(This secfion need nof be complefe tl the pe�mit !s velued ef one hundred dollers ($100) ar less.)
❑ I certity thet In the pertortnance of Ihe work for which this permit Is issued, I shell not employ eny person in eny menner so es to become su6ject to the workers'
compensetlon lews of Celiforni3� end egree that It I shoultl become subject to the workers' cym pensetion provislons of Section 3700 of ihe Labor Cotle, I shall forthwith
complywNhihe e avisions// / / �
Applicant SlgnaNre: �� r� ��? s��.� j Date: y ZF
. j WARNING FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVEMGE IS UNIAWFUL PND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND dVIL FINES UP TOONE HUNORED
TTqUSAND DOLLARE (5100,0OO�.IN AODRION TO THE WS� OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTIIXJ 3�O60F THE LABOR CqDE, NREREST, AND FTTORNEI^S FEES.
LICENSED CONTRACTORS DECLAI7ATION:
I I hereby aflirm Ihat I am licensed under�rovisions ol Chapter 9(commencing with Section 0) ot Division 3 ot the Business and�ofessions Code, antl my Ilcense is in tull
force and eflea. Llc. a � Class a C—�/b
_1 ConhactofsSignawre: T= �%C..�.i./ � Date: le�2i' /�
T
y
CONSTRUCTION LENDING AGENCY:
❑ I hereby aNirm thet ihere is a construction lentling agency for the pedormance of the work for which this permit Is Issuad. (Sec. 3097, Civil Code).
Lentler's Neme: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARA710N5:
I hereby eftirm that untler penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business end Professions
Code: Any ciry or counry which requires a pertnit to construct, elter, improve, tlemolish, or repalr any sWCNre, prior lo Its issuance, also requires the epplicam for such permit
to file e signetl stetement that he or she is licensed pursuant to the provisions of the Contractors Licensa Lew (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Prolessions Coda) or ihet he or she is exempt t�erefrom enA t�e basis for the alleged ezemption. Any violation of Sectlon 7031.5 by any epplicant tor a permit
sub�ects the epplicant lo e civil penelry of not more than ilve hunGred dollars ($500).):
❑ 1, as owner of the property, or my employees with weges es their sole compensation, WILL DO THE WORK, end Ihe structure is not intentleC or otterad lor sale (Sec.
7044, Business end Professions Cotle: The CONrectors License Lew does not apply to an owner of property who builtls or improvaz lhereon, and who tloes such work
himself or hersetl or through his or her own employees, provided Ihat such improvements are not intentled or ottered for sale. It, however, ihe builtling or Improvement is
sold within one year of completion, ihe owner-bulltler wlll have ihe burdan of proving thet he or she did not builtl or improve for purpose of sale.).
❑ 1, as owner ot tha property, em EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to conslrucl the project (Sec. 7044, Business and Professions
Cotla: Tha canirac�ars License Law doe5 no� epply �o an owner ol proparty who builds or improves Iherean, entl who contraCts lor 5uch project wlih a con�rac�or(s)
license pursuanl to the Contractore Licanse Laws.). .
❑ I em exempt untler sec. Business end Professions Code lor this reeson:
Signeture:
Owner ID verifiad by drivels license. ❑ Ves ❑ No Driver's License No.
Venfication of Ownership by (type of tlocument, i.e. - propeny tex bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
Dare:
Expires:
❑ I hereDy certily that no axcavation live (5) or more teet in tlepih into which a person Is repuired to descend, will be made in connection with work authorizetl by this
permit, entl that no builtling sWcture, scattolding, falsework, or demolition or dismantling thereol, wlll be more than thirry-six (36) feet �ig�. (C�ap. 32, Grp 2, Art 2, Sec.
341, Title B, Califomia Administretive Code).
❑ As owner-builder, I will not employ enyone to tlo work which would require a pertnit from Ihe Division of Intlusinel Safery, as noted ebove, unless such person has a
pertnit to do such wark from the division.
Slgneture: Date:
Divisi0n of Industrlel Sefety Permit Number:
CERTIFlCATE OF COMPLIANCE /WD AUTHORIZA710N OF ENTFiY: I certity undar penalry of perfury that I have read ihis application and stale that Ihe information given is
correct. I agree to comply with all state laws and ciry ordinences relatinq to building construction, antl authorize representatives of the Cly of Costa Mesa to enter upon the
ehove-described property for inspection purposes. I eqree not to occupy or allow occupancy ot any Uulldinq authorizetl by ihis permit until finel InsDection.
� Signature Of Legel Owner(s) �
� /'7n�1�
And/Or Authorizetl Applicant
CODE t. INSVECTIONTYPE Q�j{ 1C�IIDB4S
1616 Fixetl System Final Fire Prevention
1266
200
201
202
203
Pool Spa Final
Final RB-Roof
Final BIocWRetaining Wall
Final Fectory Fire Place
Finel Sign
204 Finel Demolition
24d8-4fi
COOE I INSVECTION TYFE
208 Final Mechanical
20B Final Plumbing
210 Finel Eleciricel
212 Flnal Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuiltlingiOccupancy
PAg
NTI ffIRLS
i z ,
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mese.BUILDING PERMIT n FAIR Dfi1VE, COSTA MESA, CA 92626
JobAddress: $55 ANTON BL
Suite:
, Vicinity: SWITCHROOM & ROOF COOLING TOWER
'd Parcel Number: 41050110
Applicant: SMITH, DON
Address: 55 ON BL
3RD FLOOR
COSTA MESA, CA
Owner: SAKIOKA FARMS
Address
Contracror. ACCENT BUILDERS
Address: 555 ANTON BL. #100
Zoning:
Phone: (714 5493150
Zip: 92626
Phone:
Zip: 94137
Phone: (714) 5493150
e
ISSUED BY:
Status: ISSUED
Applied: 06/22/2000
Issued: 11/17/2000
COSTA MESA, CA
Zip: 92626 License: 397790
Arch : IA Eng:
Address: 3080 6RISTOL ST Address:
COS7A MESA, CA Phona: (714) 754-1197 Phone:
SUITE 105
Zip: 92626 License: License:
SCOPE OF PERMIT
CONSTRUCT NEW 317 S� FT PRE-FAB STEEL "SWITCHROOM", GENERATOR PAD, & AUXILIARY COOLING TOWER ON THE
ROOF.
WILL BE PLACED BEHIND THE EXISTING BUILDINGS AND WILL MATCH MATERIALS USED ON EXISTING, SIMILAR
FACILITES. 5'TREES WILL NEED TO BE REMOVED TO ACCOMMODATE THE NEW FACILITY; THEY ARE REQUIRED TO BE
RELOCATED INTO THE SAME GENERAL AREA. NO PARKING WILL BE LOST TO THIS CONSTRUCTION NOR WILL THIS
CONSTRUCTION GENERATE THE NEED FOR MORE PARKING OR IS IT COUNTED AGAINST FAR REQUIRMENTS.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$204.26
$1, 256.95
$0.00
$30.72
$0.00
$0.00
$1,491.93
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
FEE SUMMARY
Calc Valuation: S�ae,3oo.00
Claim Valuation: s�ao,000.00
PLANNING 8 ZONING
Rear 0- 0 Left 0- 0 Right
Rear 0-0 Left 0-0 Right
Required: 0 Proposed: 0
0- 0
NOTICE: The work au�horized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a perlod 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
requlred Inspeetlona end final epprovel must ba obtained. Failure to obtain inspections and final approval will result in the expiration of this permi�
FOR INSPECTIONS CALL: (714) 7545626
zaaee �aroo�
,
WOqKERS' COMPENSATION DECLARATION:
I hereby aHirtn under penalty of perjury one of ihe following tleclarations:
❑ I heve entl wlll malnteln e certiticate ot consent lo self�lnsure for workers' compensation, es D�ovltled for by section 3700 ot tha Labor Cotla, for the pertortnence oi ihe
rk far which t�is permit Is issued.
I have end wlll meintain workers' compensetion in5urence, es requiretl by sec�on 3700 of ��e Labor Cotle, for Ihe peRormance of �he woAc for whlch this pertnit I9 IS&uetl.
My work ro' compensatin_on�lnsu1ranca ceirier Qndyolicy number are: �+
Cerrier: ��, ��7 Policy Num6er. �(���� `� 7 i
(lTis sectlar nsed not be canplefed i! the imit is d af o undre dollars ($100) or less.) �—
❑ I certify ihet in
I�TARMNG: FAILUPE T
TIIOUSAND DOLLARE
LICENSEDCONTRACTORS
I hereby aHirtn that I em Ilce�
forca and ettect. LJc. a_�
CONS7RUCTION LENDING AGENCV:
Jr'ihis pe ' s issued, I shall not employ any person in eny manner so lo become sub�ect to the woAcers'
shou come sub�ect to the workars' compensetion prohsions ai S llon 3700 of the Labor Code, I ahall forthwllh
Data: C!� /7, y00 O
WVEMGE IS UNLAW FUL AND SW1LL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND dVIL FlNES UP TO ONE HUNDRED
= COMPENSATIIXJ, OAMAGES AS PROVIDED FOR IN SEGfION 3lOfi OF TME LABOR CODE, INTEREST, AND FTTORNEVS FEES.
Sectlon 7000) oi Division 3 ot the Business antl P sslons Code, and my licanse is in full
s Class N � � _ �
❑ I hereby aXirm that there is a consiruction lending egency for ihe pertortnance of Ihe work tor which this pertnit is issued. (Sec. 3097, Civil CoGe).
Lendels Name: Lentlers Atltlress:
Signeture:
OWNER-BUILDER DECLARATIONS:
Date:
1 hereby eHirm t�et untler penalry ot per�ury t�at I em EXEMPT FROM 7HE CON7RACTORS LICENSE LAW tor the fallaxing reason (Sec. 7031.5, Buslness entl Professions
Code: Any ciry or counry which requires a pertnit to construd, elter, impmve, demolish, or repair any sWcture, prior to Its Issuance, elso requires Ihe epplicant tor such pertnit
to file a signed stetement Ihet he or she is Ilcensed pursuant to ihe provisions of Ihe Conirectors License Lew (C�apter 9(commencing wlth Sectlon 7000) of Dlvlslon 3 of the
Business end Protessions Code) or that he or she Is exempt t�erefrom antl the basls for the elleqed e:emption. Any violetlon of Sectian 7031.5 �y any appllcant br a pertnit
subjects the eppliCent to e cidl penelry of not more than five hundred dollars ($500).):
❑ I, es owner of t�e properry, or my employees wlih weges es their sole compensation, WILL DO THE WORK, and the structure Is not Intende0 or oflered for sala (Sec.
7044, Business end Professlons Code: The Contractors License Lew does not apply to an awner ot property who builds ar Improves theraon, end who does such work
himsell or herselt or thmugh his or her own employees, provided that such improvements are not intentled or oNeretl for sele. It, however, the building or impmvement is
sold within one year of completion, the owner�builder will have the burden of proving thet he or she did not build or Improve lor puryose of sale.).
❑ I, es ownar ol the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo consiruct the project (Sec. 7044, Business entl Professlons
Code: The contrectors Ucense Lew does not apply to en owner ot propeny who builds or Impraves Ihereon, antl w�o contracts for such pro�ect with e comrecror(s)
licensa pursuent to t�e Conlractors License Lews.).
❑ I am exempt untler sec. Business antl Professions Code For ihis reeson:
Signature: Date:
Owner ID ventietl by anver's license. ❑ Y85 ❑ NO Driver's License No.
Venficatlon of Ownership by (type ol tlocument, La. - property tan hlll or tleetl):
Ezpires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certity Ihat no a:cavatlon fNe (5) or more teet in depth into which a person is required to descend, will 6e mede in wnnection with work euthodzed by this
permit, and ihet no bulltling stn�dure, scaftolding, falsework, or tlemolition or dismantling thereol, wlll be more than thirry-six (38) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, Califomle Atlministretive Catle).
❑ As owner-Duiltler, I will not employ enyone to tlo work which woultl require a pertnit irom the Division ol Industrial Sefery, es no�etl ebwe, unless such person hes e
permh to tlo such work irom ihe tlivislon.
Signature: Data:
Divlslon ol InduS�rial Sale�y Pertnil Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I cenity under penalry of perjury that I have read this application end stete t�et the Infortnetlon given is
conect I agree to wmply with laws and city ortlinan Img to building construclion, and authodze representatives oi the Ciry ot Coste Mesa to enter upon Ihe
ebove-descnbed property ins0ectiompurpysgs. I egre lo occupy or allow occupancy ot eny building authonzetl by this permit until finel inspedion.
Dete
- � _ J /7,. �Z�n
__.__� __ . .- LDate��
fAOE 1. INSPECTIONTYPE �� Qd¢, INi1f1�LS
16/6 Fixatl System Finel Fire Prevention
1266
200
201
Pool Spe Final
Flnel RB-ROot
Final BIacWRetaining Wall
202 Final Fattory Fire Place
203 Flnel Slgn
204 Final Demolition
CQDE� INSPECTIONTYPE
206 Final Mechenical
20B Flnal Plumbing
210 Flnal Elecldcal
212 Flnel Fl�e Prevenlion
220 Final Planning Approval
222 Final Site
250 FinalBuildingiOccupenq
pl.\i�I:�mSIF�
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suile No
Vicinity:
Parcel Number:
Applicant:
Address:
Owner:
Address:
555 ANTON BL
41050110
RODRIGUEZ, LOU
SAKIOKA FARMS
MECHANICAL PERMIT
Contrecror. AIR CONDITIONING CO., INC
Address: 6265 SAN FERNANDO RD
Arch / Eng :
Address:
GLENDALE,CA
ISSUED BY:
Phone: 816-244-6571
Zip:
Phone:
Zip: 94137
Phone: (818)244-6571
Zip: 91201
License: 120696
Phone:
Zip:
License:
SCOPE OF PERMIT
MECHANICAL FOR COOLING TOWER ON THE ROOF. REF: B00-00925.
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >700 k BTU
Repair / Alt Cooling/Heal
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
523.50
$0.00
$0.00
$13.70
$0.00
$0.00
50.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quanlity
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair I Alt Absorbtion Unit
Repair I Alt Refrigeration Unit
Ventillation System
Evaporative Coolef
Commercial I n cinerator
Domestic Incineretor
Compressors I Absorption Svstems
Up to 3 hp / 100 k BTU
3 To 15 hp / 500 k BTU
15 To 30 hp 1 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
i5to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Staws:
Applied:
Issued:
ISSUED
11 /30/2000
11/30/2000
Quantity
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
537.20
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or it 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 ali
raqulred inepeetlona and ���al approval must be obtained. Failure to obtain inspec�ions and final approval will result in the expiration of ihis pertnit.
FOR INSPECTIONS CALL: (714) 7545626 /
244&/B (8N0)
WORKERS'COMPENSATIONDECLARATION:
I hereby affirm under penelry ot perjury one of ihe follawing tleGaretions:
❑ I heve end will maimein e cenificate of consent ro self-Insure for woAcers' compensation, es proNtletl for by section 3700 of the Lebor Code, lor the peAormance of ihe
work for w�iCh �hi5 permit 15155UBtl.
❑ I lieve entl will mainteln workere' compensatlon Insurance, as required Dy section 3700 of the Labor Code, for Ihe peAortnence of Ihe work for wNch Ul9 pertnit is iswed.
My workers' com0ensatlon Insurence cerde� and Dolicy number are:
Cerriar: • Policy Number: yZ pZ�/l �
(This sect/on neetl nof be complefetl i/ the � If Is velued et one hundred dollers ($f 00) or less.) �
❑ I cenity that in the pertormence of Ihe work for which this permit is issued, I shall not employ any person in eny manner so as to become sublect to the workers'
compensetion laws o Ilbmle, entl egree thet Ii I s�ou10 bacoma subject to the workers' compensetlon provislons of Sectlon 700 ot t e LeDor Cotle, I shell forihwlth
comply with thes rovi ons. ,�/ / ^
� V�
AppticanCSignature/�_,�— �� �l9� Data: �l � �
WARNING: FAILURE To SECORE WORKERS' CAMPENSAiION COV E IS UNLAWFUL AND SHALL SUBJECT NN EMP�OVER TO CRIMINAL P NALTIES D CIVIL FlNE$ UP TOONE HUNDRED
THOUSANDDOl1ARE(5100,0OO�,INADDITIONTOTNECOSTOFCO NSATION,DAMAGES0.SPFOVI�EOFORINSECTION3lOBOFTHEUBORCADE,INTEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am Ilcensed under provisions ot Chapter 9(wmmencing with Section 7000) oi Divislon 3 ot the Business�nd Pratesslons Cotle, entl my Iicense Is in tull
tose end ettect Uc. a Class a G'
Contrector's Signature_��7��� �� Dete: �
7 1
CONSTFiUCTON LENOING AGENCY:
❑ I hereby aHirtn thal lhere is a consiruction lending agency for the pertormance of Ihe work for which Ihis permit is issuetl. (Sec. 3097, Civil Cotle).
Lendels Neme: Lendels Address:
Signamre:
OWNER-BUILDER OECLARATONS:
Dete:
I hereby efflrtn ihet untler penalry of per�ury t�et I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the fallowing reason (Sec. 7031.5, Buslness antl Professions
Cotle: Any ciry or counry which requires a Dermil to consWct, elter, improve, demolish, or repair any sWCNre, prior to its issuance, alsa requlres the eppliwnt for suc� pertnit
to tile a signea stetement thet he or she is Ilcensetl pursuant ta the provisions of the Cantrectors License Lew (ChaD�er 9(commencing with Sectian 7000) of Dlvision 3 af the
Business end Prolessions Code) or that he or she is exempt theretrom end the basis for t�e allegeU eaemption. Any violetlan at Sectlon 7031.5 �y eny epplicem for e permit
sublects the epplicant to e cidl penelry of not more t�an Nve �undretl dollers ($500).):
❑ I, as owner of the proparty, or my employees wlth weges es I�elr sole compensation, WILL DO THE WORK, and the structure I5 nol Inlentletl o� oflered tor sele (Sec.
7044, Business end Profe551ons Code: The Contractors License Lew does no1 apply to an owner of property who bullds or improves Ihereon, and who tloes such work
himselt or harseN or thraugh his or her own amployees, provided that such improvements ere not Intendetl ar oMeretl lor sale. If, however, Ihe 6ullding or improvement Is
sold within one year of completion, the owner-builder will have ihe burden af proving ihat he or she did not build or improve for purpose ot sale.).
❑ I, es owner of Iha property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Businesa entl Professlons
Cotle: The contractors License Lew tloes not epply to en owner ot property who Duilds or Improves thereon, end who contracts 1or such pro�ect wlth e contrectar(s)
licensa pursuant to Ihe Cantrectors License Lews.).
❑ I em ezempl under sec. Business end Protessions Code for Ihis reeson:
Signature: Date:
Owner ID verifletl by tlrlver511tense. ❑ Yes ❑ No DriverS LiCen50 No.
Vadfication ot Ownership by (type ol tlocumem, i.e. - pwperty taa bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Ezpires:
❑ 1 �ereby canity that no excavetlon tive (5) or more feet in tlepih into which e person is required to tlescentl, wlll De made In cannectlon wlth work euthorized hy ihis
permil, and that no huilding sirucNre, scaHolding, falsework, or tlemolition or tlismantling thereot, will be more than t�irry-sin (36) teet high. (Chep. 3.2, Gry 2, Ar12, Sec.
341, Title 8, Celitomia Administrative Code).
❑ As awner-builder, I will nat employ enyane ta do work which would require e permit trom the Division at Industnul Setery, es nated ebave, unless such person hes e
permit to do such work from t�e tlivision.
Signeture: Date:
DMsion of Indusirial Salery Permit Number.
CEHTIPICATE OF COMPLIANCE AND AUTMORIZATON OF ENTRV: I certity under penalry ot perjury t�at I have reed Ihis epplication end state thet the Informatlon given Is
correct. 1 agree to comply with ell atete lews entl ciry ardinances relating to 6uiltling construction, end authodze represenletives oi the City ol Costa Mesa to enter upon Ihe
ebove-described O�oOerry for inspection purposes. I egree noi to occupy or allow occupancy ot eny builtling euthonzed by Ihis permit until final inspection.
COUE �. INSPECfIONTYPE
1818 Fixetl System Flnal Fire Preventlon
1268 Paol Spe Final
200 Final Re-Rool
201 Finel BIocWReteining Well
202 Final Fectary Fire Place
203 Finel Slgn
204 Final Demolition
�� l/ O DV v
Date
Qej[ �� �QpE1 INSPECTIONTYPE
206 Final Mechenical
208 Flnel Plumbing
210 Final ElectAcal
212 Final Fire Preventlon
220 Final Planning Apprwel
222 Final Slte
250 Final Building/OccupenCy
�7.{i I:mrt.1!��
L
• Y
!
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�oonessaew�mia: 555 ANTON BL uxT:
av�EA+ru�EiF�x*+: SAKIOKA FARMS
�u $PACIFIC SOUTHWEST REALTY
CO
? O BO}C 2097 TERMINAL ANNEX
APPL.M/JIING ADOPE59:
u�cxrtEcr a+E+ua+rrn: uc. ra_
WICN. OF ENO.'S AD�RE53: UHf:
coe�rx�c*arswvE TNT NEON SIGN COMPANY (310)434-6366
cam�crorcs�uiwo 1436 CHERRY AC'
wo�sx LONG BEACH CA ucw< 629097
90813 uxr: C
UCENSED COMP�GTONS OECL�N�TION: I Mraby dlim uMs prWy d pa'nvy Ntl 1 am liwu�d uWr pMim� M CAepx Y
(mnnpqn0 wuh 6eaion ]OW) d Oiwion J G iM Buriron uk Pminuan Coda. W my Iimu� b m hm bip eM Wrf.
cmuc,No.:0,!6�'4232 uc.euss: C q5 uc.No.: 6�29097 EXP: 02/96
Dela: �/^oG� �%� CmvWa: l �/�/ �i
� OWNER BUILUEP OECIAH�TIOM: I IweDy Mum uMar penaly d psrjwy Oim I em vemp Irpn IM Cmtrtlon L'vus lew Ior tM
blbvnq ium (SWbn ]W �S &uiw� erd Proimions Code: AmW w awNY wh'rA nVwru e D�Y io owwtl. a4r.'unVow.
ofsh, tt repv eiry �vumua. p'w m uu uwrce. ebo nQui�m iM appliaq la wN penM lo file e�qneC peturom tlW hs a�M
u Gcennd puiaw to �M pv+vons d tla Camrefon lioeroe lew �Cheqm B(mnmenmq �n� Seeion ]IpO) W Diveion J d �hs
Bueinau uA Rd�eioro Codal> IM Ir a dr u examq �heraM1an end tM bem la Na e4pad azsmplion. My videlion d 6edion
)W 1.5 by vry eypGwv ta e prmu wEje6� IM eppficertl lo e dvil pwieM1y d np mon ihen INa hwiMaE doAvs �250pp.
❑ I.00xwdthsp�opetyamyrnqoasxVhwepmmiMietlamnpmatlbn,mTEOlhsr,ak,mdOp�vWueaend'vpaMeG
«dlueG br uN (Sadan 10u. Bu�'v�sn end Prdus'vu Cods: The Camnrtua li'sue lew dou nd eco�Yto en awirra pioparly
wh0 buida a in0� Ilw�an. W Wq Ewf tuN Mqk IYmseX a MnN a Waqh he a Iw am emObJeM. PA'� �M wch
imP��ero ua ra rcuxdsC a allasd la eW. II. howv.u. tM dutlinp tt inpw�netl u wtl vrithin ane Yaa d oomWetbn. Ns
w�«am...w n..e ins w�aa� d o��u n. «.n. ad �a wua « Mw� �« m. awoe. a.wl.
❑ i... wnw a m. ww«n..m..a�.N �w.a�o �.�an u�«.ba �u�.+a. ro w„aw m. wd.e ts.a� rou. a»�e.+.m
aiw.ubm cea.: n,. cavma. ucw. �e.. m. na wpv m en o.,.. a o�w.�r •ro aae. «:npw« m..m w rno
wnveW br vrh p4+� r.ith e mmmtlMsl4eaiusE Wnueeu to IM CaN�etla� Limro� 1e�1.
� 1 un ummq uMv 6MIon: B. 6 P.C.. M Ihu rsemn:
Oab: O+mv:
I Eo Mnby cMEy Ra� I em ewue M erd unE�nWM �M iepuimnenb M Cellwnu HeeA� eM SMy Cods S�pbm t55p5, 255]�, uM
25SL. uM ihtl 1 a ury M�n WiMop oowpu�i will / wil rwi (drt4 aw) � ro canpfy xYh uM ptl� md» W IM rpulmmwm lar
•p�rmnlamuwdionamaGifimlbnham�MAi au�y enepemmt0iaria.iiaddarpwlm'm�ueioneppiretbmu��iwnqtmmiAqe
poviabm.
DNs: Applun�:
WORKER'9 COYPEN9�TION OECLAR�TION: I Mnby alfi�m undx p�roMy d pa�ury om N tlp Idbwlip dduWbro:
❑ � haw vd rA meintew � rnNictle d canMnt b utlineun M wakan' ewnpsnW ion, m prwidad la by 6�eion aroo d tAe labor
cod.. �w �n. pMorm.rc. a m...ak �v.�:cn inu v*mn u kn,.e.
�j � n... ena wu m.:u.n.oiwn• mmo«+etin, mwranc.... M1a�o.d M sa:n o"!m a u,.l.nor coa. w m. v.�>�. a m.
wak In vMd� Nu D� u e�wA. MY waken' mmM�ution inwranu mreia ad DdM�Y wm0ar en:
c.m. STAE FOND EXPIRES
Pofry Numbar. 0 7/ 3 0/ 9 6
m119 bC9'I IIOI� Iql �I MTY�� 1IINV�'��=Y ICIOIIB �IYI1dlO.� �Y9 .�1W� b �OV.�
❑ I oilM tlW n tlr V�amuiee tl Ns wk br xfiich Ihie P�e w wausd. I tlu0 rca amOM a^Y Oa�'vn M' manrwr o n to
bscqns wb�f to IM Mvtr�' aomp�mtlion lexs d CelEanie. enE qyM Ntl d I YnNP �becanr e�hjM lo IM MdYw�'
mnprutlion qw'ubn d rS�qion �]00 M tM lebor Code. I��rt�y ( i
oms: �� —�� ^ � J Mpicent. 4.
w.mbro: F.uun ro.su. vwt.n' eoinaw.uon rovenv �. unrwN4 .ne wll nelKr.n .mo�M�'ro abrJw c��tlu uw
nvn nnu w ro am nu�ene rroww aww. (srat000A b���n ro m. co.r o� mmow.uon a.�.w. .. po�.e ro• in
9�ctlon 9]PB ol MWor tod, IMvuL ���mry1 I�u.
CON9TIIUCf10N LOlOINO �OENCY: I Iw�by afirm uMx peneEy M per'�ny ihu Oen u e mut�uaion YnCvp eperc,y for tlro
�IXIIIYICO 0��1M W01k �CIIY�IIC�1��0 DM�11� U 91VOd�50L�911.'�%.(�iN.ri�.
LENOEP'8 N111E:
LENDEN'S ACDRESS:
I c«uN �nm I hm �ue mu �ppGu�ion.nd aw tlw ihe ebova iMmwbn u oorrw. I Kyw �ocamDN r.'vn en �YY W mWY adinena�
uM tWe Nxi rMtlip b buJd�p mM��uHon ud Mreby eulhw¢a �epeaenlelh» d Ihu tl�y b W v �pm IM ebW��man�qnaC p�vpMy
�w ��"�'�"� ANN I E TAN
��(e Pn-mNm�JjC ] G�-
—�^�—/ ( ��� Oma: �� - sc � . /J
Sqnet�n d Owner/b�ApptiranUCamrect«
(St51.48.WP1 While-BuilLip 8 SdetY:Oreeri-FIe:Cenery-Rppicant: Pink-Revanua:(ioldenrod-Nse�w
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E U75301
PERMIT NO: E 075301 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: C�—N PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION : INSTALL ILLUMINATEDCHANNEL WALL SIGN SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 PRODUCT COMPANY, RE:#SB75298
����*�***���*�**�***�**+�+�*�**�*���x��*�***�-*+r�r**x�***�� � *x �**�*��*�� *+r***+�*+�**�r�*
Z 0 N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i '
iE IE IE iE 3E 3E iE iE 3E iE iE aE iE 3E iE iE iE iE IE �E 3k iE aE 1E if 1E iE �E iE 1F jE iE jF 1F 1k 1F if 1F if 1E 1E 16 iF iE if iElF iE iE iE iE iE iE if !E 3E �E �E iE jE IE �E 1E 1F 1E ib if iE iE iE �E iE iE 1f iE �F iE iE 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: — �..�— DATE: �� 2��✓
1flFikiF3EiEiE1E1E�ElEiliEiEiE�IhiEiE*iE�EiE l'F���fEiEiFififiElEiEiE1E��f iEif
LEGALIZATION;N F E E� S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 240,00
SOE SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 240.00 15.00 0.00 255.00 255,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 255.00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
255.00
"} _
1E 1E IE IE 1E 1E fE fE iE IE iE iE �E iE 1E iE IE iE �E 3E iF iE 1E IE �E 1E iE iE iE 1E �E iE iE jF iE �f if iF iE iF iE 3E if if 1E i(� 1F iE 1E iE 1Flf ff ff� ff 3E iE fE I! 1E iE 1f �E fE 1E 1E 1E if 1E iF if 1E iE IE IE if 1f iE ik
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 16 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15.00 240.00
END OF FEES
" . EXPIRED �
DATE � I 2 `
r , � _
�. �' � �
�
��CONSTRUCTION AND PLANNIN `� P� 3� SPA
APPROVALS Permit #+ Date Inspector APPROVALS Permit # Date Inspector
1. 7emporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. �� 53. Stee� Reinforcement
3. Electriwl Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. 5teel Reinforcement 56. Rough Plumbing & Pressure Test
6. �lectrical UFER Grnd. 57. APPROVAL 70 COVER-GUNITE
7. Footings 58. Electrical Conduit�Undrgmd. .
8. �oundatio� 59. Gas Pipe, � Undrgrnd., Test
9. Waier Pipe�Undrgrnd. 6p. Backwash Lines, P-Trap, O Undrgrnd.
10. Struttural Fioor Syscem 61. APPROVAL 70 DECK
}}, Property Sewer Line & House Conneccion 62. Backwash & Recaptor•Final
12. Sewer Ca0 , 63. Heater & VentFinal �
13. Roof Drains 64. Plumbing System - Final
14. Fough Plumbing 65. Electrical-Final '
15. Fough Electrical•Conduit � 66. Solar SYstem-Final
16. Ro�gh Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling � � 69. POOL/SPA SYSTEA4S FINAL
19. Rough Heating & Air Conditioni�g . FIRE DEPT_REQUIREMENT
20. Rough Facmry Fireplace . APPRDVALS Permit #
21. Outts, in Struaure � � 70. Underground Hydro
22. Oucts, Ventilating � • 71. Product Pipinq OGas OOiI
23. Gas Pipe•Rough & Test ' 72. Underground Flush
24. Roof Framing � , 73. Undergrnd.Storac�eTank �Gas ❑Oii
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling ISvuctural) & Monocoat , 75; Ory Chemical
27. Freme and Flashing 76. Dry Sta�tlPiPe - ,
28. Lathing & Siding ' ' 77. FIXED SYSTEM FINAI
29. Insulation 76. F�RE PREV. FINAL '
30. D�Ywall Naiiing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPEC710N
32. Electriwl Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electrit -. ��`� �i�qtes: 1� �� �n(�jP�_� /1, _ _
��� ��7 ��
3q. Pinal Heating & Air Conditioning �� �-
35. Finai Gas Pipe-Test �
36. Hood or CanopY . ' .
37. Fina1 Faaory Fireplace
38. Final P�umbing :`� �
39. Water Service-Finai ti'
� 40. Gas Service-Final
41. SOlar OomesticFinal
42. Backflow Preventer ' �
, 43. Backflow Irrigation . �
q4. Landscape Irrigation SYstem _ �
45. Sound Attenuation . � .
46. Handicap Regulations - - ��
47. ffNALSTRUCTURE&BUfLDING •
48. FINAL PIANNING ' �' � � . -
49 � Electric Release to Edison
50. Gas Releaae to Southern California Gas Co '' . - __
51. CERTIFICATE OF OCCUPANCY
No. Date
�
' inopewaeunm+o: 555 ANTON BL ���
��xexsw�,uro+w�r� SAKIOKA FARMS
�noxns $PACIFZC SOUTHWEST REALTY
CO
O BOX 2097 TERMINAL ANNEX
�rr�.iunac �nox[sf
�ncxrt[cronexa�sx uc.xo:
�xcx. on wc.•s �roxess: urrt:
ca+m.crortsxu�: TNT NEON SIGN COMPANY ( 310 ) 434-6366
ewmncroxs�uia+o 1436 CHERRY AV
�ss LONG HEACH CA ��_ 629097
90813 �M: C
110EN5ED COMN�ROPS OEC WI�TION: I MMy ellim uMw pruly d paejry Ntl I am hwwd ivdr prwubn� d Cheqr Y
(rmune^aY wYh Srmn 1000) d Oiruion J d Ne 6�dnaa end PNwwro CaM. W mY 6�aw u'vn hA bm aM dIW.
emue.no.:064232 ue.euss: C 95 ue.No.: 29097 v
Oms: ���e%.2 —�� Conumu: ��D L\��+.
� �WNER BUIlOEA OEC WiATiON: I Mnby elfiim uMer pm�ely W parjury tAp I un uamq han IM CaVretlm lian�s lew Iv Iha
bvliq rwm l5etlbn ]Wt 3&nnu� end Prolmbne Code: AnY W a mwY Mfiidi n0� e D�u to muwq. Nr. impm+.
.mdoA a rpar vry amwae. pv b b eauuw, e6o �puim �M eppfw�t la aM pmN �o fYe a dpned peiameN tlut M a sM
e �ioereae w� m �ne va++�+ a ms caureaas Lice�se le. �cheqm s(mmm«�o xan seaon r000) a Uvebn � d Re
Bud�ru ud PeWenbm Codel a �net !r a eM u uemq Iherdmn ud ihs buo fa Ihs eMGed vamWian. Mrv vidtlion d Sedion
]W 1.5 Ey eiry eppfuN la e parmY aubje6o iM appfuM to e cvfl penelry at no� maa �Mn Ixa luMnd EaOen �SSWp.
� I.moxmdUrPr�Yam�'ampw'wawvhwapmn�neiedemmG��.wiYEOMwkeMtMu�utlu�auna"uneMaJ
aMaredlor mb (Sec1'vi ]oas. B�mnmsend Pmleaabn COEe: The CaareCaa liawua leMdon na w[Nloen ar.mrd pweM
wM b11iCf IX f11W� IhGltOfi. YH'�1�0 �OOf BYCh t�ttk hu1�M� tt h01lN IX I�VGN� �G Of 11V MI MIpV/M�. O� IIIN tllCh
'unpeaanrm re m� "vae�tletl a dlad Iv veb. tl. howwer.IM W�Einp a inpawnsi u wtl vri1Nn arY� d mmpbibn. Ne
owmrawtlu x�9 Nw �he dvden d pwin0 M ar tlro Etl nd dtlk ar impow la ths P+D�s d mla).
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c.m.: STAE FUND EXPIRES
o��me« 07/30/96
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la inepeaion Wrppea.
ANNIE TAN
^ Pnm Nem�J
l J _�--` �r� C.Or oms: �I . d.2 _ ? -�—
S�ipreturedOwned�panVAppM1cenVC treew
(5151dB.WP) While-Bubiq85e1my;Orem-Fb�,Cenery-AppFceM;Rnk-Rewnw:(3oNenm�Pweeew
CITY OF COSTA MESA — SIGN PERMIT
ERM NO: SH 07529II
PERMIT NO: SH 075298 PLAN CHECK NO; 04507-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMZT TYPE: STR SIG PURPOSE: OTH
TOH DESCRIPTION : INSTALL ILLUMINATEDCHANNEL WALL SIGN S(] FT:
CLAIM VALUE: 20,000.00 CALC—VALUE: 20,000.00 GAOUP OCC: B-2 /
COMMENTS: 76 PRODUCT COMPANY
�r�***�**rt+���*�**+�x�**+r**�r+t*rtx*�****���*�r***+trt�+t+t*�r+�***+�*�x�**��*rt**x**x�*�x+�***x�rt
S I G N I N F O R M A T I O N
DISTRICT: 1 TYPE: TOP STORY ILLUMINATZON: INT CATEGORY: NEW
DIMENSIONS: 73FT OOIN X 6FT OOIN AREA: 343.00SQFT LETTER HT: 84 INCH
STREET FRONTAGE 1: 970.00 STREET 1: ANTON HL
STREET FRONTAGE 2: 0.00 STREET 2:
PARCEL: 41050104 ZONE: PDC LOCATION > FRONT: X REAR:
HUSINESS NAME: UNION 76 > LEFT: RIGHT;
O T H E R T O T A L S G R O U N D S I G N
THIS ACTIVITY . 343.00SQFT OVERALL HEIGHT: OFT •OIN
THIS SITE . 425.00SQFT GROUND CLEARANCE: OFT '-OIN
ITEMS OF INFO : 1 PLANTER AREA: O.00SQFT
ITEMS FOR ACTIVITY: 1 BLDG SET BACK: 20FT !;
COPY VERBIAGE : 76 PRODUCTS COMPANY
76 "LOGO"
PLANNING NOTES:
� ***+�� *+�*�*�****�*�+�**�*�****�*+��*��r�*x���***��*+r*****�*+�*+r�r**�� x � � **�*�r.*�+�*� �**
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N.'T S
ZONING APPROVED HY C9 CS DATE: �:� ����_
BUILDING APPROVED BY :
APPLICATION ISSUED BY
**�r*x x **+r*+��***+���*x�*
LEGALIZATION:N
BLDG PMT
PERMIT 207.00
PLAN 134.55
ISSUE FEE
�� . �
F E E S U M M A R Y
PLUMBING ELECTRIC MECHANIC
DATE:
�2L � �
�iFiErtiEi�Drti�t��iriE 1 �3Fi�*
STRUCTURAL SEGMENT:Y
SIGN SMIP/RES GRADING
343.00
SMIP/NON—RES
4.20
HUILDING—DIV—> PERMIT ISSOE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 554.20 0.00 134.55 688.75 688.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 688.75 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK
207.00 343.00 4.20 134.55
iE iE iE IE iE iE iE 1k 1E IE iE iE 161E if iE iE ff iE 1E iE ik iF k iE 1E 1E iE If 1f IF iF 1E iF 1E if 1E 1E iE iElf 1E if iE iE jE if 1E iE 1E iF iF 1E 1E ik if iE fE i! iE if �f iE iE IE 1E IE iE IE �E iF fF 1E ik iE iE 3f 1F *
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT
� :C'.'
r,as:; :
tl
f�CONSTRUCTION AND PLANNING � & SPA
-APPROVAIS Permit # Date Inspector qPPROVALS Permit # Date Inspector
`�i. Temporary Elec[riwl Service or Pole 52. Pool & Equipment Location
2. Soi� Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit UtilityUndrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Piumbing & Pressure Test
6. E�ectrical UFER Grnd. 57. APPflOVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation " 59. Gas Pipe, O Undrgrnd., Test
9. Water P�pe�Und�grnd. 60. Backwash Lines, P-Trap, G' Undrgrnd.
10. Struttura� F1oor System 61. APPROVALTO DECK �
1 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Dra�ns 64. Plumbing SYstem - Final
14. flough Plumbing� 65. Electrical�Final ' �,
15. Rough Efectrical-Conduit 66. Solar System-Finai
76. Rough E�ectric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APRROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplate APPROVALS Permit #
21. Ducts, in Structure � . 70. Unde�ground Hyd�o
22. Ducts, Ventilating - - 71 . Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Undcrgrovnd Ffush
24. Roof Framing 73. Undergrnd.SiorageTank OGas ❑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. Insulatio� 78. FIRE PREV. FINAL
30. Drywal� Nailing , HEALTH DEPT..REQUIREMENT
31. Plaster Brown Coat • 79. FINAL INSPECTION
32. Electricai Power Meter�Final . S0. F000 CERTIFICATE ISSUED
33. Fina! Elearic � . Notes:
34. Final Heating & Air Conditioning �
35. Final Gas,P�Pe-Test � i i
36. Hood or Canopy � ' '
.
37. Final Fat[ary Pireplate - �� �
; ,
38. Final Plumbing �
"n �
39. Water Ser��ce-Final . _ , -
40. Gas Service-Final � �
41. Solar pomes[ic•Final
42. Backflow P�eventer � , , _
43. Backflow Irrigation ' �
44: Landscape irrigation System - ,
45. Sound Attenuation � '
46. Handicap Reg�lations • �
47, FINAL STRUCTURE & BUILDING Z��p6 "-�
I
48. FINAL PLANNING ' ,
a9. Elec[rlc peiease to Edison L,
50. Gas ReleSse to Southern California Gas Co
51. CERTIFICATE OP OCCUPANCY
No. Date
G�
� `'�
I �
moxcsscsauim+o: 555 ANTON BL uNT:
wmexsr+we�c�awrr,: SAKIOKA FARMS
wo�ss: $pACIFIC SOUTHWEST REALTY
CO
P Q BOX 2097 TERMINAL ANNEX
�rv�, v�nwa �oo�sx
""�"'��T�p�+�" T 6 W CONSULTING ENG �� C35693
urcwa+�+a'S�ooncsa: 1168 W SAN GABRIEL uxT: N
«wmncrarsru� TNTENEON SIGN COMp,qNyCA 91 � 3�0 ) 4 34-6366
��fXACTORSYYWq 1436 CHERRY AV
�ooxEss: LONG HEACA CA uc.�.: 629097
90813 uxT: C
11CFNSEO COMN�CTOPS DEClAN1T10N: I hraby ellim ivqer prWy d prWy Nel I em lirnrd uds pmidma d CAeqx B
(�^+mari�0 xL� Sactim )000) d Gveion � d Ns Bieiron eM Pmlauan CaEe. eM mY fmw u M 1u01aro vM oHetl.
cmuc.No.: 064232 ���� C 45 uc.r+o.: �629097 E�XP•j 02/96
De10: I� ��` � . �'/� CaX�aaa: C '�-�=P [ �A
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o li�mad Wnwn1 �o �he prwimn+ al pw Cavrmon License Lnw IChaq> e(mmmena�p wah Sedion lOpp) d Div'sion J d tM
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od,: o,.,�«:
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wM tw wliich thu VM^� b mwd. MY wabn' camM��bn Nauanu unY W pc�'cy rwmba u�:
c.m«: STAE FUND EXPIRES
�a�,r�me« 07/30/96
(iM1ia eection noM rwt b m*WnM1E l Ur P�'^�! u br aro hun9d COEen R1Ctl1 n ImA
❑ � aenN Nd M tM oMamerc� a Ne wM b �.heh �hb W� b awwG. I tlW nd wnpbY NJ Ga� n ury menMr w n io
becmr waM to IM v.aM1mY wmpa�s�im le.n W C�fdoMe, and apr�s tM G I�Muk beoonie wbjtl to iM worbn'
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D4e: !� 1ei -�}'r MdiuM: C /. � �O COG.
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Nslw.
CQNSTHUCTION LENUINO AOENCT: I MroEy �rm uMer penMy d perjury Ihtl IMro u e mnp�uGbn bMinp epenry fa Na
peHarmeMe d tM xerk br w1iiN 1�'v pe'mi u'swM (�� �]. Cw. Cl.
�ENOEfl'9 N�11E:
L6lDER'S ADDFE93:
I csnily ihe� I M1eve nad Nia eppfcmm ud aele �Mt Oie above vJan�vion iv cmw, l aprm tottmpy wu�M eryaM aouniywtl'v�v�m
emJ etale lewv �elelinp lo buikinp conetrWian eM haaby eNhorrza rspraventati�ee W INe cilyro emer upon �he ebwe�meMoneE pmpaM
lor impedion W�W�s�
ANNIE TAN
��� Ptnl N
i� ��s. om.: // - 3 2 �?
sqneture W Ormer/RYmH/Appicen✓Can�reaa
(St51yg.WP) '�s-��q85alay:O�wnFtle:Canery-Appfratl:Pink-Re+en»:GOICemoE-Ma�ap
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 075303 PLAN CHECK NO: N
PERM NO: E 075303
GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
JOH DESCRIPTION : 343SF LUMINATED WALL SIGN ON TOP OF BLDG SQ FT;
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: "76 PRODUCTS COMPANY" WALL SIGN, RE:tkSB75302
*�*******�*******�*+��***+�+�****�+�*�*�*�*�*�*********�����****�*****�r�*****�*�**�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN
PARICING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i "
if iE 1F 1E 1E fF fE 1E iElk iE 1E �E �E IE fk ik 1E 1F iE fE iE IE 1F 1E iF iE fE ff iklf iE iE iE iE aE fE 1f iElE 1E jE iElE iE 1E 1E iE 1E �E iE 1f iE 7E 1ElE 3E IE iE 1E if 1E 1ElE 1E iE iE �E �E 3E �E 1ElE 9f if !E �ElE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY '' DATE:
BUILDING APPROVED BY : �-"' DATE:
� A
APPLZCATION ISSUED BY: � �- DATE: ���
****�*+��**+�***x***�x�x*������'������F���E��'i�'iFiF�� ,��F3����F'iF�F�F+�*�e**x*�** ��**
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S£GMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
240508
PLAN
ISSUE FEE 15.00
BUZLDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 240.00 L5.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
255.�0
SMIP/NON-RES
TOTAL PAID DUE
255.00 255.00 .00
255.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
1! 1E ik if 1E fE iE fE i! 1E 1flE fE 1E if 1E 1E 1E fE 1E 1k 1E 1E 1f iE if 7E 1E 1f 1! 1E 1E iE iFlE if iE 1E fE 14 if 1f 1E 1E fE 1E IE iElk 1E iE if 1E 1k 1F 1f 1! 1E 1E k it 1E 1f if 1klE 1E iF iE iE iE 1k 1f 1f 1E iE iE iE iE
I N D I C� I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 16 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15.00 240.00
END OF FEES
��'�,1_i �^ -� ',�'��
_+.z
CONSTRUCTION AND PLANNING PODL & SPA
APPROVALS Permit # Date Inspeetor qppROVALS Permit # Date Inspector
i. Temporary Electrical Service or Poie 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steei Reinforcement
3. Etectrical Conduit Uiilitv•Undrgrnd. . 54. Forms '
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUN�TE
7. Footings 58. Electricai Conduit-Undrgrnd.
8, Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60, Backwash Lines, P-Trap, Q Undrgrnd.
10. Structuial Floor System 61. APPROVAL Tb DECK
1 t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Ven[-Final
13. Roof Dreins � 64. Plumbinp System • Final •
14. Rough Plumbing 65. Electrical•Finai
15. Rough Electrical-Conduit 66. Solar System-Final
i 6. Rou9h Eleccric V}�iring 67. Fencing & Access ApAroval
17. iiough Wirin9 Sign 68. APPROVED FOR PLASTERING
}8. Rough Electricat-7 Bar Ceiling 69. POOLISPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning . FIRE DEPT, REQUIREMENT
20. -Rough Factory Pireptace . � APPROVALS Permit #
21. Ducts, in Structure ' 70. Underground Hydro
22. Outts, Ventifating 71. Product Piping DGas ❑Oil
23. Gas Pipe-Rough & Test 72, Underground Fi�sh
24. Roof Framing � 73. Undergrnd. Storage Tank l7 Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro .
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Ory Standpipe
28. Lathing & Siding 7)_ FIXEO SYSTEM FINAL
29. Insulation 7$, FIRE PREV. F�NAI
30. Drywall Nailing . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Mecer�Final 80. �OOD CERTIFICATE ISSUED
33. F.inal Electric �_p}ry� iJV.Y Notes: - - - �
✓•• �� t�d �'
3Q. �Final Heating & Air Conditioning ' ' '
35. Finai Gas Pipe-Test
36. Hood or Canopy �
37. F�nai Fattory Fireplace - �
38. Final P�umbing
39- Water Service-Final � �
40. Gas Service-Final � . �
4l. Solar OomesciaFinat � � .
42. Backflow Preventer
q3. 8ackflow Irrigation
44. Landscape Irripation System � . _
45. Sound Attenuation
46. Handicap�Regulations
47. FINAL STRUCTUFiE & BUILDING -` �
.
48. FINAL PLANNING
4g. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CEflTIFICATE OF OCCUPANCV
No, Date
�oonessaewiocio: 555 ANTON BL u"T:
°w"E"e""°E'°'aaw": SAK IOKA FARMS
1DDXE55: C/0 PACIFIC SW REALTY
'/iSPLO.MAlIJNO/�URE54?OJ% TERMINAL ANNEX
AACXRECTOPFNtlNFFA: TSW CONSULTING ENGINEERS �"�- C-35693
u�x.opr,ws�: 1168 N GABRIEL BLVD N, uxr:
ROSEMEAD CA 91770
coxrw�craraxu�e: TNT NEON SIGN COMPANY (310)434-6366
CpRN�CT0A9YY1IIl0 1436 CHERRY AV �
�oo�u LONG BEACH CA uc.ao: 629097
90813 uar: C
LICENSED COMXACTONS DECL�NATION: I Mretr/ ertFm uMx paroly M Ihet I un I' d Cheqm B
(aommemLp xi�h 8eclion )000) d Divubn J d ths Bu4neq eM Pmlawa W my Ilo u' tull ce enE NIW
cmuc.No.:064232 �0°�8i C 45 uc.N
oda: /-/b —9b o�a
OWNEN BUILDEfl OECIANATION: I haeby alfrm uMa pauly d N 1 � Imm IM Com�aeon liueua lrw la Ns
fdb'ir'vW �sawn (Setlion ]W1.5 Buaiwa enE Rdmaioro Cads: MY cYY a wun nCum a VermE lo aomWd. Mm.'unWovs.
demalvh, or ropei erc� elriMun. prior lo b bwanca, e6o mpui� iM epplimM tor euch peimn lo file e agnaE e4temm�t Ne� he p e�e
o licenaed Wnuenl to IM pmm'vu d Ne CaNretlas Lioeme law �Cheqr 9(mmnmdM xah Saeion )000) d Diveion ] d the
Busineas uM Adamuro Cade� w ihet he w ehe n uemq thselran vM I�e bexs Iv �ha ellegeE ezemqion. My volalion W Sedion
�mi.s er �r wW�� r«. oemw �qem me roa�m m s ca oe�,eM a �n mae m.� r�a m,�dne aoam. lssooll.
� I.maxirrd�MVWe�YamVemV�'�+wYhwegea+esiheisdemmGa��.xiOdolhexvrk.ardNeew�tun'srwlinleMed
or oXereE for seb (��n )014. BuvrimaeM Prdesvoretotle: Tha Conlreeas Lioense LewEoee erol epply lo en ownerd Orapaity
'�.. wM10 Wida a inMo+e� �hmeon. eM x1a doee suM v.oM Funsetl n heeaM a Waqh he a her own emGbYaea. P�� �hel wch
imP�meNf are nd iMendeE a dlxed lor veb. M. howew. �M Wik4ep a inpoupnp4 o sold xilhin ms Y� d compl&ion. �he
owner-0uiltler vnll hew the WAm d pwiip ha w Me did nd WJE a impv.•a lar iM prtpoea d aeb�.
❑ �. ea a.m« a iM ww.m. e�..�r �uroe:w �n r�m�me conv�vws ro came„a in. v�rea (saaon �a.. ai.i�..,,�e
Prolesvims CoEe: Tla Cavrmon licetie lew Eom nol e00N w en oxiw d pW�Y xfio builda rc imV�+n ihereon aM xfio
contrecta lar wdi prqecn wiTh e mMActw�e) fcemed wnuem to �M Cont�etlas Lioen�a Lev�.
� I em examq �Mm Sec�ion: B. 8 P.G.. W �he reasm:
o�a: o.�,a,:
I do hereEy ceNy iMt 1 em ewera d enE uMentarM tM1e repwremenb d Gellanie Ibe„h eM Selery Code Seubru 25505. 255�3. end
2551a. ud ihet I ar eiry Muie drilEmp omqeni wiA / wil �(drtb aw) nsed io camply wih eeid mms mdea eM the rpuiremanb M
epe�mNlwmnavuctbnamoEi(mlionhom�M�r�y mq�emeni0utriq.RaaNeMielmmtrWionxppYraliomueexemdlmmNese
proviaiana.
Dme: Appicenc
WORKEN'S COMPENSRTION pECL�FATON: I MreEy elfiim uMer pereAy d pajury aw d Ns tdbv.inp doderatons:
� Iheveendxi0meimane<MilketedwneanitoeallimunMxpken'wmpemaibn,mpwkaElmEySeeion9100diMlaEar
caee. io, ine o��. a me w� ia �n w v� m��.e.
fl � n.�. w.;� meiwn wonw.• mmo�min,'umur.n...s r.w=se W swia, a)m al me l.mr coe.. rn ine oa�«mence d �n.
7C woA lor xfiich iM1ie peem� u mued. MY ��n' oompen�etion irourviw ud �ry num Wr era.
c�«: STAE FUND� EXPIRES
Pd�r �m� 0 7/ 3 0/ 9 6
(m;e s«rbn �eee na w cand.«e. uie wm/ e b, o,,. ni„M,.d dcmrs Isiool n
� I te�ty �hel in Ifie pMortnerce d IM work lar w1�eh IM1n pemN u en�eE. I a ampb � y meru�x w ea io
becama euEpa io iM v.orken' compenution kxe d CelXanu, eM e e ' I e wEjee to tM r.oAen'
cnmpar�aeiion ' d Saeion Ji00 d iM lsba COEe. I Wll lwth M1 ��/ . �
oda /—�A6 ��
W�m/ny: feNun ro wcun woikwi mrrpwu+tlon cov�rt� l� un ( andWll �n w�nployw ro cNMiul pm�Mu �iW
clvll flnu �y ro m� h,ntlrW llaua�ntlOWl�r� (S10q000A h etld/tlon ro tln cwt ol romperu�fbR e��pv �iW✓�� br In
SZHon 91(R' o/ Ms La6orCOW, InMns( a� �rtomry'� /ww
CONSTHUCiION LENDIHa �GENCY: I hseby elfirm uMn peiuly d pmjury tlat tAera ie e mnnivaon bMi�q epem.y br iM
p.n�� d me won in � inu wm�� u ewad lseau� 3os�. civ. cl.
LENDEH'S NM1E:
LENDEN'S RDDNE%:
I roniy ind I heva read Nb eoWi'atian uM ad. ihet Ur
enE ele�e lexa rolelip M b'4 p cmfuudpn vd hereb
Iwinsprfion W�posea
ILLIP TUF
a
A9
i51.Ce.W NTilo--Buidiq 8 Sel reen
mnqy xilh all ary eM counry ordinenma
eruar upon tM eEwa�mamioned papeM
Dete:, � / � �
�wrv-ACV��: Pink-Rmmue: GdEenivE-Avaaaor
PERMIT NO: SB 075986
CITY OF COSTA MESA - SZGN PERMIT
PLAN CHECK NO: 00182-96 L
CONSTRUCTION TYPE: PERMIT TYPE; STR SIG
JOB DESCRIPTION ; WALL SIGN FOR TOP OF BUILDING
CLAIM VALUE: 65,000.00 CALC-VALUE: 67,925.00
PERM NO: SH 075986
GOVT: N SUPP: N
PURPOSE: ADD
SQ FT:
GROUP OCC; B /
COMMENTS: "UNOCAL76" AT THE TOP OF THE BUILDING
���x�x���*x�*x x�**��+��*x�x�xxx�*�x��rx *��*x�*�*���x�+�x �r*�r*x**x**x ��+r**+r*�+r�r*�r**�***�x�r�x �r
S I G N I N F O R M A T I 0 N
DISTRICT: 1 TYPE: WALL SIGNS ILLUMINATION: INT CATEGORY: NEW
DIMENSIONS: 9FT OOIN X 49FT OOIN AREA; 682.00SQFT LETTER HT: 6
STREET FRONTAGE 1: 1450.00 STREET 1: 1[NTON BL
STREET FRONTAGE 2: 0.00 STREET 2:
PARCEL: 41050104 ZONE: PDC LOCATION > FRONT: X REAR:
BUSINESS NAME: UNOCAL > LEFT: X RIGHT: X
O T H E R T O T A L S G A O U N D S I G N
THIS ACTIVITY . 682.00SQFT OVERALL HEIGHT; OFT OIN
THIS SITE . 1.00SQFT GROUND CLEARANCE: OFT' OIN
ITEMS_OF INFO : 5 PLANTER AREA: O.00SQFT
ITEMS FOR ACTIVITY: S BLDG SET BACK: SOOFT��:'
COPY VERBIAGE : UNOCAL 6 BALL LOGO AT TOP OF HLDG - EAST & WEST ELEV - 333SF
EACH. BALL LOGO AT 15T FLR ON NORTH ELEV - 16 SF
PLANNING NOTES: PARAPET SIGNAGE APPROVED UNDER PSP �-
iE 1E IE 1E 1ElE fE 1E 1E iE 7E fE 1! iF if 1f iE 1E 1f 1E 1E 1E i! if iE 1E 1E 1E iE 1E 1f 1E iE iE 1E 1E 1E 1! if 1E iE 1t iE iE 1F iE 1E 3E 47f iE 1E 1E 1E iE iE 1! iE iE 1E �E 1E 1E iE iE 1flF iE 1f iE 1E iE if * 1E iE IE iE if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T•�S
ZONING APPROVED BY :�, ,k, DATE: ,< Z� 9
BUILDING APPROVED BY ; � DATE: -�� YY�
APPLICATION ISSUED HY: DATE: ' l0`9�
1EifiElf'1E1E1Eff7k1E1E1E1Eil1FiE1E1E1E1f1klkiFiF�F i(�1E1EiEff1E1k1iiElf 1EiE
LEGALIZATION:Y F E E 5 U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING
PERMIT 964.00
PLAN 626.60
ISSUE FEE
SMIP/NON-RES
13.65
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 977.65 0,00 313.30 1290.95 1290.95 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 1290.95 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN-CHECK
964.00 13.65 313.30
�F if 1E k 1E iE 1E 1E k 1E 1E 1E 1k 1E 41E 1f� 1E iE 1E 1E 1E if 1E 1E if i! 1E iE iE 1E 1E �f 1E 41! 1E IE iE 1E iF IE 1E 1E IE 1E 1E 1f 1f 1E iE IE M 1E 1E IE If 1E 1! if 7E 1E li i! fE 1f ii iE IE iE 1F 1f 1f �f iE iE 1E 1E if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT
ai Qr,s-,�,. ;r,., ,�• ,.. .--
cp7�' S�, �y., = � - - :. ....
COl�I.STRUCTION ANO PLANNING POOC & SPA
APPROVALS Permit # Date Inspeetor pppROVALS � Pe�mit # Date Inspector
1. Tert{porary Electrical Service or Pole 52. Pool &.Equipment Location� ,�� i�
2. Soil Pipe�Undrgrnd. '� ' 53. Steel Reinforcement � ''
(,' 4
�t ' •
•c,,.EleFtrical��Eoo�u��Uality-Undrgroii. 54. Forms - - � �
,�r4�Electrical,Con¢Lit=Undrgrnd. . 55. Electricai Bonding . �
;�,b�Steel Reinfor�c�eirient ~ 56. Rough Plumbing & Pressure Test _ ,
J'6. ElectrfcaCkIFER�nd. 57. APPROVALTOCOVER-GUNITE � �
s -, � '
���7�Footings�"T j� " 58. ElectricalCondu'it;;4Jndrgmd.
� BSFoundatioM-1 � o �^ 59. Gas Pipe, O U�tlrgrnd., Test '�� 'v
x
9�Waj�r P�pPlUndr�'tnd. � 60. Backwash Lines; �P�Trap, O Undrgrnd.
10:.Str7yctural�F,toorSystem "' 61. APPROVAL TO OECK
17�Property 3evyer Une� House'�Co�rieaion 62. Backwash & Recepior-Fin�l ,�
12. Sew�r Cap' , ' ;, j i 63. Heater & Vent•Finai �' i-� �
13. Roof Drains '' '� ' 64. Plumbing System � Fina f'�:
r
14. Rough Ptumbing .'� �'r 65. Electrical�Finat ,i�' '
15, Fiough Electrical-Conduit ' � 66. Solar Sysiem-Pipa4 � -
16. Rough El�ctric �Virin�, � 67. Fencing & AccesS,Approval '
77. Rough Wicing $ign � 68. APPROVED FO�iI'LASTERING •
�..
18. Rough ElectricaLT Bar Ce(ling 69. POOUSPA SYS�iEMS FINAL
19. Rough �Heating & Air Condtioning �IRE DEPT REQUIF�EMENT
_, ^ - _ x' K; ,;, Ga _ = �^ �:
20. Fjpugh F�.or�FiC�¢lacev5_'�..,GN � r-+r;�7 ;� :� q..ipp�jVAtSr� PeihTit.� �"• *
". :�...�,. � - c : � .� �:.� . .
21. �ucts, in$truIIure^+' = �^ ' . ' -�'�� � 7b. ��URderground Hy��o; • -- '
�- i � :: � ' -,'� � ' .� - �:
22. �cti. VeotiiaLSng`"`• ^,."� ••t"'•� ''' � 7;1. pixductPi in 6a C7CjiJ x
:J�:. i.L�;rF• Su -,mC;,; :u�7 � Q P 9Q,.,F
23. Gas Pipe•E9;ouqh & Test r�,^ C� - S� ��=+� � -'r r•: � •72, Q)rltJerground Flusfi ���'�
- -,. .�
24. R�' of-Framing^ '= �' ; �' � � � ? ' - '� ?3. �L�r1d8t,gr.nd. Storage Tank,O Gas � Oil
ii Sr. K; a'> 'F.: "ti~
�.;...- �
25. Root;-Sheathin9 , fi : n,r. [-o „y: ' • �-i . `• � � r-' s
_ 74. Q70erhead'HytlAo _
26. 7•Bar Ceiling (Structhrall•& Monoco�t' `' .r _ r j5. `�p�'r,� ChemicaG; - - ; ��'
r� t. J�, •• ^�• � _ " , c. " :,.. `
27. �rameand_Fla�ing-� �.r� �S�', ; 76. DryStandpipe �-•� '
- � -�
28. Lathin &7Sidin ` "".n. .. "' vvCx: r. F �' -
- 9 9 F, Q. "i 77. P�XED.SYSTEM��J-°,lNALj� ,_
�� . 9�. FtRE RREV. FINAL '�
29. Insulation; � . � � ro�-, • •r' _� � �^c+.+v - b; •
30. Drywall N�iling T - _ "� C �`��,::� r � ��� � � HEALTHJDEPT.'�EQU�REMEN7�
T 37. Plaster Brpwn•C.oat�* � ~ �. �. -i� � � , 79. FHJA�L�INSPECTION x .
�32. Electrical�Row M�terFinaj � -` •`' � � .x �" � 80. PtlOd�CERTIFICATE I$$UED ��,,' .: �„
ti 33. F�na�Ele6tric� ` �; ,_. 'i �c, ~ v �' I Notes�� ' ` -=i .r �� ✓
:34. FinaLfieating�& ATc'Co52Jitioning H �C "; * ~ � � E� � - : �� •' -• "�
y r.:. � H��'r". i kf'H I�_ =V �� Gi
c
,':35. �nal--Ga4Pipe;iest.e ~ �j f,f: _ �. �., � � �� ✓� ' '��,,, � = 7. � � ,
�
+ 36. Hood>or CanoPY ��r: - .. ' �„T �• �• � ; �. �;"" " .r �'
- ... .w �- « �- ti . � - <_ > � cn r�
- � -, � -r�i � � '��� . ',.z.�
�37. Fi:naP�actory Firealace�,.., -� 1�;h r- p, -' ;: C•
�38. F�i�31'Plu(libin�: .�rc;'-i:�i-tn�-,;-. C. ^cV. � � ip c -.v x:
r �i ' k f T,H _a;: x r•
Y' F � � -.... ^ y O � _„U �. I i,- . --^ ... � ...
="39. 4Vater�5ervice_.�ina4 ���,�,_� .� � �r�CC�-a. c -� ; � o x -
'40. GasSsrvice-Fioal - �<..� �r ' ;�J � •.. C- -���
- . � . �: rJ -L :_
�47. �lar pomestic Fina( _" �� ` - -'F�"m� �` '�' `: � _ _ `
x - _ _ ,nnz K I nt _ -, . . '�
0.2. Backflow Preventer x J - - � � F�T. � J � � � '� � '�- � ` � � -'
- ^-� r r c J,G�.. a - -
43. Backflow Irrigation * ` `�'"' -�� �^ Y ' � �
;= �h- � �, � �� �� ti � �� �
. '
�1
44. Laadscape;lrrfaation Sys{em; ' • ^ ••r�' . _ '"� "���' �:u :�+ �. _ G s
-_ - n ., e c' � t �:. < •-
d5. Sound Attenuetion � �` .TC�J -"`"� . _ ` ;� `'* �, r� � ..
f-�, 4�' 7 m, r i1r,. � 7 , Q' F':�
46. HandicapRegulations ' � V• •• T�' � � -�: ��" -. '-' '�
�. .. i• � 1 � r C' ii' i' .-1 '.. •' . J �
47. FiNF>� STRUC7URE & BUl'�DINGx � •a "7�' r'� `
G . ��p-G �, �.
48. FIN:�I PLANNING � :� ': �� ,' '',� "r ' r: t*'
_ � � .. � _
48. EfectP�� ftelease to Ediso y � ��`: �" �
� 4 � .. . �.s<., ,-��• �r
50. Gas Rglease to Southern Calitomia Gas Co . ; - ;i l-� + � ,• �
- •- -
51. CERT-IFICATE OF OCCUPANCY � ' �..
No. Date
�
Pfl61ECTp00flESS: SSS ANTON BL
OWNEP'SNRME: SAICIOICA FARMS
nooeEss: ;pACIFIC SOUTHWEST REALTY
CO
P O BOX 2097
TERMINAL ANNEX
ANCMIENGINEEH: NEG.NO.:
ROOflESS:
UNIT:
UNIT:
PERMITTEE: KILIAN FZRE SPRINKLERS (714)871-8283
AUDPESS: 3OO S. WALNUT
LA HABRA CA 90631
LICENSEo CONTflRCTOP oECUMTION: I nereGy allirm tlat I am IicenseA un0er pmvisions ol CtuD�er 9(commencinp wi�n SecUon
7000) o� �rvision J ol �ne BuSine55 antl Pro�essions COGe, antl my liten5¢ is in �ull lo¢e anG ellecl.
c�,ruc.:014497 s,nreuc.:z4068��uss: _1 �
Dare: � � Signama: _ .Ii�y _ ' —
WOBREBS' C MPENS ION OECIAMT10N: I nereby aliir I liave a cenificaie ol consent to sell-insu or nificate of workers'
Campensation Insurance. or a ttNlieO copy lher¢af �S¢ction 3800. LaG. q.
roucrxo.:1354035-93 E%P.URTE: OIIOSI94
'-o�,_pr rar+r: STATE FUND
J Certilie0 t00Y �5 �er¢by �umistled. � CeN�i¢0 tapy is ��IY�� ��e tily il'q Di 'sion.
i
� Oate: YL.� PDplicani:
E1fEMPIIONFflOMWOflNERS'WMPENSRTIONOFClAH,1TI0N: (il�ucumneeUnot6emmqeteOilNep ' onehwkrW�510U�arless�.
I cetli�y �lul in the peAormance o� ihe wnrk �Or wliic� IN5 Oermit is i55ue0. I 5tu0 nal employ any Dersan in any manner sa as l0 6e[ome
suoie�� lo ine worker5' CAmpensalion Laws of Calilomia.
Daie: Synatum:
� NOTICE: II, alter making t�is Cttlaration. you stwultl become sWjttt to t�e Workers Campeivation provivons of ihe LaGor
Coae. you mus� lanhwith comON �+�h suc� 0�%+��s or ihis cermit SAall 6e AeemeA aroke0.
CONSTPUCTION LENOING AGENCY: I �ereEy aifirm iAat t�ert 6 a wnslnxtion 1¢nGing agency for iAe Dedarmance ol I�e wnrk lar
wAic� ihis Dermn is issuetl (Section 3097, fiv. C�.
LENOEN:
RO�flESS:
OWNEB BUILOEfl OELUBRTION: I �er¢by a�lirm IAai I am ex¢m0� ��om Ihe CAnlratior5' State license Law lor tne following reason
(Section 703L5 Business ana Professianal Cotle: Any city ol county w�ic� repuires a permii to co�rsiruct, alte�, impmve, Oemolish, or
reDaii any stmtlure. prior to i�s iuuance, alw repuires t�e apDiiwnt lor sucA Dermit Io lile a siqne0 statemen� t�at �e/s�e is licensetl
pursuant �o the O�ovisions ol t�e Contranori Siaie Licenu Lm (Chapter 9(commencinq with Section 7000) ol Division 3 0l the Buvness
antl PmIeSSions Co�e� or Il�at M/s�e is erempl Iherelwm anG tlle Easis lor Ihe a11e0eC eMemption. Any violation ol Section 70.31.5 Uy
any applicanl tor a Oermi� sublttls I�e�appliWnl lo a[ivil penally of nai more �Iwn �ive �unEreO EOIlarS (5500).
1. as owner ol Ihe pmpeny ar my employees vnt� waA� as t�eir mle campensation, will Ea ihe woM, and Iha
❑ simcWre is not imenCeO or ofter¢C lor ule (Seciqn 70aa, Business anE Pmlessional CoEe: The Contnctors' State License Law
tloes nol apply lo an owner of a pmpeny wlq Ouilas or imOrovts Itlereon. anA wna Ooes su[h work nimsetl/nerself or inroupn
' his ar Aer own emDloy¢es, O�oviAeO Ihat SUt� imprOvemenl5 ar¢ nai inlen0ea or atlefe0 fof 5aie. 11, however t�e Guiltlinp or
impmvemenl is solC vnl�in ane year al completion, tAe owner xill IWve Ille GurEen al DrovinA �e/s�e Oitl not builE or improve
for me purpou of salel.
I,as awneroti�e O�oOerty, am extlu5ivery comraclinp w�t�licensed coniractorsto constmctt�e pmjeci�Semion 7044, Business
❑ enG Piahssions CoOe: The Coniraclor5' Staie license Law aces noi apoN to an owner al prooerry wlio OmIGs or improves iAerean
ana wtlo tonlraqs lor sucn 0�%ects witll a conVacloqs) liceme Durwam �o �ne Cantrattar5' $Iate License Lawl. I am aware
I�al pmol ot l�eir WOrk¢r'S fAmpensalion insurante S�ou10 Oe provqeG Io me.
� I am ehempi unaer Seclion: B. 8 P. C.
lor inis reason:
Da1e: Owner.
I ao nere�y cenily Ihal I am aware ol anE un0erstand ihe reduiremenis af Calilomia Heallh and Salety Cotle Seciions 25505, 25533, ana
255�4 ana Inal I or any lulure �uileing occupant vnIlNnll nol (circle ane) neee lo compry wilh saia state cOGes an0lhe requiremenls lor a
permi� lor cons�mpion or moCilicalion irom Ihe Ai� Ouality Management Districl. Pe40en�ial rAnsVuction appliCa�ion5 a�e exemp� Imm
these D�ovisians.
�aie: AppliCan�:
IM1Cf¢py cetlity�hail pdv¢rPdU IhiS dppliCaiiOn dnd SIdlPthai Ih¢ a�Ov!
or0inances an0 slaielaws rela�inglo Duiltlmg consiruclion antl hereby
propetly lar inspeciion Ourposes.
`
Oate: $ignalur .
I aA�¢e lo tompty vgjh all city anE
Driver's �icense or Saia� Securny x: ��
16<F<6 White—Builaing: Green—Cotle Enlorcement: Canary—Applicant: Pink—Revenoe: GolEanroE—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; F 063827
PERMIT NO: F 063827 PLAN CHECK NO: 03089-93 L GOVT: N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE; FIR PURPOSE; ALT
JOB DESCRIPTION : REPLACE 15 PRESSURE REDUCING VALVES SQ FT:
CLAIM VALUE: 5,500.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: REPLACE PRESSURE REDUCING VALVE —PLA2A LEVEL TO THE 7TH FL
�**�*�r+r�r�r�r*r*+r*x�*�r+�+r*�r��r**�r*x **+t*�r+�**+t**�r***�r*�r*�r��r*�r*�r*x���r***�+t**�r*****� �*�r�r��r
2 O N I N G R E Q U I R E M E N T S
ssrBAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING N<STES>
>
ik iF if if if iF iE fF if iF if if iE if ft if iF ff ik if iF 41f iE if if 1f if iE k iE if iE k iE if if k 1E if iE iF iE if if k if if !f �E 1E iF iE IE iE iE If if if 1E ik 1E iElF if iE iE iF 1E 1k iE ik �f iE ik iE 1E fE if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY :�L
APPLICATION ISSUED BY: ��
�t iF i!!f if iF iF iE �E iE if if �f iE it i! M if aE if iE if
iF iF if M iE iE iF iF if iF if iE iE iF if fk �f if if if if if iF if if if if 1E iE if if M 3f 3F if iF 3F iE M if iF if kaF 1f M
LEGALIZATION:N F E E S U M M A R
BLDG PMT PLUMBING ELECTRIC MECHANIC
FIRE SMIP/RES GRADING
PERMIT 81.00
PLAN 52665 SMIP/NON—RES
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 81.00 0.00 52,.65 133.65 133.65 .00
REVENUE DIVISION TOTALS--> COLLECTED: B1.00 OVER/SHORT; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHEC}C
, _ 8�,��
iE i! k If iF 7E 1F ik 1E k iE iE if !f M iE 1f iE 1f if iFiE If 1E 1f 1E 1t 3E iE iE 1Ek ik 1E 1E k iE 1f iE iF k iE iE ik iF 1E iFif ik iE iE 1f f( �If 1E �E iE iF�f If iEiE1E iEiE if iEiF iE iE iFif 1F iF 1t iE if 1ElF
I N D I V I D U A L F E E B R E A K D O W N
TYPE
FIR
QTY D E 5 C R I P T I O N UNIT COST TOTAL COST
81 FIRE EQUIP FEE (FROM BLDG VAL TAHLE) 1.00 81.00
END OF FEES
x
D1 �O1f5364-00146_'+64 T C�T 8:.1'�Q
- . CA7E: [?/0's/4s' TIdE: i.2:1Y
I COIVSTRUCTION AND PLANNING • T
� APPROVALS Permit�:
I1. 7emporary Etecv�cal Service orPo{e
I2. Soil Pioe-Undrgrnd. '
�-6:c!:icai Conduit Ut�hty�Undrgrnd_
4� i
� �. Eiect��cal Condurt•u�d�gmd: .
I5. St�e P:�.�ifo�cemen�
F---
�-- �� �'r�i^�c' UFER Grnd. '
i 7; Footv�s
� $. Foundatm� '
�l;'ater P�pa�Untlrgrnd, '
10. S;iuct�rat Fioor Syst�m
� 11. P��pr;y Srv�e* Linr & Hnuse �Conneet�r
1 11. Ser:er Cap . , . -
r-
i i1 Hoot �;ains
r--
� 14. Rough Plumbing . _
75. Hough t�ectrital�Condwt _
� i6, flough �Iectric4Viring �
r--
� 17. Raugh Winng Sgn �
78. Rough Elecirica6T Bar Cei6rg
19. Rough Hea2ing & Air Conditioning
�:
20:'Ro4yh'�jctory Fin�place � ' '
i .
21'. DuctS,ICS:tVLture I �•�•
I ?.?. D�..�cts, 4antrtating
i23: �G.S �?ip^_�Rovgh & 7est .
Dace
Inspector
� 74:"Roo` FYamirt§ � '
i- -- -- -
�� 73. Roc� S��.rathinq i
I ib � i �Ear C;,��I�n9 (Stnrcturall $ �b7onucoat
�27. Fiame p^.d Pashi^.g ---
i----•---_' _---„"�-'�...«=�--u
� 7$. L;tn n� 7� S�d�n- � � •
� _
I7.9. !nsu:atron . ..
Z;,. �ryr.a i f�aihng i
� 31. R,.;te� 0ro�n� Co�t- i
- _�,
3.• ticctr,r�l Po�4er �.�eted-F�na:
�
33. Fi�•�dl E�Pctnt � �
?d F,n�l i{•ating & A.r Cond�t�oning
' ' ' -
35.,Finai Gas Pipe�TeSt '
. 36. Haod o: Canopy � ' �
� 37. ° �a� F.ctmy Fiteplace._ ;
38 Fmcl Pl,tmbing � ' �
39. 1'l;ter Sztvice�Final �
� ���. Gas Se �::ce�Finat �
41. S�lar ComesticFinal '
42. Backtim:� P�evxnte: � �
43. Bad�flow Irngation .
� 44. LcndseaDe lrriqation System
45. �und Attenuation , ,
4G Nandicz� Regulations
4�f�AL STRUCTURE & BUILDING
h8 FINAIPLARNING
�9. Eleuric ReleBse to Edison
b0 Gas Release to Souther� California Gas
a
51. CERTIFICATE OF OCCUPANCY
No. Date
\w_
n
i.•.
-i---
1-� 1 '
Pi & SPA �
APPROVALS Permit;? Date Inspector
52. Poal 6� Eqwpment Locaton �
53. Stecl Reinforcement � .
54. Forms �
55. Electrical Bonding � � i
56. Rouyh Plumbing & Pressur0 Te>t .
57. APPROVAL TO COVER-GU�ITE � I �
_� .
5B. Electrical Condui[�Undrgrnd. I � �
_ �-�--�•�-
59. Gas Pipu, �, Undrgmd., Test I �
60. B�d�vaash Lin�S, P�Trap, : U^drg�rd ` :
61. APPROVAL TO DECIC
---- -� - _ `-1
62. Boe::s:ash & Reczptor�Final
�__"i _'"1
G3. Heatur & VenbFinal
- r--j�
64. Plumbing System Final � �
65. Electrical�Final
-- -�
66. Solar System�Final i
67. Fencing & Access Approval �.
68. APPROVED FOR PLASTEfi1RG -
6�J. POOUSPASYSTEG7SFINAI �
FIREDEPT.REQUIREMENT I
i,, in .
�.APPRUVAI,Si��.'Peo}�it� - .. I
i---"-+-i -
'70. UndergrounJ Hydro �
. 71. Produc; Pip�n9 CIG`as CjOil
=--�---i
'72. Undergrountl Ffusfi - �
..,73. , Undergmd. Stora�,c Tank O Gas �, OII �
74. Ovenc�ad Hydro�-J
75. �ry Cheniica� � ''
76. Dry Standpi�pr • � '
-- - ---�
7i.�FIXED.�'rYI;fEP.1���IRAL �---'--�
78. FIRE PFEV. FINHL ���/Z/Q'� j' �,
/ -�-C--�
NEALTN DEP1". REQUIRE2,E?; i '
79. FINAL INSNECTt7N ----�-- j --- � -�--1
- - r- -
8C. FOODCFHTIFICATE IS5UEi) - '
- -- -- i ------ - -- -I - -�
Notes: � -+ . I
/D/it� _%ks�� � de,,v_ �N,� .
--�
f�^ VT.�nrel �_.�,���--
J-- �
' i
- ----- -j
r1
t �_ ����� �
�
.--..�-•--
�
City of Costa Meu
Development Servites Depar�ment
Building Safety Division
� P. O. Box 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No.
The Building located at 555 ANTON BOITLP,VARn
has been inspected antl found to comply with the provisions of alt City of Co;ta Mesa Ordinances applicable thereto
for a Group S2 Occupancy.
Use of Building AThi ROOM
Legal Description 410-501-04 -
ISee reverse side for Metes and eoundsl
Building Permit No. B 6(17R9 Electrical Permit No. R. fi1f151 Plumbing Permit No._
Mechanical Permit No. M 711 77 Number of apar[ments and/or guest woms
ISSUED TO:
SAKIOKA FARMS
SSS ANTON BLVD.
COSTA MESA. CA 9262fi
Building Official T....,, r�n.. a......
by : %�/i. � �i/„ .,-.
Date November 10. 199'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 (e) U.B.C.
CMF 3o15-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File
PN6IECT ROOflFSS: SAK IOKA ,FARMS~ � UNIT:
OWNEfl'SNRME:gF1ACIFIC SOUTHWEST REALTY
RO�flESS: CO
P O BOX 2097
TERMINAL ANNE]{
pflCXIENGINEEP:LAWRE.NCE HOAK qEc.No.:34803
1210 N JEFFERSON F
nooness:ANAHEIM CA 92807 uNir:
TECHNICAL AIR CORPORATION (818)442-8191
PEPMITTEE; 3( O S ARD EN DR
aooeess: EL MONTE CA 91731
UCENSEO CONTflRCTOfl OECUMTION: I hete0y atlirm Ilui I am IirenseE unOe( D�A+sions ol Chapi¢r 9(COmm¢n[ing wit� Settion
7000� ol Drvision 3 0l t�e Business ana Pml�s�� gaE18na my iicense is in Letl Iorg�n0 eflecl.
CITY LIC.: STRTE UC.: � •A (USS:
J/ /. LIIII- —
Oa�e: _d.� Signamre: _V\./I�CJ��V«.I — —
WOflNEBS'C �Sq�O�.OECIAPRTION: I�ereOyafhrmt�atltwve�cP,�tiliy(eglcqry5eytosetf-insureoracenificateolWorkers'
Compensaiio f3iR or� 6elMiea copY ��ereol I�nron J800, LanI.GLL / V 1/ 7 4
�ucvxo.:REPUBLIC INDEM E%P.DRTE:
OMPANY: }(
J Cenihetl py is ereCy lumrsnea. ❑ Cendiea capy is IileE wit(� in c ry Buiiaing Oivision.
Oate:� Rpoliunt: �� /��`� �^�
E1fEMPfION XOM OHKEfiS' COMPENSA710N OECIAM710N: (Tlns uaion neeU nw Ee canpkleE il Ne pttmt is la me hunNeG (5700) or less�.
I cenily �tul in ihe pedormance o1 ine wnrk lor wniCli tN5 oermt is iiwed. I SIWu not employ a�ry perwn in any manner Sa as to become
subiect to tAe Workers' Campensalion laws ol Calitomia.
�att: SgnaWre:
NOTICE: II. after making Ilus Ceclarati0n, yJu s�MuIG Detome subl�� �a ttce Wotkers' Compei5ation prPrisions al ihe La�or
Cotle. you musi fonAwii� compry wit� 5uU D« or tivs permi� shall be tleeme0 revokeE.
LONSTPUC710N LENDING RGENCY: I hereby allirm t�at ��ere 5 a construction IenOinp agen�y iw Ihe pedormance ot t�e work for
which this permiiis issuetl (Section 3097. Civ. C�.
LENOEX:
aooness:
OWNEB BUILOEP DECLAN�710N: I here0y allirm roat I am erempt Imm ��e Conuactors' Sta�e License Law for t�e IotlowinB reason
�Seciion 703t.5 Business anG Holessional COEe: Any ciry oi caunry w�ich repuires a p¢rmii m consimct, alter, improve, Aemolish, or
�evair any slmclure. D�ior la ils iuuance. also rtQuiRs ine appliCdnt lor wtli Oermil lo lile a signe0 s�atement Inat hUshe 6licensee
pursuam �o �he pmdsions ol i�e Comractars' Staro License Law (ChaDrer 9(mmmenunq with Sectan 7000) ol �ivision 3 0l tAe Business
anC Protessions fAae) ot Ilut ne/sne is exemD� Inerefmm ana ihe Davs lor ine allEped eremption. My doWtiUn ol Sec�ion 7NL5 by
any applicanl for a Dermil suUle��s Ine aDDliWnl to a civil penalry ot not mOre t11an live �untlre0 tlollars (f500�.
� I, as awner ol t�e Ompeny or my emp1oyees wim wapes as tAeir mle wmpensation. will Ao ihe wod, an0 I�e
slmcWre is not inUnGeG or o11e�eE lor sale (Section 70aa, Business anE Pmfeuional CoEe: T�e Coniractors' State License Law
Ooes nol aD01y lo an owner of a pmp¢ny w�o OuilOs o� improv¢5 t�ereon, antl wM Eoes SucA vrork Ilimsel0�ersell or t�wuA�
�is or �er own em0loyees, provided I�al suc� impwvemen�s are not inten0ed or o��ereG br sale. 11, however I�e builtling or
� im0�ovemenl is Sola vnthin ane yeu o� tam01e1ion, I�e awner vnll �ava I�e EurEen ol proving �¢/5�e Gid noi UviIJ or improve
for Ine o�roose ol sa�el.
I, as owner ol ��e properiy, am exclusivery conlratlinp vni� IicenseG tOmracmrs m conslmci IAe O�oleci (Seclion 7044, Business
❑ anU Vmlessions CoAe; IDe Coniracl0r5' S�a�e License Law Oces no� appry Io an ovmer o� pmperty who EuiIAS at impmves lhereon
ana wM10 comncis lor suc� O�olects xii� a conuacmqs) license Dursuant lo �he Cantractors' State License Law�. 1 am aware
iha� prool ol t�eir Worker's Campensation inmrance shoulG De pmvide0 to me.
� I am e�empl unGer Setlion: B. E P. C.
lor Inis ieason:
ozm: ownec
I ao nere�y ceniiy that I am aware ol ane untlerstana ine repuirements oi Caiifomia HealiA ana Safery Code Sections 25505, 25533, antl
2553a ana Inal I or any IUWre Guilaing accupanl will/will not (circle one) nee0 ta compty wilh saiG state cOGes an4 i�e requiremenis for a
permil Im consimclion ar mo0ilication Imm I�e Air ualiiy ManaAemmi Ustrict. flesiAen�ul consVuc�ion apD�ica�ions are exemp� Imm
Ihese D�avisions.
�a1e: Applitant:
I hereDy cenily IAat I have reaA inis apD�italion an0 s�a1e thanhe a0ove iniormation is correci. I aA�ee compy wi�h al ily anA county
ordinancesantlst elawsrela�ingtobuiltlingconstmctionanE�erebyamlarrzerepresemativeSollNsu� I en�erupo ��e ove-menlione0
pmoetiv bri spe 'on ur0oses. �
�aie�. / � ,
�river's L ce e or Social Securiiy e:
t6Cb<6 Wbue—Bmldmg: Green—CoOe EnlorcemenL Canary—Applicanl; Pink—Ravenue; GOIEenroa—Assessor
CI'PY OF COSTA MESA — BOILDING PERMIT � '� �
PERMIT NO; M 061173 PLAN CHECK NO; N 1 r9SL'� �� �**RR� A'
CONSTROCTION TYPE: I—FRSP PERMIT TYPE: MEC PURPUSE: OTH
JOB DESCRIPTION ; ATM ROOM W/ACCE55 @ PLAZA LEVEL SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: "BANK OF AMERICA" ATM @ THE PLA2A LEVEL, RE;H60789
�r+��*�**�r�r�r��rx��r��r**�t�r*�r��x�*x�x�r*x**+e*�x��**�r*�t�*x**�x�r�r*�t�r�rx�rx�*�**x���t�rxx*�tx***��t*�r
Z O N I N G R E Q U I R E M E N T S �
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARRING REQ• PROV; PARCEL: 41050104 ZNE: REF NO;
PLANNING NtSTES>
i
if if 3f iF if 3E iE 3FiE 3f iE iF �lt i! it iF iE if iF iE if iF iF 1E 1E rt aE iE 7f iF it 1klF if iF 1E i! if�iE �E iF �1(� iE 1E 1f iE 1E i4 %� i(�-lE fE iE �N-if 1F if iE 3f iE �If 3E-)F iFlE iE i!� �lE �!E iE it iF iE 1(� iF iE iE # iE
D E V E L O P M E N T S E R C7 I C E S R E Q U I R E M E N T S
ZONING APPROVED HY l DATE:
/,
HUILDING APPROVED BY ; DATE; '
APPLICATION ISSUED BY; : DATE;*�Z��
iEiEiEiFil�likiEilillflfiliFiFlE!!�il1FlElfif s r a t � � e lfitiE1f1E1E1EiFik tt 1EiE
lE�FiEilikitki6itiFlEitifillFiEiliElflE1ElE1EkiliflEiEiElE!!!FiliElklEiFjFififkikifiFlEiFiEifM 1t1E1E1EiflFlEififiEikiE1FlEiE%�iEiklFiEfF�F�E1fiElFiE�f
LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMHING ELECTRIC MECNANIC FIRE SMIP/RES GRADING
PERMZT � 9,00
252 SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 25,00 0,00 24,00 24,00 .00
REVENUE DIVISION TOTALS--> COLLECTED; 24,00 OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FTRE SMIP/TOT GRADING PLAN—CHECK
24,��
if 1E 3E iE 1E iE iE iE iE )E iE 1f iE iF #iE 1t if iE iE iE iF k iF ik�E it it iE iF iE iE k k if )f 1E if af-aE ik iF iE 1E iF !f if if if IE 1(� IE iF ik iEi(� iE if if 1f 1E iE iF iE ik iF it ik if iF iF iE iE �E if if iE 1E if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9,00 9,00
END OF FEES
!
CONSTRUCTION AND PLANNING� f.& SPA
APPROVALS Permit 5� Date Inspector APpROVALS Permit #� Date Inspector
1. Temporary Etectrical ServiCe or Pole 52. Pool & Equipment Location ' -
2. Soil Pipe•Undrgrnd. � 53. Steel Reinforcement �
� 3. Electrical Conduit Utility�U�dr.grnd. ' 54. Forms
4. Electrical Condwt-Undrgrnd. � 55. Electrlcai Bonding
5. Steel Reintoreemen[ 56. Rough Plumbin9 & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE .
7. footings 58. Etectricai Conduit�Undrgrnd.
�� 8, Foundation - � 59. Gas Pipe, O Undrgmd., Test -
9. Water Pipe�Undrgrnd. • � 60. Backwash Lines, P•Trap, O Undrgrnd.
f• 10. Structural Floor System � � 61. APPROVAL TO DECK
, 11. Property Sewer Line & House Con�ection . 62. Backwash & Receptor-Final .
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drams ', 64. Plumbing Syscem - Pinal '
74. Rough Plumbing 65. Electrical-Finai
15. Rough Electriwi-Conduit�•, 66. Solar SYstem�Final
i 16. Rough Elec[ric Wiring 67. Fencing & Access Appruval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heati�g & Air Co�ditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Pipin9 O Gas O Oil
23. Gas Pipe-Rough & Test 72, Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceilinq (Struciural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. lathing & Siding 77. FIXED SVSTEM FINAL
�
29. Insulation ' � 76. FIRE PREV. FINAL �
30. Drywall Nailing � ; � HEALTH DEPT. REQUIREMENT
31. Plasier Brown Coat � i � 79. FINAL INSPECTION
+-�
32. Electrical Power Meter�Final � � 80. FOOD CERTIf ICATE ISSUED
33. Final Electric � ' Notes:
34. Final Heating & Air Conditioning S/��j) � L�
!
35. Final Gas Pipe-Test .
36. Hood or Canopy � � ' ;
37. Final Factory Fireplace ' '
1�" _
38. Final Plumbing �
39. Water Service-Final I � �
40. Gas Service�Final � ,
41. Solar Oomestic-Final � I
42. Backf�ow Preventer . �
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
4}. FINAL STRUCTURE & BUILDING � . '
48. FINAL PLANNING �
49. Electric Felease to Edison 1 �
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
�
PX0.1ECTf0UflESS: SSS AI�TON $L I1NIT:
� �OWNEH'S NFME: SAKIOKA FARMS
nooness:qpACIFIC SOUTHWEST REALTY
CO
P O BOX 2097
TERMINAL ANNEX
APCH/ENGINEEfl:LAWRENCE iT�FiK Aec.xo.:34803
aooxess: 1210 N JEFFERSON °N1 F
ANAHEIM CA 92807
vesminee:BANKERS ELECTRIC COMPANY (818)308-0191
nooxess: Z70 MONTEREY PAS RD
NONTEREY PARK CA 91759
LICENSED CONTflFCTOfl OECtAPATION: I herety a�lirm I� IicenseU unaer pmvisions oi ChaD�er 9(commencinp with Sec�ion
7000� of Oivisian 3 oi t�e Business an0 Pmlessions Code. G my ense is in fullforce antl efiect.
CRY LIC.: STATE LIC.:2 9 O I E � — 0
oaie: Z�� �� Signature: _ _ .
WOHKEXS' COMPENSATION OECIABRTION: I hereby aflirm ��at I have a CetliliW� f consem ro seu-ins or a ce � icare oi workers'
Comoensalion Insurance, or a cerlilied co y Inereaf (Section 3800, LaC. C.
eoucrNo.:WCS 800042�-06 exr.o .15/O1/93
-camrnxv:CA CAS INDEM EX
❑ Cehilied cooY is /ne�reGy fumishetl. � Cenifiea cooY is ileA � Division.
�ale: 2—' ` �`� Apolicam:
E%EMPiIONFAOMWOflREBS'LOMVENSATIOXOECIAflATION: (ihis5eclionneeanotUec pletMiitAepermAis ar�eAu re0�5100)orless�.
I ceriily Ihat in I�e performance al Ihe work �ar which Ihis permil is issued. I shall no� e loy any person in r so as lo Oecome
su�iect lo Ihe WorMers' Compensatian Laws ol Calilomia.
�ale'. Signa�ure: -
NOTICE: If. aller making ��is Oeclaralion. you s�oultl become sublec� to Ihe Workers' Compensation pmNsons ol t�e Labor
CoOe, you musl fotlhwith comply with such omvisions or ihis permit snall be Oeemetl revoketl. '.
CONSTflUCTION LENOING AGENCY: I heBby ailirm Iha� Ihere i5 a tOnSimClion IenAing aAency lar ��e De�ormante of Ih¢ work for
w�ich I�is permii is issue0 (Senion 3097. Civ. C�. -;�
LENOEfl: �1'I
aoosess:
i OWNEfl BOILOEP DECLAflATION: I herebyallirm Ihai I am exempl �mm Ihe Conlrac�ors' Siale License Law tor lhe tollowing reason
'�, (Se[Iion 7Q37.5 Bu5ine55 anA Pm�e55i0nal CoOe: Any tily oI toun�y whit� repUireS a Oermit to [onstmcl, alter, impmve, Aemoli5h, or
' repair any simcture, v��or lo its issuance. also reQuires Ihe applicant lor sucA permil ro file a signe0 statement inat ne/she is licensetl
pursuam m ihe pmvisions ol t�e Comracmrs' Siate License Law �ChaD�er 9 �commencinp wi�� Section 7000) ot Division 3 oi the Business
ana Pmfessions Catle) or Ihat ne/sne is eeempl inerelmm ana Ihe Gasis for ihe ailepetl eKemption. Any nalation oi Section 7031.5 Oy
any applitanl Ior a p¢rmil Su�le��s Ihe appliwni l0 a tivil penalty o� nol more than five Aundre0 Aollars (5500).
I, as owner o� Ihe O�aCe�y Or my emplayees wiih waqes as iheir sole comDensation. will Ao ihe work, ana ine
❑ slmciure is no� in�en0ea or o�lereE lor sale (Section 7044. Business antl Pmlessional Code: The Comracrors' Slate License Law
aoes noi aODly Io an ownet of a Ompeny wIW builtls or impmves thereon, antl who tloes suc� vrork him5el�/hersel� or IAmuAO
his ar her own emD�oyees, O�ovi4e0 Itut sut� impmvemenis are n0i inlenee0 ar offeretl for sale. I�. Irowever Ihe builAing or
impwvemen� is sola wi�hin one year ol complelion, I�e owner vnll �ave the bureen ot pmving he/she CiE noi build or impmve
tor ihe purpose of Shce�.
1, as owner ol Ihe pmpehy, am evclusively conVacting vnih licensed Contraciors to constmci Ihe D�oject (Section 7044, Business
❑ ana Pmlession5 COGe: T�e Coniraclors State License Law Goes no� apply to an owner of D�operty wlio 6Was or improves Ihereon
an0 who tomrans lor such D��Ie��s wi�� a wnVacloqs) license pursuan� Ia ihe ConVatlars' Staie License Law). 1 am aware
t�al pmol ol Ihei� Workei 5 COmpensati0n insurante Shou10 6¢ pmvitle0 �a me.
� I am ezemp� un0er Section: B. 8 P. C.
fOr Ihis /eason:
Daie: Ownec
I Oo �ereUy [eni�y Ihat I am aware ol anG unUer5tan0 Ne requir¢menis o� Califomu HealtA antl Satery Coae Sections 25505, 25533. anG
25530 and I�ai i or any lulure �uilAing occu0ani will/will nol (circle one) need lo comDlY wilh saitl sta�e codes antl I�e requiremenl5lof a
permil �or con5lm[lion or moGilica�ion imm I�e Air Oualiry Managemeni Di5lrici. NesiAen�ial con5imclion aDPliwtions are e�emp� �mm
t0ese provisions.
Oale: Applicanl: _
I �ereby certily��at I have read ��is apPlicalion and s�a�e Ih
orGinances an0 stale laws rela�ing Io OuilUing con9mclion an
pmOerly lor inspec,li�an {$(urposes.
�ale: _f.r � � (� Signalur . _
Oriver's License or Social Security r:
I agree�o compl wilh all city antl
tha cirvto ruppn 6ove-mE
16<LC6 Whne—Building: Greon—Caae Enlomemenl: Canary—ApplicanL Pink—Revenue; GolCenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMI7' PERM NO; E 061051
PERMIT NO: E 061051 PLAN CHECR NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE: I—FRSP PERMIT TYPE: ELE PURPOSE; OTH
JOB DESCRIPTION ; ATM ROOM W/ACCESS @ PLAZA LEVEL SQ FT;
CLAIM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: THE "BANH OF AMERICA" ATM / RE; B60789 PRIMARY BLDG, PERMIT.
�r�t***�**�r�r��r�r�e*�r�r***�r����r�r�r�r�*�r��*�*�r�x�r�r�r*�����r�r*���r*�r�r�r�r�r��r�r*���t�t�t*� �� �r�r�r�r�*x
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BIIILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PAR}CING RE • PROV; PARCEL; 41050104 ZNE: REF NO:
PLANNING N TES>
� 7.
iF iE if if !f IflflE if iE if if �lk �F iE 1F if !f !f df 1E �E 1t 1E 1F �f if �F �IF if iF iF �1F �E iE.iE iE 1E iF 1F iE i(�!t!E i!!E iE i! if 1E iE dF if iF ik if ik iE If 1ElElElF 1E if dF �E 1@ iF if !f iF iElf if if ik iE iE
D E V E L O P M E N T S'E:R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BQILDING APPROVED HY ;
APPLICATION ISSUED HY:
if 1E k 1f iE 1! 3! �E if k i! 1! lF itik it 1E iE 1E iE if iE
if iF ik iE ik i! iE if if if M if �E ik iE iE 14 it iE 1E k if
LEGALIZATION;N
i F E
DATE:
. /
r ��� DATE: �— l�o
l6iEiFiEiElEihlFjFif r ifik
•1EiEffiE1E1E1EikiEiElElE1E1f iEiElElfififlk�lfiflFN-iflFihlf1E3F1kifiEiE!(�1FiEiElEiEiflEiE
, S U M M A R Y STRUCTURAL SEGMENT;N
PERMIT BLDG PMT PLUMBING ELEC4RSC� MECHANIC FIRF� 5MIP/RES GRADING
508 � SMIP/NON—RES
PLAN
ISSUE FEE ' 15,00
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 4,50 15,00 0.00 19,50 19,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 19,50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
19,50
if 3f if iF Ik 1f if 1f if ik k it k k jf it if if 1F iE iE iF 3F �! 3E if 3f if iEiE IE k If iE iE �f iF 1E jF 3F iE ik iE iF iE it iE �E iE if iE iE �f 3f iE * 3f if if iF iE iE iF iE ih jF iE iF if it iF iF jE iE iE 9F iF if df
I N D I V I D U A L F E E B R E A H D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 3 FIXTURES LIGHTING 1 ST 20 EA, ,75 2,25
ELE 2 RECEPT/OLITLET 1 ST 20 EA, ,75 1.50
ELE 1 RECEPT/SWITCH 1 ST 20 EA, ,75 ,75
END OF FEES
e
� CONSTRUCTION AND PLANNWG ' POva & SPA
( APPROVALS Permet #_,_..�� ;. Date Inspector ApPRQVALS Permit # Date inspector
t.
. 1. Temporary Electrical Service or Pole � �, 52. Pool & Equipment Location �.
2. Soil Pipa-Undrgrnd. - 53. Steet Reinforcement
3. Electrical Conduit Uxiiity•Undrgrnd. - • 54. Forms ��
4. Electrical Conduit�Undrgrnd. 55. Electricai Bonding
i 5, Steei Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UPER Grnd. 57. APPROVAI TO COVEq-GUNITE
7. Footings , 58. Electrical Conduit-Undrgrnd. _ �
� 8. Foundation . �1 59. Gas Pipe, O Undrgrnd., Test ,� !%
�- �
`-r^. '
9. Water Pipe�Undrgrnd. , � ' �, 60. Backwash �ines, P�Trap, G� Undrgmd.
� iQ. Structural Fioor System `_' ` �'� '` 61. APPROVAL TO DECK .- �
, i t. Property SevJer Line & ti-ouse'Connectio� . 62. Backwash & ReceptorFinal �-i
- . i
�/2. $ewer Cap ' i 63. Heater & Vent-Final �
�
E
' 7 3. Roof Drains' � � 64. Plum6ing SYstem - Final � .
i 14. Rough Plumbing �. � 65. Electrical-Pinaf '
15. Rough Electricai-Conduit '. ' I (8/9S �� 66. So�ar SYstem-Fina1
i �_(
; 16. Rough Electric Wiring ' � 67. Fencing & Access Approval �
� �
� 77. Rough Wiring Sign � 68. APPROVED FOR PLASTERING '
�
18. Rough electrical-T 8ar Ceiling 69. POOL/SPA $YSTEMS FINAL
19. Rough Heating & Air Conditioning FtRE DEPT. REQUIREMENT _ f
20. Rough Factory Firepiace � ; � � APPROVAIS Permit # �
27. Ducts, in Stracture � 70. Underground Hydro �
22. Oucts, Ventilating , � 77. Product Pipiny C; Gas DOii
23. Gas Pipe-Rough & Test � � 7p. U���err�round FWsh
24. Roof Framing , � � .73. Undergrnd.Storac,•eTank:C'Gas ❑Oil
25. Roof Sheathing 74.� Overhead Nydro
26. T-Bar Geiling (Strucwrall & Monocoat ,� 75. Dry Chemical �
27. Frameand Flashing 76. Dry Standpipn
28. Lathing & Siding ,� ' 77. FIXEO SYSTEN FINA�
29. Insulation I � 78. FIRE °".:� . FINAL
30. Drywail Nai!ing . � �-" HEALTH DEPT. REQUIREMENT
31. Pi=ster Brown Coat. � I � 7g, FINAL INSPECT!ON
�
32. Electrical Power MeterFinal ' I � � 80. fOCD CERTIFICATE ISSUED
33. Final Electric ' �,I��9't' ! _�_ ' Notes:
34. Fina� Heating� & Air Conditioning � _ � -
i
35. Final Gas Pipe�Test , � " . ..
f i. -
36. Hood or Canopy � �
37. Final Factory Fireplace _ � I .���:' � -
38. Final Plumb(ng - i� � - '----- ---- -
.�
39. Water Service-Finaf -
4Q. Gas Service��inai { I � �
41. Solar pomes[io-Final � ! �
I
42. Backflow Preventer ' , '
43. Backflow Irrigation . .
44. Landscape 7rrigat'ron System
45. Sound Attenuation
4$. Handicap Regulations �
' 47. FINALSTRUCTURE&BUI�DWG + � � �
48. FINAL PLANNING i � � �
Q�. Electric Release to Edison I
50. Gas Release zo Southem California Gas Cn � ! �
51. CEPTIFICATEOFOCCUPANCY
No. Date
�
a
/
�
Pfl0.1EtT ADOflE55: S S S ANTON HL uxir:
owaeasxnrne: CURCI—ENGLAND CO
noonEss:535 ANTON BL #15�
COSTA MESA
CA 92626
(714)751-0200
APLM/ENGINEEfl: ALAN AMER I flEG.NO.: l� S 4 S S
aooxess: 8 LEDA uxiT:
IRVINE CA 92714
PEflMITTEE: �MSTRONG CONSTRUCTION ( 818 ) 967-8001
aooxcss: 9Z9 SPRING MEADOW DR
WEST COVINA CA 91791
LICENSED LONTflRLTOfl DECIAMTION: I here0y atlirm tha� I am Iicense0 unGer pmv¢ions of C�apter 9(comme�ing wit� Seclian
70U0� 01 UIVISi00 3 0� ��¢ BUSIIIC55 dlld P�OIPSSi0�5 COOE, dflU rtly IitCfISC IS III INI �06C dlld Cf(CC�.
cirvuc.:056871 sTnreuc.:434047� cuss:H—� �
Daie: � Z ' 2 � � 9 � Signama: _ � �✓� �"-'
WONREBS'COMPENSATION�ECIAHATION: IAere�yaifumt�atlluveacenii�senttosel4insurear eni�icateolWorkers'
ComDensation ns r nc �i copy �hereol �Sec�ion 3800, La�. �
=oucrxo.:���b����� EI(P.DRTE: g�OSI9A
�mraer:CRUSADER ZNS,
� Cetlifietl copy is hereby �umishea. LKJ Cetli�ied capy is �i/le0 wilh Ne cily Builtling Divisian.
Oate: �? ' 1�' � � AppliwnL ! Y/ r ��"'�—
E%EMPTION FflOM WOBKEPS' COMPENSRTION OECUflATION: (ihis Se Uan ne¢G nal Ce tOm01eIe0 il fAe permi� is �Or one hu (5100) or less�,
I cenity Ihal in ihe oerformance ol ine work lor wnicn Inis oermit is issuetl. I sllall not emoloy any person in any manner so as l0 6ecome
su0lecl lo �Ae Workers' Compensation Laws o� CalilOmia.
Daie: Signaiure:
NOTICE: I�, aller making IAiS UeClaration, yoU S�oul� Oecome SubleCl �o Ihe WoBers' ComDensation pmvisions of tAe LaOor
fAAe. you must lonnwitn comDty wilh such provisions ar IAis permil shall be tleemea revoke0.
CONSTNUC710N LENOING pGENLY: I Aereby afiirm that t�ere is a constmction IenJing agency br t�e pedormana al t�e work lor
whic� I�is permil is i[suetl (Seclion 3097, Civ. C).
lENOEfl:
noosess:
OWNEB BUILOEP OECIAflATION: I here6y affirm �ha� I am exempl �mm IM1e Contfaclors' State License Law lor ihe followinp reason
�Sectian 7037.5 Business an� Prolessional Code: Fny cily al caunty whic� reduires a permii Ia canstNc�. alter, imprOve. Gemolish, or
repai� any simclure. prior to its issuance, also reQuires ��e aOVlicant lor suc� permil to file a signeG stalement tAat he/she is licensetl
pursuam m t�e Dmvisions of Ihe Connactors' State License Law �C�apter 9(commencing vnt� Section 7000) af Division 3 of ihe Business
ana Pmfessions Coae) or t�a� ne/she is e�empt therefrom and the basis for t�e allege0 exemption. Any violation ol Section 7031.5 by
any apDlicanl br a permit 5u0ject5 lhe apDlicant �o a civil penalry o� not more Ihan five huntlr¢4 dollars (E500).
I, as owne� of t�e pmDeny ar my employees wiin wages as ��eir sole compensa�ion, will tlo i�e work, anJ tAe
❑ s�mcture is not intenEea or oifere0 for sale (Secaan 70aa, Business an0 Pmfessionat Coae: T�e Contractors' State License Law
aoes not aD01y Io an owner of a pmperty w�o �uiltls or improve5 thereon, antl who Ooes su[� work �imselV�ersell or I�mugh
�is or her own emD�Oye¢5, provideA I�al Sut� impmv¢menl5 ar¢ n01 mlenAed a! 011ete0 fof sale. Ii, how¢ver ihe builtling Or
imprm¢m¢n� is so10 wi�hin one year o� com0leiion, �he owner will �av¢ Ihe burden ol pmvinA he/she tlitl nol buil0 or impmve
for the purpose ol salel.
I, as owner ol ��e pmperty, am eeclusively contrac�ing wilh licensetl conirac�ors to cons�mct �he pmjec� (Sec�ion 7044, Business
❑ and Prolessions Cotle: i�e Coniractors' Slate License Law aoes not apDly lo an owner ot propeny w�o EutlAs or im0�oves ihereon
ann wno coniracis �or sucn Dmle��s witn a tomracmqs) license Oursuant to t�e CAmrocmrs' S�aie Lkense Law�. I am aware
Ihat pmof of their Worker's Campensation in5urance sAoutO be pmviaetl lo me.
� I am e�empi unaer Section: B. 8 P. C.
lor ��is reason:
�ate: Owner:
I tlo hereoy cetldy Inat I am aware ol ana un0erslanA Ihe repuirements ot California Healin an0 Safety Cotle Seclions 255Q5, 25593, an0
2559a and I�a1 I or any Iulure builtling occupan� wilVvnll no� (circle one� neeU lo comply wilh sai0 siale codes an01�e reQuiremenis br a
permii lor tons�mtli0n or modi�itaii0n Imm Ihe Aii Ouahry Managemeni Oi5lfiCi. R¢Si4en�iai tonstmCtion aDPlitations are eKemp� irom
�il¢SC pf0V1510115.
Oale: Npplicant:
I here0y certi�y I�ai I have read Ihis application and 51alelhai I�e aboveinlormalion is correci. I aAree lo comply with ail ci�y and [ouniy
ortlinance5and5ta�elawSreLiting�obmltlingcans�mctionantlherebyaNhoriierepresen�ativeSo�Ihisci�V� enteruDonthea�aue-mentianetl
pmpetly for inspeciian pmposei J �
Date: � ? � 21 ��� Signature: /— � '�' �'
Driver's �icense or Socia� Securi�y a: �
164t�G6 Whne—Building; Green—Coae Enforcemem; Canary—Applicanl: Pink—Rovenue; Goleenroa—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; IB 065411
PERMIT NO: IB 065411 PLAN CHECK NO: 04978-93 L GOVT: N SUPP: Y
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: OTH STR PURPOSE; OTH
JOB DESCRIPTION ; CORRECT DISABLED ACCESS PARKING S PATHS SQ FT:
CLAIM VALUE: 1,000.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: PARKING S PATHS OF TRAVEL CORRECTIONS AT TAE PAAKING STAUCTURE
r*�rwww*�r*+t*+t�r�r+t�e**��ew�r�r*��*�r�rr*********�r*r***+tr****+�*�w+tr�rr�rx��r�r�r�r****���r*+t�r�*�r+t
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG --
FRNT; FT IN AEAR: FT IN PRNT: FT IN REAR: FT
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT
PARKING REQ: PROV; PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
> �7 �
kitilitltkiFltiflflfifMitiEiFMltititMifitkMklfMk4ififilklElfMMMififMMMlFitifM/F1fifMiEitIfMMMklfiflEif1F1E1FlFMit.iEiEiE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N%T-•S
ZONING APPROVED BY DATE: /r,-
IN
IN
**
HUILDING APPROVED BY ; DATE:� I;�'
APPLICATION ISSUED BY: DATEi� '2.�'I —
MMiFitMlfMltMiFMlfiklfk7fMMM7Eit7f kitiEifififKMlE iF%
MiFNMftMMMMMM1FM1t1tKMMMkMMMMiFMitlFMkifMifltitiEKMMMKiFMifMMikMiFMMMMMMMM1fitKiEifiEMKiEiEiF�ifiEifiFlfMiFMifiEiF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL' SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING
PERMIT 60.00 `
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 60.00 0.00 0,00 60.00 60,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 60.00 OVER/SAORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANZC FZRE SMIP/TOT GRADING PLAN—CHECK
60.00
MMMkMitltitifiEitiEif%ilM/fkifMMMiEififMMifkMNMkM1kM1f1liFklfifMififilK7FkMMiFiFMifMlEififMMMKifiEiFMiF%M1tiE1fiE3EifiFifif
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ZNS 2 BUILDING RE—INSPECTION FEE 30.00 60,00
END OF FEES
01. 00152612-00152b12 Y�=�T 60.�U
DAtF: 12/2�l93 TIME� G�:42
. :� _ �-
I(.ONSTRUCTION AND PLANNWG P� & SPA
APPROVALS Permit# �Date Inspector AppflOVAIS Permit� Date �nspector
1. Temporary Elettrical Serwee or Po1e; . 52. Pool & Equipment Location
:2..,$oil,Pip�-Un�r�g,rnd3 . � �R, , 53. Steel Reinforcement
,� cr_. _, ; -
�,:c�uPiectrical C6A@iivGRility�Undrgrndc w 54. Forms � '
`'�SrEt�; �c�`Cq�c���:'{lndrgrnd. � _ �^ 55. Electrical Bo�ding
I ��,- prc�r� <; x, 56. Rough Plumbing & Pressure Tes: �'
4�..�.', - .
�-t-�e -.-:.-:-te' a=-C�' .
�!�§��ectr"tC'dl'}�JFE,R��id. � ' S7. APPROVAI.TOCOVEft�GUNiTE �--
;�y7. Foot�gs �' ,.�,, ' S8. ElecVica! Conduit�Undrgrnd. �
��"-=.t�. .. '�_"
i8`�Foundation i-•- ,. 59. Gas Pipe, � Undrgmd., Test .
L
r
9''.'�Water Pfpe-Uniir�f,nd. �, . 60. Backwash Lines, P-Trap, � Undrgrnd. '
�
I 10. Structural Pbar System � 61. APPROVAL TO DECK
�
? 1. Property Se�iaYC"� & Hpuse Con�ction g2, gackwash & Receutor�Finai �
f 12. Sewer Cap .�.. � / rv 63. Heater & VenbFinal
f 13. Root �rains,�" _ � � 64. Plumbing System � Final
14. Rougn Plumbiai� � , 65. Electrical-Final .
� �
75. Rough�iectrical•Condurt , 66. Solar SYetem�Final
G :i�
1 6. flough �jectric Wiring 6�. F2ncing & ACcess Approval
77. Rough Wiringoyn. fi$. APPROVED FOR PLASTEFING
t$. Rouyh Electric'2,I�T 6ar Ceiling 69. FOOL/SPA SYS7EMS FINAL
� 79. Rough Heating & Air Conditioni�g PIRE DEPT. REQUIREMENT
' ^^'��^ v ^'-i'z+F� G � i- !-�
20� Ro�h;{�cto_rY �'?Place i.�� ,�� � � ti y;� �"y}�PPf�V����Pec'[iit#� t�_
��
21r�DietS,'t1f StIDct trP.x i.. .. t-+S' � S G ^�r *'�70. 'hdergib''�%fid H�Iro n
22�D��-s cIentxatir{ " � f 5 t s `� `�r h71. Produ�� � 66as ,�} Oil
i i' C' �. ��.f I iJ R C� �..^ F� i}t '".�U�9 4
23..Gas.#'ipe�Rac_gh &,�est � n� w�r; �+ Q G�! -r 72. Under�roIIhd Fitxstv :, *� 4�
't?-t;' --�n-L-�i '�
24'-�Roe� Fiami�;q ``+* i � �"' ^�" * � •=� � x �" ,7�Under rnA.Story,E�Ta�k'C7Ga> ❑Cll! -
CC f R7 M 1 T, .� }'r 9 , fly,r :
25. Roo� SE,''w.athing �.,-�> � ., . � ' � � �j w �, '74�;fiuerhead Hydro'�' v .
Z6?T•E3r Ceilin9 (StYwetural) &=A,t�tr�jcoat " � " "'. � c�� x F� t7 'a
..� � x C:i x 75.,_Qi�Y Cher�cal � �
2�::;Fr. e ,d E!ashin"� � �f " -, , x � ��.�. v�S ..
�?'' �- �.^'t y� c ?- ms < 76. Dry Stanc'r,�? E--+ �7
^-�JiA-': -�---=�+ '>-� _
�-i28. Lae�Sin�& 5�-�Jinc�'+�k� �+ ����• � � E ••�r r*,. 77:� FIXED �'� E,�y,+�., �INAti. � ^�
0
), �; :q _ ^' r .�:� F; .. .. 7 �`- ;*1 � x � i � ..
29. �n9ulatjqn �. �jx S •• ;k :�. 7�FIRE PREV. FIBJfiL x>
. - -� a ^--*
"30. Drywai�jVai�ng ;T�, _ � ; �� # ; ,'�S, ,h�F�ALTh7•IJEPT*, f,'EQtlIR�'MENT
a
`;37. Plaster;�oim Ccpa�: � � n,�• � �[�`� t:,79.�FI��CT1'+N � Q=
�-c�-#'-�� . -F -�-� e.�.s_ : � �-,=-e-._ni
��32.."Electri5�1 PcS�,er'��1Y't�aF,inal: � v � ;+ � �•.50�'f �FOOp CERTIf�JtC'fE I �5�!EDr� �
.� -•• Gy� ; J, Tl i: i �.. �} ,�r; t ik r rl ^ C �� y' _ '�
-�33.rFir:,�i �jctr7 .,y ,.y i ,� r � :r 'Notes: y ;� * -� •� -
'-;34� :Firrai Flc�tin�& R:cCotadrtionfi� :� = I �� .^ <� �-- . L p �
'*' '� � n' .. Yc '� a ♦ iJ + F <( .y S
��• c = r. K» n � ns v•. -rs-
35: Fina� Ga; Pi;¢�T�S �;,
�.l ,tl C .. *�{ � .: Y J N..^. C7!-i a
m36.��Hobd oniCanoavns n ��-� � .� � (c: .r . � %',o��- ��-�•�
� -n :. x n � :: �n � .t ��_ '+- JT (, s :*7 _
�37�Fir�t FYctory Fi��s�a'c;�x ° �n' .�`�j X M �' x :�' �-
i 4+ 4
� ... -. .� - , -_
r�38c�Firg1 Phtmbing ti � �t� � �+ � � � � � :: .� a b
H � 1
Y
�39;1WatTer �vice-Fi .F'raz � � ^ � �, i i r t '� j'i .t ce
;.�40 `Ga:�$er.v�ce�FinaL, ; +y, = . . � .
a n S � • n ' I+, � � . _ � c:• a �
- � e �. � I -, �- � �:
'�1-41�Solar D@}»estic-Fih�Sis ��, �• � � ' 'Q� '"
'.F Tl '!' � a C+' 'y_ O ^� J
['� P'< < �J ; .. - T
G2. ackfioyy Preven �c� ,-�; p � �. x ;,-i^ *. � -
43. Backflow Ir"'atror?� x�= * � * '�`' * � ` "
r '-� x >+ ? :C w t �'J i w : � .
�4. Landsc$pe tnriqa�qo�q� SYsterr�,n��;j c �y n? � C C� t# M ;t, xfJ + y .-
- - . -g.��£ c -r
=45�'Sound �Atte',v-_1l.�at�or� '�''F � ` F � ,F",� F;n ; C c �¢? F:t * ^
-, : r q
(' -, ^ . .. . �t .. -T--?--�-��--f-"-w-z-
=.46..Handi� Reaul �to.tt5 ;� p y . �' � � �_:G f
� � � ' .. �, (- x
47:FItu�L ST(i�7CT.�F;E & BUTLDWG ' �'' ��- � F
L' 1 :i ) Z�j� I '1 G" Y �>_
'48�IhFAL PLA7�IN1(+�,�G i F.�. + �� '-- -M: k. t�j v,`� -•.
V '�
��49AEIeciricReleaseto�dison � � � � � � � h * '7 ,
x
^50_„Gas-ReleasetoSou�emCaliiqcniaGasCo r � ;i X';� c- . ct:; • G v
'+-� n ar .'11__ J
_51. CE}7YIFICATE OFrOCCUPFI.PTCY � . -- ��, ;� mp „ - , _
No. Date
Aoo�icant to flll In all soaces except ihose within neavy Doraer lines ana sign ali aoD�opriate tleetaratlons.
C17Y OF COSTA MESA ONSTRUCTION PERMIT PERMIT NO. O TRACT NO. LOT NO. UNIT NO.
1�i �b . f..
Prolect Address
Applicanfs MaTilin9 Address �--y_�,.� �� �
Owner'sName Irz+,'�SP�C-lr"�p ✓IrVCWf'i'�Phon 13 �
Address � �'K-
Arch/Eng. �� �1 � License No.
Address G �'�/ � ' p J -� �/� �+
Convactor's Nam hon Yi�.. -L�y'��
Address (mailing) � S•- �� �''•
Ciry License No. d�9�j$�
LICENSED CONTRACTOR DECLARATION
I h¢reby aftirm that I am licensea unaer provislons of Cna�te� 9(commencin9
with sectlon ]000) of Division 3 of the Business antl Professlons Cotle, antl
my licensa is in full force eitecL �1 r fl/ 2
�icense CI s iy€Jisa y�. �t v���
-�te ��7 519 t L2 .lw�
� �RKER 'COMPENSATION DECLARATION
.�ereby affirm that I nave a certlficate o! consent to 581Nnsure or a certiticate
of Workerz• Compensation Insurance, or a certifietl copY thereof (5¢ction
3800. Lab. Cl),�' ����I.�1'+�'1
Policy No. v�'G2�� Compan �'� ' L
rtitieC opy i5 er¢by /urnishetl.
Certi r,@�Xais " wtth the City il i i
Date �'t� Appli[ant -
E%EMPTI N FROM WORKERS' COMPE SATION DECLA0.ATION
(This section neetl not be complete0 if the pe�mll is for on¢ huntlretl (E100) or
less).
I certify tbal in th¢ perfOrmance ot tne wo�k tor whith thi5 pp� m�t i5 ISSuetl I
�sball not <m loy any pe�son in any ma➢(n�SA � t�ecoyie subjecl to t�e
Workerz' e s i n Lawz of Califoj��a. //
� Date Si9nature � �
NOTICE: 1, afte making thiz tlecla�ation, you shoultl become Subj¢Ct t0 thB
Workers' ompensation provisions of [he LabOr Cotle, y0u must fOrt�with
comply with such p�ovl5ion5 or Ihis permit shall Ge Eeemed revoked.
�CONSTRVCTION LENDING AGENCV
I h¢reGy aHitm lb here i5 a const�u on lentling agency to� the performante
_ o/ the work to�which��71s..oer���Fsyuetlll�etSlona80� Giv. C.)
Lentler's Name �r�'� r'% I' G N l O�l �G
Lentlersatltlresz Z�Z-0 U.04�' T1j�/ T31 3aD . 0
OWNER BUIL�ER DECLARATION �
I hereby dttirm Ihat I am ¢xempt from Ne Cont�acto�'s License Law io� the
followin9 reason (Section 7031.5 Business ana Prote551ondl COtle: Any city or
munty which requires a pe�mit to cons[�uct, alter, improve, CemOliSh O� repalr
any structure, prlor to its izsuance, also requires tne apo�icant for such permit
, 9 file a Si9netl statement that he/she is Ilcense0 pu�sudnt tOlhe proviSions ot
ie Contractor's License Law (Chapter 9(commencinq witM1 SecUon 7000) of
Jivision 3 of the Buziness antl Professions Cotle) or tnat he/she is exempt
lheref�om an0 the basi5 for the allegetl exemption. Any violatlon ol Section
]031.5 by any aOP���ant tor a permlt subjects thn applicant to a civil
eenalty ot not more than five huntlretl aollars (E500).
lJ I, as owner ot the property or my employees with wa9es as lheir solo
mmvensation, wiu do tne wark, antl tne svucture Is not intentletl or otteretl
for. sale (Section 7044, Business antl Protessional CoCe: Tha Contractor's
License Law tloe5 not apply to an owner Of a p�ope�ty who builtls or ImprOves
ihereon, antl wh0 tloes Such work him5elf/he�zelf or through ni5 or h¢r Own
employees, p�ovitletl thal such improvement5 dre not Intentlatl Or ofteretl for
sale. If, howeveq the builtlin9 or improvement Is soltl within one year ot com-
pletion, [he owner will have tha buraen o� provin9 h¢/sne tlIC not bulltl o� im-
prove fo� the purpose of sale�.
❑ 1, as owner of the Oroperty, am exGluSively cont�a<[Inq with lic¢n5¢tl cOn-
tractors to consttuct th¢ project (SBCII00 iO44� BUSIfIC55 dOC PI0ICSSIOOS COQU:
The CmVactor's License Law does not apply [o an owner ot properly who
builtls or improves thereon, antl who conVacts ior zuch orojects with a mn-
[ractor(s) ncense pursuant to the Contractor's Ucenze Law). I am aware that
p�oof o( Iheir Worker'S Compensation Insu�ance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. tor lhis reason
cr
Date Owner
1 ne�eby ceriify [hat I have rea
info�mation is correct. I agree [O
antl state laws relati to b iltlir
senlatives of thi c y n
inspection purp s.
Signature
Drivers' License ar 5 � —
thi5
'�
oq5c 5+-7
TVPE OFCONSTRUCTION NEW�/ AOD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH l_I OTHER ' � �
D RIPTIO OF WORK/USE OF 8 D N-• �• �� '� 1"�
�.,._ �i,_� e _.-._ �.�i�.. �,.. _ .__ �
-TVPE OF PERMIT LJ GRRDw�
❑ TENANT ❑ ELECTRICAL
❑ OTHER �
PROJEC7 DESCRIPTION Sq. F7._
IFOUNOATION�LJSTRUCTURAL
PLUMBING ❑ MECHANICAL
CONSTRUCTIONTVPE y VALVATION$
- ZONE GRADINGCU.VDS. AC
Remarks:
Sink
Preventer
Irriga[ion
rinking Fountains
loor Drains
loor Sinks
as Service Outlets
Kitchen Sink
Lavatories
P-Trap
Rooi Drains
Rainspection Fee � $15
Boiler
Duct - Under GrOund
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. IC80 #
Heating System & Ducting
❑ ai oo,000 sTu O i oo,000
Reinspection Fee � $75
1F OB65-46, rev. 30/B4 White � Builtlin9: Canary - Applicant; Plnk - Accountlng; Goltlenrotl - Assessor
ShOw¢rs
Service Sink
Sewer Cap
Sewer Conneclion
Solar Collectors
Solar Pipin9
$olar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
laue Fae
Hood or Typel ❑
Canopy Type II ❑
Refrigeration Sys[em
❑o-ioo,000eru ❑ioo,000
System Repair/Alteration
Fire Dampers
RegiSters
luue Fea
FEES
$ 3
$ 3
A.P. #
S Main Building:
E
T Front
ARear
C Ri9ht
K Left
S
Ping. Ref. #
Planning Notes:
Auromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �P5 KW C
2one
Parking Req./Provided
ELECTRICAL -
Transformer ❑ 15-50 KW
' ❑50+KW
Meter ❑up to 100 amps
Meter pover100amps
Sub Panel
Motors �41 HP �7:5 - 8
Inc.Solar 09-75 HP �i6-15+
Microwave
Pole Light
Range
Standing Sections
5-15 KW Trash Compactor
FEES
Z
O
N
I
N
G
R
E
Q
M
T
S
� Reinspection Fee I$15 ' I Issue Fee I $ 3 �'
DEVELOPMENTSERVICES REQUIREMENTS:
Zoning Approved By Date
Buildin9 Approved By Date��. %�
Appliratian Issued By Dat����"�'��
n �1MMARV OF FEES ��'
BUILDING PERMIT16�n'��'�� SMIP $ I�
PLAN CHECK § PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL § GRADING S
PLAN CHECK 50% $ MICRORLM $
MECHANICA� $ TOTALFEE $
PLAN CHECK 25% 5 � 2'J �.,
1 ,.
�j-CONSTRUCTION AND PLANNING POOL & SPA
� Date Inspector Date Inspector
"APPROVALS ¢Permit # APPROVAIS Permit #
� � __
� 1.'�T,emporary Electrical� Service or Pole 52. Pool & Equipment Location
, 2. Soil Pipe-Undrgrnd. '' 53. Steel Reinforcement
j 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. APPROVALTO COVER-GUNITE
7. Footings � .,, 58. Electrical Conduit�Undrgrnd. �
; 8. Foundation ;� • � 59. Gas Pipe, O Undrgrnd., Test I
� 9. Water Pipe-Undi§rnd.�, f 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Strucwral Floor.System 61. APPROVAL TO DECK
e
11. Property Sewef`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 Electriral-Conduit 66. Solar System-Final
16. Rough Electric Wiring • 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVE� FOR PLASTERING�
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL �'�'f.
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT_ {�' ' >
20. Rough Factory Pireplace APPROVALS Permit# � ������1 `_. �
n IU
27. Ducts, in Structure � 70. Underground Hydro � 'r -(S �"
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil. ��,� '
i
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 Chemiral � ' i� � _
27. Frame and Flashing 76. Dry Standpipe � � '
28. Lathing & Siding 77. FIXED SYSTEM FINAL �;:� _
��r _•-
29. Insulation 78. F�RE PREV. FINAL '' -,�a -
�..
30. Drywall Nailing HEALTH DEPT. R,EQUIREMENT �
31. Plaster Brown Coat 79. FINAL INSPECTION ��'� �_ �
�
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � �'
"f
33. Final Electric Notes: ? '�
�,
34. Final Heating & Air Conditioning � ' 7��
.�
35. Final Gas Pipe-Test �� �g,�(' ��L �'
36. Hood or Canopy � -
37:=Final Factory Fireplace � �, y � '� � - : �
, - ., . .
38�.�Final Plumbing � �' � ., � .�-.i.-• -��, -�,
> �.
, 39. Water Service-Final . �i , ' � � .� �� � ' � ' '
�� I I r . . _ .
:=40. GasService-Final � ' r • °' �� � �'
! i ;i
,Y41.. Solar pomesticFinal . � ;� � � - ' ��� 't; � . - :,i ,
� 42. Backflow Preventer j -I!� 'i- - ` _• �' � _ ..
� - -. w •
r. �i .. .: . .r � , • �„�
„43. Backflowlrrigation �� , �' , , � -t�-�_+ ���� .
' 44. "Landscape Irrigation System �''/'' �� �� ,; _ , �' ' w "� �� '
45.• Sound Attenuation 'r« �' + � ' ' � � '�
.A � (. / � � l
46.-Handicap Regulations _ i� r'�; �, p�'��;' '�A�`' - �
' � ;;.
47�FlNALSTRUCTURE&BUILDING ✓ �G " �"�,i �c '�: r r
�i�. !'?i I-: (..�, . .i iI
`; �
48..Special Requirements Completed - �� %�� � • } .- .� _
49. Electric Releare to Edison ��. �'�� = �� r: j� •`
�'.
50. Gas Release to Southem California Gas Co _ ��� ' . ��
51. CERTIFICATE OF OCCUPANCY /
No. Date
ApP���ant to fill in all spaces exeept those wit�in heavy portler lines anE sign all aDV�opriate tleclaratians.
CITY OF COSTA MESA CONSTR UCTION PERMIT , PERMIT NO. _ TRACT NO. LOT NO. UNIT NU.
ProjectAddress S ������
Applicant's Mailing Address � 63 ��T���� pl
Owner's Name �=T� �� � =�=�Phone
Address `�SS'�'�ST'4.�
Arch/Eng. License No.
Address ,
Contractor'sNama��`�''��"'�� Phone84l34ZZ '
Atltlress(mailin9) 135� c,o'�et�oP.D st0 �N`n�.�G�Baoc�
City License No. � �x �
LICENSED CONTRACTOR DECLARATION �
1 hereby aftirm that I am licensetl untler provislons of Charter 9(commencing
wit� section 7000) of Division 3 Of th¢ BuSiness antl Protessions Cotle, and
my license is in (ull to ce a a eifect. �t Q�—I
LicenSeClaslp ��d licenseNo�TI ` ` �
Date �'� � 1— Si9nature
WORKERS'COMPENSATION OECLA0.AT10
i nereby aitirm that I have a certificate of consent to selt-insure or a certi(icate
of Workers' Compensation Inmrance, or a certifietl cooY thereof (Section
3800, Lab. CJ . n��
Policy No. ��!0��� Company T�/G�
❑ Certifietl copy is hereby furnishetl.
J29 Ceryfi@�cop,y is (iletl with the city�yjJ61 'vi ;on.
Date � � 2t'S Applicant��1�
EXEMPTION FROM WORKERS' COMPENSATI OEGLARATION
(This section neetl nat b¢ mmpletetl if the permit is for one huntlretl ($700) or
iess).
I certify tnat in the performance of the work for which this perm�i is issuetl I
sM1ail not employ any person in any manner so as to become subject to t�e
workers' Co�}Ve tion Laws ot Calitoy��
Date ��'y� Si9nature _/j���_���f��
NOTICE: If, afte� making this tleclaration, you shouldibecom¢ Sub�ect to th¢
Worke�s' Compensation provision5 ot the Labo� Cotle, you must forthwi[h
comO�Y `�'ith such p�ovisions o� tnis pe�mit shall be tleemetl �evoketl.
CONST0.UCTION LENDING AGENCV
I hereby affirm that the�e is a const�uction lentling agency to� the performance
of the wo�k for which [hi5 permit is i55uetl (Section 309'] Civ. C.) '
Lentler'z Name
l.entler's Aatlress
OWNER BVILOER OECLARATION
I hereby af(irm Nat I am ezempt trom the ContractoYs License Law for tne
following reason (Section ]031.5�Bu5inessand Profe551onal Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repair
any st�ucture, prior to its Issuance, also requi�es the applicant for such permit
to fi�e a si9netl statement that he/she is licensetl pur5uant to [he provisions of
the Contractor's License Law (Cbapter 9(commencin9 with Section �000) ot �
Division 3 of the Business antl Professions Cotle) or that ne/she is exempt
therefrom anC the ba5is for the alle9etl ezemptlon. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
�enalty of not more than five huntlretl dollars (5500).
I, a5 owne� of the prope�ty or my employaes with wage5 a5 thei� sole
compensation, will tlo tne work, ana the structure is not intentled or otteretl
tor sale (Section J044, Business antl Pro/essional Cotle: The Contracto�'s
Lic¢n5e l2w tloes not apply to an owne� of a property who builtls o� improves
thereon, antl who tlaes such work nimselt/herseli or through his or her own
employees, provitleA Ihat such improvements are not intentletl or ofteretl for
Sale. It, however, the builtling or improvement is soltl within one year of com-
pletion, the owne� will have the burtlen Ot prOvin9 he/sne tlitl not build or im-
�rove to� the purpose ot sale).
I, as own¢r of Ihe ptoperty, am exclusively cont�acting with licensetl con-
trattors td consiruct the project (Section ]044, Business anC Professions Cotle:
Tne Cmtractor's License Law tloes not aoP�Y to an owner oi property who
bupas o� improves thereon, antl who contractz for sucn projects with a con-
tracto�(5) license pu�suanf to the Cont�actor'S LiGense Law). I am aware Ihat
proof o( their Worker's Compensation insurance shouitl be provitletl to me.
❑ I am exempt untler Section B. & P. C. �or this rea5on
Date owner '
I he�eby <e�tlty that I have reatl this applicatlon antl state that the above
iniormatlon is mrrect. I agree to comply wifh all tlty ana county ortlinances
antl state laws relating to builtlin9 �onstruction, antl M1ereby authorize repre-
sentatives of tnis city to enter upon the above-mentionetl property for
Inzpettion p ses. 1�G �qp
Siqna[ure � DateC f�-�V
Drivers' License or 55 �
� J v i —
TYPE OFCONSTRUCTION.,� NEW ADD ALTERATION REPAIR
❑ GONVERSION ❑�DEMOLISH ❑ OTHER :q.p, #
DESCRIPTION OF WOR /USE OF BLDG. �"'lSyALL
Lt�C �A��TY `-"�S C� S MainBuildi
E
TVPE OF PERMIT GRADING FOUNDATION ' STRVCTURAL T Front
❑'TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Rea1
� OTHEii FI.Q.G A�'��Rr�i SY.SZ�/`�� A -
C Fll9ht
PROJEC7 DESCRIPTION S�. FT. occuPANC �-� S Left
CONSTRUCTION TVPE VALUATION $ �
ZONE GRADING CU. VOS. ACRES Ping. Ref. #
Remarks: • �/ (^ �� „ _ 7 q 7 � �� � �j� � � \Q %� Planning Notes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
lavatories
P-Trap
Roof Drains
Reinspaction Fee � $15
Boiler
Duct - Under Ground �
Duct - Sttuctural
Duct- Ventilating �
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 sru 0 i oo,000
Reinspection Fee � $15
CMF 0865-46, rev. 10/04 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - AssesSor
$howers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
Issue Fee
Hood or Type I ❑
Canopy Typell ❑
Refiigeration System ,
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Isue Fee
FEES
Automatic Washer
Construction PoleSub.
Caoking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F,A.U.
Fiztures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW �
�
Zone
Accessory Building: �
2
O
N
I
' N
G
R
Parking Req./Provided E
Q
M
T
S
e
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors � 0-i H P � i%� 8
Inc.Solar 09�15 HP 016-15+
Microwave
Pole Light
Si9n
Standing Sections
15 KW Trash Compactor
$ 3 I
� Reinspection fee $15 Issue Fee
FEES
DEVELOPMENTSERVICESREQUIHEMENTS:
2aning Appraved By
Building Approved By
Aoolintion Iwued BY
$ 3
FEES
$ 3
MARVj�F FEES .
BUILDINGPERMIT $ S SU SMIP $ /O'a�/
PLAN CHECK $ PERMIT ..
PLUMBING $ ISSUANCE $ _
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAI $ GRADING $
PLAN CHECK 50% $ MICROFILM $ ��p� '=
MECHANICAL $ TOTAL FEE $ �' J
PLANCHECK 25% $ . _ _____ __ __
/� . .
� ' POOL & SPA
CONSTRUCTIO,N ANDPLANNING
APPROVALS Permit# Date -Inspector qppROVALS 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, � Undrgrnd.
i•
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing . 65. Electrical-Final ,
15. Rough Electrical-Conduit 66. Solar System-Final
76. 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 FINA�L
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. Produci Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72, Underground Flush '
24. Roof Framing � 73. Undergrnd. Storage Tank O�Gas ❑ Oil
25. Roof Sheathing .. , 74.' Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical �.�
27. FrameandFlashing 76. DryStandpipe � �
f.
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. Electriral Power Meter-Final , 80. FOOD CERTIFICATE ISSUED . �
33. Final Electric . Notes: . ,��f�
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 pomestic-Final '' � . '
r� �
42. Backflow Preventer • . ' �
, i•
- �43. Backflow Irrigation ' - � r�"`""-"'+� y , � •
r �
44. Landscape Irrigation System ?� ,�� . -� i . •
� �i
45. Sound Attenuation � . � '
46. liandicap Regulations •• �� ��
A!i
47. FINALSTRUCTURE&BUILDING . � �� ,
48. Special Requirements Completed � , �
49�. Electric Release to Edison - • '
50. Gas Release to Southern Califomia Gas Co - � .
51. CERTIFICATE OF OCCUPANCY . ,
No. Date . � � . . . .
_, Ii . - - � --� < _.
Applicant to fill in all spaces except those witnin neavy boraer Iines antl sign all avVropriate tleclarations.
CITY OF COSTA M a CONSTRUCTION PERMIT � P��T-1"�%r"J'-�- TRACT NO. LOT NO. UNIT NO.
Project Address �SS i�NTfY��
CApplicant'TAail� p�idress �CO �C.h1DE2 S i
D�w�ner�s �mr � Phone
Address SSS �%N%U^�
Arch/Eng. � License No.
Address
Contractor's Nam PY� Q��'*bMqTk � Phone 3'� �' �3$3
Atltlreulmailingl �SU Vt4�,(D�2 �o¢cuA 9i�zo
City License No. by � g�'�
LICENSED CONTRACTOR DECLARATION
1 hereby afti�m tnat 1 am Ilcensetl untler provisions of Chart¢r 9(Commencing
wiln sectlon 7000) ot DlviSiOn 3 Of the Business antl ProteSsionS Cotle, anC
my Ilcense is in full force antl aitect. �� �` �
License�y�rlass — �i n
'ste �/'Z�"��% Si9nalure
� JRKERS'COMPENSATION DECLARATION
. nereby aHlrm tnaY.l nave a certificate of coqsent to solf-Insure or a terUflcate
�1 of workers' Compensation Insurance, or a certitietl copy thereoi (Section
� �— 3800, Lab. �jI vS.tQ�
V aor�r No. ''ttx�Q 333 865 comaanr
ACertiti¢tl copY is.hereby fuinizh¢tl.
W Cer ie copy is tiletl with lhe city Bu' tl 9 Diviyoq. /, .-
Date �•��'>%1 Applicant �WttAd'1
(� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
V�\ (ThiS section neetl not be cOmple[<tl if tlte pefmit is tor one huntlretl (E100) o�
\Iess).
I C¢r[ify that in the perbrmance Ot t�¢ wOrK �or whith th15 pe�mR IS ISsued, I
znall not employ any person In any manner so as to become zubje<t to the
Workers' Comoensation Laws of California. �
Date � � Si9nature
OTICE: If, atte� making thi5 tleClardtion, y0u.shoultl become subject to tne
Workers' Comp¢n5ation provi5ion5 O� th¢ Wbor Cotle, you must forthwith
Compty with such provlsions ot tM1is pe�mit shall b¢ tle¢metl rCvoketl.
CONSTRUCTION LENDING AGENCV
1 nereby aitirm tnat tnere is a constructlon IeOding agency for the performance
ol the work for which thls permit is �ssuetl (Section 308� Civ. C.j-
Lentler's Name
�entler's Adtlress .
OWNER BUILDER DECLARATION
I hereby aitirm Nat I am exempt trom the ConVactor's License Law for the
tollowin9 reason (Section ]031.5 Buslness a�tl ProfeSilonal Cotle: Any ci[y or
county w�Ic� requirei a permit [o wn5t�ucL alter, improvB, tlGmolizh o� �epai�
any structure, prior to its issuance, atso reqU�rez the applicant tor such vermit
� '.o tile a signetl statement that he/she Is Iicensea oursuant to the provisions of
:he Con[ractor'S LicenSe l.aw (Chapter 9(coinmen[ing with Section 7000) of
DiviSiOn 3 ot tlle Busine55 antl -0ro(essions Cotle) or [ha[ he/She Is exempt
therefrom antl tne basis for the allegetl exemPtion. Any violatlon of Section
7031.5 by any applicant for a permi[ subjects the applicant lo a civil
�enalty ot not more tM1an five huntlretl tlollars (E500).
1, az owner ot the property or my emP�oyees wl[M1 wages as lheir 5ole
compensation, will tlo the work, antl tne stNcture is not intentletl or offeretl
for sal¢ (Section ]044, BuSiness antl Professional Cotl¢: The Cont�acto�'S
License taw tloes not apply to an owner of z Properry who builtls or Improves
lhereon, anC who tloes such work himself/I�erselt or througn his or her own
employCes, prOvitletl that zuch improv¢ments are not inte0tl¢tl o� offe�etl for
sdle. If, powever, the builtling or Improvoment is soltl within one yea� ot com-
pletlon, Ihe owne� will have the burtlen of proving h¢/She tlitl not builtl Or Im-
prova for tne purpose of sale).
❑ I, as owner oi the property, am exclusivety contractin9 witn Ilcensetl con-
tractoR [O cOnStruct th¢ plOject (Section 7044, Business antl' Prof¢SSionS COtle:
The ConVacror•s Licenze law tloes no[ appN to an owner of pro0erty who
Duiltls or Improves thereon, antl who contra�ts for such projects with a con-
t�actor�s) I�cense pu�suanl lo tbe Contractof's License Law�. I am aware that
proof of their Worke�'S Compensation InsUrance shoultl be provltletl to me.
❑ I am exempt untler Section . 8. & P. C. for this reason
Date
Signature NL
Drivers' License or 55
CMF 0865-46, rev. 10/84
— Owner
I have reaC tnis application antl state that [ha above
I agree to comply wi(h all city antl county ortlinances �
to builtling tonstruc[�on, antl hereby authorize repre-�
� to /e/n�te�r u(�y�o�n� the above-mantlonetl propmty for
Yi '//�iY'Ci + Date '2�"B 7
OFCONSTRUCTION �.J` NEW U ADD LJ ALTERATION Ll REPAIR
�CONVERSION ❑�DEMOLISH ❑OT�;
S�2IPTION OF, WORK/U$E OF,�LDG_ � �,�Z� _
TVPEOFPEHMIT LJGRADING LJFOVNDATION"L15TRUCTURAL
❑ TENANT � ELECTRICAL� �PLUMBING ❑ MECHANICAL
�O OTHER ' �.' --�
PROJECT DESCRIPTION $p. FT. OCCUPA v_
�CONSTRUCTIONTVPE VALUATIONS ��, p!
ZONE GRADINGCU.VDS. 9CRE5_
Remarkz:
� BarSink ' '
� Backflow Preventer '
� Backflow Irrigation
`, Bathtubs '
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks �
Gas Service Outkts
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating Sysrem & Ducting
❑ ai oo,000 eTu O i oo,000 sT�
Feinspection Fee � $15
White - Builtling; Ca�ary - AppllWnt; Pink - Accounting: GolUemotl - AsSesmr
$hOWCfS '
ServiceSink ' ' '
Sewer Cap .
Sewer Connection
Solar Collecrors
Solar 7iping '
Solar Tank
Swimming Pool w/Spa .
Urinal
Water Closet
Water Hearer
Water Service
' Auto-Wash
Issue Fee
FEES
$ 3
A.P. #
S Main Building:
E
T Frant
B Rear
A
C Right
g Lett
Pln9. Ref. # �
Automatic Washer
Cons[ruction PoleSub.
Cooking Unit
Dishwasher .
Dryers OGas ❑Elec[ric
Fan
F.A.U.
Fixtures'
Device Boxes
Outlets
Switches
Garbage Dispoul
Generaior �Q5 KW �5-15
b039 8/21/G7
2one
Accessory Building:
Parking Req./Provided
ELECTRICAL . -
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter �over 100 amps
Sub Panel
Motors DO-1 HP �1'f. - 8
Inc.Solar �9-15 HP �16�15+
Microwave
Pole Light
Range
Standing Sections
Trash Compactor
IANICAL FEES. Reinspection Fee I$15 Issue Fee
Hoodor Typel ❑ DEVELOPMENTSERVICESREQUIREMENTS:
Canopy Type I I ❑ Zoning Approved By
Buiiding Approvad By
Refrigeration System
❑aioo.000eru ❑ioo,00a
System Repair/Alteration
Fire Dampers
Fiegisters
Issue Fee � 5, 3'
�%9o�S� T�. I
Z
O
N
I
N
G
R
E
Q
M
T
S
FEES
$ 3
SUMMAR .FEES � �§,�
BUILDING PERMIT $ SMIP $
PLAN'CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHEC,K 50% $ MICROFILM $
MECHANICAL 3 TOTALFEE
PLAN CHECK 25% $ ,
�
. CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1! Temporary Electrical Service or Pole , 52. Pool & Equipment Location
. 2. Soil Pipe-Undrgrnd. '53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '
5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVERrGUNITE
7. Footings � �.:� � '. 58. Electrical Conduit-Undrgrnd. �
8. Foundation �� . 59. Gas Pipe, O Undrgrnd., Tes[
,i
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 I
I
18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # _
21. Ducts, in Structure . 70. Underground Hydro � -- /,�
22.. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough & Test . 72. Underground Flush �. � S,�
24. Roof Framing 73. Undergrnd. Storage Tank O Gas � Oil
25. Roof Sheathing • 74. Overhead Hydro , �' I
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 i
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster Btown Coat 79. -FINAL INSPECTION ' � - �
/
32. Electrical Power MeterFinal . 80. FOOD CERTIFICATE ISSUED . I
33. Final Electric , Notes: ' 1
34. Final Heating & Air Conditioning 1
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 pomestic-Final • .
42. Backflow Preventer ' � - � . '
� �
' 43. Backflow Irrigation � ' .
44. Landscape Irrigation System � � � - ' � � � .
45. Sound Attenuation � � .
46. Handicap Regulations � • �
47. FINALSTRUCTURE&BUI�DING - - ' .
48. Special Requirements Completed , �� . �
�
49. Electric Release to Edison � '
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY '
No. Date '
.PfltNECT AUOflESS: UNIT:���
OWNEX'SNRME: SSS ANTON BL �
nooeess; SAK I OKA FARMS
8PACiFIC SOUTHWEST REALTY
CO
P O H07{ 2097
AflCHIENGINEEfl; TERM T_ NAL ANNEX NEG.NO.:
aooaess.JAROMIR Z. HAJEH C27ur°+m2 '
3225 LACYST
PEBMITTEE;LOS ANGELES CA 90031
AOOflESS:W, 1'tEATH 6 COMPANY, INC. (213)223-4191
3225 LACY ST
LOS ANGELES CA,90031
UCENSEO CONTpAGTOB OEQABRtION: I �ereGy allirm Ilut I am ficense0 unUer prm+sro� ol Guprer 9(commencinp wil� Section
7p10� ol Oivision 3 0� ��e Busineu aM Prolessions CoOe. an0 my IiceRte ¢ in lull iwce anG eff¢Ct.
ciTruc�.:)��2587 srnreuc.:41935� cuss:�_45
oa�e: =l—��/ S � Si9na�urt: _ 1 ' _
WOARfAS' COMPENSPT{9N 6FClANAS10N: 1 h¢reEq alikm ih31 I have a c¢tii rcai�b 5eltan5me a a tthititate ot Wo�keR'
Compensation Insurance. ar a certdied copy ihereol (Seciion 3800, laE. C�.
voucrxo.:RMWC1239262 E%P.OPTE:O4IOS�99
:OMPANY:NUF'IC OF PTTTS.
� Cenifietl copy i5 �erehy Iumis�e0. �] Cenified coD 'a fiiea v' ' BuildinA �sioa
Oat¢: � �/ �i � AnMiran�' —
E[EMPiION FROM WONIIEflS' COMPENSATION OECIAflATION: ' secUon n (p� Ee mnpleteC il IM penrvl ¢ ip one AuMrM (5100) or kss�.
I cenify Ihai in I�e OA�ormdnce oi t�e work lor wnic� IM1iS Oe�mit i5 i55ueG, I stull no� emplay any person in any manner 5a as la become
sublec� �o Ihe WorkF�s' ComDensation Laws ol Califomia.
�ate: SiOnature:
NOTICE: I�. afte� makinp �his tleclaration, you ihould �ecome 5u�leci to t�e WOrkefS' Compensation provisions of I�e La6or
cotle. you musl �onnvnin mmply witn sucn o��ons or iks oermi� snau oe aeemea revokeC.
CONSTBUCTION LENUING �GENCY: I �ereGy aflirm t�at t�¢re rs a constructlon le�in9 agency tar t�e pertormance ol ihe work br
which Ihis oermii is issuetl (Section 3W7. Gv. CI.
�xoen:
aooaess:
OWNEP BUILDEP DE�VIRRT�ON: I Aere�y allirm Illal I am eeempl Uom I�e Cantrat�ofs' State License Law lor tAe following reason
�Section 7031,5 Business and Professionai Code: Any city al caunty wtlitfl require5 a pe��� �o constNc6 alter, impmve, tlemolish, or
i¢pair any SlNclure. D��ot lo I151S5oan[e, a15D �e0uir¢5111E appfitanllo� SUCh pe�mil l01Ne a vpne0 9ai¢rt2n1 ltai helsne 5litemetl
pursuam io �he pwui5�ons of Ihe Conlractors' State License Law (ChaO�e� 9(commencinp wii� Seclion 70W� ol Division 3 0l Ihe Business
an0 Pmlessions Co0e1 ar t�ai �Us�e is exemD� ��erefrom anE t�e Oasis for t�e alleOeU e.emption. Any violation ol Sttiion 7031.5 by
any aDd�nl tor a�Xrml SUEjttis IOe apDGpnl (o a[ivil DCnaliy oi noi more Itwn livE hunAreE EWWrS (f5110�.
1, as owne� ol i�e O�openy or my empbyea xit� xaqes as Neir sole mm0eination, vriA Go the xro�k. anU Ihe
❑ simcmrt is noi interbe0 ar oftered lor sale (Sectwn 70aa. Business anE Prolutio�ul COEe: T�e Coniractors' Stale License Law
Ooes not ap01y lo an owner ot a O�ope�y wlb �uilUs ar improve5 t�er¢On, anE xTo Eces suc� work �imsell/hersell ar tAmugA
�is or Oer ow� emplvyees. D�oviAed i�ai wc� imprmemmts are not intenEeG o� ollere0 lor sale. If, however �M1e EuildinA or
impmv¢ment n suld wit�in one y¢ar oi comDle�iOn. 1�¢ Owner vnll havE N2 Outden ol provinp he/s�e ditl noi Ouiltl of imDmv¢
lor I�e purpOse ol Sale),
L as owner o� the pm0erly, am exclusively contraming wiin IicenSeE comraciors to consimct ihe pmlect (Seclion 7044, Business
❑ an0 Pmies5i0n5 Ca00: ihe Comlatiors' Siale Lk¢nse Law EOes noI appty io an own¢r 01 OrOpeny wM OUi105 at impfw¢5 t�ere0n
and w�o Conlrocis lOr 5uc� O�ol��s vni� a rAnlracioqs�liunse pursuant Io t�e Coniractors' S�ate License Law�.l am aware
t�al piool ol Iheir WOrk¢is Comp¢n5dli0n insurance 5�ou10 Oe praviGeO lo me.
� I am evempl unGei Setlion: 6. d P. C.
lor inis reas0�:
Oate: Owner.
i ao nereUy cenity Ihat I am avram ol ane untlersiana ine reQuiremen6 of CalAomia MealiM1 ana Safery CoCe Sectbns 25505, 25533, ana
2553a and ihal I or any lulure Uuilaing oca0anl wilUwill noi (Grcle one) neeG lo [omply wiih Saitl sla�e coJes antl Ihe repuifemen�s for a
peimii lor con5lmcli0n ar moailication �mm �he Air ualiiy Managemenl DisVicl. ResiGen�ial conslruaion applicalions are exemp� Imm
Inese prOvisiona i
i
Oale: �cam:
i �ere�y cenily t�ai I �ave rea0 this ap0licaiion e stare �nai me iw ' correct. I aA�ee io comply vni� all city anC cowry
ammances ane slale laws relalny Io Ouiiding cm r' y amlwrize repre5ema iues o� I�a dry m enter upon ��e aDwe�memioned
pmperiy lo� i s0ec1� purpoSes.
\
�ate: � � SignaWre:
r
-� Driver's License o� So�ial Security w: ' ��� � �
1i64t�<6 Whne—B�ilding; Green—Co�e Enlorcemem: Canary—AOWicanl: Pink—Revanoe: GdCenroG—Assassor
CZTY OF COSTA MESA — SIGN PERMIT PERM NO; SBE 061762
PERMZI NO: SBE 061762 PLAN CHrCH NO: 01268-93 S GOC�T: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMZT TYPE; ELE STR SIG PURPOSE: OTH
JOB DESCRIPTION : INSTALL 2 ILLUM, SINGLE FACE WALL SIGNS SQ FT:
CLAIM VALUE: 9,000,00 CALC—VALUE; 9,000.00 GROUP OCC: B-2 /
COMMENTS: TAE "BANH OF AMERZCA"
�r�t*�rx�**��*+r*�r***+rx�*�*�*�t�r�r*x**#*�*�r�t�t*�t�t�t*fr*��t**#*#�€��r**�txxu�t�r�rxx�c�.�#**�*x#�*�r*
S I G N Z N F O R M A T I O N
DISTRICT• 1 TYPE: WALL MTD. CHANNEL LTRS ILLUMINATION: INT CATEGORY• NEW
DSMENSIONS; SFT 06IN X 76FT OOIN AREA; 836.00SGFT LETTER HT.: 5,5
STREET FRON3AGE ?: 1000,00 STREET 1; XNTON BL
STREET FRONTAG£ 2: 0,00 STREET 2;
PARCEL: 910�0109 ZONE: PDC LOCATION > FRONT; REAR:
BUSINESS NAME; HANK OF rlMERZCA > LEFT; X RIGHT: X
O T H E R T O T A L S G R O U N D S I G N
THIS ACTIVITY . 836.00SqFT OVERALL HEiGHT: OFT OIN
iHIS 3IiE : 836,OOSQFT �y, GROUND CLEARANCE; OFT OIN
ITEMS OF INFO : 6 _ PLANTER AREA: O.00SQFT
ITEMS FO.Tt ACTZVITY• 6 ¢; BLDG SET BACK: SOFT
COPY VERgT_AGE : BANFt OF AMERICA +�LOGO X 2
PLANNING NOTES: TWO 30P S30RY SIGi�SS�FZE-84—]57)
iE f! iE iE if 1E ff If iE iE iE iF iE if �f if iE if �E iE iE �If iE if # iE iE �)f if 1E if �lf iF �E.lt iE if ik iE �)f i� �t �f iE iElE ib �!f f(� iE �k iE iE �lf �)f !h if 16iElk 3E 94 �X-if� 3F iE iF * iFl/� iF if iE #�lE �If �t if i!
D E V E L O P M E N T SLE;R V I C E S R E Q U i R E M E N T S
i ZONING APPROVED HY S�'—L �� DATE: �s��
HUILDING APPROVED BY : KS DATE: Yl�
APPLICATION ISSUED BY•
****x�r�r*x��*�r**�#*+r�r�r**� �� �� �g��,� ��� ��r�' ��������r�����*�***x ,� � fixx,r�
LEGALIZAT.lON;N F E E S U� STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBZNG EiECTRIC MECHANIC SIGN SMIP/RES GRADZNG
PERMZT 63.00 30.00 836.00
508 SMIP/NON—RES
PLAN 40,95 .84
ISSUE FEE 25,00
BUiLDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 929.84 15.00 40.95 985.79 985.79 ,00
REVENIIE DIVZSION TOTALS--> COLLECTED: 985.79 OVER/SHORT: 00
BLDG PMT PLUMBiNG ELECTRZC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK
63.00 45.00 836.00 .84 40.95
if 1E 3E if 3E fElE iE iE IF iE k 1E IF iF M?F jF fE iE if� iE df iF if if �%if if iF iE Jf if *iE iE iE jf IE iE if af iF iF iF �1f iF dE �IF K� iE M iE �f �if iE �1E i( dE iE iE iF 3E iE iE i4'�)h?E �E 1E iE-)E iE fE �k iE iF df'7E
I N D I V I D O A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
ELE 2 SIGN/ OUTLINE LZGHT SYS ON 1 HR CIRC 15,00 30.00
END OF FEES
^I W13?322-00237326 Tt�7' 985.74
DATEt 04/35/93 TIItE� 14a31
,
�J CONSTRUCTION AND PIANNING PC 3� SPA
APPROVALS Permit �`r Date Inspector AppROVALS Permit � Date Inspector
, 1. Temporary Electrical Service or Pole 52. Pool & Equipment location
i
2. Sod Pipe�Undrgmd. 53. Steel Reinforcement
3. Electricat Conduit Utdiry•Undrgrnd. • 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bondinq
5. Steel Reinfo�cement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. FooUngs 58. Electrical ConduiPUndrgmU.
8. FoundaUon 59. Gas Pipe, O Undrgrnd., Test '
9. Water Pipe•Undrgmd. ' 60. Backwash Lines, P-Trap, � Undrgrnd.
� 10. Structural Floor System � 6/. APPROVAL TO DECK
, 11. Property Sewe� 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
75. Rouyh Electrical-Conduit 66. Solar SYstem-Final
76. Rough Eiectric4Viring 67. Fencing & Access Approval �
��.77. Rough l'Viring Sign 68. APPROVED FOR PLASTERING
�' 18. Rough Electrica:�T Bar Ceiling 69. POOUSPA SYSTEMS FiNAL
- 79. Rough Heating & Air Conditioning FIRE DEP7. REQUIREMENT !
20. Rough �actory Fireplace APPROVALS Permit #
21. Dutts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Pipiny O Gas ❑ Oii
23. Gas Pipe-Rough & Test 72. Undere�round Flush �
24. Roof Framing 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Mqnocoat 75. Dry Chemical
27. Frame and Flashing � 76. Dry Standpipe
28. Lathing & Siding 77, FIXED SYSTEM FINAI
29. Insutation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79...51NAL INSPECTION
32. Electrical Power Meter-Fina� 80' r00D CERTIFICATE ISSUED
33. Final Eleciric �/�O/� �� Notes:
34. Fina� Heating & Air Conditioning
35. Finai Gas Pipe�Test � ' ;
36. Hood or Canopy - - '
i
37. Final Pactory Fireplace � ' ^-�
38. Final Plumbing � � -
39. Water Service�Final � �
i
, 40. Gas Service-Finai �
A7. Solar pomestic-final
42. Backfiow Preventer '�
43. Backflow Irrigation "
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUIIDING -
48. FINAL PLANNING
49. Electric Release to Edison . , '
50. Gas Release to Souther� Califor�ia Gas Cn �
51. CERTIFICATE OF OCCUPANCY
No. Date
i��
/
�
tl
�ooncssaem�ou+o: SSS ANTON BL � uNT:
°"'"E"°"""E'°'aow": SAKIOKA FARMS
i1DDXE5& �pACIFIC SOUTHWEST AEAL1'�Y
R �-
� O BOX 2097� TERMINAL�ANNEX
AVPL. MAlI1W AOONESA
�N�Tap��� T S W CONSULTING ENG �� C35693
ANCX.OP EN6'S ADDPE55: 1 1( S W SAN GAB R I EL UNT: N
ROSEMEAD CA 91770
coHm�cTarsxuiE TNT NEON SIGN COMPANY (310)434-6366
cam�crorrsxuiwc 1436 CHERRY AV
,wmrcss: LONG HEACH CA uera.: 629097
90813 uxr: C
IICENSEU COHfRACTOFS OECLAHRTION: I Mreby ellim uMer pero�y d paejury �he� I em licemetl uMm povidons d Cheptx 9
(wmmmaM wilh Seclion ]000) W Oiwun 3 d Ne Bimnen end Prolnvone Code. end mY Iceme u in IWI brta eM e%ee.
cmuc.No.:064232 uc.cuss: C qs uc.No.: 62909A7
ome: //� 2e� _ C''! S com.aao,: / �,y��. ��-'�I
�
VEF BUILDEF DECLANATION: I MrtLy aMrm uMer panely d pe�ury �het I em ezemq Imm ihe Conlredon Liceme lnw la Ihe
+�TO �semn (Setlian 1W1.5 &niqs4 erd PMe�n ('.ode: M�'W a ouuOY whid� re0�� e De�e b tduWn. Ms. unpwe.
moloh, w repev eny sirucWra, pior m us esuance. eho'epuiras the eppli�nt Iw wch pafmil lo file e sgr�eE etetement Ihet M or eM
b licansed punuant lo �M pons'vn d the Caureaon liu�ea Law �Cheqx B(mmmercuq vAh Setlion ]W0) d Divcion 3 d tlr
Buanesa aM Prdeasuru Cade� w ihe� he a she b azemq Iheralmm enE �he beve Iv the dbped eiemqbn. My violalbn d Setlbn
'.� ]03t.5 by eiry epplKanl fa a perml abpqv the eppfiraru to a arl panelly d na mae then Me hurdnE do0en �SSW�.
I� I. u armer d �M popanY a mY emdof'�as x'vh wapm m thei ede cam�ion. wi0 Eo Ne'�ak. ard Ne at�uciure'v m� inteiMed
� orMareElwsde(Seciion]OId.BusiroueMPmfeasbiuCOEe:TheCaniradontimnseLewdoeamlepplyloenownerdpropeM
,.no w�a� «:owo.� m�. aw,.ro eo�.�n.w� �,.ac «n,�,� «w�n ne «na o.�, �dw.... c�.:eaa inm.�n
improvemaNa are nd inleMetl ar dided lor aeb. tl.lwwws. tM Wildi�p a inpvromeM ia edd xilhin areY� d mmdrnn. IM
ownerL�iltlm will heve the dvden W qwinp he a Me Etl nd drik a impws In �he puryme d eeb).
❑ �. m u.n., a �he o�w«�v. em exdwndr wn.eanc ocA bunra canvedas m omenw ue wdM (seaion ]o... eu.ine.. ene
- Prolauiane Cotla: T�e Coniretlaa licerue lew doea m� epyy io en owar d poperly who buiNe or improvm iMreon eM Mw
convem la erA yqwa MiN e mpredor(+) IcmaeE pwauw Io Ihe Coeurxaue liceme law).
� I em exemq uMm Setlion: B. 8 P.C., br Ihu reeaan:
Dme: �er.
I do �emEY ��h �Mt I em awva d md wMeisbntl IM �apnrtmenb M Cellaw Vlulh ud SdM' Code Sediom 25505. 2551t. a�M
25531, end IMt I a ury Mure buiaieq om�peni will / wll rid (aicb ar) nsed lo campy wth vek Yele mEee uM iM iepuirommie M
e VermA Iamnavuciiona moE�ianhamtMAiauaT�ivuOemen� Divnd. Mtlde�uvl mufrwion eGV�iomus mmmW Imm �hsea
prowiwn.
Dma: /.vd�:
W OPKEP'S CONPENS�TION DEC4N�TOH: I hmsby dfi uder pwully d pajury ar d Ns IaOov.irq datlermuro:
� I hew arM wJ meiruen e aMCNe d omeem io astlimun br xvke�i canparoetion, en praidd /a by Sepion 3)00 d Iha Labor
Cotle. la iM pMormeMe d iM xM Iv Mirl� thu peniin e iasustl.
, I hew eM wil meinten xdken' mmG�+dion imuruae. n �sW'vsC W Swion IIW d Ns lebar Coas. b �M PMamorce G iM
wwk fo� whiM INt permM1 ie inwd. MY ��r+' �Po���� I�uurence wrier ud pdky number vs:
c�r: STAF. F[IND EXPIRES
PdiryNumber. 17f��R1 07/30/96
(This seUion nseE rwf M cvndMN! NeW�t e M aw huM�eC �Wus R100/ uWa.l
❑ I mndy Rw in �M pMamerce d tln work i« xfiich Ihis pemiY u iaweE. I ehvA m� amploy erry peevon in enY menner eo m to
Eacome wM� to Ihe xwMers' canP�ian Mvn W CelLvnu. erW ni�ve Ihet G I eM1aik Ee�mie wMetl lo iM MwYan'
oomro��, w�� a secion a�ao d me leee, wa>. i awi �onnwn oom W ww um. aowon.
oa,,: r i—� s_� r .��: ��. �� a..
Wem/ip: F�llun ro ucun woMwi ronpwwtlon rov�rp� ls unNMul, uW aIWI wD/�cf an wriylqw ro cNmlrW pm�Mu en0
clvll Iliros up ro ons huntlrs0llnus�ntl dWl+n (S�o4aooA ����n ro tM cost o� rompawnon a�w� �+ o�HCM ror In
Sxtlon 81a5 0l M� le4or Cotls. InfwL ���mryY fwa
consrnucnon �Q+allo naeNcv: i nrenv m�m und« w�M a wriw �nm m«. u e cannn,ab, w�eina m�w r« o,.
penu,meMe a ine w«x �« wnkn ine w�^• b eeuee (s.cion x91. cH. c).
LENOEfl'S NMIE:
LEN�EF'S ADOFESS:
� cenin �nm � nma nee ws rodKmia,.ne am. inm ub enw. wom�on o cana. � ro� m canW wan.n ar �d m,Mr o.ev�v�ce.
end sle�e lexs nlelinp to buiWvq conW Wpn aM Iweby eNhor¢e iepefentetivm d Ihu tily b enler upon iM ebove-menlor�etl D�ope�b
lo� ieepeaion purymes.
ANNIE TAN '
M� w�
��. � o�: `% -�.2 . �i f
SgneNre W Oxnet/ApenUAppifan4Conl�apw
�St51�46 WP) Whne-Buildeq 8 Sefety: GreeMFb: Caary-Appkan�: Rnk-Revenue; GokmroC��Assmeor
PERMIT NO: SH 075302
CONSTRUCTION TYPE;
CITY OF COSTA MESA - SIGN PERMIT
PLAN CHECK NO: 04502-95 S
PERMIT TYPE: STR SIG
PERM NO: SB 075302
GOVT: N SUPP: N
PURPOSE: OTH
JOH DESCRIPTION : 343SF LUMINATED WALL SIGN ON TOP OF BLDG SQ FT:
CLAIM VALUE: 20,000.00 CALC-VALUE: 20,000.00 GROUP OCC: B-2 /
COMMENTS: "76 PRODOCTS COMPANY" WALL SIGN
�*��x **� ***�� �r�*rt+�� *+�x *� *+��+��***x *���**��********�**�r****����******x **� *+�+�***�*
S I G N I N F O R M A T I O N
DISTRICT: 1 TYPE: TOP STORY ILLUMINATION; INT CATEGORY: NEW
DIMENSIONS: 73FT OOIN X 6FT OOIN AREA: 343.00SQFT LETTER HT: 72 INCH
STREET FRONTAGE 1: 970.00 STREET 1: t�NTON
STREET FRONTAGE 2: 0.00 STREET 2:
PARCEL: 41050104 ZONE: PDC LOCATION > FRONT: REAR: X
BUSINESS NAME: UNION 76 > LEFT: RIGHT:
O T H E R T O T A L S G R O U N D S I G N
TAIS ACTIVITY . 343.00SQFT OVERALL HEIGHT: OFT��OIN
THIS SITE , 425.00SQFT GROUND CLEARANCE: OFT�OIN
ITEMS OF INFO 1 PLANTER AREA: O:;OOSQFT
ITEMS FOR ACTIVITY: 1 BLDG SET BACK: 20FT „
COPY VERHIAGE : 76 PRODUCTS COMPANY �
PLANNING NOTES:
iE �F �E 1E fE 1E �E fE 1E jE 1E iE iElE 3E 1E iF �E iE iE iE iE iE iE iE fF iF if iE 1E �E iElE iF iE iE if 1E if if 1E iE 1E iE if 1ElElE iE 1E 1E iE IE ik 9f 1E 1f iE 1E iE 1F iE if iE 1Elf iE iE iE iE �E IE iE fElE 3E iE iF iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N*�T S
ZONING APPROVED BY C_q �s DATE: l i/�- �1!
BUILDING APPROVED BY : DATE:. �
APPLICATION ISSUED BY: DATE: ���
�E1EiE1EiEaE1EiE1E1EfElEiEifiEiE�EiElEfEfFiE iE1f1E1E�EfE1EiEiE1E �k*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING
PERMZT 207.00 343.00
PLAN 134.55 SMIPqNON�-RES
ISSUE FEE
BUILDZNG-DIV-> PERMIT ISSOE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 554,20 0.00 134.55 688.75 688.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 688,75 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GAADING PLAN-CHECK
207.00 343.00 4.20 134.55
IE if if 9E iF 1E ik iF iE jF 1E iE 1E iE iF iE iE fE if iE if IE iE IE iF fF iE 1E iE 1f iE IE if iE 1E if if 1f 1F 1E iE iE iE If if if iE i61f iE * ik iE iE 3E iF aE if iE 1f 1E if 1E �E 1f 1f 1f iF iE iE iE if iE iF i6 if iE 1E 1E
I N D Z V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST �
NO FEES WERE SELECTED FOR THIS PERMIT
01 062?SQ47-OC145�St T rs'F' _ '
CHTE� 2!/2'.:�:i TTiiEt ,-c,., .
CONSTRUCTION AND PLANNINC 1 _& SPA -
APPROVALS Permit# 4ate Inspector pppROVALS Permit# Date Inspector
1. Temporery Electrical Service or Poie 52. Pool & Equipment Location
.2. Soil Pipe•Undrgrnd. , 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgmd. 54. Forms
4. Electrical Conduit-�ndrgrnd. 55. Electrical Bonding �
5. Steel Feinforcement 56. Rough Plumbing & Pressure Test �
� 6�. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE
�7: Footings 58. Electrical Conduit-Undrgrnd.
B. Foundation � � 59. Gas Pipe, O U�drgrnd., Test
9. Water Pipe-Undrgmd. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structurat Floor System • 61. APPROVAL TO DECK
17. Property Sewer 4�ne & House Connection 62. Backwash & Recepior•Final "
12. Sewer Cap . 63. Heater & Vent-Final
13. Roof Orains 64. Plumbin� System � Final
74. Rough Plumbing 65. Electrical-Fina� '
75. Rough Elect.ical•Conduit 66. Solar SYstem-Final
i6. Rough ElecVic4Viring 67. Fencing & Access Approval
17. Fiough VJiring Sign 68. APPROVED FO.R PLASTERING
18. Rough EleMricaLT Bar Ceiting � - � 69. POOUSPA SYSTEMS PINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEIVT
20. Rough Factory Fireplace . � ' - , , � APPROVALS Permit #
21. Ducts, in Structure .:� �-- � • 70. Underground Hydro �
22. Ducts. Ventilating � _ _ 77. Product Piping OGas ❑Oi1
23. Gas Fipe�Rough & Test � ,_ '• 7z, Undergrouod Flush '
24. Roof Framing , - _ 73. Undergmd.StorageTank OGas C70f1
25. Roof Sheathing • � � 74. Overhead Hydro
26. T�Bar Ceiling (Structural) &'IVlonocoat 75. Dry Chemical
27. Frame and Plashing , ;,_ 76. Dry Standpipe
28. Lathing &,Siding . - 77. FIXED SYSTEM FINAL
29. Insulation _ • 78. FIRE PREV. PINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINFtL INSPECTION -
- 32. Electrical Power Meter-Final 80. FOOD.CERTIFICATE ISSUED
� 33. Fina6Electric � Notes: '
34. FinaFHeating & Air Conditioning - _
35. Final Gas Pipe;Test , � � � • �
36. Hood or Canopy ' , ^
37. Final.Faciorv Fireplace ' � � � � .
38. Final Plumbing � � � ' � -- � , , � �
39. 6Vater Service-Final ,.. . �
40. Gas Service-Pinal � � � -
41. Solar pomestio-F�nal �
42. Backfiow Preventer �
43. Backflow Irriqation � � � � .
44. Landscape Irrigation System ' ' �
45: Sound Attenuation ` .-� �
46. Handicap RegulatSons � . '
47. FINAL STRUCTURE & BUILDING ) �U l�� � _ -. �
i -
48. FINAL PLANNING • � '
49. Electrie Release Co Edison . ' �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
PNOJECTADOPE55: SSS ANTON BL uxiT: CITY OF CUSTA MESA - BUZLDIA7G FERMIT PEP,M P7U: F Ub9tty�
OWNEP'SNAME: SAKIOKA FARMS
aoon[ss: COACIFIC SOUTHWEST REALTY PERMIT NO: F 069892 PLAN C:-IECK NO: 09014-94 L c,u� , .. ,
P O BOX 2097 CONSTRUCTZON TYPE: I-FRSF PERMIT TYPE: FIR PURPOSE: ALT
TERMINAL AT]NEX
PNCHIENGINEEfl:
flEG.NO.:
AODflE55: UN�T:
PEpMinEE: CALIFORPJIA SUPPRESSION (310)998-6444
PDOflESS: z S O S M I RAMAR
LONG BEACH CA 9U815
LICENSEO CONTNACTOB OECIABATION: I hereby allirm Ihai I am litensed UnAer provi5ion5 0� COaD�er 9(tOmmenCing wi�� $eC�ion
7000) ol Oiv� �o a 1 usiness ane Pmte i n Co0 an0 my license is in lull lorce an0 e�fett.
/b�ic.: a/����� $TRTELIC.:���1�///-''6������ cus�s:y��-10 EXP: 12/94
��/%�/y� Signature�—T/� G�
OflKEflS'COMPENSATIONOECIANATION: I�ertDya I�allhaveacehifiwfeottOns¢nliosell-in5ure0raCErtilitaroo�Workers
Campensalion ijcc�re�q� 09 a�cg�djed copy thereo� �Section 3800. La�. �.1 / O 1/ 9 S
roucr xo.: p EPUBL I C I ND EM E%P. ORTE:
COMPRNY:
¢rtili¢tl copy is hereUy �umis�etl. � CenifieE copy is filed wit� l�e ciry Builtlinp Division.
� /��b�`� `% 67 G'
Applicanf
EMPTIUN FPOM WOPI(EPS' fAMPFNSATION OELLAMTI .(This section neetl nal be completeE ii I�e Dermit is tar ane AunAreA �5100) ar ku�.
I teriily Ihai in Ihe Oerformance 0� t�e work lor whith Ihis permi� is issu¢G. I 5hall na� employ any person in any manner 5o a5 i0 beCome
su�lect to I�e Work¢rs' Compensa�ion Laws ol Calibmia.
�a�e: SignaWre:
NOtILE: If, afier making ihis Oeclaration, you s�oulG �ecome suDlect to tAe Workers' ComOensation provisions al I�e LaGor
Code. you mu51 tOrthwit� tompry with Suth provivon5 Or Ihis pefmi� Shall Oe CeemeO revokeG.
CONSTflUtTION LENOINC FGENCY: I hereby allirm Ihat Ihere is a consimction lentling aAency lor ihe pehormance of ihe work br
wnicn �his permii is iesue0 ISeclion 3097. Civ. C).
LENOEH:
nooeess:
OWNEB BWLOEB DECLANATION: I hereby aflirm i�a� I am exemp� �mm IAe fAnilatlOfs' Stare License law lar ihe lollovrinq reason
(Setlion 7031.5 Business and Pmlessional Coae: Any cily ol counly which repuires a permit Io [onSlmci, alfer, imOmvO, demoliSA, or
repair any simaure. onor ro its issuance. alm repuires ine apvlicant lor sucA permit ta file a 5igne0 statement tlwt he/sne is Iicense0
pursuam to the pmvisions ol t�e Comracmrs' Slaie License Law (C�apter 9(tommencinq vnl� Section 7000) ol UviSion 3 oi 1he Busineu
ana Pmfessions fAae) at ihal ne/she is exempl therefmm and the Gasis lorihe alleAe� exemption. My dolation of Se[tion 7031.5 Oy
any aDP�itant for a permit suCjetls ihe applicant to a civil penalty of nat more tnan live hunOretl Oollars (5500).
I. az owner ol Ihe prop¢ny or my employees wit� waAes as t�eir sole compen5aiion, will Oo t�e work, and tAe
❑ simcture is noi intentletl or olferee lor sale (Section 7044, Business antl Pwteuional Cotle: The Coniractors' State License Law
� tloes nol appry to an owner ol a pmpehy who builtls or impmves lhemon, antl who Eces suc� work �imself/her5elf or I�rOup�
nis or ner own emv�oyees. O�ovidetl tnat such imprwements are noi intenAeE or oifereE for sale. Ii, however 1ne CuilEinp or
' impmvem¢nl is SOItl wilhin one year ol com0le�ion, Ihe owner vnll Aave IOe Uurden ol O�oNnp Ae/ihe Uitl no� �uiltl ar impwve
�or Ihe purpose 0� sa�e�.
I. as ownerollne o�openy. am exclusivety contracting withlicense0 contractorsto constmcithe proiect(Section 7U7d, Business
❑ anC Pmiessbns Coae: T�e Coniracrors' State Lirense Law does nol aD7N �o an owner oi pmperry wlio �mlGs or impmves lhereon
antl who contraqs lar suc� prole��s vnih a coniracloqs) license pu�5uan1 �o I�e ConlracWrs' Siate Littnse Law�. I am awa2
Ihai proat of I�eir Worker's Compen5ation insurance 5h0uld De O�ovidetl to me.
� I am exempi un0er Seclion: B. 8 P. C.
br ihis reason:
�ate: Uvner.
I tlo hereby cenify Ihal l am aware af an0 untlerstanA Ihe requirements ol Califamia Healih and Satety CAUe Sectians 25505, 25533, ana
2553a ana t�at I oi any future Euiltling acupant wilVvnll nol �ci¢le one) nee0 to comDty witA saitl state cotles anE I�e reQuiremenls lar a
permil �or conslmciion o� moEilica�ion Imm I�e Au OuaOty ManaAement 0¢lrici. fle5i0eniial wnSVu[�ion aDDliw�ions are evempi imm
these prOvi5ian5.
Oaie: AODlican�:
I hereby cenity ilu� I �ave reatl t�is aOPlicaiian ana siare i�at ihe abme iniormaiion is coract. I aAree to wmpty with all ciry anE counry
artlmancesand 5laielawsrelatingto EuilEing canstruclion antl �ereby aulhorize re0re5enialivu oil�is[ity�o enleruponi�e a6ove�mentione0
propeny Iorinspet�ion purpasei.
�10/ y l
y Signamre G'—��
or Saiai Secunry e:
i6at�a6 Whi�e—BmlQing: Green—CoOe Enb¢emen�; Canary—Applicanl: Pink—Ravenue; GolEanrod—Assessor
JOH DESCRIPTION ; ADD 2 SMOKE DETECTORS 6 DOOR HOLDER SQ FT:
CLAIM VALUE: 1,562.00 CALC—VALUE: GROUP OCC: B-2 /
COMMEAITS: BAP7K OF AMEAICA ATM
iF+t+f+f �r �-+f +t+t if at iF *%aF at at ac jc �c ac r ar ac s ac aF x-�1� � aF **** if i� ac ac-u r�-F �n aF+t �t ac {[ ae+t �K a! r� �F �t a.+F ic x� at rt r iE ar-Y aF+f �w aF jc �ac �c �u iF+F+c r+F -k
Z O N I N G R E Q U I R E M E P7 T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN AEAR: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE; P.EF NO:
PLANNING NOTES>
>
itMitiFifKYifiEifil�lifiElfifif 14sif�1lfflFif Vikififif�EMMiEYiFifiFiLifMiFKiFi:it�FMiEifil�iFif4<iF�f?fififiE4ifiEicitM�iRMacaMY-iF�1f�1FYiFi4iE�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZOP]ING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISS[]ED BY; \ ��- (� DATE; �
'IF1Fif1F1MiliFlfififiF'14LYififY�F{�Milif�ifl{���l����i 1f'11��Ms ii��fi�x�YiiF{F*{�1Fif+fiMiFlFiFaf �if
�twr�**rr*r+r*.it**r�r*+��ar+c*****ir*+�+r*+t*r�irv**r***i� rt***�r*�rr�*�x-�c*�cirrr«*rafirr�*.c�*�r�-ir-
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECY.ANIC FIRE SMIF/RES GRADING
PERMIT 37.00
65h SMIP/NON—RES
P LAf7 2 4. 0 5
ISSUE FEE
BUILDZNG—DIC'—> PERMZT ISSUE PLAPJ—CHECK TOTAL PAID DUE
TOTALS----> 37.00 0.00 24,05 61,05 61.05 ,00
P.EVENUE DIVISIUN TOTALS--> COLLECTED: 37.Q0 OI,�ERlSHOP.T; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIP.E SMIP/TOT GRADING PLAN-C?iECK
37.00
it+h irit it iE 4 ir it it 1E i(� it �t iF �k iE �If �c rt M ft a4-IR #�)t riif if if it if if at if 1t �)t it ir it� iE 1E r i�� aE+t ar {� ic if� if �lf 11�+f r r iF r it it i1 iF if-aF �r i. ie� ir x�r-r �t {t a. if -lF r+t ♦
T N D I V Z D U A L F E E B R E A Y. D O W N
TYPE QTY D E S C R I P T Z O P] UNIT COST TOTAL COST
FIR 37 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1,00 37.00
END OF FEES
EXPI E
DA � �%(p �,
ai �J01?153a-0017153� T riT 37.OQ
DATi= ii/lQ:44 TII!c: 14:52
CONSTRUCTION AND PLANNING - ,' P� -- �& SPA
APPROVAlS Permit#�' _.Oate inspector p�ppROVALS Permit .�r` Date inspectori
- ,
1. Temporary Electriral Service-or Pole � 52. Pooi & Equipmenc Location %',
2. Soil Pipe-Undrgmd. - 53. Steel Reinforcement
3. Etectrical Conduit Utility-Updrgrnd. � 54. Forms -
4. E�ectrical Conduit-Undrgrnd. 55. Eiecirical Bonding
5. S[eel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgmd.
8. Foundation ,; � ��• � 59. Gas Pipe, f> Undrgmd., Tesc .
9. Niater Pipe�Undrgrnd, _ I 60. Backwash Unes, P�Trap, O Undrgmd. .
70. $tructural Floor SYstem i� 67. APPROVAI TO DECK
11. Roperty Sewer Line & FlousA Connectio� x 62. Backwash & Receptor�Final .
12. Sewer Cap � ' 63. Heater & Vent-Finai �
13. Roof Orains � � 64, Plumbiny System - Pina� �
14. Rough Plumbing 65. Electrical�Final
15. Rough Electriral-Condu�t 66. Solar System-Finai
16. Rough Electric Wiring 67. Fencing & Access Approvai
17. Rough Wiring Sign 68. APPROVEO FOR PLASTERING
78. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEM1,iS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit �
21. Dutts, in Siructure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping'.� Gas ❑ Oii
23. Gas Pipe�Rough & Test 72. Underground Plush
24. Roof Framing 73. Underymd.StorayeTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro '
26. T-Bar Ceiling (Structurap & Monocoat 75. DrY Chemical ^�
27. Frame and Flashing . 76. Dry Standpipe '-6�
28. Lathing & S�ding 77. FIXEO SYSTEM PtNAL �A,'��., _,-
29. Insulation 76. FIRE PREV. FINAL L' a �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �,e--
31. Plaster Broa�n Coat 79. FINAL INSPECTION
32. Electncal Power MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Final Elecuic � Notes:
34. Final Heating & Air Conditioning .
35. Final Gas PiDe�Test � �
36. Hood or Canopy �"
37. Final Facto�Y F��eplace
38. Final Plumbing " %�
i
39. Water Service�Final �-
40. Gas Service�Finai '
At. Solar pomesticFi�al
42. Backflow Preventer ' '-
43. Backflow trrigation f '
44. Landscape Irrigation SYs:em
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & dUILD�NG __ .
46. FINAL PLANNING - -- '
49. Electric Release to Edison __,
50. Gas Release to Southern California Gas Co -�
51. CERTIfICATE OF OCCUPANCY
No. Date
�
�
�oopEssoFewiar�c: 555 ANTON BL uxr:
OWNFA'SWWEIFplOIYN: SAKIOKA FARMS
'`o°"Eu: RPACIFIC SOUTHWEST REALTY
CO
P O BOX 2097 TERMINAL ANNEX
1VPl.YNlP1G �OOPE55:
AIiCHRECT OF (NtlNHX: 11C. NO.:
1qCN.OP EN6'S ADUXE55: UNT:
����T�g� TNT NEON SIGN COMPANY (310)434-6366
CO�APACTOXSMIl1Al0 1436 CHERRY AV
eooxess: LONG HEACH CA ucra: 629097
9 0 813 uxr: C
LICENSED COMXACTOFS OECLIPATION: I heraby tllim under panely W paijury Nel I am IironaeE uMa prwieima d Chepar 9
(mmmendng m�h Seciion )000) W DNision J of ihe Bueineee anE Pmfeecione Code, eM my license ie in lull lome and eHea.
cmuc.No.:064232 uc.cuss: C 45 uc/.No.�: 0629097
ome: � l -�� �l 't comree«: �-�O �C.�
WNEF BIIILDEX OEC WflRTION: I haraby elfiim under penaMy d perlNiY �� �� exemq Irom �M Coircrepon Lironee lew Iw dw
Ibw�q reeson (�an ]W 1.5 &ni�ase erd Prdaeabne Cade: My cTy a aouMy wfiirh npuirte e permN to mnsW�1. ella. imprne.
aemoloh, or repeir eny etmcluro, pbr to ee'veuence. alao reQuiroe IM epplkini br vuch permd lo file e eprwd eletement Met he w ehe
u IiunaeE W��t lo IM pwidme d Ne Conlretlare Lioeme lew ICheper 9(�me�p wilh Sadion ]OW) d Diveion 3 d the
Buznesa erM Adeseiona COEe� a Ihel ha w eM is eaemq �hereham enE iha Waro la tM elbped examqion. My vidmian d Seaion
]031.5 by eny ep0liwit Iw e permn eubjme Iha epD��� �a e tivil penalry ot nd more ihen INe huntlretl Edlen �5500]).
� I, ea owner d IM qopMy m my empbyaea wAh wepes m ihei ade mmpanaelion, will do IM xork, eM iM eirvnure e rql intandad
or MereE br ule �Seetion )006, Busnees enE ProleseionsCOEe�. The Conlredon Lieenae Lew Coae ewl epON�o en owner o/ propery
wM10 Wide « inWm'es IMreon. aM who daea auei� xwk IvmaeM a henN n Ihraqh hif w Mr own emV�M�. Y�ed Ihet weh
impewemame era rot in�mEad a oHered Iw eeb. X, Mwevar, �he WiWinO a�P�a'amem ia edd wnhin ma yw of eampleton, �M
ownmbuitler will heve the Wken d Oro'+inp he or eM diE �rot buiW w imD� Iw Iha WN�e d sele).
� I, m oxmr d �he propaM. a^ eRdi�ely mnvediq xnh limnsad conirecton to canvua tM prqaa (Seeion )014, Buai�me ud
PrWesabru Code: TM Contrepon Licanae Lew doaerwt epplyto en ownerd prope�y wM Wide aimproveeihereon vd who
wn�recm 1« uM pqee� wnh e oonlredor(al licenxd punuant to iM Canvmoen Liiaree lew).
� I em eaempt uMer Section: B. 8 G.C..Ia ihia reemn:
De�e: Ovmar.
i ao ne�W ronM m� i� e.me a�d unde�ssiena ma rea�����s a c�a�e Hmpn,m smmr coae seaiom zssos. zu�. ene
25530, aM Ihd I or erry INura buiMiip oavpent will / wAI nd (arcb me� need lo comON w�h sek nete codee end �ha requirememe br
eparmnlorcaul'unionamoEiHrationhomlMAi u3e�ty enepamaMDistrie.Reaidm�idmnmruqioneppYmtiomvaezamqiromiMsa
prwisions.
PERMIT NO; SB 075304
CONSTRUCTION TYPE:
CITY OF COSTA MESA — SIGN PERMIT
PLAN CHECK NO: 04804-95 S
PERMIT TYPE: STR SIG
PERM NO: SH 075304
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : NONLUMINATED LOGO SIGN SQ FT;
CLAIM VALUE: 1,000,00 CALC—VALUE: 1,000.00 GROUP OCC: B-2 /
COMMENTS: "76" LOGO SIGN
*��*��r���*��*****x��***�*��*x�*�*�*���x��x*����*��****�*�r*��**�e*��***�r*���****��
S I G N I N F O R M A T I 0 N
DISTRICT: 1 TYPE: BUILDING LOGO ILLUMINATION: INT CATEGORY: NEW
DIMENSIONS: 4FT OOIN X 4FT OOIN AREA: 16,OOSQFT LETTER HT: 36 INCH
STREET FRONTAGE 1: 970.00 STREET 1: ANTON
STREET FRONTAGE 7: 0.00 STREET 2:
PARCEL: 41050104 ZONE: PDC LOCATION > FRONT: X REAR:
BUSINESS NAME: UNION 76 > LEFT: RIGHT:
O T H E R T O T A L S G R O U N D S 2 G N
THIS ACTIVITY . 16.00SQFT OVERALL HEIGHT: OFT''iO�IN
THIS SITE , 148.00SQFT GROUND CLEARANCE: OFT�^'OIN
ITEMS OF INFO 1 PLANTER AREA: O.;OOSQFT
ITEMS FOR ACTIVITY: 1 HLDG SET BACK: 20FT� J
COPY VERBIAGE : 76 "LOGO" �
PLANNING NOTES: �"
ih iF ik 1E �flk iE iE fE iE �E 3Elf 1f iE fE 1E ff if 1E iE iE iE dE iE fE �E �)E �ElElE fElE iE iE iElE fE �E 9E 1f 1E 1E iF 1E jf 1E ik iE iFlE ik iE if fE iE iE 1E iE iE �ElE �E fE fE �)E iE i(-�1F 1E.iE if iF jE 3E iE iF iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E NjT S
ZONING APPROVED BY � � DATE: ��r ��L�L �i
/ �\
BUILDING APPROVED BY : DATE: y
APPLICATION ISSUED BY; DATE: � LL y%
De�e: ACW'ranc 1EiEikjE�lEiEkjElElElEiEiEiE1EiE�7E�E1E1E1E1E lE3f!(�1EfEiElEiEiEf(- �1fiE
WONKEN'SCOMPENS1T10NUECL/�RATION:IMrebyeff�muMerpenaltydpeljurymadtheldbxiipdedvetions: LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
❑ IheveendwiAmanteneceneicmedmnaenimeeMinwreMxwkerscwnpenmion,eaqwNedlab/SeqionaloodiheLebar BLDG PMT PLUMHING ELECTRIC MECHANIC SIGN SMIP/RES GRADZNG
c�.m,ms�no���ain,�i«.n��nin�a�n�,���,e. PERMIT 25.00 16.00
� SMIP/NON—RES
I M1ere eM wil mantem xwken' canpente�ion i�puren.e. m mQuinE by Sa]ion 3]00 d Hro lebar Code. b iM peRamence d tM
.� i�.,�nKn mm o�n u ro.�e. n+v wax�� �maa�.m� ��s�,��e �e, a,a wi� ��mn« aa: P LAN 1 6. 2 S . 5 O
c�<r: S FC1ND EXPIRES ISSUE FEE
POIkyNumber: 'I�� 07/30/96 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
�rrissxrionneea�aae�da����v�xisraa�enurw�eeed/e�s/siw/a.�.� TOTALS----> 41.50 0.00 16.25 57,75 57.75 .00
� I ronh �hm in the pe�lormence ol �he wak la whch �hie paemil ie esueC. I ehell na employ eny peron in eny manner ao n to
e,��,�ei�aioin�.�e,.�w���..ac�a�,m.�e�,e.u�ni�b�.�qeamma»axan REVENUE DIVISION TOTALS--> COLLECTED: 57.75 OVER/SHORT: 00
oom�o�ro�o�s�b��a�oowma�e«coe,.i.nviionnwnn��wnni HLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK
o�a: �/ —�` `Z �e'r "w"�'m: Q�—� ��a 2 5. 0 0 16 . 0 0 , 5 0 16 . 2 5
W�m/ny: Fellu� ro ucuro wortwi mrrpauetlon caverep� b vnl�wNl, mC sMIHu�).ct �n xrploysr ro MMIu/ p�n�Mu mG
dvliHrwwromehinerseHauwMeo/Mn(Stu0.00uANam/tlonromero�tolcomvxwnondamew+uProHdeerorin !lififififlE�lEiEkiF1ElE1EiE14ifiEiEiEiEiF1EiE1EiFiEiFififififlEiElEiElFiFiElE9EiEiFiE�lEiEiE�IEiE1ElfifiEiEiEiEiE�IfiE�1E1E1EiEiEiE�1E�1E1E�EiFkiE�lEiEiE-%iEiFiFjE
s«uo� sros o� me �roor cow, ��t�t a�e arcomey ��es�. I N D I V I D U A L F E E B R E A K D 0 W N
CONSTflUCT10N LENDINO AGENCY: I hereby �rtn uMer penalry oi peryry ihei ihere is e wnalrudan kMinp epeMy fa IM
�n����n�,.«�ro,�.n��n�nare���sn�ais«�a�aos�.ca.c�. TYPE QTY
IENDEN'S NAME:
LENDEN'S ADDNE54:
I<e�ify thei 1 heva read ihis aD0lca�im eM ete�e thei �ha ebove inlormetion ia w1ree. I egrae to wmpN ��h ell dry enE muMy oNineMea
eM etete leMs rele�m9lo buildvq mntlrueion e�d MrebY eWwrce reprewn�miam d thia rAY ta en�er upon iM ebove-mentoned propaery
lorinspaeion purposes.
ANNIE TAN
^ /� YfIn�N0m0
C '�—��! �G7n oma: !/--2� _ �'7 i
&9^eWre W Ow�rerlRpenVAppM1canUConvec�or
(5151-�6 WP) WhXe-BuilEip 8 Seleiy; Greeo-Fle: Cenery-ApPXranl: Pink-Revenue; Oddenro�Asbmr
D E S C R I P T I O N UNIT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT �
'> OI QO?4�Q:�1'1�U195D`4 C A.! T �'.7�
GATE% llli2!SS TI�''L-: '<:s5
� J
' �
CONSTRUCTION ANO PLANNING " F'- `$ SPA
APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector
1. Temporery Electrical $ervice or Pole _ 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement �
3. Electrical Conduit Utility�Und(grnd. 54. Forms -
4. Electrical Conduit�Und�gmd. � 55. Electrical Bonding
'5. Steei Reinforcement � 56. Rough Ptumbing & Pressure Test
6. Electrical UFER Gmd. � 57. APPROVAL TO COVER-GUNITE -
7: Footings `� � 58. Electrical Conduif-Undrgrnd.
� 8:.Foundation - ± 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. .. . 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Ploor System . 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection 62. 8ackwash & Receptor-Final
12..,Sewer Cap 63, Heater & Vent-Final �
13. Roof Drains � � , 64. Plumbing Syscem � Final t.
74. Rough Plumbing ,. 65. Electrical-Final �
15. Rough Electrical-Conduit � - 66. Solar SYstem-Final
i6. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR-PLASTERiNG -
18. Rough Electricai�T Bar Ceiling - � 69. POOUSPA SYSTEMS FINAL
19. Rough Neating & Air Conditionin9 � F4RE DEPT. REQUtREMENT
20. Rough Factory Fir.eplace .� _ -- � APPROVALS' Permit #
2i. �ucts,in�5tructure • - ' � � � . J0. Underground Hydro, - �
22. Dutts; Ventilating� ,� - ' 71. Product Piping OGas ❑Oil
23. Gas PiAe-Rough & Test � �- 72, Underground Flush
24. Roof Framing _ . �_ 73. Undergrnd.StorageTank-OGas ❑OiI
25. Roof Sheathing . � - 74. Overhead HYdro •
26. T-Bar Ceiling {Structurall & Monocoat -. 75. Dry Chemicai � _ -
27. Frame and Flashing . 76. Dry Standpipe � -. '
28. Lathing &-Siding � � � ' - 77. P�XED SYSTEti1 FINAL
29. Insulation � 78. FIRE PREV. FINAL T'
30. Drywall Nailing ' , ' HEALTH DEPT. REQUIREMENT
37. Piaster 8rowqCoat � 79. FINAL WSPECTION •
32. Electricai Powzr Meter-Final 80. FOOD�CEflTifICATE ISSUED
33. Final Electric . . Notes: -^ �
. 34. Final Heating & Air CUnditioning _ ' , � -
. 35. Final Gas Pipe:Test � � - _
36. Nood•or Canopy " • � ' . �
- 37. Finai Pactory Fireplac? . _ � � -
3$. Final Plumbing • � _ " � .
39. Water Serwce�Final � ` �. - �
40. Gas Service•Final ' � " • �
41 . Solar pomeStic�Final � . � " •
42. Beckfiow Preventer • �� � �
43. Backflow Irrigation • �
44. Landscape Irrigation SYstem � � • - � � '
45. Sound A2tenuation . . ' . .
46. Handicap Regulations � ' � " '
47. FINAL STRUCTURE & BUILDING � �p (�'� � ..-
48. FINAIPLANN4NG � r-• �� .
49. Electrie Release to Edison . �= '- .- ,_
50. Gas Releate to Southern Califomia Gas Co �� �
57. CERTiFICATE OF OCCUPANCY
No. Date
-�
�'.Ap0licant to fill in all spaces excep� t�ose wilhin
� oF COSTA MESA CONSTRUCTION PERMIT `
Project Address SSS s�i�.%%�I�.1 %�� v0 �
Ap�licant's Mailing AddrCss �N �OU � S C. {'l••' '
Owner's Name /�/L4NSP.4C�P/c aEvecop� hon; 3/�- �'��
Address 2377 G2ENSH8c� $�✓D •.i%E 300 �b�R/L!
/� �p
Arch/Eng. �/lR% W�' '4'SSG1C• Licpen�se, N�o. �' � J 00 .
Addreu _`���.��� Cm Q, /�cr` /�LS
Contractor's Name v�� C� b 8�`� ,3E
Addresslmailing) ��� S` F��'�''�aa- sF .�'
02 q 60 8 • ; -.�-�-
City License No. � � "
LICENSEO CONTRACTOR DECLARAT�ION ��
1
I hereby a(firm tha[ I am licensetl untler provisions of Charter 9(commencing
with section ]000) of Division-3 of the Busi�euantl�Profe551ons.Cotle; antl
my license is in full �ce anG e(fect. �.n ` 2O '
� .�. �%�. ;�� i/ -� '
ORKERS'COMPENSAY�ON�DECLARATIOf�! � � '
.te�eCy atfi�m [hat I have a ceitificate of,cbn5ent�to selt-insure Or a ceitlficate'�
ot Workers' Compensation Insurance, or a certitietl copy� thereof (Section-(
3800. �ab. CJ .t ./3] �/B�� �� •
voiicy No.�2�671����rl `Company %w4�—%`
n� /,-.ertified copy is herebY fumishetl: � l. � ��'� ' •i
L2T cert' i c i Iletl With Ihe city B� i DiviSi �a%� �
Date � APplicant � ' iy�-9�-r--� �/�1 r
EXEMP 10--�RKERS; COMPENSATIO EGLARATYON , , _
(Thiz section neetl not be completetl if the pe�mit isdor One huntlretl ($100) o��:
less). .:� . . • -� •, �l .
I certity [hat in the pertolmance of the wo�k fot which thi5 Pe�m�t is isspetl,�l �
shall not employ any person in.any�manner'so as to tiecome subject to the:
Workers' Compensa[ion Ls�+z of Calitornia. - • � ' �
Date Signature ' � "' � �- �� F .�,
NOTICE: If, after making this tleclaration; you'.snoultl become subject�to the• •
Workers' Comp¢nsation O�ovisions of the Labo� Cotle, yoU must tortM1with
comply with such proviswns or this.. permit 5hall be deemetl revoketl.
CONSTRVCTION�LENDI�`1G AGENCV '
I heteby affi�m tha[ ther2.`i5 a wnstruction lentling agency (o� the per(ormance
ot the work fqvyyjSh,jyi} ermit s��i��,nSI�15ec(iprLjj197�C�y, ,
Lentler's Name 7�/ �f"�Z tiK\ S,1M1
Lentler'S ACtlre55��%D ✓El�'�3�� Oo .A. 006'J .
OWNEH BUIL�EH DECLARATION
I M1ereby affirm�that I am exempt from the Contractor's License Law tor the
following reason: t5ectlon 7031.5 Busine55 antl Professional Cotla: Any city or
county which requir2s.a permit to conseruct; alter, improve, tlemolish or repair
any structure, prlorto itrissuance, also requlres Ne applicant for such permit
to file a signetl statement that he/she is licensetl pursuant t0 tM1e provisions oi
the Contractor's'Licen3e LPw (Chapter 9(commencing with Section ]000) of
��ivision 3 of the Bu5ine55 antl �Professions Cotle) or that he/she is exempt
therelrom antl lne basis'(or tM1e allegetl exemption. Any viOlation of Section
703L5 by any applican<_ for a perm�t Subjects [he applicant to a civil
�enalty of not more [han l��e huntlretl tlollars (E500).
1, as owne� 01 the property or my em0loyees wlth waq¢5 a5 their Sole
com0ensation, will tlo the `�'ork, antl the structure is not intentletl or offeretl
for sale (Sectlon 7044, Business antl Professional Cotle: The.Contractor'S
License Law does not app�Y to an owner ot a property who builtls or improves
thereon, antl wM10 does such wark him5¢If/hers2l! or through hls o� her own
em0�oyees, provitletl that sucM1 improvements a�e not intendetl or�otferetl for
sale. It, however, tM1e builtling or improvement is soltl within one yea� of com-
- pletion,�the owner will ha�e the burtlen of proving he/she tlitl not builtl or im-
prOva for the pu�pose of 591eJ. , ' ,
❑:I, az owner of"the property, am exclusivery cantracting with Ilcensedcon-
tractors t6 construct the pro�ect �Section ]044, Business antl Protessions Cotle:
The Contractor's License Law tloes not apply to an owner oi property who
builtls-or improves therep�, antl who Contracts tor such prOj¢Cti witM1 a con-
Iractor(5J license pursuanC to'the Cont�aCtoYs License Law). I am aware that
proof of their Wotker's;Compensation insurance shoultl be Pwvitletl to me.
❑, I am exempt unaer Section B: & P. C. for this reason
Date Owner
I hereby certiry that I have read tM1is application an0 state that the above
Information is mrrect. I a9ree to comply with all city antl county ortlinances
antl sta[e laws relatinq to builtling consty+, tion antl hereby authorize repre-
sentatives of this cily to g�ter upoytrye above-mentlonetl proderty/for
or 55 �
Dortler lines antl si9n all
%3= 28867 lo9s0 St '� - -
TYPE OFCONSTRUCTION NEW ApD ALTERATION REPAIR
�CONVERSION ❑ DEMOLISH � OTHER A.p.#LJ/O'
DESCRIPTION OF WORK/USE OF BLDG. �Z ST0�2y
O . CE U/LO/AJ ' S Main euiidi
TVPE OF PERMIT GRADING FOVNOATION STRUCTURAL T Fronr �%Q
❑�TENANT ❑ ELECTRIGAL ❑ PLUMBING ❑ MECHANICAL � B Rear J j�
❑ OTHER A
PR0.IECT DESCRIPTION 5�. FT. oCCUPnNCY �B-2 C Right --
CONSTRUCTION TVPE � �� ALUATION $ I�� �OP �'��F.3 g Left �
ZONE , GRADING CU. VDS. ACRES p�ng. Ref. #��
aemark;: P.G• 2.3 �fSiC.ZS R7,J' /O �p] lf�,�s j�. (o /S ,� Planning Notes:
!JJ �d if.i n-. i �.�.,.-...� '.... ..�' "'
Drinking Fountains
FloorDrains ' -
Floor Sinks
Gas.Service �� Outlets i
Interceptors � � ` � ��f
Kitchen Sink ' _
Lavamries � ' � �
P—T.an ' '
ROof Drains ` � ' '
Reinspection Fee $15
Boiler � � _ . ,
Duct - Under Ground �
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
O o-i oo,000 eru � i oo,000 sr�
Reinspection Fee � - $75
_ a
CMF 0865-46, /ev. 10/84 White - Builtllnq; Canary - Applicant; Pink - Accounting; Goltlenrotl - Aszesso�
SIIOWCfS
Service'
Sewer,Co cti
Solar Col or
Solar Pipin
Solar Tank
Swimming.Pool w/Spa
Urinal �
Water Closet
Water Heater
Water Service
Isue Fee
iANICAL
Hood or Typel ❑
Canopy Type I I ❑ -
Refrigeration System �
❑0-100,000 BTU �❑100,000 BTU
System fiepair/Alteretion I
Fire Dampers �
Registers .
laue Fee
FEES
Automatic Washer _
Construction PoleSu6.
Cooking Unit
�� ��%L �/�'�� .
� �
I,'f,f.1 Zone PJZ�
Accessory Building:
�� � Z
O
N2�P . l.lit-2 . N
N i
N
G
R
—g Parking Req./Provide ' � �'�/ E
S/�ca.9�' A - . I M
..........._ . . . _ S
ELECTRICAL �
Transformer ❑ 15-50 KW
❑ SO+KW
Mecer Oup m 100 amps �
Meter ❑over700amps
Dryers OGas 'QElectric
Fan �
F.A.U.
Fixtures •
Device Boxes �
Outlets ��
Switches . '
Gar6age Disposal '
Generator �0-5 KW �5-15�KW
$ 3 '
ReinspeMian Fee $15
FEES
�DEVELOPMENTSERVICESREQI
Zoning Approved By
Building Approved B�
A li ti
PP �d 00 ISSUBd BV
$ 3
Sub Panel - '
Motors �0-1 HP �1Yh � B
Inc. Solar �9-15 HP 016-15+
Microwave
Standing Sections
irash Compacior
Issue Fee
FEES
$ 3
SUMMARV OF FEES
BUILDINGPERMIT $ 36,73�0o SMIP $ DZ.3.`f
PLAN CHECK $ PERMIT -
PLUMBING • . $ � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $ "
ELECTRICAL $ � GRADING $ �
PLAN CHECK 50% $ � MICROFILM $ '
MECHANICAL � �$ TOTALFEE $3 %7 66.�8
PLAN CHECK 25% $ � - � '
CONSTRUCTION ANCI�PLANNING
APPROVALS Permit�k
/
1. Temporary Electrical Service or Pole ,
2. • Soil Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgmd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement � �
6. Electrical UFER Grnd.
7. Footings ,
8. Foundation ' �
9. Water Pipe•Undrgrnd. �
10. Structural Floor System'
11. Property Sewer Line & House Connection
12. Sewer Cap
73. Roof Orains
14. Rough Plumbing �
15. Rough Electrical-Conduit .
16. Rough EleMric Wiring
17. Rough Wiring Sign
18. Rough EleCtrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing ,
25. Roof Sheathing ' .
26. T-Bar Ceiling (Structural) & Monocoat
27. Frameand Flashing �
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
31 . Plaster, Brown Coat
32. Electrical Power Meter-Finsl
33. Final Electric'
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36.� Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Serv�ce-Final
�40. Gas Service-Final
41. Solar pomestic-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
4r3. Electric Release to Edison .
50. Gas Release to Southern California Gas Co
. CERTIFICATE OF OCCUPANCY
Date
Date
as
POOL & SPA
Inspector p�ppROVALS Permit# �
52. Pool &.Equipment Location � �
53. Stee! Re'inforcement � �
54. Forms � � � �
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit-Undrgrnd.
� 59. Gas Pipe, O Undrgrnd., Test .
60. Backwash Lines, P-Trap, O Undrgrnd.
� 61. APPROVAL TO DECK "
62. Backwash & Receptor-Final � �
63. Fleater & Vent-Final � � �
64. Plumbing System - Final
65. Electrical-Final
66. Solar System-Final .� �
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPA SYSTEMS FINAL � ;
FIRE DEPT:'REQUIREMENT �
i,
APPROVALS .Permit.# �
70. Unde�gr'ound HyBio � �
71. Product�Piping �'Gas ❑ Oil ,' .
72. Undergrouncl.Flu;h n� _, � •
73. Unde�gincl^ Storage Tank O Gas' � Oil
� 74. Overhead.Hydro .
75. Dry Chemical �
76. Dry Standpipe_
_..�
77. FIXED SYSTEM FINAL
�. ._ . � : .x_. ,. -
78. FIRE�PREV.°FINA� � �
� HEALTH�DEPT�.REQUIREMENT
79. FINAL INSPECTION .
80. FOOD CERTIFICATE ISSUED
Notes:
�
.� . 1 �' �' /
�.
�
�
Date� � Inspector
' �
�
G s� .
` .
_2.3:�
,. . �. /
� ,� � �
, '�+
� l _.
`
s
ADv���ant to fi11 in al1 sDaees encept tnose within heavy Doraer lines ana sign all appropriate Oeclarations.
PERMIT NO. TFACT N LOT NO: UNIT NO.
ci7Y,oF COSTA MESa CONSTRUCTION PERMIT �p '3 D$�/ p� �O -j 8446 10727/87 I Op5,40
-. ��. 1 _
ProjettAddress 55r�C��+/v[�,�vYv `��Z%� �
� AppliCan�'S Mailing Addre55 ���i7_� �� TYPE OF CONSTRUCTION NEW AD� ALTERATION REPAIR
Owner'S Name `on � CONVERSION ❑ DEMOLISH ❑ OTH q,p, # .� �L� Zone
-T�.�a,o,h-OFv_ � . ��Z �F. 0 ` So Pl�.
D�„$CRIPTION OF WORK/USE OF BLDG. �� ���DE�-
Address Z3�C���.�.,._`� � 3� �� �� O EL/�O S MainBuilding: AccessoryBuilding:
ArcH/Eng. ��� �'�''��,_Y,,J1��1A�� Lic�¢nS�.e..Nno. Ct����O TVPEOFPERMIT GRADING FOUNDATION �STRUCTVRAL � T Front p
Addreis9 � �J� C�•�•i�7IiH( �ST•r�� W�C ipZLQ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
ConVaCtor'S Name �'�' � �}�Z Phone �—�¢� !O OTHEf3 .�. %� �
PRbJECT DESCRIPTION 50. FT. oCCUvarvcV C Right N
Addreulmailingl��'�"�'�"��''� G'�*',/�"t�'S[A 9Z6z6 �— K C'
2Q6Oy ;CONSTRVCTIONTVPE 1 VAWATION532C.1iQ0� S Left R
CiryLicenseNo. � 'ZONE GRADINGCU.V�S. ACRES
� LICENSED CONTRACTOR DECLARATION Ping. ReL # Parking Req./Provided E
1 hereby attirm tbat I am IicenSetl untler provi5lon5 of Charter 9(commentlng Remarks: ��� �.e� �p'jg .%� �Q[ 7 y Planning Notes: h � (.� F r+ M
i with section 7000) 01 OivlSion 3 of the BuSinesS antl Profe55ion5 Cotle, antl ' �/ JL 1_,.
my license is In full force an e lec 0 , wL �•SO� p� R . (� Y� �O S/� ✓J�[. N� o , �o S
License Class � Licens - o. �� 63 9 ,
Date f0 � S�y t ' �.✓�.«• .� - PLUMBING #L �/p - L FEES IS hvV �NO �t �{'y S�y,'� tn 4w}i� � r 4 Y
WORKERS' COMPENSATION DECLFRNTION Bef Siflk $hOwE�S ' �
I hereby attirm tnat I have a certiticate o/ consen[ to seli-insure or a certiilcate . ELECTRICAL FEES
at Workers' Compensation Insurance, or a certitietl cooY tnereot (Section Backflow Preventer Service Sink
3800, L.ab. C.) . • - Auromatic Washer Transformer ❑ 15�50 KW
Policyrvo.w�)'i�i1�'����Com�any - Backflowlrrigation SewerCa �5�'
P Construction Pole Sub.
�Certifietl copy is_hereby furnishetl. . . �
Certitietl c is iletl wrth the city in9 Divisio Bathtubs Sewer Connection Cooking�Unit Meter ❑up to amps
Date AOPlicant �(il�'�— .
EXEMPTION FR M WORKERS'COMPENSATION DECL ATIAJC ON Clarifi¢fi� SolarCo�leCtOrs DiShwasher Me[er ❑ r 100amps
(This settion neetl not be completetl if the permit IS (or ona hunOretl ($100 or
iess). � Dishwasher - Solar Pipin9 Dryers ❑Gas ❑Electric Sub nel
I[ertify that In the perto�manCe o� the wo�k for which tnis pe�ml( is issuetl, I ,
shall not employ any person in any manner so as co become subject to the Orinking FOuntains Solar Tan Fan . otors 041 HP �1 h- B
Workers' Compensatlon Laws of California.
oate Signature Floor Drains " Swi mg Pool w/Spa F.A.U. Inc Solar 09-15 HP �16-15+
NOTICE: If, af[er making this declaratlon, you shoultl become subject to the ._ _
Work¢rs' Compensation provi5ion5 of the LabOr Cotle, you mu5t forthwith FI001 $iOkS �n21 FixtufCS ' Mic�OwBv¢
wmpty with such provi5ions or t�is permit zhall be tleemed revoketl.
CONSTRUCTION LENDING AGENCV GasServiCe ODUets �WaterClOset DeviteBoxes PoleLiht
I hereby affl�m that Ihme IS a Constructlon Ientling agency fo� the pe�formance 9
of the work for wn�cn this Oermit is issuetl (Section 309� Civ. C.) IntErc¢ to�s Water Heate�
Lenaer's Name �" � P Outlets Range
Lentler's AEtlress V�' Kitchen Sink Water Service Switthes Sign
OWNER BUILDER �ECLARATION ,
I hereby a(firm that•� am ¢xemp[ from the Contfac[o!'S License Ldw for the LdvdtOfiCS AutO-Wash (�idfbd 2 Di5 O
following reason (Section 7031.5 Buzlness antl Protessional Cotle: Any ci[y or 9 P $tanding Sections
county whicll requil¢S a petmlt to con5tluct, alt¢r, improvE, tlemOlish oI r¢pair P-Tfdp LduOdf T!2 5
any 5[rvcture, prior to its i55uance, also r¢qulr¢5 the applicant to� such pe�mit � Y Generacor �-5 KW Q5-15 KW Tr25h Comp2cto�
to file a sign¢0 staternent that he/sM1e Is Ilrensoa pursuant to the provisions of RoOf Dfains � ---""-' '
the ContractOr's Lic�nS¢ Law (Chap[er 9(commencing with Section ]000) of
Divlsion 3 ot [he BuSiness antl Professions Cotle) or lhat he/she is exempt �- �
the�etrom dntl the basis for the allegetl ezemptlOn. Any violatiOn of $ection �
7031.5 by any applicant to� a p¢rmi[ SubjectS Ihe appliCant to a civil
�enalty ot no[ more [han five huntlre� tlollars (E500). '
1, as owner ot [he p�operty o� my employees with wages as their sole RBinSpBttion FBe $15 ISSue Fe¢ $ 3 ,
tom0e�satiOn, will do the work, antl the structure is not intentletl or offeretl Reinspection Fee $15 Issue Fee $ 3
for ule (Settion �Oa4, Business antl Professional Cotle: The Contractor's MECHANICAL FEES
License Law tloes not apply to an owner ot d property who builtls o� improves
thereon, antl who tloes such work himseli/herself or tnrougn hls or her own DEVELOPMENT SERVICES REQUIREMENTS:�^
employees, Provitletl that such Improvements are not inientletl or offeretl �or Boiler Hood o� Type I'❑
sale. It, however, the bulltling or improvement Is soltl within one year oi com- Canopy Type I I ❑ � Zoning Approved By � Date �`
pletioq the owner will have the burtlen of provin9 he/she tlitl not builtl or im- Duct - Under Ground ' ' Building Approved 6y Date�.,.�./� 7% �-+
prOve for the purpose of sale).
❑ I, as owner of.the property, am exclusively contracting witn licensetl con- Duc[-Struttural Refrigeration System� Appliption luued By Data� ���� rl /
Vactors to construct the project (Section 7044, Business antl Protessiore Cotle: ' „
The Contractor's License Law does not apply to an owner of Droperty who Duct - Ventilating �❑0-700,000 BT 00,000 BTU �SU ARY OF FEES
Guiltls or im0/oves thereon, antl who con[�act5 for Such project5 wlth a con- �
tractor(s) iicense'pursuant to the Contrattor's Litense Law). I am aware that Exhaust System ❑ Multiple ❑ Syste epair/Alteration BUILDING PERMIT $ 3 �� SMIP $ 2'�
proot of thev Worker4 CompensaHon insurance shoultl be provitletl to me. - PLAN CHECK $ _ PERMIT
❑ I am exempt untlar Sectlon e. & P. C. tor this reason Firepl/Fact. BIL ICBO # ire Dampers PLUMBWG 5 �SSUANCE $
oate Owner Heating System & Ducting Registers pLqN CHECK 25% $ ENERGY P.C. $
I hereby certiry that I have reatl�this applicatlon antl stace tnat the above ❑O100,0008TU 0100 BT �_ ELECTRICAL '$ GRADING $
information fs correct. I agree to comply with all clty antl county ortlinances
antl state laws relating,to builtlm9 construction, antl hereby authorire repre- P�AN CHECK 50% 5 MICROFILM $
sentatives Of this clty to en[er upon the aDOve-mentionetl property for �
inspection p / 5
Signature Date �% �J MECHANICAL S TOTAL FEE $ I
Drivers' License or 55 �# Reins ion Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ �
r�CMF OBfiS-4fi, rev. 10/84 Wnite - Builtlln9: Canary - ApP���anh Pink - Accountin9: GOltlenroU - A558550�
CONSTRUCTION AND PLANNING POOL & SPA �
APPROVALS Permit# � Date Inspector qppROVALS Permit# Date Inspector
D,
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ;�
2. Soil Pipe-Undrgrntl. 53. Steel Reinforcement � �
3. Electrical Conduit Utility-Undrgrnd. �54. Forms ' `' •
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � .: Fy
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test ti.
57. APPROVAL TO COVER-GUfVITE �
� 6. Electrical UFER Grnd. -'s.* E
7. Footings 58. Electrical Conduit-Undrgmd:.:.
8. Foundation 59. 'Gas Pipe, � Undrgrnd ;'[est• �.
n'
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap'O Undrgrnd. z�
10. Structural Floor. System 61. APPROVAL TO DECK r, �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-F.inal �+-
12. Sewer Cap � . . 63. Heater & Vent-Final ��21�' �
�
13. Roof Drains 64. Plumbing System - Firial ��- `_
14. Rough Plumbing , 65. Electrical-Final ��C• �,
15. Rough Electrical-Conduit 66. Solar System-Final , ••
16. Rough Electric Wiring 67. Fencing & Access Appr'oval
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 Structura 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.Storege Tank O 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 7S. FIRE PREV. FINAL �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION �
32. Electriral 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 ' .
�
3�AFinal Factory Fireplace '� � ' '
r.
38sFinal Plumbing � j p
39�Water Service-Fin81 � � � �
40. Gas Service-Final Y
1 +,
r41. Solar pomestic-Final %J
r �
A42. Backflow Preventer � '
Y�3. Backflow Irrigation �� ,y �'
I
p�. Landscape Irrigation System � r _/� A �f �
d5. Sound Attenuation � .Q � �
46yHandicap Regulations � �, � � '
4TE FINAL STRUCTURE & BUILDING t� � � ,
48: Special Requirements Completed N� � � ' �,
4 Electric Release to Edison � � � j �
n
50. Gas Release to SoUthern California Gas Co �� � `
51. CERTIFICATE OF OCCUPANCY � � . •
No. Date , ,
.
�
�
�
Appllcant to /lll In all spaces eKcept t�ose wit�in neavy GorEar Ilnas an0 slgn ail appro0��ate Ceclarations.
CITI;OFCOSTAMESA CONSTRUCTIONPERMIT PERMITNO. TRACTNO LO O. UNITNO.
Project`Addr¢is _r'12r2 AN�� ��D� F"`�20 � S� ' 9�' 4531 2/02/OB 932008 i��
' Applicant'sMailinoAddreu,R�JL�(O C7VIG CENTi1.IL.Y�L/ .tf� GZO n'PEOFCONSTRUCTION NEw aDo ALTERATION REaAiR
Owner'S NameT Ph Z�3��_�p('v � CONVERSION ❑ DEMOLISH ❑ OTHE i ON� A,P.S� � O�+ O O Zone
,1^',' DESCRIPTIQ N OF WORK/USE OF BLDG. ed� W KwaV
Address 2�y� ��n���ff��,�28ANFE'��yn�ol WOd�(i� %�u Cll{ ToN�Cs/ -?S� 6 il i� o�_ S MainBuilding: Actessory8uildin9:
Arch/Eng. G�/`� �/���H+�' p�(�'��S.//1L4/� � /� License No. l%''�'q`�O�^ ) TVPE'O PERMI GRADwG FOVrvDATIOta $TRVCTURAL T Front p
Atltlress ��� CdV1V-4ta:.1.�%I+�--WL ��u�I.��l .F��TENANT ❑ ELECTRICAI ❑ PLVMBING ❑ MECHANICAL B Fear N
Contracror'sNam 1 nl (bIwICY/L Q.Oi Ph n �,��' �--� —�0 o7HER �
1L �1`� �---.«Ltq-/� C Right � N
AddressfmailinglL��i,_^Q�{dq7nw/J� �q�QAS,��f��_T�(�, PROJECTDESCRIPTION Sp.FT. OCCVPANCV '
CityLiCenSeNo. --QL 1 C�/ V •CONSTRUCTIONTVPEZ• VALVATIONS ��g•Q�O� � g Left G
ZONE GRADING CU. VOS. ACRES R
LICENSED CONTRACTOR DECLARATION � Plny. R¢f. � Pa�kiny R¢q./P�OvidCtl E
I bereb aHirm Mat I am licensetl untler rovislons ot Cnarter 9 wmmencin � ' n
Y a ( 9 Remarts: � Planning Notes: (1VR�t w�.�kw r M
witn sectlon 7000) ot Diviz�on 3 of the Busineis an0 Professions Cotla, antl t ,/ � T
my Iicenie is in full torce anq etfe<t. ( �� / 1y,d) 6� � C.. �p 3 S
Licenze C1 ss Lice e
Date � 'Y PLUMBIN FEES
WORKERS'COMVENSFT14NOEClARAT10N G"i. /��, ea�si�k� Snowe�s ELECTRICAL FEES
I hereby aftirm that I have a certiflcate of con5¢nt to seltinsure or a Cer ' ICate
of Workers' Compensation Insuranca, or a certHietl cooY tnereof (Sacti Backflow Preventer Service Sink ❑ 15-50 KW
3800, Lab.��Z�Z1 �y�y _ 13-7 AutOmatic Washer TranSfofiner
Polic No. 'Company � �U� Backflowitrigation SewerCap ConstructionPoleSub. �50+KW
¢rtilietl caOY i5 M1ereby fumisnetl. /�
Certifte �o iYtik_d with the city ,i Itling v' lon. 1� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 700 amps
Date L YXJ APPlicant �
EXEMPTI N FROM WORKERS' COMPENSAitO ECLAfiATI Clalifief5 . Solal ColleCtOrs Di5bwa5her . Meter ❑over 100amp5
(This sOctlon neetl not be coey�pletetl if Na permit is for one huntlre 5300) or : DiShwaSh¢r
iess). Solar Piping Dryers ❑Gas ❑Electric Sub Panel
1 cortlty lhal in the Performance ot [he wOrk tor whicb tttls pe�T�� i5I55ueQ I
shall not employ any person in any manner so as to betome subject to the Drinking Fountain5 Solar Tank Fan Motors �0.1 HP �1Ya- 8
Workerz' ComOenwlion Lawz ol Caliiotnia.
Date 5iqnaturn Floor Drains Swimming POoI wlSpa F,A.U. Inc. Solar 09-15 HP 016-15+
NOTICE: It, al[er making tbg tleclaration, you snoultl become subject to the
Wolkers' COmpenShcion�prOyi5ion5 Of lhe Ldbol Cotla, you mu5t foltllwlth FIOOf SinkS Ufindl Fixtuf¢S MiCfOVYdv¢
comply witb suCh p�Ovizi0n5 ot tbis Oe�mil Shali �e tleeTetl revoketl. �
CONSTRUCTION LEfJDING AGENCV GaSSerViCe OuUets WaterClozet DeviCeBoxes PoleLight
1 hCreby aHirm thd[ [heie Is d conSVuction Ientling agency fo� ttm Oerformance
m mn work tpS� w�hi is^p¢ rmit 5� IS UBtln �se �on 97 civ. C.) In[erce tors Wa[er Hea[er � Ou�leu Ran e
Lenticr'S Name YC��i�� �'�«� �� �Yt'1' .(���7 P 9
Centler'sAtltlress Z��7�� ��-' '�`���YS i't 'I('(� ./, ' Kitchen5ink• WaterService Swilches '
OWNER BUILDER'UECLARATION Si,yn
I haroby aftirm tnat'I•am ezempt trom lhn Contractor's �icense Law tor th0 • L2vdtO�ieS � AutO�WeSh
rollpwing reason (Section 7031.5 Business antl Professlonal Cotle: Any clty.or Garbage Disposal Standing Seclions
counly wnlch reqWres a oe�mit m construct, alter, Improve, tlemolish or ropalr P-Trap ' �yundry Treys Generator �0.5 KW 05-15 KW
any structure, pNor'to9t5 iSsuance, also reqWras lha applicant (or such parmlt Trash Compactor
t0 flle a SignBG stdteifl¢nt IAaI h8/Sh¢ Is Ilcvn50tl pufsuant to lhe prOvislont of 'ROO( DfdipS
tne Contractor's License Law (Cnapter 9(<ommentlng with Secqon ]000) of "
DINSion 3 oi lh¢ Busines5 anG Profe55ion5 Cotle) or Ihat he/The Is axempt . ,
lhe'refrom anE t�e basis tor the allegetl nxemption. Any vialatlon ot Soctlon
7031.5 by any apP���ant }or a pe�mi� SubfuGts Ihe applicaot lo a Civll
�enalty ot not moro tM1an (ive hunCratl tlollars (5500). g 3
1, as ownor oi tne proparty or my employaes wltn wages as tnoir sole Reinspection Feo $15 laue Fae
compania[ion, will tlo tha WOrk, antl the structure Is not intenCetl or olleretl ReinSpaction F80 $15 IStUO Fee
lor sale (Se<Non �044, BUsiness antl Professional Cotla: The Contractor'z MECHANICAL FEES
Llcens¢ taw tloes not appry [o an owner ol a property who bulltls or improvos
thoreon, antl who tloes such work himsaH/narseu or tnrough his or her own . DEVELOPMENT SERVICES REQUIREMENTS'
employ Ces, proviEed that SUCh imOrovemanl5 ata not In[¢ntletl O� olfernU for 80i1¢� HOOd O� TypC I ❑ � 2�2 �
� SLIC. It, ItowCve�, the bulltling or ImprOvamunt IS TOIa wlthin one y¢ar ol cOm- C2nOpy Typ¢ I I ❑ ZOning App�Oved By Data
plotlon, tho owner wlll hav¢ the Duraen ot provin9 he/she tlitl not builtl or Im- Dutt - Under Ground BuildinB Approved By Date_ � D
p/Ova fo� th¢ pur0o5¢ of sale), 2 2 p
❑ I, as owner oi the pro0frty, am ezclusivoly contractin9 with IlcenseE con• Duct - Structural Refrig2ration System Applicetion ISSued By �" Dat
lra<to�st0 con5[rucl[he prpject ($ection ]044, BuSinesS antl ProfeS51on5 Cotle:
Tho Contra<tor's License �yw does not aoP�Y �o an owner oi property who Duct - Ven�ilating ❑0.100,000 B7U ❑100,000 BTU SUMMA V OF EES
builtls or improves thereon, anU w�o con[racts lor such projects wltb a con-
tractor(s) ucense pursuant to the Contractor's �icense Law). I am aware that BUILDING PERMIT S $�e�i•Cx7 SMIP $ '�
p�ooi o( [hei� Worke�'s Cpmpensatlon InSurdnCO ihoultl be provltlotl t0 me. ExheuS[ Sy5t2rt1 ❑ MultiplC ❑ System Repair/Alreration
PLAN CHECK 3 PERMIT
❑ I am exempt unaer Section B. & P. C. �or this reason Firepl/Fact. Blt. ICBO # Fire Dampers PLUMBING $ ISSUANCE 5
Date Owner Heating System & Ducting Fegisters PLAN CHECK 25% 5 --��yy-��� ENEfiGY P.C. S
i hereby certity that i have reatl mis applicatlon antl state that tna above ❑6100,000 BTU �100,OOOB ELECTRICAL $� GRADING S
Information Iz mrrect. I agr¢e to compty witn all city antl county ortlinantes
ana state laws relating to puiltling consvuction, antl h¢reoy autnorize repre- PLAN CHECK 50% $ � MICROFI�M $
5entative5 of this city to e upon the above-menlionetl p opertya f`o�rt
Inspection P LWf�y,,nG �M �� Date � 2- �/y ���
Siqnature L�' J ��� MECHANICAL $ TOTALFEE $
orivers' u s < � Reinspection Fee $15 Isue Fee S 3 PLAN CHECK 25% $
CMF 0865-46, rev. 10/84 WM1i�¢ = Builtling; Canary - Applican[; Pink - Accountin9: Goltlanrotl - Ass¢Ssor
CONSTRUf.TION AND PLANNING " � POOL & SPA
APPROVALS • Permit # � Date �Inspector AppROVALS Permit # Date ' Inspector
1. �jemporary 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-GUIVITE �.•
7. Footings �� �.;� 58. ElectricalConduit-Undrgrnd.
8. Foundation �� . � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.� � �� 1 i• 60. Backwash Lines, P-Trap, O Undrgrnd. '
10. Structurel Floor Sysiem�� , 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 �
i 6. Rough Electric Wiring � ' 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
�„ i,
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ��
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �� '�
'I�
20. Rough Factory Fireplace APPROVALS Permit # ''
21. Ducts, in Structure 70. Underground Hydro ,;: 'y ,� ��
22. Ducts, Ventilating 71. Product Piping OGas C3;Oil� '
�.1
23. Gas Pipe-Rough & Test ' 72. Underground Flush `� �i � �
24. Roof Framing 73. Undergrnd.StorageTank�[]Gas ❑Oil �: ��
25. Roof Sheathing 74. Overhead Hydro � i �� .
.; /
26. T-Bar Ceiling (Structura�) & Monocoat 75. Dry Chemical ri �� �
. .
27. Frame and Flashing 76. Dry Standpipe '�l •
28. La[hing & Siding 77. FIXED SYSTEM FINAL � � r ��•�
.
� t��
29. Insulation - 78. FIRE PREV. FINAL � '
30. Drywall Nailing HEALTH DEPTfREQUIREMENT %•
37. Plaster Brown Coat 79. FINAL INSPECTION ' � �-
_�.
32. Electrical Power MeterFinal �`�i� -. 80. FOOD CERTIFICATE ISSUED '/' �
33. Final Electric . � �'` Notes: - -
, �'
34. Final Heating & Air Conditioning - � _� -�� �
i •
35. Final Gas Pipe-Test •�
36. Hood or Canopy _ `(� . �
� '
37. Final Factory Fireplace ' � ' • � ' •
38. Final Plumbing , • �'� � '- ;.
39. Water Service-Final . . . .
I. �
40. Gas Service-Final � � �
41. Solar pomestic-Final . � ' '
42. Backflow Preventer � � . •
43. Backflowlrrigation '- -- �' ' � ,
,
44. Landscape Irrigation SYstem , � '•� � � � ,'
r�
45. Sound Attenuation _' � ���� � .1 .'
46. Handicap Regulations . T' = �
/ -�. �•
47. FINAL STRUCTURE & BUILDING PZ � , � . _ ;' ? - ' _
48. Special Requirements Completed " � �'
49. Electric Release to Edison � �'
50. Gas Release to Southern California Gas Co `
51. CERTIFICATE OF OCCUPANCY " '" ��
No. Date
�
.�
CITY OF�COSTA MESA CONSTRUCTION PERMII
,o.,,,e,:,o:�.,.o« 555 Anton Blvd. (OFFICE BLDG
AoOlicant to fill in all soaces exceot ihose within neavy bortler Iinas ana sign all appropriate aeelarations.
PERMI O TRACT NO. � LOT NO. UNIT NO.
ApplicanYs Mailing Addresd0631 Bl oomfi el d#9 Los Al ami to
Owner's NamECi�rci-Fngl and-Transpaci fi cph@�v. 9072
Address 2'�77 f.rpnchaw tte_ 300 Torrance 90501-3325
Arch/Eng. License No.
Address .�''`
Contractor'sNam�.�� MpfhaniC.�� Cf1M�]=phoneLl��-4
Addresslmailingl�n��� Rlppmfiald N9 Inc Alamitoc 907�2
City License No. ��i41 6 '
LICENSED CONTRACTOR DECLARATION
1 hereby affirm Ihat I am Ilcensetl untle� O�ovisions of Char[er 9(commencing,
with section 7000) 01 Dlvision 3 ot the Business antl Professions Gotle, antl'
my Iicense is in �w��rce and ettect. ¢OF)HLO �
LJ<en Clazz License No . �_
late �/27/87 Si9na[ure
%ONKERS'GOMPENSHTION DECLAR TION
I hereby atiirm that I have a certiticate of consent to selLinsure or a erti(icate,
oi Workers' ComOensxtfon Insuranc¢, or a certifietl copy [hereof (Section}
3800, Lab.
con�v No. �/�WC0002580001 comaa�r Nationwide Ins. '
�CertlBetl mpy is hereby tumishatl. "
Ce i i aco is tiletl with the city Builtlin Dlvlsion.
oace �f�//£��/ noa��cant �/K n%rhan�ca] �QY'�
EXEMVTION FROM WORKERS' COMPENSATION DECLARATION
(Tnis section neeE nol be completetl it the permit is for one huntlreU ($100) ar.'
IeTS).
1 certity that in Ihe perl0rmanca Of the work fo� wlticn tnis pe�mR is Issuetl, i
snall not employ any person in any manner 5o as lo become subject lo the
Workers' Compensatlon Laws of California.
Date Si9nature
NOTICE: If, afte� making [his tlecla�ation, you snOultl become subject to the
Workers' Compensa[ion provislons of the Labor Cotle, you must forthwith
comply wi[h such provi5ion5 or� this p¢rmit Shall be tlaemetl /evoketl.
CONSTRUCTION LENDING AGENCV ,��
I hereby atfirm that Iher¢.IS a Construction lentling agency for the performance
of the work for which this permit I5 issuetl (SeCtian �3097�biv. C.)
Lentler'S Name
Lentler's AEGress -
OWNER BUILDER �ECLARATION
I hereby affirm that I am exemp[ irom the Contractor'S Llcense Law for the
following reason (Section 7031.5 Buslness antl�7rotessional Cotle: Any city or
county which �equires a pe�ml[ lo ConS[ruct, alteq improve, tl¢molistl or r¢pair
any structure, prior to its issuance, also requires the appllcant for such permlt
to file a sign¢tl statement that he/she is licensetl pu�suant lo the P/ovlsions of
the.Contractor's License Law (Chap[er 9(comm¢nCing with Sectlon 7000) of
Division 3 of the Business antl Professions Cotle) or that he/she is exemp[
therefrom antl the basis for th¢ allegetl exemption. Any vlolation of Sectlon
]031.5 by any applitant for a permit subjects Ihe appliCant [o a civil
p¢ndlty of not more than tive huntlretl tlollars ($500).
❑ I, as owne� ot the p�operb Or my ¢mploYees wlth wage5 as thelr sole
compen5ation, will tlo the wo�k, antl the StrUctu�e Is not Intentletl or ofteretl
tor sale (Section 7044, Business antl Grofessional Cotle: Tne Contractor's
LicenS¢ Ldw doe5 mt apply to an owner 0f a p�operty who bWItlS or imp�ove5
thereOn, antl who tloes Such wo�k him5elf/M1e�seH or (hrou9h his or her own
employees, provitletl that such improvements are not Intentlea or oHeretl tor
sale. It, however, t�e bWltlin9 Or improv¢men[ I5 Soltl wilhin on¢ y¢ar of com-
pletiOn, tne owner will have the burtl¢n of prOving h¢/She tlitl not builtl ot Im-
�rove tor IM1e purpose ot sale�.
I, as owner of the property, am excluslvely tontractlng with lirensetl con-
tra<[ors to construcf the prole« (Sectlon ]044, Businass antl Prolessions Cotle:
Tbe ConVaclor's License law doe5 nOt apply t0 an own<r Oi prop¢rty who
- builtls-or imOroves the�eon, dntl who contracts to� such Drojects wI[n a con-
tractor(5) I¢ense pu�suant to the Contracfot's License Law). 1 am aware that
proof of tneir Wo�ker's� Compensatlon insuranGe 5h0ultl be provitletl to me.
❑ I am ezemD� untler Section B. & P. C. for this reason
Date Owner
I hereby certify Ihat I have reatl thiz application antl state that the above
intormatlon is correct. I a9ree to mmDly wi[h all dty antl coun(y ortlinances
antl state laws relating to builtling consVuction, antl hereby authorize repre-
sentatives ot this cit enter upo � the above-mentioneU property tor
inspection purpose
Siqnature - 4� Datz7/97/R]
Drivers' License ^� � � �' --
�9� �
TYPE OFCONSTRUCTION NEW ADO ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. P� �� � ny/Offi ra RI�1 7 di na
TVPE OF�PERMIT LJ GRADING U FOUNDATION U STRUCTURAL
, ❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL
�a o OTHER
PROJECT�DESCRIPTION 5Q. FT, oCCUPA�N/C�/v�_
�' CONSTRUCTIONTVPE VALUATION$LYV�Q,Q
20NE GRADINGCU.VDS. ACRES_
,nem:rks':. R��lldl'nO PPPmit #B-28867
�
Preventer
Irrigation
Floor Drains
Floor Sinks
uas Service
Inrefceptors
Kitchen Sink
Lavatories
�ULI2t5
Roof Drains
ReinspeMion Fee $15
Duct - Under Ground
Duct - Structural
�uct - Ventilating
Exhaust System � Multiple
Firepl/Fact. Blt. IC80 #
Heating System & Ducting
❑P100,000 BTU � 100,000
Reinspection Fee � $15
CMF 0865-a6, rev. SO/84 White - Builtling; Canary - aplicant; Pink - Accounting; Goldenrotl - Assessor
Showers .
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping '
Solar Tank
Swimming Pool w/Spa
Urinal
Water Cioset
Water Heater
Water Service
Auro�Wash
Laundry Trays
Issue Fee
Hood or Typel ❑
Canopy Type 11 ❑
Refrigeretion Sysiem
❑aioo,oaoeru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers �
laua Fee
A.P. #'
S Main Bi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ret. #
Planning No
' • '�! a= _i_. �
, .
�
Zone .
ing: Accessory Building:
Z
O
N
�
N
c
� R
Parking Req./Provid E
' M
i T
S
Automatic Washer
Construction Pole Sub.
5 �0 Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
2 0� Fan
6 OO F.A.U.
iv vu DeviceBbxes, ' -
'r
4 QQ Outlets�. : �
Switches
88 Q� Garhaoe'Disoosal .
$ 3
$ 3
Generator
�..
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
KW 05-15 KW
Meter LJup to 100 amps
Meter �over 100 amps �
$ub Panel
Motors O0.1 HP O 1 h- 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light. „,
Sign
Standing Sections .
Trash Compactor �
FEES
I Reinspection Fea I$75 I I Issue Fee � I $ 3 I
DEVELOPMENT SERVICES REQUIREMENTS: �
Zoning Approved By � Data
Buildine APProved By Date
Appliption laued By Dat�
SUMMARV OF FEES � � �
BUILDING PERMIT $ SMIP . $
PLAN CHECK $ PERMIT
PLUMBING s 358.00 ��UANCE $
PLAN CHECK 25% S RR %S ENERGY P.C. $
ELECTRICAL S GFiADING S �
PLANCHECK 50% $ MICROFILM S
MECHANICAL 5 TOTALFEE 5 446.75
PLAN CHECK 25% $
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit� Date Inspecior AppROVALS Permit# Date� Inspector
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location •
2. Soil Pipe�Undrgrnd. ' .��;.Yj �t.:A�i� 53. Steel Reinforcement ^`
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms :,.�
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
5. Steel Reinforcemen2 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. ' 57. APPROVAL TO�COVER-Gl1j,VJTE
7.� Footings 58. Electrical Conduit-Undrgrnd i
8. Foundation � 59. Gas Pipe, � Undrgrnd., Test�7�
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P�Trap, ��Undrgrnd.
10. Structural Floor SYstem 61�. APPROVAL TO DECK -
11 . Property Sewer Line & House Connection 7,`,�� (rl� 62. Backwash & Receptor-Final,
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains �Z_�y�.�Z �� 64. Plumbing System - Final
14. Rough Plumbing 3-2-i%g [,� 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit # _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough &�Test � 72. Underground Flush
24. Roof Framing �, 73. Undergrnd.StorageTank OGas ❑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 7S. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT .
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICA7E ISSUED �'
33. Final Electric Notes: (Z.N(-8'J fJJf}(?jr�q�, �pp. (..�.L.1
34. Final Heating & Air Conditioning �2•Lf-i1T UCrSOl1 (Jurn�+(t�n• L.�
35. Final Gas Pipe-Test (L,Zy.�,�{J �qb�,-VF,wr (Z,024�u5 O�C. �-s•L'�
36. Hood or Canopy �.,��{e�_�g• Wq� �� �,�, q� -px. �•�
37. Final Factory Fireplace . .
38. Final Plumbing -�� �� (1� �
39. WaterService-Final � �2_2� Ll�i� '
. 40. Gas Service-Final
41. Solar pomestic-Final ' �
42. Backflow Preventer (2-2,�-b�] L� �
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING �
48. Special Requirements COmpleted ,
49. .Electric Release to Edison ,� , �
50. Gas Release to Southern �lifornia Gas Co � .
'
51. CERTIFICATE OF OCCUPANCY � . ��. '
No. Date `
.- -'"
Aoalicant to fill in all spaces exceD� those within heavy �oraer Ilnes anG si9n all approoriate aeclarations.
CITY OF COSTA MESA C NSTRUCQT ION PERMIT PERMIT TRAmCT CNO. LOT NO. UNIT NU.
, Project%�ddress -� � TZYI.� UL✓ D Iv�J� ��� —
( AppliCanYSMailingAddreis �//�% WGYV `(� £�/�L1y\.' TVPEOFCONSTRUCTION NEW�D ALTERATION REPAIR
OWner'SName���+ ��-�t��hor1�J «"��z �CONVERSION ❑ DEMOLISH OTHER qp.# Zone
�i-� DESCRIpJION OF WORKL,/7USE�BLD�� ' � � '1 h--
Address 4'� /�S�g3� ����J�NC Y�.-uwtC.S��J S MainBuildin9: AccessoryBuilding:
Arch/En ON C� 1�{ OD E Z
g. L.icense No. 1 t TVPE OF PERMIT GR DING ❑ FOUNDATION STRUCTURAL T Front p
' Add�2s5 �QL� ��� L ��/��Tk7LQZ BI�(/ ltll.�G CI. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 6 Rear . ' N
Comraccor's Nam �'?�� ���L>1"L r�.`V ��s�� \P �3) ❑ OTHER A �
L C. �� C Right N
445. S• hr u1GG1d ST" PROJECT DESCRIPTION 5c2. FT 6 oCCUPnrvCv � K G
Address Imailingl �
p�p CONSTRUCTIONTVPE VALUATION$ S Left
City License No. �'�% 1�na�ip _ R
ZONE GRADING CU. VDS. ACRES Ping. Ref. # Parking Req./Provided E
LICENSED CONTFACTOR DECLARATION Q
I h¢reby affirm [ha[ I am Iitensetl untle� provisions of Charter 9(commenclnq Remarks: 2� �� Pldnniny NOt¢5: ' ry�
with settion 1000) of Divlslon 3 of the Business antl Professlons Cotle, antl T.
my license is in (ull force�a ettect. 21O�o� S
ticense CI #�- L.J Li /�se tJp
�Date �;. �c�I._ 5'g t �C' �'�^�'` PLUMBING FEES
WORKERS' COMPENSATION DECLARATION BerSink ShowCfS ELECTRICAL FEES
I hereDy afflrm [Ita[ 1 hdve a certilica�e Of mn5¢nt to sel(tinsure Or a C¢rtiliWt¢
o/ Workers' Compensation Insurance, or a certitietl copy lnereoi (Section BackflOwPreventer ServiceSink
3800, �ab. C.) (�j-� Flutomatic Washer Transformer ❑ 15�50 KW
Policy No.N�<Z-�oZl �d`f1(�il comoanv L��-'�' ��� ��- Backflow Irrigation Sewer Cap Construction PoleSub. ❑ 50+KW
ertitieG c OY is hereby furnishetl.
CerHflea $ with tne clry ui tlin �7f'�J_'' Bathtuhs Sewer Connection Cooking Unit Me[er ❑up ro 100amps
ate � Applicant -�` • �
EXEMPTION ROM WORKERS' COMVENSATION DECLARATION Clarifiers SOId� COII¢CtO�S DiShwd5h2f Mete� ❑ov¢� 10� dTpS
(Thi55ection neetl not be Compl¢tetl it the permit is fOr On¢ huntlretl ($100) or '
�icss). Dishwasher Solar Piping Dryers �Gas ❑Electric Sub Panel
1 cer[ity that in the perfOrmance o1 th¢ work fOr which [his p¢rm4 i5 i55uetl I
zhall not employ any oerson in any manner so as to become subject to t{�e Drinking Fountains Solar Tank Fan Motors �0-1 HP Oi'r5 - 8
Wo�ke�s' ComOensation LawS oi Calito�nia.
I Date Signature Floor Drains Swimming Pool w/Spa F.A.U.
NOTICE: If, afie� making lhi5 tletlaration, you Shoultl become Subj¢Ct to the Inc.Sola� 09-15 HP �16�15+
Workms' Compen5d[i0n provi5ion5 of Me Ldbor Cotle, y0u mu5t Porthwi[h FIOOf $inks Ufinal FiXWI25
compry witb such provlsions or this permit sltall be tleemeG revoketl. MiC�owave
CONSTRUCTION LENDING AGENCV GaSS¢fviC¢ Outl¢L5 Wdt¢� CIOSCt DevicE BOx¢5
I I ne�eby af(Irm that Ihera IS a Constr Ction le tling agency tor the per}ormance Pol2 Light
of Ihe work f whic1� this p r i{ i is5uetl �{ rt 097.'f,Civ. CJ Int¢rC¢ tOrS Wdt¢r H¢at¢I
LenEer's Name �tu'� L p=• `✓�� � P Outlets Range
�- Lenaer's Aatlress �Q��• CGTI-iII 7'1.125. �� ' C�� Kitchen Sink Water Service q
OWNER BUILDER.OECLARH�ION ��� L� SWitCheS Sign
I herCby alflfm that I am ex8mp[ from tlle Contlactor'S LiGense Law fot tlle LdVdtOIiCS AUtO-WdSh
followin9 reason (Section 7031.5 Businezs antl Protezsional Coae: Any city or Garbage �isposal Standing Sections
- county whith requires a permit to construct, alter, improve, tlgmolish or repair P-Trap Laundry Trays Generator �0.5 KW 0545 KW Tresh Com actor
any Structure, p�io� to It2 ISSuanGe, also requires ttte aOP���anbtor SUCh pe�mil P
[o tile a signetl stdt¢m¢M Nat he/sbe is licensetl pur5uant to Ihe provisions of ROOf D�3ip5
the ContractorY License Law (Chapter 9.(mmmencing wlth Section ]000) of
Oivision 3 of the Business antl Protessmns Gotle) or [na[ he/she is exemp[
� tM1ereirom antl the basis for th¢ alleqetl exemption. Hny viOlatiOn of $ectlon
�]031.5 by any appli<an[ lor a petmit subject5 [hG applicanl [o a civil
pendlty of not more than flve huntlretl tlollars ($500). 3
❑ I, as owner of the pto0erty Or my emDloyees with wage5 a5 [hei� sole R¢in5pec[ion Fee $75 ISSUB Fee $
compensatinn, will Ao [he work, antl the structure is not intentletl o� otferetl Rainspaetion Fee $15 ISsue Fee $ 3
for sale (Sectlon 7044, eusiness antl Professional Coae: The Contractor's MECHANICAL FEES
License Law tloes nol apPly to an Owne� of a property who builtls or Imp�ov¢S
thereon, antl who OoeS su<h work nimselt/herseli or throu9h his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, p�ovitl¢tl that such Improv¢ments are not Intentletl or off¢retl (o� BOiI¢� HOOd O� Typ¢ I ❑
sale. If, however, the builtling or improvement is 5oltl within one year of com- Canopy Type I I ❑ Zoning Approved By Date
. pletion, the owner will have Ihe bu�den Of provinq he/she tlitl not builtl or im- Duct - Under Ground BUildin8 App�oved By Date
prove for the purpose of sale).
❑ 1, as owner of the oroperty, am exclusivety mntracting with Ilcensetl con- Duct -Structural Refrigeration System AppliWtion Issued By Dat �
t�actoR to <onst�ucl Ihe pwject (Section ]044, Business antl Professions Cotle: p
The Contractor's License Law does not apply to an owner ot property who Duct - Ventilating ❑0-700,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or Im0/oves Ihe�eon, antl who cont�acts to� sucb projects with a con-
tractor(s) ucense pursuani to ehe Contractor's License Law). 1 am aware that Exhaust System ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensatlon insurance shoultl be provitletl to me. PLAN CHECK $ PERMIT
❑ I am exemo� untler Sectlon B. & P. C. tor tnis reason FirepVFact BIL ICBO # Fire Dampers �� ISSUANCE $
PLUMBING $ �
Date Owner Heating System & Ducting Registers PLAN CHECK 25% $�_� ENERGV P.C. $
i hereby certify tnat I nave reaa this appiication and state that the above ❑0.100,000 BTU �100,OOOBT ELECTRICAL $ GRADING $
Iniormation is correct. I ag ee to comply with all clty antl <ountY ortlinances
ana state laws relatin to uiltljn constructio antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $�
sentatives of this ti t en r oy'''�he e-mentione0 pro er[y for
Inspettionpurooses. /� MECHANICAL 3 TOTALFEE $
Siqnature - �^. 6'/NJ^Date � Z' �� Reinspec[ion Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' L7 55 qF �
CMF 0865�46, rev. 30/84 White - Builtling; Canary - qOPllcant; Pink - Accountlnq; Goltlonrotl - Assesmr vl UU4U'10Yt1-YUJVYO'� Y a.JU
�
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS PermiL# Date Inspector p�ppROVALS Permit# Date Inspector
L Temporary Electrical"Service or Pole 52. Pool & Equipment Location
i.
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
i6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � �
20. flough Factory Fireplace APPROVALS Permit # � �
21. Duc[s, in Structure 70. Underground Hydro
22. Duc[s, Ventilating 71. Product Piping O Gas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. RoofFraming 73. Undergrnd.StorageTankOGas ❑Oil
25. floof Sheathing } 74. Overhead Hydro ��
26. T-Bar Ceiling (Structural) & Monocoat �� 75. Dry Chemical � - � .
r� 4
27. Frame and Flashing � _ 76. Dry Standpipe � �� i; tV %. .- -
28. Lathing & Siding 77. FIXED SYSTEM FINAL� '�� r� - '�-
i: '.�
29. Insulation 78. FIRE PREV. FINAL �'�
30. Drywall Nailing HEALTH DEPTc REQUIREMENT - �' �
31. Plaster Brown Coat 79. FINAL INSPECTION �I; � -""1
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED i_ i�•
33. Final Electric Notes: �
34. Final Heating & Air Conditioning '
35. Final Gas Pipe-Test
36. Hood or Canopy �,� ..
i r.
37'"Final Factory Fireplace i ".. � �, ' � ; �
3$: Final Plumbing 2 � Lt� ! �� � ' c • • - I .
�
39. Water Service-Final �' GB,(� ' • + = � , ;
�
40. Gas Service-Final ' � . _ ' � , - �
- . �
�dl. Solar pomestio-Final . J � - �' �� „ ,
� 42. Backflow Preventer '- . � ' �-�
� .
�43. Backflow Irrigation - � _ , ��I, , .
�44. ,Landscape Irrigation System :. '� ' ; � { � l � '��, :. _ ,
� . .
'45. Sound Attenuation ' � ; ,. � �
46. Handicap Regulations ' ' - , � � . �
47: FfNALSTRUCTURE&BUILDING �; _ � • ._', �i
48. Special Requirements Completed ! � v!' ' = . � " �
� � 1`
49. Electric Release to Edison , � I
50. Gas Release to Southern Glifornia Gas Co � y -
51. CERTIFICATE OF OCCUPANCY �
.' �
No. Date �
1�
� --� ! - : • � ' -
�
AOOlicant to fill in
" •�G7'r"bF COSTA MESA CONSTRUCTION PERMIT :y
Rroject Address -�r�� ��/ /✓ %�n� %�6 ✓i
� Applicant's Maiting Address LTIL �j�'j1��i '? y�� fi�1iA/N
Owner's Name D� SNA� T�k_��Ei%�8
Addresz ���. N SFo��i ✓�c'na Rt �� C/� 9 e e� 9:
Arch/Eng. LicenuNo. •_��
Address - - �_���_ �
ContraCro�'SNamr � ��( Phone7�4-S[?j
Address (mailing)
City Licenu No. 3,r/ �
LICENSED CONTRACTOR DECLARATION
1 hereby a(firm tnat I am licensetl untltr provi5ion5 ot Charte� 9(commGn<in9
wit� section 7000) of Division 3 of the Business antl Professions G�otle: antl
my Iicense is in full force antl ei(ect. "- b ,1 � ...
LicenSe Class C� � � License No�. /�� ��
� Dat�� Signature ' � - � ,
\WORKERS' COMPENSATION DECLARA N .
I hereby affirm that I M1ave a certificate of consent Co 581f-Insure or a certlOcate
of Wmkers' Compensation Inmrance, or a certifietl copy thereoi (Sectlon
\3800, Lab. C� _ _ // a � -
Policy No. � comPa�y l(!�Q/.�/�//L�N%�
��certifiea copy is hereby fumishetl. '
Cer ifietl copy� file0 with the city Builtlin9 Division
Datc�.�'t Applicant �_
EXEMPTION FROM WORKERS' COMPENSATION DE ARATION
(TM1issection neetl no[ be completCtl if [h¢ permlt i5 �o� one huntlr¢tl ($300) or
less). • - � '
I certity that In the performance oi the work for Which chis perm�t is i
shall not employ any pe�son in any manne� So a2 lo Oec c t0 thG
Worker5' Compensation Laws of Cali(omia. � � • � ,
Date SignaWre _ -
NOTICE: If, after making [his tletla�at� , ou snOultl becOme subject to the
Workers' Compensa[ion provisio the Labor Cotle, you must forthwith
comply with Suth pwvi5io o� this pe�mit Shall be tleemetl �evoketl.
CONSTRUCTION LE G AGENCV
I hereby a(9rm Iha re is a conSVuction lentlin9 99en<y /or the pertormance
of the work whicn [his permi[ is issuetl (Section 3097 Civ. C.)
Lentler's e .
OWIQER BUILDER OECLARATION
I hereby affirm that I am exempt irom the Con[ractor's LI<ense Law for the
following reason (Section �031.5 Business ana Gro�essional Cotle: Any clty or
county which requires a pe�mil lo const�uct, alte�� �mprove, tlemolish or r¢pair
any structure, prior to its Issuance, also requires tne applicant tor such permit
to tile a si9netl statement that he/she Is licensea pu�suant to the orovisions ot
the C.nntract�rY I icense Law IChao[er 9(rommen[�n9 with $ectlOn ]000� of
[herefrom antl the bas
]031.5 by any ap0�k
�endlty of not more th:
1, as owner ot the
comoensation, will ao
tor sale (Section ]06�
License Law tloes not x
lhereon, and wbo tloe�.
emD�aYees, provitletl tY
sale. If, howev¢r, the b
pletion,�the awner will
p�ove for tha purpo5
❑ I, as owne� o �e p
tractors [o mn uct th�
am�exempt untle�
Date
I hereby'certi(y that
ini�-mation iz correct
antl state laws relatin
. senta[ives oi tnis cil
inspectlon purposeSy
Signature - �
�Drivers' �irense ar 55
�MF 0865-46, rev. ]0/84
a pe
untlrea
ly or
<, ana
E55 , d fl
an ow
or
except lhose within heavy Gorticr Iines an0 sign all appr00riate 0eela�ation
_ 3� � TRACT NO. LOT NO. UNIT N0. �5��
TVPE OF CONSTRUCTION NEW RDD ALTERATION REPP.�R
� ❑ CONVERSION ❑ DEMOLISH ❑ OTF�fER A p y�.
� DESCRIPTION OF WORK/USE OF BLDG. `• S Main Building:
TVPEOF,PERMIT GRADING FOUNDATION STRUCTURAL T Front
{ ❑ TENANT ❑ ELECTRICAL ❑ PLUf.�BING � MECMANICAL B Rear
❑ OTHER ; A
'PRQIECT'DESCRIPTION Sq. FT. � oCCUP.aNCv C Right
K Left
CONSTRUCTION'TYPE VAIUATIONS S
. �20NE GRADING CU�VDS. ACRES Ping. Ref. # -
qemarks:�� / . � Planning Notes:
� �. _� — ._ �� �r w
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
G'as Service Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Dreins
lo d Civll
thoir sole Reinspection Fee
'ucn i rovements are noc mcenaea or onerea �or
li r Improvement is soltl within one year ot mm-
the burtlen ot provina he/she tlitl not builtl or im-
le).
ierty, am exclusively contratting witn Iicensatl con-
oject (Section 7044, Businezs antl Professionz Cotle:
Ww does not appry to an owner ot praperty who
n, antl who contracts fOr such ptoject5 with a con-
to ihe Contractor's License Law�. 1 am aware tnat
',ompensation insurance shoultl be provitleC to me.
lon B. & P. C. for this reason
Owner
ve reatl thi5 applicatioq antl s[ate tha[ the above
upon
Boiler
Duct - Under Ground
Duct - Structural
Duct � Ventilating
Exhaust System � �
Firepl/Fact. Blt. ICBO �k
Heating Sysrem & Ducting
❑0-100,000 BTU 0100,(
3 sr-� ss�F-i,-2
Reinspection Fee
White - Builtling; Cana�y - Applicant; Pink � Accounting; Goltl¢nrOtl - A55¢SSor
$15
$15
Service Sink
Sewer Cap
Sewer Connection �
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal '
Watx Closet
Water Heater
Water Service
Auto-Wash
laue Fee
Hoodor Typel ❑
Canopy Type II ❑
Refrigeration System
❑o�ioo,000eru ❑ioo,oaoeT
�
System Repair/Alreration
Fire Dampers
a«�+n.s .Q /�-/ : e /Z
Issue Fee
�
� U/)1� li'/U.�i,�/ .`�
(li Q� �] i:u9u�� T�
E3'��88G�(P� /63-S�L}
Zone
Accessory Building:
Park
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit
Dishwasher .
Dryers ❑Gas ❑Eleciric
Fan
F.A.U.
Fixtures
Device Boxes
OuHets
Switches
Garbage Disposal
Generator �0�5 KW 05-15 KW
Meter IJup to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors OO-1 HP O1 %� 8
InaSolar �9-15 HP �i6-15+
Microwave
Pole Ligh[
Range
Standing Sections
Trash Compacror
$ 3 I
� Reinspaction Foe $15 Issue Fea
FEES
�DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
Building Approved By
Aooliption Issued Bv i1
FEES
Z
O
N
I
N
G
R
E
Q
M
T
S
SUMMARV OF FEES . '
BUILDING PERMIT 5 SMIP 5
PLAN CHECK $ PERMIT �
PLUMBING g - ISSUANCE $
PLAN CHECK 25% $ ENERG� P.C. $
ELECTRICAL $ GRAOING $ �
PLANCHECK 50% $ �� MICROFILM $
�� $ �51��� TOTqL FEE S �
$ 3 I I C PLAN CHECK
,�
= CONSTRUCTION A'ND•PLANNING POOL & SPA
k' APPROVqLS Permit# Date Inspector AppROVALS Permit# Date Inspector
L f . ��
',�1. Temporary Electrical�Service or Pole 52. Pool & Equipment Location
Soil Pipe-Undrgrnd. 53. Steel Reinforcement
r3. Electrical Conduit Utility-Undrgrnd. 54. Forms ;v�
�4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �'^�� ��F�
'�b. Steel Reinforcement 56. Rough Plumbing & Pressure T:est
�''�. Electrical UFER Grnd. 57. APPROVALTO COVER;GINVITE
Yj 7 l�ootings 58. Electrical Conduit-Undrgrnd�,
.t
�' 8�oundation . 59. Gas Pipe, O Undrgrnd,;•Test��.J
,FJ; Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap;;Ll ;Undrgrnd.
�
1`0. Structural Floor System 61. APPROVAL TO DECI<�� i; �
� 4. .
11. Property Sewer Line & House Connection 62. Backwash & Receptor;6inal"`
12. Sewer Cap 63. Heater & Vent-Final �
13. �Roof Drains 64. Plumbing SYstem � Final
14. Rough Plumbing 65. Electrical-Final
15. Rough �lectrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18.,Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rougti Heating & Air Conditioning y y���p L� FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit # ' _ �
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.StorageTank OGas ❑Oil
25. Roof Sh'eathing � , 74. Overhead Hydro �
26. T-Bar. Ceiling (Structurall & Monocoat 75. Dry Chemical
i
27. Frame and Flashing 76. Dry Standpipe '
28. Lathing & Siding 77. FIXED SYSTEM FINA� >'�
29. Insulation 78. FIRE PREV. FINAI
30. Drywall Nailing HEALTH DEPT.,REQUIREMENT
31. Plaster Brown Coat 79. FINA� INSPECT�ON �
32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED �
33. -Final Electric Notex��2.yp,,,8� �vU' SiFhfliS ( 79�ZJ 4� �' '
34.,Final Ha.ating & Air Conditioning 6./(,�y� L� Q�(„ 4,EA. �. �'(er�88 �i�1L•,Q,$ QK ,bQpq.� OL
35. Final Gas Pipe-Test L�� .���„��.. 5 �Ib7�,V trWF�,�v
3fi. Hood or Canopy �y� [,�py� p���• �,� � Z+3-t�$
37�. Final Factory Fireplace ��'� �j ...O1C. (�i -rQ-���'�
s
38. Final Plumbing � �� eK Z-�v e',,. QjQj�g�-- O� p�.�
39. Water Service-Final � (�,f) -- ?.�71�� ����sT �✓CT'� TNQ..v
40. Gas Service-Final �pp fFC. L.pO� OI�( /D O(G, („6.0
41. Solar pomesticFinal � .
42. Backflow preventer
43. Backtlow Irrigation � �
44. Landscgpe Irripation System - • �- _ �
45. Sound Attenuaiion ' +' • ,
46.�HandicapRegulations � �
47. FINALSTRUCTURE&BUILDING ' , ' � � '.
i
48. Special Requirements Completed i '
4,9. Electric Release to Edison � �
50. Gas Release to Southern California Gas Co , � � �
51. CERTIFICATE OF OCCUPANCY � y�
' . /
No. Date � t ,
,. . . � .
AOPlicant to till in all spatts exeept those within heavy boraer Iinas antl sign all appropriate Geelarotions.
�
� CITY OP COSTA MESA COqN�S�TRUCTION P'IERMIT PERM�O. TRACT NO. LOT NO. UNIT N0. ; OiE� ]/' ��"�
' Pr9j ct�JAddress ��/r�q�T�� �LV�
' ApplK�ailing Addre55 / 7%2 �.SEi[- TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
O CONVERSION ❑ DEMOLISH ❑ OTHER q,p.�6 Zone
• C�arner'sNa SQ• �0 Phone DESCRIPTIONOFWORK/USEOFBLDG.
. qd�R�y: .�%S /�J1/�/J BL:��. �i'� � S Main Building: Accessory Building:
E Z
Arch/Eng. LitCnSE No. TVPE OF PERMIT GRA�ING FOUNDATION STRVCTURAL T Front Q
Addfeu ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECFIANICAL B Rear � N
COnlfattor'S Nem �� Phone 2� � �THER %� �
PROJECT DESCRIPTION � 5a. FT. ocCUPANCv
Addresslmailin9) ���Z- �$� A'✓E' K i9ht G
Gy0/ CONSTRUCTIONTVPE VALUATIONS g left
City License No. J-/ (o R
ZONE GRADING CU. VDS. ACRES p�ng. Ref. # Parking RCq.IProvid2d E
LICENSED CONTRACTOR DECLARATION Q
I he�eby aifi�m tha[ I am li<¢nSGtl untllr proviSlonS ot ChdrtOr 9(Commencing Rema�ks: Pl2nniny NOL¢5:
with section 7000� of Oivislon 3 of tha Business antl Pro/esilons Cotle, an0 M
my license iz in full totce antl etfecL ��,., � . .� T
License Ciass `� Licen�rlo.�q �+R pLUMBING FEES 5
4
� oate..���� 5'g t - � '
� WORKERS' COMPENSATION DECLARATION ' . BarSink . Showers
1 hereby affirm that I have a certllicata oi consent to wlf-inmre or a certinwte ELECTRICAL FEES
of Worker5' Compensalion Insurance, or a certifletl copy Ihereof (Section
� 3800, Lab, C.) Backflow Preventer Servite Sink � Automatic Washer Transformer ❑ 15-50 KW
Policy No.���Z9�a7L��� CompanyUB�ILTY IL1ViVCKi gackflow Irrigation $ew¢r Ca � ❑ 50+ KW
❑ Certitietl copy is he�eby fu�niinetl. P COnSt�ucti0� Pol¢ $ub.
❑ Cer[" ' tl c py' fiiea with me city Bu tling Divis�.' �� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date APPlicant �m �
EXEMPTION FROM WORKERS' COMPENSATION DECIARATION Cldfifi¢!5 $p13� CAII¢CLO�S DiShwaSh¢� M¢I2� ❑Ov¢� 1�� eRIpS
(This section need not be comD�eteE it the permit is for one huntlretl (E100) or
iess). Dishu4asher � Solar Piping . � Dryers �Gas ❑Electtic - Sub Panel �
I certity [hat In the Oe�fo�mance o( the wOrk (Or whith thi5 p¢rmR i5 i55uetl, I _ _
shall not emo�oy any p¢rson in dny manne� so as to become su0jet[ to the D�inking FOun[di�5 - $Oldf TdOk Fd�
Worke�s' Gompen5ation Laws of California. Motors �0-1 HP O1'h - 8
Date 5ignaturo Floor Orains Swimming Pool w/Spa F.A,U. Ina Solar �9�15 HP �16-15+
NOTICE: 1/, affer making this tlecla�aUon, you ShOultl bBcoma Sub�¢Ct lo lhe
Workers' Compensation pwvlsions ot the Labor Cotlo, you must forthwith FIoOtSinks Urinal Fixiw2s
comply with su<h prOWSiOnS or tM1iz permll shall be tleemetl �evoketl. Mic�Ow2v¢
CONSTRUCTION LENDING AGENCV Gas SefviCC� OuNetS Wat¢� Closet DeviCe Boxes POIe Li ht �
I herety affirm that there is a conSlruction lentling agenGy tor th0 p¢rlormance " 9
Of the work fOr whlch thls permit IS ISSuttl ($ectlon 3097 Civ. C.) Interceptors/ • Water Heater OuL12L5
l.entler's Name Range
�ontler's atltlress Kitchen'Sink Warer Service Switches . g�y�
OWNE0. BUILOER OECLARATION
I hereby affirm tha[ I am exomp[ 1�om lha Cont�aclo�'S Lltense Law tor the �dvetO�ies AUIO-WeSh
tollowing reason (Sottlan 7031.5 Business antl Professional COUe: Any <Ity or Garbage Disposal Slanding $ections
county wbich �equircs a permit t0 <onst�uc[, dll¢r, improve, tlamDllsn or �epal� p_T�yp �' Laundr T�e 5
any structure, prlor to i[s issuance, also reqWras tha applicant lor such parmit Y � GenElator �65 KW �5-15 KW Trash Comp3clOr
to tile d SignCtl slatemen� Ihat h0/Sh¢ iz Ilcen58tl pulsuanl t0 the Provislons 01 ROOf D�dinS; '
tne Con[ractor's Licensa Law (Chapter 9(commoncin9 wi[h Section 7000) ot
Division 3 ot Ma Buslness antl Professlons Cotla) or tnat ne/she is exempt .
tberefrom antl Ihe ba5I5 tor the alla9otl oxompliOn. Any violatlOn o1 SnGtlon
� �]031.5 by any applicant lor a Oermit subjects [he aOP���ant to a civil
`�enalty of not more than fivn nuntlretl tlollars (f500).
� I I, as owne� of the proparty or my amploYeoS with wd9as as their sole ReinspactlOn FBe $15 IAue Fea S 3
����'� Satlon, will tlo Ihe wO�k, dntl lhe it�uclure IS nOt Int0ntle0 or olfcrotl
for saPe-�co���on 704a, Business antl Protussional CoCe: The Contrac[or's Reinspaetion Fee $75 Issue Fee
Licens¢ Law oo. MECHANICAL FEES
s not apply IO an Owner Ot a property Who Duiltls Ot ImprOves
lhereon, antl who aoev such work nlmsolt/herselt or through his or hor own DEVELOPMENT SERVICES REQUIREMENTS:
employ¢et, provitletl tl�at such improvamenli are n0[ IntenEltl o� oll¢retl 1or BOiIEf HOOd Of TypC � ❑
sale. It, however, the builaln9 or Imo�ovomant is soltl wlthin on¢ year ot com- � Gnopy Type I I ❑ 2oning Approved By Date
pletlon, tne owner wi11 have tne buraen oi provin9 ne/sno tlle not builtl or Im- Ducl - Under Ground Building Approved 8y Data
.prOve tor tb¢ purpose ol sale). /�
�- I, az owner ol lhe property, am extluSively conlracting with IICBnSeU con- DuCt - St�uCtU�dl Fiefrigera2ion System /lpplitatiOn ISSUBd By / � Dot�
tractofst0 conStrUctlhO projecl ($¢cHon 70A4, Buslnesi dntl PlOteszlon5 Code:
Tne Contractor's Licenze law does not apply to an owner of property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU SUM V OF FEES
builtls or improves thereon, and who contracts for such pro�eCts wlth a con-
lractor(sl ucense pursuant ro the Contractor's LI<onse Law�. 1 am aware that BUILDING PERMIT $ SMIP 5
proof of tneir worker's Compensatlon insurancc snoula be proviaea to me. Exhaust System ❑ MWtiple ❑ System Repair/Alteration p�qN CHECK $ PERMIT
❑ I am exempt untler Section B. & P. C. tor this reason Firepl/Fact. BIL ICBO # Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System & Ducting Registers P1AN.CHECK 25% $� ENERGY P.C. $
i nereby certify tnat � have reatl this apolicaUon ana state that the above ❑G100,O00 BTU �100,0006T • ELECTRICAL $ GRADING S
information is correct. 1 agree to compty witb all Uty antl county ortlinances MICROFILM S
antl state laws relating to Ouiltlin9 �onstruction, antl hereby authorize r¢pre= PLAN CHECK 50% $ �
sentativ¢s of this city to enter uDon tne above-mentioneG property tor MECHANICAI $ TOTAL FEE 5 �
in5pectlan purp
Signature � Date7 %��
orivers' License or 55 � — Reinspection Fae $75 Issue Fee 5 3 PLAN CHECK 25% $
`\.,�.�� we�- o, e.. av�ew wniie - buuaing; Canary - qpppcanF Pink - q�counting; Goltlenrotl - Assessor
\ 1' POOL & SPA �
CONSTRUCTION AND PLANNING � � �
APPROVALS Permit # Date Inspector pppROVALS - Permit # Date Inspector �
1. Temporary Electrical Service or Pole 52. Pool & Equipmen[ 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, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer �ine & 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 '
75. Rough Electrical-Conduit � 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # _
21. Ducts, in Structure 70. Underground Hydro -
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing ' � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydio
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 Naiiing ' . 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 Pireplace ' . , • �
3S. Final Plumbing • . � �
39. Water Service-Final �
40. Gas Service-Final � ' '
41. Solar pomestic-Final .
42: Backflow Preventer - �
43. Backflow Irriga[ion •
44. Landscape Irrigation System
45. Sound Attenuation - �
46. Handicap Regulations � ' � '
47. FINAL STRUCTURE & BUILDING �
48. Special Requirements Comple�d �
49. Electric Release to Edison ` , .
50. Gas Release to Southern Californ3 Gas Co � ," �,
51. CERTIFICATE OF OCCUPANCY, •
, l.
No. Date _ , , ..
• � t
AOOlicant to fill in all spaces except [M1ose within heavy Oortler lines antl sign all approp�iale Eeclarations.
CITV QF COSTA MESA C�O1NSTRUCT�IjO�N PERMIT
Project Add�ess SSS r/��%� h�n. ..�. �C '
Ap�licant's Mailing Address 4/%� �Ei��s�'" ��%�-
Owner's Name T�h'�✓ S �AG/F/ C_ viv phon��
Addreu •r'rS �Ni�Qn/
Arch/Eng. License No.
Address �
Contractor's Name M����l.���M�l%Lb413 Phone�C
Atltlress lmaiiingl ��d ��YES DQ, !t/.4l/1!U%-
City License No. �GS��
LICENSED CONTRACTOR DECLHRATION
I hereby affirm [hat I am licensetl untle� O�ovislons Of Charter 9(comm¢nCing
with section 1000) oi Dlvlsion 3 Ot [he Bu5ine55 antl PrOfe55ion5 Cotle, antl
my license is in (uy,f-r � ar}p effect. /
IJcens$ �Class C (J
Date 7—' —��� 519 t ^ ' �A
1O0.KER5'COMPENSATION DECLARATION �
nereby a(tirm that I have a certificate of consent lo selt-insure or a certlficate
o( Workers' ComOensation Insurance, or a certHiee copy thereof (Sectlon
3aoo, �ao9z%je�oy2gP Companyt�%/4NLOiYO .Z.t5.L�0.
Policy No
Cert(�lfletl {�o9P� i�s Jh'}e��eb� ������h�eUY..� d)� 9� �DI isl )
Date (�T— Q / Apolicant �`�"�����/
E%EMPTION FROM WORKER$' COMPENSATION DECLARATION
(This section neetl not be compleletl if [he permit is Por one huntlretl (E300) or
less).
I Certify Ihat in the performance ol th¢ wOrk tor whith Ui5 pe�m�t is issuetl, I
shall nol employ any pe�son in any manne� 50 as [O becomB Subjett fo th¢
Workers' Compensation LawS of California.
Date Si9naturo
NOTICE: If, atter makinq this tleclaration, you shoultl become subject to the
Workers' CompenSatiOn p�ovision5 Of [he LabOr Cotle, you mu5t forthwith
comply witn sucn o�ovisions or this permlt shall De tleemetl revokea.
CONSTRUCTION LENDING AGENCV
I hereby �ftirm that there Is a construction lentling agency for lne vertormance
ot the work tor which [his permit is i55u¢tl (SeCtion 309] Civ. C:)
Lentler's Name
Lentler�s Atltlress
OWNER BUILDER �ECLARATION
I hereby af/irm that I am exempt from the ConVa<tor•s License �aw for the
followin9 reason (Sectlon 7031.5 Business antl Professional Cotle: Any city or
county whi<h requirex a permit to construct, alteq improve, Cemolish or repair
any StruCturC, prior [o Its Issuance, also �equires tha appli<ant for such pe�mlt
[o file a si9netl statemenl that he/she I5 licensetl pursuan[ to the provisions of
the ConVactor'S License Law (Chapter 9(commendng with 5ection ]000) of
bivision 3 of Ihe Bu5ine5s antl Protessions Cotle) or that he/she is exem0�
Iherefwm antl [he Dasis for t�e allegetl exemption. Any violatlon o( Seclion
]031.5 by any applicant fo� a permi[ zubjects the applicant to a civil
�enalty of not more than five huntlretl tlollars (E500).
I, as owner o( lhe Oroperty or my employees witM1 wages as their Sole
compensation, will tl0 the wo�k, antl th¢ 5[ructure is not intentletl or otferCtl
tor sal¢ (Section ]044, Business antl Professional Cotle: TM10 Contractor'S
License Law tloez nol appry ro an owner ot a property who bulltls or improves
thereon, antl who tlous sucn work nimselt/herself or Ihrough his or her own
employees, provitletl that such improvements are not intentletl or ottered for
sale. If, nowever, the builtlin9 or Improvement is soltl within one year of com-
pletion, tho owner wlll �ave the burtlan of provin9 he/she aitl not bulltl or Im-
prOve for lhe purpo5e of sale).
❑ I, as owner of Ihe property, am ezcluslvely Cantrac[ing with Ilc¢nsetl con-
Vactors to cons[ruct tbe project (Settion �044, Buziness antl Pro/essions CoOe:
Tne Contractor's license Law tloes not aoPly to an owner of Droperty who
builtls or Im0/oves tM1ereon, antl wha contracts to� such Orojlcts with a con-
tractor(s) ucense purzuant to the Contracior's License Law). I am aware that
proof of Iheir Worker'S Compensation insuranGo shoultl be provitletl to me.
❑ I am exempl untler Section B. & P. C. ror [hi5 reason
•
Oate Owner _
1 hereby certlty ehat I have reatl this
information Is rorrect. I agree to comp
antl state laws relating to builtlin9 con
sentatives of this� cit [o ter qp�
InSpectlon purp �/
Signatura
Drivers' License or SS �
above
nancez
repre-
(y tor
F 3oG 77 i i i r�-
TYPEOFCONSTFiUCTION NEW ADO ALTERATIOfV REPAIR
❑ ❑ ❑
-�6,����
�'y9-39/�
CONVERSION DEMOl.ISH OTHER Ap,*
DESCRIPTION OF WORK/USE OF BLDG. ��eG�•
S Main Buildi
TVPEOFPERMIT�q ❑GRADING ❑FOUNDATION STRUCTURA� T Front
❑ TENANT WJ E�ECTRICAL ❑ PLVMBING ❑ MECHANICAL 6 Rear ,
❑ OTHER A
C Right ,
PROJECT DESCRIPTION 5c�. FT. oCCUPANCv K
CONSTRUCTION TVPE VALUATION $ S �¢ft
ZONE GRADING CU. VOS. ACRES p�ng. Ref. #
Remarks: �/ fj� .�,!�W j"/ �(lQ�� � Planning NoteS:
Bar Sink . --
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks �
GasService OuUets
Interceptors
Kitchen Sink .
Lavatories �
P—Trap
Roof ains
Reinspec[ian Fee $15
Boiler
Duct - Under Ground
Duct - Structural
Duct- Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. BIL ICBO #
Heating System & Ductin
❑0-100,000 BTU ,000
Fee � $15
CMF 0865-46, rev. 10/84 White - Bulltling; Canary - Applicant; Pink - Acmunting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection .
Solar Collectors
Solar Pipmg
Solar T
Pool w/Spa
Water Closet
Water Heater
Water Service
Auto-Wash
LaundrY Trays
laue Fee
iANICAL
Hoodor Typel ❑
Canopy Type 11 ❑
Refrigeretion System
❑0-700,0006T 100,000
Syste epair/Alteretion
F ire Dampers
Registers
luue Fee
FEES
Automatic Washer
Construction Pole Sub.
Cookin9 Unit
Dishwasher
Dryers �Gas ❑Elec
Fan
F.A.U.
.. � Device eoxes
� � � �UtIEtS �
�% Switches
� Garbage Dispoul '
^ Generamr �0-5 KW
$ 3
FEES
$ 3
�17�G J�_..� !-1 W �: �.
ZOne
Accessory Building:
Z
O
• i N
I
' - N
G
R
Parking Req./Provided E
,� ' Q
M
T
5
ELECTRICAL �
Transformer 6rJ 15-50 KW
jd 50+KW
Meter ❑up to 100 amps
Meter '�over 100 amps
FEES
3� Sub Panel • �
Momrs 00�1 HP�1 X- 8 8
Inc.Sola�9-15HP 16-75+ �
Microwave. � '
Pole Light � ' ss
Ran9e•
Sign •
Standing Sections� '
5 KW Tresh Compactor
I Reinspeetion Fee I$15 ' I Issue Fee
DEVELOPMENT SERVICES HEQUIREMENTS:
ZoninB APProved By
Building Approved By
Aoolication luued Bv
$ 3
SUMMARV OF FEES . '
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT �
PLUMBING $ �SSUANCE $ _
PLANCHECK 25% $ ENEFGVP.C. $
ELECTRICAL $ �.2 Q-• Z� GRADING 3
PLAN CHECK 50% $ %( A. g S MICROFILM �$
MECHANICAL $ TOTALFEE $ _6,3.�i.f
PLAN CHECK 25% $
CONSTRUCTION AND.PLANNING ' ' � � � , � � �� '� POOL & SPA
�� �' Date Inspector �� Date Inspector
APPROVALS Permit:# _ . i� - ..APP,ROVALS Permit# _
14 �Temporary Electrical.Service or Pole � 52. Pool & Eq�uipment Location
i
2. Soil Pipe-Undrgrnd. '� 53,.�Steel einfp�C�r�ent
3. Electrical Conduit Utility-Undrgrnd. -� 54. Forms
4. Electrical Conduit�Undrgmd. „ 5� Electrical Bonding -
5. Steel Reinforcement 56. Rough Plurr�intj & Pressure Test
6. Electrical UFER Grnd. �, ''57. APP�OVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test
1 n
9. Water Pipe-Undrgrnd. 60. �kwash 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 o/ 6. Solar System-Final
GY
16. Rough Electric Wiring ' . Fencing & Access Approval � �
17. Rough Wiring Sign �'� '�' �' S. APPROVED FOR PLASTERING '
18. Rough Electrical-T Bar Ceiling � � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT,. REQUIREMENT
20. Rough Factory Fireplace' � APPROVALS � Permit # -
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush .�.,
�.
24. Roof Framing 73. Undergrnd.StorageTank O�as ❑Oil
25. Roof Sheathing 74` Overhead Hydro ,� ,
26. T-Bar Ceiling (Structural) & Monocoat •75. Dry Chemical �+ �
27. Frame and Flashing 76. Dry Standpipe - �i
28. Lathing & Siding 77. FIXED SYSTEM FINAL ��
29. Insulaiion 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT _
31. Plaster Brown Coat . FINAL INSPECTION
32. Electrical Power Meter-Final � . FOOD CERTIFICATE ISSUED �
33. Final Electric � . � �
34 � Final Heating & Air Conditioning
35. Final Gas Pipe-Test -
36. Hood or Canopy � �
37FFinal Factory Fireplace ~ �� , � ��
3&'�Final Plumbing ,i; ; , } �',;, •s'
r % �f,�
39�Water Service-Final t , ir � f '��'' t��, f;
40. Gas Service-Final '" 'r �--' � ! '', .
� � �..
41..5olar pomesticFinal �� • ; �'
i, i .'� •i: f, %, r ' .
�4z�sBackflow Preventer .r •� '. � ,� V, ;>'_
,� � '. , i
�,4'3`;�Backflow Irrigation � '�,� :% �'�� 1'' ;`•� �
_ r r..
;�4;"� Landscape Irrigation SYstem - � '+l�' �v ' � .;: ;; �.•i
� :1 j
s. � �.
�A5�lSound Attenuation _ � ���,;�%��; `"''�,��'; �;
r
+16;�andicap Regulations - •'r %'�': %,
r' •L n
4Z'� FINAL STRUCTURE & BUILDING � � ;� �?`:'j � ,`• �,j
'� 1�� y�,
48'.`Special Requirements Completed ✓�' t'.' ;L��� '' �.�; %� .
,�
4g� Electric Release to Edison . , � ,�: , ,
50. Gas Release to Southern California Gas Co -
51. CERTIFICATEOFOCCUPANCY - • - .
No. Daie • .`- o
u
AVG�icanl to fill in all s0aces except t�osa within neavy Dortler Iinas anG sign all aDV�opriata Eeclarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT /G PCERMIT� fNO. TRACT NO. LOT NO. UNIT NO. �
Project Ad �ress L� L�� O
Applicant's hbiling Aqd�ess Y.E__S TVPE OF CONSTRUCTION NEW ADD FI.TERATION REPAIR
C " �'S �'6/�C� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.p, �6
Own�F'i Name q �/.�j� � Phon DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi
Address - S5S .GJLC_/ ��✓ '
A�ch/Eng. License NO. TVPE OF PERMIT GRqDING FOUNDATION � STRUCTVRAL .i T Fiont
Addres5 �i� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICA� Q Rear
ConVacmr'sNam��j QO CJ�_-`���5 pho�e �pp y� ❑ OTHER
v�,-,�,p(1 � .2/-O=LLQ7 C Right
Address (mailingl— ,n/� �/\ Fy/'�-s �• i��j.��T FRQIECT DESCRIPTION Sq, FT. OCCUVANGv K Left
City License ND. _[! O� 7 CONSTRUCTION TVPE VALUATION $ $
ZONE GRADING CU. VDS. ACRES Ping. fief. #
LICENSED CONTRACTOR �ECLARATION '
I hereby affirm tbat � am licensetl untler provisions of Charter 9(commencing Remarks: �� 1�� �� (� � ���. �s� �' T Pldflning NOL¢5:
with section 1000) 01 Divizion 3 of [�e Business antl Profeszions Cotle, antl
my Ilcense is in tull 1 c antl eifect.
Licen ,CJ�� G_�i7 li<enzeNo. �30�'l3
Oate_H 59nature
'ORKERS' COMPENSATION DECLARATION
hereby affirm that I �ave a certificate of consent to self-insure or a certlficate
ot Workers' Compensa�{on Inwrance, or a certifietl mpy tnereo� (Sec[lon
3800, LaG. )
voncy No. We-G¢�.�L -S�q Company� i�/�S Swtr. e0�
Ge�tifieG coOY is he�aby (umishetl.
DateertlJ"��cqpy is jilqp wl�hC�CiLy Buil 'ng Ivis�„ ,�
T y �rs� ,�u,
E%EMPTION F0.0M WpRKERS' COMPENSATION DECLARATION
(Tnissection neetl not ba <ompletetl It the permit is tor one huntlratl (5300) or
less).
I certity that in the PBrformance of tlte work tor wM1ich tM1is pe�mR i5 i55ueQ I
snall mt employ any person in any manner o s tq� becory 0 5 bject to the
Workevs',Cp� prpsatfnw.l,.aw`.pT CalifOr la. „,/.�,/L/L�Ydw_O � /
�ate 1 Y 6� VS9nature �«/ t Tf'SY�'�/v
NOTICE: I(, aiter mak�ng this tleclaratlon, you shoultl oemme subje�t to the
Workers' Compenwtio� provisions oi the Labor Cotle, you must fortnwith
[ompty with such provisions or Ihis pe�mit Sttall be tllemetl revok¢tl.
CONSTRUCTION LENOING AGENCV
1 hereby af(irm that tM1ere i5 a mnstruction lentling a9enty for tne per(ormance
of the wOrk tor which [his Oermit iz issuetl (5ection 309] Civ. CJ
Lentler's Name
Lentler'S Aadress
OWNER BUILDEN DECIARATION
I hereby affirm that I am ex¢mpLfrom the ContraCtor'S License law for th¢
following �eason ($ection ]031.5 Business antl Prof¢SSlonal Cotl¢: Any City o�
county which requires a oermit to construct, alter, imorove, tlemolish or repalr
anv abucture_ orior to Ita izsuanre. also reaW�es the aoolican[ for Such pe�mit
Divizion 3 Of tM1e Bu5ine55 antl Protessions Cotle) or that he/ihe is ezempl
Ih¢refrom an0 the bdsls for the allegetl exemption. Any vlolatiOn of $ection
7031.5 by any applicant tor a permit subjects [he applicant to a civil
�enalty of not more lhan five huntlretl tlollars ($500).
I, as owner ot [he pioperty o� my employee5 with wages as thei� Sole
compensation, will tlq tha work, antl the siructure is not intantlotl or oHerotl
tor sale (Section 70d4, Business antl Professional Cotle: The Contractor's
License Law does nol apply to an owner of a proper{y wbo bulltls or improves
thereon, antl who aoes such work himselt/herself or tnrough his or her own
em0�oyees, prOviOetl Thaf such imp/ovements are nOt intentletl o� oTteretl for
sdle. Ii, however, [he bulltlin9 0� improvement is Soltl within ona yea� o( cOm-
pletioq the owner will have the burtlen of proving he/she tlitl not build or Im-
prove for the purpose oi sale).
❑ I, as owne� of the p�operty, am exclu5ively cont�acHng with licensetl COn-
tractors to construct the project (Section �044, Business antl Professions Cotle:
The Cmvac[or's Licanse Law tloez not appty to an owner ot property who
builtls or improve5 tqereon, antl who conttact5 for such projec[5 wiM a con-
tractor(sl I�<ense pur;uant to the Contractor's License L.aw). I am aware that
proof af theii Wo/kbt's Compensation insuranca shoultl be provitletl to me.
❑ I am exempt untl¢r Section B. & P. C. for this reason
Date Owner
1 hereby certlfy that � have reaa thfs apolfcatfon antl state that tne abova
information is wrrec[. 1 agree to comply with all city antl county o�tlinancei
antl state laws 7elating (p builtling constructlon, antl hereby authorize repre-
3enlatives ot this c� tp enter upqn tne above-mentionetl property for
Signature /�P7.R
K �
3arSink -
3ackflow Preventer
3ackflow Irrigation
3athmbs
Clarifiers
Dishwasher
Drinkin9 Fountains
Floor Drains
Floor Sin`ks
Gas Service Outlets
Inteiceptors
Kitchen Sink
Lavatories �
P-T.rap "
Roof.Drains.
Reinspection Fee $15
Boiler
Duct- Under Ground
�uct - Sttuctural
Duct - Ventilating
Exhaust System ❑ Multiple
FirepUFact Blt. ICBO #
Heatin9 System & Ducting
❑4700,000 BTU 0100,000
Reinspection Fee � $15
CMF 0865-46, rev. 10/84 White - Builtlinq; Canary - qpplicant; Pink - Accountin9: Goltl¢nrotl - Assessor
$hoWerS
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank .
Swimming Pool w/$pa
Urinal
Wd�Cf (�.�052L
Water Heater
Water Service
Auto-Wash
Laundrv Travs
Issue Fee
Hood or Type I �
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑700,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
$ 3
G'
S 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generatar �0-5 KW C
8047 4/04/8�
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 75-50 KW
❑ 50+KW
5 KW
Meter Llup to t00amps
Meter �over 100 amps
Sub Panel
Motors OO-1 .HP O1 % - 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light �
Range
Sign
Standing Sections
Trash Compactor
24000 TL
FEES
2
O
N
I
N
G
R
E
�
M
T
S
I Reinspection Fae � I$15 � � Issue Fee �� 1 r$..3—t
DEVELOPMENTSERVICESRE�UIHEMENTS: �
Zoning Approved By Date
Building Approved By Date
Application Issuad By Date�
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ Z4=N GRADING S
P�AN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ Z � �
PIAN CHECK 25% $
CONSTRUCTION AND PLANNING', .. . POOL & SPA
.APPROVALS Permit # �-- - Date Inspector qppROVALS Permit # Date Inspector
I
1: Temporary Electrical Service or Pole � . 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. �54. Forms
4. Electrical Conduit-Undrgrnd, � , 55. Electrical Bonding .
5. Steel Reinforcement 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-Undrgmd. , 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor Systein 67. 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 Sys(em-Final �
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Elearical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Condit�oning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS . Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank d Gas d Olf
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. FrameandFlashing 76. DryStandpipe , ,
28. Lathing & Siding 77. fIXED SYSTEM FINAL'
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . FINAL INSPECTION �
32. Electrical Power Meter-Final ��` . FOOD CERTIFICATE ISSUED �„
33. Final Electric Notes:s=/�� �� �. � - �
34. Final Heating & Air Conditioning
,y
35. Final Gas Pipe-Test � ��
36. Hood or Canopy '
� ( �z
37�! Final Factory Fireplace •4, i r" " .
38: Final Plumbing '�r. .�• '� � � '� � �
. , �
39�. Water Service-Final !r, �' �
+
� 40. Gas Service-Final . ,.j `,� �
i�4�7. Solar pomestio-Final - %� ✓ ', �
�
�42. Backflow Preventer � j' i' �' ,i � ' '
��4�; Backflow Irrigation ' i ' � -�' �
.�
� 44� .Landscape Irrigation System �,l ,` . i�' . � '-'
",45:: Sound Attenuation .v ��' � ' �
4�6. Handicap Regulations � � �� � . � ` - • )
47.-FINAL STRUCTURE & BUILDING ' � �' '• ' ' � - • '
� �i' -�! L . _�,I. �� - �
4�. Special Requirements Compl¢ted � _ ' ' . '
49. Electric Release to Edison I � >% � � �
50. Gas Release to Southern California Gas Co / �'' 'S � .
51. CERTIFICATE OF OCCUPANCY
No. Date
� i
AOP���ant to fill in ail spaces except those within �eavy Eoraer Iinas ana sign ali aoVropriate Eeclarations.
CITY OF COSTA M�E.�S+A CONSTRUC�TnION PERMIT
.Projer.�Address —l�S iQAr/b/� b fLii�T-. �e-
Applicant'sMaiiingAddress ��� /�E��S ��'
Owner'p,Name ��'��S'�4UFlC /'F✓ PhoneSS%�G%O(
Address S-SS /9�'�LToi✓
Arch/Eng. License No.
Address
Contracror's Name ���M6+4D04.ZS Phone�%� 77d0
Addresslmailingl �^���G✓�S Qa. /�dLnL4T�
City License No. C� 6SS�
LICENSED CONTRHCTOR DECLARATION
I hereby a(firm that I am Iicensetl untler provisions ot Chart¢r 9(commen<ing
with section ]000) of Division 3 ot the BuSinesS antl Prote55ion5 Cotle, antl
my license is m t I tor antl ettect. �� �
License Class � —�—�� �c�e�n % N
Date 7�� — 519 t ��� �
'-"�RKE0.5'COMPENSATION DECLARATION
reby affirm that I have a cer[ificate ot consent to self-insure or a<ertificate
Workers' Cort�pe ti n n5y� p�e, or a certlfietl copY thereot (Section
3800, Lab. �P '��7 �O
� Policy No�� Company ��'9 �• � •
�Cer[ifietl mpy is hereby lurnishetl.
Certiyg^ cy is {j�e,p with the cit Buil 1v'sio �/_ ,�,��,� J
P Y 9
` Da[e Y 1 —XX Applicant � iq^Y"`�✓
EXEMPTION FROM WORKERS' COMPENSATION DECLARATI N
(Tnissection neetl not be completed if [ne permit Is tor one huntlretl (y300) or
less).
I cer[ify tbat in [he performance ot tbe work for which this perm�t is issuetl, I
shall not employ any pe�son in any manner so ds to b¢come subject to the
Workers' Compensation Laws ot CaliPomia.
Date Signature
NOTICE: If, after making thi5 tleclaration, you stloultl become subject fo [he
Workers' Compensation provisions of the Labor Cotle, you must forthwlth
comply with such�0�ovi5ion5 or this permlt sitall be tleemetl revoketl.
CONSTRVCTION LEN�ING AGENCV
I hereby affl�m tnat there i5 a mnst�uctlon lending agency to� the pertormance
of [he work for which [his Oermil is issuetl (SettiOn 3097 Civ. CJ
Lentler's Nam¢
Lentler's Atltlress
OWNEF BUIL�ER GECLARATION
I hereby atiirm that I am exempt from the Contractor's Llcense Law tor Ihe
following reasan (Section ]031.5 Business antl Protessional Cotle: Any tlty or
counTy which �equires a permil to ConS[ruct, alter, improve, aemOlish or repair
any structure, prlor to Its Issuance, also requires the aDP�icaM 1or such permit
to file a sign¢tl statement thdt he/she Is licensetl pu�suant lo the p�ovi5ion5 Ot
•4e Contractor's License Law (Chapter 9(commen<ro9 wlin Sec[lon �000) of
'vision 3 of tne Business and ProfMswns Cotle) Or tha[ ne/she i5 ¢xOmpt
eretrom and the basis lor [he allegetl exemptlon. AnY violation ot Section
.031.5 by any appllcant for a pe�mil subjec[s lhe appliGant to a civil
�enalty of not more than five huntlretl Collars (5500).
I, �s owner ot IM1e propertY or my employees witM1 wage5 as thei� sole
compensatlon, will tlo the woB, antl the 5tructure is not intentletl or offeretl
for sale (Sec[ion ]064, Business and Protessional Cotle: The Contractor's
License Law tloes not appty to an owner ot a properry wno builtls or Improves
thereon, antl wM10 tloe5 Such wotk him5elf/herselt or through his o� her own
employees, provitletl tM1at suth Improvement5 are nOt IntGntled or oH¢re� fo�
SaIC H, howevet, the bulltling or ImOrovement Is soltl wltbin one Yea� o( com-
pletlon, the owner wlll nave the burtlen ot proving he/she tlia not builtl or im-
�rova tor the purpose ot sala).
I, as owner ot t�e pro0erty, am extluzively contracting with licensetl con�
tractors t6 construc[ [he project (Section 7044, Busine55 and Professions Cotle:
The Contractor's License Law does no[ apply to an owne� of property who
bulitls or Improves IM1ereon, antl who conlracl5 Por Such projects wilh a con-
� traGto�(51 licenze purouant to the Conlratfar'S License Law). I am awa�e that
, proof of Ihei� Worker'S Compensa[ion inswance shoultl be provitletl to me.
❑ I am exempt unaer Section 8. d P. C. far tnis reason
Date Owner _
I hereby certity that I have reatl this
Intormation is rorrect. I agree to como
antl state laws relating to Guildinq con
sen[atives of th�}ls c�ity� �to�- t�er -u�p /r
inspectlon pu�ifN���/`� � !� • K
Signature
Driver5' Lic¢nse or 55 �
TVPE OF CONSTRUCTION LI NEW LJ ADD LJ ALTERATION Ll REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHEj�C
DESCRIPTION OF WOFK/USE OF BLDG. E
TYPE OF PERMIT lJ GRADING LJ FOUNDATIOr�N LJ STRUCTURAI
❑ TENANT ❑ EIECTRICAL ❑ PLUMBING LJ MECHANICAL
❑ OTHER
PROJECT DESCRIP710N 50. Fr. oCcuPqNCv—
CONSTRVCTION TVPE VALUATION $
ZONE GRADINGCV.V�S. ACRES—
Remarkz:
Sink
Preventer
Irrigation
ing Fountains
�l21lIS '
Sinks ,
ShOwers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
ice •� Outlets Water Closet
tors , Water Heater
Sink Water Service
es . Auto-Wash
y , WundryTrays
Reinspection Fee I $15 I I laue Fee I $ 3
Boiler
Duct�UnderGround
Duct - $LluCtUral
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. BIL�ICBO #
Heatin9 System & Oucting
❑0.100,000 BTU � 100,000 Bf
Reinspection Fee � $15
CMF 0865-46, rev. 10/84 White - Builtling; Canary - qpppcant; Pink � Accounting; GOltlenrOtl - Assesso�
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑4100 OBTU ❑100,000
S em Repair/Alteration
Fire Dampers
Registers
Issue Fee
A.P. �
S Main Building:
E
T Front
ARear
C Right
SLeft
Ping. Ref. #
Planning Notes:
Zone
a��
Parking Req./Provided
ELECTHICAL . �
Automatic Washer . Transformer ❑ 15-50 KW
ConstructionPoleSub. � �50+KW
Cooking Unit �` Meter �up to 100 amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Electric Sub Panel � �'�AM7
Fan . � Motors�61HP�1h-8
F.A.U. Inc.Solar �9-15 HP �16-75+
Fixtures Microwave
Device Boxes Pole Li9ht
Outlets
Switches
Garbage Disposal
Generator DO-5 KW �5�15 KW
Sign
Standing Sections
Trash Compacmr
Reinspection Fee S15 Issue Fea
FEES
�DEVELOPMEN7 SERVICES REQUIREMENTS:
Zoning Approvad By _
Building Approved By
Aooliration Issued BY �
$ 3
SUMMARY PjF F
BUILDING PEFMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $ Z �
MECHANICAL $
PLAN CHECK 25% $
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM 5
�-.
TOTALFEE $
0
FEES
vi.
ML/00 TTMC• ifl•'l[
Z
O
N
I
N
G
R
E
Q
M
T
S
CONSTRUCTION AND PLANNING � `, POOL & SPA �
APPROVALS Permit # ' Date Inspector qppROVALS Permit # Date Inspector
i
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2: Soil Pipe-Undrgrnd. "� 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
,.
5. Steel Reinforcement ;� 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. ��• 57. APPROUAL TO COVER-GUNITE
7. Footings '� ; 58. Electrical Conduit-Undrgrnd.
8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test
:�
9. Wate�-Pipe-Undrgrnd., 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor Syste`m 61. APPROVAL TO DECK
11. Property Sewer Line�&'Iiouse 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 Sfgn 68. APPROVED FOR PLASTERING
18. Rough Electriral-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '�
20. Rough Factory Fireplace APPROVALS Permit # r'�
i;
21. Ducts, in Structure 70. Undergraund Hydro r
22. Ducts, Ventilating 71. Product Piping �Gas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush .�
24. Roof Framing 73. Undergrnd.StorageTankbG�as ❑Oil �.
r.
25. Roof Sheathing . 74. Overhead Hydro ��� `
✓. ✓
� ..
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � •i
27. Frame and� Flashing � 76. Dry Standpipe � 1�
28. Lathing & Siding ' 77. FIXED SYSTEM FINAL`� `�
29. Insulation 78. FIRE PREV. FINAL ��/ �
J•� �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �r
31. Plaster Brown Coat 79. FINAL INSPECTION �� ; �
32. Electrical Power Meter-Final ��u 0. FOOD CERTIFICATE ISSUED ���
.'
33. Final Electric � otes: � r,
34. Final Heating & Air Conditioning �
� �.
35. Final Gas Pipe-Test � � "
i'r
36. Hood or Canopy �
�"
37':,Final Factory Fireplace � „ "' •
i,' . r . ,
3$.' Final Plumbing i�' �. �-: � ; �' ?� , �
39�Water Service-Final i�: � �'� � ��� ,, `� .� y' �i
: i. i
40. Gas Service-Final , • / ` - .
I. I ' �
41�SolarpomestirFinal �%� '�l � ; �� r+
�42%BackflowPreventer ;� y �� • `-+ �� ' y�
,.� .r �� J � �v„ �
' 43^Backflow Irrigation �f �!� �� �% v ,'7
..
!A4' Landscape Irrigation System �� �, � i 1f �;�• -;1
,45� Sound Attenuation � � ' " �• �''
.. i �� ' j Y �� ,
46! Handicap Regulations i`"•' �' :` �. 5, '
. ('. v 9 �
47�FINALSTRUCTURE&BUILDING ' ,� rr � � j ;
`�� -J : ✓ % N ?
48.iSpecial Requirements Completed � i '�. .. � � J, J�
.�
49� ElectricReleaseto Edison j% . �� " '
50. Gas Release to Southem California Gas Co �.i .-� � -� ', .
51. CERTIFICATE OF OCCUPANCY �
� ..
No. Date
-- _ �\ t C . . , .
I 1
I
CITY OF COSTA MESA CONSTRUCTIOw�N PERMIT
� Project Address ��T�� G�p�N ` ��
, fY,pplicant's Mailing Address ' c�� � S�
' Owner's Name � r � � .�—Phon��`
Address 'Z �
Arch/Eng. C w A License No.
Contractor'sNama Y�w `:'3,-,V�T' �CL1Le�'r��— Phone-��r��
Addresslmailingl—`�„Q �1���
CityLicenseNo. �Ft��1
LICENSED CONTRFCTOR DECIARATION
I he�eby afli�m that I am IiCensetl untl¢r proviilon5 ot Chart¢r 9(COmmancing
with seclion 7000) ot Division 3 of the Business antl Prote55ioni Cotle, antl
my license iz in t II —for1c/e�antl ettect. u �%
License Clas � 1,�/ Lice e No. [� �•
� �'le�l'�� 519 [
� � 4KER5'COMPENSATION OECLARATION
Eby aHirm tnat I nave a cercificate of consent to sell-Insure or a ccrtHicatc
�.� /orkers' Gompensation Insurance, or a certifietl c py therCO( (5¢Ctlon
��0, Lab. q�a ` �
—Policy No.�/ComPanY / 11 _��/({[�
�J Certifietl copy is hereby furnished.
❑ Certifietl co is (itetl with [he citY Buil�inq DiviSion.
Date ��—���( ADP��cant "'�
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
�(This sec[ion neetl no[ �e completetl it the permit IS (or one �untlretl (E300) o�
less).
I certlty that in the pertormance of che work for whlch tnls perm�t is IssueQ I
5hall nol employ any perzon in any manner So a5 to betoma 5ubjact lo tha
WOrkers' Compensatlon Laws af CalitOmia.
QDate Si9nature
NOTICE: If, after makin9 this tleclaratlon, you snoultl become subject to tho
Workers' Comp¢nsa[ion proviSlonS of the Labor Cotle, you musl lorthwltn
comply wilh such p�ovisions or [his p¢rmit shall be tllemetl rOVOkCtl.
CONSTRUCTION LENDING AGENCV
1 hereby afll�m [hat th¢re Is a const�uction lentling agency for lh0 per/ormanc0
ot the wOrk tOr whiGh thii permit IS Issuetl (Satllon 309] Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER OECLARATION �
I hereby aHirm that I am ezampt 1rOm tno Gantracror'S Lit¢n5e Law lor lho
followin9 reason ($ection 7031.5 Business antl Profosstonal Cotlo: Any city or
mun�y wbith reqW�es a Oermil to conStruGt, alt¢r, Improve, demollsh or rOpalr
•ny slructure, prlor to iIi ISSuan<¢, al5o �eq Wros Ihe appliCanl iOr Suth pe�mll
`\(il¢ a signetl SLdttTent thdt h�/She ISIIcen58tl pWSudnl IO Ih0 provi5ion5 0l
� Contractor'S lJcense Law (C�apter 9(commencing with Section 7000) of
� . �ision 3 of the Buslness antl Profe55iOn5 CotlO) o� Inat he/iho IS azempt
� irelrom antl the basis /or the allegeG exomption. Any violalion oi Section
J31.5 by any aOP��tant for a petmil Subj¢ct5 lhB appliCant to a dvil
— enalty of not more lhan five nuntlretl tlollars (E500).
� 1, as owner of the p�o0e�ly Or Ty employees with wa9e5 as lnoi� sola
CompenSdUOn, will tlo tho wOrk, antl Ihe sVUCturO IS nOt Inlentletl or olferatl
ior sale ($ection 7044, Business antl Prol¢zzlonal CoOo: Tho Contractor's
li[ense Law tlocs not apply to an owner Ot a proper[y who bullCs Or Imp�ove5
thereon, antl who tloes such work himseli/herself or throu9h his or ner own
employces, provltletl that suGh improvamenls are not Intnntletl or otiern0 t0/
Sale. It, howaver, [he bulltling or imptovemant IS TOItl wllhin Ono yea� oi com�
pletlon, Ihu owner will hdve the burtlan O� Provin9 ne/sha tlitl not bulltl or Im-
��ove fo�lhe purpose of sale).
I, ds owner O/ the p�operty, am excluSivGly con[ratting wilh Ilcen58tl COm
tractorslo <onsVuct th¢ project ISection 7044, Business antl ProfesSions Codo:
The�ConVactoYs License law does not appty to an owner of property who
bWlas or Improves thereon, antl who contracts iar such prqects wlth a mn-
[rac[o�(sl ucense pursuant to tha ConVa<tOr'S Litense Law�. 1 am aware that
proof of thei� Wo�ke�'S COmpensatlon Insu�ance zhoultl bB prOviOetl to me.
❑ 1 am exemp[ untler Sectlon B. & P. C. for tbls reason
Oate Owner
I hereby certi(y that 1 nave reatl
intorTatlon is correct. 1 agr¢e [o i
antl s[ate laws relating to builtlin!
sentatives o( this.city to e�ter
'tale Ihat the above
�a county ortlinances
¢by du[ho�lxe repre-
ionPtl property for^7
Date.���!
icant to till in all spaces azceo� thasa wlthin neavy �oraer Iines antl sign all aporoortata aeclarations.
PERMIT NO. TRACT NO. , LOT NO. U N
� z� Z�s , ,� -
PE OF CONSTRUCTION
❑ CONVERSION ❑ I
DESCRIPTION OF WOR
TVPE OF PERMIT U GRiiDING •
❑ TENANT ❑ ELECTRICAL C
❑ OTHER �
PROJECT DESCRIPTION Sc?. FT.—
_W LJ ADD LJ ALTERATION LJ REPAIR
❑ OT ER
BLDG. � �I N Pii�
JFOUNOHTION LJSTRUCTURAL
.PLUMBING ❑ MECHANICAL
� CONSTRUCTIONTVPE VALVATION
ZONE GRADINGCU.YDS. �
Remarks: 1/ � .
Sink
Preventer
Irri9ation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service �—.
Interceptors
Kitchen Sink
Lavarories
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Dut� � Under Ground
Duct - Suuctural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting.
❑0�100,000 BTU 0100,0006T
Drivers' License or SS �
I I Reinspection Fea
' 0865-46, rev. 10/84 White - Builtlinq; Canary - Appllcanp Plnk - Accountin9: Goltlenrotl - Assessor
$15
PLUMBING
$f10WEf5
Service Sink
Sewer Cap
Sewer Connection
Solar Collec[ors
.Salar Pipin9
Solar Tank
Swimming'Pool w/Spa
Urinal
' Water Closet
Water Heaier
Water Service
Auw-Wash
laue Fee
Hoodor Typel ❑
Canopy Type II ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers �
Issue Fae
FEES
g 3
$ 3
A.P. �p
5 Main B
E
T Fronl
B Rear
A
C Right
K . .
Ping. Ref. #
Planning Notes:
� � � �
._
i-i. 7:1 " _.l �l + ,
� Zone
�„ �� � Accessor,y�8uilding:
. .. � ..��v:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Parking Req./Provided
ELECTRICAL
Transformer ❑ �15-50 KW
❑ 50+KW
Dryers LJGas L1Elecvic
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �0�5 KW �5-15 KW
Meter lJup to 100amps
Meter �over 100 amps
Sub Panel
Motars � 67 HP � 1 Y. - 8
Ina Solar �9-15 HP 07645+
Microwave
Pole Li9ht
Range
Sign
Standing Settions
Trash Compatmr
� Reinspection Fee �$15 � � Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zonin9 APVroved By p �"
Building Approved By ��S.L—�
Appliwtion lauad By
ARV F FEES
BUILDING PERMIT $ SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PIAN CHECK 25% $ ENERGV P.C.
ELECTRICAL $ GRADING
PLANCHECK 50% § ' MICROFILM
MECHANICAL $ TOTALFEE
PLAN CHECK 25% $
FEES
�
te /— /2 �� y
te 2�25� d�1
$ �
$
S
$
$��
�
c. � n .� 2
Z
O
N
1
N
G
F
E
�
M
T
S
CONS7RUCTION AND PLANNING POOL & SPA
APPRQVALS �Per�mit# Date � Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2.'Soil Pipe�Undrgrnd. 53. Sreel Reinforcement
3. Electrical Conduit Utility-Undrgmd. 54. Forms
4. Eiectrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test ,
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings '^� 58. Electrical Conduit-Undrgrnd.
8. Fountlation � 59. Gas Pipe, � Undrgrnd., Test
i�
9. Water Pipe-Undrg�nd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Recep[or-Final
72. Sewer Cap 63. Heater & Vent-Final �
13. Roof Dreins 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING .
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS�FINAL
19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT �
�
20. Rough Factory Fireplace APPROVALS Permit # _ - '
21. DuctY,in Structure 70. Undcrground Hydro �� �.
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 7. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydr � L�
26. T-Bar Ceiling (Structural) & Monocoat 75. Dr emical -
27. Frameand Flashing 76. Standpipe $� �
28. Lathing & Siding - . FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric tes: •
34. Final Heating & Air Conditioning Z�--- �� -
35. Final Gas Pipe-Test ��jj G , �� �� u
36. �Hood or Canopy � �
37. Fina! Faciory Fireplace � � ,
38. Final p�umbing - � _,
39. Water Service-Final •
� 40. Gas Service-Final ' _ � �
. 41. Solar pomestic-Final .
- 42. Backflow Preventer � � '
43. Backflow Irrigation � . � � - �
44. Landscape Irrigation System , �
45. Sound Attenuation � � , �
46. Handicap Regulations t-:� �
47. FINALSTRUCTURE&BUILDING � , . �
48.- Special Requirements Completed ' , - - ' � ,�
49:r Electric Release to Edison � .. � 1 -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY '\
No. - Date � � (r 1 �
� /� �� � � .
Applicant to /(II In all spaces except t�ose within heavy DorEer lines anE sign all apPropriata Eeclarations:
PEI7MI�N0. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESA GUN 'THUCTION PtHMI I ^^-- p p�p
Project Address � � n ,
5s5.A
Applicatut's Mailing Address � I7 6//
Owner's Name S�'�L�r/� "� ""r " /�� �/��hone9�
Address s��i�HT�A i� QYA M ��7y �B
Arch/Eng. License No.
Address
Contractor's Name Phone
/�ddresslmailing) :.�5_� C�-Ca �i q -$'O�f14 ��
City License No. ���� ya 9 D 0 5 0
LICENSED CONTRACTOR DECLARATION
I hereby affirm inat I am ��censetl untler provislons of Charter 9(commencing
with section 7000) of Division 3 ot tha Business anC Professions Cotle, antl
my Iicense is in tull force a�tl e/fe<t.
Licenseq ass LI No.3 6 6 3 oS
^+tc //!! P YG StSnat ��� ���yl
RKERS•COMPENSATION DECLARATION
areby atfirm t�al 1 �avC a certlticate o! consent to self-insure or a certlfica[e
of Workers• Compensa[inn Insurance, or a certl(letl copY thereot (Sectlon
38o0,�Lab. C.)
PolicY No.l.�1P 80 3.�5%9% companv S� a'�:l-
Certitie�tl copy is nerebY furnizh¢tl.
Date.f// /��9!�Ctl WAPPhcant_.`�in9 vi }po �p
r1i.�.a...[.[/\
. EXEMPTION FROM WORKERS• COMPENSATION DECLARATION
(This section need not be Fomplatetl if lhe parmit is for one huntlretl (5100) or
less).
I certity that in lhe p<rfurmdnce oi l�e wo�k f0� whiGh th15 pe�m�t Is Issuetl I
shall not employ any pefson in any manner so as to Gecome subject to t�e
Worker5' Compensatlon LA�'s o/ CalitOrnid.
Data Si9nalure
NOTICE: Ii, after making this tleclaraUon, you shoultl Gecome subject to lhe
WOrkGrS' CompensaUon a�ovision5 O/ [hG LabOr Cotla, you must tor[hwith
comply with such Orov�Aons or thls permit shall ba tleametl revokea.
CONSTRUCTION LEND�NG AGENCV
1 hereby at(Irm that there is a constructlon lenain9 agency �or the pertormance
of tno w<vk for whiCP^thii permll Is IssueO (SeCtlOn 3097 Civ. CJ
Lentler's Name �
Lentler's AQtlress�- -
OWNER BUILDER DECLARATION
1 hereby aifi�m l�at I art� exempt from the COntrdct0/'s License Law fo� the
followin9 reason (SecUon �7031.5 BuSinetS antl Professlonal Code: Any city or
county which reQuir¢s a permit to construct, alter, improve, tlemolish or repair
any itructure, p�br IO Il5 �STuant¢, also requlre5 tha applicant tor SUGh pe�mi[
� 'ile a si9netl Statement Ihat he/sne Is Ilcent¢tl pur5udnt to Ihe provi5ions of
Contractor'S License Ww (Chapter 9.(commen<Ing witn Section 7000) of
.Sion 3 Of Ihe BuSlnBss antl Prote55ion5 COtlO) Or thdt he/ihe Is exempt
tnerelrom anC the basls far the alle9etl enemptlon. Any vlolalion ot Section
7031.5 by any appliCatl�, fOr a permit subjec[s the aOC���anl to a civil
'� enalty of not more than f��e huntlrea tlollars ($500).
I, as owner ot the Oroperty or my employees with wa9es as their sole
compensation, will tl0 tb¢ wo�k, and the s[�Uctu�e is not intentletl o��oH¢retl
tor ule (Seclion 7044, Business anC ProfeSsional Cotla: The Contracror's
LicenS¢ Law tlOes nOt app�Y �O an owner of a properry who Duiltls or improves
thereon, antl wno tloe5 4uG� wa/k nlm5e1//ne�50H o� IhrOugh his o� ner own
employee5, providetl lhd[ such ImOrovoments a�e not IntOntletl or otteretl fo�
sale. I1, however, the bulltling or Improvement I5 soltl witbin one year ot com-
pletlon, the owner will have the burtlan of proving he/she tlltl not builtl or Im-
��OVG 10� the pu�po5a oi Sale).
I as owner of the proPerty, am exclusivaly contracting with IlcenseC con-
tmctors to constru<t the pro�ect (Sectlon 7044, BuSinesS antl Protessions Cotle:
Tne Con[ractor's Licenss La�+ doe5 nOt apply to an owner O( Property who
builtls or imoroves thereon. ana wno contracts /or suth oroiects witn a con-
tractor(s1 Lcense pursuan� to me Con[ractor•5 License Law). I am aware that
prooi o( Iheir Worker's Compensatlon Insurance shoultl ba provltletl to me.
❑ 1 am exempt untler SeGtion B. 6 P. C. for this reason
Date
I here�y certify th
Information is corre
antl stale laws relat
sentdtiv¢s ol this �
inspectlon
Slgnature�
Drlvers' License or :
_ Owner
I nave reatl this application antl state that the above
I d9ree to comply with all clty antl county O�Alnance5
l0 builtling constructlon, antl hareGy authorize re0re-
� �o er upon the abova-mentionetl Pro erty or
Date � �
.. /
TYPE OFCONSTRUCTION PSI NEW LJ ADD IJ ALTERAT�ON LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT��
DESCRIPTION OF WORK/USE OF BLDG. «
TVPE OF PERMIT LJ GRADING LJ FOUNDATION DSJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5[�. FT. oCCUPAN Y_�/'�
CON STRUCTION TVPE VA�UATION $ �Z
ZONE GRADINGCU.YOS. ACRES_
Remarkt: Q/' �GL . �e �iG_• _ // /��D�l
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Orinking Fountains
Floor Drains
Floor SinkS
Gas Service Outlets
Interceptors
Kitchen Sink
Root Drains
Reinspection Fee � $15
Bo�ler
Duct - Under Ground �
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. iC60 �k
Heating System & Ducting
❑6100,000 BTU 0100,OOOBT
Reinspection Fee � $15
0865-46, rev. 5/68 White - 8ulltling; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor
Showers,
Service Sink
Sewer Cap �
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Po61 w/Spa
Urinal
Water Clout
Water Heater
Water Service
Auto-Wash
laue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigera6on System
❑0-t00,0006TU ❑100,000
System Repair/Alteretion
Fire Dampers
Registers
Issue Fee
FEES
5 Main Buildin9:
E
T Front
ARear
C Ri9ht
S . Left
Ping. Ref. #
Accessory Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit Meter �up to 100 amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Electric Sub Panel ; �
Fan Motors O61 HP O TY, - 8
F.A.U. Inc.Solar �9-15 HP �16�15+
Fixtures Microwave � �
Device Boxes Pole Light '
Outlets Range �
Switches Si9n
Garbage Dispoul Standing SectiOns
Generemr �45 KW �5-15 KW Trash Compacror
zone
Reinspection Fee � S75 � � laue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
FEES � �Building Approved By -�
Aooliotion laued Bv
E 3
I
N
G
R
E
Q
M
T
S.
FEES
$ 3
SU ARV OF FEES
BUILDINGPERMIT $ ��0 SMIP $ Q��
PLAN CHECK $ �.65 pERMIT �
PLUMBING $ ISSUANCE $
PLAN CHECK 25% 5 ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
.MECHANICAL $ TOTAL FEE $ 13�
PLAN CHECK 25% $
01 00019393-tlL�019E95 Tra7� ;34.,�E
DATE: 11/131P$�,� 7IME: p9:p4
- CONSTRUCTION AND PLANNING P ��& SPA -
APPROVALS Permit # Dater Inspector AppROVALS Permit # Date Inspector
� 1. Tempo�ary Electrical Service or Pole r 52. J'ool.&`L-quipment Location ,. r�,
2. Soil�Rp -Undrgrnd. '�x . jl / 53. Steel Reinforcement '�
.3��Electr�rxJCondu[il,lti�ity-Undrgrnd. - ' � 54. Forms �
4^�Electrfcal Conduif�Undrgrnd. 55. Electrical Bonding i�.�.,J
5:-Steel'�Re�nforcement r ' � 56. Rough Plumbing & Pressure Test �' {�
a
6�'• El�cfrica� UFER`Gmd" �� 57. APRROVAL TO COVER-GUNITE '
. r , i '1
•�.,. � i i .v
7�Fodf�gs� • ' '�� 58. Electrical Conduit-Undrgrnd. '� �
8. Founc�at}on •, �• : ''� 59. Gas Pipe, O Undrgrnd., Test
i
9. Wate fP.iAe-UndrgSnd. i�1� `, � 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Struc�ural Floor'�System ? '�� 61. APPROVAL TO DECK �
11. Property�Sewer Line & House Connection . ` ' 62. Backwash & Receptor-Final
�2. SQ'^'eT�Ca�P : . � , ' - 63. Heater & Vent-Final � �
•,
13. Roof'Drains . �� 64. Plumbing System - Final ��
14. Rough Plumbing 65. Electrica�-Final ��
75. Rough Electrical�Conduit . 66. Solar System-Final
1�6. Rough Electric Wiring 67. Fencing & Access Approval �
�i
1�7. Rough Wiring Sign 68. APPROVED FOR PLASTERING
J
18� Rough Electrical-T Bar Ceilirig ,� 69. POOL/SPA SYSTEMS FINAL
19� Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace �� �t � APPROVALS Permit #
21. Ducts, in Structure '�� • - -
�, �70. Underground Hydro
22. Ducts, Ventilating �;.`'- 71. Product Piping 0 Gas ❑ Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing , � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � � 74. Overhead Hydro
�ta'.: „ �• -
26. T-BarCeiling (Structural) & Monocoat 75. Dry Chemical �
27. Frame'�nd Flashing ' � �� �3 d� 76. Dry Stand'pipe
28. Lathin & 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 � Notes:
34. Final Heating & Air Conditioning • ��
IO lo � - }�2 " �r�.�
35. Final Gas Pipe-Test � �� ��
36. Hood or Canopy .
37. Final Factory Fireplace
38. Final Plumbing
39. Wa[er Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer ��.
43. Backflow Irrigation � '
44. .Landscape Irrigation System ��
45. Sound Attenuation � ��
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING � � �
48. Special Requirements Completed
�
49. Electrie Release to Edison � �. •
50. Gas Release to Southern California Gas Co �- -
51. CERTIFICATE OF OCCUPANCY �
No. Date •i �
.:,
1�
Acplicant to fill in all s0aees except t�ose witnin �eavy EorOer �Ines a�tl sign ai1 appropriate tleclarations.
ciTY oF COSTA MESA CONSTRUCTION PERMIT PERM� NO._ ,__� , � UNIT NO. i_
ProjeLiw,address SSS %iN2S21� ' _
�i •
,,,Appl icanYs•Ma i I i ng Address
Owner's Name `���1.�PAC��C RRN� phone
Address �
Arch/Eng. n" License No.
Address (Se�A/%%� � �%�� `�s .�-A/`✓EL ES
Contracmr'sNam u1fY�6A1. ELECIRIC Phone 0 �
Address (mailing) �n I RC'�,Il��� AUe. �f�l'l0� �.C57A ('(�ftift
City Liceose No, � y 4 q � �
LICENSED CONTRACTOR DECLARATION
I hereby affirm [ha[ I am IicensCtl unUer provi5iOn5 oi Charter 9(comM¢ncing
with sec[ion 7000) ot Division 3 ot the Business antl Grofeszlons Cotle, antl �
my license is in full force antl efTe<t.
License Class C— IQ �icense No. 54a4� 1'
Datel�'a\'$$ Si9nature��nr^Co'^Q-VrJ
`RKERS' GOMPENSATION DECLARATION
.reby atfirm that I have a certiticate of conseM to selt-Insure or a certlflcate
. Wo�ke�s' Compensation Instl�ante, o� a certitied copy the�eof ($eCtion
3800, Lab. C.)
rorcr rvo. iilP 88�l�13G0� comaa�v FremnniT Irc�er����uC�•
�Certi/ietl copy is hereby furni5hed. .
Certitietl copy is tiletl with the city Builtlln9 Division.
�ate ��'��'xR Applicant 1</1Mrrn`���M
EXEMPTION FROM WORKER5';COMPENSATION DECLARATION
(This section neetl not be completetl ii the permlt is for one huntlretl ($100) or
less).
I certify that�in tne pertormanc6 of the wotk tot which [his oerm�t Is Issuea I
shall not employ any pe�son in any manne� so as [O b¢Come Subject to the
Workers' Compen5ation Laws of Calitornia. .
Date Signature
NOTICE: If, after making this tle��aration, you shoultl become subject to tha
Workers' compensation provisinns of the Labor �Cotle, you must forthwith
'comDly with suc� provisions or this permit shall be tleemetl revoketl. �
CONSTRUCTION LENDING AGENCV
t hereby atfirm that tnere is a construction lentlin9 agency for the pertormanca
o( the work (or which this Permit is issuetl (Sec80n 309] Civ. C.)
Lentler's Name
Lentler's Atltlresi
OWNER BUILDER DECLAfiAYION
I hereby a(tirm ihat I am �exempt from the Contractor'S LiCenSe Law for the
lollowing reason (Section 7031.5 Busine55 antl Pro(e55ional CoOe: Any city or
county which requires a permit to construct, alter, improve, tlemolish or repair
any structure, prior to its is5uance, also requires the applicant for such permit
" file a signetl statement thdt M1e/she is IicenSetl pur5udnt to the provi5ion5 of
Cantractor's License Law (CPapter 9(rommencing with Sectton �000) ot
sion 3 ot the Businezs antl Professions Cotl¢) o� that he/she is exempl
..<re(ram an0 the basis tor the allegetl exemption. Any violation of Se<tlon
�]031.5 oy any applicant for a permtt subjects Ihe apPlicant to a civil
-� enalty ot.not more than five huntlretl tlollars ($500).
I, a5 awne� of the property o� my employee5 witn wage5 as [hei� sole
<ompensation, will tlo the wo�k, antl the Structure is not intentletl or-of(eretl
for sale (Sectian 7044, Business antl Professional Cotle: The ConVac[or's
License Law tloes not apply to an owner of-a property who builtls or imOroves
thereon, antl who tloes such wOrk himself/berself or tnrou9h his or her own
employees, prOvitletl that such Imp�ovements a�e not intentletl or offefetl fo�
sale. If, however, the builtling or improvement I5 soltl within one year of com-
pletion, the owner will have the burtlen of proving he/sne tlitl not builtl or im-
�rove tor the purpose of sale). '
I, as owner ot the Oroperty, am excluslvely ton[racting wlth Iicensatl con-
tracton to canstruct the project (��tion 7044, Business antl Profession5 Cotle:
The Contracror's License Law does not apply to an owner of proper[y who
builas or improves thereon. and '�+'no contracts for such oroiects witn a con-
tractor(s1 Lcense pursuan[ co me Conva<tor•s License Law). I am aware thai �
proof of tbeir Worker4 Compensation insurance shoultl be provlCetl to me.
❑ I am exempt untler Section B. & P. C. for this r¢a5on
Date � Owner �
I hereby certify that 1 have reatl this application antl state that tne above
intormatioa is correct. I a9ree tU comply with all city antl�county ortllnances
antl state laws relating to builtlin9 construction, antl hereCy authorize repre-
sentatives of this city to enter upon Ihe above-mentioneA property for
inspectionpurposes. � S�QiM, Ddte ��—� ��—
Signature �ti
Driverz' License or 55 �f. �
TYPE OF CONSTRUCTION LI NEW LJ AD� LJ ALTERATION IJ R
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
_ DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT � ELECTRICAL � ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sa. FT. - oCCUaANCv_
CONSTRVCTIONTVPE � VALUATION$
ZONE GRADING CU.YDS. ACRES—
Remarks:
Sink
Irrigation
�rinking FOuntalns '
Floor Drains '
FloorSinks � '
Gas Service Outlets
Interceprors
Kitchen Sink
�dvatOries
P—Trep -
Roof Drains '
Reinspection Fea I $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Vencilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU 0700;000
Reinspection Fee � $15
0865-46, rev. 5/88 WM1ite - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap '
Sewer Connection
Solar Collectors
Solar Pipin9 �
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater -
Water Service
Auto-Wash, '
Laundry Tra'ys '
Isue Fee
Hood or Typel ❑
Canopy Typell ❑
.P #
S Main Building:
E
T Front
ARear
C Right
SLeft
Ping. Ref. #
7lanning Notes:
FEES � P.utomatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
r� .� Fan
_ F.A.U.
Fixtures
Device Boxes
Ouilets
Switches
Garbage Disposal
; Generator �0.5 KW �5-15
$ 3
FEES
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer�❑ 15-50KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors00-1 HP �1X-8
� IncSolar �9�15 HP �i6-15+
.� Microwave
Pole Light
Sign
Standing Sections
Trash Compactor
I Reinspection Fee �$15 I ' luue Fee
DEVEIOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
Building Approved By �
Aoolintion laued Bv
SUMMARV OF
FEES
BUILDING PERMIT $ SMIP $
Refrigeration Sys[em pLAN CHECK $ PERMIT
❑a100,000BTU ❑t00,0006TU . pLUMBING $ ISSUANCE $
System Repair/Alteration PI.AN CHECK 25% $ ENERGV P.C. $
FireDampers ELECTRICAL $ � GRADING $ �
PLANCHECK 50°h $ MICROFILM $ .�I
Registers MECHANICAL $ 3.s,o(�
TOTALFEE $
PLAN CHECK 25% $ _. _
Issue Fee � $ 3
N
I
N
G
R
E
Q
M
T
$.
O1 OG02Q082-OO12a082 TC}T 35,<5
aRTE: 11/21/88 i:ME: 12:54
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C��vSTRUCTION AND PLANNING .;� P� & SPA , - � � ,
A�PROVALS Permit # Date Inspector p�ppROVALS Permit # � Date Inspector-
1. Temporary Electric8l Service or Pole , 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. ' . �.� 53. Steel Reinfarcement
.
3. �Electr�cal Conduit; Ujility-Undrgrnd. ' �•� 54. Forms
'4. �Electrical Coniluit;Undrgrnd. ' , 55. Electrical Bonding �
5.' Steel -�ieinforcement.� ' ' � 56. Rough Plumbing & Pressure Test "1 i
6. �Electrical UFER.Grnd. �� 57. APPROVALTOCOVER-GUNITE � � �
.i :
7. Footings � i ; 58. Electrical Conduit-Undrgrnd. _;, I
8. Foundation `^' � ' � 59. Gas Pipe, � Undrgrnd., Test � . �
9. WatecPipe-Uncjrgrndl , . I 60. Backwash Lines, P-Trap, O Undrgrnd. � '
10. Structural Floqr System . � � 61. APPROVAL TO DECK
11. Property Sewer'i Line'& House Connection ,62. Backwash & Receptor-Final
I
12. Sewer Cap �.' I � ! 63. Heater & Vent-Final
13. Roof Drains ' • �64. Plumbing System - Final
14. Rough Plumbing' � l� � � i 65. Electrical-Final � ��
15. Rough Electrical-Conduit 6. Solar System-Final - � � ,
i 6. Rough Electric Wiring � , Fencing & Access Approval
1 i Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18� Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL - .
19? Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
20� Rough Factory Fireplace APPROVALS Permit # ' �
•v
2]--Ducts, in Struaure . � 70. Underground Hydro ,
22. Ducts, Ventllating , 71. Product Piping O Gas ❑ Oil �
�23.�Gas Pipe-Rough & Test 7. 72. Underground Flush �
;�24.� Roof Framing �� � 73. Undergrnd. Storage Tank � Gas ❑ Oil �
257'ZRoof Sheathing r{)� 74. Overhead Hydro
26r�T-Bar Ceiling (Structural) & Mon'ocoat 75. Dry Chemical
;•27; Frame and Flashing �� 76. Dry Standpipe
�267 Lathing & Siding �r 77. FIXED SYSTEM FINAL �
29:� Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
Y..
31� Plaster Brown Coat � 79. FINAL INSPECTION --
32��Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
33�FinalElectric �-,-� Notes:
3�,' Final Heating & Air Conditioning � _ 1
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 pomestic-Final
42. Backflow Preventer � � -� �'� ' �
,j
43. Backflow Irrigation , •
,�
44. ,Landscape Irrigation System r : �'�� !��
45. Sound Attenuation � '�
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING '�-'' '
�
48. Special Requirements Completed � •�'
49. Electric Release to Edison - �J
�
50. Gas Release to Southern California Gas Co � �'� • t V'
��
51: CERTIFICATE OF OCCUPANCY ' ^�? -� r�1
No. Date _ � � v �
^.1 7 .li. '
t .iJ
�
�
�I
PflQIECT qDOflESS: S S S ANTpN BL
OWNEN'SNRME: SAKIOKA FARMS
aooness: pACIFIC SOUTHWEST REALTY
CO
P O BOX 2097
AqCH/ENCINEEN: TERM I NAL RNNEX pEC.NO.:
nooness:
uxiT:
uxit:
PEflMITTEE: MORR�.S EL£CTRIC ( 714 ) 877-6880
aooness: 145 W BRYANT ST
BLUMINGTON CA 92316
LICENSEO CONTBRCTOB OECIABATION: I �ereby aliirm ��a� I am licen C untler O�ovisions ol Chapter 9(commencing wilh S¢ction
7000) of Division 3 ol I�e Business anA Protessi0ns Cotle, antl my lice is in full lorce antl etfect.
ciTv uc.: 0� 3� 3�q.` 9. �0 STRTE LIC.: 3� S J S SS' C S O
Date' �Gj—�-- Signalure: _ — _ _ _ _ _ -
WOHREBS' COMPENSRTION OECU1BR710N: I �ereEy afiirm that I have a cenilicate ot c s t io sell-insure or a ceniliwte oi Workers'
Compensation Insurance, or a cerli�ie0 copY �hereol (5¢cli0n J800. LaG. C�.
eoucvNo.: WC2269812 EXP.OFTE: OS�OS� 3
•omrnxv: SAFECO
J Ceni�ieo copy is nereny �umisnea. B Cenilietl cooY is iiieo i lhe city Buildin oiwsion.
Oate: �/�/ Z pppliwn�:
E%EMPfION FNOM WOflKEPS' COMPENSpTION OECIAP�TION: (iA¢ seclion neeE not �e or kle0 il Ne pemn is lor one hwqrM (5100) ar less�.
I cehify Nal in Ihe De�lormance ol lhe work for wh�c� Ihis permi� is i55ue0, I shall no pioy any pef5on in any rtlannef 50 as �o beCame
suble�� �o I�e Workers' Compensation laws o� Calilomia.
Date: Signature:
NOTICE: II. a0er making this Geclaration, you 5�oultl become subjecl to the Workers' Compensa�ion provisions o� I�e Labor
Coae, you must lon�wit� compry with such Dmvisions or ihis permit shall Ue deemeA revokeG.
CONSTflUCTION LENOINC RGENCY: I here0y allirm I�at there is a consimc�ion lenaing agenry lor ��e perfo�mante oi lhe work lor
which ihis Oermit is issued (Section 3097. Ci¢ C).
LENUEfl:
nooxess: IN WESTIN HOTEL PARKING L
OWNEfl BUILDEfl OECLAflRTION: I nereby aflirin ilu� � am exempt from t�e Contactors' Staie Lic¢nse Law for I�e lollowing reasan
(Section 7031.5 Business an0 Professional Cotle: /+ny cily ol counry wtuc� reQuires a De�mit to construct, atter, improve, Oemo160, or
reDair any simcture: prior ta its issuance, also rtquires tne applicant for sucn permit ta file a sipnetl statement Ihai nUshe is IicenseU
pursuant lo I�e pmvisions of �Ae ConVactors' S�ate �icense Law (Chap�er 9(commencing wi�h Seclion 7000� ol Division 3 ot �Ae Business
antl Pmles9ons COAe) or Ihal �e/s�e is exemp� �Perelmm ana IAe basis for Ihe allegeA exemplion. Any violation ol Section 7031.5 by
any apDlicant lor a Dermit suhle��s the apDliwn� lo a civil penalry of not more than frve AunA2E Eoltars (ESOUI.
I, as avmer ol ihe pmDeny or my emDloyees witA wages as tAeir sole com0ensation, will Go Ihe work, anE ��e
❑ slmcWre is nol imended or ofleretl lor salE (5ecuon 700d, Business anA Pmfessional Code: Th¢ Contractors' Slate license Law
Ooes nol apDly Io an owner oi a O�oOerty w�w builds or impmves �heaon. and who Ooes suc� work himscli/herself or ihmuBh
his or her own employees, O�oviAetl �hat such impwvemen�s are no� in�entletl or o��ereA lor sale. I( M1owever [he builtlinp or
impmuemenl is so10 wilhin one year o� cPm0le�ion, Ihe owner will have Ihe burtlen of provinA �e�she did no� bui10 or imD�oue
for Ihe Durpose ol sale�.
I, az owner oi t�e pmpeny, am ezclusiveN cantractinA ��h Ikenutl coniracmrs to constmct the pmject (Section 7674. Business
❑ anG Fr0lessbns Cotle: The ConVatiors' State Liceme Law Oces not appy to an owner of Orope�ty who buil4s a improves ihereon
anE w�o conUads fo� suc� pwjecLs wiih a Camrat�or(5) license pursuan� �o �he Contraciars' State Liunse Law). I am aware
Itut pmo� ol ��eir Worker'S Campensation insurance 5hou10 b¢ pron0etl �o me.
� 1 am exempi unAer Seclion: B. d P. C.
�or I�is reason:
Date: Umer.
I ao hereCy cenity Ihat I am aware oi ana unAerslinC the requirements ol Califomia Healtn and Salety Cade Sectians 255Q5, 25533, ana
2553a ana Ihai I or any fuiure Uuilemg occupan� will/will nol (circle one) neeU Io comply with saitl state cotles and �he requirements for a
permil far consimclion or moAilication Iwm ��e Air ualily Managemenl �is�rict. Resitlential cons�mdion apDlica�ions are exemD� ��om
these o�ovisions.
Date: Applicanl:.
I hereby cerlily Ilwl Ihave read I�iS applicatian and stale
ar0inances ana staie iavrs relating lo UuilOing crosimciion:
pmpetly br inspeclioQn purposes.
oaie:7� �� TZ Signalure•
�rivefs License or Sxial Se[uriiy M: �
mation is correci. I a0re¢ t0 mmpN w+�� all dty antl county
rtpreSen�ative5 0l Ihis G�y t➢ en�ei UpOn lhe abovemenlbneA
t64La6 Whita—Builtlmp', Green—Cade EnlorcemenL Canary—Aoolicant:
GalaBnroa—Asa9ssor
CITY OF COSTA MESA — HUILDING PERMIT PERM NO; E 058011
PERMIT NO:.E 058011 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE: OTH
JOB DESCRIPTION : TEMP ELECTRICAL AISTRIBUTZON SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC; /
COMMENTS; TEMP ELECTRIC FOR "CAR RACE/STREET VIB"
*� ��tx *�r****�***��*****+�*�r�r+�* �t**+�**+t�r**�*** �*x�***r*+t�*�r**��*x **�r**x �r*+r****+�+�*�c **
Z O N I N G R E Q U I R E M E N T S
ssTar.cxs
------------ MAIN BUILDING =--------- --------- ACCESSORY BUILDTNG ---------
FRNT; FT IN REAR: FT IN FRNT; FT I13 REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKSNG REQ• PROV; PARCEL; 41050104 7,NE: REF NO:
PLANNZNG NfSTES> ..--
>
jf IE 1E IE if iE iF�E fE iE 1f iF iE 1E iF 3f 1f if iF IF if if iE iE iE iE �1E if ik if iF iFlf iE;E fE 1ElF iE �E iE IE if !E �Fif iE If k iE 1F iE IF iF iF iE IF M ik iF iE if iE fF 1F if 3E iE �E f! �E IF iF if �E aE IF # 1E
D E V E L O P M E N T S E-R V I C E S R E Q U I R E M E N T S
7.ONING APPROVED BY DATE;
BUILDING APPROVED BY ; +-� DATE;
APPLICATION ISSUED BY; �' " ��� DATE; � `L'1�
ififiFlEiFifiElElfiFjfffikikMlFlkiEiF�EillE�fiFiF�F3FiF7fiF7F3FiFiF7FTF7fiF3FiF3F iFiFiFiF�iFiFiF3FiFiFiFiFifiElEiFiF�FiFiE iEif
* ik if 3E 1E 1E iE iE 1E iE iE if iF if if iE if iF IF iF if iF If iE iE �f if if 1f if if iF �f,if if ff iE 1F iE 1F 3f iFif iF iE if iE if iE ih 1E fF 1E dE iF %� i(��E if iF 1f iE #� )f lFik 1F iF 1E iF iF iF iE if iE �E if iF if
LEGALIZATION:N F E/Er S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING £LECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7.50
SOt SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7,50 15,00 0,00 22.50 22.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 22,50 UVER/SHORT: ,Oq
BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK
?Z,rJ�
IE iE iF 1E ik iE iE iF if iE iE )f 3E if �f if It k iE IF if ik if �f iE if iF iF �E iE iE IE 1Fit 1Eif # iE if iF �f iFlE iF )E iF if if 1f 3f 1E if 1E 1E-1! 3E * it iE iF iE iE iE if 1F iF iE lE 3t iE if if Ic iE jF iF IF iF ft
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
ELE 1 TEMP DIST SYS/LIGHTING EA. 7,50 7,50
END OF FEES
oz ooi�a�4�-cr�? _e�,,, -.-4 p r .; .� -.
DAiE: 0�/DZ.'S'? Y?�'�: :i'?3
% - -
CONSTRUCTION AND PLANNING PG_ _& SPA .
Date Inspector Date Inspector
APPROVALS Permit #" APPROVALS Permit #
_ .'
1. Temporary Electriwl Servicear Pole - 52. Pool & Equipment l.ocation -
2. Soil Pipe-Undrgmd. � �' � � 53. Steel Reinforcerrient
3. Electrical Conduit Utility-lindrgrnd. �_. ' 54. Forms .
4. Electrica� Conduit�Undrgrnd. 55. Electrical Bonding�
- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test '
6.'�Electrical UFEi; Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Elecfrical CqnduirUndrgmd.
8.' Foundation � 59. Gas Pipe, O Undrgrnd., Test �� �
9. Water Pipe-Undrgmd. _ � �� 60. Backwash Lines, P-Trap, O Undrgrnd. � �
10. Structural F�oor System � 61. APPROVAL TO DECK
71. Property Sewer Line & Housq',�onnection •._ 62. Backwash & Receptor�Final '' •�
12. Sewer Cap ' -' 63. Heater & Vent-Final '�%
13. Aoof Drains �, ' 64. Plumbing System - Finai '` %
14. Rough Plumbing .^, 65. Electrical�Final •�
15. Rough Electricel-Conduit �, ".N 66. Solar System-Final
76. Rough ElectricWiring ��• '. �. 67. Fencing & Access ApProval 4`1
77. Rough Wiring Sign 1� 68. APPROVED FOR PLASTERING
78. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
/9. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � _ � •. qppROVALS Permit #
21. Ducts,in.Structure, � . 70. Underground Hydro
22. Duc[s, V.entilating . 71, Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24..Roof. Framing ' 73. Vndergrnd. Storage Tank O Gas OOiI
25. Roof Sheathing ' 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical .
2�. Freme and Flashing _ 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation � , - , ' 76. FIRE PREV. FINAL
30. Drywall Nailing � � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final• R FOOD CERTIFICATE ISSUED
33. Finai Electric ' %�j�� I }�Ll��s:
7 i(
34. Finai 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 pomestic-Final . �
42. Backflow Preventer - , ' I� "
43. Backflow Irrigation
-44. Landscape Irripation System � . �
45..Sound Attenuation � � •
46. Handicap Regulations ' • " � .
47. FINAL STRUCTURE & BUILDING . � �
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Releate to Southern California Gas Co ; �
51. CERTIFICATE OF OCCUPANCY
No. Date
eoonessaea�mc: SAICIORA �FARMSy.. • -- --- -� - ,. --.,uxr: - — - �. _. _.
OWNERSlUYEIi�OORqWN: =pACIFIC SOUTHWEST REALTY �
CD ..
".P O BOX 2097 T$RMINAL ANNEX
� �v�.. Wu� �oox�ss:
LOTUS CONSULTING ENGINEEE� GE00705
��"oq�g,� 2505 MIRA MAR AVE N0" uNt:
LONG BEACH CA 90815
����s� CALIFORNIA SUPPRESSION (310)498-6444
CONiR�CT0A4Y41W0 2 S 0 5 M IAAMAR
�p� LONG BEACH CA ��. 327196
90815
uxr:
LICENSED COM1�N$ApC��Tq�ONSapDoEyCqL�fl�TON: I MreBbuyyey�lel'rqm yu��Mer pondY d Cpoep�yury� ntIqWp ryI ,uyqn rliuw�ued ivydysy qproriMm�� pd,,Gluqer 8
CRVLIC.�NOO�VLV�7tl �C.CLASS: l.�lUP �pN�� ]L A/17b/ �uPfY.1�lY� 1L�95
Dme: �{ ��/�� Gonlmda: �W'�'�.� / ' �- '• '" - �
NEfl BUILOEN OECLIN�TION: I Mnby dfirm under panaEy d prjury Ihet I em eump tmm IM Commam lioeiue lew lu tM
ox'vq reeam lSetlion ]W t.5 &uim+enA RWepbne Code: AnY cYY a couNY'�� �Cuirp e perm4lo mmWd. ellu. improw.
tlemWeh, a rapei eny evuciure. pbr b tla ewarce, ebo reQuirae IM epplirent Iw auch parmn �o fik e eqrod eWemsnt UW ha a ehe
n IiceneeE Wm+em io �he provi�ime W Ilw Conlredwe Limnee tew �Cheqa B(����q �A bwun ]000) d Diveion 3 G iM
Buaiewa end Prdaniau GoGe� a tlw M w Ne u evemq t�xalvn arM IM bnu lar Ne elbpeE mmmqion. My vide�on d Seabn
]031.5 try eiry epplicent lu a parmn eubjetls �M applicant �o e civil penally d na mwe �han tMe hwdred doAen �S,AOD.
� I.mowerdlMpopMyamyampb�eeew'YhwepevaalhsieobmmpsnWion.WldolhsxvM,WMsahupune�wluVeMed
a Mared far aeb (� ]Ou. BudMee erd Prdptlons Cods: TM CaMretlon liums LewGms nol eppyto en ownerd peoperry
who buYCs a inprwes thenon. eM xfio Eoes eurJi wak Nmeell or henN p Wpph Ai a her v.m empb�w�. pmided ihet such
Mpoveme'qa ere nd Wrded a alleiad la aele. tl.lwwever, Iha bwNinp a inpwanW o wld wXhin me yw d complNbn, IM
owrerbuiNv vNl heva �M bwden d provlip he a sha did nd build w'unpova lar iM puryme W We�.
� I. m ox�nr d �he VW�Y, em utlusMY conireaYq xil� IicemeA cmhectaa ro mumw Ns pWW (SeCion 1W�. Buaimea uM
Pmtmdav Gode: TM Caueedm Limnw Lew dou rwl WON ro en owner d D�WMY Mn Euild� a �mPb'ss iheiaon ud Mw
mn��ecb br aN pqsq� weh e mrumeMe) IiumM Wn�ent �o IM GaMrada� Liwme le'�1.
� I em uemp unEa Saction: B. 8 P.C„ br ihie rwon:
Dela: O�mer:
I do Mnby cMity IMI I am ewa d enE uMsnlend ��s isqulmmeMe d CNLom4 Haellh aM Sdety Cade Sedbm 255M. 255�3. enE
zsSJ�, uM ihm 1« ury Mws wiWinp wo+wM ..in I wil mi (crcb orw) naed ro comW wvn We aei• me« end �M naWrom«m ror
epa�mGlawnslructionairoEdwianhamlMAM ue�iy -enapam�mOMiia.RuiMniislomqruqion�ppktlipaanvamq/mmlhxs
prmiwn�.
WONKEN'S COYPEN4ITION DECL1fl1TON: 1 M�by dllim undx p'Wly d pvpuy w d tlw bGoxinp Mtlwbro:
� I hevs enE xil meinien e nnNicme W con�enl to �ell�n�uro la xwkwi compenWion, u praid�d tu by 8wian JroU W th� Lebor
Coda, la IM prtmrorcs d tM xoM la which Ihia pxmil b iouetl.
'B- 1 new W W m�imee wAa�' mmpefwtion inwreMa, n rpulrW by Sqion 9]W M tM laEor Cods. b iM parlvmeiwe d iM
worklorwM1id�N'vparmunieued.MywarbA�����,.���y�.,mw.,.: EXPIRES
°B1n" -PE9-03a39 O1/O1/96
Pofry NumEer
(This eectbn nsetl iwfW mnpNnC / tM pemiAis la aro h�nErW LWkrs /SIOJI a hu.1 .
� I mttly NN in tM pMmrorca d iM work tar v.fikh ihia perm4 u iaaueE. I Ne� nal ampb� em� pe�eon in ury maniwr m n Io
becana wbjetl lo tM wYps' oompensuion levn d CelXamle. end apna tlW tl I dcuk bacams wbjatl lo IM v.oM1en'
wmpemmlpn�prnWiu� ion3l0pdiMleborGode. Ilal xil�aom�No • wieory. I-A
/ /1 l.. �
Oels: , 1y 7 7 Applkenc V V V V- �
Waminp: F�Uun b��eun roilein'rompxwtlon eov�np� l� un1�wN1, �M �IWI ubJ�et �n �mployr fo eAMnl pxuNp �na
dr�� nn.. yi ro on. nu�er.d trou.w ewbn /e�oqronA �n .ee�ran ro a. cwr o� rnmpxu.uoq wmsy.... pov�ew ror �n
9wtlon J�O6 al fMWer CaM, /nM1m4 Nd �rtomsy'� hu.
CON9TIIUC710N LRIOIN� ROENCT: I hceby tlfirm under penelry d qrNrY �� �� m e mMiutlion bMirp perwy br tM
perlormeza d tM v.ak b which Ihe W�mi u ewM (Sedian �OB]. GH. CI.
LENDEN'9 NRME:
LEN�EH'9 ADONE39:
I eaeNy thm I Mva rW No eppleeYm ud ume ihei Na ebave IMormeibn u emw. l yna to eamply rMh ell tiy end mun1Y wdliw�oe�
eM sW e kvn rNYiq w drildiq miWutlbn aM Mroby aulhor¢e repe�enle�ivx d Ilw tiry b eNx upon iM ebo.e�memuneE pope�ty
, ;v�� W,�, L H�-�,
� y Pnnl N
Dele:
SqneWro d OwrerlApenVApp4renVContreaor
(5t51<B.WP) White-BuiNiq 8 Setely:OraerFle: Cenery-App4ceM: Pink-Ravenw: Goldenio0-Aeaenor
� -
,�__ _,. _ -. _, . .... CI,TY OF COSTA MESA - BUILD�NG PERMLT.�, ��
PERMIT NO: F 073462 PLAN CHECK NO: 02941-95 L . . _
CONSTRUCTION TYPE: I-FRSP PERMIT TYPE: FIR PURPOSE: REP ,
JOB DESCRIPTION : EMERGENCY UNDERGROUND SPRINKLER REPAIR SQ FT:
CLAIM VALUE: 13,000.00 CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: FIRE SPRINKLER Y7ATER MAIN REPAIR / EMERGENCY REPAIR
*�rx �r�r�r�r�r**x�+rx�*�**�*�x�*�**x�+r�r�r**�r+rx�*�r***x�«��rx�x�+r*x **x�*x�*+r*�*�r*���**�*��*+�*********
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDSNG ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
�
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NtSTES> r
i
iE1E I(� iE 1E ff 1E IE IE 1F 1E 1f 1E ik ft 1Eif 1E IE 1E ik iE 41f 1f If 1f 1k ff k ik If ik Ik iiif IE 1F 1E 1E iE 1F 1f 1F iE IEiF fE1E 1E If IE 1E IFiE IE IE IE if IE IE iE 1E iE fE 1E 1E 1E fE iE 1FiF 1EiE i81E iE Ik fE
D E V E L O P M E N T S E R V I C E S A E Q U I R E M E N T S
ZONING APPROVED BY DATE:
HUILDING APPROVED HY : DATE:
APPLICATION ISSUED HY: G DATE: i 27
1f1E1k1F1F�EiF1F1f1F1f1E1Ek1F1F1E1fifffiFlF IfifiEiE1@1f1@1f1ElE iiif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT :.. - 144.00
65Y SMIP/NON-RES
PLAN ,: — . 93.60
ISSUE FEE �
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 144.00 0.00 93..60 237.60 237.60 .00
♦
REVENUE DIVISION TOTALS--> COLLECTED: 237.60 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN-CHECK
- 144.00 93.60
1F if iF iE if �F if ik iF if it �k 1E iF if if �IF if lkif if ff if if iF iFit 1F k iE if �f ikiF 1f iF1f iE iE if ikif 3k iF k iF 1Eif �IE iE iFiF it iE'MM iF if �IF iF if if'M iF 1E iE K 3f 1f 1f *iI� iI� af �IF if 1FiE 1F
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N� UNIT COST TOTAL COST
' -
FIR 144 FIRE EQUIP FEE (FROM BLDG VAL TAHLE) 1.00 149.00
�,. END 'OF FEES
.� - .
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0
u
_' - 1
1' �'
QS Q4137039-00187090 '1'C�T 237,50
4ATE: d7/?E/93 TIflE: 15:?9
� CQNSTFUCTION AND PLANNIN6 �...�L & SPA
APPROVAIS Permit#- Oate InspeMor AppROVALS Permit# Oate ��dhspector
� � .
1. Temporary Electrical Service or.Pole 52. Pool & Equipment Location�. '
2. S„qil Pipe-Undrgrnd. �_ 53. Steel Reinforcement • �
�y � W
Ct3: EtectricA;Ce�t ii.,(�ility-Uodrgfnd. 54. Forms __ ,, '
�, nd. Elecv�ca'tip,�;�,vi�-Undrgrnd 55. Electrical Bonding _ �
����; Steel RGmL,oFee`mERF 56. Rough Plumbing & Pressure Test
` G',
: � 6. Electric��� ��d. 57. APPROVALTOCOVER-GUNITE �
�� Pooting�� �_ � '1 58. Electrical Con�it-Undrgrnd. 'i ��i
�y�. Foundatitsa' C� �, .� 59. Gas Pipe, V tJddrgmd., Test � `-
� ��
.�. 4�ter Pia��Uni�grnd°�° �_ . 60, Backwash LinRsWP�7rap, O Undrgr�d.
� .
10. Sfxuctura`I FloodSvstem - 61. APPROVALTyO DECK
1�1; Pwpert�j'$ew�r�ine & Hou�Connection - 62. Backwash & R�ceptor-Final ',
�? SQ`"'ef J �z 63. Heater & Vent�Finaf '
13. �of Drains�� - 64. Plumbing System � Finai ��
14. Fjough Plum4ic� � � 65. Eiectrical-Final
15. Rough E?Ectri a1-Cowduit C 66. Solar SYstem����l
16. Rough 83earie�4�iru�g .., 67. Fenciny & Access Approval - .
77. liough Wiring 5fgn i 66.. APPROVED � PLASTERING
18. Rough Electrica`l-T Bar Ceili g 69. POOL/SPA SY�EMS FtNAL
19. Rough Heating & Air Conditionin� F� RE,.PEP7 REQU REMENT �„
rr r r b" -� �. r ZS � t-'
20 Ro�h �ctq�y F��place i�� �c « � r;, �.� ��,�.' AP�t01yY�,�y' r B� � �q;.
rmit #-
21 �uCu, if9SttTiaUi¢! i '•. •. �-iS %c S � ry W •7 '., - •-,•, � <
t, � * n�- 70. Unde"ig�ound JYdro ;. �. �jl -qS ��i-�
22...�uci5. �nt' ti � * ' :•"�' � ^: .� ��" � T
. �, � n9_' � :J + G Q :J i-n * � 77. Prod4r;rP�pin9 ;Gas � Oil
23..Ga;-Aip�ottgh & T.ast i �5 f� m^� et �'�'. .� 72. Underg�3�nd �1u�%h M1 -�' � 7, �_ qs l��
24.'TRoc`f Fr�minj �,�`�, � °"zi "� * �' � G r,� = �. UndergFnd.Slqr�eTarik OGas �Oil
25. Fopt� Slj�athing -��. �G v�� ti �. : iu * pa, Overhead Hycf�_ '
26.�T-6arCeiling{Stryjczural) &=ivlp,r�dcoat *� ��„ �� �. DryCh�nical�,_, �" � �
27:LFrame ac�d Fjashie� jc; � � cr y m r 76. Dry StaFcti�iips^z '� u r:
i -
28. La(�ing�S�inc�;*r' jSx � *r .. ..� .•� Z?. FIXE[¢Q�''ST�[�FINI�iL., .�r'-'x
29. InsvNlativn y r.. `� c �� •• � �� � I �ic �, FIRE PREV. �,I�AL * � '� "
� 30. Drywall�,(�lai(r�g ��,� � * f.., �:'� S ti�EAL'1'-}iDE�I`�"RE�Ut&EMENT
l 37. Plaster@tow,rcCcs;t�,t; �-C ; � [^ 79. FINALSf�SPEC'£dON �� .�
� - ... . .. • � . � -. :.
` 32=Electric�Po er . �eZFLinal� � ; �" i � � �"• 8�. FOOD CERTI�fCATE;��UED ,
` �' C T. i :-i x i .• � � .. , � . .�. . � _.
. 33._Fin�aj El�triy� 5>. r i �y x � .. Nbtes: �E. ' � '].T7 * `: O (� �
1 - -' �`WS �1-�n1 •�'V_t..C.f�
^ 34.fFin51 He�tinty�"& AIIFCoriditidn�aj= �' z � � � � '� /� ` �' �+ �
H ' t*1 ?: ;n IT! r � `�' _lZ_ .:. �^ OW.in+. �Y�S�OVL LGI11S1f1 ( r
T _ ' � T�•I '],T"-
35{Fina G�Pi��Te�t�,y"" .. �cr- I s^ re �pI�� �r'� rq. x C'.-
�_4^-`� .V ��:�A�i-�.�
-' 36^Hodd oTCanopyG: k � � 1 ;r^_ < > C: ' �c f % � :'� * `�'
F r? I S r � � �! [�7 T•G' r ix? 7:'7
- i !-� • �. , ` � . .. . , � �-`� �."
� 37.`.EinalFa�ory Fire cex u + Fic � �� v
-� 38�Fin�t PItTHmbing r Y �� � c * ^ � i . � .r�, Nr�; * L � �---
� i � I � t. . � .� �,. w
39.�iVa{�7 Seivice-Fir`�ai� � , = ,� � � ;,; ;� p �: -:
I �
, 40.�GasSeraice-FinatS=.T, � � � !'� �,-� �'�� � "
m n� �=-. �- r �r m 1 !ry. F ,=+ � � 4
_ 41 �$olar D�nesticFin�l= �y �� �' �"� � � � rn o, •;o ,- = X �
v _
42. Backflow�Preventert �' �� � �x w •'� • % �' � -
.>+ �'.i r• �. -a r� x ;r :'t. � [*I G t z.
rv x�S > f ��..,
43. Backtlow Irri�atipP;. �; �� ;; N i`y ,� `" �. ,
.� � ri r.
^44. Landscape lefipati�h Systert��T?�= � '� m 7 O O�• o'; n: N cn xCJ N �
r� rt� t d ♦� E '�t r� G b S i-a
`45: Sound Aitecr�,atior� "�'�.. 'r � ` �,�-.� ;-7 mx' �- t• ' Ji FG �
� v: �^.. F S v0 •c #
_46.�•HandicapReg�latiais • * _ . �. � � Y
� �� �
_47.=FII�tALSTRUCTU�E&BUtiDING �,, � ,;: ' '' i �. w _
-, in
4$..:fINAL PLANNIN(3� � ��r � 'S � � ' •i< �" C: � � <.
=49.?Electtie Release to Edison � ��' � � � i � A ' -
;, i * � t: 4 Q •��a� x a
=50.:.fia�f.ielease to Sout#iern CalitoMia Gas Co f � � � r� � �"' C' • ��"' • ' •
cY s • =o ; ��o -
-57. CERTIFICATE OFzOCCUPpNCY f " -� �- , �•�- . �
No. Date
\
eoop tisovem�wwc: 555 ANTON HL �' uxT:
°'""E"'s"""E'°'°,a'": SAKIOKA FARMS
"°o"Eu: 2pACIFIC SOUTHWEST REALTY
CO
P O BOX 2097 TERMINAL ANNEX
�va�. �uuNo �ooness:
1PCXffECT OP FNtlHFER: llt. lq.:
111CX.OP ENfi'S AUURE54: UNT:
��+�T�S� CALIFORNIA SUPPRESSION SY (213)496-6444
CQAXACTOA4YYIIIq 2505 MIRA MAR AVE
moxEss LONG HEACH CA ucxo.: 327196
90815 urar:
LICENSED COMHRCTONS DECLAFRTION: 1 Mroby ellim uMer pendy d pmjury tIW I am Icenaed wMer pwubru d CAeqx 9
(wmma�n0 wn� Section 10D0) ol Divrsun 3 d Ne Butlnen erd Prdn�iaa CoEe. erd mY licen» u in IWl luw eM ellaa.
cmuc.No.: 0/20958 uc.cuss: C 16 �uc.N�oJ.: _3/J2/71 6/-y��� �E/-X�P-:' 12/95
ome: 7/�IQS cooum«:`�� f1W�/�"��"
NNEN BUILOEF DECLANATION: I he1eby elfirm uMer penely d perNA' �� I am eaemp Imm tM Coniraqon Licenae Lew lor tln
�bwmg reavm (Sedion 1031.5 Buame eM VMaeebna Coda: Mry cIY a countY �� n9uiiea e permtl to mmvuct. Mer. imywe.
Eemdoh. a rapei eiry evuctwe. prior io m bauence. ebo repam Ihe epp4rau Ip such pa�m�l to fJa e vy�wE Mlament tlW M a�M
o uos�d w�� m m, ao�o�. u� com�eo�. uo�� �w lcnw., a l�«d�ro wan sea:� �000l a oHe� a oe �ro
B�irca enA Prdeaioro CaEel a �hel he a ehs u azomq thaehom uH Ihe baris In tM aOepeE exemqion. /�m viimion d 6wian
�mis M em �oM+�� �a e w�mn eu4�• �ne rodicem �o a avi o�r a �a mae inen r a hum�aa adw �sswp.
� I. m ovmer dtha propenY w my emplayeee wIh wepea m Ihei eda mmpeme�ion. xill Eo iM xwk. eM Ns NrucNn e rwl imended
w dlared M eeb (Seelbn )OM. Busim�s eM Pmfesfiana Lotle: The Conlreelon lioxua lewEoas eW applyloen owrwrd pope�ly
wM builds a inpwas thereon. md v,fio Ems �uM v.oM Nm WI or Mnetl a ihwpli hu a her own ampbyen. qwkeE IMI wch
�vo.�aw �.a � w.m.d «on�e ia.�ro. u. now�«. in. dae��u «mwo..*«+4.aa �.'v� o�. r� a�o�oa ub
owmrewux rriY neve �ne wkm a n�m ne a aw d'd m arik v imww+ r« �ne wro+e w mel.
❑ i. e. o..,., w ina wwero. �•=a�ry �m�a:ro .an r�e oo�m�w, ro w�mw m. waw csw� ra.. a�.�. �e
ridd.ubn. eode: me can.mae limi» tew eaes na eodv w en oww d aw��v .fa driM. a'vnww« �h.aon ene who
wnvecd M eucM1 pqeas wnh a wurrfoHe) Icenwd punuem to ihs ContreGae Lioen�s Lew�.
� I em e�emq uMm Seclian: B. 8 P.G.. b No ranwn:
Dare: Owns:
i ao naanr �«uM �nm i.m er.ve w.�e unem.wm m. �w��am a cdeo�. Ha.dn .�e sew cod. swbm usos. zss». d,e
�5534, enC tlW I a eny Mun buiWinp omipani will / wil r�a (arcb aro) roeE lo campry wIh �eiE pe�e aoEn uM �M �puiromann br
Dete: ' �VP�iwn:
wonKen�s couvv/s�nor� oEcua�noN: i n...a.r� wde, o.�.ny a�.y a» a m. roeo.;� e.a.�mo�.:
� I heva aM xil meinten e canX'wa d cansenl to �e9imun la r.a�kve' cam�rronbn. m yaided la by $aCbn 3]00 d IM lebar
coae, i« m. p.n«�s a u. wwx �«.+:�n mA w�n A i..wa.
C7 � n..e w.:� maim.� www.• oomo�on �nwrerc...s nwu.e W swim aroo a N. �.no, cod.. ar me o.nvmem. a m.
7{ wak la r.fiidi Ne Va^� o iaW. �N waken' camWvelian imuruv.a mniar and GdiY wmber me:
c.m..: REPUBLIC EXPIRES
PdiyNumbar: 'aS(li() 01 /O1 /96
/mi: aee� �..d mf es oomow�ee r �ns o�� u ro. a,s n��dnd edws Isiool w rn.�
� I oenN � in Ihe pMameMa W the wak lor whch Ihu pemin b i�sued. 1 tlull nol amplvy ury preon In ury meruia w u io
beeonr eubjw m ihe w4re' eampsuetion levn d Ce4M�de. end pess Nu E I MwM scom� aibjep to iM xakon'
canpwp^7 um d SWian 3)00 d IM lebar COG. I tonhxilh ' '�ion�.
i
Dme: 7� O. MqceN:
Weminp: F�Nun ro weun wo�fcwi eomp�ru+tlon eor�rep� I� undwNl, �nJ �IWI rlNel �n xrployp roWMrol p�n�M�s �M
c/Wl flnu ,gr ro aro h'ntlrM fM�urd tloll�r� lS10QOOOA �� ��Itlon b tlr� ro�l ol rorrpxu�fbrt a�pN �� provldM br In
Sxtlan 91P6 oI M� Le6or Ca6. Infw4 �tl �rtom�y'� Iw.
CONSTIiUCfION LENDINO ApENtY: I hsaby elfiim uMr proAy d psjury ihet �Mra u e aonn�qn bMinp epriry 1or ihs
pBlIWTBIKO G IM NOtk M Whltll lll! V0�14 itYOd (SKtiOn ]09). r.N. r.i.
LENUEfl'S NANE:
LENUEfl'S 1DORESS:
I ce�ity Ihet I hevs ned No epqicetim eM ewa thet �he above iAame�ion ia ttirtse. I pros lo canply vrilh NI dry enE aouMy adiroroe
aM atme laxe NmM b buJdiq rmmurmn end herebYaNhor¢e nV�+��aiivas d �he inY �o entr u W� �M ebo.a-msniioned pW�b
IarirtOetlion paDoeas.
AANDY HARMAN
� Pnnl N
Dels: � ��
srew�re a ow�«ine�unow�ucom�aaa
�St51�ae.WP) W�ne-Buildiq85elery;areeo-Flle:Gv�ery-�OG�unLFnk-Pevenus:Ookenma-Nseeaar
. ,. CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 073461 PLAN CHECK NO: 02940-95 L
CONSTRUCTION TYPE: I—FRSP PERMIT TYPE: STR
PERM NO: H 07346
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : EMERGENCY FIRE WSPRINKLER MAIN REPAIR SQ FT: 13,000
CLAIM VALUE: 13,000.00 CALC—VALUE: 13,000.00 GROUP OCC; H-2 /
COMMENTS: REPAIR TO FIRE SPRINKLER MAIN
********�x�****r�ex*******�rx�**�r�r****�******+r*�r***��e***********��r��r*�*+���r****+rw***
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>_
> �� i
1E iE 1E if 1E 1E ik 1k i! i! iE 1E if 1E i! iF 7F 1E 1E if 1E 1EiE I! 1! iF i! 1I' fE 1E 1E 1E 1k iE iE iE iE iE fE iE 1E 1E 1F 1F if 1E iE iE k 1f iE 1f iF 1i 1E 1f 1f If iE 1E 1Elf 1EiE IE 1E 1E i('.Ik 1E1E 1E 1E iF if iF fk iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T.S
�,
ZONING APPROVED BY DATE: /"
/
HUILDING APPROVED BY : DATE; �/
�, r
APPLICATION ISSUED BY: C A� � DATE: %i:Z S
1E1E1E1E1k1f1EiElfiffE1E1E1f1E1E1k1Eif1E1E1E7F7FifiFif7F7F �lfifififif7F�{E3F7F7F7F7F7F7f7F7F�iF�'�f'iFiflElfifiEiElEiEiE1f1E kiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL�SEGMENT:Y
';
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AE�' GRADING
PERMIT 144.00
SMIP/NON, RES
PLAN 93.60 2.73
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 146,73 0,00 93.60 240.33 240.33 .00
REVENUE DIVISION TOTALS--> COLLECTED: 240.33 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
_ 144.00 2.73 93.60
1k 1E 1k 16lk k1f 1Fif if 1f iE if 1f 1f 1f 1F il� 1f iFit 1E iF 1E k if iE iE iE iE IE iF 1f ik 1f� iF ik iE ik IF 181E 1E 1E 1E1E iF 1E 1F if IE IEfF 1E 1E 1! iE IE IE 1E1E iE 1E 1E 1E IE 1E 1E iE 1k iE iE iE iE 1E 1k if IE 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY , D E S C R I P T I O N UNIT COST TOTAL COST
SFC 13000 ALTER HY VALUE COMMERCIAL NOZONE 1.00 13,000.00
END OF FEES
�1 �OI°�7�?i-00137093 T � Y' 240.33
.AT'c: 07/28l°S TIYVE: 16:29
i _ I
CONSTRUCTION AND PLRNNING ?QOL & SPA
APPROVAIS Permii# � Date Inspector pppROVALS Pennit# Date i;n'spector �.
f �,
t. Te7siporary Etectrical $ervice orPole� ' 52. Pool & Equipment Location'" -
2. So�F Pipe-Undrgrnd. ��. � ' 53. Steel Reinforcement -'
�.,:. .� � � . r �. . . ,
c,�-�lectrical Condu�d3IIlrty-Undcgrnd. 54. Forms �
�„4�Electrical Condtlt�-',�'{�n�Jrgrnd. � 55. Electrical Bonding � �
;c,�Steel Re�nforcernept= � 56. Rough Piumbing & Pressure Test
�6 Electrical UFER�,�. 57. APPROVAL TO CQVER-GUNITE -�"
r�n;
� t7�Footin9s n;E � - � 58. Electrical�Conc6a��Undrgmtl. - '
B:.Foundation a' �^ �a 59. Gas Pipe, � Ur%lr�rnd., Test.
n w
9TLVeier Pipe-Undr'�r�. �, = 6Q. Backwash Linex,i�Trap, 6 Undrgmd.
_ ,,; ,., -
10. Str.uctural Fioor'Syscem 61. APPROVAL TO DECK
11�Pro�erty Sewer �jne�& House�onrection � , . 62. 8ackwash & Receptbr-Final � � - '
12;Sewer Cap ;u a. 63. Heater & VenUFinal _ �
13. Ro�f Drains , �64. Plumbing System - Final j
14. Rough Plumbing. n� 65. Efectrical-Final -
r
75. Rough Electricaa opduit '-�' % 66. Solar SYstem-Fipal, "
16. Rough Electric 47iriny, � . 67. Fencin & Acerss-A - ' l �
9 PProval_� ,.�.
17. Rough Wiring SPqn � 68. APPROVED F�LASTERING
18. Rough Electrica�;f Bar Ceiling 69. POOUSPA SYSTtMS FINAL I
19. Rough Hea[ing & Air Conditioning � ` � � p���pT.�iEQUiF�EMENr,�T .�
20. i�;ough Fa�tor ,Fi �ace i Sr � s S��; ;,APPRDVA(,�-,_C, Pdiynit # x r..
� � -- -;.s. -
2L 9`ucts:in5truttura�K � .... �S x S G �-:: � ^ �-u , �
�+ x. i # -� f, ..r: r. 70.:(�lnder'�iyviial {�.',dro .y.
22. Quci,Y, V"til n9� ; � � x � � � �-.x 71. Produe ' `"��
> . �! � .S[�1Ring �.tc�as I�OiI -ti
r•- '_ ' ,-. -
23. Gas �ipe•,Rougti & Tqst � ' �_: _ * !<; � Q p � � � 72, Underground FtusN`� � r' =
M^ 'C"11 G �..1.
24. f%o�fra�`�rling" �" ' `" '"'' �' � ,.,� , 73; Under rnd.Sto�! ��
�K 9 tD�Ldank.,OGasY��ii
25. RoobSheffihing .4.�s � v J K , O > N! 7�-pve?#iead Hydr�� * �
f � � 4 X
26. X�Ba�.Ceiling (Stryq�Graq & M1�to'�-'oat * � " �� �� � " ` ''
r� .� * O r O� 75-,9ry-Cheq�ical �,.,p -� �
27.-F'.y'rameand:Ftashing�� .7��, �" > �k 76. DryStan'��pe^ .. �"
28. LatHsg,�Si�g ��:� ,.��� � "� ..� ..` 77, FIXED�S,�ST�d�INA�,.� ,-� s
�' 29. Insu y iolr �`�'� .� S•• .• K:•. � . r1 78 FIRE PREV. FI l �y � '^
r 30. Drywall Nailing '''` ^ ` c ��,;� i tiEALT�t, DEP�.�EQ�JIf�MENT
n 7, � i i
� 31. Plaster Bqawn-Coa,g �- � i 4'E-' ,k �+ j'it �' 79y FINAL �SPECT�N �^ � t'; �
;
.32. £�ectricaFAow^�r fv=(�rFj�al �� ��� � �` 8C`; FOOD CERTIF�aC�iTE I��E2 n
.r � r i �- .v �, I F .: u `.r- „
• 33. F+na��le�ric;, � ;r� i ¢ � �« � � N6tes: -�� � ': O e^.^
`34. �inatsHe�ting'& A!�:�o�ditionin'�5 �^ " T� i �t r ^ .^� x _ ^O
t
s � � � . :n 'r � ! (� C' -� i !--a � F
� 35. �inaf Gas�ip�esT;� �,` .. w. �--� I � �� .�-,.�,w p•= t� .-�Yn
..n � T �.
36. HooGhor CanoPv � % � ' �T' � a i ,^. ' 's � _ Ci � :� hm
r n i�..; s I � =-o *.� m
-37. �inat�FaCtory Firepi$Fe ;t � r=, r,; t� � {K K OJ
� T (
- 38. Fina[Wlur�irig x� `, , ". ': � � `-- r- � � O
r n lY :�+ O 1, 1 � Y' L:� �/.'
-�39. �YateTSennce�Final k � , ` t ;- � "!q : � _� _," w �' S
Kti
,40. Gis Service-Fix�al � T T � '5:.-• S � * �'1� . ,� �'. s � wn: r -
n�1' - Y: k+' c�� _.� > G
N41.S�OIarOom,�scc�Final�� ,�.,.�j �� 'y� � .�� - 7�;, a *�; p
� ��
^42. Backflow Preventer �� ^-' f Y � k' � %`^ ' �' 7 �
�-� �< �� nu�: s r-i : "qrii R
43. Backflow Irri�2ion ;; �5S ; � Y � U � = �
;
4Yi. Landscap8�irfJqation�System xMn � '� C; �J '7 Cx [; n; �; �. ^fJ * :u �.
.^. � i 1: '�^ �.". „" n' �: E c. .7 �' t.> r'
45. $ound Atten�ra'tion ;' ;.7�''-" m `. � �" �" r} � � f .
r m m m :-�r :a
?�'� � ` � . s • c'ti - *
6. Mandicap flegulations - ._� + ��•
c r S � �"i L- C;, x
47. F1N�L STRUCTUR� & BUIt'OING g/o � � � R �.
! ,.,
48. FJNALP6ANNINGz. i �', #. tt' � . ''c �-7 < ' �, �.'
.,, ' f t '� � : - S �: a; .
� 39. Elec�e Ra'lease to E_�lison � x y�" � ; ` ,`-._, .� ' �
� . - �. .-, -,
50. f-ias R'elease to Southern California-Gas Co x �,= r. �•=�'*� •* C •
� �' c t x S �J^- �^.m x (U O
59. CEFS7FICATE OF �CCUPANCY * " ' "'� ^ "
No. Date
89-297 AODlicant to fill in all sDaces except those within heavy borOer Iines antl si9n all aDorovriate eeelantlons. ^�
CITY oF COSTn nnESA CONSTR UCTION PERMtT P M�1 �I � TRACT NO. LOT NO. UNIT NU. 1 Y //��
555 ANTON IOTH FL. KITCHY:N �-r �/ /� .s��
�Project Address �
Appifcam'sMailingAdtlress �540 SUZI LANE� WE:�TMINSTER `�
Owner'srveme SECURITY PACIFIC phone_
Address 600 WILSHIRE BLVD. /C500� L.A. 90017
Arch/Eng. License No.
Address
Contracror's Name KIMSLE & C0. - vhone �9S- I 1 S6
Addresslmailing) 7540 SUZI LANE. WESTMINSTER, 92683
City License No. 038503
LICENSED CONTRFCTOR DECLARATION
1 horeby aHirm tnat I am IiconSetl untlar provislonz of Charter 9(commencing
with section ]000) ot Divlslon 3 oi Ihe Buslnei�antl ProfeSsionS Cotle, antl
my license is in /ul1 tor� apget�ect. 460923
License Class n � � 'rnnan nin
> Ib -f:t-� co�a� .
.RKERS' COMPENSATION DECLARATION
i nereby aftirm tnat I nave a certificate of consent to selt-insure or a certificate
of Workers' Compensation Insurance, or a c¢rUtietl copy Nertof (Section
3800, Lab. C.
�oucy No. W 88470597-01 comaa�y FREMONT INDEMNTIY -
�Ce�litietl COpy is he�eby Iu�nisnetl.
Ce�j! Ietl$$ py �� �letl with the clly�/��a�� � �Esi . (/%�� � ���/�
Date(�%�(�Q( ApP���ant 9 h •-^'�•"�--'
E%EMPTION FROM WORKERS' COMPENSATI({N DECLARATION
(T�fs section neetl not be completetl if the DGrmil IS /or One huntlretl (5100) or
Icss).
1 certlly Ihat in lha Oe�fo�manca of the wOrk for whlth thit perm�t is issuetl I
snai� not emD�oy any person in any manner so as to become suoiect to the
Workers' Compenzation Lawz oi Calltornia.
Date Si9nature
NOTICE: It, after making this tlatlaralion, you shoultl become subject to t�e
Worker5' Compansatlon provition5 Of the Labar CoUe, you muit /ortnwil�
comply wiln such provisions or this Oarmit shall be Geemetl revoketl.
CONSTRVCTION LENDING AGENCV
I �nreby attlrm that there is a conSVucLon Ientling aganty tor the plr/Ormante
oi lM1e wOrk tor wbich tnis permit IS ISSueE (Sectlon 3097 Civ. CJ
Lentler'z Name
Lentler's AtlEress
OWNERBUILDEH bECLARATION
I hereDy atfl�m lhat I am eaempl iroT th¢ Cont�acto�'s LiGenso 1..aw for tpe
tollowing reason (Sactlon 7031.5 Business antl Profe55ional Cotle: Hny city or
cOunty whith roquires a OGrmlt to conStruCt, altCr, improve, tl¢mOliz� o� repal�
any Stru[tu�a, priOr t0 its Issuanca, dlso roqW�es lhe apP���ant fOr such permit
�p lilp a signatl Sldt¢mUM lhat h0/She I5 IICPnS¢tl pur5udnt to tlle proviSiOns Of
�o Contractor's Ucensa Law (Cnapter 9(commencing wilh Secllon 7000) of
Ivislon 7 0l tho Business and Profeisions Code) or that he/5M1e Is exempt
.noralrOm antl the ba515 ior t�e alleg¢C exempllon. Any violatlon of Section
]031.5 by any apPlitanl 1or a pe�mlt subj¢Ct5 l�n applican� to a civil
�Odlty ol not mara than flve hunU�atl tlollari (5500�.
I, as owner oi ene property or my omployees wilh wa9ez az tnelr sole
CompanSation, will Oo lh0 wo�k, dntl the st�utlur0 IS nOt InlCndetl o� ol(¢retl
tor sale (Sactlon 7044, Business antl Profeisional Cotle: The Contractor's
Llcenu Law tloez nat apply to an owner of a property wtio builtls or improvez
thoreon, antl who tloes such work nimseli/hermH or tnrou9h his or hnr own
emploYees, prOvlEotl tha� suG� ImprovCmenls are not int¢ntletl o� offeretl tor
sala I� howaveq tha builtling or improvemenl is So10 wl[hin one year o1 mm-
platlon, Ine owncr wlll have the burtlen of proving he/sha Oitl not Oulltl or im-
prove tor tha purpose of sale).
❑ I, as ownCr ot t�e prOperty, aT ¢xcluSlvely cont�aCting with II<enseU con-
IractoR lG con3trUtl tlle O�ojeCt ($ectbn 7044, BuSin¢55 antl ProteS5ion5 Cotle:
The Conlractor's Litense l.aw doe5 nOt apply to an owner of O�op¢rty who
bulltls or Imoroves tnereon, antl who contracts for sucn 0rojects witn a con-
tractor(sl Imense pursuant to the Conlractor'S Lirense Law). 1 arti aware that
prool o( Ihuir Wo�ke�'S COmpenSatlOn inwrance ShOultl �e provitl¢tl to me.
❑ I am axempl untl¢r 5¢CtiOn B. A P. C. 1or thi5 r¢ason
Oate
I hereby, certity that I
InPormatron Is mrratt. I
antl state la olating t
sentatives t is ci(y
inspectlon u ses�
Signature
Orivers' License or 55 �
Owner
have reatl thi5 applicatlon antl Std[e Nat Ihe dbove
ag�ee to comply with all cRy antl county ortlinances
o' 1builtling constructlon, antl hereby authorize repre-
p e[er upon the above-mentioned properry for
Date ID-I�-&�
TYPE OF C�NSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTIONOFWORK/USEOFBLDG. _
TVPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL
❑ T ANT ❑ EnLE�CT.RICA/L ❑ PLUMBING ❑ M�EyCH-A�N.ICAL
OTHER �`�{- Sy�N�" �yS/v-"
PROJECT DESCRIPTION 5a.F7. oCCUaArvCv_
CONSTRUCTION TVPE VALUATION $ 4.000
ZONE GRADINGCU.YDS. ACRES_
Preventer
Irrigation
Dishv.esher
Drinking Fountains
Floor Drains -
Floor Sinks
GasService Outlets
Interceptors
Kitchen Sink
Lavamries
P-Trap
Roof Drains
Reinspection Fee � §15
Boiler
Ducl - Under Ground
Duct - Svuctural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact BIL ICBO #
Heating System & Ducting
❑ a i oo,000 sru � i oo,000
Reinspection Fee � $15
CMF 0865-46, rev. ]0/04 White - Builtling; Canary - Applicanp Plnk - Accountin9; Goltlenrotl - Aszessor
�
Service Sink
SewerCap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
$wimmin9 POOI w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
G
laue Fae
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑aioo,oaoeTu ❑ioo,000
System RepairlAlteration
Fire Dampers
Registers
laue Fea
A.P. qW
S Main Building:
E
T Front
A Rear
C Right
K
g Left
Ping. Ref. #
Planning Notes:
Accessory Building:
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW '
Constr tionPoleSub. �-50+KW
CAoking'Unit
DiShwasher
Dryers OGas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outle2s
Switches
Garbage Disposal
Generator �0.5 Kw �5�15 KW
2one
�
�
�
Z
O
N
I
N
G
R
E
Q
M
T
S
FEES
Meter LJup to 100amps -
Meter ❑overi00amps .
Sub Panel
Motors�0.1 HP�1Y,-8 .
Int.Solar �9-15 HP �16-75+
Microwave
Pole Light
Range
Si9n
Standing Sections
Trash Compacror
$ 3
Rainspection Fea $15 Issue Fee
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approvad By
Building Approved By
Auoliption Issued BY -
$ 3
5 3
SUM A V OF FEES
BUILDING PERMI7 $ a�� SMIP � . $
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE � $
PIAN CHECK 25% $ ENERGY P.C. 3
ELECTRICAL $ GRADING 5
PLANCHECK 50% $ MICROFILM $
$1'
MECHANICAL S TOTALFEE $ ��
PLAN CHECK Z5% $
Ol U�048448-00048448 TQT 63.00
CONSTRUCTION AND PLANNING � POOL & SPA \1
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 ' I
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, � Undrgrnd. �
! �1
10. Structural Floor System 61. APPROVAL TO DECK �-�
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final i ��•
12. Sewer Cap 63. Heater & Vent-Final � ���j
13. Roof Drains 64. Plumbing System - Final ~
14. Rough Plumbing 65. Electrical-Final '';
15. Rough Electrical-ConAuit 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. POOUSPA SYSTEMS FINAL�
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
_�.;
20. Rough Factory Fireplace APPROVALS Permit # '
i. - -
21. Ducts, in Structure 70. Underground Hydro ��. �'
22. Ducts, Ventilating 71. Product Piping OGas ❑'Oil' �
23. Gas Pipe-Rough & Test 72. Underground Flush U'�' ' '
24. Roof Framing � 73. Undergrnd.StorageTank;.l7Gas ❑Oil ' '.
25. Roof Sheathing 74. Overhead Hydro �� jyQp�
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical �'�11
27. Frame and Flashing 76. Dry Standpipe ��
, -!
28. Lathing & Siding 77. FIXED SYSTEM FINAL�. j; )� ��
29. Insulation 78. FIRE PREV. FINA� ,�: '�Q �dj
30. Drywall Nailing HEALTH DEP�T, REQUIREMEN
37. Plaster Brown Coat 79. FINAL INSPECTION �'�' `
�
32. Electrical Power Meter-Final 80: FOOD CERTIFICATE ISSUED _
33. Final Electric Notes: �-;i , � �
34. Final Heating & Air Conditioning � ! �.
35. Final Gas Pipe-Test ' '
r'
36: Hood or Canopy , . ,
♦ � •� •
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final ' "'
40. Gas Service-Final �
47. Solar pomestic-Final .
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation - �
46. Handicap Fegulations .
47. FINAL STRUCTURE & BUILDING
48. Special Requirementt Completed
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co - �
51. CERTIFICATE OF OCCUPANCY -
No. Date '� '
.
• .'
�� . � . . _ .� � � -.- - - .._.- _.. - - ..
0
�
�
�noness a eunowc: 5 5 5 ANTON B L uxi:
OIMERSNAYEIFpqN1k SAKIOKA FARMS
"°o"Eu tpACIEIC SOUTHWEST REALTY
CO
P�P�O����097 TERMINAL ANNEX
ANCMRECTONFHf+NFEN: LOTUS CONSULTING ENGINEEIi`'1°�` 00705
�xcN.onera•s�ooxEss: Z505 MIRA MAR AVE ��'
����� LONG 9EACH CA 90815
CALIFORNIA SUPPRESSION (310)498-6444
cam�croas �uimc 2 S 0 S M I RAMAR
"°°x�ss' LONG 6EACH CA pOND' 327196
90815 �
110ENSED COMRACTORS DECLAPAT�ON: 1 heroby tllim uMm periely d pmjwy �he� I am licamed imder pwidona d Chaqm 9
(wmmerci�q wuh Seqian ]U00) d Dnieim 3 d Ne Bwiiroo uM PmMeiom Code, eM my license u in lull bru vM eHact.
cmuc.no.: 020958 uc.cuss: C-l0uc.r+o.: 327196 EXP: 12/95
ome: I D- ZIo - 4 S co�vm� � y�
�WNER BUILOEF DECL�flAT10N: I hebb/ el(um under pxaly N psrjury �het I em hom �he Caqreem lioema lew Ip the
bx'vq ieeaon l5edion 1031.5 Bwnsaa erd Prolmoone Gode: My W o couM' Mhirh nQu'vea e P�u �o maWd. etlx.'vnpm+.
md'oh. a rpei eiry awnun. p'v b na u�uence. ebo rayu'vee iM µp4mnt lor wch perme ta fib a eqmE �letemsni ihm ha a vhe
q licensed W�+� �o IM pwuiona d IM Con�2tlae lioenae Lew �Cheqx 9(mmme�q vmh Sed'an )oao) d Oveqn a d iM
Buei'wae eM Prdesaons Gotle� or IM M a ehe n eaemq Ihsahom ud ihs bevia la Me ellepeE uempion. My violaton ol Setlion
)O�t.5 by vry epplirent 1« e partnn suEjeu� Ihe eppiceni io e civil penelry oi nd mae �hen (rve huMrtE tldlen �35W�).
� I, ee ownar d �ha peopeM or my em0�°�'°°° �h wepee ea �he'r ade mmponeetion, will da �ha woAc. eM ihe elruauro b na InieMed
or dlxeE br aela (Sectim 1041, Bwi�wm end Prolaeeions Cods�, Tha ConVepon lironss lew daea rot apply �o on owiwr W piopeily
wha bulda or inpmvea iherean, end � d�e euch wurk NmeeM or Mne� or Ihrwqh hi a her ovm em0loyem. 0�� �het euch
impwemenla ere eat inieMed or dl� la eab. tl, howewr, Ihe buiWinp or'unprwemem ia ealtl wilhin ona yur d romplston, iM
ow��a��ua. �;n ne�, in, wb� d ww�m ne o,.na ab �a w�m « �mww. i« m< wm� a w.).
❑ �. m o.n« a ine weroro. ��awry.N ���uoa wnn �K.�+ea canvmw. m aonmue mo wa� Iseeon rou. s�.i�s.. w
a�deaion. coae: Tr,e com�aaon ��+. �.w me. rc. wvN b e+, wm« a wro�r »ro w�m «'wnqwo tnm.w, w»ro
wnvacts Irc vdi M9�e xmh a ooMmaMe) Icemsd WnueM to iM ConVaeas liisme Lew).
❑ 1 em aromq uMx SecYon: B. 8 P C.. la N» �uaon:
Dms: ��:
I do hweb' ��H that 1 em eware d vd u���Nd iM nVuuemeMs d Cel/aene HWh vd SdetY CoEe Satlom?5505.255JJ. eM
255Ja. eM � I a enY M�m buikirp oowpeni wi11 / wil rol (acb one) med Io comply wIh aei0 mta mdr vq tM �epuirsmmb br
aGermNloroonelruclionamaAi(mlianhaM�MAi e3u il�ly eneWmamDimrkl.ReskmiielmnmrvCuneGV�ioroannaemMlmnOwe
a�.
Ome: �pWcaM:
W ORKER'S COYPENSATON OECI�q�TON: I AwWy dfvm uMx px�etly d prpvy ans d tM toAor.inp Mde'e�um:
❑ 1 hew and rril mdniau a canL'ctls d�� to eNlimure for xorkan' mnpaneuion. u pwided f« by Swion ala0 d �M leba
cod.. i« in. we�e a m. wa� �«..i:�n w. o� a wwa.
� I hm eM vril meiMan xorMen' mm0e�m�ion imuruwe. m n4u'vaE M 6eqlon J�0 d �he LeEa CaEs. br IM W���M* d Ihe
wak fa whitli thu paimn ie isaued. My waken' compenulbn iruurence mmx enE pdiry num Wr ua:
c�^�: R�FUBLIC�T^�T�x'M EXPIRES
'°'rr "°'^"°' O L/ O S/ 9 6
(This eecfion nsed na be rompbled � ths p�A l� br ais uM Cdlan 100) w bwJ
� I mM�Y �� ihe pMameMa M iM �M la whkh thie pormil ia b�ueE. I tlWl M emda/ e^Y W� In enY menner eo m to
bcome wbjed ta tM xoiken' wmWneNion lavn ol Celilanie. end prse ihtl tl I ehould becoma waw io �M warY,a�'
mmpenWion qwisiona d Sedion 9]00 0l �M Lebor Cada. I eMll IMhvri�lh Joomfp�' jxiTh t powlon�.
Deu: ID'Z� ��S Applirem: �• /�—/�/
W�m/ip: F�Ou� ro uwn rollrw�' mTp��tlon awwap� l� unlnvNl, �M Nsll �ub �n rrplqw ro cNrNrW qn�Mn �np
UNI Ilnu tp ro aro h�nOrW Nouwd �Vn (tfOq000A bi adtlltlon b N� �wt ef ro�tbR a�P� u povMW hr In
9ctlon 9106 ollM Lebor Col�, InfruL Nd �rtomy� l�u.
CON9TRUCTION LENDINO �OENCY: I MrobY �� ��dor pmally d par'�my �he Ihae o e mnrtrutlion MMinp epmry lur iM
psrtormaMa W IM xark M wt�iN ihe p�T�� �s'sasd (Sedion 908], Cw. C).
LENDEP'S NMIE:
LENDEX'S 10UFE49:
I ceNh Ihat I heve reed Nis epplicelion ud pds Ihel ihe ebova inlarmetion ie cortecl. I epne lo compy wilh ell city uM oounry adLivKee
end eime Mwe �elet'ep lo Wikvq cmmua� ud Mrabyeinlwixe repraeeninYvae d thu cily W eMer uµm IM ebovs�nwnlioned propery
la inapeaion W�Wba�
DAN MCGARTHY
� �,��. �.�/� ode: �n-7J.-%�
Slpnelum ol tl enVAppMenVCanVeqa
(5151�E.WP� WM1ile-BuilAip 8 SNmy:OreeMFb; Cenery-Appieeni; Pink-Pevenue; Goldeneo�Mww
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: IF 074828 PLAN CHECK NO: N
PERM NO: IF 07482
GOVT: N SUPP: Y
CONSTRUCTION TYPE: I-FRSP PERMIT TYPE: FIR OTH PURPOSE: REP
JOB DESCRIPTION : EMEAGENCY UNDERGROUND SPRINKLER REPAIR SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: H-2 /
COMMENTS: EXTRA INSPECTION PERMIT #F73462
��*��r*�r�r+rx�****��r�r***�*�+r�r**+r**x�x��r����r***x *x*x***�***�r*x�x��*****�r*�r*�*���*�x�r� ***
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDSNG ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKZNG REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
iF 1FlF 1E fE iE IE iE 1F 1f iE 1f 1f li ik ik 1F 1F if iE iE f!!E 1(� 1E iElE ik iF iF iE iF iF 1E iE if'lf if iE 1P iE 1E iFlE 1E iE i(� 1E 1f 1f iE if if� if If 1E 1f iE IE iE iE iE 1E IE 1E IE iE'IE'lE'If if 161k-061E 1E iE 1f� 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY .
BUILDING APPROVED BY :
APPLICATION IS
**����r*�x�***�r*
LEGALIZATION:N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 30.00 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT,PLUMBING ELECTRIC MECHANIC
DATE;
DATE:
DATE: lb �l
���*******�r* � **
STRUCTURAL SEGMENT;N
FIRE SMIP/RES GRADING
30.00
652 SMIP/NON-RES
TOTAL PAID DUE
30.00 30.00 .00
30.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
30.00
�k i! at �k M if ik iE'IE iF iF �k 1F it iF iF iF iE 1E iF iF'14 iE 1E �IF'k iE 1EiE'IFiE if iE 1kiE IFiE 1EiE iE 1f 1f iE iE IE iE 1E �IFif �E iE iE�lf af'k 1!M if M 1F iF 3f df� it if iE if k iF i! ik iE iE �IFiE'1F i("lE'1F
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
FIR 1 FIRE RE-INSPECTION FEE 30.00 30.00
END OF FEES
r
6i
• (�
O1 00193G�C-4t�lf?fi•;R �' 1� _O.p�
DATEa 10/25/9: TIP1E; IO:GD
L Y
CON_STRUCTION AND PLANNING ?�� - & SPA ;
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Te�ryporary Electrical Service or Pole 52. Pool & Equipmen[ Location
2. So�Pipe�Undrgrnd. � 53. Steel Reinforcement �
�• S�' 'L, I ' C%
3;�1¢ctncal Qnciv�rU��ty•Unck.grnd.� 54. Forms .
� �4.' Electrical 6bnd'dh�8nargrnd. 55. Electrical Bonding
r'._5r$reel Reinfo�e,�nt �'`-.~j 56. Rough Plumbing & Pressure Test ;. •
`'�8� Electrical^FER� *�d. 57. APPROVALTOCOVER�GUNITE
: � �< �r' '^
=�1`Footinqs ty£ �� � �58. Electrical CondUi��Undr9rnd.
��8�oundatiorfa^ tr� y � 59. Gas Pipe, O Untlrgtnd., Test
c r,
9,LVa@r PipA��Y�idr�nd. _,' 6p. Backwash Lines,_��rap, O Undrgrnd. �
' t•Il I �V
10. Str'ucturat`Ffoor�SYstem 61. APPROVAITODECK
11 T,Aro�erty �we� t�ne $� House�Lionqection 62. Backwash & Rec�ptor-Final �
12:_Sewer Cap;j " " y , 63. Heater & VenFFinal •
73. Rop'i Drains 9� , • 64. Plumbing System - Final
14. Rough PlumbiFg`.. �n, � 65. Electrical-Final '
15. Rough Elflo rical-Conduii m 86. Solar Systam-F �n�l.
i 6. Rough E��tric V�rin ,r ' '' ,
,,,, Q, � 67. Fencing & Access.Approval
77. Rough Wicing Sigd i ' 68. APPiiOVED F�i''PLASTERING
18. Rough Electrical�`,1' Bar Ceiling�' 69. POOLlSPA SYSTFNIS FINAL
19. Rough Heating & Air Conditioning FIRE Q��PT,�EQUIREMEN.T _,
- c c�
20. f�pugy:Fa�oryvFir�A�ce J-,h't, �k. ' C � r ,:. PPPF�OVA�I��`,�„�,Pe�it # * :' �i
. �
21. I�t�tt�in SlruqLr4iX' -.••. •-+� � _ � --�� =70. tJndergiddr� HYtiro � �(� �
r
22. �ucts?Ve�itilat�ngi�•f. I �C w0 C� F,� ,77. ProduGi�-,,,P�ci,Ping��s
[�.Oil
23. (`ias a� , ou�'n' & Test � :7 _ ., M _ �c; q � -72, Undergro'�ncl F�� • ^ 't� �.i�s
24. F�of �Frarttln X,< � i"-' • ;� � "' ^ y . . T a ""' �- .
H 9" t.,� �t q .J�, .73.3Undergm`.Stor�agB�Tank'OGasy�Oil
25. RoofiShea`t'hing ax � �. ��� � Cos 74l:Overhead Hydro� •
cr
26. F•8ar'Ceiling (Struc�I�ral) & MeijD�bat *, ^.i 7�Dry Cher`t]cal � � a ' �
27. Frame.,and,;Flashin§7-r p„�„ �� � �?� x. 76^ Dry Stan6 �e :J � u J :�
�28. LaihTh�,'g � iding �',��' y :•�� C �� ' i� 77'� FIXED $�'STE(v1�F�INAI.'; r �
:a� tu nz, �, r, ..'.. � . ` k ' ..
_29. InsulatioriT� O�n .. • '� ' �< 78� FIRE PREV. FINy�L "� ^ c 9S �
�30. Drywall N fling � x�_ ; H � �;. ,� }IEALTF[�DEP'4. R"EQG�R,EMENT� �
�31. PlasterBroyvn�Cpa�� � � m,-� < � '+ �79VFINALIRSPECT�N � [`
�^"32. El�ectrical'�'ow� M�Y�r�l,n1a� i. w� � �; �SOyF00D CERTIFI�AiE I�SUED_ �
Y'
�33. �hal�le5hic� ,::� �� i � ���. � ' x Nqies: � -7n _ � �� ,
N34. F.fnal:5eating &tAi'r-Qbnd'Hionin�� .^ � ^ � ' '" �^+. - '+� * -- ''7"=
�,.. r� u! �rt ��' %% `• fy y �-. G; P' m
'35. Fi{�a1EGasPiPe'-TesS=M1 ,rj� � �,. � � ,. `,,^,o cy�: .
s36. Hood:or Q'noPV ` J � ' `+'7 � �* �' ,� �7� $ :''� � .r �
- K �"'Ri Y � ��! T �C� :(T T
`�,..3' 7. Ft�nai-Fact�olY FirePla�e~x i �';_., ` y � � ' ..�',r,� w .� :r ��.
-38. Final�F'lum6ing '�. n% i -. s ^ i � j+ S -�c ,� ^' -
ti 1 ..� 1'X N � ' *
` 39. Water�Servi ce-Final � � ''' � ! � " '' ,
� � � r � � ( _. 'o
!*d0. Gas SeFvice.Final r m v';rtr S t t*� � �� ��c o'�' +�
� K I I �* ✓ � 'l: 4t
�41. Solar pomescicFinat� = „�^ � � " .,�� �: -- Y �. -
- 42. Backflow P.reventer - �� y� r � ff a' ^'c ` �� C �--�
�+--. :X >*i:JN l•7!1 - �-'
43. Backflow Irri 2tion f �''`c' '� `'� '�'� : " _ �
9 � .� a �
j7 �
4#. Landscape-irriGation 6ystem ^-.':*1�� = * �T� - �1 "= - �� N '� ^� �
n v -n t C ^�'. � F �'. S �-
45. Sound Attenua'tion � :"�x`' ,. E' - - `x� � - � °:l .'"'. ..
f •� .. .. c* . . m - � _ e: • - e
- : .-
4b. Ha�dicap ReguJation¢ :': � � �t c: :� �� � .
_ -�
47�. �FNAk STRU�'TURF & BUILrDiNG _ _:� ' '� '- , ' _
�
48. FSNAL PLANNING - � ^, , ' ' �� '> -'
k : r r; - �
4J. Efectrie Release to Ecljson ; ` 1`c � `
v � - ,j j • ^1 ,:
50. Qas ReJease to Southem California�Gas Co * +' � �7 •' U •
.. 't J � ao - • -
51.. CEFT-fFICATE OF OCCUPANCY� '" �� ^'-� e
No. Date
PROJECT AOUflESS: S S S ANTON B L �
OWNER'SNAME: SAKIOKA FARMS
ADOPESS: xpACIFIC SOUTHWEST R6ALTY
C�
P O 80X 2047
TERMINAL ANNEX
AflCNlENGINEEH:
nEa.xo.:
UNIT: 1 — 1 2
PDOflESS: - UNIT:
PEpMiTTEE. C2505�MIRAMARPpRESSION (310)49$-6444
nooness: LONG BEACH CA 90815
4CENSEO GONTflPGTOP OEClAi1ATI0N: I hereCy aHirm tAai 1 am licensetl untlet pmvisions of CfWDter 9(commencinA ��h Sec\ion
700D) oi Div;io� 3 0l the Buziness and P�ofessions Cotle, an0 my li�ense is in INlforce ana elfect.
ciTvuc.: �20958 sTpTEuc.:327196 cu�/ss: �—�0 EXP: 12/94
¢ B�'�� 4 SignaWre: _ � 1���
�
�MENS' COMPENSATION DECLAflAT10N: I nereby a�firm� I have a ceniticale ot consem to Sell-insure o� a Cetlilicale ot Workers'
Gompe�saiion �iyi �g; o� e�c��ed copy thereol (Sectian 7Hoo. lau. � 1/ 0 2/ 9 5
roucrxo.: AEPUBLIC INDEM E%P.OATE:
LOMPANY: ,.y(
❑ Cenitied copy is �ere0y tumishetl. L1 Certifie0 rnPY �s l/it�/x�t� th/¢'Nty BNlding Oivision.
'� Oy�� gN APDlicxm�. /�:' , w" M
i fl(EMP710N Ff10M WOFKERS' COMPEN50.TION OECUPPTION: (i - ection neetl compRcc9 ii IAe permit rs br m�e hundred (5700) m kss).
I I cCNty I�al in Ihe petlormante at (he wo�k to� whiCh IhiS petmii i5 i53uCd, l s�atl n01 employ any pC�Spn in any mann¢� 50 25 N OeCom2
su6ject �o ihe workers Compensation Laws ot Calitornia.
Date: SiAnalure:
NOtICE �(. afler making �nis aeclara�ion. you shaultl become su6ieci to me Worker5' CamOensatian Orovisbm af the Laeor
Coae. yau mus� �orthwiin compry wil� such D�oNs�ons a� tNs Dermit shall be aeemed revoketl.
CONSiRUCTION LENOING AGENCY: I �ereby aAirm t0at there is a consimctbn lentl'mg apency ta t0e Oedormance o� Ihe work lor
wnicn �nis permii is issueA (Sectian 3097, Civ. C�.
IENaEfl:
ADONESS:
OWNER BUILOEH OECUPATION: I �erebV atikm Ihat 1 am exempi trom t�e Comrac�ors' Siate Licenx law lor tAe iWbwinO �eason
�Section 7037.5 Business and Pmlessional Cotlet Rny city a� county wAic� reQuires a permit to construct alter, imprnae. tlefriONs�, or
repai� any stmcture. D��o� �a ia issuance, also �equires the applicant for such permit to file a siqned statement ihal �e/she is licensetl
� Oursuam io t�e provisioos ot Ne ContracrorY State License Law �Chapter 9 �commencinp wit� Seclion 7000) oi Oivision 3 ot the Business
' and P�oiessions Goae) m that helshe is e�emD< <herelran antl t�e Dasis for �be altege0 e�emplion. My violation ot Section 7031.5 by
'i any applicant for a Pe�mit subj¢cts tlre applrcant eo a ciNl penalty ol rwt more than tive AUMretl UWlars �5500).
� 1. as owner oi Ine D�openp or my empIoyees wiN wages as thtir wle compen5ation, will Eo the work. antl the
I❑ simcwre is na� iNentled or offerea for saie (Section 7044. Business and Pmfessionai CoOe�. ihe Conirnctors' SYata license Law
Ooes noi appy 10 an owner oi a pmpeny wtw �uilds or improves t0ereon, and who Uoea suM wnrk Ilimselfinerself or ihmugh
� nis or �er own employees. p�ovided thal suc� improvemenls are not inten0e� ar oftare0 tor sale. tl, twwever the Uuiltling or
impmvemenl is soltl within one year ol Complelion, ihe owner will have t�¢ bur0en ol provinp �e/s�e di0 �ot build ot improve
tar IhP purpose o7 Sale).
1. as aw�er al ene pro0etty, am eecl�siveW camracting wit� IipenseU cantracrors ro construct tne pmject (,Seciion )044, 8usi�ss
❑ ana Pmfessibns CaAe: T�e Contrecmrs' Slate license Law Goes nol appy ro an ovmer of propefIywho emMs or impro�es therean
ana wno conttacts (or such pmiects witn a contractor(sllicense pursuanf ID t�e Cantraciors' $tate license Law�.i am aware
that pmoi oi their Worker's CompenSaiion insurance shoWd �e pmvid¢d lo me.
� I am eeempt unAe� Sectiort. B. d P. C.
lor Ihis rea5on:
Date: Qwner.
1 a9 he�ehy certify lnat I am awa�e o� an0 understan0 tne reqoi(ements of Califomia Nealth ana Safety Code Sections 25505, 25533, ann
25530 antl tlwl I a any iWure �Ui�Ou�g OCCUPanI wilVwill nol Icucle Ooe) nee0 to comply witn 5did st2te fAtles a�C the teQuirements for a
perm�i brconsiruction or motldkation homthe Au Qua�ity Management Cisl/¢L ReS�deniialconsbuciwn applitatbns are exempt�rom
l�e5e pwvisions.
Dare: App77canC
i here�y cenily i�ai I have iead ihis application ano state tna� ine aDove �nlormaiion is carect. 1 agree m comply with aA u�y antl county
ortlmances anJ stale laws relatirry io OmMitq Lan6tNction an� tl¢reby autMr'¢e repreSmtaiiVes ol iMs ciry to enter upon thC abov0mentionCd
�oerry tor insDection omDoses.
� /n
e: ,bi — ZJ� �"i Signamre: I� /L =
o�1ro,r's ucense a� Social Seariry .:
Wnno—Builtling: 6eeen—Go�c EnfOrCem8n1; CanBry—ApP���aN; Rvk—Revenue; GWUenrotl—Assesso�
CITY OF COSTA M£SA — BUILDING PERMIT PERM NO: F 068605
PERMIT NO: F 068605 PLAN CHECK NO; 02251-94 L GOVT; N SUPP: hf
CONSTRUCTION TYPE: T—FRSP PERMIT TYPE; FTR PURP�SE; ALT
JOB DESCRIPTION : REPLACE EXI5TING SMOKE DET 6 FIRE ALARM SQ FT:
CLAIM VALUE: 106,810.00 CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: REPLACE EXTST SMOKE & FIRE ALARM ON 1 THRU 12 FLOORS & PENTHOUSE
�r*�t*�r**�r*�e*+r+r**+tx�*�r+t+�i��r+t+r�r�rx��r�r*+fx��r*r�r�rrt�r+�+r*x�*�r�x�+r*i�*+t******�rt**x�***+c�***x��r�+rt�**i��
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --- -----
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKZNG REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
>
�F 1ElE 1E 1ElE 1f iE k 1E iElF if 1E 1F iE iE if if iE SE iE iF iE iE 1E 1! 1E 1E iF tf 1E 1f iE iE 1ElE ff iE iE 1E iF 1f 1E 1FlE 1f 5E iF iE 1E iE ik iE iE fE if if if if if iE iE iE if iF 3F iF if iF 1E it iF it it 1E il� iF fE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZON2NG APPROVED BY .
BUILDING APPROVED BY ;
APPLICATION ISSUED BY; \1 ),{—k.
iFititiliFikitiEiP!lifi�iFiP3FifiFiFiFiPiFit3F iFiFif it if
!E 1f 1E 1F if 1E iE iE 7E iF iF 1f if if !f If 1E iE iE if 1E iF iE iE if if 1E K if if iE 1E iF iF iE iE iE k iE
LEGALI2ATION:N F E E S
BLDG PMT PLUMBING �LECTRIC
PERMIT
DATE;
/� DATE:
�*`��x�*'��TFT��*��***rtD�**** �- * *�x��
1flfifiEiflEiEiElEiEiFiEiEikkiEiFiEiFiki6iEiFiFiFiEiliti6fE i!lFiF ik1EiE
M M A R Y STRUCTURAL S GMENT:N
MECHANIC FIRE SMIP/RES GRADING
PLAN
ISSIIE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 664,00 0.00 431.64
REVENUE DIVISION TOTALS--> COLLECTED;
HLDG PMT PLUMBING ELECTRIC MECHANIC
664,00
65Y SMIP/NON-RES
431,60
TOTAL PAID DUE
1095.60/ 1095,60 .00
664.00 ��OVEA/SHORT; ,00
FIRE SMTP/TOT GRADING PLAN-CHECK
669.00
jk �k iF iE k jF iF iF ik ik it ik iF if it ih ik ik ik ik ik ik i! ik it ikit ik iE iN iFaE ik 1f ik i4 ik ik if iE iFiF fFR 1Fjf �Ik 14 jt iF i4 iElf it it dt iF �f iF df iF �lt iF iF if 3f it �f iF dt if iF 3l it it iF iF i! it
I N D I V I D(J A L F E E B R E A K A O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FZR 669 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1,00 664,00
END OF FEES
"�"
01 04156551—U0166551 T C�T
DNT�: RE/24/94 TTtiE: 15:39
664,' 40
\,
CONSTRUCTION AND PLANNWG � � POO'Td SPA
f _iDate Inspector Date Inspe o�,
APPROVALS Permit # APPROVALS Permit #
1. Temporary Electrical SerJice or Pote 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. � . 53. Stee4 Reinforcement
3. Electrical Conduit Utility-Undrgrnd. ' S4. Forms
,
4. EIeIX<ical ConduiFUndrgrnd. 55. Electrical Bonding
5. Sceel Reinforaement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
_7. Footings 58. Eiectrical ConduirUndrgmd.
8. Foundatfon " .-. 59. Gas Pipe, � Undrgr�d., Test �_
9. Water Pipe•Undrgrnd. ' 60. Backwash Lines, P�Trap, � Undrgrnd.
i
10. St�ucturel Floor Svstem 61. APPROVAL TO DECK '
i l. property Sewer Line & House Connection �: 62. 8ackwash & Receptor�Final �
12. Sewer Cap , . -. • 63. Heater & Vent�Final �
13. Roof Dreins . � 64. Plumbing System - Finai
14. Rough Plumbing 65. Electrica6Final
15. fiough Elenrical-Conduit 66. Solar System�Final
16. Rough Electric_ Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PtASTERING
18. Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEPAS PINAL
19. Rough Heating & Air Conditioning F1RE DEPT. REQUIREMENT
20.7Rough FactorY Fireplace - - � ApPROVALS.. Permit #
21. Ducis, in, Strocture � � � ' ' �
. � .70. Underground HYdro
22. Ducts. Ventil8ting • . � � 71. Product_Piping OGas OOiI
23. Gas Pipe'�Rough & Test _ � - 72. Underground Flush -
24. Roof Framing � � 73. Undergmd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing ' 74.�Overhead Hydro;
26. T�Bar Ceiling (Strpcturall & A4onocoat � 75. Dry Chemical � �
27.'Frameaqd Flgshing . . 76. Dry Standpipe ., .
28. Lathing & Sid�ng . : � •• 77: FIXED SYSTEM FINAL .
�29. Insulation ' -� � � 76.� FIRE PREV. FINAL �� 45
�
30. Drywall Nailing i , - HEALTH�DEPT. REQUIREMENT
37. Plaster Brown Coat , ' . ,�9. FINAL INSPECTION ' �
32. �Electrical Power Meten�Final �� -- �' � 80.'FOOD CERTIFICATE ISSUED '
33. Final Electric � � � �? 'No�es: _ �
�
�34. Final Heating & Air Conditioning ' � . �- � . � �
35. Final Gas PiDe�Test � � , �
36. Hood or CanoPY,� , •- - � •
37. �Final Faciory Pireplace ' � � � -
38. final Plumbing ; � '
39. Wacer Service•F�nal , �
40. Gas Service�Final . , ' i
41. Solar pomesticFinal �• '' •
42. Backfiow Preventer ' . .
43. Backflow Irrigation . ' -
�44. Landscape Irriqation System � � � • �
45. Sound Attenuation � - , ' ' ' �
46. Handicap, Regulations " � �� - ,
47. FINAL S7RUCTURE & BU1Lt�iNG
''�
48. FINALP�ANNING � � -, . - .
. 49. Electric Release to Edison '' �
50. Gas Release (o Southem Califomia Gas Co �-' .
51. CEiiTIFICA7E OF OCCUPANCY �'
No. Dare -' ' -
�
�
1
�oon�ssaemtara: 555 ANTON HL
QYNEM'9NAMEIFp10WN: BANK OF AMERICA
"0°"Eu' S55 ANTON BL
COSTA MESA, CA 92626
�rr�. xuuxa woness:
ARCXRECTON�NEEX:
�xcN. on �o.•s wo�ss:
uc. xo.:
uNr:
uxr:
C0�A0T0N'S^�"�' COMPETITZON ELECTRIC ( 818 ) 331-5807
cwm�crorcs�uuxc z1061 COVINA BL
• �ooxess COVINA CA ��� 516842
917 2 4 u�+*:
LICENSED COMNACTOFS DECIAPRTION: I Mreby eRem uMx perely d pe�ury Net 1 em licereed uMn prwiama d Cheqr 9
(mmmendip xilh Saclion 1000) d Drvieian 3 d the Busms+ enE Prdeaaom CaEe, ud my licensa u in hll tpce eM eHed.
cmuc.No.:056905 ��c.cuss: C 1�&�° 5168� EXP: 08/95
��,: `�' -1 G- -�'i � o����-c— ���—
OWNEH BUILDEF DECIARATION: I henby elfiim uMx / N�Y �M1e� I em eRemq fmm IM CaNredon License lew la ihe
�Wlowirg reeeon (Seaion )031.5 Business enA Prolesaiona COE<: Any cny a caunry which reyuiree e paimu m mnetmct aller, improve.
amolch, or repei eny slrudum, piw io ne asuenro, alvo reQui�ea �he applimnt la euch peimX to file e sgmE netement Net he er eM
� IicenW W��I lo IM promiona d iha Conireeme Liranae lew �Ghep�u 9(commmtiip wi�h Satlion JOOO) d Div'sion J W �In
Busrosa eM Prdeaure Codel «thet he or sM ia svemq Iherelun erd the 6am fa Ne elbped eaemqion. MY videlnn al5etlion
)03t.5 by enY aP0��1 for e permil wCpds tM epd�� lo e avJ panally W iq1 mae then Ma huMred ddlen IS`�1).
� I, es oxmier d Ihe praperlY � my empbyeea weh weges a+tMi eola mmpanaeiion, xill do Ne v.oM, erd Iha eweNea s rwl inlended
or oflered br eele (Seciion ]OCG, Businen end PMassions Code: Tha Coniracbn Licema Lew tloea ml appty lo en ownerd propeity
who buids a vnD�� �hereon, end v.tw doea euch xwk himmM a henetl or thr«qh he n her own employeee, povided thel wch
o'mpwamaMs ere nd imenEeE or dlered lor eeb. U, however. lhe W iki�p or'vnpwnnem ie sdd wnhin wre yeer d mmpl&ion, Oie
.�,a�ua., mu ne� �n� w,eo� d ww�+o na o, aa ad �a w�a «�mwwe �« ina wmoae a��.
� I, a� o�mer W Ihe propeM� � eRdwively mntredinp wnh IironaeE conVeclon io conarua tM prqea (Seeun )01d, Buainma eM
Prolexions CaCs�.The Conirac�on License Law doen mtepqylo en ovmx d propeily who buiNa orimqwee�hereon vM wlw
conlrecla Iw eu� prqetls wilh'a mnlrada(e) IkenseE p�nuenl lo Iha Conlreqoro Lirenee Lew).
p i�, �.�,p �� sai�: � e. a a.c., i« m�. �:
i.
Deie: �'. Owner.
I Eo hareby cenity thei l em eware d eM uMerstenE ihe requirememe d Celiomie Fbellh end Selety COEe SeUione 25A5, 255�3, eM
25530. eM tAel 1« enY M1nure WiWinp ox pent xill / will nm (aeeb aw) neaE lo eanply w[h eeid mme mdm vd ihe requirammp for
aparmnf«mvtruciionamadifralbnhaniMAi ue�6T�iy enapementDivria.Rndeniielmunupioneppirelbmueuemqlmmlhese
p1OV1910119. '
Dete: / Od��'
WORKEP'S COMPENSATION DECL�P�TION: I hereby alfirm urMm penelly d p«jury ma d iM Idloxiip deduNions:
� I hera ud xi/ meimen a cenGcma d mnaenl to aaXimum br waken' comPo��. m pwketl la by Setlion �100 0l �M labor
coda �« �n� o•n«�e w ins wwk ia.�:�n m� o�n m ���ed.
� I heve and wil meinten worlw%oompenmton insurence, es repuired by Seclim 310U d �M1e Lebor COEe, br t�e perfamance W the
work iw which Iliia parmn is imued. My worFart rompa�im inwrence rartier eM poliry number are:
. c�.: CTLTF FfTNh EXPIRES
°a'�"°'"bef 229-9SU�IIT12015 O1/O1/96
(This senion need na de campleteC / tM perm) is lw one hundreC EWlers /5100/ or lesv J
� I eenify thel in Iha pa�oimerce ol tha woek fa whkh thie paimn ie issuetl, I ehell nd employ e�ry peiwn in eny menner eo u �o
become eubi� to tM v.a1ken' canpeneaiion Iewe o([:elifp�i�e. eM epree thei il I.Muld became wbjeq to iM xorlm�e
comppevaiion pwia¢iom /A Seaion 3]0o d tM lebor Code. l eh�l nhxiln wmyy wph �hoae prmisima.
Deta: J�� � ^ / J ADWwe9l��
Warnln0� Fe/lun ro szun wollreri rompwetlon cm egsla w , antl she/l suD�xf en miploysr ro crVMiul pwrelXu errtl
c/vll flm� up M ms M1undred thouunE tlollen (Si00, s� Itlon ro Ms cwt ol mmpewf/on, tlamsp� �s qovMeC b� In
Sxtlon .tlfb ol fhs Lebor COJe, lnM1nit, erM ettomeyi /esa
CONSTPUCTION LENDING AGENCY: I hereby elf'm uMm Po�eM d perN'Y �� ��� is e mnsrud'an hkinB egenty br tM
peAortnence o� ihe work br which Iho peimt is eeueE (SeGion 309), Civ. C).
LENDEfl'SNAME:CONNECT PARKING GARAGE
i�oexs�ooness:LIGHTING TO 1ST FL S55 AN
1 ceniry thm I hava reeG inia epplkmbn eM mma �hai �ne ebove inlame�ion ia conep. I epree m cwnpty wilh ell tlry eM owmy adinerces
end eteie lewa rele�in0 �a �iMing mna�riwtim erd hereby eNharize ropeseMatives M t�is rily to enter upon the ebwe-mam'nned pmpery
forinspeaion purposes.
DAN ALTHOUSE
nm w�
- oe�e: �-l6-ciS-
s�a��ure a ownenneemuooi���wmec+o�
(5151dfi WP) W�no-BuilEvp 8 Sefery: GieemFle; Cenery-Aoo���: oink-Revenue; GdAenrod-Meevw
CITY OF CO5TA MESA - BUILDING PERMIT
PERMIT NO: E 073837 PLAN CHECK NO: N
CONSTRUCTION TYPE: I-FRSP PERMIT TYPE: ELE
SOH DESCRIPTION : DISCONNECT ELECT LINE FOR PARKING STRU
CLAIM VALUE:
CALC-VALUE:
PERM NO: E 073837
GOVT; N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: B-2 /
COMMENTS: DISCONN ELECT FOR PARKING STR FROM 535 ANTON & CONN TO 555 ANTON
***�****�*�*��*�*�*�*�r**��**�*+�******�***x**x*x�x�*�x�**�*+�**�*�***��+�**�*****�*
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDTNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050109 ZNE: REF NO:
PLANNING NOTES>
> �
1EiE�E9EfE1EfEfEfEiEiElEfEiEiE1EiE1E1EiEfEiE3E3EiEifiElEiEiEiE3E1EiE1EiElElEiEiEiEfEiE1E1ElEiEfE1E3EififiEfE1E1E3E1EfEfEiEiElEfEfE3E1E1FiF1E9E1Fikikif1E1f1E3E
D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S
.f
ZONING APPROLTED BY ''' DATE:
�i
BUILDING APPROVED BY : �
APPLICATION ISSUED BY: !�
*+�*�*�**�**+�****+r�*�** ,
LEGALIZATION;N F E;E'� S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 55.00
SOE
PLAN
ISSUE FEE 15,00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 55.00 15.00 0.00.
DATE:
DATE: �
��+�**��***** **
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
70,00 70,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 70,00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
70.00
ik iE IE iE iE iE iE 1E iE if iE if iE iF �E iF iE iE 1E 1E if IF iE 1E 1E IElE 1E iE iE iE iE iE iE 3E aE iE 1E IE iE iE iE 3E 9E IE IE iE iE iE 3E iE iE 1E IE 3E iE iE �E 1E iE �E iE iE fE aE iE if iE if 3E if iF 1E iE iE 3E if iF iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 3 MISC APPARATUS NOT LISTED REQ PERMIT 11.00 33.00
ELE 2 MISC CONDUIT NOT LISTED REQ PERMIT 11.00 22.00
END OF FEES
�1 QQ138»i7-ll0183479 T L�'s �Q.00
"vRTE: Qd/16/?5 TI19E; iF�3E
�:
CONSTRUCTION AND PLANNING POG.. y SPA
APPROVALS Permit# Dace Inspector AppROVALS Permit# Date Inspecmr-
t. Temporary Electrical Service or Pole 52. Pool & Equipment Loca[io�
2. Soil Pipe-Und�g�nd. � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
�4. Electricai Conduii-Undrgrnd. �jT�����,.�55. Electrical Bo�ding
. 5.'Steel Reinforaement 56. Rough Plumbing & Pres:ure Test
6. Electrical UF�R-Grnd. 57. APPROVAI TO COVER�GUNITE .�
7. Footings 56. Electrical Conduit-Und.grnd.
� 8. Foundation 59. Gas Pipe, O Undrgrnd., Tesi
9. Water Pipe�Undr9rnd. ' 60. Backwash lines, P�Trap, L� Undrgrnd.
10. Structural Floor System 61. APPROVAL TO'DECK '
77. Propert,y SewRr_ Line & House Coqnection 62. Backwash & Receptor�Final - .
I
12. Sewer Cap 63. Heater & Vent•Fina�l
13. Roof Drains 64. Plumbing System � Final
14. Rough Plumbing 65. Electrical,Fina� �
15. Rough Electricat�Conduit 66. Solar SYstem�Finai
16. Rough Electric�9iring - 67. Pencing & Access Approval
77. RoughWiringSign 66. APPROVEDFOR�PLASTERING
18. Rough Electrica6T Bar Ceiling 6'3. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE 4EPT. REQUIREMENT I
20. Rough FactorY Fireplace � � . ,. � T� � �APPROVALS� Permit # �
i
21. Ducts, in Structure • � . 70. Underground Hydro
22. Ducts�, Ventiia,4ing - � r_ "71, ProductAiping OGas QOiI
23. Gas Pipe-Rough & Test • - 72. Underground FIus6 ' '
24. Roof Framing ' �' ..73. Undergrnd. Srorage Tank 0 Gas ❑ Oi(
25. Roof�Sheathing �. 74..� Overhead Hydro� ' �
26. T-Bar Ceiling (Structural) & Monocoat .-', 75: Dry Chemical
27. Frartte and FlBshing ' 76. Dry Standpipe '-
28. Lathing&Sid�ng � � � ' ' 77;.. FIXEDSYSTEA4 FINAL .
29. Insulatioti - � 78. FIiiE PREV. FINAL
30. Drywail Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat �• , r •: 79, FINAL INSPECTION
- 32. Eiectriwl Power MeterFinal ' �p' �FOOD CERTIFICATE ISSUED . �
33. Final-Electric � � y -�'! q,�'' , Notes: � • � _ '
v
� 34. Final'Heating & Air Conditioninj "' _ - ' � -
35. Finai GasPipe:Test - , � � .
36. Hood or CanopY ' ' . - � . ,
37. Final factory Fireplace � - � ^ � ._,
�!
38. Final Plumbing - � , -
39. Water Service-Final � ' ' � . ' � . ' � _
40. Gas Service-Final � � , •
�41. Solar pomestic•Final . � ' - ,
42. Backfiow P.eventer ' �
43. Backflow Irrigation . , '' �� �
44. Landscape Irriqation System � ' ' `
45. Sound Attenuation � °' . � ,
�.
46. Handicap Regulations - ' -
47. F�INA�STRUCTURE&BUILOING . , _ . �
48. FINALPIANNiNG � � - �
� .'a + .
49. Electrie Release to Edison ,
50. Gas Release to Southern California Gas Co � - � . .'
51. CERTIFICATE OF OCCUPANCY
No Date
�
�
SCOPE OF WORK:
DISCONECT EXISTING FEEDERS FROM EXISTING BUILDING,
AND RELOCATE TO 555 ANTON. CONNECT 100A 480V.
CIRCUIT TO EXISTING MAIN S/N� r_�ep
SSS ANTON
EXT�ND (E)
CON UITS TO
PAN L
� UNDERGROUND
LL BOX 11X17
4—#000 & �6
IN (E) CON S
�
. �
ABANDON EXISTING FEEDERS
TO OTHER BUILDING.
(E) UNDER GROUND
PULL BOX TO PANEL
4—#000 & #6—G
IN 3" PVC C.
(2)—(E) 1 1 /2" �PVC C.
INTERSEPT AND XTEND TO
NEW PULL BOX
Huu iuuH 6KEAKER TG (Ej 2uu
"MSB" IN ELECT. ROOM
B OF A— METRO CENTER
555 ANTON BLVD. COSTA MESA
TOTAL RUN APPROX. 550'
TOTAL (E) LOAD 24A
(E) FEEDE�S
4—#00 & 6—G
(E) 100A 48V. DISCO
(E) 480VAPANELS
PARKWG STRUCTURE
COMPETITION ELECTRIC
(818) 331 —580"7
. _. ., _ . . _ . .. . ...-.. . . . . . . _ .-e•cT�.. yi-�r � im:.ri
� �iTY OF COSTA l� � �SA � �
Development Services, Division of Building and Safety
CERTIFICATE OF OCCUPANCY
This certificate is issued pursuant to the iequirements of tHe Unifocm Building Code, Section 308 adopted by the City
of Costa Mesa cerHfies that at the Hme of its issuance the building shucture herein below described was inspected and
approvedforoccupancyasfollows: � . � �� .
m. °
BuildingAddress 555 Antori`.:Bl..,Ste,100Q. �"g�dg.PermitNumberBC08-00409
`� _ _., . ... . : , , ", :'.: ,
Use
Office ;,t,1;4.,,876 s.f.) S'
Group B
Owner of Building
;� a �<:
TypYe of Construci
Address P• �• Box 4
�
.. �" _ �`: '. . �
i ��A Fire Zone XxXx ` Use Zone PDC
<.Tenant KMJ CORBIN 8 co.
sdale, A2` n
r / �i i
, � � �.:
BUILDING OFFICIAL-�ldllll Q. NgUyeri, C B 0. B
- Date
REQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
�
: . • . . -� ,,. � .. � <. . �.- .. . . . . . . , . .. . -.�. .. . _ . . . ... � -
� CI,_ �' OF COSTA M� ;A �
Development Services, Division of Building and Safet�
CERTIFICATE OF OCCUPANCY
This cerHficate is issued pursuant ro tlie requirements`of t}ie Uniform Building Code, SecHon 308 adopted by the City
of Costa Mesa certifies that at the fime of iks issuance the building structure herein below described was inspected and
approved for occu pancy as follows:
BuildingAddress 555 Anton B1.,' Sto :120 BIdg.PermitNumber $C07-00514
Office (3,732 s.f.) ' '
Use
B � 1-A ''' �� ` RXXXXX PD
Group Type of Construction Fire Zone Use Zone
OwnerofBuilding RREEF TenantPLATINUM PROPERTIES
Address PO sox 4900, Scottsdale, Az
By
U /
BUILDING OFFICIAL-Klldrill Q. Ngllj�2ri, C.B.O.
Date 05/06/OB
REQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
�
�
CITY OF COSTA MESA
� BUILDING DIVIS/ON
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.costamesaca.00v
�.��5 FOR INSPECTIONS CALL: (714) 754-5826 /
PERMIT NUMBER: BC12-00651 ��
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 1 211 2/2 01 2
ISSUED BY: RMD
JOs a,00Ress: 555 140 ANTON BL CM �:;,"; '=_,_ Suite/Unit: 140
APN: 41050104 -"��-��ZOf110g:, , ',
/�l�x yr . . ` . . � � � r';'_,: � �' .
Vicinity: SPACE 140 /„�%;'%��,,� ' � " ' _ � . � Pnmary Occ: : _ ��.
Const Type:l-A �"��;-� ,; �� � � �SQ.:FT:. 300 - -,Valuation: � $59,565.00
i, ', �� � .� , ) i:�.� -,= - - " - - = c__ " ',. . .�' . \ -
SCOPE OF WORK:300 SF INTERIOR TI FOR':I,-APPROVE", SUITE 140. WORK TO INCLUDE THE DEMOLITION AND
RECONSTRUCTION OF INTER�OR NON-LOAD.BEARING WALLS AND CEILINGS TO RECONFIGURE AND CREATE NEW
OFFICE AREAS, CONFERENCE ROOM AND COFFEE BAR AREA WITH 24 LIGHT FIXTS,.6 SWITCHES, 26 OUTLETS, 1 WATER
LINE, ALTER DUCTING �' '' : ����� � � �
IN 1 ZONE. ��''� � ;?� � � - -' �`'� - ,
• . � - �
OWNER: PWREF/MCGSOUTH COAST; LLC' �,Address ,- 535 ANTON BL. UnR:C08TA MESA�,.CA �
Phone: � - �:%%,1� � -� ��ClrylState2ip:� SUITE 150"' �� _ - � . ' � �
� � , { Fi'� " - ,
APPLICANT: BOES, ANTHONY . _., � -� Address: Unit: , � �
Phone: 714-993-9220� �� � ' �. � CitylState2ip: , . - , '
i. . . . .. _ . ., ,
CONTRnCTOR AMARQN CONSTRUCTION CORPORATION
License No:674307 ' - -� � � ___ . 1;��. � . �
Phone: 714-993-9220 , ��.'� . � � =�- �Address�1565��N�HARMONY:CI'�, Unih
Cell: ', ` � �� � �Ciry/State� ANAHEIM HILLS, CAZipCode92807 - -
ARCHITECT: ��- ' •�' � LlcenseNo. �" � PHONE:
ENGINEER: � � � License No. - -- ' -,PHONE:
COMBINATION PERMIT FEE SUMMARY,��� ��� ' - �- `� � �
Building FeesCheck: .;?;�\ � '� , \J$�' 3 95
Electrical Fees: �� � ; $828fi-; - `
Mechanical Fees: �`�.� � ��.$37:20 -�.
Plumbing Fees: �':'';.$33.30 - `
SMIPResidential: �-,$0.00,_`-' �
SMIP Commercial: $12:51 ��
Bldg Std Admin Fund $3.00 �-
TOTAL FEES: $998.61
HOURS FQR CONSTRUCTION ACTIVITY: EFFECTIVE 3N 612010 - PER CMMC Sec. 13-279
Montlay thru Fritlay - 7:00 em thru 7:00 pm. Saturtlays• 9:0o am thru 6:00 pm. Prohibited all hours • Sundays and the following Federal holidays:
New Years Qav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav and Christmas Dav
NO710E: The vrork authorized by this permit shall compy with all applicable handicap access requirements under Califomia slatutes and related
regulalions. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXpIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed under this permit to ba considered legal, such work must comply with all applicable codes, and all
required inspections and flnal approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
CO�E� INSPEGfIONTYPE
1616 Piaed SyStem Final Fir� prevBnGon
1266 Paol Spa Final
200 Final Re-Raot
201 Final Bbck/Retaining Wyp
202 Final Faaary Fire Place
203 Final Sign
204 Final Demdition
P�� Ixmuu
t� MSPECTIONTYPE
206 Final Mechenical
208 Final Plumbing
210 Final EleWical
212 Final Fire Prevention
220 Final Planning Approval
222 Fina15ita
250 Final Building/Oaupanq
� 1 �I�:
/� 1 / �
//% t/ �
� • `_
'2 � ��
WORKERS' COMPENSATION DECLARATIC
I hereby affrtn under penalry of perjury one of tr�� rollowing declarations:
❑ I have and will mainUin a certificate ot consent to self-Insure for workers'
compensation, as provided for by section 3700 of Ihe Labor Code, for the
performance ot Ihe vrork tor which this pertnit is issueG.
❑ I have and will maintein wvrkers' mmpensation insu2nce, as requi2d by
seqion 3700 of Ne Laba Cotle, for the peAortnance of Ne work for which this
pertnit is issued. My workers compensation Insurance cartier and policy
num� re: � ✓ � �i2 .5 � I' V ��A -� �i�
Cartie[
(�hU seccon rieaC raf De mrrplarotlANo pomrR is veluetl ot one huMiaC EoOars (Sf00) a lass.)
Policy.Number: �`Zr� b�V i9 l 3'7 �� Z- �
❑ I certify ihat in ihe peAormance of the vrork for which Ihis pertnit is
issued, I shall not employ any person in any manner so as to became subject
lo the vrorkers' mmpensatlon laws of Califomia, and agree that if I should
become subject to the workers' compensation pmvisions of Section 3700 of
the Labor Code, I shall forthwith comply with ihese provisions.
��1 ' y (( L
Ap ' nt'a SlgnaNre Date
l�- (a"
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CNIL FINES UP TO ONE HUNDREO THOUSAND DOLLARS
($100,000), IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby a�rm that I am licensed under provisions of Chapter 9(mmmencing
wilh Section 7000) of Division 3 of lhe Business and Professions Code, and
my liten5e i5 in full force and eHecl.
Cic]# Claes p Q
/%/� V �� / f� /I 2
�—ContradWe Sipnewre r^! ata
CONSTRUCTION LENDING AGENCY: V
❑ I hereby afirm that there is a consWction lending egency for the
perfortnance of ihe work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lender s Name:
Lender's Address:
Sip�Nea Data
OWNER�UILDER DECLARATIONS:
I hereby aNrtn that under penaly of perjury that I am EXEMPT FROM THE
CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5.
Business and Professions Code: My city or wunry whicn requires a permit to
wnstruct, altar, impmve, tlemolish, or repair any structure, prior t0 it5
issuance, also requires lhe appliwnt for such permil lo fle a signed statement
thet he or she is licensetl pureuant to the provisions oF the Contractors Licensa
Law (Chapter 9(commencing with Section 7000) o( Division 3 of t�e Business
and Professions Cotle) or �hal he or she is exempt lherefrom and the basis for
the alleged ezemp6on. My violatlon of Section 7031.5 by any apD�icant (or a
permit subjects the applicant to a civil penalty o( not more than five hundred
dollars ($500).):
❑ I, as ovmer of the properry, or my employees with wages as Neir sole
compensation, WILL DO THE WORK, and the structure is not intended or
oRered for sale (Sec. 7044, Business and Protessions Code: The Contractors
Licensa 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. I(, however, the building or improvement is sold within one year of
completioq the owner-builder will have lhe burden of pmving that he or she
did not build or improve for purpose ot sale.).
� I, as owner of the properry, am E%CLUSIVELY CONTRACTING WfTH
LICENSED CONTRACTORS to conswd ihe project (Sec. 76M14, Business and
Professbns Code: The conVaclors License Law does not apply m an owner of
properry who buiids or improves thereon, and who conUacts for such project with
a conlractor(s) Iicense pursuant to Ne ConVactors License Lavrs.).
❑ I am exempt under sec.
Business and Protessions Code for this reason:
305'I1813I0])
Owner ID veri�ed by � licensa. ❑ Yes ❑ No
Dnver's License No. Expires:
Verification of Ownership by (type of document, i.e. - proDerty tax bill or deed):
DMSION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby cenify that no excavatlon frve (5) or rtare feet in depth inW which a
person is required to descend, will be made in connecUon with work authonzed
by this pertnil, and that no building sWccure, scafiolding, falsewvrk, or demolition
or tlismantling thereof, will be more than thirty-su (36) feet high. (Chap. 32, Grp
2. M 2, Sec. 341, Ttle 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permil from the Division of Industnal Safety, as nolad above, unless
such pereon has a pertnit to do such vrork from the division.
AVplicsnfs Sl9newre De�e
Division o( Industrial Safery Pertnit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATON:
7. Will the applicant or preseN or future building occupant need to fle and
ceAify a Business Plan for emergency response to release or lhreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia HeaIN and Safery Code requires, with some
exceptions, that e Business Plan be filed with Ne 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
tempereture and pressure).
2. Does or will the applicant or present or future building occupant need to file
a regisiration form for acutely hazardous materialsl � Ves ❑ No
(Section 25533 of the Califomia Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Depatlment by each
business which at any one time has on hand a quantiry of acutely hazardous
materials equal to or greater Nan 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 fuNre building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safery Code provides that the
Costa Mesa Fire Department mey require the preparation, certifcation and
filing with the Fire DepaAment of an RMPP by businesses which are required
lo register acutely hazeMous materials with tha Fire Department.
4. If an RMPP is presently required, has Section 25534 of tha Cali(ornia
Heal�h end Safary Code been fully wmplied wi�h7 ❑ Yes ❑ No
5. Does or will the applicant or pre50nt Or future 6uilding occupant raquire for
the work which is ihe subject o( lhis applica6on e pertnil for such wnstruc�ion
or modiication trom Ne Sout� Coast Air Quality Management District or from
any other air pollution control tlistncl or egenc�? ❑ Y85 ❑ No
(Section 65850.2 of the CalNomia Govemment Code repuires that Ne requested
infortnation be (umished on applications for non-residantial builtling pertniGs).
6. Will any part of Iha faciliry to be constructed under this pertnit be within
7000 feet from the outer boundaries of a school? ❑ Ves � No
(If yes', Ne faciliry must meet the requirement of Sections 25534 and 42303
o( the Califomia Health and Safery Code).
7. I( a pertnit from Ihe South Coast Air Qualiry Management District or other
air polWtion conVol disUict or agency is required (or t�e work which is ihe
subject of Ihis application, have all o( ihe disdosures prescribed by Califomia
Health and Safety Code Section 42303 been made7 ❑ Ves ❑ No
8. (It'yes', attach certifcate of compliance finm ihe appropriate air pollution
wntrol oKcer).
CERTIFICATE OF COMPLIANCE: 1 certify ihat under penalty of perjury the
infortna[ion given above is wrrect. I agree to comply with all slate laws and
ciry ordinances regarding Hazardous Materials and Emissions.
SgrieWm Data
CERTIFICATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: I
certiy under penalry of perjury Ihat I have read Nis application end sWte that
the infortnation given is wrtect I agree to comply with all state laws and city
ordinances relating to building construction, and authonze representatives of
the Cily of Costa Mesa ro enter upon the above-described pmperty for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this pertnit until final inspection.
SignaNre f Lepal OvmeKs) Daro
�/�— �Z� iz (,z
��� �o���� �
l—_ . .
11
1000 E. Howell Ave. Suite B
e Anaheim, CA 92805
Ph:(714) 937-5305
M�chanical� �i��.. Fax: (714) 937-5307
l'onv.+no� i Lurn�r ntiS:0i1?
TEST AND BALANCE ANALYSIS REPORT
� �' � ���t8 lg,v�o�c !3�
�cra- ���s/
I Approve Lending
555 An#on, Suite 140
Costa Mesa, CA
Contractor:
H.V.A.C. Mechanical, Inc.
106ii 5887
COMPLETION DATE:
lanuary 11, 2013
Tech: Chris Miller
+[IRLESS OTHERNISE NOTED, INDICATED CFM (S AT S7'ANUARD CO\DITIOYS.
'�FLOW dOOD USCD ON dLL CE[LI\C SUPPLY A�D RETUB� TERMIA',ll. UNPCS, A\D SiDE1VALL REGISTERS A[iD GRILLFS
WHERE APPLICABLE.
Page 1
CSD
CEG
CER
CRG
CSR
Ci2R
EDO
EAR
FEG
FER
FRG
FSR
RAB
RAG
Rll0
RLD
SAB
SDO
SLD
W�
WE
WR
WR
WS
WS
Mechanic�l, Inc.
Cumraa7u�:, I.krnv pt�h2l%1?
MASTER CODE SHEET
CEILING SUPPLY DIFFUSER
CEILING EXHAUST GRLLLE
CGILING EXHAUST REGISTER
CEILING RETURN GRILLE
CEILING SUPPLY REGISTER
CEILING RETURN REGISTER
EXHAUST DUCT OPEN[NG
EXHAUST AIR REGISTER
FLOOR EXHAUST GRILLE
FLOOR RETURN REGISTER
FLOOR RETURN REGISTER
FLOOR SUPPLY REGISTER
RETURIV AIR BAR
RETURN AIR GRILLE
RETURN DUCT OPENInG
RETURN LINEAR DIFFUSER
SUPPLY AIR BAR
SUPPLY DUCT OPENING
SUPPLY LINEAR DIFFUSER
WALL EXHAUST GRILLE
WALL EXHAUST REGISTER
WALL RETURN GRILLE
WALL RETURN REGISTER
WALL SUPPLY GRILLE
WALL SUPPLY REGISTER
GEN�RAL REPORTING CODES
DNA
DNL
NA
1�`I
NS
NT
NVL
*
= DATE NOT AVAILABLE
= DATA NOT LICENSED
= NOT ACCESIBLE
= A'OT INSTALLED
= NOT SPECIFIED
= NOT TESTED DUE TO ABNORMAL CONAITIONS
= NO VALID LOCATION FOR ACCURATE TESTING
= MEASURED W1TA FLOW HOOD
Page 2
1000 E. Howe!! Ave. Suite B
Anaheim, CA 92805
Ph:�714) 93I-5305
Fax: (714) 937-5307
l.{}Illl�IllVl.l LILZII%' 9l1LLV�
HOOD:
METER:
RANGE:
fLOW SENSOR:
Inc.
FLOW HOOD
A COLLECTOR TYPE WHICH READS IN CFM
1000 E. Howell Ave. Suite B
Anaheim, CA 92805
Ph:j714j 937-5305
Fax: (714) 937-5307
ALONOR VELOMETER WITH EIGHT RANGE SELECTIONS, THREE EACH FOR SUPPLY AND
RETURN. ONE POSITION SELECTOR IS ADJUSTABLE TO CORRECT FOR ALTITUDE
AND TEMPERA7URE. THE OTHER T4V0 CALIBRAiED AND SEALED TO READ OUT
DIRECTLY !N CUBIC FEET PER MINUTE A7 CON57AN7 VOLUME 57ANDARD
CONDITIONS.
30-500, 100-1000, 200-2000
o-soo,zoo-i000,soo-z000
OUAL'/:" OIA. PIEZOMETER GRID SUSPENDED AT RADIUS OF AVERAGE VELOCITY.
Page 3
1000 E. Howe!! Ave. Suite B
Anaheim, CA 92805
Mechanic�i, Inc.
Co��r4et:»S Lhe-nm• nbR21k12
DIFFUSER & GRILLE TEST SHEET
Ph:(714) 937-5305
Fax: (714) 937-5307
Page 4
ical,
no3'CY72
Ine.
] 000 E. Howell Ave. Suite B
Anaheim, CA 92805
Ph:�714) 937-5305
Fax: �714) 937-5307
DIFFUSER & GRILLE TEST SHEET
Page S
�
�..- - . � ,
CITY OF COSTA MESA
�,051pMF$p BYILDING DIVISION
��g 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax p14) 754-4856 • www.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
�°�^"` PERMIT NUMBER: E11-00097
PERMIT TYPE ELEC
APN: 41050110
JOB ADDRESS: 55 120 ANTON BL CM
viciniry:
STATUS:
DATEISSUED:
ISSUED BY:
Suite/Unit: 120
ISSUED
06/0112011
RMD
SCOPE OF WORK: SUPPLEMENTAL ELECTRICAL PERMIT FOR 4 POWER DROPS.
OWNER: RREEFAddress: PO BOX-4900 Unit:DEPT 207
PHONE: City/State2ip: SCOTTSDALE, AZ
APPLICANT: SALERNO,SCOTT
PNONE: 714-9323137
CONTRACTOR: AMARON CQNSTRUCTION CORPORATION
Address: 1565 N HARMONY ClUnik
City/State: ANAHEIM HILLS; CA ZipCode: 92807
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $71.10
Reinspection Fee $0.00
TOTAL FEES $71.10
Address: Unit:
City/SlatelzZip:
License No. 674301
PHONE: 7'14-993-9220
CELL:
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, § 7, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must wmply with all applicable wdes, and all
required inspections and final approval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit.
GO�Ep. INSPECiIONTYPE pRTE INTITIpL COOEI INSPELTIONTYPE UAiE INTITIALS
7616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing �1' �;� _(1_
200 FinalRe-Roof 210 FinalElecirical �( �-r�-lD—�� �r�V�
201 Final Block/Retaining Wa0 212 Final Fire Prevention
202 Final Faclory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Si�e
204 Final Demoli�ion 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aflirm under penalry of perjury one of �he (ollowing declarations:
❑ I have and will maintain a cehificate o( consen[ to self-Insure �or workers�
compensation, as provided for by section 3700 of the Labor Code, for the
pedormance of the work (or which this permit is issued. �
❑ I have and will maintain workers' compensation insurance, as required by
sectan 3700 0( the Labor Code, for the peAormance of the work (or which this
permit is issued. My workers' compensation Insurance carrier and policy
number are: �
Came (L�1/Pi✓'�S'� 0� �C . ��s2 CO
(T�rs sMivn need rrol be mmpleted �llhe pemrR is ✓a�✓¢d af we hundredCdlars (5100) a less.)
lPolicyNumber: � � � �� / 3 ��l ` //
❑ I certify that in the peAormance af Ihe work for which Ihis permit is
issued, I shall not employ any person in any manner so as to become subjec�
b the workers' compensation laws of Califomia. and agree that if I should
become subject to the xrotkers' compensatiqn provisions ot Section 3700 of
�he Labor Co , I shall fohhwith omply with these provisions.
� ��!-/r
yppliwnfs SignaWre �Date� - �
WARNING: FAILURE TO SECURE WORKER5' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LqBOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aftirm that I am licensed under pmvisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Cotle, and
my license is in full force and effect.
I:ic-#_�_ -'��'i Ccla'ss.#=--%���`
�� — — ��/�
GoNraclor'sSignaWre LDale—'
CONSiRUC710N LENDING AGENCY:
❑ I hereby aKrm thal there is a consiruction lending agency for the
pertortnance o! the aork (a which Ihis permit is issued (Sea 3097, Civil Code�.
Lender's Name:
Lender's Address:
SignaWre �ale
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or ihe (ollowing reason (Sec. 7037.5,
Business and Professions Code: Any city or Counry which requires a permit �o
construct, alter, improve, demolish, or repair any stmcWre, prior to its
issuance, also requires the applicant tor such permit [o fle a signed stalement
Ihat he or she is licensetl pursuani to th� provisions of the Conlractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business antl Professions Code) or that he or she is exempt therefrom and
the 6asis (or [he alleged exemption. Any violation of Section 7031.5 by any
applicant for a permi[ subjec[s �he applicant to a civil penalty of not more Ihan
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wa9es as Iheir sole
compensation, WILL DO 7HE WORK, and the structure is not intended or
oflered for sale (Sec. 7044. Business and Professions Code: The Contractors
License Law does not apply ro an owner of property who builds or improves
thereon, and who does such work himself or herself or [hrough his or her own
employees, provided that such improvements are not inrended or oRered (or
sale. If, however. Ihe building or improvemen[ is sold within one year of
completion, the ovmer-builder vnll have [he burden of proving that he or she
did not build or improve for.purpose o( sale.).
❑ I, as owner of [he propeAy, am EXCWSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to consiruct Ihe projec[ (Sec. 7044, Business antl
Professions Code: The contractors License Law does not apply to an owner of
property who builds or improves thereon, antl who contracts for such project wi�h
a conirec�oqs) license pursuant to �he CoNractps License LawsJ. �
❑ I am ezempl under sec.
Business and Professions Cotle for this reason:
� -/ -�/
SignaWre Date
005➢-4fi (9I01)
Ovmer ID verifietl by tlrivei � ncense. ❑ Ves ❑ No
Driver's License No. Ezpires:
Veritication o/ Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cert'rfy �hat no excavation fve (5) or more fee[ in depth into which a
person is required to descend, vnll be made in connection vrith work authonzed
by this permit, antl that no builtling s[ructure, scaffdding, falsework, a demolition
or dismantling Ihereof, vnll be more than thirty-six (36) fee[ high. (Chap. 32, Grp
2, Ad 2, Sec. 347, Ttle 8, Califomia Atlminist2tive Cotle).
❑ As ovmer-builder, I will not employ anyone to do work which would
require a permi� from Ihe Division of Industrial Safety, as noted above. unless
such person has a permit to do such work from Ihe division.
Apphcanfs SignaWre Dale
Division of IndusVial Sa(ety Permi[ Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applican[ or present or future building occupant neetl Io (le and
certify a Business Plan for emergency response to release or threatened
release of a hazardous ma�erial? ❑ Yes ❑ No
(Section 25505 of the Califomia Heallh and Satety Code requires, with some
Azcep[ions, that a Business Plan be filed wi�h the Costa Mesa Fire
Department by every 6usiness which has at any one time dunng a reported
year a quantity of hazardous ma[edals equal to or greater Ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic (eet ot compressed gas
at standard temperaWre antl pressure).
2. Does or will Ihe applicant or presen! or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, wilh some
exceptions, requires registration wi�h the Costa Mesa Fire DepaAment by
each business which at any one time has on hand a quanti�y of acately
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic fee[ ot compressetl gas at stantlartl
temperature and pressure�.
3. Does or will the applicant or present or (uture building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of [he Cali(omia Health and Safety Code provides thal the
Costa Mesa Fire Department may require the preparation, certifcation and
fling with ihe Fire Department of an RMPP 6y businesses which are required
�o register aculely hazardous materials with [he Fire Departmen[.
4. If an RMPP is presently required, has Section 25534 0( the Califomia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will ihe applicant or presenl or future building occupant require for
�he work which is the subject of this application a permit for such construction
or motlifcation from the Souih Coas� Air Qualiry Mana9emenl DisMct or from
any other air polWtion control district or agency? ❑ Yes ❑ No
(Sectbn 658W 2 of Ihe Califomia Govemment Cotle requires Ihal Ihe requested
infortna�ion be fumished on applications fa non-residential building pertnits).
6. Will any pah of the facility to be cons[ruc[etl under this permit be within
1000 (ee[ from the outer boundaries of a school? ❑ Yes ❑ No
Q('yes", Ihe facility must meet the requirement of Sec[ions 25534 and 42303
of ihe Califomia Health antl Safety Code).
7. I( a permit from ihe SoWh Coast Air �uality Management District or other
air pollution conVol dishict or agency is requiretl (or the work which is the
subject of this application, have all of lhe disclosures prescribed by California
Health and Satety Cotle�Section 42303 been made? ❑ Yes ❑ No
8. (If yes", attach certifcate of compliance fmm the appropnate air polWtion
control oKcer).
CERTIFlCATE OF COMPLIANCE: I certify that under penalry of perjury the
in(ortnation given above is corcect. I agree to comply with all state laws antl
city ordinances regarding Hazardous Materials and Emissions.
S19nalure
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and 5[ate [hat
the information given is correct I agree to comply with all state laws and city
ordinances relating [o building consiruction, and authorize representatives of
the City of Costa Mesa lo enter upon the above-tlescribed property for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permit unlil fnal inspection.
�
—�aWreofLe IOwner(s� Oale
I�
AnQioiAu�hon32d�ApPlicdN""- ' - �"—��/ .
�'
CITY OF COSTA MESA
o ""'F BUILDING DIYISION
. ''p
> ` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ewiw.ci.costa-mesa.ca.us
�. � FOR INSPECTIONS CALL: (714) 754-5626
`'°��`' PERMIT NUMBER: BC11-00140
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: COM_ALT DATE ISSUED: 04121/2011
ISSUED BY: RMD
JOB ADDRESS
APN: 41050110
Vicinity: 120
Const Type:
555 120 ANTON BL CM
SQ. FT:
Zoning: , ,
3055
Suite/Unit: 120
Primary Occ:
Valuation: $95,774.30
SCOPE OF WORK: 3, 055 SQ FT TENANT IMPROVEMENT. SCOPE OF WORK TO INCLUDE: 53 LIGHT FIXTS, 29 OUTLETS, 15
SWITCHES, 1 EL FOR WATER HEATER, ALTER DUCTING IN 5 ZONES, 1 INSTA HOT, 1 COMM SINK AND 1 GARBAGE DISP.
OWNER: RREEF
Phone:
APPLICANT: BOES, ANTHONY
Phone: 714-9323138
Address: PO BOX 4900
City/State/Zip: SCOTTSDALE,�AZ
Address:
City/State/zZip:
CONTRnCTOR: AMARON CONSTRUCTION CORPORATION License No. 674301
Phone: 714-993-9220 Address: 7565 N HARMONY ClUnit:
Cell: City/State: ANAHEIM HILLS, CA
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
License No.
License No.
$156.94
$965.75
$132.86
$92.00
$52.90
$0.00
$20.11
$4.00
$7,424.56
Unit: DEPT 207
Unit: :
ZipCode 92807
PHONE:
PHONE:
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2070 - PER CMMC Sec. 13-279
Monday thru Fritlay- 7:00 am thru �:00 pm. Saturtlays-9:00 am thru 6:00 pm. P�OhibltBd 311 hOUfS - SUfIddYS ditd [h2 fO110W1f1g F0d@fal h011d3Y5:
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav and Christmas Dav
NOTICE: The vrork authonzed by this permit shall wmply with all applicable handicap access requirements under California s�atutes and related
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 �AYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 ot this permit.
COOE �. INSPEC710N TYPE
1616 Fiaed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Plate
203 Final Si9n
204 Final Demolition
onh ixnnnis cooEe ixsaecnoxme
206 Final Mechaniwl
20B Final Plumbing
270 Final EleCtriCal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Si�e
250 Final Building/Otcupanty
X 5 �31-iI N��p�
X 5 31 - i 1 fh�, ��
�C � -�-� " �d �"
WORKERS' COMPENSATION DECLpRATION: .
I hereby a(frm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certifi�ale of consent to selbinsure fo� workeB'
compensation, as provided for by Section 3700 of Ihe Labor CoOe, for the
peRormance of lhe work (or which this permi[ is issued.
❑ I have and will maintain workerg' �ompensation insurance, as required by �
section 3700 of the Labor Code, for the pertortnance of the v.ark for which this
pertnit is issuetl. My workers' compengation Insurance carrier and policy
numher are:
[Cairiei: ��P�C) �'" ��i" :.�� f1'� ��s��.�
(This secfim ne ��/�,1re0 aMe pemo} is vaNed at one hfu�Mmd tl�0ars (5/00) a IeuJ
Polic� ber: �% �P�%U�d �� 7 �' U I
❑ I certi(y Ihal in Ihe peAortnance o( �he vrork for which this permit is
issuetl, I shall nol employ any person in any manner so as lo become subject
[o Ihe vrorkers' compensa[ion laws of California, and agree Ihat i( I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Cotle, I s all to vnth comply with these provisions.
App' nl'i'Si9na ( le =
WARNING: ILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP Tp ONE HUNDRED THOUSAND DOLLARS
($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATI�ORNEY'S FEES.
LICENSED CONTRACTORS DECLqRqTION:
I hereby affrm that I am licensed untler provisions of Chapter 9(commencing
with Section 7000) of Division 3 of ihe Business and Pro�essions Code, arW
my license is in full (orce and effect.
�� — ..���/ _ �ass:#,
G aa ' �g�t ec / �ate" �
�/ �
CONST TION LENDING AGENCY:
❑ I hereby aKrtn that Nere is a construction lending agency fw the
peAormance of Ihe wvrk fa which this pertni[ is issued. (Sec. 3097, Civil CoOe).
Lentler's Name:
Lender's Address:
Siqnalure Daie
OWNER•BUILDER DECLARATIONS:
I hereDy aKrm that untler penalry o( perjury that I am E%EMPT FROM THE
CON7RAC70RS LICENSE U1W for the (ollowing reason (Sec. 7031.5,
Business antl Professions Cotle[ Any ciry or county which requires a permit to
conSWct, al�er, improve. demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such permit b file a signed statement
lhal he or she is IicenSeC pursuan[ to [he pmvisions of the Contrac�ors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of I�e
Business and Professions Cotle) or that he or she is exempt therefrom and
ihe basis for the allegeC exemp[ion. qny violation of Section 7037.5 by any
applicaM for a permil subjects the applicant to a civil penalry of not more lhan
(rve hundretl tlollars (5500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WOkK, and the slmcture is not inrentle0 or
oflered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law tloes not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or ihrough his or her own
employees, provided that such improvements are not intentled or ofteretl (or
sale. If, however, the building orJimprovement is sold within one year of
completion, the ovmer-builder will.have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ 1, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH
UCENSED CONTRACTORS lo construct lhe project (Sec. 7044, Business and
Professions Code: The contractors License Law dces not apply lo an owner of
property who builds or improves thereon, and who contracts for such projecl vrith
a contractoqs) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code (or this reason:
JOS]-dfi(JIO�)
Owner ID veritied by driver's license. ❑ Yes ❑ No
Dnver's License No. Expires:
Verifcation of Ovmership by (lype o! tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
� I hereby certity Ihat no excavation frve (5) or more feet in Cepth into which a
person is required �o descentl, will be matle in connecl'qn with work authonzed
by ihis permit, and ihat no building strucWre, scaffdtling, falsework, a demolitan
or dismantling thereof, will be more Ihan Ihirty-sia (36) (eet high. (Chap. 3.2, Grp
2, Art 2. Sec. 341, Title 8, Califomia Administ2tive Code).
� As owner-builder, I will nol employ anyone to do work which would
require a permit from the Division ol Intlustrial Safety, as noted above, unless
such person has a permil to tlo such work from Ihe division.
AOOlican[s $�gnaWre
Division of Industrial Safety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future 6uilding occupant need to fle antl
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 0( lhe Califomia Health and Safety Cotle requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department 6y every business which has at any one time during a reported
year a quantiry ot hazardous materials equal to or greater than a weigh[ of
500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressetl gas
at standard temperawre and pressure�.
2. Ooes or will the applicant or present or future building occupant need to file
a registralion fortn for acutely hazardous malerials? ❑ Ves ❑ No
(Section 25533 of the Califomia HeaIN and Sa(ety Cotle, with some
exceptions, requires regist2tion with �he Cosla Mesa Fire Department by
each business which at any one time has on hantl a quantiry ot acutely
hazardous materials equal to or greater �han a weight oF 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or tuture builtling 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 [hat the
Costa Mesa Fire Department may require the preparation, certification and
fling with the Fire Depanment of an RMPP by husinesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of [he Cali(omia
Health and Safery Code been fully complied with? ❑ Ves ❑ No
5. Does or will the applicant or presenl or fuWre building occupant require for
the vrork which is the subject of this application a permit for such wnstruction
or motlification (rom Ihe South Coast Air �uality Managemenl Dislrict or from
any other air pollution control disMct or agenGy? ❑ Ye5 ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires that the reques[ed
information be fumished on applicatbns for rqmresi0ential builtling permits).
6. Will any part of the faciliry to be conswcletl untler Ihis permit be wilhin
1000 feet (rom the outer bountlanes o( a school? � Yes ❑ No
(If'yes", the facility musl meet Ihe requirement of Sections 25534 antl 42303
of the Califomia Heal[h and Safety Code).
7. If a permit from the South Coasl Air �uality Management DisMcl or other
air pollution wntml dislnct or agency is required for the vrork which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safery Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air pollution
control oKcer).
CERTIFICA7E OF COMPLIANCE: I certi(y that untler penalty of perjury the
information given above is correcL I agree to comply with a0 state laws and
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and state that
the informalion given is wrrecl I agree to comply with all s[ate laws and city
ortlinances relating to building construction, antl authorize representatives ot
the City o( Costa Mesa ro enter upon ihe above-described property tor
inspection purposes. I agree not to occupy or allow occupancy ot any building
authonzetl by this permit until final inspection.
� Sgn re Legat Ovmer�s) Date
��� L
�gvQlor'Autbo�d Appll�ant--�' ale /
Lx'T:L!�3:
y'���..
�
„..
j ,�
� _:�”
CITY OF COSTA MESA
BIIILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856
FOR INSPECTIONS CALL: (714) 754-5626
FIRE SUPRESSION PERMIT
www.ci.wsta•mesa. ca. usFO$-00203
JobAddress: 555 ANTON BL _', Slatus: ISSUED
Suite: 1100 � , '. , �, , � ' Applied: 08/06/2008
Vicinity: SUITE 7100 - � ' � � . � . Issued: 09/12/2008
ParcelNunmber: 41050110 -;"ZOn�ng . �_ `
1 ', �' , .�r:�.. � -- }_.C, .
applicanC GARCIA; JAMES �
.s �> � `
Address: t F 'r � „-,.• "� ,'-
�t
� ��� %"� "�;'� Phone:''�562498-6444EXT2505 �� - �. '
r Zip
:%� ;t . _ , . . � , . � .
Owner: RREEF 1 � .. - , -
Address PO.BOX 4900 - �� � � �'< � - � � � � . '
DEPT20� . ""-� . .- Phone: � � � � � , ., '
SCOTTSDALE, AZ . . . Zip: ._85267-4900 " . ' - �
Connaaor. INTEGRATED�PRODUCTS "AND SERVICES INCORPORATED DBA CAL PROTECTION
Address: 2505 MIRA MAR AVENUE .- � - ,
Plan Check:
Permit:
Other:
Total:
LONG BEACH, CA
,�
,;
Phone: � 800 247-6497 _'.
2ip: 90815 �
License: 909573 �
SCOPE OF PERMIT
FIRE SUPPRESSION PERMI FOR (6) NEW STROBES AND (1) NEW POWER SUPPLY FOR AN INTERIOR �
TI TO'TICKETS.COM", SPACE 1100. REF; BC08-00280 - ... ' - , . . .
' . ,' FEE SUMMARY ' '
$136.01 Galc Valuation Stt 39ioo
$209.25 -� „�,.. �
$0.00
$345.26
-: ; Claimed Valuation: 3� i,sszoo �
,f�. '�
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and.related
regulations. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DA7E OF LAST INSPEC710N., � -
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and'all
�equired inspections and flnal approval must be obfained. Failure to obtain inspections and final approval will result in the expiration of this permit.
fQp�.,L �wsrEcrrox me 4dIE INPILLS �4A� resrEcrrox rroe . ' p� ��yy�
1816 Fixed System Final Fire Prevention 208 Final Mechanical �
1288 Pool Spa Final 208 Final Plumbing ' '
Z00 Final Re-Root T70 final Electricyi . �L
ZOt Final Black/ReWining Wall 212 Final Fire Prevention -�(l 3—[� _�(.�.
202 Final Factory Fire Place 220 Final Planning Approval
Z(73 FinalSign 222 Finai Site
i
Z04 Final Demalition 250 Final BuildingiOccupancy _�(, -� '%� (,, �ti�
WORKERS' COMPENSATION DECLARATION: .
I hereby aKrm unCer penaly o! perjury one o( lhe (ollowing declaralions: .
❑ I have and will maintain a certificate of consent to self-Insure for wvrkers'
compensation, as provided lor by section,3700 of lhe Labor Cotle, for the
peRormance of the v+ork for which this permit is issuad.
❑ I hava and v.ill maintain workers' compensation insurance, as required by
section 3700 of the Labor Coda, for lhe peAormance of the work for which this
permit is issued. My workers' wmpensation Insurance wrrier and policy
number are: `,
Carrier:- - ��%�S/t �%f3A"
(iM1issetlqnnaMrrofDeoom (e0/� ieperm4'sirdluetlalme�urMretltlMars(EIW)a�Mu.)
. Policy.Number: / �/1 7�/
❑ I certify Ihat in the pertormance of lhe 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 Califomia, and agree that if I should
become subject to Ihe workers'to pensation provisions of Section 3700 of
Ihe Labor Cod I shall h ifii co ply with these provisions
GY
- APW� ��'s Si iatu Dat
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNIAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($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 affirtn that I am licensed under provisions of Chapter 9(commencing
wim Section 7000) ol Division 3 of the Business and Pmfessions Code, and
my license is in full force anC effecl.
Lic. # . G Class # C�G L-��
Gon or's SignaWr e
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that there is a construction lending agency for the
peAortnance of Ihe vqrk for wfiich this permil is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lenders Address:
OWNER-BUILDER DECLARATIONS:
I hereby aRirtn that under penalty of perjury [hal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for lhe following reason (Sec. 703L5,
Business and Professions Code: Any cily or coun[y which requires a permit to
consWct, alter, improve, demolish, or repair any structure, pnor to its
issuance, also requires the applicant for such permit ro fle a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of the
Business anC Pro(essions Cotle) or ihat he or she is exempt there(rom antl
the basis (or the allegetl exemption. Any violation of Section 7031.5 by any
applican[ for a permit subjecls [he applicant [o a tivil penalty of not more than
five hundred dollare ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the svucture is not intended or
offereA for sale (Sec. 7044, Business antl Professions Code: The Contractors
License Law tices not apply to an ovmer o( property who builds or improves
thereon, and who dces such vrork himself or herself or through his or her own
employees, provided that such improvements are not intended or o(tered for
sale. If, however, the builtling or improvement is sold vnthin one year of
completion, the owner-builder will have Ihe burden of proving that he or she
did not build or improve for purpose ot sale.).
❑ I, as�ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS ro construcl lhe project (Sec. 7044, Business and
Professbns Code: The contractas License Law tices not apply to an ovmer of
properry who builds or improves thereon, antl v.fio contracts tw such pmject with
a cantractor(s) license pursuant to Ihe Contractors Ucense Laws.).
❑ I am exempt under sec.
Business and Professions Code for ihis reason:
' Slpnalure � - Dale
309�d6 �]IOI�
Oxner ID verified by drivei _...:ense. ❑ Ves ❑ No
Driver's License No. Expires:
�Venfication of Ovmership by (rype of tlocument, i.e. • property lax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby certAy Ihat no excavation frve (5) or more feet in depth into which a
person is required to tlescend, vrill be made in conneCtion with woAc authofized
by this permit, and that no building stn�cture, scaffdtling, falsework, a demolition
or dismantling Ihereof, will be more than IhiAy-six �36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Ttle 8, Califomia Atlministrative Code).
❑ As owner-builtler, I vnll nol employ anyone to do work which wnuld
require a permit from the Division of Intlustrial Safety, as noted above, unless
such person has a Oermit to do such work from Ihe division.
nppiicanfs SignaWre Da�e
Division o( Industnal Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuWre building occupant need b fle antl
certiFy a Business Plan for emergency response to release or threatenetl
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of Ihe California Health and Salety 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 dunng a reportetl
year a quamity of hazardous materials equal to or greater tnan a weight of
500 pounds, or a volume ot 55 gallons, or 200 cubic leet o( compressed gas
at standard �emperature antl pressure�.
2. Dces or will the applicant or present or fuNre building occupant need to file
a registralion fortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, with some
exceptions, requires reqisiration wi[h ihe Costa Mesa Fire Depahment by
each business which at any one lime has on hand a quan[ity of aculely
hazartlous materials equal to or greater lhan a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet o! compresse0 gas at standard
temperature antl pressure).
3. Does or will the applicant or present or tuture building occupant need to
prepare an RMPP (Risk Management and Prevenlion Program !or acutely
hazardous materials)? ❑ Ves ❑ No
(Section 25534 ot ihe Califomia Health antl Safely CoOe provides thal the
Costa Mesa Fire Departmen� may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register awtely hazardous malerials with the Fire Department.
4. If an RMPP is presently required. has Section 25534 of the Califomia
Health and Safery Code been fully complied with? ❑ Yes ❑ No
5. Does or will lhe applicaN or present or tuNre building occupant require (or
�he work which is the subject of lhis aOPlicalion a permit for such cons[ruction
or modification from lhe South Coast Air oualiry Management District or from
any other air pollution wntml districl or agencyl ❑ Ves ❑ No
(Section 658502 of the Califomia Govemment Code requires Mat the requesled
infortnation be fumishetl on applications for rroo-residential building permits).
6. Will any part of the facility to be conslructed under this permit be within
1000 (eel from the outer bountlaries of a school? ❑ Ves ❑ No
Q('yes", the lacilily musl meet the requirement of Sections 25534 antl 42303
of the California Health an0 Safely Code).
7. If a permit from lhe South Coasl Air Quality Management Districl or other
air pollulion control disirict or agency is required for the vrork which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", anach certifiwte of compliance trom the appropriate air pollution
wntrol officer). � �
CERTIFICATE OF COMPLIANCE: I ceitify that under penally of perjury the
intormation given above is correct. I agree to wmply vrith all sWte laws and
ciry ordinances reqarding Hazardous Matenals antl Emissions.� '_�
Signalure
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury thal I have read this application and slate lha[
the intortnation given is correcl. I aqree to comply with all state laws and city
or0inances relating lo building construction, and authorize represenWlives of
Ihe Ciry of Cos[a Mesa to eNer upon Ihe above-described property for
inspection purposes. I agree not 10 xcupy or allow occupancy of any building
au[horizetl by lhis pertnit Unlil (nal inspeclion. ,
SignaWre of Legal Ox py� '
(
" AnClor Autno ' Applicam . Oa e
' CITY OF COSTA MESA
BIIILDING DIV/SION
77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (71d) 754-0856 • w.wv.ci.costa-mesa.ca.usF�8-0�258
- FOR INSPECTIONS CALL: (7�4) 754-5626
FIRE SUPRESSION PERMIT
JobAddress: 555 ANTON BL . Status: 'ISSUED
Suite: 1000 �,� ; �- . , � Applied: 10/23/2008
Vicinity: KMJ CORBIN AND CO, SPACE 1000 -, l '"1 � - � � Issued: 71/10/2008
Parcel Nunmber:
ApplicanC
Address:
Owner:
Address
Contractoc
Address:
Plan Check:
Permit:
Other:
Total:
41050110 .�`;'. � `:�Zoning �`-'�� � ��� - ` �
`,,;,f. _ . . .- - - � � .
BUTCHER, BRIAN �
2505 MIRA MAR AVENUE r �
,.4+: e,":: '� Phone: 562-498-6444 XT 22W y.' -�
LONG BEACH;`CA ;'� Zip; g0815 - ' . " _ � ,
RREEF , ': - i
PO BOX 4900 -,F � . .1. i ' ' ,- - � .'` -� ` � � � •
i. ;
OEPT207 '..'-`�'�' .`�- � � Phone: - � - .� .. ,
SCOTTSDALE: AZ . . - - - Zip: 85261-4900 ' �
INTEGRATED PRODUCTS AND SERVICES INCORPORATED DBA CAL PROTECTION'
2505 MIR.4 MAR AVENUE . - _ , � _ _ _
- ..- -- �'. Phone:. 800 247-64_97 - - . . - .. ,. . , ,
LONG BEACH, CA � 2ip: 90815_� . � � r � � --- ' � .,, , ,
... . - � License: -909573 � � . . . .
�' � ' SCOPE OF PERMIT ,:%
FIRE UPGRADEFIRE LIPE SAFflTY SYSTEM FOR A 14,876 SF-INTERIOR.TI�FOR "KMJ CORBIN &
CO", SPACE 7000. REF#: BC08-00409. � ' -.
. i-' '�;.,; , -
, . ,.
, .
- , FEE SUMMARY `
$287 46 , . . ,Calc Valuation: gzs,�ai.00
$442.25 , - _ - ° Claimed Valuation:' $2s,�ai.00
$0.00 " - . , ' .
$729.71 ,
NOTICE: The work authorized by this Oermit shall comply with all applicable handicap access requirements under Califomia sfatutes and re�ated
repulations. (Ord. No. 92-28. § 1, 12-21-92) ' - ��
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � �
INSPECTIONS: In order for lhe work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all
�equfred inspections and Nnal approval must be obtained. Failure to obtain inspections and final approval will result in the ¢xpiraGan of this permit.
S�noe�. ixsrecnoxTrre gg� iNnnn�s CODE� ixsrEcnoxrrve g�g � ixmu�s
1618 FixeC System Final Fire Preven�ion
1Z88 Pool SOa Final
200 Final Re-Roof .
T01 Final BIotWRetaining Wall
Z(12 Final Faclory Fire Place
203 FinalSign
20a Final Demolition
208 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevenlion
220 Final Pfanning Approval
222 Final Site
250 FinalBuilding/Occupancy
la-�1�-0� �
' d b��l,t%
WORKER$' COMPENSATION DECLARATION: � �
I hereby a�rm unCer penalty W peryury one of ihe following declara[ions: ,
❑ I have antl will maintain a certificate of consent to self-Insure for vroikers'
compensation, as provided for by.section 3700 of the Labor Code, for the
pedormance of the work lor which t�ls permit is issued.
❑ I have and will malntaln workers' compensation insurance, as requirad by
section 3700 of the Labor Code, for ihe peRortnance of the work for which Ihis
permit is issued. My vrorkers' compensation Insurance carrier and policy
number are:
fCamer:• M IQ RS }{ (% $ /Q
(This secYbn neetl �rof Oe mmpletetl tl fna peimrt a valve0 at one nundretl tlollars (Sf00) a less.)
�POlity Number. ��� g7.s�
❑ I certify that in ihe peAormance of the work for which ihis permit is
issuetl, I shall not employ any person in any manner so as to become subjec[
t0 Ihe vrorkers' compensation laws o( Califomia, and agree [hat if I shoultl
become subjecl to lhe rkers' compensa[ion provisions of Section 3700 of
Ihe Labor , I sha hwi c ly with Ihese provisions.
l/-��°e-nr�
Ap iwnfsSignaWre Date
WARNING: FAILURE TO SECURE�WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($700,000), 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 affrm that I am licensed under provisions of Chapter 9(commencing
wilh Seclion 7000) of Division 3 of the Business antl Professions Code, and
my license is in full torce and e((ect. /�
Lic. #- ��-.Class # — �0 l — �
//-/D'OS�
oNra � s i 1 re Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that there is a constmctbn lending agency fw the
pertortnance of the v.ork fv wfiich this pertnil is issuetl. (Sec. 3097, Civil Code).
Lenders Name:
Lender's Address:
Date
OWNER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalty of peryury that I am EXEMP7 FROM THE
CONTRACTORS LICENSE LAW for lhe following reason (Sec. 7031.5.
Business antl Professions Code: Any city or wunry which requires a permit to
construct, alter, improve, Oemolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such permit to file a signed slatement
that he or she is licensed pursuant lo the provisions of the Contractors
License Law (Chapter 9(commencing wilh Section 7000) o( Division 3 ot Ihe
Business antl Prolessions Cotle) or t�at he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Seclion 7031.5 by any
applicant for a permit subjects the applicant to a civil penalry ot not more than
five hundred dollars ($500).):
❑ I, as owner of lhe property, or my employees with vrages as their sole
compensation, WILL DO THE WORK, antl ihe structure is not in[ended or
offered for sale (Sec. 7044, Business and Professions Code: The Contrectors
License Law dces not apply to an owner of pmperty who builds or improves
thereon,�and who does such vrork himselt or herselt or through his or her own
employees, provided that such improvements are not intended or oftered for
sale. If, however, the building or improvement is sold within one year ot
completion, the ovmer-builtler will have lhe burden ot proving ihat he or she
did not build or improve for purpose of sale.). ,
❑ I, as ovmer o1 lhe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to constmct Ihe project (Sec. 7044, Business antl
Professions Code: The contractors License law dces not apply to an ovmer o(
properry who builds or improves thereon, and who cont2cts for such project with
a contracta(s) license pursuant to the Cont2c[ors License Laws.).
❑ I am ezempt under sec.
Business and Professions Code for this reason:
SiBnature oa�e
305]-a6 (3/W )
Owner ID venfieU by Arive� _.,cense. ❑ Ves ❑ No
Driver's License No. F�pires:
� Venfcation of Ownership by (type of tlocument, i.e. - property tax bill or deed):'
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . '
❑ I hereby certBy that no excavation frve (5) w more feet in deptti into wfiich a
person is required lo descend, will 6e made in connectbn vrith vmrk authonzed
by this permit, antl that no huilding sWcture, sca((dding, falsework, or tlemolition
or dismantling thereof, vrill be more than thiAy-six (36) fee[ high. (Chap. 3.2, Grp
2. M 2, Sec. 341, Tlle 8, Califomia Administrative Code�. •
❑ As owner-builtler, I will no[ employ anyone to tlo vrork which would
require a permil fmm the Division of Intluslrial Safely, as noted above, unless �,
such person has a permit to do such work from the division.
Apoliranfs SignaWre Date
Division of Industrial Safely Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant need to file and
certity a Business Plan for emergency response to release or Ihreatened
release of a hazarclous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Sa(ery Code requires, with some
exceptions, thal 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 quantiry of hazardous materials equal ro or greater than a weighl ot
500 pounds, or a volume ot 55 gallons, or 200 cubic feet of compressed gas
at 5landard temperawre and pressure).
2. Does or will the applicant or presen[ oi future building occupanl need to fle
a regisiration form for acutely hazartlous matenals7 ❑ Ves ❑ No
(Section 25533 of the Cali(omia Health and Safety Code, with some
exceplions, requires regislration with the Cos[a Mesa Fire Depahment by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal ro or greater than a weight of 500 pountls, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or presen[ or (uture building occupanl need to
prepare an RMPP (Risk Management antl Prevention Program for aculely
hazardous ma[erials�? ❑ Ves ❑ No
(Section 25534 0( the Califomia Health and Safery Code provitles that the
Costa Mesa Fire Department may require the preparation, cerlifcation antl
fling vrith the Fire Department of an RMPP by businesses which are requiretl
to register aculely hazardous materials with the Fire DeOartment.
4. I( an RMPP is presently required, has Section 25534 of the California
Health and Sa(ety CoOe been fully complied wi[h? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require lor
the work which is lhe subject of this appliwlion a pertnit for such construclion
or motlification from Ihe South Coast Air Qualiry Management District or Irom
any olher air polWtion control district or agency? ❑ Ves ❑ No
(Sectbn 658502 of the Califomia Govemment Cotle requires Ihat the requested
intwmation be fumished on applications fa nOn-residential building pertnits�.
6. Will any part of the facility to be constructed untler l�is permil be within
1000 (ee[ from the outer boundaries of a school? ❑ Yes ❑ No
Q('yes", the faciliry must meet the requiremen[ of Sections 25534 antl 42303
of the Califomia Heallh and Safety Code).
7. If a permit from Ihe SoNh Coast Air QUali[y Management District Or oNer
air pollution control district or agency is required for the work which is Ihe
subjecl o( this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certificate�of compliance from the appmpriate air'pollution
control oKcer). � •
CERTIFICATE OF COMPLIANCE: I�certify that under'penalryblperyury the
information giyen above is.correcL I agree to comply with all state laws and
city ortlinances regarding Hazardous Materials and Emissions. ��
Da�e •
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury Ihat I have read Ihis application and state that
the in(ortnation given is covect I agree to comply with all state laws and city
ortlinances relating to building construction, and aWhorize representatives of
Ihe City of Costa Mesa to enter upon Ihe above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this pertnit until fnal inspection , �,
Si ur legalOwn ) Dale
- // /O-0 �
nE/or iba OG�i�'ant Dale
— L
CITY OF COSTA MESA �
BYILD/NG DIVISION
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754d856 • www.ci.cosfa-mesa.ea.usFOB-OOZ6Z
�, FOR INSPECTIONS CALL: (714) 754-5626 .
�,�.,.s'
FIRE SUPRESSION PERMIT
JobAddress: 555 ANTON BL
Suite: 1000
Vicinity: SPACE 1000, KMJ CORBIN AND CORBIN
Parcel Nunmber: 41050110
,4pp�icam: MORENO, ANNA . , '
Address: 37912 CYPRESS GLEN., �
IAKE ELSINORE, CA
Owner. RREEF , �
Address PO,BOX 4900 , � � � �
Zoning:
Phone:'�� 951-244-9836
Zip: ' �92532
Status: ISSUED
nPPrea: �omnooa
is:�ea: iinonoaa
DEPT207 � ' . Phone: � - . . �
SCOTTSDALE, AZ . , Zip: 85261-0900 . -. �� �
Contracror: ALL PRO FIRE PROTECTION"
Address: 31912 CYPRESS GLEN - ' -
� � Pbone: 951-244-9836 � � � � -
LAKE ELSINORE, CA . Zip: 92532 �- - ' ' _ - .
. � . License: 629993
SCOPE OF PERMIT
FIRE SUPPRESSION PERMIT TO RELOCATE 100 FIRE SPRINKLER HEADS FOR�AN INTERIOR TI FOR
"KMJ CORBIN & CO", SPACE 1000. REF#: BCOS-00409. ' . . . - � .
' FEE SUMMARY
Plan Check: $117.81
Permit: $181.25
Other: $0.00
Total: $299.06
Calc Valuation: sio,000.00
. Claimed Valuation: Sio,000.00
NOTICE: The work auNorized by this permit shall comply with all applicable handicap access requiremenLa under Califomia sWlutes and related
regulations. (Ord. No. 92-28, § 1, 12-21•92) � .
EXPIRATION: PERMIT EXVIRES 180 DAVS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. -
INSPECTIONS: In order for lhe work authwized under this permit to be considered legal, such work musl comply wiUi all applicable codes, and all
required InspeCtfons and final approval must be obtained. Failure to oblain inspections and final approval wili result in ihe expi2tion of this permit.
CODE �. INSPEL7NIM TYPE PdIF L�i+S 44PE2 INSPEGTIOM TYPE QLT� �
1818 Fixed Systam Final Fire Prevention 206 Final MechaniWl '
1288 Pool Spx Final 208 Final Plumbing
2q0 Final Re-Roof 210 Final Electrical "
207 Final Biock/Retaining Wall 212 Final Fire Prevention �
202 Final Facbry Fira Place 220 Final Planning Approval
203 Final Sig� 222 Final Site � �,/
p0q FinalOertwlilion 250 FinalBuildinyOccupancy ��ve �
WORKERS' COMPENSAiION DECIARATON:
I hereby aRrm under penalty oi perjury one of Ne tollowing declarations:
❑ I have and will maintain a cert�cate of wnsent to self-Insure'for workers'
compensation, as provided tor by section 3700 of t�e Labor Cotle, for the
peAormance of the work for which this permit is issued.
❑ I have and will maintain v,orkers' compensation insu2nce, as requirad by
section 3700 of the Labor Code, ta Ihe peAortnance of the v.ork lor which I�is
pertnit is issuetl. My vrorkers' cryryryPPP pensation Insurance carner antl policy
number are: �� f /" �� �
Carrier:�.- h ��p� ( q�
� lTlussedarneaAndEawnroMlaO/y`Y"I �I ' I�IV L� Odars(5�00)akxs.)
Policy_Number: I ��j
❑ I certify that in [he pedortnance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
to ihe workers' compensalion laws of Califomia, antl aqree thal if I shoultl
be subject to the workers' compensation provisionsIof Seclion 3700 0l
the r Cotle, I sh�{�1�({hyryh���,s�q�q�p�y wilh Ihese prou�i�an��'�
�� I ��Vlf/YIU I
AppliGanl's $Ign3iwe .. Dale
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($700,000), IN ADDRION TO THE CAST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
A7TORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed untler provisions of Chapter 9(wmmencing
with Section 7000) of Division 3 of lhe Business and Professions Code, and
m licens is'�/nl��tyf{/F(�o(��ce d eRect. �_/�
Lit: #" l. L l l a I
Class #
� ZD �
,ConUac�or'sSignaWre , Date
CONSTRUCTION LENDING AGENCY:
❑ i hereby aRmn that there is a consWction IerMirg agency fa the
per(ormance of the v.ork for wfiich tlris pertnit is'ssued. (Sec. 3097. Civil Code).
Lentler's Name:
Lentler's Address:
Sigrwwre Daie
OWNER-BUILDER DECLARATIONS:
1 hereby aKrm that under penalry of perjury that I am EXEMPT FROM THE
CONTRACTORS 4CENSE lAW for Ue lollovring reason (Sec. 7031.5,
Business and Professions Coda: Any city or wunry which requires a permit to
conswct, alter, improve, demolish, or repair any slrucwre, prior to its
issuance, also requires the applicant lor such permit lo file a signaC stalemenl
ihat he or she is liCensetl pursuant to the provisions o( I�e Coniractors
License Law (Chapter 9(wmmencing vrith Section 7000) ol Division 3 0( lhe
Business and Pro(essions Code) or lhat he or she is exempt therefrom anC
the Dasis lor me allegetl exempGon. Any violation of Section 7031.5 by any
appliwnt for a permit subjects lhe applicant lo a civil penally of not more than
fve hunOretl Collars ($500�.�:
❑ I, as owner of the propeAy, or my emplayees with wages as Iheir sole
wmpensalion, WILL DO TME WORK, and the slructure is not intended or
oHered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of praperty who builds or improves
thereon, antl who Oces such wvrk himself ar hersell or through his or her ovm �
employees. provitled that such improvements are not intentletl or offered for
sale. If, however, lhe building or improvement is solC within one year ol
completion, Ihe ovmer-builder will �ave the burden of proving that he or she
tlid not builtl or improve far purpose of sale.).
❑ I, as owner o( lhe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to consln�ct the project (Sec.,7044, Business and
Protessions Code: The contraclas License Law dces not apply lo an owner ol
property v.fio builds or improves Ihereon, and wfio wntracts ta such projecl vrith
a cmtracta(5) license pursuant lo the Contraclas License Laws.).
❑ I am exempt untler sec.
Busine55 and Profe55ion5 Code for �his reason:
SignaWre Da�e
9059J6 (3I01)
Owner ID verified by drive� ...�cense. ❑ Ves ❑ No
Driver'S License No. Expires: �
Verification of Ownerehip by (rype of documenl, i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation frve (S) w more feet in tlepth into wfiich a
person is requiied lo descentl, will be made in connection with work aulhorizetl
by this permit, and �hat no building slrucWre, scaHdtling, falsexork, ar demWition
or dismantling Ihereol, will be more Ihan �hirty-siz (36) feet �igh. (Chap. 3.2, Gry
2, Art 2, Sec. 341, Ttle 8, Califomia Administralive Code).
❑ As owner-builder, I will not employ anyone lo do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such per5on has a permit lo do such work Irom the division.
Applionl's Sig^ature pa�e
Division of Induslrial Sa(ety Permit Numbe[
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will 1he applicanl or present or future building occupant need to fla and
certify a Business Plan lor emergency response lo release or threatenetl
release ol a �azardous material? ❑ Yes ❑ No
(Section 25505 0! lhe Calilomia Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Departmant by every business which has at any one lime during a reported
year a quantily of hazar0ous materials equal ro or greater I�an a weight of
500 pountls, or a volume of 55 gallons. or 200 cubic (eet of wmpressed gas
at slandartl IemperaWre and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registralion form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of lhe California Health and Safety Code, with some
exceptions, requires registration with Ihe Costa Mesa Fire Department Dy
each business which at any one time has on hand a quantiry of acutely
hazartlous matenals equal lo or greater than a weight of 500 pountls. or a
volume of 55 gallons, or 200 cubic teet of compressed gas at slandartl
temperaWre and pressure).
3. Does or will Ihe applicanl or presenl or future builtling occupant need lo
prepare an RMPP (Risk Management and Prevenlion Progrem for acutety
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safefy CoCe provides thal the
Cosla Mesa Fire Depariment may require the preparation, certificaGon and
filing with the Fire DepaRment of an RMPP by businesses which are required
to register acutely hazar0ous materials with Ne Fire Department.
4. If an RMPP is presently requireA, has Section 25534 0( Ihe Califomia
HeaIN antl Sa(ery Code been fully complied with7 � Yes ❑ No
5. Dces or will the appliwnt or preseN or fuNre building occupant require for
lhe �+ork which i5 the SuDjetl o( lhi5 aOP���GOn a pertni� for SUch conSWCIiOn
or modification from the South Coasl Air Qualiry Management District or Imm
any other air pollution control districl or agencyT ❑ Yes ❑ No
(Seclbn 65850.2 0l the Califomia Govemment Code requires thal the requeste0
informatbn be tumished on applications !v non-residential builtlug pertnils).
6. Will any part ol ihe facility to be wnsiructed untler this pertnit be within
1000 feet from Ihe ouler boundaries of a school? ❑ Ves ❑ No
(II yes". �he tacility mus� meet lhe requirement of Seclions 25534 and 42303
o( lhe Cali(omia Health and Safety Cotle�.
7. If a permit Irom tha South Coasl Air Qualiry Management Dislrict or other
air pollution control tlisincl or aqency is required for t�e wvrk which is the
subject ol this appliwtion, have all ot the disclosures prescribeA by Califwnia
Health and Safety Code Section 42303 been made7 ❑ Yes ❑ No
8. jlf yes', atlach certificate of compliance Irom the appropriate air pollution
control officer�. � �
CERTIFICATE OF COMPLIANCE: I•certify�lhat untler penalry of perjury lhe
information given above is wrtect 1 agree to wmpty wilh all sWte.laws and
city ordinances regartling Hazardous Materials and Emissions. ,
� SignaWre Oate
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penally of perjury ihat I have read this application and stale that
ihe inlortnation given is covecl I agree to comply with all state laws and ciry
or0inances relating lo building construction, and authorize representative5 of
the City of Costa Mesa [o enter upon the above-tlescribed properry for
inspection purposes. I agree not lo occupy or allow occupancy of any builtling
authorized by Ihis permit until final inspeclion. . .
Signawre o�ep� q(�e�5y� ^„„� D ', a�e _��
••�'�II%W�l (rV
V ME�IX Apl�Onzetl NOW�u��� /-� W le
l__
4
• CITY OF COSTA MESA �
BYILDING DIVISION
77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 •�w+w.ci.costa-mesa.ca.us
FOR INSFECTIONS CALL: (714) 754-5626 .
PERMIT TYpE: B COMBO
Sub Type: COM_ALT
�oe n��REss: 555 1000 ANTON BL CM
APN: 41050110 �
Vicinity: SUITE 1000
Const Type: I-A SQ. FT:
Zoning:P �,C
[i7
PERMIT NUMBER: BC08-00409
• � � ,.
STATUS: ISSUED
DATE ISSUED: 1012112008
ISSUED BY:
S u ite/U n it: 1000
Primary Occ: B • •
� � Valuation: $436,163,80
SCOPE OF WORK: IN7ERIOR Tf FOR "KMJ CORBIN & CO", SPACE 1000 WfTH 307 LIGTH FIXTS, 125 OUTLETS, 70 SWITCHES,
18 NON-RE$ APPL, 2 MOTORS TO 1 HP, 1 MOTOR TO 10 HP, 7 VAV BOX, 1 FIRE DAMPER, 1 SMOKE DAMPER, 1 AIR
HANDLER, 2 ICE/SODA CONNECT, 2 KITCHEN SINKS, 2 WTR HEATERS. ��[f $7 C� S,f•�
OWNER: RREEF
Phone:
APPLICANT: SALERNO, SCOTT
Phone: 714-932-3137
Address: PO BOX 4900
City/State2ip: SCOTTSDALE, AZ
Address:
City/State/zZip:
cONiRnc7oR: AMARON�CONSTRUCTION CORPORATION License No. 674301
Phone: 714-993-9220 Address: 1565 N HARMONY ClUnit:
Cell: City/State: � ANAHEIM HILLS, CA
ARCHITECT:
ENGINEER: .
License No.
License No.
COMBINqTION PERMIT FEE SUMMARY
Building Plan Check: $1,872.62
Building Fees: $2,880.95
Electrical Fees: $519.46
Mechanical Fees: � - $12320
Plumbing Fees: � " $82.30
SMIP Residential: � . $0.00
SMIP Commercial: $91.59
TOTAL FEES: $5,570.12
"Refer to fee re�eipis for all foes pald �or proJoct
Unit: DEPT 207
Unit: :
ZipCode 92807
PHONE:
PHONE:
NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1. 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order (or the work authorized under this permit [o 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 aDProval will result in the expiration of this permit.
400E /. INSPEGhON TYVE
t818 FiaeO System Final Fire PrevenGon
i286 Pool Spa Final
200 Final Re-Root
201 Final BIocWRetaining Wall
202 Final Faclory Fire Place
203
204
FinalSign
Final Oertwlition
gAIE L�.3
COOE� INSPELlIONTYPE
208 Final Mechanical
208 Final Plumbing
210 Final Electncal
2/2 Final Fire Prevention
220 Final Planning App�val
222 Final Site
250 Final Building/Occupancy
.� u.
� ° lt
� ���
Y�; �. e1i�
WORKERS' COMPENSATION OECLARATION� �
I he2by aHirm under penalty of perjury one o( ihe o lowmg declarations: ,,
❑ I have and will maintain a certificate af wnsent to self-lnsuie for workers'�
compensatlon, as provided for by sectlon 3700 af the LaDor Code, for Ihe
peAormance of the work for which this permit is issued.
❑ I have and will mainWin workers' compensatbn insurante, as required by �
seclbn 3700 of the Labor Code, fa the peAortnance of lhe v.ork fa wfiich Ihis
pertnit is issued. My workers' wmpensalion Insurance carrier and policy
number are:
f
(.�,�,a,��«- 2��� our� FrE � ct�s u.��
V�(TMs secfon naetl iroi Ea tnmplatatll fhe pa�m4 is vahktl al vre nunWMOOEars (5�0�1 a IesSJ
Polic, Nu� er. �""��'f'0 �D� %�/pZaB �
❑ I�certify that in Ihe peRortnance of the work for vRiich this permil is
issuetl, I shall not employ any person in any manner so as to hecome subject
to the workers' wmpensation laws of Califomia, and agree that if I should
become s �ect lo lhe rs' wmpensalion provisions of Section 3700 of
Ihe La odC,LShal ort t� comply wilh ihese provisio�n�s.q
l�sy�-�f� � Of�T 6.�
App nfc5ignawre Da�e
j n
WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPIOYER TO CRIMINAL
PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S
($100,000), IN ADDfTION TO THE CAST OF CAMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE L4BOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions ol Chapter 9(wmmencing
wit� Section 7000) of Division 3 of the Business and Professions Code, an0
my license is in full force and effect. ,-�
Lic. # � � rClass # 1S^ � -
d ��i � �J 2� (� �
�ractds S�g�alure � _ Date
�
CONSTRUCTION LENDING AGENCY:
❑ 1 he2by affmn Ihat the2 i5 a tonstruction lending agency fw lhe
peAormance of the �+ork ta v.fiich tlris pertnit is issued. (Sec. 3097, Civil Code).
Lender s Name:
Lenders Address:
OWNER-BUILDER DECLARATIONS:
I hereDy aKrm that under penalry of perjury lhat 1 am FJ(EMPT FROM THE
CONTRACTORS LICENSE LAW (or the (ollowing reason (Sec. 703t.5,
Business and Prolessions Coae: Any ciry or wunry which reduires a permil to
conswct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the apPliwnl (or such pertnil to file a signe0 statement
Ihat he or sha is licensed pursuanl lo lhe provisions of the Contractors
License Law (Chapter 9(commencing with Seclion 7000) of DiviSion 3 0l lhe
Business and Professions Code) or lhat he or she is exempt therefrom and
the basis for ihe alleged exemption. My violation of Section 7037.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
fve hundred dollars ($500).):
❑ I, as owner of the property. or my employees wilh wages as Iheir sole
compensation, WILL DO THE WORK, and the struUure is not intendetl or
ofteretl for sale (Sec. 7044, Business antl Professions Code: The Contractors
License Law does not apply to an owner of pmperty who builds or improves
thereon, and who dces such work himself or herself or Ihrough his or her ovm
employees, provided ihat such improvements are nol inten0etl or offered for
sale. If, however, ihe building or improvement is sold within ona year of
completion, the owner-builder will have the burden ol proving thal 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 wnstruct lhe project (Sec. 7044, Business and
Protessbns Cotle: The wntraclors License Law dces not�apply to an ovmer of
property wfio builds or improves thereon, and who contracls fw such project wilh
a cOntrdcta(s) license pursuaN to the Contraclds License LawS.).
❑ I am exempt under sec.
Business and Protessions Code for this reason:
305Pa6�101)
r
Owner ID verified by driv�cense. ❑ Yes ❑ No � ,
Driver's License No. F�pires:
Venfcalion o( Ownership Dy (lype of tlocumenl, i.e. - property taa bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �. -
❑ I hereby ceAify that no excavation frve (5) w mwe feet h tlepN inio vrtiich a
person is requiretl to tlescend, will be matle in wnnection with xork auttqrizetl
by Ihis pertnit, antl that no building structure, scaHdtling, falsexork, or demdition
or dismanUing thereof, will be more than tkrty-sa (36) (eet high. (Chap. 32, Grp
2. M 2. Sec. 341, Tille 8. Califomia Atlminislrative Code).
❑ As owner-builCer, I will not employ anyone to tlo work which w0ultl
require a permit Irom the Division of Industrial Safely, as notetl aGove, unless
such person has a permil to tlo such vrork (rom lhe Oivision.
nopinnt's SO^a�ure Date
Division ol Industrial Safely Permil Numher:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or preseN or fuWre building occupant neetl to fle antl
certily a Business Plan for emergency response lo release or threatened
release of a hazartlous material? ❑ Yes ❑ No
(Section 25505 of Ihe Califomia Health and Salery Cade requires, with some
exceptions, thal a Business Plan be filetl with the Costa Mesa Fire
Depanment by every business which has at any one time during a reportetl
year a quantiry of hazardous materials equal to or greater than a v.eight of
500 pounds, or a volume o( 55 gallons, or 200 cubic teet of compressed gas
al standard temperature antl pressure).
2. Does or will the applicant or present or (uture building occupant need ro file
a registration fortn for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of Ihe California Health and Sa(ery CoCe, with some
exceplions, requires registration wilh the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry of acutety
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressetl gas at standartl
[empe2Nre and pressure).
3. Does or vrill the applicant or present or (ulure building occupant need to
prepare an RMPP (Risk Management antl Prevention Prog2m for acutely
hazartlous malenals)? ❑ Yes ❑ No
(Seclion 25534 0l the California Health an0 Safety Cotle provides that Ihe
Costa Mesa Fire Department may require the preparalion, certification and
filing with the Fire Departmen� o( an RMPP by businesses which are requiretl
lo register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently require4 has Seclion 25534 of the Calitomia
Heallh antl Safe[y CoOe been fully complied with? ❑ Yes ❑ No
5. Does or will lha applicaN or present or future building occupant require lor
the v.ork vmicn is the subject of this application a permit for such construction
or modification (rom lha South Coast Air Quality Management DisMc� or trom
any other air pollution control tlistnct or a9ency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires that the requesle0
inlormalion be fumished on applications fa noo-resitlential Duildirg pertnits).
6. Will any parl of the facilily lo be constructetl untler this permit be wi�hin
1000 feet from Ihe outer boundaries of a school7 ❑ Yes ❑ No
Qf'yes", Ihe (acility must meet the requiremenl of Sections 25534 antl 42303
of Ihe Calilornia Health and Salety COde�.
7. If a pertnit Irom the South Coasl Air Qualiry Management District or other
air pollWion control district or agency is required lor Ihe vrork vmich is the
subjact ol this application, have all of Ihe disclosures prescribed by Califomia
Heallh and Safe[y Code Section 42303 been made� � � Yes � No
8. (I('yes", attach certifcate of compliance from the appmpriate air polNtion
coNrol oKter). ' ' - " �
CERTIFICATE OF COMPLIANCE�: I certify thal under penalry of perjury the
information given above is correcL I agree lo comply wilh all. slatedaws and
city ordinances regarding Hazardous Materials and Emissions. , �
SipnaWrc . Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state Nat
Ihe intormation given is correcL I agree lo comply, with all slate laws and city
ordinances relating to building construction, anG authorize representatives ot
the City of CoSta MeSa t0 enter upon Ihe above-0escribed propetly (or
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by Ihis permit until fnal inspeclion. � � �,
� naWrealLega meqs) � Da1e
�E�i _ �/oz�a�
� A�M/wAul�ot ¢GAppliWnl �pale �
1
Ci_ Y OF COSTA MESA
P.O. BOX 1200 ' 77 FAIR DFiIVE ' CALIFORNIA 92628�1200
DEVELOPMENT SERVICES DEPARTMENT
�obe�e
Application for Temporary Certificate of Occupancy
BUILDING AND SAFETY
(PrinVType Only) /
Address: `7 � 5 ��`'�N �( z� Permit Number: ��C��— �1 /i � � `7'
Business Name: ���� 1(.l iVl P2�Y?��«:S Telephone: %�`f� �7 32; 3 i 3�7
Building Owner q
Name: �Q��f!C �y��,'�I�i'�'l�V;e��
Address: '�J�% S r� �`'-^U'�'1 � ��%
c�ty: �,;�.-!� ���P s/� c � z�P:
Telephone: ( %/ `'f ) -% � � — C� Z� �
This Use Would Be Described As:
Business Oqwner�/Manager/Contractor ,
Name: �4/ �-i'� �C�S'�'-(�C�'r� r.)
Address: �� 5 ��'v-+T�`+-%���U
c�cy: ( r:,/n n,(��� C� z�P:
Telephone: C r�`� 1�'! �7 Z—�J � 3�
❑ Newly Constructed Building ❑ Change of Owner ❑ Change of Occupant
❑ Exisling Building ❑ Change of Use ❑ Additional Occupant
Obtain Electrical, Engineering, Fire, Planning, Building's Approvals or Final Inspections
� ENGINEERING
BY:
DATE
❑ FIRE \ �
BY: %
DATE
❑ PLANNING �J T.C.O. — BUILDI
�
BY: DATE BY: DATE J—%— O O
Request is hereby made for temporary use and occupancy on t above project for a time period of 60 days only.
1 am fully aware of Section 110.3 of the 2007 CBC which states that no building or structure shall be used or
occupied until the Building Official has issued a Certificate of Use and Occupancy for the buiiding, or portion of the
building. I also understand that the fee is for administrative and inspection cosis.
It is understood and agreed that this approval, i( granted, will become void after 60 days, at which time a permanent
Certificate of Use and Occupancy will be granted or occupancy terminated if construction is not completed within 60 days.
Who will take responsibility to handle this marier to conclusion and will call for final inspection?
Name of � Telephoneq �p
Responsible Party (print name): S��'� � � �C-C�72r'^''� number: ! % ( - `� 3 �Z � 3 � 3 �
Reason For Request: ' Cash Deposit = Z hrs X 547 =�
'�r%� D�� S �ZY (� � Z`12 �'���-c G-� Di; fz F\�
Signature: . ,E�L9� _—�
Print Name: ��� S�Q'�-�'P�`-��
❑ Owner _ Authorized Agent Date: ��'�� H G�
Telephone Number. %�y —�3z-3i 3�
Building Division (714) 754-5273 ' FAX (714) 754-4856 • TDD (714) 754-5244 • v�,vw.ci.costa-mesa.ca.us
. 2_28-46 (rev_ v08)
�- " w
. _ , � . ;
� •
CITY OF COSTA kESA
BI/ILD/NG D/V/SION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • �wrN.ci.wsta-mesa.ca.0
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER. BC07-00514
PERMIT TYPE: B COMBO
Sub Type: COM_ALT
STATUS: ISSUED
DATE ISSUED: 02I0612008
- ` ISSUED BY: RMD
�OB ADDREss: 555 120 ANTON BL CM � .� ^ Suite/Unit:. 120
APN: 41050170 " � Zoning: U '� � �� �
Vicinity: SP E 120 Primary Occ: B
Const Type: I-A � � � SQ. FT: � 0 � ' � � ° Valuation: $122,412.60
SCOPE OF WORK: 3,752 SF INTERIOR T.I. FOR "PLATINUM PROPERTIES", SPACE 120. ELEC; MECH.
OWNER: RREEF . - � Address: ��POBOX4900 � Unit: DEPT207
Phone: � , ' . . City/State/Zip: SCOTTSDALE, AZ � � �
APPLICANT: KEN BOBICK _ ' ' Address: , �- ' � � _ Unit :
Phone: 714-9323142 ,. f , � City/State/zZip: y ' � . ,
� . -ij�'{:�.
CON7RACTOR: AMARON CONSTRUCTION CORPORATION License No. 674301 ,
Phone: 714-993-9220 � �' � � � - � � Address: � 1565 N HARMONY ClUnit: � �
Cell: , City/State: ANAHEIM HILLS, CA � - ZipCode 92807
ARCHITECT: � ' - Litense No. � � - ' t � '� � �. PHONE: �-
ENGINEER: � - - �License No.� � ' . � �� -- - PHONE: �
f•'
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check: $729.66
Building Fees: � . � $1,122.55� � .
Electrical Fees: - � - . � � $7628 �
Mechanical Fees: � - . . � - $75.25 � _ .�
Plumbing Fees: $0.00
SMIP Residential: $0.00'
SMIP Commercial: � - $24.60 - '
TOTAL FEES: $2,028.34
"Reter b fee reteipls for all fees paid for project ''_ � , ' ��
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statules and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
UE / INSPELTION ME DATE INTITIALS fi0� PECTION TVP AiE INlill L -
1816 Fixed System Final Fire Prevention ZO6 Final Mechanical��.(� �
1266 Pool Spa Final . 20B Final Plumbing c
200 Final Re-Roof 210 . Final Electrical 3(.�f�_�_ C.�
201 Final BIocWRetaining Wall 212 final Fire Preven�ion
202 Final Factory Fire Place ZZO Final Planning Approval
203 FinalSign 222 FinalSite y� tC�
204 Final Demolition 250 � Final Building/Owupancy �//� t
'T
WORKERS' COMPENSATION DECLARATION�
I hereDy aKrtn under penalty of perjury one of Ne following declarations:
❑ I have and will maintain a certificate of wnsenl to sell-Insure for workers'
Comperysalbn, as provitletl for by section 3700 ot tha Labor Code, for the
pert ance of the v.ork for which this permit is issued.
I have and will maintain v.orkers' canpensation insurance, as required by
sectbn 3700 of lhe labor CoCe, for tne peRortnance of the work fa which this
pertnit is issuetl. My wnrkers' compensation Insurance wrrier and policy
number ar -I /� -(;�
Carrier. _y��/ Y�CKJU �i V'c�� I,(� i'� 1i1 —'J11J
(Tnissecwnnead oecampetetlame'k7�r�mea/�a^7eEal ehur�c�etltla'lars( 00)wiess.) �
PolicyNumber. � oZ�.�� / -y�-,L-
❑ I certi(y that in Ihe peAormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
to Ihe workers' compensalion laws of Calitornia, and agree that if I should
become subject to the vrorkers' compensation provisions ot Section 3700 of
Ihe Lab e. I shall forthwi�mply ' these provisions
AppliulnYS$ignaNre �e �
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S
($100,000), IN ADDRION 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 hereDy aHirm thal I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of ihe Business and Professions Cotle, and
my license is yin full force and /gNect.
Lic. # / � ! Class #
Gommc�or' ignaw Da
CONSTRUCTION LENDING AGENCY:
❑ I hereby affrtn lhat there is a constructbn lentling agency fw the
peAortnance of the v.ork la wfiich Ihis pertnit is issued. (Sec. 3097, Civil Code).
Lentler's Name:
Lender's Address:
SignaWre ���
OWNER•BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalry of perjury Ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe (ollowing reason (Sec. 7031.5,
Business and Professions Code: Any ciry or counry which requires a permit to
conslruct, aller, improve, demolish, or repair any Slrottur8, prior to ils
issuance, also requires Ihe applicant for such pertnit to file a signed statement
that he or she is licensetl pursuant to the provisions of the Contrectors
License Law (C�apter 9(commencing with Section 7000) of Division 3 0l the
Business and Professions Cotle) or that he or she is exempt therefrom antl
the basis for lhe alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjecls the applicant lo a civil penalry of not more Ihan
five hundred tlollars ($500).):
❑ I, as owner ot the property. or my employees wit� wages as Iheir sole
compensalion, WILL DO TME WORK, and the structure is not intended or
offered lor sale (Sec. 7044, Business and Professions Code: 7he Contractors
License Law tloes nol apply to an ovmer of property who builds or improves
lhereon, and who does such work himself or herself or through his or her ovm
employees, providetl thal such impmvements are not imended or otfered for
sale. If, however, the building or improvement is sold vrithin one year of
completion, the owner-builder will have the burden of proving Ihat he or she
did not build or improve for purpose of sale.).
❑ I, as ovmer ol lhe property, am EXCLUSIVELY CONTRACTING WI7H
LICENSED CONTRACTORS lo consWct the project (Sec. 7044. Business and
Professions Code: 7he contractors License Law dces nol appty to an ovmer ot
pmperty wfio buiWs or improves thereon, antl who contracts ta such project v.ith
a contractor(s) license pursuant to the Cont2ctors License Lavs.).
❑ I am ezempt untler sec.
Business and Pmfessions Code for this reason:
SigiuWre Date
]051�d61310�)
�
� �
Owner ID venfietl by tlriv.. . lict.. _❑ Yes ❑ No
Driver's License No. Expires:
Verifcalion of Ownership by (rype of tlocument, i.e. • pro0erty tax Eill or Aeed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cetlAy Ihat no excavatbn frve (5) w more feet � tlept� into wfiich a
person is required to descend, vrill be made in connection wiN work authonzeC
by this permil, and that no building sWcture, scaffdding, false�wrk, ar tlemolition
Or dismantling ihereof, will be more than ihirty-5iz (36) feet high. (Chap. 3.2, Grp
2, M 2, Sec. 341, Title B, Califomia Administralive Code).
❑ As owner-builtler, I will nol employ anyone to tlo work which wrould
require a permit Irom the Division of Induslrial Safety, as noted a6ove, unless
such person has a permit to tlo such work from the division.
Applicant§ Sigwlure Date
Division of Indusirial Safety Permil Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupaN neetl to file antl
certily a Business Plan for emergency response to release or Ihrealened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safery Code requires, with some
exceptions, Ihat a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time tluring a reported
year a quantity of hazardous matenals equal ro or greater t�an a weight of
500 pountls, or a voluma of 55 gallons, or 200 cubic feet of compressetl gas
at stantlarG temperaNre and pressure).
2. Does or vrill Ihe applicant or present or tuture building occupant need to file
a regislration form for acutety hazartlous matenals? ❑ Yes ❑ No
(Seclion 25533 of ihe Calilornia Health and Sa(ety Code, with some
eaceptions, requires registration wi[h the Costa Mesa Pire Department by
each business which at any one lime has on hand a quantity of acutely
hazardous materials equal to or greater than a weight ol 500 pountls, or a
volume of 55 gallons, or 200 cuDic /ee[ of compressetl gas at standard
temperalure an0 pressure).
3. Does or will the applicant or present or fuWre building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials�? ❑ Yes ❑ No
(Section 25534 0( ihe Califomia Health antl Safety CoCe provides that Ue
Costa Mesa Fire Department may require [he preparation, certification antl
filing with Ihe Fire Department of an RMPP by businesses which are require0
lo register acutety hazardous materials with the Fire Department.
4. I( an RMPP is presenUy required, has Section 25534 of the Cali(omia
Health and Safety Code been fully complietl vrith? ❑ Yes ❑ No
5. Dces or will the appliwN or present or fuwre builtling occupam require for
ma work which is the subjecl of this appliration a permit (or 5uth COnstruction
or modi6cation from the South Coast Air Qualiry Management District or from
any other air pollution control distric� or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia GovemmeN Code requires that the requestetl
in(ortnation De lumished on applitations fa rron•resitlential builtling pertnits�.
6. Will any part o( the facility lo be wnslructetl under this permit be vrithin
1000 feel Irom the outer bountlanes o( a school7 ❑ Yes ❑ No
(If'yes', the facility must meet the requirement of Sections 25534 antl 42303
of t�e Calilomia Health and Satety Code).
7. If�a parmil from Ihe South Coast Air Quality Management District or other
air pollution coNrol disMct or agency is requiretl for Ihe v+ork which is Ihe
subjecl of this application, have all of the disclosures prescribed by California
Health and Satety Cotle Section 42303 been made? � Yes ❑ No
8. Qf "yes", attach cenificate of compliance trom Ihe appmpnate air polNtion
contml oKcer).
CERTIFICATE OF COMPLIANCE: I cenify that under penalty of perjury the
information given above is correcL I agree to comply wit� all state laws antl
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTMORIZATION OF ENTRY: I
certify untler penally of perjury that I have read lhis applicatlon and state that
the intortnation given is correct. I agree to comply with all state laws and city
ordinances relaling to building wnstruction. antl authorize representatives of
Ihe Ciry of Cosla Mesa to enter upon the above-described property tor
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by ihis permit until final inspection. -
SignaWre alOwn )` ' te
AnOIOrAu zMAO���n le
Cl�� Y OF COSTA MESA �
P.O. BOX 1200 ' 77 FAIR DRIVE ' CALIFOflNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT � �0
T. C.O.
D O
Application for Temporary Certificate of Occupancy
BUILDING AND SAFETY
(PrinUType Only) / f1 �/
Address: ��� ,��h-5 �l �v Permit Number: �� ��"' �J h _5 I `7'
Business Name: �'l�'}"1 UYV1 P� L�Y�.✓ L� Telephone: ���r ��Z� 3) 3 `
Building Owner nnA
Name: R� MY'� �l�� � �
Address: '�J�� 1=�✓`-�IM ��
City: �f>��A/t� S�' CA Zip:
Telephone: {'7/ �) 7~ � — � Z� �
This Use Would Be Described As:
Business O^wner�/Manager/Contractor ,
Name: ,�Yl ��DJ �Pr1� rK-wL' �[� �
Address: �� S �-�a`�-�����
c�cy: G�S-1;�. h.(� c 4 C a z�P:
Telephone: (�� � 1(7 ?J Z—.3 � 3�
❑ Newly Constructed Building ❑ Change of Owner ❑ Change of Occupant
❑ Existing Building ❑ Change of Use ❑ Additional Occupant
Obtain Electrical, Engineering, Fire, Planning, Building's Approvals or Final Inspections
❑ ENGINEERING
BY:
DATE
❑ FIRE ` �
BY: %
DATE
❑ PLANNING [f�T.C.O.—BUILDI
BY: DATE BY: DATE `J —%— O D
Request is hereby made for temporary use and occupancy on t above project for a time period of 60 days only.
1 am fully aware of Section 110.3 of the 2007 CBC which states that no building or structure shall be used or
occupied until the Building Official has issued a Certificate of Use and Occupancy for the building, or portion of the
building. I also understand that the fee is for administrative and inspection costs.
It is understood and agreed that this approval, if granted, will become void after 60 days, at which time a permanent
Certificate of Use and Occupancy will be granted or occupancy terminated if construction is not completed within 60 days.
Who will take responsibility to handle this matter to conclusion and will call for final inspection?
Name of Telephone�,1 � c� � 2 3 �-3 %
Responsible Party (print name): �Ge�� ALtyd2P�� number: � �
Reason For Request:
Cash Deposit = Z- hrs X$47 =�
Authorized Agent
(Ph�l� N OF�
PrintName: ��� ���� TelephoneNumber. %��—�32-313�
Building Division (714) 754-5273 • FAX (714) 754-4856 • TDD (714) 754-5244 • www.ci.costa-mesa.ca.us
2928-46(rev.1/OB)
_, �
. �
CITY OF COSTA MESA _ �
BI/ILDING O/V/S/ON
. . �
77 FAIR ORIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • waw d.c sta-mesa.p.0
FOR INSPECTIONS CALL: (714) 154-5626
PERMIT NUMBE 607-00751
PERMIT TYPE B_MISC STATUS: ISSUED
DATE ISSUED: 07123I2007
= : - � ISSUED BY:
- �r•� � - r • - _ -
JOBADDRESS: 5551ANTON,BL�CM., � . -+<-: ;„Suite/Unit.:---`1,
Vicinit : 1ST FLOOR ' -` ` � � �Y` �
y .;,,.. �.� . .'. ; . _ ;. . .. - � - Brimary:Occ�.',. . t , Const Type:??
SQ. FT: 1597 ` ' " _ -- � " Valuation - ', $3,000:00
,''r . ` i . . ,
�
� � ' , r
SCOPE OF WORK: CONSTR�UCTION T`(PE�IFR. INSTALL FILING SYSTEM FOR "WOODRUFF, SPRADLIN 8 SMART"ON 1ST
FLOOR (1,597 SF). REF.: B07-00746. ' -�i�..�� .
. ,'i�,�, . � ,
i ;:
OWNER: RREEFAddress: � -� �� �- PO BOX 4900 Unit:DEPT 207
PHONE: '' " ,; . � � . � - ' .City/S[ate/Zip: � ' SCOTTSDALE, AZ
APPLICANT: BAGDONAS, AUSRA � � _- Address: �` 4770 CAMPUS DR UniCSUITE 100
PHONE: 949-701-4685 :• '- CitylState/zZip: NEWPORT BEACH, CA
CONTRACTOR: AMARON CONSTRUCTION CORPORATION .. �� License No. 674301 �
Address: 1565 N HARMONY ClUnit: � . � . � - . , � PHONE: 714-993-9220 �
City/State: ANAHEIM HILLS, CA � ZipCode: 92807 � � CELL: .
ARCHITECT: KERRY P WILSON-� ' � -- -License�No.C19204 � . �- - PHONE:949-8513080
ENGINEER: � �-� , License No. � � � � . PHONE: �
MISCELLANEOUS PERMIT FEE SUMMARY -: �_ � -..
Building Plan Check: , ' $54.11 � -, , . � "
Building Permii: � - $83.25 � � ' ' ,
Electrical Permit: $0.00 ' ` � �
Other Fee: $0.00 ; , _ ._ _ � .
SMIP Residential . _ � $0.00 ' -�- - � „ . . �
SMIP Commercial $0.63
TOTAL FEES =` ,$83.88 , , -� ii ` -
NOTICE: The work authorized by this permit shall comply with all apP���ble handicap access requirements under Califomia slatutes and related
regulatlons. (Ord. No. 92-28, § 1, 12-21-92) � ,
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such vrork must comply with all appliqble codes, and all
required inspections and final approval must be obWined. Failure to obtain inspections and final approval will result in the expiration of this permil.
400E 1. INSPEC710N TYPE
1818 Fixed System Pinal Fire Prevention
1288 Pool Spa Final �
200 Final RrRoof
207 Final Block/Retaining Wall
202 Final Faaory Fire Place
203 Fnal Sign
2(M Final Demolition
RT INIIMLS 4QQf,j INSPECiIONTYPE
208 Final Mechanical
208 Final Plumbing
210 Final ElecUical
272 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupanty
Qll E N R
�GY// %��1L.
+' /1/� . / �
WORKERS' COMPENSATION DECLARATION:
I hereby aKrtn under penalty of perjury one o( the t���wring declaretions:
❑ I have and will maintain a certificale ot consent ro self-Insure tor,workers �
compensation, as provideE for by section 3700 of the Labor Code. (or the
pe ance of Ihe work for which ihis permil is issued.
I have antl vrill maintain v.oilcers' compensation insurance. as requiretl by
sectbn 3700 of the Labor Code, for the pedormance of the v.ork !a wfiich this
permit is issued. My workers' compensation Insurance carrier and policy
nu `�L,��,— /J
Ca ' . . TI /`�'Y� � /n /X
(Tlus safon neM rof Ee canWMM ifhe pemvt u r�luetl at me �urM�ed cbfarslSt001 a kssJ
Policy Mumber: � 6�% � Q� — 2 80 .L�
❑ 1 certify that in the pertormance ol tha work for which Ihis pertnil is
issuetl, I shall not employ any p@rson in any manner so as to bewme suGject
to the workers' c�mpensation laws o( Califomia, and agree that if 1 should
bewme subje to the vrorkers' compensation provisions of Section 3700 of
the Labor � de, I shall foRh � com 1�'lh lhese provisions.
�
� ro ' gnawre � e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CAVERAGE
IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAAMGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS D�CLARATION:
I hereby aKrm that I am licensetl untler provisions o� Chapter 9(commencing
with Seclion 7000) of Division 3 of the Business antl Protessions Code, and
my license is in full force and eH�cl. �
�
L c Class
�va r's Signa� "� � %
CONSTRUCTION IENDINCa AGENCY:
❑ I hereby affum that there is a construction lending agency fa the
peAortnance of the v.ork for which this permit is issued. (Sec. 3097, Civil Code).
Lender s Name:
Lender's Adtlress:
Sipna:ure Date
OWNER-BUILDER DECLARATIONS:
I hereby aHirm �hat under penally of perjury thal I am EXEMPT FROM THE
CONTRACTORS LICENSE LqW lor the following reason (Sec. 7037.5,
Business and Professions Code; Any city or counry which requires a permil to
consWct. alter, improve, tlemolish, or repair any slmcWre, prior ro its
issuance, also requires the appli�nl for such permit to file a signed statement
that he or she is licensetl pursuant to lhe provisions of the Conlrectors
License Law (Chapter 9(wmmencing with Seclion 7000) of Division 3 of lhe
Business and Professions Code) or Ihat he or she is exempt there(rom anC
the basis for the allegetl exemption. Any violalion of Section 7037.5 by any
applicant for a permit subjects the appliwnt to a civil penalry of not more than
five hundred dollars (5500).):
❑ I, as owner of Ihe property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is nol intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contrectors
License Law tloes not apply to an owner of property who builds or improves
ihereon, and who dces such woiic himself or herself or [hrough his or her ovm
employees, provided that such improvements are not intended or oRered tor
sale. II, however, ihe building or improvement is sold within one year ot
completion, the owner•builder will have Ihe burden of proving Ihat ha or she
did not build or improve for purpbse of sale.).
❑ I, as ovmer of t�e property, am E%CLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to croswct lhe prqecl (Sec. 7044, Business and
Professbns Code: The cont2ctors License Law does not apply to.an owner of
property who builtls or improves thereon, and wfio contracts for such project wilh
a cmtracta�s) license pursuant to the Contractors License Laws.).
❑ I am eaempt under sec.
Business antl Professions Code (or this reason:
- SiBruwre Dale
305]>6�107) �
�
Ovmer ID venfied by driv� nse. ❑ Yes ❑ No
Driver's License No. Ecpires:
� Verificatlon o( Ovmership by (rype ol tlocument, i.e. - property tax hill or tleedj:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: � �
❑ I hereby certify that no excavalion frve (5) w more feet in depth inlo wfiich a
person is required to descend, will De made in connectbn with work authorizetl
by this pertnit, and that no building structure, scaffdding, false�wrk, a demolition
or tlismantling thereof, will be mpre than Ihiny-si�c (36) feet high. (Chap. 32, Grp
2. M 2. Sec. 34t, Title 8. Calitomia Administrative Code).
❑ As owner-builder, I vrill not employ anyone to do vrork which vrould
require a permit from lhe Division of IntlusMal Safery, as noted above, unless
such person has a permit lo do such work from Ihe division.
Appliranfs S�gnaWre Dale
Division of InOustnal Safety Permit�Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or future Duiltling occupant need lo fle and
certify a Business Plan (or emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of ihe Califomia Health antl Safely Cotla requires, with some
exceptions, that a Business Plan he filed with the Costa Mesa Fire
Oepartment by every business which has at any one time during a reported
year a quantity ol hazardous materials equal to or greater than a weight of
500 pounds. or a volume of 55 gallons. or 200 cubic leet of compressed gas
al standard temperature anG pressure).
2. Does or will Ihe applicant or present or fuNre builtling occupant neetl to file
a registration (orm for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safery Code, vrith some
eaceptions, reduires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry of acutely
hazartlous materials equal to or greater than a weight of 500 pounCs, or a
volume of 55 gallons, or 200 cubic feet of wmpressed gas at standard
remperature antl pressure).
3. Does or will the applicant or present or Nture building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous matenals)7 ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Code provides that the
Costa Mesa Fire Oepartment may require the preparalion, certification and
fiiing with the Fire Department of an RMPP by businesses which are required
to register awtely hazartlous materials with lhe Fire Department.
4. If an RMPP is presentty requireC, has Section 25534 of the Caffornia
Health an0 Safety Code been fully complied with? ❑ Yes ❑ No
5. Dces or will Ihe applicant ar present or future building occupant require for
the work which is Ihe subject of ihis application a permit (or such construction
or modification Irom the South Coast Air Quality Management District or (rom
any other air pollution control tlistrict or agency7 ❑ ves ❑ No
(Sectbn 65850.2 of the Califomia Govemment Code requires that lhe requestetl
intwmatbn be fumished on applications far rornresitlential DuiWing pertnits).
6. Will any part o( the facility to be wnsWcted under Ihis permit be wiNin
1000 feet from the outer boundanes of a school? � Yes ❑ No
Qf yes", the faciliry must meet the requirement of Secfions 25534 anC 42303
of the Califomia Health and Satery Code�.
7. 1( a permit from the South Coast Air �ualiry Management Districl or other
air polWlion conlml tlistrict or agency is requiretl for the work which is lhe
subject of Ihis applicatioq have all of the disclosures prescribetl by Califomia
Health and Safety Code Seclion 42303 been made? ❑ Yes ❑ No,
8. •pf yes", attach certificate of compliance fmm the appropriate air polWtion
wntrol oKcer). . �
CERTIFICATE OF COMPLIANCE: I certify Nat under penalry of perjury the
information given above is corcecL I agree�to comply with all sfate laws and
ciry'ordinances regarding Hazardous Materials antl Emissions. '
Signalure Daie
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have reatl �his appliwtion and S�ate �hat
the infoRnation qiven is correcL I agree to comply with all state law5 and city
ordinances relating to building wnswction, and authorize representatives ot
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
au[honzed by this permit until final inspection. . -
ignaWmolLegal �5) Oale
MMo uthon eE icanl le
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(714) 754-5273 • Fex (714) 754-4856
CITYOFCOSTAMESA ��--' ����
evno�N6 oms�oN
DEVELOPMENT SERVICES DEPARTMENT ��`�
PERMIT
MECHANICAL PERMIT
JobAddress: 5rJ5 ANTON BL
Suite No 1
Vicinity: GROUND FLOOR
Parcel Number: 4� 0507 � 0
npp�icant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE CA� �
owner: SAKIOKA FARMS
Addreas: � �. � �
Contractor: AIR CONDITIONING CO., INC
Address: 6265 SAN FERNANDO RD
ArchlEng:
Address:
GLENDALE CA
Phone: 818-244•6571
Zip: 91201
Phone:
Zip: 94137
Phone•. '. 818-244-6571
Zip:'..91201 '
License: 120696
Phone:
2ip:
License:
� ,.
- - ,
PER�
M99-00'I 08
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/0911999
Issued: 03I09/1999
SCOPE OF PERMIT
INSTALL 4 F�RE DAMPERS AT THE GROUND FLOOR REF B99A0185 AND M99-00068.
ISSUE FEE
Insl FAU <100 k BTU
Inst FAU >100 k BTU
Repair I Alt CoolinglHeat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
56.50
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$26.00
$0.00
$0.00
$0.00
$0.00
80.00
$0.00
Quantity
FEE SUMMARY
Repair I Alt Absorbtion Unit
Repair I Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercial I ncineretor
Domestic Incinerator
Compressors / Absorption Svstems
Upto3hp/100kBTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 Ta 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15 to 30 hp
30 to 50 hp - � �
Over 50 hp
Other Mechanical Fee-
Investigation Fee
� Plan Check Fee
Reinspedion Fee
TOTAL CALCULATED FEES
COMMENTS I SPECIAL CONDITIONS
QuanUty
50.00 0
$0.00 0
so.00 0
$0.00 0
so.ao 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
50.00
$0.00
50.00
532.50
EXOIRATION: This permit shell eutometicaly expire end become vold if work is not commenced wlthin 180 days, or If work is suspended or flbendoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under thls pertnit to be considered legal, such work must comply with ell applicable codes, and ell
requlred Inepectlona end flnel approval must be obtained. Failure to obtain Inspeetions and final approval will resuit in the expiration of this permfl.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS'COMPENSATON DECLARATION:
I hereby eifiim untler penelry of perjury one of the fdlowing tleclaretlons:
❑ I heve end will maintain e certifrate ot consent to self-Insure for workers' compensatlon, es proNtled for by aectlon 3700 of the Labor Cotla, for Ihe pertortnence of the
�vrork tor w�ich ihis pertnif is issued.
I have and wN mantein workers canpenseUon insurexe, es requireC by secllon 3700 of ifie Lehor Code, for the pertortnance of ihe work tor wttitl� this pemdt is IsweC.
My workers' compensatlan Insurance cartier antl polity number ere:
Certier: Pdicy Number.
(7hls sectlon need not be completetl i1 Ne perm/t !s ve/ued et one huntlretl tlollars (S700J or less.) ' '
❑ I certify t e peAortnanca of the work lor which Uis pertnit is issued, I shell not employ eny perom In eny manner ao es to Decome sub�ect to 1he workers'
compe sallon law f Celifamie, entl epree t�et I1 I should become sub�ect to the workers' campensetlon provisions of Sectlon 3700 of the Lebor Cotle, I sheil fort�with
/°°� esepro isions.
pplicen7l t38oeWre ' � Dete�:� �/Gf/�
WARNINO: FAIL�i CURE WOFKERS' COlAPENSATIIXJ C EM�E IS UNLAWFUL AND SW�LL SUBJECT AN EMPLDYEHTO CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNDRED
?FDUSWiQ�OLIARE(f100,000),INFDDITIONTOTMEOOSTOF PENSATION,DAMAOESPSPROVIOEDFORINSECTION3]OBOFTHEUBORCODE,INfERESf,ANDATTORNEY5FEE5.
LICENSEO CONTRACTORS DECLARATON:
I h@reby�eNirsri. et I e licensed under proWsians at C�apter 9(commencing wlth Sectlon 7000) ot Divislon 3 of.the�Bueiness entl Professions Code, entl�my Iicense is in full
�ce end eHect. �c. a Class /tt� G� L D
Contrectofs Signetu � pa16: ifi_,r � yd ��p�T
CONSTRUCTIO LENDING AGENCY:
❑ I hereby eHirm Ihet there is e constructlon lentling egen�y for Ne pertormance ot the work tor which Ihis pertnit Is issuetl. (Sec. 3097, CINI Cotle).
LenCera Neme: Lenders Address:
Signature:
Date:
OWNEP-BUILDER DECLARATIONS:
I hereby eiflrtn t�et untler penelry of per�ury that I am E%EMGT FROM THE CONTRACTORS LICENSE LAW tor Ihe follawing reason (Sec. 7031.5, Buslness end Professions
Code: Any Clry or counry whiCh rOQuires a permit l0 conswct, elter, impmve, demolish, or repair eny strucWre, pdor to Its Issuance, Blso requires the eOP���e�t lor 5uch perm0
ta flle e signetl stetement ihet he or she is IlcenseU pursuent lo the provislons of the Contrectora LJcense Lew (Chepter 9(commencing with Sectlon 7000) of Division 3 of the
Buslness entl Professions Code) or that he or she is e:empt Ihereirom and ihe Dasis lor the elleged exemptlon. Any vloletion o1 SeMion 7031.5 by any epplicent for e Dermi�
subJects ihe eppllcaM to e civil penalry o1 not more Ihen flve hundretl dollers ($500).j:
❑ I, es owner of the properry, or my employaes with wapes es their sole compensetlon, WILL DO TNE WORK, end Ihe strucWre is not Intended or ottered br sele (Sec.
7044, Business enC Professions Code: The Contrectors Llcense Lew does not epply ta en owner af property w�o hullds or improves Nereon, end who does such work
hlmself or �erself or t�mugh his or her own employees, pravitled Nat such improvements ere not IntenCetl or olferetl for sale. Ii, however, t�e bulltling or Improvemem is
salA wit�ln one year ot completion, the ownervbuiltler wi0 hava t�e burAen of praring that he or she tlIG not build or improve for purpose of SaleJ.
❑ I, es owner of the properry, am E%CLUSIVELY CONTAACTING WRH LICENSED CONTRAC70R5 to construIX Ihe projecl (Sec. 7044, Business end Protessions
Cotle: The contrflctors LJcense Lew tloes not appty to an owner ot property who DuilQs or improves Ihereon, and who contracts for such D�olecl with e contraaor(s)
Ilcense pureuant lo the ConVaclors License Laws.).
❑ I em eaempt undBLsec. Business end Professions Cotle tor ihis reason:
Signeture: P I! •
Owner ID veritietl by �r BAe
Vedflcetlon o1 Ownershlp by
❑ No Dnvefs License No.
blll or deed):
Date:
Expires:
DIVISION OF INDUSTRIAL SAFEfV PERMRCEHTIFICATON:
•c�
❑ I �ereDy certlly that no excavatlon Ilve (5) or more feet In depih into whlch a person is requlretl to tlescenq will ba matle in connedion wit� work euthodzed by ihis'�
pertnit, enA thet no builtling 5[Ncture, scaftdtling, Iel9ew0Ac, Or dBmWition or dismentlinp thereoi, wlll be more Ihen thlrry-six (38) leet hlph. (Chep. 32, Gry 2, Art 2, Sec.
341, Tltle 8, Celifomla AtlminisVetive Catle).
❑ As owner-builder, I will not employ enyone to Co work which wauld require e pertnit from Ihe Dlvision o1 Intlustrial Sefery, es noted e6we, unless such person �as e
pertnit lo do such work from Ihe d'Mslon.
SlgneNre: Date: �
Dlvislon ot InUustAal Sefery Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND AIJfHOROA710N OF EMRY: I ceRily untler penfllty of perjury Ue� I �ave read this applicetion end stete thet �he intortnatlon given is
correcl. I epree to compty with all stete laws entl ciry ordinances reletlng ro builtling construction, and eutnodze representelives of Ihe Ciry of Coste Mesa to enter upon Ihe
eDove-dexrlGed Droperry for inspectlon purposes. I epree not to occupy or ellow occupano/ of eny buildinp euthonzed by �his pertnit until final Inspectlon.
COpE �, INSPECTONTYVE QS}E
1818 Flxed System Finel Fire Preventlon
1288 Pool Spe Finel
200 Flnel Re�Roof
201 Flnel Block/Reteining Well
202 Flnel Fectory Fire Place
203 Flnal Sipn
204 Finel Demditlon
Yu6-,e
��$ FQyFj INSFEITONT'PE
208 Flnel Mechanlcel
208 Flnel Plumbinp
210 Flnal EIeclAcel
212
220
272
250
Flnal Flre Preventlon
Flnel Plenninp Approvfll
Final Slte
Finel Buildinp/Occupency
QA� ItiiOlL4
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,. : �
(714) 754-5273 • Fax (714) 754-4856
JobAddress: 555 ANTON BL
Suite: 1
Vicinity:
Parcel Number: 41050110
Applicant: RUDI DI CAMPO
Address:
. CITY OF COSTA MESA 1, �, „✓'" �
BUILDIN6 DIYISION ��
DEVELOPMENT SERVICES DEPARTMENT �
PERMIT
BUILDING PERMIT
Zoning:
Phone: 714-754-1197
Zip:
� �� Status: ISSUED
- Applied: 04/20/2000
Issued: 04/24/2000
ISSUED BY:
PERG;IT NUMBER
:� '
., • .
; I ; B00-00524
77 FAIR DRIVE, COSTA MESA, CA 92626
Owner SAKIOKA FARMS �
Address � � � .� � - � .
. . � �� .- . .. .
` � . .. . , ` Pfione: ' � �
- ' � �- � � ' � - � - - Zip: 94137 � . . :
Contraotor: ACCENT BUILDERS EXpI1��
Address: 555 ANTON BL. #100 -
. , � .. Phone:� (714)549-3150 pA� � .
COSTA MESA, CA .
� Zip: 92626� License: 397790 � : ,
Arch : IA � � � , � . ' � � Eng:
Address: 3080 BRISTOL ST #105 . . . . " Address:- �
� � '� - JPhone: 714-754-1197 - , Phone: �
COSTA MESA,CA - � .
Zip: 92626. , � � ' - License: Lice`nse: ,
_ SCOPE OF PERMIT
. ,�" / RELOCATE OFFICES IN EXISTWG GROUND TENANT FLOOR FOR "EPOCH". �
. FEE SUMMARY
. Plan Check: $300.59 ,,,� ^ , — , ' � , 1 . , Calc Valuation: $s�,s5o.00
Permit $462.45 — - — *; , Claim Valuation: g3o,000.00
SMIP Res: $0.00 � '
SMIP Com: $6.58
Other: $0.00
Inspection: $0.00
Total: $769.62
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
. ��.� - �� . . �
Rear . 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
LeR 0- 0
Left 0- 0
Pr000sed: 0
Right . 0-0
Right 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements undar Califomia statutes and related
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is nofcommenced within 180 days, or if work is suspended o� abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to ba considered legal, such work must comply with all applicable codes, and all
requlred Inspectiona end finel epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS'COMPENSATON DECLARAnON:
I hereby afllrm under penelry oi perjury one ol ihe tollowing tleclaretions: ,
❑ I heve end wikmaintain e ceriificate of consen� to self-Insure for workers' compensa�ion, es proviaetl for by section 3700 of the Lebor Coda, for the {iertortnar�ce of the
� �work lor whlch this permit is issued.
lyl� i have entl wlll maiNein workers�cort�pensatlon insurence, as requiretl by section 3700 of Ihe Labor Code, for ihe pertormance of ihe work for which this permit is issued.
My woJicer;' compqhsation Ins�(fanqj/ cerrle{�end policy number are: . ,
Carrier.
(This sE
� I certtly i�et In ihe pe
compensation laws of
comply wiih ihese �
Applicant SlgnaWra: _
WARNING: FAILURE TO SEC
THOUSAND Dd1ARE 151
LICENSED CONTRACTORS
I hereby aHirm thet I am licen;
force and eHect Lic. # .,
ComractofsSigneWre: _
Policy Number:
of t�e w i for 'vh' i this Der,mit is issued, I shall not employ any person in any manner so es to become subjact to the workers'
and e Ih I �oultl b ome subject to �he workers' compensetion provisions of Sect�i°n 3700 0l the Lebor Code, I shall forthwith
Date: �% �Zy�O�
$A NCOVERAGEISUNLAWFULANDSHALLSUBJECTANEMPLOVERTOCRIMINALPENPLTESANDCIVILFlNESUPTOONEHUNDREO
7NTOTHE TOFCOMPENSAilON,OAMAGESASPROVIDEDFORINSECf1IXJ3%O60FTHElABOROODE,IMEREST.ANDATTOfiNEYSFEES.
wlih Section 7000) ol Division 3 at the Business�ntl Professlons Code, end my license is in full
_ Cless N t5
_ Date: � Z��OU
CONSTRUCTION LENDING AGENCY: ��
❑ I hereby ettirm that ihera is a construction lending egency tor the pertortnance of ihe work lor which this parmit is issued. (Sec. 3097, Civil Code).
LentleYs Name: Lendefs Atldress: �
Signatura:
OWNER-BUILDER DECLAHATIONS:
Date:
I hereby aHirtn ihat under penalty of perjury t�at I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e permit to wnsiruct, elter, improve, demolish, or repelr eny structure, prior to its issuence, also requlres Ihe epplicant far such permit
to tile e slgnetl statemaN that he or sha Is licensetl pursuant to ihe provisions of iha Conirectors License Law (Chapter 9(commencing with Sectlon 7000) ot Division 3 of the
8usiness entl Professlons.Code) or Ihat he or she Is exempt iherefrom and the basis tor the elleged ezemption. Any violation oi Sectlon 7031.5 by any epplicant for e permit
subjects the eppllcanLto a civiYpenalry of not more lhen flve hunLred tlollars ($500).):
lia 9' - 4-f � " ` -
❑ I, es owner of tha propeqy ,or,my employaes�with wages as their sole compensatlon, WILL DO THE WORK, end the strucWre Is not Intentled or oHered lor sale (Sec.
7044, Business and Professions Code:,�Tlie Contrectors License Law does not apply to en owner of property who builds or improves ihereon, and who tloes such work
himsetl or herself or ihrough his or tiei'own�etnployees, provided ihat such Impmvements are not Intentletl or offered for sale. If, however, the building or improvement is
soltl within one year ot comple�ion, the owner�builder will have ihe burden of proving thet he or she did not builtl or improva for purpose of sele.).
❑ I, as owner oi the property, em EXCLUSNECY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business and Professions
Code: The contrecrors Licensa Lew does not �epply to en owner of pmpeny who builds or improves thereon, and who coNrecis for such proJect with a contractor(s)
license pursuant to the Contractors LitenSe Lews.).
❑ I em exempt under sac. eusiness antl Professlons Cotle for t�is reason:
Signature: Date:
Owner ID venTied by drivels licensa. ❑ Yes ❑ No Drivers License No.
Venfication ot Ownership by (rypa ot tlocument, i.e. - pmpeny t� bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Fxpires:
❑ I hereby certity that no excavatlon flve (5) or more feet in tlepth into which a person Is requlred to descend, will 6e made in connection with work authodzed by ihis
permll, antl that no building slructure, scaHolding, falsework, or demolition or dismentling ihereoi, wlll be more than ihirty-six (36) feet hlgh. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celitomia Atlministrative Cotle).
❑ As owner-builder, I will not employ enyone to do work which would require e pertnit Irom the Division of Industrial Safery, as notetl ebove, unless such person has a
permit to tlo such work from the tlivision.
SignaWre: Date:
Division of Intlustnal Sefery Pertnit Number:
CERTIFlCA7E OF COMP CE D AUTHORIZATO F EMAY: I cenify under penalty of perjury that I have read Ihis epplication and slata Ihat Ihe iniormation givan is
correct. I egree m com y wit� all tate I entl ordinances relating to huiltling conslrucilon, entl authonze representatives of the City of Costa Mesa to enter upon Ihe
ebove-descnbed pro rty for ins ct pu . I agree not to occupy or allow occupancy of eny bulldinq authonzetl �y Nis pertnit untll final inspecilon.
COOE I. INSPECTIONTYPE
1616 Fixod System Flnal Fire Prevention
1266 Pool Spa Final
200 Fin91 RB-Roof
201 Final BIocWReWining Wall
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demalition
2M6d6
�F
�
NI TRIALS QQQf,j INSPECTIONTYPE
206 Finel Mechanical
20B Finel Plumbing
210 Final ElBctncel
212 Final Fire Prevention
220 Final Planning Approval
222 Finel Site
250 Final Builtling/OccuDancy
z �-
OfJ
ete
p�TE INTRIRLS
. ;
(
(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
]ab Address: 555 ANTON BL
Suite No 1
�cinity: GROUND FLOOR
Parcel Number: 41050110
Applipnt: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE CA
Owner: SAKIOKA FARMS
Address:
Contractor. AIR CONDITIONING CO., INC
Addre�: 6265 SAN FERNANDO RD
GLENDALE.CA
ISSUEFEE �.+;:?^�
Inst FAU <100 k BTIf:�
Insl FAU >100 k�BTU ;
Repair I All CoolinglHeal
Insl / Rep. ReceSs;WaII�HI
Refrig Sys <100 k BTU,:I
Retrig Sys >700 k BTU:
Gas Piping � '+�� p`
Factory Fireplace X�: -�
Hood w/Mech EzhaustY�i
VAV Box ��, 4..;}S
Vent Fan I Single DucG�b
Appliance
Fire Dampers
Smoke Dampers
Inst or Reloqte Appl Vent
Air Handlers � 10000cFm
AirHandlers> 70000cfm
Floor Furnace
Floor or Suspend Heater
$0.00
$0.00
$O.QO
$O.QO
$26.00
$0.00
$0.00
$0.00
$0.00
$O.Op
$0.00
0
0
0
0
0
0
4
0
0
0
0
0
0
THE
Phone: 81 &244-6571
ZiP: 91201
Phone:
Zip: 94137
Pfione: (81�
AND
ISSUED BY:
14-.y�l �.^Rep'irlAltAbsorbtionUnit
�,_; 1� R�i�ir I Alt Refrigeretion Unil
4+ r � V�'Ventillation Syslem
> Evaporalive Cooler
`�' Commerciallncinerator
Domesfic Incinerator
Comoressors / Absomtion Svstems
UpW3hp/100kBTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp I Over 1,750 BTU
@411C[S
Upto3hp
3To15hp
15 to 30 hp
30 to 50 hp
Over 50 hp
Ofher Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS I SPECIAL CONDITIONS
StatuS: ISSUED
Applied: 03/09I1999
[swed: 03/09/1999
Quantlty
$0.00 0
$0.00 0
$0.00 0
ao.00 0
$0.00 0
30.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
ao.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
532.50
�
�
' � „�I�
►�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia statutes antl related
regulations. (Ord. No. 9248, § 1, 12•21-92)
EXPIRATION: This Dermit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor e period ol 180 days.
INSPECTIONS: In order tar lhe work authvrized under ihis pertnit to be Considered legal, such work must comply with all epplicable cotles, antl all
requlred Inepaetlone and Ilnal approvel mu5t be obtained. Failure lo obtain inspec�ions and final approval will result in t�e expiratlon ot ihis permit.
FOR INSPECTIONS CALL: (714) 75h5626
zane�se lerool
WORKEfiS' COMPENSATION DECLARATION: � !
1 hereby eflirm untler penally ol purjury one of Ihe tollowing tleclerelion5:
❑ I have and will mainlain a cenificate ol consent to self-Insure br workers' compensation, as proviUetl br by section 3700 0l ihe Lebor Cotla, tor Ihe pertormance ot t�e
work tor which Ihis permit is issued.
❑ I �ave antl will maimain workers' compensation insurance, as requireA by 5ettion 3700 ot Ihe Labor Code, lor Ihe pedofmance ol �ho work lar which Ihls pertnii is issued.
My workers' Compensation Insurance carrier and policy numCer are:
Carrier. Policy Num6ar:
(T�is secfion nood nof be cwnp/e�eC il f�e permif is valuetl af one �untlietl tlollars (S i00J oi loss.)
❑ I coni�y Ihal in Ihe pertormance ol Ihe work tor wllich Ihis permil is issuetl, I snall nol employ any person in any manner so es to 6etome sublect to Ihe workers'
rqmpensatian laws ot Califomia, and agree Ihat il I s�oulC Oecome subject to the workors' campensalion provisions ot Saction 3700 ot Ihe LaDor CoOe, I s�all to�hwlih
comply with ihese D�ovisions.
Applitenl Sipnetum: �ate:
WARNING: FAILURE TO SECURE WORKERS' CAMPENSAiION COVEMGE IS UNLAWFU� M'D SHALL SUBJECT AN EMPLOYER TO CtiIMINAL PENALTIES AND CIVIL FINES UP TOONE MUNORED
THOUSAND DOLUPE (EI00.000�, IN 4001TIIXJ TO THE WST OF CpMPENSATION, OAMAGES hS PROVIDED FOR IN SECTIqJ 39W OF TNE IABOR CODE, IMEREST, AND ATTOqNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm Ihat I am licensetl untler pmvisions ol COapier 9(commencing wiih Saction 7000) ol Division 3 0l Ne Business and Prolassions Cotle, and my license is in tull .
force antl eNect. Lic. M Class a
Contrector's Signamre: Date:
CONSTRUCTION LENDING AGENCY:
❑ I horoby aflirm that Ihere is a con5imction lentling agency lor Ihe peAormance ol Iho work for w�ich Ihis permit is issued. (Sec. 3097, Civil Code).
Lendar's Nome: LenOer's Address:
Signeture: Date:
OWNER•BUILOER DECLARATIONS:
I �ereby eflirm that under penelty al perjury thal 1 am EXEMPT FROM TME CONTRACTORS LILENSE LAW for Ihe followinq reason (S
Cotle: Any cily or couNy which reQuires e permit to constmcl, aller, improve, tlemolish, or repair any stmcwre, prior to ils issuance, also
to hle a signetl siatement ihat he or s�e is licensetl pursuam to i�e provisions ol tbe Contractors License Law (Chapter 9 �cOnv'iancing �
Business and Protessions Cotle) or Ihat �e or she is eaempl therelrom entl Ne basis lor Ihe allegetl axemplion. Any Ndetldl W Sectio�
subjocls tha appliwm to a civil penalty ot not more than live �untlred tlollars ($500).�: � (/
❑ I, as owner ol the properry, or my employees wilh wages as t�eir sole compensalion, WILL DO THE WORK, and Ihe BWGWre`k (k
7044, Business ana Professions Code: The Coniractors License Law tices noI appty to an owner d prope�rywho buil69 o16nyru�ie�
himsall or harself or thmugh his or her own employees, provitled i�al such improvemenb ire nd hrtenEetl or OHeretl fOf eBle. tl, ho
soltl wi�hin one year of comDle�ion, Ihe owneo-0uiltler will have Ihe �urden ol proving'pNl he o7ehg CIG np( ppi�tl or imprOve'/M,pyry
❑ I, as owner ot I�e OroOerty, em EXCLUSIVELY COMRACTING WITH LICENSED CONipAGTORS to �uct t�e pro�l,(8ee.
Cotle: 7ha convactors Licensa Law tloes noI apply to en owner ol propeny who builde w Nryrovas Itiereai, flntl w�o contracb for e
license pursuam m the Comractors License Laws.). ��� � `1 - aI /8 �- a 1
❑ 1 am exempt under sec BuelnBee eiW Pmfossions CoOe 1M this ree.sOn: �� !� �.
Signature: I ' - -. � - � I � ., j/ . Date: � �y
� �
Ownar iD verifotl Dy tlriver's iicense. ❑ ves ❑ qo�, _� ��-.` ` DrhsYs Licefine Noi �� �� � G
Verificaiion ol Owners�ip by (Iype ol doqmoem, i.e. � protNrty �I'6ill or tlaW): � � � �/' �'� ��
Business antl Professions
i epplitant br such permit
7000) of Division 3 0l lhe
any appliwnt lor e permit
Bnded or oHeratl lar sale (Sec.
reon, an0 w�o tloes such work
ir, t�e building or improvement is
ol sale.�. '
I. Business and Protessions
pwjeci witn a comractor(s)
Espi�es:
DIVISION OF INDUSTRIAL'SAFETY PEHYtlT,CERTffICATiON:
❑ I �ereby cenify ingliro oxt�evatbn Ms (� or mOro qM hi tlepih inlo vfikfi e pBrson b raquillBtl lo descend, will �e maCe in connedian with work aulhorized by tnis
permil, and that m bidM4g stmciurY?scattoldirp, tWework, or tlemu1f11on or tlismaiHl(np Urereoi, will be more than thiny-siz (36) leel �igh. (C�ap. 3,2, Grp 2, An 2, Sec.
341, Title e, CalRpmle Adminisvative Code). � �' � )• J � ."�
❑ As owner�builder, 1 wlBfnot employ enyone to Co woAt which wpYd �aqube e parmit han the Division ol Industrial Salety, ns notoA ebovo, unless sueh peeson hes a
pormil �o tlo sutli work irom Ihe division. '��.-�' J/ ✓
Signature: � � �~7 . / Date:
i `i F f \ ../
Division ot InOustrial Se}ety P`ertnit Nunber.
HAZARDOUS MATEPoALB'AMD EMISStONS CERTIFICATION:
1 Will Ihe epplicoM p praaent Gr hMo�Guilding octupant nootl lo lil6 antl certity a Business Plan br emergency res0onse to release or threatenotl release ol a hazartlous
mo�eriol? ❑ Ytl, � 0 No ,/
some e�copiions, thal a Business Plan he filea wii� Ihe Costa Mesa Fire Depanment by every
hazartlous matorials equal to or greatar Ihan e waight ol 500 pountls, or a volumo ol 55 gallons.
1 Uoes or wnl 1na applitanl or pres8ni or IUWre buatlmg wcupani nea0 �o hle a ragi5iralion lorm lor acu�aly �azartlou9 melerial57 L1 Yes ❑ No
(Soction 25533 0l Ihe Calitomia Heallh entl Satety Code, wilh some exceptions, wquires regislretion with Ihe Cosia Mesa Fire Depenment 6y eac� business w�ich ai any
ono timo hes on hand a quantiry ol acutely hezertlous me�oriels epual lo or greular ihan o weight oi 500 pountls, or a voluma ol 55 gullons, or 200 cubic leot ol
compressutl qas at standard temperawre ana pressure�.
............................................................._.................. ...._..............__..........__......................................................................................................................................._..................._........__.........................._.............._......._.
3 Doos or will Iho applicant or presonl or IUNre builtling occupanl nee0lo prepara en RMPP (Risk Managemenl and Prevemion Program for acutely hazartlous malerials)7
❑ ves ❑ No
(Section 2553d ot 1he Califomia Health and Salety Code provides Ihat ihe Costa Mesa Fire Oepanment may requira Ihe preparation, certilicaiion and tiling wilh the Fire
Depanment ol an RMPP Dy businesses which are require0lo register acutely hazartlous malerials wiN the Fire Department.
....._ ......................................................................................................_...__.._..........._..__.._............._........................................................................................................................"'........................�.........__.............__....._._..........
4 II an RMPP is presently reQuired, has Section 25534 of Ihe Calilornia Healt� and Saloiy Code hoen fulty complied withl ❑ Ves ❑ No
..................................................................._...._.._.......___............................................................................................._......................................................................................................_...._.........._..........._._..........................._.......__........
5 Does o� will Ihe applicant or preseni or IUN�e builtling occupanl require �or 1he woB which is ihe su�jecl of t�is a�pplication a $ermi� Ior such constmc�ion or motlilica�ion
Irom thB SOuth Consl Air Ouahiy Manageman[ Dislritt or imm eny olhor air polulion conlrol tlistric� or agenq? U Ves u No
(Soclion 658502 ol Iha Cabbmia GOvernm2nt COda reQuires ��ai Ihe reQueste0 intormalion be Wmishetl on epplicetions lor nomresitlontiul builtling permits).
.................._..._....._.._.__..........._...............____".....'__—_'..._........__..........._...._..._..__..._......._........_.._..""'_....._........__.............................._.........._.._........._..... ..........__"" . ......._'_.._._......."_"'__'—_"
6 W ill eny pan ol Ihe �aciliry lo be conSlmcietl untler Ihis permit he wit�in 1000 IeBI IrOm Ihe Ouler boundaries al a school? ❑ Ves ❑ No
(II yes', the facilily must meet the requirement of Sections 2553< and 42303 ot Ihe Cahtomia Healih antl Safety Cotle).
7 If�e permii Irom I�e Souih Coast Air �uality Managemem Dislricl or otner air polluiion coniml�tlisirict�or�agenry i5 required lor Ihe work which is Ihe subject of 1�is
epplicatioq �ave ell ol lhe tlisclosures prescnbed by California Healih antl Salery Cotle Seaion a2303 Deen matle? ❑ Yes ❑ No
.........................................._..........................................._........................_......._.._....._........._._..__.._......._._........................................................................................................................................................................_.........._._........._...
B (II "yes', altach certilicate of compliance trom the appropriate air pollution conlrU oflicer�.
CERTIFICATE OF COM�NCE: I certity that untler penally ol perjury Ihe informaiion given above is correct. I agree to comply with all state laws and ciry ordinances
regartling Hazartlous Msla 15�efitl Emissions.
�.
SignaWre: �y�./ Date:
CERTIFICATE OF COMPLIANCE AND'AUTHORIZATIpN OF EMRV: t cenity under penalty of perjury Ihal I have reatl Ihis application and siate Nat the inlormation given is
wrrect. I agree to comply with all stale laws and city oiCinances wlating lo builtling construction, antl authorize represonlalivos ol Ihe City ol Cosia Mesa to anter upon the
ubov��tlescrihetl pmperty lor inspection purposes. I egroe not to otcupy or allow otcupancy ol any building aNhonzed by Ihis permit until linal inspaction.
SignaWre Of Legal Owner�s)
COOE �. IHSPECTqNTFPE
1616 Fizetl System Final I
1266 Pod� Spa FlM : .
200 . �Finel R/Slioo �
201 � � Flne181aWRatainin�
202 . Flnel Fectory Fire P6
203 'FIn91�Sipn�`J
20C F ni el Demditlon.:..�
AnNOr Authorizatl ApplicaN
e Prevention
�
Wall
m
Q�1jE INiRIALS
�..t„J""�a.-��`\
' /"'\'. .-.�,
CODE� INSPECiIONTYPE
206 Final Mechanical
e . .
� " � 212 ' Rnel F"r� Preventldf�
I
�� � 220 '•. � F4iel PlarrYng Approval
'�• � �Final Site
� t
�.�� 250_FnelBuilding/Ottupancy
Date
�E
�
�
U
(�ia) �sa-s2�s • Fax (�ia) �sa-aess
, - ,,
CITY OF COSTA MESA
BUILDING DIVISION '
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 555 ANTON BL
Suite: 1
Vicinity: PORTION OF 1ST FLOOR
Parcel Number: 41050110
npp�icant: MC CABE, MIKE
Address: 2250 S. CENTRAL AV.
RANCHO DOMIGUEZ, CA.,
owner: SAKIOKA FARMS
Address
BUILDING PERMIT
Zoning:
Phone: (310)763-2112
Zip: 90220
Phone:
Zip: 94137
Contractor: INNER SPACE CONSTRUCTORS
Address: 2250 S. CENTRAL AV.
Arch :
Address:
Phone: (370)763-2112
RANCHO DOMIGUEZ, CA.,
Zip: 90220 License: 366309
Phone:
Eng:
Address:
0
PERMIT NUMBER
I B00-00223
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 02/18/2000
Issued: 02/18I2000
Phone:
Zip: License: License:
SCOPE OF PERMIT
INTERIOR DEMOLITION FOR FUTURE T.I. FOR -BMC SOFTWARE- (PORTION OF 1ST FLOOR). DEMO NON-BEARING
PARTITION WALLS, FLOORING, CEILING, & FINISHES.
Plan Check: $0.00
Permit: $195.25
SMIP Res: $0.00
SMIP Com: $2.19
Other: $0.00
Inspection: $0.00
Total: $197.44
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING E:�stinq: 0
Rear 0- 0
Rear 0- 0
Reouired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
$10,450.00
5io,000.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned
for e period of 180 days.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply wi�h ell applicable codes, and all
requlred Inapectione and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 '
WORKERS' COMPENSATON DECLARA710N:
I hereby aftirtn under penalry oi perjury one ol tha tollowing daderetlons:
❑ I have antl will maintain a certificate of consent to seH-Insure for workers' compansation, as provitlea for by sectlon 3700 ot the Labor Code, tor the pertormance ol the
work for whith lhis permi� i5 i55ued.
antl will maintain workers' compensation insurance, as requiretl Dy section 3700 of the Lebor Cotle, for the peAortnance of the work br which Ihis pertnil is issuetl.
tcers' compensatlon insuranca carder end policy number are: / 3`3 ��^ v.7
2er�U3�.�c_ �..�;>u�v r 7�.–i �PbficyNumber.– –
� need wt be cromplefed i! fhe perm/f fs velued at one hundred dW/ers ($f 00) or less.) �
❑ I certify that In the pertormance ot Ihe work lor which ihis permit i5 i55ued, I 5hell no� employ any person in eny manner 5o a5 �o beCome subjecl to �he workers'
compensation laws of C litomia, an grae thet if I shaultl become subject to the workers' compensation provisions of Section 3700 of the Labor Cotla, I shall forthwith
complywiththese o ions. q �
ApPliran6Signewre:– – � �d'"'[ �S�— �Oate: 2 �,f (00
WARNING:FAILIIHE.TO SEGURE� WJRKERS' WMPENSATION WVERAGE IS UNLAWFUL AND SMALL SU&IECf AN.EMPLOYER 70 CRIMINAL PENnLTIES AND CIVIL FWES UP TO ONE HUNDRED
THOUSAND OOLLARE (S10p.000),IN ADDRION TO TME COST OF COMPENSATION, OAMAGES AS PflOVIOED FOR IN $ECTION 3]O60F THE LABOF �DE, ItJrEFEST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aftirtn tha! I am licensad u er mvisions of Chapter 9(commennng with Section 7000) of Divisi69�of4he.Business and Professions Cotla, and my license is in full
forca and ettecfTLia� � ���1 � �Class a �
' __
ComracmY.s.Signamre:=/�i �-�'G �! / S� Date_ a/� r•v�
� (� 7_
CONS7RUCTION LENDING AGENCY: � ��
❑ I hereby attirtn ihat there is a construction lending agency for the peAormence ot Ihe work for w�ich t�is Dermil is issued. (Sec. 3097, Civil Code).
Lenders Name: Lendels Adtlress:
Signature:
OWNER-BUILDER DECLARATONS:
Date:
I hereby aflirtn that untler penalry oi perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e permit to construc6 alter, improve, demolish, or repeir any siructure, pnor to its issuance, also requires Ihe applicant for such permit
to file a signed stetement Ihet he or she is licensetl pursuent to t�e pmvislons of ihe CONractors License Law (Chap�er 9(commencing wlth SecGon 7000) of Division 3 oi the
Business and Protessions Cotle) or ihat �e or she Is evempt Iherefrom entl the basis for the ellegetl e:emptlon. Any violation of Section 7031.5 by eny epplicant for a permit
sublects the epplicant to e civil panelry af not more Ihan llve hundred tlollars ($500).):
❑ I, es owner of the property, or my employaes with wages es their sole compensation,•WILL DO THE WORK, end the struciure is not intended or offered for sale (Sec.
7044, Business antl Prolesslons Code: The Contrectors License lew tloes not apply to en owner ol property who builds or improves thereon, and who tloes such work
himself or herself or through his or her own employees, provitled thet suc� improvements are not intentletl or otteretl for sale. It, however, the builtling or imprevement is
sold wit�in one year ot completioq Ihe owner-Duiltler will have the burtlen oi proving that he or she did not builtl or improve for puryose of sale.).
❑ I, as owner of the properry. em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the proJect (Sec. 7044, Business and Professions
Cotle: T1ie contreciors Licensa Law does not appty to en owner of property who builds or impmves thereon, and who contrects tor such project with a contracbr(s)
license pursuant to the Comrectors License Lews.).
❑ I am ezempt under sec. Business antl Professions Code for this reason:
Signature: Date:
Owner ID verified by dnvafs license. ❑ Ves ❑ No Dnvers LicenSe No.
Verification of Ownership by (type of documeN, i.e. - property tax bill or daetl):
DIVISION OF INDUS7RIAL SAFE7V PERMIT CERTIFICATION:
Eapires:
❑ I �ereby certlty that no e:cavation five (5) or more feet In tlepth Imo which a person Is requlretl ro tlescend, will be mede in connection wlth work authorized by ihis
permit, and ihat no building siructure, sceHoltling, falsework, or tlemolition or tlismantling thereol, will be more than �hirry-six (36) feet hiqh. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomia Atlminislrative Code).
❑ As owner-builder, I will not employ anyone m do work whlch woultl require a permlt trom the Division ot Intlusirial Safery, as notetl above, unless such person has a
permit to do such wark from the division.
Signawre: Date:
Dlvision of Industnel Satety Permit Number:
CERTIFICATE OF COMPIJANCE AND AU7MORI2ATON OF ENTRV: I certity under penalry of perjury that I heve read this application antl state that the information given is
correct. I agree to compty with all stata laws and ciry ordinances relating to building construction, and authorize representatives of ihe Ciry of Costa Mesa to enter upon the
ahove-tlescribed property tor inspection purposes. I agree not to occupy or allow occupancy of any buildinq authorized by this permit until final inspection.
CODE �. INSPECTION TYPE
1616
7266
200
201
202
203
Fi:ed System Final Fire Prevention
Pool Spa Final
Final Re-Roof
Final BIocWReteining Wall
Finel Factory Fire Place
Final Sign
204 Final Demolition
2M6-46
BAIE It�AL6
COpE 1 INSPECTION TYYE
206 Final Mechanical
200 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222
250
Final Sita
Final Building/Occupancy
�
INTRIRlS
�
(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION ` � ���
DEVELOPMENT SERVICES DEPARTMENT, �I�
PERMIT
Job Address: SSS ANTON BL
Suite: 1
Viciniry: PORTION OF FIRST FLOOR
Parcel Number: 41050110
Applicant: DE OCAMPO, RUDI
Address: 3080 BRISTOL ST.
COSTA MESA,CA
SUITE 105
Owner. SAKIOKA FARMS
Address
BUILDING PERMIT
Zoning:
Phone: (714) 754-1197
Zip: 92626
Phone:
Zip: 94137
Contraaor: INNER SPACE CONSTRUCTORS
Address: 2250 S. CENTRAL AV.
PERMIT NUMBER
I B00-00257
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03I01/2000
Issued: 03/29I2000
ISSUED BY: �V `
Phone: (310)763-2112
�. RANCHO DOMIGUEZ, CA., -
Zip: 90220 License: 366309 . �
Arch : IA , ' Eng:
Address: 3080 BRISTOL ST. Address:
COSTA MESA, CA � Phone: (714) 754-1197 Phone:
SUITE 105
Zip: 92626 , ' License: License:
SCOPE OF PERMIT �
9000 S� FT OFFICE T.I. FOR -BMC SOFTWARE- (PORTION OF iST FLOOR). '
Plan Check: $189.70
Permit: $1,167.35
SMIP Res: $0.00
SMIP Com: $27.43
Other: $0.00
Inspection: $0.00
Total: $1,384.48
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Lefi 0- 0
Lefl 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0-0
8730,625.00
�
Si zs,000.00
NOTICE: The work euthorized by this permit shall comply with all epplicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is no��commenced within 1 BO 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 ell applicable codes, and all
requlred Inapeetlone and finel epprovel must be obtained. Failure to obtain Inspections and finel approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARA710N:
I hereby ettirm under penalry of per�ury one o1 the fdlowing tledaratlons:
❑ I �eve an0 will maintain e cenificate of consem ro self-Insure tor workers' campensation, as provitle0 for by section 3700 of the Labor Cotle. for ihe pertortnance of the
wark for which this pertnit is IssueA.
❑ I �ave enC will mainiain workers' compe�sation insurance, az requiretl by section 3700 of ihe Labor Cotle, tor ihe peAortnanca of Ihe work for which this pertnii is issued.
My workers' com ensallon surence carrier and poli number are: .
Carder. �.r Pollcy Number. I3 I�3 � E ' D%
(Thls section etl not be comp/efetll/ Me pe�mlNsy lued at one hurrdred dollers (S 100) oNess.)
l
❑ I ceNty IhBI in Ihe peAormente ol the work T r which this pertnit is issued, I shell not employ eny person in eny menner so es to become suDject to Ihe workere'
compensatlon lews of Celifamia, entl egree Ihe� if I s�oultl �ecome sub�ect to the warkers' compensetion provislons ol Section 3700 ot Ihe Lebar Catle, I shell lorthwith
wmplywiththese ions. /�
ApplicaniSlgneiura: !� . ��_ �1.tP�t'�- Dete: �� — �-�I — ii A
WARNW�: PAILURE TO SEW RE WORKER5 Q�h1PENSr1T10N COVERAGE IS UNLAWFUL AND SHALL SU&IECi AN EMPLOVER TO CRIAUNAL PENALTIES AND CML FlNES UP TO ONE HUNORED
TIqU5qN0 DOLURE (St00,000�.IN ADDfTIIXJ TO THE COST OF COAAPENSATION, OFMAGES 0.S PROVIOEO FOR IN SEGTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm ihat I am icensed u der pr slons of Chapter 9(commencing with Section 7000) of Divislon 3 ot Ihe Business antl Professions Code, end my license is In full
torce antl eNect. �c. x 6%� O� Ciess a 1� - C`1 - C y - C/ p
CanlractoYs SlgneWre:. . � � �1__. . ✓_/.! Date: /� � ' .i % — � A
CONSTRUCTION LENDING AGENCV:
i❑ I �ereGy eftirm Ihat �here Is a mnswction lending agency for Ihe peAortnance al the work for which this permlt Is issued. (Sec. 3097, Civil Cotle).
� Lendefs Neme: Lentlets Atldress:
Signeture: Date:
OWNER-BUILDER DECLARA710NS:
I hereby eNirm t�et untler penalry of per�ury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the lallowing reeson (Sec. 7031.5, Business end Protessions
Code: Any ciry or counry which requires a pertnil ta canstruct, elter, Improve, demNish, or repair any 5irucNre, pdor to its issuence, elso requires the appliwnt br such pertnit
to tile a signatl statement ihat he or she Is licensed pursuant ro the pmWsions oi the Conirectors License Lew (Chapter 9(commanGng with Sectlon 7000) ol DiNsion 3 ot the
Business ana Professions Cotle) or thei he or she is eaempt Iherefrom and the basis tor t�e alleged ezemption. Any Nolation of Section 7031.5 by eny epplicant for e permit
subleds Ihe applicant to e civil penalty o1 not more t�an tNe hunEred dollers ($500).):
❑ I, es owner of the propeny, or my employees with wages es their sole compensetlon, WILL DO 7HE WORK, end ihe siructure is not intendad or oNeretl for sale (Sec.
7044, Business and Protessions Cotle: Tlie Contrectors License Lew does not epply to en owner ol property who builtls or improves Iherean, entl who tloes such work
himselt or hersetl or through his or her own employees, provided thet such ImprovemeNs are not inten0etl or ottered for sale. If, however, the building or improvement is
sold within one year of completion, �he owner-builder will have the burden of proving that he or she ditl not bui10 or improve for purpose of sale.).
❑ I, es owner of Ihe property, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS lo construct the pro�ect (Sec. 7044, Business flnd Professions
Cotla: 7Te contradors License Law tloes not appty to an owner ot property who builQs or improves thereon, entl who contracts for such project with a contractor(s)
license pursuant to the Contraaors License Lews.). .
❑ 1 am e:empt under sec. Business and Protessions Cotle for t�is reason:
Signeture: Date:
Owner ID veritied by tlnvefs license. ❑ Yes ❑ No Driver's License No. Expires:
Venfication of Ownerehip by (rype of daument, i.a. - property taz blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION:
❑ 1 hereby ceNfy Ihat no excevatbn five (5) or more feet in tlepth Into whic� e Derson Is required �o descend, will be made in conneclion wi�h work aut�orizeG by this
pertnit, entl that no building structure, scaHoltling, talsework, or Oemdltlon or dismantling thereot, will be more t�an �hirry-six (36) tee� �igh. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celitomia AtlministreMe Code).
❑ As owner-�uiltler, I will not employ enyone to do work whlch would require a partnit Irom the DiWsion of Intlustdel Setery, as notetl ebove, unleu such person has a
permit to tlo such work from ihe division. .
Signeture: Dete: �
Dlvisian oi Intlusirial Satery Permlt Numbor:
CER7IFICA7E OF COMPLIANCE AND AUTHORQATION OF ENTRV: I cenity under penelry of perjury Ihet I heve read Ihis epplicatlon end state thet Ihe information given is
correct. I agree to compty with ell stete laws end dry ordinances relatinp to Dullding consiruction, anC authodze representafives ot the Ciry of CaSta Mesa to enter upon the
above-tlescdbed proDerty for InspecNon purposes. I agree not to occupy or ellow occupancy af any bulldinp euthorized by this permit until finel inspectlon.
igneWre Of Le el Owner(s) Date
�_ � \ 1 , ...�Q r'� '� •- 1 4 - � D
MdOr Authonzetl Appliwni Date
COOE �, INSPECTIONTYVE QA¢, �{�j
1616 Fixod System Finel Flre Prevention
1268
200
201
202
203
204
2N8-ae
Pool Spa Finel
Final Re-Roof
Finel BIxWReteining Well
Final Fedory Fire Plece
Final SIBn
Finel Demolition
COOE� INSGECTONTYPE
206 Finel MOChanicel
20B Finel Plumbing
210 Finel Electrical
212 Flnal Fire Preventlon
220 Finel PlannlnB ApDrovfll
222 Final Slte
250 Finel Building/Occupency
Qdff. IHfIfULS
(714) 754•5273 • Fax (774) 754-0856
_ CITY OF COSTA MESA
� BUILDING DMSION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 555 ANTON BL
Suite: 1
Vicinity: iST FIOOR LEASING OFFICE
Parcel Nunmber: 41050110
Applicant: UNKNOWN
Address:
BUILDING PERMIT
Zoning:
n
77 FAIR DFiIVE, COSTA MESA, CA 92626
n
StaWs: ISSUED �li'�
Applied: 02I0911999
Issued: 02/1817999
- , , Phone: � � � .
Zip:
Owner. SAKIOKA FARMS �" � � �
,;
Address - - � � ' ' ' ��
� j" �:
�'
- '. ' . - Phone: - - ., ` = �� '
�
�-
,- .�� �� , , "_ _ Zip: 94137 ' �, , �_ - . : .
,� i � , ... �, � , ' .
Contractor.. ACCENT BUILDERS �
� , . , .
Address: 17945 SKY PARK CI - �
i . i
� , Phone:. 714757-t998 � - ��
• � . ' IRVINE CA � . �
. � � Zip:. 92614 ,� License:-.397790 . . . , ..
Arch : INTERIOR ARCHITECTS , �' ' Eng: �
Address: 3080 BRISTOL ST ' - , ' - , � AdAress: � �
. � � Phone: 754-1197 "� ' , - � - � Phone: �
COSTA MESA, CA � � ,' �
Zip: 92626 . ..Licanse: C10067 . � Litense:
� SCOPE OF PERMIT. ,
` INTERIOR ALTERATION FOR A REMODEL-OF THE 1 ST FLOOR LOBBY AND LEASING AREA: NEW ELECTRICAL
, (CEILING), R/R NON-BEARING WALLS. AIC CHANGE OUT,�AND REMODEL. � �
Plan Check:
Permit
SMIP Res:
SMIP Com:
� Other:
Inspection:
Tota I:
$190.49
�1,172.25
$0.00
$32.92
$0.00
$0:00
$1',395.66
�.:
.
�MARY � r
= � Calc Valuation: Siss,�so.00
, � � Claim Valuation: siso,000.00
�
PLANNING'& ZONING
� �, �- , � � � � .. �
SETBACKS � � � � • - . "- , , , - - � �
MAIN STRUCTURE Front 0- 0 _ � Rear 0- 0 LeR 0. 0 Right 0- 0" ,
ACCESSORY Front � 0- 0 � Rear 0- 0 LeN •� 0- 0 , Right � 0; 0
PARKWG existinq: 0 Reauired: 0 � Proposed: 0 �.
NOTES:
EXPIRATION: This permlt shall automatically expire and become void tl work Is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with eli applicable codes, end all
requlred Inepectlona and flnel epproval must be obtained. Faiiure to ob�ain inspections and final epproval will result in iha expiration ot this pertni�.
FOR INSPECTIONS CALL: (714) 754-5628
�
WORKEflS' COMPENSATON DECLARA710N: �
I hereby eifirtn untler penalry oi perjury ane ot the tWlowing AeUaratlons: '
� I have end will malmein e cenlficete at consem ro setl-Insure for warkerm' mmpensatlon, es proviCetl for Ey sealon 3700 oi the LeEor Code, for ihe peAortnance of the
work tor which this pertnit is issueC.
❑ I have entl will mainfein workers' compensetion irtsurence, es reqWreE by secllon 3700 of �he Lalwr Code, for ihe perfortnance oi the work for which �his pertnit is issued.
My workers' compensa6on Insurance cartler end policy number ere:
Cerrier. Policy Number.
(Thls section need not be completed l/ Ne iNs� /ued et o huntlred C'leis (S100J oNess.)
❑ I certify Ihat In ihe peAortnance f the w� Ac for i Ihis pertnit i issued, I shall not employ any pereon in eny manner so as to become subject to the workers'
compensation laws ot Califom , eM g(ee the I oultl bemm ub�ect to the workere' compensetlon Drovisions of SecUon 700 f the Labor Code, I shell torthwiN
comply with Ihes rovision. p
Applicam SlgneWre: r-----•-�� CDete: —�� ��&�/
WARNING: FNLURE TO SECU R$' T10N E IS UMAW FUL rWU SHFLL SUBIECT AN EMPLOYER TO CiiIMINAL PENALTIES M1D CML FlNES UP TO ONE MUNDRED
T}KKISAND OOLLARE (5100, , IN ADDITION TO E COMPENSATION, DAMAGES PS PROVIUED WR IN SECiION 31080F THE UBOR CODE, INfEREST, /WD ATTORNEY5 FEES.
LJCENSED CONTRACTORS OECLARA710N:
I �ere0y etfrm Ihet I am
brce end ettect. Lic. # _
CaNractols SlgneNre:
CONSTRUCTION LENDIlIG AGENCY:
wit� Sedlon 7000) ot Dlvision 3 0l the Business end Professions Cade, end my Iicense i5 in full
❑ I hereby ettirm NaI t�ere Is a con5trucUon lending agenq for Ihe pertortnance oi l�e work lor w�ich this Oermlt Is issued. (Sec. 3097, Cidl Code).
Lentlers Neme:
Signature: _
OWNER•BUILDER DECLARATIONS:
Lendels Addrass:
Date:
I hereby eHirtn that under penalry ol perjury thet I am E%EMPT FROM TME CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business entl Protesslons
Cotle: Any ciry or wunry which requires e permit ta canstruct, elter, Imprwe, demolish, or repeir eny structure, pnor to Its issuance, elso requires Ne epplicant 1w such permlt
ta tlle e signed statement thet �e or s�e is Iicensetl pursuant to the provisions ol Ne ConVectora LJcense Lew (Chapter 9(commencing with Sedlon 7000j ot Dlvision 3 of Ne
Business end Professions Cotle) or t�at he or she is ezem0� ��erefrom entl the basis lor ihe ellepetl e:emptlon. Any Wolation ot Seclion 7031.5 by any epplicent tor e pertnit
subjects Ihe eppllcant to e ciNl penalry of not more Nan five hunEretl OWlars (5500)J:
❑ I, es owner of the properry, or my employees wilh wepes es Iheir sole compensation, WILL DO THE WORK, end ihe structure is not intentletl oi oflered tor sale (Sec.
7044, eusiness entl Professions Code: The Contreclors Llcense Lew does not epply to an owner ol property who bullds or improves Nereon, antl who tloes such work
himself or hersell or throug� his or �er own employees, provitled that such improvements ere not intentletl or oHeretl far sale. If, however, the bulltling or Improvement Is
soltl within one year ol comDleuon, Ne owner�bullder wlll �ave the burOen ot proving that he or she did noi bulld or Improve tor purpose of sale.).
❑ I, es owner o1 Ihe properry, em E%CWSIVELY CONTFiACT1NG WRH LICENSED CONTRACTORS to consWM the prqect (Sac. 7044, Business and Pmfessions
Cotle: Tha coniredors license Lew tloes not eppty to en owner ot properry who bullds or improves thereon, end who coniracts for such pmject with e contracror(s)
license pursuant to the Contractors License LewsJ.
❑ I am exempt untler sec.
Business entl Protessions Cotle for t�is reason:
Signature:
Owner ID verllied by dnvers license. ❑ Ves ❑ No
Veriticetion oi Ownership by (rype at dacument, i.e. - property tex bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
Drivels Licen58 No.
Date:
Expires:
❑ I he�aby certliy thel no eacavetlon Ilve (5) or more teet In depth Into which a pereon Is requlretl to tlescentl, wlll De maAe In connectlon wit� work euthorizetl by this
pertnit, entl Ihet no Duiltling sirudure, scaftoltling, telsewark, ar demditlan or tlismantlinp thereot, wlll be more then tNrry-slx (36) feet hig�. (Chap. 32, Gry 2, Atl 2, Sec.
341, Title 8, Celitomle Atlministretive Catle).
❑ As owner-builder, I will nat employ enyone to do work which woultl require e permit Irom ihe Division ol Intlusiriel Sefery, es notetl ebove, unless such person has e
permit Io tlo such work trom Ihe divlsion.
SlgneNre: Dale:
Divislon ot Industdal Sefery Pertnil NumDer.
CERTIFlCATE OF CAMPLI D AIJTMORQAT OP EMRY: I certily under penalry Of perjury �ha� I heve read this applica�on and stete that ihe infortnatirn given is
wrrect. I e9ree to compl ith e le a i Inances relatlng to builtling consiruction, and authorize representatives of the Cily ot Cosla Mesa to enter upon Ihe
above-dexri6ed p ta i cUon p . I ree not to occupy or flllow occupenry ot eny building authoAzed by� pertnit until tinal Inspection.
yQyF,y IXSVECTIONME � QSjE 111i�{$
181 fi Pixed System Final Fire Preventbn
1268 Pool Spa Flnal
200 Flnel RaRaot
201 Flnal BIocWReleining Well
202 Final Fectory Fire Plece
203 Final Sign �
204 Flnel Demolitlon
244&48
GQQE� INSFELTIONTYPE
208 Finel Mechenlcal
20B Finel Plumbinp
210 Final Electdcal
272 Final Fire PrevenUon
220 Finel Planninp Approvel
222
250
Finel Slle
Finel BuIlEinp/Oaupancy
��
��
(714) 754-5273 • F8u (774) 754-4856
Job Address:
Suite No
Vicinity:
r-
_ CITY OF COSTA MESA '
BIIILp/N6 p1VIS10N
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
555 ANTON BL
1
Parcel Nunmber: 41050110
Applicant:
Address:
Owner.
Address
Contractor.
Address:
ISSUE FEE
Temp service lest
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool I Spa
Lighting Fixts �
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service l0 1000a
Service over 1000a
Motors to 1hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
FULFORD,TERRY
SAKIOKA FARMS
O'BRYANT ELECTRIC
8749 SHIRLEY AV
NORTHRIDGE, CA
ELECTRICAL PERMIT
Phone:
Zip:
Phone:
2ip: 94137
Phone: 818-407-1986
� Zip� 91324
License: 3866'19
SCOPE OF PERMIT
46 LIGHT FIXTURES, 10 OUTLETS & 3 RECPIOUTLETS. (899-00185).
322.00
30.00
50.00
50.00
$0.00
50.00
$36.90
$10.00
$3.00
$0.00
$0.00
50.00
50.00
50.00
$0.00
$0.00
50.00
50.00
50.00
sa.00
50.00
50.00
50.00
50.00
50.00
Quantity
0
0
0
46
10
3
0
0
0
0
0
0
0
0
0
0
a
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway/100 ft
Standing Sectiod
Misc Electrical Equipment
Trans(ortners up to 1 kva/kw
................uP to 70 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
PE IT NUMBER
E99-00129
77 FAIR DRIVE, COSTA MESA, CA 92626
status: ISSUED ��
Applled: 02/23/1999
Issued: 0 212 3/1 9 99
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES 571.90
COMMENTS / SPECIAL CONDITIONS
EXPIRATION: This partnit shell automaticalty expire and become vold if work is not commenced wlthin 180 days, or If work is suspentled or abendonetl
lor a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, Such work must comply wlih all eppilcable codes, end all
requlred Inapeetlona end finel epprovel must be obteined. Fallure to obtain inspections and final approval will result in the expiration of this permlt.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPENSATION DECLARATION: -
I hereby eHlrtn untler penelry of per�ury one oi the following tleclarations:
❑ I have entl wlll meintein e certificate oi cansent to seN-Insure for workers' compensetlon, es pmvided tor by sectlon 3700 of Ihe LeEor Cotle, for the peAormance of the
work tor whiCh Ihis permit 19155ued.
❑ I have and wlll meintain workers' compensation Insurence, es repulretl by seclion 3700 ot the Lebor Code, for Ihe peAortnence ot the work br which this pertnit Is issuetl.
My workers' compensetlon �nsurenca cartier antl policy number ere:
Gertier, Policy Number.
(/hfs sectlrn need not be canpleted I! the pemutls velued et one huntlred Collers ($100) or /essJ
❑ 1 cerlity Ihat In Ihe pertortnancs o1 the work r which Ihis pertrtit Is issueq 1 ahall not employ eny person in eny menner so es m become sub�ect to ihe workere'
compensetlon lews of Cali � , en0 epr S ii I shoulG Decome sub�eM to the workers' campensetlon provlsions of Secllon 3700 of the Lebor Code, I shall torthwith
campty with �hese pr
�ApplicentSigneture: Da1e: z —z3 —�
WARNINO: FAILURE TO SECURE ORKERS' ATIIXJ COVEM�E IS UMAWFUL M1D SHN,L SUBIECT Ml EMPLOYER TO CPJMINAL PENALTIES ANO CML FlNES UP TO ONE HUNDRED
TIIIXISAND DOLLARE (E100,000), IN ADDRION T E COST OF COMPENSATION, DMMGES AS PHOVIOED WR IN SECfION 31W OF THE UBOR CODE, IN7EREST, AND ATTOMlEYS FEES.
LICENSED COMAACTORS DECLARATION:
I hereby eNirm Ihet I em Ilcensetl unde provisions
forca end eMect. Lic. x
Contrectafe Slgneture:
CONSTRUCTION LENDING AGENCV:
with Section 7000) ot DMslon 3 of the euslness enA Profaqsions Code, end my Ilcense is in tull
_ Class a
_ Da�e: 2— Z3 —
❑ I hereby eftlrm t�et Ihere Is e con5trucUon lentling a8en�y br the petlormence of the work for which Ihls permit la Issued. (Soc. 3097, Clvll Code).
Lenders Neme: LenCera AOtlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby etllrtn thet untler penalty oi per�ury ihet 1 em EXEMPT FROM THE CONTfiACTORS LICENSE LAW for the followlnp reason (Sec. 7037.5, Business end Professions
Code: My dry or counry wMch requlres e pertnit to con5truci, alter, improve, demolish, or repelr eny siructure, pdor to its issuance, elso redulres Ne applicanf tor such pertnit
to file e sipnetl atetement t�et �e or she is licensetl pursuent to ihe provislons ot the Coniractors IJcense Lew (Cheptar 9(cwnmencing wlt� Seqlon 7000) of DMsion 3 of Ne
Business end Protesslons Code) or ihat he or she is exempt therefrom flrM the besis for the elleped exemption. My violatlon ot Secllon 7037.5 by eny appliwnt for a pefmlt
sub�ecLs the epplicant ro e GHI penalry of not more Nan five hundretl tldlars ($500).�:
❑ I, es owner ol tha praperry, or my employees wiN wages es Ihelr sole campensetion, WILL DO THE WORK, and ihe structure is not Inientletl or oHeretl far sale (Sec.
7044, Business antl Professions Cotle: The Contredors License Lew tloes not eppty to en owner of property who builds or Imprwes Nereon, end who does sudi work
himsetl or herselt or through his or her own employees, proNded Ihet such Improvements are not intentletl or aHeretl far sale. If, howevar, Ue DuIlGing or improvement Is
sold wlthln one year of completbn, the owner-0uildar will have the burden ot O��ng that he or she did not build or ImDrove for purpose of sale.j.
❑ �, es owner of Ihe properry, em E%CLUSIVELY CONTRAGTING WITH LICENSEO CONTRACTORS to construq lhe pro�eq (Sec. 70M14, Bu5lness end Professions
Code: The wnirectors LJcense law tloes nat eppy ro en owner oi property who bulltls or Improves thereon, and who contrecls Por such pro�ed wlih a contrector(s)
Ilcense pursueN ro the Contraqors Ucense Laws.).
❑ I em exempt under sec. Business an0 Professions Cotle tor t�is reason:
Signalure: � Date:
Owner ID vertlietl by tlrivels Ilcense. ❑ Ves ❑ No Drivefs License No. Ezpires:
Vedticetlon o1 Ownership by (rype of document, Le. - O�aPeM �%'� �III or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby ceRify t�et no exceveilon tive (5) or more feat In depth Into which e pereon Is required to descenq wlll be mede In connectlon wlth work authorizeA by ihis
permit, entl t�et no DuilOing atrucNre, scaHoldinp, falsework, or tlemolitlon or tlismentlinp thereof, will be more then thirty-six (3B) leet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Title 8, Celllomle Atlministretive Cotle).
0 As owner•bullder, I xill not empby enyrne to tlo work wNch woultl reQuire e pertnit lrom Ne Dlvision oi Industnel Satery, es noted ebove, unlav such persan hes a
pertnil to tlo such work trom Ihe diNslon.
Sipnature: Date:
DMsion ol IndustAel Setery Pertnit Number.
CENTIFlCATE OF COMPLLWCE AND AUTHORVJITION Of ENTHV: I certlly under penelry at perjury that I heve read ihis epplicetion and sfete ihet the Inlortnetion given is
conect. I egree to comply with all state laws end ciry ordinences releting to building construction, and authodze representetives of t�e Clry of Costa Mesa to enter upon the
eDove-descdbed property for inspeftion purposes. I egree not ro occupy or ellow occupancy of eny bullding euthodzed Dy NI9 pertnit until finel Inspeqlon.
�pF.y wsnernoNrve
181 B Fixed Syatem Finel Fire PrevenLon
1288
200
20/
202
203
Pool Spa Finel
Flnal RaRoof
Flnal BIoeWRetelnlnp Well
Finel Fectory Flre Plece
Flnel Slpn
204 Flnal DemolWon
244N8
� ��
FQpp2 ixsveenoxme
206 Flnel Mechenlcal
208 Flnel Plumbing
210 Flnal Eleciricel
212
220
z - Z� oec� 9
Dete
Flnal Fire Preventlon
Flnel Planning Approvfll
222 Flnal Site
250 Flnal Builtling/Occupenty
OAiF Q�ELS
�
.,
. � y . . .... . . . �. . ..
4 ' CITY OF COSTA MESA ;'
� BUILDING DIVISION
� � DEVELOPMENT SERVICES DEPARTMENT
J
•��� _ ,. <<;,;:., � PERMIT
(714) 754-5273 • Fax (714) 754-4856
JobAddress: 555 ANTON BL
Suite No 1
Vicinity: FIRST FLR - LEASING OFF.
Parcel Number: 41050'I'10
Applicant: RODRIGUEZ, LOU
Address:
�
Owner. SAKIOKA FARMS
Address:
MECHANICAL PERMIT
i
;,`p':
PERM�T NUMBER/? �
M99-00068 �
77 FAIR DRIVE, COSTA MESA, CA 92626
�.. Phone: (818)244-6571 .
Zip:
� -- Phone: • � ,
Zip: 94137 ' , � "
Contractor: AIR CONDITIONING CO., INC
Address: � 6265 SAN FERNANDO RD
. � Phone:, 818-244-6571
GLENDALE CA Zip: � 91201
' - � �License: � 120696 � � � �
ArchlEng: "
Address: . � . �
Phone:
Zip:
License:
• SCOPE OF PERMIT
RELOCATE 3 VAV BOXES. REF 699-00185. GROUND FLOOR LEASING OFFICE.
ISSUE FEE '
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU �
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV 8ox
Vent Fan / Single Duct
Appliance -
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > 10000cfm
Floor Furnace
Floor or Suspend Heater
,, FEE SUMMARY-r, , ,
Quantity.�"_ - " --- - . � . . _..
$22.00 - - - - - � Repair / Alt Absorbtion Unit
$0.00 0 � Repair/AltRefrigerationUnit
$0.00� 0 VentillationSystem
$0.00 0 Evaporative Cooler
$0.00 0 Commercial incinerator
$0.00 0 Domestic Incinerator
$0.00 0 . Compressors / Absorption Systems
$0.00 0 . . Upto3hp/100kBTU '
�$0.00 0 .� 3 To 15 hp / 500 k BTU -
$0.00 0" � ' � � � 15To30hp/7,OOOkBTU�
$28.50 3 , � � 30 To 50 hp / 1,750 k BTU ,
$0.00 0 , - - Over 50 hp / Over 1,750 BTU
$0.00 0- • , - � . . Boilers -
$0.00 0 , ` - - Up to 3 hp '
$0.00 � 0 3 To 15 hp
$0.00 0 � , 15 to 30 hp �
$0.00 � 0 . � - , 3010 50 hp . �
$0.00 0 Over 50 hp . � ', �
$0.00 0 ' � � Other Mechanical Fee � �
$0.00 0 - Investigation Fee
- Plan Check Fee
� � Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 02/22/1999
Issued: 02/22/1999
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00.-
$0.00
$0.00
550.50
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 780 days. .
, INSPECTIONS: In order for ihe 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) 7545626 s
I
1
WbRKERS' COIdPENSA710N DECLAqAT10N: "
I hereby attirm under penalty of perjury one of ihe Following declarations:
❑ I heve antl will maintdin a ceniticate of consem to self-Insure for workers' compensetion, as provided for 6y section 3700 of ihe Labor Code, for the peAormance of the
work for whiCh this pertni� is issued.
Q" I have antl will maintain workers' compensetion insurance, as requiretl 6y section 3700 oi the Labor Code, for the pertormance ot the work for which this pertnit is issuetl.
My warkers' compensatian Insurence cartier and policy number are:
Carrier: % d �L �/i� Policy Numbec � �? C � u -� �-"—
(This secfion need not be completed i! the permit is valuetl at one hundred dollare ($100) or Iess.J T�� ' �
O 1 ceniry tnat in tne
Applicant Sign T�w
WARNING: FAILUqE
ot the work for which ihis permit is issued, 1 shall not employ any person in any manner so as to becane subject ro the workers'
and egree thet if I should become subject to the workers' compensation provisions oi Section 3700 ot the Lebor Code, I shall fonhwith
' Z'"�� 2^'y^%�;a
Date:
'>' WMPENSATION CAVE I LAWFUL AND SHALL SUBJECT qN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
)NTOTHECOSTOFfAM�➢ r�l N,DAM4GESASPROVIDEDFORINSECrION3]O60FTHELABORCODE,INTEFEST,ANDATTORNEY'$FEES.
��CENSED CONTRACTORS DECLARATION:
! hereby aHirm ihat 1 am licensed urider provisions ot Chepter 9(crommencing with Section 7000) ot bivision 3 of tne Busineu and Professiors Code, end my license is in full
torce end eNect. Lic. # Class # G�-20
C4ntractors Signature � /i i�c,e_t - � Date: -7 _ n .��� _
CONSTRUCTION LENDING AGENCV:
❑ 1 hereby aHirtn Ihat Ihere is a con5iruction lentling agency for the pertormance of the work for which this permit is issued. (Sec. 3097, Civil Code),
Lender's Name: __ _ Lender's ACdress: . _
SignaNre:
Dete:
OWNER-BUILDER DECLARA710NS:
I hereby aHirm that under penalry ot perJury ihat I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Catle: Any ciry or counry which requires e permit to consimct, alter, improve, demolish, or repair any sWCNre, prior to its issuance, elso requires ihe applicant for such permit
to fila a signed stetement that he or she is IicenseA pursuant to tha provisions oi tha Contractors License Lew (C�apter 9(commencing with Section 7000) of Divisian 3 of ihe
Business and Professions Code) or that he or she is exempt Iherefrom and the basis tor ihe alleged exemption. Any violation of Section 7031.5 by any applicant for e permi�
subjeds the applicant to a civJ penalty of not more ihen 9ve huntlred dollare ($500).):
� I, as owner of ihe property, or my employaes with wagas as their sole compensatlon, WILL DO THE WORK, end the strucNre is not intendetl or oflered tor sale (Sec.
7044, Business and Professions Code: The Contractors License Lew tloes not apply to an owner of property who builds or improves thereon, and who does such work
himself or herseli or through his or her own employees, provided that such improvemenis ere not intended or oflared for sale. It, however, the building or Improvement is
sold within one year Of complation, Ihe owner-builtler will have Ihe burtlen ot proving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owner of the property, am EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The contractors License Law does not apply to an owner ot proparty who buAds w improves the�eon, arW who contracts for such prqect wlth a contractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I em ezempt under sec. Business and Professions Cotle for this reason:
Signature: Dale:
OWner tD verified by driver's license. ❑ Yes Q No Drivers License No.
Verification of Ownerehip by (rype ol documenl, i.e. - propeny taz bill or deed):
Ezpires:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I hereby certity ihat no excavation tive (5) or more feet in tlapih into which e person Is required to descend, will be metle in connection with work authorizatl Dy this
permit, antl lhat no building strudure, scettoltling, felsework, or demolition or dismantling ihereof, will be more then thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
347, Title B, Californla Atlministrative Code).
❑ As owner-builtler, I will not employ anyone to do work wbich woultl require a permit trom ihe Division of Intlustrial Safety, as nmetl above, unless such person has a
permit to do such work irom [he tlivision.
Signature: Date:
Dlvision oi Indusirial Safery Permit Number:
CERTIFlCATE OF CAMPLIANCE AND AUTHORIZA710N OF ENfAY: I cehity under penalry of perjury ihet I have read this application and state that lhe inform6tion given is
correct I agrae to comply with all stete laws antl city ordinances releting to buildinq constmction, and euthonze rapresentatives of the Ciry ot Costa Mesa to enter upon the
above-tlescribed property tor inspection purposes. I agree not to occupy or ellow acupancy of any building authonzed by ihis permit until tinal inspection.
LOOE t INSPECTIONTYVE
1616 Fixetl System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 FinalSign
204 Final Demolition
2466<6
Date
�� �� � rv"i;
Date'
p9iE II�ELS L4LE! INSVECTIONTYPE
_ 206 Final Mechenical
208 Finel Plumbing
210 Final Elecincal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
� •c .''"1►��
r_ . .
CIN OF COSTA MESA ''
� sva��N6 oms�oN
' ,�
� DEVELOPMENT SERVICES DEPARTMENT
u — .
•�� PERMIT PERMITN MBER
F99-00038 �
(714) 754•5273 • Fex (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON Bl
Suite: 1
Vicinity:
Parcel Nunmber: 41050110
Appliwnt: UNKNOWN
Address: 02505 MIRA MAR
LONG BEACH CA
Ownec SAKIOKA FARMS
Address
. `
Contrador: CAL PROTECTION
FIRE SUPRESSION PERMIT
Zoning:
Phone: 562-498-6444 ,
Zip: 90875 ,
Phone: �
2ip: 94137 � ��
Status: ISSUED
Applied: 02QS11999
Issued: 03A 111999
AdCress:� 02505 MIRA MAR � �
, � Phone:".562-498-6444
LONG BEACH CA .. Zip:' 90815 � ' .
. License: 327196
" SCOPE OF PERMIT
UPGRADE EXIST. FIRE ALARM SYSTEM FOR THE LEASINGOFFICE AND PORTION OF LOBBY. ( REF
899-185).
Plan Check: $81.09
Permit: $124.75
Other: $0.00
Total: $205.84
Calc Valuation: Se,s3z.00
Claimed Valuation: Ss,ssz.00
EICPIRATION: This permlt sheil eutomaticalty expire and become vold if work is not commenced withln 180 days, or ii work Is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work eulhorized under this permit to be considered legal, such work must comp�y with all eppllcable codes, and all
requlred Inepectlona and flnal epproval must be obtained. Failure to obtain inspeclions antl finel approval will result in the explretion of this permit.
FOR INSPECTIONS CALL: (714) 7545828
WOHKERS' COMPENSATION DECLARATION: �
I hereb mm under penelry of per�ury one of Ihe tdlowing declaretions: � -
I heve entl wlll meinteln e certlticete o1 consent to sell-Insure lor workers' compensation, es pmvided for by aectlan 3700 ot the Lebor Code, lor the pertortnence of t�e
work tor which this permit Is issuetl.
❑ I heva end wlll mainteln workers' compensatlon insurance, es required by sectbn 3700 of the Lebor Cotle, for Ne pertormance ol the work for which this pertnit is iswetl.
My e compensetion Insurence ce r antl pollcy number ere: �Z /'�cy;� �/
Carder.
�� gLf� � �E!-�ir--�� policy Number. Ji Z]�� —� O
(Th/s sec(lon neetl not �e cromp/eletl ll the permlf fs velued et ane huntlretl tlollers (5700) or Iess.)
❑ I certily that in the paAo ence the work for Ich this Oe If is Issued, I shall not employ any person In eny menner ao ea to become aub�ect to the workers'
compensatlon laws of Ce la, tl egree I houltl e sub�ed ro t�e workers' cnmpensation provlsions af Sectlon 3700 of the Labor Cade, I shall fonhwit�
wmply with Ihese prod � �� �%
Applicent Signeture: / Date: � � —� /
WMNINO: FAILUPE TO SEWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE MUNDRED
THOUSAND DOILARE (510D,ODD). IN ADOITION TO THE �ST OF LUMPEN54TION, DPANGES AS PROVI�ED FOR IN SECTION 3]080F THE LABOR CODE, IMEREST, AND FTTORNEY'S FEES.
LICENSED COHTRACTORS OECLARATION:
I hereby ettirm Uet I em IlcenseE untler p oNslons of Chepter 8(commencing with Section 7000) of Divislon 3 ot the Busines�,antl Pr fess}'ons Cotlg,,�ntl my Ilcense is In full
iorce end enect. uc. a 27 f� ra / c�ess a `— � go/c1 C^/lo
ConlrectorsSipneture: �j ` Dete: �—(� !7
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirtn Net there Is a constnicUon lending egenry tor Ne paAortnance of Ihe work tor whicli thls pertnit is Issuetl. (Sec. 3097. Gvll Cotle).
Lentlers Neme: Lentlefs Atldress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereDy eNirtn thet untler penelry oi per�ury Ihet I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for �he tollowinp reeson (Sec. 7031.5, Buslness entl Professions
Code: Any ciry or counry which requires e permil to consiruct, elter, Improve, demolish, or repeir eny aWCNre, prior lo Ita Issuance, elso requires Ihe eppllcant for such pertnit
to file e slpnetl stetement thet he or she Lv IicenseC Dursuant to ihe provLsions oi Na ContreMors License Lew (Chaptei 9(commendnp wlih Section 7000) of Divislon 3 of Ne
Business and Prolessions Cotle) or t�at he or she is ezempt theretrom end ihe basis for the allegetl eaemp�ion. Any Wdation o1 Section 7031.5 by any epplicant tor e permit
sub�ects the eppllcant to a dNl penelry ot not more than five hundrad dollars ($500).):
❑ I, es owner of the properry, or my employaes wIN weges es iheir wle compensatlon, WILL DO 7HE WORK, entl the structure Is not intended or ottared for sele (Sec.
7044, eusiness end Pratessions Code: The Contractors Llcense Lew does not apply lo en awner of properry w�o bulltls or Improves t�ereon, anA who tloes such work
�imselt or hersetl or Ihrough �Is or her own employees, proNded that such Improvemenis are not Intendetl or ottered lor sele. If, however, the Eulltling or improvement Is
soltl wi�hin one yeer af completion, Ihe owner-Dullder wlll �ave the burden of proving thet he or she did not bulld or improve for purpose ot sale.).
❑ I, as owner oi the properry, am E7(CLUSIVELV CONTFiACTING WR}1 LICENSED CONTRACTORS to consirud ihe project (Sec. 7044, Business antl Protessions
Cotle: The contrectors Llcense Lew tloes not epply to en owner of praperry who bullds or improves thereon, entl who contrects tor such project wlth e conlractor(s)
licensa pursuent lo the ConlreIXors LJcense laws.).
❑ I am exempt under sec. Business end Professions Cotle for tNs reason:
Signeture: Date:
Owner ID verltietl by dAvefe license. ❑ Ves ❑ No Orivers llcense No. Expires:
Vertlicetlon of Ownershlp by (type ot tlocument, I.e. - praperry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY VERMR CER7IFICA710N:
❑ I hereby certity t�et no excevetlon tive (5) or more leet in depth into which e pereon Is requlred ta descend, will be meGe In connedlon with work euthorizetl by t�ls
permit, end Ihat no bulltling siructure, scaHolding, felsework, or EemWitlon or tlismantling thereof, wlll be more then Ihirry-ela (38) feet hiph. (C�ap. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Cflllfomia AtlminlslratNe Cotle).
❑ As owner-bullCer, I wlll not employ enyone to do work w�ich woulG requlre e pertnit trom Ihe Dlvision of IndusMel Selery, es noted ebove, unless such person hes a
permit lo do auch work from ihe UiNslon.
Signature: Dete:
DlNslon of InGustrial Setery Pertnit NumOer.
CERfIFlCATE OF COMGLIANCE AND AUfHOR¢ATION OF EMFiY: I certity under penalry of perjury thet I heve reed Ihis applicatlon enO stete Ihet the in}ortnelion gNen is
conect I egree to comply with ell stete lews end Gry ordinances relatlng lo builEing consWction, and euthodze representatives of Ihe Ciry of Costa Mese to enter upon the
ebove-dBxrlbeC properry fa inspeclion purposes. I agree not to occupy or allow ocwpanry of eny builtling euthorized by this pertnit untll Mal inspection.
// Slpn ure OI� ner
i v�� r
M OrAUNOAzedApplicant
LOOE 1. INSVECiIOXTYPE
1878 Flaetl System Flnal Flre Preventlon
1288 Pod Spe Flnel
200 Flnal Re�Root
201 FIneI BIocWReteirtlng Wall
202 Flnal Fedory Fire Place
203 � Final Sign
200 Finel Demdltlon
2MB18
�¢ II�LS SQpEf MSiECTIONTYPE
208 Flnel Mechenical
208 Flnel Plumbinp
210 Finel Elecirlcal
272 Finel Fire Prevenlion
220 Flnel Plenning Approvel
222 Flnel Site
250 Flnel Bulldinp/Occupency
�-f%8�
Date
� ��
�� �
CIN OF COSTA MESA .1
,` � ev����N� oms►oN
: DEVELOPMENT SERVICES DEPARTMENT
� PERMIT PE IT N MBER
��� �
F99-00039
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite: 1
Vicinity: �
Parcel Nunmber: 41050110
Applicant: UNKNOWN
Address: 02505 M�RA MAR
LONG BEACH CA
O,vner: SAKIOKA FARMS
Address
contractor: CAL PROTECTION
Address:, 02505 MIRA MAR
LONG BEACH CA
FIRE SUPRESSION PERMIT
Zoning:
Phone: 562-096-6444
Zip: 90815
Pho�e:
Zip: 94137
Phone: 562-098-6444
- Zip: 90815
License: 327196 �
Status: ISSUED
Applied: 02/25/1999
Issued: 03/71/1999
SCOPE OF PERMIT
RELOCATE22 SPRINKLER HEADS FOR THE LOBBY AND LEASING OFFICE AREA. ( REF B99•185).
FEESUMMARY
Plan Check: $64.84
Permit: $99.75
Other $0.00
Total: $164.59
Calc Valuation: Sa,Boo.00
Claimed Valuation: Sa,Boo.00
EXPIRATION: Thfs perm0 shalt automalicatly expire and become void ii work is not commenced within 1 BO days, oi ii work is suspended or abandoned
for e period of 180 days.
fNSPECTONS: In order tor ihe work authorizad under this permit to be consfdaretl Vega1, such work must comply with ati applfcable codes, and a11
requlred Inapectlona and final epproval must be obtained. Failure to obtain inspections end final approval will resUtt In the explration of this permlt.
FOH INSPECTtONS CALL: (714) 7545828
�
WORKERS' COMPENSATION DECLAPA710N: -
I here rtn under penalry ol per�ury one af the following tlecl,eretions:
I heve entl wlll meinteln e cenlflcate of consent to self-Insure for workere' compenSallon, as provitled for by sectlon 3700 of the Lebor Code, for the pertarmance ot Ihe
work for which Ihis pertnit Is luued.
❑ I have end wlll meinteln workers' compgnsatlon Insurence, es repulretl Dy sectlon 3700 of Ne Lehor Cotle, for Ne peAortnence at Na woiic iw whlch Ihis pertnit La Issued.
My w ra' J tlon Il!�surence cgrder anA I number ere: �/,� ^^� �/
Cartler. � �(�%� L����./�/i� POIIcyNumber. 7`cx.� C�
(Thls sect/on nee0 not be oomploted!/ Me perm/l /s ve/ued et one huntlred dol/ers (5/00) or less.)
❑ I certity that in t�e pert ance of Ihe work for whic thls pertnit Is issue4 I shell not employ any person In eny menner so es 10 6ecome subfect to Ihe workers'
compenseHon lewg of Q611forr�k end thet H I ould become sub�ecl Io the workers' compense�lon proNslons of Sectlon 3700 of t�e Labor Cotle, I ahell IoMwlih
wmply wlth Ihesa Pra�//C, / Q
ApPIIceN Sipneture: % L d4 oele: ,�— �/� /�
WARNINO: FAILURE TO SEWRE WORKERS' CpAPEN5ATI0N COVERAGE IS UNLAW R1L AN� SH�LI SU&IECi AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED
TFKK1SrW0 OOLLFRE (f100,000). IN ADDRION TO TIIE COST OF CqAPENSATION, DAAMGES AS PRONDE� FOR IN SECfION 3]O60F THE LABOR COOE, INfEREST, AND ATTORNEI"5 FEES. �
LICENSED CONTRACTORS DECLARATION:
I hereby ettirtn ihet I am Ilcens under p spl ns of Chepter 9(commencing with Sectlon 7000) of Division 3 of the Busin and Profess' ns Code, end my Ilcensa is in tull
rorce ana eHea. ua x %1 %/ (n i ciess a �-- /� c-�6
Contrector'sSigneWre:� Date: �=//^ % �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn t�et there is e wnstructian lentling egency tor the pedortnence ot ihe work tor which this pertnit Is issuetl. (Sec. 3097, CINI Cotla).
Lenders Neme: Lendefs Address:
SlgnaNre: Date: ,
OWNER-BUILDER DECLARATIONS:
I hereby ettirm thet under penelry of perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor t�e fdlowinp reeson (Sec. 7031.5, Buslness and Professlons
Code: Any tlry or counry w�lch requlres e permit to construct, elter, Improve. Aemdish, or repelr eny siructure, pdor lo Its Issuance, elso requlres Ne eppllcant for such pertnit
to lile e slgneO stetement that he or ahe Is Iicqnyetl pursuent to the provisions of the Contrectore LJcense Lew (C�aptar 9(commendng wlih Section 7000) of DlWsion 3 of the
Business end Professions COAe) or Ihet �e qr she is exempl t�eretrom entl the basis lor ihe alleged exemplion. My vlolation of Sectlon 7031.5 Dy eny appliwnt for e permit
subjens the epplicent lo e dNl penalry oi not more ihen nve nunArea Collara (5500).):
� I, as owner of the property, or my employees with wages as their sole compensetion, WILL DO THE WORK, and the siructure is not inientletl or ottered far sale (Sec.
70A4, Business antl Protessians Code: The Contrectors Llcense Lew does nol epply to an owner of property w�o huiltls or Imprwes thereon, end who does such work
himsetl or herself or Ihrough hb or her pwn employees, O�aNdeC Ihet such improvements ere not IntenOetl or oNeretl far sele. II, however, ihe bulltling or improvement is
soltl wltNn one year ot completion, Ihe ownervbuilder will have the burden of proNng Ihat he ar she tlltl nat bulld or improve tor Duryose oi sale.).
❑ I, es owner ot the property, em EXCLUSIVELY CONTRACTING WrtH LICENSED CON7RACTORS to construct ihe projeIX (Sec. 7044, Business end Professions
Cade: The wntrectore LJcense Lew tlpes not epply to en owner oi property who builds or Improves thereon, entl w�o contracts for such pro�ect with a contrector(s)
Iicense pursuant ta the Contrectors Ucense Lews.).
❑ I em exempt under sec. Business end Professions Cotle for this reason:
Signature: Date:
Owner ID veritietl by drNefs license. ❑ Yes ❑ No Drlvefs Ucense No.
Verlticatlon of Ownership by (rype ol tlacument, i.e. - properry lex bill or dee0):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
E�cpires:
❑ I here0y certlly that no excevetion five (5) ar more teet in deDU into w�lch e perwn is required to descentl, wlll he metle In connection wlth work eutl�orizeA by this
pertnit, entl Nat no building atrucNre, eceMoltling, talsework, or tlemdlUon or tllsmamling thereof, wlll be more t�an thirty-sL� (38) feet hlgh. (Chep. 32. Grp 2, Art 2, Sec.
341, Ttle e, Ceiltomle AdministretNe Cptle).
❑ Ae owner•bullOer, I will not employ eny0ne to tlo work which would reQuire a permlt irom Ne �Ivision of Industrlel Sefey, es iroted above, unless such person hes e
permit to do such work from Ihe tlivlslon.
S(gnaNre: Date:
Oivlqion of Industrial Satery Pemiit Number:
CERfIFlCATE OF COMPLIANCE AND AUi!{ORIZATION OF EHTRY: I ceNfy under penfllry of per�ury Uat I heve reetl this eppllcatlon end slete Net Ne InfortneUon given is
cortect. I epree to compty wlth ell stete lews entl ciry ordlnances relatinp to building constructlon, end euthorize representeiNes of ihe Clry of Coste Mese to enter upon the
ebove-tlescAbed property ior inspecUon purppyes. I agree nOt to occupy or ellow occupanq ot eny bulltling euthorized Dy thls pertnit until Mal InspecUon.
n ure Of el Owner(a) �B
3-ri
MG/Or Au1 2ed Applicant Date
COOE 1. INSPECIIONTYVE
1816 Flaetl System Final Fire PrevenUon
1286 Pool Spe Fnal
Zpp Flnel Re-Roof
201 FIneI Block/Retelning Well
202 Finel Fectory Fire Plece
2Q3 Flnel Slpn
20d Flnal DemdiLon
2u8�6
�{/a�99 �
y�1 iusveenox me
206 Finel Mec�anicel
208 Finel Plumbing
210 Finel Elearical
212 Flnel Flre Preventlon
220 Flnal Planning ApProvel
222 Finel Site
250 Flnel Builtllnp/Occupency
GA� Iti�lt9
(714) 754-5273 • Fex (714) 754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber.
�..
� CITY OF COSTA MESA -
BlIILpING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
555 ANTON BL
1
1 ST FLOOR
41050110
npp�icant: FULFORD, TERRY
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
owner. � SAKIOKA FARMS
Address ' � �
Contractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA �
ELECTRICAL PERMIT
Phone: (818)407-7986
Zip: 91324
Phone:
Zip: 94137
Phone: (878) 407-7986
Zip: 91324
License: 386619
PERMIT NUMBER
E00-00279
77 FAIR DRIVE, COSTA MESA, CA 92628
Status: ISSUED
Applied: 03/30I2000
Issued� 03I30/2000
ISSUED BY: �
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR OFFICE T.I. FOR "BMC SOFNVARE" (1ST FLOOR).iNSTALL 260 LIGHT
FIXTURES, 155 RECEPTACLE OUTLETS, 36 SWITCHES, 2 SERVICES UP TO 200 AMP, 1 SERVICE
TO 1000 AMP, 1 MOTER TO 10 HP, 92 COMMUNICATION DROPS, & 6 CIRCUITS.
:7�7�:UUE�BY1.1�
ISSUE FEE
Temp service test
Res. alc package
New Res (7-2 units)
New Res (3+units) �
Pool I Spa
Lighting Fixts ,
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors to SOhp
Motars to t00hp �
Motore over 100hp
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$195.20
$178.55
$31.68
$0.00
$0.00
561.00
$62.15
$0.00
$o.00
$12.30
Sa.oa
$0.00
50.00
Quantity
0
0
0
260
155
36
0
0
2
1
0
0
1
0
0
0
FEE SUMMARY
Temp Dist System I Lighting
Busway I700 fl
Standing Section
Misc Electrital Equipment
7ransformers up to 1 kva/kw
................uP t0 10 kvalkw
.................uP to 50 kva/kw
.................uP to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Cirws ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Eleclrical Fee
Quantiry
E0.00 0
$0.00 0
ao.00 0
$0.00 0
$0.00 0
E0.00 0
$0.00 0
80.00 0
$0.00 0
80.00 0
$0.00 0
$0.00 0
8109.20 6
$0.00 0
$0.00 0
$0.00 0
30.00 0
so.00
�
NOTICE: The work authorized by ihis permit shall comply with all applirabie handicap eccess requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatirally expire and become void it work is noLcommenced within 1B0 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for �he vrork authorized under this partnit to be considered legal, such work musl comply with all applicable codes, and all
requlred inapeetlone end final approval must be ob�ained. Feilure to obtein inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARArON: �
I hereDy ettirm untler penalry oi pe7ury one of the �ollowing tlaGeretions:
❑ I �eve entl wlll meintein e certlficate ot consent to selt-Insure tor workers' wmpensetion, as providetl lar by sectlon 3700 0l Ihe Lebor Cotle, for the peAormance of Ihe
work tor which this permii Is Issued.
❑ I heve end will meintein workers' compensation insurence, as requiratl by section 3700 of Ihe Lebor Cotle, tor Ihe peAortnance ot Ne wark tw which thls Dermlt is issuetl.
My worker9'comp•/e nsa�tlon I anc/�°,�rder end policy number ere: . p
Carrler. �/r � 7`�0' �sp. kc �.f'S.. c w�s�c a Palicy Number: /�w �� 76 G��..3o.J
(fhls secflar need nof be completed I! fhe perml( la ve/ued et one huntlretl tld/ars (5700) or IesSJ
❑ I cenify tha� in t�e peAartnance oi the work for which this permic is issued, I shall not emplay any person In eny manner so es to becoma subject to the workers'
wmpensetion laws of Celifomie, entlpp ree thet it I shaultl becwne subject to Ihe workers' compensation provisions oi Sectlon 3700 0l ihe Lebor Cotle, I shall torthwilh
wmply with Nese pr�. /�/
Applicant Slgneture: "'��� Date: _l :30 - `v'�
WARNINO: FNLURE TO SECURE WORI(ER ' MPENSqTION G1�VERAGE IS UNLAWFUL M'D SMALL SUBJECr AN EMPLOYER TO CRIMINAL PENALTIES AND pVIL FlNES UP TO ONE HUNURED
THIXISANDOOLLARE(5100.0OO�.INADDR �NTOTHECp$70FCOMPENSATION,DAANGESASPFOVIDEDFORINSECTION31060FTHELABOHCOOE,IMERE5T,ANDATTORNEYSFEES.
LICENSED CON7RACTORS DECLARATION:
I hereby aKrm that I am licensed under��p��pp/visionbs ot Chapter 9(commencing with Section 7000) of Division 3 of the Business Aa d Profess(ons Code, and my license is in tull
fOrtB 8ntl BfteCl. Lic. q -'jJ u��T CI055 k `-�n
ContractoYs Signature: �.✓ Date: � 3m -- o�=+
CONSTRUCTION LENOING AGENCV:
❑ I hereby eHirtn t�et Ihere is e construction lending agancy tor the pertormance ol the work for which this pertnit is issued. (Sec. 3097, Civil Cade).
Lendefs Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aflirtn ihet untler penalry ol per�ury thet I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Business end Prolesslons
Code: Any dry or county w�ich requires a pertnit lo construct, alter, improve, tlemolis�, or repair eny strucWra, priar to Its Issuance, elso requires the epplicant lar such permit
to fila a signetl slatement thet he ar she is Iicensetl pursuent to the provlsions of the Contrectors Llcense Law (Chepter 9(wmmencing with Section 7000) ot Divlsion 3 at ihe
Business entl Professions Code) or that he or she Is e:empt t�erefrom arW tha hasis for the ellegad exemptlon. Any vlolatlon ot SeMlon 7031.5 by eny applicant tor e permit
suD�ects the applicant to e civil penelry o1 not more than live hundretl tlollars (5500).):
❑ I, es owner ol �he property, or my employees with wages as their sole compensetion, WILL DO TIiE WORK, and the structure is not Intentletl or oXered lor sale (Sec.
7044, Business antl Professions Code: The Contractors License Lew does not eppty to an owner oi property who builtls or improves thereon, end who does such work
himselt or hersetl or �hrough his or her own amployees, provided iha� suc� improvements era not intended or oHered for sale. Ii, however, the Dulltling or improvement is
soltl wl�hin one year of completion, ihe owner-builtler will have the burtlen oi proving that he or she did not bulltl or improve for purpose ol sale.).
❑ 1, as owner o1 IAe prope+ry, am EXCLUSIVELY CONiRACTING WITH LICENSED CON7RACTORS fo construct the projecl (Sec. 7066, Business and Professions
Code: The contractors Licensa Lew does not aDPly to an owner of pmparty who builds or improves thereon, antl who coNrecis for such proJect with e conVactor(s)
license pursuam to the Conirectors License Laws.).
❑ I am exempt under sec. Business end Professions Code for this reason:
Slgnature: Date:
Owner ID vedtietl by tldvaYs license. ❑ Ves � No Drivels Licensa No. Expires:
Verilicetion ot Ownership by (rype of tlocumenL i,e, - property teu bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CEpTIFICATION:
❑ I hereby certlty t�et no excavetion Iive (5) ar more teet In tlep�h Into whlch e person is requlred to descentl, wlll be matle In wnnection with wark euthorizetl by this
pertnil, end thet no builtling siructure, scetlolding, telsework, or demolitlon or tllsmanUing thereol, wlll be more Ihan ihirry•six (36) leet high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celltomie Adminlslre0ve Cotle).
❑ As owner-builder, I wlll not amploy enyane to do work which woultl require a pertnit iram Ihe Divislon of Indusirial Safety, es noted ebove, unless such persan has a
pertnit to do such work Irom Ihe tlivision.
Signeture: Date:
Divisian of Industnal Safery Pertnit Number:
CERTIFlCA7E OF COMPLIANCE AND AIJTHOR12pTON OF ENTAY: I certify under penelry ot perjury Ihet I heve read this epplicatlon entl state thet the infortnelion given is
wrrect. I egree to comply with ell stete laws antl dty ardinances relating to Dullding construction, end euthorize representalives of the Ciry af Coste Mese to emer upon ihe
e6ove-described properry lor Inspectlon purposes. I agree not to occupy or ellrnv occupency ot eny bullding eut�orizetl by this permit untll ilnal inspectlon.
COOE t. INSVECTIONTYPE
7616 FI:eC Syslem Finel Fire Prevention
1266 Pool Spe Flnal
200 Final Ra-Roof
201 Flnel Block/Reteining Wall
202 Final FecMry Fire Place
203 Flnal Sign
204 Final Demdition
2a1&ae
Pdg
�
um.
Dete
,330 �o 0
Date
COOE 1 INSPECTION TYPE
206 Finel Mechanical
208 Finel Plum�ing
210 Finel Eledncal
212 Final Fire Preventlon
220 Fina! Planning Approvel
222 Final Slte
250 Finel Building/Occupancy
PAg Iti�ALS
ba �e
�W.
� q��'.
� •._:,::: ; :
�
(714)754-5273 • Fax(714)75d-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
Contrector:
Address:
r
_ CITY OP COSTA MESA _
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
555 ANTON BL
1
1 ST FLOOR
41050110
FU4FORD,TERRY
8749 SHIRLEY AV
NORTHRIDGE, CA
SAKIOKA FARMS .
O'BRYANT ELECTRIC
8749 SHIRLEY AV
NORTHRIDGE, CA
ELECTRICAL PERMIT
�Phone: (818)407-1986
Zip: 91324
Phone:
2ip: 94137
�� Pho�e: (818)407-1986
� Zip: 91324
License: 386619
PERMIT NUMBER
E00-00382
T7 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
SCOPE OF PERMIT
� ELECTRICAL PERMIT FOR OFFICE T.I. FOR "EPOCH" (iST FLOOR). INSTALL 19 LIGHT
FIXTURES, 20 RECEPTACLES, 12 SWITCHES, 19 COMMUNICATION DROPS; 3 MISC CONDUITS, & 3
MISC CONDUCTORS. � . �� ' ' ' . . -
REF:600.00524
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to ihp
Motors to 70hp
Motors to 50hp
Motors l0 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
7emp Pwr Pole
Intermed Pole
523.50
50.00
50.00
50.00
50.00
50.00
520.90
$22.00
$13.20
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$20.90
$0.00
90.00
50.00
so.00
$0.00
Quantity
0
0
0
19
20
12
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway/100ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kvalkw
................up to 10 kvalkw
.................up to 50 kva/kw
.................up to 700 kvalkw
..................over 100 kvalkw
Low Voltage Equipment
Low Volt Wiring System I Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Elechical Fee .
Investigation Fee
Plan Check Fee
Reinspeclion Fee
Status: ISSUED
Applied: 04127/2000
Issued: 04127/2000
�uantity
$0.00 0
50.00 0
50.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$54.60 3
554.60 3
30.00 0
$0.00 0
$0.00 0
50.00 0
so.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES 5T09.70
COMMENTS I SPECIAL CONDITIONS
NOTICE: The work authorized by this pertnit shall comply vnth all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shell automaticalty expire and become void if vrork is not�commenced within 180 days, or it vrork is suspended or abandoned
for e period of 180 days.
INSPECTIONS: In arder lor ihe work aulhorized under this permit to be considered legal, such work must comply with ali applicable codes, and eil
requlred Inepectlone and fine� approval must be obtained. Failure to obtain inspections and �inal epproval wilt result in the expiration of this permit.
FOR INSPECTI�NS CAIL: (7t4) 7545626
WORKERS'COMPENSAnON DECLARAnQN: �
I hereDy eMirm untler penalty ai per�ury one af Ihe Idlowing tlecleretlons:
❑ I heve entl wlll malntain a cenllicate at consent ro selt-Insure tor warkers' compensetlon, es provided lor by section 3700 oi t�e Lebor Cotle, for Ihe peAormence oi the
work lor which this permit Is issuetl.
�� I hava and will maintaln wakers' compensaUon Insurence, es required 6y sectlon 3700 of the Lebor Code, br the pertortnance ot Iha work lor whkh Ihis pertnit Is issuetl.
, My workers' co penseli ^sur¢�ce rder end poJlq number ere: . - �/
Carriar. �/i.(.��t/� Ali.Gc �rvS L,°� 'PoliqNumber. �✓W'�27d(,//300
(This section neetl no! be compfeted i! fhe permlf !s veluetl et ane hundred dollars (5700) or less.)
❑ I certify that In the peAortnance af th work Ipr whlU this permit is issued, I shall not employ eny person in eny manner so as to becroma su6jec� �p the workers'
compensaGon laws of Celi la, a rea Ihet it I should become subject to Ne workers' wmpensation provisions oi Sec6on 3700 of the Lebor Cotla. I shell tonhwith
comply with these pro / ./
Applicant Signeture: -.�-. ��.�/ 1 Date: i'L %—OCJ
WARNING: FAILURE TO SECURE ORNE ENSpTION NVEMGE IS UNUW Fl1L AND SHALL SUBJECT AN EMPLOYEP TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED
TKKISAND OOLURE (5100.000�. IN AOOfr10N TO TryE W5T OF COMPENSATION, OAMAGES AS PROVIOED FOR M SECTION 3IW OF THE LFBOR COD� IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRAC70RS �ECLARATION:
I hereby aHirtn that I am
lorce antl eHett.�Lic. M _
Cantractors Signature:
of C�epter 9(cammencing with Sectian 7000) ot Division 3 0l the Business an0 Professions Cotle, antl my license is In full
'Clessa �-�v
.Date: -17-OJ
CONSTRUCTON LENDING AGENCY:
❑ I here�y affirtn ihat thera is e construction lending aqency br the pedortnence ot the work for which Ihis permit is issue0. (Sec. 3097, Civil Cotle).
Lenders Neme: Lenders Atltlress:
Signature:
OWNER•BUILDER DECLARATIONS:
Dete:
I hereDy eNirm that under penalry oi per�ury that I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for ihe I011owing reeson (Sec. 7031.5, Business and ProfeSsions
Code: Any ciry ar counry which requires e permit Io construcL elter, Improve, demolish, or repeir any structure, prior to Ils lssuance, elso requires the epplicant far such permit
to lile e signed siatement thet he or she Is IlcqnsaA pureuant ta tha praNslons ot iha Conirectors License Law (Chapter 9(commendng wlih Sectlon 7000) ot DiNsion 3 ai the
Business entl Pwfessions Cotle) or Net he or she is exemp� themfrom entl t�e Easis for t�e allegetl exemption. Any dolation ol Sectlan 7031.5 by any epplicant tor e permit
subJects the epDlicant to e dvll penalry ot not more than ilve huntlreC Aollare (5500)J:
0 I, es owner oi the propeny, or my employees with wages as iheir sole compensatlon, WILL DO 7HE WORK, end the strucNre is not Intentletl or otteretl for sale (Sec.
7044, Business en0 Professians Code: The Contrectore License law Uoes not apply to en owner ot property who builtls or improves ihereon, end w�o tloes such work
himself or herself or through his or her bwn employees, provldetl Ihet suc� imprwements are not intended or olfereE lor sale. If, �owever, the bullding or improvement is
sold wiihin one year of completioq the pwnerbuilder will have the bur0en of proving Ihat he or she did not build or impmve br purpose of sele.).
❑ I, as owner of the property, am E%CWSIVELV CONTRACTNG WITT1 LICENSED CONTRACTORS to wnstruct the praJect (Sec. 7044, Buslnes5 antl Pmfessions
Code: The cantradors License Lew Ooes not eppy to en owner oi property who builds or improves thereon, and w�o contrects far such project with e contractor(s)
license pursuant Io the Contractors Licensa Lews.).
❑ I am exempt untler sec. Business end Prolessions Cotle tor this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Ves ❑ No Drivers License No.
Veriticetion of Ownership by (rype of Cocument, i.e. - pmperty lez bill or deed):
Expires:
DIVISION OF INDUSTRIAI SAFE7V PERMR CERTIFICATON:
❑ 1 hereby certity that no eacavatlon five (5) or more leet In depih Into which e perwn is required to descend, will be made In wnnection with work euthorizetl by this
pertnit, enC that no builtling slruMure, sCaHoltling, falsework, or tlemolition or tllsmantling thereof, will be more Man thlrty-six (36) leet �Igh. (Chap. 32, Grp 2, Art 2, Sec.
347, Title 8, Califomia AtlminislretNe Cpde).
❑ As owner-builder, I will not employ anyone to Co work whlch would require e permit Irom the Division oF Intlustnal Safery, as noted ebove, unless such pereon has a
permit to tlo suc� work fmm Ihe divisioq.
Slgneture: � Oate:
DlviSion ol Intlustrial Sefely Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORVATON OF ENTRV: I certlly under penelty ot perJury �ha� I have read Nis appliceilon end stete that Ihe Intortnation givon Is
conect I egree to comply wlth ell state laws anC ciry ardinances relating to bullding conswctlon, entl authodze representatives of ihe Ciry of Costa Mese to enler upon Ihe
a6ove-described propeny for inspection purpbsey. I e8�ea not to occupy ar ellow occupancy of eny building euthorized by Ihis permit untll linel Inspecllon.
CODE �. INSFECRIONTYPE QdjE �
1816 Fisetl System Finel Fire Prevenlion
1266 Pool Spa Finel
200 Final Re-Roof
201 FInaI BIocWReteining Wall
202 Final Fectory Fire Place
20.3 Final Sign
204 Final Demolition
244B1fi
WOE� INSPECTIONTYiE
206 Final Mechenical
20B Final Plumbing
210 Final Electrical
212 Final Fire Preventlon
220 Final Planning Approval
222
250
-Z7- �
Date
QdIF It+�ID�4S
5 /a�/er� LC
Final Site
Final Builtling/Occupanty
(714)754-5273 • Fex(714)754-4858
Job nddress: 555 ANTON BL
Suite: 1
Vicinily: ,
Parcel Number: 41050110
, _ CIN OF COSTA MESA
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
npp�icant: MICHAEL WILLEY
Address: 78001 COWAN #A
IRVINE, CA
Owner: SAKIOKA FARMS
Address
Contracror. ASSI SECURIN
Address; 18001 COWAN-#A�
IRVINE, CA
FIRE SUPRESSION PERMIT
Zoning:
Phone: (949)955-0244
Zip: 92614
Phone:
Zip: 94137
Phone:� (949)955-0244
. ..Zip: 92614 -
- . -License: 683831
NUMBER
V .I F00-00081
.. •,.
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/20/2000
� � Issued: 05/12/2000
ISSUED BY:
' SCOPE OF PERMIT
PROVIDE AND INSTALL LOW VOLTAGE CARD ACCESS SYSTEM. INCLUDES LOCKING OF ELEVATOR
LOBBY DOORS TO BE CONNECTED TO LIFE SAFETY SYSTEM. .
REF:B00-00257.
Plan Check: $63.21
Permit: $97.25
Other: $0.00
Total: $160.46
FEE SUMMARY
Calc Valuation: So,000.00
Claimed Valuation: Sa,000.00
NOTICE: The work authorized by this permit shall comply with all appliceble handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241•92)
EXPIRATION: This permit shall automatically eupire and become void if work is not�commenced within 1 BO deys, or if work is suspended or abandoned
for e period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetione and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSATONOECLARA710N: � �
I hereby attirm untler penelry ot perjury one at t�e lallovring tleclarations:
❑ I heve and will mainteln a ceniticete o1 consent to seK-Insure lor workers' wmpensation, es pmvidetl for by section 3700 of the Lebor Code, for the pertormence oi the
—/ work lor which this pertnit Is issuad.
(�y I have and will maintaln workers' compensatlon insuranca, az required by section 3700 0l Ihe Lebor Code, for the peAortnance oi the work br which Nk pertnit is iswed.
t My workers' compensetlo surance cartier en0 policy number are: .
carder. L.rr i va✓ �i✓S - Ge ' Poliq NumberL�/G2% 2 4�/ 3�'
(ihls section nsed nat be comp/eted /1 Me pemtitls valued at one hundred tlW/ers (Sf 00) or Iess.J �
❑ I certlly Ihat In the peAormence ol the work for which this pertnit Is issued, I shell noI employ eny person in any menner so es to bemme sub�ect ta the workers'
mmpen5ation laws ol Calilomia, end egre9,Ihet tl I slp uld Decome SuDject to tha workers' campensetlon provlslons of SeMlon 3700 ot the Lebor Cotle, i shall forthwith
comPly wlih Ihese Provisbll5 �-, // / �� �' / Z �O
Applicant Signeture: � �.�/� i���� Date:
� WARNINO: FAILUHE TO SECURE WORKERS' COMPENSATION E IS UNLAWFUL ANO $HAl1 SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (5100.000). IN ADDRION TO iHE F��ENSAPON, DAMAGES AS PROVIDED FOR IN SECfION 3�O60F THE L4BOR CODE, IMEflEST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eNirm Ihat I em
force ena eHecL Lic. a
GONractor's Slpnamre:
CONSTRUCTION LENDINC AGENCY:
❑ I �ereby eflirtn thet Ihera is e crons
Lender's Name:
SignaWre:
of Chepter 9(wmmencing with Sectlan 7000) ol Dlvlsion 3 of Ihe Buslness and P lesslons Cotle, entl my license Is In lull
Cless a G` % C.t7
/ oate: S —/ Z �G
agency for the peAortnence of the work tor whic� t�ls permit Is issued. (Sec. 3097, CMI Cotle).
LenOera AOtlress:
Date:
OWNER-BUILDER DECLARATONS:
I hereby eflirtn that untler penalry ot per�ury that 1 flm E%EMPT FROM TME CONTRACTORS LICENSE LAW br the lollowing reason (Sec. 7037.5, Buslness end Pmfessions
Code: My ciry or counry which reqWres e pertnit lo canstruct, alter, improva, tlemdish, or repfllr eny s�rucWre, prior to ils issuance, also requires Ihe epplicant lar such pertnit
to tile e signed stetement Ihet he or she is licensed pursuanl to the praNsions of Ihe Conirectors LJcense Law (Chapter 9(commencing with Section 7000) of Divislon 3 of Ihe
Business and Professions Code) or lhat ha or she is azempt therefrom and the basis tor the elleged exemption. Any vialation o1 Section 7031.5 by eny epplicant lor e permit
sublecis ihe epplicant to e cihl penelry o1 not more t�an five hundred tlollars (5500).):
❑ I, as owner of the propeny, or my employees with wages as their sola compensatlon, WILL DO TME WORK, antl the siructure Is not intended or ottered for sele (Sec.
7044, Business entl Protessions Cotle: The Contrectors Ucense Law tloes not epply to en awner af property who builds or improves Ihereon, end who tloes such work
himself or hersetl or through his or her own employees, provitletl that such improvemants ere not Intended or oflered for sale. If, howaver, the bullding or impmvement is
sold within one year of completion, ihe owner-huilder will have Ihe burden of Oroving I�el he or she aia not builtl or improve for puryose of saleJ.
❑ I, as owner of ihe property, em EXCLUSIVELV CONTiiACTNG WI7H LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business entl Professions
Cotle: The contractors License Law does not apply to an owner ot property who builds or improves thereon, and who comracts tor such project with a con�rector(s)
license pursuant to Ihe Con�ractore License Laws.).
❑ I am exempt under sec.
Signa�ure:
Owner ID veritiee by tlrivers license. ❑ Ve5 ❑ NO
Business flntl Professions Cotle for ihis reason:
Venfication ot Ownershfp by (rype oi tlocumeni, i.e. � property tax bill or daed):
Drivers License No.
De�e:
Ezpires:
DIVISION OF INDUSTfiIAL SAFETY PERMR CERTIFICATION:
❑ I �ereby certily t�at no eacavaGon ilve (5) or more feet In tlepth into which e perwn Is requlretl Io tlescentl, will be made In connection with work fluthorizetl by Ihis
permit, entl that no building struMure, scattoltling, falsework, or tlemolitlon ar tlismantlinp thereof, will be more than t�irty-sis (36) taet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Ttle B, Celitomia Atlministretive Code).
❑ As owner-builtler, I will not employ enyone to tlo work wNch would raquire e permlt Irom the Divlsion of InAustriel Safery, as noted ebove, unless such pereon �as a
pertnit to do suc� work Irom Ihe division.
Signeture: Da�e:
Dlvision of Industriel Sefery Permlt Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVATON OF EMRY: I certity under penalty oi per�ury thet I have read this application flnd sWte that Ihe informatian given is
correct. I egree lo comply with all state lews and ciry ordinances relating Io builtling construction, end euthodze representetives ot Ihe Ciry of Casta Mesa to enter upon t�e
ebove-tlescnbed praperry for Inspection purposes. I egree not ta accupy or allow acupancy of any bullUing euthonzed by t�is permit until ilnal inspectian.
COOE I. INSPECTIONTYPE
1818 Fized System Finel FI P
126fi Pool Spe Final
200 Final RaRool
201 Finel BIocWReteining Well
202 Final Factory Fire Plece
203 Finel Sign
204 Final Demolition
2d48.ae
Q�¢, Q�4$ CODE� INSPECTIONTYPE
208 Finel Mechanical
20B Final Plumbing
210 Finel Electrical
212 Finel Fire Preven�lon
220 Finel Planning Approval
222 Finel Slte
250 Final Building/Occuparwy
Dat- ��
Date
BLIE I�LB
tU 3� a'ti �
(714) 754-5273 • Fex (714) 754-4856
� CITY OF COSTA MESA , _:
� BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
Job nddress: 555 ANTON BL
Suite: 1
Vicinity:
ParcelNumber: 41050110
Applicant: LORI LOPEZ
Address: 2505 MIRA MAR .
CA
LONG BEACH ` — ' �
owner. SAKIOKA FARMS
Address,"` � . , ' . - -
.,
Zoning:
Phone: (562) 498-6444
Zip: 90815 �
Phone:
T7 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03/29/2000
Issued: 04I27I2000
ISSUED BY:
� � • Zip: 94137 . .
Contractor: CAL PROTECTION
Address: � 2505 MIRA MAR '
.- Phone:- (562)498-6444 �
LONG BEACH, CA � � � Zip: 90815 � - � �
• � , � ' � License: 327196 �
. � ,
- ' " SCOPE OF PERMIT
INSTALL FIRE ALARM SVSTEM FOR BMC SOFTWARE. '� ��
REF:B00-00257
, FEE SUMMARY
Plan Check: $333.42 Calc Valuation: $3s,i�o.5o
PermiE $512.95 Claimed Valuation: Sss,»o.so
Other: $0.00 - ' '
� - ' � ..
� Total: $846.37
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automaficalty expire and become void if work is not�commenced within 180 days, or if xrork is suspended or abandoned
for a period of 180 days. ,
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and ell
required Inapeetlone and final approvel must be obtained. Failure to obtain inspeetions and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
/
WORKERS'COMPENSATON DECLARAnON: �
I hereby ettirm under penelry ol perjury one oi t�e tollowing declarations:
❑ I haJe and will malntein e cartlficete af cansent to self-Insure for workers' compensatlon, es provitled for by section 3700 0l the Lebor Code, for the peAarmence oi the
work for which t�is pertnit is IssueA.
� I have entl will malntain workere' compensation ins rance, as required by seMion 3700 of ihe Lebor Code, for the pertortnance oF Ne work for which this pertnit is issued.
My w rs' com en ation Insu ce ca er an&p cy number are: . �7 Q
Cerner: ��,��L ����� � Policy Number: �7�"i �U �� I
❑ I cenHy that in the pe ance of the work
compensatlon lews of Ce mla, entl agree tl
wmply with these provisions. ;
Applicent Signeture:
WARNINO: FAILURE TO $ECURE WORKERS' �MPENS
THOUSAND DOIIARE (5100,000), IN ADDRION TO THE CC
LICENSED CON7RAC70RS DECLARA710N:
I hereby atfirm thet I em
brce and ettect. lJt. # _
Contrectors SignaWre:
velued
orless.)
permit is issue4 I shall not employ eny person in eny manner so as to become subject to the workers'
come subject to the workers' compensetion provislans of Section 3700 of Ne Le6or Cotle, I shall forthwith
Dete: y12����
! IS UNLAWFUL AND SW1LL SUBJECT AN EMPLOVER TO CRIMINAL PENFLTIES AND dVIL FINES UP TOONE HUNDRED
IATION, DAMAGES PS PROVIOEU FOR IN SECrION 3]W OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
ot CI ter 9(commencing with Section 7000) of Dlvislon 3 of the Business anC PrW essiorts CoCe, an0 my Ilcense Is In full
Classq L�O1�l(p
Daie: ��'Z-�- bo
CONSTRUCTION LENDING AGENCY:
❑ I hereby eNirm thet there is a construction lending egency for tha pertortnance oi the work for whlch �his Dermi� is issued. (Sec. 3097, Civil Coda).
Lenders Name: Lenders Address:
Slgnature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm that untler penalry ot perjury Iha� I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for iha following reason (Sec. 7031.5, Business end Professions
Code: Any city or counry which requlres e partnit to consWcL alter, improve, demolish, or repeir eny structure, pnor to Its issuance, also requires the applicant for such permit
to tile e slgned stetement Ihet he or sha Is licensed pursuant to the provisians of Ihe Contractors Llcense Lew (Chepler 9(commencing with Section 7000) of Division 3 oi the
Businass antl Protesslons Code) or ihet he or she is exempt ihereirom end ihe hesis for ihe allegetl e:emption. Any vlolation of Sectlon 7031.5 by eny applicenl ior a permit
sublects the epplicent to e civll penalty of not more lhan five hundred dollers ($500).):
❑ I, as owner oi Ihe property, or my emploYees with wages as t�eir sole comDensetlon, WILL DO THE WORK, entl the structure is not intentletl or offered tor sale (Sec.
7044, Business end Prolessions Cotle: The Contrectors License Lew tloes not epply to en owner of property who builtls or improves ihereon, and who does such work
himself or herself or t�rough his or her own employees, provided ihat such Improvements ere not Intended or oHered for sale. If, however, the building or Improvement is
soltl within one year oi completion, the owner-builder will hava the burtlen ot proving t�at he or she ditl not buiiG or improve for purpose of saleJ.
❑ I, as owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the praJect (Sec. 7044, Business entl Pmtesslons
Cotle: The contreciors License Lew tloes nof appty ro an owner of pmperty who builds or improves thereon, end who contrects for such proJect with e contrector(s)
license pursuant to Ihe Contractors License Lews.).
❑ I am exempt under sec. Business end Profeulons Code for this reason:
Signature: Date:
Owner ID verllied by dnvefs license. ❑ Ves ❑ No Onvers License No. Ezpires:
VenTicatlon of Ownership by (rype oi document, i.a. - properry tan bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certtly thet no ezcavation five (5) or mora feat in depth Into which e person Is requiretl to tlescenQ will ba matle in connection with work euthorizetl by thls
pertnit, and Ihat no bullding sirudure, scattalding, lalsework, or demolition or tllsmentling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Tiile 8, Calitomia Atlministrative Cotle).
❑ A5 owner-builder, I wlll not employ anyone to tlo work which woultl require a Dermlt from the OiWslon of Intlustnal Safery, as notetl above, unless such pereon has a
permll to da such work trom the division.
Signalure: Date:
Division ol Industrial Salery Partnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVATON OF ENTRV: 1 certify under penelty ot per�ury Ihat I have read this application and stata Ihat the informatlon given is
correct I agree to comply with all stete laws end ciry ortlinances releting to bullding constructlon, antl authorize representatives of Ihe City oi Costa Mesa to enter upon the
ebava-descdbed prq�@M1y for inspectbn puryoses_I agrea not to occupy ar ellow accupancy of any bulltling authanzetl by this pertnit until tinel inspection.
COOE I, INSPEC110NTYVE
1816 Fixetl System Finel Fire Preventlon
12fifi
200
201
202
203
Pool Spa Finel
Finel Re-Rool
Finel BIocWRatalning Wall
Final Factory Fire Placa
Flnal Sign
204 Final Demolition
260&6e
�
O
1��
CODE 1 INSPECTION TYPE
208 Final MBChanlCal
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Apprwal
222 Final Site
250 Final Building/Occupancy
�2�1 ��
Date
P� 1[�9L5
�_3'd'(� �
��ia> �sa-s2�s • Fa: �»a� �sa-aess
Job Address:
Suite No
Viciniry:
555 ANTON BL
1
Parcel Nunmber: 41050110
Applicant: DON STEVENS
Address: 1940 GARDENA
GLENDALE,CA
owner: SAKIOKA FARMS
Address
Contrector.
Address:
CITY OF COSTA MESA �
BUILDING D/VISION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
PLUMBING PERMIT
MUIR-CHASE PLUMBING � : � �
1940 GARDENA � "
GLENDALE,CA
Arch / Eng :
Address:
Phone: (818)500-1940
Zip: 91204
Phone:
Zip: 94137
Phone: (878) 500.1940
Zip: 91204
License: 539835
Phone:
Zip:
Liiense:
NUMBER
53
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
SCOPE OF PERMIT
2 FLOOR SINKS, 1 KITCHEN SINK, 1 WATER HTR, 1 COFFE/ICE MAKER CONNECTION, 1
DISHWASHER AND 1 BACKFLOW PREVENTOR FOR BMC SOFlWARE.
REF:B00-00257
ISSUE FEE
Backflow irrigation
BackFlow Preventer
8athtub
Clari(er System
Connect pce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Dnnking Fauntain �
Expansion Tank
AMT
$23.50
$0.00
E9.80
$0.00
$0.00
$19.60
$0.00
59.80
50.00
$0.00
50.00
50.00
$0.00
FEE SUMMARY
aTY AMT
Laundry Tub / Washer $0.00
1 Landscape Irrigation 80.00
0 P-Trap $0.00
0 Pressure Regulator $0.00
0 Process Piping (per 10 R) $0.00
2 Receptors $0.00
0 Septic Tank $0.00
1 Sewer Cap for Demo $0.00
0 Sewer ConneC $0.00
0 Sewer Private Line � $0.00
0 Shower , $0.00
0 Sink, bar $0.00
0 Sink, commereial $0.00
aTr
0
0
0
0
0
0
0
0
0
0
0
0
0
Status: ISSUED
Applied: 03I29I2000
Issued: 03/29I2000
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (foilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
AMT
so.00
$0.00
50.00
$0.00
50.00
80.00
$0.00
50.00
$0.00
$0.00
$12.30
50.00
$0.00
Qn
0
0
0
0
0
0
0
0
0
0
1
0
0
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and retated
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall eutomatically expire and become void if work is noLcommenced within 180 days, or i} work is suspended or abandoned
for e period ot 180 days.
INSPECTIONS: In order for Iha work eWhorized under this permit to be considered legfll, such work must comply with all appliceble codes, and all
requlred Inapectiona end finel approval must be obtained. Failura to obtain inspections and final epproval will result in tha ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby eHirm untler penalry of perjury one of the follawing tleclarations:
❑ I heve end wlll maimein e cenificate of cnnsent to sell-Insure for workers' compensatlon, es provided br by sectlon 3700 0l the Lebor Cotle, far the pertortnance oi the
work lar which this pertnit is Issued.
'�. 1 heve entl wlll meintain workers' compensatlon Insurence, es required by sec�ion 3700 of ihe Lebor Cotle, for ihe pertormanca ol the woAc foi which this pertnit is issuetl.
My workere' crompensation Inwrence carrler end policy number ere: .
ce��a�: 57R7C '�.trl D PoIlcyNumber:� �F+6S�JOOC�i �OD
(Thls secNon need not be comp/eted i! the permlt Aq velueU et one huntlretl dollere (5100) or IessJ
❑ I certify that In Ihe peAortnence ot tha work for which this permit is issued, I ahell nol employ any person in eny manner so es to become subject to the workers'
compensatlon laws of Celifomia, end agree that If I should become subjea to the warkers' compensetion provislons ol Section 3700 of the Lebor Cotle, I shall fonhwith
compty wllh Uese D���si j �7 , /�
Applicem Signewre: C lf�—+—`�-�`--t�� Date: �i '— Z'7 —8 n
WARNINO: FAILURE TO SECUPE WORNEfiS' COMPENSATION COVEMCaE IS UNLAWFUL AND SHALL SUBIECT PN EMPLOYEP TO CFIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNORED
T/qUSAND OOLLARE (5100,000), IN ADDRION TO THE COST OF COMPENSAiION, OAMAGES AS PROVIDED F-0R IN SEGfION 310G OF THE UBOR CO�E, INfERESf, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Ihet I em Iicensed unde�rp rovlslons of Chepter 9(commencing with Section 7000) of Divislon 3 of Ihe Business entl Professions Cotle, and my licensa is in tull
rorce ana enect. uc. a S39fS3� ciess a L' —z.iki
Cantrecmr's S�gneture: �/� �— oa�e: R— 31— 00
� � � � e .
CONSTRUCTION LENDING AGENCY:
❑ I here�y ettirm thet there is e construction lending egency tor tha peAortnenca al the work for which this permit is issued. (Soc. 3097, Civil Cotle).
LentlersName: ____ _. __ ._ _ . . LentlersAtltlreu:
Signature:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby efilrtn thal under penalry of perjury thet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW far the following reason (Sec. 7031.5, Business antl Professions
Code: Any city or county which raquires e pertnit to conswq, alter, improve, tlemolish, or repelr eny sirucwre, prior ro its Issuence, also requlres the epplicant for such pertnit
to lile e signed statement Ihat he or she is licensed pursuant Io the D�ovisions of �he Conirectors Licensa Law (Chapter 9(commencing wit� Section 7000) of DiNsion 3 of the
Business end Profeuions Code) or Ihet he ar she Is exempt therefram antl the Desis tor the ellegeC a:emption. Any violation oi Sectlon 7031.5 by any epplicant for a pertnit
sub�ects Ihe epplicant to e civil penelry ot not more then Ilve huntlretl dollars ($500).):
❑ I, e5 owner of ihe prOperry, or my employaes with wegas as Iheir sole compensetion, WILL DO THE WORK, antl Ihe struclure Is not intended or oHered for sele (Sac.
704a, Business entl Professions Cotle: The Contractors License Law does not epD�Y �o en owner ol proparty who builtls or improves ihereon, and who does such work
himself or herself or ihrough his ar her own employees, provitled that such improvemants are not Intentled or ottered for sele. If, however, the building or improvement is
soltl within one year ot wmpletion, t�e owner-bulltler will have Ihe burden ot proving Ihet he or she did not builtl or improve tor purpose o� sale.).
❑ I, as owner ot the pwperty, am EXCLUSIVELY CON7RAC71NG WI7H LICENSED CONTRACTORS to conswct the proJect (Sec. 7044, Business antl Pmfessions
Cotle: The wntractors License law does not epply to an owner of property who builtls or improves thereon, end who coniracts for such project with a contracmr(s)
license pursuent to Ihe Coniractors License Lews.).
❑ I am exempt untler sec. Business and Pmiessions Cotle for thls reason:
Signature: Date:
Owner ID veritietl by tlriver's license. ❑ Ves ❑ No Drivels License No.
Ventication ol Ownership by (rypa ot document, i.e. � property tav 6ill or tleetl):
Expires:
DIVISION OF INDUSTRIA� SAFE7Y PERMIT CERTIFICATON:
❑ I hereby cenly Ihat no axcevation Iive (5) ar mare teel In tlepih into which e person Is raqulred to descend, will be matle in connectlon with wark euthorizetl by Ihis
pertnit, end that no builtling struciure, scaltoltllnp, telsework, or demolition or dismentling Ihereol, will ba more then thirry-six (36) fee� high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle B, Calllornle AtlminlSirelNe Cotla).
❑ As owner-bullder, I wlll not employ enyone to tlo wark which woultl require a permi� Irom ihe Division of Indusirial Setety, as noted above, unless such persan has a
permit to da such work tram the divisian.
Signeture: Dete:
Dlvision oi InAuStrial Sefety Permil Number:
CERTFlCATE OF COMPLIANCE AND AUTHOROA710N OF EMAY: I certity under penalty of perjury thal I have read ihis application and state that tha infortnation given is
conecL I agrae to compty vrith all state laws end dry ordinances relatinq to Cuildlnq consiructlon, anC aui�orize represeniatives of Ihe Ciry of Costa Mesa to enter upon the
ebove-tlescnhetl pmperry tor inspection purposes. 1 epree not to occupy or allow occupancy ol any bullding euthonzed Dy Uis permit until Ilnal inspec6on.
�S� Of Legel Owner(s) � Z�—OIb
-�� �
And/OrAuthodzed ApPlicant �ete
CQOE�. �NsveenoNTrce
1818 Fixetl System Final Fire Prevemlon
1266 Pool Spa Final
200 Finel Re-Roof
201 FIneI BIxWRetaining Well
202 Final Factory Fire Place
203
204
24d8d8
Flnal Sign
Final Demolitlon
Pdg
�
II�dL9
sooe. INSPECTIONTYPE
206 Finel Mechanlcel
20B Final Plum6ing
270 Final Electrlcal
212 Final Flre Prevenllon
220 Final Plenning Approvel
222 Final Site
250 Finel Building/Occupenty
BLIE I[{�45
(714)754-5273 • Faz(714)754-4856
Jobnddress: 555 ANTON BL
Suite: 1
Vicinity: 1 ST FLOOR
Parcel Number: 4� �SOI l �
Applicant: HAGHIGHI, DAVID
Address: 2505 MIRA MAR �
LONG BEACH, CA
Owner: SAKIOKA FARMS
Address
Contractor: CAL PROTECTION
Address:' 2505 MIRA MAR
LONG BEACH, CA
CITY OF COSTA MESA �
BUILDING DIYIS/ON
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
FIRE SUPRESSION PERMIT
Zoning:
Phone: (562)498-6444
� Zip: 90815
Phone:
Zip: 94137
Phone: (562)498-6444
. ..Zip:, 90815� -
- � -License: 327196
NUMBER
101
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: O4IO6I2000
Issued: 0427/2000
ISSUED BY:
SCOPE OF PERMIT
FIRE SPRINKLER PERMIT FOR T.I. FOR "BMC SOFTWARE" (1ST FLOOR). INSTALL & RELOCATE 70
FIRE SPRINKLER HEADS. �
REF:B00.00107
FEE SUMMARY
Plan Check: $313.72
Permit: $482.65
Other: $0.00
Total: $796.37
Calc Valuation: s3s,ase.00
Claimed Valuation: E33,a3a.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements unde� Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92) ,
EXPIRATION: This permit shall automatically ezpire and become void if work is not�commenced within 180 days, or if work is suspended or abandoned
fo� a penod of 780 days.
INSPECTIONS: In order lor the work authorized under this pertnit to be considered legal, such work must comply with ali applicable codes, end all
requlred Inepectiona end flnel approval must be obtained. Failure to obtein inspections and final epproval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 . �
WORKERS' COMPENSATION DECLARATON:
I here6y aflirtn untler penalry of perjury ane ot t�e lollowing dedaratlons:
� 1 have end will maintaln e certlticate of consent to seli•�nsure for workers' compensation, es provitleC tor by section 3700 of the Lebor Cotle, for [he perto�mance of Ihe
work tor which this permit is issuatl.
� I have antl� maintai �' com lon Ins rence, es requirad by section 3700 oi the Labor Code, for the peAortnance of the work lor which ihis pertnit is issueC.
My worke ompens o Insurenca car r nd cy number are: . Z q q
Carder. 9 Sl �C— , Policy Number: �)� UU! ' 1
(Thls secf/on�ot 6 omp/eted i!!he permlt /s valued et one tl tlollars ($100) or /ess.)
❑ I certlty thet in the e rtnance ot Ihe t
compensetian laws o 'fomie, end a ree th
comply wlih these proNsio
ApplicaN SlgneNre:
WARN�NO: FAILURE TO SECURE WORKERS' COMPEN
THOUSAND DOLLARE (5100,000). IN ADOfiION TO THE CQST
LICENSED CONTRACTORS DECLARATON:
I hereby eflirm thet I ah
larce entl eflect. Lic. M,
Contrectofs Slqneture:
of
Il I5 issued, I shell not employ any person in eny manner so es to become subject to the workers'
m ub�ect to the workers' compensation provisions of Sectlon 3700 pf Iha Lebor Cade, I shall lorihwlth
oe�e: � �L� I �
IS UNLFWFUL AND SHALL SU&IECf AN EMPLOVER TO CRIMINAL PENALTIES AND qNL FlNES UP TO ONE HUNDREO
1TION, DAMAGES AS PPOVIDED fOR IN SEGTON 31O60F THE 1A80R OOOE. INTEFE5T, AND ATTORNEYS FEES.
with Section 7000) ol DlNsion 3 of Ihe Business and Protesslons CoAe, enC my license is in tull
_ Clessa �-�0`Ll�
_ Date: ��%��
CONSTRUC710N LENDING AGENCV:
❑ I hereby aHirtn thallhera Is a constructlon lending egenq tor the peAormanca ol the wark lor which thls permlt Is Issued. (Sec. 3097, Clvll Code).
Lendels Name: Lentlets Atltlress:
Signaturo: Date:
OWNER-BUILDER DECLARATONS:
I hereby eNirm that untler Oenelry of perjury that I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for t�e following reeson (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e permit lo consirucL alter, improva, demolish, or repeir eny sWCNre, prior to its issuence, also requires the epplicam tor such pertnit
to tile a slgned stetement thet he or she is licensed pursuant to the provisions of the Contrectors License law (Chapter 9(commencing with Section 7000) oi Division 3 oi t�e
Business antl Pmfessions Code) or that �e or she is e:empt Iherefrom end the basis tor the elleged exemptlon. Any violation of Section 7037.5 by eny applicant for e permit
sub�ects Ihe epplicant m a civil penalry oi not more t�an Me �undred tldlars (5500J.):
❑ I, as owner ol Ihe property. or my employees with weges es their sole compensation, WILL DO THE WORK, antl the structure is not intended or ottered lor sale (Sec.
7044, Business entl Professians Catla: The Contractars Licensa Law tloes not epply to en owner of property who builds or improves thereon, and who tloes suc� work
himsetf or herself or through his or her own employees, provided ihat such imprrnements are not intended or ottered tor sale. If, however, Ihe builtling or improvement is
soltl wit�in one year oi completion, the owneo-builaer will have the burden of proving t�at he or she did not build or improva for purpase ot sale.).
❑ I, as owner of the properry, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to conSlruct the project (Sec. 7044, Business antl Professions
Code: The conirectors License Lew does not appy to an owner of propeM who builds or improves thereon, end who contrecis for such project with a contrecior(s)
license pursuani to the Contractors License Lews.).
❑ I am ezempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verllletl by tlnvers license. ❑ Vas �❑ No Drivers License No. Expires:
Venfication of Ovrnership by (rype of Cocument, I.e. • properry tax 6ill or deed):
DIVISION OF INDUSTRIAL SAFEf`/ PERMR CERTFICATION:
❑ I here0y certify ihat no excavation five (5) or more leet In depth Into whic� e pereon Is reqNretl to descentl, will �e matle in connection wlth work authonzed by this
permit, antl that no Duiltling siructure, sceHoltling, falsework, or demdition or dismemling thereoi, will be more �hen t�lrty-six (38) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Califomia AdministraiNe Cotle).
❑ As owner-bullder, I will not employ anyone to do work which would reQuire e permit Irom the Division of Inaustdel Sefety, es notetl ebove, unless such person has a
permit ta tlo such work tram the division.
SlgneWre: Date:
DlWsion ol InduStAal Selery Permit Number:
CERTIFICATE OF COMPLIANCE AND AUT}IOROATION OF ENTAY: I cenify untler penalty of per�ury t�at I have read ihis appliwtion an0 sWte ihat the infortnetion given is
wrrect. I agree to wmply with all state Wws and dry ortlinances relating to �uilding consiructian, entl euthonze representetives ot the Ciry ot Costa Mesa to enter upon the
ebove-de nbe roperty for inspection purposes�yegrae nat to occupy or allow occupancy ol eny �ulltling euthonzetl �y Nis parmlt untll tinel Inspeciian.
COOE I, INSPECTONTYiE
7818
7268
Finotl System Final Fire Prevention
Pool Spa Finel
200 Finel Ro-Roof
201 Final BIocWReteining Well
202 Finel Fectory Fire Place
203 Finel Sign
204 Final Demolition
244&a8
�s - �n �t � V�'l.�
GOOE 1 INSVECTION TYPE
208 Final Mec�enicel
20B Final Plumbin9
210 Finel Eleciricel
212 Final Fire Prevemion
220 Final Plenning Approvel
222 Final Site
250 Final Builtling/Occupency
�`2`�e� �
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(774) 754-5273 • Fau (714) 754-4856
Job Address: SSS ANTON BL
Suite No 1
(�i
CITY OF COSTA MESA _.
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT.
PERMIT
6�
MECHANICAL PERMIT
Vicinity: 1ST FLOOR
Parcel Number: 41050110
Applicant: RODRIGUEZ, LOU
Address: 6265 SAN FERNANDO RD
GLENDALE;CA� .�
Owner: - SAKIOKA FARMS - � "
Address: . � � � �
Contractor: AIR CONDITIONING CO., INC
� Address: 6265 SAN FERNANDO RD
GLENDALE,CA
, j .
�
Arch / Eng : , ' �
Address: - � ' ' � .
Phone: (818)244-6571
Zip: 91201 ,
Phone:
Zip: 94137
� : Phone: (818) 244-6571
, � ' Zip: 91201
� License: 120696 ' �
Phone:
Zip:
` License:
NUMBER
�
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 03129/2000
Issued: 03/29I2000
ISSUED BY: "
SCOPE OF PERMIT
�� MECHANICAL PERMIT FOR OFFICE T.I. FOR "BMC SOFTWARE'"(1ST FLOOR). INSTALL 5 VAV
BOXES, 7 SMOKE DAMPERS, 1 COMPRESSOR UP TO 15�HP; 8 REPAIR/ALT 1 COOCING/HEAT-� ._
SYSTEM: , � ' � �- �>
REF: B00-00257 '
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >700 k BTU
RepairlAlt Cooling/Heat
Inst I Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhausl
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
$22.00
$0.00
$0.00
$1225
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$47.50
$0.00
$0.00
$0.00
$45.50
$0.00
Quantity
0
0
1,
0
0
0
0
0
0
5
0
0
0
7
0
FEE SUMMARY
Repair I Alt Absorbtion Unit
Repair I Alt Refrigeration Unit
Ventil�ation System
Evaporative Cooler
Commercial I ncinerator
Domestic Incinerator � •
Compressors / Absorption Svstems
Up to 3 hp / t001i BTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp I Over 1,750 BTU
Boilers
Upto3hp
3To15hp
15 to 30 hp
Quantiry
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$24.25 1
$0.00 0
NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92) .
EXPIRATION: This permit shall automatically expire and become void it work is noLcommenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with alI applicable codes, and all
required Inapectlone end flnal epproval must be obtained. Failura to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATON UECLAFiAnON:
I hereby eflirm untler penalry o� perjury one of Ihe lollowing tleclarations: '
❑ I heve antl will melntain e certiticate ol consent to self-Insure lor workers' compensatlon, es provitletl tor by sectlon 3700 ot Ihe Lebor Cotle, lor Ihe peAortnance oF the
r_wotrk tor which this permit is issuetl.
�I �9ve en0 wlll maintaln workers' compensatlon Insurance, es requiretl by section 3700 oi Ihe Lebor Code, for the perfortnance ot the work for which this permit is issued.
Mv warkers' cnmoansetlon Insurnrmw rarnar nnd mlicv �Umbef 2rB'
,olicy Number. 7� 9,T 7 7/i ��
ane hundred dollars ($100) or /ess.)
❑ 1 certify thel in the pertormance of ihe work for which this pertnit is issuetl, I shall not employ eny person in eny manner so es to become subject to the workers'
compensation laws of Califomia, and egree t�at If I should become subject to Ihe workers' compensation provisions of Section 3700 oi lhe fabor Code, I shall fonhwith
comply with thes " lons.
Applicant Signatur . � ate: ;^ SO �'�J
W IARNfN(3�,F � RE WO (Efl5' WMPENSATION EB E IS UNLAWFUL AND SMALL SUflIECT AN EMPL VE�NAL PENALTIES AND pVIL FlNES UP TOIXJE HUNDFED
THOUSANDDOl1FRE($100,000),INADOITIONTOTHECOSTO OIA NSATION,DAMAGESASPROVIDE�FORINSECilON37060FTHElABORODDE,IMEFEST,ANDATTOiiNEV'SFEES.
LICENSED CONTRACTORS DECLARATON:
I hereby effirm ihat I am licensed under provislons ot Chepter 9(commencing with Section 7000) of Division
lorce entl eHect. �ic. q /2 0(/ �/.
CONSTRUCTION LENDING AGENCV:
and Professlons Gode, antl my license is in lull
❑ I hereby atFirtn thet there is a construction lending egenry for the pertortnance of the work for which Ihis permit is issuetl. (Sec. 3097, Civil Code).
Lender's Neme: Lentlefs Adtlress:
Signature:
Date:
OWNEP-BUILDER DECLARATIONS:
I hereby ettirm t�at untler penelry of perjury ihet I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a permlt to consWcl, alter, impmva, demolish, or repair any slrucWre, pnor to its issuance, elso requlres Ihe applicant tor such permit
to file a signetl stetement the� he or she is Iicensed pursuant ro t�e provisians of the Coniraqors Ucense Lew (Ghepter 9(commencing with Section 7000) of Division 3 of Ihe
Business antl Professions Cotle) or that he or she Is exempt therefrom and the basis for the ellegetl exemption. Any vloletion of Section 7031.5 by eny applicant tor a permit
suh�ects the applicant to e civil penalry ot not more then five huntlred tlollars ($500).):
❑ I, es owner ot t�e proparty, or my employees with weges es iheir sole compensation, WILL DO THE WORK, and the shucture is not intentletl or offered for sale (Sec.
7044, Buslness and Prolessions Code: The Contractors License Lew does not apply to en owner of property who builtls or improves thereon, entl who tloes such work
himself or herself or through his or her own employees. pmvided Ihet such improvemems ere not intentletl or oHeretl for sala. I( however, the building or improvement is
sold within one year ot completion, the owner-builder wiil have the burtlen ot proving thai he or she tlitl not build or improve for purposa of saleJ.
❑ I, e5 owner of lhe Droperty, am EXCLUSIVELV CONTpACTING WITH LICENSED CONTRACTORS to consiruct ihe prolect (Sec. 7044, Business antl Professions
Code: The contracrors License Lew tloes not epply ta en owner ot properry who bullds or improves thereon, and who contrecis for such projed with a contrector(s)
license pureuant m the Gontractors License LawsJ.
❑ I am exempt under sec. Business entl Protessions Code lor ihis reason:
Signature: Date:
Ownar ID veritietl by tlriver's license. ❑ Ves ❑ No Dnvafs License No. Expires:
Veriticetion of Ownership by (rype ot dwument, i.e. - properry tau bill or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify that no azcavation five (5) or more feet in depth into which a person is required to tlescentl, wlll be matle in connection with work euthonzetl by t�is
permic, end Ihat no builtling strucWre, scattoltling, felsework, or demolition or dlsmantling thereoi, will be more ihan Ihirty-siz (38) leet hlgh. (Chap. 32, Grp 2, An 2, Sec.
341, Title B, Celifomia Adminis�ra�ive Cotle).
❑ As owner-builder, I will not employ anyona to Oo work which would require a permit from the Division of Industnal Safery, es notatl aDove, unless such person has a
permit to do such work trom the division.
Signature: Date:
Division of Industnel Safery Partnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORQA710N OF ENTRY: I ceniy under penalry W perjury that I have reatl this application and state Ihat the infortnation given is
correct. I agree to wmply with all state laws and ciry ordinances relating to building construdion, end authorize representatives of the Ciry of Costa Mesa to enter upon Ihe
ebove-descnbed properry for inspection puryoses. I epree not to occupy or allaw occupancy of eny builtling auihorized by Ihis pertnit until tinel inspectlon.
COUE N. INSPECTIONTYVE
16/8 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final RaRoof
201 Finel BIocWRetaining Wall
202 Finel Feaory Fire Place
203 Finel Sign
204 Final Demolition
2d46-06
�iY/.7�.
CQOEI INSPECTONTYGE
206 Final Mechenical
200 Finel Plumbing
210 Finel Electrical
212 Finel Fire Prevention
220 Final Planninq Approval
222 Final Site
250 Final Building/Occupancy
/\I I:�YWLPF
tl � �.l
(»a) �sa-s2�a • Fax p�a� �sa-aess
Job Address: 555 ANTON BL
Suite No 1
Vicinity:
Parcel Number: 41050110
v CITY OF COSTA MESA ,
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Applicant: LOU RODRIGUEZ
Address: 6265 SAN FERNANDO i2D �
�
� � �
GLENDALE,CA' �
� .
owner.-��� SAKIOKA FARMS� �. �
Address. , � , . -
� � �
Contractor:
Address:
Arch / Eng :
Address:
MECHANICAL PERMIT
Phone; (818) 244-6571,
Zip: 91201 ,
Phone:
Zip: 94137
AIR GONDITIONING CO., INC �
6265 SAN FERNANDO RD •
. •:�Phone! (818)244-6571
GLENDALE , CA ' - � ,Zip: 91201
� ' � � � .License:� 120696
��
' �
Phone:
Zip:
License:
NUMBER
MClO'-C)(J ( ��o
77 FAIR DRIVE,
Status: ISSUED
Applied: 05/02/2000
Issued: OS/02/2000
ISSUED BY: ��
0
SCOPE OF PERMIT
.� INSTALL 1 VAV BOX FOR "EPOCH" TI. �
+. _ _ .
REF:B00-00524 - - � _ . _ " � -
� - � � '
FEE SUMMARY ,
. Quantity _ Quantity �
ISSUEFEE' . $23.50 '- - Repair/AltAbsorbtionUnit� $0.00 0
Inst FAU <100 k BTU $0.00 0 '� Repair / Alt Refrigeralion Unit � $0.00 0
Inst FAU >700 k BTU � $0.00 0 . Ventillation System " $0.00 0
Repair/Alt Cooling/Heat � $0.00 0 , EvaporativeCooler $0.00 0
Inst / Rep. Recess Wall Hh �$0.00 0 � Commercial Incineretor . $0.00 0
Refriq Sys <700 k BTU� $0.00 0 � �- Domestic Incinerator . $0.00 0
Refrig Sys >100 k BTU $0.00 0 Comoressors / Absorption Svstems
Gas Piping _ , $0.00 0 Up to 3 hp / 100 k BTU $0.00 0
Factory Fireplace ' $0.00 0 � - 3 To 15 hp / 500 k BTU �� � $0.00 0
Hood w/Mech Exhaust $0.00 0 . 15 To 30 hp / 1,000 k BTU $0.00 0
VAV Boz . $10.65 7 30 To 50 hp / 1,750 k BTU $0.00 0
Vent Fan / Single Duct $0.00 0 Over 50 hp / Over 1,750 BTU $0.00 0
Appliance $0.00 0 . Boilers .
Fire Dampers $0.00 0 Up to 3 hp " $0.00 0
Smoke Dampers $0.00 0 � 3 To 15 hp , $0.00 0
Inst or Relocate Appl Ven[ $0.00 0 ' 15 to 30 hp . $0.00 0
Air Handlers < t0000cfrn $0.00 0 � . 30 to 50 hp $0.00 0
Air Handlers > t0000cfm $0.00 0 - Over 50 hp � $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES 534.15
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements undar 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 nofcommenced 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 wilh all applicable codes, and all
requlred Inspections and final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLARATION: '
I hereby aifirm untler penalry oi perlury one of Ihe lollowing declarations: - �
❑ I heve and will meinteln a certlficele oi consent to self-Insure for workers' compensation, as provitletl for by section 3700 ot the Labor Code, for ihe pertormance of the
work tar which Ihis permit is issuetl.
�,�I�have antl will meintain wOrkers' compensatlon insurance, as requiretl by section 3700 of ihe Labor Cotle, for the pertormance of tha work for which this permit Is issuetl.
My worker5' Compensetion InSurenCe Cerrier end policy number are:
Carrier. � 6J/L/Vl� , Policy Number: ��,�d G
(This section need not be campleted i/ the permiNs velued at one hundred dollars ($100) ar less.)
❑ I certiy that in the peAormance of ihe work for which this permit is issuetl, I shall not employ any person in any manner so es to become subjecl to the workers'
compensetion laws ot Celifornle, end egree �hat if I should become subject to ihe workers' compensetion provisions of Section 3700 of the Labor Cotle, I shall torihwith
comply with thes ovisions.
Applicant Signatu . Date: �^ 2 ^��
WARNING: FAI TO SECURE WORKERS' COMPENSFTIO GE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOVEF TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSANDDOLLARE($100,000�,INADDfTIONTOTHECOST OMPENSATION,�AMAGESNSPROVI�EDFORINSECTION3]WOFTHELABORfA�E,IMEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensed under provisi
force antl eflect. Lic. a�
Comrectofs Signature: ,
Chapter 9(commencing with Section 7000) oi Division 3 oi Ihe 8uslness and Protessions Code, end my license is in full
Class # � �'�
Date: S'^�-�'�
CONSTRUCTION LENOING AGENCY: �
❑ I hereby affirtn that t�ere is a canstruction lentling agency for tha pertortnance oi the work for which t�is permit is issuetl. (Sec. 3097, Civil Code).
Lender5 Name: Lentler'S Adtlress:
SiqnaWre:
OWNER-BUILDER DECLARATIONS:
Date:
I here6y aNirm ihat untler panalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires ihe applicant for such permii
to file a signad stetement Ihet he or she Is licansed pursuanl to ihe provisions ot ihe Cantrectars License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of ihe
Business and Protessions Code) or thet he or she is exempt theretrom end the basis tor Ihe alleged eaemption. Any violation ot Section 7031.5 by any applicant for e permit
sub�ects the applicant to a civil penelty of not more than five hundretl 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 ottered for sale (Sec.
7044, Business antl Professions Cotle: The Conirectors License Law tloes not apply to an owner of property who builtls or improves thereon, end who does such work
himsalf or herseli or through his or her own employees, provided ihat such improvemenls are not intended or oflered for sale. If, however, iha builtling or improvement is
soltl within one year of completion, the owner-builder will have the burden of proving that he or she did not build o� improve tor purpose of sale.).
❑ I, as owner of �he property, em E%CWSIVELV CONTRACTNG WITH LICENSED CONTRACTORS ta consimct ihe projeCt (Sec. 7044, Business and Professions
Cotle: The contractors License Lew tloes not epply to an owner of property who builds or improves Ihereon, and who coniracis for such project with a contracior(s)
license pursuan� �o �he Contrac�ors License Lews.).
❑ I am exempt under sec. Business and Professions Code for ihis reason:
Signeture: Date:
Owner ID verified by driver's license. ❑ Ves � No Driver's License No. Expires:
Venfica�ion of Ownership by (rype of tlocument, i.e. - propehy �ax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION:
❑ I hereby certity thet no excavetion five (5) or more feet in depih into which e person is requlred to descend, will be mede in connection with work authorizetl by ihis
pertnit, antl that no huilding structure, scaflolding, falsework, or demolition or dismantling thereof, will be more then thirty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celifomia Atlministrative Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require a permit irom the Division oi Intlustrial Satety, as notetl above, unless such person has a
permil to da such work from the division.
SignaNre: � Date:
Division of InduSlrial Safety Permil Number:
CERTFlCATE OF COMPl1ANCE AND AU7HORIZA710N OF ENfTiV: I certify under penalry of perjury that I have reed ihis application and stete Ihat ihe infortnation given is
correct. I egree to comply wlth all state laws end ciry ordinances relating to builtling wnstmction, end euthorize representatives of the City of Costa Mesa to enter upon ihe
above-tlescnbetl property for inspection purposes. I egree not to occupy or allow occupancy of any builtling euthorized by ihis permit until finel Inspection.
COOE �. INSVECTIONTVVE
1616 Fiaed System Finel Fire Prevention
1266 Pool Spa Finel
200 Finel Re-ROof
201 Finel BIocWReteining Wall
202
203
204
2446i8
Finel Factory Fire Place
Final Sign
Final Demolition
QAjf, INTffI
Date
� L —c"'
Date
LOOE� INSPECTONTYFE
206 Final Mechanicel
20B Final Plumbing
210 Finel Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
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(714) 754-5273 • Fa�c (714) 754d856
JobAddress: 555 ANTON BL
Suite No 1
Vicinity: 1 ST FLOOR
Parcel Nunmber: 41050110
Applicant: STEVENS, DON
Address: 7940 GARDENA
CITY OF COSTA MESA
BDILDIN6 DIVISION
DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
GLENDALE,CA ' - ,
Owner: SAKIOKA FARMS � ,
�, � � .
Address " , . .
Contractor: MUIR-CHASE PLUMBING
Address: 1940 GARDENA ,
Arch / Eng :
Address:
REF: B00-00524
ISSUE FEE
Backflow irrigation
BackFlow Preventer
Bathtub
Clanfier System
Connect pce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roo(
Drinkinq Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets) �
GLENDALE,CA ' "
PLUMBING PERMIT
Phone: (818) 500-1940
Zip: 91204 �
Phone: ,
Zip: 94137
,•
. �-
� Phone: (818) 500-1940
Zip: 91204
License: 539835
Phone:
Zip:
license:
SCOPE OF PERMIT.
RELOCATE WASTE, VENT HOT & COLD WATER FOR "EPOCH" (1ST FLOOR).
AMT
523.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
QTY
FEESUMMARY
" AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) 50.00.
Receptors ' $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor. . _ $0.00
Sink, kitchen � $0.00�
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0 '
0
0
NUMBER
97
77 FAIR DRIVE, COSTA MESA, CA 92626
Slatus: ISSUED
Applied: 04/25/2000
Issued: 04/25/2000
ISSUED BY:
SumpPump
Swimming Pool �
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toileq
Water Heater I vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
AMT
$0.00
$0.00
$0.00
$0.00
80.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$9.80
$0.00
$0.00
50.00
QTY
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regula�ions. (Ord.'No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is nobcommenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work aulhorized under this pertnit to be considered legal, such vrork must comply with all applicable codes, and all
required InspecUone and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS'COMPENSATONDECLARAnON:-
I hereby eMirm untler penelty of perjury one of the following declaretions:
❑ I heve entl will meinteln e ceniilcate ot consent ro setl-Insure tor workers' compensation, es provided for by sectlon 3700 of the Labor Catle, tor the pertormance oi Ne
work for which ihis pertnit is issued.
�.I hava entl will mainlain wwkers' compensation insurance, as required by section 3700 of Ne Lebor Code, for Ne perfortnance oi Ne work for whkh thls pertnit is issuea.
My workers' compensation Insurence carrier antl policy number are: / /�7 /
Carrier. S�%�%Z �/Y(�i Palicy Number. �/06.7 ��CO � ��
(This sec(ion need nol be comp/etetl/l the permi( Is ve/uetl et one huntlretl dollais ($100) or less.)
❑ I certly that In the pertortnence oi the work for which this permit is Issuetl, I shall not employ any person in any manner so as to become subject to Ihe workers'
compensetion laws ot Califomia, antl egree that if I should become subject to the workers' compensation provisions of Section 3700 of the Lebor CoAe, I shall forthwith
comply with these p�m ' ' � /�
ApplicaM Slgnature: < 1/–l.-v `-��' .i—Z-- Date: �— z�—� �
WARNING FAILURE TO SEGURE WORKERS' WMPENSATIIXJ COVERAGE IS UNLAW FUL AND SH4LL SlIB1ECT AN EMPLOVER TO CRIMINFL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (5100,OW). IN ADDITIdJ TO THE COST OF COMPENSATION, UAMAGES AS PROVIDED FOR IN SECTIqJ 3]OB OF THE IABOR CODE, Il.TEREST, AND ATiORNEV'S FEES.
LICENSED CON7RACTORS DECLARATION:
I hereby aflirm Ihel I am licensed under prJo�–vis[lc
forca antl ettecL Lic. tt ���S.YJ
Contractofs Signature: �� _ �
of Chapter 9(commencing with Sectlon 7000) of Division 3 of the I
Class a
Cade, end my Ilcense is in full
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn thet there is a construction lending egency for the pertortnance ol the work lor which this permit is issued. (Sec. 3097, Civll Code).
Lenders Name: Lendefs Address:
Signature: Date:
OWNER-BUILDER DECLARA710N5:
1 �ereby aMirtn ihat under penelry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sac. 7031.5, Business antl Professions
Code: Any ciry or counry which requires a pertni� to consWct, al�er, improve, demolish, or repair eny sWcture, pnor to its issuanca, elso requires the flpplicant for such permit
to file e signetl statement thet ha or she is licensed pursuent to Ihe provlslons of Ihe Contractors License Law (Chapter 9(commencing with Sactlon 7000) of Division 3 of ihe
Business antl Prateuions Code) or ihet he or she Is exempt therefrom end ihe basis for ihe ellegetl ezemption. Any violation of Section 7031.5 by eny epplicent lor a permit
su6jects the epplicant to e civil penalty at not more then five huntlretl tlollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, entl ihe siructura is not intended or ottered for sele (Sec.
7044, Business entl Pratessians Cotle: The Contractors License Law does not apply to an owner oi property who builtls or impraves t�ereon, antl who tloes such work
himsetl or herself or through hIs or her own employees, providetl thai such improvements are not Intended or ottered tor sale. If, however, the building or improvement is
sold within one year of completlon, t�e owner-builtler will hava the burtlen of proving ihat he or she did not build or improve for purpose o� sale.).
❑ I, as awner of the pmperty, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cons�mct ihe proJect (Sec. 7044, Buslness end Protesslons
Code: The contrectors License Lew tloes not apply to an owner ol proparty who builds or improves thereon, antl who contracts for such pro�ect with e contrector(s)
license pursuant to the Contradors License Laws.).
❑ I am exempt untlei sec. Business and Prolesslons Code for this reason:
Signature: Date:
Owner ID verifietl Dy tlriver's license. ❑ Ves ❑ No Onvers License No.
Venfication of Ownership by (type of tlocumeN, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICA710N:
Expires:
❑ I hereby certity ihet no excavetlon five (5) or more feet in tlept� into which a person Is requlred to descen4 will be matla in wnnection with work authorized by this
pertni4 end that no DUIIOIng structure, scattoltling, lalsework, or tlemolition or tlismantling thereol, wlll be more than thirtpsix (36) feet high. (Chap. 32, Grp 2, An 2. Sec.
341, Tule B, Calitomia Adminis[retive Code).
❑ As owneo-builder, 1 will not employ enyone to tlo work which would require a pertnit imm the Dlvlslon ot lndustdal Safery, as noted abova, unless such person has a
pertnit to tlo such wark irom the tlivision.
Slgnature: Date:
Division of Indusirial Sefety Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUiHORIZATON OF EMRV: I certily under penelty ot perjury that I have read this application and state that the information given is
correct I agree to comply with all state laws and ciry ordinances relating to building consiruction, and authonze representatives of the City ot Casta Mesa to enter upon Ihe
ebove-descnbetl properry lar Inspection purposes. I agree not to occuDY ar ellow occupancy ot any bullding authonzetl by this pertnit until final inspection.
Signature egalOwner(s) �/ Date
�� � <-/- � � � l�% ��
�� _^And/OrAuthorizetlApplicam Date
CODE �, INSPECTIONTYGE
1616 Fixetl System Finel Fire Preven0on
1266 Pool Spa Final
200 Finel Re-Roof
201 Final BIocWRetelning Well
202 Final Feciory Fire Plece
203 Final Sign
204 Final Demolition
244836
PAIE I[�45
tooe� insv¢enoxTrve
206 Final Mec�enical
208 Finel Plumbing
210 Finel Electricel
212 Finel Fire Preventian
220 Flnal Planning Approval
222 Final Site
250 Finel Building/Occupancy
QAff It�4$
�t. '�� S.JL�
City of Cos[a Mesa
Development Services Departmen[
Building Safety Division
P. O. Boz 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No. OOG`4S�
The Building located at 555 Anton Boulevacd. Slat6f[p 130
has been inspected and found to comply wi[h the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B2 Occupancy.
Use of Building O£fice
Legal Description 410-501-04
ISee reverse side for Metes and Bounds)
Building Permit No B 36746 Electrical Permit No. E 36761 Plumbing Permit No.
Mechanical Permit No. �7 36761 Number of apartments and/or guest rooms
ISSUED T0:
Security Pacific 9ank
600 Wilshire B:]1vd.9500
Loa Annal�c. CA �O1_7
Building Official William T. Havard
by _/ Y% ..�-, �__
Aoril 4, 1989
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 3015�46 rev. 1/83 White -Owner; Canary - Numerical File: Pink - Bldg. Permit File
City of Cosia Meu
Development Services Departmen[
Building Safety Division
P.O.Box 1200
Costa Meu, California
CERTIFICATE OF OCCUPANCY No. BO�I?�B
The Building located at SSS Anton Boulevard, First Floor
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group a� Occupancy.
Use of Building flffi[�o
Legal Description dlfl-5(11-�4
(See reverse side for Metes and Boundsl
Building Permit No B 3651$ Electrical Permit No. E 36762 Plumbing Permit No.
Mechanical Permit No. P1 371�$ Number of apartments and/or guest rooms
ISSUED T0:
a�cur_ir_y Pacific Bank
600 Sdilshire Blvd.. D500
t,na Anaqlaq. CA
Building Official William T. HOward
�
July 17, 1989
This Certificate of Occupancy SHqLL 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.
C1v1F 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bld9. Permit File
\
+
�
City of Costa Mesa
Development Services Department
Building Satety Division
''� � P. O. Box 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No. �O�gJ�O
The Building located at 555 Anton Houlevard,. Suite 100
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group BZ Occupar;cy.
Use ot Building Off1CBi
Legal Description 410�5p1-04
(See reveru side for Metes and Bounds) �
Building Permit No B 46012 Electrical Permit No. E 46032 Plumbing Permit No. P df+()d4
Mechanical Permit No. �"� ��33 Number of apartments and/or guest rooms
Eire Pcevention Perm�it No. F 46124
ISSUED T0: BuildingOfficial Zbnv C�Ds Baca
Securitv Pacific Banlc � s
555 Anton eoulevard by '� , - �'� . �
Costa Masa.. CA 92626
Dace Plav 17. 1990
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Buildin9 Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CMF 3015-46 rev. 1/83 White • Ownec �anary - Numerical File; Pink - 81dg. Permit File . _
Ciry of Costa Mesa '
Development Services Department
Building Safety Division ,
P. O. Box 1200
Costa Mesa, California ,
CERTIFICATE OF OCCUPANCY No.
Tne Building located at 555 AtYfOnt F10[ff,BVARD i7f1IT �125
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group A—� Occupancy. .
U se o f B u i I d i n g OFFTCR '�R OF A 4VS'T'F.�1 F�3GtTtEERS"
Legal D
(See reve�se side for Metes and Bounds)
Building Permit NoRA�At9 Electrical Permit No. F.F5d29 Plumbing Permit No.
Mechanical Permit No. ueen� Number of apartments and/or guest rooms
Fire Prevention Permit No. F65425
ISSUED TO: Building Official
OAT7[t !1F AMFRTl�n !� O. R f �
�.: ,I
20 N. RAY[�ND AVE�7UE by 'marv n�nc� onnn � t..��'' t'�!�`
nne�ncna�: r� attliS � /� '��
Date ...�/,�.fF�/`� ��
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
_ ._ . � _,�,.�.. �� � _. . �_ �.. . —.� .. ..
, : _ : . �: ;p o f �o�ta 21�e:,� �
Development Services, Division of Building and Safery
CERTIFICATE AF OCCUPANCY
��— ��
This cerrificate is issued pursuant t/the requirements of�the,�Uniform Building Code, Secrion 308
adopted by the City of Costa Mesa cerrifies�that�at_th'e hm'e oi its:issuance the building structure herein
below described was inspected andEappro'ved�foi occuparicy:as follows:
� � ���j�� ' ��° S
Building Address, 5 5 ANTON�BL9D �FIAORS 1-12 ��Cgldg. Permit No.°eee belocs
OFFICES V,a' ��: _ .(`✓���� _ � r`i ����,��,�\1
Use I,Y%� /�..� ;
; _,�,�, � �-=s,. _ Y.. � _ _�_�. F.,,%. ;
L4�, l' />`=: _%� ' ��
Group B-2 Type of:6onstrucrion 1-FR Fire•Zone� ' �'� Use Zone PDC
��� � �, 1�-� ' �n a� v::� r:;,. > �oc �rVl �,. f� , . _ , .
r.J3 � E,•_.3Q:. . d.. . 4' t
Owner of Building Sakioka .Farma �' �—"-- jTenant '•'ma[�dn'r ^ ,
�`�� — 1•�. ,� ,G,irY—n-�-�v�'+�/�'.�„ ,q.�: :
\ 1 � � � - a s-/t-- --. �: - � �,'�� - �
Address
4874570, B7535.6, B74572;, �B745,71, B74573.; -B74633` �-i %ir �� �' �� �
„ <�i
B74632, B74631, B74630;; 00`6, B77866•;;'-B7G574 BY, „"��� ''��
x��� - -�-� ' 1��: �; --µ �:�'� .,: ,��. . � �� �:- !o'
� � � �/C "�, � � . Date'Novem6'� 14, 1996
BI(� BBOHN, CBO ����'�`��. c_�-_/ �!` I
���7 '"�f�
���
� ���"� �,, �
,s
�. „ ] ` ��
� REQUIRED TO BE OS D N A! ONSPICOUS PLACE
�:l� f-��ti � p o f�o�ta 21� e��c
■ V
'� Development Services, Division of Building and Safe �'
', � CERTIFICATE OF OCCUPAN
����
This certlficate is issued pursuant to�the�requiremen,ts� of� the,, tu orm Building Code, Section 308
"adopted by the City of Costa Mesa cer.tifies thatat, the rime of issuance the building structure herein
.,�.... - ,.. . i �..�.
below described was inspected and;ap�roved;foi occupa`n �as:follows_�
Building Address 5!
Use RESTAURANT
Group A-2
Owner of Building —
Address P • 0 R
oFFicinr. Ztonp
s�, ,� �
r: �
�' �
'��� � z
_� �.',. �'+, i.c Y'`
st cn n
�'.r�� %'(�3pz
!�'� FARMS ' �"
. ..o- i �-`�d
3RMINAL ^1E}C`
�s%�y��/
>�Ibe Ba � :x
\sJ ,�I
/i
l� l�
.���t`)
r:
Permit No. n �6455
Use Zone vnr.
REQUIRED TO BE POSTED-IN'•A CONSPICOUS PLACE
Ciiy of Cos[a Mesa
Development Services Department
Building Safety Division
P.O.Box 7200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No. OO�°JOT
The Building located at 555 An�ofl Anulav�rrl. Cniho 1(1f1
has been inspected antl found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group A�+� Occupancy.
Use of Buildi
Legal Description 41C�501—n4 —
(See reverse side for Metes and Bountlsl
Building Permit No. R 4G�7Q�, Electrical Permit No. F 97d9f1 Plumbing Permit No. p 371iQ(1
Mechanical Permit No. M 37149 Number of apartments and/or guest rooms
Fire Prev. Permit No. E 36949
ISSUED TO:
Security Pacific
600 Wilshire Blvd, Ste. 500
Los Anaeles. CA 9()t)17
Building Official William T. HoHard
„� _ i _
by . `� � i� l�� .. - �
Date �ril 10. 1989
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
_. : �... . r.; ,.�;..,,......��.,...�,,.�.......w.. ,
,u„ � � - , � `. , �i: �� o f �o�ta 7Y� e5:: � .
Development Services, Division of B,uilding and Safery
�
` CERTIFICATE OF OCCUPANCY
, ,-�a : =u- `��
This certlficate is issued pursuant to�the�requirements of; the.�Uniform Building Code, Section 308
adopred by the City of Costa Mesa ce[tifies`that at the rime of its'is`suance the building struccure herein
�. , . — - - i .�v�..
4 below described was inspected and;approyed;fo�'occupancy�aS.follows�
"- Building Address 55
�-[7se �STAURANT
Group B=2
Owner of Building S
Address p• �- A
�/ i i �� i�
�;���,15�;
f'Gon'struciic
%"°� Y
A FARMS ;'
li .,
BUILDING OFFICIAL-�Ottp
REQUIRED TO BE
� _ _ `�);l�`�h,`'� =�
I-� Fire�Zone >.> '
aavrcr:t":;IOc "trQC �� � ,-:
�` '�Tenant �S��y
_Y.r"`� -'`� ��''��' ���� ` `]�
Permit No. x 76355
UseZone PDC
PLACE
_....._ .�_...._....____..�,�,:;..:�,i.;,...,,_,4..,:�,._.:., _._-..,�..�_..,..-..,.-.-......:.
, � � �� . �-� �p o f �o�ta 21� e5� �
Development Services, Division of Building and Safety
CERTIFICATE OF OCCUPANCY
`" ' �--4
,. �,�d �"_=:i�
This cerrificate is issued pursuant to�the'requirements of� the, Uniform Building Code, Section 308
adopted by the City of Costa D1esa ce[tifies,thatat-�the rime of its issuance the building structure herein
�. i t..
below described was inspected and�approved�for�occuparicy�as�follows:
/,����d" `����\
Building Address _
Use 1tESTAURANT
Group x-�
Owner of Building —
Address p n. Rn
�� /� ��� � �� � �����. _ ' ����, �-���
�
�ti �-� I �L�' j,,'_5.�� = _ _ - -�`>'(� \�`�
r
of'Gonstruction r-xR Fire�Zone���' ' ,�
° i � " r,�•;.— :���^,t1;i.^.�i�?� '•i�' -:
�.`, -: , �
ilca _Faima � ' __ ' •.- =Tenant ��TACA`Bl
�,'�. � ' ��YvSY;r-�,��=^ C�—. ','+�J � J
�' �"_ ` ' ' ''' .L—� "� AJ 1�_�
\�\;\ � ;\\ �� ., r,iN, B'
. � „ ,, � Y
BUII.DING OFFICIAL-�Ottp �;Ibe Baca 's' ' " �} ,�,
� � � .. . ,
UG'����z �, Date'
• �\��\_,_�:�;_���y�C
,� _ �'��:,.�� ,J�,�;�i� <
� ��_��;.1;, �
:. ,�^'-��-- ,�.-s"• '�
� REQUIRED TO BE POSTED-IN—,a► CON
Permit No.B 7�55
Use Zone pnc
PLACE
� CITY OF COSTA MESA
° BUILpING DIVISION v ���
> _ �
� DEVELOPMENT SERVICES DEPARTMENT
� PERMIT PERMIT NUMBER
��
F98-00160
(714) 754-5273 • Fax (774) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
,lobAddress: 555 ANTON BL
Suite: 1
Vicinity: PLAZA LEVEL & 12TH FLOOR
Parcel Nunmber: 41050110
Applicant:
Address:
Owner:
Address
r; �� ,:
; ��
iP� `\ �r.
�� �
FIRE SUPRESSION PERMIT
Status: ISSUED
Applied: 07/14/1998
Issued: 08/03/1998
Zoning:
UNKNOWN -
/ � T -`� .. . _ _ � � .
i. _ <
�� � � � `
����-�,�; Phone � - __ _ `_
���� 1 � ��P , l r ����
/ —� , I � � ;�
/.%��/ � � � ` � , i �� �.� � -
SAKIOKA� MS �/ ; _. _ _ � '� � ��• � �V �A
i G � ` \ �
�1 � �� � _- -- -�- - ��" �J . , �, -A
%�\ % �� � Phone \\ �\ - . \ \ i; � i\�\,�,
��� � Zip: 94137 ��� � � ',� �-�'.
��VAV� �/�` � .. ,A
� ���� \V.,�, / �.�_
CACIFORNIA SUPPRESSION SY �, � ��� �: A\
.,.� �.�: ��
�
� 02505 MIRA MAR � . , � ,�� �
-_�
) ����� Phone:.- . - `�,��:_ � ��,� � �
LONG.BEACH CA _ Zip:��-� 90815_ , • • ' � � . ' ; ' �� '�� A
.;/-��.�� . �'�, _ _�License: 327196 � � ., � . �
I. �
„/� ,� � : / ' � �. _' � _ _ � SCOPE OFPERMIT '� � �
, PIPING RETi20FIT.�FROM 6" SCH. 10 TO 6" SCH. 40 TO THE PLAZA LEVAEL'NOT OCCUPIED AT
':THIS TIME. ��� � '
%� ' �' �.% i � � �� ,
f, � �
�FIa�Check: °��$154.21
��, Permd' � $237.25
� ' Other: , �$0.00
�1\� ��, ',/�
��� � .- 1 � ..
\��,1 `ToWI ; \�$391.46
/ ! " � ` % i��e � �- ; FEE SUMMARY ' '�
� j .�s �.__ ,�-i��:
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� - , _,
� ' '�
, �'.'�,
r�^�/'Vi/j��� �tr /.� ' f �.' i„
�_"_ __" -__� �/F'�..
� i
Calc Valuation: . ao.00 :
Claimed Vatuation: si5,soo.00, ,. .
/
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, ��
,;=�; i
i
�I EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 deys, or if work is suspended or abandoned
�', for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to ba considered legal, such work must comply with all applicable codes, and all
requlred Inepeetiona and final epprovel must be obtalned. Failure to obtain inspections end final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSATION DECLARATON:
1 hereby emrtn under penalty ol per�ury one of the following tleGeretions:
❑ I heve end vnll meintein e certificete of consent to setl-Insure tor warkers' compensetlon, es provitletl tor Cy section 3700 ot the Lehor CoAe, for the peAarmance at the
xTich Ihis permll Is issuetl.
. I have entl vnll meintein xrorkers' mmpensation insurance, as required 6y seclion 3700 oi the Lebor Code, for the pertomience ot the work tor whlch Ihis pertnit is issued.
, My work mpensatio In urence cartie�d polic�y%� m�,be�r e�re,: � y XO
CaMer: �% �/ ��%i. l h�L�LL�/Y � ` Policy Number: � � l/ �/%
(Th/s secNon nee n be comp/efed I/ fhe perm�t �s valued ef one huntlretl tlollars ($100) or /e55J
❑ I ceAify �het in the pedortn�nce o�.1f� work for hich �his permit Is issued, I shall not emplay any pereon in eny manner so es ta becoma sub�ect to �he workers'
campensellon lews f Celit� rnl �nd egree tha ii I shoultl became sub�ect ta the workere' compensation proWsions ot Sectlon 3700 of ihe Lebor Code, I shell torthwit�
'(" wl�h these o Islo �' �_� C/
1ce igna re: Date: �
Nu1E URE TO SECURE WOFKE S' COMPENSATIIXJ COVERAGE IS UNLAW FIIL AN� SHAl1 SUBJECf AN EMPLOYEH TO CHIMINAL PENALTIES AND GVIL FINES UP TO ONE MUNDRED
THOUSAND DOILAPE ($100,000). IN ADDITION TO THE COST OF COlAPENSATION, DAMAGES AS PROVIDED FOR IN SECfION 3lOfi OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRAC70R3 DECLARATION:
I hereby eflirm ihet I am licensed un isy'
force and eNed. Lic. q
Contrectors Signeture: �
9(commencing with Sectlon 7000) ot Divislon 3 of the Business antl Profess ons Cotle, end my Ilcense Is In full
' Class #
— Date: �
CONSTRUC710N LENDING AGENCV:
❑ I hereby atfirtn ihet ihere is a construction lending agenty tor Ihe peAoimance of the work for which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lendafs Name: Lende/s Address:
Signature: Date:
OWNER-BUILDER DECLARA710N5:
I hereby eRlrtn thet untler penelry ot peQury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reewn (Sec. 7031.5, Business entl Professlons
Cotle: Any ciry or counry which requires e pertnit to consiruct, elter, Improve, tlemolish, ar repair eny strudure, pnor ta its Issuance, elso raqulres ihe epplicent lor such pertnit
ta Ille a signeC stetemem Ihat he or she Is Ilcensed pursuant ta tha pravisions of ihe Contrectora LJcense Lew (Chepter 9(commenGng with Sectlon 7000) of Dlvlsion 3 of the
Business end Pmfessions Code) or that he or she is exempt theretrom and the basls for ihe ellegetl exemplion. My vidation oi Section 7037.5 by any applicaN for e pertnit
su6�ecLa Me epplicant to e civil penelry of not more Men five huntlretl tlollars ($500).):
❑ I, es owner oi t�e property, or my employees wit� wages es thelr sola compensatlon, WILL DO THE WORK, and Ihe structure is not intentletl or oHeretl for sele (Sec.
7044, Business and Professlons Cotle: 71ie Contractors Ucense Lew does not epply to en owner ot propeM �'�o bullds or improves ihereon, and who does such work
himself or herself or through his or her own employees, provltletl t�at such Improvemems ere not Intended or oflered for sale. N, however, the building or improvemen� Is
soltl wlthin one year ot completlon, ihe owner-builder wlll heve the burtlen oi proving thet he or she tlitl not 6uiltl ar improve tor purposa of sele.).
❑ I, es owner of the property, em EXCLUSIVELY CONTRACTING WI7H LICENSEO CONTRACTORS to construct the pro�ect (Sec. 7044, Business entl ProFessions
Cotle: Tlie contrectors License Law does not apply to en owner ot property who Gulltls or Improves thereon, end who contracts tor such pro)ect with e contractor(s)
license pursuent to the Conirectors License Laws.).
❑ I em eaempt under sec. Business enA Protesslons Cotle for Ihis reason:
Slgneture: Date:
Ownar ID veritied by drivefs license. ❑ Yes ❑ No ' Dnver's LJcense No.
Veriticetlon af Ownership by (type of document, i.e. - property taz bill or deed):
E:plres:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereDy cenity ihet no excavetlon Ilve (5) or more teet in deplh Into which a person Is reQuired to descend, wlll be mede in connecllon wlth work euthorized by Ihis
pertnit, enC Ihet no building strucNre, scafroltling, telsework, or demolition or dismantling �hereot, will be more Ihen thirty-six (36) feet hig�. (Chep. 32, Grp 2, Ar12, Sec.
341, 71tle B, Celifomle AdmlNstretive COEe).
❑ As owner-builder, I will not employ enyone to do work whic� would require a pertnit irom t�e Dlvision af Intlusinal Safery, as noted ebove, unless such person has a
pertnit to tlo such work trom the division.
SlgnaNre: Date:
DlNslon of Industrial Safery Permit Number:
CERTIFlCA7E OF COMPLIANCE AND AUTHORQATON OF EMRV: I certity under penalry ol perjury thet I have read Ihis application and stete that the Information given is
conect I egree to comply wit� all stete laws and ciry ordinences relating to builGing construction, end authorize representatives o1 the Ciry of Costa Mese lo enter upon the
above-descnbed property tor inspection purposes. I agree not lo occupy or allow occupency of eny building authorized by this permit until finel Inspection.
LQpE 1. INSVECTON ME
1616 Fixed System Final Fire Preventian
1288 Pool SDe Final
200 Finel Re-Roof
201 Finel BIocWRetaining Wall
202 Final Faclory Fire Plece
d 13 � �
f�Qf�j RISPELTONTYPE
206 Final Mechenicel
208 Flnal Plumbing
210 Final Electncel
212
220
Final Fire Prevention
Flnal Planning Approvel
203 Finel Sign 222 Final Site
204 Finel Demolition 250 Final Building/Occupancy
zea&ae
Det� � ' [_�
Data
•.I/\i�Cnu11�
3 B b-
�f
�oonEss a ea�mia:
99
ONNERB N.WE IF p1UYN:
,�ooxesx
.wi. �unma �ooness:
ANTON
EX
ura: 1 S T
urcxirEaon��n: INTERIOR ARCH. 2136232164 ucno:_ C-9378
urcxonu+as�oo�ss: 550 S HOPE ST ur�r: 1100
LOS ANGELES CA 90071
coxm�crarsxu�ACCENT BUILDERS (714)757-1998
carm�croxs�uiwn 17945 SITYPARK PARK CI
moxEss:IR CA ao.: 39779
9 2 614 uNr:
LICENSED COMXACTONS DEC W1A110N: I MreEy dlim wdr prWy tl I em Ic/�er �Mqr 9
(oommendrq wuA Sectbn )000) d Owiaion ] d tM Bueiiwm vd PMeeeiana Y fimiva' end M
cm uc. No.: uc. cuss: g uc. No.: 7790 X•
�tls: '� — CoraMr.
I � . .
N BUILDEH DEClAN1T10N: I hereby effiim uMer penelly d 'ryry �lut I vn eu Irom IM Imtlm Licen�s Lew la iM
i•� ow+iG rmwn ISatlion 10313 Buenee� rd Prdesuw�s Cods: A Uy a oounH wM1icl/n 'm a 4 �0 mutrun. elv.'vnpovs.
� demd'eh, a repei eny �vunum, pia lo b'ewenca. e6o rtyuiiu Ihe epplimm fw eucA prmu � qneE etetemenl Met he a�M
a
is IicemeE W��� �a �� pa�� d Iha Conirenan lironea lew �cn�.� e(oomm.�re wnn seaoo �aao� a oNe�o�, a a iro
Bueiroa ard Prdeniwu Codal a�� � a ahe u aaemq iharehan vM IM baw lar Ns albpaC manqion. MY vio4tion d 8adm
)0]I.5 by enY eVWK^^t lor e perm! wbpde the eppl"ram �o e d�il penely d ra mon tlun INa lwnE�eE EoOen �5500�.
� I.siowrrdiMpropenyamyemWv�mawYhwepeemiMiedemmpmwqn.xilldotMxwk.aMiMmunu�eu�imeMaE
a MaraE lar eele I��n ]oae.8u�inme eM Pmleeeions Code: The ConlreGon Liwme Lawtloee �at epply loon ovmm ol popeM
u
who buide a inP� �Mmm. ud who doas euW wak h'unrtl ar henN n tlraqh hu a her am amMWw. G�'� IMI euch
'unpowmsro ua nol'vpakM a dland ta eeb, tl. lawawr. iM ddtli�0 a inP��en u�otl wnMn ans Ym d canPMion. Ihe
ownmbuitlr wYl heve �he bwden d pwiiq M w eha did M WJd p impwa la IM p�ryme d veM).
� I. ef ohner d IM D�M, em aKtlwivay' conlradM xilh licanead canVe[�m M canprutl Ne DAI� (Sadion ]ON. Bue'uiw� md
Prdu�'vn Code: TAe Comretlm l'renw lew don iM WdY b an owner d popMY Wro builde a nwa'ss thasan vd who
wwecb br w�di M9�s xvh e mmreeMellicaueA pmueru lo �M Camre�fm Limu� Lewl.
� I em e�emq uMer Seclion: 8. 8 P.C., Im i�q roeaon:
Dma: Ow+w:
1 do hereby cMity IMI I em awere d uM urM�staM IM ipuiremenb W Celiania Heellh uM SYery CaEe Sediwu II5503. 255J�. eM
2553a, vM Nei I u eiry Mure WilEmp omqent will / wil ml (tlrcY ma) nead ro canply wih eNA aeta mdr eM tM ropuimmanb br
eperm�laaomvuctionamoEifiralionhamlMAr e3ui�iaupamomDierct.RakaXwlwMiupianappiu�iamanaasmqtmnNw
pwisims.
Dale� ApplceM:
WOflKER'S COYPENS�TION DECURATION: I Mreby elfirm ivMer perW y d prjuy me d Ow IoOowinp detlerelioro:
� I heye aed xll meimein e eaNieb d evnmm io vaMineun M wwken' wmpemelbn, n pwided la by 9apbn ])00 d tM lnEor
GoEa, lor tM pe�iamenu d Ihe xoM1 la wlich i�n pemin n InuW.
•�] 1 Mw ud xil meinien worYxY wmw�ion Mu�uo. m na�mM bI Sseian �100 d iM lebor Cods. br iM D�a�� tl �Ir
l� w�,x�«�,�n�n�na'.��.m�.e.Mr�LI�EAY MTJTUAL���um��: EXPIAES
c��:
Pafry Number. 12 / 3 0/ 9 8
(ihb wction nsed rat ds romWstM l tM w�t e ror om �unCmJ dullen Riaol a Nu.
� I mnAy iMt in IM parlameza d iM wak M wTch ihie pxmil ia imuetl. I• 'wl employ penon in p�annar m u lo
wbpa to iM xorkxe' mmpame�ion lewe d CelXanu, end thm ! I to IM xoMn'
penation pwi�iom d S�dion �)00 d �M lebor Cods. I IM� ' wmOM x4h
oais: � Z3 - � nap�m:
W /ip: F�Nun b ueun wark�n'rompewtlon rov�rap� l� unl ,�M �IWI f�el �n b a1MiW pwltlp uM
11 Ilriu up ro on� NnarM flausud CNNn (SIOO,p00/, M Mtlltbn ro M� cwt / r5 tlemep� o provMM br In
9xHon ]R16 0l M� Le�or COM, InMretl, enE ettom�y'� Iws.
CONSTNUCTION LENOIN(i �OENCY: 1 hareby elfirm urder pe'alry d prjury Ilut �Mn u e aMiudian ladi�q epmwy tar IM
�.parlpmerce W tM xwk la whiW I�e pxmi b oeuad (`waun �04). Crv. CI.
LENDEF'S NMIE:
IENUEF'S ADONE53:
1 caniN �� I hera reed ihia ' eM nele Ihet IM eEove iMormetqn ie comd. I epiae to wmpFy xil� NI dly eM mumy adineMee
ond eiete levn nle�ip lo dip oneUuqion ud hxeby�elKwSe �eqeaemetivee d ihn rny to enter upon tM ebove�mentionad papeM
lorinspadion W� �,,.,�. ,.,�;�,,,�� /
Dela: � �� �"—�u
(5151�A8 WP) While-BuiWnp 85e1e1y; OreaMFlle; Ceiury-Appicent; Pink-Re.enw:0aken�o�Mexw
_ _ ___ _ _ . _._-__ . CITY OF COSTA _MESA - _,BUILDING PEAMIT V � _ ����
__ ---- - --_ .__ _. . _ _ _ PERM NO: M 087089
PERMIT NO: M 087089 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; 1-FR _ PERMIT TYPE: MEC PDRPOSE: ALT
JOB_DESCRIPTION,_ : DEMOLISH INTERIOR NON BEAAING WALLS S(j FT;
CLAIH VALUE: _ CALC-VALUE: GROUP OCC: B /
COMMENTS: REF:H-87087
wrw****r��r**�****w*****�r�c*w��*****�r*******��tr�**+�**+t+rs+r**+r*�c�****��*+�w***�c�c�t�*�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: . FT ZN RGHT: FT IN
PARKING REQ• PAOV: PARCEL: 41050104 ZNE: AEF NO:
PLANNING NC3TES> ,
>
iFiFiFMififMMifikMMikMMMkMiFMiiifMMMifiFiFMikifkMMMiFM%IfMMifMMkiFMMitififiFitMlfikifitififNMiFMiFk%iFikMitifififiFlkMiF3F
D E V E L O P M E N T S E R V I C E.S R E Q U I R E M E N T S
20NING APPROVED BY DATE:
HUILDING APPROVED HY : DATE;
APPLICATION ISSUED HY: DATE:
�*******.�*,��******�* *******�** � �8
LEGALIZATION:N .__ F E E S U M M A R Y STRUCTURAL.SE MENT:N
HLDG PMT_ PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT. _. . -- — ---_-- --- _•. 9.50 .
. . . 252 SMIP/NON-RES
PLAN �_
ISSUE FEE 22,00
BUILDING-DIV-> PfiItMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 9.50 . 22.00 •� 0.00 31.50 31.50 .00
REVENUE DIVISION TOTALS-->, COLLECTED; 31.50 OVER/SHORT: .00
HLDG PMT PLUMBING.ELECTRIC MECHANIC FIRE SMIP/TOT_ GRADING PLAN-CHECK
_31.50.
■�r�r*�e***�rr*+errrr*rrrrr+rr***r�e�rr+r+r*r���r**�*��r�r*wr*r*�r**r****«�**+r+r***�e**�*w��r*��r
I N D I V I D U A L' F E E B R E A K D O W N
TYPE QTY D E.S C R I P T I O;N UNIT COST TOTAL COST
MEC 1 EACH APPL NOT IN OTHER CAT UNDER FEE 9.50 9.50
END OF FEES
�_ ��,� �
02-24-199BJ89:53 1.58
.�'�/' I� �i� RCPTq: -08 828
_ � 1 1 PEkMIT:O 7 89
I� 1
����
r
CONSTRUCTION AND PLANNING ,� �OL & SPA ' ,
APPROVALS �Permit# Date Inspector qppROVALS Permit#- Date Inspector
1. Temporary Electriral Service or Pole 52. Pooi & Equipment Location
_V r2. Soil PipHUndr�rn,d� 53. Steel Reinforcement ,...�
,-. ;� �lectri . Cq•ry¢q tility-Undrgrnd. 54. Farms �
" OH�!-£lectrica'�6L'��-Undrqmd. . 55. Electrical Bonding ��
c y T
�,S�.aSteel Re �o�it � 56. Rough Plumbing & Pressure Test � "�
"S_S�lectric3tOh'PR�rnd. 57. APPflOVAL TO COVER�GUNITE �"
`c � . �^
��7.�ootinqi�`�^ T� � 58. Eiectrical Con`d,�A`'��Undrgrnd. �
�J�8. FoundatisF* .�� vi 59. Gas Pipe, O U�cgrnd., Test ,�
�3. Water Pi.��Undrg�nd.,� 60. Backwash Lines; P-Trap, O Undrgmd.
J��
10. StructuraJ Floor SYstem w � 67. APPROVAL TO^DECK
1 i. Propertp-Se�r L'in�& HouirConnection 62. Backwash &�torFinal� �
�� � �
� 2• Se"°e� CaP a• 0 63. Heater & VencFiFlal �
13. Roof Drains`�^ � . • � �
�V . . 64. Plumbing SYstem • Final
14. Rough P�mbi� ,,, X � 65. Electr�ical-Finai , '
15. Rough Electricat-Coaduit •� - 66. Solar SYstem-�t�l , ��
16. Rough �'gc,,$ri ��ir�,q � 67. Fencing & Acc�s�Approval
n
17. Rough Wiee�g oign • . � 68. APPROVED RQ�Fi PLASTERING
18. Rough Electricdl•T Bar Ceiling 69. POOL/SPA SYS�EA4S f INAL
79.CRot+gh ygati�y7 8�p,ii Conditjo(aiqg �no+ x c� oo ct'! "7 ^ pfREliEpT�tREQUIREMEPoT E
m �:u,�C :n t >+ �!
20.�7or�h Fs'ctdl'.Hy (��lace ! rF xS * H � y* Q AP�O�� ¢ P�mit #« �;� n
21.�DuC�s, i��;¢tructu�* � Sr=i 3 fJ H Clr �-i 70YUnder iCOhd F�ydro '�
r,
22.�u�is,�nti�tlnfj%W � ^C'J k b Q f) Fx Q �� prod�{�i'i in 'r'''Gas �0(I
* 1 fx �: O' H# F 1 P� (',J
23. �Ga �ipe�o�h $k st � ;-�r, p�p .�,c � tr S� O 72. Undergreund �ush �c >+
24. Roof Pr�ining h"'M N * m m O n:� S�� UndergL�d.Stpy�jeTan� OGas ❑Oil
25 0^ Sh athin Y v �• " "
�,. 9;� x y [r! p* ' 74. Overhead NydID:^ X
26.VT-Ba� Ceiling �StwCtural) & MS�coat ' � >' � dY 7�, Dry Ch�ical�� . *.� � �
.. •-7 * � -�. cC * c� .� ... � � n � .,.
� 27.�rame a�*�1 Flash� ,.,�.,�,� �„ f �,w 76. Dry StagipipeQ., X o n�
28. LaTdSng@Siding t D�F C _k I 7�. FIXE(�"SI�STt�I�FINF�''�L~ n o,
29. Insulatio;� * � ,-Sj .9: 5 � . FIRE PREV. FiIM1L4L ��� ~
�
30. Drywall Nailing *'-� � *�"' s ��NEAL'(H DEf��,'f�JiE�Ui�EMENT
31. Plaster �,t`pw�Coat� S � E.�'.,'�i.T., K K� 79. FINAL�PEC ON tt� , H
,,, -Ae- ...
32."flectric3�PoAer MeterE,nal i * - rt, Bd. FOOD CERTI� TE �5911ED
33.=fina�'y Ela�ttri� { � � � '� ' s: ..CT`' R �ry �n', n `� �t /�- n�} //���
C t � 'r. �'n I H H Q'. X C. .� -fi�.�3-`-':� _/l� � 1`�� (� l, r/_L1I_Y
34 �ina�6. Hgg[in�& Air�nditioning �+y 1: ? N �-�+ '� �S'-� y T x� ,
� 35 rFinal GasPipe-Test'� G` " *'"' � _� -�.o � .+tir .x � .
.. r * 'Q d: k}: �y . .. C1 G . X [*] '�C
36.�loQd o�r�anopy *-�n i�ti -+ *� m zo �: r: m . ,
i �m rn �l � �:+7
'� 37.'Final'F�ory Firep�3Cex � F;� `u t t�: `� r
. 1• * N 'K Q rL;� �� � [*' fi �7
L � V
38. FinatPittpibing ,r.;� , � O s �� � HN!V o G c : '� -
M U
39. N'ater Se' ice-Final� E t .t tX � -, a: c*'
.+„� �e n x � . Y. i-n W :% ITI f�i �
40. Gas Serwee-Final :*'� ri�..F j :K �' � I F• o^ *�y � •
rn
� � 41. lar pomesticFin�l � ''� * � �" "�� � � � � �
N �' � r �+ C: �K S
42. Backflow Prgyenter� fi; Ci...iN t H � x [*1 t70 * F �
r G a:
, � ��h43. Backflow Irr�ationK �'�� * � * tti; ^ � 3 O ��
mc r. . Y ,.. .. .. , � - .. .. _ .
�44.;�..andscape Irriqatioa Systerrq�,:. ;,y x: �y 6�C* E �' w uG .i:.s t� �
= i-. r� rn.-� .r.
� V45.=Sound ,4tte�atior� `= " " * �T m �`'�' �� � 4 • `C' �' ' -
1 i CC $ 'I,: [t� ••fi ^ / / HN ••H A'.
��-' �: 6. �Han54icap Regulatio,�as s .. M � �t: � m :� ` rJ .rc .
S17. FIMALSTRUCTURE & BUILDIf�G * E"' � �' � F � -
� cu c� i t* . :r n r � � �
-� 46._ If�g.L PLANNINGc ; `� z�V - CJ n; S � K ,
=�9. �Electric Release to Edison i * tr. �:, •�+ � � "
x � * ,;« c ox a= n a�
� c r .ir.; i _� � . � �
':�0.'Gas-&elease to Sout�ern Califo,.tc � Gas Co r *• 5 �o vC� * :� r�
M. t i-.
�51. CERTIFICATE OF OCCUPANCY
� No. Date
�
Aop�ieant to fill In all svaees exeeo� tnose within heavy oorCer Iines an0 sign all aoProoriate aeelaratlons.
CITY OF cosTa MESA C^ONSTTRUCTIOf�,PERNf1T ,
. Project Address ss r/ N/ O�(/ �(�G
Applicant'sMailing� ress—r�'U 'QNA�C/A' .��' �6LKN
� Owner's Name �G�ti�T �� hone -7'r��
Address ssf L�.�T.C� ,�L� CorTif .�16-.7N
Arch/En9. , License No.
Addre�s /•��j
ContFett6r'sNa�sU.f/d�%t��lN'� �.1�'� Phone2�'�'�%f7/
Atldiess (mailing) �ZGs—A�,.4�,N�r'��V'`""��"' .�(L{�l�e1�(�r'
City License No. - ���7"�3
LICENSEO CONTRNCTOR DECLHRHTION �
LhereGy affirm tM1dt I am licensetl untler provi3lons of �Charter�9 (tommencing
with seclion 7000) Of Division 3 oi the BUSineis antl PrOfe551on5 Cotle, dntl .
my license is in full torce and eftect.
ucenderCI asns�.-�,s �Z� 'cense No�zoG9�
C Date� Signaty
� WORKERS'COMPENSATIOH-�ECLARl1TION ,
1 hereby affirm that I have a certificate of consent to selLinsure or a certiilcate
of Workers' Compensation Insurance, or a certifietl copy thereof (Section
\\ 3800,'la O%�Gc.'
PolicY � f� O� . ComPanY ��r�'v .
(,1 Certitietl Copy is h'ere�y furnishetl
�V Ce�titietl copyJ�5 filetl with the� y Buil Inq jD�viiioy� J
Date �-2?�S/r �' APf� canN t ��
EXEMPTION FROM WORKERS' C� PI�ENSATION DECLA ION
(�Thizsection neetl not �e completedit the pa�mit is fo� one�h tl�ed (E100) o�
less).
I rertify [hat in the performance of the work for which Mis permk is IssueC, I
shall� not emo�oy any person in any manner so'as to become subject to the '
Workers' Compensation l.aws of Calitomia.
. Date ' Si9nature '
'NOTICE: If, af[er making Ihis tlecla�ation, you ihoultl become subject [o the
Workers' ComOensatlon provisions of the Labor Cotle, you must forthwith '
compry with Such prOvi51on5 or this permlt zhall b¢ -tlG¢metl revokeU.
CONSTRUCTION LENDING AGENCV �
1 nereby affirm [hat [here is a construction lentlin9 agency tor t�e performance
oi the work tor which tNs permit is issuetl (Section 309� Civ. CJ
LenAer's� Name
Lentler's AEGress '
OWNER BUILUER �ECLARATIOfJ- ' �- ' •
I hereby afflim that 1 am ¢zompt from the Conlractor'S Ucense L.aw fOr [he
following reason (Sectlom7031.5 BuSiness antl Protesslonal Cotle: Any cl[y or
county whiCh reqWres a petmit to cOnSVuct, alter, improve, tlemolish o� �epair
any structure, prior to Its�issuance, also reqWres the applicant for such permit '
t0 file a'signetl Statement [hat �e/sh¢ is Iicensetl pursuant to thB prOvisions o(
'the Contrattor's License Law (Chapter 9(commentin9 wilti SecUon 7000) ot
OlviSion 3 Ot llle 6u5ine55 antl Prote55ion5 Cotle) "Or tila[ he/she is exempt
there/rom an0 the basis for tne allegetl exemptlon. Any violation of Sectlon
]031.5 by any applicant for a� permit sub�ects the applicant to a civil
�enalty of not more than Bve huntlred tlollars (5500). '
I, az�owne� 07 th¢ prope�ly o� my ¢mployees with wage5 as [h¢ir Sole
compensatlon, wili tlo tne work, antl tnn ztructure Is not intentlea or offeretl
�/or sale (Set[ion 7044, Busine55 antl Protessional Cotle: Tne Contractor's
Licenie Law tloes nof apply to an owner of a property who bulltlz or improves
[hereon,'antl who does such work hims¢It/M1erself or thwu9h his o� �e� own '
employees, D/ovlCetl Iha[ such improvements are nOt In[entletl or oHer¢tl for
sale. If, however, tne builtling or improvement Is soltl within one year of com-
plefion, the owner wlll have'lhe burtlen of proving he/she tlitl not bulltl or im-
prove br the purpose of salej. • ,
I❑ �, as owner Of the pro0erty, am exclusively cont�aCting wi[h Iicensetl com
� tractors[o wnstructf�e project (Section 7044, Business anG Protessions Cotle:
The ConVactor's License Law does nol aOPb to an owner of proDe�ty who
builtls or improves Neieon, antl wpo conVacts tor suc� projecls�with a con-
tractot�s) license pursuant �[o the Con[�ac[oi's License Law). I am aware tltat
orooi o( lheir Worker's Compen5ation inzuranG¢ shoultl be provitletl to me.
' L7 1 am exempt untler $ection B. & P. C. for this reason
Oate
mat b nave reatl this application antl state that tne above
rect. I agree to comply with all tlty antl county ordinances
ating to builtling construction, antl he�eby authorize �ep�e-
'. city'to ente ,u0on tM1e above-mentionetl property fot
as. f.-�?-�
Date
�VPE OF CONSTRUCTION LI NEW ' U ADD �Q ALTERATION I.J REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTH
�DESC 1 IQ�,OF WORK/ly5 E OF BLDG EN/3iC/T �Z%�U
� �/�G�-• ...5 FG!/.4� .sl`�//-20- !/ �.a
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHAIVICAL �
❑ OTHER
PROJECT DESCRIPTION' SQ. FT. OCCUPANCv ,
. CONSTRUCTIONTVPE ' VALVATION$
20NE � GftA�ING CU. VDS. ACRE$
Remarks: ,�/ �/ � � �_ ' % � T`p�� 7
Sink
Irrigation
ishwasher �
rinking Fountains
loor Drains,
loor Sinks �
as Service Outlets
Kitchen Sink '
Lavatories . � �
P-Trap
Roof Dreins '
Rainspection Fee ' � $15
Boilec -
Duct� UnderGround
Duct-Sttuctural '
Duct - Ventilating ��
ExhaustSystem,'�'J Multiple
Firepl/Fact.Blt.ICBO;k .
Heating System & Ducting
❑0700,000 BTU 0100,000
Showers
Service Sink � �
Sewer Cap �
Sewer Connection
Solar Collectors � .
Solar Piping
Solar Tank
Swimming Pool w/Spa : /.
Urinal
Water Clout :
Water Heater �
Water Service
Auto-Wash
Issue Fee
Hoodor Typel �
Canopy Type I I ❑
Refrigeration System
Oaioo,000aTu ❑ioo,000
❑ � System Repair/Atteretion
Fire Dampers'
Drivers' ense ot 55 � �
I , I Reinspection Fee I $15 I. I Issue Fee
CMF 0865-46, rev. 30/84 White - Builtlin9; Canary - Applicant; Pink - Accounting; Goltlenrotl - A55e55or
FEES
A.P. #
S Main Bui
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. �k
A utomatir W asher
Construction Pole
Cooking Unit
Dishwasher
Fan
F.A.U.
Fixtures
Device Boxes
OuHets
Switches
Garbage Disposal
Generator DO-5KW
i� ss�j
Zone
Accessory Building:
. Z
O
N
I
N
G
� R
� Parking,Req./Provided �� E
Q
M
T
S
ELECTRICAL '
" Transformer ❑ -15-50�KW �
❑ 50+ KW
'Meter ❑up to 100 amps
Meter ❑over100amps '
Sub Panel
Motors �0.1 HP 01 X- 8
Inc.Solar �9-75 HP �1E15+
Microwave - • �
Pole Light �
Range
! Standing Sections
5 KW Trash Compacror
$ 3
Reinspection Fee $15 luue Fea
FEES
DEVELOPMENT SERVICES REUUIREMENTS:
� Zoning Approved By
', Building Approved By - —
SUMMARV�OF
FEES
$ 3
�
BUILDING PERMIT � $ �� ' �
PLAN CHECK $ � ' �"5"PER
PLUMBING $ - . ISSUANCE $
PLAN CHECK 25% $ ��, E��' ��� '
ELECTRICAL $ � GRA ING .:5.+
P�AN CHECK 50°� $ ��/�/��/��r`� C�
MECHANICAL $ -� v�iOTh,p�9E�IE.L1��11_
PLAN CHECK 25% $ � .
/
�, . -
'CONSTRUCTION AND PLANNING - POOL & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Insp>cror
, 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
i
5. Steel Reinforcement 56. Rough Plumbing'& Pressure Test
6� Electrical UFER Grnd. - 57. APPROVAL TO COVER�GUNITE
� 7. Footings , � � 58. ElectricafConduit-Undrgrnd.
8.� Foundation 59. � Gas Pipe, O Undrgrnd., Test
9. Water PipC�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
�
10. Structural Floor System 61. APPROVAL TO DECK
�11. Property 5ewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. R�oof Drains 64. Plumbing System � Final
14. Rough Plumbing 65. Electrical-Final
15. �Rough ElectricabConduit 66. Solar System-Final ` �
l6� Rough Electric Wiring 67. Fencing & Access Approval �� -
�17:• Rough Wiring Sign� 68. APPROVED FOR PLASTERING
�P8: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
2Q� Rough Factory Fireplace APPROVAIS Permit # �
27�. Ducts, in 5tructure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil �.
23. Gas Pipe-Rough & Test 72. Underground Flush �
24. Roof Framing 73. Undergrnd. Storage Tank O 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. F�NAL INSPECTION •'
32. Electrical Power MeterFinal 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 iq-�
40. Gas Service-Final � � �
41. Solar pomestic-Final "' , •
il�
42. Backflow Preventer , `�' ' ' . ,
,:�
43. Backflow Irrigation � . � ' " `� r
44. -Landscape Irrigation System ;� � �y'� � �
.
45. Sound Attenuation - `;• ,;� . � �'•
46. Handicap flegulations � "�� � ' �-, �' •!!: w ';:� .�"-�-
47. FINAL STRUCTURE & BUILDING , y.';`� �� ���
��
48. Special Requirements Completed � � � � i"; :.d
49. Electric Release to Edison - � � r^:�.
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY . ��"
No. - Date - � , �'-'
�nonessaea�owo:_._ 555 ANTON_B
avr�aswweiva�mrrc SAKIOAKA FARM
�ooiau PO BOX 2097
TERMINA ANNEX
�ar�.�u�aa �oon�ss:
w.r: �ST _ _ _ _ ___ __ _CITY OF..COSTA MESA .— BUILDING PEAMIT
PERMIT NO: B 087087 PLAN CHECK NO: '. N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR
�xcxrrEeron�n:INTERIOR ARCH.2.136232,16_4 ��.: _C-9378___.
urcxonrxa•s�ss: S50 S HOPE ST_ uxr: 1100
LOS ANGELES CA 90071.
carm�srarawu�: ACCENT HUILDERS ( 714 ) 757-1998
carm�crars�uiwo 17945 SRYPARK PARK CI
,ioonesm IR CA uera_ . 397790 _ ,
92614 uxr: _
IJCFN9ED COMPACTOflS OECLAXIITON: I hxaby ellim utlx paWy d payvy em 1 Mqr D�
(camm«unu.mn s«tian l000) a a.eu� 9 a me aeinw w ria.:m. coe. my
�c uc. no.: ua cuss: B uc. No.: 7 7 9 E ___ _-
1,�_ z � - 9 k G..,_,m __-� --- _...
11 01�MER BUILDEP DECIAR�TION: I hrtly tlE�m ivtla � Nel� q han
Yb+rt�O raeaon (Saaun lmts Bu�iwaa and PNaedoru Code: W a Wid�
Eemdeh, a rWu �Y Mxtue, pv b b'ewuioe. ebo IM ePO�� a wN s
% u licenaed puaueN �o Ne pov�u d ihs Corurauan limros law �Chepr 9(onmianmp w'nh Se
Buuren ud RMmsun+ Cudel a �het he a ehe b ummq thsehwn aM tM bem ia iM elbpM ma
J031.5 Dy my eppSrM la e pmmtl �ubpro tlr epplrms w e dH pwEy d nq mon IM /vs hud�e
❑ �...o.n.win.wwsnr«mv«�c+A+..nwew..�.:w.mmV�..imm..on�
r�Cm liuw l�w la IM
�o ��. ��. ��.
�E Ya��nwtl Met M a �hs
� roml a oiwim a a ue
m. Mrv vidtlian d Seqion
Yn �SSOOp.
Ne wwiv� u na'vaeMed �
owmrbuddxwahavsiMWMendV�'oqlra�hed'dnUbWiainpvwbr�MWD4edeW). "
� 1. m onner d IM PW�Y. em urimwl/ mpretlnY wM buuM mmacbn d mmua IM M9b (Saaion �Ou. &nnws md
wa.�. cod.: m. cwv�ad. �e«w i.. m.. m adr m.� oww a ww.nv .ro wam «:'ow. a«.o� .�d .no
mwecb tar a�N V4�^ weh e mramaM�) froiwd Pn� W IM Caerauon limros Lev.1.
� 1 em memq uMer Sectim: B. 8 P.C.. br Nu iasm:
Daa: �+�
i eo i+�eM �r me i e,�..w d.na uarn.�d m. wam.�+«+. a c.uomi. ww�.�a ed.n coe. s.ac�. aws. usn..�e �
255J1. ud iha I a M' Mus biriM'vq ooupw W/ wil nal (mcb ane) need w mmlM wdh uid mle mAr eM tM nVu'uamanb la
eV+��lamrom�dionannd6rAbnbamilrAi u�I.�xWemseDiuntl.Rarida�eilmmMiannCV�vbmene��mqlromtAw
a�.
om.: �o,run:
WOXKEN'S COMPENSAIIqI OECLAF�TION: I lwtly �16m �etlr prWy d psjry oir d tlM klownp AManioro:
� IMvevdwJme'vmnacW'd�dmur��outl6uv�b�orkan'm�qwmtu�.oprnidedlab/BMb�JIWd�MlaEar
CaM.ln iM q�lmwce A Ne wak ta Mirli Ne D�b'r Wued.
�] i n....�e w�m�.ak«.� �,o.�:n m.ovw... �.aw�.a nr sen� aroo w u» i.no. coae. a. m. w�«�o. d m.
��«����� ��'LI�ERY MU AL���� EXPIRES
c.m«:
raH rn,mc� 12 / 30 �/ 9 8
-(Thu paim md na b ttmPMM ] tlr M^^!'r b ar hnbd dotls�s �SiOV) n Im
� I m�N � in Yro pMmiune� tl �h xM be vRtirJi Ob pmJt u ImME. I�� nol �mD �y �Y mww n u io
oms wbjw �o �M walan' canpanWian bw� d GeNa�rie. W tlW ! I fW�W lo'IM woM1eri
/ mr pau�lian pwu'vu al Swion J100 d tM leEv CaM. I lonh ' wmpry
pma: — — Applicu+:
W Irry: i�9un b scun �rohri mrrpwwnon.w...p.l. un , me /.c� m mr ro autiw p«�emu.ne
� MI n�w'p m arr� nuwne tMuurtl eollu� (Jloq400A h rlon m tlH t o e�nrpu n povleM ror In
Sxtlon 3106 0l 1�� IaOo� COW, InM1rp( �ml �ttomry'� Iw.
CONSTHUCTON LENpNO �OENCY: I Mreby elfirm ivtler penNy d peejuy �hn �hsa b e mw'ueion bMLp eperiey br Ne
perlormaro d tM xM M whitli �he w�i e ewM (Seaun 90a1. Civ. Cl.
LENOEH'S NAAIE:
LFNDEF'S ADOPES4:
IcenGylMtlhewmeENu vmlheliMebw�iNwmtlbnuconw.le{yri000mplyrm�NmyeMoouniyadv�enoe�
eM ebta laxe roltlnp b buJC� ud haraby aWnc� np�ewYatiws d Ihu aGyb W v upan IM abws�meMionsd poperly
���m�W�...._ � �
(S15tJ8.WP) WMo-B�ild�qaSdMy:aneMFb:Cuwy-Appiwnl:Pink-Re�wiw:0okavoA-Yas�a
0��8
PERM NO: B 087087
GOVT: N SUPP: N
,JOB DESCRIPTZON..: DEMOLISH INTERIOR NON BEARING WALLS SQ FT:
CLAIM VALUE: _ _. _ _.CALC—VALUE: 10,450.00 .GROUP OCC:
PURPOSE: ALT
20,000
B /
COMMENTS: "DEMOLISH WALLS TO EXZST. TACO BELL , SUBWAY 6 CONVENIENT STORE"
+tr+t**�*r+t*+t*wr*****r*+t+�**�rar+t+t**�r+c *+t*�r*+�*�*w****r*�r******s**r�r�****r*x **rt***r**
. _._ __ Z O N I N G R E Q U I R E M E N T S
S E T 8 A C K S_
_ -----------.MAIN HUILDING ----r—.---- --------- ACCESSORY BUILDING ---------
FRNT: FT _._IN REAR: _ FT.. _IN FRNT: FT ZN REAA: FT IN
LEFT: FT _ IN RGHT: _. ___FT . IN _ LEFT: .._ FT ZN RGHT: _ FT IN
PARRING REQ • PROV:_________PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES> ___ _ _ _
>
ifMMMMkkMkMMlfMkikfFMitMMiFIFitMffMiFMiFl4kifl%ifkii'1F1FMlFitiFkikikikkkMiEikiFMifMMkMlfMMififMMiFKMififiFlFiFMMMiFikif
D E V E L O P M E N_T__ S E R. V I C E S_ R E Q U I. R E M E N T S
ZONING APPROVED HY.__.: � DATE:
HUILDZNG APPROVED.HY_: ��r�, DATE;
APPLICATION ISSUED_HY: V 1� `- DATE:
MMMMMMMitMMilMMMMkilMMMMa! MkMfiMMMMMM M��
LEGALIZATION:N ___�__ . F E E . S U M M A R Y_.__. STRUCTURAL SE MENT:Y
BLDG PMT .PLUHBING ELECTRIC..MECHANIC _ FIRE SMIP/RES GRADING
PERMIT _ _ 17_4.J.5___ SMIP/NON—RES
PLAN _ __ _ _ _ ._ . 2 . 19
ISSUE FEE
BUILDING—DIV—>. _ PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> ]76.94 0.00 0.00 176.94 176.94 .00
REVENUE DIVISZON TOTALS--> COLLECTED: 176.94 OVER/SHORT: 00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
174.75_ 2.19
MkMkMMMifkMMMMMiFMMMMMMiflkMMMMitiFMNiEMMMikMMMkMkMMMMifMitMiFMMkMNMMMkMMMMMifMMMMMifMiFlkMM1lk
I N D Z V I D U A L F E E H R E A K D O W N
TYPE. QTY D E S C R I P T I O N UNIT.COST TOTAL COST
SFC 10000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 10,000.00
END OF FEES
� ���,� �� /
�, :V� >-�s..
8�-24-1998/09:51 AH/f176.94
RCPT�:�1-8022826
87t9f5 I
City of Costa Mesa
Development Services Department
Building Safety Division
P.�O. eox 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No. 0����?J
Tne Building located at 555 Ak�hon Houlevard, LobbY
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group A9 Occupancy. �
Use of Building Tnhhv
Legal Description 470-501—Od
� (See reverse side for Metes and Bounds)
Building Permit No.R :RF,17 Electrical Permit No. E 38628 Plumbing Permit No
Mechanical Permit No. M 38670 , Number of apartments and/or guest rooms
Eire Pceveniton Permit No. F 3'801
ISSUED T0:
Security Pacific Banit
555 Mton Blvd., Ste. 500
Costa Mesa, CA 92626 .
Building Official �rqe Edrniston
by � /r --
Date Octber 18� 1989
`� This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALI NOT BE removed except by the
�, � Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. ,
t CMF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File
f:,� .
'r \
1 . .
�
Applicant to fill in all spa[es except those
CITY OF COS7AT MEySA/� C�O�I�STRUCTION PERMITY
Proje�ct Addr¢ss �7 rJ i`��� � ��+
Applicant'S Mailing Address�
� Owner's Name Phone
Address �^'� '�--
Arch/Eng. License No.
Address
Contractor's Nam P�' � 'c Phone/ " �2
Addressll�a'I'ng �S2 Cec �/,� ev�(� 8,ti�.
. Ciry License No, Q 3 e�-/'��
LICENSED CONTRACTOR DECLARATION
1 he�eby affirm that I am licensetl untl¢r provi5ions ot Cha�te� 9(commencing
with section ]000) of Divislon 3 ot the Business antl Protesslons Cotle, antl
my Iicense is In f� torce antl effect. �/ �D�
Licens Class Licg�lo a
Dat��b• 5'gnat r E1Lii.��_
RKERS'COMPENSATION DECLARATION
reby atfirm that I hdve a ceftificate ot consent to 5¢It-in5ufe or d C¢ItIflCdt¢
� Wo�ke�s' Compen5a io r�59'ante, or d certifietl coppp y tnereof (Sec^Ion
380o, �aq:_F� O �� �
Policy Nt�Y Compam __�rn�I�LA/-'
BCertified wpy is hereby tumishetl. ' ,�p
Cer ifie copy' letl wilh the ci, ' ing�ioy. � i�
Date�� APPlican Cil�lrC.lJ`( li(�
EXEMPTION FROM WORKERS' CO NSATION DECLARATION
(Thissecfion neetl not be completetl it the permit is for one huntlretl (5100) or
less).
I cer(ify that in the pertormance of the work for which this perm�t is issuetl I
shall not employ any person in any manner so as to become subject to t�e
Workers' Compensation Laws of Galifornia.
Date Signature
NOTICE: Ii, aiter making this tleclaratlon, you shoultl become subject to the
Workers' Compen5ation provisions of the tabor Cotle, you must fortnwith
rompry with suc� provisions or this permit, snall be tleemed revoketl.
CONSTRUCTION LENDING AGENCV ' '
1 bereby afflrm that lhere is a construction lentling agency tor the pertormance
of the work for which Ihis permit is issuetl (Section 309� Civ. C.)
Lentler's Name '
Lentler's Atltlress �
OWNER BUILDER OECLARATION
I hereby affirm lhat I am exempt trom the Contractor's License Law�for the
following reason (Section 7031.5 Business antl Professional Cotle: Any clty or
county which requires a permit to construct, alter, improve, aemolish or repair
any structure, prlor to its issuance, also requires the applicant for such permit
� file a signetl statement thdt he/She is IicenSetl pu�suant to the prOvlslons ot
e Contractor's License Law (Chapter 9(commencing with Section 7000) ot
4ision 3 of the BuSin¢55 antl Prote55ions Cotle) or that he/SM1e I5 exempt
.aerebom antl the basiz for the alle9etl exemption. Any violatlon of Sectlon
]031.5 by any applicant for a permit subjects the applicant to a civll
- enalty of not more than five huntlretl tlollars ($500).
� I, as owne� ot the O�operty o� my emploYees with wage5 d5 Ihel� sol¢
mmpensation, will tlo the work, antl the sVucture is not intentletl or ofteretl
for sale (SeCtion 7044, Bu5ine55 antl Protessional Cotle: Th¢ ContraGtOr'S
License Ww tloes nol apply lo an owner ot a property who builtls or improves
thereon, antl who tloes such work himselt/he�selt o� th�ough hi5 O� he� own
employee5, provitletl that such improvements are not inte0tl¢tl O� offeretl f0/
sale. If, ho�vever, the builtlln9 or improvemenf is soltl within one year ot com-
pletion, the owner will have the burden of provin9 he/she tlitl not buila or im-
prove for the puroose oi sale).
❑ I, as owner of tne property, am exclusively mntracting with licensetl con-
tracrors to-ponstruct the prqect (Section 7044, Business antl Protessions Cotle:
The Conbacror'S Lirense Law does no[ apply to an owner of property who
builtls or improves tnereon. antl who contracts tor such oroie<ts wlth a con-
tractor(s1 hcense pursuant ID[ne ContractoYs License L.aw�. I am aware that
proof of their Wotker'S Compensa[ion insu�ance sboultl be p�ovitletl to m¢.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner
1' hereby certiry�that I have reatl-this application antl state Ihat the above
information is correct. I agree to comply with all city antl county ortlinances
antl state laws relating to builtling construction, antl hereby authorize repre-
Sentatives city to t¢ On the above-rnentionetl p�ope�ty to�
inspectlon es.�7Q �� ��c
Signatur XJ_ / ls/-CO oace ��v o�
Drivers' Licen or 55 �
lines anG sign all app�opriate Oeclarations.
�T NQ \ UNIT NO.
J l0 L-' ' 1 VJ �' V \
TYPE OF CONSTRUCTION NEW P.DO ALTERATION � REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LI GRADING
❑ TENANT ❑ ELECTRICAL
❑ OTHER
PROJECT DESCRIPTION 5(i
CONSTRUGTIONTYPE� VALUATION$
GRADINGCU.VDS. A(
�_i �.,_ _ n ..
1 FOUNDATION JG�STRUCTU
PLUMBING ❑ MECHANICAL
Remarks: �J�"
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishurasher '
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories � ,
P-Trap
Roof Orains
Reinspection Fee
P
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
rfnal
Outlets Water Closet
Water Heater
Water Service
Auto�Wash
$15
Boiler
Duct - Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iC80 dk
Heating System & Ducting
❑o-i oo,000 a ru O � oo,000
Reinspection Fee � $15
08fi5-46, rev. 5/88 White - Builtling; Canary - APPlicanQ Pink - Accounting; Goltlenrotl - Assessor
laue Fee
Hoodor Typel ❑
Canopy Type I I ❑
iefri ation System
�100,OOOBTU ❑100,OOOBTU
System Repair/AI[eration
f ire Dempers
Registers
luue Fee
A.P. #
S Main B�
E
T Front
B Rear
A
C Pight
gLeftl
Ping. Ref. #
v
FEES Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixture5
Device Boxes
Outlet5
Switches
� Garbage Disposal
.. Generator OO-5 KW C
Fee
9 3�' �
Zone
AcceSsory Building:
Z
O
N
I
N
G
R
Parking Req./Provided E
�
M
T
S.
ELECTRICAL
Transformer ❑ 15-50�KW
❑ SO+KW
Meter ❑up to 100amps
Meter ❑over100amps
Su6 Panel
Motors 41 HP 01 h- 8
In olar �9-15 HP 016-15+
icrowave
Pole Light ' .
Range
Sign �
Standing Sections ''
5-15 KW Trash Compactor .
$� DEVELOPMENTSERVICES
2oning Approved By
FEES Building Approvad By
Appliretion Issued By�
$15 � � luue Fee
��
FEES
$ 3
SUMMARV OF FEES „ .� �
BUILDINGPERMIT $ �-7-C-=� SMIP $ �
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLANCHECK 25% $ ENERGVP.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ ' MICROFILM $ t� 7
MECHANICAL $ TOTAL FEE $ <�'$ � 7�
� � PLAN CHECK 25% $
tl? aC033b22-OtJ0a352s' T4T 22R,3Ct
L"AiE: OS/23/89 TIME: i�:d7
„
CONSTRUCTION AND PI,ANNING P & SPA '
-s� -'- DateY Inspector p�ppROVALS Permit# Date Inspector
/kPPROVALS Permit# -
1. Temporary ElectriCdl'Service or Pole ? ,! 52. Pool & Equipment Location ;, .� �
' 2. Soil Piqe-Undrgrnd.� � � � 53. Steel Reinforcement �.- i• i
' i%�'. ',�' ,r�
3� Elect�ical Conduit Utility-Undrgmd. •�L " 54. Forms ��'
4. Electricel Conduit-Undrgrnd. � j 55. Electrical Bonding � �
.• e
. 5�Steel Reinforcement +� , t' 56. Rough Plumbing & Preswre Test ��-
i �; `
.6'�Elect"ricalUFER,Grnd. � , i 57. APPROVALTOCOVER-GUNITE ; �
.. .
� 7.�Footings � ��i � � i - , 58. Electrical Conduit-Undrgrnd. � � �
. 8. Foundation � � !i . •. i 59. Gas Pipe, � Undrgmd., Test /� �
.9. Water' Pipe-Undrgrnd. �-^1 �� .' � 60. Backwash Lines, P-Trap, O Undrgrnd.
-70..Structural Floor System ",� �.� 61. APPROVALTO DECK
17'._ 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�r 65. Elecirical-Final ��
15. Rough Electrical-Conduit 66. Solar System-Final
�16! Rough Electric Wiring 67. Fencing & Access Approval
It7` Rough Wiring Sign 68. APPROVED FOR PLASTERING
]8� Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL -
19� Rough Heating & Air Contlitioning FIRE DEPT. REQUIREMENT
20.' Rough Factory Fireplace , APPROVALS Permit #
21 . DuCts, in Structure �!� � 70. Underground Hydro
22. Ducts, Ventilating i_., ti 71. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough & Test �;;,� 72! Underground Flush ��
24. Roof Framing �'•_ �,r /73. Undergrnd. Storage Tank O Gas ❑ Oil ��
25. Roof Sheathing ^ ' �� ' 74, Overhead Hydro '
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical •
27. F�ame and Flashing :� � 76. Dry Standpipe �
'28. Lathing &'Siding t'} 77. FIXED SYSTEM FINAL �
29. Insulation f_, 78. FIRE PREV. FINAL
30. Drywall Nailing ;� - v ' �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 �,
.�s�
�40. Gas Service-Final ,' � i
41. Solar pomestic-Final� , � %��" .
42. Backflow Preventer�K , � ,�� , r
43. Backflow Irrigation ; �- '
44. �Landscape�lrrigation SYstem � j�� `�
45. Sound Attenuation-' j,; ��}
46. Handicap Regulations , �y
. 47. FINALSTRUCTURE&BUILDING - ,
48. Special Requirements Completed
-49. Elec[ric Release to Edison ','� '.' t t
50. Gas Release to Southem Califomia Gas Co �'� ! �`
.V
51. CERTIFICATEOFOCCUPANCY `�i�'�_ ,'�
No. Date � ,'
02 4 8 9 Applicant [o fill in all s0aces exeept Ihose within neavy Dortler lines anC si9n all appropriate Eeclarations.
PERMIT NO. TRACT NO. LOT NO. NIT NO.
CiTY oP COSTA MESA CONSTRUCT�ON PERMIT F 3-7Q-� �� ��� A.P. # zo�a
ProjectAddress 555 Anton, Ground FlOOr Temps S MainBuilding: AccessoryBuilding:
Applicant'siNailin Addre55 754Q SllZl Lane Westminst TYPEOFCONSTRUCTION NEW^� D� ALTERATION REPAIR
�'Security dCl 1C ❑ CONVERSION
❑ DEMOLISH C70THER ' '( Front p
Ownei's Name Phone DESCRIP O(V OF WOR USE OF BLq G A Rear N
Address 600 Wilshire Blvd. #500 �\ �•�.� .�,r--(y�� �t��� r-s
Arch/Eng. � License No. TVPE OF PEflM1T GRA ING LJ FOUNDATION STRVCTURAL I K Right N
G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � g� Left R
Convactor's NamP K1IilblO & Cc�nq�any phone 895-1156 ❑�o7HER Ping. Ref. # Parking Req./Provided E
PR0.IECT DESCRIPTION Sq. FT. oCCUVANcv �
Addresslmailingl 7S�IO SUZl Idl.� Westminster 92683 z, 700.0o PlanningNotes: M
City License nlo. 038503 CONSTRUCTION TYPE VALUATION $ .
7
ZONE GRA�ING CU. VDS. ACRES $,
LICENSED CONTRACTOR DECLARATION
I hereby affirm that 1 am�licensetl untle� p�ovisions of Charte� 9(commencing RemarkS. �
with section 7000) of DiviSion 3 of the Businezs antl Protessions Gotle, antl
+ + ELECTRICAL � FEES
my Iicense is in tulLlorf�and ettect. � 460923
LicenS�ClySs �• -� d a �
Dateo • S�,� 55 at �� PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW
RKERS'COMPENSATIONDECLARATION � ConStructiOnPoleSub. � 50+KW
reby atfirm that I have a ce�titicate of con5ent to sel(-Insure or d c¢rtificate Bar Sink $hOwEfS �
\�� Workers' Compensation Insurance, or a certifietl cooY thereot (Section BackflowPreventer ServiteSink Cooking Unit Meter ❑upto 100amps
3800, Lab. C.) .
aoiicy no. r.roati�A,.�,�,7nRo�_nlcomaany gackflowirrigation SewerCap � Dishwasher Meter ❑over100amps
��I'yl Certitied cooY �s hereby fumished. Dryers ❑Gas ❑Electric Sub Panel
W Cer '' tlF� oY y� //� etl wrth the city B 9 Div� Bathtubs Sewer Connection
A Date :�(L� Applicant o Fan Motors �0.1 HP �1'h - 8
v0 EXEMPTION FROM WORKERS' GOMPENSATION DECLARATION ClerifiEfs , Solaf ColleCto�s
I ssis section neetl not be completetl if tne permit is for one huntlretl (5100) or Dishvsd5her Solar Piping F.A.U. ' Inc. Solar �9-15 HP � 16-15+ '
I c¢rtify that in the pe�fo�manCe of th¢ work for which this permit is issuetl, I FixtU�ES MiC�OWav¢
shall� not employ any person in any manner so as to become subject to the � Dlinking FOuntains Solar Tank
Workers' Compensation Laws of California.
oate Signature Floor Drains Swimming Pool w/Spa Device Boxes� Pole Light
NOTICE: If, al[er making t�is tleclaraHon, you shoultl become subject to tne Outlets Range
Workers'.Compensation provisions.ot the Labor Cotle, you must fortnwittt FIoo�Sinks U�inai �
Compty with suc� O�oviSions or thi5 perTlt shall be tleemetl �evok¢tl. -
CONSTRUCTION LENDING AGENCV ' G25SelViCe • Outlets Wate�ClOSCt SWitchES Si9n
I hereby affirm that there is a con5truction Ientling ag¢ncy for the performance -
of the work for which this permit is issuetl (Section 3097 Civ. C.) �nt¢rceptors Watef Heate� Garbage Di5po521 . Standing SeC[ions
Lentler's Name
Lenaer's adaress Kitchen Sink Water Service Generator �0�5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I heleby dtfirm lhat I am ¢xempt from the Contfa<tof's LicenS¢ Law tof the L2vdtOfi¢5 ' AutO-W85h -
following reason (SecHon 7031.5 Business antl Protessional Cotle: Any ci[y or
county which requires a permit to construct, alter, improve, tlemolish or repair. P—Trap LaundryTra'ys
any Struclwe, p�ior to its i55uanC¢, also �equires the appliCant fo� suGh pe�mlt , �
' (ile a signetl statement [hat he/she is Iicensetl pursuant to the provisions of Roof Orains
ContractorY License Law (Chapter 9(commencing wlth'Section 7000) af ' '
�sion 3 m me Business antl Protessons Cotle) or that he/5he is exempt � Reinspection Fee $15 Issue Fea $ 3
...erefrom ana the basis for the allegetl exemption. Any violatlon ot Sectlon , ,
' �031.5 by any applicant tor a pe�mit Subject5 the applicant [o a clvil - �
�ena�ty ot not more than five huntlred doiiars (Esoo). ' • DEVELOPMENT SERVICES REQUIREMENTS:
LI I, as owner ot the pro0erty or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 ZoninB APPraved By
mmpensation, wi11 tlo the work, antl the structure Is not intentletl or.otferetl Date
tor sale (Section 7044, eusiness and Professional Cotle: The Confractor's ' MECHANICAL FEES Building Approved By Date
LicenSe Law tloe5 not apply [o an owner ot a properry who bulltl5 or improve5
thereon, antl who tloes Sucn work himself/herself or through hi5 or her own HOOd Or Typ¢ I ❑ %�PPlieatiOn IssUed By et
employees, p�ovitletl that such improvements are not intentletl o� otteretl fo� BOiI¢f
sale. If, however, the builtlinq or imProvement is soltl within one year of com- CanOpy Type 11 ❑ SUM RV OF FEES
O�etion, the owner will have the burtlen of proving he/she ditl not builtl or im- Duct - Unde� Ground
provatortheourposeoisaie). BUILDINGPERMIT $ SMIP $ r
❑ I, as owner of the property, am exclusively mntracHn9 wim licensetl con- Duct -Struc[ural • Refrigeration System p�,qN CHECK $ PERMIT
Iractors to wnstruct the pro�ect (Section 7044, BuSiness antl Pro(essions Cotle:
The Contractor's License Law does not apply to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builtls or improv¢s thereon. antl who contract5 for such oroietts with a mn- � � � �
tractor(sl license pursuan� to ine Contractors License Law). I am aware thac Exhaust System ❑ MWtiple ❑ System Repair/AlteratiOn' ' PLAN CHECK 25% $ ENERGV P.C. $
proof ol tneir Worker's Compensatlon Inzurance shoultl be provitletl to me. ,� ELECTFICAL $ GRADING $
L'1 1 am exempt untler Section B. 6 P. G(or this reason Pirepl/Fact. Blt. ICBO # Fire�Dampers ., :��� , MICROPILM $
� - � PLAN CHECK 50% $
Date owner — Heating System & Ducting Registers f�� MECHANICAL $ $ � t�
I hereby certiry tn have reatl t is application antl stata that the above- ❑0.100,000 BTU �100,OOOBT . TOTAL FEE
information is mr ct!I agree to c ply wrtn all city antl county ortlinances PLAN CHECK 25% $
antl� state laws r ati to builtli con truction, antl hereby authorize repre- � -
sentatives of Yls ity to e S up / t e above-mentioneG per_ty �� • � ' ' .
inspection pu . �
sy�at�re °ate���� Reinspection Fee $75 ix�a Fae � s s � 01 00028346-0�028147 TGT 54.5G
Drivars• License or 55 � � ,
DATE: �3/13/89 iItlE: Q9:29
OB65-46, rev. 5/88 White - Builtling; Canary - Applicant: Pink - Accounting: Goltlenrotl - Assassor
. . . , . `\ �� L � � �� . .r' . . . _ . .:.. -. .
CONSTRUCTION AND PLANNING '� w & SPA .
APPROVALS ' Permit#�- Date Inspector p�ppROVALS Permit# Date Inspector
7. Tefiporary 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. APPROVALTO COVER-GUNITE /� � i.'
i.
7. Footings ' -- • 58. Electrical Conduit-Undrgrnd. ' ,
8. Foundation - 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-Condui[ 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17: Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough�E2ctrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19". Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough �actory Fireplace APPFOVALS Permit #
27. DuCts, in Structure � 70. Underground Hydro
22: Ducts, Ve�tilating ' 71. Product Piping OGas OOiI
23. Gas Pipe:Rough & Test . 72. Underground Flush
24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sh'eathing �, ., � 74. Overhead Hydro
,
26. T-Bar Celling (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 pomestic-Final 1 _ �
42. Backflow Preventer : '� '
�7
43. Backflow Irrigation - � �
44. �Landscape Irrigation System ' ��,
45. Sound Attenuation ' F
, �
46. Handicap Regulations "��
I
47. FINALSTRUCTURE&BUILDING :
48. Special Requirements Completed
49. Electric Release to Edison � !•,
50. Gas Release to Southern California Gas Co �"� ' .._
51. CERTIFICATE OF OCCUPANCY -� "
No. Date ` � : �
1102489 AOO���ant tu /ill In all zDaces axcept tbase wlthln htavy Eo�Oer Iinas anE sign all approprlata tleelantlons. "" --'
P MIT NO TRACT N0. LOT NO. UNIT NO.
CITY OF COSTA MESA CONSTRUCTION PERMIT A.P. qW
ProjectAddress 555 Anton, Ground Floor� �G`�'� 3$ z'% $Y'�, /O� zo�e
TVPE OF C�NSTRUCTION NEW �q DD ALTERATION REPAIR S Main Building: ACCesiory 8uilding:
Applitpnt's'MailingAddreu� �SGO SUZ1 Lane, [�estminster �/ e z
S2.CUL1C PaCLf1C Bank p � CONVERSION ❑ DEMOLISH L4'OTHER T F��^t O
Owner's Name y hone DESCRIPTION OF WORK/USE OF BLDG. � j✓� D�i h — B Rear N
Addreu 600 Wilshire Blvd. Suite II500 . a i
Arch/Eng. L.A. 9OOI% LiCEnSCNo. TVPEOFPE IT GRAOING FOUNDATION STRUCTURAL � K R�9h� G
Addr¢55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left
R
Kl[Ilblf & COm Phone �� r
Contractor's NamP pany 895- I 156 �orHEa � / i �� Ping. Ref. �' Parking tieq,/Provided E
PR0.IECT DESCRIPTION 5a. FT. OCCUPANGV—{]�� �
Addresslmailingl 7540 Suzi'Ln., WEstminster -�. �� � � �� PlanningNotes: M
O3SSO.3 CONSTRUCTION TVPE �'� ._ VALUATION $ �.300.00 T
City License No. 2orvE GRADIfYG CU.YDS. ACRES g,
LICENSED CONTRACTOR DECLARATION
I hereby aftirm tha[ 1 am Iicensetl under provislons ot Charter 9(commencing qemarks: �` � F � �
with setUon 7000) of Dlvislon 3 of tf Business ntl Protessions CoUe, antl
my Iicense is in tull t rcB �nE etfect. 460923 ' ELECTRICAL FEES
License a —� ice e lo. Automatic Washer Trans(ormer ❑ 15-50 KW
���e� SlgnaWre �,f!�_ PWMBING FEES
tKERS' COMPENSATION DECLARATION Construction Pole Su6. ❑ 50 + KW
\;eby aHirm that 1 have a certl(Icata of consent lo selfansure or a certiflw[o Bar Sink ShOw2rs
ol Workers' Compenzation Insurance, or a certifietl covY Ihereot (Section gecktlow Preventer Servite Sink Cooking Unit Meter �up to 100 amps
,^ 3800, Lab. C.
N voiicy No. ��PB$4 7089 7-0 1 comeany FREMONT IND. Backflowlrrigation SewerCap Dishwasher Meter ❑over100amps
Certiti copy a nereby furnishea. Dryers ❑Gas ❑Electric Sub Panel
Cen� tl y� ' ea witn tne clty Bu g v}5I,},�',A•_ Bathtubs Sewer Connection
bp Date�� APPlicant ��t JY/ Fan
E%EMVTION F0.0M WORKERS' COMPENSATIOt�iDECLARATION Cleri(iers $plar Coll2ttofl MOLOrs �0�1 HP O1Ya-B
(ThI55eCtiOn neetl not be cOmpletetl It the pe�Tlt is f0� OnG huntlretl (§300) Or F.A,U. Inc, Solar �9-15 HP �1 G75+
less). Dishwasher Solar Pipin9
I certify [hat in th¢ ptrfOrmance Ot ih¢ work fOr whiGh thi5 perm�t i5 i55uetl I Fi%[u�ES
shall not employ any person In any manner so az to become subjett to t{�e Drinking Foun[ains Solar Tank Microwave
Workers' Compensatlon Laws ot Calltornia.
Date Slgnature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE: 11, after making tnls tleclaration, you shoultl become sub7ec[ to tha Urinal OuNets Reng2
Workms' Compensatlon Orovisions of the Labor Cotle, you must forlhwl[h FIOOr Sinks �
comply with such provisiont or thli Darmil shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV G855CrVice Outlet5 Wat2fClo5et SWitChes gj9�
I nereby aflirm that there is a construtUon Ientling agenty for the parformante '
of tha work for which thiz permlt Is IszueU (Section 3097 Civ. CJ Interceptors Water Heater Garba9e Disposal Standing Sections
LenEer's Name
Lsntler's Aatlress Kilchen Sink WaterService Generator �65 KW �5-15 KW Trash Compactor
OWNER BUILDER OECIARATION
I bereby aifirm lhat I am exempt irom tha ConVactor'S License Law for tha �evatoriEs AutO�WaSh
following r¢dsOn (Sectlon 7031.5 BUSiness antl Pro(e5510nd1 Cotle: Any City Or
county which requiraz a permit [o construtt, alter improve, Cemolis� or rapalr P—Trep Laundry Tr2'ys
+ny SlructUre, prbr to it5 issuanca, at50 reqWrCi l�e applicant for Such permit
�il@ a SlgneE italemin[ lhat h8/Sh¢ IS Ilcen58tl puf5udnt tOlh¢ ProvlSionS 01 ROOf D(9if15 �
Contractor'S License Law (Chapter 9(commencing wiN Sectlon ]000) of
iiilon 3 of the BUSiness antl PrO/essloni Cotla) or thdt he/Sne i5 exampt Reinspeetion Fee $15 ISSue FBB S 3
tnerelrom anE the Oasis for Iha allogotl exomptlon. Any violatlon of Sectlon
7031.5 by any applicant lor a permit subJects tna apP���ant to a civll
eenaity oi not more tnan tiva nundretl tloiiars (ESoo). $ 3 DEVELOPMENT SERVICES REQUIREMENTS:
IJ I, a5 owner ol lhe property or my amployees wilh wa9es as [halr sol6 Reinspeetion Fee §15 Issu9 Fee
com0ensation, will tlo tne work, antl tho structure Is not IntentleA or offerotl Zaninp Approved By Data
�o. sala (Section 7044, eusiness antl Protessional CoAe: Tha Contractor's MECHANICAL FEES BuildinB APP/e�d By Date
License L, w aoes not epply to an owner of a property who builtls or Improvoz ,
thoreon, an0 wno tloez zuch wo�k hlT5el1/hurself or Nrough hls o� h¢r own ' {�ppliWtl00ISSUBd By ' (}�.0��_Det
employecs, provitletl that such Improvements are not Intentled or oiferetl for Boiler Hood Or Type I ❑ i
wlo. H, however, the builtling or improvement Is soltl wlthin one yoar of com- Canopy Type II ❑ C� � i—�
plelion, tne owner will nave lho burtlon ot proving hc/shn aIE not builtl or Im- Duct - Under Ground SU MARV FEES
n�ove �or the purpose ot saie�. BUILDING PERMIT' $ ��• f7 0 SMIP $ �--� �
❑ I, as owner ot the property, am extlusively contracting witn Ilcensetl con- Duct -Structural Re(rigeration Sys[em PLAN CHECK $ PERMIT
tractors to <ons[ruc[ [ne project (Section 7044, Buslness antl Professions Cotle:
bu�tls or� improves �tna ¢on na wno contPacis�for such orale�cti�with�a con� Duct - Ventilating ❑4100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
tra<tor(sl Lcense pursuani �o �ne Convactors License Law). I am aware that Exhaust $ystem � Multiple ❑ System Repair/Alterationn PLAN CHECK 25% $ ENERGV P.C. $
prool of tnair Worker's Compensation insuran<e shoula be proviGaO to me. ELECTRICAL $ GRADING $
❑ I am exempt unaer Section B. & P. C. tor tnis reason Firepl/Fact. Blt. ICBO � Fire Damper5 �/ MICROFI LM $
PLAN CHECK 50% $
Date dMner Heating System & Ducting Registers MECHANICAL $ 3 �.,Sa
1 here�y ceriify t I have reatl his apDlicatlon antl state tnat the above ❑Q100,O00 BTU �100,0008T . TOTAL FEE $
informatlon is w� C I agree to mplY "/�Ih au Uty antl county ortlinances � PLAN CHECK 2$°�6 $
an0 state laws r a' g to ul i g c structlon, antl hereby authorize repre- , • -�
58ntativ¢5 ot City tel he dbove-mentioneC 0 Perty 7 '- �
Inspection p . �
Signature Date � �j
�rivars' Licenu or 55 Reinspection Fee $15 laua Fee _ S 3 DATEQ�04%?6/89D�7FI9E: Oc�6� -1� ��
oeti5-ne, rev. o/nn wnrte - aunaing; Canary - qpputanp wnK - Accounung; uoiaenroo - qssessor
, . , ..
�� `: . ... -
CONSTRUCTION AND PLANNINC %' F �. & SPA
AFPROVqLS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
1. �emporary Electrical Service or Po�e �' , 52. Pool & Equipment Location .
c i.
2. Soil Pipe-Undrgrnd. ` ��' 53. Steel Reinforcement
; .
3. Electrical Conduit Utility-Undrgmd � .• . 54. Forms - !�
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding i'�-��
5: Steel�Reinforcement . 56. Rough Plumbing & Pressure Test l� "
' .:
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE � 1
7. Footings � � '� 58. ElectricalConduit�Undrgrnd. '•'�
8. Foundation `� � ,,� 59. Gas Pipe, O Undrgrnd., Test `�
�
9. Water Pi�e-Undrgrnd. ,. f t_ �, 6p. Backwash Lines, P-Trap, � Undrgrnd.
70. Structural Floor System '� l',� 67. APPROVAL TO DECK
1�1. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
�
12. Sewer Cap 63. Heater & Vent-Final ��
nn
13.^Roof Drains 64. Plumbing Svstem - Final ;,�
14.;'RoughPlumbing 65. Electrical-Final ;_1,;.-
15. Rough Electrical-Conduit 66. Solar System-Final
�1,6. Rough Electric Wiring 67. Fencing & Access Approval
�•
117. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
v
J8. Rough�Electrical-T Bar Ceiling- 69. POOL/SPA SYSTEMS FINqL
(19. Rough Fleating & Air Conditioning FIRE DEPT. REQUIREMENT
20. RoughFactoryFireplace.i- APPROVALS Permit#
21. Ducts, in StrucIure ,j 70. Underground Hydro
22. Ducts, Ventilat�g � �. 71, Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test ��t 72. Underground Flush
24. Roof Framing� �� � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing, �' ` 74. Overhead Hydro i
26. T-Bar��Ceiiing (St�uctOral) & Monocoat 75. Dry Chemical
27. Frame and Flashing � 76. Dry Standpipe
28. Lathtng & Sidin� ,- " 77. FIXED SYSTEM FINAL
29. Ins�lation �� ' 78. FIRE PREV. FINAL Z �(� �,
30. Drywall Nailing7 �_. HEALTH DEPT. REQUIREMENT
�31,. Plast�r Brown Coat -• 79. FINAL INSPECT�ON
32. Elecirical Power'Meter-Final 80. FOOD CERTIFICATE ISSUED
i
33. Final Electric tl 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-Finaf - _ _ � �
40. GasService-Final ��-
41. Solar pomestic-Final
i'� r ,
42. Backflow Preventer %
i
43. Backflow Ir�igation � ' •
i
44. Landscape Irrigation System ' �� � �
'v .
45. Sound Attenuation � • (�,-�
46. Handicap Regulations i
47. FINAL $TRUCTURE & BUILDING � r�
48. Special Requirements Completed
49. Electrie Re�ease to Edison ;.�
50. Gas Release to Southem California Gas Co �':', '
51. CERTIFICATE OF OCCUPANCY '" �
I% :
No. Date �. '
PpOWNEflSNAMF: SSS A1'v`ON BL �N�T. P'�
aonRess: SAKIOKA FARMS �'w�
�PACIFIC SOUTHWEST REALTY
CO
P O BOX 2097
TERMZNAL ANNEX
qPCN/ENGINEEH:LAWRENCE HOAK xec.xo._34�Q�
nooness: i .
1210 N JEFFERSON F
PENMITTEE:��EIM CA 92807
aoosess:DEB CONSTRUCTION (714)632-6680
1210 N JEFFERSON D
y�jj�{7R7� CA 92p 7
IICENSEU CONTNRCYIIA- BFCCFIiAiI11N[ I hereEy a��um that I am hcen5e0 un0er pmvisons T�a0�ar 9(commencing wit� Section
70011) ol DMsion 3 0� lhe Busine5s and Prote55lons Cotle. ana m license is in lull force an0 efieci.
cm��: 2 sTaTeuc.:372419 c ss:g,� �7����
�
Oate: _ SignaWre: _ •
WOflNENS'COMPENSATIONOECLAflFTION: I�ereEya��ir AallhaveacetlihtalealtonSen�toSell�insureoracerti�iCatea�Worker5'
Compensalion Insurance. or a ceriilietl coDY �hereol (Sec�i n 38p1. Lab C�.
PoucrNo.:pWC-108375-01 E%P.DRTE:O6IOII93
�omrnxr:GOLDEN EAGI,E
� Cerliliea capy is here6y tumiSheC, xJ Cenilied coOYY /�je0 wi�� the cny 8 ilding Di '' n.
�ate: /_/�� '� Applicanl:Tji:3� ��' 'G ��
EEEMPiION FflDM WOPMFPS' COMPfNSATION OECIABATION� (This secuan need iw1 be wmDleleC il Ihe perm� is lor one �uMrM (51IX1) or I�t�.
I ceriity I�a� in Ihe De�ormance o� t�e waB tor which Ihis Dermil is issue4 I shall not employ any person in any manner so as to �ecome
subie�� �o I�e Workers Compensa�ion Laws ol Califamia.
Oate: Sfgnature:
NOTICE: 1�. aRer making Ihis Ueclaration, you shoulA becnme su�iect Io Ihe WorkeK Campensation pwvisians of ��e LaOor
Code. you muSl �otl�wilh compty wilh such provisions or Ihis permit shall Ue Oeemetl revoked.
CONSTflUCTION LENOING RGENLY: I hereby aflirm thal �here is a consiNction lentling agenty for the pedormance ol tne work for
whic� �his permit is issued (Section 3W7. Civ. C�.
LENOEfl:
AOOflES$:
OWNEB BUILOEB UECLABPTION: I Aereby aifirm �Iui I am exemp� irom ��e Coniractors' Stare License Law lor t�e followinp reawn
i in n Pr I i nal Cotle: An cit oi couni w�ich re uires a ermi� �o mnstmct alt¢r im mve Oemoli5� or
Secton 7037.5 8us ess a 0 o esso
0 P
( Y Y Y D
I i h a li n� I r su h rmit to file a si ne0 statement tAat he/s�e is licensed
repair any S�mtNre. prior lo rts issuanCe, a So reQu res � e �P ta o t p¢ g
pursuam �o Ihe pmvisions ol Ihe Comrac�ors' State License Law (ChaD�er 9(commencing wi�� Sec�ion 7000) ol Division 3 0l �Ae Business
and Prolessions Code� or ��at he/she i5 ezempt iherelmm antl t�e basis �or Ihe allegetl exemplion. My vialation ol Section 7031.5 Dy
any a0�lican� for a permit subjecis I�e applicanl Io a civil penalry o� not more than tive AunareA Aollars (ESIXI).
I, as owner of ihe pmpeny or my employees with wages as ineir sole campensation, will Ao ihe wark, an0 ine
❑ siruc�ure is not intendetl or olleretl �or sale (Sedion 7044, Business antl Pwlessional Cotle: T�e Comracrors' S�ale License Law
does noi aDDly Io an owner ol a pmpetly who Uuilds or impmves thereon, antl who aoes such wark �imself/Aersel� or IhmupA
nis or her awn employees. pwvieetl that such impmvemenis are nol intenUe4 ar ottereU for sale. If, however t�e builaing or
imOmvemeni is sald vnthin one year ol compleiion. Ihe owner will �ave I�e DuNen oi Droving he/she Eid not buila or imDmve
lor ihe purpose ol sale�.
I, as awner ot lhe pmperty, am eMclusively contracting with licensea conlrac�ors to con5imc� the pmject (Section 7044, Business
❑ an0 Pm�essions Code: TAe Contradors' Sla�e license Law tloes not apply lo an owner o� pmperry who huilOs ar impraves Ihereon
anE who contracis for such pmjects vnt� a conirac�or�s) license pursuant to the Cantractors' Slaie License Law). I am awa�e
I�ai prooi al t�eir Worker'S Compensatian insurance shoNG Ee pmviGcO la me.
� I am exempi unaer Section: B. 8 P. C.
�or Ihis reason�,
Date: Ownec
I ea hereCy certily ihai I am aware ol ana unaerstana ihe requirements of Calilomia Health anA Salery Coae Sections 25505, 25533, an0
25534 anA Inal I or any IUWre 6uilaing ocapanl will/wtll no� (circle one) neetl �o comply with saitl s�ate cotles and Ihe requiremenis for a
permil for cons�mc�ion or madilication imm Ihe Nir Oualiry Managemenl �iSVict. fle5i0eniial conSVuctmn applica�ions are evempt tmm
Ihese pmvisions.
Oaie: NOPlicanC �
I herebV �erlitylhal I have reatl t�is applicaiion antl Slale Iha��he above inlOrmali0n is correCi. IaAree�o Comply with all Cily and county
or0inanre5 antl sia�elawsrelatinglo �uilding cons�mclion and hereUy au�hor¢erepresentatives oll�is ciryto en�eru0on��e above-men�ioneU
pmperly 1 inspec�ion pwpases. (/�� (^/
�aie: �) Signature: �j��� � � /, I� �
/
Drivefs License or Social Seanty a: `.
1fi41-a6 Whue—Bmlding; Green—Cotle Enlo¢emem; Canary—Applicanl; Pmk—Revenue; Goltlenroa—Assessor
CITY OF COSTA MESA — BUILDING PERMZT
PERMIT NO: B 060789 PLAN CHECK NO: 00272-93 S
CONSTRUCTION TYPE: I—FRSP PERMIT TYPE; STR
JOB DESCRIPTION ; ATM ROOM W/ACCESS @ PLAZA LEVEL
CLAIM VALUE: 15,000.00 CALC—VALUE; 15,000.00
PERM NO: H 060789
GOVT; N SUPP: N
PURPOSE: ALT
SQ FT\ 15,000
GROUP OCC: H�2 /
COMMENTS; BANK OF AMERICA ATM
�r**�r�r�t�t+t*�e+t�e�r***r*�r***�e�r�r��r*�t�e�r**�t�t�t�t�t***x�**�r�r�r�r�e**�t�t*x�rr�*�t�t�t�t�r��r�t�r*�r**�r** �t*�r�r
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL; 41050104 ZNE; PDC REF NO;
PLANNING NZ51'ES> INTERIOR ALTERATIONS TO ADD ATM ROOM ACCESS AT PLAZA LEVEL,
i '
�t�rx�t�t�t:**�t+r�r�r�t*�r�e*�r��r��rx�r�r�r�r�r�r�r�r*�r�r�rx�rx�rx�r�r�rx�r�e���r,ex �r�r�r��r�rx ***�r�r���tx.�t*�r*�t***�r�r�r
D E V E L O P M E N T S E R V I C E S R E(� U I R E M E� N T' S
ZONING APPROVED BY (�—,—E DATE: I' �2— 3
BUILDING APPROVED BY
DATE: '�
APPLICATION ISSUED BY•� � � DATE• �
ifiFlFiFififiEiFififiEltlFifiEiEiE�fiFiflflf F iflFiEiF1li(�fFiEiflf iFiF
iFiFkiFifillEififkifiEiEiEikiEiFlFlElklkllitkiFikif%�iklkikifil�Fifiki ik3f �f�FlfiEiklflEif�fiflEifiki 1f3EifiEillliFiF�kilM�.iFiEiEiFik�EiFiEiFiE1FiF
LEGALIZATION;N F E E <S U M M A R Y / STRUCTURAL'SEGMENT:Y
r �
BLDG PMT PLUMBING ELECTRIC MEC{iANIC FIR SMIP/RES GRADING
PERMIT 162,00 ,.. i•' o
,,� �
SMIP/NON—RES
�_� . ,
PLAN 105 30 S
. 3.1
: �J
ISSUE FEE . �
�
BUILDING—DIV—> PERMIT ISSUE PliAN-CHECK� TOTAL PAID DUE
TOTALS----> 165, 15 0, 00 :' �1.0-5, 30 r. i/270, 95 270, 45 .00
REVENUE DIVISION TOTALS--> COLL`ECTED:� ;•• �2.7.0,45 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC ✓'FbRE SMIPYTOT GRADING PLAN—CHECK
162.00 �� ;� � _i3.15 105.30
iF iF i! ik if iF �1! if i! it ik k if ilit iE iF iF if 1t i! iF if if if !f if iE 1F i! i! if 1! it iFlk k 3E if iE fF iE iFiE iF IE I! if fE i69! iE If k iE ikiE fE 1E ik 3F k iF iF iF ik if iF iF if if ik iF iE IF 1F iE �E iE ��
I N D I V I D U A L F E E�. !B R� E, A K, D O W N �
r'
TYPE QTY D E S C R I P T Z Oy`N i.%� UNIT COST TOTAL COST
SFC 15000 ALTER BY VALUE COMMERCIAL �'NOZdNE �. 1.00' 15,000,00
CEND OF FEES
_ �J �j�
�
f%?
t � �
� � "J
, J �� ,
i•
�� '
�
,
-- _
CONSTRUCTION AND PLANNING . P� $ SPA
� APPROVALS Permit # Data Inspector qppROVALS Permit # Date Inspector
7. Temporary Elec[rical Service or Pole � 52. Pool & Equipment Location
2. $pi� Pipe-Undrgmd.. _ �� 53. Steel Reinforcement
3.�ElectricalT.onduiiUtiliry�Undrgmd.' - - 54. Forms �
; 4. �iectri�al Condpjf-Undrgrnd. 55. Electrical Bonding
� 5. �Steel Reintorcemenc . 56. Rou9h Plumbing & Pressure Test �(
6:,£IecCri'cAf UFER-Grnd. ; �� 57. APPROVAL TO COVER�GUNITE
:.7,:Footing5 � . 58. Electrical Conduit�Undrgmd.
8. •Fountlation' ' S9. Gas Pipe, O Undrgrnd., Test
9..Water Plpe-Undrgmd. 60. Backwash Lines, P-Trap, O Undrgrnd. y
70. Structural Pioor System " � " 61. APPROVAL TO DECK
17. roperty SevJei Lin�& Ho�seConne�tion 62. Backwash & Receptor•Final
72..Sewer Cap � • 63. Heater & Vent-Final
13. Roof Drains �� -, . 64. Plumbing Syscem - Final
tA. fiough Plumbing 65. Electrical-Final �
75. Rough Etectric3t=Contlu�t 66. Solar System�Final
76. Rouyh 'c[ectric,4Viring . 67. Fencing & Access APprovai �
77. Rough Wiring Sign 68. APPROVED FOR PLASTEFING
�.1$. Rough ElectricahT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIR� [�EPT. REQUIREMENT
20,rRou�h Factor,Q Fir@place '� ; , �, � ' ;r : a iAPPROVAk3�' � Permit # . I
21.�.Ducti, io-5tructure' • " � , { ; , 70. UndergroUnd.Hydro '
- �
22. ,Du�, Vgnti��tint��, � � . - � � � , _ ;]i. Product Piping O Gas ❑�Oil �
23. Gas Pipe-Rough & Fest � � • �� . •. �.72, Underqround Flush' ' ' -
n �- r = �c � r
24.�qooPFramin'g' , , - _ _ , ;. �; .73. Undergmd.Srora,geTank OGas ❑Oi! i
25. Roo4 ShEathing ��- � ^ 74, pverhead Hydro
26.. J�Bar Celing IStracturall & MonQcoat ', ' 75. .Dr.y Chemical ' ' '
27. frame and Flashing .. • � 76. Dry Standpipe �
'28. Latf�ing & Sfd'in9;'� ^ r-' i i� . � � ��� " 77.t FIXED SYSTEM FINAL� • , .
29. Insvlatio� �• �� �� - 78.'^FIRE PREV. FINAt
30. Dryw.ali�Nailing ^ . �� �, HEALTH DEPT: REQUIREMENT
31. Plaster Brown Coaf �. �.� �� � � � 79, FINAL INSPECTION • �
�
,32.'-Electrica! Power MeterFinal � � �$0.�'F'OOD CERTIFICATE ISSUED {
.93.,Fina+El�cuic t .i Noc�s: � � �
_Fa,�,�..►��_" � - _/` ��-�s� ' �
�34 �Final Heating& Air•Corfditionirig�• • '" f Z�,/��� � .
35.. Final Ga; Pipe-Test . ._ � f ` � �
36. Hood or Canopy = - ! -
37. Final Factory FireP�ace� ' �,�� �y�� �i�lQ��i� sv/� �[ s� j
38. Final PiEfmbing ��� � J�/J
39. Water Se��ice�Finai• � j ` ` / //�ys-
. s • � • ��
, . A0. Gas Service-Ftnai _ . - � I � • • . •
'41. Solar pomesttcFinal:. ` - � ; �� .,/r/�) �/��/�/ Q�/�,'�
. . �i���. /\K/ �� 7r'�/
42.� Backflow Preventer . . , : . _ - � r���
�
43. Backflow Irrigation _ : ' , : � ' -.
44. Landscape Irripation System � ' - - � • "'
45. $ound Attenuation ', �, ' �� . '
'46. Handicap Regulations • �
i
47. FINAL STRUCTURE & BUILDING '*��$�y �_ r
A8.�fINALPLANNIiVG . i � � , ,
I
' �49. yElectric Aelease to Edison � -
50. Gas Release to Southero California Gas Co � '
51. CERTIFICATE OF OCCUPANCY � + �
No. Date
}_
AOO��eant to flll In all s0aees exeept t�ase wllhin heavy bo�Ea� Iines anG Sign all approprlata Oaclaralions.
CITV OF COSTA MESA CONSTRUCTION PrERMIT P RMIT TRACT NO. LOT NO. ;YIT NO. A P�y
Project Address 555 /�nrtoN ��t�0Y1.Q. �bft/J� � ��� � � / e� / S Main Buildi
� TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR E
AppliwnlsMailingAddress �'�O 1qV1A7E AVE NPT �N Front
❑ CONVEft510N ❑ DEMOLISH ❑ OTHER 'T
Owner'sName 5������_��GEZANK Phone
"� DESCRIPTION OF WORK/USE OF BLDG. —�.— A Reer
Address ��5 PA�T�n1 AVE_ •
Arch/Eng. RqINTM1 `t fiS�l1!` Licens¢ No. TYPE OF PENMIT���///''' GRADING FOUNDA71oN STRUCTURAI � K Right
AddfEii �3aa �+ELI AVF_ T1GY1 f� ❑ TENANT I.�LECTRICAL ❑ PLUMBING ❑ MECHANICAL g� Left
NUTCHISON C RP p ❑�OTHER � Pln Ref. 5W
Controctor's Nam - honelqo�� � 9'
PROJECT DESCRIPTION SCi. P7. OCCUPANCv p�annin Notes:
Address�mailing) 34�n iPYWf: QVF CONSTRUCTIONTVPE�.pC�.'�� VALUATIONS 9
CiW LicenseNo. _p3a�R7 ZONE GRAbINGCU.VDS. ACRES
LICENSED CONTRACTOR DECLARqT10N
I hereby aftirm lhat I am Iicensetl untler provlslon5 oi Charter 9(commentlng
wilh set[lon 7000) of DIVI510n 3 O( the Bu51na55 antl Profe551on5 CotlO, antl
my license Is in (ull torce antl etiect.
License C ass Licanie No. ��S �.Z
Dale� $I9ndture
`�ORKERS' COMPENSATION DECLqRAT10N
nCreby aftirm t�at I havG a certlticat@ of mnsent t0 solt-Insure or a certiflwt¢
ot Workers' Compensation Iniurance, or a certl/letl copY thereof (Section
3800, Lab. C.)
aoiicY No. ���PR049aR1� ComPanvEre nG Fut��
�. Certifietl c�oy is f I etlbwithrthehcitly Bu Itling Dlvision
Date sia�Ygg� Applicant �Anu/`� i�nf�4� /w%
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl i( t�e permit Is lor one huntlreC (5100) or
lessj.
I certi�y Lhat in [h¢ perto�mance o1 tAG work f0/ whlcn th15 p<rm�t 75 I55Uetl I
snall not employ any person In any manner so as to betome zubject to t�e
Workeri' Compensation Laws of California.
Dale SI9naWre
NOTICE: II, atter making this tletlara��on, you shaultl become subject to lhe
Workers' Compensa[ion provisions o� t�e Labar Cotle, you must forthwilh
comply with such provisions or this Dermit shall be tleemetl rovokotl.
CONSTRVCTION LENDING AGENCV
I horeby attlrm thal thera is a construc��on Ientlin9 agency for the Derformance
Of [ho work tor whicn Ihls perrqit IS i55uetl (Saction 3097 Clv. C.)
Lantler's Name
LUntlel'S Atltlre55
OWNER BUILDER DECLARATION
1 �eraby aHirm ihat 1 am exampt irom the Cantra<lor's Ucenie L.aw lor the
followin9 reason (Sectlon 7031.5 Bu=inezs antl Professlonal Cotle: Any city or
munty wnich requiras a permil to CahStruct, allGr ImprovO, OGmoliSh Or mpalr
any ztructure, prlor to its Issuance, also requires t�e applicant for such parmit
n�iix a xienetl statement lhat h¢/She is Iic¢nsad ou�Sudnt to the prOVISIo05 Of
e
]031.5 by any dpplicanl f0� a permit subjocts tho applitant to a tivil
eenalty ol not mOre lhan tivG huntlr¢tl tlolldri (5500).
LJ I, as owner of the Oroperty or my omployeei witn wages as thoir solo
CompCnsation, will Oo [h0 w0/k, antl {he sVUCluro Iz nol inlentl¢d o� OItO�¢tl
tor sab (Se<tion 7044, Businass aqd Professlonal Cotla: The Conlractor's
Licenie Law tloes not appty to an owner ot a proparty wbo DUIICs or Improves
tnereon, antl who aoes such work h�mself/herseH or throu9h Ms or nar own
employ ¢es, prOvitletl tbat such iTP/avements are nOt Intentlatl O/ offered Por
sale. II, nowever, the �ulltlin9 or improvement Is soltl within one year ot com-
pletlon, the owner will have [he burqen of provin9 ho/s�e Altl not builtl or Im-
�rove for the purpose ot sale).
I, as owner ot tlte OroOerty, am Bxclusively contracting with Ilcensetl con-
l�aclorito COnst�uct the project (Setqon 7044, Busineit dntl PrOte55ions COtle:
Tno ConVactor'S License law does no[ apply to an owner of proparty who
bulltls or Imoroves lhereon. antl who contracts for such oroiects with a con-
tractor(sl Lcense pursuant eo �ne Contractor•s Ucansa Law). I am aware tha[
proof of their Worker's Compen5alion InsuranCO Shoultl be prOvltletl t0 me.
�] I am exemp[ untler Section B. 8 P. C. (or this reasan
Remark�:
Sink
Irrigation
parifiers '
Dishwasher.
Drinking Fountains
Floor Dreins
Floor Sinks
GasService Outlets
I nterceprors
Kitchen Sink
Roof Drains
Rainspection Fee � 515
Boiler
Duct � Under Ground •
Duct - Structural
Duct - Ventilating
Ezheust System ❑ Multiple
Firepl/Fact. Blt. iC80 #
Oate owner Heating System & Ducting
I hereDy certlty tnat I bave reaU tq�s applicatlon antl state that the above ❑0-100,000 BTU 0100,000
Information is wrrect. I agree to comply wi[h all tlty antl county ortlinances
antl state laws reldting to builtling cbnStruCNOn, dOE nerGby authorize repr¢-
5entatives of this city to enter upon the above-mentlonetl property for
InSpettion Ourposes. '
519nature Date 7/�1189
Driverz' Llcense or 55 � Reinspection Fee
0865-46, rev. 5/88 White - Building; Canary - Appliwnt; Pink - Ac<ountin9: Goltlenrotl - Assessor
$15
ShOw2f5
Service Sink
Sewer Cap �
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Urinai
Water Closet
Wa[er Hea[er
Water Service
Auto-Wash
leundry Tre'ys
Issue Fea
Hoador Typel ❑
Canopy Type II ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
S 3
FEES
$ 3
Automa[ic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Fan
F.A.U.
Fixture5
Device Boxes
Ouclecs
Switches
Garbage Disposal
Generator �65 KW
Zona
Accessory Building:
Parking Req.IProvided
ELECTRICAL
Transformer � 15-50 KW
ffil 50 + KW
Meter ❑up to 700 amps
Meter ❑over 100amps
� Sub Panel
Motors �P7 HP �1'f. - 8
Inc.Soiar 09-15 HP �1E75+
Mittowave
Pole Light
Range
KW
I Reinspection Fee � $15
DEVELOPMENT SERVICES RE�I
2oninp Approved By
Building Approved By
Aaoli�ation Issued Bv
Standing Sections
Tresh Compnctor
luue Fee
BUILDING PERMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $ �
PLAN CHECK 50% $
MECHANICAL $ '
PLAN CHECK 25% $
N
1
N
G
R
E
�
M
7
S.
FEES
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $ Q
TOTAL FEE $ 7�+ ' g�
O1 OOQd3748-Ct7033748 T�T � %e9�
OATE: Q5/2v/29 TIi4E: ;;:f3
CON3TRUCTION AND PLANNING PC & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
. �
1. T�mporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3.'�Electrical Coriduit Utility-Undrgrnd. 54. Forms
��
41Electrical 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. -
70.'Svuctural Floor System ', � 61. APPROVA� 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 �
r �
14:;,Rough Plumbing � 65. Electrical-Finai " '
15. Rough Electrical-Conduit . Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
�.
�17. Rough Wiring Sign . APPROVED FOR PLASTERING
�18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
.19�. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT
20� Rough Factory Fireplace ��) APPROVALS Permit #
21�� DuCts, in Structure r` 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.StorageTankOGas ❑Oil
25. Roof Sheathing �; 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing .76. Dry Standpipe
28. Lathirg & Siding 77. FIXED SYSTEM FINAL
29. Insula4ion � 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31- Plaster Brown Coat. 79. FINAL INSPECTION
32: Electrical Power Meter-Final OOD CERTIFICATE ISSUED
33:,Final Electric �/ No
34�FinalHeating&AirConditioning ��� '•n..
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final ' j
41. Solar pomesticFinal ,u� �
i � l�
42. Backflow Preventer _• -• _- ) �' •
43. Backf�ow Irrigation , • � " "
44. .Landscape Irrigation System I �' �
45. Sound Attenuation � ! ��- �
r
46. Handicap Regulations ` l
47. FINAL STRUCTURE & BUILDING 1
48. Special Requirements Completed
49. Electric Release to Edison ;i �
50. Gas Release to Southern California Gas Co . � •
51. CERTIFICATE OF OCCUPANCY . �- ( `\
No. Date �' � � `� •
- i
tt�7
V
2
2
�
Appllcant to fill in all spacef axclD< <hose wit�in �eavy Eo�Ee� linas antl sign all aoDroD��ate Oeclaratlona.
GTY OF COSTASSS CO�� UC�TION PE �fV��T �
Project AdAress or{ _
Applicant's Mailing Address 5. `V/A('�{1`���qn�
Owner's Name �'����. ��-.^AC- •�1 �=P lSR4' �'%4�8
Address 3�/33 N • �!G/9`�+ �n GZ/1I�`��N'�
Arch/Eng, L.E��N Qc�Y LicenseNo.( ��,271
Address s • � 5
Con�ractOr'sNamp�NNF�C. SQ�� Pho n�-%I�L%
Addreu (mailing) S�'� G�'�U� �T '� ��
City License No. 3Z ���
LICENSED CONTRACTOR DECLARATION
I hereby aftirm tnat 1 am II<ensatl untler provisions ol Char[er 9(cammencing
with secllon ]000) of Divislon 3 of the Business antl Professions Cotle, antl
my Iicense is in full brce antl eHect. �� /30 O
Litense Class � l.it¢nsa No. (D ��
DSte � —L Signature '� «������C
�VORKERS'COMPENSATION DECLARATION
'I hereby aifirm thal I have a certiflcata of consent l0 5eif-insure or a cerUfi�ate
oi Workerz' Compensation Insu�ance, ot a ce�tlfietl cOPY theteot ($ectlan
3800. Lab. C.���77,/z^
Golicy No. ( r a company ��EtP'T %m�% -
�Certllietl coOY is �eraby lurniSheC.
Cejtifietl cop is filetl wlth the city Builtling qivislo
Date1,7 � � � APPlicant � ��
EXEMVTION FROM WORKERS' COMPENSATION DECLARATION
(This 5ection neetl not be completetl if the permit is tor ane huntlretl (y300) or
less).
I certily that in thG perto�mance o� the wo�k 10� whic� [nIs petmk is IssUetl I
shalP not employ any person in any manner so as to become subject to t�e
Workers' Compensatlon Laws o! Calitomia.
Date Si9nature
NOTICE: If, atter making t�is tle<laratlan, you 5hou1G be<ome subject to the
WOrkeri' Compen5dtion prOVlSioni O1 thG LdbOr COtlG, y0u mu5t fOlthwith
comply witn such provisions or thls permit shall be aeemetl revoketl.
CONSTRVCTION'LENDING AGENCV '
I hereby afflrm lhat there is a mnztruclion ientling agency for the performance
of Ino work for wblc� t�is permit is issued (Section 309] Civ. CJ
Lqnaor's Name
Lontler's AtlOress
OWNER BUILDEft DECIARATION
I hereby alfirm lhat I am oxampt from the Contractor's LicenSe Law tor the
lollowing reason (Sectlon 7031.5 Buslnass anG Professional Cotle: Any city or
county which req Wres a permit to construc[, alter, improve, tlemolis� or re0alr
any slructure, prior to its issuance, also requirei the applicant for such parmit
to 1110 d SI9nOtl slatem¢nt tha� he/sh! IS Iic¢n58tl DurSudnt to the pfovlSiOns Of
he Conlractor's License l.aw (Chapter 9(commencing with Section 7000) ol
)IviSlon 3 of t�e BuSiness and ProIGSSions CoOe) Ot tnat ne/ih¢ ii Oxempt
therolrom antl the basis tor the alle9atl exemplion. AnY vlolaUon of Seclion
]031.5 by any applican[ tor a Permit SUDjects lha aDP��cant lo a civil
�nalty of not more than five huntlretl tlollars (5500).
I, as owner of the p�operty O� my Om010yees willi wa9es as tM1oir sole
compansaUon, will Eo the work, antl lhe structure is not intontlatl or offeratl
for salc (Section 7044, Businoss anU Protessional Cotlo: The Contraclor4
License Law tlo¢s not ap01y t0 an own¢r of a prop0�ty wM1D builtli or imp�oves
t�oraon, antl who EoeS SUGh wo�k himselt/hOr5011 Or thrOugh hii Or he� own
employees, provitletl that such improvementz ara not IntenCetl or otteretl for
wle. If, howaver, tne bulltling or Improvement Is soltl wit�in one year ot com-
Dletlon, the owner will havo tne buraen ot proving ho/snc elU not Duiltl or im-
prove lor the purpose of sale).
❑ I, ai owner of che property, am exclusively contracting wilh licensetl con-
tractorzto construct tne oroject (Saction 7044, Businass antl Professions Coae:
_The Conlractor'S License Law does not apply to an owner of proper[Y who
builtls or imoroves thereon. antl wno contracts for such orolects witn a con-
tractor�t) Lcense pu�sudnt [o Ine ConVacto�'s Llcen58 Law). I dm aware Iha[
proo� of tnei� Worker's CompenSatiOn inzuran<B Shoultl bo oroviaea lo me.
❑ I am axempi untler Sn<tlon B. 6 P. C. for lhis reason
�_-- �6 si�- I/o �sa I `7 I I�rT"�o�
TYPE OF CONSTRUCTION NEW ADD LTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DgSCFIPTION OF WO�c /USE OF BLpc,� � �N�OTA�L,A O O
/�tTinwt�'f l��P vvtc+��lINE
TVP�qE OF PERMIT GRADING FOUNDATION STRUCTURAL
yqTENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION 5�. FT. oCCVan G�v� � J��
CONSTRUCTION TVPE VALUATION 5�_�QSM�/ _
ZONE GRADING CV. VDS. ACRES
Remarks:
Bar Sink
Backtlow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
FloorSinks '
Gas Service Ou{lets
Ki[chen Sink
Roof Drains
Reinspaction Feo
e ��
$howefs
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool wl5pa
Urinat
Water Closet
Water Hearer
Water Service
Auto-Wesh
$15 Isue Fee
Duct- UnderGround
Duct - Struttural
Duct - Ventilating
Exhaust System � Multiple
Firepl/Fact. Blt. iC80 #
Date owner Heating System & Ducting
I hereby certifY that I hava reatl Ihls appliwtion antl state that Ne above ❑P700,000 BTU �100,000
Informatlon iz corre<L I agree to comD�Y `�'«h all Uty antl county ortlinances
antl state laws rllating t0 builtling ConStructlon, antl �ereby aut�orize repr0-
Sentatives O1 thls City [O G(Itef upofl th¢ dbov!-TentlO�atl ploperty tOf
IhSpactlon py� s n
Slgnalure� � Date ��-Z-80
DNmrs• Li cc � Reinspection Fee
0865-66, rev. 5/88 V White - Bulltl(ng; Canary - ApP����t: Pink - Accounting: Goltlenrotl - Assessor
S15
Hood or Typel ❑
Canopy Typell ❑
Refrigeration Syrtem
06100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers �
Iswe Fee
FEES
$ 3
$ 3
A.P. qW '�I O
S Main Building:
E
T Fronl
ARear
C Right
K
Ping. Ref. #
Planning Notes:
Automatic Washe�
Construction Pole &
Cooking Unit
Dishwasher
Dryers ❑Gas ❑EI
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Ger6age Disposal '
Generator �0.5 KW
Fee
_ �. Zo�a
Accessory Buildin9:
2
' O
N
1
N
G
R
Parking Req./Provided E
U
M
T
$.
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to t00amps
Meter ❑over100amps
Sub Panel -
5�15 KW
$15
DEVELOPMENTSERVICES
2oning Approved By
Building Approvad By _
Moiors 0Q7 HP O1 Ya - 8
InaSoiar 09�75 HP 016-15+
Microwave �� r;
Pole Light
Renge '
Sign
Standing Sections
Trash Compactor
laue Fea
FEES
$ 3
��— O— O
//-P2-8�
SU RV OF FEES
BUILDING PERMIT $ � � SMIP $ O' 90
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL� $ TOTALFEE $ ��� �
PLAN CHECK 25% $
Ol OD021001-00021�D2 T4T 81.90
DR7E: 12/02/88 TItlE: 10::,2
CONSTRUCTION AND PLANNING � • PL- -& SPA ,
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
• t
T. Temporary EI_ectrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Und�grnd. •• �� 53. Steel Reinforcement - �
3.�Elecirical'Conduit Utility-Undrgrnd. 54. Forms
4�Electdical Conduit-Undrgrnd. ' 55. Electrical Bonding �
5. Steel Reinforcement , • 56. Rough Plumbing & Pressure Test
. i
6 Electrical IJFER Grnd. 57. APPROVAL TO COVER-GUNITE
7,_Footings "' + . 58. Electrical Conduit-Undrgrnd. �
8�Fsundation � , � - 59. Gas Pipe, O Undrgrnd., Test
9. W2ter� Pipe-Undrgrnd. ; � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. St%uctural Floor System � • 67. APPROVAL TO DECK
11..Property;Se�er Line & House Connection ' 62. Backwash & Receptor-Final
.
� Z• S�wu CaP�. � ' . 63. Heater & Vent-Final
13.-Roof;Drdi�s � 64. Plumbing System - Final
� ��
14. Rou�li Plumbing , 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Elect \ic Wiring 67. Fencing & Access Approval
17. Rough N'/iring�Sign • 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19:� Rough Heating & Air Condi�ioning FIRE DEPT. REQUIREMENT
20. Rough Fattory Fireplace �' , APPROVALS Permit #
21. Ducts,!n�Structure 70. Underground Hydro
22. Ducts, Ventilating , 71. Product Piping � Gas ❑ Oil
I".
23. Gas Pipe-Fiough &'Ti,est �" --• 72. Underground Flush
� 24. Roof Freming %� '' -} J3. Undergrnd. Storage Tank O Gas ❑ Oil
� ✓�
25. Roof Sheathing � � 74. Overhead Hydro
26. T-Bar'Ceifing (Structural) & Monocoat 75. Dry Chemical •
� ,:�
27. F'rame;and Flashing �! Ni � 76. Dry Standpipe '
28.' Lathing & Siding � � 77. FIXED SY9TE�v1 FINAL
29. Insula"tion � 78. FIRE PREV. FINAL
30. Drywall Nailing "` HEALTH DEPT. REQUIREMENT
31. PlasteqBrown Co�j, i� �� 79. FINAL INSP,ECTION '
32. Electrical Power Meter-Final' 80. FOOD CERTIFICATE ISSUED
33..Final Electric �-j � Note �_
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Gnopy
37. Final Factory Fireplace
38. Final Plumbing .
391 Water Service-Final - '
r
40. Gas�Service-Final �
41! Solar pomestic-Final • �
42. Backflow Preven[er i
43. Backflow Irrigation , � .
.�
44. .Landscape Irrigation System -
45. Sound Attenuation i
r
46. Handicap Regulations •
�
47. FINAISTRUCTURE&BUILDING / � ��
48.� Special Requirements Completed
p9. El�ectric Release to Edison �
50. Gas Release to Southern California Gas Co �
51�. CERTIFICATE OF OCCUPANCY '
No. Date ,
�
� �' .°.VP���ant lo fill In all s0aces ezcept those wit�in �eary eo.ae. Iines ane sign all apvroo��ate tlaclarations.
ciTv oF Cosra nnesn CONSTRUCTIO7N PERMIT PER T N� �' �� TRACT NO. LOT NO. IT 0 �
.•ProjectAddress •�.s_rdi(/%!�/✓ lJLC//-7 _
Applicant's Mailing AddrEss �� �.fV ' V � TVPE OF CONSTRUCTION NEW AD� ALTERATION EPAI R
� ��� ��, �, � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' ' A.p, y�6
Owner's Name �����r7 ee. Phone:J�L.GO ' DESCRIPTION OF WORK/USEOF BLOG. Tr// �T .,% 6L[
Address •�,{�� �/�'��T .���C✓.i ��IT/ 1�-9'�c !�
Arch/Eng. License No.�
Address
Contractor's el� �-�/�/Te/�/K �-n pho�t�yy''Gr7/ -
Address (mailing�2G r S.eU �iGi✓.0.U/y �CT�C/iils— �
City License No. -_P� � PG �� � .
LICEIJSED CONTRACTOR DECLARATION '
I hereby affirm that 1 am Ilcensetl untler provisions o1 Cltarter 9(commencinq
wit� sectlon 7000) of Dlvlslon 3 of the Business and Prolessions Cotle, antl
my Ilcense is in tull farce ana effect. 2�`�i
License Class � Licanse No�
Datrl �LZ �� Si9naf� ra
WORKERS' COMPENSAT�ON DECLARATION
I hereby atfirm lhal 1 have a tertificata o/ consent to self-insure or a certltlfate
of Wor�k-�eQrs' Campensalion Insurance,.or a cer[Itied cOGY Ihereof (Secqon
pp00y p(p�%IS�GCO�Ii/�� ComPanY ��t�v . .
Certlfietl copy Iz hereby fumishetl.
Cer[ifietl cop ��I(( file0 wit� the Buii ng Olviz n.
Oate� /L �� Apo/l an� ��
E%EMPTION F OM WORKEHS' C ENSATION DECLAR ON �
(Thissection naetl not be complatatl if tha permit is tor one �untlretl (5100) or
less).
I certily tnat in the partormanca of tha work for wnich tnis perm�t Is issuetl I
shall no[ employ any person in any manner so as to betoma subject to t�e
Workers' Compensatlon'l.aw5 oi Ca111ornia.
. Date Si9nature
'NOTICE: It, afte� making lhis tlecla�ation, you Snoultl become subject to Ihe
Work¢r5' Comp¢nsation provi5iOn5 O/ th¢ LabOr Cotla, you must forthwlth
cOmpty- with suc� 0/oWsions o� Ihls pe�mlt's�atl be CGemetl �Ovok¢0.
CONSTRUCTION LENDING AGENCV -
I noreby alllrm that there Is a construttion lentling agency for tne parformanca
of tho work for wh(Ch thi5 Oermit IS issuatl (Saction 309] Civ. C.)
Lentler's Name
Le�tler'z Atltlro55
OWNER BUILDER DECLARATION �
1 he�eby dt(irm thdt I dm ¢xampt �rom tho Conlracto�'s Ucense Law for th0
followin9 reason (Section 7031.S,Business anU Profasilonal COEe: Any city or
munty wblch raqWres a permit [O cOnSlruCt, aller, ImOrovO, demolish or repalr
any structure, Orlor to Its issuance, also reqWros t�e applicant for suth permi[ ,
to iile a Signatl Slat¢menl tnd[ h0/She Is Iicanietl purivant to Ihe proNSiOns oi
'the Contracto�'S Ucensa Law (Chap�e� 9(COmmOnCin9 wlth Sectlon 7000) of
Dlvision 3 ot tno Business antl Prole551ons Cotle) or tna[ M1o/she is exempt
tharelrom antl the basis lor t�e allege0 nxamptlon. Any violatlon o1 Section
7031.5 by any applicant tor a parmit sub�ects the appli<ant [o a civil
�enally of not moro than /ivn huntlretl tlollars (E500�. �
I, as owner o/ Ihe proparty or my employe05 with wa9os as lnelr sol¢ �
compenuUon, will tlo tho work, antl lho strucWre is not Intantletl or oHeretl
lor wlc (Section .]OC4, Businoss antl Profesiional Cotle: The Contractor'S
License Law tloes not apply lo an owner o! a property w�o bulltlt or Improves
' thoreon, antl who tloes such work �Imzeif/nerSeH or through his or ner own
em01oy ees, provl�o0 that SUCh Improvem¢nl5 are nOt Inlentlatl or otteretl to�
sale. II, nowevar, the Dulltlin9 Or improvement Is soltl wit�in one ynar ot com-
Olalion, lha owner will have�the burden O1 prOving he/th0 tlIC not builtl or Im-
�rOv! lo� the purpOsa of sale).
I, as owner of the OropertY. �m oxcluslvely contracting wllh Iicensetl con-
tractors to mnstruct lh¢ pro�ect (Sectlon ]OG4, Buslness antl P�otessloni Cotle:
The ContractoYs Liconso law does not aooly to an owner o/ property who
bulltls o� Improva5 the�ean, antl wbo Contracts tor suth projecls with a con-
tractor(sl Ilcense purSudnt�to tM1a Contractar's License Law). I am aware that
proot o( lheir WOtker's Compen5ation InSuranCe ThOultl be provitletl t0 me.
❑ I am exempt untler Sectlon 8. & P. C. for thls reason
Date
certi
in is
Signature �
Drivers' Licyji�or 55
CMF OB65-46, rev. SO/04
_ Owner
I' have reatl lnis aOPIIcaUon antl ztat¢ that t�e. above.
I agr¢e to comply with dll city anG COUnty ortlinance5
to builtlin9 conslrucHon, antl hereby authorine repre-
to e�tar upo the abova-menilonea property for
/J�� oate 1 —{2 �4
= �, „� `�
TVPE OF PERMIT �LJ GRADING LJ FOUNDATION LJ STRUCTURAL
�O TENANT ❑ ELECTRICAI ❑ PLUMBING �MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sq. FT. oCCUPANCv_
CONSTRUCTION TVPE � VALUATION $
20NE � GRADINGCU.YDS. - ACRES_
Remarks: �%�li n��l r/ s_�� ��/�i./�
� .-xi /��c� (0 6
1
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories
P—Trap
Fioof Drains
Reinspection Fee
515
Boiler
Duct-UnderGround .
OUct - StruCtUral
Duct-Ventilating �
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
Oaioo,000 eru Oiao,000
i
Reinspaction Fee I $15
Whita - Builtling; Cxnary - Applicant; Gink�- Accounting; GOICenrotl - Assessor
Service Sink
Sewer Cap
Sewer Connenion
$olar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa '
Urinal
Water Closet �
Water Heater . '
Water Service "
Auto-Wash
Laundry Trays
Issue Fee
Hood or Type I �
Canopy Type 11 ❑
Re(rigeration System
❑aioo,000sru ❑ioo,000
System Repair/Alteration
Fire Dampers
Issue Fee
S Main Buildi
E
T Fronl
B Rear
A
C Right
K
g Lett
Ping. Ref. �h
Planning Notes:
Auromatic Washer -
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fix�ures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generaror �0.5 KW �
"%L
Zone
Accessory
ELECTRICAL �
Transformer � 15�50 KW
❑ 50+KW
�
Meter Uup to 100 amps
Meter ❑over700amps �
Sub Panel
Motors �0.1 HP �1'rS - 8
Inc.Solar 09-15 HP �i6-15+
Microwave '
Pole Light
Range
Sign �
Standing Sections
Trash Compactor
S 3
Reinspection Fee $15 luue Fee
FEES
DEVELOPMENT SERVICES RE�UIREMENTS:
� ZoninB APVroved 8y
Building Approved By
Aoolication Issued Bv
�
. SUMMARY OF F
BUILDINGPERMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $ � —�
MECHANICAL � $ �5��".—_
FEES
$ 3
SMIP $
PERMIT
ISSUANCE $
ENERGY P.C. $
GRADING $
MICROFILM $ 2 11
TOTALFEE $ di.D(J
Z
O
N
I
N
G
R
E
Q
M
T
S
ooa42a�-o0024237 Tr_�T .tr,G�t,
� O1/12/S4 TiMFe ttr�t
�CONSTRUCTION AND PLANNING POOL & SPA -
� APPROVALS Permit # Date Inspector qppROVALS' �Permit # Date � Inspector
i
1�Temporary Electrical Service or Pole � 52. Pool & Equipment Location
:2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5..Steel Reinforcement � 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.
•70. 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 Orains 64. Plumbing SYstem - Final �
14. Rough Plumbing 65. Electrical-Final
15.. Rough Electriwl-Conduit 66. Solar SYstem-Final ' �
1_Fj._ Rough Electric Wiring 67. Fencing & Access Approval � -
�17.'Rough Wiring Sign 68. APPROVED FOR PLASTERING
�:18. Rough Elearical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
1�9.� Rough Heating & Air Conditioning ` 8� (� FIRE DEPT: REQUIREMENT
20: Rou9h Factory Fireplace APPROVALS Permit #
-21. Ducts, in Structure . 70. Underground Hydro
22. Ducts, Ventilating , 71. Product Piping � Gas ❑ Oil �
23. Gas Pipe-Rough & Test 72. Unde�ground Flush -.
-24. Roof Framing � 73. Undergrnd.StorageTank �Gas OOiI
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
31i Plaster Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33: Final Electric Notes:
34. Final Heating & Air Conditioning �[t LF,p
+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 pomestic-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 .
i
49 lectric Release to Edison - . . - � � _ • �!,
5ii. as Release to Southern Califomia Gas Co
r
51. CERTIFICATE.OF OCCUPANCY � . . � � '- '_%
No. � ' Date � +
ADC�icant to fiil in all spaees exeeDt those within heavy EorGer Ifnes anG sign all aopropriate tleclarations.
CirvOF.�OS7aMESA CONSTRU^-C1TIONPERMIT
Pfoject Addres: -'��.C5 A('1R>�l t-CP � + � — �� L' .
Applicant's Mailing Address �
Owner'sName �������� PQ������nx Phone
Address
Arch/Eng. �1� L�cenu No.
Address '��� �� ��� aMr �e-L
Con Vactor's Name
� ��c'c�PT� ��PC_-�Y��(` Phone�
Address (mailingl.�h��`�h��I i�a - \Oi � 0.S}G MP�A�
City License No. n�9RL
LICENSED CONTRP�TOR DECLARATION
I hereby afti�m thaf � am licensetl untler p�ovi5lon5 ot Chdr[¢r 9(commencing
with section 7000) of Division 3 of the Business antl Professions Cotle, antl
my Ilcense is in (ull force antl etfect.
Cicenie Class L(cen e No. Sy'a�.i7 �
oate ��a'��'RR Siynature �
�NORKERS'COMPENSATION DECLARATION
• 1 hereby aitirm that I have a certificate of consent to self-Insure or a certificate
of Workers' Compensation Insurance,.or a certifietl mpY thereot (Settlon .
3800, Lab. C.) �
aoi�cr No. 1LlP8B�!'13(�09 company�f'PiMt�TT(Y�((htl�%/�V,
�Certitietl copy is hereby furnishetl. ,
Certi(ietl coOY is tileU with the city BJi�ltli�n9 D�lv�iSioj1.
Date �a' 1'�i—R� qpplicant �7—\ ` ���� � ^'- �
EMPTION FROM WORKERS'.COMPENSATION DECLARATION
(Thi55¢<[ion neetl not be completetl i( the Oe�mlt I5 to� One huntl�etl ($100) or
less).
I certity [hat in the performan<e ot the wo�k fo� which IhiS pe�m�t i5I55uetl, I
shall not employ any person in any manner so as to become suGject to the
I Workers' Compensa[ion Laws oi Calitomia.
Date Si9nature
�- NOTICE: If, after making this tleclaration, you snoultl become subjett to tne
Workers' Compensation provisions of the Labor Cotle, you must (orthwith �
, comply with such P/ovi5ion5 or this pe�mit Shall be tleemetl �evOk¢tl.
^ CONSTRVCTION LENDING AGENCV ,
J I hereby affirm that tpere is a wnstruction lentling agency for the performance
o( the work for which [his permit is. issuetl (Section 3097 Civ. CJ
�� LRntler'S NaT¢ � �
Lentler's Atltlress �
OWNER BUILDER DECLARATION '
I hereby afiirm lhat I am exempt from the Contractor's License Law tor the
following reason (SeG��on ]031.5 Business antl Professional Cotle: Any city or
county which r¢quires a permit to construct, alter, im0�ove, Oemolish or re0dir
� any structure, prior to its issuance, also requires the apPlicant for such parmit
��� � tile a signetl stater�ent that he/she is licensetl Pursuant to the provisions o/
( e Contractor•s LicenSe Law (Chapter 9(commencing witn Sactlon 7000) of
ivision 3 of the BUsiness antl Pro(essions Code) or tha[ he/she is exempt
therefrom antl the basis �or' Ihe allegetl exemption. Any vlolatlon ot Section
7031.5 �,by any applicant for a permlt subjects the applicant to a civil
�enalty ot not more than five huntlretl tlollars ($500). -
I, as owner of tne piope�ty� o� my employee5 with wage5 d5 th0ir sole
compen5ation, will tlP [he wo�k, antl the Structu/¢ is not int¢ntletl o�-o(fe�etl
for sale (Section 7044. Businezs antl Professional Cotle: The Contra<tor'S
License l.aw tloe5 not apply to an owner of a property who builCs or improves
thereon; antl who anes such work himself/herseif or tnrou9h his or har own
emDloyees, provitletl that such improvements aB not Intentletl or o((eretl for
sdle. I(, however, the buil0ing o� imp�ovemenf is Soltl wlthin one yea� of coM-
o�etion, Ihe owner will have the burtlen ot provin9 he/she tlitl not bulltl or Im-
prove for [he�purpoze ot sale). .
❑ I, a5 Own¢r O( th8 G�operty, am exclu5ively contracling with IicenS¢tl COn-
tractors to construct ihe Oroject (Section ]044, Busine55 antl Pro(essions COGe:
T�e Contractor's Licanze Law tices not appty to an owner ot property who
builtls or improves the�eon. antl,who cont�acts for Such o�oiects with a co�-
tractor(3) Lcense pursuan[ to tne Contractor•s Licenu Law). I am aware that
proof o4 thei� Work¢r'S Compensation insurance shoultl be proW�ed to me.
❑ I am ezemp[ untle� ��cion B. & P. C. for thiz reazon
Date
certify t
�n is con
Si9nature /
Drivers' License or
0865-46,rev.5/80
— Owner
I have reaA this application antl state that the above
I agree to comply with all city antl county ortlinances
to builtling constructlon, antl bereby authoNze repre-
� to enter upon the above-mentlonetl property for
� o ��(z`.��jM�� _ �aceia-,3-88
TYPE OF CONSTRUCTION NEW LJ ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEM LISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPEOFPERMIT�f UGRADING LJFOUNDATION L15TRUCTVRAL
❑ TENANT qYELECTRtCAL ❑ PlUMB1NG ❑ MECHANICAL
❑ OTHER �
PRQIECT DESCRIPTION 5�. FT. oCCUVANcv
CONSTRUCTION TVPE VALUATION $
ZONE GRAOINGCU.YDS. ACRES
Remarks: � a3%�5 �R
3ar Slnk
3ackflow Preventer �
3ackflow Irrigation � �
3athtubs
�larifiers
Jishwasher
7rinking Fountains
°loor �rains �
Floor Sinks
�as Service Outlets
Intereeptors '
Kitchen Sink - �
Lavatories '
'-Trep
Roof Drains -
Reinspeition Fee $15
Boiler
Duct - Under Ground '
Duct - Vemifating
Exhaust System ❑ Multiple
Firepl/Fact.6lt. ICBO #
Heating System & Ducting
❑ ai oo,000 aTu o i ao,000
Reinspeaion Fee � $75
Wnite - Buildin9; Canary - Appllcant; Pink - ACtountln9: Goltlenrotl - A55e55or
Showers
Service Sink
Sewer Cap
Sewer Connection
$018f COIICCLOfS
Solar Piping '
Solar Tank
Swimming POoI w(Spa
Urinal
Water Closet ' �
Water Heater
Water Service
Auto-Wash
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeretion System
oaioo,000eTu ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
Iwue Fee
FEES
A.P. �i`-
S Main Building:
E
T Front
B Rear
A
C Right
g . Left
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole S�
Cooking Unit
Dishwesher
Dryers ❑Gas ❑EI
Fan
F.A.U.
Pix[ures
Device Boxes
Outlets
Switch¢5
Gar6age Disposal
Generetor 00.5 KW
Reinspection Fee
'. ' Zone •�.
Accessory Building:
2
O
N
I
N
G
R
Parking Req./Provided E
U
M
T
S.
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50 + KW
. Meter ❑up to 100 amps
Meter ❑over 100 amps
� Sub Panel
Motors �0-1 HP 07:5 - 8
Inc. Solar �9-15 HP 016-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compactor
$15 � � laue Fee
$ 3� DEVELOPMENTSERVICESREQUIREMENTS:
Zoning APProved By
FEES Buildine APP�a�ed By
� Aoolifation Issued Bv . __`u�
FEES
. �-g-+
� SUMMARV OF FEES .
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT �
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ �j �2-� GRADWG $
PLANCHECK 50% $ MICROFILM $ ['� �
MECHANICAL $ TOTAL FEE $ �
PLAN CHECK z5% $
$ 3
414a023t163-t�Od220b3 TO"Lr 58,25
�ATE: 12/i3/88 TIME: 1f1:`7 _
, �
- ,CONSTRUCTION AND PLANNING � �� �� . F . & SPA - .
�APPROVALS Permit # Date Inspector p�ppROVALS Permit # � Date Inspector�
�1., Temporary Electrical Service or Pole � 52. Pool & Equipment Location .
2.' Soil Pipe-Uridrgrnd. � ^ � ' 53. Steel Reinforcemenf � ' � � � .
3..�Electrical Conduit Utility-Undrgmd � � ' 54..Forms � ;
4.�Electrical Conduit-Undrgmd. �' _ �� 55. Electrical Bonding � �
5. Steel Reinforcement� '� � � 56. Rough Plumbing & Pressure Test � •
6. -Elect�ical UFER Grnii. , 57. APPROVAL TO COVER-GUNITE �
7. Footings I', , .- � 58. Electrical Conduit-Undrgrnd. _
��8.i Foundation �.���i i 59. Gas Pipe, O Undrgmd., Test � �
9. Water Pipe-Undrgrnd. " 60. Backwash Lines, P-Trap, � Undrgrnd..
10. Structural FloocSystem � � �� 61. APPROVALTOAECK
11.' Property Sewer Line & House Connectiou � 62. Backwash & ReceptorFinal
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. SolarSystem-Final
16.� Rough Electric Wiring 67. Fencing & Access Approval �
17,.. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � , � 69. POOL/SPA SYSTEMS.FINAL
19: Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT .
20� Rough Factory Fireplace . APPROVALS Permit# � .
21. Ducts, in Structure • 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �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 • � Q � � _ _
35. Final Gas Pipe-Test .
36. Hood or Canopy .
37. Final Factory Fireplace �
38. Final Plumbing � -
39. Water Service-Final .
x
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer _ �
�
43. Backflow Irrigation • ' � .
44. .Landscape Irrigation SYstem '
45. Sound Attenuation X
46. Handicap Regulations _
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed . .
�19. Electric Release to Edison ' . -'
F9. Gas Release to Southem Califomia Gas Co � , ., �
51. CERTIFICATE OF OCCUPANCY � , � � ' � ; � �
No, Date - �• •
- i
�
(
PflOJELT p00flE5S: � 5 J ANTON B L �NIT: 1 5 1
OWNEfl'SNAME:BANK OF AMERICA
auoeess: z0 N RAYMOND AV
PASADENA
818-578-7680
AHCM/ENGINEEfl:ROY HERBOLD flEG.N0.:C11O%2
noonEss: Z522 AQUASANTA uxiT:
TUSTIN CA 92680
rcxminee:COMPETITION ELECTRIC (Q18)331-5807
aooxess: 635 STEPHORA
COVINA CA 91724
UCENSED CONTBACTOP UELLRflATION: I �ereby al�irm tAal I am licensea unUer pmvisions ot Chapter 9 �commencing wit� Section
7000� ol �ivison 3 al �he Business ana Pm�essions Cotle�o license is in lulllorce and e��ec�.
c�rvuc.:056905 sTnreuc.:516842 uss:C—: '
, n,,.,: 3' � —� Siqn e:
� WOPREBS' COMPENSRTION OECLAflATION: I he�@by a��irm N ve a cenilicate of consent io selbinsure or a cenifiwte oi Workers'
Compensalion Insurance. o� a cetlilieG copy ihereoP(See' . La0 C�.
� POLICY NO.: 1 O E S S% i EXP. DRTE: O 1 I O 1 I 9�f
cameanr:STATE FUND
❑ Ceriifietl Copy is here�y �umiS�eA. � Cetlilie0 cnDY �5 ile �ith th¢ ciiy Builtlinp Oivision.
te: �—�+—� AOVlicani:
E%EMPTION FROM WOHKENS' COMPENSPTION DECUflRTION: ( rs sec�ion neeA not be complete� il ihe permit is forone hunAreA �5700) or less�.
I ceriily iha� in I�e pertormance ol I�e work �or whic� I�is permii is issue4 I shall not employ any Derson in any manner sa as �0 6ecome
sueiecl to tne workers' Comoensalion Laws ol Calilornia.
Dale: SiqnaWre: •
NOTICE: II, alter making Ihis declaration. you s�oultl �ecome suClec� m the Workers' Compensalion pmvisions 6flhe Labor
Code. you must �arthwith comply wilh such pmvisions or �his permit shall be aeemeE revoked. i
CONSTflUCTION LEN�ING AGENCY: I hereby allirm �Aat there is a constmc�ion lentling agency lor Ihe pertormanie ol t�e work br
which Ihis permi� is issuetl (Seclion 3W7. Civ. C�. �
LENOEN:
ROOflESS:
OWNEH BUILOEB OELIANRTION: I hereby affirm Ihai I am exemD� ��om the Cantracmrs' Slate License Law for t�e tollowing reason
(Section 703L5 Business ant Pro�essional Cotle: Any city ol county which repuir¢5 a p¢rmii lo cOnSim[t, alter, imprme, demoli5�, or
�eoair any stmtlure. pnor lo iu i55uance. alsa repuires �ne ao�liWnt lor such permit 10 lile a signe0 slatement �hat he/she is licen5¢tl
pursuam m tAe pmvisions oi tne Comraciors' Siate License Law (C�apter 9(commencinp vni� Section 7000) oi Oivision 3 ot tAe Business
an0 Pmlessions Cotle) or ihat he/s�e is exempl iherehom antl Ihe basis �or the alieBeG exemp�ion. Any viola�ion ol Sec�ion 7031.5 by
anY apPlicant lar a permit suble��s Ihe applican� to a civil penally ol noi more Ihan live �unCred aollars �E500�.
I. as owner af Ihe pmpetly or my employees wi�h waAes as �heir sole compensa�ion, will ao ��e work, antl Ihe
� s�mcWre is not inlentled or ollereA lor sale (Section 70a4, Business anA Pmiessional Code: The Contracmrs' Staie License Law
Ooes nol aOPty to an own¢r ol a prOperiy wtlo builds or improves Ihereon, antl w�0 Eoes such work himself/hersell or ihroug�
his or her own employees. pmvitle0 ihal suc� impravemenls are not intenGeE or o�lereE lor sale. II, however I�e OuilOing or
imOrov¢menl is soltl wil�in one year oi cample�ion, ihe owner will have the OurOen ol pmvinp heh�e tlitl not builtl or impmve
lor Ine owoose of saleL
1, as owner of ihe OmDeny. am exctusively coniracting wilh Iicense0 conlractoR to conslmct ihe Drolect (Section 704a, Business
❑ antl Pmtesvms CoOe: The Comracmrs' State License Law Aow not aDDN �o an owner ai O�operry who 6mI0s or imD�%'es �hereon
ana wno comraas lor sucn o�oiecis wit� a contracmqs� licenu Oursuam m tAe Contracmrs' State License Law�. I am aware
t�at prool oi ��eir Worher's Campensa�ian inmrance s1roulG �e pmWUee �o me.
� I am evempl un0er Seciion: B. 8 P. C.
�or Ihis rea5on:
Oate: Owner:
I Oo hereoy cenity Ihat I am awaie ol an0 unAerstantl Ine requiremenls af Calilornia Meallh anU Salery Cotle Sections 255U5, 25533, anA
2553a antl Ihat I or any iWure CuilOing occupanl will/will not (circle ane) need to comDly with saiU siale coCes and the reQuiremenls br a
permil �ai consimclion ar madilication �wm�he Air Oualily Managemen� Oistricl BesiUen�ial consiruction applications are exempt Irom
mese pmvisions
Dale'. Ap0litan�:
I ne�e0y ceriity I�at I �aue reaC ��is ap0liwtion anE siate thal lhe above in�ormalion is wrreci. I agree �o wmply vnt� all cily anU couniy
oiEina�esanEstalelawsrelalingtoDuilOingconslmtlima �ebyamhonzerepresemalivesoflhisuryloenterupon�hea�ove�mentioneG
pmperiy foi inspec�ion purposes.
D�' �ZS�7� Signalure- I — '��—
Dri�er�s �icense or Sociai Secudiy x:
i6at�a6 wm�e—BuilOing; Green—Cotle Eniorcemem; Canary—Applicam; Pink—Revenue; Golaenrotl—nssessor
CITY OF COSTA MESA — HUILUING PERMIT PEkM NO; E 061514
PERMIT NO; E 061514 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE; OTH
JOB DESCRIPTION ; INSTALL LIGHTS/SWITCHES SQ FT:
CLAIM VALUE; 200.00 CALC—VALUE: GRO[IP OCC; B-2 /
COMMENTS• FOR THE "BANK OF AMERICA" REF:B61473 C37bI�flG�� M�
fE iE lE lE it if iFlElE-If df ik iF if 1Flt !f iE k%iE if 1Elk IE iE If !F iF iE if if iE 7F fE 1E �lE if �lE iF M� ik �)f if iF Ik If %• ff� iF if� if lE f( 3(� iE If fE i[� if iE 3F iE # It ik # iE # if IElF iE iE'k !F iE #!F
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGAT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ� PROV: PARCEL; 41050104 ZNE; REF NO;
PLANNING N(5TE5>
� �'
ik if k iE IE if iF 1f !f iE iE !t if iE if if it iElf ##}f iE if iF # 1f 1E iE �!f �k�lE !k if k,iF9f �If -IE 1h iF it i!�!k 1E 1f !(� iE i(� dF if iE if iE iE iE #�IF if 1f IF?Eih #)k 1F %iF if )f if �1FlE iE iE iE 1E iE ik
D E V E L O P M E N T S'E'-R V I C E R E C� U I R E M E N T S
ZONING APPROVED BY i DATE:
BUZLDING APPROVED BY ��� _ C� DATE-
APPLICATION ISSUED
1E ff IE iF 7Eif iE ik if iE iE k If #!E fF if 1E if
�f IF ik iE iE iE if iE iE iE iE ik IF fF fPiE �f-%iE
LEGALIZATION:N
BLDG P,�iT
PERMIT
i,'i i.
1E 3Flt if it #9E �lEfklk iE if if iE 1P M.�i
F E� E. � S U M M A
PLUMBING ELECTkIC
650E
MECHANIC
y
DATE: � 3
t!r ��R ielFxiflhil�lflkifif�Eil1F �]r fr ftx �#�Jf
3l� iE ic '� #it iE if X if %i! �rt i(� fE 1E i!� 1E if• it lE iP # ih iE iFlE iP i(� if•
` STRUCTURAL SEGMENT;N
FIRE SMIP/RES GRADING
PLAN SMIP/NON—RES
ISSUE FEE 15.00
BUILDING—DIV—> PEkMIT I5SUE PLAN—CHECR TUTAL PAID DUE
TOTALS----> 6.00 15,00 0.00 21,00. 21,00 ,00
kEVENUE DIVISION TOTALS--> COLLECTED; 21,00 OVER/SHORT; 00
BLt�G PMT PLUMBING ELECTRIC MECHANIC FIkE SMIP/TOT GHADING PLAN—CHECK
2 1 , 0 0
if if iF 1f #k it iElf iE iE �k k k iE it iF iE±t %� iE !E iE iE fF iE i! ik i! 1E fE il� k iE iF iE # 3F M iF ik �E i! 3F 3t it # iE if itiF it it M� K�iF iE it iE it 1E k it k ik ft k k iE i'r ft fP-%iE if iE ic iF # it
I N D I V I D U A L F E E H H E A K D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
ELE 4 FIXTURES LIGHTING 1 ST 20 EA. ."75 3,00
ELE 4 RECEPT/SWITCH 1 ST 20 EA, ,75 3.OU
END OF FEES
CCC\�
\I
CONSTRUCTION ANO PLANNING � ' F .& SPA �
� APPROVALS Permit,$ Date Inspector qppqOVALS Permit�k Date Inspecmr
t. Temporary Electrical Ser�•ice qr Pole 52. Pool & Equipment location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. E�ecirical Conduit Utiiiry-Undrgmd. � 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electricai Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Pootings 58. Elactrical Conduix�Undrgrntl.
8. Foundation 59. Gas Pipe, O Un�lrgmd., Test -
9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, O Undrgrnd.
10. Structural Ploor System 61. APPROVAL TO DECK �
17. Property Sewer Line & House Connection 62. Backr+ash & Receptor-Final i
12. Sewer Cap 63. Heater & Vent-Final '
13. Roof Orains 64. Plumbing System - Final
14. Rough Plumbing 65. Electricai�Final �
15. Rough Electrical-Conduit RR. Solar System-Final
_�
16. Rough Electric Wiring 3�3 ; R� Fencing & Access ApProval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING I
18. Rough Electrical-T Bar Ceihng 69. POOL/SPA SYST[PAS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
i
20. Rough Factory Fireplace APPROVALS Permit �
21, Ducts, in Structure 70. Unde�ground Hydro �
22. Ducts, Ventilating 71. Product Pipin9 � Gaz � Oii �
23. Gas Pipe-Rough & Test 72. UndergrounA Fiush ,
24. Roof Framin �
9 73. Undergrnd. Stora,e Tank � Gas � 0�1 �
-- - �
25. Roof Sheathing 74. Overhead Hydro �
26. T�Bar Ceilinq (Svuctural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. i.athing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation � I
I � 76. FIRE PREV. FINAL
30. Dry�vall Naiting ' HEALTH DEPT, REQUIREMENT �
37. Plaster Brown Coat -� 79. PINAL INSPECTION
32. Electriwl?ower Meter�Final � ' 8� r00D CERTIFICATE ISSUED I
33. Pinal Electric `�3�' _ ' Notes:
y-- t
34. Final Heating & Air Conditioning ��
35. Finai Gas Pipe-Test � - -,
36. Hood or Canopy ' �
� -
37. Finai FactorY Fireplace � �
38. Final Plumbfng � � ,� ��
39. tNater Service-Final �
40. Gas Service-Final' +'�'
41. Solar pomestic-Final ,
42. Backtlow Preventer , � �
43. Backflow Irrigation �
44, tandscape Irrigation System
45. Sound Attenuation
46. Handiwp Regulations �
47. FINAL STRUCTURE & BUILDING ( ''. '
48. FINAL PLANNING ,
49. Electric Release to Edison .,
50. Gas Release to Southern California Gas Co
51. CERTIPICATE OF OCCUPANCY
No. Date
.1
11poNESSUFBNLqNG: _ SSS IiNT�N $L
O/MERSNAMEIFp1IXRt SAKIOAICA FARMS
�o� PO BOX 2097
�__TERMINA ANNEX
�rr�. wuuxo �ooxess:
u"T 1 S T
u�cxirzcron�xa+�nn:INTERIOR ARCH.2136232164 �� C-9378
�xcx.oxet�c�s.�noxEss: 550 S.HOPE ST �r+T 1100
,_ LOS ANGELES CA 90071
coxm�crarsru� ACCn£NT HUILDERS ( 714 ) 757-1998
CONfN�CTORSYNWIG S7J4S SKYPARK PARK CI
�oo�ss,IR CA �.�.: 397790
92614 uxr
LICENSED COMHpCTOfl3 DECLAP�TION: I hereby eflim uMm penely d pe�ju I lice Mer an ona d Chepter 9
(mmmendnp vmh SxMbn ]000) d Orvoun 3 d Ma Busi�was eib PMevaions COE , eM my w' lull e%ee.
c c. No.: buc. cuss: H uc. No.: 97
o�,: - 2 - O � com�m«:
NEF BUILDEN OECL�N�TION: I Mreby eifiim unEer peneXy d r'ryry ihel I Irom I Conlredaa Licenee Lew lor IM
' Idlowip reeeen (SeGion ]031.5 Businesa enE Prdeeeione Code: �ry ciry a muMy wfiich 'rea �mn to oanwcl, eller, imprare,
demd'oh. w ropav viy mmcwre. pria w ib eaeMe, eho reQuiree tM apd�� �« euch paimn t e eip�wE eletemant thm M w sM
o i��e w�� �a �na aowau a ma com�eca: um�sa ie. lcneqa a Iwmm��e wnn seaon �oaol a oiveim a d ib
Busrmsa eM Profesaiore Codel a thm he a ehe e eaemN iherelmm eM ihe baw t« tlro elb8� naemNion. Am' vidmion d Saeion
]031.5 by eiry epplMent la e prmil wbjMs �In eppli�am b e a+Y pendy d�M mas �hen fxe hu�Mmd ddlen �5500�).
� I,uownero/tMqope�yormyampbyeeewlhwepanmtheieolecwnpanution,willdotMMork,ond�heaWnunondimeMed '
orMered br eeb (Se Yion 101a, BuanaeeervJ Prolessions COEe: The Contrmwa Liceme Lew doen nW epplyto en ovmer ol prape�ly
wha bu/Ee w'unVroves Ihereon. e�d who Eom euch wak IwnaeM or Mrse1 or NrouOh he a har own emGbM�. M�ed �het vrh
impwemems ara M inleMad a dlaeE Im eeb. H. howewr. iM WiNing a inpovemeM e edd wilhin aw yeer d como��. �e
owirorbuildar xill heva iM Wrden W poviiq M or eha d'd m� bwN a impws la �M Wmone d eebl.
❑ i. � o.�w a ina noo«n..�,.�a�r mmrec:ro .;m i�me �v��. m 000ww ub wdae �seeo� �a.. a,.�� �a
v�wm.�o�. coee: rne cwmaaa. uce�. iaw eom na eoMr �o en ow�r a aownr wno w�u. « �mwo+� �nxeo� ena wno
conlrecle br suM o�l�e xilh e o�niredor(e) Icenaed purauanl lo Ihe Gonlredas Liwnae Law�.
� I em exwnpt unEer Seclion: B. 8 P.C., la ihn raesan:
Dme: Owrier:
I tlo M1ereby cenily Net I em ewue d W uMxsieM Ilw repuimmmb d Celianie MeeA� eM SeMy Code Sediam 25505. 25533. end
25534, eM Ud I w eny Mun W ikin0 �Pa^� mll / wll r�d (rircb aw) need m canply wih aeid tlna mEee eM tM ipuiromaNa br
a pemin tamneVudion w madifi etion homiMAb�arepamen� Dimnd. pasiEanliel conelrud'an epptiraiiomue exemqimm tl�me
yovisima.
Dale: APd�_
WONKEP'S COYPFNS�TION OKLAN1110N: I heraby alfum under peretly d pejivy ane d Ma tdbxiiq dedeem'wre:
� I heve eM wJ maintan a ttMcma d conaent lo aetlimure M Mwkeis' companeetion, m povided /a by Sedan �100 d �he Lebor
coee, �o, me penarmence m ma wak �« whon mla re�il i. n.uae.
.�] in....�e�;��m�.�.n��ao.�o���w�.��a��.eanrsm�,a�aoama�n«coae.i«maoart«��dma
wpk la v.fiiM Nc pamil u aaued. MY wvFen' mmpenxlbn irourenee umer eed pdiry number ere:
c�: pL�IBE�I
Pdiry Numbar, py4L
�rn;: �n� �d,pr m�obrae r rna w�x;. rw o�. n��d.�
� I cerliy Ne� in the parlamence d �M wak Iw wfiich ihia p
///�'�� become eubjee m tM worken' campanmiion lewa d C/
�com Wnve�im povucna d SMiOn 3]CO W �M lebw CoE\
�o� �— z3-9S� ��
em/np: FeNun b sseuro woMri rompawtlon rovenps/
Sxtlon J10G o/ fhe Lebor Coas, Infsiea( enO elromsy'a Ieea. \
CONSTHUCTION LENDINO A�ENCY: I hareby elfimi under pruXy d perjary �hm
perlortneMe d iM v.ak Ia whch thc P�I o eauad (Seqion 9091. CM. CI.
LENDER'S N/JIE:
LENOEfl'S AOOflE44:
I ceMM �� ��� ��hre epplireiion end siete Ihet the ebave inlamelion' . I a
�aawsm..,��a�ow�a:ro�%�m �dna�vew�o�as�'„a�n�
�MIIL90K�OIIWfW9M. J -J._-� � �
12 0/98
�ny "pa�aon i vry enner eo m to
uld ' to IM MOM1:e�a'
oyx fo ellMnsl p�naltlsa eM
u ory Aemvps u provltletl br In
o�n9iudion ImdiM e�picy M tl�s
ply xilh ell dry aM oounry adirenue
v upon tM ebow-men�ioned poperry
om.: —, z3 -�`
(5151-48.WP� WhAe-Buikvp 8 Sdery; Orear.Fle; Carary-Appireni; Rnk-Rvxnue; OddenioA-Avaaaor
CITY OF COSTA MESA - HUILDING PERMIT .
_. � _ _ PERM NO: E 087088
PERMIT NO: E 087088 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE; ELE PURPOSE: ALT
JOH DESCRIPTION : DEMOLISH INTERIOR NON BEAAING WALLS SQ FT:
CLAIM_VALUE: CALC-VALUE: GROUP OCC: H /
COMMENTS: REF:B-87087
�r*****�r*�e���rxx�w�r�x**�e�r�**�t+r�t+r�r+t+r�r�r�**�r�r�r�**+r+r+r�r+��err***�*****�r«*+e+r+r*r*x*�e***�r
__. Z O N I.N G R E Q U I R E M E N T S
_.S. E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSOAY BUZLDING ---------
FANT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT;. FT_ IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV:_ ___. PARCEL; 41050104 2NE: REF NO:
PLANNZNG Nt3TES>
1- I�J
ifiFiFlklfififikifiFlFkMMif1E34iF1F1k1fiFiFiFiFiflEif�FMMMikitikikiFMkMlEkiFMN1f IEMiEifiFikikkiEiklf'ikkMKlfifif ifikiEikilffMM1k1E1EiFlfkik
D E V E L O P..M E N T S E�� V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY v DATE:
BUILDING APPROVED_HY_: -'i. DATE: � ^
APPLICATION ISSUED HY: �+� DATE: v�
iF1E1F1fiFfFMMMifiFMMiFlklfiElkMiFMif itlfiF�FiiiFiF%KiF iF
LEGALIZATION:N ____ F E E S U M M A R Y STRUCTURAL SE MENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE . SMIP/RES_ GRADING
PERMIT 16,25
PL� ' ✓;SOt SMIP/NON-RES
ISSUE FEE 22,00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 16.25 22.00 �-� 0.00 38.25 :. 38.25 .00
� ,.
REVENUE DIVISION TOTALS--> COLLECTED: 38.25 OVER/SHORT: .00
,, HLDG PMT PLUMBING ELECTRIC MECAANIC . FIRE SMIP/TOT GRADING PLAN-CHECK
38.25
1t iFif� iFiF if 1k if ik 1('iF N iF iF iF if iF iklF M iF iflf'1E ik iE iE 1F 1F if 3E if if 3M M 11�.ik if �F K iE iF If iF 1F M M M if if if 1f ii if iF 1E Naf 1F M aE iE iF 3E if If M 1f'IE il' it 7k liff if if it M If
I. N D I V I D U A L�- F E E H R E A K_D O W N
TYPE.___QTY D.E S C.R_I,P_T..I O�N UNIT COST TOTAL COST
ELE 1 MISC APPARATUS NOT LISTED.REQ PERMIT 16.25 16.25
END OF FEES
'i
n
�.�
,
�� f�
- - — -- - — - . 82-�4-1998/89:52 AH/f38.2�
� kCPTq:81-A028027
f~ PERMIT:087088
• P60 L & SPA ,
CONSTRUCTION AND PLANNING` �
APPROVALS Permit # - Date Inspeetor qppROVALS Permit �h Date Inspector
i. Temporary Electrical Service or Pole . 52. Pool & Equipment Location
v2. ^Soil PipeF Undr �r,nd.^ ' 53. Steel Reinforcement
,� lectrica "� " y- g �
.� L�a u+,taWt�ht Undr md• 54. Forms S
� G��Electrica�ie�nB�U� ndr9md. 55. Electriwi Bonding ^� '
25� Steel Re�£oUr��ept . 56. Rough Plumbing & Pressure Test . r '
T'8-'�IectricafCls'6?SR+Qvnd. ' 57. APPROVALTOCOVER-GUNITE
� i �c - rn rn .�
�7. t�ootings`�� M� 58. Electrical Conc��Undrgrnd.
� 8. Foundatium- c~u � ;n 59. Gas Pipe, O UrXlr.�rnd., Test -
9. Water Pi��Undrg�d. a � � 60. Backwash Line��?Trap, O Undrgmd.
10. StructuraLFloor S�stem �� - 61. APPROVAL Tp�DECK �
n�
11. Propert �ewEr Li��fB� Hous6tannection � 62. Backwash & Fi�i�tor-Final
12. Sewer Cap y,, o.. � 63. Heater & Vent-FiAal
13. Roof Drains �%� -' . . 64. Plumbing Systom � Final
14. Rough P(ymb�nfy � k, � 65. Electrical�Final �
15. Rough EtiectricaLConduit •� � 66. Solar System-HTi��i � �
n
16. Rough ��,tricvViri� � 67. Fencing & Accc;S,�,/approval �
77. Rough WiriDg SQgn _ 68. APPqOVED FOR'PLASTERING
n
18. RoughElectrica`1�'1'BarCeii�ing 69. POOVSPASYS�EMSFINAL
19.�ftoughFj�9tiqg&�i(�Conditioq'tr� t�rn W vi b��t s P3fi�&c�£�T7AEQUIREMEIWT m
,., ��-� .-� . , �.. `. .... . .-, r7 y N � � R1 .K } ....
20.�7ou F3�to�}Fi place �->�' �'E � 5''" �'* APP�O��gQ�� • P�Cimit#'� ��
� � n �% � F F+ .Z S :k !--i '7 '7 x s. ".':'�X7 '4" [�7 �
�T _.
21.'c,�uc�y, i tructumx � >^=+ � CJ �-; C;'�K 70.FUndergret7kid dro � �
22. �uc�. �ntil�ing'U� � � �% * `J � `� � t 71. Prod� P'P'"9d�'ias �10i� �
23. Gas �pe=Rouqh BrT�st � z,�, �;C � M �^' S� 72. Undergreuad �yush :t �
24. �Roof Framing t*'� � �'% *� = ` r; +• 7� Undergrdd. S[c��e Tan� O Gas ❑ Oil
r- N *!+7 b7 f� * v
25.�oa�he�thing �� �.,.i �f �x y � j�M 7`. Overhead Hyd�n+ *
26. �T-BarCeii;ng �Struce�ral) & M&36coat K O �� d K 7� Dry Ch "' i�al F' � ��, � N
27.�ram"� a� Flashi�� rv.y� � *� � j,y 76. Ory Staglp+peK;�.., � o ��
28. Lathitig�Siding * O�(= 6 ��� � � « 7 FIXED59�ST��FINfi�." n T
29. Insulatiq� � S � �� .�,� � � 7 FIRE PREV. F.YIdAL �k � x
30. Drywall Nailing �' �-+ � '" F' � �3£ALT�FI�BEPR EQUI
� � * T
37. PlasterB�wr�oat,'�','.'' ; rr, * � ' 79. FINAL��PEC�qJ *,, F, r
32.'Eiectriw"�Po�6%er Meper�Ftdial • �K �V � � � 867 FOOD CrERTIRI�P,TE �S&IEB' F
# [s1 I � '1--i c�'-" # '7 �
33. �in�El�ri ` � , � ,,�% y�� �� � G
e�g %� : i �-i � _1� _ %� �'�,..-�"-�-�f� it✓.O-�-P�
34. � ina'�iHeffiin Air Eppditioning�' !T: t 7 ' + �c�o o i �+�t � CJ
-+ s� o x F
35. �inal GasSPipBTest * � " * " xc r-+ � tn
,� .. Y 'L^ x * Tl • •. C'� 4 P3 t7
36. •Hood�or anopy * r;� i�C; -� x� cn xo Y t-� s
r. c X. f*1
37. FinafFa�ory Firepl�c�X i';`", c � n3 � :*� * �
� � � � i i
38. FinaF lursbing x c*t i o .x i H � :� � m
39. Water Se'�jice•Final *� � x� �K m � 2'
�a. #: [n 'K I -. _.�K c.:.l • � h7 H
40. Gas Serv' -Final r C�FH tT1 �� i i. E-� • �'� * G
41. Solar pomestic-FinaY ^ ^ ��` �' �T' "'�N �' * �
<' 'K N * � � �-+ O � fi S
42. Backflow Preventer x n; �F.;r; �; H, a r Mp � F �
43. Backflow Irrifjetion X ?'�,,,, x^ �� N y 3 O'�
,,,
i44. �l�andsca�e Ir igacionSystem�Yr�w ?± �� ��^, �* E E u G�Cxr�-+ s -�
'� � i-.. .. .'x tJ r T i rJ' ;,^ 'at • H Ci 4
45. �und Atte ' tionX O S *?f •• ••a i i r.c� ••� x
�6. Nandi�cap Aegulatior:};c � `.'. x S I � k , � p '''��J �j .+,
t�7. FINt�L STRUCTURf & BUILDING x�^ 1 � � * j
48. FINA� PIANNINGK i`�`� i� � � y: � n n; S x: ¢
r49. JHectric Release to Edison � * '* a 'r' * �
; x I"� f� c o� M n�
a0. �ias Release to Soutfiern Califo giaGas Co y � � ',; . S �� n x. ,Vv ;n
� �
�51. GEFiTIFICATE OF OCCUPANCY
do. Date
— � �
� AOO���ant to flll in all s0aces except those wit�in heavy eortlerTinas ana's19� au aoo�oo��ate Oeclantions.
a— . .._ ' __"'
Ci7Y oF COS7A MESA ON�RUyC�TION PE�RM'7IT
Project Address � � � � ' L�� 1� �%� � � IC
Applicant's Mailin Rddreu
Owner's Name / one
Address �
Arch/Eng. License No.
Address
Contrecto 's Nam� � � d�G' e- P o�i_77/i/2�e
Address�m ��' ,1 �5��% U� ��is=. 5'h��T�b-��
City License No. r1 � �„/4�'
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensetl 4ntl¢t p�ovislon5 Of Cha�ter 9(comm¢ncin9
with SeCtion 7000) oi Oivislon 3 O} the Business antl Profe55iOn5 Cotle, an0
my license is in 11 f rce antl eitect,
, .�e�.o ,.,�.. Y# Y _ _ _ A,.___ .,_3/_ i .� o s
� K�qS'COMPENSATION DECLAFATION •
eDy afiirm that I nave a certificate o( <onsent to self-insure or a certi(icate
orkers' Compensation Insurance, or a certitietl copy [hereof (Section
0, Lyb.
Policy No ���d-3 c%s!9� Company � ,
8 Certitietl copy is hereby turnishetl.
�I (� CerUti¢ AY ��� eU with the tity-B eng iy,,��'^o.,
{ Date � APPlicant � / /+ ' � iti��
�.. EXEMPTIO FROMWORKERS'COMPENSATION LARATION
�(Thissection neetl no[ be completetl if the permit is for one huntlretl ($300) or
Iezs).
I certity that in the perto�mance of the wo�k tor Whlch thl5 p¢rT�t is lssuetl, 1
shail no� employ any oerson in any manner so as to become suGjecl to the
Workers Compensatlon Laws o( California.
Date Si9nature
NOTfC�; �(, after making fhis declaratlon, yoo should bemme subject to tne
�Workerx� Compensation provisions ot the labor Cotle, you must forthwith
comply with such p�ovisions or tnis pe�mit Shall be tle¢Tea �evoketl.
CONST0.UCTION LEN�ING AGENCV
1 hereby a�firm that t�ere is a con5trucUon lentling a9ency for the performance
ot the work far wM1icn this permit is i5suetl (Section 3097 Clv. C.)
LPntler'S Name
L.entler'g AtlEress
OWNEk BUILDER DECLARATION '
I hereby atfirm Lhat I am exempt from [he Contractor'S License taw Tor the
followipg reason (Section 7031.5 Business antl Professional Cotle: Any tltY or
county which �equirEs a permit to Const�ucf, alt¢�,.imp/ove, tlemolish o/ �epai�
any struc[ure, prior [o its issuance, also requires the applicant tor such Oermit
[o file a siqnetl statement that he/Sne i5 Iicensetl putsuant to the prOVlSions of
- �M1e Contractor's License Law (Chapter 9(commencing with Section 7000) of
'siop 3 of the Business antl Prote55io�s Cotle) or that he/She is ¢xempt
etrom antl tne basis for the allegetl exemption. Any vlolaHon ot Section
.,1.5 by any applicant for a permit subjects the apP�icant to a civil
�enalty of not more than five nuntlretl tlollars ($500).
1, as owne� o( [he prope�ty O� my emplOy¢es wi[h wage5 as thei� sole
�wmpeq5ation, will tlo the work, antl the structure i5 not IntentleC o��otferetl
for sale (Section 7044, BuSiness.anG Professional Cotle: The Contractor's
Licensg �w tloes not apply. to an owner of a property who builtls or improves
thereoq, and wbo Ooes such work himself/herselt or through his or her own
employees, provitletl that su<h improvements are not intentleA or otteretl tor
sdle. If, however, tM1e builtling or improvement is soltl within one Year oT com-
pletion� the owner will have the bur0en of proving he/she Ultl not builtl or im-
prove for the purpose of sale). ;
❑ I, as owner ot the property, am exclusively tontracting with Iicensetl con•
tractors to construct the project (Section 7044, Business antl Pro(esslons Cotle:
The COntractor's Litense Law does ml applY to an owner of property who
builtls or improves Ihereon, antl who cOM�acIS �o� such oroiect5 with a mn-
tractor(51 hcense pursuanx ro tne ConVactor•s Llcense Law). I am aware that
proot o( {heir Worker'S Compensation insurance snoultl be provitlatl to me.
❑ I arr�"exempt untler Section B. & P. C. for this reason
Date
Drivery�
_ Owner
iat I have reatl this applicatlon antl state that [he above
ect. I agree to comply with all city antl county ordinances
ting'to builtling construction, antl hereby authorize repre-
cit to en upon the /abpve-mentiOnetl pro/p�� rty or
� `- Oate .�-/ /
Sc !
t�'3(o1 `� �i � I OQSO � � � l� Fe.o�s�
7YPEOFCONSTflUCTION " NEW AO� ALTERATION REPAIiZ
❑ CONVE(3510N ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. '
TVPE OF PERMIT LJ C.RADING U FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTftICAL ❑ PLUM8ING ❑ MEGHANICAL
❑ OTHER
PRQIECT DESCRIPTION 5�. FT oCCUPArvCv
CONSTRUCTION7VPE - VALUATIpN$��Q�
ZONE GRAOINGCU.VDS. ACRES_
Remarks:
Preventer
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains � ,
Floor Sinks
Gas Service " Outlets
Inter�¢ptors �
Kitchen Sink -
Lavatories
Drains
Reinspection Fee
$15
Duct- Under Ground
Duct - Structural
Duct - Ventilating �
Exhaust System ❑ Multiple
Firepl/Fact. BIt. iC60 #
Heating System & Ducting
❑ ai oo,000 aru O i oo,000
Reinspec[ion Fee � $15
0865-46, rev. 5/BB White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
PLUMBING
� Showers
Sewer Cap ' : �
Sewer Connection
Solar Collecrors
Solar Piping �
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
Laundry Tra'ys
Issue Fee
Hood or Typel ❑
Canopy Type II ❑
�
�
Refrigeration System
❑aioo,000eru ❑too,000
System Repair/Alteration
Fire Dampers
laue Fee
A.P. �i`- � I U
S Main Buildin9:
E
T Front
ARear
C Right
S . Left
Ping. Ref. #
Planning Notes: �r
LtiQOZi�'fl�
—
� _ •
_--
��r
�'
��� �{�
Ii��':� �l Y��• � i �
7-'��1 i � _ r ��!
a .. � �I " � • 4 .
FEES Auromatic Washer
Construction Pole Sub.
Cooking Unit .
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Disposal
rt �0.5 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over 100.amps�
Sub Panel � ,-
Motors DO-1 HP.�7'h - 8
IncSolar �9-15 HP 016-15+
Mitrowave • � '
Pole Light � �'�
Range t
Sign '
Standing SectiOns
Trash Compactor�
1
L > �
Rein.speMion Fee $15 Issue Fee
$ 3 DEVELOPMENT SERVICES HEQUI EMENTS:
Zoning APProvad By
FEES Building APP�oved By gS\
$ 3
FEES
$ 3
G�+ �� SUM RVOF�F.EES .Z�
b"
�_,� I,BUILDING PERMIT $ -- SMIP $ ZS
F �.PLAN CHECK $ PERMIT
. PLUMBING $ ISSUANCE $
'. �PLAN CHECK 25% $ ENERGV P.C: $
. � ELECTRICAL $ GFADING $
' PLANCHECK 50% $ MICROFILM $ �'' ��q
�.MECHANICAL $ TOTALFEE $ �Q�2_
��PLANCHECK 25% $
OI OQ622227-UC��22229 TC�i' 10;5.2�
DATE: 12/14/38 TIhiEs 09��5
� . i" " ' /
• COAISTRUCTION AND PLANNIN � �.' SPA . .
APP.ROVALS Permit# Date Inspector p�ppROVALS Permit# �� Date Inspector.
1. Temporary Electrical Service or Pole ,� % 52. Pool & Equipment Location � ,.
:�
2. Soil Pi e-Undr rnd. � �
P 9 53. Steel Reinforcement Sj ,
3: Electrical Conduit Utility-Undrgrrid, . • 54. Forms .• �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
b� Steel Reinforcement � - � 56. Rough Plumbing & Pressure Test �
6., Electrical UFER Grnd! �� 5,7. APPROVAL TO COVER-GUNITE
�.� 7.�Footings � �� °- . 58. Electrical Conduit-Undrgrnd.
I i
8'. Foundation� �� ' 59. Gas Pipe, � 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 Co�nnection . 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 � -
t�
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' �
19.- Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
,20. Rough Factory Fireplace APPROVALS Permit#
; �•
21. Ducts, in Structure 70. Underground Hydro
.22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
` 23. Gas Pipe-Rough & Test 72. Underground Flush ��
24. Roof Framing - 73. Undergrnd.StorageTank �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 �^ �gQ _ HEALTH DEPT. REQUIREMENT
31. Plaster 8rown Coat- t' 79. FINAL INSPECTION
32. Electrical Power Meter-Final �, 80.' FOOD CERTIFICATE ISSUED
V � •
•33. Final Electric . Notes:
34. Final Heating & Air Conditioning �. - � �. �i /��
w
35. Final Gas Pipe-Test `• � �„� ` ��_ C �' --2
.36. Hood or Canopy �.�Y �
37. Final Factory Fireplace.;
38. Final Plumbing � � �
39. Water Service-Final � '
� i
40. Gas Service-Final � • �
. 41. Solar�Domestic-Final, . '
42. Backflow Preventer -•
� i
43. Backflow Irrigation � . � -'
� 44. ,Landscape lrrigation SYstem ' •
45. Sound Attenuation
46. Handicap Regulations � '
47. FINALSTRUCTURE & BUILDING �"
48. Special Requirements Completed _
49. Electric Release to Edison � �'
50. Gas Release to Southern California Gas Co � � �
51�. CERTIFICATE OF OCCUPANCY , . �
No. Date , � �
4 �
Applieant to Iill in all sDaces exceD� ��ose witnin heavy EorAar Ilnas antl sign all aODrooriata Eaclarations.
CITY�'COSTAMESA CONSTRUCTIONPERMIT PERM NO._ TRACTNO. LOTNO. l�[�17N AP�y
t 3 ir
Project Address y � �S T lo`�— . S Main Bu
`Applitant'S Mailing Address «v� L�.1 �Q� TYPE OF CONSTRUCTION NEW /�.DD ALTERATION REPAIR E
❑ GONVERSiON ❑ DEMOLISH ❑ OTHER � T FrOnt
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLOG. A Rear
Address
Arch/Eng. Licenu No. TYPE OF PERMIT GRaDING�-y FOUNDATIorv STRUCTURAL ' K Rlght
Address ❑ TENANT ❑ ELECTRICAL i6J PLUMBING ❑ MECHANICAL ' g� Left
ee�s� S �.j�s'�� ❑ �OTHER P��9. Ref. #
Contractor's Nam ihone �
Address (mailing) �5 �a o6J Q �cleGo PROJECT DESCRIPTION 5c1. FT. oCCVPANCV Planning No�
. .L CONSTRVCTION TVPE VALUATION $
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affi�m [hat I am IicenSetl untler �rovi5ion5 of Cha�[e� 9(commencing,
with seclion ]000) of Dlvislon 3 of the Business antl Pro�es5ion5 Cotle, antl.
ny Iicense is in t r e antl eHect. �/ �Z
�icense ci�}s G-3G License No Z �� �
Date��l� 5'9 t �,� 'S
WORKERS'COMPENSATION DECLARqT10N
�reby aftirm lhat I have a certi(Itate of �onsent to seH-insure or a certificate
No�ke�s' CompenSatiOn Insu�ance, ov a certitietl COpy th¢�BOf ($ection�
J0. Lab. ) �y� �/
PoIicY No. VL)G fee V�7 CompanY �/(�L�1'/�J
❑ Certitietl copy is �ereby tumisheG.
�(7�e�rti}f� tl o y is flletl with tha dly Buj� in9 �sio
Date%������ APPllcant �{�
EXEMPTION Pl20M WORKERS' COMP�NSATION DECLARATION
(This section neetl no[ be completetl It the permit is (or one huntlretl (E100) or
less). �
I certify tnat in.the performance oi the work for which this perm�t Is issuetl I
shall not em0loy any persOn In any manner So a5 to become subject to t�t0
Workers' Compensation l.aws ot California.
Date Si9nature
NOTICE: If, afte� making this tlecla�atiOn, you shoultl Decome Subj¢Ct to th0
Workers' Comp¢n5ation provislon5 Of [hp �bor Cotle, you mutt fOrthwitn
complY '�'��h such O�ovi5ion5 Or this pe�mit shall be tl¢¢med �evoketl.
CONSTRUCTION LENDING AGENCV
I nereby alBrm that lhere is a conztructlon lentling agency for the per/ormance
of the work tor whith lhis Oermit is ISSuetl (Section 3097 Clv. C.)
Lentler's Name
LenUer'S Atltlre55
OWNER BUIIDER DECLARATION
I hereby affirm l0at 1 am exempt from the Contractor'S License Law for the
following reason (Sectlon 7031.5 Busine;s anG Profe55ional Cotle: Any city or
county which requires a permil [o construct, alter, improve, tlemolish or repair
any structure, prior to ils issuance, also requires the applicant for su<h permlt
to tile a signetl Statem¢nt tltat he/She I5 Ij�¢nsetl pursuant f0 tlte prOvl5ion5 0(
the Con[ractor's License l.aw (Chapter 9(�ommencing wi[h Section 7000) ot
�ision 3 of the Business antl Protessions Cotle) or that ne/she is exempt
'efrom antl the basis for lhe allagetl exemption. Any violation ot Section
�1.5 by any applicanl tor a permit subjects tita aOP���dnl to a civil
�endlty of not more than five huntlretl tlo�ldrs ($500).
LJ I, as owner of tha prooe.ty or my employees with wagas as their sole
Compensalion, will tl0 tbe work, antl the Structu�e is not intentl¢d o� otf¢r¢tl
for sale (Section 7044, Busines5 antl Protessional Cotle: The Contractor's
License Law tloes no[ apply to an owner o1 a property who builtlt or improves
thereon, antl who tloes such work nims¢It/herself or throu9h his or her own
employees, provitletl lhat Such ImproveTents are not intentletl Or olleretl for
sale. It, however, the builtlin9 Or ImO�o�ement is so10 within one y0ar of COm-
pletion, the owner will hav¢ the burtlen b( p�oving he/sh¢ tlid not builtl o� Im-
prove tor the purpose ot sale).
❑ I, as owner of tne property, am ezclUsivety wntractlng with Ilcensetl ton-
t�act0�5 t0 mnst�uct lhe 0/oje[t (5¢<tion 7p44, Business antl Pr07eSz1on5 CODe:
The Con[ractor's License l.aw does no[ apply to an own¢r ot proper[y who
builtls o� improve5 [hereon. antl who contrdcts tor Such otoiec[5 wit� a-r.on-
traGto��sl license pu�suani to tne ConVdCtOr'S License Law). I am dware tha[
proof of their Worker'S Compenution Insurance Shoultl be proWdatl to me.
❑ I am exempt untler Section B. 6 P. C. for this reason
Date Owner
I hereby certify that I nave reaE this application antl state that the above
In/ormation is correct. I agree to comply witn all city antl coun[y ortlinances
antl state laws rela[In9 to builtling <ons[ruction, antl hereby authorize repre-
sentatives o( this c ter upon the above-mentionetl properry br
Inspectlon purpose yt
Signature Date ' T�
orivers' �i cc a< �--
Remavks: � �
Bar Sink
Backflow Preventer
Backflow Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee
GRADINGCU.VDS. ACREi
$15
Duct- Under Ground
Duct-Struttural '
Duct - Ventileting
Exhaust System ❑ Multiple ❑
Firepl/Fact Blt. iC80 d`-
Hea[ing System & Ductin9
❑a100,000 BTU 0100,0008T
Reinspection Fea � . S15
�865-46, rev. 5/88 Wnite - Builtling; Canary - Applicant: Plnk - Accounting; GOICenrotl - Assessor
ShOwerS
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wesh
Laundry Trays
Isfue Foe
Hood or Typel ❑
Canopy Typell ❑
Fiefrigeration System
❑4100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
luue Fee
$- 3
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher 1y
Dryers ❑Gas ��Elec�
Fan
F.A.U.
Fixtures
Device Boxes ..
Outlets
Switches
Gerbage Disposal
Generator O45 KW C
Fae
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer O 15-50 KW
❑ 50+ KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel
Motors OO-1 HP 01'F. - B
Inc.Solar �9-15 HP �i6-15+
Microwave
Pole Light
Range
Standing Sections
5-75 KW Trash Compactor
$15 Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
� Zoning Approved By
Building APProved By
� Applimtian Issued By
FEES
$ 3
- SUMMARV OF FEES
BUI�DING PERMIT $ SMIP $
i
PLAN CHECK $ �7� � , PERMIT
� PLUMBING $ � ��UANCE $
PLAN CHECK 25% $ ENFRGY P.C. $
EIECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ /�
MECHANICAL $ TOTALFEE $ /.O O
PLAN CHECK z5% $
I
N
G
R
E
Q
M
T
$.
01 ��023811—U0023311 Tr37 ?.00
DATE: 01/09/89 TIHE: 08:�9.
� .��_,\ � . . .
'CONSTFiUCTION AND PLANhuJG POQ SPA �
' Daie Inspector Date Inspector \
AIPPROVALS Permit # i APPROVALS Permit # �
• 1 y Temporary Electrical Service or Pole ' `� 52. Pool & Equipment Location
� e� Soil Pipe-Untlrgrnd. ��'�° .�'�p/�C� (�j) 53. Steel Reinforcement
3; Elecvical Cond� Utility-Undrgrnd. � 54. Forms r�
r- (
4:�Electrical ConduiF-�ndrgrnd. '� � ' 55. Electrical Bonding ,�
�� :
��Steel Reinforcemeni �. � / 56. Rough Plumbin9 & Pressure Test �/I� •
sS ��ectrical UFER,,G nd� ��� F 57. APPROVAL TO COVER-GUNITE C
7�F�ootings �� � �1� � 58. Electrical Conduit-Undrgrnd. N
8' FFoundation ��i d v 59. Gas Pipe, O Undrgrnd., Test v�
i,
9. Water Pipe-Und�grnd. �� n 60. Backwash Lines, P-Trap, O Undrgrnd. � �
�
10�.� Si�ructural Floor Sy iem � v� � �,61. APPROVAL TO DECK c �
� n
11�'Pioperty Sewer Lin.��& HouseC ji�nection �' �, '62. Backwash & Receptor-Final �
12�Sewer Cap /► ; '^ " � Y63. Heater & Vent-Final � � �1
13.� Roof Drains �� �
� 64. Plumbing System - Final �
14. Rough Plumbing� 5.j� MOT� 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
�t7. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
��. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
,19' Rough Heating & Air Cond'ifi'oning FIRE DEPT. REQUIREMENT
�
20. Rough Factory Fireplace � APPROVALS Permit #
2d� 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.StorageTank OGas ❑Oil
25.� Roof Sheathing . �, 74. Overhead Hydro � .
e
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.L{OOD CERTIFICATE ISSUED
`33. Final Electric Notes: ��O�d9 U��4RZ �✓�?`OIL• LTO
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �y �3r� L� '
�39. WaterService-Final�- ' ' - ' ' � � �`, ' � �� '� ' � �
40. Gas Service-Final
41. Solar pomestic-Final .
42. Backflow Preventer
L-
� 43. Backflow Irrigation � �
44. Landscape Irrigation System
45. Sound Attenuation 1
46. Handicap Regulations 7 � '
47. FINALSTRUCTURE&BUILDING . �
48. Special Requirements Completed
49. Electrie Release to Edison
50. Gas Release to Southern California Gas Co � ��' I
51. CERTIFICATE OF OCCUPANCY _ • � �
No. Date
` lU S�/
CI.T.V�O� COSTA MESA CONSTRUCTION PERMIT .
Project nddress S�S� /qif/�O� .BLu� '
APPlicant's Maili�� od�+.�« /�C r�i-LJ �A/.�� ��
� �J
:Owner'sNamr��/�-/�vT /��+`�n- Pho�G�
Addreu ��r? �//�!/ CoS%A. �G1i'L �L
Arch/Enq. License No. '
Address
Contractor's N rl� GO,Up_ �. !U� honeZ4'Y� �7/
Addresslmailingl�Z�f��� ��'�����o �/
Gity License No. ' �� ��� -
IICEfiSED CONTRACTOR DECLARATIOPI
I,hereby aifirm thai 1 am licensetl untler provision5 of Charter 9(commencing
with section ]000) of olvlsion 3 of the Buslne55 antl Proteszions Cotle, antl
my licenze is in full force ana effect.
License dass _Ucense No. �Zd�iP�
oate,L/� -� � Si9na/tu _
IORKERS'COMPENSATION D RA ION /
h2l¢DY dHI(T IIIdI I bdVB d CCf(IfICdI2 O( COlISClII [O 581(-IOSIIfC�e a certitiwte
of Workers' CompenwHon Insurance, or a Certlfietl' cOpy thereof ($ecllon
3800, Lab. CJ' - ; - .
Policy NoZo._�Y�•^ r_,.,_/_�_� Co �1' � ��.,,i ! '�
R Certifietl copy is h¢re�y furnisn /
y..i'Certif'etl co y is f� with t� Ity Buil fng Divisi �
bate ' Ao icant
E%EM TION FROM WORKERS• C PENSATION DECLARATI � /
(This section neetl not be completatl if the permi[ is for one huntlre 1 or !
lezs).
I certity that in the performdnce o1 Ihe work fo� wM1lch this Oe�mk is ISSuetl, I
shall not employ any person in any manner so as to become subje<[ to the
Wo�kers';COmp¢nsation Laws of Califomia..
. Date Signa[ure
�NOTICE: If, after making this tleclaration, you snoultl become sub7ect to the
Workers' Compensation provi5ion5 of lne l.abor COEe, you mu5t forthwith
camply with such O�ov{sions ot thi5 permit Shall bB •tl¢emetl �evoketl.
CONSTRUCTION IENOING AGENCY
1 hereby affirm tbat there Is a conslruction lentling agency tor tne performance
of the work tor which this permil is issuetl (Section 309] Civ. CJ
Lentler•s Name' �
Lentler's�Adtlress �
OWNER BUILDER �ECLARFTION '
I hereby affirm that I am exampf irom the Contrac[or's Llcense Law for tha
following reason (Section ]031.5 Busineis anG Professlonal Cotle: Any cily or
county wnlch r¢quires a pe�mit to Construct, alteq {mprove, Uemoli5h or repai�
any structure, prior to Its issuance, also requires the applicant for such permit
to file a signe� statemenl that.he/ine i5 licensetl pursuant t0 th¢ Provi5ion5 of
-the Contracror's License Law (Chapter 9(commen<ing with'Secllon 7000) ot
' Division 3 of the Business antl Protesswns Cotle) o/ that he/she is exempt -
lber¢from antl Ihe basis to� lhe allegetl exBmption. Any. violat(On of $ection
]031.5 by any ap0licant for a permit subjects the applicant to a civll
�enalty of not more than five huntlretl tlollars (5500). -
I, a5 owne� ot (he p�operty o� my eTployees with wages as their Sola �
.comp¢nsation, will tlo tne wo�k, antl the st�ucture i5 not in[entletl or offeretl
(or sale (Section ]044, Bu51nes5 antl. Professional Cotle: Tha Cont�acto�'s
LicenSe Law tloes nOt apD�Y �o an own¢t of a p�o0e�ty who builtls or improves
thereon, ana who aoes such work himselt/herselt or throu9h his or her own
employeez, provitletl that such Improvements are not Intentletl o� otferetl for
; sale. If, M1owever, tM1e bulltling or improvement is 5oltl wilhin one year of com-
pletioq the owner wlll �have the burtlen ot provin9 he/she tlitl not bulltl or im-
prova fo� tne putpose of Sale). -
❑ I, as owne� of the Draperty, am exclusively Contractin9 with Ilcensetl com �
tractors to consVuct the O�ojec[ (Section �044, Business anA Professions Cotle:
The Contractor's License Law tloes not apply to an owner of property who
builtls or improves thereon, antl wha mntracts for such.projects with a con-
iractor(s} license pursuan[�to the�ConVactor's license Law). I am aware that
proof of tM1eir Worker's Compen5ation insurance shoultl be Provltle0 to ma..
'�, ❑ I,am exem0� untler Section _ 8. & P. G. to� Ihis reason
Applicant to fill in all spaces excepl those within heavY bortle� lines anC si9n all apPropriata Oeclarations.
Date
I hereby certity that
, information is correct
antl state laws relatin
Sentatives of this cll
Inspection purpbses�.
Signature �
Drivers' Li e or 55
7F 0865-46, rev. 10/84
Owner
have reatl [hi5 application antl state thxt the above
agr¢e to comply wltn all cify antl county ortlinances
o builtling consbuctlon, and hereby authorize repre-
ro sen[er.up/Jon the above-mentlonetl property for
N „�� Datr�/=/2_^_�9
..., �.
. �. . .,. � - _ �,
37IS�
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR'_
� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER -1
�DESCRIPTIDN OF WORK/USE OF BLDG. T����%'� S�L��-
TVPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STaUCTuaAL
❑ TENANT ❑ ELEC'fRICAL ❑ PLUM6ING I�MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sct. FT. oCCUvnrvcV_
C O N ST RUCTION TV PE , V A LUATION $
ZONE � � - GRAOING CU. VOS. ACRES—
Remarks: /_{r �.���t % =!/ •S�[y .
Clarifiers .
Dishwdsher �
Drinking Founta:
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen.Sink
Lavarories � '
P-Trap
Foof,Drains '
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collettors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
�Outlets ' .Water Closet
Water Heater
� WaterService
, �Auto-Wesh '
FEES
�' � v
�Reinspaction fee I $15 I I Isue Fee ( $ 3
Boiler
Ducc - Unden Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. BIL ICBO �/k
Heating System & Ducting .
❑ ai oo,oao eru.O i oo,000 sT
Reinspaction Fee 'I $15
White - Bulltling; Canary -�Applicant; Pink - ACcountin9: Goltlenrotl - Assessor
Hood or Type I ❑
Canopy Type I I ❑
Refrigeretian System
❑0�100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers�m G�Co [
Registe�s �
laue Fae
n
A.P. qf`- '
S Main Buildi
E
T Front '
B Rear -
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construc[ion Pole Sub.
Cooking Unit
, . ��
, Zone .
Accessory Building: '
Z
O
� N
I
N
G
p
Parking�Req./Provided - E
�
' M
• � T
' S
ELECTRICAL
Dryers IJGas LJElectric
Fan
F.A.U.
Fixwres ' - � '
Device Boxes
Outlets
Swimhes
Garba9e Dispoul
Generator DO-5 KW 05�15 KW
❑ 15-50 KW
❑ 50+KW
Meter LJup ro 100 amps
Meter ❑over t00amps
Sub Panel
Motors �47 HP 01'h - 8
InaSolar.�9-15 HP �16�15+
'Microwave '
Pole Light .
Range
Standing Sections
Trash Compactor
= Reinspectian Fee $15 Issue Fee
� DEVELOPMEN7SERVICESRE�UIREMENTS:
' 2oning Approved By
Buiiding Approved By '
FEES
$ 3
:l
� SUMMARV OF FEES
e= BUILDING PERMIT $ SMIP $
— PLAN CHECK $ PERMIT ,
� PLUMBING . ; $ � ISSUANCE $
PLAN CHECK 25% �$ ENERGV P.C. $ �
ELECTRICAL $ � � GRADING $
PLANCHECK 50% $ MICROR�M $ � c+� �
MECHANICAL $ � TOTALFEE $ ��.J v
v P�AN CHECK 25% $ � ' � �
r�T � �1�.�{�
I4:. 7
1
� \ `�l ` `,
CONSTRUCTION AND PLANNING POOL & SPA , �
APPROVALS PCrmit# " Date Inspector AppROVALS Permit# Date � Inspec*�r
�, 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•Undrgmd. 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressu�e 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 �
� 75. Rough Electriral-Conduit 66. Solar System�Final � ' �-
.L& 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 Z�3.•yY �� FIRE DEPT. REQUIREMENT
2(l. Rough Factory Fireplace ' APPROVALS Permit #'
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 SVSTEM 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 rvocP5:Lt3_�t_ p�� GovetQ c�,ti(�,tk�as,sY-
34. Final Heating&�Aif Conditioning L� �ct (�% �
'�35. Finai Gas Pipe-Test ,
36. Hood or Canopy
37. Final Factory Fireplace . . �
38. Final Plumbing �
39. Water Service-Final � �
40. Gas Service-Final �
41. Solar pomesticFinal _ _
42. Backflow Preventer
1
43. Backflow Irrigation
44. Landscape Irrigation System . � �
45. Sound �Attenuation '� -
�
46. Handicap Regulations � - �
47. FINAL STRUCTURE & BUILDING , , ,
48. Special Requirements Completed � ' �
49. Electrie Release to Edison - - � � • �-
50. Gas Release to Southem California Gas Co , -i �. �
57. CERTIFICATE OF OCCUPANCY _ . , , ,_ ., " >` - .�`�
Nn. �' Date ' � � �" '
Applicant to flll (n all spaees excepl tnose wit�in �eavy GorCer linas anE sign all ao�ropriate tleclarations.
ICITY OF�COSTA MESA CONSTRUCTION PERMIT PFRMIT N(1 TRGCT N(1 I(1T N/l iu.ur un
PmjectAddress ir���iR�Of1 ART G411C.��/
Applicant's Mailinq Address
Owner'sMame S�Ck���--� �-��'`��Ank phone
Addreu
Arch/Eng, unK 1 License No.
Address �� �g nR LDs {�av� \aS
Contracror'sName� \�rnPn Flen-lv-�r Phone�QLL�
Addresslmailingl��IQe[�h'�\� A��pYkA-IOT i�c�5}q (hPso)
City License No. - �u4�18h
LICENSED CONTRACTOR DECLARATION
I hereby atfirm that I am licensetl untler provislons of Charter 9(commencin9
with section 7000) o! Divislon 3 of ehe Busineu antl Professions Coae, antl
my Iicense is in full lorce antl effecL �
License Ciass C"�f�—_License rvo. 54a41 (
�3tc.Qa-OP-Aq Si9nature �p�a'v-� C-Crc��
>RKERS' COMPEr15ATION DECLARATION
.iereby atfirm that I have a certificate of consent to seiT-insure or a certiticate
� o/ Workers' Compensation Insuranca, or a certifietl copy thereof (Sectlan
3800, Lab. C.)
vo�icv No. .litPRRV1�t,o4 compa/�y
Cer[ifi¢tl Copy i5 hereby fumish¢d. ( Ex�Q �0-��-gC� �
Certitietl copy Is filetl with the city Buil�ng Division.
ate�%�-O� APPlicant�V'.nem `Lmc��:r�
EXEMPTION FROM W00.KER5' COMPENSATION DECLARATION
(ThiS Section neetl nOt �e cOmpletetl it t�e permi[ is fo� one hunGretl (y300) or
less).
1 certify ihat In the Performance ot the work fOr which this p¢rm�t i5 i55uetl I
shall not employ anY oerson in any manner so as fo become subject to t�le
workers' Compensallon Laws o� California.
Date Si9nalure
NOTICE: If, alter mAking this �eclaratlan, you shoultl become subject to tne
Workerz' Compensation provisions o/ the Labor� Cotle, you muzt forthwith
comply with such P�ovisions or thts perm�l shall be tleemetl revoketl.
CONSTRVCTION 4ENDING AGENCV
I hereby at(Irm that {here is a construction lentling agency for the performance
of the work for which this permit is issuetl (Section 3097 Civ. CJ
l.entler's Name
Lentler's Adtlress
OWNER BUILDER DECLARATION '
I h¢reby dlfirm Lhat I am exempt from the Cont�acto�'s License Law (or th<
following reason (SBction 7031.5 Bu51ne55 and Professional Cotle: Any citY or
counly wM1ich requiYeS a permit to ConStrutt, alter, Improve, tlemolisn o� fepai�
any structure, priOr t0 it5 i55uanc¢, also requifes the applicant fo� such pErmit
t0 fil¢ a Signetl TtatBment that ne/she is licensetl Ou�suant to tne p�ovi5i0�5 Of
the Contractor's License Law (Chapter 9(commencing with Section 7000) of
DiviSion 3 ot the �usiness antl Professions Cotle) or that he/she is exempt
thernfrom an0 the Pasis for the allegetl exemption. Any violation o( Secllon
7031.5 �by any app���anl (or a permit subjects the applicant to a tivil
�ndlly of not more than five huntlretl tlollars (E500).
LJ I, as awner oi tha oroperty or my employees with wages as their sole
Comp¢nsatiOn, wlll Co the work, antl Ne st�ucture is not Intantletl o�-offe�¢0
for sale ($eclion ]044, Business antl Protezswnal Cotle: The Contractor's
Liceni¢ l2w �oes no� apply to an owner ot a prooerty wha builtls or ImD�oves
lhereOn, an0 wno doe5 such wOrk hlmsel(/h¢rselT or thiough his o� �e� own
emD�oYeeS, provitled thaf Suth improvements are nOt inteOtletl o� ottareA for
sdle. It, howlvlr, the builAing or improvement is soltl within one y¢ar ot rom-
v�etion, the owner W�II have the burtlen ot oroving he/she tlitl not builtl or Im-
prove for the puroose ot sale).
❑ I, as owner oftPe property, am ezcWsively contractinq with Iicensed con-
t�aclors �o con5tru<t �he project (Se<tlOn 7044, Business anA PwfG55ions Cotle:
The Contractor's Li�ense Law does not apply to an owner of property who
builtls or imoroves thereon. antl who contracts tor sucn vroiects witn a mn-
traclor(s1 license pursuane ro me Contractors License Ww). I am aware tnai
prooi o( their WOrMe�'S Compensation in5urance shoultl be provitletl t0 me.
❑ I am exempt untler Section B. & P. C(or this reason
3 74L0 S r
TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVEASION ❑ DEM LISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERM�T LJ GRADING U FOUNDATION LJ STRUCTURAL
❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ �OTHER
PROJECT DESCRIPTION 5�. FT. OCCVPANCv �
CONSTRUCTION TYPE�_ VALUATION $
20NE GRADING CU. VDS. ACRES
pemarks: A�'' G IiLI.ER� '
'�k 6 - 3(fl'14(
Bar Sink
Backflow Preventer
' Backflow Irrigation
Drinking Fountains
Floor Dreins '
Floor Sinks
Gas Service � Outlets
Interceptor5 -
Kitchen Sink �
Lavatories
Roof Drains
Reinspaction Fea � $15
Boiler
Duct - Under Ground
Dutt - S[ructural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact.6lt. iC80 #
Date owner Heating System & Ducting
I hereby certity tnet I hava read this application antl stata t�at the aDove ❑0�100,000 BTU �100,OOOBTi
Intormation is WrreFL � agree to comply wiM all tlty antl county ortlinances
anC State laws rela[ing to builtling WnStructiOn, antl he�eby autho�ize r¢P�e-
Sentdtives of this C�ty to enfe� upOn the dbove-mentiOnetl Property ta�
Inspection purposes.
519�ature � r. 0 6�n��� oate0.�'08' S9
Drivars' License or 55 � - ' Reinspeetion Fee
0865-46, rev. 5/B8 White - Builtling; Canary - AOPilcant; Pink - Accounting; Goltlenrotl - Assesior
$15
Showers
Service Sink
SewerCap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Sv�i+fiming Pool w/Spa
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fee
Hood or Typel ❑
Canopy Type I I �
7a70 ;QOOBTU ❑100,000
i em Repair/Alteration
Fire Dampers
Regis[ers
Issue Fee
A.Y. $
S Main Building:
E
T Front
B Rear
A
C Right
S . Left
Ping. Ref. #
Planning Notes:
FEES Automatic Washer
Construction Pole Sub.
Cooking Uni[
Dishwasher
Dryers OGes ❑Electric
$ 3 .
FEES
V
S 3
Fan
F.A.U.
Fixtures �1�7
Device Boxes ,
Outlets .
Swi[ches
Garbage Dispoul
Generator �0.5 KW �5-15
Zona
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter LJup to 100 amps
Meter ❑over700amps
Sub Panel
Motors �0-1 HP O1'F, - 8
InaSolar �9-75 HP �16-15+
Pole Light
Range
Standing $ections
Trash Compacmr
Reinspection Fee $15 laue Fea
�
�DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
Building Approved B ��
. �
� �
.__�.�..__''__�.... .. . /
SUMMARV OF FEES V
� . BUILDING PERMIT $ SMIP g
, PLAN CHECK $ pERMIT
' =PLUMBING $ ISSUANCE $
•" PLAN CHECK 25% $ ENERGV P.C. $
�ELECTRICAL $ ��^ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $
PLAN CHECK 25% $
O1 00026025-00026025 TQ T
DATE: 02/08/89 TIftE: 13:28
I
N
G
R
E
Q
M
T
S.
FEES
19�.ti5
. _ '
•< ��. � .. ,�.
= CONSTRUCTION AND PLANNING , Ft.�L & SPA
' APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector
• 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location �,
2. Soil'Pipe-Undrgrnd. . �, 53. Steel Reinforcement
3. Electrical Conduit�Utility-Undrgmd. 54. Forms
4. �Electrical Cond'uit-Undrgrnd. �. 55. Electrical Bonding .
5.. Steel �Reinforcementl 56. Rough Plumbing & Pressure Test
�6. �Electrical UFER Grnd. � i 57. APPROVAL TO COVER-GUNITE � ,
7. Footings •�• -j � �� 58. Electrical Conduit-Undrgmd. 7'
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 . Fencing & Access Approval -
t•
17.1 Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT
20�. Rough Factory Fireplace � ' APPROVALS Permit #
21� Ducts, in Structure � • 70. Underground Hydro
22. Ducts, Ventilating :- { " � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test ' �, 72� Underground Flush - "
24. Roof Framing , 73. Undergrnd.Storage Tank O Gas ❑ Oil �
25. Roof Sheathing 7q. 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. Irtsulation � 78. FIRE PREV. FINAL
30.'Drywall Nailing . ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32:'Electrical Power Meter-Final OOD CER FICATE ISSUED
33.�Final Electric � es: `
34. Final Heating & Air Conditioning •` � �„ ;;�_
�x] .i
• 35. Final Gas Pipe-Test `� „� n
36. Hood or Canopy .
37. Final Factory Fireplace �
38. Final Plumbing � � � �
39. Water Service-Final -
�;�
40. Gas Service-Final �
41. Solar pomestic-Final �
42. BackflowPreventer ��( : � '�
/
43. Backflow Irrigation .
44. .Landscape Irrigation System ,� �
45. Sound Attenuation
46. HandicapRegulations� . � �
47. FINALSTRUCTURE&BUILDING ��
48. Special Requirements Completed .
49. Electric Release to Edison ,
50. Gas Release to Southem Califomia Gas Co ��� �' . _ ` �
�
57. CERTIFICATE OF OCCUPANCY CJ' ': ,�' -� . � ' .
No. � Date �' ' - ' .
.� ,
� � �
� 41688 vv `•`�' �w AVPlicant to till in all spaces except those within heavy bo�0er lines antl si9n all appropriale tleclaralions.
CI.T`70F COS7a MESa CONSTRUCTION PERMIT
Projectnddress 555 ANTON� GROUND FL. CORR.
Applicant'sfyla[IinQAddress 754� $UZI LANE klpSim,nSfCf
owner'sName SECURITY PACIFICpho�e f�
Address 600 WILSAIRE �{500 L.A.
Arch/Eng. Licenu No.
Address
Controctor'sNamr KIMBLE & CO. _phone $95-115
Addresslmailing) 7540 SUZI LANE WESTMINSTER
City License nlo. 0 3$ 5 0 3
LICENSED CONTRACTOR DECLARATION
1 nereby affirm [hat I am licensetl untler provisions of Charter 9(commencing
with section ]000) oi Division 3 ot the Business 9ntl Professions Cotle, antl
my license is in (uu foy,e argettect. - } 0923
Licen ¢s /1' � '�lqnse
, 'tr��� 5'9 t ��
JRKERS'COMPENSATION OECLARATION
i hereby afiirm that 1 have a certificate of consent to self-insure or a ce tlficate
of Workers' Compensation Insurance, or a certifietl copy thereof (Sectlon
3800, Lab. C.
aorcy No. �P8a470897—O�,mPanv FREMON IND.
8 Certifietl c�qo�o�Y is hereby furnishetl. L
Datee�`t�e` `��" il¢tl wAPPncantY ' 9 I v+�
EXEMPTION FROM WORKERS• COMPENSATION OECLARATI N
t1 (This section neetl not �e comple[etl it the pe�mit is to� one huntlretl ($100 0�
`� less).
r� \� I certify Ihal in Ihe perto�mance of the wo�k fo� which this perm�t i5 issued, I
\snall not employ any person in any manner so as to become subject to Ihe
Workers' Compensation Laws of Caiitomia.
� Date Siqnature �
NOTICE: tl, after making [nis tleclaration, you shopltl become Subjecl to the
Wo�ker5' COmpensa�ion provisions ot the labo� Cotle, you must fo�thwith
\comply with such provisions o� this permit shall be tleemetl revoketl.
I CONSTRUCTION LENOING AGENCV
rl I herety affl�m that thete is a construcfion lentling agency (o� the performance
�y � of the work for which this permit is issuetl (Section 3097 Civ. C.)
V Lentler's Name
Lentler's Atltlress
OWNER BUILDEN �ECLARATION
I hereCy afiirm tnat I am exempt trom the Contractor's License �aw tor the
following reason (Section 7031.5 Business and Proi¢ssional Cotle: Any clty or
county whlcM1 �equires a permit to construct, alteq improve, tlemolisM1 o� repalr
any structure, prlor to its issuance, also requires the applicant tor such permit
to (ile a signetl statement that he/She is licensetl pUrzuant ta [he p�ovisions ot
the Contractor's License Law (Chapter 9(commencinq with Section 7000) ot
�ivision 3 of the Business antl Protessions Gode) or that he/she is exempt
. therefrom anG the basis for tM1e alle9etl exemptiaq. Any violation ot Sectlon
]031.5 by any ap0���ant tor a permit subjects the applicant to a civil
��nalty ot not more than five huntlretl tlollars ($50b).
I, as owner of the property or my employees with wages as their sole
compensation, will tlo the work, antl the struciure is not intentleG or ofteretl
for sale (Section 7044, Busine55 antl Professiondl Cotle: The Contractor'S
License l.aw tloes no[ apply t0 an owne� ot a prope�ty who builtls or improves
thereon, antl who tloes such work himself/herself or throu9h his or her own
employees, provitled that such improvements are qot intentled or otteretl for
sdle. If, howeveq the builtling or improvement is s01tl wkhin one year of com-
pletion, the owner will have tne burtlen of proving he/she tlitl noi builtl or im-
p�ova for tM1e OurpoSe of sale).
❑ I, as owner oi Ihe property, am exclusivery coqtracting with lirensetl ton-
tractors to construct the pro]ect (Section 7044, Business antl Professions Cotle:
The Con[ractor's License Law does not apply to an owner of Oroperty who
Cuiltls or improves tnereon, antl who contracts for such prqects with a con-
tractor(sl i¢ense pursuant ro the contractor's �icpnse Law). I am aware that
proof of their WorkeYs Compensation insurance shoultl be provitletl to me.
❑ I am exempt untler Section — 6. & P. C. tor this ieason
Date Owner
I hereby certify that I have reatl this appliwtion antl state tnat the above
information is ronect. I a9ree to comply wrth all tity antl county ortlinances
antl state law relating to builtlin onstruction, ana hereby authorize reore-
senta[ives is u�nter n the above-mentionetl pro erry��/
inipectio p r s� �'i �� y�
Signaturd ��/�
-�--=�
TYPE OF CONSTRUCTION � LI rvEw LJ ADD LJ ALTERATION LJ REPqIR .
❑ CONVERSION ❑ �EMOLISH ❑ OTHER �
DESCRIPTION OP WORK/USE OF BLDG. -
TVPEOFPERMIT GRADING FOUNOATION ❑ STRUCTURAL
❑ TENANT'❑ ELECTRICAL O PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sq. FT. oCGuvANCV
CONSTRUCTION TVPE VALUATION $ Z.�Q'1.'
ZONE GRADINGCU.VDS. .PSRES
Bar Sink
Backflow Preventer
Bacliflow Irrigation
Bathtubs � '
Clarifiers �
Dishwasher
Drinking Fountains
Ploor Dralns
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee � $75
Boiler
Duct - Under Ground
Dutt - $truCtural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 4100,000 BTU � 7 00,000 BT'
Reinspection Fee � $15
CMF 0865-46, rev. 30/84 White - Building; Canary - qpppcanh Pink - Accounting: Goltlenrotl - Assessor
$f10W2f5
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9 '
$olar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
Issue Fae � $ 3
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
9
Automatic Washer
Construction.Pole Sub.
Cooking Unit �
Dishwasher
Drvers �Gas ❑Electric
2one .
Accessory Building:
i
ELECTRICAL - , �
Transformer ❑ 15-50 KW
O So+Kw
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0�5 KW �5-75 KW
Meter Llup to 100 amps
Meter ❑over 100 amps
Sub Panel ' .. -
Motors �0-1 HP �1'h-8
Ina Solar �9-15 HP 016�15+
Pole Light '
Range
Sign _ .
Standing Sections
Tresh Compactor
IANICAL fEES Reinspection Fee �$15 laue Fee
Hoodor Typel ❑ DEVEIOPMENTSERVICESREQUIREMENTS:
Canopy Type II ❑ Zoning Approvad By
BuildinB APProved 8y �
Retrigeration System
❑0-1000006TU ❑100,000
System Repair/Alteration
F ire Dampers
Registers
Issue Fee � $ 3
SUMMARV OF FEES
BUILDING PERMIT $ `��� SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PLAN CHECK 25% $ ENERGV P.C.
ELECTRICAL $_ GRADING
PLAN CHECK 50% $ ' MICROFILM
MECHANICAL � $� TOTAL FEE
PLAN CHECK 25% $
Z
O
N
1
N
G
R
E
Q
M
T
S,
$ 3
$ �
,CONSTRUCTION AND PLANNING , POOL & SPA
APPROVALS ��Permit# �Date Inspector ApPROVALS Permit# Date Inspector
1�.`Temporary Electrical Service or Pole � 52. Pool & Equipment Location
2f �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, � Undrgrnd., Test
� ,
9. Water Pipe-Und�grnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
'40. 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
i6. Rough Electric Wiring 67. Fencing & Access Approval -
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
�
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �'
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' �.
20. Rough Factory Fireplace APPROVALS Permit # �` `' I�'
i 1 Y
21. Ducts, in Structure 70. Underground Hydro �^f ' ��
/
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil ��
23. Gas Pipe-Rough & Test 72. Underground Flush �
�-
24. Roof Framing s 73. Undergrnd.StorageTank OGas ❑Oil
25.. Roof Sheathing � � � �- � 74� Overhead�Hydro • - 1 %' �j �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical f�
27. Frame and Flashing 76. Dry Standpipe �
28. Lathing & Siding . 77. FIXED SYSTEM FINAL � . I
r..
29. Insulation 78. FIRE PREV. FINAL �'� �,�
;i
30. Drywall Nailing HEALTH DEPT..REQUIREMENT _
31. Plaster Brown Coat 79. FINAL INSPECTION �, �� f� .'
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 . - � u � �
39. Water Service-Final .' � i'
.
40. Gas Service-Final -
41. Solar pomestic-Final � �
��
�42. Backflow Preventer . �
�
..43�. Backflow Irrigation � , �
`44:fLandscape Irrigation System ; -
'45: Sound Attenuation � -
'46. �Handicap Regulations
47. FINAL STRUCTURE & BUILOING .
48. Special Requirements Completed - _ � �
49. Electric Release to Edison ' � • i
50. Gas Release to Southem California Gas Co -. -� � �
51. CERTIFICATE OF OCCUPANCY � '
No. Date �
.. .. . . . � _ _ ... `_ � -� \ • ��
1
PR0.IFCTRODflES4: SSS ANTON BL uxrt: 100�
OWNEB'SN�MF: SCCURITY PACIFIC HANK ' -
"°9"Ess. 555 ANTON DL
' COSTA MESA
. CA 92G26
( 219 ) 754-f377f3
�ecxrtxcixeex: INTFRNI DESIGN �0N0�'C-O:L7042
�ooness: 5 PARK PLAZA ux�T:750
ZRVINE CA 92714
r�pMiTTFE: INNER SPACECONSTRUCTORS (7.7.9)76J-211<^.
• eooeess: 7,�96 P.O: DOX
SOUTH GATE . CA 902t30
11tEN5ED CONTIUCfOB OEClAMT10X: I �erehy aKrm mat I am IicenuU un0er pmvisions ai ClwDttr 9(commencinp wit� Section
70W) ol DNision 3 0l lhe Business an0 Pmfessions CaOe, an0 my license is in full forca anC eflect. �
cm unc.�: 0 Q3 214 4�aTe uc./: j�, 6, p��ss:
Date:.5_J —�—_ V T Signat� ��/
WOBKEPS' COMPENSA710N OELUMTION: I Aere�y aKrm [�at I �ave a certiticat¢ ol consent to self-Insua or a certiticate at Worked'
Compensatian Insurance. or a certifie0 coD ihereal (Sectian 3800, Lab. C�. ' ' .
roucrxo.:WCP 667286�' ocr.onh: 12/31/99
cornr►Nr: GREAT AMERICAN ,
� CerlifeA copy is hereby lumished � /Certilied rs hle0 with ihe ciry BuilOinq Division. �
Oate: Z— �— �D NPpli��g � -• �--�= �
IXFMPfION FPOM WOHI(EHS' COMPEXSpT10N OECLAMTION: (itus section nee0 not be mmplete0 il ihe permit is for oire hwMreO (E70� or less).
1 certity ihat in ihe pedormawe ol the work Por wAich t�is pertnit is iuuetl, I s�all nat employ any person in any manner so u �o Decome
. su6jeclto ihe Worker5' Compensatlon Laxs oi Califomia.
�� Date: 'Signature:
'� NOTICE: II, afler makin0 ��is Aeclaretion, you shoul0 6ewme suGle�� ro IAe Workers' Compensation Drovislons ot tAe LaUor �
' Cotle, you must lorthwilh mmpry vrit� such provisions or tNs permit SAall he deemeA revokeU. �
I fANSTNUtT10N 1FN01NG ICENCY: I AereDy amrm IAat Itrere is a consiruciron IenEinp apenty for Ihe peAormance ol tM woM far
whicA t�irpermit is i5sue0 (Sec�ian 3097, Civ. C�. .
lENOEH: •
aooxess:
OWNER BUILOEP OECUMTION: I hereby attirm that I am exempt Irom t�e Contactors' State License Law lor tAe lollowinp reason
(Sectian 7IX11.5 9usiness ana Prolessional Catle: My ciry ot munry whic� repuires a permit to wnstruct, alter, im0�'e, tlemolish, ar
repair any structure, O�ar to its Issuanu, also repuirts Ne aDP�icant Por sJch permtt to file a sOneO sWtement Itwt �rJs�e is liunsed .
pursuant to ihe D�ovislons oi tAa Contractors' State Licensa Law (C�apter 9(cammencinp wltA Section 7000) oi Oivision 3 oi the Buuneu
antl Professions CoOe) or that he/she is erempt thereimm antl tAe basis for the alleAed axemption. Any violation at Section 70315 6y
any aD7licani.for a permit su0le��s IAe aOD�icant ro a clNl penalry of not mom tAan five hunAreO tlollars (5500�. '
I, as owner of [he DroDerty or my emVloyees vril� wayes as t�eir sale compensation,'will Oo Iha work, and [Ae
�❑ structura is nm imenAetl or aflereA for sale �Secuon 70aa, Business an0 Professional Catle: T�e Contractars' State License Law
Eoes not aDPty to an awner at a pmperry wAo �uiltls or impmves Ihereon, and who Aoes suc� wark himulf/Aerself ar.thmuph
his or Aer own employees, D�a�iAeA tAat sucA Impmvements are nat in[entled or o11ere0 lar sale. It, however the 6uil0inp or
improvementis m10 vntAin one ycaroi completian,ihe owner willtuve Ne OurEen of O�oNnO ��she d10 not bui10 orimDmve
lor tne purpose of sale): • . '
I, as owner ot tAe pmperry, am eMclusively coniractinp with licensed contracmrs to constmct Ihe Omject (Sectlon 70M,.Business
❑ � anE Professions CaUe: ihe Coniractars' State Licenu Law Eces not appry to an owner of D�a7�rty who Emlas or im0�'�s Ihereon
' anG wtro contracts for suc� D�alects vnth a contractor(s) license pursuant lo Iha Controcrors' State license �aw). I am awam
Ihai proof oi their Worker's CamDensation insurance sAoultl De DroNOeE ro me.
� I am exempt unUer Section: � B.. 8 P. C. �•- � � � ' ,
for this reamn: .
Uate: ' � • Owner. � - '
I EO here0y ceniTy Ihat I am aware of antl understantl Iha reQuiremenl5 of Calilornla Health anE Sal¢ry CoEe Sectlons 25505, 25533, anE
25539 an0 itHt I or any fNuro bViltlinA �cupant vrilUvrill not (circle one) nee0 to fAmply wit� Saitl siate coEes and t�e requiremenR lor a
permit for constmciwn or moAifiwtion imm the Nr Oualiry ManaOement Oistdct. R¢SiAential construction apDlications are exemD� �ram
Ihese DroqWsions. - p � /
Date:. eC — % 90 � pppli� � _� �a�+C/l� . i
I �eaby certity IAat I have rea0 ihis ap0�icatian antl stata ihat tAe above in/ormation is correct. I aqree to comply wit� all ciry an0 counry
or0inances antl state laws relatinp to huiltlinq constmctlan anA �erehy authonre represen�ativas oi this ciry ro enter u0on the ahove�mentione0
pmDeM �or inspection Durposes. /� .
Date..1— � /� Sipnatura a,�p, ��T+'��,p�
onver's Liunse ar Sociai Secunry a: '
16Ct-OB � Whi�e—BuiWina; Green— a Enlorcament Canerv—AoO�icanf Pink—Revenue; olEenrotl—Aasesmr
CITY OF CQ6'fA MESA - BUILDIMC PERMST
PE[tMIT NO: D. 046012 PLAN CHF•.CK M0:,02071-09 L
COMSTRUCTION TYPF; 1 FR'�PRINK PERMIT TY.PL": STR
PERM A70: B �46U1"l
GOVT: N SUPP: N
' PURPOSE: AI.T
JOB DESCR'[PTION : COMM, 7'.I. (OFFICIiS) SQ FT: 200,000 '
CLAIM VALUE: 200,000.00 CI�LC-VALUE: 209,000.00 GROUP OCC: H-2 /, .
COMMENTS: 1ST FLOOR T.I. �
***�***��r*+tit*x�e*�r�r��*x��r****xx�� x�*�r�rrt��+�x�***�+t���*�*��e**+�*ir***�r�r**��*��*x�e*�x �u
� Z O N I N C R E Q U I R E M E N T S �
' :3 E T B A C.K S . �
------------ MAIN HUILDZNG ---------- .----•----- ACCESSORY HUILD'!NG --=-------
FRNT: PT IN REAR: . F'T IN FRNT: PT IN RF.AR: � FT IN
LEFT: • FT IN RCH1': FT IN LEFTd F1' IN RGFL'P: FT 7:N
PARKING REQ: ' PROV: PA[iCEL: 41050104 ZNE: PDC REF NO:
,PLANNING'NOTES: T'ENANT IMPROVEMENTS FOR SECURITY PACIF1'C DANK - PLAZA LLVEL.
� > CONSIS'TS OF OEFICE AND CUS'fOMCR AREA.
*+��r�r*�r�t*�t�*�*�*�r�t��r*�r******�+��r+t*�t+rrt*�-*+t+r*�**,*�r�x�****��-x�*�-�+r**i�**x-*x-�x�*�*�+t�x-�x-*�x**
ll E V E L O P. . M t? N' T ;'L•' R V.I C E S , R E Q U I R E M E N�.T. �S �
ZiONING APPROVED BY � lAJ'�r�,L _ UATE: �Z—. �=�.p
klUTLDING APPROVED ,BY :_ _ � _ _� DATE: _'', . _
APPLICAT70N ISSUED,-�yY:�l�,)�f(.,L_I � DATE:�Z���
**at�r-�r*x��c��t*at**it*�tx��t*�t�it +r �F *iFiFia3F3FiF�FiF� �3F'iF'��iFiF*�-�t*�rt��t*�� �rx-�x-
if 1k i! �%i! iF iE iF it �k iE K� if it k it it if k iE if iE iE iE iE iE iE 9F 9f iE k 1F iF if 1E 3k if 1E �%1f k if ik ik ik iF it iE iE iE �k �F 3f �f iE it iF iE if 9t iE it ih it iF iF iE �t dE iF 3E iF iF iF iE i! iElE iE
I�F.GALI7,ATION:N F E E S U M M A R Y STRUCTURAL' �SEGMENT:Y'
�•'
BLDG.PMT PLDMRING ELECTRIC��� ME�HANIC FIRE' SMIP/RES GRAllING
PL'RMIT 1,021.00 " � �. •.
� ' � SMIP/NON-RES
PLAN 663.65 •:v� �, .' 30.00
�s,oe r•Es • r .
DUILAING-DIV->. PERMIT `IFiSUE 'P.LAN-CHfiCK�- TOTAL PAID DUE
1'OTALS--->. 1051.00 0.00 65J;_65 ,; 1719.65 1714.65 � .0.0
REVENUE DIVISION TOTALS-•-> COLLECTED.: tiI1051.00 OVER/SHORT: � .00
BLDG F?MT PLUMDING ELEC1'RIC MECHANIC 'PIRE SMIF/TOT GRADING PLAN-CHECK
1027..00 • ;• ' ,� 30.00
%. •r �
1E iE iF it 1E if ik if IF if iF if if if iE if it ik if iE iE iFlf 3f if iF iE �%d@ �k 1t i! iE 1F 3E 7F iE if 1E lF.tf if aE 1E �F i� iP a! iE iF if k 1! it IF ik fE dE i! �k fF if iE fE �I6 iF d(� i! �t iE if �F iE ih 3E iE if 1E 3f
; � ] N D I C� I D U A� L F fi E r-r.� f3 R E A K D O W N :
T.YPE �TY D E S C R I P T I O;.N �C • UNIT COST TO'fAL COST
i� -h .
SFC ?.00000 ALTER DY VALUB COMMERCIAI. NOZONE 1.00 . 200,000.00
END OE' FEES�;
. . � . . 1 /1.. '
. . � � . ' .. . ' , � � i
. . � � �� i, � j . � . . . .
, �� • . .
: �
' ��. , �
01 00053784-00053785 TL�T lOS1.U0
A E: �2/09/90 TIM£: 11�24 � "
,
n
e
0
0
. �. �i'
� ;,r�
I�`
r,
\
CONSTRUCTION AND PLANNING R ' PO. . SPA �
•�Date Inspector Date Inspector
APPROVALS� Permit# '� �.t APPROVALS Rermit# � -�
�
1.' TemDorary Electrical Service:o� Pole. - 52. Pool & Equipment Location �:
. �
.2. Soil Pipe�Undrgmd. : %' � , ��, 53. Steel Reinforcemen[ ' /
3: Electrical Conduit Utility-Undrgrnd.� n� 54. Forms � � '
4.,.Electrical.Conduit-Undrgrnd. _ 55. Electrical Bonding
-;5. Steef Reinforcement �- 56. Rough Plumbing & Pressure Test -� �_
6.. Electrical UFER Gind. �. � , 57. APPROVAL TO COVER�GUNITE _
7. Footings -,� _,�„� t �,� 58. ElectricalConduit-Undrgrnd. �,�� �� .
, .� � vv : .
8. Foundation �` t 59. Gas Pipe,.O Undrgrnd., Test � �i � ;?� �'
,
,9. Water Pipe�Undrgmd. ���-� •�' 60. Backwash Lines, P-Trap, O Undrgmd. �r'r�� �,^'`;/�
10. Structural Floor SYstem � - �� - 61. APPROVAL TO DECK � � ,
11. Property Sewer. Line�& House'Connection� � 62. Backwash & Recepmr•Final ;r'1 r�
12. Sewer Cap - �• •� _, � - 63. Heater & Vent-Final � �� j �� �
13. Roof Drains_' .. ' 7 � 64. Plumbing SYstem - Final � �
,
14. Rough Plumbing -� �,� 65. Electrical-Final �- �
75. Rou9h Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Fough Electrical-T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating�& Air Conditioning � , . FIRE DEPT. REQUIREMENT
20: Rough Factory Fireplace - . � -_ _ :' �APPROVALS _,� Permit # �� � Zy
21:Ducts,inStructure =- - - -• 70.UndergioundHydro �
4- _ . { .
22.Ducts,Ventilating',. ,. _ - � ; ,�71,productPipingOGas ❑Oil
23.�Gas�Pipe-iiough & Test . ' � -7z. Underground Flush -
24. Roof Framinq '. - _, , . 73: Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing -. � � ' ' 74,. Overhead Hydro- .
26. T-Bar Ceiling (Stiuctural) & Monocoat y f� 9p 75: Dry Chemical �
27: Frame and Flashing V,: .� y�� ' �� 76. Dry Standpipe - � -��
� 28. Lathing & Siding ;;, ' :j� �_; . � ' �. 77�� FIXED SYSTEM;F.INAL . - $_ti-/I@ y��Q
29. Insulation _ _ 78`� FIRE PREV. FINA_L • S-.ti-�1�J
� 30. Drywall Nailing ` fr"- = ;HEALTH�DEPT. REQUIREMENT
31. Plaster Brown Coac � -• .�r " 79�. FINAL INSPECTION •
32. Electrical Power Meter�Final. _ - 1� � 80. FOOD CERTIFICATE-ISSUED_
33. Final Electric t - � Notes: ��
r� i' �
34. Firial Heatirig & Air Conditioning "- . �' _ � - _
.>:, - - '
35. Final Gas Pi'pe-Testi - . i � •, ;'��. : " �� _ � ' L�� �
" 36. Hood or CanoPY ' - � _ _ <:-, _ - . S_ 0
�37..�Final Factory Fireplace�' � •'c � � � �
. 38: Final Plumbing ' ' � ' , • � -
39. Water Service-Finaf - - ` , ' � � � - _
40. Gas Service-Final > � - � ' ' � - � �
r
41: Solar pomesticFinal ._ . ' . ' . -- ,
42. Backflow Preventer � " - -
• t
43. Backflow Irrigatiori, - . '
�� 44. Landscape Irrigation SYstem' � � �_ '- * - ' _ ` � . � ' "
45.: Sound Attenuation � ' ' � � � . _ '
46. Handicap Regulations � "' �' ' - . •
r
.47: FINALSTRUCTURE&BUILDING � � � , "
� 48: FINALPLANNING - ' -� • .
..
49. Electric Release to�Edison � ` � ' � ;� ; . �
50. Gas Release to Southern California Gas Co `J ' -' " ,
- �
51. CERTIFICATE OF OCCUPANCY � - -'
No. Date
�
PN0.1E1�10DNE38: SSS ANTON AL� �«' �NIT:���
fowxlSdaME: SECURITY ;PACIPf_C.,�1NH � �
. �ooxess: 555 •ANTON AI..'
COSTA ME;SA �
CA 9?.626 ,
(2i3)354-877a '
�ecxrtesixeen: INTERNI DESIGN flE6.N0.:C�O'I%OQZ
RODflESS: �'j pARK PLA2A uxrt: �SO
IRVINE. CA 927]4
PEpMITTEE, STBRN SUPPLY. CO. ' (27.3)633—OS].1
RDONESB:'1SSSO ILI;INOIS
PARAMOUNT CA 90723
LICENSEU CONTMCTOH DECIAMTION: I Aereby attirm that I am licensetl unAer pmNsians ol Chapter 9(commenclnB ��ction
7000) ol ONisian 9 at t�e 8usiness ana Protessions Coae, arM my licenu is in fuN force a(M ettecf.
cin uc.: 0 4 6 0 21 . sTp7E uc.: 7 916 21 cus� ��- 3 6.
Date:2��� - SiOnacurt: � ���—
WORKE S' COMPENSRTION OECUMTION: I here0y affirm ihat I have a certilicate ol consent Io selFinsure or a cMi/icate ol Workers'
Compensa�ion Insurar�ce, o�a ceNlietl cop thereol `SecUon 3800, LaD. C). .
POIILT NO.: FiWC 19 4 6 2 5 S� exr. oeh: O 1/ 01 / 91.
cornrnHr: HIGHLANDS � �
❑ Certifietl�caOY �5 here0y tumis�e0. � Ceni11e0 capy u �fil � IM /u1y�fluiWinO �on,
oa�e: 7�1�/S��% ADPlicani: ^._/`++�' .
ECEMPftON FHOM VIONlFp3' COMPFN&TION DECWWTION: (Iliis secuon need not Ue mmpktetl if the permit is lor one AuntlreE (5100) w less).
I ceniN «� �n t�a pehamarice al the worN la w�iclr t�is pemrit is i5sued, I s�all rwt empby any persan in any manrie� so aslo �ecome
suEject to ttre Workers' Campenwtlon Laxs ot Califomu. , �x.
Oate: Sipnawre: -
NOTICE: II, atler makinp this tleclaration, you shoul� Eecome sublect ro IM Warkers Campensation�provisbns of Ihe Labor
CoEe, you must forthvrit� compty wi[h such provisionsbr tNs permit slWl Ue Eeemetl revoke0. • �
CONStt1UCT10N LENOINO IIGENCY: I'hereby aKrm fhai Ihere 6 a consfmction lenainq aqency (or the:peRormance af the work lor
which tAi4 permi� is i5suetl (Settlon 3097, Clv. C). . i •
IFNDEq: ' , . ' '
RDOXESB: . ' � ' � -+
OWNER BUIL�EB DFCIAlUTION: I Aereby atfirm tAat I am exemp� Irom.�he Contractors' SWta llcense Law br the follovnng reason
(Section 7p31.5 Business antl Pml¢uional CoEe: My city of wunry whic� rapuires a Darmit ro consirucL atter, imprpve, Oemolis�, or
repair any struciure, priar ro iis issuance, aho requMes the applkmt lar sucn perm'rt ro Ide a siqnetl statertrent tRat helstre 6 IicenseA
pursuant �o the proNslons o11Ae Contractors' State License Law (Chapter 9(commencinp with Section 7000) oi Oivislon 3 oi tAe Businass
anE Protessians CoOe) or Itwt IwJshe is exempt Nemfrom an0 the Gavs tor t�e all¢peU exemD�an, My dolation ol Section 7031.5 �y
� any applrcant !or a permlt subjects Ilre aDO�ant to a civil penatty of irot mo2 than five hwMreA tlaflars (y'S001. � .
I, as owner of I�e property or my empbyees wtlh wa0es as tAeir sWe comDensa6on. vn11 do Ihe work, anE I�e
�siruclure Is rwt inten0e� or ottere0la sak (Section 7044, 6usiika anC Pro�essional Cade: TM COMractors' State License Law
Ooes not aOVry ro an owner af a Droperty wtio Euilas or. impmves theraon, ana who tloes SucA xrod �imsettf�erseli or thmuph
his nr her own emDloyees, OroN0e0 that suc� imD�ovements are not Intende0 or atlered tor sale. It, twwever tha Ouiltlinp or
improvement is solE witNn One yeaf ol com0�etlon, Ue ovmet vriil have Ihe UurOen al provinp bWshe Oi0 n0i Euiltl or unplove
tor ihe Ouryose oi sale). � , , ' -
I, as ow(rcr al Na proce�. �m exGutiveN contractinp vnih IlcenseU conVactors to constmq Ine D�oject (Sectian 70q4, Business
❑ anA PmfeSsions CoOe: T e Contactors' Stale Licensa Law Does iwl apPN ta an awner ol pmperry w�p bmlEs or imprpves Ilierean
- anU who contracts br suc� pmjecis with a contactoqs�license pursuant to ihe Coniractors' Slata License Law�.l am awara
IIUI D�� al tAelr WorkeYs CamDensation insuranm shoul0 ba pmviJetl �o me: ,
� I am exem0� unEEr Sectlon: '. B: 8 P. C. , („
for Ihis reason: � ' � F'
Oate: Owner:
I Eo here6y ttrtiry tlut 1 am aware at aM unOersWM tAe reQuirements of CaNfomu Heatth anC Salery CaEe Sections 25505, 23533, anQ
25534 anA t�at I Or any IUWa builEinp occupant vnllNrill not (circle one) neeA to wmpN ��� sziG Slate coAes anA t�e requirements lar a
permit for consiruction or mo0ification Irom t�e ir valiry Manapement Oistrict. PesiOen�ial construction appliwtians are exempt irom
t�eu Orm�a�. �
C7TY QI' C05TA MESA:— HUILDING PkRMIT
PERMTT NU: P 0460�4 PLAN CHECx �10: N
CONSTRUCTION T.YPE: 1 FR SPRINK PF.RMIT TYPE: PLU
1�E[2M NO: P 045094
GOVT;' �N SUPP:, PJ
PURPOSE; ALT :
JOB DESCKIPTIObI : COMM, T.I,.(pFFICES) , SQ FT:
CLAIM VAL[JE:. � 2,OOO.QO CALC—VALUE: GROUC� OCC: 9-2 /
COMMENTS; ]:ST FLOOR T.I. REF, B-46012 . �'
�-f�-it .r it +r * it r it- iE it �� it it ie it rt it it 1F *�tE iE �t �E it it it iE it iE it it �+t rt*** it it �t * it it 3t it it� �E x ie iE 1k iE * ie �E k it jt k�E �t iE �E+r iE it it �t k it �t 3t it * i� iE,
Z O N I N G R E Q I) 7 R B M G N T 5 , `
S E T B A C K S
------------ MAIN BUILDTNG -----=----- -------- ACCESSORY BUILDING ----•-�--=
FRNT: FT IN REAR: FT IN FRNT: F'T ZN RLAR: FT 'IN
LGFT: F'T IN RGfiT: FT IN LEFT: PT IN RGHT: ,_ FT 'IN
PARKING REQ: . PROV: PARCEL: 41050104 7.NE: REF NO: '
PI,ANNING NOTES>
� . . _
jtit+o-�rat�r**�r�r**��e� ��ata�*�*�t�+tfrrt�r*+tat**�e*****�iF*it�r***:x��*���r�r**�*�•*�*x*�*�r�rt�*�t���+t�rt*
' D E V E L O P M E N T S E R V I C E$"i R,E Q U i R'E M E N T S
ZONING APFROVED HY � DATE: �
HUTLDING APPROVED BY : ' .�(���� DATE:
APPI,TCATION ISSUED BY.: i' I DATE:
*i�i��r�x**�t**�x-*�r****x�r+r�-* �"iF'�if3F� iF'i��FiF**�Frt*+r�t*�t�r���**
3f if iE if if d( jE %iE 3E !f iE iE 3f iE IE iE �E iE fF it if iF it if if iF 3f if ik 3t iE k ik f! if it iF if # iE fF iF if ikif �E �lit it Ik iF it �k it ff k iE if if iE iE fk 1E iE iE �E �f k 1t iE iE it iE if 1t � it iE
LEGALIZATION:N ' F E E S,'U M M A.R Y STRUCTURAL SEGMENT:N
BLDG'PMT PLUMDING ELECTRIC MECHAA]TC FIRE SMIP/RES GRADING
PERMIT 4.00 �
Z��� � ' uMIP/NUN—RES.
PLAN ,
ZSSUE FEE �� 3.00
-BUILDING—DIV—� PERMIT' ISSUE PLAN—CHECK TOTAL PAIll � DUE
:TOTALS----> 4.00 3.00 0.00� += 7.00 ,7.00 � ' .00
REV�NUE DIVISION TOTALS—=> COL1,F_'C'TED: 7.00. OVER/SHORT; �,00'
BLDG PMT PLUMBING ELECTRIC MECHAN7C ' FIRE SMIP/TOT GRADING PLAN—CHECK
, � ' �%.0� . . � � � �
i! it N� il ik -0F if iE If if # if !<ih 1E 1F �lf if �f if �ElE It if N� iF if iE iF 1t !f ff �It IF iFlk 3F it �N-1E fE it 1E !f fF 3f 1Elf�3F if IF If 1f ik IE iF iP 7F iF ik if f41ElE iE iE it if if 1t ff� df �M-1F iE iF iF it 1k
I N D I V I D U A L � E E B.. R E: A K D O W N
TYPH QTY. D� S C R I P T I O N �UNTT COST� TOTAL COST
, : �,
PLU 1 WASH BAaIN ' : • 2,00 2,00
PLU 7 WATER CLOS,ET (TOZLET) 2,00 2.00
� - END OF FEES _s
Uate: - ' Applicani:
I �ere�y ceniN eAat 1 hava aa0 t0i5 apDd�uon an� state that the above intormation is correct. I apree to compty wit� all dry an� counry
ordinances anE statelawsrelatinpto bui16n0 �onstmciion an0 �erehy authonierepresentatives oll�is ciry ro anterupontheaUove-mentione0 .
proGem rar ms0�'tlan purposes, ^ _
� /' ���
Oate:� � � Siqnature: �_� �� �
Oriver's iunse or Social Securiry x: .
18stJ6 - White—BuiMhp; Graen—Cotle Enbrcemenl Cenery=ApolicanC Pink—Ravenue; GOltlenraE—lweawr
J
�1 OQ
- DATE=
e
I
� CONSTRUCTION ANDPLANNING�
; APPROVAL5 Permit # ;..�..,.._....._
1.�Temporary �lectnca� Service�br;Poie�,�, .
2._ Sbif-Pipe�Undrgrnd,.. � �
. ,
3..Electriral Conduit Utility-Undrgrnd'.�:; '
.4;;Etectrical.Condvit�Undrgrnd. � �
-� �. . . .. ;r • ,
`5:�SieeLReinfarcament' v k
"•'6..,��¢�tric$I UfER Grnd. �
_'7. Footin9s = '�r, .
, •-
R„ � & SPA
Date Inspsatar App�pVAIS Permit #
��
� 52. Pool & Equfpment Location
� 53. 5teel.Reinforcement
� 54. Forms
55. Eiectrical Bond�ng
. 56. Raugh plumbing & Pressure Test
57. APGRpVAL.Tp COVER-GUN17E
5$. Eleciric8l ConduibUndrgrnd.
� 59, Gas PiPe, C7 Undrgrnd., Tesc
9. Water Fipe-Undrgrnd. (} �;� 64. 8ackwash Lines, P�Trep, C7 Undrgrnd,
10. Structurei Floor System. �� `'" ;' (' 67. APpRqVAL TO DEGK
71. Property Sewer l.ine,& House Con�ection �' ' g2, Backwash & Receptor•Final
1
12. Sewer Cap s - : � 63, Hsater & Vent-Final
13. Roof prains'•„� u„ 64. Plumbing System - Final
14. Raugh Piumbing '� 7�1��/Cro (,,,(yF;p 65. ElectritabFinai
75. Rough EI¢ctrical•Conduit 66. Solar SYstem�Final
16. Rough Electric Wiring. � 67, Pencing & Acceos Appraval
?t�. Rough Wi;ing S�gn 6$. RPPROVEO FOR PLAS7ERING
18. Rvugh Elettrigat•7 Bar Ceiling 89, pOqUSPA SYS7EM5 6INAL
79. Rough Heacing $i Air Conditio�iwg r„_ , Fi9E DE7T. REQUIREMENT _,,,,
20:'Rough Eactory "r��iiepface ` y,. `"� ,t. � " � , �
APPROVALS,`_';� Permit �
21rDut[s, in Structure* •• ^'-=: � = � y;� `7tl, Undergro ntl Hytlro i
22,�.D�cts, Ventilatiing;.� � - y' � ,} _. ;` ,'� :�7, ProducrP,iping O Gas ❑�Oii
23. Gas Pipe�Rough & Sesc _ ' - ;;72. Underground Fiuzti ',; "
I A T:
24r Roof B�aming �'.' � � ';y u � _ _ ' : ;:73-Undergrnii,3toraggTank�C7Gas�OOii�
25. Roof Sheathing -� + •s � - y74��Overhea0 Hydra: . '
26. T�6zr Ceiiing (Sccucturaii &�Monacoat , 75: Ory Chemicai ,
27,r_Frame and Flashing, _.-c ""�.! � 76. Dry 5[andpiPe - a`=,�.
`28. Lathing;& 5fding a� -�' ... 77�; FiXED SYS7EM.KINAL� . :� �
� Z9. Insulation � : L : - '� � '„ � � 7$'- FIRE PREV. FINAL . � .: ,'_;,:
'30, Rrywall_Nailing ; �Y ., ?, t , �x � - ' �; HEAITH DEPT: R'EQUIREMEM1
; 31. Plasfer Brown Caav ' � r , 78. �F'INAL IN5PECT�ON �' J'
"32 _Eiectricai i'ower Me�ar�Finai : r= y � � ': �'SD: -FQqD CERtfPtC'117E ISSUED_. �.
, ,� ._ i•j � .
.'33.�Final Elearic , ; � - �: Notes: - ^- r= � " � r+'_7
, ;' r ` ;� " ; i ` ,: r . - - .�.
'34.;Firiai Heaung & Air' Contlitioning`' ',n ; * .; _ ,
35. Fina� Gas Pipe-Test_ -� ` : u v � : � zc '1 =� .
�"36. Hood Ot CanoPY ' � ' ' `' °' ` r i _ ' °
t. �� �r„ _. �: + �-c � r7
..:.
�-37 .Finei Pacmrv Firepl8ce: r, �. . .- - .. ��
r
�"38. FinalPlumbing `n. - "Z �j '•-;, ..��;���,`..�0 ��� ro�
' 39. Water Servicc�Finai� . " i ; � ,,.� � , - �
40. Gas Service-Finai ' ' ^. `
' 47, Salar pomestic•Fioai' - , i � >. ;-+ � , � ,
42, BackFlpw Prevencer + � � • ' ' �' �
43. Backflow lrrlgatian; " - � '
44. Landsca0e Irriqation Systerri , • � ` , -"
45. Saund At<enuation � .
46. Handiczp Regulationa • ' ' " '
.47: FINAL STRUCTURE & BUILpiNG ' `' ` ' " ,
4$, FINAL Pt,RNNING " E, , ' ; .
49; Electric Reiease to.Edison . ^,.` • , '
50. Gas Releass to Sou'thern California Gzs fv L•' > ' ,
51. CERTIFiGATE QF OCCUPANCY + • '
No. Dace
Oate I i
. 417.rj
rc
�';
I�
I�
rxaecr�ooxcu: 555 ANTUN DL
owxes•s�e: ,�CURITY PACIFIC••
• nooness: g;qME P.S ADOVE
714/742-7.2GJ
IIpCH/ENGINEEfl: .
�DOflE35:
n�o.xo.:
uxn: 100- !
uxrt:
vexremee:AIR COND7TIONING CO. INC. (01II)244-6571
RODHESE: FiZGS SAD1 FEkNANDO R�
GLENDALE CA 91701
LICENSEU fANTR11CfON OECIAMTION: I hereGy aKrm Wt I am Gcensetl un0er Drovislons ol Ctupter 9(comme�uJnp wit� Sectlw
70W) ol Oiv6ion 3 0l tna Busineu ana Protessians COEe. anE my Ikeme is in full torca an0 eflecl. '
cmuc.:01440O3 sunuc.:120696 cusa:C-20 y/'
�Oate: ,., � � S — /� SlOnatu�- � „LC4���
WOflKEflS'COMPENSRTIONOECUMTION: Ihea� afli Ilhaveacertificatealconsentmselldnsury� cerNiateolWorkers'
Curtpenuti0n Inwr�ce' PrA [�ert��ietl capY I�tteol �Se o� LaU.LI.. � O��� O •
�ucr xo.: 4\/ 9 L C �. 0��: 11/
•oMru+r: TRANS . I NS .�r,
❑ CertifieU wpy z �ereEy Iumis�e0. L'J CeNfiM copy � 0 wM Na ciry Buil0in0 Di�rislon.
DdiO: 2����' G I' ���� � ��+
F%FAFf10N FIIOM WOPKERS' COMPEN311TON U�pNr (ili¢ secum rrceA na he comp �, IM permil's la me nuMrM (5100) w less�.
1 Ceriih/ Ihai in Ihe pedOrmante al t�e wOrk faf whiC� Ihis permif i5155uetl, I S�all noi e�o any persan in any manner m az ta Oecome
suCjttt ro I�e Workers' Campenutian laws bf Calilomia.
Daro: S�pnaturt:
NOTICE: If, atler malonp this Oeclaralion, j� sl�ouM become suEject ta tM Workars' Comperrsat4n D�wisb�rs ol tM Lahor
COGe, yau mirst IonlnAtn comv�y ��h sbch proWsions or tNs permit slWl oa aeemeU revokea.
LON87PUCfION IFNDINO �OENCY: I �ereqy atlirm WI Nere rs a constmction lentlinp apency lor iha petlwmance ol I�e vrork for
wMtn fhis pertnit a hsuaE (Sectian 9047. Civ. Ci. .
LENOEN: �
�DOHESS: � � �
OWNEP BUIIDEP OECWWTION: I �ereGy imrm Itut 1 am exem0� �rom the Contractors' Sute Liunu law iw Ne fo0oxin0 R�n
(Section 70J7.5 Business aM Professional Coye: My tity al munry wMCA requires a pertnit to corxtn�ct, atter, imprwa, EertqIISA. or
repair any slrucWm. pnor to its issuance, aLsu aquirw Ne Spqicam lor wch permii to file a siOneE sUtement tlat hNshB is�ficenseE
pursuam ro the pmviskns ol tAe Caniractars' Staro License Law (Chapter 9(commencin0 ��� Sation 7000) of Divisron 3 0l che Business
anE Pmfessians CoOe) or tlwt �rJSAe is exemp� ��erelmm anG Ne hasis lor Ihe allepetl aemD�n. My vplation ot Section 7037t5 by
any applicant far a permit su�la�s iha applkam ta a civil penalry oi nat rtrore tnan fWe AunEretl Uollars (f5W).
t, az awner ol tM prOpCM1y or rtry � p wRA wapes as Ihrir sole. crompens�6m, xAll do Ne waM, a�M I�e
� structurt is not intenUeO ar o11ere01or Sye (Sx�iw 70C4. Business an0 Protessional COEe: Tlro Confractors' Sute License Law
Eces rql appry ro an awner of a Droppfty who Wil6s w 4nprwe5 Uereon, aM wtro Oas sucti work IrimselMerself or t�rou9�
�is or Mr ovm emD�M�?. DmviAeU pu� SutA improvemenls are noI intenOeE or oBBreO lor sale. If, Mwever IM hullEinq or
improvement u sa10 mtNn one year al comde��, ��u will tuve tAe UurOen ol provinp IWshe NO not OaW or im0�ove
� fortne purpose ol ule1. .
I, as awner of Ilu Droperty, am exclugvelY contrattinp MI� Ilunse0 wntractors ro conslruct Ihe projat (Sectlon 7MC, Business
❑ anE Prolessions CaOe: The CanlraMon' Stata Lkensa Law dou mt apDN �a an owner oi D�rty ��s m Improves therean
� anG wtq convazts tor suc� pmjects wit� � wntractoqs) liunsa pursuant to I�a Contnctors' Sure License Law�. I am aware
[Aat D�t of Nelr Worker'S CompengaLm insuzxe 5tqu10 EB P��� to me.
� �I am aempt unEer SecqOn: - B. 8 P. C. .
Iw [Iris reamn:
Oate: - Owner.
I Eo hereby certtry that I am awaa oi anE unCersuntl tAe reQuiremmts of GlitamW Healih anE Salery CoEe SectlwS 25505, 25533, antl
25534 a�M ttut I or airy lutum euilEinp occupam wiNvrin not (drde one) neeA m comON ++�� �4 sute mGes aM Ne repuirements for a
per�rvt lar crostruclion or mo0ificatlon irom t� Au Uualiry Manapement Distnct. fleSiEential corxtructbn appicatWis ua exempt trom
I�e58 DrOv6ions. �
Dd�B:' NVD�k2fli:
I MFe�y ccnity tAa� I �ave matl Ihis applicatlan anU state tAat tha aUove inlormation is cormct. I apme to crompty wit� all clry an0 counry
ar0inancei artl sute laws rWtinp to UuilGinp wnstructim an0 nere ttnrixe apresentatives ol IN5 dry ro uiter upon Ne �bm�ementbne0
prapeM �or impettion Dumoses.
Daca 2/C =Q✓ Slaiu i e� �.�'�%'Y.1 • ,
�ri'ver's Liceme or Soda� Securiry x: .
18Cf�8 W�ito--BuilEi�q: Graen—COEe Q��oreement: Cenaev—AODliean�; Pink—Revenue; Goltlenrotl—Avexwr
' , CITY OF COS1'A MESA - BUILDItJC pENMIT
FF.RMIT NO: M 0461J3 PI.AN CHECK NO: N
CONSTRUCTION TYPE: P�RMIT 'fYPi:: MEC •
PERhT A10: t9 0461�3
GOV'C : id SUPP : N �
RU1tPOSE: 01'H
JOB DESCRIPTION : MECHANICAL FOR T.I./OFFICE B.UILDING , SQ F'C:
CLAIM VALUE: CALC--VALUE: _ GRUUP..00C: / �
COMM�NT.'",: B--'46012
M� ik i! �IF 3i it �F 1k 1E If iF k iE k 3E iE'iE iE 3E iE IF lf iE iE iE 9E iE ik iE it iE iE k if iE iE if iF dE K� 3E iE 1k iE iE iE # i!-aE iE N� 1(� it IE %if iE 1f # if if iP �lf iE fE iE i( iE iE dE # iE iE if iF dE iE� ;F #
� Z O N I N G R� Q U I R E M E N T S
S E T B A C K 5
- t-0AIN �UILDING ----------- -------,- ACCESSORY FiUILDING - -
FRNT: FT IW RFAR: F'L' IN FRNT: ET IN REAR: FT IN
LEFT: F'P T1�7 RGIIT: PT' IN LEF'P: F1' IN RGHT: F�T IN
PARKING RE�• PROV: PARCEL: 41050104 7.NE: REF NU:
PLANNING N TES>
>
,iF')E i! iF k i6 k'%iE if iElf if ik iE i(' iE k if if if iE ik iE iF 1E if if'lE 1h iE fE iE ih 1l' i4 if iF')f iE iE 3E 1! ih ih iE �E 3E if if'%1k iE �E if if 3f ik 1h ih 1f ik 1F iF aklE # iE!!'k iF 9t'1F i!� 1klf if iE i('
i � D E V E I. O P M E N T u E R; A I C E S R L•: Q U I, R� M E N T: S
ZONING APPROVED BY DAT£; •
'f _ � — _'
BUILDING APPROC�ED BY : i_ �. __ -DATE: _ '
�APPLICATION ISaUEU BY: • � �DATE: rcL��� /9 �
iEMN��lfifiEif��Eil�lEifiE±ff6)f�F?EiEitif3f9f��i����fF�'. �iF�{'�'����(�3F�k1E1EiEMlfifiEi4�F�(F���,4iF� r4�.j4�.
if 9E iE iE a(� 1E k!f iE iE iF !E iE 3E if fF k k k k ik iE %� iF If if-1f iF?t iE if �k if �N-iEl6 iE IE dF jE it iE if if iE it iF iElF iF iP IF ib ik if k it if rt�f it IF �t iE if if # i6 iE Y,-i' if iE �F if k iE 1ElC�
LEGAL,IZATION:N F E E S U M M A k2 �Y STRUCTURAI� SEGMEM'T:�PI �
BLDG VMT PLUMBING ELI:CTRIC MECHANIC FIRE SMIP/RES GRADI�dG .
PERMIT' 9.00 ,
. 258 SMIP/DION-RES,
�LAri .
ISSOE FEF ' ' ' 15.00 '
BUILDINC-DIV-> PF.RMIT ' ISFiUE PLAN-CHECK T01'AL PAID DUF.
TOTALS-�--> 9.00 15,00 0:00 24.00 7.4.00 .0'0
REVFNUE DItIISION TOTALS--> COLLECTED: 24,00 OVER/SHOR't: .00
HLDG PMT PLUMBING ELGCTRZC MrCHANIC FIRG SMIP/TOT .GRADING PLAN-CHECK
24.00 •
�r�r+��*��c�r;�x�*+t�rrt��e�*�*�e�****����tx�*�+t�r*��r�e�r�*�rt*�e*�r*�r**��rx �x�r*+�jc*x�*ir*rt��r******�
I N D I V I D U A L F E E A R E A K D U W N '
TYPF•. QTY D E S C A I P T I O N UNIT,COST 'POTAL COST'
MEC 1 TNSTALL FORC/AIR FORN <='100 IC BTU/f3 9.00 9.00
, . LND OF FEF.S ' ,
0
01 000542?1-0�054221 T�7T 2{.0l1
OATE: q2/15/9D TIf1E: 14:41
•CONSTRUCTION AND PLANNING� ' � � � $ 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 Reinfarcemen[
� 3. Electrical Conduit Utility-Undrgmd. 54. Forms
4. Eiectriwl 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, � 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
74. Rough Plumbing � 65. Electrical-Final
15. Ro�gh Electrical-Conduit 66. Solar SVstem-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign ,� 6$, AppROVED�FOR PLASTERING
18. Rough Electriwl-T Bar Ceiling 69. POOL/SPA SYSTEMS F INAL
19. Rough Heating & Air Conditioning 3�� (�/) � FIRE DEPT. REQUIREMENT .
20. Rough FaGtory Fireplace . APPROVALS Permit # -
21. Ducts, in Structure . ' 70. Underground Hydro -
22. Ducts, Ventilating, � 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Fram��g 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing • 74. Overhead Hydro
26.'T-8ar Ceiling (Strucwral) & Monocoat ' 75. Dry Chemical -
27. Frame and Plashing . • 76. Dry Standpipe ��
28. Lathing & Siding . � � 77. FIXED SYSTEM FINAL
29. Intulation • 78. FIRE PREV. FINAL �
30. Drywall Na�ling . "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 Heat�ng & Air Conditioning �� � -
35. Finai Gas Pipe-Test
36. Hood or'Canopy � �,�
37. Final Factory Fireplace � '
- 38. Final Plumbing ' - . ._
39. Water Service�Final ' ' "
40. Gas Service-Final .
41. Solar pomestic-Final •
42. Backfiow Preventer .
43. Backflow Irrigation
44. Landscape Irrigation System • � '
45. Sound Attenuation ' . � _
46. Handicap Fe9ulations � ��
47. FINAL STRUCTURE & BUILDING -
48. FINAL PLANNING �j
49. Electric Release to Edison :��
� 50. Gas Release to Southern California Gas Co j '
51. CERTIFICATE OF OCCUPANCY �1,�
No. � Date �
..
�
r PBOJECT pDOflESBc S S S ANT'ON til. ' ' � UNIT: 1�)�
OWNEfl'SN�ME: SCCURZT�Y PACIF7:C�HANK -� �
nooeess: 555 ANTON DL. ' '
CUSTA MG`SA " `"
� c'A 92G26 ' .
� (2'13)354-077F1 . �
eecxrtxcixeen: INTERN.T. DESIGN REO.NO.:�_�17047
nooxess: 5 PARK PI,A2A x�r:750 .
PEHMIiTFF: ZRVINE CA� 92"7] 4
FiC1TCH I50NCURP . ( 21 :S ) 771- 7111
� nooeess: 5052 .CECELIA
SOUTH GATE CA'902II0
❑LENSEU CONTMCTOP OECLAWITIOM: I �em0y allirm ttia[ I am Iicense0 un0er proNsions al Chapter 9(commencinq with Secllon
7000) of DiNsion 3 0l Ihe Business an0'Professions Cotle, an0 rtry iicense is in lullforca antl ettect.
cin uc.: p 3 2 7 8 7 srnre uc.: 2 6 9 512 cuss __
Oate: �L � � 3 �-% � Sipnawre: ���'
WOBKEBS' COMPENS�TION OECIAMTION: 1 �ereG atlirm Ihat I hava a ceniliwie of consent to selbinsum or ermiwte ol Wohzrs'
CamDensatian Insuranu or a cenifieA co iheaal �Seclian 3800, Lab. C�. '
� �ucrxo.:WP8d3392Ei1� exr.onn:05/O1/90
coMp�xr: NATIONAL SURETY
❑ Certified copy is �ere0y fumishe0. � CeNfied copy i5lileJE 4y7Ae ciry 9ui q Oivision. ppp���
Date: Z � / 3 -�'% � qppliWnt: / �� �� �� � �
IXQAPfION FNOM V/OflNF144' COMPENSATION OECWIATION; (iltis uctlon reW irol be wmplele0 il Ihe pemril b la oirc hundr 1 � a ku�.
w
I ce�ify lhal in I�e pCdormance of Om wOrk br x1nc� tA6 pBrmit IS i55u0E, I S�all n01 Bmp10y any p¢r50n in any man t0 �ecame
suyect to the Workers' Compenution Laws of Glifamia. , � �
i. .
�ah: � Sipnature: - '
NOTICE: II, after makinp ttus Aeclaration, yau stwulU became subjecl to t�e Workers' Compensatlon provisions� 1 Ne Labor ,'
COAe, you must fortMviN camDM ��� such Dmvivons or Ihis permit stwll Ee EeemaO revoke0.' I �
fANSfBUCTION IFNUIN6 �GENCY:'�I herehy atfirrti Nat t�ero ¢ a cansiruction Ientlin0 a0emy lor Ne pertormance o4t�e woM lor
which �his DermA is iSsueU (Section 3097. Gv. C). %
� IENOEH: • � ••i ��!
RDOflES3: ' ; . . ..� . .
OWNEO 6URDER OFCIAMTION: I hereby aRirm tlwt I am awempl Imm t�e Coniractors' S�ate License Law lor tha lollowinp reason
(Smtion 7031.5 Busineis an0 Pmlessional CoOe: My cRy oi counry whkA repuires a pemut lo cansiruct, alter, imD��e, Uemolish, or
rtDair any slrucNra, pdor ta its Issuance, atso reyuires I�e appllunt lor suc� peimit to lile a 5ipneE stat¢mem ttat helsAe is IicenSeG
pursuant to.tAe pmvtsians af IM Contnctors' Staro license Law (Chapter 9(commendn0 ��� Sectlon 7000) ol Division 3 al IAe Business
an0 Pmlessions Code) or that twJSAe is eeempt therelrom and ��e Oasis br Iha alle0� exemption: My violatlon of Sectlon 7031.5 hy
. any aDD�icant lor a permit suhjecis the aDO��ant to a cMl penatry al not more Ihan Me AunEreO datlars.�E500�. '
I, as awner ol tM Oroperty or my employees witA wapes az Iheir wle' compansaGon,'�vnil Ao the work. and the
7 structure is not inrenEeE ar aifereA lor sale (Sectbn 70aa, Busineu anU Pralesslonal Cade: TAe Contractors' State License Law
dces not aODh �o an owner al a propeM �o huilds or imD�a�es Ihereon, an0 who tlaes suc0 wuM himself/hersetl or t�rouph
his ar her own employees, proviEeA that such imOmvemems am not IntenOetl or otlere0 far sale. Ii, however Ihe buildinp or
imDmvement is solE vntM1in ane year af com0�etron, IAe awner will Aave IAe 6urUen of D�oNnA �e�she Uitl not huilU or improve
lor ��e purpou ol sale�. . '
I, as owner of IAe O�oDeM, am extlusiveN contrapinp wl(h Iicansed contractors b consirucl Ihe project (Seciion 70M, Business
'❑ an0 Pro/ewions CoOe: The Contactors' State Licensa law does not apply to an owner oi property wAo OUAEs ar Improves thereon
ana who contacts for sucA pmjecls with a contractor(s�license Oursuant Io I�a Contrzcrors' Slate License Law�. I am aware
that D�� a� ��eir WOMor's Compensatlon insurance shoultl Ce Dradtled to ma.
� I am eeempt under Sectlon: B. 8 P. C. • '
fm tAis reasan: � , �
Date: ' Ownec
i
I Oo Aereby certity Ihat I am aware ol and unAerstanU tAe requirements oi Calilomla Health an0 Safety CoOa Seclions 25505. 25533, antl
25534 anE that I or any future builtlinp occupant wilVwill not (clrcle ane) nee0 to comply with saiA state caAes anA the reQuirements lor a
permit lor consiructlon or motlitication irom the Air �ualiry ManaOement �istrict. Hesitlantial consirvctlon appliwtlons are exempt irom
these provisions. ' - '
Dafei ' Appliwnt:
I hereby certiTy IAat I Aave reaOlAis apDlication antl Stat8lfwl the aEovO inlormation is cotrett. I aprea Io tomply wilA all tiry and c0unry
'orEinantEs and 5ta�2 Ww5lela�in0 �o huil0in0 �nSlNc�ian antl her¢by aN nze repre5entatNes af this ciry ta enter upon the ahove-mentlanetl
D�operry Ior inspetlion purposes. � �
Date: �-� � 3 ��Qd SIOnalure:
odver's �icense or Sociai Secunry x: ' �
tfidl�Ifi While-BuilOino; Green-COEe Enlorcement: Canarv-AuollcanC Pink-Revonue; GOIEe o0-Aueasor
,
CI'CY OF' C05TA MI;SA �� BU,TLDING PE:RMIT PERM NO: E 04603?.
P£•.RMI1' N0; E . 0460J2 ' PLAN CHECK NO: N GUV1': N' SUPP: N'
CONSTRUCT70N� TYPE: 1 FR� SPRINK PERMI'P 'L'YPE': Ei.E , PURPOSE: ALT
SOB DESCRIPT30N : COMM. T.I. (OPFICE5) ,� SQ FTr '
CLAIM VALUE: CALC-VALUE: • GROUP OCC:;B-2 /.
COMMENTS: RE: FJ46012 PRIMARY DLDG. PERMIT. '
�c���+�+�*��*�r+c�x��r+e****x�*�*x�c��r+r+tx*�r**���rit�r**��r�+���+���ie*rt�xx�*�r�x�+�****�**+�*� x x �*n
' Z O N I N G R E Q U I R E M E N T S
S E'T H A C K S ' �
MAIN HUILDING --------- --------- ACC�SSORY AUILDING ----------
FRNT: . F"P IN REAR: ET IN PRNT: ET TN REAR; 'FT IN'
LEFT: PT : IN RGFIT: FT I�l LEFT: FT IN RGH1': F1' IN
PARFCIIJG RE(Z: PRUV: PARCEL: 41050104 ZNE: REF r10: • �
YLANNING NOTES> � �
�
iE �k iE iE iE iF iF iF ih aE i(� iE if if iE if N� jf if iF fE if jE N- i! iF iE �E k�k �E * i!lFiE fk.i! ik k�lf %i! if lf i4 iE K iE iE iE lE iE iE iE if iE if 7E iE 1E it 3f it it iE iE 3F if iE 1f� iE aE jk iE N- jE iE if iE
D E V E L O P M E N T S.E� V I C E S R E Q U I R E M E N T S
'LON7NG APPROVED.DY '
HUILDINc; APPROVGD BY :
APPL7CATION I;SUED BY:
*��*���***�*x��*�tt�*�c**�* � iF'* x�
K� iE iE �6 ff 16�iE iE �E fE f(-iE 3f jf iE M if iE iE M if if fPlE If iF 4 iE k!e �F iF fF iE iE if
llATE:
DATE:
DAT�: � -�3 -
iFif iF�E 1E fE iE �E k iE if 1E 3P iF iE iFiE if� iE ikiF ��iE�i' iF
iE if if k iF 1E ih iF iE iE !E if iE 3F iE it �IE iE jk if if if 3E if !E!k #
LEGP.LLZATION;N F E E S U F] M A R Y ST2UCTURAL- SEGMENT:N '
' BLi)G PMT PI.,OMQING Ei,ECTRIC � MECHANIC FIRF.: SMIY/RES GRADTNG
PHP,MIT ' .' 129.95 r "
' ' ,t� 50$ ��. SMIP/NON-RES
PLAN � � . ,
IJJUh F.EG ' �'1S.00 ' '1
�BOILDING-DIV-> PERMIT�• ISSUE' PL,AN�'CHECR� ' TOTAL, PAID DUE
TOTALS----> 124.95 ]5.00 0.0,0 f 139.95 139.95 .00
" , � ;; . �
REVHNUE DIVISIODI TOTALS--> � COLLECTED: 139.95 UVER/S,fIORT: .00
� DLDG PMT PI,OMDING ELrCTRIC. MECIiANIG �' FIRL SMIP/TO'C :GRADING PLAN-CHECK
r , 139.95 , . ..
� �
.. : .
�!-X�±t ik iF it i! iF 3F it if iE i6 iF dF df iE iE �If iF i(� iE 1t it if iE iE it iE iE iE 3E iE # i(� ie iE i! iF IF N�;)E'�l(-iE�)f iE`k iE i! 1E iE it iF if iF iE iF �% i(� fE it if iE IE �lE �F iE iE jE iF iE iF iE 3E �E 3E iE it iF #
� I N U I V'I D U A L. �F�-E E �rA R E A K D O W N �
� . . j. ,r '��. .
TYPfi QTY ll F. S C, R•I: P T I O.N '� ,±� J` , UNIT COS'T TOTAL COST
ELE 20. CIXTUf2E5, �LIGFITING , 3�; ST '20 EA. .75 15.00
ELE 77 FIXTURES, LIGIPCS.NG ADDITTONAL EA. .4S ' 31.95
ELL " 7_0 REC6PT/OUTLL'f 1,` ST 2,0 EA. .75 ' 15.00
ELF. 40 RFCEPT/OOTLET ADDIT70NAL EA. '.45 't8.00
F.LE IO RECF.FT/SWITCII ' 1.ST 2.0 EA. �.%5 7.50
ELE 1 SERVZCF.S ]3,ELOW 600 V& 2'00•r- i.000 AMP 37.50 ' 37,50
' END ,'QF'• FEES + ,
. � . .... . . _ . . ' . . , .t.
�
e
a
tl
O] 00053E54-�0053854 TfjT 139.95
DATE:.OT/13/9U TItfE: �9:s5 �
� CONSTRUCTION ANU.YLANNING �
APPROVALS . Permit# Date
1
• 1: TemPorary Electrical Service or Pole
2. Soil Pipe-Undrgrnd. ! : �
3.� Elettrical Conduit Utili[y-Undrgrnd. `
4."�E�ectrical Conduit- n g d�. - ���
�S.�Steel Reinforcement ^ . "� �
_ 6.� Electrical UFER Grnd. ' -
- 7. Footings � , �
$. Foundatiom �� � , i'r
9. Water Pipe�Undrgmd. =�:+ (' "+
10. Str�cturel Floor System j� � •
11. Property Sewer Line & House Connection�'
12. Sewer Cap .. l� !
13. Roaf Drains . � ^ � '
r�
14. Rou9h Plumbing � . ' '� ',,
15. RoUgh Electrical�Conduit '� % .
:
16. Rough Electric Wiring � � �a '
e
�77. RoUgh Wiring Sign '
18. Rough Electriwl-T Bar Ceiling � �
19. Rough Heating & Air Conditioning � �
20. Rough F.actory Fireplace . � -
21 -Ducts, in Structure• '
22.� Ducts, Ventilating `. -
23.�Gas Pipe-Rough & Test ' - �
24. �Roof Framing _ � ' � .
25. Roof Shea[hing . . • '
26-'T�Ba� Ceiling (Structural) & Monocoat � - '
27. Frame and Flashing '
28. Lafhing.& Siding ; � , � '
29. Insulation -
30. Drywall Nailing �� . _
; 31. Plaster Brown Coab '
32. Electrical Power Meter-Final _
-_33. Final Electric f
�
34. FinOl Heating & AitConditioning .,
35. Final Gas Pipe-Test, ' -
�-36. Hood or Canopy '" �_ ' �
� 37. Finel Factory Fireplace� :. �
_ 38. Final Plumbinq _
� 39. Water Service-Final, ;-
. 40. Gas Service-Final � �� ` � " .
_ 41. Solar pomestic-Final , � �
42. Backflow Preventer� "
43. Backflow Irrigation �
44. Landscape Irrigation System �- � � .
' 45.,Sound Attenuation . - �,
" 46.• Handicap Regulations ' .
47. FINAL STRUCTURE & BUILDING
48: FINALPLANNING -
' 49. Electric Release to Edison
50'Gas Release to Southern California Gas Co •
- 51. CERTIFICATE OF OCCUPANCY
No. Date
i �L & SPA -
Inspector � Date Inspector
APPROVALS Permit # r, ,
52. "Pool & Equipment Location
. 53. Steel Reinforcement �
54. Forms
� . Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Condui[-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Undrgrnd. �
67. APPROVAL TO DECK �
62. Backwash & Receptor-Final
63. Heater & Vent�Final
� 64. Plumbing System - Final
� 65. Electrical-Final -
66. Solar System-Final .
7. Fencing & Access Approval
. � 8. APPROVED FOR PLASTERING
9. POOL/SPASYSTEMSFINAL �
. FIRE DEPT. REQUIREMENT _ .
� APPROVALS ., Permit# � , ' �
- ' 70. Underground Hydro
- t-� , 71 . Praduct Piping O Gas O Oil
� 72. Underground Flush -
- � . 73: Undergrnd. Storage Tank O Gas ❑ Oil
' 74. Overhead HYdro-
75; Dry Chemical � ` _ _ -
' 76. Dry Standpipe - �
� � � 77. � FIXED SYSTEM FINAL � �
78� FIRE PREV. FINAL ' -
` .i� - �NEALTH DEPT,. REQUIREMENT. '
j� • 79.� FINAL INSPECTION . ' '
. -
��„�, 80:`�FOOD CERTIFICATE ISSUED �
�' . ..�_.__. � _ _ . . _. � .
'�l/: t� I eF lud/.�S sK:v�� in/
a
. . � �" _ . -
, .
, , . -_ . .
Y [T ' '
r
4 '
� l � Y
�
�
�
�
,si
�
�
r
rxaen�ooaeu: 555' ANTOPI Bi, uxrt: 100
-OWNEB'SNRME: SGCURITY 6'ACIFIC BIiNK .
eooeeu:500 WILSHIRr �L
Sf]ITE 500
. L.A„ CA 900L7
(llJ) 745-78fS0
�NCHIENGINEEH: , IIEQ.NO.: '
�OUflE38: ' ' UNR: .
PEqMITTFE: KT.MBI�F. G CO. ( 71 A) A95-115G
� nnoxess: . 7; 4 0 S U'L I L N .
WESTt4TN5'PF.R • CA 92683
UCENSED LOMIMCTOR DEClAM710N: I AereEy amrm Wt I am Gcensed under provisio�¢ oi Chapter 9(commendn0 �4h Senion
7000) ol Oivisim 3 ot IM Business antl Professims Cotle, an0 my'Gcense is in lull toru antl enect. .
cmuc.:�j85U3 �p�uc.:460923�//� ��Lry�g(7� 16,/�/
Oate: '�— — 1 � ^ {—� SiOnature: �J/^/'�q,���'r
tir��
WOPNEIIS' COMPEN311TION OFCIAMTION: � AereEy aKrm tlwt I Iwve a anific3B of conSenl !0 uIlJ�num Or a anilicale 01 WOAeR'
c�x�uuo��4`$ $`� fS`!�?� `P°Y fi`i`°� �s� aaoo. vo.lf�ll / 2 3/ 9 U
roucr xo.: rRCMONT �' °��'
fAMPIINY: �{,
❑ CeN�M ropy'¢ hwehy turtusAeO. CJ CeNfieO copy a fileG ��e ciry Buil0in0 Division.
oau: '�- — � S�-9c raWc����//�.r� -
[z[rvrrox �ox won�cxs� ca�euis�nox o�wuuirox: (ms satio� �m ee mmqerm a ue o� m m me nudaa Isioo� or kssl.
I uNry WI in ttre pvformance a1 tne work for wtrich tttis permit is issued, I shall not em0�oy any person in any manrcr w az ro become
su0ject to tM Workers' Compe�ation �axs ol CaGtomia.
Uate: Sipnature:
NOTICE: If, atter malanq tNs G¢daratian, you slnAtl Eemme wbjecl ta Ihe Workers' Compensation prmisions of Ne Lahor
COEe. yau nnaY IorllmitA camDN �h sucA provaians or [tu pemut SAall Ca EeemeE revokeE.
LONS7PUCf10N 1FN01N0 �GENCY: I �ereEy allirm that ttrea c a cam[ruction IenOinp apenty lor tlre peAorma�e al tM work lor
wlticn N'x Dermit is iswe0 (SecGon 3W7. CN. C). .
IFNOEH:
nnoxeu:
OWNEB BUIWEfl UECIAMTION: 1 heaby affirm tAat I am exempt Irom t�e Comranors' Staro License Law for tM taAavnnp reason
(Sectbn 703t.5 &ainess aM Protessional CoUe: My tlry ol cauny wltich apuires a permit ro camWcl. alter. improve, aemolLSA. or
rtpair zny sWcture. pnw ro its issuance, also requires t�e appGunt lor wch pemm ro Gle a sipneE statemem Nat hrlsM is fuense0
and Pmt toessionsPCOGe) or tAat'MJs�e�¢!e e p�l Iherle�irom anU tl��OEasistor�lhe all Oe0 exemP�� ��atlm o�f SeNm 7031.5 �
a�ry appliwnt Im a Dermit suhjecis me appliwnt lo a civil penalry at irot rtrore than tive �unAred dolWrs (SS W). ,
I, u wmer of tne o�M or my emobyees vriN wa0es as tneir wle mmpensatlon. will Eo the woh, �nU TAe
❑ structua u not intenEeE ar allere0lor sale (Sectlm 704C, Buvness antl Pm/euional COGe: TAe Contanors' State License Law
- Oces irot appry to an owner ot a DropeM � ��s or ImOraves lAereon, an0 who Ooes wc� xrork NmSdMerull or throu0h
•Ws w ner oxn employees, D��4� ��� suc� im0�menes am not intenUeO or bflereC for sale. Ii, Avawer IM DWIEinp or
Improvertrcnt k sa10 vntNn one year ol comdetbn. Ne owner wiU luve t�e burOen al Dravuip trJsla Oi0 roi Dd10 or improva
tar Ina purpose ol sale�. . ' �
I, as owner of ttro propeny, am excluslveN wnVadinO �+�h kense0 coniracrors ta construct the D�q� (��� ��. Buslneu
❑ aM P�ofessions CaOe: The Conlractors $ta�e License Law Oces not appy ro an owner ol D�M wb Md� or improves Neaon
an0 wtp contrac6lor suc� Drol�� �+�� a conVattoqs) Ikense pursuant m the Contractors' �tate �w:enu Law�. I am awam
Ilui proof ol lAtif WaAer'S Campen5aU0n in5u2ntt SAONE Ee 0�4� �o rtre. � ,
� I am exempt uMer SecGon: B. d P. C.
for cnis reuan: �
Oata: � O�mer
I do �ereCy certiry Wt I am aware of and un0erstan0 Ne repwremenu ot California Health anE Safery CoEe Secuom 25505. 25533, and
25534 an0 t�at I or any lutum DuilEinq acupant wilUvAtl not (�vde one) neetl to comWy wit� sai0 sWte w0a �M ttie repuirtments lor a
permit lor canstruction or mo0i�cation Imm t�e Nr �ualiry ManaOement OistncL ReSiAential constmction applira6ons are exemD< «om
inase provisians. . , �
Uate: RpP�nt: . .
i I Aem6y cetlity t�at I Aave aa0 tAis aDPlication anE sta�e itut t�e aCave inlormation Is coiroct. I apae lo comply wit� all ciry anE counry
�, wtinances aM state laxs relatinp to EuilUinp consUuction anG trerehy aNhorim represenWtives al Inis dry lo urtu upon ttce aDove�mmUwetl
�i O�aDaM �or inspeciion purpous. . q��/ /J� / � �
I� Date:2—/S�-9� SiAnature:lL(�'�•�Ye'
Dn.er's License w Social Secunry x: • •
184118 W�it�Builtlinp; Green=Cotle Eniorcement: Canarv—ADDliwnt: Plnk—Revenua; GOIEanroO—Aveemr -
' Ci'I'Y OP C.OSTA t�fESA - I30ILp7:T1G CERtdI7' E'F.Rt4 h10: P 04G] 2'4
PERMIT NO: F 04G174 � PLAN CFIGCK N0:�01935-(39 S GOVT: p] SUPP; N'
�CONSTRUCTIOtd TYPG: i. CR SPRI( PERMIT TYPE: 1?]:R . PIIRD056: AL"f
JOD DESCRIPTIUDI . FIRE SPIIINKLi'RS lCOMM.•T. I.), ,Q FT:
CLAIM VALUE:. 7,J00.00 CALC-VALUE: GROOP OCC: B-2 / �
COMMENTS: RE: D460.12 PRIM:4RY IILDG. PERMZT.
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7. O N I N G R E Q U I R L M E N T 5 � '
S E T D A C' K 5
- MAIN BUILDING - - ACCC•.SSORY DUILDING -
FRNT: ^ FT LN REAR: FT ^ IN ERNT: FT IN RtiAR: FT IN�
I,EFT: F1' IN RGFIT: FT IN LEFT: FT IN RGIiT: FT T.N
PARi(ING RL•'Q: PROV: PARCEL: 41050104 ZNE: RGF NO:
PLANNING NOTES> � ' . ',
>
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U E V G L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED FiY DATE:
DUILDING APPROVEb DY : DATE:
APPLZCATZON IS;UED EJY:� DATfi:
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LGGALIZATION:N 1' E E S U M M A R Y ,TRUCTURAI. SEG[dGNT:id
DLDG PMT PLUMHING 'ELECTRIC MECAANIC FIRE SMIP/RES GRADiNC,
PERMIT 63.00 '
• 65Q SMZP/NON-RES
PLAN 40.95
ISSUfi FEE
BUILllING-DIV-> PERMIT ISSUE PI�AN-CHGCK 'POTAL FAIP DOT•_'
TOTALS---% 63,.00 0.00 40,95 10J.95 103.95 ,00
REVENUG DIVISION TOTALS-->. 'COLI.LCTGD: 6J:00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELGCTRTC MECIiANIC FIRE SMIP/T01' CRADTNG PLADI-CFIL-'CK
• 67.00 '
X�1E iF If ik %�1F )f fP # I( iE 3f i4 lE iF Il )(� iE if 1f if� 1E iE if dE iE% M M-�(� IF dE fE k X� 3! IE # k fE� IE if k k if iE �%if IE �ElE iF If if M if -lE if 1f if if if if �l( 9E ib �1f aElf k if 1f 1f 1f 3� if� i(� lE
I N D I V I U U� A L F F E H R E A IC D O W DI
'PYPE ATL' D E S C R i P't I O N UNIT COST TOTAL C05T
FIR 61 FIRG LQUIP fiGE lFROM 13LDG VAL'TABLE) 1.00 61,00
END OF FfiES
O1 OOOS4146-00054146 TtiT
DATE: 02/15l90 TItiE: 10:19
0
I
63.00
.` CONSTRUCTION AND PLANNING POOL & SPA
Date Inspector ' Date Inspector
APPROVALS Permit # . APPROVALS Permit # •
i.
'.1. Temporary Electrical Service or Pole � . 52. Pool & Equipment Location ' �
�
2. Soil Pipe•Undrgmd. = � ,-; � 53. Steel Reinforcement � � 1
3. Electrical Conduit Utility-Undrgmd. - 54. Forms -
4. Electrical Conduit-Undrgmd.. • ;; '-' S5. Electrical Bonding � � �
5. Steel Reinforcement ' � � 56. Rough Plumbing & Pressure Test .
.6..Elec[rical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE .
7. Footings . ' ' S8. Electrical Conduit�Undrgrnd. -
8. Foundation ; � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines. P-Trap, O Undrgrnd.
10. Struttural Ploor System • � i 61. APPROVAL TO DECK
17. 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 ElectricabConduit 66. Solar Svstem-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wirin9 Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � . 69. POOUSPA 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 �Gas OOiI
23. Gas Pipe�Rough & Test � � 72. Underground Flush '
24. Roof Framing �. � . � ��. 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro �' L'�U �'�'�
26. T-Bar Ceiling (Structural) & Monocoat -. 75: Dry Chemical
27. Frame and Flashing ' 76. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM FINAL j_�; p
29. Insulation 78. FIRE PREV. FINAL $�-C� (1.t��
30. Drywall Nailing �„ HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ;if ,'•� 79. FINAL INSPECTION
32. Electrical Power�Meter-Final - � 80. FOOD CERTIFICATE ISSUED . �
33. Final Electric . ���, Notes:
34. Pinal Heating & Air Conditioning � %- -
i-
35. Final Gas Pipe•Test ,
�.
36. Hood or Canopy ; : � � ..�j ` ' �
37. Final Factory Fireplace , '
38. Final Plumbing , ' " ,
39. Water Service-Final � � �
40. Gas Service-Final ' � '
41. Solar pomesticFinal � �
42. Backflow Preventer �
43. Backflow Irrigation � �
� 44. Landscape Irripation SYstem � ' ,
45. Sound Attenuation .. .- '
46. Handicap Regulations - ' .
�,
47. FINALSTRUCTURE&BUILDING ' �
48. FINAL PLANNING j , .
49.�Electric Release to Edison '�
50. Gas Release to Southern California Gas Co '��
51. CERTIFICATE OP OCCUPANCY
No. Date
�
ADP���ant to flll in a11 spaees exceot tnosa witnin neavY eoraei I:nes anE sign all approorlate aaelarations.
PE IT NO. TRA T NO. L T NO. UNIT O.
CiTvoFcoSTA SA ON,�-` ,tTRUCTIONPERI�V T �+ 3��¢/ D `�� A.P.# /o^ al-o zooe �,�,
Project Addre$s ��•�F'� %i � � r ���� �P
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR S Main BUilding: ACCe55ory Building:
AppFcant's Mailing Address E Z
� ' � �(�(S 7g ❑ CONVERSION ❑�DEMOLISH. ❑ OTHER - T F�ont 0
Owner's Name �� , Phone DESCFIPTION OF WORI(/USE OF BLDG. B Fear N
Address �i�Yi 1�/ l L � ���.� -P"�� ��17 L�•/� . '� A 1
Arch/Eng. � d� License No. TVPE OF PERMIT GRnDWG FOUrvDATiOrv STRUCIVRAL I� C Right N
K G
Address ❑ TENANT ❑ El_ECTRICAL ❑ PLUMBING ❑ MECHANICAL . g� Left - R
Contractor's Nam �-� ne� ��o7HER � _ Ping. Ref. # Parking Req./Provided Q
Addreu (me'f�nl L,S 7-- Cc.� o_i%y � �,o. PRQIECT DESCRIPTION SQ. F7. dU OCCUFANGv r 9 M�
Y � ����� /� Plannin Notes:
CONSTRUCTION TVPE�J_L_'�1.L1__ VAIUATICIN $ T
I Ciry License No. m 3 a I -( / 1 ' •
� ZONE GiZAOINGCU.VDS. ACRES S.
LICENSED CONTRACTOR DECLARATION
I hereby aftirm that I am licenzatl untler provi5ion5 of Charter 9(commencing Remarks: G O�, �$ �
' with section 7000) of Olvislon 3 of the Business antl Professions Cotle, antl � ELECTRICAL FEES
� my Ilcense is in full torce antl elfect.
�License Id55 L�CC
'•e�� Slgnatur PLUMBING ' FEES Automatic Washer Transformer ❑ 15-50 KW
�KERS' COMPENSATION DECLARATION ConStruGtiOn POI¢Sub. ❑ 50+ KW
� ear Sink Showers � �
,..ereby aHirm lhat I have a certl(icate of wnsent to selLinsure or a certltiwte
ot Workers' Compensatl n Insurance, or a cerlifietl copy chereot (Sectlon � � Cooking Uni[ � Me[et ❑up to 100 amps
Backflow Preventer Service Sink
3800. Lab. C.1 :�1� �/7/1s�i.f G.2F-4LT WIEYL/��}�l% .•.
�.� y,.e _..�„ �� Dishwasher Meter �over 100amps
- Policy NoI+�T-�=��—��— Company �� - Backflow Irrigation Sewer Cap -
rtitietl copy is hereby �urnishetl. Dryers ❑Gas ❑Electric Sub Panel ��. �
ertifip�d coy y is filed with the city ng DI I�a�' BdthtUbS S¢W¢I COnfl¢Ct1011
� Date; �(I2/ 7� Appllcant � �$Ga�.�R/Lj Fan Motors 1 HP �1 X� 8
�EXEMPTION FROM WORKERS' COMP SATION DEGLARATION Clarifi2r5 Solac CAIIeCrofS ,
(This se<tion neetl not De completetl ii Ihe permLL is tor one huntlretl (5300) or Dishwasher Solar Piping F.A.U. a Solar �9-15 HP �16-15+
� less).
I certily Ihat in fhe performance of the work for which this perm�t I5 issuetl I .. Fixtures
shall not employ any person In any manner so as to become subject to t�e Drinking Fountains Solar Tank , Microv.2ve
IlWork¢rs' Comp¢nsation LawS af CalifOmia.
, Date Signature Floor Drains Swi ming Pool w/Spa Device Boxes Pole Light
NOTICE: If, af[er making this tletlara[ion, you shoultl become sub�ecl to the OutIEtS Rang2
Workers' Compen5dlion OrovI5IOn5 Of the Ldbof Cotle, you mu5t torthwith FIOOf $iOkS fiOdl
comply with such provlsions or tnis Dermlt shall be tleemetl revoketl. Switches �
CONSTRUCTION LENDING AGENCV Ga55erviC2 OUNeti WeterCloSCt . $ign
� I hereby affirm that thera i5 a<onstructlon lentling agency ior the pertormance � %� Ga�bagE Disposal ' S[ending $ections
of tha work for which, t�is permit i5 issuetl (Sectlon 3097 pv. C.) InterCeptOrS Wetef Heacef �
Lentl¢r's Name
' �enaer's Aaaress Kitchen Sink Water Service Generator �65 KW �5-75 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby attirm lhat I am exempt from the Contractor'S Llcense Law tor the LavatO�ies Auto-Wash
' following reason (Saclian ]031.5 6usiness antl Prote55ional Cotle: Any cily or
county which requires d Permit lo wns[ruct, allEr, improve, tlemOlisn or r¢pair P-Tf2p LaUndry Tre'y5
'-v s(ructare, prior to ils issuance, also requiros the appli<ant for such permit
- 'il¢ a signetl stat¢men[ thdl he/SFIe i5 licensetl pur5udnt t0 ttle pfovi5ion5 of ROOf DIdi115
Contractor'S License Law (Chapter 9(commencin9 wltn Section 7000) ot
_.oislon 3 of the Business antl Profe55ion5 Cotle) or tha[ ne/she is exempt � Reinspection Fee $15 Issue Fea $ 3
[h¢reirom antl Ihe ba5i5 tOr t�e allegetl exemption. Any violatiOn of SectiOn .
]031.5 by any ap0���an[ for a permit subjects tne applicant to a civll
.�enaity ot not more than (ive hundrea tlollars (5500). 3 DEVELOPMENT SERVICES REQUIflEMENTS:
LJ I, as owner ot the pro0erty or my employees with wages as thelr sole Rainspection Fee $15 Istue Fae $ „/2 �Q„�
compensation, will tlo [ne work, antl the structura is not intentletl or o(feretl 2oning Approved By Dat9
lor wle (Section 7044, Business antl Protessional Cotle: The Contracmr's � MECHANICAI FEES 8uiiding Approved By Data �Z`�-3--�
LiCenSe Ldw tloes not apply t0 an own¢r Of a property `Mio builtls o� Imp�Ov¢5
lhereon, antl wno tloes such work himself/herself or t�rough his or her own Applimtion Issued By � ate �j_/3-4Gt
employees, orovitlea tnat sucn Imorovements are not Intentlea or o((ere0 for Boiler Hood or Type I ❑
sale. If, however, the builtlin9 or improvement is soltl within one year o1 com- Canopy Type II ❑ SUMMARY OF F S
pl¢tlOn, the owne� will �ave lha bu�Gen Of proving hG/She CIa not builtl or Im- Duct � Under Ground 9�7
rova tor the purpose ot saie�. BUILDING PERMIT $_��=.� SMIP $
� I, as owner of the property, am exclusively contracling with licensetl con- Duct -Structural Ref ' eration System PLAN CHECK $ �� G�:1 PERMIT '
' [ractors to construct the project (Sectlon 7044, Business antl Profe55ions Code: .
The Contrac[or's License �aw does not apply to an owner oi'properly who Duct- Ventilating 0-100,OOOBTU ❑100,000 BTU ' PLUMBING $ ISSUANCE $
�uiltls or imoroves thereon. antl who contracts for such oroiects with a r.on-
tractor(s license pursuan< <o �ne Contractor•s �icense Law). 1 am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGY P.C. $
proo( o� their Worker's CompensaHon Insurance showtl be provitletl to me, ELECTRICAL $ GRADING $
❑ I am ezempt untler Saction B. & P. C. tor thiz reason Firepl/fact. Blt. �CBO dk Fire Dampers MICROFI LM $ �
� PLAN CHECK 50% $
Oate owner Heatin9 System & Ducting Registers MECHANICAL $ ��,�' (O �
I hereby certify tnat I have reatl tnis application ana state that the above ❑0.100,000 BTU �100,OOOBT . TOTAL FEE $
Information is correct. I a9ree to comply with all city antl county ortlinantes PUaN CHECK 25% $
antl state lawz relating to builtling wnsVuction, antl hereby authorize repre-
5entatives of tnis cit to enter upon tne above-menUonetl pr perty for
Inspectlo s. -
Signature� � �Ls¢ oate �- �� pei�spe�tio� Fee 875 �ss�e Fee $ 3 O1 00021994-f10021996 TC�T S1Z.60
Drlvers' Lice r 55 �
�JATE� 12/13/88 TIIiE: 09:12 ,
0865�46, rev. 5/88 Wbite - Builtling; Canary - AppllGanl; Pink - ACCOUn[In9: GOIUenroO - AS5e55o�
; � . -. . i �.'��.�� ;i� :
CONSTRUCTION AND PLANNING F .& SPA
APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector
�
1�. Tempora,ry Electrical Service or Pole � ' 52. Pool & Equipment Location - o.,
2. Soil�Pipe�Undrgrnd. . ' - � , 53. Steel Reinforcement ` 'i,�
3��lectri'cal�ConduitlJtiliYy-Undrgrnd. �_� 54. Forms .��
4r��lectrical�Conduit-Undrgmd. E� . 55. E�ectrical Bonding
[eel:R�inforcement V�. 56. Rough Plumbing & Pressure Test
6JElectticaf UFER Grnd � J.� '" 57. APPROVAL TO COVER-GUNITE '��
�.
7. Footiogs ' , �� ��' 58. ElectricalConduit-Undrgrnd. � ' �
B�Foundat�ion ,.� � � 59. Gas Pipe, � Undrgrnd., Test �:'�.
9. Water Pipe-Undrgrnd � • � � =� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System • 7 �' •� 61. APPROVAL TO DECK
11t'Proberty Sewer,L'ine`& HouseCo�nection �i-{ ' � 62. Backwash & ReceptorFinal
12. SewerCap V; '� '�+ :-!� ,' 63. Heater & Vent-Final ,
13.� Root Drains �� . '' � - 64. Plumbing System - Final
, r.
74..Rou h Plumbin "� ` �
g g �� � . 65. Electrical-Final
15. Rough Electrical-Conduit , 66. Solar System-Final
16�"Rough Electric Wiring 67. Fencing & Access Approval
i .i
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 #
i
21. Ducts, in �Structure �' 70. Underground Hydro
22. Ducts, Ventilatin `
9 - � 71. Product Piping O Gas ❑ Oil �
23,�Gas Pipe-Rough & Test' � 72� Underground Flush '
24..Roof Framing 1� 1 �' '73. Undergrnd.StorageTank OGas OOiI �
25. Roof Sheathing �' 't' 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing a 76. Dry Standpipe .
28. LatFiing'&�5iding _,_,,,�„ 77. FIXED SYSTEM FINAL
29. Insu�at�on .' 78. fIREPREV.FINAL
30. Drywall Nailing '' � � HEALTH DEPT. REQUIREMENT
�:
37� Plaster•Brown Coat.St 79. FINAL INSPECTION
32! Electrical Power N+etQ�inal 80. FOOD CERTIFICATE ISSUED
33. Final Electric r' tes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test ,
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ,-�i
39. Water Ser'vice-Final �
� i ,•i
40. Gas Service-Final � /'� ��
�., � �
� �� '
41�. Solar pomesticFinal,,� •� � r:1
42. Backflow Preventer �" ; � � �+j" •�
r �
43. Backflow Irrigation � 1 ;i, ��
�..
44. .Landscape Irrigation SYstem '�i� �+ V
45. Sound Attenuation � : ' ��' �
46. Handirap Regulations .(
47. FINAL STRUCTURE & BUILDING /r 9
4S. Special Requirements Completed
49. Electric Release to Edison �� .- ` �
50; Gas Release to Southern Califomia Gas Co -- ,� . ,
51: CERTIFICATE OF OCCUPANCY y �,�
N0. Date � � � ' �' . � .
�QS9 .°.DG�icant to lill in all spaces except those within heavy bortler lines anG sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTIOpN PERMITSuiT=
ProlectAddLess s-S-�/ A�f/T�1� ,�+Q�� /-�� _
Ap(�licant's Mailing Addressloz /Au ��������� -�
Owner's Name --SEGU/i! �C�aF`-� �f�.��b
� Address 'Sfr �¢N%�.(� .Q� p CJ/ir �/G{f7
' Arch/Eng. License No.
Address /1
Contractor'sNam1*�� �u� � //•�G PhoneZ%�t'�'�r7�
Addresslmailing1�26�SU �iE.'ti.�.t/m� �[:ti
City License No. Q � �-�
LICENSED CONTRACTOR DECIARATION
I nereby affirm tha[ I am licensetl under provi510n5 O� Chdrter 9(Commencing
wit� Section �000) of DiviSion 3 Of the Bu5ine55 a�tl Professions CoOe, antl
my license is in full torce anrl ef�ect.
License Class C�' License No.lzO�o�lv
"le��-! �l G-% Siqn ure �
RKERS'COMPENSATION DECLARATION
� .areby atlirm that I have a certificate of consen[ to sei�-insure or a certificate
I of Workers' Compensation .Insurance, or a certi(ietl copy thereof (Section
I 3800, Lab. C.) '
Policy N�U��//V� � y ����r�� •
II �Certifietl copy is hereby furnish
Certifietl copy is filetl with th city Buii ng �Ivls �/����'
� Date - Ap cant �-� .�
EXEMPTION��RKE b' CObSPENSATION DECLA��
(This section neetl not be completetl if the permit Is tur one huntlretl (g100) or
less).
I certify that in th¢ per(ormdnGe Of the wo�k Po� which this pe�m�t i5 i55uetl, I
snall not employ any person in any manner so as to become suGject to the
Workers' Compensation Laws of Calitornia.
Oa[e - Signature �
NOTIGE: If, aiter making this tleclara[ion, you shoultl become subject to the
Workers' Compensation provisions ot the Labor COtle, you must torthwith
' rompty with such p�ovision5 0� this pe�Tit Sht�l b¢ tl¢emetl revok¢tl.
CONSTRUCTION LENDING AGENCY
� 1 hereby affirm that there is a constructlon lentlin9 a9ency for the performance
� of the work for which this permil is Issuetl (Section 3097 Civ. CJ
LPntler's Na�ne
�enCer's Atltlress
OWNER BUILOER DECLARATION
I hereby atfirm that I am exempt from Ihe Contractor's License Law tor Ihe
� tollowing reason (Section 7031.5 Businass antl Professional Cotle: Any city or
county which requires a permit to construct, alter, Irnprove, tlemolish or repair
'^V structu�e, O�io� to its issuance, also �equi�es the applicant for zuch pe�mit
'ile a signetl statement tnat he/she Is licensetl puYsuant to the provisions ot
Concractor•s License Law (ChaO�er 9,(commencir�9 w�tn Section 7000) of
�ision 3 of the,Business antl Profe55ion5 Cotle) Qr Ihat he/she is exempt
Nerefrom antl the basis for the allegetl exemption. Any vlolation o� Section
]031.5 by any applicant for a permit su0jects the aOP�icant to a civll
�enalty of not more than live huntlretl tlollars ($500).
I, as owner ot the property or'my employe¢5 �+�th wages as thei� Sole
compensation, will tlo tM1e wo�k, antl the strUcture is not intentletl or_otf¢rEtl
. for sale (Section 7044, Business antl Professional Cotle: The Contractor's
� License l.aw tlaes not apply to an owner ot a propertY `�'ho builtls or improves
�� thereon, and who does such work himself/herself or through his or her own
. employees, provi0ed that such improvements are not intentletl or offeretl for
'� sale. It, noweveq the bulltlln9 or Improvement Is soltl within one year of com-
', Pletion, the owner will have the burtlen of proving be/she CiG not build or im-
Iprove farthe purpose oisale).
❑ I, as owne� ot the property, am ¢x[lusively conVacting with IicEnsetl con-
Irattorsto constructthe prOjet[ (Section 7044, Busire55 antl Profe55ions Cotle:
The Contractor's License Law does not appty [o an o�+ner of property who
builtls or imoroves Inereon. antl who rontractz tor such oroiects with a con-
tractor(s) Lcense pur5uant to [ne Contractor�s License Law). I am aware that
proof of their Worker's Compen5ation insurance snoultl be provlGetl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner
I hereby certify that I have reatl this applicatlon dntl state that the above
intormation is mrrecL � agree to comply with all tlty antl county ortlinances
antl state la r lating to builtling con5t�uction, and hereby autho�iie �Epre-
sentative t th' city to enter u fi the above-mentionetl property for
•InSpec � n pu� oses. 2 f�
M'3�777 I I I� 3°-
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' �
DESCRIPTION OF WORK/A15E OF BL�G. i ,_
TVPE OF PERMIT LI GRADING LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PWMBING �MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION Sa. F7. oCCUvnNCv
CONSTRVCTION TVPE VAIUATION $
ZONE GRADING CU. VDS. ACRES
Remarks: �i. Ti � 7if .Q 9% -f A/
9ar Sink
Backflow Preveruer
Backflow Irrigation
Bathtubs ,',
Clarifiers '��
Dishv.asher "
Drinking Fouritains
Floor Dreins
Floor Sinks
Gas�Servic.e Outlets
Interceptors �
Kitchen Sink
lavamries �
P-Trep
Roof Drains
Reinspection Fee $15
Boiler
Duct- Under Ground .
Duct - Structural
Duct - Ventilating
Exhaus[ Sysiem ❑ Multiple ❑
Firepl/Fact.8lt ICBO dk
Heating System & Ducting
❑4100,000 BTU O 100,000 BP
Sign ure .'.�. Date( /.�-_
Drivers' � icense or.9i�-� _� I I Reinspection Fee � $15
0865-46, rev. 5/88 White - Builtling; Canary - qPP�icanQ Pink - Acmuntinq; Goltlenrotl - Assessor
PLUMBING
Service Sink
Sewer Cap
Sewer Connettion
Solar Collectors
Solar Piping
Solar Tank
Swjrtiming Pool w/Spa
Water Closet
Water Heater
Water Service
Auto-Wash
Isua Fee
Hoad or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑aioo,000eru Oioo,000ar
System Repair/Alteration
FireDemoers is /.,.. �.
laue Fee
$ 3
FEES
A.P. #
S Main Buildi
E
T Front
6 Rear
A
C Right
S . Left
Ping. Ref. #
Planning Notes:
Automatic Washe�
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garhage Dispoul
Generator �65 KW C
Zona
Accessory Building:
Parking Req,/Provided
ELECTRICAL �
Transformer ❑ 15-50 KW
❑ 50+KW
Meter �up to 100 amps
Meter ❑over100amps
Sub Panel
Motors OO-1 HP O 1'/: - 8
Inc.Soiar �9-15 HP 016-15+
Pole Light
Range
Standing Sections
KW Trash Compacror
� Reinspeaion Fae �$15 � � laue Fee
DEVEIOPMENTSERVICESREQUIREMENTS:
2oning Approved By �
Building Approved By �� n �A�1 �����
Application Issued Bv �-�•�74 / n //(i/
FEES
$ 3
N
I
N
G
R
E
Q
M
T
S.
SUMIOfARY OF FEES-�
BUI�DING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ / MICROFILM $
MECHANICAL $ p-'�I,•aD . TOTALFEE $ ��
PLAN CHECK 25% $
01 0�'02216e�-00�221bD TCeT ti3,00
DATE: i2/is/$E TItlE: 14:58
. ....',�'i \ ���� . . . _
CONSTRUCTION AND PLANNING � F & SPA
APPROVALS Permit # Date , Inspector p�ppROVALS Permit # Date Inspector
. i ;t
1. Temporary Electrical Service or Pole� � ' 52. Pool & Equipment Location
:.
2. Soil Pipe: Undrgrnd. �, � 53. Steel Reinforcement •.
. �
3�`Electrical Conduit�UfilitY-Undrgrrid: , -.� 54. Forms � Q�
�_
4��Electrical Conduit�Undrgrnd. , '� 55. Electrical Bonding �
f 5. Steel�Reinforcement � f � ' " 56. Rough Plumbing & Pressure Test
�
� 6�;Electrical UFER Grnd.,� , - 57. APPROVALTO COVER-GUNITE
� 7YFootings . .,��� � 58. Electrical Conduit-Undrgrnd. .
i
8%Foundation '-; � �, ' 59. Gas Pipe, 0 Undrgmd., Test � �
9. Water Pipe-Undrgrnd' . � 60. Backwash Lines, P-Trap, O Undrgrnd.
10,.St�uctural Floor5ysiem _ 61. APPROVALTODECK' ��
A..
' 11.-Property�SewerLine & HouseConnection ' � 62. Backwash & ReceptorFinal �
12. SewerCap � - 63. Heater & Vent-Final �
1;3.�Roof;D ains � � �; 64. Plumbing SYstem - Final
�14URough Plumbing.,� � 65. Electrical-Final� ,�
15. Rough Electrical-Conduit 66.� Solar System-Final
16: Rough Electric Wiring 67. Fencing & Access Approval
77�: �Rough Wi�ring Sign � 6S. APPROVED FOR PLASTERING
� 18 ��!Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79� Rough Fleating & Air Conditioning /�`�� L�b FIRE DEPT. REQUIREMENT �
20� Rough Factory Fireplace 'I'�� APPROVALS Permit #
i
21. Ducts, in Structure �� � .
� , � 70. Underground Hydro
22. Ducts, Ventilating - �' 71. Product Piping � Gas ❑ Oil
23. Gas Pipe'Rough & Test 7,2. Underground Flush � /�
24. Roof Framing ;�73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing y,i� � 74. Overhead Hydro
.
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. F s�ni�e and Flashing 76. Dry Standpipe �
�,� i.
28. Lathin '& Sidin '?
, 9} 9 �� 77. FIXED SYSTEM FINAL
29. �nsulation '� 78. FIRE PREV. FINAL �
30. Drywall�Nailing HEALTH DEPT. REQUIREMENT `�
31e•Plaster Brown Coat 79. FINAL INSPECTION �,) j.
32? Electr,ical Power.Meter-Final 80. FOOD CERTIFICATE ISSUED i'✓• ��, J���
33. FinallElectric � Notes: . "
34. Final Heating & Air Conditioning 3l� �yj�
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 pomestic-Final � ,��
.i
42. Backflow Preventer / � l: '
�
43. Backflow Irrigation , i� ` : , "
44. �Landscape Irrigation System � ' �,_,
.
45. Sound Attenuation i �. -�
46. Handicap Regulations �j�J �
47. FINALSTRUCTURE&BUILDING t.
48. Special Requirements Completed
49.. Electric Release to Edison �,
50. Gas Release to Southern California Gas Co `
�-J
51. CERTIFICATE OF OCCUPANCY . "•�7 �
• No. Date r•.� `{' t�
•�w ,
AOPlicant to /tll In all svacas except enose withln heavy Ooraer Iinas ane sign all apprapriate tleclarationz.
CITY OF COSTA MESA CONSTRUCTION PERMIT P RMIT�NO. � TRACT NO. LOT NO. UNIT N A P#
Projec(AddRss 555 Clnbnn �i��i-1-e ��O _ J b S MainBu
E
Applicant's Mailing Address � T Front
Owner's Name e Phone g
Rear
Address '�'
C A�9ht
Arch/Eng. �nK LicenuNo. I K-
Address �,1�� ��� �R . �s fl �� � e5 g� Left
� �1�(�n��� Pln Ref. #
Contractor'sNama ��SmPfl �on�"r�(^ Phonea2T_L6111.2_ � 9�
Address (mailing) 3nn1 RL'S�F1\ \ I #�-3- 1 C1'l COS�FI M�G(] 1
City License No. ���9$(n
LICENSED CONTRACTOR DECLARATION
1 hereby aftirm that I am licensetl untler provislons of Charter 9(commencing
with section .7000) of Division 3 of the Buz�ness antl Professions Cotle, antl
my Iicense is in full orce antl effect. '
License Class � cense No. J�4'� �
� 'e �' 13 -fl� signature
iRKERS'COMGENSATION DECLARATION
I hereby aftirm tbat I have a certitiwte ot conSent to salf-insure or a certlfiwte
of Workers' Compensation Insuranca, or a certllletl copy Ihereot (Settlon
3800, Lab. C.)
Por,or No. IilPRR4l'3fo09 ComPanY�2M(x�� �rAem��ir/Co
Certifietl copy is hereby fumishetl.
Cer[ifietl wpy Is tiletl with Ihe Nty Bulltlin9 Dlvisip n.
ate IS�����kli APPlicant 'K�1n �M CSl'(�Q � r� t
EXEMPTION FNOM WORKERS' COMPENSATION DECLARATION
(Thi55eclion neetl nOt be completetl i( the pe��nit I5 (o� One hunG�etl (E100) Or
Iess).
I certiry thal in Ihe performance oi the work for which this perm�t is lssuetl I
M zhall not employ any person in any manner so as to become sub7ett to t�fe
w Workerz' Compensation Ldws O/ CdlitOmia.
�ate Signature
� NOTICE: 1f, after makin9 this tleclaraUon, you shoultl become subject to the
Workers' Compensation provisions ot the' Labor Cotle, you musl forthwlth
comply with such provisions or this perm�t shall be tlaemetl ravoketl.
I CONSTRUCTION LENDING AGENCV
^ I bereby atfirm lha[ there is a mnstructton Ien0��9 agency for tha performance
N of tne work for which this permit is ISsuetl (Section 3097 Civ. C.)
�� LenOer's Name - ----- - ---
Lentler's Atltlress
OWNER BUILDER DECLARATION
1 bereby affirm lhat I am ezempt from lhe Cantractor's License Law for the
following reason (Section 7031.5 Buslnass and 7rofessional Cotle: Any city or
^ounty which tGqulres a pe�mil to ton5truct, alte�, Improve, GemOliin O� repai�
y Struciure, p�io� lo itS is5uance, also req W�es tha applitant t0� such pe�mil
file a signetl Sld[!m¢nt that he/ihe IS licen�tl purSudnt t0 ttle plovlSlonS O/
.e Contractor's License Law (Chapter 9(commencing witn Seclion 7000) of
Division 3 of the Buziness antl Protessions CotleJ or t�at he/sha is exempt
therefrom antl the basis for tha allegetl exen+Ptlon. Any vlolation of Section
7031.5 by any applicant for a permlt suPiects the aOP���ant to a civil
� enalty ot not more than tive huntlretl dollars (SSOOj.
� I, as owner of tlte property o� my employ¢¢T with wages a5 thalr 5018
compensation, will tlo the wOrk, antl Iha StN�[ure Is not Inlentle0 or oHeretl
for sale (Section ]044, Busine5s antl Professional Cotle: The Conlractor's
I license Law tloes no[ applY to an owner ot a Property who builtls or improves
thereon, antl wh0 Uoes such work Nmself/h2rself or lhrough his or her own
, employees. Ptovitletl that suth Improvaments are not intentletl or offeretl !or
sale. Ii, noweveq the builtling or ImprOvemetlt i5501tl within One year o( com-
pletion, the owner will have the burtlen ot provin9 ne/she tlIC nol builtl or im-
prove farthe purpose otsale).
❑ I, as'owner oi,the property, am exclusive�Y �ontracting with Iicensetl con-
tractors to construct the project (Section 704d. 8usin¢ss antl Professions Cotla:
The Contracror's License Law does not apply to an owner of property who
builtls or improves th¢reon. antl who contrads ior such oroiects with a r.on-
tractor(51 hcense pufSUan� to me ConVatior'S Llcense Ldw). I dm awar8 that
proof ol [heir Worker's Compensation insurance shoultl be provltletl to me.
❑ I am exempt untler Section 8. & P. G. for this reason
Date
I he/Gby certity t
iniormation is cori
antl state laws rel:
sentatives of this
inipectlon purp e
Signature �
Drivers• Littnse or
0865-46, rev. 5/BB
_ owner — - —
I have reatl thls appliGation antl state that the above
I a9ree to comply witP all city antl cOuntY ortllnanc85
to builtlin9 constru<tion, antl heraby authorize repre-
�[o e^nter upon the above-mentlonetl property for
9M l(1�Y� �f M_�. �ate �a-l�'A9
TVPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPEOFPERMIT GRA�ING FOUNDATION STRUCTURAL
❑ TENANT � ELECTIi1CAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION SQ.FT. oCCUPANCv
CONSTRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES
Remarks: � p Z i_'l lL/_
Bar Sink
Backflow,Preventer
Backflow IAigation
Bathtubs.'
Clarifiers !
Dishwasher,
Drinking FOuntains .
Floor Drains
Floor Sinks
�i85$¢NiC¢ �UtlB[5
Interceptars
Kitchen Sink
LaVetories � -
P-Trap
Roof Drains
Reinspection Fee $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ven[ilating
Exhaust System ❑ Multiple ❑
Firepl/Fac[. Blt. iC80 �k
Heating System & Ducting
❑ 0.100,000 BTU O 100,000 BTi
Reinspec[ion Fee � $15
White - Builtling; Canary - Appli<ant; Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink "
Sewer Cap
Sewer Connection
Solac C011ectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auta-Wash
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑0-t00,0006TU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Inue Fee
FEES �lutomatic Washer
Construction Pole Si
Cooking Unit
Dishwasher
Dryers ❑Gas ❑EI
Fan
F.A.U.
l� FIX[11t2i
� Device Boxes
a Outlets
Switches
Garbage Oispoul
Generator 065 KW
$ 3
$ 3
Fea
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer � 15-50 KW
❑ SO+KW
Meter �up to 100amps
Meter ❑over 100 amps
5KW
$15
Sub Panel
Motors 00.1 HP � 1'h - 8
Inc.Solar �&15 HP �i6-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compactor
laue Fee
DEVELOPMENTSERVICESREQUIHEMENTS:
Zoning Approved By
Buildine APProvad 6y ' _e
FEES
N
I
N
G
R
E
�
M
T
5.
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
C ' PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25%c� ,$�8� ENERGV P.C. $
ELECTRICAL J� GRADING $
PLAN CHECK 50% $ MICROFILM $ '
MECHANICAL $ TOTALFEE $ �
PLAN CHECK 25% $ � �
Ol QOA2?062-D002?052 Ti]T `O.ES
DATE: 12/13/RR T]tIF: tli:56
CONSTRUCTION AND PLANNIN '! �L & SPA .
AFPROVALS Permit# Date Inspector p�ppROVALS Permit# ' Date Inspector•
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location
2. Soil Pipe-Uridrgrnd. �� - �'n 53. Steel Reinforcement �
3. �Electrical Conduit' Utility-Undrg�nd. ' 54. Forms i�
4. �Electrical Conduii-Undrgmd. "j •i 55. Electrical Bonding -
T
5. Stee(Reinforcement� . 56. Rough Plumbing & Pressure Test �
i
6. 'Electrical UFER�Gmd. ; 57. APPROVAL TO COVER-GUNITE �,
i
7. Footirigs ,- i _� 58. Electrical Condui[-Undrgrnd. , i
8. Foundation � � � �• � 59. Gas Pipe, O Undrgrnd., Test
�9. WaterPipe-Undrgrnd! ) � 60. Backwash Lines, P-Trap,.O Undrgrnd.
10. Structural Floor System ' ' ' 61. APPROVAL TO DECK �
17. Property Seweq Line & House Connection -� 62. Backwash & Receptor-Final �
12�. Sewer CaP . \ L . , .1
r _ . 63. Heater & Vent-Final .
13. Roof Drains �� - ' 64. Plumbing System - Final �
. '�
14. Rough Plumbing' � j ' 65. Electrical-Final �
15. Rough Electrical-Conduit � 66. Solar System-Final
1'6.j Rough Electric Wiring ��� � 7. Fencing & Access Approval
1,7� Rough Wiring Sign 68. APPROVED FOR PLASTERING
18l Rough Electrical�T Bar Ceiling ��� , POOL/SPA SYSTEMS FINAL �
19"'Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
A'
20: �Rough Factory Fireplace APPROVALS Permit #
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.StorageTank �Gas ❑Oil '
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurel) & Monocoat 75. Dry Chemical .
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding , 77. FIXED SYSTEM FINAL
29. Insulation 78. F�RE PREV. FINAL �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31..Plaster Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter-Final . FOOD CERTIFICATE ISSUED
33. Final Electric �'� Notes: � l
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 pomestio-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 Caiifornia Gas Co - '�
51. CERTIFICATE OF OCCUPANCY . _ � ' - � ' � ,
No, Date �
Pfl0.1ECT AUOXESS: UNIT:
OWNEH'SNAME: SSS ANTUN bL 151 CITY OF COSTA MESA - BOILDING PERMIT PEftM NO; B 061473 ,
nooeess:BANK OF ANERICA
20 N RAYMOND AV PERMIT NO; $ 061473 PLAN CHECK NO; 00237-93 A GOVT; N SOPP; N
PASAt�ENA
AflCHIENGINEEfl:
ROONESS:
PEflMIREE:
nooxess
18-578-76A0
AQUASANTA
SON, INC.
flEG.NO.:CS � z
UNI�
CA 92680
(618)967-8001
929 SPRING MEADOW DR
WF T rnV�i�A CA 91"l�i
ULENSEO CONTflALTOfl Df�UNRTION: I ere y a�lirm ��al I am licensetl unCer pmviswns ol C pler 9(eammencing with Setlion
7000) ol �ivision 3 0� I�e BuSiness an0 Pmlessions CoOe. anU my litense is in �ull lorce anJ effec�.
cmuc.: �687i sraeuc.:434097 S'f"y'�_2}
�ate: _��— Sipnalure: _ _ _
WOBRENS' MPEN TION oEtuNa7lON: I hereoy alli iha� i �ave a cenif¢a�e al consem ro sell-insure or a cenifica�e aI Workers'
Comoensation Insurance. or a cenilie0 covY ��ereol ISec�ion 3800. La�. C�. .
oOLICY NO.: P�i�` _ 2 1 Q'�'� a_ Q Q E%P. URTE: O S I O 1 I 9 S
*omeaNr:GOI.DEN EAGT B
,_] Cenifi¢a copy is hereby Iumis�eA. � Cenilie� copY is /j'i d vn�h /t9�/,ci�ry .8{J-�-l}Ei—ng �ONision.
�ate: �� q� APDlicanl: _��%"li.... 'e'+Gy�=�"��
E%EMVfION FBOM WOflKEPS' COMPENSATION DECIAMTION: �ThiS 5ec6on nepA not 0e wmpletetl i perm� ¢ for me hunAretl (5700) ar lus�.
I certity Ihai in Ihe Dedormanc¢ oi Ihe work lor which ��is permi� is i55ueQ I s�all not employ airy Person in a�ry manner so as �o become
subiect to Ihe workeri fAmoensation Laws ol Cabfomia.
Da�e: Si9namre:
NOTICE: II, atler making t�is declaralion, yau shoWd �ecome su6lect to tAe Workers' Compenutmn provisions al the LaUar
COG¢, you mus� IorlRxilh tompty wi�h Such pmvi5ions or I�is permi� Shall be tleem¢0 rewk¢G.
COh578UCTI0N LFNOING AGENCY: I hereby allirm tlut t�ere is a consiructron IeMing apency br t�e ce�ormance ai ihe work lor
whicn mis oermn is issued l�tion 3097. Civ. C�.
�exoee:
aooxess:
OwNEB BWLOEP DEUAflR7lON: I nere�y allirm Ihat I am exemD� ��am Ine Coniractors' State Litense Law lor ine Iollovnnp reason
(Section 7031.5 Buvneu antl P�afesvanal COEe: Any ciry oi counly wni[n repuiru a permil to COnStmct, alter. impmve. demolisn, or
reoair any 9rucNre. pri0t to its i55uance, also reavires Ihe applicant for sucA Oerrttil la ide a 5i0ne0 statement that hUsne is littnsetl
pursuanl to Ine Orovisions ol t�e Contractari State License Law (ChaO�e� 91�ommenGinq wit� Settian 7pp) af Division 7 of Ihe Business
anE Pro�essians CoEe� or Inai I�e/s�e is exemp� ��erelmm ana �ne Uasis foe Ihe allege0 eeemption. Any violaiion ol Seciion 7031.5 Oy
any appticanl �or a Dermil subjttts ��e applicani lo a civil penally oi no� more than live �unGreG Gollars (`�1.
I, as Owner ol Ihe pmoerty or my employees witll waAes as ineir 5We COmpenSalion, will Oo Ihe wOA, antl Ihe
❑ stmcmre a no� imenCeE or olferea tor sale (Section 7044, Business an0 Protessional CoGe: T�e Cantractors' State License Law
�ces nol apply to an owner of a pwperiy w�o builtls or impmves lhereon, antl w�o Oo¢s such work �ims¢II/Aersell or thmup�
his or het own emDloyees. DwviUetl �Iwt such impmvemenls are nol intenae0 or oltere0 for sale. 11, nowever ihe builAinA or
im0�wement is 5dE x+tttin one year of completion, ihe owner will IWve the OUrEen ai pmNng �e/She Gitl not GuiIG or imDmve
�or �he purpose af sale�.
I. as owner ot ��e pmperty. am eeclusively contracling wilh licensed comraciors m conswci I�e prole�� (Section 7044, Business
❑ antl Pmtessims Coae: Tne Comractors State License Law Does nm aO�N �o an avmer of DmceM � �uil0.s or impmves thereon
antl w1w cmuaca to� such pmjttis with a contractoqs� lic¢nse pursuant to Iht Contraciors' Slale Lzenu Law�. I am aware
��� 0��� o� I�tir Workei 5 Compensalion insurance shoultl be pmvided Ia me.
� I am exempl un0er Sectqn: B. 8 P. C.
for Inis reason:
Date: Owner.
I Eo nereUy cendy Itu� I am aware ol an0 un0eistanA Ihe reQuiremenis ol Calilomia Heall� and Safery Code Seclions 25505, 25539, anA
2553a anE Ilwt I or any lulure WilGinq Occupanl wilYwill nol �circle one) neetl �a wmply vnth ui0 stal2 COC¢5 and I�¢ r¢Ouir¢m¢nl5 br a
permtl lor cansimclion w mo0ilitation Iwm I�e Ai� Ouabty Management Disintt. FeSkential mnstNctiOn appliCatbnS are e�empl iwm
IIIeSe DrOvisi0n5.
Dale: AppliCanl: _
I �¢r¢py ttNly I�ai I IWre �¢dtl I�iS d00�iCdliOn dntl Sidl¢ I�a�
otGinanc¢5 an0 slaie Ww5 rWling Io 0ud0ing fAnsiruclion an0 �
pmP¢r1Y lor i peclbn Wrpote5.
Daie: ��J_1-1_1_ SignaWre:�
Omer's Gcense or Social Secunry r: <�
i5 COrrecl. I apr¢B Io compry wii� atl Ciry anE t0unry
f�livPS ol 11LL5 Gry lo ¢nl& upOn Ille abOve�men�ioned
t6at�a6 W�ne—BviWing; Green—CoCe EnlorcemenC Canary—Appliwnl: Pink—Revenue: GdJenrotl—Assessor
CONSTRUCTION TYPE; PERNIT TYPE; STR PURPOSE; ALT
JOB DESCRIPTION ; REPLACE WALL ZN STORAGE AREA SQ FT; 5,000
CLAIM VALUE; 5,000,00 CALC-VALUE: 5,000,00 GROUP OCC; B-2 /
COMMENTS; FOR THE "BANK Or AMERICA"
*�r�*��t**��x**�K*� ��r�x �x �*u ux �*��*�x�r*� u�rx *��r�r�r� *�rx�e�r� x�t�t**�r�x��r�rx#�tn�*�r� x•*�rK�r*��r
Z 0 N I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAk; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT ' IN RGHT; FT IN
PARKING REQ• PROV; PARCEL; 41050104 ZNE; PDC kEF NO•
PLANNING N(5TE5> MINOR TI TO ADD STORAGE AREA TO AN EXISTING ART GALLE
i
*�r*��x�x x*�*���� *u*�c x�*x*x*.'*�x����r*�*#*��r�r*�r��r*��r�r�r*�x���r**�*�r*�r�x���x*�,�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E Ni
20NING APPROVED BY ; Q'-� DATE;��
BUILDING APPROVED HY ;.B S DATEi ,�,�
APPLICATION ISSUED BY; �5;,,� � DATE; �
iFx�iflEx�lEikl6iEiEiElEfEiEIE�%iEitkifKkiFT� fF �ti IFiF+c eit �f�R ci�tt/1-lt�Ft�Fx�i�3F3Fk�iFSFih#iE##lEif##Y.x%
xx*�r��t**��tx�r**��rx�x�t�tk�tx�F�t�tfd�t��txx�t�t�t�tx��txx-�t • x�t�t��t�u��t��t��t�t�t�t�tx�t��x�t+i.�?c,
LEGALZZATION;N F E E 5 U M,�M„A R Y STRUCTpr�tAl7
, , , � �
BLDG PMT RL"UMBING ELECTRiC MBCEfANIC FIRE SMIP/RES�
PERMIT 72,00 �• j
�**��c•##�
S
�Tr it3F# iF
�*�t�r� a �rx-.r
SEGMENT:Y
GRADING
+� � •�^ SMIP/NON-RES
PLAN 11.70 ;.✓ . r �. 1.05
HUILDINGEDIV-> PERMIT ISSUE PliAN-CHECK ' TOTAL PAID DUE
TOTALS----> 73,05 0,00 �' .':11,70,.� 84,75 84,75 .00
REVENiiHLDGVPMT PLUMHING ELECTRIC�MECNAN�ZC /� ffiIRE3�SMIP�TOT/SGRADING PLAN-CHECK
% 2 , � � • . . 1 , 0 �J
i ;�
k ff if k if i(� 1k if iE iElE ik if iF ik fF iE 1E ih If �k 1F iF iE if iF if 3E i! Ik 3! ih ik i! fk �lE!lilE'if 1F if #iE �(, i! i! iE iE%#� �)F�IE iF !t'k if !t iE ## IElF�IE iE iE fE �)h iF # lE �If ik !h 3h 1f� ik iF iF iE
I N D I V I D U A b� ��FrE E B R E A K D O W N
�. �
TYPE QTY D E S C R Z P T I O N��i � UNIT COST TOTAL COST
,<, ! -•"
SFC 5000 ALTER BY VALUE COMMHgCIAL` NOZONE 1,00 5,000,00
$ND OF FEES
//
. _.'
.%
/.�/
C
A
CONSTRUCTION AND PLANNING
APPROVALS Permit #
1. Temporary Electriral Service-o�Pole
2. Soil Pipe•Undrgrnd. _. :
3. Electrical Conduit Ut���ty-UndYgmd.
4. Electrical Condwt�Undrgmd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
�. Footings
B. Foundation . '
9. Water Pipe•Undrgrnd, �
10. Structural Ploor System �' � �
it. Property Sewer Line & House;Connectioa
12. Sewer Cap
ii
13. Roof Drmns
14. Rough Plumb�ng
15. Rough Eiectnwl-Condurt
16. Rough Eiectric Wiring
17. flough 1Niring Sign
18. Rough Elect�icaLT 80r Ceilmg
19. Rouqh Heai��g & A+r Conditioning
20. Rough Factory Firepiace
21. Ducts, in Structure
22. Duc[s, Ventiiating
23. Gas Pipe•Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structwall & Monocoat
27. Frame and Flashing.
28. Laihing & Sid•,ng
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat
32. Electnwl ?ower VieterFinal
33. Final Electric
34. Final Heating & Air Gonditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final FactorY F�replace
38. Final Plumbing
39. 6Vater Service-Final
40. Gas Service-Final
41. Sofar pomestic-Final
42. Backflow Preventer
43. Backfiow Irrigation
44. Landscape trrlpation System
45. Sound Attenuation
46. Handicap Regulation5
47. FINAL STRUCTURE & BUILDING �
48. EINALPI.ANNlNG
49. Eleciric Release to Edison
50. Gas Release to Southor� California Gas Co
Date
Dace
�
�e
� .i
�
P & SPA
Inspector APpqOVALS Permit �
�52. Pool & Equipment Location
53. Steel Reinforcemant
54. Forms
55. Electrical8onding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Eloctrical Conduit�Undr9rntl.
59. Gas Pipe, O Undrgrnd.. Test
60. Backwash Lines, P�Trap, G' Undrgrrtd.
61. APPROVAL TO DECK
62. Backwash & Recepior�F�nal
63. Haater & Vent•Final
64. Plumbing System - Final
- 65. Etectrical�Finai
66. Solar System-Finai
67. Fencin� & Access Appro�al
68. RPPROVED FOR PLASTEflING
69. POOL/SPA SYSTEti75 FINAI
FfREDEPT.REQUIREMENT
APPROV%1LS Permit 9''r
70. Underground Hytlro
71. Product Pipin9 � Gas C Od
72. Underground Flush
73. Undergrnd, Storage Tznk O Gas ❑ Od
74. Overhead Hydro
75. Dry Chemica�
76. Dry Standp�pe
1��77 �IXED SYS7EM FINAL
'IRE PREV. FINAL
��w-�'r_ HEALTH DEPT. REQUIREMENT
I � 79. PINAL INSPECTION
. � 80. F000 CERTIFICATE ISSUED
1
Notes: ���� �/j �e��
/'
� '�lTc . � - Z ' - P� � i�i�%
0
��
: � �1L S,
�
Y
Date � Inspector
�
�
�
�
�
PN0.IECT ROOflESS: S S S ANTON BL �
OWNEfl'S NRME: BANK OF AMERICA -C . R. E,
noosess:20 N. RAYMOND AV
PASADENA,CA.91105
UNIT: 1 2'-j
818) 578-7700
RNCMIENGINEEP:ROW W. FIERBOLD ARCHITECT xec.xo.:C-11073
�noxess: 2555 AQUASATA uNiT:
TUSTIN CA 92680
PEXMITTEE: ARMSTRONG CONSTRUCTION ( 818 ) 967-8001
RUOPESS: 929 SPRZNG MEADOW DR
WEST COVINA CA 91791
LICENSFD LONTflFtTOfl DECIAPATION: 1 hereby a�lirm I�a� I am licensed unGer provisions of Chapler 9(COmmenting wilh Seclion
7000) o� OiviSion 3 0l I�e Business aiM Pmlessions Cade. anG my license is in lutl brce anE eifect.
cirruc.:05667,�1q sTueuc:434097{/ cuss: —�
Oaie:_�2�2�— V SignaWre:_` �"' ���'
WONREPS'COMPENSATIONOfCIABATION: I�ereEyaflirm��ail��t¢rtditateo�tonsent�o ¢Il�inwre0racerliliCa�eolWorker5'
Comoenuiion�i�w�n� �� ci��i�a cony tnereoi (Section 7eoo. �ao.�18 / 0 5/ 9 9
POLICY NO.: CRUSADER INS , E%P. OPTE:
COMPANY: ,y,
❑ C¢tlilie0 toDY i5 �Creby IumiS�eE. C7 Cenilie0 coDY is lijl 0 wit� t�e city Builai g Uivision.
Oate: �� ' 7-� — � / ApDlicam: L �I�'_'� ��`"' ��
E%EMPTION FBOM WONMENS' LOMPENSATION OECLAPRTION: (T�is se tion neeA no1 be complete0 il the permn is one �unUreG �510�) or less�,
I cerlity I�al in I�e De�ormance ol t�e work for which Ihis Dermit is issued, I shall not em0loy any person in any manner so as to Oecome
Su�le�� Io I�C Warkers' Campen5ation Laws Oi Calilornia,
Uate: Signature:
NOTICE: II, al�et making I�is Oeclaralion, yau shouttl become 5u0jett IO tlle Wofkers' Compensa�ion provisions 0� Iha La�or
CoGe. you must lorlliwilh comON ��� suc� pmvi5ions or t�is permit slWll Oe deemetl revoketl.
CONSTflUCTION LENOINC PGENCY: I �ereCy allirm Ihat Ihere is a ConStmciion lendinp apency lor ��e petlormance ol t�e work lor
wnicn inis oermit is issueA (Section 3097. Civ. CI.
LENOEN:
RODflESS:
OWNEB BWLOEB OECLANATION: I �ereby aflirm IOat I am ezemD� �mm ttre Cantractors' $�a�e Lkense Law tor Ih¢ �ollovnnp reasan
(SeCiWn 7031.5 Bu9ness ana Pmte59onal CoOe: Fny city ol County whith repuires a Dermii to conStNct, altet, fmpmve. Gemolish, or
repdit any sVu[Wre. prioi lo its iuudnce. al5o repuires Ihe aoVlirant lor wcn ve��� �a �ite a sipnea slatement rtWl npJs�e is Iicense0
pursuant m tne D�avisions ol I�e Caniracbrs' State License Law �Chaprer 9(commencinq wilh Section 7000) ol Uivaion 3 al t�e Business
an0 Prote55i0n5 Coa¢) or I�ai he/She is ¢�em0� Iher¢Iwm and Ihe Gasis lor t�e allegeA eaem0�ion. Any Wolal'qn ol Seclion 703L5 Oy
any aov�iunt lor a oermil suojecis ine apolicant to a dvil penally ol mt moa tlun live huntlretl Oollars (5500).
I, d5 0'xllEf 01 111! O�OOtrtY Of Ilry CrtlpId/CCS wiill wdAtS d5 IhGll SpIE LUfIlOe��IqO, WIII EO Iik WOlk, d04 IIIB
❑ svucwrt is noi inten0e0 or ollerM fo� sale (Senion 70aa, Busineu anG Pmfessional CoOe: The Coniractors' State License Law
aoes no� apo�y �o an owner ol a pmpeny wlw omlas or impmves inereon. ane wna Jaes sucn work NmseVlnerulf or inmuan
�5 ar �er ovm emWoyees. O�a�� ��� suc� impmvements are irot inteiMeG ar aflereA for sale. If. tqwever I�e builtling or
im0�ovem¢nl is so�d witNn one year af wmpl¢lion, t�e owner vnll have t�e Gurden of pmvinB ���e Ntl nol Gui10 ot impmve
lor I�¢ putpOs¢ ol Sale).
I. as uwner ol ��e pmperty, am ¢xGiaivep conVacting wiih licensed conVactors Io rnns�mtl the pmjtt� (Sec6on 70ad, Business
❑ aik Rolessions CoCe: i�e Contraciors Siare License Law Oces mt appy ro an mmer of properry who EmICs w improves iAerean
aM wM convacts lor suc� prqetls xit� a conlracloqs�lk¢nse pur5uanlia lhe Coniractors' $late lk¢nse Law�.l am awar¢
IIWI Ymot 0� I�eir Worker'S Camp¢nsation insurance S�ouW Oe provi0ed to me.
� 1 am e.empt unAer Seclion: B. 8 P. C.
lor I�iS rcason:
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO; B 065412 PLAN CHECK NO: 04684-93 A
CONSTRUCTION TYPE; I-FR PERMIT TYPE: STR
JOH DESCAIPTION ; INTERIOR OFFICE T.I.
PERM NO: B 065412
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT: 3',067
CLAIM VALUE: 45,000.00 CALC-VALUE: 56,003,42 GROUP OCC: B-2 /
COMMENTS: FOR " B. OF .A. SYSTEM ENGINEERS"AT THE FIRST FLOOR
+rr*�r*+r+r*r**�r*w*+r+rw**+r*******r***�rx �**+r**r*+r****�r**r******+rr+r*�r**+r�r�*r+r�rr**+r*+r**
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGI{T; FT ' IN
PARKING REQ: PROV: PAACEL: 41050104 ZNE: PDC REF NO;
PLANNING NOTES> INTERIOR ALTERATION - REDUCE SIZE OF EXISTING ART GALLERY
> AND. REPLACE WITH CORPOAATE OFFICE AREA FOR B OF A.
rt+rx+�***r*x �r+r*r*xx�r�*�rxw+r*�r�rxr*r*�r*�r�*��r�r+r+r+r*r+�*�rr�r��r****+rx�*��r*�x w**r+r+r+r�rx�*x**�x
D E V E L."�O 2 M E N T S E R V I �C eE- S R E Q U I R E M E If �'��S
ZONING APPROVED HY ;," : lM� DATE: �� -!�
BUILDING APPROVED�'HY' : DATE: �q
.,,'Jy �n✓ !%/ L p^
APPLICATION ISSUfiD BY; SI DATE: .2.- � l`
MMMN1f/f1f�tMlfMkMkMMififklfkM iFkMiEiFMMiFMif ffiE
MMMMMMiEMMififlEiFMMMMMMMMMMMitiFMlf7fiFMMMMifMMkMk1fMMMMMiflfifiFMMMMMifMMiFK1fMiFMMMM1ENMiF1fMMififkiflE
LEGALI2ATION;N E E E 'S U M-M A�R Y STRUCTURAL SEGMENT:Y
� w � r-
HLDG PMT PLUMHING ELECTFtIC MECHANIC. FIRE SMIP/RES GAADING
PERMIT 446.00 '
•�� % � SMIP/NON-RES
ISSUE FEE �Z � 4 a %'� � � ' ( / 11 . 76
HUILDING-DIV-> PERMIT ISSUE PLAN� CHECK ,,.TOTAL PAZD DUE
TOTALS----> 457.76 0,00 }/ •�72,48 530.2'4 , 530.24 .00
.i ii
REVENUE DIVISION TOTALS--> COLL�ECTED: •? 457.76��OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC . FIRE. SMIP/TOT GRADING PLAN-CHECK
446.00 . ' �11.76
� i
+l y
�tMifMMMikftMlEltffMltlf klfkk7kMNMiF1t1f M1FM1ffEMlEklElkMiFiF1f fFiF1F/f'1�ilftif 1f MkfEK1F%1f MMiFlf 1EM1F1kMMMM1E1FM1E1E1E1tM1k1l1!
I N D I V I D U A I: '�F E E" B R,'E A'K D O W N
- r:
TYPE QTY D E S C R I P T I O N�' • ,� ;•UNIT COST TOTAL COST
Oate: avner. �� : � % • r�
SFC 3067 OFF-INT. ALTER TYPE T II F.R. -AVER 17.24 52,875,08
I tlo I�ere�y ceNly t�a� I am aware ol afM unaer5lanG I�e re0uiremen�5 0l Calitomia Nealih antl Satery Cotle $¢clions 25505, 25533, anG I$ FC 3 0 67 EQU-ALT C�MN1 , SPR I NKL �R SYS ��/�'-AVER �', . 3 3 i� � i 2, i i
2553d ana I�at I or any luture OuilOing occupam wiiVvnll nol (ctrUe one) neeG m rAmpy wi�h said slale m0es arb Ne repuiremen�s �or a S FC 3 0 67 E(,�U—ALT COMM . AI R COND U � AVER +i,'%' % . 6 9 2, 116 . 2 3
ue�rtut �oi Consimnion ar mo0ilicaiion Imm Ine ti� Ouahiy Management Disinct. fleztlential cons�mction aDP����b� are ezempl Imm � �
mese om�i4ons END OF FEES� • �'
Dale: Ap0licant:
I �erCOy [¢NIy I�a� I have reae I�iS ap0�itaiion and 51a1e Ihai the a0ove informalion is corret�. I agree �o tamON'M�h aA tiry an0 toUn�y
o�tlinancesanastalelawsrelalingloUuilOmgconslructionana�erebyamtpr¢ere0����a�Nesolihist IoemeruponlheaEove-m¢mioneG
pru0etly Iorin50etl�On purposes �
Date:.� � ��/ ' $ignaiure: ���%`� ���'�l—
o�roers ��ce�se o� sociai secuni� �:
i64L46 W�ite—Builtling; Green—CoOe EntarcemenL Canary—ApO����C Pi�k—Revenuo: GolGenraO—Auaswr
� j
r� �_ . ��
f.� � l i
o.
�', •
• ��2 , p' t'L�1"�t:i-��152614 Y!'�'� 'vSi.�e
/ , • 6AiF: ,L �.�53 'firt: 09:42
CONSTRUCTION AND PLANNING F"'� & SPA ��
APPROVALS Permit+'"�- Date Inspector �pROVALS Permit ;,= j Date Inspecmr I
t. Temporary Electrcal Se��Yce'pr Po!e� , 52. Pooi & Equ'pmer.t Locat�o� '
� ���Spd P�p�-Uqdr�rn¢� '� ,�� � 53. Steel Reinforceme^t I •
>
. .J.:_• � - . .
.,y3. Electriv�'Go[+,�ia'.•�LGty-UAdrgrrtd. �.1 54. Forms �
:_ �-.--'+?'...�v+
-'�4.'�ect �ick�,'Ec'�j .•{�rtdrgrnd. �� 55. Electriwl Bonding '
�
`' S.��cel�jwrt�b� �i�R � SE. Rough Plumbing FL Pres.ure Test ;.; i
;'_""-�R "_'1
��ec�ri�al`t)F R•C��d : 57. APPROVAL Tp COVER�GUNITE �
��F1yot��jr. ;" .� 58. Electrica� Corcu�,i�Undiymcf. .� I
��a'Foundanon �, � � . 59. Gas P�pe, � Ururg^'�d .'cst J
-,�, -
�9. l�:ater f�ipe�Urt3rgr�d. fi0. Bacio.vash Lines. P�Trap, ,^. Undr�r;�d ,
•�7. Structuhal Flocr�rSystem � 61. APPROVAL TO DECK _ ;
7'1. PropertQlSewsei.¢i,n���e. & H�se Cononction 62. Bacic�vash & Reccpter Fuial .
12. Se�ver ap �, 1, �', ,;, - 63. Heater & VenbF�nai �
73. Roof Drai�s� - ' 64. ?lumbing Sysrem � F� ai � !
14. Ro�gh Plum'�iqq � 65. Electrical�Final -
75. Rough 'lectrical-Cor.du�t 66. 8elar SYst2m�Fin,:� �
-r , - - - --r-- - - -----
76. Rou9h �'lectritVJiring 67. Fcncin9 & Aeeess AnP�u��l
� - -�----
:17. Rough��rin9'��9� 68. APPROVEO FOR PLPS7ERING
18. Rovgh Electri�l-T Bar Cell�r.g 69. POO VSPA SYSTE��,;S FtNAL
19. Rough Heating & Air Cor:drt�on�ng FIRE DEPT. RE�UIREMENT
' ' : m 7� .r,;�-. F ��� I "----- -
(I.
2(j�;Ro�gh L-'g eTorY Fr�Piate . ��i; `�•y � -• �� ' _� rAPPF�,'x.IV �'��'°e�Rirt ;:�_��-�_f' ,
.n S7 c= - . `•4 a t! �.uHi-'
... ^^ �. .. �p.y-�.-�`:':T"7t--DT .. _-_.__
21.-iDuqs.ipSt�ctµr,e� •... .,S a � i+-.r k'�170. �FJndergr.d�lrtC H�ri:r =
�
22 D�s ^•nt+ tin-� ' �.ti ' S SF? T'` `�'-�c '�Oil -_
r��j � hY{ � 7.: 7:_.x f 71. Prcduc.,�pjn9 �j. -i �
2 _.Gai,Pi�Roqgh&�est � „�S .Z ^r . .72. Undergr�rtd FiysSc R r ' �
.-P": -._--.-n-4 �-��_:__� ._..
24,= RoSf Framing O.� -'•• :. �� *% �� I� ��` 3'/�., Undergrr�. Sto -�' T_Lr.l,a ❑ Gas ;' Q;Y �
C; -+ n s �trr.•. `�
25. R �f SRitathin ' '`: :' " r :,, r '-'�_.. v �+F"�%- --
�, _ 9. .. , v, '> tv+ x 7�Averbead Hydrp .
•-r' ?r .-r �-..�; �.y. .
26AT�93r Ceiling (S[Wcturall Bu�Vio�bcoat„` ��.Qc�l�?_ 7� �try�en�i�l �j "' � - -� - -
.. .. . , :�".
27.',Frap�e �qd �}as � r ^ , E-r_���-�;_ - � » Y ��v t.� r , .r � ...-7. . -- -
'U 'P^� �:: Itl 76. L�r Sta e�-.� u 'i '
-r:.�-^-"-�'. -9r�*-- r^--C: . - .: - --
28. �:r�in¢& S?ling .r c� ':1" �^.�iC + � .•r * 7T' FIXED 51`,3TE�?-`-'�NA S � - -
.� �'-i '1�' a `! - �U '1
• DC T G: . v �.7 ` ` .r �
29. Insulat{.r�.�'n '". �y `� �� � .. � �, - 7p� FIRE PREV. FI."�itL • ,� e; �(:; .
- 30. Ory�•rai'rVai3'mg^3.r -�-. • " J ( : � .+ '}�1EAlT&iiDEP7. REQNJI�' �JT ---- -
� 1p! JQ-'� --�` ----- ----
37. Piaster .��,ro ; .. ~T'� a ~ . x ") n�„ . F, -- --�-r7 ... T . �.
`;W �� :: . L • , I h . 79. FINAL Ii�[CTr{y1 � _ j
32:'Electriee^. PGNer:�S� te ~� ` a Ri � �n ;$L;.FOOD CERTIF.^.�'(�4TC 19SUED �-'F�}��{`-
�� f � .� , tC�'!`_�__ �-
3�'Fi�IHecirl� ��': .; i ``Jt '"'� '. .,N�es: � ^`�S--fi .. ��j /
S' � � ..:.:. � i. � � . /_".r7i•/�_�!l�ll�7 %�: W''- _!./d�
.34,lFir,s�l h�featirt�i&�' �eC�kufitiorTyL7 � �'. 1 � ��TL/-'ri� r�2/ '� -.._�-.�-- ---
� � . �ti 9.'T�.
35,'Fimdl Gai Pi�e-i4t� 'F �' � , - . :*�� � ; "
. f+? ..?� � �.-i � Ji� ^ � u. O r. i r •:
' .,. �-�__ _ _
36�HopdorCanopK'�-�' � c^-, � � ,� � �. �' Y �< ris .r,-- _ r� � ..- - ---
�. _ . . `,' � ��;/- �m : ;u R,
:37. Fir1,`ai Factory F��taee,• � .- ...• ,r* tn --' i ;' x . �fQ /� /��/ _�C„--Q./ �'/�J,; --�--
I^ ' - �. � --^'.* �is:. L �� .• '� J- --.--- �
�N3&^FiTI Plumtrim9 �•< . � ' ' s �� � rJ i � �`� -
. .-. " ' /j-s .' : �'Ll�-� -
:�33:�V'JaC%r ServicP-Fifi81 � .;*t�: • • //'I /�v� �j� a'� ��� / i/9%iy��y//�''.
i c� y 7: t ���/�.��0"`/al-j J"�d/� �ity-'��---.:i�. / %
. �;:40�.� Gas Service-F.in '` 1 � • �„ . - •, �J -
�:k C7 SC"f•' ":n ��i ( + Y 1. �
, •�-�--.1" �/J �
�41,•+Solar pomestic-f�rtaz � � ••tn•� � U � � C=� -},[i / is�rz�L
� . r R] 3 ' i; - LT' �C//✓� LiCT :r
��42: BacWlow Prevente� .� �- - _ '� -�T���c
-� I � T � r ' `7 ' r+
43. Backflow Ir�atc�r� '� ��� ' � _ * � _ � ��T� A �
r � � � t�
�44. Landscapet'FriqaciqnSyste�m�� -�� +?: �, � 7ig . v _ ;Cr �'
� � -
�.4°;�Sound Attc�rluation ~ " .' - ^ E F" � '- -�=� -< �
� . i x y�• • r�• �3 r, Cn �i! '4 .^ C•� .: • F7 �
i L Y •. •. �
;-,46., Fiandiwp Re,�ulatiqns~�� � �'� � � � .�j = y � , �a ���-�-�
` - ' / ' • - �-- x
47lF14�U4L STRq1CTURE & BULLDING '? 3����[/ t� N<�o V ; �
48� FIR�,L PLA`i1NIN� , ,-' ' + � - `' "
l�.�; ,_-� k , . .� � F: �.
^49_ �Elflctric Releese to3Edison i � , s. ,: - z � _:,e -+
a � ' .,i
�50rGasAe(�ase to Sou�hern Caljf�nid Gas Cn � � ,� F',� p, c,:,� ; •~ ':
� 51. CE$TIPICATE 0 UPr� � ^� ;- F .- .: _
n r '�no ,
N0. Date
PNOJECT AOOHESS: S S S ANTON H L
OWNEfl'SNPME: BANK OF AMERICA —C.R.E,
nooeess: 20 N. RAYMOND AV
PASADENA,CA.91105
818) 578-7700
UNIT: i25
FRCN/ENGINEEH: PEG.NO.:
PDOflESS: UNIT:
rcnrnmee: COMPETITZON ELECTRIC ( 818 ) 331-5807
aoosess: 635 STEPHORA
COVINA CA 91724
UCENSEO CONTNACTOB DECUIHATION: I heroCy aliirm Ihal I am licensea un0er prov¢ions ol L�aplei 9(wmmencinp with Sec�ion
7000� ol �ivi i n ol I�e Business ana Pmlessions Co ana my license is in lull lorce an0 eflect.
cirruc.: ���905 STRTELIC.:51 cuss: C-10
J�--'L1�=�;}— Signai e \�i �
WONKENS'COMPENSRTIONOELLANATION: Iner alfir t+taveacenificaleotconsennaselFinsureoracenificateolWorkers'
Comoensation p��s g 9�iliea coDY �nereol ( mw� 3eoo. iao.�l / O 1/ 9 4
raucr xa.: STATE FUND EXP �pTE.
LOMPANY: ,y(
❑ Cenitie0 copy is �ereDy Iumis�e0. L'.i CeNIieO�mpy-��� mt� t�e ciiy BuilGinA ��on.
I cehily Ihat in Ihe DeAormance ol Ihe work lor w�ich this pelmit is i55ue0, I ihall nol emplay any person in any manner so as to become
5u01ec1 lo Ihe Workers' Compensation LawS 01 Calilomia.
�ai¢: Signaiure:
NOTICE: If. atler making IAis Geclaralion. you ShoulG G�me SUElec1 Io I�e Workers Compensalian pmvisions o� Ihe Labor
Cqtle. you musi lanirvnih fAmON `^'��� such provigdR or IN5 perrttit 5hail Ce Ueemed rtvokeE. '
CONSTPUCTION LENOING RGENCY: I �er¢Gy atlirm I�a� t�e�e is a con5tmtiion IenEing apency for I�e p¢rtormance ol I�e woB �or
w�ic� Ihis permil is issued �Seciion 3097. Gv. C�. �
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E
PERMIT NO: E 065422 PLAN CFiECK NO: N G VT: S P:
CONSTRUCTION TYPE: I—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION ; INTERIOR OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: REF: B-65412
a*w*****�r***r****�r**w**+r****�r****+t�rw********�c*a«**w****�rw w*********+r«**��r**r**+�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FANT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGFiT: FT IN LEFT: FT IN RGHT: ET IN
PAIiKING REQ • PAOV: pARCEL: 41050104 ZNE: REF NO:
PLANNING NdTES>
�
if ik/f lfikihiFitiEltlf ikklkkklkkikfFMitMitiEiflFikMkMitiFffftMkifiFiFititMikitifMlEiFlkiEififltftiFkiEikillEMifMitfFltMiEitiliEif if 1EkiEMM
D E V E L O P M E N T S�E R V I C E S Ei E Q U Z R E M E N T S
ZONING APPROVED BY �- DATE:
BUILDING APPROVED HY :
DATE:
1
LENOEN: MffitMkitiEkiflEifM/fifkifMMMkifiEifkiFklfitilifMilMltkMlFk1F1f1fff1ElfiEkMMiflfklfiFitMitiE%ifiFlEiFif/tiflkMMkMitiElfkiEM�fifM
aoonEss: LEGALIZATZON:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
OWNENBUILUEBOECIABRTION: I�ereOyallirmtlutlart�e*empllromtlreLontrac�ors Stateliceiaelawlart�efdlovnngreason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
ISection 7031.5 Business ann Pmlessiowl CoOe: any city o� �unty whicn re0uims a Oermit ia consimcC alier, impmve, aemolisn, or P ERM I T 8 6, 4 5
repair any s�mclure. prior �o its issuance. also requires t�e applicant br suc� permil to lile a SipneG Statement Itu� �Ushe is licens¢tl 5 �_
Oursuanl Io Ihe Omvisions ol the Coniranors' S1ate Licenu Law (ChaOter 9(commencinq wit� Section 7000) of Oivivon 3 0l ��e Business pLAN
ana Pmlessions Coae) or ihat ne/s�e is exempt t�eretmm anG t�e Gasis lor t�e aliepeU erem0�ion. Any vioiation ol Section 709L5 by I SSQE FEE
any aooi�cam m� a oermii subiens me aooiicani to a cM� penauy o� noi ma�e man ime nunarea adiars �ssoo�. 15�, 00
t, as owner oi ine pmoeny or my emVioyees �+�n wa0es as meh soie comDensauon, wiil do ine work, and me BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
❑ simcture is nat imenee0 ar ofleretl lor sale (Seaian 9Daa. Buvness ana vmieuional Caae: Tne Comracmrs' State License Law ' TOTALS----> $(, 4 S 1 5. 0 0 �, � ��, � Q
aoes not aDPly lo an ownei ol a D�oDeny wlq ouilAs o� �mproves inereon. ana who aoes sucn work himself/herself or ihmuph
�is ar �er awn employees. pmviEeO i�at suc� imprwemems are not imenG¢U or oftereC lor sale. tl, �owever i�e �uilGlnp or RE V ENUE D I V I S ION TOTALS--> COI:I: ECTED ;
impmvement is solA wnNn me year ol compteiion. ��e owner vntl have ihe burEen ol pmvinq ne/she aiU not OuilO or impwve B LDG PMT PLUMB I NG ELECTR I C MECHAN IC
lor ine purpose ol Shce�.
I, as awner ol t�e pmpeny, am eecNsiveIy contrac�in0 ��� �icenseE contractors lo wnsirucl lhe pwlecl (Seclian 7044, Business
❑ an0 Professions CoOe: T�e Cont2ctws' Slate l¢ense Uw Oces not apply to an wmer of D�certy �u ��as w improves iAereon
antl who contncts lor suc� D�olecis vrith a wntrapoqs� licenu Dursuanl Ia I�e CantracloK Sta�e License Law�. 1 am aware
I�at prwl o� I�eir Worker'S Compenuli0n i�uran[e 5tpulU Ee D�oviCM to me.
� 1 am eaemp� mM¢r $¢Ciion: B. d P. t.
for t�is reason:
Dam�. Owner.
I tla here�y ceniy ��at I am aware oi anU under51an0 �he retluirements ol Calitomia Heallh an� Salety Coae Sections 25505, 25573, and
25534 an0 Ua1 I or any Iuiure Ouileing acupanl wilVwill not lurcle ane) neeE �a comply wii� saiU s�ate totles anU the reQuiremenls lor a
permil foi consimction or modilicalion Imm the Air Ouali�y Managemenl Oisiritt. Ne9Aenlial con5lNtlion aD0lica�ion5 are evempl irom
Inese pmvisians.
Uaie: AUptiWn1:
I neeeoy cendy tl�al 1liave reaOlNs apptiWtiOn anA slate t11d� �ne a6ove informdtion B CarreCL I agree to wmply with all city an0 coun�y
orCinancesanOstatelawsreWlinglo�uilamgrqnsimc�i hereoyauthor¢erepresenutivesoliniscirytoenterupontneabove�mentione0
pmperly bi inspet�ion pmposes.
� � ?.2z ,S �, sm � —�_
Driv¢Ys License or Socul Secunty .:
16ai�n6 Whue—BmlOing; Green—Coae EnlarcemenC Ce�ary—Applicant: Pink—Revenue: Golaenrotl—Assessor
101.45
SMIP/NON—RES
TOTAL PAID DUE
101,45 101.45 .00
101.45 OVER/SHORT; 00
FIRE SMIP/TOT GRADING PLAN—CHECK
1fMifMMlFltiFlfM7fM1f1fftfffflfikMiElfkMMMltlfk%lf1fMM7t1F1fifNiFiFlflfMlfMMMMiflfkMif7FiFiF1FM1EM1F1fM7f1f1FM1f1fiFifiF%MiFflitif
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I'O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTZNG� 1 ST 20 £A. ,75 15.00
ELE 27 FIXTURES, LIGHTING ADDITIONAL EA. .45 12.15
ELE 20 RECEPT/OUTLET 1 ST 20 EA, ,75 15.00
ELE 54 RECEPT/OUTLET '.• ADDITIONAL EA. .45 24.30
ELE 12 RECEPT/SWITCH •. 1 ST 20 EA, .75 9.00
ELE 1 SUB—PANEL �' 11.00 11.00
END OF FEES
U1 �01`25b7-0�1526E7 T�a T lOL 4E J
L�aTE� :='?"e/43 TIt'sE= ?fj.;g
CONSTRUCTION AND PLANNING
APPROVAIS Permit# Date I�spector
t. Temporary Electncal Service or Pole..
2. Soil Pipe•Undryrnd. � � ^'
crical CorvYU�N.Undrgmd. --
�
c
";-8{Fdundation ;�" �
��
9. �da[er Pipe•Ui�rgrntl.
1,0. Structural F�qar System
11. Properry Sewer Line & F-tduse Connectian
..
12. Seiver Ca - '
P e� o,
13. Roof Drains -
74. Ro�gn Plumbjr�g '`
15. Rough Electriwl•Condwt
76. Rough Electrie'�Viring Q
_ �a� �3��
„ 77. Rough Wiring$ign I
18. Rough Electrkal�T Bar Ceii�ng
79. Rouoh Heating & Air Condiuoning
-s,-r. ' ' . ' _ . . " ^' _'F.�CF� " ♦ c� :Ji.Ti'�`'I.�.R7
20'7Ra0gh�ac;arY�ireplace � S:7 �t�: .� � x x..APPfillVijCS�� Pa"tnit� ''�$,: y`:
.. � z .. .-a � �-��,, *; S _^'x , �:�-�t� � , _ �nR, _ , _
21`.,'.D4s:ts.�St�ct'yR�. � ... .�= s s +�;na 70.._
9 .
2 c Dwts. Vent^iatirgb .. � � : g�• 71.
23;,G�:Pi��RoDgh $�lest � A .r �+ : .. 72.
-��
:� O .
24�R�f R�amiry �; ' % . .:.. , . � �t s
-1 ' .a '� ^ � Y (�
25. flo�qf S,}�'.athing ..,� y y�'� G�_- � nir y
26: T• ar Ce�ling �Svur.w*all �+Aoa�coat ■� e� "� r+:r '
2i1 FraSne a�d FIasF�'tiB � _ ` # _ � �� �
i 2�.� Ldlhing.Fi Sidiltg�v i i 7-; : A' y • ••F 7
_ � t . .' � j r. x
� 29. Insula(rqn � = ' " ,; �. � ' � �
�
� 30. Orywai ,Nailing x �� �c y ' �
' 31. Piaster•Sro�i.� Coat � � �,r• > � � � e
..-i�fi - � -.�„ ,� � �r--�
-� 32;� Electrical Popuer ���c;��F��al m n• i �� f
"" {', i-�
_ 3�`: Fi I ETct�,ic �'1�- �
a
�-� � a � . �: -. , � -? �t-� -G�
; 34•�, Fir�31 Heatiiy & A�r Cuud.t�praiig r � �•
�_... . _<I r � �-,..r.
35; FiEal Gas PlprTest - � � '
� � r
{ H � F
� 36' HdAd or CanoPY ���' ' a Y f� 1 �. e
� I •^ f
'37QFiirBl FaQory Fv � 62R_ = � * "� �
. .. �' �-. ;-. � x �
1
', 38. Fi..ryil Plumbing �•• •. ti T , r,� :p
139. V✓ater Service-Final � � a , , �
a'_ r�^ � � :� r
;� 40. Gas Service-Final ; �; ,- ; � * ;,. ' �
_ 41. Solar pomesticFinaL' ' � •• �;: fr r�
- r I ' �.�_
'42.'Backfiow Prevente�' ` t: � � � �K #
43. Backflow ICSgatio� � �=:; a r x
/` s >.
�44. LandsCa�e h'ri9atipn SYs[eEajr � }-,. 7 ..;� t
_•�'
_4Y..Sound Att4�uatian �-+_,� , � E r - i��
� � m:r
�46: Handica;p Re�julati�ns � " "" "
G • t 7
h'1 1� a' � �
��47,,;F1(��AL STP,.i1CTlkRE & BUtLDING r� I . F
r � ' N fi
48: FINALPLAIVNIN�i m� �` � �' k t
�
•.49-�Elee[ric Rel�ase [o.�Edison , � i � ' .
�
r 5�. Gas. Release to So�lhern Cajifnlpja Gas Co ,� � j' �"�
':51. CE~TIFICATE OF OCCUPANCY , .,
No. Date �
POOL & SPA
APPROVALS Permit �p
52. Pool & Equipment Locat�on
53. Stenl Reinforcement
54, forms
55. Electrical Bonding
56. Rough Ptumbing & Pressure Test
57. APPROVAL TO COVER�GU�IiTF
58. Electncal Conduit�Undigmd.
59. Gas Pipa, O Undrqrnd., Test
60. Backwash Linas, P�Trap, L7 Undrqrnd.
61. APPROVALTODECK
62. Backwash & ReceptorFinal
63. Heater & Vent�Finai
64. Plumbing System - Finat
G5. Elactrical�Final
66. Solar System-Finai
67. Fencing & Access APPruv�l
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEhASFINAL
FIRE DEPT, RE�UIREMENT
�
Date Inspecmr I
�
�-`��-E� .. -.
Produ . �i m9'��as � Oii �
f�.�qi- ' ---
Under�r�^,�r�d F�i� ��-
-�'r�--> --e- -?�--ca=+c - -- -
UndergrA?1.Storar,�Tznk�OGas ".2Jif-- �-
i .�,
M r�
Ovenc�a�HVdrp� �
- '�'�--.------- ---- �
Dry Chemical - x �-+ '"% t*'r.�. „YcJ , .
t+� F:'^� X +�_- _ "
�7 � J F. • �S .� ?S �`!1 � .J -.
Dry StJr�y+'.K,pe �.. , i-�H�y'1^i:�i �
-2�--�G'-.--T"'�-9J-7"T „'^�'- -
FIXED .:TEaI`n INAE _. r x�' �----
FIRE PREV. F��;rj.L ; ti ,;; �.�:- _'��•�_�__ 4
---��---r----r- - •.. -
�F16ALTfv46EP'�.�7 EG�UI REfJFT� i:-
_[i.^.._-..ic.- 1--1tz-iL1:,.�' - --- - _- .
7�,' FINAL I�jtQECT,.�".�J�q �. r ': ''�: �' I
-7r{II-ar.i_-'XV _F__�,-a.t- .______ i._-_. _'
BQ:7 FOOD CERTIF.iL'AYE ISSUED ��, �
� 3� -^ --r-r .. <-
N3ies: , ��� l�JYG�� �0 �
�.s-�' nr- -mr--� - -��-��
- ;� 7; s �. <, C� ,
.j,, . � -' i-.�.^ � __=_7"��__ �
..r.•�• O'1 b1� 8 �r . _i
�
'� J � .-t � '
� . . r ',-T�F_- - _ _'
�:o .r � . �. ,
w.� .'1 '� }d '______. .
a - �S= '
�t. V d v`, ?:
_ �__._-_____ . _ .
H I �.
."�'m r c� -- --•
y
��_
�. `.^i a
- F • .:
T x
>: -
�`.• � �
v..
- - ... r, .r L.
x
,- +
�v • �n
�_.-o..�_
�-1 M J � i �: :�
C O' � C: �
/ h: . •'M
� 71� S
z ; ,�
.�..�.r.� �-�
�•� vn, �
li S 'F i
;�-r: + - __�
, q �1 * F I
r- t y y.. 1
'7 O.i ! �. �.'1:.�.��-
� t7 • : M �� �l . . . . . I
. : . :--Ca -_ � '
' .^J F . , .. ,'.Ci.rJ
I
�
r
��
�
PNOJECT ROOflESS: S S S ANTON B L UNIT: 1 Z 5
OWNEP'SNpME: HANK OF AMERICA —C.R,E.
pODflESS: ZO N. RAYMOND�AV-
PASADENA,CA,91105
818) 578-7700
FflCH/ENGINEEN: ROW W. HERHOLD ARCHITECT eEc.xo.: C-11073
nooeEss: 2555 AQUASATA uxir:
TUSTIN CA 92680
vexroinec: MECHANICAL ENERGY SYSTENS ( 818 ) 336-1218
AODflESS: IEIOZS ROBIN WY
INDUSTRY CA 91745
UCENSEU CONTflACTOB OECIAMTION: I �ereCy aifirm Ihal I am lic¢n5e0 un0er provisions af Chapte� 9(commencing wiih Section
7IXq� ol Oivisian 3 0l tlle Business antl Pwleuions CoOe. anU my license is in lull lorce anA effec�.
CITYLIC.: STPTELIC.:3SSBES c ss:C-20
��"�,0 /2.1���
Uate: �� 2' Signalure: _
WOflNEflS' COMPENSRTION OELNflRT10N: I here0y allirm t�at I Ilave a ceriilicate o� consenl to 5¢II-insure or a ceriificale ol Workers'
Campensalion Ju�iuy�c$ af q�r4liea coDY ��ereol (Sec�ion 3800. LaD. Li 1/ 01 / 9 4
roucrr+o.:REPUHLIC ZNDUST E%P.ORTE: U
COMPRNY: ,}�
❑ Certitietl ca�is �ereUy lumished. L1 Cetli�i¢tl Copy is IileO wi� ltlinp O� isioa
Date: ApDlican�:
` 2 �
E%EMPTION FXOM WOBNEHS'COMPENSp710N �ECIABRTION: (Thissection need no�becomplete0iflhe permitislorone huntlretl gi00�arless�.
I cerlily tha� in Ihe petlormance of the work �or which Ihis permit is i55ue0, I shall noi employ any person in any manner so as lo become
su�ject lo Ne Worker5' Compensalion Laws of Calilomia.
Oa�e: Signalure:
NOTICE: II, a�ier making Ihis declara�ian, you sAou10 become su�lecl to Ihe Workers' Compensation pmvisions of �he Labor
' Cotle, you musl lorthwith camply wilh 5uch D�ovisions or t�is Oermi� shall be 4eeme0 revoked. /
�� CONSTPUCTION LENOING RGENCY: I hereby allirm tha� there is a conSUuclion lentling aAency �or Ne pedormance ol the work lar,
w�ich this permil is i55ue0 (Seclion 3097. Civ. C). �
LENDEB:
aooness:
OWNEfl BUILOEfl UELLFNATION: I hereby alfirm t�al I am exemD� �mm Ihe Conlractors' State License Law for Ihe lollowing reason
�Seclion 7031.5 Business anC Pmlessional Co�e: Any ciiy o� toumy which reQuires a permil to cons�mc6 al[er, impmve, demolish, ar
cepair any slmtlure, prior Io iis issuance. also reQuires �he ap0�icani lot such permii lo lile a signeG Slalemeni �hai �e/she is licensetl
pursuanllo Ihe pmvisions ol the Contramars' Slaie License Law (Chapter 9(commencing wi1� Section 70W) oi Division 3 of Ihe Business
antl Pmiessions Coae) or �hal he/she is eKempt t�ereimm an0 Ne hasis lor Ihe allegetl e�emption. Any violation oi Section 703t.5 by
any applicanifor a Dermit subjecis the applicanilo a civil penaliy ol nol mote Nan live �un4reG dollars (5500�.
I, as owner ol IAe D�apeny or rtry employees wit0 wagu as I�eir sole compensdtion. vrill Ao ihe work, an0 �he
❑ sirucwre is not intenUeO or offeretl for sale (Section 704a, Business anC Professional Caae: TAe Coniracmrs' State License Law
Uoes nol ap01y to an owner oi a Dmpehy who builAs or impmves �hereon, antl w�o does such work �imsel0�ersel� ar I�mugA
�i5 ot �er Own ¢mpl0yee5. O�oviAeU Ihal Such impmvemeni5 are nal inlenaeA Or olleretl �Or sale. 1�, however �he building or
impwvemen� is 5dE vnlNn one year oi comDle�ion, Ihe owner will have Ihe burUen oi pwvinp he/she EiG not builtl or imprwe
lor ihe purpos¢ of 5a1e1.
I, as owner ol I�e pm0eny, am eMclusively comracling wil� licensetl comracmrs m constmci IAe D�ole�� (Seclion 7044, Business
❑ and Pmlession5 CaAe: The ConVac�ors' SW�e LiC¢n5e Law Ooes no� appty Io an owner 0� pmperiy who 6uiIQ5 or impmv¢Slhereon
antl wtw contracis br suc� pmlecls with a canlracioqs) liCense Oursuant Io I�e Conlratlars' State Licenst law�. I am aware
Ihat prool 01 Iheir Workei s Campen5alion insurante ShoWG �e pmvia¢G Io me.
� I am e�empl untler Sec�ion: B. 8 P. C.
br I�is reason:
Da�e: Qr+nec
I Uo nere�y cendy ihai I am aware of ana untlerstana ine reQuiremems of Cahlornia Heallh antl Safery Code Sections 25505, 25533, antl
2553A antl rtu� I or any �uWrt GuilOing occu0an� vniVvnll not (circle one) neeE to comply vrilh sai0 sla�e codes antl ��e reQuiremen�s �or a
pe�mp lor conslluQion or mOtldicaiion Irom I�e Ai� Ouali�y Management Oistricl. flesAemial Canslrvtiion apD�iCdiions are e[empl trom
�hese provisions.
Oaie: Applitanl:
I Aere�y ceriily IhaU �ave reaA t�is appiicalion ana 51a1e t�al l�e a�ave inlormaiion is carrect. I agr¢e to comply wi�� all ciry antl counry,
artlinancesa��s�at�lawsrelalinqlobuil0inpcon5lmclionantlherebyaNnor�veSol�AiSci�enleruPonlAeabove-men- ed
pmperlY fo� inspetlion Durpases. �
\
�a�e: �,�93 Signaiure:
�river's �mense or Socia� Security x:
ifiAb<6 Whue—BuilOing; Green—Co�e Enlo�camam: Canary—ApplicanC Pink—Revenue: Galtlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 06542�
PERMIT NO: M 065429 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: I—FR PERMIT TYPE: MEC PUAPOSE: ALT
JOB DESCRIPTION : INTERIOR OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H-2 /
+�r�***+�r**�r�r*���r�*Bir*�*x*�xr*�***��r*******************�**r**���%****�B*****�r�r�r*�e*
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN R6AR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV; PARCEL: 41050104 ZNE: AEF NO:
PLANNING NOTES>
>
-�,��»*�***�***»�,�**,������»�,��,�*****���,�,��*�*�*»�»*��,�*****,�,�,�**�**,��***��,�*,�,�,�,�*
, D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
•�ZONING APPAOVED HY DATE:
'BUILDING APPAOVED BY ; '��� DATE:
� I � � ,
�APPLICATION ISSUED BY; � � DATE:�. �23I
�ihiFitlfffltftMihlflfilifikM/fihMikllffif if1ElfKiPMiEMiFiF iEiF
7it%iFklfifitiEltiE1E�lMMMkMiFitlfifiElEMitlflEklfifllikifiElEiEiFififiElE7FfkM�1FlFififiEMiEMMlfMMifiEifiFiEiEN1ElFitifllMlfMiFiElEiEitlfMiE
�LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9.00
252 SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUZLDING—DIV—> PERMIT ISSOE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 15,00 0.00 24.00 24.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
1fMM�t�tiFiFMifififMMMiFitMMkMiFifiEMkkMltMMkkMMMitlfiElflkifMiFiEMifMMiEMifM%1FMMMiEiEMMKMMMiFKKMiFiFNiflEiflEfEiE1E
I N D I V I D U A L F E E B A E A K D O W N
TYPE (aTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9.00 9.00
END OF FEES
ot ooisz�+s-aoiss�is r �� � z4.oa
4r+TE: 12;?3193 TIh1.: 1?.:4?
.. , � ��. � _
CONSTRUCTION AND PLANNING P� _& SPA
APPROVALS Permitsr Date Inspector qppROVALS Permit,�
1. Temporary Electncal Service or Pqle- ' � 52. Pool @ Equipment Locacion
�
.2.. _15pd PID��Urn_,d(�q;y� - =� _- % 53. Steel Reinforcement
,�.�clect�Z:rGa^�ifiu:yyiltllity-Undrgrn�--L.+ �J 54. Forms
'. �;i--.s .
'_4.'Cti,ect;ia.A��S�'yi4•�ndrgmd. '^n 55. Electrical Bond�ng
�- �5E •ael���prierv�at ; X 56. Rough Plumbing & Pressure Test
�^---�- zf-�"F-i
.,-�,-�'r'- ec�t�f�JFEyj�rnd. -� =' S7. APPROVALTOCOVER-GUNITE
��pot y�.`� S� ,x ' 56. Electrical Conduit�Undrgrnd.
��--�---�-} � -�.
i�!�a,�undation a � -i 59. Gas Pipe, O Undrqrnd., Test
:�c •)
;9. �eter t?l�e-Und}gmd. 60. Backwash Lines, P�7rap, O Undrgmd.
�
_ I 78. StructUrol Flobr SYstem � - 61. APPROVAL TO DECK
�
�i`1, Propert;y,-Se�i�r�Lifla & Hbuse Conr�ection. � 62. Backwnsh & ReceptorFinal
�
��2• SeWe� �aP a�ei: o. o.' L � 63. Heater & VenbFinal
73. Roof Dra�n£� � , , 64. Plumbing SYstem � Final
i 14. Rough Plumo:nA '� . 65. Eloctrical�Final
15 Rough Electriwl-Condwt , 66. Solar System-Final
ti
,-i6. Rough'`E'Iectric�Wiring , 67. Fencing & Access Anproval
'-17. Fough!Nirir.g� -gn 8$, ppp({OVED FOR PLASTERING
�
18. Rough Electri�l-T Bar Ceihng 69. POOUSPA SYSTE67S FINAL
79. Rough Heating & Air Conditioning 2 �� / �/� FIRE DEPT. REQUIREMENT
�: ' C` '� s r-� .w �� �'/: .. 7`tJ, ,3�7' ..� - �: rp c.. O; r F. '
2Ci`;Rd�gh'�acfo`'fY �ap:�c., � �;� YS R 'S N �,�i * APPfj�1V,�'��FPe�t'iiit;r�T
� �.. � �-� <, . �i c- .. _. . . � _ , . � ,
27...D�F.:s,mSt:yct:'r,3 �•• •• �-+S k S C-�c * �70. ijnderg!tl�itif H�ro ��
_q--M y< <' ,X .-. n,
2?,c,D�s,�en+r�-itii�y# ��� r� ,.' �s *�71. Produe{�t`�'�yng:a��s L;.OiI
23: GatPip..`R Roqgh &�'est � in �,;r� �� p'i. x t+72. Undergrdttnd FkusPU � F
=7---"''!'-t-t=-!i'-t�c'
24.�flo:if Framiry �� , F�-� ••F � G y H� *;73?Undergrr�.S[ora(`�Tank'xL-IGas ❑v�l
25. Rqnf Sl�eathing :," ti v �� - :` :.� i a� y 74.: Overheed Hydrei)n-_�
- - - �#
28'�T-E3r Ceiling (StAieturali &7vh��coat k�, C' `� C! * 75� Dry Chernical ._� ti'"'' '= G
. . c _,
27``Fr�e�d FlasFl��. ��.� y c ����u 76. Dry St_ a��_C� ti� �
r -t.l- a
f-i28. LaZhmp•& Siding A,� ��x S Y£ ••! ,•'} * 77;" FIXED �`��(E�EtNA� ti �-�-
^ + ^ �` r U .-� .. .. - Y :�7 ti a: � X �
29. �nsulat'E:,�'n . � .. x � � �� �. 7 FIRE PREV. FINM17L +�� r 7
.. . . . . _c.._
^30. Drywa�'fiVailing �� � v � 4 � � ' � �1iEALT �EPlk RECtN11R,�M'�
� ' ' ' �'-=
�31. Piaster�.`�,,.-oiyn Gdatr � � ,.m r � � � .79�FINAL IRf$,,RECTI�N ''y � ' �
32."E�ectri-�' PC'�ierSlhtFn�^�� Finali�•t �- c� I 4� �• SO�T7FOOD CE TIFI �TE 19SUED `'T
�_ (� n . m . r --� S
: 3J��'��`il E¢Ctri� `�t R� � ? t� � t x* j'NOieS: -3�[� -�/�/�/i,�„__(�
--["`�-n �r-'-� _1,7;�r�T_•ocCE�
ti34,�Firral eacirtq�H`txCo�ditiorrit�g (-,$�� 1' J r ^ ,�^:.� . S�_+
{ �� ' �;" �
35;� Fii!'dl Ga's P;'bl�T�j� '7 r x � ° r , . (� ;ns • � �^ i-iC
1 .1 �:p N' .-� I x x:J :.HO 4 F[*'
::,36.�Hasd or CanoPVvt a ?.`� �. � ^ � 1 t < _ ; ;��'�''�-*�r' :`^
- .. - � �. : , i
;.�37�F��Sy;i Factory Fi��l�'c�e,K � �F � ; �' I �� � � J r N�;
.y38. Fin�yi Piumbing t,�, tV ' '-+ � y i � ' - • ., r � �-
_,� �,. . . - _ ,. _
��39. Wafer Service�FiflAf' � � � ' � , e � �,p�. •> v„r, .� y _G
:% a I i IC � s�+ t.. �[ E�
!�40. GasService�Fina,t��:i.� .�y;�,�n S .s m I � �. w� �-.i c;N >� cU
' 6:-: ^F+�,,,-:r ' � ` c . L� ..,
�41. Solar pomestic�h'�I� `� •• '= C+ I �` * '�' ' +
� c. � :Y � �' t �" '" � P '.' T.. �
'�42SBatkflow Prevnntex. ;t; I . i.y ,. � - t c' �
43. Backflow Ir�gatpr� � �=::� ` ' '• � # v °'
. R ?+ " C, II h (1
G �i . i . } :F w ' •J v
M44. LandseePe �«rigauonSVsterm[n� ,r, .,� ^.+ �. ���.. r� �; • ^�n t ro o
-, ..
f4$'�'Sound Atte�'ruatiq�Y ���:- �'"' � E e" �• �: t C'.. ^�; :
'� 'r ' i- i�7 Ri !*):} i' i 'Q ' 'r+l: T
�46F.Har.dicaFp R�gulaijons _ - y . . ..� y. , p� ' ..
• 475PIi�l STRAJCTUIRE & BULIDING � '� �r • w . k
" t � I it •f O' � F
48.JFIf, L PLAI�iNIF76 � ' �" � " �' %'
� .F;, x�. i « .7 ��
49.'Elearic Release to�£dison � � � , � ' � � > .
* a •
T50 .Gas Release to Sou�hem Callfotnia Gas Cn x , t;. � �, ; �j � � W
- 51. CEBTIFICATE OF..00CUPI#NC4 x . -. .. i� ; : _
Date
:
Oate Inspector
'. i
f
0
PH0.IELT ADDflESS: S S S ANTON BL �
OWNEN'S NAME: BANK OF AMEAICA —C . R. H.
noonEss: ZO N, RAYMOND AV
PASADENA,CA.91105
818) 578-7700
AflCM/ENGINEEfl:
ROONESS:
UNIT: 1 2 5
flEG.NO.:
UNIT:
PENMITTEE: GOLDF•N STATE FIRE PROT ( 719 ) 356-5699
aooeess: 15777 SLOVER AV
FONTANA CA 92334
LICENSEU CONTflFtTOfl OELIAflATION: I hereby affirm Ihai I am licensed un0er pmvisions oi ChaD�er 9(commencing with Section
7000) ol �ivision 3 af the Business an0 Pmtession5 Code. ana my license is in full lorce and eifeci.
ciTv .. 7649 STPTELIC.:3SOZZS „ �aSS,�C— /�
ale: Z'—Z- — SignaNre: _��_ ��
REBS' COMPENSATION OECLAApTION: I hereby aflirm that I have a cenificaie ol consenl to sell-insure or a ceni�icate o� Workers'
Compensation r�a9c9. ��Q�.�'e� �q� �ereo� �Section 3800. La6. � 3/ O S/ 9 9
eoucrxo.:REPUBLIC IND EXP.ORTE:
COMPFNY: ,}�
❑ 'fie0 coDY �5 hereby �umis�etl. 'L7 Certi�ietl copy is �ilea with the ciiy Building Division.
aie: Z'22 � FPPlicanL / 1-��,... Gi �/ �
%EMPTION FAOM WONNEflS' fAMPENSATION UECfAPATION: (This seclion neee not �¢ trompletcd ii �he perm� is for one huMreE �5100� or less�.
I cetlify that in Ihe pedormance of tt�e work br which ihls permit is issueq I s�all no� employ any person in any manner so a5 io hecOme
sublecl Io the Workers' Compen5a0on Laws o� Cali�omia.
py�e_ _ Signature:
NOTICE: If. aiter making �his declaration, you shoultl Eecome suGlec� to the Workers' Compensation Orovisions oi Ihe Labor
Cotle. you must farthwilh comPry wi�h such pmvisions or �his Dermit s�all be OeemeU revoke0.
CONSTBUCTION LENOING RGENCY: I hereby affirm ��at ��ere is a cons�mciion lending agenCy for �he pedormanCe ol �Ae work lor
whic� ��is permn is issuetl (Semion 3097. Civ. C).
LENOEN:
aooness:
OWNEF BOILDEfl DELLAflFTION: I hereby aifirm that I am exempt irom �Ae Contractors' $tate License Law �or I�e fallowing reason
(Sec�ian 703L5 Business antl Pro�essional Coae: Any ciry oi couniy which require5 a Dermi� to constmct. al�er, improv¢, Oemo�isn. or
repair any 5tmciure, prior to its issuance. also requires ��e applican� �or suc� permit Io tile a signeC staiemen� Iha� he/she i5licensed
pursuant m ��e pmvisions ai the Connamors' Staie License Law (C�aD�er 9(commencing wilh Section 7000� of �ivision 3 oi the Business
antl Professions Coae� or tha� he/sne is e�empt there�mm and the �asis tor ��e alleged exempiion. Pny violalion oi Section 7031.5 Dy
any applicant for a permi� subjecis �he applicanl to a civil penalry oi noi more Ihan five hun4reU tlollars (E500).
I. as owner of ihe pmptny or my employees with wages as iheir sole compensation, will Oa ine work, antl Ihe
� slmclureis notintentled or a��ered for sale�5ection 7044, Business and ProlessionalCotle: The Coniractor5' Slate License Law
Ooes not apPly �a an owner o� a pmpetly who bui105 or impmves ��ereon, and who tloes such wafk �imself/herself or �hmugA
his or her own employees, P�ouided that such imOmvemenis are not intende0 or offeretl lor sale. II, however the buil0ing or
improvemen� is sold wit�in one year a� completian. Ihe owner will have �he burden ol O�oving he/she 4i0 noi build or imD�ove
lor the purpose oi sale�.
I, as owner ot ihe pwperty, am exclusively contrac�ing wi�h licensetl contrac[ors �o constmct I�e pmject (Section 7044, Business
❑ and Professions Cotle: The Conirac�ors' Slale License Law aoes not appty to an owner oi propehy who builOs or improves theteon
and who Contrad5 lor Suth Prolects with a Conirat�oqs)license pUrSUant b the Conirat�ors' Sta�e LiCense Law�. I am aware
�hal pmof oi �heir Worker'4 Compensation insurance 5houlA be D�ovide0 to me.
� I am exempt under Section: B. 8 P. C.
br ihis reason:
Da�e'. Owner.
I Do hereby cenily that I am aware o� ana untlersiantl the reQuiremenls oi Caliiomia Health an0 $afery CoDe Sections 255Q5, 25533, an0
25534 and Ihai I or any iNure building ocapan� will/will not (circle one) neetl �o coroply with said s�aie codes antl the requiremen�s br a
permii for cans�mction or modifica�ion imm Ihe Air Oualiry Management �iSVicL Resitlential conslmc�ian applications are exemp� Imm
these pwvisions.
�a�e. Applicanl
I hereby certltythall havereaa Nis applicalion antl siate tha� Ihe above inlormalion is correc�. I agree lo comply wi�h allcity and counly
ortlinances antl s�a�e laws rela�ing ta butlding consimction antl here�y aN�orize reD�eSen�aiives ol �his ciry to en�er u0on I�e above-menti0netl
pr spectmn purposes
0 . �.i—�2—`'�S— Signature� � l^ ��
oriver's Lmense or Sociai Securiry x-
1641-46 Whne—Butlding; Green�Cotle Enlorcemenl', Canary—Appl¢anl; Pink—Revenue: Goltlenrod—Assessor
CITY OF COSTA MESA — HUILDING PERMIT PERM NO; F 0 542
PEAMIT NO: F 065425 PLAN CHECK NO: 04872-93 S GO . ,
CONSTRUCTION TYPE: I—FR PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR OFFICE T.I. SQ FT;
CLAIM VALUE: 3,800.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: FOA " B. OF A. SYSTEM ENGINEERS"AT THE FIRST FLOOA
**+r***�r*�r*�r�r�r**�r�*��r*+r**�r�r*�ex**�r+r+r****+r**�r+e***x�*�r�r*�r*�r+r***�+r*�rx�**�r+r****�r�**�r��+r
Z O N Z N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGE[T: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
>
ik i! if if it k if M 1f it iF i! ik it iFlF ft if ff if 1k 1t if k M M iF M iF iE 1! if M if 1f �E 1E M 1Elk ik fF it it iF iF {f k!t kit it M if %iF it it 1E M if if 1E it iF i! iF iE if k iF iE 1E iE 1f if itlE ik
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED_BY ; DATE:
APPLICATION ISSUED BY; �L C� DATE: Z ZZ� J
1FitfFififitiFltlklENikiFifffiFMiklkififM ft1E1l1EfflEitMiFi! lfiF
1f iE iE if 3E iF iF it 1E iE f! it iF if if M M it M iE iE M it iF if 1E if if iF 1f if iE k if iE if 1E if iF iF if M iF if iF iF iF it fF M M 1E if it iF K if iF if iF iF iE 1E iE 1F 1F iF iF if iE M iE iE iE i! iF 3f iE iF
LEGALIZATION;N F E E S U M M A Et Y STRUCTURAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIp/RES GRADING
PERMIT 63.00
652 SMIP/NON—RES
ISSUE FEE '10.95
BUILDING—DIV—>. PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> �.,63,00 0.00 40.95 103.95 103,95 ,00
1
REVENUE DIVISION TOTALS--> COLLECTED; 63.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63.00
ilif iFiF iF it iki! if ik iE if 1E iF ikk kif if iFiF if 1f if iF 1f iF if k if it it it ik ik ik itiFiFiE i! k if it if if iFMiF it �f itiF if 1! if 1FiF iFif if iF iF�F3t iF iF if 7!i! if iFiF1lif itif if if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 63
FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00
END OF FEES
. ��
', !
1
63.00
US Q01,271:-031i2%tl T�C�T oS.O.^,
C�A?E: 12/2�/4o T?M=: ibc13
C6NSTRUCTION ANp PLANNt(VG �' F _& SPA
APPROVA�S Permit #� Pate lnspector RPPROVAl5 Permit �F Date � lnspectorT
7. 7emporery ElecYricai Se��v{ce or Poi� - . 52. Pool & Equipmant Location - �
�
. 2. Soii Pipe-Undr md. •'� '� ���' S3. Stee! Reinforcemeni � � ��
:��.,...�, .-�.�., ,�, ,.�
,��c�:_g�ectCical Can't�} z�JtiVity Undrgrriy � . 54. Forms �
a-�--- .
`�4,�'E?ectrica! �ori�£vnVJndrgrnd. ' c� 1 � 55. Electrical 8o�diog i
�, .. , r .- . �. _ _"_._.'"i
^"-
�=rG^�ee�fieln?or��i�i2 ,i � � 56. Rough Plumbing & Pressura Tesf � ;
rp"'!
�: `_`'�,:61eCtfical'UF£�.Fa*Grnd. �v 57. APF'ROVAI i0 CGVER�GUNITE a �
.• en r ..i � , :-.1-��. �'�
�"' oo �ngs r`Z ,;'' S8. Electrical Con@uit-Undrgrnd. �"'�
7 -+�c;�, �.�
��;��oundatioe, L�;� , '� - 59. GasPtpe,Cl Undrgrna.,Tesi ' �
-; "' ^'
n9. rvn3ater Pipa-Urt''�rgrnd. • ; � 60. 6ackwash �ines, P-Trap, rJ UndrGrnd, �
:i0. S�rucaara( Fia`�,r SYszem , w � 61. APPftOVAL TO DECK �
i?ri. PreP�rty Seev�r Li�e & Hause'Connectlon 62. Sackwash & Receptor-Fina1 �
i2. Sewer Ca a, ,;y " ��
P � . 83. Hea2er & Vent-Fir.ai �
13. Rooi Drains w � 6A. Piumbing System - Final
�: �
74. Rough Piumb�� `�' 65. Electrical-Final �
15. Rough Electricat-Condu(�r 66. Soiar Sys2em-Finai ��
i
26. fta�oh Elec2ri�Wirin9 67. Penein� & AccessAppr��ai � `
1
-----Y
i�77. Rough4Niringv5lgn 68. APPROVED F6(� ('�AS7ERiNG ..
^ - -----+
18. Rau,n Elect,P'�aI-T Bar Cei(�;ng &9. POOL?SPA SYSTEh;+,S FINAC -�--u-�-,., ;
19. Rough Neacing & Air Condit�onlr,9 FSflE DEPT. RGQUIRER-0eNT '
.`1-�- : . -t�^^---_-___�-?na::__s. � - r._._.<c . t .- � F-' �,-� [" I
_x
2C:; ft6ugh(`vac�ry FiPepiace i G ;!�"' * C'� - �'* �-.APPRQVA��S:7C PeEMit �_ + ?� t-+ �
•_.+ �; .r v � : S r'� S C'r' �' ( , �: ('�'-i � # iT �
s `l � 1 i ;- 7:':,. .R ti ,.. � ._. , r. 'F :'! i
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No. Date t
" ` (
I1
�oonwaew�ncm: 555 ANTON HL
wmeasru�eica+wrK'SAKIOAKA FARMS
'0D"� PO BOX 2097
TERMINA ANNEX
�vv�. �wima �noxEst
u"t: 1 S T
"^�""ECTON�tlN� INTEFiIOR ARCH.2136232164 �"°= C-9378
1RBw0R�'f°0°"�' SSO S HOPE ST uNr: 1100
LOS ANGELES CA 90071
C0N1""CiORBNA1� CAL PAC ( 310 ) 645-3500
B01iR"GT01°�'°'"'0 6076 BRISTOL PKWY
'0°"� CULVER CITY CA �c�= 392102
90230 �Nr:
LICEN9ED COMN�CTONB DECL�N�TION: I h�nby dlkm und�r p�nely M pr�ury I un IbnpE uMa p dom of Ch�Wv Y
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CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 07635
PERMIT NO: B 076355 PLAN CHECK NO: 03709-95 A GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 1800SF / RESTAURANTS SQ FT: 1,800
CLAIM VALUE: 35,000.00 �CALC—/ 34,%76,00 GROUP OCC: B-2 /
COMMENTS: 76 PRODUCTS CO / 6 SUBWAY
******+t***���*****���r**�* �a *�***��x��***�* *�x�x��***���*+t��r�r*+t***�*u��*�r****
Z O N Z _I. R E M E N T S
S E T B A C K S
------------ MAIN BOILDING --------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN , LEFT: FT IN RGHT: FT IN
PARKING RE(� • PROV: PARCEL: 41050109 ZNE: PDC REF NO:
PLANNING NbTES> TENANT IMPROVEMENT FOR 76 PRODOCTS CO., 1ST FLOOR -
> FAST BREAK ROOM "
1F 1F iE fE jE iE 1E IE 9E iE fE 1E 1E fE iE 1E 1! iElE 1ElF 1E iE iF 3F if if iE fF jE iE iE iE 1f if Ik 1F 1E iE 1E iE iF 1E ik iE 1E 1E iE ib iE 1E 1E 9E �E fE �E iE iE iE iE iF fE iF 1E iFlE 9E 1ElE �E 1f if ik iElf ff 1E jE 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N,-T S
ZONING APPROVED 8Y �,�� ✓� DATE: — /
BUILDING APPROVED BY ; I/CI i � � DATE: 1I%, Z� 6
❑ i�a..mp��e«s«�: e.avc,m,�n�.,sa.�: APPLICATION ISSUED BY: I�<
oms: � ow�er: * ik iE fE �E iE iE iE iE �t �E x-* �t * it **** iF ieTF7'F3F�F3F �TflF3FTFiF3FTF3F � iETFTFTFTFTFTFTFiF7'FTFTFTFSf�FiFiF*
i ao n.r.nr c«wr ma i.m...�. a.,e �.w�.��e m. nw�,«�.m. a cauo�:. �..nn w s.ien coe. s.a�. uws. mm..�a
LEGALIZATION:N F E E S 0 M M A R Y
uSN, W Mq I w enY Mun driknro maipeni win l wil ml Id�cb aw) riseA ro campN r+in uiE etle mEw eM iM nwiiwnena br
apwmatammbutlbnamoddrNiontrwniM�i�y enepemempiprid.qe�Mwuolmnnruuioneppireiiauenenemqlmm�Mw BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
p°"�"" PERMIT 317.00
oe.: �od'sm: � , �
WOHKEN'9 COMPENSATION DKL�N�TIOM: I MraEy df uMr p�nMy q pr'ryry on� d iM lobwinp d�dvtliom:
❑ 1 Mw wd N m6aen. aeW"uu M mroeni to wtlJnwne br r.a�k»• mmpemuion. e pwid+E 1« W Saaim alW a iM lebar
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.(^ waF la xliidi Nu V�M u oud. MY wvFen' odnGermlion inanencs mnwr W V�Y wmber ue:
c.m«: T.TRPRV M�iTIIAT. EXPIRES
P��'^�^� w1�66nnnanan-nFF 02/O1/99
(rn's e.aiw, rroaa nor w mmpbteC � w w+m� w m, wre nund,ed edl,�. rs�ool d ro.l l '
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��w�/M�� oo, a s.n� a�oo a ine �c« cm�. i�i ann.�� w.mm � o��o �
Dv �. /��/ .� �� ADVlcenl: ..�1lI • �
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n m.s �p ro aw n�nerw Nouwie adlw lSfoqaooA b�iuon ro a eo.� o� co n e+m.w u povro.e ro.ln
S�etlon �)P6 al tln LNor Cod. Iner�st. �rM ettomsy'� Isu.
CONSTIIUCTION IENDINO �GENCY: I Irreby elfirm uMer peneRy d perjury ihd �hra u e cmv�wfion WMilq e{�ency In Jr
�n,m„M. a n+.on� ro� wda� ine o«m� A�»a �s.a:M aoo�. c�. c�.
LENOEP'S NRNE
LENOEP'S �ODNE34:
I cendy �M I hma neC Nis eppfra�ion uk qds tMt tlro ebwa iMwmetion u consq. I epns lo camp!/ w+th eA cey mE wmtypCiiw�m�
enE auu le+s mW�q io ddd�q m�mueion eM hereh' aNhor¢s iwawmeli+w d Ne mY �o wx upan iM ebora�mworiaE poWM
�« in.waiw, o�w.e..
150N MIT
I/ � Pnm /J /
� !� + // Y � ^��'%L. De�G: �+C��/�>
q re tl A pIX � •
(5151d6.WP)
Selery: Green-Fle: Cenery-�ppl�ani; Fnk-Rewnue; poWenrod-Avmpr
1�7�l�i�J
3�aF�� iF-i�i��t *
SEGMENT:Y
SMIP/RES GRADING
SMIP/NON-RES
PLAN 51.51 ' ++ 7.30
ISSUE FE£ i
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PI�ID DUE
TOTALS----> 324.30 0.00 .,, 51.51 375.81 375.81 .00
REVENOE DIVISION TOTALS--> COLLECTED: 324.30 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
317.00 � � 7.30
iE If iE iE iF if iE 3f jf if 1k 1f 16 iE 1F iF IF 1E IE 1E if iE ib fh iF 1f if !E ik �E IE IE �E iE K If IE 1f 1E 1E iE iE iE dE �E 1E iE iE iF iE k�k iE iE 1E 1f IF iE iE iF 1f �E iE �E iE iE iF iE ib iF 1f if 1E iF 1f ff� iE iE iP
I N D I V I D U A�L� F E E B R E A K D 0 W N
TYPE
SFC
SFC
SFC
QTY
1800
1800
1800
D E S C R I P T I. O N .�
OFF—INT. ALTER TYPE I,II'F.R. —AVER
EQU—ALT COMM. SPRINKLER SYS —AVER
EQU—ALT COMM, AIR COND —AVER
END OE' FEES
0
UNIT COST
18.24
.36
.72
TOTAL COST
32,832.00
648.00
1,296.00
�i
\
• CONSTRUCTION ANO PLANNIIVG i. � •��L & SPA
APPROVALS Permit#�- Date Inspeetor pppROVALS Permit# Date Inspector
�
1. TemDorary Electrical Service or Pole 52. Pool & Equipment Locatiorj . �
2. Soil Pipe•Undrgrnd. �� 53. Stee� Reinforcement � .
3. Electrical Conduit Utility�Undrgr�d. 54. Forms � � •
4. Electriwl Conduit•Undrgrnd. 55. Electrical 8onding
5. Steel Reinforcement 56. Rough P�umbing & Pressure Test -�
6. Electriwl UFER Grnd. 57. APPROVALTO COVER�GUNITE �
7. Footings 58. Electrical Conduit-Undrgrnd. �
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-U�drgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Svuctural Floor Syscem " 61. APPROVAL TO DECK �
11 . Property Sewer Line & House Connection 62. Backwash & Receptor-Final .
12. Sewer Cap - � 63, Heater & VenFFinal . �
13. Roof Dreins i ' 64. Plumbinc� System • Final
74. Rough Piumbing 65. Electrical�Final
15. Rough Electrical-Conduit , � 66. Soiar System•Final � '
16. Rough Electric Wiring 67. Fencin9 & Access Approval� �
17. flough Wiring Sign 68. APPROVED FOR PIASTERING -
18. Rough Electrica6T Bar Ceiling � 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' � APPROVALS Permit #
21. Ducts, in Siructure •• 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil �
23. Gas Pipe�Rough & Test � 72. Underground Flush
24. Roof Framing' � • ,73. Undergrnd�StorageTank OGas ❑Oil
25. Roof Sheathing - ' 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat -� 75. Dry Chemical
27. Freme and Flashing _ 76. Dry Standpipe
28. Lathing & Siding � -`� ' 77. FIXEO SYSTEM'FINAL
29. insutation 78, FIRE PREV. FINAI '
30. Drywall Nailing '. HEALTH DEPT. REQUIREMENT
31. Plaster 8rown Coat� � 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric , Notes: q Zj/ 6 A��„r���.lz,�_/�
� / - -r1
34. Final Heating & Air Conditioning ' • , '
35. Final Gas Pipe•Test - �
S/)/t6 _A�Y�..✓�C/ei .�
36. Hood or Canopy . �
37. Final Factory Fireplace
38. Final Plumbing
39. 4Vater Service�Final � _ ' �
40. Gas Service-Fina�
-41. Solar pomestirFinal
42. Backflow Preventer -
43. Backflow Irrigation
44. Landscape Irripation System ' - '
45. Sound Attenuation ,
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING �Z6 G/{j � ' .
48. FtNAI PLANNING . ' � j : �
49. Etectric Release to Edison _
50. Gas ftelease to Southem Calitornia Gas Co _ .
51. CERTIFICATE OF OCCUPANCY
No� Date
�I
�I
ROOHRS OF BNLOPIG: .J J J HN 1 V IV D L
OWNEM'SNWEIFppMlL SAKI�OAKA FARMS
.00x�sk PO BOX 2097
TERMINA ANNEX
�vx. wuuxc �uoness
uNr: ST CITY OP COSTA MESA — BUILDING PERMIT
PERMIT NO: M 075933 PLAN CHECK NO: N
CONSTRUCTION TYPF.: 1—FR PERMIT TYPE: MEC
�xcx�cTox�ffn: INTERIOR'ARCH.2136232164 uc.xo: C-9378
AqCIIOPEHO.'411WflE55: SSO S HOPE ST urn: 1100
LOS ANGELES CA 90071
���T�s� AIR CONDITIONING COMPANY (818)244-6571
caxrn�crorrsYuiwc 6265 SAN FERNANDO ROAD
,�p�u, GLENDAI,E CA ���, 120696
917.01 uNT:
LICENSE� COMNRCTORS OECLAN�TION: I �amCy ell'�rm unEer peneAy d parjury Nm I em f rmed i�Mx pwivipro ot Chepm 9
(oommenarq rmh Senian )000 d Dir»ion � W Il�e &nineee enE Prolmeione Gode vd my licenae a in lull lpce eM eM
cmuc.no.:01940�3 uc.cuss: C 36 uc.No.: 120696 EXP: 0�'//96
Oaie: .�'� � �l CaN or:_ . .✓� �/ —
OWNEN BUI�DEH OECLARRTION: I hreby etfiem under parely d perN�Y �� I em emmq tmm ihe Camrma oeroe� Law Iw tha
Idbx+q reum (Setlian )W t.5 &niwse eM Rdeaeane Cotle: RM ciY a muniY which �e0uim e G�� to wnshuct. ellm. imMove.
demdah. w repei mry smlaure. prior w �s oeuvwe. dso rtQuiree tM applirem la euch pemw �o fib a eqned swemem tlw he a eha
o IicenseE purn��eru m �he pwieiorn d ihe Comreaaa License Lew �Gheqm 9(mmmmmq rmh Saeion )OW) d Oi:eion 3 W �he
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J0�1.5 b/ enY WG��� ia a permil wbpCf tM epplicanl lo e crvil penelly d nal mwa then (xs huidrld ddlan �5500�).
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, orofleredMseb(SecYan)Ou.BusmueMPrdeesbnaCoda:TheContretlaalimnselewEoeandeOWYtoenormerolOroDeM
,.. wro w�a. «mw�+inereoa ene..no aoee a�m.oa mmsen a nenw «w�ayi w Q ne. o.n •maM.d. w�+dea mm e�cn
�maa.m.w �a �a ���dee «on�a �« a.�. n, now�«. ma n��ame «mw�em s.�e.anm w ro.� a wmo��. mo
ownervEuitlm xill heva �M burden d wm'in0 ne or Me ek no� build o, impwe 1« lM WT�s a eebl.
� 1. n owror d iM O�W�Y. em uWmely wn�rm�q xnh liranead caNreclon io emmua Ne pW� (Seuion )dd.8uvir�e vk
PMamaie Code: TM CaNrodas licenee law don m� eGWY b en owner d papeitY �}n Wi1Ca a'unD�'m �hraon vd who
coMrecb Iv wJi popes wnh e mrumeor�e) IceneeE punuem to iM Convrfas llcave ler�.
� I em exemq uMu Seciion: B. 8 P C., lor Nia reeaon:
Deta: O�mer
I do hereby cenM � I em ewersW eM �Mmslend ine raQuiremaM� d Cellanie HeNh eM Sdery Coda Seaions 25505. 255J3, and
2555a, en0 tlw I w ury Mure buikirp oocupent will / wYl nol (circb one) naed la cwnpry wIh uiE peb mEu eM IM mpuiremann br
s pertnn Iweonstruciion a moEifreiionhom�haA'r�epamem Diqrid. Reaidemiel mrutrveion eppiraioroersuamqimm ihxa
womro�,:.
o�a: �ooiKeoc
WOFKEfl'4 CONPFH9�TION OECIAR�TION: I Mroby elfilm �nEe� panMy d pa'ryry aw W ihe Idbwi�p detleiuum:
� I heva erd xil meiMen e cMliule d wmant �o veMinaun fur wwken' oomqnwion, n pwdeA tu b� 8wion J)00 d iM lebor
Cala, la IM pMmvncs M Ne xak In wlich ihu pem�n ia lnuM.
�] I �mW wil meimew noMae' aompenulion insurence. m repuiroE Ey Saaion 3rop d ihe lebar Coda. br iM palormenm d Ihe
��a.na�i�w�am4+�.a.Mr.,«�n����°l�%°�°�'u'mw....: EXPIRES
c�«:
Polic�' Numis: 1 �� � 1� 9 6
Rn;: eenia, n.ee nor ae candnee e rne vmm� �+ ro, o,b nmid,ae ddr.nlsraol a bn.�
� I cenly tlut in Ne perlmme�o d tM wak far xfiich Ihis pe1mil b iseued, I Me0 nal emWq eiry penon in eiry manmr o u to
br.ome wbjetl to IM �a�Yae' wnpe�wLLion lev.a d Celifamie, arM epree Ihet 0 1 YOWJ Eecortr abjeC to iM v.wken'
comp)emuion qwuioro d Sauion 3]00 d iM lebor Cotle. hv.iih mm/py wGh ihoea pv+nio�u.
Oma: J '-Z.l ��� AV �.J �L ' �-! �
W�minp: Allw ro rcun woitwi rompwwtlon covsreps l� unNwNl. �ns �Hll NlJ�cf+n wmploy� Mml pxuttlu �M
c/Hl Ilnu W ro om hvWreJ thouuM aollw (JIOQ0001, In sAf/tlon ro IM cwf o/ compmutbrt �O+s �i poHtled br In
Swtlan 31P6 0l M� labm COJ,. Int�ut, mC �fromsy'� IN�.
CONSTXUCTION LENDINO ��ENCY: 1 hmeby elfiim untler penelry d perNrY �� �Mn u� mrmrutlbn bMieq epeney br IM
perlormeMe d IM1e xwk la whitl� thc permY o uweE (5eaion 309). C'rr. CI.
LENOEN'S NAYE:
LENOEH'4 �DDHESS:
I corlily �hm 1 heva neE Nb applietim vd ane Ihel ihe abwa inlamdion %coneC. I epres to compfy xilh all ory and muMy pdineMee
eM etaie lews nkliq w buildiq omm�utlim ud Mraby euiMrize ieqewnletnva d thu ery to Ma upan Ihe eEova.memunad pvpe�ry
'«'"'D°"'°"°"'°°°°' LOUIS RODRIGUEZ
Pneu Neme
� ��li���� ome: .� —�-5%
sy�mureaow�wn vc«n.ea«
(5151-48.WP� Whne-8�ldiq d Sefery; GreerFle: Genary-AppFcent: Rnk-Ra.enue; (3alEen�od-Avsmmr
PERM NO: M 07693:
GOVT: N SUPP: N
PURPOSE: ALT
JOH DESCRIPTION : INTERIOR 1800SF / RESTAURANTS SQ FT:
CLAIM VALUE: T�Co L�C—/�ALUE: GROUP OCC: B /
COMMENTS: 76 PRODUCTS CO / n�'��c^�^ S SUBWAY, RE:#B76355
*fE*****�t****�t******atet�r�tx�et�t*��****+�+t�-�t**i�x��r�****�*x�*x�*+�****x�*atat**iEx�et*****it�****x�*
Z O N I N GS ERTEBgAUCIK�SE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES>
% �
1E IE IE 1ElE 3E iE IE IE ff IE 1E 3E 1E 3E 1E 1E 3E iE iE 1E aE iE iE 3E 1E 3E IE iE jE iE ib iE iF if if if lF�if IE iE if �E �E jE 3E iE iF iE if jf iE iE jF �flE �E �E iE �E 3F iF if iE 1f if ik iE if iF 3f 3E fE �F 1E �E jE iE If
D E V E L O P M E N T S E R��V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY �,n DATE:
BUILDING APPROCrED BY ; ��l _ __ __ DATE:
LEGALIZATION:N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 35.00
25$
PLAN �;,
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 35.00 15.00 n; 0.00
REVENUE DIVISZON TOTALS--> COLL`ECTED: 5
BLDG PMT PLOMBING ELECTRIC tkECHANIC FIRE
��50.00
DATE: ���EO( �6
��ifiEiEiklfifl!lE1E3E�iF;E�i� �S��EiE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
50.00 50.00 .00
0.00 OVER/SHORT: .00
SMIP/TOT GRADING PLAN—CHECK
i61E if if if if iF iE 3E if iE iF iF fE if 1E iE 3f iF if 3E iE iE if if iE iE iF if iE iE iE iF 3f IE jE 3E dE iE if iE IE iE iE iE iF if iE iE iE iF iE iF jEif 1E iE iE 3F 3f iE iE �F iE 1F iE �E if 1E 3E iE 3E �E 1F 3E iE 1E if iE
I N D I V I D U A L", F E E H R E A K D O W N
TYPE QTY D E S C R I P T I 0=N ONIT COST TOTAL COST
��
MEC 1 REPAIR/ALT COOLZNG !<UNIT/SYS W/CNTLS 9.00 9.00
MEC 1 INST HOOD W/DUCTS FjED BY MEC EXHAUST 6.50 6.50
MEC 3 VA6� BOX " 6.50 19.50
END OF FEES
• � �
J-`
�-.
� -,,, -
� -• - - .'•.:
�
� v .,�•
' CONSTRUCTION AND PLANNING P�JI & SPA ,
iAPPROVAIS Permit# Date I�spector AppROVALS Permit# Date Ihspector
1. Temporary Electrical Service or Po,le 52. Pool & Equipment Location
. 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. �Efectrical Conduit Utility•Undrgrnd. 54. Forms "�
• 4. Electrical Conduit-Undrgrnd. _ 55. Electrical Bonding
- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrica:.UFER Grnd. 57. APPROVALTO COVER•GUNITE
7. footings . -- � , 58. Electricai Conduit�Undrgrnd.
8. Foundatiori � -• '� 59. Gas Pipe, O Undrgrnd., Test '
9. Water Pipe-Undrgrnd. . ' 6Q. Backwash Lines, P-Trap, C] Uodrgrnd.
10. S[ructural Pioor System � 67. APPROVAL TO DECK -�
11. Property Sewet Line & House Co�nection 62. Backwash & Receptor-Final �
12. Sewer Cap . 63. Heater & Vent-Final
13. Roof Orains 64. Plumbinp System � Final � �
74. Rough Plumbing 65. Electrical-Final ,
15. Rough Electrita�-Conduit , 66. Solar Svstem-Final '
i 6. Rough Elettrit Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING •
18. Rough Electrica��T Bar Ceiling 69. POOL/SPA SYSTEMS FWAL
79. Rough Heaiing & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace .� . . APPROVALS Permit #
21. Ouas, in StruCture 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping O Gas OOiI
23. Gas Pipe�Rough & Test . 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storaye Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoa2 75. Dry Chemical
27. Frame and Flashing. - 76. Dry Sxandpipe '
28. Lathing & Siding �� � 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTIi DEPT. REQUIREMENT
37. Plaster Brown Coat • 79. FINAL INSPECTtON
32. Electrical Powzr Meter�Final � ' 80. FOOD CERTIFICATE ISSUED
33. Final Electric � _ Notes: C_�S �j �l_
� ��
34. Final Heating & Air Conditioning ,[S � ��
�z�- �
35. Final Gas Pipe-Test � �
36. Hood or CanopY -
37. Finai Factory Pireplace - -
38. Final Piumbing � .
39. Water Service-Finai . , .
40. Gas Service-Final �. � "
41. $olar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem �
45. Sound Attenuation
46. Handicap Regulations
47. FiNAL STRUCTUft�E & BU4LDING -�
48. PINAL PLANNING „ - .
49. Electric ReleaSe to Edison � _ -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date �
�
� '
AODPESS OF BVILOMO: �. J J 7_ NN 1
a�m�as�wu`e�is�wavn: SAKIOAKA
AUDFESS PO BOX ZO
TERMINA A
APPL. M�II1N0 ADUNES4:
.. .UNT:._ 1J1F.,
urcxnecronu+m/�n:..INTEAIOR_ARCH.2136232164 uc.xo, C-9378
nacx.onua.�s�ooxus: � 550 S HOPE ST �NT, 1100
. I;OS ANGELES CA 90071�
���� � MORROW MEADOWS CORPORATIO (909)598-7700
cam�croxawauxo p O HOX 509
WALNUT CA 230813
A°0RES9` 917 8 9 �` ND
uxT;
LICENSED COHfP�CTOPS UECLANITION: I heraby ellim wdx periely d pwjury thu I em licemed uMw poviaon� of Cheqer B
(mmme�ip wnA Seciim )000 d Oiviaion a d �he Busnm eM PMneims d ms u in lull laro vM
ic.no.:00655� uacuss: C 10 uc.N ����� EXP• �� 96
�, - 3 - G ��� :��
W N BUILDEfl DECIAflAT10N: 1 hmeby dfum wds paWy d perjvy �he1 I un a�emq tmn iM Camreaae Lirome lew ta ihe
w'vq rcsron (�ian )03t.5 Bueinae uW PMeasbna Code: A'ry cry a countY �� �Vuiree e pertnil to mvVucl, ellar. improve.
aamdmn. «,ov� �r s��,n�. w+« w m o�,�., wo �a� �ne «od� �«.� v� m rue a w�oa nmemom wm n, o,.ns
ie licensed pum�ent lo ihe prwisione al lha Conireqon Lioen» Lnw �Chaqer 9(oommario�q xilh Seticn )0pp) ol Divwion 3 d �he
Bueiriea end Rdmsione Codel «�het M a eM o emmP �herehvn vd �M bme ta Ne eAepaA ummqion. AM'vidmion M Satlion
�oa� s W.�r ecd��� r« e w�e wq«b ins roW�m w e wa w�n d �a more md, r. n��erea eoi�. �Ssoop.
❑ I.moxirrG�Mpopenynmyempb�mewlhw�epmmtMieobmmpeveYm.wTdolMwek,aM�hsslruelunemlinlaMeE
ar MereC Iw xle (�� 10u.0uvrca eM Prafmuan Cade: The CoMmfwe Lioenu lewAma Mepplytoen ownerd prapeM
who Witle a inpm+e iMreon. end vho Joea suN xak limsatl u Mne� a Nrwph he v hm ovm emOM��. Vp+b� �he1 eucli
imqovemenb ere mt imeMed or d1ueA Iw sab. tl. Mwwer. �M buiMi�p a'unpowmmil ie adtl wilhin me Y� a�mpblion. IM
ow�ror-0uikm wYl Mro IM EuNen d pwi�q he w aho did np WdC a'vnqv.a lor tM purpme d mb).
� I. ea awirr d the weOeM. em mtlu�MY owmdn0 wph tieeeneE eano-eeiae to eanatr�e the P9� (Seaion ]Ou. Bua'vima end
Prolenione Code: TM Conlreaan L'cena law tloev nol apply ro en oMnar d popeny who buJds a impovm thermn eM who
mnVacte /a wrh popea wdh e mm�or�a� Icemed puauw to tM Caa�aCore liema Lev�.
, _ e . ' :: .t._ _. ,... CITY OF COSTA.MESA — HUILDING PERMIT
_ PERM NO: E 078140
PERMIT NO:,E 078140 PLAN CHECK NO: .N GOVT: N SUPP: Y
CONSTRUCTION TYPE: 1—FR,, PERMIT TYPE: ELE _._.. ...._- PURPOSE: ALT
JOB DESCRIPTION : SUPPLEMENTAL.TO E-76906 __SQ FT: .
CLAIM VALUE: _. '%�CUL��UE: GROUP OCC: B /
COMMENTS: 76 PRODUCTS CO / B�ES�-t�0 & SUBWAY INTERIOR TI, RE:#B76355
x�x�*x�+t�*x��*x�x�*��x�**�r*��r�rx��*�r*x�**x��rx�*�*�rx��r�r*��r*�***�rx�x�*�r+r**x�*x�x�*�+r�r�*�r**x�x��r�r***�r�
�_, Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING.---------
FRNT: . FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: . FT _.,�IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE�• PROV: PARCEL; 91050104 ZNE: REF NO:
PLANNING N TES>
i
�E if')h 1f 1E iE iF 1f 1E fE1f 1f fk fE if �f iE ff 1E ff 14!! iF 1k 1E 1E 1f'll"k 1E 1E iElE 1k�k 1E 1Elk 1k 1k 1f 1E 1f 1E 1E 1k iE 1f 1F 1k 1F IklE �E iF 1E iF 1E 1E i! 1@!f!E!E 1f 1F if 1E 1k iE 1E 1E 1E 1k 1E 1k 1E IEiE
D E V E L O P N E N T- S-E'R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
.�
HUILDING APPROVED BY : i`-- DATE: � �
❑ i�,.,mp�,�a„s«r�: e.av.c..a�nn„db�: APPLICATION ISSUED
x� �t x� �t+t �t �t �r �t x� *+r+t �t �t * �t �t �t
o�'° °`"'"' L EGAL Z Z AT I ON ; N
I do hereby cenM Md I em ewua G eM uMemeM ihe nQuiremema d Cetlwnu MseAh uM Sdery CoJe Sed'am 25505, u5�3. ard
255�a, vM tne� I a ury Mun buik'aq omqe�a will / wil na (tleeb ore) roed ro eomqy Wth �eid ume mEm end iM ropuiremmd /a B LDG PMT
epermnlaroonevunionormod'RmtionhwnlM�rawiiyiT. �enepameMDiprie.FUNenioloumruqioneppiMioneanezemqfmmlhme
,��;�e. _ PERMIT .
Deb: Appl'rau:
WORKEN'9 COMPENS�TION DECUi1�TON: I Mreby dfinn uMv psutly d pmjury ms d Ns IdbMiq dsduNueu:
� IhewendwilmeimehecerlMiceledmnseMloeaMimunlav.arkas'cwnpanWun,nprwidadlwbySedim3]OOdthsLebor
coa.. r« in. wn«menc. a N..«k �a wricn mu w�a u a.�.e.
�I Mw end wil meimen wM1en' mmpewtion imurenu, n'pu'vsd by Ssqim �lW d �hs lebor CaEs. W tM perlamenu d tM
` wak �«.,niT mn wrmn u u.u.a. Mv.ork..' �yp�pi bqry�' ypypAt�naory numn« u.: E X P I R ES
�,,,;,,, r ttttr AtVJ t u1VU
Goliry Numbr. 0 7/ O 1/ 9 6�
(mia uctctan ns.e ml e. cana'��.d r w o�� u m. ua nuwna emei.ls�ml rc Is..J
� I uMY �� in IM1e pMormerica W IM wak la whfch thu psrm4 b uuMd. I Mell na ampby eny pemn In any menmr o u lo
beeome euEla to �M woeken' eanpanWim lern d CaNmtie. �ss tlW E 1 4auk bxome aNjarl to tM worken'
ompeneatbn pmviaons d Satlian �)00 d tM LeEw COM. I hxil aomp�y v'v /Nor i
/ eb: � � AVdiceM: �/�.�/ � L _
s--
W Inp: F�llun b��eun wortN�'rompxwtlon row� li unl�wful, �ntl �lull WtlNe! en �myloyw fo n/Mn�l pxulUu en0
II Iln�� �q ro om hu�ArW thouurd JMNn lJIOq000A M Mlltbn ro IM ewt ol rompw�tbA danrp� �� peHCW br In
3xtlon J1P6 0l M� LeborCoW, IMenif, �nEafbmsy'� I�u.
CONSTNUCTION LENDINO 10ENCY: 1 MnW ��m �Mx pendry d perN�Y �� IMn ie a mneliuqion bMinO apenry lor IM
peAmmeMe d IM xwk M xfiiM �he D�Y u ewM (Saeion �Wl. C'ra. CI.
LENDER'9 NMIE:
LENDER'4 �DDflE39:
I ceniy �Mt I heve mW Nu eppfr�ion eM am� �MI tlro ebwa iMormetion u corteG. l epne to camply wilh eA ay enE oouMy oMibnoee
arM etma lewe role�m0 �o buikvq conpruqion aM hereby eu�hor¢e repecentaiivee d �hie ary b anlar upon the ebwa�meniionetl piope�ty
'°""°0°"'°"0"`D°°" DAV£ MORTON
. ,�
G /3 - s'L
"� sro�� a o«o n c vv�ocau� oma:
(5151ds WP) Whns-BuiWiq 8 Selery: Grean-Fb: Carary-AOP���: Fnk-Rmanue; OdEenroFReaeaor
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
F E E S U M M A R Y
pLUMBING ELECTRIC MECHANIC
27.25
sox
6.50
DATE
5'6
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
27.25 6.50 0,00 33.75 33.75 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 33.75 OVER/SHORT: .00
BLDG PNT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33.75
iE1k1EiE1E1EkiFMiE1ElE1fIF1EiliflEkkiFikikkifikilkl@kifikkiklEiliFiFlElfifiEiFM7Ekif1kik1Fit1FlkifikiEMlE1EiE1fiE1F1EiF1f1f1E1FiElfikikMlElfiFiEif
I N D I V I D U A L F E E B R E A K D O W N
_TYPE_ QT.Y,,,,,,.. D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V 5 BELOW 201 AMP 27.25 27.25
END OF FEES
`.:- .�'. - '-a: �.-. -_
G. E . • i
+'' , : •", . .. ,
a'�r� i-:-.'' _ _ ' •x70L & SPA � � -) ,
-�^ -CONSTRUCTION AND PLAN`NIMG �
�''� ��,,�. _� Date Inspector ��� Date ins ector
J� APPROVALS Permit #- � APPROVALS Permit # q�j
�
' yL Temporary EleGtrical5erviceor� oTe 52. Pool & Equipment Location�� � �/
�
2. Soil Pipe-Undrgrnd. �% 53. Steel Reinforcemenc � `
.. :
�
'3�eElectrica�Co � t �ilitY-Un�rgrnd. 54. Forms � � '� f
;���lectrica��p t-l�drgrnd, `�� 55. Electrical Bonding � � � ���
.S'C .�teel Re'^wYb'ncem�'nt 56. Rough Plumbing & Pressure Test O
m
F r•'�
R,`�j�lectric�l� t,'rnd. . 57. APPROVALTOCOVER-GUNITE p'(✓
J ��
. J�'ootingy��,7� GO 58. Electrical Cone}wtL�Undrgrnd. �
N8. FoundatLc�� NN y � 59. Gas Pipe, O U�f�qrnd., Test ' k��
9. Water P�np�Un �� d.co � J.� 60. Backwash LineSt'1�7rap, Q�IJqdrgrnd. ��
i.i
0
10. Structur�Flo SYstem N� � 61. APPROVAL T�Q`�ECK ��
11. Property .ev�e,r in�& Hou�Corjnection 62. Backwash & R�:eptor-Final-
12. Sewer Cay n '-� � . 63. Heater & Vent-Final `i�
c� w •
73. Root Drainso;. � 64. Plumbing $ystem - Finai ;`�
,�
14. Rough Plumbit4j t4 �,�l, 65. Electrical�Flnal �`�� /'
�
15. Rou h ctri duit T '
9� �'� ..�. �. 66. Solar SYstem-f��J I� d /
76. Rough EUctrio�Viriag ^ i��' 6�. Fencin9 & Acc�SfApprov ij�, �- �� �
�� 77. Rough Wi�tg �n � ��� 68. APPROVED F��PLASTERiNG .`.�
� 18. Rau9h Electric�T 8ar Ceiling 69. POOUSPA SYS'f�MS FiNA�. . A-
79. Rou h Naratir�g &,A�.r Cond�cio�n9 G,� t� ;, � FcL�'�,PT�REQUI�EME(yT
C c�i rC 1� � C iT:
i • � �. . . c, . i_ ..: v . � N ^ V i � fi i+ '7
20.i�oy�h Fgctn�y Fgeplace ��•�,. �,t � s r� ���: AP�01E�kU�E- Pyrmit # y -�
� ti m
21 . �uc�, in�,-�'i, tr�cCueE * � .. .- 5 � * � � n x . 70.�.Jnde�y,�y, �d t�dro ;�
r �o_
22.�HucT;,�entl�tiny,:�t r rCi Q n n� 77. Proditcn'lli in�li'.t'�as fl0i�
, 23. Gas�ipeki4o "h & Test � !*i� -a t*; e c O r �- � [-
x �s c S? " 7z• UndergrFoy4�d F,a4iEh � y
c.. �. m.r. -c� 4 �- 1.
j 24.�rto6f'frd�ning ,� - ��r; x � S r,* • T3 Undergrnd.Stc14'�TankOGas ❑Oil
-�
25. Rodf�Sh�thing �% Q �,_, � m a' 7�4�. Overhead Hyd'rS�. Q, i
c
26. •Ba'`�j,Ceil,ing (Str� ura1) &�f01�'-soat ;� '� -��
y� ! � e�+� +^, >� v* 7 Dry Ch¢mical �p t R
27.�ramea�nfFlashii� c�c ��' � m� 76. DrySca�iaipe".� *e n; �
c -
- 28. Lat�ng'�$�i Sidin9n* � CaF p �� ..� ..ti FIXEDESi15TETC�FINRH_.-� C1 [*
29. Insulatio�7 �' = " X I � 7;�. FIRE PREV. F��I�%1L F' "' m
30. Drywall�ai�in �^ ; � � ~ AL � ERT REQUI �� MENT
� 9:7: r+ � F S NbtE f�:�
� .. .. ' � �,. ' ' .s..r.,�=�
31. Plaster Bfawd�CoSi' = k I �� 79. FINA��PEC'Pf�N fi � � �
: 32.�lectrica�„Po�gf ���F��ai � �; � �% � 8� FOOD CERTI �F�Ef �EB, o -
.. -I . ` � '. ��y� . �
- 33. inahElectriE•Yvr. [a i �C � � o�cLs: '� ""��T! i"� " ^�
� ti,� T�� _
� 34. �in�He�ting� A�r?Cq�ia'�tiontri� .n * ^ I �` t,,.��, � N i � � .� ,9
35. Finai Gas.Pipe•7eStr�. � �� * �e w.o �7r- �!� �:"
..� :k !^ {T,
� 36. �oq�or�PanoPY �: �i-� � r.r,; � * � I t£T7 �o x M G?t
�•.
. 37.kina4•Factory Fireptecex i c-E. r., s� � '� x: iL
n t i �a k: �n
'_ 38. Fin�Plumhin9 z;,* s: N + y I ` � � '* �
�`� 39. Water Service-Fi `� �� g � 4 Y x kx^ � v� K a
iv . m �
�' 40. Gas Service-FinalQ�` � ¢�''' � � � % ' �x ,--' �.� '` `
t...k r'�:.:. :.7 � F• rui ��
_ 41. Solar OomestiaFin �r, �� � `� i ( �t n+ �-7n: e * �
♦ ^� k
42. Backflow Prexentet'� "� x � � �!' �^ >�"' �� """'
x N C�-+ �-, +� r, n m cn O s E- c.+
43. Backflow Irrigatiop� � s�' x � i '- i� •
� r s. ' ,J 'Y. Vt
� 4. Landsca� I�pa ASystem'�r�� '� F m b d O+� a N N xC)
SID�t ��',,. R! Y eC Q d:K � � w O U; K S F N
n�� �. . . r, ,. .. ,.. .
'45. ;$ound Ataer�ciatioicK ;... r: ;+; �r7 tn x c^ r,-� s
� -+ � �� r� x
�A6. �Handicap'Regula�id{s s C k S I I * V a 5 rU �
.�, O �' s
�(l7.'FINA�L STRI�TUf�� & BUfLDING �'r F-. � � � � x !-
- tr' � G
48. �61NVL PLANNING'•: � �"'r" �K n' � � ` R' ~
i .� I �' 1 I- CJ N S r. �S
;�9: �lecli'.ie Release to ison � ,r i .y ;� r
`80.'Lias'aelease to Sout.hem Cali(ohji�GasCo .;` � � f • � �o �'r � N N
51. CEFfTIFICATEOF`OCCUPANCY "' " ^
No Date �
AD0p�3°'s"'Lp1'�' S55 ANTON BL �■* 15T I CITY OF COSTP_ MESA — BUILDING PERMIT
y�auyv�EiF�o,a�*+:' SAKIOAKA FARMS PERM NO: P 077022
" �°w� PO BOX 2097
TERMINA ANNEX PERMIT NO: P 077022 PLAN CHECK NO: N GOVT; N SUPP: N
�rvi.wuuxo �ooxrss:
urc""Ec�°"E*a'�'° INTE�tIOR 'ARCH. 2136232164 "c10o C-9378
MCNOHENd'6�WNE55: SSO S HOPE ST �M� 1100
LOS ANGELES CA 90071
c«m+�cTonSx� CONTINENTAL PLUMBING INC ( 909 ) 360-8300
carn�croxs�uiwo 11165 THURSTON LANE
�ooxess: MIRA LOMA CA uc.ra.: 399073
91%SZ UNT:
IJCEN4ED COMHRCTOfl3 DECL�XATION: I Mieby ellim uMer qroly d pmjury Ntl I am licensed uMer poriacna d Cheqs 9
(oomme�M wn� Seclbn 1000) d Dwiaun J tl iM Busroa eM Prdasaans Code. and mY licensa m m Il lace e�M e%etl.
c.r+o.: 027563 uc.cuss: C 36 ��' 3 907 � 9/96
ela: � �� Cormeuu
JW N BUILDER DECLAR�TON: I hreby atfum uMs penNy d pmjury 1 em e�emq �am ihe Canrenon licama lew I« tha
' rwm (Seaion 1mt5 Bwiw�. md Prdreb�n Cads: /.m' euv o mwiv Mh'xA mawrea e o�t to c«nwn. M«. "vnMwe.
Mmd'sh. a ropv emy av�c�we. prior b da ewencs. ebo n4uvw Ihe epqimm lar suM parmu to Na e upred �tmemem Nm M a ehe
u �omeee wm�w io ine wwiviai. a ins camreean Liceme lew Icheq« e(�me�m w'nn s.ec� r000) d owuon a d tlr
Buvina erd Rdaseiona Cadel a�� M a ehe is axsmq thershwn arM IM bmu lor IM allepeE memqon. My vblelion af Serlion
�aat s M�v rod�ni Ia e rorma wM� �ns epdiuni �o e cia ro�M d na mae �ne� tiv. mndred dd4n I`�II.
� I, u ownm W Ihe propeny w my mmpbyese wlh wepes m Ihei rob oompenWbn, MII do ths xdk, ud Uia sVunuro u m� imaMed
or dixed la eela (Senion )Oi1, Bunmu vM PmlpsiomCods: TMCaMratlon licerue LewEme iwl epplyloan ownerat pmpMy
who Euids a mpmvx Iheieon• xM nfio Eoes �uch wak Nmwlt a Mnall or ihrouph he a her own ompbyses, provNM �hm wch
impwemmbme not in�ended p allaed In Wa. tl, lawaver, tM EuiNiiq a inpwemmu u soN xilhin pp yw W mmpbiion. �he
ow�arbuiMer will heve iM buMen d pwi�p M a ehe did ml ddk a'unprow lar IM WTae af eeb�.
� I. m owror W �M V WMY. am sstluwM/ oonlretlYq vrilh IironaaE mntrenae io wweue tln pqep (Sodion )OM. &uiira erd
v�am.ian. coa: �Th. com�.uu. li�«�. L.w me. na eoWv b.� own« a c�w�r �.�,o wJa. « impwm �n.roon .m .nu
eonvecta lor wM�prqetla wXh e aom�vfor(s) Icaroed punueni io Ihe Canlradae Liomea Law).
❑ I em eiemq � Sztion: B. 8 P.C.. br Nu reason:
Dete: . _ _ O+mer:
I do hereby ceNy thel 1 em ewua d erd uMenlenE Ihe repuiremeMe d Cellomle Ileehh eM Selaty Code Saaam T5505, 25533, erd
25500, enE thPo I a eny lulure DuilEinp om�pent will I wJl nd (dreb orw) need io comply wih eeid eleb cadee xM Ihe rpuiremems for
epermnlorconewclionormadifmtionhanlheAir u ie��anepementDis�nd.ReelEenlielmnaVWionepp4ulioneuaeRemptlromlhme
pwieiane.
Dele: APGlcenl:
WOPKER'8 COMPplSATION DECL�RATION: I Mraby elfi�m uMer pwAyW pejury ww W Ns Idbrrirp ErLreliom:
� 1 hew enE vril meiMeii e caNlcNe d conesm to setlimun la xakai campevelion, n pwkM tor by &wiai ])00 d tM labar
coe.. i« ine o«��.� a u».w�w io...+:�n in4 v.�n o 4+�d.
� i n....�e w�m.i, wonw.• mmo��, ��w�.nw. m�+a���.e M sww� aroo d me �en« cod.. w me o�� a n»
work la whic� I�ie peemil u iuued. MY ��n �Pe�� iroureece cenbr and polky number era:
c.m.,: C'NA EXPIRES
va�N�mne,: �naaann�aS 07/O1/96
(Thia aMion rreed rwt be comderod Y i�s perm,t u M aa hundred ddlan jti001 a Ine.)
❑ I pn'N � in IM pMormuic� d �he work lor xfich ihh p tlWl ml ompby e^� �n in ury menmr o ro to
became �ubl� to ihe worka�' camp�metian lev.� d C' u. uW pr e 1� I eh e w'� M
can°�' m povisiom�° m]�00 d IM labar Cads. e I IonMM omp ' iMe ro '' e.
om � L' � � I � �w�'c.m:
Waml�p: F�Hvn ro acun woilrw�i rompwwtlen eor�rp� l� wM • W/I rbpct an �nployn ro cAMnl pwvltlq uM
GHI Ilnu �q ro arM hindrMWuuN JWhn (t10q000A b�Itlan • cwt ol rortqru�WM1 Eunpu u provldM br In
9�ctlm ]]PB o/ tl�� la6or COJ�, Irrtwl. �ntl �tfomry'� fw.
CONSTti11C1fON LENDINO AOENCI': I Mntr/ dfiem ��ae� oerony d�,�y inm u,.�. n.�,nNeo� w�e� �zy � me
pMameme d IM v.oek fa which Ihv pwmi u ewsU (Sedion 309], Civ. C).
LENDEN'S NANE:
LENDER'3 �ODPE94:
I ceniy ihet I I�me rteE Nu epplicvion uM ptls Iha Na ebovs WormYion b cmW. I epne io campty vrilh ell �Yyend odmry adironme
ud ewe bx� nWiq lo buJdip wnNWion eM Mrsby �Nhares np�wniethw d IAia dly io ar�tr upon �M epove�msmiprd popeny
i« i�. w,we,,.
/'� n RP�YnTHORNTON
�
Dtle:
`(515��6.WP) While-Buildip 8 SdMY: OresrFle: Cuury-AppfuM: Pink-Mvenue:OddenroFNexwr
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: PLO PURPOSE: ALT
JOB DESCRIPTZON : INTERIOR 1800SF / RESTAURANTS SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: REF: B-76355 ��-�}C_CB.�,F�.A�!<" ��C.A �2/���[,�,�GJG<-�
lEIEiEiFiEiE�EifiElEiEiEiEiFifi6ifiEiF1E iE�'if3Edfi[�+4..� HH ��jEi(�lE3fifikiEikiEiEjE3f fE iF�EiEiE1ElE�7E iEfEiEiElEiFiFiEiFlEfEiEifiEiEfE3EiE3E
N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
� i
iE jf iE 1f 3E iE �E jE jE jElE 1E iE iE iE �E 1E 1E 1E iE 1E iE 9E iE iE iE iE jE 1E iE �E iE 3E iE iE iE iE 1E iE iE 3E iE iE �E 1E IE iE.iE'iE jE if if �E it 1E iE 1E iElf 1E if 1f iE 9E iE 3E iE iE iE iE iE iE iE iE 3E iE iE ik 3E
D E V E L O P M E N T S E R V I C E S��' R E Q U I R E M E N T S
ZONING APPROVED BY r}" DATE:
BUILDING APPROVED BY : iv� DATE:
APPLICATION ISSUED HY: ��I DATE: � v
it-�E**i�**i�-�x-*iEiE*iEiE*�titi�iEiF+t3FiFiF3F3fTFTF3FTFiF�FiF7F3F3FiF'iF �F3F�F'�3f3'F3F3F'iETFiFiF7F'if**ic�iEiE�(-�-+fiFit� i�iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGM NT:N
._. ,,�,
BLDG PMT PLUMHING ELECTRIC— ME�HANIC FIRE SMIP/RES GRADING
PERMIT . 70.00 ��
258 � ��' SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE
TOTALS----> 70,00 20.00
...- �'
'•' 1✓
PLAN—CHECI(� TOTAL
0'.00 90,00
PAID DUE
90.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHOAT: 00
BLDG PMT PLUMBING ELECTRIC MEEHANIC ��f FIRE SMIP/TOT GRADING PLAN—CHECK
90.00 /•'� �� �
iE 1f �E 1E iE �E 1E-lE �IF 3k iElE iElE �f 1E 1E 1E fE IflE 3E IElE �k 1E'� iE IE 1E if iE iElE iE iF 1E iE 1E iE 1E iE �E�IE dE 1E 3E iE iE 3E iE iE if !E iE 1E iE iE 3F iE ik if iflElk iE 3E fE iE iE ik 781E 1E jE �IE ik 1E 3E
I N D I V I D U A Lr F'E E� B R E A K D O W N
TYPE QTY D E S C R I P T I O�N , UNIT COST TOTAL COST
PLU 1 WASH BASIN � �',��. 7,00 7,00
PLU 1 WATER HEATER AND/OR�VENT T,� 7,00 7.00
PLU 1 SINKS, COMMERCZAL OR INDUSTRIAL 7.00 7,00
PLU 4 SINKS, FLOOR � ,= 7,00 28.00
PLU 1 SINKS SERVICE / MOP' 7.00 7.00
PLU 1 REPAI{2/ALTER DRAINAGE/VENT PIPING 7.00 7.00
PLU 1 WATER RE—PIPE 7.00 7.00
.ENb, OF FEES
' 7 ' ., . _ _ � . ' .
i
!
��-CONSTRUCTION AND PLAN�NG i P.,.,L & SPA =�}
�'APFROVALS PeTmit# -�� Date Inspector qppROVALS � Permit# � Date Inipe'ctor
�1. Temporary Electrical Service or Pole 52. Poo� & Equlpment Location- � '��
p, $oil Pipe�Undrgrnd. 'i � ._ � - � 53. Steel Reinforcement . ^ �
'-3. Electrical Conduit Utility•Undr�rnd. - 54. Forms a��
4. Electrical (;onduit-Undrgrnd. , 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Piumbing & Pres:ure Test "� '
6. ElectricaL•UFERGmd. 57. APPROVALTOCOVER-GUN�7E
7. FOotings 58. Electrical Conduit-Undrgrnd. -
8. Foundation 59. Gas Pipe, O Undrgrnd., Test ��/ ` �
•� l
9. WBter Pipe-Undr4rnd. ..-� 60. Backwash Lines, P-7rap, O�Undrgrnd. "'
10. Structurai Floor Svstem �� 61. APPROVAL TO DECK � �
71. Property Sewer Line & House Cor�itection 62. Backwash & Receptor-Fin� �
12. Sewer Cap � , 63. Heater & VenbFinal
13. Roof Drains �� 64. Plumbing System � FinalY '
14. Rou9h P�umbing ��, � 65. Electrica6Flnal _. •
. 15. Rou9h EleMricai-Conduit . 66. Solar SYstem-Final • -
76. Rough Eiectric Wiring � 67. Pencing & Access Approval �
77. Rough Wiring Sign � 68. APPROVED FOR PLASTERING �'R .
78. 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. Duccs, Ventilating 77. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing - � 73. Undergmd.SrorageTank OGas ❑Oil
25. Roof Sheathi�g 74. Overhead Hydro
26. T�Bar Ceiling {Structural! & Monocoat 75. Dry Ghemical
27. Frame and Flashing 76. Dry Standpipe
28. L2thing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
37. Pidster Brown Coat 79. FINAL INSPECTION
32. Electricat Powzr MeterFinai 80. FDOD CERTiFICATE ISSUED �,
33. FinalElectric Notes: � .�•�����������_ _!
C�
34. Final Heating & Air Conditioning _ �
35. Final Gas Pipe-Test r% �s / i� /
_ � i -� b�<_!i �h^r Z- S!K - .�_�L'JI'�.-- - - -
36. Hood or Canopy , /�- p�_�.�`�Zl.
C-L _/
37. Final Factory Fireplace . -
38. final Plumbt�g / -,r_ G .
h"/S �
39. Water $ervice-Final
40. Gas Service-Final � � � � '
41. Solar pomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �?
48. FINALPLANNING '-
49. EI¢ctric Releare to Edison ' � .
�; .
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY .
No. Date
�
�
�oonusaewtnno: S55 ANTON BL
ONNEABN.WEIFqqNk SAKIAAKA FARMS
. . '.00�sx PO HOX 2097
TEAMINA ANNEX
�rr�. wnna �no�ss:
�wexrtecT ax wm+Ftn:
ua No:
uxr: 1
�RCLL OR ENQ'f I�DDPESS: ' ' UNT:
mxmncrarnru�: SOUTHWEST FIRE PROTECTION ( 618 ) 359-0039
CONfPALTORSYIJIdlO 215 E EL SUR ST
mw�sa MONROVIA CA ucra, 190173
91016 u�r:
LICEN9ED COMFRCTONS DECLAPATON: I M�eby ellim uMm perelY d pmjury UW I am licemad uedx povieiona ol Cheper B
(oommaMvq wn� Seclian 1000) d Oivision � d Ihe Buamm utl Rdaa'vu Cotle. vM mY �^ee o in h01aw vd Nlae.
cmuc.no.:013054 uc.cuss: C 16 uc.No.: /90 73 EXP: 04/96
om.: 3`Z�'�1'G c�w« � f—!+� /'�
"(/NER BUILUEP DEC4F�TION: I haeby al(um ivtlar pnWy d perjuiy Ihel I un azemq han �he Cweeeon l'xa�us lew la tM
bwip iaeaon l5etlian )W IS Bufiras W PManivu COEa: MyW a advaY Mid� n'pnas e O��e to mmbucY. e4a.'vnPow.
wmd'eh, a repv eny auuclwe. pnr b re eauem, abo iepu'vm Ne epp5rM la wch pemM io IJs a apned atmemeni tlut M a eM
0 1'vnW W�v�ue io �M p'omc�u d dr Conroms Lioema ler �CMqa e(��q �� �� �) d Oweion 3 d ib
eubm�a em Raenvn coe.l a�nn ro a sne 4 uema �ner.m�m am in. e.m i« � eueoae m�«nqvn. �nr vdmon a seau�
]W t.5 by ury appG�nm la e pmrtu abpa� tM epp(rsm lo � uH peneCy d ml man Ihm �rro hivWed do0a+ �SSWU.
❑ te�wiwa�nec�ro�v«mv«�Wbrem..n �p+.su.:.d.mmw�..�eou,awkwu»mwui.om:vww
a dimed M veb (Setlian "loM.Bus"uws end PMmdvn Code: The Caurwas lim+e lew dom nd eWNto en owner W PWeM
xM ddCs a inP�+�twean. rd Mo dwa sud� wA Fbn�aC a MnN a Ywqh he a har am emdofMa, pw'db �hr wc�
imp�vlemrnU ve ro� iiuended a dfaed ta+eb. tl. hor.ewr. �M WJEinp or inpowneN b wN wilhin aaY� d wmWoiun. tM
, oww�Euitlw �0 Ma tM WNen d pw'vq M a qn d'd M hwld a inpwe la tM pvpus d ab�.
� 1. n owroe tl IM pWMY. em udmvNl mNiatlM wvh 4cwueE caLedon m mmtrW tla P9sd (Satlion )OM. &niire ud
Proleaions Code: The CaNreean L'cmw law Eoes nal xppy to en owiwr W popMy wlw W�ds a imprwm thweon eM wfio
convew I« aiN pqwa v.ith e mNraCoHe) Gcmrd punuem to iM Canveifwe limue lewl.
� I em e�emp ueda Seclian: B. 8 P.C.. br Nu �auan:
Dma: �:
� ao h«•M eaniN uw � em .wv. d end �mdasw�a me iw�«nw, d c.umd. w.en md Sel+v coee seaiau xssos, z55b, ene
2555a, uq �Iw I a ury lulun builtlinp m�eni vriA / wil m� (ticb one) �weE lo oompy w'h uid 4me mdr ud iM repuirom�n�� lar
. vmma �«con.vuciim«moad�bnhan�n.A:�e�mr+omrvf. R.ed.vW mmruaion wP�ion..�.az.ma �mm m...
a�.
DNe: MV��:
WORKEP'S COYPENS�TION DECWI�TON: I hrN� el6m wNa pruly d prpry w d Ne bOmwp dstlere�iom:
❑ �nmew.ameini.n.unaweam�+.vm.w:�m.w.ws.•eompen.mcne.pwdee�orMs.eiona�ooam.�ma.
CoM, la IM pMamuco W IM wk la wlitl� Ne ps�w u mueE.
r] ii,...m,ewme:a.n.on..•mmw�mun:ma.�...am�:.ahs.a4,�aodm.imorcoe..enm.o��am.
wani�«whidiihope�nb�wued.Mywa`en'canymwON�T��������m�us� EXPIRES
�,,,;,,: Fkt F:M
va� n�n« 0 6/ O 1/ 9 6
�mo .eeron n.w na a �o,�dw.e r w o�e o m+m. nwww eomn R+oo� o. r...�
� I xnAy Nu in Ihe palamence d ihe work br xhch ihu paimu is u�ueE, I NNI nd ampby eny penm in ury menner �o u io
becwna wbjw io iM v.orFen' campruetian lew d Cafdmis. xk apiw tIW 1 Nwk bcmn �uEjaa m iM MwYan'
companaeiion pmAauru d Seabn 9)00 d �M labar Code. I Mell 1 can pwi4me.
ova: 3-�- S�6 �ow�: c' i'"._�
�
W�minp: F�Nun ro Neun roikwi �o�o«wao�.w.�.w i, wnn..nn, .�e.w� we��.o.��o�w ro�nmw p.�.iaw.�e
clvlr nrw� w ro on� n�ne�N tMuuM AWYn ftI0q000A e+ �llbn ro fM eosl of rompmutbn dam�W �s provMW ror In
S�ctlon J105 0l l�� LMor Cob. INr�aG Nd �ttmMy'� Iw'.
CONSTFUCTION LENDIN6 AGENCY: I hraEy tlNm utlx pmeYy d pa�jry �M tMs u e ou�9�uGion 4Mvq epancy b tlr
porlamerco d IM v.ork la whiN �hu D�� u'ewaA (Setlian �091. CF. CI.
LENDER'S NAME:
LENDER'S ADOFE54:
I<enJY Rin I Me ned Nia e00« W pme �Mt pn abvn idummion e mneG. I pyas lo wmVN vN� el mY eM mmtY oN'vuim
BM BW G Nw0 eNNM b Wdtl�q �10M hefB�Y GIlhOfGf �WMM��OINM M ��Yt M1' blMG YQM IM ObvN�TM�ipIBd p1ap01!/
�°`"'°"��"'°'�' ROHERT BROWN
Prva Nama
�/�1�—� om<: 3 zo -46
s�oo edo�.inwminov��rocom�ao,
(5151�d6 WP) Whne�Buildiq 8 Sel&y; Greeri-fib: Ceneiy-App4ua; Pink-Revsnw; GoldanioC-Asseuor
CITY OF COSTA MESA — BUILDING PEAMIT
PERMIT NO: F 076856
PLAN CHECK NO: 00969-96 L
PERM NO: F 076856
GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : RELOCATE FIRE SPRINKLERS SQ FT:
CLAIM VALUE: 2, 600.0O�,�C� C�—I�ALUE: GROUP OCC: B /
COMMENTS: 76 PRODUCTS CO / 6Eir-�A£f� 6 SUBWAY , REF: B-76355
�*�***�r**�******�****�r*�*���x�**x **�*�r****�***x��*x�*x *x�*�r�*��*�**�*� � �r*x *x���****+�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
3E iE IE iE fElE if if iE iF if iE jE if 1f iE iE 1E �E IE IE iE iE fE fE jF 3E iE iE 1E iE iF iE 1E iE iE iE iE iF iE iE 1E iE iE if iF 1f iE iE 1E iE �E iE iE iE IE iE iE IE IE iE 1E iE 3E iE iE iE iE iF 9E 1E �f �)E iF iF iF �1E iF fE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED HY :
APPLICATION ISSUED BY:
if 1E if 1F 1E iE 1E 1E iE IE 1E 1E iE fE fE IE IE iE 1E 1E 1E M
LEGALIZATION:N
f�-�1�^fi1L�'u��:11
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 54.00 0.00 35.10
DATE:
DATE:
DATE:
�F'�*****�**�� � � � � �+�
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
54.00
652 SMIP/NON—RES
35.10
TOTAL PAID DUE
89.10 89.10 .00
REVENUE DIVISION TOTALS--> COLLECTED: 54.00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00
ik 1k 1E iF if if �E 1E �E jE 1E fE 1E iF iE It 3E IE 1E �E 1E ik 1E �E 1E 1E 1E 1E fE 1f fElE 1E iE If 1f i! iE 1E IE 1E �E 1E 1E 1! iE 1E iE 1E iF �f 1E 1E 1F iE iF 1E k iE iE 1E 1E 1f fE iE �f 3E iE �E ik iE �E iE 1E iE if iF iE �f
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 54 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00
END OF FEES
:
54.00
l'.,�Ci i�� . • ♦ � `�u�}y `
•�. �
L �'
`CONSTRUCTION AN� PLANNING .. � P� & SPA
APPROVALS Permit # � Date Inspector qppROVALS Permit #� Date Inspector
1. Tempofary Electrical Service or Poie 52. Pool & Equipment Location
,2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �'"
3. Electrical Conduit Utiiity-Undrgr�. 54. Forms � -
.A. Elettrical Conduit�Undrgrnd. 55. Electrical Bonding
�
5. Steel Reinfprcement 56. Rough Plum6ing & Pressure Test
6. E�ectrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electricai Conduit-Undrgrnd.
8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Sttuctural FloorSVsrem � 61. APPROVAL70 DECK .-
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final�
12. Sewer Cap . 63. Heater & Vent-Final �
73. Roof Drains • 64. Plumbinp System � Final
14. Rough Plumbing , 65. Electrical•Final '
15. Rough E�ectriwl-Conduit 66. Solar SYstem�Final
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electriwl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Condicioning FIRE DEPT. REQUIREMENT
20. Rouqh Factory Fireplace . APPROVqLS Permit # �
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating � ' , 71. Product Piping OGas ❑Oil
23. Gas Pipe-iiough & Test ' 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74, Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical
27. Prame and Flashing , . . 76. Dry StanUpfpe
28. Lathing & Siding � . ` ' '- 77. FIXED SYSTEM FINAL �.. �Q-Q(D �
29. Insulation • 78, FIRE PREV. FINAL (�•tq.lj(a D.�
30. Drywall Nailing . HEALTH DEP7. REQUIREMENT
37. Plaster 6rown.Coat 79. FINAL INSPECTION
32. Electrical Power Mecer-Final 80. FOO� CERTIFICATE ISSUED
33. Final Electric � Notes: -
34. Final HBating & Air Conditioning
35. Final G8s Pipe�Test _
z
36. Hood o� Canopy - _
37. Final Factory Fireplace � �
38. Fina� Plumbin9 -
39. Water Service�Final
40. Gas Service-Final ' .
41. Solar pomesticFin'al . ' . � .
42. Backflow Preventer . � �
43. Backflow Irrigation
44. Landsc9Pe Irripation SYscem � �
45. Sound Attenuation .
46. HandicaP Regulations _
47. FINqLSTRUCTURE&BUItDING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Retease ta Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
y
r
�I
�
eoonessaemwmm S55 ANTON BL
ONNER'SNAl1EIFpqNk SAKIOKA FARMS
"°°"ES'' PO BOX 2097
TERMINAL ANNEX
MVL. Y111IIl0100HES4:
u� 1ST
"�""�T0"�'�"` MORROW MEADOWS CORP �NO= 230813
""CNO"�"1D°"��' 610 REYES DR u"'
WALNUT CA 91789
t0N1"'0T0N4N"'�` MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
CONf"1101R1""� P O BOX 509
10°"�A WALNUT CA 1GN0= 230813
91789 �'
LICENSED COMfl�CTOF4 DECWIATION: I Iwaby elfrm �aMr paWy d{wjvy tlW I mn fcruM uMr pwuau d Cheqr 9
(canmenr n0 Mh SMvi 1000) d Oiwion J d Ne &emen eM Pmlwabu CaEe. uM mV fmriw u in hA bru mtl MM.
GT' 11C. NO.: LJG tt�SS:
006558�+ C 10 `2�308�13 • . 96
I Dmc ����� `/� . s:�-�7 �i17 ���
IOWNEN BNLUEfl OECUfl�TION: I hrtly elfom ivMr peW y d pry�y thtl 1 an �vmq hom IM Cuq�tlon Licww Lew In IM
'bwip reewn (SWion JIX115 &eieat end Aalm'vn Cods: A^Y M' a advYY MJd� nV�M s D��Y b muWd. War. MPon.
md'vh, or npv ary aNic4ne: pna w ia "vaue�ce, ebo rxpnn Ns eppi'mp tor arA perm! to fJe e spneE MteneM tliu M a�M
. r,ce�sea w� �o me nw�+ d er cammm uowa ie. �Cn.qs e lmmm.,m,o wan swun �mol a awo, a a� nr
6uau,en ena haev'vn caeel «�w ns « ene o memq �n>a�mn ene �ne bam �« m..espad e.nw:�. �.n �idmnn a swun
10�1.5 Eq ury eppbuM la e pemN abpCa IM eppli'aN to e dai pwieEy d nal man then fi.v hmNtl ANv� �SSWp.
� I.moMnerdlMqoperlyamyanpb+nx'tAMepmnNwcbopnpsuqion.wipAotlrwak.mNtlrttnmrsunuiaeMed
a aRaad b eeb (Ser�bi )01�. B�mmav end PNeadauCotle: Tha Cauredasl'srae lnwdon nal nooA'to en mmerd popeny
who buidf a inP�ae IMrmn. mM wta doee eurh wdk Nmaetl a MnM a Maqh lie a M own amGbAd. D�b IIW eurli
impw'emwn ero nd'vqeded a aMaad Iv Ws. tl. howv.ar. tM WNSvq a inpwwnetl e mtl �itM w Y� d mmNMbn. tM
owrcrbuddx xill heva �M EUMen a D�'��0 M« Me Lk nol dntl «'vnpow la IM WTae a aels>.
� I. ea owner d IM poVeM. em ssduairdy mntrrfvq xdA Goeiued canUstm W oon�bue IM Mola (Seuun ]OM. Bus'uwe end
vidwime code: me caureaa, t'sa�e law eom na wW a m o.�w a wwMr �o duw « bnpwse in«aon end wno
eonveeia ln wtli yqetls wN e mNeatloH�) �s� p�� Io ihe Caumaa� Uoeius law).
❑ i���a ��, s�i�,: e. a v.c.. ra w. �:
Dela: Ox+w:
i eo nawv �v uw i.m w.e.e a.�a �d..w�d m. �.me�«+. a cwo�:. w.en em swn eoes s.aom xs,ws. nsa�..�d
25531. md Np I or enY Mwa EUJd'uq ommW xW / wil nal (drtY one) need b oomWY wU md tltls aodm aM iM niubemaM br
e cemnl lawnevuniona madilwionhan iM�i�ixTiyi.raneprneeu Oiqnd. ReoEmiW mM�ufun mofmionen a�rriq hdntlres
om.: �oc�+:
WOPKEP'8 COYVENS�TION OKLAFATON: I MrW� elfmi �vdar pxupy W prjvy dr ol iM bpow'vp AMme�'vu:
� IMweMwilme'vdenacaWktl�dmvwutowtlamunlaYakan'oompamuion.mprwk�AlnbyBrfionJ]rod�MlaEn
coe.. i« u» o.�� a m..on� m..�:a w. wm+ n swea.
il � n....�e w meim.�.an.r mmo.�:�:.w.na...'wm.a M swbn ano a e. War eoe.. erm. wk�mmw a m.
�r� wak t« r,hidi thu vMM u iuueE. MY warken' mnpevmion vwvw�c�'aniar end w�Y mmbx w:
°e11ei SIRSMItAI' S �'��"�^ EXPIRES
'°�'"'°^"'� 8iiF897�9�7� 07/01/97
(Tn .secn,..e �or n cm�pM.a � w v.m+v a,. o�. n�.im.e eom.lsioo� d r...�
❑ I eaniY thn n Ne v�miw�ee d Na rork la r.T'vii tM D� b baNd. I dW nol �WW M' V>� h ert/ mennar n n w
bsrnns u�bjea �o IM xaM1aY mmpanWbn Wn M CYdamie pna Nm tl I tlndJ Eecpro wb�q �� IM walmn'
compan.uo� ww++o�, a seim noo d in. �ee« coe.. onn oo-�cN .tn ma. womu
om.� /D - � S - �L �oa�: ,
9
wamsw: an�,. ro.«vn wrt..� com�w.non cov.nw �. �, ua.wi mNn.� rro�m+ro mmmn«wn« ma
mn nnu w ro ar. nvie�.e rrow.na aa+sn !si W aooA a.m�dw, m m. cm� ol ernq�u�uin � n proMeM ror �n
9Ktlon ]lGi o/ IM Ww Lo6, IirtwLL ���m�Y"� /wa
CONSTIIUCiION LQ1pN0 AQENCY: I IrrN� dbm �dar pwrEy d prjvy tM ihs� b e mu�'unbn Wtlup pw.y br iM
pM«mvxa a11M Mak kr wnid� tiis w�1 u'swsa ISwion �Oal. CM. CI.
LENDEN'S NAME
LENDEX'S �DDRESS:
I wnM �hm I hm neL Mo eVWcetion md nms ihet Ne eEme'vdwmYion u conad.l eNw b oomW wn� eG mY enE mumYad6vror
ud sima leMa nlatiq b WddM mmv�e'v� eM MrWV eWarza nP�tliw� d Nh W b WR Wm Ilr Wvw�mWiwwd popary
la ilnD�� PwW��
DAVG MORTON
L N✓"�/ �i%�%L Oele:/O�/l�'/L_
Spnelum d Oxnx/OqmVRppf�anUCoMrma
15151�06.WP) Whue-Buldip85tl&y:GnarFb;Carary-Appiwil;Rnk-Rewnus:(bldmmA-N�evea
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 080183 PLAN CHECK NO; 04306-96 L
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
JOB DESCRIPTION ; EMERGENCY POWER FOR FLOORS 4, 5, 12
PERM NO: E 080183
GOVT: N SUPP: N
SQ FT:
PURPOSE: ALT
CLAIM VALUE: CALC-VALUE: GROUP OCC: B /
COMMENTS; 76 UNION PRODUCTS / NO BLDG PERMIT REFERENCE
�t**x�**�r***�r*�r*******�r�r*�r*x�x��t�r***�r�r+t**r*x��ri��t+t�r*i�*i�it�t*it+�i�**�rx�x��r*r+t*iri��t�t�r�t�t**�**�r�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NCSTES>
i
k iF 1E 1f If 1f 1E 1f iE fE 1E if 1f iE 1f 1E 1E if 1E iE k iE if 1f if 1E 1E iE 1E if if !E 1E 1k fE iF if if iE iE ik 1E fE iE fF 1E fE if k 1F ik �ElE It iE iE 1E If IE iE 1! fE 1F 1E fE �E 1f 1f !f If k 1E if f4 4 k IE 1E fE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY � DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: �t- DATE; ��'�-��tL
i� �e *�-* ** �r �r �r �t �* x� �r �r �r i� �t ** r �r �t * f� it �k x�+t �t i�TF�'iF'4�R�"�Fir fr
LEGALIZATION:N F E'E S U M M A R Y STRUCTURAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING
PERMIT 76.75
503 SMIP/NON-RES
PLAN 38,38
ISSUE FEE 22.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 76.75 22,00 38.38 137,13 137.13 .00
REVENUE DIVISION TOTALS--> COLLECTED: 137.13 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
98.75 38,38
IE iE 1E iE fE 1E fE 7E iE iE 1E if 1E iE If fE IE if 4 iE iE 1E iE it 1E iF fE fE IE If iE 3E fE IE 1! 1f 1E If k 1E if 1E iE fE k 1E iE iE k k iE iE iE iF k iE iE k!E k 1f iE iE if iE iE iE iE if iE iE iE iE iE if iF iE iE 1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C A I P T I 0 N UNIT COST TOTAL COST
ELE 2 SUB-PANEL
ELE 1 MOTOR/POWR APPARATUS 50,1 -100.0 HP
END OF FEES
• • ,
�
1 � �
� ' �� �
16.25 32.50
44.25 44.25
oi OOZ17898-00?17399 T O T 137.1'J
�ATE: 10/25l95 TIItE: 10:05
�
r
CONSTRUCTION AND PLANNING PO S SPA .•
APPROVALS Permit �h Date I�speMor APPROVALS Permit # Oate Inspeitor
1. Temporary Electrical Service or Pole . ' 52. Pool & Equipment Location' �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Electricai Conduit UtilitV•Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrnd. � 55. Electrical Bonding • �
5. Steel Re�nforcement 56. Rough Plumbing & Pressure 7est �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE .
7. Footings 56. Electrical Cqnduit-Undrgrnd.
.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test .
9. Water Pipe•Undrgrnd. ; % 60. Backwash Lines,P-Trap, O Undrgrnd.
10. Structurol Floor Syscem . 67. APPROVAL TO DECK '
11. Property Sewer line & House Connection 62. Backwash & Recepror�Pinal ,
12. Sewer Cap 63. Heater & Vent�Final �
i
13. Roof Drains ,,' 64. Plumbing SYstem - Final ��
14. Rough Plumbing � 65. Electrical�Final i
15. Rough Electrica6Conduit i � 66. Solar System�Pinal ': i
16. Rough Electric Wiring - �'/ ; � �� 67. Fencing & Access AnProvol r `
77. Rough Wiring Sign � � 68. APPROVED FOR PLASTERtiNG -
18. Rough Electricai-T Bar Ceiling� � 69. POOL/SPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Fattory Fireplace • APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Oucts, Ventilating 77. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead HyAro
26. T•Bar Ce�ling (Structurai) & 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 Nailinq HEALTH DEPT. REDUIREMENT
31. Plasrer Brown Coat 79. PINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � 6( � Notes: . _
34. Final Heating & Air Conditioning � • ,���j -
35. Final Gas Pipe�Test ^ ' ,
36. Hood or CanopY -
,37. Final Pactory Fireplace - • �
�
38. Final Plumbing .���
39. Water Service�Final , � ' . ` �
40. Gas Service-Finai
41. Solar pomestic�Final �
42. Backflow Preventer •
43. Backflow Irrigation
44. Landscape Irripacion System - �
45. Sound Attenuation
46. Handicap Regulations
47. FINAI STRUCTURE & BUILDING
46. FINAL PLANNING '.
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�ocnEssarsaiowc: 555 ANTON BL
°""Eas"""E"'°,o""'SAKIOKA FARMS
/i0DNE55:PO BQ}{ '20(j%
TERMINAL ANNEX
.w�. �mwc �sx
°"'' 1ST CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: E 076606 PLAN CHECK NO: N
""`""�TOP�'� INTERIOR ARCH.2136232164 "�NOo 9378
��p�'S� 550 S HOPE ST °NTo 110
L.A, CA 90071
����T� � COMPEL CORPORATION (310)946-8321
CUIINACTORSWdW610410 PIONEER BL
�u SANTA FE SPRINGS CA ��= 392693
90670 ��:
LJCENSEO COMFRCTOX9 DECUF�TION: I hereby allim uMx psnaly d prjury ihet I am limmed uMs ywivms af CMqr D
(mnmmr'uq n�h See�ion ]000) d Dnieion 3 d iM Buaim» and Pmimenne Cade. and mY �+s e h IuA tpcs ad aHed.
cmuc.no.:032054 uc.cuss:C-10 uc.No.: 392693 EXP: 08/96
(o� -a9- c�v.n«: ��. �e�.Au.-.
0 NER UILUEN DECLRFAnON: I hereby elfirm wder peneYy d perFN�'/ �� I am ezemq Imm iM Comesfwe Lirome Lew lor ihe
eeeam ($eqip� 1p71.5 &»irevs eM Pmleeeione Cods: �ny ety a oounry r,fiM �pu'vea a qrmp to omatrun, ellm, impv.e.
nn ' h, or rapei e�ry avucwn, pior io ns eeuuce, e6o repuime Ihe epplirem Im wch permX lo fib e aqrod etatemenl ihet M a�M
' seE pursuenl io tM ywieione d tM Conirmas Liceme lew �Cheptar 9(mmme�ip wuh Seaqn )000) W Oineion 3 d the
�Buaircm eM Prdevaiau Ca�l a IhN M a�he o memp tAerelmm end IM buia lp iM dbpeE uempion. My violeton d Setlon
]W t.5 by eny epplirant lar a permn waacu �M eppliceM lo a dvil penelry d rot mae �hen Ina �uMred ddlere (55W�).
� I, ea oxmier d iM properly a my anpbyea xih wepee n Ihei eab mmpeneetion, will Ao �he w�k, eM IM et�uclure c ml inleMed
w dlereE Iw seb (Secli� ��. BuuMns eM PmleseansCode: Ths Conlrenae Licenea Lew Eoes ml epply ia en owrwrd prape�ly
who Wilds or'vnpmvee ihareon. ud Mn doee euch wwk h'unwll a MneM a Nroup� �e a her own employeec. P�� �� u�ch
impovemente ere rat in�erMed a aHxed lor eda. M, however, IM buiNirp a inprtwamem u eoM xi�hin aro yeer M mmpbiion, Ne
xmer-buiNx will heve Iha buMen ol provinp �e w eha Eid na bulW w impeava la IM purywe d mb).
❑ �. m oone, a me wowhr. �.x�N oa,umvro wun foe�..e mnuevva. ro wnn��a ine o�iea (swo� �ae. ewu,...m
Pmfeeione Coda: T�e Contreaon licen» lew doea na epply io en owror tl propeity xfp W ike ar impovm tM�eon enE Mp
wnVeaa irc wN O�a wnh a mmredor�a) I'reneed Wnuenl lo tM Conirrlaa Lioeme lew�.
� I em aumpt uMar SeG��: B. 8 P.C., M thn iwon:
Daie: Ormu:
I Eo Mnby <MJy tlet I em awua d ud ivds�ie�d Ms rpuiramanb d Celfwn4 FNetlh eM Se/sy Code Sspom Y5505. ]553�. ud
25SX. end Mm I a ury Mun bdkinp omiWnt will / wil �(emcb pro) neeE b canply wih uid eW e mAes and the �pui�omwps 1or
epeemnlamnavueiionarnoe��han�MAi�iy enepenpnlpipnd.Raeidsntileonpiueluneppf�miomene�emqimmlhua
yo-risom.
Dale: App'saM:
WOflKEN'S COYVENS�TIOM OK Wi�TiON: I Mraby affirm uMr penMy W pmjury one d tha blbx'vp Esduetioro:
� 1 hm eM rA memten a cMAcate d aonvenl lo �Nlinwn la workas' mmpeiuetun. u prwidstl la by Saman J]00 d iM lebor
Code, lor iM pMpmance a� tln v.ak la Msh t�n permil n usued.
i n.w.�e.0 �m� wn�A• �o�.m� ��w��o.. m nawne sr sw� a�oo a m. i.e« cod.. b. me oena� d m.
w«x �a.n�, ma o«�^^ m o.ud. Mr wo,�n �wvm�, �m��. �« w o�.v �n., a.:
ca.»= nar_nnirrr EXPIRES
' Pa'�"""'"" ide3057-1i-155Z6 02/O1/97
�n;.,,a�,,,�e,�or a. �omd•�.e e m. ro�e o b+o,e nwe�.e em.�.lsrool o. �,.�
❑ I mnry tlW in Iha parlormerca tl tM wark for r.fic� iho pimn ie ivuad. 1�hell � empby elry penon in enY mennar n n to
becaro wbjea to tM �Me�s' mmenWian levn d Ce6lmiu. aM eproa thm it I ehould became wEpa io �M xaken'
mmpensmion pwubna d Setlion 3]00 d tM lebor Cods. I kWl la%thr//.njh apn/p]ry�wilh) 1IlI1meG�(y/�j� .
ele: — r.! Aidicenl:� /'(tHV \(IT �/ C�.*✓�.BtF�I
�D� Fa/lun ro ueurs ��M�n'ronpen,etlon eov�rp� la unlerNl, enE �lull u�/�ef en �mploysr to MM�W pwuMq �n0
C HI flM! up b on0 hu�tlrPd �hoUurd da/kn (S10q000f, In addltlOn b MI roIf OI COmp��wfbM1 tlameps u povlCW bI In
SxHon��6o/tlroLeborGoW,lnlruf,�ntl�ttom�y111u. '
CONSTHUCiION LENDINO AGENCY: I �areCy elfrm unEer pariMy d per'pay Ihet �hare h e mnn�uqbn bMirp eperwy br ihe
peNormemn d IM xwk /w Which ��u pertn� ia eeueE (Seaon 309), Crv. C�.
LENDER'S NAME:
� LENDEH'S AOOPE59:
I1 ceMih �� I hm�a neE thie aOW�d� eM pe�e IM1eI �he above inlammion i� coriea. I epree to canply wkh ell tlty eM muMyadinezee
eM aiab 4vn ielelip to WiW�p �evuaion end Mroby anhorrse rtpeeenidivee W Ihu tltY to mter upon ihe ebwe-mentiwied popery
b�infpetlun Wrpoves.
MONTY PEARSON
/-�L`L✓l kI -m P�LAa�`—.
o�, a -a9-9�
ggreturpdOvnwrl �pppl ' ir¢nw
� �
�isdnwv)
Nnk-Rewnue: (iddenro�Asaeaa
PERM NO: E 076606
GOVT: N SUPP: N '
CONSTRUCTION TYPE:. PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : VOICE DATA AND FIBER OPTIC CABLING SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B J
COMMENTS: 76 UNION PRODUCTS REF: H-75356
�+t�************x +t�+t+t*�r*��*x�***��*+��r***��****��*�r****x ****x **�rt***+a��*����crt�***�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: Fi IN
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
' f'.
fElE 1E 1f 1f iE 1F iE 1F iE iF 1E 1! 1F iE fE iE iE 1E 1E IE iE 1E iE If iElElE 1f 1FlE iE if iE iE if !f 1! 1k f4 fE �E 1E fF 1k i! i! �E 1E 1E fE 1E 1E if iElElE iE �E if iE iE iElElE iF iE !E 1Plk iFlf ff iF iF 1F'1f 1t 1F
D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S
ZONSNG APPROVED BY DATE:
HUILDING APPROVED BY : DATE: /
APPLICATION ISSUED BY: . DATE: � 2� l u
1flEifiFfEiEiEiElhiElEiEdf1f1E1fif141f�illEfE iE'1E1E1E1EifiElElElE 'lE1E
LEGALIZATION:N F£ E S U M M A F Y STRUCTURAL SEGME T;N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 66,00
508
PLAN
ISSUE FEE 15.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 66.00 15.00 0.00
REVENUE DIVISION TOTALS-->j COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
/ 81.00
TOTAL
81.00
Gy���[i1�D:la�y
PAID DUE
81.00 .00
81.00 OVER/SHORT; 00
FIRE SMIP/TOT GRADING PLAN—CHECK
M 1! 1ElFlk if 14 fE 1E 1E f(' 1E 1E 1f 1klF 1E 1E 1E 1E If 1E iE lE 1E 1E if iE if 1E 1E iE iF 1f 1E 1E iF �k!(� 141E 1f iE fk iE iE 7k 1E 1E 1E fE iE 1E fE 7E 1E iE ff iE 1E 1E 1ElE IE �1F iE 1f"k iE 1f iE 1E 1E 1E iI� iflh i! If
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S/C R I,P T 2 O N UNIT COST TOTAL COST
�
ELE 44 RECEPT/OUTLET 1 ST 20 EA. .75 33.00
ELE 3 MISC APPARATUS NOT LISTED REQ PERMIT 11.00 33.00
END OF FEES
`(�• `�
�
�� �.
r: '
CONSTRUCTION AND PLANNING RO(. .. SPA �
APPROVALS Permit # Date Inspector AppROVAIS Permit # � Date I�spector
t. Temporary Electrical Service or Pole 52. Pooi & Equipment Location. .�
2. Soil Pipe-Undrgrnd. y 53. Steel Reinforcement ' �
_ '_9. Electricai�Cond'uit Ut71itV-Undrgrnd. 54. Forms
- i4��Electrical Conduil:Undrgrnd. 55. Electrical Bonding -
�'5. Steel Reintorcement'. 56. Rough Piumbing & Pressure Test
�,6.=.EiectricalU�ER'G�nd. � 57. APPflOVALTOCOVEfl�GUNITE �
7. F-ootings _ � T 58. Electrical CondujrUndrgrnd.
8. Foundation ,_ �.- " 59. Gas Pipe, O Undrgrnd., Test --
9. Water Pipe�Undrgmd. - 60. Backwash Lines; RTrap, C Undrgrnd.
10. Structural floor System � 61. APPROVAL TO DECK
17. Property Sewe��Line & Hou:e Cortnection 62. Backwash & Receptor-Final � �
12. Sewer Cap _ = � 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing Syscem - Final
14. Rough Plumbing' 65, Electrical�Final -
15. Rough Electrical-Con'c�uit .. - 66. Solar Svstem-Final
16. Rough Elettric Wiring _� 67. Pencing & Access Approvai -
17. Rough Wiring Sign " 68. APPROVED FOR PLASTERING
78. RoughElectrical•TBarCefling 69. POOL/SPASYSTER4SFINAL
79. Rou�qh Heating & Air Conditioning . . FIRE DEPT. REQUIREMENT _
20. Rough Factory,Fireplac� ' - 'APPROVACS - Permit # �
21. Duccs, in Struciur�- � ���- - - 70. Underground Hydra
22. Ducti, Ventilating� �� � �� 71. Producf,Piping qGias 130i1
23. Gas Pibe�Qouq� & Test � � - � : � 72, Underground Flus}i' � -
24. Roof Framing � + 73.: Undergmd.StoragaTank,OGas ❑Oil
25. Roof $heathing �� . , ' 74. Overhead Hydro ��
26. T•Bar.Ceiling (Svuytarap & Monocoat � � ' 75r. Dry Chemical � - _ . '
27. Freme and Flashing � ' � �; J6. Dry StanZlpiDe , . �
28. tathinq & Siding �' � . � t + 77= fIXED SY�STEM�F.INAI� '- • �
29. Insulation . "` - 7g,. FIRE PREV. FINAL - ' -
�`
30. Drywall Nailing � � . _ HEALTH DEPT, REQUIRtEMENT
.�
-37. Plaster Brown CoaT-. = ' �T . �� 79. FINAL INSPECTION' . �
- 32. Electrical�Powei Meter�Finol �� 80. F000 CERTIFICATE ISSbED - '
`33. Final'Electric%. '. . "' ,� �,Jp¢ Notes: :'�� �' ` .
� '�{ �'{/
34. F.inal'41ea�ing & Aii Conditioning ,- `. _ ' ' - . _ . ' . _. ' `,
:� ��
35. Final Gas Pipe-Test - ' - '- . , ' , . .. '
Y ; T
36. Hood'or qnopy - " � ,: _ � �
37. Pinal Factory Fireplace„- ' - � `- � -
c � -
- 38. Final.Plum6ing . - z , � � .
�
39. Water Service�Final ' ' " '
40. Gas Service-Pinai : _ . � , �. .
"41. $olar pomestic•Final � ' ' - ' ' "
� -
42. BackflowPreventer _ _, ., � , .- �
43. Backflow Irriga[ion : - .
44. Landscape�irrigation System � , _y - � � -,
45. Sound Attenuation ' • ^ • . -
46. Handicap Regu7ations , � . - ' � - ,�
47. FINAL STRUCTURE & BUILDING - '
48. FINAL PLANNING ' . �
49. Electric Release to EdisO� . � � - -�
50. Gas Release to South�m California.Gas Co � ,
51. CERTIFICATEOPOCCUPANCY .
No. D&te �
�-
i
�oontssaemioixa: SSS ANTON HL
°'""E"'s""wEi°�: SAKIOKA FARMS
�ooness: p0 BOX 2097
TERMINAL ANNEX
APPL. YNNq i10DNE59:
uHt: 1 S T
�ncxnECTonwaN�n: INTERIOR ARCH.2136232164 �� 9378
RPCX.OPENO.'SADURE55: SSO S HOPE ST �r+T� 110
L.A. CA 90071
wNm�crarsru� MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
COMPACLORSYNIWG p O HOX 509
�pE� WALNUT CA ucxo.: 230813
91789 uxr:
LICENSED COMPeCTOqS DEC�AN�TION: I hemby Mim uMer penely d peijwy tMi l em IicemM uMx pwiebne d Gheqer 9
��m.�doa wnn s«� �oao) a a.;s� a a ina a,�� �e v�ae..� cm,..m mr �� g�� �wi ro� �d ,x,a.
arruc.No.:0/06�558 uc.cuss: C 10 uc.No.: z308�3 EXP; 1�2/96
oaa:_/— 1—Ej � H�� c�vma
OWNEN BUILDEP UECL11fl4TON: I hemby elfirm undar perely W perN9 �� �+�emp Irom IM Conlreuon limnee lew lor iha
�Ybxirp ieeaon (`�� )�t.5 Bwneu enE Rot�s COEe: Mry cry a m xAid� n ui�a e pem�e to mmmict. ellx. impwe.
� masn, a�ao� �y am,n�. a� w m:�a. ��c� ma « w�n � m nb a+�a.im�x mm �a «.na
r e�d w�� �o me yorisiom a qe cwreao.a �Km.,e Lew �cneqer s Im�m�e wun s«» �aoo) w u,e� a d�b
Busi�wss enE Tdessiona Gotlel a tM1et ha n ahe b uemp �here4om eed tM '/a elbpeE e�empian. MY violetion d Setlion
)03t.5 W eny epp4reni lor e permn wbpC� IM eppcW �o e m 1 pmelry d (xe huMrad ddlen �3500�.
❑ i.�o�,a�neawe�v�mr�,dw�wn��ine:��,v�o�,..;ueom.�k�du,e.wnwe:�a�ma�aad
a ollered fa eab (Seelbn>Ou. Buarea eM Pealasvone Code: TheConiretlon limnse law Eoea not eppytoen ownerol prape�y
.no waes « mw� �nareo�,. ene w�o aoes sucn .wn� nmmn or nersee «m�n na «nm ��Ww�•, v�aee md .�,�n
'mV�mm�b ua rid imaeded «atlaeE t« eab. tl. Mwever. �he brildifq «inpmemem o sald wilhin oro veer W mmWeiun. tM
owmr-0uiltler wi0 Mw �M bu�den d pm+ro he v aha did ed ddd a impv.e In t!n P�W�e W aeb).
eb
� I. ea oxner d ihe pmpem�. em e�tivsively coniradip x�lh IimnaeE mnvecfpe io mvmw tAa pmjea (�� �. Buai�e erd
PMe»ions COAe: The Camreean Licenae law does M xpdY b an ow}nr M AW�Y w1a bulffi or imC�'p tArean e�d xfio
wnvecb la vdi M4wa wM e mrv�mMa)1'cenxE Nnuaru �o �Aa Caviadae limius Lawl.
� 1 am uemq uMm SeeUon: 8. 8 V.C.,1« Nw eaeaon:
o,�.: o�«
i eo nerenr �anM uw i�....e u�e �w.nim,e in. rew���u d cd�«�m Heeim em sman coae seaion: assos. usa�. ene
25534, end iAm I a arry Mure brikinp ompent xJl / wil rwi (wcb aw) meE io comply wYh eeA nms mda vd iM mpuiremame br
ao�nt«mmvuciionamodifimionkan�heAi�iy ampememDisrie.Reud«uielmmvaion•wF'a�iwwanuemqfmmihma
Wm+awna.
oeie: aod�:
WORKEN'S COMVENS�TION DKLIP�TIOH: I M1xeby elfvm undx ps�My G�wjivy wn d Ne Idbxi�p dedueiom:
� I hera vM wil meinten e cenJicma W ooneent lo eM�imurt br wkws campensetun. n pwidetl Im by Sed'wn �)00 d tl�e Lebor
coae. i« m. �.n«�e a ms wM �o. w:on � wmm o A.�e.
ii i new.�e me meimec� .,on�a.• oomo�on im�reze. m na���.e W saaian a�oo a m. �ee« coee. �« �ne rortoimence a �ne
][ wak la w1�kA thu pmmX b aeued. MY wvlve' mmpxumion imurerca xriis W pofv.y numEx ma:
Carrier: FTRRMAN' S FUND EXPIRES
oa��+�mb«: nwranF�FFa� 07/O1/96
(This aMion need riw M canpleied / Ne pmml is br aw hwMiedCdkis /SIW/ a b.n.)
� I mnN �� in ihe pMamencs d Ita wk la wliich iNs pamu o enrotl. I WII na empby enY De� � NY maruia w u �o
become eubjed lo IM1e xorFera' canperuuion lewa d CeWwnu. erd prss tIW ! I wk become wbjed to M1e xorkere'
tam naelion qwiaona d Sedion �]00 d IM lebor Cotle. I ehell �!n%y� mmpl/ wnh 1 oea pwiebna.
o,�e: � /�' _`� � ��: �� '
Wamlrp: F�qun ro�ecun worken' comvwwtlon mv�r�p� l� un4wN( �nC • a�lJ�c( ��mploYM to crlMiu/pxu/tlu entl
clvll IIM� up ro on� huMre! fMuunO Edl+n (SIPq000/� M sAd/tlon ro M� t ol ro �..rron e.m.p.... o.o.w.e ro. ��
Sxtlon 9105 0l Ihs Leboi Cods, Intxul. �M �Rom�Y� I�u.
CONSTHUCTION LENDINp �GENCY: I hneby elfum uMx pdWiy d pxjury t u e m�uvwbn bM'uq epe�r.y Irc Ne
parlarmemx W �he xoM M whitli �he pertN'a owed (Sedion 3091. Cv. C).
LENDEH'S NRME:
LENOEP'S AD�FESS:
� cenlN �nm � neve reee mc wo�cmim ero ame �ne� th..bave m�om,eibn b oonm. � ro� �a comW wnn m� tlir eiw counq «ainenms
end etme lewe reldng io buik'vq wnmufnm eM Mreby ainhor'¢s �apasenimives d Ihu dly Io enlar upon �M ebwa-memunad popeiy
lorinspeaian puryoaes.
CHUCR JACOHY
,..4 . ,,`,
Dae:
(St51d6.WP) 1 INfiue-BuiMip d Setery: GreamFb: Cawy-Appkani; Pink-Rerarvn; Gddevod��M.xeaor
\�
CITY OF COSTA MESA - BUILDING PERMIT
. PERM NO: E 07600
PERMIT NO: E 076008 PLAN CHECK NO: N GOVT: N SUPP; Y
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE PURPOSE: ALT
JOH DESCRIPTION : INTERIOR 18000SF T.I. / ELECTRICAL SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS / REF 8-75356 � S�� �����9
�rx�+r*x�*��x��+r*x��**x��x���x�x����r�**�x�x�**����x��rx�* *+rx� �* x�*x*x�x�**�*�**+r+��r�r���r
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDZNG ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING Nd1'ES>
� n �
1E 1E ik'1E 1f 1E 1E 1E 1E iE iE 1E 1F 1E 1E 1E 4 fE fE iE iE 1E IE IE IE 1E 1t 14 ff iE aE if' iF 1E IE 1E if 1E 1F 1E IE 1f iE Ip 1F iE 14 iE 1f 1F Ik 1E iE 3EiE 3F iE 1E iE iE iE 1E 1F if 1E iE 1E �E iE if if ih iE 1E IE 1E iF 1E 1E
D E V E L O P M E N T S E'•R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY � DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: �+�
iE 1F iF 1k 1E iE 1E ik 1E ik 1k if iE 1F 1E If 1k iE 1E iE 1E if �iF�f�FiE 1k 1E 1E iE iE iE i(� 1k 4�7F{FiE 1E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT �50E SMIP/NON-RES
PLAN
ISSUE FEE 4.50
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 7.50 4.50 0.00 12.00 12.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 12.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
12.00
kiliE1i7f1E1kiflFif 1E44MKIEIE1Efl1kikltiFiklEif 1fMlk�kiEkiFlElEifiFikiEltiflkiElElE1li4ik1EiE1E1ElE1E7t1kiFk1k1Ek1f IE1EiE1E1E1E1fiEiklFlfiEififlkibif
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 10 RECEPT/OUTLET
1 ST 20 EA. .75
END OF FEES
E T D
12
U� �iU�4�,.1i .1].�'.t�� " "
�InT.".� t�� i�, ' i, _ J _.
7.50
CONSTRUCTION AND PIANNiNG � POl .SPA .
APPROVALS Permit # Da2e Inspector qppROVALS Permit # Date Inspector
1. Temporary Eiectriwl Service or Pole 52. Pooi & Equipment Locacion
'2. Soil Pipe-Undrgrnd. - ' 53. Steel Reinforcement � �
� 3JElectrical�Eond�E UQity•Und�grnd. 54. Forms � �
�- F�4-7�Iectrical�t ohdutTF_�U�rgrnd. 55. Electrical Bonding ��
' i -,
�;:5�`$teel Reinf,orcemef?t" 56. fiough Plumbing & Pressure Test
-�� 6:� Electrical U.�ER��nd. 57. APPROVAI TO COVER-GUNITE
l r,
���' �ootings�;n ' D 56. Electrical Cond[i{t�Jndrgmd.
7 8. Eoundation. n,y �� 59. Gas Pipe, O Undrgrnd., Test
,�
9. Water Piqe�Undrgrn�i. �.- 60. Backwash Lines�7rap, � Undrgrnd.
10. StructuratJFioor.System 61. APPROVA�.TC1x7ECK .
11. Property S�wer Li��e � House-Connection 62. Backwash & Recr'e�Stor-Final �
. ti ,
12. Sewer CaB. `r' • 63. Heater & Vent-F'tnal
13. Roof Drains ,-��,_ 64. Plumbinc� System � Final '
14. Rough Plumbi'n�, �;; � 65. ElectricabFinal
15. flough ElectricaLConduit 1 66. Solar SYstem�Finai
i6. Rough Electric4Vifir}`�g, _, 67. Fencing & Acces �Approval
',;17. Rough Wiriag SiB� 66. APPROVED F6RPLASTERING
� �.ii
.18. Rough EleMricaFT Bar Ceilin�'` 69. POOLISPA SYSfF(viS FINAL
t9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
�'��. _ n+ ..` rT �.HCJ;- .:: + h '^.
20. RougE7F�CtOr�Fir�ace � T`;� Z� y '��, H c,b`-.s'APPROVp;.1��_:�_.Pe'rmit# Y � ,
27. 6uct� in $truLturt^� •� �� t ti '� .� 70. �l'Jnderg'rb+�irid Hj�dro �
�k
22. Qucts? Vetitila�jng �K • ��> �* � � � ��'. �`7�, produ��Rf,pinG �.J�as y.0il
23. Gas FiAe-AougFi & TeSt r. !n �� a; � fi�, 72. Undergr3und Flush � F
24. RbofFraming • � * � ' _ * •" -,' : �, i • , 73T Undergrna. Stor�`a�;Tank;D Gas ❑ Oil
25. Roo�heathing "�,� a; �• v�x -+ 7 �: �� 7�YJ Overhead HydreD
26. 7•Bar'Ceiling �Strad,t�ral) & Mony'46at �. � �; '��� 75� Dry Chemical F,� *'- `~' ';
27. FramGand,Flashin��y ���, � C �. . 7b. Dry $tandpiPe F co # ro
.28. LathSng BrSiding ��t. c� ��� ,T� P �- �• •-F 7� FIXED S��S,7Eti�:FINAL ;,
"29. Insulation� ?: �� 5 •. * ry � �r 7$`�.,' FIRE PREV. FIMfCL ?^ �'
' 30. Drywall PTailing ��� y � � i �k ��., �HEdALTH�DEPT�.'fEECYGIF�MENT
31. Plaster8rpwn;Coaf K, ,NR « � ;�.,-79�. FINALI�SPECT�N x" Y r
�32. Electrical�ow8i M€terBinal ' ' '� � '`� ?80;�FOOD CER7IFL� �f I�'$U.ED
33. 6lnakElectric _, ° � �jr r•�(�� K�J � � `^ -'._ � ..' ..
_ .. . .- Or. m I '• v1��� 7rJ I -�• Nq4es: ^� '7:': ' y � _
.r34. Pinal�Heaiing�Ai�Eondiiionin¢S i'� �x x �'7 �v �S �-.�. t _. :
- .�� z, m� e�� �vo � i - t _.
35. Final Gas-PiPe Tesv{ �" : * f; ! i,'k , .'`"° "=- - "." * r;n;
. 36. Hood or CanoPY J* _. r• 7 a :r C� ; '` ' � �'.G r�� ^
x li: RI 7' C ) : SS
.37. Final� Faet`'�ry Pire�i�ce`.r ' � = � �` :' '" t � . •..
� x v Y n:
� .: . .. , - . -
�38. Finat'Plu�fibing "'R J :�� � . ' ' {" - �+ .+� � ' Q
- r .x I� �
��39. Water"Serojce�Pinal ' l � � � !a` �' " � ��
a � �: t �n� m
�40. Gas Service-Final'' ir m r:���� � s��: �; t� �.-�v, ac� � y � •-
* �' . o F �'
'�•41. Solar pomesticFir+a� � �' ' �'�' � "�, �, ;y` ^ * ,.., �
� c y-� -�
. �. �
�42. Backflow Preventer. �x r1 i � 4 �; ^ -• * J :- `� � -''
.-+ _ w .. n [l K '-
43. Backfiow Irriga"tion .�' ^, '":= * ,' �-' '. `; � .
♦ } u 7: .{. , �.7 i �A i •
.. ' a �. :- . - �
• 44. Landscape;IrrigationySystem m!:7:: � .a!*t G O �7a' � a ��� xCJ « �� �
n - ,, �
� -1��. ' : . i-� F� `- a ...� rr Q'U. 3' �' '
4$. Sound Attenuatio� r -... .'� m y i-; ; rr .� • 4, z
_ r•
,46. Handicap 8egu�ationi = ,� : ` �� � "- �7c s ,.
.,
47. F1NAL STRIICTURf� & BUILDING y� c �`' ^•� S �
: � r �e s n
48. FINAI PLANNING e rF• �:v ` M. t*� 4 y� h
.�Y f �
49. Eteciric Re{ease to Etlison • '+ �' =�; �
w
�. i . M.. r v
50. Gas R@lease to Southern Californ;a 6as Co « I x� �� �� c n� y .' •
\- 1�� J
51. CERTIFICATE OF OCCUPANCY^ �' fa '-tt � .. r • �
No. Date
�
IrJ
�
; �.
0"eoodESsaem�axc: SSS ANTON �'L
ax'nEasru�Eiip+o"'": SAKIOKA FARMS
�ooncss: p0 BOX 2097
� TERMINAL ANNEX
uxr: 1 S T
; �AYFL. M111JN0 ADDPE55: . , . .�.
�"�wcxnec,oe�xu+�n: INTERIOR ARCH.2136'232164 ��� 9378
UKROPEWY'SADONESS: SSO S HOPE ST �,_`:i'S ' IINT: LSO
L,A. ``!'� CA 90071
coxmncrarsrun: MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
cam�croRs �uuxc P O B OX 5 0 9
�nn�ss WALNUT CA uc.ra.: 230813
917 8 9 �,.�:
LICENSED COMfNACTOXS DECLANRTION: I Mreby ellim undar penetly d parjury that I am Icerued uMer povisians M Chepter 9
(mmme�M wilh Seclion 1000) d Diviaun � d Ure &m�a ard PMeasbn Code. vd my li�enae w m IUA Mce enE eMeA.
cmuc.No.:006558 uc.cuss: C 10 uc.No.: z30813 EXP• 12/96
�ae i z- v- 9� ���..�,,. /�-�..�, �„,�n '
�W NEF BIIILDEH DECIAHATION: I Mreby elFrm uMer penetly d perlury �he� 1 eeamp rom the Conveaon liwnee Lew lor ihe
bxiq eaewn (Setlbn 1031.5 Bwiima md Prdeaiona Code: RM <N a .nw� �re.. o�n io ooawn. �na. �woV..
.molsR a wpeir any avuewn, peiw m na ewenee. eko repuirea the epqieeM i r sue� il lo file e egired vimamont �het M a eM
n�K,�„e w�� �� �� v��. n ma c���a«. �K«,� v. ICAeWar 9 oomm h0 wnh Seaion 9W0) d D'veian 3 d ihe
Bimron vd Rdeaiom Cadel a ila� he a she b ezamN ihare/mm end the elbped exemqion. MY vidmion d Seaun
)03t.5 Ey any epdireni lor a permn wbjew the epvlicem �o e avil parelry d ml more ihen five hundred dollve �5500��.
❑ I.mowrerdiheVW��YvmYemWT+a+wlhwe9esmihsdecom0�ian.willdotMwark.vdtMemMuree�wlinleMeE
or oflared la eeb (Seclion 104I.9�simm eM ProfessionaCoEe: The Contreqon Lioensa Lew does iwt epplyto en ownerd Propany
wM10 Wlds a inpwea �he'eon. aM xM dm� autli wak limeetl w MnM ar Uvuqh hc or her own emWvleea. pwiCed ihel wch
impwemeius va ria imeMed n dleieE for eele. tl. howwer, iM buikiip a'vnpovemeni u eoN xnhin wp yw d comde�bn. �M
ownw-0uikw x41 here Ihe buNen d Mo+��O M a eha ditl nd buk a imW� la �he VwDae W We).
� I. v o�mer d iM popaity. em eztlusivety conirediq wnh licenwd convacbre to wnshutl iM pmjea (Secvn )W4. Buairime eM
amm:m. coee: rne comraao9 uxnse �e. eom m mW �o .� o.,w a wooero wno w�a. « Mww. �ndeo� .�d .+w
wnVada �a vxi� pqep+ wdh. mmrmMa) liceneed wrsuam b ihe Canrmon Lioiu. Lew�. .
� I em eump uMx Seciion: B. 8 P.C..Ia ihia �mxm: ' �
Dme: Owner:
i eo ne�M =�nM �n.� i em awda a�a ��aen�ana m. �eau���e d cveanie Heenn ene s�rnv coea sea�. usos, zss�a, ena
?553a. eM iM1el I a enY Mu�e Wikuq maqw will / wA rwi (ertb me) rieed w canVh wih eeid qe�e wdes W tM �e0wremaw br
epermnlnomsbunbnartaERrationhamiMAi u3eTi�y anpemeniDimiiq.Red�mlielmmrudioneppirmiwnenezamqfmmUpee
p��.
ova: Aavi�:
W OflKEq'3 COYVENSATION DECUHATON: 1 hareby dfi�m uMx perW�y d pe�jwy me d �lie IWowirp JMereiioru:
❑ I hava enE xJ meiNen a ce�Eiule M tonaen� lo aalfi�ww far wkm' cpnpsiuYcn, u prwided b by Seroon 3'!00 d �M leba
coea. i« ms wno�� a ub w�x io...i:�n mo wmm a ro�a.
pine.�.m,ewmevvenwna.•m�v�oni�w,rance.mna�.dMs.a�3�ooame�.ec.coe..rorm.w��am.
. wwk la which Mie permn u uaud. MY wa�' �G��� imurenca �ertier end pdiq riumEer ue:
c�: �FUND EXPIRES
aa�r�mw: nwranF� q�— 07/01/96
(rhis aMion mei rof 6s mmpMmO ) tlro Vm'ml % b wv hundred Qo1as �5�00/ w/w.)
� 1 mniy Nm In Ne perlomiuice d iM Work M w1�cA �his pe�mi� o iaixd. I eM1ell m� ampby erry penon M anY men'wr eo m to
bxane wbjen to tM xakas' mmpmetbn lew d Cafdama, enE eprae J I alwld perome abjw to �M xdbn'
n.�.n� wwre d saa�a, a�oo a ma tem, cma. i onn.mn wm� »;m uob wo+na� �
o�,: I 2- L7 -�s ,,,,�,�„„: 7'"i .
Wam/ny: F�tlun ro aecun wvrkwi mmpawllon eovs�ep� Is vn/eHul. e �IWI • J�ct en wnplaysr to ulm'rW pau/tlu uM
nH� nnu � ro ms nuwrse rnou..ne edbn (tfa4aaoA ����n ro• ewf o rompewtbn, tlunpn �s provldM br In
Sxtlon 3]fA6 0/ fM LNo� Code, /Merut ���mry'a /wa
CONSTNUGTION IENDING PGENCY: I Mreby dfirm uMs penetty d Ihen u e mnm�utlion bMi�q epmry /or tM
wn�� d m..,o� ro�..nw� me w�� o�e (s�eo�, xs�. c:.. cl.
LENDEP'S NAME:
�v+oen�s �ooAess:
I ceniM �het I heve �aaE Nc eDdication enE pma ihat the aCove iNmiwian a canetl. I V� to comW wu� e0 cry aM mvtlY ad'mercm
aM ale�e kwa reletip �o Wldiq cmNumon end hereby eNhwrsa reprexnte�ivm d Ih'v tiry b eMer upon IM eEove�menlionad proparry
�� �� ��.
CHUCK JACOHY
(5151d6.WP)
i z-z�-ys
�,Vfyi(e-Buiqip 8 Sdery; Green-Fb: Caneiy-Appfunl; Pink-Revmue: OOMenm�Mamw
CITY OF COSTA MESA — BUILDING FERMIT
PERM NO: E 07576�
PERMIT NO: E 075769 PLAN CHECK NO; N GOVT: N SOPP: N
"CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE PUAPOSE: ALT
SOH DESCRIPTZON ; INTERIOR 18000SF T.I.'/'ELECTRICAL SQ FT:
CLAIM�VALUE:' CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNTON PRODUCTS / REF B-75356
�� **�����*x �**�*�**��**+��'*��r*.*+�*+���*x *�+�*�+r�+r��r�r+�� � *x **x��*+r***+�+�� �***��*+�*�****
Z O N I;•N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i '
�+��**�� �*+�*�x+��**� ****���*x�**�***:�*i�« *�**+�����x�**�r�r*******��*�*��*+�+��*��������*
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY �ri DATE;
BUILDING APPROVED BY : DATE: ��
APPLICATION ISSUED BY: DATE: I�% !/!�`j„S
ifiF�FiE1EiE1EiEiFifiEiElEfE1EiE1E1EiE7E1ElE , iF IEjF1ElfiEiFiF�FiF1E1E fEfE iFif
LEGALIZATION:N F�E�E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 248.55
50� , SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 248.55 15.00 0.00 263.55 263.55 .00
REVENUE DIVISION TOTALS--> COLLECTED: 263.55 OVER/SHORT: � 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
263,55
1E iE fE IE 1E 1E 1E 1E 1E iE 1E 1E 1E 1k iF iE 1f iF iF 1ElE 1E iE 1k 1E 1E ik 1k iE 1klE if iE iE ik iE 1E �E 1E if iF 1E if if IE 1F iElf iE iF iflf i! iE iE IE 1f 1E iF 1f !f fE k ib if !k If fE �E aE aE 1E �E iE i! 1f If 1E 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75
ELE 180 FIXTURES, LIGHTING ADDITIONAL EA. .45
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75
ELE 94 RECEPT/OUTLET ADDITIONAL EA. .45
ELE 20 RECEPT/SWITCH 1 ST 20 EA, .75
ELE 5 RECEPT/SWITCH ADDITIONAL EA. .45
ELE 3 SUH—PANEL 11,00
ELE 1 MOTOR/POWR APPARATUS OVER 100.
END OF FEES
D �:
15,00
81,0�
15.00
42.30
15.00
2,25
33.00
45.00
� �
� PC & SPA
,I, COf�!$T,RUCTION ANq PLANNING _�. .: - ..-..,
i APPROVALS Permit # Date �Inspector qppROVALS Permit # Date � inspg'ror
t.� Temporary Electrical Service or Pple 52. Pool & Equipment Locationi
J
2. Soil Pipe�Und�gmd. 53. Stee� Reinforcement ' �' ti
.
3.; ElectricaLConduit Utility-Undrgrr�d. 54. Forms ��-
,4: Electrical Conduit-Undrgrnd. 55: Electrical Bonding ��
5., Steel Reinforcement 56. Rough Plumbing & Pressure Test
� 6.= Electrical I;FER Grnd. � 57. APPiiOVAL TO COVER•GUNITE �
7., Footings �� � 58. E�ectrical ConduitUndrgrnd. ' �
- 9. Foundatiorn,� � � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. : '. 60, Backwash Lines, P�Trap, O Undrgmd.
70. Struttural Floor System r-' ' 67. APPROVA� TO OECK "�
1 t. Property Sewer Line & House ConneEtion 62. Backwash & Receptor-Final
12. Sewer Cap � � . 63. Heater & Vent-Pinal �
13. Roo4 Dra+ns -_ 64. Piumbing Sysiem • Finat � ti
14. Rough Plumbing; .� 65. Electrical-Final
�
15. Rou9h Electricaf•Conduit ' 66. Solar SYstem-Final ' �
16. ftough Elearic Wiring � 67. Pencing & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
18. Rough Electrical_T 8ar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � _, , FIRE gEPT.REQUIREMENT
20. 8ough Factor,Y FiPepiace � _ , - _ ,. ' APPROVAL-S_ c� Permit # ,- - --,�, ,,,, �
27. DuCts, in'Struc[ure' • - ` � " 70. .Under�'iound Hydro
r:; �
22. Ducts, Ventilating , ' � '.� �• 7�, praductPiping OGas OOiI
23. Gas Pipe�Rough & Ten - � � � ,, - � 7z, Underground Flush '
24. Roof Framing". ' � _ , _ _' 73: Undergrnd.StorayeTank �Gas ❑Oil � �
25. Roof Sheathing ' �' v+: � � 74. Overhead HYdrQ , '
26. T-Bar Ceiling (Structuraq & Monowat �` � - � 75. Dry Chemical � � �
27. Frame and Fleshing - • � � 76. Dry Standpipe �'• ,
28. Lathing & Siding . • � . - � ' . 77� FIXED SYSTE(v1�FINAL � �
29. Insulation - • •� 78; FIRE PREV. FINAL - -
30. Drywall Mai�in9 �' ;; ' HEALTM DEPj. REQUIREMENS -
31. Plaster Brown Coat _. -. • � 79. FINAL I'NSPECTION �� �-
32. Electrical�Power MeterPinal � Sd: FOOD CERTIF,iCATE ISSUED -� `
. . . .. _. . �I`u - . . `. ,
33. Fina�,Electiic � ,. • ,. Notes: - ' � �
34. Final"Heaung,& Air Conditiomng- ' ._ , - • � - _ . , -
35. Final Gas Pip¢:Test, ., . . ' � : , • � .- - � .
,
36. Hood or CanoP4 = ' - ' : _ , , �. " , �_
� 37. Final Factory Pireplace . � � � � . - . � .. . .
38. Finai Plumbing ' ` - ' � --
Y " / -
39. Watei Service-Final _ '" _ -r_ � - � . . , , 1t--�' �
i � rr
�40. Gas Service•Final r �:� , - - . , , • h
F Y =� '�
41. Solar pomesticFinal` _. ' �. � . , � � . �" '7 -
42. Backflow Preventer � � - ' • '�
� :'.' '
43. Backflow Irrigation �- � . � �_�� ;
44. Landscape IrriAationSystem . � ' ' - r . � - � ' � � ' ' y�
45. Sound Atrenuation � „ ' , � �- �, .. - • ,
46. Handicap Regulations '� � -
47. FINAL STRUCTURE & BUILOING � � , �
48. FINAL PLANNING � , � ' "
49. Electric Release to Edison � . � � , .
50. Gas Retease to Southern Ca4itomia Gas Cp ' . - - � � _ ' • . _
51. CERTIFICA7E OP OCCUPANCY ' � - �
No. Date
e"1D0'� 555 ANTON BL
, 'F�"'� SAKIOAKA FARMS
"�o"� PO BOX 2097
TERMINA ANNEX
1VPL.��DOPESS
uNr: 1 S T
�xcxnecrone�ax�n:INTERIOR ARCH.2136232164 ��� C-9378
�xcx.on�+a•seooxess: 550 S AOPE ST �M� 1100
LOS ANGELES CA 90071
canm�crarswuu ACCENT HUILDERS ( 714 ) 757-1998
ca+m�croas�uwq 17945 SKYPARK PARK CZ
mo�sa IR CA ueao.: 39779
92614 UNT:
IJCENSED COHfN�CTONS OECLINATION: 1 M�eby dlim wder ponely d pmjury I I' ol Cheqm 9
(m drp xilh SacWn ]000) d Divieion 3 d �he Buamee arM Pmimeions Coda, m lioen i lull bme d .
uc. io.: uc. cuss: g uc. No.: 'j O EX
ome: ' comma«:
OWN BUILOEN DECIARATON: 1 hereby elfi�m uMx perWy rNrv �� � em hom �M repaa Limnee Lew �v IM
reeaon (Seubn lW 1.5 Busiae+uM Prdmebrm COEe: cry n mumy Mfiid� iiee a'mn to omeWn. Mer. impa.a.
m�pIph, or repei eiry emidum, prior to ils eeuence, deo rpui iM epplimnt lor m�ch pamil e a ey'wd sbtemenl ihel M a�M
licdnaed W9uenl lo Ihe plovieione d iM Conlreclwe Licenea Lew �Chepter B(oommend�p wil� Sed'qn ]000) d Orvbion 3 0l lb
dusireee eM Prdeaons COEeI a Ihel he w ehe ia aremp Ihereimm eM the beao tw Uro elbped uemqion. MY voluin d Seaion
1031.5 by enY eGd� lor e pmmA wbpea Ihe epplicenl to e dW penelry af M man Ihen fxe hunEred Edlen �5500�.
❑ I, ea owner oliM qoperly a my empbyeae wYh wepee m �Mi aob mmpeneetion, will Eo Ihe vroM, enE iM NiuCure u nd intantleE
a oflereE br ede (Section )OCJ, Budiwea eM Proleaaiona Loda: Tha Con�reclae Limnee Lew daee m� eppF� lo en uwnerd qoperry
wM Wlds a inP�a Ihereon. md Ma daea euN Mqk Fimaetl n Mne� Or NruNA hc a her am emGbYw. G�'� thet euc�
impwememe ere nd iMaMed a W«ad la eele. tl, howeror, tM buJdiip a inpwemem ia eoM wi�hin an yeer d camplsion, tM
ownerbuiMm xill heve tha buNm d povinB he or she did mt WiIE or improve lar IM WT�e d eeb).
❑ l m ow.e. d ihe amwm. em exd�mwlr camrer,:ie .�nh �icwu.a connmia. b conatrua un w9� (s.aun roae. ai.iris. w
PMeaeiona Gade: TM Comrmm Lironae lew does ria eGVN to en owmr W pW�Y who Witla a imD�'�� the�son aed who
wntrena M wM prqeqa wnh e mmrador�e) IicenaeE pureueM to IM ComreGon lironee law).
� I em uempt under Secibn: B. 8 P.C., M thn reean: - -
Dme: Owner:
I Co hereby cMity IMt I em ewere d eM uidersterM IM reyuiremente M CelLamie Heellh ud Setety Cada Smiaa ?5505, 25533. xM
4559a. eM thet I w enY �um Wikirp o¢upeM xill / wil rwi (a�cb me) �ed to camply wih �ud etae codee eM ihe mpuimnenb br
a pmm� lamrebuction«modifr�ianhantMAi�eneyemenl Dvliia. Reckentml mrm�utlion eppiratbroen�emq Imm Nms
provisiore.
Dale: Appl�uX:
WONKEP'S COMFEHS�TION DECIAX�TION: I Mreby elfiim uMer paneXy M perjuy me d iha Idlowiip Eetluetiona:
� IheveeiMxilmeinteinecerliticeledmuentioaetliruuroMxakaa'compemelun.mprwidWlubySenian3)OOdlhelebar
cud.. �« �ne wdormence d Na.ak �«.hirl, inu v�a u u.uee.
. Cl I hm vd xil meiMen woMen' eompenatlon imueenw. n rxryired by Seqim 3�0 d tlre Labor Code. br tM pMormenw d tM
lr work fa which thia parmil ia ieaueE. MY wakeie', canpenamion inwrence ceniar eM pdiq number ara:
I c�, _.LIHERY MUTUAL EXPIRES
1 Pdiry Numbec 1 2 � 0/ 9 8
rTm:�.r���e�weaeoma�.dern.ro���.ro.w�.n��dreeedbm/siaolo.�,. /
i cenh' �nm m �ne v«�ameMe a ine w«x ror wncn mro o�a a muea. I e m� emWw ineruie. so u io
eooma a4✓� �o �M wwkare• canGe�ion lern a cefilanb. eM e Ihm H I - to IM worken•
ompans&ion proviaiom W Sepbn 3)00 d �M lebor Coda. dall lonh ' 1 can ' t 'eion .
o.�e: 7i3 — nod'c.m:
WeminO� Fellun ro wcun worteti romperwtlon rovsreps Is un I, antl ahel au6/�cf m loysr ro cNMiuIOM+�tlsi enL
c/W/ fliros up ro a�s huntlrs! fMuasnJ do/Mn (S10q000/, M fbn ro M� ew / comp fbM1 tlameps� a� pvvldsd br In
Sxtlon 91Q5 0l M� leEor Cotls, InMv4 Ntl ertomsy� Iwa
CONSTPUCTON LENDINO AGENCY: I MmEy elfiim urMer pandry d per'Nrv �� �M1era ie a cane�udion IwMi�p epexy �a IM
perbrmenca d tM wak br wfiiM Ihe parmL is uaueE (Sedion 309), C'v. C).
LENDEP'S NIIAIE:
LRlDEWS ADDRESS:
I cerlily ihet I heve �aed Ihia eppl' E etele ihel ihe aCove iMormmion p mrtetl. I epree to compN �h ell ary enE oounry adinenro�
vd atae leMa reletiq Io W�ixfion erd Mraby eWpr�reprsaenlamee diNs dry b enta upon tM ebwe-mentvied popeny
IainsOed'w^WrGn+ee... �... �
�
•
(515Pa6.WP� WhnsBuikino 8 Seley: Oreeo-Fle; Cenery-AOP��C Pink-Revenue; Gddenro�Aememr
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: P 087090
PERMIT NO: P 087090 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION : DEMOLISH INTERIOR NON HEARING WALLS SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: REF:H-87087
�*+t*��r�r�r�*���r�e*�itr�r�r�r*it*+t�r�t*+a***�t+r*+t+t**+t*it�r�****�****�****+r�r�at*+t*�r*�r�t��t*at**�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: _ FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGFiT: FT IN
PARKING REQ• PROV; PARCEL: 41050104 ZNE: REF NO;
PLANNING NZSTES>
�
M1FiFklflfikMMikMMiflfMiflfMikl!lFlfkiFMitifiEif ifikifMMiklklFkifMlkiliffFiFiFiFitMitkititikiElkiFiFlFif1F1f1EiFiFiFMMifikiEifM1F'1li4161FiF
D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E N T S
20NING APPROVED HY. DATE:
BUILDING APPROVED BY..: DATE:
APPLICATION ISSUED HY: DATE:
ififlFMMMitMitltiFiFiFiFifMitiFitiFiFM kMitiFMifikiFkk 1EiF
LEGALIZATION:N F E E S U M M A R Y _..STRUCTURAL GMENT;N
PERMIT BLDG PMT .PLUM8I75 ELECTRIC MECHANIC FIRE SMIP/RES GRADING
25t ' SMIP/NON—RES
PLAN
ISSUE FEE 22,00 ''
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 8.75 22.00 0,00 30.75 30,75 .00
REVENUE DIVISION TOTALS—.—> COLLECTED; 30.75 OVER/SHORT: 00
HLDG PMT PLUMHING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK
30.75 •
iF iF±F ik iE ik 1f ik iF iF if M iF 1F N M M iF M it M M M it if iF 1f �F if 1k iFlE if iF iFiF iF MiFiF iE ik iF M�41F 1F iF M M Mik K if iF ik if 1F if iF M 1k 1f 1F iF IF iF'N' iF iF aF iF if iF if'lf 1f if� 3h
I N D I V I D U A L- F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O.N UNIT COST TOTAL COST
PLU 1 SEWER CAP / DEMOLITION EACH 8.75 8.75
�. _ . END OF FEES
- A2-24-1998/89:53 HN/f38.75
— RCPTq:01—A620023
• PEkMIT:087090
! \
P60� SPA
( 'NSTRUCTION AND PLANNING - •
Date Inspector Date Inspector
A�OVALS Permit # ' ' APPROVALS Permit � � .
i. TEmporary Electrical Service or Pole 52. Pooi & Equipment Location �
.2_ Soil PipeFUn r rnd.H � 53. Steel Reinforeement � � r,
,; 3: �lectrica , tn,� ulity-Undrgmd. 54. Forms . ,�^�
047�EIectricaf���Undrgrnd. 55. Electrical Bonding � ^� �
ar- tr � 1
'�5,r$teel Re„�or�q�gpt 56. Rough Plumbing & Pretsure Test ~'
' R'8.'%IectriWittQF'5R+Qrnd. 57. APPROVALTOCOVER�GUNITE �
I "" T t�'I
£7.�ootingsSn �� 58. ElectricalCon��Undrgmd. ..
��y8. Foundaticin- t� �:n 59. Gas Pipe, � Uachyrnd., Test �� '
9. Water Pi��Undrg�i, d. � 60. Backwash Line�,'�;Trap, � Undrgrnd.
10. StructuraLFloor Svstem w 61. APPROVAL TD'DECK
; 11. Property9ewe� Lir� Hous`Connection 62. Backwash & R$�'N.rp�torFinal -
�' 4
12. Sewer Ca �, � •'�� pp K 63. Heaier & Vent-fiFal • �
�
73. Roof Drains �" , � 64. Plumbin9 System � Final �
�V
14. Rough PEymb n� .� _'-,��. � 65. Electtical-Final � , �
15. Rough Etectrical-Cossduit •• - � 66. Solar System-Rfi(at
�
,� 76. Rough E�€�ic�]irir� � 87. Fencing & Acc#��.s�f�pProval �
. 17. Rough Wiripg 5i8n � � 68. APPROVEO PE3R'PLASTERING
�� �
18. Rough Electrica'I�T Bar Ceiling� 69. POOL/SPA SYS"�MS FINAL
19.�j'iot�q{it{eating&�i�Conditionine� �p+ x ;.� �.tn !r RJft�&Sil�PT4REQUIREMEPtT C
""' B7 ":N�O LTJ � T '7
20. �;ou�q} f3�to� F��lace j 4N �'� .r S� Q'* APP�,O�`�a P�mit #�: '" �
xS ��: H "7 '7x,. `. � ���
21.�uc ir`�,T.,,tructur�,: i SN M C.`. �-+ (1#. 70.F{Jndergr+otflJd dro � �
<" T h'!! �!`
22. �uc s, V�til in�* � �� C '¢ � F�� 71. Prodt�`r1'�iJ,in���' {,ns Oit
r) � * I qC x tf' .� R' [T�" � Y V � G
23. Gas,P�pe�o , &x7�st � �r.z-. p�0 �' r� a �* �_ 72. Undergrevad FJush x� >,
24. Roof Fr ' ing �T'* � � v.q m O N� �� Undergrad. St� Tan� O Gas ❑ Oii
25. �oq'�;Sh thing �* �,.� � * 1 cr1 D.� 7� . Overhead Hyd�c *
26.:�-BerCeiiing (Strl�e�rali & Mri'c�eoat 'K O�� V* 7� Dry Che�ieal F"E�, r S ,n �" � '
27.�ramea Flashir'�` � `�� �' �" �'K '� "
:t � �+� �•[r.lJ a x �� 76. Ory Stap�IPipe�H • x C� cu �
E 28. lath7hg�Siding �, :+FF O t �+� 7 FIXEDESS`STE'�4�F'11VA'�." n n
i 29. Insulatiqp .,*t S CSJ � S � 7�c:fIREAREV, Fif7AL �
30. Orywall Nailing �'-� � n�-' � i � ��� oRNF1EAL7�F1 DE��„�tEQU1�MENT
Mc S I[�' C' X f` u K � R:
;' 31. Plaster B�wr�oac �. ; �..,r. 79. FINAL I�PECT�N x p F�
32.;Electrica.YowEr Meter�F4�'Aal t T a� ' � Ba FOOD ERTIICD TE *3EIEB' H
33.'fin�Ele�3ri't�'�'. x �' � S �'. . (�qte,, � y � � <
,, > x � �H � r �; -� T,�IN��.�G�: -
� 34.;F�nal,Hed{in� Air£cJ�ditioning ,:1 �> ' �+ i Fry x S
c. � -+
35. �ina�Ga�(p@Test * a� � "� � ��'' „�� � m �"
� 36. �(iood�or noPY ^� � %e. '+ � , I t1 ::O x Gt t-1
1 r I:t Y, ;' [:]
y 37. Finy(Fa�nry Firepl�c�^ ';,�, C e: N I #�� � �
f tT' x
�
38. Finat�PluTbin9 �;n V i o .t r� G 'M
Y h'
39. Water Se'ice-Final * E ' * Q �' � `_ .
�,' � :•. s Ei: t- w • *;T; n
�' 40. GasServ�cje-Final '� ;-;r.�... � � � � t.. • r�a, i:v, -'
�
41. Solar pomesticFi�aF �"• * �" `=^� '�' * x �
M F : J iF � �-+ O� M S
y 42. Backflow Pre�vgnter,� ;p pF.:u y; �; , i M ri7O *`� F
H Y c'
Q3. Backflow Irrig tion * �' ^^ M x x n � �' `� •
a � x x'^ � � r� * 3 G:�
�: �, _
N •� v
�4. �-l�andscapg IrripationSystem^t,,�,� �; w r1 �L �2� � � w p•X � S F
_ w
„�5.;Sound e tion�r y..-.. y x m rr, M*' tr C K• p.� x , .
' 4B s c s x m ••� �� r-�c, ••.-• x
'46. �andicap f?egulatior.Ti� 5 `�: A: S �* tT! G n •; .
!R7. FIN1l'�� STRUCTUI�'E & BUILDING * �"' � T * F _
N Q' 1F 1� C^ # i '� �] k O
48. � INE[;L PLANNINGk ��r � �^� S � �L
.�; .
�9. Eleciric Release to ffdison i x +� � K C ��? � ^ y ''
x � i-e �,
�0.'Gas�eleasetoSout�ernCalitorgie;GasCo �� � ' i� S Do C� * c'� L- .
4
�51. CEFTIFICATE Of OCCUPANCY
No. Da[e
u
AOOPESSOFBNLOMG � 555 ANTON BL
o�+�RswwEi('�"°"": SAKIOKA FARMS
, �oorrtss: p0 BOX 2097
-� TERMINAL ANNEX
ur�. �uuNo �ss
uNT: 1 S T
uKx�cronwm+an: INTERIOR ARCH.2136232164 �� 9378
�k�p�'g�� 550 S HOPE ST �� 110
L.A. CA 90071
�^uT�'a� CAL—PAC CONSTRUCTION ( 310 ) 645-3500
caNrnaronsMu� 6076 BRISTOL PARKWAY
�o�K COLVER CITY CA uc.no.: 392102
90230 uNr: 106
UCENSE� CONTNACTONS UECLAH�TION: I Mreby N'vm under pereYy d pmjury ihel I em licemetl uMer pwivione d Ghaqm B
�(commencirp xilh Sec�ion ]OW) d Diviaion 3 d I�e Busima ud Prdmiona CoEe. eM my ticeme n in lull brce eM eliad.
cm uc. No.: uc. cuss: g uc. No.: g 21 E�yg �
d,. // /,�/y � �«� . 1�Y
�/ V{1 fl BNLDER DECLAFATION: I haeby e1fi�m uMw pmdy M porjury iM I am eaanp han tM Comradon Liaima lew Ia the
"�av.rY eemm (Saeian �031.5 Bueiasa eM Fdmbn COEe: MYW a mumY W�idi nGwea a G�tl m mmhud. eds.'vnVow.
K:Fnh, a rpv eiry elnciiva. p'v w u cawMe. ebo repui�es IM1e appliraM la ach pmmC �o IJa e aq�wd oWmmmt Ihtl hs a eM
vwd w� Io iha pv.mwe d the Comreaora liceme lew �Cheplv 91�meniap xLh Satlion ]000) d Divwian J d the
e��� �a na��� cmal «mm n� «.n. m u�q m>.m� �d in. m.n r« m, dbaad memqa,. Nn •owo� a swo�,
>03t.5 by enY ��I /or e permn eubptlf IM epplicenl lo e dW penally d ml mae tlan INe �uMred Edlen �55001).
� I, m omror d Ihe propeny a my empbyeea wIh wapae m Ihei ede mmpeneetion, vrill do tha woA, enE �ha elru�.Muro e nd iMeMeE
w olleretl Iw eela (Senion'lOu. Buvrev ard PMasaione CaAe: TM Comreqwe Uceiae law doea m� appFyb an amer d popaM
who bulEa a'vnD�m �he�eon, enE who doee euch xrork IimaeM w henep a �hraph ho a her own empbyeee. pmvideE Ihel euch
imqovemmU are m� inteMeE a dlereC ta eele. X, Irowmer. �he buiki�p a inp1v�emeM e aotl wil�in ms ymr d mmpbtion. �M
awnu-0uiker will I�eva iha buNen d povinp M or she d'd iwl builE or impwe Iw iM puiposa d We).
� 1. es owror W �he prope�y. em ezdueively conlreqiq xiih licemad wnvacipv to canatrud Ihe piqetl (5edion 10u. Busi�re W
Peoleeeime Code: TM Conlratlae l'cenae lew doee rwi WWY w en oxiwr d pW�Y who builtle a imV�'a ihmaon eed xfa
comrecla Iw aMi qqeea vmh e mpretla�a) licemed pu�euent to iM Conireaon lioenve lewl.
� I em axmmq uMa Sxlian: B. 8 P.C.. M i�u imson:
Oma: Omer
i ao n.eM canM u,ei i am a�re.e d.m �me��em ina �eaNremew d cdaom� �wnn d,d smmr caea sw�om assas. usaa. ene
T5531. aM Ihet I«e�ry lulure buikiiq oowpaM will / wil ml (arcb wro) nseJ lo comph/ w�h sek 9ela mEes ard IM �puiramaNa br
epermXlwwuwtlionwmod'draiianhan�he�i u�y enepemenlDiaritl.RmkemidcaimivaioneppfratianarenaemqlmmlMee
povivions.
ome: ncp�:
WONKEP'S COMVENS�TION �KL�N�TION: I Mreby df wd« pmNy d paj�vy an d IM b0ow'vq dedermian:
❑ I hew ud wJ meiruei� e cenA'reta d ao�uanl lo wtlimun br xakaa' oompameton. m prwiEed la Ey SWion �100 d iM Lebar
cod.. �o, m. o�o�,�a a me wax i« �n m�. v�u m��e.
f] � n.w.�d w meime:,..aka.• oomo�mo� mw,.M.. a�ec��a M swin, a�ao a me �m« coe.. �ar me ronnnw,c. a m.
woh ta w}iich INe pertn� u iaued. My worken' oompetqe�ion inwrerce umer vd pafiry number va:
c�,: FIREMAN'S FUND E}CPIRES
,� PdicyNumher. KWP 02 /01 /96
r� iliis eection need nw 6e canpbteE I tM pemrA ie ror one hwrdred EolMre /Ilool w Iew.J
',� I wnry ihv in �ha pMortnence d tM work �w wnkh ihie pemid ia iasueE, I ahell � mmqq eny perem in vry menner vo n m
Exome eubjatl ta iha workers' canpeneelon levn d Celilanie. uM eprae thm il I ahauN bxmie wEj b IM wwken'
mmpemeiion piw+aiom d Saeion 3100 d the lebor Cada lo N ��
i
Ome; Apd' ; �
�
m/iry: F�Oun ro'xvn wAsn'rompwuatlon rowrap� Is wlMul, uWY�ll ub/M en �mplo�w ro crtmlrW paultlp uN
nd� n,�.. w ro w�. n�e..a �ro�a.�a ddr., lsiuuaoox a.ee�eo� ro m. eo.� or ro�m.�.+wn dmw ., wo�n.e ro. m
•CONSTRUCf10N LENpNG AGENCY: I MnEy eRum uMx panely d perjury IIW �Mra u a memvfion MM'vq epency br the
perlame� d �M work M whitli �hb pem�� ic 6eued (�� �). Civ. CI.
LENDEP'S NMIE:
LENDEH'S RDDFESS:
I ceniry �nm I heve reeE ihis eppliceiim eM pma ihei iM ebova inl«meiion ie wrtea. I apree m compry wi�� ell tlty eM couny ordinerwn
� eM ewe bwe relvip io Wildip conwuqion enE hereby euiMce repeeemmivas d ihie oty b amx upon Ihe ebova�memioneA pmpeny
la irov�ion vurpoaae.
DAVID DESISTO �
� —{y Dme: _�� / �J / '�
sqnm�n a o.,bn uco�v Tr—
(5i51d6 WP) W�ne-Buildip d Sdeiy; Greee�Fib: Cerory-�ppirant: Hnk-Revenue: GOldenmE-Avxaror
a
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 075356 PLAN CHECK NO: 03710-95 A
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR
JOB DESCRIPTION : INTERIOR 18000SF T.I.
�ERM NO: B 075356
� GOVT: N SUPP: N
PURPOSE: ALT
SQ FT: 18,000
CLAIM VALUE: 320,000.00 CALC—VALUE: 312,984.00 GROUP OCC; B-2 /
COMMENTS: 76 UNION PRODUCTS
***� � *+�***� � � *�« �*� � **� ***��r*�+�+r�***� *****� ***�� �+E��rt��+�+����*�*�+r�****�*****�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPAOVEMENT FOR 76 PAODUCTS COMPANY — iST FLOOR
i • " �
***�*****�t*iexfe��'+�+��*��r*���t�*x�**�r*at*�*ie****�tir�**�rtie����*��*�*+��**��+�+e*'*+�*******�
D E V E L�O � M E N,T S E R V I C E S R E Q U I R E M E N T S
�i j'.� � ' i p
ZONING APPROVED BY ' � � � � � DATE: �I� Z �`, l�
BUILDING APPROVEDtBY : !, �� I DATE; �I•^ ZI —��^
�� /.'
APPLZCATION ISSUED�.HY: i �� DATE: I'�—`Z���l�
ifikififiEifiEiElfiElEiEiEiEiEfhihiEiEfEfEff�F��,�3F�f3fiF3f�i�i�-��F�FTF i6 ���i�����F�7��f��E1EiF3E�E3E'lEjE1ElE�7F�F�iFif3E
LEGALIZATION:N � F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,385.00
PLAN 225.06 SMI65NO3—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 1450.73 0.00 225.06 1675.79 1675.79 .00
REVENUE DIVISION TOTALS--> COLLECTED: 1450.73 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1385.00 65.73
iE aE iF 3E 1f iE iE IE iE jE 3E IE iE iE iE if 1E if af iE iF iE �)F iE iF �E iE iE �E IE �f if iE IE if iE iE if i6 jE ik ik iF if if if if iE IE iE �E �1F 3F if i6 iF i6 if if iE iE iE 3E iE i61F iE 1E iE if if i6 iE �FiF iE 3E iE 3E
I N D I t1 I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 16200 OFF—INT. ALTER TYPE I,II E.R. —AVER 18,24 295,488.00
SFC 16200 EQU—ALT COMM. SPRINKLER SYS —AVER .36 5,832,00
SFC 16200 EQU—ALT COMM. AIR COND —AVER .72 11,664.00
END OF FEES
��
PO( SPA �
' G(ONSTRi1CTIDN ANO PLANNING � %
APPRO�/ALS Permit # : Date Inspector AppROVALS Peirhit #`. Date Inspector
� 7. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' '
I �:
: 2. Soil Pipedtndrgrnd. •• 53. Steel Reinforcement �
� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms , � �
4. Electrical Conduii�Wndrgrnd. . 55. Electrical Bonding _
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6� �PlectricaJ UFER Gmd, � 57. APPROVA�. TO COVER�GUNITE
7. Pootings � 58. Electrical�Conduit-Und.grnd. � •
8. Foundation � 59. Gas Pipe, O U�drgrnd., Test .
9. Water Pipe�Undrgmd. - 60. Backwash Lines, P�Trap, C� Undrgmd. �
70. Structural Floor SYstem 61. APPROVAL TO DECK .,
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fin�! -
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 Elearic Wiring � 67. Fencing & Access Approval .
17. Fough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough ElectricabT Bar Ceiling 69. POOUSPA SYSTEMS PINAL
19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMEIVT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in Structure' 70. Underground Hydro
22. Dutts, Ventilating � 77. Product Piping OGas ❑Oil -
23. Gas Pipe-Rough & Tast 72. Underground Flush
24. Fioof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. �Rpof-�Shea,htng �• - 74. Overhead Hydro
26. T_Bar Ceiling (Structural) & Monocoat //3��6 �' 75. Dry Chemical
I �%
27. �,�ra.rrLe.dqd�lashing J/�b/�� ///. 76. Dry Standpipe
� T/
28. Lath7n9�i�Siding� ' , 77. FIXED SYSTEM FINAL
29. Insulation � � � 78. FIRE PREV. FINAL
30. Drywall Nailing ,/��9� � HEALTH DEPT. REQUIREMENT
/
31. Ptaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34, Final Heating & Air Conditioning _
Z 35. Final Gas Pipe-Test .-; �
36. Hood or Canopy J� - i."
37. Final Factory Fireplace � �
36. Final Plumbing
39. Water Service•Final . �
40. Gas Service-Final
41. Solar pomestic�Final
42. Backflow Preventer
43. Backflow Irrigation
44. landscape Irripation System �
45. Sound At[enuation � ,
46. Handicap Regulations
47. FINAL STRUCTURE & BUfLDING �� �� 9/ -
v
48. FINAL PIANNING i�,, i�,
49. Etectric Release to Edison , -� �. -•
50. Gas Release to Southem California Gas Co . . ' �
51. CERTIFICATE OF OCCUPANCY " •
No. Date �' '
�
I.
��
�I
�oun�ssaewioua: 555 ANTON BL
oM,exsx.�eira�wm: SAKIOKA FARMS
• , '.00xEss pOI BOX 2097
TERMINAL ANNEX
wv�. �u�ma.uox�ss:
uxT:
1ST CITY OF COSTA MESA - BUILDING PERMIT
: RM NO: B 074696
PERMTT NO: B 074696 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: STR PURPOSE: ALT
uicxrtecronErr+x�n: INTERIOR AACH.2136232164 ucxo: 9378
urcwanewa�s�ss: 550 S HOPE ST urar: 1100
L.A. CA 90071
coxm�crarsxu� SWINERTON 6 WALBERG ( 213 ) 896-3400
carn�croirs�uiwn 865 S FIGUEROA ST
.00xcss L, A. CA uc xo: 9 2
90017 uNr: 3000 {
110EN5ED COMqACTOpS OECWiAT10N: I Ameby MFm imds penely d �njivy Nel I am fmvad wdx pwidma d Cheqs B
(mnmeron0'Wh Sz�ion ]000) d Oimun 3 d Ne Bussieu eM Pmimaiw Code. entl mY fiomw u i hB luu end afletl.
cmuc.No`.:Qq(179 uc.cuss: g uc. o.: 92 EXP• 10/95
om.:�f�•��%�� c��:
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cnnvecte lar arh qqed� wM a mnlredor(el licemed WnueN to iM Comrmae lioeroe lew).
� I em ewmq uMer Seciion: B. 8 P C.. la No rmaon:
Deio: Owner:
I do hneEy Mily ihel I em ewve d anE uMenwd tlro rpulrameMe d Cellomu /bNh erd Seley COEs Safbm 25505,?SS]�. eM
]553a. eM tlut I a erry Mun WJdiiq oaupent will / wil nd (ertb ma) nsed ia eanply x'vh veid ewa mdm ud tM epu'vamems M
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awnrom.
., Dtle: Appliaru:
I WOHKEH'8 COYpENS�TION pECIAPATION: I MaEy eHum uedr pwlly d pr}ry ane d IM Idbrmp Getleieliom:
� I hen eM rril meinlew � cMLiWe d wesn �o �dlin�w b xaken compe�union,n pwiMd tn by Swun 9"!OU W ths lebar
COEe. la IM prlamuca d Ne �wrk la wl'wA thu permn e musE.
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wak In wlirA Nu D� u u�usE. My waMaa' canWmaiian wuruw:s uniw eM W�Y rwmber era:
�,,,;,,: AkGONAUT EXPIRES
aaryra,�e,, w� o> >o�tiv77v 08/O1/96
i irruss eecim nsed mr e. mno� r w w�t u ro� a» nu�sa eomn Isrwl n �wJ
❑ i mnh ma m m. o«��. d ine .wk ro. �.ncn mm w�+ uwea. i enee �a .�+cM r o� m�r mwb..o m io
Exvm miEjetl lo iM xaVe ' canpanation lexs d d apr Nm L I e d �ecmia aubpa to tM wo'ken'
iuuo v a eeion ])00 d Ne labar CaEe. I o ' � '}1� n.
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Sectlm ��5 0l IM LNor Cob, IM�nst, mJ aMmq i Nu.
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peAartnenro d iM v.ak In wfiiN ihu D+miY u eaaE (Sedion �. CM. Cl.
LENUFA'S NAYE:
LOlDEN'S AODNE34:
I cenih �hm I he.e reeE iho epd' � end aete ihm tlro ebove iNanmtion u mrtea. I qpee io comGN wuA e0 cN' eM muaY ad'menro�
aM eltle Iew MPoM b WJi�q CanNutlion W herspV aNhorixO npwm�etivae M Ihu ely b enler UP� IM ebwa�memueqE pWe�Y
Iw imVeeion WVwee. ... .. ............
(51
o�, d '7�e � 9,�
8 Sdory: �reeMFb: Cenery-�ppirani: Pink-Ravenue: OakenmE-A�aeavor
JOB DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAZM VALUE: 20,000.00 CALC-VALUE: 20,900.00 GROUP OCC: B-2 /
COMMENTS: 76 Ur1ION PRODUCTS PREP FOR TZ
*********�rx�ir��***rt�+��*+t****it*�xit�r��r*x*+�*itu�tit*?tieit+t��x�*rt**�t�****�**�t��t**#+e*u*�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- ---------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN kGHT: FT IN
PARKING RE • PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING N TES>
�
a(-1F �If �IF 1E IE IF iE iE iE iE 3E IE 1E iE iE IE i�if 3E jE iE if j(-')E �E 3f # iE iE �)f lE iE 1f !f if if iE 1f ik 1! iE iElE iF iF 1k dF iE aE 1E iF iE IE iE 1E iE iE if iE ik iE �E iE # 1E �E;IE iE �lE'1E iE iF 1F IE �E 1E iE 1E
D E V E L A� M E N�2T S E R V I C E S A E Q U I R E M E N T S
� �. % .
ZONING APPROVED ffY �`i DATE:
BUILDING APPROVED Sf�: ' DATE:
/' :9 I
APPLICATION ISSUED 8Y:
1f if 1E if if if iF 1f !f iE 1f iE IElE iE iEi1F if 1E 1E iE IE��
LEGALIZATION:Y
F E E S U M M A R Y
DATE : l o(Zo I� 1�
iE ik iE 3E iE iElF iE��F i��1E3FiFiF# �f
STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 437..00
PLAN SMIPQNO9-RES
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 436.39 0.00 0.00 436.39 436.39 .00
REVENUE DIVISION TOTALS--> COLLECTED: 436.39 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
432.00 4.39
# iE iE 3E iE 3E iF iE iE iE If * 3E iE 3f aE 1t iE iE 3f iF iE if if if iE 3f if iE iE if iE iE if it iF iE iF it� if 3E if if if iE i63E iE �1E if k if iE iE 1E IE iE iE 3E iF iE 3E iE # iE 1E 3E #�E it iE iE ik it iE 3E # iE iE
I N D I V I D O A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 DEMOLISA BY VALUE COMMERCIAL NOZONE 1.00 20,000.00
END OF FEES
/
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��
CONSTRUCTION ANDPLANNING POL �SPA
APPROVAIS Permit # Date Inspector pppROVALS Permii # Date Inspector
�. Temporary Eiectrical Service or Pole 52. Pool & Equ�pment Location � �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement '
3. Elearical Conduit Utility•Undr9rnd. 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 Cond�it�Undrgrnd. '
8. Foundation 59. Gas Pipe, O U�drgrnd., Test
9. Water Pipe�Undrgrnd. _ 60. BackwasN Lines, P�Trap, � Undrg�nd.
10. ScruMural Floor SYstem - • ' 61. APPROVAL TO DECK --
11. Property Sewer Line & House Conhection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Droins � - 64. Plumbing Sysrem � Pinal •�
74. Rough Plumbing � , 65. Electrical�Final .
15. fiough Electrica6Conduit _, � 66. Solar SYstem�Finai .
16. Rough Electric Wiring -• 67. Fencing & Access Approval
17. Rough Wiring $ign 68. APPROVED FOR PLASTERING
18. Rough Electricai•T Bar Ce�ling 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Cond�tioning FIRE OEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Oucts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. ftoof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & Monocoat � p�% � 75. Dry Chemiwl
27. Frame and Flashing �3�01 �"� 76. Dry Standpipe
L�
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL
30. Drywall Nailing //JO��j � HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final E(ectnc NoteS:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Piumbing
39. Water Service•Final �
40. Gas Service•Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backfiow irrigation
44. Landswpe Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ��/'/ Q�
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
,�
anon�ssa euaomc: 5 5 5 ANTON H L� uxr:
owrhAswwe�va�mvn: SAKIOAKA FARMS
. �ooxes� PO BOX 2097
TERMINA ANNEX �
APPL.1WIlNfi AOOHE54:
��cxrrecrox�ffn: INTERZOR ARCH.2136232164 uc.xo: C-93.�1�8
urcx.ox�a.•sxoo�sa: 550 S HOPE ST uxr:- ' 1100
LOS ANGELES CA 90071
cormucrarsru� CAL PAC (31'P)645-3500
cam�cTomey,maa 6076 BRISTOL PKWY '
,��u CULVER CITY CA ��, �392102
90230 _ uxr:
TF�CTON9 OECL�NATION: I hemW dl'vm under peneAy d p�ury t I em fironaad u pwiebn� of Cheqm B
h Saction ]a0o) d Oivebn � d Ne Buelnew antl Pm/e�abm CaEs. Y�+> b In lau end Nfed.
065824 uc.cuss: uc.No.: 3 2 E P: 09/ 6
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OT'/NEP BUILOEF OECIAfl�TION: I haeby e1Nm uMar paiuYy d prjup( �IW 1 e ,�m rq n iM Cam�etlm lberoa lsw la tM
��Mwiq neson (Seqion "l031.5 Buenne eM Pralmeianc Cods: �nY c(�a muM' m s wrm§ �o aonawct, allx. impws.
md'eh, a rope"s ury nr�nuro, prior ro e� eaueMe, elao rpuiree tM epd� br wc� lo fib e epr�eE stmemem tlw ha a eM
licenwd W�� �o IM pwisone d Ne Conireaon Licenee Law �Chaqp B(mmmentlrq wuh Saaion ]OW) W D'vuion 3 IN iN
Bueinav entl Adeaora Goda� a�hu M a Me is ezemq ihereham enE IM bnu la IM d4psd ssemqbn. My vbW ion d Sadion
1031.5 by ury epplirent fn a perrtN wbjetle IM epplirsN �o e rnil pe�Wly d nal maa Ihen INs hivMmE AOYen �SSW�.
� 1, n ownar W Ihe popMy or my ampbye� wYh wepee ee �ha'r eola mmpenmtion, WI Eo Ne xak erM Ne at�uctun n nd inteMaJ
a ottaed far We (Servon ]oe�. BUNrom eM PmfadoneCaG: TM Canimm Uoen+a taw doee na ewN �oan owrord popairy
who Wida a inP� �haeon, end xfio Eam euAi wak NmeeX a Mne1 a M�aqh he a her wm emGbM�, p�eE �het wch
impwemmd ve nd iMended a oHaaE tn seb. X, however, �M Witliep a inqrnmaM u wld xilhm ms yaer d mmpblion, iM
ownr-0uiltla will hmro tM Wrtlm d qo+iep M or ehe did na WiW or improve la �he purywa d We).
❑ I. ae owMr d tM pioperty. 0m n[thuively conl2dip xilh NoeneeA tomRclpv lo mneb�d tlro pajstl (Satlun ]ON. Businse eiM
Pmleedon� Code: TM Comruam Licenw Law Eoes nol eppy m an ow�r� d popeM � buM+ a imqwa IM�san eM who
wnlrMa br wN pqstls wM e aoNratlor(s) Icanfed Wnuenllo IM Conlrtla� Liasnte Lew�.
� I em wmq uMu Snion: B. 8 P�C.. br t�i� reeeon:
Oms: . Umer.
Mu I em ewera W enE undenleM IM nQuiromeiM W Calfortde Hsellh eM 9dMY Cod� 9Wiaa 25505. 255b. uM
v vry Mun WilEiiq 000upent will / wiA na (dreb aw) rwM lo mmpry wih uid pat� mEw enE tM rpuimnanh br
Dme: APdkem:
WONKEN'8 COMPEN9�T10N DECLAA�TON: I Mnbi elfirm �ndar pnMy d qr�ury ons al Na Idbwiip Aedumbm;
� I hm uM wll meinlen s cMilbets W aonwnt lo �eMineun br Mwken' campenW bn, a pwNM Ip b� Bwtbn J10D W �M lebar
coe.. �« �n. o.nomw�ce d u» wk �a n�,�on inl. vmmil I. �..�ea.
[�] in....m.���m.a.,om.�.��o.�:.���,'.�,o....naw�.a�s.a�a�ooam.�,m.ca..ain.o.�m.��ain.
wakiar.fiichNhpeminuinuM.MywarW�e'Lm1�BERY �MUTUAL°d�ry��m�u�� EXPIRES
c.m«:
va�r�mw - 02/O1/99
(Thls eeaion mM mt W cwnNetM l rhs perm! is M ons hundlN ddNrs /S10o/ a Nn.l
❑ I oMMy tlW in Ns perlamence d ihe wuh M whbh thh pumA b'wswd. 1�� nd • 7 perpn in ury manrw w n to
Eamm� wE�etl Io IM xpFwt' mnpsnWbn Isxs �dilomu. enE p pitl ! � wb�W lo � xoMen'
_ yynpmmbn P�� d S�dbn ])00 d �M Lebor C s. 1 MNI tmhr.il eom
F�Bun ro ucun
YMn.�.m.. .ne
4 povWW b/ In
CON9TRUCTION LENUINO �OENCY: I Mnby elli'm uM�r puielry d parjiry �htl IMn b e mut�udbn MMI�p p�ncy br iM
paAame�w� N IM xak br whlth �hb M�Y b b�wd (9wfbn OOGI. CN. CI.
LENCER'8 NAMB:
LENCEN'8 �DDPE99:
I ceniy �M I heva neE Nn eppliraibn ud pms thal �As ebovs Inlamu�ion i� comtl. I pn� lo oomyy wXh M �Yy W oouMy ortlinenw�
andewalsws�aWin4�obuiM' tlanendM1asbYeu�pa!Q•AP�p11�tlIVMOfIhIlC1YbMYMJD��M�M'l�IIMf1�l0tIWOroWM
farineD�ianWrD��. _._ _..l1__ / .
ow: ?J-Zz�c/�
WINe-BuildYq 8 SdaiY: OrsertFb� Cenar�AON��: Pink�immue� Oddaiwd-Nmoe
CITY OF COSTA �SA - HUILDING PERMIT
/- PERM NO: B 076881
PERMIT NO: B 076881 PLAN CHECK . N GOC�T: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR PURPOSE: P;LT
JOH DESCRIPTION : COVERED PARKING AND RAMPS SQ FT:� 23,000
CLAIM VALUE: 23,000.00 CALC-VALUE: 24,035,00 GROUP OCC: B /
COMMENTS: 76 PRODUCTS CO / PARKING LOT IMPROVEMENTS FOR T-29
*�r***�**��*�**�*****�x *******�******�**��*****��***+�******�r****�r*x�*�*��****+�***
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN HOILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNZNG NOTES>
i
1E 3E iFlE fE aElE 1E aF IF iE iE iE 1E iF fE 1E jE jE iE �)E iElE 1E iE 1E iE iE !F IE fE 1F �E * iF iElE iE 1E iE i! ik iE IE iE �E iE IE iE fE 1ElElE fE fE iElE �f if 1E iE 3E jF if fE iElE 9f fE *�F IE 1ElF iE 1ElE iF iF
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N"T S
/
ZONING APPROVED BY . DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY;
LEGALIZATION:N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC
PERMIT 252.00
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHE
TOTALS----> 257.05 0,00 0.
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
252.00
MECHANIC / FIRE
/
CK / TOTAL
00 257.05
DATE:,
DATE: J Z� ` �+
iFiEaFiflFifl6iE iEiE
STRUCTURAL EGMENT.:Y
SMIP/RES GRADING
SMIP/NON-RES
5,05
257AOD D00
257.05 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
5.05
�E 3E IE IE 3E iE iE iE iE iE 1E iE iE iE iF iE IE iE iE iE iE �E �E 9E 3E 3E fF 9ElE iE IE jE iE 3F �E IE if iE 1E jE �E iE iF iE 1E iF if if iF iE IE iE iE iE iE jE iE iF iF if iF iF iE iE iE IF iF iE K iE 9E aE iE aF iE jE If iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 23000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 23,000.00
END OF FEES
\
CONSTRUCTION AND PIANNING � PO( SPA �
APPROVALS Permit�h Date, Inspector APPROVALS Permit# Date Inspector
'1. Temporary Electrical Service or Pole 52. Pool & Equipment Locacion �
2. Soil Pipe•Undrgrnd. � ' 53. Steel Reinforcement ' �
3. Electrical Conduit Utility-Undrgrnd. 54. Forrtis
4. Electrical Conduit-Undrgrnd. • 56. Electrical Bonding '- �
�5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 5
6. Electriwl UPER Gmd. 7. APPflOVAL TO COVER�GUNITE
�
7. Pootings �.io � 58. Electrical Conduit-Undrgmd. _
8. Foundation 59. Gas Pipe, O Undrgrnd., T3t ,�
9. 4Vater Pipe�Undrgmd. . �, , 60. Backwash Lines, P�Trap, O lJn�tr'gmd. �
10. Structural Floor System � 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final . �
72. Sewer Cap ) 63. Heater & Vant-Final -
13. Roof Drains � 64. Plumbing System - Final ��
14. Rough Plumbing . � 65. Electrical•Final ( �i �
15. Rough Electrical-Conduit - 66. So�ar SYstem-Final � �
i
16. Rough Electric Wiring � � 67. Fencing & Access Approval •
17. Rough Wiring Sign � 66. APPROVED FOR PLASTEAING
78. Rough Electripl-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts, in StruaurE � 70. Underground Hydro .
22. Duc[s, Ventilating 77. Product Piping O Gas 'J Oil
23. Gas Pipe•Rough & Test 72. Underground F�ush
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hyciro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �
. 27. Freme 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. E�ectrical Power Meterfinal 80. FOOD CEFTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy � � � •
37. Finai Factory Fireplace _ -
38. Final Piumbing ' -
39. bVater Service-Finat
40. Gas Service-Final
41. Solar pomesticFinal �
42. Backflow Preventer "
43. Backflow Irrigation � .
4�4.��ndscape Irriqation System � -
45. Sound Attenuation
46. Handicap Regulations j
47. FINAL STRUCTURE & BUILDING �p/� �
48. FINAL PLANNING . '
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co
51. CEFTIFICATE OF OCCUPANCY '
No. Date
�oonessocemtomc: S S S ANTON H L
xercsn.weivaa�m: gAKIOKA FAAMS
• ADDHE55: PO I H�}� z � 9%
TERMINAL ANNEX
�ra. wuw�o woxess:
uxr:
1ST CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: M 076042 PLAN CHECK NO: �N�
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: MEC �
.ncxnEc.ox�aN�x: INTERIOR ARCH.2136232164 "�NOi 9378
""�KOfl��g"ODN�' S50 S HOPE ST °NTi 1100
L.A. CA 90071
��+^C1�'%"� AIR CONDITIONING COMPANY ( 818 ) 244-6571
��+��T��� 6265 SAN FERNANDO AOAD
�nonEss: GLENDALE CA ucr�o.: 120696
91201 uxr:
LICFNSED CONTPRttOFS OKLANATION: I hareby eftim uMer pe�y d pmjury IMI 1 em IironaeA uMa prwmona d Cheqa 9
(rommenorq xiih Sectian ]000) d Oivision 3 d IM Buaiire» eM PMesaiona Cotle, enE my liceva o in lull lorce ud e%eq.
cmuc.No.:014403 uc.cuss: C 36 120696 EXP: 07/96
y�
Date: /�/�—�// Co a: � A ����/�?
�—
OWNEN BUILDEH DECLRHRTION: I ha�eby elfirm unds�parely d perjury Ihm I em eumq from �M Co qa ema law lar Ne
Idbwig emvm (�� 103t.5 &ni�ms ard Rdesaona COAe: My tiy n eounly Mfiidi �epuine e pe�ma to ownvun. aXx. imqwe.
bmdnh, m reyei e�ry sbucture, qbr ro ila ewema, ebo re�uima Iha epplkent la ach pemin io fib e aqmE sblemenl Ilat M a ahe
.a lieensed W�uenl lo the provisiom W iM Conlreeiore Lieense lew [CAepar 9(mmmervieq wilh Sed'an )OW) d Ovoion 3 d Iha
Buwrieas aed Prolme'w Goda� w Ilw he a ehe ia examq thaehom eM iM baw tor Ne elbped azemqion. My violelion d Setlbn
>W t.5 by eery eppirani fa e permn aubptla Ihe eppieeni lo a dvi peneM1y d�M mm Ihan fxe Auntl'ed EdWa �SSOOp.
� I. es mmer d tM popeM a rtry empbyeea win wepes a9 �Mi ede mmpe�uation. WI Eo IM xwk. eM IM niuctun e ria imeMed
,a
w oMered fm aele (Sxfwn ]Oaa, Bummea end PMesaians Code: The CaNredan lironse lew doea mi epply �oen ownerd D�oVe�Y
who WiCa ar in W�s �hereon. arM who doea nuch xak Nmeep or henN a tivwqh hi a Mr ovm emWWee�. P�'b� tAet euch
impovaneMs are nol iniaMed a WaeC In eak. tl. Mwma. �M1e buJCiM a inP��em w wtl xrhin one Yeer d oomP�ion. Ne
w.��.w��...ui nere ma e� a o�i�q ne « ena ed na dau « �mwwe i« me wmae a mel.
❑ I. m ox�wr d tM popehy. em exd�My mntrea'rq wdh licenaed wnVenpa to car�mua tM pmjw (�� 10u. Buainme enA
Piweaaimo com: rne wa�.aoA lsen.e �e. ao� �a wMr m a� owner a n�w«�v wno wua. v onww. m«eon ena wno
canirew M wM qoHd+ wuh e caaredals) IicenaeE WnueM m the Cw�eaas Limnse le'�1.
� 1 am eaemq uMer Seciian: B. 8 P.C., br ihia reeaon:
Dma: Ownx:
I do AareEy ceNly Mel I em ewve d eM uMenieM the reyuiremenls d Callwnu Heellh eM Selety Catle Sediom u505, 255�3. eM
255J6, eM IAat I tt e�ry Mure Wikirp oavpen� will / wil nd (drcb aro) need Io campF/ wIh eek qe�e mdp erd iM rpu'vemenb br
aGertnrtf«mnatrueGonamodifWonhanlM�r�eirv�y areW��Oinrid.FeaEeNolmeWMunWG�umenvemq/mmlMfe
pwenna.
WOflKEN'S COMPENS�TION DECLAN�TION: I hereEy elfvm ueder penMy d pepvy ane d Ne IoOowinp dotle�miom:
� I heva uM wil manten e unAi�ata d mruent to eeMireum br xaken' compenemion. n paridad t« by Seqion �]00 d I�a LeEor
Code, in iM parlormerce M Ne wak lor wlich Nia peimu u iaued.
fl in�e.�e.a��.�.ond.•�o�o��,�.m�.aweaMsw�,aroodm.�no,coa..w.�rovMa�uin.
7� wak la whidi Nb V�n u aaued. MY wakan' mmV��ian imurenu rartix utl W�Y wmbm ero:
c��: ('nNTiNENTAL. CAS EXPIRES
rary�,�me« �tr an �S� dR 45 10/01/96
(rnr: me�an �d na es eanobree i me v�t rs ro. aro n��d�ea edws Riool o. ksa.l
❑ I cMAy Nel M �he peAmnu�ce d�la wak br Mfich thia psrmG ie iaeuaC, I ehdl m� mmplq vry pr�on in vry mennx o m to
bxmw w4� �o iM xarbn' mmY�ion lex� tl Celtloma. eed �Oree ihet Y I qwuN bemns w4� to iM MOM1en'
canV��ion pw'vian d Satlnn T00 d �M lebor Code. I rNh mmpl/ xqh pioeeL P%%,����j►�� �
Dele: ^�—/� ^'7� Ao � M: � �i�C� `� V
To—T� J[
ro m. rost oI romoau�rbn aurw�YsburlCM ror In
CONSTi1UC110N LENpNG RGENCY: I haeby alfum uMer penaXy d perjury ihm thwa u e oonm�uaion bMi�p epancy lor pp
�no�� a m..on� n..md� mo v�+ m:•�»a �s<ao� ws�. cH. cl.
LENOEN'S NGME:
LENDEN'S AODqE%:
I<enity thet 1 heva reW Nb eppfcmion eM qats Ihet Ma eboue iMametion e carea.I epne to romply xrh N cey ud oouMy pdin�mes
uM eiete lawe �Neivq to W ikvq conqrutlion end Mreby eutMrue mpeaentmivn d thn cily to emm upon iM ebwe.memionetl prtpeM
ta impeaian pupow.
LOUIS RODRIGUEZ
�15f51�16.WP) WAde-9uYdnp85efay,GrterrFle:Ceixry-Appkam:Rnk-W.enw:Oddxuod�N�em
PERM NO: M 07604
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 180005F OFFICE TI SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC; H /
*��*****�t***�r***�****�D****�r��***�***�x��*i�*B x* x�****x�x��r�t�x x x�x�*x u*�r*�x ****+t�***
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 41050104 ZNE: REF NO:
PLANNING NOTES>
��
i �.'9
I�7 oi�� oi i��1�7 � il ll
ING APPROVED HY .
ILDING APPROVED HY :
1E74iE1k1l1Efkfl1E1E1E1k�lillEiliElE1E1E1EiE1E1E1kiEi4iElE14iE1E1t1E1E1Ekk1kiE1ElEiffElElE1Ek
S E R�'V I C E S R E Q 0 I R E M E N T S
DATE:
DATE:
APPLICATION ISSUED BY: 4' i `��/Ll4� DATE: �'�
*itx��tx��t�i[�x�**�t*x�x��t�t�titit+tit��FiFiF3F3F�FiF�F�FiFiF'iF�F'iFiFiF�F7F�F7F�FiF3F7F3F3F7FtF'�F'iFiF TF7F{Fi�it��-itit�x�itx�x�* �tx�
LEGALIZATION:N F E E S U.M M,A R Y STRUCTURAL SEGMENT:N
✓� v. 4 � i
BLDG PMT PLUMHING ELECTRIC� MECHANI�C FIRE SMIP/RES GRADING
PERMIT .i � l �225.00
25Y SMIP/NON-RES
PLAN i �i„`,- _ . . �.
ISSUE FEE +/ " •'� , � � i' 1�5.00
BUILDING-DIV-> PERMIT ISSOE PLAN-CHECK� TOTAL PAID DUE
TOTALS----> 225.00 15.00 `��0'.00 �, S 240.00 240.00 ,00
REVENUE DIVISION TOTALS--> COLLECTEDe • �� 240.00 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC�" 'FIRE SMIP/TOT GRADING PLAN-CHECK
' 240,00 '�^ r
� r �
=+. •� .�
lElEifiE1E1E1EiElflElEif1F1f1fiFiFiFlElElElElFiE1EfElEifiF!l1EiE1ElEiEiE1EiE1E1E,iEiEiE.iEiFlE1E1EIEfkillEfE1lf!!E kiEiflElElEfEifiFlFftikikfEiElEiE1E1E941E1E1k
I N D I V I D U A;L -- F;E E' � B;R E A K D O W N
TYPE QTY D E S C R I P T I O�N '�,ti l^ 'l UNIT COST TOTAL COST
MEC 17 VAV BOX n%� �r� 6.50 110.50
MEC 22 FIRE DAMPERS (� �- ,� 4,50 �• 99,00
MEC 1 INST/REL AIR HANDL' UNIT 0 10000 CFM 6.50 6.50
MEC 1 INST/REL HOIL/COMPR �1 -,0.'0-'- 3.0 HP 9.00I 9.00
END OF FEES' , I
n � I � �n' ' /
. � ;
"' !�' r. . - -
• . , . �••
�1
�,,. �
' � POl .� SPA �
CONSTRUCTION AND PLANNING - �
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:- Electrirai_Conduit Uiiiity-Undr.gmd�. 54. Forms �
� -4. Eectrical�CondOitrU�drgmd. 55. Electricai Bondi�g
-` 5;'-$teel Reinforcemeno-� 56. Rough Plumbing & Pressure Test �
:�6_' Electricai UEER'(`arnd. 57. APPROVAL TO COVER•GUNITE
- _ 7. Footin9s "� - . ' S8. Electrical Conduit-}Jndrgrnd. -
- 8. Foundation. ^� _� '• 59. Gas Pipe, O Undrgrnd., Test .
r •
9. Water PIpe�Undfgrnd. '" ' 60. Backwash Line{; p•Trap, O Undrgmd.
10. StructuratFloor,�ystem 67. APPROVALTODECK .
11. Property Sewec 1FJn,C & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap `�'y ' 63. Heater & Vent-F.inal
13. Roof Drains = . 64. Plumbing System - Pinal _
.�-
74. Rough Piumbicx} - ? 65. Electrical�Final
15. Rough Electrical-Conduit ' �. 66. Solar SYstem�Final _
/6. Rough EI�Mric Wiring �.` 67. Fencing & Access ApProval '
�'17. Rough Wiring Sign ` . 68, APPROVED F0-1: FLASTERWG
19. Rough Electr�icaf-T Bar Ceiling 69. POOL/SPASYSTEMS FINAL
79. Rough Neating & Air Conditioning -�� FIRE D.EPT.rREQUIREMENT �
- ,�" , �C6=- ') c � .
20. �oug6 Fa�tor�FicepJate :^; G' � r,,:; y,* ��.APP�OVALS';E, Permit #��_�,r
21. �ucts, in��Structurc:� �• •• _ � �' _ -� ` '. 7p, �nde�giouTiti F{ydro �
22.O.uctt:Veatil�(ing,".;. ' �,. � r;t.L�71. ProductPiping`CLT�as C30i1 '
23. Gas Pipe-Rougfi & Test '-y: x?; '�- 72, Underground Fiush ' �-
,. �
24. Roof`Fraining" �-x ' , � - _ _ `-', 7�3, Undergmd.Stoia9eTank.OGas ❑Dil
25. Roof Sheathing =- c: r� n; �, � 7Q;. Overhead Hydrb.r
r
26. T-Bar'Ceiling (Structxra�) & NTol�owat ' � �' 79',� Dry Chemical . � -
27. �rame and,Flashing 1 - � j� ..: i 76. Dry Standpipe r �
,
- 28. Lattdng&Siding �' `• „-;;°;_ ^ !' = ". '";' 77y FIXEDS�STEfUtfINAL .
_
29. Insulatio�^ ;, z-� _ fi� � t�� 78: FIRE PREV. F�NAL -
30. Drywall R�ailing •" y = "HEALTki DEP'�. REQUIRERjEN7
�.: Y ,
.31. Plaster 8r,eyvn;Foa�x, S �- ti ti-• 79. FINAL ItVSPECTtON
- 32. Electrical�ower Me'C�rFinal A-' '. �� 86;' POOD CERTIP.L�ATE I�SUED . -�=
_ , _.
. '.,>. ,, R, : � a. /^2'S�4 � e.orL�t. -�c�y �cz �-�
. 33. Final=Eleciric� � ;r �c � Notes: ��� -•�• �.m
34. Finat.Heating_& AirvConditionirC� � F Z-=� `i =6 S� �'- -r�Y�7tt �''���
�. _. - , • m -- �-2:3 `�l � , z�-�-p=+��z '�crzc-'
`T-W/',��;- us�, ,-
35. Efnal Gas Ffpe;Tesi-;; ,1 "' .: „ ., � 2 -V �
� � , . � ' �v-"3- L f=�,�_ �GL-���
- 36. Hooa or PanoPY ' r _ ' . - �, f •� ' `2'*�'� ��'-i��G�-
- :. �' .� ` ' k
.�' T r. : � _.
,37. Finat Faciory Fireglac'e � . . �
�'3�g� �t � crz-a��zAs--� =5�&ux�L- '"1
- 38. Pinal:?I�mbing - ' � -� ^• ' ` � ' "' ' y.�-
•-. -. . -r, r ` � r' i. ,_ �< " �. �Z-4`� �i/J�-
?�'L!� !_�G�"d_2�
39. Water Service-Final't r . r .; �r , ��,a,. _ �+..-.
-,40. Gas Service-Final x -i C�r -' _ �t � t� '- �-�-y �
�. ���_- r r�� �?'
� 41. Solar pomestic-Final; ` f' ` t � � ` `. � _ � -
�42. Backflow Preventer . `�� � � � - � "
43. Backflow Irrigation '. �`-t� a. `,� - -
� �1" < '
A4. Landscape Irrigation-System =• -a:� ' ' _ '� ` ' �� - _ � - - -
, ,. - c• e �. '.
A5. �ound Attenuation '. _ `' � - ; '- � _ _ i _ - _ , .
.. �
46. Hendicap Regutations �� � " - - - `
y
47. FINAL STRUGTURE & BUICDING ` ' `� '' � .
.
48. FINAI PLANNING �� - - � � � � w ' " '- , �
49. Etectrie Release to Edison = � .
4 .('
' i
50. Gas Re�ease to Southern Califomia-GasCo + -� - • ' • -, ' ' ' '
� -
51. CEiiTIfiCATE OF QCCUPANCYc f� �• � " " -
No. Date
�onnessaewinc�c: 555 ANTON BL
"v�rs"""E'°'°'av" SAKIOKA FARMS
� �I� NDNE ` PO BOX ZO9%
.,' -� TERMINAL ANNEX
aw�. �wwa �ooAess:
uxr: 1 S T
A1KN1EtT0P�'�" INTERIOR ARCH, 2136232164 �� 9378
.xcwo"o�'S�noxEss: 550 S HOPE ST �M 110
L.A. CA 90071
�+�T� � CONTINENTAL PLUMBING INC (714)360-8300
cwrn�croxs�uiwc 11165 TFIURSTON LANE
�ss MIRA LOMA CA ucr+o: 399073
91752 uxr:
110ENSED COHfA�CTOFS DECIAXATION: I Mmby dlim uMx psrely d perjury Net I un licanaed uMx prwidma d Cheqx B
(aommmcrq �mh Seciion ]000) d Oniaun J tl tM Budrow vN PNxa'vn CoCe. end mY 6cavs b m h0lacs vd sltatl.
cmuc.No.: 027563 uc.cuss: C 36 uc.No.: 399073 EXP: 09/96
'Dara: Conveaa:
TOWNEH 9UILDEfl DEClAflA710N: I here�y elfi�m uMer penetly d perjury ihet I em uemq leom IM Conlredan Lieenea Lew la Ne
�dbw*ro �en+on (Senion ]W �S Buinea eed Rdeaabns ('•ade: Am' euv a mWY x1iiN n9� e V�d to oo-vo-ua. eC«.'vnwae.
femd'nh, a repei em� nrunuro, prior ro ils eaence, e6o �uim IM epplimnt la auch qmN to fib e mpmE �telemeN tlw he a�M
'm 4amad W�t Io tM porieion+ d tlw CwNretlon Liceroe Law IChaqer 91�monanp wilh Setlion )000) d �'r.vion 9 d �M
au�inev ene aram.iuu coeel « �nm he >.he u wma �ne..han .ne ine mtie e« �ns albpsd e..mpia,. Nn �detion af seebn
103t.5 W eiry eppiunt Iw e parmn wbpU� IM eppl'rsm �o e'ivil pe�aly d ml more Ihen Me �undreE dallen �5500��.
❑ I.novmerdtMpeMMamYamGM��ihwapnmtheicMcomV���.w21EOIhewM.eMNe�vueunum�WandW
n o11meE br ale (Seclion ]Oaa. Bueiroen eM PMmaiona Gotle: TM Contrmon lbiva lawdoe nd wd/Io en owinr d MWeM
wln buide n inWma� �Miem. W Ma doe� �uM waklimaetl u Mnall a Urwph he a her ovm wnOM�. p�d �Iw v�ch
impwemenu era m� imeMed a d1emE lar aale. p, howaror, tM buiNiiq w inprv.emeM u�dd wilhin me ymr d mmpinion, Na
owner-0uiku WI Mw IM WNm d pwifq M a aM d'd na Cuik a imprv.a M �he qupoas d eW).
� 1. m owner d tM O�H. � utlueively aonlretlip wilh IicameE conuectae m conmup iM pqetl lSedion 101t. &»I�wa uM
Pmlmeiom COEe: The CaMntlm L'cmee lew Eau nal eDdY b en oMnu M W Ws�Y who builds a impwx ihasan W wM
wnvecia M edi prqem wnh a mmmeor(e) IcanaeA pveuem m �M Comrapa� Licero� Lev�.
❑ I am uemp u�dr Sociion: B. 8 P.C.. br IIw raaaon:
Oete: Oxnx:
I do haroby cenM �� I em ewere d enE uMentanE iM rtpuimnenH d Cdywn4 Heellh uM 3dely CaEs SeUione u'A5. 25533, enE
255Ja. vd ihtl I a enY Mun buJdiiq oavpni tiA / wil nd (tircle w) rrW b oomPN wYh uiE mta mGa W ihe nW'v�m«W far
• pamil IaoonaVuclion a modif�bnhan IM �raeniiy . enepement Diet�. RuidwaW mimMion app4Aiwpenwmq Imm IMro
pwiwne.
om.: noWK�c
WONKEN'S COMVENS�TON DECLAPATION: 1 MreEy eRum under qiWy d pxjury one W ihe tdbxinp dw4reiiom:
❑ �n.ueenewm.�m.�awnaw.doomani�o..namur.w.on�e�+�cano��.e+w��«Ms«ra,a�aoa�n.�ma.
Coda, la IM prlormenca d tlr �wrk lor whiah Ihn pamN n iauad.
C7 � n.ve.ne w meimd,.onen• oomo«+wia, imumnn. m na��.d M s.au, mo w N. �.e« cae. rw �ne o.�«menc. a m.
7t woA lor which �nn W^^G � ivwd. My wobn' canWnwion i�raMe wner ud Daiq' numbor ue:
c.m..: CNA EXPIRES
PdityNumGr �naa4an�as 07/01/96
(T1rie ssaion ma0 miW cwnpetM l NaW�x b hr a» nurMrW Edlerr R�WI a Isu.l
� I canA' � in tha pAomienu W the work far wfiih ihi� pe�mN b ueuM, I �MII m� amploy erry penon In any manMr w n lo
be�nro wbjep lo IM xwkere' mnpx�eetion le� d CNtlamis. aM apn� put Y I Jwk becm� a4b lo IM ha�W�'
campsneelbn pmvieiam W Seuian 3]00 M ihe Lebor Gods, I a�Nl IorIMmA oompy �tith thoee qwialone.
Deu: Apqiram:
Wem/ip: F�Nun b ucun woM1'w�'romp1rwtlon cov�rep� l� unl�Wul, �ntl W/I iWJcl �n r�vloyw ro cNnYlul pwMu �ns
elvll flins up ro on� huntlM tMuwrd tlolhn lSt00,0001� In Mfltlon ro M� ewt ol romp�nutbn, Mmspu �� provMW Iw In
sxtlon 91a6 or N. Le4or coa. Inrx�t •nd.mmer'• Iw�.
CONSTPUCTION LENOINO AOENCY: 1 hereby elfiim wWar penelry M Po�N'Y �M1d Iharo h e mntliuqbn krdi�p eponty Ip Iha
penonn.rco a �n. wak �ar wniN �nc v�� m mw.a (seao� ao9). cH. cl.
LENDEfl'S NM1E:
LENDEfl'8 AUDXE59:
I ceMy Ihm I hew reed ihu epplicelbn end qats ihel Ne ebove iNamdion e conw. I epiesto camp�y xilh NI dly uk aouMy wdinencee
enE ste�e lewe relelinp lo buiN'vq conalruqion end Mreby suhorrse �epseenieiirm W Ihie dty lo anler upon tM ebova�mentioneE propaity
brinapMion Wrpaeas.
RAY G THORNTON
Dme:
SiO�ure d Ownm/ApenUAOD„��onlreqp
(St51�e.WP) Whiie-Buildip85elely;Oreer�-FJe;Cenery-App4cenCPink-Rwmua;Oddenmd-Memror
Cl�l:lylill�.[�Zi:]
CITY OF COSTA MESA — BUILDING PERMIT
076043 PLAN CHECK NO: N
/
PERM NO: P 07604
GOVT: N SUPP: N
CONSTRUCTION TYPE: L—FR PERMIT TYPE: PLU PURPOSE: ALT
JOH DESCRIPTION : INTERIOR 18000SF T.I. SQ ET:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS / REF B-75356
x�*x�x��t�r*x�*****�r*�r+t*****i�***�r*�tit�t�t***r�*r*x��**x-+�*��r�r�r�r**�+��+r�rirf�x�**�r***i�*****�e****
Z O N I N G R E Q U T A E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NOTES>
i s�
1Plf if 1E 1k if 1F iE 1F if if 1E 1(� 16 ik 1k iE IE 1E Ik 1E If 1E 1E 1k ik 1k �E ik 1E IE IE 1E 41k �E iE iE iE 1E ik 1E 1F 1E 1E 1f if iklf'k 1f if iE 1f iE �E 1E fE iE 1E IE 1E 1E if 1f 1f if ik 1k ff �E iE 1E 1E 1E 1E iEiF if
D E V E L O P M E N T S E R V I C E S R E(j U I R E M E N T S
i.
ZONING APPROVED BY DATE: �
HUILDING APPROVED BY : ' ' DATE:
APPLICATION ISSUED BY: � DATE:
1E 1E ii 161E 1E 1F 1E 1E iF �i 1E if if iE iE ik IE if 1f iF 1f 1E 1E 1E 1E if iE iF 1f 1E 1f�3F�E1k if
LEGALIZATION:N F E E S U M M A R_Y STRUCTORAL SEGMENT:N
iw ! 1/ `� :. •
BLDG PMT PLUMBING ELECTR.IC„�.MEGHANIC�'v': FIRE .-.SMIP/RES GRADING
PERMIT 208.00 , �. ;� •! ,/ ,_ " ' •
PLAN 25E � S - i�' ,y SMIP/NON—RES
ISSUE FEE 20 . 00 "- � f „ ' ' - ' ' '
BUILDING—DIV—> PERMIT ISSUE P_L'AN—CHECK •�' TOTAL� 1• PAID DUE
TOTALS----> 208.00 20.00 � = 0.00 . :.228,g0_ , ; 228.00 .00
� i . f`� ;
REVENUE DIVISION TOTALS--> COLLECTED? ; 228,00 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC �-FIRE .SMIP•/TOT'.GRADZNG PLAN—CHECK
228.��� ; �i ✓ �� ,. '.
� n ' � .
iFlfik1f1F1k1F1E1E1E1EfEfE1E1E1EiE1k1E1kfEffIF1EIElE1Eil1E1FiFIE1EiE1E'1Eik1k1EiE1k1EfElFMiE1E1EiEIf1E1EiEiE1Flf1Eif1E1Elf1EfE!!!f!ElE1EiE1E1ElE1E1ElffFlEiE1E
I N D I V I D U A L'. /F E E`,;H,.fi:E A K.D O�W N
TYPE QTY D E S C R I P T I O N,�'. �� %�.�—"`�, UNIT GOST_ TOTAL COST
PLU 7 SHOWER ;�" y✓ 7,00' 49.00
PLU 1 SINK, KITCHEN %; r,,; �' , 7.00% 7.00
PLU 8 WASH BASIN ��" r •'. .� 7,00 56.00
PLU 5 WATER CLOSET (TOIL6T)� � �: ' 7'.'00 35.00
PLU 1 WATER HEATER AND/OR' VENT,a ' ^ ~�' 7:00 7.00
PLU 4 FLOOR DRAINS '; �' '� : ^. 7:.00 28.00
PLU 1 SINKS, FLOOR '; ���' • ��� 7.00 7.00
PLU 1 URINALS, WALL 1,• 7.00 7.00
PLU 1 REPAIR/ALTER�DRAINAGE/VENT PIPING "', ' 7.00 7.00
PLU 1 VACUUM HRKR/BACKFLOW PROT. 1 T0.4 ��� . 5,00 �- – 5.00
� END�OF� FEES . �� � ` . � - ' '
.`�/\ �..� . . �
_ �
tl
1
. y,
J�CONSTRUCTION AND PLANNING P9� � SPA
�'APPROVALS Permit # Date Inspector qppROVALS Permit # DaYe Inspector
t. mporary Eiectrical Service or Po�e - 52. Pool & Equipment Location -
2.':�oil Pipe�Undrgrnd. � 53. Steel Reinforcement
�3: Electrical Conduit Utility-Undrgrnd. 54. Forms � _
• •4r'Electrical Conduit;Undrgmd. 55. Electrical Bonding _ .
r .
_5: Steel Reinforcementr- 56. Rough Plumbing & Pressure Test -
'6: ElectriwlUFER-G_��� 57. APPROVALTOCOVER�GUNITE -
a -
-�CY. Eootings =� � ''� ' 58. Electrical Cond'uit-Undrgrnd.
� B.,Foundatior+�. ^� ' - 59. Gas Pipe, O Undryrnd., Test
9. Water Pipe�Undrgrrtii. :. 60. Backwash Lines, �Trap, O Undrgrnd.
10. StruccvrebF{oorfSVstem � 61. APPROVAtTODECK
1 i. Property Sewer Line & House-Connection 62. Backwash & Receptor-Final
12. Sewer Cap' - ' `_ 63. Heater & Vent-Final
13. Roof Drains �' 64. Plumbing System � Final
74. Rough Piumbing. - 65. Electrical-Final
15. Rough Electrical-Conduit ' 66. Solar System-F�pyl,
16. ftough ElBctric Wiring 67. Fencing & Accr,"3s,Approval .
�17. Rough Wirir�g Sign � 68. APPflOVED F(�iiPLASTERING
18. Rou9h ElectricaG,7 Bar Ceiling 69. POOUSPA SY$TEMS FINAL
79. Rough Heating & Air Conditioning FIRE D�PT. REQUIREMEf�T _ -C� c'-
_ rt �-. � ... m -� C:•• -w
20. Rougti Fa�tor"y�Fi�e�lace : �,,; `.� r - ` �,;.'. ; �APPF�O��,S�C Pex�nit# ' _ - - -�~
21. buccs,in'Struc[ure � � �• �• -_ �� ' 70.;Underg7oun"d Hy',dro
r ,e.
22. �ucc,s�; Ventilatfng � - . , '� r k'� 77. ProdueE Piping �J fjas Cl Oil
23. Gas P.ipe-Aough & Test � ;n - ^ � - � 7p, Underground F�tdx'F+ ' "
24. Roof-Framing•' � ° • ' �. �' ' � _ � � ; 73�., Under9rfid. Stoiaye Tank.O Gas ❑ Oil' " " �
25. Roof Sheathin - L � �� c
9 �2 �* = � ��= 74�, Overhead Hydro_ .
s
26. T-Bar Ceili�9lStruct�rop & 11�bn6Coat • '- � �� �� ~ ,. . -' °,��•`� "� -
�. � 75r� Dry ChenaVSa� r�:. ,: � -•i' -:� �
27. �rame and�Flashing � ,';� : ;; T � 76~ Dry StarfUplpe P^t'=. a� _. ' ' '
��� � -
•28. LatFiiitg &;Siding �:� �" =� �; 0 ` � .. •a- 71� FIXED S,l,$'`TEi�1�.[IVA�._,� '' .x,- `
_i ' . : '=
29. Insulation. - . . .� � i 78(.<FIRE P.REV. FINAI r'-� - '.� - _
30. Drywall Nailing �'�'" V ` ' ';,� " "`" "T�tEALTl:i'DEPT..REQ'UIREMEN,j`-'=, r:?;'
+: E� so,� on,., ,-
- 31. Plaster Bro�waCoa"t x= � � �r �� 79� FINAL INSPECTtON � J J
32. Electrical Power Me'4�rvFinal �' �� � a"8Q'.' FO00 CERTiFICATE I�S�UED '
�� t r � J' � T1 � *' . 1 -� � � � ��
_33. Final,Eleciiic;� -Y ny ! e• , �� Notes: ^ .i�4tf.��
_ � - �� 6 `_-�r2tU/w�ii rLt's7 2azi��s d / `_1
34. Fina4'He�Fing,& AirEonditionirSg �: ' i , ,� -' ' '� -' T.
- � . . .- * > �r � /� -9��C.'tnc,%tin* I�u'u./.l.�csE7u� d�
35. Finai Gas�Pip{�'Test,;� � ' .: : : � ., . -i= . "� . - ' -
' '�_ZS-.g'�:,=�"F_F��=l,�_M_L_SCiSC(<_(.�/COY_/CO
-. 36. Hood�or CanoPV T =� y r � '- . { '+.. 'Of2/bK -G� + . •C-�
,. r �:+� z r-; �c �� n�
:37. Pinah�actoryFire0lace �. ,.., :� .,'�' y` , - �j
_ .. �-�' -`�� i2�.cT&ri 2,c�r_ !Z�-�s \
� 38. Final:Plumbing ' ^' n p/ -'I (��/ . �/1-
- '�S-7 6 : (:lG7f��.'"1'L # rt-ccia7C SL �rK �Sl
39. Water$ervice-Final ' ''' '� , ^.�`-� � �.-�-�. � ���
T C %�t��L.._! nr'Cs' � C.1 S_rr-`�C �
40. Gas Service-Final � ��� -• � ^: �� - " "' ^� +�
_ : „ � a��rL � �cm4�� L�--�w�P _
�41. Solar pomestio-Final� -- _ " ; ' " � ' `` '-
. �� 4� �6� � � ��. _���-�s-�� . � -
� 42. Backfiow Prevente� � ., � a: ,vc';CL � _� -� r.
U / ��
43. Backflow Irrigation ; " ' � * �''� � � ` . � ." . �.
� � � 6-iLr��z�.���>- - -
44. Landscape:lrr qation�System c:+;:,, ' " " = C'� ' '�� t c- - - � , �
_ _ ' ' � = :��lS�b-a'4i�� = -
�
45. $ound Attenuation ,`. '_ '� " ' �� �.; ' ! r• . a,
. r - _ ,�
46. Handicap Regulati0ns � �j � � � � _ '- - �
< r i. ,
47. FINAL STRUCTURE & BUIlDING ' ' �Y � � '
, � - .
4$. FlNALPLANNING - � � '� ' '
e -
+18. E{ectric Release to Edison - ,� � _
50. Gas Reiease to Southem CaliforAia�Gas Co � - -• • '� �; x " • � • • • • •
� _ _ Y _ _ _ _ _ _
51. CERTIFICATE OF OCCUPANCY � : .T^ : � ^ - - - - �
No. Date ,
ADDfiES50FBNLqNG: SSS ANTON HL
NEP'SNAYEIFpqWN:SAKIOKA FARMS
' �nox�ss:pp BOX 2097
TERMINAL ANNEX
MPI. WIl01G WONESA
uxT: 1 S T
umxrtecrox�xN�x:TRI—SIGNAL INC. ����� 0
u�cxonvc�smonEss: 1945 GARDENA AV 818-247-1194 uxr.
GLENDALE CA 91204
mNmacrarsruweMORROW MEADOWS CORPORATIO ( 909 ) 598-7700
cam�croxs�uiew P O BOX 509
,��WALNUT CA ��; 230813
91789 u�:
UCENSED COMflRCTON4 DECLAq�TION: I hereby elikm under parely d perjury Nel I em licenesd uMm provieian d Cluqm 9
(epnmarc'yp wit� Seelion 1000) d Drvisa+ J d the Buineu eed Pmhsapp CoEe. eM my limms u in Iu0 tau eM Wetl.
cmuc.No.p06558 /u}c.c s: uc 0813 EXP: 6—
Dme: �� /�O _ / � CaNreda: ��� ./fA �
OWNEfl BUILDEP DECLAR�TON: I Miaby dfiem untlm paWy d pmjury ihet I em ssemp Imn �M Com�rfon liea�aa lew lor tlw
Nbxig raason (`�� ]W I.5 &piwea md PNlpiona Cods: Airy Uy a aouMy xfiitn nyum e psm! to mroWd. Ms. impow.
demd'oh. m repei eny sirucluro. pr'a io e� bauarKe. ebo raQuires iM eppl'rant lar euch prmn to Rb e eqrwd atetemsm that M a eM
o liee�ued punueN lo iM pwisima d Na Coeurmora lieenu lew �Cheqar 9(eanmmdiq xiiA Seaion 1000) d Diveion 3 d Ihe
Bu�ima and Ndma'an Codel a tM M a ehe o azemq iMelrum eM IM bmis la tM eOeqaE uamqion. My videtion d Seeion
)Wt.S by ary epplrent /or e pemN abpW tAe appfwu to a riW perutly d nol mas Ilun liva hundred do0an �55001).
� I.mawrcrdlMpeopenYamyempbyaeaxihwepeaa��heiMaepnpenWbn.willdothoxwk.aMlMaWetunwMiManded
a MereE la eeb (Sec�on loM. Bu�'vmaeM PModana CoCe: The CaMrenon lim�ua lewEoee nd eVW �o en owner d popeiry
.ro naa. «:nw� inmem..�d.no me..ua� wak nm..n «n«.w «wuyh ne w n.,.,� .*pw.... wwb.e in.�.�cn
�. impwxnwm ere mt'utla�tled a dlaed la eeb. tl. howawr. iM Eu�ldinp a inpev.amM w wld r.nh'vi aw yau d mmpbtion. iM
'�. ow�rorL�iNm wdl heve iM bu�dan M o��G M or ehe did m� bvik a'unwm'e ta Re PwVu+e W Wel.
.' � I. aa ox+wr d �he MWMY. em uduweN oonlretlM wilh IicaroeE conveciws m m�muri tM pqw (Se4ion ]O11. &u'ure ud
� Pmlmabm Code: TM Capemm liron�e law Com nol eGdY b en oww d RW�Y Ma EuOde ar mym'r iMeeon ud who
�I muraev tar arh pqaas wM a aau�eea(+) fcaroad pveuvm io �M Ca4eems L'mns Lew�.
❑ I un ezemp uMs Sectian: B. 8 P.C.. br Nu reamn:
Dme: Owner:
I tlo hraEY ��Y Nel I am awvs d xd vWniaid Na nG��ew tl Cel/wrie Nsatlh end Se1otY Code SWbro 25505.255�J. end
25S3a. aM Nw 1 a ury hnun EuaCvp omryei4 �I / wil m� (�4 aa) � Io mnply wIh rek Yete aoEe� enE iM re�ry'vamanb br
eVertnAlwwvvuctionamod'ifraianhaniMNi3i y�ene0��10ibrie.Reeideniidmmt�uaioneVD�raiiaroeraeaemqlmmiheea
oma: ��:
WORREN'S COYip131TON pECL�flATON: I Mraby effirm uMer peneAy d peijury ans W IM blbwiip EeWalom:
� I he�a end vN meinien e cenR'rsu d muent �o vatlimun lar xaken camprvuion. m praW W la b� Seaion 9)OU af �M lebar
Cada.la iM pMamucs ot ihe nak la wlich ihu penNl u iwued.
x❑ � n.re em Mi� mmNe:i waheia• cano�on mw�.�m. m�.aurtee W saion nao d m. len« coe.. ro. �n. w�a�� d �ns
��«..nw�im.w�nm�..�.e.Myw�F'I�EMANS �k�OJ�°d���m""" EXPIRES
c�.:
aary rmme,,: 0 7/ 01 / 9 6
(Thu saion meJ rot 6e ca+ndkeC I Ns Vs^^k u b om huiNisd Jdlas Isi001 w bv.1
� I cerlty Net in Na paAmrence W tM wwk lor whch this pemin o ueuad, 1 ehall np mmqq airy pseon in eny manw w u �o
Eecoma wqw ta tM waM1era' mmpernmion lews W CeIJmJe, eM eprse thu ! I ehauk beconr mApf to tM worlws'
�o«+�� o��. a�� d tM lebor Coda. I ,� �„i y,� ���
�- _ i.
Wun/iq: F�Nun b uwn wortri romp�nutlon cov�rap� h unlawM. �ntl �NII wb/�ct �n wnvlorx ro ulM�ul pxwNu �M
c/HI Ilnp ap ro ar ��ndrW WuuM AWI�n (S1Pq000A N MUtlon b tln cwt o/ rortpw�ufbM1 Cernyu u povWW br In
S�ctlon J106 0l Ms le6or COJ�, Intwv4 � elromsy'� Isu.
CONSTFlUCTION LENOINO AOENCY: I heraby �rm uMar pendy d peryry ihat tMro h a mrutivaian Mrdirp epency br Ne
parlamerce d tM xak br whitli Ih'v Oe^^i o'vwed (5wion 308]. Civ. CI.
LENOEN'S NM1E:
IEN�EN'S AOOPE59:
I ceniN Ihet I Mro reed iM epq'sation eM ama ihet IM eEova inlamdun o ca�ae. I prse lo canply xhh dl cuy W cauNy adinenue
eM �We lawe �Nn�q io buiWM convo-udion utl hereM' eWw¢� iepmen�eY�w af thu e7 b ants u0� iM aEws-moNiaad pvparly
����'°'tl�0"`D�"'DAVID MORTON
Name
� ' s-/G - 9�
.oi.v� om.:
Sipnelure Ownar/Rpen RppFcen n�r
/5151�8.WP) WMs-Buibnp 8 Sdery:O�esrrFle: Cenery-Appfun�: Pink-Revarw: Goldenmtl-Aeeevar
CITY OF COSTA MESA – BUILDING PERMIT
PERM NO: F 077717
PERMIT NO: F 077717 PLAN CHECK NO: 01921-96 L GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE: OTH
JOB DESCRIPTION : FIRE LIFE SAFETY SYSTEM SQ FT:
CLAIM VALUE: 7,000,00 CALC–VALUE: GROUP OCC: H /A-3
COMMENTS: "76 UNION PRODUCTS" / RE: H76355 PRIMARY BUILDING PERMIT.
x�*��x�x *x��r*�r*x x *�r*�r**�r**�r*�r*+�*�****�rx������*�x ***�******��**��*�+�**x *+�� ***+�*x���**
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
IE iE 1E 41E 1k 1E if iE iE ik 1! if if if 7F K k iF 1f if 1F IE 1E 1f 1i 1E 1E IE IE 1E iE iE IE 1EiE 1i iE 1E 1E 1E iE M�E iE if 1E 1E 1E 1E 1E 1f 1ElE iE 1E 1E 1E If 1E IF iF iF If iE 1f 1F iE iF 1E �E 1E iE 1E IE fE iF fE 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : ouJ � L� ��� IS�Q� DATE: � Z
APPLICATION ISSUED BY: � DATE: ��
1E1E1E1E1E7E1EIE1Eltitfkif1E1f1kiEiFiEiE1F1E � �EIEfE1EiE1E1ElEiElE 1F3f
LEGALIZATION:N F E E S U M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 125,00 0.00 81.25
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
125,0�
653 SMIP/NON—RES
81.25
TOTAL PAID DUE
206.25 206.25 .00
206.25 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CAECK
125,00 81.25
iE 1F iE �14 iE if i! 1f if ik iF 1F iF ik k 1F 1f 1f iEif 1k 1ElflE �lf iE iE iF 1F if'If'IE'k!! 1I' iE iE ik iE 1E If 1E iF iE �1E if iF iE if if ik k iF iE fE iF iE * 1E iFiE 1E if �F iE if i! fE k�IE if iE 1h jF iE iF 1E iE iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 125 FIRE EQUIP FEE (FROM HLDG VAL TAHLE) 1.00 125.00
END OF FEES
0
[11 f,t�=:'' �J�.l�a5i�. i, ; . "_
�'i'F� 'J°�ih.'V: ��I'.t; �19y..�
'
CONSTRUCTION AND PLANNING ' PO..� & SPA
� APPROVALS Permit # Date Inspecior qppROVALS Permit # Date � inspector
7. Temporary Electr(cal Service ar'Pole 52. Pooi & Equipment Location �
2. Soil Pipe-Und�g!nd._ �� � 53. Steel Reinforcement ` �
�� -
-3. 'Electrical.Conduit Uijlity-Undrgrnd. 54. Porms � �
. 4: E�ectrical'CondumtJniirgrnd. � 55. Electrical Bonding � �
. 5. Steel ReiqfbrtAment �' -� 56. Rough Plumbing & Pressure Test �
� fi•ElectricaCt7FER� Grnd. 57. APPflOVAL TO COVER-GUNITE ti�,�
-r + '
�-7. Footings- . ;y 58. Elearical Cond'uh�Undrgrnd. '
� 8. Foundatioa -- - 59. Gas Pipe, � Uuticgmd., Test �
9. Water Pipe,Undrgmd.�, � � 60. Backwash Lines;P-Trap, �] Undrgrnd. i
70. Structurai F1oor Svscem ., • 61. APPROVAL Tfl OECK �
t t. Property SewB„ line & House-Connection 62. Backwash & Receptor�Final �
72. Sewer Cap �.'� � . 63. Heater & Vent-Final .
73. Roof Drainr'r ' 64. Plumbing SYstem � Final '
74. Rough Plumbiny: � Y ' 65. Electrical�Final � �
15. Rough Elec[rical-Conduit •� • i 66. Soiar SYstem•Fnal �
76. Rough Electric Wiri�g � 67. Fencing & Acceszfipprovai ' '
_ 17. Rough Wiring Sign , � 68. APPROVED FOR PLASTERING -
4
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
i9. �Rough Heating & Au Conditioning �S r+� v - �' PIR-E�EPTrREQU1REMEAfT -
tT; r.; .. '.
20. jiough Facto'f"y Fi�eQiace -�" �,,;`° r - ' ;r � '� AppROV.ALS,� Pexmit # ' '
21.�Ducts,in�$tructur,�: �;� • . - �..a' 70.''Underq.rgu"ridHydro �;
22. Duc[s,VentilyFing�* �� �`, =' � � C;' 71, ProducL'Piping_E7�as QOiI -
23. Gas Pipe�Giou�� &.7,�st rz V =� p � 7Z, Underground F•7ush Y ?�
- �,
24. Foof FraPtin9 �" -� �' ` �'".* � 73, Under rnd.St a gTan OGas �^Oil
-,., i- � �� s di" � k
25. Roof ShBathin .�y� ��� h � =��.s
9 . � 74. Overhead HydrB'- +
r,
26. �T-Bar Ceil'rng (Str�tt�ural) & (vlonocoat �y � '' Cy �' 4 7�; Dry Cheq�Fal � s ; � �.�. �- .
27. �F_'rame an�, Fl�shingT F.f-'� � �� :,r 76. Dry Staodpipe- 1 a� r � �
�
28. lathing & Siding "'� r y-.�-: ,; w_r .° 77. FIXEDFS�STE�M PINP:�r ' '�'
29. Insulatioq � ; ^ = +� :_; , _ � 78. FIRE PREV. WiCY�L - ~ ' b•�4� 46 �.�,
30. Drywall Nailin9 .' �''-' r. E" '� - ;LNfALTH DEPyT,AEQ,UiREMENT
' � '-
37. Plaster Browri,Coat ,� " � c-.� �r - ' , � 79. FINAL fNSPECTaON - _ F
. 32. Hectrical'Powar l4,TeterFinai �, �, � 4' . 8� FOOD C.ERTIFICATE �$SUED L'
i � 33. Fina�Electric'. ..,'�� . �, � t �• �- � •r Notes: o' : - � .E`,�
r
34. FinaE HeOting.& Aif Cw�ditioning tr �� > ' '�' � t Q Y
r. r -rw �. .� T -
35. ;Final GasPipe�Test, :' ''�r ' t � ' . � -' •'' � .` _
_ v. � . ..� . e � .
_ 36. Hood o� CanoPY * J � � 'x!� • ' r. � ,.� � - >�T:
- . .- i r. . T :�. - - -
~ � � F - rt. C � `_..
� 37. Final'�Factory Firepi�a�e,` .. . , �„ � r� ..
0
' 38. FindF-Plumbing -`.* ?;� � =� * � ' 'i � H . • x _
• a -� � '- .: -
39. Water $ervice-Finai'�a '^ c- , "- , . •y. . v .. " r
- r
�� 40. Gas Service-Pinal � c ! -i-. �, � �a - • r_: � -�
v Y r . +G
41. Solar OomesticFinaf � �' ^ ��' "`' _ - '
_ � � � �-. -� -
42. Backflow Preventer,. � ;r, �_ r � �R ,-. * �r, c. -, . � �" F
- -� �. ir� -.
43. Backflow Irrigation;` "� . ' ��. `_ ." '� �
w
J �. . -
44. Landscape Irripation System_ �.�! a' !+ - . . G.' + � _
- c- r a
45. Sound Attenuatio� �- ' "' ' � � ' � � .
�. .,r .. .M_ � ..1
46� Handicap Regulations �• _ ' , � = �� " •
47. FINA� STRUCTURE & BUILDI,NG ` � 'j'��� _ : ,` -
� .
48. FdNAL PLANNING • " '-
+ i fs
49. Electrie Release to Edison ° � � -'' � � '3 - '- �
,g � . ��
.50. Gas Release to Southern Califor,nie Gas Co ' ' _- z' -
� _J� y F- _
51. CERTIPICATE OF OCCUPANCY
No. Date - "�
� �
�-
ADOFESSOFBUIlqNO: SSS ANTON BL
"E"'s""NEiFw�avx: SAKIOKA FARMS
' ��E�% PO BOX 2097
TERMINAL ANNEX
1iPL.YYIRM AOORE59:
�NT 1 ST
urcxnccronErawun: INTERIOR ARCH.2136232164 �G� 9378
u�op�s�� 550 S HOPE ST uxr 110
L.A. CA 90071
CONIIiACTpfBNAYE: SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
cwm�croma�,utmo 215 E EL SUR ST
mmnss MONROVIA CA ucra.: 190173
91016 mrt:
uc coNrn�crons oEcux�noN: i n.� .n:m �e. a� a o.mw mn �.m m.�.sa �w.� a�.w�. a cn.p. e
men np wGh Sactbn ]000) d Oirision J M iM &n'viw enE Pmlp�bn� CoEs, enE my lioema u in htll Mw enE efletl.
mueHo.:013054 uc.cuss: C 16 uc. o. 9 7 EXP: 04/96
om.: Z-?—`%L c�� ���
i �
NEN BUILDER OECLAF�TION: I Mnby dfirm unGr pauly W perjvy thel I em wmq hpn tM CpnMpf lkpus law la tlro
b0ov�ip tupn (Satlbn ]IX11.5 Butip�� uW Rdeub�u COAl: Mty Ciy a aouniY v.fikA iaquv�� e PertnY to mmtrutl. eCs. hnpwa.
.Nmdil�. «upei mry �Vuelurs. prior b G�'s�uena, ebo nQuim tM epplkeM la weh pamiu b Ns a dp�wd detmronl tIW M«�M
i� IionwE W�� �o Iha qM�bns d IM Conlretlon �aerus Lew �CMqer B(eomms�rp wnh Sad'en 1000) d Divwion � d ths
BwLwu .nE RdeaMu COMI a tIW M a dro b uxnq �hsaham aM th� bem b Na eIIpM axemqion. My vbinbn d 6Wbn
'!W 1.4 Ey em/ eppliouilla e p�mN wbNW �Ir epplhsM to � dN peiWry ol nd man Ihen M� hundred do0en �f500]j.
� I, u oww diM qopsny a my ampb�w� wYh wepn u iMi wle oompansetbn, MII do IM work, uM IM piucWn's na InbMeE
o.orc...a ro�.w �s«u� �a.. ewm...�a r,aa.w� coa.: rn. c���a. u�,.. V. eo.. m ww+�o.� o�„Na wowm
who WIE� a inwa+� �Mnon. ud r,ho Eou �uM xwk Nm�etl a Mna� n WwW Iuw a Mr own �mWv�+o. paidad iM ach
impwwnatl� v� nd ImaNed a o1bnE la uM. tl. howwv� IM buikinp w Ynpwemaq b wld wkhin aw Ym M comWwion. iM
ownx-0uikx xill heva iM �u'dw� d proviiq M or �M dk M EuIN a Impmn la �M puipwa d eW).
❑ I. u owMr W tM D�WM. un atlwlwM aamreCYq xXh Ilanwtl caMrmtm b oonmua �M O�Wb (BWion ]Ou. &p4�w� W
Prdwluu Cab: TM CaNrtlm lkanM lew dou nd �PWY ro en own�r G D�WsM who EuiW a Lnpa'e IMrsan W rAq
conlracb la wN prqeM MN � mmrmor��) Iium�A Wnuent m tM Gomredw� lJwro� levQ.
� I un mmpt undar SxMlan�. B. 8 P.C., br Ihb newn:
Dtic Ownw:
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: F U7632
PERMIT NO: F 076323 PLAN CHECK NO: 00068-96 L GOVT: N SUPP: N
CONSTRUCTZON TYPE: 1-FR PERMIT TYPE: FIR PURFOSE: ALT
JOB DESCRIPTION : INTERZOR 18000SF T.I. SQ FT:
CLAIM VALUE: 4,950,00 CALC-VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, SPRINKLER SYSTEM ALT, RE:kB75356
******�*****��***��**�����*���*x�*�*��****��****�***�**x*x�*����**�*�*****��*rt�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 41050104 ZNE: REF NO;
PLANNING NOTES>
i
1E iE 1E 1F iF iE If 1E IElF i4 iF if !E i! 1f if 7f 1E iElf 1f 1E iE iF iF 1E ik if iE * iF 1E 1E if fF if 3E �E if if fE if IE iE IE iElElE �E 1E 3E IE fE if IE iElf 1E 1f 1E iE iF iE 1f iE 41E 1E fElf iblE iE If� iE iE iF 1f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY ;
CATION ISSUED BY
LEGALIZATION:N jl
��. I tlo hareby nnlH ih�t I un ewm� d m0 unEmtenE IM rpulnmmb d Geliomle Hullh end SWty Coda 8eaiom P5506, 25539, enE �
�� RSsa�, eM thd I a�ny Mun WlWlip oacup�m wlll / wYl nm (drcM oM) nwd to camDM w�h WE Wte aoAn erd �M rpulram�Ma b
�•pxmMluaomWclbnamodiflmtbnhanlMAk�iny�m�nt0lprld.FWd�n�Wmrot�upbnepplutlanv�uwnpfmmNn� BLDG PMT PLUMBING ELECTRIC MECHANIC
I o'°'^•'°^• PERMIT _
•
F E E S M M A R Y
o�.: �aoir�:
WORKER'S COMVDI9�TION DECUN�TIDN; I hu�by eXinn uMw p�nN1y M po'ryry oM d IM IdbMrp E�du�tbnc
� I hew end �Wp mdmein a c�nHkN� d oonsan� m ��tlamun la worFai aompnWbn, v D��� �or by BMlon 0'!00 ot ih� lebar
CoM, fa iM p��larmenc� d IM wrk Iv wNCA ihb pa�mN b Wusd.
i n.».�e �� �wm.� .an.�• �v�� i�.,�.,.. �o��.e w e.aw� a�oo a m. �,n« cae.. ra m. �. a m.
wk lor xfiich IAI� pe�mil b IpusA. My wabn' mmpenutbn ins�rar�c� milx W pdiry numGr v�:
c.�.i.�: FREMONT EXPIRES
Pdicy Numbw: 0 6/ 01 / 9 6
(Thb maM mH mt M mmP'�tM / IM PmmR b M an AaMni ddkn If'IOJI w Im.J
❑ I mnlly Ihtl in IM pMormv�a W iM wark M whhh �M� pemX 4 bw�d. I dWl ml amplvy airy qnon in ury menew �o n lo
wE�W m iM xa�k�n' mnp�nWbn lerw d CdilaMe. �nd�n� tlW ' 1�Nywtl baoonw wb�q m 1M woM1r�'
W�Wbn pwbbra M 6wbn �)00 N �M l�la COJ�. I 4W17 I±�mV O��—
�
Dtl�: — �'��� Applkud: _ O
liq: F�Nun ro�1eun werM'romp�rwtlen rowrp� l� unhwM, mtl �Irll utl/ct �n �mplonr ro alM�rl pwltla �ntl
IHI 11nu �q ro m� MntlrM HpuNn0Oo1Mn (tfOq000A M Mtlltlen b M� ewt ol eempwwtbn Eunpp u povMW bi In
8�etlon JIOB o/ Cu L�Dor Cob, Inrwt �ntl �ttomql br�.
CONSTItUCT10N �ENDINO �OENCY; I Mnby dfi�m andx pmlly d pxjvy ihn iMis b� cm4�udbn bMhp Wenry far tlM
peAmneno� d tM �wrk Iv wt�kA ih's pwml b'stwE (8W un �OG1. CH. CI.
LENDER'9 NMIE:
LENOEN'e �UDFES4:
I eanily �M 1 heva rerl thu eppfrNlon eM nets iM N� ebwa'vilamelbn h oonsq. I p�se to comply wilh eA cry uM munry ord'meMm
eM �We I�wt nW'vq to Witivp canprutliq� end Mreb/ sulMrli� i�plNnlNWx d Wt tltyb �mar upon tM eboro�mm�oneE propeny
la imperiqn p�vpo�u.
�
ROHERT BROWN
o.�: ��7 �L
(5151-M.WP) WM1��Iknp Stlsty:WsaM s:CenW-ADD��:Pink-Re.wws:Addanm�Nwmr
PLAN
ISSUE FEE
DATE:
DATE:
STRUCTURAL 3EGMENT:N
FIRE SMIP/RES GRADING
72.00
�a 65t SMIP/NON-RES
� 46.80
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK ���•' TOTAL PAID DUE
TOTALS----> ' 72.00 0,00 ,46-:80 118r80 118.80 .00
REVENUE DIVISION TOTALS--> COLLECTED:-�,'� �72.00 'OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SM-IP:/TOT GRADING PLAN-CHECK
+ 72.�0�
' '". f ,
**��r*�*�**�+����*�+��,����*+�*+��r+�**�*���r�x��*'�*���*��r��r******�**� x *+��*�r���*�***�*�*+�
'� I N D I V 2 D U A L F. E E , H R E P: K�D O W N
TYPE QTY D E S C R I P T I O N �; ��1 UNZT COST TOTAL COST
FIR 72 FIRE EQUIP FEE (FROM HLDG VAL TABLE)� 1.00 72.00
END OF FEES
.;
�/
t
" ci �o_c , .. -; �.z�:r-'� T�.=
,, car,�. a.,_ ,_� ,-. � 10�.i
�2.C�J
� CONSTRUCTION AND PLANNING,� �P��" $ SPA� . - - �'
Date Inspector Y �� Date Inspector
� APPROVALS Permit.�k �� APPROVALS � Permit # ,
1. Temporery Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. . 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. � � 54. Forms .
4. Electrical Conduit=Undrgmd. � 55. Electrical Bonding ,'
5. Steel Refnforcement�� 56. Rough Plumbing & Pressure Test i�
6. ElearicalUFER�Grnd. � 57. APPROVALTOCOVER-GUNITE (.
7. Footinqs . 58. Electrical Conduit-Undrgrnd. � 1
i
8. Foundation � . 59. Gas Pipe, O Undrgrnd., Tesi
� .
9. Water Pipe�Undrgmd. ' 60. Backwash Li�es; P-Trap, � Undrgrnd. ��
10. StruMurai Floor System 67. APPROVAL TO pECK ,'
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap � 63. Heater & Vent-Final �
73. Roof Drains - 64. Plumbing Sys[em � Fina� �
74. Rough Plumbing - 65. Electrical-Final �
15. Rough EleGcrical-Conduit 66. Solar SYstem-Final
16. Rough EleCtric Wiring 67. Fencinq & Access Approvai
77. Rough Wiring Sign 68. APPROVED FOft PLASTERING
18. Rouqh EleCtrical�T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAI
79. Rough Heating & Air Conditioning ,� . FIREpEPT. REQUIREMENT
20. Rouqh Factory Firepiace " - , - , � APPROVALS.� ; Permit #
21. Ducts, in Struaure � - � - '' 70. Under9round HYdro �
22. Ducts, Ventilating �' � - � 71 . Product �Piping �Gas O Oi�
23. Gas Pipe�Rough & Test .� 72. Undergraind Flush
24. RoofFraming - � , 73: Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing • ' - ' 74, Overhead "-,-'.., �`�.� �•/�.�[ �rF-I-
_ +_ '
26. T-Bar Ceiling (Scructuroll & Monowat �, 75. Dry Chemical
27, frame and Flashing - . �' 76. Dry Standpipe - . -
28. Lathing &,Siding . - � , • ' 77. FIXED SYSTEM FINAI. �
29. Insulation 78. FlRE PREV. FtPIAL '� -
30. Drywall Nailing ,. ' HEALTH DEPT.�REQUIREMENT �
31. Plaster Brown Coat � �•� 79. FINAL INSPECTfON ` -
32. Electrical Power MecerFinal '� �� 80.� FOOD CERTIFICATE ISSUED -
33. Final E�ectric � �� � CT Notes: - • ' .
34. Final Heating & Air Conditioning _ ' �` .�/�d(G� � s . . _
� � -r
35. Final Gas Pipe•Test - -�' ' ► �
: � G�_C�_� U�.
36. Hood or CBnoPY �. �- ", ' ' -- - � � . ��•
37. Fina� Facto�Y Fireplace � • � '' � . C�i ��rLOyy� �
38. Pinal Plumbing � ' Q,' ���
39. Water Service-Final . ` � � � el PA 0� `d/(,
y ��d„A� y��
40. Gas Service-Final � , ' � „ /
c2e �l�il_ass.�> �'c�`'f G �i�,(
41. Solar pomesticFina� _ � - . _ � /
42. Backflow Preventer -
43. Backflow Uriqation � � � ' ' � .
44. Landscape Irrigation System � - - - . � �; ' . '
45. Sound Attenuation. .' .. ' � , _ � . .
46. Handicap Re9ulations "' �
47. FINAL STRUCTURE & BUILDING _ �� �
48. FiNAL PLANNING - - • ' '
49. Electric ReleaSe to Edison . r� �
�
50. Gas Release to Southern California�GasCv -• _. - '
57. CEFTIFICATE OF OCCUPANCY , ` -
No. Date
' 11oMcss a euitu/o: J� 7 HN 1 V N tl
ameasxuieiva�orm: SAKIOAKA FARM
� �AOOPE54: PO B�}� 2�9%
� TERMINA ANNEX
�vr�. �uaa �oo�ss:
UNi:
.�cxnecTan�aN�n: INTERIOR ARCH.2136232164 ucr,o: C-9378
�y urcx.onwn•siwo�ss: 550 S HOPE ST uxr: 1100
LOS ANGELES CA 90071
conrx�crarsNu�: MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
CWiP�Ci0R5YY18A P O BOX 509
�� WALNUT CA �� 230813
917 8 9 �,R,
UCENSED COMN�C70N4 OECUN�TION: I hsab� elfim udr pvuly d pspvy tlW I em fcw�sea vder pmidm� d CMqx 9
(wmmmaiq wnh Sectian )000) d Drvieion ] W Ne Buumn eed Pralaaaiona Code. eM my lioeiue n in IUA laca erd Nlee.
arru�cJ.No.:006558 /uc.cuss: C 10 ue.No.: 2308 3 EXP: 12/96
� Deta: T-�l � ��(� Camw %�Y�
��
:/
��
��
OWNEF BUILDEF DEClAfl�110N. I hxeb/ efbm uder psWy d px'vy I em u �q han tM Corairam Lioema lew Ip tM
ItlbwnB ronwn (5edion )W1.5 &eiimf eM Rdpdmt COEe: MY e�� nVwa a VamA lo anutrud. etlar. inYove.
brtqlsh, p eepai e�ry at�ui]we. prv b b e�uvqe, eb0 rp�w �hs b penim �o Ae e tlpnW qmmwa Cm M p�M
� r,m,e w�m w ma w�+ a u» com�. uw�.e t... �c �e�u .vn s.a� r000� a oa,e� a a m.
9usinea ena Raeaom coael a �nn �r>.ne u wmn �neraM1m� a,d �ne e� �« ms eOepeE m«nqa,. Nrv vnwim a seeun
)rot.5 by vry eppl'rant In e parmil wbjeC� �M epp4am to a uvi psWly W nd maa then /r�a �wHM doAen �SSOOp.
� I.00x�dtMpW�Ynm1'emd�Mxthwppao�hei�abmmO�.NdoCawork.mdthsetrucmeenal'vaanded
a dlered la sab (Secuan )ON. B�nu dd PMne'vu Cads: TMCa�lradaf lionfa LawEomnd eDO�Y loen ownerd piopeny
wIn ddde a inD�+� �hxeon. eM Ma Eoes �uN xM FhnaN a Mnal a Wary� he a Ir own emVM�. pw'db �he ach
impwem«vs ma rid "mtnded a aflseG la aeb. !. Mnawr. IM dutl'uq u inpwanam u wld wilAn msYw d wmqMion. iM
arner�driNv xiG M1aw IM dvdsi d pd'vq M a tlw tid na bWd a bnpwa la Ne p�vqwa M�eM).
� I. n owrer d tM M�Y. em mduswlY mvreq^Y xiN lioemed eanveeoes m m�mw tM V4� (SWun 10u.8winws vd
Prtlaevon Code: TM CaCMm licww lew dow nd Md/ n an owns d O�Y who dnld� a iiPw'w thason vd xfio
comrecta lu eiM prqwfa wuA e mrarrfor(alliumeE punuw to tM WNreCon licp�ss tew�.
� I em uemq imdar Sx�'vi: B. 8 P.C.. lu Nw �sewn:
Deb: Owiw:
I Ao hseW unCV Net 1 em ewera al eM WraaM tM iapiLemama d Cdiwrce IWtlh eM SdatY CoM Saaiam A5505. 255]�. enA
usw. d,e mm i«.�v nn�.. w�mro ommd+ T I wi m� (aeb ane) nseE io eomOA' wTh eeiJ mu eoEe md tM �puieemema br
aVenminmuiv.'miumoASmianhan�IrAi�Y mePmeuDivria.Rs�dxqwlwnCiutlione00kdbrousuemqtmnllw�e
wwmon+.
om.: �oo4+m:
WORKER'9 COYPENSATIOH DKL�R�TION: I IwWy alfim ukr pwpy d pe*ry wr d iM bWw'vp ErLrtlum:
� I I�ew aM wJ meiruen e cenEiuta d ovuenl to �atl�i�uun br wkwi mmpanWion, m prwitle0lv by Satlion �)00 d �M leEar
Gads. Irc �M pMmnucs d Ns wM 1> Mi� Ne pamW u ivueA.
�] � nn. end w meimei,.alw.• como�� ��o.... �ameea M s.aion �loo a m.leEn coe.. �« �n. ro�«menm a �n.
,.awi«w�w.w�44.�.e.Mr.�.•�°i°�FR�i�i��e«�•: EXPIRES
cemie.:
Pa4ry Number: Q 7� Q 1� 9 6
'(rniv seabn nesd rra a canokiae � rlr w+�� u b w nunbM JaOan 1%�001 n ImJ
� I cenM thel in IM pMamenro d tM wak la xt�cn Ihu pertnn u iuueE. I WY id smploy xry pn�on in enY menn« �o u lo
b nnw �uhpa to �M xaM1ws' m�vaqn Isvn d CdLmu, and apns tlW tl 1 Ywk Mcvnr abjea �o tM xaM1en'
eompenmiim pwiviam d Setlbn 2l0p d Ihs lebar CoUs.�l lat�wnh oom wnA iMn pewisions.
0�<:.3-2C-9G �,� �'r,
Wemlrrp: F llun ro ueun Mo�kwi ronpwwtlon rovmp� l� u�4wM, �r �IWI JICE N MIpIOyM f0 CIIMNI pIMMM IIIJ
c/vll fln�� up ro onr h�nOrM tMuurtl Jtl4n (ti0q WOA b�Rbn ro• cwf I rompxu�fbM1 E�ryp� �� provWW br In
Sxtlon 9106 0l tlro LMor Cob, IntwaL ���mry'� Iw�.
CONSTHUCTION LENDINO AGENCY: I hseby df uMm penelry W per'ryry �hq iMrs u e mimrWion Ixqinp qpM,y M IM
poAormaMe d iM wak I« whicA tne pmmi n eweE (�1ion �OB). Civ. CI.
LENOEH'S NANE:
��oea�s �ooxeu:
I canih �� I hew read �hn epdrd� � ama iAei �M ebwe inlmretion a co�ncl. I epree to compN �h ell aiy and mumv �inenme
eM elele kws rMeliq to buiEiq consUudion mtl Mreby eWarus iapeamteiirm d iha cty b anix upon iM ebwe�meMionaE popory
�°'�°apetlpnp1pO9°' CHUCK JACOHI
Dme: ✓ � /"�%i � / �
(5151�48.WP) `� Whne-Buikip 8 Selery; GieemFle: Cenery-�ppimnt; Rnk-Reven�e; (iol0enroE-Aerouor
CZTY OF COSTA MESA - BUILDING PERMIT
PERM NO: E 076906
PERMIT NO: E 076906 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 1800SF / RESTAURANTS Sg FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B /
COMMENTS: 76 PRODUCTS CO / DEL TACO 6 SUBWAY INTERIOR TI, RE;tIB76355
**********�-****+�*****�t-***�-�-**+r+�**x��r*******x�*�rx�**«**x�x�**x�***+t********+t*****�r�r***
Z O N I N G R E Q U I R E M E N T S
sETeAcxs
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
>
1E iE iE 1E �E iE 1E if if 3E iE iE iE 1E iElf 1E iE iE iE iE 3E iE iE 1E if iE if iF �F iF jF if if.iE 1f !E if iF iflF ik 3f iF iF iE iE if if if 1E iF �f if iE 1E �E IE 1E IE 9E 1E �E IE aE IE �E aE iE 1E iE iElE iE iE iE 1E iF iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
BUILDING APPROVED BY : � DATE:
APPLICATION ISSUED BY: ' S-�- DATE: � ��I.6
* * �t * * * * * * * *** **�t�t�tiE�t3t�t�F�FiF3F�F3FTF�F7F�F'fF'iF�F'iF3F'iFTFTF3F'iF3FiF3F�F TF3FiF7F"{F'iFiF'3F�t * *ir * ** **iE7FiFiFiF iE *
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 116.25
SOt SMIP/NON-RES
PLAN
ISSUE FEE ,I5.�00
BUILDING-DIV-> PERMIT ISSUE PL`AN-CHECK TOTAL PAID DUE
TOTALS----> 116.25 15.00 0.00 131,25 131.25 .00
e.:
REVENUE DIVISION TOTALS--> COLliECTED: 131.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
131.25 ' �
t/
iF 1f if if iF iE i43F 1E IE 1E IE If if 1E 1f IE 1i 1E iE iE iE IE IE iE 1F iE �E 9E fF iE iF 1F iF 1F 1FlE if 1E 1E iE iF iE 1E iE if iF if iF 1E 1E K iE if iF fE 3E iE 1E iE iF �E �F iF iF if if iE iE 1F fF iE iE 1f IE iF if iE iE
I N D I V I D U A�L'.� . F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE
ELE
ELE
ELE
ELE
ELE
ELE
2�
40
20
15
3
2
FIXTURES, LIGHTZNG ' 1;ST 20 EA.
FIXTURES, LIGHTZNG. ADDITIONAL EA,
RECEPT/OUTLET •% 1y-ST 20 EA,
RECEPT/OUTLET ADDITZONAL EA.
RECEPT/SWITCH : �1 ST 20 EA.
SUB-PANEL
MOTOR/POWR APPARATUS .'1.1 - 10.0 HP
�END;OF FEES
/°� '
i %
.%S
.45
.75
.75
11.00
7.50
15.��
18.00
15.00
9.00
11.25
33.00
15.00
M -L. I ' ♦
� � � �
, � �. CONSTRUCTION AND PLANNING . POO.. _ SPA �
\�� APPAOVALS Permit # Date Inspector qppROVALS Permit �h Date Inspector
f. 7emporary Electrical Service or POFe 52. Pool & Equipment Location
Z, $oil Pipe-Undrgrnd. 53. Steei Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Eiectrical Bonding
5. S�eei Reinforcement 56. flough Plumbing & Pressure Test
6. �lectrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. footinqs 58. Electricai Conduit�Undrgrnd.
8. Foundatian 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgmd. 60. Backwash Lines, P�Trap, O Undrgmd.
10. Scructural Floor Svstem 61. APPROVA� TO DECK
}1. Property Sewer Line & HouseConnection 62. Backwash & Receptor-Finat �
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Finai �
15.� Rough Electrical-Conduit 66. Solar $Ystem-Final
16. Rough Electric Wiring 67. Fencin� & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78, Rough Electrical�T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rbugh Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventitaiing 75. Producl Piping OGas ❑OiV
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. S[orage Tank � Gas ❑ Oil
25. Roof Sheathing 74, Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �.
27. Frame and Fiashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL
30. Dryevall Nailing HEALTH DEPT. RE�UIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric I(�II�6 Notes: y--6� T.7���j-� V�
< < < � ��
34. Final Heating & Air Conditioning �
`�'=l6-96 �.��
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace -
38. Final Plum6ing '
39. Water Service-Final �
40. Gas Service-Final ,
41. Solar pomestic-Final
42. Backflow Preventer
43. 68ckflow �rrigation
44. Landscape lrriyatia� System
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison '
50. Gas Release to Southern Cali(ornia Gas Co
51. CERTIFICATE OF OCCUPANCV
No Date
, I
�
� ��
� �itp o f �o�ta 21�e5a �
Development Services, Division of Buiiding and Safety
CERTIFICATE AF OCCUPANCY
This certificate is issued pursuant to the requirements of the Uniform Building Code, Secrion 308
adopted by the City of Costa Mesa certifies that at the rime of its issuance the buffding structure herein
below described was inspected and approved for occupancy as foilows:
Building Address 595 ANTOx SLVll. FLOORS 1-12
Use OFFICES
Bldg. Permlt No.*aee belw
Group �-Z Type of�ConsirucUon 1-FR Fire Zone Use Zone PDC
Owner of Building Sakioka Farms 1-epani �hn�mc.ar."
Address ^-� '
*B74570, B75356, B74572, 574571, Bi45?3, B74633
B�4632, A�4631$��l 00 � 877866, B745]4 By '
.'�.ITi�f?:
Date November 14, 1996
RICK BRO'w�ld, CBO
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
�..;.:n v��•^•--r�.J:u.:i-�' .. . ��„ `.�°k;�-.ti .: • r �+'�"kn+`..,-., ,� ... � . . _ _. . ; . .. _. . - . .. .. ' � ti ri%c:r�+.�x.ro,r
� � . _�.<_ ... . - , �,- �„ �v�l
� CI�Y OF COS;TA Mr �A _
Development Services, Division of Building and Safety.
CERTIFICATE OF.00CUPANCY
�:�;� �� �g��_
� ,�,,
This certificate is issued pursuant to the requirements of the Uniform Building Code, Section 308 adopted by the City
of Costa Mesa certifies thatat the,Hrne of its issuance fhe buildingstructuce heiein below described was inspected and
�;,w
approvedforoccupancyasEollows ,-��, � �,,;}�,a t"�,
BuildingAddress 55�;�'Anton�,B1.. Ste`�2��2nd� F1 ��- �Bldg PermitNumber B06-01112
,. � y ' ^� "' , $.3 '.5 i��t
4
� _ „ , _ .. .,. r J� ��...� yK'�,�.r�
Use 0ffice _�'`,, s:� (5;92�1 af), �.,,/ ��„-,.,,,
-- ' .,.r ; a.,
Group B Type of Constructwn - �l F-R 7�N".t�',g����� �- "'! fi' Use Zone C1
z , w ��q ; ,� a a'� ` �� _ ` ^ � . ^ ":
OwnerofBuilding RREEF �.�.,� � ��� - .,���� '' �=Tenant *�N�F.TI�FICE
�.,,, s� �t �� � � f:. �,� _ a� �,' y� .d
p.0. aox 4900, DeptF. 207, Scottsdale,� AZ 675
Address rt�.
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F. . �, , r � B .
BUILDING OFFICIAL-K11d11Z1�Q `NgUyeri,?.0 B � rx� �: `'` 02/ 1/
Date>�'%� �
� _ . u 'n
. .. . � .: �',-, -
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REQUIRED TO BE POSTED�IN A CONSPICOUS PLACE
_ �
Ciry of Costa Mesa
Development Services Departmeni
Building Safety Division
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No.
The Building located at 555 ANTON BOULEVARD. 2ND FLOOR
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B2 Occupancy.
Use of Building OFFICES
Legal Description 410-501-04
(See reverse side for Metes and Boundsl
Building Permit No A 5RR71 Electrical Permit No. F. SA97(1 Plumbing Permit No._
Mechanical Permit No. M 50 �n Number of apartments and/or guest rooms
ISSUED T0:
BANK OP AMERICA
555 ANTON BOULEVAfW, 2ND FLOOR
COSTA MF.SA. CA 92b96
Building Official TONY C'nE RACA
.i
.
� ���
by. �. �>�
Date DF.CF.MRF.R 10 _ 199'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 (e) U.B.C.
CMF 1015-a6 rev. 1/83 White - Owner; Canary - Numerical File: Pink - Bldg. Permit File
�
City of Costa Meu
Developmeqt Services Department
Buildi�g Safety Division
P. O. Box 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No. �O�J1,�9 ^
The Builtling located at aqq a��.... w,,,iAvar�1, sar.onA Rloor
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group R� Occupancy.
Use of Building Of£iCe
Legal Description 410-301—Q4
(See reveru side for Metes and Bounds)
Building permit No. R 4FF,tlFi Electrical Permit No. i69 Plumbing Permit No
Mechanical permit No. M�H77R Number of apartments and/or guest rooms
iSSUED TO: � Building Official William T. Howard
c...+�.rihi� parifiC iir3R�C I
600 Wilshire Blvd. by � -� �.
te�a nnnal�a, CA �Ol%
- ' Date July 14� 198S
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premius 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-q6 rev. 1/83 White - Owner; �-,�ry - Numerical File; Pink - Bld9. Permit File �
�
CITY OF COSTA MESA
BIIILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax Q14) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754•5626
F10-00087
Job Addres 555 ANTON B
Suite: 200
Vicinity: UNIT200 �
SUBTYPE: ALARM
Parcel Nunmber 41050110
Applicant: AHRAR,"SEYED
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
Owner: RREEF
Address PO BOX 4900
DEPT 207
SCOTTSDAlE,A2
FIRE SUPRESSION PERMIT
Phone: 878-683-1500 XT 3023
Zip: 90815
Phone:
Zip: 85261-4900
Status: ISSUED
Applied: O6/21/2070
Issued: 06/21I2070
Contractor: INTEGRATED PRODUCTS AND SERVICES INCORPORATED DBA CAL PROTECTION
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
Phone: 800-247-6497
Zip: 90815
License: 909573
SCOPE OF PERMIT:
FIRE SUPPRESSON PERMIT TO UPGRADE AN EXISTING FIRE ALARM SYSTEM BY INSTALLING 8
NEW
DEVICES IN CONJUNCTION WITH A 1200 INTERIOR TI TO UNIT 200 FOR "MEGAPATH", SPACE
200. REF#:BC10-00164
FEESUMMARY
Add'I Inspection Fees: $0.00
Total Fees: $235.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: PERMIT EXPIRES'I80 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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. Pailure to obtain inspections and fnal approval will result in the expiration of this permit.
COOE t. INSPECTIONTYPE
1616 Fixed SyStem Final Fire Prevention
7266 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
20a Final Demolition
DAIE IN1rtIA�5 CQOE� INSPECTIONTYPE
208 Flnal Mechanical
208 Final Plumbing
210 Final Electrical
272 Final Fire Prevention
220 FinalPlanningApproval
222 FinalSite
250 FinalBuilding/Occupancy
O�TE INiln��s
�,—S 10 _S.LL'�I—
WORKERS' COMPENSATION DECLARATION:
I hereby affrm untler penalty of perjury one o( the following declarations:
❑ I have antl will maintain a certificate of consent to self-Insure for vrorkers'
compensation, as provitled for by section 3700 0( the Labor Cotle, lor the
per(Ormance of Ihe work lor which this permit is issued.
❑ I have and will maintain vrorkers' compensation insurance, as required by
section 3700 of lhe Labor Code, for the performance of Ihe work for which this
pertnit is issued. My vrorkers' compensation Insurance carrier antl policy
�,neu�mb�er are: '��
p:anic�. ���l.l�
(ihissarl.onnaetlml pefeClMepemNavaluetlalmehuntlietltloqan(31001w1esx.)
NcyNumGer. �zn+G � �� � p� - t ~
❑ I certi(y that in the pertormance of the �vrork (or which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws o� California, and agree that if I should
become subject lo Ihe vrorkers' c mpensation provisions o( Section 3700 of
Ihe Labor Cod I 5hall fort iwith se provisions.
� /�� 0
�'ppll�nt's ignaWre �pa
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVII FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LqBOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrtn that I am licensed under pmvigions of Chapter 9(wmmencing
wilh Section 7000) of Division 3 of the Business and Professions Cotle, and
my license is in full force and eRect. 1 I
Liy�� /1 � !.' i 7 � `ss'# G/`O (' l �^�
./s-� Z_..
SignaWr 3(
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that �here is a consiructbn lentling agency lor Ihe
peAormance of the work fa which this pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name:
Lender's Address:
OWNER•BUILDER DECLARATIONS:
I hereDy affirtn thal under penaly o( perjury [hat I am EXEMPT FROM TNE
CONTRACTORS LICENSE LAW for the Pollowing reason (Sec. 7031.5,
Business and Prolessions Cotle: Any city or counry which requires a permit to
cons[ruct, al[ar, improve, tlemolish, ar repair any structure, prior to its
issuance, also requires the applicant for such pyrmit b fle a signetl slatement
Ihat he or she is licensed pursuant to the provisions of �he Contractors
LiCen58 Law (Chapler 9(wmmencing wilh Seclion 7000) of Division 3 0( the
Business and Professions Code) or that he or she is exempt therefmm and
the basis (or the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant tU a civil penalty ot not more than
five hundred dollars ($500).):
� I, as ownei of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the siructure is not intended or
oKered for sale (Sec. 7044, Business ana Professions Code: The Contraclors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such vrork himself or herself or Ihrough his or her ovm
employees, provided that such impmvementg are not intended or oRered tor
sale. If, however, lhe building or improvemynt is sold within one year of
completion, the owner-builder will have the burtlen of proving that he or she
did not huiltl or improve lor purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to cons[ruct the project (Sec. 7044, Business antl
Professbns Code: The contractors License Law dces not apply to an ovmer o(
propeAy who builds or impmves thereon, and wfio contracts for such project with
a cm[rac�a(s) license pursuant to�he Cont2ctqrs License Laws.).
❑ I am exempt under sec.
Business and Professions Code for Ihis reason:
5ign�lme oate
JOS]-Ofi (10))
Owner ID venfetl by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifiwtion of Ownership by (rype of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certAy that no excavation (rve (5) or more feet in tlepth into wfiich a
person is required to descend, will be made in connectbn vrith work authorized
by this pertnit, and that no huilding structure, scattdding, false�+ork, a demolition
or tlismantling lhereof, will be more than ihirty-sia (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 347, Ttle 8, Calitwnia Administ2We CoOe).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from Ihe Division of Industrial Safety, as noted above, unless
suc� person has a pertnit to do. such work from the division.
Applit'anYs Signature oale
Division of Industrial Safety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicanl or presenl or fuNre building occupant need to fle and
ceAi(y a Business Plan for emergency response to release or Ihreatened
release of a hazartlous material? ❑ Yes ❑ No
(Section 25505 0( [he Califomia Heallh and Safely Code requires, with some
eaceptions, Iha[ a Business Plan be filed with the Cw[a Mesa Fire
Departmem by every business which has at any one time during a reported
year a quantity o/ hazardous materials equal to or greater than a weighl of
500 pounds, or a volume of 55 gallons, or 200 cubic feel o( wmpressetl gas
at standard temperature and pressure).
2. Does or will the applicanl or present or (uture building occupant need to file
a regislration form for acutely hazartlous matenals? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safety Cotle, wilh some
exceptions, requires registration with the Costa Mesa Fire Depadment by
eac� business which at any one lime has on hand a quantiry of acutely
hazardous matenals equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feel of compressetl gas at s�antlard
temperature and pressure).
3. Does or will [he applicant or presen[ or fulure 6uilding occupan� need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous malenals)? ❑ Yes ❑ No
(Section 25534 of the California Health and Satery Code provides that the
Costa Mesa Fire Departmenl may require the preparation, certifcation and
fling vrith the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous materials with Ihe Fire Departmen[.
4. If an RMPP is presently require4 has Section 25534 0( the Califomia
Health and Safery Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or luture building occupant require for
the work which is the subject of Ihis apD�italion a pertnit for such construction
or motlification fmm Ihe South Coast Air Qualiry Management District or fmm
any olher air pollution control district or agency? ❑ Ves ❑ No
(Section 658502 of Ihe Califomia Govemmenl Cotle requires that the requestetl
intortnation be fumishe0 on applications for nomresidential building permits).
6. Will any part of the faciliry to be constructed under Ihis pertnit be vrithin
1000 feet fmm the outer boundaries o( a school? ❑ Yes ❑ No
Qf "yes", the facility must meet the requirement o( Sections 25534 and 42303
of the Califomia Health and Sa(ery Code).
7. I( a permit from the South Coast Air Qualiry Management District or other
air polWtion control district or agency is required for the vrork which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. pt'yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certity thal under penalry of perjury Ihe
information given above is correct I a9ree to comply with all state laws and
ciry ortlinances regarding Hazardous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y untler penalty of perjury that I have reatl this application antl state that
the information given is wrrect. I agree to comply with all state laws and city
ordinances relating to building construclion, and authorize representative5 of
the Ciy of Costa Mesa ro enter upon the above-described property tor
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permit until f nal inspeciion.
...�. .. .
��/ a
�, �F��r -
(�14) 754-5273 • Fau (714) 754-4856 • www.c�.costa-mesa.c��ILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 2
Vicinity: SECOND FLOOR NETIFICE
Primary Occ: B Eal<50/ OKcel Bar<50
Parcel Number: 41050110
npp�icane LOGAN, PETER
Address: 33161 PASEO BLANCO
SAN JUAN CAPISTRANO
Type of Conslruction: I-FR
Zoning: G7 '
Phone: 949�89-5196
ISSUED BY:
Status: ISSUED
Applied: 07/052006
Issued: 09/12/1006
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Owner: RREEF O /�'�� _1 - c_
Address POBOX4900���`�"� � � �� � �� ���
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intracror: �CLOGAN COMPANY� �----�'��� � C�
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Existin 0 Reaulred: ,�`0; � -„ �PF000sed: �� 0 �ir-:�/
� ��/�i � -G'� o�, ��o � ���.�ii �� �.
�s�o c o����;_��,=- -���� �,�
�
0
� �p � ��r=--;� !; '� �O
��
(� �� ��,���,_t �
\� ��1�-�� '.: �--� _ -;-,�
� ---. ,., �
-- -- „�
��»����%�'' i
J'��� �\
, \ ��,�\��
� � �,1 �,
� ` � �
'ACCS; EL, ME
•_ i � � �
.. . i
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Cali(omla statules'and related
regulations. (Ord. No. 9248, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If ork is s� or abandoned
for a period of 180 days.
INSPECTIONS: In ordar for the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlred inapaetlona end final epprovel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5628
zaaaas (erool
AND
WORKERS'COMPENSATON DECLARATION: � "
I �ereDy aHirtn under penelry of perJury one of the following deGaretions:
❑� I have end will malntain e certificate oi consent ta self-Insure for workers' compensation, es provldetl for by sectlon 3700 of Ihe Lebor Code, for the peAormenca of the
work for whlch lhis pertnit is �syued.
ensation insurance, es required by sectlon 3700 of Ne Lebw Cade, for Ne peAortnence of Ihe work for whkh ihL� pertnit is issued.
cartier antl policy number ere:
�"�
-�S� �. L Pa�ryNumoec iOb(�LZ I -2�L
�emtit is velued et one hundred dollers ($100J a Iess.J
❑ I certity Ihet In Iha peAortnan� of the work for which this pertnit is issueC, I s�all not employ eny persan in any manner so es to become sublect �o Ihe workers'
compensatlon lews of Celifomia, end egree that If 1 should become sub�ect to lhe workera' compensetion pmvislons af Section 3700 of Ihe Lebor Code, I ahell forthwith
comply wit Ihese Dr c� ���
�rtwn`�qnature: � �_ Daie;-`, �'- � Z-- Di
WAFiNINO: FNLURE TO SECURE WOij�q$' pyA COVERAGE IS UMAWiUL Ml� SNALlSU&IECf AN EMPLOYER TO CRIWNAL PENALTES AND CML FlNES UP TO ONE HUNDRED
T/10USAND OOIiME (5100,000). IN AOpRIpN TO THE CQST OF COMPENSATION, DNA44GE5 0.5 PiiOVIDED FOR IN SECf10N 37080F THE IABOR COOE, INTEREST, PND ATTORNE`fS FEES.
LICENSED CONTHACTORS DECLARATON:
n Iicensetl u er provisions af Chepter 9(wmmencing with Sectian 7000) of DlNsion 3 of the Buslness a Prolessions CoOe, end my Iicense is in full
�f�1-ts4 cr�,«--_ �-� L-�3
�r1-�- ��--'�Ci—«6
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that there is a consiruction lending agency for ihe pedormance at the wark far which this pertnit Is issuatl. (Sec. 3097, Civil Cotle).
LentleYs Neme: Lendets AOdreu:
Signeture: Dete:
OWNER-BUILDER DECLApATQNS:
I hereby eflirm Ihet under penelry Of perjury thet I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe lollowing reason (Sec. 7031.5, Business end Professlons
Cotle: Any ciry or counry which requires e permit to construd, alter, improve, demolish, or repair eny structure, pdor ta Its Issuenca, elso requires Ihe epDlicant for auch permit
to file e signetl stetement thet he or ehe is Ilcensed purauent to the provlslons of t�e Contrectora License Lew (Chepter 9(wmmencing with Sectlon 7000) oi DlNslon 3 0l the
Business end Professions Cade) br Ihet he or she is e:empt Iherefrom and ihe basis for the alleped exemption. Any vloletlon of Seclion 7031.5 by eny eppllcant for a perm%
sub�ecis the epplicant lo a civil pe�aly oi nat more than live huntlretl Aollare ($500).):
� I, es owner ot the properry, or my employees with weges es their sole compensa6on, WILL DO THE WORK, enA ihe structure Is not intended or oifered for aele (Sec.
7044. Business and Professions Cotle: TTe Contractors License Law tloes not apply to en owner ol properry who bulltls or Improves Ihereon, end who does Such work
hlmself or herself or ihrough his or her own employees, provided ihat such ImDrovemenis ere nol Intended or oflered for sale. If, however, ihe bulldinp o� Improvement Is
eold within one yeer oi completlon, the owner-builder wlll have ihe burtlen oi proving that he or she did not bulltl or Improve tor purpose o1 sele.). •
❑ I, es owner at ihe property, 4m E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 70CA, Buslnesa end Profesalona
Code: The contrectors Llcense Lew tloes nat epply to en owner af propeny wha builds or Improves thereon, entl who contrects for such pro�ect wlth e contrector(s)
Ilcense pureuenl to Ihe Contractars License Lews.).
❑ I em exempt under sec. Business end Pratessions Code for I�Ls reason:
Slgnalwe: Da1e:
Owner ID vertlletl hy tlrlver's Ilcenge. ❑ Ves ❑ No DrlveYs License Na. Expires:
Verlticetlon oi Ownerehlp by (rype of tlocument, i.e. - properry tac blll or tleed):
DIVISION OF INDUSTRIAL SAFFTY PERMR CERTIFICATON:
❑ I �ereby cenity Ihet no ezwvation flve (5) or more teet in depth into which e person is requiretl to tlescend, wlll be mede In connection wlt� work eut�odzetl by Nis
pertnit, antl Ihat no building structure, scaflolding, telsework, or tlemolltlon or dismantling thereof, will ba more than t�lrty-sIx (36) feet hiph. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Celifarnls Adminisiretive Cotle).
❑ Aa owner-Dullder, I wlll not employ anyone lo do work which woultl requlre a permit irom the Division ot Industriel Sefery, es notetl eDove, unless such persan hes e
pertnit to do such work from ihe divlsion.
Sipneture: Date:
Dldsion oi Indusidal Safery Pertnil Number.
ICERTIFICATE OF COMPLIANCE pND AUTHORIZATION OF ENTRY: I certify under penalty oi per�ury ihat I have read this epplicatlon end stete Iha� �he Intortnation glven Is I
correct. I agree to comply wlih all stete lews entl ciry ordlnances relating to bullding consiructlon, end euthorize representatives of ihe Clry of Costa Mese ta enter upon �ha
ebove-tlescribed propeny lar insppctlon purposes. I agree not to acupy or allow accupenq of eny building autharizetl by this pertnit until tinel Inspection.
COUE �. INSVECTIONTYPE
1816 Fi:ed System Flnal Fire Preventlan
1268
200
201
Pod Spe Final
Finel fiaRool
Final BIocWRetelning Wgll
202 Finel Fectory Fire Placa
203 Finel S10n
200 �FinalDemWtlon
�
COpE1 INSPECTIONTYVE Qe¢, �$
206 Final Mechanical
208
210
212
220
Final Plumbing
Final Electrical
Final Pire Preventlon
Final Plenninp Approvel
222 Finel Site
250 Final Building/Occupenry
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��sCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite No 2
Vicinity: 2ND FLOOR NETIFICE
Parcel Nunmber: 41050110
Applicant: HACKENY, DAVE
Address:
Owner: RREEF -
Address PO BOX 4900
DEPT 207 ,
, SCOTTSDALE, AZ.,
Contractor. HACKNEY ELECTRIC INC
Address: � 23286 ARROYO VISTA
RANCHO SANTA MARGARITA, CA
Phone: 949-264-4000
Zip
Phone:
Zip: 85261-4900
Phone: 949-264-4000
Zip 92688
License: 686227
Status: ISSUED
Applied: 09/22/2006
Issued: 10/23/2006
ISSUED BY: ��
SCOPE OF PERMIT
5,921SF INTER�OR T.1. FOR "NETIFICE" ON THE 2ND FLOOR ONLY. WORK TO INCLUDE: NEW
, � NON-LOAD BEARING PARTITION WALLS, ELEC, MECH AND PLUMBING WORK.
` - � REF: BO6-01112 � ' �
21 LIGHT FIXTU,RES,-38 OUTLETS, 11 SWITCHES
ISSUE FEE
'Temp service test
� Res. a/c package'
New Res (1-2 unils)
New Res (3+units)
Pool / SPa
Lighting Fixis �
Recept Outlets -
Switches � ,
Non Res Appl
Res Appl
Service to 200a\
Service to 1000a ��
Service over 1000a
Motors to 1 hp ' , '
Motors to 10hp
Motors to SOhp � , ' '
Motors to t00hp ' � `
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
` Quantiry
$23.50
$0.00
$0.00
$0.00 0
$0.00 0
ao.00 0
522.73 ' 21
$35.14 38
$12.10 11
so.00 0
�so.00 a
$D.00�y--.. �p•: '.
$0.00A' , - 0�` -
$0.00 ' , "�10 i--
50.00, ��'-0A, �
$0.00 �� ��0�-= ��
ao.00 ; " o ' �
$0.00� �` �0�,�,
�50.00� � ' � 0
$0.00 . 0
`$0.00 � � 0" �
$0.00 0
$0.00 0-
$0.00 0 '
$0.00 0 �
FEE SUMMARY
, - � - Temp Dist System / Lighting
- - -� Busway/100ft�
Standing�Section�
Misc Eledrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
_
, • � .................up to 100 kva/kw
; � ...........:...:..over 100 kva/kw
. - Low Voltage Equipmenl
Low Volt Wiring System / Ckt
Misc. Conduit . -
, Misa Conductor �
' \ ' Circus ( gen or ride) -
. Circus (mech ride or lights) �
� Christmas Tree Stand " - �
� �' � � Fireworks Stand "
- - Other Electriwl Fee ,
'InvestigationFee� _
Plan Check Fee -
` Reinspection Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 " 0
$0.00 0
' $0.00 0
� $0.00 j 0
$0.00 _ '.' 0
$0.00 0 "
$0.00 0
$0.00 ,
$0.00 ,
$0.00
$0.00
. - -- TOTAL CALCULATED FEES E93.47
r�uueurniener�w� n�unir�nuo
NOTICE: The work authorizetl 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 wlthin 180 days, or il work is suspended or abandoned
for a period of 180 days. �
.
INSPECTIONS: in order (or the work authorized under this permlt to be considered legal, such work must comply with all applicable cotles, and all
requlred Inepeetlone and final epproval must be obtalned. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2448d81�)
WORKERS'COMPENSAnON DECLAflAnON: ._ � ,
I hereby eflirtn under penalry ot perjury one oi Ihe tdlowing tleclareUons: . .� ' � . ,
❑ I va antl will maintain a ceniNwta ot consent ro sell-Insure lor workars'. compensetlon, es O�oNded tor by section 3700 oi Iha Lebor CoCe, fa Ihe peAarmence of tha
ork for which this pertnit is issuetl.
I have end wlll melntain w ers' canpensetion insurance. es requireC by sectbn 3700 ot Ne Labor Code, for the peAortnance af Ne work for wh�h W5 pertnit is issuetl.
My workers' co nsatio I suran car er andydiey number era: O ��/
Carriar: ��L... C� �v✓..? „ Polity Number. � � � �
(This section neetl complefed / e pertNf L9 velued et one hundre0 tlW/ars ($100) w less.)
❑ I certify that in the pertortnance at Ihe work tor which Nis permit is IssueO, I shall not employ any person In eny manner so as to become sub�ect to Ihe workers'
compensatlon laws of �' omia, and a r e t�at il I s�ould becoma sub�ect to Ihe workers' compensellon proWsions of SQQctlon 37 0 0l the LeDor Code, I shall torthwith
comply with these pm r � � � ��� � � �
ApP�LSlpnBturBs_ � Dela:
WARNINp: FAILUFE TO SECUFE WORKERS' COMPENSATIO CO ERAOE IS UNLAWFUL MlD SW1LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES M'D IVIL FlNES UP TOONE HUNDRED
TIIOUSPNDOOLLARE(5100.OW),INMDITIONTOTMECOSTO MPENSATION,DMMGESASPROVIDEDFORINSECTION3'lOBOFTHELABOfiCADE,IMEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm that 1 em licensed under pmNsions ol
lorce entl eHecL Llc. a � �. .!
CONSTRUCTION LENDING AGENCY:
7000) ot DlNsion 3 of Iho Bi
C�099 N
Dete:
Catle, antl my license is In full
❑ 1 hore0y eNirtn thet there is a construction lending apenty lor the pedortnance oi t�e work tor which tNs permit is Issuetl. (Sec. 3097, Civil Code).
Lendefs Name: Lenders Address:
Sipnatura: Date: _
OWNER•BUILDER DECLARATIONS:
I hereby eilirtn Ihet under penalry ol perjury that I em E%EMPT FROM THE CONTFAC70RS LICENSE LAW lor tha following reasan (Sec. 7031.5. Business entl Prolessions
Code: Any city or county which requires e pertnit to wnstruc6 elter, improve, demolish, or repair eny structure, prlor to Its issuance, elso requires the apDlicant lor suth pertnit
to lile e slgnetl slatement t�et he or she is Ilcensed pursuant to t�e provisions of �he Contrectors Ucense Lew (Chapter 9(commendng with SecUon 7000) of Dlvision 3 ot the
Business end Prolessions Cade) or Ihat he or she Is exempt thereiram end tha �esis for the elleBed e:emptlon. Any violetlon ol Sectlon 7031.5 by eny applicant for e permit
sub�ects tha applicant to e dvil penalry of not more than five hunCreA dollars (5500).):
❑ I, es owner ot the D��hY. w my emplqrees wit� wapes es their sWe compensatlon, WILL DO THE WORK, end Ihe sWdure is not Intentled or oflered tor sale (Sec.
7044, Business entl Professions Code: Tha Contractors License Lew daes not apply to en owner of property who Dui105 or Improves theraon, and who tloes such work
himsetl or herselt or t�rough his or har own employaes, pmvitletl that such improvaments ere not IntenAetl or ofleretl for sale. II, however, t�e building or improvemem is
soltl within one year of complation, the owner-builder will heve Iha burden ot pmving that he or she did not builtl or improve tor puryose ot ule.).
❑ I, es owner ol the pmperty am E%CLUSIVELY CONTRAC7ING WITH UCENSED CONTRACTORS to conSlrutt lhe projec� (Sac. 7040, Business antl Profes5ion5
Cotle: The contrectors License Law does not appty to fln owner of pmpeny who bulltls or Improves Ihereon, antl who contracts lor such project wit� a contrectoqs)
license pursuant to the Contractors License Lews.).
❑ I am e:emp� untler sec. Business anA Professions Cade lor this reeson:
Signawre: Date:
Owner ID veniietl 6y tlrivers license. ❑ Ves ❑ No Drivefs License No.
Vedlicatlan ai OwnersNp by (type af documem, i.e. - propeny tax bill or tleed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cenity t�et na excevetion Ilve (5) or more tee� In dapih Into which a person is required lo descend, wlll be mede in connec�lon wlth work euthodzed by this
pertnit, end that no builtling siructure, scaHolding, falsework, or demolition or dismantling thereof, will be more than thirry-siz (36) taet hiph. (C�ap. 32, Gry 2, Art 2, Sec.
341, TIUa 8, CBlitomie Administrailve Co�e).
❑ As owner-bulltler, I will not employ anyone to tlo work wMch woultl require a pertni� trom ihe Divlslon al Indusirial Sefety, es nated ebove, unleu such person hes e
permit to tlo such work trwn the division.
Signeiure: Dete:
Divislon of Industdal Satery Parmit Number:
CEHTIFlCATE OF COMPLIANCE AND AUiHOR¢A710N OF ENTAY: I ceNry under penalry ot perjury that I �eve reatl Ihis application enO state t�at Ne infortnatlon given is
correct. I egree to wmply wlth ell state laws end dry ortlinences relatlng to builCinB wnstruction, antl euthodze representatives ot Iha Clry of Coste Mesa to enter upon Ne
ebove-described property lor inspection purposes. I agree not to oaupy or allow occupency of any building authorized by this permit until Ilnal inspecGon.
COOE I. INSPECTONTYPE � 1�-
1616 Fixed System Flnal Fire Preventlon
1288 Pool Spe Final
200 Final Re-Rool
201 FIneI BIocWRetalning Weli
202 Final Feciory Fire Place
203 Finel Sipn
204 Final DemdiGon . . ..
�
'� �::
I
�.:
COUE I INSPECTION TYPE
208 Finel Mechanical
200
210
212
220
222
250
Flnel Plumbing
Final Electricel
r
Finel Flre Prevention
Final Plenning Approval,
Finel Slte
Finel Builtling/Occupancy
Qe� u�eis
�
� %
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: SSS ANTON BL
Suite No 2
Vicinity:
Parcel Number: 41050110
Applicant: LOGAN, PETER
Address: 33161 PASEO BLANCO
Owner:
Address:
Contractor.
Address:
SAN JUAN CAPISTRANO, CA
RREEF
PO BOX 4900
�DEPT207 . � �
SCOTTSDALE, ,4Zi "
LOGAIV COMPANY
33161'PASEO BLANCO
SAN JUAN CAPISTRANO, CA
MECHANICAL PERMIT
Phone: 949-874-8169
Zip: 92675
Phone:
Zip: 85261-0900
Phone: 949-874-8169
Zip: 92675
�� License:401759
�-
\
Status: ISSUED
Applied: 10/23/2006
Issued: 70/23/2006
\
V �
ISSUED BY:
SCOPE OF PERMIT
5,921SF-INTERIOR T.I: FOR "NETIFICE", 2ND FLOOR ONLY. WORK TO INCCUDE: NEW
NON-LOAD BEARING PARTITION WALLS, EL, MECH AND PL WORK. REF.: BO6-01112
MECHANICAL TO INCLUDE: 1 ALT/REPAIR COOLING/HEAT AND 2 VAV BOXES. �
Quantity
ISSUE FEE � , $23.50
Inst FAU <100 k BTU - $0.00 0� . ,,
Inst FAU >100 k BTU . $0.00 0 _
Repair / Alt Cooling/Heat ,; $13.70 � . 7 , � _
Inst / Rep: Recess Wall Hir $0.00 0
Refrig Sys <100 k BTU 50.00 0
Refrig Sys >100 k BTU $0.00 0
Gas Piping � , � $0.00 0
Factory Fireplace . � � � ? �' $0.00 0
Hood wlMech Exhaust� $0.00 0
VAV Box �� � ' . , $21.30 2
Vent Fan / Single Duct �. $0.00 0
Appliance � � ��50.00,. _0 . -
Fire Dampers .', �., � �"$0.00 � 0"��i ' � �
Smoke Dampers ` i '� $0.�00._, 0 - '
Inst or Relocate Appl Vent �,=� $0.00=:��0 ���
AirHandlers< 10000cfm � � $0.00�' 0���`�� �
AirHandlers> 10000cfm, � � , $0.00 ,. 0� , _ �
Ploor Fumace � � � ,$0.00 , 0�..
Flooror�SuspendHeater �` :'-- � $0.00'�'�0 ��� -
_ FEE SUMMARY
� ._
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System,
Evaporative Cooler
C o m m e rc i a l I n c i n e rat o r
Domestic Incinerator
Comoressors / Absomtion Svslems
Up fo.3 hp�/ 100 k BTU
3To15hp/500kBTU
]5 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k 8TU
Over 50 hp / Over 1,750 BTU -
Boilers
Up to 3 hp ' " �
3 To 75 hp
151a 30 hp , ,
30 to 50 hp � - - , �
Over 50 hp, . , �
Other Mechanical Fee �
Investigalion Fee � �,
Plan Check Fee .
Reinspection Fee � . ,
• TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
�uantity
$0.00 0
$0.00 0
30.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$58.50
NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period of 180 days. - . ,f- ��./'
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all
requlred inapeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe e�
FOR INSPECTIONS CALL: (714) 7545828
zaasae �sroo�
WORKERS'COMPENSATION DECLARAnON: � ,
I hereby aHirtn under penalry ot perjury one of the following declerations: �. - � • � ,
❑ I have and will maintain e certilicete ot wnsent to seN-Insure for workers' compensation, es provided for by section 3700 ot the Lebor Cotle, tor the pertortnance of iha
�, -w,ork for which this permit is issued. '
��have entl will maintain workers' compensatlon Insurance, es required by section 3700 of the Lebor Cotle, for the pertortnence oi Ne work for which this pertnit is issuetl.
My workers' compensation Insurencgparrier and policy number are:
one
PoticyiNumbar:.� "e'O�oi 1
oNess.) �`
❑ I certify thet in the peRortnance of the work for w�ich Ihis permit is issueQ I shall not employ any person in any menner so as to become suDject to the workers'
compensatlon laws oi Gelifornia, and egree Ihat it I should become subjec[ to the workers' compensation provisions ol Section 3700 oi Ihe Lebor Code, I shall forthwith
comply with ihese prarie� �
AppHca� _ nt�Slgnatuie:-"- -� Date:�T
�,.r,::
,, .,.:..
WpBNW6. FAILURE TO'SEGYJRE WORKERS" ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL�YERtTO,CPIMINAL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED
THOUSAND OOLLARE ($100,000�, IN ADOITION TO THE COST OF CAMPENSATIIXJ, OAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CAOE, INTEREST, ANO ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I here6y affirm that�l 2m�licensed under provision�sp f Chaptg� 9 oQmencing with Section 7000) of Division 3 0l ihe Business ar}�Profassions Code, end my license is in full
tor�e end eHect. L. "jc.iq'�''s::. �: .. -�'fi::"� `-t� \ ( 1 G�ess�a�^+++.��- �5-1 C ✓3� -
ContrectarsSipnature:-.--.-..-\�� � Da�e: "l}o�^Z3—Q
�p��«�t�A'Z{iK�. � :�_r
CONSTRUCTION LENDING AGENCV: '
❑ I hereby aHirm that there is a consiruction lending egency for the performance of the work for which this permit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Siqnature: _
OWNER-BUILDER DECLARATIONS:
Lentler's Adtlress:
Dete:
I hereby atfirtn Ihe� under penelty of perjury Ihe� I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requires a permit lo constma, alter, improve, tlemolish, or repair any structure, prior to its issuance, elso requires the applicant for such permit
to file a signed statement lhat he or she is licensed pursuent to Ihe provisions of the Contractors LicenSe Lew (Chepler 9(commencing wilh Section 7000) of Division 3 of [he
Business entl Professions Cotle) or thet he or sha is exempt Iherefrom and the basis for the alleged exemption. Any violetion oi Section 7031.5 by any appliwnt for a permit
subjects the applicanl lo e civil penalry of not more ihan five hundred dollars ($500).):
❑ I, as owner of the property, or my employaes with wages as their sole compensation, WILL DO TTIE WORK, and the structure is not intentletl or oHeretl for sale (Sec.
7044, Business end Professions Code: The Conirac[ws License law dces not apDly �o an owner of properry who builds or improves Ihereon, and who does such work
himseN or herself or ihrough his or her own employees, provided ihat such improvements are not intended or otteretl for sale. If, however, the building or impmvement is
sold within one year of completion, the owner-builtler will hava the burden of proving ihat he or she ditl not builtl or improve for purpose ot sale.). �
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construtt the prolec� (Sec. 7044, Business antl Protessions
Code: The conirecrors License Law tloes not epply to an owner of property who builds or Improves Ihereon, end who contracts for such project with a cornrector(s)
license pursuam to ihe Contractors License Laws.).
❑ I am exempt under sec.
Signa�ure:
Owner ID verified by tlriver's license. ❑ Yes ❑ No
Business and Protessions Code for this reason:
Venfication of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N:
Drivers License No.
Date:
Expires:
❑ I hereby certity ihat no ezcavalion Five (5) a more feet in depth into which a person is requiretl ro tlescentl, will he matle in connection wlth work authodzed by Ihis
permi�, and iha� no builtling structure, scaHolding, falsewolk, or demolition or dismantling ihereof, will be more ihan ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title e, Celifornia Atlministretive Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from iha Division of Intlusirial Safery, es notetl above, unless such parson has e
permit to do such work from the division.
Signature: Date:
Division of Industrial Sefery Permit Number:
CERTIFlCA7E OF COMPLIANCE AND AU7HORIZATON OF EN7RY: I certity under penalry of perjury that I �ave read this epplication and state that the information given is
correct. I egree to comply with ell stata laws and city ortlinances rela�ing ro building construction, end authodze representatives of the Ciry ot Costa Mesa to enter upon the
above-tlescnbed properry lor inspection purposes. I agree not to occupy or allow occupancy of any building euthorizetl by this pertnit until finel inspection.
1616 Fixed System Final Fire Prevention
1266 Paol Spa Final
200 Finel Re-Root
201 Final BIacWRelaining Wall
202
203
204
Final Factory fira Place
Finel Sign
Final Domolition
�'��
�
COUEI INSPELTONTYVE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220, Final Planning Approval
222 Final Site
250 Final Buil
�_1 IIL"
• � � r \
O
(714) 754-5273 • Fax (714) 754d856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 2
Viciniry: 2ND FLOOR
Status: ISSUED
Applied: 10/27/2006
Issued: 11/06/2006
Parce� Nunmber: 41050110 Zoning: ��7/�
ISSUED BY: �/ �
Applirant: ANTONIO DOWNS
Address: 2505 MIRA MAR AV - , � . � , -
Owner:
Address
Contrector:
Address:
Plan Check:
Permit:
Other.
Total:
� � � �' Fhone:- 582-498;6444 x2207 � � ' -
LONG BEACH, CA ' `;,,� "Zip: ' �i, 90815 � i �
RREEF i,. � � � �. . � i� �� �
POBOX4900 , '. � • _. ___ .__ _ '_/�_ � � �, � _�,�_ ��
DEPT207 ` ' � ' � P-hone �_ . - - � � •� �` ��
�
6COTTSDALE,AZ �. - "Zip: 85261-4900�� ��'c� ���_ . ' i ����'�
.-"' . ���' �
� � �."� , .., : � �
ACKERMAN,.MAGGEY ��;\ ��\ �,� �/ ,' \�,�
_ �„ A �.A`��/ i� � � �
� Phone: '��';� ; ��.� V' � �,
Zip: ,
f` � �
. ' . License:' 327196 �� ; "� , , � �
SCOPE OF PERMIT �
INSTALL FIRE ALARM SYSTEM FOR "NETIFICE" 2ND FCOOR. REF.: B06-01112 ��'
. i , .. . . ' ' � _ ' ' . .
FEE SUMMARY � � �
$172.41 � �Calc Valuation: '
$26525 " � �� Claimed Valuation
50.00
. „ � - -;• r�- t--,;-�.-;z -..�.-r'�('% A�
. _ � � �' ,.� �
� . �.%i_ . . .�1 „1�. � �
$437.66
c^�y 1 �
, .,E �
. . � -- _ - �-- ` � ���.��'cti-' ,
-..' .. ,
__ , , .�,.,
,
� .. ,. �,� ,��,,,, � _� � _ � _ �,��%1 / %
�
� -., - �,..,,
, „
_ ... � .,.
� ; - ;�;i� %:: "
$15,703.00
$15,103.00
x/
; - �j�
__ � �:�� � � � _
,J'.� ,. ' i./ .
,/ �
� - - . h �: � � �r..i q � j� � . .
.� '_ - � '. - '����/�� �
� �
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: This permit shall au[omatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
tor a period of 780 days.
INSPECTIONS: In order for t�e work authorized under this permit to be considered legal, such xrork musl comply with all epplicable codes, and all
roquired Inspeetlons and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration ot this perm8.
FOR INSPECTIONS CALL: (714) 7545628
YL•.r,+�:i(9�Y01
�
WORKERS'COMPENSAnONDECLARAnON: � � '
I hereby aHirtn under penelry of Oerjury one of ihe tollowing declaretions: �
❑ I heve entl will meinlain e certificate ol consent to self-Insure for workers' compensalion, as pmvided Por by section 3700 oi the Labor Coda, fordhe pertortnance of the
work for which this pertnit is issuetl. �
� 1 have antl will maintain workers' compensation insurance, as requiretl by sec[ion 3700 of the Labor CoOe, for ihe peAortnance oi the work for wNch this permit is issued.
My workers' compensailanpInsurance caMer and poliCy number are: /' �/ p�
Carrier. /.0 0 �n a / Policy Num6er: �`OU ��
(This secfion need not be complefe i/ the permif is velued et one hundred dallais ($1 J or Iess.J �' .
❑ I cenity that in the peAormance oi the wark for which ihis permit is issued, I shall not employ any person in eny manner so as to becoma subject to the workers'
compensetlon laws of CalHornie, and agrea Ihet ii I should become su6ject ro the workers' compensatlon provisions of Sectlon 3700 of the Lebor Code, I shall forthwith
comply with these provisions. /� /� � � �/ -�/
Applicant Signature: C� /L61��— Date: �� `� V �
WARNING: FAILURE TO SECURE WOFKERS' COtAPENSATION COVERAGE IS UNLAWFUL AN SHALL SUflIECT AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO dJE HUNORED
TFIOUSAND DOLLARE �E100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 3]W OF THE UBOR CADE, IMEFEST, AND AiTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eNirm that I am Ilcensed untler provisions ot Chapter 9(commencing with Section 00) of Division 3 of the Business antl Protesslons Cotle, and my license is in tull
force and ettect. Lic. # 2� 4 Class M G—!u /[ -(4
Conirectofs Slgneture: a� �` Date: _�/Cr � (o
CONSTRUC710N LENDING AGENCV:
❑ I hereby aflirm that ihere is a construction IenOing agency tor the peAortnance of ihe work tor which this permil is issued. (Sec. 3097, Civil Cotle).
Lendefs Name: Lentlefs Atltlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aNirm that under penelry of perjury thet I em EXEMPT FROM THE CONTAACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business antl ProFessions
Coae: Any ciry or counry which requires a pertnit to consiruct, alter, improve, demolish, or repair any struqure, pdor to i�s issuance, elso requires the epplicant tor such pertnit
to file e signed stetament thet he or she is Ilcensed pursuent to the provislons of the Contractore License Law (Chepter 9(wmmencing with Section 7000) of Division 3 of Me
Business and Professions Code) or t�at he or she is exempt therefrom and the basis for the alle9ed exemption. Any violatlon of Section 7031.5 by any epplicant for a pertnit
subjects the epplicant to a clvll penalry oi nat more than five hundred dollars ($500).):
❑ I, as owner oi �he property, or my employees with wages as their sole compensation, WILL DO THE WORK, end the structure is not intentletl or otteretl for sale (Sec.
7044, Business and Prolessions Cotle: The Contractors License Law does not apply to an owner ol properry who builds or improves ihereon, and w�o tloes such work
�imself or herseN or through his or her own employees, provided ihat such improvements are not intentletl or oflaretl for sale. If, however, the building or improvement is
sold within one year of completion, the ownerbuilder will have Ihe burden of Oroving ihat he or she ditl not huiltl or improve for purpose of seleJ.
❑ I, as owner ol the prOperry, em EXGLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Bu5ine5s end Professions
Code: The contractors License Lew does not epply to an owner ol property who builds or Improves thereon, and who contrects for such project with a contractoqs)
license pursuant ta the Coniractors License Laws.).
❑ I am exempt under sec. Business and Professions Cotla tor this reason:
Signature: Date:
Owner ID veniied by driver's Ilcense. ❑ Yes ❑ No Dnver's Licensa No. Expires:
Verification of Ownership by (rype of tlocument, i.e. - propeny tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity thet no excavetlon tive (5) or more feet in depth into which a person Is required to descentl, wlll be metle In connection with work authorized by this
permit, end that no builtling structure, scattolding, felsework, or demolition or tlismantling thereoi, will 6e more ihen thirty-six (3fi) teat high. (C�ap. 3.2, Gry 2, Art 2, Sec.
341, Title B, Caltlomla Atlminisiretive Code).
�� i
❑ As owner-builtler, I will nol employ anyone to do work which would require a permit irom ihe Division of Indus�rial Setery, as noted atiova, unless such pereon has a
permit to do such work trom the divisian.
SignaNre: De1e:
Division af Industriel Setery Permit Number:
CERTIFICATE OF COMPLUWCE AND AUTHORIZA710N OF ENTRV: I certiy under penalry of perjury thet I heve read ihis epplication and state ihat the infortnation given is
correct. I egree to comply with ell s�ate laws end ciry ordinances relating to building construIXion, end euthonze representatives of t�e Clry oi Cos�a Mesa to enter upon ihe
ebove-described properry for inspection puryoses. I a9ree not to occupy or allow occupancy ot any building euthorizetl by this permil until finel inspection. �
COOE I, INSVELTIONTYPE � " o�re
1616 Fixed System Final Fire Preventlon
7266
200
207
202
Pool Spa Finel -
final Re-Rool
Final Block/ReWining Well �
Final Factory Fire Plece
203 Finel Sign
204 Finel Demolition
i TN RIALS
CODE�' INSVECTIONTYPE '
206 Finel Mechaniwl
20B Final Plumbinq.
210 Final Elecincal
212 Final Fire Preventian
220 Final Planning Approvel
222 Final Site �
250 Final Building/Occupency
(714) 754-5273 • Fex (714) 754-4856 • www.ci.cwta-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 2
Viciniry:
Parcel Nunmber: 41050110
App�iwnt: ANTONIO DOWNS
Address: 2505 MIRA MAR AV
LONG BEACH, CA
Owner: RREEF
Address PO BOX 4900
DEPT 207
SCOTTSDALE,AZ -
Coniractor: ACKERMAN, MAGGEY
Address: � , - � �
Zoning:
� � � Phone: 562-498-6444 X2205
Zip: - 90815 _
Status: ISSUED
Applied: 10252006
Issued: 11I062006
ISSUED BY: ��
Phone: - � � � - � � - `
2ip: 85281-4900 . - . ,' ��
� ,
. , �: . �. �.
� Phone: � � � � . �
, � . Zip: . , _
License: 327196 - � , ' �
SCOPE OF PERMIT
INSTALL 1 OVERHEAD SPRINKLER AND PRE-ACTION SYSTEM FOR "NETIFICE". REF.: B06-01112.
2ND FLOOR. ' - • ' � .
, - " � ` � .' . � �
FEE SUMMARY .
Plan Check: $236.11 Calc Valuation: 523,000.00
Permit: 5363.25 Claimed Valuation: s2s,000.00.
Other. $0.00 � '
Total: $599.36
i
, .
0
� � �, �
� '� �
. , :; �
NOTICE: The work authorized by this permit shall compy with all applicabte handicap access requirements under Calitomia statutes and related
regula�ions. (Ord. No. 92-28, § 1, 12•21•92)
EXPIRATION: T1ds permit shall automaticalty expire and become void if work is not commenced within 1B0 days, or if work is suspentled or abandoned
lor e period of 180 days. �
INSPECTIONS: In order tor the work eulhorizetl under Ihis pertnit to be considered legal, such work must comply with all epplicable codes, and all
requlred Inapeetlona and flnel epprovel must be oblained. Fallure to obtain Inspectlons end flnal approval will result in the expira�ion of this permlt.
FOR INSPECTIONS CALL: (714) 7545828
�
WORKERS'COMPENSAnON DECLARAnON:
I hereby etlirm untler penalry of perjury one of Ne IWlowing tledarations: �
❑ I heve entl wlll melmein e ceNflcate ot consent to sell-Insure tor workers' compensetlon, es provitletl for by sectlon 3700 ai ihe LeDor Catle, tor the paAortnence oi Ihe
�ark lor which t�is pertnit is issuetl.
have end wiA maintain workers' compensatlon inwrance, es repuired by section 3700 W Ne labor Cotla, for Ne performance of Ihe work fw which Utis permit Ls iswetl.
My workers' compensellon Insurance cartier entl poll�y num6er ere:
Cartier. �4i7 � h d Poliry Number: 3`�f'io ' 2,r
(7hls sectlar need not be oompleted I7 the permit (s va/ued er one hundred dd/ars (S7 ) w IessJ
❑ I certity t�at In t�e pertarmanca of the work for whlch Ihis perml� is ltsuetl, I shall rwt employ eny person In eny manner so es to become subl� �o the workers'
compensetlan laws ai Celifomia, antl agree thet II I shoultl become sub�ect lo t�e warkere' compensetlon provisions ol Sectlon 3700 ot t�e LeDor Cotle, I sheil fonhwit�
cpmpty with Ihese provi5ions. n-_�- - -
Applicent Slgneture: �.�- �"�N� Date: ����
WARNM�:FAIWRETOSECUREWORKERS'COMPENSATIONWVEMGEISUNLAWFULANDSFW.LSUBIECTANEMPLOYEPTOCRIMINALPENALTESANDGVILFlNESUPTOONE RED
hKK1SAND DOLURE (5100,OW). IN �DDRION TO TME WST OF C0IAPENSATION, OAMAOES AS PROVIDED FOR IN SECfION 3�OB OF THE LABOR CODE, IMEREST, ANO ATfOHNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I horeby atfirtn Ihat I em Ilcensetl untler provislons at Chepter 9(cammenGng wllh Sectlon ) ol Dlvislon 3 oi �he Business antl
torca antl enect. uc. a 3'�'! t 4 4 /' Class x �'�
ConVaclor's Signeture: / Date:
_�
and my license Is in full
CONSTRUCTION LENOING AGENCV:
❑ I hereby eHifm that there is a construclion lentlinp eponCy br tha peAormante ol tha work br w�ich this permlt is ISSUBtl. (Sec. 3097, Civil COAe).
Lendefs Neme: Lendefs Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn t�et under penalty o1 perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor Iha tollowing reasan (Sec. 7031.5, Business antl Professions
Code: Any dry or counry which requires e pertnit to construct, alter, Improve, demolish, or repair eny structure, prlor lo Its issuance, elso requires the applicent for suc� pertnit
to 111e e signetl statement that he or s�e is licensetl pursuant b tha pmWsions ot ��e Contrectore License Lew (Chepter B(commandng wit� Seclion 7000) of Division 3 ot the
Business end Professlons Catle) or thet he or she Is exempt therefrom end Ihe basls for the alleged ezemption. Any vlolation oi Sedion 7031.5 by eny epplicent fw e pertnit
sub�ects the epplicant to e civil penelry of not more t�an five hundretl tlollera (5500).):
❑ I, es owner ol t�e property, ar my employees with weges as iheir sole compensation, WILL DO 7HE WORK, antl ihe structure is not Intentled or oXered ior sale (Sec.
7044, Busineu and Pmtessions Code: The Contractors License Lew Cces not epply to an owner of propetly who builtls or improves thereon, and who Coes such work
himsell or herself or through his or her own amployees, providetl thet such improvements are nol intended or ottered lar sele. II, however, the builtling or improvement is
sold wilhin one year of completion, the owner-builder wiil have the burden of proving that he or she did not bulld or improve for purpose ot sale.).
❑ I, e5 owner ot t�e pmperty, am EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construtt the Dro�od (Sec. 7044, Business end Professions
Cotle: The conirectors Llcense Law tloes nat apply to en owner of property who bullds or Improves thereon, end who conVects for such pmject with a conirecror(s)
license pursuant to the Contradors Llcense Laws.).
❑ I am exempt under sec. Business entl Professions Cotle tor t�ls reeson:
Signeture: Date:
Owner ID veritiad by driver's Ilcense. ❑ Yes ❑ No Drivefs License No.
Vedflcatlon ol OwnershiD Dy (type of tlocument, i.e. - properry tea blll or deed�:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION:
❑ I hereby certity Ihet no ezwvatlon live (5) or more teat in depth Into which e person Is required to descentl, wlll be mede In connection with work euthorized by t�is
permit, and �het no builtling structure, scefloldinp, falsework, or tlemolition or tlismentling thereoi, wlll 6e more then Ihirty-siz (36) lee� high. (C�ap. 32, Gry 2, Art 2, SeC.
341, Tltle B, Celltomla Atlminisiretive Code).
❑ As owner-bulitler, 1 will not employ enyone to tlo work which would roquire e permit trom the Dlvision ol Intlustdel Sefery, es notetl ebove, unless such penon has e
permit to do such work trom Ihe division.
SignaWra: Deto:
DivLalon ol Industdel Safory Permit Number.
CERTIFlCA7E OF COMPIIANCE AND AUTFIORVJITON OF EMAV: I certily under penalry ot perjury thet I heve ree0 thb epplication ana state that Ne infortnation gNen Is
correct. I egree to compy wlth ell stete lews entl ciry ortlinences relatlng to builtling consWction, end aNhodze representatives of t�e Clry oi Casta Mesa to enter upon the
ebove-descrlbeC proDeRy for inspectlon purposes. I epree not to accupy or ellow occupancy ot any building euthonzetl by this permit until fnel inspection. .
I SignaWre 01 Lagal Owner(s)^ /
� `�' . �
And/Or Aui�orizetl AOPllcent
COOE �. ixsvecnaxnre .
1818 Fixod System Flnal Fire Preventlon
1288
200
201
202
203
20d
Paol Spe Final
Flnel Re-Root
Final BIocWRetaining Well
Finel Ffldory Fire Place
Finel Sign
Finel Domolitlon
Q� � Q�$ COpE1 INSPECTIONTYPE
206 Finel Mochenicel
�n 20B
210
212
220
Flnel PlumDinp
Final Electncal
Finel Fire Preventlon
Finel Plenning ApProvel
222 Final Slle
250 Finol BuIltlingiOccuOancy
G / C�
Date
ueiE li�ew
/a •7� • 0'i �''
t .. �_ .
(714) 754-5273 • Fex (714) 754•4856 • www.ci.coste-mesa.ce.us
JobAddress: 555 ANTON BL
Suite: 2
Vicinity: 2ND FLOOR NETIFICE .
Parcel Nunmber. � �, , �
.,
Applicant: HOAGLAND, BRIAN
Address:
Zoning:
Phone: 949�39-1979
77 FAIR DRIVE, COSTA MESA, CA 92626
Stalus: ISSUED
Applied: 11/222006
Issued: 12/04/2006
� �
' ISSUED BV:
Zip.
i" '' ' ,- � � - , - - _
Owner: RREEF � ' , � �
Address PO BOX 4900 . � - �
!DEPT2W `� � . . � ' Phone: - - . . � . -
-SCOTTSDALE, AZ - � - Zip: 85261-4900 , � . �
i
Contredor. `,��( �� " � , f-j��Mt �%1 L ' - � ' � �
Address:
, , ,�,�9/;s�y ��� p'�e q��_�39-/9��9
. ��/lit%( n2� � IrT�o a � . License: � ! / Z� �p �
%
� � S(
' S,921SF INTERIOR T.I. FOR "NETIFICE", 2NI
.BEARING PARTITION WALLS ref b06-01112
11 SP HEADS .
Plan Check: $27.17
' Permit: . �41.80
Other: $0.00
Total: $68.97
FEE SUMMARY
,.. _ . - -
�
'. �
, . > . .
��� , - � �
�
TO INCLUDE: NEW NON-LOAD
� Calc Valuation: s�,�oo.00
Glaimed Valuation: S�,ioo.00
,
, `} • , . . `;
, � '
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Californla 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 1 BO 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
requlred inepeeliona and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. ��
FOR INSPECTIONS CALL: (714) 7545626 j -'
zaas-as �r✓oo� �:� -
WORKERS'COMVENSAnON DECLARAnON: �
I hereby aHirm under penalty oi per�ury one oi the lallowing tleclaretions: �
❑ I heve end will maintain e certificate of consent to self-Insure tor warkers' compansetian, es pravidetl tor by section 3700 0l the Labor Code, for the pertormance of ihe
—�work ior which ihi5 permit is I5su8E.
��I have arW wlll meintain workers' compen5ation insurance, az requiretl 6y section 3700 of the Lebor Code, lor the pertortnance ot the work tor which Nis permit is issued.
My w rkers' com ense� Insurence carrler end policy numEer ere:
�"..' iv .
Certier.� V� �Policy:Number. �� ����
- is secnar need nof be com0�eted i/ fhe perm/f (s valued af one hundre dW�ero (S�oo) oi leu.)
I certity t�at In t�e perlortnance oi Ihe work lor which this pertn' s ued, I nat employ eny peroon in any manner so as to becane subjed to Ihe workera'
compense�lon laws ' t�at If I s�oultl E om uD�e o t workers' compensalion provisions of Secti� 70p ot �a Labor Cotla, 1 Shall forthwilh
mply with these provislOns. � /
Applice�t SignaNre: � Date: � � � �� /�
WARNING FAILURETOSECUPEWORKEF PEN RAOEISUNLA FULANDSHP115UBIECTANEMP�OVERTOCfiIM�NALPENALTIESANDGVILFlNESUPTOONEHUNDRED
THOUSANDDOLURE�5100,000),INAODRIONTOTMECOSTO/ MPENSATION,D GESASPROVIDEDFORINSECTION�OfiOFTHELABORCAOE,If�lrERE$T,ANDATTORNEI"SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licen�s p
lorce end ettecc Llcrp
CONSTRUC710N LENDING AGENCV:
9(commencing wlth Section 7000) of Dlvision 3 0� the
and my license Is in full
❑ I hereby aHirtn that Ihere Is a conslructlon lending egency for the peAormance oi the work for which this permit is issued. (Sec. 3097, Civll Code).
Lentler's Neme: Lender's Address:
Signature:
OWNER-BUILDER DECLARATONS:
Date:
� hereby efllrtn Ihet untler Oenelry ot per�ury thet I em El(EMPT FROM THE CON7RACTORS LICENSE LAW tor Ihe lollowing reason (Sec. 7031.5, Business end Prolessions
Cotle: Any ciy or counry which requires e permit to consiruct, elter, improva, demolish, or repair any siructure, prior to its issuance, elso requires lhe applicant for such permit
to file a signed stetement thet he or she is Ilcensetl pursuent lo Ihe proWsions oi Ihe Contrecrors License Lew (Chapter 9(commendng with Seclion 7000) of Dlvlslon 3 of the
Business end Profeuions Cade) or Ihe� he or s�e I5 exempt therefrom entl the besis for the elleged eaemption. Any violetion of Section 7031.5 by eny epplicent for e pertnit
subjecis �he epplicent lo a clvll penelry c� not more then tive hundred dollers ($500)J:
❑ I, es owner of the properry, or my employees wlih weges es Iheir sole compensetion, WILL DO THE WORK, and the structure is not inientled or ofFeretl for sale (Sac.
7044, Business end Professions Code: The Contradore License Law tloes not apD�Y �o'an owner of pro0erry who builds or improves thereon, and who does such work
himseN or hersell or through hIs or her own employees, proviAetl thet such improvements ere not intendetl or oHered for sele. II, however, Ihe building or Improvement is
sold within one year of completioq the owner�builder will have the burden of Droving ihat he or she did not build or improve tor purpose oi sale.). '
❑ I, es owner ol the property, em EXCLUSIVELV CONTRACTNG WI7H LICENSED CONTAACTORS to construct the pro�acl (Sac. 7044, Business and Professions
Catla: The contractors License law tloes not epply ta an owner ol property who bulltls or impmves t�ereon, antl who contrects lor such prqect wit� a contrectoqs)
liCenSe Dureuant to Iha Contractors UcenSe Lews.). '
❑ I em asempt under sec. Business anA Profeuions Code for this reason:
Signature: Date:
Owner ID verllied by tlrtver's Iicense. ❑ Ves ❑ No Drivefs License No. Expires:
Vedficatlon oi Ownerehip hy (rype o1 tlocument, i.e. - pmperry tex blll or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON:
❑ I hereby cartlty ihet no exwvatlon live (5) or more leet In depth into which e person is required lo descend, will be made in wnnectlon with work euthorized by this
permit, antl �hat no building strudure, scettolding, ialsework, or demolition or tllsmantling theraof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Calitomla Adminlsiretive Cotle).
❑ As owner-bulltler, I wlll not employ anyone to do work which would require e permit irom the Division of Indusirial Satety, as notad above, unleu such pereon �es a
permit to do such work irom Ihe division.
Sipnature: Date:
Division oi Intlustrial Sefety Pertnit Numher:
CER7IFlCATE OF COMPLIANCE AND AUfHORRATION OF EHTRY: I certily under penalry oi perjury ihat I have read thls applicetion end state ihet Ihe information given Is
canect. I egree to compty wlt� all stete lews and ciry nances releting to building consiruction, entl euthorize representalives ot che Clry at Costa Mese to enter upon the
ebove-descnbed properry tor inspection puryoses. rae not to occupy or ellow occupancy of eny building authonzed by this pertnit until final inspection.
CODE �, INSPECTIONTYPE !/
1816 Fixetl System Final Flre Prevention
1266 Pool Spa Finel .
200 Final Re-Rool
201 FInaI BIocWReteining Well
202 Final Fedory Fire Plece
203 Final Sign
204 Finel Demolitlon
PAiE II�LS
CODE� INSPEC710NTYPE
206 Final Mechanical
20B Final Plumbing ,
210 Finel Eletlrital
212 Final Fira Prevention
220 Final Planning Approval
222 Final Site
250 'Finel Building/Occupanty
��7tl�ui7.1�.,9
ia � �s • od Gicw
►
I
(714) 754-5273 • Fax (714) 754-4856
� CITY OF COSTA MESA I � V
BUILDING DIVISION �'i1�.1�'�
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 555 ANTON BL
Suite: 2
Vicinity: SECOND FLOOR
Parcel Number: 41050110
npp�icant: DON SMITH
Address:
Owner: SAKIOKA FARMS '
Address
� .
, ,. ,� - �
��,.'�, �. � _ .
Contrector: ACCENT BUILDERS
Address: 555 ANTON BL. #100
BUILDING PERMIT
Zoning:
. i
Phone:
Zip:
PERMIT NUMBER
B00-00020
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01I06/2000
Issued: 01 /21 /2000
ISSUED BY: �
i
Phone: *{
Zip: 94137 � � " �+� �
�\
OA'1'� 1
, ' Phone; � (714) 5493150 ,
COSTA MESA, CA
� 2ip: 92626 � License: 397790 _ '
Arch : IA � � , - Eng:
Address: � 3080 BRISTOL ST #105� - ' � , � Address: .
� " . Phone:�(714)754-1197 Phone:
� COSTA MESA,CA . ,
` Zip: 92626 � � � . License: License:
SCOPE OF PERMIT
� 3,410 SF,TI ON THE SECOND FLOOR FOR "EPOCH INTERNET'.:
Plan Check: $110.30
� Permit: $678.75
SMIP Res: $0.00
SMIP Com: $11.52
Other: $0.00
Inspection: $0.00
Total: . $800.57
SETBACKS
MAIN STRUCTURE front 0- 0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: - 0
FEE SUMMARY
-.- � ' Calc Valuation:
- Claim Valuation
PLANNING & ZONING
LeR 0- 0
Lett 0- 0
Proposed: 0
Right 0- 0
Right 0- 0
ssa,asz.so
$52,500.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is nol commenced within 780 days, or if work is suspended or abandoned
for a penod of 180 days.
INSPECTIONS: In ordar for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlone and final approval must be obtained. Failure to obtain inspactions and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I herehy eHirtn untler penalry of perjury one ot the following declarations:
❑ I heve and will maintain e certilicate of consent lo setl-Insure for workers' compansation, es provided for by sectlon 3700 of t�e Labor Cotla, br the peAormance ot Ihe
lCvork far which this pertnit is issuetl.
Garrier.
not
raquired by section 3700 oi tha Labor Catle, br Ne parformance of Ne work for w�ich Ihis permit is issuetl.
er are:
or less.)
Pollcy Number: /�G L �
❑ I certiry that in the pertor �nce ol t ork I r i� h ihis permit is issuatl, I shall not employ any person in eny manner so as to lecome subject to the workers'
compensetion laws af C ifornle. ree e' I �ould beCome subleci lo Ihe workers' compensation provisions of Section 00 o the Lebor Cotle, I shell forthwith
com e r si
icant Signemr � - a�e: !r� zi D�
r
NING: TO CURE WOflK6 MP SATION COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN E OVER TO CRIMINAL PENA�TIES AND CIVIL flNES UP TOONE HUNDiiED
TMOUSANDDOILARE(5100.0OO�.INADDITIpV ECOSTOFCOMPENSATION,DAA4IGESASPROVI�EOFORINSECTI ELABORCODE,IMEREST,ANDATTORNEY'SFEES.
LICENSED
lam
9(commencing with Section 7000) of Division 3 of �he Busines^s and Professions Code, antl my license is in full
CONSTRUC710N LENDING AGENCV:
❑ I hereby aHirm thet ihere is a constructlon lending agency for the pedormance of ihe work lor which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lendefs Name: Lentlers Adtlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn ihat under p ne elry of.perjury.ihat I am E%EMPT FROM THE CONTRAC70fiS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Cotla: Any city or counry:whlch�r9qutr5s�e permihio construd, atter, improve, demolish, or repair any simcture, prior to iis issuance, also requires ihe epplicant tor such permit
to tile e signetl statement ihat"he�oi sfie�is license`d pur8uant to the provisions of Ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) ol Division 3 of the
Business and Protessions Code) or thet he or she��ie�ezempt �herefrom en0 the besis for ihe alleged eaemption. Any violation ot Seqion 7031.5 by eny applicam for a permit
sublects the epplicant to a,civil penalty of not more than tive hundred dollars ($500).):
❑ I, es owner of tha propetly, or my employees!wlth wages as Iheir sole com0ensation, WILL DO THE WORK, entl the stmcture Is not intended or oHeretl tor sale (Sec.
7044, Business and Profassions Code: Tha Contractors License Lew tloes not apply to an owner of property who builds or improves thereon, entl who tloes such work
himself or herself or ihrough his or her own employees, provided ihat such improvements are not intended or oflered for sale. If, however, the builtling or improvemem is
sold within one year of completion, ihe owner-builtler will hava the burtlan of proving that he or she did not build or Improve for purpose of sale.).
❑ I, as owner ot ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to canstruct the project (Sec. 7044, Business antl Professions
Cotle: The contradors License Lew tloes not appty to an owner of property who builtls or improves thereon, antl who contracts for such projact with a conirector(5)
license pursuant to the Contractors License Lews.).
❑ I am exempt untler sec.
Signature:
Owner ID verified by drivers license. ❑ Yes ❑ No
Business and Professions Code for ihis reason:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
Onver's License No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby cehity �hat no excavatlon five (5) or more feet in tlepth into which a person is required to descend, will be matla in connectlon wl�h work authorizetl by ihis
permit, antl Ihat no builtling swcWre, sceHolding, talsework, or demolition or dismantling ihereof, will be mOra Ihen thirty-six (36) feet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Tiile 8, Califomia Adminisire�ive Code).
❑ A5 owner�Duiltler, I will not employ anyona to do work which would require a permit Irom the Division of Industriel Safery, as noted above, unless such person has a
permit to do saU work trom t�e tlivision.
Signature:
Division of Industrial Safery Permit Number:
Date:
CERTIFICATE OF COMPLIANCE AND AIfTHORiZA710N OF EN7RV: I cenify under penalty of perjury that I heve read this application end stete ihat iha information given is
wrrect. I aqree to comply with all la nd ciry ances relating to building consiruction, and authorize representatives oi the Ciry of Costa Mesa to enter upon the
ebove-descnbed properry for i ecti �iry�es. gree not to occupy or allow acupancy oi any builAing aut�orizetl by this pertnit until final inspection.
COOE 1' INSVECTIONTVFE "'
1616 Fixed System Final Fire Prevemion
1266 Pool Spa Finel
200 Final Re-Roof
201 Final BIocWRetaininq Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2446<6
�& INTIfULS
ate
�� Z/ � �
�'— a e
CODE� INSPECTIONTYFE
206 Finel Mechenical
20B Finel Plumbing
210 Finel Elecirical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Fina1 BuiltlinyOccupancy
� INTITIRLS
(714)754-5273 • Fax(714)754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
:,
555 ANTON BL
2
41050110
Applicant: DON SMITH
Adtlress:
CITY OF COSTA MESA '
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Ownec' , SAKIOKA FARMS _
Address �
Contracror: ACCENT BUILDERS
Address: 555 ANTON BL. #,100
�COSTA MESA, CA , ,
REF:E00-00049 & E00-00052
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool I Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl -
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors l0 1hp
Motors l0 10hp
Motors to SOhp
Motors to t00hp
Motors over 700hp
Communication drops
Sub panel to 200a
ELECTRICAL PERMIT
�Phone:
Zip:
Phone:
Zip: 94137
,
, r '��Phone: (714) 5493150
� Zip: 92626 '
License: 397790
PERMIT NUMBER
E00-00084
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 02/03/2000
Issued: 02/03/2000
SCOPE OF PERMIT
OVERTIME INSPECTION FOR SUNDAY 2/6/00 FOR RANDY BUCK FOR "EPOCH INTERNET" TI.
$23.50
$0.00
$0.00
so.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
_ FEE SUMMARY � ,
Quantiry
Temp Dist System / Lighting
Busway /100 ft .
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kvalkw
Low Voltage Equipment
Low VOIt Wiring Syslem I Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Quantity
$0.00 0
$0.00 0
so.ao 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under �his permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectiona end flnel epproval must be obtained. Failure to obtain inspections end final epproval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby eflirm under penalty ot perjury one of the following declara�ions: . �
❑ I have and will maintain a certifiwte of consent to setl-Insure for workers' compensetian, es provided tor by section 3700 0l the Lebor Code, for the peAortnence of the
work for which this pertnit is issued. '
❑ 1 have and will maintain workers' compensation Insurance. as required by sectlon 3700 oi the Lebor Cotle, for the pertortnance oi t�e work for which this pertnit is issued.
My workers' compensation Insurance carner and policy number are:
Cerrier. � Policy Numbar:
(This section nsed not be comp/eted i/ ermit ued e one�red dollars ($100) ar less.)
I certity that in the perfo ce of Ih9iWork for this pertnit is iuueQ I shell not employ eny person in any manner so� s to be� ome subject to t�e workere'
compensetion laws ot C ornie, alul,�giae the ' shoulqbacome su6ject to Ihe workers' compensation provisions of SectioyJ700 of y!e Labor Code, I shell fonhwith
�1 Appliwnt Signawre: � +---'x-� 'a-�•
WARNINO: FAILURETO CURE WORK 5' OMP
THOUSANOOOLLARE� 00,000),INADOITION
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm that I am licensetl u rovisii
force antl eHact. Lic. e �%
ContractoYs Signature:
rl �
L_.✓�w�, � � oece: %/�/U3 /O 6 �
SATION CAVERAGE IS UNLAWFUL ANDSHALL SUBJECT AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
COST OF CAMPENSATION, DMMGES AS PROVIpED FOP IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND NTTORNEV'S FEES.
(commencing with Section 7000) of Division 3 of Ihe I
� Class x
� � Data' _
Code, and my license is in full
CONS7RUC710N LENDING AGENCV:
❑ I hereby affirm that t�ere is a consiruction lending agency tor the pedormance ot Ihe work for which this parmit is issued. (Sec. 3097, Civil Cotle).
Lender's Neme: Lendets Atldress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirm that under penaliy of perjury t�at I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7037.5, Business and Professions
Code: Any ciry or counry which requires a permit to construct, elter, impmve, demolish, or repair any slrucWre, pnor to its Issuance, also requires Ihe applicent for such permit
to file a signed statement ihat he or she is Iicensed pureuam to the provisions of Ihe Contractoro License Law (Chapter 9(commencing wlth Section 7000) of Division 3 ot the
Business and Professions Cotle) or that he or she Ig exempt Iherefrom and the hasis lor ihe alleged exemption. Any Wolatlon ot Section 7031.5 Dy any flpplicant for a permit
sub�acts Ihe applicant to e civil penalry of not more then fiva hundred dollars (5500).):
❑ I, as owner ot the property. or my employees with wages as their sole compensetlon, WILL DO THE WORK, and the structure is not imentled or oHeretl for sale (Sac.
7044, Business and Pmfessions Cotle: The Caniractors License Law does not appty to an owner oi property who Duiltls or improves ihereon, antl who does such work
himsetl or hereelf or through his or her own employees, providetl that such improvemems ere not imendetl or ottered for sele. It, however, Ihe building or impmvemant is
sold within one year of completlon, the owner-builtler will have the burden of proving Ihat he or she did not build or Improve lor purpose of sale.).
❑ I, as owner ol the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business and Professions
Code: The contrectors License Law does not apply to en owner ot property who builtls or improves t�ereon, and who contrects for such project with a contractor(s)
license pursuant to ihe Conirectors License Lews.).
❑ I em ezempl untler sec. Business antl Professions Cotle tor this reason:
SignaNre: Date: '
Owner ID venfied hy tlriver's license. ❑ Yes ❑ No Dnver's License Na. Expires:
Verification of Ownership by (type of daument, i.e. - properry tau bill or deed):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
❑ I hereby certity Ihat no axcavation tive (5) or more feet in depth into whlch e person Is requiretl to descend, will be made in connaction with work authorized by ihis
permit, and that no Duiltling siructure, scaHolding, lalsework, or damolitlon or tlismantling thereol, will be more Ihan thirry-six (36) ieet high. (Chap. 32, Grp 2, Atl 2, Sec.
341, Tiile 8, California Adminisirative Cotle).
❑ As ownar-builder, I will not employ enyone to do work which would require a permit from ihe Division ot Industrial Safety, es noted ebove, unless such person has a
permit to tlo such wark fwm ihe tlivision.
Signature: Data:
Division of Industnal Safery Pertnit Number.
CERTIFlCA7E OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certity untler penalty of perjury ihat 1 �ave reatl this application and state Ihat the intormaiion given is
correct I egree to compl II state laws antl ciry nces relating to building consiruction, and authorize representatives of Ihe Ciry of Costa Mesa to enter upon �he
ebove-descnbetl pro for in ecti�oses. rea not to occupy or allow occupanry of any builtling authorizetl by this permit unt�l inspeciion.
COOE Y. INSiELTONTYPE ��
1676 Fized System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final Blak/Retaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
2416d6
UATE
Ijl�$ �Q� INSPECTIONTYPE
206 Final Mechanicel
208 Final Plumhing
210 Final Elec�rlcal
272 Final Fire Pravention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
o� INTITIALS
�/(j] i / , i
�
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
��ia��sa-sz�s • Fex(�ia��sa-aess
Job Address: 55$ ANTON BL
Suite No 2
Vicinity:
Parcel Nunmber: 41050110
Applicant: TERRY FULFORD
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
Owner. SAKIOKA FARMS _
Address � . � - --
Contractor: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA � ,
INTERNET'
REF:B00-00020
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa ,
Lighting Fixts _
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1 OOOa
Service over 1000a
Motors to ihp
Mo[ors to 10hp
Mators to SOhp
Motors to t00hp �
Motors over 700hp
Communication drops
ELECTRICAL PERMIT
Phone: 818-407-1986
Zip: 91324
Phone:
Zip: 94137
e
i
� � �� Phone: 818-407-1986
. Zip: 91324
License: 386619
PERMIT NUMBER
E00-00049
T7 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/24/2000
Issued: 01/24/2000
ISSUED BV: `� `
SCOPE OF PERMIT
60 LIGHTS, 50 OUTLETS,25 SWITCHES AND 40 COMM DROPS FOR SECOND FLOOR TI FOR "EPOCH
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$4920
$41.90
523.65
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$34.60
. . ,. .�. -; . �. ' � .
FEE SUMMARY � �
�uantity
0
0
0
60
50
25
0
0
0
0
0
0
0
0
0
0
40
Temp Dist System / Lighting
- � �- Busway /100 k
"' Standing Section
. Misc Electriwl Equipment
Transformers up to 1 kva/kw
................up to 10 kvalkw
.................up to 50 kva/kw
.................uP to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System I Ckt
Misa Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Chrislmas Tree Stand
Fireworks Stand
Other Electrical Fee '
Investigation Fee
Quantiry
50.00 0
�' $0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
30.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
NOTICE: The work authonzed by ihis permit shall comply with all applicable handicap access requirements under Califomia s�atutes and relaled
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all
requlred Inepeetiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of Ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATION DECLARATION: .
I hereby aHirm under penally oi perjury one oi the following tleclaretions:
❑ I h - and will maintain e ceniticate of consent to self-Insura for workers' compensation, es providetl for by section 3700 of the Lebor Cotla, lor the pertortnance of the
ork lor which ihis permit Is issuetl.
j�aV�9 entl will maintein workers' compensation insurence, as requlred by sectlon 3700 of the Lebor Code, for the peAormence ol the work lor which ihis permi[ is issuetl.
M-y�7orkers' compensetion Insurence carner and policy numbe ere:
PolicyNumber _. � YV W/i- ��� 7�7(�
one hundred dollers ($100) oileu.J
❑ I certity that in ihe peAortnance of the worl for which this pertnit is issueQ I shall not employ any person in any manner so as lo become subject to lhe workers'
compensetion laws of Califo , end agar�et if I should become subject to the workers' compensation provisions of Sedion 3700 of tha Lebor Cotle, I s�all torthwith
�m I with thesa provi� /,
�° .cL / l— z y— ae�
ApplicantSigneture: -"'T 'T"7l"�� Date: - ---
WARNING FAILURE TO SECURE WORKER$' CO SATION GUVERAGE IS UMAWFUL PND SHALL SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES ANO GVIL FlNES UP TOONE HUN�RED
THOUSAND DOLLARE (5100,000),IN A�DIiION TO THE WST OF COMPENSATION, OAMhGES AS PROVIDED FOR IN SECTION 31O60F THE LABOR OO�E, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTOHS DECLARATION:
I hereby aNirtn t 'censed under Drovisions ot Chapter 9(commencing with Section 7000) ot Division i ess and Professions Cotle, end my license is in tull
force antl eHect Lic # n�ii f GI A� ss M Ci� �
�ontrac�ofsSignatu � � a .[��% �—r m u
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn thet lhere is a construction lending egency for ihe pedormance ol Ihe work for which Ihis permit Is issuetl. (Sec. 3097, Civll Coae).
Lantler's Neme:
SignaWre: _
OWNER-BUILDER DECLARATIONS:
Lentlefs Atltlress:
Date:
I hereby ettirm ihat untler penelty of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business end Professions
Code: Any ciry or coumy which requires a pertnit to constmc6 elter, improve, demolish, or repair eny sirucNre, prior to its issuance, also requires ihe applicant br such permit
lo tile a signed statemeN ihat he or she is licensetl pursuant to the provisions of ihe Conirectors License Law (Chapter 9(commencinq with Sectlon 7000) of Dlvision 3 ot Ihe
Business antl Pwfessions Cotle) or ihat ha or she is exempt therefrom antl Ihe basis for t�e allegeG ezemption. Any violation ot SeIXion 7031.5 by eny applicant for a permit
subjects the epplicant to e ciNl penalry of not more than five hundred tlollars ($500).):
❑ I, as ownBr ot Ihe propeny, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe sliuclure is not intended or oHared for sale (Sec.
7044, 8usiness antl Prolessions Cotle: The Conirectors License Lew tloes noi epply to an owner of property who builtls or improves therean, entl who tloes such work
himsell or herself or Ihmugh his or her own employees, provided Ihat such impmvements are not intended or oHered tor sale. tl, however, ihe building or improvement is
soltl within one year of completion, the owner-builder will have the burden of proving Ihat he or she tlitl not builtl or improve for purpose of sele.).
❑ 1, as owner of lhe properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS Io con5iruct the prolect (Sec. 7044, Business and Protessions
Co�e: The contrectors License Law dces not appry to an owner ot property w�o huiltls or improves ihereon, and who contrects for such pmject with e contracbr(s)
licensa pursuant to t�e Contraciors License Laws.).
❑ I am exempt untler sec. Business and Protessions Code for this reason:
SignaWre: Date:
Owner ID veniietl by tlnver's license. ❑ Ves ❑ No Drivar's License No. Expires:
Veritication of Ownership by (rype of document, i.e. - property tax hill or deed�:
DIVISION OF INDUSTRIAI SAFEN PERMIT CEflTIFICATION:
❑ I hereby certity ihat no axcavation five (5) or more feet in tlepth into which a person is requiretl to tlescend, will he matle in connectlon with work authonzed by this
permit, end ihat no builtling structure, scattoltlinq, falsework, or tlemolillon or dismanlling lhe�eot, will 6e more than thirty-siz (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tule B, Californie Adminisirative Code).
❑ As owner-builder, I will not employ anyone to do work which woultl require a pertnit trom the Division of Indusirial Safery, as notetl a6ove. unless such person has a
permit to do such work irom �he Civisian.
SignaNre: Date:
Division of Intlusinal Sefery Permit Number:
CER71FlCA7E OF COMPLIANCE AND AUTH081ZA710N OF ENTSiV: I certity under penalry of perjury that I have read this application and state tha� the information given is
correct. I agree to comply with all state laws antl city ordlnances relatlng to builtling construction, antl authonze representatives of l�e Ciry of Costa Mesa to emer upon the
aDove-described propeny for inspection puryoses. I egree not to occupy or ellow occupency of any building authorizetl �y t�is parmit until final inspection.
COOE t. INSPECTIONTYPE
7fi16 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Finel Blak/Retaining Wall
202 Finel Feclory Fire Place
203 Finel Sign
204 Final Demolition
26a6d6
QAjf, INTITIALS
COOE♦ INSPECTIONTVPE
206 Final Mechanicel
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 PinalBuiltling/Occupancy
l-c�j'_c��
Date
pag � wiRIALS
M
4` p
O �
> _
f
J
'*�,ro,,,m'� .
(714) 754-5273 • Fax (714) 754-4856
w._ � { ��
CITY OF COSTA MESA "�
BUILDING DIV/SION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
PLUMBING PERMIT
.lob nddress: 555 ANTON BL
Suite No 2
Vicinity: 2ND FLOOR
Parcel Nunmber: 41050110
npp�icane STEVENS, DON ' ' '
Address: 1940 GARDENA . � � �
• � � � Phone: (818)500-1940,'
GLENDALE, CA ' - � ' Zlp: 91204 '
i
i
� �,� , : , _ . .. , . - _
Ownec(' SAKIOKAFARMS---- � � _
Addre�ss� �/ � -
' , � ' : Phone:
� i -
, � . .- Zip: 94137
- , � /:i,: i.
Contracmr. ' � .MUIR-CHASE PLUMBING . . . . �� � �
Address: 1940 GARDENA � ✓ � � ` �
� , � �� ' � �' �Phone:_ (818)500-1940 -
. �.
� � GLENDALE,CA�:�' '. Zip: 91204
' 7 -�' �_� License: 539835
�..
Arch / Eng : �
' � Address: �
PRIMER.
REF: B00-00020 ��.
REF:B00-000 ��
�
ISSUE FEE
BackFlow irrigation �
BackFlow Preventer
Bathtub
Clarifer System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor -
Drain, Rainwater
Drain, Roof
Phone:
Zip:
� ':��'�'Llcense:
- - �
SCOPE OI
PLUMBING PERMIT FOR OFFICE T.I. FOR -EPOi
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
9
- � ";' :' .
FEE SUMMARY
AMT
Laundry Tub / Washer � $0.00
Landscape Irrigation $0.00
P-Trap � $9.80
Pressure Regulator $0.00
Process Piping (per 10 R) $0.00
Receptors � $0.00
Septic Tank $0.00
SewerCapforDemo� $0.00
SewerConnect $0.00
Sewer Private Line � • $0.00
Shower " $0.00�
PERMIT NUMBER
Poo-000a2
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/24/2000
Issued: 01 /24/2000
ISSUED BY:
R). INSTALL 1 P-TR4P & i TR4P
_- 4
QTY
0
0
1
0
0
0
0
0
0
0
0
'
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash 8asin
Wash Basin Set
Waste and Vent Syslem
Water Closet (Toilet)
Water Heater / vent
AMT
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
1
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
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 1 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepectlona end finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION: . .
I hereby aHirtn under penalry of perjury one of the following declarations: ,
❑ I have and will maintain a certificale of consent to self-Insure for workars' Compensation, as provided for by section 3700 of the Labor Cotle, for the paAortnance of ihe
work for which Ihis permit is issuetl. - '
� I have and will mainlain workers' compensation insurance, as requiretl by section 3700 oF ihe Labor Code, for the peAortnance of ihe work for which ihis permit is issuetl.
My workers' compensation Insurence carrier and policy number are:
Carrier: _{�G�L (� Policy Number: WG S�� O S 3g
(Thls section need not 6e completed il the permit is velued af one hundred dollars ($100) ar /essJ
❑ I�certity thet in Ihe performance of the work for which Ihis permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Californie, and agrae that it I should 6ecome su6ject to the workers' compensation provisions ot Section 3700 of Me Labor Cotle, I shall forthwith
camply with these pr �>� �l
Applicant SignaWre: ��n..�--�. s� V Dete: �� Z 7' —Qd
WAFNING: FAILUFE TO SECURE WORKERS' COMPENSNTION COVEPAGE IS IINLAWFUL AND SHALL SUBJECT MI EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAN� DOLLARE (S10D,000), IN AODfiION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 3]O60F THE LABOR CODE, IIJrEREST, AND ATTORNEYS FEES.
LICENSED CON7RACTORS DECLARATION:
I hereby aHirtn that I am licensed under provisions of Chaptar 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my licanse is in full
force and ettect. Lic..a Class #� C� .J �i
Contractor's5ignawre: � �,,.__-. Date: /— 2g--00
✓
CONSTRUCTION LENDING AGENCV:
❑ I herehy aNirm t�at thare is a constmction lending agency for the peAormence ot the work for which Ihis permit is issued. (Sec. 3097, Civil Code).
' Lender's Name: Lentlets Address:
� Si9naWre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby attirm Iha� under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a pertnit to construct, alier, improve, tlemolish, or repair any simcture, pnor to its issuance, also requires the epplicant for such permit
to file a signad statement that he or she Is licensetl pursuant to the provisions of the Contractors License Law (Chepter 9(commencing with Section 7000) ot Division 3 of the
Business and Professions Cotle) or that he or she is enempt therefrom and the basis for the alleged exemption. Any vlolation oi Section 7031.5 by eny epplicant for a permit
sub�ects the applicam to a civil penelty of not more ihan five hundred dollars ($500).):
❑ I, as ownar of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the stmctura is not intentled or oHered for sale (Sec.
7044, Business and Protessions Code: The Contractors License Law does not appiy to an owner of propeny who builtls or improves ihereon, and who tloes such work
himself ar herself or ihrough his or her own employees, provided ihat such improvemen�s are not intended or oflered tor sale. It, however, the building or improvement is
soltl within one year of completion, the ownerbuilder will have the burden of proving ihat he or she ditl not builtl or impmve for purpose of sale.).
❑ I, as owner ot ihe property, am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The contractors License Law tloes not apply to an owner of properry who builds or improves thereon, and who coniracis for such project with a contractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am exempt under sec.
Signature:
Ownar ID verified by drivefs license. ❑ Yes ❑ No
Business antl Professions Code tor this reason:
Verification of Ownership by Qype oi document, i.e. - property tax 6ill or tleetl):
Dnver'S License No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CERTIFICA710N:
❑ I hereby cenity ihat no excevation tiva (5) or more faet in depth into which a person is required to descend, will ba made in connection with work authorized by ihis
permit, antl ihat no builtling swcWre, scaHolding, falsework, or demolition or dismantling Ihereof, will be more than ihiny-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Califomia Atlminis�raiive Cotle).
❑ A5 owner-builder, I will not employ enyone to do work which would require a permit from the Division of Indusirial Safety, as notetl above, unless such person has a
permit to do such work from the tlivision.
Signature: Date:
Division of Industrial Safery Permit Number:
CERTiFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalty of perjury ihat I have reatl this application and state ihat ihe information given is
correct. I agree to comply with all state laws and ci�y ortlinances relating to building constmction, antl authorize represematives oi Ihe City of Costa Mesa to enter upon the
above-tlascnbetl property tor inspection purposes. I agree not to occupy or allow occupancy ot any building authonzetl by this pertnit until final inspection.
� iqnature Of Legal Owner(s) Date
l - �--av
Antl/Or Authorized Applicanl Date
COpE Y. INSPECTIONTYPE OATE INTRI1l5
1616 FizedSystem Final Fire Prevention
7266
200
201
202
203
Pool Spa Final
Final Re-Root
Final Block/Retaininq Wall
Final Facrory Fire Place
Final Sign
204 Final Demolition
2446-46
C0� INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrlcal
212 Final Fira Prevantion
220 Final Planning Approval
222 final Site
250 Final Builtling/Occupancy
QAjE IMR R
(714) 754-5273 • Fax pia) �sa-aess
CITY OF COSTA MESA ' �
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
MECHANICAL PERMIT
Job Address: 555 ANTON BL
Suite No 2
Vicinity:
Parcel Number: 41050110
Applicant: LOU RODRIGUEZ
Address: 6265 SAN FERNANDO RD
GLENDALE-,CA.
Owner: . SAKIOKA FARMS
Address:
/ �
Contractor: AIR CONDITIONING CO., INC
Address� 6265 SAN FERNANDO RD
Phone: (818)244-6571
2ip: 91201
Phone:
Zip: 94137
- ' . . . , phone:" (818) 244-6577
GLENDALE , CA � ,i� Zip: 91201
� ' � � � "- License: 120696
�
Arch / Eng :
Address: ; -� � .
Phone:
Zip:
� , . . License:
PERMIT NUMBER
M00-00043
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/26I2000
Issued: 01R6/2000
ISSUED BY: �O �/
� SCOPE OF PERMIT �
' • INSTALL 1 VAV BOX AND 1 REPAIR/ALT COOLING/HTG SYSTEM FOR "EPOCH INTERNET" TI.
SUBJECTTOFIELD'INSPECTION. , ' �'�-, -- - - � _ , �
REF:B00-00020 _ � • � - � � - -- - � � "
ISSUE FEE � �
Inst FAU <100 k BTU
Inst FAU?100 k BTU .
Repair / Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Re(rig Sys <700 k BTU
Refrig Sys >100 k BTU
Gas Piping .
Factory Fireplace �
Hood w/Mech Exhaust �
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 70000cfm
Quantity
$23.50
$0.00 0
$0.00 0
51370 1
$0.00 0 .
$0.00 0
$0.00 0 -
$0.00 0
$0.00 0 ^
$0.00 0
$10.65 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
FEE SUMMARY
. � Repair/AltAbsorbtionUnit
, - � Repair/AltRefrigerelionUnit
Ventillation System
Evaporative Cooler
Commerciallncinerator -
Domestic incinerator
� Compressors / Absorption Systems
Upto3hp/t00kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To75hp
15 to 30 hp
3010 50 hp
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
50.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap accass requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automalically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a penod of 1 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLARATIpN:
1 haraby aHirtn untler penalty of perjury one oi �he following tleclarations:
❑ I have antl wiil maintain a certificate of consent to self-Insure for workers' compensation, as provitletl for by section 3700 of the Labor Cotle, for the peAortnance of Ihe
wark tor which Ihis permit is issued. �
�I have antl will maintain workers' compensation insurance, as required by section 3700 of the Lebor Code, for the perfortnance of tha work for which Ihis pertnit is issuetl.
My workers' co�m9 ensation Insur nce carner and policy number are: O
Carner: � U �/v �� Policy Numbe ,J � �%�U��
(fhis section need not be completetl il the permit is velued at one hundred dollars ($100) or less.)
❑ I certify that in the perfortnance of the work (or which this permit is issuetl, I s�all not employ eny person in any manner so as to become subject to the workers'
compensation law of Calitornia, and agree thet if I shoultl become sublect to the workers' compensetion provisions of Section 3700 of the Labor CoOe, I shall forthwith
comply with se p�r sions�.� �j�
ApplicamSign re:E�� Date:�/=2�.��iJ
WARNING:FAILUPETO DUREWORKERS'CO!dPENSATIQ�� ,O,tV,' RAGEISUNLAWFULANDSHPLLSU&IECTANEMPLOVERTOCRIMINALPENPLTIESANDCIVILFINESUPTOONEHUNDRED
THOUSANDOOLLARE�$100,000),INADDRIONTOTHECAS'f F�y9PENSATION,DAMAGESASPROVIOEDFORINSELTION3]O60FTHELABOP(YJDE,INTEREST,ANDATTORNEY'SFEES.
LICENSED CON7RACTORS DECLARA710N:
I hereby affirtn that I am licensed untler provi5ions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Protessions Cotle, and my license is in full
brce antl ettect Lic. k Class N /- �..r�
Contractor's Signature: �� Date: i/ —��._ n.�
,� a
CONSTRUCTION LENDING AGENCV:
❑ I hereby aflirtn that ihere is a constructipn lentling agency tor the pedormance ot the work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lenders Name:
Siqnature: _
OWNER-BUILDER DECLARATIONS:
Lenders Address:
Date:
I hereby aHirtn ihat untler penalty of perjury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Protessions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any simcture, prior to its issuance, also requires the applicant tor such permit
to file a signed statement that ha or she is licpnsed pursuant to Ihe provisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Protessions Cotle) or that he or she is ezempt iheretrom antl ihe basis for ihe alleged e:emption. Any violation of Section 7031.5 by eny applicant for a permit
sublects the applicant to a civil penalry oi not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my emplbyees with wages es their sole compensaiion, WILL DO THE WORK, end the strucWre is not intended or offered for Sale (Sec.
7044, Business and Professions Cotle: 7he Contractors License Law does not apply to an owner of property who builds or improves thereon, and who dces such work
himself or herseli or t�rough his or her qwn employees, provided ihat such improvements are not inrended or oNered for sale. If, however, ihe builtling or improvement is
soltl within one year of completion, Ihe owner-builder will have ihe burtlen oF proving thet he or she did not build or improve for purpose of saleJ.
❑ I, as owner of Ihe property, am EXCIUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to cons�ruct the project (Sec. 7044, Business antl Professions
Code: The contracrors License Law does not apply to an owner of pmperty who builtls or improves thereon, and who contrecis for such project with a contrector(s)
license pursuant to ihe Contractors License Wws.).
❑ I am exampt untler sec. Business end Professions Code for this reason:
Signature: Date:
Owner ID veritietl by drivels license. ❑ Yes ❑ No Driver's License No.
Ventication of Ownership 6y (type of document, i.e. - property taz bill or daed):
DIVISION OF INDUSTRIAL SAFETV PERMIY CERTIFICATION:
Expires:
❑ I hereby certify that no excavation tive (5) or more feet in depth in�o whic� a person is required to descend, will be matle in connection with work authorized by Ihis
permit, antl ihat no �uiltling sirucNre, sCallolaing, talsework, or demolition or dismamling ihereof, will be more ihan thirty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle e, Calitomia Atlministrative Cpde).
❑ As ownervbuiltler, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as notetl a6ove. unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industnal Safety Permit Number:
CERTFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenity under penalry of perjury that I have reatl this application and state �hat the iMormation given is
correct. I agrea b comply with all state laws antl ciry ordinances relating to building constmctlon, and authorize representatives oi ihe Ciry of Costa Mesa to enter upon the
above-described property for inspection purpnses. I agree not to accupy or allow occupancy of any building authonzetl by this permit until final inspection.
^ Signature Of Legal Owner(s)
CODE M INSPECTIONTYPE
7616 Fixed System Final Fire Preven�ion
7266 Pool Spa Finel
200 Final Re-Roof
201 Final BIxWRetaining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
24A6A6
QeT�F IN AL
Date
/-ZG �O✓
Date
CO�E♦ INSPELTIONTYPE Ut� INTRIRLS
206 Final Mechanical �
208 Final Plumbing
210 Final Elecincal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856
Job Address: 555 ANTON BL
Suite No 2
Vicinity: 2ND FLOOR
Parcel Nunmber: 47050110
npp�icant: STEVENS, DON
Address: 1940 GARDENA
CITY OF COSTA MESA
BUILD/NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
GLENDALE;CA � ,
Ownei: • ' SAKIOKA�FARMS .- `
Address . � � �
Contracror: MUIR-CHASE PLUMBING
Addre3s: 7940�GARDENA � � �
` . .
� GLENDALE,CA '
Arch / Eng : .
� Address: � �
PLUMBING PERMIT
`J
t
PERMIT NUMBER
P00-00060
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BV:
Phone: (878)500-1940 -'
Zip,_ 91204 , .
Phone:
Zip: 94737
/ �
� Phone: (818) 500-1940 �,
Zip: 91204
License: 539835 �
Status: ISSUED
Applied: 07/31/2000
Issued: 01/31/2000
Phone:
Zip:
,�. - - '
- - License:� . ' - � '
_ _
: ;
SCOPE OF PERMIT
SUPPLEMENTAL ELECTRICAL PERMIT FOR T.I. FOR -EPOCH- (2ND FLOOR). INSTALL 7 P-TRAP &
1 TRAP PRIMER. . -" " .
REF: 600-00020 8 P00-00042 .
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drein, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
AMT
$7.25
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY,
FEE SUMMARY '
- AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $9.80
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
Seplic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line � $0.00
Shower $0.00,
Sink, bar � $0.00
Sink, commercial $0.00
�TY
0
0
7
0
0
0
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trep Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toileq
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
AMT
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
1
0
0
0
0
0
0
0
0
0
0
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit [o be considered legal, such work must comply with all applicable codes, and all
requlred Inapectlona end flnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSA710N DECLARATION:
I hereby aflirtn untler penalry of perjury ane of the lollowing dedarations: �
❑ I heve end will melntein e cetlificete of consent to self-Insure tor workers' compensation, es pravided for by secllon 3700 of ihe Lebor Code, tor Ihe pertormenca of the
work lor which this permit Is issuetl. "
�[{_ I have antl will maintain workers' compensatlon insurance, as required by section 3700 of the Labor Code, tor Ihe Dedormence of �he work for which this partnit Is issuetl.
My workers' compensetion Insurance cerrier end policy numDer are:
Certiec���Gd PolicyNumber. GfICS���S.3g
(This secNon need not be completed il the permit /s velued ef one hundred dallers ($f 00) or less.)
❑ I certity thet in the pertortnan4e of ihe work for which this permit is iuued, I shall not employ eny person In eny manner so as to become subject to the workers'
compensation laws ol Califomig, antl agrea Ihat il I should become subject ro tha workers' compensation provisions ot Sectian 3700 of the Lebor Code, I shall torthwith
comply with Ihese prov
Appliwnt Signatura: ��a---��� Date: I— � I— O O
WARNING: FAILLIPE TO S URE WORKFRS' COMPENSAiION COVERAGE I5 UNL4WFUL AN� SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO IXJE HUNDRED
T}10USAND DOLLARE (E100.000). IN AD�IT�pN TO THE COST OF WMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF TME IABOR CO�E, IMEREST, AND ATTORNEYS FEES.
LICENSED CON7RACTORS DECL4RATION:
I hereby affirm that I am licensed untler rovisions of Chapter 9(commencing with Section 7000) ot Division 3 ot the Business and Pmtessions Cotle, antl my license is In tull
torce ana ettect. ua a �. 9 8 3� ciass x C'.— 3.6
Comrectors Signe�ure: � � a Date: �— � �— n(�
CONSTRUC710N LENDING AGENCV:
❑ I hereby attirm ihat there is a consiruction lentling agency for the pertortnance oi the work tor which this pertnit is issued. (Sec. 3097, Civil Code). ,
Lenders Neme: Lendefs Address:
Siqnawre: Date:
OWNER-BUILDER DECLARATION$;
I hereby aflirm that untler penalry ot perjury ihet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a permit Io construc6 alter, improve, demolish, or repair any swcture, pnor to ics iuuance, also requires ihe epP���ent for such permit
to file a signed stetement that he or she Is licensetl pursuant to ihe provisions of Ihe Contractors License Law (Chepter 9(commencing with SecNon 7000) of Division 3 of Ihe
Business antl Professions Code) or Mat he or sha is exempl therefrom antl the basis for the alleged exemption. Any Wolation ot Section 7031.5 �y eny appliwnt tor e permit
subjects the epplicant to e civll peneqy of not more than Iive huntlred tlollars ($500).):
❑ I, es owner of the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, entl the structure is not inten0etl or oHeretl for sale (Sec.
704d, Business antl Prolessio�s Cotle: The Contractors License Law tloes not apply to an owner oi property who builds or improves ihereon, entl who tloes such work
himself or herself or t�rough hig or her own employees, provided that suc� improvements are not intended or oNeretl for sale. If, however, Ihe builtling or improvement is
sold within ona yeer of completlon, ihe owner-builder w10 have the burden of proving Ihat he or she did not build or improve tor puryose of SaleJ.
❑ I, as owner of the propeny, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct t�e pm�ect (Sec. 7044, Business antl Professions
Code: The coniractors License Law does not apply to an owner of property who builds or improves thereon, and who contracis for such prolect with e coniractoqs)
license pursuant to the Comractors License Lews.).
❑ I am e:empt under sec. Business antl Professions Code for ihis reason:
SignaNre: Dete:
Owner ID veritietl by drivers licanse. ❑ Yes ❑ No Driver's License No. Explres:
Verification ot Ownership by (type of document, i.a. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY pERM1T CERTIFICATION:
❑ I hereby certiy that no ezcavetion live (5) or more teet in dapih into which a person is requlred �o descend, will be mede in connectlon with work authorized by ihis
pertnit, antl Ihet no builtling structure, scaMolding, talsework, or demolition or dismantling thereot, will be more ihan t�irty-siz (36) teel high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Titla B, Celifornie Administrative Cotle).
❑ As owneo-builtler, I will not employ anyone to tlo work which woultl require a permil from Ihe Division of Industrial Sefery, as notetl above, unless such pereon has a
pertnit to da such work trom thp division.
Signature: Dete:
Division of Indusirial Safety Partnit NUmber.
CERTIFlCATE OF COMPl1ANCE AND AUTHORIZATION OF ENTAY: I certity under penalty of perjury that I heve raad Ihis application end stata that Ihe information given is
correct. I agree m comply with ell stete laws and city ordinances relating to building construction. antl authorize representetives ot the Ciry oi Costa Mesa to enter upon the
above-tlescribed property for InsDeciion purposes. I agree no1 to occupy or allow occupancy ol any building authorized by Ihis pertnit until final insDection.
� Signatur Legel Owner(s) Date
I-3I-oD
An[ll r Authonzetl Applicant Da�e
CODE �. INSiECTIONTYPE
1616 Fized System Final Fire Pr4vemion
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Finel Fectory Fire Place
203 Final Sign
204 Final Demoli�ion
2446 46
�Ag, IMITI�LS
COUE I INSPECTIONTYFE
206 Final Mechaniwl
208 Finel Plum�ing
210 Final Electdcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Oaupancy
Q� INi1fIRL5
I D �
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; •;,;.�;: �
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(714) 754-5273 • Fax (714) 754-4856
Job Adtlress:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
2
COMPUTERROOM
41050110
App�iwnt: TERRY FULFORD
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA .
CITY OF COSTA MESA � "�
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Owner:' SAKIOKA FARMS
Address - . ' �
Contrador: O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
� - �
NORTHRIDGE, CA �
ELECTRICAL PERMIT
Phone: 818-407-1986
Zip: 91324
Phone:
Zip: 94137
� Phone: (818) 407-1986
Zip:- 91324
License: 386619
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01124/2000
Issued: 01I24I2000
ISSUED BY: ��
. SCOPE OF PERMIT
� 75 LIGHTS, 110 OUTLETS, 6 SWITCHES, 1 400 AMP DISCONNECT, 3 COMM DROPS, 2 200 AMP
SUB-PANELS AND 1 UPTb 100 KVA TRANSFORMER FOR SECOND FLOOR COMPUTER ROOM TI FOR
"EPOCH INTERNET' � �
REF:B00-00022
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
LigMing Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service l0 200a
Service to 1000a
Service over t000a
Motors to 1 hp
Motors to 10hp
Momrs to 50hp
Motors to 100hp
Motors over t00hp
$23.50
$0.00
$0.00
$0.00
$0.00
50.00
560.15
$85.70
$6.60
50.00
$0.00
$30.50
50.00
$0.00
$0.00
50.00
$0.00
50.00
$0.00
�uantity
0
0
0
75
110
6
0
0
1
0
0
0
0
0
0
0
FEE SUMMARY
- - Temp Dist System / Lighting
Busway I100 ft
Stantling Section
- Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kvalkw
Low Voltage Equipment
Low VOIt Wiring System I Ckt
Misa Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Chnstmas Tree Stantl �
Fireworks Stand �
Other Electrical Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$49.50 1
50.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap eccess requirements under California statutes and related
regula�ions. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permi� shall automatically expire and become void it work is not commenced within 1 BO days, or if work is suspended or abandoned
for a penod of 180 days. '
INSPECTIONS: tn order for tha work authorized under this permit to be considared legal, such work must comply wi�h all applicable codes, and all
�equlred Inepectlona end finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WOAKERS'COMPENSAnON DECLARAnON:
1 hereby eHirtn untler penalry of perjury one of the Idlowing tleclaretions:
❑ I have entl will maintain a certlliceta of consent to selt-Insure tw workers' compensetion, as providetl for by sectlon 3700 oi t�e Lebor Code, for the pertormanca ot the
for which Ihis pertnit is issued.
Q I ve antl will maintain workers' compensalion insurance, as requiretl by sectirn 3700 of Ne Labor Cotle, for the peAortnance of Na work tw which this pertnii is issued.
My workers' compens�a ion I9sur wr nd po�li number�/
�emer.� 'l�fliu'-�4/ ��� �/+CS �+ Poll �Number.;:��W'¢ Z7��el/�OU
��-�,..,. s _
neetl not be cnmplefetl i! Me permit ls velued af one hunLred Collers
❑ I certiy thet in the peAortnance of Ihe work for which t�is permit is issuetl, I shell not amploy eny person in eny manner so as to became suDject to the workers'
compensatlon laws at Calilamle, end ree Ihet ii I should becoma subject to tha workers' compensetion provisions of Section 3700 of the La6or Code, I shall ton�wilh
comply with these pr ns.
A lieaat ip eWre: � �� �Dee: _� ?�—m�
NG: F,NLU � O SECU E WORKE ENSATION C1�VERAGE IS UNLnWFUL AND SHALL SUBJEGf AN EMPLOVER'IO'CRIh9NP1 PENPLTIES AND qVIL FlNES UP TOONE Hl1NDRED
THWSAND OOLLARE (5/00.000). IN MDRION TO THE ODST OF GUMPENSATION, OANAGES AS PROVIUED FOR IN SECrION 3]OB OF THE LABOR WOE, INfEREST, M!0 ATTORNEV'S FEES.
LICENSED CONTAACTOHS DECLARA710N:
I here6y aXirtn Ihat 1 am Iis;ensed u er Dmvisions ot C�apter 9(commenGng with SecUon 7000) oi Dlvision 3 q ICei,usineu antl Professlons Coda, antl my license is in tull
lorce nnd eHect. 'c a � �(0 6 � �ie:s eTL C� �l �
CoAROC[ s laneW�e: � t � �_ �: /—Zti/-8(lj
�„s�
CONSTRUCTION LENDING AGENCY: �
❑ I �ereby eflirtn ihat Ihere is a construction lending agenty br Ihe pertormence oi Ihe work tor which Ihis pertnit Is issued. (Sec. 3097, Civll Cotle�. ,
Lentler's Neme: Lentlers Atltlress:
Signatura: Date:
OWNER•BUILDER DECLARA710NS:
I �ereby aMirtn Ihat under penalry ol per�ury that I em EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7037.5, Business end Professions
Cotle: Any city or counry which requires e permit to construct, elter, improve, demolish, or repair any structure, prior to its issuance, also requires iha epplicant for such permit
lo tile e siqnea statemeN thal he or she is licensed pursuaN to tha provisions ol the Contractors License Lew (Chapter 9(commencin9 wi[h Section 7000) of Division 3 of �he
Business and Pwtessions Code) or Ihet ho or she is exempt therefrom end the basis br the allegad exemptlon. Any vlolatian at Section 7031.5 by eny epplicant tor a permit
sub�ects the epplicant to a civil penalry ol not more then live hundred tlollars ($500).):
❑ I, es owner of the proPerty, or my employees with wages as their sole compensation, WILL DO THE WORK, end ihe structure is not intentletl or offered lor sele (Sec.
7044, Business antl Professions Cotle: The Conireclors License Law tloes not apply to an owner ot property who builtls or improves thereon, and who tloes such work
himsetl or herself or Ihrough his or her own employees, pmvideA t�at such impmvements are not intended or oHered for sale. tl, however, ihe building or imprwement is
sold within one year oi completion, the owner-builder will have tha burden of proving that he or she ditl not builtl or Impmve tor purpose of sale.).
❑ I, es owner of Ne properry. am EXCLUSIVELV CONTRACTNG WIT1 UCENSED CONTRACTORS to construa the project (Sec. 7044, Business and Pmfessions
Catle: lTe wntrectors Ucensa Lew tloes not epply to an owner Of properry who builds or impmve5 lhereon, Bnd who coniraas for such pmject with a con[racior(s)
license pursuant to the Contrectors License LawsJ.
❑ I am exempt untler sec. Business and Professions Cade for IhiS reason:
Signature: Date:
Owner ID verifietl by drivefs license. ❑ Yes ❑ No Drivefs License No.
Venfication ol Ownership Cy (type ot tlocumeN, i.e. - properry taz bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I �ereby certity that no excevetlon Ilve (5) or more feet In tlepih Into whic� a person Is requlretl to tlescend, wlll be meda in connection with work euthodzed by this
permit entl thet no builtling structure, sceHoltling, talsework, or tlemolltlon or dismantling ihereot, will be more ihen thlrty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tule B, Celifomia Atlministrative Code).
❑ As owner-builtler. 1 will noi employ enyone to do work which woul0 reQuire e permit Irom the Division ol IntlusMel Safery, as noted ebove, unless such person has a
pertnit to tlo suc� work Irom the tlivision.
Slgneture: Date:
DivlSion al Intlustnal Sefery Permli Number:
CERTIFICA7E OF COMPLIANCE AND AUTHOFiVATION OF ENTAY: I ceM1ity wder penalry of perjury that I heva read Ihis application and stata fhat the information given is
correcl. I egree to compty with all stete laws and dry orCinances relating to bulltling construction, and au�hodze representatives of the Ciry of Cosla Mesa to enter upon tha
ebove�descdCed pmperty for insDectlon purposes. I egree not to occupy or ellow occupancy ot any bulltling euthodzetl by tMs pertnit untll final InspecUon.
COOE A INSVECTIONTYVE
7618 Fixetl System Final Fire Preventlon
1286 Pool Spe Final
200 Finel Re-Roof
207 Flnal BIocWRataining Wall
202
203
204
26a&46
Final Fectory Fire Place
Final Sign
Finel Damalition
�g
,� n _
CODE� INSPECTIONTYVE
206 Final Mechenicel
20B Finel Plumbing
210 Finel Electricel
212 Final Fire Prevention
220 Finel Planning Approval
222 Final Slte
250 Finel Buildinq/Occupency
— c. — cLV
Date
P6IE INiITIALS
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^�bwn
(714) 754-5273 • Fex (714) 754-4856
Job Address: 555 ANTON BL
Suite: 2
Vicinity:
Parcel Number: 41050110
Applicant: JEREMY COLLINS
Address: 2505 MIRA MAR
LONG BEACH, CA
Owner: SAKIOKA FARMS
Address , - - _ �� .
CITY OF COSTA MESA �
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Zoning:
Phone: (562) 498-6444
Zip: 90815
Phone:
P�IT����ER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01I10/2000
Issued: 02/03i2000
ISSUED BY: � �"`" 1
; . " Lp: 94137
Contracror: ' CAC PROTECTION
Address: 2505 MIRA MAR ,
CA � Phone: (562) 498-6444
, . , LONG BEACH Zip: � 90875
. � License: 327796
SCOPE OF PERMIT
INSTALL FIRE ALARM SYSTEM FOR THE SECOND FLOOR TI FOR "EPOCH INTERNET".
REF:B00-00022 "
FEE SUMMARY
Plan Check: $72.31
Permit: $111.25
Other: $0.00
Total: $183.56
Calc Valuation: SS,000.00
Claimed Valuation: 35,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and rela�ed
regulations. (Ord. No. 92-28, § 1, 1241-92)
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 e period ot 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, antl ell
requlred Inapectlona and (Inal approval must be obtained. Failure to obtain inspections and flnal approval will result in the expiration of this permit.
FOR INSPECTIONS CAIL: (714) 7545628
J
WORKERS'COMPENSAnON DEC�qqAnON:
I hereby eHirm untler penalty of perjury one of the following declarations: • ' -
❑ I have antl will maintain a certificate of consent to setl-Insure tor workers compensation, es provided for by sectlon 3700 oi ihe Labor Cotla, for t�e pertormance ot the
wark tor which this pertnit is issuetl. �
� I have antl wiil maintain workerg' cnmpensation insurance, as required by section 3700 of ihe Labor Cotle, Por ihe peAortnanca of ihe work br which [his pertnit is issue0.
My worke/rs�' co�mpensetio Insurance carner end policy number are: �, / (�/ p p�
Cerrier. /�� O�L �% ��L �T�� �-YY� Gl,. i/ v Policy Numher: 3! O�^� a
(This sectian need nor e complefed if the permit is veluetl a( one hundred Oo I ($700) or less.) -
❑ I certify that In the pertormance of �he work for whith thi5 permlt Is issueQ I shall no� employ any person in any manner so as to become subject lo �he workers'
compensation laws of Califomla, antl agree that if I shoultl become subiect to the workers' compensation provislons ot Section 3700 of the Lebor Cotle, I shall tort�with
comply with these pro isio
Applican�SigneWre: ��� ��� ` D0�8: � � � ` �
WAFlNING FAILURE TO SEWFE WORKEqS' WMPENSATION COVERAGE I$ UNLAW FUL PND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIE$ AND dVIL FlNES l/P TO qJE HUNDRED
THOUSAND DOLLARE (5100,000�, IN ADD1710N TO THE COST OF COMPENSATION, OFMAGES AS PROVIDED FOR IN SEGTIIXJ 3]O6 OF THE LABOR CODE, INrEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLqqAT10N:
I hereby aRirm that I am licensed under provislons ofl hapter 9(commancing with Sectlon 7000) of Division 3 ot lhe Business an0 Protesslons Cotle, and my license is in full
force entl eNecL Lic. a g K� Class a �' �^f��� C' �� b
Contrectots SigneWre: �i /.L` � v—` Date: ,1 � ' S — �
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirtn that ihera is a cqnstruction lending egency (or the peAormance of ihe work br which this permit is Issued. (Sec. 3097, Civll Cotle). ,
Lentler's Name: Lentlefs Adtlress:
Siqnature: Date:
OWNEF-BUILOER OECLARATIONg:
I hereby etlirm Mat untler penalry of perjury ihat I am E%EMPT FROM TTIE CONTRACTORS LICENSE LAW for �he tollowing reason (Sec. 7031.5, Business antl Professions
Cotle: Any city or counry which requires a pertnit to cons�ruct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit
to tile a signad stetemen� Ihet he or she is licensed pursuam ro the provisions ol the Contradors Licanse Law (Chapter 9(commencing with Section 7000) ot Division 3 of the
Business and Professions Cotle) or that he or she is exempt theretrom and the basis for ihe alleged exemptlon. Any violation of Section 7031.5 by any epplicant for a pertnit
sub�ecis Ihe applicant to a civil panalty ot not more than five hundred dollars (3500).):
❑ I, es owner of the property, or rny employees with wages as their sole compensation, WILL DO THE WORK, entl the structure is not intended or oHered for sale (Sec.
7044, Business and Prolessions Cotle: The Comractors License Law does not appry to an owner ot property who builds ar improves thereon, antl who dces such work
himself or herself or ihmugh his or her own employees, provitletl that such improvements are not intended or ottered for sale. If, howaver, the building or impmvement is
sold within one year of comple�on, the owner-builder will have Ihe burtlen of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, arti EXCLUSIVELV CONTRACTING WITF1 LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Professions
Cotle: The coniractors License �aw tloes not apply to an owner of property who builtls or improves thereon, and who contrects for such project with a coniractor(s)
license pursuani to tha Contracbrs Licensa Laws.).
� I am eaempt under sec. Business entl Professions Code for ihis reason:
Signature: Date:
Owner ID verifietl by tlrivels ticen5e. ❑ Ves ❑ No Driver's License No.
Verification of Ownership by (type ot tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CERTIFICATION:
Eapires:
❑ I hereby certity that no excavalion tive (5) or more feet In depth into which a person Is required to descentl, wlll be made in connectlon with work authorizetl by Mis
pertnit, and t�at no building strucNre, scaHolding, falsework, or demolitlon or aismantling thereof, will be more then thirty-slx (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celifomia Atlministrative Code).
❑ A5 owner-builtler, I will not employ enyone to do work which woultl require a permit trom �he Division ot Intlusirial Satery, as noted ebove, unless such person has a
permit to do such work from the division.
SignaWra: Date:
Division of Indusinal Setety Permit NUmber:
CER7IPICATE OP COMPLIANCE AND AU7HORIZATION OF ENTFiV: I certity untler penalty of perjury ihat I have reetl ihis application and sta�e that the information given is
correct. I agree to wmply with all stgte laws and ciry ortlinances rela�ing to builtling conswction, and euthorize representatives of the City of Costa Mesa to enter upon the
above-descdbetl property for inspection puryoses. I agree not to occupy or allow acupancy oi eny huilding euthorized by this permit umil final inspection.
Signawre 9i Le ner(s) � ? Date
���iY �� �iC�/.�� � _ J �Dat�
AnNOr quNorized Applicant
COOE �, MSPECTIONTYPE QAjF INTRIALS
1616 Fized System Finel Fire Preyention
1266
200
207
202
203
204
2a4&d6
Pool Spa Finel
Final Re-Roof
Final BIaWReteining Wall
Final Fectory Fire Place
Final Sign
Final Demoli�ion
COOE 1 INSPECTION TYPE
206 Finel MechaniCel
208
210
212
220
Final Plumbing
Finel Electdcal
Final Flre Prevention
Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
BESE IximALS
Z-�i- Lb � !
(�ia��sa-sz�3 • Fau���a��sa-asss
Job Address: 555 ANTON BL
Suite: 2
Vicinity: SECOND FLOOR
Parcel Number: 41050110
Applicant: WILSON, WALTER
Address: 2505 MIR4 MAR AVE.
CITY OF COSTA MESA '
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
LONG BEACH, CA '
Owner: SAKIOKA FARMS
Address . - �, � �
Contrector.
Address:
Zoning:
Phone: (562) 498-6444 EXT. 2205
Zip: 90815 �
Phone:
Zip: 94137
PFOII-UU0�5ER �
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
� Phone:
, �
Zip:
License:
_ SCOPE OF PERMIT
INSTALI 15 FIRE SPRINKLER HEADS FOR T.1. FOR -EPOCH INTERNET- (2ND FLOOR).
REF: B00-00022 , ,
Plan Check: $72.31
• Permit: $111.25
Other: $0.00
Total: $183.56
FEE SUMMARY
Slatus: ISSUED
Applied: 01I10/2000
Issued: 02/03/2000
Calc Vatuation: Sa,ata.00
Claimed Valuation: sa,aia.00
NOTICE: The work euthorized 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 eutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a penod of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered lagal, such work must comply with all epplicable codes, and all
required Inepectlone end finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALI: (714) 7545626
WORKERS'COMPENSArON DECLARATON:
I hereby eNirtn untler penalry of perjury one at the Idlowing dedarations: ' �
❑ I heve end will melnlain a certllicate of consent to self-Insure tor workers' compensation, as providetl for Cy sectlon 3700 0l the Labor COEe, for t�e performance ot the
� work for which Ihis Pertnil Is I55ue0. �
�I have and will mainlain wwkere' compensaibn insurence, as required by section 3700 of ihe Lebor Cotle, for Ihe peAortnance of the work lor which ihis permii Ls issued
My worke compensation I�}surenca cerner end Ilcy number era: ^t [�,� ^ p�
Cerrier: �{L (L� VJ / 1� ` � i 1'✓) �/L� �/. Policy Number: j(�� —/ O
(Thls sect/on need n8( be comp/eted I! (he permit Is veluetl et one huntlred d ars ($100) or less.)
❑ I cartlty thet In the pertortnence oi the wark for which this pertnit is Issued, I shell not employ eny person in eny menner so as to become suDject to the workers'
compensation lews ol Celitomia, antl egree thet If I shoultl become subject to the workers' crompensetian provislons of Sectlon 3700 of Ihe Lebor Code, I shall torthwith
comply with these O�ovl 'ons. l�—
Applicant Slgneture: /� /SAL� �� Dete: ��3 � B�
WARNINO: FAILUFE TO SECURE WORKERS' CAMPENSFTION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TOONE MUNDRED
THOUSAND �OLLARE (E100.Opp�, IN A�DRION TO TNE CQST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3'108OF THE LABOR CODE, IfJrEREST. AND ATTORNEVS FEES.
ILICENSED CONTRACTORS DECLARATION:
I hereby eilirm that I am ��Censed under provislons oi Chapter 9(commencing with Section 7000) of Divislon 3 of Ihe Business nnd Professlons Cotle, entl my license is In full
force end eeect. Lic. q ,- Class a G—/ c�� L�— .G
Contractors Signature: 1 � Date: .% " — cYC7
CONSTRUCTION LENDING AGENCY:
❑ I �ereby atlirtn thet there is e consiruction lending agenry lor Iha pertormance ol ihe work lor which this permit is luuetl. (Sec. 3097, CIWI Coda).
Lendefs Neme: LentleYs Atldress:
Signawra: Date:
OWNER•BUILDER DECLARp710NS:
I �ereby ettirtn ihat unCer penalry af perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7037.5, Business and Professions
Code: Any ciry or counry which requires e permii to construct, elter, improve, demolis�, or repair any structure, pdor to Its issuence, elso requires the applicam tor such pertnit
to file e signed stetement that he or she Is licensetl pursuant to tha provisions of the Contractors License Lew (Chapter 9(commencing with Section 7000) oi�D'Msion 3 0l ihe
Business antl Professions �e) or that he or s�e is exempt t�erefmm antl Ne basis for the elleged e:emptlon. Any Noletlon oi Sectlan 7031.5 by eny epplicant tor a pertnit
su6�ects Iha applicent to e ciNl penalry ol not more than frve hundred dollars (5500).):
❑ 1, as owner ot lhe property, or my emplqrees with wages as their sole compensation, WILL DO THE WORK, entl the structure is not intended or ottered lor sale (Sec,
7044, Business and prolessions Catle: The Contractors license Law does not appty to an owner ol property who builds or improves thereon, and who does such work
himself or herself or throug� his or her own employees, provided that such improvements are not intended or ofleretl for sale. It, however, tha building or improvement is
sold within one year oi completion, the owner-builder will have the burden of proving thet he or she tlitl not huild or improve tor purpose of sale.).
❑ I, as owner oi the p�operry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prol�� (Sec. 7044, Buslness antl Professions
Code: The contractors License Ww does not appy ro en owner of pmperty who builtls or im0�o�es ihereon, end who coniracts lor such pmject with a contractor(s)
license pursuant ro the Contracbrs Licensa Lews.).
❑ I em exemp� under sec. Business and Professions Cotle lor this reason:
Signature: Date:
Owner ID veniietl Dy dnveYs license. ❑ Ves ❑ No Drivers License No. Expires:
Verification of Ownerehip by (type ol document, i.e. - properry tax bill or deetl):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICATION:
❑ I hereby certlty lhet no ezcevetlan Ilve (5) or more leet In tlepth into which a person I5 reQulretl to descend, will be mede In conneclion wit� work euthonzetl Dy ihis
permit, entl thet no hulltling sWcture, scaflolEing, talsework, or demolitlon or tlismantling thereol, wlll be more t�en t�lrty-siz (3fi) leet hlgh. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celitomla Adminisiretive Cotle).
❑ As owner�builtler, I will not employ enyane to do work which would reQuire e pertnit from ihe Division of Intlustnel Salety, as noled ebove, unless such person has a
permi� to tlo such work from the tlivision.
Signature: Dete:
Divislon ol Industriel Salety Permit Number:
CERiiFlCATE OF COMPUANCE AND AI7THORIZATON OF ENTRY: I certity under penalry of perjury ihat I have reed this application and sta�e ihat the infortnation given is
correct I egree to cwnply �y��p ell stete laws flnd ciry ortlinances relating to builAing construction, entl euthorize representelives of the City of Costa Mesa to enter upon the
ebove-tlescribed property tor inspection purposes. I agree not to occupy or allow occupancy ol eny building authonzed by this pertnli until linal Inspection.
% J���wre o, �egpi e� s, 2 3� oec��
�L G`� s
And/Or Aut�orized Applicant Date
CO�E �, INSPECTIONTYGE
1616
1266
Fixed System Final Fire Prevention
Paol SOe Final
200 Flnal ReRoot
201 Flnel Block/Retelning Well
202 Flnel Factory Flre Place
203 Flnel Sign
�20a Finel Domolition
244&d8
�g ��
Z—'.{-O�� I�io
COpE� INSPECTIONTYPE
208 Finel MechaniCel
208 Final Plumbinq
210 Finel Electdcal
212 Finel Fire Prevention
220 Finel Plenning Approval
222 Flnal SIIe
250 FInalBuiltling/Occupancy
Q� IMIII�lS
Z`I-�'�.
(714) 754-5273 • Faz (714) 7543856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
2
2ND FLOOR OFFICE
41050110
Status: ISSUED
Applied: 09/O6/2001
Issued: 09/O6/2001
Applicant: SMITH, DON ISSUED BY: '
Address: 3184AIRWAYAVE ."��; i�_'� " - - _ ��
� �� �i'�� � - -Phonet p14) 438-22�2 ��_ ; -
', .
COSTA MESA�, CA,- ' � , Zip: 92626 % � �� ,-
' % - - , , i ' /'� _ �
� , �
: � c , , `�\ ; _ _ . _ � - � -' i � � � '
i i, ,: . . -. _ � � ` , i � . .
owner::'SAKIOKA�FARMS - ' � � � � � ` , ���
�; , � ���
Address � / � - � , .. - � " �� � �
� Contracror:
Address:
Phone:
��i
� ',;.
�, Zip: 94137
. � , �
� HOWARD BUILDING CORPORATION'�
3184 AIRWAY AVE � �
� . � _ ' i �
\� ,� . . ` .. �
��
� , � � .Phone: p14)438-2272
COSTA MESA, CA � " � Zip: 92626 .
- - � � - License: 445804
� -' .
�, �� `�. _
. SCOPE OF PERMIT
ELECTRICAL PERMIT FOR�INTERIOR OFFICE T.I. FOR PEPOCH INTERNET" (2ND FLOOR). INSTALL ,
2 RECEPTACLE OUTLETS & 1 SWITCH. - - - � � - - � � � � ` ' , ,
', REF: 801-07387 � -.. '� '
� ' � � `- - . :. �
, � FEE SUMMARY % . "
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units) �
New Res\(3+units)
Pool / Spa - '
Lighting Fixts �. � �
Recept Outlete ,
Switches
Non Res Appl �� � �
Res Appl
Service to 200a
Service to 7000a �
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
�
Quantity
$23.50
50.00
$0.00
S0.00 0
�50.00 0 `
SOAO 0 , _
50.00 ' '-�0
52.20 . 2
$1.10�'.��,1
50.00_ �` � .0-�
50.00 0
50.00 0
$0.00 0
$0.00 -. -.0 , . . ,
50.00 0
$0.00 0
50.00 �, -. 0 -_ �
$0.00 �- 0 . .
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
Temp Dist System / Lighting
Busway /100 ft '
. . Standing Section
� � Misc Electrical Equipment
Transtormers up�to 1 kva/kw
................up to 10 kva/kw
� _ .:.............up to 50 kJa%kw':
. ...........:.....up to 700 kva/kw
..................over 100 kva/kw
Low Voltage Equipment � -
Low Volt Wirin9 System / Ckt
� Misc Conduit ,
Misc. Conductor
, Circus ( gen.or ride);
� Circus (mech ride or lights)
. Christmas Tree Stand .
� '� Fireworks Stand ,
_ Other Electrical.F,ee �
� lnvestigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00'. -�0
$0.00 0
$0.00 0
$0.00 � 0
$0.00 , 0
� $0.00 ,� 0�
$0.00 0
$0.00 0
50.00 D
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00
So.oa
50.00
$0.00
TOTAL CALCULATED FEES $26.60
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handirap access requlrements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become vold if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 tlays. .
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all appllcable codes, and all
required Inspectlona end final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5626 �
24A&OB (W00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby efllrm untler penalty M perjury ane of the tollowing dedaratlons:
❑ I heve end will maimein a certiflcate oi consent ta selt-Insure tor workers' compensetion, es pmvidetl tor by sectlon 3700 oi the Lebor Code, for Ihe pertormence of the
work tor which thi5`pertnil i5155ued.
❑ � neve end w��� me�uw� �wncers• compensetl�lNs�rarice� as requlred by sectwn s7oo or u,e Lebw code. ror uie venamance ar 1he wanc fw wnkh mis pemii� Is �swed.
Camer. 7 [ 1 £':/�-�
(Thls sectlar neetl not!
❑ I certity ihal In the
compensetlon law
compry wun mese
Qs7
n�e
LICENSED CONTAACTORS DECLARATON:
�mber ere: �i�1 �)
S Pdlcy Number. dW(/ �/7� �
Ihis rmit is IsSueQ 1 shall not employ any pemon In eny manner ao es to become suD�act to the workers'
wu becane sub�ect to the workers' compensatlan proNsions of Sectlon 3700 01 the Lebor Cotle, I s�all foRhwlth
� oa�e: , ' �%�o D /
IVERA�E IS UNUWFUL MlU SNALL SUBJECT AN EMPLOVER TO CRIAUNAL PENALTIES AND CMl FlNES UP TO ONE MUNDRED
OMPENS�TION, DAMAOES AS PROVIDED FOR IN SECTIIXJ 31080F 7HE UBOq CODE, INfEREST, AND ATTORNEYS FEES.
I hereby efllrtn that I em Ilcensed under I on ol ter comm cing with Section 7000) of Divlslon 3 of iho Buslness tl Professions Code, entl my Ilcense Is in lull
brce ena ettect. uc. a �L% ` � cless a �q—
Contrectofs Slgneture: �` / r-Dete: - /--/n �/J/
�
..___— __.i.._ ' _—
CONSTRUCTION LENDING AGENCV:
❑ I hereby eMirtn Ihet t�ere b e consiructian lending egenry tar the peAortnenca of Ihe work tor whic� Ihis permit Is Issued. (Sec. 3097, CiWI Cade).
Lentlefe Neme: LenAels AdAruss:
Signeture:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby eMirtn Ihet under penelry of perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor t�e lollowing reeson (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry whic� repuires e permit to construct, elter, Improve, tlemolish, or repair eny siructure, pdor to Its iasuance, elso requires the ep011caN for such pertni�
to Ille a sipneC stetement that ha or she Is Iicensed pursuent to Ihe praNsbns ai the Contractors ticense lew (Chepter 9(commencing vrith SecUon 7000) of DMslon 3 of the
Business end Professions Code) or that �e or she Is ezempt therefrom arid the basis lor Ihe alleged axemptlan. Any Wdation of Seclion 7037.5 Dy any applicant for e pertM'
suD�ecte the epplicant to e civil penelry of not more than live hundred dollars ($500).):
❑ I, es owner oi t�e property, or my employees with wages as their sde wmpensetion, WILL 00 THE WORK, end Ihe structura Is not intended or otleretl for sale (Sec.
7044, Busineu and Proteuions Cada: The Contrectors Licensa Lew does not apply to an awner of properly w�o bullds or Improves �hereon, flnd who daes such work
himself or herselt or through his or her awn employees, proNded that such impravemenis are not Intentletl or oXered for sele. If, however, the building or improvement Is
sold within one yeer of completion, ihe owner-builder will heve Ihe burden ol proving that he or she did not builtl or improve for purposa of sale.).
❑ I, es awner ot Ihe Droperty, em EXCLUSIVELY CONTRACTNG WRH LICENSED CONTRACTORS to consiruct the pra�ect (Sec. 7044, Business antl Profes5ions
Code: The cnntrectors License Lew Coes not apPN �o an owner of pmperry who builds or Improves thareon, antl who conirects tor suc� project with e contredor(s)
license pursuent to the Contractors License Laws.).
❑ I am exempt under sec. Business entl Professions Code tor this raeson:
Signeture: Date:
Owner ID varl�led by drivers license. ❑ Yes ❑ No Orivel9 Litense No.
Vetlflcatlan oi Ownership by (rype of document, i.e. - praperty teu 6ill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
F�pires:
❑ I hareby certily Ihet no ezcavetion flve (5) or more feet in tlepth inlo whic� e person is reqWred to tlescenQ will be made in connection wit� work auNodzed by Ihis
pertnit, end t�a� no building struciure, scattdding, lalsework, or demolilion or dismantling ihereoi, will be more t�an ihirry-six (38) teet high. (Chep. 32, Grp 2, An 2, Sec.
341, T1tle 8, Calitomla AdminisiratNe Cotle).
❑ As owner-bullder, I wlll noI employ enyone to tlo work whlch woultl require e pertnit Irom t�e DlNsion ot Industtlel Sefery, es noted ebove, unleu such person has e
permit ta do such work from the division.
Signeture: Date:
Divislon of Industrial Selary Pertnit Number:
CERTIFlCA7E OF COMPLIANCE AUfHORQATION EMAV: 1 cenify under penalry ot perjury that I �ave reatl ihis epplicetion entl state Ihat ihe Inlortnetlon given is
correct I egrea lo comply wit I stete lews end ciry inances releting to Euilding construcNon, and euthodza �epresantatives oi the Ciry oi Cosle Mesa to enter upon t�e
ebove-descdbed properry inspectlan pu�pSs�s. I ree notto occupy or ellow occupancy of eny building eulhodzed by this permit until finel inspection.
CODE �. INSiECTONTYPE \/
1818 Flxed System Final Fire Preventlon
1266 Pool Spe Flnal
200 Flnal RaRool
201 Flnal BIocWRetaining Well
202 Flnal FaIXory Flre Place
203 Final Sign
204 Finel Demolition
Qdjg ��$ COpE1 IN4PECTIONTYPE
206 Finel Mechanlcal
20B Finel Plumbinp
270 Flnal Electdcel
212 Flnal Fire Preventlon
220 Flnal Plenning Approvel
222 Flnal Site
250 Finel BuilAing/Occupency
PAIE
�
It��
(714) 754-5273 • Fez (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: 555 ANTON BL Status: ISSUED
Suite: 2 Applied: 09/O6/2001
Vicinity: 2ND FLOOR OFFICE Issued: 09/O6/2001
Parcel Number: 41050110 Zoning:
Applicant: SMITH, DON ISSUED BY: '
Address: 3184 AIRWAY AVE - � , � � � � _
� � ,�5 " - Phone: (714) 438-2272 - � ._
COSTAMESA,-CA��' . _ , ' Zip: 92626 � � '. ��
�', �' �- ' , � _ � �
Owner SAKIOKA FARMS � � � �� �
Atldress /' � . " � � � � - � �� , . . , � �` .A
V `:
� . . � . - Phone: _ _ , . � . �\
� � - 2ip: 94137 ' - � ' ,`' .
Contrector. �NOWARD BUILDING CORPORATION � � � � , �
Address:. 3184AIRWAYAVE - � � �
! '
- , Phone:. (714) 438-2272 ' -
COSTA MESA, CA ' � , � - � .
� Zip: 92626." License: 445804 � ' - �
� Arch : � - - � Eng: �
Address: � , , ,' - � Addiess: �
, � � Phone: , � . Phone: �
Zip: � License: � License:
SCOPE OF PERMIT
` INTERIOR OFFICE T.I. FOR'EPOCH INTERNET' (2ND FLOOR). ADD NEW PARTITION WALL TO CREATE NEW OFFICE
AREA. � - ' - - - - � � � .
FEE SUMMARY
Plan Check: $54.11 '' � Calc Valuation: 52.si2.so
Permit: $83.25 Claim Valuation: Ez,5oo.00
SMIP Res: $0.00 � ��� �
SMIP Com: $0.55
Other: $0.00
Inspection: . $0.00
Total: . $137.91
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Fiont 0- 0 Rear 0- 0 �eft 0- 0 Right 0- 0
ACCESSORY Front � 0. 0 , Rear 0. 0 LeH 0- 0 � Right 0- 0-,
PARKING Existing: �� 0 Reauired: 0 Proposed: 0 � �
NOTES: � ' ..
NO710E: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomfa statutes and related
regulations. (Orcl. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall eutomatically expire and become vold if work Is not commenced withln 780 days, or if work is suspended or ebandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vrith all epplicable codes, and all
required Inapeetione entl final approval must be obtainad. Failure to obtain inspeclions and final approval will result In the ezpiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5626 /
xaa.e �e�oo� v
WOHKERS'COMPENSATON DECLARATION:
I hera ettirtn under penelry oi perjury one of t�e following CeUareUore:
� I heve entl wlll meintaln e ceNticate ot consent to self-Insure for workers' compensatlon, az proNtled for by sectlon 3700 of t�e Lahor Code, for the pertarmance of Ne
woAc for which ihis pertNt Is issued.
❑ 1 heve entl will meinialn woAcers' wn{�eruetbn i2wrence. es raquireE Dy secllon 3700 of Ihe leUor Code, far tha perfortnance oi the wwk for wh�h Ws pertNt is LaweO.
M w Brs' com n tlon Insu riCe cel en�l numbef efB:
Certier.Y �j3�rVZY�� V.) ev��.J-v�fS1� PolicyNumber. �7(7O �I7O �
(Thls sec� need rrof be awnpleted I! N rMt Is, lu a� . e hwMred ddlars (5700) or less.)
❑ I certify Ihat in Iha
�rompty.wflh ihese d
Applicant Slpneture:-=
WARNINO: FAILURE TO SEC
TLqUSAND DOUARE (5100.1
IICENSEDCOHTRACTORS
I hereby eMirm Ihet I em Ilcene
torce and eflect. LJc. p�
t�e
noomor�
CONSTRUCTION LENDQIG AGENCY:
�hich fi�.4 permit l9 issued, I shall not employ eny person In any mennar so as to become sub�ect ro Ihe workers'
if I Ou4 e sub ect to t�e workers' campensation provislons ot Sectlon 3700 ot t�e LeCor Code, I ahell forthwlth
�,Dete:. ��� �� �
XJ ODVEMOE IS UMAWM AND SNALL SU6IECT Ml EMPLOVEA TO CRIMINAL PENALTES M!D CML FW ES UP TOONE NUNDRED
OF COMVENSATION, OAMAGES AS PROVIDED FOR IN SECiION 3]OB OF THE IPBOR COOE. INTEREST, PND �TTORNEYS FEES.
with Sectlon 7000) ot Dlvision 3 01 the Buslness end Pratesslons Code, end my Ilcense Is In tull
_ Class q � _
❑ I hereby eNirm Ihet Ihere is e construcilon Iending egency for Ihe pertortnanCe ol the work for whic� ihis Oermlt Is issued. (Sec. 3097, Civll Cotle).
Lendels Neme: LenAer's AAtlress:
Signeture:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby ettlrtn Ihet under penelry of perJury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Buslness entl Professlons
Cade: Any ciry or counry w�lc� requlres a permit to construct, elter, Improve, tlemolish, or repalr any sWcture, prior ta its issuence, elso requlres Iha flppllcenl br euch pertnit
to Ole e slpned slatement t�at he or she Is Iicensetl pumuam to the provislons of ihe Comrecrors License lew (Chapter 9(cammencing with Seclion 7000) ol DlNslon 3 of the
Business entl Professions Code) or Ihet he or she is eaempt iherefrom and the basis for the elleged ezemption. Any vloletion of Sectlon 7031.5 by eny eppllcant for e perm�'
subjects the appllcant to e civil Denelry ol not more than flve hunOretl tlollars ($500).):
❑ I, as owner of t�e property, or my employees with weges es their sole compensation, WILL DO 7HE WORK, end ihe siructure Is not IntenOed or oXered lar sale (Sec.
7044, Business enC Profeubns Cade: The Contrectors License Lew does not epply lo en awner of Droperty who builds or impraves ihereon, antl who does such work
hlmself or herself or through his or her own employees, pravided that such improvements are not intentletl or oHeretl for sale. If, however, the building or Improvement is
solC within one year ol completion, the owner-builder will heve iha burden al proving that he ar she did not builtl or improve for purpose at sele.).
0 I, as owner of Ihe property, am E7(CLUSIVEIV CONTRACTING WRH LICENSED CONTRACTORS to canstruct the project (Sec. 7046, Business end Prolessions
Code: The wntractars License Lew tloes not appty to en owner oi property who �uilOs or improves thereon, and who contracis for such pro�ect with a contrector(s)
license pursuant ta Ihe Cantrectors License Laws.).
❑ I am exempt undar sec. Business end Professions Code for ihis reason:
Signature: Date:
Owner ID verilied by drivefs Iicensa. ❑ Yes ❑ No Drivers Licensa No.
vedrwnon or ownersnip by (rype or aocumen�, �.e. - property �e�c om or aeea):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFlCA710N:
❑ I here0y cerlify lhet no excavation Me (5j or more teet In depth into which e person is required to descend, wlll be mede In connedlon wllh work euthoAzed Dy NL5
permlt, antl thet no building strunure, scaflolding, felsewoAc, or tlemoli�ion or tlismantling Ihereol, will De more ihen thirly�si: (38) teet �ig�. (CheD� 32, Grp 2, An 2, Sec.
341, Tille 8, Califomla AOminlstretive Cotle).
❑ As owner-bulltler, I will not employ enyone to do vrork whiU wauld require e pertnit from Ihe Divisian of IntlusMel Setery, es noteG ebove, unless such person has e
pertnit lo do such work Irom t�e divlsion.
Slgnature: Da�e:
Divislon o1 Industrial Setery Parmit Number.
CERTIFlCATE OF COMPLI AND AIlTMORQATON OF EMAV: I certiry under penalry of perjury that I have read Ihis aDPliwtion antl stete Ihat t�e infoimation gNen is
conect. I egree to wmp t� e I stete laws and ciry-ordinances releting to bullAing consiruction, end euthodze representatives ot Ihe Ciry ot Costa Mesa to enter upon Ihe
ebove-described pro tor Inspec� purpose�!(egree not to occupy or allow occupanry ol eny building euthonzed Dy Ihis pertnit until fnal inspectbn.
COOE�• INSVECTIONTYPE �
7616 Fi:etl System Final Fire Preventlon
1286
200
201
202
203
204
Pool Spe Final
Finel Re-Root
Finel BIocWRetelning Well
Finel Fectory Fire Place
Finel Sign
Finel Demolition
Peie Il�e�a
9-� -ol
' J Date—.,
COOE� MSPECTIONTYPE
206 Final Mechanlcel
20B Flnal Plumbing
210 Flnal Eleclricel
212 Finel Flre Prevention
220 Final Plannlnp Approvel
222 Final Site
250 Final BulltlinglOccupenc
PAffi It�LB
0
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: SS5 ANTON BL
Suite: 2
Vicinity: NEW OFFICE ON 2ND FLOOR
Parcel Number: 41050110 Zoning:
Appliwnt: SMITH, DON
Address: 3784 AIRWAY AVE " � . � " - � - , � �
, � � �,; - . Phone: (714) 438-2272 - . -
COSTA MESA; CA �- - � Zip: 92626 ,
�
„
Owner. SAKI�OKA.FARMS ` " �
, .
Address , . � . - . - ' --
. " �. _ Phone: � � �
, ' . . , - . Zip: 94137 � .-
Contractoc HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY"AVE
� �� Phone: (714)438-2272
COSTA MESA, CA '
Zip: 92626� License: 445864
Arch : � , - Eng:
Address: , � � Address:
_ . . � � . Phone:
Zip: � � License:
� ' 238 S� Ff INTERIOR OFFICE T.I. FOR "EPOCH �INTE
OFFICE: - � � �
, Plan Check: $108.71
Permit: $167.25
SMIP Res: $0.00
SMIP Com: $1.71
Other: $0.00
Inspection:: $0.00
Total: $277.67
Status: ISSUED
Applied: 08/16I2001
Issued: 08I20I2001
ISSUED BY: '
Phone: .
License:
E OF PERMIT
(2ND FLOOR). ADD PARTIT�ON WALLS TO CREATE NEW
� � � FEE SUMMARY
. �.
SETBACKS,
MAIN STRUCTURE Front �" 0-0 -- Rear 0-0
ACCESSORY Froni ��0. 0� Rear 0. 0
PARKING Exlstina: � 0 � Reauired: 0
NOTES: �
Calc Valuation:
Claim Valuation:
PLANNING & ZONING
Lek 0- 0 . Right� 0- 0
� ,
Lek 0-0 � . Right 0-0'- i'
� i i � .
� , Proposed: 0 � -
E8,151.00 �
S7,Eoo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
ragulations. (Ord. No. 92-28, § 1, 12•21•92)
E%PIRATION: This permit shall eutomatically 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 �egal, such work must comply vnth all applicable codes, and all
requlred Inspeetlons and tinal approval must be obtained. Failure to obtain inspactions end final approval will result in the expiretlon of thia permit.
FOR INSPECTIONS CALL: (714) 754-5626
iaac-ae larool
WORKERS' COMPENSATION DECLARATION: -
I hereDy ettirtn under penelry af perjury one of the tollowing tlecleretions:
❑ I heve antl wlll meintaln e cartlficate of wnsent to selt-Insure tor workers' compensetlon, es pmvidetl for by sectlon 3700 0l lhe Lebor Code, (or lhe pertormance ot the
work for which tfiis pertnit is issued.
.
❑ I have a II maintain wwkers' compensatlon insurance, as requiretl by sectlon 3700 of Iha Lebor Code, foi Ne peAortnance of Ne woAc for wh�h this pertnit Is Lssuetl.
My wo e/�° mpe wn Insurence carder and policy number are: /.� 7
Carner. LF/iz� /iT� // PolicyNumber. �C/d ��/O z
(Thls sectlon need not be comp/eted il fh rm' s lu d ef u9dred dW/ars ($100) or less.)
❑ I certity t�at in the peAorma oi ti
crompensetlon I s of C' mla,
cromplywitht�e .
Applicent Signeture:
WARNINO: FAILURE TO S URE WORK
TVIOUSrWDWLURE(St ,OOO�.INAODfTION
LICENSED CONTRACTORS DECIARATION:
I hereby eHlrtn that I am
torce end eMect. Llc. M_
Contredors Signeture:
CONSTRUCTION LENDING
Kic i grtnit is issued, I shell not employ eny Dereon in eny mennar so es to became subject ro t�e workers'
emesuh�ep to t�e warkers' compensellon proNslons of Sectlon 3700 f the bor Code, I shell fonhwith
oa�a: g lZa� � 1
iN COVERAOE IS UNIAWFUL M'D SHMI. SUBIECT AN EMPLOVEF TO CFIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
OF COMPENSATION, DANAGES PS PROVIDED WR IN SECTION 3]080F THE LABOR CODE.IMEREST, pND ATTORNEV'S FEES.
with Section 7000) ol Divislon 3 af the Busin¢scyntl Prolessions Cotle, and my Ilcense Is In full
CIa59 M .C�
J Dete: /
❑ I hereby eNirtn thel lhere is a consiruction lending egency for Ihe peAortnence ot the wark lor w�ich thls permil is issuad. (Sec. 3097, Civil CoOe).
Lendels Neme: LenCefs Aatlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettlrm ihet under penalry of perjury thet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the tollawing reason (Sec. 7031.5, 8uslness flnd Protessions
Code: Any ciry or counry whic� requires e pertnit lo construct, elter, Improve, demolish, or repair any structure, prior to its issuence, also requlres Iha flpplicant for such pertnit
to flle a slgned sletement thet he or she Is Iicensed pursuent to the pmvislons of ihe Contrectore License Lew (Chepter 9(commencing with SecUon 7000) af DlNsion 3 of the
Business and Profeuions Gode) or that he or she is exempt thereirom and the basis for ihe allegetl exemptlon. Any violallon oi Section 7031.5 by any epplicant tor a perm�'
sub�ecis tha appllcant to e civil penalry of not more than fve huntlred dollars ($500).): �
❑ I, as owner af the property, or my employees with wages es their sole campensetlon, WILL DO 7HE WORK, end ihe structure is not intended or aHered tor sale (Sec.
7044. Business end Professions Cotle: Ttie Contrectors License Law does not apD�Y �o en owner of property who builds or improves ihereon, flnd who does such work
himself or herself or lhrough his or her own employees, provltled thet such Improvements ere not intentled or oNeretl for sale. If, however, ihe bullding or Improvement is
sold within one year of completion, the owner-builder will have the burtlen of proving that he or she did not build or improve for purpose oi sale.).
❑ I, as owner ot lhe property, am EXCLUSIVELV CONTRALTING WITH LICENSED CONTRACTORS to consiruct ihe prolect (Sec. 7044, Business antl Protessions
Code: The contrectors Llcense Lew tloes nol apply to an owner ol pmperty who builds or Improves thereon, antl who contrects for such prolect with e coniractor(s)
license pursuant to the Contractors License Wws.).
❑ I am exempt under sec. Business and Pmfessions Code for ihis reason:
Signeture: Date:
Owner ID verified by drivefs license. ❑ Yes ❑ No Drivets License No. Expires:
Vedficatlon of Ownership by (type of tlacument, i.e. - pmperry tez bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION:
❑ I hereby ce�ily ihei no excavellon five (5) or more feet in tlepth into which e person is required to descend wlll be matle In connectlon wllh work euthonzetl by this
perml6 antl Ihet no building 51rucWre, scattolding, lalsework, or demolilion or dismentling �hereol, wiil be more ihen thirry-si: (36) feet hig�. (Chap. 32, Gry 2, Art 2, Sec.
341, Tllla 8, California Aaministretive Code).
❑ As owner-builder, I will not employ enyone to do work w�ich waultl require e pertnit Irom the Divislon ol Intlustrlal Sefery, as noted ebove, unless such person hes e
permit to da such work irom the division.
SignaNre: Date:
Divislon of Intlustnel Safery Permit Number:
CERTIFlCATE OF COMPLIANCE AND TON OF ENTAY: I cenify under penalry ot perjury that I heve read Ihis application and state t�at �ha iniortnation given is
correcc I egree to comply with ell s lews end ortlin ting to building conslruction, end authodze representatives of Me City ol Coste Mesa to enter upon Ihe
ebove-descn6ed property for in ction pu . I§qr not ta accupy or ellow occupancy ot any Duilding euthonzed by this pertnil until linal insDection.
COOE I.
1676
1286
200
201
202
203
Fixed System Final Fire PrevenNon
Paol Spa Final
Final Re-Root
Finel BIocWRetelning Well
Finel Fadory Fire Pleca
Finel Sign
204 Final Demolilion
� �/0 / Date
� Date
COOEI MSPECTIONTYFE
206 Final Mechanical
20B Final Plumbing
210 Flnal Elecidcel
212 Final Fire Prevention
220 Final Plenning Appraval
222 Final Slte
250 Final Building�Occupancy
PdIE 1t�L$
(714) 754-5273 • Faz (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Jobnddress: 555 ANTON BL � Status: ISSUED
Suite No 2 Applied� 08116/2001
Vicinity: 2ND FLOOR Issued: 08I20I2007
Parcel Nunmber:
41050110
Applicant: SMITH, DON
Addreas: 3184 AIRWAY AVE _ � -
, �� `�� - Phone: (714) 438-2272
COSTA MESA; CA, - .. � � , Zip: 92626
�� �� �- ' _ �. ' .
Owner. �'SAKIOKA�FARMS -
Address - � - .
Phone:
Zip: 94137
Contracmr. HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE ' � `
COSTA,MESA, CA
.Phone: (714) 438-2272
Zip: 92626 ,
License: 445804
ISSUED BY: I '
/ '
/ `�
�
/ _ � �\
\ �
, �
SCOPE OF PERMIT
ELECTRICAL PERMIT�FOft INTERIOR OFFICE T.I. FOR'.EPOCH INTERNET' (2ND FLOOR). INSTALI
2 RECEPTACLE OUTLETS & 1 COMMUNICATION DROP. - �'
REF:B01-01282
ISSUE FEE
Temp service rest
Res. a/c package
New Res (1-2 units)
New Res,(3+units)
Pool I Spa
Lighting Flxts -
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a `
Service to t000a ��
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors to 50hp
Motors l0 100hp
Motors over 700hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Si9n Circuits
Temp Pwr Pole
Intermed Pole
�uantity
523.50
50.00
so.00
$0.00 0
50.00 0
50.00 0
50.00� �� -0
$220 2
30.00 ' 0
$0.00 0
30.00 . 0
50.00 0
� 50.00 ' ' � 0� -
� 50.00 �� � �� 0
�'-SD.00- � 0 �
60.00 0
50.00 '��, ... 0
50.00 0
50.00 0
57.00 1
50.00 0
50.00 0
50.00 0
50.00 0
50.00 0
FEE SUMMARY„
�uantity
Temp Dist System / Lighting $0.00 0
Busway /100 ft $0.00 0 � �
. Standing Section 50.00 0 �
� Misc Electrical Equipment $0.00 " � 0 �
Transformers up�to 1 kva/kw 50.00 - 0
................up to 10 kva/kw . 50.00 0
.................up to 50 kva/kw 50.00 0
� .................up to 100 kva/kw 50.00 0
..................over 100 kva/kw 50.00 0
Low Volta9e Equipment 50.00 0
Low Volt Wiring System I Ckt 50.00 0 ,
Misa Conduit 50.00 ' , 0 '
Misa Conductor - . � �' �50.00 ��.0 �
Circus ( gen ar ride) ' 50.00 i i0
Circus (mech ride�or lights) _ 50.00 %� 0
ChristmasTreeStand'� --$0.00 0
�� � - � Fireworks Stand , ; � 50.00 0
Other Electrical Fee ' 50.00
- Investigation Fee 50.00
Plan Check Fee $0.00
Reinspection Fee 50.00
TOTAL CALCULATED FEES 526.70
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicab�e handicap access requirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § 7, 12-27-92)
EXPIRA710N: This pertnit shall automaticelly explre and become voitl it work is not commenced within 180 days, or if work is suspended or abandoned
tor a pedotl of 180 tlays. -
INSPECTIONS: In order for th0 wofk aut�orizetl under I�is permit to be considered legal, suc� work mus� comply with ell epplicable codes, and ell
requlred inepectlona end finel epprovel must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5628
zaawe �aroo�
WORKERS'COMPENSAnON DECLARATON:
I hereby eHirm untler penalry of perjury one of t�e lollowing daGeretions: '
❑ I heve end will maintain e certificate of consent to setl-Insure for workers' compensatlon, es prodded tor by sectlon 3700 of the Lebor CaEe, for the pedormence o1 the
work tor which this pertnit is Issued.
❑ I heve arq wil iaintain wo cers' oompensetbn Inwrariw. es requiretl Dy secllon 3700 ot Ne Lebor Cotle, for Ne pe�tortnence of the work for whidi Ws pertNt Lv Iswetl.
My workers' mpensatio Insurence carrier end policy number are:
Cartier. Gv1^ i Policy Number: ���%/J �I � O z_
(Th/5 sectlon nee nof be complefed 1! fhQ eimit ls velue9Et m untl tl tld/eis (5700) or IessJ
/ /
❑ I ceritly (�e� In Ne pertormance fl� �he work tA�'/Nc� Ihi Issued, l ahall not employ eny person in eny menner ao es lo become suD�ect to Ue workers'
ApPlicent Sipneture: �
WARNINO: FAILURE TO SECUF
THOUSAND OOLLARE (E100,0(�
LICENSEDCONTRACTORS
I hereby eMirm Ihet 1 em Iicen:
rorce end enect. LJc. a�
Contrectofs Signeture: _
IN ADDRION [O THE WST
e workera' compensatlon pravisions of Section 3700 1 the Lebor Cotle, I shell IOMwiN
oa�a: �IZ�O �
IS UNUW FUL M1D SHALL SUBJECT AN EMPLOYER TO CRIMINAl. PENALTIE AND GVIL FlNES UP TO ONE HUNDRED
\TION, DAh41�ES AS PFOVIDED FOR IN SECTIIXJ 3]OB OF THE UBOR CODE, IMEREST, AND FTTORNEV'S CEES.
with Section 7000) ol DMsion 3 of Ihe Businesa entl Professians CoGe, end my Iicense is In full
_ Cless p � i
Date: r' ��I D t�
CONSTRUCTON LENDING AGENCY: �
❑ I hereby eHirm thet Ihare is e construMion Iending epenry for Ihe peAormence oi t�e work for which Ihis pertnit is issuetl. (Sec. 3097, Civll Code).
Lendels Neme: Lenders Address:
Slgneture: Date:
OWNER•BUILDER DECLARATIONS:
I hereby eNlrtn Ihet untler penelry ol per�ury Ihet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for t�e following reeson (Sec. 7031.5, Busineu flnd Protesslons
Code: My dry or counry which requires e pertnit ro mnstruct, alter, imprwe, demdis�, or repelr eny strucWre, pdor to 14q Issuance, also requlres Iha flpplkant for such peimit
to file e signetl stetement thet he or she Lv Ilcensed Dursuant to the provislons at the Cantrectore Ucense Lew (Chepter 9(commencing wlth Seclion 7000) ai DlNslon 3 01 Ihe
Business entl Professlons Catle) or that he or she is ezempt Iherefrwn arM itie besls br the ellepetl eaemption. Any Ndatbn ai Sectlon 7031.5 by any applkant for e pert .W.
subJects the epplicant to e civil penalry oi not more than live hundred dollars (SSW).):
❑ I, as owner of tha property, or my employees with weges es their sola compensatlon, WIL� DO THE WORK, entl the slrucWre is not intentletl or oflered lar sele (Sec.
7044, Business and Professions Code: The Contractors Licensa Law does not apply to an owner of property who builds or improves thereon, antl who does such work
hlmselt or herself or Ihrough his or her own employees, providad Ihat such improvements are not Intended ar otteretl far sflle. It, however, the hullCing or Improvement is
sold within one year of completion, t�e owner-builder will have ihe burden of proving that ha or she did not build or improva for purpose of sale.).
❑ I, as owner ot the property, em E%CLUSIVELY CONTRACTING W17H LICENSED CONTAACTORS to construct Ihe O�o�ect (Sec. 7044, Business entl Professions
Cotle: Tha conirectors License Lew does not appty to an owner ol property who bulltls or Improves ihereon, end who wntrecis tor such projed wlth e conirectar(s)
license pursuent to t�e Contrectors License LewsJ.
❑ I em exampt under sec. Business entl Professions Code lor this reason:
Signature: Date:
Owner ID verllletl by tlrivers licensa. ❑ Ves ❑ No Drlvefe LltenSe No. Expire5;
Vedticetlon o1 Ownars�ip Dy (rype at document, i.e. - properry tex 6ill or deetl):
DIVISION OF INDUSTRIAL SAFE7Y VERMR CER7IFICATON:
❑ 1 �ereDy ceNiy Nat no exwvetlon tNe (5) or more feet in tlepi� into which e person Is required to descen4 wlll be made in wnnectlon wlth work eulhoAzed Ey Ihb
permlL antl that no building strudure, sceMolding, talsework, or tlemolition or tllsmentlinp thereof, will be more then ihirry-six (36) feet high. (Chap. 3.2, Grp 2. Art 2, Sec.
341, Title 8, Calllamla AtlmlNsiretNe Code).
❑ As ownervbulltler, t will not employ enyone ro tla wark which vrould require e permit trom ihe �Ivislon ol Industdel Sefety, es noted ebove, unless such person hes e
pertnit to tlo suc� work irom Ne tliWsion.
SlgneWre: Date:
Dlvlsion of Industnel Satery Pertnit Number:
WIII t�e eppllcant or present or future bullding accupent need to tile end certlty e Buslness Plen tor emergency response b release or threatenetl releese of e hazartlous
meter1e11 ❑ Yes ❑ No
(Sectian 25505 01 Ne Celifomia HeaIN en0 Selery CoOe reQuires, wlih some exceptions, t�at e Busineu Plan be liled with the Costa Mesa Fira Department by every
Duslness which hes et any one time during e reported year e quantiry of hezerdous mateAsls equal to or greeter t�an e weiphl 01500 pountls, or e volume ot 55 gallons,
or 200 cubic teet of compresseC ges et stantlard temperature antl pressure).
.................__.........................._'_".............................................."'__'............._...._.._............................................................................................................................"".................... ...............__............_......
Daes or wlll Ihe epplicant or present or future builGing occupent need to file e registretlon Iwm lor aately hezerdous matedals? ❑ Ves ❑ No
(Section 25533 of the Celltomia Health entl Setery Catle, with same e:ceptiona, requlres reglstratlan with the Costa Mese Flre Deparimenl by each business w�lch et eny
one Iime hes on hend e quantiry ot ecutety he�rtlaxa meteriels equal to ar preeter Ihen e weigM ol 500 pounCs, or e vdume oi 55 gallons, or 200 cubic teet of
compressetl ges et stendard tempereWre end pressure).
............................................................................................................_..............................__.............................................................................................................................................._.................._.............._............�........
Does or will the applicant or p�esent or tuture bulltling occupani neeC lo O�epare en RMPP (Risk Management end Preventlon Program for acutely hasertlous matedals)9
❑ Ves ❑ No
(Sedlon 25534 ot ihe Califomia Health end Satery Code provides ihat the Caste Mesa Fire Depertment may require Ihe pre0aration, certification end Iiling with Ihe Flre
DeoaRment oi an RMPP by businesses which ere required b register acutely haeardous metedels with the Flre Departmem.
u en nrnrr is presentry reqmrea, nes secnon zoaw o� me cauromia neenn ena �arery coae oeen rmry compnea wi
—.......'_"..._._._. _.._ ..............___......................
Does or wlll ihe applicanl or present or fuNre building occupent reqWre tor lhe work which is the sub�act oi thls e p
fmm Ihe South Coast Alr Ouellry Manegemem Distnd or Iran eny oNer eir polWom m�trd tlistdct ar agency7 �'
(Sectlon 658502 oi Ne Celifomia Gwemment Code requires that the requesied informatlon be fumishetl on epplica
..................__....................'_ """'_ _ ...._—.—..................'__'
WIII any pert af Ne faUliry lo be consiructetl unAer Ihis pertnit be within t0001eei trom Ihe outer haundanes ot e sch�
(II yes', the feciliry must meet the reQuirement of Sections 25534 anC 42303 0l ihe Celifomia Heal�h and Safery Cod
"'__""_'__.._ .....'_—..._ ............._._......._.
tl a pertnit from Ihe South Coast Air Ouelity Manegement Distdct or ather eir pollulion control tlistrict or egency
aoolication. �eve ell 01 the disclosuras orescribed by Califomia HeeIN enC Safery Cotle Sedlon 42303 been matle7
�J No
lor non-resitlential
�G
or
CERTIFICATE OF COMPLIANCE: I cartiy thet untler penalry ot perjury ihe informetlon given above is correct. I egree to comply with ell state laws end ciry ordinances
regertling Hazartlous Matanals and Emissions.
Slgneture: Dete:
CEH7IFlCATE OF COMPLIANCE AN OHQATO F EMR . I certiy untler penelry ol perjury that I have read this apD���etion anG state that Ne infortnation given b
correcL I egree to wmply with ell te laws end orAlnances lating to 6uildin� �cronstructlon, end euthorize represantetives of the Ciry ol Cas�a Mesa to enter upon the
eDove-descnbed properry br in ection pu �. e8ree not to ar ellow ocwpenty-�f�srrytwiltling euthodzed by Ihis pertnit uNil linel Inspection.
CODE �, INSPECfIONTYPE Q�¢ �
7618 Fixed System Finel Fire Prevenilon
1288
200
201
202
203
2oa
Pool SDe Finel
Finel Re-Roo1
Flnel Block/Retaininp weil
Flnal Fectory Fire Place
Finel Sign
Finel Demolilion
� �� � �ate
�, oe,a
COUEI INSPECTIONTYVE j1dj� ��$
206 Final Mechenical
208 Finel Plumbing �
21d Finel Electdcal � � O ^
212 Finel Fire Preventlon
220 Flnal Planning Approval
222 Final Site
250 FinalBullding�Occupency
(714) 754-5273 • Fax (714)
,. ':
r-.
CITY OF COSTA MESA ' ��
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
' BUILDING PERMIT
'� �s_,
�'7ib Address: 555 ANTON BL
�� Suite: 2 .
Vicinity: SECOND FLOOR COMPUTER ROOM �
ParcelNumber ' 41050110� Zoning: �
Applicant: CANEZ, JAIME
Address:
, . .
� -Phone: 213-2193518
Zip:
PERMI� NUMBER
B00 t0022
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01/06/2000
Issued: Ot /21 /2000
Ownec SAKIOKA FARMS � _
Address - � , � � / � _ _ � , ' -
.s���. . � .. , . . ,
'� � , . . , Phone: " , -
• " , . � � .' - Zip: 94137 � ,_ ' � .
Contrador: �,CORPORATE-BUILDERS INC. � � �
Address: 523 W. 6TH�ST. � �
� LOS,ANGELES, CA Phone;� (213) 689-0650
SUITE 815
� Zip: 90014-1222 License: 699620 . ,
Arch : -IA � � - � �` � � - Eng:
Atldress: 3080�BRISTOLST�. '� �'�. �`�" .' Address: �
� COSTA MESA, CA -� Phone: (714) 754-1197 Phone:
� SUITE 105 ; .. � . � ' � -
' , , Zip: 92626 � " .- �License: � License: ,
. _ ` . ��,� , . ,
, , - . � SCOPE ORPERMIT- .
- ,� 4,900 SF TI FOR THE COMPUTER�ROOM.ON THE §ECOND FLOOR FOR "EPOCH INTERNET".
� Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other.
Inspection:
Total:
$43.10
$265.25
$0.00
$329
$0.00
$0.00
$311.64
SETBACKS ,
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existin : 0
NOTES:
FEE SUMMARY ;.
�. - - — `'' �
„ ,.,, . - , .
r _ %' `.
. �
Rear , 0- 0
Rear 0- 0
Required:. 0
_'
Calc Valuation:
Claim Valuation:
PLANNING & ZONING ,
Left 0- 0 Right
Left 0- 0 Right
� Proposed: 0
GS�;
$15,675.00
$�s,000.00
NO710E: The work authorized by this permit shall comply with all applicabla 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.
INSPEC710N5: In order for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all
required inapectlona and final approvel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION: .
I hereby afNrtn under penatty of perjury one of Ihe following declara(ions:
❑ � have antl will maintain a certificate of consent to self-Insure for workers' compensation, as provitled for by section 3700 of the Labor Cotle, for iha Oedormance of the
work for whic� Ihis pertnit is issuad.
I hava and will maintain workers' comp nsation insurance, as required by section 3700 of the Labor Code, tor the pedormance of ihe work for which ihis pertni� is issuetl.
My workers' compens tion Insurence rner policy numher ere:
Carrier �� Policy Number:
(This section need not be campleted it th e it is velued at one huntlred dollars ($100) or less J
❑ I certiry lhat in e pertorn ance of th work for which Ihis permit is issued, I shall not employ any person in any menner so as Io become subject to ihe workers'
WARNING:
� laws of Cal' ornia, and agree t a I should become suhject to ihe workere' compensation provisions oi Section 3700 oi the Labor Cotla, I shall forihwith
hese rovis a� Date: I/� i l� CJ U U
__T �
TOS REWOFKERS'WMPENSATIONCpVEFiAGEiSUNLAWFULAND$HALLSUBJEGTANEMPLOVERTOCRIMINALPENALTIESAN�CIVILPWESUPTOONEHUNDREO
E ,OOO�,INADDITIONTOTHECOSTOFCOMPENSATION,OAMAGESASPfiOVIDEDFORINSECTION3]tl60FTHELABORfADE,IMEREST,ANOATTORNEY'SFEES.
LICENSED CON7R�
I herehy attirm that I
force and effect. Lic.
❑ I hereb�.a
Lentlers Name:
Siqnature: _
9(commencing with Section 7000) ot Division 3 ot the Business �o�Brofessions Coda, and my license is in tull
da _. i__. ._ ClassM_ 1L� . ,
ING AGENCY:
there is a construction lending agericy tor the performence of the work tor which this permit is issued. (Sec. 3097, CiWI Code).
Lender'S Atltlress:
Date:
OWN�q-BUILDER DECLARATONS;
I hereby aHirtn Ihat untler penalry of perlury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or counry which requires a pertnit b consiruct, altar, improve, demolish, or repair any strucNre, pdor to its issuance, also requires Ihe applicant for such permit
to tile 8 signed statement ihat he or she is licensed pursuaN to the provisions of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business antl Professions Cotle) or ihat he or she is exempt therefrom and Ihe hasis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
sub�ec�s the epplicant to a civil penalry ot not more than five huntlred dollars ($500).):
❑ I, as owner of the property, or my employees with weges as their sole compensation, WILL DO THE WORK, and the stmcture i5 not intended or oHered tor sala (Sec.
�044, Business and Professions Code: The Contracbrs License Law does not apply to an owner oi property who Duilds or improves thereon, end who does such work
himself or herselt or through his or her own employees, providad that such improvements are not intended or oNeretl for sale. If, however, the huiltling or improvement is
sold within one year of completion, ihe owner-builder will have ihe burden of proving that he or she did not builtl or improve for purpose ot sale.).
❑ I, as owner ot the property, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to consiruct the pmject (Sec. 7044, Business antl Pmfessions
Code: The conVactors License Law tloes not appiy to en owner of propetly who huilds or improves thereon, antl who conirects for such project with a coniractor(s)
license pursuant to the Contractors License Lews.).
❑ I am exempt untler sec. Business antl Professions Code for Ihis reason:
SignatUre: Data:
Owner ID veritietl by drivefs license. ❑ Yes ❑ No Driver's License No. Expires:
Veriticg�ion of Ownership by (type of tlocumem, i.e. - propeny tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION:
❑ I hereby certity that no excavation tive (5) or more teat in depih into which a person Is requiretl to descend, will 6e made in connection with work authorized by ihis
permit, entl Ihat no Duiltling siruciure, scaHolding, talsework, or demolition or dismantling thereot, will be more than thirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Titla B, Calitomia AOministretive Code).
❑ As owner-builde�, 1 will not employ anyone to do work which woultl require a petmil trwn ihe Division ot Intlustrial Safery, as rtoted above, unless such person has a
permit to tlo such work from the division.
Signa�ure:
Division ot Indusinal Satety Permit Number.
Da�e:
Will the applicant or present or tuture building occupant need to file antl cenity a Business Plan tor emergency response to release or threatened release of a hazartlous
matetlal? ❑ Ves ❑ No
(8ection 25505 ot ihe California Healih and Safety Code requires, with some ezceptions, that a Business Plan be tiletl with �he Costa Mesa Fire Department 6y every
6Usiness which has et any one time during a reported year a quantity of hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
Doas or will Ihe applicant or present or future builtling occupant need to file a registration form tor acuteiy hazardous materials? ❑ Yes ❑ No
(3ection 25533 of the Califomia Healih and Safety Code, with some exceptions, requires regisiration with the Costa Mesa Fire Depahment Dy each business which at any
one time has on hand a quamity of acutely haurdous matenals equel to or greater than a weight of 500 pountls, or a volume oi 55 gailons, or 200 cubic feet of
cbmpressed ges at standard temperature end pressure).
or wni Ine applicant or present or
(3ection 25534 of the California Health and Satery Cotle
Department of an RMPP by businesses which are require
"...""' "..... . "'........ ......
4 If an RMPP is oresenlW reouiretl, has Section 25534 oi iY
to prepare an
Ihat the Costa Mesa Fire Department may require tha preparation, certification antl filing with ihe Fire
ler awtety hazardous matenals with the Fire Departmeni.
. . ......... ............._ ' "'_'._....., .. __"_"
ia Healih and Safety Cotle been fully complied with? ❑ Yes ❑ No �� � �� �
5 upas or will ine appiicant or present or tuWre bulltling occupent raquire for ine work wmcn rs me sut�ect or tms a piicabon a germrt tor sucn consmction or moonicatbn
trom the South Coast Air Qualiry Management District or from any other eir pollNion coNrol district or agency? � Yes L,I No
(Section 65HSo2 ot i�e Catifomia Govemment Cotle requires Nat tha requestetl intormeNon be tumished on applications for non-residantial builtling pertnits).
"""—""""_""'""""_"".._____ """""_'""""""_""___"_`"'"""""""""""__'"'"'"'""""'"_—"_'"""""""..."_'_`"_"'—
6 Will any part of the facility to 6e constmcted under this permlt be within 1000 feet from tha outar boundaries of a school9 ❑ Ves ❑ No
pi yes", the faciliry must meet tha requirement of Sections 25534 antl 42303 ot the Calitomia Health and Satery Code).
.. ..............._..__.._.........._...____..__._..____ __
7 If a permit from the South Goast Air Oualiry Manegement Disirict or o�her air polWtion control tlistrict or agency is required tor the work which is ihe subject of ihis
application, hava all of the tlisclosures prescribed by Califomia Health and Safary Code Section 42303 been matle? ❑ Ves ❑ No
8 (1i "yes", attach cetlificate of complia�e lrom the appiopnate air pollution contrW oHicer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury Ihe intormation given above is correct. I agree to comply with all state laws and city ordinances
regartling Hazartlous Materials end Emissions.
SignaWre: Dete:
>F�OMPtIANCE AND AU7HORIZATION OF EMRY: 1 certify under penalty of pe�jury ihai 1 have read this applicatiort and siata that ihe information given is
to omply with all state laws and ciry ortlinances relating to huiltling consiruction, and authonze representatives of the City of Costa Mesa to enter upon the
1 p operty for inspection purposes. I egree not to occupy or allow occupancy of any builtling authonzed by this permit until ilnal inspection.
�OG�F_M, INSPECTIONTYVE
1616 Fixad System Final Fire Prevention
7266 Pool Spa Final
200 Final Re-Roof
201 Final BlaWqetaining Wall
202 Final Factory Fire Piace
203 Finaf Sign
204 Final Demoli(ion
2646-4fi
pATE
INTITIA 4QIj�N INSPECTIONTYPE
206 Final Mechanical
208 Finaf Plumbing
210 Final Electrical
212
220
222
250
�" '
/ /1� �
Final Fire Prevention
Final Planning Approval
Final Site
Final BuildingiOccupancy
D�fj� INTITIFLS
pia� �sa-sz�s • Fex (�ia) �sa-aess
Job Address:
Suite No
Vicinity:
��
555 ANTON BL
2
COMPUTER ROOM
Parcel Number: 41050110
CITY OF COSTA MESA
BUILD/NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
App�icant: LOU RODRIGUEZ
Address: 6265 SAN FERNANDO RD
GLENDALE,-CA
owner: SAKIOKA FARMS
Addresa:. � - �
MECHANICAL PERMIT
Phone: (818) 244-6577
� ' Zip: 91201
Phone:
Zip: 94737
Contractor: AIR CONDITIONING CO., INC
Address: 6265 SAN FERNANDO RD
GLENDALE,CA � �
Arch ! Eng : �
Address: , - ��
� . �
� . Phone: (818) 244-6571
. � Zip: 91201
License: 120696
Phone:
Zip:
License:
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/26/2000
Issued: 01/26/2000
ISSUED BY: ��
SCOPE OF PERMIT
' INSTALL 1 VAV BOX , 1 REPAIRIALT COOLING/HTG SYSTEM AND 1 UPTO 15 HP COMPRESSOR
FOR "EPOCH INTERNET" COMPUTER ROOM TI. � � ' , , _ - �� '
�
�
REF:B00-00022 ' - � - ' - , � ,�
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU �
Repair/Alt Cooling/Heat
Inst I Rep. Recess Wall Htr
Refrig Sys <100�k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlero < t0000cfm
$23.50
$0.00
$0.00
$13.70
50.00
50.00
$0.00
50.00
50.00
50.00
$10.65
50.00
50.00
$0.00
$0.00
50.00
50.00
Duantiry
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeralion Unit
Ventillation System
Evaporative Cooler
Commercial incinerator
Domestic Incinerator
Compressors / Absomtion Systems
Up to 3 hp I 100 k BTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
75 to 30 hp
30 to 50 hp
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0 .
$0.00 0
$0.00 0
$27.75 1
$0.00 0
$0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-20, § 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 poriod of 180 days.
INSPECTIONS: In order for ihe work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectlons antl flnel approvel mus� be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5628 ,
WORKERS' COMPENSATION DECLARATION: '
1 herehy attirtn under Denalty ot perjury one of the tollowing declarations:
❑ I heve and will maintain a cartificate of consent b self-Insure for workers' compensation, as provided tor by section 3700 oi ihe Labor Cotle, for the pedormance of Ihe
work for which this permit is issuetl. �
� I have and will maintain workers' compensation insurance, as required by section 3700 of lhe Labor Cade, far tha peAormance of the work tor which this permit is issued.
My workers' compensation Insurence wrtier antl policy number ere: p
Carner. �- �/1s'vl.F� Policy Number( '19770 G
(This section need no( be complefed il fhe peimi( is valued et one hundred dollers ($100J or less. J
❑ I wrtify Ihat in ihe peAormance of ihe work tor which this permi[ is issued, 1 shall not employ any Oerson in any manner so as to become subject to the workers'
compensation la Califomia, and agree that i! I should become subject to the workers' compensation provisions of Section 3700 of Ihe Labor Code, I shall forihwith
comply with ese pr i5iq�s.
Applicant Sig Wre: Date: � 2�.y.s �
WARNING FA URE SECURE WORKERS' IPENSATION CAV GE IS UNL4WFUL AN� SHALL SUBJECT AN EMPLOYEF TO CRIMINAL PENALTIES AND CIVII FINES UP TOONE HUNDRED
THOUSANDDOLLARE�510D,000),INqDDITIONTOTHECOSTOF NSATION,�AMAGESASPROVIDE�FORINSECTION31060FTHELABORCODE.INTEFEST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby attirtn that I am licensed under provisions of Chapter 9(wmmencing with Section 7000) of Division 3 of the Business and Pmfessions Cotle, antl my license is in full
force antl etfect. Lic. a____ i2 �/ rlL� Class p G' Z a
Coniracbr's Signature:
Data:
CONSTRUCTON LENDING AGENCY: �
❑ I hereby aHirm Ihat ihere is e constmdion lentling agency tor Ihe pedormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: Lenders Address:
Signature:
Date:
OWNER-BUILDER DECLARA710NS:
I herehy attirm ihat under penalty of perjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or counry which reQuires a pertnit to construct, alter, improve, demolish, or repair any sirucWre, prior ro its issuance, also requires the applicant tor such permit
to file e signetl statement thet he or she is licensed pursuant to ihe provisions ot ihe Coniractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 oi Ihe
Business antl Professions CodO) or tha[ he or she is axempt ihe�efrom and the basis for the alleged eaemption. Any violation oi Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty ot not more ihan five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and the structure is not intentled or oNared for sale (Sec.
7044, Business antl Professions Cotle: The Contreclors License Law does not apply to an owner of properry who builds or improves lhereon, and who does such work
himself or herseH or ihrough his or her own employees, provided that such improvements are not intended or oflered for sale. IF, however, the builtling or improvement is
soltl within one year of completion, ihe owner-builder will have ihe burden of proving Ihat he or she did not build or improve for purpose of sale.).
❑ I, as ownar of the propeqy, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conslmct ihe pmject (Sec. 7044, Business and Professions
Cotle: The con[rec[ors LiCense Law does nol apON �o an owner of pro0erty who builds or improves thereon, and who contracts tor such pmject wilh a contractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am exempt under sea Business and Protessions Code for this reason:
Signature: � Date:
Owner ID verified by drivefs lic�nse. ❑ Ves ❑ No Dnveis License No. Expires:
Varitication of Ownerehip by (type of documem, i.e. - property taz Dill or daed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby cenity lhat no excavation fiva (5) or more faet in dep�h into which a person I5 requiretl to descentl, will be mada in connection with work authorized by ihis
permit, and ihat no building structure, scattolding, falsework, or demolition or dismantling thereot will be more Ihan ihiny-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Title B, California Atlminislrative Cotle).
❑ As owner-builder, I will nor employ anyone to tlo work which woultl require a permit irom tha Division of Industrial Safery, as notad above, unless such person has a
permit to do such work fram lhe division.
Signature: Date:
Division of Indusirial Safery Permit Number:
CER7IFICATE OF COMPLIANCE AND AUiHORIZATION OF EN7RY: I cenify under penalry of perjury ihat I have read ihis application antl state that lhe information given is
correct. I agree to comply with eli state laws and city ordinances relating �o builtling consimction, and authorize represematives of the Ciry of Costa Mesa to enter upan the
above-tlescribetl property tor inspection purposes. I agree not to occupy or allow occupancy oi any 6uiltling authodzed hy this parmit umil final inspection.
C�E� INSPECTIONTYPE
161fi Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire PIaGe
203 Final Sign
204 Final Demolition
2446d6
pATE �NTRIALS
�
.�/^ %'G�-��
Date
COpE� INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final
7 P� INTRI L
�
(714)754-5273 • Fan(714)754-4856
Job Address: 555 ANTON BL
Suite: 2
Vicinity: 2ND FLOOR
Parcel Number: 41050110
�
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
npp�icant: GONZALES, HUMBERTO
Address: 2505 MIRA MAR
CA
LONG BEACH � - ,
Owner:
Addres
coniractor
Address
SAKIOKA FARMS.
s
.. ' � . ' . . < - '
CAC PROTECTION
. 2505 MIfiA MAR
Zoning:
Phone: (562) 498-6444
Zip: 90815
Phone:
Zip: 94137
000 33
77 FAIF DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 02I10I2000
Issued: OZ/23/2000
� CA , � � Phone: (562) 498-6444
, LONG BEACH Zip: . � 90815
� License: 327196
' . _, SCOPE OF PERMIT
INSTALL SPRINKLER-PROTECTION FOR PROPOSED WATER CURTAINS FOR -EPOCH- (2ND FLOOR).
REF: B00-00022 � '
Plan Check: $54.11 �
Permit: $83.25
Other: $0.00
Total: $137.36
, FEE SUMMARY
," , —
- _ - J
Calc Valuation: Sz,soo.00
Claimed Valuation: $z,soo.00
�
NOTICE: The work authonzed by this parmit shall comply vrith all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void i( work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepectlone antl tinal approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARATION:
I hereby attirtn under Oenalry oi perjury one ot i�e follovring tleclarations:
❑ I have entl will meintain a certificete ol cnnsent to self�lnsure for workers' compensetion, as provitletl For by saction 3700 of the Labor Cotle, tor the pertormance of the
work for which this permit is issuetl. '
� I have and will maintain workers' wmpensation insurence, as requiretl by section 3700 ot the Labor Code, tor tha peAortnence of tha woB for which this pertnit is issued.
My workers' compensation Insurence cerrier end policy number ere:
Carner: Policy Number:
(This section neetl not be comp/e(etl i! the permil is velued et one hundred dollers ($f 00) or IessJ
� I cartity that in the peAortnance ot Ihe work for which thi ermit Is issued, I shall not employ any person In eny manner so as to become sub�ect to lhe workers'
compensetion laws oi Califomia, antl ee ihat if should b me subject to the workers' compensation provisions ot Section 3700 of Ihe Lebor Code, I shall fonhwith
camply with Ihese/� o1vi�sions. q
ApplicentSigneWre: \ M�� � _ Date: �—Z�—L�
WqRNING: FAILUFE TO SECURE WORKERS' COMPENSATION WVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPIOVEFi TO CRIMINAL PENALilES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND OOLLAPE (5100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTION 3/W OF THE IABOR CODE, INrEFEST, AND ATiORNEV'S FEES.
LICENSEO CONTRACTORS DECLARATION:
I hereby aHirm Ihat I em licen�gd}�n_tl'erl p�vjs'�s ot Chapter 9(commencing with Section 7000) of Division 3 of Ihe Busin�ss er�professions Cotle, antl my license is in full
torce end ettecL Lic. #-7 �j 1 �� Cless a �— (<o
CoNractors Signature: J� i i� .� Ll AA1 � Date: __ 7`Z3— `l
CONSTRUCTION LENDING AGENCV:
❑ I hereby eflirtn that Ihere is a consVuction lending agenCy tor Ihe peAormance of Ihe work lor which this permit is Issued. (Sec. 3097, Civil Code). II
LentleYs Name: Lendefs Addreu:
Signeture: Date: ',
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn Ihat under penalry ot perjury ihat I em E%EMP7 FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Code: Any city or counry which requires a permit to constma, alter, improva, demolish, or repair any strucWre, pnor to its issuance, also requires the epplicant for such permit
to tlle a signetl stetement thet ha or she is Ilcensetl pursuant to �he provisions ot ihe Conirectors License Law (Chepter 9(commencing wi�h Section 7000) of Divlslon 3 of the
Businass antl Protessions Code) or thet ho or she is ezempt therelrom anA t�e basis tor t�e allegetl exemption. Any Noletion of Section 7031.5 by any epplicant lor e permit
subjects the aDP�iwnt to a civil penalty of not more then five hundred dollars ($500).):
❑ I, es owner of the properry, or my employeas with wages as their sole compensation, WILL DO TME WORK, antl the structure is not Intentle� or ottered for sale (Sec.
7044, Bu5ine55 and Protessions Cotle: The Conlractors LicenSe Lew doe5 noi apply to an owner of properry who build5 or improves lhereon, end who does such work
himself or herself or ihrough his or her own employees, provitled that such impmvemems ere not intendad or oflered for sala. If, however, the building or impmvement is
sold within one year oF completion, tha ownerbuilder will have the burden of proving that ha or sha aia not builtl or impmva for puryose of sale.).
❑ I, as owner of the property. em E%CLUSNELY CONTRACTING WITH LICENSED CONTRACTORS to consiruci iha project (Sec. 7044, Business antl Professions
Cotle: The coniractors License Law tloes not epply to an owner of propetly who builds or improves thereon, and who coniracts for such prolect with a conirector(s)
license pursuant to the Contractors License Laws.).
❑ I em exempt untler sec.
SignaWre:
Owner ID verifietl by tlnver's license. ❑ V85 ❑ No
Business end Professions Cotle fOr this reason:
Verification of Ownership by (type of tlocument, i.e. - propetly tax bill or deedj:
Dnvers License No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ,
❑ I hereby certify that no excaveilon live (5) or more teei in tlepth into which e person is required to deuend, will be made in connection with work authorizetl by this
pertnit, and thal no builtling structure, scaMolding, talsework, or tlemolition or tlismantling thereot, will ba more then thirty-six (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, TiNe 8, Celitomia Atlministrative Code).
❑ As owner-builder, I will not employ anyone to do woric which woultl require e pertnit irom ihe Division of Industrial Safery, as noted above, unless such person has a
permit to tlo such work Irom ihe division.
Signature: Date:
Division ot IndusMal Safery Pertnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OP ENTRV: I cenify under penalty of perjury that I have read ihis application and state ihat tha inlormation given is
correct. I aqree to comply with all siate laws end city ordinances relating to building wnstruction, and authorize representatives of ihe City of Cwta Mesa to enter upon ihe
ebove-descnbed pmpe�for inspection purposes. I agree not to occupy or ellow occupanty of any 6uilding authorizetl by this pertnit until final Inspection.
i
Si9n�ture Ot Legal Owner(s) �` ��ele.-, �
d'
` And�Or Authonzed Apphcant Date
COOE I, INSYECTIONTYPE
7616 Fizad System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Fina181ocWRetaining Wall
202 Final Factory Fire Plece
203 Final Sign
204 Final �emolition
244E98
pg$� INTRIALS
3-Zo-rn ) tah
COOE I INSPECTION TYVE
206 Final Mechanical
20B Final Plumbinq
210 Finel Elecirical
212 Final Fire Prevenlion
220 Final Planning ApO�o�al
222 Final Site
250 FinalBuilding/OCCuDanty
� INTRIRLS
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``�t�1IJ MFSQ
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`�ro� �'
(�ia)�sa-s2�s • Fax(774)754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant
Address:
Owner:
Address
�
555 ANTON BL
2
41050110
DON SMITH
SAKIOKA FARMS
:
CITY OF COSTA MESA `.
BUILDING DIVISION
DEVELOPMENT SERVICES DEPAR7MENT
PERMIT
Contrecror: ACCENT BUILDERS
Address: 555 ANTON BL. #100
REF:E00-00049 & E00-00052
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motars l0 1 hp
Mo�ors to 10hp
Motors to SOhp
Mators to t00hp
Motors over 100hp
Communication drops
Sub panel to 200a
COSTA MESA, CA
ELECTRICAL PERMIT
Phone:
Zip:
Phone:
Zip: 94737
Phone: (714) 5493150
Zip: 92626
License: 397790
PERMIT NUMBER
E00-00084
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: U2103l20�0
Issued: 02/03/2000
ISSUED BY: � �
SCOPE OF PERMIT
OVERTIME INSPECTION FOR SUNDAY 2/6/00 FOR RANDY BUCK FOR "EPOCH INTERNET" TI.
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QUantity
FEE SUMMARY
Temp Disl System ( lighting
Busway /100 ft
Standing Seclion
Misc Electrical Equipment
Transformers up to 7 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Vollage Equipment
Low VOII Wiring System / Ckt
Misa Conduit
Misc. Conduclor
Cireus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree S�and
Fireworks Stand
Other Elec�rical Fee
Imestigation Fee
Plan Check Fee
Quantity
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$�.DO 0,
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92�28, § 1, 1241-92)
EXPIRATION; This permit shall automatically expire and become void if work is not commenced within 780 days, or it work is suspended or abandoned
for a period of 180 days. _
INSPECTIONS: In orde� for Ihe work authorized under this permit �o be considered legal, such work must comply with all applicable codes, antl all
requlred inepecHons and tinal epproval must be obtained. Failure lo obtain Inspeciions and flnal approval will resul� in the expi�ation of ihls permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSAYION DECLARATION: � ,
I hereby aflirm untler Oenalry o� perjury one of the tollowing tleclaralions: �
� 1 have and wili maintain a certilicate ol consent b self-Insure br workers' compensation, es providetl for by section 3700 of ihe Labor Cotle, br iha performance ol ihe
work for which lhis permi� is issuod.
❑ I have antl will mainta�n workers' compensation insurance, as requiretl by seclion 3700 of the Labor Code, for ihe peAormance ot lhe work tor which ihis Oermit is issued.
My workars' compensalion Insurance cardar and policy number are:
Carrier. � Policy Number.
(This secfion need not be completeo� e�6ermd veretl el one un0`ed dollars ($100J or /ess.J
%� I cenity Iliai in Ihe pedorma6co ot �ho- ork Inr whictl ihis parm➢ is.issuod, 1 shall nol employ any person in any manner so s I�ome subject lo iha workers'
componsnlion laws of Callbrnio, and agree Ih � ihi should bocome subiec� to Iho workars' componsation provisions ol Soctio 700 0l o Labor Code, I shall forihwilh
camPly wilb �noso nrdvisions. - �' . —
J iz��..c< a �
/ ApplicanlSignaWre: ��/�'� \ � Uale' //l C�..� l� �-�
WMNINO', FMLUfiE TO .CUfl� Wn�K RS°CqMP NS�II(MI fqV[fiAO[ IS UNI AWFUL ANO,."IIM.I. SU0.IECT AN [MPLOY[R ID Cl11MINA� PENPLTIES AND CIV�L fINES UP TO O!!E HUNDf1ED
IHOUSANDpO(.LARE(�OU.00�I�INADOIIIONl�O� 1ECOSTOPCOMPEN56110N,UAMAGESASPROVIDEUfORINS[CTION91O60FI11ElA�ORGODE.INTEREST,ANDATiOflNEV'SFEES.
LICENSED CONTRACTORS DECIARATION: -� -�
I hereby atfirm ihal I am IicRnsed u d8fprovision Cha iCr 9 commencing with Section 7000) of Division 3 of lhe Business and Pro essio is Code, antl my license is in luil
force and eHecl. Lic. a -y'i �U � qass M
Contractor'sSignamre: ' G� < _� Date: i�i, 6t�
.--1
CONSTRUCTION LENDING AGENCV:
❑ I hereby ailirm thal there is a conslmclion lending agency for ihe pedormance of Ihe work br which this permit is issued. (Sec. 3097, Civil Code�.
Lender's Name: Lender's Address:
SignaWre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby alfirm Ihat under pCnaily of perjury ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW br Ihe lollowing reason (Sec. 703L5, Business and Pwfessions
Code: Any city or coumy which requires a permit �o consimct, alter, improve, demolish, or repair any slmcWre, prior ro its issuance, aiso requires Ihe applicant tor such permit
l0 1Je a signed stalemanl ihal he or sha is licensetl pursuanl �o �he provisions of the Coniraclors License Law (Chapter 9(commencing wilh Section 7000) o� Division 3 of Ihe
Bus�ness and Pro/essions Gode) or Ihat he or she is exempt Iherefmm and Ihe 6asis for Ihe alleged exemption. Any violalion ol Section 7031.5 Oy any applicant for a permit
subjecis Ihe applicant to a civil penalry ot nol more Ihan fiva hundred dollars ($500).):
❑ I, as owner o� �he propetly, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and �he slrucWre is no� intended or oHered for sale (Sec.
7044, Busines5 and Prolessions Code: The Contrac�ors License Law tloes no� apply to an owner ot pmpetly who builds or improves thereon, and who does such work
himsell or herseli or �M�ough his or her own employees, provided �hat such improvements are nof in�endad or oflered lor sale. I�, however, �he building or improvemen� is
sold within one ycar o� coinplelioi�, �hc ownervbuiltler will havc Ihe 6urden ol proving Ihat he or she did nol 6uiltl or improvp for purpose ol sale.).
❑ I. as owner of �ho proPehy, am E%CWSIVELY CONTRaCTING WITH LICENSED CONTRACTOFiS to conslmct lhe prolec� (Sec. 7044, Busines5 antl Professions
Cotle: The conirac�org Licenso Law does nol apply lo an ownar o� pmparty who buiids or improves �hereon, and who con�rac�s for such project wilh a coniractor(s)
license pursuant b IhC Con�ractors License Laws.). .
❑ I am exmnp� under sec. Business and Prolessions CoAe lor Ihis roason:
Signaturo: Date:
Owner ID verified by tlriveY9license. ❑ Yes ❑ No Oriver's License No. Ezpires:
Veri(icaiion of Ownership by (rype of documenl, i.e. - property tax bill or tleed): �
DIVISION OF INDUSTPoAL SAFETY PERMIT CERTIFICATION: ���
❑ I hereby certify Ihat no excavation five (5) or more faet in tleplh into which a person is required to descentl, will be made in connection wilh work aulhorizetl by Ihis
permit, and fhat no building sirucWre, scaflolding, talsework, or demolition or tlismanlling Ihereof, will be more Ihan ihitly-sia (36) feel high. (Chap. 32, Grp 2, Art 2, Sec.
341, 7ille 8, Califomia Adminisirative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit Imm �he Division of Industrial Safety, as noted above, uniess such person has a
permit to do such worK �wm Ihe division.
SignaWre:
Division ol lnduslnal Satety Permil Number:
Date:
1 W ill iha applicant or prRsenl or fulure building occupant need b file and cetlify a Business Plan br emergency response to release ot Ihreatened reiease of a hazardous
ma�erial? ❑ Yes ❑ No
(Section 25505 0l ihe Calilomia Healih and Satety Cotle requires, with some ezceptions, �ha� a Business Plan be liled with the Co51a Mesa Pire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greeter Ihan a weight of 500 pountls, or a volume of 55 gallons,
or 200 cubic feet of comp�essed gas at stantlard lemperature and pressure). �
____"'.______'--_
2 Does or will the applicaN or present or luture building occupanl need to file a regisiration lorm for acutely hazardous ma�erials? ❑ Yes ❑ No
(Section 25533 0� Ihe G�li�omia Healih and Sa�ery Codo, with some exceptions, requims reyisira�ion wilh Ihr� Cos�a Mesa Fire Depahment by each business which al any
ono limo hns on hnnd e yuanlily ol acutely hazartlous ma�erials equai �o or greatar Ihan a weigh� o� 500 pounds, or a voluma ol 55 gallons, or 200 cubic feet of
compressetl 9as a� slaPtlard temperaWra and pressure).
"..__.. .. _....._._._.. ."'_ .......... . ...._. .... ."""".... .....__ ._.. ....... . .............. ...._.... .....__ _........'_'_'.
3 Does or will Ihe apPlicant or presenl or fulura building occupant need lo prepare an RMPP (Risk Management and Prevenlion Pro9ram for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of Iha Galifomia Health and Salety Cotle provides thai lhe Cosla Masa Fire Depariment may requiro ihe preparation, cetlificalion and liling wilh ihe Fire
Depariment ol an RMPP by businesses which are required �o register acutely hazartlous matarials with ihe Fire Depatlment.
'_'__'_'__'_"_'_""""'__'___—_______'_—"_ _' _ _
4 If an RMPP is presenity required, has Section 25534 ot the Galilornia Health and Salely Cotle 6een tully complietl with? ❑ Yes ❑ No
__'_"'_ __—'_'--'.__' '_'—_ _—_'_--___'—_'____ '___.. _____.......__
5 Doos or will Ihe applicaN or preseni or fu�ure building occupani require for tha work whlch Is Ihe sublecl of ihis a plication n germit tor such constmcbon or motldication
tmm the South Coast A�r Oualiry Management Disiriq or fmm any o�her air pollu�ion contml dis�rict or agency? � Ves u No
(Section 658502 of ihe Calitornia Govemmen� Code raquiras Ihat Ihe roqueslatl inlormetion be fumished on applications lor nomresidential 6uiitling permils).
.................. ................. _....... __............. ............_ .... ._____.. ............... ....... __..._... ......._.,.. ......_.. ....................._..
6 Will any part ot �he lacillly �o be cons�meted under fhis permi� 6a wilhin 1000 teol from �he oulor boundaries oi a school? ❑ Ves ❑ No
(If "yes", ihe faciliry mus� meef ihe requirement ol Sections 25534 and 42303 of Ihe Calilomia Healih and Safery Cotle).
, ....___ ......._.. _...._.. ____ .._.___.. ..........__ .........._. .._.___. ............_..._..
7 If a permtl 1mm Ihe South Coasl Air Ouaiity Management Disirict or olher av polWtion conlrol dislrict or agency is required for the work which is Ihe sublect oi tM1is
app�ication, have all oi �he tlisclosures prescribed by Calibmia Health and Safery Cotle Section 42303 been made? ❑ Yes ❑ No
8 QYyea", a�tach certilica�e of compliance Irom ihe appropriate air pollution conirol ofiicer). ����
CER71FlCA7E OF COMPLIANCE: I cetlity lhat under penalty ol perjury the inbrmation given above is correcL I agree lo comply with all state laws antl city ordinances
regarding Hazardous Materials and Emissions.
SignaWre: Da�a:
CERTIFICATE OF COMPLIPNCE AND AUTHOflIZATION OF ENTRY: I certity under penal�y of perjury Ihat I have read ihis application and state ihal �he information given is
correcl. I agree to compl�ilh.@II state laws antl a1y i'nances rela�ing �o building consimction, and aulhorize representatives of Ihe Ciry of Costa Mesa to enter upon the
above-tlescribed proAerly tor inspeclio urposes. gree not to occupy or allow occupancy of any building authorizetl by Ihis permil unti�81 inspection.
CODE N, INSPECTIONTYPE �'�
1616 Fixed Syslem Final Fire Preven�ion
1266 Pool Spa Final
200 Final Re�Rw�
201 Final BIocWRataining Wali
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2d46 46
onZ
INTJTIALS CODE� INSPECTIONTYPE
206 ' Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Pinal Fire Prevention
220 Final Planning Approval
222 FinalSita
250 Final Builtling/Occupancy
oaTe ixnTIALS
�
�
�
PflQIECT PDONESS: , rj rj rj ,
OWNEP'S NRME: $ANK �
aooxess: 20 N.
AVE 3RD FL
uxiT: ZNDFL
CA 91105
(818)578—'/700
BBCNIENGINEEB: RWH ARCHITECT PEG.NO.:C—SIO�J3
aooness: 22072 CAMINITO VINO uNiT:
LAGUNA HILLS CA 92653
renminee: GOLDEN STA'TE FIRE PROT (719)923-4060
aooxess: 9 3 6 E FRANC I S B
ONTARIO CA 91761
LICENSEU CONTRFC70B UEClANl1710N: I here6y alfirm t�at I am licensea untler pmvisions of Chapter 9(commencing with Section
7000� of OiNsion 3 0� �he eusiness antl Pmlessions Code, and my license is in �u0 �orce and ei
cirru.:007 4 s reuc.:350 _ c ss: C—lE
Dale. � � � Signamre: _ _
WONNEBS' COMPENSpTION DECIABpTION: I here6y aflirm hal I have a ceniticate of consent to sel -i rear.bcenifiwte of Workers'
Compensalion Ips a�f5�{ c�jtpI'Ie 1 ereoi (Section 3800, Lab./ry1
^OLICY NO.: `�`/ r� J J��� � EXP. OATE: V-� � O S� 9 3
�ornraNr: REPUBLIC I,N+,�D
� Ceni�ie0 coOY is hereEy n�umished. L7 Cenifie0 c is hletl,Ml �he ciry BuiiOing Division.
Da�e: � � � �� / ` AD�lica G �
EXEMPfION FBOM WOflNEBS' COMPENSNiION OECNMTION: is stttion neeA irol be wmpletetl i� Ne permil is to� one �untlr 5100) a less�.
I certify tha� in the pedormance of ihe work �Or whicA IhiS Dermil is issuetl. I shall not employ any person in any manner so as lo become
suble�� �a Ne Workers' ComOensalion Laws ol Calilomia.
Date: Signature:
NOTILE: II. afte� making t�is Ceclaration. yau s�oultl become su01e�� �o t�e Workers' ComDensation pm�sions oi t�e Lahor
Code. you mus� forihwith comply wilh SucA Orovisions or Ihis permit s�all Ee deemed �evoketl.
CONSTPUCTION LENDING RGENCY: I Aere�y allirm ihai Ihere is a cans�mc�ion lending agency �or the De�ormance oi lhe work tor
which this permit is issuetl (Sec�ian 3097. Civ. C).
LENOEN:
aouness:
OWNEH BUILUEfl OECLAHATION: I her¢by aflirm thai I am exemD� «om �he ConlratlOrS' State License Law for ihe foliowing reason
(Seclion 703L5 Business an0 Pmiessional Code: Nny cily o� counry which requires a De�mi� to coretruct, al�er, impmve, demolish, o�
repair any stmc�ure, prior to its issuance. also reQuires �he applicanl fo� such permi� �o file a signed sta�emenl Ihai he/s�e is licensetl
pursuant to ihe pmvisions of ihe COMraclors' Stale License Law (Chapler 9(commencing wi�h Sec�ion 70W) of �ivision 3 ot ihe Business
antl Pm�essions CoOe) or �ha� he/s�e is exem0� �here�mm and the 6asis �or Ihe allepe0 exemption. Any uiola�ion o� Seclion 7031.5 by
any applicanifor a permit suble��s �he applicam �o a civil Denalry oi no� more ��an five huntlred dollars ($500).
I, as owner oi Ihe pmpetly or my employees with waAes as �heir sole compensation, will ao ��e wo�k, and �he
� stmcmre is not intentletl or oiferetl for sale (Secuon 7044, Business anU Pmfessional Cotle: The ConiracroK State License Law
tloes not apply m an owner oi a pmDerty who builds or impmves ihereon, an0 who tloes such work himseli/herseli or ihrouAh
his or her own employees. D�ovitleU ��at such improvements are no� intenaed or otfered for sale. I�, however �he builAinA or
� improvement is soltl wilhin one year o� comple�ion, Ihe owner will have Ihe burtlen of proNng he/she tlitl not huild or imDmve
lor ��e purpose o� sale�.
i, as owner oi Ihe propetly, am exclusively convacting with licensetl coniractors �o wnstmct the DmRct (Section ]OE4, Business
❑ antl Pmfeuions Co�e: The Coniractors' S�ate License Law Aoes not aDPly to an owner of O�aperty who huilds or improves thereon
and who coniracts lor such pmlecls wilh a conVactoqs�license pursuani�o the Con��actors' Sta�e License Law�.l am aware
�ha� pmof of Iheir Worker's Compen5ation insuran[e shaultl Oe pmvitletl Io me.
� I am ecemp� un0er Sedion: 8. 8 P. C.
for ihis reason:
Date: Ownec
I Oo hereby cenity that I am aware ol anA un0erstan0 tne reduirements o1 Calilomia Heallh antl Safery CoOe Sections 25505, 25533, antl
25534 an0 �ha� I or any lulure bmlding occupant will/will not (circle one) neeE Io compty wit� saiG s�a�e cotles and ihe requirement5 Por a
permit tor conslmciion or moailicalion �mm �he Air Ouaiity Managemeni DiSiric�. Fesiaential conSVuclion aOPlication5 ar¢ exemp� imm
�hese O�ovisions.
Daie: ApDlicant:
I hereby cer�ily I�a� I �ave reaG Ihis aDPlication antl 51aie ��al Ihe aDove inlorma�ion is correcL I agree �o compty wi�h all ci�y antl tounry
ortlinancesands�atelawsrelalingbbuildingcons�mc�ionan4here6yaNhor¢erepresemativeso��hisci menteruponlheaUove-menlioned
proper lo�n1pe i pur es_ � ��
oaie. 2 Signature� � e
oriver's license or Social Searity x: /.
1641-46 White—Bulltling�, Green—Cotle Enlorcemenl: Canary—Applicant; Plnk—Revenue; Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F OSyUS'
PERMIT NO: F 059052 PLAN CHECK NO; 03447-92 L GOVT; N SUYY;
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE; FIR PURPOSE: OTH
JOH DESCRIPTION : COMMERCIAL T,I, (FZRE SPRINKLERS) SQ FT;
CLAIM VALUE; 1,600.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS; RE; H58871 PRIMARY HLDG, PEkMIT,
i!� iF 1E iE iFlElE iE 1f 1f 1E iElf if�lt �N� if �3FlF �If 1E iF i(� #�I(� �!F if- If �IE iFif iE'k if iF if if 1f lE i(� if if iklE iF iF �1F iFik iF dE iE IF iE if if 1E fF if �]F if if k� iF if !F iEiE iE if IE if f(� if �%� i(� if iE !E
2 U N I N G R E Q U T R E M E N T 5
sETaacxs
------------ MAIN HUILDING ---------- --------- ACCE550RY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT' IN
PARRING REp • PROV; PARCEL; 41050104 ZNE; REF NO:
PLANNING N61'ES>
i
���r*�rx �r***�r�r�r�t**+e�t��r+�*x�*�t*�*�*�r�e*�*�r***�*�t*�r�r***��******�**�#*�r*�t****�r�t�*�r***x�*
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BOILDING APPROVED BY ; DATE:
APPLICATION ISSOED BY: ��—iL � DATE; I �{
iPiFifilifiFi(�iEiEifiE�7Eif1EiE�1fiElEihitiEiF3Ef'iF�f3F3aifTF'iFfF3E7F7F�Fi iFiFiF F7F 7F�FiF3F3F3't�iFiFiEfFiFiEikiElEiEifiE tt rf r r 3f
iE iF iE iE it iE it iE iE if if �7F iE i(� if iE ff iF iE 3f iF if # iF 1E 3E ik �lt iE 1f 3F 1E iF iE �1F �F iE if if iF iF �lE ik �t iE iEif if *�f 1E if 1E iF �F �E iF iE iE if iF �lf iE iE iF �lE 1F iE iE ft iE iE1E 1E iE �IE iF3F iE
LEGALIZATION;N F E E S U M M A R Y STRUCTQRAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 37.00
65Y SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 37,00 0,00 29.05
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRTC MECHANIC
24.05
TOTAL PATD DUE
61.05 61.05 ,00
3'7,00 OVER/SHORT: .OU
FIRE SMIP/TOT GRADING PLAN—CHECK
37.00
iE iF if iE i4 *iE �lflL� 1E iF *if dE �1( iF iE dE dF 3E iE iE iE iE it �lP iF 1E �lf 3FiE iE iE 9FiFj! 1E 3F �%iE �%iFiE iE �%iE ih �1E 1E •� lE iEif -X� i(� iE�%�E 3FiE iF iE�)FjE if 9f �1F �� iE iE�IE �1k � iFif •%i4 iE 1E
I N D I V I D U A L F E E; H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAI. COST
FIR 37 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 37.00
END OF FEES
� :�
4l CG1_�_Rt-�rl'zotq -- : .�i
LATEt L9.+'.4;;,, T.�,: „-�;�
Y
CONSTRUCTION AND PLANNING - � P� �& SPA _
APPROVALS Permit# �- Date Inspector qppROVALS Permit# Date Inspector
1. Temporary ElBctrical Service or Pole � � - 52. �Pool & Equipment Location
2.� Soil Pipe•Und�grnd. • � 53. Steel Reinforcement � ..
3. Electrical Conduit Utiliry-Undr.grnd. .� 54. Forms •
4. Electrical Conduit-Undrgrnd.' � , - 55. Electrical Bonding
5. Steel Reiniorcement � - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � � 57. APPROVAL TO COVEfl�GUNITE
7. Footing5 - � 58. Electrical Conduit•Undrgrnd.
8. Foundation , � -- ' _ 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System '- 67. APPROVAL TO OECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor�Final -
�2• Sev`'e' CaP 63. Heater & Vent-Final
73. Roof Dreins � 64. Plumbing System - Final
14. Rough Piumbing 65. Electrical-Final
15. Rough Electriwl-Conduit ' 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval .
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectriGabT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rouqh Factory Fireplace ' APPROVALS Permit #
21. Ducts, in Strudure - +� 70. Underground Hydro
22. Dutts, Ventiiating ,� 71. Product Piping � Gas ❑ Oil
23. Gas Pipe�Rough & 7est 72, Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas O Oil
25. Roof Sheathing � � 74. Overhead�iiyc4:�a. �,_-3�� l�
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Sid�ng � � , 77, FIXED SYSTEM FINAL (� �.9�
� �
29. Insulation j � 78. FIRE PflEV. FINAL. a. �
30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT
31. Plasrer Brown Coat � � 79, FINAL INSPECTION
32. Electrical Power Meter�Final � I 80. FOOD CER.TIFICATE ISSUED
33. Final Electric i � � Notes:
34. Final Heating & Air Conditioning, i .
I I i .
35. Fina� Gas Pipe-Test ' � I � '
1
36. Hood or CanopY I �
37. Final Factory Fireplace � I ( �
38. Final Plumbing � i I �
39. Water Service-Final � �
I !
40. Gas Service-Final ( �
47. Solar pomestic-Final � I � �
42. 8ackflow Preventer � , � , -
43. Backflow Irrigation
44. Landscape Irripation System �
45. Sound Attenuation -
46. Handicap Regulations
�47. FINAL STRUCTURE & BU�LDING i ! I
i �
.48. �FINAL PLANNING . f f , ��
49. Electric ReleaSe to Edison i j -
i
� 50. Gas Release to Southem California Gas Co � �' ,! �
51. CERTIFICATE OF OCCUPANCY
No. Oate
�
�oonessaem�allo: 555 ANTON BL
w�r�as""'E"'wa''": SAKIOKA FARMS
�oox�ss: p0 BOX 2097
TERMINAL ANNEX
�rv�. wmuw �oox�ss:
unr.
2ND CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 076016 PLAN CHECK NO; N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE
axcx�cron�xm�nn: INTERIOR DESIGN 21362321&�"�- 9378
1RCIlOPfNC.'SAWflE55: SSO S HOPE ST uNT: 1100
L.A. CA 90071
�MT�'s� MORROW MEADOWS CORPORATIO (714)598-7700
cam�cionsWuiwc 610 REYES ST
�oo�sx WALNUT CA uara.: 230813
91789 uxr:
110EN5ED COMRACTOFS DECIAN�TION: I Mroby Mim uMm penely d pejury iMt I em liearued under pwiaiana d Cheqm 9
�(canme��q wG� Sxlian )000) d Dimon 3 tl Ne Buai�wx end Pmlaaioro Cade. uM mY licems o in IWl lace end eMetl.
cmuc.No.: p06558 uc.cuss: C 10 uc.No.: 3081 EXP: 2/96
Uale: /` �� � �� Comreau:
W/NEP BUILUEH OECI�N:TION: I Aereby elfirtn urMer penelly W perpiry �hm I em a q lin �he Contwon lioeroe lew la tM
AbwinO ree.wn (Setlion )W 1.5 &niqas vM Rdaviwu Code: RM dY a cauM' M n9ar e e M�� lo mmWct. edm.'unpove.
EmmdsR a eepai mry sWdura, p'a b n ceuenoe, ebo nQuirm tM eppliram t wch ' olJe e upned �tmamxu Jw he a�M
u ticrosed Wm�uu to �M pweiom d tlr Comrmaa Licanas law ICMqr 9 aomm ' wGh Sedian ]OW) tl 0'r�reion J W tlr
Bmrea end Admeiom Codel n ihm he a 4w u vsmP IhseM1vm end �M ' la albpeE uemqion. /sY videtion d Sedion
J031.5 by ury eppYreru fa e permil wbpm iM eppficeiu to e dvJ penelry d rioi Ihe huM�ed ddlen �55ooD.
❑ I.eaawiwdlMpopaMamyanpb/eaa�N�wepeaniMiadsmmpeewiion.xilldotMxdk.ud�MNrucwreaMlnleMed
«ofiereE be ub (Seciion ]oN. Buvnen eM PMm+'vuGods: Ths CoMredon Lican�a lewEaee nd eDON�o en ownara paparty
wM WMt ar inpwm Ilwom. ad Ma daee tuM wak limfell a MnN a Wo�qh he a Aer arm amVbYM�. p�b �hel wch
imV�meMa me nal iiveMod n tllaed la We. tl.lawawr. tM buYC'uq a inpwwnaa u eold vmlvn awYw tl oomVMiion. tM
ownmbwlis r�iA heva �M dvden d pwi�q ha w ehe did nd hdd a'unpo.a la IM pnpm d�els).
❑ �... o»n« a me ww«n..m..��N �xreewa wn rcmaa canu.cwu ro omw�a m. waa+ cs«iim nu. anvw..�e
Gmlaeeom Ga4: The Caureaae l'cmro lew Eaee M MMY b en owmr W PW��Y Ma dnlde a impa'u tlwaon eM v.M
wnirecu tar wtli prqeda wilh e aaurm«(e) licar�wd punuem to ths Conirepors Lirnnae lewl.
❑ I em uemq uMx Sanion: B. 8 P.C..Ia No �euon:
Dam: O.+�er:
i eo na,anr �wv wm i,m..,,�. a w�,d..w�e me �a�'.�,�n d cdi�. Hewn �a s.iar coae s.ao� uws. zssa�..�e
255Ja. arM tlw I n eM' Mun drikuq om+Vem xiA / wil m� (orcb ar) meE to mndY wl� veiE pete mEe� aM �M ia0uiremaMs lar
epermillaarnbunionamodifrationhomtMAi�ei y%�enepenwnlDietiia.RevEaniialoonqruaioneppirmbmeramemqlromiMee
a�.
Dme: Appfrva:
WOqKEN'9 COYPEHSATION DKLAflAT10N: I hweby dlvm uMa ponNy d pe�ury ans d tlr IaOorrirq Eetle�etuns:
� 1 Mw aM xd meiman a unifraie d mmenl to �Mlinwn M xaken' canpan�etbn, n provkad la by Saeion J]UOd iM labor
coa.. lo. m. w��,�. a �n...«x �« wlJcn mi. w�il ie a.�ea.
�] I Mro eM wil meinlan weFen' campeme�ion iruurenro. m �pu'vad by Saion 3100 W tM lebor Cods, br iM peAormeMe d tM
wwk la whitli Ne D�E u ivueE. MY wakers mm0eneaion vuueuics wrisr mtl D�Y numbx ms:
c�«: FIREMANS FU D EXPIRES
aa�wmnd nw��,9T,�4'� 07/01/96
(This secTbn need imf he canG�ed / NSG'��I ie b we hurdM ddlen �SIPO) a/ep.1
❑ I cMty Nel in IM pMormvKe d �M work im wh'ch �his peemil le beuetl. I MeY M amplo� erry pemn in eny menrror w m to
becane w4ea m iM wakms' wmw��ian kws a ceuiamu. ene ro.r inm e enoua n.mnr w4 m me wawe�e•
om,: / ���„ a� �� a �M ��. � .� .��,�, �.. �.. � .
Wam/np: F�Ilun ro szun wortwi ro�o�nutlon rowrap� l� unbwful, entl N 1 wD/ cf �n �mployn ro cr/Mnl pm�Nu uW
' e/vll flrisi � ro om huntlro0 tMuund Ao/Yr� (Sf00,0001, In etltllHon ro M� c 10/ �utlon, Wmsp� �� provMM br In
� Sxtlon J106 0l Ms laEorCol�, Infxss4 entl �ttomry'� Iw.
CONSTtiUCiION LENOIND A6ENCY: I Mietr/ Wm� uMm pmelry d pe�ury v a mnYruqion WMinp eporcy for Ns
paAamenee d ihe wnk la wliidi ihu Deemi u eeueE (Swon ]OB). Cw. CI.
LENUEfl'S NAME
LENDEH'S �ODPESS:
I cenity Ihe� I heve reaE I�is epdKe�ian end pele Ilul �he ebove inipmelim ia mrtep. I apree lo mmply wil� dl ply vk muMy ordinancm
� arqslqelewerMPoiploWikvpcon9ruqione�dMrobyeulhw¢a�ap4eenleliveedlhutilywmtarupanlMebwa�memoneEpoperty
(5151d6.WP)
Oeie�, `� /8 9�
8 Sefety; OreerFle; Cenery-AppFrant: Pink-Ravenue; ONEenioE-rtseevaw
PERM NO: E 07601
GOVT: N SUPP: Y
PURPOSE; ALT
JOB DESCRIPTION : INTERIOR 20000SF OFEICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS REF: B-74570 / SUP E-74576
x�*****x ******�r*+r+�x *+��r*****�r+�x�*�r*�x ��r��rx�x�x���r+r+r���rx�*�t�+r*�*x�+��r��*�*+rx�***r�rx�***�r�r*�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
� (_('
K iE if iF IF1E iE if M iE iE if k if 1f If 1E if 1E 1E IElE fElE ik ik ik 1F iF 1E 1E iE iE 41E iE iE iE iE IE 1E 1F ii k ik iE k iE if iE 1E if 1E if iE 1f 1E 1F if 1f iF iE IE 1k 1E iF 7F iE 1E 1E iE 1E iF iE 1E 1E if iF 1E
D E V E L O P M E N T S E=R V I C E S R E(J U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : � DATE:
APPLICATION ISSUED BY: �' Y' DATE: ��
if ik IE if iE 1E 1E 1f 1E iE iE iF If 1E 4 if iE 1f iE 1E 1f if 1E IF 1f IE 7k ik ik if ik 1E�i�i�if if�
LEGALIZATION:N F E E�= S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 16.80
502 SMIP/NON—RES
PLAN
ISSUE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 16.80 4.50 0,00 21.30 21.30 .00
REVENUE DIVISION TOTALS--> COLLECTED: 21.30 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
21.30
if�klEiElElElEMlFiEikikkibifiEiElkikikiEikiFkklElEikiliFiFiElilEkikifiklEiElElkiElFiF1kIF1EiEfllElEfEiEikiEillFfkfElEiEiEiEkiiifiEikiflFlElE1E1E1E1EifiF
I N D I V I D U A L F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20 fiA. .75 15.00
ELE 4 RECEPT/OUTLET ADDITIONAL EA. .45 1.80
END OF FEES /
��. �! .�� :,ea -u ::y..
!O/YO Tt��..• 4V�M16
'L.�
GONSTRUCTION.AND PIANlQ!l�4G � _ & SPfr-�
, APPROVA�S Permit # Daie Inspecto� APPROVAIS Permit # Date l�spector
1, Temporay ElectficalServiceor Pole 52. Pool & Equipment Location
2, Soil Pipe�Undrgmd. ;� , . 53. Steel Reinforcement .
_3: Hectrical,�;ondiQt UulitY-Undrgrnd. 54. Forms
���Iectrical�GqPdl�b�rgrnd.� 55. ElectricaiBonding '
��-5.'Steel RelnfoCcemettt`� 56. Rough Plumbing & Pressure Test "
�r'8?ElectriwLtlFE ^ nd. 57. APPROVALTOCOVER�GUNITE
-.v^..
r�
�Y. �botings vr; -,� " 58. Electrical Condujn�Undrgmd. �
'7��8. Foundatido� c�i-� a� c 59. Gas Pipe, O Uridr�rnd., Test
C�- J
9. Water PipeqUnd'r�,gfnd.' = 60. Backwash L(nes`�t-P`-.Trap, � Undrgrnd.
10. 5tructura7�FiootSyscem � 61. APPROVALTODECK
T�
1 i. Property Sewer'�,'F'vne.& Hous�'oConnection � � 62. Backwash & R�'ptor-Final
12. $ewer Cap; ;.� ` � 63. Heater & Vent-Final
13. Roof Drains J� . 64. Plumbing System � Final
74. Rough Plumbing�-. -� 65. Electrical-Final
15. Pough Elactricai-Coaduit c' 66. Solar SYstem-Fiq� '
r�
16. Rough E(�''ccric Wiri � _ 67. Fencing & Accr�s.Approval
_17. Rouqh Wiri�g Sign � � 68. APPROVED F�LASTERING
78. Rough Elect�iraTjT Bar Ceiiing' 69. POOUSPASYSTyE6�iS FINAL
19. Rough Heating & Air Conditioning _ Y � r k C FiRHp��pT�iEQUIF�,EMEI I�T ,n�
y,.
� �;., c; , -, � m� o r r 7-�
20.'�ou�lF�toryFi��ace 'S�; ^v « S H �,� APP�V�(�,'"�FP�qni[#.r��
21. DuCGy in'3truCiura7a: ��..'.. H`. � -. � ;� Y. 70. � nderC�+j�p� �dro k .
22. Duct"r, Veqtila�n9. t� ' '�` rj ,� ;+ 4*� 77. P�odup+� Ping�as � Oil
23. Gas 2ipe-�a�g1a & Test t�... �� c�; s { O t.� 72, Unde.grbund Piu� `'
-.,
24. fioof-Fraltting" 'tir ��"" "� �F = ? �" r` 7� UndergrFj�d. Sto{dc� Tank� Gas ❑ 0 I
25. Roof;Shee�hing S,^ '�: ���' *� -, ^* 74? Overhead Hydr�; � y
i � A � G•S
26. ��BaFCeiling IStr6�t�ral) & Nl���oat ` � d"� " 7�: Dr Che �cal T
..� .� �k O >+ �'K Y E� F J K~ �'T1.
27, F�Jameand.Flashir�g� -;r,- ..^ � '.�i 76. DryStarS&WpeF� � � � c*tt*;
- n
28. LatNi?tg&Siding Jxti ��� O %� � � 7X, FIXEDaS.�, $T�INA�.,� i�
y29. Insulp¢iors� (�! J S �• > � 7�: FIRE PREV. FINAL ^��
_
��
�30. prywall (@ailing ��» F+ � F I r S ;��1-I�ALT��EPt.''REdUIR,f�IV�ENT
�31. plaster Br'�p.wn,-�oa;��M � . �� � i r� 79� FINAL Y.NSG'ECT�tON x� V
- - �,��
� 32. Eiectrical�owyr MM�r=Fnal � �`;• � �.� 8Qr FOOD CERTIF�CA"rE I�S�UEQ_:
.� 33. �ina�Elec�ric� �'> -� �. . . � ��qf� ��� _�p � ' ` Dt�� -+�,.L^^, u �7 �. m'
�/ {p_. -
..34. FinaL�HeaYing'& A'rr�onditionirfgS !�': ! �' !�` � •4� `.� '�� ' -� V�r
-n NY � !�7 f J h' -.�90 lJ I ��C, '-�G
35. �nalTia�Pipe:7es4 � ` .: * F., I •i; . . ���e C:.-; -+?' .� .
' 36. Hood-or BanoPY ' n -� � x,`= y * f� � � -' � �U � '"" .
i � t�: x,o % ?; �pcn �
.. r y. �., . �C"' G � n � : i -t__'_"..f+` .
37. �inal.Eactory Pire¢�ace x i �..F ;� * 1 :Y. � �t� �5:.+ � .'
r
-38. Finah�Plumbing �.� �v . -� r ^ p�': � S - 7 � . '
� 4- , N k x
� 39. Water.Service-Final;.y G � ''' * K '' y, ', � -_ * � � w� " , o� . .
: 40. Gas Service-Final n;a m .:;-:'r S *�*' 0=^ -.• �: K •' "�"�
c-� "- I � F• C< Y• Q ^'
�41. Solar pomesticFinal� � „ " .�`� �'' ( � �. rc � x ` .
42. 9ackflow Preventer r ^� :! ✓ ' � G: � F �='� r'
n n� r� X , iTl G r i-'
43. Backflow irriqation � �'sC * �G * �r � � r
J
4$. 4andscapeJrripation*System ��'*:C) �r x^ r:• O Cw c' ^� N wCJ *' �'� "�'•-
�� „� r� t c' i; � s ;r ��i G S �. c F..
�5. Sound Attenutjtion r ~' ^ � « `' `.; F" �x ; � = C C� FD +'
q{i, Nandicap Regulations - x�� r�, � S C�' � x
� � � t'; : d
� 47. KINgL STRU�TURE & BUI�DING }' �', '�` 'U -' .
r, � � �
�- �
48. F N/kL P�ANNING+ F-F r cu ' �' c'; 4 + t-'
t i. �k � �'r ' S �: Q
4g. Electr�c Retease to EBison ^ � ' �� � s _ '' -
i r h. t� � r. ��
50. Gas RElease to Southern Califoreia�as Co r %��' b' �-+ o• � r' y � ''
�< ,� . o o n r ro c, m
51. CERTIFICATE OF OCCUPANCY � x' i.� :�;u ., + r _
No Date
�
�
Pfl0.1ECTJ�00NE55: S S S ANTON
Q�lNEB'S NAME: $ANK OF AMER
noosEss:20 N. RAYMON
PASADEI3A
CA 91105
(816)578-770
0
3RD FL
uxiT: QNDFL
FflCN/ENGINEEB:RWH �iCxITEC�� NEC.NO.:C—LSO%3
nooxess: 22072 CAMINITO VINO uxtr:
LAGUNA HILLS CA 92657
PENMITfEE: %{RMSTRONG CONSTRUCTION ( $18 ) 967-8001
nooxEss: 97.9 SPRZNG MEADOW DR
WEST COVINA CA 91791
LICENSE� CONTflACTOfl OECIABRTION: I �ere�y aliirm �Aa� I am litense er Dmvisions of CAapter 9(commencing wi�� Section
7000) ol Divismn 3 of Ihe Business ane Pro�essions CoOe. antl my licens is in u e anJ eHect.
cmuCc►.:�056871 s�aieuc.:434047 c B—
Oate: y_L � `1 % � Signalure�. _
WOBREBS'COMPENSRTIONOfCIAMTiON: IhereEyallirmlhailhaveat¢2ilitaieolmn5 Itasel ins eoracenifiwleolwarkers'
Compenuuon lus�ce� a� ��ieo cooY �nereoi ISecuon 3eoo, �ab. �11 / O 1/ 9 3
roucrxo. REPUBLIC INDEM EXP.ORTE:
COMPRNY:
❑ Ceni�i¢0 copy i5 AereGy lumis�ed. � C¢nili¢G copy i5 IileG wilh I e cit uiltlinp Division.
Da�e: R/ � /�y ApplicanL
EXEMPTION FflOM WOHI(EPS'COMPENSATION �ECIAPPTION: (Thi55et�i0n nee0 noi�¢tompl ¢Oil�hepermili5 ne huntlre0($100�Dr1¢55�,
I ce�ity ��ai in ��e pedormance of �he woB for w�ich Ihis Dermit is issued I shall not emplo erson � an manner so as �o become
SUEIec� �o Ihe Workers' Comp¢nsa�ion Laws ol Calilomia.
Oate: Signature:
NOTICE: II, after maNing t�is Geclaration. you S�oWE become suGject ro the Workers' Compensation D�ovisions of tAe La6or
CoOe. you mu5i forlhwilA [amply wi�h suc� prOviSions or I�iS permi[ s�all �e EeemeO r¢voke0.
CONSTBUCTION LEN�ING AGENCY: I herBby allirm (hat Ihere is a constmction lentling aAency for ��e De�ormance ol I�e work �or
which ��is permi� is issuetl ($etlian 3097. Giv. C).
lENOEN:
nooxess:
OWNEfl BUILDEP DECL4flRT10N: I hereby aliirm I�at I am evempl iwm the Conlracmrs' Slaie License Law for Ihe following reason
ISection 70J1.5 Business anA Prolessonal Code: Any cily ol counry which requires a permit to tonsiNct. alter, impmve, dertrolish, or
reDair any struciure. prioi io its issuance. also reQuires I�e appliwnt for such permit io lile a signea staiemem t�at he/s�e is ticense0
pursuam to t�e pmvisions af t�e Comracmrs' Siate Lic¢nse Law (C�apter 9(commencinq vnih Section 7000) af Diviion 3 of iAe Business
and Pmfessions Co0e1 or �Aa� �e/she is exempt inerelmm antl �he Oasis for Ihe alleqeA exemption. Any violation ol Section 7037.5 Oy
any apPlicanl br a Oermit suhlecls t�e applican� Io a civil penally of not more �han live hunOreO Aollars (E500�.
I, as owner ol IAe pmpeny or my emyIOVees wit� waAes as Iheir sole campensation, will Oo ihe work, and �he
❑ simcWre it nol intenEeE or offeretl fo� sale (Section 704A, Business and Prolessional Catle: The Coniractors' State License Law
Goes noi aDDty �o an ownerof a O�oDeny who Uvil6s orim0�oves Iherton, an0 who Ooes such wark �imseli/hersell orthroug�
�is or Aer mm empioyees, O�odde0 ��i such impmvemems are not intenUM or ofiereA for ule. II, Mwever Ihe Duiltling or
imprOvemenl 6 5010 wilhin one year oi campl¢Iion, IAe axner vnll tuve IAe Ouraen ot proving A¢/S�E GiE nai builtl or improve
Ior �ne ourpose ol salel.
I, as owner ol Ihe pmpeny, am e�clusively conlracting witA licensetl conlraclors to constmct the pmject (Section 7044, Business
❑ antl Pmlessims Coee'. The Contractors' State Licenu Law tloes not apDly lo an owner of properry who buil45 or improves �hereon
antl who conlracts lor such pwiects ��� a coniractor�s) license pursuanl Io t�e ConVaclors' $Iaie LiC¢n5e Law�. I am awafe
Ihai prool of Iheir Woder'S Campe�sa�ion insurance 5hoW4 be D�oviJeE lo me.
� I am exem0� un0ei Seclion: 8. 8 P. C.
tar Ihis reason:
Oa�e: Owner.
i ao nere�y cenity ilut I am aware ol antl unGers�antl ihe requiremems af Calilornu Healtn ana Safeiy Cotle Sections 25505, 25533, ana
2553d and ihal I or any luture GuilEing occuDan� ;II/.v�will no� (circle one) neetl to comDN wi�� said slaie coaes an0 the reQuiremen�s for a
permit for conslmction or moAilication imm I�e Au ahry Management Oistrict. Besitlential wnsimction applica�ions are exempt Imm
ihese pmvisions.
Oate: Applicanl: _
IhereGy terlilyl�ai I�aver¢atll�i5 aOD����i0n anU SIaIeIAai
or0inan[es anG s�ate laws �elalin0lo 6uilding W�simclion antl t
pmDe�y lIai inspeclion Durpo5e5. 1 L
oate �! � � � Z. Signaiure�j
m��ar� i��o��a �, s�,��,i so.��,;�„ .� .
I agree lo compty wi�h all q�y antl coun�y
INSG�ylOCIll2fY0W1�I1C dUOVE-fI1CIIlIMCE
164La6 White—Bwltling; Gwen—CoOe En✓'� AOPlicanl; Vink—Revenue; GOltlenro0—Assessor
�
i
CITY OF COS'1'A MESA — BUILDING PERMIT �, ; tf
PERMIT NO: B 058871 PLAN CHECK NO: 0289"/-92 L —T,aIII��iTi I
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE; STR PURPOSE; A1�T
JOB DESCRIPTION ; COMMERCIAL T.I. (OFFICES) SQ FT: 3,600
CLAIM VALUE: 50,000,00 CALC—VALUE: 21,912.00 GROUP OCC: H-2 /
COMMENTS: REMODEL OF 1200#SF ON 2ND FLOOR
*�r*������*�r**x*�t�*�r�r**�r*****�**�r*�**�+��r*�r�r�*�r�*�t+t*�t******�******�t*�t�***x ***� �*�
Z O N I N G R E Q U Z R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAft: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT ZN
PARKING REp • PROV: PARCEL: 41050104 ZNE: PDC REF NO;
PLANNING NOI'ES> INTERIOR ALTERATION FOR AN OFFICE WITHIN AN EXISTING OFFICE
> BUILDING �
�e*�r�r�x *�r*�rx��r*�r�r��t*�r�r�r**�r�r*�r� � *�rx *�r�r*�t**�r+t�*�tx�e �e*�r**�r�t*�r�r****�r*��t x***�r�t�t�� � ***u *
D E V E L O P M�E.� yN� �T S E R V I C E S R E Q U I R E M E.N� T_S
ZONING APPROVED BY ; � fV� _ DATE; '� ��
BUILDING APPROVED BY : S� DATE: ,9 ��2
APPLICATION ISSUED BY: + DATE• � 2
if1FlEiEiEiEiElElEifik1E1F1FiEi(�1E1EiEiE1FiE iEiFiEaf3FlEiFififif iEk
iEiFifiE1FlFlElFiEiElkikiflElFiFitiElEiFlP1ElEiflEikiElElfikiEiF�kiEiFiEiEifiEififiEiE iEiEikiEifikfElEiElElfjklfiflElEiElF3ki(�1ElEiflt.i�iF1FlEifiEl6iEiFik
LEGALIZATION:N F E E S 0•M M A R Y STRUCTORAL••SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES� GRADING
PERMIT 225,00 ': ' . _
PLAN 146.25 , • : SMIP�N6N�,'RES
ISSUE FEE ' �•' •
BUILDING—DIV—> PERMIT ISSUE PLAN=CHECR ' TOTAL PAID' DUE
TOTALS----> 229,60 0.00 146',25 375,85 375,85 = .00
REVENUE DIVISION TOTALS--> COLLECTED:• 229.60 OVER/SHORT: ,00
BLDZSP00 PLUMHING ELECTRIC MECHANIC JFIRE SMIPqTO�T GRADING PLAN—CHECK
f ., _ P �' '
if iE iE iE �E iE ik ik * iE iE iE 1E if iE iF iF iF iF 1f if if 1tiE iF 7f 1E �f !flPiF 1f iE %if if iE iFlE iE.iE iE if 1f iE iF ik iE iF 1! iE iF 3E 1E iF iF iE if iF iE k iEiElE 1F iE iE iP 1F iE )f !E If Ik Ik iF 1E iF iE
I N D I V I D U A L - F�E'E ' B�R E A K D O W N �
TYPE QTY D E S C R I P T I O N ��'� "� UNIT COST � TOTAL COST
SFC 1200 OFF—INT. ALTER TYPE I�II F;R: �,AVER,•: 17.24 �20,688,00
SFC 1200 E U—ALT COMM. SPRINKL�R SYS -AVER;� '
SFC 1200 E�}U—ALT COMM. AIR COND •�—AVERr" ,69 ? 828.00
END� OF FEES ,% '
. , ��' � � �
� . � �
r � . _ -
� _ ."
'� . � :/� �.i_ .. _ . .
� CONSTRUCTION AND PLANNING • PO, S SPA
�;�APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
�
i. Temporary Electrical Service ot Pole . 52. Pool & Equipment Location ..
2. Soil Pipe•Undrgmd. ' -�- 53. Steel Reinforcement �
-• �
3. Electrical Conduit Utility•Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical.8onding
5. Steel Reinforcdment 56. Rough Plumbing & Pressure Test
6. Electrical UF�R Grnd. � 57. APPROVAL TO COVER�GUNITE
7, Footings �� . 58. ElectricalConduit�Undrgrnd. -
8. Foundation ' -� . 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgmd. ' 60. Backwash Lines, P�Trap, O Undrgmd.
10. Structural Floor System �� 61. APPROVAL TO DECK . _
11. Property Sewer�L+ne & House Connectio� . 62. Backwash & ReceptorFinal .
12. Sewer Cap � � 63. Heater & Vent-Final
13. Roof Drains' � ' 64. Plumhing System � Pinal . '
74. Rough Piumtiing ' 65. Electrical�Finai
15. Rough Electrical-Condu�t � � � 66. Solar System�Final
i6. Rough ElectriG W��ing 67. Fencing & Access Approval
1J. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica��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 Siructure . . ' _ ' " � `
�.70. Underground HYdro
22. Ducts, Ventilating �- '� �77. Produc(Piping OGas �Oil
23. Gas Pipe-flough & fest - . . . � ` 72. Underground Flush � . � ,
24. Roof Framing ' 173:�Undergrnd.Storoge.Tank'�Gas ❑Oit�� =
25. Roof Sheathing � . � 7A.� Overhead Hydro_ � �
' 26. T�Bar Ceiling (Structurell & Monocoat _ ' • 75. Dry Chemical �
27. Frame and F�ashing _ 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 Coaf , ' � �� 79. FINAL INSPECTION �
32. Electrical Power MeterFinal �
I �'.; S0. FOOD CERTIF�CATE ISSUED
33. Final Electric � _ �� ' Notes: ,:
34. Final Heating & Air Conditioning, - r. � -� t
� r�Z,.t�r!_ - - _o.! Y�n�v� ��
35. Final Gas Pipe�Test _ " - I ` .�f <�� � ✓!- � � •
. ' !C�_ or� . !-�.P✓ O_F 3.(-� ,
36. Nood or CanopV . f ',� 1 �� �
�s� g_._Qav r �>-L-r-c��,2_S_�v�-��_�
37. Final Factory Fireplace ' � � - - -��t l - -
38. Final Plumbing � ' � _ `� •
� (fJ��
39.�WaterService=Final 1 i� �J
��,r ` `� /��p-a/�-9�I JL
40. Gas Service-Final � ; /����
. 41. Solar pomesticFinal j � ' '.
42. Backflow Preventer ! ; � '
43. Batkflow Irrigetion � � ' .
44. Landscape Irripation System - - . � - � , � •
45. Sound Attenuation ' ' .
�46. Handicap Regulations � � .
/ r-� �� 7
47, FINALSTRUCTURE&BUILDING �J3� Z' �i � , .
( �'G //-C rjsLCJG/) -
48. FINALPLANNING . �� . .
49. E�ectric Release to Edison � � . -
�
50. Gas Release to Southern California Gas Co i � , � _ � .
51. CEflTIFiCATE OF OCCUPANCY
No. Date
aecrnooxess: 555 ANTON BL ` uxir: 2NDFL
OWNEfl'$NMAE: B�]K OF AMERICPf `"
nooxess: 20 N. RAYMOND AVE 3RD FL
RXCN/ENGINEEfl: RWH ARCHITECT NEC.NO.: C—S SO%j
noosess: z2072 CAMINITO VINO uxir:
LAGDNA HILLS CA 92653
PEflMITTEE: HORIZON HEATZNG & A/C (714)974-3702
aooAess: 17853 SANTIAGO BL STE#107-243
VIILA PARK CA 92667
IICENSEO CONTBRCTOfl OELLAflATION: I hereby aifirm iha� I a i n eG unG¢r D�ovivons ol aD 91�mmenung wilh $ection
]qp� ol Oh^sion 3 0l Ihe Buvne55 a�b Prolessions CaOe. an0 m li e is � Il/arce antl
cinuc.: 56944 STRTELIC.:64�%2 c ss C• 0
Date: � ' �2� Signat .
WONKEflS'COMPENSPTIONOECIABATION: IhereEya��irmthail aveacenilicateotconsennosell-insurearaceniticateofworkers'
Compen5alion Insuran[e. or a certiliea caOY �hereo� �$¢c�ian 380D, La�. C).
POUCV NO.: EI(P. ORTE:
COMPANY:
❑ Cerii�ietl topy is �er¢�y fumiSAed. ❑ Cehilietl copy is fileE wii� �he ciry Building Divivon.
Daie: pPD�icani:
EXEMPTION FNOM WOBKEBS' COMPENSp➢ON OECUflATION: is s n n eGl�i p be aomplete0 � permn is lor one �uM �E�001 a iessl.
1 cenily that in the oehormance of the work lor whicn ihis per iit i5 s e, I sh II n e oloy ny ers in any manner o as to hecome
suble�� �o(//he Workers' ComOensation Laws o� Ca
Date: % ���1'L-� Signamrt: �
NOTICE: Ii, after making ihis tleclaration, you s�oultl hecome suUject to ihe WOAers' Compensation pmdsions ol t�e Labor
fAde. you must foh�wil� com0ly wi�h such pmvisions of �his permi� shall be tleemetl revoketl.
CONSTflUCTION LENOING RGENCY: I hereby atlirm Ihal t�ere is a constmction IenAing aAency lor ihe petlormance of ihe work for
whic� Ihis Oermii is issue0 (Section 3097. Gv. C).
LENOEfl:
aooness:
� OWNEP BUIWEB OECIAMTION: 1 �¢reGy aflirm I�ai I am exemp� imm the ConVaciors' State License Law lor �he iWlowinq reason
. �Section 7031.5 Business an0 Professional Code: Any ciry o� couniy wliic� requires a permi� �o constmc�, alter, improve, tlemolish, or
repair any stNCNre. prior ta its issuance, also reQuires t�e apDlicant lor such permit to file a siAneA stalement ihat he/she is Iicense0
' pursuanl 10 I�e pmvisions ol the Contraciors' State License Law (Chapter 9(commencing wit� Section 7000) ol0ivision 3 0l lhe Business
antl Pmlessions Caaq or t�at hGs�e is exemD� t�erelmm antl t�e Oasis for the alleged eeemption. My Nolatian oi Section 70.37.5 �y
any apDlicant for a Dermit subjttis Ihe applicani ta a civil Denalry ol �rot more ttun live hunEreA Aallars (5500).
I, as awner ol IAe pmDeny ar my employees vntn waAes as iheir sole compensatian, will do t�e wark, anA ine
❑ simcmre is not imended or o��eretl �or sale (Semion 7044, Business an0 Pmlessional Cotle'. The ConVacmrs' S�a�e License Law
Coes not aOGly to an owner ol a pmperty w�o Luilds or impmves th¢reon, antl who tloes suc� work �imsell/hersel� or �hmuA�
�is ar her awn employees. pmvitletl �hat such impmvemenis are noi in�entletl or oifere0 lar sale. II, however Ihe huilding or
impmvement is soltl within one year a� compleiion. the awner will have Ihe Ourtlen ol DmNng �e/she Citl not EuiIE Or impmve
lor ihe Durpose of sale�.
I, as ownerol �he pmpetly. am eKclusively cunvacting with IicenseE contractors to constmet the pmject (Section ]044, Business
❑ antl Pmfessions CoGe: The Comrac�ors' State License law Gces not apply lo an owner ol pmperty who hmlQs or imprmes Nereon
ana wno contrads far sucn O�oiems vnih a coniractoqs) license Dursuanl to tne Cantractors' State License Law�. I am aware
I�at prool of I�eir Worker's Campensa�ion insu(ance shoultl 6e O��detl la me.
� I am erempl under Sec�ion�. B. 8 P. C.
lor �his reason:
Ua�e: Ownec
I Oo �ereby cetlify �ha� I am aware o� antl under51an01he requiremenls of Califomia Heal�� anA Sale�y Cotle Sec�ions 25505, 25533, ana
2553a antl �Aai I or any INure building occupant will/will no� (circle one) need lo compty wi�h saitl siate codes and �he requiremen�s for a
permi� br cons�mction or modificalion Imm �he Pir Oualiry Managemen� DisVicl. ReSiGential constmtlion applications are exempt tmm
these omvisions.
Oaie'. ApPlicanl:
I hereby cer�ity tha� I have rea0 ihi5 applicaiion antl state ihai I a�m ini ation i5 correc . I Bree to comply wi�h all ciry antl counry
or0inancesantlslatelawSreWtingtoEuilGingwnstmc' by o eepres �alives tisci enlerupon�� bove�men�ionetl
propeny /yfo��inspec�ion Oyurposes.
/ ���' / �� / '
�ate: � Signalure:
oriver's License or Socia� Securiry a:
=41-a6 White—Bwldmq: Green—Cotle EnlorcemenC Canarv—Aoolicanl; Pink—Revenue: Goltlenrotl—Assnssnr
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: M 05903U
PERMIT NO: M 059030 PLAN CHECK NO: N GOVT; N S PP:
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE; MEC PURPOSE; OTH
JOH DESCRIPTION ; COMMERCIAL T.I, (OFFICES) SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: RE: 858871 PRIMARY BLDG, PERMIT,
x��*x�r *� **x �r�r*�t**� ��e+ex�e �**�r***�r�*�***�r***� ****x * �r���� �r***��*x �r�r**+��r�r� �t�*x * x * *�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------
FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN
PARKING REQ � PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NO'I'ES>
i
**��t��r�*���x�**�x*�*�r***�r**�**�e,ex*,«*x��t.�r�*�**x�e�e*x�***xx*�x*x**�t�t��*+t+�*x�r*�***�**
D E V E L O P M E N T S E R-V I C E S R E Q U I R E M E N T S
20NING APPAOVED BY , �
BUILDING APPROVED BY ;
APPLICATION ISSUED BY; A�L�-�.a_i7
iE if i! ih iF iF 3E iF iE iF iE iF iE iE iE 1E iE fk iE iE k il7F�"R��
k if fE iE iE ik iF iE k it iP 1flt iPlE 1E iE iF iF if iE iE iF iP k iF �! iE iE if f! ik iF iF
LEGALIZATION;N F E E
DATE:
DATc;
DATE: � ( Z
iliEififiFM3fiE�lkik ifiF
iEiEifiklFkifikffi! ifiEiElFiE�fkifififk�E�FkkiFiFlEitlf.�lEif1ElE3FifiFif�F
S U M M A R Y STRUCTURAL SE�`GMENT:N
PERMIT BLDG PMT PLUMBING ELECTRIC MECA9Noo FIRE SMIP/RES GRADING
'152 SMIP/NON—RES
PLAN -
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
'POTALS----> 9,00 15,00 " 0,00 29,00 24,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 24,00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CNECK
24,00
if iE if k 1f if iE it iE1t iE if iE iE fE if 1E if 3E iF iFiE i! ik iF if iE iF iEif 1E iF if iF iE ik f! ik k 1E ik IF IklE k!f if !f ik k 1f if !f iF iE �k ih iE i! iE 1E if IE fE iFiE iE �E ik ik 3E ik iE iElE ii iE iE 3f
I N D I V I D U A�L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I 0 N ONIT COST TOTAL COST
MEC 1 REPAIR/ALT COOLINGc UNIT/SYS W/CNTLS 9.00 9,00
END OF FEES
tl
r
J
r�� n�i1:�J��.'� �'i` __ _ J4�..
9rTE: U9,�t�.'92 �'ri". S?c�� .
� CONSTRUCTION AND PLANNING - P�"'` $ SPA �
- APPROVALS Permit # Date Inspector p�ppROVALS 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 Bondi�g
5. Steel Reinforcemeht 56. Rough Plumbing & Pressure Test
6. Electriwl UFER Grnd: � 57. .APPROVAL TO COVER�GUNITE
, 7. Footings ' ' 58. Electrical ConduiFUndrgrnd.
,8.. Poundation . 59. Gas Pipe, � Undr9md., Test �
9. Water Pipe�Undrgrnd.,� - � 60. Backwash Lines, P-Trap, � Undrgmd.
70. Structural Floor System ' 61. APPROVAL TO DECK �
1 t. Property Sewer Line & House Connection � 62. Backwash & Receptor•Final
12. Sewer Cap - � 63. Heater & Vent-Final '
13. Roof Drains - ' 64. Plumbing System'� Final -�
14. Rou h Plumbin � " � �
g 9 '� I 65. Electricai�Final �
15. Rough Electrical-Conduit ' � 66. Solar System-Final
16. Rough Electric Wiring - 67. Fencing & Access Anproval �
77. flough Wiring Sign � 68. APPROVED FOR P�ASTERING
18. Rough EleGtrical�T Bar Ceiling 69. POOL/SPA SYSTEMS F�NAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . APPROVALS Permit #
27. Ducts,in Structuie� ,'. . - 70. Underground Hydro
22. Ducts, Ventilating ' 71. Product Piping O Gas ❑ Oil
23. Gai Pipe•Rough & Tesc . 72. Underground Flush
24..Roof Freming � 73: Undergmci�. Storage Tank O Gas ❑ Oil
25. Roof Sheaching 74. Overhead Hydro -
26.�T•Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77." FIXED SYSTEM FINAL
29. Insulation I . 78: FIRE PREV. FINAL
30. Drywall Neiling i '� HEALTH DEPT. REQUIREMENT
37. Plaster BroWn Coat � , 79. FINAL INSPECTION
32. Electriwl Power Meter�Final , � � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric " � I (/'j Notes:� ���> ��y���lL____ �Li`
� i G
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test � L- �
I
36. Hood or Canopy .. � � -
37. Final Factory Fireplace � � •
38. Final Plumbing �
39. Water Service-Final - . -
40. Gas Servic6-Final � .
41. Solar pomestic-Final
42. Backflow Preventer � � �
43. Backflow Irrigation
44. Landscape Irrigation SYstem - � -
45.�Sound Attenuation �
46. Handicap Re.gulations � � -
47. PINAL STRUCTURE & BUILDING � . •
48. FiNAL PLRNNING �
.49.; Electric Release to•Edison • '
'.50..GaFRelease to Souihern Califomia Gas Co � �� �
�51. CE9TIFICATE OF OCCUPANCY
No. Date �
I ��I
I�I
PNOJECT AODNESS:
� OWNEfl'S NAME:
aooxess:
ANCHIENGINEEfl:
nooness:
PENMITTEE:
JN BL uxiT: 2NDFL
NERICA
!tOND AVE 3RD FL
770U
TECT nec.xo.: C-11073
INITO VINO { uNir:
LLS CA 92653
ON ELECTRICAL;/ (818)331-5807
FODXESS: (jS STEPHORA
COVINA CA 917Z4
UCENSEU CONTflRLTOP OECUIBRTION: I here�y aftirm tAa� I am licensed untler O�ovisions o� Chapter 9(commencing with Sec�ion
7000� of Orvision J ol Ihe Business antl Pmtessions Cotle, an0 my license is in full �orce antl eflecL �
cirruc.:056905 STpTEUC.:�jl(54��0
Date: � —� — 9 2 Signature:, � �� �
WOBNEPS' COMPENSpT10N �ECLABATION: I here6y aft+[mWa ave a cerbf� of consent to sel4insure or a certilicate ot Workers'
Compensation Insurance, or a cenilied coOY Ihereol (Section 3800. Lab. C�.
POLICY NO.: EXP. ORTE:
COMPRNY:
❑ Cetli6etl copy is hereby fumished. ❑ Cehiliea coDY is filetl wiN the ciry BuilOing �ivision.
Date'. ADDlicanC �,..`.� �%�
. �
E%EMPTIONFBOMWOflNENS'COMPENSATIONOECLFBATION: (ihissec�ionneetlnotbecample�edi�Ihepermi�islaronehunar��5100)orless�.
I cetlify t�at m the pedormance ol Ihe work �or whicA ��is permi ' issued, I shall not emDloy any person in any mEnner sb as �o �ecome
SuDlea� �o �he Workers' Compensaiion Laws 01 Cali�omia ��, �/�•�
Date: �-8— �2 Signaiure:
�' � rj
NOTICE: If, afler making �his declaration, you should e su61e�� �o ihe Workers' Compensatian provisions�N;i�e Labor
Cotle. you mus� lohhwil� comDly wiih si��p pmvi5ions o� �his permit shall be aeemed revake0. �� �/
CONSTHUCTION LENOING RGENCY: I hereby athrm iha� there is a conslmction lending agency for �he periormanc�91 the work for
whic� this De�mil is issuetl (Seclion 9097, Ciy. C�. �'� �,
LENOEfl:
aoosess:
OWNEB BUILOEfl OELUFlFTION: I �ere0y dflirm Ihal l am exempt �mm Ihe Cantroclors' S�a�e licenye Law lar IAe lallavnnp reason
(Section 7031.5 Business and Pm�essional Cotle: Fny ciry ol counry which requires a permi� to con5�mci, al�er, imOmve, demoliSA, or
r¢pair any SVutlure. priDr Io ils issUance. a150 repuires lhe applicant tor such permit lo file a SigneG S[alemeni Iha� Ae/5he is licen5¢tl
pursuani Io ihe pmvi5ions ol IAe Conlrati0r5' Slale LicenSe Law (ChaD�e� 9(commencing with Sec�ion 7000) af Division 3 af Ihe Business
antl Professions Coae� ar ihal he/sne is eKempt therefrom ane the basis for ihe allegeA exemption. Fny violation of Section 7031.5 ey
any applicant �or a permil suble��s Ihe applicant �o a civil penalry a� noi more �han five hunOretl tlollars (E500�.
I. as owner of Ine prooeny or my emplayees with wages as their sole compensation, will Ao Ihe work, and ihe
❑ stmcwre is noi imenaeU ar offerea lor sale �Section 7044, eusiness and Pmfessional Cotle: T�e Contractors' State License Law
Ooes nol apply lo an owner of a O�operty who builUs or improves �hereon, and who tloes suc� work himself/hersell or throuAh
�is or her own employees. D�ovidetl �hat such impwvements are not intendeU or ofleretl lor sale. 1�, hawever ��e Uuilaing or
improvemem is solJ within one year e� comple�ion, Ihe owner will have �he hur0en of proving he/she Uitl no� builA or improve
lor ihe puroose ol sale).
I, as owner of the pmperiy, am eKclusively convacting wilh licensee coniractors ro constmet t�e prolacl (Section 7044, Business
❑ anA Pmiessions Code', The Cqmracior5' $�ate License Law tloes no� aDPly �o an owner o� pmDehY who hwl0s or improves �Aereon
an0 who Con�racts �or SUCh pmlacis With a Contrattor�s) litense pursuan� �o [he COn�rac�ors' $�a�e License law�. I am aWafe
ihal proof ol lneir WOBer's Compen,ation insurante shaul0 be provitletl to me.
� I am ezemp� un0er Section: B. 8 P. C.
for this reason:
oale: Owner
I tlo here6y cetlify �hat I am aware of antl untl¢rstan0 �he requiremenh of Califomia Healih and Safery Cotle Sections 25505, 25533, an0
25534 antl �hal I or any fNure �uiltling occuDant will/will no� (circle one) neetl �o camply wi�h said state cotles and �Ae requi�emenls br a
permi� �ar con5�mciion or motlilication Imm �pe Air Oualily Management �iSVic�. Fesitlen�ial constmc�ion applications are exemD� ��om
Ihese provisions.
Oate:
I hereby ceriily Ihat I have reatl�his ap0licali
ortlmances and Slale laws relaling to DuilEing i
property forinspec�ion purposes.
Date: � —�" � Z
Oriver's license or Social Seariiy x:
16<1-a6 W�ne—BwWinq: Green—CoEe Enlorcemenl Canary—AooiicanC Pink—Revenue: Goltlenro0—Assassnr
CITY OF COSTA MBSA — BUILDING PERMIT
PERMIT NO; E 058970 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE
JOB DESCRIPTION ; COMMERCIAL T,I, (OFFICES)
CLAIM VALUE:
CALC—VALUE:
PERM NO; E S89
�O T: N S PY:
PURPOSE: OTH
SQ FT:
GROUP OCC: B-2 /
COMMENTS; RE; B58871 PRIMARY BLDG. PERMIT,
if 3f iEiEiE iE iE iF iE iE it if ik IE k iE ik if iE 7F iF iF fE iE it iE ik iF iF fE if iE IF IF iE it 1E iF iE 1E 1E iE iE 3E iE iE 3! �Eik iE it if iE if iE iE iElF 1E iE iE �E iE it iE it iF iE iE 3E iE 3F �F if *iF iF 3E if
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAFt: FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE�i • PROV: PARCEL; 41050104 ZNE; REF NO:
PLANNING N13'I'ES> ,
\ i.
iF if iE iE if iF iE jF if �K� iE 3E 1F �Fif �f iE iE iE iE iF�F�If if if it iE iF 1E iEiE if 1F iEiE if if if if iF�E 3EiE jF �E 1E iE iflE iE iE IFlE it iFjf iPiFlF iE iEiE �1F �1F iE iE iF i� 3E �E i't 3F �E 3f iEiF 3F 3k 1F
D E V E L O P M E N T S�E", ft V I C E S R E Q U I R E M E N T S
20NING AI�PROVED BY ��i DATE:
BUILDING APPROVED HY ; i DATE;
APPLICATION ISSUED HY; � 'r DATE; ���������
ikif�ifiEifiEiEiEiliFfEitiElEiff(�if3FiEiF1Elf 1Eifi6if�iEiElEiFiFIF ifiF
ifiFiEiEiEiElEiE3EitititjFiFiE�IFiE1ElfiE�E3E1ElkiEiElE1liFitiEitAEiEiE�f1E1EiEiE1E �EiE3E 3EiFiFifiFlflfif�ElE�EiEil1ElFiffklEfFik�FlfiFiEik3F#iEiFiE3fiE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 20,85
.i SOt SMIP/NON—RES
PLAN
ISSUE FEE �5-.00
BUILDING—DIV—> PERMIT ISSUE ALAN—CHECK TOTAL PAID DUE
TOTALS----> 20.65 15,00 "' 0.00 35,65 35,85 ,00
��
HEVENUE DIVI5ION TOTALS--> COLLECTED; 35.85 OVER/SHORT: ,00
BLDG PM1' PLUMBING ELECTRIC MECHANIC FIRE SMIP/TO't GRADING PLAN—CHECK
35,85 j
ik iE iE �1F 1F 3f �]E it iE iFlE-lE iE �IF �lE 3F if IF 1FiE iFikib iF iF �h iF �1f- iFlE iE�IE IE jtlE i(� iF �1F iE lE iF �lf jF 3F 3k iE iE �lE if iE !E �E �E iF iE iE iF iF 1E if #�lE 1E IE 1E iE k ik �1! iF af if iE iE IE 3E 1F ih �E
I N D I V I D U A�L F E E H R E A K D O W N
TYPE QTY D E S C R I P T Iy0 N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET �� i ST 20 EA. .75 15.00
ELE 3 RECEPT/OUTLET = ADDITIONAL EA, ,45 1,35
ELE 6 RECEPT/SWITCH .�- 1 ST 20 EA, .75 4,50
<END OF FEES
ir )
�.1
� --
! '��:1.''e. ;'Ii' .��r .. _ ._ - �
[.!•'1 L �� _ . . ' . .
� CONSTRUCTION AND PLANNING . . � PO�, . SPA
APPROVA�S Permit # Date � Inspector qppROVALS Permit # Oate tnspector
i. 7emporary Electrical Service or Pole ' 52. Pool & Equipmen[ Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Uiility-Undrgmd. 54. Forms �
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5.'Steel Reinforcement - � 56. Rough Plumbing & Pressure Test
6� Electrical UPER Grnd. � ' 57. APPROVAL TO COVER-GUNITE �
7. Footings � ' 58. Electrical Conduit-Undrgrnd. � �
8. Foundation �' � - 59. Gas Pipe, � Undrgrnd., Test
� %
9. Water Pipe-Undrgrnd. ' ' � 60. Backwash Lines, P�Trap, O Undrgmd. •
70. Structural Floor System , 61. APPROVAL TO DECK �
71. Property Sewer Line & House'Connection 62. Backwash & Receptor-Final
12. Sewer Cap ' .. . . 63. Heater & Vent-Final " •
7 3. Roof Dreins j 64. Plumbing System - Final �
14. Rough Ptumbing � 65. Electrical�Finat ' ��
15. Rough Electrical-Conduit � 9��QZ �� 66. SolarSystem-Final �
16. Rough Electric Wiring ' �s/ ,Q��o 67. Fencing & Access Approval
'- l
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAI �
19. flough Heating & Air Con4�tioning FIRE DEFT. REQUIREMENT
20.�Rough Factory Fireplace " ` - APPROVALS Permit # -
21. �Ducts, in Struaure . , 70. Underground Hydro
22. Ducts, Ventilatin9 � _ :77. Product Piping OGas ❑Oil
23. Gas Pipe-Rough &'Test �- � 72. Underground Flush
24. Roof Framirg •• � - �73.- Undergrnd�. Storage Tank O Gas ❑ Oii
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 - .' -. • i 77, FIXED SYSTEM� FINAC
29. Intulation -
i I- � 78.• FIRE PREV. FINAL .
,
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Piaster Brown Coat � �' 79. FINAL INSPECTION.
32. Electrical Power Meter-Final - � � � 80. FO00 CERTIFICATE ISSUED �
33.�Fina1 Electric /Q� � Notes: /�� ' �fa` , . (' ((�V���
34.��Final Heating & Air Conditioning , . � � � , � ' •
35. Final Gas Pipe-Test � , -'�� _ �
36. Hood or Canopy . . � � j� ' �
. j
37.•Final Fattory Fireplace ` ' � � . . ,
� j
38. Pinai Plumbing � .
f
39. Water Service�Finaf� � ), ' ' �
i
40. Gas Service-Final - ' �� �
I
41. Solar pomestic-Final � � ' '
I
42.'Backflow Preventer - I � � -
43. Backflow Irrigation ' �
44. Landscape Irrigation SYstem, , . _ , , . �
45.:Sound Attenuation • � '
46;' Nandicap R'egulations - ' � � �
47. FINALSTRUCTURE&BUILDING .
48. PINALPLANNING � • -
�49. Electric Release to �Edison l,.. ,
50. Gas Release to Southem California Gas Co ( ���! � ' . .
"51. CERTIFICATEOFOCCUPANCY
No. DatC
ApPlitant to fill in a11 spaces except those within heavy eortle: lines antl sign all approoriate Oeclarations.
� CrfY oF COS7A MESA CONSTRUCTION PERM�InT�-
Project Address �s �TON �L�17� C./'7. �y. Z�
Applicai
. `
Owner's
Addr`ess
Arch/Erv
Address
Contract
Addreu
Ciry Lia
LICENSED CONTRACTOR DECLARATION
I bereby aifirm Ihat I am li<ensetl under provisions ot C�arter 9(commencin9
with section 7000) of Divislon 3 of lhe Businesz antl Professions Cotle, antl
my license is in IWI torce and etfect. �3 ��
�icense CI ss L' No.
Oale Si9natu�e
'vORKERS'COMPENSATION �ECLARATION
�ereby aHi�m lhat 1 hdv¢ a Certiflcate of consent to self-insure o� a certiticate
. Workers' Compensation Insurance, or a certifiee copy thereof (Section
3800, Lab. C.) �
vo�icy No/JP46 3z5—l99 Comoany
8 Certifietl cop is hereby fumishea.
Certiti 0 co I fileC with the tity `i�.� -. I/�
Date Applicant
EXEMPTION FROM WORKERS' GOM�ION �ECLARATION
(ThissectiOn neetl not be mmplet¢tl if Ihe permlt is (o� one huntlretl ($100) or
less).
1 certify that in the perPormance oi the work tor which this permrt is issueC, I i
shall not emo�oy any person in any manner so as to become subject to the
Wo�ke�s' Compen5ation LawS Of CalifOrnia.
^ Date Si9nature �
'✓/ NOTICE: If, atte� making IhiS tleclaration, you shoultl become Subj<ct t0 the
`� Workers' Compensation provisions of tne Labor Cotle, you must forthwith
comply wilh such provisions or this permlt snail be aeemetl revoketl.
CONSTRUCTION LENDING AGENCV
� 1 nereby afllrm t�at there is a'construction lentlin9 agency tor the performance
of [he work tor which this permit iz issuetl (Section 309] Civ. C.)
ZLentler's Name
Lentler's Atltlress
�OWNER BUILDER DECIARATION '
I hereby alfirm lhal I am exempt from tbe Contractor's License Law for the
� following reason (5¢ction 7031.5 Business antl Professlonal Cotle: Any city or
county which �¢qui�es a Oe�mil f0 const�utt, alteq imOrovO, tlemolish or repai�
any structure, pnor to its issuance, also requires the applicant for such permit
f0 lile a sign¢tl stalement [hat he/zhe is Iicensetl pursuant to the provisions of
C 'he Contraclor's Li<ense Law (Chapter 9(commencing with Section 7000) ot
�ivision 3 ot tbe Business and Pro(essions Cotle) or that he/she is exempt
aeretrom anU the ba5i5 tor the allegetl exemp[ion. AnY violation oT Section
7031.5 by any applicant for a permit subjects the applicant to a civil
�enalty of not more tnan tive nuntlretl tlollars ($500).
I, as owne� of the property o� mY ¢mploy¢¢s wlN.wagez az their sole
comoensauon, wiu ao tne work, antl the st�uctur¢ is not Intentled o� ofter¢tl
for sale (Section 7044, Business antl Pro(essional Cotle: The Contractor's
License Law tloes not apply lo an owner of a property who builtls or improves
th¢reOn, antl who tloes such wo�k himsel�/nerselt o� Ih�ougM1 his o� h¢r own
employees, provitletl thal such improvements are not intentleC or offeretl tor
sale. I/, however, the bulltling or Imp�ovement I5 Soltl within one yea� of coT-
pletion, the owner will nave the burtlen of orovin9 he/she tlitl not builtl or im-
prove forthe pu�pose of sale).
❑ I, as owner of the property, am exclusively contracting with licensetl con-
tractor5to Const�uct Ihe projecf ($ection 7044, Bu5ine55 antl Profession5 Cotle:
The Contractor'S license Law does not apply to an owner of property who
Duiltls or improves thereon. antl who contracts tor such oroiects wich a con-
tractor(s) license pursuan[ to [ne Contractor's License Law). I am aware that
proo( of lhei� Worker'S COmpensatlon insutance Shoultl be provi0etl to m!.
❑ I am exempt untler Section B. & P. C. for this reason
Date Owner
I hereby certity that I have reaa this application antl state that the above
information Is corrett. I agree to comply with all city antl county ortlinances
dntl State IawS relating t0 builtling mn5tructiOn, antl hereby authoriie re0�e-
sentatives of tnis city e� Iron the above-mentionetl prop—= ert��
IOSp¢Ct100 C5. ��
, .......,. ...._..._. I
36 fo �-(� /0 S 90
TYPE OF CONSTRUCTION NEw noo
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. Q
H. nr.,«.,-,u� _ das,.�.Pai /�nii
TVPE OF PERMIT LJ GRADING IJ FOUNDATION LJ STRVCTURAL
�TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
OTHER
PROJECT DESCRIPTION 5o. FT, a oCCUvaN�C7v����
C O N ST RUCTI ON TV PE V ALUATION $_{��5!
20NE GRADINGCU.VDS. ACRES_
Remarks:
Sink
Preventer
Irrigation
rinking Fountains
loor Drains
loor Sinks
as Serviee Outlets
Kitchen Sink
Lavatories
P—Trap ,
Roof Drains
Reinspoction Fee
$15
Boiler -
Duct - Under Ground
Dutt - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑6700,000 BTU 0100,000BT
$IIOWCfi
Service Sink
Sewer Cap , '
Sewer Connection
Solar Collectors
Solar Piping •-
Solar Tank ��
Swimming �Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
'� A.P. �W L . O — ,� �
S Main Building:
IR
/Y. 7 Front
B Rear
A
— I C Right
g . Le
_ Ping. Ref. �p
� PlanningNotes: pAjJjJ,�,
BSi
sFEES
'i
Automa[ic Washer
ConStruction Pole Sub.
Cooking Unit
Dishv.xsher
Dryers ❑Gas ❑Elec[ric
Fan
F,A.U.
FixtU�¢5
. Device Boxes
Outlets
$WitCh¢5
.� Garbage Disposal
. Genera[or Da5 KW 05-15
Iwue Fee § 3
�ANICAL FEES
Hood or Type I ❑
Canopy Type 11 ❑
Refrigeration System
❑o-�oo,000aru ❑ioo,000eru
System Repair/Alteretion
Fire Dampers
Registers
zo�e
Accessory Bui
fleq./Provitled
ELECTRICAL
Transiormer ❑ 15-50 KW
❑ 50+KW
Meter �up to 100 amps
Meter ❑over 100 amps
Sub Panel ,/
Motors�67 HF �1'/.-6
IncSoiar �9-75 HP �16-15+
Microwave
Pole Light „
Standing Sections
Trash Compactor
FEES
N
I
N
G
R
E
Q
M
T
S.
� Rainspeytion Fae �$15 � � luue Fee � $ 3 �
DEVELOPMENTSEHVICESREDUI NTS: �Z, 9. 8�
2aning Approvad By � �ate
�Building Appravad By pate� �7
Application laued By � Date3Y�
SUMMARV OF�EES C 2
BUILDING PERMIT $�OP� 4�' SMIP $ 33 ,
PLAN CHECK $ �� �� �� PERMIT
' PLUMBING $ ISSUANCE $ .
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING S �
PLANCHECK 50% $ MICROFILM $ �
MECHANICAL $ TOTALFEE $ � �
PLAN CHECK 25% $
Signature �y� Da[e �
Drivars' License or 55 � �� I I Reinspeetion Fee I $15 I I Issue Fea I $ 3 I I
O1 D00216?�4-�0021fi28 YuJY i294.07
0865-46, rev. 5/80 White - Builtling; Canary - Appllcant; Plnk - AC<Ounting: Goltlen�otl - ASsesso� OATE% i?/�9/$$ TIME: 09:11
1- • ', 1
;�' COM1ISTRUCTION AND PLANNING P� s` SPA
� APPROVALS Permit# Date Inspector AppROVqLS Permit# Date Inspector.
� 7:'Temporary ��ectrical Service or Fol2 52. Pool & Equipment Location -
2. Soil Pipe�l4Jndrgmd. -�,f �", 53. Steel Reinforcement w: -1
�3�. Electrical�Conduit Utility-Undrgmd. 54. Forms �
'4. Electrical Conduit�Uncl.rgrnd. , 55. Electrical Bonding i^i;
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test '"' '
6. �Electrical UFER'Gmd�:' I� � 57. APPROVALTO COVER-GUNITE� �� �•'
� �t i • ,
7. Footings � 4j," ' j j��� 58. Electrical Conduit-Undrgrnd. '� '
�8. Foundation =�'• � %� 1� 59. Gas Pipe, � Undrgrnd., Test �' ,
' 9. Water Pipe-Undrgrnd. �� 60. Backwash Lines, P-Trap, O Undrgrnd. -'
r
� 10. Structural Floor System i' �� 61. APPROVAL TO DECK
11. PropertY Sewer Line & House Conp'ection, _ ., 62. Backwash & Receptor-Final .
� 12. Sewer'Cap . � ' '} p� 63. Heater & Vent-Final . _�
.�
+13..Roof D�ains' � • . � � ` 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 6S. APPROVED FOR PLASTERING
•18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
"1,9. Rough�Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,'in Structure ' 70. Underground Hydro
22. Ducts, Ventitating i� � 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 ,�dl� 76. Dry Standpipe
28. Lathing & SiAing 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing j � � HEALTH DEPT. REQUIREMENT
!31. Plaster Brown Coat;' ' 79. FINAL INSPEC.T.ION
i32. Elecirical Power Memr-Final 80. FOOD CERTIFICATE ISSUED �
'�33. Final Electric ''�� ' Notes: � -
�
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test
�
36. Hood or Ca'nopy '
' 37. Final Factory Fireplace
38. Final Plumbing -
39. Water Service-Final � . .
.40. Gas Service-Final . �
41 . Solar pomestic-Final _ _
.42. Backflow Preventer .. �'� ' �
43. Backflow Irrigation " " , ,�
44. Landscape Irripation System . ' . �1
45. Sound� Attenuation �
46. Handicap Regulations. . �
47. FINAL STRUCTURE & BUILDING G�i�
48. Sner.ial Requirements Completed
49. Electric Rel�ase to Edison "� �
50. Gas Release to Southern California Gas Co .,' �_ .!
� 51. CERTIFICATE OF OCCUPANCY . T �; � �
rt
No. Date � ' ' ,
`f✓ �'�/ ADplicant to till in all soaees except those within heavy CorCer Iines ana si9n all avProv��ate eeclaratianz.
CITY OF COSTA MESA CONSTRUCTION PERMIT.Sc,t�T ? MIT NO. TRACT NO. LOT NOi Ury^IT N�6.
Pioject Addrgfs S�-s /�N'T�L/ .Q i.d zd0 ' � " �V � ,
Appticant'S Mailing Address �� " 6!J TYPE OF CONSTRUCTION' NEW A�D �.4LTERATION REPAIR —�
Owne�'S NameS Gv.L�Y �YGl�'YG� Z,��p � CONVERSION ❑ DEMOLISH ❑ OTHER Ti_.ua�T �6G1�2 A P#
Phone DESCRIPTION OF WOfi /USE O,nF BLDG. `
Address ��� - Q%��� �vl r'�' k�✓'^ G� : r /' [J�(�Y ��-Y� �!/j�! Op S Main Buildi
Arch/Eng. . License No. TVPE OF PERMIT ❑ GRADING FOUNDATION STRUCTURAL T Ffont
Address -' ❑ TENANT ❑ ELECTRICAL ❑ PLUM6ING�MECHANICAL � A Rear
ContracroPsNama��� ���",� l�_ /_�Phone Zf'y-�/ ��/ �'oTHE(t' � - - . C Right
�uA�� �jd���� PROJECT DESCRIPTION 5Q. FT. ocCUCANCv
Address,Imailingl�l�G����y"w -f CONSTRUCTIONTVPE - VALUATION$ S Left
City LiCense NO_ ' � l r�OJ � , ZONE '` GRAOING CU. VDS. ' ACRES p�ng. Ref. #�
LICENSEDCONTRACTOR�DEGLqRATION � ' � �' ' ' "
I hereby af(i�m tM1at 1 am licensetl 4nder provision5 0( Charte� 9(commencing Remarks: �� � 2QD �� - Planning Notes:
with section 7000) of �Division 3 pf tbe Business antl Professions Cotle, antl —
my Ilcense is in full torce antl eifect, i ' , - . - -
'Jcense Class �Z� License No.�2��s%�,
)ate�� ��'�� Siqna re ' � PLUMBINCa FEE$
WORKERS'COMPENSATION DECLARATION � ,
� I hereby atfi�m ttlaf I have a certificg�¢ of con5ent to self-inswe o� a certitiwte 83f Siflk ShOW¢�5
of Workers' Compensation Insurance, or a certitietl copY thereof (Section BackflowPreventer - - ServiceSink --- -� - �
3800. Lab. C.) - . . . . . . _ •
Policy No. ZU/�/i�Tl��6� company �✓/�5�� Backflow Irrigation � Sewer Cap � .�'
Certitietl copy is hereby turnishetl. �
Certitietl copy is filetl witn the cit uiltli , Divisi .. � Bathtubs !.'�, � Sewer Connection � ��,
oate�/�1L�-c�f Appli t_� � . . �
EXEMPTION FROM WORKER pMRE SATION OECLARATIO� CI3�ifi¢!5 �� �_..� SOIa� COII¢cL0�5
(ThisSection need not b¢ completetl jf the permiLis�tor�one huntl�etl ($1 ) or ,
iess). � Dishwasher . - Solar Piping .
I certify �that-in the perform5nce ot �he work tor which this pe�mi� is issuetl, I
s0a11. not employ any person in any manner so �as to become subject to tne . Drinking Fount3iris Solar Tank -
Workers' Compensation�LawS o( Cap}ornia. .
. Date Siqnatwe ' Floor Dreins Swimming P I w/Spa '
`NOTICE: Ii, atter making this tleclaration, you shoWtl� become subject to the .
Worke�s' Compensafion provisions of the Labo� Code, you must torthwith FloorSinks . Urin � �- -
comDly with such p�ovi5lon5 or this pe�mit shall be:tleemetl revoketl. �
CONSTRUCTION�LENDING•AGENCV ' _ GasSelviCe .Outlet5 _ , aterCloset - '
I hereby affl�m tM1at there is a constructiomlentling a9ency for the pe�tormance
of thc work for, which this permit is issuetl (Section 309� Civ. CJ Intereeptors • Water Heater
LenOer's Name� - -
Lentler'sACtlress � � � � Kitchen.Sink WaterService
OWNERBUILDER OECLARATION " ' � '
I hereby afiirm thai I am exempt trom the Gontractor's License Law for the . Lavatories � " Auto-Wasll '
tollowing reason (Section 7031.SiQuSinezs antl Protessional Cotle: Any city or .
counry whlch requires a De�mit to const�uct, alter, imOrove, tlemolish or repal� ' P—hap ' �'LdUndry T�dys �
any sGuctu�e, prio� to il5 is5uance� also requires the applicant for Such pe�mit .
to file a signetl statement that he/she is licensetl pursuant to the provlsions of q��f nrains . ' . �
the Contracto�'S License Law (Chapt¢
Division:3 of theBusiness antl Pro7
therefrom anC the basis tor Ne allec
7031.5 by any ap0licant for' a, pe
, enalty of not more than five huntlrei
�� I, as owner oi tM1e+properW 4r,
mmpensation, will tlo the work, ahtl
tor sale- (Sec[ion 7044, Business ar
�icense Law tloes not apply to an Ow
tpereon, anC who;tloes Sucli work ry
¢mployees, proviGetl Ihat such Imprc
sale. It, however, the Ouiltling or im�
pletioq the owner will have the bUr<
p�Ove tor the purpose oi sale).
❑ 1, as owner of tlte property, aT E
tractorsto const�uctthe Orojec[ (SNct
The Contractor's License Law tlops
builtls or improves thereon,�antl Wp�
tractor(sllicense pursuznt to the Co
proof o1 Iheir Worker'S Compenseti
❑ I am exempt untler Section�
�ate
Owner `
certify that I have reatl this
�n is mrrect. 1 aqree to cpmp
pt
�.he.applicant'to a
with wages as thei
� not intentletl ar o'
operty who builtls or improves
�elf o� th�ou9h his or he� awn
re not infentletl or offeretl tor
is soltl witnin one year of com-
�ing he/She tlitl not build or im-
wMractin9 with licensetl con-
Business antl Profession5 Cotle:
to an owner of -property who
� for such projects with a con-
License Law). I am aware that
ice should be provitletl to me.
— B. & P. C. for this reason
'�tate that the above
tl county ortlinances
eby autho�ize repre-
Ionetl property tor
D ts/L'7?->��G
t � ,
Reinspec[ion Fea $75
Boiler
Duct - Under Ground
Ouc[ - Structurel
Duct-Ventilating '
Exhaust System ❑ Multiple ❑
FirepVFact.8lt. ICBO #
Heating System $ Ducting
❑ 0.100,000 BTU O 7 00,000 BTi
��Y��ature cr v d
Drivers' icense or9T-/p I ' I Reinspectiou Fee I �$15
CMF 0865-a6, rev. 10/84 White - Bulltling; Canary - Applicant; Pink - Accountinq; Goltlenrotl - Assassor
laue Fee r ' $ 3
Hood or Typel ❑ '
Canoov.' Tvoe II' O�'G'�
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers�u�s�,
Registers .
Issue Fee
�.
- Zane �
� • Accessory Buildin9:: �
Z
' ^ O
� N
1
_ N
G
R
Parking Req./Provided � , E
i Q'
i M
• � T
S
EIECTRICAL �
Automatic Washer Transformer ❑ 15-50'KW
Construction Pole Sub. ❑ 50 + KW
Cooking Unit '
Dishwasher � '
Dryers ❑Gas� OElectric
Fan
F.A.U.
Fiztures
Device Soxes � '
Outlets
Switches
Garbage Dispoul
Generator 065 KW �5-75 KW
Reinspectian Fee
DEVELOPMENT SERVICES
Zoning Approved By
a Building Appraved By �—
. Aoolintion Issued BY�
FEES
T
Meter LJup to 100'amps � '
Meter �over100amps �
Sub Panel �
'Motors 61HPO1Y.-8 �
nc. Solar�09-15 HP �16-75+
Microwave ' - ' — ' ��
Pole Light �
Range
Sign �
; Standing Sections '
Trash Compactor
$15 � � Issue Fee
� ' SUMMARV OF I
BUILDING PERMIT $
PLAN CHECK $
� PLUMBING $
PLAN CHECK 25% $ '
ELECTRICAL $
PLAN CHECK 50% $ ��
MECHANICAL $ � 6L -3. b::
PLAN CHECK 25% $
$ 3
9
er �
SMIP � $
PERMIT
ISSUANCE �$ '
ENERGV P.C. $
GRADING $
MICROFILM '$
TOTALFEE $ - �7�•�
Q 3 00022151-00022161 '� 0'�
11AT�. t�»^ian r�tu�. �eueo
,.. �
-._ ,
�CONSTRUCTION AND PLANNIN� -. . � POOL & SPA
APPROVALS Permit�# .Date Inspector qppROVALS Permit# Date Inspecror
�,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-Undrgmd. . 55. Electrical Bonding � � .
- 5; Steel Reinforcemen[ ' 56. Rough Plumbing & Pressure Test �
6.. Electrical UFER Gmd. " � - 57.'APPROVAL TO COVER�GUNITE
r
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 � � - �
�1.6. Rough Electric Wiring � ' 67. Fencing & Access Approval - - ��.
77.� Rough Wiring Sign 68. APPROVED FOR PLASTERING
18^ Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning (!3 L� FIRE DEPT. REQUIREMENT . .
20� Rough Factory Fireplace APPROVALS Permit #
21': Ducts, in Structure ,70. Underground Hydro
22. Ducts, Ventilating , 71. Product Piping O Gas O Oil •
23. Gas Pipe-Rough & Test � 72:� Underground Flush � i /
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceilin9 (Structural) & Monocoat 75. Dry Chemical .
27. Frame and Flashing , 76. Dry Standpipe � .
28. � Lathing & 5iding ' 77. FIXED SYSTEM FINAL �
29. Insulation • 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31� Plaster Brown Coat 79. FINAL INSPECTION �
32! Electriral POWer Meter-Final . 80. FOOD CERTIFICATE ISSUED -
��
33. Final Electric ' Notr.s:
34. Final Heating & Air Conditioning Z� LE/� .
' 35. Final Gas Pipe-Test • �
36. Hood or Canopy ,
37. Final FactorY Fireplace , � .
38. Final Plumbing �
I 39. Water Service-Final �"
' 40. Gas Service-Final - .� �
' 41. Solar pomeSticFinal - .
� :s..
� 42. Backtlow Preventer � ' �
� 43. Backflow Irrigation ' � � � '
44. �Landscape Irrigation System
I� 45. Sound Aitenuation � - ' � � ,'
46. Handicap R¢gulations � � -
J 47. FINALSTRUCTURE&BUILDING . . . . "
� 48. Special Requiremenis Completed � . �
` 49. Electric Release to Edison ' , � - . - - • - , _ -
,
i 50. Gas Aelease to Southern California Gas Co � ' �`
51. CERTIFICAIE OF OCCUPANCY- _ . . . . .:_ �
� No. - � ' � Date � ' . � ' ... .
..�
ADONcaa< to HII in ail spaees except thase wlthln heavy Oortler Iines an0 sign all apP/oprlate Oeelaration0.
CITY OFLOSTA MESA CONSTRUCTIONZE�MIT
a�oi��Aaa��s 55S Ani-a� �-{ . .
Applicynt's Mniling Adtlress
Owne?'s Name � hone
Adtlress
A�chlEnq, � � K License No.
Address �
Contractor's Nam -i�,�` � Phone 549 QS t�
Atldressfmailing)�i.l CiS.3h�" ��-��7�n��n MP�(1)
Cify License No. n��qa�n
(_ICENSED CONTRAGTOR DECIARATiON
I �ere0y a(lirm that 1 am Ilcflnsatl untl0r proWiionS of Charter 9{commantlng
with soction 7000) o} Oldzion 3 of che 8usioess an0 Orofesslon5 Cotle, and
mY Ilcense is in fWl torce antl eftect,
Ucansc Class� r_ ��� l.tcense No. S�e�2�F7,_,�
�te 1�l'('19'r� c�e�a���a Hi�,np� L'tw��l�rn 1
JKKE0.5'COMVEN5AT10N OECLARATION
, neieny atiirm tnat I nave a Certlticate of co�sent to SelHnsure or a cerHticate
of Work¢rs' Comp¢nSdtiOn Ins�rance, or a certiHetl coDY tltereot (Section
3800, Lab. C.j
aoi�cy no. ���p$g`�1�1U� CompanyFrnlTY1f1T �rcipmn�.
�Certified copy iz herebY turnizhe0,
Certffietl toDY �s fileb with tne clty Bui dfng Otvisfory,
pate�d"09'$%� qpplicant na ('nrnd�/+��,
EJ(EMPTION FROM WORKERS' COMPENSATION OECLARATION
(Tht55ectton neeE not be completea if the Vermit K for one �unOratl (E100J or
Iessi.
. I cortify tha! �n the periorman<e of Ibe woik toi wnich [bIt petm�t is i55ue0, 1
shall not employ anY Person in anY manner so ai to become su0ject fo tha
Workers' Compensation Laws o� Calltornia.
Date Si9nature
NOTICE: If, after makin9 [his OeCla�ation, you Shou10 betome Subjott to the
WOrke�s' COrt�pepydtlon p�ovl5i0�5 O� lhe LdbO� Cotle, y0u TUit �orthWltp
compty w�tn' sucn O�ovizlons or tni5 pOrmlt sNall Ge UeemeO revoketl.
CONSTRUCTIDN IENO�NG AGENCV
1 hereby altirm that there Is a construtlton lentling agen<Y for the perio�manta
of tho work for whith th�s perT�t is issuetl (Settion 3097 Civ. C.j
LenCer's Name
IAnG@�'S Atltlre55
OWNERBUILDER OEC�ARATION
1 hereby aHirm tbat 1 am exem0l from ihe Contractor'i L(censa Law for th0
followi�9 reasbn (Section 7031.5 8usinusz antl Professional Cotla: RnY titY or
counly wnith requires a Oermlt to coostruc[. alte/, ImP+nvB, Oemollsh ot raDa(r
my sVucluve, prior to ifs Issuanco, diso reqWr¢s tl+e applicant tor suc� Oarmlt
) file a signetl statemcn[ [bat ne/sh9 i5 Iicentetl pursuant to the ProviSionS o1
ne Contracto�'s U<ense law lChaplor 9(commencing wlth Section 7000} o�
� Division 3 0� thu gu5fno55 antl Protessions COtle) or [hat ne/ibe is axempt
I ther¢fmm antl Ihe ba5i5 lo� tn@ allegetl exem0��on. Any vlolation of $otllon
7031.5 by dny app�ican� fo� a Permit 5ubjett5 thu appifCant to a ciWl
�enalfy of not more tnan itve hundretl Eoliars (S540i. '
1, as uwner ot the proplrty o� my emD�oyofls witn wagas as their solo
�compcnsaUon, wiV aa tne vrork, ana tha sUuctura is not �ntantletl or oflmatl
br Shce ($oction 7064, Business antl Grotessional GOCe: Tha ContractoY'S
Licensc law tloes not appry to an owner of a property who bullas o� itnProvas
t�areon, antl wM10 tloes such work himielf/har=elt o/ throug� hls or ner own
emPlo�¢e5, provitlCtl ihat Suc� (mO�OveTen[S d�e not Intentled O� Of}ereE fo�
sala I nowevaq t�e Ou1lAing or Improvemont is sala wit�7n one yaar of <om-
' Piatlon, the ow�rtr wlll have tha bwCen o� Oroving �e/she tlitl nof �uiltl or im-
prove forthe purpose of wle).
❑ 1, ds owner oi lhe pro0erry, am exUuSlvaiy contractin9 �+it� 11<anietl com
iractors to construct tne Dro�ect {Section 70a4, Business antl Protesslons Gotla:
Tne ConHactor's Licenie Law Ooes not apply to an owner of propetty who
�u�1G5 or imD�Ovez thereon, dnG wt10 cOfltrdCtS tot SUCh DYOiBCts with a can-
frattor(sV Lttnsa pursuam ro �ne Comra<tors License Law). I am aware tha�
proof a/ thelr Workerg Compensatbn insuranca Shoultl be provltletl to ma.
L7 1 am exempt untler $action 9. 6 0. G. far tni5 rea5on
Oate Owner
1 OBreGy certify tbat 1 have reatl thi5 aOP���ation antl State tnat the aDove
Information is correct. I agrea to comO�Y with all c(ty antl county ordfnaM1ces
anC state laws relaRn9 to GuilOin9 construCtion, anC hereby aactlo�7ze rep�e•
sentaUvas o( tnis clty to enter upon the above-menUonetl property for
insvectton ou o �ses. �
Signature Oate le-i'n4'$$
O i ers licen r 5� �'� ��
0865-66, rev. 5/B8 White • BUlltling; Canary • ADP��caM; P(nk • Accountt
__ . .._.
3���
TYPE OFCDNSTRUCTION NEW ADD ALTERATION REPAiF
❑ CONVERSION ❑ DEMOL�SH ❑ OTHEp
DESCRIPTION OF WORKlUSE OF BIDG.
TVPE OFPENMIT LIGHAOING lJ POUNDATION LJ STRUCTURAL
❑ TENANT �ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ •OTHER
PRQIECT DESCRIPT�ON 54, FT. oCLVVANCY_
C O N STI7UCTION TV VE VALUATION $
ZONE GRAOING GU, VOS. ACRES__
Remarks: �j�/�/ �f �
Sink
Pieventer
Irrigation
Floor Sinks
G8S $0NIC8 �ut18t5
Interceptors
Kiichen Sink
Lavatories .
P—Trap
Rouf Drains
Showers
Service S{nk
Sewer Cap .
$ewer Connection
Solar Co�lecto�s
Solar Pipin9
Solar Tank
Swimming Pppl w(Spa
Urina�
We[e� ClOset
Wa�ar Heacer
Water Service
Auto-Wash
Leundry Trayc
Hein:pection Foe � 515 �' Isue Fee � a 3
Hood or Type I �
Under Ground �^opy TVPe II ❑
Duct � S�ructural Refrigeration System ,
Duct - Ventilating ��-100,000 BTU �700,000 BTU
Exhaust System ❑ Multipie � System RepairlAlteration �
FirepllFect Blt, �C80 � Pire Dampers
Heating System & Ducting Registers i-:
❑6100,000 BTU 0100,0008T �
Reinspection Fea � $75 � � Izwe Fee � S 3
ng; Coltlenrotl - qssessbr
A.P. 5W
S Main Buildi
E Front
T
aRear
C Right
g . Left
Ping. Ref. #
Pianning Notes:
Autpmatic Washer
Cooking Unit
Dishwasher
Drye�s ❑Gas ❑E�
Fan
F.A,U.
Fixtures
Device 8oxes
OUtlets
Switche3
Garbage DiSposal
Generator �0.5 KW
15
Zona
ELECTRICAL
Translorme� ❑ 15�50 KW
❑ 50+KW
Meier ❑up to 100 amps
Meter �over100amps
� Sub Panel
Motors �67 HP [� 7 X- 8
Inc.Sola� �9-75 HP D7fr15+
Microwave
Pole Light
Range
Standing Sections
Trasb Compnctor
� Reinspection Fee ' S76 � luue Fee
OEVELOPMENT SEPVICES REQUIREMENTS:
2oning Approyed By
Building AOproved By ^
fEES
c�
1
N
G
H
E
�
M
T
S.
SUMMARY OF FEES
BUILDINGPERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ � ENERGV P.C. $
ELECTRICAL $ --y�--l-'� GRADiNG $
PLAN CHECK 50% $ MICROF�LM $
MECHANICAL $ TOTAL FEE $ 32� �--
PLAN CHECK 25% $
0 i Q0021b82-00021682 T� T
DATE: i�l�J9/38 iIME: I2�t3
's24.80
\
�. V
CONSTRUCTION AND PLANNING � � L& SPA .
APPRpVALS Permit # Oate Inspector APPROVALS Permit # Date Inspector
•1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
• 2. So'ii Pipe-Undrgrnd. 53. Steel Reinforcement '
3,�Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Etectrical Bonding
5. Steel Reinforcemenl 56. Rough Plumbing & Pressure Test _
fi. Electrical UFER Grnd. 51. APPROVAL TO COVER•GUNITE
7. Footing: . 58. Electrical Conduit-Undrgrnd,
8. Foundation ' S9. Gas Pipe, O Undrgrnd., Test .
' 9. Water Pipe•Unclrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10 :Structural Floor System � � 67. APPROVAL TO DECK
1�1. Property Sewer Line & House Conneciion 62. Backwa:h & ReceptorFinal
72.�Sewer Cap 63. Heater & Vent•Final
13. �Roof Drains 68. Plumbing SYstem - Final �
14. Rough Piumbing � 65. Electrical-Final
15. Rough Electrical-Conduit 6. Solar SYstem-Finai
76. Rough Electric Wiri�g � ¢ 7. Fencing & Access Approval
17, Rough Wiring Sign 68. APPROVED FOR PLASTERING
18� Rough Electriral-T Bar Ceiling ,n ,� 6 OLlSPA SYSTEMS FINAL
19� Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20:-Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Oucts, Ventilating 71. Producc Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StoregeTank OGas ❑ON .
25. Roof Sheathiog - 74. Overhead Hydro
26. T-8ar Ceiling (Strucmreq & Monocoat . 75. Dry Ghemical
27, Frame and Flashing 76. Dry Standpipa
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. fINAL
30. DrYwall Naiiing HEALTH DEPT. REQUIpEMENT
3L Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED
33. Finai Electric Z Z.. � tes: r�
34. Final Heating & Air Conditioning _ _
35. final Gas Pipe-Test
36. Hood or Canopy '
37. Final FaMorY Fireplace
38. Finai Plumbing
39. Water Service-Final
40. Gas Servica-Final
41. Solar pomestic-Final
i
42. Backflow Preventer _
43. Backflow Irrigation ; ' �� �
44. .Landscape Irrfgation Syslem ; � "
45. Sound Attenuation � .
i
46. Handicap Regulations � -
47. FINAL STRUCTURE & BUILDING � '
i
48. Special Requireme�ts Completed
k
49. Electrie Release to Edison � ""
50. Gas flelease to Southern Califomia Gas Co . � � �
51, CERTIFICATE OF OCCUPANCY : , , � • . ' �
1 No Oate •; •, � f� . ,
� , . :
�
Mn'
Vv
^�
V
Applicant to flll in all spaces exceo� t�ose witnin heavy eortler Iines ana sign all avProvriate eeclarations.
CITYOFFOSTAMESA CONSTRUCTIONPERMIT
Projett�Address 555 ANTON� 2\TD FLOOR
Applicant's Mailing Address � ��'�� •
Owner's Name $ T� Pj�ane
Address 600 WILSHIR� BLVD. r VU
Arch/Eng. License No.
Address
Conttactor'sName Kimhlp anti C'n. Phone �95-1156
Address (mailing) V '
Ciry�LicenseNo. (13R503 U • in �t'1�.
LICENSED CONTRACTOR DECLARATION
1 heteby a�fi�m tha[ I am licensetl untllr provisions of Cna�te� 9(commencing
with section ]000) ot Division 3 of [he Busines3`antl Professlons Cotle, antl
my license is in tu11 force antl ettect:
LicenseClass C-16 �ic , 'No. 460923 �
'�te �Z-S' c'onar .
)0.KER5'COMPENSATION DECLARATION
.iereby atiirm that-1 have a oerti(iWte ot consent to selttinsure or a certificate
of Worke�s' Comp q� r� }{r o� e q� a ce�t' � h (Section
3800, Lab. � yj'����b� /—�l Pa�Y ���� -
Policy No. SZ1 S7S
��`'j ,�.ertifletl copy is hereby fumishetl.
y`��rtjfie�{�'y is filetl `�+'APPI canify qu iNl,tl`Ipg [�ivi y'9Q�
� t4 Z dd KI � CL
EXEMPTION FROM WORKERS' COMPENSATIOIG �ECLARATION
(This section need not be completetl if the Oermit is tor one huntlretl ($300) or
less) ,
I certify that in [he performance of the work for which this perm�t is issuetl, I
shall not employ any person iin any manner so as to become subject to tne
Workers' Compensation Laws of Califomia.
Date Signa[ure �
NOTICE: If, afte� making t�is tleclaratlon, you sM1Oultl becom0 subject to the
�Wo�ke�5' Compensatlon provisions of [he Labor Cotle, you must forthwitb
comply with such p�ovisions or this permit Shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby affi�m tnat [here is a comtruction lentlinq agency for the pertormance
of tM1e work tor which t�is parmil is issued (Section 3097 Civ. C.)
Lentl¢r'S NdmC
Le�tleYs Atltlrei5
OWNER BUILDEN �ECLAPATION
I hereby afBrm [hat I am exempt from the ConVactor's License Law for the
following reazon (Sec[ion 7031.5 Buslness antl Professional Cotle: Any tlty or
county which �equir¢s a permit f0 Construct, alteq imD�ove, tlemOlish or repai�
any 5[ructu�e, prior t0 ils issuance, also requlres the appli<ant fOr such permit
� fiie a signetl 5ta[ement [hat he/she is Iitensetl pursuant to [ne provisions of
:e Contractor's License Law (Chapter 9(commencing witn Sectlon 7000) of
�ivision 3 Ot the Business antl Prot¢Ssions Goae) o� that he/She Is exempt
theretrom antl the ba5i5 for the alleqetl exemption. Any violatlon of Section
7031.5 by any applicant for a permil Subjects Ihe applicant to a clvil
�enatty of not more than tive nuntlretl tlollars (E500).
I, as Owner o/ the p�o0erty Or my omO�oYeeS with wages as thair sole
[ompenzation, will tlo the work, antl [he stfucture IS n0[ Int¢ntletl of Off¢rC0
tor sale (Section 7044, Busin¢ss antl Protessional Cotle: The Contractor's
�icense Law tloe5 nOt apply to an Owne� ot a prop¢rty who builtls or improves
thereon, antl who tloe5 such wOrk himselt/h¢rself or throuqh his or her own
¢mployees, p�ovitletl that Su[h improv¢menis are no[ intentletl or oHeretl tor
sale. If, how¢ver, the Oulltling or Imp�ovement IS Soltl wlthin One year of com-
pletlon, the owner will have the Durtlen ot proving he/sne tlltl not builtl or im-
prove tot the purposo ot sale).
❑ I, as owner oi the property, am ezclusively contracting with licensetl con-
Vactorsto conztruct lM1e project (Section ]044, Business an� Profe55ions Cotle:
The Contractor's License Law does mt apply to an owner of p�operty who
builtls or�improves tltereon, antl who contract5 for such project5 wltM1 a con-
tractor(sl I¢ense pursuant to the Contractpj'S.License Law). I am aware that
proof of tnei� Wo�ker's Compensation insurance shoultl be prOvltl¢tl to me.
❑ I am ezempt untler Section B. & P. C. for this reason
Date
I hereby certify that I
information reci. I
antl state I s re ati g I
sentatWes f t c y
in5pection oses.
Siqnature
Drivers' License or 55 �
F-3�72Z1
�TYPE OF CONSTRUCTION.�
❑ CONVERSION ❑ DEMO
DESCRIPTION OF WORKlUSE
J ADD LJ ALTERATION LJ REPAIR
OTHER
TVPEOFPERMIT LIGRADING LIFOUNDATION LISTRVCTURAL
❑ TENANT ❑ ELEC7RICAL �LUMBING ❑ MECHANICAL
` ❑ OTHER
PROJECT DESCRIPTION 54. F7. OCCUPA�NC�vT�j
NSPERSTRUCTION TVPE VALUATION 5 �
20NE GRADINGCU.VDS. ACRES—
Remarks:
Sink
Preventer
Irrigation
Disfimrdsher - -
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank=
Swimming Pool w/Spa
Urinal
Water Closet -
Water Heater
Water Service
Auto-Wash
$15 Issue Fee
Boiler
Duct - Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. BIL ICBO #
Heating System & Ducting
❑0700,000 BTU O 100,000 BT
Fainspection Fee � $15
CMF 0865-4fi, rev. 30/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goldenrotl - Assessor
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration System
❑4100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Issue Fee
FEES
g 3
$ 3
A.P. �p
S Main Building:
E
T Front
A Rear
C Right
S Left
Ping. Ref. #
Planning Notes:
Automatic Washer
' Construction PoleSub.
Cooking Unit
Dishwashe� � ,
Dryers �Gas ❑Electric
Fan
Zane
Accessory
ELECTRICAL
Transformer � 15-50 KW
❑50+KW
Fixtures
Device Boxes
OULICLS
Switches
Garbage Disposal
Generator �0-5 KW OS-15 KW
Meter lJuptot00amps
Meter ❑over 100amps
Sub Panel
Motors 00.1 HP �i'fi - 8
Inc.Solar �9�75 HP �16-15+
Microwave
Pole Light
Sign
Standing Sections
Trash Compactor
I Reinspection Fee I$15 I I Issue Fee
DEVELOPMENT SERVICES REDUIHEMENTS:
Zoning APProvad By
Building Approved By
Appliration laued By
FEES
5 3
Z
O
N
I
N
G
R
E
Q
M
T
S
SUMMARY OF FEES / /7
BUILDING PERMIT $ • �� SMIP $ �
PLAN CHECK .$ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. S
ELECTRICAL $ GRADING �$
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $
PLAN CHECK 25% $
.
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit�h Date Inspector qppROVALS Permit# Date Inspector
1., Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Condui[ Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical 8onding
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, � 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'Electri�yl-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 FIFE DEPT. REQUIREMENT ��
20. Rough Factory Pireplace APPROVALS Permit # _ _ ,
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 Framinc� - 73. Undergmd. Storage Tank 0 Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro ��
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical
27. Frame and Flashing 76. Dry S[andpipe �� �
28. Lathing & Sicling 77. FIXED SYSTEM FINAL ( �
29. �nsulation , 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.�Finai Plumbing
39:-Water Service-Final
40. Gas Service•Final
41. Solar pomestic-Final �
42. Backflow Prev�nter
43. Backflow Irrig�tion `- �
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING'
48. Speciat Requirements Completed
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co � � '•
�
51. CERTIFICA7E OF OCCUPANCY _ •
No. Date ' - �•�
�uon�orrew�w+a: 555 ANTON BL ��+T� 2ND
o�,�Rsr+�EiFa�+: SAFCIOKA FARMS
moness: FO BOX 2097
.,,, � i.... TERMINAL ANNEX
/�pVI.fWIRW ADDNES3:
�XRKTO"�� IhITERIOR DESIGN 21362321E�� 9378
�Kap�`�=�p�� SSO S HOPE ST ��+*� 1100
L.A. CA 90071
coxm�cTarsw�: CAL—PAC CONSTRUCTION (310)545-3500
CONfP�Ctt7X'9M41M0 6076 HRISTOL PARKWAY
,�oo�s+: CULVER CITY CA uara.: 392102
90230 uxr: 106
LICENSEU COMXACfON4 DECL�PITON: I Mroby dfrm undx pruly M pmjury tlet I em fcemtl uMm prwi�iuu W Cheqr 9
(mmmene�q w§h Sac�ion ]000) d Oivuun � d Ns Buarow and Pml»ooro Code. end mY Foeius n in Iu01au end Mw.
cmuc.No.: uc.cuse: B /L�y/� o� �92'..� ,XF.
Dele: / V�1��7 � Came�m�.—F�� �
7--p-�
OWNER BUILOEN OECLAN�TION: I hxeby dfvm uMw prWy �1 porpry ihm I un exemq fmn iM Cartretlon Licam� Lew ta Me
Idbw*q neson (Setlion 10�t.5 &nirae eed Rolapims Cads: AMW a ooumY rhieh rsCu"ve� e D�u to matruet. eCv. imWae.
Mmd'nh, a ropv ury nrurlua. piw b Ca e�uenca, abo �apwm IM eppliun� la turJi pum! lo Ne e dpned MdemeN tlW M a eM
a u�e w�ww �o m. ww�. a u» cw�.no�. uw�.. i.w Icnw« e Ioo�Ma�,a »�n swo� �mo> d awo� a a n.
Bumrov vd Rdaa'wa CoMI a Ihel M a�As u aamq �Asshpn vk IM beau far IM aApM ummdion. Nry vuW ion af Swian
)091.5 by arry apqiunt la e prmn eubpe� �M epplicaM to a cnl perolry d mi maa �han INa huMrad EdW �55W��.
� I.a�owrerWihepopenYamY�dM��hwapweslheisdecampansetbn.vrillAothexvA.vMtMnructuroeMinleMeE
w dtsad la We (5aclim )ON. Buwmu end Prdesuans COEe: TM Wmrapwe Ucsnss lnwdw� ro� appyto en owrror W qopMy
who Wida a inpewu iMreon, end wta Eom �ueh xak HmwH w Mne1 w Nrouph he a Mr own empbyses. qwdeE �MI vueh
imprtrvemeNs ue m� imaMaE a atlaieE la �W, d. Irowewr.IM WiNirp a inpmaneM u wH wilhin aneYwW mmplelion. Ne
owirrbuiNar �w0 hevs IM WNm d pvriiq M or Me ditl nol buik or'unprova la tM WTae d seb).
❑ �... o.n« a in. ww.m..m..aw.h oo��rea�w ,w� Ymn..e mnv.na. �o cmn�,e u�. v� (seaiu, �a.. ai.ins. ene
Pml�au COM: The Caqretlm Lianw lew dou na apply a an owrwr d popMy x1ro builds a imqwa ihsaan and who
wniratl� la wch prqea� wnh e mMretlor�q lic�n�ed Wniunl lo IM Canlretla� lioen�� lev�.
� I un exemq uMer Setlion: B. 8 P.C., lor ihis newn: �
Dela: Owner.
I Eo Mnby u�iy Uet I�m ewua d ud unE�nlenE �he ipuiremenb ol CelAomu Haellh enE 8elery COEe SaUiaro 25505, 25SV. enE
Y5531, uM ihet I a ury Muro buikvp oocupun v.ill / wil na (rirtb aw) nd to mnply wYh �eid qet� codss ud �M rpuiremams for
Date: AGd�:
WOflKEfl'S COMPENSATION UECLAHATION: I Mreby elfirm uMer peneXy M pse�ury wx ol iha lolloxirp deduNon�:
� I heve enE wil melmdn a wnil'rate d mn�enl to eaManauro br wkort compenW ion, m poWdad far by SeGion �)00 d ihs Lebar
Cotle, fa IM qddmence d iM waA/a wNc� �hi� paime i� InuM.
i n�. �a �;e �m�.ona.� �w�w�a, i�w..a.... �.a�nea ev sea� a�ao a m. � coe.. ro' m. v�m.�,w a m.
n wM lor whitli Nu Wrmil b isueJ. MY wakeri camOenW ian Irourer�c� urtier uk OdM/ riumEr era:
c.m«: FTRF.MAN'S FUND EXPIRES
PdkyNumber. uwD Ylf1`�4hHi/ 02/01/96
�TAre..niw� n..d �a w comW.r.d r rn. o�x ie ror wi. nunel.e ew�er. R�ool w r.,..�
� I canAy tMi in ths prloimenu d IM woA br whbh thb pertnX i� bsu�tl, I Mell iwl empby ury pemon in eny mennm m d to
become aubjep to �M eorken' canpenmtbn ler.e d Celilanieti/� �hwi� �o iM xnM1en'
cwnpaiumbn pmme/o]ne d Smian �I00 d IM labar CogKrh�l n' n Py
Dms: �r��7 � Appll mL �
�
Wam/np: Fa/lun b ucun wor.t�n' eompwu�tlon covx�p� I� Jnl�wlW, .nd �IWI ulf�et.n Mtploysr ro eAMn�l a�tlu uM
e/Nl flrros �y ro orw h,ntl�W flauurd eolNn (5100,OOOA M MN1/tlon ro M� cwl ol rortp�nuWrt e�P+ u provWN br In
S�ctlon 9108 0l M� L�6oi Cotls, lrrtlnaf, �nJ �ttomry'a Nu.
CONSTqUCT10N LENOINO �OENCY: I MnW dRrm urder pe�Wiy d perjury ihel IM�e u a canqNpion bndiip epawy M Me
perlamence W iM wwk lu wh'wA thi D�Y u ewed (Seaion �OB). Cw. CI.
LENDEX'S NRME:
LENDEN'4 ADDflE35:
I ceNty Ihe� I hew ned U'v eppfravon eM mma iM tla ebws iNametion u oortq.l epne tocomyy rmA M ay ud wumy ad'uwvm
ud ete�a lexe MPoiq b buYdip mKtud'pn W Mrsby eulhu"¢e iapsesMeYwt W Ihe dly lo enlx upon IM ebaw�nrMionetl qoperty
Iw irppedion W�D�.
Ume: o�[�f
(5151y6.WP) WMe-Bui1EYp 8 Sday: �reen-Fb: Cerory-�ppirent: Rnk-Rwenw:OoMenro�Ae+e+v
CITY OF COSTA MESA — BUILDING PERf1IT
PERMIT N0: B 0745'70 PLAN CHECK NO: 03'711-95 A
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR
PERM NO: B 07457G
GOVT: N SUFP: T1
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 20,000
CLAIM VALUE: 365,000.00 CALC—VALUE: 386,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
*��***ac*�;E*�*�***x-?t*+�*+Ea�?�+t+t�r***aEtE***rt***�**x�*a�*�**********�-*�**z�+Ei�*****�*+tit**ac
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
--------- -- MAIN BUILDING --------- --------- ACCESSORY BCIILDING --------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARI{ING REQ: PROV: PARCEL: 41050109 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENTS TO 2ND FLOOR FOR 76 PRODUCTS COMPANY
>
�E 3E iF iE dE #E jF iE iF iE it ik iE iE iE �)E jE iE�f iE�3E iE iE jE 1E iE,if if jE iE iE dE iF jf iE jE iFlf iE dE iE iE If vE fE iE iE iE iF 3F iE iE dE iE 3E iE 1f !F 3E �t IE 3f iE iF iE 3f iF iE 1E if' �f �E iE iE �1E i6 iE 1ElE
D E V E L O P M E N,T S E R V I C E S R E t� U I R E M E N T/S
ZONING APPROVED BY :_Q_�C� DATE: 9( �y �9t—
BUILDING APPROVED iBY _�.�(,�w� DATE: /�/.3�'J��S—"
1. . _ i. w A � • .
P.PPLICATION ISSUED;9Y: � ` `v
�*�t*****�**�*�**.�rx�****3�F ���iFiFF�:�r'��,rR��� ,F�F3F
LEGALIZATION:N ' F E E S U M M R Y
..
BLDG P.MT PLUMHING ELECTRIC MECHANIC
PERMIT 1,644,00 �
PLAN 267.15 � �
.. .. �
I5SUE FEE /.
BUILDITIG—DIC�—> PERMIT ISSUE PLANTCHECK
TOTALS----> 1725.14 0.00 `2�(i7.15 19
REVENUE DIVISIODI TOTALS--> COLLECTED: 17"l5
BLDG PMT PLUMBING ELECTRIC MEfiHANIC FIRE
1644.00
f34��ii
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
SMIP/NON—RES
81.14
TOTAL PAID DUE
92.29 1992.29 .00
,14 OVER/SHORT; .00
SMIP/TOT GRADING PLAN—CHECK
81.14
1E * 3E iE jE 9f � IE 9E ff 3f iE 1E iE 3E 9FlE if iE 3f 1F �F iE iF It 1k iE it iE iE iE iE �1F i�1E jE 1E i� �E 3f ir iE 1P �ElElE Ic 3E iE 3E 1E 1E if !E iE iE 3E �E i( if iE IF ik if if * 3E IE iE if 1E �E 3E if >E if �E 1f iE
I N D I V I D U A I, F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF—INT. ALTER TYPE,I II F.R. —AVER 18.24 364,800.00
SFC 20000 EQU—ALT COMM. SPRINfCL�R SYS —A��ER .36 7,200.00
SFC 20000 EQO—ALT COMM. AIR COND —AVER ,72 14,400.00
END OF FEES
01 0�19_��� :,�iv�D53 r t��' �,�;.:�
lOiEq t�•1-./t: 1?i.d: :%:C�
,!' -.� '
CONSTRUCTION AND PLANNWG POOL & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date lnspector
t. TemPorary Elecvical Service or Pole 52. Pooi & Equipmen[ Location! '' .
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement , �.
3. Electrical Conduit Utiiity�Undrgrnd. 54. Forms � '
4. Electrical Conduit-Undrgrnd. � 55. Electrica� Bonding ' r
5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test '�
6. Electrical UFER G�nd. 57. APPROVAL TO COVER-GUNITE - �
7. Foot«gs � 58. Electtica� Conduit�Undrgsnd. '
8. Foundation �; 59. Gas Pipe, O Undrgrnd., Test
9. Watsr Pipe-Undrgrnd. ' . 60. Backwash Lines, P-Trap, � Und.gmd.
10. Strutturai Floor System " 67. APPROVAL TO DECK �-� �
71. Property Sewer Line & House Connection . 62. Backwash & RecepmrFinal
12. Sewer Cap � 63. Heater & Vent•Final '
t i
73. Roof Drains ! -� 64, Plumbing System � Finai ': -
74. Rough Plumbing 65. Electrical�Final � '
75. Rough Electrirai�Conduit , 66. Solar System-Final �.' �
16. Rough Electric Wiring " 67. Fencing & Access Approval �.
17. Raugh Wiring Sign 68. APPROVED FOR PIASTERING '
18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Nydro
22. Ducts, Ventilating 71, Product Piping OGas GOiI
23. Gas P�Pe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Ba� Ceiling �Structural) & Monocoat .�Je �/ � 75. Ory Chemical
27. Frame and Flashing ��� 76. Dry Sta�dpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL �
30. Drywall Nailin9 (/JO p�i,. HEALTH DEPT. REQUIREMENT
�
31. Plaster Brown Coat - 79. FINAL INSPECTION
32. Elect��cal Power Meter Finai 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: /� � /
/O/ 3./4� A�1i� � ��ZA�jN`� . �L Zr�f/'
34, final Heating & Air Conditioning � oN� C/J V
�/.r
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Firepiace .
38. Final P�umbing �..
39. Water Service-Final �
40. Gas Service-Fina� - ,
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irri9ation
44. Landscape Irriyation Sysiem
45. Sound Attenuation �
46. Hand�cap Regulations
47. f ItJAt STRUCTURE & BU4LDING � u Qtj
48. FINAL PLANNING � .
49. Electric Release to Edison �
�'� d
50. Gas Release to $outhern California Gas Co � ,
57. CERTIFICATE OF OCCUPANCY
No. Date
�I
monessarea�bu�a: 555 ANTON BL
QYNEASNAYEIFRlOW�t gAKIOKA FARMS
irp� Po Box 2097
�.
TERMINAL ANNEX
�nv�.wuimo,�noxssa
uNr: 2 ND
�xcxrtceroxam+�x: ZNTERIOR DESIGN 21362321EV�� 9378
WCX.OPFIM'SAWflE49: SSO S HOPE ST uxr: 1100
L.A. CA 90071
mxmAcrars ru�:
cwm�croxa �uiwo
MDIIE99: UC. NO.:
uNr:
110ENSED COMRACTOAg DECLAPATION: I Mraby eflim uMv panely M ps�ury Nu I em Ikanssd uMa proviebns af Cheqa Y
(oommor�e�p wilh Ssction ��) d DNeun a d tM Budiwu uW Pmin�bm Cods. ud my fwnw b In tuA lau vd sltep.
em uc. No.: uc. cuss: uc. No.: E X P:
om.: com'aaor.
OWNER BIIILDER OECUA�TON: I Mieb/ dfirm undar pxWy d parN�'/ �� I un exemq /mm iM CanrWm Licam� lew In Ow
Yowip �maon (Seubn Y�1.3 &niiue anE Rdaqbns Cod�: Mry ery p mumy hhidi epuim s prtnE to ronewn. Mx. impv.a.
Mnd'eh, a repei eiry �bu�lun, pr'n lo rte ewerws, ebo nquim iM epd�� Iw wch peimn m fiN e dprwd �tetament tIW M a �M
n IicaneeE pum�enl lo IM Mw+��e d IM Conlretlm llams Lew �CMpar B(oommx�anp wilh 8sdion ]000) d DMebn � d Ih
Buuneu W Rdpeion� Wde� a �htl M a ehs b usmq Iherdrom and ihs Wa la Ne NbpeE uamqion. My violelion at Setlion
]0�1.5 Ey em� epplimnl la� e prmil wbjWe �M eppliram �o e m+l penelry d nal maa tMnlve huMrad dollen �55W�.
❑ I.nowwrdlMqaVeMwmyamplvyeaewYhwapasmiheieoMmmpomtlbn.willEotMwqlt.endiMalruwnbndlnloMed
ar MereA tar sels (5l��� ]OU. Buwna uM Pmfwdan COJe: Tha Canlredon lianee lewtlau rwt eGOh�o enownard paparty
who Wide a inpa+! �Mnm. ud Wa Em� �uM wak lim»C a Mner a �Maph he a M own mmV�+d. pa'�d ihtl ach
Impv+emmW �r� nd mlakeE a aflwad la ub. X.Iqws.er. iM Witlirq a YnpmwneN u wtl wilhln ar Y� d mmplMon. qs
�awror-0ulEr hill heb ��a EuNen d paiiq M or aM L'd M Wik a imqwa for Ihs WNa� d Wa).
I. n owror G �M poV^T/. am eRduNM/ conlradiq Mnh liw�ssd conVenhon ro omY�ud iM O�lap (Sotlion ]01/. Bwinr� end
PrNanune Goda: TM CoMmdan Licenss lew Ew� nd apply b en ow*w M qopeity who WIN� a impwp Iherson W who
� conlrecb lor wN prq� � a aontredor�e) Icemsd WnueM to iha Conlratlae liorue lex�.
� I em axem uMer Bee ion: / B. 8 P.C., br Ihu eseson: `L �)
Dua: ' 2.� .b Owna: �I / • �-�.�
i do nMnr ewv mn i n.wv. a.oe �a«.w�e m. na��e�,am a c.uaw iwnn d,e s wr coe. s.a�. uws. xssa..�e
P5591. W Nel 1 a anY Muro Wiki�q oodryem wiA / wil ml (erele ona) � Io eanpty wh wid ptla mEr end iM epu'vomeM� br
Dms: Applcenl:
WOPKEH'S COMPEN9A7��N DECIANATION: I hereby aifi�m uMar psndly d par�ury pp d iM bllowirq EacWetiom:
� IMneMNmeima�ecMdcpedcwasnitowMtimnbrxakm'oompanWion.mpwkMlnby3Wiai3l00dlMlebor
COM. for tM pa�lom+�s d Na xak /n wNch Mu pami! ie ususd.
❑ i n... d,d.a �ma:�.Anen� m�w�o� s,w�am.... �w��w W s.a�an aroo a m. �.e« coa.. rw m. o«amenw a m.
wpk la xNi� �hw p�� v umued. My waFen' odnpanatlbn imurerce mrtiar entl q#.y number aro:
cwd..:
� pplicyNumbx:
(TAie cecfian neetl irol bs rompNreE I Ne puml is M wro hvntlreC LWlers /SIQDI a/us.)
� I oenh' ��� DM^^^^^�a d IM wark la whfch ihia ppmp u IuusA. I MeA nal ampby ury panon in ury meruir .o n to
becvna wEjed to IM w�Fe�s' wmpruetbn k�w W CelJomle. W epns OW ! I�hwk becams mkjW �o iM xaken'
eompanwion pcviebm W Setlion 3]OD d tM LeEu f:ods. I dWI loMxah wmpfy wEh Nwa ppvubns.
W�minp: F�Nun ro ueun wortw�'romp�utlon rnnr�p� b unbw/ul. �ntl M�11 w6J�c1 m xnpleyx to MMnI pm�ltlu �nG
c/vll M�i up ro on� himtlrM �houuM soll�n (SIOO,OaoA In N�/tlan ro M� ro�t ol nmpmrtbn, Wm�p�� .. provleW ror ln
S1etlon J1P6 0l fh� I.�bor CoE,, /ntxwt, eM �ttom�Y'� I�u.
CONSTflUCTON LENDINO AOENG�: I Mnby eMim uMa Po�Y d psr�ury IMt iMn b e oonNrupion IW'up epmry tor Ns
pMameroe d IM xak Ip whirh Ihe P�mY u 6eued (9W ion ]Oe]. Cw. Gl.
LENDEq'8 NAME:
LENOER'9 AUUXESS:
I csnM ihel 1 Mro nW IhV Wd�� Nd pW Ihet Ihe ebovs infametion b oomtl. I epise to tanply wMh NI ay aM wur�ty oNinv�oe�
W �W a lavn nlelinp io b4ilErq cmnruabn ud Mreby urtMrixe rapasenleiWm ol �hie dry b an�er upon Ihe abwa�membnW pmpe�ly
lorinepeqion purpoe�a
ERNIE VITUCCI
E Q PivTY Neme 1- /
' /`� � /� /��.f..� �. L .�[t� Uets: � Zb
%% q'ut n d AppYren�Cp�imqa
i /
(5151d0.WP) W��>BuiWinp d Selny; Orsso-Fle; Cenery-epplleenl; Vink-Revenue; Ooldonrod-Mrouor
PERMIT NO: B
CITY OF COSTA MESA — BUILDING PERMIT
076185 PLAN CHECK NO: N
PERM NO: H 076185
GOVT: N SUPP: N
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000,00 CALC—VALUE: 339,625.00 GROUP OCC: B /
*�����x**x�*****�****�D**�*�**+Rr***����*+�r***�*�**�*4�r���*B****�*****�r�r�r�*****�t**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; PT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING NOTES>
i �^ -
�IE fE 1E if iE If iE 1f 1E iE iE �lE 1E iE iElE 141k 1E 1E iE IE IE iElE 1(� 1E k 1E 1E IE IE 16 if 1E iE 1E fE 1ElE IE IE iE IE iE iE iE iE iF 1f 1E 1E 1E IE iE iE'K� ik �)E iE'lE iE 1E 16 iE 1E 1E IE ik.1E 1E 1E 1E iE iE 1E ik iE IE
D E V E L O P M E N:T S E R V I C E S R E Q 0 I R E M E N�T S
. � . �: ' �.
ZONING APPROVED BY '" DATE: "
BOILDING APPROVED.•BY
APPLICATION ISSUED+B
1E 1E 1f 1E iE iE 1E 1E ik 1E iE 1E iF 1E fE IF IE iF IE if
LEGALIZATION:N /' F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTftIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,479.50 ""-- '
PLAN _ SMI�iNO2—RES
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN-CHECK. TOTAL PAID DUE
TOTALS----> 1550.82 0.00 . 0.00' 1550.82 1550.82 .00
REVENUE DIVISION TOTALS--> COLLECTED.: � 1550,82 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1479.50 ' -- 71.32
1F iE iE IE 1E 1E ii jE 1E iE iE 1E 1E 1E iE 1E IE 1E 1flE 1F iE fE iE 1k if if �E df� iF 1E fE 1E 1ElE iE 1F iE 1E IE fE 1Flf 1f iE fE 3E 1Eif 1E 1E ih fE 1E IE fF 1E 1F iE 1E iE 1E IE 1E 1E iE IE iE IElE 1E 1E 1f 1f 1E k!E iE IE
I N D I V I D U A L_'F E E, B R E A K D O W N
TYPE QTY D E S C R I P T I O N.,:� -rJ UNIT COST TOTAL COST
SFC 325000 T.I, OF£ZCE HY VALUE/$1 1.00 325,000.00
END70F�.FEES
��
' � �
) r�.
�
,� �
t - � '
_ , „ .:, r,;r::
CONSTRUCTION ANP PI.ANNING ' PG a SPA
� Date Inspector Date I�sRector
APyROVALS P,ermit # APPROVAtS Permit # �� -
i'
t�Temporary Electrical�Serviceor Pole �'�52. Pool & Equipment Location �
2. So(I Pipe-Undrgrnd. 53. Steel Reinforcement
3: Electrical.Conduit UtilitY•Undrgrnd. " 54. Forms •
4. Electrical.ConduirUnd�gmd. � � 55. Electrical Bonding
J�
._5. �teel Reinfoccement 56. Rough Plumbing & Pressure Test "
'�f� Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
" -7. F.00tin9s, =;r, 58. Electricai Conduit�Undrgrnd. �
B. Foundatiori . 59. Gas Pipe, O Undrgrnd., Test "-
9. Water Pipe�Undrgrnd. 6p. 8ackwash Lines, P-Trap, O Undrgrnd.
70. Structural�Floor SYstem 61. APPROVAL TO DECK �
17. Property Sewer. Line & House Connection __ 62. Backwash & Receptor�Final '
12. Sewer Cap� � . 63. Heater & VenFFinal �
13. Roof Drains " 64. Plumbing System � Final
14. Rough Plumbing C�i " 65. Electrical�Final
15. Rough ElEctrical-Conduit - .-� 66. Solar SYstem•Final
16. Rough E�ectric Wiring 6�. Fencing & Access ApProval
-17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
t9. RouQh Heating & Rir Condicioning_ � a. ,_, F{RE O€Pi ;flEQU1REMENT
20. Rou h Factor Fii��lace _ � ~ ` �
x . �..
9 Y fl -�' ,-� C+, APPROVAL$_'; Permit# •
21. Ducts, in5trutiure^•' ''' �`- ' s� "' 70. �Undergfq�f c�d Hj?dro '
- �.
22. DuM's,Ventilating�;�, � _•, 77. ProductP,ipingOGus ❑Oil
23. Gas Pipe�Rough & Test � ��' + '� ' - � ; � 7Z, Undergrou�d FSuSh- ' .
'.. n r„- � . .
24. Roof �Frarnin9� - �` c. c- -. �• 73:! Undergrnd.Storaqe-l'anb�Gas ❑�Oil
25. Roof Sheathing ' �� �� r� [•"!� 74?�Overhead Hydra �, '
26. T-Bar,Ceiling (Svuctu�aU & Mwioioat �� G6 '" `� 7��,,rpry Chemical
27. Erame and Flashing � - /j�Qr . l,�Y� 76. Dry Stand�pe i'`� _
LQ /�i�i
_28. Lathing&}Siding'r�,; j."�� ' ,�" °. 77: FIXEDS.Y.S7HM,'�INAL �
29. Inwtation� � •� �, " 7$= FIRE PREV. Fff1EL , �
30. Drywall Neilin9 '''' ` ��0��� �� � �HEALTH DEPT. REQUIREMENT
/..
. 37. Plaster Brown'Coat� �� � ' ' �' 79.� P�NAL I�NSPECTfON ?
�-
-.32. Electrical'Power AAeierrFinal � ��' _ ' � 80.� FOOD CERTIF'iCATE ISSUED
'33. Einahflecrric- ;.:_. c�� . ^ • > Notes: ' • � � -'
.. � _. . • : - . � �
-�_--
34. FinaFHeaiing.& A�?CondStioniriy � `_ � , _
- : . - _ � l'�11IRfQ � ^ 0__-,__ �[.
35. Final Gas Pipe•Test-. ~ � • � '�, L•
--��1- R�.-� _
_ 3s. Nooa o. CanoPY � ��i ' £ i ': /� „�' - . � �
l,�/� l
- 37. Final•Factory Fireplate . - �- n. •+ � - �- '
�� r
38. Finai Plumbirjg '' `t" � ' ... : . �
r n
'39. WateiService-FinaF. _- . .. , n �.. . �
:40. GasService-Fihai � �'� :�''�'" ' ` " - :
_ *
: 41. Solar pomestic-Pi'riaf, ' ,-� � � ' -. -
42. Backfiow Preventei' �� C � � �' �-'
� n.� �,-. r� �l 5 ti G' : .
43. Backflow Irrigaiion � �; c t c� �
44. LandscaPe irrigativn SYstem C'T,= �. , -' -' _ _ ." :� . •
� i: � �
_ [• � i- r , � . - ,
45. Sound Atienpation . �, ..'.� ^+ -± Y:+ ; . c � , .- .
46. Handicap Regulations . � ^ . � �� � -
47. FINR'L STRUCTURE & BUILDING �(L�! �- , ` .- ' ,-
D
48. F{iVAI PLANNING � ' °' ' _
� � - •
49. Electrie Release to E�ison , '; ' r: ' •
50. Gas Releaie to Southem CaliforniaGas Co ' r` ' � � '
� •
51. CERTIFICATE OF OCCUPANCY ' �-
No. Date
�
�oonessaem�aric: SSS ANTON BL
avNercsruueiFrywrtc SAKIOKA FARMS
• �uoxess: POI BOX 2097
TERMINAL ADINEX
�vv�. �.uuxc wo�ss:
UNT:
"= CTTY OF COSTA MESA - HOILDING PERMIT
2ND
PERMIT NO: B 074698 PLAN CHECK NO: �l
CONSTRtICTION TYPE; i-FR PERMIT TYPE; STR
��cxnEc,onu+r+Nax: INTERIOR ARCA.2136232164 uc.xo.: 937£S
WLX.OXENG'SAOOflE55: SSO S AOPE ST uar: 1100
L.A. CA 90Q71
ca+m�crarsru�e: SWINERTON & WPL6ERG ( 213 ) 89G-3400
CQRPACTONSMNIdM 865 S FIGUEROA ST
�oo�ss L. A. CA uc. xo.: 9 2
90017 �,: 3000
LICENSED CONTHACTOqS DECLRXATION: I hereEy efl'�m uMer poneAy d perjury Iliet I em I'renaed under pro-riabm o/ Chepter 9
(wmmandnp vnih Section 7000) oi Oiviaion 3 W Iha Buuneee enE Proleeeiora Code, end my licenae is in full /�ce end eHaf.
cmuc.No.(:04627�)} uc.cuss: B uc. . ?• r.� /95
Deb: � 11� /!l Conlredor.
OWNEH BUILOEN OECLAHATION: I heraby �rm unEer panely ol Nry I m I em e�emq om IM on�rapae licenee w Ip ihe
tdbw'vp raeson (Seaion )0�1.5 &cei�ese end Profemione Code: q A coumY �id nquiiq.e nn to oomVucl. Mm. improw.
, Eemdsh, a npei any slrucwro, pbr Io da 6wieroe, ebo rpuires �M epd� lar euch perme to fi e sgnaE sWement Ihet M a sM
� licmeed W��t to tM ywieiom d IM Coniretlwe liceme Lew IChapter 9(�mmentlip Mh Setlbn )000) ��� �� Ihe
isineas eM Rdeaebm CoEe� «thm he w ehe is axamq IMrehom eM �he bsvia tw Na elbped ezemption. Any videton o/ Sad'an
�31.5 by eny ep0lirani for e permX subpGe tha epplicant to e dvil penely W nd more Ihen (rve hunEred dollere �SSW]).
❑ �. aa owiwr a �ne worenr «mr �WMeae win wepn av �ne: de con,w�amia,...il� do uie wwk. ene u,e eviciura e na m�mMed
aMered la ub (���^^ )�. Busima erd Pedesaima Cotle: Tha Contrmm Lieeme lewdoea �epply loen owrrerd prope�ry
who W1Ea ar inpmvef Ihe�eon, end xfio does such xvrk NmaeX w MrseC a ihrouph ha a Mr own empbyaae, pwitleE tAm e�ch
improvemenla ere ra inlaMed a dlarad fa seb. H. however. iha buiNi�q w inproremem ie eold wuhin me yeer d mmplatun, tha
�i, ownarbuiMm xill heve iha burAen o/ provirp Ire ar ehe dk � WiW ar improva Iw IM WN�e ol sele�.
� I. m owiw d tM popMY. em eRtlu�neN eoniradYq xnh limnaed wn4enwa ro eonmutl �he Grol� (SeUion )06a. &ainesa eeW
Pedesabns Code: Tha CWrepas Lieansa Law Aoee m� apply ro an owrrer W popeny x1w Wilda « impova thareon ad who
mnttecie /a eucM1 pqeua wnA e conlreda(s) IicenseE W9�� to iM CantreGon L'ame lew).
� I em exemp under Seciion: B. d P.C., for ihie reawn:
Oale: Owner:
i ao n�renr �anM inm i em e...e a ma ��wersi�e me rea�+�ems a ce�aomie Neenn ene seeN coae saaan. assos, zssaa. a�e
2553a, anE IM1et I or eny Mure building ocwpent will / wil nd (dreb ore) need io comply wih eaW alete codee enE the raQuimmeme br
a parmit loroonevuction w modifirationham iM A'v3ueT/�enepemenl Divnd, qeskamiel mnslivaon eppimtionevaexempt Imm thase
prwisions.
Deie: ApWkw:
' WOHKEPBCOMPENS�TIONDECLRFATION:IMmbyelfi�munEerpenellyMperjuryaiwNlMldlowiigpetlarNom:
QI heva eM xil man�ein e cerMirate G mnvent io eaM+neure br xdke�e' wmpemmbn, m povided lar by &ed'an 3)00 d ihe labar
Code, la tM pMwmerce d Ne xak Iw wlich the permA b iauetl.
p ine�.�em��m����,w�����.�.�«.��n��reews��a�aoamaimo,cae.ainao�o.m.�ama
w«k lar whiM this permn ia isaueC. My wakare wmpenaation ineurence fartiet end poliry number ve:
c�a�: AkGONAUT EXPIRES
PdiryNumbec w� o� JOJL1V774 08/O1/96
s s«eion need iwe he cand�ai i iM v�t is ror aiw n�ndred ealers R�ao7 «Ivss.)
FJ I cenity �hel in tha peAormence d ihe wwk (w which thie pa � le i»ued, I ehell na emdW �Y Pa� in eiry manner eo a+ to
bacome aubjad �a iM woAera' mmpenaeiion lews d Celila ie. en eproe Ihat A become euM� b IM warkers
com snion s W'Seeion 3]00 dtheleborCada,le 'h py t ve visbi
o�,: �fl � �4 �,j—_ A�� �
Weming: Fallun ro axuro workxs'romyuwtlon eovenps u k I, entl Ms wD/sef n smploye� ro erl ro/ psnelHu ens
Nvll flnsa y� ro ons h�mtlrM fho��sM dolNn (S10q000A �� b ths cwl co siwf/on, demep� �� proWrlq br /n
Sxtlon 91116 0l Me Labor Cocb, /nfsruf, end ettomsy'a Isq.
CONSTPUCTON LENDINO ►GENCY: I herMy eifi�m uMm penelry d perjury thtl �Mre ia a eonmeuqion brdirip egeney la IM
�IBI�p1119MB O� 1�1p WOf�[ Ip W�11C�I �M10 �IBIIIIL IB 69YBd (�Ufl 300%. CN. C�.
IENDEq'S NpME:
LENpEP'S �ODXESS:
I��i �� I heve �ead�fiia epqcm'iwi eM ctma �hm �he eEova'inipme�ion'ia canea. t prea �o mmply wfd� efi fny enA oounry ardi�e
pnC elate levn Meting Io W ilAiip canstruaion vM hereby eWMr¢e reprexntetivea oi I�is ury to ante� upon tM ebove�mantioned pmperry
����9'����Pu"� DAN CONfROY
��.��i,'�.TIi�'!. //1 , •
i���'�' ..:.,,�_ . :
a smay; c��mFie: c�erv-npa�c R�k-r����: ooim��na,,,�
PERM NO: B 0'74698
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : LEGALIZE UEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,OOQ.Q� CALC-C'ALUE: 2Q,9�Q.00 GROUP QCC: B-2 (
COMMENTS: 76 UD]ION PRODUCTS PREP FOR TI
*��**��*�t*�***x�**��t�*+���r**�t*x**�r�**��***#*��r*******�r�****�**�*?�;�**�r*****��rx�r*�*
Z O N I N G R E Q U Z R E NI E N T 5
S E T B A C K S
----------- MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT I1V
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO;
PLANI3ING NOTES>
i /
�E iE 1E 3E 1E iE 1E iF 3E dE fE iE if !E 9ElE3i iE 1P'1EiE iE 3ElE iE ik 1E jE jE 1E 3E 1E if df iE iE 3E 1E if i; 9E iE k of iE fE iE �Elf fE �E 1f iE fE iE jE ik if �)E!E iE iE df �E iE fE �E iE i�'iE iE 1E �E jE �E iE dE 9f iE
D E V E L O P-M E N T S E R V I C E S R E Q U I R E M E N�T S
ZONING APPROVED BY '`' DATE:
BUILDING APPROVED ;BY, : �
APPLICATION ISSUBD.;BY:
iE3E3E16iEifiEdE3EifiliEiE�lEiEiE�if3E�lFfEiEif . xib�iF
LEGALIZATION:Y F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRI'C MECHANIC
PERMIT 432.00 "
- _.__r_�_�
DATE: �
DATE• ��.� Gt
�FiFiE 3ElE iF if iE iE if �E iE7FiF�F�"iF 3fiFiF�yfi�iE-)f
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
- � " SMIP/NON-RES
PLAN 1 �z_, 9.39
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK' TOTAL PAID DUE
TOTALS----> 436.39 0,00 O,QO 436,34 436,J9 .QQ
REVEr1UE DICTISION TOTALS--> COLLECTED: 436.39 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANSC FIRE SMIP/TOT GRADING PLAN-CHECK
432,OQ ` , ;.,� 4.39
�)f if jE')E iF 3E if �3f 9E 9E �' 9E 1ElE 1E iE if iE 1f iE 1E # iE iE 1E jE iElE IE iE iE iE 1E dE i(� iE 3E �1f�iE 3E iE 1klF iE iE 3E 1E �If 3E iE iE �E i(� iE if �)E iF 1E �E j(-9f �E aE jE iE iE iE-�F �1E 1f iE 1E iE iE iE if 1E jE"T
I N D I V I D U A L �.F:E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N �'� UNIT COST TOTAL COST
SFC 20000 DEMOLISH BY VALUE COMMERCIAL NOZONE 1.00 20,000,00
END�f1F _ EEES
�l ��
`I �.. � �
�
�1 00192E71•-p0192672 Te�"�' 436.35 �
OATE: 16/2319` ?iflE. C9:?b
CQNSTRUCTION AND PLANNING POOL A
�'qPPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
�1. Temporary Electricai Service or, Pol�e 52. Pool & Equipment Location ' '
i
'2. Soil Pipe�Undrgrnd. ' � 53. Stee� Reintorcement -�
3. Eiactrical Conduit Utility-Undrgr�d. � � 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .'
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. Electrical UFER Grnd. ' � 57. APPROVRL TO COVER-GUNITE ,
7. Footings - . 58. Electricai Conduit�Undrgmd. �_�
8. Foundation 59. Gas Pipe, C'i Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P�Trap, C� Undrgrnd.
10. Structural Floor Svstem _ _- 7 61. APPROVAL TO DECK � �
11. Property Sewer Line & House Cqrinection . 62. Backwash & Receptor�Finai . i'.
`
12. Sewer Cap ' 63. Heater & Vent-Final
73. Roof Drains � � 64. Plumbing System � Final�
- �
14. Rough Plumbing . -, 65. Electrica6Pinal
75. fiough ElectricabConduit '_! 66. Solar SYstem-Final '
i 6. Rough Electric 4Viring � 67. Fencing & Access Approval
�� 1•7. Rough Wiiing Sign _ -� . 68. APPROVED FOR PLASTERING -
r
�' � i$. Rough Electrical�T Bar Ceiling 69. POO VSPA SYSTEMS FINRL
19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMEIVT
20. Rough Factory Firepiace APPROVALS Permit #
27. Ducts, in Strucwre � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas � Oii
23. Gas Pipe-Rough & Test 72. Underground Fiush
24. Roof Framing 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat //��� � 75. Dry Chemical
7
27. Frame and Flashing �j�/� � 76. Dry Standpipe
�..
28. Lathing & Siding .. 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywail Nailing ���� � HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED
33. Finai Electric Notes: Fl
34. Pinai Heating & Air Conditioning � � b/ I A� _ 0 if/�nn,�`,� �
_ v- ��wr�;�_
35. Final Gas Pipe�Test �(,� n//,i„p �� � lJ
�"� f�
36. Hood or Canopy - ��, U _�
�
37. Final factory Firepiace '
38. Final Plumbing .
39. LVaxer Service�Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preve�ter
43. Backfiow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations -
47. FINAI STRUCTURE & BUILDING I�Y 6
48. FINALPLANNING
49. Etectric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF 6CCUPANCY
N0. DaT¢ / a
�
�p�aa"� 555 ANTON BL �� 2ND
wraasru�EiFa+owK SAKIOKA FAAMS
� �p� PO BOX 2097
,
� TERMINAL ANNEX •
/�VPI.YAIt1N0 IOOHESS:
♦
_ �YMNREC10flENfdlffA: INTERIOR DESIGN 213623216���� 9378
u�cN.a+E++n'g,�oop�s: 550 S HOPE ST �� 1100
L,A. CA 90071
cartx�,crararuwE CONTINENTAL PLUMHING INC ( 909 ) 360-8300
eam�croxswu�mo 11165 THUASTON LANE
,�oo�ss MIRA LOMA -I CA uo.ao: 399073
91 / S Z UNT:
LJLEN4ED CONTR�CTOfl8 DECL�PATION: I h�nb/ N'rm uMx pe�eMY d WQury ihel I un IkanwA uMx proMNom W Cheqer Y
(aomm�mbq xilh Section ]000) d Dh'vbn a d Ns BuNnsp uM ia � Cods, uM my Yoens b in lull fau erd aHW.
cmuc.No.:02756 ��•��g C 36 uc.No. 90 EXP: 09/96
� l `
Dns: ^ � Coruradr.
,
OWNEP BUILDEfl DECIAHATION: I hwW/ affirtn wMx peeWy of ps�lun I un wmq hom �M Canlraaon Uams Lew ta IM
IaOov.hi0 raeaon (Sequn ]031.5 &wi�n� enE Rolepona Code: MY W aouM' whkfi nmuixix e P�mY to mrotruu. Mr.'unpws.
demd'eh, p ropei eny sVunuro, pqr b ba's�uenca, e6o rqu'vee tM eDP��u'M ta weh psrmii l0 61e e dp�wd Mament Mel he a eM
. u IiunNd W�1 to tM yowqen tl IM CaYrotlus LiOenas Law �Chepin B(�mM�tiiq xiih Satlion ]000) W D'rueion J af tM
Buvinau eM RMeseiom Cotle� or thtl M m Ms u uamq therelran eM �he ba�n lar iha ellepeE uamqion. My violalion ol Sedion
]O�t.S by eny eppliranl lor e permil eubjep� �he appica�t lo e civil pe�e�b d nd mas ihen 1've huiWretl Edlan �SSW��.
� I, ea ovmar o/iM properlY m my empbyeee wvh wegea es iM'r aJ�e mmpenea�ion, will do iha xnM, anE iM evuciure u nat inlended
' waReradloraeb�Seciion]OId,BudnaeeendPrWeaeionaCoda:TMConirenaeLicenaalawdoeerwlepptyloenownero/propaery
who WtlEs or unproves Iheraon. eM w1a Eoee euch work Mmaell w heneM or I�rouph hc ar har own emolayem, providad Ihet euch
'mprovemeMs are nd imeMeE a dbreE la eeb. II. Fawever, the b�iNiip or'unprovemenl is edd wnhin one yeer d mmplMon. �he
owror-buJder xill hsn iM buNsn d pwiiq M or ehe di0 iwl WiM or improre fa IM Wm�s a�e�.
� I. m orm« d ihe ww�Y. em e.tlivivW aonirednv wnh M1ceiwd cono-ston to mu�rue tM a4x� (Seaion )oae. Busi�va ene
a,a� coee: rns com'.ea. �c.�.. �.. m.s �,u �dr m.� o� a a�w�+r wno eww a��wo.� m.e� .oa wno
convacb b exA prqeee wuh e mrumao�e) Icamad pveuaN lo IM Cant�eeae licems lex�.
� I em memq �nder Sedian: 8. 8 P.C.. br Nif reeam:
Dala: Owrier:
II Eo hmeby cMily Mel I am awue d vM �vMe�aieM Iha mQuirameMs d Celianu Heellh utl $efery Cods Seaiam 15505. 2553�. erM
u5>I. eiW thet I or e�ry fulure Wikiip oaupent will / wll rat (artb mel neeE lo comply wYh eek aaia mdm vq IM reQuimneMa lar
e permn lamuvucfwn amodifrationhan iMlir�Oue iTy .1%repamenl ��. Residemid miw�ueion appirelbruen exemp Irom iAeae
wweiam.
�
tl
�
,i
Dma: Apq'ram:
WOFKER'S COMPENS�TION DECLAFATION: I hmaby elfvm uMer p�eAY d pa'ryry aro d tM tdbr.inp AeNue�bm:
� I hera ud xil meinten e canAiuts d coruent lo eeXinwre br wakms compenwion. m pwidH la Ey Se�nm �)00 d tM lebar
cae.. i« �na �n�<a m. wwx i« w�m m� �„ou a��e.
❑ i n.� e�e �;� �m.:� �na.• �c«�.m�w, �nu,e�. o�eaovea W smv� a�oo a ine �.ror cue.. r« ma rono,me�w. d in.
wak for whiW ihb pamil o iwuM. My wvken' mmpansalbn iNi+rerra umm anE pdiq numbar ae:
c,�;a,: , CNA EXPIRES
Pa� N�mn«: 0 7/ O 1/ 9 6
(This settion need na be canplered f �M pxmt is b are hundred dd�eis /SiW) w le.sa.)
❑ I mnty Net in Na penmrerca d ine work tar v.hich ihb pe ' ' ed, I eMll nq sy�D/ enY pa� vi enY menmr eo o lo
Eecome wbjed m tM worMero• canM��ian lewe d a Nf e Nm '/! . io d bacoma eu4a o �M xwken'
�w��, wa{++�� w( ]s.eion 3]0o d iM lenn, cea nho; �r omv� �h 0 e provmon
Dme: � ��Y' �-15 �Dd�
Wem/ny: FSUvn ro aecun warkxi rnnpwwtlon rovenys Is un I, �nd �Ivll utlJ�cf �n xrplqw roWMiul pn�lYr aM
��w n�e, w ro w» n�e�.d mo�n�r aoir� ls�oaaool. n.ea+no m m. �o.� o� �o�n��an d�rw ., vp•w.a ro. ��
Sxtlon ]�5 oI tlro LWor Cob, InMs�t, md ettnmsy'� lsp.
CONSTPUCTION LENDINO AGENC�: I MreW �rtn uMer pereM d perjury Ihet tMn ia e oonniuqion bMi�p epem.y la iM
paAoemence W iM wrnk la whi h �he WrmY ia eeuad (Sed'un 3091. Cn. CI.
LENDEN'S NAME:
LENDEH'S RODPE34:
I cenily thet I hew read ihis epplceiion uM ava ihm IM ebove iMorma�on e wrtea. I eprse lo comply wilh ell'ity eM muny ordirenw
eM etale lewe mlet^0 b buJduro wnaVuqion utl hsaM eNhorae �eWa°°^�mivae d t�e mY �o anier uW� Ihe ebo+a-meMbned P�CeM
tnina rposes.
� R�1Y. T�QRNTON
Dme:__�p^ ��1'S
Wh�e-Buildmp 8 Sdary: OreemFle; Cenary-A ; Rnk-Pevenue; Gokenm�Aseavor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NOf; 'P 074732 PLAN CHECK NO: N
CONSTRUCTION.TYPE: iFR SP PERMIT TYPE: PLU
PERM NO: P 074732
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B—•2 /
*����****x�*�x��**��x�**�D*+Cr*+Srx��**�***�*(��+Ar*�******x *x�x�**x�*�r x�*�r*�*��r*x ��*+e�r�x�*r�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARICING REQ• PROV: PARCEL: 41050104 2NE: REF NO:
PLANNING NtSTES>
i i
ik 1k 1E 1k1E 1E 1f 1E 1E iE iF iE if iEiE 1E M 1f M fE 1F IF 1i 1f 1i 7f if iE iE 1F if if 1f iE 1F ik fEiE 1F 1E if 1E 1@ IE k if 1E�MiF IE1E1iii k 1! 1E 1E if ik IE 1F 1F 1E if iE IF 1F 1f 1E 1Flf 1f 1E1E 761E if 1k iE�
D E V E L O P M E N T S E R V I C E S''' R E Q U I R& M E N T S
rf
ZONING APPROVED BY . �r DATE•
HUILDING APPROVEI
APPLICATION ISSU
1fiEMMKKKKK1F1EifRIEK1f
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE: Io 2�i1 v'
1FiFiFiFiFiFiEiEiF iFiF
STRUCTURAL SEGMENT:N
BLDG PMT pLUMHING ELECTAIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 42,00
25Y $MIP/NON—RES
PLAN �
ISSUE FEE 20.00 '
BUILDING—DIV—> PERMIT ISSUE PliAN—CHECK TOTAL PAID DUE
TOTALS----> 42,00 20.00 0.00 62,00 62.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 62.00 OVER/SHORT: ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
1f 1E 1f 1E IE iE if 1f k 1F 1ElF ik 1E it 1f 1f 1f 1E 1f if 1F IE IF iE IF 1p 7f 1E If iE 1E 1E 1E 1E iE iF iF 1E IEIE 1E it IE 1E Ik1E 1Ek 1f if 1E if iE IE If 1k M IE iE iE IE 1f 1E ik i@ iE 1f 1f /f fE IE IE if if iE if iE ik
_ I N D I V I D U A L' F E E B R E A K D O W N
TYPE
PLU
PLU
PLU
PLU
QTY D E S C R I P T I O N
2 SINK KITCHEN �
2 WATE{t HEATER AND/OR VENT
1 SINKS, FLOOR
__.1 REPAIR/ALTER DRAINAGE/VENT PIPING
END OF FEES
UNIT COST TOTAL COST
7.00 14.00
7.00 7.00
7.00 7.00
�.' r. � eyY '�?�' �J� tl .i nf
� ,,.. ,` ... , ;CG C. ..
CbNSTRUCTiON AND PIANNING FOC,� & SPA
�. ' Date Inspector
- APPROVALS. Permit # APPROVALS Permit #
7. Temporery Eiectrical Service or ��e 52. Pool & Equipment Locauon �
2. Soil Pipe-Undrgrnd. � . 53. Steel Reinforcement �
`. �
��Electrical5ondifi•L�tility•Undagmd. 54. Forms .
�� '��tectrical�'a��d'`�i �ritlrgrnd. ' � 55. Electrical Bonding -
y55.� eel Reir�oaceqiePtp ' 56. Rough PWmhing & Pressure Test
��Q'�,u'„€IectricaLl�E�U�. 57. APPROVALTOCOVER-GUNITE
� . %�botings;�h '�.., ` � 58. Electrical Cond`fg'CUnd�grnd.
- 8. poundatios?f�� ��' n' rt'� �- 59. Gas Pipe, O Undr�rnd., Tes4
9. Water PipetUndr@ftyd. N ,� � 60. Backwash Lines, P. ;Trap, C� l7ndrqmd.
10. Struccura$Floor��%3tem � � '' 61. APPROVALTO �ECK �
it. Propertys�wvrc��lne,&House�onnection 62. Backwash&�Receptor-Finai
I
12. Sewer Ca#H '; ; ' �� .63. Heater & Veni-Final . � '
13. Roof Drains j� - '� 64. Plumbing System � Final - �
�W
14. Rough Plumbin¢+ cq 65. Electrica��Final '
15. Rough EkttricayCo�uit ' 66. So�ar Svstem-Ftp�
76. Rough Electric�jring p Y � 67. Fencing & Ace�t23-Approva) ""
J 17. Rough Wirit� Swn a� _ 68. APPROVED F(�PLASTERING
18. RoughElect`ricat7 BarCeiling 69. POOUSPASYSTEMS�FINAL
19. Rou h Heating & Air Conditionin� F ,D,EPT. EQUI EMEN
: ..� : r � ;� _ cra + � : cc * T 4�� _� � � ,-T cr� c�
^ i . T C. . t t ] t J t7 :Tl * Y �-••�
20. &ou F�tor,�Fi�y''ace ���r � g S,.., �* APPF�V&I��..iE.,Pexnit# - -
21. BWcfs invytructure*�'e i'.. .. �-+� * 5 C H= . ryy �i7_'1 uS_, �
s i S" X O'-! Clr 70 p�nder �f:tiY. Jr.ro *
22. @,uc� V�til�ing�Ur � .. p ,y � F* 71. ProdueG JPin9 '8as Oil
23. Gas Rnpe•i.ioug7� & Test � crT1^ x m �� �t -. �Z. Undergr�Sr�fQ FpsM "�
x
24. ROof fr0�i ing.. L X i'' `� ..E *> C �' 'r
t� ,� ♦• 7� Undergrnd. Stot~o�Tank :� Gas ❑ Oil �
25.RoobSheShing S� � ��� �7 7 cJ# 7�OverheadHydr�_ *
-, n. n • > .� ., x
m i--� '}". ^ tD � !T1:1' � 's. r-� . s � . �+.
26. �Bar;Cei!�ng (Str�ral) & f�ti�osoat �� �., ��; 7� Dry Cher.�ical
F� � -G r
27. fiame and Flashir�r Dw � *� >' ��' 76. Dry Sta "" 'be Fw:n * y � xm.:�:
r-� n: ; =-
,rjT f.] '7d.'C Ci !' i ••.� �y� �-tS O # '.+. .
28. Lattf�ng �Siding ��: 7,s..,c, .) � ..� �Y 7�.y FIXED g.t�STFciG12rC.$JAk !-� � i �T i
" 29. Insutation+ �1� S •• � � � � 7 �' �IRE EV. F L � �' ", `;¢
� � �
iJ'K K K H•N •!i• � m� rt�
30. Orywall fGeiling � F., : F � So�v cr�;�ALTR,DEP�.'�EQUIFf�(yi�
31. Plaster BFDwrc"�oaa�*� S i Cc*' �* ' 79.� FINAL 1345PECT4DN '� ^ _ J'Z C
r �r+ e -�
,. 32. �Jectricaff�o�r ATet�r`�F�I � W't' . ' SC�FDOD CERTIF`SATE ��S,t�EO.; �'
� � � „ � �
33. F��ahEle�ric; ��r �t i tt x" � � N�4es: t - i� - �
� ���` � :
' 34. �na�,7ie�ng� Ati'�°o�itionirtg� :� � � � � � nx * " _ ' -
,� �' R " � ,'# r+. [ �t i .�� .
. y 35. Fina Ga5-Pipe,Tes� i� �„s � •� i� � � x:. o- :� F al
� i Y
36. tlpod;,br �'enoPY "x � t�,.�,' n ��1 � I� � C�c � i-
sa: n ix.�. a: � ;.; -o Wtn
, 37. Finaf�Factory Fireplace x i �'-� r� r�� � � S * �
y38. FinaE('lumbing ��' '�' i `" ./-y�5'g/ '' S r' x d
.. t m I C / t ,4'. , r-� S x S
39. Wate'rJService-Final r� i y � q � •• .n.. n ..
.-, ra
• 40. Gas Service-Final * m ¢: `i'' =' *'� � « v''� �'�� r
x :'1FH ^ r � � F. og �� �
41. Solar 0omestic�Finalr ;q s ' �: � �o C �k 7.' o
# C
42. Backflow Preventer w� r� '� � ti� ^ ="" k� ^
•' �: OH.-. x-� �T. Ri0 �" F
43. Backflow Irri�tion �f y� :� tr, t i t •� ••r• •
�. handscap,�'rlm�ation�$ystem "��x m � �`;
$5. �und A{tenjretion* �y�•• ` :y
Q'6. Hand'icap•Regdlatior3 � * S
47. F1NF,�. STRtjCTUR� & BUIC ING ; f..
48. �7NP.� PLANNING; ' "�" # `�'
k
��9. �(e��c Rele�e to E ison : *
60. 6as F�'elease to SoutFkrn Californfi"�as Co !
INo Date
n; t �r
O�' ti n: ^ � s
d* E E �o O� .r S
n __A'�:�_
!-n�' c c a;V• �•o �
.
# S S �7G S f
t� C t, C *
�• �,. .�
q y
.�.
;+ � m c, r
tP .� N S t
.r
r. � • i^, *
� �7 • o t*� a
� � �: oo n x
Date Inspector
e
_. _ �
_a
_ i
�
�O�flE490FBUlqNO: S S S ANTON B L
°""E"'"""E"'aa`'": SAKIOKA FARMS
�ooncss: p0 BOX 2097
TERMINAL ANNEX
�VP�.IWIWO �DDPE54:
UNT:
2ND CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 075841 PLAN CHECK NO: 04810-95 L
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR
urcxirecronEr�cw�x: TRI—SIGNAL INC. ��"� 0
�xcxon�s�oo�ss: 1945 GARDENA AV 818-247-1194 ��
GLENDALE CA 91204
�+TM��T�%� MORAOW MEADOWS CORPORATIO ( 909 ) 598-7700
cwm�croRs�uuNc p O BOX 509
�� WALNUT CA ��.: 230813
91789 uN*:
IJCFNSED COHfPRCTOX3 DECIAF�TION: I Mreby ellim untler peraly d pujury tlie� I am IicmxE uMer prwiviana d Cheqm B
(camneneM v.ilh Seclion 1000) d Dirnian � d Ne &�en W Pmlmvms Coda. uk mY 4onue c m Iu0 Mtt eM ellarl.
cmuc.no.:006558 uc.cuss: uc.No.: z30813 E} P• 12/96
— o�,:�— �— 96 ��, �r � •�
OWNEH BUILDE ECIANATION: I hereby elfirm uMer pene�y d pxjury t 1 em w mq Imm tM Comranon Lioeroe law la tM
idbwip �samn (`�� ]W 1.5 &nweas aM Pralmaions CaEe: My Uy a ounry xlii rpu'um e pertnE to muWn. etler. "vnpow.
' tlemd"oh. u repei arry sir�cWro. pria w Aa ewarce. eho repu"vee iM eppli lar prmu to fJe e aqmd sWemenl tlW he a aM
o�licenaed wnuent Io iM Vo+ivom W tlr Corurmon liceme lew ICheq mand^Y xilh Seaion ]000) d Oi+ubn � d ihe
Buaineu eM Prolaaiom CoEal a iM he a tlie e uemq �Ivelmm eM tM � tie la Ne eGeB� e�amqion. MV volm'vn d Seqion
]03t.5 by enY eGW�t la e parmil eubpqe ihe epWirant to e avil perelry d iM mae IMn /Ne huMretl Edlen �5500�.
❑ I.mmmerdtheP�C�YamYandWM+xihwpe+u�hsdeaomG��.w�YEONexvk.aMNem�cYunenol"vuenEeE
«MereE 1a We (SeeWn ]aa. euainen uk Pmle.ebn.CoEe: The Contreaon liom+e lew doee ew ePGNmen oxnxd propeity
wM buidn a in0�++�he�ean. mtl Wn doee auch xak Fnnaetl a Mne� aWaph he a her own emW Weaa. pw'ided ihet ac�
imprwemam� ere nd imenEeE a al�aeC la vab. X, hawmer, iM buJCinp a mpwaneM b aoM xi1Mn ons yaer M oomplelian. IM
o..nerw�ae. wi n�. me d� a aa�ro ne « ene eia nw wue «imw�» �« in. wmd. d wel.
� I. o ox�w d iM MWe�Y. em e�dvmdY mnirm�q xnh liomead wnveclon to wnaV�p Ne Mqa1(Seaion>OH. &nirm� eM
Profeu'vu Coda: The Car4retlm liesve lew dou ew eVW w en owror d pWMY who bdids a'vnV�+a �hmean aiM xtn
mnUeeU be adi pop4f rmh e mMretla(�) Isenss0 W�swnl lo IM Canlntlm lioeme law�.
� I em enemq xker Secibn: B. 8 P.C.. br Nu �mson:
ode: a�.:
� do nereW c.nar inm i.m a..�a a�d wee�sim,e m. na��mmem. a cdeome H.ann e�d sd.�vi ced. seco�. um, zssa�, �d
255Ja. vd thm I ar eny Mwa drilGnO om�u� WI / wil mi (arcb an) roM b camdY wi� uk ptle wMe eM IM nWiremWs lar
eD��lacwnvuUion«modifretionham�heAi w�y enqe^e^�D'mtritl.RmiEmteloonqvfionePV�iaroenexemqhamiMa
wovisioru.
oma: �ca��:
WOHKEF'S COMPENS�TION DKL�N�TON: I Mraby elfmi ueMx peiully d pa'ryry an d �hs Mbwi�p Jetivelbm:
� I Mw mtl xil meiruen e cMtliub d wwnt io vatlrne�ie lor xpkeri aompenwbn, m provitleE lorlry Swrion 3M0 d tM labar
Coda. fa tM pe�lamence d Iln wk la Mich ihu pamin n musE.
fl in��a.a��m,.�o��,��w�.mo���w�..a.��.eMsaa�a�aod��n«cod..ro�m.w��dm.
j� wak /a which mie pam�n n ioued. My warken' canpenmlbn inwrencs fariar ud pdiry number us:
c�,: FTRRMANS FITNn EXPIRES
aw�N�mc,,: nw�nn����a� 07/O1/96
(tAa senian reed � be ewnWMeC i tM w�l'a !w ars hvrMmd ddW If1001 w bse.1
� I cenAy thei in ihe pMamenw d tM wak fa which tho peimd ia iaued, I ehell na empby any pneon In any meniror eo m to
bevmb wbjaif io iM v.ohars' mnpenselion 4vn d Cetilanu. vM piee thq p 1 ahouk berome ubjetl to tM wke�a'
o,��-< nxli D�eona d Setlim 3)00 M �M laEo� COEe. I e ��Mil� oompN ���h Ihoee pmviaiixu
f - 9 � A��: -w� ..
Wamirp: Fal/un ro,seun woMsn'rompmutlon roverp� b unlnvlul, en �NII • pc� en.mp�oy« ro cnmiu� pxumu.ne
dvll Iliros y� ro an� hwtlretl tM�auM LN/en (5100,000), M eWlfbn ro M eost o romwns�tbrr, Winp� �� provkNtl ror In
9xtlon 9)O6 0l fhs la4or COW, InfNut, end ettom�y'� Iwa.
CONSTflUCT10N LENUIN6 AOENCY: I hereby ��m unEer penelry d perju iMie h e canatrudion IsMinp epenry lor ihe
pailmnerca d iM wak la whirh Iho pennY e eureE (�� �. Cv. CI.
LENDEfl'S NM1E:
', LENDER'S �DOFE55:
I cenily thet I heve roeE Nia epplicetion erd ume ilw Ne ebova inlame�ian u conxl. I ep�ee lo comqy xilh ell tlry enE couMy oMinenm�
end smie lewe relain0 �a builEip cannmdion erd hereby aNMr¢e npmxnletivm M ihie dty lo enbr upon ihe ebova�memioned pmpeM
lor ireperiion Wrposea.
CHUCK JACOBI JR
�y�,4 /� Pnni 0.�
i / / I P /.P� / / Ome:
(5t5t�d6 WP) �hne-Buildvp 8 Sdary: �reemFle; Conery-�pplcenC Pink-Revenua:OakenroC-baeav
PERM NO: F 075841
GOVT; N SUPP: N
PURPOSE: ALT
JOH DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74570
**fe� � �+�+�**+r+t*��**�*it*atetet*�at*atx��***at***at�et**�*�ie�*+�irit�*�****at*irit**� *+tat�atx atat*�at�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAZN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT �_
PARKING REQ• PROV: PARCEL; 41050104 ZNE: REF NO:
PLANNING Nd'I'ES>
i
IE IE iElE iE IE iE �E iE iE 9E iE 9E iE 3E 1E If IE iE if 3E IE iE If IE IE iE iE iE iE fE fE fE �E 1E 1E iE 1E if iE IE iE iE iE fE 7E fi 1f IE 1E if 1E if if iE 1f iE iF iE iF iE iF if iE �E iE iE iE fE iE K iE iF iE IE IE 9E iE 1E
D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY .
HUILDING APPROVED BY :
APPLICATION ISSOED BY:
*+��t*�******�*****�t*�*r
LEGALIZATION:N
BLDG PMT PLUMBING
PERMIT
PLAN
ISSUE FEE
HUILDING—DIV—> PERMZT
TOTALS----> 90.00
F E E S U M M A R Y
ELECTRIC MECHANIC
DATE:
DATE:
DATE:
*�***���� � �*
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
9065�
58.50
ISSUE PLAN—CHECK TOTAL
0.00 58.50 148.50
SMIP/NON—RES
PAID DUE
148.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
1F iE iE�f jE if'lE if� if 3E �k fE fE 3E iE 14 if� iF 3f �Ik iF M iE iE iE 1E iE iF iE iE iE iE iflE iF'IF iF iF iE'IE'1E if'IF iF'lE')E 3F 3I' iE 1E'lE'IF �E iE iF if iE if 1E 3f iElF if ih �F i@ i! �If if iE if ik fE iF i(' 1E if fE jE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 90 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00 90.00
END OF FEES
.�
i,
Ol. �Ji��;� .5�17�:1 �,��%T �i.11�r
O�;iE: �,..,— _ i'i,Ct j^:�_r.
CONSTRUCTION AND PLANN�NG POOI & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit#�- Date Inspector
t. Temporary Electrical Service or Po�e 52. Pool & Equipment Location -
2. Soil Pipe-Undrgmd. �� 53. Steel Reinforcement ,
3. Electrical Conduit Utility-Undrgmd. 54. Forms �
4. Electrical Co�duibUndrgind. 55. Electrital Bonding �
5. Steel Reinfarcement � 56. Fough Plumbing & Pressure Test
-� �6.-Electrical UF'ER'G'cnd. 57.� APPROVAL TO COVER-GUNITE '
' 7. Eootings � ' 58. ElectriCai ConduiFUndrgrnd.
'� 8. Eoundation � � � 59. Gas Pipe, 0 Undcgrnd., Test
9. Water Pipe�Undrgrnd. �. � � 60. Backwash Lines,;RTrap, � Undrgmd.
10. Structural Floor�SYstem " 61. APPROVALTO DECK '
17. Property Sewer Line & House�Connection 62. Backwash & ReceprorFinal �
12: Sewer Cap � '. v - ' 63. Heater & Vent-Final •
13. Roof Drains � 64. Plumbing Syscem�- Finai
)4. Rough Plumbipg 65. ElectricabFinal
15. flough Elec[ricabConduit - 66. Soiar SYstem-Final
16. Rough Electric Wiring ._, 67. Fencing & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
78. Rough Electrica6`( Bar Ceiling ' ' 69. POOUSPA SYSTEMS FINAI�
19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ; ` ' APPROVACS�' 'Perinit# �
21. Ducts, in Siructure . �� _ - _ ' 70. ttndergiound Hydro '
22. Duct�. Ventilaiing - y , 77. Product Piping QGas O�OiI
23. Gas Pipe-Rough & Test - . 72. Underground FIuSfi -
24. Roof Framing ,� ` "'�� � � _ .,73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Shea[hing �� „- � . � 74, Overhead Hydro�
26. T•8ar Ceilin9 (Structdrall & Mono,c.bat � 75. Dry Chemical
27. Frame and Flashing •. � � 76. Dry Standpipe -� �
=28. Lathing & 5ding � � ��`"'�� _ ', • " " � 77, FIXED SYSTEM FINAL
29. Insulation � � � � 78. FIRE PREV. FINAL � - 2�7 R(� �„�-
r
30. Drywall Nailing •� ,� 1 ! HEA�THDEPT. REQUIREMENT
31. Plaster Brown Coatr �. _ r,- ,. �79��FINAL INSPECTION �.
32. Electrical Powei MeterFinai '`' ' $0('�'.FOOD CEflTIFICATE ISSUED
�33. Final Electiic � I � �'�� � Notes: � � - "
�_34. F.inalHeating&AirConditioning - ' - � �
35. Final Gas Pipe•Test . . � ', , .
•36. Hood or CanoPV � ' � -. _ ,
37. Final Factorv Fireplace - , - � �
38. Final Plumbing " - -
c .
39. Water Serviee-Final ., , : _ -
40. Gas Service-Final � -; - . • .
- 41. Solar pomeSticFinal • ' � � _ � .. ,
42. Backflow Preventer �� • ' • - - � -
43. Backflow Irrigation "-` ' . ,
44. L.andscape Irripation System ' ` � . " = ' ti
45. Sound AttEnuation �, • �. ' ". �
46. Handicap�Regulations � ' .
47. FINAL STRUCTURE & BUILOING - �' .
48. FINAL PLANNING ' '
49. Eiedrih Release to Edison . � f '
50. Gas flelease to Southern California�Gas Co � ' ��
51. CERTIFICATE OF OCCUPANCY "
No._ Date
�nonessaeuuowa: SSS ANTON BL
OWNEHBWIAEIFqlOWN: SAKIOICA FARMS
ADDHESS: pO HOX 2 0 9 7
TERMINAL ANNEX
�vv�. �,uuwo �nox[ss:
APCNRECT OR ENOINEEP:
ANCIL OH ENO.'4 �OONE54:
IlG ND:
uNr: Z ND
UNT:
�+�T�s� SOUTHWEST FZRE PROTECTION (818)359-0034
caxrx�cronexuuNc 2 1 5 E EL SUR ST
�oowEss: MONROVIA CA ucr+o.: 190173
91016 uwr:
110EN5EU COMPACTOqS DECLAfl�TON: I M�epy dirm uMs piWy d perjury Nn I am licanaod uMm pwieime W Chepbr 9
��.�a wnn s«ua, iooal a dwa, � a m. a� w v�ro..�. coes..�a mr e�.. o;, iw a2. w.nw.
cmuc.No.:013054 �0C1"u' C 16 uc.No.: g0,,1c7�3 EXP: 04/96
o�.: /0 a� - 4 S c�m.e« �� ////�---�
OWNEP BUILDEP OECUfl�710N: I hrsby dGmi udsr pruly d perjuy IIW 1 em aumq ham �M Wenum liama law la tlw
Idbw'vp reesm (�� �t.5 &nine� erd Rale�aon� Ccb: Mry dy a couMy whirh mpirirm a peimG lo aomlrucY. Mm. imqwa.
�emds�.Or reV� aM' aNxliva. pv b Lf eaiun.e. abo �W�vm Ne e00�p tOr vch V�N lo N! a �9bd pelainN tlW M a�M
ia licenseE Wmieni io �M V�atiuu W Ne COMretlon Limrca faM I�tiqx 9laomma�q xil� Setlion ]000) d Diveion 3 W Ib
Birev�ea eM Prc1ea'vn Codej a tlut M rc ehe u uemp �hselmm e�M tM Mm In Ne elspaC memp�ion. My violmion d Ssqion
]031.5 by enY aGDr� la e pemw e�Ap�u �M eppfram to e dvi penWy d np mas �Iw� (Ne hwiMed EdW� �SSOOn.
� I.mmwwrd�MPw�YainYaWbYM+w�weWnNrdeovno�.v.AEolM1evakmtltlreweununa'vuarded
«afleeed M aeb (�� ]a�.8�rca vM PmlmdmaGods: The Caarmon Lbnee lewdoae rot xppyto an owmrd popoM
wM diiCs a inn� tAnam. sd Ma dom wN rM 1"vnaetl o MnM aWuM he a Mr mm amply'en. V�b �het arA
impovemeMa ue M in�aMed « Wmd lor eeb. tl, howevr, tM WAdinp a inpwemml o eoltl rmhin ane yaer d campinion, iM
owrcr-0udder vnT heve iM dWm d pwinp M a Ne dd nol pdC a"vnpvn iv Na pvpme d ub).
� I. ea o�.nar d ihe popenY. em u�' mrurmM weh Gorwd caVrxbn b mrWutl Ns M9a (5edion ]OM. &uirws enE
Pmleasbro Code: Tha Comraam t"<w�w ler Eom rci eppl� m em m�w d papeny wM W�C� a'vnpwa tMraan eM Ma
camrtcu la wM prajeda xiN e mvrecor(v) fomed punuW lo Iln Catlrxam liodua lew).
❑ I em eaemq uMx Sxtim: B. 8 P.C.. br tliu �mam:
Dela: Ow�w:
� eo nxea cenM �w � em,.ere a m,e uia..xna m. nm,'van«m a cauo�:. w.im.�e sder coe. swian. uws. uza�..na
ss+.. aM tlW I a eM heun bukcq m+mem will / wil nd (ertb oro) neetl ro canWl M� uid ude raAu enE iM nVunma�m tar
a0�lumeumctionamoERrationtromtM�r�i vuyanrYD'etna.Reetl�roielmutvaioneGV��iwawaxanqlvnUwe
o�.: �ovc�u:
WORKEF'S COMVENSATON DKUN�TON: I AerWy eMum uqw prully d pxryry ons d Ns IaOo�inp detluuom;
� IMnvdwdmeimanecaniwedmervioutl+ewoM�.vkan'mipsiWion.opaiJWinb�Brfcn]�OdiMteEv
Code. la tM pMunienc� W IM xM lo which th'v pxme e mueG.
❑ � n.r. end w mmm.n.onen• mmw�+mun I�mv.nce.., �apwM M s.a:n alao a u» lmu. coEe. br �ne ron«menc. a �ne
waF la MUUi Nu WnM b uaud.l.7 waken' mmpamtion'vmrano mmw mtl D�Y wmEs aa:
c�..: FREMONT EXPIRES
va�rn�c« �T8"l6�— 06/O1/96
(mb s«tbn msd mt M mnpixed / Nr o�� e b a+w hvNed A�9x� /J�mi n 1mJ
� I unN Net in Ow iMmiwrw d iM work br v.fiirl� �hu OMti u mi»d. I WO nol �mOM �Y Vd� In �nY memar n n io
becmw abjed to tM xdMn' miqavtlbn lew d Ceflaris. W epn� Ne ! 1 NwN pecmr �ubjW to tM warken'
comD�Wion Wa'viom d Sae'vyZ"!00 d iM labn CoC�. I NW 1 ih wm��} xM itrow pa�miu.
o�e: �S'%3—'�Jf �oc�ma: • I/77i1^"—�
W�minp: F�qun ro wcun Morkwti c�w�p�nutlon cor�re� l� unlnHu( uM Ntll rtlf�cl br w�nplonr ro cNm'iul pm�Nu uW
UHI flirs �q b arw hurtliM tlnuuM Otlbn (11%OWA h�Af/tlon (o IM cosf ol canpr�utbR C�m�p� � prvvbW br In
Sxtlm �106 0l M LMor G6, IrrtwuL �� ��m�y'� M1u.
CONSTIIUCiION LENqIW AGENCY: I hraby alfim� under pmelry M psrjvy �hq ihre u a mrutwion Isdvq paM.y br tM
pmlamerce M tM wvk br utiN Ihe 0�� e ea»E (Setlion �09J. Civ. CI.
LENDEH'9 NMIE:
lENOEP'S ADDXESS:
1 cMilytM I Mva ntl Ne app4aum eM tltl� Ilut IM �Em� efamaion e conq.l qpw to camp�y wilh e0 �Yy eM mnty oNvwice�
uMeteiakwa�elry toEuild�9mimvrimerdAereEYawlwae�ana�etletiwsaltMaYroamxuG�tMWaa.memurrdpcwM
ImiiapeeunpuW _
� �LOJv-ti/
� � oma: /D a3-S5�
, sipv�m• o.�.c�u.�/Mc�mwc«+me« -
(StStdB.WP) Whi1s9NN�pbSelely:GreerRe:Cenery-Appivru:FnkJiwenue:CaddenioE-Mwawt
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 074750
CONSTRUCTION TYPE: 1—FR
PLAN CHECK NO: 03945-95 L
PERMIT TYPE: FIA
PERM NO: F 074750
GOVT: N SUPP: N
PURPOSE: ALT
SOB DESCRIPTION : INTEEiIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: 10,350.00 CALC-VALUE: ' GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS RE:#B74570
+rx��x�x�x�*x��rx�+r�*x�******x��r*�rx�r�rk*�r�r�x���w*x*�r**�x�x�*x��x��r+r*x��r*x�*+r*x*x�r*x��r****x*�r***xx *
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
j------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
ILEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV:� PARCEL: 41050104 ZNE: REF NO:
PLANNING NiSTES>
i
1E 1E fE 1f M 1E 1i 7E ik iE iF 1! 1k 7E 1E 1E 7F 1E 1E 1f 1i 1E 1E 1E 1E If 7f 1E 1E 1F 1k if 1i 1E� iF if 1E 1E iE ik iF 1k it 1E IE 1E iE iE 1E 1E 1k iE1F 1E iE 1k 1f 1E if 1f 1k 1E 1f fE 1E iF It 1E 1E IE IE 1E if if if 1f if iflf
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: �� DATE:� 3 k r
ififlflEiElEiEiFiFlEifiFiEM11�IF1FifMKihif ifiElFiFiFMiFiEKIE KiF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
,s
BLDG PHT PLUMBING ELECTRIC ,MECHANIC FIRE SMIP/RES GRADING
PERMIT „ .' l; 126.00
` 65i SMIP/NON-RES
PLAN -' 81.90
ISSUE FEE "
BUILDING-DIV-> PERMIT ISSUE PLAN'CHECK' TOTAL PAID DUE
TOTALS----> 126.00 0.00 '81.90 207.90 207.90 ,00
�
REVENUE DIVISION TOTALS--> COLLECTED:' � 126.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANI•C <, FIRE SMIP/TOT GRADING PLAN-CHECK
_� 126.00
ifM�FMiFiFIFNMMiFMItifMifiFiFMMiFiklf�FiFMiF1F1f Mif1fMKMMMififlfifMMMMKMMMMIFMIFMMMifMMMMiFMMMiFiFiEifMN7fiFiE'klEifi(�1f
I N D I V I D U A L F•E E H R E A K D O W N
, �:.
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 126 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00 126,00
END OF;FEES
%�
. JI o ,
,y .
[ '
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r=
Q' ��:7' 1�'''.^1i�7;Q ��� 1:E.�.'�
�47�- 10/:?g, ti.- -7�:q: 1'; 3b
CONSTRUCTION AND PLANNING PO(, s SPA
APPROVALS Permit # Date Inspector qppROV.ALS Permit #
,
i. Temporary Electrical Service or Pnfe 52. Pool & Equipment Location. '
2. Soil Pipe�Undrgrnd. �., 53. Steel Reinforcement �
Ki��lectrical Conduli UG1itY-Undr+grnd. 54. Forms
,�c�-{ectrical Cond�iT��rgmd. � 55. Electrical Bonding �
r� .�eel Reinforcertiept:-, 56. Rough Plumbing & Pressur� Test
�s? ectrical UFEFf'(,j�'[,nd. 57. APPROVAL TO COVER�GUNITE
, u
�'E�.` otings ,.,;U 58. Electrical Condvi�lndrgrnd.
� 8. Fbundation :Tf� n+ �0 59. Gas Pipe, � U �rnd., Test
�
9. Water Pipe-Und �id. � . 60. Backwash �ine��Trap, O yndrgrnd.
10. Structural Floor�ystem y. ' 61. APPROVAL TO 6ECK -
17. Property Sewer �ne�& Housr"�o�nection 62. Backwash & Rec�gtor-Final'� �
12. Sewer Cap ` �- 63. Heater & Vent-Final .
r
13. Roof Drains _ � 64. Plumbing System - Final .
14. Rough Plumbing-: ;+� 65. Electrical�Final
75. Rough Electrical-CoRdu�t a' 66. Solar Syttem�F�a1,
r, c
16. Rough Electric �rir�q 67. Fencing & AccesS-Approval
� 77. Rough Wiring Si9� � 68. APPROVED F�f�'LASTERING
18. Rough Electrica� Bar Ge��fng - 69. POOUSPA SYST@MS FINAL
19. Rough Heatin & Air CO�ditioninq� � F�,iE p�PT.�EQUIgEMEfV�
'1 r. ' M 7� [� C� C ti�.7 6
20. t��`tou�h F�Gmry� Fi�(�lace '"`.' } � T' . APP'� V i{,`.�O P mnit #�- �~
i S c�' C � S ry �� � ��Y-�r. F 3^=
21. @uces� inStruE2ur2nY �.. .. " +' S � N* 70. �nder�i��l Fijdro x
22. Quc�; Vei�til�ingv� � :•� � rJ +r f !-r , 71. Produ��PingYJ�fas �Oil
23. s PiPe,Rougd & Tost � M [': t r•? c' < O+ �� 72. Undergr ,nfl F�st1 �. �"" f
24. iioo�framing" '�f � F'-� x� O C Y� � 9� r�t+ x r.,
_ « x > a, ;. ♦. 7�-.� Under r d Stor�ye Tanfa.� Gas ❑ Oil
25. Roof.SheHthing Sr' �C � va � i; • c�• 74?Overhead"..�+•�� � �}•�
26. �`-BaPCeiling (Str ral) & at 7 pr �' •�' m
'�,f'nF}�+,�+� f ^ W G �f
i '`yR' "'�`�' * O Y G� � Y Che�ical r� .-,
27. rarua and� Flashirig * ��: � a� ++ mk 76. Dry Sta ' e Fm .•. -� �'
.c '7 L'
28. Latffh9�Si�}Agh�"� C;rY, C �� ..: 7i,j FIXEO�T�INA�.., �, ^ �l•
_�29. insulation+ �• ilrc Y S.... _ 4 c I 7' FIRE PREV. F L k% °a �"' gl
' 30. Drywall NailiFig �;:K ,_, , y � � �F,ALT�DEP�.�E�JIF{�MENT
� 31. Plasrer BmwrYCoa. �� 5 '!*'tT' � �� . 79. FINAL IlOSCECTiON V `
,; 32. '�ectrical:Qov,�er M�;c�r �jr�al � . � N I � � � � 8Q� FOOD CERTIF� ATE I�SUEd, ".
33. � T i r .. � � � �
na}:�leptritr tr � Ti � # r N6tes: � ^� �'= O�
-e7- �
; 34. Finai�lied,t)ng�i AV��o�ditiortin�jS � { ^ I (�' % p�2 f>_ .. ���x/� _n. G
� I� i��.[s+� �7(5wt.✓�:G
35. �inat ag3ipe:Test r; p:W � * ti ! , �/ � /'� �-��` C +'n �
� �
�L ^��`^,^ . _G�(t't�
36. Hooii-br C'd' nopy �� � '�"� � * n �} LF�` J �'' � ,/ '
_ S Q' s it I S lT. -. ♦ k! I�`O`� � • n
r i i , -tt--�� .-� _Mr�
37. Final.FaCtory Fireplace x � F�- n� t ,:. .P "C`
t
� 38. FinafPlurrtbin a� /'i � r` � , � H � %' '-
9 ., ,H i o : � � -, tc • �¢
' 39. 4Vatei Service-Final x r � x cC �� ;n :o`'O �
. -n
•.40. Gas Service-final * t�• �•""�*' S �*. [� � �� o� ;, a '
' 41. �olar Oomestic•Fina� s ;� � �Y ``� � f �r.;n r., •�p j• n;, �
42. Backflow Preventer m� �� � � r t�T2�• ^.F. x� �
� ���---� * r. �a movc. t*;G + F
43. Backfiow Irriqetion } j cc� a r .}. i`� �� �
n -,
�lA. Landsw ' Irr�qation}System yr�r� �' R7 � O O•K , :�� N �� x:e > N o
r. x . Q"„ ^ :K Gx . £ � O '�S. :Y S .-
A5. 53und A+,fen�tion y "� �. .. r 1� (T) m`�.-iY `• � c p+ qV �-;,_ r
Q6. Hendicap•Regoia[ionk � O * * ' �= '� 7� S *
r � y. � ,r, O i � X
(37. �-iNAZ STRUCTUR� & BUILDING � c., ;; ' � C+
48. EtN/ILPLANNING� ' `^F' M � I � =� � ' "'
� +� � .r.: CJ n: S t r;
�. �lecfijc Relea£e to Eyison � fi y�; •n * J �;
�� r rn
50. G3s Release to Soutt;ern Califorrtit�!'ias Cn ' �*' , S �o �� :;, � o
61. CEflTIFICATE OF OCCUPANCY * �' '�" ^ * • "
No. Date
Date � Inspector �
.
.'
�
�oonessaeuuou+o: 555 ANTON HL
OMN'HSNNIEIFIQqWtt SAKZOKA FARMS
�oo�ss p0 BOX 2097
TERMINAL ANNEX
�vv�. iumwc �noness:
uxT: 2 ND
�ncxrtEcron�ax: INTERIOR DESIGN 213623216�N0' 9378
ANLILOfIFNO.'SAWRE55: SSO S HOPE ST �"T� 1100
L.A. CA 90071
COMXACTIXf31LLYE:
cam�crorts �uiwc
�ooxess ua xo.:
uxr:
110EN5ED CONfNRCTOPS DECIAFATION: I MreW ellim uMm panelly d peejury Nal I em lieanaed wder proN.tiana d Chaqx 9
(wmme�r�+q xVh Sec�ion ]000) d Divoun 3 d Ne Bueinan erd Pmleaa'vm Cods. eM mY 4ceros o in IuA Mw vd Mloq.
cm uc. No.: uc. cuss: uc. No.: EXP :
Dme: CaN'eea:
OWNEN BUILDEN DEClAN1TION: I hreby dfum witler peWy W perjury Ihei l em uemq Imm tM CONmam Lirona law /a Ihe
Idbw'vp �ees�n (Setlbn )W1.5 &niiea+erd Prdamona Coda: AnY ery w wunty wt�iN �viees a pnnn lo mnWt�. Mm.'vnpwe.
Eemdah, n repei eiry aUuclum, pior b ea 6vueMe. e!w reywrea IM epplism ta wch prmd lo Rb e eproC elmameN Nel he a�In
a �c.�+.e w� io �ne wwivw a me cau�mas l;obna le. lchapa e(mNnandm .'nn seeun �aoo) a o'r�reon a a �ro
Buaim» eM Rdev'wu Coda� a ihm M a 4w a e�emq ihaehan aM IM ba�u la Ihe elbped memqion. Nry viobibn d Setlian
�w,.s M.m eva� �«. oe� a4�+• �n. y,w�,� �o. e,u oe�n a �a ma. in� r. m�m.ea eaw+ �swnn.
❑ I.mowrerdiMO�D�YamYsmDbMsxtnwpeemtMisolsmmWnaeYan.wadothowark.eMtMemMuie'vriaiiusded
a MseE la We (�� ]OM. Butirnsf aM Prdaagions GoCe: The Conlredm lironae law Eoes nd epplyto en oMtw�d pivpMy
who Wlda or inG�� �Iwean, end who dwa ew3� wik Nmsatl n Mnel a Waph he rc hr oxn emWMM�. p�ed tl� wcA
Ma�am. me noi wemea «on.�d io..d.. n. m�..b.. m. w�u�y «:nnw«�w o.aa.mnm o�. vea. d�Wm�. ine
�owrorbwidx xill hew the buMen M D�'uq M1e w eM Ci0 nal CUJE w impm+lor Ne WUV�< W aelsl.
�. o ow�x a roe awem. am a.diurveM oom�euno .iin rcmeae ca,n.cw.. w w�mw m. aaa Iseao� mu. an'vrse em
Rdeaeiom coEe: The Coniraaws licanm Lew Aoee � eWN w en owner d popenY who Wilte a imP�'u ihraon W�N�o
mnUec�n lo aM pqeef wM a aoMretlor�v) Icanaed WnueN to �M GaNretlar� Lironss Lew�.
� I an eR wtler Sec�/io�n: B. d P C.. la I`h�e ieewn: `
IDale: ��Z6/'I � __ Ox.w:_ rQ� / . �
I
prwisbna.
G W urdenWk IM m�ui�emenb d CelAanu HeeEh erd $elelY �e Setlion� Y5505. 2553�. eM
G^0 oonqer� will / Wil na (tlrtb ans) riaed b ranVN wih �eid mna mdu ud Ihe nV��emems br
ianhomihe A�8T1rar�epam«n Diarid. Rsedenliel oonpiudion WO��iom an a�emq Irom Nrs
W ONKEN'S COYPENSAIiqi OEC4H�TON: 1 Mrab� alf urdar px�ehy d pxjuey pn d tlw blbr."vp detlermioro:
� I liew uM xil meinien e cenGicele G conwnt io vaMrruum lur xorken' wmpenWion. u pwided /w by Seqbn J]OD d ihe leCor
COM, f« tM pa�imnvice ol Ne xak 1« wlich i�u psmu u inued.
� I hevs eM xi1 mainten woMen' aompevmion inwruiw. u rpuirW by SeGbn �]00 d ihe LeEar CaEs. br �Iw pMormeMe d IM
wwk tor whitli Ihu permG'v ioued. My waken' compenW ian inwrance mrtiar ud pdky number ere:
c��:
Pa�v H�mna,:
(Thia sxlbn meA rx� be mndkM / tM ro�] is M aro hvrMnE Edlers R�001 a bu./
� I eenLy thet in tha pMameze d tM wak fa whch Ihie permil Is i»usd, I ahell na employ eery penon in eny menner n m to
becare aud� �o iM wkeis' oomDM+a�un levn d Ce4lomu. ard �lree rtW E I dwuN becama a4� �o iM xpFwa'
mmpanxlion D�+Ana d Seeion ��a0 W tha labor Coda. I eholl IonM1rrit� oompy wii� tM1ws Orovhbm.
Dale� �pd��
WeminD� F�llvn ro�xun wotlnri rompswtlon rovsrp� b unlewAu( �nd sMl1 wC/�ef an miployo fo cdMrMl p.naltls� nM
c/H/ Ilnu ap ro wn huidrW fMuunO 0ollan (f100,OW), M�dlltlon ro M� cwl o/ rompwvafbM1 Mlnp� u pvvWM br In
SscHon eM5 0/ tlrs LMar Cod, Infx��l, entl eMmsy'a Iwa.
CONSTRUCTON LENDINO RGENCY: I heieby elfirm uMx penelry d peejury �!w �Mn u e oon�liudan bnE'up epeney tar ihe
pBrlOimenCB O/ IM1B WDh. �Of whlCh IM1'v pB�ma IH lf WBd (SBCIim'J09), Civ. C�.
LENDER'S NAME:
LENOEfl'S 1DDPES3:
1 cenih �� I hew red �hu epplicetion erM nma Ihet IM eEove intamu'wn u mrteq. I eq�ee �o canply wah dl ary ud mumy adineritte
enE etele lewe nleling to buildvq ca�ulruqion vd hereby ainhor¢e iepreeenlelivee d �Na cny w mter upon Ihe ebwe�memioneG popeM
�Ol119�Bd1011Wf�J5B9,
ERNIE VITUCCI
� 2n/�sr � V f T�V LC � Dme: � Z6 �
sqrieture d Oxmer/lqenvAoW�✓�o���eda ' '
(515ts8.WP) While-BuilEvp 6 Safery: Grean-Fb: Cerory-Applran; Nnk-Reuenw; (ioldema�Nsesw
CITY OF COSTA MESA — BUILDING PERMIT �
PERM NO: E 076186
PERMIT NO; E 076186 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FA SP PEAMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION ; INTERIOR 200005F OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
*�**�***i�******+�r�***��D*�**x***********���****�*��k+r**i��B+�r***�**+rH*�***�rx*����*
Z O N I N G R E(j U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
«��*****�r�r�*�*�*���**��x**����**x�*��*�xx�****��*���*�*��r��x�x�*�x�*+r«�+�*****x�*���x*
D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY — DATE:
BUILDING APPROVED HY : DATE:
. _. 1
E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 108::60_,
—502 .__ SMIP/NON—RES
PLAN '� �
ISSUE FEE 15.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 108.60 15.00 0.00 123.60 123.60 .00
REVENUE DIVISION TOTALS--> COLLECTED: 123.60 OVER/SHOAT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC— FIRE SMIP/TOT GRADING PLAN—CHECK
123.60
1f �F 1f iE iE iF iE 1E 1E 1E fE 1E fF 1E iE �E 1E 1E 1f 7EiE 7f if iF 1F 1k 1ElI� 1E 1E 1E k 1E if 1EiE iF if iE iE IE 1E if 1F 1F 1F 1k 1E ff iF 1F 1f iFlf� i! 1k 1E 14 iE 1E iF 1E 1E iE 1E 1! fE iE ih 1E'1f' fE ff 1f 41E iE IE �k
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N;--- �' UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET
ELE 208 RECEPT/OOTLET
1 S.T 20 !
ADDITIONAL.
END OF .F,EES� ,
) I
. �1
—1-
EA. .75 15,00
EA. .45 93.60
�a OuiS�;�ai �u11°?z9` '��.'�' r:3 :r
CArE: p•,,,i '-° rIf't' 7'i�
CONSTRUCTION AND PLANNING ' � POG . SPA
APPROYAL$ Permit # Date Inspector APPROVALS Permit # Date Inspeccor
' t. Temporary Electrical Service or Pole .- 52. Pool & Equipment Location •
2. Soil Pipe-Undrgmd. . ,�3, Steel flei�forcement '
� 3: 6fectrical£onduit Utility•Undrgrnd. � 54. Forms
4:'�lectrical GO"DdGit�Undrgrnd. ' � 55. Electrical Bonding ;,. '_
, 5. 5(eel Reinfo�cement 56. Rough P�umbing & Pressure Test
-'6. Electrical,SfFER Gr�d. 57. APPROVAL TO COVER-GUNITE �
'7: Footings `-� �. 58. Electrical Conduit-Undrgrnd. �
'� 8. Foundation��� 59. Gas Pipe, O Undrgmd:, Test .
c-
9. Water Pipe-Undrgmd. � 60. Backwash Lines, P�Trap, O Undrgrnd. -
10. Structural Floor Svstem 61. APPROVAL TO DECK
i t. Property Sewe[ Line & House Connec2ion ' 62. Backwash & Receptor-Final
12. Sewer Cap - . 63, Heater & Vent•Final
13. fioof Drains _ • 64. Plumbing System � Final
14. Rough Plumbing - 65. Electrical�Final ,.
15. Rough ElactricabConduit " 66. Solar SYstem-Final
16. Rough Elecvic Wiring � �67. Fencing & Access Approval �r
17. Rough Wiring Sign , 68. APPROVED FOR PIASTERING "
18. Rough Eleci�ica6T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
79. Rough Headng & Air Conditioning � �� _ p�({E p�rpT. REQUIR�MENT mM
* C - : t',. -�• *• r ti �^.
20. RoughFaetory,;Fire�JTace i� y, �. ,� �,;APPR'l�VAL$;'•- PeKmit# �-
21.O�ct�,inStrucLureT:,- ' "'• .;« ; -, ^Y '70.�i7ndergroundHy.�iro A
22. Quctr�VentilatingCa: � `-= '. y `L ,�� �` .. b"
r'_'� d, r-x. i. ProduGF;Pipl��g fias C7;Oil
23. Gas Pipe-Rough & Tost ;�: � 'n h+ er G ^ c, � 72, Undergroand F�Crsfi� � �
I^ C - V I
24. Roof frahiing ��* `" "�, F' � N r r ,7� Undergmd. Store�e,Tank��j7 Gas ❑ 6i1
25. Roof Sheathing :.* <t � ci :� y+, � 74"-0verhead Hydro,�, �'
26. T�Bai Ceiling (Strugti}ral) & Moho'�coat �,-� q ' �* 7� Dry Cher�iral • � -
27. Frame.and F�ashing-; __ C; � .� 76. Dry Stan€I�EApe 'J-� ��� � _
r
28. Lathing fi-Sding ;' ^ =�;`y _ _ � " "T. 77,'. FIXED SY,STEAy F�NAl. ._ � ��
J ( ` 78`.� FIRE PREV. FINAL "� �
29. Insuiation- , .. .. .. � � �.. " "
30. Dryevail Nailing "' . y " H�AITH`�'dEP� REQUIRiE.MENT
. �: ' .
31. Plaster Brown.CoaVr �-. , r �� 79. PINAL 114SPECTION� r v
, 32. ElectricalPowei Mei¢"r�fiqal r .� 80'.;FOOD CERTIFtLA'�E IS'SUED �
-�33. Final,EleFti�c - _ , a �-3l�� �Notes: - 4 -� . '
. _t:. .'' . _ . .-. _ _ "� .
'� 34. Final.kleating & AirConMdacioninT'-'`-' �T; X; � r (� i ��� ,(
• • �' � Ci `Y � lNii-�/�" , ti-
35. Final Gas�Pipe�.Tes%,-: - . r ,.. ' , - � �--�-�'-' � ��
�:�1�a��1'1��_
'�'36. Hood or CanoPY , ` _ . �.• - '`. , � ' _ a "��'
_ � ••: �r-. � ,r� ._ .- �M�r�- (�MMf�., v-�"[1,�,�.
37. F.inal'FactorY Fireplaee ;� � ,_�..� � „" �: ' ^ 1/11��� � _
� - Y \.�v
38. Final� Plumhing :�'•. �'�., * ^ . * _ - --
..v� r.
39. Water'Servite-Final-' � � � r 1 , ��'. `. ' :. ,
� �40. Gas Service-Final � dt�c- �!. [Tt � ' " ' '
� a. x - .
'�41. Solar pomesticFin@Ix �-� � ;` �' n.. - , -
42. Backflow Preventer. • r� .K ' +� �'
.1 ' r �.+ A ' ♦ -
43. Backtlow Irrigation ' � ' '" r � x -, r �' . .
44. Landscape�lrrigation System '�^ •� = �• ��' - = ' " ' �% -J ` �•' 4 ' �
'e r � a � _ " i -
45. Sound Attenuation'�� �""... .. ra � - �^�. �'r-1 :
46. Fiandicap Regulations � ' � � � � : • _; "'� _ r•
�.
47,. FINAL STRUCTURE & BUILDWG ; _ . .� ^ � - �
48. FINALPLANNING c-r� ' * �± •� _
� 'J _ _
49. Elect�ie Release to Edison � . ',` � - - �
50. Gas Release to Southern CaliforniaGas Co • t - - ' �'
51. CERTIFICATE OF OCCUPANCY ` ' �- " � - '
No. Date
AD�"`�0°B11pN°` S55 APITON �L
' r.vi+Exanru�c�cwawm: SAKIOKA E'ARMS
FO�� PO $dX 2097
, � TERMINAL ANN�X
�M. Yu�n+c �oo�ss:
uhr: �Nj�
�R�op�+�-INTERTOR DESIGN 21362321E� � 9378
uicwaxcxcs�eonEss: S50 S HOPS ST uN* 1100
L.A, CA 90071
�+TM�C7�'g� MURROW MEADOW$ CQRP6RATT0 ( 714 ) $98-77Q0
��+�Taas� 616 REYE5 ST
+��� WALNUT CA ue ra: 2 30 $1 3
91789 U�:
(10EHSED fANTFACTOWS OECLAHATION: � MrMn MYm mMx OenNY d� ihe11 Am IranaM uidar Woritiwis d Gheptm e
(oommei�arq xlth Seclion l00% d pivbqn 3 d fie 8uv�asa NA PMeaO:�ma Code. sfAr�1Y lironw o in luli tores and eNea.
e uaNa.:p06558 �.c'°ss: C 14 �"0 230813 6Xt�: 12/95
, o�. lD-/ - ��.� . r.�....�/n
NER BUItDEN DECUpAflON; 1 Mnby affittn uMx pmWY d P�WY 1 e�mµ from iM Cpnry,loq liwme 6ew ki tl+e
Wbve.'v�9 reafon l5edbn )0.�13 &uAroas ¢M Profe�iam CodO: AaY cily aainc whia� rc9uiro4 n Oarmd b b�qMict. eCa, urqrm+.
qemdeh, a�eper wrv eWnwe, pda a ds bwvew. aho repuirp �M kam suc� pem�u �o fib e apned awqmm ihat he a sha
b Iqenaee pmaen� io 1M po+ibns a d» Camey�ae tianes lew �C 9 fmm�ns�p wnA Ssuio�+ �M�o) d Daeiw+ 8 N tln
8u4ixze vd Fratassiona Coda� a thM he a eM o axqrt�p Ihsretmm end lM Gvia 1w �M elleged exemAion. My vuimim d SediM
ro8t.s M aM avN�� ta e v� wN�+�b epplben� �o e dv�l oe�ahv d na mare �nen t:n nu�9rea ddkn (S54op.
[� I.WownardtM1eMW+MYw!Msmd�r*sevrthwepafmllwsdnoEmPa��.+10d9Mew4�lt.mMlMshuct�+rsendinlenNetl
win heve �he Wken d cYwaro tre a ehe 4H na wiw w�mv� 1« ira w��ro+e d e.b).
CITY OF COSTA M£SA - SUILpING PEAMTT
P£RM 1V0; E U74576
PERMII' NO; E 074576 PLAN CH£CR NO: N GOVT; N 5UPP: N
COAISTFtUCTION TYPE; 1f'� SP PERMIT TYP�: ELE PURPOSE: ALT
JOH DE5CRTPTI6N : INTERIOR 2fl606SF OFFICE T.S. 5Q FT:
CLAIM VAL[7E: CALC-VALUE: GRDUP qCC; B-2 /
CqMMENTS: 76 4NTON PROnUCTS REF: 8-74570
�********�**�-*s��*��*��u �***��***��**���**�*��#�*+��rt��**�� *�**� *s��*+��*t�*t�*���**s�*
Z Q N I N G R E Q D I R E M E N T S
S E T H A C K S
- MAIN BUSLDING ----------- ________v A�r_��SORY BUZLBING - -
FRNT: rt FT IN REAR; FT IN FRNT: FT IN REAR: FT �~~IDI
LEFT: FT IN RGHT; FT TN L�FT: FT IN RGHT: fiT TN
PLANNZNGftN6'I'6S> �'�OV: PARCEL: 910501U4 ZNE: REF Nq:
a
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A E V E L O P M E N T S E�R V I C£ S R E Q U I R E M E N T S
ZONING APPROVEI7 BY .
DATE:
Q v,°�a�c�:r"�c roe`M_�°°i:°p���,a.ap"°'�edrro��`�a"r.w�a+r»+��°«���in� w'� 9UTLDING APPRdV£4 SY : I)ATE: _
coMrMa la wxh p'qeqa with 6 wamddorfaj iicer�ad Oun�en� lo IM Con4adms liamae lawi.
p i,ma.�a�saa�: M a.nv.c..m.am�: APPI.TCATTON IS$UED $Y: '� DATE: �.7.-��C p��
Daza: O.+ner #jtif�)F±EiE-M3f�7E#iEiEiFifi�'lF3FlEiE�lFi4iF .'-"�a� iF3�if�rt . . . iFiFifkiF#�-IFiFiE�FI� ���it`if1E
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
1 do Mr•bI cMW tl+tl I em enae d etM w�0a�siand the rewimmeMa d CeHuma Fbenh end SaMY �•otla SeRbro ¢556:. 2553�, erd
2E5�a. wq �/w i a m�Y Mwe buiWirp �»JI! wtli (ORb one) naed Ia comply wiA seN Meia mdd entl tha rpuitmmeMs Itt
epercnntaaorminmtionumodificaionham°�:'��a�ea.a.����,��«���.�.�.�w�m�.+ BLDG PMT PLUMBING ELECTRTC MECHANIC PIRE SMIP/RES GRADING
a� PERMTT 341�00�
owe: ua�:
wank�x•s cowa�sinow oecurtAnoN; i nv.w amm�,o wa« w�+mv d oanm � a m. rouo.;� a.a.�v�.: pi''��
TS3UE FE£ 15.00
d c�'„e���s �w�a �m�� �'�oe��,.e�wa,aea�aers.�„a�cnaubia� pUILDING-DIV-> P�ftMIT ISSUE PLAN-CH£CK
[� in.�.mw��an��ron��,�,,.,,..,rov��aWseaw,amowe,.�,c�.,ro.�n��eam,�Pow�na TOTALS_.._-> 341.8d 15,D0 0,00
n +ax r«.7nm pd. aertnt b ipn,e. Mr•��'�^o�wion ma»aroe evris ana ea�cY munb» er.:
�,: �rRFMAra4 c'tintl7 £XPIRE$ REVENU� DIVTSTON TOTALS--> COLL£CTEp;
Pa�N,,,,,e,,: nr.rrAn��Ft;a� 07/01/96 BLDG PMT PLIIM9ING 6LECTRIC MECHANTC
(mia �er,r�m n.ea i.x a wmde�ea r m, nama rs%o�e w�drad aomn Isiool o. ran,.� 3$ 6. 8 0
❑ � eenN �nm m me o+�ormaiee d iho weM f« ..ficn mi. vbrmd 'w �uee. � aMd m emWm+m M�� M•m mannx .o e+m
EeE[V�IB W�e.210 IM MONM9� C0.TpM60f9M1 �flWt C1 C8l'�ot��N. MA 14�M Ulm S I lIW�Ik) �ARa PlLY%� 10I�B MRkMa� ')i"�if
companatlbn Mwvimro d SxSU� 3)00 d IM LSCor Goda. I e IMhwn� �mPN xah �hoba (xo.is�.
�%G�-� ^�.� �
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u`wm��wm�roi.n�`u�e."°a�n�sMa�.nsioawo`j,°��,��� m.ro oNiOh`��a��xc�viwa"�i�M TXP
Sxtlon 9146 of IM 4bor Cvb, InIMu4 � atSomy'f len. � L E
sansrnucnoN �Et+wno naencr: i naaW ,re�n ww,� �oM w�uy ma mm. a a mnnwaia� �au+o w�r � ub EL E
peAamo�qa M �he wk e« xftich tnb o�+� b bswe cs.eun JOsr. ew, ei. �,' I, �
4ENOEp'$ NhME:
4fNbEN'S AOURE53: � � �.�,
i�n�ymmi�a�eimo�d�a�a�a�ms,nmmaenob�+om,m�a�e.i.ye.w�ronwan�no�rene��rvw,+i�ar�c<+ ELE
eM slaie lawz rcletnp ro huiWvp cwMruCion eM herebY ���e �epeeeotmivae dthiactY W an�aupn Ine eEwe-men�bnad proptrry
^. �sisiaa.wv�
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Dete:/ [/' �(CJ � („}
SMIP/NON-R6S
T4TAL PAIl7 DUE
955.80 356.80 .00
356.80 OVER/SHORT: 00
FTRE SMTP/TOT GRADTNG PLAN-CHECIC
if 3F iE iE iE i4 �F if lE if iE iE 1Eif 3F iE if aE df' iE'�f iE IE if' i(' if iF iE aE if k iE'If it'1E # iE iF 3f'�' #f # 1E # iF if ��1F i4 3E iE'�E dF if� dE �'1f #E iE d(' if 9E #�C-3E �F * iE �1f' if 3E j:-0E i4 �E #
I N D I V I p U A L F E E B R E A K p 0 W N
£ �TX d E S C R I P T I O N UNIT CO$T TOTAL COS'f
20 FIXTURES, LIGHTING 1 ST 20 �A. .75 15.00
296 FIXTURES LZGHTING ADDITTONAL EA, .45 133.20
20 RECEPT/p�ITL6T 1 ST 20 EA. .75 15,p0
23$ [tECEPT/OUTLET ADATTIONAL EA. .45 107,10
22 RECEPT/SWITCA 1 ST 2Q 6A. .75 16,50
5 SUB-PANEL i1.00 55.60
END O�' PEES
��
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�' CONSTRUGTION AND PLANNING • . POOI & SPA .
APPROVALS Permit # Date inspector APPROVALS Permit � Date Inspector
1
i, Temporery Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. � 53. Steel Reintorcement .
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduii�Und�grnd. ' � 55. Electrical Bonding
5. Steel Reinfprcement 56. Rough Plumbing & Pressure Test �
6. Electrical UFEft Grnd. � 57. APPROVAL TO COVEF-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 Svstem • 61. APPROVAL TO DECK "
i i. Prope�ty 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. Electricai�Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Si9� 68. APPROVED FOR PIASTERING .
78. Rough Electrical•T Bar Ceiling ' 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit #
21. Ducts, in St�ucture 70. Undergiound Hydro
22. Duas, Ventilating 77. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test 72. Underg�ound Flush
24. Roof Framing � 73. Under9rnd. Storaye Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Celling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. (.athing & 5iding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Dryevall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster 8rown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Pinal Eleciric L�3�� Notes:
34. Finai Heati�9 & Air Conditioning
35. Final Gas PiPe�Test
;�.
36. Hood ar Canopy
37. Final FactorY Fireplace `
38. Final Plumbing
39. Water Service•Final �
40. Gas Service•Final
41. Sofar pomestic-Final .
42. Backflow Preventer .
43. Backflow irrigation
44. l.andscape irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING .
48. FINAL PLANNING _ ..
49. E�ectric Release to Edison '
50. Gas Release to Southern California Gas Co I
51. CERTIPICATE OF OCCUPANCY
No. Date �
�
��
�
�oow�ssaeW�w'c: S55 ANTON BL
°N"E"s"µ`"�'°"" SAKIOKA FARMS
eooness: PO BOX 2097
TERMINAL ANNEX
�vr�. wniuNc �ooness:
uxT: ZND
urcxnecron�+�+: INTERIOR ARCH 2136232164 uc.ra.: 9�78
umKon�+n•s,�ooxEss: 550 S HOPE ST °' 1100
coNmacrarsru� L.A. CA 90071
caxm�croas�uuxa COMPEL CORPORATION ( 310 ) 946-8321
10410 PIONEER BL
woxFss: SANTA FE SPRINGS CA �GNO' 392693
90670 u"T
LICEN4ED CONfHACTONS OECLAR�TION: I hereby eRvm under peneXy d perjury Ihe� I em licensetl uMer parieione of Cheqer a
(mmmendn0 ��h Sec�ion ]000) ol Divieion � d Ihe Buainees eM Prdeaaione Code, eM my license ia in lull brce enE aMetl.
CRY LIC. NO.: LIG C1A89: LIC. N0:
03205/4 C—SO ,�u 3�92693[^/ EXP: 08/96
Dele: �� '2 � �CJ Coeareaa: � � ��/S � • /— ia-Plar'�
OWNEN BUILDEF DECLAPATION: I Mraby elfirm uMer per�ely of perjury Ihet I em eicemq ham iM Conlredm Licanee Lew /a tlw
Idbxip iseaon (�� )031.5 Buanan enE Pmfineions Cade: Airy cty a wunry xfiich �epuiree e pamX to wnstrucl. Ms. imprwa.
demd'oh, p repei eny aVunure, pnor W A� avuvKe, alae reQuires iM epplimnt la euch paimil to Rle e apneE ele�smsnt IM� he w eM
u liceneed punuent io tM promiona d Ihe Gm�redwe Licenee Lew [Chepta e(mmma�ip with Seaon )000) d DNuion 3 d t!a
Buainao enE Profe»ions Cotle� or ihel M or eha is exemq �herehom end IM beao la �he dlapeE uemplian. Airy vblelion ol5etlion
'l031.5 by eny eppliram for e parmn eubjede Ihe epplicent to e mnl penelry M na moro than tXa hundred dolleis �$500�).
� I. ee owner ol lha propeny or my emobY� �h weges es ihei nola mmpaneaiion, xill do Ihe wak, end Iha elrucWrc ie nN inleMed
wallaredlasele(Seclion]01d,BuwiwsseM ProlasaionaCode:TMConirenoreLicenselewdoennmepplytoenownarMpropeM
wno n��m « mo� ine�. �e.no aoe. a��n wo� Mm�n o, nerew «mro�en ns «n« ow� <moim�, v�eaa ind w�n
im0�menis ara ml iMeMeE a dfered lor sale. X, howaver, tM buiNirp w inqovemenl u eok wilhin one yeer d mmpletion, ihe
�.,a��u., �;n n� ma w„aa� w m�mc na w an, aa �a w�u o� �mv,w. i« ine wm�e d.da).
� I. m owner d �M pWeM. em ssdmrM' mnirea+q wnh lioenaed wnvatlon io mna�ruq tl�a Wqetl (Sed'an >Ou. Bwiresa eM
Prdesaiona Goda: TM1e Comeaqae l'cense law does na eOPN to an ow�w d popa�Y wlw WJM a unC�'aa Ihe�ean aM x1w
convecia M vitli prqeaa wnh e conirep«(e) Icanaed purmuam io �fa Conlreuon lioen�e lewl.
❑ I em ezamq uMer Sactian: 0. 8 P C.. br �hn iaeaon:
De�e: Ovmar:
I Eo M1eraby cenity the� I em ewere d enE uMerelend �he rayuiremenH d Celtomie Hael�h elk Selety Cade Seeione 25505. 255�3, end
25550, enE Ihel I a eny lulure builtlirq accupent will l will nd (arck ona) neaE �o camply wilh eaid atela mtles enE �M repuiremeMe fa
epeimnlormnnrunionwmoCificelionlromiheA'v u�iiyRrenegemenlDislnd.ReeiEenlielmnsVud'aneppf�aionaereexemplromlMae
pIOVl91W9.
Dete: Applicem:
WOFKEP'S COMPENS�TION UECL�N�TION: I Mrebi elfirm uMer paWiy d perjury aro d Na idbwiip Eetluetbu:
� I hm erd wJ meinten e cMilica�e d awwnt io aeMireure b r.pken' cpnpenaetion, m prwided tar by Seaian 3]00 d tM labar
Cods. in iM parlormence d �lia xwk la wlich ihis pmnu u iaueE.
� I M1ere vM wil meimen woMen' canD��ion imureM.e. m ra0u'ued M Safian 3]00 d iM Lebar Cada.lor iM V�o�m� d the
work for x1iiM� Nie pmm� u inued. MY+��n �0�%�� imurerics urtwr uM pdiry numbar are:
Oen1ef €R�#GAlT C61MF EXPIRES
'a�' ""'""°' 0 2/ 01 / 9 6
(This sMion neeE rro� be canpleteC! tM permd ia lw om hun len 100 a bm,
� I caMM �hel in Ihe peilormenu d tha wak fa whkh thia pem�n u iaeued, I ehdl na empby elry paieon in eny menrer eo as la
becoma subjea io �he workers' canpenaeiion lexs d Lelibmia, enE epree ihel il I ehoulE Decama wbl� �o iM woMers'
COmpenaeiion proviaione M Sxtbn 3100 d �M leE« Code. I 9heyll IM�hwi�lh co—m�p!/, /wtlM1I��/p/ pmvi+iona.
ode: !(n �LG �%� Applirent:. ///(�w/{ Q/�. /�P/�it�-�
W�m/np: F�Ilun ro ascun wortai ronpwwtlon caverags b unl�rb( m sn.n ne/.c� an smp�oysr ro cnmw v�rou ane
clvll fl� iq N ar hinErM lMuunJ OdYn (J/Oq0001, M MOltlan ro ih� cost ol romps�ueWM1 A�m1p� u proNdM bi /n '
SxHon 3]06 oI tlro Labor Code, Infenif, entl efromeyi Isu.
CONSTFUCTION LENDING AGENCT: I hereby elfiim under penelry d parjury ihm iMre ia a cme�ruaion bMinp epeMy la Ure
�ao��m oi ina.ro� m, .n�d, ina ��n n osu�e �saeon aw�, ca, c�.
LENOER'S NAME:
LENDEH'S ADDFE55:
I ceniry Ihet 1 heve reed ihis epplcetim end mma �hei �ha ebove iniame�ion ia conM. I eprea lo compN �h ell dty enC counly oNinarims
uM ele�e lews relelFg �o buiW'vp consVud'qn eM hereby eNhor¢e �ep»anlelivea M t�is tily lo mter upon tM ebwa�menlior�ed poperry
lorimpedian Wrpasea.
D !`v rm.. Marhy �aasoa
m Neme
�,,,��9 • -�.-� o�, �n �� -2S
Si e�ure M Oh+wrlAgenUApDicenVComreaor
(515t-a6 WP) While-Buildin0 8 Selmy; Greeo-Fle; Cenery-Applicen�; Pink-Revanue; GolEenrotl-Assesmr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 074836 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE
SOB DESCRIPTION : INTERIOR 20000SF OFFICE TI
CLAIM VALUE:
CALC—VALUE:
PERM NO• E 074836
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: B-2 /
*�******+�***x ��*�****��*****�*****x�**�r�**ir*B**�**4�*�*�**�****��********�r***+�+r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
1E iE 1E 1E 1E 1E 1E 1f 1E 3E iE 1E 1E 1F 1E 1F 1t 1F 1E 1E 1E ff 1E 1E 1E 1E 1E 1F 1E 1! if 1F 1E 1f�!%if 1E iEiE IE 1f 7E 1F iE I! 1E 1E 1E iE �1E if 3E iE iP 1P 1f 1E 1E 1E 1f if IE 1F 1ElF iE 1E IF 1E 1E 1F if iF 1Ei(� �E iE iE 1E
D E V E L O P M E N T S E�R V I C E S R E Q U T A E M E N T S
ZONING APPAOVED BY DATE:
BUILDING APPROVED BY : ' ' DATE:
APPLICATION ISSUED BY: �;; DATE: l0 Z�n .
iEififlfifififlfiFifiEifitiEi(�iE1ElfifiFi(�iE 1EIEiE1ElEiE1E7Fif1E F IE1f
LEGALIZATION:N F E E�, S U M M A R Y STRUCTURAL SEGMENT:N
L 1
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 73:05,.—
50Y� - SMIP/NON—RES
PLAN �
ISSUE FEE 15:00 f'
BUILDING—DZV—> PERMIT ISSUE PLAN-GHECK TOTAL PAID DUE
TOTALS----> 73.05 15.00 �'0.00 88.05 88.05 .00
REVENUE DIVISION TOTALS--> COLLECTED':� 88.05 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
88.05 � �
if if 1I� iF 1f 1f 1E 1E 1f 1f 1F 1E iF ik ik ik 1F 1E iE k 1f if'IF iE if� 1E 1E 1E iF iE IF iE 161E iE iE 1f�lE�II� if IE iE IF iE iE IE iE IE 1E 1Ei! 1E1E iE i41f 1f iE 1f 161f 161f 1E IE iE 1[�!F iE 1Fl8 iE iE 781E iE iE dF 1(�
I N D I V I D U A L �F E-.E H R E A K D O W N
�
TYPE QTY D E S C R I P T I O-N�� � UNIT COST TOTAL COST
� ' ;. �
ELE 20 COMMUNICATION DROPS 1 ST�20 .75 15.00
ELE 129 COMMUNICATION DROPS ADDITIONAL .45 58.05
END' OF� FEES
i:'1 .i +.
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APPROVALS Permit # Date inspector p�ppROVALS Permit #
i -
1. Temporery Electrical Service or Po�e� � 52. Pool & Equipment Location �
• 2. Soil Pipe-Undrgrnd. �,�; 53. Steel Reinforcement
�Ss..�,kctrical C�onduiJ�ii�Gty�Undfig?fd. 54. Forms '
1:'4.aE7£ctrical GUptlutTdrfdrgrnd. � 55. Electrical 8onding '
.. �� _ r�r
�.'�4:'�S�el Rein'f'0�6em�ru,�,. 56. Rough Plumbing & Pressure Te:t
^tfioElectrical UEER�rnd. 57. APPROVAL TO COVER�GUNITE
•-� cn
-' �!-'F�otings `M j�a. ' 58. Electrical Condu i�.7ndrgrnd.
=j��. Fqundation v Q( �Sa, c 59. Gas Pipe, O Un��',gcnd., Test
9. Water Pip�Undr�`lc !''� 60. Backwash linestP� rap, � kJndrgrnd.
10. Structural;F.loor ystem �� 61. APPROVAL TCYtlECK .
r
11. Property 3awe�Line & House Qohcrection 62. Backwash & Rea7llor-FinaL �
„
12. Sewer Cap,s, `' Q,- �: 63. Heater & Vent•Fin,31 �
13. Foof Drains � '-� _ 64. Plumbin� System • Final �`�!�
14. Rou h Plumbi " �
9 I�9.-� ;:y : 65. Electrical�Final
75. Rough Electrica� onduit c+ .� _ 66. Solar SYstem�Fin��
16. Rough Electric �1�in� V'- 67. Fencing & Acces_Ys�'}�pproval
;77. Rough Wiring.5�4o i 68. APPROVED FOR`PLASTERING
"t
18. Rough Elect�ic01`T Bar Ceiling `' 69. POOUSPA SYS�ET�AS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEMT
a ^-+s- - x - n;�
20. Ftdug.�iFa�or�ir��Pace � S� G r � _� PpR�jVA��H`Per�iit#��=;'
R S •�
21.Ci'ucts5in5yruc,fy�etj� �'.•• -�,� �: � �7 - .70. tlndergPeluntDH ro �
22. Ducts;�/er3tilaF�g Jx, � *, J =� �x ,77. Product��' ing C`'�'�as C�OiI
23. G�s Plqe-F�nugh;& l'e�i � M' �; ;n v d; �j* �72. Undergromi� FlmtLr E- �+
24. RSof�ra �ng " '�,*r ' F"`"" �= � �Q ;73Q'Undergrnd Slor���.Tank�llGas ❑OTI�
25. Roof �ea�hing � y •�; �� v n� ;: .�:� 74 �Overhead Hydro�
26. T�Bar-6eiling (5truQitrall &�rroc�at " ? - tik 75:?Dry Chemical r,y Y` ` �C
27. F,�mg.�n�lashi�g�,v �M� *a, a r.�� 76�DryStan�pipe �,re .c � F.<.
;-i28. Lathin Sc�Siding O+� h ':�� x * E •• ��•x 77Q` FIXED $lf�. E�y NA "� ^� =�
n t "'x' ; r' I ' 'K `7 :;t/ 'ib � �f: t� C i -, t-!
x -� �. � H .. .. , p -r1 � . � :
�'29. InsulatiorL� �,a S � I � rr 78.T_FIRE PREV. FIN,WL M.� �': <.0
T30. Drywa11PF3iling n" V • ; Iz h�'vALTH��P'f�REQi7IRE�ENT
�,�7. Plasier Br`�'an Coatti;� � ', :,..-� � ^ � � 7g.`"FINAL 1 ECTI N'. � `
n. . . _ .<'-�-' - �
--32.ElectricalEaw�M��FFnal `N � �* 40:�FOODCERTIFI�/C"F�IS�U D._, j�
� _ '1
.;33. �hal�lec�Yic �, ''�< ,� i c { . � r'�'No�es:. -.�-cj -�R; e -y � vN'
�a34. F.iraal�eat�y�98GAir-Cflndhioning;� r� I t u,���-/�f_.,. '�- � t-.
� „ . - • • � -, . , �, , �7 �iY; -P- ~ �'/�
�35. F'nal C,as �peP?estM; C� � � � x �v �.�' � �,qa�,. ,_"„�
f5-.��a�'�
.:.36. HoodAr CanopY �•�'� � ' �' 7 = ' .' , (� �: ���( � �
.- ... � .-� r.- �. . �, m /�/�ln
`�3` 7. Fiial �Ctg�fY Fireq'I�d4er. _ , c.•, C R:*i � I* - r �'R;-
� k CN
J
-38. Finat d>tumbi�g '� *. � N � � +� •� 't ~ - r -�; �
i r �i: �-r G
r39. Water'Service�Final�* ^ - �' " � x `. �"`� `
�c:. i �r, �t :o �
,;,40. Gas Service-Final ,1r t-� dr•• -� < t,� i �e �J�-: oN s`
� - t �J } %f �J'
F41. Solar pomestirFin �' S '� • -', , "; � ' " _
H � k ?7 x � .4 m _ b+ %%�
"42. Backflow Preventer� fi �� i �* jL- � �
=� s
43. Backflow irri �or�* 'z '� # u * '^ � K U J
9 C,f v s.¢ �; a r �
� �N �A � . .� •
4�y Landscape�.irri�atior�SYstem 2,-: : s .� �.� ��i - ��� :� �,� fi m nr•�
vl` N' !' - S' tY' ( I t C Lr
4�J�. Sc�und Att�nuatiortS* t-�:::� . w i `� T� _ -� ��% Fr� F
45 Handicap Regulatior� " " ��' > = � _„ _
�
. 4�: FA�IA[ STRUG�TU�& BUIL6WG _ i �-: c: S *� _
,. �. _
48. FIit1A�.iPLANNING i: Fi-� = ^; . �.'7 "t Q * `--
Y Y, a[
49. Efectric Release'to Edlson y '" L 7' * --
' 1. .'�'. ' : I"' ai Y
5�. Ga, Re,jease to Southern Calitornia 6as Co i� ! �� ' -� �� • ^�t ! ^�✓
- � . v cc
5t, CERTtFPICATE OF OCCUPANCc ^ �. -o . _ � -�--
No __ _ _ Date
Date Inspector
��J
B
� �nwess a ew�nra:
OMIR_RSXAYEIFqpWN: 555 An�Tor� BL
•-eoe�ss SAK IOKA FARMS
� PO BOX 2097
/ TERMINPL ANNEX
�-� �rr�. �uiwo �ooaess:
UNT:
2NP
ti.NCXRECT Ofl FNC�NHA: IIC. ND.:
wcxon�a•s�ooness: I�ITERIOR DESIGN 213623216 °M7.8
550 S HOPE ST 1100
��T�".K. L.A. CP. 90071
c�,���� AIR CONDITIONING COMPANY (818)244-6571
„��u, 6265 SAN FERNANDO ROAD ��
GLENDALE CA 1��0696
LICENSED COHfNACfORS DECLAR�TION: I Mroby Mim u� p�ly tl pmjury tlw I em Iceneed uMa pwisians d Cheqm 9
(canme�no .nn sxiion �ooa) d oniao� a a Na am�,es, ene vmeava�+wde. ene my 4nme o m hn km ene ellea.
CT' IJC. NO.: 11Q QA59: IIC. NO.:
0144U3 C 36 120696 EXP: 07/96
Dme: /ii..// �/�� Conireea:
T—rc
OWNEP BUILUEH DECLANRTION: I ha�aby etFrm uMer penelly d perM�Y �� ���emq Imm �M C ws �icenee Lew la the
IOAownB reeaon l5ecion ]W 1.5 &uneaa eM Prdwia�s Gode: Mry cry a cawlY wA'xA nVu'um e ni mm4w. Mer. imYove.
Eemdsh, a rpei mry si'uelun, pna b ea neuenea. ebo npidm �In epp4ma Iv sueh paemu to RI d sWemeM tlW he a ehe
o u�,..e w� �o in. no�+ d m. com�m«. uoan. i.. �cnea« a l,o�e�o wan s.ao� �000l a u+:� � a m.
Bu�'vien eM Ndembn Codel a ihtl M a da u vsm7 tharehom vW IM beda la Ns e0e0� memqion. MY vidmion d Seaun
>W �.5 b/ ury epplimm la e pe�mil euEpaa iM epplicem to a rn2 proEy d na mors ihen Ms �undred ddWa �5500D.
� 1. es awmr d �M pope�Y a my «nWryeee wih wapee m IMi sde companution. wJl do tM woh. vW ihe evumn b m� imended
a oflmed la eele �Sanion )ON. BuwMea ud Proinsiana Cods: The Conlretlas liaenea Lawdom M epplyloen owna d piapeity
who buide a inpwes Ihpeon. rd Wo Aam �urh xak Nm�ell a henN a Wwp� he a M own employr. povidsd thn wch
imP��Wa ve nal im�Med a aflseA fa ub. tl. hows.er.IM Euiltlin0 a inpo�nen u wtl rmhin ma Yev d oomV�ion. tln
owrorbuiFW wA hevs �M bvdan d pwieq hs or ehe did m� buJd a unpow ta iM pcpme W ubl.
� 1. m ox�wr d ihe pw✓7. em uM�eh mmrad'n0 wM IicameE oonvenas w muvua Na pq✓� (Sw'nn Tlu. &nirime md
Prolseaions Code: Tha Cmirmm Liwnro lew Ooes ml appy lo en oxner d pmpMy who Wilds or impovu the�aon uM w1a
eonvan�lorwM prajede wnh e mmreuor(e)IceneeE Wnueniioihe Ganlradorv Limeuel.aw).
❑ I em saamq uMer Section: 8. 8 P.G.. br Nis rauon:
Dele: O�ma:
i eo n�er �nar �nm i.m ..a. a�e ��w«.ww me �o���.w a cdromr w.en �e sdm cod. sw�. zsm. zss�..�e
25536, ud thet I a eny fNun Wikiip ompant will / wdl na (arcY me) ewed lo eomqy wIh uid qeU oode� uM IM'eyuiremanb br
epermM1lorwrutiunionamoEifimtionhomiMA'v ue�ly anepemeMOielnd.NesiEeMieloonpiutlonepplralion�enuemqfroml�ero
Dete: Applium:
WONKEP'S COMPENS�TION DECIIR�TON: 1 MraEy elfirm uidx pwuAy d pwjury aa d 1!w Idbwiip dwleemiwa:
� I hevs and wil maintein e cerliliuls d aoneeni io aaN-insuro br worken' canpemetbn, m praidaE Iw by Sad'wn 3]W ol ths lebor
Code, for ihe petlormencs ol Ihs xoek la whieh ihle permn is Ipued.
❑ � new d,e wi� meim.:i wonm� oomv�b� m.w.�m... r.awi.e M swio� a�ao d m. �enw coee, ror m. o•ir«ewb. d m.
X work la whiM Nu pem�n b iaued. MY+'a�n' compensetbn Inwrence mrriar ud pdky numbx as:
Gvner:
PolicyNumber: �.vlVlll ��,L ��:� EXPIRES
(]hia eection rreM nw bs canpblM / tAs prmA le br . n��d 'ew� Ri�l a� .l � 10 / 01 / 9 6
� I cerlly Ihm in �ha pMomunm d IM work la xfith Ihie paimX ie Inuad, I ehdl rwl employ eny person in vry menrwr �o v to
become aubjee lo IM xorkere' compemelion bxv d Celibmie, W epne ihd il 1 ehauk becmns eubjw �o tM xaMeie'
wmWn�elian Pm+iaians d Sedion �)00 d iM lebor Code. I rmh mmW wnh iMw po�h'via.
Dne: �r�� 59�/� �GW� j ���s _
Weminp: F�llun ro�xun wont�r�' mmpxuetlon rovsnp� l� un/awNl, �npsMll �WJ�ct en �mp ro enmw o«�.ros. ana
elvll A� up ro ons hwdrs! IMuund JNlen (51pp,0001, �n etltl/tbn ro M� ewf ol romp�nutb , tlemrys� u prov/AeC br In
Sxtlon 3106 0/ M� Lebor COJ'. InfMsa4 Ntl �tbmryi Iw�.
CONSTfiUCTION LENDINO AOENCY: I hseby dfiem under penMy d per'Fvy tAa IMn u e mrW�uUion brdinp epanry br Ihe
paAamsrce d iM v.ark br xfiidi thu pmmY u ewM (�� �]. Cw. CI.
LENDEN'9 NANE:
LENOER'S RDOflESS:
I cenily thm I hew reed Nu epplirmian vM ptls IIW iM ebwa'udormelian e crosct.l pies io canply xiih ell cuy erd owmiy pdirercea
vN sfale 4xw rNmiq w Euildiq conWueion W MraEy eWnr¢e iepwenia�i�m d tM ary lo eNer upon �M eEwsmeMion�E paperry
la irepenion pvpoau.
om.: fa' /�-5✓
(515116.WV) Whils-BuiWip 8 SNMy:Oroe�rFb; CNery-App4arn; Pink-R�.enue: (3olden�o�bteev
,i
CITY OF COSTA MESA — BUILDING PERMIT ❑rnnn FIII. M n�etiu�.
PERMIT NO: M 074595
PLAN CHECK NO:
N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: MEC PURFOSE: ALT
JOB DESCRIPTION : I�ITERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B—"l /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#74570
a�**�**+�****�**�******�**�***��*****�*****�*�*����*�*��*�**�*;�*x****���r****����*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCE��RY BUILDING ---------
FRN1': FT IN REA.R: FT IN
LEFT: FT IN RGHT: FT IN
PARFCING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
i
if 3E 1E iE iE if iE 1E if �E iE 3f 1E iE df if iE iE fk fF 1F if dE if iF iE 1f ik ik 3F �E 1E * if iE iE iE i� iE �E jE �E aE �E 9F 3F iE iE iE if iE if 3E 1k �f iE 3E iE 3E iE 3E 1E iE iF iE iElE 1FlF 1E �E 1E fElf 3f Ik i4 iE iE
D E V E L O P M E N T S E R N I C E S R E Q U I R E M E N T S
M1
ZONING APPROVED BY DATE:
BUILDING APPROVED BY � /Y DATE:
APPLICATION ISSUED BY: � DATE:IpI�lof�..
LEGALIZATION;N F E E S U M M A R Y STP.UCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 105.00
25$ SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 105.00 15.00 0,00 120.00 120.00 .00
REVENUE DICrISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
120.00
120.00 OVER/SHORT: .00
FIRE SMSP/TOT GRADING PLAN-CHECK
iE 3E fE iE iE iR jE IE IE fF iF �)f 1E IE iE �E �E �E iE �E 1f iE fE fE if IE 1E if iE iE IE iE 9E �E iE iE iE iF 3E if aE iE �F iF iE aE �E 1E1ElE jf 3F IF 1E iF �E iE iE ik if iE 1E 9E !E �E 3E �E fE 3E if �)E �E iE IE iE if if iE 1E
Z N D I V I D U A L F E E B R E A K D O W �]
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 2 VAV HOX. 6.50 13.00
MEC 17 FIRE DAMPERS 4.50 76.50
MEC 1 INST/REL AIR HANDL UNIT 0-10000 CFM 6.50 6.50
MF.0 1 INST/REL BOIL/COMPR 0.0 — 3.0 HP 9,00 9.00
END OF FEES /
�' JOt�?� _ --�;•�1:; 'q"'.l> >�-
:�.'d: :P - � ,-.t = - �---
_ . ;,L
�
� C(,'NSfRUCT10N AND PLANNING
' APPROVALS Permit #-
1. Temporary E�ectriwl Service or Pole
2, Soil Pipe-Undrgrnd. �
3. Electrical Conduit Utility-Undrgrnd.
4. Electrical Conduit�Undrgrnd.
5. Steel Reinforcement
6. Electriwl UFER Grnd.
7. Footings
8. Foundation
9. Water Pipe�Undrgrnd.
10. Structural Floor SYstem �
i i. P,roperty Sewer Line & House Connection
i
12. Sewer Cap i
13. floof Drains �
14. Rough Plumbing j _
�
15. Rough Eiectrical-Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign
78. Rough Electrical•T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough FactorY Fireplace
21: Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathin9
26. T-Bar Ceiling (Structurat) & Monocoat
27. Frame and Flashing
28. (.athing & Sidin9
29. Insulation
30. Drywall Nailing
37. Plaster Brown Coat �
32. Etectrical Power Mecer�Final
33. Final Electric
34. Final Heating & Air Conditioning
�
35. Final Gas Pipe•Test
36. Hood or CandPy
37. Final Factory Fireplace
38. Final Plum6ing
39. hVater Service-Final
40. Gas Service-Fina�
41. Solar pomestic•Final
42. Backflow Preventer .
43. Backflow Irrigation �
44. Landscape IrriAation System
45r Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PIANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Q
Date
\_
Date . I�spector
„
1
POO� a SPA
APPROVALS Permit #
52. Pool & Equipmenc Location '
53. Steel Reinforcement
54. Forms �
55. Electrical Bonding '
56. Rough Plumbing & Pressure Test �
57. APPROVAL TO COVER•GUNITE
58. Elearical Conduit-Undrgrnd.
59. Gas Pipe, C] Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVALTODECK �
62. Backwash & Receptor-Final .
63. Heater & Vent-Final
64. Ptumbing 5Ystem � Final
65. Electrical-Final ' .
66. $olar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL(SPA SYSTEMS FINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Piping � Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry StandpiPe
77. FIXED SYSTEM FINAL
78. FIRE PREV. F�NAI
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
T
Date Il�spector
�
�
�— --- -- - . . _.__.
�
��itp o f c�o5ta 21� e5a �
Developmenr Services, Division of Building and Safery
CERTIFICATE AF OCCUPANCY
This certlficate is issued pursuant to the requirements oF the Uniform Building Code, Section 308
adopted by the City of Costa Mesa certifies that at the rime of its issuance the building structure herein
below described was inspected and approved for occupancy as Follows:
BuildingAddress 5�5 AN'LON BLW. F[.00xS 1-12
Bldg. Permit No.*eee below
Use OFFICES
Group B-2 Type of•Construction 1-FR Fire Zone Use Zone PA�
Owner of Building Sakioka Farms Tenant "miocn►"
Address � ' ^ . - ° '
•B74570, B7S356, B74572, B7457I, Bi45?3, B�4633
B74632, &74631, B74�630��7 006, B77566, B74574 BY �
.xs.vu,�r
Date Novzmber 14, 1996
RICK BRO'a2i, CBJ
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
, ��
. .. . . . _x. . . . . . . . . . � ... .. ,... . _ .. ...
� Ci 'Y OF COSTA M; �A : �;�
Development Services, Division of Building and Safety
CERTIFICATE OF OCCUPANCY
This certifiwte is issued pursuant to ttie requirements of the Unifo'rm Buil"ding Code, Section 308 adopted by the City
of Costa Mesa certlfies that at the Hme of its issuance the building structure heiein below described was inspected and
approved foroccupancy as follows:
BuildingAddress S55 Anton B1_, Ste' 300 BIdg.PermitNumberB06-01293
Use Office (18,.064 s.f.) '
_ �r . - . - - --s� . ., , .
Group B TypeofConstruction 1-FR 1� FireZone XXXXXXXX� UseZone PDC
Sakioka Farms
OwnerofBuilding�'�ozgana Hotel Limited Partn. Tenant MAERSK
Address Attn: Joe Crawford, 1050 17th`St., Ste 1'2h0, Denver, CO 80265
, - . BY ;. . ^ , � U� -�a.-�/
BUILDING OFFICIAL-KI1driIl Q. NgUYBri, C.B.�. - /
Date 09/0
_ .
REQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
�
Ciry of Costa Mesa
Development Services Departmen[ C E R T I F I C A T E O F O C C U P A N C Y' No.
Building Safety Division
P: 0. Box 1200 '
Costa Mesa, Califomia
The Building located at 555 ANTnN AnIR,FVARTI '1RT1 rrnnR
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group R� Occupancy.
Use ot Buildin
Le9al Description 41(1—SN—l1G
(See reverse side for Metes and Bounds)
Building Permit No B 59140 Electrical Permit No.p 5Q141 Plumbing Permit No.➢ SQIG'1
Mechanical Permit No. � 59142 Number of apartments and/or guest rooms
Fire Preventian Permit No. F 59193 �
ISSUED TO: BuildingOfticial Tonv !C'De Baca
Rank (lf 4mn�i�n � '— F
555 Anton Blvd. , 3rd. Floor bY •""'��� ` -�� � ` ' �
Cn4rA Macn r.� q���a .
Date October 10. 1992
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 Corta 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 $ervices Department
Building Safety Division
P. O. Box 1200
Costa Meu, California
CERTIFICATE OF OCCUPANCY No. OO���O
The Building located at qcq �„�.�n w,nle�rarA. .Suite 300
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordlnances applicable thereto
for a Group B2 Occupancy.
Use of Building OffiCe
Legal Description 410-501-04
(See reverse side for Metes and Bounds)
Building Permit No B 36887 Electrical Permit No. E 36930 Plumbing Permit No.
Mechanical Permit No. M 37150 Number of apartments and/or guest rooms
UED T0:
Building Official �'lilliam T. H�rd
cennriYv PtaC1�1C Bdli}C - /
600 Wilshire Blvd.� 0500 by _
r..a annoto4. CA
• - Date ,7ulv 17. 1989
This Certificate of Occupancy SHALL BE pos[ed in a conspicuous place on the premises and SHALL N07 BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CfJIF 1015-46 rev. 1/83 White � Owner; �w�ary - Numerical File; Pink - Bidg. Permit File
�
City of Costa Mesa
Development Services Department
Building Safety Division
P. O. Box 1200
Costa Mesa, Calitornia
CERTIFICATE OF OCCUPANCY No.
The euilding located at 555 Anton Blvd. Unit 350
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group Bz Occupancy.
Use of Building OffiCOS
Legal Desc
Building Permit N
410-501-04
848775
Mechanical Permit No. M43d66
(See reverse side for Metes and Bounds)
lectrical Permit NoE48835 Plumbing Permit No. P48924
Number of apartments and/or guest rooms
ISSUED TO: • BuildingOfficialTon� C'De Baca
Security Pacific National Banlc ----�-. -- ,
555 Anton Blvci - by %`_.—. .;'i'-,,i �i�
Costa I�lesa, Calif.92627 • � `
Date September 10, 1990
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. �,
CMF 1015-a6 rev. 1/83 White - Owner' ��ary - Numerical File; Pink - Bltl9. Permit File .
��
,�ii'.�'
y�.
; � i
� CITY OF COSTA MESA �--`-=-
B{/ILDING DIVISION
...�. .+3 .,. _...._.�......... A
77 FAIR DRIVE, COSTA MESA, CA 92626 �(714) 754•5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us
PERMIT TYPE
JOB ADDRESS:
Vicinity: 300
SCOPE OF WORK:
OWNER:
PHONE:
FOR INSPECTIONS CALL: (714) 754•5626
PERMIT NUMBER: E07-00573
ELEC STATUS: ISSUED
DATE ISSUED: O6/11/2007
ISSUED BY: CAC
Y f r
�1 . ':^
�,:.� }� � $Ulie�..
,
555 300 ANTON BL CM �. �
' � Umt .,.300
��� r
t k � [. �
,
INSATLL 42 QUBICALES S6�OUTLETS FOR MAERSK SUITE�300„
,, � q�
, ;' i �' r4;' � �
,ddress � � PO BOX 4900 Unit;DEPT 207 ���
rY: f " �,Ci"ry/State/Zip: : SCOTTSDALE AZ ' `
. li . li :...4 � -
APPLICANT: ROBERT.MCCORKL
PHONE: 949-251-7692
CONTRACTOR: INDOFF� INCOI
Address: 11816 LACKLA�
City/State: SAINT�,LOUIS, P
li' �
r., .-
Electrical Plan Check
Elect�ical Permit Fee:
Reinspection Fee
TOTAL FEES
,� �. i,; _ . ,, _ , . , _ -..
- `; � � Address: . -�-=29351 ELBA DR �, Unit: .
`� -� - City/State/zZip: � LAGUNA NIGUEL„CA � �� ,
�RATED � �=-���--- - � -- - � � License-No.- 732090 : �
',DUnR - : , j. � - �- . _ .�� PHONE: - 314-997-1122 �
. , . . :... - . ,
_ _-
� :..,ZipCode:' 63746 - � - � -' CELL:-.. -_ � -. ,
i .
i.i, "
�5 � ��
— . '�Q.�� {�,:.,. .
`� ,$71 78 � z � ;.�-�,�
� , ,�
� �$OOOF ; ��i
$71 78 �`, , ��
w p,
, � .- .. ,
�
;�;> i�,w ''
C F � I
4. � ��'j :` ..
� .._.... .1_ ��
I
si I` 3
`i�F.�'..., r . . � �. _ _
NO710E: The vrork authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28. § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applirable 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.
CODE p. INSPEC710NTYPE
1818 Fixed System Final Fire Prevention
1268 Pool Spa Final �
200 Final Re-Roof
201 Flnal Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
onh ixn n
�
CODEI �Nsveenoxrne
208 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
Q�jF� INTITALS
WORKERS' COMPENSATION DECLqRqTION:�
I hereby aKrtn under penalry of perjury one of the vnng declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as provided (or by seclion 3700 of [he Labor Code, for Ihe
pertormance o( the work for which this permit is issued.
� I have and will maintain workers' compensation insurance, as required by
sechon 3700 of [he Labor Code, for Ih2 peAormance of Ihe vrork for which tAis
permit is issued. My vrorkers' compensation Insurance carrier and policy
numb are:
arr' : /�%�%�lP1-Sl/�vC
(TN55eU ednol0ecompleletlilthepepnituv/a�luetl/a(oQnehvndred0ollars(8f00Joi1e55.J
P cy Numb : wC �32 � %F, /��
❑ I certify that in ihe peAortnance of the work for which this permit is
issued, I sball �ot employ any person in any man�er so as to become subjecl
[o the workers' compensalion laws o( Calitornia, and agree that if I should
become subjecl to Ihe vrorkers' compensation provisions of Section 3700 of
the Labor Code, I shall forthwith comply with these pmvisions.
Applicanfs Signature Dale
WARNING: FAILURE TO SECURE WqRKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm lhat I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of lhe Business and Professions Code, and
my license is in (ull force antl e%ect.
ic. 73�� las D�
6' /i d7
Gomra r's Slgn e
CONSTRUCTION LENDING AGENCY:
❑ I hereby aRrm lhat lhere is a consWction lentling agency for the
peAortnance of the v.ork t« wfiich ihis pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Da�e
OWNER-BUILDER DECLARATIONS:
I hereby affrm 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 counry which requires a permit to
construct, alter, improve, tlemolish, or repair any strucWre, pnor to its
issuance, also requires the applicant fbr such pertnit to fle a signetl statement
that he or she is licensed pureuanf to the provisions of the Contractore
License Law (Chap[er 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or ihat he or she is ezempt therefrom antl
ihe 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 tlollars ($500).):
❑ I, as owner of the property, or qiy employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intendetl or
oHered for sale (Sec. 7044, Business and Professions Code: The Contrectors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such vrork himself or herself or through his or her own
employees, provided ihat such improVements are not intended or offered for
sale. If, however, ihe building or improvement is sold within one year of
completion, the owner-builder will have the burden of proving that he or she
ditl not build or improve for purpose of sale.). � -�
❑ I, as owner of the property, am EXCLUSNELY,CONTRACTING WITH
LICENSED CONTRACTORS to constNct the project (Sec. 7044, Business and
Professions Code: The contractors License Law dces not apply to an ovmer of
propeny who builds or improves �hereon, and who contracts (or such prqecl with
a contracta(s) license pursuant to ihe Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
SignaWre
305]<6 (3I0])
Ovmer ID verifietl by driv� ,se. ❑ Yes ❑ No � L.
Driver's License No. Expires:
�:Venfication of Ownership by (type of document, i.e. - property tax bill or deetl):
DIVISION�OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby ceAify that no excavation five (5) or more feet in depth into wfiich a
person is required to descend, will be made in connection vrith wurk au�honzed
by �his permit, and that no building slrucWre, scaffolding, falsework, or demolition
or dismantling thereot, will be more Ihan [hirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builtler, I will not employ anyone to do work which woultl
require a permil from the Division of Industrial SaFery, as notetl above, unless
such person has a permit to do such vrork from the division.
Apphtanfs 5ignalure Dale
Division of Induslrial Sa(e[y Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
i. Will Ihe applicant or present or tuture building occupant need to file and
certify a Business Plan for emergency response to release or Ihreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, wilh some
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantily of hazardous materials equal [o or greater than a weight of
500 pountls, 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 ❑ No
(Section 25533 0( the California Health and Safety Cotle, with some
exceptions, requires registra[ion with [he Costa Mesa Fire Department by
each business which at any one time has on hand a quanti[y 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 compressetl gas at slandard
temperature and pressure).
3. Does or will the applicant or present or fuNre building occupant need to
prepare an RMPP (Risk Management antl Preven[ion Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Seclion 25534 ot the California Health and Safety Code provitles that [he
Costa Mesa Fire Depanment may require the preparation, certification and
filing wilh lhe Fire Department o( an RMPP by businesses which are requiretl
ro register acutely hazardous ma[erials vn[h [he Fire Department.
4. If an RMPP is presently required, has Sec[ion 25534 of lhe California
Health and Safery Cotle been (ully complied vnth? ❑ Yes ❑ No
5. Does or will the appliwnt or present or future building occupant require (or
the work which is the subject of [his application a pertnil for such construction
of motlificalion from lhe SOulh Coa51 Air Quality Managemen� DiS�rict or from
any other air pollution control district or agency9 ❑ Ves ❑ No
(Seclion 658502 of ihe Califomia Govemment Code requires that the requested
infortnation be Nmishetl on applica[ions fa rroo-resiUential building permits�.
6. Will any part o( the lacility, lo be constmcted under this permit be within
1000 feet (rom lhe outer boundaries of a sclSool?:" � Yes ❑ No
Qf'yes", the tacility must meet the`�requirement,of,Sections 25534 and 42303
of the California Health antl Safery Code).
7. I! a permit from the South Coast Air Qualiry'.Management District or other
air polWtion control disVict or agency is requiretl for [he work which is Ihe
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No,
8: Qf "yes':, ariach certificate of compliance from the�appropriate air pollution
control offcer). � _ , � .
CERTIFICATE OF COMPLIANCE: I certify tha[ under penalty of perjury the
information given above is cortecL I agree to comply with all slate lavrs antl
crty ordinances regarding Hazardous Matenals and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y under penalty of perjury that I have read this application and state that
the information given is correcL I agree to comply wi�h all state laws and city
ordinances relating to building construction, and authonze represeNatives of
the Ciry of Costa Mesa to enter upon [he above-descnbetl property for
inspection purposes. I agree not to occupy or allo occupancy o/ any builtling
authorizetl by this permil until fnal inspec[ion.
Qre ol e ale
Antllor uth nze '�0.p�li n� 1 � / al O
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL Status: �SSUED
Suile: 300 Applied: 04/162007
Viciniry: SUITE 300 Issued: 05/10/2007
Parcel Nunmber: 41050110 Zoning: ,
Applicanc ANNA MORENO - - -,::� _;` _;�,-_ - , ISSUED BY:
Address: 30060 SIWER SADDLE CT� ✓" ���-� J- ',�� - -- - � �
� �// �'-� — ': Phone: 951-244-9836 "' � �� _
CANYON LAKE,QA�„ ���� Zip: _ � 92570 , � / . �� ��� �� _.� �
/ i t, , � ' � �
_ i � ,_� , �',� I � i ���� '�•�
Owner. RREEF � " �\ � �, � , ` � ' /; � i � / �.,�-
�
Address PO BOX 4800�, � �/ � _= - � --� � �� ���� � \
�DEPT,207 � � /-� , � Phone. � - -�� -J ��� A AI � ;; �
' � ._._ . - ,�� , � , � /����.
/ � � �j SCOTTSDAL� j � �y� Zip: 85281-4900 ' � � \ \� \\ � � i �� ���\ �
� � � �
Coniractor. �ALL PRO FIRE PROTECTION �\ "\\\i � �
i Address: 30060 SILVER SADDLE CT '���� -� � �� ���
� �� / ,.`,. /�ji� Phone:f-951-244-9836 �` �� ' \ �� ,��
��'-� CANYON LAKE, CA Zi : �
_, . ; i�.=/ P � 92570 ����„ ( �'V� ', �,��
- " ' � 1 License: 629993 ' � % V �
� �
';,j� - „ �.� , ��
' — �
� � ' � ,� �SCOPE OF PERMIT : )
� � 'RELOCATE 8 FIRE SP HEADS FOR� MAERSK" IN SUITE 300 � � � � �' �
� B06 01243 � �% � `4> , ._ - -.-_ _ _ , , . 1 ,
„
-_ , ,.i_�� i .�� 1/�� � �J� � ' ,��
_ � .. - � - - �, '
, � �� � _ , �^- - _
� ' '' � � FEE SUMMARY '-� � � �
Plan Check: ��$2122 � Calc Valuation; , gaoo.00�� i�
Permit: $32.65 ,, :; : ; _, �-_ -^,r - `/ r., ; .,,,� 'Claimed Valuation: Saoo.00
Other:� $0.00 ' � � � ��1� 1 ����r ll.�-'��L; .f'•' -�':.�; �: � � �
.. - � . , �
'� - - - _ - " ;� � - � ,� :
;"
` Total: $53.87 ��._ __"_ 'r�. �r,� ✓� ' ' ' �
V� ' _ - � =1c,) ��-�r i. �1_�� � - � /,, G� —., ; _ i '�,
� _. � - -- � ..,.
' � � �- � ' - � � � � � �
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'�\�\�//( �\�\�\�\\� '_ `+��.,\ ; �'�\\�i����� �//
VA � ' � _-� __ ' �_ �- , ,.-� i
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_�- -- ;i� - -
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-_. , - �c.:. -,.- - . . -
NOTICE: The work authorizad 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 ot 780 days.
INSPECTIONS: In ordar for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapeetlona end flnel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5828
i
2ane-ae Iflroo) LJ
WORKERS'COMPENSATIONDECLARATON: � �
I hereby eflirtn under penalry ot perjury one ot the following dedarations: .
❑ I heve end will meintaln e ceRificate of consent to self-Insure tor workers' compensetion, es provlded for by section 3700 01 tha Lebor Cotle, tor ihe peAormance of the
�ork tor w�ic� this partnit is Issuad.
have antl will maintaln woBers' compensation Insurence, es required by section 3700 of Ne LeDor Cotle, fo� Ne peAortnence of ihe work for whl this pertnit is issue0.
My work mpecnsation Insur nce carrie,,r/ antl policy number are: /� `/ /�
Carrier: �i�. �Z��/'lJ'( . Po6"�cy�uN mber. /l�-Y��/��V�
(This section neetl not be comp/et /f fhe permit Is velued af one hundred dd/ars ($100) or /ess.)
❑ I cetlify that in the pe rmance ot the work for which this permit is issueq I shall not employ eny person in any menner so ns to become subject to the workers'
compensetion lew elitomia, end a��at it I s�� come subject to Ihe workers' compensatlon provislans of Section 3700 of the Lebor Code, I shall fonhwlth
comply with these is s. ,
ApplicanLSigneWre: �aet :
�.�
WARNINO: FAILURE TO SECURE WORNERS' COMPENSATION COVEPAGE IS UNLAW FIIL M1D SW1LL SUBJECf AN EMPIOVER TO CHIMiNAL PENALTIES PND qVIL FlNES UP TOONE HUNDRED
iMOUSAND DIXIAPE (5100,000�, IN ADDfTION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTON �OB OF THE LABOR COOE, INTEREST, AND FTTOFiNEY5 FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eMirtn thet I em licensed under�Provisi�s of Chapter 9(commenclnq with Section 7000) of Division 3 oi lhe Business d Pryf§ssions Code, and my license is in full
brce end effeCL �M ��8,2 �/'�/C r/i �/')/I /1 „n CIeSs'» �- L i�
-contraaorlSiqnawre: �/L%(. ���� DeU S /D D
CONSTRUCTION LENDING AGENCY:
❑�I hereby aflirm that ihere is e consWction lending agency lor iha peAortnance of the work tor whic� ihis permit Is issuetl. (Sec. 3097, Civil Code).
Lentler's Name: Lantlar's Atldress:
SigneWre: Dete�
OWNER-BUILDEH DECLARAT10N5:
I hereby aHirtn that untler penalty ot perjury that I em E%EMPT FROM THE CON7RAC70R5 LICENSE LAW for the tollowing reeson (Sec. 7037.5, Business anC Protesslons
Code: Any city or county which requires a pertnit to construct, alter, improve, tlemolish, or repeir eny s�rucWre, prior lo its issuance, also requires the applicant for such permit
lo tile a signed atetement thet he or sha is licensed pursuant to ihe provisions of Ihe Conireclors License Lew (Chepter 9(commencing wiU Section 7000) of Division 3 af Ihe
Busineu enA Professions Cotle) or that he or she I5 exempt therefrom antl [he Eesis for the elleped exemption. Any violation of Sectlon 7031.5 by any applican[ for e pertnit
sub�ects the epplicant to e civil panalry af not more Ihen five hundred dollars ($WO)J:
❑ I, as owner of Ihe properry, or my employees with weqes es their sole compensation, WILL DO THE WORK, entl Ihe structure Is not intentletl or otteretl for sale (Sec.
7044, Business entl Professions Code: The Contractors License Law tices not apply to an owner of properry who builds or Improves Ihereon, and who does such work
himself or hersetl or ihrough his or her or.n employees, provitletl that such improvemaNs are not IntentleC or oflered tor sale. tl, however, Ihe building or Improvement is
sold within one year ol complation, the owner-builder will have the burden ol proving thai he or she did not builtl or improve lor purpose of sale.). '
❑ I, es owner oi ihe properry, am E%CLUSIVELV CONTAACTNG WITH UCENSED CONTRACTORS to cansiruct the pro�ect (Sec. 7044, eusiness end Pmfessions
Cotle: The contrectors License Lew tloes not epply to an owner ot properry who builtls or Improves thereon, end who contracis for such proiect with e contrecror(s)
license pursuant ta the Cantractars Licensa Lews.).
❑ I am exempt under sec.
Signa�ure:
Owner ID verifled by dnver's license. ❑ Ves ❑ No
Business and Prolessions Code for this reeson:
Vedficetion of Ownership by (type of tlacument, i.e. - property tax bill or deetl):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTFICATION:
Orivers License No.
Date:
Expires:
❑ 1 hereby certity thet no axcavetion five (5) or mora teet in depth imo which e persan is requiretl ro descend, will �e mede in wnnection with work authorizetl 6y this
permil, and ihat no building structure, scaftolding, felsework, or demolition or tlismantlinp thereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Calllornla Atlminlsirellve Cotle).
❑ As owner-builtler, I wlll not employ anyone lo tlo work which waultl require e permit from the Division of Indusirial Sefery, es noted above, unless such person hes e
permfl to do such work From Ihe tlivision.
SianaNre: Date: _ _ _..
Division of Intlusirial Safety Permil Number:
CERTIFlCATE OF COMPLIANCE AND AIfT}IORIZA710N OF ENTRY: I certity under penelry oi perjury that I have read this application and state that ihe intormation given Is
corract. I agree to comply with all state lews and city or0inances releting to buittling cons�ruction, end authonze representatives oi the Ciry of Coste Mesa to enter upon Ihe
aDove-described praperty lor ins0ection purposes. I egree not to occupy or ellow occupanry ol any builtling eutharized by Ihis permit un�il finel inspection.
CODE �. INSPECTIONTYPE
7616 Fixetl System Final Fire Preventian
1266 Pool Spa Finel
200 Final Re-Roof
201 FIna181ocWRetaining Wall
202 Final Fectory Fire Place
203
204
Finel Sign
Final Demolltion
PAL Ri�9l5
s/,o/o
cooer ixsvecnaNrrre
206 Finel Mechanical
20B Finel Plumbing
270 Final Eleciricel
212 Final Fire Preventian
220 Flnal Plenning Approval
222 Final Site
250 Final Bullding�Occupency
� �
c4�Z''�"O% �lM.
JobAddress: 555 ANTON BL
Suite: 300
Vicinity:
Primary Occ: B Eat<50/0ffic�/ Bar<50
Parcel Number: 41050110
Applicant: MARIN, MICHAEL
Address:
Type of Construction: I-FR
Zoning: JJ � U
�
' _Phone: 774.948.0913
. �, ., - Zip: - .
� � '
Owner. SAKIOKA FARMS MORGANS HOTEL LIMITED �
Adtlress PARTNERSHIP.ATSN JOE-CRAWFORD
Contractor ° AMAP
Add es ji'1565 N
� �� � \,
�ANAHE
�,
� � i Zip: 92807/.
..,� i i.
� Aich :� �> ! %ii
�Adtlress: �.J j� �
� � /;�G-
i„/
, ; Zip:-� / �'�� .i /
�
, �,.' i /,".
� 18,064 S.F. INTERIOR TENAI
"MAERSK" IN SUITE 300
��' �� � � Phone: '
\; � � � - Zip: �
\ /-� " - -_ _ - -
VST.ROGTION CORPORATION `' � .
Y;CI�,' �. . , �- -'',. - . .'
774-993-9220 �` �� � ' �
� � ,�.\, �
674301 '` �.�':
•� �
Slalus: ISSUED
Applied: 07IZSI2006
I55ued: 01/182007
ISSUED BY: ��j��%��� —
'� -
% �
i
� _
Phone:
License:
i
_. Phone: �;
' ���. . -.
�.
, �,-lice,nse `-° "�����
� '' � ` SCOPE OF PERMIT
MPROVEMENTFOR
� i
Eng:
Address:
Phone:
�
Licanse:
� �/� �� � i �� ii���'�i���7 �' �FEE'SUMMARY'.;,' /+<
: ��' Plan Check' $1,315.70 ' �� ��� %• �� �✓'' i' �� `� - -'�< <� � '�� Calc Valuation:
Permik' $2,024.15 ( - Claim Valuation:
SMIP Res: $0.00 �
� SMIP Com: � �59.46 �. 1 � `'�,-• ,; :� - ��� � ,
Other.. � $0.00 — — � �— � ��' "�'�
Inspection.' '' $0.00 � �� ' '
,
� ' �'� i% .
Total: ,�,$3,399.31 ' - '_
�'•.: �
�� ' i �'��� � . ,PL''ANNING & ZONING ��
SETBACKS ,� � � � -
�.� ' i G.p , ,i.�
MAIN STRUCTURE �Front 0• 0 Rear 0 0 Lek - 0 0"' �� �� -. Right ,, 0• 0�
� � . ���� � ... . , � , , . „ � � - . �
ACCESSORri Fronti� 0-0;-��,' �Rear 0-0� „ � Lefl � 0-0 _ Right,� - 0-0 ,
PARKING\\E 5tinq: j",0� �\Reau ed 0' ",-. Pr000sed: 0 �� ' �;
.�� � �_,- „�- � - _ . . �, ,
c � i
���� ��� .'/��A�_ "` --- � � � � �-��'
��� ��1����i � 1 �� . �i -. •; � . �� � ,i�.
� � � � , r r_ ' ' . , � , '
� �� � � � � 1 . A�. � . . . ._, - _ � - '� i � .
�'�.,� J _j, �
` =!� �j' _.._ , �-�CJ'� "
�'_� >. , '�i.�!.• . �
5283,15320
5270,960.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia statutes and related
regulations. (Ord. No. 92-28, § 7, 12-21-92) ��
EXPIRA710N: This permit shall automaticylly expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a perfod of 180 days.
INSPECTIONS: In order (or Ihe work authorized under this permit lo be considered fegal, such work must compfy with all applicable�e� , and afl
required Inspaeliona end (inal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration/ of/�his permit.
FOR INSPECTIONS CALL: (714) 754-5626 �/
zaaa+s lalool
WORKERS'COMPENSAnONDECLARAnON:
I hereby aHirtn under panalry of perjury one ol Ihe fWlowing tleclarations:
❑ I heve end will meiP�ain a cenifitate of consenl Io self-Insure Por workers' compansation, es pmvideC br by section 3700 0l the Labor Cotle, for Iha pedormence ol Ihe
work tor w�ich t�is Pennil is iuued.
U�(,[�,I�heve end wlll maln�in workers' compensatbn InSurance, as required by section 3700 0l lhe Lebor Code, for ihe pertortnance of Ihe work for which ihis pertnit is issuetl.
"` Mv workers' como9nsatlon Insurance carder entl poiicy number are:
(he permif !s velued af one hund�ed dollers
olicy�Number.�� Vl�� I'I r'1 �-' % U) P
❑ I certiy t�et in the pedortnance ot the wod�� r which IhiS pertnit is issueQ I 5h811 noI employ any person in eny mannar so es to bocnme subject to ihe workers'
wmpensation laws of C" la, tl e r iet i� becoma subject to tne warkere' compensetion pranslons ol Section 3700 0l the Labor Cotle, I s�all forthwit�
wmply with the p �o . C'
A Ilcant SI neWre:— ---. ��' d'(� �
�PP --� G � _ �ete:...—= : ��
WARNINO-FAICURE TO SE ` E WORKER ODAIPENSATIO) COVEMGE IS UMAwFUL AND SHnLL SUBIECT nN EMPLOYER TO CRIMINAL PENALTIES AND C1VIL FlNES UP TOONE HUNDREO
T/IOUSAND DOLURE (510U, . IN �DORI TO THE CO6YOF COMPENSATION.OMMGES AS PROVIDED FOfi IN SECTIIXJ 31O80F THE LABOF CODE.IMEREST. M1D nTTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy eNirm t�ai l erts.lice�se��tpd`�r�roNs�� of Chepter 9(commencing with Sectlon 7000) of DlNsion 3 of._ t�e Buel�n,ess enA ProleSsions Code, ena my license is in tull
CONSTRUCTION LEND�NG AGENCY:
❑ I hereby affirm that there is e construction lentling egenty tor Ihe peAormance ol Ihe work for which this permit is issuetl. (Soc. 3097. Civil Cotle).
Lendels Name: LenAefs Address: _ .
Signeture:
OWNER-BUILDER DECLN�ATONS:
De�a:
I hereby atlirtn lhet undef penalry ot perjury that I em EXEMPT FROM TT1E CON7RACTORS LICENSE LAW for the lollowing reeson (Sec. 7031.5, Business entl Profession5
Code: Any ciry or caunry whic� requires e permit to construct, alter, improve, demolish, or repair any strucWre, pnor to its issuanco, also requires t�e applican� for such permil
lo tlle e signed siatement that he or she Is Iicensetl pursuant to the provisions of the Cantrectore License Law (Ghapter 9(commencing with Section 7000) oi D'Msion 3 of tha
eusiness end Pmfeuions Cotle) or ihat ha or she is exempt t�eralrom end ihe 6asis for the ellegad ezemption. Any violetion of Section 7031.5 by eny epplicant for a permit
sub�acts lhe applicent to a civil penalty ol not more Ihen live hundred dollars ($500).):
❑ I, as owner of Ihe p�oPeny, or my employees with weges es their sole compensetlon, WILL DO TME WORK, and Ihe structure Is not Intendetl or offered for sale'(Sec.
7044, Business and Professions Cotle: The Contractors License Law dces no� apply to an owner of properiy who builds or Improves thereon, antl who does such work
himsel� or hersel� of through his or her own employees, providetl ihat such impmvaments are not imentletl or oRered lor sale. If, however, the builtling or improvement is
sold within one year of completion, 1he owner-builtler will have the burden of proving ihat he or she tlid not build or impmve for purpose ol sale.).
❑ I, as owner ot the proDerty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construci the project (Sec. 70d4, Business and Professians
Code: The contractars License Lew does not epply ro an owner ot pmperty who �uilds or Impmves ihereon, antl who contracts for such project with a contractor(s)
license pursuant to the Coniractors Ucense Lews.�.
❑ lam ezemptuntlersec.
SigneWre:
Ownar ID vaniled by dnvers licensa. ❑ Ves
Verilicatlon of Ov.•nership by (rype ot document, I.e.
Business and Professions Cotle lor Ihis reeson:
❑ No Dnvers Litense No.
property tex 6ill ar deed):
DIVISION OF INDUSTRIA� SAFETV PERMIT CERTIFICATION:
Date:
Ezpires:
❑ I hereby certify that no axcavetion Ilve (5) or more feel In depth into which a person Is requiretl to tlescend, will he made in connection with work euthorizetl by this
permit, entl that no buildinq sirucWre, scefloltling, felsework. or demoli0on or dismentling ihereol, will 6a more ihan thiny-slx (38) feet high. (Chap. 32, Grp 2, Ah 2, Sec.
341, Title 8, Celilomia Adminis�retive Code�.
❑ As owner-builtler, I w�ll not employ anyane to tlo work which would reduire e pormit from Ihe Division of Indusirial Sefe�y, es noted eDove, unless such person hes e
permit to da such wo�k from the division.
SignaNro: Date:
DIN91on oi Intlu52nBl Sefery Permit Number:
CERTIFlCATE OF COMPl.�N10E AND AUiHORVATION OF ENiRY: I certity under penalry of perjury that I have reatl ihis eppliCation antl stare that the intormation given is
correcL I egree lo compty wilh ell stete laws end ciry ordinances relating ro builtling consiruction, end authonze representatives ol t�e G�ry of Costa Mesa to enter upon the
ebove-descnbed properry tor inspe,Qliqn purposes. I egree not to occupy or allow occupancy ol eny building authonzed by this permil umil finel inspection.
[d�1�7�1�I:f�99t�Ti[• ,7`f�777
1616 Fixed System Final Fire Praventlon
1268 Pool Spa Finel
200 Flnel Re-Roof
201 Finel Blotk/RBIaIning Well
202 Final Fectory Fir6 Place
203 Final Sign
204 Final Demolition
PAg It�LS
CO�E� INSPECTIONTYPE
206 Finel Mechenical
20B Final PlumDing
210 Final Electrical
212 Finel Fire Preventlon
220 Final Planning Apprwal
222 Final Site
250 Finel Builtling/Occupanq
PAIE lt�dl$
i • • `��
(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite: 300
Vicinity: MAERSK
Status: ISSUED
Applied: OS/072007
Issued: 05I172007
Parcel Nunmber: 41050110 Zoning: �
npp�iwne DOFNER,DANNY -.:��,., �...;:. - - _ ISSUEDBv:
Address: 2505MIRAMARAV.--'�.�/'�!,-� - .�.� -- - �- ��'. _ _� �.....�
/ i'!. %�-�'"�� � Phone:- 562-498-6444 ��_� _- . � ��
� LONG BEACH, CA�" " � ` �� � Zip: � 90815 � � , � �- `�
�"�� � %� �'��
owner: RREEF" �' � `, � ," - ---- �� � � �� ��
. �. �_•�/ \��\
Address �PO BOX 4900� ' � ` " � � , - � 1 � /` �
�
� DEPT207 '�., _ / � -_ Phone. - - _ �_.��� `A��V�
j�SCOTTSDALE,AZ� . � Zip: 852814900 �� � \ �
�.
i /'� � � ` -. � . \ ��\
��' � ' �/,!vi" ��. � � � ,:�`�
Contractor. '�ACKERMAN; MAGGEY �' ������ � j ����
.�Address: ' �!%i� \��V�� ����;�
, p\ ; �
'�i�'� � ,"> �ij Phone:E ,.�� � ��� •.`
, , ' ` ' /�% �• / / � ' V.� �
_ -i Zip: �'- ��.1�A ' ���`..
" � =' ; License: 327196 � -- - . :�A "- `. ,�� �
, ' � - , „ �"� � � - -- . . _ � _ ,-;° - . - � ; ,� .. ` , . .
� . � . i; � ` � �SCOPE OF PERMIT -' � �1 �, � "�' ,' ��
." , FIRE SUPPRESSION�pERM1T TO RECOCATE AND INSTALL 2�SMOKE DETECTORS, 16 STROBES AND 2. '
. . . � _, ,� . ,�DUAL SYNCHRONIZATION FOR 18,064 S.F. INTERIOR TENANT IMPROVEMENT FOR �MAERSK" IN • . ��
'SUITE300.- , - - _ - - - � � �
, , _ '_ - .'/ ����� , , .
. . . REF#: 808-01243 � - -•� " �. • _ ' � � '
., � . , . .. �•�
� '
' � / i"; '�-; FEE SUMMARY : �`��� �'` �
, Plan Check: $45.01 - . : . _ �"'� `_ _ _ � ":. "" ' _ ' . '"` Calc Valuation: ' Sz,000.00.� .
Permi4: $69.25 = J Claimed Valuation: , s2,000.00 � ,
T v Other $0.00 � ;� _ , � �� �,. � �
i - ��� �, j - . , , , , �
� - T�' �L_� �� _ ,� ,,�.
� - _ -� _ -����_ <<; ; i•: �
� TotaL• ��� . 5174.26 - _ _ _. . 5 � /'i : �
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-� ���_� - , c� � � .�
�� .�,I/� ^-� � _-�`--_ - _=_� " �V�,�;� ��..
_ � ���� ��; ��% _,`/.�.•-�.-' -". . �� • ,!%�"
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—��;`--,_ _�.���„ .� 1- �.���-%%
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— _ - � _ ,�. � � - �'�-- --i
' .,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremems under Califomia statutes and related '��'
regula�ions. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This parmit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days:
INSPECTIONS: In order for the work authorized untler ihis permit to be conslEeretl legal, such work must comply with all applicable codes, and all
required Inspeetlona and iinal approvel must be obtained. Failure to obtain inspections and tinal approval will result in tha expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
eaao-ca �aw�
WORKERS' COMPENSATION DECLAppTION:
I hereby aHirtn under penalry oi peryury one oi t�e followinq tlecleratlons:
❑ I have and will maintain a certificate oi consent Io self-Insure lor workers' compensatlon, as provitleG for by section 3700 of the Lebor Cotle, tor the pertormence of Ihe
work tor which this permi� is issueq.
❑--�I have and wlll maintein woAcers' compensatlon Insurence, as requlred by section 3700 ot �he Lebor Gode, for ihe peRormance of the work for which Ihis permit Is Issued.
�My workers' compensallon Insurance carner end poliry number ere: /"r— \ 3y�o � a�
carrier� RC- PU bL I� / n � t"�E ✓H ni T/ (�Policy Number: �
(This section need nat be complete0 i! (he permit is velued one hundred dollers ($f 00) or /ess.)
❑ I certity ihet in Ihe peAormance af t�e work for whic fSis pertnit is issuetl, I shall not employ any pereon in any manner so es to become suh�ect to ihe workera' �
compensation laws of Calitomia, e�daq e that IF iould become su6�ect to t�e workers' wmpensatlan pravisions oi Sedlon 700 oi t 9 Lebor Cade, I shelllorthwith
comply wilh ihe i � .
�Plf—cenl Signature: - - rDate:` � 6 �
WARNING FAILURE TO SECURE WORKERS' �pMPED SATION COVERAGE IS UNLAWFUL AND SW1LL SUBIECT AN EMPLOVERTOOFIMINAL P ALTIE PNO CIVIL FlNES UP TOONE HUN�REO
TF10USlWD OGYURE �510D,OWA IN AODRIOry 10 TH(tQ570F COMPENS4710N, DAAWGESAS PRWIDED i0A IN SECf10N 3]C80F THE UHOA CODE.IMEREST, AN�ATlORNENS FEES.
LICENSED CONTRACTORS DECLARqTION:
I hereby.attirtRt�al I em licq{�sad underg rovisions of Che 9(commencing wilh Section 7000) oi Divlsion 3 0l the Business entl Pratesslons Cotle, entl my Ilcense is In full
tor�ce�and eeect,uc. a 3a% ��c'i b �ss a L' -�l O r- I b
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm that there is a construction lending egency for the Dertortnance ot Ihe work for which Ihis permil is issuad. (Sec. 3097, Civil Code).
Lendefs Name: Lenders Address:
Signature:
OWNER-BUILDEH DECLARATONS:
Date:
I hereby eHirm Ihel under penalry of perjury thet I am E%EMPT FROM THE CON7HAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Busineu end Professions
Cotle: My ciry or wunry which requires e pertnit to construd, alter, improve, tlemdish, or repair any sirucWre, prior to its issuance, also reduir05 t�e applicant tor such pertnit
ro(le a sigrred stetement Ihat he or she 7s IicenseA parsuant ro the O�o�s�o� o� the Contredors IJcense Lew (C�epter 9(oommerrcirig with SecNan 7000) ot DlNsion 3 ot fha
Business antl Professions Cotle) or that he or sha is e:empt Ihereirom an0 t�e besis for Iha ellaged eaemption. Any violation of Sectlon 7037,5 by eny epplicant for e pertnit
sublecis ihe applicent to a civil penalty o1 not more then five hunAred dollare ($500).):
❑ I, as owner af the praperry, or my employees wii� wages es their sda compensatlon, WILL DO THE WORK, entl ihe structure Is not Intentled or oHereO for sale (Sec.
7044, Business and Professions CoAe: The Conirectors LJcense Law Ooes not appy to en owner at properry who builds or Improves Ihereon, enA who does such work
himself or hersetl or ihrough his ar her own employees, provitletl ihat such improvements are not intendad or oNeretl for sele. If, however, the builtling or imprwement is
sold within one year oi completion, the ownervbuiltler will heva the burden ol D�oving Ihet he or ahe did not build or improve tor purpose of saleJ. '
❑ I, es owner of the properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTAACTORS to construct Ihe pro�ecl (Sac. 7066, Business end Prolessions
Code: The contractors IJcense Lew doas not apON �o an owner o1 property who 6uiltls ar improves �hareon, entl who wnirects for such project with e contrector(s)
license pursuant to the ConlraMorg License Lews.).
❑ I em exempt under sec. Business and Profeuions Coae for this reason:
Signature: Date:
Owner ID verified by tlrivers license. ❑ Ves ❑ No Drivers License No.
Verification ot Ownership by (type ot tlocumem, i.e. - property tax blll or deed):
Ezpltes:
DIVISION OF INDUSTRIAL SAFETY P�RMR CERTFICATION:
❑ I hereby certily that no excavetion tive (5) or more feet in Cepth into which e person is requiretl to descen4 will be made in connection with work authorizeG by �his
permit, and Iba� no builtling sVucture, sceHWding, falsewolk, or demolition or Gsmantling thereot, will be mwe iban thirty-slx (36) leel bigh. (Chap. 3.2, Gip 2, Aq 2, SeC.
341, TiNe B, Califomla AdministraCrye Code).
❑ As owner-builder, I will not employ enyone to do work which would require a permit iram t�e Division of Industrial Satery, es notetl above, unless such person has e
pertnit ta do such work from Ihe tliVision.
SignaWre: Date:
Division of Industrial Safary Pertnit Num6er.
CERTIFlCATE OF COMPIIANCE AND qUTHOHIZATON OF EHTRY: I certify under Denelry of perjury ihai I have read ihis application end stete tha� t�e intortnation given is
corract. I egree to comply with ell stete lews and city ordinances releting to building construction, and euthonze representatives oi the Ciry ot Costa Mesa to enter upon the
aDove-described propeny lar inspection puryoses. I agree not to occupy ar ellow occupency of eny builtling autharized by this permit until finel inspection.
COpE I. INSPECTIONTYPE �. �Qd¢, ��
1618 Fixetl System Final Fire Prevenllon
7266
200
207
Pool Spe Final
Final Re-Roof
Final BIocWRetaining Well
202 Final Fectory Fire Place
203 FinalSign '
204 Final Demolition
CODE� INSPECTIONTYFE
20fi Final Mechenical
208 Final Plumbing
210 Final ElecMcal
212 Flnal Fire Preventlon
220 Final Planning Approvel
222 Flnel Site
250 Finel BuildinglOccupency
R• �b� fC1�
(714) 754-5273 • Fau (714� 754•4856 • www.ci.costa-masa�c�i.�TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite No 300
Viciniry: MAERSK
Parcel Nunmber: 41050110
Applicant: LAMB, SCOTT
Address: 1975 1f2 N BATAVIA ST
ORANGE,CA -
E
Owner: RREEF'
Address PO BOX 4900
DEPT 207
SCOTTSDALE,AZ- .
Phune: 714-998-G580
_ Zip . 92865
� . �
i
I
Phone:
Zip: 85261-0900 .
Contractor: IRONWOOD ELECTRIC INC
Address: 1975 12 N BATAVIA ST
ORANGE,CA
0
SWtus: ISSUED
Applied: 04/182007
Issued: 04/18/2007
ISSUED B
Phone: 714-998-6580
Zip: 92865
License:61797'I . �
SCOPE OF PERMIT '
�. ECECTRICAL PERMIT FOR A 18,064 S.F. INTERIOR TENANT IMPROVEMENT FOR '. �
. , "MAERSK" IN SUITE 300. � . -
�
ISSUE FEE
' � Temp service test
Res. a/c package
New Res (t-2 units)
New Res (3+units)
Pool / Spa
Lighting FiMs,
Recept Outlets
Swilches
Non Res Appl
Res Appl
Service to 200a
Service to t000a�.
Service over 7000a
Molors l0 1hp ,
Motors to 10hp
Motors to 50hp
Motors to t00hp
Motors over 100hp
Communiwtion drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
REF#: BO6-01243
WORK TO INCLUDE: 41 LIGHT FIXTS, 5 OUTLETS, 6 SWITCHES AND 6.FEEDS.
. � � -' . . .- . � . �
Quantlry
$23.50
$0.00 �. - --.-
$0.00
$0.00 0
$0.00 0
$0.00 0
537.33 41
$5.50 5
$6.60 6
$0.00 0
��50.00 0 -��
-50:00 .; -� -0: �.�:,
� $0.00 �, � 0� � �
�$0.00. , , 0�.
� '$0.00 - �� 0.
� �$0.00'� -_0-�`�
\ � 50.00 � � 0 - �
$0.00 0
� '$0.00 .' ' , 0 �
� 80.00 � �0"- -
so.00 . o . �
$0.00 0
so.00 , o _: _ .
so.00 o .
$0.00 0
FEE SUMMARY �, -
Quantlty
, - Temp Dist Syslem / Lighting $0.00 0
- -- -Busway/700fl - - - - $0.00 0
- � ' Standing SeIXion � �' - ' $0.00 0 ".
Misc EleIXrical Equipment $1820 1 � •
Transformers up to 1 kva/kw � $0.00 0
........:.....up to 10 kvaBw � $0.00 -0 -
.................up to 50 kva/kw $0.00 . � 0 .
• .. .....::...........up to 100 kva/kw $0.00 .�" � 0 , .
,. .
�.' '�.: � ..........:.......over 100 kva/kw 80.00 � 0 �
' Low Voltage EQuipment $0.00 � � 0
'� Low Volt Wiring System / Ckt $0.00 0'
� � , Misa Conduil - � _ _ ,.�. '" $0.00 0 �
� � Misc. Conductor � $0.00 . 0
, Cirws ( gen,or ride) , $0.00 0
Clrws (mech ride or lights) $0.00 ,� 0,�
" ' Christmas Tree Stand ; , �$0.00 � 0
� Fireworks Stand " . $0.00 � - 0 - '
� Other Electrical Fee . �� $0.00 - - , �
� � Investigation Fee �" . $0.00" -
� � Plan Check Fee . . �50.00
� . � �, ReinspedionFee . �$0.00
. TOTAL CALCULATED FEES 591.13
i
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitomia statutes and•related
regulations. (Ord. No. 92-28, § 1, 1241-92) ���
EXPIRATION:'This,permit shall automatically expire and become void if work is not commenced within 1�ys;or'if work is suspendetl or abandoned
for• a period of 180.days::
INSPECTIONS: In ordar for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all
�required Inspeetlona and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2446-dfi�fi/00)
WORKERS' COMPENSATON DECLARATION:
I hereby affrtn under penalry of perjury one of the followinq decleretions:
❑ I heve and will malntaln e certificate o1 cansent to seli-Insure for workers' compensation, es provided tor by sectlon 3700 ot ihe Labor Cade, for the pertortnance of the
wolk tor which ihis permit Is 155ued.
�_,I heve and will maintain workera' compensation insurence, es reQuired by sectlon 3700 ot the Labor Code, for tha pertortnence of ihe work for which this parmit is issued.
��My workers' compensetlon Insurenca carner antl policy number ere: �^--��
Cam'er. ��re-Terree� Z`�'+��/oy<rS �s�S �'� PoIE icyN'umber. WKN/32�/S$/
'(Thls section need not be completed il the Oermit is valued et one hundred dollars ($100) or less.)
❑ I ce�ity Ihat in ihe pertortnance oi the work tor which this pertnit is issued, I shall not employ eny person in any manner so es to become subject to the workers'
compenution laws ot Calitomla, end agree that Ii I should become subject m the workers' compensation pmvisions of Sectian 3700 of the Lebor Cada, I shell torthwith
comply with thesa pr sions.
ApPlicent�Signature: ���'�� �Dat --, y'!&-U7
CWARNINO� FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS IINIAWFUL AND SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNORED
TMOUSAND DOILFRE ($�pp,ppp), IN ADDRION TO THE COST OF COMPENSATION, DAM4GES AS PROVIOED FOR IN SECTION 3)O60F THE LABOR CODE, IPf�EREST, AND ATTORNEY'S FEES.
LICENSED CONTRqCTORS DECLARATION:
I hereby eNirm that I em licensed under provislans of Chapter 9(crommencing with Section 7000) ot Division 3 of the Business and Protessions Cotle, and my license is in full
force end eHecL Uc. q � f .,�s q C I(J
�'" J
Comrectors�Signeture: Gn.R�+� Date:._� C/—(5-07
CONSTRUCTION L�NDING AGENCY:
❑ I hereby aflirm that there is e consiruqion lending agency tor the petlortnance of ihe work tor w�ich this permit is issued. (Sec. 3097, Civil Code).
Lenaer's Name: Lentler's Address:
Signeture:
OWNEH-BUIL�ER qECLARATIONS:
Date:
I hereby eRirm Ihat under penalty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Buslness entl Professions
Cotle: Any ciry or caUnry whic� requires a pertnit to construct, elter, improve, demolish, or repair any structure, prior to its issuance, also requires the epplicent for such permit
to file a signetl statement ihet he or she is Iicensetl pursuant to the provisions of ihe Contrectore IJcense Law (Chepter 9(commencing with Section 7000) of Divislon 3 af the
Business end Professions Code) or that he or she is exempt therefrom antl the besis for the elleged exemption. Any violetion oF Section 7031.5 Dy eny epplicant for e permit
sub�ects the epplican� to a civil penalry ot not more than five hundretl tlollers (5500).):
❑ I, es owner of the property, or my employees with wages es thelr sole compansation, WILL DO THE WORK, end the structure Is not intended or oNe�ed for sale (Sec.
7044, Busines5 and Professions Code: The Contractors License Lew does not apply to an owner of proparty who bullds or improves Ihereon, and who does such work
hlmseN or herealf or ihrough �is or her own employeas, provided that such improvemenis are not Intended or oflered lor sale. If, however, Ihe huilding or Improvement is
sold wit�in one year of completion, ihe owner-0uilder wlll heve the Durden ot proving that he or she did not builtl or improve For purpose of sele.). �
❑ I, es owner of Ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions
Code: The conirec�ors License Law does not epply to an owner of propeny who hullds or improves thereon, and who contrects for such project with a comractor(s)
license pursuam to fhe Contrectors License Laws.).
❑ I am exempt under sec. Business antl Profeuions Code for this reason:
Signeture: Date:
Ownar ID ventietl by dnvers license. ❑ Ves ❑ No Orivers License No.
VedNcetion ot Ownership by (type af tlwument, I.e. - property tax blll or daetl):
Ezpires:
DIVISION OF INDU$TRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cerlify that no e%cavetlon five (5) or more feet in depth Into which a person Is requiretl to descend, wlll be metle In connection with work euthodzed by this
permit, antl ihat no builtling sWcture, scallolding, felsework, or demolition or dismantling ihereof, will be more ihen thirry-six (36) teet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Ttle 8, Calitomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work whic� would require a pertnit irom the Division ot Industrial Sefety, es noted above, �nleu such person has e
pertnit to do such work irom ihe division.
Signature: Date:
Division of Intlustrial Safery Permit Number:
CERTIFlCATE OP COMPLIANCE AND AUTHORIZATION OF ENTRY: I certiy under penalry of perjury that I have read this application and state thet ihe Information given is
correct. I agree to compy with ell state laws entl ciry ordlnences relating to Guilding consWction, and authonze representetivos of the City ot Casta Mesa lo enter upon iha
above-described property tor inspection purposes. I egree not �o occupy or ellow occupancy of eny building authorized by this permit un01 finel inspection.
Signature Of Legal Owner(s)
S�' �-Pr V—(�-o
COUE L INSPECTONrypE oere
1616 Fi:etl Syst�m Final Fire Prevention
7266
200
201
202
203
Pool Spa Final
Final Re-Roof
Finel BIocWRetaining Well
Final Factory Fire Placa
Finel Sign
204 Final Dem0lition
�Ni1TIpL5 �f.,( INSPECTIONTYPE
206 Final Mechanical
208 Flnal Plumbing
210 Final Electrical
212
220
Finel Fire Preventlon
Final Planning Approval
222 Final Site
250 Final Building/Occupency
� ,�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job address: 555 ANTON BL
Suite No 300
Viciniry: SUITE 300 MAERSK
Parcel Number: 41050110
npp�icant: ANDERSON, JOHN
Address: 1000 E HOWELL AVE ,
STE B
ANAHEIM, CA' � � ,
Owner:
Address:
Contrector.
Address:
RREEF
PO BOX 4900 �
DEPT207 � , -.
SCOTTSDALE,AZ- '
HVAC MECHANICAL INC
1000 E HOWELL AVE
MECHANICAL PERMfT
'Phone: 714-937-5305
Zip:'. � 92805
Phone:
Zip: 85261-0900
Status: ISSUED
Applied: OS/02/2007
Issued: 05/02/2007
ISSUED BY:
STE B Phone� 714-937-5305 � ' .. "
ANAHEIM, CA . Zip: � , 92805 . � �
• � - License: 682002 � • - ' � �
SCOPE OF PERMIT
18,064 S.F. INTERIOR TENANT IMPROVEMENT FOR "MAERSK" IN SUITE 300.
REF: BOB-01243 � �� ' � � � � �
2 VAV BOXES
Duantiry
ISSUE FEE $23.50 -
Inst FAU <700 k BTU 50.00 0
Inst FAU >100 k 8TU $0.00 0
Repair/Alt CoolingMeat 50.00. 0�.
Inst) Rep. Recess Wall Htr 50.00 . 0--
Refrig Sys <100 k BTU 50.00 �" �'0
Refrig Sys >100 k BTU $0.00 0
Gas Piping $0.00 0
Factory Fireplace � $0.00 0
Hood w/Mech Exliaust � � � $0.00 0
VAV Box� �� � � ` �'; �; $21.30 2
Vent Fan % Single Dud ' $0.00 0
Appliance ,� . �\� ` $0.00 0
Fire Dampers ' `� � $0.00 0
Smoke Dampers � $0.00=- ' 0, ;
Inst or Relowte Appl Vent :� � ��' $0:00 0-
Air Handlers <,10000cfm'. �/ � , �$0.00 �. A �'
AirHandlers> 10000cfm '�' � $0.00' �0�'-
Floor Furnace , i $0.00 0.:�
Floor or Suspend Heater .� , �$0.00 0
V'�
ti �
_ FEE SUMMARY _
� Repair/AltAbsorbtionUnit
Repair / Alt Refrigeration Unit
Ventillation System
- - �� �; - � Evaporative Cooler �
- � ' - ' - - � Commercial IniinePator
- - Domestic Incinerator �
Comoressors /Absorotion Svstems
Upto3hp/100kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
t�r,,%;�;.�- 30To50hpl1,750kBTU '.
�,:, �,, Over 50 hp / Over 1,750 BTU
, Boilers ,- �- , .
Upto3hp:•.�,_ �
_ � , 3To15hp.::,,r';� '--
� 15to30hp �� ���
� � .30 to 50 hp - . �
" Over 50 hp � " ' � , ,
- Ofher Mechanical Fee , �
, �- Investigation-Fee ' ,
' Plan Check Fee � , -�
� -. ReinspedionFee ��
Quantity
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0 '
$0.00 0
$0.00 0
� $0.00 0
„ $0.00 0
, $0.00 0
,. . � ...$0.00 0 �
,_\' . '.\'�_`..' _,. . ., .;,�.:
. • TOTAL CALCULATED FEES
50.00 0
� $0.00 0
50.00 0
' $0.00 0
' , ' . $0.00 0
$0.00
$0.00
50.00
544.60
NOTICE: The work authorized by this parmit 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 commencad within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In order fof the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTI�NS CALI: (714) 754-5626
2446d6 (fl/W)
WORKERS' COMPENSATION OECLARA710N:
I hereby eHirm under penalry of perjury one of Ihe following decleretlons:
(] I heve entl will maintein a certificete of consent to self-Insure lor workers' crompensation, es proNded for by section 3700 0( ihe Lebor COGa, for the pertormence of the
�work for which t�is permit Is Issuetl.
1i I heve end will maintain workers' campensaUon insurance, as reqWred Dy secUm 3700 of Ne lebor Code, for Ne peAortnence of ihe work tor whiU this pertnit is IssueG.
My workers' mpensatyio Insurance cartier antl polfcy number ere:
Carrter.—� l�L�e 1—�^^ Fo�iryNumoer. ��/L — UJ J,1 r�.2
(7h/s sect/on nesd not be cvmp/eted!! the pemrills ve/uee at are hunC�ed dollers (S1C0) aless.)
❑ I certity t�et in the peAortnence of the work for which this permit Is issueq I shall not employ any person in any menner so as to become subject fo the workers'
compensetlon laws ot Californie, end egrea thet If I ahoultl become sub�ect lo Ihe workars' campensetlon provislons ol Sectlon 3700 0l ihe Lebor Code, I ahall forthwit�
comply wlih ihese provision�
'Applicent5igneture: I—�T� �-- �Dete:=7 ��(�7
WARMN6: FAILURE TO SEWRE 1 ENSAiION CpVERpGE IS UMAWFUL AND SMIILL SUBIECT AN EMPLOYER Tb CflIMIW1L PENALTES.WD CML FlNES UP TO ONE HUNDRED
TNOUSAND OOLLARE (5100,000J, IN ADDITIIXJ TO THE COST OF COAIPENSATION, DAMAGES PS PROVIDED FOR IN SECTION 31080F THE LABO(i CODE, IN7EFEST, PND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
� hereby eHirm Ihat.l am licensed under provisions o1 Chapter 9(commencing wlth Section 7000) o� Dlvision 3 oi the Business antl Professions Cotle, end my Ilcense Is in full
�orce end eHect. CIc�M �a�i�-J UY C�ese x C� i-J
ConirectolsSig_nat,ure� �ete: � rl .�-�
CONSTRUCTION LENDING AGENCY: _
[] I hereCy eMirtn that Ihere Is e construction lending egency tor ihe peAortnance of the work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lenders Neme: Lenders Address:
Sign9fure:
Dete:
OWNER+BUILDER DECLARA710NS:
1 hereby effirtn thet under penelry of per�ury Ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor t�e tollowing reason (Sec. 7031.5, Business entl Protessions
Code: Any ciry or county which requires e permit to consWcL elter, improve, tlemolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit
to file a sipnetl statement thet he or she is Ilcensed pursuent to the proNsions ol ihe Contractors IJcense Law (Chepter 9(commencinp with Section 7000) at Dlvision 3 of iha
9usiness end Protessions Code) or ihet he or she Is exempt t�erefrom enA the basis tor the allegad exemption. Any violetlon of Sedlon 7031.5 by eny epplicant for e pertnit
sub�ecls the epplicant to a civil penelry of not more lhan live hundretl tlollars ($500).):
❑ I, es owner of the property, or my employees wlth wages es ihelr sole compensation, WILL DO 7ME WORK, antl the struclure is rat intended or oflered tor sale (Sec.
7044, Business anC Protesslons Cade: The Contractors LJcerua Law does not apply to an owne� o! propeRy who buiMs or improves thereon, artd who does such work
himself or herself or �hrough his or her own employees, providetl that such ImOrovemenis are not intendeC or oHered for sale. H, however, t�e building or Imprwement is
sold wit�in one year of completion, the owner-builtler will have ihe burden ot pmving ihet he or she did not build or Improva tor puryose of sale.). '
❑ I, as owner ol the properry, am EXCWSIVELY CONTpAC71NG WITH LICENSED CON7RACTORS to construct the project (Sac. 7p44, Business and Professions
Code: The conirectors License Lew does not epply to en owner of propeny who bullds or ImD�oves Ihereon, enA who coNracts tor such project with e contrector(s)
license pursuant to the Conirectors License Lews.).
❑ I am exempt undar sec. Business antl Professions Cotle tor this reeson:
Siqneture: Date:
Owner ID venfled by drivers license. ❑ Yes ❑ No Driver's Ucense No. Expires:
Vediication oi Ownerehip by (type of Aocument, I.a. - property tex bill or deetl):
DIYISION OF INDUSTRIAL SAFFTY VERMI7 CERTIFICATION:
❑ I hereby certify that no excavatlon five (5) or more feet in depih inm whlch a person is required ro tlescend, wlll be mede in connectlon with work authodzed by this
pertni�, end that no building swdure, scaHolding, lalsework, or demolitlon or dismantling theraoi, will ba more then thirty-six (36) teet high. (C�ap. 3.2, Gry 2, Art 2, Sec.
341, lltle 8, Califomia AdminislreUve Code).
❑ As owner�builder, I will nol employ anyone to do work which would require e permil from ihe Division of Intlustnal Safery, as noted e6ove, unless such parson hes a
pertnit to do such work from t�e division.
SignaNre: Date:
Division of Industrial Safery Pertnit Number:
CERTIFlCATE OF COMPLJANCE IWD AUfHORVJ1T10N OF EHTAY: I certiy unaer penalry of per�ury Ihat I have reed this appliwpon enA stale thet the infortnation given is
conect I agree to compty with ell stete laws antl cily ordinances releting to 6uilding constructlon, entl euthodze representatives of Ihe Ciy of Casta Mesa to enlar upon Ne
above-descnbed property tor inspection purposes. I egree not to occupy or allow occupancy ol eny building authorizetl by this permit until Tinel inspection.
COUE �. INSPELTIONTYVE
1616 FixeO 5}5tem Final Fire Prevention
1266 Pool SDe Final
200 Finel Re-Roof
201 Finel BIacWRetaining Well
202 Finel Fectory Fire Place
203 FInalSign
'204 Finel �emolition
Qdj[ �$ �j INSPECiIONTYPE
206 Final Mechanicfll
208 Finel Plumbing
210 Final Electncal
212 Flnel Flre Prevention
220 Final Planning Apprmal
222 Fi�alSite
250 FinalBullding/Occupancy
- 5 -c5 $.�
��.,
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us
BUILDING PERMIT '
Job Address: 555 ANTON BL
Suite: 3
Vicinity: 3RD FLOOR
Parcel Number: 41050110
App�icant: SMITH,DON
Address:
owner. SAKIOKA FARMS
Address
Zoning:
Phone: 714-038-2272
Zip:
Phone:
Zip: 94137
Contractor: HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE
Phone: (714)438-2272
COSTA MESA, CA
Zip: 92626 License: 445804
Arch : LPA INC Eng:
Address: 17848 SKY PARK CIR Address:
Phone: (949)261-1001
77 FAIR DRIVE, COSTA MESA, CA 92626
� Status: ISSUED
Applied: OS/17/2001
Issued: O6/29I2001
ISSUEDBY: �/0�`""
Phone:
IRVINE, CA �
Zip: 92614 License: License:
` ' r SCOPE OF PERMIT
13,520 SQ FT INTERIOR OFFICE'T.I. FOR "MAERSK SEALAND" (3RD FCOOR). - .
Plan Check: $1,312.06 _ - '
Permit: $2,018.55 •
SMIP Res: $0.00
SMIP Com: $59.34
FEESUMMARY
- _ _ _ Calc Valuation:
- - Claim Valuation:
Othec $0.00 '
Inspection: $0.00
, :;� '�.
Total: $3,389.95 � �
� ,`� , �j � _ � ` � � � PLANNING8�ZONWG � �,�. �
SETBACKS � V ` � /� , �� � , , .; " , � ,
MAIN STRUCTURE� Front 0..0 ,� - Rear � 0- 0 Left � 0-0 �'� RigHt � 0. 0' . ,
�
ACCESSORY Front 0- 0�� Rear 0- 0 Le(l 0- 0 � Right� �� 0- 0 �
PARKING Existinq: ' 0,� � Required: 0 Pro osed: .0 � -.. �,
NOTES:
�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia
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 it work is sus{
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all appl
required inepeetione and final approval must ba obtained. Failure to obtain inspections and final approval will result in the expiral
FOR INSPECTIONS CALL: (714) 7545626 J
2d4&46 (fl�00) �///
il
5282,568.00
s27o,aoo 00
and related
orabandoned
�le codes, and all
of Ihis permit.
WORKERS'COMPENSATONDECLARAnON: � ,
I hereby aHlrm under penelry of perjury one of Ihe following decleretions:
❑ 1 heve entl wlll melntain e certiticate of consent to self-Insure for warkers' compensetlon, es provided lor by sectlon 3700 ot t�e Lebor Cade, far the peAormence of Ihe
wark tor which t�is pertnit is issued.
���I��ave e will maintain workers' ompensatlon Insurance, as requlretl by sectlon 3700 ot the Lebor Cotle, tor Ne perfortnance ol the work tor whiCh Ws permit Is Issued.
My w rs' com nsetlon Ins anca carr"6r an ollcy number ere:
Carder. � 9 "� £ PolicyNumber:- O�D�/%O�
(This sectlon nee0 not be cc eted i! the pe t is velued'af one hund ddl ($100) oi less.)
❑ I certlTy t�at in tha peAortnanca of t work for c is ertn s I ed, I shall not employ eny person in eny menner so es to become sub�act to the woAcers'
compensetlon lews of Celifomia, d agre t I h d sub�ect to the workers' wmpensation provislons of Sectlon 3700 of t�e Labor Code, I ahall torthwith
comply with ihese /
Appliceri(Signet--ure� �---'Date:� (O yy—'U�
WARNINQ: FAILUFE TO SECUFE RKERS' COMP �CO RAGE IS UNLAWFUL PND SHALL SOBIECT AN EMPLOVER TO CFIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
TqUSANDDdlARE�Et00.OW NADORIONTOTHECOSTO PENSATION,DAMAGESASFROVIDEDFOflINSEC(ION3)OBOFTMELABOqCODE,IFREREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARAT9I 1�
I hereby ettirm that,l em Ilcensetl der e6visi s f Ch i 6 9(co mencinq with Sectlon 7000) of Division 3 of ihe Business�d Pmtessions Cotle, and my license is in tull
force end,ettecL.Lic..A 0 qass'x� ,6
� ti ���
Contracrofs Signemre: Dale:� � �L /l —iJI
/ l % �
CONSTFUCTION LENDING AGENCY:
❑ I �ereDy affirm ihat t�ere is a construction lending agency tor Ihe peAormance of the work for which this pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lenders Neme: Lentler's AdOress:
Signature: Date:
OWNER-BUILDER DECLARATIONS: �
I hereCy elfirm t�at under penelry ot perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW For ihe tollowing reason (Sec. 7031.5, Business end Protessions
Code: Any city or county which requires a Dermit to construct, elter, Improve, tlemolish, or repair any slructure, pnor to its issuanco, elso requires the applicant for such pertnit
to flle e slgnetl stetement thet ha or sha Is Ilcensetl pursuent to the provlsions oi the Coniraqors LJcense Lew (Chepter 8(commencing with Section 7000) of Dlvislan 3 of ihe
Business end Professions Code) or thet he or she is exempt therefrom and the besis for the allegetl exemption. Any violetion of Sectlon 7031.5 by eny applicant for e permit
subjecis iha ep011cant to e civll penalry of not more than Nve �undretl tlollers ($500)J:
❑ I, es owner of ihe properry, or my employees wl�h wages es ��elr sole compensetlon, WILL DO THE WORK, end the struaure Is not intentletl or otteratl iar sale (Sec.
704d, Business antl Professions Cotle: Tlie Contractors License Lew tloes not epply to an owner of property who builas or improves thereon, antl who does such work
himself or �ereetl or throug� his or har own employees, provided thet such improvements are not Intended or oifered for sele. II, however, Ihe builaing or improvemen� is
sold within one year ol completion, the owner-builder will heve Iha burden ot proving that he or she did not build or improva tor purpose of sele.).
❑ I, es owner oi the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the projaCt (Sac. 7044, Bu5in85s and Professlon5
Gode: The contrectors License Law tloes not eppty to en owner ol property who �ulltls or impmves ihereon, end who wntrects for such projact with a contrecior(s)
license pursuant lo the Contraccors License Lews.).
❑ I em exempt under sec. Business end Professions Code for ihis reason:
Signature: Date:
Ownar ID venlied by drivers license. ❑ Vas ❑ No Dnvefs License No. Expires:
Veritication of Ownership by (type of daument, i.e. - property tex 6111 ar tleetl):
DIVISION OF INDUSTRIAL SAFE7Y PEHMIT CERTIFICATION:
❑ I here6y cenity Ihet no axcavation five (5) or mo�e feet in depth into which e person is required to descenq wlll be made in connection with work authorized by this
permll, end ihet no builtling structure, scettoltling, lelsework, or tlemolition or tlismantlinq �hereof, will be more than Ihirry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Titla 8, Califamle Administretive Code).
❑ As owner-builder, I will not employ anyone to do work which would require e permi� fwm ihe Division ol Industnel Sefery, as noted above, unless such person hes e
permil Io do such work irom the division.
Signature: Dale:
Division oi Intlusinel Satery Pertnit Number:
7 Will the epplicant or presem or future bullding occupant nee0 to flle entl certity e Busineu Plan for emergency response m release or threatened release ot e �azardous
matedel9 ❑ Yes ❑ No
(Section 25505 0l ihe Califomia Heal�h antl Safery Cotle requires, with some exceptions. Ihat e Business Plen be tiled with Ihe Cosla Mesa Fire Depanment by every
business which has et eny one time during a reported yeer a quantiry oi hazertlous materials equal to or greater than a weight ot 500 pounds, or a volume o155 gallons,
or 200 cubic feet of compressecl gas at standard temperature and pressure).
........................................................................................................................................................................................................................................................................................................................................................................................
2 Does or will the epplicant or present or fmure builtling occupem need to lile e regislration fortn tor acurely hazarAous matenals7 ❑ Ves ❑ No
(Sectlon 25533 of Ihe Califomia Healih and Safery Cotle, wit� some exceptlons, requires regisiratlon with the Cwte Mesa Fire Depanment by each business which at any
one time hes on hentl a quantiry of ecutely hezardous meterials equal to or greatar than e weight ot 500 pauntls, or e voluma oi 55 gellons, or 200 cublc feet of
compressed gas et stentlard temperature antl pressure).
............................................................................ ............................................................................................................................................................................................................................................................................................................
3 Does or will the epplicant or present or tuWre builtling occupant nead to prepare an RMPP (Risk Management antl Prevention Program for awtely hazartlous materials)7
❑ ves ❑ No
(Sactlon 25534 oi the California Health and Safety Cotle O�ovides ihat ihe Coste Mesa Fire Depanment may require ihe preparetion, certifiwtion and filing with Ihe Fire
Depanmenl of en RMPP by businesses which ere required to register acutely hezertlous matenals with t�e Flre Depertmenl.
............................................................................................................................................................................................................................................................................................................_...........................................................................
4 If en RMPP is oresentlV reauiratl, has SeCtiOn 25534 of ihe Celitornie Heelth end SafeN Code been fully comolied with7 ❑ Yes ❑ No
�es or wlll Ine eOP��cam or present or rmure nunaing occupam reqmre tor tne wore wnicn is tne suo�ect or tn�s a�F
�m Iha South Coes� Alr Oualily Manegement Distticl or /rom ony other eir pollution conirol tlistrict or egency? ��
ection 658502 of ihe California Government Code reduires thet the repuested information ba furnished on applica
....................................................................................................................................................................................................................................................
ill any part of the facility to be constructed under this permit be wlihin 1000 teat Irom the outer bounderies of e schi
yes', Ihe faciliry must meet t�e requirement of Sections 25534 end 42303 oi the Califomia Health and Salety Cotl
_.._ ........................................................_..........................'_'..................................._....................._._......................_..........................._.........................
e permii irom the South Coast Air Oueliry Menegement DisMct or o�her elr pollu�ion con�rol tlisMct or agency
�Olicatlon. have ell of the discbsures prescnbetl by Calitornla Health antl Saleiy Cotle Seclion 42303 been matlel
❑ No
for non-residentiel
�C
or
B (It yes , anach certifiwte of wmpliance irom the appropriata air pollution conirol oHicer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry ol perjury Ihe intormation given above is correct. I egree to comply with all state laws and city ordinances
regartling Hazardous Materials antl Emissions.
Signature: Date:
CERTIFlCATE OF COMPLIANCE AN ORIZA710N OF I certify under penalry of perjury that I have read this applica�ion antl s�ate ihat t�e intormation given is
correcL I agree Io comply with ate IaJ+s anC city o' ances relating to building construction, end authorize representatives ot the Ciry of Costa Mesa to enter upon t�e
above-descnhed pmperty for' pection purpgs6}. I e e not to pEcupy or ellow occupancy ot any building authodzed by Ihis permit until (inel inspection.
COOE �. INSVECTION TYPE
1676 Fiaed System Final Fire Prevemion
7266 Pool Spa Final
200 Finel Re-Roof
201 Final Block/Reteining Wall
202 Finel Fettory Fire Place
cooe�
206
200
210
2tt
220
� �y �`�d�
� Date �
INSiECTIONTYPE
Finel Machanical
Finel Plumbinp
Final Electrical
FInalFlre Prevenilon
Final Planning Approval
203 Finel Sign 222 Final Site
204 Final Demolition 250 Final Builtling/Occupency
OATE INTRI�LS
(714) 754-5273 • Fex (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite NO
Vicinity:
555 ANTON BL
3
3RD FLOOR:.
Parcel Nunmbec 41050'110
Applicant SMITH,DON
Address:
Owner: SAKIOKA FARMS
Address
PLUMBING PERMIT
Phone: 714-438-2272
Zip:
Phone:
Zip: 94137
Contractor: HOWARD BUILDING CORPORATION
Address�. 3184 AIRWAY AVE
Arch / Eng :
Address:
COSTA MESA, CA
Phone: (714)438-2272
Zip: 92626
License: 445804
Phone:
Zipt
License:
a
Status: ISSUED
Applied: 06I28/2001
Issued: O6/29/2007
ISSUED BY: �
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "MAERSK SEALAND" (3RD FLOOR). INSTALL
1 DISHWASHER, 7 KITCHEN SINK, 8 1 WATER HEATER. � ' �
-- i
REF:801-00717
FEE SUMMARY
� � � <, AMT '� QTY � . � � - AMT
ISSUE FEE _��� $23 50� �;��. >�Laundry Tub / Washer $0.00
Backflow irrigation ' , � �$0.00 0 �� '�Landscape�lrrigation � $0.00
BackflowPreventer -$0.00' � 0 - � P-Trap $0.00
Bathtub S0.00 0 Pressure Regulator $0.00
Clarifier System 50.00 _ 0� �- Process Piping (per 10 ft) $0.00
Connect (Ice,Soda,etc) 50.00 0 Receptors $0.00
DenialUnits 50.00 �0 SepticTank . $0.00
Dishwasher $9.80 1 Sewer Cap for Demo $0.00
Drain, Floor 50.00 0 Sewer Connect $0.00
Drain, Rainwater $0.00 0 Sewer Private Line $0.00
Drain, Roof 50.00 0 Shower $0.00
Drinking Fountain 50.00 0 Sink, bar $0.00
Expansion Tank 50.00 0 Sink, commercial $0.00
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00
Gas (1-4 outlets) $0.00 0 Sink, kitchen $9.80
Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00
Gas Repipe 50.00 0 Spa (private) $0.00
Gas Service 50.00 0 Spa (public) $0.00
Interceptors (Grease, Oil) S0.00 0
Interceptors (Sand Auto ) 50.00 0
�
QTY- . _,� -. . i ' � �,
0 � ! � Sump Pump' �
,0 �'�" . �"Swlmming Poal' � ,� �
0 ' Trap Primer � ,
0 Urinal
0 � � � Vacuum Brkr Bkflow(1-4)
0 � Vacuuin Brkr Bkflow(5+)
0 , � Wash Basin
0 , Wash Basin Set
0� Wasle and Vent System
0 Water Closet (Toilet)
0 Water Healer I vent
0 Water Piping (Inst or Rep.)
0 Water Re-pipe
0 Waler Service
1 Water SoRener
0 OTHER
0 VIOIATION
0 PLAN CHECK
REINSPECTION
TOTAL CALCULATED
NOTICE: The work authorized by this permit s��Q��� di6�6�A1. iG�NIfJ1TiiQNS nquirements under
regulations. (Ord. No. 9248. § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it w
for a period of 180 days.
INSPECTIONS: In o�der for the work authorized under this permit to be considered legal, such work must comply v+
required inapectiona end final approval must be obtained. Failure to obtain inspections and final approval will result�in
FOR INSPECTIONS CALL: (714) 7645626 /
2d46d6�N00)
AMT
50.00
$0.00
$0.00
$0.00
50.00
$0.00
50.00
$0.00
$0.00
50.00
552.30
$0.00
$0.00
$0.00
$0.00
50.00
50.00
50.00
QTY
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
statutes and related
suspended orabandoned
ith all applicable codes, and all
the expiration of this permit.
WORKERS'COMPENSAPON DECLARAnON: �
I hereby aXirtn under penalry ot perjury ane oi the fallowing declaratians:
❑ I have antl will malntain a cenificate oi consent to self�lnsure for workers' compensetlon, es provlded for by sectlon 3700 of the Lebor Cotle, tor the peAarmanca of the
//work for w�ich lhis pertnil is issuetl.
�.�p I have antl will maintain woitcere' mpensa0on Insurance, as requiretl by sectlon 3700 of the Lebor Code, for the pertormance of �he work Por which this pertnit Is Issuetl.
My workers' co�p ensation Ins nce w�rde�t entl pol numDer ere:
carrier. � ft1r�9'FTdr.v� ti .zn Lv%l1i �� Pollty NumDer. l%DOU//7l] 7
(This section need nat be com / e i! th rmit' vg�uetl�t0lfb huntlred dallers ($ f00) or less.)
❑ I certity that in the pertoi
compensation laws of C
comply wilh these pf�vj;
;�_�a���
WARNING: FAILURE TO S RE
TVIOUSAND DOLURE (51 000).
LICENSED COMRACTORS
I hereby attirtn that I em licen:
force end�eXecti.Ck:� �
tha ASAbryfilch Ihi rtnit is issued, I shell not employ eny person in eny manner so as to bacama subject to the workers'
egyde t�5111 I sh Id become subject to the workers' compensatlan provisions oi Sectlon 3700 oi tha Lebor Coae, I shell tonhwith
IN ADIXiION
untler
�— ��-- oe�e� G—��—oi
IJ WVEMGE IS UNLAW FUL M!D SFULL SU91ECf PN EMPLOVER TO CRIMINAL PENALTIES M1D CML FlNES UP TO ONE NUNDRED
OF GYMAPENSATION, DMUGES AS PROVIDED FOR IN SECfIpJ �OB OF THE UBOR CODE, IMEHEST, AND ATTORNEY'S FEES.
Section 7000) ot Division 3 of the.Bueiness antl Protessions Code, and my Ilcense is in full
Fi —'l_5' rJ/
CONS7RUCTION LENDING AGENCY: �/
❑ I hereby ettirm that there is a construction lending egency lor ihe OeAormence of the work for which this permil is issuetl. (Sec. 3097, Civil Cotle).
Lentlers Name: Lendefs Address:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby effirtn that untler penalry ot perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or counry which requires a pertnit to construct, eltar, improve, tlemolish, or repair any structure, pdor to itg Issuence, also requires the applicant for such permit
to lile e signetl stetement ihat he or she Is licensed pursuent to Ihe pravisions of Ihe Contrectors License Lew (Chapter 9(commenclnp with Sectlon 7000) of DlNsion 3 af the
Business and Pr0lessions Cotle) or that he or she is eaempt therelrom end tha EaSis for ihe ellegetl e:emplion. Any violetion o1 Sectlon 7031.5 Dy flny epplicant for a pertnit
subjacls the epD�icant to e civil penalry of not more than five hundred dollars ($500) J:
❑ I, as owner ot the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe siructure Is not Intentle0 or offered tor sale (Sac.
7044, Business and Professions Code: The Contracrors License Lew does not eppty to en owner ot pmperty who builds or improves ihereon, end wha daes such work
himself or herself or Ihrough his or her own employees, provided ihei such Improvemenis ere not intended or oflared lor sale. If, however, the building or improvament is
sold within one year ot comple�ion, ihe ownar-buildar will have Ihe burtlen of D�ovinq �het he or she did not build or imprave for purpose oi sale.).
❑ I, as owner ot the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Prolessions
Code: TTe contraciors License Law does not epply to en owner oi property who builtls or improves thereon, entl who contrects lar such prolect with a contrector(s)
license pursuant to the Comractors License Laws.).
❑ I am exempt untler sec. Business antl Professions Code lor this reason:
SignaWre: Date:
Owner ID verifiad by drivefs licensa. ❑ Yes ❑ Na Driver's License No.
Verificetion ot Ownerehip by (type of document, i.e. - propeny tea bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Espires:
❑ I hereby certily thal no excevetion tive (5) or more faei in tlepih into which a parson is requlred to descend, will be made in connectim with work authorized by this
pertnit, end Ihat no building structure, scaHolding, falsework, or demolition or tlismantlinp ihereoi, will be more than Ihirty-six (36) leel high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Calitomia Administretive Code).
❑ As awner-bullder, I will not employ anyone to do work which woultl require e permit from the Division ot Industriel Sefety, es notetl ebove, unless such person has e
pertnit to do such work from the division.
Sipnature: Date:
Division oi Industnel Safery Permit Number.
CERTIFlCATE OF COMPLI AN AU7HORVA710 E Y: I cenify untler penalry of perjury Ihat I heve rea0 this application and stata that tha information given is
correct. I agree to comply h all s e I and ci rdinanc relating to building construction, end authorize representetives of Ihe City of Casta Mese to enter upon t�e
above-described prope or ins tio�ases agree n o occupy or ellow occupanry of any building euthonzetl �y t�is pertnit until finel inspectian.
FI'7d31ICFil(a�Pf7l9tl
1616 FizeO System Final Fire Prevention
1268 Pool Spe Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Feclory Fire Placa
203 Final Sign
204 Final Demoliiion
D�TE �^
Date
G�i •-ZP d/
COOEI INSPECTONTYYE
206 Final Mechenical
208 Final Plumbing
210 Final Eleciricel
212 Finel Fire Preventlon
220 Final Planning Approvel
222 FinelSite
250 Final Building/Occupency
1�7.11�Ciii1L749
$-I -c� f �
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFiIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 3
Viciniry: 3RD FLOOR
Parcel Number: 41050110
npplicant SMITH,DON
Address:
owner: SAKIOKA FARMS
Address:
MECHANICAL PERMIT
Phone: 774-438-2272
Zip
Phone:
Zip: 94137
Contractor: HOWARD BUILDING CORPORATION
Address: 3784 AIRWAY AVE
COSTA MESA, CA
Phone: (714)438-2272
Zip: 92626
License: 445804
Status: ISSUED
Applied: O6/28/2001
Issued: O6/29/2001
ISSUED BV: � C�
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "MAERSK SEALAND" (3RD FLOOR).
INSTALL 1 FAU, 1 REGRIGERATION SYSTEM, 1 VAV BOX, & 2 SMOKE DAMPERS.
REF: 801-00717 �
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k-BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhausl
VAV Box . � , %
Vent Fan / Single Duct , �
Appliance ' ' ,'
Fire Dampers ,
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers � 10000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
Duantity
523.50
$14.80 1
$0.00 0
30.00 0
$0.00 0
514.80 7
$0.00 0
50.00 0
$0.00 0 '
50.00 0
510.65��7 _ � .
$0.00 0 ,
� � " $OAO- 0 `
50.00 0
514.50 2
so.ao 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
FEESUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeiation Unil
Ventillation System
. Evaporative Cooler .
� - � Commercial Incinerator ,
' Domestic Incineralor
Compressors / Absorption Systems �
Up l0 3 hp /�100 k BTU,,.,_ , ,", �
3 To 15 hp / 500 k'BTU� `. ,
15 To 30 hp / 1,000 k BTU ."
- - 30 To 50 hp / 1,750 k BTU: -�;�j � ��
, ,Over 50 hp / Over 1,750 BTU "- G'
��Boilers .. �
Upto3hp � ' ' " ,
3To15hp ' - , , '
15 to 30 hp � '
30 to 50 hp � . � � . "
, Over 50 hp ' .
Other Mechanical Fee �
Investigation Fee �
- Plan Check Fee
Reinspection Fee
TOTALCALCULATED FEES
COMMENTS / SPEC�AL CONDITIONS
Quantity
$0.00 0
50.00 0
50.00 0
50.00 0 ,
so.00 0
50.00 0
30.00 0
50.00 0
50.00 0
50.00 0
i 50.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
50.00
$0.00
50.00
$78.25
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requiremenis under California
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is susj
tor a period of 180 days.
INSPECTIONS: In order tor ihe work authorized under this permit to be considered legal, such work must comply with all app
requlred inepectlona and flnel epproval must be obtained. Failure to obtain inspections and final approval will result In t�ezpira��.
FOR INSPECTIONS CALL: (714) 7545628
zaaasa �eroo�
and related
orabandoned
�le codes, and all
of this permil.
WORKERS' COMPENSATION OECLARATION: '
I herehy aHirtn under penfllry of perjury ona of the tWlowing dedaretions:
❑ I heve entl will meintain e cenilicate of consent to self-Insure for workers' compensetlon, es Orovided for by section 3700 0l the Lebor Cotle, lor Ihe pertortnance of Ihe
�WOB fOr hith t�is permlt is Issuad.
a
❑�I �ave e wlll mamt ' workers' pensation u2nce, as requireA Dy sectlon 3700 ot t�e La6or Go�e, tor tha perfortnance W the work tar whiU Nis partnit is IssueA.
Mywo rs'com sallonln5�u qGm er d numberere: �{�� �7
Certier. /�AiO�'14 / R�N �� i Policy Numher. iL�/� ��3 /7D !
(lnis sectlar need nor be ed il rhe ' Is velued etpjB huiM dql/ers (S �00) or �ess.)
❑ I Certify ��et In lhe perlortnance �[
campensatlon lews ot Califo �, end
compry with Ih rovisio .
Applicem Signeture: — - -
WORKE0.5'
LICENSEDCONTRACTOHS
I heroby eNlrm th,at I em licen:
forCe BnC BttBcirGc ! �
work for whi " pertnit is e4 I shall not employ eny person In any manner so as lo becana suE�ect to the workers'
9oreB4tiat 5 Id De ub�ecl lo l�e woMers' compense�lon proWsions ot Secllon 3700 of Ihe Lebor Cotle, I s�ell forthwith
/ _.oe�a:_ l0 L/�—fJ�
T OE IS UNLAWFlJL AND SHAl1 SUBIECf,AN.EMPLOIER TO CPoMINAL PENnlT1E5 AND CML FlNES UP TO ONE HUNDfiED
1 THE CO$ ENSATION, DAM40E5 il5 PROVIDED FOR IN SEGfIIXJ 3]O60F THE IABOR CODE, INTEPEST, AND ATTORNEY'$ FEES.
wit� Section 7000) ol Divlslon 3 ot the.8usiness er� Protessions Cotle, end my Ilcense Is in full
CONSTRUCTION LENOING AGENCY: �/
❑ I hereDy aHirm t�at thera Is e canswction lending egency for the pertormance ol tha wark br which this pertnit is issued (Sec. 3097, Civil Code).
Landera Neme: Lentlefs Adtlress:
Slgnature:
OWNER-BUILDER DECLARATIONS:
Dale:
I hereby aHlrm t�al under penelry of per�ury thel l em E%EMP7 FROM 7ME GON7RACTOR3 LICENSE LAW for the tollowing reawn (Sec. 7031.5, Business and Professbns
Code: My ciry or counry whiCh requlr85 e permit to consiruct, elter, improve, demoli5h, or repair eny sWcture, prior to ics issuance, elso requires t�e ep0���nt lar such pertnit
to file e signetl statement t�at ha or she is Ilcensed pursuant to t�e provlsions ot t�e Contrectore ticense Law (Chapter 9(commencinp with Sectlon 7000J of Divislon 3 oi Ihe
Business end Profe55ions Code) or �hat he or she is exempt therefrom end the basls for the elleped e:emptlon. Any violation of Sectlon 7031.5 by eny epplicant tor e pertnit
subjects tha epD���en� �o e cNil penalry of nat more ihan frve hundretl tlWlam (55W).):
❑ 1, as owner ot t�e D�operty, or my emplqrees with wages as iheir sde comperuation, WILL DO THE WOFiK, end t�e strucWre is not intentletl or ofleretl lor sele (Sec.
7044, Business flnC Protesslons Coda: The Coniractors License Law does not appty lo en owner of property who builds or improves thereon, antl w�o tloes such work
himself or �erself or through his or her own employees, provitletl that such improvements ere not Intended or ottered for sale. If, however, ihe bullGing or improvement is
sold within ona year at completioq the owner-builtler will have tha burden ol proving that he or she did not build or improve tor purpose oi sale.j.
❑ I, es owner of the properry, am EXCLUSIVELV CONTAACTING WRH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pmfeulons
Catle: The contractors License Law tloes not appty to an owner of pmperty who huiltls or impmves t�ereon, and who contrects for such pro�ect with a contractor(s)
license pursuant to the Contrectors License Laws.�.
❑ I am eaempt untler sec. Busineu end Professions Cotle lor this reason:
Signeture: Date:
Owner ID vedfletl Dy tlrivers licen5e. ❑ Yes ❑ No - Drivers Licen9e No.
Vedficatlon of Ownership by (rype ot Aocument, i.e. - properry tax biil or deed):
Ezpires:
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICA710N:
❑ I hereby certify t�et no excevetlon five (5) or more feel in tlepth Inio which e person is requlred to descend, will be mede in connection with work euthorizeC by this
permit, antl that no building strucNre, scattolding, falsework, or demolition or tllsmanlling Ihereoi, will De more �han ihirry-six (36) feet high. (Chap. 32, Gry 2, Atl 2. Sec.
341, Tltle 8, Celllomia AtlminislratNe Cade).
❑ As owner-builder, I wlll not employ enyone to tlo work w�lch would require e pertnil lrom the Divislon ol Industnel Sefety, es noted ebove, unless suc� person has e
permlt to tlo suc� work trom the dlvislon.
Signature: Date:
Divislon of Industdal Salery Pertnit Number.
CERTIFlCATE OF COMPLIANLE AND A RVATION OF ENTRV: I rtity under penalry ol Derjury that I have read this flpplication antl state that Ihe inlormation given is
cortecL I egrae to comply with ell s laws end dry ortlinance ting to builCing constructlon, and euthodze reD�esentatives of the Ciry ot Costa Mesa to enter upon t�e
above-described D�aPertY �or In �ion purpose�gree n occupy or ellow occupency ol eny builtlinq authorized by this permit un�il linal ins0ection.
COOE 1. INSVECTON TYPE
1616 Fixed System Final Fire Prevemlon
1288 Paol Spe Flnel
200 Finel Re-Rool
201 Finel Btock/Reteining Well
202 Final Fectory Fire Place
203 Finel Sign
204 Finel Demolitlon
Q�IE II�EL9
Dat
�d����—e7�
'-'� Date
tooe� ixsveerioxnve
206 Flnal Mechenicel
20B Final Plumbing
210 Final Elactdcel
212 Final Fire Prevention
220 Finel Planning Approval
222 Flnal Site
250 Final Bullding/Occupency
P� II�IALS
...
(7�4) 754-5273 • F� (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
555 ANTON BL
3
3RD FLOOR
41050110
FULFORD,TERRY
SAKIOKA FARMS
Contracror O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts '�
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1hp
Motors to 10hp
Mo[ors to SOhp
Molors to 100hp
Motors over t00hp
Communication drops
Sub panel t0 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ISSUED BV:
Phone: 818-540-5884
Zip:
Phone:
Zip: 94137
Phone: (B18)407-1986
Zip: 91324
License: 386619
Status: ISSUED
Applied: O6/28I2001
Issued: O6I29I2001
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "MAERSK SEALAND" (3RD FLOOR). INSTALL
103 LIGHT FIXTURES, 74 RECEPTACLE OUTLETS, 31 SWITCHES, & 42 LOW VOLTAGE WIRING
SYSTEMS.
REF: BO7-00717
823.50
50.00
$0.00
50.00
50.00
50.00
560.69 .
�= 567.99
53222 -
50.00
50.00
50.00 `
50.00
50.00 .
50.00 �
512.30
50.00
50.00
so.00
$37.52
50.00
50.00
50.00
50.00
50.00
Quantity
0
0
0
�� �73
B3 .
34 => �
0�
0
0
0
0
0
�
0
0
0
44
0
0
0
0
0
FEE SUMMARY
Quantiry
_ Temp Dist System / Lighting $0.00 0� �
Busway /100 ft $0.00 0�
Standing Section. $0.00 , 0
Misc Electrical Equipment $0.00 0 `
Transformers up to 1 kva/kw $0.00 0
................up to 10 kva/kw $0.00 0
.................up to 50 kva/kw- ; :-�-$0.00 - 0 -
.................up to 100 kva/kw- '$0.00 � 0 ,�' .
� ......:...........over 100.kva/kw� . �$0.00 ' ` p ' '
Low Voltage Equipment -� � �$0.00 -' ,0 �� "
Low Volt Wldng System / Ckt '.$0.00 , 0
Misa Conduit ', 591.00 5
Misa Conductor $0.00 � 0
Circus ( gen or ride) ' ,; $0.00 0
� ` Circus (mech nde or lightsj ".�.-�50.00 0
Christmas Tree Sland � 50.00 0
-FireworksSland 50.00 0
Other Electrical Fee 50.00
Investigation Fee 50.00
Plan Check Fee 50.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES 5325.22
COMMENTS I SPECIAL CONDITIONS
NOTICE: The work autharized by this permit shall comply with all applicable handicap access requirements untler Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become vold it work is no� commanced within 180 days, or if work is suspe� ed or abandonetl
for a period of 180 days.
INSPECTIONS: In order lor the vrork authorized under thls permlt to be considered legal, such work must comply with all applicable codes, and all
requlred Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in Ihe ezpiratlon of this permit.
FOR INSPECTIONS CALL: (714) 7545626 / /
2aas�ae ferool
WORKEAS'COMPENSAnON DECLARATON: •
I hereby aMrtn under penalry of per�ury one of the following tleclaretlons: •
❑ I heve entl will malntain e certificate ot wnsent to sell�lnsure lor workers' campensetlon, es pmvitled for by sectlon 3700 of the Lebor Cotle, br the pedarmance of Ihe
�ofk for w�iCh IhiS permil Is issued.
ave and will maintain workers' oompensation inwrence, es requlretl by secUon 3700 0l Ihe Lebor Cotle, lor Ihe peAormance ot t�e worlc for whkh this pertnit Is Issuetl.
My workers' wmpensetlon Insurance carrier and poliry number ere:
Cardec PWiry NumDer.
(Thls secllon need nof be canple(ed 1! the perMf fs valued et one huntlred tld/ers (5100) or less.)
❑ I certity that in ihe pertormance �he work tor w' t�is pertnit is issuetl, I shell not employ eny pereon In eny mannei ao es to becoma suDject to the workers'
mmpensation laws of Calil end egra� shoulE �ecame suCJect ta the worken' compansetlon proNsions ol Section 3700 t the La Cotle, I s�all foMwith
compty with these provi
WAHN NO: FN�URE TO SECURE WORI(EAS' COMPENS OOVERAOE IS UNUWFUL MlU SHALL SU9IECT AN EMPLOYER TO CRI� EST1 AND GVIL FlNES U! TOONE HUNDRED
TMIXI$M1D DOl1ARE (f100.000�, IN �DDRION TO THE OF COMPENSATION, UMUGES �S PFOVIUED FOR IN SECfION 3108 OF THE UBOR CODE, INTEPEST, AND �TTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby afllrm that I am Ilcensetl untler provtsions ol C�apter 8(com enGnO with Section 7000) of Divislon 3 of the Buslness anC Protesslons Cade, enA my Ilcense is In full
�orce eoe ettecc. uo. x �n � _��i/,: / 9 aess x �' —� o
Contrectors sianeture:� �� oate:
CONSTflUCTION LENDING AGENCC •
❑ I hereby aflirtn that t�ere is e consiruction IenOing apenq tor Ihe peAormance ol �he work lor w�lch I�Is permil is issuatl. (Sec. 3097, Civil CatleJ.
Lenders Neme: Lenders AdAress:
SignaNre:
Date:
OWNER-BUILDER DECLARAilONS:
I hereby aftirtn Ihat unAer penalry of perjury Nat I em EICEMPT FROM 711E CONTRAC70RS LICENSE LAW br iha tollowing reeson (Sec. 7031.5, Business entl Professions
Cotle: My ciry or caunry which requires e pertnit to consiruct, elter, Imprwe, Oemdish, or repeir eny structure, pnar to its issuanco, elw raqNres the appliceN for such pertnit
to tile e signetl stetement Ihet he or sha is Iicensed pursuant to the provisiore of the Contrectors LJcense Lew (Chepter 8(cammencing wlth Sectlon 7000) of DMslon 3 of Ne
Business and Pmfessions Code) or thet �e or s�e I5 eaempt therefrom end t�e besis tor Iha elle8ed exemption. Any Nolatlon of Sectlon 7031.5 by any epplicenllor e pertnit
subjects the flpplicant to e dvil penalry of not more than Me hundreC dollars ($500)J:
❑ I, as owner oi 1he property, or my employees with wages es Iheir sole compensatlon, WILL DO THE WORK, entl the structure is not intentled or otleretl for sale (Sec.
7044, Business and Professions Code: The Contractors tJcense Lew tloes not apply to en ownor ol property wha builds ar Improves thereon, and who does such work
himself or hersetl or ihrough his or her own employees, provitled that such improvements ere not Intende0 or ottered lar sele. It, however, t�e building or improvement is
sold within one year o1 completion, the owner-builder will have the burden of proving that he or she did not builC or improve lor purpose of sala.).
❑ 1, as owner ot the properry, am EICCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business entl Professions
CoAe: The comrecrors License Law does not appry to an owner ol property who bullds or Improves Ihereon, end w�o contracts tor such pmject with a crontractor(s)
license pursuant to the Contractors License Laws.).
❑ I am evempt untler sec.
Signature:
Bu5ine55 end Profe55ion5 Cotle fof �his re85on:
Owner ID verilied by driver'S license. ❑ Yes ❑ Na DriveYs License No.
Vedticetion of Owners�ip 6y (rype at tlocument, i.e. - property tax bitl or tleed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICATON:
Dete:
Expires:
❑ I hereby certify t�a� no e:caveiion five (5) or mora fael in depth Into which a person Is requlred to descend, wlll be mede in connection wllh work authorized by I�Is
pertnit, end thet no building structura, scaffoltling, falsework, or tlemolition or Cismentlinp ihereoi, will be mora �hen thirty�six (38) laet �ig�. (ChaD� 32, Grp 2, Art 2, Sec.
341, Ttle 8, Calitomia Atlministrative Coda).
❑ As awner-builder, I wlll noi employ enyane ta do work which would reQuire e permit Irom lhe Divislon of Induslriel Setety, es notetl ebove, unless such persan hes e
permit to do such work tmm the didslon.
Signeture: Dute:
DlNsion of Intlustrial Safery Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHOROA710N OF EMAY: I certity under penalry of perfury tha� I have reaC this eppGcetion and state Ihat the infortnation given is
cortect. I egree to compty with all state laws end dry ortlinances relating to bullding construction, end authorize representatives ol t�e Ciry oi Costa Mesa to enter upon t�e
ebove-described properry for inspectiyypurposes. I agree not to occupy or elbw occupency oi any building euthanzed by this permil until tinel inspection.
CODE �, INSGECTONTYPE
1616
1268
Fixetl System Flnal Fire Prevention
Pool Spe Final
200 Final Ra-Root
201 Flnel BIocWRetaining Wall
202 Final Fectory Fire PIaCB
203 Final Sign
204 Finel Domolitlon
Q�g �$
GO�EI ixsreenoxnve
208 Flnal Mechenical
208 Final Plumbinp
270 Final Eleciricel
212 Flnel Fire Prevention
220 Final Planning Approval
222 Flnal Site
250 FlnalBulltling�Occupency
on���u���a
(714) 754-5273 • Faz (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Atldress:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
3
3RD FLOOR
41050110
Applicant ARTHUR, SCOTT
Address: " ' _
; � // .� � -- ' ; Phone:
� 'i � � , Zip:
. �/;�' \ _- , , ' .
�i , � `
Owner:.�SAKIOKA�FARMS�� ; - -
' �, i� _
Address��� .� � � _� '
:
> Phone:
i . ' � ,
, �i Zip:
Contracror: ' E A TAGER COMPANY "
714-434-8969 /
�
�/
/�:
94137
Address: 2602 SOUTH OAK STREET �� �, -" ..
, SANTA ANA„CA„ -"
' � , , : x �- ! _ - -
, �i
�`\
�' .
,,,� P hone: 714-034-8989
` Zip: 92707 . , .
License: 754501
Status: ISSUED
Applied: 0723/2007
Issued: 07/23/2001
ISSUED BY: �
SCOPE OF PERMIT .
REF: 801-00717.�TENANT IMPROVEMENT; FOR "MAERSK SEALAND". 91.OUTLETS FOR MODULAR �
FURNITURE STATIONS. � - �-"'- � -- � � - � �'� - � � -�
� � " � �.`FEE SUMMARY � � �
Quantity Duantiry -
ISSUE FEE � 523.50 Temp DistSystem / lighting $0.00 0 _ � . - , , ,'
Temp service test 50.00 Busway /100 ft $0.00 0.- � -
Res. a/c package 50.00 Standing-Section� $0.00 0 '
New Res (1-2 units) 50.00 0 Misc Electrical Equipment $0.00 � 0 � '
New Res (3+units) 50.00 0 _ : :Transformers up to 1 kva/kw $0.00 -',0�� . , � .
Pool / Spa � 80.00 0 -:' �� ` ................up to 10 kvalkw $0.00 -� 0 � �
Lighting Fixts �. 50.00 0 . � � '-' " .............::..up to 50 kva/kw $0.00 - � � 0
Recept Outlels � 573.83 . 91 _ - . .................up to 100 kva/kw _ $0.00 ' � 0 � �
Switches ' ' - �50.00 -"�'0 � � � � ..................over100kva/kw' $0.00 0 � �
Non Res Appl ��� 30.00 . 0 �,. Low Voltage Equipment $0.00 . 0 - ,
Res Appl � � � SQ00 - � � � ,0 Low Volt Wiring System I Ckt $0.00 . . 0 - /
Service to 200a ` , , � SOAO �- � �0� _ Misc: Conduit � � $0.00 � � �0 %
Service to 1000a � � 50.00 �, 0 � ' . ' Misc. Conductor " $0.00 0- � �
Service over 1000a .. , 50.00 -- 0 Circus ( gen or ride) $0.00 � �0
Motors to 1 hp � 50.00 � 0 Circus (mech ride or lights) ,$0.00 �' 0��
Motors to 10hp , i0.00 � 0 Christmas Tree Stand $0.00� `��0
Motors to 50hp ,S0.00 0 - Fireworks Stand .$0.00 �" 0
Motors to 700hp 50.00 0 , Other Eleclriwl Fee � $0.00
Motors over 100hp 50.00 ' .. . 0 ' � . � � - � �
Communication drops 50.00 ��0 Investigation Fee -�- $0.00
Sub panel to 200a 50.00 0 - -" � Plan Cheok Fee - $48.67
Pote Light Pkg 50.00 0 , �Reinspection Fee $0.00
Siqn Circuits 50.00 0
Temp Pwr Pole 50.00 0 TOTAL CALCULATED FEES 5146.00
Intermed Pole 50.00 0
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with ail applicable handicap access requirements under Califomia statutes and relatetl
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire flnd become void if work Is not commenced within 780 days, or it work Is suspended or abandoned
for a period ot 180 days. ,
INSPEC710N5: In order for the work aulhorized undei this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2A48d8 (8l00)
WORKERS'COMPENSAnON DECLARAnON: •
I hereby affrtn untler penalry of perjury one of the tollowing deGaratlons: .
I h ve end will maintein e certificate of consent to seN-Insure for workers' compensetion, as provided tor by sectlon 3700 of ihe Lebor Cotle, for the pertormence of the
oM for which this pertnit is issuetl.
I have entl will meJnWin orke���,,,sss' cOm9en tlon Insurenc , required by sectlon 3700 of the Labor Code, for the perfortnanca ol Ne work for whiU t�L9 pe� ue0.
My workers' con(pe e lo In6urence car er end pallc� nu ber ere: � r- ��
Cerrier: I ��. Policy Number. l�l Q
(lhls secfron need nof be campleted il fhe pertnrt /s va/ued et one undred�00) or less.)
❑ I cartity Ihat in Ihe peAortnance ot th o erWlfiSA this pertnit' ' I shell not employ eny person In eny manner so es to be ma sub�ecl to the workers'
compensetlon laws of C omle, ree at1�l s ul me sub�ec the workers' compensetlon prodsiong ot Sectlon 370 oi Ihe Leb Cotle, I shall forthwlth
comply with Ihese si �
Appllcant Slpnature: Date:
WMNINQ: FAILURE T RE WORI /TION COVEMGE IS UNUWFUL M'D SHNLL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML NES UP TO ONE HUNDRED
TTpU$PND OOLLFRE (5100,000), IN ADOITION TO THE COST OF COMPENS4PpJ, DAMAGES PS PROVIOED WR IN SECf1IXJ 31060F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirtn Ihat 1 em licensed er n ommencing wit� Sectlon 7000) oi OMslon 3 of Iha Business enA Prolesslons Code, and my Ilcense is In tull
foroe antl eHect. Llc. A Class p
Contrector's Signeture: Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there Is a cronsiruction lending agency for the peAormance of Ihe work for whlch thls permit I5 issued. (Sac. 3097, Clvll Code).
Lenders Name: Lendefs AdGress:
Slgneture:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eXirm thet untler penelry of per�ury t�et I am El(EMPT FROM THE COHTRACTORS LICENSE LAW for t�e following reason (Sac. 7031.5, Business end Pratesslons
Code: Any ciry or counry w�ich requlres e parmit to construcl, alter, improve, demolish, or repair any structure, pnor to its Issuance, alw requires the applicant for such pertnit
to file e signetl stetement t�at he ar she is Ilcensed Dursuent to the provisions of ihe Contractors Ucense Lew (Chepter 9(commencing with Section 7000) ot Division 3 of the
Business end Pmfesslons Cade) ar t�et he or she is exempt theretrom and the besis tor the allegetl ezemptlon. Any vloletion of Sectlon 7031.5 by eny epplicant for e pertM:
subJects t�e epplicent lo a cMl penelry of not more then iive hunEred tlollers ($500)J:
❑ I, es owner o1 ihe pmperty, or my employees with weges es thelr sole compensatlon, WILL DO THE WORK, and the strudure Is nm Intended or oXared for sale (Sec.
7044, 8usiness erid Protessions Code: The CoNradors Licensa Law does not apply to en awner af properry who builds or impmves thereon, antl who does suc� work
himsetl or herself or through hls or her own employaes, pmvided Ihat such Improvemems ere not Imendetl or aHered for sele. Ii, however, the Dulitling or improvement is
sold within one year of completion, the owner-builder will heve iha burden ol proving that he or she did not build or improva for purpose of sele.).
❑ 1, es ownar o1 ihe propBM• am EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to consiruCt Ihe pwject (Sec. 7044, Busineu end Protessions
Cotle: 7he comractors Llcense Lew tloes nat appy to en owner oi propeny who builds or Improves t�ereon, end who coNreds tor such pro�ect wlih a contrector(s)
licensa pureuant to t�e Contrecrore License Lews.).
❑ I em exempt under sec.
Signature:
Business and Professlons Code for Ihis reeson:
Owner ID venlied by driver's license. ❑ Yes ❑ No Dnvels License No.
Vertlicatlon of Ownere�ip by (type af document, I.e. - properry ta: blll or tleetl):
DIVISION OF INDUSTRIAL SAFEN PERMR CERTIFICATION:
�ate:
E:pires:
❑ I hereby certify ihat na excavetion tive (5) or more feet in depth into which a person is raquired lo descend, will be mede in connection with work euthonzed by this
pertnit, and ihat no bullding siructure, scaflolding, talsework, or tlemolition or tlismentling ihereot, wlll be more then thirty-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, CelHomia Administretive Code).
❑ As ownerbullder, I will not employ enyone to tlo work whic� would raquire e permit from t�e Division of Industnel Selery, es notetl ebove, unless such pereon �as e
pertnit ta do such work trom the division.
Signalure: Date:
Division at Industriel Satery Permit Number:
ICERTIFlCATE OF COMPLIANCE AND AlITT10RIZA710N OF EMAV: I certify under penalry of perjury that I have reatl ihis applicetion entl state Ihet the inlarmation given is
cortect. I egree ta comply with ell stete laws end city or relating to building consiruction, and aNhodze representetives of Ihe Clry oi Costa Mesa m enter upon Ihe
ebove-descn6ed proOeM �a� �OSPV�i9aP P�� ee not to occupy or allow occupency of any building euthorized by ihis permii until finel inspection.
COOE 1. INSPECTIONiYiE
1616 Fixed System Final Fire Preventlon
126fi Pool Spe Finel
200 Finel Re-Rool
201 FIneI BIocWRetelning Well
202 Finel Fedory Fire Place
203 Finel Sign
2d4 Finel Demolitlon
VdIE INID�4S
CODE� INSPECTIONTYPE
206 Flnal Mec�anical
208 Flnel Plumbing
210 Flnal Elactncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/OccuDancy
PlIE 1NIIDSLS
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
FIRE SUPRESSION PERMIT
JobAddress: 555 ANTON BL
Suite: 3
Vicinity: MAERSK SEALAND (3RD FLOOR)
Status: ISSUED
Applied: 07/11/2001
Issued: 07/19/2001
Parcel Number: 41050110 ZOflifl9: ISSUED BY: �
ApplicanC KNESPLER, JOHN � „ � � "� - _ �
�i � _
Address: . . (/ '-�,. -. � � . i' - - _
i ,; %-; �" � - , Phone: 323-582-5703� . � �
i �.
',, �- � . ' ' ZiP: � � � ��
� � - , . . . _ , _ - � � � ,�,
Owner: ,'3AKIOKA`FARMS� . � . � � � ��� ��
Address /. . "-- � ' ��� ' � ,A. ��
,-� . . . .. Phone: ' _ , � � : �
i_� � _ - � � '-.
' � � i; ; Zip: 94137 � =; � , -� - _
� i
j �. , �
` � . . ;
contractor. SCOTT�CAMPBELL COMPANY � �
� Addresst � � 02532 E 49TH ST �-` � A ' � � ,
� . . � . Phone: � 323-582-5103 - � � � -
' � VERNON, CA �'-Zip: . 90058 - � - , . ,
. � - �� � , � .licenset 180206 - .. . .. ,
� - . � . � , , �. - �
. . `
, /;� - _ „ SCOPE OF PERMIT _ � ' ,�� -, � _ • , �
, INSTALLATION/RELOCATION OF 29 FIRE SPRINKLER HEADS FOR A 13,520 SF OFFICE TI-FOR � ��
"MAERSK SEALAND" ON THE 3RD FLOOR., , � �� ' �,
REF: BO7-00777� , . , - �� �`� � . .
. , �, ti "i lr ' . ,
"� � -- - - FEESUMMARY'- -
Plan Check: $6321 . C I V I f '
Permit: $9725 �.
Other: $0.00 -- — - - - - _ _ �
. ,%
Total: $160.46
.
a c a ua ion. sa,000.00
Claimed Valuation: 3a,000.00
. � '; � �
. . .. .
c ��' ,
�.
, � � � �,
NOTICE: The work authorized by this permit shall comply with ali applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § t, 12-21-92) .
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1B0 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
requlred Inepections end final approval must be obtained. Failure to obtain Inspections and final approval will result in the ezpiretion of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5628
2aaae �aroo)
WORKERS' COMPENSATION DECLARATION: '
I hereby eHirm under penalty ot perjury one ot the followinq declaretions: „
❑ I heve entl will mainteln e ceniticate at consent to seN-Insure for workers' compensetion, es provided for by section 3700 of the Lebor Code, tor Ihe petlormence of the
work ior which Ihis parmit Is Iuuetl.
�I �ave end wlll mainteln vrorkers' compensatlon Insurance. es required by secUon 3700 ot Na Lebor Cotle, for the pertortnance of t�e vrork lor whkh Nis pertnit la issuetl.
Myxc�orke[7s' compensatlon Insurence carrler end pollcy number are:
Cerrier. \_��/1� Pallcy NumDer �RFCYS � G�,�C6 C
(fhis secNon neetl not complele� i/ Me permit Is ve/ued et one hundred dWlars ($100) or less.)
� I certity that in t�e ormance of the work for which t�is partnit Is issued, I s�ell not employ any person in eny manne� so as to become subject to Ihe workers'
compensetlon lew o Callf mia, end epree thet if I should become sub�ect to the workera' compansetlon provisions o1 Seq�lon 3700 of the Lebor Caae, I shall fohhwith
compty wlth t�ese slon� � 1 I� I� I
Applicent SlgneNre: Date: I
WARNINO: FN�URE TO SE WORKERS' WMPE ATION CAVERAOE IS UNLAWFUL ANO SHP115UBIECT PN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
TINJUSANDDOLURE(S10D, ),INADDITIONTOTMECQSTOFCOMPENSATION,DANAGESASPHOVIDEDFOHINSECilON3]WOFTHEUBORCODE,INfEHEST,AN�ATTORNEY'SFEES.
I hereby aMrm that I e�
force antl eNect Lic. N
Contracrors Slgneture:
DECLARATION:
etl untler provisions ol Chapter 9(commencing with Section 7000) ot Division 3 of Ihe Business and Professions Gode, antl my Ilcense is in tull
Cless x
/ /1 Date: �
CONSTRUCTON LENDING AGENCV:
❑ I hereby aHirtn that thera is a canstruction lending egency for Ihe peAormence oi the work tor whic� ihis pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lendafs Nflme: Lendefs AdCress: �
Signeture:
OWNER•BUILDER DECLARATIONS:
Dete:
I hereby eNifm t�a� under penalry ol per�ury thel I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Buslness end Professlons
Code: Any ciry or counry which requires e permit to construd, alter, Improve, tlemollsh, or repair eny structure, pnor to Its Issuance, elso requires ihe eppliwnt for such permit
to file e signetl stetement that he or she is Ilcensetl pursuent ta the provlsions oi the Coniractore License Lew (Chepter 9(commencing with Section 7000) ot Division 3 of the
Business end Professions Cotle) or thet he or she Is exempt therefrom end the basls for the elleged exemption. Any vloletlon of Sectlon 7031.5 6y eny epP����� fa� e OertM:
subjecis ihe eDP���nt to e civil penelry oi nat mare then five huntlred dollers ($500).):
❑ I, as owner ot t�e properry, ar my employees with weges as �heir sole compensation, WILL DO THE WORK, end ihe structure is no1 intentled or oNeretl for sele (Sec.
7044, Business and Professions Code: Tha Coniractors License Lflw tloes no� app1Y �o an owner oi property who builds or improves thereon, and who tloes such work
himself or herself or through his or her own employees, provitled that suc� improvements are not Intendetl or oHered tor sale. It, however, ihe bulltling or improvemant is
soltl within one year ol completion, ihe owner-buiitler will have Ihe �urden oi proving that he or she did not builtl or improve tor purpase ot sale.).
❑ I, as owner of the pro0erry, am E%CLUSIVELY CONTRACTING WfTH UCENSED CONTRACTORS to construct the project (Sec. 7044, Business and Protessions
Cotle: The contrectors License Lew does not apply to en owner ot property who bulids or Improves t�ereon, end who comrects tor such proJect with a contrectar(s)
licensa pursuent to the Coniractors License Laws.).
❑ I em exempt under sec.
Signature:
Owner ID verified by drivefs Ilcense. ❑ Ves ❑ No
Business antl Professions Code for this reason:
Vedflcetion ai OwnersNp by (type of tlocument, I.e. � property tex blll or tleetl):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
Drivefs License No.
Date:
Expires:
❑ I hereby certify ihat no exwvetion five (5) or more feet in depth into which e pereon Is requlred to descend, wlll be made in connecilon wlt� work euthorized by this
permit, and that no bulltling structure, scattolding, lelsework, or demolition or dismentling thereot, will be more then ihirry-si: (36) teet hiph. (C�ep. 32, Gry 2, Atl 2, Sec.
341, Tille 8, Celifomie Administretive Code).
❑ As owner-Gulltler, I will nat employ anyone to tlo work w�ich would require e pertnit from the Division ot Intlustrial Sefery, es notetl above, unless such parson hes e
permit to do such work trom the division.
Signeture: Date:
Division ot Industrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHOHIIATION OF EMRV: I certlly unaer penelty of perjury �he� I heve read ihis eppllcation and state that ihe intortnatlon given Is
wrrect. I agree to compty wit� ell staie lews end ciry ortllnances releting to building constructlon, and euthodze representatives of t�e Ciry ol Coste Mesa �o enter upon the
ebove-de�ribed properry for Inspection purposes. 1 agree not to accupy or ellow occupancy of eny bullding authorized by this permil until Tinel inspection.
COOE I, MSPECTIONTYPE
7816 Fixed System Final Fire Prevention
7266 Pool Spe Final
200 Final pe-Root
201 Finel Btock/Retaining Well
202 Finel Fectory Fire Place
203 Flnal Sign
204 Finfll Demolltion
� ��'-� I oe�a
Date
QejE + - � COpEI INSPECTIONTVVE
�.�10
�✓ 206 Flnal Mechenical
20B Final Plumbing
270 Final Electrical
212 Final Fire Preventton
220 Final Planning Approval
222 Finel Slte
250 FInalBuilding/Occupency
I•].\i�Ciii�7.1S�1
-z I W�
�oonEssaeaim+c: 555 ANTON BI.
a�m�xswy+EiF�rT+: SAKIOKA FARMS
�o�% PO BOX 2097
TERMINAL ANNEX
�vr�. wuia,a.00n[ss:
�� 3RD
urcxnectonwax�nn: ZNTERIOR DESIGN 21362321&�� 9378
u�cxonu+asaoonEss: 550 S HOPE ST �M 1100
L.A. CA 90071
��T� � MORROW MEADOWS CORPORATIO (714)598-7700
cwrn�croxswu�wo 610 REYES ST
�noxEss WALNUT • CA ucw_ 230813
91789 uirt:
110EN5ED COMFA4TOHS DECL�flAT10N: I Mmby ellim wEr pe�y tl pmjury tl�el 1 un Ibenetl under provama W Cheqm 9
(cammmwiq vm� Section ]OW) d Oivieian 3 d �Iro BueiMee W PNeae'va Code. and mY licava e m tu0lau end eRerJ.
emuc.No.:006558 uc.cuss: C 10 uc.No.: z308 3 EXP: 12/96
l^ /R- �'1 C� yy� "
Dete: ^ �J Comrmor
�;NER BUILUEX OECIARATION: I Aaraby elfiim uMer pmaXy d perN�Y �� I eum Irom ihs Cmtraqas Ucenae Law la IM
owip �eawn (Sedqn ]031.5 Buainme eM Roleaepne Code: Rny cily a munl� wM1i'h � uiree e permX to mnshuct, eller, impove,
�mdoh, w repv eny elrueluro, qiw w in ceuenee, eho rpuieea the eppliunt lo weh pe G �o file e aqmd ele�ament Ihet he a�M
ia licenesd punuem to Iha pransiom d Na Conireaon licenae lew �Cheqer 9( 'ip xilh Sepion 1000) d DHibn 9 0l �M
Bueineu erd Prdwona Code� or �hu M w ehe is memq �hereM1om eM ihe beao m NlepeA ewamqion. My vidmon d Saaon
)W t.5 by env eGWiuni 1« e pemN wbjede the eppliunt to a tivil per�eliy d m� mpe Ihen liva huMeM dd4n �5500p.
❑ I.uox'rrdiMpopaMamyanWvysmwYhwepeantheiedemmpenWion.xilldoNexM.endtlwebucWnuiwlinlantlod
a dleM br seb l5e�ion )oM. Bueineu enE Pivtmmne CoCe: TM CaMretlae liowe LewEma nol ePPNto en ownr d popeny
.. wM Wide ar inP�s IMrton, eM xM doea euM xdk h'unmC a Mner a Ihrpph he a hm oxn emVblee�. pmiMe �M wch
'�. impwemema are nd intendad a Wered la eeb. X. lawewr. �M buiNiiq a inpv.emeM o sotl wilhm me Yw d compbtion. tla
'. owmrEuiNm will have �M WMm d pwiip M w eM did ml Wiltl a impv.e lor Ihe puryms d eeb�.
I❑ I. s� ovmar W IM properry. em utlinnaly mntrmip with IiwnsaE canirenae to cwmruq Ne qqeq (�� �. �iroe� uq
Prolenime Coda: The Conirw» Liceroe Law Ewe ral eppy lo en owner d qupeM ��itle a impwr tM�son a�d Mp
conlreN la wtl� prqxN wilh e conVeqa(e) Icenaed punuem �o �he Coniredme Limnse Lew).
� I em eeemp mMer Section: B. 8 P.C.. br Ihis roewn:
Dma: Ovmar
1 do henby anity IIW I em ewara d vM uMantend the reyuiremenls ot Celdomie Heellh vM 3afery Code Seqone 25505, 255�.t, uk
2553a, vq �hd I m eny Mure WikinO �M^� �II / wdl nd (a�cb ma) med to comp�y wIh seM elele mEes eM tM iapuiromann br
epsrmnlwmnstrudionamodifimtionhanlMAi u�y ennpemeniDislntl.RaeidaniWmem�uqionappira�'vnwexemqlmmiMss
�.'IWI80M.
Oms: �vp�' �:
WORKEN'9 COMVENSATION DECUfl�TON: I hsreby eMim wdm penelly d pxjury ona d IM tolbxirp detle�etom:
❑ IMwudwJmeinlanaceMM'rsledaonronitoaallinaunMxoMentanpenWbn.uprwkBdfabySMion3)OUdlhalnbOr
cce.. lor �n. o.n«mence a in. v.«x r« wmcn mo pemiil ie oe�eE.
�] I hew uM xil munten xnhan' oompameton ineurence, e� required by Saaim ])W d iM leEor Cada, br�M psrlormar�m W Iha
wak br w1iiM Mie permn h iwued. My waken' rompanution inau�ence cerrisr erd pdiry number ve:
c;m;;: FIREMANS FUND EXPIRES
Po��Yr+�ma�: nwr 07/01/96
(This esdion med mx be complefM / tM pwmAie lur wa huMied dollen �SfW/ w Isu.J
� I oenty Net in �he pMoimenea M tM work b whch Ihie pmmil ia ueuM, I ehell nd empby eiry penan in eiry menew w m Io
becpne �ubjxl lo �M xoMae' wnpaneetbn Irne d Celibmie. end epna Ow B I ehouk become wae to �M xwlu�
oomWnetlion pm+eom d Satlion /9lOD d IM labor Code. I ehel rAlh apnpl� Ihws pvrisum. "
Dps: / ` � � � � (� AVWiceN:
W�minp: F�llun ro ucun woher�'ronpru+tlon cov�rp� N unbwful, �ntl �II • ct �n �rrployu fo cNMiW p�ruMu uM
dHl flrw tp b o�w h�nGrN IMunnd tlo/Yn (JfoqaOoA M Mtl/tlon b M t ol mpxwtbn, tlem�pu u provWW bi In
9�ctlon 9108 0l tln LeDor Cods, Intxu4 �tl �ttomly's /w.
CONSTp11CTON LENUINO AOENCY: I MroW elFrm uMx pendry W perju Ihan u a m�Mrudion IaMi�p aperwy br iM
perlormenw W iM wak fa wfiiM ihe pemil i� esuM (Seaion 3091, CM. C).
LENDEN'S NMIE:
LENDEWS ADDNE54:
I ceMiN �� I hevs neE Nis epplicNian ud qma �het Ns Wwe iMamLLbn u cortsp. I p� to compy wilh NI ey uM counry ortlironou
uM eteta levn ielelnp W buikip con�trutlion ud Mrsby aNhor¢s iepeaenletiv» d Ihe tltyto amw upon iM abws�manliawd pioparty
�«��.ceaim wm��
CHARLES JACOHI
1
—��— �
Dme:
(5t51J�.WP) `�i(s-Buildip d Sefery; O�eeMFle; Cerory-ADO���: R�k-Revmus: (3oldan�od-Aeaepor
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: E 07601
PERMIT NO: E 076011 PLAN CHECK NO: N GOVT: N SUPP; Y
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
JOH DESCRIPTION : INTERIOR 2000OSF OFFICE T.I. S(J FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS REF: 8-74570 ��� ����
*******�r*+�*�*+r**��r�**�r**�r*r*�r***�r�*x***x�x* x�* * � x� �r�r+r**�rx�*�x�**x��**�x�r+�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i �=,.
IE �k 1E 1f� IE 1E 1E 1F 1E 1! iE it ik 1k 1k IE 1E 1k ik ik IF 1i IE 1k M 1F 1E 1E 1f iE if' IE 1f ik 1k 1E 1E ik if ik 1f M iE iE 1E 1F iE M 1E iE ik ik IE 1k if 1E 1E 1E 1E if 1F iflf 1E 1E iE 1E 1E iE 1E M ii IE 1E 1E iE 1E If if
D E V E L O P M E N T S-E.R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ��' DATE:
� :1� � � � �� � f �l::1 � �L���L��� � � +
APPLICATION ISSUED BY:
1EfEiF1E1E1EiF1EiEiflFMiF1E1E1Eil1F1E1E1EM
LEGALIZATION:N
M���-`ii�bs'uf:ti7
DATE:
DATE; �— �
iEiFiF�EikiEitiE1E iEiF
STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 20.40
SOY - SMIP/NON-AES
ISSUE FEE 4,50
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 20.40 4.50 0.00 24.90 24,90 .00
REVENUE DIVISION TOTALS--> COLLECTED; 24.90 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN-CHECK
24.90
1E iE iE iE iF if 1E 1k 1(� 1f iE 1t 1k 1F 1E 1E iE iE iE fE 1E 1i 1E 1k ik k iF 1F M 1F 1E iE 1! 1E 1f iE iF if IF k ik k 1E ff ft iE 1F ik 1! iE 1k if 1E 141F 1E 1f iE i! 1E 1ElE 1E iE iF 1FlF iF iF ik 1k 1k 1E 1E iF 1E'X'1E iF
I N D I V I D U A L F E E B R E A K D O W N
`���
ELE
QTY
2�
12
f �i �.'��:� i;sl ���7.1
RECEPT/OUTLET 1 ST 20
RECEPT/OUTLET ADDITIONAL
END OF FEES
UNIT COST
EA. .75
EA. ,45
TOTAL COST
15,00
5.40
9 ,_1-:.1>':IS � -;-Y
n, _ � ... , .
CONS'fRUCT10N AND PI.ANNING . F. .& SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# � Date inspector
�
1. Temporary Electrical Service or Poie 52. Poo� & Equipment Location � -
2. Soil Pipe�Undrgrnd. ,`�'.� � 53. Steel Reinforcement ' '
=z3.;,�lectricai.:�Gondu�i Un7ity-Undrgrnd. 54. Forms .
�'�'�EVectrical� r�ond "=y��@drgrnd. 55. Eieciricat Bonding _
..�,, .-� 'Y.:. �EG.�
_,�5.` teei Rei�orceme�t`� . � 56. Rough Plumbing & Preswre Tesl �
'r`6�' ElectriwU}FEF2`Yl'nd. � � �57. APPROVALTO C6VER�GUNITE .
. q' CL r.. :., i
'�-�'7�. £-.3'ootings�Um �"' ' 58. Electrical Conduit=Undrgrnd. � �
�� 8. Fbundatiari�� �aH y � 59. Gas Pipe, O Und�gmd., Test �
f'
G �'i
9. Water Pipe:Und�rnd. `y`- - 60. Backwash Linea�;A�Trap, � Undrgrnd.
70. Structurat-floor�5ystem 61. APPROVALT06ECK
11. Property�Sewe,r�+ne;& Hous�.Connection- • 62. 8ackwash & Rcee'ptor-final
�
12. Sewer Cap: ``,.; ' � �- 63. Heater & Vent-Final
73. Roof Drains �^ 64. Plumbin9 System -'Final
14. Rough Plumbing-� �r, - 65. ElectricAl-Finai ,�
15. flough Electrira JCopduit � c � �66. Solar SyStem�F,i.nal
76. Rough Electric�M,irin'� .. 67. Fencing & Accrss.Approval .
:' 17. Rough Wiri� Sign � 68. APPROVED FQ�PLASTERING
y 18. Rough EleciricaY�T 6ar Cei�ing 69. POOU5PA SYST€MS FINAL
19. Rough Heating & Air Conditioning FI,JiEpF PT, REQUIREMEN T
��- ^ M k C i. (, ,--i w F [-" ':? � i
20. '��'ou � Fa tor,� Fi� ace �'"� "`'_' .� '�� � "' *' APPh�OV,a6�i,_.J Pe'r,'mit # * � ,7�
� �,5. � I � iT c:'G � S 7� * C . +� . (-+ �-°r�.ar-
21. BucCs; in'Strtaaurst+ ' .: .. �'S �� s � '- � ' 70. "Gndere�7o�pH �d;o '� - .
22. O.ucts: V�iitila�in `•� • . * �- `r*' m�•
�, 9-J r Jr� � O c� C; r+� �' 71. ProdugssFAing�as � Oii
23. Gas 2ipe-4iouqh & 7ast ;.7� �+ n a� � c� , 7p. Underground F,iu�fi `-�
24. Roof`FrahSing" � � - � ";;, * �' ^ � ti * , 7,3y Undergrn'd, Sto;age Tank;:O Gas ❑ OiI
25. Roof�Shea�hing ;,x v v v`� C� r Nr 74v Overhead Hydrg;rt, t
26. T-Ba� Ceilin iStru tural) & Mono'Goat y' � � ``�� ' "" � x�'
,� 9 .�... .�_ -, 7 �. p* 75': Dry CherX+ical � �; �..�y
--,
27. Frame and. Fiashing;;; ptz;� x c� co� 76. Dry StarS€(bipe �; w �_ c1[+'
4 r+Y
-'28. Lathing$t'Sidingr"�.'':� `"�^. �- x�^ • :' 7X, fIXEDS�STEi{+irFINA�_ - �`�
�� C �7�^r-. p w ..z i.�
1� C: _{.� H-.r• .J .L: , • .�J
� 29. Insuleiioa; �,# S �� * { i� 7� FIRE PREV. FIf�AL i% - �_ �
30.Drywalll�Tailing �x� *�., ' �` � ��i�EALTk�DEP�"RE6UIF�,E�ENT
-, 31. Plaster Bra.wn-Coa,t�'y* S t^r• * j* : 79.� FINAL ISi3PECTTON � J 4�
; 32. Electricacotti�r A4 ��rrFir�al � * n' � n-� 86" F000 CERTIF�CAi'E I��yUED�
�• n, . �- ji Fl .. �
i
� 33. �ina[,Ele fric;: `�i n � . . . a; Q��j7� � IIL�" N6tes: ^'-: �,r--'. * ^ O .�:
t�- 4� V ' . c
� 34. FinaF.}�ieaiing'& A+�•Conditionin'g ; '1 + i ; tr ,,•�r � . . �;.^ - _ r;''
ti r. rti.F . {. � `t C �-+y.^. vc �� ' Y
,� 35. FinarGai$iPe;TesY�`: p� .. :; .� � ;� . � ,,•, � - s • .-a=+r'
o � �,a'
. 36. Hood�or Canopy � ^ �'"" 4 � � � � f' E �� -
- . ,� m --� m �aor
;37. Final�actorYFireplace';t � �''� •" *" � *. � - '
-� ;. r..: � �, w, �. � �' '
L. -�
-'38. Final'Plumbing � +. `r� � " ` � i� c� �. = oJ � ----
.,�: n, o :v I 4. �-+ z' �
�39. WateTService-Final �; �: , ` �;T + �t•.., '' �.., � -;',� ' .
-f
=40. Gas Service-Final ' � �♦ :_! d:4T'r" � �: T I ' -� er� � =� :�' : ~ . . ..
� i n� rr '� P+ . : �c '-i
�41. SolarpomesticFi ��. f, .. * � �'i * W - �` '
_ n C. � � ' ,, � ;� ,� : � � ;I
�
- 42. Backflow Preventet,s n� i' i ;.F c; .- y C• ��
a n �1�,..i #- s ii7 •r•'•� C r
r-� e� .- �. c � r. ✓
43. Backflow Irrig3tion ;. "`-'- + � :a; : �: r' . .
�Y
49. �andscapE�Irri9ation�System =^?:� � � tT; '7 C7 O v� n� ,L a:,`� �: cu v ti�
-� c1 Y. a C' %K ' e. V�.. -r. S
�5. Sqund A�,tenti�tion:� '^,`;', ''� � £ � ; m* � „ : ��� `�r' r
.�
�. Handicap F�egulations ;; r� �� t� T S Cr s r
�. / ' Y
�. F�INAL STRUZTUFi� & BUILDING � ' ��� �' " � '
�. � n
48. QiNRL PLANNING": � .- . *'.L ,.' k , ri c: �: [-� �
x : i ;+: c z r.;
d9. Electne Reiease to E�lison � � � `^' � � -�
. �
Il.•,FR:] C •�` y.
50. 6as R:elease to Southem California-Gas Co * �'�� t� e-� h� ='a � �� •�
-t- �� - t ..t
51. CEflTIFICATE OF OCCUPANCY +' +� :' �� �'�-' ' � �' � -
No. Date
1
,PflQIECf RDORESS: S S S ANTUN BL uxrt: 3 5 0
OWNER'SNRME: SECURITY PACIFIC NATL BNK
aouxess: 555 ANTON
' 957-1989
.RflCNIENGINEEH: , REG.NO.:
aooeess: uxrt:
� PEflMITTEE: INNER SPACE � ( 213 ) 771-7126
nooxess: .5052 CECELIA
' - , SOUTH GATE CA 90280
UCENSEO fANTMCTOP OECUMTION: I hereby affirm that I am IicenseU unUer D�ovisions of ChaO�e� 9(commencinp vnt� Section
7000) ol Oivision 3 ai ihe Business and Pmfessions CoOe, and my license is in full farce antl ettect.
�m ��.; 0 3 214 4 STATE LIC.: 0 0 ,. C,• ��
�� - 6 - siynawa�� _ '� �C...J�.._opp �
NFflS'COMPENSIITIONOECLARATIO : IAereEya rtmihatlhaveacertificateofwnsenitoself-insureoracertlficateoiWorkers'
pensatian �i s�a3c9 os $cgnilied copy t�ereof (Section 3800, Lab. C)Z � O 1/ 9 9
POL1CY NQ.: 3 EXP. U1TE: 1
'�rnrnnr: GREAT AMERICAN
Certifie0 coDY �s herehy fumisheU. � Certified caD� fAed with the ciry BuIItlInO Di '��' n.
� Daro:, � � � p — �� � ApDlicant: � o— N `
FIIEMPfION FHOM VIONKFAS' COMPFIIEAlION OECUNITION: (1A¢ sectlon nee0 noI Ee complete0 il tl�e ce� a �a� a�e AuMaO (5100) or less�.
I ceniry that in tAe performance of the waM lor wtiicA tAis permR is issued. I shall not emDloy any Derson in any manner sa as ta Oecama
su6lect ta tAe Woders' Campensation Laws ol Califomia.
'Oate: ' SOnature:
XOTILE: If, atler making this Aeclarztion, you shoul0 �ecame sublect to the Workers' Compensatlon proNsions ol tAe La�or
� Catle, you must fotl�witA comply with such pravisions or [his permit sAall he OeemeO mvoked.
i CONSTflUCTION LENOING AGENCY: I herehy aifirm Ihat there is a consimc[ion lentlinp a0ency for Ihe peAOrmance oi the work for
whicA tAis De�mil is issueA (Section 3097, Civ. C�. '
' LENOEH: � .
nooness: -
OWNEB BUILUER OECIAIWTION: I Aereby affirm IAat I am exempt imm the Controctors' State Licenu Law for Ihe tollowinp reason
(Sectian 7031.5 Business anA Pmfessional CaAe: My ciry oi caunry whic� requires a permit to construct, alhr, imD�ove, Oemolish, or
reDair any structure, prior to its issuance, also requires Ihe applirant for such Dermit lo lile a si0ne0 s[atemen[ [hat he/sha is IicenSeE
pursuant to Ihe pravisions ot Ihe Contrectors' State License Law (Chapter 9(commencinp witA Section 7000) of �Nisian 3 of the Busineu
U Pralessions Coda) or that �e/she is exempt tAerefrom an0 t�e hazis lor the alleqe0 exemDtion. My Nolation oi Section 7037.5 Ey
aOP�icant 1or a Dermh suhlects the applicant to a cidl penalry oi not moa than five hundreE tlollars (SSUO).
I� as awner oi the DroDenY or my employees with wapes as iheir sole campensation, vnll Ao [he woM, anE the
simcture is not intenAetl ar oifereA for sale (Section I044; 6usiness an0 Professional CoOe: T�e Cantractors' State License Law
� Ooes not aDPly to an owner af a Dropetly wha,builOs or im0�oves thereon, an0 who does such work himself/herself or IAmuph
� his ar �er own employees, D�ovideA ihat sucA improvemenis are not intendeA or ottered for sale. It, however ihe Uuil0in0 or
� impmvement is soltl within one year of comDletlon, the owner will hava Ihe burdan ol pmvinp he/she Oi0 not Uui10 or ImD�ave
for the puryose of sale�.
I, az owner oi the pmperry, am ¢xclusively contractinA �th licensed'contractors to constmct the prole�� (Sectian 7014, Business'
❑ anA Protessbns CaOe: The Contrectors' State License Law tices not apDN �o an owner ol pmperry who CmIOs ar improves tlierean
� anA wtro coniracts for such projec[5 c{Ih a coniracroqs) Iicense,Dursuanl Io Ihe Coniractors' State �icens¢ Law). I am awam
' tha� proot at tAeir Worker's Compen52Uon insurance shoul0 be DroWOetl to me.
� I am exemD� unUer Sectian: B. 8 P. C.
� tor t�is reamn:
�ata: Ownec
I Aa Aere�y certiTy that I am aware oi an0 wAerstan0 ihe requirements af California HealtA antl Satery Cade Sections 25505, 25533, anE
' 25534 anE that I or any future buildinp occupant will/will nm (circle one) neeA ro comDly with sai0 state co0es and Iha requiramenis tor a
permit for consimction or mo0ifica[ion from ihe Air Oualiry Manapement Distric�. Hesidential construction applications are exempt Irom
, thesa provislons. ' . ,
�ate: ApDliwnt
I herehy certity tAat I have reatl Ws ap0lira[ion an0 rtate that the ahove iniormation is correct. I apree to compty wit� all ciry anG counry
ofdinances anG stare laws relatln0 �o EuilEinp conslNctian anC hereby autlarire re0�ntatNeS Oi [his dry to eMer upon Ihe abovamentlonetl
pm0erty for inspecqon purpases. —+�
Date: �'"'ti/ �'- � � SipnaNre: � � � - -.� ���� �
onver's �icense or Saia� Securiry x: — �
1601-48 W�ita—BuilEing; GrBan—Catle Enbrcament; Canery—Appllcent: Gink—Revenue; GolEenroE—Asseeaor
�
CITY OF C05TA MESA — BUILDING PEkMIT PERM NO; B 048775
PERMIT NO; B 048775 PLAN CHECK NO; 05248-90 S GOVT; N SUPP; N
C6NSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION ; T,I, OFFICES SO FT: 2.900
CLAIM VALUE: 65,00 CALC—VALUE: 96,632,00 GROUP OCC: B-2 /
COMMENTSi T.I. OFFICES
*** �**� ���x��*��* �** �** �*� �*��r****�*a�+��***� � ��**+�** �**� * � x�r� � * �����***�**** �*�-�r�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
----------- MAIN HUILDING --------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN ' FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REo • PROV: YARCEL: 41050104 ZNE; PDC REF NO:
�PLANNING N(�TES> TENANT IMPROVEMENT ON 3RD FLOOR
>
iE if 1F if iE iE if iE if iF i! it j! it if� iE jE jE �t if it �E ik 1! 1! iE if iE iE jE jE jE 1E ik fE ik �k �Y(� jE 3f jE 9f iF iE iE iE if iE iE fE 3E �E i! �E iE iE i6 if it iE jE iP 3E iE iE iE iFlf i(�*9F �E iF �F iF jf iE iE �E
D E V E L O P M E N T S E R V I C E 5 k E Q U I R E M E N�'E.S
ZONING APPF.OVED HY ''
� G• DATE: Q�'=?_C� �c�
' / �
BUILDING APPROVED BY : DATE: � I�;�/
APPLICATION ISSUED HY� `T-G� �7� naTF.I �7P�-`_Ir
if iE iF iF jk ih iF 1R it it 1! jk ik iE iF iE iF iE iF # iF ik if iE ik ik9E iE jk iE 3F iE±E �)E iE �k• ik iF if iF it �If� iF iE iE iF iE iE iE it i(� iF iE iE iE �lE iE �1E �lF 3k iE iF i(� iE iE iE iE,iF1E iE.it 3F �IE �E iE iE * i(� iF
LEGALIZATION:N F E E S U M N1 A R Y� STRUCTURAL �SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE� SMIP/RES GRADING
PERMIT 395.00 � �
' ' SMIP/NON—RES
PLAN 256.75 6.99
ISSUE FEE '
HUILDING—DIV—> PERMIT IS5UE PLAN—CHECK'. TOTAL PAID DOE
TOTALS----> 401,99 0,00 256.75. 659,74 65fl.74 , `,OQ
REVENUE DIVISION TOTALS--> COLLECTED: - 901.99 OVER/SHURT: 00
BLUG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
395,00 6,99
iE iE �F ik iE -Ik if i! i! iE it if iF 3E �1E 3E #�f-if �1k 3E iE if fE it it it �f 1F j! iE iE �)E iE iE iE it if iE ff 3E �It �F iE iE �IF 9h iE 3E if �E iE iE �lf iE iE iE iE if iE iE if 3E iE jf ik iE if� iE iF if 9F iE iF iE iE iF iE iE
I N D I V I D D A L F E E' B R E A K D O W N
TYPE QTY D E S C R I P T I 0 N -' UNIT COST TOTAL COST
SFC 2900 OFF-INT, ALTER TYPE I,II F,R, -AVER 16.08 46,632.00
END OF FEES .
": >
�'
01 Ot�Q695;1-Q0063`I7 T C�Ti 4Gi.9-'
4ATE: D8/'j6l4Q TI!'IE: �8�23
CONSTRUCTION AND PLA �y� � . SPA
APPROVALS Permit # ' Date Inspector pppROVALS Permit # Date Inspector
1. TemOorary Electrical $ervice or Pole � 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. � , 53. Steel Reinforcement - �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Condui[-Undrgrnd. 55. Electrica� Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gtnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation � -_ � •� � � 59. Gas Pipe, O �Undrgrnd., Test � � �
i �
9. Water Pipe�Undr9rnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Structural Floor System �. 61. APPROVAL TO DECK ' , i 1
11. Property Sewer Line &�House'Connection .� 62. Backwash & Receptor�Final �
72. Sewer Cap �. � 63. Heater & Vent-Final
13. Roof Drains � � 64. Plumbing System - Final
14. Rough Plumbing - . 65. Electrical-Final �•
15. ftough Eleccrical�Conduic ' _ 66. Solar SYstem-Final �
16. Rough Electric Wiring � 67. Fencing & Access ApP�oval
77. Rough Wiring Sign 68. -APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. RooS Framing 73. Undergrnd.StorageTank OGas L]Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat . 75. Dry Chemical �
27. Freme 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 pomestic-Final
42. 8ackflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING �/� (��
48. FINAL PLANNING .
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No. Date ,
PflOJECT�DOflE33: SSS ANTON BL
owxee�sxarne: SECURZTY PACIFIC NATL BNK
aoowess: 555 ANTON
957-1489
AqtNIENCINEEfl:
�DOHE38:
NEO.NO.:
uxrt: 3 5 0
UNIT:
PEflMIREE: AZR CONDITIONING COMPANY ( 818 ) 294-6571
aooxess: 6265 SAN FERNANDO
GLENDALE CA 91201
IJCENSEO CONTMCTOfl OECIAMTION: I here6y aflirm tlwt I am Iicenu0 wAer Drovisions oi Clwpter 9(commencinp wR� Seciqn
7W0) of Oivision 3 0l the Business anA Pralewions CoOe. and my Iicense is in lull lorce and elfecl.
cinr��014403 sr�reuc.:1206 cuss:C-20
?2\ q^ �7 s ure:
,ceas� wrnr�xsanox oecuxnnox: i eq� arc� ai i nave a uwicaro o� ca,um io uai��ure or ce 'naie m wan�ers
I Compenution �s�+ a9c� gr �cgnip� copy I�ereo� (SecOon 3800, Lab. LIO I O 1 I 9 O
icvxo.: TRANSPORTATION �P'O�TE: 1
IMPANY:
I� Cenifie0 copY is AereEy fumisAetl. L� Cert� y �s i tl with tAe dry Builtlin0 DiWslon.
Oate: �— r���v Pnnrnm� ��� �`
E%EMFfI�X FlIOM V/OPKEPS' COMPENSITION OE ION: (Ihis uctian nee0 rot Oe campleteE i pe it' lar oire �undred �S10U) rc lar�.
I certity that in t�e Dertormance of the wark far w�ic� this Dermit is issue0, I s�all not employ pers ' any mannar so as ro Uecame
� SUEject to the Workers' Compensation Laws ot Califamia.
Date: SIO�ature: '
NOTICE: II, aher malmi0 tAic Eeclaratian, you ShoNE Eecame wEjep ro t�e Workers Compensatlon D��� a� Ne Labor
CaEe, you must IonMrith camply with wcA Drm�ions ar ih¢ permi� 51WI Ee EeertceE rewYSE.
LONSTBUCTION IENDINO AGFNCY: I �eaby aifirm IAat tAere a a wnsWcqon IenEinp a0ency lar the petlormanca ol tAe work lor
w�ich tAis Dermft is issued (Sectian 3097, CN. C).
IENDEfl:
— �noeess: +
. OWNEB BWlOEB OECIAMTION: I �ereCy atfirm that I am exempt tmm the Coniractors' State License Law lor the lolloxinp reasan
'(Secnon 7031.5 Business and Pmleuional CaOe: My nry af counry w�ich reQuires a permit to mnstruct, alter, improve, Eemolis�, or
apair any stmcture, prior la its issuance, also aquires the apDlicant lor such Dermit to file a sipne0 statement IAat he/s�e is IicenseE
•�suant to IAe pmvisions'oi the Camracmrs' SWIe Licenu Law (C�apter 9(cammencinp with SecGon 7000) ol Oivision 3 0l Ihe Businea
Pmfessions Cotle) or ihat he/sAe ls exempt thereirom an0 tlre Oasis tar IAe allepe0 exemptian. My violation ol Section 7031.5 Ey .
, ap0licant lor a permil suEl� �� aVP�w�� �o a cMl penalry of not more than frve huntlreE OOIWrs (5500�.
�� I, as owner ot Na propeM or my empIryces wit� wapes as Neir sole compensatlan, vnT Oo ttre work, anE Ne
� structure is not intenOeC or oHereE 1ar sale (Sectim 70M, Business anE Prolessional Code: Ttu Cmiractors' State Lkenu Law
Oces not appN �a an mmer al a Dmpe�ty wAo EuilEs or improves IAereon, anE who tloes suc� work �imSelMerself or thmup�
his or her own employees, provitled tAat such imD�'ements aa noi IntenEeO or offeretl for ule. 11, howaver I�e huilain0 or
impmvement is sold vnt�in one year of comDletion. the owner will �ava tAe hurtlen of D�'in0 Ae/she UiE not bui10 or Improva
fortAe ourpose ol ule).
1, az ovmer of Ne pmperry. am ewclusively conlracGnO wdh Iicense0 contactars ro consiruct t�e Drajep (Saction 7044, Business
❑ - anE PrMusions CoOe: The Contractars' Sfate Lica�Se Law Oces not appty to an ovmer of Droperry who CmIOs or improves therean
anA who contracis for sucA projxts ciN a contractar�s) license Oursuant to the Contractars' State L¢ense Law). I am awam
tAat proof af their Worker's ComOensetion insurance sAoWE Ee pmvitleE to me.
.� I am exemD� unCer Section: � B. 8 P. C. �
for ItliS reasan:
Date: Oa+ier.
I do IureEy ceniry tAat I am aware ol anE unGerstanA t�e repuiamenis of Calilorttia Heatth antl Salery COEe Sectlons 25505, 25533, aM
T5534 an0 t�at I ar any imure builOinp ottupan[ wilVwill no� (cirde one) nee0 ro rnmpty vnth ui0 sta[e atles anE Ne reQuiaments lor a
permR Por constmctwn or mo0ifiwtion iram ihe Nr �ualiry ManaBement Districl. HesiOential construdion applications ara exempt imm
�heSE D�5ion5.
Da[e: ApD�iwnt
I here0y ceNy itwt I �ave aaA INs aDDlication an0 state Ihat IAe a6me inlormation is conep. I a0�ee ta campty wit� all ciry an0 counry
or0inancesanUstatelawsrelatinptahuilAinpcanstmctionan authonzerepmxntatNesolthiSCAyroeMeruponlhea6ovo-menOoneE
pmperry lor inspactian purposes. , �
Dmrer's uunse or Socw Secunry »:
�'—•^at!6 ��ita--Buiqi�p: Oreen—CoOa Enlorcement: Canary—PpPlkant: Pink—Revenue: GOWanrotl—Avmaor
__.' _ � ' •���i'`----
. . .�
CITY OF COSTA MESA — BUILDING PERMIT PEAM NO: M 048866
PERMIT NO; M 048866 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE; MEC PURPOSE: ALT
JOH DESCRIPTION : T.I. OFFZCES SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H-2 /
COMMENTS: REF B48775ES
*�t**�t*x�x�x�**�r*a**�t**+t**�*�**�*�r*+�**�t**�tx�***�*-x-*�+�-�t**��*�*�t-a�*****�t�t-�t�t�r�x��t-�t*�t-x-*-x��t-��t
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT ZN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
>
-iF iE �E it iE M 1E it 3E iF iF it if iF if iF iE iE iF ik i! iE iF ik iE iE iE 3E iE iE ic jE iE it iE jF iE3E iE if.iE iF iE if iE iE it HE iF iE it if if 1F iE ik if if iE iE iE ik if iF it it iF if !t iF iF it 9E it iE iE if 3E iE
��:. D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
i .
tZONING APPROVED HY � DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED HY. DATE: � ��J'g D
iEfEifiEfE*iEjEjEik9FiFiE3EiE3fiFikifiFiEii3FiFs iF�F�' ..., n+� � - F�'iF'�iF�tiFiFikiFiFifiElEaF��ikjEjE
ifjEiEiEiEiEl:i6ifiEiEif�iEifjEiEiEjE3EiE*itifiFifitifiFiFi iE*.' .. +v rtFiF iEikiE*ihiFiEiEiEiE3Eif9EiEitiE1F3ljfiEiEiEiEiEif�EiFiEifiEififif�iEjFi(-
LEGALIZATION;N F'E E S U.9 M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAAUING
PERMIT 61.50
25R SMIP/NON—RES
'ISSUE FEE
HUILDING—DIV—>
TOTALS---->
15.00
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
61.50 15.00 0.00 76.50 76.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 76.50 OVER/SHORT: .00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
76.50
ik 3F if ik iF if iP iE iE iE iE iE iE ik iE �E iE �E it iF if 3t ik iF iF ik jf iF iF iF iE iE iE iE * if iF jE if iF iE jE �k i4 �E jE �E 3E 3k iE iE * iE dE ff if iE aE iF iE iF 3F it if dE iE iE iE �E iE iE �F iF iE �f iF aE ak iE
I N D I V I D U A L F E E \ H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT HEATING UNIT/SYS W/CNTLS 9.00 9,00
MEC 6 VAV BOX 6.50 39.00
MEC 3 FIRE DAMPERS 4.50 13.50
END OF FEES
h .
✓
01 OOOe$931—GQ066931 T G Y r5,?d
DATE: 09/U4/90 TIYE: t4a41
-• CONSTRUCTION AND PLA JG - ,� -L & 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 Condui[-Undrgrnd. 55. Electrica� Bonding
5. Steel Reinforcement . � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. _. 57. APPROVAL TO COVEfi�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. ' 60. Backwash Lines, P�7rap, O Undrgrnd. �
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap - . 63. Heater & Vent-Final -
13. Root Drains � 64. Plumbing System � Final
14. Rough Plumbing � 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solaf 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. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning Q� FIRE DEPT. REQUIREMENT
20.� Rough Factory Fireplace APPROVALS Permit #
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 7ank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling IStructurall & Monocoat - 75. Dry Chemical
Z7. 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 CERTIPICATE ISSUED
33. Final Electric ' `t,i� Notes:
34. Final Heating & Air Conditioning a,- 7� p� �
35. Final Gas Pipe-Test y ��'
� �f �1 /.
36. Hood or Canopy '� f%
37. Pinal Factory Fireplace •'��
:.
38. Final Plumbing V� �
39. Water Service�Final � '
40. Gas Service-Final �'
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
4a. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
r
47. FINAL STRUCTURE & BUILDING ..
48. FINAL PLANNING ry
49. Electric Release to Edison „
5�. Gas Release to Southern California Gas Co '�
51. CERTIFICATE OF OCCUPANCY
No. Date
'PH0.IECTRODHESS: SSS ANTON B1, uxrt: 350
owxersn►Me: SECURITY PACIFZC NATL BNK
�F�` 555 ANTON
� .
j 957-1489
p9CIUEN0INEER: REO.NQ:
� RODHESB: UNR:
PE"MmEE'WESTERN SUPPLY CO. (213)633-0511
nooxess: 15510 ILLINOIS AV
PARAMOUNT CA 907�3
LICiNSEO CONTMCTOP OECIAMTION: I Aerehy atlirm that I am licensed under Drovisians o C apter 9(commencinp wi�� Section
7000) of DiWsion 3 al Ihe Business anE Professions CaOe, an0 my licenu is in lull torce an0 effect.
i CITY LIC.: STATE LIC.: C1A33:
0,4<6021 91621 �� C-36 /
Oate: �// Signature:
WOHKENS�COMPENSRTION DECIAMTION: I �ere6y affirm [hat I tuve a ce�ilicate ol cansent to sell-insure ar a certiliwte of Workers'
ComOensation Insurance, ar a certilietl copy t�ereof (Section 3800, laE. C�.
Poucvxo.: gWC194625 FxP.o"7E: 01 /01 /91
'MP^"'' HIGALANDS
CertilieC copy is AereEy fumishe0. � CeNfieE coDY is liletl wtth ihe ciry Buildinp Division. �
Date: Applicant ��/ �
E%FMPfION F OM WOXKEBS' COMPEN&1TI0 OECWUTION: (ihis xcuon nzE not Ee comDleteA ii Ne permi is for oire hunEred (E1U� or kss�.
I cetlity tAat In the Oehormance oi the wnM for xTich lhis parmd is issue0, I shall not emDloy any person in any manner so as to becortre
suhlect to the Workars' Compensation Laws al Calitomia.
Oate: SiqnaNre:
� NOTICE: If, alter makinp tAis Oeclaation, you should bacome suhject ta ihe Workers' Compensauon Drovisions oi Ne LaUor
CoOe, yrou must lorihwith comDly vnih such provisions or this De�mit shall be UeemeO revok¢d.
CONSTBUCTION LENOING �GENCY: I AereUy ailirm IAat thera is a constmction Ien0in0 aOencV �or Ihe pedormance of IAe work tor
whicA this permit is issued (Section 3097, Civ. C�.
LENOEH:
RODflE88: ' '
OWNEB BUILDER OECIAMTION: I hereby aflirm tAat I am exempt Imm IAe Coniractors' Stah License Law tor IAe lollowinp mason
(Section 7031.5 Business antl Prol¢ssional CaOe: My ciry of counry whic� reduias a permit ta constmct, altar, ImDmve, demolisli, or
repair any stmc�ura, pdor to As issuanca, also 2qWres the applicant for we� permit to fila a 5iqneE statement ihat �e/she is Iicensa0
pursuant to tAe D�ovisions ol t�e Contracrors' State License Law (ChaD�er 9(commencin0 with Section 7000) ot Division 3 oi t�e Businesc,
antl Pmlessions CoOepor t�at he/sAe is ewempt Iherelmm an0 Ihe basis lor t0e alleqed examD�lon. Any Nolation ot Sedion 7031.5 Oy
any apDlicant for a Dermit SuElects ihe apDlicant to a civil panalry of not mare Ihan five AunOred Oollars (5500).
�
I; as owner oi Ne pmperty or my employees with wapes as t�eir sole compensatlon. wlll Oo the work, and �he
�� simcNra is not intenAeO ar atfere0 for sala (Section 7044, Business antl Professional Cotle: TAe Contrectors' State License Law
Ooes nat a00�Y �o an owner oi a D�operty who 6uiltls or impmvas thereon, anA wAa daes such work himseli/hersell or throuq�
his oi her own emptoyaes, provide0 t�at such impmvements are not intenUeO or oflere0 lor sale. If, however tAe EuilUinp or
impmvement is wltl vnihin one year ai cam0letion, [he ownar will Aava the hurtlen ol D�ovinp Ae/she did not DuiIE or improva
- for tAe purpose oi sale�.
I, as owner ot ihe DroparN, am eeclusively contractlnp with licensetl conlraRors ro construp the project ISectlon 7044, Business
❑ anA Pmfessions Cotle: The Cantracrors' state Ucense Law Ooes not appty to an owner of pmperty who Dullds or ImD�s Nareon
anU who conbacts far such projects witA a coniractm�s)license pursuant ro the Coniradors' State License Law),I am awam
Ihat Orool of Iheir Worker's Compensation insurance should ba pmviEeC to me.
� I am exemDt un0er Sec[ion: B. E P. C.
for �his reazon:
Date: Owner.
I Ao heahy certiry t�al I am aware af and undars�and Ihe reQuiremen�s af California Healih antl Safery COAe Sections 2550.5, 25533, ana
25534 anE that I or any INum builEinA occupant wiNwill nat (circle ane) neetl ro comply wltA saitl state codes anE tAe repuirements lor a
pe�mit lar consimction or motlification fmm the Air Oualiry Manap¢mant Oistdct. flesi0ential constmction applications are exempt irom
�hese O�ovisions. .
Date: � NDPlicant:
I Aereby canity tAat I ham reatl ihis aOUlication anE state that �he a0ove information is correct I apree to comDly wilh all ciry and counry
orAinances antl state laws relatinp to Euildinp consimctian antl �e2hy authonze reD�sentatives of this ciry to entar upon Ihe a0ove�mentiane�
praDetly torinsDection purposes.
f �
Dat�/�/'� SipnaNr�
� oriver's License or Social Security M:
186/J8 Whlte—Builtling; Grean—Cotle Enbrcement; Cenery—Applicent; Pink—Revenue; GolOanrotl—Asaeasor �
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: P 048924
PERMIT NO: P 098924 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMZT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION : T.I, OFFICES, REFER TO #H98775 SQ FT:
CLAIM VALUE: CALC—VALUE: . GROUP OCC: B-2 /
COMMENTS: T.I. OFFICES
*�t**�r****x�**�t*�r*�t�r�-�r�t*�t�r*****�t�rx+r-�t�t��-�tx-�t*�r*�r�*�t��r�r�t-�r�t�r****�t�r+�-�r�x-**��x��ft#�t*�r�--�t*�t*�r�x-
, Z O N I N G R E Q U I R E M E N T S �
s E T H A c x s
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN`
LEFT; FT IN RGHT: � FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL; 41050104 2NE: REF NO:
PLANNING Nt5TE5> '
>
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D E V E L O P M E N T S E R V I C E S';�-R E Q U I R E M E N T.S
ZONING APPROVED HY '' DATE:
:�_��� � A_�Z�!'�'j 3 5% ii�l�f � ��_C�
.�
DATE:
APPLICATION ISSUED BY: ��' DATE: q^1�— � D
iEifikiFifiFiffEikihiFiFiEiEdFitdkiFikifiEiEiFiFiF3fif3FiF3FiF3FiF7F��3i'���F'�F 3FiF 3FiF'iF��Fif3FiFiF3F3FiE3E3E1F1FiE*iEiFiF��iE�E
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LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT • 4.00
25$ SMIP/NON—RES
PLAN
ISSUE FEE 3.00
BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 3.00 0.00 7.00 7,00 ' ,QO
REVENUE DIVISION TOTALS--> COLLECTED: 7,00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK
7.00
iE �k i! iE i! iE if iF 3E iE iF ib if jf iE �f iE ik 9f iE iE it iE �k iF 1k iE ik iF dt iE iE iF iE i! i! iF if it ik �t iE iE ik 3E iE iF iF iE iE �E iE 3E 1E 9E 3E 3F iE 3E if iE iE iF it 3E 3! iE 3E 3f 3E 1E 3E it if iE iE if 9F 3E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY
PLU 1
PLU 1
D E S C R I P T I 0 N
SINK, BAR
WATER HEATER AND/OR VENT
END OF FEES
UNIT COST TOTAL COST
2.�� 2,0�
2.00 , 2.00
02 Ut1G69364—OGII69.254 "C�Q"i"
itNiE= G9i1S/9� TItiE: 11:33
7.D0
�
G(�$TRUCTION AND PLANNING � �� P� �' SP'0'
'+.. APPROVA'LS Permit # �Date Inspector ,qppROVALS Permit # Date Inspeitor
� , �
i: Temporary Electrical Service oi Pole:" �/ 52. Pool & Equipment Location /
Y
2.; Soil Pipe•Undrgrnd., _, '_,� � 53. Steel Reinforcement �
'�3: ElectricalConduif-Ufility•Undrgmd �-. 54. Forms - .
-�. �
4.�Electrical Conduit-Undrqrnd. ,�=� 55. Electrical Bonding �
l5t Steel Reinforcement � - 56. Rough Plumbing & Pressure Test ^
.�6. Electrical UFER:Grnd. �" 57. APPROVAL TO COVER-GUNITE _
i -
.^7: Footings - - � 58. Electrical Conduit�Undrgmd. �,� ;-
8.' Foundation � -�� 59. Gas Pipe, � Undrgrnd., Test �
9: Water Pipe�Und`rgrnd.. ' �-,=� ' ��!'� . � 60, Backwash Lines, P-Trap, � Undrgrnd. �� t�
70. Structu�al Floor System � ����) �� i� 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � I
12: Sewer Cap " ^% '� � 63. Heater & Vent-Final
c -
13. Roof D�ains . , 64. Plumbing System ; Final
14. Rough Plumbing � 65. Electrical-Final _
15. Rough Electriral�Conduit � 66. Solar System-Final
16. Rough Electric Wiring � � - 67.'Fencing & Access�Approval
�77. Rough Wiring Si'gn . 68.�.APPROVED FOR PLASTERING
18. Rough ElectricaFT Bar Ceiling- �� � 69. POOL/SPA SYSTEMS FINAL _-
19..Rough Heating & Air Conditioning ,�n., ,�, ;,� .FIRE DEPT. REQUIREMENT .
- . , , j;Y Y -. .~ .. - t' .. .-1: :. *7 `
20. Rough Factory' Firepiace i � �-;:� ;. `� .i �+:-r. APPROVALS�t•-��Bermit# -
- � -, s �
21.•Ducts,in.Structure. . "' - = -' � �
- _ „ .� . # 70. Underground Hydr,o .
22..Ducts,VeMilating,y ���- "'" - , +� � =71. Product;Pipin9L7Ga's ❑Oil
23. Gas Pipe;Qough & 7est , �.�„ . , ,?� �� T � . , _7y, Underground�Flushf' -_ _
24. Roof Framing� ��� - . r ., � ,73.�Undergmd✓Storage%T.ank C]Gas ❑Oil
�
25. Roof Sheathing � � � � 7q, Overhead Hydro
26. -T-BacCeiling (Structural) & Monocoat .: f1 '. J '��_ �� 75.:Dry Chemical . � '
27.��FrameandFlashing = ' " �-� 76. DryStandpipe ..,' � .
�.
.28. Lathing & Siding �; � �� -� � 77, �.FIXED SYST�EM�FINAL ' - ` -
�FIRE PREV. FINAL• ' �
29. Insulation - -� " `� ` ' • 78..�„ � '�
30. Drywall Nailing . _. . ;� f. i � ;-:o i -HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat -- ` � ,��� ; '� � ' ' ��79. FINAL INSP�ECTION _
;32.:Electricsl Power Mefer-Final � � . . "80. �FOOD CERTIFIC�ATE ISSUED +
��33. �Final%Electric' � � . " r �, � - � '� "
�� 7 ' y� :'� Notes: `7 ..
�� i r G:: �
.34..F.inal Heating & Air Condi'tioning ' "� � � _ -� ., " _ ' . �
35. Final Gas Pipe-Test - - � " ' ="� = - '
� .
�36. Hood.or Canopy ,' ;p. �, . ' � " . ,�-'o ,, .-
�37. `Final Factory Fireplace_ =� � �` ~-� ' � � ' •
-� y .r
'38. Final�Pl�mbing ' �, � �' O (�� + . - "- . `
39. Water S¢rvice-Final ^ : ' . -
i
40. GasService-Final . � .' `
41. Solar pomesticFinal � . . - �.
42. Backflow Preventer
43. Backflow Irrigation '
44. LandscePe Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STftUCTURE & BUILDffVG
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas RelBase to Southern California Gas Co �
51. CERTiFICATE OF OCCUPANCY
No. Date
7flEJECT�DORE33: SSS ANTON HL uxrt: 350 CITY OF COSTA MESA — HUILDING PERMIT PERM NO: E 048835
OWNER'SNRME: SECURITY PACIFIC NATIONAL -
�noo'xess: SAME PERMIT NO: E 048835 PLAN CHECK NO: N GOVT: N SUPP: N
957-1489
RflCHIENGINEEN: Z NTERN I b ES I GN HEO.NO.: C O O �
aoowess: S PAFtK PLAZA �NR� 750
IRVINE CA 92719
PEflMRTEE: HUTCHISON CORP ( 213 ) 763—'/991
nooxess: ZZ50 5 CENTRAL AV
RANCHO DOMINGEZ CA 90220
LICENSED CONTMCTOB DECIAMTtON: I hereby attirm that I am IicenseU unGer proNsions ai ChaD�er 9(cammencin0 wi[� Sec6on
7000) al Division 3 oithe Business anA Proi�ssions Coda, and my license is in tulltorce anA eRect. -
cmuc.:0�32�±7 �ra�269512 c�ss:C�� �
^+te: �y SipnaNre: �� � !T�
NKEBS' COMPENSATION DECIAMTION: I �¢reby affirm ihat I have a certilicate oI conse t[ tl-insure or a certiticate ot Workers'
,n0ensationJnsy�3pcb p��certifeA �wDY Ihereol (Section 3800, Lab. �
I� Po�CY NO.: W l. Y U / 4 L �7(P. DATE: Z I O 1 I 9 9 _, -
�rnraxr: GREAT AMERICAN
CerlitieE coDY is hereby fumishe0. d Certitietl copy is filed witA the ciry BuilEi q s.
Date: �— � I r � �lpplicant: ��� ��i /,
E%EMPTION FBOM WOPNEBS' fAMPENSRTION qEC1AHATtON: Qhis sectlon need not �e com0letetl if ihe permit is fa ane hundreE (5100) ar less).� �
I cetlity that In the petlormanca ol Ne work for wAicA this De�mit is issued, I sAall not employ any person in any manner 3o az to 6ecome,
sublect ro Ihe Workers' ComDensa[ion Laws of Calitnmia. .
f�
Oate: SiOnature: '
NOTICE: tl, aher makinq lhis tlecla2iion, �
you shoul0 become suble�� �o �Ae WaM1ers' Compensa0on provisions of the Lahor � �
COGe, you must totlOwitA comOW ��� such Drovisions or Ws permit shall Ge Oeemed reroketl. .
CONSiqOCTION IENUING AGENCY: I �eaby attirm ihat ihere is a construction lentlinq agency for ihe perlartnance al tAe work tor �
w�ic� t�is Dermi� is iSsueE (Seciion 3097, Civ. C). . �'l
LENUEH:
IIODPESS:' . . ✓ � � ,• .��
IOWNEB BUIL➢FB OECUMTION: I �erehy attirm ihat 1 am exempt from t�a Contractors' State License Law for the followinp reazon
(Section 7031.5 Business and Pmhssional Caee: Any ciry at counry which requires a Oermit to construct, alter, improve, Aemolish, or
repair any s(ructure, D�or ro tts issuance, al5o requires t�e applicant for such permit ro file a signetl statement that he/she is licensed
pursuant to t�e Orovisions oi the Contractors' State License Law (Chapter 9(commencinq with Section 7000) oi Oivision 3 oi ttu Business
^nA Pralessions CaAe) ar Ihat �e/sAe is exempt lherefmm and the Oasis lor the allepeE exemption. My violaUon ol Section 7031.5 by
� aD0licant lor a permit su�lecls Ihe aDD��Cant to a civil penalry of not mam ttwn iNa �un0a0 Uollars �55W�.
-. I, az owner oi ihe pmpe�ty or my ¢mployees vnth waAes as Iheir sole compensatlon, will Eo t�e waA, and the
V I i� stmcture is not intenUeO ar ottereA lor �le (Secnon 7044, Busmess anU Pmfessional Cotle: The Coniractors' State Licenu Law
Coes not apply to an awner of a pmp¢�y who builds or improvas thereon, and who Aoes such �mM �imsell/herseli or tArough
his or her own employees, pmviOeA that such imDmvemenis am nat intended or ofle2E for sale. II, Mwaver the huil0ing or
impmvement is sold wiNin one year oi completion, IAe awner will have ihe 6urtlen oi provin0 Ae/she UiU not builC or improve
�or the Durpose of sale). .
I, as owner of iha Ompetly, am exclugively con[ractinA �h Ilcense0 contracmrs to wnstmd Ihe Omject (Sectlon 70A4, Business
❑ an0 Protessions CoAe: The Contractors' Sta[e License Law Ooes no[ apDly to an owner of properry w�o OmIAs or impraves thereon
anE wha cont2cls for suc� pmlec[s witA a con[actor(5) license Dursuant to Ihe Contactors' SWte Licensa Law). I am aware
that pmot of iheir Worker's Campen�tion insurance should Ee proNAetl ta me. "
� I am exempt untler Section: B. 8 P. C.
lort�a reason:
Date: Ownec
I tlo hereby certiy I�at I am aware ol ana untlerstantl the requiremenis of Calilomia Heali� anE Safery CoEa Sectians 2550.5, 25533, an0
2553< and that I or any fNure 6uilAinA occupqnt will/wll not (circle one) neeU Io comply with saitl state cotles anA ihe repuiremenis tor a
permit lar constmction or modification irom �he Nr �ualiry Manapement Oisirict. Fesitlential constmction apDlicaiions are exempt fmm
these Dmvisions.
Oa�e:- Applicant:
I AereCy ceniry ihat I have read this apDlicatipn antl state ihat the a6ave information is wrrect I aAree to compy wit� all ciry anE counry
oNinancu anE state hvrs relalinq to OuiWinp construc6an antl herehy aulhorizg repreum t ciry 10 enter upon Ne above�menGonetl
m
pmperry tor inspection purposes. (� `�
' Date: ��� Si9naWre: " � ���
Ionver's License or Social Secunry x: '
i.,� i841-46 W�ite—BuilCing; Green—CoOa Enlorcement; Cenary—Applicant; Pink—Ravenue;
CONSTRUCTION TYPE: I—FR PERMIT TYPE: ELE PURPOSE:'OTH
JOB DESCRIPTION ; ELECTRICAL FOR OFFICE T.I. SQ FT:
CLAZM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: H-48775
�*��****�r�r�r���r*�r****�***�r�r+�*******� ��r� *+�****�*******+�***x�*******�r**�+��r+���*��r***
Z O N I N G R E Q U I R E M E N T S �
S E T H A C K S
------------ MAIN bU2LDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARICING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES> :
>
ik iE �1E iE �1f it i(- ik ik iE �lE #�Ik iE jE iE ie� iE iE_iF-iE iE �E 3F if �F.�1F �H�'iF 1f iE if iE i6 iF if iE iE �lE iE iF �)E 9E 9E it iE if 3E dE iE iE 9E dE if iE �f 3F 3f tt if iE it 3E ip if iE if iF * lE ih 1f ib it dE iF iF i(� �1f
D E V E L O P=M E N_T' S E R V I C E S R E Q U I�R E M E N T S
l.
ZONING APPROVED bY %?: '- DATE:
BUILDING APPROVED BY :' .�' . DATE:
N- �' I.� �'��//
APPLICATION ISSUED BY: � DATE: ����Y�����
iEiFiE�F�likif��FjFiFdfiEitif3fiEiE3i�i4'�E�lEik�... 9EiEiE9FiEdE3EiEjE* iEiF
iE IE iE iE iE ik 9E iE 3F �E jE dE jE if if if iE iF iE iF if �E i(-9E iE 9E 3E iE �E iE if iF if IE jf iE iF if if if if if iE it iE i4 jE iE iE iE iE iF 3E 3E 4E iF iE 3E iE iE iF 3F iE �1F iE iE # iE aF �74 * 3f jF �F iE dE iE iF iE
LEGALIZATION:N F E E S U M M A R Y ' STRUCTURAL SEGMENTeN
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 65.90
SOk SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 65.40 15.00 0.00 80.40 80.90 .00
REVENUE DIVISION TOTALS--> COLLECTED: 80.40 OVERISHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
80.40
iE �t iE iE �t it iF ik dE df iE it k!t ik iE iE it jE iF ik it iE it it ik iE iF 3E ik it if jE iF iF iE if iE 1E 3f iF iE iE ik if �E ik �E if iE iE �1F dE it k dE IE 3E �E iE iE if jt iE ik 3E iE iF it itlF it iF jE iE iE iE iE iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE (aTY L1 E 5 C R I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA, .75 15,00
ELE 22 FIXTURES, LIGHTING ADDITIONAL EA. .45 9..90
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 40 RECEPT/OUTLET ADDITIONAL EA, .45 1II.00
ELE 10 RECEPT/SWITCH 1'ST 20 EA. .75 7,50
END OF FEES
ot onaEs�ss-oaoba�9� -��-s- ;:,�.•:�
ttATE: C�&!3t'9Q Tii�E: 'J�:2;e
+ CONSTRUCTION AND PLANn...G `� �' SP�' �
+ Date Inspector Date Inspector
APPROVAIS Permit# APPROVALS Permit#
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
.,
Z, $oil Pipe-Undrgmd. � �- 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. Efectricaf UFER Grnd. 57. APPROVAI. TO COVER�GUNITE
7. Footings - 58. Electrical ConduiFUndrgrnd.
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 ��
73. Roof Drains 64. Plumbing System � Final
14, qough Plumbing 65. Electrical-Final
15. Rough Electrical�Conduit 6. Solar System�Final �
16. Rough Electric Wiring �,!� , encing & Access Approval
17. Rough Wiring Sign � � . APPROVED FOR PLAS7ERING �
18. Rough Elecirical•T Bar Ceiling 9. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning � . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � - APPROVALS Permit #
21. Dutts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank Q Gas ❑ Oil
25. Foof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. FrameandFlashing �� 76. DryStandpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing a HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final � 80. F000 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 pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
. 44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Fegulations
47. FINALSTRUCTURE&BUILDING _
48. FINAL PLANNING
49. Electric Refease to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
��
0
PflOJECi PDOflESS: S S J AN i ON �L uxir: 3AD
OWNEfl'SNAME: HANK OF AMERICA �
�ooxEss: 20 N RAYMOND AV 3RD FL
PASADENA, CA
818-578-7700
FNCN/ENGINEEX: RAY HERBOLT PEG.NO.: C S 1 O% 3
nooeess: 22072 CAMINITO VINO uNir:
LAGUNA HILLS CA 92653
PEflMITTEE: ARMSTRONG CONSTRUCTION ( 818 ) 967-8001
ADDPE55: 9%�i SPRING MEADOW DR
WEST COVINA CA 9179]
UCENSEU CONTBRCTOfl OECIAflRTION: I �ereGy aHirm Ihai I am Iicen5e0 un �apter 9lcammencing wi�� Sec�ion
7IXq) ol Divisian 3 0l ihe Business an0 Prolessions Code, and my license i fulP�orce antl efle .
ciTruc.:056871 srereuc.:4340a�7r1 (��) s. —1
Oate: ry/��' ��— .SignaNre: �W?Q,. . _ - _ — —'
WOBNEB$'COMPENSRTIONOECUBATION: Iherebyaf7irmlhatl�aveacerliliCat¢o�consenliosel � sure a ertificateolWorker5'
comoensation �iycuLw�ei o� �cr.�t�iea coov ��ereo� (Section 3800, �ao. ��S / O S/ J 3
roucrr+o.: REPQBLIC INDEM E%P.ORTE:
COMP�NY:
�� CeM1ilieO copy is hereEy tumiS�eA. � Certilie0 copy is fileA vnt� ihe ' Builtling D' sion.
Uate: 9 f ���� pODlicanl:
E%EMPTIONFBOMWOBKEflS'COMPENSRTIONOECLAflATION: RhisseclionneeAno�becomplete0ilihepe islmo hunUreU�510D�orkss).
I cenily t�al in ��e pedormance ol IAe wark for which �his permi� is issue0, I shall not employ any person in any manner so as to become
suGlect lo Ine Workers' COmpensalion Laws ol Califomia.
Dalel SignaNre:
NO710E: II, alter making Ihis Ueclaraiion, you shoultl Oecame suEle�� �o t�e Workers' Compensation pmvisions of ihe Lahor
CoOe. you must fonhvnt� wmply wit� suc� prnvisians or IAiS OQ�mii sAall �e Oeemed revoke0.
CONSTflUCT10N LENOING RGENCY: I he�¢by afiirm thal there b a COnSimClion IenGing age(u,y �or lhe pCAOrmante ai t�e work lar
wnich I�is oe�mi� is issue0 (Section 3097. Gv. C�.
LENOEN:
aooRess:
OWNEB BWLOEB OECLABFTION: I hereby afiirm �hat I am exempt Imm tAe Contractors' State License Law for the following reason
(Section 7031.5 Business an0 Prolessional Cotle: Any ciry oi county w�ic� requires a permit to con5iruct, alter, impmve, demolish, or
repair any simcture. prior to its issuance. also requires Ihe applicant for suc� Oermit to file a signe0 statement tAat �elshe is licensetl
pursuanl 10 Ihe pmvisions o� t�e Conirac�ors' Sta�e License Law �C�ap�er 9(commencing with Sec�ion 7000) al 0ivision 3 of Ihe Business
anO.Vrot¢SsionS CADe) orl�ai he/S�e is exempl IAeretrom an0 Ihe OasiS �or Ihe allegetl e�emp�i0n. My viola�ion ol S¢t�ion 7031.5 �y
any aDVlicani for a permii su61��s I�e aD����ni lo a civil p¢naliy of nol more Ihan �ive �unOretl Oollars (SSW).
I, as owner oi Ihe pwDeny or rtry emyloyees with wdqes as Iheir Sole compensatian, win Oa tlle woB, an0 t�e
❑ siructure 6 notintendeU or ollere4far5ale�5et�on 70E4. Business anA Pmfe55ionalCotle: T�e fAniractors' State LicelLte Law
Eoes not aDDN �o an owner ol a Dmpeny who butlAs or impmves tAerron, anU wlw tices such xrork �imselimersell or tAmupA
Ais ar her own emD�oyees. D�ovide0 ihai such impmvements art not intenUed or atfereA lar ule. If. Aowever t�e DuilUinp or
imOmvemem is so10 within one year al campletion, Ihe owner will �ave ihe bur0en oi DmvinA he/she Uia nol buil0 ar imDmve
lor ihe purpose ol sale�.
I, as ownerol �he proper�y, am exclusively contracting with licensetl contractors �o cons�mc� �he pwle�� (Sec�ion 7044, Business
❑ an0 Pmtessions CoOe: TAe Conlractors State License Law aoes not appty to an owner af prooetly wno Uulltls or improves tAereon
antl w�o contrans �ar such pmle��s wil� a conVapor(s)license Dursuan� to Ihe Contrac�ors' State License Law�. I am aware
ihat proot oi their Warker's ComDensation insurance shoultl be O�oviOed to me.
� I am e�empt unGer Seclion: B. d P. C.
lor �N5 reason:
Daie: Umer.
I ao nereby cenity that I am aware ol ana un0erstand ihe requiremenis ol Califomia HealtA antl Salery CoOe Sections 25505, 25533, an0
25534 antl Iha� I or any fulure building occupant willlwill no� (circle one) need lo comply wi�h said s�a�e co0es antl t�e requiremenls for a
permil lor cons�mclion or moUilicalion �mm �he Air �uali�y ManaBement OisVicL Resitlential cons�mc�ion applicalions ar¢ exemD� ��om
IhCSC pfOV1510115. .
Oale: Applicant:_
I �¢reby ceility I�aI I have r¢aa IhiS a001iCalion antl S�at¢ (hat t
ordinanc¢5 an0 slaie laws reW�ing lo DuilOinp COr6VuciiOn anU �e
pwperly tor insp clion purposes.
Uate � Signamre. _
oriver's License or Socia� Secmiry x:
lo tomDty wiltl all tity anE touniy
(o enter upon Ine aDwe-menuone0
I6nP4fi Whne—Builtlinq: Green—CoOv EnlorcemenP. Canary—Aoolicanl: Pink—Revenue�. oldenro0—Assnsxnr
CITY OF COSTA MESA — HUILDING PERMIT r�x N�; a u5yi u
PERMIT NO: B 059]40 , l PLAN CHECK NO; 03445-92 A t, �; uri:
CONSTRUCTION TYPE: IFR SP' / PERMIT TYPE: STR PURPOSc; ALT
l�
JOB DESCRIPTION ; 3950SF OFFICE T,I, SQ FT: 11,850
CLAIM VALUE: 50,000,00 CALC—VALUE: 72,127,00` GROUP OCC: B-2 /
COMMENTS; BANK OF AMERICA 3RD FLOOR T,I.
****�r�* ��r��**� ***�r�r�r*x *�****�****�r**��+��***�r***�*�*x�*x+�+��r*�r**�*+�**********x �r#*#
Z O N I N G R E Q U I R E M E N T S
ssrsAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT'; FT IN
PAFi'KING REQ• PROV: PARCEL: 41050104 ZNE: PDC REF NO•
PLANNING Nf51'ES> TENANT IMPROVEMENTS FOR THE 3RD cLOOR OF BANK OF AME�� CA
> HUZ:LDING � %
���*��.��*���.�*****�*��*���-�*��,��*���,�.�*�-,�**��.���-*,�,���x.���.���*�x.��.*�,���.�,�����*.�.
D E V E L O P M E N TD S E�R•;V I C E S:�' R E Q U I R E M E N'� S
20NING APPROVEA BY.. • �p� /6� �y� '�." DATE: —��'%�/�2..Z
BUILAING APPROVED B A; S f i DATE; .
o � .= 2
APPLICATION ISSUED *B•Y: - ,.: — DATE; �7`T /S� /`�
iEiElfifiElkiEihiEifiEillFiEfklElEifiF3Fil�ik se � � x 1kiEifiEjFififlfifiF -,r x ##
ifiElEifiEiEiElEiflEifiFiFfF1Ei'riEi4lFJiEfEiE�EiE�IF1f-�lFiE1klf1ElEifi4,kif9fjE�F3fiFlf.l� xif�i4iEfEiEltf4�IElE-%��%#�iE3kiE3Fi(-#'lHE�Fik'�IE3Fif?EifY-!ElEif3E
LEGALZZATION:N F E E'� S U M�M A R Y ST�iUGYUR'$L� SEG,+4ENT;Y
<< �
HLDG PMT PLIIMHING ELECTR`�C MECHANIC FIRE ISMI /RE5`�' GRADING
PERMIT 518.00 , ' % /SMIP/NON-gES
/ .
PLAN 84 ..1 8 � -� f( �i15 .�15 � �
ISSCIE FEE � "
BUILDING—DIV—> PERMIT ISSUE PL'ANrCHECH TUTAL PAID � DUE
TOTALS----> 533. 15 0.00 % i84 , 1"8 617, 33 61Y.,9� ���' , 00
REVENUE DIVISION TOTAL5--> COLLECTED:,—i 533.15 OVER/SHORT:�� ��� 00
B1,DG PMT PL[JMBING ELECTRIC MECi�ANIC-. FIR� SMIP/TOT GRADSNG piAN—CHECR
518.U0 15,15
� V• ' i
�x*�x**x*�*x��*��*�c�*****+c•�**u*����*� i�*�**x*x��*�*�*r-�r�r�r*})�*��***��r�***���x±�**�**
I N D I V I D U A L ''F E_E/ B R E A K DI O W N��' �
� i% � �
TYPE QTY D E S C R I P T I.O jv f% UNIT COST '1 TOTAL COST
SFC 3950 OFF—ZNT, ALTER TYP,E { I3' F,R, —AVER 17.24 �� 6�8,098.00
SFC 3950 EQO—ALT COMM. SPRINKL�R;SYS —AVER ,,33 �w 1,303.50
SFC 39 i0 EQU—ALT COMM. AIR ,CONp '/ —AVER � ,69 �,5- � �2,%25.50
E}JD O�'=rFEE5
�� 't �
it �" \ � !
1
\
'; . . �`•��✓ i, . .
. _ -i ,:. .. .
/
CONSTRUCTION AND PLANNING � FOI. _ s SPA
APPROVALS Permit # Date Inspector qppROVALS Permii # Date Inspector
i. Temporary Electrical Service or Pole - 52. Pool & Equipment Locatio� ._
i.
2. Soil Pipe•Undrgrnd. •-- 53. Steel Reintorcement � �
3, Electrical Conduit Utility•Undtgrnd. � � 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Piumbing & Pressure Test
� 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE _
7. Footings � 58. Electrical Conduit�Undrgrnd. '-
@. Foundation , '-! 59. Gas Pipe, � Undrgrnd., Tesi '
9. Water Pipe-Undrgrnd. � '� 60. Backwash Llnes, P�Trop, � Undrgrnd.
10. S[ructural Floor System . ,� - 61. APPROVAL TQ DECK ' �-
11. PropertY Sewer Line &' Ho05e Connection` ` 62. Backwash & ReceptorFinal , '�
72. Sewer Cap -' 63. Heater & Vent•Final
13. Roof Drains - �� � % 64. Plumbing System - Final �--
�_
14. Rough Plumbing � � ` ' 65. Electricai-Final � �
15. Rough Electrical-Conduft �_ -- - � 66. Solar System-Final �
16: Rough Elec[ric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOL/SPASYSTEAIS FINAL
19. Rough Heating & Air Conditioning " FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure � 70. Underground Hydro
22. DuMs, Ventilating 77. Product Piping OGas ❑Oil
23. Gas Pipe•Rough & Test � . 72. Underground Flush
24. Roof Framing 73. Undergrn�i. Storage 7ank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing q G� 76. Dry Standpipe
28. Lathing&Siding � �' 77. FIXEDSYSTEMFINAL
29. Insulation �� _ 1 ; � 78. FIRE PREV. FINAL
30. Drywall Nailing ��- ���� NEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ! „i 79. FINAL INSPECTION
32. Electrical Power MecerFinal � j � '; 80. FOOD CEFTIFICATE ISSUED
i"
33. Final Electric �3.�y, �. Notes: / �.r�•_% 1�0 �
� C�/�v/ �r e -r__. rMnY _ YKd
34. Final Heating & Air Conditioning ��,p� G.�' �M ,-�0��-_ _ /
cF , ��a� ���-�`r�Si�6��
35. Final Gas Pipe-Test . •; � �-
/c'-6 -p' -
36. Hood or CanoPY `'�- �� SU�% `I ?��\ )
37. Final Factory Fireplace ..
38. Final Plumbing 't' �..fJ (��.'O
L
39. Water Service>Final � �,
40. Gas Service•Final
41. Solar pomesticF�nal -
42. Backflow Preventer � . �
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation �,�, �Q���w� i� �
46. Handiwp Regulations � `��y � F�[/
R-"
47. FINAL STRUCTURE & BUILDING ���y � G.,.`(„
48. FINALPLANNING
49. Electric Release to Edison �•
50. Gas Release to Southern California Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
r—
PH0IFCT RDOflE55: �S S S ANTON HL
OWNEfl'SNRME: BANK OF AMEkICA
aooeess: 20 N RAYMOND AV 3RD FL
PASADENA, CA
�N�,: 3an
818-578-7700
IIBCMIENGINEEfl: RAY HERHOLT flEc.No.: C11073
nooxess: 22072 CAMINITO VINO uNiT:
LAGUNA HII.ZS CA 92653
PEflminEE: ARMSTRONG CON5TRUCTION ( 818 ) 9G7-8001
FDDflESS: 9z9 SPRING MEADOW DR
WEST COVINA CA 91791
IICENSEU CONTBACTOB OECIAHRTION: I herehy aliirm �Aa� I am licens ovisions ol C�ap�er 9(commencing with Seclion
7000) ol Oivision 3 of ihe Business and Professi0ns CoOe, and my lic se is in lull forc ellect.
ciTr�c. 056871 STATEUC.:4 �404
Da�e: � ���„ Signa�ure:. _ _ ' _
WOflKEPS'COMPENSRTIONOECIABAT10N: Ihe�e�yaffir�hatlhaveacertilicateo�consenuosel ms reo certi�icaleoiWorkerY
Compensalion y�$ ce a ieU coDY �heRollSection 3800, Lab.
POLICY NO.: �` l�� J�� E%P. URTE: S� O 1 I 9 3
comraxr: REPUBL"1C IIVDEM
❑ Cenili copy is hereby IumiSAetl. � Cehi�ied cop is �il �dmg�
-oa�e: 9 � _ Av7licam���
EXEMPfIONFqOMWOBKENS'fAMPENSRTI0N0ECURpTION: (Thissectionneetlnot�e[omple� - permi�Bi onehuntlretl�5lIXl�wle55�.
I ce�ily Ihal in ��e pedormance of I�e work �or which lhis Oermit is issuetl, I s�all noi employ any person in any manner so as �o become
su�le�� �o Ihe Workers' Compensa�ion Laws o� Caiilomia.
Oate: Signature'. �
NOTICE: II. al�er making �his tleclara�ion. you shoultl became su6leci to ihe Workers' Compensalion�pmvisions o� Ihe Labor
Code. you musi �anAwith comply wi�h such P�ovisions or [his permit shall be deemea revoke�. ��,
CONSTBUCTION LEN�ING RGENCY: I hereby al�irm �ha� ihere is a cons�mc�ion lentling agency �or Ihe Denormance af �he work for
w0ich I�is permit is issuetl (Section 3097. Civ. C). '
LENDEN: �''
aooness: .
UWNEfl BWlOEB DECIABATION: I hereby anirm inal I am exempt imm the Contractors' State License law for the followinp reason
(Section 7031.5 Business anA Pmlessional Code: Any city of counry which reQuires a Dermif to consimct, alter, imD�ove, Uemolish, or
repair any S�mt�ure, pnor to iis issuante. als0 reqWres ��e applitant for SUth permif to fiie a 5ignetl 5talement �ha� he/She i5 iiCensetl
pursuam to ihe pmvisions al ihe Contracmrs' Slais License Law (Chaprer 9(commencing with Sec�ion 7000) of Oivision 3 0l the Busineu
an0 Professions Co�el orthat he/sheis exempl Nerefrom and ihe basis for the alleAQO exemption. Any violation of $ection 7031.5 by
any applican� lor a De�mit su�jec�s �he apPlicant to a civil penal�y of not more t�an five huntlretl tlollars �5500).
I, as owner of the propeny or my gmployees with wages as ineir sole compensation, will Oo ihe work, and tAe
❑ siructure is not intentlee or olfereA for salR (5et�ion 7044, Business antl Professional Cotle: The Cantractors' State License Law
tloes not apply �o an owner ol a DmOehY who builtls or improves thereon, an0 who Ooes such woM himself/hersell or thmugh
his or �er own employees. D�a��Oea iha� such improvements are nol intenAea or offere0 for 5ale. If, however Ihe Uuilding or
improvement is so10 wilhin one year of cOmplelion, �he owner will have Ihe �urAen ol provinA he/she Ai0 not 6uilA or impmve
lor Ihe Durpose of sale).
I, as owner of ihe Omperty. am exclusively conVacting wn� licensetl conVac�ore to cons(mc� ��e Dmle� (Sec�ion 70A4, Business
❑ and Pmfessions Code: The Coniractors' S�ate license law tices not apOly to an owner of property who hmlds or impmves tAereon
antl wha conVacis lor such pmlec�s wi�h a con�raclm�s)license pursuan��o ihe CONractors' Sia�e License Law),I am aware
Ihat pmo� o� �heir WorNer's Compensa�ian insurance shoulU 6e D�oviOeA �o me.
� I am eeemp� untler Sec�ion: B. 8 P. C.
lar Ihis reason:
�ate: Ownec
I do hereby cehily Ihal I am aware ol and untlers�ina I�e requiremen�s of Califomia Healih antl Safery Cotle Sec�ions 25505, 25533, and
25534 antl Ihai I or any �uture 6uilding occupanl w�lllwill noi (circle ane) need lo comply wi�� saitl siale codes and �he requiremenis for a
permit lor cons�mction ar modilicalion �mm �he Pir �uality Managemen� �isiricl. Resiaen�ial consimction applica�ions are exempl irom
Nese provisions.
Oa�e: Applicam: _
Ihereby cer�ifythat Ihave reatllAis applicalion an0 state�Aal I
ordinances antl 9ate laws rela�ing �o �uilaing consiNc�ion antl �e
pmpetly lor mspection purposes.
oa�e: � Signamre.
on�ers ucense o� sociai securiiy a:
comON ��h ali ciry anU counry
enlerupon�he above�meniionetl
tsal�a6 wnile—Builaing; Green—Cotle Eniorcemenl; Canary—Apv��cant; Pink—Revenue; Goleenroa—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO; P 059143 PLAN CHECK NO: N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE: PLU
JOB DESCRIPTION ; 3950SF OFFICE T,I.
CLAIM VAI�UE; CALC—VALUE;
Y�ft NV; Y 7 19�
!�U 1'; N SUY ; N
PURPOSE; OTH
SQ FT:
GROLIP OCC: B-2 /
COMMENTS; RE: B59140 PRIMARY BLDG, PEftMIT,
�r�r*�r�r***�c*��*�c�x*�**� �*�t*�***�****�****�u*��*+tt�**�**� �***��r***t�*�*�*****���t�**#
Z O N I N G R E Q 0 S R E M E N T S
S E T B A C K S
------------ MAIN BUSLDING ---------- ----- --- ACCE550RY BUILDI'NG ---------
FRNT; FT ZN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: £T IN RGHT; FT IN LEFT; FT IN RGHT': :T IN
PARKING RE • PROV; PARCEL; 41050104 ZNE: REF NO;
PLANNING N TES>
�
iF iE i6 �lE 3F iE iF )f!F 1E �f 1E %� 3E 3E iE iE iF 1f iE% }k!k iE 3(� if !E 3F iF iE 7P 3F iE if !t iFiE if iE1E iE iE iE if if iEdF iE k iEiE 7f iE iEif 3f iE if �1F iE iE 3EiE ik if 1E iE iE iE iE jF 3E �F 3f iE # iF if 3i'
D E V E L O P M E N T S E R V I C E S: R E Q U I R E M E N T S
ZONING APPROVED BY ��• DATE;
�
BUILDING APPROVED BY ; .r DATE; ��
APPLICATION ISSUEL� BY� �° �tr�'' DATE; i����%yi�
itil�iFiFiFiFiFiE�%�itlEiEif�FiEiEiEitiEiEiEiEiFiF'iF '# ie-,r c - iFSr £'�'F�r�"i�'k'7F�iFifiF3Fir'iF7F3E3Eifi6iF�7EiFiFiF�IE x�r �3FiF
****�**�r�x�***�t***�***x�*�t�t*�rx�t� �r��r**��E+t3t*E✓kx�**�*�x�x*�ar**�-****x�**���********
LEGALIZATION;N F E E S iJ M M A R Y STRUCTURAL SEGMENT;AI
PERMIT BLDG PMT PLUMHIN�G� ELECTRSC MECHAA]IC FIRE SMIP/RES GRADING
'158 �,'r SMIP/NON—RES
PLAN t
ISSUE c^EE 20,00 ��
BUILDING—DIV—> PERMIT ISSUE P.LAN—CHECK TOTAL PAID DUfi
TOTALS----> 7,00 20,00 �- 0,00 27,00 2'7.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 27,OU OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIkE SMIP/TOT GRADING PLAN—CHECK
2%,�0
�
�k if it j!� iE-lE iE jE ih%iE if iE if df 1h iP �FlElE iE iE ik iE �f iF i(� �lE iF �7F 9Eif 16 if� {F N� iF iE jE if iF M� 3t if ih iE iE if ih iE iF *)f jF if iE M� iEiE iF if jf ik * iE 1E if ielf 3E * 1f !f iE� lE 3f if 3E 3F
I N D I V I D U A x F E E $ R E A TC D 0 W N
i
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
.�
PLD 1 SINK� KITCHEN }' '7,00 7,00
END 6F FEES
.�
�[I
�
^1 Lti:' - - -�,��c -.-.- - ..
^a_� :^, : -- " ..
CONSTRUCTION AND PLANNING . POC.� e4 SPA
- APPROVALS Permit �kT,- Date Inspector AppROVAIS Permit # Date Inspector
" t.'7emporary Electrical Service o} Pole Y � 52. Pool & Equipment Location '-
2. Soil Pipe-Undrgrnd. " ��� � 53. Steel Reinforcement �
• 3. Electrical Conduit UtilitY-Undr'yrnd. 54. Forms ��
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement _ 56. Rough Plumbing & Pressure Test
6. Electrical UPER Grnd. . 57. APPROVAL TO COVER-GUNITE
7. Footings � � - 58. Electricai Conduit-Undrgrnd. -�
S. Poundation � '�. �.��' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. �j . �!^; 60. Backwash Lines, P-Trap, G Undrgrnd. ���.
10. Structural Floor System �� , �+ � 61. APPROVAL TO DECK � '
1 t. Property Sewer Line &�House�Connection + 62. Backwash & Receptor�Final -
I
72. Sewer Cap • � ; - � 63. Heater & Vent•Pinai � � = ��
�
53. Roof Drains � .� 64. Plumbing System - Final �
14. Rough Plumbing � � � 65. Electrical�Final •
9��r,� - -
15. Rough Electrica6Conduit _�- 66. Solar System-Final '-
16. Rough Electric Wiring 67. Fencing & Access Approvai �
-17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. RoughElectrica6TBarCeiling - 69.�POOL/SPASYSTEMSFINAL
19. Rough Heatin9 & Air Conditioning FIRE DEPT. REQUIREMENT
20.� Rough Factory Fireplace " - •APPROVALS Permit #
21.� Ducts, in Structure - . � 70. Underground Hydro
22. Ducts, Ventilating � � 71. Product Piping O Gas OOiI
23. Gas Pipe�Rough & Test . - - 72. Underground Flush
24. Roof framing 73. Undergrnd.StorageTank OGas OOiI
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 � j 78. FIRE PREV. FINAL
30. Drywail Nailing I !" - HEAITH CEPT. REQUIREMENT
� 37. Plaster Brown Coat � i 79. FINAL INSPECTION -
32. Electrical Power Meter-�inal . ' I- 80. FOOD CERTIFICA7E ISSUED
33. Final Electric i � Notes:q�2,f-Q2,_,
Nclr--aw+�nY-- c.ei�
34. Final Heating & Air Conditioning � � �
35. Final Gas Pipe-Test I- i
36. Hood or Canopy � � � � �
37. Final Factory Fireplace "
38. Finai Plumbing �( � (��
39. Water Service�Final
40. Gas Service-Final l �
41. Solar pomestic-Final �
42. Backflow Preventer � � �
i i I
43. Backflow Irrigation
44,. Landscape Irriqation System •
45. Sound Attenuation �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48.-FINAL PLANNiNG -
49. Electric Release to Ediso�
.' •
50. Gas Release to Southem California Gas Co j i.�, �
51. CERTIFICATE OF OCGUPANCY .
No. Date
PRQIECT RUGHESS: �> S S ANTON BIr
OWNEX'SNRME: FiANK OF AMERICA
aoosess: �p N RAYMOND AV 3RD FL
PASALIcNA, CA
uNiT: 3RD
818-578-7700
' AflCHIENGINEEN: RAY HERBOLT NEG.NO.:CLLO%3
aoowess: 22072 CAMINITO VINO uxiT:
LAGUNA HILLS CA 92653
PEHMITTEE: ARMSTRONG CONSTRUCTION ( 818 ) 967—R001
nooness: 929 SPRING MEADOW DR
WEST COVINA CA 91791
LICENSEO CONTBACTOP DECU1BI1t10N: I �ereby allirm IAai I am Iicense0 er prouis C�apter 9(commencing wil� Section
7000� ol Oivision 3 ot I�e Business anG Pmfessions Code. ana my license is � tuil lorce anE e t.
ciTruc.:056871 srnreuc.:434047(� S: ..
oaie9� 1__��`�'1— siqnamre: ��J_� . _
WOBI(EBS' COMPENSATION OECUflATION: I hereby aliirm I�at 1 have a cerli�itaiE al consenl Io 11= Sure Or a Ilica�e al WOAefs'
Comoensation ��u�� o� §ce{ij�ed coDY ��e�ea� (Section 3800, La�. �.S � O I� 9 3
roucrr+o.: REPUBLIC INDEM EXP.OATE:
COMPANY: ,.};
❑ Ce�ifietl topY is h¢reby Iumishea. lJ Cerii�iea taDY is IileU w e cily BuilGinp ir' ion.
Date: �/ � �/ � Z Applicant.
EXEMPTION FNOM WONREBS' fAMPENSA710N oECIABpTION: R�is section nee0 nol �e comple ilihe perm is o e hunGred �$1W) or less�.
I ceriily IM1a� in Ihe Derlormance o� Ihe work lor whic� Ihis permit is issued, I shall nol empl any per in any ann¢r so as to become
subjecl to t�e Workers' fAmoensation Laws of Calilomia.
CITY OF COSTA MESA — BUILDING PERMIT
PEkMIT NO: M 059142 FLAN CHECK NO: N
CONSTRUCTION TYPE: IFR SP PERMI7' TYPE; MEC
JOH DESCRIPTION : 3950SF OFFICE T.i.
CLAIM VALUE; CALC—VALUE;
Y "tt NU; M ]yl
: N bUY.: N
PURPOSE; OTH
SQ FT;
GROUP OCC; H-2 /
COMMENTS: RE: B59140 PRIMARY BLDG. PERMIT.
r�rx�r��r*�c*x x�*�*�r*�**�*+r*�t**xx��x �*�*��*�x***��*�r**��r*�*****�+�**x���r+�t�*�r*��c�*��r+�*
Z O N I N G R E� U I R E M E N T S
S E T B A C K S
------------ MAIN B[IILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN .
LEFT; FT IN RGHT; FT SN LEFT; FT IN RGHT: FT IN
PARKING RE(� • PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOT'ES>
�
If !F IE iF If If 3f 3(� 1E 1(-1FlE iF9f iF if� �F if 3F i(� if iE ik if IE 1E iE � iF iE i4 iE IE 36 iE �1E iP'if iE #�!E iE IE�(� if iE if �IE 1E iF�)f if iE iE if lf if iE �E �Elf iE ]E if i(� �f iE jE # If 3E i'r ie iE 3F iF # iF iF
� D E V E L O P M E N T S E R`V I C E S R E Q U I R E M E N T S
�ZONING APPROVED BY DATE:
oate: siq�amre. ,.rHUILDING APPROVED BY ; DATE:
NOtICE: II, alier making ihis �eclaration. you s�oultl Uecome suble�t ro ihe Workers' ComDensation O�a��sions of t�e labm / ,,
Coae. you must ronnwiih compiy wnn sucn orovisians or tnis permi� snali De deemen revakea. '�APPL I CAT I ON I SStJfiD BY ; L '• � DAZ'fi ' 3FR?T�"��iF�
CONSTBUCTION LENOINC AGENCY: I here�y allirm ihal l�ere is a consimction lentling apency for Ihe De�ormance oi the work for
whichl�ispermitisissued(Seclion3097,Civ.C�. .�'�"K'�'*"%'*'x'x'K'K'�X'"x"K'i!'3F�("K'�('i('1('K'�FiF7i'S��'��'�' 'i�' -F7FF' �' �r ii'k��'iF�'kx'K'%i�!('if'K'iE'ikM"1E 'r 'K'
LENUEfl: iFffiEiFlE�lEif1F1F')EfFikitiElEiFi(�1(�lEiEihiEifihihikihiEil�lEiFil�i(�%�iEltlFiElFltiEifiEiFiE.' iElE3FltlFiklEiF3FiFlFif�iFiElFikif�iEiFifi6i(�ifj'tf'riFiEiFiFIF#if
aooxEss: LEGALIZATION;N F E E S iJ M M A R Y STRi7CTURAL SEGMENT;N
OWNEN BUILOEN OECIANRTION: 1 �ere�y allirm t�at 1 am exempi Imm ihe Camractors' State License Law ior I�e lollowinp reason
(Section 703L5 Business antl Pm�essional CODe: Any ci�y of counly whic� requires a permii Io conSlmci, aller, imD�ove, demolish, or
repair any slmcture, o�ior to its issuance. also requires ihe applicant for sucA permit to lile a sipne0 statement ihat he/sne is Iicense0
pursuant lo Ihe provision5 of Ihe Comracmrs' Siate License Law �C�apter 91�ommencinp vn�h Section 7000) oi Oivision 3 oi ihe Business
ana Pmlessions CoOe) or Ihal he/She is ¢xempt �herelmm ana Ihe DaSi5lor I�e all¢qetl eKempli0n. Any viola�ion Oi $etlion 7031.5 Oy
any applicanl lor a permil subjecls Ihe applicant to a civil panalty of nol more Ihan five hunOreO Oollars (5500).
I, as owner of tAe pwpetly or my employees vnih wages as iheir sole compensation, will tlo t�e work, antl I�e
❑ slmclure is nol inlen0e0 or o�fered br sale (Section 70Ed, Busine55 an0 Pmtessional Coee: i�e Conlraciors' Sta�e License Law
tloes noi apply lo an owner oi a prop¢hy who budds or imDmveS �hereon. an0 who tloes SUc� work him5¢Ii/herself or �AwuAh
his or her own employees, Orovitl¢4 Ihai SUCh impmvemeNs ar¢ nol in�entle0 Or ofiered lor Sale. I�, �owever Ihe bUiltling or
imOmvemeni is soltl wiihin one y¢ar ol camp�elio4 Ihe owner will �ave �he 6u�Uen ol D�ovinp he/she ditl no� Ouiltl or improve
lor t�e Durpose ol sale).
I, as awner ol Ihe propeny, am extlusively contracling wi�� licensetl conVac�ors to constmc[ �he O�ojec� (Sec�lon 7044, Business
❑ antl Pmfesvons CoUe: The Coniractors' State License Law does not apP�Y �o an owner ol pmperty who 6uiids or imOroves t�ereon
an0 wAo conirads lor such O�oleds with a coniraclor�s) license pursuant Io ihe fAniractors' $tate License Law�. I am awaro
Ihat pmof ol iheir Worker's Compensation insurance shoultl Ue pmviAeU to m& �
� I am exempl under Seclion�, B. B P. C.
for �his reason:
BLDG'PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 39.00
258 SN,IP/NON—RES
PLAN j-
ISSUE FEE �.� 15,00
BUILDING—DIV—> PERMIT ISS[JE BIy7?N—CHECK 'COTAL PAID DUE
TOTALS----> 39.00 15,00 f 0,00 54,OU 54.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 54.OU OVER/SHORT; OU
• BLDG PMT PLUMHING ELECTRIC MiiCHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
ti? 54,00
iF iF iF it ik 1F if �)k )k!f k iF i6 if 1t !E ff i(- 3E fF 1F if �lE 1E iF iFdf iF 1E if� ik # 1E iE�if if 1E iF iF iE if If !f !F iklE �If 3E iE'1E iE iF iE iElE iE iFlE iEif 1EiElk iF if iF iE ii�!(� iE iE iE iE iF iE it iE �1E if
I N D I V I D U A�� F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Dale'. Owner. I MEC
I Oo hereUy cenily �nai I am aware ot ana unaerstand tne repuiremen�s o1 Catilomia Heatln an0 Salety Cotle Sections 25505. 25533, antl
255Ja ana �hat I or any lumre Uuildinp occupant will/will nm (circle one) nee0 to comply with saiA state co0es an0lhe requiremenis for a
permit lor conslmc�ion or motlificalion imm I�e Air Ouali�y ManaBemeni �isiric�. flesitlential cons�mc�ion applicaiions are eeemp� Irom
Ihese O�o�isions.
�ale: ApplicanP. _
I �ereby tetlily ��ai I have rea0 ihi5 apPliCalion an� Slaie Ihal l
orUinances an0 slalelawsrelalinqlo GuiltlmB �Onstruc�ion an0 he
pmpetly lar inspection purposes I
Dale: �, (,r SignalurL+-�.
oriver's License or Sacial Securily x:
lo comply with all City antl Counly
l0 en�eruponihe above-m¢nlioneA
1646a6 WM1ne—BOAtlino: Graon—Cotlo Enbrcamanl: Cenarv—Aoolicnnl; Pink—Revenua; GolCenrotl—Asseswr
6 VAV HOX
END OF FEES
/�
6,50
�, `�1��..'y��_��t.� i).`':''� "' _
��f:'� �i. l. ,. � I f.��'. _..
39,00
�
CONSTRUCTION AND PLANNING POL_ d SPA
Date Inspector Date Inspec[or
APPROVALS Permit # - APPROVALS Permit # .
1. Temporary Electtiwl Service o� Pole , 52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. - - - 53. Steel Reinforcement ..
3. Electrical Conduit Utility-UndTgmd. ;� 54. Forms �
4. Electrical Conduit�Undrgrnd. 55."Electrica� Bonding .
5. Steel Reinforcement . 56. Rough Piumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footing5 58. Electrical Cqnduit-Undrgrnd. -�
8. Foundation • � 59. Gas Pipe, � Undrgrnd., Tesc - '
9. Water Pipe�Undrgrnd. �. �� � 60. Bac�•.vash Lirte6, P�Trap, � Undrgmd. r �� Y
70. Structurel Floor System � �` � 61. APi-80VAL TO �ECK '
11. P operty Sewer Line & House}Connection 62. Bu: -..��h $ Rec:Ftor-Final '
12. Sewer Cap � "�1 i- 63. Hest^ M`/ert:•Finai ���
73. Roof Orains � 64. PlumUmg Syuem - Final -
14. Rough Plumbin9 ' ��' 65. ElectricabFinal -�
75. Rough Electrical•Conduit � `1--- 66. Solar Systein-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
78. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI. �
19. Rough Heacing & Air Conditioning �I30/� �� ' FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS - Permit #
21. DuCts, in Structure . 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank�O Gas ❑ Oil
25. Ropf Sheathing - � 74. Overhead Hyd%
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemicai
27. Frame and Flashin9 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL �
29. Insulation 78. FIRE PREV. FINAL '
30. Drywall Nailing � �.- �j• HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Elecirical Power Meter�Final j �' 80. FOOD CERTIFICATE ISSUED
33. Final Electric '�-'' Notes: q/Z��L yo��y_ �
!
34. Final Heating & Air Conditioninq �Q � .�p
35. Final Gas Pipe-Test i I
36. Nood or Canopy . I
37. Final Factory Fireplace
38. Final Plumbing _.
39. Water Service•Final � �
40. Gas Service-Final i
41. Solar pomestic�Final
42. Backflow Preventer , � �
43. Backflow Irrigation
44. Landscape IrriGation SYstem
45. Sound Attenuation
46. Handicap Regulations _
47. FINAL STRUCTURE & BUILDINC� ,,
48. FINAL PLANNING . �
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co ; i,; -
51. CEFTIFICATE OF OCCUPANCY
No. Date
noosess: ' 555 ANTON BL
i'SNFME: HANK OF AMERICA
aooness: ?0 N RAYMOND AV 3RD FL
PASADENA, CA
uxit: 3 RD
818-578-7700
RNCN/ENCINEER: RAY HERBOLT flEG.NO.:CSLO%3
aooxess: 7p072 CAMINITO VINO uxir:
LAGUNA HILLS CA 92653
PEpMinEE: ARMSTRONG CONSTRUCTZON ( 818 ) 967-8001
aooness: g29 $pRING MEADUW DR
WEST COVINA CA 91791
LILENSED LONTflRCTOfl OECUPATION: I hereby alliim Ihal I am licens r pmhs�o 1�6 �er 9(wmmencing wit� Section
7000) ol Division 3 oi the Business ana Pmfessions COUe, an0 my license � in tulliorce anA eHect.
cirrqa O S 8 71 sTare uc.: 4 3 4 0�Nl'j ss: —
Date: _ Signature�`. _ _ —_
WONNENS' COMPENSRTION DECIAPAT10N: I �ereUy allirm Uat I have a cenificale oi consent to selbinsur a eniticate ol Workers'
Compensaiion lat�p�� o� �ce.��Uietl cooY �hereo� ISec�ion 3800. Lab. &1�1 / O 1/ J 3
raucr No.: ftEPUBLIC INDEM E%P.ORTE:
COMPpNY:
❑ Cerlilie0 copy is here�y �umished � Cerlilie0 co y is IileU i�h he ciiy Builtling Division.
'OaIQ� ` (_., Applicani:
EREMDTION FBOM WONNEPS' COMPENSATION OECUPATION: (This sedion neee no� be comple�e0 if ihe Oermit i ora e h red (1100) or less�,
I cerlily Ihai in ��e pedormanCe 01 �he work for whith �his permi� is i55ueQ I Shall no� employ any person in anner 5o as �o betOme
suEleci lo I�e Workers' ComOensa�ion Laws ol Cab�omia. / Y�
Oate�, Signawre:
NOTICE: II, after making t�is aeclaration, you shoWd become suhlect to Ihe Workers' Compensation provisions of lhe Labor
COUe, y0u mu5lfOMwith tomDly wil� Suth provisions or thi5 permi� S�all be aeemed revoked. f/�
CONST811CTION LENDING �GENCY: I here0y allirm ihat there is a constmction lending agency for ihe 0??armance ol ihe wark for
wnich mis permii is issuea ISedion 3097. Civ. CL ry��
LENOEN:
noonEss:
OWNEP BOILUFfl OELLAflRTION: I here6y affirm I�at I am exempl irom ihe Contractors' State License Law for lhe following reason
(Section 7031.5 Buvness anC Pmtusional Cotle: My ciry ot counry whic0 reQuires a Dermii �o cons�mc6 alter. impmve, Cem0lish, ar
�¢oair any stmcWrt. O�a� �o �Is issuance. al5o reQuires Ine aoVlicant lor sUCh oe�mit to lile a signea statement itlal hpJshe is Iicense0
pursuam io ine pmvis�ons ol Ine Comraclora' Sia�e License Law �C�apter 9(commencinA ��h Section 700U) oi Division 3 of ihe Buvness
ana Pwlessions Code� or Ihal he/she i5 exempi Ihereirom and Ihe basis for Ihe allegea e�emption. Any violatian o� Sec�ion 70.3L5 Uy
any appliWnt lor a Oe�mil su�lec�s �he aOPlican� �o a cinl penalry 0� not more t�an �ive �unGred dolWrs (8500�.
I, as owner ol �he Dmpeny ar my employees with wayes as t�eir wle compensaiion, wiA Uo ��e »rork, and �he
❑ stmcmre is noi intenGeA or olhre0 lor sale (Seclion 70C4, Business antl Professional Coae: The Contracmrs' State Licenu Law
Ooes no� appry lo an owner ol a pmpeny wAo builOs or impmves lhereon, an0 w�o Coes such vrork him5el�/Aersell ar lNouAh
�is or �er own employees. pmviGeE lhat suc� impmvemenis are not inten0etl or otteretl tor sate. If, Iqwever the 6uilEinp or
imD�ovemeni ¢ SoIU within one year 01 cOmDleiion. Ihe owne� vnll have ihe bm0en o� pmving he/she Gid nai builG Or improve
lar ihe ourpose af Satel.
I, as owner ol ��e properiy. am ertWsively conirac�ing vnlh licensetl con�ractors to wns�mct I�e pmleci �Seciion 70M, BuSiness
❑ antl Prolessia¢ CaGe: T�e Conlractors' Stare License Law tices not appry lo an owner of pmpe�Iy who buA0.s or impmves Ihereon
ana w�0 Lronffatls lo! Such D�ajeCls wit� a fAnlratior(5) litense pursUan� �o �he fAntrat�al5' $Iate LifRnse law�. I am dware
Illal O�ool af Iheir Woiker's fAmpensation insurance s�oulA Oe pmvMeO to me.
� i am ezem0� un0er Seclion: B. 8 P. C.
lor Inis aasDn:
Date: Ownec
I Go �ereby cehi�y I�a� I am aware oi antl untlersland Ne r¢Quirements a� Calibmia Heallh antl Sa�e�y Cotle Section5 25505. 25533, antl
2553d anU Inal I or any future buil0ing acupant vnlVwill nol (Grcle ane� neeA to tampty xittl 5ai0 stale to0es and t�e �equirements for a
permit tor conslruclian or m04ilicalion Imm ihe Air Oualiry ManaAement OisMct. PesiGentul fAnsWction aDPliWlions are eeemD� ��om
IAese Diovisians.
Oale: Applicanl: _
I �ereby cerlily I�al I haveread Ihis apD�icalion an0 s�a�e Iha� Ihe
ordinances antl slalelawsrelalingto builtling consimclion an0 herel
pmOatlY �or insp¢[ ion purpo5es
� Dale: �_l l_�_ SignaWre�
odvers �kense or Sociai Secmny x:
wi�� all ci�y antl
t60tAfi W�ile—BoilOing; Green—CoOe nlorcemenL Canary—Applicam: Pink—Revenue; Goltlenrotl—Assessor
CITY OF COS1'A MESA — BUILDING PERMIT
PERMIT NO; E 059141 PLAN CHECK NO; N
CONSTRUCTZON TYPE: IFR SP PERMIT TYPE: ELE
JOB DESCRIPTION : 3950SF OFFICE T.I.
CLAIM VALUE; CALC—VALUE:
Yh:F1M NU: t V� 191
O 1': N ' Y: N
PURPOSE: OTH
SQ FT:
GROUP OCC: H-2 /
COMMENTS; RE; B59140 PRIMARY HLDG, PERMIT.
x�-**�*�t�**�t*x�+r�r***x��c*x�*�*�****��*****x*�t**�*�r+r*�*+�**x�**�t*�u�r*�tx•**�r�rx�**��r+��r**�r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; F1' IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PAR3CING RE • PROV: PARCEL: 41050109 ZNE: REF NO;
PLANNING N TES>
%
1E iE iE if 3E iE ib lE IE iF IF if ih 1E iF if iElElE 1E iE ik iE 3E !E iFiE�7F # iF iE ik iF iF.lP jElE iE iE iE iF iE iE iE if iE �k iE 341E # iF iE iE iE iE it iEif if N� iE it iElF iE iF iE aE 3FiE iF )F 3F If ie iE le iF
D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S
i .
20NING APPROVED BY ' DATE:
HUILDING APPROVED BY
APPLICATION ISSUED BY;
if �tlF if iFlE iE iF iF ik it if �E ik iF iF 1F if it if if ifiFiF
iE ik if �% iE iE it if ik iE It 3f it M� IE iE k iE if 1E # �f 1E if
LEGALIZATION;N
F E
DATE:
iE 3F-1E-1f iF iE IEiF if 3f �f if jE 3k iE iE iPif �F iE 34 ib if 1E at �1E�)f iF iE iF iE 1FlE iE if ik 1f iE 3F if iF iE
S LT M M A R Y STRUCTURAL SEGMENT: iV
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMSP/RES GRADING
PERMIT 49,80
PLAN �;�50Y SMIP/NON—RES
ISSUE FEE t15,00
BUILDING—DIV—> PERMIT ISSOE P�LAN—CHECK TOTAL PAID DUE
TOTALS----> 49,80 15,00 � 0,00 64,80 64,80 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 64.80 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
64,80 '
/
3f if ik iE iE it iE iEif iE 1f 1E 3E iF 1e 3f �f if iE iE#F if iF 1E IE�If� �F iFif it if !F i! 3F �4,�E If iEiF iF i(� if ir 3f if iF if iE iF iF if iE # iFif iE ik iE?E iE i(� k if if IF iF if !f �f iF if iF k if ie if iF 3k iF
I N D I V I D U AsL F a E B R E A K D O W N
TYPE QTY D E S C R I P T I Q N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTINGi•. 1 ST 20 EA,
ELE 33 FIXTURES LIGHTING- ADDITIONAL EA.
ELE 20 RECEPT/OGTLET .� 1 ST 20 EA,
ELE 6 RECEPT/OUTLET ' ADDITIONAL EA.
ELE 3 RECEPT/SWITCH ✓
�END10FTFEES EA,
�r
,45
.45
, '15
!��'�TLi+I' .yr . .�11��. �.�I.
15.00
14,85
15.00
2,%�
2,25
�ONSTRUCTION ANDPLANNING
APPROVALS Permit # :_ Date
t. Temporary Electrical Service pi Pole ,
2. Soil Pipe•Undrgrnd. -- -
3. Eiectriral Conduit Utiltty-Undrgrnd.
4. Electrical C,onduit�Undrgrnd.
5.. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings � ,
� '
8. Foundation ' �
9. Water Pipe-Undrgrnd. �
10. Structural Floor System� '
i t. Property Sewer Line & Hduse Connection �
• t
12. Sewer CaP � - .- 3
73. Roof Drains , - ,
14. Rough Piumbing j �
15. Rough Electrical�Conduit � Q
/:/�
16. Rough Electric Wiring
17. Rough Wiring Sign
78.. Rough Electrical�T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rougn Factory Fireplace
21. DuCts, in Structure
22. Ducts, Venti�atin9
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structuraq & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulatfon
30. Drywail Nailing �
31. Plaster Brown Coai
32. Electrical Power Meter�Final
33. Final Electric � �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factorv Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final , ,
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
4�. FINAL STRUCTURE & BUILDING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
�o. Date
POOL & SPA
Inspector qpPROVALS Permit#
52. Pool & Equipment Location
53. Steel Reinforcement -
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Tezt
57. .APPROVAL TO COVER�GUNITE
58. Electrical Cq�duit•Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines; P�Trap, O Undrgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent•Final
64, Plumbing System - Final
65. Electricai�Final
(��, 66. Soiar Svstem-Final
/L
67. Fencing & Access ApProval
68. APPflOVEO FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71 . P�oduct Pipin9 O Gas ❑ Oil
72. Underground Flush -
� 73. Undergrnd. Storage Tank O Gas � Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
i 77. FIXED SYSTEM FINAL
i 1 78. FIRE PREV. FINAL
'� -� HEALTH DEPT. REQUIREMENi
I �
' I 79. FINAL INSPECTION
i
' !/ � 80. FOOD CERTIFICATE ISSUED�
� � /
� Notes: �i o n � /%, ��� � nfr
; t
0
Date inspector
�
�
��
PX0.IELT RUOflE55: •S S S ANTON B1. uNir: 3 RD
OWNEfl'SNAME: B�1( QC AMERICA
aoosess: J.0 N RAYMOND AV 3RD Fl.
PASADENA, CA
818-578-7700
. RflCHIENGINEFH: RAY HERBOLT xec.xo.: C11073
aooness: 22072 CAMINiTO VZNO uNR:
LAGUNA HILLS CA 92653
PEflMITTEE: GOLDEN STATE FIRE PROT ( 714 ) 923-4060
RDDflESS: 93G E FRANCIS B
ONT'r1RI0 CA 91761
LICENSEO LONTNRCTON OECUMTION: I here0y atlirm tlw� I am licensetl unEer O�ovitians al CtuDter B(�mmencinq vni� Seclion
7000� of Division 7 0l ��e Business an0 Pmlessions CoOe. antl rtry license is in iNlforce an0 ettect.
c�rruc.: 007E49 s,�Teuc.:350225%� cuss: C-16�
� Date: �'ZZ`tZ Signaiure:_L�'Z-�'��s✓�:A'-�
I WOflNEflS' COMPENS�TION OECIAflRTION: I �ert0y allirm Ihai I �ave a cenilicare of consent to self-insure ar a certilicaie of Workers'
Comoensation i�s�aa�5 u� �r{Jt�e4 c� �ermi �secuw� �eoo. �=o. �..� / O 1/ 9 3
roucvxo.: REP(JBLIC IND E%P.�RTE:
COMPANY: ,}(
❑ Certihed Copy is �ert�y Wmis�etl. L'J CenilieC copy is file0 wit� ihe ciry Building Division.
Oate: °�-22-az npplicant. � C' "'✓ �
E%EMPTION FXOM WOflMEflS' COMVENSA710N OECIANAT10N: (itus teciim need noi he campleletl if ttie pemn ¢ fa one huMrea (5100) a less�,
I cerlity lhat in t�e Dedormance al t�e work br w�ic� I�4 Oermii i5 i55ue0. I shall no� employ any person in any manner so as �o become
su�le�� �o IOe Workers' Compensalion Laws o� Caiilamia.
Oale'. Siqnamre:
NOTICE: II, alter making tAis declaration, yau sAoultl Uecome su01e�� �o t�e Workers' Compensation pwvisions oi the Labor
CoUe. yrou must fonhwitn compN w+�� sucn provisions ar tNs vermit shall Ue OremeU revake0.
CONSTflUCTION LENDING �GENCY: I �er¢Cy af�irm I�ai I�efe is a conslrutlion IenGing apency lor ��e peri0rmante o� �he work �or
which Ihis Oermii is i55ue0 (Settion 3097. Civ. C�.
lENOEfl:
nooness:
OWNEB BUILUEH OECIANATION: I �ertq� atlirm tAat I am exempt Irom t�e Comractori State license Law lor I�e followinA reamn
�Seclion 7Q71.5 Business antl Professiunal Cotle: My ply ol fAunry wNt� rtQuires a permit Io fAnSimct, alter, imD�ove, tlemolish, or
�e0air any Simtlure, prior lo iis i55uantl. also requires lhe aD0litani Ior SUC� permit IO lile a SiA�eO Sia�ertcen� �ha� he/S�e i51i[¢n5etl
Oursuam to t�e D�odsions ol t�e Conlractors' Slate Lkense Lrx (Ctapter 9(commenunp vnU Sectron 7000) ol Oivision 3 0l the Business
anC Pmles9ons fAae� or Itlal tMlsne i5 ex¢m0� ��eretrom anC the Dasis lor tne alleqea exem0��on. My violation ol Section 7031.5 by
any applicant lor a Dermil suEl��s IM aDa���� �o a dvil pCnaliy ol iWi m0a itlan live hunOrEO Oollars (5500).
I, as ovmer ol iAe O�oOeny or rtry employees xit� wapes as i�eir sole compenution, will Go I�a work, anA Ihe
❑ stmcture's noi inteMeE or ollerW br ule (Seciron 70aa. Business aM Pmfessqnal Coae: The Contractors' SWte Littnse Law
EoeS nol apply la an owne� 01 a prOp¢M1y wM Cuilds ar imD�a�s t�¢re0n. aM wlp Eoes Such waM �im5elUherseli Or Umup�
�i5 Of hEf OWII CIIIpIp�CCS, pfOVIECO IINI SYU1 IIIIpf0VEI11EIlI5 df2 IIOI NICIIEGE Of OfltflA �O! SdIE. I1, �OVRVp! fllE D1111E1110 Of
impmvement a sdtl xitNn we ypr ol cOmDletion. t�e ownn wi0 tuvC I�e EurGen ol provinB hNslie ditl nat OuiIE or improve
lor tAe ourpose ol saie�.
I. as owner ol Ihe pmceny, am exGuSivery toniracGnp vnt11 licens¢a coniractors to tonstrlict ihe proiect (5eciion 7041, Business
❑ anG PrOfessim5 CoOe: The ConlractOrs' Staro Lia�ae Law Ooes no� apqy ro an wmer ol properry Mp �utl�s w impro�es lhlreon
� an0 wtro contrac¢ lo� sucn prqttts witn a cantraporls) Ikeme pursuant to t�e Cantractors' State L¢ense Law�. I am aware
Iha� pmol 01 I�Cir Wo�ker'S Campen5aibn inSutance 5iwN0 Oe prwNetl Io me.
� I am eAempl unGer Sectun: B. 8 P. C.
lor Inis reason:
�ale: �e�:
I Oa nereby cenity Itul I am aware al ane unaersuna Ihe reauuements ol Cdlilamu Mealih anG $afety COEe Slctions 25515, 25533, an0
2557C and Illat I ar any fulme OuilGinp aCupanl wilWrin not (tirde One) neEO to fAmDN mID SdiA state co0e5 and t�e reQuiremenis lor a
Oermii lo� cons�maiw or moCilia�ion tmm Ihe N-� MaiuOemem qstrict. HesiOentlal consvuciqn appliwtions are enem0� <<om
mese o�avisions.
Oa�e: Apq¢ani:
1 �ete�y cenity IAat I �ave reaE iN5 a0�litatian and state ihat Il�e aDwe informafion 6 tortett. I agree ta compy with all ciiy anE county
ordinances aM state laws reWtinp lo CuiiNng cwatmc�ion anU �ere0y authoriae reD�esenutivu of rtus ary to enrer upan the ahove�mentiane0
pmpeny lor Insoection o�rposes. /
Date: �'22-�1 L Sipnature: �G �✓�
od�ers �icense ar sociai secuniy r:
I6G1-46 While—Buildinq; Green—CoOe Eniorcemenl: CanarV—Aoolican�; Pink—Revenue: GoltlenroE—Asanssnr
CITY OF COSTA MESA — BUILDING PERMIT t�cxM rvt�: r u�7iy�
PERMIT NO; F 059193 PLAN CHECR NO: 03530-92 L � t; rv �u r; �v
CONSTRUCTION TYPE: I FR PERMIT TYPE: FIA PURPOSE: ALT
JOB DESCRIPTION : 3950SF OF FIRE SPAINKLERS (ALL OF 3RD ) SQ FT;
CLAIM VALUE; 3,940,00 CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: BANK OF AMERICA 3RD FL REF:B
****�t+���**x �r��r*���x+�*****�c•����+t*+�***�r�t�t�r**��***�***+t****�*�****+r�#*��x*�t� *�r**�**
2 O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: F'f IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARFCING REQ• PROV; PARCEL; 41050109 ZNE; REF NO:
PLANNING Nt7TES>
�
1E iFiE it iF it� iF # if ih iE 1E ib iE ih iE if iE iE iF ik it iE iE IE 3t i4 ik 3E 3E iE i(� ik iE iP iE �E iE iF iF iEiE #�1(� iE it� iE 3F if if it iE iF iF iE iE IE iE if iE 3F ih �E �fE if iE�ik it if iE iF if # iF iF iE iE iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
HOILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY; � µ i� �}�� DATE: cI 22-
IE'iEihX'IFiEiEM'M'iE')I'iEiFitiFil'iEil'iEiFiEiF�FTFA�3i'Tti'r�iF'3FiFiF3F3F3F1t�'TF 'it3i''iF3F i7�%TFiFifi�£iFSfM'1I'IF'K'iFiElt'M'iEN' Y *1tiFil'
IF a4 iE �N� ik iEiFif iE if ik iE ik �k if if iE ii� # iE Ib iE if IE 1E IE If i! k iF 1f �! k if iF iE iF 3E iF iE iF �f if iF iEif iE iE iE iF M�f ik 1E iE�E jF ik �E iF 1E iE 1F k!! * iF iF if 3E if if iF iE iE iE iF iE if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT �3�i5t SMIP/NON—RES
PL.AN 40,95
ISSUH FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63.00 0.00 40.95 103.95 103.95 .00
REVENUE DZVZSION TOTALS--> COLLECTED; 63.00 OVER/SHORT; 00
BLDG PMT PLUMBING ELcCTRIC MECHANIC FIRE SMIP/TOT GRADING FLAN—CHECK
63,00
1E �IE �If �k if� i(� �lf-it it i4 ft iE �IEiF 1E ih iE 1E�X i( �k �1F91-i( i(� IE iE iE if k 9f iF if iE )f if IE K-if iE % iE iE�fE i(�iE iEiF.N..K..IE iF iF fEiEiF 1Fif �lf i(•k iti! if it IE %iEit itjf if �lf !f if if if iE iF
I N D I V I D 0 A L F E E B R E A K D O W N
TY.PE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 63 FIRE EQUIP FEE (FROM BLDG VAL T'AHLE) 1.00 63.00
ENll OF FEES
�� ..�" ' � .. ' "
CONSTRUCTION AND PLANNING PO, iSPA
APPROVAIS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electricai Service oi Pole 52. Pool & Equipment Loca[ion
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Eiectrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electricai Bonding
5. Steel Reinforcement 56. Rough Plumbing & P�essure Test
6. Electrica� 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�7rap, O Undrqrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Properry Sewer line & HouseConneaion 62. Backwash & ReceptorFinal
12. Sewe� Cap . 63. Heater & Vent-Final �
73. Roof Orains 64. Plumbing System � Final
14. flough Plumbing 65. Elect�ical-Finai
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
16. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air�Conditfoning FIRE DEPT. REnUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # ,
21. DuCts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipinc� C7Gas OOiI
23. Gas Pipe-Rough & Test 72. Undarground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Root Sheathing 74. Overhead F�«e�
�3_v_f Z �I!
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashin9 76. DrY Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL ��p.,/�+Z, ��
29. Insulation . 78. F�RE PREV. FINAL S_3�� µ� �
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat i 79. FINAL INSPECTION
32. Electrical Power MeterFinal ' I � 80. F000 CERTIFICATE ISSUED
33. Final Electric � � � Notes:
34. Final Heating & Air Conditioni�g I � (
35. Final Gas Pipe-Test � �
36. Hood or Canopy �
37. Final Factory Fireplace I �
38. Final Plumbing i - -
39. Water Service�Final
40. Gas Service-Final
41. Solar pomestic-Final �
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING •
48. FINALPLANNING �
49. Electric Release to Edison
50. Gas Release to Southem Califomia Gas Co i �
51. CERTIFICATE OF OCCUPANCY
No. Oate
PN0.IECT RDONESS: S S S ANTON BL
owxex•sx�Me: SECURITY PACIFIC NAT BANK
, eooa¢ss:600 WILSHIRE HL, L.A.
�ptN/FNCINEEfl:
�ODPESS:
uo.xo.:
uNrt: 3 0 0
UNR:
r�xMmce:KIMHLE AND COMPANY (714)895-1156
nonxess: 7540 SUZI LANE
WESTMINSTER CA 92683
LICENSED CONTMC70P OECUNITION: I �ereW aifirm ttut I am Ikrns�.�! Mer prwaions al Ctwpter 9(comme�np wlth Section
70W�'ol Oivision 3 o11Ae Business aM Professions COEe, a�M my 5ceilyP'6 m fu0 lorce a�M eilect. �
cmuc.:038503 sranuc.: 60923 � ss:C—
Oate: —ZS SipnaNrt'
, W�qKFNB' COMPENSIITION OECUfUT10N: I �erehy affum Wt I lu� iilcate of wnsent W utlJnsura or a cenificata oi Workers'
'msauon�`?1 � j�"�+� `iuv�o� Isecvon 7eoo. �ae. 8/ 2 3/ 91
� X0" FREMONT INDEM. �' �'��
APU7Y: M
❑ fanified copY 5 tkR�7 N�Nshe6. C� NTied w7Y ¢ Ned v� e f1h &a7Ein9 0'rid . �'
��. Oate: �'�S — U MPGcant
IXFMPf10NFli0NWOPRF145'COMPFNSAl10N0EGAMTION: (�secOn mmpeteEdNeD�islameAwtlrcA1S100)akal. �
I certity ihat in Ue pertormar¢e oi the wark Im wtuch tltis permif ¢ iss��. I ml employ airy persan in any manner so az lo Eemme
whtect to Ihe Warkers' Compe�ttation Laws al GGfomia.
Date: 9pnaNre:
NOTICE: II. aher maldnq Nk Cetlantion, you shoWd Decome w�l� ro tM Wohsrs' Compe�atian Drov¢iom ol Ihe Labor
CaOe. )rou mu5t IortRxiN comDN vriN sudi Vrovisions or tlds Gemtit 5hatl De aremeE reroke0.
fANSTHUCf10N IFNDING �GFNCY: I Aereby aifirm ihat Ucere 'a a�sbuc�ion kndin9 apem,y for Ne pertormanca oi Ne work for
wNc� Itus Mrmil a iswM (Seciion 3W7. Civ. C).
lENOEN:
�OOflE33:
OWNER BURDEP DECUM7ION: I tcertCy attum Wt I am exempt M1om ttre CoMractors State lice�se Law lor Oie totlowinp reason
(Seceion 70�7.5 Businea anE Profassimal CaUe: My dry ol caunry ��Wuires a pemtit to matruct. atter, Improue. tlemolish, w
repair airy sinMure, pMr ta Rs issuaxe, also reyuires Ne apqirant Im wcli pemtit lo We a sipne0 statement fAat ��/stie I5 IlanSeO
purwant to Itre 0�� al Ihe Cantraztors' Statn Licensa Law (CI�+DRr 91�mrtce�n0 with Section 7000) ol Division 3 0� Ne Business
anE Pmlessions CWe) a Wt MJshe Is exempt Nerefrom aM the bam tor ihe allepe0 eaempibn. My vbWibn ot Sectbn 7031.5 Ey
a�ry applkant lor a pemit su01K� � aDW��t ro a dvil penalry ol �ot more Nan Iive hwWreO Edlars (f5(10).
I, az owner of Ne propeM or rtry employees wiU wapes xs Ne'v sole compensatlm. xiu Ca Ine vrork, an0 tAe
Siructure is no� inlenEeO or oHerpA lor sale (Seciian 704I, &ul��ss:nE Prolessional CaOe: T�e Contractors' Slate Licensa Law
. . Ooes nat aDON �o an awner ol a DmpeM ��+��� or imprWa t�ereon. a�M wAo Eoes such work �imsetlmersell ar throup�
' �is ar Aer own emplo�tu, provltleE Ihat suc� improvertrcnis are irot ntenOM or oflereE for sale. If. hmvever ttn WIIEinp or
Improvament is sda witAm wre year al mmpefion. Ne mme� ��w tM EUNen of provinp nNstia dk �rot OWId or improve
lor IM purpose ol xle�.
I, as owner oi tlre Droperty, am udusivery convaztinp with IicE�d �vactws ro wnswct Ue prol�� (��on 704/, Business
❑ an0 Professians Cotle: The CmVactars' Suro Licensa law Aces rot appN ro an owner o1 D��y � �u ds ar impraves Nereon
anA wAo canfrac45for SucA Drojects wiN a conVaqor�s)Iice05e Dursuant ro t�e Contractors' Stata License Law�.l am aware
Ihat praol al tlreir Worker's Campematian iirsuance SMWE Ee DroviOeE lo ma.
� I am aempt unEer Secllan: B. E P. C.
lor Inis reason:
Date: ��
I Oo MraEy ceniry IAat I am aware ol anE unaerstanG �M repuiremeni4 a� Califomia Health anC Safery CaOe Sectians 25505, 25533, anU
2553A an0 itWt I ar any lutua CuilGinp aapani vrilUwill noI (prde an6) neeE Io compty wiih sai0 sUta co0e5 anOIAB repuirements lor a
permit for wnstruction or moAi/iratlon tmm Na N'�ManaBemEnt Ustrict. HeSiEentul consWcGon aDDlications are e�empt Iram
tAese pmvisions.
�ate: MD��� —
I Aertby ceniy tAat I twve rea0 tl� apD��on arid siaro Nat Ne
orEinanusanO5lateWwsrela4npkEuilEmq tructimaMherel
praperry �orinspection purposes.
Oaie: — SOrem�
or�ver's �iunse or Socia� Secunry w:
I a0�� �o mmDN �� all Ury anE counry
tg a�o mter upon Ine aCoue-mentipne0
i
j � O
i)-.r t—�C �
1841J8 W�i�e—BuiWinp: Green—COEe Enforcomant: Canery—APGlicant: Pink—Rovenue: GoWenrotl—Aveswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 049165
PERMIT NO: F 049165 PLAN CHECK NO: 05265-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERHIT TYPE: FIR PURPOSE: OTH
JOH DESCAIPTION ; FIRE SPRINKLER SYSTEM FOR OFFICE T.I. SQ FT:
CLAIM VALUE: 2,680.00 CALC—VALUE: GROUP OCC: /
COMMENTS: X
*�**r�r�er*rr***�r+r*rrwrrrw*�r�r**rr*+r**+rr*�r�r�r*�r+rxr*r+t+r*�r*x*+r*�r*�*r**+r*r�rr***+r*�*��r
Z O N I N GS ERTEBQA�CZKRSE M E N T S ,
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN "
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 2NE: REF NO:
�ANNING NOTES> '
>
MlfitikifkiFMilMMkilltfkfkMkM%MMMkkffikMMiFitlfikMMfflFNiFMMikkMlFiFiFkkMMiFfFMMiFiFkMifiFitMiklkiEfEltitiEiFiEififiEifik4
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ZSSUED BY• DATE: �'0
MkMMiFiFlFMilMMMkMMMMMMifNM iFKMMiFKMiFKif MiF
1f�klkifihififikMMMMkMfFfFMMMititMkkifikMililkMkMMMMMifMitMillfMMiFkMMkiflffFMkMMMMMMMiF1FMifiFitMMiFilMiEMMif%k
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 54.00 0.00 35.10
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG pMT PLUMBING ELECTRIC MECHANIC
54 �0
�i5i SMIP/NON—RES
35.10
TOTAL PAID DUE
89.10 89.10 .00
54.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADZNG PLAN—CHECK
54.00
iFMIF1litKiFKif itllMilMiFiFiFMiFiFiFiFM�f iFiFMMKMNiFiFiFM1FMiEMMMIfMiFMif iFiFilMkilikMiFMiFMilMifMMikiFiFiFif 1f 1f Mif iFMaFkif if if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
FIA 54 FIRE EQUIP FEE (FROM BLDG VAL TAHLE) 1,00 54.00
END OF FEES
. .n
m
0
D2 00070362—CC07�3G2 T �.� �
DATE: D9/25/9� TittE� 12:35
CONSTRUC. N AN LANNII - �L & SPA
APPROVALS �- er it � Date Inspector pppROVALS Permit# Date Inspector
1. Temporary Electrical Se ' or Po�G 52. Pool & Equipment Location
;i3�SoilPipe-Undtgrn� o ;�,�' 53. SteelReinforcement
��3'Electrical Con�i�i��hi�iry-UndrgrriQ�F 54. Forms �
V�. -
s.A-;Electrical Concli�it-, , drgrnd. �,y 55. Electrical Bonding
^�SNStee1 Reinforc�i�i 4 ��%`• 56. Rough Plumbing & Pressure Test �
��Electrical UF � Grnd. � �. 57. APPROVAL TO COVER�GUNITE �
yN.�Foo[ings OC u. 58. ElectricalConduit�Undrgmd. 6
,�-
{$. Foundation �" 59. Gas Pipe, O Undrgrnd., Test �
�.^.Water Pipe�Unt#rgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
� .
��QStructurel Floor System q 61. APPROVAL TO DECK
�. Property Sewer LiriF & House Conpgction 62. Backwash & Receptor�Final
�
f2. Sewer Cap a •� , n' 63. Heater & Vent•Final
:.n `+
•J
13. Roof Drains -� 0 64. Plumbing SYstem � Final
14. Rough Plumbih� 65. Electrical�Final
15. Rough Electrical-Conduit 66. Solar System-Final
wi 6. Rough ElectriCXJiring 67. Fencing & Access ApProval
�77. Rough Wiring,�jgn 68. APPROVED FOR PLASTERING -
18. Rough ElectriG3Y-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19;7,RouQh F�,leat�ng &�r Conditi4piu� ,_..., * y 2 Q� Y C,FIgE.DE�T. F�EQUIREMEN3. ,-n
".i�
��. O Ri ti N �
20�.:;Ro�h �actcqy �aplace i ST G.^, * S .-� Cx � � PPR9VAiS-�FPednit # '*' "'
n• s �•�. ac ^.«. r. 'r '�
21."aDu s, il�St�ct �'�r.,�� � .. •. �'-''' '' S � �'� � `70. �der n u� Hy�ro x
- � �. i S t- K CJ i-; C1 �� 9 0� fi
22�ucts. Ventdatir�# i ��!'� �.7 � CJ F* ��71. Product�7�i�g ,�s Q�OiI
23.'Ga{_ iP^Roqgh B�Test � '� * `': � `t O" �' �' '"i * �
�,P � �, K i mn� CSU * � a S� s �z• Undergro FI�.S� y� �, -�
24: Roo Fcaming �M �� � �r; x > � r-,x x••73yUndergrnd. StorS'g�ank'{] Gas ❑ Oil
25GRo�f Sheathing � � ���� .. e' m �� M 74�"Overhead hiYdro��., �'
9 �z.�- cv�h
N W V 1 .
26" �8�+ Ceiling (Struat�ral) & rgicoat � O >+ Cx W 75�Dry Chemtcal i-�D >'. ^ v �-+
n
27�frameand Fi3shin �^� X Q' >' �tW w �'^� x ^'T�
h� H � HmCJ Q, � �,k �M 76. Dry Stanc�i'�e a�,.., rt G N
,��2, 8. Lathin S' in9 * OCCF O �� � I �� 77'7 FIXED SYSSfEIGLFaNAL?' ^ C� U� ��..q.s�D �,Q
�
�� S •• z # i � r y: > 'J', t�
29. Insulati}h o � S CJ � S I * 78dFIRE PREV. FId.4L y; S �
� 30. Drywal4Mailing � r-i i � F• � I x S �hJEAITF�'bEPT�tREQU1REMENT
�31. Plaster �o�Coat* S i�"F ,� I I �* 9^FINAL If�gECTI�I M� �'"•
'r. - ��s7 " � i a x ^
.=32.=�lectrice2 Povyer Mqier-�nalt � I I x O.�OOD CERTIFIyAl'E IS6lJfDt; r+
b33.�i E(' crie M � i 'Q * I i * Noies: " '-� �`- C�� .
t'^ i ri �! x x G . W r < m n �Ic �T. S
,�Q342Fin� H¢atin�& Ai*CeR�itioni ?; � � I y: `� � F� d`�
^, ..
�35.rFinal Ga`s Pip2-Test� O� " X�+ I I �* �,'� Cn * M `-r
�. n
,�.. x � � r• �: a �: � � : .� Y .. .
�6.SFio� o�CanoPY � Cl i �T.� 7 -r .K i � ' k: !Tf XO * ^ >.Ti
y 7. •Final Fa tory Firep�ar�� ' `"�"' ^� * I ' - � � x � ^ro
c� i • o x;� � ¢ mv >
5.38.1J-in3m1� Plpmbin9 x;a i O z � � X � tx • * �
r39.�/ater Se�vice-Final� E i N � Q � I KK* F� ?� * n "'-
�
AO.,I ?: i 7 '� T T S a" [Tl M '..� u �--
as Serv' e�Final '
.�' r� x !1 c, F [*: * * F• o E *�G
i-41. Solar pomestic�Fina1 � i*i x^ � M rv w io c �e z �
c. � r-. f I * ri n. r.: C i x S
42. Backflow Preventer* �'' * � 1 `� * •'� • r' "" '�
„ * cv o-,r-� *.-� � x c�or�--� m0 * .
43. Backflow Ir yation� � �" � � � n% �� * ^ •�
� � +: ��F N x3 O O
� 4. Landsc�9 I�iqatiop Syste y�� � * m " ** r w . s-� �
� r F '^�¢..-. t*7 x �¢ ¢�2* t� � E m o." � s
45. Sound kttenuatiora ^. .... ' � -' :�; :*: ma � i-+ c' et • F� *
c 4 n a .•M M / / H� ••F.y *
�16.'Handicap"Fegulati "s " ,. � x'
°.i� S '� � 5 •.� .•� �k * Q :�7 O CJ *
t*47. INf�L STRUCTUFE & BUILDING � F I I *� � i c' � �
� ;} � m �n x !K * N .T. '7 l� .r`i
46.�IMl�}L PLANNING� �`�`� *� I I M ~
t x ��!K !J 7:J S * G
i1l9.vElect'ric Release [o Edison i z: I ' �*� •C'� �? � r�
w i i F. x O^ i � G
(' x I ! :� * F �-+ O• c;� � �.
�60.=Gas�,ie�ease to Sout�ern Calitor�."�� Gas Co Y �,•• s �o l� * :.; ..
"51. CERTIFICATE OF OCCUPANCY ' '" "- " '
No. Date
• ADv���ant to fill in a�l spaces exeeot tnosa witnin neavr porEer Iinet antl sign all aDo�oprlate aaelantlons.
P T NO. TR C N LOT NO. U IT NO.
CITY OF COSTA MESA ACO STRUCTION PER IT ��� � �j�i1� p D A.P.vW r,^Q j� p Zone C
Project Address . S S� Ll-1C/ �" 3 C7L, _ S Main Building: � Accessory Building:
Applitant'S Mailing Address TYPE OF CONSTRUCTION- NEW ^ ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMbLISH ❑ OTHER T Front 0
Owner's Nome �C:J J one DESCRIPTION OF WORK/USE OF BLDG. � A Rear ��� N
Address
Arch/Eng. License No. TVPE OF 7ERMIT GRADING FOVrvOA710N STRUCTVRAL I K Right G
' Addr2S5 7-�' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL , g� Left
Cantractor's Name�;P+N p.G .Si�n o.Q 1 Phona�'� 7��' 7�1 ��oTHER � �� ping, Ref. # Parking fieq.IProvided E
Atldreu (mailing) ;h$� C ���� SV�. f�l �o"� ti. PROJECT DESCRIPTION So. FT. I OCCUPANCY � Planning N e M
Ci�y�icenseNo. �3,Z ��J� CONSTRVCTIONTVPE VALVATIONS 1�n T
ZONE GRADING CU. VDS. ACRES g,
LICENSED CONTRACTOR DECLARATION �
I nereby attirm that I am ticensed untler provi5ioni of Charter 9(tommenting qemarks: ✓
wi�h SeCIiOn J000) O} DlviSiOn 3 01 Lhe Bu5in855 entl Vr0}¢SSIOnS COEe, dntl •
. my Iicense is i�l /.ce ana errect. Z/�G 3 � � ELECTRICAL FEES
uaeose i� I: toe o1c.Sd ��
Oate�/L� Si9nature � � PLUMBING FEES Au[omatic Washer Trensformer � 15-50 KW
._;^j3RKER5'COMPENSATIONOECLARATI N ConStructiOnPoleSub. ❑SO+KW
.areDy aflirm Ihat I have a certiticate ot consent to seifansure ot a CGrtlfiWte ge� $ink $hOwC�S
'. - Workers' Compensation Insurance, or a certifletl copy thereot (Sectlon gackflow Preventer Servite Sink �oking Unit Meter ❑up to 100 amps
� 3eoo, �ao. G.1 � 0 3��5 ��, " Dishuvasher Meter ❑over 100 amps
Policy No��F� Company Backflow Irrigation Sewer Ca
P
Certifietl <opy is hereby tumizhetl. Dryeri �Gas ❑Electric Sub Panel
Certi iep c j+ f�iletl with the citv�ig Isi � Bathtuhs Sewer Conn¢ction �
Date� �/ ��[�Y nooiicanf � i J-c-�-�-' l Fan MOtors �Pl HP � 1 X- 8
' EXEMPTION FROM WORKERS' COM SATION DECLARATION Clarifiers $ole! CAlIeCtOrS
(This section neetl not be campletetl i( tne permit Is for one �undretl (E100) or f,A,U. Inc. Solar 0315 HP 016-15+
Icss). Dishwusher Solar Piping
I certity tnat in the oerformance ot tne work for which jhis perm�t Is Issuatl 1 .
shall not amploy any person in any manner'so•as to become zubject to tf�n Drinking Founteins Solar Tank Fiztures Microwave
Work¢r5' Comp¢nsatlon LawS of Cali(ornia. DeViC¢ 80X¢5 P01¢ Li ht
� Date Signature Floor Dreins Swimming Pool w/Spa 9
NOTICE: If, after making this declaration, you shoultl become sub�act to the ,
Worker5' Compensation provision5 of the Labor Cotle, you mu5t torthwith FloofSinkS Ufinel ODUetS Renge '
comply with such plovl5iOn5 Or thl5 pOrTlt Shall'"DB tl0C'mttl rUvokatl. $WiLChQS
CONSTRUCTION LENDING AGENCV GasService OUtlets WBterC105et � 5�9� '
1 nareby a/8rm that there is a construction Inntling agency for the performanco
oi tho work tor whicn this permit Is issuea (Sectlon 3097 tiv. C.) Interceptors Water Heater Garbage Disposal Standing Settions .
l.entler's Name
Lentlo�'s Atlaress Kitchen Sink Water Service � Generator �0.5 KW �5-15 KW Trash Compattor
OWNER BUIL�ER DECLARATION . - .
'.,.,a 1 hereby atfirm L�at I am exampt from tno Contractor'i Licensa Law tor the LavatO�ias Auta-Wesh "
1 following reason (Section ]031.5 Busineis antl ProfeSsional Cotle: Any clty or
."t' County which �equire5 a permil [o construtt, dltOr Improve, tlemOlish Or �opai� p_Trep �ellndry TfeyS ��
� any structure, prbr [o Its issuanca, also reqWres tl�e ap0���ant tor such permil
^ lilo a signetl statemenl that he/she Is Iicenzetl pursuant to tna orovlsions of Roof Drains
Con[ractor's License Law (ChaO�er 9(commencing witn Sectlon 7000) ot
sion 3 of the Business an0 Professions CoOe) or [hal ne/she ii enempt Reinspeetion Fee $15 luue Fea $ 3
_�retrom ana the basis tor the allegetl exempUon. Any violation of Soctlon
� 7031.5 by any appliwnt for a p¢rmlt Sub�e[Is tno aPplitant lo a clvll
�enany o� not moro man troe nunaretl tlouars (E500). DEVELOPMENT SERVICES REQUIREMENTS: r�
LJ I, as owner of t�e property or my employeos witb wa9e5 as thelr solo ReinspBttion Fee S75 laue FBe $ 3 �,% f L—/�
compensa[ion, wlll Ao lhe work, an0 Ihe strutture ii not inlentlatl or offerotl Zoning Approved By Dat
�or salc (Section �044, Business ana Pro(essional COCo: Tha Conlractor's MECHANICAL FEES Buildinp Approved By
Date
� Ucense Law tloes not applY [o an owner of a prgparty who builtls or Improvas � _
�� tnoreon, ana wno aoes sucn work himsmf/netsell or tnrougn nls or her own go��er Hood or T e I O APP��mtion lesued By 1 �at
¢mplOyees, plovlGetl lhdt such ImprOveTenlS dr8 nOt Intentletl of offOratl fOf YP
wle. If, however, Me bUlltlin9 or ITprovaTMl Is soltl wlthin ono y0a� ot com- ��ODY Typ¢ II ❑ $UM$�S l0�
pletlon, th! owne! will havG the buftl8n Of pfoving h0/She tlitl nOt builtl Or IT- �UCt - U11d¢f CifOUnd , �
piova tor tho puroose ot saie). . BUILDING PERMIT $ MIP $
❑ I, as owner of the proDerty, am exclusivelY contracting with Iicensetl con- Duct-Struttural Refrigeretion System � p�,qN CHECK PEfiM1T
' tractors ta construct the project (Section 7044, Businesi antl Profasilons Cotle:
. The Contractor's License Law tloes not apply to an owner ot pro�erty who Duct - Ventilating �4700,000 BTU ❑100,000 BTU ISSUANCE $
PLUMBING $
buiias or imoroves thereon. antl who contracts �or such orolects wlth a con- ' ENERGY P.C. $
1 trattor(s1 hcense pursuam ro ene ConVattors License Lnw). I am aware that Exhaust Syitem ❑ Multiple ❑ Syitem Repair/Alteration � PLAN CHECK 25% $
� orool o( tneir Worker's Compenutlon Insuranca shoultl �e pwvleetl to me. �ELECTRICAL $ GRADING $
1 I] I am exempt untler Section B. 6 P. C. for this reason Fir¢pl/Fact. Blt. ICBO dk Fire Dampers
� PU1N CHECK 50% $ MICROFILM $ �
I Date owner Heating System & Ducting Regizters -MECHANICAL $ TOTAL FEE $
I hereby certity tnat I hava reaa tniz aoP�ication and state that tne above ❑P700,000 BTU �100,0006T P�AN CHECK 25%
Informa[ion is correct. I agree to comply with ail <ity 8nq county ortlinances i $
antl state laws relating to uil ing constructlon; dOd hr�by authorize repre-
sentatives ' it ent - the above-mentionetl prop rty or
Inspection p . �
Slgnatur� u—t / oate � y peinspaction Fee $75 laue Fee S 3 . 01 ODO:?54D—�D022542 YEJT 64C.^C
. Drivers' en or 55 � �
D�aTF: 12/15/88 TIME: 1^:�❑
oaeo-ne, rev. >�an wmee - ewiaing; canary - iappucanr, wnK -'accounim9: uoiaenroa - sassessoi
CONSTRUC710N�AND PLANNING . P� & SPA
APPROVALS Permit # Date Inspector p�ppROVALS Permit # � Date Inspector
1� Temporary �lectrical Service or Pple ' , 52. Pool & Equipment Location . ,
2. Soil Pipe-Undrgrnd. ," . 53. Steel Reinforcement . .; ; �
3. �Electrical Cqnduit Utility-Undrgind. , 54. Forms �
4. Electrical Conduif-Undrgrnd. � ' 55. Electrical Bonding
I,
5.��Steel Reinforcement ' , 56. Rough Plumbing & Pressure Test . i.
-6: Electr,ical UFER Grnd:•• ' � - 57. APPROVALTO COVER-GUNITE � - _
,7._Footings � � � � 58. Electrical Conduit-Undrgrnd. �
8. Founda[ion , � 59. Gas Pipe, O Undrgrnd., Test .
9. teriPipe-Undrgrnd;. . � • 60. Backwash Lines, P-Trap, O Undrgrnd. ' .
10. Struc{ural Floor System ��� • ' 61. APPROVAL TO DECK
1J:-Property Sewer Line & House Connection � 62. Backwash & ReceptorFinal
�2; �e"�'ef �P � � � 63. Heater & Vent-Final � �.
13.'Roof Drains � ``• • , 64. Plumbing System - Final �'
14��RoughPlumbing 65. Electrical-Final ,�
15. Fough Electrical-Gonduit 66. Solar System-Final �
�16. Rough Electric Wiring 67. Fencing & Access Approval
�17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
t
21. DuCts, in Struc[ilre 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.StorageTank�Gas ❑Oil
25. Roof Sheathing � ,' 74� Overhead Hydro '
26. T-Bar Ceiling (Structural) & Menocoat //���� � 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 Mete�-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � - . � Notes: ��� Co
34. Final Heating & Air Conditioning � L� � �
35. Final Gas Pipe-Test ' �
C' /
36. Hood or Canopy - �
. �
37. Final Factory Fireplace :.� 7
3S. Final Plumhing � -.
39. Water Service-Final • �
�40. Gas Service�Final :�" , � � _
41.Solarpomestic-Final� � .
� 42. Backflow Preventer _ ,
43. Backflow Irri9ation � �
44. Landscape Irrigation System ' ' ,
45. Sound Attenuation � - � �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING ' ] Z� - /
48. Special Requirements Completed
49. Electric Release to Edison � '+
50. Gas Release to Southern California Gas Co ' ��
51. CERTIFICATE OF OCCUPANCY ,' - �
No. Date '
�/
\
�
�
0
`�Q S y/ .4oni��ant Io /ill in all spaces exeeot Inose within neavy Goraer Iines ane si9n all aoorooriale Eaclaretions.
CITY OF COSTA MESA CONSTRUCTION PERMIT � PERMIT N0. TRACT NO. LOT NO. L1NIT NC� �
Project'Address S �-d�b
Applicant's Mail�ng Address l�� 'LS/�-�/NALI/�O
Owner's Name �FG //iL� !sL//i'r� pn�� ,
Address .�r� .'Q.L/%UL/ �iLvr �t�[Lffd �
Arch/Eng; � License No.
Address
Contractor'sNam �- hone�YY-6r�
AddreulmailinglCZ/T �.e.,ii� i � �/
Ciry License No. (i� ¢� �
LICEfJSED CONTRACTOR DECLARATION
I �er¢by affirm that I am Iicensetl untler provislons ol Charter 9�(commencing
with section 7000) of Divlsion 3 0l the Busineu antl Professlons Coee, antl
my Iicense is in full force antl eHect '
l.i<ense Class - License No�Z UIs�C
Date �-/�_?� Sign�e
WORKERS' COMPENSATION DE LARATION �
1 her¢by affi�m that I have a certlfitate Ot consent lo seHtinsure or a cerUticate
o� Workers' Compenssfion Insurance, or a certitletl copy thereot (Section
3800, Labr C.) " � "
Policy No70[�'/_=rr'iuT� Company��t<'�
❑ Certifietl mpy Is hereby turnishetl. �
L�VCertifietl copy iz fil¢tl with the ci uiltl q Divii on. `
Date I �{ji� APPIir �,� ,A�ie_� '
EXEMPTION�FROM WORKERS' CO ENSATION DECLFR ION
(Thi55eCtion neetl no[ be completatl if tha pBrmi� Is �o� on! hu �etl (E100) o�
less).
1 certlty that in the pe�formanc¢ O/ the wOrk lo� w�ich Ihis perm�t is ISsuetl, I
snall. no[ em0�0y any pe�son in any mann¢r so a5 to become subjec[ to [h<
Workers' Compensation' Laws of California.
Date ' Signature '
�NOTICE: If, atter makin9 this tletlaratlon, you snoultl'become subject lo the
Worker5" COmpinsalion provlsio05 of lhe LapOr Cotle, you must fOrMwi[h
compry wlt� such provlilons or 'this permlt s�all �e tleemetl revoketl.
CONSTRVCTION LEfYDING AGENCV -�
1 hereby aHirm Inat lhere IS a ConSbuCtion Ientling agency lor Ihe pertormdnce
Of [h¢ wOrk tor whic� thls permit IS •iiivatl (Saction 3097 Civ. CJ
Lentler's Name
BUILDER UECLARATION �
afflrm IhaC I dm CxemO� 1rOT tho COntractor'S LI<GnSE Ldw 1of llle
reason ISectlon 7031.5 Buslness and Prolesslonal Cotle: Anv citv or
11.5 by any applicant for a permit sub7ects tno appllcant to a
alty o1 not moru tban flvo huntlretl dollars (E500).
I; as owne� o� �he p�opo�ty or my artlpl0ye05 with waga5 as lhei
ipensaHon, wlll tlo the work, antl the structuro is not in[en0etl or oi
sale (Settion 7046, Buslnoss 5ntl, Prolesslanal Cotlo: The Contra
nnse law tloes not aooW to.an ownar o1 a omoertv wtio bui105 or Im[
saie. n, nowever, tne owimng or imOrovomen� is soia wi�mn one year, o� com-
pletion, th¢ owne� wlll have the burUen o1 p�oving ha/she ditl no[ bui10 0� im- .
p�Ov! fo�the purpo5e ol5ale). •
❑ I, az owne� of tha p�operty, am ezCluSivGly Conttactinq wi[h lic¢n58tl Con-
tractors to cons[rucl the project (5¢CtiO� 7094� B�SiO¢SS dntl P�Ot¢SSio05 COtlO:
The Contractor's LicanSe Law does nol apply [o an owner of property who
builtls or improves theraon, antl who contracts tor such projecls witn a con-
tractor(s1 Iicense pursuant'to tne Contractor'S Licanse Law�. I am aware lhat
proof o( their Worker's Comp¢nSaUon Insurance should be provitletl to me.
❑ I am exempt untler Sectlon 8. 8 P. C. for this reamn
Da[e pwner
I here0y certity that I nave reatl this application anE state that Ihe above
Information is correct. I agr¢e t0 Comply wltlf dll City antl county Ortlinances
antl scate laws relating to bulltling conitruction, antl hereDy authorize repre-
sentatives oi tnis'ciry to enter upon the above-mentloneE property'for
inspection pur ose5. '
Signatur� Data�y� �lr
TVPE OFCONSTRUCTION �LJ NEW LJ ADD �ALTERATION IJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT-H� '
SCR;PTION OF WORK��.1SE OF BLDG. �R [<L(tT �`J
L�T �!/�c��'y�cy.� i�E Gi0
TVPE OF PERMIT��WG LJ FOUNDATION �STRUCTV RAL
❑ TENANT ❑ ELECTRICAI ❑ PLUMBING � MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sc1. F7. OCCUPANCv
CONSTRUCT.ION TVPE VALVATION S
20NE' GRADINGCV.VDS. ACRES
Remarkt: %%/ .�/ .�l�i�.;T� iQ_%� fJ%�i
$ink
<flow Preventer
<flow Irrigation
rtubs � �'
ifiers
iwasher . .
FlOor Drains
Floor Sinks
Gas Service . Outlets
Interceptors' -
Kitchen Sink
P-Trap
Roof Dreins -�
�Reinspection Fae ` $15
Boiler
Duci - UndenGround
Duct - Structural
Duc� - Ventilating
ExhaustSystem ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 eru � i oo,000
R'
Drivers' enze or'S5 � I I elnspect�on Fee
CMF 0865�46, rev. 10/84 White - Builtling; Canary - ApP���ant; Gink - Accounting; Goltlenrotl - Assessor
$15 `
Showers
ServiceSink � �
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
laue Fea
Hood or Type I ❑
Canopy Type I I ❑
Refrigeretion System
OPi00,0008TU ❑100,000
System fiepair/Alteration
Fire Dampers�y G Z f.
Registers .
laua Fee
FEES
S 3
A.P. yW
S Main Buildi
E
T Front
B Rear
A
C Right
K Lett
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole
Cooking Unit '
Dishwasher �
Dryers ❑Gas C
Fan
F.A.U.
lectric
Device Boxes �
Outlecs
Switches
Garbage Disposal
Generator �0.5 KW
Zone.
Parking Req./Provided
ELECTRICAL �
Trensformer ❑ 15-50 KW
❑ SO+KW
'Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors�blHP�1h-8 •
Inc.Solar 09-15 HP 01frt5+
Microwave ' '
Pole Li9ht
Range
_�_ �; Standing Sections
5�15 KW Trash Compactor
��
FEES
I Reinspaction Fee ' I$15 I I laue Fee I �$ 3
DEVELOPMENTSERVICESREQUIREMENTS: ,
2onine APProved By Date
Building ApP�oved By Date�
APVliption Issuad Bv n nate-1.J..L�J!
� SUMMARVOFF
BUILDING PEFiMIT $
PLAN CHECK .$
PLUMBING $
PLAN CHECK 25% $
E�ECTRICAL S
PLAN CHECK 50% $ �
MECHANICAL s �f •�v
PLAN CHECK 25%' $
Z
O
N
I
N
G
R
E
Q
M
T
5
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $ ��� ('��
TOTA�FEE $ �
01 oa024239-OD024339 T�T E.J.J�
UATE� OL12/R9 71HF: 74eSR
. 1 ` •.\ . . � . . . .
� 'CONSTRUCTION AND PLANNING . � PV.+� & SPA �
APPROVALS Permit# - Date Inspector AppROVALS Permit# Date Inspecmr
�1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Elec[rical Conduit Utility-Undrgrnd. • 54. Forms
4. Electrical Conduit-Undrgrnd. _ 55. Electrical Bonding .
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
`7,.'Footings � 58. Electrical Conduit-Undrgrnd.
�. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test -
� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgmd.
10. Structural Floor SYstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains _ 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical-Final
75. 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 SYS'fEMS FINAL
19. Rough Heating & Air Conditioning ��� G� FIRE DEPT. REQUIREMENT
• '� .
20. Rough Factory Fireplace APPROVALS Permit #
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.StorageTank OGas ❑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
32i Electriral Power Meter-Final � 80. FOOD CERTIFICATE ISSUED �
33. Final Electric Notes:
34. Final Heating & Air Conditioning �/�b/� (��
�
35. Final Gas Pipe-Test
36. Hood orCanopy �
37. Final Factory Fireplace � _
38. Final Plumbing �
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Final �_ .
42. Backflow Preventer �
43. Backflow Irriga[ion �
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. CERTIFICAT.E OF OCCUPANCY . . � . .
\,
Nn. � � Date , ' t � , ' �
��
AOD���ant to fill In all spaces exee0� lnose wll�in neavy EOrEer lines ana sign aIl aoorovriata tleclantions.
CITY OF COS7A MESA CONSTRUCTION PERMIT
Project Address S��` �L'�j �1lITE ���� _
Applicant's Mailing Address
Owner's Name hone
Address ,1
Arch/Eng. -L���� License No.
A�ldress ���� � �� L �S p �o��es
Contractor's Nama �- `lf�L\ f IPrir1L Phon�—
Addresslmailing) �CZI��h�t� �' 10�1 �'n-sj'R N,FSA
City License No. n=��Q� �
IICENSED CONTRACTOR DECLARATION
I•hereby affirm tha[ I am licensetl untler provislons of Charter 9(commencing
with section ]000) 01 Division 3 ot tM1e Busineu anC Protessions COUe, antl
my license is in tull force antl e(fect.
. .. . . _. _ /� — 1 f1 . . _ . CI \'1LL�1 �
� �iiKERS' COMPENSAYION DECLARATION
.e�eby af(i�m [hat I have a certifi�vte of con5E0t to 5¢IttinSu�e o� a ce�tifica[e
o/ Wo�kers' Compensation InsU/ance, o� d certlfietl copy [he�eot (SeCtion
�3800, l.ab. C.)
cor�r No. ��P$8413��r14 comoa�v �Pmnt�T TcvlPrnc�i �1
\ Certifietl copy is hereby furnished. �x 1� —1 —�
Certifietl copy is t11eU with uty Bu ��9 Division. P
� te IA'I(e' $SJ AP I nt yM G7�.�OyA _
EMPTION FROM WORKE�COMPENSATION DECLARATION
(This section neetl nat Ge completetl if the permit is �or one huntlretl (E700) or
Iess).
I certify that in tne performancG of tha work for, which this perm�t IS IsSuetl, I
shall not employ any person in any manner so as to become suGject to the
WOrkers' Comp¢nsation Laws ot Cali(ornia. �
Date Si9nature
NOTICE: If, after making this declaration, you shoultl becoma subject to the
Workers' .Compensation orovisions ot the Labor Coae, you must torthwith
comply wi[h such prOvi5iOn5 or thi5 permit snalt ,be Oeemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby af/lrm that there is a tonstruttlon lentling agency for the performance
of tne work for wM1lch this permit is isiuetl (Section 3097 Gv. CJ
Lentler's Name
lentler's Atltlress
OWNER BUILDER DECLARATION
1 hereby af8rm that I am exempt from tna Contractor's License Law for ehe
following reason (Seclion �031.5 Bu5lness antl Professional Cotle: Any ci[Y or
county which requiras a permtt to construct, alter, improva, tlemolish or rapair
any stru<tura, pNor to i[s Issuance, also requires t�e apPlicant for such permit
� file a slgnotl statement that he/she is II<ensetl pursuant to tM1e provisions of
� ConVactor's License Law (Chapter 9(commencing with $ection 7000) o(
vision 3 of t�e Business antl Protessions Cotle) or that ba/she is exempt
anerefrom and tne basis for the alle9eC exemption. Any violation of Sectlon
7031.5 by any applicdn[ for a pormit suDjec[s Ine aOP��tdnt to a civll
�enal[y ot no[ more than frve huntlretl tlollars (5500).
I, az owner of [M1e property'or my employees with wages as thalr sola
tompensation, will tlo tha work, antl the zlructure is not IntenCetl or.offeretl
for sale (Section 7044, Business anE ProfeSsional Cotle: The Contractor's
License Law tloes not apply to an owner ot a property who builCs or improves
tM1ereon, antl who tloes such work himself/herself or through hls or her own
employees, provitlatl [hat such imprOvements ar¢ nOt Int2ntl¢tl or offe�etl fot
5ale. If, however, the builtlin9 or improvement is soltl wi[hin one year ot com-
ple[IOn, �he owner will have Ine bu�tlen af p�oving he/Sh¢ tlltl not builtl o� lm- .
�rove torthe purpose of sale).
I, as owner ot tho property, am exclusively contracting with licensetl con-
tractors to tonstruc[ the Oroje<t (Section 7044, Business antl Professions Cotla:
The Contractor's LiCense Law does nOt appty t0 dn owner ot O�operty who
builtls or improves therean, an0 who conVactS for such oroieCtt with a mn-
tractor(51 license pursuam [o [ne ConVactor•s License Law). i am aware that
proof of thei� Wo�ke�'s Com0en5ation Insuran<8 ShOultl ba O�ovltl¢tl [o me.
❑,1 am'exempt under Section B. 6 P. C. for this reason
Date Owner
I nereby certify that I have reatl this application antl stata that the above
Information is correct. 1 agree to comply witn all city antl county orainances
antl state laws relating to builaing construction, antl hereby authorize repre-
sentatives ot this city to enter upon the above-mentioneU properry tor
in tion purposes.
S9�ure �c1' � — e (e�'1in'g�
� 3693o I I la�3oo
TYPE OFCONSTRUCTION NEW ADD ALTERATION RE�AIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT�{ LJ GRADING LJ FOVNDATION LJ STRVCTURAL
❑ TENANT� L�.ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ �OTHER � ' '
PROJECT DESCRIPTION 5(2. FT. oCCUVANCv_
CONSTRUCTION TVPE VALUATION $
20NE GRADINGCU.YDS. ACRE$_
Remarks: � p ��. VO'9
Sink
Preventer
Irrigation
Drinking Fountains
Floor Dreins
Floor Sinks
Gas Service Outlets
Interceptors �
Ki[chen Sink
lavatories �
Roof Dreins
Reinspection Fee � $15
Boiler
Duct - Under Ground
Dutt - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/FacL Blt. ICBO #
Heating System & Ducting
00.100,000 BTU O 100,000 BS
R'
Oriv¢rs' Licen e} 5� — � � emspee[�on Fee
0865-46, rev. 5/88 Wnite - Builtlinq; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
$15
ShOWE(5
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Wa Clout
a[er Hea�
Wa[er Service
Auto-Wash
Laundrv Tra'vs
Isue Fee
Hood or Type I ❑
Canopy Typell ❑
Refrigeratlon System
00.100,OOOBTU ❑100,000
System Repair/Alteration
Issue Fee
A.P. qW
S Main Buildi
E
T Front
B Rear
A
C Aight
g . LeFt
Ping. Ref. �h
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit . _
Dishwasher
Dryers ❑Gas ❑Electric
f an
F.A,U.
FIXtUfCS
Device Bozes
OuUets
Switches
Garbage Disposal
Generator 00�5 KW 05-15 KW
2ona
Parki
ELECTRICAL
Transformer � 15-50 KW
❑ 50+KW
Meter �up to IOOamps
. Meter �over100amps
Sub Panel
Motors �0.1 HP �1'h - 8
Int. Solar �9-15 HP �16-15+
Microwave .
Pole Li9ht
Range
Standing Sections
Trash Compacror
Fee �$75 � � luue Fee
$� DEVELOPMENTSERVICESREQUIREMENTS:
ZOning Approved By
FEES � Building Approved By
Appliwtion laued Bv ' l'
S 3
' • SUMMARV OF F
BUILDING PEfiM1T $
�i . PLAN CHECK $
' PLUMBING $
PIAN CHECK 25% $
ELECTRICAL $ 2 OI. OC7
PLAN CHECK 50% $
� MECHANICAL $
, : PLAN CHECK 25% $
9
N
1
N
G
R
E
Q
M
T
S.
FEES
SMIP $
PERMIT
ISSUANCE $
ENEPGV P.C. $
GRADING $
MICROFILM $
TOTAL FEE $ �
D'+ 00O22748-OUO?27�8 TCaT �ul.�J
n6TC! iil11/IIB TTpP• i1��'1L
\i \���'•
CJNSTRUCTION AND PLANNING.- . % & SPA _
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspeimr
1> Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. _, 53. Steel Reinforcemen[ �,
�t Electrical Conduit�Utility-Undrgrnd. • ' 54. Forms -
4'.`IElectrical Conduit�Uridrgrnd. �, 55. Electrical Bonding
5:i,Steel Reinforcement � � i, , 56. Rough Plumbing & Pressure Test . �
6{�ElectricalUFERGrnd.^ � 57.APPROVALTOCOVER�GUNITE
� "Footirigs � I ' , 58. Electrical Conduit-Undrgrnd.
„8. Foundation , � � 59. Gas Pipe, O Undrgrnd., Test
i
9. Water�Pipe-Undrgrnd: • '� 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structurel 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-Finaf .
15. Rough Elect�ical-Conduit ' - 66. Solar System-Final �
1�6.� Rough Electric Wiring p 67. Fencing & Access Approval
�� : `��.
7.7:, Rough Wiring Sign - _ APPROVED FOR PLASTERING �
�. , s,
18:1 Rough Electrical-T Bar Ceiling �,( .� POOL/SPA SYSTEMS FINAL
1�9:'Rough Heating & Air Conditioning ; � FIRE DEPT. REQUIREMENT
.
20� Rough Factory Fireplace .` , APPROVALS Permit #
r,
21. Ducts, in Structure � 70. Underground Hydro
;�22. Ducts, Ventilating ' 71. �Product Piping O Gas ❑ Oil
!
� 23. Gas Pipe-Rough & Test 72.� Uniierground Flush
i
24. Roof Framing 73. �Undergrnd. Storage Tank O 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 0. FOOD CERTIFICATE ISSUED
33� Final Electric ?� Notes: � a
34. Final Heating & Air Conditioning -�. �_ yg� �
-k ,. � '.
35. Final Gas Pipe-Test
36. Hood or Canopy � - '
37. Final Factory Fireplace .
38. Final Plumbing ,
39. Water Service-Final
40. Gas Service-Final : ` �
'i
41. Solar pomestic-Final ' �
.
42. Backflow Preventer �� �; �
i
43. Backflow Irrigation , - -�
�.
44. .Landscape Irrigation System �,��'" �
, •
45. Sound Attenuation � �"-
46. Handicap Regulations ��
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison , ,� �%'
50. Gas Release to Southern California Gas Co � . %'l �.
•I _
51. CERTIFICATE OF OCCUPANCY ,' • • �',
No. Date � i �' '
• �.
� � .
l•'
N
1
V�./
� /�p Aoplicant to fill in all spaces exceot those witnin heavy DorOe� Ilnes ana si9n all approoriate tleclarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. uNIT Np.
�'!2 /'_ Q O / _ .. � ,�i /� ...rl .�
Pro,lectitddress 555 ANTON. 3RD FLOOR
Applicant's Mailing Address � •
Owner's Name SECURI ' A R Phone
Addreu �i00 WTISFTTRF Br� �500�_�_A__90017
Arch/Eng. Licenu No.
Address
Contractor'snleme Klrtibl2 3rid CO. pryp�e 895-1156
Address (mailingl
ciry�icenseNo. 038503 7540 SUZI LN. TiTES'II�IIIVSTI
LICENSED CONTRACTOR DECLARATION
' I beroDy affirm thal I am Ilcensetl untle� p�oviSiOnt ot Charte� 9(CommenCin9
wi[h section 7000j of Divlsion 3 0l the Business antl Protesslont Cotle, antl,
my Iicense is In tull far,�e a{��yettect. t] 60 � 2 3.
License Class �' 1 d cens 1 � �
Date��l4�� 519 t �
NORKERS'COMPENSATION DECLARATI
hereby aifirm tnat I hava a certiflcate o1 consent to sel!-Insure�or a certiticate
ot Workers' Comp e r a certHl r SBclion
3aoo. �b. ��$?1��F��37`-0Y g9t�St�i� °45d.
Policy No. - Company {���-�-�-- --�
�Certitietl copY Is hereby Turnishetl.
Cerf" " d 5o i" tl with Lhe city�j� tlin ivi5' �f �y
e � -/S�' APPlicantLS//��r. }. � /3�%1/ifA%�/
EXEMPTION FROM WORKERS' COMPENSATIOfi DECLARATI N �
(Thissection neetl not be comple[etl if the parmit Is for one huntlr¢tl (E300).or
�Iess). � -
I certlfy that in the perfOrmdn<¢ of the work 1or which [hI5 perm�t is ISsuetl I
Shall not emplOy any pe�son In any mdnner so as to become sUbjeG[ to t�<,
Workers' Compensation Laws of Calitomla.
Date Si9naturo
NOTICE: II, after making this tleclataHon, you shoultl �DeCome Sub)ett l0 lhe
WorkCrS' CompensatiOn provi5ion5 Of the Labor Cotlo, you must brthwith
comply with Such O�ovl5ion5 or this permit S�all be tleemetl tovoketl.
CONSTRUCTION LENDING AGENCV
1 hereby aflirm thal tM1ere is a const�ucllon Ientling a9onCy fo� tne pa�lo�manco
Of t�a work for �which tni5 pe�mil is issuatl (SaCtion 309] Civ. CJ
l.antler'i Name
Lentler's Aaaress
OWNER BUILDER OECLARATION
I hereby aHirm t�at I am exempt from [he ConVaclor'S Licenso Law Por tne
lollowing reason (Section 7031.5 Business antl Profe551onal Cotlo: Any city or
counry which requiras d P¢rmit to ConStrutt, al[¢r imprave, Uemolish or rCpair
any structure, prior, to its Issuance, also �ea W�es t�e applicant for Su<h pe�mit
[o fiie a signetl statement tna[ ne/she Is licensetl pursuant to lhe provlsions ot
the Con[racror•s Licenu Law (Chapter 9(commencinq witb Section ]000) of
Divizion 3 of the Busin¢i5 antl Pro(¢SSiOnS COtl!) or that he/sbe IS ¢zemp[
tbe�etrom antl the bdSiS tOr [h< allegetl ezemplion. AnY violafion of Sectlon
7031.5 by any applicant tor a permit sub)ects the applican[ t0 a civil
�enalty of nol more ihan tiv¢ huntlretl tlollare (§500).
1, as owne� ot the praDe��y or my emplOy<GS wi�� wag¢s as [heir sole
Cortfpensation, will tlo �he work, antl th! structure is not IntOntleE Or O1f¢rG0
for sale (Section ]044, Business and Pro(essional Cotle: The Contractor's
License Law Eoes not apply to an owner o1 a property who builtls or improves
thereon, antl who tloes such work hlmself/herselt or through his or her own
employees, provitlea [hat suth Improvement5 are nOt IntentlOtl Or offeretl for
ule. It, nowever, [ne bulltling or improvement iz solC within one year of com-
plttlOn, lh¢ Owner w{II have the bu�0en Of p�oving hG/She Eltl n0t bulltl o� Im-
prove to� t�e pu�po5e oi Sale�.
❑ I, as owne� 01 the property, am extlusively conl�acting wilh IICOnSetl con-
l�actoRlO conSVuct the prOj¢Ct (SBCIIOO iOAA� BIISI11C55 dOC Pl01855I005 COEB:
The ConVactor's License Law does not apply to an owner of property wpo
Uuiltls m improves tnereon, antl wno conVaclt lor zuch pwjetts with a con-
tractor(s) 1¢ens¢ pursuant to the Conl�actor's Llconso Law). I am awar¢ lha[
pro01 0( tneir Worker's Compnnsation insuranGu Shoultl De proviEed �o me.
❑ I am exempt untler Setiion B. 6 P. C for tnis reason
Date Owner
Drivers' Li<enze or 55
1 tnis application antl ztata that the abova
comply with all city antl <ounty ortlinances
p cOnSVuctlon, antl hereby autbo�lia repre-
�on tho above-mentionetl property torL
� Daies��(J
1 � / "' C�
TYPE OFCONSTRUCTION': NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTIONOF WORK/USE�OF BLDG. �
_ �,
TVPEOPPERMIT GRAowG FOUNDATION STRVCrUaA�
O TENANT ❑ ELECTRICAL'• ❑ PLUMBING ❑ MECHANICAL
❑ OTHER. ' '�
PROJECT DESCRIPTION 5�. FT. oCCUaANC�v/���
\ CONSTRUCTIONTVPE VALUATIONS�"'�[Q.IL_
'� ZONE GRADING CU. VDS. ACRES�
Remarks: (���-�t �
� a
Bar Sink _ . .
Backflow Preventer .
Backflow Irrigation
Bathtubs
Clarifiers � - '
Dishwasher
Drinking'Fountains
Floor Drains .
Floor Sinks
-CidS$CNICQ DUIIQlS
Intercepmrs
Kimhen Sink
Lavarories
P-Trap
Roof Drains •
Reinspection Fee S75
Boiler
Duct - Under Ground
Duct � S[ructural
Duct - Ventilating
ExhaustSystem ❑ MW[iple
FirepllFact Blt. ICBO �h
Heating System & Ducting
❑6100,000 BTU 0100,000
Reinspection Fee � S15
CMF OB65-46, rev. 30/84 White - Builtling; Canary - Appllcant; Pink - Accounling; Golaenrotl - AsseSsor
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Urinal
Weter Closet
Water Heater
Water Service
Auto•Wash
Issue Fee
Hood ar Type I ❑
Canopy Type I I �
Re(rigeration System
�aioo,000eru ❑ioo,oao
System Repnir/Alteretion
Fire Dampers
Registers
luue Fee
FEES
A.P. �
S Main Building:
T Front
B Rear
A
C Right
gLeft
Ping. Ref. #
Planning Notes:
Auromatic Washer
Consvuctiom Pole Sub.
Cooking �Unit
Dishwasher -
Dryers OGas ❑Elec
Fan '
F.A.U. •
Fiztures
Device Boxes
Outlets
Switches
Garbage Disposal
Generaror �0-5 KW C
Zone
Accessary
ELECTRICAL
Trensiormer ❑ 15�50KW
❑ 50+KW
SKW
Meter LJup to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors �0-1 HP O1 h� 8
Inc. Solar 09�15 HP 016�75+
Mivowave
Pole Light '
Range
Sign
Standing Sections
Trash Compactor
S 3 I �
I--- Reinspection Fee 515 Isue Fee
FEES'
DEVELOPMENTSERVICESRE�UIREMENTS:
Zoning ApPraved By
Building ApProved BY
Application Issued Bv
$ 3
Z
O
N
I
N
G
R
E
�
M
T
S
FEES
5 3
SUMMARV OF FEES -�S
BUILDING PERMIT. $ ,Z Q(J SMtP $ _4=
PLAN CHECK S PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ � ENERG� P.C. 3
ELECTRICAL S GRADING $
PLANCHECK 50% $ MICROFILM $ --��
MECHANICAL S TOTAL FEE $ ��S
PLAN CHECK 25% $
,CONSTRUCTION AND PLANNING � POOL & SPA
APPROVALS � Permif# Date Inspector qppROVALS Permit # Date ' Inspector
1, Temporary Electrical Service or Pole � 52. Pool & Equipment l.ocation .
2. Soil Pipe-Undrgrnd. �� 53. Steel Reinforcement
3. Electrical Condui[ U[ility-Undrgrnd. 54. Forms • �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .
5. Stee! Aeintorcement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings � 58. Electrical Conduit-Undrgmd.
8. Foundation i 59. Gas Pipe, O Undr9rnd., 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 prains 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. F2ough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL �
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # `
21. Ducts, in Structure 70. Underground Hydro �
22. Ducts, Ventilating � 71. Product Piping OGas ❑Oit.
23. Gas Pipe-Rough & Test 72. Underground Flush . .
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof $heathing . . 74. Overhead Hydro ��P�'
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,
27. FrameandFlashing � 76.�DryStandpipe -�
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-Finaf 80. FOOD CERTIFlCATE ISSUED �-
33. Final Electric Notes: ` "
34. Final Heating & Air Conditioning , p�, ��
35. Final Gas Pipe-Test �
36. Hood or Canopy
37. Final Factory Fireplace � 3d �•
38. Final plumbing � . �
39. Water Service-Final �
40. Gas Service-Final �
41. Solar pomestic-Final j �
42. 8ackflow Preventer �
43. Backflow Irrigation . ' �
44. Landscape Irrigation System
45. Sound Attenuation � .
46. Handicap Regulation5 �
47, FINAL STRUCTURE & BUILDING I
48. Special Requirements Completed I
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY � '
No. Date ' �'•� �
C�
AOplicant to fill In all spates except t�osa within �eavy Oortle� Iines antl Slgn all appropriate tleclarations.
CITV OF COSTA MESA CONSTRUCTION PERMIT 3_��, PERMIT NO. � TRACT NO. LOT NO. UNIT NU,
Pr4�ect Address ��"1 L+ i.� V�� � ���(j.ApO�
Applicant'sMailingAddress �Zli—D Garden �'iLOV2 BIVCl.
Owner's Name Phone
Address
Arch/Eng. License No.
Address
Contractor'snlamP Kimbip- 8rid Co Phone 895-1156
Addresslmailing) ��I1—D �3T(3 ri • nV2 Garden (�iT.
City License No. 0 3 8 5 0 3
LICENSED CONTRACTOR DECLARATION
1 hereby af}i�m that 1 am licensetl untler provision4 of Charter 9(commencing
with section ]000) oi Division 3 of t�e Business antl Protessions Cotle, ana
my license i5 in full tor e a q.eftect. �
�icenseC ss �—fb � e,ns% ty.io� 4�60923
Date ��� � Si9 [ ' �'�—'t""�
WORKERS' COMPENSATION DECLA0.ATI
: hereby afflrm that I have a certificate ot consent to self-Insure or a ccrtlficate
05 Workers' Compen5a[lon Insurance, o� a certii�atl Wpy thar¢of (Section
3800, L'.ab. C.)
Por�y No. PC981581 como/a�y Republic Ind.
�ertlfietl <oPyYv .i.s uheetlbwi[hrthehc�[Y B iftlin i 1 °� �% �
DateT���C,� APPlicant �� Tf'�l�
EXEMPTION FROM WORKERS' COM NSATIO�`1 ECLARATION �
(Thi55ection neetl not be completetl it tbe permit is �a/ One huntlretl ($100) o�
Iess).
I certity that in Ihe performance oi tne work tor whlch this oerm�t is issuetl, I
shall not employ any per5on in any manner so as to become zubject to the
Workers' Comoensation l�ws ot Caiitornia.
Date Signature
rvOTICE: Ii, aiter makin9�this tleclaration, you shtlWtl becoma subjett to the
Workerz' Compensa�ion p�ovisions of [ha �abo� Cotle, y0u mu5t forthwith
comply with such p�Ovisions or thi5 permit shall De tleemetl �ovoketl.
CONSTRVCTION LENDING AGENCV
1 hereby atfl�m tltat there iz a<onstruction lentlin9 d9ency fo� the perto�mance
of the work Por wM1ich this Oermit is issuetl (Section 3097 Civ. C.)
Lentler's Name
LenCer'z ACdre55
OWNER BUILpER pECLARATION
1 he�eby affirm Ihat I am exemp[ irom the Cont�dcior'S License Law for th¢
following reason (Section ]031.5 Business antl Pro�essional Cotle: Any city,or
county which requircs a pe�mit to conStruCt, a1tCq imp�ove, 0¢molish o� repdir
any structure, prlor to Its issuance, also requlres tpe applicani tor such permit
to file a signetl stalem¢nt tha[ he/she is Iicens¢tl pursuant t0 lhe provislons of
the Con(ra<tor's Ucense Law (Chapler 9(Commenc�ng witn Sectlon J000) ot
-Division 3 of the Business antl Profe55ion5'Cotl¢J or lhat he/she Is exempt
there/rom ana the basis for Ne allegetl exemptioP. Any violation ot Section
]031.5 by any applicant for a permit 5ubjectS the aOP���ant to a civil
�enalty of no[ more Ihan five huntlretl tlollan ($500).
I, as owner ot the� property or my employeBs witn wages as their sole
com0ensation, will tlo the wo�k, antl the structu�6 is not intenCetl or offetetl
for sale (Section �044, Business antl Protessional Cotle: The Contractor's
License law tl0esnot apply to an owner ot a propdrtY 'Nho bwlGs or improves
thar¢on, antl who tloes such wo�k himself/h¢r5elf or Ihrough nis or h¢� own
employces, o�ovltletl Ihat such improvements are not Intentletl o� otforetl for
sale. It, however, the bulltling or improvement Is SQItl within one year of com-
pletion, Iho owner will have [he bu�Cen Of provinq he/she ditl no[ bulltl o� Im-
prove tor tne purpose of sale).
❑ I, as owner of �ne proDe�ty, am exclusively co��ra[ting with licensetl con-
l�actors to construct the project ($eclion 7044, BuS�ness antl Prof¢55Ion5 Cotle:
The Con[rac[o�'S License Law tloes no[ apply to an owner of property wh0
builtls or improves tnereon, antl who conVacts tor such projects witn a con-
Vactor(s license pursuant to the Cont�actor'S License Law). I am aware that
proof o� their Worker's Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untler Sec[ion B. & P. C. Po� thi5 rea5on
Date
I hereby certily t
iniormation is c e
ana state laws I n
s¢ntatives oi tit
inspettion p ses. e
Siqnature
Drivers' License or 55
IF 0865-46, rev. 10/84
Owner
have rea�
F 3�1 2� �1f �.
TYPE OFC�NSTRUCTION�'� � NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑.DEMOLISH ❑ OTHER A p � �
DESCRIPTIONOFWORK/USEOFBLDG. S MainBuilding:
E
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL ' T Front
❑ TENANT ❑ E�ECTRICAL'� � PLVMBING ❑ MECHANICAL 8 Reer
❑ OTHER '. /• %�
PROJECT DESCRIPTION SQ. FT. OCCUPANC C Right
CONSTRUCTIONTYPE VAIUATION$�� g Left
ZONE GRADINGCU.VDS. ACRES p�ng.Ref.#
Remarkz: �� �; � L � 2 ) . n�� � 17 ���+�(j Planning Notes:
Bar Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspec[ion Fee � $15
Duct- UnderGround
Duct - Svuctural
Duct - Ventilating
ExAaust System O Multiple C
Firepl/Fact.8lt. ICBO #
Heating System & Ducting
❑ai oo,aoo sru 0 i oo,00a eT
Reinspaction Fee � � $15
White - Builtling; Candry - APpliGanh Pink - ACCounting; Goldenrotl - Assesso�
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
AU[O-W85I1
laue Fee
Hood or Typel ❑
Canopy Type II ❑
Refrigeration Sys[em
❑0�100,000 BTU ❑100,000 BTU
System Repair/Alteration
Fire Dampers �
Issue Fea
$ 3
$ 3
Auromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Oryers ❑Gas ❑Elec
Fan
F.A.U. �
Fixtures
Device Boxes
OuHets
Switches -
Garba9e Oisposal
Generator �0�5 KW C
Zone
Accessory Buildin9:
2
O
N
� I
N
G
R
Parkin9 Req./Provided E
Q
M
T
S
ELECTRICAL
� Transformer ❑ 15-50 KW
❑ 50+KW
15 KW
Meter LJup to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors �0-1 HP � 1'h - 8
Inc.Solar 09�15 HP �16�15+
Microwave
Pole Light �
Range
Sign
Standing Sections
Trash Compacror
� Reinspection Fee � 315 � � Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
Building Approved By
Appliration luued By
FEES
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ _�,�_�_ SMIP $ C�
PLAN CHECK 5 PERMIY -
PLUMBING S � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $���
MECHANICAL $ TOTAL FEE $ 21._
PLAN CHECK 25% $
; 191ii9 TTMG: ttlefi6.
CONSTRUCTION AND PLANNING POOL & SPA
APPqOVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
$. FoUndation 59. Gas Pipe, O Undrgrnd., Test ,
9. Water Pipe-Undrgrnd. 6D. 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 Wi�ing 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 Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # _ „
21. Ducts, in Structure 70. Underground Hydro ''
22. Ducts, Ventilating . 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground�Flush
24. Aoof Framin9 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing . 74. Overhead Hydro � � �
26. T-Bar Ceiling (Structural) & Monocoat 75. Ory Chemical
27. Frame and Flashing 76. Dry Standpipe �. '
28. Lathing & Siding � 77. �FIXED SYSTEM FINAL ' �
29. Insulation ' 78. FIRE PREV. FINAL �(e
30. DryWall Nailing HEAL7H DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION �
32. ElecVical 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. Weter Service-Finai
40. Gas Service-Final •
41. Solar pomestic-Final
42. Backflow Preventer ,
43. Backflow Irrigation " �
44. Landscape Irrigation System �
45. Sound Attenuation - -
46. Handicap Regulations
47. FINAISTRUCTURE & BUILDING
48. Special Requirements Completed '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ��
57. CER7tFICATE OF OCCUPANCY •
No. Date � %._ ' �
�,
�op�%��� 555 ANTON BL uN*: 3RD
r�+'sru�Ei�� SAKIOKA FARM
.... .. �� P.O. HOX 2097
fRhiIt,IAL ANNEX, CA 714-433-6005
— —-
'�""�T0"�'� INTERIOR ARCHI2136232164 �ND= C-9378
wcxonvns�oo�ss: 550 S HOPE ST �M� 1100
L.A. CA 90071
���T�"� CAL—PAC CONSTRUCTION (310)645-3500
����T��� 6076 BRISTOL PARKWAY
�%k CULVER CITY CA ��= 392102
' 90230 uMr: 106
UCENSEO COHtP�CTOq4 DECL�F�TON: I hereby Nim uMx pensly d pmjury Ntl I un fcsusC uMs paievu W Cheqr 9
(wmmwiM wh� SecYan )000) d Oiroian J d ma Buuros ud Ralxdom CoM. uM my bmn e u Iu0 ba md eliw.
cmuc.No.: uc.cuss: g uc.No.: �q210? EXY:
�, �d/�3,��- ���� .��- D�_�
OWNEfl BUILDEN DECIAN�TION: I Mreby elfum uMs pmely d rjmy Ihtl I em usmq hpn �M Caqretlan liwme lew la the
"dbwiq iaum (�� 1W I.5 &nnp� aM Prdovian Code: �M ciY a camiy Mwh �pinu e pmni �o muwn. eEx. unprwe.
amdsh, a repei vry �mctws, pria b n ewerica, ebo requiroe tM eppliraN Iw wch psmil to fib e dproE qetmiaY tlW he a�M
a IicameE pwwenl to IM pwiavn d Ne LONretlne licenas lew �CAaqx 9(oommanup wCh $sCun ]000) d DNeon 3 W IM
Bimira end RWaaioro Codal a ihet M a tln u exmmq IM1araM1vm aM iM bne la tlw eUepaE azsmqion. My vuW un W Sepion
]0�1.5 W any app4uN Iv a DaM W� �M epWirani io e tlW O�M d nal man �hen fxs MUWad doCen ji`.A011_
� I. u oww d �Ir propeny w my empbyeee wih wepee ea thei eob mmpeneeton, WI Eo Ne v.ak, eM Na awcture e na "unerdeE
a aRerad lar eeb (Secibn )Ou. Busiiww aM Proleaeione Cotle: Tha Camreeas liraroa law dwn ro� eppyto an oxmmrd qopeM
who buiM « inpmaa thnaon, ad wfio Aoee euch woA Mmaell a hueatl w Ihraqh he a hm own emplqeea, pmviEeE �hal auch
imprwamama era rd imeMed a d1aaA la eele, tl. �owever, tlw buiNinp a inpwemeM b wld wilhin aw ymr d oomplelion, Ne
ownerWiker xiA luw IM WNen d qwiip he w ehe did nol Wik or imD� �a �M WrW+a d eale).
1. m ov�w d tM pW+M. em utluwMl mM�ad'n0 vriln licanwl coni�Mon lo miMiC iM D�Nb (3eCion IOM. Buameea enE
Proteuioro COCe: TM Coruesem Lieams Lew Aoe� na eDON w en ox+w d W WMY Mw Gn'k� a'unpw'p Ihsean uW who
.•conUacU br wtl� popqs w4h a munqor��) licanrod Wnwnt to IM CaMrma� Linme ler�. �
I am memp uMm Sxtim: B. d P C., br ihis reeeon:
Dme: Owner:
I do hemby cenJy pw 1 em ewe d ud unEx�uM tM requirememe d CelAom4 HWN end Sdery CoEe Satliam P5505. u5�, enE
755�. aM Ntl I a ury Min briHirp ompen� will_/ wil iwt la�cb me) naeE lo compry M� eeiE mts mG� eM tM ipuimneme lur
Oma: Appicem:
WOPKEH'8 COMVEN9ITION CEC4fl�110N: I Aer�py alflem wMar pxully ol pr�ury pr d tlw bb�r'vq dadvqiwa:
� I t�m rd W meLven � cndr�� d ao'umt lo utlanwn tar Maksn' wmpwqion. s pwiC�C ta bySatl'm 9]OO d tM lebar
coe.. �« �n. oN�w,c. d m. wt �u .Mcn w. o� a �..we.
❑ �n...wwmam.:i.aw..•mmv�on�nwr.z..e.na��MMswiu,moam.�maeoa..ewm.o«�«menwam.
A xak la xAid� No Vd� e iausd. MY wvMn' oomVMW bn inartariu wrier end 0�/ mvnbar ra:
c.�;w: FTRFMAN'S Fl1Nf1 EXPIRES
v�c�i.ra�n«: xiao Hn54�aa i 02/Oi/96
(iNs a«tim iwsd na w mn{YeM / w v�i u M aw nuMne ea@en Rim/ a 4aJ
❑ I mth Ihtl in IM VMamurw W Na xak M xfi4h Ihis M�e b imwG. I tluY m� wnDM �Y Dd+� w any menror n n lo
baconr �u[jea to iM �aten' mmp�nWion lew d CN'dddaaammm�yyg��enE epras iNt ! I 4nutl Mcm� oibjw m iy xoNen'
mmpMWion pwuiow d SWian ]]00 d �M labor Cods�YwlRe�. / //
o.�e: lo�i 3�9 S' wa�. .��u
WITIip: FIOun ro ucun MwkM'roiry�nutlOn rov�np� IIYnI�vNI, �M �IUII u!/M N�mplqw ro vIMrW pwvltlM Ntl
c/Hl niw �p ro w» nuM� Nouu�d AO/Nn (J10d,PWA In Md/tlon ro M� ro�l eI ro�Gon d+�P� u prvHEW ror In
9KtlM �1(MOI IM L�DO! i�.Od. INMI[ IIIQ �ffOTry•'! IIY.
CONSTIIUCf10N LENOINO A6ENCY: I len�y Wem uMor peneXy d pajury ihet �hwe u e mM�utlion WN'vp pmicy M iM
perlamems d iM v.ark la xfiirh �he pemii u u�uM (�bn 90D]. CM. CI.
LENOEA'S NAYE:
LENOEP'S �DDPE49:
I eMtlY tIW I hr.e rmd thu ePdvlim W nu� OW Ns eEow Wammion b eanW. I ePM lo eanW w'n� e0 tiYeM oduuY adiew�oss
ud �wa W.n nWnO b bWd�q oumudian vd horWy mhor'¢s isp�wNetM� d �hu W ro xuw w� tM abwsmraioned piope�ry
la impecion prpau.
� ,OV/� �L �S�
�� r �—N� i
� o�.:�a �s �
Sq'utun d Ox�wrll�pmVAppicenUConlreaa
(5151-IB WP� Whns-Budtliq 8 Selery: Grem-Fle; Cenery-AOG���: A�k-Ferenie:0oldenmd-Aseesmr
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: B 0745�72 PLAN CHECK NO: 03712-95 A
CONSTRUCTION TYPE: fFR SP PERMIT TYPE: s"TR
�PERM NO; B 0'74571
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : 20000 SF OF�'FZCE T.I. SQ FT: 240,U00
CLAZM �'ALUE: CALC—VALUE: 386,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
+�****�**********x*;��c�-�e�-�*�-**�-+t+�+��-iF**�**�-****et*�t�*i�+��aF**�+�**�*+r+F*�-****it�t�**�***+c�
Z 0 N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDZNG ---------- --------- ACCESSORY BU7LDING ---------
FRNT: FT IN REAR: FT IN FRNT: F'P IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: F1' IN
PARKING REQ: PROV; PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR 3RD FLOOR FOR 76 PRODUCTS COMPANY
� • �"
�1E iE iE 9E �)E iE iE iE �E iE 1E iE iE 1E 1F 1E'i'i iF 1E iEiElE 1E 1E IE!(�iE k if iE i!' 1E iE 7f iE 1E±E IE iE iE iElf 1F iE fE jE iE iE?E fE iE iE dE jE iE iE if iE iE if ik 1E iE �E 3E iE iE iE iEjE iE 3E k 1E iE �E fE iE �E
D E V E L;O P, M E N'T S E R C� I C E S R E Q U I R E M E N.'P /S
ZONING APPROVED BY � : �Q_�— DATE: �%(//S�S'S—
BUILDING APPROVED,�BY ;_�� _ _ DATE: �� /�3 �%S�
APPLICATION ISSUED��BY: ,c DATE: i���3�7�-5�
ic�l(�iEitkifiEffiE�If1E�lE�FfEiE�1E1F1EiEiklEif��k1F M n , t ��iFit iFi�iFlEifiElEifiEiliFiEiE�����$FIFiE
LEGALIZATION:N F E E S U M M A.t Y STRUCTURAT. SEGMENT:Y
BLDG PMT PL[JMBING ELECTRIC MECHANIC
PERMIT 1,644.00
PLAN 267.15
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 1725.14 0.00 267.15
REVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMBING ELECTRIC MECHANIC
1644.00
FIRE SMIP/RES GRADING
SMIP/NON-RES
81.14
TOTAL � PAID DUE
1992.29 1992.29 ,00
1725,19 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
81.14
3E fE fE fE 3E 3f fE 3E iE fE iE iElE ik k 1E 1E 1E i' 3k iE 3E 1E iE?E !E fE 1P iE �E �ElElk iE dE 1E k 3E 3E 1E iE �E iE dE fE �E 3E iE 1F 1E fE iE iE 3E iE iE fE ik 1E iE 1E iE IE iE fE iFlE fE iE iE �E 3E fE iE fE iE 1E �E iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF—INT. ALTER TYPE I,II F.R. —AVER 18,24 364,800.00
SFC 20000 EQU—ALT CpMM. SPRINKLER SYS —AVER .36 7,200.00
SFC 20000 EQU—ALT COMM. AIR COND —AVER .72 14,400.00
END OF FEES
01 �D1°'C;3-7��142054 �i73 17i5.Y4
pCyC= :'�r''�/" Tirt�e 16:�i
CONSTRUCTION AND PLANNING � � PO� ,� SPA
APPROVALS Permit # Date In.".peetor pppROVALS Permit # Date 'Inspector
1. T,amporarY Electrical Service or�ole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit-Undrgrnd. ' 55. Electricai Bonding ,.
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' �
6. Etectrica4 UFER Grnd. 57. APPRQVA� 70 COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Poundation � 59. Gas Pipe, � Undrgrnd., Test -.
9. Water Pip¢-Undrgrnd. , 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural floor System " 61. APPROVAL TO DECK (
11. Property Sewer Line & House Con�oec[ion 62. Backwash & Receptor-Fir�al
12. Sewer Cap � 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System � Final j �
74. Rough Plumbing 65, Electrical-Final � •
15. Rough Electrical-Conduit 66. Solar SYstem�Fi�a( ' '�
16. Rough Electric Wiring : 67. Fencing & Access Approval � �
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriral�7 Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in $tr�ciure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas O Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergsnd. Scoraye Tank O Gas � Oif
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiting (Structural) & Monowat [�f0�� ir// 75. Dry CMemical
7 /•'
27. Frame and Plashi�g �/J�� � 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 INSPEC710N
32. Electrical Power Meter-Final � � 80. FOOD CERTIFICATE ISSUED
33. Final Eiect�ic ' • • Notes:
34. Final Heating & Air Conditioning '
35. Final Gas PiPe�Test -
36. Hood or Ganopy �
37. Final Pactory Fireplace
38, Final Plumbi�g
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Prevencer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL SYRUCTURE & BUILDING 1T�y 9 �
48. FINAI. PLANNING �
49. Eiectric Release to Edison . -
50. Gas Release to Southern California Gas Co �
51. CERT{FICATE OF OCCUPANCY
No. Date
7
AUDRESSOFBVILqNO: SSS ANTON BL
°`aiE"s"""E'°'°'°a": SAKIOKA FARMS
A°°"�° PO BOX 2097
, TERMINAL ANNEX
APPL. IWIING AODRE55:
uNr: 3RD
�xcxnEcron��n: INTERIOR DESIGN 21362321&�"0 9378
u�cx.ox[xc.�s�ooness: 550 S HOPE ST ��+T� 1100
L.A. CA 90071
CONfRACTpfS NAME
cwmacTorrs�uuxc
�on�ss: uc. ao.:
urrt:
LICFNSED COMFACTONS DECLRFITION: I Mreby aRirm under pn�ebY d perjury that I em Irsmad u�Mx pwisione d Chapx 9
(commenafq wiih Sec�ion 1000) d Oiwun ] d the Busirwv end Pmfmaians COEe, end my lioansa ia in full Iwce vM e11M.
cm uc. No.: uc. cuss: uc. no.: EXP :
Dme: Comrea«:
OW NEP BUILDEfl DECLRFATION: I Mreby etfi'm uMer penelly d parNrY �� � em axemq Irom iM Contreeae Licerue Law t« tho
lollowinp ro�on 1�1im ]03t.5 Bus'vima vM Prdeasiona Code: p�ry CIY a�unry wfiich rx�uirea e permil lo awbuct, ellm. imprae.
molah, or repeir eny ai�uctura, pia io da uweMe, eho repuirea the eVGlicenl la such peimX to fib e apred ateiemam HW M or eM
,licenaed pu9ueni to Ne porisum d tlre Cantraaas Licenee Lew IGhepier 9(�mmentleq wnA Sea'm ]OOD) W pv'�eron 3 d Re
,usiness eM Prdeabna COEe� a Ihel M a she ia eaemq tMrehom end Na bauv fa Ihe elbped exempion. My violetion d Seaon
>031.5 by eiry epplirant Iw e permil subjeqe Iha ePd� to e avil parelry d nd more then Iwa huMmd ddlen �5500�).
� I. es owner oI1M papenY ar my emplvyms xfh wepea ea Ihai eda compenselion. will do IM xoM. eM tM einwiuie'v M'uNeMed
w oRereE (or seb (Seclian 1WA. Busima eM PrdessonsCode: T�e Comrenon License LewAoea nd epplytoen ormer d pope�y
who Wida a'vnpmvea iheieon, uM who doee cuch wak himeaX M hereetl a ihraqh ho a her oxn empbyeae, pwideC Ihet euch
improvempua ere mt interded a dlaed lor eab. X, however, ihe buiki�p w inpovemem ie add vmhin me year ol rompleton, iha
�owner-0uilder will hna IM buNan d poving he or ehe tlitl nd Wik or imprwe Iw IM WT�e M sele).
I, as owner d the O�W�Y. ��tl�erv�eN �Ireaip xnh IicenaeA canveclon lo canmrwf Na prqea (Seevn )014. Businme eM
ProlBssim9 COEe: TM Coruredae tironsa leW Aoes rat apply n en ox+�e� d popeny who WtNs a Impovo the�eon arM who
convecia /a ad� prapqa wnh e mmredw�s) Icanaed pureueni to Ine Comreuora Liwnae Lew�.
❑ I am uemp unEer Seclion: B, d P.C., fa Ih�ie roeson, 1� �
Dele: �- � Owner � / � �
I do here cenM ��� eware d eiW urdersierM iM reyuiremema o/ Ce�Jomie Mmlih eM Cade Seeiom 25505, 2553i, eM
25530, end ihet I«ury Mure WiNi�q a¢vpant xill / wll nai �arcb one) need lo canply wih aeid qela wdee eM IM requiromenla lor
epafmill«cwnVuctbnamodificelionhwnihaAi uaeilTyL�anepemeniDistMa.Reeideniielomq'uGoneppG�bnaeieaxemptimm�heae
prwiaone.
Dele: Appli�ant�
WOPKEP'S COMPENSATION DECLRNATION: I Mreby effiem uiMer penehy d parjury one d ihe blbxirp Eetlereluns:
❑ I haw vd W meinlen e w�Akele W mneenl �o eetl-inwro /a v.aM1a�e' wmpenmtion. m povMeE la by Seaion �]00 d the labor
�iCdO. �IX �1M �GIiIXTBlIM Ui 11q Mdk �Of W1YC�1 �111! i41T11 p 091H�.
❑ I heve aM wil meinlen waken' mmpenselian ina�rarrca, es reyui�ed bY SeGian 9)OU af IM lebar Code, tor �M paAormenca d iM
work fa whidi ihie peimn u iaued. MY ��A �mpeneeiion iroura�e raner eM pdiry num Wr ere:
c�a�:
Pd'ry Numh«:
,,nre s«rian oeea �m es comwmee. �� a�a u ro. o�e n��e�ea edws rs�ool w i„a.l
❑ I can'ty thet in IM pmlormeMe d iM xroA fw whch ihie Po�� g��. I Mell m� amploy enY Ve�eon in enY menner eo es io
became aubject �o �M v.oAera' rompamelion kwe of CelHomie. end e9�sa Ihm E I alrould become aubjea m the v.vrken'
compenamion pmnabne o15eCion 3]00 d tM lebor Coda. I dWI lonhvAh mmp�y wit� ihoee qoviaione.
Deta: Appium:
Wamlrp: Fellun ro sroun wortsn' mmpwetlon covereps li unllwNl, an0alull ud/�cfen wnployer to cNMrW peneNn en0
clHl flMs up ro on� huntlrM fhouuM tlolkn (S/OQOOOA In eWllbn lo Ms cwf ol compan�etbR tlamepu u proHdsrl bi In
Sxtlon 91fb' ol IM L�bor Cotls, Infsrotf, entl ettomsy's /ws.
CONSTHUCTION LFHMNO ADENCY: I hanby elfiim uMx penelry W parjury ihet tMm 'n a mna��uGbn N�Miip apanry Ia Ma
periormanm M �M v.ak la whiN Ihe pe'mi n esueE 1�� ��. Giv. C�.
LENUEH'S NM1E:
LENOEfl'S ROOXE55:
��aniN mm � ne�re,e.e mi. eadcdion ene �me met me ebove iMmw�oo is wnaa. � a�re. io wmdv.mn d� cnr ene �ou�n obirer�cee
eM sWe kvn reWl'vp to Wikip caMr�clion aM hereby aNhor¢e repBeemawes d Iho My lo mtar upon Ihe ebove-menluned qopaT/
fainspeaion purpoeea,
ERNIE VITUCCI
Pnnt Nema
wA. ���� % . � . Dma: ��.!�� � ��%
SpreluredO�me penVA�it�an�/Conlretlw•— / /
— --
(5151d6 W P) Whne-Buildvp 8 Selely; G�eert-Fle; Cenery-APP��I Pink-Revenue; GoWanroE-buva
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 076187 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR
PERM NO: H 076187
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT; 325,000
CLAIM VALUE: 325,000.00 CALC—VALUE: 339,625,00 GROUP OCC: B /
COMMENTS; 76 UNION PRODUCTS FURNITUAE INSTALLATION, RE:#B74572
+�+r**ie�ic**it****it**et*�*etat*��at**atx�x *it**�ie�**��tit��iF+�iF*ie***�*��**af *+�ie��*ie**��*�*� ***
Z O N I N G A E Q U 2 R E M E N T S
5 E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGFIT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NO:
PLANNING NOTES>
i
i ' i' ' `
iE If 1E 1E iE 1f If iF if if iF iE ik if 1E iElE iE IE 1E`1E 7E iE 1E fE iE iE 1E iE 1E iF iE 1F 1F if iElE iE iE iE iE 1E IE iE iE 1E 1F if iF IE if fE iF iE 1E iE 1E IP IE iE 1E iE 1E 1E iE 1E iE 1ElE iE.iE 1E iF if iF iF 1E �E ik
D E V E L,:O P"M E N�T S E H V I C E S R E Q U I R E M E N�T"S
' . � � iy
ZONING APPROVED BY � DATE: '='
BUILDING APPROVED�BY;: DATE:�
. . . _ , "�_
APPLICATION IS
IEiE1EiEfE1E1EiE1FiEiEiEiEiE
LEGALIZATION:N '" F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 1,479.50
/
PLAN — i 71.32
ISSUE FEE '� -
BUZLDING—DIV—> PERMIT ISSUE PLAN—'CHECK TOTAL PAID DUE
TOTALS----> 1550.82 0.00 , 0�.00� , 1550,82 1550.82 ,00
�
REVENUE DIVISION TOTALS--> COLLECTED: - 1550.82 OVER/SHOAT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC �FIRE SMIP/TOT GRADING PLAN—CHECK
1479.50 . " , 71.32
1ElElE 1E 1E iflE 161E 1E iE ik iE ik iE 1E 1E iE iE 1E fk fE 1E iE 1E k 1E 1FlFlElE 1E fE 1E 1E fElE iE iE 1E 1! iE 1E iE fElE 1E 1E 1E 1EiE 1E iF 1f 1F 1f 1E 1!!E fE �E ff iE 1ElF iF iE 1E 1E if iE iE 1F jE 1E 1f iE 1E 1E
I N D I V I D U A L F E E. � B R E A K D O W N
TYPE QTY D E S C R I P T I O N -' UNIT COST TOTAL COST
SFC 325000 T.I. OFFICE BY,VALUE/$1
END'• OF FEES�
UO
STRUCTURAli SEGMENT:Y
FIRE SMIP/RES GRADING
SMIP/NON—RES
1.00 325,000.00
�.. U�e �' ' __t'�.�[Cl. =ti':Y _��.�.
cF�=E: j�. : e . , _,. . _„� ,
CONSTRUCTION AND PIRNNING POO SPA �
APPROVALS Permit# Date Inspector APPROVALS Permit# Date inspector
1. Temporary Electrical Service or Pole ' � f52. Pool & Equipment Location ',
2. Soil Pipe-Undrgrnd. - � 53. Steel Reinforcement
<3._ Electrical Conduit Utility-Undrgrnd. ' 54. Forms ' ��
.,�4: Electrical.Conduit-Undrgrnd. 55. Electrica� Bonding
�;a5��5[eei Reinfor.cement - 56. Rough Plumbing & Pressure Test .%
`"'fi ��.lectricaV_t�FEfl Grnd. ' 57. APPROVAL TO COVER�GUNiTE _.
=7. Footings �� �, . 58. E�ectrical Conduit�Undrgmd. � '
" S. Foundatiori � ' S9. Gas Pipe, O Undrgrnd., Test
9. Water Pipe;Undrgrnd. . � 60. Backwash Lines. P�Trap, G' Undrgmd.
10. Structura.FoFloor SYstem � 67. APPROVAL TO DECK '
11. Property Sewer, Line & Hous� Connectlon 62. Backwash & Receptor�Final
12. Sewer Ca� ' 63. Heater & Vent-Final
13. Roof Drains � '�64. Piumbing SYstem - Final
74. Rough Plumbing �" � 65. Electrical-Fina� . ••
15. Rough Efectrical-Conduit -, ,1 .66. So4ai SYstem-Finat ,
76. Rough Electrc W�ring � 67. Fencinc� & Access Approval ��
t7. Rough tNiring Sign ' , � 68. APPROVED FOR PLASTERING" '
78. Rough Efect`rica6T Bar Ceiling 69. POOLISPA SYSTENiS FINAL
19. Rough Heating & Air Conditionin�- _. FIRE QEPT.REQUIijEMENT
., . � i k �" C^ G * ' a C .. ' - r- .
.� I a � '4, C V J f ! �. ... -�-` l.� `i c . �.�
20. Rou�h Fastor,�Fi'r�qlace ��., H n, �;APPROVkL�`�F� Petmit #•�
- r. ..
27. Ductrin Stru`siur€^•� " " ' � ` ` - n,'y ' , 70. :Undergrouud Hydro � �
22. Duct5�, VAritil�iin F` ` ' ' `� ��
9, � r C' (� �-� : �t. Produ��Piping d�Goe UOiI
23. Gas Ripe-floug7i & Test �'" ` y' ^' r, � �"' I' 72. Undergro_und Ft.ush" : �
r �r rr� �-1�r c = i: t. '
24. RooFframi�g.. "'k '�r ••E ; = -- w r x �� 73c llndergrnd.StoraqETank �LiGas ❑Ail
25. Roof�Sheaihing ��'� •v v�� _, � i „'` 74r Overhead Hydrq. �
26. i'--BaF;Ceiling (Struct�rali & Monocoat (/�j0��6 � 7S -pry Chemical .
. ' .' ] ��. � . . -. :
27. Prame and� Fiashing� � '�`; � 76. Dry Star(d�ipe a� a' _
_ . ,. _._, - - 1��i6
- 28. Lattifn �i5id'm �` `. ���'" r` � s .. . * . .
9� gf--* r,�,r_ r,� � , 7�; fIXEOSYSTEtv1�INAL�- ,
29. Insulatlon • � i - - " '` " 7$, FIRE PREV. FIP}RL � '
30. Drywall Neiling f`'' ` � jp_� � � -HEALTH'DEPT. REQUIREMENT
37. Plasier Brnwn.Coax':� S �'� r � '' : 79. FINAL INSPEC710N '
„'=
' 32. Electrical,Power Meter+Final ; '. n' ' r' "86:_ FOOD CERTIFdCATE I�Sk1ED
' r�. -
.33.FinalEleciric: n- ;*: a: � '� NoiPs: '� '"•" * - '
34. FinaFHeating L�i A��Go,t�ditioning � �' „ , � ! V � � ^�,,,�
�. . . � ' ' � � i��1 _ �� �:=; j� '� qc� . -Vv�
35. Final Gas.Pipe l'est: �- _ �• * -� '�_ � � '
- 36. Hood o� Canopy f- ` � ' " -'� � ' Z C � - �� � �
� " �S. . - ,-, - '! � " �� 11�� ` l�(1 _ _ -_
_ 37. Fina! Factory Firepiace _ - - * � - (J Qa �� .
Uµ
: 38. PinaIFPlumbing' F"' `J ` � � ' ,. - --
.. ��. ..." i x i
-�-
� '39. Wate� Service-Final.y- j ^ � t r. � � 1� ,_ .
•.40. GasService-Final �'* ^�^'r" rr, • - .- _ �
- `.[� ,.i r e _, . , . .
�41. Solar pomestierFit+al,� " =' � ` �, _. u••� r -
�
- .42. Backflow Preventei� " ;J °: ^ � '* � •'" ' -
^ � �'
y _ � �, ,
� ,.
43. Backtlow Irrigazion�•;y -'J r y -.� t: � � x` �
44. LandscapQ�Irrigation�SYstem;•'",: _ "� C '� �'�"- s1 `'_ � �; �
G' E.... � Y� �1 tl; T
45. So�nd Attenuation : ^ :�.. `- � � _
_ �5 • � � ^ t� a. � . `.
�•
46. Handicap Regulatwn5 �' { l '- � ` `- " ,
.- c S
A7. F1NAL STRUCTURE & BUICDWG s �� - -
- � ���1y6 -
48. FtNkL P��ANNING �"'� ' �' �� - �. y
49. Electrie Release to Edison � �,: �
50. Gas Relea3e to Southern Caiifomia Gas Co ' �' ' ; '
�
51. CERTIFVCATE OF OCWQANCY -
No. Date
�
�oonEssaeainuu: 555 ANTOPJ BL
ss
QYNERSIUYEIfRlON1t SAKIOKA FARMS
�sx POI BOX 2097
. � TERMINAL ANNEX
�pp�. Yuia+c.00�ss:
urr:
K'�
u�cx�cronvirn+�e INTERIOR ARCH.2136232164 ucw: 9378
�xcxa+vas�oo�ss: 550 S HOPE ST uxr: 1100
L.A. CA 90071
cwrxAcrursru� SWINERTON & WALBERG ( 213 ) 896-3400
cam.crom�mvio 865 S FIGUEROA ST
,�� L.A. 90017 CA ��, 92 3000
u�rt:
LICENSED COMRRCTOPS DECLAFATION: I �ereby � m uMer perWy d qe"ryry Nq I em fcmeaE urqer pov
(mmmwnq v.v� Secwn )000) d Oiriaion 9 af Ne Buairou uM PMm ' Cods. ud mY iwnw u F tuA laa d
cm uc. No.: 0 4 6 2 7 9 uc. cuss: H uc. No. 9� _{ P:
Dms: � �� ,zb � Rs CaXretla: n
OWNEH BUILOEN DECLIP�TION: 1 Ae�eby dlum uMw pendy d t I em axenp ihe �epm L
bwip �sevi (�� �t 5&nnm eM Rdmeiom CaEa: �m ci xhiCi e ! lo mmu
.nd'vA, n npei my �Wnure, pur ro Es iwnce, ebo rpui�m iM ta vch penw io a a'ryad pe�m
. r¢«uee w�w m we uw�sm+ a Ns cawaaon ucense �aw Ic e. a loomm«iac .an seam �000l �
Buvnea aM Habobn Lade� a Na he ar tln e mamq �haelrom vd IM Eem tn IM �Aep�E mempion My
ioais M�r eoo� �or e v«na •apa+ ms rod'<m �o e dw �eneM d na mas u� as n�vdrw mue�s �Ss�
n d CMqer 8
flatl.
10/95
oeairo
d ssa�
❑ i.�e,.,�«au,evaronr«mv�owva«�wn,.�„dma:.weo�v.�.,.amnb.,o�..�wube�.:owwawee
rc alle�ed br nle (Swbn )ow. &dros� end Prdasaioeu Code: Tha Cauratlan liews Lew Em� nd eDONtoen ox�rrd peopa�ry
wlu buids a inP�'e� Ihaean. eM Wn doee euM xark limeetl a Mnel a Neou� A"v a her wm mipbru. qwided ihel we�
im0��+me nol'vneMeE a dlaed la eeb. tl. lwws.er.11a dnidi'q a inD��av o wtl wkM ar Yav d aom0�ion. IM
mnw�daier w� hew Ns d�dai d qwinp M a Me d'd rw dAd a impws la IM Wipws d aM).
� I. m ormm d IMWWaM. em udmroly mrarm�q xdh licansa caNncYm b mmnw Ne pqw (Setlian ]W�. Bw'vm0 end
PMmau Code: TM Caurtlon liaue lew doas m� epply ro an ovmer d G�W�Y Mo drild� a L�povw thason W who
eamrero ior wN pajrt� wh e mrtlmeor(e) ke� Wnuw m �M Comreecr� liares lew�.
� I em vamp wdr SwM: B. 8 V.C., M Nia roeaon:
Dete: Owiwr:
i eo na.w unm mm i�.r+a. a w Mde�.i.�d me ����em. a c.ieom. H..m�.m sean, cad. se�. uws. zssv. �e
iAet I a vry Mun driMuq ooapem will / wil rwi (arcb
oa.: �op�:
WONKEP'S COYPENS�TION UECLAH�TION: I heraby a1Nm undx psaXy d pr�ry w M IM b0ow4p Eatlunqm:
� I M�e eM W me'v�ten � cenA'r.e1e of miuent io �aXiiuun la xakai mipanwbn. n poridaE la Ey 9ee'vi �)W d iM lebar
coee, i« m. wn�,c. d m..m� �«.w�, inm v� �. mwa.
❑ � nev. ene w meim.n nwk.n• oomn�.man imure�ce. d rcv��'.e M swim a�ao a m. lanor cod.. a. me v.�«mence a m.
����'�°�p��Mv���''Ak�c.',U%JA�'��""�"�"�'"�""`� EXPIRES
c.�
aanH�mw,: w� o� JOJL1V7�4 08/01/96
�%�i19 8K11M INOfI MI �! MTG�b � I�IOG>mt l� �OI pl! hYllf//f.� �GIO �1�� p.VL.i
� I un/y tM m Ns pMpmercs d �M wM la whcA iho peem4 h ueusd, I dup np empb� an� pereon In yry memwr eu n lo
becortn vubjea w tM Ma'ken' canpanWian lews d Cali1 4, anG ym� tM E o yI ca�r �ubj�u Io IM waMen'
comD�^(p\� �/'�/{ �l�w on 3100 d IM LeEn Cade. 1 ''0�71 N o� pl ' n�.
Date: � l/�✓ V F' Applicenl:
W�m/np: F�llvn ro��cun wAwti eomvxwtlon rov�rep� I vn • LI, uM �1W1 J�e �n rr�vloyw fo erin ryl pmalUu �nC
c/v/I llnu �q b om �inErM IhouunE OOINr� (1f00,OW1� In rM/ ro U� cut o ru�fbM1 sanyp� u pvvWW br In
9�etlon ]]06 0l tln l�nor Cob, /nfwwt �tl �ttomry i Iw.
CONSTtiUCTION LENqNO �OENCY: 1 hxeby �em uMer pendry W pxjury IIW Nwe e e amuwbn kMirp epemq lor Ne
pMormerca d iM w�k In whiM ih's pemiY n'mwed (�� �], CH. C).
LENOER'4 NMIE:
LENDER'9 AOOXES4:
I cMiy Ihet I heve neE I�u epqicNian uM dels IMt IM Wovs inlormnbn ie conw. I p�w t0 canply wilh tll tlry uM muMy oNlrwKe�
enE etme lex� nW iq ia EuiMip conmwion W hereEy einhorue rpneentalrvn ol t�u ay ro mter upon iM ebw�•mxNionaE pmperry
IaimpxvbnWrpmea. �r�i n��inr.v
�ete 8 '�� " /�
Whde-BuiNiq 8 Selery; O'ser�-Fle: Cenery-�OD���: Pink-Re.anue: (iallsnroE-N�nv
CITY OF COSTA h1ESA - BUILDING PERMIT
PERM NO: B U74699
PERMIT NO: B 074699 PLArI CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC-VALUE: 20,900.00 GROUP OCC: B-2 /
COt4MENTS: 76 UNION PRODUCTS PREP FOR TI
�*#*�***�*�*�****�**+�+�+�x*�*�**�*�x��+��***+�**��*****�******�***��*��****�*+��*****
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REfi NO:
PLANNING NOTES>
>
Y.� 3[� iE iE iE if iE iE iE if ik iE iE 1E # iF �iE i! iE.iE iE iE i(� iE 1E 3E�E 3E iE �E iE if iE iF iE 1E iE iE iE if iE iF iF iE it iE iE it ik iE 3E iE iE iE iE k 1E k iF if iE iE iF iE iE iF iE if iE iF iE iE iE iE iE # 9E �lt iE
D E V E L O P M E N',T S E R V I C E S R E Q U I R E M E N T S
i✓" /%
ZONING APPROVED BY .' � DATE: "
BUILDING APPROI�ED ��Y : " DATE: I
APPLICATION ISSUEH ,fHY: �.f F� DATE: ���LOI,�..
ik if'14 if iflf 1F if 1E # iflf 1E iE
LEGALIZATION:Y
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 432,00 '
PLAN -
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 436.39 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC _
432.00
���EiEiElElElE1EiE�E�f�E ,�iF1f
STRUCTURAL SEGMENT;Y
FIRE SMIP/RES GRADING
SMIP/NON—RES
4.39
TOTAL PAID DUE
436.39 436.39 .00
436.39 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
, 4.39
iE 1E 1E �IE 3E if 1E 1E iE'lE lE �)E 1E 1E 1E �f iE 1E IE 1f 1E if 1E �)E �1E 1E iE �IE 1E 1ElE If 1E If iE 1E lE if iE aE jE IE 1E iE 1F iF i%�E �Elf 1ElF if # IF IE 1E iE iE if IE iE iE if if if 3E iE �E iE'IE iE 1E 3E IE �1F?E # If
I N D I V I D U A L._F.E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N. ? � UNIT COST TOTAL COST
�' �
SFC 20000 DEMOLISH BY VALUE COMMERCIAL NC�ZONE 1,00 20,000.00
END OF FEES,
.. . � �
!
01 0019it5--CGi.926bS Ti]Y -.?0.,"!9
OATE: 1Ni3'-5 'iKc: CSe24
CONSTRUCTION AND PLANNING PO 9 SPA
APPROVALS Permit � Date Inspector qppROVALS Permit # Date inspector
1. Temporory Elec[iical Service or Pole 52. Pool & Equipmenc Location ' , �
2. Soil Pipe�Undrgrnd. - 53. Steel Reinforcement �
3. Elettrical Conduit UtilitY•Undrgr�d. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � .
6. Electriwl UFER Grnd. 57. APPROVAL TO COVEFi-GUNITE •'
7. Footingz 58. Electrical Conduit-Undrgrnd. �
8. Foundation ' 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe�Undrgrnd. . 60. Backwash Lines, P-7rap, � Undrgrnd.
10. Structural Floor System - 61. APPROVAI TO DECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap i 63. Heater & Vent-Final , �
13. Roof Dreins � 64. Plumbinq System • Final
i
14. Rough Plumbing • 65. Electricaf-Final •
15. Rou9h Electrical-Conduit ' 66. Solar System-Final '
76. Rough E�ectric Wiring . 67. Fencing & Access Approval
77. Rough Wiring Sign � 68, qPPROVED FOR PLASTERING
18. Rough Electrical-T Bar Cei�ing 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE �EPT. REQUIREMENT
20. Rouqh Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Unde�ground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas � Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roaf Framin9 73. Undergrnd.StorageTank �Gas'OOiI
25. Roof Sheathing 74. Overhead Hydio
26. T•Bar Ceiling (Structural) & Monocoat �Je�6 � 75. Dry Chemical
27. Frame and Flashing ���� � 76. Dry Standpipe
28. La[hing & Siding . 77. FIXED SYSTEh1 FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Naifing /��� � HEALTH DEPT. REQUIREMENT
31. Plazter Brown Coat 79. FINAL tNSPECTION
32. Electrical Po�ver Meter•Final 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes(((: L
34. Final Heating & Air Condiiioning ��_ /�j _ � -rr��1/1,ff,' . -
-IV� �' W�����-
35. final Gas P�pe•Test �( � �`�'j�(�,,,. ,n I�\
36. Hood or Canopy �'Y"u"�' u, •1 �� C�� 1(i`�v"`--'
37. Final FaMory Fireplace ��„
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape IrriAation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING f/ /(� (�
48. FINAL PLANNING
49. Elearic Release to Ediso�
50. Ga: Release to Southern California Gas Co
51. CERTIFICATE OF OCGUPANCY
No. Date
�oonessaeuimn 555 ANTON BL �M� 3RD
a„�wsn+,�EiF�: SAKIOKA FARM
�+� P.O. BOX 2097
ERMINAL ANNEX, CA 714-433-6005
ux. �uiwo moaEss:
YKXIfECTONfHfd1EEN: UC.NO:
41CI1 OR ENG'S AOUqESS: tlMf:
cwm�crarswu� SOUTHWEacT FIRE PROTECTION ( 818 ) 359-0034
cwm�crorca�uimc 215 E EL SUR ST
�oo�ss MONROVIA CA ucao, 190173
91016 u,rt:
llCEN5E0 COIiTP/�CTOq4 DECl1R�T10N: � huebf Mlim u�dx W�e{y d ppj�vy p6 t am IcMveE uMr pdadu d CMy�w B
�(mmmam^Y xiih SecUon 1000) d Oivuun ] d the &�wa and PiWmebna Gode. mk mY Gcaw e in tW Mce uN alled.
cmuc.no.:013054 uc.cuss: C 16 uc.No.: 901 3 EXP: O4/96
om.: /D a'3 -�'� — c�> � ���
��, OWNEH BUILDEfl DECIAflATION: I lweby PM� uMs paWy d perpuy IMI I em emmq hom tM ContMon lica�as lew lar IM
md�u�A. rn aperlSe�riY ��Nuura, V� �o ea N�. ebo nVWa �ha WC�� Imu or arli V��Y �elJs e dP� qtlamaK tlW MMa M
. Gmn..e pn.uw m me po.�m, a in. camrmu. uo.Ms ta.. �cnep« 0�om.�aa;�q .nn s.ao� �aoq a oiv:ion a a iro
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)W t.5 b/ vry epp4reN la e pmmC wbpqn �M epDfwY w e cW psiMy d ro� mps ilim 1wa �untl�sE ddlan �SSOOu.
� I.mownardihepW�YamyamdW�°xihwqp+nihv�demmM��.v9dotMxoM.eMNe�mcueeuna"vueMeA
a d1aeE M eeN (SecYm'lD1,. Budron W Pmtma'vn Code: TM Gomretlon liowa lewdaaa M cwN�o m owiwrd o'w�Y
who Wi6� n inpu'n+ihneon. md v,ho dma wM wA hinae0 a henN a Wwph he a her ovm emMorw. P�� thm wc�
'vnpovememe ua m�'vasded n dlaad la eeb. tl. Aowewr. �he Wikinp a inpo.pnM u�old xilhm aa yaer d mmpMion. iM
owiwrbuiltlar xi4 haw IM bWm W prW��p M a eM Etl nn ddd a improro la Ns pvpoee W WeI. '
� I. m owner d iM propany. em urbn'rvaly �timip xdA fi�mpoC convecbn b mmmw tlp pop? (Setlion )Ou. &w'vs� eM
aid...ion. coee: m. wvmoo �cen.. �. eo.. m epch ro an o»,w w wooNr .no wib. « u,wo... ro«eon w wno
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25SL. eM Nel 1 a ury Mun buitlinp awpent xill I wa nd (ercb orc) �peL lo camply wiA uid tlele codp end �M �pu'vananb /a
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ome: �oo��.:
WOHKEF'8 COMPENS�TION OECL�RATION� I haraby effinn �vqx qnMy d ps�vy ana d Ns to�oxirp dedeee�iam:
❑ IhevaeMwume'vnan.csWiweamrm�uiowtlJrouelawaken'conwa+mion.uawidedlaMSaaimalood�MleEw
COAa. la tM pe�orme�Ke d Ne wM1 Iw which ihu pmmC o iouetl.
� I hava eM wil me'vnan xwlwe' wmpenle�on imueence, m nyuind by 6aaim J]00 d iM Lebar CaEe. b �M prlarmenca d Ihe
wak la v.Tidi INe Po�� u iausd MY Maken' com0e�ion "unurerce mniar W W�Y mmbor me:
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: F 074751
PERMIT NO: F 074751 PLAN CHECK NO: 03946-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: I—FR PERMIT TYPE: FIR PURPOSE: OTH
JOB DESCRIPTION : RELOCATE SPRINKLERS SQ FT:
CLAIM VALUE: 8,900.00 CALC—VALUE: GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS REF:H-74572
x�*�r+r+��r�r�r�r�r�r*�r*�r�rx�r*****�r�r�r+r**r�r***�c*x�x�w��r*x��r+r*r*��r��rx����rr�rx**x�*�rr+���rrtx **�x�r�*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: . FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 2NE: REF NO:
PLANNING NOTES>
)
iE if it 1h if ih ih 1F il' 1i' iE II' 1E iI' ih 1f ii' iF iE iI' ih 1F ih ih iI' 1E ih M ib M i! 1k if 1i' 1f ii' 1E 1E ii' 1E iE 1f 1E 141h ik 1k ih 1f IE ih i%i%1f K iE ii' iI' iI' %iE II' iI' ik 1f 1f 14 iI� 1f 1E 1k iE iF i4 i4 ii' i4 ih il'
D E V E L O P M E N T S E R V I C E S R E(j U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE
PERMIT 10855t
PLAN 70.20
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL
TOTALS----> ; 108.00 0.00 70.20 178.20
DATE:
DATE:
DATE: �b 2''1��.v
ik k iF M M iF iFiE��iFiF iF
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
178A20 D00
c�..: FREMONT EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 108.00 OVER/SHORT: .00
varyrx�ne,: 06/O1/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
�rnr:.«r;o,�,a.e,�wn�a.�.e�m.ro�+an �.n��mwaar.�.�rmldw.� � 108.00
� 1 centy thn In iM parlom+erw W �M wM la xfikA Ilw pwm4 h IeauaE. I NeA nd empby erty perwn M ury menMr n n to
becane wM� to IM xvka�' comWMdion lew� d Ce4lamie. enA Wn� Nel! 1 NwN beeaw cpq lo IM �Fon' iEitillFMiFififiFltlfitiFMiflfikitMMMMMifififiFifiFlFiFiFifififikifiFMififlfifiFifiFififiFiilFMlfifMlFMltifitlfififM1f1f1fiiiflf�ifififi4ififiFiflt
���a, ��, d s.a� s�oo a m. �n« cm., i.nan.�.nn �� ,�w ina. p,ow.�.. � I N D I V Z D U A L F E E H R E A K D O W N
om.: /� �33-� -ri'� �ww�: )S_
WamMp:F�tlunroueunwoikwi'wmpMwtloneorn�plsunNwN(�ne�htllwCNefm�mployrrocrlrtYnlpn�Nu�rM TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
Grll 11ms ap ro om h�nNM fbuuM OO/Pn (SIOqOqOA ��lMan ro M� cwf ol mmp�nufbM1 Oam1qa u provMM br In
s.�nm s�oe er rn. L�O. cae.. mr...c .ne.m�.n.�, rw. F I R
CONSTIiUCl10N I.ENOINO ROENCY: 1 �eNM �� uMw peiWy M perry�Y �� �� e e mng�upion 4Minp ap�nry M tM
DMamaMs d �M waM la whirh ih's D�Y N ewed (9opian �OB). CH. CI.
LENDEN'4 NMIE:
LENUEX'S AOOFES4:
1 ce�Jy i1W I l�evs mM Nu epplutian W nme �het Ne ebow Woemetbn is coma. I epns to tanpy wi�h NI �Yy eM admry adiwqs�
Ld s�81e IeW9 �2�1B�"T�9��10 WiMvq cOn�ltlqn 8� �eby eNhOlCe 1!qlwnlelivai d I�1lf Gty b MNe1 upO111MlLoA.mMlipNd pOpp�ly
:IXIMWVIq1yu�NeJa. � .
Oms�, f� if7 �7.s
(5t5t-,B.WP) WMs-BuiNiq 8 Sele�Y: a�mFb: Cenery-�ppYraN: Pink-R�vwuN: (ioldeneodNsenar
108 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00
END OF FEES
!,1
� _d.
I I . �J
� • �
108.00
�1 OOt9Y7.;_-�:1927Q8 TEo"S' SOS.G�
fF+TE: 1���7'75 Tfrc: .1."0;
Cq�STRUCTION AND PLANNING PO S SPA
APItROVALS Permit # Date Inspector qppROVALS Permit # Date inspector
�:
t. Te`mporary Electrical Service or Pole 52. Pool & Equipment LocatioR � .`�.
✓' f %
i �
2. S�l Pipe�Undrgrnd. .,"� `�. 53. Steel Reinforcement „ .
�.'.3 • EI€Gtrical Conduit Ufllity•Un�lrgrnd. 54. Forms � l
-.� ..,
.� i
' J4: Ele�trica� Condu...+`l�-,'��irgrnd. �� 55. Electrical Bonding ,/
�e�j StEei Reinforcemer[tr, 56. Rough Plumbing & Pressure Test •
d�, Electrical UFER"l4'�nd. 57. APPROVAL TO COVER�GUNITE
'�' Footings N�; `� 58. Electrical Conc�uk Undrgrnd.
" 8. Foundation c* � Q+ � 59. Gas Pipe, O U�7grnd., Test
�
9. Water Pipe�Undf@ �end. � 60. Backwa:h LineS� R,Trap, �.�ndrgrnd.
10. Str'�ctural Floof'TSystem 67. APPROVAL TO EiECK
11. Pr�Spertv Sewer�,ine�& Hous�onnection 62. Backwash & Recgptor�Final �
72. Searer Cap ;, ' ,� • 83, Heater & Vent•Final �
_ � � ,
13. R�'of Drains �, � _ 64. Plumbing System - Final
14. Rough Plumbing. 65. Electrical�Final •
15. Rough Electrica�YCo�tluit � 66. Solar SYstem•FYr.�J
16. Rough Elettric�9iripg c 6�. Fencing & Acc63vApproval
17. Rough Wiring Sign ' � 6$. APPROVED F��PLASTERING
J
78. Rouqh Electrical�T Bar Ceiling 69. POOL/SPA SYSI'EMS FINAL
19. Coug�h He`ati�g &rA,�� Conditioning� � T � Q, �� _ �, Fj�4p�T,AEQUIE�EME�VT �,
20. ou�i F toFy Fi�'q`lace _�r - � S r. Q.,; . APPE�Ou�L�,� P`�'�.'mit #� }
c e�.�
21.'t3uc� in�tructur�* '... .. ^` ' S-'-'* 70.�(Jndehj}` R}:rjd ti�rqdro i
:� r,
22.3uc49�� V�ntil"�iin�;.r y � C G H� V 71. PtodUc[h.''iping��J'6as �Oil
23. fias PipeKio & Ttst M� ,��� r'*1 C' `. GX � 72. Undergr�d F7Usfi t �, -
24. �iootSFr.t� in �� 2'' � - � � �` 1 _ _.
�L' 9 �a ,� > cc ,--� �• 7� Undergrnd. Storapp Tanla. � Gas ❑ Oil
25. RooJ�ShdSthing S+� � �� +�� � > N K 7q; Overhead ", _.�'T �-Uy;:��,,, l)•L4ts j,lj...
26. ��r n . c _ _, z y ^J :*1 u _ +. r-
-B�r;Cei�tng (Str�t�ural) & fvto�iecoat r � y p* 7 Dry Chemival i-., :r �
27. �.rarRe ar� Flashir.yt �M� < c� >+ or 76. Dry Sta�jilpef'� � r r
28. LatFSTn B�Si -�'r.� '7<x � • � .. ..x i-,^ - (�
+,9.� �9p�i �';�F �J � h �� FIXEDlSYfiT '�FINA;�..- • �L'LQ•�S �'TJ'
29. Insulatior� �''�# ,_, ^ .. .� � � I 1� 7 FIRE PREV. F�l k> � � 2 � I�6 ��
�-V
' 30. Drywall N�ailing '���j,,,i � y f., � I �� c p}F�ALT�i DEPy7 REQUIf{fMENT
• 37. Plaster BWwn CoATIx � ' r'r I � 79�. FINAL �N EC7ibN 'T
�
. 32. �Iectrica�'o��v�yr I�y���igal �� '"' � 8� FOOD CERTIF+CATE I�&yJED+
� ,
� 33. inatnEleciric> c. w m i � * � tes: �^? '%'� O'J!'�
�1' 34. � inaFHe� ng� A`i� � ditioni -`�,gS C� a � ' I* M � !:� { 5 _
� �. i�7 .� v�� �: Fi� r C Y� +.�
, 35. 'nal Gas Pipe.�esi r p. •� �-, � xo o� r Or*
* � ,�
� 36. �loo�or CanoPY '' � t •`� � " '' E nL° .x `'r
r n �:r•. I x n xo r m >m
_ 37. Fina�Factory Fireplace .-: � FF- r� # � � I �. x -� .y =�:
c *:
J 38. �na�lumbing � m� o ;. I � y ya� 'y d
� 39. �ater Service-Final . ,�r�, . � r c, � � m �o : -
r � , p. '
�• 40. Gas Service•Final ' m `�'T'�T' ` �' � � � C'C' ' "'' . "
Cl = c.. M +� � � F• O i � a;
� 41. Solar pomesticFina' ..j �� I t t*�o � ;c _ �3 X
_ -, � :
42. Backfiow Preyenter K, �% '' H , I 1* �^•2 • �F c C
�� r tu �r.H '•� �-, �•. ?fc.ticn t*O t
43. Backflow Irrig.ation r �J - r oq *,` v �� i 3 v �� •
y n
�t*1!'J '*: C1 p �..c . 1: N �. �-':: � N ...
'�4. Landscap� Irfi'.patio�5ystem_ �� � ., a ,4 Qy ; � � �� G� � S �,
'�5. §ound Ftttenpation� r • � � � .r 'q��. � � c� Q • E.:p *
- ..� .
36. �Handiwp•Regulatior�s " �- * t. cC s '. S t
S ?? .7 i � i.
;q7. fiINl� STRLY�,CTUR� & BUII`bING =� E-, �V y o+ _ �-
i '� , c
48. FiNAX PLANNING t ,"'�" * N � (y . � x
., �
•`49. �lect`�ic Releaie to h'clison i � � '�. ; � •; � o
., ... -
�50. �as fl�lease to Sout(�em Califbijli'S�GasCo ± ' k� " '� • o�', x O ,
�• s �o �` � v c
5L CE IFICATE OF OCCUPANCY ' ' " " '
No Date
aooaessaeuaou�c: SSS ANTON BL
°w"E"s"'"Ei'p+""": SAKIOKA FARMS
woxcss: p0 BOX 2097
• • TERMINAL ANNEX
�vvi. YuuNa �oo�ss:
uNT: 3 ND
""ONt�TON�tlN�" TRI—SIGNAL INC. ��� 0
urcxonu+a�s�oox�ss: 1945 GARDENA AV 818-247-1194 uxr:
GLENDALE CA 91204
��*�s� MORROW MEADOWS CORPORATIO (909)598-7700
cwm�cTorcawuurxi p O BOX 509
�oo�sa WALNUT CA uc.xo: 230813
91789 urar:
IJCENSEU COMN�CTOFS OECL�fl1TI0N: 1 Mieby dlim ivMs penely d pmjury ihet I un I'seneed urder prv.vau d Gheqx 9
(mmmentirq wilh ScYon )aao) tl DMuion � d Ihe Bus�ro uk Pmipuma CoM. uq mY Ycmx u in IUA Wa md Mletl.
cmuc.No.:006558 uc.cuss: uc.No: z3081 EXP: 2/96
�,: /-- f'- 9 � ��a: -rn
OWNEP BUILDEX UECIAXATION: 1 haeby effirm undx pwaly d pxM'Y �� � mn iM COMnpm Liowa lew la IM
Oowiq �semn ISatlian �ml.s &nneu rM Rdm�ciu Cada: Mry uY a Wiih r uin� e O�e io mnwn. e4ar.'rnpo.e.
mdeh, or rapv eny �vuclura, por b m'saarca, abo rpidiw IM eppliraeu 1 wc� - to fiN e�ipn�E ptlwroru Nei M p�M
. 4ense p+rsudv m �ne aw'viau d Ne coiureeon Licm.a Lew Icluqx ( «�o wnn sseun r000) a a.'slm a a ins
Bman uM PrWaaioro CaCal a �Mt he rc Me u memq �naahwn uM tM a tlw e0epad manqbn. Mn v'dtlion W Satlion
'!W l.s M�V WV�N 1« e GaM �+ IM Wd"ran io � dW D�Y W nd man Ihn fw� MiMrW EOYen I'�D.
� I.moxwdlMpapenyamywnplvyeeewthwaqam�heiwboompnWbn.w�YEotMMak.udtM�vur�ue"snp'v�bndsd
adtaeCbrsebl5 �wilOs�.BudrieveMPrvlwdmsCotle:TM1eCan�rfa+liosvalewdosarotnDohtoen'awnerWpopetty
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impwmmmU ve not'vuaided a WamE la �ab. tl. Mw�wv. tM buJdinp a inpmamaM u wtl wnlwi aw Y� d mmpbtun. Ns
ow�w-0uildx wiA Mw tM burtlan d pwiip M p Ya ditl nd buiN or imprava b tM pvpme d We).
� I. m oxw d iM P�WMY. em uduwiary cont�eeYq � foenM canirenon b m�W W IM O�ol� (6wion lW. &n'vr� W
VMWq11f (�.OEf: TIM {�.W2C01� LC011N IJv dJM IYJI GVD�/ b M OvnNe C1 PaDM�Y Wq EUIH� M MpOVM IMIWn 41d M�O
mnlracb M aM q4✓+� Wh e owvetla�tl4cameE P�uvN lo IM Canl�bas Liosu� lewl.
❑ I em uemq uMn Sa1im: B. 8 P.G.. br Nb �mean:
Dma: Ow'w:
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Mwisain.
Ome: �ppfceN:
WONKEN'S COMVEN9ATp1 OKL�fl�T10N: I hxWy affvm �Wr p�rWy d pepry ons al tha Idbxiiq podeeatioro:
❑ �nn.e�a.um.w.b.o.w�m.acm..m�o..e;�wo.ror.afca.•comv.�4+.owo.ia.ar«Ma.aionwmain.�.no.
CaEs. la tM pMmiww d iM wak Ia wlich ihu prnW o bueJ.
C] ine».�d.umew.w.ane.•mno.�on:wn.rce..sna��Ms.a:narooau.�.mcoa..m.m.vmkm+.�eam.
7C woM1 la xfiidi �hu D� e mueE. MY wnten' mmP�+mion'umu.ancs wler utl V�Y numCw me:
c.m« FIREMAN FUND EXPIRES
Pofry Mvnber. n'�'7S�'T �iT— 0 7/ O 1/ 9 6
(Jh'v sMion need m� W mrp4fMlW P�! u b aw hu�WM JaOen If100f a 4uJ
❑ I canh Oiv in tl� c«�umencs a iM wak br whkA th'w v�M u bueE. 1 tlu1 nd �qb/ a^V Oa� m M' mem« w u io
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o.�.: > — �'— �� �oaw.: %N
wnr�InY: F.evn m�xun wilrai mmFxwOon am'�iM I. unYwNl, me � wD er �n mWlol'w ro erlMiW awWtlu �nC
dva ror. w ro on. n�nmw �rou,.b eaw. (nW anA sr.eeiuon ro m. r oi nu.`ron a.��wu n v�.�e.e ro. �n
sxtlm ]1PAol tMWorCatM, InM�st �a.rtomry'• rww
CONSTiIUCIION LENDINO �OENCY: 1 Mroby elfi�m wWr p�iWy d perw t iMn u e cmnruaion Wtl'vy ep�nty for Ihs
c.�ama�s a ins xax �« nka� m: v«m1 b bw.a Isseon �oc�. cw. cl.
LENDEP'9 NAYE:
LENOEN'8 �DDPE99:
I canly thtl 1 haw nM Me eppliraum uk qtla Ihet Hw ebvn INamelion M mneq. I pne to oomyy wllh ell dry W mumy ddinenro�
antl ne�e IlMt roWrq W WJCnO oonm�Mion vAIwWY eulhoriE� �ep��enlelivm d IM W b wtls uW� tMlbMmx�tiwrod G�WM�V
la ineVedb� WT�s�
CHUCK JACOBI JR
T—. _ . .. .
od. /-8— 6
(5151�6.WP) ` �hus-BulYJvpbSefs�Y:4rwMFk:CenW AOW���:PNk-Hwymr:OokenmC-N�xsor
�/
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: F 075840
PERMIT N0: F 075840 PLAN CHECK NO: 04811-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: iFR SP PERMIT TYPE; FIR PURPOSE: ALT
JOH DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 2.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74572
***�x�**rt*�r*����'*�r*�*�*�*�*+t*�*+t�+t*+t**+�******� �r�x *��****+t�*�***��*��x����*+�x�**�+tx�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
if �f iE 1E IE 1E 1E 1F 1E 1E IE IE 1t 1E 1E iE 1F 1E 1E 1f iE 1f iE iF 1E 1E 1E 1f ib if if if iF iE 1! iF 7E if 1E iE ik if k 7F 7F 1E 1E �F i! iE fE iE iE 1E 1E 1E iE 1f ik 1F 1F 1E IE 1F IE iF iF 1E 1E 1E iF 1E ik ik 1k ik iF 1E if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: ��F��
iFiFiFiElEiEififlfiflEihlflEiEiEiElEiEiEiEiE �iflEfFiElElEiEiEiFik 1Eif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 90.00
652 SMIP/NON—RES
PLAN 58.50
ISSUE FEE
BOILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 90.00 0.00 58.50 148.50 148.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
�r�*��+rit�r+��*��+r�ir*at�at�r�*atr�*���r�r�r�**it��t�r**���r�t�r*�ritit*��r�r�r�e�r*irx*�r�*�+r+�+eitx�**+r+r+r�r�tit
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FZR 90 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 90.00
END OF FEES
ni pp� _^14..,n --i. �,- .: ,,.�
l+'r�'<. _ . � 1'._. :. :i
CQNSTRUCTION AND PLANNING PO� .+ SPA
APPROVAIS Permit # Date Inspector pppROVALS Permit # Date Inspector
1. Temporary Electrical 5ervice or Pole 52. Pool & Equipmen[ Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit U[ility-Undrgrnd. 54. Forms
4.=Electrical Condvit-Undrgrnd. 55. Electrical Bonding .
5.� Steei Reinforcement 56. Rough Plumbing & Pressure Test
' �� ElectriwlUFER'Grnd. 57. APPROVALTOCOVEii�GUNITE
� 7. Foocings , ' S8. Electrical Conduit•Undrgrnd.
8. Fo�ndation �• 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. " I 60. Backwash Lines; P�Trap, � Undrgmd.
10. Struciural Ftoor System �� 67. APPROVAL TO DECK
71. Property Sewer Line & HouseConnection 62. Backwash & Receptor•Final
12. Sewer Cap ' 63. Healer & Vent-Final
13. Roof Drains "" � 64. Plumbing System � Final
74. Rough Plum6ing. � � 65. Electrical-Final �
15. Rough ElectricabConduit � • 66. Solar System-Final
16. Rough EleMric Wiring , 67. Fencing & Access ApProval
77. Rough Wiri�g Sign 68. APPROVED f0'R PLASTEFING
78. Rough Electriql-T Bar Ce�ling 69. POOL/SPA SYSTEMS FINAL -
19. Ruugh Heating & Air Gonditioning FIRE �EPT. REQUIREMENT
y
20. Rough FActory Firepaace , -- ; ;qpPfjOVAC,$; _��� Permit # , ��
21. Ducti, in Structure� � • ' - �• � 70. Undergr6und Hydro
.�
22. Ducts; Ventilating^' ' - ' _�. . 77, Product Piping O Gas � Oil
23. Gas Pipe•Rough & Test � '� '72. Underground FIusN
24. Roof Framing ' " � �. , 73:� Undergrnd.Storaye_Tank,OGas ❑Oil
25. Roof.She�hing _ - ' ' � + 74: Overhead Hydrq �"
26. F�Bar,Ceiling (Struccural) & Mopocoat � - � My 75: Dry Chemical : - � � '
27. Frame and�Flashing� , - _ . . . w�. 76. Dry Standpipe � ' • � �
28. Lathing &:Siding y' . G" � -' � �� y 77, FIXED SYSTEM FINAL
!-
29. Insulation_ yr •� 78_ FIRE PREV. FINAL '� � 2i"'( 6 1�,�-
'30. Drywall Nai�ing ' : �HEALTH'DEPT. REQUIREMENT
31. Plaster BrownCoatr�. :., . . •� 7g� FINAL INSPECTtON ;�
32. Elearical�oweF MetArFinal +�� '� � 80.' FOOD CERTIFICATE ISSUED
� 33. Fina�;Electric� , ~ x ^ � � No4es: - -� � - .
- `i
34. Final�Heating & AirCOnditioning � „ � ' � „
� , < ' �7
t T 1�
35. Final Gas Pipe�Test. . . • .: � ', • - - _
- 36. Hood �or Canopy " ^- ` �' � � ' � �
' r-• !, '
37. �inai.Pactory Fireplace . _ - . � � � . -
- �38. Final�P�umbing ` ' ' ' ' � • ' ' -
. �. : .
39. �Vatei Service-Final 1 ' . � , �� _ . . ,
�
. 40. Gas Service-Final � � _ -' ' � "
, �
" 41. Solar pomesiicFinat� '� t - � - , � �� � � .
42. Backflow Preventer - fi� � " � ' '
� w
43. Backflow Irrigation . '" � _ � � .
44. Landscape Irrigation SYstem ' ' � ' � �; -
r
45. Soand Attenwtion � � � ; � -� - , �
46. Handicap Regulations _� r ' '" � -
47. FINAL STRUCTURE & BUILDING � . . . .
48. FINALPLANNING ' - ` '
49. Electiic Retease to Edison � . - , .
50. Gas Release to Southern California Gas Cv -
�
51. CERTIPICATE OF OCCUPANCY '
No Date
u
�I
J
A°0qES0F81"L0� 555 ANTON BL
°NME"'""'�'�101""" SAKIOKA FARMS
'��` PO BOX 2097
. • TERMINAL ANNEX
wvi.. wutau �eo�ss:
0N1e 3RD
utxnecroao+mr�+: INTERIQR DESIGN 213623216�M0a 9378
�m
�ON°xi'8AD°��' S50 S HOPE ST �"T 1100
L.A. CA 90071
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(aanm<nc+q naA Ssnion ]C0�) M L��'v6n a d �he &idnea aM Pmtwaian GoM, aM mY IFanw b in hdl tmr eM ellw.
CRYIIC.N�: {lGClA88: UC.NO,: �'Xp�
Dma� Cawaan:
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TW t.6 by erry �ppYani la e prmN � tM eppiium ta s tivi psnMy d nq mars tMn INa MW�sd dc/len jiSWU.
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WOFNEP'S CO4PFNS�TIN1 DECUP�ITIUN: 1 haraty eMrm wbw psnNy W peGW ons d IM k0ow'vp dedare�6ru:
� IhmenOWmavnenacen[¢metlmum��o.atl+miuebewoeken'mmyxuubn.n0�a�dtablSeubnNmN�tateGu
Code. la �M partomiaz�ca d Ns nak tu wFich Ihu pwmu u itawd.
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wak fa xhich Ym D�A b ipW. MY wnF�n' canPm�ion mwrence mrbr aM vdkY rumW mc
c.mer
� Pol'ry Num�er:
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❑ i oenh' qm m ma o�o.menu a �M wM 1a wYrch iks P�d'a iuuw. i aun n+ emdM drv P��* b+ u+Y mw�w so u to
becorn� �ubjeq to �he waXs�' �mWenePoion bw� d Calibnie. rM aprr tlw if I 4�owi becwm u�bjm le tM wpMen'
como«iw�on v�.o�, d s.am amo m �ne t�o. coee. i.non �aunwn oanak »nn u+w wwivm..
oda: �.b_
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'�, s.�von ams o, m. �.eor cod.. rm.,,sc.�w.rto",.r', n.a.
I CON$iP11CT�ON LENMNO AGENtI': i Mraby affum vdw pmuhy d parjury thtl tlwe e e oor�tl�wfion kM'vip apa�cy lor �M
Wrlormena at Ne nork br wN:h iM W^^� u uauee (Seom �09]. Cx. CI.
LENDEF'S NAYE
IENDEN'S AODHE34:
� canily ihe� I hew mad the eOWKm��nJ qate ihp Me nbovs iMdmnion b conea. I prop�oeonµh w'rnh eX rnY end cwrRV wd'menas
uN etme kw �elatiq w buik6y canfuinion end M1+rebyeiMatre raprwanteuo dflria eryro mnmupon tM ebova.mmtbrrE propoM
Ia iropptqn pupons.
ERNIE VITUCCI
Dms:
(S�S�JB.WPI Wlwa-Buildn0 d SetatY� O�wrt-Fb: Canery-AppiuN: Pink-Wverwe:OdOavnd�Aewonr
CITY OF COSTA MESA — BOILDING PERMIT
PERMIT NO: E Q76188 PLAN CHECK NO: N
PERM NO: E 076188
GOVT: N SUPP: N
CON5TRUCTION TYPE: iFR SP PERMZT TYPE: ELE PQRPQSE: ALT
JOB DESCRIPTION ; INTERIOR 20000SF OFFICE T,Z. SQ FT:
CLAZM VALUE: CALC—VALUE: GROUP OCC; B /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION, Rfi:#B74572 & B76187
**x�+t�r�tat�t��t+r�t*x��t�t*ft+t�tjtx��t*��ti[��it*�t�r�t+t�t+��+r�t�tx��t*+r�rt�rt�t+eit*+t�t*it�*�+t#tx�it+tft�r*+t�t�rit+�i�+�*rt�t��t�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
ERNT: FT IN REAR; ET IN ERNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: ET IN LEET; ET IN EiGHT: FT ZN
PARKING RE � PROV: PAftCEL: 41QSOiQ4 ZNE; REE NO:
PLANNZNG N TES>
% "
1E iFlE 1F iE IFiE iF1E iE iFlf 741F {E IF 1E 1f IE 1(� �f 1F If 1f If 1F 7F 1E 1F 1EiRlf fF 1F 1F fElE 1E 1FlEiFlf 1f if 1E # ff 1f if� If iF IE if ih IFlE iE i41F IE iF 1(' �F 1F iF IF 1FlE IF IP 18 ff ff� IF iF 1F �lElF 1f
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
20NING APPROVED BY DATE;
HUILDING APPROVED BY : DATE;
APPLICATION ISSUED HY: DATE: l�%Ia,��
iEiEiF±E#FaFiFiEiEiFiEiliFiFiFi�iEiE�ElfiEiF iE#FlfifiEiEffiEiEif it#t
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP(RES GRADING
PERMIT 211.20
SOt, SMIPlNON—RES
PLAN '
ZSSUE FEE 15.'OQ
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 211.20 15,00 0.0� 226.20 226.20 .OQ
REVENIJE DZVISION TOTALS--> COLLECTED: 226.20 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZPfTOT GRADING PLAN—CHECK
226.20 � .
iE iF 9F #F #F iF 1f iF iF iF 1f k#F iE if iE k iF #f 1F iF 1E ik if iF if 1f iF iE #k 1F iF iE fk iE iF iE iF k iF 1E k if iF 1E iE iF if iF �f }f 1E iF IE iE #F 1E iF 1k iF iE 1F 1k �F 1F #E iF 1F iF #F iF iF iF 1f ik 1E iF iE iF
I N D I V I D U A L �F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N, UNIT COST TOTAL CQST
ELE 20 REGEPTIOUTLET 1 ST 20 EA. ,75 15.00
ELE 436 RECEPT/OUTLET ADDITIQNAL EA. ,45 196,20
END=OF FEES
(11 6614+��2 ;.C1°��42 "6'P_l'!�' ^^i
�AT�: . . �� r, t1- �jK�t. :: •:J
CQNSTRUCTION AND PLANNING � � POl a SPA
APPROVALS Permit # Date Inspector qppROVALS Permit � Date Inspector
1. Temporery Electrical Service or Pole � 52. Pool & Equipment Location �
2. Soil Pipe•Undrgrnd. ' 53. Steel Reinforcement
3. Hectrical Conduit Utility-Undrgmd. ' 54. Porms .
' � 4:"'Electrical.COt�dUit�Undrgmd. " 55. Electrical Bonding
5. STeel Reinfq�ceme�t 56. Rough Plumbing & Pressure Test
6. �Electrical_IPcER Gmd. 57. APPROVAL TO COVER�GUNITE '
•. �.
.7'. FOotingz -�r 56. Electrical Conduit�Undrgrnd. � �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
�-c
9. Water Pipe�Undr9rnd. 60. Backwash Lines, P�Trap, L� Undrgrnd. .
10. Structurat-Floor System 61. APPROVAL TO DECK '
17. Property Sewer, Line & House Connection 62. Backwash & Recepior�Final
12. Sewer Capf �" - . 63. Heater & Vent-Final
13. Roof Drains � �64. Plumbing System � Final
74. Rough Plumbing - 65. Electrical�Final -•
15. Rough Elac2rical-Conduit �' '" 66. Solar SYstem�Final � ,
16. Rough Electric Wiring 67. Fencing & Access Approval '
- 17. Rough Wirij Sign 68. APPROVED FOR PLASTERING -�
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Condition�� _ _ FIRE D,�PT.�gEQUIREMENT ._ m
20. �ou9h PactoryLFirePlace '�� `t �, � ,_, _ � ; •APPROVQ.iS`,F Pekmit #��_
21 . Ductf in STruLRure- • • •� �-" ' - - ` " � 70. Underg�ftSnnd Hydro '
�y
22. DuctS; VcTdtilatin9 � . �- �' ;� � 71. Product Piping u Gas OOiI
23. Gas PJpe�Rough & Test �r,, n� w "��+72, Undergrourvd Flasfi
24. Roof-Fra�rimg`" "�;, � ; ' �;� �,73. Undergrnd.Srorege�Tank��OGas OOiI�
25. Roof.Sheithing � •� �; � • � � � � Na 74 �Overhead Hydro_ _
26. T�Bai'Ceiling (StrugSJ'rall & Mopo�oat .', � �; 75 Dry Chemical ,- �'� �•-
27. Frameand.Flashing�� - � ,_ w c-c 76. DryStan7pipe r-" a y '.�
28. Lathing $CSiding � � `` �y ; � ; � . ..�y 7� FIXED SYE�TERA fINAL . � '
� 29. Insuletion�� � ' � * � * 7&.. FIRE PREV. FIN�L �` -' � _`
30. Drywall N3iling �".'z , y_� % �.tiEPLTH1D�P�. REQUIRE�ItENT
r � -
'37. Plaster8rpwn.CoaL - - x ��79. FINALINSPECTIaN > J
,
32. ElectriwlPower MetEr'-F`-i�al ' `= *��80.; FOOD CERTIFIC`ATE I�SUEDr,
s.33. FinalEleet'ric-. �, `�„ � j'2(� �Notes: -+� � - ; ,
_ . /� ;,
�34. FinaGHea�ng&Ai�:G;onditioning�`� _ t ' �I
/ �
* - • �fi� � - t� :�1'►1S :Q rs4i (n-� (� _G9.�J�
35. 5inal Gas.Pipe:Testr . . �, _ !1IT - ^�- �'/l��' �%�►� '� �-^-�,!
� -�- ������_ -U_
36. Hood or Canopy `- ` � ' - ' !,Q _
'l ^ � � �4�-��
37. Final�Facfory FireetaeeJp; �:r v - � �.
38. FinalFlumbing -'' ' ' " , ` =
:�� e
39. Water $ervice-Final�' ; T � ' x �.- � ' ,�. .: - �. -
��
40. Gas Service-Final = ��. �. r.• � r. �: `- , i�, •
1�' k Y { k C
� �41. Solar pomestiaFinai"� S � ' " �- � _- , �' _
� ' i � R - ..
42. Backflow Preventer� r � - �� `
�.� n� � � r ' f
43. Backflow Irrigatioit;y. �` �' • t ;, �� � �
44. Landscapt�lrrtpation�6ystem �t*!�' z �� r, e" j . �F, ' '= --
-� '♦ .ir•- � _ r _ F i �- r � � _
45. So.und Atten4ation } �7 ••'• fi � !� `� K - o �' •� � .
46. Fiandicap Regulations r • - •`� - S ^
r r
47. FINFtL STRU�YURF� & BUILDING ' ' " �..
48. F'INAL PLANNING � � , -. ,�
49. E,I'ectric Release to Edjson . '__
50. Gas Release to Southem Califorrtia•6as Co ' - � T ' �
- f.
51. CERTIFICATE OF OCCUPANCV '
No Date
5�e'^��: 555 ANTON BL
""ME'F�u�o"": SAKIOKA FARMS
"��"Eu PO BOX 2097
' TERMINAL ANNEX
MPL. YutWO AUDRE45:
�N*: sxn
APONR�To"Ef°"�" INTERIOR DESIGN 21362321f.�N°= 9378
u�cxonac•s,�noxea: 550 S HOPE ST �N* 1100
L.A. CA 90071
�+�T�'S� MORROW MEADOWS CORPORATIO (714)598-7700
CWfPACi0R5YNWA 610 REYES ST
�ss: WALNUT CA ��+o: 230813
917 S 9 urn:
IICENSED CONfR�CTOP4 DECL�NATION: I Mroby eli`m uMx penaly d q�ury Nm I em licaaed uMs prwmma d Cheq�r 9
(oommentlrq x+l� Seclian 1000) W Oiroion 3 d tM Buti�ron ud Profsaaim� COEe. eM mY limn» u in h0 bm mM dletl.
�em .N : p06558 ����g C 10 uc.No.: z30 3 EXP• 12/95
/ me: �- canme«: 7'YL
owNb auaoen oecun�now i n� m� �a« o�y a o.;� mm i ,.,m i t� ms cwv�m� i�ea i.. i�, m.
J�RnB rmwn (9etlion 1IX11.5 Buviwe� eM Prdmdone Gods: MY aY a ooumf xfiitli Vuiree e pumu to wnsWCY. Mx. imMma.
�mdsM1, a repei any avupu�e, pia b ea uauence, ebo nQuirae iM epplimit la �m�il lo fib e ep�wd au�mmm Nei he a�M
♦ lironaetl W�aueni io iM prwiwane d tM Cwreaae limroe lew �Cheqm B( �� wnn s.ao� �000� d on.a� a a�ro
9uarien ene vrdm.on codel «ind ne «.ne ro memp �nnehom ene �n. mae �« u�e albpad memWin,. Mr vidmon a seuo�
1W 1.5 tr/ erry applicent la a pmrml abpqs �M eppliram �o e avJ peiWiy d iwl mas �hen Me huM�ed ddlan �550U�.
❑ I, es oxmr dtM poperty a my anWv/see wY� wapea m tMi eds mmpenalion. vrill Ao Na wak, eM tM nrunure e nd inlenEed
impwememe ars M imeMeC n qfsaE lar eeb. II. �anawr. iM buiqiip a inpovemeM ia �dd xilhin awYw a/ mmplqion. iM
ownn-0uiltlar will hew iM buNen d proviip M or ehe d'q M Wik ar impwa la the purpve d aeb). '
� I. n ownx d iAe prapeny, em a�tlid�ely oonlrean0 �h IicaneeE comrac�on lo conaV�d Ne pivjeU (Sedion )01A. &uvre mM �
Profeaioro Code: TM Comrrfm licenro Lew Eaee na apply to en ow�w d popMy who Wika ar impwa tM�eon uM who'
wnVecta Iw wcM1 pqeqe xilh a wurmor�e) Icenaed punuem to �he Conlreeon Limme lew�.
� 1 em memq uMm Seclim: 8. 8 P.C., la Ihia roemn: .�
Dete: O.mx: �
1 Eo henby ceNN �� I em eware d vd uMenlend ihe repuiramania W Celiomu HaeAh erd Seiety Coda Saabm 25505, 255�J, md
255�0, enE Nel I w eny INure DuiMirq ocapant will / wdl nai (arcb one) neeA lo comply w1h veid atate codm uM IM repuiremante Im
ape�mnlmmnsteudbnamodAutionhanlMA'x�ii yG�.aapememDi�mf.RaeidmlielmiMiutlioneppfulomemevsmW����e
ymisiom.
Dele: Applcent:
WOHKEH'4 COMPENS�TION UECL�N�TION: I Mreby elfi�m uMer penetly al p«jury ar d ihe lotlowi�p EeWreliorra:
� IheveenEwiOmeintenecenMcetedcomenlloveXinwnlaworkers'campenWbn,nW�dadlwby5atlion3lood�Mlebor
Code, fa tM pMamuice d IM wak la which ihn pemiil is iaueE.
❑ inm,.�a�;e�ma:,wona.•�v«�.aoo�,w�...�.a��.eews.u�e�aoam.tanwcoe..n�m.wm*�.am.
A wark ta whiW ihie permn n musd. My Waken' wmpnee�ion imurerica urrier end pdky numEx va:
, c�.,: FTRFMANS FfTNP EXPIRES
Pdic/Number. nrarun���c.4� 07/01/96
i MionnsMrw�6emndaedf�MO�lnbromhunCndCwMemRIP0lnlw.)
nh � M �� DM�<d IM work la xfikh �hu psrmil o iawed. I Nell nal emplq ury paaan m erry menrier ao n to
a wMa io iM hoM1en' romW��bn Ievn d CeNanu. enE nires Ow il I ehouN bconr wAl� io �M v.o�lwe'
% penae�ion qwiviom d �]a0 d �M lebor Cods. I xnh wmyy ' Nw pevrieiom.
/
v.: - � �cdsw:
em/np: Fequn ro ucun woilrw�i rompxwtlan ew�rap� h unMwN( �nE � �/I • J�ef �n xrrylrysr ro eilm'nl pwltlu �mI
elHl linu �q b aw ��nErM MouuM JWI�n (JIOQOOOA N Wlltlon b IM .e or moen..rron �w u povmw ro• in
s.caon 9)a o� m. uew coa, �nM1r.,t .�a.rtormr'. �.u.
CONSTNUCf10N LENUINO �OENCY: I MnEy ellum urder perohy d perjvy �htl Ihas u e mrul�lbn bnd'mp epency lar tM
wnoem,Me w m. wM m..nKn ma v�+� a:.�.a eseaian �09�. cN. cl.
LENDER'9 NIWE:
�aoen�s �ooness:
I cMity Ihm I heva rwl Nn eppfr�ion eM aeu tAm tha ebow iNwmtlbn b cortsq. I pne io aomply wuh eA dly eM muYyadironcw
erd ewa lewa eelelip to WJdip emWudion end Mreby aNlw¢s np�a»nieinm d Ihie tlryto eMx upan tM ebme�meruuriad popMy
�� �mo� o�w...
CHARLES JACOBI
n _ . ..
✓
Dme�12 /�i �
(5f51ya.WP) \ /WhXs-BuilEiqd5elMy;Oreen-Fb;Cenery-Applum;Rnk-Rewnue;Goldaneod-A��ensor
\�
CITY OF COSTA MESA - PUILDING PERMIT
-- PERM NO: E 079577
PEFtMIT NO: E 074577 PLAN CHECK NO: N GO��T: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 200005"F OFFICE T.I. SQ FT:
CLAIM VALIIE: CALC-VALUE: GROOP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74570
��***�**+�****�******��***+�***�r�r***�*��*****�*�*+��*+�****�*��*���*��r��**�*�******
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
� �:i
iF 3E iF iE 1E jE *!t iE 3f iE if ik iE iE ib iE *?E!E iE if iF 3f af fE if iE 1E if 3f 9f 1E iE:iE 9E IE �)E iE iE iF 1E 1f if iE iF 1E iE jE jE fF 3E 3E 1E 1E iE if if Ik iE jk iE fElE �k 9E iE �E iE jE iE IE k iE if 3E 1E iE 1E
D E V E L O P M E N T S E=R V I C E S R E Q U I R E M E N T S
-n
ZONING APPROVED BY DATE:
i
BUILDING APPROVED BY : DATE: p
APPLICATZON ISSUED BY: .� i�( DATE: J�- J�p- I�
dE3E�fiElEiEiEiEiEiEiEiEif%�ElEiE1ElEififif�E� rriF �jt��Eiti�F��F3F�if3F�FiF�iFiF�fif�F�iFifiEjEiflEiE-)(-ifi61E� 7F��i�i��i�SFiEiE
LEGALIZATION:N F E E/� S U M M A R Y STRUCTURAL SEGMENT:N
�
BLDG PMT PLUMBING EL'ECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 208.05
508 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 208.05 15.00 0.00
REVENUE DIC'ISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
223.05
TOTAL PAID DUE
223.05 223.05 .00
223.05 OVER/SAORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
3E 1f i6 iE ik iF if jElE if 1E �f if iE iE 1F iE IE 1F 1F 1E 1E N-3E 1E 1E if iF if aE if �E 1E 3E iE if iE 1E iF iE iE 3E aE �E if iE iElE 1E iE iElE iE 1E iE if if k iElElE iF iE if if !f iE iE fF fE 1E iE 3E # if 3E iE 1f iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15.00
ELE 171 FIXTURES, LIGHTING ADDITIONAL EA. ,45 76.95
ELE 20 RECEPT/OUTLET 1 ST 20 EA. ,75 15.00
ELE 118 RECEPT/OUTLET ADDITIONAL EA. .45 53.10
ELE 20 RECEPT/SWITCH 1 ST 20 EA. .75 15.00
ELE 3 SUB-PANEL 11.00 33.00
END OF FEES
D! C0192C4�-�G192098 �P'7�ey' ??3.G5
ORTEa d�7�'_o.�°S 7IYP: 0^:20
�
� C4NSTRUCTION AND PLANNING ,
i9PPROVALS Permit #
1; Temporary Electrical Service or Pote
2. Soil Pipe�Undrgrnd. �
3. Electrical Conduit Utility•Undrgrnd.
4. Electrical ConduibUndrgrnd.
5. Steel Reinforcement
6. Electricaf UFER Grnd.
7•. Footings
8. Foundation
91. Water Pipe�Undrgrnd. '
10. Struc[ural Floor System
1 i. Property Sewer Line & House Connection
12. Sewer Cap �
13. Roof Drains �
74. Rough Plumbing "
15. Rough Electrirai-Conduit
76. Rough Electric Wiring
77-. Rough Wiring Sign
18. Rough Electriwl-T Bar Ceiling
79. Rough Heating & Air Conditioning
20. Rough Factory Firepiace
21. Ducts, in StruCture
22. �utts, Ventilating .. .
23. Gas Pipe�Rough & Test
24. fioof Framing
25. Roof Sheathin9
26. T�Bar Ceqing �Structural) & Monocoat
27. Frame and Fiashing
28. Lathing & Sidin9
29. Insulation �
30. Drywall Nailing ,
31. Plaster Brown Coat
32. Electrical Power Meter-Finai
33. Final Electric
_ _ ___
34. Final Heating & Air Conditioning
35. Finai Gas Pipe-Test
36. Hood or Canopy
37. Fina� Factory Fireviace
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final '
41. Solar Oomestic•Final
42. Backftow P�eventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations
47. F�NAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
Date
Date
PO� t SP�
i�spector f� �
APPROVALS Permit #
52. Poot & Equipment Location
53. Steel Reinforcement
54. Forms
56. Electrical Bonding
56. Rough Plumbing & Pressure�Test
57. RPPROVALTOCOVER�GUNITE
58. Eiectricai Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test .
60. Backwash Lines, P�Trap, C Undrgrnd.
� 67. APPROVAL TO DECK �
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing SYstem • Finaf
- 65. Electrical-Final
66. Solar SYstem-Pina1 .
-67. Fencing & Access Approval
66. APPROVED FOR PLASTERING
� � 69. POOLlSPASYSTEMSFINAL
FIRE DEPT. REOUIREMENT
APPROVAt_S Permit #
70. Underground Hydro
71. Product Piping � Gas OOii
72. Underground Flush
73. Undergind. Storage Tank � Gas ❑ Oif
74. Overhead Hydro
�� 75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION �
",, FOODCERTIFICATEISSUED
Date � i�spector
.
I�
AD°"�40°B�"1dN°' S55 ANTON BL
°a"E"s"'WEi`i°q"": SAKIOKA FARMS
, � AD°"`� PO BOX 2097
TERMINAL ANNEX
�rvi. �uwro �oowcss:
°NT` 3RD
�xcxnEerowu'ax�x: INTERIOR ARCH 2136232164 �'N0t 78
urcxone+as�ooncss: 550 S HOPE ST ��` 1100
���s� L.A. CA 90071
COMPEL CORPORATION (310)946-8321
CONiNA�TOR5�4Nq 10410 PIONEER HL
�ooxcss: SANTA FE SPRINGS CA �BNOi 392693
90670 °Nf
LLCQISED COHfPACTONS OECL�R�TION: I hereby ellim wder penelly d �wr'ryry Net I em IienasC wMx pa�idma d Cheqx 9
(wmmaidn0 �ii� S«tion )000) W Dn»ion 9 M ihe Buvrov vk Vmleaebm Cads. enJ mY licenx e m IuA bru end Werl.
cmuc.No.: 032054c /�`'""�` C-10 uc.wo./:� �39 ,2[�6/9�3 EXP: OB/96
Date: !�/�Z.� � 7�) Conreaa: /%N1/� �C7' �L.B..t6J/L.
OWNEA BIIIlOER UECIAHATION: I Mnby elfirm uMer penely d parN�Y �� �� e mq hom iha COMrepae Licerue Lew la Me
MWwinq �eewn (Seaon Mi1.5 &renm� end Proleasbru CoM: Riry cYy a aountY'�� �Qu'vas e permil io mmVucl, eller, imP�.
bmdah, a ropei arry svucture, p'pr io ea iaieiwe. abo requim �he applirani fa euch pe'mu to fib e aqmE �luameni tlW M or �M
u liunaed W��� lo tM powiona d Yw Comratlon lioen+a Lnw �Chepa e(aommercuq wnh Sepion ]oou) d D'vwion 9 d tM
Bumnen eM Pedowiam CaAel ar �hp M a ehe u eaemq Iherehan vM I!a beve In IM db9� uemqcn. AnY vidmion d Sepian
)03t.5 W enY aDO�� lu e pem�1 abje6� Ihe ePplicem to a cHl perohy d nq man �hen Iws hund�eE Edlen �SSOOn.
❑ 1. m mmer d iM paperry «my empb�ma wih wepea n IMi ede mmpeneetian. will do Ne xwk. eM tlw et�un o �wl iMeMeA
d�erad Iw eeb (SMion )WA. Buurcas vM Pmleesiorp Code: The Contreaon Licanss law daea mt epWy lo en ownard popmry
wlio buiEa ar inprovea iharoon, uM Mw Eom euch wak Nmaell or hersell m Ihrauph he a her ovm ampbyaan, prwided Ihet euc�
imD�emenle era mi'interqetl a dlered for eeb. lf, hanever, iM W'ik'irp ar'vnproveman�'ro eold wilhln ms ymr d mmqMion.1M
o.��a��a> �n n,� ins wtte.�, d ww�m n. «.ne ab om w�a a �mo�w. �« �ne wmo� w.�).
� I. n oxner W ihe MWMY. em utluti.eN mNretlM wYA liosaed canVeciae ro eanYrue Na C9b (Satlbn IOM. Buairo�a eM
pwmdm. Coes: rne cavnem liwne L.w aoea na ewN a an oww d wweM wno dnN. v�mqwn �ns.m ane wno
Wntreaa W uxA pqaas ww41N� e mMraea(sl �emed wnuaN to tM Caniroea+ lioxue lew).
❑ I em exmmq wder $xtian: B. 8 P.C..Ia Jue re+eon:
I Dme: ��
I do hemby ca�ity thu I em ewve d erd uMenbM Ne ropuimmen� d Callomie MmEh uM Se/ey CoEe Seabm 25505, 2553�. eM
p559a, enE Nv I«ury Mum Euiki�q omlpeni wJl / wAI m� �drcb aia) need to compty wIh emE uma mdn eM iM requiromems lor
eV�FlawmbucYbnarmoEifmionhomihe�r e�ly enepuMnlDistria.RmidoMielmmrudionWG�iameraaxemqlromMme
a�.
Dete: ADqieM:
WOflKEH'S COMPEN4ATON UECLAPATION: I hxaby alRim urd« penally W pujury me d ttro IOAowi�q bdueliwn:
� � heva vM xil meinlen e nnil' ae d coneent lo eell�nwro la v.orkere' canpsnetlion, d praviAed IaW bwun 3]00 0/ lhe LeEor
C�e, ln iha pAormence d �ha xah Iv wFich ihia pem�n h buetl.
p in....�ew�mv,..«+�n��mwi��.,,.�...,�.a��aMs.e�a�aoau.i.ne,caes.ro�m.c.�a�+.�am.
wak fa whiN Ihia permE's ieuW. My wvke�e' wmpenmtion imuruwe wrir ud poliry number aa:
c�«: For.un�im rnuo EXPIRES
Pd'ry Number: � 2� 0 1� 9 6
(ih'xsMionme0mfbscanWateO/IMpermd'nMmehun IPOa/w.!
� � cenLy Ihet in Ihe pe�amer�ca d iM wMc la whch thie parm� in iaeueE, I ehell mt emWoy ury penon m enY men�wr eo u to
becane eubjeu to �M r.wkere' companeetbn lexa d Ge4lomie. end epros iM1tl il I ehouW bxome abyd lo tM woMen'
mmroow��f�^'`�! a sae� a�ao n me �no� coes. i.w� im�yn.vn �_oh, •nn ub..°'�°"°
ome�. ��Y:O'ii nod�um: � _�4�C[7�� 7`-'!.l�R.Ba..
Wemlrl0: F�Nun ro ucun roilnn'rompw�utlan cov�rap� l� unl�wM, enJWll /�ct en rrp/oyw ro crlMix/ p.rultla uN
clHl fIM� �q b ma �ind�W tM1ouaud oo/4n (S10qIXlpf, M adtllfbn b M� cw10/ rnnpsneWM1 E+msp� u povldW br In
3xtlM �105 0l tlir Leboi Cob, Inf�4 �� ��msYY I�n.
CONSTAUCTION LENqNO �OENCY: I MreW �rm undx penahy d perjury Ihet �here ie e cvnelruaion MrMi�p epency M iM
paAmmarim d tM v.wk la xfiich Ihu permY ie ivaued (Swion �pe]. CN. CI.
LENDEN'SNA4E�.
LENOEX'S ADDNE53:
I cenity �MI I heva rteE Nb eppfceiion vd nme ihm tM ebws iNamvian b canse.l epree to canpy wilh eY ary mM cauvyaEimiam
e�M aW s levn Mel'vq to WJdinp con.muction aM Mrsby eNhorus �OpaSenletiw d INf dly b eMu upon IM ebwe-menlimaA properry
torirepsdio� W�Wsea.
-�fFF 3`�4'�a /IAOI�Tl�4250/�
��. Pnn!'— �!./I /��_ Dme: ��'"� �.Ci
—��m�,e w w�.n�u.w�ucomreaa
(515t-aB.WV) WhnsBuiNiq 8 Selery:OreerFb: Cener/-Appiuni: Pink-Revanw: (3oldenmE-Iaees+or
PEAMIT NO: £
CITY OF COSTA MESA - BUILDING PERMIT
074835 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
JOB DESCRIPTION : INTERIOR 20000SF OFEICE TI
CLAIM VALUE:
CALC-VALUE:
PERM NO: E 07483
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: H-2 /
*�***�***�r******�****��****+r�*�*+Cr****%***+i�*B�**+�r*f��*��+Mr�*��***�*�r+Lr**+Er***����� x��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARXING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
1F 1f if it 1E IE 1E ik 14 if 1E 1F IE 1k 1E IE 1flf If 1f IE 1F 1! 1EiE 1f iflf 1f 1E IE 1E 1F 1f iE iE iF 1E IE 1E if iE if if 1F if 1F 1! iF 1E ik 1f 1E fE IF 1E If 1F 1E iE 1E iE 1E 1f IE if IE IE IE iF 1E iE i61f if If 161E it
D E V E L O P M E N T S E;,R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY
BUILDING APPROVED BY :
APPLICATION ISSUED BY: � � �M
iEifiFikiFiF1E1E1fifiFiFlFif 1EifiEiEiEiE1k1F
LEGALIZATION:N F E'E' S_U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 6150i
PLAN , � •
�
ISSUE FEE 15.00'
BUILDING-DIV-> PERMIT ISSUE PLAN�CHECK
TOTALS----> 61.80 15.00 0%.00
_�
REVENUE DIVISION TOTALS--> COLLEGT,ED�
BLDG PMT PLUMBING ELECTRIC MECHANIC
76.80 =�
DATE:
_ DATE:
DATE: (a Z.Co
��K1FiFlFkiFiEiE�1E1E��� �E1k
STRUCTURAL SEGMENT:N.
FIRE. SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
76.80 76.80 .00
76.8Q OVER/SHQRT: .QO
FIRE SMIP/TOT GRADING PLAN-CHECK
� _.i �
IE fF 7F 1@ 1E IE IE 1E if If 1E 1E 1E 1P if iF 1E 1E 1F iE 1h 1E 1t iF 1E 1E 1k IE It 1f 1t 1E ft 1f if� IE If 1E iE 1E iF �E iE iE iE 1E Ik 1E 1E if iE Ik 1E if IE fE 1i if if iE 1F 1E 1E1k 1k IE 1E 7E 1k 1E IE 1E iE If 1k IE IE iE 1E
I N D I V I D U A L ,F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N� '� UNIT COST TOTAL COST
ELE 20 COMMUNICATION DROPS '1='ST 20 ,75 15.00
ELE 104 COMMUNICATION DROPS ADDITIONAL .45 46.80
END, OF. FEES1
�= �' � �
_� J o� oaJv:,�za-aois3.?s Yri�' �6.3C
'z �-� DATE: IQ/7o/C5 rt�;F: ia:ui
1
1
GONSTRUCTION AND PLANNING � PG.. �& SPA
APPROVALS Permit# Date I�spector qppROVALS Permit# Date lnspector
..
1. Temporary Electrical Service or Pote 52. Pool & Equipment Location'. . .
�
2. Soil Pipe-Undrgrnd. '^��'' 53. Steel Reinfarcement � ,Y �
;3.=Electriral �pndu�t�U ity-Undrgrnd. 54. Porms � �
i ;4�tectrical �p�i'd�'T-�rgmd. ' 55. Electrical Bonding '
, �
�.�5"SF,�eI Reink!yemer+}.�� 56. Rough Plumbing & Pressure Test
^��Electrica( FnER�,E� 57. APPROVALTOCOVER-GUNITE �
^ a.''Fs�otings �Y. � Ma' n 58. Electrical Cond�ndrgrnd. ` �
C1.v J�'SOC 1
� r. _
-�8. Fxiundation n' ¢ S� e 59. Gas Pipe, � UnIIiQrnd., Test ;
�..� �nr�
9. Water Pi � � rJr� �ly.
piJndr n�. . 60. Backwash Lines�rx� rap, O Undrgmd.
10. Structural-FloorSvstem � �� , 6J. APPROVALTC7'6ECK
11. Property S�wer.Line ¢; HouseZ'�.osthection 62. Backwash & Rel�psor-Final�, �
12. Sewer Ca� �, :^ ' 63. Heater & Ven[-Fina�i �{
73. Roof Drains o� _ 64. Plumbing System � Final ..
74. Rough Plumbing:' ��" 65. Electrical•Final ` '
75. Rough E7ectricaFEorrtluit- � a^ � 66. Sofar System�Fi� .
� :.�
16. Rough El�ric 4tirin� �? 67. Fencing & Acce , Approva� ' �'�
i
ctl. Rough Wirirg�Sign � i 66. APPROVED P�'PLASTER�NG '
y •v.
18. Rough Elect7fcal� Bar Ceiling 69. POOL/SPA SYSTEA9S FINAL
79. Rough Heating & Air Conditionmgy � y �, FI�E+��T. �EQUIR�MEN` ���
-, i c• r , .:, c� `, o x ��..;
20. f�.�du9p.FaElor�Fir`ei��ace � Sn, � � * Q,�...-�qPPf�V�,,..,�Pe�it#��..,..
21. t�uct$-in StruQLre*3'r .. .. --< �; � v �++� .70. iJnder�� H�iro " .
22. Qycts;�Ve�ila�n9 n* ' "� � p ��x ��71. Produoi FPing �1�s i�0il
23. Gas Fiipe-Rouq_h & Teet ^� r p; � pe �72, Undergrounii Ft^sfi� r .^(,
24. Aiiof�rarf�7ng �� E"" ��a � ,,�r '7�,.�Undergrrt"c(.Sior�Tank,�]Gas t�0�(`
25. Roof,�%hee�hing Sa �� �� t� � ': ti� 74rOverhead Hydr� '�
26. T-`Baf£eiling (Stru��rall & NFo��at # �. a �=;* 75g�ry Cher�:cai :, - ; ~ `� =�-r;
27. F�me.andflashinq,z �xc.� �c^ �, a�. 76. DryStan �' e i ai x J �• S<
. n '-.n
!-28. Wth�q 8� iding �� � `�,'= S � � "� "y� 77,'�., FIXED �Y_S,TE��'INAF� �..� {� S�
�29. Insulation� CJi� �' S� • r � 'a 7� FIRE PREV. FIN,�I *% ��'�
s �.
-,:30. Drywall N�iling `�'* ,y , * F� ' i � _ `J��E�ALTF4�DEP� fi�EQT)IR�NT
j37. Piaster Brc�vniFoaQ� a � x: � � � 79yfINAL 1�6{6P.ECTt�N• x✓ � �
i n ;--
�,32. F�ctriwl, wF,� M�-'�Sn�21 ; i•� � n"0�:.,��FOOD CERTIFlCX�7E I�'S�ED;�. O�
- N . C*7:� ' . �s n ���kY'�� ` . .
,33. �al,�-E,leotric �. �. ;� , Q � Nates �-+"� "m �- "'� _� �vNm
'" y ., c
'-u34. F.inal�3eafng StlAirLondirionin§�= ^ ' ' ;*" �{�j � � x -� ��
•� _. �. . .:t� [T7 3 :� � I iy. '`_ <t-'( Y� i � , t � Y
Y. '1' . . i � 7 � � w "'f. L�' _ '
35. Fa�aI�C`,as�jpe`-Test�*� C; .: ', ;, i � -� _� ,
.. - '� ��� -' -
.�36. Hood=or CXnopy ••e. = � t^•� a r C� i i� S i,o =� r-i[*`
- � �� n �'-; � � ,� n �o ,::n �o-
T �
�7. F'nai Fattory FirepJaqe�'x ��'r� r� *' � � �* fi ti�v
'-38. Final7lumbing 'ti'# �`U • '� a 1 � ` = " � K
-+ G # ' � �1' � : V'.
`39. Wate�ervice�Finaf'�,.�,'. f ; ` * r i • ,�: � ' � ,� "
r.40. GasService-Final ^�;,m �,*[r^ S y'n � ,x J�' c'N t
.� r n r-.:-� : � M E, . o S f�."
-41. Solar pomestic�Fin�* � �.�,.' � ,K. `� ( � � :.� ,� �x z �
- � i �
� 42. Backflow Preventer.S� � ;u � ( ��c � tiF- x� e�
!-. �n• n t" x t*+ mG � F
��� TSS 'i 7'. �..r : .�
43. Backflow Irrig�tior{Ky. �, ,; � R• �. n ••
„
44. landscap€.irriq2tivn��System d:TC: ' a c�� t7 O� ^� N T2 �^ n; r, n.�
n s a i c g, c� !; S "t 5 H
45. So'und AttenuatiorrS;` ""�F `'- *' - � ' ' " . �
y.. .. t �: rr �� r t' -n � ;-. C
46. Handicap Regulatioa9� :-� p s:. „" c: S �7� S x
.- �r c �k S t*7 C' .'J �
:� r
4,��. �NAL STRU�°fU ,�& BUIL�ING � �.. � ; * 7 x ^
48. F1NAL PLANNING 'b • -� * C� ' , �� T� �T ¢ t'' r'
� � i z � y �
49. Erectric Release to E�ison � " ' � '
. �^ •,"i � •-n.
�
5fl. Gas Release to Southern Califorrtia�Cas Co '" � 'r� -J - C. •=+[h � O^• •
� x . c- = � .^i !: �li D�
5l'. CEflFhFtCATE OF OCCUPANCY ` � �` •- � =� •� +• r v
No. Date
:'
.t
�nonessaew�wa: 555 ANTON BL ,, ��T _ 3RD _,
ONNEFSNAYEIFqqMlk SAKIOKA FARM . .
. �o�� P.O. HOX 2097
iERMINAL ANNEX, CA 714-433-6005
APPL. WIlWO LOOPE55:
.�cxrtecron�am�nn: INTERIOR ARCHI2136232164 �� C-9378 .
�PCN.OP ENO.'4 ADDPE55: S S O S HOP E S T UNT: 1 1 � �
L.A. CA 90071
ca+m�crarswu� CONTINENTAL PLUMHING INC (909)360-8300
� cwm�croas�u�wc 11165 THURSTON LANE
�no�ss MIRA LOMA CA ��.: 399073
91752 uNr:
LICENSEO COMRACTOpS DECLAP�TION: I hereby Mim uMs e�ury tlW I em IieneE unCs po�ieime W Cheqw 9
(mmmerc M Milh Section 1000) d Onuion 9 d Na BvsMa vd Pmf ' ns Ee. uM Y limu i tu0 tatt eM Nlee.
cmuc.No.:027563 uc.cuss: C 36 9 7 EX • 09/96
Daie: 'LJ' � l � �.� Cmtreaor:
OWNEN BUILDEP DECIARRTION: I Mreby Wrm uMer panely M perNrv � em e�emq fmm iM CwNreqon Licenee Lew la �he
Idbw'vq reeaon (Seuion ]W 1.5 Busiroa+aM Vroleavians CaEe: My cGy n munty whlM roquiroe e parmn lo consuuct, eM1x, Imqova,
demoluh, ar npei eny sVuclure, qior lo Xa ewewe, dw requime tM epplirent Im auc� permX lo fib e ayried awemenl Ihal M a�M
ia licemeE W�1 lo IM prweion� al Ihe CmVapon Licenee lew jChepler 9(�mendtp x+lh Sepian )000) a�+eion � d ihe
B�anew eM Prdeaiore COEaI or ilw M u ehe is e�emp iMreimm enA tM beais la Ne elbpeE exemqion. My vidmion d Setlion
�oa�.s M env wW�� ��. vkmn +ud�+ ine avWcem m e wJ w�N d nd m«a inen �Hs nvMrsd ddw. RsaoU.
� I. d ox�wr d the paperry or my emplayase xih wepea es ihai wla mmpamqim, will do IM xork, vd ihe awciwe i m� InleMed
a dlered lar vab (�� ]Ou. Bimiwu enE Pmtma'vnCotle: The Camrmae Lioenu Lew dom nol epply lo en mmerd piapMy
who Wide a inpm++�haean. enE Wn dox vueA v.oek IimseX a Mne� a Wwqh he a Mr own smWNee%. pwidad OW a�M
imaowmw. �e �a wddee «arone �o..w. n. no...e,. m. witlny « mw�«a o wd.nn� o�. rm, a w�W.ion. me
m
owrorLuiker wiA here �M bnden tl Pa+�O M a Me did nd ddd a impvn ta tM W�W+e d�ebl.
❑ �. e. o.n., a ina wwenr. em mwmdr ow.m:a .w xeneea mnv.�ia. �o wnmua in. cmiw (s.aon ra.. 6uv�n. w
Prdemons Code: The Cantretlm Licen» law daea m ePWY �o en oww d popenY x1a buitls a imGro+s tMraon W xho
convecia la euch pqeqa xiih e oomretlor�s) Icenaed punueni lo IM Conlredas Liume lew).
� I am axemq unEar Sectim: B. 6 P C., br Ihis reamn:
Dete: �✓
I Ao heieby eMJy tlw I am awara d enA uMenbM iM eaQuiremenb d Cel(omie Heellh eM Seftly Code Seeiom 25505, 2553J, aM
25511, end IhN I a eny �Nure WilEiip ompanl will / wJl nM (drcb aw) naed lo comply wX� eeiE btele mEee eM IM reQuiromeMe la
a permA laconevunion or modAiratimirom IheAi�egament Oimnd. ReeidemW oonnrwaon epp4uiionaere examq Irom iMae
pWIH�NIIf.
Dma: ApdiuM:
WOFKER'S COYPENSATION OEC Wi�TON: I hw�by etfmn uMw pw�etly d �wpvy aw d tM IOAow'vp dWum"ve:
❑ I Mw aM r.il meinian e catilicele W wneent io eaMiroun M xwkrs' cpnpenW bn. u pwdsd fa b/ Samm �]00 d iM lebor
Gods.la ihe pertameM:e d �lie wak lar wlich i�u pe1mn ie inued.
❑ 1 hew ud xd meimen walwe' mmpmwon imurerce. o rpui�od by $etlon �)W d IM Leba Cods. b tM pMvmeio d iM
work In wturA Mb Germn u mued. MY waken' wnV+�ion inwra�cs m'riar eM D�/ wmbx ero:
c�., CNA EXpIRES
ra�. r+�me«: 0 7/ O 1/ 9 6
(Thia aenion nead not 6e compbfeC l t�e peimd ie la one hvndieC dWlers /S1W7 a�eJ
� I eenRy Ihet in IM paelormu�ee N tM waM lor v.fich ihie ' n o ueE. I e1Wl ml emd enY paem in eiry menn w n to
becwne wbjeq to tM �aMxe' cwnpenealim iex+ G Gel' ie, e E epr Ihd a W becams wbjM b I xarken'
compenation pw'n\" d SeGian 3C]00 d tM LeEa Code. 1 �� mpy MiN qovi�'vn.
Dale:�O � �i� � � J �Odirav:
Wemlrp: F�Nun ro iseuro workn�'rompxuetlon rowisps la un , entl M`II �Ilef �n wrplqw b eNMnel p�n�Mw �M
clvll fln�a up ro an hv�tlrH tMusud da/l�n (SIOQPOOA M eJJ/tlon b M� caf al rompru�tbrt �p� u povltlM br In
Sxtlm �1a6 0l �h� laGor Gb. llrtvW4 �� ��m�Y� I�
CONSTIIUCTION LENDINO AOENCY: I hmeby tlfirm uMs p'utly d perjury i1W IMn e e mW�urlian bM"vp epancy br Ne
paAamerca d tM vuM M whiA tlie pmmi e uaM (�� �. Cw. CI.
' LENDEP'S NANE:
LENUER'S RDUflE4S:
� ce�ily Ihel 1 hew read Nia epplicelian eM slele IM1et IM above inlormelion is conaa. I eprae io comply wilh ell dly eM wuMy oNinenoee
�ind etele leMe iNelip lo Wikiq canavWion enE MreEy eNhorae repesan�elivee d Ihis cilyto anler upon IM ebave�memioneE piope�ly
����0'�' RAY RNTO
i.� ��p n-�Li �l
1
Dete: IO � �7 ��
(St51�6.WP) While-BuikipBSafMy:Oram-Fb:Cuury-Appirani:Pink-Revanue:GolEenraaNa»sar
PERMIT NO: P
. CITY OF COSTA MESA — HUILDING.PERMIT
074733 PLAN CHECK NO: N
PERM NO: P 074733
GOVT: N SUPP: N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION : 20000 SF OFFFICE T.I, SQ FT:
CLAIM VALUE: ,. CALC—VALUE: GROUP OCC: B-2 /
�����*�****�r�*��**�*�D**w*r�***�****4x�*�*+arB*+4r�**x�*��r***x���r***x�x��r**+r��r�r�*+r�*x*�r
Z O,N I N G R E Q U T A E M E N T S
S E T B A C K S
------------ MP,IN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNTd FT IN REAR: , FT IN FRNT: FT IN REAR: FT IN
LEFT: ,_FT �IN.RGHT: � FT � IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NfSTES>
i �
1f if if iEiE 1E if if if 1F iF 1f iF 1k 1f IE iE if 1E iE if ff 1E if IE 1E 1E 1E 1E iF 1F if iE iF iEiE if if fE iE iE iF iE ik 1f iE K IFfE 1E iF1E M iFif iF iF M 1E M 1E iE 1F iF M iF iF 1E k 1E iF iF 1F If iF iE 1E iE IE
D E V E,L O P M E N T S E R V I C E S�;; R E Q U I R E M E N T S
ZONING APPROVED BY " DATE:
BUILDING APPROVED B.Y.: �t� DATE:
APPLICATION ISSUED BY: 7�- DATE: (,b��L'�,Lti,l-
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 42.00
252 SMIP/NON—RES
PLAN--
ISSUE FEE 20.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 42.00 20.00 0.00 62.00 62.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 62.00 OVER/SHORT: .00
BLDG PMT pLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
62.00
M iF 1F k 1F 1E 1FiE /E IE iE 1E M/k 1f if if iE iE iE iE 1E ik if iE iE M M 1F IE IE fE 1E If if 1E it k 1f 1f 1f 1f 1f 1E 1f if k 1F1f iF kiF 7t 1F 1f 1f 1t it 7k 1f iE 1E �F 1F 1E 1k 1F iE 1E it 1F if if if if if 1E iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY, , D E S,C A I P T I O N
PLU 2 SINK KITCHEN
PLU 2 WATEIi AEATER AND/OR VENT
PLU 1 HACKFLOW PAEVENTER
PLU 1 „ SINKS, FLOOR
END OF FEES
UNIT COST TOTAL COST
7.00 14.00
7.00 14.00
7.00 7,00
7,�� %,UU
O1 09r '�53-i,�14�?'$3 '6t] � •^.G��
Da�r: t�,_.�.:_� 'It'�. r. ...
_�..
:� . .
s : j _ . -,
ODf�STRUCTION AND PIANNING ,. POo� & SPA ,,
APV�ROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector
1.,Temporary Electrical Service or Pole 52. Pooi & Equipment Location- _
" r
2. SQI� Pipe�Undrgrnd. V.�; 53. Steel Reinforcement '-'
a3.•Elestrical�:onde�,.,+Ctltility-UnBTgrntl. 54. Forms .
m �,�
, �G4.,EIEctrical��d�i}�,�Ct°ntlrgrnd. 55. Electrical Bonding . _�
�t: Steel Reinfo:cec�rrtJ �-' 56. Rough Piumbing & Pressure'Test O
�
"�6.. Electriw�EG,�ntl. 57. APPROVALTO COVER-GUNITE �.r-., �
��:;,footings%,�: E. 58. ElectricaiConclSlicUndrgrnd. 5 ..
'- 8. Foundati6'� '?S � ^' 59. Gas Pipe, � Und�rnd., Test,
9. Waier Pipg-Undtgrayd. r� _ ' 60. Backwash Lines, 2�Trap, � Undrgrnd.
10. St�cturaP'Floo�tem -.,,w' •+ .. 67. APPROVALTO'�:ECK '
11. Property5gw�r„Lin�-& Hous�, ngection 62. Backwash & Receptor•Final�
12. Sewer Cap. C� � �� �� 63. Heater & Vent-Final � �
o �. u - - -
13. Rpof Orains ��. ' -' 64. Plumbing System -,Final
14. Rough Plumbin ?7 , 65. Electrical�Finai
, •
15. Fough El�fuic�TCo�puit a . 66. Solar SYstem-F;iryid}
16. Rough Etectric Idiripg o 67. Fencing & Acc�YApproval '� -
H
• 17. Rough Wiri�tj S'r�'n � 68, qPPROVED F�,�,'Ij-PIASTERING - �
18. Rough Electricah�T Bar Ceiling 69. POOUSPA SYS7EMS FINAL
19. Rou�qhHeating&�i;Conditio�� ,,,Q, .r �„ m�� .., FJ�4j.f,�FyT�iEQUIF�EMEfpLT �� .
20. ou` F`�to Fi lace "' `' `' ..; • qpp��`�O n > � _ "7 "
��� i'% R � St+^ .':d 'k S r s. F Pesmit # �
� � r
21. p'uc� in�tru�¢ur�� .. .. HS � = G -�� � l*1C1`7 S K
5� x i;� -� f�� � �0. ndergrn{.�yJ F-ydro *
22. Ducts, Vgntii�inyy� i ��j * p �¢; � hz 71. Prod�t(Biping O'ioar �Oil
23. Cns Pipe�Rou & Tlst � TiS *[n m�C O* ^ +�' ,..�n r 'r�.
r�v: +.�;r * x S:� 72. Undergr d r.ays" * �,
24. RootFrap�ing � 2; `� tn x � c� r-i x• 73; Undergmd. StcaY: TanM O Gas ❑ Oil
.,
25. Roof'She52hing �'' `Z ��'s v � Nx �Q Overhead Hydr� '
o -� * i-+ r� m a+� _ m x
26. �'C-Ba4,�Ceiling (Str�yi�rai! & Nf�o�oat R J >' � 7M 7� Dry Che;r�ical E-C �Y � v �K �
c• ^ �
27. �Erameand�Flashir4�? DC7t� � c' �+ �* 76. Dry Sta p"�peF�cn x :rm x
, * n ' Y. � `2H • .K O N 'Q iJ
28. Lath�i'ng&SidingCr� Ca'.F O K� � � 7 FIXED�h'ST@DA'Y¢NAd;.� ^ X�'
29. InsuTStion. ��� �, S " * � I �: 7��IRE�REV. F�l *"� S nF O
� 30. Drywall Nailing �'� �; s!-. ^on� c� AL � DEP7. REQUI f`t�Y
_ [�
�
31. Plaster Bd6wn 2m��. S � 4L y 79. FINA� �ECI�N � a 4 S
.� 32. Fylectrica�oty�r f�et�C��f�pal � x� � i 8�,`,� F000 CERTI�%�j .4TEC F6Si)E6:
:. 33. .�anai'E�ectric.� � x ;n i C , I � I�d[es: ^ �-im r�7 O x c
r•, n x
° 34. �inaF,j--lea`fjng;& A r�op�itionirigs ��.,�, x� I �;, ,� i F,� 4 -' M
c '�
a 35. �inai Gas Pipe-Tesf;� G� •� * �-+ � ' � � xo G� ,. . !+�
e �� ..Cl Y [+;
36. Hoo�:Ar CanoPY "* � � �"`' a x !� ! R g , �o � •
sx k n i�n; * � � m �c ♦ t*t n�
. 37. Final�Faaary FirA�tice 7: � F!-� n� * Y N
� S'� #
� 38. Finat�Plumbing vK yN I --� .r. t« ,� r+ s
�* :•, i o ���^ Z � ;-: � #
" 39. Wate� Service-Final �# E � a. cC i • i.. ;� u, y
� i n �.�c * �+7
• 40. Gas Service-Final * � <�' �'" s * "� t ) � '-+1 " �
'F !� e+ F �1 x � � i-+ • G E K G;
�
� 41 . Solar pomestioFinal� �j # _ � i % ,r ,p C �: x 7
/ K S
42. Backflow Pre nter �'�� . " '� I I . � .- r
�i�'PS * n: C:� H x'-, r m :�: p � E-
43. Backflow Irrig�tion � >: .� x • , i '* c� • • • • �
�: c� a O ococ
�4. Landscape_Irnqatio,v� System�'''"�� 'x *" " � C# • :" N ' x "
,., 'i�. a�tu. ir; : �t c, �t�: £ E ra CJQ t 5 F v
�1$. �S�ound /{ttenpation� y ..�.. v� � R7 � �r;�: �' � • FO #
' c r. � / �p ..p.a e
$6. Wanc(iFapi7egU'latior�s �'' O r � x I, r c _; .
5 S v: �,- � �x [*1 O !'J �
47. FINAi STR TUfi� & BUIL`DING .' c- I � � j p+ +- ^
" "' G 'i 1 V
48. �NRLPLANNING;. ' `-"'^ `c� � {� m x
� I M j ,h i!J N S * eC
49. Electric Re�ease to Eiiison ; y� � .� i j '
� 't�l .'�, �•1'�'I
- -, o- M r: aaV�
�50. b"as Release to Sout ern Cali(ocoS�-y�as Co ' � �' '"'' �0 • o `^ �` • ' • •
++ � �`S''' Y. .+ � � O rl +.: N J 00 G
51. CERTIFICATEOF CCUPANCY •' •_ •
No Date
/i
AD�FESSOFBNLqNG: UNT:
� ONMEp4NWEIFpqMN: SSS ANTON BL 3RD
.ouness: SAKSOKA FARM
� ' ' P.O. BOX 2097
� T,F,AGLiu;d,3n�ss,�NNEX, CA 714-933-6005
I�
u�cxrtecr oe enax�n: uc. ao.:
�acxon�o�s�oon�ss: INTERIOR ARCHI2136232164 C�wT9378
550 S I-IOPE ST 1100
coNm,�crarawu�: L.A. CA 90071
CONiPACTOASYYIPM AIR CONDITIONING COMPANY ( 818 ) 244-6571
5265 SAN FERNANDO ROAD
�'°°"� GLENDALE (f CA "`"'- I�M0696
LJCENSED COMPRCTOflS UECUp�nON: I Mreby Nim u� p�snOely d perjury Ntl 1 am li[mmE uMx pvrisma d Chepla� Y
(mnu�andno .iln sa�Yon l000) a Prieun s a We 9iuu,en end am�«.be code. vd mn c�mm u in ho tace end enw.
CRY UC. NO.: UQ CLASS: lJt. NO.:
�0/�149U3 C 36 120696 EXP: 07/96
Oeia: �[�LTp � � � /
OW NEN BUILDEN OECLAFATIOM � M�ebi efNm uMr W WY d psrjury Ihet I em e�emq han iM Cwr 6 beme law ta ths
IoOowiq raesan (Sqion 1031.5 Buaiwn vd Prdaw'vo CoEs: Mry uy a aounry whirh requi�m e peemu t mrotruel. Ms. improw.
Eemoleh, or ropei eny etiucture, qi/x a �a asueMe, eleo rquime iM eppliiant lor euch prmil to fib a egrwE elmemeni Mtl he a eM
n IioemeE punuenl lo tM Wv.+abn� d Ne Canirmas Li�anee lew (CMper 9(wmmeivip xilh Satlion �auo) d D'v6bn � d ihe
Businew W Prdeabm Cadel a lhel M a ehe u uemq iMreMm end ihs beau b Na ellapad azemptbn. My vidmion d Seaion
)W 1.5 by enY WW�t la e permn umpa+ iM1e ePPfrent to e cAI pemlry M rqi mas Ihen (na hueMmE EoOas �S500p.
� I,eaownerd�hapropenyarmY�pbYeeaw�hwepeamtMisdecompanwim,willEo�heMwk.endthanructureerolintentleE
a oMereE Iw eele �Seclwn ]OIa. Buvrem eM Prdeesione Code: The Con�repon Lkama lewdon rot appl�toen ownerd propery
who Wlde a'vnprovn ihareon. �d who Coee suM woM IimrH a Mne� w ihraph ho w her own amplryrs, prwidad Ihtl wch
improvamema ua � imeMed a�MeeaE lor eele. X, lawsm, iM Wiki�p ar inpim+�neM ie edd within ane yeer d mmpWion, tlis
ownm-Wi'4a will Mw 1ha EuA� d pwinp M w dro diC ral build a Mnqwa la IM puryose d asle).
❑ 1, m o�mer W Ihs prapeM. �^xduervety coniredep wilh liwnead oonVactore to connruq ihe qojep (Sedion ]0.M. Bueiroee vM
Prolenbn� COJe: Ths ConlrM� �ee Lew Eom iwl epply a an owner d popany xM buiN� a impova tM�aan ud who
mNeclt In pxf� pqsqa witl� a mNretla�e) Icenaed Wnuenl lo IM ComMon Lkwe lev�. .
❑ I un aumq uMm Senian: B. 8 P C.. br Nu rouon:
Dets: �r:
� do A«eM �r �,m �.m .n,.e d am mdmaiend �ne reawam«w w cellamie wenn ene smetr coae seaom T55os. zss9. ane
RSSJ�. anC UY I a ury Mun brikpq �� �+A / wil m� (a�cb ar) � b camply wih sek mta codes anE Ihe repuimnenn Ia
aWrmilloraonsiriciionamodifratio�haniMAi3ueC .�y vxpememDidritl.RaekaniWwM�uqionWV��iamereexemWlmmNxs
ww+dan..
Deu: MN�cmtl:
WORKER'S COMFp19ATON OECUP�PON: I Mreby elfirm uMer penMy d prjury ane d Ma bAoxi�p dederalurp:
� I Mvs eM wJ mainian e cMEctls d aoneeN lo �Wiiuuro M worken' cpnpemnbn, o prwidM la try Swion 3)00 d tM leba
Cods.ln iM W�mvrce d ths wek la w1Jeh Nb G�b "s hsusd.
❑ in...�d.;���.:�.onere•�v�����...+�.a�u.ews.a�,a�aodm.im«cm..ro,m.w�m�.wm.
X wwk /or whidi I�ia pe1mil is iL�. MY ��n' rompenW bn inwrence urtier W pd"u.y num Wr are:
Gerrim: _
PdiryNumMc �- < <� - �- � EXPIRES
(rhia sxYion nesd rrot M canpletd i fM permt ia M e n� ewia,. �siool ,�.1 10 / O 1/ 9 6
� I mMly Ihet in IM pMormem.+d the woA la whkh Ihi� partnX is inued, 1 ahdl nd employ eny penon in any mannx ao u lo
becwne wbjoq to �M v.orkare' oomPenae�ion le� d Califomu, uM yns tIW H I e1auN become abjeU to IM worbn'
eompnuiion D�+sione d SWion 3)00 d iM lebor Cods. I s�cW�l�hilh oGmG�Y xilh Ilme qwifian.
/ 7
�Ne: .� � RVd�I: J/ _/� i�
W�mNp: F�Nun b ucvn workxi ror�oxuatlan coverp� l� unbwful. �ntl �IWI utl/1ef en �n r ro crfMKl P��u uM
nM nnu w ro ar. nurer.e rnoww dwYn (t�u4aooA b�ee�wn ro rM eo.� o� ro�ro�rnn d+�w u c+ovw.n ror In
91etlon 9�GG ol M� LeDor Cotls, I��M+4 uid attomey'� f�u.
CONSTIIUCiION LENDINO ADENCY: I MmW elfiim uMer penetly d perN�Y �� �Mn b e aonelrud'an bMirp epeMy tm tlro
peNormenn d tM xak M whid� uie wmi u ewed (Saein �0?/. Civ. CI.
LENUEP'S NNME
�aoen•s �oonea+:
I ca�ily ihet 1 M1aw netl Nu epplicatiwi end ve�e Ihet Ne aEon iMpmelion u canq. l ep�aa to comply Mnh aA ayenC muruy ord'uwaro
e�d �wa len Mm�q to buiMiq mrvm W� eed Mreby aulMrvs �aqssxutlivp dihu rny ro amar upon ihe abow-meruianad popmry
la impeqion W�Wsas.
� I ___...._ Prvn wm.
`�� ��e .wTLM__.._.._. ome:�/ �G^S/�-
(S151d6 WP) W�ue-BuildPq 8 Selery; Q�semFle; Ceneey-�ppiwN; Pink-Revenue; (3oldaneo�Anaeuor
CITY OF COSTA MESA - BUILDING PERMIT DFRM nin. M n7aSy7
PERMIT NO: M 074597 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE; MEC PURPOSE: ALT
JOB DESCRIPTION : 20000 SF OFFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74572
**it*�***********+�*+t***+t�-*+�x�iF*****�****;�t�x�*�r**+rx�ar**�-****x**x-***x-*******�-�c�t**aF**+�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 91050104 ZNE: REF NO:
PLANNING NOTES>
i
*��*�������**+��*�*��*+���***��*�*�+� �******�+�**�***��*�****�**�x��***+�*********+r*+�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
HUILDING APPRO�'ED BY :
APPLICATION ISSUED BY:
LEGALIZATZON:N
F E E S U M M A R Y
DATE:
DATE:
DATE: ��l lfn I �
�-;� +� * * * � *�F'#�'�� �* *
STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 88.00
25� SMIP/NON-RES
PLAN
ZSSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 88,00 15.00 0.00 103.00 103.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 103.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
103.00
if iF i! ih iE iE iE if iF iE IE if IE iE 7E-)E iE jE iE �)E iE if ik * iE 1f 1E ih 1E'lE iE iE if 1E if ih ih 1E 3E iE aF iF jF iE if 1f if if ik IE iE iE if 1f iE 1f iE iE 1ElE iE 1E �f'1E �f')f iE if if if if 1E if iF if if iE iE �lE
I N D I C' I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N• UNIT COST TOTAL COST
MEC 8 VAV BOX 6,50 52.00
MEC 8 FIRE DAMPERS 4.50 36.00
END OF FEES
r� n019^laa-�;�£9?d4� T 4l'(t 1�3�CG
bbTtt t0/to/SS P:rt: EG:ul
_ .. �, - .
�
G7NSTRUCTION AND PLANNING _� PO�� & SPA _
A�PPROVALS Permit # ' Date Inspector qppROVAL.S Permit # Date I�spector
t. ,Temporary Electrical Service or Po�e 52. Poot & Equipment Loca[ion -
2. Soil Pipe�Undrgrnd. � 53. Steei Reinforcement �
3. Electricai Conduit UtilitY-Undrgrnd. . 54. Forms .
4. Electrical Condui[-Undrgrnd. 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. ElectricalUFERGmd. 57. APPROVALTOCOVER�GUNITE '
7. Footings 58. Electrical Conduit-Undrgrnd. "
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
. 9. Water Pipe�Undrgrnd. • 60. Backwash Lines, P•Trap, � U� drgrnd.
10. Structural Floor SYstem 67. APPRO`!AL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Finai
12. Sewer Cap 63. Heater & Vent•Final •
7 3. Roof Drains � 64. Plumbing System � Final �
r '
14. Rough Plumbing ! 65. Electrical�Final ,�
15. Fough Eiectrical-Conduit �., 66. Solar System-final
i 6. Rough Electric Wiring 6�. Fencing & Access Approval
17. Rough Wiring Sign , 68. APPROVED FOR PLASTERING
18. Rough Electriwl-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
20. Rou9h Factory Fireplace APPROVALS Permit #
21': Dutts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71 . Product Piping � Gas O 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 (Struccurai) & Monocoat 75. Dry Chemicai
27. Frame and Fiashing 76. Dry Standpipe
28. Lathing & Siding 77, fIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywail Nailing HEALTH OEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinai 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
�'
� 35. Pinal Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace a,
38. Pinal Plumbing ' �
:�
39. Water Service-Finai '
40. Gas Service-Final �
41. Solar pomesticFinal �
42. Backflow Preventer
43. Backflow Irrigation
44. �andscape IrriQation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTUflE & BUILDING 1
48. FINAL PLANNING .a
49. Elearic Release to Edison -�
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
\
�oonessaeuiowm 555 ANTON BL
"E"'s""�EiF'aoxT+: SAKIOKA FARMS
' �� PO BOX 2097
TERMINAL ANNEX
APPL.IWWq �DDRE39:
�NT 1ST
urcxnecToner+ou+r�x: INTERIOR ARCH.2136232164 ���: 9378
APCN.OH FllO.'S ADDPE93: S S O S HOP E S T uxT: 1 10
L.A, CA 90071
coxrnacrarsru�: SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
COlfP1Ci0R8YNIW0 215 E EL SUR ST
�oonus MONROVIA CA uera: 190173
91016 uxr:
ll COMP�CfOP4 DECLAP�TIDN: � M1�H dlim uMer psnNY d p�rjury Nq 1 un I'am�sd uMr prwidms d Cheqr B
en �q wG� Bction ]000) ol Divuion 9 d Ns Bue"viae eM PMp�'vn CoEs. W mY Ib's b In lutl lau eM eflM.
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: F U7632.
PERMIT NO; F 076323 PLAN CIIECK NO: 00069-96 L GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: FIR PURFOSE; ALT
JOB DESCRIPTION : INTERIOR 18000SF T.I. SQ FT:
CLAIM VALUE: 4,950.00 CALC—VALUE: GROUP OCC: B /
*�********�*�***�*�**�D****x�**�**��+�t%+�****��*********��r*�**�****B��****�r*�****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K 5
mueNo.:013054 uc.cwss:C 16uc.o. g� EXP: 04/96 ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
Z-7-9L ��,,,,,� ��� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
o°'° LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
i
NER BUILDEN DECI.�R�TON: I hwWy e� uMx O�dv d Wb+rv thm I am aumq Imm iM Caniedan lbensa lew ta tM
'dbwirproewn(SatlionJWl.SBu�'vin�eM7MaeianeCOEe:Am/cYyamuntywhM�puimepsrmMt000mbucY,Nm,improvs, P�I(ING REQ• PROV: PARCEL: 9IOSOSO4 ZNE: REF NO:
'u�� `pu�w nNi �M pmv.� w m.b��.em uo�en..,iaw Icndeq�n e(m�mmad� Iwern a.aw�i0�0oj a�� s w�ro PLAN N I N G NOT E S>
Buslnsa mE Proln�bm COEa� or �hel M n eM M eaamp ihxehom enE ihe bub la Ns dlped ax�mpibn. My viaW bn of baqbn �
)N1.6MenYWO�iunllar�WrmNabj�e�IMaPd'ceMlo�dWpsnNrydnalmmihenfW�hunEraCddlen�'LWU. il�iEitiEiEiEiE1EiE1EiflEiEiFiE1E1Eif1ElhfEiEfE1ElEikif1F1f1EiEitiFiEiklEiE1E�7EiEjElEif�EiFikfEiElEifiElEi43EiEifillElEifiEiElfiEiE1E�7EiE1E�Ik1EfflEfElEiElEiFif
I� I,e�ovmardlhsOropaMa�myamplq�M��+'hwepnmlM'rwlemmp�nWbn,willAOlMwork,andlhs�wpun'snaimantld D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N Z' S
�.. aoMeredlpuls(9ec�lon]OIl,Bu4metleMFrola�slonsCoda:TbConlreqonLlosnnlewdomiwtepplymenownarWpropery
� wMWlMainqov�tlMnon,uMwhodon�uWMwkNmWlaMnslMNraphh'sahuownlTWqw�,provid�dlhtlwch
I Imo�'+�sm�usrdimane�d«dM�i«�ds.M,now«vr,mebwdinp«Ynpiowm�mbeoawMn�nomywMwmv�a���he ZONING APPROVED $Y DATE:
ownerbulNer wlll heva iM buN�n at ywinp hs or �M d'k nd bulld «Improw In IM WNa� d uM).
❑ I. m oxmr d Ih� popMy, un udwrW amimpip wilh liamwd canvecion ro eomtriq iM pm�M (BWun ]w. BwMn uW
Pmbnlon� Cod�: Th� Canlrepm LkM� uw dox ml �pply m�n owiwr W qopxly who buik� ar Impovr iMiwn end wla
caMrecY� la uxi� W9w wph e aoMMal�) lcawd Wnuem to �M WMretlar� lbn� l�vA.
� 1 un �xemq uMar Sanbn: B. 8 P.C.. M �hu newn:
Otic OYmw:
i ao n«�W �«uN uw i.m .w.�. a w ��.w�e u,. �w�«m a wiromr H..en em sew coes ewa�. zssos. assa..�a
PSSt1. eM thu I n�ny Mw buJd�^Y oopDs"�.xiA / rA nd (drc4 ar) nwE ro oomON wlh pid ptl� ood�� eM tlr nVulnmrib br
eW�„IammtrvelbnamodfimlanhamiMAr�uei�l�t uu0�mwn0luna.Rald�nlWomprvCbn�PVk'elbaenwmplmmlAas
od.: ww�m:
WORKEN'8 COYPEN9�TON OECL�HATOX� ��sb) elkm uMar pmetly d pr�ury w ol M toOowlnp E�duetbro:
❑ 1 hen ud xU melmNn � aNfkW d mNMt to eNlJmun M wken' compamLLbn, n pwid�d la tr/ 6arlbn n00 N tM l�Eor
CoG./a tM p�elmnene� N Ns wk IU �'h � D�Mt b Wwd.
� n.w.ne xie nwm.in wonun� mmc.�wc� �neu,.n�.... r.awne M e.aro� arvo w m. �.nor coa., ror�n. wrtormanc. d m.
la whkh Nu Wmiu b bwd. MY woM1+n' canWnW bn Imurene� �rtbr W DdkY numbr an:
c.�n«: F'REMONT EXPIRES
' Polky Numbx: W P�SS G-i� 0 6/ 01 / 9 6
(TAis eMbn mM rrolW canpHNL I IM perTd L fw on� hundred ddlus (flW) a Hu.)
� I pnNy NN In Ih� pWoimuiw M Ih� w�M M whbh ihb psrmM h bu�d, I�MII ia1 �mploy ury puwn In ury menmr �o u to
�m� wb�W la iM wiken' eompmtlbn lex� d CdibrNs, n� Np I�hwW b�cvn� wbNtl m tM v.pbn'
co panwllon D���� d Bwfion 8100 d ib Lebor CoG, I ehall f n h mp wllh/ ��hy/J�f�p/roNNom.
�tr — %'�6 MdiuM: O' O // �"��
Inp: FWun ro oeun wort�n• cwrowwtlon eevneW l. unNwN�� .neWll wbh�'� ur xrWIM'�'ro uhNivl Gn�itlu.nd
rd nn.. �.q ro an. mndrw aauuw ewW. (nn4�A M Witlon ro m. rost er rorqoru.uon a^�W u por�e.e roi �n
91ctlon.170R ol M� LMo� CaW, InM1n�4 �� m°�^�Y'� �
CONSTAUC710N LENDINO AOENGY: I MroW dfum �Mm D�dp' a Gsr�ury Ihtl IMn b e aormruabn 4ndinp epav.y br ihe
partamenoe d tM wk M whitl� �hb V�i H wwd (Satlion 90Y'!. CM. CI.
LENOEH'S N1YE:
LENOEP'8 ADDNE94:
I c�rWy �hn I Mv� nW Nu �ppOcnion uq tlef� Ihtl tlw eba�'vdortn�ibn b eonW.l pn� to oompfy witM1 etl �Yy W muNy atl'uwier
eM �ws 4w� nWmp W buik'vp conatruqlan Nd Mraby eWrorhs �epra�antetHa d �hb dry to mix upon �M ebovs�meMianed popory
�«��'��W�� ROBERT HROWN
�
(5151-M.WP) WhNrBuild'ep
D�b: �'7 7Y
%nk-Rwenw: OddanmE-Nnuar
HUILDING APPROVED BY :
APPLICATION ISSUED BY: �V"
ifiF3fif1EiElEiEiFiEiE1E3E1E1E3EiE1EiEiEiElE��i �iF
LEGALIZATION:N F E E S
BLDG PMT PLUMBING ELECTRI
PERMIT
PLAN
ISSUE FEE
MECHANIC
FIRE
72.00
-� 652
� 46.80
1�1
ENT;N
�Y'�ii ��i:i�^=�l:i��]��T
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK `�.=' TOTAL PAID DUE
TOTALS----> ! 72.00 0.00 ,46.80 � 118.80 118.80 .00
REVENUE DIVISION TOTALS--> COLLECTED:-�; �7'2.00 ;OVER/SHORT: .00
BLDG PMT.PLUMBING ELECTRIC MECHANIC ' FIRE SMIP./TOT GRADING PLAN—CHECK
. � i2.00�
4- ' A
iF'!E 1f k if 1t if iE 1E 1F iE iE iI' 1E'IF'iE ih iE iE iE iF if iP 1f if 1f i41f' iE iF iE iF'N' if iE if ik iE iE jf�iF if ih iE if iE if iE iEik i! if'If'lE li� 1i"IE'IE iE iE 1E iE iF iE')E iE iE iE iE if iE if iE if 1E 1F'lf iE 1h
1 I N D I V I D U A L F.E E, B R E A K�D 0 W N
TYPE QTY D E S C R I P T I O N v: � �J, UNIT COST TOTAL COST
FIR 72 FIRE EQUIP FEE (FROM BLDG VAL TABLE)� 1,OQ 72,00
END OF FEES
,i.
' l"
" 'l
O1 �0,�. : ...,�,=.,E,�� T�� r •2.'J7
CaTE. f,�;_,�,-. �: .. 1.0'_;.
' - '' �FOt.� & SPA� ' r
CONSTRUCTION AND P�ANNING? y % � - - .`
i Date Inspector Date Inspector
� qpVROVALS Permi&#�� APPROVALS � Permit # ,
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrg�nd. 53. Steel Reinforcement
3: Bectrical Condait UtiGtY-Undrgmd.- . 54. Forms .
4. Electrical ConduiFUndrgrnd. 55. Electrical Bonding .'
5. Sieel Reinforcement�- 56. fiough Piumbing & Pressure Test ! �
6. E�ectrical UFER�Grnd. � 57. RPPROVA�TO COVER�GUN�TE !
7. Footings , 58. Electrical Cond�it-Undrgrnd. ��
r i
8. Foundation ' - 59. Gas Pipe, O Undrgrnd., Test �
.
9. Water Pipe�Und�grnd. ' 60. Backwash tines, P•Trap, � Undrgrnd. ��
10. Scructural Floor System 61. APPROVALTO DECK. '
1 i. Property Sewer Line & House'Connection 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & VenbFinaf �
73. Roof Drains - 64. Plumbing System � Fina� �
14, Rough Plumbing - 65. Electrical�Final �
15. Rough Electricai-Conduit - 66. Sotar SYstem�Finat �
76. Rough Electric Wiring . 67. Fencinc� & Access Approval
i7. Rough Wiring Sig� 66. APPROVED FOR PLASTERING
18. Rough Elect�icabT Bar Ceiling � 69. POOL(SPA SYSTEMS FINAI
19. Rough Heating & Air Conditioning _1 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' . �, � APPROVA6S � Permit #
21 . DuCts, in Struc[ure -. - '' 70. Undergrovnd Hyd�o �
22. Ducts,Venti�ating� � � �� 71. ProducC�PipingC.?6as ❑Oil
23. Gas Pipe-Rough & Test -. ,- 72. Undergrouncl Flush
24. Roof Fremi�g � � 73; Undergrnd. Storage Ta�k � Gas ❑ Qil \
25. Roof Sheathing ' � ' � ' 74. Overhead '�'-; - ,. fc.--�-�.� / .�[ f��
� _f� �/
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 - 7$, FIRE PREV. FIMA� ' -
30. DrYwatl SVaiting ,. � HEAITN OEPT. REQUIREMENT .
31. Plaster Brown Coat � �• 79. FINAL INSPECTtON •
32. Electrical Power MeterPinal �� ' � 80.� F000 CERTIFICRTE ISSUED -
33. Pinal Eleccric � � � • �T Notes: � ' �- � " .
34. Final Heating�& Air Eonditioning '. � ..�/�a(� � s _
. � �..�•
35. final Gas Pipe-Test - ' G�_��PL� U��
_ � ' "/ �-
36. Hood or CanoPY - � �. . � .. � µ ___ �„_ ���
7....'-'��-
37. Final Factory Fireplace .. ' , ' - _" - C�1 ��W'N�v�"�
38. Final Plumbing ' � " � ; �J��
39. WJter Service-Final ' �- ` � � � �` � (�Q� q�_ d
e '
���r
� 40. Ges Service-Final ' ^ F /
, ~ ____�`�-`'-ol�e�il_�.�+..i O��'f L ro��k/l
41. Solar �omestio-Fina� _ � � . � /
42. Backffow Preventer
43. Backflow Irrigation � � � ' - � � �
Q4. Landscape Irriaation System � � � - � - '. � �r ' � '
45. Sou�d Attenuatioa,: .' .. - � , . . � .
46. Handicap Regulations _ _� � "' ' � -
47. FiNAL STRUCTURE & BUILDING , �J . -
48. F,1NAL PLANNiNG - � �' '
49. Electric ReleaSe to Edison . Y�- . . �
50. Gas Release to Southem Cali(ornia-Gas Co �-• __ -, '
51. CERT4FICATE OF OCCUPANCY . ' �
No Date
t
i
Y
�
���
f
��
��
� �XOJA433 OF BNIpNG:
QYNEN9 NYIE IF IRlOWH:
' � ' �ooxeu:
�vv�. �uuria �oo�ss:
ANTON HL
KA FARMS
2097
!A ANNEX
VNT:
uicxnEcronu+rn+�n: INTERIOR ARCH.2136232164 uc.xo.: C-9378
urcxoxua�s�ooxea: 550 S HOPE ST uxf: 1100
LOS ANGELES CA 90071
eaxm�eroasru� MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
ca+m�croasxuuxc P O B OX 5 0 9
.00xEss: WALNUT CA ��.�, 230813
917 8 9 uNr:
UCENSEO CONTHACTOPS DECL�HATION: I hereby ellirm under ponelly d perjury ihe� I am Icemed uMer povidone ol Cheplm 9
(mmmenarq vAih Section ]000) ol0iviaion � d iM Buaineao erd PMeeaione CaEe, eM my licensa b in lull brte eM eMetl.
cmu�cj.No.:006558 uc.cuss: C 10 uc.No.: 230813 EXP: 12/96
Dma:�r�(' �� Cmvaav %�%'�
OWNEN BUILDEN DECLAHRTION: I hsaby etfirtn uNx penely d pr'�vye'�I mn u q fmn Ihe CaNretlm liuma lew fa ihe
IOAowiq �mam /5etlian )W t.5 &nims md Raleavw COEe: MY W �+NY '�9wae e De�md to ouvTxi. a4x.'vnwwe.
bmdeR a repei ury siw�ve. prior b b eavw, abo mQu'um iM lor pemW lo fib e eyneE ueiairo'u Net M a e!n
, i�e w�.m m m. w��+ a ub camreao�. ����e �. �c oomm�,a wan see:M r000l d a�,e� a d n,.
aue'viw .m v,deuom coeel a �mm �. «.n.'v u.mq tnar.om .�d ine naz. �« ma eApaC uemqion. Mr �aletion a seaion
�mis M�r wp�,� ��. w� �+ ine ei,Wicem m e wu ro�r a na mo,. me� rHe n�m.ed edW. I�II.
� I. ea owmr d Ihe paperlY ar my empbyeee w1� weB� m Ihei eob companaetion. will do the xwk. vM tha ewnuro u rw� imandeE
w oNerad lor eab (Seclion 101a, Buvrov end PMaesiom Cada: TM Comreclon Licenae lawtlom nM epplyto an ownerd D�VeM
wM WiEa w inpweo iherean. arM wlw Eoes e�ch xwk Nmeell w henetl or thraph he or Mr oxn empbyee�. O�+db �� euclr
improvememe me iw inteeded a allereA tor eeb. H, however, ihe Euildi'q a inpovemeM is sold wnhin ma yaer d mmplMion, IM
ownar-0uikbr will heve Ihe WNm d povilq M or aAe Ek nd buiN or impwe la IM WT�e ol eab).
❑ I. u mwwr d ihe popMy. em utlusivey oonirediq xilh liunsed wnVeclon lo mMrW Iha poptl (Sedion )0l1. Buainen eM
rm�e.mo�. cme: rne co�veaon �ee�.e �.. eoee �a wWv io .� wm« a nw�r wno wias « imo�o �n«aon ene wno
conirecia �« m�M prqaw wui e c«nred«(e) IiemeE punueni io iM Convmore liw�ue lawl.
� I em eRemp �nEm Section: B. 8 P.C., M Nn reevon:
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 076906
PERMIT NO: E 076906 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 1800SF / RESTAURANTS SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 PRODUCTS CO / DEL TACO & SUBWAY INTERIOR TI, RE:#B76355
***�**+�*****at-x-*x�*�*****�**�**�*****�-x-*at*�+t�r**at�-x��rx�***�x-x�x�*x�*+e*�it�-x�*�rat+eitx�*��r**it*
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
>
�ElE �E 3E 1E iElE iE 1E if 1E * 3f IE iF 1E if iE iF iE iE iE-IE iE 1E ik if iE iE iElE 1E If iE.iF iE 1E iE iE 3E iE 1E If 9E 3E fE fE %�E 1E iE fE iE 1E iE IE iElE IE �E iE iE jE iE iE if If iP iF iE 1E 1E 1F 3E iE iE if iE 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . ' DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
oms: � ILEGALIZATION;N F E E S U M M A R Y
1 do h«eEy eeniry ihel I em ewere d vM iudnsierd tM repuiremema d Cdtwnb HeeXh ud Sdery Cotle Sed'am?5505. 2553J, aed :' .
2551a.endiMtive�ryMuraWikirqox�pentxill/wilmi(drebaw)rweElowmplywY�seMsmemdaendiMrpuinmeMebr BLDG PMT PLUMBING ELECTRIC MECHANIC
epa�mnlaewuirvtlion«modifrationhwniMAi uZ eT�y enepementDMnd.Rmideniielmna�ueuneppiWianenssemqlranthae pERMIT �116. 2�5
povifiane.
ome: �nq�:
WOXNEP'S COYVEMS�TION DKWIATON: I Mr�Ey elf wder p�nMy d pajuy ane W Ihe idbw"up Astlutlnm:
❑ � nev..iw w me�ae� a cenacme a mmen� m.w:ma. �« xaks: oomo«umon, m a� �« M swon a�oo a m. �eeo.
COEe. la iM psAmmrce d Ne xak la w1irA thn pmmil a ua�sd.
�i 1 heva W rril meinten xaMae' comD�+e�ion imuraw. m nCuinE W Swion ]h1U d Ne Lebar Code. br ihs V�a�� M IM
�i«..nd,mnv�mxe.�.e.rnr.«wen'��FR�.Y��`s�.�w„r��n«u.: EXPIRES
Cemm: �%�01�9f1
Polcy Number:
�lm;e e�� ��e na ca comvrerae e rna �a �s ro. o�a n��d,.d ewrem /srao) w�.�
� I cenify Ihel in I�e parlameewe W iM wah lor whch �hie parmn u iea�wd, I ehdl iwl empby eny pareon in eiry manner w m to
Decoma vubpa io ihe woAera' campenu�ian lewe d Galilanie, enE epree IMI M I shauk becoma eubpa io IM hvMen'
coJmp_�_ tion pmviauna d S�eeyion J]00 d ihe lebor COEe.�I lonAwnh oom xdh iM» pavuiwu.
Dms: J — �-� � / � Mo�- ' -�j%
W�minp: F�Bun ro sscun wMen'ronporu�tlon eorr�p� l� im4rvN1, • 4Wl bNrt en w�nplyw to cr/m'nl pwltlp enG
GHI Ilnu �q ro am huWrM MouuM AolNn (S1IX{QWA ��Idon b• cmf I rompwwtbM1 Gnrpu u pvvMW br In
Ssctlm �IOB ol Ms LeEor Cotls. /Irtersa4 � attomsY� Ira
CONSTNUCTION LENDING AOENCY: I hseW � uMa peneXy d perjury �Iw �hse e e ouctwion Isdvq qpnry b rte
pMormance d �M xak b whid� ihe M�i e uwed (Seuion 3091. Cv. Cl.
LENDEP'S NGME:
LENDEfl'S RUDNE55:
1 cerldy IM1ei I heve reaE No eppli�ation eM aele it�ei the ebove inlpmmbn ia corteq. I epiee io canply xilh ell dy eM coumY oNiremm�
eM steie levn mWnp ia build�q mmvWion eM Mreby euthoriza mpeaenteirvee d �his myto eMer upon tM ebove�mentionetl pioq�ly
�°'ioapotlio°""°°'°' CHUCK JACOHZ
om, 3— �G-9 6
(5151<B.WP) `� Whue-Buildip 8 Selery; OraerFle; Cv�vy-qpplrem; Rnk-Revenue; Gdtlenrod-Asaeamor
508
PLAN `
ISSUE FEE ,15..00
[�i:l?
DATE:
DATE: 2Cv R�
iEiEiF1EiE1EiE1F1F���i- iEiE
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMZT ISSUE PL`AN'—CHECK TOTAL PAID DUE
TOTALS----> 116.25 15.00 �' 0.00 131.25 131.25 .00
b �
REVENUE DIVISION TOTALS--> COLliECTED; 131.25 OVER/SAORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
131.25 i.' -
IF 9E iE iE iE iE �E iE iE iE iF iF
TYPE QTY
ELE 20
ELE 20
ELE 20
ELE 15
ELE 3
ELE 2
I N D I V I D U A�L. .`� F E E
D E S C R I P T I O N
iElE if jF IE �E �E 1E iE if 1F iF iE i61E �E IE �E iF iF iF iE 1E IE iE if iE 9E aE iE iE iF if
H R E A K D O W N
FIXTURES, LIGHTING ' 1;ST 20 EA.
FIXTURES, LIGHTING. ADDITIONAL EA.
RECEPT/OUTLET ' % 1'rST 20 EA.
RECEPT/OUTLET ADDITIONAL EA.
RECEPT/SWITCH ,' �1 ST 20 EA.
SUH—PANEL '
MOTOR/POWR APPARATUS •1,1 — 10.0 HP
�END`OF FEES
.'� •�
;
UNIT COST
.%5
.�5
.45
.75
11.00
7.50
TOTAL COST
15.00
18.00
15,00
9.00
1 1 . 2 5
33.00
LrJ,��
.. ... � � / .. i
� V �.. i
� I �-
6 � :' CONSTRUC710N AND PLANNING . P00� _. SPA ,
��i APPROVALS Permit # Date Inspector AppROVAL$ - Permit � Date Inspector
(. 7emporary Electricat Service or Pole 52. Pool & Equipment Location
2, Soil Pipe•Undrgrnd. 53. Steel Rei�forcement
3. �lectrical Conduit UtilityUndrgrnd. 54. Forms
4. Elettrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinfo�cement 56. Raugh Plum6ing & Pressure Tet[
6. �lectricaf UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings � 58. EIe�Krical Conduit-Undrgrnd.
8. Foundation . 59. Gas Pipe, C Undrgrnd., TeSt '
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, �� Undrgmd.
10. Structural Ploor Svstem 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. flough Electrical�Conduit 66. Solar SVstem�Final
15. Rough Etectric Wi�ing 67. Fencing & Access Approval
17. Rough Wiring Si9n 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rbugh Heating & Air Condit(oning FIRE DEPT. REQUIREMENT
20. Rough FactorY Fireplace APPROVALS Permit #
21. pucts, in Structure � 70. Underground Hydro
22. Dutts, Ventilating 71. Product Piping OGas OOiI
23. Gas Pipe•Rough & Test 72, Underground Flush �
24, Roof Praming 73. Undecgcnd.5t�rageTa�k aGas ❑Oil
25. Roof Sheathin9 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � �.
27. Freme and Fiashing 76. Dry Standpipe
28. Lathing&�Siding 77, FIXEDSYSTEMFINAL
29. Insulation 78, fIRE PREV. PINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
- 31. Plaster Brown Coat - 79. FINAL INSPECTION
32, E�ectrical Power Mecer�Final 80. F000 CEA7IFICATE iSSUED
33. FinalElectric ���I�6 � Notes`y-7�� T�y���� V�
{ - �
34. Final Heating & Air Conditioning �= //_p6 �/✓.,,�/
t C� � T"_l(
35. Finaf Gas Pipe-Test �L�� � �(L_
.7f r
36. Hood or Canopy
37. Final Factory Fireplace -
38. Final Plumbing � - '
39. Water Service�Final '
40. Gas Service-Final _
41. Solar pomestic-Final
42. Backflow Preventer
43. BSckflow trrigation
44. Landscape Irripation System �
45. SOund Attenuation ' � �
46. Handicap Regulations "
47. FINAL STRUCTURE & BUILOING
48. FINA� PIANNING -
49. Electria Release to Edison
50. Gas Release to Southern Cali�ornia Gas Co �, -
51. CERTIFICA7E OF OCCUPANCY
No Date
� c�itp o f�o5�a 21�e5a �
Developmeni Services, Division of BuiIding and Safety
CERTIFICATE AF OCCUPANCY
This cerrificate is issued pursuant to ihe requirements of the Uniform Building Code, Secrion 308
adopted by the City of Costa Mesa certifies that at the rime of its issuance the building structure herein
below described was inspected and approved for occupancy as follows:
Building Address 5�5 ANTON BLYD. FLOORS i-12 Bldg. Permit No,keee beiov
Use QFFICES
Group B-z Type of•Construciion I-FR Fire Zone Use Zone pDC
Owner of Building Sakieka Farms Tenant "��'�+I•"
�B74S70, B75356, B74572, B74571, Bi45?3, 874633
'n74X 6�3Z,t&7463I�74�630,�1 0� 0�6, B�77g66, B74574 BY �
��av1�
Date November I4, 1996
RECR BRO'wRd s CBJ
� REQUIRED TO BE POSTED IN A CONSPICOUS PLACE
�
. ,..r2. n;;v . ,'� ;r��•�
CI�Y OF
I�! �! � �/! \
Development Services, Division of Building and Safety.
1.r:4. �: .,�.
n
CERTIFICATE' 0F OCCUPANCY
,
� l,.. � .,5 � .
This cerHficate is issued pursuant toitie requireme�its of the Uniform Building Code, Secrion 308 adopted by the City
of Costa Mesa certifies thatat the Nme of itr issuance the building structure heiein below described was inspected and
approvedforoccupancyasfollows:' �'.;3,, � �
:�� I: �
BuildingAddress SSS� Anton�81.. Ste` 2-2nd F1'. ^"�" Yg]dg PermitNumber H06-01112
. ,`
�, . . ., {�, .
Use Off1Ce .. ' ci},';'..:t(5,921�ef) _ - `y= .
�
Group H Type of Ci
r,°
RREEF �,-r:
Owner of Building
s�-c
P.O. Box 4900;` t
Address '
ichon '._ ,1 .,F�R i .^t+�?{���9f}� -." '- � ��,°,� Use Zone C1
y
�`'�� - " NETIFICE
Tenant
>t. 207, Sc,ottsdale,, AZ �b75
�� 7�
;. % By n
�
su1LDiNc oPFicceL-Khanh Q Nguyen;, C B O �:.� o a/�O 1/
„ Date. -
� REQUIRED TO BE POSTED [N A CONSPICOUS PLACE
�
Ciiy ot Costa Meu �
Development Services Oepartment C E R T I F I C A T E O F O C C U P A N C Y No.
Building Safety Division
P. O. Box 1200
Costa Mesa, Califomia
The Building located at 555 ANTON BOULEVARD 2ND FLOOR
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group B2 Occupancy.
Use of euilding OFFICES
Legai Description 410-501-04
� ISee reverse side for Metes and Boundsl
Building Permit No. R SRR77 Electrical Permit No. F. SR97(1 Plumbing Permit No.
Mechanical Permit No. M SO�Z� Number of apartments and/or guest rooms
ISSUED 70: BuildingOfficial TONY C'nF, AACA
BANK OF AMERICA - j � �"�
555 ANTON BOULEVARD, 2ND FLOOR bY •__ �� ��� '" �'+ --^
COSTA MF,SA. CA 92fi26
Date DP.CF.MRF.R 10. 199'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 Meu under Sec. 307� (e) U.B.C.
CrvtF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink'- Bldg. Permit File
�
City of Costa Mesa
Development Service5 Department
Building Satety Oivision
P. O. Boz 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No. QU�JJ�9
The Building located at FScyn.Lr wn,�la�r�rr7. Rs�rnnA FloOc
has peen inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicabie thereto
ior a Group A9 Occupancy.
Use of Buildi
Legal D
(See reverse side for Metes and 8ounds)
Building Permit No q'�ti�1Fi Electrical Permit No. �69 Plumbing Permit No
Mechanical Permit No. M����A Number of apartments and/or guest rooms
ISSUED T0:
Building Official William T. Howard
Cn.. ri h�r ParS Fl f` Be3l1�C /
6Q0 Wilshire Blvd. by % �` ' -� �-..
re,a annclrs.a. CA 40017
- Date July 14, 1989
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Buiiding Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CMF 3015-46 rey. 1/83 White - Owner, �'—qry - Numerica� File; Pink - Bldg. Permit File �
�
CITY OF COSTA MESA
B!/ILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
F10-00087
Job Addres 555 ANTON+B _
Suite: 200
Vicinity: UNIT 200
SUBTYPE: ALARM
Parcel Nunmber: 41050110
Applicant: AHRAR, SEYED
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
Owner: RREEF
Address PO BOX 4900
DEPT 207
SCOTTSDALE,AZ
FIRE SUPRESSION PERMIT
e
Phone: 818-683-7500 XT 3023
Zip: 90815
Phone:
Zip: 85267-4900
0
Status: ISSUED
Applied: 06/21/2010
Issued: O6/21/2010
Contractor: INTEGRATED PRODUCTS AND SERVICES INCORPORATED DBA CAL PROTECTION
Address: 2505 MIRA MAR AVENUE
LONG BEACH, CA
Phone: 800-247-6497
Zip: 90875
License: 909573
SCOPE OF PERMIT:
FIRE SUPPRESSON PERMIT TO UPGRADE AN EXISTING FIRE ALARM SYSTEM BY INSTALLING 8
NEW
DEVICES IN CONJUNCTION WITH A 1200 INTERIOR TI TO UNIT 200 FOR "MEGAPATH", SPACE
200. REF#: BC10-00164
FEESUMMARY
Add'I Inspection Fees: $0.00
Total Fees: $235.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statules and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order (or the work authorized under this pertnit to be wnsidered le9al, 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 �he expiralion of this permit.
COpE �. INSPECTION TYPE �g INTIi1RL5 OE / INSPEGTION TYVE ORL INiRIRL
1818 Faed System Final Fire Prevention 208 Final Mechanical
7286 Pool Spa Final 208 Final Plumbin9
200 Final Re-Roof 270 Final Electrical
201 Final BIocWReWining Wall 272 Final Fire Prevention P�-��10 ��L
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolltion 250 Final BuilOing/OccuOancy
WORKERS' COMPENSATION DECLARATION:
I �ereDy aKrm untler penalty ot perjury one of Ne following declarations:
❑ I have and will maintain a certificate of consent to sel(-Insure (or vrorkers'
compensation, as provide0 (or by section 3700 of the Labor Code. for the
peAormance of the work for which this pertnit is issued.
� I have and will maintain wvrkers' wmpensation insu2nce, as required by
secibn 3700 of the Labor Code, (or the performance ol the wvrk for which Ihis
pertnit is issued. My workers' compensation Insurance carrier and policy
�n�um�cb�.er are: '�•
V:^n'c', ddQ�� �
(inis seclon noetl irot Lm'LwnpeleE A rna permn is vahre0 af are nvndretl Wllars (St00) w lass.)
lic}+ � umber: �n � � Z(,.J n'Z 01 �1
❑ I certify that in the peAormance of the vrork for which Ihis permit is
issued, I shall not employ any person in any manner so as to become subject
to Ihe workers' compensatiqn laws o( Califomia, and agree Ihat if I shoultl
become subjecl to the workers' c mpensalion provisions ol Seclion 3700 of
the Labor Cod I shall fort with se provisions.
� /�� 0
'.[pyrtclnl's �gnoture �
WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CADE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTOR$ DECLARATION:
I hereby affrm thal I am licensed untler provisions of Chaprer 9(commencing
vrith Seclion 7000) of Division 3 of the Business and Professions Code. antl
my license is in full force and eHect.
���R o�r� ��— ,,� �/to � l(�
h-� �Z_ �
$�QfldlUf V �IC— —
CONSTRUCTION LENDING AGENCY:
Q 1 hereby aHkm that there is a construction lending agency tw the
peAormance of tte �+ork for which tltis permit is issued. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
OW NER-BUILDER DECLARATIONS:
I he�eDy a(frm Ihal under pg�alty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LqW (or the following reason (Sec. 7037.5,
Business and Pmfessions Code: Any city or counry which requires a permit to
construct, alter, improve. tlemolish, or repair any sWcture, prior to its
issuance, also requires the applicant for such permit ta flle a signetl statement
that he or she is licensed pursuant to the pmvisions ol the Contrecrors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business and Prolessions Code) or that he or she is exempl therefrom anA
t�e basis (or the alleged ezemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civii penalry o( not more than
five hundrad tlollars ($500).):
❑ I, as owner of the property, or my employees with wages as lheir sole
compensation, WILL DO THE WORK, antl the siructure is not intended or
ofteretl for sale (Sec. 7044, gusiness and Professions Code: The Contractors
License Law does not apply 10 an ovmer of property who builds or improves
thereon, and who does such work himself or herself or lhrough his or her own
employees, provitled that such improvements are not intended or offeretl for
sale. If, however, the building or improvement is sold wilhin one year ot
completion, the owner•builder will have the burden of proving that ha or she
ditl not build or improve for purpose ot sale.).
❑ I, as owner o( the property, am EXCLUSIVELY CONTRACTING WITH
UCENSED CONTRACTORS to consWct the prqect (Sec. 7044. Business anC
Protessions Code: The contreclps License Law dces not appy to an owner of
property who builtls or improves thereon, and who cmt2cl5 for such pmject wilh
a contracta(s) license pursuant to lhe Contractors License laws.�.
❑ I am exempt under sec.
Business and Professions Cbde for this reason:
SgneWre
305]-a6 (3ro))
Owner ID verified by dnver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification o( Ownerehip by (rype of document, i.e. - property tax bill or deed):
DIVISION OF INOUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify tha� no excavation frve (5) or more feet in depth into wfiich a
person is required to descend, will be made in connection with work autMrized
by this permil, and that no buil0ing swcNre, scaf(dding, (alsework, or tlemolilion
or tlismantling Ihereof, will be more than Ihirty-su (36) (eet hgh. (Chap. 32, Gry
2, NI 2, Sec. 341, TiUe 8, California Administ2live Code).
� As owner-builder, I will not employ anyone to do vrork which vrould
require a permit lrom Ihe Division of Industrial Satety, as noled above, unless
such person has a permil lo do such work from the division.
APWir�m's SignaWre Oale
Division of Intlustrial Salety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will tha applicant or present or luture builtling occupant neeA to file antl
certiry a Business Plan for emergency response ro release or threatened
release of a hazardous material7 ❑ Yes ❑ No
(Section 25505 of Ihe California Health antl Safe[y CoOe requires, with some
exceplions, that a Business Plan be filed with the Costa Mesa Fire
Depanment by every business which has at any one time during a reported
year a quantity of hazardous materials equal ro or greater than a weighl 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 Ihe applicant or present or future building occupant neetl to fle
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires re9istration with the Costa Mesa Fire Department by
each business which at any one time has on hantl a quanGry o( awtely
hazartlous materials equal to or greater than a weight of 500 pountls, or a
volume ot 55 gallons, or 200 cubic teet of wmpressetl gas at stantlartl
temperature and pressure�.
3. Ooes or will ihe applican� or present or fuNre buiitling occupant nee0 ro
prepare an RMPP (Risk Managemen[ and Prevention Program (or acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of tha Califomia Health and Safery Code provides that the
Costa Mesa Fire Deparlment may require ihe preparation, certification and
filing with the Fire Department of an RMPP by busines5e5 whith are requiretl
to regisier acutely hazardous matenals vrith Ihe Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 0( the California
Health and Safety Cotle been fully complietl with? ❑ Yes ❑ No
5. Does or will Ihe applicant or present or future building occupaN require for
[he work which is the subjecl ol ihis application a pertnit for such construttion
or motlifwtion from Ihe SoNh Coasl Air Quality Managemenl DisMct or Irom
any other air pollulion control district or agency7 ❑ Yes ❑ No
(Section 65850.2 of �tre Cali(omia Govemment Cotle 2quires that ttre requested
information be fumishetl on applications fa rron-residential building pertni�s).
6. will any part of the facility lo be constructetl untler this permit be within
7000 (eet Irom the outer boundanes ol a school? ❑ Yes ❑ No
Qf yes", the facility must meel lhe requirement of Sections 25534 and 42303
of the Calilornia Health antl Safery Code).
7. If a permil from the South Coast Air Oualiry Management District or ot�er
air polNtion control district or agency is required for Ihe work vRiich is Ihe
subject of this application, have all of the disclosures prescribetl by Califomia
Health antl Safely Cotle Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes', attach certificata of compliance from the appropriate air pollulion
control offcer�.
CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury the
infortnation given ahove is cortecL I agree to comply wiN all state laws antl
city ordinances re9arding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF EN7RV: I
certiry untler Denalty o( perjury that I have reatl this appliwtion and state that
the information given is correcL I agree to comply wit� all state laws and city
ordinances relating to builtling construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property tor
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authonzed by this permit until Mal inspection.
... .. -
��� / • a
�(�/.'%A.�:'%� i� � �
(714) 754-5273 • Fax (714) 754-4856 • www.c�.costa-mesa.cFgFJILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite: 2
Vicinity: SECOND FLOOR NETIFICE
Primary Occ: B Eat<50/ Officel Bar<50
Parcel Number: 41050110
Appliwnt: LOGAN, PETER
Address: 33161 PASEO BLANCO
SAN JUAN CAPISTRANO
owner: RREEF
Address PO BOX �
i J � ��
/ Zip:
/ ` _
�� � 5 921SF IN
�� PL WORK.
� � , �-,
� �� � � :
j � � Plan Ch
i } � � � Pe�
� " �,SMIP-I
' ,� i
� : , SMIP C
' �; � �`' OI
,,``�� Inspec
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Status: ISSUED
Applied: 07/052006
Issued: 09/122006
Type of Construction: I-FR
Zoning: G! '
Phona: 949-489-5196 ISSUED BY:
.� ���.-,i_-t �P: ,� 92675_ _
-�.
��- ��-"--•; � �-����.��
��-'i �� �� l � ��,
� �-
JPhone:' , � �,/ � ���' �Z�
� - �� Zi � � 85261-��490 � � �� �
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Phone: 949-489-5196 ��� �
License: 401759 � �
CA
\�� ,� c �
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� i� � Eng: \,'��
r � Address � ��
I � f' � � � " ��`��
_ Phone: . ,�`� e -�,
- —� I��� I ' G �; �
�-• '� - i ' � ;
! ` license: - ��/,f � �� � �
/ '�
r �/ �'` i' �'—; �_... _ .. 1--� � i �
, �;.,,_; =�-"-1=— � SCOPE OF PERMIT� -�� � . �,;,// �
2=NETIFICE". 2ND FLOOR ONLY. WORK TO INCLUDE: NEW NON-LOAD�BEARING PF
�� ` �/ � �� �� ��� d �' ��-, ; � ' `� �l �I
�� ,._ i �' �;�
li rj - �— -- -FEE SUMMARY' — � � ' � � ' I � I
�, -$1,796.18 ( ����� ��(� !i 1i l��° ���� f���Calc Valuation: I� � �r �� � ' S4is,9io:oo �
' � $2,763.35 � __— - -- — _ - Claim Valuation � �� �� �a3ea;000,00�
I $0.00 � • � / I I
1 ^ Jr I�� i, � i �: f ;I,
' �� $07�0 iG-^�4���_)�_L.�� `����� V� '�Ijl� 1 ��J ��'i 1
$0.00 _.._ � _--�-�._ --- ,
� .j
,
i /' ` _
—> I � j
�\` �� � � %/,,, , . _ -i
�54,646.87 ` �l. �� 0/� �� J � ,
�. _
.��;� �%/�, �Av �.i�
�
., zJ,-;, :
tE�Front �0.0 � Rear.,-�a00.0;��' �, ��� Lefl` 0-0`-.a,:
'iJ ��� lfar--�fi£� '�oo =� ` .���„ � `--r I.nri?0 .
Front� 0=0� -Rea��� � 0=0> " �. / Lefl � 0 0
l�� � � \ �� o ° � 3 � ��,Y'
\Exislina� 0� :Reauir'ed: ,'05 . � � Pr000sedi �� 0 �`
/� � oa ,_ '_=�%
�� ` ` vf � \\��� ��c�>�_s-_�'"�- � "i
��' �1� -
����� i -� -,� - !� '1
�_. � c. �� �-, �'ti � �
� V��;J-1 i �,� , ) - i
��
� �j �i �'
,/� i . ,�
e�yn� � a'or / �
Ct
�r..n� ;✓ �// / S /.
�µ.�
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=� �� ��
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AND
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requlrements under Califomla stalutes-and �elated
regulations. (OM. No. 92-28, § 1, 12•21•92)
E)CPIRATION: This permlt shall automatically expire and become void if woAc is not commenced wlthin 180 days, or II work is euspended or ebandoned
tor a period of 180 days.
INSPECTIONS: In order for tha work authorized under thls permit to be considered legal, such work must comply with all applicable codes, arW all
requlred Inspeetlona end finel approvel musl be obtained. Failure to obtein Inspections and final approval will result In Ihe expiratlon of thls pertnit.
FOR INSPECTIONS CALL: (714) 7545828
zwe�ae (a�uo)
WORKERS'COMPENSArON DECLARAnON: • -
I hereby ettirm unOer penalry of per�ury one of tha tdlowing dedaratlons:
❑ I heve end wlll meinteln e ceNiicete oi consent ta selt-Insure tor workers' compensation, es proNded tor by secHon 3700 of the LeDor Cotle, tor the pertortnence of Ne
work for wMCh I�i9 permit 191ssuBd.
❑ I have entl will mainte4i�warkers' compensetlon Insurance, 85 required by sectlon 3700 of the LeDor Code, fof Ihe peRortnance ol the work for which this pertnit is issued.
�'"�My workere: compensetlon Insurence cartler end polcy number ere:
�"�"'_�
ceme �_�y��1S''� �"�-J� i.J: L _.__. . . PoncyNo`oe�_ :Ob�Ll � —2mL
❑ I certly thet In t�e peRormance of Ihe work tor which thLs partnit Is Issue4 I shall not employ any peraon in eny menner so es to becoma sub�ect to Ne workers'
compensetlan lews at Calltomle, entl epree t�at tl I s�oulA became sub�ect to the workere' compensetlon prodslons af Sectlon 3700 01 Ihe Lebor CaAe, I shell fort�wiN
comply wlt these pr�—� ��� [�
AppneanJpnature: c�� � D,_te� -l'—�Z--�i
WMNINO: FNLURE TO SEWRE WORNERS' � MGE IS UMAWFUL AND SWLLL SU6IECT AN EMPLOVER TO CRIMINAL PEWLLTIES AND CML FlNES UP TO pJE HUNOqED
THOUSrW D DOl1ARE (5100.0OO�.IN ADIXTION TOTHE COST OF COMPENSATION, DAMAOES AS PROVIDED FOR IN SECfION 3]OB OF THE IABOR COOE, INTEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLAPATION:
I �ereby aflirrn_Ihet I em Ilcensetl un er praNsions of Chapter 8(commencinp wIU Section 7000) ol Divlslon 3 oi t�e 8uslness eqg Prolessions Code, and my Ikense is In tull
larce end ettect. Uo'7a f� (-1.S 4 1Clesa�x—.�- 5'� �;'�
co rect�.sl9neture: _��y oete:��C��LirlJ,(�
� v
CONSTRUCTON LENDINO AGENCV:
❑ I �oreby eRlrm thal there is e construction lendinp epency for the pertortnence o1 t�e work tor which this pormit is Issued. (Sec. 3097, Civll Cotle).
Lentlefs Neme: Lenders Address:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eXirm thet untler penelry ot perjury Ihet I em E%EMPT FHOM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Protessions
Code: Any ciry or counry which requires e pertnit to consWd, elter, imprwe, tlemolish, ar repair eny awcture, pdar to ils Issuanca, elso requires the epplicam tor suc� pertnit
to file e signed stetement thet �e or ehe is IlcenseE pursuent ro Ne proWsbns oi ihe Contrectors lJcense Lew (Chepter B(commencln9 with SecUon 7000) of D'Msion 3 af the
Business end Pmfessione Cade) ar that he or she is exempt Iherefrom entl Ihe �asis for ihe elleped ezemption. Any vialation ot Section 7031.5 by any epplicant far e pertnit
sub�ecl5 the eppllcent lo e Gvil penatly oi not more than frve hundred ddlars (5500).):
❑ I, es owner of t�e praperty, or my employees with weges es Iheir sole compensatlon, WILL DO TME WORK, end the structure Is not InlentleC or otleretl for sele (Sec.
7044, Buslness end Professlons Code: The Contrectors Llcense Lew tloes not eppty to an owner of properry who builtls or improves thereon, and who daes such work
hlmsetl or herselt or throug� Ns or her own employees, proNded that such imprwements ere nol Intendetl or oHered lor sale. If, however, the building or improvement is
solA within one year ot compleilon, Ihe owner-builder will heve �he burtlen oi provinp that ha or she diG not bulltl or improve for purywe of sele.). '
❑ I, as owner of t�e D�WaM• em EXCLUSIVELY CONTRACTING WIiH LICENSEO CON7RACTOR3 to construct ihe pro�ect (Sec. 7044, Business end Profassions
Catle: The contrectors License Lew tloes not appty ta an awner ot pmDerty who huiltls or Improves thereon, end who cpntrects tor suc� prol�i w�ih a contractor(s)
Iicense pursuflnt �o the Contradors License Lews.).
❑ I am exempt under sec. Business entl Pmfessions Cotle br this reamn:
SlpneWre: Dele:
Owner ID verltietl by drlvers Ilcense. ❑ Yes ❑ No Drtvers LJcense No.
Vedflcetlon oi Ownerehip Dy (rype ot tlocumem, i.e. - property tex blll or tleeO):
Expirea:
OIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON:
❑ I hereby ceN1y t�at no excavetlon INe (5) a more feet In depth Inro which e person b requlred to descend, wlll he metle in connectlon wiN work euihorizetl by NLv
pertnit, end Ihat no building strucNre, scaHOltlinp, felsework, or demolltion or dlsmantling t�ereol, wlll be more than t�lrty-slx (38) feet �IgR (Chep. 32, Grp 2, M 2, Sec.
341, Tltle 8, Calltomla Atlministretive Cotle).
❑ Ae owner-builder, I will not employ enyone to tlo work w�ich woultl require e permil from Ihe Dlvision at Induslriel Sefey, ns noted ebove, unless such pereon hes e
permit to do such work Iran Ihe tliNslon.
SlgneWre: Date:
Divislon o1 tntluslrial Salery Pertnit Number.
CERfiFlCATE OF COMPLUWCE ANU AUIHORPJITION OF EMIRY: I certily unEer penelry oi perjury thet I have read Ihls epplicelion end state thet the infortnalion given Is
conect. I egree to compty wlih all stete laws arM dry ordinences relating lo builtli� canstrucUon, entl euthorize represenleEves of t�e Gry ot Coste Mesa to enter upon ihe
ebove-descdbetl proper�y for inspectlon puryases. I agree not to occupy or ellow ocapancy oi eny building euthodzetl by this pertnil unGl finel inspecllon.
COUE I. INSVECf10NTYPE
1818 FIxeG System Final Flre Prevembn
1288 Pad Spe Flnel
200 Finel Re-Roo1
201 FIneI BIacWRetelning Well
202
203
206
Finel Fectory Fire Place
Flnal Slgn
Finel DemW6on
QAg
Q�L4
��
CAOEt INSVECfIONTYPE
208 Final Mechanical
208 Finel Plumbing
210 Finel Electricel
212 Flnal Flre Preventlan
�
222
250
Final Plannlnp Approvel
Finel Slte
Finel Bulldinp/Occupanq
_ Date
PAIF Q{�Etfi
.
(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.��,sCTRICAL PERMIT n FAIR DRIVE, COS7A MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
555 ANTON BL
2
2ND FLOOR NETIFICE
41050110
HACKENY,DAVE
Owner: RREEF � -�
Address PO BOX 4900
DEPT 207
SCO77SDALE,AZ
Contrector: HACKNEY ELECTRIC INC
Address: � 23286 ARROYO VISTA
n ,,
RANCHO SANTA MARGARITA, CA
Phone: 949-264-4000
Zip
Phone:
Zip: 852614900
Phone: 949-264-4000
2ip: 92688
License: 686221
Status: ISSUED
Applied: 09/222006
Issued: 10/232006
ISSUED BY: ��
SCOPE OF PERMIT
5,921SF INTERIOR T.I. FOR "NETIFICE" ON THE 2ND FLOOR ONLY. WORK TO INCLUDE: NEW
NON-LOAD BEARING PARTITION WALLS, ELEC, MECH AND PLUMBING WORK.
REF: BO6-01112 ,
� 21 LIGHT FIXTURES, 38 OUTLETS, 11 SWITCHES
ISSUE FEE
Temp service test
� Res. a/c package ��
New Res (1-2 unils)
New Res (3+units)
Pool / Spa
Lighting Fi�s � �
Recept Outlets �
Switches , ,
Non Res Appl
Res Appl
Service to 200a'.
Service to 1000a ��,
Service over 7000a
Motors to 1 hp ' , �
Molors to 10hp ,
Motors to SOhp ,
Molors to 100hp
Motors over 100hp
Communiwtion drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intertned Pole
i
` Quantiry .
$23.50
$0.00
80.00
$0.00 0
50.00 0
$0.00 0
522.73 ' 21
$35.14 38
$12.70 11
$0.00 0
�$0.00 0
50.00 � J "� ' 0' " '.
,$0.00\ � 0 �
80.00 ` _\` =� 0 - .
80.00_ �� �0\�_ �
$0.00�. -0 �
So.00 , o "
$0.00 ; ' 0�- .
�50.00� � 0 �
ao.00 0
$0.00 . 0�' �
$0.00 0
$0.00 0-
$0.00 0
E0.00 0
FEE SUMMARY
Temp Dist System / Lighting
Buswayl700N -
Standing Section�
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kvalkw
.................up to 50 kvalkw
:................up to 100 kva/kw
...........:...:..over 100 kvalkw
Low Voltage Equipment
Low Volt Wiring�System / Ckt
Misa Conduit � - � ' -
Misc. Conductor
Ciras ( gen or ride)
Circus (mech ride or lights) �
Christmas 7ree Stand " .
Fireworks Stand �
Other Eledrical Fee . �
Investigation Fee
Plan Check Fee -
Reinspection Fee
Quantiry
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 o -
sa.00 0
$0.00 0
$0.00 0
$0.00' 0
$0.00� 0 �
50.00, - 0
$0.00 j 0
$0.00 _ '- 0 � -
80,00, 0
$o.00 0
$0.00 ,
$0.00
50.00
$0.00
- - TOTAL CALCULATED FEES 593.47
n/�u�¢urc� i c�nen���
NO710E: The work authorized by ihis permit shall comply with all applicable handicap access requlrements under Califomia 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 1 BO days, or if work is suspentled or abandoned
for a period of 180 days. �
,
INSPECTIONS: In order for the work authorized under this permit to be considered legel, such work must comply with ell epplicable codes, and all
requlred Inapeetlone and tinal epprovel must be obtalned. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zusas (erool
WORKERS'COMPENSAnONDECLARAnON: ,
I �ere6y aHirm untler penalry ot perjury one of the tollowing tleclaiatlons: �_ '. � ' � . .
❑ I ve antl will maintain a cenificate ot consent to self-Insure for workers'.compensation, es provitled tor by section 3700 at the Lebor Code, for the peAormence ot the
ork for which Ihis permit is issuetl.
1 have antl will maintain wo ers' compensation insurence, es required by section 3700 of Ihe Lebor Cade, for the pedortnance of the work tw which this pertnit is issuetl.
M workers' co nsatio I sur nc wr er antl num6er are: O ��
CertierY ��L._. C� c�iv✓J �. PoliryNumCer. � �� � /
(This section need e tomplefed�permit is va/uetl ef one huntlred tlW/ars (5100) or less.)
❑ I certify thet in ihe peAortnance ot lhe work for which this permit is issuetl, I shell not employ eny person in eny menner so as to become sub�ect to t�e workers'
compensation laws of CaJ ornia, end e r e that If I should become subJeCt to Ihe worker5' compan5ation provi5ion9 of 5 ttion 37y0 Of �he LBbor Code, I ahall fotlhwilh
comply with ihese pro �� � � c� 23 I��
�Appllraut:Signeture:-� Date:
WARNING:FAIWRETOSECUREWOFiI(ERS'COMPENSATIO EMGEISUNUWFLLANDSHALLSU6IEGTANEMPLOVERTOCRIM�NALPENALTIESAND VILFlNESUPTOONEHUNDRED
TYqU5AN0 Od.LARE (5100.OW),IN ADDfTION TO THE COST O MFENSATIpJ, DAAIFGES /S PROVIOEO WR IN SECTION 31080F THE IABOR ODDE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby affirm that I am licensetl undar provisions of Chapter 9
force and ettecL Lic. q � �� . � .� _.
CONSTRUCTON LENDING AGENCV:
7000) ot DiNsion 3 ot the B
Cless N
Date:
and my license Is In tull
❑ I hereby atfirtn thel there is e construction IenGing agency for ihe pertormance of ihe work for which this permit is Issuetl. (Sec. 3097, Civil Cotle).
Lender'S Name: LentlBr's Atltlress:
SiqneNre: Date: . _ _ _ _ _ . _ .
OWNER-BUILDER DECLARATIONS:
I hereby attirtn that under penalry ot per�ury t�at I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Prolessians
Cotle: Any ciry or counry whic� requires e permit to consWct, alter, improve, demolish, or repair eny slrucWre, pnor �o Its Issuance, elso requires the epplicant tor suc� permit
to file a signetl stetement ihat he or she is licensed pursuant to the provislons oi Ihe Contradore Licensa Law (Chepter 8(commendng with Sectlon 7000) ot Dlvisian 3 oi Ihe
Busineu an0 Protessions Code) or Ihet he or she is e:empt thereirom end tha basis for Ihe elleged exemption. Any violation of Sectlon 7031.5 by eny epDlicant for e pertnil
subjects the applicent to a civil penalry oi nat more Ihan (ive hundred dollars (5500).):
❑ I, as owner of the property, or my amployees with wages as their sole compensation, WILL DO TME WORK, antl the structure is not Intended or offered for sale (Sac.
7044, Busineu and Pmfesslons COGe: The Conirectors License Lew does nat apply ta an owner ol propeny who builds or improves thereon, flnd who does such work
himsetl or herself or Ihrough his or her own employees, pmvidetl ihet such improvements ere not intended or oflered lor sele. It, however, the building or Improvement is
sold within one year of completion, the ownerbuilder will heve Ihe burtlen oi Droving that he or she tlia not builtl or improve for Durpose at saleJ.
❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conslruct t�e projec� (Sec. 7046, Business and Professians
Coae: The contractors License Law tloes not apply lo en owner ol property who builds or Improves thereon, antl who contracm tor suc� project wit� a contractoqs)
license pursuant to tha Contractore License Laws.).
❑ I am exempt under sec. eusineu antl Pmlessions Code tor t�is reason:
Signature: Date:
Owner ID verified by tlriver5 licen58. ❑ Ves ❑ No Drivers License No.
Venfiwtion of Ownership by (rype oi tlocument, i.e. - property tex bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION:
❑ I herehy ce�ity that no excavation tive (5) or more teet in tle0�h into w�ich a person is required to descend, wlll be made in connecllon with work authorized Dy ihis
permit, and that no building structure, scaHolding, felsework, or demolitlon or dismanUing t�ereof, will be more than thirty-six (36) taet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Calilamia Atlminislralive Code).
❑ As ownar-builder, I will not amploy anyone to do work which would require a permil from the Division al Indusirial Sefety, es noted ebave, unless such person hes e
permit to tlo such work irom the divislon.
Signature: Date:
Divisian af Industrial Safery Permit Number:
CERTiFICATE OF COMPLIANCE AND AllfHORVA710N OF ENfRY: I certify untler penalty of perjury ihat I have read Ihis application entl state that the infortnelion given is
correct. 1 agree to comply wit� all state laws end city ordinances relating to bullding consiruction, end authonze reDresentalives ot Ihe Clry of Costa Mesa to enter upon the
above-described D�oDerty tor inspection purpwes. I egree not to occuOY or ellow occupancy of eny builtling authorized by this pertnit until tinel inspection.
CQOE t.
1616
1266
200
Fi:eO Sys�em Final Fire Preveniion
Pool Spa Final
Final Re-Rooi
201 Final Block/Retaining Wall
202 .Final Factory Fire Place - ,
203 Final Sign
ppb Finel Domolition
/� (� ��D�
T o e
CODE� INSPECTONTYPE � Qdj[ ��f
206 Final Mechanicel
20B Finel PlumDing �
210 � Final Electncal � � %
i
212 .Final Fire Prevention
i
220 ' Final Planning Approval,
222 Final Site
250 . Final Building/Occupgnty
(714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 2
Vicinity:
Parcel Number. 41050110
npp�icant: LOGAN, PETER
Address: 33161 PASEO BLANCO
Owner:
Address:
Contracror:
' Address:
SAN JUAN CAPISTRANO, CA'
RREEF
PO BOX 4900 � -
DEPT 207 � � •
SCOTTSDALE,AZ,
LOGAN COMPANY
33161'�PASEO BLANCO
SAN JUAN CAPISTRANO, CA
MECHANICAL PERMIT
W
Phone: 949-874-8169
Zip: 92675
Phone:
Zip: 85261-4900
Phone: 949-674-8169
Zip: 92675
License: 401759
�-
�
Status: ISSUED
Applied: 10/23/2006
Issued: 1 012 3/2 0 0 6
v �
ISSUED BY:
, SCOPE OF PERMIT
�5,921SF INTERIOR T.I. FOR "NETIFICE", 2ND FLOOR ONLY. WORK TO INCLUDE: NEW
NON-LOAD BEARING PARTITION WALLS, EL, MECH AND PL WORK. REF.: BO6-01112
MECHANICAL TO INCIUDE: 1 ALT/REPAIR COOLING/HEAT AND 2 VAV BOXES. �
ISSUE FEE
Inst PAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat.
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >700 k BTU
Gas Piping ,
Factory Fireplace . �
Hood wlMech Exhaust
VAV Box
Vent Fan / Single Duct �
Appliance
Fire Dampers . � ,
Smoke Dampers `
Inst or Relocate Appl Vent ,
Air Handlers < t0000cfm
AirHandlers> 10000cfm
Floor Fumace
Floor ocSuspend Heater V' .� �-
Quantity
$23.50
50.00 0
$0.00 0 - _
$13.70 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$21.30 2
$0.00 0
`$0.00 0
$0.00 0
$0.00 , 0
� $0.00-- ;0 � .
50.00 0 '
50.00 0
50.00 0
�50.00 , �0 - ,
FEE SUMMARY
Repair / Afl Absorbtion Unit
Repair / AI� Refrigeration Unit
Ventillation System
Evaporative Cooler
Commercia l I n cineralor
Domeslic Incinerator
Comoressors I Absorotion Svstems
Uplo3hp/100kBTU
3To15hp/SOOkBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp I Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15to30hp , .
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee , .
Flan Check Fee -
Reinspeciion Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIALCONDITIONS
Quantity
$0.00 0
$0.00 0
$0.00 0
50.00 0
` $0.00 0
$0.00 0
S0.00 0
30.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
$0.00
$0.00
50.00
558.50
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, 1241-92)
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. � � j
INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicable�CoiJes, and all
requlred Inepeetlona and final epproval must be obtained. Failure to ob�ain inspections and final approval will result in the expiratian o this Dermit.
FOR INSPECTIONS CALL: (714) 7545626
zae-ae �aroo�
WORKERS' COMPENSA710N DECLARATION: ' �
I hereby affirm under penelry of peryury one of the following declaratlons: � . � � �� ,
❑ I have enA will melntain e certificate o1 consent to selt-Insure tor workare' compensatlon, es provided br by sedian 3700 of the LaDor Code, br �he peAortnence at the
work for whlch this pertnit is issuetl. �
� I have flntl will maintain workers' compensation insuranca, as required by section 3700 0l Ne LeDor CoOe, for Ne peAortnance of Ihe work for xTiCh Nis pertnit Is Issuetl.
�My workers' com�ensation Insuranc9�arder entl policy number ere:
POIItyNumber..�J�v 'e'6�o�C �
orless.) �""
❑ I certify Ihet in the perlormance oi the work tor which t�is pertnit Is issued, I shell not employ eny person in eny manner so as to become sublect to tha workers'
compensatlon laws of Gelifomie, and eqree ihel II I should become subject to the workere' compensatlon provisions oi Section 3700 of the Lebor Cotle, I shell forihwith
comply with ihese provie� �
AppNcenD;Slgneture:'"'- �-' rDate:,
Wtsa,^ t,..
ABOIW6�FAILURPTO SECURE WORKERS" ENSATION COVERAGE IS UNUWFUL AND SHALL S091ECT AN EMPIOVER TOORIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED
TFKKISAND DOLLARE (5100.000�, IN AODITION TO THE COST OF CdAPEN5AT10N, OAMAGES AS PROVIDED FOR IN SECfION 3108 OF TME LABOF CODE, IMEREST, AND ATTORNEI"3 FEES.
LICENSED CON7qACTORS OECLARATION:
with Sectlon 7000) af Division 3 of t�e Businass
end my license Is in tull
CONSTRUCTION LENDING AGENCV:
❑ I hereby ettirm that Ihere is a wnsWdion lending a9ency For ihe Dedormance ot the work br which Ihis pertnit is issued. (Sec. 3097, Civil Gode).
Lendefs Name: Lentlefs Atltlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS: .
I hereby ettlrtn ihet under penelry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe lollowing reason (Sec. 7031.5, Business antl Protesslons
Code: Any ciry or counry whic� requires a permit to consiruct, alter, improve, demolish, or rapair eny structure, prior to its issuance, also requires the epDlicant for such permlt
lo fila e signetl stetement ihet he or she Is Iicensad pursuant to the provisions oi the Contrectors License Lew (Chepter 9(commencing with Section 7000) ot Divislon 3 ot lhe
Business and Professlons Code) or thet ha or she is exempt iherefrom end ihe basls lor the elleged exemption. Any violation of Section 7031.5 by any epplicant for a permit
subjects the applicant to e civil penelty of not more than five huntlretl tlollars ($500J.):
❑ I, as owner ot t�e propeM. or my employees wi�h wages as t�eir sole compensation, WILL DO THE WORK, end the structure Is noi intentletl or oHered lor sale (Sec.
7044, Businass end Professions Code: The Contractors License Lew does not apply to en owner of propeRy who builds or improves iheraon, end who does such work
himself or hersalf or through his or her own employees, proviaed Ihet such improvements ere not Intendetl or oNered for sale. tl, however, the building or impmvement is
sold within one year ot completion, the owner-builder will have the burden of proving ihat he or sha ditl not builtl or improve for purpose of sale.). �
❑ I, es owner of �he pmpetly, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to canstmct ihe project (Sec. 7044, Business antl Professlons
Code: The conirectors Ucense Law Coes not apply to an owner of pmperty who builtls or Improves ihereon, and who contracis for such project with a contrectoqs)
license pursuant to t�e Contractors License Laws.).
❑ 1 am ezempt untler sec. Business entl Prolessions Cotle�for this raason:
Signature: Dale:
Owner ID veritled Dy driver's lltense. ❑ Yes ❑ No Onvers Lltense No. Expires:
Venfication ol Owners�ip Dy (type ot Caumeni, i.e. - pmperty tau bill or tleetl):
DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICATON:
❑ I hereby certity ihat no excavation flve (5) or more feet in depth In�o which e person Is required to descenq will be made in connection wi�h work authorized by thls
permit, antl �hat no builtling s�ructure, scalloltling, falsework, or demolition or tlismantling ihereot, will be more Ihan thirty-siic (36) leet high. (Chep. 32, Grp 2. Art 2, Sec.
341, Tltle 8, Celilarnia Atlministrative Code).
❑ A5 owner-Duiltler, I will not employ anyone to do work which would require e permit irom Ihe Division ot Indusirial Safety, as noted above, unless such person hes e
permit to do such work irom the division.
Signature: Date:
Division ol Intlusirial Sefary Permit Numbar:
CERTIFICATE OF COMPLIANCE AND AUTHORVJITON OF ENTFiY: I cenity untler penelry of perjury that I have read this application and state thet the inlormaUon given Is
wrrect. I egree �o comply with all state laws entl ciry ordinances relating Io building construction, end euthorize representatives ot Ihe Ciry ot Costa Mese to enter upon Ihe
ebove-descri6ed property tor inspection purposes. I egree not to occupy or ellow occupancy of any building euthorized by this permit until final inspection.
161fi Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Finel Re-Roof
201 Flnel BIocWRetaining Wall
202
203
206
Finel Factory Fire Place
Finel Sign
Finel Domolition
PAg
CODE� INSPECTIONTYFE
206 Final Mechanical
20B Final Plumbing
270 Flnal Electrical
272 Finel Fire PrevBnlion
220. Final Planning ApOroval
222 Final Site
250 Final Buili
Date
�. � mi..
i • i \
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 2
Vicinity: 2ND FLOOR
Parcel Nunmber: 41050110
npp�icant: ANTONIO DOWNS
Zoning:
Address: 2505 MIRA MAR AV , � � - - , -.
Owner:
Address
Contrador.
Address:
Status: ISSUED
Applied: 10Y27/2006
Issued: 11/06/2006
ISSUED BY: � "
= „ Phone: 562-098-6444 x2207 - �
LONG BEACH, CA ' - . Zip: " � 90815 �.` � �_ ��
,i,� - , � . . � � � ,�
RREEF . � � � � ��; � ���. ;�
PO BOX 4900 � � � ` _ - - - _ - ' � � - �
DEPT 207 `� � . � . ' . P-hone: � � -- - -� - � _ � � i ' �
SCOTfSDALE.AZ:' ":. . - � Zip: 85261-4900����� � -� ='-� �` � � �� ���
. �
ACKERMAN,.MAGGEY \ ��� �� / <��% ; ',\�,�,
�
_ .ii/ � �� `:\�, �� =��
- Phone: AC� �� �_� �'.�
. , 2ip: ._ . , '�.
, �'
. License'.' 327196 �� �" , � - • ,
SCOPE OF PERMIT '
INSTALL FIRE ALARM SYSTEM FOR-'NETIFICE" 2ND FLOOR. REF.: BO6-01112 +- - �,
. . . � ._ . _ . . , , , � . �
FEE SUMMARY ,
Plan Check: $172.41 .Calc Valuation: $�e,ios.00 ,
Permit ' $265.25 " �� Claimed Valuation' , Sis,io3.00
Other. $0.00 � - - �
, , - - � ,. � - -'� f '' �`� �� �
� � - .. ,. .':...-r . -�- ���--:�:�
� Total: $437.66 - ��'� � � � '
.,,
. . . „ . .� _ ...., � � .
�: - .. -r �,.�„
_r- - �. -._ '.� _
� ,;- �
- '� - � � ;�,�"
-.z,. _ � :,, � � ,
�';: � i
.. , . .
` . . � � ' . .. � �. t . [ � ' •
/ „
� � _ , .i .. i " . '. � �� V . . .
� . l >
. . � '�- � � �:%� �/ . � � �' �� �
; � - - �-� < �v
� � ' 'i '` � - _-- � � -� • � %�i /,- ��
. i ,:
� , � - � , , j
�
�� - -��
_ . ._ y, �-
_ �. ,
- _ - .�.. , -
� ,�;i.�- _
.. � . _�_ ,: .-
NOTICE: The work authorized by this permit shall compy with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ortl. No. 92-28, § t, 12-21-92) �
EXPIRATION: This permit shall automaticalty 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 autharized under this permit to be considered legal, such work must comply with aIi applicable codes, and all
requlrecl lnspectfons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
2aawe �sioo�
�
WORKERS' COMPENSATION DECLAHATION: � � � � � -
I hereby aHirm under penalry ot peryury one of the following declarations:
❑ I hava and will malntain a certificate ot consent to selbinsure for workers' compensation, as provitled for by section 3700 of the Wbor Code, toathe partormence of the
work far which this permit is issuetl. �
� I have antl will maintain workers' compensation insurance, as requiretl by section 3700 of tha Labor Code, for the pedormance of the work for which this pertnit is issued.
My worke�s' compansation Insurance carrier and policy number are: /' �/ ¢� �
Carrier. �[0 �tia / PolicyNumber: 3`OG^2�
(Triis secfion need not be complete il the permit is valued at one hundred dollars ($10 ) or less.) - ' - .
❑ I certity that in tha pertormance of Ihe work for which this permit is issued, I shall not employ any person in any manner so as to become su6ject to ihe workers'
com0ansation laws of Califomia, and egree ihat if I should become subjecl to Ihe workers' compensalion provisions oi Section 3700 of lhe Labor Cotle, I shall forthwith
comply with ihese provisions. /� /� � � ) /-//
Appliwnt SignaWre: Cn /G�— / Date: /�`� �+' �
WAFNINGFNILURETOSECUREWOPKERS'CAMPENSATIONCAVERAGEISUNL4WFULAN SHALLSUBJECTANEMPLOVERTOCRIMINALPENALTIESNNDCIVILFlNESUPTOONEHUNDRED
THOUSAND OOLLARE ($700,000), IN ADDITIpJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31W OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirtn ihat I am licensed untler provisio
torce and eHecL Lic. # 2%<<!
Contractor's SignaNre:
of Chapter 9(commencing with Section 00) of Division 3 of ihe Business and Professions Code, and my license is in full
Classa C�<�/[-!4
a �Y- _ �� Date: /U G � Co
CONSTRUCTION LENDING AGENCV:
❑ I herehy aHirtn that there is a consiruction lending agency for ihe pedormance of Ihe work for which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn that under penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions
Code: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair eny siructure, prior to its issuance, also requires the applicant for such permit
to tile a signed statement that he or she is licensed pursuant to ihe provisions oi the Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot ihe
Business antl Professions Code) or that he or sha is exempt therafrom and the basis for ihe alleged exemption. Any violation ot Section 7031.5 by any applicant for a permit
suhjecis the applicant to a civil penalry of not more than five hundred doilars ($500).):
❑ I, as owner of Ihe property, or my employees with weges es iheir sole compensatlon, WILL DO THE WORK, and tha structure is not intended or oftered for sale (Sec.
7044, eusiness and Protessions Code: The Contractors License Law doas not apply to an owner of property who builds or improves ihereon, antl who does such work
himself or �ereelf or through his or her own employees, providad ihat such improvemenis are not intandad or oHered tor sale. If, however, the builtling or improvement is
soltl within one year of completioq tha ownar-builder will have ihe burden ot proving Ihat he or she did not build or improve for purpose ot sale.).
❑ I, as owner of Ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contrectors License Lew does not apply to an owner of propeny who builds or improves thereon, and who contracts for such project with e contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am anempt under sec. Business and Professions Code tor ihis reason:
Signature: Date:
Owner ID verified by drivefs license. ❑ Yes ❑ No Driver's License No.
Verification of Ownership by (type of dxument, i.e. - property tex bill or dead):
Expires:
DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: '
❑ I hereby certify that no excavation five (5) or more feet in tlepth into which a person is required to descend, will be made in connection with work authorizatl by Ihis
permit, and that no builtling siructure, scaHolding, falsework, or demolition or tlismantling thereof, will be more ihan ihirty-six (36) feet high. (Chap. 32, Grp 2. Art 2, Sec.
341, Title 8, Calitornia Atlministrative Code).
�1
❑ As owner-6uilder, I will nol employ anyone to do work which would require a permit irom ihe Division of Indusiriel Satety, as noted atiove, unless such person has a
permit to do such work from Ihe division.
Signature: Date:
Division of Industrial Safety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTFiORIZATION OF ENfRY: I certify under penalry of perjury that I hava read ihis application antl state �hat �he infortnation given is
correct I agree to comply with all stete laws antl city ordinances relating to building construction, end authorize representatives ot the City of Costa Mesa to enter upon the
above-described propetly for inspection purposes. I egree not to occupy or allow occupency of any 6uilding authorized by ihis permit until final inspedion. �
Legal
CppE N, INSPECTIONTYFE � '
1616 Fixed System Final Fire Prevention
1266 � Pool Spa Final- - - ' �
200 Finel Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition � ��
DRTE . IMRIpL3
CODEN' INSPELTIONTYVE"
206 Final Mechanical
208 FinalPlumbing. �
210 Final ElecMcal
212 Final Fire Prevention
220 � Final Planning Approval �
222 Final Site �
� 250 Final Builtling/Occupency
Data
! f�/ ,_ /
ate
�g �
�3'i�+Qo _ ,�l�
(714) 754-5273 • Fex (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite: 2
Vcinity:
Parcel Nunmber: 41050110
npplicant: ANTONIO DOWNS
Address: 2505 MIRA MAR AV .
LONG BEACH, CA
Owner: RREEF
Address PO BOX 4900 .
DEPT 207
SCOTTSDALE,AZ : -
Contrador: ACKERMAN, MAGGEY
Address:
Zoning:
Phone: 562-498-6444 X2205
Zip: � 90815
Phone:
Zip: 85261-0900 .
Status: ISSUED
Applied: 10I25/2006
Issued: 11I062006
ISSUED BY:
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- Phone: � � ,
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Zip: , . . . � . .
License: 327196 - � �
SCOPE OF PERMIT
INSTALL 1 OVERHEAD SPRINKLER AND PRE-ACTION SYSTEM FOR "NETIFICE". REF.: 806-07112.
2ND FLOOR. - � � ' �
FEESUMMARY - �
Plan Check: $236.11 Calc Valuation: Szs,000.00
Permit: $363.25 Claimed Valuation: S2s,000.00.
Other: $0.00 � - � -
Total: $599.36
i
- � .. . -'�= '� -
i�
i. .
NOTICE: The work aulhorized by this permit shall comply with all applicable harWicap access requirements under Califomia statutes and related
��, regulations. (Ord. No. 92-28, § 1, 12-21-92)
�� EXPIRATION: This permit shall automatically expire and become void if xrork is not wmmenced within 180 days, or if work is suspended or ebandoned
ror a period ot t 8o days. �
INSPECTIONS: � In order for the work aWhorized under this permit to be considered legal, such work must compy with all epplicabte codes, end all
requlred Inapeetlona end final epproval must Ge obtained. Failure to obtain Inspectians and final approval will result in the expiretion ol this permit.
FOR INSPECTIONS CALI: (714) 7545828
«ase (eroo)
WORKERS'COMPENSATION OECLARATON: '
I hereDy eNirtn under penalry ot par�ury one o1 the followinp tledaretions: �
❑ I heve end will maintflln a certiflcate oi consent to sefl-Insure for workere' compensetlon, es provitled for by section 3700 of 1he Lebor Cada, tor Ihe peqormance o1 the
�ork lor whkh this pertnit Is issuea.
hava end will maintein workers' compensatlon Insurance, as reQuired by sectim 3700 of the LaOor CaAe, for Ne peAartnence ot Ue work 1w whkh thls pertnit Ls issued.
My workers' compenseilon Insurenrs carrier and pollcy numDer are:
Carder. Q�CD Ind POIityNumber. 3YY0—ZS
(This sec(ion neetl not be ownplefed il fhe perml! (s veluetl ef one huntlretl ddlers (87 ) or less.)
❑ I cerUly Iha� in ihe peAartnence of the work tor w�lch Ihis pertnit is Issuod, I a�all rrol employ eny person In any manner so es to 6ocome sub�ect to the workers'
campenseNon taws of Capfomia, entl agree Mef If 1 ahoul0 becwne subJect ro t�e workors' compensetlon provisions of Sectlon 3700 ot the Lebor Catle, t shefi forthwtth
compty wIN t�ese Provisions. � � / //�/
Applicant Signature: Data: (o
WARNING: FNLURE TO SEWRE WORKERS' WIAPENSATIIXJ COVEMGE IS UNUWFUL AND SNALL SU&IECi PN EMPLOVER TO CRIMINAL PENPLTIES AND CML FlNES UP TO ONE RED
T/IQISAND DOILFRE (5f 00,000�, IN pppmpry TO THE W5T OF COMPENSATION, DAMSGES Il5 PilONDED FOH IN SECTION 31W OF THE UBOR CODE. INTERE5T, AND FTfORNEVS FEES.
LICENSED CONTFiACTORS DECLARATON:
I hereby ettirtn that I am licensed untler provisions ot Chapter 9(commencing with Section ) ot Division 3 of Ihe Business and Professions Cade, end my license is in full
force end elfect. LJc. a 32'7 �4 4 Class q �'� ��L —! L
f
Contrector'sSigneWre: /- Date: //�G��
CONSTRUC710N LENDING AGENCV:
� I hereby eHirm Ihat Ihere is a consiruction lending egency br iho pedormence ol Ihe work lor w�ich ihis Oermit is issued. (Sec. 3097, Civil Coda).
Lentlers Neme: Lendefs AdCress:
Siqnatura: Date:
OWNER-BUILDER OECLARA71pNS:
I hereby ettirtn thet under penalry ot perjury that I em EXEMPT FROM THE CONTRACT01iS LICENSE LAW tor the following reason (Sec. 7031.5, Buslness and Profeulons
Cotle: Any ciry or counry which requires e permit to canstrud, alter, imprrne, demollsh, or repeir eny structure, prior to Its issuance, elw requlres the epplicent tor such permit
lo Ille e si8netl stetement thet he or she is Ilcensetl purauant to t�e provlslans of the Contredora LJcense Lew (C�apter 9(commendng wlth Sectlon 7000) ol DMslon 3 of the
Business end Protessions Cade) or that he or sha is exempt Ihorofrom entl the Desis for the ellagetl e:emptlon. Any violatlon of Secllon 7037.5 Dy any epplicant br e pertnit
subjects the epplican� to a Gvil penalry o1 nat more then five huntlred tlallars (5500).):
❑ I, es owner of the property, or my employees with wages es their sole wmpensation, WILL DO THE WORK, and the structure is not InterrcleC or oMered for sele (Sac.
7044, Business anC Professions Code: The Contraciors lJcense Law tloes not apply Io an owner of properry who builds or improves thereon. antl who tloes such work
himsetl or herself or through his or her own employees, providad that such improvements ere not intended or oflered for sale. II, however, Ihe Duiltling or improvement is
sold within one year ot completion, the owner-6uilder will have Ihe Durden ol praving that he or she did not build or improve for purposa ot sele.).
� I, es owner of the property, am E%CWSIVELY CONTRACTING Wf7H LIGENSED CONTAACTORS to construct the pmjed (Sec. 7044, Business antl Pmfesslons
COCe: 7he comracrors LJcense Lew tloes not eppty to en owner ai pmperty who builds or Improves thereon, and who coNrads for such OrWed w�th e mntrecior(s)
license pursuant to the Contractors Licensa Lews.).
❑ I am exempt under sec. Business antl Pmlesaions Cade for Ihis reason:
Signeture: Date:
Owner ID venfied by tlrivefs Iicgnse. ❑ Yes ❑ No DAvelg Lkense No.
Vedficatlon of Ownership �y (rype ot Oocument, i.e. - D�operty tax DIII or tleetl):
Expires:
DIVISION OF INDUSTRIAL SqFE7V PERMIT CERTIFICATION:
❑ I hereby certity t�et no exCevetlon Ilve (5) or more feet In depth Into w�ich a person is requlrad to descend, wlll be ma0e In connectlon with work authoHzed by this
pertnit, and that no buildlqp sWciure, scettoltling, lelsework, or demolltlon or dismentling theieof, wlll be more then thirty-six (38) teel high. (Chep. 32, Cary 2, Art 2, Sec.
341, Title B, Celitomla AOministretiva Code).
❑ As owner-builder, I will not employ anyone to do work whiCh would require e pertnit trom the Divibion ot IntluSMel Sefery, es noied above, unles9 BUCh peraon he9 B
permit to do such work frOm the divlslon.
Signature: Date:
Division of Intlusirial Safery Permit Number:
CERTIFlCATE OF COMPLIANCE lWD AUTHORIZATION OF ENTRV: I certity under penelry ol perjury thet I heve read this epplication enO state that the infortnetion given Is
correct. I egree to compty with ell stete lews antl ciry ordlnances relating to builElnp construciion, end euthorize represenlatives af Ihe Clry ol Caala Mese lo enler upon I�e
ebove-described property lor Inspectlon purposes. I egree not lo occupy or ellow occupency ot eny building euthorizetl by this pertnit until linel Inspection.
I Signeture Of Legal Owner(s�^ �
_\ ci�
�-7 AnNOr Authorized Appliwnt �
/
COOE t. INSPECTONTYPE .
1618 Fixed System Pinal Fire Prevention
1288 Pool Spa Final
200 Final Re-Root
201 Flnal BIocWRetaining Well
202 Finel Factory Fire PIaCe '
203 Final Sipn
204 Finel Domdltlon �
Q�g, �- Q�$ COpE I INSPECfION TYVE
206 Final Mechanical
m 20B Finel Plumbing
210 Final Electrical
212 Finel Fire Prevenllon
220 Finel Planning Approvel
222 Final Site
250 FinelBuilding�Occupancy
� D�
PAIE I[�L4
/7 •i'i�'o'% �r'
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ce.us
JobAddress: 555 ANTON BL
Suite: 2
Vicinity: 2ND FLOOR NETIFICE
Parcel Nunmber: � ' , , �
npp�icant: HOAGLAND, BRIAN
Address:
Zoning:
Phone: 949-439-1979
Z
77 FAIR DRIVE, COSTA MESA, CA 92626
A
ISSUED BY:
Status: ISSUED
Applied: 11222006
Issued: 12/042006
ip.
Owner: RREEF , ' �
Address PO BOX 4900 . .
'DEPT207 �- - � ` Phone: _ � �
. 'SCOTTSDALE, AZ . � - Zip: 852614900 -
ContraGlor. �� �� S ��AS .L%"IL � .
Address: � r
,. �l %�S'�/�,SI� A�1�-� Pno�a:, �'j cfy — �f3�'i — /�'/79
��`^'� �� I �� L cense:
S�a� f 73z3q�
SCOPE OF PERMIT
5,921 SF INTERIOR T.I. FOR "NETIFICE", 2ND FLOOR ONLY. WORK TO INCLUDE: NEW NON-LOAD
.BEARING PARTITION WALLS ref b06-01112
11 SP HEADS � ,
FEE SUMMARY
Plan Check: $27.17 Calc Valuation: Si,�oo.00
Permit: . �41.80 - , Claimed Valuation: s�,�oo.00
Other: $0.00 "" � "`� � � �
Total: $68.97
. . �;.::r, . ',"
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i,
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NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authonzed under this permit to be consideretl legal, such work must comply with all applicable codes, antl all
requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 754-5626 j
zaauas (eroo) �
,�
WORKERS'COMPENSAnON DECLAHArON: �
I herehy aHirm under penalry at perjury one ai t�e following declaratlons: �
❑ f have entl will meintain e certificate of consent to selt-Insure for workers' compensetion, as proWtletl tor by seclion 3700 of tha Lehor Code, tor Ihe pertormence of Ihe
—� wOrk tor which f�is permit i5 iuued.
❑ 7 heve antl wlll maintaln workere' compensetian insurence, es requiretl by section 3700 af the Lebor Code, for the perfortnance of the work tor which [his pertnit Is Issued.
r�,My.w kers' com ense�io� Insurence cerder end pollcy number ere:
Cerrie�=- ` �''UN �Policy�Number. � � �O� �'�
�(1i� rs sect on need not be comp/eted i! the permit is ve/ued et one huntlre dallers (5100) or less.)
cartity Ihet in t�e pertOrmance of Ihe wOrk for whiCh Ihis pertn s IssueQ I nol employ eny pareon in eny manner so as to Uecome 5ub�eCt lo tha workers'
compensetion lawa ' that II I sho Itl om u6�e o t workers' compensetlon provisions oi Sectlon 370 of e Labor Cotle, I shell forthwith
omDly wilh ihese provisions. � - �,,,,�/'
App6cen� Slgnat�re: �� Date-��'1 �� ti!�
WAPNINCi"FAILURETOSEWREWOPo(E RAGEISUNLA FULrWDSMALLSUBJECTANEMPLOVERTOCRiMINACPENALTIESMIDCMLFlNESUPTOIXJEHUNDRED
TVIOUSFND DOLLPRE (E100,000), IN ADDITION TOTHE W5T � ENSATIOH, D GES AS PROVIUED FOR IN SECTION 3'!OB Of iHE IABOR CODE, IMEREST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECIARATION:
I heraby aHirm that I em Ilce.ns�f u pW9i}f� s�f Chapler 9(commencing with Section 7000) of Dlvision 3 01 the
farce end ettecL LiCrN, �l� � S�/-b�� _ Cless
antl my license is in full
CONSTRUCTION CENDING AGENCW. �� '
❑ I hereby eflirm that ihere is e construction lending egancy for tha pertormance oi t�e work for which this Derml� Is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lenders Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Da�e:
I hereby efllrm ihet under penalry ol Derjury ihat I am E%EMPT FROM THE COMRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professions
Cotle: Any ciry or counry w�ich requires e pertnit lo canstruct, alter, improve, tlemolish, or repair any structure, Onor to its issuance, also requires the epplicant for such pertnit
to tile a slgned statement that he or she Is Iicensed pureuant ta the pmvislons of the Contrectors Ucanse Lew (Chepter e(commencing wit� Sectlon 7000) oi DlNslon 3 of the
Business entl Professlons Catle) or thet he or she is eaempt t�eretrom and the basis for the allagetl exemption. Any violaGon af Seclion 7037.5 by eny appllcant tor a permN
subjens Ihe epplicam Io e civil penalry c� nat more then Ilve hundred dollers (3500).): �
❑ I, es owner of the property, or my employees with weges es Iheir sole compensation, WILL 00 TME WORK, end the siructure is not intended or offereC for sale (Sec.
7044, eusiness en0 Professirns Cotle: 71�e Conirectors License Lew dces not apply to'an owner of property who builds or improves Ihereon, and who tloes such work
himsetl or herself or through his or her own employeas, provitletl that such improvements ere nol Intended or oMered for sele. I�, however, t�e builtling or Improvement is
sold withln one year of completion, ihe owner-builder will heve Ihe burdan oi proving that he or she did not bulid or improve tor purpose of sele.). �
❑ I, es owner ot the properry, am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct Ihe pro�act (Sec. 7044, Business antl Professions
CoCe: The contractors License Lew tloes not epply to en owner ol property who builds or Improves Ihereon, end who comracts tor such project wilh a contrectoqs)
license pursuant to tha Coniractors License Lews.). � -
❑ I em eaempt under sec. Business antl Protessions Code lor this reason:
SlqnaNre: Date:
Owner ID vertlied by dnver's license. ❑ Ves ❑ No Drivers License No.
Verification of Ownerehip by (rype oi document, i.e. - pmperty teu bill or tleetl):
Expires:
DIVISION OF INDUSTflIAL SAFETY PERMIT CERTIFICATION:
❑ I �ereby certily thet no excavation five (5) or more fael in depth into whiU a person is required to descend, will be matle in connection with work euthorized by this
pertnit, end that no DuilCin9 sLuqure, scattolAing, felsework, or demolition or dismantling theraoi, will be more than thirty-six (38) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title 8, Califomla Administrative Codej.
❑ As owner-builder, I wlll not employ enyone to tlo work which would raquire e partnit trom the Division ol Intlustnal Sefety, es noted above, unless such pereon hes e
permit to do such work from the division.
SigneWre: Date:
Division of Industnal Safety Permit Number:
CEHTIFlCATE OF COMPLIANCE AND AUTHOR¢ATON OF ENTRV: I certiry under penalty of perjury ihet I have read this application and state thet the infortnation given is
wned. I agree to comply with all stata lews and ciry nances reletlng to builtling construction, end euthodze represeniatives ot the City of Costa Mesa to eNer upon the
above-described property for inspection puryases. ree not to occupy or allow occupency ot eny building eutharized by Ihis pertnit until final inspection.
CQOE�• INSPECTIONTYPE //
1616 Flaed System Flnal Fire Preventlon
1266 Pool SOa Final .
200 Finel Re-Roof
201 Finel Block/Reteining Wall
202 Finel Facfory Fire Place
203 Final Sign
204 Final Demolition '
PA7F . 1ti�9L$
COUE� INSPEC710NiYFE
208 Final Mechenicel
208 Finel Plumbing ,
210 Final Electricel
212 Finel Fire Preventlon
220 Finfll Planning Approval
222 Final Site
250 FInalBuilding/Occupenq
pl.}1�CIIYICIF:
ia • �4•06 Gicw
►
(714) 754-5273 • Fax (714) 754-4856
� CITY OF COSTA MESA I '(} V
BUILDING DIV/S/ON I � 1 �'o
DEVELOPMENT SERVICES DEPARTMENT �� �
PERMIT
Job Address: 5S$ ANTON BL
Suite: 2
Vicinity: SECOND FLOOR
Parcel Number: 41050110
Applicant: DON SMITH
Address:
Ownec SAKIOKA FARMS '
Address �� . \ �� �
i � � i �
Contractor: ACCENT BUILDERS
P,ddress: 555 ANTON BL. #100
COSTA MESA, CA
Zip: 92626 �
Arcn : IA
Address: 3080 BRISTOL ST #105- � '
. . Phone: (714)754-1197
BUILDING PERMIT
Zoning:
Phone:
Zip:
PERMIT NUMBER
B00-00020
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01/O6/2000
Issued: O7 /21 /2000
Phone: ' �tT�i {.( r,
Zip: 94137 � E y,i li•�Y '�
. 3 ,
OA'1'E �.
Phone:� (714)549-3150
License: 397790
. Eng:
Address:
Phone:
COSTA MESA,CA
Zip: 92626 �" � , License: License:
� � � �_�
' SCOPE OF PERMIT
� 3,410 SF TI ON THE SECOND FLOOR FOR''EPOCH INTERNET". �
Plan Check:
� Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$110.30
$678.75
$0.00
$11.52
$0.00
$0.00
$800.57
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existina: o
NOTES:
Rear 0-0
Rear 0-0
Required: 0
FEE SUMMARY
PLANNING & ZONING
left 0- 0
LeR 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
$54,862.50
$52,soo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under lhis permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlona and final approval must be obtained. Failure to obtain inspections and final epproval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARATION:
I hereby ettirtn under penalry ol pe�ury one of Ihe following declaretions:
❑ I have and will maintain e certificaie ol conseni to selt-Insure lor workers' compensaiion, as provided for by section 3700 0l tha Lehor Code, for Ihe pertortnance of �he
ork tor which this pertnit is issuetl.
have and will maintain workars' compensation insuranca, as required by sedion 3700 ot ihe Lebor Code, for ihe peAormance of Ihe work for which this pertnit is issued.
My workers:compensajion Insur�ce qprrier epd policy number are:
Cerner.
(Th15 Sf
� I�
LICENSED
the
lam
PolicyNumher: L(/GG �
M(e perm i uetl one huntlred tlollers ($700) or /essJ
of t ork f r i Ihis permit is issued, I shall not employ eny person in any menner so es to ecome subject to the workers'
ree I oultl becoma subjact b the workers' compensation pwvisions ol Section 00 o iha Lahor Cotle, 1 shell forthwith
• ate: �� Zi �O
�
P TION C/JVERAGE IS UNIAW FUL AND SHALL SUBIECT AN E OYER TO CRIMINAL PENALTIES AND CNI� FlNES UP TO ONE HUNDRED
Nl E�ST OF COMPENSATION, DPANGES AS PROVIDED FOR IN SEClI E IABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCV:
9(cammencing with Section 7000) of Division 3 of Ihe Busines�5 and Professions Cotla, an0 my license is in tull
❑ I hereby affirm that there is a construction lentling agency for the pertortnance of the work for which this pertnit is issued. (Sac. 3097, Civil Cotle).
Lentler's Name: lender's Address:
Signaiure:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirm ihat under pen Ifl ty ot.perjury.that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, 8usiness and Professions
Cotle: Any ciry or counry';wh`I_cti r6quirgs�a perrnitdo construc6 alter, Improve, demolish, or repair any structure, prior to its issuance, elso requires the applicant tor such permit
to file a signed sietemeM tliat'h`e�oi she,is licensetl purjuent to the provisions ot the Contractors License Lew (Chepter 9(commencing wlth Section 7000) ot Dlvlsion 3 of the
Business and Professions Cotle) or ihe� ho or'she`+ie�exempt iherefrom antl the basis for Ihe elleged exempiion. Any violation ol Section 7031.5 by any epplicent for a permi�
sub�ects tha applicant to a civil penalty of not more than tive huntlretl tlollars ($500)J:
❑ I, es owner of the property, or my employeesnWth wages as Iheir sole compensation, WILL DO TME WORK, and the slructure is not intentletl or oHeretl lor sala (Sec.
7044, Business and Profeuions Code: The Coniractors License Law tloes noi appry to an owner ot property who builtls or improves thereon, and who does such work
himself or herself or through his or her own employees, provitletl t�at such improvements ere not intentletl or oHered for sele. It, however, the builtling or improvement is
soltl within one year of completion, Ihe owner-builder will have ihe burden of proving �he� he or she tlid not build or improve tor purpose of sale.).
❑ I, as owner ot the property, am EXCLUSIVELV CONTRALTING WITH LILENSED CONTRACTORS to wnsiruci the prolect (Sec. 7044, Business end Prolessions
Code: Tha contractors License Law does not apply to an awner ot properry who builtls or improves thereon, and who contracts lor such pmject with e contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Businass antl Professions Code for this reeson:
Signeture: Date:
Owner ID veritied by drivef5licen5e. ❑ Ves ❑ No Dnvers LicenSe No. Ezpires:
Venfication of Ownership by (type of tlocument, i.e. - property taa bill or deed�:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N:
❑ I hereby certity Ihat no excavetion tive (5) or more feet in depih into which a person is required to descend, will be made in connection with work authonzetl by this
permit, and that no builtling structure, scattolding, talsework, or demolitlon or tlismantling thereof, will be more than ihirty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, Califomia Atlministretive Code).
❑ As owneo-builder, I will not employ anyone ro do work which woultl require a permit from tha Division of Indus[rial Satery, es noted above, unless such person has a
permit m do such work from ihe division.
Signeture: Date:
Division of Indusirial Safery Permit Number:
CERTIFICATE OF COMPLIANCE AND AIfTTIORIZATION OF ENTAY: I cetlity under penalry of perjury ihat I have read this application and state ihat ihe informatlon given is
correct. I agree to comply with all le� nd dry ances raiating to builtling constmction, end authorize representatives of the City of Costa Mesa to enter upon ihe
abova-tlescnbed pmperry for i ecti ,pGrpqSes. gree not to occupy or allow occupancy oi eny building authorized by this permit unlil linal inspection.
COpE �, INSPECTIONTYVE "' pOjF INTRIRLS
1616 Fizetl System Final Fire Prevention
1266 Pool Spa Final
200 Finai Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Plece
203 Final Sign
204 Final Demolition
2d4&46
are
�� z/ � �
ae
LODE 1 INSPECTION TYPE
206 Final Mechanital
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
¢Ag INTITIpLS
(714) 754-5273 • Fax (714) 754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
2
41050110
Applicant: DON SMITH
Address:
Owner: , SAKIOKA FARMS
Address ,
CITY OF COSTA MESA '
BUILDING DIYIS/ON
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Contrecror: ACCENT BUILDERS
Address: 555 ANTON BL. #100
COSTA MESA, CA
ELECTRICAL PERMIT
�Phone:
Zip:
Phone:
Zip: 94137
' �_ Phone: (714) 5493150
� Zip: 92626 - ' �
License: 397790
PERMIT NUMBER
E00-00084
77 FAIR ORIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 02/03/2000
Issued: 02/03/2000
. SCOPE OF PERMIT
OVERTIME INSPECTION FOR SUNDAY 2/6/00 FOR RANDY BUCK FOR "EPOCH INTERNET' TI.
REF:E00-00049 & E00-00052 ,
`�
ISSUE FEE
Temp service test
Res, a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighling Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to 1hp
Motors to 10hp
Motors to 50hp
Motors to 700�p
Motors over 100hp
Communication drops
Sub panel to 200a
$23.50
$0.00
so.00
so.00
$0.00
$0.00
$0.00
50.00
so.00
so.00
so.00
so.00
$0.00
$0.00
$0.00
$0.00
80.00
$0.00
$0.00
$0.00
$0.00
Quantity
FEE SUMMARY ,
Temp Dist System / Lighting
Busway/100ft
Standing Section
Misc Electrical Equipment
Trensformers up to 1 kvalkw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva�kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Olher Electrical Fee
Investigation Fee
Plan Check Fee
Quantity
so.00 0
50.00 0
so.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1. 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO 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 considared legal, such work must comply with ell applicable codes, and all
requlreA Inepeetlone and flnal approval must be obtained. Failure lo obtain inspactions and final epproval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARATON:
I hereby eflirtn under penalry ot perjury one of the lollowing declarations: .
❑ I heva antl will maintain a certi(cate of cronsent ta selF�lnsure for workars' compensetion, as provided for by section 3700 of the Labor Code, for the pertortnance of the
work for whiCh IhiS permit is issued. '
❑ I have antl will maintain workers' compensallon insurance, as required by section 3700 ot Ihe Lebor Code, for the perfortnance ot the work for which this pertnit is issuetl.
My workers' compensation Insurence carner end policy number are:
Carrier:
(rnis se
I Certify �he� In the
compensation lews
comply with Ihese F
�1 Applicen� Signeture: ��
WARNINO: FAILURE TO $EC
iHOUSAND DdlARE (S500.
�
of
INl�DfTION
LICENSED CONTRACTORS DECLARATION:
I hereby attirm that I am
force entl eHect. Lic. a
ConnactoYs Signature:
/ Policy Number:
�ed e one ed dollers ($100) or /ess.J
for l this permit is issued, I shall not employ eny person in any menner so s to be ome sublect to the workers'
ia ' shoul ecome sub�ect to the workers' compensation provisions of Sectio 700 ojf '�e Labor Cotle, I shall forthwith
/ oe�e: �7 03 /o a ,
fION COVERAGE IS UNIAWFUL AND SHALL SU6IECT AN EMPLOVEP TO CRIMINnL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
ST OF CqMPEN$ATION, DAA41GE5 AS PROVIDED fOR IN SECTION 3%O60F THE Ll�BOR CODE. INiEREST, ANP ATTORNEY'S FEES.
(commencing with
on 7000) at Division 3 of ihe F
� Class 8
� Date: _
Code, and my license is in full
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirm that there is a constmction lending agency tor the performence of the work tor which this permit is issuad. (Sec. 3097, Civil Code).
Lentler's Name:
Signature: _
Lentle(5 Atltlress:
Date:
OWNER-BUILDER UECLARA710NS:
I hereby eflirtn ihat under penalry of perjury thai I am EXEMPT FHOM THE CONTRACTORS LICENSE LAW for tha following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which reQuires a pertnit to conswci, alter, improve, tlemolish, or repair any strucwre, prior ro its issuance, also requires ihe applicant for such permit
�o file a signed statement Ihat he or she is licensed pursuant to t�e provisions of Ihe Con�rectors License Law (Chapter 9(commencing wlth Section 7000) of Division 3 of the
Business and Professions Code) or ihat ha or she is exempt ihereirom and tha 6asis for t�e allege0 exemption. Any violation ot Section 7031.5 by any applicant tor e permit
sub�ects the applicant to a civil panalry ot not more than five huntlretl dollars ($500).):
❑ I, es owner ot t�e property, or my employees with wages as their sole compensation, WILL DO THE WORK, an0 the structure is not intentletl or otteretl for sale (Sec.
7044, Business and Protessions Code: The Contractors License Law tloes not epplY lo en owner of property who builds or improves Ihereon, and who does such work
himself or herself or through his or her own employees, provided that suc� improvements are not intentled or oMeratl for sele. It, however, the building or improvement is
sold within one yeer of completion, the owner-builder will have the burden of proving thet he or she did not build or impmve for purpose of sale.).
❑ I, as owner of ihe propehy, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe project (Sec. 7044, Business and Professions
Code: The contrectors License Lew does nol apply to an owner of pmperty who builtls or improves thereon, and who contracts for such project with a contractor(s)
license pursuent to the Goniracbrs License Lews.).
❑ I em e:emp� under sec. Business and Profassions Co�e for this reason:
Signa�ure: Date: �
Owner ID verified by drivefs license. � Yes ❑ No Drivers License No. Expires:
Vaniication ot Ownership by (type of document, i.e. - properry tax bill or deed):
OIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
❑ I hereby certlry ihat no excavation five (5) or more feet In tlepih into which a person is required to descend, will be made in connection with work authorizetl by ihis
permit, and ihet no builtling strudure, scettolding, felsework, or demolition or tlismamling thereof, will be more then thirry-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celifornia Administrative Code).
❑ As owner-builtler, I will not employ anyone to tlo work which would require e permit Irom Ihe Division oF Industrial Safery, as notetl ebove, unless such person has a
permit to do such work irom tha tlivision.
Signawre: Daie:
Division of Industnal Safery Pertnii Number:
CERTIFICATE OF COMPLIANCE AND AUh10flIZATON OF ENTRY: I certity under penalty of perjury �hat I have read Ihis application and state Ihat �he information given is
correcL I agree to comply II state laws and city nces relating to bullding consiruction, antl authorize representatives ot the City ot Casia Mesa lo enter upon Ihe
above-tlescnbed oro for in ectioy-pGdases. rea not to occupy or allow occupancy of any bullding auihodzetl by this pertnit untilJ'rt5�1 inspection.
CODEN. INSGECTIONTYPE �� E
7616 Fized System Final Fire Preventlon
1266
200
207
202
203
Pool Spa Final
Final Re-Roof
Final BIocWRetaining Wall
Final Fectory Fire Plece
Final Sign
204 Final Demolition
2448-ae
INfRIpLS y,QQE,K INSPECTIONTYPE
206 Final Mechanicel
208 Final Plumbing
210 Finel Elec�riwl
212
220
222
250
Final Fire Prevention
Final Planning Approval
Final Site
Final Builtling/Occupancy
PAIE 1tffII1SL$
. /(�] i / � i
• q��'.
� :.:.::n ; :
�,
;`:,.� '
(�ia) �sa-sz�s • Fex (714) 754-4856
Job Address:
Suite No
Vicinity:
Parce1 Nunmber:
0
�,
CITY OF COSTA MESA ��'
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
555 ANTON BL
2
41050110
Applicant: TERRY FULFORD
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA
,/" /
Owner: �,�SAKIOKA FARMS "_�t
Address � � � � .
Contracror: O'BRYANT ELEC7RIC
Address: 8749 SHIRLEY AV
NORTHRIDGE,CA��. �
0
ELECTRICAL PERMIT
. Phone: 878-407-7986
Zip: 91324
Phone:
Zip: 94137
, � ''�Phone: 818-4W-1986 ,
. � Zip: 91324
License: 386619
PERMIT NUMBER
E00-00049
i •
77 FAIR DRNE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01/24/2000
Issued: 01 /24/2000
L�
• SCOPE OF PERMIT �
� - 60 LIGHTS, 50 OUTLETS,�25 SWITCHES AND 40 COMM DROPS FOR SECOND FLOOR TI FOR "EPOCH �
INTERNET' - ' � - "
REF:B00-00020
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)�-
New Res (3+unils)
Pool / Spa
Lighting Fixts ,
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to ihp
Motors to 10hp
Motors to 50hp
Motors to 100hp �
Mo[ors over t00hp
Communication drops
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
549.20
$41.90
$23.65
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
534.60
FEE SUMMARY �' �
Quantity
0
0
0
60
50
25
0
0
0
0
0
0
0
0
0
0
40
Temp Disl Syslem / lighting
Busway /100 ft
Standing Section
MisdElectrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kvalkw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor
Ciras ( gen or ride)
Circus (mech ride or lighls)
Christmas Tree Stand
Fireworks Stand .
Other Electrical Fee �
Investigation Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 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 1 BO days.
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requfred inapeetiona and tlnal approval must be obtained. Failure to obtain inspections and final epproval will result in the expiretion of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
WORKEflS'COMPENSAnON DECLARAnON:
I hereby attirm under penaliy oi perlury one oi �he following tleclaretions:
❑ I h antl will maintain a certificate of consent to self-Insure for workers' comDensation, es provided tor by sectlon 3700 of ihe Labor Cotle, for the peAormance of ihe
__ ork for which this vermit is issued.
will maintain workers' compensation insurance, as raquired by section 3700 ot the Lebor Code, for Iho pedormance ot the work for which this permii is issued.
- � N S . .'Poli Number. � � �` �� 7�J U
one hundred dollers ($100J or /ess.J
❑ I certify that in lhe peAortnance of the wod tor which ihis permit is issued, I shall not employ any pereon in any manner so as to become subject to Iha workers'
compensa�ion laws ot Califor i'�, end eggg���r�et if I shoultl 6ecome subject ro the workers' compensation pmvisions of Section 3700 of the Labor Cotle, I shall forthwith
, om�l . Wit�h thesa pr.ovi��� �
Applicani5iqnature: -'�'7 l�� .:.Date: .-l—L� a��
WNRNING: FAILUFE TO SELURE WORKERS' CO SATION �pVEMGE IS UNLAWFUL AND SMFLL SUBIECT AN EMPLOYER TO GRIMINAL PENALilES nN� pVIL FlNES UP TOONE HUNDRED
THWSAND OOLLARE (5100.000I. IN AOOfiION TO THE COST OF COMPENSATION, DAMAGES PS PHOVIDED FOR IN SECfIQ`131W OF THF LABOR COOE. INTEREST, AND ATiORNE1"S FEES.
LICENSED CONTRAC70RS DECLARATION:
I hereby aftirm t censed under provisions ot Chepter 9(commencinq with Section 7000) ol Division . iQess antl Protessions Cotle, antl my license is in full
forceandeNect Uc-# � �n�i�l l'I A� ��;s(#�r� �i� n
•oniractF�O ofs�S'q atuj„� _ O / /—t o u
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn thet �here is a consiruction lending agency lor Ihe peAormance of Iha work br which this pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lentlefs Name: Lentlers Atltlreu:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirtn that under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or county which requires e permit to constmct, elter, improve, tlemolish, or repair any sWcture, prior to its issuance, also requires the applicant for such permii
to file a signed statement that he or sha is licensed pursuent to the provisions ot the Contradors License Lew (Chepter 9(commencing wlth Section 7000) of Division 3 at the
Business antl Professions Code) or ihet ho or she is exempi t�eretrom and Ihe basis lor Ihe ellegetl aaempiion. Any Nolation of Section 7031.5 by any applicani lor a pertnii
subjecis the apP�icant to e civil penelry af not more than five huntlretl tlollars (5500).):
❑ I, as owner of the property. or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intendetl or ottered for sale (Sec.
7044, Business entl Protessions Code: The Contrectore License Lew does not apply to an owner ot properry w�o builds or improves thereon, antl who does such work
himself or herselt or through his or her own employees, provided Ihet such improvements are not intended or oflared tor sale. tl, however, the builtling or improvement is
sold within one year oi completion, tha owner-builder will heve the burden of proving ihat he ar she did not build or improve for purpose af sale.).
❑ I, as owner of t�e property, em EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the projact (Sec. 7044, Business and Professions
Code: Tha contrectors License Lew tloes not apply to en owner oi property who builtls or improves thereon, entl who contracis for such project with a contractor(s)
license pursuani to the Camrectors License Laws.).
❑ 1 am exempt untler sec. Business and Professions Code for this reason:
Signature: Date:
Ownar ID verilied by driver's license. ❑ Ves ❑ No Onvels License No.
Ventication of Ownership by (type of tlocument, i.e. - propeny tex bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION:
❑ I hereby certily ihet no excavetion live (5) or more feet In tlep�� into which e person is requlred to descend, will be made in connection with work authorized by ihis
permit, antl Ihat no building siructure, scattoltling, felsework, or demolition or dismantling t�ereol, witl Ge more than thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sac.
341, Ttle 8, Celifornia Atlministretive Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require e permit irom ihe DNision of Industrial Safety, as notetl a6ove, unless such person has a
pertnit to tlo such work from the division.
SignaWre: Date:
Division of Indusinal Safety Pertni� Number:
CERTIFlCATE OF COMPLIANCE AND AIfTHORIZA710N OF ENTHY: I certify under penalry of perjury ihat I have read this application and state Ihat the information given is
correc�. I agrea to comply with all stete lews and city ordinences relatinq to builtling consWction, and authonze represen�alives of the Ciry ot Casia Mesa lo enter upon the
above-tlescribed propeny tor inspection purpases. I egree not to occupy or allow occupancy oi eny building authorizetl 6y this pertnit until tinal inspection.
CQOE �. INSPECTIONTYPE
1616 Fixed System Final Fire Preveniion
1266 Pool SOa Final
200 Final Re-Root
201 Final BIocWRateining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
2a68A6
2A7E
ixrrtu�s CODE� iNsvernoNTrve
206 Final Mechanical
200 Final Plumbing
210 Final Electrical
212
220
222
250
Final Fire Prevention
l-�' �'-oe�
�Dare "�
_�E ., L—
� R L�
Final Planning Approval
Final Site
Final BuiltlinglOccupancy
(»a) �sa-sz�s • Fax (�ia) �sa•aess
`
CITY OF COSTA MESA � '�
BUILDING DIVISION
DEVELOPMENT SERVICES DEPAfiTMENT
PERMIT
Job Address: 555 ANTON BL
Suite No 2
Vicinity: 2ND FLOOR
Parcel Nunmber: 41050110
Appliwnt: STEVENS, DON
Address: 1940 GARDENA
GLENDALE,CA �
ownei: SAKIOKA FARMS .
Address � � �
PLUMBING PERMIT
Phone: (818)500-1940
Zip: 91204
Phone:
Zip: 94137
Contracror. MUIR-CHASE PLUMBING
Address: 1940 GARDENA � , - � /
- � - � � �, Phone: (818) 500-1940
GLENDALE, CA - Zip: 91204
� . License: 539835
Arch / Eng :
Address:
PERMIT NUMBER
P00-00042
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01/24I2000
Issued: 01I24I2000
• . Phone:
Zip:
' - ' �� � "License: � - � � � .
� -
SCOPE OF PERMIT
PLUMBING PERMIT FOR OFFICE T.I. FOR -EPOCH- (2ND FLOOR), INSTALL 1 P-TRAP & 1 TRAP
PRIMER.
REF: 800-00020
REF: B00-000
ISSUE FEE
BackFlow irriga[ion
BackFlow Preventer
BathWb
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor �
Drain, Rainwater
Drein, Roof
AMT
523.50
$0.00
$0.00
$0.00
50.00
50.00
$0.00
50.00
$0.00
50.00
50.00
FEE SUMMARY
QTY AMT
Laundry Tub I Washer $0.00
0 Landscape Irrigation $0.00
0 P-Trep $9.80
0 Pressure Regulator $0.00
0 Prowss Piping (per 10 R) $0.00
0 Receptors 50.00
0 Septic Tank $0.00
0 Sewer Cap for Demo� $0.00
o SewerCannect So.00
0 Sewer Private Line $0.00
0 Shower $0.00
QTY
0
0
1
0
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(7-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Sel
Waste and Vent System
Water Closet (foilet)
Water Heater / vent
AMT
50.00
50.00
39.80
50.00
50.00
50.00
50.00
80.00
50.00
50.00
50.00
QTY
0
0
1
0
0
0
0
0
0
0
0
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 780 days.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all epplicable codes, and ali
requlred Inepeetlona end final epproval must be obteined. Failure to obtain inspections and final epprovel will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DELLARATION: .
I here6y attirtn untler Denalry oi perjury one of the tollowing dedaretions:
❑ I have and will maintain e certificate of cons�nt ro self-Insure for workers' compensation, es provided for by section 3700 oi Ihe Lebor Code, for the pertortnance oi the
wark tor which this permit is luued.
+� I have and will maintain wwkers' oompensa�pn insurence, as requiretl by section 3700 of the Labor Code, tor ihe pertortnance ol ihe work fo� which t�Ls permll I5 issugd.
My workers' compenselion Inwrence carrier and policy number ere:
Cerrier: �,G�L � Policy Number: WG S�� O S 3�
(This section neeC not De cromp/etetl ii the permit is valued et one �undred dollars ($100) or less.)
❑ I�certity that in the pertortnence ol the worh for which Ihis permit Is issued, I shell not employ any person in eny menner so es Io beCome subl�� �a Ihe workers'
compensation laws oi Celiforrua, antl agree that if 1 should become sub�ect to Ihe workers' compansation provislons ol Section 3700 0l the Lebor Cotle, I shall toM1�wit�
wmply with these p�r �
Applicam Signature: C✓ti.�--- �� Dete: �'� z�—�d
WAPNING: FAILURE TO SECURE WORKERS' CpAPEN5p7�pry �pyERAGE IS UNLAWFUL AND SHNLL SUBJECf AN EMPLOVER TO CFIMINAL PENALTIES PND CNIL FlNES UP TO ONE HUNURED
THOUSAND OOLLr1RE (5100,OW), IN A�DITION TO iHE Cp$T OF COMPENSATION, DAA41GE5lS PROVIDED FOR IN SECTION 31O60F THE IABOR WOE, INiEREST, AND ATTORNEY5 FEES.
UCENSED COMRACTORS DECLARA710N:
I hereby aNirtn that I em licensetl untler provislons of Chapter 9(commencing with Sectlon 7000) ot Divislon 3 of ihe Buslness ntl Professions Gode, entl my license is in tull
torce an0 eHect. Lic. M Class a L� - 3 G
ContracbfsSignawre: ��� Data: /— �SL-00
CONSTRUCTION LENDING AGENGY:
❑ I hereby aHirtn that there is a construction IenCing agency for the peAartnence of the work for which Ihis permit Is IssueG. (Soc. 3097, Civll Code).
Lentlers Name: Lentlels AtlCress:
Signature: Date:
OWNER-BUILDER DECLARAT10N5:
I hereby aHirm that under penalry of pe�jury iha� I gm EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Set. 7031.5, Business end Prolessions
Code: Any ciry or counry which requires a pertnit Ib construci, alter, improva, demolish, or repair eny siructure, prior to Its Issuance, also requires tha eppliwnt for such permii
to tila e signed statement t�at �e or she is licensetl pursuant �o tlie D����s of the Canirectors License Law (Chapter 9(commencing wlih Sectlon 7000) of Divisian 3 ot the
Business and Professions Cotle) or ihal he or s�d is exempt therefrom entl t�e basis lor lhe alleged exemption. Any violetion oi Section 7031.5 by any applicant tor e pettnit
subJecis ihe a0�licant to a civil penalry oi not more Nan tive hundred ddlars (5500)J:
❑ I, as ov+ner of tha properTy, or my employees with wages as Neir sde oompensation, WILL DO THE WORK, and the structura Is not Intentletl or otteretl lor sele (Sec.
7044, Business end Pmlessions Cotle: The Contracbrs License Law tloes not apply to an owner ot propetly who builtls or impmves t�ereon, end who does such work
himself or herselt or through his or �er own Bmpbyees, provided Ihat such improvements are not intended or oHaretl lor sale. If, �owever, the building or improvement is
sold within one year oF completion, the owneo-builder will have the burden ot proving that he or she did not build or improve for purpose oi sale.j.
❑ I, as owner af the property, em E%CWSNELY CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, 8usiness entl Professions
Cotle: The contractors License Law tloes not aOPN �o an owner ot property who builtls or improves Ihereon, entl w�o contracis lor suc� project with a contractor(s)
license pursuant to Ihe Contrectors license Laws.).
❑ I am exempt under sea Business entl Professlons Cotle for this reason:
Signa�ure: Date:
Owner ID veritied by Unvefs licanse. ❑ Ves ❑ No Drivers Licensa No.
Venfiwtion ot Ownership by (rype of tlocument, i.e. - property taz bill or Oeetl):
Ezpires:
DIVISION OF INDUSTRIAL SAFETV VERMR CERTIFICATION:
❑ I hereby certlty that no exrevetion Me (5) or more leet in Oept� inta which e person Is reQuired to descenG, wlll be matle in connection wl�h work aut�orizetl by INs
pertnit, and that no builtling struciure, scaHolding, falsework, or tlemolition or dismantling thereol, wlll be more Ihen ihirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Calitomia Adminisiretive Cotle).
❑ A5 owner-builder, I will not employ enyone t0 Go work whic� would requlre a permit Irom the Division of Intlustrial Sefety, es notetl abava, unless such person hes a
permit ta do such work tmm the tlivision.
Signature: Date:
Division ol Intlustnal Safety Permlt Number:
CERTIFlCATE OF COMPLIANCE AND AllTHORqAT10N OF ENTAY: I cenily under penelry of perjury that I �eva reatl this application antl state that Ne intortnation given is
cortecc I egree to wmplY wit� all state laws enC dry ordlnances relaHng to bullding conswction, and authodze representatives of ihe Ciry ot Casta Mesa to enter upon the
ahove�tlescribed properry tor insDeciion purposes. I agree not to occupy or ellaw occupency oi any builtling authorizetl by t�is pertnit until �Inal inspecilon.
�ignaWre Ot Legal4wner(s) Date
,. � "' �`ti�7
AndOr Authonzetl Applicant Da�e
GODF I. INSGECTIONTYVE
1616 Fized System Final Fire Prevenilon
1266
200
201
202
203
Poal Spa Finel
Finel Re-Raol
Final BIocWReteining Wall
Finel Fectory Fire Place
Final Sign
204 Flnal Demolilion
24a&ae
ps¢, �L$ �iQpEd INSPECTIONTYVE
206 Final Methenical
200 Final Plumbing
210 Finel Electdcal
212 Final Fire Prevention
220 Final Plenning Approval
222 Finol Slio
250 Final BuildinglOccupency
� 1[��
�»a) �sa-sz�s • Fax (�ia) �sa-aess
CITY OF COSTA MESA -'
BUILD/NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
MECHANICAL PERMIT
Job Address: 555 ANTON BL
Suite No 2
Vicinity:
Parcel Number: 41050770
Applicant: LOU RODRIGUEZ
Address: 6265 SAN FERNANDO RD
GLENDALE,-CA
Owner: . SAKIOKA FARM& �
Address: � � " - �
Contractor: AIR CONDITIONING CO., INC
Address: , 6265 SAN FERNANDO RD
Phone: (818)244-6571
Zip: 91201
Phone:
Zip: 94137
� � � . . . Phone:" (818) 244-6571
GLENDAIE , CA r�� �,i " Zip: 91201
� � � � \ ." . .:License: 120696
, �.
Arch/Eng: i�
, Addrese: ; �' . �
Phone:
Zip:
" . . . rtLicense:
PERMIT NUMBER
M 00-00043
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/26I2000
Issued: 01/26/2000
ISSUEDBY: XOo/
SCOPE OF PERMIT
� ' INSTALL 1 VAV BOX AND 1 REPAIR/ALT COOLING/HTG SYSTEM FOR "EPOCH INTERNET' TI.
SUBJECT TO FIELD�INSPECTION. _ � � �� , � `- . - - -- ' ' ' ,
REF:B00-00020 _ � - � - -- � ' �
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair / Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <700 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < t0000cfm
Quantiry
$23.50
$0.00 0
$0.00 0
$13.70 7
50.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$10.65 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
FEE SUMMARY
�- �� - Repair / Alt Absorbtion Unit
. Repair/AltRefrigerationUnit
Ventillation System
- Evaporative Cooler
Commercial I nci neretor
Domestic Incinerator
Compressors I Absorption Systems
= Upto3hp/t00kBTU
3 Ta 15 hp / 500 k BTU
�' 15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
' 3To15hp
15 to 30 hp
' ' 30 to 50 hp
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
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, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlona end finel epproval must be ob�ained. Failure to obtain inspections and final approval will result in the expiration oF �his permit.
FOR INSPECTIONS CALL: (714) 7545626 �
WORKERS' COMPENSATION DECLARATION:
I hereby attirm untlar penelty of perjury one of the following declarations:
❑ I have antl wiil maintain a certifiwte of conseN to seli-Insure tor workers' compensation, es provitletl tor Dy section 3700 ot the Labor Cotle, tor ihe pedo�mance ol ihe
work tor which this permit is Issued. �
�I have and will meintain workers' compensation insurance, as reqWretl �y section 3700 ot the Lebor Code, for the pertormance of ihe work for which this permit is issuetl.
My workers' com ensation Insur nce carrier end poliCy number ere:
Carner: Z�i�/r/l� PolicyNumber,���%�U�
(This section need not be comp/eted il the permir is velued af one hundred tlollars ($100) or less.)
❑ I certity that in the peAormence of the work for which this permit is issuetl, I shall not employ any person in any manner so as to become subject to the workers'
cnmpensalion law oi Californla, and agree that if I shoultl become subject to Ihe workers' compensetion provisions of Section 3700 of the Lebor Cotle, I shall fort�with
camply with e pr isions.
Applicant Sign ra: � Dete: — J
WARNING: FAILURE TO URE WORKERS' COMPENSATI / OV RAGE IS UNLAWFUL AND SHFLL SU&IECT AN EMPLOVER TO CRIMIN PENALTIES AND CIVIL FINES lIP TOONE HUNDRED
THOUSANDDOLLARE($t00,OW�,INADDRIONTOTHEC05 F(�IIPENSATION,DAAV�GESASPROVIDEDFORINSECiiON3lO80FTHElABORWDE,INrEREST.ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm ihat I am licensed under provisions oi
force and eflect Lic. a
Contractors Signature:
9(commencinq with Section 7000) of Division 3 of the Business antl Professions Cotle, antl my license is in tull
CIasS k /_ � F.D
�_ Dete: t/ — � l _�,�
CONSTRUCTION LENDING AGENLV: // V
❑ I hereby aHirtn thet there is a construc�ion Ientling agency tor Ne peAormence ot the work tor which this permit is issued. (Sec. 3097, Civil Code).
Lentler's Name:
SignaWre: _
OWNER-BUILDER DECLARA710NS:
Lendels Addreu:
Date:
I hereby aHirtn ihat under penalry of perjury Ihai I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing raason (Sec. 7031.5, Business antl Professions
Cotle: Any ciry or counry which requires a pertnit to construct, elter, improve, demolish, or repair any strucWre, pnor to its iuuance, elso requires ihe applicant tor such permit
to lile e signed statement that �e or sha is licensed pursuem to the provisions of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the
Business antl Protessions Coda) or Ihat he or she is exempt theretrom and the 6asis far the allegetl exemption. Any violation of Section 7037.5 by any applicant for a pertnit
subJects the applicant to e civil penelry ot not more than live huntlretl dollars (5500).):
❑ I, es owner of the property, or my employees with wa9e5 as their sole compensalion, WILL DO THE WORK, and the structure is not intentletl or offeretl for sale (Sec.
7044, Business end Prolesslons Code: 7�e Contraciors License Lew does not apply to an owner of properry who 6uilds or improves thereon, and who dces such work
himself or herselt or t�mugh his or her own employees, pmvided thet such improvements are not intentletl or oHered for sale. If, however, Ihe builtling or improvemeni is
sola within one yeer ot completion, the owner-builder will have the burden oi proving that he or she did not build or improve tor Durpose oi sale.).
❑ I, as owner of t�e properry, em EXCWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Protessions
Code: The conirectors License Lew �oes not apply to en owner of property who builds or impmves thereon, and who contracts for such projecl with e contracbr(s)
license pursuant to the Contrectors License Lews.).
� I em e:empt untler sec. Business and Professions Code for this reason:
SignaWre: Da�e:
Owner ID venfietl by dnvefs license. ❑ Yas ❑ No Dnvers License No.
Veritication of Ownership by (type oi document, i.e. - property tax 0111 or tleetl): �
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
Expire5:
❑ I hereDy cehih/ that no excavation five (5) or more taet In tlepth into which e person is required to descenQ will be made in connedion with work authorized by ihis
pertnit, end ihat no builtling strucWre, scaHolding, felsework, or demolition or dismantling Ihereof, wltl be more ihan ihirry-six (36) feet hig�. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, Calitornia Atlministrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit irom ihe Division oi Intlusirial Safety, as notetl above, unless such person has a
pertnit to do such work Irom Ihe tlivision.
Signature: Date:
Division of Indushiel Setery Pertnit Number.
CERTFICATE OF COMPLIANCE AND AUTHORVATION OF ENTAV: I cenify under penalry of perjury ihat I have read this application and state that Ihe intorma�ion given is
correcc I agree to wmply wilh all state laws and ciry ortlinances relating �o builtling conswciion, and authonze represematives of Ihe Ciry of Costa Mesa to emer upon the
above-tlescribed Dmpeny lor ins0ection purposes. I egree not to occupy or allow acupancy ol eny building authodzed by this pertnit until final inspection.
Of Legal
CODE t. INSPECTONTYPE QA7E IISI�L¢
1616 Fixetl System Final Fire Preveniion
1266
200
201
202
203
Pool Spe Final
Final Re-Roat
Final BIocWRetaining Wall
Finel Fectory Fire Plece
Finel Sign
204 Final Demolition
244&a6
COpEr �NSPECTIONTYPE
206 Final Mechanical
20B
210
212
220
Final Plumbing
Final ElecMwl
Final Fire Prevention
Final Planning Approval
222 Final Site
250 FinalBuilding/OCCupancy
Date
�O.
Date
_� INi1TIR S
�
(714)754-5273 • Fax(714)754-4856
Job.4ddress: 555 ANTON BL
Saite No 2
Viciniry: 2ND�FLOOR
Parcel Nunmber: 41050110
Applicant: STEVENS, DON
Address: 1940 GARDENA
GLENDALE,CA�� ,
OwneF. SAKIOKA FARMS
Address �
CITY OF COSTA MESA
BUILD/NG D/VISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
PLUMBING PERMIT
, Phone: (818)500-1940
� Zip; 91204� ,
Contractor: MUIR-CHASE PLUMBING
Address: 1940 GARDENA � � ^
r
' /_' .
� GLENDALE, CA . � '
Arch / Eng :
� Address:
.
1 TRAP PRIMER.
REF: B00-00020 & P00-00042
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
qariiier System
Connect (Ice$oda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwa[er
Drain, Roof
Drinking Founlain
Expansion Tank
Phone:
Zip: 94137
/! .-
Phone:. (818)500-1940
Zip: 91204
License: 539835
J
0
PERMIT NUMBER
P00-00060
77 FAIR ORIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01/31/2000
Issued: 01131/2000
Phone:
Zip:
. . ' �"License:,- -- ' ..
SCOPE OF PERMIT
SUPPLEMENTAL ELECTRICAL PERMIT FOR T.1. FOR -EPOCH- (2ND FLOOR). INSTAIL 1 P-TR4P &
AMT
$7.25
so.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
�.
FEE SUMMARY
�TY, AMT
Laundry Tub I Washer $0.00
0 Landscape Irrigation $0.00
0 P-Trap $9.80
0 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
0 Receptors $0.00
0 Septic Tank $0.00
0 SewerCapforDemo $0.00
0 . Sewer Connect $0.00
� 0 . Sewer Private Line � - $0.00
0 �Shower $0.00
0 Sink, bar � $0.00
0 Sink, wmmercial $0.00
QTY
0
0
1
0
0
0
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
AMT
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
QTY
0
0
1
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (OYd. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS; In order for ihe work authorized under this permit to be considered legal, such work must comply wi�h all applicable codes, and all
requlred inspectlona and flnel approval must be obtainad. Failure to obtain inspections and final approval will result in ihe expiretion of lhis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON UECLARAnON:
I hereby aHirm unCer penelry of perjury one of the tollowing tleclarations:
❑ I have antl wlll malntein a certiiicete ot consent to seli-Insure tor workers' compensetion, es provided for by section 3700 of the Lebor Coae, for the pertortnance of the
wark tor which t�is pertnit is isguad. '
'[{_ I �ave and wlll maintein workers' compensatlon insurance, az require0 by section 3700 01 Ihe Lebor Code, fw tha peAormance ot the work br which Ihis pertnit is issued.
' My workers' compensation InsVrance wrtier and policy number are:
Cerder. �,UGO PolicyNumher. �CSI�US�g
(This secfion need wt be campleted i! Me peimit is ve/uetl af are hundred dollars ($f00) or Ie55.J
❑ I certiy that in the peAormance of Ihe work for which t�is pertnit is issued, I shall not employ eny person in any manner so as to become sublect lo Ihe workers'
crompensetlon laws of California, and agree that ii I should become suDject to the workers' compensation provisions of Seclion 3700 of the Labor Cotle, I shall torthwith
compty wit� these prov
Applicant Signature: � - Date: �— ��— � O
WARNING:FAILUPETOS UREWORK�RS'COMPENSATIONCOVEMGEISUNLAWFULANDSHNLLSU6IECTANEMPIOYERTOCRIMINALPENALTIESANDGVILFINESUPTOONEHUNDRED
T/IOUSPND OOLLARE (5100.000), IN ADO17�pry TO iHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3)O60F THE LABOR CODE, IMEREST. AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLqqp710N:
I hereby aHirm ihat I em licensed
force antl eflecL LIc. »
Contracrofs SlgneNre: �
9(commencing with Section 7000) of Dlvision 3 of the Business and Prolessions Code, and my license is in tull
Class a i� �- 3 .�i
Date: r -� �— n [7 .
CONSTRUCTION LENDING AGENCV:
❑ I here6y aHirm thet there is e construc�ion lending agency tor the pertormence of the work for which this permit is issued. (Sec. 3097, Civll Code). ,
LentleYs Neme: Lentlels Atltlress:
Signeture: Date:
OWNER-BUIL�ER OECLAFATIONS:
I �ereby aHirm that under penalry of perjury ihat I am EJ(EMPT FROM THE CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or county which repuires e pertnit ro consWct, alter, improve, demolish, or repair any structure, prior Io its issuance, also reqWres iha appliwnt for such permit
to File e signed statement Ihat he or ghe is licensed pursuant lo the provisions of the Contractors lJcense Law (Chapter 9(commenCing wlth Section 7000) ol Division 3 of the
eusiness antl Pmtessions Code) or thet �e or she is eaempt Ihereirom en0 the basis for t�e alleged exemption. Any violation of Sectlon 7031.5 by eny applicant tor a permit
subjects tha applicant to e ciWl penalty oi not more than /lve hundred dollars ($500).):
❑ I, as ownar of Ihe O�aOerty, or my employaes with weges as Iheir sole compensalion, WILL DO TME WORK, and the siructura is nat iniended or offeretl lar sale (Sec.
7044, Business entl Professio�s Cotle: The Contractors License Law tloes not apply to en owner of properry who 6uiltls or improves thereon, entl who tloes such work
himself or herseN or ihrough hi5 or her own employees, provided that such improvements ere not intentletl ar aHered tor sale. II, however, tha building or improvement is
sold within one year oi completion, the owner-builtler will have the hurden of proving thet he or she did not 6uild or improve tor purpose ot sele.).
❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business entl Professions
Cotle: The comrecbrs LicensB Lew does not epply to an owner of property who �uiltls or improves ihereon, and who contrecls br such project wit� e contractor(s)
license pursuent to the Contraators License Laws.).
❑ I am ezempt under sec. Business end Professions Code for this reason:
Signeture: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drlver's License No. Ezpires:
Veritication of Ownership by (type of document, i.e. - property taz bill or deed�:
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION:
❑ I hereDy certify t�at no excavatlon tive (5) or more feet in depth into which a person Is requiretl to descend, will be made in connectlon with work euthorized by this
permit, end ihat no builtling strUctura, scafFoltling, falsework, or demolitlon or dismaniling thereoi, will be more Ihan ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Tule B, Celifomia Adminisiretive Code).
❑ As owner-builder, I will not employ anyone to do work which woultl require a permit from Ihe Division oi Industrial Safery, as notetl above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Indusirial Safery Permit Number:
CER7IFICATE OP COMPLIANCE AND AUhiORIZATON OF ENTRV: I certify under penalty of perjury ihat I have read this application antl state that the information given is
wrrect. I agree to comply with all state laws and ciry ordinances relating �o bullding consiruction, end authorize representatives ot ihe Ciry of Costa Mesa to enter upon tha
ebove-descnbea pmperty tor inspection purposes. I agrea not to occupy or allow occupancy oi eny builtling authorized by this permit until Ilnel inspection.
�Signatur LegalOwner(s) `Date
�..._. �!1-�a�.�— ' � � � —li�
Antl/Or'quthorizetl Applicam Date
COpE�. INSGECTIONTYPE 1J,9jE �$
1616 Fixed Sysiem Final Pire Pr�vention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demolilion
2446-46
LO�EI INSPECTONTYGE
206 Final Mechanical
20B Final Plumbing
210 Final Eleciricel
212 Final Fire Preveniion
220 Final Planning Approval �
222 Final Site
250 Final Builtling/Occupancy
Pdg �
/ O �
(714) 754-5273 • Fax (714) 754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
2
COMPUTER ROOM
41050110
CITY OF COSTA MESA "�
BlIILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
npp�icant: TERRY FULFORD
Address: 8749 SHIRLEY AV
NORTHRIDGE, CA . "
owner: ; SAKIOKA FARMS �. -. .
Address , . � � _ � .
ELECTRICAL PERMIT
� Phone: 818-407-1986
Zip: 91324
Phone:
Zip: 94137
' Contrecror: O'BRYANT ELECTRIC �
Address: 8749 SHIRLEY AV � �
� � - � �'��Phone: (878)407-1986.
� � , _
NORTHRIDGE, CA ' � Zip:- 91324
' . � � License: 386619
PER NUMBER
00-00050
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: Ot124/2000
Issued: 01/24/2000
ISSUED BY: _�
SCOPE OF PERMIT
. 75 LIGHTS, 110 OUTLETS, 6 SWITCHES„1 400 AMP DISCONNECT, 3 COMM DROPS, 2 200 AMP
SUB-PANELS AND 1 UPTO 100 KVA TRANSFORMER FOR SECOND FLOOR COMPUTER ROOM TI FOR
"EPOCIiINTERNET' �
REF:B00-00022
<
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets -
Switches
Non Res Appl
Res Appl
Service l0 200a
Service to 7000a
Service over t000a
Motors to 1hp
Motors to 10hp
MotOr5l0 50hp
Molors l0 100hp
Motors over 100hp
$23.50
$0.00
$0.00
$0.00
$0.00
50.00.
$60.15
$85.70
$6.60
$0.00
so.00
$30.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
FEE SUMMARY
Quantity . - -
0
0
0
75
110
6
0
0
1
0
0
0
0
0
0
0
�' - Temp Dist System I Lighting
' � Busway /100 ft
_ � Standing Section
- Misc Electrical Equipment
Transformers up to 7 kva/kw
................up l0 10 kva/kw
........:........up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kvalkw
Low Voltage Equipment
� Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
� Christmas Tree Stand.
Fireworks Stand
• Other Electrical Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$49.50 ' 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
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: tn order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlone and tlnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnONDECLARAPON:
I hereby eMirm untler penalry of perjury one ot the following daclaralions: �
❑ I have end will mainlain a certiticate of consent to self�lnsure for workers' compensation, es providetl for by section 3700 of the Labor Code, for the peAortnence ot the
���far which this pertnit is issued. �
ve and wlll maintaln workers' compensatlon Insurance, as required by section 3700 of the Lebor Cotle, for the perfortnance of the work for which ihis pertnit Is issueC.
MV workers' compensalion I sur car' , ntl poli number
• c%. v4el �-� � li.c s Cm P.olity Number.=%�W�' Z �8 �!/� o c�
need not be completed i!!he permit is velued ef one hundred dollers ($700) or less.)
❑ I certity tha� in Ihe peAormance ot the work lor which this pertnit is luued, I shall not employ eny person in any manner so as to becama subject to the workers'
compensatlon laws oi Californie, and ree thet if I should become sublect to the workers' compensetion provisions of Section 3700 ot ihe Lebor Code, I shall forlhwiih
wmpty with these pr ns.
A .iguaWre: � � � 'Dae: I'z4�—mC�
INCa�FA1LU�T0 SECU E WOFKER PENSATION COVERAGE IS UNLAWFUL AND SNALL SUBJECT AN EMPL QER'ipDRIN1INAL PENALTIES ANp CIVIL FINES UP TOONE HUNDRED
iHOUSAND DOLLARE �E100,000), IN ADDITION TO iHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOP IN SECTION 3IW OF THE LABOR CODE, INrEREST, AND ATTOPNEY'S FEES.
LICENSED CONTNACTORS OECLARATION:
I hereby aHirtn ihat I em ' nsed u er provisions of Chapter 9(commencing wi�h Section 7000) of Division 3 usiness and Professions Code, and my license is in lull
torce and eflect. ic: # � � ���o �o l �% .D� �ass a � f �l �
�., a,,,.,o.,..e _ a�o i_ z✓—fi3.i,
CONSTRUC710N LENDING AGENCV:
❑ I hereby aNirm ihai t�ere Is a constmction lending agancy lor the peAormanca ol ihe work br which ihis permit is issued. (Sac. 3097, Civil Cotle).
Lender's Neme: Lender's Address:
Signature:
OWNER-BUIL�ER OECLARATIONS:
Date:
I hereby aHirm Ihat undar penalry oi perjury ihat I am EXEMP7 FHOM THE CONTRACTORS LICENSE LAW for Ihe following raeson (Sec. 7031.5, Buslness and Professions
Code: Any ciry or county which requires a permit to cons�mct, elter, improve, demolish, or repair any siructure, prior to its issuance, elso raquires ihe applicent for such permit
to file a signetl statemem ihat he or she is licensetl pursuant ta the provisions of tha Contractore Licensa Law (Chepter 9(commencing with Section 7000) ot Division 3 of ihe
Business end Pwlessions Code) or �het he or she is exempt Iharefrom and Ihe basis lor Ihe alleged exemption. Any violation oi Section 7031.5 by eny applicant tor e permit
subjects Ihe applicant to e civil penelry of not mora then tive hundred tlollars ($500)J:
❑ I, as owner o� the propehy, or my employees with wages as iheir sole compensalion, WILL DO TME WORK, antl the structure is not intentletl or ottered for sele (Sec.
7044, Business antl Professions Code: The Contrectors License Law tloes not apply to an owner of property who builds or improves thereon, and wha tloes such work
himsetl or herself or Ihrough his or her own employees, pwvided that such improvemenis ere no� intended or oHered for sale. H, however, the building or improvement is
sold within one year of completion, ihe owner-builder wlll heve ihe burden ot provinq that he or she tlitl not 6uiltl or improve tor puryose of sale.).
❑ I, as owner of the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTflACTORS lo conslruct Ihe project (Sec. 704d, Business antl Professions
Cotle: The coniractors License Lew tloes not epply to en owner of property who huilds or improves thereon, antl who contracts tor such project with a coniractor(s)
license pursuent to the Camractors license Lews.).
❑ I am ezempt under sec. Business and Professions Cotle tor this reason:
Signature: Date:
Owner ID venfied by drivers license. ❑ Ves ❑ No Driver's License No.
Venfication of Ownership by (rype of document, i.e. - propeRy Iav bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certity that no excavation five (5) or more leet In tlepth into which a person is required to descend, will be matle in connection with work euthonzed by Ihis
pertnit, and Ihat no Duiltling siructure, scaHolding, falsework, or tlemolition or tlismantling thereof, will be more ihan ihirry-six (36) teet high. (Chap. 3.2, Grp 2, An 2, Sec.
347, Ttle 8, Celifomia Administretiva Code).
❑ As owner-builder, I will not employ enyone to do work which would requira a pertnit trom the Division of Indusirial Safery, as noted above, unless such person has a
pertnit ta do such work from the tlivision.
Signeture: Date:
Division ot IndusMal Satety Pertnit Number:
CERTFlCA7E OF COMPLIANCE AND AU7HORVATION OF EN7RY: I cenity under penalry of perjury that I have read this application antl state that the infortnation given is
correct. I egree to comply with all stece laws and ciry ordinances relating �o builtling consiruction, and authonza representatives of ihe City of Costa Mesa to enter upon tha
above-descnbetl propeny lor inspection purpwes. I egree not to occupy or allow occupancy ot eny building authonzad �y this pertnit until Ilnal inspection.
Owner(s)
COpE �, INSPECTIONTYPE PS¢. TI�SS
1676 Fixed System Final Fire Prevention
1266
200
207
202
203
204
2aa8d6
Pool Spa Final
Final Re-Raof
Final BIocWRetaining Wall
Final Fectory Fire Place
Final Sign
Finel Demolition
CODE� INSVECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final ElecMcal
212 Final Fire Pravention
220 Final Planning Approval
222 FinalSite
250 Final Building�Occupancy
O�TE INTITIALS
�, ' l J -DO ��
��i a> �sa-sz�s • F� (�i a) �sa-aess
JobAddress: 555 ANTON BL
Suite: 2
Vicinity:
Parcel Number: 41050110
�.
Applicant: JEREMY COLLINS
Address: 2505 MIRA MAR
CITY OF COSTA MESA �� �
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
LONG BEACH„CA . -
Owner. SAKIOKA FARMS
Address - � ��
Contracmr: ' CAC PROTECTION
Address: 2505 MIR4 MAR
Zoning:
- Phone: (562) 498-6444 J �
Zip:. 90815
. � Phone:... . . . .
Zip: 94737 �
� d�li � i � �i
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/10/2000
Issued: 02/03/2000
ISSUEDBY: �rrl
� CA , � Phone:'- (562) 498-6444
, " LONG BEACH Zip: � 90815
, � ,License:� 327196... � '
' � " .
'" _ ., SCOPE OF PERMI�T
. ,INSTALL FIRE ALARM, SYSTEM FOR-THE SECOND FLOOR TI FOR "EPOCH INTERNET".
REF:B00-00022 � � .y � � • � � �
' Plan Check:
� Permit:
Other:
$72.31
$111.25
$0.00
�,
Total: $183.56
, , . , FEE SUMMARY
� � � - � � • ' . � . � Calc Valuation: 3s,000.00
Claimed Valuation: $s,000.00
.y:` „ --- ^:' - . �
_ �-_- � , - .
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, 12-27-92)
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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inapectlons and final approval must be obtainad. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
J
WORKERS'COMPENSAnON DECLARATON:
I hereby ettirm under penelry of perjury one of the following tleclarations: � ' �
❑ I heve antl will meinlain a cartilicate ol consent Io self-Insure for workers' compensalion, e5 provided for by seCilon 3700 0l tha Labor Cotle, For Ihe pBAormanCe of iha
work tor w�ic� t�is permit is issuetl.
fa^ 1 have an0 will mantain workers' compensation insurance, as required by section 3700 of the Lebor Cotle, tw ihe peAormanca of Ihe work for which �his pertnit is issuee.
My worke�rs' colmpensetio3 Insurance carrier and policy number are: G p�
Carner /� /�r.� (�� ��L CTl^-� Eti7� GI � Policy Number. 3 YO �� l a
(This sectlon need not e comple(etl il fhe permit is velued af one hundred do I ($100) or less.)
❑ I cenity that in the peAormance of Ihe work for which this pertnit is issueQ I shall not employ eny person in any manner so as lo become subject to the workers'
compensa�ion laws of Califomia, and agree ihat ii I should becrome subjact to the workers' compensetlon provisions of Section 3700 oi the Lebor Code, I shall forthwith
comply with these pro sio
ApplicantSigneWre: ��/�"� ��� � Dete: � — � ` �
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNLAWFUL AND SHAl15UBIECT AN EMPLOYER TO CRIAUNqL PENALiIES AND GVIL FINES UP TO ONE HUNDRED
TTIOUSANO OOLLARE (5100,000), IN ADORION TO THE COST OF COMPENSATION, DPN.AGES AS PROVIDED FOfi IN SECiION 37080F TME LABOR CODE, IMEFEST, AND ATTORNEI"5 FEES.
LICENSED CONTRAC70RS �ECLARA710N:
I here6y aflirm that I am licensetl untler provisions of hapter 9(commencing with Section 7000) of Division 3 ot the Business end Professions Code, and my license is In full
brce and eRect Lic. k g Class p � � C�/
Contractofs Signawra: �l �-?`� a^"ti Date: �� — — i
CONSTRUCTION LENDING AGENCV:
❑ I hereby eHirtn Ihet ihere is e construction lending agency tor ihe peAormance of Ihe work tor which t�is pertnit Is issuea. (Sec. 3097, Civil Cotle). .
Lender's Neme: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARA710NS:
I hereby affirtn that under penalry of perjury ihat I am EXEMPT FFiOM THE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business entl Professions
Code: Any city or wunry which reQuires a permit to construct alter, improve, demolish, or repeir eny stmcture, prior to its Issuance, elso requires the applicant for such permit
lo file a signed statemem thet he or she is licensetl pursuant to t�e pmvisions ot the Conireaors License Law (Chapter 9(commencing with Section 7000) of DiNsion 3 oi the
Business entl Protessions Code) or that he or she is e:empt iheretrom and the basis tor the alleged exemption. Any violatlon oi Secdon 7037.5 by any applicent for e permit
subJects the applicant to e civil penalry oi not more than five hundred dollars (3500).):
❑ I, es owner ot l�e propeny, or my emploYees with wages es their sole compensation, WILL DO THE WORK, and Ihe swcture is not intended or oHered tor sale (Sec.
7044, Business end Protessions Code: Tha Contractors License Law does not epply to en owner of property w�o builtls or improves t�ereon, antl who aoes such work
himselF or herself or �hrough his or her own employees, provitletl ihat such improvements ere not intended or ottered for sale. If, however, the building or impmvement is
sold within one year of completion, the ownervbuilder will have the burtlen of proving thet he or she did not builtl or improve for purpose of sale.).
❑ I, as owner of the property, am E%CLUSIVELY CONTNIICTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Cotle: The comracbrs License Law tloes not apply to an owner of propeny who builds or improves ihereon, and who contracts for such project with a contractoqs)
license pursuant to the Coniractors License Laws.).
❑ I am exempt untler sec. Business end Professions Cotle for this reason:
Signature: Date:
Owner ID venfietl by tlriver's license. ❑ Ves ❑ No Drivels License No.
Venfication of Ownership by (rype ot document, i.e. - property tax bill or deed):
Ecpire5:
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N:
❑ I hereby certity Ihat no e:cavation tive (5) or more fee� in depth into which a pereon Is requiretl to dascend, will be made in cnnnection with work authodzed by ihis
permit, antl ihat no building stmcNre, scaHolding, talsework, or demolition or tlismantling thareof, will be more ihan ihlrry-slx (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
347, Ttle 8, Celifomie Adminisiretive Cotle).
❑ As owner-builder, I will not employ enyone to do work w�ich woultl require a permit fmm ihe Divislon oi Industrial Safety, as notetl above, unless such person has a
permit to tlo such wark from the division.
Signeture: Date:
Division of Intlusinal Safety Permit Numbar:
CER7IFICA7E OF COMPLIANCE AND Al7THORIZA710N OF ENTFiY: I certity under penalry of per�ury that I have reed Ihis application antl state Ihat iha information given is
cortect I egree to comply with all state laws end ciry ordinances relating to 6uilding constmction, end authorize representatives of the City of Costa Mesa to enter upon Ihe
above-tlescnbed pmpeM �or inspection purpases. I agree not to occupy or allow owupency ol any 6uilding euthorized by this permit until final inspection.
/�� �� Sig� ture f Le Owner(s) � � _ � �Dat��`
V CJ
And/Or Authorized Applicant Date
COOE �, INSPECTIONTYPE A�L INTITULS
1678 Fixed System Final Pire Prevention
1268
200
201
202
203
204
2a48d6
Pool Spa Finel
Final Re-Roof
Final Block/Retaining Wall
Finel Fectory Fire Place
Final Sign
Final Demolition
COUE I INSPECTION TYPE
206 Final Mechanical
208 Finel Plumbing
270 Final Elecincal
2�2 Finai Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupan�y
�¢, INnTIAlS
Z-<{- LD �
pia� �sa-sz�s • Fax (�ia� �sa-aess
JobAddress: 555 ANTON BL
Suite: 2
Vicinity: SECOND FLOOR
Parcel Number: 41050110
Applicant: WILSON, WALTER
Address: 2505 MIRA MAR AVE.
CITY OF COSTA MESA
BUILDING D/VISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
LONG BEACH, CA � "
Owner: SAKIOKA FARMS
Address - � , —
�i
Contrector. �
Address:
Zoning:
Phone: (562) 498-6444 EXT. 2205
Zip: 90815
Phone:
Zip: 94137
P�TORiHP��ER , r
V
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 01I10/2000
Issued: 02/03/2000
Phone:'
_ Zip: �
License:
. 'SCOPE OF PERMIT
. INSTALL 15 FIRE'SPRINKLER HEADS FOR T.I. FOR -EPOCH INTERNET- (2ND FLOOR).
REF: B00-00022 � �
r �
' Plan Check: $72.31
• Permit: � $111.25
Other: $0.00
<
Total: $183.56
0
Calc Valuation: 5a,aia.00
Claimed Valuation: Sa,ais.00
0
NO710E: The work authorized by this permit shall comply with all applicable handicap access raquirements 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 1 BO days, or if work is suspended or abandoned
for a penod of 780 days.
INSPECTIONS: In order for the work authorized under this permi[ to be considered legal, such work must comply with all epplicable codes, and all
required Inapeetlona and flnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSATIONDECLARATON:
I hereby ettirm untler penalty of perjury one ot t�e lollowing tleclarations: ' •
❑ I have antl will meintein a certiticate of consent ta self-Insure lar workers' compensetion, as OroviAed for by section 3700 ot the Labor Cotle, for Ihe pedormance oi lhe
� work for which ihis permit is issued, �
�I have antl will maintein workers' cpmpensaUon insurence, as requiretl by section 3700 ot the Lebor Cotle, tw the peAortnance of ihe work for which ihis permit Is issued.
� My worke compensati`on_ I surence wrtier en0 p licy number are: L. p�
Carrier. �{C aj� J � f� � � � Y✓1 ✓L� � /. Policy NumDer: � � �Q — �O
(fhls sec(ion need n�f be completed I! fhe permif /s ve/ued et one huntlretl tl ers ($100) or less.)
❑ 1 certify that in the pertortnance o� the work for which Ihis permit Is issueQ I shall not employ eny person In any manner so as to become sublect to the workers'
compensation lews ol California, and egree that if I shoultl bacome subject to Ihe workers' compensation provisions of Seaion 3700 of ihe Labor Cotle, I shall fonhwith
comply with ihese pmvi "ons� . . /�
Applicant Signeture: / /7 � !i� Date: � �� �- B-�
WARNING: FAILUPE TO SECURE WORKERS' pOMPENSATIIXJ COVERPGE IS UNIAWFUL AND SHALL SU&IECi AN EMPLOYEF TO CFi1MINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
THOUSAND DOLLARE (5100,OW), IN ADDITIOry TO THE CAST OF COMPENSATION; OAMAGES AS PROVIOED FOR IN SECTION 3106 OF THE LABOR COOE. IPIrEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA7�ON: .
I hereby aHirm �hat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Protessions Code, antl my license is In full
torce antl eHect. Lic. x /'- Class B C.—/ �� C'� —/ �:
ContractoYs Signatura: J Date: 1" — cYc'7
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirm ihat t�ere is a consimction lending egency lor the peAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code). ,
Lendefs Name: Lentlers Address:
SigneWre: Date:
OWNER•BUILDER DECLARATIONS:
I here6y ettirm ihat under penalry of perjury thet I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Profassions
Cotle: Any city or county which requires a permit to consiruct, alter, improve, demolish, or repeir any siructure, Prior to its issuance, also requires the epplicaot for such permit
to file a signed statement tha� he or she is licensed pursuem to the provisions of Ihe Contractors License Ww (Chapter 9(commencing with Saction 7000) obDivislon 3 of the
Business end Protessions Code) or ihet he or s�e Is ezampt iheretrom end ihe besis tor the ellegetl exemption. Any violation of Section 7031.5 by any epplicant for e permit
sub�ects the applicant to a civil penalry at �ot more than live hundred tlollars (5500).):
❑ I, es owner oi ihe property, or my gmployees wi�h weges es their sole crompense�ion, WILL DO THE WORK, and �he slrucNre is no� inlended or oHered for sale (Sec.
7044, Business and Proteulons Code: The Contrac�ors License Law tloes not epply to en owner of property who builtls or improves thereon, and who does such work
himself or herself or t�mugh his or her own employees, provided that such improvements are not intended or oflered tor sale. tl, however, the building or impmvement is
sol� wit�in one year ol completion, the owner-builder will have the hurden of proving ihet he or she did not build or improve for purpose of sale.).
❑ I, as owner of the pmperty, am EXCWSIVELY CONTRACTiNG WITH LICENSED CONTRACTORS to construci Ihe project (Sec. 7044, Busines5 end Professions
Code: 7he comrectors License Lew tloes not apPly to en owner of property who builtls or im0�o�es ihereon, and who contrects for such project with e contractor(s)
license pur5uant to ihe Contractors Liten58 Laws.).
❑ I am exempt untler sec. Business ana Professions Cotle for this reason:
SignaNre: Date:
Owner ID verifietl by drivers licen5e. ❑ Yes ❑ NO Dnvels LicenSe No.
Verification of Ownership by (rype ot docUment, i.e. - property tex bill or deetl):
DIVISION OF INDUSTRIAL SAFETV P�RMIT CERTIFICATION:
Ezpires:
❑ I hereby certiy that no excava�ion tive (5) or more feei In depth into which a person Is requlretl to tlescend, will ba made im m�nection with work authonzed by this
permit, end Ihet no Duilding stmcNte, scaHOltling, felsework, or tlemolitlon or tlismanNing thereof, will be more Ihan ihirry-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec.
341, Tiile 8, Celifomia Admini5lretiye Code).
❑ As owner-builtler. I will not employ enyona to do work which would require a pertnit from Ihe Division of Industrial Safery, as noted above, unless such person has a
permit to do such work from lhe tlivision.
Signa�ure: Da�e:
Division of Industnal Safety Permit Numher:
CERTFICATE OF COMPLIANCE AND qUTHORIZATION OF ENfAV: I certify under penalry of perjury that I have read this application and state ihat �he inlortnation given is
correcL I agree to comply with all stete laws antl ciry ordinances relating to building construction, and authorize representatives of the Ciry of Casta Mesa to enter upon ihe
abova-tlescnbed pmperry br inspection purpases. 1 egree not to occupy or ellow occupan�y of any 6uilding authonzetl by this pertnit until tinal inspection.
�� �� 5'gneture Of Legal er s) Date
� r�/ �-'-�_ 2- 3 -- CrZ7
And/OrAuthonzed Appliwnt �ate
COUE �. INSPECTIONTYPE
7616 Fiaed System Final Fire Prevention
1266
200
207
202
203
Pool Spa Final
Final Re-Roof
Final Blak/Rataining Well
Final Factory Fire Place
Final Sign
Final Demolition
� QA¢, INTRIRLS
Z-`{-tri� l�
0
0 � INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbin9
210 Final Electncal�
272 Final fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
P.AIE INTRIRLS
Z-�- Cv �.(g_
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
555 ANTON BL
2
2ND FLOOR OFFICE
41050110
Status: ISSUED
Applied: 09/06I2001
Issued: 09/O6/2001
Applicant: SMITH, DON , ._- . ISSUED BY: '
�.-.i�.�. -� „
Address: 3184 AIRWAY AVE %, �;; '% �: - ; - � _ - � _ � ; �
�', �/��� �- � _.Phone: (714)438-2272 � - �
!,7`. _' � . , /-�.-_
COSTAMESAjCA; � , ' '� Zip:� 92626 � �
' ,i // ; ' _� � , . ` . / �` � .A
' \
; - �\ � / �\_�
/� � - � �
� � � � , � �'�
owner SAKIOKA'FARMS � - � � ��i �. � �
Addres� j - . " �' ������
' , �% ,i , ���.
�� , �V � Phone: �
\i
�.
_. \
, , •�_ j, /.% � � Zip: 94137 � C �� �� / � . ,�
� � �_' . �
' , _ �V� `� � ��,��
Contracror �HOWARD BUILDING CORPORATION: � �,� � �� -
Address: 31�84 AIRWAY AVE � � -< �" " ' _ � � . � ��� �
� ' �Pho e: (714) 438-2272, ' , , - � � .
. � : COSTA MESA. CA' � �'; � ' � � Zip: �92626 , - , . . � • �
,".� ' - . � - License: 445804 �- � _ � �- -' � ��. -._ � ,
� i _ '` �
� � � � ' \
� , . A
. /`
::. SCOPEOF PERMIT ,
ECECTRICAL PERMIT FOR'INTERIOR.OF,FICE T.1: F.OR "EPOCH INTERNET" (2ND FLOOR). INSTALL
2 RECEPTACLE OUTCETS 8 1� SWITCHr � '-_'-- -- -' ! - � -'�� � - - �
REP: 801-01381 � . . �-��, ,
�. . i _ ` � -- � � ;
. __ _ . � ' i ' '
ISSUE FEE
Temp service test
Res: a/c package
New Res (1-2 units) �
New Res (3+units) „
Pool I Spa. .
Lighting Fixts� \ �
Recept Outlets � �`�
Switches
Non Res Appl �` � .
Res Appl
Service to 200a �
Service to 1000a
Service over t000a
Motors l0 1hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motors over t00hp
Communication tlrops
Sub panel to 200a
Pole Liqht Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
- FEE�SUMMARY �-'
Quantity _ �� (�uantity �
$23.50 � Temp Dist System / Lighting 50.00 0
$0.00 Busway /100 ft ' 50.00 0
$0.00 i �Standing Section $0.00 � 0, � .
,- $0.00 0 �;:"���'��' Misc Electrical Equipment $0.00 � � 0� - �
. $0.00 0 ;` �' ' ' � - ' Transfor`me'rs up�to 1 kva/kw $0.00, � i�0 �
� ':$0;00 0 , .:'' � '. ..............up l0 10 kva/kw ; $0.00. , � 0 . •
� $0.00+ t --'.'r.0,�.� ` _ �, . .; �' �..........._....up to 50 kva%kuv �...<�. - '$0.00' 0 �� ' � �
�. $220��:. .2 .. � ' .;: r ............�..._upto100kva/kw , �.$0.00/�,0 . . ,
� -- $7.10'. - �. 1 ' ,. ' � . .. ..............over 100 kva/kw � �' $0.00 �,.0 . .
' � � $0,00_ � � b-� �- : - Low Voltage Equipment - � ' $O.DO � % 0� - � �
, $0.00 � � �' 0. � Low Volt Wiring System / Ckt $0.00 0 - -
$0.00 0 - � � Misc. Conduit �$0.00 -0 "
- � $0.00 ' 0 ` Misc.Conductor ' -$0.00 � 0,
\ -.So.00 , - ,0 Circus ( gen or ride), ' ' $0.00 . > ' -0
` $0.00� 0 ' � . - �Circus (mech ride or lights) $0.00 � � 0
$0.00 . 0 , �� Christmas Tree Stand - -� 50.00 0
$0.00 � . 0 - _ - -- • � 'Firework5 Stand � ' ' - $0.00 0
$0.00 �� 0 , - , � _ Other Electrical Fee "- " $0.00
$0.00 0 " . - � � �� '�
$0.00 0 - Investigation Fee $0.00
$0.00 0 Plan Check Fee $0.00
$0.00 0 Reinspection Fee $0.00
$0.00 0
$0.00 0 TOTAL CALCULATED FEES 526.80
$0.00 0
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 Inspectlons and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626 /
2446d8 (6/00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby ettirm under penalry oi perjury one of the following Oaclarations:
❑ I heve end wlll maintain a certificete of consent to setl-Insure tor workers' compensatlon, es provided tor by section 3700 of the LeDor Cotla, for tha peAortnence af iha
work for whiCh ihis permit i5 i55uetl.
❑ I have end will mflinWin workers' comQensetlo surance, as required by section 3700 oi Ne Lebor Catle, Por IDe pertormance of ihe work for which this pertnit Is Issued.
My% n�fkers' compensatlon Insuran cartl e tl pol� number are: /vf�7 /
Cartier: 71/i5/���g'�- �!� � �i�NS PolicyNumber: DW(///7D7
(This secNon neetl wt be comp/ete0 il the perml( ive/ued et one hu dollars ($700) or IessJ
/
❑ I cenify t�at in the pertartnance oi ihe ork tor which this rtnit isissued, I shall not amploy any persan in any manner so as to become subject to the workers'
compensetlon laws i Califomie, a e �tha shou become subjact lo t�a workers' compensation provisions of Sectlon 3700 of Ihe Lebor Cotle, I shall forthwith
comply with these p visions.
Applicent�Signeture: ' '. . Date: rro � � d �
WARNINO:'FAILURE TO SECUF ORKEFS' E�I�SATION VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FMES UP TOONE HUNDRED
TIqU$ANDOOLLARE�S100, ,INADDITIONTOTHECflSTOF MPENSATIpJ,DAMAGESASPROVI0E0FOFIN$ECTION3]OBOFTHELABORCODE,IfJrERE$T,ANOATfORNEV'SFEES.
LICENSED CONTRAC70RS DECLARATION:
I hereby effirm Ihat I em licensetl under i on of ter comm cing with Sectlon 7000) of Division 3 of the Business entl Professions Code, and my license Is In tull
force end ettect Lic. # � � Class e .�4—
ConUactofsSlgneWre: Dete:— - /--/� �-'(J�
�.. - r �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that there is a wnstruction lending agency foi the pedortnance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lendere Neme: Lender'S Atltlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I here6y ettirtn Ihet under penalty of perjury Ihet I em EXEMPT FHOM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business end Protesslons
Cade: Any ciry or counry which requires e pertnit lo construct, alter, improve, tlemolish, or repeir eny sirucNre, pnor to its Issuanca, also requires the applicant for such permit
to flle e slgnetl statement ihet he or she Is Iicensetl pursuant to the prwisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Divlslon 3 of the
Business and Professions Cotla) or ihet he or she is exempt iherefrom and t�e basls for Ihe alleged exemption. Any violetion of Seclion 7031.5 by any epplicent for e pertM'
sub�ecta Ihe epplicant to a civil penelry of no� more then fiva huntlred dollars ($500).):
❑ I, as owner oi ihe properry, or my employees with wages as their sole compensatlon, WILL DO TME WORK, antl the struqure is not iniended or ottered tor sale (Sec.
7044, Busineu and Professions Coda: Tha Contractors License Law does not apply to en owner of properry who builds or improves thereon, and who does such work
himselt or herselt or Ihrough his or her own employaes, provided Ihat such improvemenis are not intended or oflered tor sale. If, however, the building or improvement is
sold within one year oi completion, the owner-builder will have ihe burden of proving that �e or she ditl not build or improve for purpose of sale.).
❑ I, as owner af t�e property, am E%CLUSIVELY CONTRACTING WITH LICENSE� GONTRACTORS to construct the proJect (Sec. 7044, Business and Professions
Code: Tha coniredors Licensa Lew does not appty to an owner ot propeny w�o bulltls or Impmves thereon, and who conhacts for such project with a contractor(s)
license pureuant to the Conirectors License Laws.).
❑ I em exampt under sec. Business and Professions Coda for this reason:
SignaWre: Date:
Owner ID verified by dnvers license. ❑ Yes ❑ No Drivers License No.
Verlficatlon of Ownership by (rype of tlocument, I.e. - propeny tax bill or deed):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I he�eby certify that no excavation iive (5) or more feet in tlepth into w�ich a person is required to descend, will be made in wnnedlon with work authodzed by this
permiL and that no building siructure, scaflolding, talsework, or demolition or tlismantling thereof, will be more than thirry-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Califomia Atlministrative Cotle).
❑ As owner-Duiltler, I will not employ enyone to tlo work which would requira e permit from the Division of Industrial Safery, es noted above, unless such person hes e
pertnit ta do such work irom the division.
Signeture: Date:
Division of Industrlal Safety Permit Number:
CEB7IFlCATE OF COMPLIANCE AIJTliORIZATION ENTHY: I certity untler penalry oi perjury ihat I have reatl this epplication antl state that the informetion given is
correct. I agree to comply wit stete laws entl ciry dinances relating to building construction, antl authonza representatives of the Ciry of Costa Mesa to enter upon ihe
above-described property inspection�pu�s. I ree not to occupy or allow occupency of eny building authorized by ihis permi� until final inspection.
COpE �. INSVECTONTYPE �� P9I€ INiITIRLS
1616 Fixetl Sys�em Final Fire Prevention
1266
200
201
202
203
Pool Spa Final
Final Re-Roof
Final Block/Retaining Wall
Final fectory Fire Placa
Final Sign
204 " Finel Demolition
COOE• INSPECTIONTYYE
206 Finel Mechanical
200 Final Plumbing
210 Final Electrical
212 Final Flre Preven�lon
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
o"re
� ; .
II�9LH
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: 555 ANTON BL Status: ISSUED
Suite: 2 Applied: 09/06/2001
Vicinity: 2ND FLOOR OFFICE Issued: 09/06I2001
Parcel Number: 41050110 Zoning:
Applicant SMITH, DON _„ ISSUEDBY: �
Address: 3184AIRWAYAVE .- �� J � � ' - �� . �-
_,�:c '
��//"� � �-Phone: (714)438-2272 -� � .
/� jJ-� ,. - .
COSTA MESA� CA-'- ���".- � < < �� " � � Zip: 92626 � � ��`�
i o ��- ' ` , � � � ' �
Owner SAKIOKA;FARMS � � ... � � �� ��`�
/ � "� " - - � / \��:�
Address � ,/ � � � . = . � `. _ " _ - , - � � � . . \` `�
� . i��.. �� � . . �Phone: - ,. , . ,.i�V��\
� � � � Zip: 94137 � � � / ��.`' �
� .�� � '� ' - /.
`�\��,�\� . , .
ContiacPor: `HOWARD BU�ICDING CORPORATION � � � ' ; �� �'; ��
Address: 3164 AIRWAY AVE � � � � � �. , A
�
� - - , Phone:. (714) 438-2272 `. � � - _ _
i' ,
� COSTA MESA, CA .. � �
.� Zip: 92626;' �License; 445804 ' . � ���'� '' -
. , \
.� Arch :. � ' , , .- -- .• Eng: ,. . . � � �
Address: � , = , �, ,' . Add�ess:� � � � .
- , , � ;Phone: . � ' _ ';:�'- . . Phone: _ '
�
'�
�2ip: - �, ,License: , � r 'License: �
SCOPE OF PERM�T
- .-. -
` ' INTERIOR OFFICE T.I. FOR "EPOCH.INTERNET" (2NDIFLOOR)rADD.NEW PARTITION WALL TO CREATE NEW OFFICE .
AREA. . . � � •' ' _ '_ ' . '_ ' ' _' _ . __. . . _,
, � FEE SUMMARY - . ,
"Plan Check: $54.11 � — — - - ' .Calc Valuation: ,' g2,siz.ao
Permit: ' $83.25 � �' � � � � � j%, �� ` Claim Valuation: � � Sz,soo.00
SMIP Res: $0.00 .
SMIP Com: $0.55
Other. . $0.00
Inspection: � $0:00 �� -. . .
`.
' , . >' -
�� Total: . �$137.91 � � �- � �
� : � , ._. _ . �
� PLANNING & ZONING
SETBACKS �� � � � ' � � � �
MAIN STRUCTURE' P�ont � 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 Reauired: 0 � Prouosed: 0. � .' �
—. ..,A, �. . . .
NOTES: � -
NOTICE: Tha work authorized by this permit shall comply with all applicable handirap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 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
tor a penod of 180 days.
INSPECTIONS: In order for ihe work authorized under ihis 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 ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 /
2448-48�&00) V
WORKERS' COMPENSA710N DECLARATION:
I here y eRlrtn under penalry of perJury one af the following tlecleretlons:
I heve end wlll maintein e cartificate of consent to seli-Insure for workers' compensetlon, es provitle0 toi by sectlon 3700 at tha Lebor Code, for the paAormance of Ihe
work for which t�i5 pertnil i5 issued.
❑ I heve ena wlll meintaln workere' compensatlon Insurence, es requiretl Dy section 3700 of Ihe Lebor Code for Ihe pertortnence ol t�e work tor which t�is pertnit Is Issued
Cartier. Yyi�iV/Y4,-t {.]�A�1
(lhfs sec�ar need not be crompleted il6
❑ I certify Ihel in the peAortnance t
compensetlon law Ot C011f0 8, f
�comply.with these _
Appliwnt Signeture:—r u�
WARNINO:FNLURETOSECUR ORKERS
TIqUSAND DIX.LARE (5100,000�, IN ADOITIO
LICENSED CONTRACTONS DECLAR�
I hereby ettlrm t�et I em Ilcensed un r
force end eHeM. Lic. N
Con�rectofs Slgneture:J
CONSTRUCTION LEND G AGENCV:
iie car enA_policy numEer ere: � �
' Poliry Number: �� �� 7� �
i rmit is elu et e huntlretl tlollers ($100J o/ /855.) �
t�e wo�5. r hic� pertnll Is issuetl, I shall not employ eny person in eny manner so es to become suhJect lo the workers'
�Q.egr4eil t If I ul e sub ect to the workers' compensatlon provlslans of Sectlon 3700 of the Lebor Cotle, I shell forthwlt�
�-- r--�eca: %lo -� %
NSA ON COVERAOE IS UNLAWFUL AND SHr1LL SU&IECT PN EMPIOYFA.TO CfiIMINPI PEWILTIES AND CML FlNES UP TOONE HUNDPED
VT E _ TOFCOMPENSATION,OAMAGESASPROVIDEDFOFINSECfI0N3)OBOFTHELABORCODE,IMEREST,ANDATTORNEY'SFEES.
wlih Section 7000) af Divislon 3 oi t�e Business end Professlons Code, and my license Is In full
Class q /� _.
❑ I hereby eflirtn that there is e consWction lending e9ency for Ihe pedortnance ot the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Nema:
Slgnature: _
OWNER-BUILOER DECLARA710NS:
Lendefs Adtlress:
Date:
I hereby eflirtn t�et untler penalry oi perjury thet I em E%EMPT FROM 7HE CONTAACTORS LICENSE LAW lor Ihe tollowin9 reeson (Sec. 7031.5, eusiness end Professlons
Cotle: Any ciry or counry which requires a pertnit to construct, elter, Improve, demolish, or repair eny structure, D�or to Its Issuance, elso requires Ihe epplicant for auch permlt
to flle e signed atetement that he or she is Ilcensetl pursuent to ihe provisions o1 ihe Coniractors License Lew (Chepter 9(commendng with Section 7000) al Divislan 3 0l the
Buslness enC Pratesslans Catle) ar that he ar she Is exempt therefrom entl t�e besis for the elleged ezemption. Any Wolatlan of Section 7031.5 by eny applicant for e perm�'
sub�ects the epplicent to e civil penalry of not more then iive hundred dollers ($500)J:
❑ I, es owner o1 the properry, or my employees wlth weges es t�elr sole compensatlon, WILL DO THE WORK, entl the stmcture Is not iutentletl or ofterad for sele (Sec.
7044, Business and Professions Code: The Contractors License Lew does not apply to an ownar of property who builtls or impmves thereon, antl who does such work
himself ar herseN or through hls or her own employees, provitled ihat such Improvements ere not Intended or otteretl for sele. If, howaver, Ihe building or improvement Is
sold within one year ot completion, the owner-builtler will heve 1�e burtlen ol proving ihal he or she did not bulld or Improve tor purpose of sale.).
❑ I, es owner ot the praperty, em E%CLUSIVELV CONTRACTING WITH LICENSED CON7RACTORS to construct the pro�ect (Sec. 7044, Business entl Professlons
Code: The comrectors License Lew does not apply to an owner ol properry who bullds or improves thereon, en0 who comrects for such pmject wlth e comrector(s)
license Dursuen� to Ihe Contrecmrs License Lews.).
❑ I am exempt under sec. Business ana Profeuions Cotle for ihis reason:
Slgneture: Data:
Owner ID ventietl by dnver5license. ❑ Yes ❑ No Drivefs License No.
Veriticetlon of Ownerehip by (rype oi document, i.e. - properry tea blll ar deetl):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION:
❑ I hereby certity thet no exwvation five (5) or more fee� In tlepih into whlch a person is requlred to descend, wlll be made in connedion with work authorized Dy this
permit, entl ihat no Ouiltling siructure, xaXolding, falsework, or demolitian ar dismantling thereaf, will be more ihan thlrty-six (36) teet high. (Chap. 32, Grp 2, ArI 2, Sec.
341, Ttle 8, Celifomia Administrative Cotle).
❑ As awner-bullder, I will not employ enyone to tlo work which would require e permit from the Divlslon af Indusidel Sefery, es noted ebove, unless such person has e
pertnit to do such work trom the divisian.
Signeture: Dale:
Division of Industrial Safery Pertnit Number:
CERTIFlCA7E OF COMPLJ AND AIfIHOROATION OF EHTRV: I certity untler penalry ol perjury thet I have read this epplicetion and state that ihe Intormetion given is
correcc I egree ro comp tn a I stete lews end d-ortlinances releting to building consWction, anC authonza representatives oi the Ciry of Costa Mesa to enter upon the
e6ava-descnbed pm for inspectJa,R puryose�gree not to occupy or allow occupency of eny builtling euthorizetl by this permit umil tinel inspection.
COOE�. INSPECTONTYPE �
7616 Fixed System Final Fira Prevention
1288 Pool Spe Final
200 Final Re-Roof
201 Finel BIacWRetalning Well
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demolition
QAIE I�LS
CODEt INSPECTIONTYPE
206 Finel Mechanical
20B Final Plumbing
210 Flnal ElecMcal
212 Finel Flra Prevenilon
220 Final Planning Approval
222 Finel Site
250 Finel Building/Occupen�
�_ ��
Date �
— P� II�L4
�
(714) 754-5273 • Fez (714) 754-4856 • w�w+.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
OFFICE:
Job Address: 555 ANTON BL
Suite: 2
Vicinity: NEW OFFICE ON 2ND FLOOR
Parcel Number: 41050110
Zoning:
Applicant SMITH, DON
Address: 3184 AIRWAY AVE - " � , :� _ " ' �_ -
,_�j/i��� _ .Phone: (714)438-2272
COSTAMESA,CA = � Zip: 92626
ii .
� .,'i - �
Ownec SAKIOKA".FARMS�` � � .
Address -, j- � � - - � �_
�\
; � � - - PhOrie: -
, .•�� - • . Zip: 94737
\ �
Contraotor: HOWARD BUICDING CORPORATION
Address: 3184 AIRWAY "AVE
Status: ISSUED
Applied: 08/16/2001
Issued: OB/20/2007
ISSUED BY: '
� . � � Phone:i (714) 438-2272
COSTA MESA, CA -
Zip: 92626" - License: � 445804 -
Arch : , � ' , �- �� � � . Eng:
Address: , � �� Address:
, � ,� Phone: �
� ..
Zip: � , -License:
Phone:
� , ��
, � ' License:
,-.
SCOPE OF PERMIT
238 SQ fT INTERIOR OFFICE T.I. FOR "EPOCH INTERNET' (2ND FLOOR). ADD PART�TION WALLS TO CREATE NEW
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$108.71
$167.25
$0.00
$1.71
$0.00
$0.00
8277.67
FEE SUMMARY :
�
PLANNING & ZONING
0
Calc Valuation: se;istoo;
Claim Valuation: s�,aoo.00
SETBACKS�- � � � - �
MAIN STRUCTURE Front �" 0- 0 _ Rear 0- 0� � Lefl 0- 0 . Righf � 0- 0- -
. - _ _ .. � .� l
ACCESSORY Front� �0-0 � �� Rear 0-0 Left_ _ 0-0 � Righ[' � 0-0 i"/
� . , .- { � - � _ - /
i
PARKING Existina: �- �0' Required: 0 � Pronosed: 0 l -� /
.-,_ _ . ...,A.A., .. -- �
NOTES: � � - - „' � �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and relatad
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 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, antl all
requlred Inspeetlons and ilnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545826
zaae-ae �eroo�
WOHKERS'COMPENSAnON DECLARAnON: -
I hereby eltirtn under penelry oi perjury one of ihe lollowing daclaretlons:
❑ I heve entl wlll malnteln e certfticata of consent to self-Insure for workers' compensetlon, es proviAed for by sadion 3700 0l ihe Lebor Code, for the peAormence of the
work lor which tliis permit is issuetl.
.
❑ I have a � I meinWin workers' compensaUon insurence, as required by section 3700 ot Ihe Lebor Cade, for the peAartnance of the work for whlch this pertnll is Lssuetl.
My wo e mpen lon insurence cartler enC pollcy number ere: n^/,� �! 7
Cartier. �/zC`� /�1 // PolicyNumber. /�}"/(�V ��/O 7
/rnis secaon need nor ee comp�eree u m Rn s w d er uyared da�ars /aroo) or �ess.�
❑ � cenif
Applicent Sipneture:
WARNING:FFI�URETOS UREW
TYqUSHND DOl1ARE (51 .000). IN ADDfTIIXJ
LICENSED CONTRACTORS DECLARATION:
I hereby attlrm Ihet I em
torce antl eHect. Lic. # _
Contractofs SlgneNre:
CONSTRUC710N LENDING
i rtnit lv issued, I shell not employ eny person in any manner so es to become subJecl to the workers'
to lhe workers' compensation provislons of SeMion 3700 t t�e r Code, I shell farlhwilh
oa,a: _ 8 %Za��o 1
COVEMOE I$ UMAWFUL ANO 5l4LLL SUBIECT AN EMPLOYER TO CRIMIN/ L PENPLTIES M1D CNIL FlNES UP TO ONE HUNDRED
° q7AAPENSATIIXJ, DNMGES AS PROVIDED FOR IN SECTION 3]O60F THE IABOR COOE.IMEREST, Ml� ATTORNEY'S FEES.
with Sectlan 7000) ot Dlvision 3 of ihe Busin nd Prolessions Cotle, end my license Is In lull
Cless p � � / _ ,
❑ I hereby ettirm thet there is e constructlon lentling egency for ihe perlormance of t�e wark for which this pertnit is issuetl. (Sec. 3097, Civil Code).
Lendels Neme: Lendefs Atldress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby ettirtn thet under penelry of per�ury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7037.5, Business end Professions
Code: Any clry or counry which reQWres a permit to construct, elter, improve, demolish, or repair any sWcture, pnor ro its issuance, elso reduires the eppliwnt for such pertnit
to flle e slgnea statemem thet ha or she Is Iicensetl pureuem ro the pmvislons oi ihe Contrectore License Lew (Chapter 9(commencing with Sectlon 7000) of Dlvlsion 3 of ihe
Business end Professlons Code) or thet he or she Is ezempt therefrom and the basis tor ihe alleged evemption. Any vloletion of Sectlon 7031.5 by eny epplicent for e perrN'
subjacts tha epplicant to e civll penelry ol not more ihen Ilve hundretl tlollars ($500).): �
❑ I, as owner ot Ihe D�oOerry, or my employees with weges as their sole compensetlon, WILL DO THE WORK, and the structure Is not Intended or otteratl tor sele (Sec.
70d4, Business enC Profeuions Code: The Contrectors License Law dces not epply �o an owner ot properry who builds or improves ihereon, entl who does such work
himself or herself or through his or her own employees, provideA thet such Improvements are not intended or ottered tor sale. II, however, ihe bullding ar Improvement Is
soltl within ona year al completion, the owner-bulitler will heve tha burden of proving that he or she did not builtl or improve for purpose oi sele.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING W17H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business entl Profeulons
Cade: The contwctors Llcense Lew tloes not appy to en owner oi property who builtls or improves thereon, end who comracts tor such pro�ect wflh e comrector(s)
license pureuant to the Contrecrore License Lews.).
❑ I em exempt under sec. Business end Professions Code tor this reason:
Signature: Date:
Owner ID venfied by drive/s licen5e. ❑ Ve5 ❑ No Dnvefs License No. Expir85:
Verificatian ai Ownership by (type of daument, I.e. - property tu blll or deetl):
DIVISION OF INDUSTRIAL SAFETY VERMRCERTFICATION:
❑ I hereby certify ihat no excevation five (5) or more feet in tlepth into which a pereon is required to descenq will be made in connectlon with wark authorizetl by this
pertnit, end that no building structure, scallolding, felsework, or demolition or tlismantling ihereot, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Ari 2, Sec.
341, TIUe 8, Celifomia Atlministretive Cotle).
❑ As owner-builtler, I will nat employ enyone to da wark which would require e pertnit trom the Division at Indusirial Safery, es notetl above, unless such pereon hes e
permit lo do such work from Ihe tlivision.
SignaNre: Data:
Division oi Industnal Satery Permit Number:
CERTIFlCATE OF COMPLIANCE AND TON OF EMRY: I certify untler penalry of perjury t�at I have reaA this appliwtion antl state that t�e information given Is
conect I agree to comply wlth ell s laws end ortlin tlng �o builtling consirudion, entl authorize representatives of Ihe Ciry oi CaSia Mesa lo enter upon the
ebove-descnbed properry for In tion pu . I r not to occupy or ellow occupancy of any building authonzed by Ihis pertnit until tinel inspectlon.
GOOE 1, INSV.ECTIONTYPE
7616 Fixetl System Final Flre Preventlon
1266 Pool Spa Finel
200 Final Re-Roo1
201 FIne181ocWRetaining Wall
202 Flnel Fectory Fire Placa
203 Finel Sign
204 Final Demolition
/O / Date
Date
Qdjf, � �QpF,( INSPECTON TYPE
206 Final Mechanital
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
Pdg 1tlI�L@
(714) 754-5273 • Faz (774) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
JobAddress: 555 ANTON BL • Status: ISSUED
Suite No 2 Applied: 08/16/2001
Vicinity: 2ND FLOOR Issued: 08/20/2001
Parcel Nunmber:
�u�Y�yr���
Applicant SMITH, DON __ ISSUED BY: I �
Address: 3184AIRWAYAVE � � °��"�"- � - - � - � � `�
� jii'-'� _ . �� - ".-- _'�
/�//� - 'Phone: (714)438-2272 �J- � .A,
/ ; `\
COSTA MESA;.CA ' � Zip:� 92626 -- � ,
/ � �l' � 'V ' : '. . � ' �� . � �;.
:' ' ; ' � � ' � i ;�
;
� �, - :: , , �;_; _�
owner �SAKIOKA'FARMS � �" � � _ � � - ` , `���
�
Address - � � " _ � %
`�:. .
"� Phone: � 'e,�.� , .'� �1
. ' . � , ��� ✓ . �
, . . � �� j � i%. . Zip: 94137 ��� '� - `�� , i
_ �� � �� �' .: ��, �.
i s
/ �
. . . _ \ � '>\ - .
Contracror. � HOWARD BUILDING CORPORATION' � � ����
. .
Address: 3184 AIRWAY AVE " , , �-;r � �- '- " . " . - - ' �
, , . . .r,Phone: (714)438-2272 ' � . . .
5
' COSTA,MESA,CA°� ' � ' � Zip: �92626 , . � - '. " jj.;
' � _ " ,
� � � - � Licenae: 445804 -- � .. � , ' rl� �
/ _ .
� � � . . ' � � �-� � ,
SCOPE OF PERMIT
ELECTRICAL PERMIT FORINTERIOR OFFICE T.I. FOR'.EPOCH INTERNET" (2ND FLOOR). INSTALL � - ��
� 2 RECEPTACLE OUTLETS & UCOMMUNICATION DROP.' <� �- • - - - � - ; , �
ISSUE FEE
Temp service tes
Res. a/c package
New Res (1-2 uNts) �
New Res�(3+units)
Pool / Spa
Lighting Fixts �
Recept Outlets'
Switches
Non Res Appl .
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1 hp
Molors to 10hp
Motors to SOhp
Molors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pale Light Pkg
Sign CirGuitS
Temp Pwr Pole
Intermed Pole
REF:B01-01282 � .
. � i'
. __._ __ _ _._--•� ' . •
' i.. _
Quantity - Quantity" .
$23.50 Temp Dist System / Lighting $0.00 0 �
t � $0.00 Busway /700 ft $0.00 -.0 �
$0.00 _ ; _ Standing Section $0.00 � ,0: � ,
_ � $OAO 0 ����p MiscElectricalEquipment $0.00 �"�0 '
, $0.00 0 ' � - Transforrners up�to 1 kva/kw �0.00'� -�0 �
�. $0.00 , 0._�.''"� . ................upto70:kva/kw.... $0.00 � 0
$0.00 � '� -"=-- 0 � � � � .................up to 50 kJa/kw � $0.00 0 � �
.- $220 ; 2 . � _ - ' ..................upto100kva/kw $0:00, ' 0 , .
� $0.00� ' 0 . � ..............._.over 100 kva/kw - $0.00 . 0 �
, $0.00 ,' b- � � � Low Voltage Equipment � $0.00 � 0 "
,$0.00 .` 0 � Low Volt Wiring System / Ckt - $0.00. 0 � - /
`� , _,, � $0.00 . . . '• 0 � ' _ _ � ��� � Misa Conduit 50.00 � � � 0. " �
�'." _ i
'� . � �_$0.00' - � ; ��0"� � '. �Misa Conductor , . -$0.00 , ' ; 0.
��$O.00���i�� 0� .� ���� Circus,(gemorride) ' �`$0.00=j /0
� '
'�-$0.00' -. � 0, � ,' . �� - ^ �Circus (mech ride or liglits) �-$0.00 ,' 0
$0.00 - � �_ 0 ' � � Christmas Tree Stand� �" $0.00 0
$Q00 �-_ ��_ 0 - � - ��� �`Fireworks Stand ' -' $0.00 0
$0.00 "�� 0 , - Other ElectricaLFee�' � - � $0.00
$0.00 0 - _ " - � � " �
$1.00 7 � - � ' Investigation Fee $0.00
$0.00 0 Plan Check Fee $0.00
$0.00 0 Reinspection Fee 50.00
$0.00 0
$0.00 0 TOTAL CALCULATED FEES $26.70
50.00 0
COMMENTS / SPECIAL CONDITIONS
n
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under CaliPornia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire antl become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order tor ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2<46.16 (NW)
WORKERS'COMPENSAnON DECLARAnON: '
1 hereby aNirm under penelry oi perjury one of the tollowing declaretions: '
❑ I have end will maintein a cenificete o1 consent to selt-Insure for workers' compensatlon, es provided tor by section 3700 of the Labar Catle, for ihe peAormance o� the
wark for which Ihis'permit 15 issuetl.
❑ 1 have and wil aint0in wo cers' compensation insurance, as required by section 3700 of the Lebor Gode, for the peAormance ot Me work for w�ich this pertnit is Issuetl.
My workers' mpensatioi Insurance cerrler entl pollcy number ere:
Cartier: GU1� I PoliCy Number: ���% �(i /% O'7
((his secfion nee not be completetl i/ the ermit is ve/ f on undr d Uollars ($f00) or less.J
❑ 1 certify ihet in Ihe peAormance Ihe work f hic �lhi pe 5 issued, I shall not employ any person in any manner so as to become subject to the workere'
compansation lew of Califo �, entl at it h Id b o e workers' compensetlon pmvisions of Sectlon 3700 f the Lebor Cotle, I shell torihwith
comply with these
AppliceniSignature: � ^-� �^ Dete: � ��0'
WARNING FNLURE TO SECUR WORKERS' TIIXJ ERAOE IS UNLAWFUL AND SHALL SUBIECT AN EMP�OVER TO CRIMINAL PENALTIE ANO QVIL FlNES UP TOONE HUNDRED
T}IOUSAND OOLLARE (5100, , IN AODITION TiE COST COMPENSATION, DAMAGES AS PfiOVIDED FOR IN SECTION 31060F THE IABOH CODE, IMEREST, FNO ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATI .
I hereby aHirtn that I am license un rovisb ha r 9 om encing with Section 7000) of Divislon 3 of the Business antl Protesslons Code, end my Ilcense is in full
force entl ettect. Lic. # U Class N
ContracmYs Signeture: � Date:
CONSTRUCTION LENDIN AGENCY:
❑ I hereby aHirm thet ihere is a construction lending agency for Ihe pedormance of ihe work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lenders Neme: lander's Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS: �
I hereby aHirtn ihet under penelry of perjury Ihet I am E%EMVT FROM T}1E CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business enG Professlons
Cotla: Any ciry or county which requlres e permit to construct, alter, improve, demolish, or repair eny siructure, prior to its issuance, elso requires Ihe epplicant for such permit
to file a signed statement Ihat he or she Is Ilcensed pureuam to the proNsions af the Conirectors Llcensa Law (Chapter 9(wmmencing with Seclion 7000) ot Divislon 3 oi the
Business end Protessions Code) or thel ha or she is e:empt therefrom and Ihe basls for Ihe alleqed e:emption. Any violation of Section 7031.5 by eny applicant for e perm�'
su6jeds tha appllcent to e civil penalry of not more then five hundred dollars ($500).):
❑ I, as awner of the properry, or my employees with weges es iheir sole compensation, WILL DO THE WORK, antl the structure Is not intended or affered for sale (Sec.
7044, Business and Professions Coda: The Contractors License Law does not eDPly to en owner of property who builds or improves thereon, entl who does such work
himself or herself or ihrough his or her own employees, provided that such improvemenis are not Intended or oftered for sale. If, however, Ihe building or improvement is
sold within one yeer ot completion, the owner-builder will have ihe burden of proving ihat he or she did not build or improve tor purpose of sale.).
❑ I, as owner af the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions
Cotle: The coniractors Llcensa Lew tloes not apply to an owner of property who builds or improves ihereon, and who contracts for such pro)ect with a comractor(s)
license pursuent to the Conirectors License Lews.).
❑ I am exempt under saC. Businass and Profession5 Code tOr lhis reason:
Signature: Date:
Owner ID venfied by dnvef5licen5e. ❑ Ves ❑ No Dnvefs License No. Expires:
Verification of Ownership by (rype ot tlocument, i.e. - property taa bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify that no axcavetlon tive (5) or more teet in depth into which a person is required to descend, will 6e made in connection with work euthorizetl by ihis
pertnit, and that no building sirucNre, scaHolding, talsework, or demolition or dismantling iheraof, will be more ihan [hirty-six (36) tee� high. (Chap. 32, Grp 2, Art 2, Sec.
347, Title 8, Califomia Atlminisirative Code). .
❑ As owner-builtler, I will not employ enyone to do work which woultl requlre e pertnit trom the Divislon of Industrial Sefery, es noted above, unless such person hes e
pertnit to do such work irom the division.
Signeture: Data:
Divislon ot Industriel Safery Permit Number.
1 Will the epplicant or present or future building occupent nead to file end certiTy a Business Plen for emergency response to release or threatened release of a haiarUous
meteriel7 ❑ Yes ❑ No
(Section 25505 oF ihe Califomia Healih and SaFery Cotle requires, with some exceptions, that a Business Plan be filed with the Coste Mesa Fire Depariment by every
business which has at any one time tluring a reported year e quantiry of hazartlous matenals equal to or greater than a weight of 500 Dountls, or e volume of 55 gallons,
or 200 cubic teet of compressed ges at standerd temperature antl pressure).
..................................................................................................................................................................................................................................................................................................... ....................... ...................................................
2 Does ar will the applicant or presem or future building occupent need to file e registration fortn lor ecmely hazaMous meterials9 ❑ Ves ❑ No
(Sectlon 25533 of the Celifornie Health antl Sefety Cotle, with some exceptlons, requlres reglstretlon with the Coste Mesa Fire Depertment by each business which at eny
one time has on hantl a quantity of ecutely heurdous meterials equal Io or greater than e waight of 500 pounds, or e volume of 55 gflllons, or 200 cublc feet ot
compressed gas at stentlartl tempereNre and pressure).
........................................................................................................................................................................................................................................ ...........................................................................................................
3 Does or will t�e applicant or present or future builtling occupant need to prepare an RMPP (Risk Manegament and Prevention Program for acutely hazarCous mfltenals)7
❑ Ves ❑ No
(Section 25534 of ihe Californie Health end Sataty Coda provldes ihat the Costa Mesa Fire Depatlment may require the preparation, certitication and tiling wi�h ihe Fire
Department ot an FiMPP by businesses which ere requiretl to register acutely hazardous matenels wlih the Fire Department.
..................................................................................................................................................................................................................................................................................... . ........................ ...................................................................
4 If an RMPP is presently reQuired, hes Section 25534 ot the Califomie Heellh end Satety Code been fully compliad with? ❑ Ves ❑ No
........................................................................................................................................................................................................................................................................................................................................................................................
5 Doas or will the applicant or Dresem or fuwre building occupant repuire for the work which is Ihe 5ubjact ot ihis a plication a permit for such cronsWction or modification
from �he Sou�h COeS� AI� Quality Menagement Disirict or trom any other eir poltutlon conirol disinct or ageney? � Ves LJ No
(Section 658502 ot the Califomia GovemmeN Code requires ihat the raquested Infortnetion 6e tumished on applicetions tor non-resitlentiel builtling permits).
................................................................................................................................................................................................................................................................................................................... .................................................................
6 Will any pan of the teciliry ro be constructed under this permit be wlthin 10001eet from Ihe outer hountlanes of a school7 ❑ Ves ❑ No
(If'yes", the facility must meet the requirement of Sections 25534 and 423W of ihe Califomia Health end Satery Cotle).
........................................................................................................................................................................................................................................................................................................................................................................................
7 If e permii irom the Sou�h Coast Air QualitY Menagement Disidd or other elr polWtion control district or egancy is required for ihe work which is the sub)ect ot Ihis
epplicatlon, heve all oi the disclosures prescribed by Celifornla Health antl Safety Code Sectlon 42303 baen matle7 ❑ Ves ❑ No
.......................................................................................................................................................................................................................................................................................................................................................................................
B Qt yes", etteCh certificate of complianCe irom the appropnate air polWtion conirol oRicer).
CERTIFICATE OF COMPLIANCE: I certity that under Denalry oi perlury the information given above is correcL I egree to wmply with all state laws and ciry ortlinances
reaardino Hazerdous Matarials and Emissions.
Signature:
CERi1FICATE OF COMPLIANCE
correct I egree to comply with el
ebove-described prapertyforin�s¢
cooe �.
7676
1266
200
xo�
202
203
204
laws end.c' orCinance
puryo �. I egree"not to
/
egai �e�cs�
horized Applicant
Pdg
Fi:ed System Final Fire Prevention
Pool Spa Final
Final Re-Roof
Finel8locWRetaining Well
Final Factory Fire Piace
Final Sign
Final Demolition
Date:
under penelty of perjury ihet I have reed this application end state that Ihe informatlon given is
�ildin conslruction, end authonze representaiives oi iha Ciry ot Cosia Mesa to enter upon the
w occupancy building euthorized 6y this permit until finel inspection.
uw. .
P Ze�� C� %e`e
��� Date
CODEA INSPECTIONTVVE
206 Final Mechanical
20B Finel Plumbing
270� Final Electrical
272 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 Final Building/Occupency
PdIE 1tII.�L$
8 o O
4p'rtp Mf
t �
o.
>
J +.� �
tar,wn,m
(714) 754-5273 • Fax (714)
;_._
' CITY OF COSTA MESA
BUILDING DIVISION
, DEVELOPMENT SERVICES DEPARTMENT
� PERMIT
BUILDING PERMIT
�
� °4t�
',IpbAddress: 555 ANTON BL
v..
Suite: 2
Viciniry: SECOND FLOOR COMPUTER ROOM
Parcel Number� 41050110
Applicant: CANEZ, JAIME
Address:
Owner: SAKIOKA FARMS
Address
Contrador: CORPORATE BUILDERS INC.
Address: 523 W. 6TH ST.
LOS ANGELES, CA
SUITE 815
Zip: 90014-1222
PERMIj NUMBER
B00-b 022
77 FAIR DRIVE, COSTA MESA, CA 92626
Zoning:
ISSUED BY:
Phone: 213-219-3518
Zip:
Phone:
Zip: 94137
Phone:� (213)689-0650
License: 699620
Slatus: ISSUED
Applied: O7I062000
Issued: 01/21I2000
Arch : IA � . � Eng:
Address: 3080 BRISTOL SL '. .� Address:�
COSTA MESA, CA Phone: (714) 754-1197 Phone:
SUITE 105
Zip: 92626 License: � License:
SCOPE OF.PERMIT
.� 4,900 SF TI FOR THE COMPUTER ROOM ON THE SECOND FLOOR FOR "EPOCH INTERNET'.
FEE SUMMARY .
Plan Check: $43.10 - , Calc Valuation: S�s,e�s.00
Permit: $265.25 - Claim Valuation: $�s,000.00
SMIP Res: $0.00
SMIP Com: $3.29 '
Other: $0.00
Inspection: $0.00
Total: $311.64
SETBACKS •
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0. 0
PARKING Ezistinq: o
NOTES:
Rear 0. 0
Rear 0- 0
Re uired: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
Righl 0- 0
Right 0- 0
NOTICE: The work euthorized by this permit shall comply with all epplicable hendicap access requirements under Califomia 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 7 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply wi�h all applicable codes, and all
raqulred Inapectlone end final approval must be obtained. Feilura to abtain inspec�ions and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626
WOFKERS'COMPENSATON DECLAppnON: �
I hereby ettirm under penalry of perjury ane ol the following declaraiions:
❑ I heve end will meintain e cenlficate ot consent to seli-Insure for workers' compensation, es provitletl tor by section 3700 of Ihe Labor Code, for Ihe pertormance of Ihe
work for whiU ihis pertnit is issued.
I have and will mainiain workers' cOm nsa�on Insurence, es requiretl by sectian 3700 of the labor Code, tw ihe peAortnance ot Ne work tor which this pemtit La issueA.
My workers' compe° �tion, �Insurance rtier policy number are:
Cerder: VV \ PolicyNumber.
(Th/s sectlon neetl nat be comp/etetl Il fh e it is veluetl a( one hundred dollers (5100) or less.)
� I certih/ Ihat in e peAorn ance o� th work for which this permit is issued, I shall not employ any person in eny manner so as lo becoma subject to the workers'
comply with
WARNING:
� laws ol Cal' omle, and agree t a I should becrome subJect to the workers' compensation provisions of Sectlon 3700 ot the Lehor Cotle, 1 shall tort�with
hese rovis' r. I/� I /� �
Date: ���
TO S RE WORNERS' �,�pENSAiION WVERAGE IS UMAWFUL PNO SHALL SU&IEGT PN EMPLOVER TO CRIMINAL PENALTIES AND GViI FlNES UP TOONE MUNDRED
E ,OOO�,INADDITIOryTOTHECQSTOFCOMPENSATION,DFA/hGESASPROVIDEDFORINSECTION3]OBOFTHELABORCODE.IMEHEST,ANDATTORNEV'SFEES.
LICENSED CONTR.
I hereby aXirm that I
lorce antl eAecL Lic.
�Contrecrofs SlgnaN
CONSTRUC ONL
❑ 1 hereb
Lender's Neme:
Signatura: _
9(commenGng wit� Section 7000) of Division 3 of t�e Business gp�rofessions Coda, end my license is in lull
Cless x-y /''77 _
� Date:_ _. _ _! / �/_ _%�P%
IflG AGENCV:
Ihere is e conslNction lending egency lor the peAormance at lhe wark lor which this permit Is IsSueA. (Sec. 3097, Civil Cotle).
Lendefs Address:
_. Dete: _ _ .__. _
OWNER-BUILDER DECLARATONS:
I hereby eHirm that under penalry of perjury t�at I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW lor the lollowing reeson (Sec. 7031.5, Business enC Professions
Code: Any dry or wunry wluch requires a permil to conslluct, alter, improve, demWish, or repair any structure, prior to its issuance, elso reqWres the appRcant for such permif
to file a signed stetement ihat he or she is IicenseC pursuant to the provisions of t�e Coniractors License Lew (Chapter 8(commencing wiih Section 7000) of Division 3 ot the
Business and Protessions Catle) or thet ha or she is exempt Iherefrom and lhe Dasis Far the alleged exemptlon. Any Wolalion oi Section 7031.5 by any epplicent tor e pertnit
suh�ects the epplicant to e dvil penalry of not more Nan (ive huntlreC tlallars ($500).):
❑ 1, as owner ot t�e pmperty, or my pmployees with wages as their sde compensatlon, WILL DO THE WORK, end Iha 5trucNre ii not IntentleC or oNeratl tor sale (Sec.
7044, Business end PrOfessions C�e: Th8 Conlractore License law does not eppy to an owner ol property who builtls or improves thareon, end who does such work
himsetl or herself or Ihrough his or har own emploYees. provided that such improvements are not intended or oNered for sale. If, however, the builtling or improvement is
sold within one year oi completion, Ihe ownervbuiltler will hava Ihe burden of provin9 that he or she ditl not build or improve for purpose ot sale.).
❑ I, es owner of the pmperty, am EXCLUSIVELY CONTRl.CTING WITM LICENSED CONTRACTORS lo conSVuct Ihe pro�ect (Sec. 7044, Business and Professions
Code: The coNrectors License Lew Coes not apply to an owner of propeny who builds or improves thereon, and who rnntracis for such prol�i vnth a conirector(s)
license pursuant to Ihe Contractors License Laws.).
❑ I em exempt untler sec. Busineu entl Professions Cade for this reason:
Signature: Date:
Owner ID venfied by dnver's license. ❑ Yes ❑ No Drivels License No. Expires:
Verilication of Ownership by (type ot Cocumeni, i.e. - pmperry tax bill or tleed):
DIVISION OF INDUSTRIAL SAFE7Y PEqM1T CERTIFICATION:
❑ I hereby certlty t�et no excavetion five (5) or more feet in de0th into which a person is reQuired to descentl, wlll be metle in connection wlth work authonzed by this
pertnit, entl I�et no builtling structure, scaffolAing, felsework, or tlemolition or dismantling Ihereol, wlll be more t�an �hirry-six (36) laet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title 8, Cellfornla AOministretive Code).
❑ As owner-bulltler, I will not employ gnyona lo do work which woultl require a permit from the Dlvision of Intlustnal Sefery, es noted ebove, unleu such person has a
permit to do SUCh work Irom lhe divi5ion.
Slgnawre:
Divislon ol Industrlel Safety Permi� Number:
Date:
ARDOUS MA7ERIALS AND EMISSIONS CERTIFICATON:
Will Ihe applicant or Oresent or tuture builtling occupant neeA to lile and cenity a Business Plan for emergenty response to releese or threatened release ol e harardous
meterlel? ❑ Ves ❑ No
(Section 25505 of tha Celitomie Healt� antl Sefery Code requires, with soma exceplions, that a Business Plan De filetl wlth the Costa Mese Fire Department by every
Dusiness which hes et eny one time tluring e reponetl year a quantiry of �azertlous meterials oqual to or greeter then e weight of 500 pountls, or a volume ol 55 gallons,
or 200 cubic leet of compressetl gas at stentlartl temperature and pressure).
Does or will the applicaN ar present or futura building oaupant need ro lile e registretion lartn tor acutely hazardous matedals? ❑ Yes ❑ No
(Section 25533 of the Califomie Heelth end Satery Cade, wiN some ezceptions, requires regislretion with the Coste Mesa Fire Departmeni by eech business which at any
one tima has on hand a quanliry 01 ecutety hazertlous materials aqual Io or greeter then e weig�t ol 500 pountls, or a volume oi 55 gallons, or 200 cu6ic feet of
compressed gas et siantlartl tempetature enA pressura).
3 Does or will Ihe epplicant or presen� or tuture builtling occupant neeA to prepare an RMPP (Risk Management i
❑ ves ❑ No
(Section 25534 oi tha Calilomia Health and Safery Coae provitles Ihat the Casia Mesa Fira Depertment may r
Department of an RMPP by busine85es which ara requirea to register aatety hazardous meterials with Ihe Fire
4 II en RMPP is presentty required, has Section 25534 of the Califomia Health and Satery Code Ceen tully cnmplii
5 DOBs or will Iha applicant or presen� or future building occupant require tor ihe wodc whiCh is lhe Su6ject ol Ihi:
from the South Coast Air Oualiry Management Olsidct or trom any other air paiution convol distda or egency7
(Section 658502 of the Calilornia Govemment Code requires that the reQuested informetion be furnished on ap
Ihe preperelion, tetllfltation antl filing with lhe Fire
❑ No
non-resitlential
or
6 WIII d0y pBrt Ot NB 10CIIIly IO �e co05lmctBtl uOtlB� th15 pBrtnit bB WiN10 1 WU tBBI I�OrtI I00 011iBf DOUf10B�B5 O� 0 SGn00i / LJ TB9 V rv0
(tl'yes", ihe Iecillly must meet the r�quirement ot Seclions 25534 antl 42303 oi ihe California Health entl Sefety Cotle).
7 If a permlt trom the South Coast qir Dueliry Management Dis�nct or other eir pollution contml tlistrict or egency is required for the work which is ihe subject of �his
epplication, have all of the disclosures prescnbed by Califomia Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No
B (It yes", atlach certificate ot complience Irom the appropnate air pollution contml oflicer).
CERTIFICATE OF COMPLIANCE: I certity thai under penalty of perjury Ihe infortnation given ebove Is correct. I agree ta comply with all state laws end city ordinances
regarding Hazertlous Meterlals end Emisslons.
Signature: Date:
OF �OMPLJANCE AND q{JT}10RIZATION OF ENTRV: I certify under penalty of perJury that I have read this appliwtion and stata that Ihe infortna�ion given is
i to omply wilh all siate laws entl dty ordinances relating lo builCing consiructlon, antl authorize representetives of ihe City oF Costa Mesa to emer upon �he
itl p openy for insDection purposes. I agree not to occupy or allow occupancy of any bullding authoAzetl by Ihis pertnit unlil Ilnal inspection.
WO�L INSPECTONTYYE
1618 Flaetl System Final Fire Prevention
1266 Pool Spa Finel
200 Final Ra-Rool
201 Final BIocWReteining Well
202 Final Fectory Flre Place
203 Final Sign
204 Final Demolllion
2aas.n8
�,g IMILIALS
/ �� /� at
��T Date
CQOE � INSPECTION TYVE
206 Finel Methenlcal
20B Finel Plumbing
210 Final Electrical
212 Finel Fi�e Prevention
220 Finel Plenning Approval
222 Final Slte
250 Final Builtling/Occupenry
Pl� IMiTIALS
� }
CITY OF COSTA MESA
Bl/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
���a� �sa-sz�3 • Fax ���a� �sa-aess
.lobAddress: 555 ANTON BL
Suite No 2
Vicinity: COMPUTER ROOM
Parcel Number: 41050110
Applicant: LOU RODRIGUEZ
Address: 6265 SAN FERNANDO RD
GLENDALE,�CA "
Owner. SAKIOKA FARMS �
� Address � �
MECHANICAL PERMIT
Contractor: AIR CONDITIONING CO., INC
Address: 6265 SAN FERNANDO RD .
� �Phone: (818)244-6571
. . � Zip: 91201
� License: 120696
Phone: (878) 244-6571
Zip: 91201
Phone:
Zip: 94137
GLENDALE.CA
Arch / Eng :
Address:
Phone:
Zip:
License:
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01I26I2000
Issued: 0126/2000
ISSUED BY: �/ !/
SCOPE OF PERMIT
INSTALL 1 VAV BOX , 1 REPAIR/ALT COOLINGIHTG SYSTEM AND 1 UPTO 15 HP COMPRESSOR
FOR "EPOCH INTERNET' COMPUTER ROOM TI. ' . , : - - � ' ' ,
REF:B00-00022 � " - ,
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU �
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relowte Appl Vent
Air Handlers < t0000cfm
$23.50
$0.00
$0.00
$1370
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.65
$0.00
50.00
$0.00
So.oO
$0.00
$0.00
Quantity
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeretion Unit
Ventillation System
Evaporative Cooler
Commercia l Incine rator
Domestic Incineretor
Compressors / Absorption Systems
Up to 3 hp H00 k BTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15to30hp' -
30 to 50 hp
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0 .
30.00 0
80.00 0
$27.15 1
$0.00 0
50.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremants under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become vaid 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 �he work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlred Inapectlona and finel approval must be oblained. Failure to ob�ain inspections and final approval will result in ihe expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 ,
WORKERS' COMPENSA710N DECLA(7ATION:
I hereby eNirm untler penalry ol perjury one of t�a tollowing tlacleretions:
❑ I heve entl will maintein a certilicate of consant Io sell-Insure for workers' compensation, as provided tor by sectlon 3700 oi the Lsbor Cotle, for the peAortnance of Ihe
work for which this pertnit i5 issuetl.
� I �ave end will mainleln workers' compensation insurance, es required by section 3700 of the Labor Code, for Ihe pertortnence of the work for which this permit is issuetl.
My workers' compensation Insurance wrtier entl policy number are:
Cerrior. Zd/1s<✓l.f POIIcyNumberP2fl7iOG
(This section need nat be comp/eted ll the pe�mirls veluetl e( one hundred dollers ($100) or less.)
❑ I certlfy thet In the peAormsnce of �he work tor which thls Dermi� i5 Issued, I shell no� employ eny person in eny manner so as to become suDjecl to �he wotkere'
compensation le Gelilornie, antl agree Ihet if I should become subject to the workera' compensetion provisions of Section 3700 oi lhe LaDor Code, I shell forthwith
camply wlt 5e pr i5ions,
AppliCant Sig Wre: Dete: /^ 2�e J
WARNINO: F URE SECURE WOfp(ERS' PENSATION CO GE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PEWILTIES M!D pVIL FlNES UP TO ONE HUNDRED
THOUSAND DOLLARE (5100.000�. IN ADDRIIXJ TO THE COST OF SAT10N, OAMFGES AS PROVIOED FOR IN SECTION 3]OB OF THE �pgpR COOE, IMEREST, ANO ATiORNEI"S FEES.
LICENSED CONTRACTORS DECLqqpTION:
I hereby aflirtn Ihat I em licensetl untler praWsions ol Chapter 9(commencing with Sectlon 7000) of Dlvlsion 3 of t�e Business antl Prolessions Cotle, antl my license is In full
larce entl eHecc Lic. a� i, 7 L/ OL� Cless p /_ 7 �
COnhectoYs SigneNre: ,G� �i Dete: /�. � �
CONSTRUCTION LENDING AGENCV: `
❑ I hareby eHirm that ihere Is a construction Iending egency lor t�e peAormance ot the work tor which this permil is IssueA. (Sec. 3097. Civil Code).
Lentler's Name:
Signeture� _
OWNER-BUILDER DECLARA710NS:
Lendels AEdreu:
Dale:
I hereby eNirtn that under penalry 01 perjury thal I am EXEMP7 FROM 7HE CONTAACTORS LICENSE LAW br the following reason (Sec. 7031.5, Buslness and Pmfessions
Code: Any ciry or county which requires e pertnit to consWct, alter, improva, demWish, or repeir eny sirucwre, prior lo its issuance, also requires the applicant for such pertnit
b fila e signed stetement thet he qr she is licensed Oursuant m ihe pmvislons of ihe Conirectors lJcense Lew (Chepter 9(commencing wlth Sectlon 7000) of DiNsion 3 ot the
BuSiness entl Pwfeuion5 Cotle) Or ihat he or S�e is exempl Iherefrom enO t�e ba5is tor t�e alleged exemptlon. Any violation of Section 7031.5 by eny appliwnt for e permii
subJects Ihe applicant to a civil penalry oi nat more than live hundretl tlollars (5500).):
❑ I, es owner of the propeny, or my employees with wegas es Iheir sola compensation, WILL DO THE WORK, antl t�e strucWre is not intentletl or aHeretl for sale (Sec.
7044, Buslness entl Professions Code: The Contractors License Lew tloes not epply to an owner ot properry who builds or improves thereon, antl who tloes such work
himself or herseN or Ihrough his or �er own employees, prbvitled that such imD�ovements are not intended or offered for sale. If, however, the builtling or improvement is
sold within one year at completioq the ownerbuilder will have the Durtlen of proving that he or sha did not builtl or improve tor purpose of sale.).
❑ I, es owner ot the pmperty, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Profassions
Code: The contractors License Ww tlaes not eppty to en owner of properry who builds or improves therean, entl who caniracts far such prqect with a contracbr(s)
license pursuent to the Contrectors License Lews.).
❑ I am exemOt under sec. Business antl Pmfessions Code for �his reeson:
SignaWre: � Date:
Owner ID venfietl Dy tlrivefs IicenSe. ❑ Yes ❑ No Dnvets License No.
Verifica�ion of OwnershiD by (rype of documem, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y pERMR CER7IFICA710N:
Expires:
❑ I hereby certlty lhai no excavalion Me �5) ar more teet In depth into which e person I5 requlretl to descend, wlll Ge matle in connection with work euthodzetl by this
permit. entl that no bulltling „•trucWre, scattoltling, telsework, or tlemditlon or dismentling ihereot, will be more then lhirty-six (38) teet hlgh. (Chap. 3.2, Gry 2, Art 2, Sec.
341, T1Ue B, Califomia Administretive Code).
❑ As ownerbull0er, I will no1 employ enyone ta tlo work wNch woulA require e pertnit from I�e Division ot Indusirial Satery, es notetl ebove, unless such persan has a
permit ro do such work tmm the division.
Slgnature: Daie:
Divislon ol Intlustrial Safety Permil Numbar.
ICERTIFlCATE OF COMPLIANCE AND AUTHOR¢ATION OF ENTRY: I certity under penalry ol perjury that I have reed this apD����ion antl state thai Ihe information given is I
correct. I egree Io wmply wlth all state laws entl ciry ordinances relating �o building consWctlon, entl authorize representetives ol the City ot Costa Mesa to enter uppn Iha
ebove-described property lar Inspgction purposes. I agrea not to occupy or ellow occupancy ol eny huiltling euthorizetl by this permit until final Inspection.
CODE �, INSYECTIONTYPE Q�jE
1618 Fizetl System Finel Fire Grevention
1268
200
201
202
203
20C
2aa&48
Pool Spe Final
Finel Re-Rooi
FInaI8locWRelalning Well
Finel Fectory FIrB Plece
Finel Slgn
Finel Domolitlon
_��^ i�^Gci
Date
�� �QQ�( INSPEC110NTYPE
206 Finel Mechenicel
208 Finel Plumbing
210 Finel Electncal
212 Final Fire Preventlon
220 Finel Planning Apprpval
222 Finel Slte
250 Flnal Builtling/Occupancy
�. 1 1111 .
/1 ��
pM
44 4
o. �
' --
t
J
•� A�
��ia)�sa-s2�a • Fa:(�ia)�sa-aess
Job Address: 555 ANTON BL
Suite: 2
Viciniry: 2ND FLOOR
Parcel Number: 41050110
�
CITY OF COSTA MESA
BI/ILDING DIVIS/ON
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
App�iwnt: GONZALES, HUMBERTO
Address: 2505 MIRA MAR
CA
LONG BEACH '
Owner. SAKIOKA FARMS
Address , , ; . . �. -
Contraetor. CAL PROTECTION
Address: 2505 MIRA MAR
Zoning:
Phone: (562) 498-6444
Zip: 90815
Phone: �
Zip: 94137
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 02I702000
Issued: 07J23I2000
CA - - - Phone: (562) 498-6444
� LONG BEACH Zip: ; 90815
� - License: 327196 �
�SCOPE OF PERMIT
INSTALL SPRINKLER PFiOTECTION FOR PROPOSED WATER CURTAINS FOR -EPOCH- (2ND FLOOR).
REF: B00-00022 � .
Plan Check: $54.11 � �
Permit: $8325
Other: - $0.00
�
Total: $137.36
FEE SUMMARY
Calc Valuation: Sz,Soo.00
Claimed Valuation: s2,soo.00
i
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 1 BO days, or if work is suspended or abandoned
for e period ot 780 deys.
INSPECTIONS: In order for ihe work authorized under this pertnit to be considered legal, such work mus� comply with all applicable codes, and all
requlred Inapectlone end finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnbN DECLARAnON:
1 hereby attirm under penalry o� p¢�ury one of Ihe following declarations:
❑ I have antl will maintain a certificate of consent to selbinsure tw workers' compensatlon, as provitletl tor �y section 3700 ot Ihe Labor Cotle, tor the pertormance ot the
work for which this pertnit is issuetl. �
� I have entl will mainfain woAcere' compensailon insuranca, as reQuiretl by seclion 3700 oi Ihe Labor Code, for ihe peAortnance of ihe work for which Nis pertnit is issuea.
My workers' compensation Insurance carrier and poliry number are:
Carrier: Polity Number:
(This sec(ion need rwr De cqnp�eted i! Ne permit is valued et one hunEretl tlW/ars (51001 or less.)
� I certiy thai in the peHormance of the work for which thi rmit is issued, I shall no� employ eny person in any mannar so as to becwne subject to the worken'
compensation laws of �itomia, and ee Nat if should b e subl�� �o the warkers' compensetion provisions of Section 3700 ot the Lebor Cotla, I shall forthwith
comply with Ihese/�ovisians. q �(
Applicant Siqnature: \ ,��� � Date: %—Z �— L'\
WARNING: FAILURE TO SECUR� Wpq�(ERS' NMPENSATIIXJ ODVEMGE IS UNLAW FUL AND SMALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES ANO CMl FlNES UP TO ONE HUNDRED
T/qU$AND OOLURE (5100.00%, IN AODfTION TO THE WST OF COIMENSFTION, DAAi4GE5 AS PRONDED FOii IN SECiION 7lOB OF THE IABOR WDE, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTOR$ DECLARATON:
I hereby attirm that I am licen�dxn� p�vjs'�s o� Chapter 9(commendng with Section 7000) of Divislon 3 0� ihe Busln�55 e�tl profeuions Cotle, antl my license is in tull
force and eHect. Lic. a L 1 i� Y Class a �— ( b
Contractofs Signawre: � � f� Data: %—Z3� `f
CONSTHUCTION I.ENDINq qGENCY:
'�, ❑ I hereby aHirtn that there Is a wnswction lentling agency tor the pedortnence of t�e work tor which Ihis permit Is issuetl. (Sec. 3097, Civil Catle).
Lendefs Name: Lendels Addreu:
Siqnature: Date:
OWNER-BUILDER DECLARA7IONS:
I hereby aNirtn that under penalry oi perjury that I em EXEMP7 FROM 7HE CONTAAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Protessions
Code: Any ciry or wunry which reQuires a pertnit ro consiruct, alter, improve, demdish, or repair any siructure, prior �o its issuance, also requires the appliwnt for such permit
to file a signed sietement that ha or she is licensetl pursuant to ihe provisions of ihe Contrectors License Law (Chepter 9(commenUng wit� Section 7000) of Division 3 oi t�e
Business and Professions Code) or ihat he or she is exempt thereirwn anA t�e basis tor t�e alleged exempiion. Any violation of Section 7031.5 �y any epplicant lor a permit
subjects the epplicant to a ciyil penaliy of not more than tNe huntlratl tldlars ($500).):
❑ I, as owner of the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, antl Ihe StruGure is noi intentled or ottered for sala (Sec.
7044, Business and Pro(�ions Cotle: The Contractors License Law does not apply �o an owner ot property who �uiltls or improves thereon, end who does such work
himsetl or herselt or iluough his w her own employees, provided tbat wcb improvemenis are nol intended or oHared for sale. If, howevei, the butWing w impsrnemem is
sold within one year oF �qmpletlon, the owner-builtler will have Ihe burden of pmvinq that he or she tlitl not builtl or improve for purpose of sale.).
❑ I, as owner ol Ihe property, am E%CWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construcl lhe prol�� (Sec. 7044, Business anC Professions
Cotle: The contractors License Law dces not appty to an owner ot property who builds or improves thareon, antl who contracts tor such project with a wntractor(s)
license pursuant to ;he Coniractors License Laws.).
❑ I am exempt under sec. Business and Professions Cotle for this reason:
Signature: Dare:
Owner ID venfietl by drivefs license. ❑ Yes ❑ No Drivers License No. Expires:
Venfication ot Ownership by (rype of document, i.e. - property Iaz 6ill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: .
❑ I hereby certliy �hat no ezcavation ilve (5) or mora feet in depth inlo which e person is reQuired Io tlescentl, will De matle In connection wlth work euihonzetl by Ihis
pertnit, entl that no huiltling swcture, scattolding, falsework, or demolition or tlismantling thereof, will be more �han t�irty-six (36) feet �ig�. (C�ap. 32, Grp 2, An 2, Sec.
341, Ttle B, Calitamia Atlministretive Code).
❑ As owner-builtler. I will not employ enyone to tlo wark whic� woultl require e pertnit from Ihe Division ol lndustnal Salery, as noted above, unless such person �es e
pertnit to do suc� work irom the division.
Signature: Dete:
Division ot Indusinal Safety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVJITON OF ENTRV: I certity undar penalty of perjury that 1 have reatl this epplication antl state ihat ihe infortnation given is
correct. I agrae to canply with all siate laws en0 city ordinances relating ro building construction, and authonze representatives ol ihe City of Costa Mesa to enter upon Iha
above-descd�etl properry for inspection purposes. I agree not to occupy or allow occupancy oi any building authorizetl by this pertnit umil Ilnel Inspection.
i A
Si n Wre Of Legal Owner(s) /� ^�ate.� / �
��/i.cA �L_rJ� o•�K
� And/Or Authonzed Applicant Date
COOE �, INSPECTIONTYGE
1616 Fizetl System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Rool
201 Final Blak/Reteining Well
202 Final Fectory Flre Place
203 Finel Sign
204 Finat Demolition
2aaG48
�:� .mi
� /J � �
CODE I INSVECTION TYVE
206 Finel Mechenical
20B Finel Plumbing
210 Final Elecirical
212 Finel Fira Prevantion
220 Final Plenning Approvel
222 Finel Slte
250 Final Building/Occupancy
PAI: I[{�LSS
• . �.
4`05tN MFs9
o �
>
r
J
•A�bqropp�u�'
(714)754-5273 • Fax(774)754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
ApplicanC
Address:
Owner:
Address
� i.
• CI7Y OF COSTA MESA �
BUILDING DIVIS/ON
DEVEIOPMENT SERVICES DEPARTMENT
PERMIT
555 ANTON BL
2
41050110
DQN SMITH
SAKIOKA FARMS
Contractor ACCENT BUILDERS
Address: 555 ANTON BL. #100
REF:G00-00049 & E00-00052
ISSUE FEE
Temp service tesl
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Oullets
Swilches
Non Res Appt
Res Appl
Service to 200a
Service to 1000a
Service over t000a
Motors to 1 hp
Motors to tOhp
Morors to 50hp
Molors to 100hp
Molors over t00hp
Communication drops
Sub panel to 200a
COSTA MESA, CA
ELECTRICAL PERMIT
Phone:
Zip:
Phone:
Zip: 94137
Phone: (714) 5493150
Zip: 92626
License: 397790
PERMIT NUMBER
E00-00084
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 02/03/2000
Issued: 02/03/2000
SCOPE OF PERMIT
OVERTIME INSPECTION FOR SUNDAY 2/6/00 FOR RANDY BUCK FOR "EPOCH INTERNET" TI.
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Seclion
Misc Elec[rical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up [0 50 kva/kw
.................up l0 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lighls)
Christmas Tree Stand
Fireworks Stand
O[her Eleclrical Fee
Investigation Fee
Plan Check Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0,
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applica6le handicap access requirements untler Califomia staWtes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
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 o( 780 days.
INSPECTIONS: In order for the work authorized under Ihis permit to be considered legal, such work must comply wi�h all applicab�e codes, and all
rsqufred inspectlona end final approval mus� be obtained. Failure �o ob�ain inspeclions and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WOqKERS' COMPENSATION OECLARATION: � �
I her2by allirm untler penalty of perjury one ol ihe foliowing declaralions: -
❑ I have and will maintain a cer�i��cete ol consent lo sell-Insure lor workers' compensation, as Orovided for by section 3700 of the Labor Cotle, for �he OeAormance of Ihe
work �or w�ich this permi� is i5suod.
❑ I have antl will meintain workers' compensation insurance, as required by secllon 3700 ot ihe Labor Cotle, br ihe peAormance o1 Ihe work lor which Ihis permit is issued.
My workers' compensation Insurance carrier and policy num6er are:
Carrier. � Palicy Number.
(7his section neetl nat 6e completed Afhe �rmi��d ef ane�iunOred tlallers ($100) ar Iess.J
'�� I certity uint in Ine
com ansnlion laws
P
com il wilh Ihoso
IY P
� I qpplicanl Signawre: �'
W4RNING' PAILUfI[ TO S�C
i ol Iho.Cvork lar whicii�hl5 parmit is iSsuoQ I shall nol employ any porson in any mannar so s lo bepome subject lo Iho workors'
, and ugwo tha� i(I'should bocamo sublacl to Iho workers' componsalion provisions o/ Seclio �00 0l fe Labor Codo, I Shall �orlhwith
`�/�L\ Da1B: (/� C>� C? L�% ,i
J
1$'COMP NS�IIONWVFi11A0['ISUNIAWfULAND.�11A1L5U1}I[CiANCMPLOYEHTOCPIMINALPENALTIES/.NOCIVILFINESUPTOOflEIIUNORED
IONI'p� tECOSTOPGOMPENSAf10N,UAMAGLS�SPROviDFUFORINS[CfION�lWOFTHELAOORCAOE.INTERESf,ANDAnORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION: �
I hereby allirm Ihat I am licensed u , provision O(Cha ter 9 c( ommencing with Section 7000) ol Division 3 0l ihe Business and Pro Ssio s Code, and my license is in Iuli
torce antl eHect. Lic. � 3� �-U � Class #
,
Contractor'sSignaWre: ��F� .- ' � Oate: ')�'– 6t�
�
CONSTRUCTION LENDING AGENCV:
� I hereby alfirm I�at there is a consimclion lending agency lor Iho pedormanca ol Ihe work lor which Ihis permit is issued. (Sec. 3097, Civil Code).
LendBr's Name: Lendars Address:
Sign2Wre: Date:
OWNER-BUILDER DECLARATIONS:
I heroby aHirm Ihat under ponalty ol perlury ihal I am E%EMPT FROM THE CON7RAC70RS LICENSE LAW for �he lollowing reason (Sec. 7031.5, Business and Professions
Cotlo: Any ci�y or counly which requires a permi� �o conslmct, all¢r, improve, demolish, or repair any simclure, prior to its issuance, also requires ihe appliwnl br such peimil
to file a signed statement �hal he or she is licensed pursuant to Ihe pmvisions ot the Coniraclors License law (Chapler 9(commencing wi�h Section 7000) ol Division 3 0l the
Bus�ness and Pro/essions Code) or that he or sho is exempt �horetmm and Ihe basis br lhe elleged eaemplion. Any viola�ion ot Seclion 7031.5 by any applicant lor a permil
subjects �he aOPlicant lo a civil penalty ol nol more Ihan five hundretl Collars ($500).):
❑ I, as owner ol Ihe pmpehy, or my omployee5 with wages n5 Iheir sole compensalion, WILL DO THE WORK, antl �ha s�mcWre is no� inten0etl or afieretl for sale (Sac.
70a4, Businass and Professlons Code: The Contraclors Licenso Law does not appty lo en owner ot pwperty who builds or improves ihereon, and who does such work
himsell or hersell or Ihmugh his or her own employees, O�o��ded Iha� such impmvemenls are nai in�entled or oflered br sale. It, however. ihe builtling or improvemen� is
soltl wilhin one year ol complelion, �he owner-builtlor will ha�e Ihe burden ol pmving that he or she tlid nol bui10 or impmve lor purpose o� sale.).
� I, as owner ol tho pwperty, am E%CWSIVELV CONTRACTING WIiM LICENSED CONTRACTORS to conslmct Ihe pmject (Sec. 7044, Business and Professions
Codo: The conlmctors Licenso Lnw does nol apply to an ownor ol pmperty who builtls or improves �hereon, antl who coNracls tor such pmjecl with a coNractor(s)
license pursuanl �o Ihe Coniractors License Laws.�.
❑ I am exempt undcr sec. Husinoss antl Prolessions Cale �or Ihis mason;
Signa�ure: Date:
Owne� ID venlietl by drivar's licensa. ❑ Yo5 ❑ No Driver's License No. Expires:
VerifiCation of Ownership by (lype ot documeni, i.e. - pmpetly lax bill or deed): �
DIVIS�ON OF INDUSTRIA� SAFETY PERMIT CERTIFICATION:
❑ I hereby cenify I�a1 no ozcavation five (5) or more leel in tlepih in�o which a person is requiretl lo descend, will be made in conneclion wilh work authorized by �his
permil, antl �hal no building sirucWre, scallolding, lalsework, or damolilion or dismamling thereol, will be more �han thiny�six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Calilomia Adminisirative Cotle�.
❑ As owner-builde�. I will not employ anyone �o do work which would require a permi� irom ihe Division of Indusirial Safary, as noted above, unless such person has a
permit Io do such work Irom ihe division.
Signa�ure: Date:
Division ot Industrial Saleiy Permit Number:
1 Will the applicanl or present or WWre builtling occupani need to lile antl cenily a Business Plan br emergency rasponse to release or threa�ened releasa of a hazardous
malerial? ❑ Yes ❑ No
(9ection 25505 0� Ihe California Healih and Sn�ery Coda requiras, wilh some exceptions, ihat a Business Plan be tiletl wilh the Costa Mesa Fire Departmeni by every
business wM1ich has at eny one lime during a reportetl year a quentiry ol hazardous materials equal to or greater than a weight ot 500 Oounds, or a volume of 55 gallons,
or �00 cubic leet of compressod gas at slantlartl IemporaWre and pressure). �
............ . ... .... ............. . ....... . . ._...._. __,... _......_.. ... .. ........ . . ., .. .__ _..._ ' ._ ._..
_"'__. .. ....._"....... .. _
2 Does or will tho applicant or presanl or luluro bmlding occupent neod to lile a regisiration lorm for aculely hazardous materials? ❑ Yes � No
(5ection 25533 of Ihe CNilomia Heal�h anA Satoty Codo, wilh somo exceptions, requires registration wilh Iho Cos�a Mosa Fire Deparimont by each business which at any
ono limo has on �mnd n yunnliry ol aculoty hazeu�ous mNoriaL^ oqual to or groator Ihan a waight oi 500 pounds, or a volumo o� 55 gallons, or 200 cubic fea� o�
cOmpressed gas a� slandard �ompomlure entl p�essure).
......_..... _ _.........._. .............. _,........ ""_ . ...._.... ,..,.... ........ .......... ........... ............. .......... . ............. ......
3 Dces or will Ihe apDlicant or pmsenl or fuWre builtling occupant noed lo pmp2re an RMPP (Risk Management and Prevention Program l0� aculety hazartlous materials)?
p Yes ❑ No
($eclion 25534 ot Ihe Cnlifomia Hoallh and Safaly Code provides thel Ihe Cosla Masa Fira Depatlment may require Ihe preparalion, cetlification and liling wilh ihe Fire
Oepatlment ol an RMPP by bus�nesses which are requlred lo regisler acutety hazartlous materials wilh ihe Fire Depanment.
—�___—_-- _.___.—_..'___'_....__..'_......_._._...'___.._........_..._..___ . ___..._ ..... . ..........._......._._...._.....__._ _._._........
4 II an RMPP is Oresanlly required, has Seclion 2553a ol the Califomia Haelih and Safaty Code been fulty complied with? ❑ Yes � No
5 Does or will Ihe applicanl or presen� or lu�ure builtling occupant requlra lor Ihe work which is �he suble�� o� �his a plic
Irom tho Souih Coasl Air Ouallty Managemenl District or Irom any o�her air polWtion control Oislricl or agency? � Ve:
($ec�ion 658502 of the Califomia Govamment Code roquims thal the roquestetl inlormation be lumished on applicatio�
6 Will any patl ot �ha faciliiy �o bo construcletl untlor ihis permll be wl�hin 10001aet irom the oNer bountle�ies o� a school
(II'yes", ihe faciliry must meet ihe requirement ol Seclions 25534 entl 42303 ol Ihe Calibmia Heallh antl Safety Code).
—_'___ �_ __�_—'___'..._.."'_'__"""______"'_'__.__._.__...
7 If a permit imm Ihe Soulh Coas� Air Duality Management Districl or olher air polWlion coniml disirict ar agency is
ypplication, have all ol the tlisclosures prescnbed by Calilomia Health and Sabty Cotle Section 42303 been mada? [
QI "ye^.", attech cetlificato of compliance irom Ih
CERTIFICATE OF COMPLIANCE: I Cehily �hai
rdgartling Hazartlous Materials and Emissions.
SI9naWre:
or
(or non-rasidenlial
No
penalry of perjury iha inlormation given aDove is correcL I agree to compty with a0 state laws entl ciry ortlinances
Date:
CERTIFICATE OF COMPLIANCE AND AUiHORIZATION OF EN7RY: I cetlily under penairy ol perjury thal I ha�e read this applicalion and stale thal Iha information givan is
carred� I agrea to compl�llR@II slate laws and c�ty inances relating to builtling conslruction, antl authorize repres=ntatives ol the Cily o� Cosla Idesa Io enter upon Ihe
abova�tlescrihed property for insj�ecUo�poses. greo not to occupy or allow occupancy of any building aulhorized by this permit uNi�M181 inspection.
CO�E � INSPECiION TYPE ��
t616 Fixed System Final Fire Provention
1266 P�I Spa Final
200 Final Ra�Roo�
201 Final BlocklFetaining W all
202 Final Factory Fire Place
203 Finel Sign
204 Finai Damolilion
zaaa q8
1}_Ajf, INTRIAlS
COOE I
206
20B
270
212
220
222
250
INSPECTIONTYPE
Final Mechanical
Final Plumbing
Final Elecincal
Fina1 Fire Prevention
Final Planning Approval
Final Site
Final Building/Occupancy
0� iR4
♦ rv 1'�*
�
�I
�
Pfl0.1EtT PODXESS: S S S ,ANTON B1.
OWNEN'S NFME: BANK OF AMERICA
nooeess: z0 N. RAYMOND AVE 3RD FL
18)578-7700
uxrc: ZNDFL
APCN/ENGMEER: Rj•J$ ARCHITECT flEC.NO.:C—SSO73
aooeess: 22072 CAMINITO VINO uxiT:
LAGUNA HILLS CA 92653
PENMITTEE: GOLDEN STATE FIRE PROT ( 714 ) 923-4060
aooness: 936 E FRANCIS B
ONTARIO CA 91761
LILENSEO CONTIUCTOfl OECUflATION: I here0y allirm Ilwi I am IitensM unEer o�o��s of Cnao�cr 9(commendnp wltn Section
7000� ol UivSion 3 0l IM Business anC Pmlessions CoOe. ana my luense i5 in IWI lorce and e�
CITYLI.: 00% 4 s�euc.:350 _i c ss: C—lf
Date: ��� Si9namre: —
WOBI(fB5'LOMPENSpTIONDECIABRTION: IAereOyallirm hatl�aveacenilicateofconsemtosel-i �aa,;certiliwteofWorkers'
ComOensa�ion IqS a `Q{ �fe �j eaol (Sedion 3800. Lan.
"OLILYNO.: l��/C��J��J� E%P.ORTE: -j�OiI93
•oMrnNr: REPUBLIC IND
�] Certitiea mpy is �ereby fumiSheU. � Cetli�ie0 rs IileU n �he u�y BuBdmq �ivision.
oa,e: �— i �— i Z ���r ��—�—� �
FIIEMPTION FXOM WOflKENS' COMPENSATION OECL�fl�ITIUN: �firs uction nre0 not Ge mmWaeE il Ihe permi s IW qre AuMr 00) w kss�.
I cenily Ihat fn t�e p¢Aarmance af l�e work tOr wNt11 tli6 Oemnt is 6weC. I Shall not empby atry per50n in dlty manner 5o as to become
.. subiecl �o Ne Warkers' Comoensation Laws al Calilomu.
..� �ate: SI9wWre:
NOTICE: If, atler ma'ung I�is GeUaratian. y0u ShWW EttOrtre w�l� �o tlx Wo�ker5' COmpenSdtion D���ns al l�a LaEOr
CoOe. Yau must �onMvii� comON �^l� suc� prov5bt6 or Itit permii 51w0 Oe GlCmCO r¢vOkeE.
CONSTHUCTION LENUING RGENCY: 1 �ereW aflirm Ihat I�ere is a mntution IenOing agemy for tAe peAormance of Ihe work lor
wnicn �Ns Dermit is �sue0l�tion 3W7. Civ. CI.
LENOFfl:
nooxcss:
OWNFB BUILOEB OECUB�TION: I �erzEy atlirm tlut I am aempt imm t�e Camracmrs' Slate License Law br t�e followinp reason
(Seclion 7031.5 BusineSS aM Professional CoOe: My citY �� tounry which repuire5 a perrttit to cOnsWct, atler, improve, Oemolisn, or
fEpol! dlly SIf11LIWE, pfl0f �OIIS ISSUd11Ct. d150 flQNlCS IIIE dppllCdlli 10! WC11 P!lRYI IO IIIE d 90�=� SldiCrtICOI Iildl hP1511E IS 6LEIISEU
oursuant Io IM o�ovisions ol me Canuaciws' State liceme Law (Gup�er 9(mmme�np xit� Section 7000) ol DNivon 3 al Rre Business
ane Pmiesvans Ca0e) oi tlut he/s�e 5 eKemD� ��eretrom aM ine Uasis lor t�e atleqM e.emptian. My Nolauon al Sectbn 7N7 S Gy
any applitant lot a permit wejttts Ine applifani Io a tivil pqWlty of not mOR thdn live nunEreE C011ars (5500�.
I, as owner al ine propeny or rtry em byets with wap¢5 as t�eir 501e compen5ation, wiA tlo tAa wofk, an0 ine
7 svucmm ¢ not imenON ar ofhrN loi ule I�tqn 70e1. Buvness afM Protesswnal Cotle: Tne Comraaors' S�ate License Law
. Gaes not apP�Y �a �n owner al a D�ocehY � OUJEs ar imD�'a t�ereon. anG wtn Eces such woM MmselV�ers¢II or t�mupA
his ar her own emD�oyees, o�oviU¢0 tlWt wcn imprOvemenis ate not inteneeE or oftereA lar u1e. I1, however Ihe Ouilainp or
� imD�ovement is solE witnin one year ol COmpletion. ine Owner win nave tna eureen ol O�ovin0 �ushe Uitl no1 buil0 or imo��e
la� Ilre ompose ol ule�.
I. as owner al ttie D�openy, am eRUusiveI� conlractinp vnt� IkenseU wmraclors to wnstmcl l�e prolect (Sectlon 70ad, Business
❑ anG NOleSsions CoOe: T�e CanUactOrs Staro Lke�ae Law Eoes not appy ro an ovme� al properry who OwICs or improves tAeaan
an0 w�o wmraqs for such Drqecls vnt� a mntrapoqs) licrnse purswnt to tAe Comrac�ors' State License Law�. I am awaa
itwt praof ol t�eir Wwke�'s Comperrsation insunnce slnuW Oe yovi0e0 to me.
il � I am e.emo� un0cr Section: B. 8 P. C.
lor Inis reason:
Oaie: Owner.
I ao AereOy cenily I�al I am aware ol an0 unaerslanG I�e repuiamenis of Ca0lomia Healt� anE Sa�eiy fAEe Sections 25505. 25533, and
2553a anG t�ai I or arry Imure �uilEinq occupant wilVwiA n t �drde one� nreE to comON ��� �i0 state wOes an0 i�e repuiremenis for a
permi� br con5tmction or moCilicaiion Irom I�e Air 311�y MdOdpl111COI USIfICi. flC4GMIWl L9051f11LI1011 dppllQi10115 2(ClNCIIIO� �fOrtl
I�eS¢ provisions.
Date: ApDtiwnt:
I hereGy cenify ��a� I nave reaC Ihis a00�iwtion anA s�ate �tw1 t�e aGov¢ inlormaiion is carrM. 1 aBrtt b comON `^��� all ciry anA couniy
or0inances antl s�ate laws relating to bWOirig constmctian ana �ereby aultnrize reDresentaliva ol lhis dt la enter upon i�e ahovrmentione0
O�op� f�n � e� i pur es._ � /-'� �
(_ 1
�aie Signaiurv �Y �L
o�mers ucense o� sac�ai securiry x: [
t641<6 wpite—BuiWing; Green—COCe Enlorcement: Canary—Apd��ant; Pink—Revenue: GdOenroa—Assasmr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F USy 5
PERMIT NO; F 059052 PLAN CHECK NO; 03947-92 L GOVT; N SUY1+;
CONSTRUCTION TYPE; 1FR SP PERMIT TYPE; FIR PURPOSE: OTH
JOB DESCRIPTION ; COMMERCZAL T.I. (FIRE SPRINKLERS) SQ FT:
CLAIM VALUE: 1,600.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: RE: B58871 PRIMARY HLDG. PERMIT.
ik iE 1E 1F fF 1E it lf fFlF iE �If iF 1E iE if iF fE !E!E iE It If iEiE fl� 3E 1E �lElE 1t iE iF if i! iF iE if iE iElf -lE ik if if 1E 1E 1E iE ikif iE ik iF iF iE fF !f iF if it iE M� iF iE iF M iklf ih iE if �F IEif iF iE iE )f
Z U N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE; REF NO;
PLANNING NbTES>
>
*�*�*�*���*��������****��,���,�**,�*�����*��,��**�*��,���,�**�***�*���*���*������*�*,�
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED HY; �' �- � DATE; I Q
iEiFiFitifiFiliEit3FiE�iEi(�iti�-iEiti��itiEiE7fiFiFifiF'ie��i' �F'iFiFii' fiE 7F'3fiF3F�fiFif3f7FiEkiEiFitifiFitiFif �r s iE
k it �E iP 3t iE it �t iF iE if iE 3k iE iE if iE 3i iE iF iE if 1E iF iF if IE it iF 1E 1E iE iE iE iE iE iE iE iF iP if 9E it iF if it 1E iFiE 1E iE iE iE iE iE �E iE iE iF iE iE iF �E iE 1E iE iE iE iE 1E iE 1F iE ik iF iF iF1h iF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 37.00 0,00 24,05
REVENUE DIVISION TOTALS--> COLLECTED;
HLDG PMT PLUMHING ELECTRIC MECHANIC
37.00
65t SMIP/NON—RES
24.05
TOTAL PAID DUE
61,05 61,05 ,00
37,00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
37_00
1E iF it iE if ik iE if M� fE iE iE iE iE �E if iE-%� iE�7E iE IE k iE iF lE 1ElE �K� iFit iE iF itiF i(� iE ik iE if �1(� iEiE iF �%1Fi( it �t dE �lE iE if%�E iC �lE iE �lE iE iE iEdE iE iF iF af �l! iE if �E�IE�F iFit-�%iE iE iE
I N D I V I D 0 A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 37 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 37.00
END OF FEES
n) [GI_�C ��;-,��. �i : ,.e -
�'
6RTE: po,;b ".! .. "
CONSTRUCTION AND PLANNING P � SP'�' -
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspeetor
i. Temporary Electrica� Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3. Electrical Conduit UtilityUndrgrnd. 54. Forms
4. Electripl Conduit-Undrgrnd, . 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
B. Foundation � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Scructurel Floor System - 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal '
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electricai-Conduic 66. Solar Svstem-Final
16. Rouqh Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPfiOVED FOR PLASTERING
18. Rough Electriral-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. Under9round Hydro
22. Ducts, Ventilatirig � „ 77, Product Pipinc� � Gas � Od
23. Gas Pipe�Fough & Test 72. Underground Flush
24. Roof Framing 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � 74. Overhead�Hye4ra. G,-3D'�i. �(J
26. T�Bar Ceiling (Struciuraq & Monocaat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL (� �,q�
29. Insulation � � 7$, FIRE PREV. FINAL Q.��.
30. Dr � � HEALTH DEPT. REQUIREMENT
ywall Nailing
31. Plaster Brown Coat ; � 79. FINAL INSPECTION
32. Electrical Power Meter�Final � I 80. FOOD CERTIFICATE ISSUED
33. Finai Electric ; � i Notes:
34. Final Heating & Air Conditioning, � � '
I �
35. Final Gas Pipe�Test � I
36. Hood or Canopy I �
37. Final Factory Fireplace � I � 1
�
38. Final Plumbing � � � �
i
39. Water Service-Final � �
I 1
40. Gas Service-Final � � .
41. Solar pomestic-Final • � I �
42. Backflow Preventer � � . -
43. Backflow Irriqation
44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING i � I
,48. FINALPLANNING ( � � I
49�. Electric Release to Edison i � �
50. Gas Retease to Southem Ca6fornia Gas Co � �' S
51. CERTIFICATE OF OCCUPANCY
No. Date
nnnnessaewowo: 555 ANTON BL
OMNERSNYIEIGpqNk SAKIOKA FARMS
��51 PO BOX 2097
TERMINAL ANNEX
�rv�.�.nnio �sx
u"T 2 ND
�xcx�cTone�mi�n INTERIOR DESIGN 213623218��= 9378
�K�����% 550 S HOPE ST uNr: 1100
��T�� MORFtOW MEADOWS CORPORATI0��714)598-7700
cam�croxs�uwa 610 REYES ST
mox�sa WALNUT CA ucra: 230813
91789 uHT:
110EN9ED COMP�CTONS DECLAFATION: I Mmby Nim uMa penely d pejury Net I em lieawd wdr qwuoru d Chepm e
(canms�n0 wl� Seclian ]0001 d Oivi+ion 3 W Ns Bwima and Pmlmaiau CoCa. utl mY Ymiw u m hA lau eM aflw.
cmuc.No.:006558 �nu/c.cuss: C 10 ��N� 3081 EXP: 2/96
Dma: ��' � � � / i�s Gapredor.
„4NER BUILUEP OECIANATON: I Mreby dfim inMer penely d perjury IMI I em p ho IM CaEratlm Limnss Lew /a Na
iAo�+iq �mam (Satlim JO]1.5 Bu�iw�a eM Rdmiwie Cada: �nY cYY a ewm�Y di �+V �� a W�u to auumn. eEm. impan.
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n uro�a cewdv �o m. ao�. a m. cwu�� uo.o.. �w Icnaw« s oo�.� �.vn saaoo �mol d a:� a a iro
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a m«.a �a.w (s.nion �a..6u�m ena ridm.ion. e,a.: m. eavema. Limn,. �..eoe, m.ppry�,.� own..a nwem
wM10 buiCs a inpo.as �M1ason. vd who dou �uN wak Nmaetl ar MnN a Waqh he a her am emplqee�. pwMM �htl ac�
impmwmm� ere nol iiusMed v dlareE lar eele, tl, however, iM Witl'up a inparomeM e wtl vrilh"vi ane ysv W mmpMian, tlw
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� I. u oxner d iM proqity. em utluvively con�rapnp xnh liceneed wnvaclwe b canW W IM pojeC (�b^ �. �oiiwea ard
Frola�ians code: The Conveam lica'ue Law tloe. nd eDON m an owie, a pw�Y xM bWds « impw'm iMrwn uM wlw
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WONKEN'9 COMPEN9�TIIX1 DKUfl1TI0N: I hxaEy eMem udx psWy d pwkry ww d ths to0mmp dedereom:
� I Mn rd W me'vven � canArsts d ovmnt to wpinwn br wkai mnpanWion, m prwidW la Ey SMbn �]00 W �M labor
coa.. �a �n. v.��. d u» .w �> xticn Nw c.� o b.ued.
�] I luro W W meiNen wpken' mmpenwion'vuurariw, n ipuintl by Swion 9]00 tl IM Lebor COM. br iM pulormeiws d �M
wwk ta Mh'rA Ne M�e u'v+uM. MY waMn' oomOMeetbn iiuurenea wner W V�Y ewnEr era:
c�: FIRE►�p,�g gUND EXPIRES
Pd'ry Number. n�7S�T��i� 0 7/ O S/ 9 6
(This ewion rod m� Ae mmdKeE r tM G'�� ie M wre nunCrW dd/ua If�ml a lsv.1
❑ I pnN � m� D��e d IM wak la whch ihu pemin u uurE. I ehell nd empby ury pewn n ury men�wr w n to
Eecama uibjed io ihs v.vY s' mmpeimmian lews d CelJamie. W e0ns tlW i�J .haAd bmro nAid to tM woM1en'
canpmWianpqvaro d SWb+ 3]W tl tM labor COM. I kWJJpphMLh mmq/ wN �M C���� /� �
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S�etlon 1106 oI �M Wo� COA, lirtw�s4 vM arturmY'� Iw.
CONSTIIUCLION LENOINO �UENCY: I hreEy elf uMer pmNy d p
psAarmeme d tM wM la x1�iN Nu pumi u ewed (&eaion 908). Cw. C)
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CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: E 07601
PERMIT NO: E 076016 PLAN CHECK NO: N GOVT; N SUPP: Y
CONSTRUCTION TYPE: iFR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 200005F OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS REF: H-74570 / SUP E-74576
itit�tx itititx itfeitirit�rit�t*itit�rititit���tit*it*�rx�x��t+t�rititit�tx�itx�it�E�+r�t�r�iEftx�*�r�rit�r�titit�titfaititit�x�at�t�r*at*x��r�t*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
� ^r
14 iE iE 1EiE1E 1E if 1E 1E 1! 1f 1E 1E M M ik M 1! 1k 1k iF 1E 1E 1k iE iF if if If� IE 1E 1E k 1E M iE 1E 1f if k iF If 1f 1E if k 1F if IE 1E iE 1E 1k iE IE 1F 1E �E iE IE iE 1E iE IE 1E 1E IE 7k iE 1E iE 1E 1E iE 1E Ik 1k fk
D E V E L O P M E N T S E=R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : , DATE:
APPLICATION ISSUED BY: � DATE: �
If iE il� 1F 1F if i81k iF 1k 1E Ik k 1@ k IE 1E iE 1E 1E 1E ik 1E 1E k IE 7f iE 1k if ik ik�iF{F1F 1E
LEGALIZATION:N F E E{% S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 16.80
SOt SMIP/NON—RES
PLAN
ISSUE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 16.80 4.50 0.00 21,30 21.30 .00
REVENUE DIVISION TOTALS--> COLLECTED: 21.30 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
21.30
�f161EiE1E1EfEiFiFIFltiklEiFkiF1E1E1fff1ElEiFiFMlE1F�k�FlkikikiFlEkikikfkikikiE1E1E1lfklFflikkklEfElEMlfifiklEk1f1F1E1EfE1klEfklklFiEiE1E1k1kiFkiElflk
I N D I V I D U A L F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
I ELE
u e ommuaion wdinp epmcy mr u�e ELE
..T'i.�.
Dma: / /8 9l
(St51�6.WP) � WIWo-�uddnp 8 Selely GioemFb; Cenery-�ppFan; Rnk-W�a�uw; Gdderco�Asana
��
20 RECEPT/OUTLET
4 RECEPT/OUTLET
1 ST 20
ADDITIONAL
END OF FEES
EA. .75
EA. .45
�. � ;��6 � L' N
15.00
1.80
CONSTRUCTION,AND PlAN71�t1$G - - � _ & SPk'-
,APPROVALS Permit# Date Inspector qppROVALS Permit# - Date Inspector
,1. Temporay Eiectriral Service or Pole 52. Pool & Equipment Locacion
2. Soil Pipe•Undrgrnd. � 53. Steel Reinforcement
3 Hectrical.�ond�t UuJitY-Undigrnd. 54. Forms
;¢ Electric2��Cqhdl�7Jp��irgrnd. 55. Electrical Bonding '
.�
�5.'Sieel Reinfor.cemeq( 56. Rough Plumbing & Pressute Test
��' ElectricaLl�E nd. 57. APPROVAL TO COVER�GUNITE
'.d'-..
X�Do[ings ij : �� '' 58. Electrical Cond j�Undrgmd. '
� 8. Foundatimn' c;E� . c 59. Gas Pipe, O UrtBr�rnd., Test
9. Water Pipe�Und'r`ymd.' � 60. Backwash LinesSP=Trap, C3 Undrgmd.
70. StructurakFioorSystem 61. APPROVALT06ECK
T�
11. Property Sewer'�ine:& HousN�f.onnection 62. Backwash & RcQ2"ptor-Fina� -
12. Sewer CaP; _.� ` - 63. Heater & Vent-Final '
73. Roof Drains � � 64. Plumbing System - Final
14. Rough 7lumbing, -� 65. Electrical-Final
15. Rough E�ectriw�-Copduit Q' 66. Solar SYstem-Firj� '
16. Rough E�ectric VCiri ` _. 67. Fencing & Acc�ss ApProval
_ 17. Rough Wirio Sign G 68. APPROVED F�LASTERING
� 18. Rough Elecfica�T Bar Ceiling' 69. POOUSPA SYST'Eh4S FINAL
79. Rough Heating & Air Conditioning _ } � t C FiRH,pEpT.q[tEQUif�EMEN�T ,�m
p• F.
20. �uu�tl F�tor� Fi��' ace ' S`��, .� « S� c.�., x APP�V�(�� PAr}nit #�
27. 9ucG; in'3truCIura7x . ••�•• t+' * - � ^ � _ 70. `UnderCjl&n� Ft�dro �
22. OuCta: Vrljtila.�in9� ��; ' `�` ,� � 4 y� 71. Produ�q, Ping�lJ�,,as � Oi{
23. Gas Pipe-�au & Test 1T�1.: �+' tT7 �' : 7 x. � 7p, Undergrb'und Ffvfti ��
24. fioof�Fraliting ''�* � E"�' "_' fi% 7'� „�� ` 7� Undergr�d.Sto��Tankt�Gas ❑OY
25. Roof�SF+e`aJhing g� C� V'J K 'J � N* 7� Overhead Hydre, �
r
26. �,T;BaFCeiling (Stri�C�ira11 & f�j�oat ,`K � � d �* 7� Ory Che�aical �„� x� ` .e-,�T
27. E�'r 3: ., . � .
ameand.Flashir�gr. ^t:.^; *� ��m 76. Dry Stari4l�TipeF� * mt*,
- - n
28. LatMiAg&Siding�*y e'�� � K` ..� 72. FIXED�'.`$T�FFINA�.r, - ��
N �: x U n .. .. �
' 29. InSuly¢iOp. ('�t S •• > � 78; FIRE PREV. FINAL ' % " ��
L
t
30. Drywall IU'ailing :�'� �� � F I �t. S Zki�ALT�#1�EPt.`REQUIR,€14A�ENT
- 31. Plaster 0r�r4-Coav;�� c . mp+ * � :.� 79� FINAL kA15DECTtON ��
-' 32. Electric5l�ow�r MPt�r=Finai � # �� � * SQr FOOD CERTIF�AT'E I��UEQ.,
33. FinaFElec3�iic; �'f .:y � � Q� �t:o_'' � btes: ^� -±r a'7 � .T.
Cl/� {O
:��34. FinaL'lieafing'&AiF�onditionirfg� f: !+� R •" •S :��. ' -� �y � ,
:t.�� � „� . � r - -oo �: i �� �-C
35. 6�nat7'ias�Pipe;�Ie t�v � : s H � .f , •xc Ei�; • -.T
.� .
36. Hoodur CanoPY '- ' -•••= n x n ' E !jo • ��,
�R'J a � n xo : - .i.m -
� " -- � � 5 �:. , �
- 37. Final'Eactorv Fire�ace �x � HF ^� � � . `t � �i:� ' -
-38. FinalLPlumbing TY .lL � � r��.� . != X a� --..
`39. Water SCrvice-Finat y G � ''. * m .' s : •.. � y � �tt*1 `" . a
Z
�r,40. GasService-Pinal �c:x;; �.:?'r•� S' *T -� � O`� • t�: K . . � -
• > �.:� -+ F • c �. T 4
� �
�41. $olar DOmesticFinat� '; " � I � �, .�_ �. - - ,
42. 8ackflow Preventer r n �� 'F � � C 'F R G i^
� MG a r
43. Backflow Irrig�'a�tion y �'SS � Q *• � T" n •.
4,4. LandscaPe IrrigationsSystem �T.C) ^ r,^ ' C C+: ' N cu -.^,C� +� ��� ^-
-� �-c� vi c e a' Y. � �' :n J� e. K' 'r
$5. Sound Atten(rstion+ `�xF r a`' -`. H�,`,:' .- r�-� �� i..p x
46. Handicap Regulations - r�� t; vt S G�"� � M
� i n r,,
47. FINF�1. STRUF.'TURE & BUILDING '' �' �` v�' .
t� i ka:_ G-' r
�
48. � NPct PLANNING c ;-�F r N . v' �, c^ �: � H
+ ' �� , . n S >. �G,
49. Electnc Release io Ediso� '' � ' `� - � "
� . c � �s
50. Gas Rel¢ase to Southem Californta�GasCo i ���' i, '" po Jn a� ai '�r
51. CER�IF�CATE OF OCCUPANCY � ' �. :'r� � -
No Date
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ADOflESS:
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NO.: (�'��2 q• �fC�qRAtlO ; SiOnatore. g ° Qionsp�� i
� OO����a �RE �U$L j�C e I,ND e ep bsecii��� h(ab a certilica� 8` antl enec�Pfer 9(commencin0 wi�h Section ,
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teq��b a( FBOM q' Ofl �Qnilie0 capY is /il I/OS �9 3+ro se� ins o a�
Dateie<t to the Wo�cesor��c�o PENSITION �pPliran(: e� �th f e Ci uilai ertilicare
�°mne�salroe �rork �o�f��RAilO �g �'ron.
�e�CE� ll. aller ^ Caws oi Cali o�h�s p'p�mT�s s���
CONSiq�' Yo� m�sf 1�k�9 fAis nia. s�ssued,�^otb¢
wh��h th�s pe�m� �s ND/ �nACEN m�Y w�ih s' Y0� shoul shaBno( ¢mp ro'if��nriis
A����S; °�(detlinY,7�97e�d��lpmnhrothee'/SsOc�m���apeWO/kers� �son'anman��astp�dec
rop�0.715fq�fC(qN acansfr�.lionbe�d�9 �reVok�qUh�ProNsioruo��heLabor
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J�8 D� CCTj�N TypE 8g7jcrry �F c�srA M
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CLAj'y VAL PT r�N 1 FR SP 1'L.�/V C� Bflr� D
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P,�x p� '� �NBUrLD N c R** �O** 21. 912 0 p SQ F PURpas, •
*L�NiN� ��, IN R�NT'?N� � F,, S E T g A ci*�* E****� �ROUp �cc ° 3 6' ALT
sj �`##*�**�*�TEg; rNTE pRov F� � SN `` X g M E N* �**��** B,2 % �0
Z�NjNG D E v E L 8*** zNG ALTER p jN LEFT' �`�� AC S *********�*
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'SN BL� SpMr P ** �'***'�** DAT E N T-s��*****
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SN� D, v` I 4 6• 25 rN G ELF� i S U� M M ��*** �A7'E: �
SN � Dlvi � 2�9�yIT TRIC.. �Mg�X��c.y****"�*�,*�* * � ** ** • .,��Z
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C 12p� D g S v I p U***** ..- , �FIRg9�60 37pAjp ,
�2p0 EQFU'INT R r p T I L/�fi E•g****�*•�rSMI9T�T/SHORT;BS DUE
Ef2U,ALT c�� g S��pE r ' f: ,� g� R E A K*� **0 **cR�ING PL,�N,C�� 00
AIRrCpN�R �Y:R,�! `� pN � W N**�*�**� HE�X
END OF F S -�VER�•% rT ��ST � �*�**��*
� EES `Av�R ` J 1>� 2q T�rAL
. ,: 33
, , . , ��: �.;� • 69 -� 2p ' C�ST
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CONSTRUCTION AND PLANNING � PO. S SPA
�,�APPROVAIS Permit #�._ Date Inspeeior APPROVALS Permit � Date Inspector
� '
1. Temporery Eleciriwl $ervice ot Pole . 52. Pooi & Equipment Location �.
2. Soil Pipe•Undrgrnd. . ' -�� 53. Siee� Reinforcement •
3, Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrital Conduit�Undrgmd. 55. Electriwl Bonding
5. Steel Re�nforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7. Footings � � 58. Electrical Conduit-Undrgrnd. -
8. Foandation �� - . 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structurel Floo� System �� 61. APPROVAL TO DECK .
11. Property Sewer�l.ine & House �onnection 62. Backwash & Receptor�Final .
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains- ' 64. Pl�mbing System - Final '
74. Rough P�umbing � - 65. Electrical�Final �
75. Rough Electrical-Conduit � � 66. Solar System-Final
i 6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign fi$. APPROVED FOR PLASTERING
18. Rough Electripl�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. flough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factwy Fireplace � ^. ' - ' ' APPROVALS-� -Permit #
21. Ducts, in Structure� .. ' _ �:70. Underground Hydro
22..�ucts,Ventitating - ' � '77. Product,PipinqOGas ❑Oil
23. Gas Pipe�Ro�gh &'rest , . 72. Underground Fiusfi � .
24. Roof Framing � 73. Undergrnd.SmrageTank �Gas ❑Oil-� =
25. Root Sheathing � . - 74. Overhead Hyd%
' 26. T�Bar Ceiling (Struciureq & Monocoat � ' 75. Dry Chemical -
27. Frame and Flashing . 76. Dry Standpipe
28. Lathing & Siding - � 77. FIXED SYSTEM FINAL '
29. Insulation ' ; -� � f 78. FIRE PREV. FINAL
30. Drywail Nai�ing . HEALTH DEPT. REQUIREMENT
31. Plaster Browo Coaf. � � �� 79. FINAL INSPECTION �
32. Electrical Power Meter�Final 80. FOOD CEFTIFICATE ISSUED
33. Final Eleciric .' ' Notes: ' .
34. Final Heating & Air Condi[ioning. - Ir. . � � /
�.t�.✓!. � _0.! /�(%l.���- 7� �
35. Final Gas Pipe�Tesc .' - I � /J ,/ �/ � ,
_ �_ _Uj_/_G_G-�f.'[.P�✓-l-O_F T.aC.c3(_a� •
36. Hood o[ CanopY � " . - � ) �.
- Dr��_._Qd.O_✓ �-t_!��!?��_$_G`�+-�.,j_�
37. Final Factory Pireplace '' � _ _ _ _�� � _ _
38. Final Plum6ing " •
' =/_d-=Y��j�
39. Water Service=Final � i� ��� '�J- -'�
�c%, o�C m/L 9�'i��/�/
40. Gas Service-Final � � ;
41. Solar pomesiicFinal i � �
42. Backflow Preventer � I �
43. Backflow Irrigation • �
44. Landscape Irrigation System � . - . "
45. Sound Attenuation ' • , ' �
'46. Handicap Regulations '
47. F�NAL STRUCTURE & BUILDING ��� � //;� �x,rG/ � L���� .. / �� , �
r � c Gi Pl
48. FINALPLANNING . • • •
49. Electric_Releaseto Edison - -
.
50. Gas Release to Southern California Gas Co i � � _ �
51. CERTIFICATE OF OCCUPANCY
No. Oate
�
'PflQIECT�DOflE55: SSS ANTON BL `� uxrt: 2NDFL
owxea•sxune: gANK OF AMERICIf'
eoosess: ZO N. RAYMOND AVE 3RD FL
PASADENA '
CA 91105
RflCM/ENGINEEP: RWHBARCHITECT AEG.NO.:C—SSO%3
nooxEss: zZ072 CAMINITO VINO uxiT:
LAGUNA HILLS CA 92653
PEHMITTEE: HORIZON HEATING 6 A/C (714)974-3702
nooeess: 17853 SANTIAGO BL STE#107-243
VIILA PARK CA 92667
IICFNSED CONTMCTOfl DECLAMTION: I hereby auirm Ina� I a i n eG un0er proursions ol aD 9(tommendn0 wi�h Section
]p00� oi Divison 3 0l IAe Buane55 anG Pr01e55i0n5 COAe, and m li e i5 � II brW anE
cmuc.: 56944 sureuc.:6472 c ss C- 0
� Daie: ' ' �2� Sipnal . — — — _ '
I WOBNEPS'COMPENSRTIONOELUXRTION: I�erebyalfirmihail veaceNlicateofconsenlWUlNnsureoraandicaieolWorkers'
�. Compensa6on Insurance. or a cenitied cuoY ��reof (Setlion 3800. La6. C�.
PoLICY NO.: EXP. ORiE:
fAMPRNY:
❑ Cenifiea copy i5 hereq fumistreE. ❑ Cenifie0 topy is 1ileG witn tne ciry BuilEinp Divivon.
Da�e: Applicam:
EIfFMPTION FflOM WOPIIEAS' COMPENSITION OECIAfl�TION: 'S n � he cmWleleO pEmit is fp me httW (5700) a less�.
I certity tlui in Ihe petlormance nf t�e work �w wMcA Ihis er ii i 5 e, I 5 I n 0 ploy try in arry manner as la 6ecom¢
SOOjCLi �0(�/e warkeri Comoensation Laws af Ca �
Oa�e:! ���2— SipnaWre: �
NOTICE: Ii, aner maldng �Ns Aeclaratlw. you shoula �ecome suhlect m the Workers' Compensauon provisions ol tAe Lahor
Cotle, you must fonnvnin comoN w+�n sucn pmv6ions or tttis oermit shall Oe Ceemea rewkeE.
CONS7HUCTION LFNDING RGENCY: I hereby aflirm t�at tAere is a constnrctian IeiMinq apem.y lor t�e peAormance al tAe work for
wnicn inis oermit ¢ issue0 (Section 3097. Civ. CI.
IFNOEN:
ROOflESS:
OWNEB BUIIDEP OECUMTION: I �ere0y al�irm t�at I am evemp� Imm ��e ContratlOrs' Sute Litense Law lar I�e lollowinp reason
(SectiM 70J7.5 BuSineSS arb Prole55iandl CoOe: Any city ot Counry wNc� Rquires a permit la fAnStNct, alter, improve. Aemolisn, or
re0air any stNqure. D� lo iLS iRuanC¢. a150 r¢puires t�e apDlitan� lar suth cermii to lile a 9pne0 sUtement tlut MJShe i5 IiunseC
pursuant io ine D��b� ol ine Coniractors' Siate Licrose Law (CAaD�er 9(cammencinp wiU Section 7000) ol Division 3 0l t�e Business
an0 Pmlesvons CaGe) or Itui �e/stre is exempt t�erefmm an0 t�e Casis lor t�e alleqeG eeem0���� /�Y �oWqon ol Seciion 7031.5 Oy
any aOGlicant �or a permit suEjttis t�e aDPlicani Ia a civil penalty o� noi rtrore tAan /ive huMreA OdWrs �550�.
I, as owner ol t�e pmpeny or rtry employees wi�� waAes as t�eir sole compe�ation, wiA tla t�e work, an0 ihe
❑ simcture a no1 intenGeO or oneretl far sale (Section 7044, Business an0 Pmfessional Code: T�e Contractors' State License Law
Coes nol apply to an owner oi a propeny who Guilds or improves IMrean, antl wtq tl0es sut� wark �imsell/IleRell or t�muAh
his or her own emDloyees, provitle0 Ihai sut� impmvemenis are not inlentle0 or aflereG �or sale. II, however I�e UuilAinp or
'� improvement 6 501tl witNn one year ol comple�ion. Ihe owner vnll have t�e OurOen ol provinp �Pls�e diJ noi �ui10 or impmve
L
�
tor Ihe pur0ose of sale�.
I. as owner oi IAe pmperty. am ezcluvvely conVactinA w��n licensed contrac�oa Io wnsUuc� ihe pmjeci (Seciion 7044, Busines5
antl Pmiesims Code: TM Coniractors' SWte license Law aoes not apply to an wmer al Droperry wM GuA65 or improres tnereon
antl w�o conlracts lor such pr01ect5 wiN a contractor(s) license pursuanl Io ine Contrac�ors' SWie Licenu Law�. I am awaie
�hai proof of their Workei s CqmDensation insurance shoula be OmNCetl lo me.
I am exempt un0er $e[lian: B. 8 P. C.
lor tNs Rasan:
�aie: Owner.
I ao nertoy cenify Ihal I am aware ol anU uneerstanC Ine requirements ol Calilomia Mealtn an0 Salety COEe Stttions 25505, 25573, an0
255J< ane Inal I or any luture euileing occu0anl wiluwill nol (circle one) neeU Ia compy wilh Saie stale co�es antl Ihe reQuiremenis tor a
permit lor constmction or motliliwlion �mm Ine Air uality Manapemem OisincL NesiCential conslmction applicaiions aru eeem0� Imm
Nese pmvisions.
Dale: Applicant:
I her¢Gy cer�ify I�a� I have r¢a0 IN5 application and s�ate �Aat I aUo inf Iion i5 cor2c I pRe lo tompty wilh all cl�y and county
ordinancesanOslalelaxsrelalingloUviqingconslmc' by o e epres la�iues N¢C en�eruponi� Oova�mentioned
pm0ehy tor in50eciion Durposes.
%//- 9zr ' -
Da�e. � SignaWre:
Dri.ers License or Sociai Secuniv w�
_ 16E1-46 W�ile—BuilEinp; Green—COtle Enlorcemenl: Canary—Aoolicanl; Pink—RBvenue: GOltlanraE—Att95ufr
`
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 0590j0
PERMIT NO: M 059030 PLAN CHECK NO; N GOVT: N SUPP;
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: MEC PURPOSE; OTH
JOB DESCRIPTION ; COMMERCIAL T.I, (OFFICES) SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: RE: H58871 PRZMARY BLDG. PERMIT,
*�r*��r+r�****x�**�r*�x**�r**��r**�r**+rr�r*�*�*�r*���r**x-�**��r*+t**�****�r*�t*�**x**�***x�r*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUZLDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING RE�• PROV: PARCEL; 91050104 ZNE: REF NO:
PLANNING N 1'ES>
i
jE iE IE ik M� if iE i! iE iF iE k if iF It iP k iE fh i! i! it if iF �k K a4 3f iE k IE k iE it if if 7F.k 3E iE iE iF iF k ik ik k k iE iF 7E iP K�lE iF1f if M iE ik ik i! iF iE iE if iE iF 1E iF iF iE iF iE 3E if iF if iF
D E V E L O P M E N T S E R-V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY � DATE;
HUILDING APPROVED BY ; DATE;
APPLICATION ZSSUED HY• DATE• l ( Z
ilikiflEififiElflEiElEiFkil�lflElElfiflfifiE �f1ElhkikiFiflEiElk il3F
ilkitif3EifiEilkiEiEil�kitkikkkifkilifififkl4�kffiFifflifif7! ikilifkiFifiFlfklfiEif iE�lEififiliEitxifikififiEfFkiki(-iFitik�fEiFiEiE1Fil�ififlF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL S�GMENT;N
PERMZT HLDG PMT PLUMBING ELECTRIC MECH9Noo FIRE SMIP/RES GRADING
'15Y SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DIIE
TOTALS----> 9.OU 15.00 0,00 24,00 24,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 24,00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
zi,00
i! if iE it iF it iE k!f it if if i! 1E k ik 1E fklt i4 ik if iF �1k ik 1f Ik 1E iEif 1E i! iE ik it 1k i! iF fk iE if if if ik lE1f if if iF ik if iF k ik ff IE lhif if iE�! if iE ff ik iE iE jF M it 3E iE aE iE iE iE �! i! jF
I N D I V I D U A I. F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS
END OF FEES
0
0
9.00
c, p.1' "' _ _ ,�.: "' . .
9F.TF' U9/9 j,•y'�.. -.i �'ii�: _ _:l;
• ��
J
:ll�!
� CONSTRUCTION AND PLANNING PG.,� & SPA
APPROVALS Permit,i-` Date Inspector AppROVAL$ Permit# Date Inspector
1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Electriwl Conduit Utility-Undrgmd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UPER Gmd: 57. APPROVAL TO COVER-GUNITE
. 7. Footings ' ' 58. Efectrical Conduit-Undrgrnd.
:8. Foundation . 59. Gas Pipe, O Undrgrnd., Test �
9. Waier Pipe-Undrgrnd.,. - 60. Backwash �ines, P�Trap, � Undrgrnd. �
10. Structurel 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 � � j 65. Electrical�Final �
15. Rough Electrical-Conduii ' 66. Solar System�Final
16. Rough Electric Wiring � - 67. Fencing & Access ApProval �
77. flough Wiring Sign '� 68. APPROVED FOR PLASTERING
18. Rough Electriwi-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Contlitioning FIRE DEPT. REQUIREMENT
20. Rouqh Factory Fireplace . APPROVALS Permit #
21. Ducts, in Structure ,� . � 70. Underground Hydro
22. DuMs, Ventilating � 77. Product Piping OGas ❑Oii
23. Gas Pipe�Rough & Test 72. Undnrground Flush
24. Roof Framing •73.� Undergmd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standplpe
28. Lathing & Siding 77.� FIXED SYSiEM FINAL
29. �nsulation i ' 78, FIRE PREV. FINAL
30. Drywall Nailing � ''' HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal , � i � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � I/ �' Notes:Gi ., a� p��_�-r���%�'--''"' �
� �6�7
34. Final Heating & Air Conditioning �
9% r.�`
35. Final Gas Pipe-Test � L
36. Hood or Canopy . � �
37. Final FaMory Fireplace � -
38. Finat Plumbing '
39. Water Service-Final - -
40. Gas Service•Final
41. Solar pomesticFinal
42. Backflow Preventer � j � -
43. Backflow Irrigation
44. Landscape Irrigation System - .
45. Sound Attenuation •
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING � � �
48. FINAL PLFCNN6NG �
.49.: Eleccric Retease to �Edison . �
50�GaYRelease to Souihem California Gas Co � j i
v51. CERTIFICATE OF OCCUPANCY
No. Date >
/ I
rnaecraooAess: 555 ANTON BL uxir: zNDFL
� OWNEfl'SNRME: BANK OF AMERICA
nooxess: ?0 N. RAYMOND AVE 3RD FL
PASADENA
CA 91105
(818)578-7700
APCN/ENGINfEfl: RWH ARCHITECT wcc.xo.: C-11073
�DOBE$$: zZO%Z CAMINITO VINO � uNiT:
LAGONA HILLS CA 92653
PEpminEE: COMPETITION ELECTRICAL /( 818 ) 331-5807
aooeess: 635 STEPHORA
COVINA CA 91724
LICENSED CONTMCTOfl OELUMTION: I tlereEy iffirm Ilul I am IiceriseE uMer prmiivon5 0l ClWptet 9(commencinA wilh Secibn
70001 of Divivon 3 of ine Business aM Frotessions Catle. an0 rtry littnse is in IWI forte an0 eHect. �
cirruc.:056905 suTeua:51684" c� uu:�0
Da1e: � �/�— 9 2 Signamre:� � ) � �� —
WOBKEBS' COMPENSIITION DECUM710N: 1 �ere0y a�WmIC+N�Gre a cenilirate al consent to sell-inwre or a certilicate ol Workers'
Compen5ation Insurance, or a cendieA copy inereol (Section J800. LaG. C).
POIICY NO.: E%P. U�TE:
, COMPRNY:
❑ CertilieU copy is �ere0y fumisheG. ❑ CertilieA coq ¢ fdeC wiN Ue dty BuilEinq Oivision.
Date: Appliranc ' `�' �%•
E%EMPfION FflOM WOPIIFAS' COMPENSATION OECIAMTION: (IIi65MAm IIeM roi Ue mmplelN i� tle pem15 �a ak hmGiM,�f100� a I¢55�.
I cenity Inal in ine pMormance ot tlie xVrk lor w�it� tt¢t ce�mi ' it5uetl, I shau twt emvbY am/ per5on in any m5nner su as to berAme
subiect la ��e Warkers' Compensaiion Lavrs oi CaliloMa. i./ �
Daie: q � 8— S2 Si9nawre: � Y
NOTItE: It. atler makinA I�is tletlara6on, you slroulG e w�lm �a tAe Warkeri Compensaiion proWsqnS ol�the LaLor
CoOe. you mus� IwtRwilh compty wii� SucO ym�bid6 or ltis permi slwll Oe Oeemetl revok¢E.
CONSTBUCTION LENOING �GENLY: I �ereEy atlirm t�at t�erz is a mistruction Iendin0 apency for Ihe peAormar¢e�W)he xrork lor
w�icA Ittis perrttil ¢ issuM (�lan J097. Civ. C1. ./� �,
IFNOFfl:
�ooness:
OWNEB BUILOEB OECIABRTION: I �¢r¢Cy altirm IIWI I am eRempi Irom I�¢ COnlratlOtS' State Licenu Law lar Ihe lallowinq reason
(Section 70.77.5 Business anA Prolessional CoOe: My city of county wtiicA repuires a permii to con5tmci. alter, impmve, tlemolish, ar
ieoair any sVucture. prior to its issuance. also repuires ine appficani lor sucn parttit to lile a 9pneE statement ihal ne/sna 6 licensetl
pursuani io ine provisians al Ine Comractors' Sute lkense Law (Gupter 9(cammencnp wiN Seciion 7000) ol 0ivision 3 of �Ae Busineu
antl Prolesvons COGe) or tlidllMlslie 6 eRempitherelram iiM the OaSiS Iw t�e alleq¢d ezemptial. My violatlon ol $etUon 70315 Cy
any aDV�iant lor a Dermit wEjects Ilm �DWw�� lo a civil Denatty ol not rtqre tlun five hunaretl EaIWrs (5500�.
I. as owner ol Ine pmDerty or rtry em loyees witn wapes as ineir SOIe Lompen5ation, wIT tlo Ihe wod, ane ine
❑ s�mcwre is noi inronaee or oaerm mr uie 1�� 701d. Buvness anE Prolessional COEe: T�e Contracrori State License Law
Eoes nol apply lo an owner ol a O�optny wtp Euil4t or imw�s thereun. an0 �Wro GOes wCh wOrk �imsell/nerulf w Nmupn
�is or �er own empl0yees, pro`riEeC tlut suc� imprOv¢menis are not intenCeO or ollereG br Sale. I1. Aaw¢ver lhe �uiltlinp or
im0�ovemen� i5 5010 vni�in one yBar 01 COmpletion. Ihe ownei vnll �ava the OurOen o� pmnng �¢/5�e EiA noi build ar improve
lor ine omoose ol sale).
O I, as owner ol t�e propetly. am exclusively com�actinp wii� IiunuA comractors la consirutl t�e pmject (Section 70Aa, Business
anG Fmlessio�s Coae: The Camraclors' Siate License law Eoes rrot aD7N �o an avmer ol Omcerry w�o CmIEs or impmves thereon
ana who contracts far suc� D�ojects wi�� a caniraclm�s�license pursuam ro ihe Comractors' State Lice�rse Law�.l am aware
Ihal prao� ol tneir Worker's COmp¢n5alqn iRwranm SliWltl Ee prwqe0 la me.
� 1 am eRemp� unGei Sectlan: B. 8 P. C.
lor Inis reason:
�ale: �er.
I Ao �er¢�y ceriily Ihal I am aware ol anG unEerslanU ��e reQuiremenis of Calilomia Heatt� antl Salety CaCe Sec�ions 255Q5. 25533, and
25534 ane tnat I ar any Iwure ouilainp acuDant wilUwiil not (crcle one) neea to comply vnt� saia sta�e coEes and t�e requiremenis for a
permit br consimtlion or moGilication Imm ��e Air Oualny ManaAemmt Oistnct. HesiGenual constmction apP�irations are erempt imm
Ihese O�avi5ion5.
Oaie:
I here�y ceriily I�al I Aave reaG I�is
or0inanc¢5 an0 51ate IawS reW�ing Io
pm0er�y lor ins0e��ion purposes.
oaie: �%'�i'c12
AppliWni:
n an0 siale �Iwl Ihe a0ove inbrmaiion is carrecl. I aB�ee �0 Comply with all Ciry and tounry
mSVuciion a�ertUy autlpriie represen�alives ol Iks ciry �o enter upon Ihe above-mentwnetl
ori�er's ucense o� Sociai securiiv n: .
16<I�a6 W�ile—BpilOinq; Grepn—COOe Enlo6ement Cdnarv—Avulic2nt; Pink—Revenue: GolAenroE—Asseswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E
PERMIT NO; E 058970 PLAN CHECK NO: N O: N .
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE; ELE PURPOSE: OTH
JOB DESCRZPTION ; COMMERCIAL T,I, (OFFZCES) SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: RE; B58871 PRIMARY BLDG. PERMIT,
��e**xxx� x�r�rx�e*�*�*�e+rx �r*x�r�r*x�r�r�r*x�t*�r��r*x�r*�rx*�t*��r�t�r+��+�**�r�r�***�r�+tx�r*****�t*x*�r�r*
Z O N I N G R E Q U I R E M E N T 5
S E T H A C K S
------------ MAIN BUZLDING ---------- --------- ACCESSORY BUILDING --------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ • PROV; PARCEL; 41050104 ZNE: REF NO:
PLANNING NOTES> ,
\ %
ik ik if if if if If �k �lE iE ft jF iF iF iE 1E iE iF iE iE iE ik if 3E �E it iElE iF it * if if iE iE iE ik if k iE 1E �F iE iF 3f iFiE if k iE iE 1! iE iF if �k iE fF iE iE iE ik iE 1E iE �E iE 1E iE 1F IE iE if iE iE it �F k iE
D E V E L O P M E N T S•E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . %,� DATE:
BUILDING APPROVED BY ; �' DATE;
APPLICATION ISSUED BY; DATE; ��������, 2
ifi6iEiEiEiEiEiEkiEiFiEiElEifiklEiEiFlFlElf � r lkifiFiEiEiEiEitiEiE itiE
ififififlElFlfiflfikiFifiElFlE1Ek1!lkiEiFiFkiFiEifkitlklfiE1�1f1Eif�ElfifiEifiF �kkik lElfifMiEklkklflFiEiFkkiflfkklEififlEififiFiFfE1ElEif�E�E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 20.85
i 50t SMIP/NON—RES
PLAN �
ISSUE FEE ��I S•, 00
BUILDING—DIV—> PEEiMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 20,85 15,00 'j 0.00 35,85 35,85 ,00
.l
REVENUE DIVISION TOTALS--> COLLECTED: 35.85 OVER/SHORT: ,00
BLDG PMT' PLUMBING ELECTRIC MECHANIC FIRE SMIP/TO'P GRADING PLAN—CHECK
35, 85 ,;
iF �ElE �E 1E �F iE ik M if ik if ib iE if M M fF 1F iF if if iFit ik M� if iE iF iE ik jF if if if if 1P 1k iF k iE k ik Ik �f i! iF iE k ik if �t iE k iE iE k if k 1k if iE ik fklf iE k IF if iE aE ik IF IE iE 1f IF iF iF
I N D I V I D U ASL F E E B R E A K D O W N
TYPE QTY D E S C R I P T I�O N UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET '� 1 ST 20 EA. .75 15,00
ELE 3 RECEPT/OUTLET
ELE 6 RECEPT/SWITCH
• ADDITIONAL
1 ST 20
<END OF FEES
., j
�.�
EA, ,45
EA, .75
l,-.''!1.' __ _� _' _
1,35
4_SO
� CONSTRUCTION AND PLANNING . PO� . SPA
APPROVALS Permit # - Date � Inspector pPpROVALS Permit # Date Inspector
� i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2, Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Electriwl Conduit UtilitY-Undrgmd. 54. Porms -
4. Electrical Conduit-Undrqrnd. 55. Eiectrica� Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test `
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUN.ITE
7. Footings - 58. Electrical Conduic•Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test .
9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P�Trap, 0 Undrgrnd.
10. Structural Floor System . 61. APPROVAL TO DECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap � ., 63. Heater & Vent•Final �
13. Roof Drains � 64. Plumbing System � Final
74. Rough P�umbing 65. Electrical-Finat
15. Rough Electrica6Conduit � 9�� 9Z �D� 66. Solar System-Final
a-�
16. Rough Efettric Wiring � �s% � 67. Fencing & Access ApP�o�al
17. Rough Wiring Sign / 68. APPROVED FOfl PLASTERING
� 18. Rough Electriral-T 8ar Cei�ing 69. POOL/SPA SYSTEMS FINAI
19. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS Permit #
21. Ducts, in Structure . 70. Underground Hydro
22. DuMs, Ventilating _ �71. Product Pipin� OGas OOiI
23. Gas Pipe�Rough & Tesc - - 72. Underground Flush
24. Roof Framing �• 73.� Undergrnd.StorageTank �Gas OOiI
25. Roof Shea[hing � . -74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing �6. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM FINAI
29. Insulation � I. � 78.. FIRE PREV. FINAL
30. Drywalf Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat �� 79. FINAL INSPECTION
32. Electrical Power Meter•Final I � � 80, FOOD CERTIFICATE ISSUED
/ ' a� / ---
33. Final Eleciric /Qlj Notes: /`��3 � LfaG� ('
{
34. Fina� Heating & Air Conditioning � • '
35. Final Gas Pipe-Test I �.
36. Hood or Canopy . . � j. �
37. Pinal Factory Fireplace ' , � � ,
38. Final Plum6ing � {
39. N,'ater Service�Final• � ��
�
40. Gas Service-Final - � ' ' '
41, Solar pomestioFinal � '
42.�Backfiow Preventer � �
43. Backflow Irrigation
44. Landscape Irrigation System . _ �
45. Sound Attenuation , '
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING .
48. FINALPLANNING � • • �
-49. Electric Release to EdisOn �,
50. Gas Release to Southern California Gas Co � �-� � .
�51. CERTIFICATE OF OCCUPANCY
No. Date
a
�
�5
�
Z
C
Applicant to /ill in all s0aees exce0t t�ose within heavy
CrrY oF cOS7A MESA� •C,ONSTRUCTION PERM�IcT+�
ProlectAddress �5 �"TO�✓ �1/O• C.� f.y. ��
Applicanl's Mailing Addrezz
Owner'sNamt sGGUR/'f /.� F� �a e 3yss��Y
Addiess �O /GS��ad YO �/%• �00�r%
Arch/Eng. Licerjse No.
Address ��99 BvNor ' oo �'j
Contractor'sName.'X,/11 Ph ne. •dt0�
Addresslmailing�� SnV
City License No. � 3 Z� 4y
LICENSED CONTRACTOR DECLARATION
I hereby atiirm lhat I am IicenSatl untlBr proviSion50/ Chdrt¢r 9(Commencing
with section 7000) of Divislon 3 of Ine Business antl Pratesslons Cotle, antl
my Iicenze is In full (mce ana effecL ��
license CI ss L No.
Date Si9naWre
'40RKER5' COMPENSATION DECLAWATION
iereby aftirm that I have a certificate of consent to self-Inzuro or a certltiwte
: Workerz' Compensation Inmrance, ar a cartifietl copy lhereaf (Saction
3800, Lab. C.) �
Po�icy rvo/Jy�6 311.5—l99 company
eCertifietl cop is nereby furnl5hetl. �
Certifi tl co Ij.f�lled with t�e city 'iv�.
Date �L— Applicant �
EXEMPTION FROM WORKERS' COM�ION DECLARATION
(Thi55ec�iOn nee0 not be compleletl if lhe pGrmit ii to� One huntlrBtl (E100) o�
less).
I certify that in the pertormance oi Ine work tor whith this permR Is lssuetl I�
shall not emD�oy any oerson In any manner sa as to become suDject to t�te
Workers' CompanSatlon Laws o/ Califomia.
Date Signature �
NOTICE: H, aiter making t�is tleclaration, you shoultl �ecomo zubject to lha
Workers' Comp¢nsaHon provi5ion5 Of th! ldbor Code, you must (orthwith
comply with Su<h provlsiOns o� lttis pe�mit Snall be tleem¢tl /Ovokotl.
CONSTRUCTION LENDING AGENCV '
1 nereby alfirm that there is a consCructlon lentling a9enty (or tha performance
oi the work for which thls permil Is issuetl (Section 3097 Clv. G.)
Lentler's Name
Lentler's AOtlress
OWNER BUIIDEft DECLARATION
I �ereby af/irm Ihat I am exempt irom tho Contractor's Liconzo Law tor the
following reason (Sattlon 7031.5 6uslno55 antl Profe55ional Cotlo: Any clty or
county whlch requir05 a permit lo ConS[ruct, aller, improva, tlemOliSn or re0dir
any structu�e, prbr to Its Issuanc¢, dlso �eqWreS tbe aDP�lcant fOr Such OarTil
to tile a signetl s[atemunt lhat he/s�a Is Ilcense0 pursuanl to lho Provisions ot
'he Contrattor's License Law (Cnapter 9(communcing wlth Sectlon 7000) of
ivision 3 of tho Business antl Prolessions Cotle) or lhat ho/sne is exompt
.�erelrom antl the basl5 lor Ih0 allegeG ¢xCmptlon. Any viOlation Of Sactlon
7W1.5 by any apPlicant for a permit subjecls tha apPllcant to a civil
�enalty of not more Ihan flvo nuntlretl tlollars (5500).
I, as owner of Ihe property or my amD�oyeos with wa9os as thelr sole
comp¢nSaliOn, will tl0 1110 work, dn0 the Structulo 15 not IntOntletl or Offeratl
lor sale (Sectlon ]044, Businass and Profassional Cotla: Tha Contractor's
License Law tloes not applY �o an owner ot a proparty who builCs or Improves
thereon, antl wM10 OoeS SUGh work hlmself/M1Cr501f o� Ibrou9h his o� h0r Own
employeas, providetl that such improvaments are nol IntentluC or oflorotl tor
sale. I1, however, the bulldin9 or Improvemenl is soltl within ono yoar of com-
pletlon, the owner will have tne burtlen ol proving hu/she tlltl not builtl or im-
p�ove lortha purpo50 Oisale).
❑ I, as owner ot the property, am azclu5ively contracting wilh Ilcensetl con-
traclors to conslruct the proje<t ($ecHon 7044, Business antl Professions Cotle:
The ConVaCtOr'S Licenia Law does not apPIY to an ownor of property who
i builtls or imowvez thereon. antl wbo conVacts lor sucn o�oiects wim a r.on-
l�actor(51 Lcense pursuanc to me ConttactOr'S Ucense l.aw�. I am awar0 thai
proot ol tneir Worker'S Compensation Insu�ante ShOultl ba 0/ovltlBtl to ma.
❑ 1 am axempc untler Sectlon 8. 6 P. C. far thli reason
Datc Owner
I herebY c¢rtity Ihat I hav¢�reai
Signature (�.1 .�
Drivers' License or 55 =
0865-46, rev. 5/BB
abova
C3� 36 � �-(n � �o�S�90
TYPE OF CONSTRUCTION NEw
❑ CONVERSION ❑ DEMOLISH ❑ O
TVPE OF PEHMIT LJ GRnDiNG
�TENANT ❑ ELECTRICAL
OTHER
PRQIECT DESCRIPTION SQ.FT._
CONSTRVCTION TVPE —� � VALUATION S.
G0.ADINGCU.VDS. AC
Iln<s anE sign all approprlate Gaelarations.
OT NO. UNIT NO.
ADD LJ ALTE
I FOUNDATION LJ STRUCTURAL
PLUMBING ❑ MECHANICAL
Remarks:
Preventer
Irrigation
Drinking Fountains
Floor Drains
Flaor Sinks
G85 SerViCa Outlets
Intercep[ors �
Kitchen Sink
Lavatories
P—Trap ,
Roof Drains
Reinspection Fee
PLUMBING '
Showers
Service Sink
Sewer Cap , '
Sewer Connxtion
Solar Collectors
Solar Piping --
Solar Tank t�
Swimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service
Aum�Wash
Laundry Tra'ys
$15 laue Fea
Duct- UnderGround
Duct - Strucmral
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact Blt. �CBO dk
Heating System & Ducting
❑P700,000 BTU 0100,000
peinspection Fee � $15
White � Builtling: Canary - Appliwnt; Pink - Accounting; GOICenroC - Assessor
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
00.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fea
FEES
A.P. vW U —
S Main Building
E
T Frant
ARear
C Right
K
Ping. Ret. �
Planning Notes:
— � Zona /�pL
Accessory Building:
Z
O
N
1
N
G
R
Parking Req./Provided E
(�Ni '-� M
T
S.
ELECTRICAL
Automatic Washer Trensformer � 15-50 KW
Construction Pole Suh. ❑ 50 + KW
Cooking Unit Merer ❑up to 100 amps
Dishwasher Meter ❑over100smps
Dryers �Gas ❑Electric
Fan
F.A.U.
Fixlures
Device Boxes
Outlets
SwiMhes
Garbage Disposal
Generator 00.5 KW 05-15 KW
Sub Panel
Motors �0.7 HP �
Ina So1ar 09-15 h
Miaowave
Pole Light
Range �
Sign
Standing Sections
7rash Compactor
Fee �$15 � � luue Fee
17X-8
P �16-15+
FEES
$ 3
§ 3 DEVELOPMENTSERVICESREQUI NTS: p p
2oning Approved By Date�2' /' �r
FEES �Buildine APP�oved By 7�—t1�� Date1
Application luued By �`� � ; �+ T �ateJ ��
SUMMARV OF�EES C rL
BUILDING PERMIT $ � C)S �i �' SMIP g 33 ,
PLAN CHECK $ (�I C� �� PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $ �
PLAN CHECK 50% $ MICROfILM $ �
MECHANICAL $ TOTALFEE $ �2��} —
PLAN CHECK 25% $
S 3
OI DU0216?4-OQ021628 7tJY I�94.fl7
OqTE: 12/09/&8 TIhE: 49:11
1 � '� i
;�' CONSTRUCTION AND PLANNING P� �' SPA
� APPROVALS Permit # Date` Inspector AppROVALS Permit # Date Inspector .
l 1:' Temporary Electrical Service or BoIE . • 52. Pool & Equipment Location � ,
�.
2. Soil Pipe-Undrgrnd. - �,� r 53. Steel Reinforcement A' �?
�3�. Electrical�Conduit Utility-Undrgrnd. 54. Forms �
'4. Electrical Conddit�Undrgrnd. , 55. Electrical Bonding :'�;
5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test ."� "
, �..
6.ElectricalUFER'Grnd:" 57.APPROVALTOCOVER�GUNITE� ,' i•'
I� � ' i
7. Footings ��; j ���, 58. Electrical Conduit-Undrgrnd. �� ''
8. Foundation �� � � .r � !� 59. Gas Pipe, O Undrgrnd., Test �� ,
' 9. Water Pipe�U�drgrnd. ��{ 60. Backwash Lines, P-Trap, O Undrgrnd. �
' 10. Structural Floor System �� � 61. APPROVAL TO DECK
11, Properry Sewer Line & House Con�ection _ ., gz, Backwash & ReceptorFinal .
. 12. Sewer'Cap � ' 'd -� 63. Heater & Vent-Final .�
ti 13..Roof Drains '' �• � 64. Plumbing System - Final
.
14. Rough Plumbing � �� 65. Electrical-Final �,
15. Rough Elettrical,Conduit 66. Solar SYstem-Final
.i6. 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
"1.9. Rough�Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,'in Structure ' 70. Underground Hydro
22. Ducts, Ventilating �; 71. Product Piping O Gas ❑ Oil
' 23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing , 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing �_ 74. Overhead Hydro
26. T-BarCeiling (Sfrvctural) & Monocoat 75. Dry Chemical
27. Frame and Flashing ,�/6!� 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINA�
30. Drywall Nailing � 1 � HEALTH DEPT. REQUIREMENT
�31. Plaster Brown Coar,; � 79. FINAL INSPECT.ION
�32. Elec[rical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
V33. Final Electric �� �� , Notes: � '
34. Final Heating & Air Condi[ioning �
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 pomesticFinal _
.42. Backflow Preventer � _ � ' . _
43. Backflow Irrigation . � '� � _
44. Landscape Irrigation System . �' �
45. Sound�Attenuation
46. Handicap Regulations '
47. FINAL STRUCTURE & BUILDiNG G�y
4R. Sner.ial Re.quirements Completr.d
49. Electric Release to Edison "' �
50. Gas ReleaBe to Southern Caiifornia Gas Co , ._ _
51. CERTIFICATE OF OCCUPANCY T �� -
.�
No. Date � ' ' '
`� s' f// Applitant l0 flll in all sDaces exceD� those wit�ln neavy Dortler Iines anC sign all aDC�opriata Oeclarations.
�
arv OF COSTA MESq CwONSTRUCTION PERMITS�T
Pioject Addrgfs � _!1/V%U.i/ .QG//.b 200
Applicant's Mailing Addr@ss �i zG� fav ���,{/�.%/�p
Owner'sName--sEG°'".G"'r� ��1�''r�� phoneZS�b
address ._S"'tS .d.[��!✓ G�Jl�� .�.s.r.. Gs�
Arch/Eng. License No.
Address '
Contrecror'sNam�_� �/,Q �� / �Phone 2Yt'-/ ��/
Address (ma'iling) ��ct�-Ss.��.tNA,.U.Cb �er,U.otGr
Ciry License No. ' 0 l�'�0.7 �
LICENSED CONTRACT4R DECLAfiAT10N � .
I hereby alfirm that I am licensetl unU<r provi5ion5 of Char�er 9(commencing
with sectlon �000) ot ;Division 3 of the Buziness antl Professions Cotle, antl
my Iicense is in full force �ntl effect. '
Vicense CIa55 ��0 Li<ense No.:�ZO�.��
late��� ��y+ Signa re
WORKERS•COMPENSATION DECLARATION .
� I hereoy altirm that I havg a certifitdte of consent to self-inzure or a certiticate
of Workers' Compen5atiqn Insurance, or a certifietl copy thereot (Section
3800, Lnb. C.) ' ' ' ' ' � - • �
Polity No. Z�%�i��._,T -rvr��r6�li COmpany �✓�s�✓
�Certifietl copy it hereby turnisnetl.
Certi(i¢a copy is tiletl with the cit uiltli , Dlvisi ,.
Date,L_/�-a�� ROPIi t ,
EXEMPTION FROM WOpKER OMRE SATION DECLARATIO .
(This sectlon neetl nol be Completetl if the Oe�mit�i5dor One puntlretl (El ) Or
less�.
I certi�y that in tbe perto�m5nte Of the wo�k for which this petm�t Is ISSu¢tl 1
snall nOt employ any peKon in any manntr so �as to be[ome subjett to l�e .
Workers' Compen5ation�l.aws ot Calitomia.
Date Si9nature
'NOTICE: If, atler makin9 this tleclaration, you shoultl Oecome sub�ect to the
Workers' COmpensatlon provisions ot the Labor Code, you muSl forlhwilh
comply wl�h Such prov�Slons or [his Oermit shall be tllemed �evoketl.
CONSTRUCTION LENqING�AGENCV
I nereby attlrm that inere Is a conztruction lentlin9 agency tor the oerformance
ol lho work fo� whicM lhis Oetmit i5 i55uetl ($¢ctiob 309] Clv. CJ
Lantler's Name
LanOer's AtlUre55
OWN�ER BUILDER DECLARATION
I hereby altlrm thal I arp exemp[ trom th¢ Conlractor'S License Law ior th0
following reason (Sectio� 7031.S�Business antl Profezsional COOo: AnY citY or
COunry whiCh requires d p¢rmll to Conztruct, alt¢r, Impwve, tlemolish Or �eDair -
any stru<ture, orior to its issuan<e, also requires tha applicant tor sutn parmll
to Iile a 5ignetl StdtCment thdl ha/ih¢ i5 Iicensetl purzuant to the ProviSions oi
the ContractoYs License �w (Chapter 9(commencing with 5ectlon ]000) of
DlviSion� 3 of lhe Bu5in855 antl Profession5 Codej or that he/ihe ii exemOt
therofrom antl tne basis for the allegetl exemption. Any vlolation of Section
7031.5 by any applicary( fpr a permlt subj!<tz tne appllcant to a Clvil
, enalty ol not mor¢ lhan tiy¢ huntlretl dollar5 (E500j.
�� I, as owner of l�e� brope�ly Or my ¢mployee5 wit� WageS as thel� So10
<OmponsatiOn, will tlo th¢ work, antl the struc[ure is nol IntonCetl or off¢retl
for sale (Suctlon 'l044, Businesz antl Pmtessional Cotle: Tha Contractor'S
Licanse l.aw tloes not apply to an owner oi a Oroperty wl�o bulltls or ImD�ovez
thereon, antl who,tloes such work hlmseN/nerself or through hls or her own
emploYeeS, O�ovitl¢d Ihat suGh Improvement5 are no[ interltletl or OHe�etl tor
zalo. H however, tne bullding or improvement it soltl within ona Year ot <om-
pletlon, thu owner will 11ave the burtlen of Provin9 he/she tlIG not bullA or im-
p�ova fo� [M1e purpose of salo).
❑ I, as owner ol Ine property, am exclusively contraCting wilh Ilcensetl con-
builtls or Improves merBon,�:
traClor�51 license OurSuaNt�[o�
proof o1 Iheir Worker's Com
❑ I am eaempt untler Sectlon
nss antl Professlons Cotle:
i owne� o! proparty wno
�uch projecli wilh a con-
ce Law). I am awar¢ tnat
oultl be O�a�itlatl to mo.
B. & P. C. lor thi5 reason
Date Owner
I horeby certify that I have reatl [Itis application.antl stat¢ tnat Ihe above
intormatlon is correct. I agree to comply with all city antl county ortlinances
antl stata laws relating to builtlin9 construction, antl hereDy authorize repra-
sentatives o Is city to en[er pon the above-menlionetl property tor
InSpectio urp SeS. �
5�9 t D t�Z7T���G
z
M 3�7 z � I �
TYPE OF CONSTNUCTION NE
❑ CONVERSION ❑ DEMOLISH
DESCRIPTION OF WORK/USE OF.,
J ADD �`1 ALTERATION U REPAIR
OTHER Ti.u�T �•G/d'eL
TVPE OF PERMIT LI GRADING IJ FOUNDATION LI STRUCTURAI.
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING�MECHANICAL '
❑ OTHF_R
PROJECT DESCRIPTION S�.F7. oCCUPANCv
CONS7RUCTION TVPE VALUATION 5
ZONE GRADINGCV.VDS. ACRES
Remarks: �U��� �
Ber Sinli '
Backflow Preventer -
Backflow Irrigation �
Bathtubs � .'',
Clarifiers
Dishv�2sher .
Drinking Fount2ins
� FlOor Drains
Floor Sinks .
GasService ,Outlats
In[erceptors � �
Kitchen,Sink
Lavatories '
P-Trap
Roof Drains
Reinspec[ion Fee S15
Boiler
Dut� - Under Ground
Duct - Struccurel
Duct- Ventilating
Exhau:t System ❑ Multipte ❑
Firepl/Fac�. Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 sTu O i oo,000 eT�
fleinspection Fee
I Drivers' tenSeOrA9�-Jp
�
CMF 0865-46, rev. 30/84 Wpi{e - Bulltling; Canary - Appllwnt; Pink - ACcountl0g; GOltlenrOtl - q55a55or
$15
Showers
Service Sink -- • �
SeWer Cap
Sewer Connection
Solar Collectors �
Solar Piping
Solar Tank
Swimmin9 �I wlSpa
Water Closet
Water Heater
Water Service
Auto�Wasli
Isue Fee
Hood or Type 1
Canopy_ Type I I
Refrigeration System
Oaioo,000sTu Oioo,000
System Repair/Alterotion
Fire Dampersva�s'D
Registers
Isue Fee
St7
FEES
A.P. qW
5 Main Building:
E
T Front
B Rear
A
C Right
g Left
Ping. Ref. dh
Planning Notes:
Automatic Washer
Construc[ion Pole Sub.
Cooking Unit
Dishwasher �
Dryers ❑Gas• �Elec�
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Swi[ches
Garbage Dispo581
Generator 065 KW C
0
5 KW
Zona
Buildin9: . . -
2
O
N
I
N
G
R
E
�
M
T
$
Parking Req./Provided
IICAL
Transformer ❑ 15-50'KW
❑ 50+KW
Meter ❑up to 100 amps
Mecer �over 100 amps
Sub Panel
Motors 0.1 HP O1'/.-8
naSolar��9-15 HP O1G�
Microwave '
Pole Light
Range
; Standing Section:
Trash Compactor
53I
��m Reinspectian Fee $15 Issue Fae
FEES
�DEVELOPMEN75ERVICESRE�UIREMEN7S:
Zoning Approved By
� Building App'roved By ��� � � �.
SUMMARVOF
BUILDING PERMIT $
PLAN CHECK $
PLUMBING� $
PLAN CHECK 25% $
ELECTIiICAL $
PLAN CHECK 50% $ �
MECHANICAL $ � Zd-3 ��
PLAN CHECK Z5% $
�
FEES
�
$ 3
t� ,
SMIP $
PERMIT
ISSUANCE �$ '
ENERGV P.C. $
GRADING $
MICROFILM $
TOTALFEE $ ���•�
0100022161-OOQ2216? TOT 2C3.D"u
neTre t���:iao rTnr. ,<.co
_,
-.. CONSTRUCTION AND PLANNINV . � POOL & SPA
_ APPROVALS Permit-# Date Inspector AppROVALS Permit # Date Insp>cror
�,i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
� 2. �Soil Pipe-Undrgmd. • 53. Steel Reinforcemen[ _
. 3. Electrical Conduit Utility�Undrgrnd. 54. Forms �
4. Electricai Conduit-Undrgrnd. 55. Electrical Bonding � _
� 5; Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6., Electrical UFER Grnd. � 57.' APPROVAL TO COVER�GUNITE
i�
7: Footings 58. Electrical Conduit-Undrgrnd.
�8. Foundation . 59. Gas Pipe, � 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 _
r12. Sewer Cap 63. Heater & Vent-Final
13. Foof Drains 64. Plumbing SYstem - Final -
14. Rough Plumbing 65. Electrical-Final -
15. Rough Electrica6Conduit - 66. Solar System-Final � � � �
,1.6. Rough Electric Wiring � � 67. Fencing & Access Approval ✓-
17.� Rough Wiring Sign 68. APPROVED FOR PLASTERING �
78: .Rough�Hectrirat-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning (�3 („� FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace APPROVALS Permit #
ZYf Duc[s, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil �
23. Gas PiPe-Rough & Test 72: Underground Flush i �
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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. Drywa�l Nailing HEALTH DEPT. REQUIREMENT
31� Plaster Brown Coat 79. FINAL INSPECTION
�.
32: Electrical Power Meter-Final S0. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning Z�(,��
� 35. Final Gas Pipe-Test �
36. Hood or Canopy ,
37. Final Factory Fireplace . � -
38. Final Plumbing
39. Water Service-Finaf '
I 40. Gas Service-Final '
� 47. Solar pomesticFinal - . _ '
� - .i•
42. Backflow Preventer � ' �
r 43. Backflow Irrigation . � � '
` 44. �Landscape Irrigation SYstem ' �
� 45. Sound Attenuation - ' �
46. Handicap fle9ulations ' '
J47. FINALSTRUCTURE&BUILDING . '
� 48. Special Requirements Completed �
�I 49. Electric Release to Edison � - , , - •
� 50. Gas Release to Southern California Gas Co � ;� ,
51. CERTIFICATE OF OCCUPANCY . . . c �
No. ' ' Date ' � � " "
APD�icant to till in all s0aces axca0� thosa wlt�ln heavY �artler Iin<i anC sign a�l apD�oprlata tlec�arations.
CiTv oF�coS7a MESA CONSTRUCTION PE�F MIT
Projc+ct Adtlress 555 Ar,ton � 2-- fi-( . .
Applicant's Mniling Address
Ownei's Name � } Vhune
Address
Arch/Eng. � "� K � license No.
Addrest e
Contractor's Nam �-}-��� � Phone �'9 b1 i�
Adtlressfineiling) ��1-s'.OL"" #a'\01 (Tn�Tn (YIPVi�
Ciry L�cense Na. n�.�qg�
LICENSEO CONTRACTOR DECLARATION
1 �ereby attirm that I am Ilcense0 untler provisiOnS of C�artur 9(commencing
Wil� 5¢C1100 7000j bi OIVIS(O� $ Of 1110 Bt1SiOCSS dM1C PIOfQ55VO�S COtlO� dM1d
my �iceme is (n full iorce antl effecL 5���� ,
LICBt15C C1d55 LiCl059 NO.
•te �a'n9'.� S19�atwe
�RKERS' COMPENSATION DECLARATION
. ne�eby aiti�m that 1 �ave a teA46cat! of consent to selfinswe o� a certifirat!
of WorkeR' Compensdtion Insurance, or a certi�letl copy [hereot (Section
3800, Lab. C.)
VolitY No. lIiPSSV�I�inCA ComPanr FrncM�1T �1Y�PmfltivCD.
,Q Certifietl copy is hereby furnliheG.
Dd Certitietl copy is tiletl witit t�e tlty BW tling Oivislon
oate 1o't'09 � S$ Avplicant _�L1.L�S�?.[`�� 4�n- �
EXEMPTION FROM WORNERS' COMPENSATION �ECLARATION
(Tbis setlbn nee0 not be completetl if the permlt (s for One hunOretl (E306) or
�ess).
i tertUy that in the Oer(ormance of tne work for wM1ich th15 perm�t i5155uetl 1
zM1all not emPloy any perSon in a�Y manner 5o as ta be<oRiH subjed to t�te
.^ Workers' COmpensalion LAWS Ot CalifOrnia.
�� Oate 5�9natu�e
NOTICE: It, af[er making this tlec�aratlon, you shoultl become subjact to the
i Workars' Comoenuuon pmvisions of tne Laoor Gotle, you must forthwlth
� <omPly wi[h' suc� provisions o� this permil Sball b0 tleemeO revoketl.
CONSTRUCTION LENDING AGENCV
1 hereDy affirm Nat there IS a<onstruttbn lentling a9encY for tha parformance
� ot thB work fOr whitn tnlS D¢�Tit IS �SSUBd (SeGtlon 3097 Civ. C.)
l.entlaPs Name
Q LenOe�'s AtlCress
� OWNER BVILDER DECLARATION
1 ne�e6y aflkm tnat i am exoma� hom tha Contranors L(conse �aw for Me
loi�owing reason (Sottlon 70315 Bus(ne55 antl Pmio55�onai COCe: Any Uty or
county which f¢qUbei d p4fTiL LO CO�SIl11Cl, dHOI� ITP�aVe. ACT611511 O! lepd{!
iny stru<ture. Prio� to its izsuance, also requiros �hn aOP�lcant for such pe�mlt
> file a 5ignaC statem0nt that he/s�o k IlcenseG pwsuant to t�o provisions oi
ne Contractor's L.icen5e Law (G�aptar 9(commonc7ng wN� Sectlon 7060) of
Division 3 ot 1ha Business antl Professtons Cotle) or that ne/she is exempt
t�erolrom antl the basls for lhfl a11e9eC 9x4mption. Any violaUan O� SB<tlon
7031,5 by any appflcant fo� a permlt SUDjectS t�e applicant to a civil
eena�ty of not mora than Nve nuntlretl tlollars (E500).
tJ I, as owner of tno proDe�fy o/ my employces with wagas as Iheir sole
CORIpenSatiOn, will CO tt10 work, anA t�e Stfu«U�e Is not intentletl of Of(¢tCtl
br sble ($ecUon 7044, Business anG VYofessional Cotle: Tha Conbattor'S
License l.aw does not apply to an owner o1 a properry w�o Du1105 or (mprovet
thareOn, antl wt10 tlo85 sUGh wOrk h{m5¢If/hels8il Ot tflrougfl his af I18f Own
BmplOy¢¢5, OtOvitletl tbdt suGh Iry�p�6vertlfnt5 ata pat inf¢�tletl or Otter¢tl tD�
sa�e. 1f, nowever, tne ountling ar improvemen� i5 So�G witnin one Year o� Com-
' platioo, tno owner will have the burden ot provVng �e/sho tlIG not DWitl or Im•
prOv! �Ot Ihe pU�Pose Ot 5alo).
❑ I, ai o�+ner of the OroOerty, am exdusivelY tontractin9 wit� Ilcensetl con-
iractorsto canstruct the prolect (SCctIOn 7044, Business antl Prote551on5 Cotle:
Tne Concractor's Llcenie Law daes �01 aOP�Y �o an owner of proporty who
ouilas o� �mo�avas tnoreon. ana who contracts ror such oroiects with a can-
t�actor(s1 6<ensa oursuan� to me Convactor's Ltranse Law). � am aware that
proof of their Worker's Compensation Insuranta ShoulA be proviAed to me.
❑ 1 am exempt unCer Se<tlon B. 6 P. C. �or tM5 reawn
Date
cert
�n cs
99nature _np
DrWars` Ucensc m
0865�46,rev.5/88
_ Owner
1 hava read this ap0���ation anC sta5e that tbe a0ove
I agr4e to comp�Y wi[h all city and county Ordinant¢5
to OuilEin9 conStruCHon, antl hereby authoriZe repre-
� to enter upon tne above-mentionetl p�opertY for
� L.' ,O`ti4.)./'il ^ ,� Date j� n9' gg
, .. ... .........._. __..__. ..... ,..,.
3 � � � A.P. 5P
S Maio Buildi
TVPE OF CC1NSTflUCTION NEW ADO ALTEfiATiON REP0.1R E
❑ CONVERSION D DEMOL�SH ❑ OTHER 7 Front
OESCflIPT10NOFWORKlUSEOFOLOG. A Rear
TYPEOFPERMIT GRqoING FOUNDA71oN STRVCTURAL C Right
K Lefc
❑ TENAN7 �EL@CTRICAL ❑ PLUMBING ❑ MECMANICAL S'
❑ �OTHER Pln9. F9f. 7!�
PRQIECT DESCRIPTION SQ. FT, OCCVPANCY Vlanning Notez:
CONSTRVC710N TVPE VALUATION $
ZONE GRA�INGCU.YOS. ACRES
pamarki:
Sink
7reventer
Irrigstion
Roar D�ains
Floor Sinks
GeSSffViCe OUt18f4
InterCeptors
Kitchen Sink
(�Va[or1e5
P—Trep
Roof Dreins
Reinspection Fea S�5
Boiler
Duct - Untler Ground
Duct • Structurai
�uct - Ventilating
Exhaust System ❑ Multip�e ❑
FirepllPecc. BIL ICBO d`
Heeting System & Ducting
❑0-700,000 BTU Ot00,0006T
Reinspection Fee � S15
WhitC � BuVltlln9; Canary - ApD�lcant; Pink - Atcount(n9; Goltlemotl - Assessor
Showers
Service Sink
Sewer CaP .
Sewer Connection
Solar Collecto�s
Solar Piping
Solar Tank
Swimming Pooi wlSpa
Urinal
Water CIOse[
Weter Heater
Water S¢rviCe
Auto�Wesh
Aummatic Washer
Constracrion Pole Su
Cooking Unit
DiShwasher
Dryers OGas ❑Eb
Fan
F.A.U.
Fixtures
Oevice Boxes
Outlets
Sw"rtches
Garbage Digposal
Generator [1p5 KW
Zo�
lProv'�dtd
ELECTRICAL
Transformer � 15-50 KW
❑ 50+KW
Mecer �up ta 10� amps
Meter ❑overt00amps
Sub Panel
Motors �0-1 NP �7'fi - 8
InaSolar 09-15 f1P U16�15+
Microwave
Pole Light
Ra�9e
Standing Sections
75 KW Trash Compactor
Reinspectio� fee $15 Izsue Fee
§ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Iaue Fee 2oning Approved By
FEES Buildin8 MP�ovetl By � �
Hoodor Typel ❑
CanoPY TVOe 11 ❑
ReTrigeration Syrtem
�atao,aooaru ❑iao,000
System RepairlAlteration
Fire Dampe�s
Registers
Issue Fee
S 3
N
1
N
G
R
E
Q
M
T
S.
FEES
"a 7
SUMMARV OF FEES
BUILDINGPERMIT $ SMIP $
� PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PIAN CHECK 25% $ ��-7�.�.��p.o�_ ENEAGY P.C, $
� ELECTRICAL $ -���,�---4-�— GRADING $
PLANCHECK 50°,6 $ MICROFILM $
MECHANICAI $ TOTAL FEE $ -'?`�'--Y--
PLAN CNECK 25% $ _
Q100021682-0002l6&2 T4T
DATE: 12/�J9/SE 7IItE: I2:13
� , .
CONSTRUCTION AND PLANNING � � L& SPA
APPRpVALS Permit# Date Inspector qppROVALS Permit# Date inspector
•I. Temporary Elecxrical Service or Poie 52. Pool & Equipment Location
• 2. So'il Pipe-Undrgrnd. 53. Steel Reinforcement '
3. Electrical Conduit Utiliry-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -
5. Steel Rei�farcement � 56. Rough Plumbing & Pressure Test _
6. Electricai UFER Grnd. 57. APPRQVAL TO COVER�GUNITE
7. footin9s , 59. Eiectrical Conduit•Undrgr�d.
8. Foundation� � - 59. Gas Pipe, O Undrgrnd., 7est .
� 9. Water Pipe-Undrgrnd. 60, Backwash Lines, P•Trap. � Undr9rnd.
70 �+Structural Floor System � � 61. APPROVAL TO DECK
7•t. Property Sewer Line & House Connection 62. Backwash & Receptor-Pinal
12,�Sewer Cap 63. Heaier & Vent-Finel '
13. •Roof Qrains � gA. Plumbing SYstem - Final
14. Rough Ptumbing ' 65. Electrical-Final
15. Rough Electrical-Conduit 6. Solar System-Final
16: Rou9h Electric Wirin9 � � 7. Fencing & Access Approval
17; Rough Wiring Sign 69. APPROVED FQR PLASTERING
18� Rough Electrical-T Bar Ceiling ,� .S 6 OUSPA SYSTEMS FINAL
19* Rough Hea[ing & Air Conditioning FIRE DEPT. REQUIREMENT
2QrRough Factory Fireplace APPROVALS Permit #�
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilatin9 71. Product Piping O Gas ❑ Oii
23. Gas Pipe-Rough & Test 72, Underground Flush
24. Roof Framing '% 73. Undergrnd. Storage Ta�k Cl Gas ❑ Oil ,
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling {Structural) & Monocoat � 75. Dry Chemical
27. Frame and Flashin9 I6. Dry Standpipe -
28. Lathing & Siding 77, FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTN DEPT, REQUIREMENT .
31. Plaster Brown Goat 79. FINAL WSPEC710N
32. Electrical Power Meter-Final . FOOD CERTIFICATE ISSUED
33. Fina� E�ectric 2, �. F9 tes: ��
34. Final Heating & Air Conditioning _ __
35. Final Gas Pipe-Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Piumbing
39. Watar Service-Final
40. Gas Service-Final
41. Solar pomestiaFinai
42. Backflow Preventer _
43. Backflow Irrigation ; ' �
44. .Landscape IrriGation System ' � "
45. Sound Attenuation � .
1
46. Handicap Regulations �� '
47. FINAI STRUCTURE & BUILDING � �
48, Special Requirements Campieted +
r
49. Eiec[ric Relea:a to Edison - " _
50. Gas Release to Southern California Gas Cn _ � � �
51. CERTIFICATE OP OCCUPANCY ,_ , j " t
` No Date �� � � � ;
�
AOPlicant to Iil1 In all soaces exceDt ihose witnin neavy Doreer Ilnas ana sign all aoo�opriate tleclarations.
PERMIT �PERMIT NO. TRACT NO. LOT NO. UN1T NO.
CITYOFFOSTAMESA CONSTRUCTION
Proje�t�Address 555 ANTON� 2�1D FLOOR
Applicant's Mailing Address ��'�� •
Owner s Name S � P ne
I ,4ddress 600 WILSHIRE BLVD. ��a
'I Arch/Eng. License No.
Address
I Concracmr's Name K i mh 1 a a n A ('c� Phone � 9.`�2--� � 56
� Address (mailin9) �� N �
ICity LicenseNo. 04R50"i 'U ` � n -jil��
' LICENSED CONTRACTOR DECLARATION
I hereby attirm thal t am licensetl untler Orovisions of Cnarter 9(commencing
with section 7000) of Division 3 of [he Business"antl Professions Cotle, antl
my license is in tuil force astl eftect:
LicenseClass C-16 uc � �no. 460923 �
'�te /2-C - c���ar��._
)RKERS'COMPENSATION DECLARATION
.�ereby atfirm thal�l have a certificate of con5ent to Self-insure or a certificate
ot Workers' comp ry$ r c� e pr a ceri' h (Section
3800, Lab. Sl�� / �l
Policy No. � 2� Company
erti(ietl mpy is hereby furnishetl.
ert)'fiej�yJ�y is filetl with the <it iltli$�� vi " o.
Da �7—'�"J1C Applicant ��'J'+' �
EXEMPTION FROM WORKERS' COMPENSATIO DECLARATION
(This sec[ion neetl not Oe completetl if the permit is for one huntlretl ($300) or
less). .
I certify that in the perto�mance o( tbe wo�k fo� whicb Nis Oermit is issuetl, I
shall not employ any person �in any manner so as to become subject to the
Workers' Comp¢nsation Laws of CalilOmia.
Oate Signature `
NOTICE: It, afte� making this tleclaratlon, y0u shOula become subject to�tne
�Workers' Compensation provisions ot the Labor Cotle, you must forthwilh
comply wilh such provislon5 or thi5 permit Shall be tleemetl revok¢tl.
CONSTRUCTION LEN�ING AGENCV
1 M1ereby af/lrm tha[ [here is a constructlon lentling a9ency for the performance
of ihe work for which tnls permit is issuetl ($ection 3097 Civ. C.)
Lentler's Name
LentleYs Adtlre55
OWNER BUILDER OECLARATION
I nereby affirm that I am ezemD< <rom [he Contractor'S License Law Por the
following reason (Sec[lon 7031.5 Business antl Professional Code: Any city or
county whiGh requi�es a p¢rmit t0 const�uct, alte�, Imp�ova, tlemOlish o� �epalr
any structure, prior to lts issuance, also requlres lhe applicant for such permit
� fiie a signetl statement tna[ he/she is licen5etl pursuant [o tne provisions of
.e Contractor's License Law (Chapter 9(commendng with 5ection 7000) o(
�ivision 3 of [he Business antl Professions CoOe) o� thal he/she I5 exempt
� theretrom antl [M1e basi5 for th¢ allegetl exemptlon. Any violatlon o( Section
7031.5 by any appliGant for a permit SubjeCts Ihe applicant t0 a civfl
�enalty of not more than Iive nuntlretl tlollars (y500).
�J I, as Owner of the pw0erty Or my employees with waq¢5 as Iheir sole
comoensation, will Co lhe work, antl the siructure is not Intentletl or ofteretl
lor Sale ($ection 7044, Business antl Professional Cotle: Tho Contractor'S
License l.aw tloes not aOPry to an owner of a property who builtls or improves
��� thereon, antl who tloe5 such work hlmself/her5¢If or IhrOugh his or her own
' employees, O�ovitled Ihat suCh improvem¢nts are nol Intentled or otfaretl for
'i sale. It, nowev¢r, lhe builtling o� imProvement IS Soltl wiNin one year of com-
�, pletlon, lhe owne� will hav¢ the buttlen Of provinq he/stte tlitl not builtl o� Im-
�rove forthe purpose olzale).
1, a5 owne� of the prOPerty, am ¢xtlusively contracting wi[h IlcenSetl con-
lracto�s to conStruc[ the project ISet[ion 7044, Business anU Prote55ions Cotle:
The Contractor's License Law does not apply to an owner of property who
builas or �Improves thereon, antl who coniracts for sucn orojects witn a con-
' traCtor(s1 ucense pursuant to the ContractQ�S.Lirense Law). I am aware that
proof of tneir Worke�'s Compensatlon insurance shoultl be prOvPoetl to me.
❑ I am exempt untler Section B. & P. C. for lhis rea5on
Date
I hereby certity that I haye reatl tnis application antl state that the above
intormation ' recL 1 a/ee to comoly with all city antl county ortlinances
antl state I s re1ati g t builtling construclion, antl hereby authorize �ep�e-
Tentative5 f t l5 c y o en ef upon ltle abOve-men[iOnetl' {tfop¢�fY�Dr
inspection oses. L S o
Siqnature Daie
Drivers' License or 55 �
- 3G 7ZZ �1�� �
�TYPE OFCONSTRUCTION,�, NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ OEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT L7 GRADING �LyJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ EIECTRICAL ILhPLUMBING ❑ MECHANICAL
" ❑ OTHER
PROJECT DESCRIPTION SQ.FT. OCCUPA�NC�VT�j
TiSPE`RSTRUCTION TVPE VA WATION 5�
ZONE GRADING CU. VDS. ACRES_
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service OuHets
Interceptors
Kitchen Sink �
Lavamries �
P—Trap
RoOf Drains
Reinspection Fee
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank•�
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater �
Water Service
Auto-Wash
Laundry Trays
$15 I�sue Fee
Boiler
Duct- UnderGround
Duct - Structural
Duct � Ventilating
Exhaust System ❑ Multiple
Firepl/Fact Blt. ICBO #
Heating System & Ducting
❑ o-i oo,000 sru O i oo,000
Reinspection Fee I $15
CMF OB65-46, rev. 30/84 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Asse55or
Hood or Typel ❑
Canopy Type II �
Refrigeration $ystem
❑O�t00,0006TU ❑100,000
System Repair/Alteration
F ire Dampers
Registers �
Issue Fee
A.P. �WW
S Main Building:
E
T Front
A Rear
C Right
g Left
Ping. Ref. #
Planning Notes:
n
Automatic Washer'
Construction Pole Sub.
Cooking'Unit
I Zone
Accessory Building: '
Parking Req./Provided
ELECTRICAL
Trensformer ❑ 15-50 KW
❑ 50+KW
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generemr �0-5 KW �5-75 KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel
Motors O0.1 HP �l Y� � 8
Inc.Solar �9-75 HP 016-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compactor
531
J— Reinspection Fee $15 luue Fee
FEES
�DEVELOPMENT SERVICES REQUIREMENTS:
Zoning APProved By
�Building Approved By
Application Issued By (
-$ 3
FEES
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ . �� SMIP $ � �3
PLAN CHECK .$ PERMIT
PLUMBING $ ISSUANCE 3
PLAN CHECK 25% S ENERGV P.C. $
ELECTRICAL $ GRADING �5
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $
PLAN CHECK 25% $
2
O
N
I
N
G
R
E
�
M
T
S
CONSTRUCTION ANDPLANNING POOL&SPA
APPROVALS Permit # Date Inspector p�ppROVALS 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. S[eel 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 & HouseConnection 62. Backwash & Receptor-Finai
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough'Electrical�Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign � , 68. APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT •�
20. Rough Factory Fireplace APPROVALS Permit # _ ,
21. Ducts, in Structure 70. Underground Hydro � '
22. Ducts, Ventilating 71. Product Piping �GaS ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing ' 73. Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat � 75. Ory Chemical
27. Frame and Flashing 76. Dry Standpipe • �
28. Lathing & Siding 77. FIXED SYSTEM FINAL ( �J
29. Insulation 78. FIRE PREV. FINAL �'
30. Drywall Nailing HEALTH DEPT. REQUIREMENT � �
31. Plaster Brown Cqat 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 pomestic-Final �
42. Backflow Preve�nter
43. Backflow Irrig�atipn `-
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 Califomia Gas Co - � '•
51. CERTIFICATE OF OCCUPANCY . •`
No. Date � - ���
. ��
� 1
�ouxcsea�em�oiwo: 555 ANTON BL �NT� 7ND
s
owr+Ea9ruuEiF�v": SAKIOKA FARMS
NDNE44: PO BOX ZOJ%
:.,. ;, �..- TERMLNAL ANNEX
APPL ;M/JI1N0 JODAE54:
axcxrzEcronu+ani�+: IIJTERIOR UESIGN 21362321E�� 9378
WCLLOflFNQ'9AWRE53: SSO S HOPE ST ��� 1100
L.A. CA 90071
mNm�crarsru�: CAL—PAC CONSTRUCTION (310)545-3500
cakm�croxs�uiwa 6076 BRISTOL PARICWAY
�nonEs4 CULVER CITY CA ucxo_ 392102
90230 uNr: 106
LICENSED COMN�CTONS DECLAP�TION: I MmEy dtim undr penelly d pxjury Uut 1 em IiwiwE under po-ntbna d Cheqv B
(comme�n0 �it� Seclion ]000) d Oimion � d IM BudMn end Pidweau CaEa. ud mY fioenea u m M Mu enE aflaa.
emuc.e+o.: ue.euss: B o� z92'- � ,XF.
Dme: �O�l�f 7 � C� � -
�
OWNER BUILDEfl DECLAfl�TON: 1 hmeEy dfirm under prWy perjvy ihet I em e�emq /mm iM CaMretlm licera� lew la iha
tdbMTq iauon (SetliOn )W t.5 BWiqaf eM Raleabm CaM: Np' �Y a owMV wfiidi nVww s Ve^�i lo aoroWct. Mx.'vnVoro.
Eemoleh, a repai e�ry avucture, q'v b Ya'v�uence. ebo rpu'up Ihe eppl'xwu Ip a�ch pamw to fib e sqrod eWemon� IIW M a�M
a �icemed w�u m �ns wa� a ma cavreena Licema lan f��q� 91wmm«�ro wrtn Ssaun laoo) d Div'sion a d �M
BuaiMn uM Vrdeuicu Codel a Ihat M a dro u azomp �hselmn uM iM bean trc Na NpM axamqion. My vblmion at &atlon
�oats W enr eocbwu �«. w� ��ne roo�rsm �o e aui owM d na ma. menlxs hwd.ad dmen �Swop.
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a oRmeE br aeb (Seclian tou.8ue'vmeM PrdumneCade: Ths CatlreCon L.iww Lew doea nol epplyto en ownmd qopeny
who buids a in V� �he�ean. W Mu dom suc� wk Fhnaatl a MnN n Waph he a hs axn emGMM�. V�'db �Mt wM
'unpmnmmU va ro� imeMed ar a11xM la veb. tl. hoWewr. iM buitivp a inpo�emw b wtl wnhin ons Y� d oomplNbn. tM
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conVaM tar a�tli peopae weA a mm�eeor�e) feweE punuem �o tM Cavrem� tizms tew�.
� I em uemN uMa Section: B. 8 P.C.. ta Mu �seaon: '
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Dal�: Appfram:
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❑ �n.»w.am�Ui�.an'sr�.aaan+.vm.wa�a,.m..oni«Yc�pwuw�...a��aMe.aw�a�roam.�.na
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n wak lor xiikh ihia W�n u Wusd. MY MnYen' mmW�bn Imwenc� arier eM D�Y m�mbr v�:
c.m«: FiRF.MAN' S FOND EXPIRES
PufryNumber i(WP HI)'�41.N{/ 02/O1/96
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Mcm�e wMed �o tM whws' mmpnWian Isw� d Ce4taris. rtw � I yN�dtltl Eecmw aE�e �o iM MONr�'
�M��b�n jpw6/ia]a d• �Setlian �]OG d tM lebar � n � 1'L�
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perlormerce d iM v.ark la xfiidi ihe pmml u ewsd (SMcn �061. Civ. CI.
LENDEN'S NAME:
�aoen•s noopess:
I ceM' Rim I hew �aad Ne+W�ra4m �nd qtls tAm tM abo.s'vdamtlion u oortW. I qpe+m camW xnh aA eu�'rd oouM' adLv�xm
BII� 9�010W910�6�1p b�Tj CMffiIlblll Glb �MlGd/ BYI�1VCB ApllMIYlIh9� d Ib f�' b ONp u�Vll �M GbPl�IMNMl� pICOGII)'
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(5t51iB.WP) Whds&ad�q85e1ery:Gmei-fle:Cenmy-Appium:Rnk-Revanue:Gotlenio6.�ve�v
CITY OF COSTA MESA - BUILDING PERh1IT
PERMIT NO: B 074570 PLAN CHECK NO: 03711-95 A
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR
PERM NO: B 07457u
GOVT: N SUPP: N
PURPUSE; ALT
JOB DESCRIPTION : INTERIOR 200005F OFFICE T.I. SQ FT: 20,000
CLAIM �'ALUE: 365,000.00 CALC-VALUE: 386,400.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS
**�r**i�*****s���c+�*�-**�*+t*+�*r+r�rt*x�**+tit�*i�**+�;�*****it�****i[�**�t**�t-iti�i�i�;r*#i�rt*iex�i�*�*�[-i��c*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 41050104 ZNE: PDC REF NU:
PLANNING NOTES> TENANT IMPROVEMENTS TO 2ND FLOOR FOR 76 PRODUCTS COMPANY
i -
�***���*��**�**��?�**x���*�.****�***��*�*�**��******�+�*�******�*+�;�**�*��**�****��
D E V E L O P M E N T S E R V I C E S R E c� U I R E M E N T S
ZONING APPROVED BY :_Q_�C� DATE: 9/�� /9t-
BUILDING APPROVED .BY :_ .2�1��e^-� DATE: /�/.3���-
APPLICATION ISSUEU,BY: ' �/�% DATE: ld//.3�'/"��
i�i��itiEi�*i�i�*i�it�i�i[-if*�i�rt*ic�iti� iFiFiF'iF .:3r�. Tr,e�iF'3F��%���„F'�"�'�"�F��F3FiFiti�i[�***f��i�?�-�F�,c�Fi€�FiF��r**
LEGALIZATION:�1 ' F E E $ U M M R Y STRUCTURAL SEGMENT:Y
.,
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT' 1,644.00 c
PLAN 267.15 % 'j
ISSUE FEE
BUILDI�IG-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 1725.14 0.00 `2�67.15
REVENUE DIVISIt�N TOTALS--> COLLEC'fED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
1644.00 "
SMIP/NON-RES
81.14
TOTAL PAID DUE
1992,29 1992,29 .00
1725.14 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
81.19
3f �k 1f 1ElE iE iE iF �iF 1(' iE #!E if iE IF 1E # i(� �1F iF �)k iE iF iF 1E iE 1EiE �1F'K-iE If 1& 1f jE 7F it if iE 1E 1E iE iE IE If R iF If IE iE iE iE Ik 1E fk iF 1ElF if R iE iF 1f 3E i4 if 1f iE iE 1f if !F if iE if !6 # 1E
I N D I V Z D U A I, F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF—INT. ALTER TYPE,I II F.R. —AVER 19.24 364,800.00
SFC 20000 EQU—ALT COMM. SPRINKL�R SYS —AVER .36 7,200,00
SFC 20000 EQU—ALT COMM. AIR COND —AVER .72 14,400.00
END OF FEES
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CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date tnspector
'' t. Temporary EleCtricai Service or Pole 52. Pooi & Equipment Loca[ion! � .
2. Soil Pipe-Undrgrnd. • 53. Steei Reinforcement . �
3. Electricai Conduit Utility-Undrgrnd. 54. Forms ' �
4. Electrical ConduibUndrgrnd. • 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 Undrgmd.
70. Structural Floo� System ' 67. APPROVAL TO DECK �� �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Finel
12. Sewer Cap � 63. Heater & Ven[-Finai �', '
i
13. Roof Orains ? � � 64. Plumbing System - Finai �. -
14. Rough Plumbing 65. ElecTrical-Final � "
75. Rough Electrical-Conduit . - 66. Solar SVstem�Final .
76. Rou9h Electric Wiring " 67. Fencing & Access Approval .
17. Rough Wiring Si9n 68. APPRpVED FOR PLASTERING
18. Rough Electrira�-T Bar Ceiling ' 69. POOLlSPA SYSTEMS PINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rouqh Facmry Pireplace APPROVALS Permit #
21. Ouc[s, in Structure 7D. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Ten 72. UndergrounU Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hyciro
26. T�Bar Ceiling (Structura�) & Monocoat ��/Js�� � 75. Dry Chemical
F
27. Frame and Fiashing ��� 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL �
30. Drywall Nailinq ( fQ P�i, HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat - � 79. FINAL INSPECTION
32. Electrical Power Meter�Pinal .. 80. FOOD CERTIFICA7F ISSUED
33. Final Electric Notes: � /
/D� ?_/qS drl��oa � ��vl ry`G�C Zstv�
34. Final Heating & Air Conditioning on� r-/J U
���
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plum6ing �..
39. bVater Service-Final
40. Gas Service-Finel ,
47. Solar pomesiic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. landscape Irriga[ion System
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �� Q6
48. FINAL PLANNING
49. E�ectric Release to Edison '�
r
50. Gas Release to 5outhern California Gas Co
51. CEflTIFICATE OP OCCUPANCY
No. Date
�I
eopn�ssaem�Emo: 555 ANTON BL
avxEa9ru�EiFaa�r�+: SAKIOKA FARMS
�p�9i PO BOX 2097
�•' TERMINAL ANNEX
�PPL. M�IIIIM /i0UNE5A
uxr: zND
�xcxrteeTox��+: INTERIOR DESIGN 21362321EV��� 9378
�xcxonera.�e�oonea: 550 S HOPE ST uxr: 1100
L.A. CA 90071
LONfNACidI'8 NAYE:
CONfP�CT01fl Y16Dq
�nonEss:
ua xo:
UNT:
110EN4ED COHfPACTOX9 OECL�fl�TON: I Mnby d�� ada qro�Y d pr�ury Nq 1 un fewu�G under pwidm� d CMµv B
(mmm�ndnY MIA BeciM ]000) M DMbbn ] N iM BudMe W Pmfa�bru COC�. md mY Gwnw u In hA bm uN Ntw.
emue.No.: ue.euss: ue.No.: EXP:
Deb: Guu�wa:
OWNEN BUILUEF OECLAN�TION: I IwW/ eRi�m uMM D�Y d porjvy tlut 1 em vamq hpn tM Caarwon liun�a Lew tar 1M
Yowiq num (8an'an ]W 13 &siw� ad PralaMaM Cab: MJW n mWy vrtidi nQuim e P�Y to muhuU. eEsr.'unpow.
xnd'e�, a repei ury aWctiv�, prior b b sws�w, eb0 �a � ePO�N �a ach pm�N to As e opirL ptlamsM ihu M p�M
a IiwnM punuW to �M pv.acn� d Ns CaNratlw� �� �+w (Cheqp 91��diq wEh SWun ]OW) ��'eb^ �� Ihe
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ImpwMn�nu u� nol Imad�E a a1bnE fa u4. tl. �'�. iM builCvp a inpvpnW e wld rrilhin aw Y� d aomplNm. �M
�amarbWdr vAI hew �M EuNen d pMnO M> tlr did na ddd a'vnR� ta IM pnW�e al Wsl.
�, m oMna d in. ww«�r. em ud�.MN oaa.wbo .an 4awd miwmm. ro mmvua tl» wqb (swbn la�. Bwin«s ene
PNi�ql� Ci0d0: PM i�iMlYILA �lMIIM �IM I�u�' � IIQ 11{�/ b tll OAIY (� �MY M�q � V�11PwM ��N10IX1 LIY� N�W
� eonuecn In aM pqwa wh e mMMor(�) feerob P�� to tM Cqq�aCa� Liwro� lewj.
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WORKEP'8 fAYVpl9ATON OECWI�TION: I MrW� �� udw pau0y d prjry ar d tlw bGow4p bdvmpu:
❑ �n.r.wwumWn.b.unaw.amnwv�o..a+�.n.awk.:mnp.mna�.ewor.k.d�arWewiona�ooam.�.n«
CoG. la �M pafamv�n d tlw xM la Mli�A Nu DM�t b loiwtl.
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c.M«:
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canp�nu�bn pwubm d 8wbn 9]00 d IM Leha ��.1 NeA fMhwEh mmpf� MiN Uan prwbbn.
Dete: Md�
W�minp: F�Nun ro�cun worM'rorryw�wtlon eer�rry� b unlnHul, mL�lrll WlNe! m ntplqw ro u1Mnl paultlu �M
nvn nnu �p ro om nuwne uauwW ad�.n l�i�+4�A N Wtlu�n ro m� eo.r o� mrrp.n..wn � u provM�e roi In
9.euon aro6 or m. L�eo, eoe., �Nr..e .�d.mmh". r....
CON9TflUCTON LENDINO �OENC1: I IrNry elll�m � pwM d pwjey tNl iMn u� amuvfbn 4ndi�p epsKy tor ihs
perlormeria o/ IM xak far whkh iAY q�mY 4 iauM (9K1ion �OW. CM. Cl.
LENDEP'8 N�IIE:
LENDEN'8 �OOREBS:
I eanity iMt I Mva nad I�b epdr� � mm+tlw Na /bew Woemdim b eantl. I pne io eanply wXh NI iAy eM muny oMinanas
uM �me Isw� nWN m WYEnO amtrunian uM MrWY �Wvh� np�romati.a� M Nu ml' b aaw u0� tM eEws�matlionW G�WeM
lor irupaqian pwpoee�.
ERNZE VITUCCl
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, _(5tS1.�6.WP) Whil�-Bu1Niq b SdalY• OiaeMFb: C�nery-Appirani: Pink-Rnanu�: pddanmd-A�wwr
CITY OF COSTA MESA - HUILDING PERMIT
PERM NO: B 076185
PERMIT NO: H 076185 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC-VALUE: 339,625.00 GROUP OCC: B /
*�*****+�t**�*+t***�*�**��w*�*x*********����*�*****�*�t�t*�**Bw****rt**********�t**�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN AEAR: FT IN FRNT: FT IN AEAR: FT I13
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE; PDC REF NO:
PLANNING NOTES>
i �
it iE 7E aE IE 1E iE if �IE 1E ib iF if if 1E iE ik fE 1E 1E iE iF iF iE iE fEtt if IE iE iE If IE i6 if 1F fF it it if it IE 1E 1E it fE iE ik iE iE iE it iE M iF if iE 1E if 3f if iE rt iE if it iE iF iE.iE aF iF iF iF iF iF iE �t iF
D E V E L O P M E N.T S E R V I C E S R E Q U I R E M E N,T S
� " if
ZONING APPROVED BY ' DATE: �
BUILDING APPROVED-BY : .' DATE:
APPLICATION ISSUED•BY: lA�
iE'IE 1E 1F iE 1! 1E 1E k 1E If 1f 1f if if iE if fk if ik iF iF
LEGALIZATION:N % F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 1,479.50
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK
TOTALS----> 1550.82 0.00 . 0.00'
REVENUE DIVISION TOTALS--> COLLECTED.: -
BLDG PMT PLUMHING ELECTRIC MECHIiNIC
1479.50 '
DATE: I ?_I� Q
i��il�iFiEiE1E1EiEiliflE ifiE
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
SMIP/NON-RES
71.32
TOTAL PAID DUE
1550.82 1550.82 .00
1550.82 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
71.32
iE 1f iE if 1f 1f if iE ik 1f 1E 7E iE 1f 1E if 1E if fE fE iE fE iE if iE if ik �F fF 1E if ik 1f If 1E 1f iE f! iE 1k 1E M!E ik ib ib if 1E k 1F iE 1E fF 1F k if 1f iF iE iF i61F �! M fE IE 1f ik IE fE fE iF if iF iE iF iF 1E iE
I N D I V I D U A L-'F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N.", �'� UNIT COST TOTAL COST
SFC 325000 T.I. OFFICE BY—VALUE/$1 1.00 325,000.00
END�OFYFEES
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� CONSTRUCTION AND PLANN�NG � P� & SPA
APyROVAIS P.ermit#-- Date Inspeetor qppROVALS Permit# Datc I'�sR��tor
i'
i�Temporary Eiectrical Service or Pole '�52. Pool & Equipmenc Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd. 54. Forms •
4. Electrical_Conduit-Undrgrnd. 55. Electricai Bonding
l'
�5. �teel Reinfoccement 56. Rough Plumbing & Pressure Test `
•:�• Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
' �7.�F.00tin9s,�=;r 58. Electrical Conduit-Undrgrnd.
8. Foundatiort 59. Gas Pipe, O Undrgrnd., Test "
9. Water Pipe.Undrgrnd. 60, Backwash Lines, P-Trap, O Undrgrnd.
10. Structurai Floor Svstem 67. APPROVAL TO DECK �
71. Property Sewer Line & House Connection _ 62. Backwash & Receptor-Final '
12. Sewer Cap 63. Heater & Vent•Final
13. Roof Orains - 64. Piumbing System • Final
14. Rough Plumbing -' 65. Electrical�Final
15. Rough Electrical-Conduit � .• 66. Solar System�Final
76. Rough Eiectric Wiring 67. Fencing & Access Approval
-17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou�h Heatina & Air Conditioning „a _ .. FIRE O�PT ;REQUIREMENT
20. RouqhFastoryFiraplace _.i' x ,-, C: -� APPROVALa-�: Permit# �� - .
27. Dutjs, in'StniUur�' �'' �= � � "' 70. UndergfUjjRd H¢dro ;
22. DuctS,VEntilOting „ � .-� �-. 71, produCtPipingOGes lJOil
23. Gas Pipe•Rough & Test �'" � L ' '% _ - ' �.' 72. Undergroupd F]u'sh- �
. � r.: -.
24. Roof Frap�ing' -. •`' . � - . � -� � . .
�: 73� Wndergrnd. Storage Tanb O Gas ❑ Oil
25. Roof Sheathing .. ��` - r �•�' 74'.•�Overhead Hydro „
26. T-Bar, Ceiling (StrucTura1) & Manocoat `�/Ofj � 7�;,tjry Chemical
l /� .�
27. Frame and Flashin8 '. - - //jG/� � 76. Dry Standbipe �'- �_
. . . • _ !-�' � ,
_ 28. Lathing &�Siding r.; � - ' a''' �� � a 77. FIXE� SY£TEM'�INAL �
29. Insutacion- ` . _ " ' 7$- FIRE PREV. FJJ�) � L , ,
30. Drywall N2iling '" ` ��O�P6 �� '� �HEALTH DEPT. REQUIREMENT
��
. 31. Plaster Brown�Coat- �- ' • 79� PINAL INSPECTI�N �'
� ,-
'.32. Eleciriw�:Power Met'erFi�al *�� � � 80'. FOOD CERTIF'iCATE ISSUED
.:33. Final-Elearic � ;.�+. r• . � � Notes: "- ' � �
. . _ � : - , � c '-' �-V
34. FinaF�Heaiing & A�i'ConQ1tioniriq =' _ �� _ '
'...
35. �inal Gas.Pipe Test'. � - I�1�I�� / -c -^ �y_ -
. � ,�(_ _ R��
_ 36. Hood'or Canopy ,: - - , � . � ` " ��, �
.'( .
-�37. Final�Factory Fireplace . - - n. �. ^j •�, , �, �
.38. Pinal Plumbirig, / `�" �. - � _ "- .
'39. Water Service�FinaF- � � . .. � n .
�:40. GasService-Fihal x:•. :[•'�� - . . - _ r
�y - ,. .
�- 41. Solar pomes2ic-Fiti2�. ' � ' ^ - . � _
42. Backflow PreventeY �� � �- �� -� -
n.. �_ i, c F- �.� r�.- ,
43. Backflow Irrigation . � c , t
44. �andscape Irrigation Syscem'•''�`••- � . � „ _ '�� "�- . '
-� .- ti
45. So�nd AttenUation �, :, . � . ^�+ � r: � c � ' .
46. Handicap Regulations ` ~ = '� �
47. FINa1 STRUCTURE & BUILOING ����,(� - ' . V ' .
v
48. FINAI PEqNNING ' ' .
49. Electric Release to �{lison . � _
50. Gas Release to Southem California Gas Co " '" " �
51. CERTIPICATE OF OCCUPANCY ' `-
No Date
�
i,noxEssaem�umc: 555 ANTON BL
owxercsxu�eivap�m: SAKIOKA FARMS
• .noaEss: POI BOX 2097
TERMINAL ANNEX
1FP�. WVl1tM IOONEu
I /
�
— —'= CITY OF COSTA MESA - BUILDING PERMIT
2 tdD
PERMIT NO: B 074698 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: STR
uwx�aoxwm��n: INTERIOR ARCA.2135232164 ucwo: 937$
AXCN�apF110.'BWDNESS: SSO S HOPE ST UNT: Z1OO
L.A. CA 90071
ca+m�crarsru� SWZNERTON & WALBERG ( 213 ) 896-3400
ca+m�croxs�uuxc 865 S FIGUEROA ST
moefss: L, A. CA ue r�o.: 9 2
90017 urr: 3000
uCR15ED COMNRCTOR9 DECL�NATION: I heroby Nirm uiWer penMy d parjury Ihet I em IicaneeC urdx pwieione d Cheqar B
(ca�mend'p wil� 5ection 1000) d Division 9 d Ne B�airon enE Prdxdom Coda. enE mY ��b b in hA /' s W a/leri.
cR'r uc. No.C: 0 4 6 2 Q7 � uc. cuss: B uc. . ?. * n 19 5
Da�a: � 11 � 1.�f ��/� CaMrodar
OWNEfl BUILDER OECLAqATION: I hereby �im undm peneXy d ry 1 m I em eeemp om IM nVedon Licenee w la IM
Idbwip raevon (Sstlion ]OJ1.5 Busroea vM Prolauiona Code: An � munly whidi nquiiqa G to muWcl, eda. impraro,
i �nd'eh.a�epaimryspuc�uro.prinmdsevarw.abonpuirmlMepplim+IfawcApe�m�to aaignadsfelxrwMtlWMasM
� 4canaed W�e�e�1 Io IM povmons d Ihe CaNredon licenee Lew fChaqer 9(mmms�np xilh $atlion ]000) tl Divibn 9 d the
w�u eM Rden'va Codel a iMt he a ehe b axemq tMre4an enE iM bem lu tM eGOb uemqian. MV volmi�n d Sed'an
.J�1.5 by ury eppFmru la e permG aEpG� Ihe epplicaM �o e dW pa�ulry d nd mps ihen liaa hwq�etl EOAe�� �S,AOp.
� I.eeownardiMpape�yormyempbyeeewihwepma�t�e'vwbmmPo��ion,willdoihewwk.end�haeWCWrecminbndeE
a Mered br seb (5ec�ion )a1. Buvmea eM Prolaedww GaCe: The Comrmwa lioenss Lawdaea mt epply lo en omrmrd qopeM
who buida a inpn+a* �lroreon. aM who doea s�cfi wak IimsM w hend w 11xou9� hu a Nm own en+WWe». Pro+kad tlw euch
impovemmla ere rot imeMaL a oXereE la aeb. H, Mwever, ihe DuiMinO w'unpraromem u eoltl wi�hin wr yw d mmplmun, Ne
owrcrhuikbr wJl Mw tM burds� d pwinp he w eha did nq WYJ a unpwe la tM piryoae d ub�.
� I. n ox�w M tM O�wdW. em eaWisiwlY oomrmiq wdh I'icaned convacwe a mmtrua ihs o�9� (Seuon )Ou. Bwume eiq
Prolepims CaAe: Tha CanVedan Licanss lew daea iwl npply w en owner d qopeily who buiNa a impar IMreon erd Ma
� cono-ectf 1« wd� prqMa wiN e mNratla�a) Ikemed Wn� �o IM CanlratlMa lioeme lewl.
� I em eaemq unEer Sanian: 8. 8 P.C., br ihis reewn:
Dl�e: O�nar
I do ��eb/ cwNyVml I em ewma d eM uMenterM tM reQui�emenn d Cal/omie Fleellh entl Selary Gotle Sedwe 25505. 255�. eM
usae. ene uw �«enr nnms dukma «�m.�i �n �.ai na laicb awl nead ro wmM� win evid etate mdm vd �ne iw�w, ror
eCs^"�IuounvurlonamoAif�ianhantM�r�y wpm�e�YOiprct.RetldarAelooMiuuioneVG�iorousmemqlromNess
pIp'1910118.
Da�e: ApqiceM:
WONKEN'S COMPENSAAON DECL�N�TION: 1 M�Ey etNm wdar penMy d pmjury one d tlro Idbw'vp dsderNbro:
[] ina.eane.ameimennc«Wiuudm�wua.an+nwnt«wakea�wmpawtan.maw"riee�aWs«r:ana�oodtnelee«
CaM, la IM p�lwmrcs d Ne wik la wlich iM1u peimit u iaued.
❑ � n,v, d,e xi� maimen wakeA oomv�� ����. e. �eauo.a w swiu, s�ao d ub lee« coa. ror me v��a^� a m.
W01�t �IX M�141^ 11�119 pGllllll R M�. �AY WpkMl� WTP01189�1011 If1W f91N:B fBIM! 9M14 �b/ fIYTblf 8lB:
c,,,;,,: AftGONAOT • EXPIRES
Pd'ryNumber: w� o� JOJL1V7J4 OS/O1/96
� asnian meE rnu be mnV�ed l tM P�t 's b wx hurdred 0dlers IS�00/ w Iw.1
J i�nh mm m ub o«i�. a ma won i« .nKn m�. � o�. i meu �,a �Na� v oe�aon n dn merv�« o m m
become w4M m tM waM1m' canP�+vian 4we a c.r e. �.o�„ um n e«�» wqea �o me ..on�,�
com xfwn�/� io o({' etlian 3]00 d �he lebor Lode, I e � Rr ph � �' ione
Oda: �Q `IiV �l Aodcenl:
b
WAmlrp: F�Uun ro wcun ro�lrsn'rompsiuetlon roverep� Y �ntl ubhct smyloy�r foW nsl pwulf/u aM
c/vll �roa �p ro arM h,nOrM MouuM rbl4n fJ1IX{OOOA '� b��uf ro wuaqoM1 Cemep� u pmvltlW br In
SKtlon JIp6 0l rtis le6or Cotls, IMres4 eM ettomsy� /su.
CONSTNUCTON LENDINO RQENCY: I Mnby �rm uMx pe�utly d prjmy thei iMn b a canrt'ueion bM'up epmry fa Ne
pe�om�anae M Nro wak fa whiN �lin pe�mt in eauW 1��+ �l. CH. C).
LENDEq'S NAME:
LENOEN'S AODXE34:
I cenih �� I here rodihn epp'ration uM ste�s iMl iM ebove iniametion b cana. l apme lo comply wiln ell tlty md counly adirw�we
y� alete kvn rNatiq IobuJdiq emwu�on W heraby eWwrrsa �epraaemetiwa dihia ay io enier upon �M ebwa�mentioried popury
��`�D�'�'P��D�" DAN CON�F20Y
�
Ome: r�, �.9s
8 Sefery; pnan-Fb: Genery-Appirani: Fnk-Fmenue; OONmrotl-A�eauor
PERM NO: H 0'14698
GOVT; N SUPP: N
PURPOSE: ALT
JOB DESCRIPTIOPi : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE; 20,000.00 CALC-VALUE: 20,900.00 GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS PREP FOR TI
1E fE �1E !f if if iE iE iE fE �IE i! if 9E ff IE iE iE �lE ik iE 1E 9E ik iF fE 1E iE iE iE 1E if iE iElE IE jF * 1E IE 1E iE fF df if iE �E iE 1E �)t iE if iE iElf 1E iE iE iE �F ff IE±F iE #E �IE fE �F iE iE iE iE dE iE iE iE iE #!E
Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDSNG ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT SN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
!E if if iF iE 3E 3E �E iE iE IE f! jE dE iE iE9F iElEiEiE iE iElf 1f iE iE jf if iE fE 9F �f iE * 1E IElE if ik 1F IE k if iE 3E dE �ElE dF if iE k ib 1E iE 1E 3E iE iE iE iE fE 9E jE iE �E 1E i(' If 1E iE �E iE 16 if if �f 9k
D E V E L O P�M E N T S E R V I C E S R E Q U I R E M E N T S
•�
ZONING APPROVED HY r. DATE:
BUILDING APPROVED,BY, : �
APPLICATION ISSU£D;HY: �
iE iE iE df �E IE if 1F it if'1E �E fE 1E 1ElE�1E 9EiE iE iE if ��jf
LEGALIZATION:Y F E E 5 0 M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PERMIT 432.00 ' .
PLAN
ISSUE FEE
DATE: �
DATE: �� . � Gi,�,
IElfifjE�EiE1E1Fi�iFtF3��i('3FiFyfiFiEiE
STRUCTURAL SEGMENT:'L
SMIPIRES GRADING
SMIP/NON-RES
4.39
BUILIIING-DIV-> PERMIT ISSUE PLAN�CHEGK TOTAL PAID DUE
TOTALS----> 436.39 0.00 0.00 936.39 436.39 .00
REVENUE DIVISION TOTALS--> COLLEGTED: 436.39 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECFiANIC ' FIRE SMIP/TOT GRADING PLAN-CHECK
432,00 , �� 4.39
iE 1E 1E dE iE 3E �E iF iE dE iE 3E iE iE 1f iFjE IE if iE iElE if !E iE if iE 1E iE fElE iE iE if iE 1E 1f iF 1E fE 3f If iE iE �E if * iE iE 3f 1F 3f iE 1E iElf * 3E iF 1E jf �E iE 1E !E i61E iE �F iE 1F fE iElF iE� iF if jE 9E
I N D I V I D U A L_."F:E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N t, UNIT COST TOTAL COST
SFC 20000 DEMOLISH BY VALUE COMMERCIAL NOZONE 1,00 20,000.00
END�OF FEES
_i , �
� � �
,:
oa ooi9z��:-��iQ?a�z To� �' <3E."s�
DRTE: 10f2�l9:, 7IFi�c Q5:2o
CONSTRUCTION ANDPLANNING POOL A
�'APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector
•i. Temporary Electrica� Service or. Bo�e 52. Pool & Equipment Location ' '
Z. Soil Pipe-Undrgrnd. ' i 53. Steel Reinforcement -
3. Electricai Conduit Utiliry�Undrgrnd. 54, Forms
4. Eiectrical Cond�it�Untlrgrnd. 55. Eiearicai Bonding
5. Steel Reinforcement 56. Rough Ptum6ing & Pressure Test _
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE ,
7. Footings 58. Electrical Conduit-Undrgrnd. �
8. Foundation 59. Gas Pipe, � Undrqrnd., Test
9. Water Pipe�Undrgrnd. . 60. Backwasb Lines, P-Trap, O Undrgrnd.
10. Structural Floor Svstem . 61. APPROVAL TO DECK �
17. Property Sewer Line & House Connection 62. Backwash & Recepior-Final i -
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Dreins � � 64. Plumbing System - Final ._ �
14. Rough Piumbing . , 65. Electrical�Finai
75. Rough Electrical�Conduit �! 66. Solar System�Pinal '
16. Rough Elec[ric Wiring • 67. fencing & Access Approval
, i 1�7. Rough Wiring Sign � 66. APPROVED FOR PLASTERING
.
� i$. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in Structure 70. Underground Hydro
22. Ducis, Ventilating 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oit
25. Roof Sheathing 74. Overhead Hydro
26. T-Ba� Ceiling (Structural) & Monocoat (���� � 75. Ory Chemicai
/ �/J
27. Freme and Flashing �'% !.!/ 76. Dry Standpipe
�..
28. Lathing & Siding . 77. FIXED SYSTEM FINAL
29. Insulation 7$, FIRE PREV. FINAL
30. Dryveall Nailing ��/�r � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal ' 80. F00� CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning � / (( �`
�_ 1 (0 Y"'� �C�llt� _�u�-
35. Final Gas Pipe�Test Q�i �� � Q
36. Hood or Canopy ��
� - -� -
37. Final Factory Fireplace �
38. Final Plumbing
34. Water Service-Fina�
40. Gas Service-Final
41. Solar pomestic�Final
42. Backfipw Preventer
43. Backflow Irrigation
44. landscape Irripation Svstem
45. Sound Attenuation
46. Handicap Regulations - .
47. FINAL STRUCTUfiE & BUI�DING %J�Y 6
48. FINAL PLANNING
49. Etectric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�uSaissaeu�wo: 555 ANTON BL
,oxr�xsx�E�i�m: SAKIOKA FARMS
� �p� P0 HOX 2097
,
� TERMINAL ANNEX �
'wr�.iww+a �noxEss:
�I
�
8
uxr: 2 ND
�xcxnec,onunnm�n: jNTERIOR DESIGN 213623216��� 9378
�
/iNCN.Ofl FJI�.'4 AOOPE54: S S O S HOP E S T uNT: 110 0
L.A. CA 90071
���T�'B�: CONTINENTAL PLUMBING INC ( 909 ) 360-8300
CQRfl1CTOR8YYlW0 11165 THUR5TON LANE
�nors�ss MIRA LOMA CA uexo: 399073
917 5 2 uNr:
LIGENSED CONTR�CTON9 DECLANATION: I Mnby d�'vm untlw DsnNy d psQury tIW I em Ikemsd uMx pvHbm d Chequ 9
(cammanenp wXh Haction ]000) d OM�ion 3 d ih� Bu4Mm � ia � Cods. uN my Iksiu b In lull laa W NIM.
cmuc.No.:02756 ��•��9 C 36 ue.No. g0 fiXP: 09/96
om.: ^ `�'l � caro.a«:
,
OWNEP BUILOER DECLARATION: I hastr/ dfirm u� OUWY a MrWry I em �rsmq Irom iM ConVqon Lioema Lew In tM
IdbwnO iwm (5oqbn l0]1.5 Busnns W RWwid�e Goda: MYW ooun�Y wtiiN n0uim a GeemG to om+Wet. aEx. LnVrwa�
demofwh, a eWei eny svueiu�a, p'ar b h e�uenoe. eMo �eVu'va tM WWi a� ta aeh PormC lo Ns a Wnad petamenl Ntl M a eha
u fmnsd W�� �0 tM powiana d Ns CauroeM �anas Law jCheqr 8(rnrvnarc'ap wuh Satlun IOW) d Dbebn J d ihe
Biuinw W Prdme'nna CaEal a �hel hs a tlro b memq thaelmm ard �he bess In tlr eAepW azemqian. My videtion al Saeion
lW 1.5 b/ eny epplionl /w e prmd whpas �M epqcM� to e dW pmelly d m1 mora ihen Ma hwMnE EdWt �SSW�).
� I. ea owner o/1M propMY or mY empbyeee vnlh wPp� ee iMi eda rompanmlbn. vrill do Ne Ma�k. end iM alnwture u nM inleMeE
a ollered for aeb (SecWn 10a6, Butlnev erd Prolnaiona Coda: The Conireeon Liconae lew doee not epplyto en ownr W D�WaM
who Wtld� or'vnprovea ihereon. xW wfio Eoes euc�'� timmX a henel a �hrap� Ae or M own emplv�eaa. qovked Ihei wch
impwammms ere na iniendeE a ollered la eeb, p. M1�'ere�. �he W�Nnq a inpovemem ie edd xnhin aw yeer d oompbtun, the
owner-buiWar xill hew the buNm d pwiip M w eM d'd nal WiN or impewe Iw IM WN�s d Ws�.
� I, ee owner d iM qopeiry. em exduaNely conlrediq v.ith liwnead contreclaa io conmruu �M qqeq (SeCion 1pM. &ninoa erM
Prdeseions Coda: TM Contreclon licenee Lew d�s nu ePWY �o en ovmer d papMy who buiNe a impwm iherson eM who
wmracb lor eurh prol�e wnh a mnireaor�e) licansed Wnuenl lo ihe Comredwe Limnse Law�.
� I em ezamq mder Seclron: B. 8 P.C.. M thn reewn:
oa�: o�:
i eo n�nv �«wr mm i� a....e a w�arei�a we �am�a,n d c��. H,.m, e�w smmr cm. s.c�. uws. zssa�. d,e
25530. vd Rw I or eny Murs WikiM �� rrill / wn �(oicb me) neaE b canW wYh eeid awe wEee eM �M n0uiremenn br
apmnillacauwctionamodifiraiionhwniMR'r�iy —e�epamenlDistrie.Reuden�WowM'uqoneppireiomeneaamq/mm�M1me
a�.
Dare: App�reru:
WOHNEH'S COMVENS�TION DEC4PATION: I herebY eMvm undr W�etY af pe�W ar d tM b0or.'vp Esduetiom:
❑ I heve eM vnl meiMen e cenAiwa d ooment lo eOM+nwn far xakae' compaiuetion. p pmiCsE la Ey Sedion ])OU d iM lebv
coaa io. me wno�� a ine wwk i«.M�n in�s o�u A��d.
❑ � nme eiw wi� meime'n waken• mmv�:�n inwv,m... �.aa�ee M smim alao a ms Labv coea. ror �ne w�a�p d �n.
w«k fa xfiitl� ihie prmn u ivued. MY waMen' o'+mDamdian'vaurerce anier end pdiry numMr ma:
c�,:
rw�,N�me,,: 07P/O1 /96
(This secfiwr need nof 6e compbfeE I t�s pem�d ie Iw Ma hundrad dolbrs (SiOpJ w lese.)
� I mnity ihei in ihe peAarmence W Ihe wwk la wFbh Ihia pami ' ep, I ehNl ml eyyy���0/ �Y Ve� in eny menner m av to
became wbjed lo tM vroNori compenaaiion b� d Cd' u d epy e Net'��e io N become wqeq o iM Mwken'
mmpenaeiion proviaom d Sanbn 3)00 d tM Lebv CaOe I nh f omp� A R a pwiabn
oaa �a _�V °Is ,��
Weminp: F�llun ro wc�n wortsn' compsrwtlon cO�xaps h un l, aMahs/l utl/�cf ur xnployer ro cNm�nsl prraMu entl _
e/N/ flnu up ro me hundreJ Ihauund EWNn (SIW.�I, M edd/tlo ro m. �o.r o� �o�.�..�m�, m� ., porm.e ro. ��
Sxtlm J106 of ths le6a� Cob, Intwu4 Nd �tbmry'� �su.
CONSTIIUCTION LENMNQ RGENCY: I heeby effum �der panalY W pujury �het �Iwe u e cma�upbn bnE"vq epency b Ne
paNarmam d tM xak ta which tAc prmi u ewed (�� �91. C'v. C). •
LENDEP'S NN.IE:
LENUEN'S 1DDNE39: �
1 an��Y �hm I Ma roed Nh eVWrd� eM vma ihet Ne ebwe iNomWion o ca�aa. I ap�w to wmdY wn� e0 rnY eM counry adi�wicea
eM stete lews iWliq b buikiq confUuclian mklweb/ e��rse repefeNeuvea W iM alyto anlv upan IM eEma�manlipMd pmpatry
.� �
, (S151d6.WP)
Deu: �p ^ � c15
WhBe-BuilEip 8 Sdmy; OrrorFb; Cenery-Appkrant:"Rnk-Rerenae; GdEenrod-Avaewr
CITY OF COSTA MESA — BUILDING PERMIT
PERl�IIT NO'; "P 074732 PLAN CHECK NO:
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: PLU
JOB DESCAIPTION : INTERIOR 20000SF OFFICE T.I.
N
PERM NO: P 074732
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H-2 /
*��*�+�r*�����*�����*�*�D�***x��**��**�*(��*+Erir+#r�*+Sr*��r�r*�*x�*+r+r�rx�*x x�*x��rx�x��r���rx �*�cx�x r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAA; FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REp • PROV; PARCEL: 41050109 ZNE: REF NO:
PLANNING N(STES>
i i
iE iE iE IE 1f iF 1E IE It M 1i 1k 1k 1k if 1E if iF 1E 1f 1E 1E 1f�iE1E 1E fEik 1f' 1E 1E K if iE 1f iE iE iF iE i(� 1t 1E 1E ik iE iE iE�k if 141E 1E 1E 1t1k 1k 1E if 1f 1E 1f 1E IE1E 1E 1E 1E 1f' iE iE kiF M iE i(� If 1@ M 1i
D E V E L O P M E N T S E R V I C E Sr' R E Q U T A E M E N T S
ZONING APPROVED BY r� DATE;
BUILDING APPROVED BY : .�'.�t DATE;
APPLICATION IS
1f iE iE 1E 1F 1F 1t 1F it 1F 1F 1E 1F IF
LEGALIZATION:N
F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 42.00
25i
PLAN .`
ISSUE FEE 20.00 '
BUILDING—DIV—> PERMIT ISSUE PI;AN—CHECK
TOTALS----> 42.00 20.00 ' 0.00
REVENUE DIVISION TOTALS--> COLLECTED: 6
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
62.00
DATE; �� 2�i1 v�
MKiEifiEfEiEiE If1E
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIPJNON—RES
TOTAL PAID DUE
62,00 62.00 .00
2.00 OVER/SHORT: 00
SMIP/TOT GRADING PLAN—CHECK
ik IE iE 1(� 1f� 1E IE iE IE 1E 1E 1E 1E if 1F if k 1F 1E if iE1E if 16 M iE iE K if iE 1F IE IE 1f 1E 1f ik 1E if 1P iE if iF Ik 1E� 1f if iEk IE 1t M M 1f 1I'1E 1P M 1! If if iE 1E 1E Ik IE 1f' iE 1I' 1E ik if� 1k if ik iF 1E if ik
_ I N D I V I D U A L' F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N
PLU 2 SINK KITCHEN �
PLU 2 WATE�7 HEATER AND/OR VENT
PLU 1 SINKS, FLOOR
PLU 1 REPAIR/ALTER DRAINAGE/VENT PIPING
END OF FEES
UNIT COST TOTAL COST
%, 0 0 1 Q, � �
7.00 14.00
7.00 7.00
7.00 7.00
�7. �Jt�.? . _ll�?%9D : s�'e ��?.01
D','Ec :'. (1!^,�: G:. ..
�
L �' -
~GbNSTRUCTION AND PLANNING PO(,.. & SPA
j' - Date inspector Date Inspecror
APPFiOVALS. Permit �# APPROVALS Permit �h �.
- '
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. �` - 53. Steel Reinforcement ^ -
� �-= a
�Q.,Electrical:�ondtCu•{itilitY�Undtgrnd. 54. Forms � �" �
-'��ectrical�and'�`j�r5tirgrnd. � 55. Electrical Bonding - �
.��eel ReiqJ.o�certiePtij ' S6. Rough Plumbing & Pressure Test
" LL, F,`,IactricaLl2vE�,�. 57. APPROVAL TO COVER-GUNITE �
g.%_ootings ny�� F, `� 58. Electrical Cond�tUnd�grnd.
-�8. �oundatio�F "' �' a' `r� - 59. Gas Pipe, � Und�rnd., Tes�
9. Water Pipg;Und tgr�yd. N ,- 60. Backwash Lines, P"Trap, Q t7ndrqmd.
10. Structura�floor��J3tem ��, �' "` 61. APPROVALTO QECK I
i
17. Property$�wgc F�ne-8e Houseybnnection 62. Backwash & Receptor-Final
I
12. Sewer Cap ';^, ' �• .63. Heater & Vent-Final _� �
73. Roof Drains j� - '� 64. Plumbing Syscem � Final -
14. Rough Plumbesiga [^ 65. E�ectricai�Final ' -
75. flough EkCtricaY-yCo�uit � - 66. So�ar SYstem-FEp�,4
16. Rough Eleccric�ring o y , 67. Fencing & Acc*�.S�Appro`val '- �
17. Rough Wirit-�Jt Si§1t � , 68. APPROVED F�LASTERING ,-
18. Rough Elect`rica Bar Geiling 69. POOUSPA SYSTfiMS FINAL �
19. Rou h Heating & Ai�Condition�� T J * � � * T F�FE,QE,PT.,�EQUIF�EME(J�' C.�, �.
t � � : T C. . V ] ^7 i J d� ,m, Y y r••�
20. �ou . F7�tor,�Fi �'ace i ;�. � .% S ,.,., �,* APPf�V�I�..iFPe'mit# -
21. Eucfs in�truciur�T1'� � �•' •' '-' � * 5 G �'+x t '� ��"� � �
- - r: i S- x CJ � C1r �0. nder ro �
22. t}ucf� V�+%til3�ing�v. . � G *p q C� F� 77. ProduCp jping �8as Oil
23. Gvs Pip�e��ougln & Test � � cr'7^ �i� m��Q �-n . 72, Undergr�r�i{I Fps`Fl '� `•"'
24. Roof`�fre�'jing.• L X � HF *> C v' 't m -+ • +: c�
�:-+r . 73:! Undergrnd. Sto�Tankr.0 Gas ❑ Vil ��
25. RoobShaRhing SY '� � Y� �7 ^ N* 7�p�erhead Hydr�� �
M �.-� x m� m x a. �-, _�.s. ..,;
26. �C�Bar; Ceiling (Str�k1`ct�irall & ts�Dn�osoat F J ;, p�; 7� Dry Chemical F,- * ��. .,:
27. fiarneandFiashiry�r. D;.,� T � cr ?� w* 76. Dry Sta 'be F��^ * u .. ��`�•:`
Hq S •�; -
28. Lattt�itg �Siding �;; �! �,�j�� 7 x� ..� ..j� 71y FIXED pHYcyTF�il(y�.lA'*s ri C, Xx �i
' 29. Insut2tiom C�K S •• # � � Y D �, �Q ,'-
^ r. � � � 7�"PIRE EV. F' L ,. ,�
30. DrYwall fGBiling :�T r, � F � Son� cc"t+ALT,�',OEP�.'�EQUIfi�fy9�
31. Plaster BrDwriC'�oaar'�a' 5 � r• r' � - 79.�FINAL 1345PECTFDN *_ y� �%
� �, � r k _� ' S w
� 32. £�ectrica�ov�r N��r`-�1{�aI � *"' , ' 8C�F00� CER IF��ATE I�SS�- E� c'
_ , _
33. fdnarEle�ric; ��s � t i n: h' �� I Nofes: t�-'�' -'�. �� - c'.�
� 34. £)naR�ie�f ng;� AI'i:� i ionirt; � :�' x � � � nx + � _-> _ _
� � [*: A� I ri F� �C � .T.
, ` 35. Final Ga5-Pipe.:Tese; �� �,s � •• s �, � � z.: O.- + � :*7!-'
� i Y.
36. dPO�! C�enoPY .'X � � I'�M 6 X t-1 ' IJF � �IQ # r'Y
..i YL K �1 I.'[ �•• �' T !`. � �f i� i�.
' � � M
,37. Finaf•�actory Firealxe � i F'� rv �� � '* x s �-'c.:
r 38. Fina�lumbing � t�'L j p�/-�S `�� H � x� S
39. Watei�Service-Final w� i � k c� � ��• �� ��� � x� ��
Y
� 40. Gas Service-Final �� a�'�r *�' tk O✓ c�N r
> Ct e-� F r j t 'r� • o E �� Q
t
�41. Solar pomesticFinal;: ;.; f , : � -yo C 'r x p
c
42. Backflow Preventer w � `� ' � � `-` � y�" �� � ^
<' [+; 0�+- x-+ .� in h70 '� F
43. Backflow Irriq�tion k y' M c� x� �� * ^� •-✓•r•
n� �r c�obo
4A. kandswp�' Ir�'l}i, ation'$ystem '�m�' T *-T; '� J Ok' N N ^ � ► CJ G� 00 '
�] � r v ��2 x m # '�-.^ <C �4 k E S "� O x A: r'
�5. Lound kFtenyretion* �~�•• � x =, :.-, ,r`r7* • c c �r;+- F7 �
t
�i6. Handri,cap•Regaiatio � � S ..i ..M M C '7O -- �
47. �IN%�L STRI(CTUR� & BUIL ING : c. I :� `� " r r E-•
, ., ,
48. FaNA�.PLANNINGy '``" *:�' � j,p�` .� N S K K
�9. �e�e Rele�e to E ison : * �!: 4 •r 'ti -
'� cnr �
�0. C'as k'llease to Soutli�rn Califor�'�3asCo r � �" '" � ' �� � �' ' ' ' '
a. � c � S oo n x tu ���oo
5i. CERh1FICATE OF (SCCUPANCY r � , .-- _ �
No. Date
AOORESSOiBU1LqN0: SSS ANTON HL
°'""E"'s"""'E"'Q'°w": SAKIOKA FARMS
'DOP�'' PO BOX 2097
TERMINAL ANNEX
MPL.NANNO�OOflESY
uNr: 2 ND
urcertecron�aw�n: TRI—SIGNAL INC. ���NOs 0
1qCN.OP EH0:4 ADURESS: 1 9 Q S GARD ENA AV 818 — 2 4 7-119 4 uHr:
GLENDALE CA 91204
����T�"'g""� MORROW MEADOWS CORPORATIO ( 909 ) 598-7700
�a+TM����u� P O BOX 509
�op� WALNUT CA ueno.: 230813
91789 uNT:
UCENSED COMHRCTOHS OECLAfletION: 1 Mreby ellim wMs penely d pe�ury �hel I am licemetl unEx poviviom M Cluqar 9
(commeriarq xilh Seciim IOW) d Oivuion � W Na Busmma eM Pmluaao Gode, eM mY liodis c in IUA Mce eM ellea.
cmuc.No.:006558 uc.cuss: uc.No.: z30813 E}P: 12/96
�
._ o�<: �— f� — 6 �� �r
��
.
�
OWNEN BUILUEF OECLRHATION: I Mraby elfirm uMer penely d pmjury i I am v mq Imm iM Conlredas Licema lew for Me
fdbwiq tmton 1�� l0]t.5 &uiinv erd PrtAem�a Cado: AmW a ouNy xfii requim a pertnu lo mutrucl. Mer. impave.
demoleh, a repei eny svunure. qior b Xs ewiaMe, a6o repu'ves iha eppli t Iw pa'mA m file a sgneE elalement Ihet �e or eM
m i��e w�m m m. a� a me cw� u�� �. Icnap endn0 wEh Seaion ]OW) H Ow'¢ion 3 d tln
Buainean aM Prdessiau Goda� or thet ha v eha ia mcemq �haraLom end IM baffi la tha dbped exempbn. Nry violalon d Sedion
)0�1.5 by eiry eppliram la a parmi� sWpe� �he epplKam �o e avi penetly d nol maa ihen Me hundred dollan �SSro�.
❑ I.mow+wAiMP�YumV�PM��hhwapa+miheiwbcvmO��.MAdothaMoik.ardUnnwnureerwiinteMed
«Mered lor sele (SxUon l0aa. eusross eM Prdeasiona Gode: The Contrmon License Lew tloes ml WM' Ioan ownera ProDeM
who Wida a in V� �hereon. md Ma Eoes auM wh h'vndl a hena! a Waph he a her oxn emWw�. pa'�daE ihet wch
impovemema ere rot imeMad a dleeed lor sab. X. howavm. the WiHinp or inpoveineru o eold wnhin wrYav W aomd�bn. �M
r,e.t�uder win ne�e me eu�den a ww��ro ne «.na eie na dad «�wwe �v u�e w�o�e a.eiel.
� I. as owrr d ihe G�W�Y. em udu�i�dJ odurea�q weh 4mnad canbectas lo mmua tln pM� (Sedon )Oa1. &n'uwea eM
waa��. coae: Tna c�o-mo�. uo�b �., me. �,w mdr w� o.,w a ww�r ..no w�a. w Mw«« ma..a, .�e .Nw
Cd11t9t19�Of tll(�1 V�Ga�9 WE�180JItlf ]IX(B) �R'B110p� V�=YBN�O��1! CMYIBdIXe �JIHf100 �6W].
� I em exemp uMer Senian: B. 8 P.C.. br Ne �eevi:
Ome: Ormr:
i do n�sr �on�H uw i.m a.�.e a w�d..�d in. �.c�«m a cwom. w.m�.�e smwr coee saaoo, uws. usaa. �e
25534. arW �hel I ar enY INuro Wikiiq ¢apenl will / w11 �q1(tircb aw) �� �O mmply WIh �ek YeIB oodee end �M �eyuirements M
epermnfwwuirvnion«modifmionhantMA'r wSiR�aropmiantDatrie.qeuCemmlmnurw'vnappicq'vyeneaemqimmlheae
Novisiana.
ome: �oa�:
WOXKEN'SCOYPENSATIONDEttAR�TION:IMrebydf uMspenMydpryrymedlMldbxirpdeduetbm:
� I �eve anE xil meinian e eeMctla d mnearu to vatlinwia la v.oeken' epnpenWbn, m prwidaC lor by Setlian 9)00 d iM lebar
Cotls. la IM peAamvca d iM xwk lu whicA thu psmq u 6eued.
n � nev. ene wi� mainien xa�w.� wmw�mo� iwranc...� Aa�ub M swiw, �roo w ms Vn« cm.. ror �ne wewmeno. a in.
f� wak Ia wl�idi �hia pertnn u iesued. MY ���* �0��� inarerce w�ier erd pdiry numbar ue:
c.�.m.: FTRRMANS F[7ND EXPIRES
va�r,�mw: nwran����a� 07/OL/96
(TAia eMion rresd nd W mnd�eC l NeO�t u M ms h�rMrW EdYn Rioo� a MvJ
� I cenAy Nei in Ihe pMwmence W IM1e work la wM1cn inb pem�Y b eaued, I ehell mi emplvy any pvson in eny menner w v to
e«ome �qea m ine �w.n• m�ee�o� r.. d cerea�:.. .�e ro� �nq a i.nwa n«m. .�,q,a �o me waxen�
co n5e� D�abm d ion �]00 d IM Lebor Cotle. I prlhwil� mmpy ,�iiN Ihosa pwivna
„�-f�``��° �-w� ..
om i �oa�v
Wem/np: Fe/lun ro ucun woikwi corry�nutlon cov�rep� h unYw1W, �n �NII s/.n.n «rp�oy.. ro cnmlur v�au •ne
clvll flrM� up ro on� hi.nErotl flroua�n0 tlollen (JIOO,IXIOA M Mdltbn h M cwt o romp.ru�fbM1 GmsP� �� P�h� br /n
Sxtlon �ftlb ol N� laDor COM. Infw�st � artom�y'� I�u.
CONSTRUCiION LENDINfi AGENCY: I hxeEy elf uMr penMy d �Mn b a aonqeWbn IeMi�p eperwy la Ue
p.na,meMe m me woh �u, wnid, me ro�� b��ea (seaYn aos1. civ. q.
LENOEP'S NAME:
LENOEp'S �OOHE55:
I cerlilY Ihet I he`e read No epplireiion enC pale �Mt Yro ebv.e'udammion w conetl. I ep�ea to camdY wi�A e0 tiiY ard wunry adir�er�cee
ena steta lews rNe�ep to Wikine cmmrumon e�E MreM eWv¢e �epmenietivea d thv rnYto.mx uP� Ihe abwe.mamionetl pmparly
brinspeqion purposas.
CHUCK JACOHZ JR
J
Dme:
(515t16.WP) �ne-BuM�q 8 Selery:Gmeri-FIe;Canery-I�ppicenl; Pink-Pevenue:Goldenrod-Asseew
CITY OF COSTA MESA — BUILDING PERMIT
�PERM NO: F 075841
PERMIT NO; F 075841 PLAN CHECK NO: 04810-95 L GOVT; N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE; ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE: 6,400.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74570
���+�**+���x�r*xx�*�*��**����*�*��r**��************�**�**x*�******�����*�**+��***�**�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT �N�
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NdTES>
i
iE iE 1ElE iE iE iE iE 9E �E 9F �7E iE iE fE iE fE �E iE iE iE 1E 1E iE 1E 3E iE 1E iE 1f if iE if iE if iElf iF iF iE iElE iE iE iE 1Elf �E 1E iE 1ElE IE dE iE iE 1F iE if iE iE iE iE iE iE iE iE �E �E iE IE iE iE 1E IE 1E if if iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY :
DATE:
DATE:
DATE: L�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 90.00 0.00 58.50
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
90,00
65� SMIP/NON—RES
58.50
TOTAL PAID DUE
148.50 148.50 .00
90.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
90.00
'N"IE 1E jf iE iF iF iF �F iE'1F iE iE if iE 1t iE 1E iE if aE 1E 1E iF iF 1E �k'If af iE 1E iE 1E iE it if if if iE ik 1F iF iF iF 1E i! 1E if iE 16 if 1F it iF iE iE if iE ik iE 1f if if i! iE aE iE �E if iE 1E iE 1E iE �E 1h if 1E 1F
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR
90 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00
END OF FEES
90.00
V< ��I.�...-..t ��������. ': ��� r�.U'J
�ii'E; U•�'G'r-�� TT{�G: j,�',._�
CONSTRUCTION AND PLRNNING POOI & SPA .
APPROVALS Permit# Date Inspector qPPROVALS Permit�p�� Date inspector
1. Temporary Electrical Service or Poie 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. - � 53. Steel Reinforcement ,
3. Electrical Conduit Utility-Undrgrnd. 54. Forms •
4. Electrical Conduit-Undrgrnd. 55. Electricai Bonding �
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Te:t
��6.-Electrical UFER'Gcnd. 57. APPROVAL TO COVER-GUNITE '
' 7. Faotings ,� �' 58. Electrical Conduit•Undrgrnd.
'� 8. F.oundation � . � 59. Gas Pipe, O Undcgmd., 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. Foof Drains 64. Plumbing System - Final
14. Rough Plumbipg 65. Electrical�Finai
15. Rough Electrical-Conduii - 66. Solar SYstem•Final
i 6. Rough Electric Wiring . 6). Pencing & Access Approval
-- 17. Rough Wiring Sign 68. APPROVEp FOR PLASTERING
18. Rough Electrical-'[ Bar Ceiling ' � 69. POOUSPA SYSTE64S FINAL
19. Rough Hea[ing & Air Condi:ioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ; � - - APPROVAL'S '' �Perinit # � �
21. Ducts, in Structure�. . � _ ' _ � - �70. Underground Hydro '
22. Ducts,.Ventilaiing � , 77. Product Piping OGas OOiI
23. Gas Pipe�Rough & Test � 72. Underground Flush �
24. Roof Praming .' ' 'i F� __ „73. Undergmd. Srorage Tank O Gas ❑ Oil
25. iioof$heathing J�- ::- � � 74, OverheadHydro�
26. T•Bar Ceiling (Struct6rali & Mono.c6at . � 75. Dry Chemical
27. Frame and Flashing , . � � 76. Dry Standpipe �� �
-�28. Lathing &,Siding � ,-��`-�� . '._ • � "� 77„ FIXED S'Y,STEM FINAL ,
29. Insulation � � - 78, FIRE PREV. FINAL � 217 R(� �„�-
�
30. Drywall N2i�in`g • ,� � �' HEALTNDEPT. REQUIREMENT
37. Plaste� Brown Coatr r,: , 79`�FINAI INSPECTION
32. Electrical Powe: Metar-Final `' ' �80,^"P000 CERTIFICATE ISSUED
� �33. Final Elect�ic - � � • ��� Noies: � . - '
�.34. Final Heating & Air �onditioning . �' •� �� �
35. Final Gas Pipe-Test . ' . .
: 36. Nood or Canopy ' �"- •
37. Pinal Factory Fireplace - � � -
38. Final Piumbing ' � � .
39. Nlater Service-Final , � . - -
40. Gas Service-Final - -,; - ' •� �- •
- 47. Solar pomestiaFinal� � _' ' • � . - f , . ..
42. Backfiow Preventer �� • ' � � - � -
43. 8ackfbw Irrigation ' ` • . T� .
44. Landscape Irripation System - - : � - � '
45. Sound Attenuation ' '
46. Handicap�Regulations � � " _
47. FINAL STRUCTURE & BUILDING � -
48. F(NALPLANNING � ' .
49. EleMria Release to Edison
50. Gas Release to Southern California Gas Co �• •
51. CERTIFICATE OF OCCUPANCY "
No Date
�oonasaeuwara: 555 ANTON HL
QYNERBWMEIFRlOWN: SAKIOICA FARMS
��p�' PO HOX 2097
TERMINAL ANNEX
wv�. �uw+c �ooxFsa
1qCNRECTOXFl1@lFFA:
urcx on era.•s �oo�ss:
uc. xo_
uNr: zND
uxr:
coNmACTarswu� SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
CpIfRACfORSYYIWG 215 E EL SUR ST
mo�ss MONROVIA CA ucxo.: 190173
91016 uxT:
110ENSED COMP�CTOPS OECLANITON: I Mreby eflim uMer perely d pmjury ihel I em licensed uMm pwieiona d Cheqm 9
(mmmantl'q w4� SscYm ]000) d D:`'vun � d Ms &�eim» ud Prdndma Code. end mY Gceme'v in htl lau mH eliw.
cmuc.No.:013054 10°'"'g' C 16 uc.No.: 90,,1c7�3 EXP: 04/96
om.: /D a� - Y S c�o-.a« �� /////�------
OWNEP BUILOEN OECLAPITION: I heeeby eN�m uder prWy d per'µy ihe� 1 mn emmp Imm �M CoMMm Limnse Lew la Ms
idw..ro � ts.a�o�, �oais a,.:b.. �e v�d�.io�. coae: nm oa o, oo��n �.�,w� rew�,o e o•�u io oo�,.wn..n«. �>o.b.
damd'uh, or repei vry si�ucture, p'w u G� 6eueMe, deo npuiraa Ihe epplireM la ax� pamN to fib e sipned eletement Nel he a�M
b 4cem.e w�� �o �ne am;wnu d �ne convae«. Lioenee lew lCMq« s(oumienero Mnn Seeun �aoo) a oMuion a a �he
Bueinesa eM Prdeviom Code� a Ihel he or ehe ia exemq th>ehan uM the bmo la ihe dbped examqion. My vuletion ol Seqion
]W 1.5 by enY aWlimnl ia e permil wbjetle IM epplicenl lo e dvil penelly d nol mors Ihen INe huMreE ddlero �450011.
❑ I.mownera�MqWo�v«mYsmWW��.thwWma�iheieabmmP��ion.wdldoUnwoM.erdtMabunuree�iniandeE
or MereE br eeb (Seciion ]0«. Bueiiwm end PMeveione Code: TM1e Can�reclon license LewAoes rwt eppyto en owner o/ propery
wM10 bulda a in0�'� Ihmaon, ud rAa doee eutli hoM Nmedl or hena� a tivouph he a her oxn amWWaee. P�� �hm euch
impwamems ere nd inteMetl aW«ed lor sele. tl, Mwever, Ihe WiMirq a inpwemem n add wnhin are yaer d mmplation, tM
ownar-0uiNer vnll heve the buMen d provin0 he ar eha did nd build or im0� ta ihe Wmoae W aele�.
� I. u awner d Ihe qWsM. em e�dwiveN oonlreGM �il� licenxd wnvenas �o construa IM V�I� (Seeion ]OM. Bu�iMe� enE
Pmiseeiom COEe: T�e Conireeon Lkenae Lew Aoea 1w1 epqy lo en owrwr d qopeny who Euika w imqovea Iherean eM who
conVecta Ia arh prqech wiih a canireear(e) IcenseE W��� �o iha Coniradva Limva Lewl.
� I em examp under Section: � B, d P.C., br thrc newn:
CITY OF COSTA MESA - HUILDING PERMIT
PERMIT NO: F 074750
CONSTRUCTION TYPE: 1-FR
PLAN CHECK NO: 03945-95 L
PERMIT TYPE: FIR
PERM NO: F 074750
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 200005F OFFICE T.I. SQ FT:
CLAIM VALUE: 10,350.00 CALC-VALUE: ' GROUP OCC: B-2 /
CONMENTS: 76 UNION PRODUCTS RE:#H74570
iE 1E i(' 1E 1E 1E 1E 1E1f 1E 1f iE 1E 1E 1E 1f 1E iE 1E 1E 1E 1! iE IF 1k i81E;F iF ik iF 1E 1f� 1E 1F 1f if 1E �E 1E 1@ 1E 1k 1E1E 1f M iFiE iE 1i 1E 1E 1E iE 1k 1E iFlE 1E 1E 1E ik 1E 1! 1! 1E 1E iElE 1f 1E 1E 1E 1E i! 1E 1! if
Z O N I N G R E Q U I R E M E N T S
S E T B A C K 5
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV:� PARCEL: 41050104 ZNE: REF NO:
PLANNING Ni5TE5>
i
1k iE 1E If 1E 1F If if if 1(� i! 1@ iF 1E 1E if 1F 1F 1f if iE 1F iE fE 1F If 1E 1E 1E 1E iE 1f iE 1E iF iE M i! 1E 1E1E if M M iE 7E 1E 1t iE 1E fE 1f 1i iE 1E 1t'lI'iE k iE if iF if iElE ik iE 1E iE� 1k fE 1E 1E IE 1E IF iE M 1E
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED 8Y DATE:
BUILDING APPROVED BY ; DATE;
I
Dale: �KK' ILEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
I da hereby cenity Ihet I em ewere d enA uMeniend the rayuiremente d CelYomu HeeXh eM Setety Code Sed'anv 25505. 255J3. uM . ,.�
25.U�, ud Uw I a erry Mun buiMiiq om�pem vrill / wil M(dreb one) nead to canpy wth eed mta oode� ud tM iapu'vwnenb br
eparmnlorwnvutlionormoEilKalanhantM�r�enepement0ipnq.ReeitlenlWcamruaioneppimtiarowwmqhomiAeee HLDG PMT PLUMBING ELECTR�IC . MECHANIC FIRE SMIP/RES GRADING
„W�s�..
o�a: �od�
WOflKEP'S COYPENSATIqI DECL�NATON: I Mab� etfvm wdx peneliy W psjivy ar d Ne Idbw'aq dadarmoeu:
� I hew enE wil meinlen a canilWe d caneanl to eeX.inaun lor xvrkwa' compenWion. n pwNad In by Seqion 3)0p d �M lebor
Cods. ln IM pxfmnvcs d Ne xoM1 Iv whic� Nu qmtit b inueE.
❑ i n..e.�e m� mein� wona.• oomo�� ��w.�.., �.a���e M seaon a�ao a mme iee« coe.. ror me o�«meze a m.
wak la wliidi Mie G�e e ueued. MY wvFen' oomPomMion "vuurerce furwr ud Dd'ry wmbr us:
c�«: FRgMONT EXPIRES
Pd'ry Number, ii�S5�i7S�46T- � 0 6/ O 1/ 9 6
(ihid SeyR�n iwd M bf CPnP�MM / IMGs'��� 9 b bN Aun4Gd dollG/a /SI W� V IW.)
� 1 cenly Net in Ne pelomieMa d iM work lar whch ihi� pamn o inuad. I ehdl m� ampby erry pe�oon in erty men�wr m n lo
becprc wbjea to iM wM1ws' mnpenaYion lew+ d Cefdonu, arq pree Ntl J I eMAE pacoms aiAjw �o tM MVMn'
�o�m� w��+. a s.a��ao d ine imo. coe.. i�n i n� ��n, u� qo,�o�e.
ome: ��'%J %'S Mdiwn: • � .%/4'v"-'—�
Weminp: F�llun N�xun woRrws' nmpwuetlon rowny� l� un/eMu( and slWl ,ubJ�ct en anployr ro MMroIp�nNl/u en0
Gvll flros ip ro aw hu�drW NouuM ao/Yr� (f1IX{OOOA b���� ro tlr� cwl ol rolryawWr� tlemep� u prvHJM br In
Sxtlon J]G6 0/ Me LSUor Cotls, Inrorut, �nJ �ttomry i/w�.
CONSTIiUCT10N LENDINO AOENCY: I hmeby effi�m �� oe�y a�y mm m� n e oam�,am w�� �.zy m. m.
peAoemeMe W the xmk br whieh inv permi n heued (�� �]. Cv. CI.
LENDEH'S NAAIE:
LENDER'S ADOPESS:
I ceniN Ihel I Aeve natl Ihb epd�� a�d qma tMl Na ebova iNmretun is wrtaq, l pree lo wmply xith etl ciry ud muruy ad'mencm
eMeimakwemWi IOWikiqmnnruaionuqMrabyeullprrsempevenia�iveedthuamyioenixupantheebwa-menlianedpropery
la inepe tbn Dur
� ��
nnl Nam
i Dete: �e � 3'�5^
Sipnelure OvmedApanl/Appticenl/GonVeda '
(SISI�B.WP) W�ne-BuiW'vpdSdelY:OroeMFb:Ceneiy-Appirani:Rnk-Revenue:Galdeneo�Asaevar
PERMIT . � 1: 126.00
" 65i SMIP/NON-RES
PLAN y 81.90
BUILDINGEDIV-> PERMIT ISSUE PLAN�CHECK' TOTAL PAID DUE
TOTALS----> 126.00 0.00 81.90 207.90 207.90 .00
�
REVENUE DIVISION TOTALS--> COLLECTED:'�' 126.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTAIC MECHANIC '�- FIRE SMIP/TOT GRADING PLAN-CHECK
,� 126.00
1F1f1FifiEiFlFMMiE�IFiEiEiF1l1F1fiEiEMiF�EiEitifMMlFikMififif�fiF1EKMMMiFdfik'*Miflfif M1fM'll'ik1E1E1FKN�EiEiF1FiElEifiEiElf�f3FitiEiEifififiEill('
I N D I V I D U A L ' F•'E fi H R E A K D O W N
� '�J
TYPE QTY D E S C R I P T I O N �•; UNIT COST TOTAL COST
FIR 126 FIRE EQUIP FEE (FROM BLDG.VAL TABLE) 1.00 126.00
END 'OF;;FEES
� ��
'. -, li C 1 • .
. G .. n_
�
, . � i� �•� `..
%} � �
!�� f
ir N
` l.- 0: Q2.?9?it�'-L"_14?71Q 3'Di I.b.DL1
- i' - �are: �a.�2.,ss rr.r,t. u.�s
CONSTRUC710N AND PLANNING POl � SPA
APPROVALS Permit # Date Inspector pppROVALS Permit #
i
i. Temporary Electrica� $ervice or Pnfe 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. w,, 53. Steel Reinforcement �,
��lectrical CondiAi UG ity-Undngind. 54. forms
_�"�fectrical Cond�i'��rgrnd. � 55. Electrical Bonding
3 •
r, •�{'eel ReinforcemQp};-; � 56. Rough Plumbing & Pressure Test
� Electrical UFEfi'Q[�'�nd. 57. APPROVAL TO COVER�GUNITE
"E7^ otings :.:;U 56. Electrical CondviCSiJndrgrnd.
� B. Fbundation Ttr• n' � 59. Gas Pipe, O Ur�rY�Ynd., Test
�-1
9. Water Pipe-U�d �id. � , 60. Backwash Linek2 Trap, C� Und�grnd.
10. Structural Floo' ysrem y, � 61. APPROVAL TO 6ECK -
11. Property Sewer �jne�& HouseSor�nection 62. Backwash & Rec �or-Final"� �
12. Sewer Cap �� ` ��� 63, Heater & Vent•Final ,
�
13. Roo4 Drains �„ 64. Plumbing System � Final -
14. Rough Plumb�ng-, ;n ' 65. ElectricabFinal
15. Fough Electricat�Co�luit o' - 66. Solar SVstem-P�al,
76. Rough Electric�ring 67. Fencing & AccesLApproval
a 17. Rough Wiring Sign � 68. APPROVED F�'LASTERING
18. Rough Electrica�f Bar Ceiling • 69. POOL/SPA SYSTEMS FINAC
19. Roug^h Heatin & Air Conditioninq� F�tE �FF,PT.�EQUIi�EMEIIJ
> M t^ 1( f�] �w'. C' �' t�
20. ',i��ou§h F5<tor�FiE¢�lace � ^`'± '� � � °'" APP T V it,�� P mnic # �+� � Y
� S[T' G:' � S '-+ � � � �4dr.F
21. 6ucis� inStruF.3urC�1w �'.... �-' � S C� '''� 70. i�nder���i H�dro f
22. D.uca', VBtStil�^gV fi r C r O �a; CJ Fr �. 77. Produ�PJPing�7�fjas �Oil
23. s pipe.Ro�4b & Test .�� t^ r tTt c � O+ � 72. UndergrOa�d F�st1 �: } N
24. 'itoo�framin '� n�{ � H'--� x r• G t^ s' > ��c+ : n
9 K � � � ;..,x .7�., Undergmd.StoracgTankr,QGas ❑Oil
25. Roof,Shegthing Sx �G i v{ ��: T �vs 7� Overhead "�_���x_. �`. �}.�
26. 9'•BaP;Ceiling (Str�tt�rol) & nr_,.!�,t��,at � ^� "' �' "�� 7 p� �'" � " ` �
.a. � R ""S"�' x O Y G» � Y Che�ical r,p ,. -i
27. rame and� Fltshirtg;; ��x �� i: m�: 76. Dry Sta � e�b ;. -� �+
1 �" Xy
28. Latf{�g �Si�9 �,�j * y �,3�.� G *� ..i.. 7� FIXED €.�T�INA* r., �� ". (l•
_i29. Insulatiort+ �• n-KV 5 • ��� I 7 FIREPREV.F L k> a"'' �I
' 30. Drywalll�ailiri�g �;:�,_, � ��., � �FALTpI'DEP�,'�E�IIF�;EMENT
-� 31. Plaster BmwKCoat7-� S !�m M �� : 79. FINAL 17AS�ECTiUN V �•
- m F.
' 32. �lectrica�ow.'er Mh�c�r ��al i K N I ��� 8Qy FOOD CERTI�TE I�$iJEQ, :,.
� � � r � .. . , .�
33.�ina�leptriG7 V'� ;+7 �.* �+�� N6tes: ^7 ^n �6'= � O.*:
� rf 1':1 /1 ;Y, �' <'
, 34. Fina�kl-lea,T,t'�ng�i A�� �d�tiorrin�j S �? � : � � ;'r � � x s �'
l Z tz�.� G�....�;e c�
35. inal a;.Pipe.Test �; �w •. * H � . ,f�� C �+ 0''L-� G�
36. Hoo�'or C'�nOPY � � M � �`'� � � n L � '
S v' K C? I x[-: X' � � 'I' � n
� �.y �. I .- ~ .l . �1�'_�Y'�� . . ._�/�'1.%�
37. F.inal.Factory Fireplace � i�--c. n� t t `�'C'
rnu .i
38. Finaf�Plurrtbing h,�� � � fi` I P� y �x �*= ;�
' 39. tlVater Service-Final �; g '• ' x � ' � y :�;"� '
•.40. Gas Service�F�nal � t*: �:T'tT' S :k m � �� �V oN T -
n . c, . o � : n;
''47. Solar pomesticFina�` S ' ' � �6 � �� r ' _
`.T1 Y I r- ln:.t w "-0 � 7 "'•' r
42. Backflow Pre�enter .n � c; �: r �T r'' u -^ ^ --'
� n�-. :-� �: r. M m o rv c, R; p s~ F•
c' . x' : S =.' �; + .. �
43. Backflow Irriqetion *� �, A: z; � c i� � � •
�ri. Landsca� Irriqation�System ^�%�� '-' '� �" r' a p�` , "� s o 75 r S [�-� V
r. r . C"' :K 'S 24 . �
(l i; H !^ r� * � :'� i"�.f t � . l.-V M�
a5. �und AFten�tion.,. ... x [m m �• c a' a; •:+,-� w
&6. Hendicap•Regolationk � C y '+ �'" Oo S �'
r c w . !J iJ
�}7. `F�iNA�. STRI�,CTUR,� & BUILDING * r._, ;; ' � � i;. ;.,
48. EIN%CL PLANNING� '`-��" *�� I I� '� C� ` "
� : ?r : �� n: S t N;
�3. EiecfFic Rele�£e ro E�iison ! # ' ` "
� fi � ,T •!i x � ca
t r. m
50. G2s Release to Southern Califdr��4'iasCo • �*' �' C' ='`� ',; i �
� • s �o �
61. CEFTIFICA7E OF OCCUPANCY u , , . , .. , . .�
Date
Date Inspector
.
noonessoFea�ur+o: 555 ANTON BL
°w"E"s"""E'°'Q'°"": SAKIOKA FARMS
AppXESS p0 HOX 2097
TERMINAL ANNEX
�vvi. �auxc �oo�ss:
uNr: 2 ND
u�cxnemonv«a+�n: INTERIOR DESIGN 21362321610N0 9378
�xcx.on�cswoxtss: 550 S HOPE ST °NTi 1100
L.A. CA 90071
CONINACTOP'SNA1�:
cam�croxs �uiwc
mowEss uc xo.:
uKr:
LICENSEO COMHACTONS DEC4IXATION: I Mrtby ellim uMx penelly d perjury Ihat I em licenaed uMx poriuona d Cheqer 9
��m<��e wan sa� �000) d a�� a a ina a,�� �e e�ae.aw cma. �d mv i� d� mn mR„�d on,d.
cm uc. No.: uc. cuss: uc. No.: EXP :
Dma: ConVatlar:
OWNEfi BUILDEH DEClAF4TON: I heeeEy elfirtn uMm penelly d perjury Ihm I em eramp fmm tM Comretlon lirome lew ta ihe
Idbwng �eawn (Seqion )031.5 Bufiwsf eM Pmleea'v�e Code: AnY cIY a county whidi rtyuiree e permil �o cauVucl. eller. impwe.
Eemd'sh, a repei enY aNxtum. pria �o ea oeuenoe. ebo nQuirea Ihe epplirant tar wch pa�mn io fib e apred stmement Mei M or aM
a i�emee w�� m me wo�sian: d m. c�vmo,. uceree iaw Icnew. e(oomme�a�q .mn saau� �aaol d or.00� a a u,a
Busima e�d Prdeaiom Codel «ilw he a ahe is exemq IMrel�an eM IM bavu lor Na elbped uempion. My videlion d Sedion
)031.5 by eny npplieani lor e parmA wbjeda iha epplieent to a cnl peeWy d ml mae �hen fxe huMratl Ed4n �55W��.
� 1. sv ov.nar d iM propeM a my emplv/eee xih wapee n thei wb mmpeneation. will Ao Ne xork, eM tln qruqure o iw inteMed
w oRered br sele (5etlion )ad.6udrw�a eM Prdesarom code: The Conlrmon Lifenae Lewdoea �w evGN lo en ownera MwaM
wlw Wi�s «mqavea ihereon, eM xtn doae s A xak h'vnaeH «hanetl a ihraqh hb a Mr own empbyeae, prwidad thm such
imprwememe ua rat imeMed a allered /a mk. X, Mwarer, �M WiNiep a inqwemmt ie aoltl wilhin om yeer d eanda�ion. tlie
owrer-0uJda will heve �he buNm d pai'p M or ehe Ek rwl Wik a impwe lor ihe W�e d aela).
�] I. m ox+rer d �M pmpeily. em e�clueively mnirerfiq xnh loved wnvnc�ws lo conqruq Ihe pqed (5aqion 101d. Buai�s vd
Profeseion+Code: Tha Conlrepon Licema law does ria eppy io en oxnw M qopeny who WiNa a impovs ihereon eM x1a
conlrens fa wW pqedn wnh e oonlredoHs) IcemaE W�uenl �o �M Coniredan Limne law). �r�
❑ i� a.a �oa« s«i�: e. a P c.. i« m�a �,:
oaa: � Z6 /+ o.,,�,: '� _ �i— � . � s=-
-�� �
i ao nare cenM ind em e.�e d�e u�aniena ine reuui�emenie a ce�eomie Hmnn ene Smery cae seuom zssos, zss�. e�w
25531, eM thm I a elry Mure Wikinp ampent will / wGl rwi (tlrcb aie) need �a comply wih edd mpa cadm end tM raquiremanm la
epeimnlaconsVudionormodifiraiionhaniMA'v�u ityi.l—enepamaniDiatrid.ResiEenimloonstrwfoneppkralbnsereuemptimmiheea
prwisions.
Deb: RpplicenL
W OXKEN'S CONPplSATION DECUINRTION: I Mreby dl�m undar panelry d parjury aw d tha tollowirp daduetbna:
� I hava enJ wiA meiniein e centicele d conaeni lo seNinauro br workeie' compemalion, m pwided Ia by Sedion �100 d IM LeEar
coea, r« ina reda��oa m ina won� ia.n��n m�. ro��� �. ��ee.
� I heve end wiM meimen warkere' mmpenealion ineurence, m rpuireE by Seclion �)Op d ihe laEor COEe, br ihe pe�amence d Ihe
wwk lor which ihie permX ia ivuad. My wnkere oompenealbn ineurenca ramer end paliry number ere:
c��:
' PoliryNumbec
/m;s saa;on neee oa ae �cr�ae r me c�a ra ro. o�< n�ndred ea�ers Brool w�es.,.�
� I cMily ihe� in Ihe pe�lamerca W Iha wwk la whch ihia permn ia imueE. I ehell nd empby eiry penon in eny menner eo es lo
become subl� to the workars' canpense�ion lexe ol CelXomie. enE eprae tlw il I ehould becwne eubjee m �ha xorlmn'
companseiion provisiona W Sedion �)OU W iha labor Code, I ehell lonhxi�h comp�y xilh ihoee pmvrsiom.
oe�a: AodK��
Wam/np: Fdluro M s�cun woAxi comp�rwtlon toverpl Is �nl�wNl. �ntl �NII w6/�cf �n mployx ro cr/Miul P�rou anG
e/vll flries up h ons hundrstl fMuuiM Aollan (S10QPWA M etltl/Hon ro M� ro�t ol rompsnsefbM1 demspu sa pmv/dsd br /n
Sxtlon ])(16 0l fhs Lebor COW, Inforast, and ertomsy's /ssa
CONSTtiUCTION LENDINO AGENCY: I MreGy elfirm under penelry d per'ryry thel IMm is e cana�uaim bMinB eperu.y br Ne
j9f�OfI118fICB Oi1hB WOf�(�Of W�1M�11�16 pGl1111 19 BBYBQ($BClpll.'1U8�/. CiN.ri�.
LENOEH'S NAME:
LENUEN'S ADDPE55:
I cMiy iM1at I hew read this epdretian eM 9ata IM1e� the ebave in/ormelion is carea. I eprae to comply wil� ell ary eM wuMy ordiriaM.m
arrd sle�e lexs relelirp lo Wildvg conYrutlun enE Mreby eWlwrae reqaeenletivea ol lho tily �o enler upon Ihe ebv.e-mmloried propany
forirepepbn qrtposes.
ERNIE VITUCCI
EfZq(�.ST' T— �/t TU «� o�a: � Z6 (
Sqna�ura d Owmr//penVRppManuCon�rena . .
(StSt-CB.WP) Whna-Buildip d Sdery; areemFle: Cenery-Applrant: Pink-Revenue: Gddenrod-Aeaeexr
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: E 076186 PLAN CHECK NO: N
PERM NO: E 076186
GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION, RE:1iH74570 6 H76185
*itititititiFirit*et*ieiFit**x�+tetie*+��t+r***+riratit+�x��atetitatit*at�tet*it**x�x�*at**it�rftx�it*atet*atatet�r�tx�x��at*x�*atat�t*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES> -
i
*�r*x�*�*��**x��****x�****x�*****�r*�r*��r*�r�r�r�rx�x���*�*+r�+r**+r+r*****�**x�+r**+r*�****+�**x�*�*
D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
LEGALIZATION:N
HLDG PMT PLUMBING
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
F E E S U M M A R Y
ELECTRIC MECHANIC
108::6A_,
-50� ;
15.00 � -
DATE: �I������
�t�t�t**�r�* �t*
STRUCTURAL SEGMENT:N
f aL�;��.9�Fi:7f:r�i-��eici:�7�i.Le7
SMIP/NON—RES
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
108.60 15.00 ' 0.00 123.60 123.60 .00
REVENUE DIVISION TOTALS--> COLLECTED: 123.60 OVER/SAORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC—„ FIRE SMIP/TOT GRADING PLAN—CHECK
123.60
1E if 1f if 1E 1F iF 1E iE iE 1E'IE 1E 1E �E 1E iE 1E 1f iE if iE 1f iE 1E IE 1E 1E 1flf ib 1f 1E 1F i(' iI' 1E 1E 1E'141E 1E iE 1E'k.iE iE 1E 1E if iE iE 1flE� 1F iE dE 1ElI� iflF ik if 1E!(� 1E fFlE if 1E 1E 1f iE 1F iE iE 1E IE 3E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N,-- UNIT COST TOTAL COST
ELE 20 RECEPT/OUTLET
ELE 208 RECEPT/OUTLET
1 S.T 2 0 !
AbDITIONAL.
END OF �F.EES.r-�
; ' (
"l
—/- "
EA. .75 L5,00
EA. .45 93.60
fi? OO±eo�*v:-001°?29` '�e�aT 1�3,�.:�
n4TE: 4:'"S. `�F Tii'E' "���i
CQNSTRUCTION AND PLANNING ' � POG s SPA
APPROVALS Permit # Qate inspector qppROVALS Permit # Date Inspector
' 7. Temporary Electrical Service or Poie � 52. Pool & Equipment Location -�
�
2. Soil Pipe•Undrgrnd. . ,�3. Steel Reinforcement '
�-3; 6lectrica�:eonduit Utitity�Undrgmd. ' 54. Forms
4:: Electrica�;GoAdUit-Undrgrnd. � � 55. Electrical Bonding ;� '_
�� 5. �teei Reinf'orcement 56. Rough Piumbiog & Pressure Test
'6, E�actricel.S�ER Grnd. . 57. APPROVAL TO COVER-GUNITE �� '
7�: Footings =�� � 5B. Electrical Co,nduit-Undrgmd. �
'$. Foundation��� � 59. Gas Pipe, O Undrgrnd.; Test ' .
c �
9. Water Hpe�Undrgmd. ' 60. Backwash Lines, P�Trap, ` Undrgrnd. �
10.5tructura��FtoorSYstem 6t. APPROVALT04ECK
i i. Property Sewer. Line & House Connectlon ' 62. Backwash & Receptor-Final
12. Sewer Cap - . 63. Heater & Vent-Final
13. Roof Dr2ins _� • 64. Plumbing System - Final
74. Rough Plumbing � -� 65. Eiectrical-Final ,.
15. fiough E�ectricabConduit - i� 66. Soiar SVstem-Final
76. Rough Electric Wiring � •67. Fencing & Access ApProval �
. 17. Rough Wirin95ign , 68. APPROVED FOR P�ASTERING �
18. Rough Elect7ica6T Bar Ceiling � 69. POOUSPA SYSTEMS PINAL
79. Rough Heating & Air Conditioning � , FI E�EPT..ijEQUIR MENT �
_ - .: i o-� r, <' � .R,_� r 1. � r-� [T1M
20. RoughFae'tory,iFireplace ;:;T; :..J` .� ` �y C ��',APPROVRIS��cPeRmit,�'�
21. Ducts;.in Structure�' �- • �� •� -��� * �` � -�' ' =70. �i7nderground Hyjlro -
l 'i � 1'
22. Qutts�VentilatingE'� "� r-� c'� �-�:'71. ProduqtPipjngO�as C30i1
23. Gas Pipe-Roug.h & Test m � :n r+ tr d : t. �� 72, Undergroand F�'sfi' �
- -v
24. Roof fre�nin9^ 'x L y ���. �- �: � r r J� UndergmsJ. Storage:Tank.� Gas `� Oil
25. Roof ShOathing �_t C •� o,: �� '_� �a. � 74=0verhead Hydro,•^, �
26. T�Bai Ce�ling (StrugtiSral) & M000�oat k,_; � � �* 7� Dry Cherpiral =- � -
27. Frame.and Flashing-; � r�-, *�- . 76. Dry Stan�}A3e t-•= .• �
.r _ r
28. Lath�irig &:Sidin9 G'� ", _�- •- .• ..' 77.� PIXED SY,STE.�9 F�NA4 ._ f. ��
29. Insuiation- �; � � �� I ti 78s FIRE PREV. FINAL �> " F �
� 30. Drywall Nailing t'' ,� y: '" ,HEALTFi DEP� REQUIRiE�MENT
n F , .
� 31. Plaster Brown,Coa(�tc =-, �! i. , .;� 7g, �FINAI IATSPECTION� �' v
�32. Electricalpowe"r MF$}-�F�qai ;� �80 �FOOD CER71FiCA'fE IS`SUED j (
-.33. Fina6Ele�tric � i Kr; �=����t - - .Notes. ��'. K" .: I
.. . -'' �' . . . . � �
-� 34. FinaGMeating & Air�Eo �tionin�'S' �� M r � + ; y� � �,�' ,[ ", _
' � � � _Ll.� � �� = ;� ��W �
�
35. Final Gas�.Pipe,Tes�-.. - n :. �; „ : �a. - ��-
�? �p._u� ��_
�36. Hood�br CanoPY t-•• = ' � -' -: •. , , �^ !� � � x { �
_ u' ': t, . 4!<' - " C/Y�,l� �l�:c��-- �" �i.�,l.�.
37. F.inal Factory Firepleee ;-K � �-N v � x�- � :, � ��
�
38. FinaPPlumbing '' ` : * ^ - -.v = . -
.-.� Y � � K k
39. LVater'Sef�ice-Final�'�' _, ' "� � jn ,; -- , �
--40. GasService-Final � � •tr>'c- - :st�: " . '" ' '
- � �; z � • c �
;�41. Solar pomesticFin@I r -' - ; �' R, _"." . . - -
_ i
42. 8ackflow Preventer.• i� � -x - ' ;, �..' �
�.� r' p F� ?: m y c
43. Backfiow Irrigation`_.: ,� "" F � x �. * �� . . �
44. Landscapedrriqation System �"'-a e M v` _ = ' " r N ?' " ��' * '� `
- m �� o , - 4 � -
45. Sound Attenuatiori'T- ,,, ' ' ^ � , , '��' ,
�. , � r� } n
- �
46. Fiandicap Regulations �� '' +� � � � � , - -- - ��
� �- -
47,. FINALSTRUCTURE&BUIL-DING , ,_ � �; ^ � ' � �
48. F1NAL PLANNING i-r � �" :' •r
J !J ^- - '
49. Electrie Release to Edison x '; �- ' _ {
50. Gas Release to Southem Califor�iaGas Co I - �-' '- �'
� <. _ . � -� -., -
51. CERTIFICATE OF OCCUPANGY � •- - � • - •
No. Da2e
/
,
eooxasaew�axo: 555 ANTON BL
• a,vuexswweivu+w�m: SAKIOKA FARMS
d00NE5S: PO H OX 2 O] 7
, TERMZNAL ANNEX
�vri. �uuNo �ooness:
uNT: 2 ND
u�cN"Ec�o"v+°"�n: INTERIOR DESIGN 21362321E��= 9378
1pCN.OH ENO.'4 ADDPE53: S S O S HOP E S T �N* 1 1 U 0
L.A. CA 90071
�+��T� � MORROW MEADOWS CORPORATIO (714)598-7700
cartn.croxsxuuxo 6 1 0 REYES ST
��s% WALNUT CA uc.no.: 230813
91789 ur+r:
UCENSED CONtR�CTON9 DECLRPRTION: I hanb/ ellim uMm Po�Y d pe�ury Nel I em IceivwE uMer proviuwn d Cl�ep�m B
(commeiuinq hi1� Section 1000) d Oiwion 9 d �he Bvmso end Pmladoru Cada. enE my liama e in IUA lacs enE eflad.
c uc.No.:006558 U0°� C SO uc.No.: Z30813 EXP; 12/95
o�e: /O-/ - c�o-ae . C'
NER BUILDER DECIAFATION: I hselry Mvm uMs penMi d per'rvy et I m� aumq ham IM Caqrepm License lew la the
db�wq reawn (Srfion ]W IS &eiwa rd Rd�pv ('.ade: My W wu 'd� npiraa e V�a �o muuw. elr. imqw+.
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e Iwiwd pu�euem lo IM pvnvms d tM Cavranas Lioeroe leM jCh !B (mmmwi�'np xah Setlion ]W�) W Oimian 3 d iM
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A31.5 Ey emy epp4raN lor a perma whjee+tM appfraa io a ai paneEy tl m mpe Wn fxe hWred doAen �SSWp.
❑ Lmowro.ameww�v«�nr�dm�..nw�s+mm..woomw�..aao�n.w«ke�em.avimi.u�a'vaw.e
n MereE br e+b ISa�ion )ou. BiarwssenJ Prdnebna CoEe: The Cwrmm limue LewEm� �wt MVM10 en ownm M pweM
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❑ I. as owner d iM prapeM. em ucM1e.ely mnvmip wuh fiowued cani�ston �o muvuf Ne pqaf (�� ��. &+einme erd
r�a.o�, coe.: rn. wmreaa. � i.., me. m ewN m.n o.,., w ww�v wno w�u. « i�aao mr.on ene wno
mnvecU la wM pqeua wph e mNmtloHa) Ike�usd punuW io iM CaMretlm Limnse Law).
� I em enemp uMm SxYbn: B. 8 P.C.. br Nu �eewn:
De�e: Ormx:
1 do Mnby canJy Nel I am awara d erd uMnaleM Ne rpuinmwqa M CellaNe IbNh and Selay CoEe Setliana 25.A5.25.'p. uM
RSSJa. vM ihm I«wi Mun dntlinp mxpmn xi0 / wil m� (ertb ana) rcsd m cpnDN wih uid uma mdea md tM nVu"vamama M
eG�alamnMcfqnamodfrationbomiMA��I enpemwYDvlritl.Mri4aYwlamA'uGianeVV�nrearsssm+qhanihma
pavom.
on.: �ocr�.:
WORKEN'SCOYVpISATONOKWI�110N;IAxaEyeff uderpsu4ydpajvyonsdNebGor."vqddum'vm:
� 1 Aeva eM xil meirven e cenGiuis d mmmeu to sdlanvm br xakars' m�paNmbn. m po+idsU ta by Sedian �]00 d iM LnEn
COM, la iM palmvrcs a� IM wh la wlirJi this pemd "u ivusE.
� �n.Nenewm.vu.�wnwrmno.+�m�.o�.mm.eMswionarooau»�mo.coee.urmeo��wu.am.
jt vaM la vA�idi IM D� u mueE. NY Morken' oomD��cn ivurerc� nrtiee ud V�Y numbr ue:
cmri..: FTRFMANS Ff/N�l EXPIRES
adeyrv�n«: nr.r�qnF'7FF47 07/01/96
(Tnr...nion nese �a bs cmiWer.e r �ns v�� u w. ons nvne�.d ed�e�. Riool w lua.l
❑ I cenM � in iM perlwmeme d Ihe wak M wM1ch iAie parmn u Ivued. I rhell M emplvy enY Ce� � NY mennar eo ee to
becomo vuppp ta IM r.wken' m�np�nwion kwe d Ca4lanb, enA epne Ne� ! I thouW becoms wbjed b Ihs woM1a�e'
compenation qvrimiom W Swion 31W d �M leEa Code. I• fMhw9� mpry WA ilusa pw'u' �.
oe,a: io- /� -9.� �� � '
�min0: F�Nun ro��cun wort�n' comp�nutlon covx�p� l� im1�wlW, iM �IW ulhct �n xryloyw to uIMrW p�n�lU�� �ntl
clvll lln�a �q ro an �uMrM fho�uMlulbn (JIGqp00A b� �dtlltlon 1�� ro o/ romp�u�WM1 E+nup�� �i povM�J br In
SKtlon JIGK OI IM L�Dor Cobr INwL ��m�Y1 lw�.
CONSTIIUCTION LENOINO AOENCY: I here0y elfi�m ivNer paully d perjury iNt iMn u a mMeufian Imdvq epriey br �hs
pMamerca W iM wk lar xfid� N's D�� e ewed (Sea'ai �041. Cw. Cl.
LENDEP'S NAME
i�oen�s �ooness:
I ceN71tW I hm �aW Nu WVrraian eN aeu ihu Ne eEoro'vdamaion c oonee.l eRw �o camOM rmh eG mY end awMY adwncm
vd ele�a kwt nWiq b WJdnO rneUumon eitl MrebY eWqrae �eP��� W Nu riy b Wr uW� �M Wo�a�mauioneE popetry
i«��,� ,�..
%'�M. �1GZco. i
� (5151J6.WP)
`��
� �,:/D /� -�
Cuwy-A : Pink-M�mue: GclEximtl-M».w
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: E U74S76
PERMIT NO: E 074576 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB UESCRIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74570
**+�**+�x******�****�*�***�*t�*********it�*�t�+�*�**�*��at�**�*�*�**�ieit�*�******+�**��*
2 O N I N G R E Q U I R E M E N T S
S E T B A C.K S
----------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ � PROV; PARCEL: 41050109 ZNE: REF NO:
PLANNING NbTES>
i
if 1f iE iElE iE iE if 3E fE jE �)E IE fE fE iE iE iE if iE if fE iE iElE iElE IE if 3E jE 1E 9E 3E iE iElE 1E jE iF if if if jE iF iF iF iE iE �E iE jE �E 1E fE �)E iE iE f� fF iE 3E if jE �f 9f iE iE 3E 3E iE 9E iE �E 3E �E �f iE �E
D E V E L O P M E N T S E�R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY DATE:
HUILDZNG APPROVED BY : �� DATE:
APPLICATION ISSUEG BY: �� DATE: l J� I I.( P+�
iF'1f�iFiEifiE�EjEiEiEiEiEifiEifiEiF�EiflflEiE . rc±i iEiFit�.c . 3fififiFlFiEiEKiEiFs'F�'iF�iFiF�F'iF1fiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 341.80
50� SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BOILDING-DIV-> PERMZT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 341.80 15.00 0.00 356.80 356.80 .00
REVENUE DIVISZON TOTALS--> COLLECTED: 356.80 OVER/SHORT: .00
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
356.80
�i(� �F iF if if 1F if 1E iE iE 3E iE If IE iE iElE if iF iF 1E �E �E if if iE iE iF iE iF iE aE �E 34 iE IE iE iE iE iE iE k if 1f i( if 1F iE iF iE �E iE iE �E �E dE iE 3t IE jE IE iE IE 9f iE iE If iE if iF jf 3E iF * iE if iF iElF
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15,00
ELE 296 FIXTURES, LIGHTING ADDITIONAL EA. .45 133.20
ELE 20 RECEPT/OUTLET 1 ST 20 EA. ,75 15.00
ELE 238 RECEPT/OUTLET ADDITIONAL EA. .45 107.10
ELE 22 RECEPT/SWITCH ]. ST 20 EA. .75 16.50
ELE 5 SUB-PANEL 11.00 , 55.00
END OF FEES '.l
�? J� 14:; ': -�719^G97 l'tCi ;r
Cr�:c' 1.7;,_/q` 'ii: �9'1>
0'. J 1' -� t.':4:' Y s_• T
��- C�.`1,,��� _ _>:_,
i`�.'.:
�� CONSTRUCTION AND PLANNING • . POOL & SPA .
APPROVALS Permit # Da[e Inspector qPPROVALS Permit # Date Inspector
�
i� TemOarary Electrical Service or Poie 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement ,
3. Electrical Conduit Uti�ity-Undrgrnd. 54. Forms
4. Electrical Conduit�Undr9rnd. ' S5. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Elecvical UFER Gmd. 57. APPROVAL TO COVER-GUNITE .
7. Footings 58. Electrical Conduit-Undrgrod. �
8. Foundat�on 59. Gas Pipe; � Undrgrnd., Test •
B. Water Pipe•Undrgmd. , 60. Backwash Lines, P�Trap, � Undrgrnd. "
10. Structur8l 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 DrBins • 64. Ptumbing System � Final �
14. Rough Plumbing 65. Electrical�Final �
15. Rough Electrical-Conduit - 66. Soiar System-Finai
16. Rough E�ectric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING .
18. flough E�ectrical�T Bar Ceiling 69. POOL/SPASYSTEMS FINAL `
/9. Rough HeatFng & Air Conditionin9 FIRE DEPT. REQUIflEMEIVT
20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
2fi. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Fiashing 76. Dry Standpipe
28. Lathing & Siding 77. F�XED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Orywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster 8rown Coat /� 79. FINAL INSPECTION
32. Electrical Power Meter�Final �� // 80. F000 CERTIFICATE ISSUED
1 �v-/ /
33. Final Elactric ��31Gj�„ �l Notes;
L �C �
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test .
36. Hood or Canopy r
37. Final FaCtory Fireplace `
38. Final Plumbing
39. LVater Service�Final �
40. Gas Service•Final
41. Solar pomesticFinal .
42. Backflow Preventer .
43. Backflow lrrigation
44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL 5TRUCTURE & BUILDING .
48. FINALPLANNING '_
49. Electric ftelease to Edison '
50. Gas Release to Southem Calitomia Gas Co �. I
57. CERTIFICATE OF OCCUPANCY
N0. Date ,
�
�
�oonrssaewu�+�: 555 ANTON 8L
°""E"s",wEi°a�wrt�: SAKIOKA FARMS
�'0°"�' PO BOX 2097
TERMINAL ANNEX
�vr�. Wuuxo wonEss
uxr: ZND
umxrrecronvawern: INTERIOR ARCH 2136232164 10'N0'` 78
""`"'0""'0�'"0°"��` 550 S HOPE ST �"�`' 1100
���e� L.A. CA 90071
CWfPACfOR4Y41➢10 COMPEL CORpORATION (310)946-8321
10410 PIONEER BL
10°"� SANTA FE SPAINGS CA 1QN0` 392693
90670 °Nio
LICENSED COMRACTOXS OKLAFITION: I hratr/ ertim �etlx pwWy N pwj�vy qtl I em fm�usE u�M�r prwn'vu af CMqs e
1om,m«�ono �an s«w� �aoo� a aw:s a a a» euw� md a�a.:a» coa.. w mr �.. b m mo wR. ena.me.
cm uc. No.: uc. cuu: ue. No:
03205/4 C-10 392693r^/ EXP: 08/96
Dma: �� �iG �fJ Cametlw: _� � • /— �-/:QI'��
OW NER BUILDEfl DECL�N�TION: I Iwaby tlNm uMv pwly d prjvy tIW I am �umq Imm iM CoNMm Licama lew la Na
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w urtn.e ro..de (swon ]a.. eumra a,a v�waaaion.coE.: m.cw'euw.L'on+.l..eos. na wdr�o ��,b,a wwsm
vM buiCa a inpw+s �Imean. md xM ma surh v.pk Innmtl a land a N�aph he a her own emN�+n. Vp+b� ihet euc�
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De�e: Oc+w:
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WORKEN'SCONPENSATIONOECIAN�TON:IMabyeR udsps�MydpapryarMNaldbw'vpAWudiom:
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work la whiW tlin C�+n u mued. My waken' camM�ian "vuurence uniar aM VdiY riumber ue:
Oe1nx €R�MnNT COM� EXPIRES
°a" ""'""": 0 2/ O 1/ 9 6
(TAiswbnneedndbecanpMeJ/NeprmtbMms io0 wMn.
❑ I cenN thel m Na DMomunce d Ns wak la wh'rA �hb G� 6 mwd. I dutl nd amNW M' Vab^ in M' manrwr o d lo
bxome euEjetl to �ne wwMn' canpeneation �vn a C�IEpiJs, uM pree Ilut tl I Mouk Eeconr wbjw io �he worlmn'
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CONSTNUCiION LENDINO AOENCY: 1 hmeby Mrtn uMs periNiy d pmNrV �� IMn ie e aonetiudion bMinp epeM.y lor Ihe
paA«meMe d ��s wak lar xhic� �he pe�mi w uwed (�� �]. Crv. CI.
LENOER'S N�ME:
LENOEfl'S AOOHE55:
I cenM thei I heve rted Nu epplicNon W ptl� Ihtl Ne abv.e iNwmetbn b cmW. I epne io compy v.nA NI dry W mumY aduwicaa
enC sW e kws roW'vp b Wikvq caW Wion e�d Iweb/ eulMrvs �epawYetim d Ihu e�yb enler upon IM Wwe-menloneE qopoM
larinspeaion purpoeea.
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(5t5t-b.WP) WhGsBuik,q 8 SffiMY• Gnm�FJe: CenuY-AGP�: Pink-Rmnue:Oddenmd-Aawaa
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO• E 07483
PERMIT NO: E 074836 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1—FR PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE TI SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
���M�***i�+����r***���r**����**��*+Fr*�**+Tr�4***��8�****k**�*�****w**��+r***�*�r******�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i �
141E 1E 1f 1E iE 1k 1f ff IF 1E if Ik 1E 1E IE IF IE 1i 1E 1E IE iE ff iE fE 1E 1E iE 1E IE 1f iF 1f�if 1F if 1F if 1F 1E if 1E iE 1f 1E 1E 1Eik 1E 1! 1E if iE if 1E if 1E iE 1E if If' 1f 1f 1f 1E 1E iF 1E iE iE 1E i61f if iE 1E 1f 1E
D E V E L O P M E N T S E•�R V I C E S A E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY :
DATE:
APPLICATION ISSUED BY: �' DATE: l0 'Lfa
IEIFiElflfifl(�1FiF1fiFKKIFiEiElFiFiFiF1E1E 1fifKiFlFiFiFlFikiE k1E
LEGALIZATION:N F E E�, S U M M A R Y STRUCTURAL SEGMENT:N
�
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 73:05�
SOi~ , SMIP/NON—RES
PLAN '
ISSUE FEE 15:00 .'
BUILDING—DZV—> PERMZT ISSUE PLAN-GHECK TOTAL PAID DUE
TOTALS----> 73.05 15.00 �'0.00 88.05 88.05 .00
REVENUE DIVISION TOTALS--> COLLECTED: 88.05 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
8 8. � S l � �
1F if K iE 1E 1E if i! 1(� 1E 1E IE If 1F 1E 1E 1F 1E 1E IF 1E 1f 1E 1F IF iE iF 1F iF Ik 1E 1E iF 1E IE M 1k iF iF1f 1E iE 1E iF iE Ik iE 1f 1F Ik 1F 1E 1f M 1f 7! 1F 1f ik 1k 1E 7k ik M Ik 1E 1E 1F 1E iE iE 1F 1F 1F iF 1E iE iE 1F
I N D I V I D U A L�F E-.E B R E A K D O W N
TYPE QTY D E S C R I P T I O N�' � UNIT COST TOTAL COST
� ".�
ELE 20 COMMUNICATION DROPS 1 ST�20 .75 15.00
ELE 129 COMMUNICATION DROPS ADDITIONAL .45 58.05
END OFr FEES
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ui oei?:t.o-^�t9a13o Y �� T °s.C=
OA7E= 10,:�r;5 'tIi��£: iF:��
GONSTRUC710N AND PLANNING POG. . SPA
• APPROVALS Permit # Date Inspector APPROVALS Permit #
i
1, Temporary Electricai Service or Pple 52, Pool & Equipment Location �
2. Soii Pipe•Undrgrnd. �, 53. Steel Reinforcement .
�
�9r .�`"jac[rical Conduit^,�i�xtY-Undcgmtl. 54, Forms
v�4at7ictricat GUdtlui?F}rtdrgrnd. ^ 55, Electrical Bonding �
"f�'- T.
`',�'t'iyS�el Rein%�em�u,�,. 56. Rough Plumbing & Pressure Test
=�fi�.r..Electrical U�ER�rnd. 57. APPROVAL TO COVER-GUNITE
<.
-���f�otings `�; jn� • 58. Electrical Condi i�lndrgrnd.
:y'�, Fqundation U q Sa� c 59. Gas Pipe, O Unai�6grnd., Test
9. Water Pip2'UndrgSfidN` 60, Backwash lines f�'q rap, O kJndrgmd.
10. Strucwral;F.loor ystem � 61. APPROVAL TCYDECK �.
17. Property 3swe�Line & House6rohieection 62. Backwash & Reryp4or-Finai -
12. Sewer Cap„ ' "� c. • 63. Heater & Vent•Fin,�l '
13. Roof Drains o ��� 64. Plumbin� System � Final `��,
74. Rough Plumbi(fg� ..� ; 65. Electrical-Final '
15. Rough Elattrical orrduit ;^ 1 66. Solar System-Fin�l_
V1
i 6. Rough Ele`ctric V�in� �' 67. Fencing & AccesS r�pproval
`�77. Rough Wiring.Sigp " i 66. APPROVED FOR'PLASTERING
� ,
i$. Rough Electncal�7 Bar Geiling `' 69. POOL:SPA SYS'(jE�AS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
Cr �-,-�Sr - x - :�!:�7
20. �ugr�',Fa�or�'"'�ir�y�ace S� � ' t � ' � ' PPR�VFI�.�HFPe,rt�iit#� ;� �
M �
21. Cf".�+ct�n �yruc�y�em� � �-. x � p - � -• >
� �0. tlnderge4iTrt61 H�7ro
22. Ducts.�',�1�er�tiiaF�g ��. � � � -`�4 �71. ProducT�ing C`�'G'�as C�fJii
23. P1Ae- ug�& fie�t ' � i ,� ;n .; %� * �72, UndeigiotDid FIe�tG '-� `�
24. RBof�ram.ing�•� ��t '�-'�-' s> a, �Q :73a'Under9rnc� Srora�«�Tank�Gas O�fl�
25. Roof �eaFhing � � ,G � . v a � � : :�:t 74 �Overhead Hydra7
26. T.9ar'Qeiling (StrufiStrall & �iigEpat " � - � � 75w_Dry Chemical �,� * " ` `G
27. F.�mgpn��ashin� ` �' ' A� y �'� - ' -
�-. ��Q �tr y m• 76. Dr Stan ipe F.m :.
'-�28. Lathin 8i3idin Or h ':�T s F •� = v' ` � * ^ � �s
9 ,� ,...,�,._ ,"�a 77,y FIXED ��'EIC��NAt�. ti - �F,,
''29. Insulatiori "�� `J M •• •• ^ ,y� T � � �• S' f .. ,> . •
� �.� S I v 78�FIRE PREV. FIN,W1 *' �. �c�
i^30. DrywallN�iling ^" ~ ' ; !F S �ALTH��P7�*,R£QDIREfv``l�
�1, Plaster Br�n Goat�,�,� �c �r-� : � 79��FINAL I e�CTt N• *` J
�.: . B-+:�'c t �_ 4--v�e^
� 32. 6lectrical Ebw2'd Me:tW�Fenal t N �� 90�'FOOD CERTIFI��'F� IS�t�Ep -• �C�
r �
-33. h�ial'��',lec�1.'ic '�' ,; 7' T^ ,r .� n� c �-i�" "'"�
j :� i e� l Nqrea:. 7 "7r �'7 � v:v
ti34. F1nal �eaqAg &iAir•-ConAttioning� _' .^ i l ' ,� I'�(�7/��.� _
�35. Final�t,as�pel�estx! C°J �, ',, x '� uv `�'���
: � :r
;.36. h(oodAr GanoPY ••s � ' tT'7 < , f' S; -.<�� Y i�
r �� - i � m r
:.'37. Fr,ir,al�ct�jYFirep'i$4e�'.. ��" C R:n : - * •
J `
38. Finai6?fumbing •�•. ^CJ ' *' Y . r � .= h' 'SP
r �t �.+ S.
•'739. Water'5ervice-Final�* � �' ,`� � k `' 'x'� `
. ,< < s n :.o :
�.,AO. Gas Service•Final �� f - C� ^ `' s .- } ��= o� r �
�'q1, yolar pomestio-Fin�{x 5 '� ✓ '� c " '
�,y •Y ?7 � 't _ _ O' i' � �
42. 9ackflow Preventer� fi ;�.: .. i � j:. -� �
', *
43. Backflow Irrig�Lion'1* zSS t_ � w� r �
� C, y � i�': II C'
471y Landzcapttilrripatio�SYstem � S 7� � ,-� -:� M ca
.� .+' r c c �..
^ � i--1 � n i- � y i --• • • � ^ -' C' ,'� 'S, c^
4��.Sc�undAt,�t;nuatiortS* „„ ' �� ;r.c_. - T .� p..r� .
4;6. Handicap Regutatio� " ; � > z cc � : n _
�
47. FASIAC-STRUG'TUFi�& BUIL6ING ` ' ��'' S z
t*; c.r r.� - i a. -
48. F�It1A�PLANf11NG �. :-i. : •� ' t +; -7 e, � 4.
.- ' c ..
49. Electr,a Release'to Edison y ' i 7; *
,. � �' ,
5�. G4S Re�ease to Souihern Calitornia Gas Co �5� � �. '� - Ci • ^�� t ^
-1 x Y
5t CERT�FICATE OF OCCUPANC^ • " r. . -� _ ; -
No Date
i�J
Date Inspettor
/
0
I rT
9
.
� ADDqE55UiBUILqNO:
OWMERSNWEIFIPlpA'N: SSS A�ITON BL
-acexess SAKIOKA FARMS
� PO BOX 2097
TERMINPL ANNEX
f-' ��rr�.�,uuxcmoxesx
UNT:
2ND
iixcxrteci ox �m+¢n: uc. na:
acxonae•seooxrss: Ir�550IORHOPEIST z13623216 ��T78 1100
���T�g�, L.A. CP. 90071
�����T�ag�V� AIR CONDITIONING COMPANY ( 818 ) 244-6571
��, 6265 SAN FERNANDO ROAD �G�,
GLEDIDALE CA 1�M0696
110EN5ED COMN�CTONS OECLAXRTION: I hereby dlim u�Mx p2a�oelld pmjwy �IW I am licm»d wNm prvmima af Ghepls 9
��m«��y .mn s«w" �000� d a�.� s a ub a�.��...�d a�wo.�. coee..�w mr uo� o� mo ro� d,e �roa.
CT' 11C. NO.: 11Q C1A55: LJC. NO.:
0144U3 C 36 120696 EXP: 07/96
on.:�z �/,�_ cam.a«:
OWNEH BUILDEN OECLAPRTION: I hraby dfirm uMw perWy d pe'ryry Ihel 1 am acmnp tmm �he Caal wa L'mma lew Ia tlr
IOAowiq �aamn (Setlion ]W1.5 Buaim� eM Adaniom Code: AnY W a muniY WwA n0��� e a�1M omsh�ct Ms. "vnVove.
demaleh. a repai vry �Wctura, pia lo d'swucs, dso �pwree iM epplimd la euc� pxmu to fildt�rod eWmw�t Ihm he a ehe
is IicemW W��� lo Ihe paviabne d Ihs Comreaors Lioenea lnw �Cheqer 9(cpnmana�q rmh Sed'an )000) d pv'sion J d the
Bua'vwn vd Pedeniom Cade� a thn M a eha b exemq Iheralmm arM IM Ea�u loe Ne elbpeE ezemqion. My vbW ion d SeUion
l0]1.5 by eiry eppGunl la e permd wbje6e Ihs eppliunl lo e dW pe�utly d M mas Ihenlxe huiM�ed doOen �5500A.
� I.a�ownerdlMpropenYamY�WW^��hwepmntheidecompeneetion.willdotlwxwk.end�heebucWnomlin�eiMad
a Mered lor eele (Seclion 10M. Buvmn eM PMweiona CoAe: Ths Coniretlae Lioenae lew Ems not epplyto en ownerd propaM
,.i,o wie. «mw�. �n.,�. �e.ro ro...�n »on� �,..0 «na.,� «wwon n: «n..,.,� .mwm«.. ww�aea mm.�n
imprwemeMs ue rid imaMsa n dlxed la vab. tl, howawr, iM buiNi�p a inpwamam u edd wnhin wro yeer d compbion, Iha
owrcr�buitlx will hew �M1a burdon d provinp M a Me d'd ral WYE a impearo lor the W�e W mle�.
� 1. ea owror d iha pmpeny. em e�tivaiwly oonireairq wnh IiosruW contrecion �o eonmrue tM prqea (�� ]OM. &niriess ud
PMmdaro coh: Tne Caureaas Liconn lew eoas na eDMY w en ow�er d ww«iY who builds a Imwwm ihareon uM ww
contrew lar wW pqwa wi�h e mMrepor(�) fcmved punuenl to IM Conlratlon Liceros Lew�.
❑ I em eaamp unEer Seclion: 0. d P C., br Ihie reeeon:
Dme: �_
1 da hereby cenity iM1el I em ewere M enE uMeniend IM ip�inmeme d CelLomie Heell� end Sdety Code Sediom 25W5, 2553J, end
255�a, end thY I a eiry INun W ildiiq oocupeM will I w41 rwt (drcb ane) neeE lo comply wIh eek pets mE» erd tM requiremsnU br
a pamul iwmneVueiion a moEif�ion haniMAi�enepemem Diuvf. ReeNaniid oonmruqbn eppiratioerow evemq Irom thaa
a�w�a.
Dele: Applient:
WOPKER'9 COMVEN9ATON DECLAR�TION: I MrWy dfirm �ndsr penMy W qr'ryry ons d tlw /dbw'up Eedeietiwa:
� I �eve end vriP meinien e cerlilkme d ooneeM ta s�llaneuro br wMers'rompenmtbn, ee proHEeE lor Ey 6edion 3]00 d ihe Lebor
Code, la �M pMamenw W iM w,�k lor which I�i� pertnil i� IoueE.
❑ in�..oew�m.:�.,w�e�.•w�w�:M�,,.�o....�.a�n.ews.a'�a�roam.�e«we..ro�m.w�«m.�o.wm.
x wmk fa wAitli I�u permX u isueE. My wwkon' mmpemetbn IrqurarKe fartisr enE poliry n�mber va:
Gerriec
PdiryNumEx �-v� ii�� � .e:i. �.eeo EXPZRES
(This eectron med r�a W rompNNC / tM prmt ia br ��hunJ�iedddlais (5i00/ a kv.l 7 J 10 / 01 / 9 6
� I mnry Nel in ihs pMmvrca d ihe work iar v.fikh ihia pamE is busd, I ehell M emqq erry penon in ury mannm w o to
bKMlp tUqYl 10 �M MqkM�� CQII�IW�1M �G'M C� CG�I�IXNG. OII� �AO I�W d I� btl'.IXIN WqVI 10 I�IG Mqkllf�
comp.nwlon wv+vlam a swwn a�ao a in.l.eo. coa.. �• n.nn oomoN.nn mw wd.:.bn..
Dele: �/�/i_9/� Appl'
Weminp: F�Nun b ucun wark�n'roirywu�tlon rov�rp� l� unl�Mul, mtlWll ulhcf �n wmp ro cNMIW pmeltlp uM
NHI nnu �p ro om nuierM rMuunE tldNn (sfOq000A M rNltlon ro!M rosl ol ronpwu+tb urWes u provM�A ror In
Sxtlm 9106 0/ fhs l.�bor COM, Inf1rsal, �ntl �ttom�y'� /wx
CONSTFUCf10N LENOIN� ��ENCY: I hmab/ e1f urder peneb� M pejvy �het tMes u e emmrmion Ind'up epanry lor the
MlIOI11181M.tl CI IM w01k M'.MiV11A! VM�Y 1� GtIMA (.iAii011'.I�BI. CN. CI.
LENDEW9 NANE:
LENOEX'S MOflE44:
I cMity Ihe� I heva reeE No eppficmion enE ame �MI tla ebv+e iMametion u mnatl.l eQree to mnply wG� a0 dry vk muMyadireiKea
enE cle�a levn �Nel'vp to buildip wnaUWion eM Mroby eulhoraa represanitlivas d Ihn ciryb mter upan IM ebwa�mentoneE p�operly
la impetlion pvpmes.
Ome:1G� ���/✓
(S151yB W P) WM1��+�d,q d Selsry: GrseMFb: Cuwy-Appfrani: Rnk-Mwnue: (3ddenroA-bwra
CITY OF COSTA MESA - BUILDING PERMIT ❑roe,n �tn. �� n�etiU�.
PERMIT NO: M 074595 PLAN CHECK NO: �J GOVT; N SUPP: N
CONSTROCTZON TYPE: iFR SP PERMIT TYPE: MEC PURFOSE: ALT
JOB DESCRIPTZON : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM C'ALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS OFFICE TI, RE:#74570
*�c��*********��***�c*�****�c**��*x��******+�*****�**�*x*�*+��*�***�r��***�*�***�*��e*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ----------
FRNT: FT IN REAR: FT' IN
LEFT: FT IN RGHT: FT IN
-------- ACCES���RY BUILDING ---------
FRNT: FT �IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
PARFCING AEQ: PROV: PARCEL: 91050109 ZNE: REF NO:
PLANNING NOTES>
i
��***�****���*******+��**�+�*��*�*�****�***��*���**���*�+�+��*�*x*+�*****x*+��****�**
� E V E L O P M E N T S E RrV I C E S R E Q U Z R E M E N T S
r�
ZONING APPROVED BY DATE:
!
BUILUING APPROVE� BY : � !� DATE:
APPLICATION ISSUED BY: � DATE:IQ ICo �
if�EiEifi�iElElEiEiE3EfEiFMlEiElEiE1ElEiEiE��if3fiF�F3FiF3F�iFit3FTF�FiFif�if�f�iFiFiE�iFSFiF., iE3F��F�3i�F�iFih1F3E3EiE3ElE3E'%�iE�aF �FifiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/RES GRADING
PERMIT 105.00
25Y SMIP/NON-RES
PLAN
ISSUE FEE 15.00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 105.00 15.00 0.00 120.00 120.00 .00
REVENUE DIC�ISION TOTALS--> COLLECTED: 120.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHP.NIC FIRE SMIP/TOT GRADING PLAN-CHECK
120.00
if iR �f if 1f K iE IF 1E iE iE iE iE 1E if 1F 1E iE if �E iE iE if 3F if !f If 1E iF af if iE 9f if if fF jE 1Flf if # if if 3E If iE fF 1E 1E if 3f iE jE �E iE fE 3f 3k IE �E 3E 1E iF �E 3E iE IE �E 3E if jE �E if 1E iE �E 1f !f iE
I N D I V I D U A L F E E B R E A K D 0 W �]
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 2 VAV BOX 6.50 13.00
MEC 17 FIRE DAMPERS 4.50 76.50
MEC 1 INST/REL AIR HANDL UNIT 0-10000 CFM 6.50 6.50
MF.0 1 INST/REL BOIL/COMPR 0.0 - 3.0 HP 9.00 9.00
END OF FEES /
ri ��l'�i' �.. � �'.'�1:.5 �'.�+-. �.r. .,-
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'� � • � � � � POO L a SPA � - ' -
. C(:NSI`RUCTION AND PIANNING � '�
' APPROVALS Permit #- Date Inspector pppROVALS Permit # Date I�spector
. 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd". � 53. Steei Reinforcement
i
3. Electricai Conduit Utility-Undrgrnd. 54. Forms •
4. Electrical Conduit-Undrgmd. � - 55. Electricai Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test '
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Structurai Floor SYstem ' 61. APPROVAL TO DECK �
11. P,roperty Sewer Line & House Connection 62. Backwash & Receptor-Final .
i
12. Sewer Cap i 63. Heater & VenFFinai
13. Roof Dreins � _ 64. Piumbing System � Final
14. Rough Plumbing � 65. Electrical-Final �. '
15. Rough Electricai-Conduit 66. Solar System-Final
16. Rough EleMric Wiring 67. Fencing & Access Approval
57. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
18. Rough Elecirical-T Bar Ceiting 69. POOL/SPA SYSTEA4S F�NAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21: Ducts, in Structure 70. Underground Hydro
22. Ducts. Ven[ilating 71. Product Piping �Gas ❑Oil '
23. Gas Pipe-Rough & Test 72, Underground Fiush
24. Roof Freming 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•Bar Ceiling (Structura1) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe �
28. Lathing & Siding 77. FIXEO SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Powzr MeterPina( 80. FOOD CERTIPICATE ISSUED
33. Final Electric Notes:
34. Fina� Heating & Air Conditioning � Z� - js. .
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 pomesiicFinal
42. Backflow Preventer .
43. Backflow Irrigation �
44. Landscape Irriaation System
45: Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING _
48. FINAL PLANNING '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CEFTIFICATE OF OCCUPANCY
No. Date
�\
�
�
��. --- --.
� �itp o f �o�ta �e5a �
Developmenr Services, Division of Building and Safery
CERTTFICATE AF OCCUPANCY
This ceruficate is tssued pursuant to the requirements of the Uniform Building Code, Section 308
adopted by the City of Costa Mesa certifies that at the rime of its issuance the building structure herein
below described was inspected and approved for occupancy as follows:
Builcling Address 5�5 ANTON BLVll. FIAORS 1-12
Bldg. Permit No.'eee belov
Use ur,i�na
Group B-2 Type of�Construction 1-FR Fire Zone Use Zone 1'DC
Owner of Building Sakloka Fazms Tenant "mtocsl"
*B74570, B75356, B745J2, 874571, Bi45?3, B74633 �' �
B74632, s74631, B74630,�7 006, B77866, 574574 By '
Date November 14, 1996
RI(.'K Bk0'dN, CB�
� REQUIRED TO BE POST'ED IN A CONSPICOUS PLACE
a
, _ . ..r . ..�.:t n _ . . .,_n • .,.-n., . . . . .
C, �Y OF COSTA M� �A
� ��
Development Services, Division of Building and Safety
,,, � _,,�. �
CERTIFICATE OF '� CCUPANCY
p� � �
��.
This certificate is issued pursuant to the'requ�remerits of the Uniform Buildtng Code, SecHon 308 adopted by the City
of Costa Mesa cerHfies that at the time ofits issuance the building structure Heceui�6elow described was inspected and
approved for occupancy as follows � �'`.,.
pa �i a .
� �.
BuildingAddress 555 Anton Bl ,$-te 300�x'�+ � g�d`g PermiENumber B06-01243
., , -� �, - - . �.7. - �s <� +, -
S�` , € y� - : ,,: M . , , �
Use Office (16,�64�s.f.) �ti,� ` ��
,.'. ' � f`_s "-;.df K' � €i�
Group B TypeofConstiuction 1 FR' ` Fue`Zone XXXXXXXX;� UseZone PDC
Sakioka °Nar'n"es' , � , , ;�;�� ` ,. , �., ; - .�
OwnerofBuildingtdorgans HoteT Li,inited Par`tn Tenant �AERSK
��r .,
.,:. � � � . ..., ,,,
Address Attn: Joe Crawford, �L;050 17Cki��"6t. , Ste 32�0, Ilenver, CO 80265
,.'` �g +'.a . � -
' s� �-� " ° By,�' � ". �
BUILDING OFFICIAL-KI1dTl17 Q.�NgU�!2II,�C 8.�:� �.� .�:'
Date._�`.'' 09/0 �
� :,
v a,�:
... i.1"� asi �J .
..:....i:i.:`..< ..
� REQUIRED TO BE POSTED IN A CONSPICUOUS PLACE
�
_
City of Cosca Mesa
Development Services Department C E R T I F I C A T E O F O C C U P A N C Y' No.
Building Safety Division
P. O. eox 1200
Costa Meu, California
The Building located at 555 ANT(1N R(11R,F1/ART1_ iR11 �.nf1R
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances app�icable thereto
fora Group R� Occupancy.
Use of Building OFT�T(`R
Legal Description 410—Sfll—OG
(See reuerse side for Metes and Boundsl
Building Permit No B 59140 Electrical Permit No. R 5414� Plumbing Permit No.9 SQIG7
Mechanical Permit No. M 59142 Number of apartments and/or guest rooms
Fira Prevention Permit No. F 59193 �
iSSUED T0: BuildingOfficial Tonv C'De Bnca
Rank (lf Amn�irn � — �
555 Anton Blvd. , 3rd. Floor bY •��'� '� �-�� i:, �—
(;ncYn Mnen !'n Q�(��(�
Date October 10. 1992
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 Meu under Sec. 307 (e) U.B.C.
CMF 3075-46 rev. I/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File
City of Costa Mesa
Development Services Department
Building Safety Division
P. O. Box 7200
Cosre Mesa, Califomia
CERTIFICATE OF OCCUPANCY No. OO���O
The Buildfng located at rLq�3..T�� onnle�racci. Suite 300
has been inspected and found to comply with the provisions of ali City of Costa Mesa Ordinances applicable thereto
for a Group 82 Occupancy.
Use of Building O£f].00
Legal Description 410-501-04
ISee reuerse side for Metes and Bounds)
Building Permit No B 36887 Electrical Permit No. E 36930 Plumbing Permit No.
Mechanical Permit No. M 37150 Number of apartments
UED T0:
Building Official
_ and/or guest rooms
William T. Hpaard
ce,.�,.irv nacific Bank /
600 Wilshire Blvd.� 0500 by -.� .
�..� n�noln.a. CA
• � oate Julv 17, 1989
This Certificate of Occupancy SHALL BE posted i� a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mew under Sec. 307 (e) U.B.C.
CIOIF 1015-46 rev. 1/83 White - Owner; ��nary - Numerical File; Pink - B�d9. Permit File
Crty of Cosia Meu �
Oevelopment Services Departmem C E R T I F i C A T E Cl F O C C U P A N C Y No.
6uiiding Safety Division
P. O. Box 1200
Costa Mesa, Caiifornia
The Building located a
5S5 Anton Bivd. Unit 350
has been inspected and found to comply with the provisiOns of all City of Costa Mesa O�dinances applicable thereco
for a Group �Z Occupancy.
Use of Building Off 1C08
LegalOescription 410-501-04
ISee «erse side for Metes ar�tl Bounds)
Building Permit No �48775 Electrical Permit NoE48835 Plumbing Permit No. P48929
Mechanical Permit No. Id48d66 Number of apariments a�d/or guest rooms
�SSUED T0: • BuildingOfficialTon� C'De Haca
Security Pacific National Ban)c " ----"
r% �1. _ :.
S55 Anton Blvd � by .��_ . __.. . :' ..'-,,�r�.e�ior7
Costa Ydesa, Calif.92627 • I �
oace September 14,1990
This Certificate of Occupancy SHALL BE ported in a canspicuous place on the premises and SHALL NOT 6E removed except by the
Building Official of the City of Cona Mesa under Sec. 307 (e) U.B.C. ,
CMF 1015�46 rev, 1/83 White � Owner " y�y - Numerical File: Pink • Bld9. Permit fiie . .
L
��
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,. .
' CITY OF COSTA MESA / � �`"'" "' " "
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754•5273 • Faz (714) 754-4856 • wvnv.ci.costa-mesa.ca.us
FOR INSPECTIONS CALI: (714) 754-5626 '
PERMIT TYPE ELEC
JOB ADDRESS: 555 300
Vicinity: 300
PERMIT NUMBER: E07-00573
STATUS:
,-. _ .,.,, .,, ,, DATE ISSUED:
- -'-ISSUED BY:
- t F�
� _x ,
`; � .'.'� Suite'/Unit ;�;�,,30U
CM r.
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" - - �.i>s:-
ISSUED
06/11I2007
CAC
SCOPE OF WORK: INSATLL 42" QUBICALES:�56 OUTLETS FOR MAERSK SUITE 300r�
.n`�� y`" "� ��
. t,'" ti`;;.
s � �;
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OWNER: RREEFAddress y. � � : �� POBOX4900'UnitiDEPT20Z� ���`'�
PHONE: !��( _ ; ' �Ciry/State2ip: , SCOTTSDACE AZ
:;_ r . },. : N� - .
APPLICANT: ROBERT MCCORKLE +� `-: ', ' Address ��,�29357 ELBA DR Unit:�- �
PHONE: 949-251-{692 �-' ! - City/State/zZip: LAGUNA NIGUEL; CA � �
�
CONTRACTOR: INDOFF,INCORPORATED� _ �- � - � � • - -� - ��License No. 732090 ��
Address: 11816 LACKLAND,RDUnd � .��% PHONE:' 314•997-N22 r.
City/State: SAINT•LOUIS , MO ZipCode 63746 ' ' � � " -� `-, � � "� CELL:. � -
,
-.;� ;�; �. -- � -
,a __
ELECTRICAL PERMIT FE�ES " > ' �`�
Electrical Plan Check Fee $ '$0 00 :
Elect�ical Permit Fee: � � � ` ,; $71 78 �;,: � ` � ''� t �_ `
ReinspectionFee - �^$000 ;`- � • ,,.-
TOTAL� FEES ,� r � $71 78 �� fi, "" . �
a �� _ i .;
�1-. , 's;... -,. _ . 's :�
k, � � ..,.: �„ -, - _
4 �� �� 3
. , ,�_:;.��'.
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorizad under this permit to be wnsidered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the ezpiralion of this permit.
�OpE/, INSPEC710NTYPE
1876 Pixed System Final Fire Prevention
1266 Pool Spa Final �
200 Final Re-Roo(
201 Final8lock/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Damolition
D� IN7171AL5 y9�[ INSPEC710NTYPE
208 Final Mechanical
208 Final Plumbing
210 Final Electnwl
272 Final Fire Prevention
2T0 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
on�r ixnna�
�%�' ��� .
WORKERS' COMPENSATION DECLARA710N:�
I hereby aKrm under penalty of perjury one of ihe wing declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers' ,
compensation, as provided for by seclion 3700 0( Ihe Labor Code, for Ihe
peAormance of Ihe work for which this permit is issued.
� I have and will mainlain v.orkers' compensation insurance, as required by
sectan 3700 of the Labor Code, for ihe performance of the vrork for which tliis"
pertnit is issued. My vrorkers' compensalion Insurance carrier antl policy
numb are:
ar r: Ai1%�'.7P1-S�//i��
(IDrssect rai6emmpetedJlhepeimrtisv/al�vetlaloQnehmMred�i'lars(Sf00Jwless.)
P cy Numb : wC ��� Z%� /��
❑ I certify [hat in the peAormance of [he work tor which [his permit is
issued, I shall not employ any person in any manner so as to become subjec[
to the vrorkers' compensation laws of California, and agree that if I should
become subject to the vrorkers' compensation pmvisions of Section 3700 of
the Labor Code, I shall (orthwith comply with these provisions.
Appbcanl's SignaWre Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALI SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($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 aKrm that I am licensed under provisions of Chapter 9(commencing
vnth Section 7000) of Division 3 of lhe Business antl Protessions Code, and
my license is in fu/ll fo�rce and effect. �j
ic. 7'3�� i`-' las DJ
6' /i d7
Conva r's Slgn e
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a constructbn lending agency for the
peAormance of the v.ork for wfiich Ihis pertnit is issued. (Sec. 3097, Gvil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty o( perjury that I am EXEMPT FROM THE
CON7RACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5,
Business antl Professions Cotle: Any city or county which requires a permil to
consWct, al[er, improve, tlemolish, or repair any structure, pnor to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuan[ [o [he provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the
Business and Professions Code) or thal he or she is exempt lherefrom and
the basis for the alleged exemption. Any violation of Section 703t5 by any
applicant !or a permit subjects the applicant [o a civil penalry o( not more lhan
fve hundred dollars ($500).):
❑ I, as owner o( [he property, or my employees vn[h wages as lheir sole
compensation, WILL DO THE WORK, antl fhe structure is not intended or
offered tor sale (Sec. 7044, Business and Professions Code: The Contracrors
License Law dces not apply to an owner of property who builtls or improves
lhereon, and who tloes such work himself or herself or through his or her ovm
employees, provided that such improvements are oot intended or oHered for
sale. If, however, the building or improvemenl is sold within one year of
completion, the owner-builtler will have fhe burden of proving that he or she
did not build or improve for purpose of sale.). � �
❑ I, as ovmer o( lhe properry. am EXCLUSIVELY.CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec.-7044, Business and
Professions Code: The con[2ctors License Law does not appy to an ovmer of
property who builds or improves thereon, and who contracts for such prqect with
a contracta(s) license pursuant to [he Contrac[as License Laws.).
❑ I am exempt under sec.
Business and Pmfessions Code tor Ihis reason:
SignaWre
305]-46�0I09)
Owner ID, verified by drivi se. ❑ Yes ❑ No � �.
Oriver's License No. Expires:
�Verifcation of Ownership by (rype of documen[, i.e. - pmperty fax bill or deed):
DIVISION�OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceAify that no excavation frve (5) or more feet in tlepth into wfiich a
person is required to descend, will be made in connection vnth work authonzed
by this permit, and that no building sirucWre, scaffdding, falsework, or demolition
or dismantling thereo(, will be more Ihan Ihirty-six (36) fee[ high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Atlministrative Code).
❑ As owner-builtler, I will nof employ anyone to do work which would
require a permic fmm the Division of Industrial Safety, as noted above, unless
such person has a permit to do such vrork from the division.
Appllwnfs Signalure Dale
Division of Industrial Safery Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
i. Will ihe applicant or present or tuture builtling occupant need b(le and
certify a Business Plan for emergency response to release or Ihreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, with some
exceplions, that a Business Plan be filed wilh the Cos[a Mesa Fire
Department by every busine5s which has at any one time during a reportetl
year a quantity of hazardous matenals equal to or greater than a vreight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standartl temperature and pressure).
2. Does or will the applicant or present or future building occupant need to Poe
a registration form for acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, vrilh some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quan[ity of acu[ely
hazardous matenals equal to or greater Ihan a weight o( 500 pountls, or a
volume of 55 gallons, or 200 cu6ic �eet of compressed gas at standard
temperature and pressure�.
3. Does or will the applicant or present or fuNre building occupant neetl to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Sa�ety Code provides that the
Costa Mesa Fire Deparlmenl may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register aculely hazardous ma[erials with [he Fire Department.
4. If an RMPP is presently require0, has Section 25534 of the California
Heal[h and Safe[y Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre building occupant require for
the work which is the subject of this application a permit for such construclion
or motlifcation (mm the South Coast Air Quality Management District or fmm
any other air pollution control tlisMct or agency? ❑ Ves ❑ No
(Section 658502 of the Calitomia Govemment Code requires that the requestetl
infortnation be fumished on applications /a rwn-residential building permits).
6. Will any part of ihe faciliry, to be constructed under Ihis pertnit be within
7000 feet from the outer boundaries of a scliool?�' � Ves ❑ No
`� n
(If'yes", the facility mus[ meet the�requiremen6of,Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the Sbuth Coast Air Qualiry Management DisMc1 or other
air pollution coMrol tlisMct or agency is required (or the vrork which is the
subject o! this application, have all of [he tlisclosures prescribed by California
Health and Safery CoOe Section 42303 been made? ❑ Yes ❑ No.
8: Qf "yes',, attach certifcate of compliance from the�appropnate air pollution
controi offcer). � . � ,
CERTIFICATE OP COMPLIANCE: I certify that under penalry of perjury the
informalion given above is conecL I agree to comply with all state laws and
ciry ordinances regartling Hazardous Materials and Emissions. �
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state Ihat
the information given is correcL I agree to comply wiN all state law5 and city
ordinances relating to building cons[ruction, and authonze represenlatives o!
the Cily of Costa Mesa to enter upon the above-tlescribetl pmperty for
inspection purposes. I agree not to occupy or allo occupanry of any building
authonzed by this permit until fnal inspection.
.�@��R✓/X//Qreof e / ate
O � O
Anaror um me r nt at
(714) 754-5273 • Fax (774) 754•4856 • www.ci.costa-mesa.ca.us
77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL Status: ISSUED
Suite: 300 Applied: 04116/2007
Vicinity: SUITE 300 Issued: OS/102007
Parcel Nunmber: 41050110 Zoning: �
Applicant: ANNA MORENO -- - ",- -- ISSUED Bv:
Address: 30080 SILVER SADDLE.CT� ./ %'�" ���- -- - � - � '�
",. ,%,i�%� _ — -. Phone: 951-244-9836 �" - . '
CANYON LAKE, CA-� /�� � � Zip: , 92570 , ' ; r-� -_ -� \
��'�� �' j �� . � �'�, J% �'�\���\
Owner. RREEF ' �' � � �� . • /' r % ��� � � �,•
Address �PO�BOX 4900� � j � _ _ � , � � "' � `-� � �-,`� A �
-.DEPT2W �. � � �� : Phone. �.. - ` �.�` �- ,.,> _,�'�� � `;.�
� ;!SCOTTSDALE;AZ,/��� Zi 852614900 �'' ` �����" � � ��;���
p: . � , _�.. , -,
/ � �� �_ i" � � � �� �, .A�'� ��� // i� ' ��`�`
/ : % , A� . _ � �✓ ;� � ��A
Contractor �.ALL`PRO�FIRE-PROTECTION ��;�� i � ,��
%Address: 30060 SILVER SADOIE CT � � ;��� �. � ������
, �� �/�', i�q�� Phone�-,957-244-9836 �`�;.�V � � � .�\
�-;-i � � � CANYON LAKE, CA Zip: �- 92570 `�� � � ' ; �1�. �� � �
� � ,���
� _ . /�/�� 1 Licensei 829993 - ��o'� �', �: `,�
, . � .: :�� . ' _ _ � �. , ���
%, - -�- � ��SCOPE OF�P_ERMIT .` j �, .
„
� ��RELOCATE 8 FIRE SP HEADS�FOR� MAERSK' IN SUITE 300 '.'� � � � � �1� ,�, `
� � 806;07243 � �// ; - � . � � , , � � � . � ,� ��
�� __ ; _
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� '/ �� � `, / '� � FEE SUMMARY � ;
�
PIan�Check: $21.22 , � � � Calc Valuation: ' Saoo.oa� . �,
-Permit:. $32.65 � ,,. , --� �; � �,� ��� � T,.� rj,� � __,,. �,�,� 'Claimed Valuation'. 3aoo.00
Other: � $0.00 � . �1: 1l _:-c �1.� .�.�^. �i ;� �- , , � �
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Total: $53.87 ✓_' ' y ,_ - - , /��.-- _ � �;
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NOTICE: The work authorized by this permit shall comply with all applicabla hantlicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall aiRomatically expire and become void it work is not commencetl within 180 days, or if work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicabie codes, and all
requlred Inepectlons entl flnal epprovel must be abtained. Failure to obtain inspectlons antl final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
i
2at6-ae Iarool U
WORKEHS'COMPENSAnON DECLARAnON: ��
I hereby effirm untler penalry oi perjury one ot the following tleclarailons: .
❑ I heve entl wlll meintaln e ceniflcate of consent to self-Insure for workers' compensetlon, es pmWtletl for by section 3700 0l the Labor CoCe, tor ihe pedormance of Ne
�ork for which t�is permit Is issuetl.
hava end will malntein workers' compensatlon Insurance, fls required by soctlon 3700 of the Lebor Cotle, for Ihe pertortnance of Ne work lor wh Nls pertnit is Lswed.
My worki� ompecns-a.rtion Ins�u�r nce cerner entl poliry number are: // �/ ,)
Cerrler: l�r�' � )'/�/�//���. Poll�cy uN mber. /(�-Y��/��V�
(This sactlon need nol be wmplet f! (he permltls veluetl et are hundred dollars ($ f00) or /e55.J
❑ I certiy thet in the pe rmance of t�e work tor w�ich Ihis permit is IssueA, I shell not employ eny person In eny manner so es to becane subject to lhe workers'
compen5a0on law allfamla, antl e�� t II I s��ecome sub�ect to Ihe workers' compensatlon pmWsions of Section 3700 oi tha Lebor COAe, I shall fotlhvnth
wmply wlth these Is s. ,
AppllcanLSigneture: Da et :
---� �
WARNIN(3: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNUWFUL AND SW1l15UBIECT AN EMFIAVER TO CRIMINAL PENA�TIES AND CML FlNES UP TOONE MUNDRED
THOUSMID DOl1ARE (5100.000�, IN ADDRION TO TME COST OF �OMPENSATION, DAAIFOES AS PROVIDED FOR IN SECTION 3]OB OF TME UBOR CODE, IMEREST, FNO ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARA710N:
I hareby aHirtn thnl I am Ilcensetl under yr visi s ol Chapter 9(wmmencing wilh Sectlon 7000) of �Ivlslon 3 of Ihe Business�d PrOf¢551on5 Code, en0 my license Is in Full
force end eHect. �a G�y2 ��/C/ �� � �l'1� /1,,,, CIos9'M ���
,Comraciors�Signeture: �f�j4Ll. �� De, �� S D O
CONSTRUCTION LENDING AGENCY:
❑�I hereby eHirtn Ihet there is e conslruc0on lentling epenry lor the peAartnence at the work tor which ihis portnit is issuetl. (Sec. 3097, Civil Cotle).
Lentler's Name: LentleYs Atltlress:
Signeture: Dete:
OWNER•BUILDER DECLARA710NS: .
I hereby eNirtn thet untler penelry of perjury Ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for lhe tollowing reason (Sec. 7031.5, Business end Professions
Cotle: Any city or wunry which reqWres e pertnit to construcL aller, imprwe, AemWish, or repair eny structure, pnor lo Its issuance, elso requires the epplicant lar such pertnit
to file e slgnetl statemem Ihat he or sha is Ilcensed DursuaN to t�e prodsions ot Ihe Cantrecrors License Lew (Chepter 9(commendng with SecUm 7000) of DNi51on 3 ot the
Business end Prafesslons COAe) or ihat he or she is e:empt therefrwn end 1he besis for t�e ellepeO e:emptlon. Any vidation oi Sec6on 7031.5 Dy any applicant for e pertrtit
sublecis t�e eppliwnt lo e civil penalry of not more then live hundretl AWlare ($500).):
❑ I, es owner ot t�e property, or rtry emplqrees with wages as their sde compensetion, WILL DO THE WORK, antl the swcture Is not intended or atteretl tor sale (Sec.
7044, Business entl Professions Cotle: Tho Contractors License Lew does not epply to an owner oi propeny who builds or improves thereon, end who daes such work
hlmseH or hersell or through his or �er own employees, provided Ihat such improvements are no� intentlea or otterea for sele. II, hawever, the builtling or Improvement is
sold within one year of completion, the awneo-builder will heve t�e burtlen ot proving tha� he or she did not build or improve for purpose of sale.). '
❑ I, es owner oi ihe praperty, am EItCLUSIVELY CON7AACTING WITH LICENSED COHTRACTORS to rnnstrucl lhe project (SBc. 7044, Business antl Professions
Cade: The con[redors License Lew tlaes not appty to en owner ol property who buil�s or Imprrnes thereon, antl who contracis tor such pro�ect with e coniractor(s)
license pursuant to ihe Contractoro License Lews.).
❑ I em exempt under sec.
Signalure:
Owner ID veritietl by tlriveYs license. ❑ Ye9 ❑ No
Business and Prolesslons Code tor t�is reeson:
Verilicetlon ot Ownerohip �y (rype of tlocument, i.e. - property lex 6111 ar tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICA710N:
Drivers Licensa No.
Data:
Expire5:
❑ t hereby certity tha� no excavetlon tWe (5) or more feet in dept� Into w�ich a person is requlred ta descen4 will be maGe in connectlon with work euthodretl by tNs
pertnit, and t�at no bullding structure, sceXoltling, falsework, or Aemdition or dismantling �hereof, will De more than Ihirty-siz (38) leet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Celilomia AdminislretNe CoCe).
0 As awner-bullder, I will not omploy enyone to do work which would reQuiro e permll from the DMslon ol Industriel Sefery, es notetl ebove, unless suU persan hes e
pertnit to do such work irom the division.
Slonawre: __—. — _ _ Deta:
Divislon ol Intlustnel Selery Permil Number:
CERTIFlCATE OF COMVUANCE AND AUfHORVJITION OF EMRV: i cenify untler penelry of perjury ihat I have reaG this application end state that the intortnation given is
wnoct. I egree lo compry with ell stete laws entl dry ordinances releting to bulltlinp consiruction, entl euthorize representatives oi ihe Ciy of Costa Meu to enier upon the
ebove-descdbeC Droperty tor inspection purposes. I egree rrol lo occupy or albw occupancy ol eny building euthorized Dy this permit umil finel Inspection.
WpE I. INSPEttIONTYPE Q�¢
1618 Fixed System Flnal Fire Preventlan
1268
200
201
202
203
204
Pool Spe Final
Finel Re�Roof
Flnal Block/Retalning Well
Finel Fectory Flre Place
Final Slgn
Flnel Domolltion
��$ �fj INSPECTIONTYPE
20B Finel Mechanical
208 Final Plumbinp
210 Finel Electricel
212 Finel Flre Preventlon
220 Finel Plennlnp Approvel
222 Final Slte
250 Finel Bulltling/Oaupency
� u�
g- 2fro 9 [`iAn.
Jobnddress: 555 ANTON BL
Suite: 300
Vicinity:
Primary Oa: 8 Eat<50/ Office/ Bar<50
Parcel Number: 41050110
npplicane MARIN, MICHAEL
Address:
owner: SAKIOKA
Address PARTNERS
Coniractor .C' �AMARC
Address;' �1565 N H
���/� � ���
ANAHEIA
�i•� � i;
� , / Zip: 92807 �
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��Aich : � � i %'
.Address: �,; ;��
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' � Zip:-" . 'i ��. ,
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' � 18,064 9.F. INTERIOR TENA�
� "MAERSK" IN'SUITE 300
Type of Construction: I-PR
Zoning: � � U
' _ _.Phone: 714.948.0913
, ., „ . Zip: ,. . .
Slatus: ISSUED
Applied: 07/25/2006
Issued: 07I18/2007
ISSUED BY: �/j��%%�� — �
--'G.- -_ . - ' . _ .
\RMS MORGANS HOTEL LIMITED �
ATTNJOE�CRAWFORD ' j � _
� ` 1 `�
� " � -�� . Phone: ' �/, ' i .
V�,�V � Zip: _ � .� .
�� ( - - � � � � _
�NSTRUGTION CORPORATION ` � `�- ' �, �
IY,CI;�" i �"
.. Phone: , `
- . � .
r..--.
. -License.' ` f .
IMPROVEMENT FOR
� . / �
Plan Check: . $1,315.70 ',
Permit: $2,024.15 `�
SMIP Res:� �� � $0.00 �
� SMIP Com: � � $59.46
�.-` Other. : $0.00
: � Inspection' ` . $0.00
. , � ` `1.
,Total:\ ��;$3,399.31 �
' ,�
-� • � _
���..�
Phone: 714-993-9220 �� �
: A
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License: 674307 \, .
�,�,
Eng:
o Address: ' ;
SCOPE OF PERMIT
�'- � FEE SUMMARY -.,
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.� �' � ..- i ;�
Phone:
' ' License:
j ', �
� Calc Valuation:
Claim Valuation:
, i�'; .
:�:
,;, ,.
i%
i
� • �PL'ANNING & ZONING
SETBACKS�, ��� `� , ; `' " � ' �
\ �� �;r.' '
MAIN`STRUCTURE 'From��0. 0 � � Rea� � 0-�0� � Left - �0- 0�� � � -Right � � 0- 0�� �
. � ' ����.�.. - - -'-, _ ' . . , �• � . . � .
ACCESSORY� Front� 0- 0��`�-, Rear � 0. 0 -. Lefl � 0- 0; Right��,- 0- 0,
� V� ��/ '/� � ��_ o. ,�_0 - ,�i� ',/i /. .
PARKING �'\Ezistin �",0,> � � Reauired 0� ° " �. Pr000sed� 0 �; '
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5283,15320
sz�o,sso.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia 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 wilhin 180 days, or if work Is suspended or abandoned
for a period ot 7B0 days.
INSPECTIONS: In order for the work authorized untler this parmit lo be considered legal, such work must comply vnth all applicable�c� , and ail
requlred inepections and tinal epprovel must be obtained. Failure to obtain inspections and linal approval will result in the expiration of (his permit.
FOR INSPECTIONS CALL: (714) 7545626 V
2448d818100)
WORKERS' COMPENSATION DEGLAFiA710N:
I hereby eHirtn under penelry of perjury one ol tha tWlowing tledaratbns:
❑ I heva end will maintain a cenificate of consent to seli-Insure tw workers' compensetion, as provided for by section 3700 0l Na Labor Code, for tha peAortnence ot the
i work for which Ihis permit is issued.
;�fha-Le anA will maintain wwkers' compensation insurance. az required by soctim 3700 0l the Lebor Code, for Ne perfortnance of Ihe work for whkh this partnll L515wetl.
My workers' crompensation In5ur0nce carrie^r e,nId po��ty num6er ere: ��,,� /�^ 7
�,� 5� co��nr�sP,-T�UI`1 1—%��QG:nI['F F-,/�.)i� dicyNumber.-�Wl�,'I'"1�-'2�ii)lo
rs sectiar need not be canplefed if tlre pemtit is velued a( me hundred dWlors (S I00J ar /ess.)
❑ I certily Ihet in Ihe pertortnance ol Ihe wod� r which this pertnll is issued, I shell not employ any person in any menner so as lo becoma subject to Ihe workurs'
compensatbn laws of C 1 la, tl e � et I� Decome subject to the workers' campensetion provisions of Section 3700 oi the LaDor Code, I shall tort�with
complywit the pr sio .
ApplicemSlpneWre:-----. - �Qat���"�'�"U�'
i. _..�... .
ApNINff�FAIEUHE TO SE E WORKER COMPENSATIOJ COVEiUOE IS UNUWFUL M'D SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED
THOUSAND DOLLFRE (5100, �. IN ADDRI TO THE WSYOF ODMPENSATION, DMNGES PS PROVIDED FOR IN SECTION 9lOe OF THE IABOR CODE. IMEREST, AND ATTORNEY'S FEES.
UCENSEDCONTRACTORSDECLARATON:
I �ereby eMirm thal I arrylice�nse� upd�r pmvisiy� ot Chapter 9(commencing with Sectian 7000) of Division 3 of the Buslness end Professlons Code, end my litense is in full
CONSTRUCTION LENDING AGENCV:
❑ I hereby eflirm ihal lhere is e conslruction lentlinp egency lor I�a peAormence ot lho work lor w�ich Ihis permit is issuetl. (Sec. 3097, Civil Code).
Lenders Neme; Londer s Atldrass:
SlgneNre:
OWNER-BUILDER DECLARATONS:
Date:
I herehy eHirtn thet untler penalry ol perjury ihet I em E%EMP7 FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sac. 7031.5, Business entl Professirns
Cade: Any ciry or counry which requires a permit to consiruct, elter, improve, demolish, or repair any struciure, prior to its issuance, also requires t�e epplicant tor such permit
to file e signetl statement that he or she is licensetl pursuant to t�e praWsions ot t�e Contractors License Law (Chapter 9(commencing with Sectlon 7000) of D'Msion 3 of the
Business end Professions Cade) or thet he or she is ezempt theretrom end the besls tor the alleged exemption. Any violation ot Section 7031.5 Gy eny epplicant for e permi�
subjects tha applicent lo a civil penelry ot not more than live hunEred dollars ($500).):
❑ 1, as owner ol iha properry, or my employees wlth wages es their sde compensatlon, WILL DO TME WORK, and ihe structure is not Intendetl or offered lar sele (Sec.
7044, Business antl Professions CoCe: The Conir9dors License Lew does not epply to en owner oi propeny who builtls or improves thereon, and who tloes suc� work
himsell or hersetl or thmugh his or her own employees, D��ded �hei such impmvemems ere not intended or oflered for sale. If, however, the building or imprwement is
sold within one year of complelion, the owner-buil0er will have Ihe burtlen ol proving that ha or she tlitl not build or improve for puryosa ot sele J.
❑ I, as owner of tha property, am EXCLUSWELY CONTBAG7ING WITH LICENSED CONTRAC70RS to construct the project (SacJ044, Busineu end Professions
Code: The contrectors License Law tloes noi appty to en owner of pmpeny who bullds or Improves Nereon, antl who comracts lor such prqea with a contracror(s)
licensa pursuam to the Contractors Licensa LewsJ.
❑ I am exempt under sec. Business antl Prolessions Code for �his reason:
Signeture: Oate:
Owner ID venfied by tlnvers license. ❑ Ves ❑ No Dnvers License No. Ezpires:
Verification ol Owners�ip by (rypa ol document, i.e. � properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cehity that no eacevetion five (5) or more feet in tlepth Into which e Oerson is requiretl to tlescend, will be mede in connectlon with work euthodzed by Ihis
permit, and Ihet no building sWcture, scaHolding, lalsework, or demollllon or dismantling thereof, will be more Ihen thirty-six (38) faet �igh. (Chep. 3.2, Gry 2, An 2, Sec.
341, Tille B, Calilomia Adminislrative Cotle).
� As owneo-bullder, I will not employ enyone to tlo work which would requlre a permil Irom the Division of Industrial Safery, as noted above, unless such pereon hes e
permit to tlo such wark Imm tha division.
Signa�uro: Date:
Divislon ol Intlusinel Sefery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AllTHORQATON OF ENTHV: I cenily under penalry of per�ury that I have reatl this applica�ion antl state Ihat 1he inlormation given is
correct I egrae to compty wit� eA sUte laws and ciry artlinances relating to building construction, end euthonza represeniatives ot t�e Ciry ol Costa Mesa to emer upon �he
abave-describetl pmperty tor inspegtiqn puryoses, l egcee not to ocapy or allow occupency of any builtlinq au�horized by this pertnit umil final inspection.
COOE 1, INSVEC710NTYPE
1618 Fixetl System Final Fire Prevention
1286 Paol Spe Flnal
200 Flnal Ro-Rool
201 Finel BIocWReteinin8 Well
202 Final Fectory Fire Place
203 Finul Sign
204 Final Domolitlon
peg �bq £pp�� iNsvernoNrrve
206 Finel Mechanical
208 Final Plumbing
210 Finel Eleciricel
212 Flnel Flre Prevenilon
220 Flnal Planning Appro�al
222 Final Site
250 Final Building/Occupency
i • • � �T,,-
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL Status: ISSUED
Suite: 300 Applied: 05/072007
Viciniry: MAERSK Issued: 05/17/2007
Parcel Nunmber:
41050110
Zoning:
Applicane DOFNER, DANNY � - �,,,„ -..,�:, - -,
% �..:�'- - . - - --� . �
ISSUED BY:
Address: 2505MIRAMARAV, -'��!-� ;'�_ _ � ,__ - - ; � �
� i;�'"� r ' Phone: 562-498�6444 , , _ �._A
LONG BEACH, CA-:� ' _ �' Zip: � 90815 � � j ' � � �? ,�
„ . � / . , . ' , �
, � • - - . � �- � � '
ownec RREEF� r � � � ` _- - �� ��� ����� �
i / %, -- - - �- '-� / . \
Address PO BOX 4900�, � � -:- _
j �DEPT207 '�, r , , . - -Phone � . � � �i � � A����
� \ � �
' . i jSCOTTSDALE, AZ � -,- ' Zip: 85261-4900 � � ' � A`, .- `,
��/ � V ��`//% �� � � ,_ �� �� � ����
Contrador. '�ACKERMAN �MAGGEY � � � %� � \���
. �, <�
' Address - �' ;' `� �`�Q� V�
� /%.%/ ��,�� ���J�
, � :�, �) • ��.� Phone:f` �' ��� � � ����
. ' '%i„ �.�. , � . � V /`',' ',� `,
, ' ,"y",' ; License: 327198 ' ,--� " - ��..���� �''.-- �� � � -�
. -- _ - -- " � A ��. , t
- � �, � �` ��_�;.SCOPE OF PERMIT � •- , � -
'. FIRE SUPPRESSION:BERMIT TO RECOCATE AND INSTALL 2�SMOKE DETECTORS, 16 STROBES�.AND 2
: DUAL SYNCHRONIZATION FOR 18,064 S.F. INTERIOR TENANT IMPROVEMENT FOR "MAERSK" IN�� `�
'SUITE300.;;-, ' - � '- �''� � "�
:�, _ �� � \v��' � � ,
, REF#:808-01243 � " � -
� „ � ��� , . �-
� Plan Check: $45.01
Permif: $69.25
, A Other $0.00
� Total: ��• . $114.26
" � / �/ �` ��,�FEE SUMMARY , `• .;�' V�� �
., ' : _ l`'�', - , `l .' "' . . . . :��" Calc Valuation: '
� • � � Claimed Valuation; ;
,'" . A�n � �
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_ __ ___�.... _'-
. , �;� �� __ f„r
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s2,000.00./
s2 000 00 ;
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— "- --��. .�.,— -:,-, _,iic '/
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 7241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspentled 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 ail
requlred inapectlona and finel approval must be obtained. Fallure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
244&4fi (fJW)
WORKERS' COMPENSATION DECLARATION: �
I hareby aRrm under penalry of perjury one of tha tollowing deGarations:
❑ I have entl will maintain a certiticate of consent to sell-Insure for workers' wmpensetion, es provitled for by sectlon 3700 of the Lebor Code, tor the pertortnance of the
work tor which iMs permit Is issued.
❑-1 have entl will maintain workers' compensatlon insurance, es requiretl by sectlon 3700 of Ihe Lahor Code, fw Ihe pertortnance ot the work tor which Ihis pertnit Is issued.
�,My workers' compensatlon Insurance carrier entl poliry number are: �� 3y�o a�
Cartier:� R� v� bLi r I N L�iE ✓�'� N fT�/ Policy Numher.
(Thls secfion need not be canpleted l(!he permit is velued one huntlred ddlars (5100) or less.)
❑ I cenity Ihat in the perfortnence af t�e work far whic is permit is IssueA, I shell not employ arry person in any manner so as to become subjact to Ihe workers' �
compensetion lews ot Celilomia, e that If ould hecama subl�� �o the workere' wmpensatlan provisions oi Sectlon 700 oi t Lebor Code, I shall forthwit�
comply with Ihe i
AVpplicent SigneWre: - - �Date:� � 6 �
WARNING:FAILURETOSECUREWOfiKERS'COMPEo SATIONCOVERAGEISUNLAWFULANDSHALLSU&IECTANEMPLOVERTOCRIMINALP ALTIE ANDCIVILFlNESUPTOONEHUNDRED
TlIOUSPND OOLLARE (5100,000�, IN ADDRION TO TH(GOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECf10N 3]OB OF THE UBOR CODE, INTEREST, AND ATTORNE`fS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby.attirmJhat I am li sed untler rovisions of Cha 9(commencing with Section 7000) of Dlvlsion 3 of Ihe Business and Professions Code, and my license is in full
torf�.e�antl BNed. lic. M `�a� i� g �CI~e� q L' - 1 O - lo
-_--- , , -� !- �7 0 7
.Contrector's Signature: � Dele:-- >
� �
CONSTRUCTION LENDING AGENCV:
❑ I hereby aMirm that there is a canstruction lending agency tor the pertormance of Ihe work for whic� this permit Is issuetl. (Sec. 3097, Civil Code).
Lendels Name:
Signeture: _
OWNER-BUILDER DECLAFiAT10NS:
Lenders Address:
Dete:
I hereby ettirm ihat untler penalty ol per�ury Ihal I am E%EMPT FROM THE CONTRACTORS LICENSE LAW ior the tollowing reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires e permit �o construct, alter, improve, tlemolish, or reDalr eny sWcture, pnor �o its issuance, elso requlres ihe apDlicant for such permit
b file a signetl stetement t0at he or she Is licensetl pursuant to the proWsions of the Cantrectors License Lew (Chepter 9(cammendng vnth Seclion 7000) of Division 3 of [he
Business antl Professions Cotle) or ihat he or she is e:empt t�erefrom entl the besls br ihe elleqed exempiion. Any violatlon of Sectlon 7031.5 6y any applicant for e pertnit
suD�ects the epplicant to a civil penalty of not more then five hun�retl dollers ($500).):
❑ I, as owner oi Ihe propeny, or my employees wlth wages es thelr sole compensation, WILL DO TME WORK, end Ihe structure Is not intended or oHered for sale (Sec.
7044, Busine55 end Prof855ion5 Code: The ConireclOrS Llcen58 Lew does nOt epply to en owner of properry who builds or improves thereon, and who does such work
himsetl or hersetl or Ihrough his or her own employees, providetl that such Improvemenis ere not Intended or oHereO for sale. II, howevar, Ihe builtling or improvement I5
sold within one year of completion, ihe owner-builder will heve ihe hurden ol proving that �e or s�e tliA not builtl or improve for purpose ot saleJ. '
❑ I, as owner of the property, em E%CLUSIVELV CONTHACTING WITH LICENSED CONTRALTORS to construct the pro�ect (Sec. 7044, Business end Professions
Code: The coniraaors License Law tloes nof epply to en owner oi properry who builds or Improves t�ereon, and who coniracts tor suc� proJect with e contraqor(s)
license pursuant to ihe Contrectors License Lews.).
❑ I am exempt untler sec.
Signa�ure:
Owner ID verified by dnvers license. ❑ Ves ❑ No
Business and Professlons Code tor Ihis reeson:
Verification of Ownership hy (type of document, i.e. - propeny tax �III or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Driver's License No.
Daie:
Expires:
❑ I hereby certity Ihet no excavetlon flve (5) or more feet In depih into which e person Is required to descend, wlll be metle In connectlon with work eutharized by Ihis
permit, entl that no builtling sWdure, scaHoltling, falsework, or tlemolition or tlismantling t�ereoi, will be more than ihirty-sia (38) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, 7tle 8, Celifomia Administretive Cotle).
❑ As owner-builder, I will not employ enyone to do work which would require e permit irom the DIvl5lon of Industriel Sefety, es notetl abova, unless such person hes e
pertnit to tlo such work trom ihe division.
Signature: Date:
Division of Industnal Satery Pertnit Number:
CERTIFlCATE OF COMPLUWCE AND AUTHORVATION OF ENTRY: I cenity under penalry ot perjury that I heve read t�is application end steta that ihe iniortnation given is
correct. I agree to comply with ell stete laws entl dry ordinances relaqng to bullding construction, end euthorize representetives ol Ihe Ciry ot Costa Mesa ro enter upon ihe
ebove-descnbed proDerry for inspection purposes. I egree not lo occupy or ellow occupanty of eny building euthorized by t�is permit until fnal inspactian.
LO�E I, MSPECTION TYPE ' �Qd¢. �$
1616 Fixed System Flnal Fire Preventlon
7268
200
201
202
203
Pool Spa Final
Final RaRoot
Final Black/Retaining Well
Final Fectory Flre Place
Finel Sign �
204 Final Demolition
COUE I INSPECfION T'PE
206 Final Mechanical
20B Flnal Plumbing
270 Final Electricel
212 Final Fire Preventlon
220 Flnal Plenning Approvel
222 Flnal Site
250 Final BulltlingiOccupency
➢AIE U�
• b'1 (�y�
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.cos[a-mesa�C��TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Swte No 300
Vicinily: MAERSK
Parcel Nunmber: 41050110
Applicant: LAMB, SCOTT
Address: 1975 1/2 N BATAVIA ST
Owner:
Address
Contraitor
Address:
Phone:-714-998-6580
ORANGE, CA - � . . �- Zip . 92865 - -
RREEF ,
PO BOX 4900 � - " � '
DEPT207�� ` � ' �
.SCOTTSDACE,AZ�� '
IRONWOOD ELECTRIC INC
1975 1/2 N:BATAVIA ST
� , �� ,
Phone:
Zip: 85261-4900
. Phone: 714-998-6580
ORANGE, CA Zip: 92865
- ', _ License: 6� 7971 .
'
Status: ISSUED
Applied: 04l18/2007
Issued: 04/18/2007
ISSUED B
/ �.
" :� �
, ,
� � � � � • �. - �
SCOPE OF PERMIT :
�'� ECECTRICAL PERMIT FOR A 18,064 S.F. INTERIOR TENANT IMPROVEMENT FOR �- '.
- "MAERSK"+IN SUITE 300. �
_ -. .REF#:606-01243 � � � �
r
� � WORK TO'.INCLUDE: 41 LIGHT FIXTS; 5 OUTLETS; 6 SWITCHES AND 6,FEEDS.
. _ i " , i . 1 . �. �,. �.
A
FEE SUMMARY'- ;_; '
� � � ' � Quantiry - � Quantity
ISSUE FEE � $23.50 - ' - .. -� Temp Dist System') Lighting , � $0.00 0 . .
, Tempservicetesl $0.00 � - -.--- ---..- ' -Busway/100,fl 'n: . = • �- • $0.00 0 � �
Res. a/c package� , " $0.00 �' � - � � � �Standing Section - -� --� $0.00 0 : ,
New�Res (1-2 units) � $0.00 � 0 Misc Electrical Equipment $1820 1�. �
New Res (3+units) , $0.00 0 Transformers�up to 1 kva/kw �,$0.00 0
Pool/Spa . � ��� �� $0.00 � I 0 ........'.._...uptol0kva/kw $0.00 -0�� - ��
Lighting FiMs, ' -' � `� $37.33 41 .................up to 50 kva/kw � $0.00 .� 0 �
Recept Outlel's - ; �`.; ; $5.50 � � 5 '�� _:... .::...........up to 100 kva/kw $0.00 ; '� 0 , .
Switches � ��,1 ,,', $6.60 � 6 ;t. :� �-; �,� � ......: :.:.......over 100 kva/kw $0.00 �� � - 0 �
Non Res Appl c�. $0.00 ' 0 Low Voltage Equipmenl $0.00 �`. 0
Res Appl. � � l �1' $0.00 . 0 � :� � - . ' Low Volt Wiririg System / Ckt � $0.00' � 0 '
Service to 200a - -$0 00. ;t �: �-�.0- � _; � � � � � , Misa Conduib - , "�'k =' $0 00' 0
Service to 1000a, � � _ $0.00,'��„ -- .0' � - Misa Conductor � � $0.00 . 0 �
Service over 1000a, -�,�/ � $0.00: . ;��., 0� . �. � Circus ( gen,or ride) , � $0.00. - 0 ' ,
Motors to 1 hp � , _ � � �/ '$0.00 � �, �-`� OS " , Circus (mech ride or, lights) $0.00; , 0 ,
Motors to 10hp � , , � $0.00.:� � �.0_"` � " Christmas Trea Stand �. � �$0.00 0 �
Motorsto50hp �=A �"'$0.00: - - 0"�� ' � FireworksStand � � " :�$OAO�� -0 '
Motors to t00hp ' � � g0.00 ; . , 0-, - �., Other Electrical Fee � � �. $0.00 � . . �
Motors over 100hp �`� � �$0.00 �." � , -0� , ' , , � . �� � �. �'� - -
Communicationdrops ���$0.00 ,��,0'�;,� � � �InvestigationFee. ` .$0.00"-"
Sub panel to 200a $0.00; � , 0' : . � i , � Plan Check Fee�. �� � � � $0.00
Pole Light Pkg $0.00 . . 0 - . - , �, Reinspedion Fee _ - -$0.00
SignCircuits $0.00 ._ -0-�.__- � -
Temp Pwr Pole $O.OD 0� ;-� - TOTAL CALCULATED FEES � 591.13
Intermed Pole $0.00 0 - � � �_ .� ��
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califor�and�related
regulations. (Ord. No. 92-26, § 1, 12-21-92)
EXPIRATION: 'This permit shall automatically expire and become void if work is not commenced within 1LB.O=ys; oi'it work is suspended or abandoned
for. a period of-1 BO�daya :
INSPECTIONS: In order for Ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codas, and all
�required Inspeetions and final approval must be obtained. Failure to obtain inspections and tinal approval will result in tha ezpiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626
zaas�ae ld�)
WORKERS' COMPENSATION DECLARATION:
I hereby eHirtn under penelry of perjury one of Ihe following tleclarations:
❑ I heve end will meintain a certificete of consent to salt-Insure for workers' compensetion, es providetl for by sedion 3700 of Ihe Labor Code, for the peAortnance of ihe
work for w�ich this permit is issuetl.
❑_,I have and will meintaln workers' compensetion insurance, es requiretl by section 3700 of the Lahor Code, for ihe peAortnance oF ihe work for which ihis pertnit is issuetl.
f��My workers' compensetlon Insurance carrler antl policy number are:
J
Cam`er. i re-rerr<e� t'�'^p�oy<�'S �nS C� PolicyNumber: �''�KN/32�%sSl
�(T6is section need not be campleretl i/ the permit is va/ueC ef one huntlred dollars ($f00) or less.)
❑ I certity that in the peAormance oi ihe work Por which this Oertni� is issueq I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Celifornie, and egree Ihat if I shoultl �ecome sub�act to tha workers' compensatlon provislons of Section 3700 of the Labor Cotle, I shall forthwith
comply with Ihese pr vislons. j - o
Applican��SignaNre: ��~�""=-^�' `pg( � �%-�&-U7
CWARNIN(3 FNLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAW FUL AND SW1LL SUBIECT AN EMPIOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO dJE HUNDRED
TFKKISAND DOLLARE (5100,000�, IN ADDITIdJ TO THE C0.5T OF CO�.IPENSATION, DAANGES AS PROVIDED FOR M SECTIpJ 3%OB OF THE UBOR CODE, INTEPEST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I herehy aHirm that I am Iicansad under provlsions of Chapter 9(commencing with Section 7000) ot Dlvislon 3 of the Business antl Professions Code, entl my license is In full
force end ettecc Lia a �7 f .,�ss'a C/ U
Contractor's�Slgnature: �c�1— Date:.-i V—��-07
CONSTRUCTION LENDING AGENCV:
❑ I hereby aflirtn ihat there is e construc�ion lending egency for Ihe peAormance of the work for which this pertnit is issuetl. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby attirtn thet under penalry of perjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor t�e following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or counry which requires e permit to consiruct, elter, improve, demolish, or repair any structure, prior to its issuance, also requires the epplicant tor such pertnit
to file e signad stetement ihet he or she Is Ilcensetl pursuent to ihe provislons oi ihe Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the
Business end Professions Code) or Ihat he or she is ezempt ihereirom end ihe basis for �he allegetl eaemption. Any violetion of Section 7031.5 by eny epplicant for e pertnit
subjects Ihe epplicant to e civll penalry of not more than five hundred dollers ($500).):
❑ I, es owner oi ihe property, or my employees with wages as their sole compensation, WILL DO TliE WORK, and the strudure is not intended or oHeretl for sale (Sec.
7044, Business and Professions Cotla: The Contractors License Law tloes not apply to an owner of proparry who builds or improves thereon, end who does suc� work
himsalf or herselt or through his or her own employees, providetl Ihat such Improvemenis are not Intended or oHered tor sale. If, however, ihe building or improvement is
sold within one year ot completion, ihe owner-builtler will �ave ihe burden of proving Ihat he or she did not build or improve for purpose of sale.). '
❑ I, as owner of the properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions
Code: The contredors LJcense Law tloes not apply to en owner oi property who �ulltls or improves thereon, and who conirects for such project with e contractor(s)
license pursuant to t�e Comractors License Laws.).
❑ I am exempt under sec.
SigneNre:
Owner ID verified by dnver's licanse. ❑ Yes ❑ No
Business and Professions Code tor Ihis reeson:
Verificetion ot Ownership by (rype of dwument, i.e. - proparry tax hill or deed):
Driver's License No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify ihat no ezcavation five (5) or more teet In depih into which a person is requiretl to descend, wlll be made in connectlon with work authonzed by Ihis
permit, end ihat no building strucwre, scaHoltling, talsework, or demolition or dismantling thereof, will be mora than thirry-six (36) feet high. (Chep. 32, Gry 2, An 2, Sec.
341, 71t1e e, Califomla Adminisirative Gode).
❑ As owner-builtler, I will not employ anyone to do work which would require a permit irom the Division of Industriel Sefery, as nated above, unless such person has a
pertnit to do such work irom �ha division.
Signature: Date:
Division of Intlustrial Safery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUfHORIZATION OF ENTRV: I cartity under penalry of perjury lhat I have read this applicetion end state thet the InFormation given is
correct. I agree to comply with all state laws entl ciry ordinences releting to builtling construction, and euthorize representetives of the City of Costa Mesa to enter upon ihe
above-described property tor inspection purpases. I agree not to occupy or allow occupency af any building authorizetl by Ihis pertnit until finel inspectian.
S�/ n Signature Of Legal Owner(s)
('C� r
COOE t. INSPECTIONTYPE
1618 Flzed Sys�em Finel Fire Prevention
1266 Pool Spa Finel
200 Finel Re-Roof
201 Finel BIocWRetalning Well
202 Finel Factory Fire Place
203 Flnel Sign
204 Flnal Demolition
pag, �C� yQpF�( INSPEC710NTYPE
206 Finel Mechanical
208 Flnel Plumbing
270 Final Eledricel
212 Finel Fire Preventlon
220 Finel Planninq Approval
222 Finel Site
250 Final Building/Occupenq
PAIE U�Lfl
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 555 ANTON BL
Suite No 300
Vicinity: SUITE 300 MAERSK
Parcel Number: 41050110
Applicant: ANDERSON, JOHN
Address: 1000 E HOWELL AVE
STE B
ANAHEIM,CA- �
Owner:
Address:
Contractor.
Address:
RREEF
PO BOX 4900 -
DEPT 207 " , �
SCOTTSDALE,AZ " �
HVAC MECHANICAL WC
1000 E HOWELL AVE
STE B
ANAHEIM, CA
MECHANICAL PERMIT
Phone; 714-937-5305
ZiP:�.. 92805 .
Phone:
Zip: 85261-4900
Phone: 714-937-5305
. Zip: � 92605
• � � License: 682002 ' �
Status: ISSUED
Applied: OS/02/2007
Issued: 05/02/2007
ISSUED BY:
SCOPE OF PERMIT �
� 18,064 S.F. INTERIOR TENANT IMPROVEMENT FOR "MAERSIf' IN SUITE 300. � �
REF: BO6-01243 � - � -� � . ' � � � ' �
2 VAV BOXES
FEE SUMMARY
. . , � ' � �uanlity , . � � � , � Quantity
ISSUEFEE 523.50� - RepairlAltAbsorbtionUnit 50.00 0
Inst FAU <100 k BTU $0.00 0 Repair / Alt Refrigeration Unit $0.00 0
Inst FAU >100 k BTU $0.00 0 Ventillation System $0.00 0
Repair / Alt Cooling/Heal $0.00 0 � " . ,- � � . �Evaporetive Cooler - � 50.00 0
Instl Rep. Recess Wall Hir $0.00 .0 �' --� � Commercial Incinerator -� 50.00 0
Refrig Sys <100 k BTU $0.00 0 - -� Domeslic Incinerator ' $0.00 0
Re(rig Sys >100 k BTU 30.00 0 ComDressors / Absomlion Svstems '
Gas Piping $0.00 0 Up to 3 hp / 100 k BTU �. $0.00 0
Factory.Fireplace ' � $0.00 0 3To 15 hp / 500 k BTU '�� �$0.00 0
Hood w/Mech Exliaust � $0.00 0 15 To 30 hp % 1,000 k BTU ,, $0.00 0
VAV Box � $21.30 2 - ;=. 30 To 50 hp / 1,750 k BTU ' " ' $0.00 0
Vent Fan / Single Duct $0.00 0 -''���� � � Over 50 hp / Over 1,750 BTU � - '�_$0.00 0�
r:'. �:
Appliance ; '�� ` $0.00 0 � i? . - Boilers �- ," -
Fire Dampers ' �` � 30.00 0 � Up to 3 hp :..; ,.. , .� $0.00 0
Smoke Dampers � �� . $0.00= ' 0�' � � ,� � - 3 To 75 hp�� <�_ �f'; � �'=. �' $0.00 0
Inst or Reloca[e Appl Vent � �� ,$0.00 0- , � 15 to 30 hp ' � � � , � $0.00 0
Air Handlers < 10000cfm','i ' $0.00`� 0"� � '� 30 to 50 hp �- ' ' S0.00 0
Air Handlers > 70000cfm " � � � �. $0.00 � 0 r� ' " � � Over 50 hp ' ', � " � � - , , ' . � . $0.00 0
Floor Fumace - �$0.00 0: ' � Other Mechanical Fee � �
Floor or Suspend Heater,�, � $0.00 0 � � . � � � . .Investigation.Fee � �� 30.00
� ; � ; , �� � � - . _ - Plan Check Fee ` '� ` � , $0.00
� i
\ ` � . , � -� .. Reinspeclion Fee •- , 50.00
� - - � ,� � � TOTAL CALCUCATED PEES E44.90
`- COMMENTS / SPECIAL CONDITIONS J
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlona and final approval must be obtained. Failure to obtain Inspections and final epproval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545628
2448-48 (flNO)
WORKERS'COMP�NSAnON DECLAiiATON:
I hereby eflirm under penelry ot per�ury one of ihe lollowing declaratlans:
❑ I heve end will melntain e certilicate of consent to sell-Insure tor workers' campensetion, es provided for by sectlon 3700 0l iha Lebor Cade, for Ihe pedortnance of the
L work for which thls pertnit is Issued.
I❑1. I heve end wlll mainteln workers' compensflUon InSurance, es requiretl Dy sectlon 3700 oi Vie Le6or Catle, tor ihe performence of ihe work for which this permit Is Issued.
� My workers' wmpensetyl nInsurence cartler end pollq number ere:
c„�er-� /��1-< ?-�-•^ PolicyNum�er (7YL — W J� S��
(Thls secHon need nof be comp�eted I/ the pe�mlNs ve�ued et one nundred douen (St00) or �ess.)
❑ I certity Ihet in Ihe peAortnance ol the work tor whlch thLq pertnit la IuueO, I shall not employ eny person In any manner so es to hewme sub�ecl to Ihe workers'
compensation laws af Calitomla, end epree Ihdt If I ahoultl become sublect to Ihe woBers' compensetlan proWsions of Sectlon 3700 0l Ihe Lebor CaCe, I shell forthwit�
comDly with thase provisio�
'ApplicentSlBneture: � �Dete:? r�Jy/o7
WARNINO: F�ILURE TO SECURE PENSATION COVEfUOE IS UNLAWFUL AND SMALL SUBIECT Ml EMPLOVER TO CRIMINAL PENALTIES uJD CML FlNES UP TO ONE HUNDRED
T/%%1SVID DOLLARE R100,OOOA w��� T� THE COST OF COMPENSATION, DAAl4GE5 �S PRO`/IDED FOR IN SECfION 37080F TME UBOR CODE, INfERE5T, AND ATTORNEYS FEES.
LICENSED CONTRACTOflS DECLARATION:
1 hereEy eHtrcn Mfltl em ilcen$ed under proNslons ot Chapter B(commendnp wiN Sectlon 7000) of Divhslon 3 of the Buslness end Professlons Code, end my license is tn (ull
force end elfecf. Lia�p /i��-d UY C� lase a Gi-�
Contrector'sSigneWre� LDate: ' �^
0
CONSTRUC710N LENDINO AOENCY:
❑ I �ereby eHirtn that there is e consWctlon lending epen�y tor the peAortnance ol Ihe work for which Ihls permlt is Issued. (Sec. 3097, CNiI Cade).
Lentlele Neme: Lender's Atltlress:
Signelure: . Dete:
OWNER+BUILOEH pECLARATIONS:
I hereby eXirtn t�at under penely at per�ury that I em EXEMPT FROM TNE CONTAAC70HS LICENSE LAW lor the tollowinB reeson (Sec. 7031.5, Businass enC Professlau
Code: Any ciy or coUnry which requires e permit to consiruct, elter, Improve, demolish, or repeir eny structure, prlor �o its issuance, elso requires tha epplicent for such pertnit
Io flle e aigned eteler�enl Uat �e or she b Iicensetl pursuflnt to the provisions o1 the Contractora License Lew (Chapter 8(cammendrg with SecUon 7000) O1 DMsion 3 0l the
Business end Professlwu Code) w t�at he or she Is exempt Neretrom entl Ihe besls tor the elleped exemptlon. Any Wdation oi Seclion 7031.5 by any epplicant for e pertnit
su6�ecta the epplicaqt ta e civil penalry of not more Ihen Me hundretl ddlers (5500).):
❑ I, es owner at the O�oPertY� ar my employees wilh wepes es lheir sde campensetion, W ILL DO 7XE WORK, and the structure Is not interMed or ottered for sale (Sec.
76A4, Busines9 entl Prolessions CoCe: The Contrflctors Llcense Lew tloes not eppy to en owner of property who 6uilds ar improves Ihereon, and w�o tloes such work
himselt or hersetl or ihrough his w her own empioyees, provitled thet such imprwements ere not Intendetl or oflered tor sale. II, havever, the 6uilding or improvement is
soltl witNn one yepr ot completion, Ihe owner-builder will heve ihe burtlen oi proving thet he or she tlitl not builtl ar impmve tor purpose of sale J. •
❑ I, a5 ownar ol the property, em E%CLUSIVELY CONTFiACTING WRH LICENSED CONTRACTORS lo construct lhe prol� (Sec. 7044. Busin¢S.y end Professions
Code: The contrectors License Law does no[ flppy to en owner ot Droperty who builds or Improves t�ereon, and who coniracts tor such prqect wiih a contrector(s)
Iicense pursuant to Ne Contrectors License Lews.).
❑ I am exempt untler sec.
Signature:
Owner ID verilietl Dy drNefs Iicensa. ❑ Ves ❑ No
Busin855 end Professions Code for thls reeson:
Vedflcation ot Ownership 6y (type of document, I.e. - properry tar DIII or tleetl):
Drlvefs Llcense Na.
Date:
Expires:
DIVISION OF INDUS7RIAL SAFETY PERMR CERTFICATON:
� 1 �ereby certlty t�et no exravatlan tNe (5) or more feet in dept� into whlch e person is requireC to tlescenq will be mede In conneclion vrith work aut�o�IzeC Dy lhis
permlt, antl t�4� no building sifucture, scafidtlinp, felsevrork, a Cemdition or dismentling Ihereoi, wlll he more Ihen thirty-sIM (36) tee� high. (Chep. 3.2, Grp 2, M 2, Sec.
341, Title 8, C911fomle AdminlsiraWe Coda).
❑ As owner-builder, 1 will not employ enyone to Eo work which woultl require e permit Irom Ihe Divlslon ol Industrial Salery, es notetl ebove, unless euch parson has e
permll to do such work Irom Ihe tlMsion.
SignaWre: Date:
Dlvision ot Indusldal Salery Permit NumDer.
CEHTIFlCATE OF COMPLIANCE AND AUTHOR¢ATON OF EMRY: I certily under penelty of perjury ihet I have read this application antl state that the Infortnation given is
wrrect I egrea to comply with ell stete laws end dry ordinences relating lo bulltllnp conslructlon, entl euthodze representetives ol the Ciry oi Cos1a Mese to enter upon the
ebove-describetl properly lor Inspection Duryoses. I aprea not to oaupy or allow occupanq of eny building eut�orized by Ihis permi� until finel Inspection.
COUE �"
7816
1286
200
201
202
203
Signature Of Lepfll Owner(s)
AnNOcAuthoAzetl Apdicenl- -�
Fi:ed Systam Final Fire Prevenlion
Pool Spe Final
Finel Ra-Rop�
Finel Block/Reteining Well
Final Feciqry Fire Plece
Flnel Sign
Final Demqlitlon
Pd7E
J�$ �a INSPECTIONTVPE
208 Flnel MeChenlcel
208 Flnel Plumbinp
210 Flnel Elecidcal
212
220
222
250
Flnel Fire Preventlon
Finel Planning Approvel
Final Sl�e
Finel Bullding/Oaupency
C� �5 •oi �
�
(774) 754-5273 • Fax (714) 754-4856 • waw.ci.coste-mesa.BUILDING PERMIT � �� FAIR DRIVE, COSTA MESA, CA 92626
Jobnddress: 555 ANTON BL
Suite: 3
Vicinity: 3RD FLOOR
Parcel Number: 41050110
Applicant: SMITH,DON
Address:
Owner: SAKIOKA FARMS
Address
Zoning;
Phone: 714-438-2272
Zip:
Phone:
Zip: 94137
Contracror. HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE
Phone: Q74) 438-2272
COSTA MESA,CA
Zip: 92626 License: 445804
Arch : LPA INC Eng:
Address: 17848 SKY PARK CIR Address:
Status: ISSUED
Applied: OSI77I2001
Issued: O6I29/2007
ISSUEDBY: C/4�`
Phone: (949) 261-1001 ' Phone:
IRVINE, CA
Zip: 92674 License: License:
SCOPE OF PERMIT
13,520 SQ fT INTERIOR OFFICE T.I. FOR "MAERSK SEALAND" (3RD FLOOR).
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$1, 312.06
$2,018.55
$0.00
$59.34
�0.00
$0.00
$3,389.95
�
SETBACKS �,
MAIN STRUCTURE� Front 0- 0
ACCESSORY Front 0. 0
PARKING ExiStinq: 0
NOTES:
Rear 0-0
Rear 0. 0
Required: 0
FEESUMMARY
Calc Valuation:
Claim Valuation
PLANNING & ZONING
� �' �
LeR 0- 0 '� Right '= 0- 0'
LeR 0- 0 , Right 0- 0
Proposed: 0 , . , ,
5282,568.00
8270,400.00
� //
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes/and related
regulations. (Ord. No. 9248, § 1, 12-21-92) ,�
EXPIRATION: This permit shall automatically expire and become void if work is not commencad wlthin 180 days, or il work is suspended or abandoned
for a penod of 180 days. �
INSPECTIONS: In order tor ihe work aulhonzed under this permit to be considered legal, such work must comply with all applieable codes, and ell
requlred Inapectlona and Iinel epproval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of lhis permit.
/
FOR INSPECTIONS CALL: (714) 7545626 ' /
zaaaae (aroo) �
I
WORKERS' COMPENSATION OECLARATION: .
I hereby eflirm under penalry of perjury one of the IWlowing deGaretions: `-
❑ I heve entl will malmaln e cenificate at wnsem lo sell-Insure lor workers' campensetlan, as provided lor by section 3700 of the Lebor CaCe, tor 1he pertortnance oi the
WOAc tOf whiCh this pertnit is Issued.
���I have e will maintaln wwkers' pensatlon insurence, es required by section 3700 ot Ihe Lebor Cotle, for t�e peAortnance ot Ne work lor whkh Vus pertnit is Lswetl.
M w rs' cwn nsation ins flnce car/rig_r an� i numDer ere:
Certler:Y .Q�Y1�• �i77➢I//�. 1� �% PdicyNumber. OOD�/JO�
(Tlds sectlon need not be cc�n etetl i!!he pe t!s veluetl'et one hund doll ($700) or less.)
❑ I certily lhat in the perlormance ot tl
compensatlon lews ol Calitomia,
Cwnply with �hase '
ApPlMari(Signeture: 1
WARNIN(i:FNLUFETOSECURE RS'�
T/ql1SAND DOLLARE (S10p.000 N AODfTION
LICENSED CONTRACTORS DECLARA
I here6y eHl� that I am Ilcensetl der
force Bntl,ettBct..Lic.�M �_�y�
lar �s erm i ed, I sliell not employ eny person In eny manner so es to become subl� �o Ihe workers'
t 1 h tl 6 sub�eci Io Ihe xrorkere' compensation provi5ions oi Settlon 3700 of Ihe Lebor Cotle, I s�el� fOrthwith
_ .... ��Date:� (O Zy�d�
MGE IS UMAWFUL M'D SMALL SUBJECT AN EMPLOYER TO CFUMIWIL PENALTIES AND pVIL FlNES UP TO ONE NUNDRED
USf PENSATIIXJ, DAMAGES /S PHWIDED FOP IN SECTION 3/08 OF TME LABOR CODE, IMEFE5T, AND ATfORNEY'S FEES.
wlth Sactlon 7000) of Divlsion 3 oi I�e Buslness §jid Prolessions Code, entl my Ilcensa Is in full
CONSTRUCTION LENUING AGENLY: —
❑ I here�y ettirtn that thare is a consiructlon lentlinp agenry lor Ihe peAormence ot the work for which ihis Dermit is issued. (Sec. 3097, Civil Cotle).
londer9 Neme: Lentler's Address:
Signeture:
Date:
OWNER•BUILDER DECLARATONS:
I hereby effirtn Ihet under penalry of per�ury Net I am EXEMP7 FROM TME COMAACTORS LICENSE LAW lor the tollowing reason (Sec. 7037.5, Business end Professions
COEe: My ciry or wunry which requires e permit to construct, elter, improve, tlemdlsh, or repair any strucWre, pnor to iLv issuance, also requires the appliwnt for such pertnit
b file a signed statement �het he or she fs Iicensed pursuant ro the O��slons of the Contreqors Licensa Lew (Chepter 8(commencing with Sectlan 7000) of D'Msion 3 of t�e
Business end Professions Cotle) or thet �e or sha is e:empt Uerefrom end Ihe besis tar the elleged exemption. Any vidation oi Section 7031.5 Gy any applicant Iw e pertNt
subjecis Ihe epplicent to a Gvil penalry of not more then live hundred dollars (5500).):
❑ I, as owner at t�e properry. or my employees with wages as Iheir sole compensaqon, WILL DO THE WORK, anC ihe siructure Is not Inlendetl or otteratl tor sale (Sec.
7046, Busineu and Professions Code: The Contrectors tJcense Lew does rwt eppty ta an owner of properry who builds or improves Ihereon, end who does such work
himselt or hersetl or through his ar her own employees, prodtletl that such improvements ere not intended or oflared tor sele. If, however, the bulltling or improvemeni is
sold within one year ot completion, iha owner-builGer will heve the burden of proving Ihat he or sha did not build or improve for purpose oi sale.j.
� I, es owner oi ihe properry, am EXCLUSIVELY CONTRAL7ING WRH IICENSED CONTRACTORS to canstruct the prolect (Sec. 7044, Business antl Professlons
Code: The contradors License Lew does not appty lo en owner ol Droperty w�o bullds or Improves Ihereon, antl who contracts tor such prqecl with a contracror(s)
license pursuant to the Contradors License Lews.).
❑ I em exempt under sec. Business antl Pmfessians Code lor this reason:
Signature: Date:
Owner ID veritied by dnvers license. ❑ Ves ❑ No Drivers License No.
Vedllcatlon at Ownership by (rype of document, i.e. - properry tex bill or deed):
Ezpires:
DIVISION OF INDUSTFIAL SAFETV PERMR CERTIFICATON:
❑ I hereby certity thet no excavation frve (5) or more leet In depth Into which e person Is requiretl to descentl, will be matle in connectlon with work euthorized by t�ls
perml�, antl thet no 6uilding structure, scaHddinp, lalsework, or demdltlon or dismentling thereot, wlll be more than thirry-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Titla B, Califomla AGmlNsiretive Code).
❑ As owner-bullder, I will not employ anyone b do work which woultl requlre a permit trom the Division of Intlustnal Satery, es noted e6ove, unless such person hes e
permlt to do such work irom Ihe division.
Slgne�ura: Date:
Divislon of Industrlel Salery Permit Number:
CERTIFlCATE OF COMPLIANCE AN ORQA710N OF 1�t I certify under penalry ol perjury that I �ave reatl this application end stata Ihat the inlortnation given Is
cortect. I agree to compty with te IaJrs enC dry o ances relating to building constructlon, anC autnodze reD�esentauves of tha Ciry of Costa Mesa ro enter upon the
above-descnbed propeM �a� � Pectionyurpqv6j. I e e not toyEcupy or ellow accupanty of eny builCing authorizetl by this permit until tinel inspec6on.
COOE I, INSPECTIONTYPE
1818 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Rool
201 Finel BIocWReteining Wall
202 Finel Fectory Fire Place
203
204
Flnel Sign
Finnl Domolltion
I,HifCRi
cooer ixsrecTroNTrre
208 Finel Methenitel
20B Finel Plumbing
210 Finel Elot�rlCel
212 Flnel Fire Prevention
220
222
250
�-z�`-n/
�� Date `
Final Plenning Approval
Finel Site
Final Building/Occupancy
PAg UII��LS
,
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 555 ANTON BL
Suite No 3
Vicinity: 3RD FLOOR ,
Parcel Nunmber: 47050110
Applicant: SMITH,DON
Address:
Owner: SAKIOKA FARMS
Address
PLUMBING PERMIT
Phone: 714-438-2272
Zip:
Phone:
Zip: 94737
Contractor: HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE
COSTA MESA, CA
Arch / Eng :
Address:
Phone: (714) 438-2272
Zip: 92626
License: 445804
Phone:
- Zip:
� License:
Status: ISSUED
Applied: O6/28/2001
I ssued: 06/29I2001
ISSUED BY: V �
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "MAERSK SEALAND" (3RD FLOOR), INSTALL �
. 1 DISHWASHER, 1 KITCHEN SINK, 8 1 WATER HEATER. ' � �
, , �_i ,
REF: B01-00717 � � . ' '
� �.. �
�-A
ISSUE FEE , A��
Backflow irrigation
BackFlow Preventer
Bathtub
Clarifier System
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Root
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 ouilets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
FEE SUMMARY
C, AMT ,' ; QTY'�'� �, . , '� � , . AMT. , aTY .' i � . ,%�' � % .
$23.50 i, : ; _ � ��Laundry Tub / Washer , $0.00 0-= . / � Sump Pump';
i ,
� $0:00 � 0 � � Landscape Irrigation $0.00 � 0 ! �" , �Swimming Pool'�� �
$0.00 0 � P-Trap $0.00 0 .Trap Primer � � �
$0.00 0 � Pressure Regulator $0.00 .. 0 � � Urinal � �
50.00 0 Process Piping (per 10 ft) $0.00 .0 � ' Vacuum Brkr Bkflow(1-4)
$0.00 0 • Receptors $0.00 0� Vacuum Brkr Bkflow(5+)
$0.00 � 0 Septic Tank $0.00 - 0 ,�. � Wash Basin
$9.80 1� ; Sewer Cap for Demo $0.00 0., Wash Basin Set
50.00 0 Sewer Connect $0.00 0� Waste and Vent System
$0.00 0 Sewer Private Line 50.00 0 Water Closet (Toilet)
50.00 0 Shower $0.00 0 Water Heater / vent
$0.00 0 Sink, bar $0.00 0 Water Piping (Insl or Rep.)
50.00 0 Sink, commercial $0.00 0 Water Re-pipe
$0.00 0 Sink, Floor $0.00 0 Water Service
$0.00 0 Sink, kitchen $9.80 1 Water Softener
$0.00 0 Sink, service/mop $0.00 0 OTHER
$0.00 0 Spa (private) $0.00 0 VIOLATION
$0.00 0 Spa (public) $0.00 0 PLAN CHECK
50.00 0 REINSPECTION
$0.00 0 ' ' ` ' ,
TOTAL CALCULATED
NOTICE: The work authorized by this permit sl�����'��b���i�i��SrnquiremeNs under
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or it H
for a period ot 180 days.
INSPECTIONS: In order for Ihe work authonzed under this permit to be considered legal, such work must comply w
requlred Inspeetione and final approval must be obtained. Failure to obtain inspections and final approval vnll result in
FOR INSPECTIONS CALL: (714) 7545626 //�
�
AMT
S0.00
$0.00
50.00
$0.00
$0.00
$0.00
50.00
50.00
50.00
50.00
512.30
i0.00
50.00
50.00
$0.00
$0.00
50.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
statutes and related
suspended orabandoned
ith all applicable codes, and all
the expiration of ihis permit.
WORKERS'COMPENSAnON DECLARAnON: �
I hereDy eHirm untler penelry o1 perjury one at Ihe tWlowing dedarations:
❑ I have and will maintein e ceNticala ol consent to setl-Insure for workers' compensatlon, es provitled br Dy secUon 3700 of the Lebor Code, tor tha pertormence of Ihe
work tor which this pertnit is IssuoO.
mainteln workers'
Certier. �{Rl+'�9TTe
(This seclion need rrot be
❑ I certify lhat In tha F
compensation laws
comply with ihese {
TO
UCENSEDCOHTRACTORS
I hereby aKrm Ihe� I em Iicene
forceanC�eNecL'.Ck:a� �
i, es require0 by settlm 3700 oi Ihe LeGor CoCe, lor NB poAormenco 01 tho work br whlGi Nis pertNl is IssueE.
number ere:
Policy Number. �%QI�U/� %l% 7
orless.)
is IssueA, I shall not employ flny person in eny mennor so es lo become subject to ihe warkars'
ne sub�ect to t�e workers' compensatlon provislons of Sectlon 3700 at t�e Labor Code, I shall forthwith
�,� __� oa,a-a G—ys—oi
ISATION COVERAQE IS UNLAWFUL AND SHr1Ll SUBJECT AN EMPIAYER TO CRIMINAL PENALTIE$ AND GVII FINES UP TO ONE HUNORED
COST OF COf.1PEN$ATIIXJ, DAMAGES PS PRONDED FOR IN SECTION 31O80F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
wilh Sectlon 7000) of DNLsion
Prafessions Cotle, entl my licensa is N full
Fi -%5' ro/
CONSTRUCTION LENDING AGENCV: 6/
❑ I hereby attirtn that there is a construction lending agency for ihe pedormance ot ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle).
LenOer'b Neme: �BnAels Atltlress:
Signeture:
Data:
OWNER-BUILDER DECLARATIONS:
I �ereby eNirtn thet under penelry of per�ury lhet I em EXEMPT FROM 7ME CON7RACTORS LICENSE LAW lor the tdlowing reeson (Sec. 7031.5, Busineu entl Professlons
Cotle: My ciry or counry which requires e permit to construct, elter, improve, demolis�, or repair eny strucWre, O�o� �o Its issuence, elw raqulres the epplicam tor such pormlt
to lile e sipnetl stetement t�at he or she Is IlcenseC pursuent lo Ihe provislons of the Contrectors License Lew (Chepter 8(cammendng wlth Sectlon 7000) of DMslon 3 01 Ihe
Busineu and Protessions Cotlej or Ihat he or she Lv exempt therelrom end the basis tor Ihe elloged exempllon. Any vidation ol Section 7037.5 by any epplkent for e pertnit
sub�ects Ihe eppllcant lo e cMl penalry of not more than tWe hundred dollers (5500).):
❑ I, es or.ner of Ne property, or my employees vrith wages es Iheir sole compensatlon, WILL DO THE WORK, end t�a structure is nat ImentleC or oHered tor sala (Sac.
70a4, Business an0 Professions Code: Tlie Contractors License Lew tloes not epply to an owner of properry who build5 or Imprwes thereon, and who tloes such work
himsetl or herselt or through his or her ov.•n employees, provided that such imprwemencs ere not intended or otlered tor sale. II, however, the building or improvement is
sold within one yeer of completion, t�e owner-builder will have the burden oi proNng Ihat he or sha did not build or improve tor purpose ot sele.).
❑ I, ag owner of t�e property, em E%CLUSIVELY CONTRACTINO WITFf LICENSED CONTRACTORS to con5truct the pro�ect (Sec. 7044, Business antl Prola55ions
Cotle: 7he contrectors Llcense Lew tloes not epplY to en owner of pmpeny who bullds or Impwves thereon, end who contrects tor such project wit� a wntractoqs)
license pursuant to ihe Contractors License Lews.).
❑ I em exempt under sec.
Slgnature:
Owner ID verilied 6y driver'a Ilcense. � Ve9
Vedticetlon of OwnerShip by (lype ol documenl, l.e.
Business en0 Professlons Code tor this reason:
❑ No Drivere Litense No.
properry tex bill or deetl):
Date:
E:pires:
DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATION:
❑ I hereby cenity Uat no escevetlon tNe (5) or more faet in dapih Into which e person is requlred ta descend, will be mede in connection with work euthorized by t�ls
permit, and Ihat no building siructure, xaHolding, falsework, or tlemolition or dismenlling thereot, will ba more ihan Nirty-sL� (36) leet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title B, Califomia Atlminislretive Cotle).
❑ As owner-builtler, I will not employ anyone to do work whlch would require a permil Irwn the Division ol Industrial Selery, as noted ebove, unless such person has e
pertnit to do such work irom the divlsion.
Signature: Date:
DlNslon ol lndustrial Sefery Pormlt Number.
CERTIFlCA7E OF COMPLI AN AUTHORVA710 E V: I cenity unOer penelry of perjury ihat I have reetl t�is epplication antl s�ate �ha� the infartnetlon given is
correct. I egree to comply h ell s e I end ci Ninanc relating to bulltling construc�lan, end euthonza representellves of lhe City of Costa Mesa to enter upon t�e
ebove-descnbed D�aOe ar in50 tlo es egree n o occupy or ellow occupency oi any building authorized by this permit until linal Inspection.
CODE I, INSVECTONTYPE
7816 FixeC System Final Fire Prevenllon
7286 Pool Spe Final
200 Final Ra-Root
201 Flnal Block/Relaining Well
202 Final Fectory Fire Placo
203 Final Sign
20a Final Demolition
�g �j � INSGECTIONiYPE
206 Finel Mechenical
20B Finel Plumbing
210 Finel Elecirital
212
220
Final Fire Praven0on
Final Planning Appmval
222 Final Site
250 Final Building/Occupanry
PAg Itii�15
F�- I -C� ( � )1 V
(714) 754-5273 • Fax (774) 754-4856 • www.ci.coste-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: SSS ANTON BL
Suite No 3
Vicinity: 3RD FLOOR
Parcel Number: 41050110
Applicanr. SMITH,DON
Address:
Owner: SAKIOKA FARMS
Address:
MECHANICAL PERMIT
Phone: 774-438-2272
Zip:
Phone:
Zip: 94137
Contractor: HOWARD BUILDING CORPORATION
Address: 3184 AIRWAY AVE
COSTA MESA, CA
Phone: (774)438-2272
Zip: 92626
LiGense: 445804
Status: ISSUED
Applied: O6/28/2001
Issued: O6/29/2001
ISSUED BY: � ��
SCOPE OF PERMIT
ELECTRICAL PERMIT FOR INTERIOR OFFICE T.I. FOR "MAERSK SEALAND" (3RD FLOOR).
INSTALL 1 FAU, 7 REGRIGERATION SYSTEM, 1 VAV BOX, 8 2 SMOKE DAMPERS.
REF:BOi-00717 . �
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heal �
Inst / Rep. Recess Wall Hir
Refrig Sys <700 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box .�� ; !/
Vent Fan / Single Duct,-, � �
Appliance ' �
Fire Dampers ,
Smoke Dampers
Inst or Reiocate Appl Vent
Air Handlers < 10000cfm
Air Handlers > 10000cfm
Floor Furnace
Floor or Suspend Heater
Quantiry
$23.50
$14.80 1
$0.00 0
y0.00 0
$0.00 0
814.80 7
$0.00 0
$0.00 0 .
� $0.00 � 0 '.
$0.00 0
�-�510.65�V,"-
' $0.00 0 �;� ��,
� ' S0.00- 0 �- � �
$0.00 0 �
514.50 2
50.00 0
$0.00 0
30.00 0
50.00 0
50.00 0
FEE SUMMARY
i' -
Repair / AII Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System �
Evaporative Cooler .
Commerciallncinerator ,
Domestic Incinerator -
Compiessors / Absorption Svstems �
Upto3hp/100kBTU,_ , �
3 To 15 hp / 500 k'BTU ' ,
15 To 30 hp / 7,000 k BTU ;�, �
30 To 50 hp / 1,750 k BTU, � '
Over 50 hp / Over 1,750 BTU '/"� �
:i
Boilers- - � � , .
Upto3hp
3To15hp, � � � -
i5to30hp � '
30 to 50 hp � � .
Over 50 hp � . - . - "
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
. ,
Quantiry
$0.00 0
$0.00 0
50:00 0
$0.00 0 �
�0.00 0 !
50.00 0 '
$0.00 0
$0.00 0
50.00 0
, 50.00 0
/ $0.00 0
� $0.00 0
$0.00 0
$0.00 0
50.00 0
So.Oo 0
50.00
$0.00
50.00
578.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California
regulations. (Ord. No. 9248, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 180 days, or if work is susj
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all app
required Inspeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpirai
FOR INSPECTIONS CALL: (714) 7545626 , �
zaere �eroa�
✓
tutes and related
fed or abandoned
�le codes, and all
of this permit.
WORKERS' COMPENSATON DECLARATION: �
I �ereby aHirm under penalry of perJury one of t�e IOIIaMng declere�ions:
� 1 heve enC will melntein e ceritlicete of consent lo sell-Insure tor workers' compensatlon, es provided for by section 3700 0l the LeDor Code, lor ihe peAormence ol the
�.woM tor hic� lhis pertnit 15155uetl.
a
�.0�1 have a wGl memtan workers' pensetion i urence. as requ'uetl by secilon 3700 af tha Lebor Cotla, for Ne perfortnarwe o1 Ure wwk for wAich this pertnit Is IsweG.
� My wo rs' com,r,�/�''Q'llon Ins�u er dof,d/'a,v numEer are:
Cartier. I�AI�O'�i,J�9'1N / n"���//i i Poliry Number. (,�D ��%� 7
(ihfs seclion need not Ee ed ll Ure 't ls velued efp(B hundr dql/ais ($100) w IessJ
� Ia
Appllcan[ Signeture:
WARNING: FAILURE'TI
LICENSEDCONTRACTORS
work
IN FDDITION TO TME
9t is od, I shall not employ eny pereon In eny manner sa es ta become suD�oct to the workers'
ub�ect to Ihe workers' compensetlon provisions o1 Sectlon 3700 of Ihe Labor Cotle, I shall forthwith
_ Date:_ �O �lr—t�L_
IS UMAWFUL AND SHALL SUBJECi,AN.EMPLOVER TO CPoMINAL PENALTIES rWD GVIL FINES UP TO ONE MUNDRED
1TION, DMl4GES AS PROVIDE� F-0R IN SECfIIXJ 31080F THE LABOR CODE, INTEPEST, AND ATTOqNEY'S FEES.
I hereby aNirm that I em Iicensed undor oNsi ol Cha r 9(co en with Snction 7000) of Dlvislon 3 of Ihe.Business aj� Prolessions Code, entl my Ilcense is In full
force end etteGrLlc r�� � Class A� G
� ` � �� / —z9—o
Cont�torjSigneture: +' .0..�_7 .�..+� Da� : \
_ C� �.
CONS7AUCTON LENDING AGENCY:
❑ I hereDy aMlrm Net there is e wnstruction lending agency tor the peAartnence ot tha work for which Ihis permit is issuetl. (Sec. 3097, Civil Code).
Lenders Neme:
Signeture: _
OWNER-BUILDER DECLARATIONS:
LBnAefs Atltlress:
Date:
I hereby aNirm thet untler penfllry of per�ury ihat I em EXEMPT FROM THE CONTfiACTORS LICENSE LAW far the follawing reason (Sec. 7031.5, Business entl Professlons
Catle: My ciry or cwnry which requires e permit to construct, elter, Improve, tlamallsh, or repeir eny structure, pdor to Its issuance, alsa requires the eDD���ant for such permit
lo Ne e siBnetl stetement t�et he or ahe Is Ilcensed pursuant lo ihe provisions of Ihe Gonirectors LJcense Lew (Chapter B(commendng with Section 7000) ol DhAsion 3 of the
Business end Pmfesslons Cotle) or thet �e or she is exempt therefrom enA the besis for tha allogotl exemptlon. Any vbletbn of Sectlon 7031.5 by eny epplicent lor e pertnit
sub�ects [he ep0�lcam ta e clvll penelry of not more than flve �untlred tlWlars ($500).):
❑ I, es owner ol t�e property, or my employees wlth wages es lheir sole compensatlon, WILL DO TME WORK, end Ihe structure is nol imentletl or oNeretl tor sale (Sac.
7044, Business end ProleSSions Code: The Contractors License Lew tloes not apply to an owner of DroDeny who Duilds or impwves Ihereon, and who does such work
himself or hersell or through his or har own employess, provided ihat such improvemenls ere not Iniendetl or oHereC tor sale. It, however, ihe bullding or improvement Is
sold within one year at completion, ihe owneo-6uiltler will have the burden of proving that he ar she did not 6uild or improve for purpose oi sale.).
❑ I, es owner ol the properry, em EXCLUSIVELV CONTRACTING WRH LICENSED LONTRACTORS to construct tha praject (Sec. 7044, Business end Prolessions
Cotle: 7he conlrectom Llcense Lew does not epply to en owner ot propeny who bullds or ImOrwes Ihereon, entl who contracts for such project wlth e comractor(s)
license pursuant to ihe Contrecbrs Llcense LawsJ.
❑ I em exempt untler sec.
Signature:
Owner ID verifled Dy tlrivers Ilcense. ❑ Ves ❑ No
Business entl Pmfesslons Cotle tor thls reason:
Veri9cetion oi Ownership by (type ol daument, i.e. � praperty tax bill or tlee0):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICA710N:
Ddvers Licensa No.
Date:
Ezpir89:
❑ 1 hereby certily Net no exCevetlon tNe (5) or more teet in depth inro which e person Is required to Cescand, will be made In connection with work euihorized by this
permlt, entl ttiet rw building siructure, scaflolding, tel9ework, or tlemWition or Olsmantling thereol, wlll be more Ihen thirty-siz (36) feet hiph. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle B, Gelifomla Atlministretive Catle).
❑ As awner-builder, I will not amploy enyone to tlo work which would require e pertnit irwn Ihe Division ol Industrial Satery, es noted above, unless suc� person hes a
permit to do such work trom the divisian.
Signature: Date:
Division of Intlustnal Safery Permit Numbor:
CERTIFlCATE OF COMPLIANCE AND A RIZATION OF ENTRV: I rtiy under penalry ot perjury that I have reatl this application and state that the information given is
conect. 1 egree to compty with ell s laws anC ciry ardinance ating to 6uilding cnnsiructlon, entl authorize representatives of t�e Clry of Costa Mesa to enter upon the
ebove-tlescribed property tor in ction purpose�gree n accupy or allow occupency ot eny building euthodzed by t�is permit until final inspection.
GOOE /. INSVECTIONTYPE
1616 Fi:ed System Flnal Fire Preventlan
7266 Pool SDe Final
200 Finel Re-Roof
201 Final BIocWReteining Well
202 Final Factory Fire Place
203
20d
Finai Sign
Final DemollUon
�. mi
Dat
l'O �z � -:��
--� oa�a
COpE1 INSPECTIONTYPE Q�jf. �
20fi Final Mechanical
208
210
212
220
Final PlumDing
Flnal Elactdcal
Finel Fire Preventlon
Finel Planning Approval
222 Finel Sita
250 Final Bullding/Occupenty
(714) 754-5273 • Fa�c (714) 754-0856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicani:
Address:
Owner:
Address
555 ANTON BL
3
3RD FLOOR
41050110
FULFORD,TERRY
SAKIOKA FARMS
Contractoc O'BRYANT ELECTRIC
Address: 8749 SHIRLEY AV
ISSUE FEE
Temp service test
Res. a/c package
New Res (7-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts ���
Recept Outlets � � �
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1hp
Motors to 10hp
Motors to SOhp
Motors to 100hp
Motors over 700hp
Communication drops
Sub panel to 200a
Pale Light Pkg
Si9n Circuits
Temp Pwr Pole
Intermed Pole
NORTHRIDGE, CA
Phone: 818-540-5884
Zip:
Phone:
Zip: 94137
Phone: (818)407-1986
Zip: 91324
License: 386619
Status: ISSUED
Applied: 06/28/2001
Issued: O6/29/2001
ISSUED BY: �
� SCOPE OF PERMIT .
ELECTRICAL PERMiT FOR INTERIOR OFFICE T.1. FOR "MAERSK SEALAND" (3RD FLOOR). INSTALL
103 LIGHT FIXTURES, 74 RECEPTACLE OUTLETS, 31 SWITCHES, & 42 LOW VOLTAGE WIRING
SYSTEMS. � �
REF:B07-00717
�uantiry
523.50
50.00 -
$0.00
50.00 0
$0.00 0
$0.00 0
; $60.69 ,� � - �73 -
� �' $67.99, '83:�
� . $32.22 � - 34; r_ : -
50.00 0
50.00 0'
$0.00 0-
$0.00 0
$0.00 . p
$0.00 '� ' �� 0 � -
$12.30 ' 1 :.. '
50.00 0 �-� .
$0.00 0
30.00 0
537.52 44
$0.00 0
50.00 0
50.00 0
$0.00 0
50.00 0
FEE SUMMARY
- - Quantiry', .
_- Temp Dist System / Lighting $0.00 ; 0� �
� 8usway /100 ft $0.00 � 0
Standing Section. $0.00' - , 0
Misc Electrical Equipment $0.00� � 0 ^
Transformers up to t,kva/kw -' $0.00 0 '
................up to 10 kva/kw <, $0.00 , 0
.....__....._.upto50kva/kw �':$0.00-,�,0 ,...
.................up to 100 kva/kw- � � $0.00 %0 � ; �
� ..............:...over 100.kva/kw � $0.00 � � 0 '. - !
Low Voltage Equipment -� :,�$0.00 -' .0 � "
Low Voll Wiring System / Ckt �, 50.00 � 0 �"
Misc. Conduit . � �. $97.00 . 5
Misa Conductor ,50.00 - � 0
Cirws ( gen or ride) �� ,� $0.00 0
�.' Circus (mech ride or lights) -' .�-50.00 0
Christmas Tree Stand ' - $0.00 0
- Fireworks Stand - $0.00 0
Other Electrical Fee $0.00
Investigation Fee 50.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES 5325.22
COMMENTS I SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is sus�
for a period of 180 days. /
related
orabandoned
INSPECTIONS: In order tor ihe work authorized under this parmit to be considered legal, such work must comply with all epplicable codes, and all
required Inspectione and final approval must be obtained. Failure to obtain inspections and final approval will result in ih �z�ration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zsas-ae(dool , /
WORKERS' COMVENSATION DECLARATON: '
I hBrBDy aHirtn under ponelty ol perjury one of t�e following dedaretions: �
� I have end will mainteln e ceNOcate ot consent to setl-Insure for workers' wmpensatlm, es prodded lor by section 3700 0l the Lebor Cotle, lor the peAarmence o1 the
'j� xrork tor w�ich this permit is Issued.
'�'� ��•�ve end witl malnWin workors' compensation insurence, es requiretl by sectbn 3700 01 Ne Lebor Codo, for Ne pe�tortnance ol Ne vrork for whlch Nis portnit Is IsweC.
��My workero' compensetlon Insurenca carrler and pdiq number era:
Cartler: PWicy Number.
(7his setlion need not be comple(etl !! the permit is ve/ued et ane hundred ddlers (5100) a less.)
❑ I certify tliat in Ue peAortnance Ihe work for w' Ihis pertnit is iSsueA, I shell not employ eny person In eny manner so as to became sub�ect to the workers'
compensation laws ot Celif entl egree lk - should become sub�ect ro 1he workers' compensatlon proWslons ot Sectlon 3700y t the Leh�y Coae, I shall torthwith
comPN with ihese provi ' . � � _ /^ij /� /
ApPlicent Sipneture: "7 Date: F� � L� !�
WARNING: FAIWRE TO SECURE WORNERS' COMPEN fJl COVERAGE IS UNLAW FUL AND SHr1LL SUBIECT AN EMPLOYER TO CRIMINN. PENAL�IES AND CIJIL FINES UP TO IXJE HUNDRED
hKKISANDDOLLARE(5100.000),INADDITIIXJTOTHE OFCOMPENSATION,OAMAGESASPR.7JIDEDFORINSECL10N31080FiHEUBORCODE,IMEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLAHATION:
I hereby atfrtn Ihat I em Ilcensed under proNsions ot Chapier 9(comj�encing with Section 7000) ol Dlvislon 3 ot the Business end Professions Cotle. entl my license Is in full
force and ettect Uc. a � ��,il/% (% Class a �' '-'� a
Cantractofs Signeture: � � �.� Date: i
CONSTRUC710N LENDING AGENCY:
❑ I hereby emrtn that there is a constructlon lentling agency tor the pertortnance of ihe work br which Ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentlers Name: Lentlefs Atltlress:
Signature:
OWNER-BUILDER DECLARA710NS:
Date:
I hereby ettirm thet under penelry of per�ury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the tdlowirg reeson (Sec. 7037.5, Business entl Professlons
Code: My dry or counry which roQuires e permillo construct, elter, improve, tlemdish, or repair eny strucWre, pdor to Its isswnce, elso requires the eppliceN tor such partnit
lo lile e signed atetement ihet he or she Is Iicensed pursuent to ihe praNsions of the Contrectora lJcense Lew (Chepter 9(commendng with Sectlon 7000) ol DMslon 3 ot t�e
Business antl Pmfesslons Code) or thet he or she is e:empt theralrom end ihe Desis Por Ue elleged exemptian. Any viWellon of Sectian 7031.5 by eny epplicent for e pertnit
subjects the epplicant to a civll penelry ol not mare t�en live hundreC dollars ($500).):
❑ I, es owner oi Ihe properry, or my employees with wages es t�elr sole compensetlon, WILL DO THE WORK, end Iha siructure is not intentletl or oHeretl tor sele (Sec.
76M14, Business anA Professions Code: The Coniractors License Lew does not epply to en owner ol property who builds or improves Ihareon, and who does such work
himself or herself or through his or her own employees, provided ihat such imprwements are not IntenOetl or oHeretl tor sale. II, however, Iha building or improvement is
sold within one yeer o� completion, the owner-builder will heve lhe burden of provinp ihal he or she tlitl not build or improve tor purpose oi sale.).
❑ I, as owner oi Ihe property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to canstruct Ihe project (Sec. 7044, Business entl Profe55ions
Cotle: The cantwctors License Lew tloes not flpply to en owner of properry who bullds or Improves thereon, end who contracis tor such prolect with a conirector(s)
license pursuent to the Contredors License Laws.).
❑ I am exempt under sec. Business entl Pmlessions Coae tor this reeson:
SlgnaWre: Da�e:
Owner ID verifietl by drivers license. � Yos ❑ No Drivers License No.
VedllcaUon of Ownership Dy (rype ol documenL I.e. - property tex bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTFlCATON:
❑ 1 hereDy ceNty Ihat no excavetion Iive (5) or more teet in depth into which a person is required to tlescend, will be made in connection wiih work euthoAzetl Dy Uis
pertnit, end Ihat no building siructure, scafloltlinp, falsework, or demolition ar dismentlinp thereol, will De more Uen ihlrry-s�c (36)leet hig�. (Chap. 32, Grp 2, M 2, Sec.
341, Title 8, Califamie Administrative CaAe).
❑ As owner-builtler, I will not employ anyone to do work which would require e pertnit irwn the Divislon ol Industrial Safery. as noted ebove, unless such persan hes a
permit ro do sucti work iran the divislon.
SignaNra: Date:
Dlvision o1lnAustrial Selery Permit Number:
ICERTIFlCATE OF COMPLIANCE ANU AUTHOR6A710N OF ENfAY: I certify under penalry ol perjury that I �ave reatl this epplication antl state Ihet �he Infortnetion given is I
canect. I egree to wmpty wlth all state laws entl ciry ordinances relating lo builtling canstructlon, entl eut�orize representatives oi the Ciry ot Costa Meu to enter upon t�e
ebovedescnDed prapertY br InspectiqqDurposes. I agree not to occupy or allow occupenry ol eny builCing euthodzed bylhis permit until tinal inspection.
COpE1, INSVECTIONTYPE(�
1616 Fi:ed System Finel Fire Prevention
7266 Pool Spa Finel
200 Flnel Re-Roof
201 Finel BIocWReteining Wall
202 Final Feciory Fire Place
203 Final Sign
20a �Final Demolition
ceie u�e4s
COOE� INSPECTIONTYPE
206 Final Mechanical
208 Flnel Plumbing
210 Finel Electrical
212 Final Flre Preventlon
220 Finel Planninp Approvel
222 Final Site
250 Final Builtling/Occupanry
Pdg It�ki
(714) 754-5273 • Faz (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
�obAddress: 555 ANTON BL Status: ISSUED
Suite No 3 Applied: 07123/2001
Vicinily: 3RD FLOOR Issued: 07123/2001
Parcel Nunmber:
41050110
npp�iwnt: ARTHUR, SCOTf
nddresx , " , _
/ ��%
,
i�_�;
�,_, ;
� �i.
i ' ��
� /: ��
- . �.. . -
Owner. �AKIOKA FARMS �
� �
�
Address ` ��� ,' � � " -
�� �
i
� i .� .
contracror. ' E A TAGER COMPANY
Address: 2602 SOUTH OAK STREET
� .
. SANTA ANA„CA/."„
�
G : ,�
: , i >� ., ., .
�� �
Phone: 714-434-8989
/
Zip:
J
Phone:
Zip: 94137
., Phone: 714-434-8989
� Zip: 92707 . , . �
License: 754501
ISSUED BY: �
\
� � � •.�
�.
>�
� � .`.
��� �' .A
. � �
. ,
�
�.
� �, .
�� ,. . � . �. • , ��
, - , �,
� .
SCOPE OF PERMIT
REF: 80�-00777.�TENANT IMPROVEMENT�FOR�"MAERSK SEALAND". 91,OUTLETS FOR MODULAR �
FURNITURE STATIONS. - �-" - � � • - � � � � . �
� � � �FEESUMMARY � � �
Quantiry - - - � �,��, � Quantiry .=
ISSUE FEE 523.50 Temp Dist,System I Lighting $0.00 0'� � .,
Temp service test 50.00 Busway A 00 R .$0.00 0 � �
Res. a/c package 50.00 Standing Section 50.00 0
New Res (7-2 units) 50.00 0 Misc EleclriCal Equipment $0.00 0
New Res (3+units) 50.00 0 .: �Transformers up to 1 kva/kw $0.00 0�� � �
Pool! Spa � 50.00 0 .' � ................up to 10 kvalkw $0.00 0 ,
Li9htin9 Fixts 50.00 0 .................up to�50 kvalkw 50.00 � 0 .
Recept Outlets 573.83 , 91 .................up to 100 kvalkw 50.00 0
Switches � � ' - � 50.00 � - 0 � ..................over 100 kvalkw � $0.00 0 � .
Non Res Appl ��, 50.00 .. 0 . Low Voltage Equipment E0.00 0 - '
Res Appl � , ' � 50.00� � 0 Low Volt Wiring System / Ckt 50.00 . 0
Service to 200a � � 50.00 �0�� Misa Conduit �$0.00 0 ' �
Service to 1000a � �. 50.00 �. 0, � . �� Misa Conductor $0.00 0 �
Service over 1000a � 50.00 0 Circus ( gen or ride) �� 50.00 �0
i
Motors to 1hp � 50.00 � 0` Cirws (mech ride or lights) .$0.00 ' 0�
Motors to t Ohp , 50.00 � - 0� Christmas Tree Stand $0.00 � 0
Motors to 50hp �SD.00 0 Fireworks Sland -$D.00 %� 0
Morors to 100hp 50.00 0 Other Electrical Fee � 50.00
Motors over 700hp 50.00 . 0 � �
Communication drops 50.00 � 0 , Investigation Fee -�- $0.00
Sub panel ro 200a 50.00 0� � �Plan Check Fee E48.67
Pole Light Pkg 50.00 0 . Reinspection Fea $0.00
Sign Circuits 50.00 0
Temp Pwr Pole 50.00 0 TOTAL CALCULATED FEES E146.00
Intermed Pole 50.00 0
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorizad by this permit shall wmply with all applicable handicap access requirements under Calitomia 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 epplicable codas, and all
requlred Inapectlons and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5828
xenaee �eroo�
WORKERS' COMPENSATION DECLARATION: •
I here6y eHimi under penalry o1 per�ury one of ihe lallowing dederellons: •
I � ve enA witl maintein a ceNllcete ai consent lo sell-Insure br workers' compensatlon, es provided far by sedlon 3700 W Ihe Lebor Code, for the peAortnence ol the
ork tor whiU this pertnit is IssueO.
1 h9vB &W wlll m�IaIdlrl AcB 9� WQI�BIK Ilp� 11ISU�flnq . �ByW�Bd by SBCtI0f13700 W thB LBbW COdB. 10� th9 PBAOrtnB�B 01 thB �Wfk IOf Whkh MI9 PBlrtlit 19156UBd.
My workers' mr(pe e lo In urence cerr 3r entl polic�l nu ber are: � '� ��v�
Cenier: Poli Num6er:
(Thls sec0on need not be complered I! fM1e pertnlf �q valueC ef are undred�00J or IessJ
❑ I cartity Net in t�e pedortnance ol ih o i this pertnit I s�ell not employ eny persan In eny mennor ao as lo be �me subJect ro the workere'
compensation lewa of C ornls, ee a I s ul me sub�ec tha workare' compensetlon provlslons ot Sectlon 370 of the l.eb Code, I shell forthwlih
comply wlth these sl � O
Applicent Signature: Dete:
WARNINO: FAILURE T RE WORI qTIdJ COVERAGE IS UMAWFUL AND SMALL SUBJECT Ml EMPLOVER TO CRIA9NAL PENALTIES M1D GML NES UP TO ONE MUNDRED
THOUSAND DOIURE (f100.000), IN MDRION TO TNE CpST OF COMPENSATON, DHMGES AS PHOVIDEO FOF IN SECiION 3%OB OF TME IABOR WOE.INTEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATON:
1 here6y aHirtn that I em
force entl ettect. Lic. N_
Conlrectols Signature:
CONSTRUCTON LENDING AGENCY:
with Sectirn 7000) of DMsion 3 ot the Buslness and Pratessions Cotle, antl my Iicense is In lull
Cless k ��
Date:
❑ I hereby ettirtn ihat there Is e wnstructlon lendlnp egancy for ihe pedormence ot the wark for which this pertnit Is issued. (Sec. 3097, Clvil Code).
Lendefs Name: Lentlera Atltlress:
Signeture:
Dete:
OWNEH-BUILDER DECLARATIONS:
I hereby etflim that under penelry of per�ury t�at I em EICEMPT FROM THE CONTRAC70R3 LICENSE LAW far the tWlowing reason (Sec. 7031.5, 8uslness entl Professions
Cotle: Arry dry or counry whic� requlres e pertnit to conswct, elter, Improve, tlemdls�, or re0air any struMure, pdor to Its Issuance, elso requlres 1he appllrant br auc� pertnit
to flla e signetl stetement Net ha or she Is Ilcensetl pursuent to Ihe provisions of the Contractors Llcensa Lew (Chepter e(commendng wlih Secllon 7000) oi Dlvision 3 of Ihe
Business eiW Protessions Cotle) or lhet ha or she Is exempt Neretrom entl Ne besis tw Ihe elleged exemptlon. My vldatlon of Section 7031.5 by eny applkent tor e pertM:
sub�ecta �he epplicent to a dNl penalry o1 not mor0 �han five hundred ddlars (5500).):
❑ I, as axner of Ne properry, or my employ0e9 wllh wages as Iheir sole mmpensatlon, WILL 00 THE WORK, an0 Ihe struclure is not inientletl or oHereC for sele (Sec,
76M14, Business end Profasslons Cada: Tha Gontractors License Lew does not appty to en owner ot properry who builds or imprwes thareon, end who tloes such work
hlmseM or herself w through his or her own employees, Provided that such ImD«ements ere not intended or oNereO for sele. If, however, the building or improvement is
sold wiihin one year o1 wmpletion, the ov.•ngr-builder will have tha burden ol proving t�at he or she diA not �uiltl or improve for puryose oi sale.).
Q I, es owner of tha properry, am E7CCLUSIVELY CON7HACi1NG WITH LICENSEO COHTRAC70HS to consiruct the projecl (Sec. 7044, Business and Professions
Cotle: The conlwctoB License Lew does not eppty ro en owner of properry who 6uilCs or Improves thereon, end who wntrects tor such pro�ect wtlh e contreclor(s)
license purevant to Iha Coniractors License Lewa�.
❑ I em exempt untler sec. Buslness and Protessions Code tor this reason:
SlgnaNre: Date:
Owner ID verified by CrNefs Iicense. ❑ Ves � No Drlvere Ucense No. Expires:
Vedticellan ai Ownership Dy (type of dacument, 1.9. - properry taa hlll or deed):
DIVISION OF INDUSTRIAL SAFETY VERMIT CQpTIFICA710N:
� I hereby certify tfiaf no excavetlon Ilve (5) or mare leet in depih Into whicli e person is requlred to descend, wlll be matle in connecUon wlth wwk euUiorizetl by this
pertnil, end that no Duiltling sWqure, scaflolding, lalsework, or tlemolition or dlsmamling thereol, will be more then thirty-slx (38) tee� hig�. (C�ap. 32, Grp 2, Art 2, Sec.
341, Title B, Celitomia Atlminlstre�ive Code).
❑ As ov.ner-Duilder, I wlll nat employ enyone to tlo work which would require e permit from Ihe Division ol Intlusiriel Safery, es notetl above, unless such person hes e
pertnit to do such work trom ihe divislon.
Signeture: Date:
DlWsion ot Intlustnal Safery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHOR12p710N OF EMAY: I certlly under penelry ol per�ury that I have reed thb epD������ entl state t�at the Infortnation given Is
correct. I egree to wmpty witn all ste'�te� �lews end� clry o s relatlng Io builtlinp constructlon, and authadze representatives of the Ciry at Caste Mesa to eNar upan the
ebovedexdbed praperry for I�SpqMyupuryyy..a, I ee not to occupy or ellow occupancy ol eny building euthoAzetl by Ihis pertnit umil linel inspection.
GpDE /. MSFECiION T1PE Q� �
1818 Fi:ed System Final Fire Preventlan
1288 Paol Spe Final
200 Finel Re-Roof
201 Final Blxk/Retainlnp Wall
202 Flnal Factory Fire Place
203 Finfll Slgn
20M1 Final Demditbn
COOE 1 INSPECTION TYPE
206 Final Mechanlrel
208 Finel PlumEing
210 Final Electricel
212 Finel Fire Praventlon
220 Final Plenning Approvel
222 Final Sita
250 Final Builtling/Occupency
I�7.}i�I:lulLiFl
(714) �54-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
' FIRE SUPRESSION PERMIT
Job Address: S55 ANTON BL
Suite: 3
Vicinity: MAERSK SEALAND (3RD FLOOR)
Status: ISSUED
Applied: 07/1 V2001
Issued: 07/19/2007
Parcel Number: 41050110 ZOfll�9: ISSUED BY: '
- - � .i� „- _. �
Applicant: KNESPLER,JOHN �;��-!�' ��� _ - �'- _ � ��
Address: : �" � / ' ', � '� ' �
'' .,i �'�� � �`t_-\`.
� �%. � ' � Phone: 323-582-5703' ' � � '���
- � i, I � . i' ; i
% . _ ' Zip. ., � . .��
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�� � � ` ' . ��
Owner ,'SAKIOKA`FARMS ' � � ' -,�'� � �; � � .
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Address � �� - � �
.-j%�/ \ � � , �, . \��\�
� � Phone: . � 2: � % „ \\'.` \
�.
- � � �-�� .,, Zip: 94137 �::` � ;.�,�i
i
' � � ��: A'` �
'_� /,�''..i' �\.,�� � � /� �
Contractoc SCOTT�CAMPBELL COMPANY , .
_ '�'
r� Address: ;�� 02532 E'49TH ST �`,i. �� i ,.
�
� , ' . Phone: ; 323-582-5103 .. .- - - . � ��' � �� � .. ,
,' . , VERNON, CA . ' Zip: ,_ �" 90058 ��. . � .. ., ,
, ' � � -Licensei - 160206 �� .
� .. , - - ., � �..!.. .. . V, , � �,
. � �=, � �� � /� �,�'�. SCOPE OF PERMIT .-; � � � � � : �
� INSTALLATION/RELOCATION OF 29 FIRE SPRINKLER HEADS FOR A 13,520 SF OFFICE TI�FOR� ,' � �. �- _.
"MAERSK SEALAND" ON THE 3RD FLOOR. ,,� . . � ' , ' .
REF: B07-00717 � ; - �� �. . � '
� - . ' .. - _ _ . . " - � � ,
. . . � .. �t'r_ .�,� ' _� , .; , -'�,... ._. , ,
Plan Check:
Permit:
Other:
Total:
� ,
" " "' �%.
$63.21
$97.25 , .: ,_
$0.00 -
$160.46
rCt JUMMHKY'_ � ' � �
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m
Calc Valuation: ' � Sa,000.00
Claimed Valuationi $a,000.00
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: �
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia siatutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) .
EXPIRATION: This permit shall automatically ezpire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
, for a penod of 180 days. -
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
. required Inspeetlons and final approvel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
II FOR INSPECTIONS CALL: (714) 7545628
xas�as (aroo)
WORKERS'COMPENSAnON DECLAqpnON: ' ,
I hereby ettirm undar penalry af perJury one of ihe following declaratlons: .,
❑ I have end will maintaln e certifcate ot consent to selbinsure tor workers' compensetion, es provlded tor by section 3700 oi �he Lebor Cotle, for t�e peAormance of ihe
,,..,,LL work tor which this permit is Issuetl,
y/� I have and will malntain workers' canp¢nsatlon Insurence, es require0 �y section 3700 of Ihe Labor Code, for Ihe pertormance ot the vrork tw wtilch Nis pertnit is IssueC.
% My ork s' compensetion Insuren�e cerrler end policy number ere: —�n
Camer. �GM?c�� PolicyNum�ar �N`F��I�C�,�C6(
(Thls sectlon neetl nat e complefed i! Me permit Is va/uetl et one hundred dollers (5100) or less.) °
❑ I cartiy that in the e ormence of the work for which ihis permit is Issue4 I shell not employ eny person In eny manner so es to hecome su�jed to Me workers'
compansatlon law o Calif mia, end egree Ihet II I should become suDlect to t�e warkers' compensetlan proNsians ot Seeeqqqcccion 3700 of Ihe Lebor Code, I shell faMwlih
comply with these slon . � 1 I/� � T I
Applicam Signature: Date: I ��I U
WARNINO: FAILUFE TO SEC WORKERS' ppMP ATION COVEMOE IS UNLAW FUL AND SMKL SUfl1ECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP i0 ONE MUNDRED
T/qUS4NDDOl1ME(5100, ),WAWfTIONiOTHECQS70FCGMFENS4T10N,0AAKCaESASFfi041DEDFOHW$ECTION3lC140FTHElABIXiCODE,INiEAEST,ANDATIORNEI^SFEE5.
I hereDy flffrtn thet I a�
force end eflect. LJc. M,
Comrectols Signature:
DECIARATION:
ed untler provisians ol Chapter 9(commencing with Sectlon 7000) of DlNsion 3 of Ne Business entl Professlons Code, and my Iicense is in tull
Cless p
� /� Dete: �
CONSTiiUC710N LENDING AGENCY:
❑ I hereby alfrtn t�at there is e construction lending egency for Ihe perlortnance of ihe work for which Ihis pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address: �
Signature:
Deta:
OWNER-BUILDER DECLAfiAT10N5:
I heraby atFirm Nat under penalry ot per�Ury that I em EXEMPT FROM TNE CONTflACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professlons
Code: My dry ar counry which requires e pertnit to consWd, alter, improve, demolis�, or repair eny slrucNre, D�e<<o ita issuance, elso requires the appliwnt for such pertnit
to flle e signed stetement thet he or she Is Ilcensed porsuent ta the proNsions of Ne Contrecrors License Lew (Chepter B(commenGng wlth SecOon 7000) of Dlviston 3 of the
Business antl Protessions Code) or thet he or she is exempt t�eretrom end the basis lor the alleged exemption. Any Wolation of Section 7031.5 6y eny applicent for e perm�:
sub�ects the applicent to e civil penelry oi not more Ihen five hundred dollers ($500).):
❑ I, fls owner of the properry, ar my employaes with weges es their sole compensatlon, WILL DO THE WORK, and Ihe structure Is not Intentle0 or oNered lor sele (Sec.
7044, Business antl Professions Code: The Contrectors License Lew tloes not apply to an owner ol property who builds or Improves Ihereon, enC who tloes such work
himsetl ar herself or through his or her own employees, pravided t�at suc� Improvemenls ere not Intended or otlered lor sele. II, however, Ihe building o� Improvement is
soltl within one year of completion, the ownervbuilder will heve the Ourden of proving that he or she did not build or Improva tor purpose of sala.).
❑ I, as owner of the properry, em EXCLUSIVELY CONTRACTING WRH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professlons
Cotle: The contractore Llcanse Lew tloes not epply to an owner oi propeny who bullCs or Improves Ihereon, entl who contrects lar such project with a contractor(s)
license pursuant to Ihe Contredors License Lews�.
❑ I em exempt under sec. Business entl Professions Gode for Ihis reason:
Signature: Date:
Owner ID verified by drivers Ilcense. ❑ Yes ❑ Na Drivers License No. Expires:
Vedficetion oi Ownarship Dy (type of dwumenL i.e. - property tax blll or deed):
DIVISION OF INDUS7RIAL SAFETY P�RMR CERTFICATION:
❑ I hareby certify ihet no excevetlon flve (5) or more feet In depth into which e person Is required to tlescentl, will be made in connection with work authonzetl by t�ls
permiL erM that no buiMirtg structure, scaHaldirtg, felsework, ot tlemWiCron or dismantling thereot, wlll De mo�e lhan thirty-siz (36) �eet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Calitornia Adminis�ratiVe Code).
❑ As awner-builder, I will not employ anyone to tlo work w�ich would require e permit irom the Dlvision ot Industnel Setery, es noted ebove, unless such person hes e
pertnit to do such work fmm ihe divisian.
Signature: Date:
Division ot Indusirlel Sefety Permit Number:
CERTIFlCATE OF COMPLIANCE /WD AUiHOROJITON OF ENTRY: I certity under penalry of per�ury that I heve read Ihis epplicatlon entl state ihet the Iniortnetion given is
conect. I agree ro wmpty with all state laws an0 ciry oNinances relating to bullding construction, and authodze representatNes oi the Ciry at Coste Mesa to enter upon the
ebove-de�nbed property far inspection purpwes. I egree not to occupy or ellow occu0ency at any building euthonzed by Ihis pertnit until finel ins0ectlon.
COpE I, MSPEGTONTYPE
7616 Fixed System Final Fire Preven(ion
1268 Pool Spa Finel
200 Finel RaRoof
201 Finel Block/Retalning Wall
202 Finel Factory Fire Place
203 Final Sign
204 Final Demolition
•.� ,uu_.
i /
^ I� I Date
'� I
Date
CO�E I INSPELTION TYFE
206 Finel Mechanical
208 Finel Plumbing
210 Finel Eledrical
272 Finel Flre Preventlon
220 Finel Planning Approval
222 Finel Site
250 Final Building/Occupency
�� �
�nonrssaFea�ov+c: 555 ANTON BL
OWNERSNAYEIFRl04YN: SAKIOKA FARMS
�p�% PO BOX 2097
TERMINAL ANNEX
�vv�.Wuw�o,�oowEss:
urn:
3RD CITY OF COSTA MESA — BUILDING PERMIT
PEAMIT NO: E 076011 PLAN CHECK NO: N
�xcxrtecrox��n: INTERIOR DESIGN 213623218�� 9378
NCIIOXFlA.'BMDNE53: SSO S HOPE ST �M� 1100
L.A. CA 90071
cam+�cTox'Sw� MORROW MEADOWS CORPORATIO ( 714 ) 598-7700
cartn�croaewuuNc 610 REYES ST
waxEss: WALNUT • CA ucr�o.: 230813
917 8 9 urn:
UCEN9EU COHfN�CTOXS �ECLAF�TION: I Mroby elt'em uMer peiutly d pmjury Net I em liceneed uMx provieiona d Cheqx 9
(oommenu�q with Saclbn ]000) d Oivieion 3 tl Ilro Buu�was enE Pmleaebm Cada. anE mY lioerm b in tuA laro end ellea.
cmuc.No.:006558 ����% C 10 uc.No.: 2306 3 EXP: 12/96
/R- f r � "
Dtla: �� � CaNaaor:
�,�.;� NEF BUILOEN OECLANRTION: I Mrtby dl�m uMer pwuly d perjvy tAel I ezem Imm IM GoMraqon Licen�s lew Iw Me
..owip rae+on (Setlion 1031.5 Bwiaae ud Vmindms Catle: RnY cry' a mun xfikh uim e Wrtnu to odutrun. Mr. impova.
��:�'imdch. or repei eny evunure. priw ro 8e uwaMe. ebo rsawrea the epd�� � uch pe il 10 file e aipmd �Ietement Nm M or �M
� ia lioeneed Wnuent lo �M povieiona W IM Conlrapon Licenae Lew �Ghepter 9( m lp vrilh Seaion ]000) d Diveion 9 d ihe
Bueinaa enE PrWeuionv Code� or Ihtl M a ehe ie eMamq Ihsehom end tM buu s dlpeA exempion. My violeiion d 6stlian
10'Jt.5 by eny epplifanl/or e permn euEjxL IM appliunt to e avil peneXy d nol mon IMn liva huiMrod ddkn �5500��.
� I, m oxner W �he pmpanY ar my «npbyeee wlh wepee av �Mi ede mmpemelbn, will Ao ihs vrork, eM Ne eVunure e rwl intenEad
or Mered la eela (Section )ON. Buwiwn and PMeesioro Coda: Tha Convapon Licams lewdoea �w epply io en owner W popsM
who Wld� a inpmrea thoreon. W wfio Eoee �uM v.wk Nmeed m hena� or IMaqh he a Mr ovm amplv�ae�. prwked Ihet ac�
Mpa'ammta ero not'vYadod a dlraJ ta We. tl. howewr. ihe WikinO a inM�aN u wk wGNn one Ya+� d cand+�ion. Ne
owwrbuJder rrill he+a iM buNen d pwi�q M a ehe Gd nd bu� a'unqv.a fa IM qiryosa tl eeb).
� I. n owr d iM Mw�Y. em utlmWY muropnY xdh 6wnesd contreclan ro omYrua tlr o�9b (Sedion ]Ou. &ninws aM
aid.wbn. coaa: r�» com�aeon �c«,. �.. eo.. m wWr a.� omw a ww�v �,o a,aa. « Mww« nww� w w,o
epvecta br wh pqetla w4h a aomreeor��) ��� WnwM to iM Cmvreqon 4on�e Lew).
� I em azanq udr �: B. 8 P.C.. W Nu �eawn:
Dme: O+mer:
I tlo henby cenily thel I em ewere d and u�denlend ihe requiremeMs W CelAomM HeMh enE SNaty Catle Sediona A5505, 25539, uM
25511, enE ihet i w erc� Mure WilEinO �W^� mll / will nm (drck ona) need to comply wih uid neia cadw eM iM reyuimmame tar
aprmXlormnelluclionormod'ifiWanhaniheAir u� eniyT.ianepememDiatnd.ReelEaMleleonel�udioneppica�ionsenewemptimmiheee
,��u�..
Dale: Mq�:
WORKEP'4 COMPENSATION OECL�fl�TION: I Mra� elNm uMx pruXy d psipuy w d Ms bAow'up detlunioro:
� I hm and xU me'vvan e canAut� W mnoN to �WJnwe lar xvrkai mmpawlbn. n prwidod la by SW'vi JIOD d IM Leba
coa.. �« in. w��. a u..oix �a.AiG, thia v� w u.u.a.
r] � n.r..na.0 m.wd,.oaw.• oomo«re�on inwiarce. o �.wu.d W s.abn na a u,. �wc. coa.. a m. w�«m.n. a �n.
wM In whidi Mia i�^e u a+usA. MY wabn' mmW�ian ma�enca wnar W DdKY numbor ua:
c�« FIAEMANS FUND EXPIRES
aa�N�mn., n��6T,�f;4'� 07/O1/96
(Thi� eMlon nesd na be complMeC / fM psrmR ls br ws hunErsE LWlen /51001 or Nes.1
� I wrlYy Ihel In iha peilormenw d tM xroM br wfich ihi� permN ie ueuM, I e1Wl nd employ eny peiron in ury menmr eo m lo
bscoms eubl� �a �he xnMn' componWlon lewe W Celilamie, aM apra� IhY M I ohould beroma was to �M xorks�
compeneuim4 D�eune d Seaion �a)a0 01 �ha lebor Coda, I hxilh oompy w Ihoea pwlsions. �
Dtle: /` �/�— �(^'1 Applirsm:
W�mlrp: F�Nun b ucun woAen'rortpxwtlon cowp� li unl�Mul. �nG �II • �CE N MIyIOYM f0 CIIINIW pMNMN IM
nw nnu �q ro om h�nane rnovwe aww. (tta4000A b���n ro i er npwiwtbrt e+m.w u povww ror �n
9ctlon �108 0/ tln le0oi Cob, Infw( uM �tfomry'� /w�.
CON9T11UC110N LENDINO R6ENGY: I MnEy elf�m �nMe penelly d �Mn b e epW�uqun WMuq apency lor Ne
pNormuwe d IM wak M whitli ihe prml b ewod (�� �]. CM. CI.
LENOEP'S NAME:
LENOEN'S AODNE39:
I cs�ity Ihm I hevs neE this epd�� �e ptl� IhN �he abovs inlormLLion ie conop. I apiae �o comply Milh dl ery uM cauMy adinenm
', W�telslevnmlelnpbbuildiqeonaUuqbnendMreEysullnr¢ampreeenletivadt�helyromixupontAsebwe�manibneEpropsity
�o��M'�b�'u���� CHARLES JACOBI
_ /O /'
Due: G IC7
(5151J6.WP) ���iMip 8 S�lay: �naMFle: Cenery-AppireM: Nnk�iwwur: (ialEen�ad-Nwna
PEAM NO: E 07601
GOVT: N SUPP: Y
CONSTRUCTION TYPE: iFR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCAIPTION : INTERIOR 20000SF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS REF: H-74570 ��� ����
+�+�*�x�x�+t*x****�r**x�*��x�*�*�t**�+t****�*x*xx*�rx� *� * * * x��*x�*�r��*�*���**x�*�t�ex*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i �=,/
if 1E 1f 1F if iE 1k IP 1k k 1k if 1E 1t iE it k 1k iF i! 1E if ff iE iE ik iF Ik 1F IF II� Ik iE iE 1E IE 1E 1E 1F 1E 1F iE M M ik 1E K if 1E if 1E if ii 1f if i! if if iE 1F if iE ik ik 1k iE if iE 1f 1E ik 1F fF iE iE iE if iF 1E
D E V E L O P M E N T S—E.R V I C E S R E Q U I R E M E N T S
ZONING APPAOVED HY . "`�' DATE:
HUILDING APPAOVED BY :
APPLICATION ISSUED BY:
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE; Ir �
41f1EfE1E1FiEiE if1E
STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 20.40
SOY SMIP/NON—RES
ISSOE FEE 4.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 20.40 4.50 0.00 24.90 24.90 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24.90 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.90
iE IE 1F 1E 1E 1E'IE iE 1F 1El41E 1E 1F 1F 1E 1E 161ElE 1E 1E iE iE'lf' 1E 1E 1E 41l' 1k 1k iE if 1E 1f iE ff 1F iF if 1E 1E 1E if 1E fE iE 1f 1k 1F'lE 1E 1F 1E iE 1E 1F 1! 1E 1E iF 1k ik 1E it iE 1E 1E 1E 1F ik If'k iE 1E 1E 1k IE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N ONIT COST TOTAL COST
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 12 RECEPT/OUTLET ADDITIONAL EA. .45 5.40
END OF FEES
l'i��. - �e'�ill '-.—�'� .
=�� ._ _ ... . ..
CONSTRUCTION AND PLANNING . P, _& SPA
APPROVALS Permit# Date Inspector qPPROVALS Permit# � Date Inspec�or
1. TemporarY Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgmd. � � 53. Steel Reinforcement �
,�. �� h
�3��lectrical�6o�duft Unjity-Undr.grnd. 54. Forms
'�#°E`Iectrical�9,ndUb't�igdrgrnd.✓ 55. ElectricaiBonding
.,�5�' eel Rei�orcemest`~ , 56. Rough Plumbing & Pressure Test a
,� GlectricaUiFE �� nd. � � 57. APPROVALTOCOVER•GUNITE -
��Rbotinqsp m �" ' 58. Electrical ConduieUndr�rnd. �
. 8. FbundatiaK'� ��F �+ a' 59. Gas Pipe, l� UrSdrjrnd., Test �
��
9. Water Pipe;Und�rnd. ;: 60. Backwash Line,`r�P�Trap, � Undrgmd.
10. Strutturat,�,�-F�oort�System 61. APPROVAL TO 6ECK
11. Property'SewGr,�vne�& HousA'Connection � 62. Backwash & Re�eptorFina4
12. Sewer Cap: ��. •-r � 63. Heater & Vent-Final
13. Roof Drains ,�')'_ 64. Plumbin9 System ��Final �
14. Rough PWmbing=i is; 65. Etectrical-Final �
15. Rough Ete_ctricaF�Coaduit e 66. Solar System�Fioa!
16. Rough Efeciric �jrir� ..� 67. Fencing & Access Approval
_ 77. Rough Wiri� Sign � 68. APPROVED F(2FYPLASTERING
. 78. iiough Eleciiirai.,"T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rou9h Heating & Air Condition�g ^� 4 � F�RE,Q�PT�(iEQUIREMEl�T
- - i;
20. �nugh Fa��4,tor� Fi��lace x.� �,� �. `. � o,* � APPF�OU.fi�J Paynit #�
�
21. ButSS: in'Strth.3ura1+ • .. .. � � �� 'r '? !'� � � 70. _,Under�i0�qd F�`ydro � . .
22.O.ucts;V�tila�'ting��. ' •�=-' y�." ,� r r*"��1.Produ��F'jRing �as �Oil
�
23. Gas P-iAe-Fiough & Test �-1� + n a' �a; �X� r 7z• Underground Pi,�n4N �'
24. Faooi=Frafl.,+Sin9�� �� �' - ; ' � � ,.�'* . 7� Undergrn`d.Stof�ryeTanli;�Gas ❑Oif
25.Roof�She�hing S� `� 'vv's.'� Cf p Nt 74vOverheadHydr"�T `
26. �Ba� Ceiliog {Stru�t�ral) & 161o��doat ;� � ?�'„ � �� 7�'; Dry Cheraical _ ;; `i � xr,hj
27. E�ame and-Flash(n,g� �a;� � t� cG� 76. Dry Starft�ipe _= '' J �•7�T
�- m
-28. Lathing�SidingC�;-� �aF � �g . ..y: 7Z: FIXED��STEK1'�INAj,.�. �F
� 29. Insuletiop: ^ � � S � * I �x 7� PIRE PREV. FI(�,AL �" = � - �
30. Drywail I�aiiing `��k � � �, � � S -`�i�EALTI-�D,EP� �RE6UIR,EI�ENT
-, 37. Piaster Brown-Coa,c � S rr + r, 79.� FINAL tNSPECTtOtv fi J ✓'
; 32. lectrical-��?ow�r M� r'�i al � *^' ��� 8Q`.� FOOD CERTIF`CATE I�SllED,
n• n�. � !�Y. i ^ *�_'r
- 33. ._�-'�naFEleet�nc� . r m ' ti Qe� �7� � �r � Nntes: � 70' t'"_ 6 r•:
�34. FinaLHeaFing�ffiAi4•6ondi�tioning.": C1 � �, � fr '�•�'2, ,`t ��-� . - qr
�t r!' RI�K - ^1 {. ^• t �'K C HctG L. ' i'
�35. FinarGas''��,�Pe:Tesjt � .: :.' � � ., •1. _ r' .-��^
36. Hood`or CanoPY � ^ �" � t i � � f• � �: _ � n"
- - * ,« m � m c, C [ ,
� kf� AC' < 4i� �
�37. Final'.�actorY Fireplace ;� .. r� �r �x �� * �'� � J.J �' -
+. -�
38. Finaf�Plumbing � �� r� • -�+ +: - ! ':p ' ^ .-. � :i ` .
"4 m p :t �i . H 3' F
�39. Watei Service-Final � }, , �' x r � 1,•, '' -:.�� � . ". '
� �M
r40. Gas Service-Pinal ���t tT1 cI*'�" S A: c* I��' 1a:, �:. =�r; �~ .. . •.�.
- n' E+ . �a, � u
.:41. Solar pomesticFiq�(�; - �y •� * = � �� �� ,.�, .y� a� � J �� ,.
�
�'42. �ackflow Preve�tet .� � N t� . :� c ,: - - c � '
- a n � "� �...; t.. + R�
4 C"+. = ^
43. Backflow Irrigation ,. � • v; ` y'. '' �- ..
>
49. Landscapa� Irrigation•System � ^'. •,� x � �*% � �? C ` , � {' .L ", k' N -J L
� r.l 1. C' <#�1 � ' _/.. 1.S
�5. So�nd P�t,teni�tion�` ' ^`," ' * � E" " F�' -. "'
� !� C*! .•1 [+7X. r 7:
db. Handicap i�egulations - ;, * r' .' 7' S C. S ?
�- � n
�.�. ��INqL STRIRTUR� & BUItflING x �, ', �: � � � ,;
48. EINAL PLANNING -!: ... Y:U c�. i L �; r �
d9. Electnc Release io Edison ' � '" � � -� ' '
fi s � � , i+• r � < • �" ''
50. Gas Rslease to Southern Californ�a Gas Co * �'» t� r+ ?' -. k 7 •
51. CERTIFIC.QTE OF OCCUPANCY f !. . - r .-• . "' � -
No. Date
.PpWFCTl10UflE33: SSS ANTGN BL
OWNEfl'SNAME: SECURITY PACIFIC NATL bNK
nnoeess: 5 5 5 ANTON
957-1489
.IIqLH/ENGINEEfl:
�OOHESS:
uxn:350 CITY OF COSTA MESA - HUILDING PERMIT
PERMIT N0: B 048775 PLAN CHECK NO: 05248-90 5
CONSTRUCTION TYPE: PERMIT TYPE: STR
NEO.NO.: JOB DESCRIPTION ; T.I, OFFICES
UNR:
PFflMITfEE: INNER SPACE ( 213 ) 771-7126 '
ROOBESB: - SOSi CECEI�IF1
" - SOUTH GATE CA 90280
OCENSED fANiMCTOB OECUMTIUN: I hemby aHirm that I am Iicense0 untler prnvisions ol ChaD�er 9(comme�uinp xith Seciion
70W) ol �iWsion 3 0l Ihe Buvness antl Proteuions CaOe, and my liunse is in tull force anU etlect. �
c2r uc.: 0 3 219 4�p� uc.: 0 � ci.�se_P_�� �p� /
- ' 6 sionat �» - ��.�
^ i
NEPS' COMVENSRTION OEClAM710 : I herabp a irm ihal I �ave a certtlicate af consent to selbinsure or a certificate ol Workers'
�oensatian �i s�a3c9 =�rfrt�en copy ihereo� (Section 9800, Lab. �12 � 01 / 9 9
roucrxo.: GREAT AMERICAN IXP.OITE:
�1MPANY:
CenitieE copy is Aereby fumished. � CertiGeA co0 is Ne0 wilA the dry BuilOinq U' '� n.
�Oate:,�—��—�� � APGlicanC �� `
E%EMFfION FPOM YlOBNENS' COMPENSIITION OECUMiION: Qhis sec1ian nee0 not 6e comDletetl if IAe permii is for one hundred (fiW) or less�.
I cetliry ihat in iha pedormance at the work Por which [his permit is issueA, I s�all not employ any person in any manner so as to hecome
suble�� �a Ihe Workers' Campensation Laws ol California.
�ate: - ' SiqnaWa: - - ' '
NOTICE: Ii, atter makinq this declaation, you sAoulA hecome suUleC la Ihe Workers Compensatlon provisions ol Ne Lahor
COAe, yau must torthvnt� comply vntA such OroNsians or this permit shall Ea GeemeO revokaE.
� CONSTflUCTION 1EN01NG IIGENCY: I AereCy alfirm that there is a constmction Ientlin0 a0ency far Ihe DeAormanca of Ihe woA for
, which this Dertnit is issued (Seclion 3097, Civ. CI.
lENOER: �
ROOHESS:
OWNEN BUILDEP OECUMTION: I here0y aKrm t�at I am exemD� �rom Ihe Contractors' State License Law for t�e lallavnnp reason
(Section 7037.5 Business anE Proteuional Cotle: My ciry ot wunry wliic� reQuias a permit ta consiruct, atler, impmva, Oamolis�, or
0
❑
3ny s[ructure, D�or to its issuanca, also mquias t�e aDD�icanl lor such permit ro/ile a sipneE statement that hUshe is licensetl
nt ro the pmvisions ot tAe Contactors' State license Law (Chepter 9(commencinq wiN Section 7000) ot Division 3 0l IAa Bu51ne55
Nessions Cotle) or Ihat he/she is exemD� �herefrom antl IAe basis lor iha allepaE exemption. Any violatlon ot Sectian 7031.5 by
plicant for a Dermit subl��s t�e apDlicant �o a civil penalry of nol more Ihan tive hunCmG Eollars (5500).
1( az owner ol t�a pmperty or my employees vnt� wapes as Iheir sole compensation, will Eo the work, an0 Ne
structure is not intenOeU or offereE br ule (Section 704d. Busmeu anE Professional CoOe: T�a Contractors' SGte License Law
dces not appty to an ovmer ot a pmperry wlq builEs ar impmves tAereon, and wtw Uau suc� vro�e himseltPoersell or thmu0h
his or her own emDlayees, proNtled t�at suc6 imprm¢ments am nat intentlM or otlereA lar sale. If, however Ne DuilAinO or
improvement is solU within one year oi completion, Ihe owner will have the �uNen oi provin0 he/she di0 not DuilO or Impmve
�or the puryose of sale�. �
I, as owner al t�e pmperty, am exclusively coniracting wiN Iicense0 con[ractors to conSVuct tAe projed (Sectian 70N, Business
an0 Rotessions Catla: The Con[2crors' Siate License Law �aes not appy to an ovmer oi Droperty who hml0.s or impmves thereon
anE wtia wniracts br suc� Drolecis cit� a condactor(5) Iicense,0ursuant to t�e Contrzetors' Sute License �aw). I am aware
ihat proof of �heir Warker's CompensZtion in5urance S�ouIE be D�o�ritleC ta me.
I am exemD� uiMer Section: 9. 6 P. C.
forNis reason: . . . .
i Date; Owner:
I do �ea6y cenity that I am aware ai an0 un0erstand tAa r¢yuirements ol Califomia Heal[h anU Safery CoAe Sections 25505, 25533, an0
"2553d anC tAat 1 or any luture EuilEinq occupant wilYwill not gircle one) neeE to campy xith sald state coEes anE Ihe reQuirements for a
permit tor consiruction ar matlifcatlw imm t�e tir �ualiry Manapement Usidct. HeSiGemial wnsiruction appGatians ara exempt Irom
I�ese Drovidons. . .
' Date: ApPlicam:
I heaby certiTy thal I Aave reatl IOis applicatian anU state tAat the aEova informadon is cortecL I a0ree to wmDh ��� all ciry antl counry
ordinances anA state laws alatlnp ro Duildinp cansiruction antl hereby authoriro reDmsenW[ivas ol IAis clry to enter upon t�e ahove�mendonetl
propehQy lor inspepion purp0u5. ,)
Date: �/—� �^ � a SipnaWre: �— x /
Oiirer's Lkense or Soriai Secunry x:
180118 While—Builtlinp; GrBon—Cotla Enlorcemen�; Cenary—AppllenM; Pink—Rovenue; Gobamotl—rlseeaeo�
�
PERM NO; B 09S77S
GOVT; N SUPP: N
PURPOSE: ALT
SQ FT: 2,900
CLAIM VALUE: 65,00 CALC-VALUE: 46,632.00 GROUP OCC: H-2 /
COMMENTS: T.I. OFFICES
�r�x****x�**��*�*� x��**�*�*+�*�t**�*�**x+�x�*�*�rz���r�r����**��x**��r*�r**�t�t**x�r*�� **�r�r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDZNG ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV: PARCEL: 41050104 ZNE: PDC REF NO:
RLANNING N TES> TENANT IMPROVEMENT ON 3RD FLOOR
) "
M k k �k if iE 3E 3E it ik if iF it if dt ik 3E if it i! it ff ik i! i! iE 1F 4�1E ik iE ik it it if ik 1k 3F it iE if iE iF iE i! if iE ik it iF it 1f 3t if M iF if iE iFlE it iE iE iF iE it iE �k it if1F 3E �E �F iE * iE it k
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T.,S
��,.�
ZONING APPROVED BY ��C• DATE: _Q�'=?.C`i �,�
HUILDING APPROVED HY ; DATE: � �/r9/
APPLICATION ISSUED HY: G' � DATE:� � Z�— �7�
k if it if ik ik if if ik if ik iE ik 3k itlE it M it �k iklF iE iE fE dE iE ik iF �t �F ik3F�iF�IF £fF iE
iE iE iP 9E i! iE 9E if if it it if if i6lF iF iF i! it iE it ik dF if i! 1f'k k�1E ik 3E i4 if iE iE ih it if if iE iE ik IF iF iE it iE if iE �F iE if iE iF ik 3F if ik ik iP 1E iE iE fE iE iF �14,iE i6 ik:it iF df jE 9E iP iE it dE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL�5EGMENT:Y
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE� SMIP/RES GRADING
PERMIT 395.00 �
� ' SMIP/NON-RES
PLAN 256.75 ti• 6.99
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK. TOTAL PAID DUE
TOTALS----> 401,99 0.00 256.75 658,79 65II.74 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 401.99 OVER/SIiORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECIC
395.00 6,99
if �k iE fE fk k iE i! 3k fk if �F if iF if �E if it ik ik iE it iF ik it ik ik if if i! M iF iE i! iE iE it if 1F if �E 1E iF iE if it ik iF �f iE 3F iE if ik iF iF * fE iE 3E i! if ik iF 3f ik jE iE ik it 1F if iE iE �E if �E iF dF
I N D Z V 2 D U A L F E E' B R E A K D O W N
TYPE QTY D E S C R S P T I O N - � UNIT COST TOTAL COST
SFC 2900
OFF-INT, ALTER TYPE I,II F.R. -AVER
END OF FEES .
;,
16,08 96,632,00
oi oor,sasii-oaosa.�i:r rc�-r 4o;.y�
DP.TE: fl3/?3r90 TIME: Op:?8
CONSTRUCTION AND PLA �� ' � SPA
- Date Inspector Date Inspector
APPROVALS Permit # �, . , APPROVALS Permit # �
- 1. Temporary Electrical Service or Pole y �. � 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 Gmd. 57. APPROVAI TO COVER-GUNITE
7. Footings � 58. Electrical Conduit�Undrgrnd.
8. Foundation .� /� � � = � � 59. Gas Pipe, O �Undrgrnd., Test �� � � '
i . i
9. Water Pipe�Undrgmd. � ' , 60. Backwash Lines, P�Trap, O Undrgmd. �
10. Structural Floor System . . 61. APPROVAI TO DECK " ' , i-��
11. Property Sewer Line &-House;Connection : �� � 62. .Backwash & ReceptorFinal - � ��
12. Sewer Cap �. -+ ' ' 63. Heater & Vent-Final
73. Roof Drains � . ' � � 64. Plumbing Sysiem - Final-'
14. Rouqh Plumbing � ' , � � 65. Electrical-Final - -
75. Rough ElectricabConduit � ' „ 66. Solar SVstem-Finat ��
16. Rough Electric Wiring - 67. Fencing & Access ApProval
17. Rough Wiring Sign � 68. �APPROVED FOR PLASTER WG � ��
18. Rough Electrical-T Bar.Ceiling • 69. �POOL/SPA SYSTEMS FINAL -
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in $tructure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Freming . 73. Undergmd.Stora9eTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurap & Monocoat . 75. Dry Chemical �
27. Frame and Flashing 76. Dry S[andpipe
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 Eleciric Notes:
34. Final Heatin9 & 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 pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING : /� (�Q
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas�Release [o Southern Califomia Gas Co - .
51. CERTiFICATE OP OCCUPANCY
No. Date
�
PRQIELT 1DORE38: S S S ANTON B L
owxea�sxerne: SECURITY PACIFIC NATL BNK
ADDflE55: SSS ANTON
957-1489
RNCHIENGINEEH:
ADOIfE38:
REO.NO.:
uxrt: 3 5 0
UNIT:
. PEflMITTEE:AZR CONDITIONING COMPANY (818)294-6571
�ooness: 6265 SAN FERNANDO
GLFNDALE CA 91201
LICFNSEO CONTMCTOR OFCIAMTION: I hereby aRirm ihat 1 am Acense0 untler provisions ol Chapter 9(commentinp wit� Section
7000) ol Division 3 al tAe Business anA Professiws COEe, anU my license 5 in Iull forca an0 eHecl.
cin �.�014 4 0 3 sr�re uc.:12 0 6� cuss: C— 2 0
2�.q�'Q.� 5� ure: �
.AEBB' COMPENS�TION OECIAMT10N: I eh attir at I have a certlficate at wnunt to selbinsure or ce Iticate af Warkers'
� comemss�ion �sii'�`"4 i"l`f`� b C0°r'ne,mi 7sec��a, sso�, iao. i�0 / 01 / 9 0
icrno.: TRANSPORTATION �P �p��
1MPRNY:
L] CenitieE copy is nereey mmanee. C� Cen� y is i U wftn the ciry BuilElnp D'msion.
Dare: �— �— f o AppUcan � �G ��w�'� —
E%FMPTIOX FPOM WOHIIFAS' WMPE11S1TION 0 ION: (�hit secUM nceU nol0e WmpkleA i p i�' M drc �uN�W (51 W) a kss).
I cenity that N Ue perlarmance of the work im whic� Itus pemtit is i55ueE, I stWl not emdoY 7ers � any manner sa az ro Oewme
suEjett ta I�e Workers' ComDensation Laws ol Califomia.
"Date: SipnaWa:
NOTILE: U, aner maldnp this Declaration, you slwul0 beroma w�ject to tAa Workers' Compensatlon Wovisbns of IM WDor
Cotle, you mustfonhwit� compty vrit� suc� provmons ar tNs permil stWl Ce Ueemetl revukeE.
CONSTBULTION 1FN01NC. �GENLY: I A¢2Dy atfirm IAat Nem is a construction IenAinO apency lor the pertarmanca ol [he xrork tor
wAicq tnis permit is issueA (Section 3097, Gv. C�.
IFNOEN:
� noosess: +
OWNEP BUILOEH OECIAMTION: I �ereEy amrm that 1 am exemD� hum tlre fqntactors' State Lice�¢e Law tor tAe tolloxinp aason
�(Seciion 7031.5 Business and Prafessional COEe: My ciry oi counry wNch requlres a permil to cons[rucl, alter, improve, tlemolisA, or
repair any stmcture, Dnor to ils Issuance, alm reQuires t�e apDlicant lor suc� Dermit to Ne a sipneC statemem that he/s�a is IlunuA
-rsqant ta t�e D�a�sians'of tAe Contractors' Stala License Law (ChaD�er 9(cammencinp wit� Seclian 7000) oi Division 3 al IAe Business
Pmlesslans Catle) ar that AUshe ¢ exempl thealmm an0 Ihe Uasis lor the alleqeE exempqon. My NOWUon of Sectlon 7637.5 Ey
. dpplicant tor a Demtit whtats tlro appticant ro a civil penalry of not rtwre IAan five huMreE OdWrs (5500�.
�' I, as ovmer ol t�e proDeM o� my employees vntA wapes as I�eir sole campenution, will Eo t�a work, anE tha
� stmcture is not intende0 or olferetl for ule (Section 70CI, Business aM Professional Cotle: Tne Comoclors' Slate �icense Law
tloes notappyto an owner ota pmDerty who EuilOs orimDrovesthereon, an0 wAo tloes such work himsalt/Aerself or Ihrouph
his or her own employees. pravltleE that such imDrovemenis are not intenEed or oifereC lor ule. It, however the buildinp or
imprwemrnt is sdd witNn one year oi mmDletlon. Na mmer will tave t�e DurEen of provinp �eJshe ditl no� buiW or Improve
lor IAe Durpose al sale�.
I, as owner of the pmperty, am exclusiveN cont2cGnp wit� IicenseU contractors to construct IAe D�ojM (Section 7041. Business
❑ - anE Pmfessions CoEe: The Contactors' Stata Lkense Law Oces nat appy to an avmer ol D�aDe�Iy �o Cmlds or improves thereon
anC wha caniraqs lor suc� Drolects vitA a contractm�s) license Oursuant lo the Coniracrors' State License Law). I am �ware
tlut pro0f of t0eir Workcr's fAmpensf�lon iRSutantt stloNJ Ce prOviAeO to me.
Q I am exempt u�der Section: B. 8 P. C. � .
lor th¢ reason: - �
Date; Owner.
I do pereUy uniy Wt I am aware at an0 undersun0 tne repuiamenu ol Califomia Heatt� anA Salery CaOe Sectk�u 25505, 25533, an0
25534 antl ttwt I or any lutura EuilEinO �upant wilUwiA nat (cirde one) nee0 ro camply wit� uiG sute co0es anU t�e reQuiremenis for a
Dermh br consiructian or moAiliratlan Irpm the Nr Oua4ry Manapement DLSVict. NesiOenUal consiructlan apD�kations are ezemD� ��m
Ihese Orovisbns.
Oate:
I herehy ceNy t�at I �avg rBaA tN5
nr0uwnces an0 sute Wws relatinp ta
GropeM lor impection purposes.
OfNer's Licenu or Social Sacuriry x:
ApDlicant:
n an0 state ihat IAe aGwe intarmatlon is conact. I a0ree lo compty wlt� all ciry anA counry
nsVucYon an� autliorue roD�eu�taUves oi Nb dN w eraw eW� UeaCwrmmtane0
Greer�—Cotle Enlorcamant: Canery—Applirant; Pink—Re.renue; GdEenroE—Avessor
''�' - ' -'�L.. •—'
�
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 048866
PERhtIT N0: M 048866 PLAN CHECK NO:
CON5TRUCTION TYPE: PERMIT TYPE: MEC
JOH DESCRZPTION : T.I. OFFICES
N GOVT; N SUPP: N
PURPOSE:'ALT
SQ FT:
CLASM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: REF B48775ES
�*�*�r***+r***�*+��* �**�*+��**��***�r* ��x **rr*���+��r�r**�r�r�x **� *�r����r*� ��r �r x�r**�r� �***�t#�r*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEET: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050109 ZNE: REF NO:
PLANNING NOTES>
>
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;_ D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONZNG APPROVED BY DATE: �
bUILDING APPROVED HY : _ _ DATE:
APPLICATION ISSUED HY. ' DATE: � �4"g Q
iElEitiEiEifiEil�3Ei(�ikifiEiEiElEiFiEifi4iEiEiFiF+ ..., n +t � FiFi�iFiFiE7FiFiFiFi�iFifikiFiE3fjEaEi43EiF�iF3FiFikifih
iFiE�EiE�kifi6ifikiEik*i6iEiElfiE�FiEiFjEkifiFifiEjEiEaE iEiE ' ., sf iEiF 3Eif1E3EiF1EiFltiEiE9Ei4jElFitiE�Ejk3EiEiFiFiE3EiliFiFiFiFiEiFitN�iEiE3E
LEGALIZATION;N F E E S U.9 M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/RES GRADING
PERMZT
61258
SMIP/r10N—RES
'ISSUE FEE 15.00
BUILDING—AIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 61.50 15,00 0.00 76.50 76.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 76.50 OVEFt/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
76.50
iE iF it iF iF if it iE iE it ik it iE dE jE it **�E i6 dE �k �f if iE iP �E it i4 3F �E it if iF it ik iE iE iE iF iE �74 if iF if iE iE ik 3! 3f 3E jE it ik iF ik iE iF iF 1E �E �E iE dF i6 i4 3E iE df i6 if dE �E if IE 1E �1h iE 9E
I N D I V I D U A L F E E B R E A K D O W N
\
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT HEATING UNIT/SYS W/CNTLS 9.00 9,00
MEC 6 VAV BOX 6.50 39.00
MEC 3 FIRE DAMPERS 4.50 13.50
END OF FEES
R
J
01 00068?31—OU0683s'2 7U �' I5,?J
DATE: 09/�4/40 TItiE: 14:41
►i
^ CONSTRUCTION AND PLA JG -� ,, � -L & SPA
APPROVALS Permit #- Date Inspector p�ppROVALS Permit # Date Inspector
_1�. Temporary Electrical Service or Pole � . � 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. . - . 53. Steel fleinforcement
3. Electrical Conduit Utility�Undrgrnd. - 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electricai Bonding-
5. Steel Reinforcement . _ � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. _ 57. APPROVAL TO GOVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation _ - 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trep, 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 Plumbin9 65. Electrical-Final �
15. Rough Electriral�Conduit ' 66. Solar System:Final � -
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING
18. Rough Electriwl�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning Q� FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipin9 � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Freming - 73. Uadergrnd.StorageTank�Gas �(lil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Scructuraq & Monocoat � 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding i; 77. FIXED SYSTEM FINAL
29. Insulation � Y' 78. FIRE PREV. FINAL �
'; �
30. Drywail Nailing � �� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat �� , 79. FINAL INSPECTION
32. Eiectrical Power MeterFinal ,' . 80. FOOD CERTIFICATE ISSUED
33. Final Electric � 'f � '
, ,i � ' Notes:
34. Final Heating & Air Conditioning '� p'� �
35. Final Gas Pipe�Test i�!�
• I i I j � .
36. Hood or Canopy �''• �;%
37. Final Factory Fireplace ' �y,��
38. Final Plumbing , � �' �
39. Water Service�Final j �
4D. Gas Service-Final � �
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
48. Handicap Regulations
r
47. FINAL STRUCTURE & BUILDING _:
48. FINALPLANNING �
49. Electric Release to Edison „,
50. Gas Release to Southern California Gas Co ��
51. CERTIFICATE OF OCCUPANCY
No. Date
II
'PflD1ECT�00flE58: SSS ANTON BL
ow"E:�sx""E: SECURITY PACIFIC NATL HNR
�t�Ess: S55 ANTON
,i
{ 957-1489
�ACIIIENCINEEP: flE0.N0.:
' �onxcss:
uxrt: 3 5 0
uxrt:
PEPMITTEE: WESTERN SUPPLY CO. ( 21 3) 633-0511
�ooa�ss: 15510 ILLINOIS AV '7
110EN5ED CONTMCTOR ERIAMTIOON NheaCy anirm ina� I am Iicenu0 unaCA� Ool �3er 9(commencinp witA Section
70W) a1 DWlsion 3 0l tM Business artl Prolez4ons CaOe, an0 my Ilcense I5 in lull force aM etlect.
cin uc.: su� uc.: cuss:
046021 91621 C-36 �
Date: �//����O�ature: _�' � "
V/ppl{EqS�fAM NSIITION OECLAMTION: I IrereEy allirm Itw� I Aaro a ceNficate oi cortsent to sett�4isure or a anificaro oi WaAers'
'��, ComDmsation Ifnurance. w a ceNfrcE copy Iliereof �Sectlon 3800, LaO. C�.
I voucr xo.: gWC 19 9 6 2 5 E%P. WTE: O S I O S I 9 1
'bP""�� HZGHLANDS
CeNfeE mpy is hereDy fumSAeE. � CeNfeO copy is fileE wtth 1Ae cily Buildinp Oivision.
Oate: ✓ AppllwnC ��y i �
EYEMPTION F OY WORKEAS' COMPFNSl1TI0 DEGAiWTOX: Rhis sttlbn neM roi De canplete0 ii Ne permi'a fa ace AwtlreE (5700) a ku).
� I certity l�at In t�a pertarmance oi the wark /ar whic� Ihis permit i5lssue0, I shall nat empby any ce� �� any manner sa as ta �ecame
suDlect to IAe WOMus' Compensatlon Laws of Calilomia.
Date: S�pnaWre: '
NOTICE: II, �riu malMp tlus �erlaratlon, you s�oulE bewme suElect to t�e Warkers' Compensation D«orts of tlie LaOar
COCe. you must IONmiN camPN �N sucli pravhions or tNs perMt shall Ce tlremM revoNeE.
CON$fNUCfION 1EN01NG AGENCY: I hereEy affirm Itwt I�era l5 a construction IenUin9 a0emy lor t�a peAormaxe al (Aa wark lor
wNcO Ittis permit e isvuE 1� �7. Civ. CI.
LENOEfl:
IIOOHESE:
OWNER BUILDEP OECIAMTION: I tua0y atfirm that I am exempt Imm t�e Cantrzctors' Sute Licmu �aw tar tAe lollowinp reawn
(Section 7031.5 BusNess an0 Professional COEe: My �Iry ol counry vAiic� reyuires a De��� �o mns(ruct. alter, Improve. Eemolisti, ar
apair any stnrcture, priw to H5 iswance, aLw rtyuires the aDD�icant lor suc� permit ta lile a 51qnM statement that Ads�a k IlcenuO
pursuant to IM D�ons al IM Contrzctors' State Licansa Law (Chapter 9(commendnp with Secibn 7000) ol OMslon 3 0l IM Buslness.
an0 Pmfeuions CoEe) or that hUshe is exempt I�erelmm an0 t�e Aasis lar I�e alleOeE exemD��a�� �Y holation ol Sectian 7031.5 Dy
any appliwnt fOr a Dermii wEjats I�e �DP���� �a a clWl penalty oi nOt maro than live �unOrM Eo0ar5 (SSOU).
I; as mvmr ot Ne OraDerty or my employees wiN xapes as Iheir sole compemaWn, wiA tla t�e vmr�, a�e me
� stmctum is wl intendeE or otlereE for sala (SeCtion 7044, Business anU Pmtessianal CoOe: T�e Convacmrs' State License Law
Uoes mt appry to an owner af a Droperty who bWl0.s or Improves t�ereon, aM wM Oces such woM1 Nmsell/hersell or Uroup�
lus or Aer ovm empbyees. provltle0 iha� sucli improvements ara not mtentle0 m atlere0 tar sale. II, Ipwaver t�a DuilElnp or
improvement h saM vn[Ain one year ol amDletlon, IAe awner rrill have ihe �urtlen ot 0�0 �� dp �� Ouiltl ar imDrwe
for Ih puryose al sale).
1. az wmcr ol Ne propeM. ��duSivW wmractinp vnN ticenud canvactars to crosfruct Ne DrojM (Sectlon 70a1, Business
❑ aM PrNecdms WEe: Tha Contrxtors' Staro lkrma Law Oces �a[ apph/ to an wmer ofpraper1y wAo OWQs a Mproves Ihe2m
an0 wla contrzcts for sircn piojMs wim a contracior(s) licenm pursuant to fAe Catt2ttors' Staro Lkmse Ww). I am axara
Illdl pf001 0� I�G! VdOfk2f'S COfIIpCI15dG011 IIISIIf811E0 SMUIU EB pIPAEEE !0 IIIP.
� I am eaempt unOer Seqion: 8. 8 P. C.
for tn6 reasan:
Date: 6+mer,
I Eo �areEy ceniy IAat I am axzra al anE unAerstanA tAe m4Wroments ol Calitomia HealtA anC Safery CoCe Sections 25505, 25533, and
2553C an0 t�at I or any lutum builUNO occupant wiNwill noI (circle ona) naed to comON ��� �tl state co0es anO t�e repuirements lor a
permit br consVuctbn or mWillpUon Imm Ihe�ManaOement DistAct. Hetldentlal constructlon �pplintlons am axemD� ��om
Iheu provisbm.
Date: MM�cant:
I �ere�y cerUry Wt I �ave rea0 tlos apd�wtion anC state ihat tAe aCove informatian 5 mrrect. I aprn lo camqy wiN all dry anE counry
or0inancw aM sute trws relaLnO ��7 �svuction ana nereDy aNnofiza reprevntauves al N¢ cry m prter upm Ine a0ovo-menYoneE/
DropeM �ur �s0��lon Durpoxes. /
Dat�///�O `9a�tur��
Driver's Liunse or Sauai Sewnry x:
1841i6 White—BWWinp; Grean--CaCe Enforcement; Cenery—Ap011cent; Pink—Ravenue; GoNenraG—Avesnor
CITY OF COSTA MESA — BUILDING PEAMIT
PERMIT NO: P 048929 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU
JOB DESCRIPTION : T.I, OFFICES, REFER TO #B48775
CLAIM VALUE:
CALC—VALUE:
PERM NO: P 098924
GOVT: N SUPP: N
PURPOSE; ALT
SQ FT;
GROUP OCC: B-2 /
COMMENTS: T.I. OFFICES
if it it 1E iF if iE iF ik iE IE if iF if iF it iE if �lk jt iF it iF i! �7! iF it ik it it ik ik if 3E it iF it�ik # i( �1F it-k if if it �it ik dt if i(��lt i! if # if �IE # ik �k iF�k iF �! �lE it iF it #ik i(��IF iF it ik if iE i! ik
Z O N I N G R E Q 0 I R E M E N T S
S E T B A C X S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FANT; FT IN REAR: FT ZN
LEFT; FT IN RGHT: � FT ZN LEFT: FT IN RGHT: FT IN
PAAKING REQ• PROV; PARCEL: 41050104 ZNE; REF NO:
PLANNING NfST'ES>
>
iE 1t iF if� ik if� 3E iE iE iE ik ik iF iE iE it iE it ik-0t i! fE 3F if if it i41E it i! il� iE i! iE iE it �k �i! �1E ik �! it iF iE i! �lt iF 3E i: iE iE iE i! iE iklE 3E �)f iE * 1k # iE iE iE iE �E 3E iE �E iF ik �t iE iF iF ik iE iE
D E V E L O P M E N T S E R V I C E S':•-R E Q U I R E M E N T S
20NING APPROVED BY DATE;
BUZLDING APPROVED HY : �� DATE:
i. n
APPLZCATION ISSUED HY: �' DATE: —l^II— 0
kiEikiEiliFi(�iEi4lEit±kiEiki(-ilik�titkiEiE 3EiE1F##iEiEihiF3E iEiF
it IE iE iE 1f iF iE if k if k iE �F �F i(� it if ik it iE ik M it 1t i! if iE �E iF if iE iE iE iF ik if jE ik it iE ik iE i(� it ik ik iF iE iE 3E �1E iE �)E if iE iE iE # iF iF iF ik if it iF if iE iE iE iE if It �It IF # it iF iF #
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 4,00
253 SMIP/NON—RES
PLAN
ISSUE FEE 3.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 4.00 3.00 0.00
REVENUE DZVISION TOTAI,S--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECHANIC
7.00
TOTAL PAID DUE
7.00 7.00 ' .00
7.00 OVER/SHOAT: .00
FIRE SMIP/TOT GRADZNG PLAN—CHECK
ik iE i! it iF fk iE if iE it iF 1F it iF iE iF iE if it iE k it ik 1k ik iF if iE iE it it ik iF iE ik �t jk i! i! fk ik iE iF if if iE 9k M 3! iP iE iE df i! iE if iFlE iE k it iF ik k �F 3F iF iE iF iE iE iE iF it iE if iE iE iE
I N D I V I D U A L F E E B R E A K D O,W N
TYPE QTY D E 5 C R I P T I O N UNZT COST TOTAL COST
PLU 1 SINK, HAR 2.00 2.00
PLU 1 WATEA HEATER AND/OR VENT 2.00 2.00
END OF FEES
01 �DGb9264—OOD69.264 �'Co'p' 7,00
u�iiE� G9i15/90 iI�E: 11:33
C(�S7RUC710N AND PLANNING P� . SPA
�. APPROVALS Permit # ✓ ate Inspector AppROVALS Permit # Date Inspector
/%
1: Temporary Electriwl Service o�, Pole �% 52. Pool & Equipment Location /J
2. Soil Pipe•Undrgrnd. .,- � 53. Steel Reinforcement v
' 3". Electrical Co�duit �Utility�Undrgrnd. � 54. Forms
4. Electrical Conduit�Undrgrnd. . • 55. Electrical Bonding
� 5: Steel Reinforcement - 56. Rough Plumbing & Pressure Test -- -
..6. Electrical UFER�Gmd. " 57. APPROVAL TO COVER�GUNITE �
"7. Footings - 58. Electrical Conduit-Undrgrnd. ��
8. Foundation _ � � 59. Gas Pipe, O Undrgrnd., Tes[ �
9: Water Pipe-Undrgrnd. ' � � 60, Backwash Lines, P�Trap, O Undrgrnd. (�
10. Structural Ploor Svstem �+� � � �'� 61. APPROVAL TO DECK I
71. Property Sewer Line & House Connection 62. Backwash & Receptor•Final �
12�. Sewer Cap '' - 63. Heater & Vent•Final
13. Roof Drains .. 64. Plumbing System - Flnal
14. Rough Plumbing 65.. Electrical-Final
15. Rough Electiiwl�Conduit � 66. Solar System-Final
16. Rough ElectY�c Wiring 67. �Fencing & Access ApP�oval
17. Rough Wiring Sign 68, qppROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOL(SPA SYSTEMS FINAL -
19. Rough Heating & Air Conditioning. , . . �-FIRE DEPT. REQUIREMENT �
20. Rough Facto�Y Fireplace � � _ : ; � APPROVAL'S �� 'Permit # �
27. Ducts, in Structure- ."' . - 70. Underground Hydro
22. Dutts, Ventileting_: � . � ��77, Product Piping �Gas OOiI
23. Gas Pipe,-Rough & Test . � ' - � . .72, Undeiground.Flush
24. Roof Framing • - _. 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead HYdro
26. T�BacCeiling (Struc[ural) & Monocoat .. r'1 .. . 75.:Dry Chemical
27. Frame and Flashing , u -" ' 76. Dry Stand�pipe .�. .�
�28. Laihing & Siding �, � � " _ � � 77.�-FIXED SYSTEM��FINAL � - ' '
29. Insulation �' ' _ � 78.�fIRE PREV. FINAL � ' �' �
30. Drywall Nailing � . , �� -;I-IEALTH DEPT. REQUIREMENT
31. Plaster Browri Coat 79. FINAL INSPECTION . ,
32. Electrical Power MecerFinal ' 80. F,OOD CERTIFICATE ISSUED �
33. Pinal�Electric � . Notes: ,�' - - � ,
34. Final Heati�g & Air Conditioning � _ , , � �
35. Final Gas Pipe�Test . �' �
96. Flood-or Canopy ' � ' , � " .. ; � . -
37. _Final Factory Fireplace ' � � V � �
i .
�38. Finat Pltimbing � - _ ( p (��j �. . ' -_ �
'39. Water Service�Final �� : � - -
�
40. Gas Service�Final . . �
41. Solar pomesticFinal .
42. Backtlow Pre�enter
43. Backflow Irrigation �
44. Landscape Irriqation Svstem
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Aetease to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
PflGIEtf �DUNESS: S S S ANTON BL
OWNEfl'SNIME: SECURITY PACZFIC NATIONAL
� aooxess: SAME
uxR: 3 S 0
L
957-1469
nncxrtxcixeee: INTERNI DESIGN x�o.No.:C00
' IIDDIIESS: S PARK PLAZA �NR� 750
IRVINE CA 92714
r�RMiTTEE: HUTCHISON CORP ( 213 ) 763-7991
�oonEEss: Zz50 S CENTRAL AV
RANCHO DOMINGEZ CA 90220
utEnSED fAxiIWCTOP oEt WU710N: I nereOy anirm tlut I am IlcenuE unaer prm�Lsidu of Clupier 9(cammmdn0 wltn SecUon
7000) ol Div¢iai 3 oi tAe Businar m0 Pralession5 COEe. and rtry Ike�a B N INI torce aM ellect.
cm uc.: O0 3 2 �7 8 7 ps���.yh� uc.: 2 6 9 512 chss: C�
:.."�?e: —P—'�P-� � l–D'— Skreture: �.�_
i �.
-�-�flIIEp3' fAMPENSATION DECUMiION: I �ere affirm t�at I Iwve a ceNMrte o mnse t 1 ell-Insure or a cenifinta oi Workers'
'�°"�,ce�uo�Jr�5y�yptq,{ya,�t�j �nr �n�r�oi°�s�.,m� 3eoo. ��n. ��2 / O S / 9 9 �
Pol1CY NO.: W C. Y b U// 4� 2S E%P. WTE: .
�MP,wr: GREAT AMERICAN
CertifeA mDY a tcereM NmisheE. � CeN11eE wPY Ls fileU wR� IM d1Y B 0
- R � e.�.e��� ,.
� Oate: � ` � � ApWicanl:
EXEUPf10NFNOMWOPIIEP3'COMff11S1TI0MOEpAMTION: (�uctimrrcMnathemnqletWiltlsD�'siaamAumedlSt001akss1+
I artity Nat in ehe perlormaoce ol Ue work for Mtich tAu permA u iuueE. I stuA imI employ any person in arry manror so as to 6emme
su0iect ro the Workers' Compensation �avrs ol Califamia. , ,
�
Date: Sipnrtua:
N071CF: tl, afru malaip tlris EttW2tbn, you 5trou10 hemme wUject ro tAe Workers' Compensatlon D��s ol Ne �a6or �
Code. rou must ta[hxiN comDM wiin such orovLUms or this certrit snau Oe OeemeO revokeE.
CONSTPUCTIDN LENOINO �GENCY: I AereOy amrm �hat ��ere Is a wnstructbn len0inp ape�rcy lor Itro peAormance ol tha work lor �
wnicn Itus Dermit's issuM (Secllon 3W7. CN. CI. _
LENOEfl: �
nooxcsa: :
OWNEB BUIIDEfl OECWUTION: I �amEy aifirm tAat I am exempl irom tAa tontanors' State Lkense Lrx lor t�e tollowinp reasan
(Section 7031.5 Busmcss an0 Pmlesslonal COEe: My clry ol caunry wliic� requires a Dermlt to consiruct, atier. improve. Cemolls�, ar
repair any sVucWra, prior ro its issuance. also apulres t�e aDV����� �or 5uU perml� m file a slpneE statemenl tlwl �ds�e is IicensaO
pursuant to Ne Dravisions ol Ne Contnctors' SWte License Law (CMpter 9(commencinp wiN Sectlon 7000) ol OMsion 3 0l tAa Business
�M Pmfesslons Code) or WI MJSAe Ls exem0� �hemlmm anU Ihe Easis lor Na aOepeU exem0�� �Y ��� o� ���on 7031.5 by
appficant lor a permn w6ject5 tha a0d�wm ro a dvll penalry al not more IAan Ihro hunEreE Edlars (5500�.
- I, u owner ol tAe O�apeM or my amployees vnih wapes as Ilceir sole compenutlon, w1A Eo t�e work, an0 Ihe
~ I i� strupure a not urteiMeO ar attereE for ule (Section 70C4, Busmeu enA Prolessional COEe: The Contactors' State Licanse Law
Goes not appN �o an owner oi a D�aDeM �o UuAas or imDmves tAerean, anG wlro Cou suc� vrod �imsell/Aersell or Nmuph
� Ais or her awn employees. DroviOeC that suc� imDrovements am not intenGeO ar a11erzU tor sale. II, �owever t�e builElnO or
improvement is sd0 x�Vun one year al compleilon, 1�e owner will Aave t�e OurGen ol provinp �e/slie Eid not DuiIG or ImDrove
tor Ne Durpose ol s�le�. .
1, az owner oi Ne Droperty� am ezGusivery wnVactinp with Iicense0 caniracrors to connruct Na prqect Sectlon 7670, 8usiness
❑ and ProlessWa Cade: The Contractors' State License Law Uces not appry lo an awnu ol property who 0 IOs or ImD�s thereon
an� who cmiracts for wch Drol��s ��� a cantractor(5) Ilcense Oursuam to IM CanVapars' State License Law). I am aware
ihat Droot at iheir Worker's CompenuUon Insurance sMNE Ee proNEeE to me.
� I am exempt unEer Section: B. 8 P. C.
for ihis reazon:
Oate: Owner.
I Uo hereby ceNy ttut I am aware ot anE unEersWnOl�e raquimmenis al CaIIIwNa H Wt� anE Salery COEe Sectlons 25505, 25533, an0
25534 anE tAat I or any future EWIEInp ottupant wllUvAll rrot (circle one) neeE ta compy vAt� SaiO sWte codes anE Ne reQulremenis far a
permit lor construction ar moCificatlon trom t�e ar �ua iry ManaOamen� Uslnct. NeSiGential canstnrctbn applkatbns are axempllrom
t�ese provaions.
Date: AppliWnt:
I here0y CCrlity WI I have rcaOltns applkatlon �ntl SId�B t�dt the aEove inl0rmatlOn IS Wffetl. I apfee f0 wmpy wl(h all ary an0 COUnry
ortliiunces anA state qwz rtlatirp lo OWtlNp mutnwtbn anU �eaby autAorI(tg� repase�rty ��11s d1y lo errtu upan Ilie a�ovo-mentlmeE
PraperlY lor i�0ectian WrOosas. ��-V-1 ^ Y y�M
Q � �
' Oaie: '� _�/_ Sipnaiure: �'� i`
oriver's uanse or sotia� securny N:
�` i861-C6 NTit�&nNing; Green—Cotle Entorcamant: Cflnery—Applicant: Pink—Rmanue: GolOanro�Aasaaaor
PERMIT NO: E
CITY OF COSTA MESA - BUILDING PERMIT
048835 PLAN CHECK NO: N
PERM NO: E 048835
GOVT: N SUPP: N
CONSTRUCTION TYPE: I-FR PERMIT TYPE: ELE PURPOSE:'OTH
JOB DESCRIPTION : ELECTRICAL FOR OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: H-2 /
COMMENTS: B-48775
*+r�*��t***�******�***+r**�*�r�*�*�r*���rx�*�x*+rjrx�r*�**�+r**�r��e�***��*�x*+����**�*�****�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN bUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT ZN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
>
ik iF iE 1E if iE iElF �f if ik iE ik ik 3E �E jk 1f iE 3E-iE ik iE it aE 3E-3ElE iP 1E if iE iE iE iE if ff 1E if iE �lf� if if ib ik iFit iF if iF 1E iF if iF iF iF ik iE iF iE it if iF iF iF iF iE il� iE 3E it iE iF iE �E i6 iE iF iF
D E V E L O P-M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED bY !�: " DATE:
BUILDING APPROVED HY.;' .f • DATE:
/
APPLICATION ISSUED HY: � DATE: � / ��
iEififiEiflF�Fifif*dFitiEifikjFik%it'1FifiE���FiF,.. v iFifK�FiFiFiFitiFiF iE�lh
i! if if it 1F dt k iE if it iF if jF *%fE �f aE iE iE iF if iF �F iE 3E if iF if iF jE it It iE �Flf it iF if iE if iE if if if i4 iF iE if af if iF iE iElf if iF if iE iF iF 3F iE iE iE iE if if �f iE if if iE if ik iF iE 1F iE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRAUING
PERMZT 65.40
503 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 65,40 15.00 0.00 80.40 80.40 .00
REVENUE DIVISION TOTALS--> COLLECTED: 80.40 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
80.90
ik fE ik �k it it it k iE if iF iF iE jF iE iF?6df ik ib fk iE jk ik iF i! ik iE ik ik ik ik ik if i6 ik 1F if iE i! iF ik dF fF ih iE ik iF iF ik iE 3t it 1E %dF iF iE ik iE ik iE i! iE iE iF if �E iE iE iE it iF it it iE iE iF iF
I N D I V I D U A L F E E B R E A K D O W N
������
EL E
ELE
ELE
ELE
ELE
I � � i-"t�:i �`�I iii�7.1
FIXTURES, LIGHTING
FIXTURES, LIGHTING
RECEPT/OUTL£T
AECEPT/OUTLET
RECEPT/SWITCH
1 ST 20
ADDZTIONAL
1 ST 20
ADDITIONAL
1 ST 20
END OF FEES
UNIT COST TOTAL COST
EA. .45 19.90
EA. .75 15.00
EA. ,45 1II.00
EA. .75 7.50
�i DOQ6�7�iE-GQ06379� "C"QY d� '..
QA7E: 4El3ifSt1 TIfIE: QS:?r
+ CONSTRUCTION AND PLANi....G /C L SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date � Inspector
1. Temporary Etectrical Service or Pole 52. Pool & Equipment Location
.,
2. Soil Pipe-Undrgrnd. _ r' 53. Steel Reinforcement _. _
3. Electrical Conduit Utility-Undrgrnd. . 54. Forms
4. Electrical Conduit�Undrgrnd. � � 55. Electrical Bonding •�
5. Steel Reinforcement 56. Rough Plum6ing & 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, � Undrgrnd.
10. Structural Floor Svstem 61. APPROVAL TO DECK
17. Property Sewer Line & House.Connection 62. Backwash & Receptor�Final �
72. Sewer Cap � _ 63. Heater & Vent•Final -
13. Roof Drains 64. Plumbing SYstem - Final
14. Fough Plumbing 65.� Electrical-Finai
55. flough Electriw6Conduii 6. Solar System�Flnal �
16. Rough Electric Wiring `,!j , encing & Access Approval
77. Rough Wiring Sign . APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 9. POOL/SPA SYSTEMS FINAL
19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. RooiFraming 73. Undergrnd.Stora9eTankOGas ❑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 a HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriwl 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 Pl�mbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING _
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PPOJECT�DOflESS: 5«j AN:ON BL uNrt: 3RD
OWNEX'$N�ME: BANK OF AMERICP; �
aooeess: 20 N RAYMOND AV 3RD FL
PASADENA, CA
818-57A-7700
RBCM/ENGINEEB: RAY HERBOLT flEG.NO.: C I S O% 3
noosess: 22072 CAMINITO VINO uxir:
LAGUNA HILLS CA 92653
resminee: ARMSTRONG CONSTRUCTZON ( 818 ) 967-8001
�onness: 9?,9 SPRING MEADOW DR
WEST COVINA CA 91791
LICENSED LONTIUCTOP OECUMTION: I �ereGy atlirm iAat I am Iicense0 un IUDter 9(commenGnp wit� Seclion
7000) ot Dvrisim � ol I�e BuSinCss antl Prole55ion5 COGe. anA rtry IKenu' Iu0'iwce an0 en .
citrry/056q871 sTaeut.:4340g7� � s. — _
Date: _, ��' L�% .Si9nawre: _�'_ ' ' - — — __—
W08KEB5' COMPFNSI�TION DELlAMT10N: I �ert0y allirm Iha� I lwve a ceniliute of consent loul ' e a enificate ol WOMers'
Comoenutbn ��4 a� §ce�t�eo wpy tMreol (Section 3800, Lab. ��S / O S I 9 3
roucrxo.: REPUBLIC INDEM E%P.URTE:
COMPRHY: �[
•❑ Cenilie0 [opy i5 �ereoy IurniSheG. L� Ceniliea rAVY �s fileU with ihe � BuJainp D" ''
�ate: 9 ApPiiwnt:
E%EMPTION FpOM WONMEPS'COMPENSATION OECIAIlAT10N: (TtuSsectnn neeC rolbecompkle0ilthe . ai« AuMre0�S100�orless�.
I cenity UWt in Ihe p¢�orman[e ol ihe work lor whicn ihis vermil is issuetl. I shall iwt employ am Pe�n in any manner so as to 0¢come
subjeci to roe Workers' ComOensation Laws ol Calilomia.
Oate: Siqnalure:
NOTICE:Ii, atler maMing I�is Geclaration, yau shaultl Uecome sublectto �he Workers' Campensation provisions of the lahor
Coae. you mu5t IOMwiI� ComDN'�^�� Sut� Dmvisions or �his p¢rmii Shall Ee OeemeA revOketl.
CONSiflULTION LENDING �CENCY: I �¢re�y allirm Ihal ��ere is a COnSlmtiion lentlinp aAenry tor N¢ petlormanCe af Ihe work lor
which IAis permi� is issueG (Setlian 3W7, Civ. C�.
IENDEfl:
ROONESS:
OWNEB BUILDEB OEClAHI1TI0N: I �ere�y allirm I�at I am e�empt imm tAe Conincton SUte lkense Law for tAe follawinA �easan
�Seclion 7Q71.5 Business and Pmlessional COGe: Any city ol caunty w�ic� repuires a ptrmit to mnSiNct. atter, imprwe, demolish, or
repair any sVu[�me. prior lo i6 iuuance, also reQuires t�e aDP�icani lor such p¢rmi� Io lile a 5iqneG 5tatement llui �tlshe is Iicense0
pursuant Io tlrc O�orsions ol tne Cantnctors' S�ate License Law (Chapter 91�mmentin0 •+�h Section 7000) af Oivision 3 al ine Busineu
anaPmlessions CoOe) or tAat �dshe is eeem0� ��erelmm and t�e Easis for lhe alleqe0 e�emption. !ury vioWtian ol Section 7031.5 Uy
any appfitani br a 0lrmil SuUittISIM applkani lo a Civil p¢nally al nol more Inan INe nuMretl Oonars 1`�1.
I, as owner of tAe propetly or my emyloyees with wapes as I�eir Sole WmpenSaiion, w�l Oo Ne vrork, antl Ihe
❑ slrucWm s nol intenCea or allaetl for sale (Sennn 70ad, Bu9ness an0 Protctsional CoGe: T�e Cantra[mrs' Sute License Law
doa trol appty lo an o`�'ner ol a Dropeny wM bu�lUs ot imprOvu tM1eieOn, anC who Eoes such work hitmetl/Aerself ar t�rou0h
Iris oi �¢r wm employees, pravide0 I�ai suc� impmvem¢nis are not inte(MM of aHered tw sale. tl, Mwevcr the builEinp or
im0�wement 5 tqU wit�m one year ai campletion, t�e awner vrill �ave t�e OurEen nl 0��9 �� ditl not 7uild or imprm¢
tor the purpOse ol Sale).
I. az owner al Ine pwp¢riy am exUUSivUy coniraclinp wiih IicenSeO wntractor5lo canSVuct tne proiect (SecOon 7lbd. BWineu
❑ anE Professipis CoOe: 71ce Coniraziws' State license Law tlaes not wpry to an wmer o( praperrywtn EW45 a improves Nerean
anG x1m conincis lar sucli Drqecis wit� a coniractoqs) licenu Durswnt m tAe Cantactors' State license Law�. I am aware
Ilwi prooi ot iM� Workefs Compensatwn insurarrce S�oNE De proviAeE to me.
� I am evempt unOer Sectian: 8. a P. C.
loi INS teasan: ,
�ate: Umer. '
I tlo ne¢�y cenify inai I am arraa a1 anA unUerstan0 ine reQuiiements ot Calitomia Healtn and Sahry CaUe Sections 25505, 25533, an0
2553a aM �hat I o� any lutme OuilGinp acupam wi�Vwi�l n t(circle one) neeA Io wmpry with saiU siate coCes antl t�e repuiremenis for a
permil fo� consirutlbn or moUiliCation Imm ihe Rir Oualily ManaAemenl �ist(ict. NeStlentldl mrtVNttian apWicdUons art eKempl Imm
Iheu proviLons.
Daie: ApWicam:
I nereoy cenily itWt I luve rWa IhiS ap0��alion an0 sla�e Ihat ihe ahove Narmation 4 tArrect. I
or0inancesanOstalelaxsrela�mAioOuNCinpconstmnionantl�erebyauth izerep25enla�ive50�i1
pmpeny lor ins0 IiOn pu�005¢5.
Oate.� Signalure. �
oriver's License oi Sociai Securiiv x:
wmpty wiih allcily anC county
enrer upon �he aAwamemioneA
i641�<6 W�i�e—BuilCinq; Groen—CaEe EnlorcammC Canary—Aoolicanl: Pink—Fevenue: GoWenrod—Asxxmr
CITY OF COSTA MESA — BUILDING PERMI'f N6x NV; tl 5yivu
PERMIT NO: B 059140 PLAN CHECK NO; 03495-92 A ��TSurTrv
CONSTRUCTION TYPE; IFR SP � PERMIT TYPE: STR PURPOSE; ALT
JOH DESCRIPTION : 3950SF OFFICE T.I. SQ FT: 11,850
CLAIM VALUE; 50,000.00 CALC—VALUE: 72,•127.00` GROUP OCC: B-2 /
COMMENTS; HANIC OF AMERICA 3RD FLOOR T,I.
**��r�r**x ��r**�r��**���rx�x**x�****+��+��r****xx*�r*�r�tx�t***�*x�*****�ex+�*+t+��rx**+���*x�*x*#*#
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUII�DING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARRING REQ• PROV: PARCEL; 91050104 2NE: PDC REF NO;
PLANNING NOTES> TENANT IMPROVEMENTS FOR THE 3RD FLOOR OF BANK OF AME�ICA
> BUz.I,DING � ^ r•° ri
**�r**�r����*�+r�r**��#*x***�xx�*+e�***��(*it��*****x �t��*�e���x**�***x�x-�x**w****�**�*�
D E V E L O-�P M E N T S E.r R• ; V I C E S.y R E Q U I R E M E N�T S
1
ZONING APPROC'ED HY -� �� ��" y! y`.' DATE: % 2Z
BUILDING APPROVED BY : S i, � DATE; 2
APPLICATION ISSUED *EY: - '� — DATE; ��`� /� 1��
lEiEiEiElEiFiFifff'1Fffik1f1k1f1E1FiE�F�il�ih frtt � . ' ffiEifkiEiFiElFifiF - .c x ##
iEiFlflEiF1E3E%%11�lFlE!(�lFlflcfhjGlPl6lEiE�Ejf�lfif!(�IFikikiFlF!libii��7f� �iFil�fElFiE.3f rriE�il�N�fflEihlhiElf-1F�K�itiEikihif�M-iPiHE,ii�iE�41f3f�1EifiF?FiEif�ifiF
LEGALIZATION:N F E E'�� S U M M A A Y ST�iUC•Y`Uk �L� SEGMENT;Y
BLDG PMT PLUMBING ELECTR�C MECHANIC FIRE ��SMZ�/REi,; GRADING
PEkMIT 518,00 � �iSMIP/NONr�iES
PLAN 84 . 18 % t /'}.5 ;115 � �
ISSUE FEE "" '
BUILDING—DIV—> FERMIT ISSUE PliAN,CHECH TUTAL PF,ID �� DUE
TOTALS----> 533.15 0.00 - :89.1"8 617.33 � 61Y„3� 1'�' .00
REVENUE DIVISION TOTALS--> COLLECTED:ii 533,15 OVfiR/SHORT �� ��. 00
BLDG PMT PLUMHING ELECTRIC MECi[ANZC-- FIRE SauIP/TOT GRADING PiAN—CHECK
518.00 ` , 15.15 N , �
IE iF iE ih iFlF iE i(-1E 3E iF iE iE iE it �l(� iE �i-ik iE 3F if� �k iE # 3E iFlf #iE iE ft±Eii-iE iFiF iFiE?F!E iElE 1t iF �41f IE it * iE if M� i! if ik if �FlE iE �IE iF �1E iF ff iE ir k if 1E iE if ik iE iF � 3E iF jE
I N D I V I D U A L`'F E_fi� B R E A R Dk O W N� ^ ��
TYPE QTY D E S C R I P T I.O N�� i� UNIT COST '1 TOTAL COST
SFC 3950 OFF—INT, ALTER TYP.E �'I� F,R, —AVER 17.24 �� 6�8,098.00
SFC 3950 EQU—ALT COMM, SPRTNKL�R�.SYS —AVER ,.33 �.� 1,303.50
SFC 3950 EQU—ALT COMM. AIR.CONA / —AVER .69 �,-- -2,77.S.50
END O��FEES
. / . G- ' �%
. � . / � .
''` � �. ��!'
�+ " . ,
l
/
/ ��
CONSTRUCTION AND PI.ANNING � POL_ d SPA
APPROVALS Permit� Date Inspector Oate Inspector
APPROVALS Permit #
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location ._
2. Soil Pipe•Undrgrnd. '-- 53. Steei Reinforcement �:
3. Electrical Conduit Utility-Undigr�d. ' � 54. Forms
� 4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reittforcement 56. Rough Plumbing & Pressure Test
� 6. Electrical UFER Grnd. 57. APPROVAI. TO COVER�GUNITE _
7. Footings � � 58. Elearical Conduit•Undrgmd. '- �
8. Foundation -, -' 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. � "� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System . } � 67. APPROVAL TO DECK ' '-
11. Properry Sewer Line & HoGse Connection� ' 62. Backwash & ReceptorFinal '��
�
12. Sewer Cap � 63. Heater & Vent•Final
73. Roof Droins � • 64. Plumbing System • Final -
�-.
14. Aough Plumbing � '. ' 65. Electrical-Final
75. Rough Electrical-Conduit __ -- 66. Solar System-Final �
16: Rough Elettric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Elearipl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning " FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPFiOVALS Permit #
27. Dutts,in Structure � 70. Underground Hydro
22. Ducts,Ventilating 77, ProductPipin9OGas ❑Oil
23. Gas Pipe�Rou9h & Test � 72. Underground Flush
24. Rooi Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Fremeand Fiashinq q f�'t,�L 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SVSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' I.,i 79. FINAL INSPECTION
32. Electriwl Power Meter�Final �; ' 80. FOOD CERTIFICATE ISSUEO
33. Final Electric �.=,.�y �,Bi�Notes: � ^ /
34. Final Heating & Air Conditioning +� �� C2/.� "_%.Y ��,-/_tM�..%/1_'tQY_�
�
� �M ,_.r%_G�t �'°� �a /-�L��i�r.�
35. Final Gas Pipe�Test . � �� --` �0� �, ��
36. Hood or Canopy � ' ��� ��SU /3 l�! �����
37. Final Factory Fireplace `� _._ . .
38. Final Plumbing 'r�.. (�€O
39. Water Servicp-Final �
40. Gas Service�Fina�
41. Solar pomestic•Final
42. Backflow Preventer � �
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation ��� a� Sw6_L(!�-�. �F-�
46. Handicap Regulations ����y � ����
47. FINAL STRUCTURE & BUILDING � ��ry / �`(„
�L
48. FINAL PLANNING �.. -.
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Dats
Pfl0.1FtTA00NE55: �SSS P.NTON B1. �N�T� 3RI)
OWNEfl'SNAME; BANK OF AMERICA
aooeess: 20 N RAYMOND AV 3RD FL
PASADENA, CA �
818-578-7700
' RNCM/ENGINEEN: RAY HERHOLT NEG.NO.: CZ 1O%3
�DONE55: ?ZO%2 CAMINITO VINO UNIT:
LAGUNA HILLS CA 92653
PERMITTEE: �MSTRONG CONSTRUCTION ( Bi 8) 967-8001
nooness: 929 SPRZNG MEADOW DR
WEST COVINA CA 91791
UCENSEO CONTBRCTOB UECtAMTION: I �ereEy dflirm Itu� 1 am Ike�tt of Chapter 9lcommentinq vnt0 Section
n
7IXI0� ot Uvivan 9 ot t�e Busine55 aM Prof¢Ssions CoOe. ]M my I' a in lull for elittt.
CITYlIt: 05% %1 srareue.:43404 . '
c� �Oate: _ Si9reture:. _ _ _ _
WON� EPdS, COMSENSR�TION DECIAMTCON�Y 1M1e � Ei� �� �hdv�a terlilifai! o� [On5¢ni l0 Sel uu re 0 cenilicate of Warkers'
roucr no.: ��4 ��� exr. o�n: � 1/ O 1/ 9 3
coMrnxr: REPOBLIC INDEM
❑ cen�u wny a nereoy mr�anea. C� cen�rea co a iu�
-oate: 9 �� �i � AooM1cant�� �
E%EMPfION FPOM WOXIIEXS' NMPFNSRTION OEWXATION: (ilis 5a0m MeG na Ee complete partii o I me AunEieA (5100) a kss�.
I cenity Nat in ihe performance of i�e work lor wliic� ihis pErmit is i55uetl. 15tlall not emplq am/ persan in any manner 5o ds to befAm¢
subject to tAe Workeri fAmpensauon Laws o� CaGtomu.
�ate: 5gwWre:
NOTICE: 11, aner malting tAis aetWration. y0u 5houla DecomE suOjetl to tAe WOMeIs' Compen5ati0n Drovi9oR5 of ihe Labar
CaEe. you musi tonMtit� camply wii11 suc� D�o��O� a� �� Ve�mii slwll be EeemeE revoke0.
CITY OF COSTA MESA - BUILn2NG PERMIT tx Nu: r � iy
PERMIT NO; P 059143 PLAN CHECK N0: N U, S Y; N
CONSTRUCI'ION TYPE; IFR SP PERMIT TYPE; PLU PURPOSE; OTH
JOB DESCRIPTION : 3950SF OFFICE T,I, SQ FT;
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS; RE: B59140 PRIMARY HLDG, PERMIT,
�*�**�*���**x��-�t**xx****xx**�***�t****�r*���r*�r�r*�***��*�**���u*�+��***�x��*�*�***�#x�
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL; 41050109 ZNE: REF NO;
PLANNING NUTES>
>
it it *�lt �t iF 3f it iE ft �f iF iE iE it iF �e?e iE if iF%fF iE%iE if 1E iE iE iEit iF 3E it it iF iP ik if 3E iP iE iE iE iEdE iE iE N-iE 3E if iEiP k if iF it iE iE it if iE iF1t if if it ik 3E IE 4 iF iE if-it 3f if�
D E V E L O P M E N T S E R V Z C E 5��� R E Q U I R E M E N T S
ZONING APPROVED BY ^- DATE;
BUILDING APPROVED BY :
CONSTBUCTION LENOING nCENCY: I nereoy aflirm tnai mert ¢ a constmction IenAinB agenry lor tAe pedormance al tAe work (or APPL I CATION I SS UED H Y•;F��{�F���
whicht�ispermitisissuea�5ection3097.Civ.C�. M�iEiFiFiE�(-iEifkitiEiEititiElfitiEiEit1lit x c
LENOEP: �1.� iE1EiFiFiF3flEiFifiEitikitiFikiFiffEifikikififiEif3EiEiFiEi6ik iliE
nooeess: LEGAL I ZATION ; N F E E
- DATE:
��� AATE• �Q���
.. e � tt �iF'iFif3(�lF�F3flhiFiFifjE �c, xiezitifiE
iFi�it�FiE' iFiFilaEiF�fiEiEiEbiE�E3tklfiEMihifiEiEifiEieiE3eiEiE3FifibiEiF3fik
S iJ M M A R Y STRUCTURAL SEGMENT;N
OWNEB6UIlUEBOECIANNTION: I�ereGyatlirmt�atlamerem0���omlAeContracmri SlateLicenseLawlorlhefollovnnAreason BLDG PMT' PLUr78ING ELECTRIC MECHANIC FIR$ SMIP/R$S GRADING
(Section 7�31.5 Business aiM Pmlessronal Cade: Any cily of munry whic� repuires a permil 10 conslrucC alter, improve, demolish, or P ERM I T 7 0 0
repair any simclure, D��or to i�s issuance. alw repuires ��e applicant lor such permit to lile a siO�eA slatement tlul �e/she is Iicense0 � S= ,<- SM I P/NON-RES
pursuani to t�e prawsions ol ihe Cantracmrs State Laenu Law �CIUD�er 9(cammencmp vnth Seciron 7000) ol Orvision 3 of ihe Business pLAN
anA Prolessions CoOe) or I�a� �e/She is ¢xempt IherelrOm anC I�¢ OaSa br IhB all¢peE eeempli0n. Any violaiion ol Setiion 7031.5 6y
any applicanl br a permit su0jects t�e a071icant io a civil penalry ol nat moa t�an live hunEreC Collars (5500�. I SSUE FEE 2 Q, 0 0
BUILDING-DIV-> PERMIT ZSSUE
i, as awner o� ��e prop¢rty Or my empiayees wim wayes as tneir wle campe(rsation, will aa me work, ana the TOTALS----> %, �� 20, �0
❑ simcture is not intenGeG or ollered lor sale (Sepan 76aa, Buuness and Prolessional COCe: The Contractors' State License Law
tices not aDD�Y �o an owner o� a pmpeny wM �uilEs or improve5 t�ereon, an0 wlq EoeS 5ut� vrork himsell/h¢rsell or Ihrouph
�is or �e� own empioyees, pmvitleOlhal wc� improvements are nol inten0e0 ar ollereE lor sale. II, however the huilCinp or RE VENU�. D I V I$ I DN 7'�TAL$--> CO
im0�ovemem is m10 vn�Nn one year of compietmn, ine owner vrili hava tne burGen ol omvinp hUs�e Eitl noi huild or impmve $ LD G P M T PLUMH I NG E L ECTR I C
for ihe purpOSe ol Sdie�.
I, as own¢r ol I�e property, am ¢x[lu5iv¢Iy comrac�in0 ��� iicenSeE camractors lo constmq the pmleci (Section 70a4, Business Z 7• O O
❑ anOProteSSionsCoOe: TheCqnirattars'SUIeLiC¢nSCLawCOP,SnotapptytaanownerolproDerry whoOuilQSorimprovest�ereon ********K************�***********
antl w�o contratt5 lor sucA Omletis wllA a caniractoqs�license pursuan� lo Ihe Coniracmrs' Siate License Law�. I am aware
t�at p�ool ol t�eir Worker's Compenutian inmrence s�oNO De pwvi0e0 io me. I N D I V I D U A
� I am eeempl unEer S¢ciion: B. 8 P. C.
ror �ms reuon: TYPE QTY D E S C R I P T I
Date: P«ner. I PLU
I Go �ere0y cenify Ihal I am aware ol anU unUerStanE rtle repuiremMis ol Calilomia Healtll anG Sdfery CoGe Sections 25505, 25533, and
255Ja anE t�at I oi any Imure builAinq acu0ant vnIIM+T not (arde one� neeU io comDH ��� �i0 state cades anOlhe reaWrements for a
permii lor conslmc�i0n or m00ilicalion Iramine Air abty Maila9Cmeni Oi5lriCi. P6iAentidl COnsimctian aODlications are eRempl Irom
inese provisians.
Oate: Applicant: _
Inere�y cenilytnatinave reaatnis apvlrcati0n ana slalethallne
artlinances ane 5�alelam relatingio �uilAinpconsiruclion aM Aer
pmpetly forinspection Durposes.
Oare: � 9gnamre.
Driver's License or Sociai Securiry �:
I aArte 10 fAmpty vn�h aA ciry antl counry
�a ury to enter upon Ine a0ove-mentionea
�I6a1-<b Wnne-9wlaing; Green—Goee Enlorcement: Canary—Applicam: Pmk—Revenue; GolEenrotl—Auessor
l
1 SINK, KITCHEN
(i
I
piA�-cxscx
?- 0,00
C
TOTAL PAZD DUE
27.00 2'7,00 .00
7.'7,00 OVER/SHORT: ,00
FIRE SM7P/TOT GRAAING PLAN-CHECK
� if ie iE if 3f 3E i! it if jE k iE IE if 1E k k 1E k if 1(� k 1! i(� iF i(� if iE iE iEiF ik 1E fElf iF if IE if i(� if iE !E IE iP
� F E E B R E A K D O W N
{
O N UNIT COST TOTAL COST
i
}' 7.00 7,00
END OF FEES
'1
J
��� "�� . :r, _' -. . _
�.�_ "' ' " _ . .
CONSTRUCTION AND PLANNING POG� & SPA
APPROVAIS Permit#,_.._ Date Inspector AppROVALS Permit# Date I�speetor
1.'Temporary Elecvical Service oi Poie � 52. Pool & Equipment Location �-
2. Soil Pipe�Undrgrnd. �, � 53. Steel Reinforcemont ,
• 3. Electrical Conduit Utility-Undrgrnd. � 54. Forms >�
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Piessure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings - 58. Electrical Conduit•Undrgrntl. .' _�
8, Foundation '' � 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe�Undrgrnd. _ � � 60. Backwash Lines, P•Trap, O Undrgrnd. . '
70. Structural Floor System ' 61. APPROVAL TO DECK
i t. 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 ', Ll� a/pq � 65. Electrical�Final '
7 /j' 7f
15. Rough Eleccrical•Conduit ._. _ 66. Solar SYstem-Final '-�
16. Rough Elettric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20.� Rough Factory Fireplace ' �APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro �
22. Ducts, Ventilating - , 77. Product Piping �Gas OOiI
23. Gas Pipe�Rough & Test . � 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Fiashing 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 j i 79. FINAL INSPECTION
32. Electricai Power Meter�Final � �, -�� 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:Q?/-qZ,
l�a�`-'2�GacY-- trPa�
34. Final Heating & Air Conditioning � �
35. Final Gas Pipe-Test �
36. Hood or Canopy �
37. Final Factory Fireplace -
38. Final Plumbing ql�� (�f,(�
39. Water Service�Final
40. Gas Service-Final �
41. Solar pomestic�Final
42. Backflow Preventer , '
i
43. Backflow Irrigation
44,. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAI STRUCTURE & BUILDING '
48. FINAL PLANNING � -
49. Electric Release to Edison
50. Gas Release to Southern Califomia Gas Co � � �
51. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECT AUOPE55: �> S S ANTON B L
OWNEN'SNAME: FIANK OF AMERICA
aoosess: 7,0 N RAYMOND AV 3RD FL
PASP1lENA, CA
�N�T: 3an
818-578-7700
' APCN/ENGINEEN: RAY HERBOLT flEG.NO.: C 1 S O%�
noosess: 22072 CAMINITO VINO uxiT:
LAGUNA HILLS CA 92653
PENMITTEE: ARMSTRONG CONSTRUCTSON ( 818 ) 96%–R001
noosess: 929 SPRING MEADOW DR
WEST COVINA CA 91791
UCENSEU CONTHACTOP OECNBATION: I hereby allirm �Aa� I am Iicense0 er pmvisi Chapter 9 gommencinp with Section
7000� ol Division � oi t�e Business an0 Pmlessions COAe. ana my license is' full brce antl e t.
ciTr uc.: 0 5 6 8 71 STqTE LIC.: 4 3 9 O 4 7 S: .
Dale:� � � ���2— Sipnature: �� _
WOflRFflS' COMPENSRTION OECLABATION: I hereEy aflirm I�at I �ave a teni�icate ot consen� to II= Sure or a ilicaie o� Workers'
Comuensatmn �s�a o� §ce�t�ied coov tnereoi ISection 3eoo. �ae. �1 / O 1/ 9 3
roucrxo.: REPUBLIC INDEM E%P.OFTE:
comrnxr: ,y
❑ Ceni�ieG copY is Aere�y fumisheA. L'] Ce�ilieU coDY is f�letl v e ti�y BuilOing '' ion.
oate: 9'/ L 4�/, Z ADPlicanl.
E%EMPTION FNOM WOPIIFB$' COMPENSPTION OFCLAMTION: (TIliS 5etipn neM ipi be tOm01e i� (he pelm is e hunCf¢0 (5100) a Iess�.
I cenily thai in the pedormance of ihe work lor w�ich this Dermit is issue0, I shall nat empl r any p� in any anner so as to become
SUEIe�� �o I�e Workers' Campensalion LawS of Calilomia.
Dare: Siqnature:
NOTILE:If. after making Inis tleclaration, you snoultl become suCletl to ine warkers' Compensation provi9ons of tne LaEar
CaCe. 7rou must Ionhvni� compry vnih suc� provi5ions or IhiS perrtut slull Ge Geem¢E rewkeE.
CON5T8UL710N LENDINC FGENCY: I here�y allirm thal ihere is a consiruction IenOing apency for the performance of ihe work for
wnicn �Ns oermii is issue0 (Setlion 3097. Gv. CI.
LENUEN:
nooxess:
OWNEB BWLDEN OECLRBRTION: I hereGy a8irm tAai I am exem0� ��om tAe Comracmrs' State License Law for ihe fallowinp reazon
�Seciion 7031.5 Buvness anU Prolessional CoUe: My ciiy ol counry wNc� repuirw a permii �o wnSlruci, alier, imprwe. O¢m0lish, or
re0air any stmcmre, prior to i1s issuance. also repuires t�e aD7licant lor such permit Io lile a siA�ea statement that he/she is Iicense0
pursuam io �ne o�ovisions of the Camractors' State License Law IClwo�er 91�mmencinq witn Section 7000� of Dividon 3 0l tne eusineu
antl Professinns Coae) or iAa� ne/s�e is exem0� ��ertirom and i�e Dasis for t�e allegeE exemD��on. My violatian of Section 7031.5 Uy
any appliwni br a oermil su�iecis Ne applicant ta a civil Oenalry of no1 more Ihan live nundre0 Oollars (5500).
I. as awner ol ihe O�openy or my employees vntA wages as their sole comDensation, will Ao Ihe wark, an0 t�e
❑ stmdure is not intendeE or ollered lar sa@ (Secuon 70aa, Buvneu anU Pmleuional Code: T�e Comracmrs' State License Law
tloes not apply io an owner ol a pmDeny w�o Ouilas or imOmves ihereon, ana w�o Joes such work Oimself/�erself or �hmup�
his or ner own em0�%ees. OmviGeE lhdi sut� im0�m'emenis are no� in�endeE or ollere0 lar 5ale. II, �owever �Ae 6uilaing or
improvement is soltl vnNin one year ol complelion. I�E own2r vnll Iwve t�e CurCm ai pmving �e/she OiG noi build or imD�ove
tor tAe purpose of sale).
I. as ownei oi l0e pmperty. am eeclusively wniractinp with lic¢nsetl cOnlractor5 io cons�mcl lhe pmleci (Seclion 7044, 6usine55
❑ antl Prolessions COGe: The Comracmrs' Slate Lkense law Uoes not appy Io an owner of DropeM � 6mI0s or improves Uereon
anU wno conbatls for sucn pmjecis witA a coniractorls) license pursuant to ihe Cantractors' Siate L¢ense Law�. I am aware
that o�ooi ol ineir Warker's ComcenSaOon insurance shoul0 6e D�ovidetl to me. �.
� I am exempt unaer Seclion: B. 8 P. C.
lor Inis reason:
Oate: Ownec
I do �ereby [etlify Ihal I am aware ol an0 untler5lanU Ihe f¢yuir¢men�s of California Heait� anG Sa�eiy CaOe Seciions 25505, 25533, an0
2553E antl tAat l or any fulure Ouil�ing occupani vnll/will nal (circle one) neeU to com01Y wi�� saiU slate toAes and lhe repuiremenis lar a
permil far constmction or mo0ilicalion Imm �he Air Oualiry Manapement Oi5Vic1. Re5i0enlial con5imction ap0liCa�i0n5 are eeempt �mm
I�ese pmvisions.
Da�e: ApDlicam: _
I hereby certityt�at I�avereaA Ihis aDDlicalion antl state thal il
ordinances antl stale laws relating lo builtlmg conslmction antl hel
pmperry far in50ection Dur0ose5. (
Dale: �, („ Signatur�
od�ers �icense or sociai secudty a:
to tamply with allcity anG coun�y
�o enleruponihe above-mentionetl
16At�06 WMte—Boiltlino', Groan—Cotle Enlorcemenl: Canarv—Aoolicanl; Pink—Revonue: GoltlenroE—Assessor
CITY OF COSTA MESA – BUILDING PERMIT
PEkMIT NO: M 059142 FLAN CHECK NU: N
CUNSTRUCTION TYPE: IFR SP PERMII' TYPE; MEC
JOB DESCRIPTION ; 3950SF OFFICE T.I.
CLAIM VALUE; CALC–VALUE:
i� 'n u: M 7y14
; N SUt'.: N
PURPOSE; OTH
SQ FT:
GROUP OCC: B-2 /
COMMENTS; RE; B59190 PRIMARY BLDG, PERMIT.
�***x*��t-*���*�****�**�#�*�����r��r****��*****x�t*�**��r*��**+tx�x�xx***�r�*�rx*�*x*�r*�
Z U N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT' IN REAR; FT IN
LEFT: FT IN RGHT: FT SN LEFT; FT IN RGHT: FT IN
PARKING REO• PROV: PARCEL; 91050104 ZNE: REF NO:
PLANNING NtSTES>
i
_IE iF IE it if 1E !E iF iF aF iE iF it �lE iF 3F iF 3E iF if dF iE iP 3F 3E i(- iF � 3E if x� if lE 3(� if iE ie-if Ih iF ib iF iE it if iE �lf if it iE jf if it iE 3E iF iE jt iE i4 if �lE %� �F ihjE iE-x� if iF iE i"r 3e iE 3f 3F # iFiE
- D E V E L O P M E N T S E R`V Z C E S R E Q U Z R E M E N T S
�ZONING APPROVED BY DATE;
I,BUILDING APPROVED BY : _ DATE:
'�APPLICATION ISSUED BY•�— • • o� DATE• ��{����rf,�-=�
�iFifiEfEif3f-iEiFlFi(-IfiE1E�lEiEiFlEititifMk3F3F3F .�C.. 3� R ir'icir3F . iF . ir iF'%SFiFTf��iEfE1E#!flfiFifiEiE � r. tr3k
iFiEiElFiEikiEifil�%lEiEiE3Fif3Eih�7EiEiffE3F3t�kitkiF�E�EifiEifiEN�iE1FiflEiEiFiElEiE�FIf ' iflf3F3tiFjflfi(��N��FiflfiFtEiF9EiE3EifklE#lE�EiflFiEifiF!lifiE
LEGALIZATION;N F. E E S U M M A R Y STRfICTURAL SEGMENT;N
HLDG'FMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RnS GRADING
PERMIT 39,00
258 SMZP/NON–RES
PLAN �
ISSUE FEE �� 15.00
BUILDING–DIV–> PERMIT ISSUE Bii,'?:N–CHECR TOTAL PAID DliE
TOTALS----> 39,00 15.00 � 0,00 54.00 54.00 ,UO
REVENUE DIVISION TOTALS--> COLLECTED: 54.OU OVER/SHORT: 00
- HLDG PM'P PLUMHING ELECTRIC M��'vCHANIC FIRE SMIP/TOT GRADING PLAN–CHECK
�� 54,��
iE 1E iF if i! if iFiE k it iE iE 3E iF ik if ik iE 3f jE iElE 3E ik iF iEiE M� lE iE if IE iE iE�if if iFlE iE iE IE !E iE iF iF if it if 1Elk �F �1F 3f iE iE iE if if iEif iE�F ih if� iE i! iE'R if iE if �E )E iE iElf iE iF 3F
I N D I V I D U A�� F E E B R E A K D O W N
TYPE QTY D E S C R I P T I'O, N UNIT COST TOTAI. COST
r'
MEC 6 VAV BOX
END OF FEES
��
J
6.50
� � U�:� �^. _r�r-�i l �`9j, ..' _
_i:_ �.•,., _ . ._•^.'
39,00
�
CONSTRUCTION AND PLANNING P0�_ d SPA
Date Inspector Date . Inspeccor
APPROVALS Permit # APPROVALS Permit # _
i. Temporary Elect[ice� Servlce or Pole , 52. Pool & Equipment Location
2. SoilPipe�Undrgmd, - - 53. SteelReinforcement _.
3. Electrical Conduit Utility�Undrgrnd. ;� 54. Forms �
4. Electrical Conduit•Undrgmd. 55.' ElecTrical Bonding
5. Steel Reinforcement , 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical ConduibUndrgrnd. -�
8. Poundation � �� ' 59. Gas Pipe, � Undrgrnd., Test - '
9. Water Pipe-Undrgrnd. �, �l. � 60. Ba�'J::yash U�rs, P-Trap, � Undrgmd. T �
r �
10. Strucwral Floor System � Gl. A�rFlQV/�L TO 7EC�t �
1 t. P�perty Sewer Line & House Conneciion • g2, g„�'. �,-::h @ R�c.ptor•Pinal '
12. Sewer Cap � .- 63. He�lt .:. `�ert:•Finai
_ _ 1
13. Roof Drains � 64. Pium6irg Syuem • Pina� - ��.
14. Rough Plumbing - �' 65. ElectricabF�nal -�_
15. Rough Electrical-Condurt ; -- 66. SolarSystein-Final
16. Rough Electric Wiring 67. Fencing & Access Anuroval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & A�r Condi2ioning 0�3D f� L� FIRE DEPT. REQUIREMENT
I
20. Rough Factory Fireplace � APPROVALS � Permit #
21. Ducts, in Struauie 70. Underground Hytlro
22. Ducts, Ventilating 71. Product Piping �Gas OOiI
23. Gas Pipe�Rough & 7est 72. Underground Flush �
24. Roof Framing � 73. Undergrnd.StorageTank�OGas ❑Oil
25. Roof Sheathing ' 74,- Overhead Nyd%
26. T-Bar Ceiling (Structurap &�Monocoat 75. Dry Chemical
27. Frame and flashin9 �6. Dry Standpipe �
28. Lathing & Siding -� � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL �
30. Drywall Nailing I•'j. HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ; ., 79. FINAL INSPECTION
�
32. Electrical Power Meter�Final � !' 80. FOOD CERTIfICATE ISSUED
33. Final Electric '�•'' Notes: Cl�j,��L yo,.�s�Y- t.Eo
34. Final Heating & Air Conditioninq rQ � .�p
•_
35. Fina� Gas Pipe•Test � �
36. Hood or Canopy . I
37. Final Factory Fireplace .
38. Final Plumbing ' _.
39. Water Service�Final �
40. Gas Service-Final � �
41. Solar pomestic-Final
42. Backflow Preventer , � ;
43. Backflow Irrigation
44. Landscape Irriqation SVstem
45. Sound Attenuation
46. Handicap Regulations _
47. FINAL STRUCTURE & BUILDING i
48. FINAL PLANNING � -
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co ;�..
51. CERTIFICATE OF OCCUPANCY
No. Date
_�
1
cTnooeess:' S55 ANTON BL uxir: 3RD
OWNEfl'SNRME: $,�NK OF AMERICA
RUOflESS: ZO N RAYMOND AV 3RD FL
. PASADENA, CA
818-578-7700
ancx�excixeen: RAY HERBOLT BEG.NO.:CSLO%3
RDONE55: �2O%Z CAMINITO VINO uxrt:
LAGUNA HILLS CA 92653
PERMinEE: ARMSTRONG CONSTRUCTION ( 818 ) 967-8001
nooeess: 9zg SPRING MEADUW AR
WEST COVINA CA 91791
LICENSEO CONTMCTOfl OFCIAflRTION: I �¢reEy allirm Ihai I am liren5 r pmvism ter 9(commenNnp wi�� Sectian
7000� of Uivision 9 o���e Business ana Pro�essions Coae. an0 my license ' in full�orce and efleci.
cm�c�05 871 sTnTeuc.:4340�1J ss: —i
Da�e: SignalurecL. _ _ _ _
WONKEB$'COMPENSRilONOECIAflFTION: Iller¢Eyallirml�allAaveatetliliWleottonSenliosell-in5ur a eniliwreofWorkers'
Comoensabon I¢srrp�e� a3 �cutitiee ropy mereo� ISet�ion 3800. lan. ��1 / O 1/) 3
raucvxo.: REPUBLIC INDEM E%P.DRTE:
COMPFNY:
❑ Cenilietl copy is hereUy furnisheU. � Ceniliea co y is IileA ith he ciry Builtlinp Division.
Wt� ` %'6/�7 _ ppplicant: '
E%EMPTION FBOM WOXKEPS' fAMPENSRTION OEClANR110N: (This sec�ion nee0 not Ge comple�eE i� the permil i or o¢ h 4re0 (5100) or less).
I ce�ify I�a� in Ihe Oetlormance al �he work �or w�ic� t�is permit is i55ueE, I s�all no� employ any person in znn¢r so a5 io Eecome
subjec� lo tAe Workeri' fAmpenSation Laws ol Calilornia. •' n
Date: SiAnalure:
NOTICE: II, after making ihis deGaraiwn, you ShoulE Gecome suble�� to the Workers' ComOensation Dmvisions of tAe Labor
CoGe. you must lorthwith comDN wiih such pmvisians ar this Dermit sAall be Oeemed remkeA. _j�;
CONSTBUCTION LENOINC �GENCY: I her¢Cy al�irm Ihai Ihere is a wnstrucfion IenEing agenty fOr Ihe pEdOrmante ol I�e work lar
wNeh Ihis permi� is is5ue0 (Setiion 3W7. Gv. C�. "^
LENOEfl: +•�"^
ADOPESS:
OWNEP BUIlOEB OECIABRT10N: I her¢Oy atlirm �hat I am eMempi imm I�e Contrac�ors' S�a�e License Law br lhe iWlawinp reason
(Section 7031.5 Buvness and Pmfessional Cotle: Any city oi counry wAich reQuires a Oermit to constmct, alter, imDmve, Oemalish, or
reDair any 51rucWre. prior to rts issuance, also reQuires Ihe aOVlicant for such permi� lo lile a signeU Slalemeni I�ai he/she i5licen5e0
pursuam m t�e provisions ol the Contramors' Staie License Law (Chapter 9(commencing wilh Section 7000) oi Oivision 3 oi IAe Business
an0 Pmfessions CoOe) or Iha� he/she is exemp� Iherelrom antl Ihe basis br Ihe allege0 exemplion. Any violation ot 5¢c�ion 7031.5 6y
any aoolicant for a permit subjecis Ihe applicant to a civil penalty ol noi more ihan live huntlretl tlollars (u�l.
I, as owner of �he pro0erty or my employees wilh waAes as iheir sole compensation, will Oa Ihe work, anA t�e
❑ slrucWre is not intentletl or ollereC lor Sale �5¢ction 70dd. Business an0 Profeuional Cotle: T�e fAniractors' State License Law
Ooes nol apDly to an owner ol a D�ope�y w�o builOs or impmves thereon, and who Ooes sucA waM �imsell/herseli ar ihmugA
Ais or Aer own employees. DmviOetl t�at mc� impmvements are nol inten0e0 or aflert0 for sale. II, however Ne buil0inp or
impmvement is sala within one year ol com0leiion, t�e owner will �ave ihe 6ur0en of provinA he/she di0 noi EuitA or impmve
lar the purpose of sale�.
I, as awner otihe o�oOe�Y• am extlusively toniractinq vn�n licensee contractorsto construcline prOjeCt(S¢Ction 7044, BuSiness
❑ an0 Pmlessiws COAe: Ttu Coniractors' Slate License Law tices not appty to an owner ol 0�opetly who 6vilOs or impmves t�ereon
an� w�o convac�sior suc� Dmlects with a coniracloqs�license pursuan��o Ihe ConVactars S�ate LltenSe Law�.l am awafe
ihat prool of Iheir Worker'S Compen5ali0n insurance slbula be Wa�ded �o me.
� I am exempt under Sectian: 8. 8 P. C.
br this r¢ason:
oaie: ownec
I do �ereGy certily ihat I am aware ol anG unEerstana ihe repuiremenis of Califomia Nealih an0 Safery Code Stttions 25505, 25533, antl
2553d anU Ihal I or any future builtling occupant willlwill nol (circle one) neetl to comply wiih said sla�e cotles ana ��e repuiremen�s fo� a
permii br conSlruciion or motli�icalion irom Ihe Air �uality Management Dis�nct. fle5i0¢n�ial conslmclion ap0lica�ion5 are e�empl Imm
Inese pmvisions.
Oa�e: Npplicanl:
I �ereby cendy t�at I �ave reaa ihis aOPI¢alion anA siate tAa� t�e a6ove i ormation is wrrecL I ag lo compty vnlh all cily antl county
orAinancesanOs�alelawsrelatinglohuilUingconstmclionantl�erebyaulhorrz resenta�rveso�ihis � �ewpeMheabareimenlioneG
pmperty �or inspec ion purposes.
Oale: � Siqna�ur .
oriver's �icense or Saui secudty r:
i6aLn6 W�ite—BuiWing; Green—Coee Enlorcemenl: Canary—Applican�; Pink—Revenue; GoWenraE—Assesmr
CITY OF COSTA MESA — B6ILDING PERMIT Yk:KM NU; � ��yiqt
PERMIT NO; E 059141 PLAN CKECK N0: N GOVT; N Y: N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE: ELE Pi7RPOSE: OTH
JOB DESCRIPTION ; 3950SF OFFZCE T.I. SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS; RE; H59140 PRIMARY BLDG, PERMIT.
x�*�r*��rx**��***�*�*x*x*+�*x ��*�*xx**x**x�*�t*�r+t�*���+�*�x��*�tx*�*+�*x�*�***�***+�**���c
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDZNG ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT' IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEfiT; FT IN RGHT; FT IN
PARKING REp • PROV; PARCEL; 41050109 ZNE; REF NO;
PLANNING N(SI'ES>
�
jE dF 3E if if jE iF lf !E if iP iE i43E if if }k 1E iE 1E iE iEiE iE iE �F iE # 1E 3E iE iE �f 3f.* 1f i( iE if iE iE if 3E �k 1f iE �IE �E N� if 3E iF # if if�iE i(• If if iE 34 if iF iE iE 3F �1F if M� ihjE �F 3'r iF 3e ie �F fe iE
D E V E L O P M E N T S E��-R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY '� ' DATz;
HUILDING APPROVED BY
APPLICATION ISSUED BY;��F�I���(F
*�**�t**+rrt+�***�r�r�r*�*�** �tt
iE iE k iE If �E iE af it iE iE 3f iF 1E iE iF i! iF iE !E if 3E 3ElE 1E 1E if iE iE 3k 1E �f if
LEGALIZATION;N F E�
DATE:
� 'iFiriF3fiE1EDiE3EiEjEif�i7�lfi4
iEiFiE�kiFiFiF iFjfififiE3EifikiEiEiFiFlEifiE�EltiF�FiFiEiFie�ElfifiE3Ele3E1e3E3i��E
S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 4g�8�0� SMIP/NON—RES
PLAN i•
ISSUE FEE t15.00
BUILDING—DIV—> PERMIT ISSLIE PiLAN—CHECK TOTAL PAID DUE
TOTALS----> 49,80 SS,UO �.�f 0.00 64,80 64,80 ,UO
REVENUE DIVTSION TOTALS--> COLLECTED; 64,80 OVER/SHORT: ,UO
BLDG PMT PLUMBING ELECTRIC M£CHANIC FIRE SMIP/TOT GRADING PLAN—CHECR
64,80 %
i
iE iF if �lElE if iE iE �k iF if �E iE iE le iE if ik iF iF 1f iF iE 3E lFiE iF iF �� i4 iE !(-1f ik �E,�E IF 1F 3f iE 1F 1f ie iE IE iF if iE if it� if iE 1E 11�iF iE 1E if ?E iE if IF IE 3E iF 1F if if if if iE iF If !t ie iE 1E if fF
I N D I V I D U A>L F c E B R E A K D O W N
TYPE QTY D E S C R I P T I O.N UNIT COST TOTAL COST
ELE 20 FIXTURES, LIGHTING�•. 1 ST 20 EA, ,75 15.00
ELE 33 FIXTURES LIGHTING- ADDITIONAL EA, ,45 14,85
ELE 20 RECEPT/Ot7TLET ' 1 ST 20 EA, .75 15,00
ELE 6 RECEPT/OUTLET '- ADDITIONAL EA. ,45 2,70
ELE 3 RE:CEPT/SWITCH L 1 ST 20 EA, ,75 2,25
END OF FEES
�r
iC�irl ��' ._. _ �._'i' . i. ,!..
r ' '
�ONSTRUCTION AND PLANNING
APPROVALS Permit # -- ,_ Date
1. Temporary Electrical $ervice�0� Pole ,
2. Soil Pipe-Undrgrnd. �
3. Electricai Conduit UtilitY-Undrgmd.
4. Electriral Cqnduit�Undr9md.
� 5.. Steei Reinforcement
6. Electrical UFER Grnd.
7. Footings � ,
8. Foundation ' �
9. Water Pipe-Undrgrnd. `
70. Structural Floor System� ' �
t t. Property Sewer Line & Hduse.Connection �
t
72. Sewer Cap - 3
13. Roof Drains ' , • Y
14. Rough Plumbing ' �
75. Rough Elenrical-Conduit �
� �/�
76. RoughElectricWiring
17. Rou9h Wiring Sign -
18.. Rough Electriql-T Ba� Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. DuCts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T�Bar Ceilin9 (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
� 30. Drywall Nailing �
31. Plaster Brown Coat
32. Electrical Power Meter�Finai
33. Pinal Electric � �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumhing
39. Water Service-Final
40. Gas Service•Final
41. $oVar pomestic-Fina1
42. Backf�ow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILOING
46. FtNALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
Date
POOL & SPA
Inspector pppROVALS Permit #
52. Poo� & Equipment Location
53. Steel Reinforcement
54. Forms
55. E�ectrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL7000VER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Uncirgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor-Final
63. Heater & Vent•Final
64. Plumbi�g System - Final
65. Electrical�Finai
��, 66. Solar System-final
67. Fencing & Access Approval
68. APPROVED FOR PLAS7ERING
69. POOL/SPASYSTEMSFINAL
FiRE DEPT. REQUIREMENT
APPROVALS Permit #
,
70. Underground Hydro
71. Product Piping O Gas ❑ Oit
72. Underground Flush
73. Undergrnd.StorageTank OGas OOi�
74. Overhead Hydro
75. Ory Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
79. FIRE PREV. FINAL
HEALTH DEPT. REQUfREMENT
79. FINALINSPECTION
80. FOOD CJ-ERTIFICATE ISSUED
Notes: ii/p/ry-� ��,��� /l nf/'..
Date �Inspector
�I
�I
Pfl0.1ECT R�UflES$: •S S S ANTON BL uxit: 3 RD
OWNEN'SNRME: BANK OF AMERICA
nuosess: 7.0 N RAYMOND AV 3RD FL
PASADENA, CA
818-57A-7700
, APCNIENGINEEfl: R]i5( HERBOLT NEG.NO.: C 1 S D% 3
aoonEss: �2072 CAMINITO VINO uxiT:
LAGUNA HILLS CA 92653
PEPMITTEE: GOLDEN STATE FIRE PROT (714)923-4060
nooness: 936 E FRANCIS B
ONTrlRIO CA 91761
ULENSEO CONTBACTOB DEIXAM710N: I �ereEy atlirm ttat I am ficerseG under D«�s of C�aDier 9(commencinq vnih Seclion
7000) ol Oivisian 3 0l ��e Busineu aiM Pmlessions CoOe. and my Ike�e a in full lortt anE elfect.
uTruc: 007649 sr�Teuc.:350225(� cuss: C-16�
Daie: �I -Z2 �i Z Siq�umre: I.iL.-� /�.✓e.�b
WOflNENS' COMPENSR7ION oEtIAMTION: 1 nereGy aflirm Wt I IWve a ceni(i[ale ol ton5ent to ull-itrsure or a ceniliWte of worker5'
comcensaron i�s�a�y a���t�e4 �e� �e«oi is���, asoo. iao. �'� / 01 / 9 3
aoucrxo.: AEPUBLIC IND EI(P.ORTE:
COMPRNY: ,y
❑ Ceniliea copy is nere�y fumishe0. L'J Ce�ifetl copY a��etl wit� t�e dry BmlEing OivSion.
Date: � -22 -� 2 ApplicanL � C' '"✓ �
E7(EMPIIONFNOMWOHIIFNS'WMPENS�TIONOECWIATION: (iFissecOmnceDrotbemmqeleOiftlepemtrsfaanelaNreE�5700�akss�.
I ceNty ttu� in tAe pedormante oi lhe work far wttic� this permii is ¢sue0, I shall not empby arry pCrsOn in a�ry manner so a5 to Gecome
su�lect �o �he Workers' Compensatian laws o� Catifomia.
Date: Signamre:
NOTILE: II. aM1er making this decWration, you sMuIG Eecome suEl�� �o t�e Workeri Compensation Orwisrons al l�e Labor
Ca�e. you mus� tantrvnt� Campty wi�� SucA 0�a'mions w INs pemtii 5Aa0 Se UremeO fevoked.
CONSTpUC710N LENOING �GENCY: I �ere0y atlirm that t�ere is a construction leikmp aAe�Y �o< <�e peAormance of ihe woA lar
which inis permit is issue015ection 3097, Civ. CI.
tENOEfl:
aooeess:
OWNEP BUILUEB oECIAMiION: I �ereGy aflirm ttat I am aem0< <mm tlle Contanwi State License Law tor I�e taAowinp mawn
(Section 7031.5 Business ana Protessiorel CoOe: My dty ol munty which repuires a permit to cwisiruct, alter, imDrw4 Eemolis�, or
reDair any stmcture, prb� �o iis iuuance. also repuires t�e aOW�� �or wU Oermii io lile a vpne0 statement tlwt �rJshe ¢ licenutl
pursuant b t�e pmvisions af t�e GomracmK Sta�e License Law (Chapter 9(wmmencinq vni� Stttion 7000) ol Division 3 ot t�e Business
ano Prolessfons CoOe) or Ihal ne/sne is e�empt inerefrom ana Ine Ea5i5lar tne alle0ea etemption. My Nolation ol Seciion 7037.5 Cy
any aoPlicanl lor a vermil suEie��s Ine apvliWnt to a civil penalty al not more ltlan live nunArEA Uallars (SSW).
I, as awner ol tne prop¢rty or rtry employea wit� wd0� az t�eir 5ole fArtpenSatian, will tlo t�a woM, an0 ihe
❑ simcmre is not intendetl or olleretl lor sale (Secuon 70aa, Business and Professbnal CaEe: T�e Coniracrors' State License Law
Uoes nol apD�Y to an owner al a pmpeny wta EuiIGS or impmves t�ereon, an0 wlio GoeS suctl w0A �imsell/herull or tllmupA
�iS Of hEf OWII 2111pI0YCE5, plOVIGCG IIIdi SOt� IIIIOfWCfIIC0I5 d!0 001 IOIlIIGBG Of O��tfCd 10( Sd10. I�, AOwCVCf I110 �NId�Q Of
impmvement is w10 wit�in one year ol completion. i�e axner witl �ave t�e �urtlen ol pmvinB M��e Eitl not Oui10 ar imOmve
for iAe Durpose of ule�.
I, as owner oi Ine pmDe�Y. am erUusively contractinp vnt� Iicense0 coniractors to wnslrup t�e prolect (S¢ction 7U44, Business
❑ an0 Prole55ion5 fAOe: itre Caniractors' Slate Licrose Law tloes not apply to an avmef ol DroOerry wh0 OUAUs or improv¢s lheroon
anC wno coniracis for sucn o�ojecis vntn a mntractorts� liceme Wrsuant to Ine Cantractors' S�ate Licensa Law�. I am aware
��at Or00� O��hev Worker'S Campensalbn in5uranCO Stqu10 Oe prm�iUdeO to me.
� I am exempt under Seclion: B. d P. C.
far l�is reason:
Oate: Owner.
I Ao here�y certily ��at I am aware of antl uritlerslan0 i�e r¢Quir¢mtn6 01 Glilomu Meal�h antl $a�¢ry CoEe Seclions 25505. 25533, antl
25534 anU��al lorany�ulure Ouiltling OcapanlvnlVvnil nol (Cirtle one�ne¢OIO mmDly wiih 5ai0 S�a�¢ coAes anOl�ere0uiremenis�ora
permil lor constmclion m modilication Irom I�e Ai� Ouality Managemeni Oislricl. flesi0eniul con9mction appiication5 are exempt Imm
Ihese provisions.
�ale: AOO�icanL
I hereby [¢r�ily Ihal I have read I�iS aDGlita�i0n antl 5laie I�ai th¢ aGove inlormaiion ¢ corr¢t�. 1 agre¢ lo romDW wi�� all clry antl County
ortlinances antl s�ate laws reW�inq to �uil�ing consimc�ian arM he�e0y aulhor¢e re0��nia�ives oi Ihis ciry �o ¢nier upon ��e aEove�menlion¢tl
pmperry lor in50eciion OurDases. /
Daie: '�-ZZ-9Z SignaWre: �.�-+ �✓�
�river's License or Sacial securily n:
I6a1�46 W�ite—Bwltlinp: Green—Cotle En�orcement: Canary—Aoolicanl; Pink—Revenue: Goltlenrotl—Assasxnr
CITY OF COSTA MESA — BQILDING PERMIT N�xM Nv; r v�yiy�
PERMIT NO: F 059193 PLAN CHECK NO; 03530-97. L � ; n 5u r: rv
CONSTRUCTION TYPE; I FR PERMIT TYPE; FIR PURPOSE: ALT
JUB DESCRIPTION : 3950SF OF FIRE SPRINKLERS (ALL OF 3RD ) SQ FT:
CLAIM VALUE; 3,940,00 CALC—VALUE: GROUP OCC; B-2 /
COMMENTS; BANK OF AMERICA 3RD FL REF:B
****x��x�*�rxx�r*�r��**+�*�***x�**�r��r**x�*��r�e�r*�**�r*�r**��+�*�***�*��****ce******:�*x�*��*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL; 41050109 ZNE: REF NO;
PLANNING NiSTES>
>
1f 1F 3E af iF iE 1E 1E iE if k iF aF iF iElE 1E if iE iE iE iE 1f !F If !E 1F if if iE it i! if if iE 1F iE 1E iE fE iE ik IE iE iE if if iE iF 1F if 1E iE if 1f 3E iE iE ff jE 3F iP �# 3E ib iF iE !E iE iF iE 1EiF fE iE ik iF if
D E V E L O P M E N T S E R V I C E S R E Q U I R'E M E N T S
ZONING APPROVED HY DATE;
BIIILDING APPROVED BY ; �1 ' DATE:
APPLICATION ISSUED BY• t'�L S� DATE; Z2-
1Ejf�lEiriFififikiEifitiEitkkififiFitifiE*7F7F3FTFfei'r�F'iF'fFiZ�£3FiFft/F1FiFif iF3fiFif 3FSf3FTF'iF3FTFiFiFlElFlElfiEififiEiEif � trttiF#
IE iF if �lF if iE if iE ik * ik iE it if it iE k 1FlF if iE iE iE IF If if 1k �E it iF if �)f !f iF iE iE if �F if iF iF 3c 1E if if 3t iE !t iE iF M 1f iFlf If iE k 3E iE k iE 3E jE k iE �E iE iF k iC� 1E �E iElF iE iE k iE jf
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SECMcNT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63�SY SN,IP/NON—RES
PI.AN 40. 95
ISSU6 FEE
BUILDING—AIV—> PERMIT ISSUE PLAN—CHECR T01AL PAID DUE
TOTALS----> 63.00 0.00 40,95 103,95 103,95 .�0
REVENUE DIVISION TOTALS--> COLLECTED: 63,00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING FLAN—CHECK
63.00
1f iE if �k if� iF iF�k rt iF if dE iEiE if i(� iF if iE K ie �k it if� iF IE iE iE iE M iE if if iE-1F 1f iE i(� lf iE k iE iC if k if i(-it �M� I( �IE iE iE M� iEit iFiE lEd6 ikitiFlE it iE if 9FiE �ItiE if iE if if iE if iE�IE
I N D Z V I D 0 A L F E E B R E A R D O W N
TY.PE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 63 FIRE EQUIP FEE (FAOM BLDG VAL TABLE) 1,00 63,00
ENU OF FEES
fr1 il' ' .- " �
i:�'� � .. _ .' .' '
CONSTRUCTION AND PLANNiP1G PO. . SPA
APPROVALS Permit #_�- Date Inspector AppqOVALS Permit # Date Inspector
. 1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location
- 2. Soil Pipe�Undrgmd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF£A Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footin9s 58. Electrical Cqnduit•Undrgrnd.
8. Fo�ndation 59. Gas Pipe, O Undrgrnd., Tesc
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 67. APPROVA� TO DECK
11. Property Sewer Line & HouseConneaion 62. Backwash & Receptor•Finat
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drains 64, Plumbing System � Final
14. Rou9h Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System�Final
i 6. Rough Elearic Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPftOVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
� 19. Rough Heaung & Air Conditloning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in Struaure 70. Underground Hydro
22. Ducts, Ventilating 71. Produc[ Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Under9md.StorageTank �Gas OOiI
25. Roof Shea[hing 74. Overhead ;�;y�i.a ,3✓��- (N
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL ���7, �
29. Insulation , 78. FIRE PREV. FINAL S_3�1j� (.VM�1 �
30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION �
32. Electrical Power Meter�Final • I � S0. FOOD CERTIFICATE ISSUEO
33. Final Electric � ; � Notes:
34. Final Heating & Air Conditio���9 I (
35. Final Gas Pipe-Test � '
36. Hood or Canopy � i
i
37. Final Factory Fireplace � �
38. Final Plumbing � '
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic•Final �
42. Backflow Preve�ter
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILOING -
48. FINALPLANNING �
49. Electric Retease to Edison
50. Gas Release to Southern Califomia Gas Co � �
51. CERTIFICATE OF OCCUPANCY
Na. Date
PH0.IECT RODflF33: S S S ANTON H L
mvxex•sxnxe: SECURITY PACIFIC NAT BANK
�ooeess:600 WILSHIRE BL, L.A.
RflCNIENCINEEfl:
ADONESB:
REO.NO.:
r
uNR:300 I CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: F 049165 PLAN CHECK NO: 05265-90 S
UNIT:
' v¢ernirree: KIMBLE AND COMPANY ( 714 ) 895-1156
noaeess: 7540 SUZI LANE
WESTMINSTER CA 92683
IICENSFO CONTMCTOP DECUMTION: I �ereby alfirm that I am Iicensp,gNnUer Drovisians of Chapter 9(commendnp xit� Sectlon
7000�'of Division 3 al tAe Business anE Prolessions CoOe, anE my fice ;a a in lull taru an0 ellect. �
cmuc.:038503 sre�uc.:�60923 ''' Gss:C— _
oate: �-zS %v l ±�n9d�Of0:
wnBNEPS' COMPENSRTION OECLAMTION: I �ereby affirm IIWt I have itiwte of conunt to selbinsure or a artifiwte oi WOBers'
' '•nulioNnvuaqrq y��Ntiad �py 3petpo� (Section 38o0, Lah. � Z 3/ 9 S
INO.: WY079 C7 VL �](P.DITE:
..�P,v�x: FREMONT INDMEM.
❑ Certifie0 capY is herehy fumisheE. C� ertifieA coDY is fle0 't a clry BUIIEInp 0' 'si . �
Date: 7 �zS� U _ Fpplicant:
IXEMPfI0NFP0A1VlOPI�R3'COMPEIISIITIONDEWMTION: (Iticsectim m�ete0iftlrepemilicfaaneAwtlrN�5100�alessl. ,
I ceniry that in t�e peAormance of ttre vrork lor wNCA tNs Dermit ¢ iswe0, I I not employ any person in any manner w az ta Oecome
wUject to Ue Workers' Compensation Laws of Calitamia.
Date: Slonamre:
NOTICE: II, aRer makinq this Oeclaration, you sAoulE become su6lect to t�e Workers' ComDensatian provisions of t�e La�or
CaOe, you must IorthwiN wmpN �+�� such prwisims ar ihis permfl stwll Ee deemeE revokeU.
CONSTRUCTION 1EN01NG RGENCY: I here�y atlirm t�at there is a constmction IenAinq a0enq for the peAormance ol t�e work for
x1uc� t�is permiti5 issueA (Seclion 3097, Civ. C�.
LENDEfl:
RDOflE33:
OWNEN BULLOEH OECIAMTION: I �ereEy aifirm Ihat I am exempt Irom t�e Coniractors' State Licensa Law lor tAe lollowinp reason
(Sectan 7031.5 Business anE Protusional CaUe: My ciry ot caunry whicn requira a permt ro mnsiruct atter, imprave, Oemotisn. a
repair any simcture, D�or to hs issuance, also roquires Ihe appliwnt lor SucA permit ta �le a sipned statemen� Ihat ha/s�e is IicenuE
pursuant ta Ne provisions af ihe Conlactors' SWte Lkense Law (CMpter 9(camrtcendnp vntA Section 70W) al Oivision 3 al Ne Business
anG Nohssions CoOe) or [lut hUSAe is ewempt IAerelmm an0 [he 6asis for the alleOeA eKemDibn. My NolaGon ol Section 7031.5 hy
any applicant lor a Oerrtut wbjtt¢ Ue aDDliwnl ta a civil penalry ol not moa Wn INe �uMreO tlolWrs (5500�.
I, as owner ot !he propeM or my emplayees with wa0es as thelr sole comDensation, will Uo Ne work, anE tha
stmcwa is irot interMeO or ollered lor ule (Section 7W4, Business an0 Pmtessional Cade: The ConlraMars' SWta License Law
. Ooes not aDOtyta an owner oi a D�oDerty who EUIIEs orimpmvesthereon, an0 who does SucA work himseli/hersell ort�rou9h
' his or �er own.emD�oyees, DmWtled l�at such impmvements aa not intentleE ar ollered br sale. Ii, �owaver t�a builCinp or
Impmvemant is solE within one year at completlon, ttre owner will Aave t�e UurOen ol Drovinp Ae/she EiE not Uuiltl or improve
� br the ouryose ol Sale�.
1, as awner al Ihe proDeM• am exclusiv¢ly cont`rafRctimnep �t�h lic�en� contnctors to consimd t�e praject (Sectlon 7044, Business
❑ an0 Prolessims Cotle: ma Cartractors' state appty to an avmer of properrywlro Wtl0.s or improves ttrereon
anU wAo conirncts for such pmle��s with a coniractor(s)license pursuant to iha Caniraclors' State L¢ense Law),I am awam
tAat D��� ol Neir Worker's Compematlon inwrance shouW he proviEeO ro rtre.
� I am exempt unAer Section: B. 8 P. C.
. lor lnis reason:
Uate: Ownec
I Oo herehy certity Wt I am awara oi anE undersGnE t�e requirements of Calitomia Meall� anA Safery Cotle Sectlons 25505, 25533, an0
25537 an0 t�at I or any hrture EuilOing occupant vnll/vnll not (circle one) nee0lo camply with sai0 stata coEes anE IAe requirements br a
permit lor cansimction or moEifiwtion trom t�e r Uuahry ManaAement Olsidct. ResiOential consimdian ap0�ications are exemD� �mm
lheu pmvisions.
Date: rlppliwnC _
I �ere0y aNry ttut I luve rwE tNs appliption aM state ihat ine
or0inances an0 state Wxs rehtlnp to GuiPoinq c stnwtian and herel
properry tor inspecfion D.urposes.
Oate: — Sp�atur�
oriver's �icenu or Soci� Seanry x:
¢ conecl. I
ampry wuA all dry anE counry
�Mer upan Ihe aUovo-men/tlpneE
�C _ /
1841-48 W�it�Bulltling; Grean—COEa Enlorcement; Cenery—Applitant; Plnk—Ravenue; GOWanrotl—Assasaor
PERM NO: F 049165
GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; FIR PUAPOSE: OTH
JOB DESCRIPTION ; FIRE SPRINKLER SYSTEM FOR OFFICE T,I. SQ FT:
CLAIM VALUE: 2,680.00 CALC—VALUE; GROUP OCC: /
COMMENTS: X
*���e***�*�e*r*+r*xx�rr*r**�e**�r*�r�r��e*+r�r���r�rr***�*+r�r*+r*�**�*+r+r+r*�r**�*+t�r**at�r+c**�**�r*
Z O N Z N G R E Q U Z R E M E N T S
S E T H A C R S '
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN AEAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PI,�ANNING NOTES> "
>
/irkilMkkMififMiliflfMiFMiFM1EMifMkiFkiFkikNlFifMitfflkiFlkiklFiFlFMiFlEifkikkMklFlfMifMM±FiFklFkikMlflFitltkikiFiFiF!lfk1FlElfikif
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
ZONING APPROVED BY ,
HUILDING APPROVED BY :
APPLICATION ISSUED BY•
MMMifMMMMMMMMilMMMikMififMM
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LEGALIZATION:N F E E S U M M A R Y
DATE:
DATE:
�
k ikD K M K M 1f'iF'iE7F'IF�iFM M�
iE IF�fF iF M M IF iF ik M if k if iE iF it IE iE IE iE
STAUCTURAL SEGMENT;N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIAE SMIP/RES GAADING
PERMIT 54.00
PLAN 35610 SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL , PAID DUE
TOTALS----> 54.00 0.00 35,10 89.10 89.10 .00
REVENUE DIVISION TOTALS--> COLLECTED; 54.00 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54,��
ikiFlFikiki:MitM1E iF iF iEiF iFiFiFiF aF ik if if iFiF ik iF it iFiFikiE iE iF iF�FiFiFiFMi! iFik KiE�k iFikiF�F at ik iF3F If iE MiF3f iFaFiFM ik ik ikif if 1EiFiFM 1F iF iEiFiFiF Mit
I N D I V I D U A L F E E H R E A K D O W N .
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
FZR 54 FIRE EQUIP FEE (FROM BLDG VAL TABLE) . 1.00 54.00 '
END OF FEES
'" l' �
� ,
, ' "
. � fli DOD70362—ODD74362 Tra'� . 54.1ID /
DATE: 09/25/40 TiItE� 12:35 �/
\\
CONSTRUCT N AN LANNI�i - 'L & SPA
APPROVALS � er it �- Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Etectrical Se ' or Po�� 52. Pool & Equipment Location
;i3 � Soil Pipe-Undr,grn¢; o �E 53. Steel Reinforcement
� �Electrical Con�i'i�'�tility-UndrgrricSF � 54. Forms '
.�,. =o :a
:.$�.�;Electrical Condilrc-, . drgrnd. :,,,•�; 55. Electrical Bonding
�5�'Steel Reinforc ' `�%• �
�f�i � ` 56. Rough Plumbing & Pressure Test
��Electrical UFER Cm d. � 1 Z 57. APPROVAL TO COVER�GUNITE 4
�'.T-�� �Footings O'C � 58. Electrical Conduit-Undrgrnd. a
;�. Foundation e`- 59. Gas Pipe, O Undrgrnd., Test �
�9�Water Pipe-Untlrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
r .
1�"'Structural Floor System � 61. APPROVAL TO DECK
i�. Property Sewer lirig & HO,use Conpection 62. Backwash & Receptor�Final
�
f2. Sewer Cap y '- , °1 63. Heater & Vent-Final
�i --�
73. Roof Drains -� a 64. Plumbing SYstem - Final
14. Rough Plumbi4 . 65. Electrical-Final
15. Rough Electriwl-Conduit 66. Solar SYstem-Final
16. Rough ElectriC-Wiring 67. Fencing & Access Approval
w
�77. Rough Wiring�jgn 68. APPROVED FOR PLASTERING .
18. Rough ElectriC3Y�T Bar Ce�ling 69. POOL/SPA SYSTEMS F�NA�
79Q,Ro,uQh H�atwg 8�jir Conditi�i[� ,� * y,y �* k �,FI�E.DE�PT. f,?EQUIREMEN�, �„
20.�Ro�h ctcaty%''�eplace i ST G�, � S H+�..^+� � PPRflVAiS.��.F-Pet,tnit# � 'T' ""
.� %: � ti x "`i--� .T. x.
21'"r,'�Du"�.ts, il�St�actt�� � .• •. `�'' � S `� �'� * 70. _�l'nder i�,u{�4j y�c ''
i S� � CJ �-+ [1* � g o H ro �,
22SfluCts. VentrlatiRq# i •,�� � b M CJ Ft Y: 71. Product�;ng O�i s O�OiI
i "S * :�; �S � O* .K � .-� * F
23.'T'ia�Pip�Ro�gh � �est i r• C�' C50 � � a SX � �z. Undergro`}�jKJ Flus�i"� x �, -�
24��Roo Fcaming �� c�n R �'� > x H* *••73hUndergrnd.StorSg�f'ank'OGas ❑Oil
25 Roa( Sh�athing x� d �� ���' C� f��' � 74�"Overhead �~ '�
c � � � x� m o* � F�s� q-Z�- �/�
26a,T- u Csiling (Strueiural) & �coat * O � Ox �: 75<Dry Cheral'cal i-D x� v �--�
!1 �' M
27�Frameand FiSshin �^� � 3' �" �� x ~ c'� " ^ � 'P�
. tv r-� � NmCJ c a: yx� � 76. Dry Stanc�i#e ¢F: ;� G N
�8. Lathing� S' ing *�� OcF O � � I 4. x 77.'7 FIXED S'/9TEIWF�INAL�' - C1 6�'b,A.ljD �,V;,�
a s •• r �» E i-,- �> Q i-;
,.,29. Insulatit� � * S �j * S I I �* 78oFIRE PREV. FIdAL y 7 �
^30. DrywaIFAlailing *H � �'r-� I I �:K S JdEALTF{-bEPTxREQUIREMENT
.,
`J31. Plaster �o Coai� S �`"`"' � I i �* 9^FINAL If��CTl�I * T�`•'
�� � i r: x �: � i-+
F - -� x � �c � -�
�32.=�lectri ` Povrer Mtjier-funal� �: I 1 * 80.�OOD CERTIFI`�ATE IS6l;IfD'; !-
�33.�irp'� EI"�trie � � � a � I I . * ,� � .,,,,,1 �' � O ��.: .
�� i�;� x x� ;� x Notgs: ¢ mn * fs
��� c•. . -� s i . � � �: .. .,
4.�,Fin� HgBtin�& Air*Cp itionin z: �; � � �*; ^ � �..;� d^
�35.�finrl Gas Pipe-Test* O� y `'' I � � * �,,� �^ � � �''.'
�^ * o i r• � a. �: � � , .., ' .
�6.SFIo� ot�,CanoPY x C1 i x:. x I � �r: :n ta zo * c-, >,�,
7.'FinB� Fa tory Fire x ' `'E" �`-' * * � * �"-`�
� �%e � .. . o W ,� I � � � K [rv fi
538.�inaml� Plp�inbing *�; i c � � � M ;..� G. * �
�39.`3Vater Service-Final� F i r� I , ?� * 4� x T "
rn r v' �K t% Y E-� ^s. �K C�1 i�?
'0.0. �Gas Serv' e-Final '� � "'-" S ?� m � �-
C u. � * C1FF [+; * I I rc F• OE * C
�-41. Solar pomestic-Final' [�1 �^ I I " M t^�v w �7o c � X �
n, ,,� c., x kk � �-a a r„ C i x S
V42. Backflow PreYenter* n' � � � � * '� � `" �'
.✓ * N O!-�r-� * �-, � � [T7oN-. m0 �k .
r
43. Backflow Irr atior� �'� �� ** N �' k '��
`Y y' 4 i'. i: [lI X 3 .�
"' 4. Landsca Ir�'ri. atio S ste ��� � * m " * * "' .� �� �:
� f�. 9� 4 P Y mJ'� .: [�7 * �t �L <C � Y, � E E a> O�"'•, �c S
a v . "
45.:Sound Atterivatior� ^- ^ •• � � T :T7 ?!* * �^ -" C' 'Q • i-�7 r
t'1 k; .• M * 'J / � H �-f .. F-i �(
C46.'Handicap'Regulatio�s S � * S � � �* K m O r *
!*47. It�FAL STRUCTURE & 6UILDING * H , 1 * w � � � �- T �
r,; r m-n x :K � Zi Q '7 l: r�
J
48. INY�L PLANNIN � e.E- � N � * cr r
�. � i x. I � ,�r*:� r;.; s * ¢
!s39.��Electric Release to Hdison i s � ! �: * m •C� k �;�
v� r i F. � o^ a: !n a
� !
`tiT�O.=fias�elease to Sout�iern Calito`c�'i�� Gas Cn ,,. I M,Y, F" S �� �'�'�j * y„
"51. CERTIFICATE OF OCCUPA'NCY ' '" "- " -
No. Date
L)
CITY OF COS7A MESA CO STR UCTION PER IT
Project Address � � _�_
Applicant's Mailing Addrea
Owner's Name �` v ' � �� one
Address ��� �" � 6 1
Arch/Eng. License No.
Address
Convactor's Namerf�JN a.C. SbU o+2 1 Phon��'� %�/' ��1
Addresslmailinglsh� �� t � 1�.. SV�fI�! �e.1 �c.
City License No. n 3.�. /4 q
LICENSED CONTRACTOR DECLARATION �
I h¢reby affl�m tltat I am licensetl untllr prOvitlOni of Chdrt¢r 9(<OmTlnCing
with sectlon 7000) o( DlviSion 3 of the Business antl Pro(e5sioni Cotle, antl
my Iicense is in I f rce antl effect. �
License (�Ia/fs ice G1w �
Date �/�+r S9ndt r �
s'„�fiKERS' COMPENSATION DECLARATI N
�: ?areby a/Brm that I hdve a certlficate of consent lo self-Insure or a certlficate
� Workers' Compen5ation Insurance, or a c¢rtifietl copy thereof (Settion
� 3800, Lab. p
Policy Noi�� fl C 3'� �5 9 S� Comvany
eCertitie�� q�y�y� �� f�ed with�the�G�y n9 izi
Da[e! •2l S�a✓ APP��canC, .�4 i-t-�-' f
EXEMPTION FROM WORKERS' COM NSATION UECLARATION
(Tnis section neetl not be comple[eU if tne permit is for one �unUretl (5700) or
less).
I c¢rtify tnat in th¢ performant¢ Ot the work fOr which jhis plrm4 is Issuetl I
shall not emplOy dny perzOn in any manne� �so�as to become subject to [�e
Workers' Compensation laws of California.
Date Si9natvre
NOTICE: Ii, after making this tleclaratlon, You shoultl become sub�ect to Na
Workers' Compensation provisions ot the Labor Cotle, you muzt forthwlth
comply with such orovlsions or this permlt shall^roG tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hareby afllrm tnat tnere ls a construction lentling agency for tha performance
��� of the work for which this Derm4t Is iisuetl (Section 3097 Civ. C.)
I Lender's Name
� Lenticr'z Aaaress
OWNER BUILDER DECLARATION
I hereby afBrm lhat 1 am exempt from [he ConVac[orY Licanse Law br tne
/ollowing reason (Section 7031.5 Business antl Profe551onai Cotla: Any cltY or
county which requires a pGrmit t0 cOnitruGt, dll¢r ImO�ove, tllmOlish or r¢palr
any structure, pNor to iti issuance, atso requires t�e ap0���ant for suth pormit
'^ Iile a Si9n¢tl ilatem¢nt tnal h¢/shG I5 Ilcensetl pur5udnl to the prOvisloni oi
Contractor's �icense l.aw (Chapter 9(commencin9 witb Settlon 7000) o/
sion 3 01 tlle BuSiness antl Pr01es51an5 COC!) Or tllat tle/5h0 Is exempl
.retrom antl the basis for Ihe allegetl ezemption. Any vlolaUon ot Sectlon
7031.5 by any applicant for a permit sub7ects the aDP���ant to a clvil
enalty of not mOr! lhan live huntlretl t1011ars (b500).
� 1, as owner o! tne oroperty or my employees with wa9es as their sole
comoensation, will Oo the work, antl Ihe structure is not intentletl or o7feretl
lor sale �Section 7044, Business anU Profezsional Cotle: Tha Contrattor'S
Llcense Law tloes no[ apP�Y to an owner of a prgperty who Dulltls or improves
tpareon, anU who COes Su<h wo�k himself/h875G1t Or tnroug� hls o� het own
employees, oroviCetl tnat suc� improvements are not Intentletl or otferatl for
sale. If, however, lha builtling or improvement I5 soltl wi[�in ono year of com-
pletlon, tho owner will have the burtlen ot orovin9 he/she aitl not builA or Im-
prove tor tne purpose of 5ale). �
❑ I, az owner of the property, am ¢zclusively contracting wit� Iitensetl con-
traclors to construct the O�oject (Section 7044, Busineis anC Protesslons Cotle:
The Contractor's License Law does nol apply to an owner of praDerty wno
builtls or impraves ln¢reon. antl who conVatts fo� SUGh orol¢cl5 wIM a mn-
tractor(s license pursuan[ m me ConVattor•t License Law). i am aware lbae
prOot o� [heir Wo�ket's CompanSallon insu�anGe Tnoultl be ptovldatl to me.
❑ I am exempt unUe� $ection B. & P. C. �or this �ed50n
AOD���ant to lill In all sDaces axeaD� Inose wit�in �aary DorEer Ilnet anC sign all aovropriata aeelarations.
�RjypT NO_. _ TR}1Cy,N¢. LOT NO. UNIT NO.
Date Owner
I nereby certify t�at I have reatl
inl�rmation is correct. I aaree to t
. Drivers' L en or 55 q/
0865-46,rev. 5/88
ta[e that the above
tl county orainances
�by authorize reD�e-
ionea Orop rty or
oate / L
�
TVPE OF CONSTRUCTION- LLNEW _LI ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMUtISH ❑ OTHER
DESCRIPTIONOFWORK/USEOFBLDG. -
TVPE OF PERMIT LI GRADING LJ FOVNDATION U STRVCTVRAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL J
❑ �OTHER C L4
PROJECT DESCRIPTION S4.FT. OCCUPANCv
CONSTRUCTIONTVPE � VALUATIONS��
ZONE GRADINGCU.VDS. ACRES_
Remarkf: � I �% � ✓ �
Sink
Preventer
Irrigation
Drinking Founteins
Floor Drains
Floor Sinks
Gas Service Outlets
Interceprors
Kitchen Sink
Lava[arias
P-Trap
Roof Drains
$hOW¢f5
Service Sink
Sewer Cap
Sewer Connection
SOlaf Collector5
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wesh
FEES
Reinspection Fee I $15 I I Isue Fee I $ 3 I
MECHANICAL FEES
eoiier
Duct - Under Ground
Duct - SlruCturel
Dutt - Ven[ileting
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iCBO #
Heating System & Ducting
❑0.700,000 BTU 0100,000
Reinspection Fee � $15
White - Builtling; Candry - Applicant; Pink - Accountin9; GOItl¢nrOtl - AsSessor
1
Hood or Typel �
Canopy Type II �
Refngera[ion System
❑0.700,OOOBTU �100,000
System Repair/Alteration
Fire Dampers
Registers
Isue Fee
S 3
A.P. qIE �
S Main Building:
E
T Front
A Rear
C Right
K
g Left
Ping. Ref. �F
Autometic Washer
Construction Pole
Cooking Unit
Dishwasher
Dryers ❑Gas ❑
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
-� p�- Zone �
Accessory Building:
Z
O
�' N
I
N
- G
R
Parking Req.IProvided E
U
M
T
S.
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Garbage DispoSal
Generator 00.5 KW �5-15 KW
Sub Panel �
Motors 00�1 HP � 1'/h � 8
Inc. Solar 09-15 HP �16-15+
Microwave �
Pole Light
Range
Sign
Standing $ections .
Trash Compactor
FEES
� Roinspection Fee �$15 � I Issue Fee I $ 3'
DEVELOPMENT SERVICES RE�UIREMENTS: /
ZoningApprovedBy � �at6 2���
Building AVProved BY rr . %.r—Date��
SUM".'-7—�5 —L�=
. BUILDING PERMIT $ ,�SMIP $
PLAN CHECK PERMIT
PLUMBING $ ISSUANCE $
t PLAN CHECK 25% $ ENERGV P.C. $
_•ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
�-MECHANICAL $ TOTAL FEE $
, PLAN CHECK 25% $
01 �DO:?SGO-UQD22542 Yea"P 54C.�C
DaTE: 1?/15!8E TIfiE: 12:OD
CONSTRUCTION�ANDPLANNING . P� &SPA
APPROVALS Permit # Date Inspector p�ppROVALS Permit # � Date Inspector
1 r Temporary Electrical Service or Pple ' . 52. Pool & Equipment Location . ,
2. Soil Pipe-Undrgrnd. ;, ; . 53. Steel Reinforcement . .; ;
3.�Elec[ricalCond`uiLUtility-Untlrgrnd. �, 54. Forms ' �
4. Electrical Conduit-Undrgrnd. � ', 55. E�ectrical Bonding '
5.;Steel. Reinforcement " . 56. Rough Plumbing & Pressure Test . �.
-6: Electr,ical UFEfl Grnd: �- � - � 57. APPROVAL TO COVER-GUNITE - .
.7.;Footings • � � � 58. Electrical Conduit-Undrgrnd.
8. Foundation , , ' 59. Gas Pipe, O Undr9rnd., Test ,�
,.
9. teiiPipe-Undrgmd; , � - 60. Backwash Lines, P-Trap, O Undrgrnd. ' _.
10. Structural Floor System e�•� � • ' 61. APPROVAL TO DECK
17�- Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12: �Sewer Cap - ' � 63. Heater & Vent-Final � '.
73.'Roof Drains `` , � 64. Plumbing System - Final '
14� �Rough Plumbing � 65. Electrical-Final
15. Rough Electrical-Gonduit 66. Solar System-Final
�1�6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiiiny 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
20 Rough Factory Fireplace APPROVALS Permit #
i
21. Ducts, in Strucnhe 70. Underground Hydro
22.- Ducts, Ventilatirig � � " 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush
,24. Roof Framing _� � 73. Undergrnd.StorageTank OGas ❑Oil
'25. Roof Sheathing .' 74� Overhead Hydro - '
26. T-Bar Ceiling (Structuraq &�oat /���y r� 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: ��� °c.y�r Go
34. Final Heating & Air Conditioning
/Z Z8 �6 /
35. Final Gas Pipe-Test '
G• /
36. Hood or Canopy - / , �
�37. Final Fac[ory Fireplace . , 7
38. Final Plumbing . -.
� 39. Water Service-Final • �
'40. Gas Service-Final :�" . � '
41. Solar pomestic-Final� ' t ,. ,
� 42. Backflow Preven[er ,
43. Backflow Irrigation • �
.,
44. (andscape Irrigation System " ,,
45. Sound Attenuation � ' � �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING ' 2 z� � /
48. Special Requiremen[s Completed
49. Electric Release to Edison � •�
50. Gas Release to Southern California Gas Co ' ��
51. CERTIFICATE OF OCCUPANCY .' - �
No Date � � `
�
�
- io syr
arv oF CosrA MESA CONSTRUCTION PERMIT
ProjecYAddress Ld'D
Applicant's Mail'ng Add e s /� �� s
Owner i Nome .�.='G //iL� •66U� . P �i /,�„O
� S
P:ddress .�",r'� ��1!u!J GLt.0 �t� /f:—Jt l�L
Arch/Eng. � License No. �
Address
Contrac[or'sNnm � �— C hone?Nj'—��'7� '
Address�ImailinglCZlT —/�/Ni� iit��/ �i
Ciry License No. //� �5'T� �
LICENSED CONT0.ACTOR DECLARATION '
I nereby affirm t�at I am licen5etl untler provitlon5 oi ChartCr 9(Commancing
with section 7000) of Olvision 3 of tha Buslneu antl Pro/e55ion5 Cotle, antl
my Iicense is in full torce antl eflect. '
License Ciass — Lic¢nse No�L Ulsi�'G
Date � �? f� Sign�ure
WORKERS' COMVENSATION DE LARATION
I hereby attirm tnat I have a tertificata oi <on5¢nt to selftinsure or a certlfiWte
oi Workers' Compensalion Insurance, or a certlfl<tl copy thereof (SG<tlon
3800, LdC.- C.) ' �• '
Policy No���!'�.r �-� COmpany G ��if✓ ,
❑ Certifietl cooY Is nereby tumisnetl.
L�VCer[ifietl copy 15 fil¢tl with the ci uiltl g Dlvls on.
Date l q�� �i� APPIi �_ �—��+•
EXEMPTION�FROM WORKERS' CO ENSATION DECLAR ION
(Thissection naetl not be completetl i( Iha parmit Is lor one hu retl (5300) or
less).
1 certity lnat in the pe�formant¢ Ot the work tOr whic� thi5 p¢rrtdt IS ISSUGO I
shall not employ any person in any manner so as to becoma sub7ect to t�e
Workers'.CompensaHon' Laws of California.
. Date � 99nature
'NOTICE: Ii, afte� making Ihis tleclaration, y0u ShOUIE beCOme Subject to Ih0
Wo�keri" Comp¢n5ation provi51on5 0( [he Labo� CoOe, yau must fortnwl[n
comply witfl suc� provlsions or'this permit shall be tleametl revoketl.
CONSTRUCTION LENUING AGENCV ' `
I hereby affirm t�at Ihere Is a conitruttion Ientling agency tor the p¢rtOrmance
oi the work tor which thi5 Permit is •issued (Section 3097 Civ. CJ
Lentl¢r's Ndme
Lentler'S AtlOreSs
OWNER BUILDER DECLARATION �
I haieby atilrm Iha� I am oxempt 1rOm Iha Conlrattor'S LI<OnSo �aw for (h0
followin9 reason (Sactlon ]031.5 Business antl Proleisional Codo: Any city ar
county wblcn �equirGi a Oermit to con5trutt, alt¢r, ImDrove, tlemoli5h or repair
any structure, pdor to its,issuance, alm requtres tha appli<ant for sucn permit
to file a 5ignetl statemenl that hn/s�e is licensetl pursuant to tne provisions ot
the Contractor's License Law (CbaOter 9(commencing with SCCtlon 7000) ot
DiviSion 3 O� tll¢ B�Si�85T antl Prote55ion5 Cotle) o� �hat h0/Sha Is exempl
therelrom antl the �asis tor the alloged ezemptlon. Any violation of Soction
7031.5 by any applicanl for a Dermlt SUD�ects Ibe applicant to a civil
�Enalty of not more than tivn huntlretl tlollars (5500).
LI I; as owner of tne property or my employees wilh wages as their solo
'compensation, will tlo the work, antl tne stru<ture is not IneonOetl or ollareE �
for sale (Section 7044, Business antl. Pro/essional Cotle: The Contraclor's
Licenie l.aw tloes not apply to.an owner ot a property who bullEs or impmves
thereOn, antl wh0 Uo¢s sucn work hlm5¢If/htrzell or th�ough h15 Or he� own
emplo eas, provitletl that such imorovoments are not Intentletl or olloratl for
, sdle. I� howeveq the UUIIUing o� ImprovemGnt IT saltl wiltfln Onn yCar o1 com-
Dletlon, tne owner. wlll hava the Uurtlen of oroving ha/she tlitl not bulltl or im- :
prove for the purpOse Of salo). '
❑ I, a5 Owner of Ihe property, am exclu5iv¢ly Conlracling witb II<¢nsetl con-
tract0/s to cons[ruct [he project'$ectlon ]044, Buslne55 antl P�o1¢sslon5 COtle:
Tne Contractor's Ucensn Law does mi avoir �o an owner 01 Oropnrty wno
builtls o� improves Ihereon, anE who wntracts to� Suth p�o�ect5 wlth a Con-
tractor(s) licenze pursuant�to t�e Contractor'i Licensn Law�. I am aware inat
proof of tM1eir Work¢r'S Compensation insurance s�oultl be provldetl l0 mn.
❑ I am exemp[ untler Seclion B. & P. G. tor this reason
Appllcant to /ill In all spaees eaeeo� those wilhln heavy oorGer Ilnes antl sign all appropriate aeclanlions.
� PERMIT NO. TRACT NO. LOT NO. UNI7 N��
Date Owner
I �ereby certify Ihat I have reatl [hi5 apPlicatio0 dntl Stale that ttle aDova
intormation is correct. I a9ree to complY w��h all Uty antl coun[y orEinances
antl state laws r¢latin9 to builtlinq consVucHon, antl hereEy autnorize repre-
sentatives Of th15 <ity to enler u00n [hG dbOve-mentionetl property fo�
insoectiany ur oses. /� //�—/ `..
Si9ndturE _..� A�//N_�'_'�/L OatY�%�� �y
I Drivers'�"wfense or'SS � � ��
CMF 0865-46, rev, 30/84 White - Builtlin9; Canary - App
TVPE OF CONS7RUCTION LI NEW LJ ADD �ALTERATION LJ REPAIR
❑ CONVERSIOIV ❑ DEMOLISH ❑ OTH '
4ESCRIPTION OF WORKLUSE OF BLDG. ��[�,�(/T �/r'J
TVPE OF PERMIT' LJ GRHD�NG LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �J' MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5a. F7. oCCUaANCv_
CONSTRUCT.ION TVPE VALUATION $
ZONE ' GRADING CU. VDS. ACRES_
Remarki: �G.OG• ��/�«� L) ��COlJr
. � ��' FC..0 �i%G,iJ.GGT �laGi�G .SrJI%'eS _�G
Bar Sink
Backflow Preventer
Backflow Irriga[ion
Bathtubs
Clarifiers '
Dishwdsher . .
=1oor Drains
=1oor Sinks _
.ias Service . Outlets
Interceptors' �
Kitchen Sink
Lavatories
a—Trap
Roof Drains -�
PLUMBING
Showers
Service Sink � -
Sewer Cap
Sewer Connection
$olaf Callectors
Solar Pipin9
Solar Tank
Swimming Pool wlSpa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
FEES
�Reinspection Fee I $15 I I laue Fee ' I $ 3
Duct - UndenGround
Duct - Struttural
Ducl - Ventilating
Exhaust Sysrem ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ o-i oo,000 eru O i oo,oao
Nainspection Fee � $15
Accounting; Goltlenrotl - Assessor
Hood or Type 1 ❑
Canapy Typell ❑
Re(rigeration System
04100,OOOBTU ❑700,000
System Repair/Alteration
Fire Dampers� G Z f
Repisters
laue Fee
A.P. �
5 Main Buildin9:
E
T Ront
ARear
C Ri9ht
K Left
S
Ping. Ref. #
Planning Notes:
Automaiic Washer - "
Construction Pole Sub.
Cooking Unit .
Dishwasher
Dryers OGas ❑Elec[ric
Fan
F.A.U.
c:..l..e.. . _
Device Boxes �
Outlets
Switches
Garbage Disposal
Generaror �0.5 KW
Zone
Accessory
ELECTRICAL �
Transformer � 15-50 KW
❑ 50+KW
'Meter ❑up to 100amps
Meter ❑over 100 amps
Sub Panel
Motors�61HP�1X-6 '
Inc.Solar �9�15 HP �16-75+
Microwave ' -
Pole Light
Sign
; Standing Sections
15 KW Trash Compaccor ,
IReinsPection Fee ' I$15 I I Issue Fea
DEVELOPMENT SERVICES RE�UIREMENTS:
Zoning APProved BY
Building Appraved By
APoliption lasued BY
FEES
$ 3
Z
O
N
I
N
G
R
E
Q
M
T
S
� SUMMARY OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK . $ PERMIT
PLUMBING $ ��UANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ / � MICROFILM $ ���^ (�'-'(�
MECHANICAL $ r2���G TOTALFEE $ _SL'�"
PLAN CHECK 25%' $ . , �
O1 0002�234-ODD2423S T�Ji E5.�0
UaTE: Oti}9/R9 tTqCe /L•50
. 'CONSTRUCTION AND PLANNING � ; PG..� & SPA �
APPROVALS Permit# - Date Inspector qpPROVALS Permit# Date Inspecror
•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. ElectricalConduit-Undrgrnd.
. 6. 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 Electriral-Conduit 66. Solar SYstem-Final
T6: Rough Electric Wiring 67. Fencing & Access Approval '
17..Rough Wiring Sign 68. APPROVED FOR PLASTERING
,,}
18. Rough Electrical-T Bar Cei�ing 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning ��� G� FIRE DEPT. REQUIREMENT �
20., Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush ,�
, 24. Roof Framing , 73. Undergrnd. Storage Tank O 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".�Plasier Brown Coat 79. FINAL INSPECTION
32i Electrical Power Meter-final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning �(�b/� (��
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service�Final �
40. Ga's Service-Final '
41. Solar pomestic-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 Southem California Gas Co ' - � . . . �
51. CERTIFICAT.E OF OCCUPANCY , . ' _ ,
Nn. ` Date , � t , i , _
; '
ADO���ant to fill In all spaees exeept those within heavy Eo�Eer Iines antl s(gn all aporooriata tleclantions.
CiTY oF COS7A ME ^CONSTRUCTIONCPERMIT
P�ojectAddress �{j{�� �l�\ITE ��i�
Applicant's Mailing Address
I Owner's Name hone
Address
Arch/Eng. —���� License No.
Address �Lrf��i �1�'� l�� (� iYl�e-���S�q����
Contractor'sNama�/��L1MPl�F_�P(`ir�L phone—+ � �i
Addresslmailingl��•t��°�h1U �-107 �',n—�'�A NFSH
City License No. �4�Q� '
LICENSED CONTRACTOR DECLARATION
Phereby altirm that 1 am IICenSetl untle� p�ovisions of Chartet 9(corOm¢nCin9
witn section 7000) ot Divislon 3 of the Business antl Pro/e55ion5 Cotle, antl
my Iicense is in full force antl eHecL 5��4,, 1
�cense Class !Yf — Licens/e� N�o.� A �
t¢ 1�_ ��e —l�Jl llll¢ �A�M l lx�Y�+�-t�n�
�RKERS' COMPENS ION DECLARATION
.ereby a/firm thdt I have a CertitiW[e Of cOnSent lo self-Insure o� a ce�tlticate
, of Workers' Compensation Insuranca, or a cartifletl copy [hereo/ (SecUon
3800, Lab. C.) .
aou�v No. �.�P$A4131�(X\ Company FPCMf�T TcV�Pmc�i�1-l�
Certifietl copy is hereby (umishetl. �Xn �� —1 ��
Certifietl copy is fllea with� cily Bu�Itling Division. ��
te la-��- 8g APy� fynt '{�(ln � i�..��
EMPTION FROM WORKERYCOMPENSATION DECLARATION
(Thissection neetl not be completetl it the permit is for one huntlre0 (5300) or
iezs).
I certily that in tM1e petfo�mance ot the wo�k 10[ wM1lch lhis pGrm�t i5 I55u0tl I
snall not employ any person In any manner so as to become subject to [�e
Workers' Compensation Laws o! Cali(ornla.
Date Si9nature
NOTICE: If, after making this tletlaralion, you 5houltl bacome subject to tha
Workers' CompensaUon provi5ion5 ot the Labor Cotle, you must (orthwith
<ompty wi[h such proWSIOnS or [his pe�mit shall .b¢ tl¢emetl revoke0.
CONSTRUCTION LENOING AGENCV
I hereDy alllrm that there is a construction IenAing agency for tha performance
of [he work for which tnis permlt is issuetl (Section 3097 Civ. C.)
LenCer's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION
��� I hereby affirm lhat I am exempt trom the Contraclor's License L.aw tor the
� following reason (Section �031.5 Buslness antl Professlonal Cotle: Any tlty or
� County wnicn �equire5 a pe�mit to conStruCt, alteq Improve, tlemolish o� �apalr
��. any stfuctufe, priOr to its Issuanc¢, d150 Iequiles tha dppllCan[ fof such parTl[
� � file a signetl statement that he/She I5 IlcenSatl pu�suant to the p�ovisions of
� Confrac[or's License Law (Cnapter 9(commencing with Section 7000) of
vision 3 of [he Busines5 antl Pro(essions Cotle) or lhat he/she Is exempl
I.ne�efrom antl the basi5 tor [he alleged exemptlon. Any violation o( Section
7031.5 by any apPliGant fo� a petmlt sub�ects the appllcant to a civil
�ena1[y oi noc more [nan tive nuntlretl tlollars'(E500).
LJ I, as owner of the property' or my nmployees with wa9es as their sole
compenSatlOn, will tlo fho work,�antl tne struGture I5 not Intentletl O/�otferetl
for Sale (Section ]044, BuSin¢ss antl Professlonal Cotle: The ContrattOt'S
License l.aw tloes not apply to an owner ot a property who builtls or Improves
Ihereon, antl who tloes such work himself/herselt or through hi5 or her own
employees, provitletl [�at such improv¢ments are not intentletl Or of(¢r<tl for
sale. It, however, tne bulltling or improvement is soltl wlthin one year of com-
pletion, the owner will �ave tha burUen o( proving he/she tlitl not builtl or im-
�rove tort�e purpo5e of sale).
I, az owner ot the proverty, am excluzively tontractin9 with Ilcensea con-
tracto�sto wnstruct tne project (SecUon 7044, Business antl Professions Cotle:
The Contractor's License Law doez not applY to an owner ot property who
builtls or Improves ther¢on. antl who contracts tor sucn oroiects wilh a con-
tractor(s) license pursuanc m me Contracror's License I..aw). i am aware that
proof oi tbei� Wo�ke�'s ComOensatlon Insu�anca Shoultl be O�ovitletl t0 me.
❑ I am'ezempt unUer Section B. & P. C. for this reason
Date Owner
t hereEy certify that I have reatl this application an<
information is corre<L I agree to compty with all Nty
antl state laws relaUng to builCing conitructlon, antl h
sentatives of this clly t0 ent<r upOn [he�/a/b�o�ve-mp¢�
In tion Pu�Poses. `a� I�O —SH T�l ➢�VtJ
S�ure
Drivers'Ucen `�+r S�F.
0865-46, rev. 5/88 White - Bullding; Canary - App
. _....... .__. . _" __' "" ..�.. �....
36 3o sofl A��
S Main Building:
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T F�oni
DESCRIPTION OF WORK/USE OF BLDG. B Rear
A
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL I C Rlght
�/ K
❑ TENANT� Li1ELECTRICAL ❑ PWMBING ❑ MECHANICAL g� Left
❑ �OTHER � � ' Ping. Ref. #
PRQIECT DESCRIPTION 5Q. FT. OCCUPANCv Planning Notes:
CONSTRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES
Remarks:
Sink
Preventer
Irrigation
Clarifiers'
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
InterceptOrS
Kitchen Sink
Lavatories
P—Trep
Roof Orains .
Reinspaction�Fee
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Outlets Wa rCloset
ater Heater
Water Service
� Auto-Wesh
� Laundry Tra'ys
.. $15 laue Fea
Boiler
Dutt - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFact. Blt. iCBO �k
Heating System & Ducting
❑ o-, ao,000 eru o, oo,000 e=
Reinspeetion Fee � $75
Pink - Accounting; Goltlenrotl - Assessor
Hood or Type 1 ❑
CanOpy Type II ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
laue Fee
FEES
$ 3
FEES 'I'
S 3
" " I Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 75-50 KW
Construction Pole Sub. � 50 + KW
CAoking Unit _ Meter ❑up [0 100 amps
Dishwasher Meter ❑over 100amps
Dryers �Ges ❑Electric Sub Panel
Fan Motors 00.1 HP � 1'f, - 8
F.A.U. Inc. Solar �9-15 HP �16-15+
Fixtures Microwave
Device Boxes Pole Light
Outlets Range
Switches Sign /�„�
Garbage Disposal Standing Sections
Generator �0.5 KW 05-15 KW Trash Compactor
Reinspection Fe9 !$15 � � Iwue Fae
JELOPMENT SERVICES RE�UIREMENTS:
ing APP�oved�By
Iding Approved By ��?J � � �
SUMMARV
, BUILDING PERMIT $
i PLAN CHECK $
� PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $ DI-D
PLAN CHECK 50% $
. MECHANICAL $
. . PLAN CHECK 25% $ _.
N
I
N
G
R
E
�
M
T
S.
FEES
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $
TOTAL FEE $ 2n r. n�
01 OCQ22748-�QG?2?48 TC�"i' 2Ci.tlu
ncrc: i,fu�fl� 7ipC• 1t•OL
�f' \\�'` . .
C9NSTRUCTION AND PLANNING. '�� P & SPA _
,CPPROVALS Permit# Date Inspector qPPROVALS Permit# - Date Inspector
1> Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ,� 53. Steel Reinforcement �,
� •
3�ElectricalConduitiUtility-Undrgrnd. �., � 54. Forms
4lrElectrical Conduit-Uridrgrnd. ,. 55. Electrical Bonding
5:�Steel Reinforcement � � � �_ . 56. Rough Plumbing & Pressure Test . ��
r
6{�Electrical UFER Grnd.^ � � 57. APPROVAL TO COVER-GUNITE
.` "Footings � I -' � 58. Electrical Conduit-Undrgrnd. �
,8. Foundation ! � � � 59. Gas Pipe, O Undrgrnd., Test
9. Water�Pipe-Undrgmd. � '� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � ��� 67. 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 �
T6.� Rough Electric Wiring `��p 67. Fencing & Access Approval
1,7.� Rough Wiring Sign s. '- � APPROVED FOR PLASTERING �
18� Rough Electrical-T Bar Ceiling .� ,� .� POOL/SPA SYSTEMS FINAL
18:'Rough Heating & Air Conditioning ; � FIRE DEPT. REQUIREMENT
20.' Rough Factory Fireplace . .'• APPROVALS Permit #
n
21. Ducts, in Structure � 70. Underground Hydro �
;�22. Duc[s,Ventilating ' 71.�ProductPipingOGas ❑Oil �
�, 23. Gas Pipe-Rough & Test 72.� Unilerground Flush . �
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil r
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 INSPECT�ON
32? Electrical Power Meter-Final 0. FOOD CERTIFICATE ISSUED
33�FinalElectric �j,� Notes: � a
34. Final Heating & Air Conditioning �-; �_y�� �
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 pomestic-Final � �
�
42. Backflow Preventer �/.'.� �;
43. Backflow Irrigation _ ' ' ���
/ _.
� �,�,�
44. .Landscape Irrigation System �, .
45. Sound Attenuation " �' L' �
46. Handicap Regulations i�
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed ,
49. Elearic Release to Edison . � � t
50. Gas Release to Southern California Gas Co .� � %'l •
51. CERTIFICATE OF OCCUPANCY ,' � -.' �� � �,
No. Date .-� � ` '
• �.
� .
/'
�' 9,288"
CITY OF COSra rnESA CONSTRUCTION PERMIT
Pro,iectKddress 555 ANTON, 3RD FLOOR
ApplicanYs Mailing Address �- � 5 - 5a�.4�l�TT34�--
Owner's Name $+�ITY PACIFZC�QR �phone 4� v�
Address 600 WTiAHTRF. $T.VD. #500.__I,i.A. 90017
Arch/Eng. License Na �
Address
Convactor'snlame RiIRbl2 clrid CO. phone 895-115
Address (mailingl
c�cYu�e�:eNo. 038503 7540 SUZI LN. Ti1ES'IIAINS'
LICENSED CONTRACTOR OECIARATION
I 1 he�eDy alfi�m inat I am Iicensetl unde� provislons oi Charttt 9(Commancing
�� wifh 5¢ttion 7000) 01 �IviSion 3 of the Buiiness dntl Prolessions Code, antl,
I, my license is in fuu (or�,e aT�erre�:. q 60 ° 2 3'
'� License Class _ cens 1 . �
I Date��2 ��`�.�Sanar . ,c` .
NORKERS'COMPENSATION DECLARATI
. hereby affirm that I have a certiflcate of consent to self-insura�or a cerUiicate
of Worker5' Com e r a rertiBpy.,yp��� rent..(S¢ction
'. 3800. Lab. P�@`��`�$�`%04 li(C1S/LV'1' ivli
�fi�00� cn� ne.a..4:i ' . r,-..i .
Policy No. ��r Company �TT�T�•
Certifietl copY Is hereby (urnishetl. �
Cert' ' tl co i a with the city�ayr7 tlin D���s" r� .
oate l�'�S�'�fi� naoiicantLS//11�1���-%�/�%�1�-�`'�
EXEMPTION FROM WORKERS' COMPENSATION DECLAR�
(This section neetl not be completatl il Ihe permit is for one huntlretl (5100�,or
—less). i-
I certify that in the pertormanca ot tha work tor which this perm�t Is issuetl, I
shall not employ any person in any manner so as to bacome subject to the.,
Workers' CompGnsation Laws Of California.
Date 99nature
� NOTICE: If, atter making this tleclaratlon, you shoWd become subject lo tne
Workers' Compensation provislons ot the Labor Cotle, you must torthwith
comO�Y with Such provi5iOn5 Or [his p¢rmlt Shall b< tl0¢m¢tl rOvoketl.
CONSTRUCTION LENDING AGENCV
1 hereby aifirm that there Is a constructlon lentlln9 a9ency tor the pertormanca
� o/ the work for �w�ich tNs permit Is issuetl (Sectlon 3097 Civ. C.)
Lenaer's Name
� Lentler's AtlEress -
OWNER BUILDEH �ECLARATION
I her¢by a1fl�m l�at I am Oxempt from the Con[rdG[Or's LlcOnsn Law tor [h0
I following reason (Sectlon 7031.5 Business antl Prolessional Cotla: Any city or
''�, counry wbich requires a permil to ConStruct, alte�, ImO�ove, demOlis� o� �apair
'� any SVucture, prior, to ils issuance, alw raqulres the apD���ant for such parmit
' lo liie a si9netl slatement lhat ne/she ii Iicensotl pursuant to the Drovisions ot
the Contracror'S License Law (Chapter 9(commentlng witn Sottion 7000) of
DiviSiOn 3 0( lhe Buziness antl Prof<Ssions Cotla) o� [hal ha/Sht Is ezempl
lhere/rom antl Ihe Dasis for lhG allagetl exemptiOn. Any vlolation o/ SeCliOn
7031.5 by any apP���ant fOr a Oe�mit subjectz lhe aoo�icant lo a civil
�a.nalty of not morc tnan nve nundrea douars (E500).
I, a5 Owne� o� the proDerty or my om0�oyea5 with wage5 as Ihair Solo
coTpenSatlOn, will tl0 Ihe work, dntl t11e SlruGtufO IS nOt IntBntlotl or 071CI00
' for sale (Settion 7044, Busineis and Protesslonal Cotle: The Contractor's
license Law tloe5 not appry to an owner of a proporry wl�o builEs or improves
thereOn, antl wh0 tlOes such wOrk hlmSClf/herself o1 Ihrough IIIS Or hOr Own
employ ee5, provitled that Suth Improvament3 ara nol int¢ntletl or oftaretl for
sale. It, however, the Uuiltling or ITp�ovaTent Is solU wit�in On0 Year Of COm-
pletlon, tM1e owne� wlll �ave the bu�tlen ot proving ho/sha tlltl nol Dulltl o� Im-
' prove tor [h0 Pur005a 01 zale�.
❑ 1, as owner ot tha property, am exclusivoly contracting with Iicanso� con-
trac[ors to construct l�e O�oject (Section 7044, Buziness antl Proiessions Cotlo:
Tne Conlractor's License Law do¢5 not apply IO an owner oi p�operty wh0
builtls or improves tnereon, ana wno contracts for such projects wltn a con-
tractar(s bcense pursuant to the Contractor's License Law). I am aware that.
proof o� their Wotker'S Compensalion InSurance z�oultl be provid¢tl to me.
❑ I am exempt untler Sectlon B. & P. C. /or this reason
Avo���ant to flll In all spaees ezcept those witnln neavr eorCer Iines ana si9n all apvropriate aeclarations.
Oate
Oriver5' License or 55 �
Own¢r
1 this application antl state that the above
comply with all cily antl cOunty ortlinance5
y cons(ructlon, an0 hereby aut�orize reore•
On lh�nqonetl ProPe/rtY tOrL
Dates?-/"'),��(J
�
TVPE OF CONSTRUCTION . LJ NEW LJ ADD LJ ALTERATION IJ REPAIR
❑ CONVEft510N ❑ DEMOLISH ❑ OT{-IER
DESCRIPTIONOF WORK/USE•OF BLDG. �
TVPE OF PERMIT LJ GRApING LI FOUNDATION LJ $TRVCTURAI
O TENANT ❑ ELECTRICAL O PLUMBING ❑ MECHANICAL
O OTHER . '!�
PROJECT DESCRIPTION Sa.FT.� oCCUaarvGlv�
1 CONSTRUCTIONTVPE VALUATIONS�
�� ZONE GRADINGCU.VDS. ACRE
0.amarks: _ r j� „ n. /1 I �� '�i �. . �_ _ I 7 1�["' �
Bar Sink .
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers �
Drinking'Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavamries
P—Trap
Roof Drains �
Showers
Service Sink . • -
Sewer Cap '
Sewer Connection
Solar Collectors '
Solar Piping �
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
FEES
Reinspection Fee I S15 I � Isue Fee I $ 3
Boiler
Duc� - Under Ground
Duct - S[ructural
Duc[ - Ventilating
Exhaust System ❑ MWtiple
FirepUFact BIL ICBO #
Heating System & Ducting
❑a i oo,000 aTu � i oo,000
Reinspec[ion Fee I $15
CMF 0865�46, rev. 10/84 White � Builtlinq; Canary - APPllcani; Pink - Accounting; Goldenrotl - Assessor
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Isue Fee
$ 3
A.P. qp
S Main Building:
E
T Front
B Rear
A
C Right
K Left
s
Ping. ReL #
Planning Notes:
Auromatic Washer
Construction PoleSub.
Cooking Unit ,
Dryers LJGa
Fan
F.A.U.
Fixtures
Device Boxei
Outlets
Zone
Accessary Building:
ELECTRICAL
�Trensformer ❑ 15�50 KW
O50+KW
Garba9e Dispoul
Generetor �0�5 KW �5-15 KW
Meter LJup ro 100amps
Meter �over 100 amps
Sub Panel
Motors �0.1 HP �1 X- 8
Inc. Solar �9-15 HP 016�15+
Microwave
Pole Light '
Range
Sign
$tanding Sections
Trash Compnttor
Reinspectian Fee S75 laue Fee
DEVELOPMEN7SERVICESREQUIREMENTS:
Zoning Approvad By
Building Appraved By
Aaolication Issued Bv �
FEES
5 3
2
O
N
I
N
G
R
E
Q
M
T
S
� SUMMARV OF FEES —IS
BUILDING PERMIT S_�� Q(J SMIP $_�_
PLAN CHECK . $ PERMIT
PLUMBING S �SSUANCE 3
PLAN CHECK 25% $ � ENERGV P.C. S
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICFOFILM $ --��'7�'
MECHANICAL 3 TOTAL FEE $_Ll �
P�AN CHECK 25% $
,CONSTRUCTION AND PLANNING � . POOL & SPA
APPROVALS rPermif-# Date Inspector qppROVALS Permit# Date ' Inspector
1, Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3. Electrical Condui[ Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. E�ectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. .
8. Foundation t 59. Gas Pipe, O Undrgrnd., Test
--'+
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Structurel Kloor SYstem 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap � 63. Heater & Vent-Final '
13. Roof Dreins 64. Plumbing System - Final
14. Rough Piumbing 65. Electrical-Final �
75. Rough Electrical-Conduit 66. Solar System-Final
16. Rough E�ectric Wiring 67. Fencing & Access Approva�
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAt '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS Permit #� _ '
21. DuCts, in Structure 70. Underground Hydro �'
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil.
23. Gas Pipe-Rough & Test 72. Underground Flush . �
24. Roof Framing 73. Llndergrnd.StorageTank OGa; ❑Oil
25. Roof Sheathing . 74. Overhead Hydro /�p�'
26. T-Bar Ceili�g (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. �Dry Standpipe �
26. 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 , { Ti�, d.�
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace � 3d �' '
38. Final Plumbing . '
39. Water Service-Final (
40. Gas Service-Final �
i
41. Solar pomestic-Final �
42. Backflow Preventer � �
43. Backflow Irrigation ,
44. Landscape Irrigation Sys[em
45. Sound Attenuation .
46. Handicap Regulations .
47. FINALSTRUCTURE&BUILDING I
48. Special Requirements Completetl i
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY - '
No. Date - � . _• `
M_`
\v
�
AGolicant to fill in ail spaces except enose within heavy eoraer Ilnes ana sign ail apvropriate tleclarations.
CITY OF COSTA MESA CONS1TRUCTION PERMIT �j'r^ �L�
PrqiectAddress ���"+ Q✓�1'�V����(�,����t.+
ApplicanYsMailingAddress �Z11—D Garden Grove BIVCl.
Owner's Name Phone
Address
Arch/Eng. License No.
Address
Contractor'sName KiThl drid O Phone 895-1156
Address (mailing) �% � �—D +dL'CI n ov , Garden Gr.
City License No. 0 3 8 5 0 3
LICENSED CONTRACTOR DECLARATION
�. 1 hereby atfirm that I am licensetl untler provlsions of Charter 9(mmm¢ndng
� with section 7000) of Division 3 of [he Bu5ine55 antl Prof¢55ion5 Cotle, antl
I my license is in full for e a qeffect. `
� �icenseC ss �—�b 'ens' . 4609Z3
� Date ��� S"g t
VORKERS'COMPENSATION DECLARATI�
jhereby atfirm that I have a certiticate of consent to self-insure or a certiticate
of Workers' Compensation Insurance, or a certlfiea copy thereof (Section
3800, �ab. C.)
vo�i�v No. PC981581 co,,,P,,,y Republ•ic Ind.
ertifietl �coPpy �is �n+ereby furnlshetl. �ypy�
Ce��� 'Q.L Q WAPPhcantY B ////l1�CC���Ni�
Datew
EXEMPTION FROM WORKERS' COM NSHTION ECLARATION
(This section neetl not be com0�etetl if the permit is for one huntlretl ($100) or
less).
I cer[ity that in tM1e perto�mance of the work fOr which thi5 perm�t is ISsuetl, I
shall not employ any pe�son in any manne� so as to become zubject to the
Worker5' Compensation LawS of Californid.
l Date Signa[ure -
'� NOTICE: If, atler makin9 thi5 tleUara[ion, you ShOultl become SubleGt to the
, Wotkers' Compensation provlsions ot the L2bor Cotl¢, y0u muzt fOrthwith
comply with suGh pwvisions o� this Oe�mlt sball ' be tleemetl �evoketl.
� CONSTFUCTION LENDING AGENCV
' I nereby af(irm that N¢re i5 a Construc[ion lentling agency to� tne Oer}ormance
'. of (h¢ work for wnich [his permit is I55uetl (Sectlon 309� Civ. CJ
�. Lentler's Name
Lentler's Atltlress
OWNER BUILDER �ECLARATION
I heieby afflrm [ha[ 1 am exempt irom tne Cont�ac[o�'S Llcense Law tOr [he
followin9 reason (Section ]031.5 Buslness antl Professional Cotle: Any city or
county which requires a permit ro construct, alter, improve, tlemolish or re0air
any structure, prior ro its issuance, also requires the applicant tor such oermit
to fi�e a signe0 statement Iha[ he/sne is Iicensetl pursuant to Ihe provisions of
the Contractor's License Law (Chapter 9(<ommencinq wl[h Sectlon ]000) of
•Division 3 of the Busine55 antl Proles5ion5 Cotle) o� [Itat he/she i5 exemp[
the�of�om antl the ba5is fo� the all¢gEtl ¢xemption. Any v101atiOn o1 Sectlon
7031.5 by any applicant for a permit sub�ectz [na aDP�icant [o a clvil
��nalty of not morc man five nuntlrea tlollars (E500). .
LJ I, as owner of the�oroperry or my employees witn wa9es as their zole
. com0ansation, will tlo the work, an0 Ihe structure is not intentletl or offeretl
fo/ sale ($ectlon 7044, Busine55 antl Protes5londl Cotle: The Cont�acto�'S
License Law tloes not apply [o an owner ot a property who DUI1tl5 or Improves
thereon, antl who tloes such work himselt/herseli or through his or her own
em0�oyee5, prOvitletl thal such improvem¢n[5 are not Intentletl o� offe�etl for
sale. H, howeveq the bulltling or improvement is Soltl wilhin one year al Com-
pletlon, tne owner will nave the burtlen ot proving ne/she tlitl not bulltl or im-
�rove for [he pur0ose ot sale�.
I, a5 own2r ot the Oroperty, am exClusHely con[raCting wi[h IiCEnsetl con-
tractors to construct the project (Section 7044, Business antl Protessions Cotle:
The Con[ractor's License Law does not dPPIY to an owner ot property who
builtls or improves tnereon, antl who contracts for such projects wltn a con-
[raclor(s1 ucense pursuant to the Contracior'S license Law). I dm aware Ihat
proot of their Wo�ker's Compensation insuranc¢ Shoultl be provltletl to me.
❑ I am exempl untler Section B. & P. C. fo� this reazon
Date Owner
I hereby certi(y t I have re i
intormation is c e. I agree
antl itate laws I ng [ b'tlin
sentatives oi city to nter
inspectlon p ses.
Signature
Drivers' License ar 55 �
cou
Oaie
F 3 ^7 2 � �!- ,eJ� . . .
TVPE OF CONSTRUCTION �, ' tvEw noo ALTERATION RE7AIR
❑ CONVERSION� ❑ DEMOLISH ❑ OTHER A p.� �
DESCRIPTION OF WORK/USE OF BLDG.
-' 'J'.. ' S Main Building:
E
TVPEOFPERMIT GRA�ING FOUNDATION STRUCTURAL T Front
❑ TENANT ❑ ELECTRICAL' ❑ PLUMBING ❑ MECHANICAL B Rear
❑ OTHER . r. /• � %� .
PROJEC7 DESCRIPTION 5Q. Fr. oCCUanrvC C Right
CONSTRUCTIONTVPE VALUATIONS_ ..Q� $ Lef[
ZONE GRADING CU. VDS. ACRES Ping. Ref. #
Remarks: ��" r t.. L �� ) . �'�D � � 7��--���Q Planning Notes:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Claritiers
Dishwasher .
Drinking Fountains �
Floor Drains
Floor Sinks
GasService Outlets
Intercepmrs
Kitchen Sink
Lavarories
P—Trap
Roof Drains
ReinspeMion Fee
Showers
ServiceSink -
Sewer Cap
Sewer Connection
- Solar Collectors
Solar Pipin9 '
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Aum�Wash
$15
Boiler
Duct- UnderGround
Duct - Structural
Duct - Ventilating
Exliaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ ai ob,000 eTu O i oo,000
Reinspection Fee � � $15
CMF 0865-46, rev. 30/84 � White - Builtling; Canary - Applicanq Pink - Accountinq; Goltlenrotl - Assessor
Issue Fea
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Issue Fee
FEES
S 3
$ 3
2on8
Accessory Building:
2
O
N
. '
N
G
R
Parking Req./Provided E
a
M
T
S
ELECTRICAL '
Auromatic Washer � � Transformer ❑ 15-50 KW
Construction Pole Sub. � 50 + KW
Cooking Unit .
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U. �
Fixtures
Device Boxes
Outlets
Switches - � -
Garbage Disposal
Generator DO-5 KW �5�15 KW
Meter LJup to 100 amps �
Meter ❑over 100 amps
Sub Panel
Motors �0-1 HP �1 %- 8
Inc.Solar 09-75 HP 01fi-15+
Microwave
Pole Ligh[ �
$ign
S[anding Sec[ions
Trash Compactor
� Reinspactian Fea ' I$15 � ' luue Fee
DEVELOPMENT SERVICES REQUIREMEN7S:
Zoning Approved By
Building Approved By
APolication luued BV
FEES
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ -� Z I� SMIP $ n—
PLANCHECK $ PERMIT�
PLUMBING - $ � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL �$ GRADING 5
PLAN CHECK 50°� $ MICROFILM $ •_.--��_�_
MECHANICAL $ TOTALFEE $ LL�
PLAN CHECK 25% $
i/i911i9 7tflF_ 7(lefid
CONSTRUCTION AND PLANNING � POOL & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electri�l Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrica� Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical ConduibUndrgmd.
$. Foundation 59. Gas Pipe, O Undrgrnd., Test ,
9. Water pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
73. Roof brains � 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final ,
76. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIFiE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit # _ ..
21. Ducts, in Structure 70. Underground Hydro •
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storege Tank O Gas ❑ Oil
25. Roof Sheathing . 74. Overhead Hydro � ��
26. T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe . "
26. Lathing & Siding 77. �FIXED SYSTEM FINAL ' �
29. Insulation 78. FIRE PREV. FINAL �(o
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION �,
32. Etectrical 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 pomesticFinal
42. Backflow Preventer .
43. Backflow Irrigation •
44. LandScape Irrigation System �
45. Sountl Attenuation '
46. Handicap qegulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co ��
51. CERTIFICATEOFOCCUPANCY •
No. Date � :•:_ `� '
�,nonessaeu� 555 ANTON BL °NT' 3RD
ss
a�xs"WE�F�m SAKIOKA FARM
�:.. ... .nopEsf P.O. HOX 2097
�, ., �
�<�l�RMINAL ANNEX, CA 714-433-6005
IPVL.WIWIG �D�IiEti
�
��
urcxnccTone�«a+�n: INTERIOR ARCHI2136232164 °�"�- C-9378
�xcxowEw.•swox�ss: 550 S HOPE ST ��+T� 1100
L.A. CA 90071
-c«rtn.cTarswu� CAL–PAC CONSTRUCTION (310)645-3500
CONfi11CTOR5YNIW0 6076 BRISTOL PARKWAY
�o� CULVER CITY CA ��= 392102
' 90230 oNr: 106
110EN5ED COMXACTOFS DEttAHATION: I henEy Nim wCer parely d pajury tlW I em lica'uaE unAer powb�m d Cheqer B
(cammaiwM xilh Seciim )OW) d Gvcion ] d Na Buanev W GMseron� Code. uk mY licann u in hA brta erd Nlw.
cm uc. No.: uc. cuss: H uc. No.: � q Z 10'� EXP�: A
o�.: l0�/.3,%YS— ca.,�6��a�����
OWNEN BUILDEfl DECIAPRTION: I Mrtby elfiim uMer pmNy d ry �hm I em ezemq Irom iM Con�repors lironse Lew la IM
"dbwiq ieeson (Setlian 1W �.5 &miwss aM Adwons Cods: MV vY a mw�Y Mirh ipiurse e G�u io mmuud. aM1r. imV�m+.
emWch, w repei eny meudure, pin b us u�uenee, ebo nyu'um IM epp4reni Iw weh pumil lo fib e ripmd atabmeM Net M a ehe
e �imnsea w�� m ine po.deian d me convee«e lioeme lew Icheqr e(mmm�«icnu wvn saaion l000) a oMeun 3 a ine
Buainan eM Rdevbm Codal a �MI M a ahe o uamp �hvdmn end the Gm In tl�e eCeO� e�ampion. /�m vidmion d Seaion
�osi s W a�r �� r«. vKma e�ye. u» eoWi s�u �o e aw ro�M d �a m«e men r e hunared adien R%�U�
� I.mowwd�MPbOe�YumyemNW�v.ihwerpamiheiedemmV�.YitldolMwrk.andNe�4uclunundiMaMeE
w oRereE lor eele (Setlion )Oaa. Bumroa vd PMnaione Cotla: The Conlrmon lioeroa lewdoee mt epply �o en awwd propeM
wlp buida u inqmsa ihenm, mA wfio Aom �uN work h'vn�eE a Mnd a Wwph he a har oxn emplv�se�, pwiEM Ihet wch
'unDA+emerua ere nd imeMeE a d1aM la eeb. tl. hw�ewr. �M duNmY a in0��ap b wtl w9Nn ar Ymr d cam0�ion. tM
ownu-buJler wiil hew ihe buNen d povirq he or ehe did np builE a impove lor iM W�e d seb).
I, m owner d I�e piapeily. em utlimirely canlratlinp xtlh IioenuA mntretlps b cone4W Itq pqq ($etlpn 10N. Bufine�e end
..Pmlueiom CoCe: ihe Canrodm Limes lew Eom no1 eppy m en rnnw d pvpaty rAw Wi1fi a impww IMnon eM who
convecb br vdi p4w++ xdh e mrv�raMe) IicmueA P�� W �M CoNram� Lin�ua ler.'l.
I em memq uMa SMbr. B. a P.G.. la Ihu rasaon:
Dme: O.ma:
I do herebY �MM Nu 1 em ewera d eM ivMesWW IM nG��wa d CallaNs HaeM eM SdalY Coda Satlbru 45505. 25SV. enJ
255N. eM Met I a my Mws buildirq ommem r.ill / wil m� (wcb pp) � lo oomyy M� uid peta aoEn eM tM rpuinmams M
e 0� tarwnewtlian v modifiwiantramNa �r'CueL�%nepmwN D'etriu. RuidM� W mwruaian eVG�� en azanq ham IMro
yorisons.
Dels: �ppv�ira:
WOFKEN'9 COYPENSATION DECIAFATON: I Mrab� �flrm u�d�r psWly d pwhuy pr d tlr IoOOMiq dMuqiom:
� IhewuMWmeiMenec�MictledaonwNto�Winwmbv.akrimmpenWion.opwidadlabySWbna)WdtMlebar
ca.. �« m. c.n�. a m..� i«.mm w. w�a A��.a.
❑ in�.w.um.:v.�.ak«.��o:+ma,�..M....�w�.ewswt,�noodn»t.eo�ea..ram.o.��m.�.wm.
n work r« MJCA Nu D�e e mueE. MY walun• oomW�bn'vmrtuav uriw mtl G�Y mmbr er.:
c.m«: F7RFMAN' S FtINI� EXPIRES
a,u�.n„�,e.,: vwo a�sa�xa� 02/O1/96
(Tlih artim m�i rrotW ewno'Mb e �IaW^�t o M aa huMnE CaOen R�mI a 1wJ
❑ I cenh Ntl in IM V�amenc� d iM wark b v.fihl� NN D� b fnuW. I NeY m� �mOM �Y W� in �nY menmr o n lo
bxma wbjw m tM xaYw�' mmp�mtlion Is�w d W epiw tlW Y I �4wuld/ �EMecm� aE�w m t wabn'
mmD mtl
campnWion V�'biwn d Saqion ]100 al tM lebor COM 'Yw� w'sh/ �,
ome: la/i 3�9 S� �wor�.: ��
w.mlip: F.uun ro Ncun rorkwti rompwu�tlon rov�� b urWrN4 �a �IWI �uDNer �n wnployn ro ulmlrl pwultlu.ne
e/Hl Ilrws �p ro aw hurtliW fhouuM EWhn (JiPD,P00A Mi M11lbn b M� ewf ol ronqxu�fbR Junpn u provWW br In
S�ctlm 9)06 eI1M LNorCa►. IntruL ���m�✓� lw�.
CONSTflUCTION LENOINO AOENCY: i haaby dfiim uMs pwudy d parjury Ihtl IMn u e amprudian Winp eparcry lor tM
pMamence d �Iw wak br xti4i �h"v v�i u euwA (Seeun aoTl. CM. GI.
LENOER'S NMIE
LENDEF'S ADOFE99:
I cmtM IMt I hm reeE Nu WV�cetian erd ueu ihd iM eEwa iNormtlian o cvnW, t aWw to oomCN wVh aG d1Y eM cou�iY adnencse
and ewe lewa rtW nY b W0dn0 mn+m�an aN hmsbY eWvaa npnpnuii.a d �Ab �Yyb wqs upan iM eEwa�mwoewd piopairy
la irupedian purpwae.
' c% Dvro �.SSTa
� f".�L._"°"'° �
� Dms:ld �.3 �
Sp�wuro d OmrotlApeWAppfunt/Cwreda
(StSt-�6.WP) Whi�s-Buildiq85dery:0ieemFb:Cenuy-App4enl:Rnk-Rownue:OdCarvod-�sww
CITY OF COSTA MESA – BUILDING PERMIT
PERMIT NO: B 074572
PLAN CHECK NO: 03712-95 A
�PERM NO: B 014571
GOVT: N SUPP: N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : 20000 SF OF�'FICE T.I. SQ FT: 240,000
CLAIM C�ALUE: CALC–I�ALUE: 386,400.00 GROUP OCC: H-2 /
COMMENTS: 76 UNION PRODUCTS
+��;�**�*�x**�x*�**x���****�**��*+�*x;�*�c*�*�**�**+��******«t�*+�***a��*�+�*��*��*���***
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ; PROV: PARCEL: 41054104 ZNE: PDC REF NO:
PLANNING NOTES> TENANT IMPROVEMENT FOR 3RD FLOOR FOR 76 PRODUCTS COMPANY
� �.
iE �E iE If 9E iE �E fE iE iE jE 3E 9E 3E iE iE 1P iE fE 3E1E 9E iE iE 1E f(�iF k 1E 1c iF 1E iE iE iE iElE * ik iElf IE if iE 3E 3E jE iE iE �E iE 9E 3E �E if 9E tE iF?E if iklk iE 3E 3E if iE iF kiE 3E 3E iE 3E 1E fF �E 1E 1E
D E V E L;O P M E N�T S E R V I C E S R E Q U I R E M E N.T S
ZONING APPROVED BY � : ���— DATE: ��S�S'S—
HUILDING APPROVED,�BY ;_�f _ . DATE: ��"��3 �r/S�
APPLICATION ISSUED��BY: ��,����'��r�dr–`r�� DATE: (O/�3�7�5�
1Eit3fdFiEifiElEiE1EiElEaEiE3EiE1E1EiElEifiEi�'� iE iti(� .. �1F 1EiE1EiEififilifiE�E�iF���fEiE
LEGALIZATION:N F E E S U M M A�t Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,644.00
SMZP/NON–RES
PLAN 267.15 81.14
ISSUE FEE
BUILDING–DIV–> PERMZT ISSUE PLAN–CHECK TOTAL � PAID DUE
TOTALS----> 1725.14 0.00 267.15 1992.29 1992.29 .00
REVE�IUE DIVISION TOTALS--> COLLECTED: 1725.14 OC'ER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN–CHECK
1644.00 81.14
iE ii?E �)f !E!E?E!E 1E iE iF iElf if 1E 1E %fE iE 3ElE iE 1E iE 3E iE IE 1E 1E fE fE iE ik iF fE fE 7E iE iE 1E IE iE iE 3(- fE 1E iE 1E iE7E �E 1E �E iE iE 3f iFlf if',E iE iE if if if if �F iE iE iE iE fE 3E # If iE iE iF 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 20000 OFF–INT. ALTER TYPE I II F.R. –AVER 18.24 364,800.00
SFC 20000 EQU–ALT COMM. SPRINKL�R SYS –AVER .36 . 7,200.00
SFC 20000 EQU–ALT COMM. AIR COND –AVER .72 14,400.00
END OF FEES .
�3 0015_r,,;•OG142QdS � O �' 1;_5.c4
D9Y'cF l��ts/;=• riCiE: iC:L'l
CONSTRUCTION ANO PLANNING - � P�� � SPA �-
APPROVALS Permit# Date Inspeetor qppROVALS Permit# Date Inspector
1. TemDo�ary Elect���l Service or jo�e 52. Pooi & 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.
70. Structural Floor Svstem � 67. APPROVAL TO DECK j
11. Property Sewer Une & House Con�eection 62. Backwash & Receptor�Firlal
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing SYstem • Final � '
74. Rough Plumbing 65. Electrical�Final •
15. Rough Electrical•Conduit 66. Solar System�Final ' �
i 6. Rough Electric W��ing � 67. Fencing & Access Approval �
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. RoughEiectrical-TBarCeiling 69. POOUSPASYSTEMSFINAL
79. Rough Heating &%��r Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiate APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat /�JO�� ir// 75. Dry Chemical
27. Frame and Fiashing �/Jg/� � 76. Dry Standpipe
28. Lathing & Siding . 77. FIXED SYSTEM FINAL
29. Insulation •� ' 78. FIRE PREV. FINAL
30. Drywall Nailing //jy� � HEALTH DEPT. RE�UIREMENT
31. Plaster Brown Coat � J9, FINAL INSPECTION
32. Electriwl Power MeterFinal � 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 �omestic•Final
42. Backflow Preventer
43. Backflow irrigation
44. Landscape Irrigauon Svstem
45. Sound At[enuation
46. Handicap Regulations / -
47. FINALSTRUCTURE&BUILDING f///y 9 �
!
48. FINAL PLANNING
49. Elearic Release to Edison
50. Gas Release to Sauthern Calitornia Gas Co �
51. CERTIPICATE OF OCCUPANCY
No Date
ADDNESSOFBUILqNO: SSS ANTON BL
°r'"E"s"""E"'w°`''": SAKIOKA FARMS
AUDNE55: PO B �}� '2 Q Lj %
TERMINAL ANNEX
uri. �uimo �oo�ss:
UNT:
3RD CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 076187 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1PR SP PERMIT TYPE: STR
uicx�on��xmffn: INTERIOR DESIGN 213623216K� 9378
urcxower+c:s�oox�ss: 550 S HOPE ST ��� 1100
L.A, CA 90071
ca+mACTarsru�
ca+m�croxs xuuxo
.00xess: uc rio.:
urR:
LICENSED CONTRRCTOq3 DECIAN�TION: I Mmby ellim uidx panaly d pajury Na 1 em fcanaed uMs pwiuom d CMqr 9
(mmmerciiq xilh $ection 1000) d Diviaion � d Ne Bueinen ard PMeaaiona CoEe, eM my lice�ue u in Iu0lace eM etled.
crtruc.No.: uc.cuss: uc.No.: E}CP:
Dab: Caaeaaa:
OWNEN BUILDEF OECIAHRTION: I Mieby eMrtn uMer pe�Wy d perjury IIW 1 em exemq Irom iM Corureuan licxoa Lew la tM
Idbwiq reason (�� )��.5 &iviaaa ad Prola�ms CoEe: Mry cty a mwiy Miirh �p�irp e pmmG to awnNcf. apr. imprwe.
vndah, a repei eny el�ucture. piw to in uauence, ebo reyuiree iM eppliraM la wch pmma io fib e egred nmement Mat ha p eM
4ca,.ed w�v io ine n�+e d ur comreeaa licerue lew Ich.o�s s(mmm+nomw .un s«aion r000) a oivecn a a �he
.u�esa en0 hdwiam Cotlel a Ihel he a ehe a vmmq IMelmm eM ihe Wan la IM eMOb e�mmqun. MY volmion d Seaun
]0]1.5 by eny epplifant lar a permn wbpe� tM epplirani io e avi psnMy d nd mas iMn I'va hurd�ed ddWv �5500�.
� I.nowrerd�MP�MYamYamMA'�xthweP�mthr�dewm0�bn.MiAdoNewk.vdMasbucNiaenalmisMeE
«dlerea �« seb (seaion la.. eusroa. ena ria«eoiu coEe: The com..aa.licen..lew aoe. na epwr�oen owro,d papxry
wAo b�dda u inpavee �he�ean. end xfa dou suM Mak Nmrtl a hend ar Ovaph he a Mr own smWw�. pwddeE �hel ach
MP�mO� ere nd imeMeA n aHenE la �ele. p, lrowwar. tM buil0iiq a inpownem u sotl wnhin an Yur d wmV�bn. iM
�owrorLuidar xi0 heve iM WNm d pwiiq ha a she did na Euik n impo.a fa iha Wm�e d�ebl.
I. ro ownr d �he Papa�Y. em utliviv✓�' cWrotlM v.d� Icwued wn4ectm ro cmmuf tM Wqa (SWun )OU. Bw'vme W
Prdmsiona COEe: The Conlretlon L'r.ensa law Eom nol eWN w en owner W P�WMY who dtitle n Inwa'n thason eM who
ewvrar�a b adi pqeaa weA e mermor(a) ��b WnueM �o iM Caueaaps Liunee Lew�.
❑ I em esamq under Sxiim: B. 8 P.C.. M Ws rmm:
Dete: 2�a �s O.mx: - �w � ��.
i ao �nav um i.m �,.e a w�w�.w,a ub ��.e, a e.vom. M.mn d,e s m eod. s.ao�, uws. us�a. w
2553t. uk that I a enY �uro Wikiiq mc�pent will / wil rwi (aicb aw) neeE lo canply wi� vid mate wtl» aM iM rtquiromenro br
eD�lawuvuaion«moddrationhomiMn'r iu�iiy ar�epemaNOinna.Reddallolamp'utlioneDW'diomeraexemqlmnNsss
Deta: Appliram:
WONKEF'S COMPFN9ATION DECL�R�TION: I hereby dfiem uiNer penelly d par�ury one d �he blbwirp Jetlumons:
� I heva vd wJ meimen � carlilktle d wn�eni b��Xinwn M wake�i eomp�nWbn. n pwideE Iw by bwon �)00 d�M Lebor
Code, fw the paAwmence d �M wM1 Iw wlich t�is permN iv is�ued.
❑ I Nm eM xil mein�ew xaken' canpenWbn imurenoe. u npu'vad by SW bn 9]W d tM laEor Code. b iM paAameMa d iM
wak for which thie permit o iuueE. MY ��n �mpenwbn inwrence fa�isr ud pdiry number ue:
c�«:
Polky Number:
.,nh aea�w, �.ee ow ae canore�w i w vmme v ro. m. w�ene ewa�. rsiool d w..l
❑ I mnity iM1e� in �he parlameme d iha wak lor whch Ihu pe�mA ia usueE, I ehell � employ any pereon In eny men�wr n m �o
become wbpa io iM MOMn' compemelion bxe d Ce4lanie. end eYrse Um il I�hwtl becm�e w4� m �M xwFon'
rompermibn pim�ieione d Sepion �]OU M ��e Labor Code, I ehdl lonhxvin oomp�y with Owa qavivions.
Dale: Appl'kam:
Wemirp: FeNun ro s�cun woik�ri romp�nutlon rowrp� Is vnbwNl, �ntl shll utl�1ef �n xnploysr ro cNMml pmeMu �nL
c/vll M�ws up ro ons hunSrM IMuurd tlo/kn (JIOqp00), In etltlltlon ro tlN cosl ol rompxuefbrt O+�W � P'ovWW br /n
S�cHon 9RM' ol fhs L�Lor Code, /nfuuf, mtl ettomry'� /ww
CONSTPUCTION LENDIlW AGENCY: I Mmby elfi�m under pe�uhy W perlury ihet �han i� e oontlmdion bMinp epency br tM
parformsnm d itw vroA for which Ihu perml u eeuetl �SeUon 309], CH. C).
LENDER'3 NM1E:
LENDEfl'S ADDFESS:
I ceMiy Ihei I heve reeE ihis epplketim enE pe�e ihn iM ebove inlormelion ie rortep. I epies lo cwnpy wil� ell rily end couMy adinencee
end aiete lewe �ele�ing lo build'vq conmruqion and MreEy eW�aixe ropeeen�etivee d thu.iUy lo amer upon the ebove�menlioneE propeily
iwimpeabn purposee.
ERNIE VITUCCI
Pnnl Neme
� 40� .� ._— Oma: � z-6 �
-��O�eluraolOvme penVAp itanVCpnlredm•
(5151d6.WP) WhXe-Build'vq 8 Sdary; Oreen-Fb; Ce�y-�ppYcenl; Fnk-Hewnw; Ootlemo�Maeaaw
PERM NO: B 076187
GOVT: N SUPP: N
PURPOSE: ALT
SOB DESCRIPTION : INTERIOR 200005F OFFICE T.I. SQ FT: 325,000
CLAIM VALUE: 325,000.00 CALC—VALUE: 339,625.00 GROUP OCC: B /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION, RE:#B74572
*+�iE�icie*�**�*iE�*�***��at�at�*�*+r*�rit*it**it***�*�at****ieaf*itif*******at**atatie*iE+�+�****at��at*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PAAKING REQ: PROV: PARCEL; 41050104 ZNE: PDC REF NO:
PLANNING NOTES>
/
i � � "
�rx�**x�***�***�****�r�x�+���*+�***�r� **x�x���r*x *�*�*���+��+�x *�**x �**�*+r+r******�*�***��r**�
D E V E L,:O P.M E N�T S E R V I C E S R E Q U I R E M E N�T'S
ZONING APPROVED BY � DATE: f
BUILDING APPROVED�BY;: DATE:�
APPLICATION ISSUED HY: �i , W(�- � DATE: ti�(�L
IEiE1flEiEiEiElElEiElElE�E1FlF�E1f1FiEfEjEfE iE1ElEMfE1E1EfEiflf iEiE
LEGALIZATION:N � F E E S U M M A R Y STRUCTURAI: SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1,479.50 �
PLAN � _ . SMI�iNOz—RES
ISSUE FEE "
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 1550,82 0.00 0,•.00• • 1550.82 1550.82 .00
REVENUE DIVISION TOTALS--> COLLECTED: • 1550.82 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC,_ •'FIRE SMIP/TOT GRADING PLAN—CHECK
1479.50 : ,� 71.32
1F1EIE1E1E1ElE1E1EfE1E1EfEfEfElEfEiEiElEiEiEfElEfEiEiEiE1l1E1E1f1E1E1E1E1EiE1E1E1ElEfEiEiE1E1E1E1E1E1E1f1EiE1E1f1k!lfE1ElEfEfE1f1E1k1E1EfElEihfF1E1E 4lE1EfEik
I N D I V I D U A L F E E.� H R E A K D O W N
TYPE QTY D E S C R I P T I O N •' UNIT COST TOTAL COST
SFC 325000 T.I. OFFICE BY,VALUE/$1
END'• OF FEES�
1,00 325,000,00
D: ri[_-� - .s�>�`i: .. ' .
GH'•c- ,-i . ' jT,., .� .-
CONSTRUCTION AND PL/1NNING POO SPA
APPROVALS Permii # Date Inspector pppROVALS Permit # Date inspector
t. Temporary Electrical Service or Pole �'52. Pool & Equipment Location �,
2. Soil Pipe•Undrgrnd. � 53. Stee� Reinforcement
c3. Eiectrical Conduit Utility-Undrgmd. • 54. Forms �
' 4. Electrical.Cond'uit-Undrgmd. 55. Electrical Bonding
�a5'.�Sieel Reinfa�cement 56. Rough Plumbing & Pressure Test ��
-�;6,-; �7ectrical_t�ER Grnd. 57. APPROVAL TO COVER-GUN�TE
�7. F.00tings � ... 58. Electrical Conduit�Undrgrnd. � '
" 8. Foundatior; � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe;Undrgrnd. -. � 60. Backwash Lines, P-Trap, t'7 Undrgmd.
10. Structura�Floor SYstem - 61. APPROVAL TO DECK �
i i. Property Sewer, Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap� � 63. Heater & Vent-Final
13. Roof Drains � �` �64. Plumbinq System � Final
74, Rough Plumbing �T. � 65. Electrical-Final , •�
15. Rough Elec[rical-Condui2 - ! 66. Solar SVs[em-Final ,
16. Rouqh Electric Wiring 6�. Fencing & Access Approval .
77. Rough Wiring Sign 66. APPROVED FOR PLASTERING '
18. Rough Elecirical-7 Bar Ceiling 69. POOL/SPA SYSTEAAS FINAI
79. RoughHeating&AitConditionl�nQ � _ � , � _, FIREII�PT.REQUIf�EMENT
20. �iougM Fattor,�Fi�R'�1ace .,� � ; �� ,., r-,,"�, �;qppROVhL�aF Pe�mit # �{
21. Duct�; in St�u`stur�Y "" _� t - - �.� 70.:Undergrguad Hqdro #
22. Duct5. V2riti1�'fingr�' ' ;• �; �,-� �'a �. �7. ProducrPiping dd'ies �Oil
23. Gas Pipe�i;oug"ri & Tett r � � ^� � � '" ' 72, Underground Flush'� . •
T 'T' �tl � �.
24. Roof Freir�ing" �' � ' ' _ t " � , n ` 7�c Undergmd,StorageTank �7Gas ❑Oil
25. Roo rShebthing -�'' � �� � � _ � �� "'� 741 Overhead Hydrq_
26. �'�BaFCeiling (Str�lctyraq & Man'ocoat �jO�p'6 � 7$,- Dry Chemical _; j
- - ��
27. Frameand�Fleshing'. �F�:r, _ � '� 76. DryStarid�pe,�� ��
. ,���f6
- < . .� :. ^, ,� s .. . ,Y
- 28. Lathing$iSidfng c.� nr, �_ p . , 7X; FIXED$YST6M:PINAL= :
29. Insulation • � � �, - •� '* _ " 7�. FIRE PREV. FIPtAL ' `.
30. Drywall Nailirig `'.� _ p y _; -HEALTH DEPT. REQUIREMENT
�s �f� •� . _
' 31. Plaster Brown.Coai�x 5 '� T � � � 79. FINAL I�NSPECTION '
�
-� 32. Electrical:l'owzr Nteter'Final � r R' � r�' 8(j... FOOD CERTIFICATE ISSUED
.33. Final Elec{ric�_ r% r' = � NotPs: " "•" ' - '
34. FinaFHeacin & A���o ditioni - � , r ` ' `
_. 9 P ^�� ;. . (: 11_ � - .-1: o � ,
35. Final Gas�Pipe•Test � _ .. * _ - �
� . . .' � � �_� q�o • `�
- 36. Hood or Canopy Ft � ' " '• �- r��VY/�`�
ti - T K � �
fi I
37. Final Factory FirePiace . -�-. ;- �x � TO 0. � - _
� - U"YJK1L - -
_ 38. Pinal�lumbing' ,f,"'' _ , �= ` " _ � _ ,
� ��
'39. bVatei Service-Finel,� �- ` k r_� t' _ ,
.
40. Gas Service-Pin81 ' � ."""` " r '" _ _ - .
� �
.-.41. Solar pomesiic:Firial,� ` - • , � � . _. u•- .
42. Backflow Prevente� " ' - +' ��` � ' �
: •- ; +� - + r - !
c _ '- -
43. Backflow �rrige,tion�k . y r�: �� i. � •
44. LandscapQ Irrigatioii'SYstem ;'�;� . "� � " � �` ; �,; ''c - ;� .
r.- - � - � �;'� �. , i„
• , r- Y � - � ' _ r- � . �-
45. Sound Attenuation. .�.... x -a . ^rt, a,� �-='
4.
46. HandlcapRegulations �� - '� ` � j - ' �- _
S
47. FiNA�L STRUCTURE & BUICOING J���. Y6 - .
,
48. FINA� PLANNING r''- ' .
�' - ,
49. Electric Release to Edison ;, �. :' .
50. Gas Release to Southern Cafitornia Gas Ca �� � � ,
51. CERTIFICATE OF OCCUPANCV � '
No. Date
Ip
7
�
I�DDNFSS OF BIllqNO: S S S ADJ TOPI B L
wn+Ensru�eira+wm: SAKIOKA FARMS
,�ss POI BOX 2097
. - TERMINAL ANN$X
APPL.WUIIIG AODXE59:
uxt:
==t CITY OF COSTA MESA - BUILDING PERMIT
3 R�
PERMIT NO: B 074699 PLAM CHECK NO: N
CONSTRUCTZON TYPE: 1-FR PERMIT TYPE: STR
u�cxnEc,on�+m+�n: INTERIOR ARCH.2136232169 ucr+o: 9378
41CN.OPENQ'S100PE55: SSO S HOPE ST urar: 1100
L.A. CA 90071
coxm�crarawue SWZNERTON & WALBERG (213)896-3400
CONiPACTON4YYWq �355 S FIGU$ROA ST
�oox�ss: L.A. 90017 CF' uc.w.: 92 3000
uxr:
IJCEN3ED COMF�GTOflS DECL�HATION: I Mreby dlnn udy pyy�y d peijury Ne� I un fcanetl wdm porie'vn d Gheqar 9
(commenaq v.nA Seciion ]000) d Di�'vion 9 d tM Buzmm and Pmim ' a CoCe. end mY 6oerme o in IUA brce md aXsd.
cm uc. No.: 0} 4 /6� 2 7 9 uc. cuss: B uc. No. 9� <P : 10 / 9 5
Dete: l �� ��/{/ • �� Contmaa:
OW NEN BUILDEF DECLAXATION: I hartEy alfirm uMor par�dy d per' Ih I em eaemq 1 m �M omreaae Licanse ta tM
'bwnV �anwn (Seaion ]W I.5 Busixae vd Proleubna CMe: Any ct mY xfiitli n0ui e imn io omsWcl. .'unpwe.
md'eA a repv ury elricWro. p'v w ha eauerKe. dw ma�im �he ' t la wch peimil lo a eqmd+tmammi Nq M a�M
. lioenaed W��t lo IM qwis'vu d Ns CoMredon licerae Lew IC m B(aomma�p wilh Setlian ]000) d Diveion J M �b
Buaircu end RWea'vn Codel n IMI he a eM u uemq Ihereham uW iM buu In Ne elb0� examqion. MY violetion W Sepian
1mJ1.5 by ury eDpiunl la e permn aubpcta iM eppliceM �o e c�il pemliy d na mas �han liw hurMred tloAan �SAoI).
� I.uawroediMpropMyamyemplvyeeewlhwepea4ihaisdeeanpenmlion.x�Ildo�hoxwk.eMtheai�ueiun'wMimeMeE
ordlmedlaveb(SaetianlWa.BudrruuMProbedoe���:Py� yps�selewEoesnoteppytoenoxirordqapMy
wM buiAa or inpv.aa ihaieon. W Mw does s�M xak Iimaell a henM a Wouph he a Mr own ompbyees. poridW tAn suc�
imV�mema me na'vneMed a WanE la ub. tl. howerer. the buitlin0 a inG��wa u wd xi1Nn ar Y� d mmGwion. Ne
owne'bu3ler xi0 heve iM budm d P�+�O M or ehe 6tl nol ddd a imqove ta �he Wm�e d eebl.
� I. o oxner d IM V WNY. am uWendY wYreq�q xVh fvwd conVaclon W m�utrw Ne q4a (Seaun NM. &nirw� W
a�w.ae�m cae.: rn. cw.ma, ucem. �.. eo.. � ewN �o .� �« a wwe�v � w�w a�w«« mram .ne wro
convectv 1« auch propaa wnA a mmreaor(s) IcenaeE p���ry io iM Contrm«e Liaenss Lew�.
� I em eRempi undar Senion: B. 8 P.q, �a this reeaon:
Daia: O+mer
I do hwaby cMJy Nei l em ewua dW undenWM iM reQaremenb W Celfanie NaeYh erd Stlery Code Sed'am 25505. 2553J. vd
25SN. uM Met I a enY hnun buikvq wvYb vn0 / wil na (acY oro) �wd W camWV wYh uid m�s mAn eM iM n0wnm�nb br
eparmillacansYuctionamodCrmiontramlMAisuei�ty v��yrypq�y.ppjdepp��q�yqq�app{�oyy�v�qlmmiMa
n��.
Dets: Apqiqb;
W OPKEN'4 COMPENSATION DECI�fl�TION: I MrWy efFrM urder peroM1y d perjury one d the bllowi�q Eatlaretion�:
� I hevs eM wil meintan a cenifcme d oonwnl to �ettinayn br xaken' awnpenWion. u povided lor by Seaion 9]W d t�s lebar
Cads. lalM psrimnmiea d ihe �wrM 1a wlich ihis pxe�q is ieeuad.
❑ � n..e ene wi� meim.:� xanun• oomw�.mion mwrenoe. m�.amme M s.aia, a�ao d in. �w« coee. a. me w�«menc. d m.
work fa whiM ihie pwmA b aaued. My wabri q� Fq���n A�e mrrbr e�d pdicy numeu ma: EX P I R E S
' Pd'ryNumber: A� o> >o��iv o OS/O1/96
�rnb .«riw, n..d �a w co.,�nbred i rne vmme re ro. o,�. wne�ee eana. rsiaoi w b,..�
� 1 anM � in Ne porlamuce d iM wak Iw which thti q�M1 b iaued. I ehetl roi empby en pemn in ury memwr n n lo
beconr wbjea io �he v.aM1e�a' canpanWian lev.s d �aN L. uq pr, Ntl tl ha xome wEje'i lo iM xakan'
mm�pen/��tan7pv�.�owwnggyppp11 m TW M tM leEu CbEe. I '� N � w P;� i ne.
Dds: 1 l l� L(I � npplcen:
�
W�TI/ro: F�NYI� b��CVI�WO/kM�CVrtpIN�HOII COY�I1dIl un I, �ntl �IWI �u0f1c �n �mployr b eNn NI pHulflu �nJ
cnn nn.. w ro oM mndr.e mow.ne ewrn lt�o0.oaoA M � ro m. co.r o .�w�bn a�.�.... poHae ro. ��
9�ctlon 9)OB ol M� LeDo� COM, Infenst, erW eRomry'� I�u.
CONSTflUCTION LENDINO AGENCY: I Mreby eKrm und0r paneMy W perjury thu tMro b e mntlmdian IeMinO Wency br ihe
paAormenro W IM v.ork Ip Mhich thb perml is esuM (Saaion 30g], CH. C�.
LENOEN'S NAME:
LENOEfl'S ADDPESS:
I eanM thel I hm neA Nn eOV�ceYm ud qete ihtl tM ebal iNomution b eonetl. l e0na lo eanWY wilh eP M' eM ep+eMY adiiwm
BM t�Olawl1GW11Y �O bUi�11Q CMW Wlql Ntl Mtlb'/ GN�1OIR! A�t9MIBINtl N �Iti! (f1Y IOlNM U0� lM BGM�IMMC11lE plOpMy
IaiiupedionWN��...r�i r.�..�n..as
Ome � "�
WhGsBuildiip 8 Salety; Oreer�Fle; Canery-AOG�en�: Pink-Revenue; OoNanraE-rlexamr
PERM NO: B 074699
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : LEGALIZE DEMOLITION WORK SQ FT: 20,000
CLAIM VALUE: 20,000.00 CALC-VALUE: 20,900.00 GROUP OCC: B-2 /
COt�IMENTS: 76 UNION PRODUCTS PREP FOR TI
*��**��*��+������****�*��*��***���*�*x*�*�*�****���*�+��**��*****�����+��*�x�*****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
----------- MAI�1 BUILDING ---------- --------- ACCESSORY BUILllING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT SN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
� <
IE 3(� 1E �E iE 3E 7E !f iE ik iE 3E iE iE iE �IE iF if iE.if)E * iE 1E iE iE�F iE iE iE 3E 3E �lf' 3f �lE �E iE 1f iElElf 9f 9E if !E 1E 1E iE 1E 1E 1E iE iF 3f' i(� ff 3E if jE if if iE ik df ik iElE �f �7F d!' iE iF iF-/F iE # if it 1E
D E V E L'O P. M E N'rT S E R V I C E S' R E Q U I R E M E N T S
ZONING APPROC'ED BY ��'� /� DATE: "
BUZLDING APPROVED�HY : " DATE:
APPLICATION ISSUEb;,HY: ��? DATE: 1Q�� LG1a.
iE if iE jE 3f !E if� if iE if if'k 1E iE iE dE�E IE �f IE 1E 1E i� �f iF���F�f iE 1E iE iE iE 1f iF 1E df3E'1� ��lE 1f
LEGALZZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRxC MECHANIC FIRE SMIP/RES GRADING
PERMIT 432.00 '
-- SMIP/NON-RES
PLAN 4.39
ISSUE FEF. -
BUILDING-DIV-> YERMZT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 436.39 0.00 ' 0.00 436.39 436.39 ,00
REVEDIUE DIVISION TOTALS--> COLLECTED:.. 436,39 OVERlSHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC _ FIRE SMIP/TOT GRADING PLAN-CI-IECK
432.00 . . 4.39
if iE 1E �lE iE �)E dE �1E 3R'1E 9F �F iE i(� iF iElE IE 1E if IE 3E iE IE iE 1E ih iE IF iE iF jE iE if �E 1E iE i4 iE iE iE 1E N' i4 if iE iE iE 1E 1E 1E fE ik iE iE IE iE 3f dE iE 3F 3f 3P iE iE 1E iE it iE iE ik if iEiE ff i[� df # 1E
I N D I V I D U A L . F. E E B, R E A K D O W N
TYPE QTY D E S C R I P T Z O N� ,� i UNIT COST TOTAL COST
SFC 20000 DEMOLISA BY C'ALUE COMMERCIAL NdZONE 1.00 2.0,000,00
END OF FEES,
!
01 002S2C5'-OGi92668 Tf�1Y k?g,39
�aTE: 1��23.'i5 Ti�;F: [;:24
�
CONSTRUCTION AND PLANNING PO .L SPA
APPROVALS Permit # -Date Inspector AppROVAIS Permit # Date Inspector
1. TemPorary Electrical Service or Pole 52. Pool & Equipment Location ! -
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement �
3. Electrical Conduic Utility�Undrgrnd. 54. Forms
4. Electrical ConduiFUndrgmd. � 55. Electricai Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .
6. EleGtrical UFER Grnd. 57. APPROVAL TO COVER-GUNiTE •'
7. Footings 58. Efectricai ConduirUndrgrnd. ��
8. Foundation ' 59. Gas Pipe, O Undrgrnd.. Test �
9. bVater Pipe�Undrgrnd. 60. Backwash li�es, P�Trap, � Undrgrnd.
10. Structural Floor SYstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Congection 62. 8ackwash & Receptor-Final
12. Sewer Cap � 63. Heater & Ven[-Pinal . ..
73. Roof Orains � 64. Plumbing System � Final � �
74. Rough Plumbing 65. Electrical�Final •
15. Rough Electrical-Conduit ' 66. Solar SVstem-Final - ,
76. Rough Electric Wiring . 67. Fencing & Access ApProval
17. ftou9h Wising Sign � y 68. APPROVED FOR PLASTERING
16. Rou9h E�ectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou9h Hea[ing & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, Ventilating 71. Product Piping O Gas G Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas �CJ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•Ba� Ceiling (Structurol) & Monocoat �J0�6 � 75. Dry Chemical
27. Frame and Flashing ���� � 76. Dry Standpipe
28. Lathing & Siding . 77. fIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. DrY4vall Nailing (��� � HEALTH DEPT. REQUIREMENT
31. Plasier Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FDOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning �( _� `r�^/} �o' L�-
�� �-yv.�.��-
35. Final Gas Pipe-Test �( Q G4,/-`\6�,C./
36. Hood or Canopy �"Y"`�"'_�'�•1 �� � �j
37. Fina� Fattory Ffrepiace ���
38. Fina� P�umbing
39. Wate� Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landsrape Irri9ation System
45. Sound Atrenuation
46. Handicap Regu�ations
47. FINAL STRUCTURE & BU�LOING �j (t� ((
48. FINAL PLANNING
49. Eledric Release to Edison
50. Gas Retease to Sauthern Catitornia Gas CA
51. CERTIPICATE OF OCCUPANCY
No Date
�oonEssaem�urn: 555 ANTON HL uxT: 3RD
wrt+Fxsnweivioiwvx: SAKIOKA FARM
�ooxeu p,0. H07t 2097
CERMINAL ANNEX, CA 714-933-6005
�rx. �uwn �ss:
urcxrt� ox wowffn: uc. xo<
APCN OX EW.'S /�DDPE55: UNT:
ea+mAcrarswu�: SOUTHWEST FIRE PROTECTION ( 818 ) 359-0034
ca+m�croaswuiwo 2 1 5 E EL SUR ST
�no�ss MONROVIA CA ucxo, 190173
91016 , uxr: . .
110EN5EU COMF�CTONS DEC�AN�TION: I Inreby eftim uMm pene�y d perjury Ihel I am licenasd uMa pwiNma d Cheqx 9
(mmmencinp xith Seclbn ]000) d Divison 3 d Ihe Businew enC Profeeaionn Code, eM my lioenw ia in full fome eM eHaq.
cmuc.no.:013054 uc.cuss: C 16 uc.so.: 901,J3 EXP: 04/96
y /� .
Dma: �4 �'� �� Comr+aa: / �/B— '
OWNER BUILDEN DECIAN�TION: I hemby effirm under paraly d parjury tAai l em aumq Irom tM Comrmaa Lirorea lew ta IM
ro»:a �(s<aion �m,s eu�:ma m,a aidmaon. coe.: ��r �n a�wmv .n:n �s�m. a o�e �o aomm�ct. m«. vnc�w..
mdah, a repei eiry evucluro, pria lo m"veuarlw, ebo ieyuirm �he epplimni Iw euch pa�mn to fila e vyriad ewement thet M w eM
. GcenseE pumwi �o iM proviaiam d tln Lameeeora liuma lew �Cheqm 9(aommanunp xilh Saqion )OW) tl Divcion 3 tl tb
Buriroa ud Vrdma'aro Code� «ihn b a�he b uemq Iherelmm enE �M Eess lu Or eAepeE memqion. My vnletun d Setlion
IOJt.s by vry eppliceni lor e pmmil wbjetla tha eppl�ant to e anl qnehy d nal mas �lun frve huMrad OWv� �i50Ull.
� I.mownerW�hepW�YamYamdW�exihwapeamthwedawmpmnelbn.x�TdolMw�k.endlhs�Wdunamlmtadd
or Mared la eeb I��� �. B�aneu eM Pm/esebna Coda: The Conirmon lioen�a lew dms ndepplyto en owmrd p�opMy
who EUWa a in V� �Mrean. eM Ww dom swh xork h'vnceM a Mnd a INwqh hu v Iw orm amdol�+. n��d ihm vich
impo.amei+s va m�'vusnEeE a dfeeC fw aeb. tl. howmr. the buitliiq a inpwaneN o odd xi1Nn msY� d wnple�un. tha
owrorbuiltler will Mw IM buNen d pwinq M w¢he Ek nal Euik a impave /or IM purywa d We�.
� I. es mmee d iM MW�Y, em utli�+rvdY mrureeM wuh Gowad eannxlan ro mi9ruq ihe pqed (Sequn ]OM. Bwiren ud
rid�iw�. coee: rne comreea. u�.�� �.. doe. �a ecvM w m, o.,b. a wow�r .�o wib. « imwwe. �n.,eo� .�a wno
conVe[tl W turl� piopqs xiN e mNiedor(s) GcenfeC Wn�� to iM Canlredm Lidnee Lew).
❑ I em oRemp unEer Section: B. 8 P.C..Ia Nu roawn:
Dete: O.mer
i eo n.�M �«iM inm i.m a.d. d�e u�wersiena ub �ea���.w a ce�iomie wenn .�w smmr coee s«aom nws, zssaa..�e
25531, vM �hei I a eny lulu�e buildiip oxvpent will / will na (drck ons) need to canpty wnh eaid nete oodee enE the requiromanlv la
apertMfacmel�uctionwmodifit�alionhanlMA'r�y 'vupemsniDiatna.RmMaNidmWvfionappkmiomwezanqiromiMes
pravisione.
Dets: ApW�:
WOPKER'S COMPENSATION DECI�NATION: I hereby dlum uMer paridiy d par�uy ma d Na Idbxieq deduubro:
� IhmWxilmeiMenecanEhated�enitoaetli�aunbrxwken'wnpanWion.uprwidsdfaby5oqimJ]Ood�MleEv
caee, ia in. ron�s oi ine � ia �+:�n ma w�a n �a�ed.
❑ �n.v..na.ammm.n.wka.�oomwromun'vrw�.n�e..+iem�=wWs.uionarooamel.nacoEe.atneo���a�n.
wak la xR�irh Nu permn u'v�ued. My wakere compenaYbn inwrenee r'w eed pdiey numEer ua:
c�«: FREMONT EXPIRES
rw� r+�me�.: 0 6/ O 1/ 9 6
(iAia seniun nr� mi bs mnWMed � Uis pdmt u/ar ane huMrW GaEers Riaol a Mu.)
� 1 cMiy Nel in IM pMmmuica d iM wark M wM1kh Ihis Po�� 4 aeued. I Mell iwl amploy ury peaan in em/ mamwr ao m to
beconw �Wjae io IM xarFwa' wmpruetion lewe d CeGtmtis. erd epns Na E I ehouM beccma wEpn io tM xaM1ae'
canpenfetbn o�evn d SeGon 3]00 d IM lebor Cade. I ehdl wilh wmoi.� wilh Ihova qmisiwu.
oda: /� a3^7�� �op�m: , �.
Wem/np: F�llun ro ueun woMen' eompwuaflon rovs�ep� li unbwNl. �ndsh�/l NtlNef en employer to cNMiul pxul0u uM
e/Hl fliws �q ro on� Iruid�l flauunC eollar� (5100,Gd0A ��Itlon ro M� cwt ol rompaiutb2 Aem,pw a, provkNd bi In
Swtlon eRl6 0l fM I.�borCOM, Infevaq �nC attomsy i Iwi.
CONSTHUCTION LENDINO AOENCY: I �ereby etFrm uMer penelry W parN'Y �hd iMro u e canet�udion bMinp eperwy br �M
peAormenw d ihs wak Iw wfiich Ihi peimY n eauad (Seaun JOB), Civ. C�.
�ENDER'9 NAME:
LENDEN'S ROUNESS:
I ceniN �hu I hew neE �nia eaVlkmian ud nma Oim �na ebow inrammbn ie mma. l ep�sa io canWy rritn ell mY uM munty «diner�caa
enEeta�ekv.s^� �qWbuild'vqconsbWianendhereG/eWia¢s�meNeYwsdllYftilybaNxuponlMabmsmenliansdqope?/
��, iaimWdionMl�l� � .
ome: // a3-5s
(5151-M.WP) Whne-BuiMiq d Sdery: Oreee�Fb: Cenary-Appira�t: Hnk-Reven�e: UddeneoFAewemr
CITY.OF COSTA MESA — BUILDING PERMIT
PERM NO: F 079751
PERMIT NO: F 074751 PLAN CHECK NO: 03946-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: I—FR PERMIT TYPE: FIR PURPOSE: OTH
JOB DESCRIPTION : RELOCATE SPRINKLERS SQ FT:
CLAIM VALUE: 8,900.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PAODUCTS REF:B-74572
�r+t*x�x�*x�*��rx*+r�rx�*��*r�+rx��r**x�r*x���rx�*x�x�x�x�x�x�**+t�rx�*�r*xx��rx*x��r�r�r*�r***x��+c�****�r�r*�r�r�r*�r�r�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: . FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
iE iE iE 1f 1E 1Eif iE 1E if If iE iFlE 1E iE IE fE if iE ik if 1f iE 1E 1E it 4 iF IE ft 1F IE iE 1E 1E 1E 1E iF iI� iE if 1E iiif 1f iE 1E if It IE 1E 1E 1E iE 1E 1E 1E 1E iE iF 141F iE iE if 1E if 1E 1E 1k iE 1f 1f 1I� 1E 1E iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
HUILDING APPROVED.,HY : DATE:
+Ar+�r***+Cr����*�r�****Dir*** �` ****D*****�c� 2��Fx��r
LEGALIZATION;N_ , F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 108.00
" � 65$ SMIP/NON—RES
PLAN 70.20
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> ;_108.00 0.00 70.20 178.20 178.20 .00
�
REVENUE DIVISION TOTALS--> COLLECTED: 108.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
- 108.00
1F 1f If M if if if k M iE 1f'!f 1f iE it 1F iEM iFM M if M if M iFM'IFiE il� M1FM iF if if iF i(' if if if 1f iE k'1liF k M iF Mif if 1F M�IE IF iF M if it 1FiF 1(� �F M 1f M if if iF ik 1F iF Mif if �k iF if
�I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR
108 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00
END OF FEES
!.1
. � d.
eJ �,' J
108.00
a+ no��lr:-a:i9z�os -r�� :a._.00
GATE: iD/2"s'4S TIMS: .1:'s%
CD,NSTRUCTION ANO PLANNWG � PO 3� SPA
APF$iOVALS Permit # Date Inspector qppROVALS Permit # Date i�spector
�:
i. Temporary 81ecVical Service or Ro'le 62. Pooi & Equipment Locaxiori ✓: ���, %�.
• i �
2. S�}7 PiDe�Undrgrnd. j; �-. 53. Stee� Reinforcement •
�:.3.• El�ttrical Conduit Utillty-Un2ltgrnd. 54. Forms ' l
r� � :�
�� � .
-4: Ele�trical ConduWii .t�-,�d�grnd. '+ 55. Electricai Bonding �
y'yj Sterl Reinforcemerct-, � 56. Rough Plumbing & Pressure Test � J •
�6, Electrical UFEf!'�'nd. . 57. APPROVAL TO COVER-GUNITE
��
��', Footinqs Fa[+; . 58. Electrical Con �Undrgrnd.
8. Foundation �- � � (=' � 59. Gas Pipe, O U�Pgrnd., Test
9. Wa4er Pipe�Undr�r�tid.... 60. Backwash Liney, A•Trap, O,�ndrgrnd.
10. St�cturol FIoo�Svstem ,�� � 67. APPROVALTO�ECK
11. P��Tperty Sewer�j;ine�8c Hous�Cosnection 62. Backwash & Rec;ptor-Fina�.'
12. Seerer Cap p � • 63, Heater & Vent-Final "
c� '
13. R�bf Dreins �, • 84. Plumbing $ysiem ��Fina1
14. Rough Plumbing. 65. Electrical-Final •
15. Rough Electric�4Y-Co�tluit -. � 66. Solar System-F�
76. Rough Electric�liri69 c 67. Fencing & Acc6'syApproval
77. Rough Wiring Si�rt ! - .68. APPROVED F��PLASTER WG�
w
18. Rough ElectricalsT Bar Ceiiing 69. POOL/SPA SYSI'EMS FINAL
19. Rou h Heating & Air Condltiooing� �n, v, � C� - �, FJ�,F4D�,FJ'T,�REQUIE�EMEQ�IT
c 1, �� � n s �u� ;+�
20. �ou�i FwtoC�' Fir� lace ��r ,�r �r S F, �,r . APP��R',OU�1�.� Pgmit #� y
s ���.
21. �Buc�S in�tructur��' � -.. .• � `� ' � H ''+* "'� 'T�� c' *
,* c_ r, . 70. � nde �{rjd FS;'dro y
22. �uct�, V'�n'til$iin�j� ' �' -' � v � E�-�'� 71. ProdUct:EiPing as � Oi�
23. 6as Pipe+flo�5'"h & T*n '�� �,,-'� x �'7 �" � rC, � 72, Undergrp`�r d F�t1sh ; ,�?`,. c
24. �ioof Fr�,r ing � V� '� r r r� > a.� *• 7� Undergrnd. Stqnag2 Tanlo-.O Gas ❑ Oil
25. Root�5hP5thing s+ a: i� � i � � > Nr ^ �� � �s ��
y � x 70: Overhead:�.� �- �� {•ZG
26. 7-Bii Cei�;ng (Str�t*ural) & K1b3iq-ioat r �, y �: 7, Dry Chemioa� F_7 x' � �-+
27.�f.rar»ear�Flashir.gW �c,h �c� '+ o� 76. Dr Sta� eF"W * ''
' K Y P!P ry �k r ,i
28. Latl�ng �Si�P9 C7 r y 'yVxt�-� J ��. � ..I .. ..� .,. ��T . INA�.-�. C, - �i�L4•RS ��TI
7� FIXED
29. InsulatioA: �'�# y � " � � � jx 7 FIRE PREV. F,f�L �' 7 x `i �, �
x a� 21�I
,_ 6 �'�'
30. Drywall Nailing '�� ;y � * E, I � �# � '��,-4�ALTk1 DEP%7�RE�UIR£MENT
31. Plaster BPSwn"Codiiy � � �r" i I 79. PINAL r[.,N ECT�N �: � r
�
32. �lectrica�o��v�yr f�'"t�`,.��i�al � .; {�' � � 8�'; FOOD CERTIF±.C�TE I��ED+
33. �inalnElettriu� i� • a+ � � '' � ! otes: '7�? k `� � ��
34. �ina�He�ng,& A`ir ��4�ditioningS Cl a � I'x �. S ��::: a S �
ti � ..+ v�: « �• tt n r. t c^ �y' `k "TJ
35. ,ina Gas Pipe�Test t �x •� .: �e
♦ `^ ,.'
36. Noo�or CanoPv '� ��, � �� "` ; '�'
37. Fina�•Factory Fireplace :: � F�- r� #
38. �na�Plumbing � m�` ' o ;.
--i.
39. �ate7Service-Fnal ,� � . 4 �: c[
. ,
40. yas Service-Final ' T� ``�'T ,S + 7
.. _. �.
41. Solar Oomest�cFina '.j
42. Backflow PreYenter .{ � 1%Fr{ r^
� p '+ -+
43. Backflow Irrigdtion x >+J -� . o�
�. Landscap"�Irhgatio*System�,Ma.S R , "`� Q
N M :^ � 1' L
�
�
mo
2t5. §ound P�EtenA�tion � ... �M n � Y (ij'# � �'
m
36. �Hand �cap�Regulatiorks S J '"
;47. f'INAZ STRITCTUR� & BUIL'DING : E-,
48. F,�NAi PLANNING; , "�'' �. N
�49. �klect`�i}jc Release to �dieon � .
150. �as R'elease to Sout(�er� Catito�li$_Gas Cv �.
'51. CER"FIFICA7E OP OCCUPANCY
Date
0 o F-. �
..n * r;
O T :�7
a -
�
C+" C +
r-i m * S�
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8F^.5 e- -`,
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-� �- r X �
fi�• k C
:� H i .`.
t*.O *
--%�'t+-r�
i � C�
N r 3 n
�+ "i. � N
1� �"i S x S F
�'yY . Q S - "- S *
--L' C7 O � J �.
'. �.. . p. .c c..
I Frr�., #
� �::� :� n = *
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� �%� : tr • o��. * p •
�• S �C� R .s N C
AOOPESS OF BUILqNG: S S S ANTON B L
a""Eas""MEiFro+a"": SAKZOKA FARMS
�oonEss: p0 BOX 2097
• • TERMINAL ANNEX
�vr�. wi�a wo�ss:
uxT: 3 ND
""�"��Ta"�*'+"�" TRI-SIGNAL INC. �"� 0
ARClLOHFNQ'S�DOqE55: 1]QS GARDENA AV 818-247-1194 uxr:
GLENDALE CA 91204
�o�m�a«r%w� MOAROW MEADOWS CORPORATIO ( 909 ) 598-7700
COIIINACTOASMIRRM P O BOX 509
�oo�ss WALNUT CA uc.xo.: 230813
91789 uNr:
IJCENSED COMFACTONS OECIAFATION: I hnaby ellim uMx panaly d pmjwy Nel I em fcermaE under pv.tiam d Cheqx Y
(mmme�iq wiih Seciion ]000) d Dirieun 3 d tha Buai�wee end Pm/esvona CoEe, eM my licenae u in IUA lorca enE efletl.
cmuc.Ho.:00655Q8 �u^c.cuss: uc.no: 23081 EXP: 2/96
� Dele: /"� �` / l!� Cowmm i ' (
OWNEF BUILDEP DECIAPRTION: I Mieby elfirtn uMer penety d prjiry IMI I mp mm IM WMmdm Liwma lew la M
Jbxiq reewn (Seuion )W 1.5 Bwiima eM Notwoeu Code: �MW a wu wfiiN r im e D�u io mmwa. Mx.'unOron.
molsh, a rapei eny e4ud�na: piw io in eeueM:e. ebo rpuim tM eppliceni 1 wch il �o fle a eqneC eWemeM IMI he a sM
. k.�.ae w�i �o ms ww�.�+ a m. com�m�. uoM,. �. Icn.q« 1 �V xqh SeCian 1000) d Diveion 9 d Ils
Buv�wss eM Rdm"vre Cadel a Ihet he a Me ie eumN iherMram erd tM a tM eIbWA uemqion. AnY videtion d Sepion
]0�1.5 by ury epplimnl la e Pormil wbptle iha eppli�anl lo e civJ pa�Wly d M mm Ihen Irve huMnE EOWn �5500�.
� I.mowrerdthepopuMamV�GbiMwhweP+mihaiedacom0emetwi.wTEOIMv.wk.udtMevuctunendimended
or MereE Im sek (Sectian )OM. Budrbae eM Prd»aiau CaEe: TM C«ureqon Limnae law dom not appylo en owmrd paqry
`M�tl bl�! M �IIpOM91�IMlpl. Btb `M�IO dOBf �Yf31 MCIk f%1118G1� IX 11M]!� IX dlfqY�h b IX �1IN OMT MIIVbIw. G�w�d 1� Wf�l
ITM�mMU 9!! Iql IMBIIQB� IX CMqlE �p fB�p. N. �1OWTM. ��I! N111YJ41A IX�IIpM'BIIIMM O�O{� W11�1YI IXM YYf G� CIIII�q11.1�N
ow�wrbuiNx will heva Re buMen d pwinp he w elie d'W nd EuiM or impova la ihe qvpvea d ub).
❑ L m ow�« a me wwem..m �dmw,• �ro.e�w .,un r.�..e wm�m, ro omww me o� ls.uion �ow. a»i�.0 w
vrae.,om coro: rne cw,mon Lc.�. �en eo.. �a ewN m.� o�.n« a wwenv wro wib. n vnpo.., mr.a, ene wno
mntrzb la axh pqedf wuh e mttlrador(a) liceneed punueN lo IM CONiaudf Limroe taw�.
❑ I am ezemq wdar Swun: B. 8 P.C., la Nia reaeon:
Dete: Owrr.
i eo n�nr �r ����•ae a�a �.wRi,�a we �w�,«m a c�eo� r�.een.od svw coe. seac�. nws. nsaa..�a
]SSW, eM IM1et I w eiry Mun Wikiiq mwpeni will / wil mt �a�cb ons) med io canpy w�F ud pele mAea eM tM iepuimmeMe br
Deb: Appfrau:
WONKEfl'S COYPp19AT10N DEC�AP�TION: 1 Mreby affrtn under parWy d paejury ms d IM IWowi�p Aeduetiom:
� I Mn end rnl me'vNan e canArse W mnaani io utliiuun br wwken' comG��ion, n pwNM ta M Sarmn �100 W iM labar
Code. ta �he pmlamvca d tlr xak lor w1JCM1 Nu pe'mil b roued.
�] in�..�wwu��.ona.��w��:,m,�.�,o...,bw:.dq�s«a�a�ooam.�,n«coe..f«in.o��wm.
work la whid� Nie pamil u uaued. My wvken' cwnpwtion imurance wner ud po4ty number us:
c�..: FIREMANS FUND EXPIRES
Pd'cy Number. n W��i'°t��iT1 �— 0 7/ O 1/ 9 6
(11tls mem rwd mr M mmaMred / NaW'mt o br aa �wW W tlo9ers Istwl a Mn.)
❑ i cenN �nm �� me o«imnence a me � m...ncn ime w�a s b.usa. i.mm �oi «nNw �r oa+u� o enr mww .o ro �o
Dacome wbptl lo Ihe xoAmn' mmparoe�ion lev.s d Cefdamie, enE epns tlW tl I ehddd beqne vibjp o IM xaM1an'
cwnMrt+dion( p�wieiore al5eeian 3]00 d iM laba Code. I hwilh comDN wi IMn pv+iton+. /
Dme: % '� T. � �„�� AOd'reN: �
Wunlip: F�Yun ro a�cun wrksn'rompwuetlon rov�rap� Is un4wN( �rW � wpl r en wnployu ro tAr�irol p�ruMu �M
clHl nnu up ro ms h�ndrM NouaW la/lw fSI0QP00A bi �ddlGbn ro M� c st ol c mutbn � u pvvWM ror In
Sztlon J1P6 0l M� LeDoiCods, Intvu4 �na �Iromry i Iws.
CONSTFUCTION LENDINO AQENCY: I Mreby elfi�m uMer pe�Wiy d pmju t tMn w e eor�stiuqqn bMirp epeney lor Ns
pmlormerce d IM wk fa xfurA the pxmi h 6wed (Swion 309'!. Cw. CI.
LENDFA'S NAYE:
LENDEX'S �DOPES4:
I ce�ity ihet I hew �eed Nu appliuiion uM ueta thel �M ebove inlormetion w wnep. I piee lo canply Nilh NI tlry enE counry oNinenae�
erd stme bxe reletig w bWdiq canetrumm vd Mrsby aWvc� iapawitetHu ol tNe rny Io aNr upon �M ebova�meMia�sE propany
fa'uupetlion pummes.
CHUCK JACOBI JR
(5151-b.WP)
Dme: / � �
d Stlay Oi�ls: Cerwy-Appicem: Pink-Rw�nw: Oddeniod-Mw�cr
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: F 075840
PERMIT NO: F 075840 PLAN CHECK NO: 04811-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: FIR PURPOSE: ALT
JOB DESCRIPTION : FIRE ALARM ADDITION SQ FT:
CLAIM VALUE; 2.00 CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 UNION PRODUCTS REF: B-74572
*it****�t**�t**it*�*�t***it�**it***it�t**et*x�et*******+Ei�ie�t��***x��r*�t*****�t*�**it+�*+tatf�*at�-***�-
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
i
ih 1(' 1h fh if II' 1i' iE 1f if ff if iE 1E'IF if 1f 1i' 1E iF 1f if ii if 1h if 1E iP iE if IE iE 1E 1E 1k 1E 1E ih i41f 1h 1h 1E iI' ih ih i(' 1h k 1k iE ik iE iE 1h 1E iI' if iF i(' iE ih ff iE IE 1f iE'lf'lElE IE iE if if iE iE iE iE �f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
HUILDING APPROVED BY :
DATE:
DATE:
APPLICATION ISSUED BY: DATE: ��F���s
iflf7fififlfififiEifiE�ElEiflfiElEiilflfifiE IEIflfiflEifiElEifif �3FaEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 90.00
65Y SMIP/NON-RES
PLAN 58.50
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 90.00 0.00 58.50 148.50 148.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 90.00 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
90.00
kiklf kkiFiflE�f fEiFif iEifikiEfFfkkif 1fif1kiE1kiklfiEiEalillf kilif i!ilaEklllEkMlEiEklEkiFiElEiEifif iEifiFififklkiFkiEkiFifiEiEifiE�EiEiEiE�IE�Ek�IE
Z N D Z V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C A I P T I O N UNIT COST TOTAL COST
FIR 90 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 90,00
END OF FEES
�'�
��
�v
7-
n� ;;L7'" - -C15•0 �• 'r2� i�' ?:.CL
UF+ii:L �: ��.:..Y: �i��Li �. :/
CQNSTRUCTION AND PLANNING . P�� '' SPA �
APPROVAL5 Permit # Date Inspector qppROVALS Permit # � Date Inspector
L Temporary Electrical Serv�ce or Pole 52. Pool & Equipment Location '
2. Soil Pipe�Undrgrnd. ., 53. Steei Reinforcement � � �
3. Electrical�Conduit UtilitY-Undrgrnd. � 54. Forms .
4 �Electrical Con�u.ibUndrgmd. 55. Eleciricat Bonding , � "
5.' Stee� Relnforcemertt 56. Rough Ptumbing & Pressure Test
-'6: ElettriwiUFER'Grnd. 57. APPROVALTOCOVER�GUNITE
,r _
:'7. Footings �� � 58. Electrical Conduit.Undrgrnd. _ .
8. 6oundation . . 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrqind. ' I 60. Backwash Lines; P�7rap, V Undrgmd.
70. Structural Floor Svstem � - 61. APPROVAL TO OECK _
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final '
12. Sewer Cap ��' � 63. Heater & Vent-Final '
73. Roof Dreins " � 64. Plumbing Sys2em - Final
74. Rough Plumbing, -� ,� 65. Electrical-Finaf •
15. Rou9h Electrica6Conduit �' • 66. Solar SVstem-Final ' .
76. Rough Electric Wiring , ; � 67. Fencing & Access Approval
'.77. Rough Wiring Sign 68. APPROVED PO�R"PLASTERWG _
78. Rough Eiectrical•T 8ar Ceiling � 69. POOUSPA SYSTEMS FINAL �
79. Rough Heating & AirkConditioning __ FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fir.eptiace - . ,Y , - ' :. r , ;APPR�OVA'L,$�.r Permit # . ��
21. DuctS; in StructureF+� •- ' - � �' �' 70. Undergrtiund Hydro �
.r i
22. Oucts; Ventilating� � � _ - ;= i, 71, Product Piping G' Gas G Oil
23. Gas Pipe-Rough & Test . � ��+ � 72. Underground FIusH '
24. Roof Praming ' � ' " -'_ � 73:� Undergrnd.5torage,Tank<`JGas uOil
25. Roof.Shea;hing : � � � _ . + 74; Overhead Hydro;, �`
26. ;f-Bar Ceiting {Structural) & Modowat � _ � �r`.,' � 75= Dry Chei�icai : � � ' '
27. Frame and.Flashing- � - _ . � A 76., Dry Standpipe r` � ��
28. Lathing&�Siding _',' � `'"=�� � ' -�• " "` 7Z, FIXEDSYSTEM'��PINA� . T
- o. �.
� 29. Insulation_ � ya - •� � - 7$:. FIRE PREV. FINAI ' � 2�'T ��„ f�.�r�-
�30. Drywall Naifing ' . , . "HEALTH'DEPT. REQUIREMENT
i .
31. Plasrer Brown;Coatr .-. • . i •�� 79� FINAL INSPECT10� '*
32. Electrical-�Powe"r Meter�Final �� ;� 80r FOOD CERTiFICATE ISSUED
_ . , , t, % cT • � i ., .: � -
- 33. Finaj;Electric;� �. .r . '< No{es: � * • � '
<= �
� 34. Final"Heating & Air-Conditioning � � ; � � ' � � '
9.� f Y < _' �k � P �
35. �fnai Gas Pipe=Test,� { `;, -.'. _ I,� ; ' � �j�•
i.
- 36. Hood�or CanoPY ' - "' ,� ": . 4' � =. .r r .
� . � � � r-' ;. :. ;r .._ x �. ..
,37. F:inai.Factory Fireplace , .-- . .� _. -
;.
-�38. Final�Plumbing �i • � ' x ' ' . _ ^ � �
� ,+ i r' •
39. Watei Service-Finai � �` '� :v � . "�� � �' �
• 40. Gas Service-Final . _ '� ' * ' t , � .
, .
"-41. Solar 0omesticFinal; �� i ' ' � s -���, : � . . .
42. Backfiow Preventer • � •' � :�� � �'
, _r � n '
43. Backflow Irrigation ,. �. " ' ` ` - f ' . �
44. landscaPe Irri9ation SYStem ' ' _ � '.. - . . . . - � i, '
�� -
� 45. Sound Attenuatio� ' �� '- - - ' � � =. � � � . .
r ' .
46. Handicap Regulations r u � !T' " - . �
47. FINAL STRUCTUflE & BUILDING '. _, . .
48. FINAL PIANNING ' ' ' '
49. Elect'ric fteleas@ to Edison `` �
v '4 ^
50. Gas Release to Southem Califomia Gas Co - - ' " ' �
r �
51. CERTIFICATE OF OCGUPANCY ' " -
No Date
�I
mon�ssaewiaxo: 555 ANTON BL
°""E"'9"""E'°'m°'"": SAKIOKA FARMS
"°0P�' PO HOX 2097
• � TERMINAL ANNEX
aw�. iuuurw woness:
u"T 3RD
urcxnecran�ow�n: INTERIOR DESIGN 213623216�N0 9378
MCHOPFHO.'8d00HES4: SSO S HOPE ST °NTo 1100
L.A. CA 90071
axix�nars"•�.
CONINACi0R5 YNIIIlO
NORE59: 11G Iq.:
um:
LJCEN9ED COHfR1CTONS DECL+�pATION: I Mnby dfrm uMw qrWy N par�ury iNl I em IkameE uWs po.'vqns d Choq�r 9
(canm�ndn0 v.ilh SecYon ]000) d Oiv6un 9 W iM Burirne end PiMaaan CaJ�� W my frems b in IuA tau and eflee.
CRY LIC. NO.: LIQ C1A49: IJG. NO.: �`xP �
Dma: Gaweaa:
OWNEfl BUILOEfl OECIANATION: I Mnby dfi�m untlar prWly al psr�ury Ihet I em �wnq Imm iM Com�atm Liunss lew la ihe
'dbwip �ueon (Sspbn )0313 BN�� �d Prdstsb�a Cod�: Mry ciy p oouMy whidi �oquim e permil lo mnewcY. Mx. Imprws.
smdn�, a rapi mry Hiunuro, pW m Ya ewuKa, ebo npuira� IM epplimnt 1> tuch puma Io fib e aqned Mlement tlW M or eM
s 4cawe wmuni m ina am'abn. w Ns canremr. lioM,.a ler �cheq« Y(oomnenriro wn swun looq a oivcon a a �h.
Bu�'visu eM Pralaa'vu Codel a Ihtl M a Me n usmq IherYmm end iM bew In pr eEepeA azempen. Nry vialatnn d Satlnn
1W t.5 by ury appficeN /a a pam4 ��M eppfceM to a dvi pmePy d m mas �Mn (xe huMnE Eaaen �SSoop.
❑ I.movmmd�hePWe�YaMY�nVbRs+wl�wepesealhsiWacanPo�uiion.willEONs�k.erdtMnrudureemlinleMed
or Mered M eab (Seciion ]OM. Buunen eM ProlueioneCads: TM Conlrmon Lkanas lew does not epplylo en owrierd propMy
wM10 WiCf a inpme� IheeM. enE nfio Eoes �uM v.otk Nmsell a haael a Y✓aN� he a ha own emVbYMe.O�+�deE �hN fu[h
imp�wameNa ars na'upanded a WanE la ub. 0. Mwaver. tM bua]inp a inpmxneM u wld wuh'v� ons Yw d aompblian. Ne
y� oww�dAdar xi0 heva �ha dndsi tl Pa+rq he a ehe did na drild a'unPa+lv �he wrVo+e d valel.
LJ I. m ormer M �he popMy. em exdeiuely conlrepnp �ih lioensad eonvaeton lo cansUutl tM pojeu (bedon )pa. Bus'vim� eM
Pmleabns CoJe�. TM Conlraa� ���� lew tloee nd epply to en oxns d DropenY �o buika rc impwm tha�eon aM who
comreda for a�tli pqeaa wM e oonvmor�e) licenead Wnuem to iha Convectae lirnme Lew�.
❑ 1 am mamq uMm Se 'm: B. 8 P.C., br Nu raeaon:
Dma: � Z � Ovrtbr. ��
i ao ne�e cen�N �� i em e.ar. d� ����� �ns �cunemew a ce�eome wenn e�d sy ry CoLe Setlbna 25505, 2553], ud
25551. eM Nm I a vry M1aure buikuq �+CaM vrill I w11 r�d (tlrcle an) �waE to oomyy w1� eeA(mta mdas uM �he ropwremenb /ar
a pxmn InmruwaionamodSrmim haniMAi�uity .1�vupaMrit Dipiitl. Rmideruelmnarudion eypfutioroare uemp tmm iba
provcioro.
oaa: nod�c
WOPKEN'S COMPENS�TION DEGUPATION: I hereby elfimi uMn penelly d peijury one d iM Idbwiip dedve�'vu:
� I heva uM wil meimen e csnil�a d ooruent lo �Mtivun lor xpkere' companmion. n pwided Iw by Setlbn 3roU d tAe lebor
COEa.lar iM parlormence ot i� ��M Iw wNch �hie pemin n iv�.
� I hera end witl meiniein workart � W�a�bn insurence, n reQuired by Seaim 9)00 d IM Lebor Code.la Ihe peNamenw d iM
wwk Iw w1iiM ihn perm� ie iasued, My warken' mmpeneelion inaurence umer vM poliq number ere:
c�..:
Pdicy N�m��
(ilris eecfion rrees nw 6a canObfed / Ms permrt ia lw one hunEred do/kn /StOJ� w b.sa.1
❑ I cMAy Ihel in Ihe parlame'We ol ihe wpk Iw v.nkh Ihie permn le iaeued, I ehall nd employ eny penon in any menner ao d lo
bxome aubl� �e �M xorke�e compe�uelbn lewe d Cd'ilwnia, aM epree Ihel q I ehouk became wbjed to IM waM1en'
compenvetion pwieum d SN� 3)00 d iM lebw CoOe. 1 eha11 lal�wnh mmp�y xrh Ywea pwiaione.
o�a: �oa�:
Weminp: F�lluro ro�.cun woMrM� rompxwflan rovxp� l� unbwiul, entl aNll wb)�cf �n �mp/oysr fo crlMvl pauMu eM
c/vll flM� up ro ons hunOlstl (InMyb ���� (5100,Op0A M eWltlon N fM ewf ol mmyxwfbM1 Mm�q� �+qovMW br In
Sxtlw J1(A6 0l M� LNor COJs, I��M�S � ettomry's l�u.
CONSTFUCf10N LENDINO AGEN�� � M1�ebY dfirm �Mer penely d perjury ihtl Onre'n a oonetiva'an bMiiq egency M tlre
peAamanca d tM xwk la whiM tne partni ia oaueA (Seaun �OB]. Civ. C).
LENDEN'S NRME:
LENOEF'S ADOFE59:
I cenity Ihel I heve read I�b epplicelY� � pe�e Ihel �he ebwe iMame�ion ie conw. I ep�ee io romp�y wnh dl ory W cwnry pEinenu�
eM s�ela lewe rele�up lo buikvq cM�b Wion end Mraby eNhw¢e reqaeente�ivae W Ihb cily lo enler upon IM ebove.meMioned pmpaR/
Iw impepbn Wrposee.
ERNIE VITUCCI
. � � Piini Nem� � .
' Dme;
(StS��B.WP) WINe-Butld�qbSdMY•Oieer�Fb:CenW-AGG��:Fnk-Wvenr:Otldmeod-Aswva
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 076188
PERMIT NO: E 076188 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 20000SF OFFICE T,I, SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
COMMENTS: 76 UNION PRODUCTS FURNITURE INSTALLATION, RE:#B74572 6 B7fi187
if if 3F 1E 1E i61E �f 1f IF I(� iE iE 1E If iE 1f if if 1F �F 1E 1E iE if ff If If iP 1R If 1f 1E 1f 1f �k 1E 1F 1E iE iE 1E iE iE If 1f If ik �f i6if ik iE if 1f If 1k iE iE IE �IE IE 1E iE �E �If 1f 1F 1F i4 iF iE iE 1f�iE fE 1E iE 1(�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: ET IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL; 41050104 ZNE: REF NO:
PLANNING NdTES>
i �
1EIEfEfE1E1E1E1E1E1F1FlFIE161EiEiE1ElE1E1fiE1EiE1E1E1f1EfF1EiE1EiEiE1E1E1E1f1EiEiE1F1E1EiE1E1E1EiEfEififiFi6iFiElEiEiEiElEiEiElE*�EiflEfElEiE1E1f1kiEif161FfE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: l�Zie
****�*�*��*��r�*�r+ti�*it�*iFiF'i�TF'iF?F7F'3F�F"iF�"�"iF�'R'�F'if"iFiF�F 7f±F�'I�'iFl�"iFifiF'iF****�r�r*x�i�* **
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 211.20
SOY. SMIP/NON-RES
PLAN ' "
ISSUE FEE 15:00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 211.20 15.00 0.00 226.20 226,20 .00
REVENUE DIVISION TOTALS--> COLLECTED:.' 226.20 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
226.20 � �
iE iE �IE iEiE 1ElE'lE IF iE if 1E if If if if iF iF if 41f 1f� fE IE if 1E 1E iE 1E 41E iE if 1E 1E if ik iI� 1E IE fE iE M iE If 41! 1f 1E if if iF 1E iF if if 1E 1E ff if 1E iE 1E iE 1E 1E 1(-if iF iE iE IE IE 1f iF iE 1E if ik
I N D I V I D U A L `F E E B R E A K D O W N
TYPE
ELE
ELE
QTY D E S C R I P T I O N.._ UNIT COST TOTAL COST
20 RECEPT/OUTLET 1'ST 20 EA. .75 15.00
436 RECEPTIOUTLET ADDITIONAL EA. .45 196,20
END OF FEES
US 0019a:+2-;,G34�?92 Yc0'q' 2?e::�t
CA7c': .�1: :,�9� ii��:_ ;,3�,56
CQNSTRUCTION ANO P�ANNING : � POl �SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporory Electrica) Service or Pole � 52. Pool & Equipment Location �
2. Soil Pipe•Undrgrnd. • 53. Sieel Reinforcement
.3.-Etec[rical.Eondu(t Utility�Undrgmd. ' 54. Forms .
"4;"Electrical`Cond'uit-Undrgmd. " 55. Electrical8onding -
�� 5. 5(eel Reinfq�cement 56. Rough Plumbing & Pressure Test
�6:'ElectricalSlFEFiGmA. 57. APPROVALTOCOVER-GUNITE '
- .7'."Faotings -r� 58. Electrical Conduit-Undrgrnd. `
8. FOundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. .
70. Structural-Floor Sysiem 61. APPROVAL TO DECK '
1 7. Property Sewer� Line & House Connection . 62. Backwash & Receptor-Finai
12. Sewer Cap_. ' • 63. Heater & Vent•Final
73. Roof Drains � 64. Piumbing System - Final
14. Rough Plumbing - 65. E�ectrical�Final -•
15. Rough Electrical�Conduk - 66. Solar System•Finai ��
16. Rough Electric 4Viring � 67. Fencing & Access Approvat '
-'17. Rough Wiring Sign 68. APPROVED FOR PIASTERING -•
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
t9. Rough Heating & Air Condition�g �_ _ F1RE D�PT.�gEQUIREMEN� __m
20. �ough FactoryLFiregtace '��' K * �' ti�,.;� �.APPROVe'ISS�F. PeFmit#��.._
21. Dutts-, in StruCiure= • •� ^ �- � - - - * +70. 17nderg�Kund Hydro
-• v
22. Ducts,- Vc%tila=ing :, i ' ,-, ,: �; �`, ;, �� 71. Product P�ping E7 6as G Oil
23. Gas Pipe-Rough & Tqt ,r'� * T �y �� ��� 72, UndergrounYl Ftasfi '
24. Roof-Fra�iing" "r � -' "` ;. ; ' .,,,�;� .73. Undergrnd.Sto,ege�Tank;�L�Gas ❑Oil^
25. Roof.Shej"thing �e; ��� � � C' > N� 74=0verhead Hydro_ _ ■
..
i '
26. F-BaPCeiGng (StruptJral) & Mopocoat `y � ' r y 75� Dry Chemical �. ; r•
27. Frameand.Flashing�; - F � . Mz 76. DryStandpipe e-t= »' � -.!T
28. Lathing &Siding �.', `� �°�'� � ; i ' ",* 7� FIXED SY�TEM;FINAL � � '
, : •��
� 29. Insuletion- � � `� +� � � �' 78FFIRE PREV. FIN'j�L �` � �- �`
30. Drywali NBiling "'� , i,_„ • �: :�.Ef�LTH�D��P7�. REQUIRE�{tENT
'37. Plaster Brown Coa(�� ' -- K 79 �FINAL INSPECTIpN� +�'" v -
.
�.32. ElectricalPower MetCr=Fna1 ' ` = � ' �80:�fO0D CERTIFiC`ATE IS'SUED,�
'J � HX' 1 � ' /J/J � 1
�,33.Final.Electricr �._p� � _ !�!A'_ /LA/,t6 �Noies: : _ :
. ._ .. _ Qp � �....� -: � ,-
� 34. Finaf•Hea�ng & AiP:G�.onditioning�" _ _ � 4 ; , p�_`-� : ,� •� ,:--�,_/ •.� -� '� ^�
• v �%�I . G� �J�
� 35. 6�inal Gas�Pipe,Testr . ; � � - , � �x.%,� `�„ (�a;,,,,. ,n
Va_.� ❑ v��f�-�'
• 36. Hood or C2nopy � ` - � - _ , ' - -
- - - - � ;�,r.�eer��<.-
37. Flnal�fac ory Fire�laCey� r::-, � � '-h - � • ��'
�
� 38. FinalFlumbing � � ' "� , = ; ��
:,� s r
39. Water Service�Finat-' ; g � �; e . ' „� :r. T a �� : ��-
. �.
40. Gas Service-Final o:•. :.r .� c e m �,• J'� _ T
r� .: +�, r t �� - k d
'41. So4ar pomestic-FinaV� c �' � � �' � � " ''
['] �' . '7. .k ; ^
42. Backflow Preventer� a * ' � � F � � '-
�. - n � �- � !' l L
43. Backflow irrigatio�;i, �' -' ,.'. x �� . •
44. LandscapE�Irriqation6Ysrem _s*!�' x `� ' Y, C� �� )� �
45. Sou�d Ruen�tion � ylr', � �� ~ n. `- * o' � :���. ' =' i -
46. tiandicap Requiations J • * �' _ S x
��
47. FI�NA�L STRU�TURF� & BUILDING ;� _. ' ' - '-, ,, �,
_,
� 48. F'tNAL PLANNtNG '� � - � ' � - �
, r _ i,.
49. Electnc Release to Ec;json . ' ` = ' ' ; ',' _�
•: .
50. Gas Release to Southem Califorrtia�GasCo ' �"`' �' � �
- - - r.
51. CERTIFICATE OF OCCUPANCY � '
No Date
BUILdNG: SSS ANTON RI,
�F�'0"" SAFCZOKA FARMS
woxess: p0 BOX 2097
' TERMINAL ANNEX
�VPL. NAll1NG PUDRE55:
UNi:
3RD CITY OF COSTA MESA - BUILDING PERMIT
� '
PERMIT NO: E 0'74577 PLAN CHECK NO: N
CUNSTRUCTION TYPE: 1FR SP PERMIT TYPE: ELE
encxnEcronu+r�x�n: INTERIOR DESIGN 21J62321E,°0N0o 9375
ANLX.OP ENG.'S ADUHE55: S S O S FIOP E S T uxr: 1 10 0
L.A. CA 90071
cartn�craxsx�Me: MORROW MEP.DOWS CORPORATIO ( 714 ) 598-7700
CONiN�CTOR5NNIING 6 1 0 REYES S T
�onnEss: WALNUT CA uc.xo: 230813
91789 uxr:
LICENSED COIRHACTOHS �ECLApATION: I hereby ellirm under perely d pa�ury the� I am licensetl uMer provisiwre W Ghepter 9
(mmmeridng wXh Section ]000) d Drvision 3 0( Iha Buainass end Pmleasiona Code, aiM my license is in lull brce arM aHed.
�em .N : OU655II ��acuss: C 1U uc.No.: 230 3 EXP• 12/95
� ete: �- coovae«: . }%'YL
OWN BIIILDEF DECIAHRTION: I hereby elfrm under panaly d perryry ihel I eaem I iram the Conlredon Lironse Lew for Me
inB �a� (�ion 1031.5 Buenasa end Profeasbns Code: Any ciry a munt� wfiich Quirea e permd to mreVuct. eller. improve.
xnolsh. w repeir any ewcwre, qbr w ils ewence. also requiras �he epplirem Iw uch rmn to fib e sg�d aie�ement tha ha a she
.e licensed Oursuan� �o �he provisiore W �he Conlredors license lew �Chepte� 9( ndn0 �h Sedon )00p) d �rvqion 3 of �M
BUSIIIBS Blld PfO�B98U119 CiOjB�011hBl �1B M 8hB 9 BFB111q�hPlB�fp11 efld�hp bB419 �Oflh! B��BBB'� BIIBTH4G11./111)'Vp�B�p110� $BC1U11 .
10.a1.5 by eny epplicen� for e parmn subpas Ihe epplicenl to e civil qnelry of nm mare then live huMred ddlan �$500��.
� 1, es owneroi Ihe pmpa�Y or my empbyees vnlh wepes es iM'r wle wmpenaetion, vnll do tha wak, end �he eimcNre ie nN in�endad .
aoXaredMsele(Section]�46.BusnesseMProfesaianaCode:TheCon�redonlimnselawEoes�wtepplytoenownerINpopeMy �
�� wM builEs or improves �M1ereon, end who does su<h vroik MmseM a hermeN or thrwgh he w her oxn emplryees, O��ded thm wchl
improvemenH are rro� inlmdad a Weied lor sale. II, however, lhe buiMinB or improvemeM ia soN within are year o/ mmpleton, the"
owner-buiNer will have ihe WNen d provin0 � or eha did nd Wiltl a impraro la iM W�e d oele).- -- -- _
� I, es o�mer W �he prapeM. � eKdusivey conlraclin9 �Ih IimnsaE conhectora to mnmua Hre pml� (Swqn )000. Buaineas e�M �
Prolessions Coda:Tlre Contredore Lironse Law Eoes nd appylo en ownerd peopeny who buiMa aimqoveathereon end wlw:
convecb Iw wch prol�s �h a mn�redar�s) Icensed pursuem to tha Lan�redwe License Lew�.
❑ i�,.�m ��aa, s«uo�: e. a r.c., b, m� ,e�o�: r
De�e: Ownec � �1
I Eo hereby caniry ihel I em aware of and uMersteM Ihe requiremema W CelAomia Neellh end Sa/aty Code Sedione 25505. 25533, eM
25534, enC ihat I a e�ry lulure WiWi�q amupen� wiil / will nm (a�cb one) need lo comply w1h sad stele mEea enE Ihe repuirements br
epermNformnstruclionormodifirationhomlhaAk ueSlilyA�epemeniDislnd.Reaidmtielcanstiudionepp4miauereexempfmmtheea
povisions.
De�e: Applcent:
WONKEH'S COMPFHS�TION DECLAHRTION: I hareby elfirm uMx panally d perjury ore o/ the lolloxirp Eetleretona:
� 1 heve entl vriM meintan ece�Xicete d mneent la eeM-ineure M vroAers' mmpenemun, ea provMad fa by Sadion 3)00 d the leEor
COEe, lor �ha paAarmence d Ihe woh for which ihia permn ie iasued.
.I heve eM witl meintam woAe%oompenutun irreuranm. m requireE by Sedion 3]00 af tM Lebor Cade. brtM peflormv�oe M 1ha
.� wwk Iw whidi ihis parmA ia iesued. My wM�en' mmpensetbn inaurenca ramer eM poliry number ere:
c�a.: FTRFMANS FtTN� EXPIRES
roi�rN�me�,: nrtrnnc.�c.Fq� p7/01/96
( i ection need not 1» comOble.f B the pem�Ais br one hundred dollera (SfOp) w less.)
nAy Ihet in IM paRamence d tM wwk Iw whkh thia permit is ivued, I ahdl nd employ eiry panon in enY menner eo av lo
me eubjee to �he wrkeri compansation lewe d Celilwnie, end eprea ihel il I ehoub bacome eubjetl m ihe waMere
co pensetbn qoviabna N ' 3]0o W Ihe lebor CaCe. I qixiih comON iN ihme provisbre. �
e�e: nodt�c ✓ \ �
emlip: F�Nuro to �eeuro wodrerY rompenutlon rovenps b unl�wNl, mtl • 11 a)wf an �mployx to etlMrul p�vMu arW
elvll nnu up ro on. nunerea mo�a�w eonen IStn0.oaoA �n.ad�non ro ms o�t ol omp�nuWn, am�pu �s provmW roi /n
Swtlon 9106 0l Ms LMor COW, Intxstl, and attomey'e leu.
CONSTRUCTION LENDING AGENCY: I hereby �rtn unEer penelly d perjury ihel lha�e ia e caMmdion brMi�p epenry br ihe
periormenm d tha wrk lor which ihe pemiA is iesued (Sedon 309), Cir. C).
LENDEF'S NAME:
LENUEfl'S MOPE55:
I cenify �he� I heva reed ihis apqkelbn eM ete�e �het �ha ebova inl«metion is corte�l. I eprea to mmpN �h all cry uM muny oNinenme
end atele ievn relelinp to building eonsvudan end hereby euthoriza repreaentmivea W thia enyto enter upon ihe above-memioned propeery
�« mscecro� w,wsas.
i CHARLES JACOBI
o�a�l% �� � >
(5151d6.WP) � /WhNa-Buildinp 8 Setery; Greeo-File; Ganery-ApplicenC Pink-Revanue: GOldenroE-Rssesmr
PERM ni0: E 079577
GOC�T: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION : INTERIOR 2000OSF OFFICE T.I. SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: 76 IINION PRODtJCTS REF: B-7457U
x**********�c****�+�r��t�*�***�+��*�r��r*�*****�r**�****+�*��***����t*�*�r�c ���**x*****#��: �
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
----- MAIN AUILDING ---------- --------- ACCESSt�RY BUILDING --------
FRAIT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT' SN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTE5>
% � %'�
iE iE 1FlE jE 3E �ElE iF if 3E 1E 9E 9f 1E df 9E 36 9F 3E if eE if if iE iE iE iE iE iE if if iE ifr?E 9E jE �E iE iE jE 1E iE iE 1E-� iE iEiE aElE iElE IE 3E 3ElE �E 1E iE iE 1F 3E iE iE iE jE �E 3E 1E 1E iE iE iE 1E iE 9E dE iE
D E V E L O P M E N T S E"=R V I C E S R E Q U I R E M E N T S
"t.'
ZONING APPRGVED HY DATE:
- - - � .-
BUILDING APPROVED BY : ii:; PATE:
/ � rr
APPLICATION ISSUED HY: J�-� DATE: ._.'Q_-_/ ���
dF3EjEiE3E3ElE*3EiE9EiE�fifiE3E�lEifiE9fiEiE F E t 1F E* �E �iF'.�t�F�iFiEiF�E���f�f��)�$F�F�FTF�F{F3fiEiffEiE9E9EiE3E�1EiFifiE�E-k-3%iF�i iEiE
LEGALIZATION;N F E;EIk S U M M A R Y STRUCTURAL SEGMENT:N
�' %
BLDG PMT PLUMBING EL'ECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 208.05
508 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDZNG-DIC'-> PEP.MIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 208.05 15.00 0.00 223.05 223.05 .00
REVENOE DIC'ISTON TOTALS--> COLLECTED: 723.05 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
223,05
iE iE 9E iE dE 9F iE df jE �F 9f 9E #�E jE iE iE iE iF 3E 3F jE jF9' iE 3E 3E dF 9E iE 1F iE jE iE 3E dF iE iE iF iE i: iF iE �E # 1E iE 7E iE iE iE iFjF iE iE iE iE iE 1E 9E jE if iE jF iE �-1E jE iE iE 1E 1E 9E iE iE �E jE iF iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R 2 P T I O N UNIT COST TOTAL COST
ELE 20 FIN.TURES, LIGHTING 1 ST 20 EA. .7S 15.00
ELE 171 FIXTURES, LIGHTING ADDITIONAL EP. .45 76.95
ELE 20 RECEPT/OUTLET 1 ST 20 EA. .75 15.00
ELE 118 RECEPT/OUTLET ADDITIONAL EA. .45 53.10
ELE 20 RECEPT/SWITCH 1 ST 20 EA. .75 15.00
ELE 3 SUB-PANEL 11.00 33.00
END OF FEES
ti
4: COk92nog-OGf92093 7'Y�a'i Z��.(?5
�:ti�e= �ai�s!?s �,rE: as1.za
.p% i� _" ' ��
�'��''' CQNSTRUCTION AND PLANNING •_ . PO. � SP's4' �,�
i4PPROVAIS Permit # � Date Inspector qppROVALS Permit #_,- Date I�spector
t: Temporary EleGtrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms - -
4. Electrical Conduit-Undrqmd. � 55. Electrical Bondiny
5. Stee� Reinforcement 56. Rough Plumbing & Pressure�Test I
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �' I
7�. Footinqs 58. Electrical Conduit•Undrgrnd. ' �
8. Foundation - 59. Gas Pipe, O U�drgmd., Test ,
9. Water PIpe�Undr9rnd. ` 60. Backwash Lines, P�Trap, � Undrgrnd.
70. Structural Floof SYstem �� 67. APPROVAL TO DECK �
t t. Property Sewer Line & House Connection 62. Backwash & Receptor-Finai .�
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System � Final
14. Rough Plumbing " 65. Electrical-Finai ' '
15. Rough Electrical-Conduit 66. Solar SVstem�Final . '
76. Rough Etectric Wiring -67. Fencing & AcceSs Approval �
77-. Rough Wiring S�9n 68. APPROVED FOR PLASTERING
18. Rough Electrica�-T Bar Ceiling �f..�� � 69. POOUSPA SYSTEMS FINRL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in StruCture 70. Underground Hydro (
22. �ucts, Ventilating _. . 71, Product Piping � Gas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas ❑ Oil
25. Roof Sheaihin9 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. Dr.ywall Nailing , HEALTH DEPT. REQUIREMENT
37. Piaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal ''� FOOD CERTIFICATE ISSUED
33. Final Electric �Z3 � � Notes:
34. Final Heating & Air Conditioning . - ! _ _ , . „ .
35. Final Gas Pipe-Test �
36. Hood or Canopy
37. Fina� Fac[ory Fireplace - � �
38. Final Plumbing .
39. Water Service�Final
40. Gas Service-Final ' � �
41. Solar pomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrioation System ,
45. Sound Attenuation ...
46. Handicap Regulations ,
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison " �
50. Gas Release to 5outhem Califomia Gas Co
57. CERTIFICATE OF OCCUPANCY
No, Date
�
♦ODflE550F BNLOPIG: S S S ANTON B L
OWNERSNAMEIFpqWN: SAKIOKA FARMS
. �D°"Eu' PO HOX 2097
TERMINAL ANNEX
�rvi. �uurw �oowess:
um:
3RD CITY OF COSTA MESA - HUILDING PERMIT
PERMIT NO: E 074835 PLAN CHECK NO: N
CONSTRUCTION TYPE: 1-FR PERMIT TYPE: ELE
wcxnecron�aN�a: INTERIOEi ARCH 213623216q uc.r�o.: 78
wcxonu+e.�seooness: 550 S HOPE ST ��` 1100
CONTHACiqYSWWE L.A. CA 90071
COMPEL CORPORATION (310)946-8321
cwrn�croxs�uiwo 10410 PION6ER HL
�oow�ss: SANTA FE SPRINGS CA 1CNDi 392693
90670 uNr:
LICENSED COMNACTONS OECLApATION: I hareby PRrm uMer peraly d pujury the� I am licensed uMm proviaiare d Cheqer 9
(commanonq wnh Sxtian ]000) d Drvision � o/ �he Buti�ess end Fmfaseiona Gode, eiM my licenm is in lull larce enE eHM.
cmuc.r+o.: 032059 uc.cuss: C_10 uc.no.: 39 693 EXP: 08/96
o�,: !a—z 4— 9.� ���da: %t1�- Pe,�.�....�
OW NEF BUILDEP DECLAFRTION: I Mreby etFrtn unde� pane�Y d parNry �� �� e mq Irom IM Conlredon Licensa Lew la the
�dbwvg �en+on (�1ion 103t.5 &reiima vk Pm/e�iMs COEe: �M ciy a couny whiM reyuirea a pe�mn to m�struci. Mx. impove.
emolsh, ar repei eny evucture, prior io iro owarKe, ehe �eVuirea �he appiifani br wch permil lo file e agrwE etatement Ilul M a ehe
� ie licenaed pureuem m �he proWeionn d Iha Contrenore Licansa Lew �Chepmr e(cammandn0 �h Sed'on ]OW) d DHision 9 M the
Buzimav eM WMewione COJaI or Ihel he a ehe c ezemp ihae�rom and �M bsais for tM elleped uemqion. My violelbn d Setlion
]031.5 by eny eppluenl Iw e permil wbpGn ihe epplcaMl to e mil peneily d nd mpa �han (ve huM�ad EdWa j5500��.
❑ I, es owner of ihe poparry ar my mmpbieee w¢h weqae a+Ihek eole mmpanamon, vrill do Iha vm�lc, eM iM avuc1ure u nW imended
or dtered br seb (Se Yion'lOM, Busi�wss eM Prole9aions Code: TM ConlreNon Licensa lewdoea ml epply Ioan ownerd propeify
wM Wltls a mqovea ihaeeon, vM x}w doen aueh wo�k NmeeM a Mnatl «thrwpA hb w Mr own empbyaae, povided thet weh
impewemenia ve rot inteMed a dlered la seb. X, �wwe�m.IM Wikirq a'snpwement b witl wilhin one Y� d mmpbtion. Na
owmr-0uikbr vnll heve IM WMen d proviip M or sM1e d'M mt buiN w improve Ia tM W�Pae d mle�.
❑ I. m ownn d the propeny. em ududwy contreainp wnh licenxd convecias ro conaUuq ihe projetl (`�� ��. �9in�a uM
Profavioru Cade: TM Comrmwn licmae lew daea m� epM/ lo en ow�r d popeny who buiWs or impo.m Ihereon erd xfio
conlrecb M wM prqeds xilh e cauredor(s) Icensed W�� to iM Coniredore liceree lewl.
� I em aeamD� uMar Senion: 8. 6 P.C., la �hia reeaon:
Dele: CM�er
I do hereEy ceniy Ihet I em ewera W aM undemtend i�e �eVuiremenro d CelAomie Heellh enE Selery Coda Sadiona 255p5, 25533. enE
25SL, end Ihm I a eny fulure Wiki�p oaupenl wiil / w' �(tlrc4 ma� nead m wmply w�h eaid etate aodm eM �M rpuiromeMs M
aG�tllwemevuc�ionwmodi&aiionhomiMRi iY e^Ma��parie.Reaidemilmera�lupioneppireiianwexemqtramlMw
pwiaiona. '
om.: noc����:
W ONKEX'S COMPENSATION DECLAPATION: I hereEy elfiim under Deneily d pajury aw d tM fdbwnq Eetleralim�:
❑ I heve vM xid meimen e cenAcme d ooneeM lo seA�inwre lor vroMe�s' compenWion, m providetl /or by Setlbn 3)00 d tM Lehar
Code, tw tM pe�lormenca ot iM work for wNch ihis Permn u usued.
❑ ine.<ena�;��m,:��are•�v�����.a,,,cw�aeMse�3�ooame�morcoa..w.meowa��aine
wak la wAiM Ihie permX n ieaued. My workan' compenutbn inwrence certier eM pdiry number are:
ce^'°' �'R£N161A1'�C�D4fi EXPIRES
Pdiry Number: 0 2/ 01 / 9 6
(Thia saction need ria Es mmdereJ / Na permAis M one hun d era tOJ w Mxv.)
� I centy ihet in Ihe pe�lortneno of ihe wak fa whCh ihia peimX is iwuad, I ehdl nM empla/ eny pamn in eiry menne� eo es lo
become wbjepe�l`o'��IM xorkera compenembn lewe d Celifanie. aM eprea Ihm it I ehouN b ome wbjap b ihe xaWn'
Deie�. ��Q�—�-W � d Sedion 3]00 ot �he teEo� �. I ehell lat�wnh mmpl� wiUi IMae qoyqiau.' ''.
i L'r.�e:��� i �
Wamlip: F�uun ro aecuro rorten'romWnsetlon eo✓weps l� vnl+wNl, �nailull �set en �mp/oyx ro ulMiul psnerou uM
clvll flnes'q b om hi.ntlrM IMus�rd tlo1Nr� (SiGd,O�A M aW/tlon b M� cwf o/ compxuaHon, Jemsq� u prov/ded bi In
9xXon 91f16 0l Ms LaDor COW, Infs�eaf, end ettornsy'� Iw.
CONSTPUCiION LENDING A�ENCY: I Iw�eby e/firm unCer Po�Y d perjury �Mt �Mn o e mrst�ion bMiip eperroJ br �he
cen«m� d me .o� ro�.nan mo w�i IH 69YBj (SBCUfI'JO9%. CN. CI.
LENDEF'S NRME:
LENOEP'S AOOXESS:
I cenM �� I heva reaE �his epqicalion enE eteb Ihel ihe abave inlwme�ion is corted. I epree io romply wilh dl dty eM munry ordi�a
enC stele lewa relelinp to buiMinp conmmeion ud hereby eNhor¢e mpresenteiivea d Ihie dly lo enlar upon tM ebave�mentbned piopeM
fainspeuion purposes.
��F 3�Y'itit'�'i'9RD MOI�T y PEa,Q�Cti)
Pnn� ema
�t ��. � ..�._. D,�e �O`z6-�S
�y�pretuea W Oxner/RpenVFppXce��oniraan
(St51d6 WP) While-BuiWip 8 Selery; GreerFFle: Cerery-AppFceni; Pink-Ra�mue; (3oldenro6-Aemau
JOH DESCRIPTION : INTERIOR 200005F OFFICE TI
CLAIM VALUE:
CALC-VALUE;
PERM NO: E 07483
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: H-2
*�*******�****�*���+Pr*�D*�***�**+Ir+Cr****k*****B*+4r**+Zrk�**�*�*��****�*x �*+Nt+Er��***�r+�*��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NOTES>
>
if If 1E 1h iI' ii' if ii' 1F i(' ih 7E iF I! 1h ii' ih ih iE if' i41E iE if ib i%IF'IFi41f iE iF il' 1f'ih 1@ IE-0E il' if �E ih if if' i4 if 1E if ii' if iI' iI'ii' ii' 1h iE i8 if iE if' ih 1E if i41f ih if ih iI' 1I' 1E iE i6 ih if ik 1F if' 1E
D E V E L O P M E N T S E�,R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : ' DATE:
APPLICATION ISSUED BY; ��� `--t�t DATE: I d ZCo �
IEifik1E1E1E1fiEikiflElEiEiElElElEiflElElEif iE1EiEifiEiElfiflflf if'1F
LEGALIZATION:N F E E' S U M M A R Y STRUCTURAL SEGMENT:-[il,
BLDG PMT PLUMBING ELECTR-IC MECHANIC FIRE SMIP/RES GRADING
PERMIT 61.80
503_� SMIPJNON-RES
PLAN -" •
ISSUE FEE 15.00'-+
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PATD DUE
TOTALS----> 61.80 15.00 � 0�.00 76.80 76.80 .00
REVENUE DIVISION TOTALS--> COLLECiT,ED� 76.80 OVER/SHOAT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
76.80 ?
1-�I
1E1E 1EiFlE 1E li 1E ii iE if iF 1E 1f If if if iF iF iE 1E iE IE iE iE iElF ik IE iE 1(�iE Ik iE 1E 1f k!E iE �E iE 1F 1E iF IE iE IE1f 1E k if If 1E iEfE iE If 1E IE 1E 1! 1E iElE 1E 1F iE iE 1E 1E iE 1E iE 1E fE'lh 1E iE iE
I N D I V I D U A L' `F E E H R E A K D O W N
c_
TYPE QTY D E S C R I P T I O N� =� UNIT COST TOTAL COST
ELE 20 COMMUNICATION DROPS -1��'ST 20 .75 15.00
ELE 104 COMMUNICATION DROPS ADDITIONAL ,45 46.80
END10F, FEESI
ti •� �� �
a� /
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,
� ,J t71 001931:�-Q�319�128 ra�s �6.so
OATE� !0/?.u/;�5 iI�E: 1o:0i
1
GDNSTRUCTIOIV AND PLANNING PG.. _& SPA
APPROVALS Permit # Date Inspector APPROVALS Permit #
i. Temporary Electrical Service or Pole - 52. Pool & Equipment Location'. .
2. Soil Pipe-Undr9rnd. "',''� 53. Steel Reinforcement ��
:3.=Eiectrical �pndu�t�Ui+litY•Undrgrnd. 54. Forms '~�
' 4�ectrical •'},idue�l'-�rgrnd. ' 55. Electrical Bonding
�: �_ ,� •
��5y.�'€',eel Re�nFo!iyemerrj�r 56. Rough Plumbing & Pressure Test
�_B:yElectricalHFrER� d.. 57. APPROVALTOCOVER-GUNITE
^:7�otings r�� 'J�a `j 56. Eiectrical Cond'pZY�Jndrgrnd.
^_�8. Eoundation;c a(�Sy o 59. Gas Pipe, O UnOtgrnd., Test
•n� `.n
9. Water Pip�iJndr�n��"`�'' � 60. Backwash Li�es�}'�'rap, O Undrgrnd.
� /
70. Structural-Floor SYs.em 6J. APPROVAL TCf'DECK
t t. Property 5@wei :Line y�i House���,8o�fiection 62. Backwash & Re�[jor•Final����
12. Sewer Ca� * c� �' � 63. Heater & Vent-Fina�l {
73. Roof Drains � 64. Plumbing System � Final ..
o^
14. Rough Plumti n�`g.�'.. ;� � 65. Electrical-Pinal �'
15. RoughElectrica�onduit� v' ? 66. SolarSYstem�Fit}ii� .
76. Rough Ei�ctric4 jin� '� 67. Fencing & Acce� Approval '
� i
r�77. Rough Wiring�Siga � � 68. APPROVED F�'PLASTER�NG
78. Rough Electiical�` Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air�Conditionmg� � y FI�E �PT. �EQUIR�MEN�T T
C r+ ib;
20. F,g'pugp'Factor�Fir��dce � G�; � '' ' a �` . �APPF�V ���Pe�it # '�._.,�
1 4� I S: 'K Q��: .E"
21. f�uct�-in ffsru�raTt* � .• .. , :< � .� O rir � .70. SJnde�fFbH ., Fi�ir° � .
22. �ucts;: Ve ila�n N., � . � - . ~ c �
� � � 1 9 �'« y� p �� ,�r � 71. Produoi �PI^9 ��Ps �Oil
23. Gas �Ae-laou�ii�& Teet h� r, m < Oa -72, Undergrounti Flv,��fi� � � , f,
24. R�of�rarfMng-' �'n F"' �'� M ,y.�, ,��Undergrrfd.Stor�y,�Tank�[7Gas ❑Oil�
25. Roof,€nhea�hing S= �y v = ` � �. > n:x �7qyOverhead Hydi� '�
�
26. '48afPeiling iStru`��ral) & ��,�at k C � '��'.;* 75g Dry Cheraical :., ; ; ~ `� -�';
27. F,,-O�meandFlashing+x �^;cC xc >, ax� 76. DryStan.,'_e �,� �� ,• £�
�8. Lath�98�'�Siding 7r'� Cx� � �� ., ..I ..,.* 77:.yFIXED�'�'.',_£+,�'E��,INAl:4+-� n Sr
�29. Insulation� ,'�i� � 5 • * i t+� 7� FIRE PREV. FIN�L �= �`�"'e
�30. Drywall N�iling `1i* ,_, f F„ ' 1 M� � h��ALTI,�EP� R�EQT)IR�NT
p37. Plaster Br�n,fioaQr� .�: � � � �-79.� PINAL 16tSP.ECTt�N• x✓ � �
;r32. Fzji�c[rical�ow�M ��-��q�l �'� , ��^^0,�..�iFOODCERTIFIC?�,TEI�S�EDr, �Q
�t e
r33. hrhal�le�ic � ��� m Q � fi � '���Natas �-+h `�1tn � � _ vNtr
.. r
!u34. Fina131eaiSng&lAirConditlonln§�= ^ * � +t' �;` � �'�� ���/Jy'' ��
�' ... �. -n � y: :TJ R7 T � I I Ir. 'I_ t �' J i! ' ' ��f . UT_ .
35. F+r't,ialEGas�pe:Test�� �,: .: : " � � _ _� �� � -�T
�36. Hood�or CanoPY �* �; � ' �w� �' � : � j � �� no ` F'"M
... C1 :�C t: ?7 :��
� 37. FY�nal Factory Fire�aqe�'x �'� R; *� � � r# � rv�
'-38. Final��Plumbing �"' "� c � ' , -' * � � x �
�-39. Wate�ervice�Finaf�;; F ' �' * s i , � ` � � "
r.40. Gas Service-Final r,�* ^7 ^�ry S ��T, I � '� J�� coN !c �
� ^
fi. :, . O E #
A1. Solar �omestio-Fin�� '� � � ,r, i � � r, :;` 4 y; ��
� ,
� 42. Backflow Preventer�a'� N *� � I �4 �. 7F �' G:-��
�-. - �'t x`-t x LT! I*1 G # �•
43. Backflow Irrig�iior{yv f.. SSS � w �,. Y.� r ..
� x � '
� :
44. Landscap€arrlqation�-System x tr,^. .�:: O O�: .:i: cu ^' ^ a^ n: r, r�
.-• ^.^ �- x a t^ z' F, i �' T. �t S !-�
45. So'und Attenuatio� ;� `� �, r' r * ` - � . � - ' `~ � �'
-y .. � rr i, r Y T C• [� C
46. Handicap Regulstiof+s� :-i O *�� , .� ^� S �c S y
c t C '�.' S' C+S C� .7i
4.7�. �NAt STRU �C`��U�& BUIL•DING � r, � ; * 7 c' � F,
�
-�
48. F1NAL PLANNING "�� ' . '* �'� ' , '� T T� � * q
� ~ i z r'
49. ET'ectnc Release to Ec�ison ' ' ! ' � -
. � � �^ •:%� x� �-.a
50. Gas Release to Southern Califorrtis�{',as Co ' 'i� + 7•_+[*� x O�•
- � .K c ,^� K �9
51. CERglfICATE OF OCCUPANCY � v .. ., -� .• , - ^�
No. ._. _ Date _ .
Date Inspecmr
.r
Y./
.�
•�J
L
�ooxessa em�owa 5 5 5 ANTON B
���E�� SAKIOKA FAAM
, �Op�: P.O. BOX 2097
�'ERMINAL ANNEX, CA
�vr�. wmwc �oo�ss:
714-433-6005
uM: 3RD ._
.�cxnecron�ax�x: INTERIOR ARCHI2136232164 ��� C-9378 ,
JKN.OPFNd'SA�DNE55: SSO S HOPE ST �M� 1100
L.A, CA 90071
corrm�orarswu� CONTINENTAL PLUMHING INC ( 909 ) 360-8300
cam�croas�uia�c 11165 THURSTON LANE
noor�s: MIRA LOMA CA uoxo, 399073
91752 u�:
LICENSEO COMPRCTOflS DECIAP�TON: I hereby ellim unAer pe e�ury tlxt 1 em licenaed uMx poveiona M Cheqx 9
(commend�q �mh Sec�ion )000) ol Di�ieon � ol iha Businen end P eione C ds, eM y licene i lull lace end eMed.
cmuc.No.:02''7')563 uc.cuss: C 36 9 7 EX • 09/96
Dete: Il� ~ d- l� l,� Conveam
OW NEN BUILDEfl DECURRTION: I Mnby e/firm uMer panelly at perjury t em evemp hom tM Cauretlae licaroe lew la the
Idbwiq reemn (Seeion )ro1.5 &ninaa vd Prtdeniom Cade: q�y c1Y w aouM' whidi nWim a D�G b aom0ucl. Mx.'vnpwe.
demolah, or repei eny el�w.luro, p'v io �e eeuenm, ebo requi� iM eppl'ram lor vuc� pamn to fib e eq�C elvament IMi he or �M
u limnaed pu'eueM to Ihe yvmions d Ne COMretlon liceme law �CMpa 9(oommananp wuh Seeion ]OW) d �iueion � d the
euainea. w vrdea'vm cod.l «�w ne v a» o e..mq �ne..hom .m �ne eaA. �« N. dbpeE e.emqia,. Mr �idetia, a secia,
]W t.5 b/ vry eppliranl lar e permG wbpae iAe eppliceru to e dN perolry d na moro then IMa huMred dollen �550011.
� I.moxirrWtMpuPe�YamYanVbl+mr.vhwape+miheiedammM�+dian.wadotlwxwk.aMtMtwmineiw'vueMed
a dlereE /a eeb (Seciim ]OI�. Butliwa end Pmfmaions Coda: The CoMrerlon L'xerue Lew Eoea not eppFy lo en ow'wrd popsily
who bulda ar inD�aea 11w�ean. md r,fio Ame euM wak h'unM a Mna� n UvwqA he a hm axn anWq'ee+. V�b thn wch
impiovemeeua ere ml inleMeE aWreA/a ede. tl, however, ths buiMirp a'vnpwemem ie sotl ��nhin wx yw d mmpb�ian, the
owiwr-W iNor will heva �ha buken d qoviep M or eM did �wl buik a impmve tar tM WN�a d eele).
� I, ea ormer d Ihe poperly, em exduarveM ���recYirq wnh IicenseE ronirectae to connrua tM 0�1� (Seeion ]OM, Buaineve enE
Proleuione CaEe: The Conlreqwe Licmx lnw Eoee nd eppry lo en oxnar d popMy who Wilda or impovee Ihareon eM wM
cmvxv la wrh popna Mit� e wnlratlor(e) Icened qrceuam io tM ConVapan L'varua Lex�.
� I em examp uMer Section: B. d P.C..Ia Nb reemn:
Dete: Owner
1 do MnLY �dY tlut I em ewere d enE WonieM tln �W��ata d CaOarie Nsetlh aM SdMY CoEe Setliaro 25505. 255}i. W
255Ja. vd ihet I a enY Mu�e b ldirq oodpenl will / wA eM (dmb orie) � to eanpy wYh aaid aate oodas enA the mawremenn br
•pe'mClamuwdionnmoE'ifratbnhan�Mlv�ui�i ar�ensuDimnd.ReakwuilomevameGGkdiwnenvemqtmnNsaa
a�,..
i WONKEN'S COMPENS�TION pECL�RATION: 1 Mreby eifirm unEx panelly d pe�ury one d �ha /dlowiip Eetluetions:
�i � I heve vM wil meinten a cMXkma d mnamt lo aetlinwn br wake�e' canpmetion, u prwNad In by Saaion 9)00 d tM lebar
Coda, lw ihs peNormerce d �M waM Iw w1Ych Ihia paimit u iavuW.
I❑ I M1aw aM wJ meinten woekers' ewnM�ion imurmce. m rWu"vod M Soqim J]00 d Ma lebor Code. br iAs MAamuxs M tM
wak la wM1iM thu permn ia ivueE. MY wmken' mmpenaeiion inwrence umw end pdiq number xe:
c�« CNA EXPIRES
rwry N�mn«: 0 7/ O 1/ 9 6
(iAia aeim nsed iar De mmpMeO / Ne pwm) u hr aa huMreE LoOen /71ou1 a MnJ
� I cen,Y � in tM1e pMwwce d tM wak la v.fic� Ihu pe u eE. I kWl nol amDl eiry pereon in ury men eo n to
nemnr a�4b m �M .ronen� mnWanwion mw. d � e m �nn tl �, k nerom. wEjw �o i .lon.n'
m panwiion prwie\' W Sauion �100 d iM Lebor Cade, 1 hxil moh �h pwivione.
Dele: IO � �i� � �� ROdiceni:
W�minp: Fallun M ueuro woAxa'rompwwtlon rovenp� li unb ,�rW shsll �ub/Iet en wnyloysr to eNMrul pxultla �M
c/WI fln�� yr ro wro �untl�etl tMuuMlv/kn (JIOQQOOA In aWltlan ro N� cwt ol rompwetbn d+�W �s pvNtlW foi /n
S�cflon J106 0l tM LeborCob, Int�n�f, siM ettomey'� Isu.
CONSTIIUCIION IENpINO RGENCY: I MreEy elfirm uMm penelly d perM�Y �� �� a e canA�utlian bnd'up epercy br tln
peAormerca d �M wak M v.hiN tM1i psmiY u ewed (Seaion �. Civ. C).
' LENOEN'SNNIE:
LENDER'S ADDNE59:
iF.n�N mm � ner. reea mo epd��.�,e ume iw ine eeo.. io�omwio� u m�en. � ea,e. �o comWr.nn v� an.�a oo�mv «ee,m,oa.
uM stelekwsm�vqta Wildipcon%�udpn and MreEyairthar¢e�eptmentativesdlhedlylomlaupon�Mebo.e�maMionod properly
�����P�p ��� RAY RNTO
' , nn N __ I lU
Dme: I� � 0. 7 `�
Sipreture a wnar//penVRpplfanUConlreaa
(5�51a6.WP) WMrB�iNvqBSdary:Dieen-Fb:Cenuy-Appirani:Fnk-Hevewa:Otldmro�Nenw
. CITY OF.COSTA MESA — HUILDING PERMIT „
,' ". _ _ , PERM NO; P 074733
PERMIT NO: P 074733 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: IFR SP PERMIT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION : 20000 SF OFFFICE T.I. SQ FT:
CLAIM VALUE: , CALC—VALUE: GROUP OCC: B-2 /
*�**�**�*+r�**�*+Ir�***��D*****���*****�(r�r***+#r******+�*x�**�r*�r*x�**�r�*�r*�***��r***�r�*�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------,MAIN HUILDING,---------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT,. IN REAR: , FT . IN FRNT: FT ZN REAR: FT IN
LEFT; , FT . IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41050104 ZNE: REF NO:
PLANNING NdTES>
i �
iElEififiEiE1E1t/fM1F1FIElkififiEMiflkl@If1f1E1EiE1E1F1kifiFll'1E1E1EMiF1F1F1k1F1E1klf1l'iFlfkiflElfiE/E1fM1E1FIk1EM1EiElFifiEiElkIEMiE11'liikif'1FiFiE1Fk
, D E�V E, L O P M E N T S E R V I C E S 4,; R E Q Q I R E M E N T S
ZONING APPROVED BY " DATE:
BUILDING APPROVED BY : "j DATE:
APPLICATION ISSUED BY: DATE: ,b 2 L
1F1F1F/F1FIf1EfEiFif1E1E1E1E1f1EiflfilMlflF 1FMiE1fM1EiE1EiEM 1Fit
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADING
PERMIT 42.00
25t SMIP/NON—RES
PLAN _
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 42.00 20.00 0.00 62.00 62.00 .00
AEVENUE DIVISION TOTALS--> COLL£CTED: 62.00 OVER/SHOAT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK
62.00
iE1E1EfEifiE1E1f1F1f1fifiEifiElFMk1f1E1flfiEiEfEiE1t1f1EiEiFkkMkiflEiElEiElE1FMiFlkifiEM1@kiEififiEK1EM1EM/EiEiEifiEiElE1f1i1E1kiFiElE1FiFIF1E1F1f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C A I P T I O N UNIT COST TOTAL COST
PLU
PLU
PLU
SINK KITCHEN
WATEIi HEATER AND./OR VENT
BACKFLOW PREVENTER
SINKS, FLOOR
END OF FEES
%,��
7.00
7.00
7.00
Ol 0�77''7G,]'tl.'.14?7E3 3E��t
GRTe: iG/:�:�yF: T:t7E: C�:2:.
14.00
14.00
7.00
7.00
_'_.G:,
:a- . = _..
� � j POv� & SPA
00t�$TRUCTION AND PIANNING
APPROVAIS Permit # Date Inspector AppqOVALS Permit #
t.,Temporary Electrical Serviceor Pole 52. Pool & Equipment Location-�
•, n
2. Sqll Pipe�Undrgrnd. ;� _; 53. Steel Reinforcement
a3.• Elascriwl�ond{+c`ttcllity-Un6?gmd. 54. Forms .
m �... s-.r
�G4.�Ei2ctricai�'G%d�Slntlrgrnd. 55. Electrica�Bonding
;a�JJSteal Re�dfi6ice�r+t0 �-' S6. Rough Plumbing & Pressure�Yest
�
's6.i Electrica�Ef��ntl. 57. APPflOVAL TO COVER-GUNITE
E.�J Footings; ip; E, � 58. Electrical ConclS7i�Undrgrnd.
M •
'- 8. Foundati6� � S � ^= 59. Gas Pipe, � Und�rnd., Test
9. Wa'ter PipgUnd�gK}d. rv _�. �� 60. Backwash Lines, B:Trap, � Undrgrnd.
10. StycturaP•Ploo�tem ,,w` i., 67. APPROVALTO'�ECK
11. Pro`perty°5gw�'L,ine�-� Hous ng'ection 62. Backwash & Recepto�•Final�
12. Sewer Cap. (� � ✓�' 63. Heater & Vent-Final �
n a� w - -
13. Rp`of Drains ��_ ' "' 64. Plumbing System � Final
14. Rough Plumtrin ?� . . 65. Electricai-Final
15. Rough El�ftric�TCol�puit � . 66. Solar System-F;b,a�
76. Rough Electric.4E�iriog o 67. Fencing & Acce�4s' pproval
$ 77. Rough WirijSkj S�n � 68. APPROVED F,4�,Fj:PLASTERING
, 18. Rough ElectricatsT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou�.h Heating &�iX Conditio ��� ,,,Q, .r �, y�� _, F��;EPT�J?EQUIF�EMEIpLT �'y . �
20. �'Sou�i Fz`gtoc'! Fi qlace � <R: „-,� � S '.. v+* , APPtt,V��F� P�-mit # - �
., .,
27. iYu ^ in�trui4u � ..•. SS � ,� -' n� �"' t*]C'] S s
c� `� � � 70. FUndergrn�{pc1 t�dro *
22. Ducts V`gntii$jing�fi � � � C7 r; CJ Fa: V 71. Prodtfl7fcBiping Q'6as U70i1
23. Cras Pipe�ou &r T�st + �'?S *^� S'¢ 5* . 72• Undergry'�j�d F� * j;
24. RootFraming ��� r `i �; z� > c� r-i a• 7@; Undergrnd. StcA::¢P Tan� O Gas ❑ Oil
25. Root�Shea2hing �� H ��".��. � � m �* 7Q pverhead Hydr.�.a, *
26.'C-Ba1 Cei�r9 (Su'��'''•(ural) & tv'io"ipcoat x p >. p� 7t Ory Chenital F� � v�-+K �•
� �
27.'Erameand'Flashirt�r ✓a'G *a' "�+' 76 D S "� Fmcn x :^;�7 x
y 28. Lath�ing & Siding C.i*' � C'^.F O ��
29. InsulStion, �'� S " *
�: �
� 30. Drywall Nailing �� H x: F
� 31. Plaster Bdbwn AT'�r. � � �"f" fi
z. i �. �. .
y 32. Fylectrica�posy�r �{}etF�ppai � % N
= 33. Einal�FlecCric? � � � � w �
� x
� 34. �ina�ieatjng;& A'7�o,y�itionirtg�' `��, * �.,
i 35. Final Gas PiprTesC� Ca •• ��+
�
° 36. Koo�or CanoPv ¢� �n i�c.; 6 x n
7 37. FlinaPFactory PirBptice T, � �E� �v *
i ..
; 38. FinaGPlumbing �� ,;.��� i ` ���
° 39. Wate� Service-Final * f � », cC
? 40. Gas Service-Final * m <�''" S * n'
�R !1 i-� F ?7 '!*
' 41. Solar pomestic•Fina -' �
C± t
42. Backfbw Pre�nter k n� C�ti ��+
43. Backflow irrig�tion * >: !� x
�4. ,Landscap'e.ir7ipatio.r�."System��� r *'"•
� � wr
�{5. ,Sound AMenpaUon� y .. .. * `
b�:�: ^
'd6. Wa�d,�,capRegUlat+oi�5 �' � r
S t_ �_
47. FiNP-,,�L STR 7UR� & BUIL�ING :� i-
..
48. �INAL PLANNING r '`•""�` k �"
i x
49. Electric Release to �'ciison ; ;x
'S0. b"as RClease to Soutl�em Califor�S�Gas Co ,�
51. CERTIFICATE OF - CCUPANCY
No Date
,� . ry ta"r�ppe�
� � 7� FIXEDEµSCST&�A
I �. 7��IRE�REV. F,iJ
;orv cNasALI
F �.
I � b n 79. FINAI �ECI
� � 8�,j FOOD CERTIt¢
I t �c�.e�. _± -�
� �.:, H i t�
�f ' xO G
ti n•
+ S �io
� m �o
�
[R
J b �
7
r
mi m m�
Y
C
6;
u.
�T�
GS
C
£ E rJ r'.�
Y� F
i i +-o
.-.�-
m o
2NAt� ;� X�
� v�c > T F 4
� nF
IN � a ;�
TE k6Si9E6,
�
r "7 O
x
�-S
4
l �'
xm
�+m
t E-
} E3 b-�+-:-
# (l . . . .
�3 O 000c
; T��uT,L
� S F
�-1 �i
6 4 L-'v
0000
Date Inspector
•. L
.i
O
S t ,
F
1�
;r
nooeess ov euadnc:
� qYNER'SNANEIiplOWN: SSS ANTON BL
',r , �oowess: SAKIOKA FARM
� P.O. BOX 2097
�
�
�
, CA 714-433-6005
uxT:
3RD
ARCNRECT Ofl ENtlNEER: 11C. NO.:
u�cx.oeEr+c�seooxEss: INTERIOR ARCHI2136232164 C�aT9378
550 S HOPE ST 1100
coNmncrars Nnwe: L. A. CA 9 0 0 71
ca+m�cro�sMu�wc AIR CONUITI+JNING COMPAA]Y ( 818 ) 244-5571
5265 SArI FERNANDO ROAU
�°opEss' GLENDALE CA "`'N0'` 1 �0696
91201 °NT`
UCENSEO COMHACTONS DEC�pNRTION: I hereby aRirm under peneXy d pe�ury ihet I em licensed uMer yoviaions d Chepter 9
(wmmenan8 �h Seclion lOW) d Divisun � d ihe Busi�wee eM PMessions Code, eM my licenee is in lull brce end eHacl.
CRY LIC. NO.: LIC. CLASS: LIC. NO.:
0194U3 C 36 120696 EXP: 07/96
oae: com,eay�.
OWNEP BUILDEfl DECLAPATION: I Mreby elfirm undm pCenely of parjury Oiet 1 em a�emq trom Ihe Comr icenae Lew lor Me
bllovmp raeeo^ (`�ian )031.5 Buaness enA Professions Cale: Any eiry w munty xfiich raquiree e perm� t� consVucl, eller, improva,
demoloh, or mpeir any sbutlure, pnor lo As oauence, aleo requirea Ihe epplirant fa auch peimX lo file e sgrnd atmement the� ha a ahe
ie licenaed W��� �a �he pmisiom d Nw Conlreclws Licenaa Lew [Chepter 9(comme�nip xilh Seabn )OW) W Divilm 3 d �M
eusinesa enC PrMamuna Code� or ihet he w aM is axemp therehom end the bam br iM dlaped exemqion. My violeton d Sed'an
1031,5 by any epWirant lor e permit wbl� �he epplicait b e dvil penelry ot rwl mare �hen frve hundred ddlva �550p��.
❑ I, m ownar d Ihe propeM or my empbyeee wFh wepea m ihei eole mmpenmtion, will do Na wark, end IM svucNre o mt in�ended
or MereE br sele �Section ]Odd, Bueiirev end Prdesabna Code: Tha Con�repon License Lewtloea ml epply lo en owrbr W propery
who buiWa «'vn0��� �hereon, enE who Eoee euch work Nmaelf or herseM or throu0h he a her awn employeee, pmvidad ihet such
improvamen�a are �al intended ar oRered Im seb. H, howaver, iM buiNinp or imp�wemem ie eold within one yeer o/ completon• Na
owner-buiMer will heve Ihe buNen M pravinp he or ahe did nrn build or impmve br iM puryosa ot eele�.
� I, ea ownar d t�e OropeXy, em exdusively mn�redinp wilA licensed coMrectoro to mnatrud tM Orol� (�� ��. Buairesa aM
Pmieaeime Code: The Conlreclors Licenx Lew doee nd epply b en owner d propeity who buikh w improvn thareon end w1w
conVecte fa auch prqed% wnh e wmreNor(s) Icensed Oursuent to ihe Conveqom License lew�. ,
� I am exempt unCer Section: B. 8 P.C., lar thia reeaon:
Date: Owrrer:
i eo nereny cen�y mm i� e.,.e d�d �ndemena me reQuiremenm d c�aam�e Hed�h ene sete�y coae sx�iona �ssos. usa3, ene
255�6, eM Ihel I m any futurc builEinp oaupent will / wil na (dreb oiw) neeE lo compry wih aeiE ateta mEee end tM requiremene for
eparmillwmnawctionormodifirationhaniMRir ue-G1ity�eB�aMDiMna.ReeidemidcpMiuCioneppimtioneereuemqfromlheae
a�ab�a.
ome: AaviKN�:
WOPKEN'S COMPENSATION DECLAflATION: I haraby etfi�m undar penelly M perjury me W ihe followiiq Eederationa:
� I heve vk xitl mantein e cerlHcela d mneant io eeH inaure br warken compenaeiion. ea DrwiEed lar by Sadian 3)OU d iha lebar
Cade, for iha perlormenca W Ihe work br which thia parmil ie iaeueE.
� I heve vM xill meintein warlrore mnpenuton imurenca, � required by Seaim 3)00 of Me Lebor Code, br iha pa�immarKe of �he
X work tor which Mie peimn ie ipued. My worMen' compenaelion inaurence cemer eM poliry number ere:
cem" � ,, EXPIRE5
Poliry Number:
�rn�:�n����e�ace��dar<exm.Po�a;,ro.',n�� dm�lsraol �.� 10/01/96
� I ceMAy ihet in Iha perlormenca d tM wark lor whch thia permA ia iaeuatl, I ehell nd employ e�ry pemn in eny menrier eo ea lo
become eubl� �o Ihe wnrken' wmpenaetion lawn o/ Celifomie, end epree the� J I ehould become wbjad lo �M xvrkaii
compenae�ion pmviaione of Setlim 3]00 0l �he lebo� Code,�vrilh rompy wtll� ihoee pmviebm.
Dete:�%/� �% � P✓ Appli�7 /
Wem/np: Felluro b sxuro wotlren'rompxua0on roror�p� b vn/swNl, end shell sublxt en x ro etlM�u/ perwMw end
civll HMa up h one huntlre0 tMu�and do/bn (SfOq000), In etlrl/tlon ro M� rost ol rompsnset/on, damsp� u prov/tlsC br In
SxHon 3]O6 0l Ms Labor COW, Inbnaf, antl aftomsy4 /esw
CONSTFUCTION LENDING AGENCY: I hereby elfrm unEx penely ol parNrv ihet �hem ie a wneUudion bntlinp epency br iM
penormence N �ne work ror wnicn ine ro�n re ma�ad (saaa� aae�, cN. c1.
LENUEH'S NM1E:
LENDEF'3 ADDPE55:
I ce�ify ihet I heve reed ihis epplbetion end me�a thm ihe ebova inlormation is corted. I epree to comDN �h ell cry eM munty oNinencea
end stete lews releling to building conavuclion erM heraby eNhor¢a repreaentetivea W ihis dry ro en�er upon ihe above-mentonetl properry
fwinapedion purposes.
Dete: CA �li l f/�
(5151-66.WP) Whdo-Buildiip 8 Sefety: GrearrFle: Canary-ApPlirant; Pink-Ravanue; Oaldanro�Aasessor
CITY C�F COSTA MESA — HUILDING PERMIT
PERMIT P70: M 074597 PLAN CHECK NO: N
PFRM Alf1• M n74'i97
GOCTT: N SUPP: N
CONSTRUCTIOiJ TYPE: IFR SP PERMIT TYPE: MEC PURPOSE: AI�T
JGB DESCRIPTIOCd : 20000 SF OFFFICE T.I. SQ FT:
CLAIM VALUE: CALC—VALQE: GROUP OCC: B-2 /
COMMEPdTS: 76 UNION PRODUCTS OFFICE TI, RE:#B74572
�*�***�*����****�*****��**��******�*��*�*�***�*+�***�**�*�**���*���*�*�*+�*�*****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
-------- ACCESSORY HUILDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT I1�I
PARKING REQ: PROV: PARCEL: 41050104 ZNE: REP NO:
PLANNING NOTES>
i
*,���***�«�****+��****�***�*�*��*��*��*���*�**�,��,�***���*�*��**�*�,��*����,�***�*���
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILLING APPR�VEU BY :
APPLICATION ISSUED BY:
3E 3F 3E dF 1E dE 1E iE jElE 3E dE �F �E dE iE 3F 9E dE 3E 3E il
LEGALIZATION:N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 88.00
iso
PLAN
ISSUE FEE ` 15.00
BUILDING—D N—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 88.00 15.00 0.00
DATE:
DATE:
DATE:
STRUCTURAL SEGMENT;N
FIRE SMIP/RES GI2P.DING
SMIP/NON—RES
TOTAL PAID DUE
103.00 103.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 103.U0 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
103.00
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I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 8 VAV BOX 6.50 52.00
MEC 8 FIP.E DAMPERS 4.50 36,00
END OF FEES
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G�NSTRUCTION AND PLANNING - PO�� & SPA _
A�PPROVALS Permit# ' Date Inspector APPROVALS Permit# Date Inspector
1. ,TemporarY Electrical Service or Po�e 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgr�d. 54, Forms ,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test
6. Etectrica4 UFER Grnd. 57. APPROVAI. TO COVER-GUNITE �
7. Footings 58. Electrical Conduit�Undrgrnd. `
8. Foundati0n , 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. ' 6p. Backwash lines, P-Trap, � Undrgmd.
�
70. Structural Fioor SYstem 67. APPROVAL TO DECK �
i t. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final
�
12. Sewer Cap 63. Heater & Vent-Final •
7 3. Roof Drains � � � 64. Plumbing System - Finai j
14. Rough Plumbing � � 65. Electrical-Finai
i
15. Rou9h Electrical-Conduit ,., - ' 66. Solar SYstem-Finat
i 6. Rough Electric Wiring 67. Fencinc� & Access Approval
77. Rough Wiring Sign , 68. APPROVED POR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTE69S FINAI
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rou9h Factory Fireplace APPROVALS Permit #
21: Ducts, in SVucture 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping G' Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Fi�sh
20.. Roof Framing 73. Undergrnd.StorageTank V7Gas d0il
25. Roof Shedthing 74. Overhead Hydro
26. T-Bar CeiGng (Structuraq & Monocoat 75. Dry Chemicai
27. Freme and Flashing 76. Dry Standpipe
28. Lathing & Siding _ 77. FIXED SYSTEM FINAL
29. insulation 7g, FIRE PREV. FINAL
30. Drywall Nailing HEALTN DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTiON
32. Electrical Pow2r MeterFinal 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final HeaT�ng & Air Conditioning C.
35. Final Gas Pipe-Test
36. Hood or CanoPY
\ .
37. Final Factory Fireplace �
38. Final Plumbing �� '
39. Water Service-Final '
40. Gas Service•Final '
41. Solar pomesticFinal
42. 8ackilow Qreventer
43. Backflow Irrigation
44. Landscape �rrigation System �
45: Sound Artenuation .
46. Handicap Regulations
47. FINAL 57RUCTURE & BUILDING �
4$. FINA� P4ANNING �
49. Electrie Release to Edison -;
50. Gas Releaae to Southern California Gas Co
5L CERTIPICATE OF OCCUPANCY
No. Date