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HomeMy WebLinkAbout1590 ADAMS AVE - Building Permits 7 ' 9 CITY OF COSTA MESA 4 BUILDING DIVISION � %1 ,.,,->a ..t DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 i I /i/s • PERMIT E00-01196 mp • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1590 ADAMS AV Status: ISSUED Suite No A Applied: 12/20/2000 Vicinity: REAR OF PROPERTY Issued: 01/09/2001 Parcel Nunmber: 13931330 Applicant: SLUSHER, RANDY ISSUED BY: Address: Phone: 480-861-7077 Zip: Owner C J SEGERSTROM &SONS Address 3315 FAIRVIEW RD Phone: COSTA MESA,CA Zip: 92626 ' Contractor: ETEC ELECTRICAL INFRASTRUCTURE Address: 401 S 2ND AV Phone: 602-716-9576 PHOENIX,AZ Zip: 85003 License: 745661 SCOPE OF PERMIT INSTALL 800A,208V ELECTRIC SERVICE FOR 10 ELECTRIC VEHICLE& 17 FUTURE ELECTRIC VEHICLE CHARGING POWER SUPPLY UNITS. 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 $182.00 10 New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool I Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $62.15 1 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to lhp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 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 $267.65 Intermed Pole $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.92-28,§ 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 (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-461&00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This -:coon need not be temple ed if the pens - valued et one hundred dollars(MO)or less.) ki I certify that In 1•13 pert• manor wh'• this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation I.ws• Cainef ,�1. '' the I should become subject to the workers'compensation provisions o1 Section 3700 f theLabor Code,I shall forthwith comply with thes:y, Ion- - •,4 r� Applican t Signature: / II II Date: IE1 I WARNING:FAILURE TO ECURE WP E • -EN - RAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI AND VIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(Si C0,030),IN. •DITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECL:•ATION: I hereby affirm that I am license• path 0`` - ter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Liu4 ■� Class a Oontrpctor's ��� ,gF Date: LTJ CONSTRUCTION LENDING AGEN•Y: ❑ I hereby affirm that there is a••nstructlon lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.), ❑ I am exempt under sec. _ Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL.SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,An 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for—acutely hazardous materials)?-: ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant ar present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non.residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? In Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 0 (if yes",attach certificate of compliance from the appropriateeair pollution pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comity with all state I s and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described pr••e y •- • • •• is.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ,Sig :tu Ip, eget Owner(s) I/ i 1//1 / lite/ ✓1 ( t •nd/Ou Uro :•Applicant -7 Date conn E, IffSPECTIOH PE RALE lila COOFE 185PECTION TYPE PAIL MONS 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing /� (] (�// • 200 Final Re-Roof 210 Final Electrical .' /•7f0/ FL7Ae 201 Final BIock/Retalning Wall 212 Final Fire Prevention ) 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy i Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - C*-TV.DF,COSTA MESA - PERMIT NO. • TRACT NO. LOT NO. ••BLDG.NO. - •• CONSTRUCTION PERMIT /5- 571q - • Project Address I `90 dc��.a.s...� Ate] CACT-la IMccv� TYPE OF CONSTRUCTION • - - - gtZb Owner Phone �.1 .C��6v-,s-,svO -D NEW 0 ADD 0 ALTERATION - I'‘'.:7,-; i- Ii.!/,,,1• I UJr.;.. .Tl Address Z2,V5 'Fv,,1ClJs ew t1' SCM C5� 0 REPAIR ❑ CONVERSION.0 DEMOLISH • - Arch/Eng. License No." 0 OTHER ZONING REGULATIONS " I Address DESCRIPTION OF WORK 18.-_•••• Rco e. A.P.#V _ ZONE PLNG. REF.$ ContractorCsas-v',r• 1/_jccn' [r..,F •Phoneqq(1 (1sT( TYPE OFPERMIT - - BUILDING Tp gt�I�plrvG • - SETBACK C/ ST. PROPERTY LINE Address '-Q. 9.,n K ens-N. . '- 0 GRADING 0 FOUNDATION 0 STRUCTURAL ' SSIDE YARD - • - • LICENSED CONTRACTOR DE LARATION - O-TENANT 0 ELECTRICAL OPLUMBING OMECHANICAL `S5EDTI I hereby affirm that I am licensed under provisions of Charter 9 (corn- - RIGHTARD• -- - - , mencing with section 7000) of Division 3 of the Business and 'D OTHER - Roo P-(w. _ Professions Code, and my license is in .full force and effect. S . REAR YARD(TO P/L)- . License mass C-- Z 9 License No. �g;4`\Z' PROJECT DESCRIPTION • - • • SQ.FT.rifer OO PKG.SPACE REQ. 'PROVIDED"" "` • • Date k t2 Z-Signature �=.--- li",ff'�' '" . • STREET WIDTH PARK FEE'S WORKER'COMPENSATION DECLARATION - OCCUPANCY C N TRUCTION TYPE - ZONING APPROVEDBV ' ' -DATE I hereby affirm that I have a certificate of consent to self-Insure or a VALUATIO QCf ZONE - - .. ' - • - • certificate of Workers' Compensation Insurance,-or a certified copy - thereof (Section 3800, Lab. C.). - GRADING CU.YDS. ACRES SPECIAL CONDITIONS: -' - Policy NO.." S. 3 fC, Company Gr -c-- rV . . .. .r • - 'ertified copy is hereby furnished.. REMARKS: . - • _ - _ frtifIed copy is-filed-with the city Building Division. - - - t..cMPTION FROM WORKERS' COMPENSATION DECLARATION ' - .- - - - - - - (This section need not be completed if'the permit is for one hundred - • , ($100) or less). . - - . . _ -• - I.certify that in the performance of-the work for which this permit is . issued, I. shall not employ any person in any manner so as to become .,PLUMBING• .. e' PLAN CHECK' • ELECTRICAL PLAN CHECK - -. subject to.the Workers'Compensation Laws of California. UWtLLIN(a . c,AHA(, -L - - Date Signature BATHTUBS SHOWERS - SO FT SO FT - - - NOTICE: If after making this declaration,you should become subject TOILETS - URINALS' GENERATOR to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER '''. forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS . ' ' - ' APPLIANCE - -'10-50-KW. -50+ KW - • - , revoked.. _ . - - CONSTRUCTION LENDING AGENCY KIT.SINKS- - DISHWASHERS ' ' MOTORS - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS • -SUMPS (INC.SOLAR) •10-50 HP_50.+HP- - - . . - _... - • formance of the work for-which this permit is issued (Section 3097 ' LLendeName' C/oL c-` ' ' FLOOR SINKS FLOOR DRAINS FIXTURES 'OUTLETS' SWITCHES '- ' - • - Civ. CIL' _ Lender's Address DRINKING FOUNTAINS • ' - GAS TUBE SIGNS - - OWNER BUILDER DECLARATION "" INTERCEPTORS CLARIFIERS - - ` '- ' POLE LIGHTS ' hhereby affirm that I am exempt from the Contractor's License Law for • the'following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - . - - .LOINS I NUL I ION - _ Any city or county which requires a permit to construct, alter, POLES METERED SUB - improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE -ALTERATION - - • PANELS - MAIN ' SUB' • qulres'the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETSSERVICE ' - •- -AMP' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT — • - - - - - • basis for the alleged exemption. Any violation of Section 7031.5 by ' - - - - ,- applicant 'fora permit subjects-the applicant to a civil penalty SEWER-CONNECTIONS '- - - --' rt more than five hundred dollars ($500). • ' as owner of the property,or my employees with wages as'their SOLAR TANK' COLLECTORS , - - - - sue compensation,will do the.work, and the structure Is not Intended , - or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE . - . Contractor's-License Law does not apply to an owner of a property - - APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE •' through.his own.employees, provided that.such Improvements are not ' , Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES • is sold within one year of completion, the owner will have the burden - 1,‘5-• s of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT G $ ISD ai SMIP• --E • SQ D I, as owner of+the-property,-am exclusively contracting with AND DUCTING licensed contractors to construct the.protect (Section 7044, Business _ 100,000+ BTU PLAN CHECK $ PERMIT- and Professions Code: The Contractor's License Law does not apply to-- • .ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING . $ - • tracts from such projects-with a contractor(s) Ilcesned pursuant to. SYSTEM - - . GRADING-- $ - the Contractor's License Law). 100,000+BTU , PLAN CHECK $ ' - • ' - - • D I am exempt under Section ' B.& P.C.for this BOILERS BTU ELECTRICAL $ $ reason - MICROFILM § ' SYSTEM REPAIR,ALTERATION PLAN CHECK $ • Date Owner- - TOTAL FEE E I hereby certify that i have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ - information is correct. I agree to comply with all cityand county PLAN CHECK § • • -• VANESS EAPC pY VANCE PC § repiesenta i and state relating to t construction,and hereby authorize St property fives sofp this city toos enter upon the above mentioned - !J� J- Signatur f s9in,.- '.. oses. _ \ Signature " r%�� Date t� LZ 1 Y2 FINAL FEE E • Drivers' License or SS* ISSUE FEE _ - • , CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor I , ,. CONSTRUCTION AND PLANNI/N.0 POOL&SPA' • APPROVALS Permit# 'J��`/� Date Inspector APPROVALS • - Permit# Date, •- Inspector _ 1 Temporary Electrical Service or Pole - ';; - - . 43. Pool & Equipment Location - - ' - - - - - - 2. Soil Pipe-Undrgrn ' ' - •_ - 44. Steel Reinforcement, • -- - - " - - .3._ Electrical Conduit.Utility-Undrgrn _... - _ _ . _ 45. Forms , - -- • -. • - - - ". ' 4. _ Electrical Conduit-Undrgrn - _. . ._ - - _ 46. Electrical Bonding - - - - - - - - -- ' 5. . Steel_Remforce _ 47. Rough Plumbing& Pressure-Test - - - - - •_ 6.6.- Electrical UFER Gm , _ 48. APPROVAL TO COVER-GUNITE - - - - - - 7. _Footings _ - - _ - 49. Electrical Conduit-Undrgrn ' 8. Foundation _- .. . ... . ' - 50. Gas Pipe, ❑Undrgrn,Test , - 9. Water Pipe•Undigrn • _ . . . .___ 51.-,Backwaih Lines.P-Trap. 0 Undrarn - - "- - 10. _ Structural Floor System , - _ _ - , • 52. APPROVAL TO DECK - -. -. . 11. .Property Sewer Line,&.House.Connection - • - ... _ _ -53..- Backwash & Receptor-Final ' • ' - 12. Street Sewer.Connection "_ - " 54.• Heater &Vent-Final• • • , 13. Rough Plumbing - _ - - , •_ . __ -' 55. Plumbing System - Final -- •- •` 14. Rough Electric-Conduit - - - - - 56. Electrical-Final - 15. Rough Electric-Wiring -- - - - - -57. Solar System-Final - ' ' ' .. , "-16. -Rough Heating&Air Conditioning = - - - -66. Fencing&Access Approval . . . 17-.' -Ducts, in Structure - - - . - ..._ _ :69, APPROVED FOR PLASTERING • - -18. - Ducts, Ventilating _ _ _. - ' - .. - ._ . _.. - _ . . 19. Gas Pipe-Rough &Test- - - - _60. POOL/SPA SYSTEMS FINAL -• 20. Roof Framing- I . - - - - - - . .,, _. - .. - . _ 21.1 Roof Sheathing - - - - - r •- 22. Frame and Flashing- - . .- NOTES: - ' . . 23. Insulation- -- - - - - - - - - _ .. , 24. " Lathing &Siding. --- - - _ _ _ - _ _. - - _ - - • 25., Drywall Nailing - . - . . . -- - - - -. _ .. _ - .. . 26: Plaster Brown•Coat - - - - - . - - _ _- _ . - 27: Electrical Power Meter-Final -- ' - 28. -Final Electric - _-. _ _ - _ _ _ . • 29.'- Final Heating &Air Conditioning- - -- _ - - -- ` - . ' 30. - Final Gas Pipe-Test - - - -- _. _ _ . _ - _ ' • - - . 31.-- Final Plumbing. - . - - __ - • - ' - 32. Water Service-Final ' • . - - - - . - . ._ _ . . _ ._ ,,• .. • 33. .Gas Service-Final - _ _ - - -- I . _. . . - • . _ . - • 34. Solar Domestic-Final - . . 35: '-Landscape Sprinkling System- - 36. Sound Attenuation - - - � • - 37. Handicap Regulations - - ' - ° ' 38. FINAL STRUCTURE &BUILDING ' . • 39. Special Requirements Completed - . . • _ _ 40. Electric Release to Edison 41. Gas Release to.Southern California Gas Co. - i - - - - _ • "I -. . , • • 42. CERTIFICATE OF OCCUPANCY • - - _ .- F ' . . • ' - ._ ! - No - --a ' . Date _ _ _ .. _� - - - - - - •-- -- - - - - --1 - - - - _ -- - . a man o I In all spaces-within heavy border lines and sign all appropriate declarations. • OF COSTA MESA PERMIT_No. TRACT NO. LOT NO. BLDG.NO. -^ - . - -- - - - , ONSTRUCTION PERMIT "- ..,..7E 2069 _ - ' ' ' f -(- --Project Address irk Adams. C sta Mesa, CA 1 TYPE OF CONSTRUCTION . 9643 i2 'I7/81 ;x,39 e.2? TI. -_Yw .Owner US �L �ERA •Phone5_4/-4,3300 NEW ❑.ADD k'ALTERATION �1 - - - - - cI • Address 0 REPAIR 0 CONVER• SION ❑DEMOLISH vYs Arch/Eli . - License No ❑ OTHER' ZONING REGULATIONS • V 9 Andrpw Joncich 62019 A P. 7 'sd Address 3Sn Lt7 5th St #S70R San ➢Pr7Tn ('A DElSC.RIPTIO OF W�QRK ! —7/kJ^3 � '• py,rsr� I/V/TeOAL 4Lwe ,����5 - ZONE PLNG.REF. Contractor Pa rk Snnmin rem Str Co � ' J730-7053(YPE OF PERMIT - - BUILDING - TTpp BUILDING • SETBA K C/L ST. PRO V LINE Address 2836 W.Bth St.#102, LOS A] .ge1e5. CA ' -❑ GRADING' ❑ FOUNDATION .STRUCTURAL - SIDE YARD LICENSED CONTRACTOR DECLARATION - EFT 00• TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA sgiQpE YARD /^� I hereby affirm,that Lam licensed under provisions:of Charter 9(com• RIGHT (L • mencing with section 7000) lot Division 3 of the Business-and' ❑ OTHER - Professions Code, and my license is In full force and effect, - - - , REAR YARD IT )' •, ' PROJECT DESCRIPTION ' ` License Class B-1 1 _icens• -o. '✓/ i -. -._ _. -.--- - .- . - " •' - ' �� SQ.FT. •PKG.SPACE REQ. pl, PROVIDED, . ' Date 12-416/8 7 Signature w�IO _ .. p _ / WORKERS'COMPENSATION DECLARATION8-Z STREET WIDTH PARK FEES$ ,.,, OCCUPANCY• r� CONSTRUCTION TYPE .�, J.hereby affirm that I have a certificate of consent to Alt-insure ora FD^eDe,•_- - - - ZONING APPROVE -OAT E.^ • -certificate of Workers' Compensation Insurance, or a certified copy, VALUATION ZONE ' /J'-��' thereof.(Section.3800, Lab.C.). - - - - -- - -- - - GRADING CU:YDS. ACRES - • - SPECIAL CONDITI N : - ' ' Policy No. 597475-A1 Company Stat,. Cnnsp F_n_nd , t __ . _ --. Certified copy is hereby fhrhished. - REMARKS:,,,,'. - - r A 1 r( I . PC't'___ED .[2 Certified copy.is flied with the-city Building Division. - - • - - • • •-y., -, - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION • ' _ - U�. ��,</�6 8Y /� /J . (This section-need not be'completed if the permit is for one hundred. • - - VT. `,,,. i'.1'.- \ _;. - D -IJ / -. • ($100) or less2. , _ _ - - _ - . - - - - f certify that In the performance of the Walk for Which this permit is i issued, I shall not employ any person in any manner so as to become : PLUMBING „a.__.-. - - PLAN-CHECK- - - - - -ELECTRICAL - ' PLAN CHECK �' 'subject-to-the Workers Compensation Laws of California... . . - . .uW tLtlNb - GH HHUE BATHTUBS - SHOWERS • - - -Date- - - - Signature ' '- - - - ' - ' - SQ FT SO FT ' [ • NOTICE: If after making this declaration, you should become subject TOILETS _ URINALS - - - - • - GENERATOR- - 0-1 KW_'1-30 KW . to the Workers' Compensation provisions of the Labor Code,you must; . - TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS. - -- - . APPLIANCE' 10-50 KW--_,50'+KW I revoked. . ..CONSTRUCTION LENDING AGENCY - - - _.- KIT.SINKS. ---. • • -DISHWASHERS -- . -- • -MOTORS- - 0-1 HP_1-lo i-i -,I 1 hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS SUMPS - --- - - '. -(INC.SOLAR), 10-50-HP,=50+HP, ' " - - • formance of the work for which this permit is issued (Section 3097 : + ( ICiv. C.). _ • _- - FLOOR SINKS =-- FLOOR.DRAINS' % 'FIXTURES S- - OUTLETS SWITCHES '3 ,, „ 3• oe Lender•s-Name — _ _ _ Lender's Address' rs• •-•• '-� -s DRINKING NG FOUNTAINS - , '" ' GAS TUBE SIGNS -" '- - - - OWNER BUILDER DECLARATION •+ INTERCEPTORS-- - -CLARIFIERS ,.. 'POL-E'LIGHTS� - - • I nereby affirm that'I am-exempt froni'the Contractor's'License Law for + - '+ ' the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL - P TRAP + a 2,,UNbl Kua-ssury -- • - -- - , Any city-or county which requires-a permit to construct; alter, POLES METERED ,. SUB improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE - -••ALTERATION - "- - - PANELS MAIN - SUB , quires the apOirant-for-such permit to file a signed statement that he - - -_ is licensed pursuant to the provisions of the Contractor's License Law - GAS—SERVICE OUTLETS '- - -- - "-' -- • SERVICE ' - AMP I (Chapter 9-(commencing with Section-7000)--of tit-vision 3 of the - Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS -BTU OUTPUT - ' ' - _ - • _.-- I • basis for the alleged exemption. Any'violation of Section 7031.5 by - - i any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - --- ---9- - - . ' - _ , I of not-more than live hundred dollars-($500).- _ ❑ I, as owner of the property, or my employees with.wages as their, , SOLAR TANK- - - C goL TPRe5b . .. _ - - 'sole compensation;will do the work,and the structure is not intende 'a1 .y,_1;Ls.LV - ..1 3' 00 I or offered for sale. (Section 7044, Business..and Professions Code:Thi 'SOLAR PIPING-SYS. ' " . ' "" - ISSUE FEE Contractor's License Law does not apply to an owner of a property //�1 1-L p whobuildsor Improves thereon, and-who does-such-work himself or - - ISSUE FEE'-- DN`` (P ce .1� -)?PPLICATION APPROVED BY ' DATE&Neal through his own employees, provided that such improvements'are not l -1 PEE- or: ((( &N intended or offered for sale. If, however, the building-orifmprovement• MECHANICAL ' - PLAN CHECK • SUMMA RV OF FEES • . . ..is,sold within one year of completion, the owner will have the burden s' * ` ' I' _ of proving._he .did not_build or improve for the'purpose of sale). - 'BUILDING NO. •-SNIP - 3 TO ❑ I, as owner of the property, am exclusive/ye—contracting with HEATING SYSTEM 0-100,000 BTU' \7 PERMIT .$ • -licensed contractors to-construct-the project. Section-7044;Business 'ANO DUCTING.-- 9(. - ( _ 100,000 +-BTU ;1 y„t - (PLAN CHECK $ y-L. PERMIT _ and wn r of-property Code: The Contractor's License Law tl , a not apply to - ISSUANCE $ - tofro of chprojects a c tractors) ilcesn, and who con- REFRIGERATION 0-100,000 BTU °"; PLUMBING S • t tractsheC from c Such projects with a tontrac--- Il ccs n ed pursuant to SYSTEM �- ' - - -- - - - _ GRADING $ ' -the Contractor's License Law): - • - _ - . . - 100,000+BTU PLAN CHECK . $ • - - _ , _ ❑ lam exempt under Section • B..& P.C.(car this- - - - - -- 1 - • --�,00 $ ! BOILERS BTU ELECTRICAL S' , reason _ ' ' • - -PLAN CHECK S •-MICROFILM S --„,�,� !�_,�•- ”, + ;SYSTEM REPAIR,ALTERATION ' ' ' Date Owner ---••'- -- •- - - TOTAL FEE$ - MECHANICAL E I hereby certify that I have read this application"and state that the above EXHAUST SYSTEM MULTIPLE _ - 'LE55 AD- ' - Information Is correct- I agree to comply with all city and county 'PLAN CHECK- S -- ' VANCE PC $_ • representatives ordinances and state laws relating to construction,and hereby authorize - - r r ' t; ' • ' prorfoof lOsl city, to en r upon. the above mentioned •- - - - -- property rJ�Qsgq propert for Ins Oslo ur o ., / O G ( LC+ Signature. - - Date /`7/2/7C/, - _ FINAL FEE $ Drivers'License or.SS . - .ISSUE FEE - -. - _ - - -- - • -- ^- - - " • CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor AIMI - •- : CONSTRUCTION AND PLANNING POOL&SPA . .- _ Date Inspector - Dete. Inspector ~ . APPROVALS Permit# APPROVALS Permit# - _y _ _ . , 1. Temporary Electrical Service or Pole -' 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn _ -_ _ ,_ _ •_ 45_-..Forms 4. Electrical Conduit-Undrgrn - -- 46. Electrical Bonding • 5. Steel-Reinforce- y 47- Rough Plumbing & Pressure Test - 6. Electrical UFER Grn• 48. APPROVAL TO COVER-GUNITE 7. Footings, ,_ - 49. Electrical Conduit-Undrqrn 8. Foundation ._.• • 50. Gas Pipe, ❑Undrqrn,Test • • 9. Water Pi a-Undr rn t' .- i. P 9 - - _ 51: Backwash Lines. P-Trap;•D�Undrgrn `�= - - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT � TRACT NO. LOT NO. •BLDG.NO. (]SFjJ I I U�r^ Ii.a CJ L CONSTRUCTION PERMIT Z •• •Project Address /f7 A d�.ms ` TYPE OF CONSTRUCTION �/�/y� - -• - •- • ' Owner 0S', 'po.5flLt S,2K Phone 4 .03b❑ NEW 0 ADD 0 ALTERATION _.1 .1/ Address - /.• . , ❑.REPAIR 0 CONVERSION ODEMOLISH ll,� "`ZONING REGULATIONS Arch/Eng. Andeeas -1-zi4(t•e c4 License No. ♦^• 24119 0 OTHER -77 r A P # IresS TL -y DESCRIPTION OF WORK' •V 12� /'/477tH x IS?— 3l3- -- SO 3,sa u/ 3 ,?oR .SAf r/KO ZONE c"-- A PLNG. REF. • 'regtorpA�.�S"M-eN,6w/ L�'.�r•rtpl75C' �.19'✓ TYPE OF PERMIT - BUIBAING - - Tp gs�II PING - VZy' SETLDCK C/L$T. PROERTYLINE rens Q34. CA/• $Tit Sr "C(OZ L� • 0 GRADING' - 0 FOUNDATION 0 STRUCTURAL $10 TYARD LEF LICENSED CONTRACTOR DECLARATION TENANT E YARD . - -_ I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT , - mencing with section 7000) of Division 3 of the Business and 0 OTHER - ' REAR YARD(TO P/L) - _ Professions Code, and my license is in full force and effect. PROJECT DESCRIPTION ... License Class • R ' ( License No.V 2.91 PKG.SPACE'REO. ' - PROVIDED - - '"' • - Date ti-(tn--V Signature - - SQ. FT- _ ,. _ -, WORKERS'COMPENSATION DECLARATION !OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE E. I hereby affirm that I nave a certificate of consent to self-Insure or a - ZONING APPROVED BV - I DATE certificate of Workers' Compensation -Insurance, or a certified copy VALUATION ZONE thereof(Section 3800,Lab.Ci. GRADING U.YDS. _ - I ACRES SPECIAL CONDITIONS: - - _ -- Policy No. - Company - ^ - • •. - - - - 'ertified copy is.hereby furnished. - REMARKS: Bt. sx 4e !p ' 2ertified copy is filed with the city Building Division, ? �J nEMPTION FROM WORKERS' COMPENSATION DECLARATION N C4a - eet-0 - JO. 04.71/(N T;'?K - , This section need.not be Completed if the permit is for one hundred I - ' §10(7or less). - - 'certify that in the performance of the work for which this permit is issued, I-shall not employ any person In an manner so as to become PLUMBING - -- - PLAN CHECK- • ' ELECTRICAL -PLAN CHECK - - ' - ' • subject tI61 Slgnat ure �+o the Workers'Compensation f iforn , • • UW tLLINV LiA HAVE DateI/-i �8 - ,....-.../ BATHTUBS SHOWERS . SO FT SO FT NOTICE:'if after making this-declaration, y hould become subject TOILETS - ' URINALS GENERATOR to the Workers' Compensation provisions o e Labor Code,you must • TRANSFORMER forthwith comply with such provisions or t s permit shall be deemed LAVATORIES DOUBLE LAVS - - APPLIANCE 10-50 KW_50+KW - - revoked. . .. - CONSTRUCTION LENDING AGENCY KIT.SINKS' - DISHWASHERS .MOTORS 0-1"HP�1-30 HP- - '- - - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC.SOLAR) 10-50--HP=50+HP ,- .. .... formance of the work for which this permit is issued (Section 3097 • - Len C.). - FLOOR 51 5 FLOOR DRAINS FIXTURES OUTLETS HES - Clv, 's Name _ _ _ C/1- l.ender's Addiess " - " ' DRINK! FOUNTAINS •- GAS TUBE SIGNS - - 1^t - • " - - • OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS - 'POLE LIGHTS 1' I hereby affirm that 1 am exempt from the Contractor's License Law for 1 ' the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP' - LUNbi KUL,I Ivo �J - --. Any city or county which requires a permit to construct, alter, POLES • M UO 'SUB " Improve,demolish-or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION PANELS - SUB quires the applicant for such permit to file a signed statement that he - - is licensed-pursuant to the provisions of the Contractor's License Law GAS SERVICE •' OUTLETS ' . - SERVLCE - • - -AMP - - - ' (Chapter 9 (commencing with Section 7000) of Division 3 of the r` •' Business and.Professions Code) or that he Is exempt therefrom and the WATER HEATERS •' BTU OUTPUT ` - - - - • • • - basis for the alleged exemption. Any violation of Section 7031.5 by - �y applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - - ' . . , not more than five hundred dollars ($500). • ' I, as owner of the'property,Or my employees with wages as their SOLAR TANK " COLLECTORS . - - - . . . • -- - •.ole compensation, will do the work,and the structure Is not intended - - or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. • • ' ISSUE FEE - • A Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED-BY It f,ase�l/-DATE / o who builds or improves thereon, and who does such work himself or ISSUE FEE '/may-01 through his own employees, providedthat such improvements are not If, however,or offered for sale. If, howeaver, the building or Improvement MECHANICAL PLAN CHECK is sold.within one year of completion,the owner will have the burden SUMMARY OF FEES of proving he did not build or Improve for the purpose of sale). • ., BUILDING - • �s - .. HEATING SYSTEM •0-100,000•BTU _ PERMIT $ 7D• r SM IP $ ' ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000+BTU and Professions-Code: The Contractor's License Law does not apply to - PLAN CHECK § PERMIT- . ISSUANCE. $' • an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - _ - GRADING. $ the Contractor's License Law). 100,000;BTU PLAN CHECK $ • ,� I am exempt under Section �Q� B.& P.C.for this - - . - .- $ �f BOILERS BTU ELECTRICAL $ X reason ©eat N•e.‹ 4ual MICROFILM,E '• ' SYSTEM REPAIR,ALTERATION PLAN-CHECK' S Date if-I L�tt Owner ��. _ S TOTAL FEE§ - I MECHANICAL I hereby certify that I have read this applicatl nd state that the above EXHAUST SYSTEM MULTIPLE • . LESS AD'- information is correct. I agree to comp) ith all city and county "-- - - . - PLAN CHECK $ VANCE PC $ ordinances and state laws relating to constr ion,and hereby authorize • representatives • this city t• e ter upon the above mentioned - - - ' property for ti. Pur•/'e". __ _ .O 7 K Signature � � ' ISSUE FEE CMF 0865-46 hate-Building;Canary-Appl cant; Pink-Accounting;Goldenrod-Assessor • - ' • • -i a • CONSTRUCTION AND PLANNING POOL&SPA • . . APPROVALS Permit# Date _ Inspector - - -' , Date Inspectors s-sSvy APPROVALS Permit# _ 1, _Temporary Electrical Service or Pole _ ` ' 43. Pool & Equipment Location - . ? 2. Soil,Pipe-Undrgrn - _ _ _ 44. Steel Reinforcement . -- -- • -- - '- 3. Electrical Conduit Utility-Undrgrn.- . ...... __.. , . s - . . :- - 45. Forms - .. • - • ' 4. Electrical Coriduit-Undrgrn _ , . _- _ , _ , .- _ 46. Electrical Bonding -• -- •- -•-- - -- - 5. .Steel Reinforce _ _ _ _ _ _ 47. Rough Plumbing& Pressure Test, ..... . . - - • _ 6. Electrical UFER Grn _ - - - - -- _ 48." APPROVAL TO COVER-GUNITE • 49. Electrical Conduit-Undrgrn ' 8.--Foundation - . _ ' . 50. . Gas Pipe, ❑Undrgrn,Test, • - . - 9. Water Pipe-Undrgrn, . _- _ -, 51. Backwash Lines,P-Trap. ❑Undrorn - •• - 10. Structural Floor System _ • _- r-_ . - 52. .APPROVAL TO DECK - " ' r, .1.1. _Property.Sewer Line,& House Connection,_ __ --- -, - __ .,• _53. _Backwash & Receptor-Final ' - . 12.-_Street Sewer Connection . ._. ._ _ ____ . -- .- - 54. Heater&Vent-Final' t3. .Rough Plumbing _ . . -. _ - -- _ ' 55' Plumbing System-Final - - - -- - - ' 14. Rough Electric-Conduit . - - - -:56.- Electrical-Final - -r• 5 15. Rough Electric-Wiring - - - --- - - -57. -Solar-System•Final -' ' : f 16. =-Rough Heating &AirConditi0ning- - _ : 68. _Fencing.&.Access Approval . • .r , • - 17:. Ducts, in Structure= -.. _• ._ - _ - . _ __ APPROVED FOR PLASTERING ', . . • -18.- -DuctsyVentilating .a. - •- . _ _. _ - - + `�- 19.' Gas Pipe=Rough &Test _ _ - __ 60._ POOL/SPASYST,EMS FINAL • -20::- Roof Framing - - . - ' 21,' Roof Sheathing - -• •- - - - - - - _..- -- - - - - - 4. 1 22;-Frame and Flashing_ - - -_NOTES: _ s,. .._ �. 23. Insulation - ---- -- - - - . _ -- .. -- - -- _ _ - - - - -- - ' - - - - - - - - 4 24- Lathing &Siding- __ - - - - __ -_ - - - _ _, _ - - - . , 25.,- Drywall Nailing. -- -. ...- . • 26. Plaster Brown Coat - -' _ r 27. Electrical Power Meter-Final '..i. _ . . , . ._ . . _ . 28: Final Electric - •• - • • 1 T/-/7-Y)_ 29., Final Heating&Air Conditioning . _.- - - - -- - , • 30-; Final Gas Pipe-Test - - _- _ . . . ' _:. __. 31.. Final Plumbing . _ _ _ _ • ; -32.' Water Service-Final- - . -. • 33.-- Gas Service-Final _ - - _ _ _ _ 34. Solar Domestic-Final " • , 35. Landscape Sprinkling System _ . - . • 36. Sound Attenuation , - : _ " - - 37. Handicap Regulations '• - • 38. FINAL STRUCTURE&BUILDING "' ' /1-/7-57, 741, • - 39. Special Requirements Completed - - - ' ' . 40. Electric Release-to Edison - - . . _ - . _ \ '`- - -- - •1 41. Gas ReleasetoSouthern California Gas.Co. • - - . - :- 42. CERTIFICATE OF OCCUPANCY ' - Date No :- - - . . - - - _ - - . Paorrr,T: . a.l .Kb12)C Iobbt' rxr,►►aelor4 MINN rtwi pFFace. COTTAoAwls A P.4E5h CA 92er°24I • EXISTNG NedI. , n. i ME ExItT yG ti i4 r fee LIC: Vlt7. .E .: ot re t tat tti:t itWrecbnF • 4 . '-o4 STEEL 'bolt- . • le LO0-14 31-0'.O.C- ,. ez2rs 11/i RE MES-I ,/ext /loxio • 5e-C11O.1J AT PJ Ai ANO VXI5TILIC . Cor.cfc r L.tO? S1APS st 0.00 ci1L � kL . (f .. ANDR.nILT . On C7CFi .A_INTD ASSOCL&a jS T °•jt, R. SIT •.H• ►90•. ♦•• •.•r.. •.tl/...1• • lilt-m7 Xe.t. 1.6•.N , . 8 E; Pe.AAAnql-- BE 2069 - --- . I \ 4.____ owl bei pot Joi 614 10" -- - \ V vrieu et 4 0 0.c • \ \ , \ \ a x4 czAr..e. 4-1-al oc. _ . , to ex'ortfr4 .. ROOF DAR 4016r6 \ . • litilig. < a- r2.)c.41- PLATE. gall i• ' , 1 . k, p , ,.., • 1404 -Il. ac•-. eTL/25. ' s„ , 0 , . i I . . Ti so(. 43R)son44 IS , . . . A CC.E.VTA • i , 1 eigio 7 r .. . --Nn741:1: .15g fr-kee-if%{& Vel-A IL' p arA Ile- 5 , Nam's:kr-Nat : tft err NO I _ _04.4S PATE° , 4-Pet . lies1 . . k . . , , t - . } . !LOCK feta EXTAkiet004 ; 1 , , • I i 1 -. ;t ., ' l'IMAIN1 ,WCST-s OeFiCe- . : • . , , i ' I'1910 AWD ON t , . , , . . (4.06TA i NA eibA H to4DiaseLLO 52-a4citt-i ti, Di,4 . - , rt.. ' , . m; .,- PICIIITIL ANDREWiJoigcmcw AND assoL-7..A.Ticts : -2 AI' -tit ; lt • IblICIC IINERINO • ' nt.iima not., 12154. 30, 1K Rihi ftin _. __ ).. 627, buttes. elan.. o•dro, callfornla 90732 • 213 / 831-2372 di:feid k _ ant City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY N? 1767 C P. 0. Box 317 Costa Mesa, California The Building located at 1590 Ade= Avenue has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Tr? Occupancy. Use of Building post office Legal Description AP #139-371-04 (See reverse 2s�siideefoo�r Metes and Bounds) Gn Building Permit No. 20029 Electrical Permit No. 5apPlumbing Permit No. 39169 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments_ and/or guest rooms ISSUED TO: Building Offieial l /J G Date Februarys 10,'196& 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. 306 (e) U.B.C. Form Bv34-1M-11-e3—S-B P Applicant to fill in all spaces exce• pt those within heavy border lines and sign all appropriate declarations. .CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT O. / (TRACT NO. LOT.NO. - UNIT NO. • ProjectAddress • 1590 Adams Ave. /�� - OY/7 G Applicant's Mailing Address 714/ TYPE OF CONSTRUCTION U NEW UALTERATION U REPAIR 0196 9/I4/RB - 1n.an 'II Owner's Name U.S. PostOffice Dept. Phone 546=5330 . ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A P # Zone Inglewood 90311-9202 DESCRIPTION OF WORK/USE OF BLDG. — Address ! - S Main Building: Accessory Building: - Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUND TIO STRUCTURAL T Front • ZO �I..s Address - 714/ ❑ TENANT'.❑ ELECTRICAL ❑ PLUM BI N MECHANICAL B Rear _ , , - N 1 Contractor's Name Barr Engineering, Inc.Phone !522-1943 ❑ BOTHER A s 1 do Address(mailing) R402 Al 1 port_ Ave. , SFS 90670 PROJECT DESCRIPTION SQ. FT. - OCCUPANCY C Right N /r CON ST RUCTION TYPE VALUATION $ S Left Q City License No. 4 / 5 ZONE • GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - Ping. Ref. # Parking Req./Provided - E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Cotle,and - M my license is in full force and effect. , T - OLicense Class C(` 20 License Ne1/2-2-(18.12.-1-19---- S \ Date'__9/1"17AS Signature{�21/4_ �-s�.^^—. PLUMBING FEES WORKERS'COMPENSATION D CLARATION iBar Sink Showers • I hereby affirm that I have a cert) state of consent to self-insure or a certificate , ELECTRICAL 'FEES of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Backflow Preventer Service Sink Automatic Washer " ' - Transformer ❑ 15-50 KW - Policy No. Company_Beaver Tnm,r Backflow IrrigationCap t Construction Pole Sub. 04h 4y 5— 9 Sewer 0 50+KW Certified copy is hereby Iurnishetl. - Cer {d ro l� (led with the city itqq Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 7 is j' ApplicantC /4 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or - less). Dishwasher Solar Piping - Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00.1 HP 0114-8 Workers' Compensation Laws of California. Date Signature Floor Drains / Swimming Pool w/Spa F.A.U. — - ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Fixtures "' Microwave CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service Switches Sign - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal i,Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays - Generator ❑0-5 KW ❑5-15 KW any structure, prior to Its Issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt l therefrom and the basis for the alleged exemption. Any violation of Section ' 7031.5 by any applicant for a permit subjects the applicant to a civil psi-laity of not more than five hundred dollars($500). I. as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 ompensation, will do the work,and the structure is not intended or offered - - Reinspection Fee ` $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own _ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or Improvement is sold within one year ofcom- Canopy Type 11 0 Zoning Approved By nate pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground, prove for the purpose of sale). Building Approved By Date ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Ref eration System / Application Issued By Date 9/'/,,/€' tractors to construct the project (Section 7044,Business and Professions Code: 1•ld [� The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 100,000 BTU 100,000 BTU 7 O. SUMMARY OF FEES builds or improves thereon, and who contracts for suchiprojects with a con- n/ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration . BUILDING PERMIT $ SMIP $ • proof of their Worker's Compensation insurance should be provided to me. — PLAN CHECK $ PERMIT ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers- PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify,that I have read this application andstatethat the above -00.100,000 BTU 0100,000 BT - GRADING $ information Is correct. I agree to comply with all city and county ordinances ELECTRICAL' $ and state laws relating to building construction and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ ' sentatives of this--f2Iity to enter upon the above-mentioned property for Inspection Plays Signature - jj 'J---cDate__g i13/85 r\ - MECHANICAL $ Irr�75 TOTAL FEE $ id,-51) Drivers' License or SS# Reinspetition Fee $15 Issue • Fee $ 3 . PLAN CHECK 25% $ , CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • , . . _ . _ CONSTRUCTION AND PLANNING - POOL & S ` Date Inspector - Date Inspector APPROVALS 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 _ -12Footings r 58. Electrical Conduit-Undrgrnd. • 8. Foundation ' 59. Gas Pipe,.0 Undrgrnd.,Test :9. Water Pipe-Undrgrnd. ` ' I .60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ,12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains - • 64. Plumbing System - Final 14. Rough Plumbing -65. Electrical-Final . - 15. Rough Electrical-Conduit 66. Solar System-Final - - 1& Rough Electric Wiring67. 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 Structure70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough & Test 72. Underground Flush , 24. Roof Framing -, 73. Undergrnd.Storage Tank 0 Gas 0 Oil„ • 25. Roof Sheathing 74. Overhead Hydro . - - ' 26. T-Bar Ceiling (Structural) & Monocoat 75.' Dry Chemical 27. Frame and Flashing 76. Dry Standpipe ', 28. Lathing &Siding 77. FIXED SYSTEM FINAL 29. Insulation - ' - - 78. FIRE PREV. FINAL - • 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT r 31. Plaster Brown Coat - 79. FINAL INSPECTION - 1- '32. Electrical'Power Meter-Final , - 80. FOOD CERTIFICATE ISSUED 33. Final Electric / / Notes: , , 34. Final Heating & Air Conditioning • IA a tom 35. Final Gas Pipe-Test • "`444"' "Y • 36. Hood oranopy ` - ' .0 37. Final Factory Fireplace .- 38. Final Plumbing 39. Water Service-Final , 40. Gas Service-Final • 41. Solar Domestic-Final ' . . , , 42. Backflow Preventer . • 43. Backflow Irrigation , 44. Landscape Irrigation System - 45. Sound, 'Attenuation ` ' 46. Handicap Regulations . _ - ' 47. FINAL STRUCTURE & BUILDING . 48. Special Requirements Completed • - 49. Electric Release'to Edison - , - . - 50: Gas Release to Southern California Gas Co , 51. CERTIFICATEOF-OCCUPANCY - i. No. - Date - 39252 ' v 19-71.1 00 652* **tr*-21.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 jIIONILDINGPEIT For App/icant to Fill in Complll eterlyD DATE RECEIVED D IS UFF,,pp BUILDING 1QMS i•\VI�e r ADDRESS 1 `ThMJ '��G7�'— j.�/IIQ,. MAIL OWNER e � c n+sem A.P. NBUILDO. 1.3-4 313 --29 4 ,IJ-J � ADDRESS ADDRESS'S-Clip F�)AMSfY�E'. W W TEL. 1 -V1+ c'V AW RT Z BLOCK . C. U CITY NO. CONSTRUCTION m • NEW ADD J ALTFR J REPAIR MOVING DFMOI ISH O m LENDER �O�YL'L- 0- ,J D BRANCH - 1 —y� n� - \r, -J In OWNER I FCfhnStRin h 11,,/0,1•' <IL ADDRESS LVL m Qm ARCHITECT OR ENGINEER TEL USE A!/ / �{.P� VALU$ /r J„_, �- NO u) FIRE yam/ �— W Ir ADDRESS ZONE PE li 1.-GROUP Cl JQZ CONTRACTOR 47LGC. -,a, /7t dr 'L` aY •, 1J/ DATE CO Z W w ::z — l.s�'4 p.y� (` ZONE NO.OF jUSEOFNEW�ZF=- NOOK<�7 '� PL4N5 BUILDING •wO �. CITY YARDS APPROVED YARDS APPROVED -�`� co O LIC.NO. L -S Cr2..S 0 LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF SLOGS. IFROM Ch.STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. _&BIDE _FT. FT, I— SIZE OF NO.OF �}-� ZZ NEW BLDG. ROOMS STORIES -L,SIDE FT. �� FT. V EXTERIOR WALL I ROOF ,r-� COVERING 1 COVERING REAR FT. --b" FT. CL USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0- / L / �9�A/ MAIN SLOGS. ACCESS.SLOGS. Q .��3 /�/ - �/ t( ���G(. CU.P.# DATE APPROVED I- APPROVED/ CV 6 '4e/4 RL DATE/l'/9-)/ZO - sta D 1 hereby acknowledge foon I have or read this application t to and with that the above information is correct and agree to comply with re all laws regulating building construction, and I shall not employ I,,, any person in violation of the workman's compensation laws of (i) the State of California. Co ? SO. FT. I hereby certify that I am properly licensed as a contractor under Xo the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER TT NIS FOR a Chapter 9. and that such licenses are in full force and effect,or I THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLY: em exempt from the provisions of the State of California Business' VALUATION �• and Professions Code, Division 3,Chapter 9. //�f N PERMIT FEE $ // 7 Signature of 7.-" //��/�� co S Permittee //s� $/SW PLAN CHECK $ �// E Authorized Agent �2.[-C itt,e J ar: 2/ l u' TOTAL FEE $ / nr i 21028 _ FEE DECEIVED COSTA MESA BUILDING-SAt ,Y DEPARTMENT - NOV 1 8 1963 / P.O.BOX 517 COSTA MESA,CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely AP&4afNCPATP P IN TYPE OR PRINT BUILDING /, ///� For Office Use Only ADESS DR /3-ye,0 17C-/P/17S /7!/G 09 RECEIPT NO. PL�A'1028 COSTA MESA, CALIFORNIA L 1 IJLO / l //' J/ f / DATE R IVED_ DATE IBBU�f er OWNER �if/O/7 �,7,�JfyP��S%OI!'J.�"�N /�/ Q� '-�J / /'�//O,p�3 ADDRESS SY'S- %A����/57/.9(//FLi/ /Pe /( ,/fADDRESS BUILDING /C/o /,�/fZp /d7/-C / A / / Cl/ LT:. 'FIRE CITY dS ,O "X'S", ZONE E /GROUP -�/ APPROVErilliP DATE// Q - a _/O ARCHITECT ,Q Z/ F See t(//J TEL. BY 6J OR ENGINEER 9-4cc O G NO. _ / / /z /J ZONING ADDRESS /0 Sp� 4/1. 64 s/' .. . ''f`J ZONE NO,oP 1E OF NE454 �1/ �iJ T/� / r C—.) I PLAHe // ouILDINO CCCC)JJ)���• I CONTRALTO 4 /PN_ .J 1.4 /o/f/i'JC, ` fff /, - C �-/116j 1p'Q1' F ADDRESS,/e)/c-- 4�2:4-C9421. I-�.PA/ 37A-e7 DaDSCrnmoN��jCf^yl 'v"`I J `— TJ`f-f� CITY 1 ..4. // l y/, A.P.NO. 17/ 11 �/yp^ ''// p off/ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE LIC. /it 70 NO. ,44 °v/ J � 30"TO SIDE 8REAR P.L. q • EAVES OF LOT.L SOD X c2 30NO. FON LOT ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. Pas r OFF/C. ---- -- - - (FROM C/LSTREET FI SETBACK LINE FROM FRQNT /60FT. rim. FT. CENTER OF STREET REAR YARD 'I SIDE YARD LEFT I RIGHT - R.HIDE FT. I FT. DESCRIPTION OF WORK L.SIDE FT. ' FT. NEW X ALTERATION ADDITION REAR FT. FT. J DISTANCE BET. BET.MAIN& ACCESS.SLOGS. REPAIR MOVING DEMOLISH MAIN BLDGS, VAR.# DATE BUILDING NO.OF SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR COVERING WALL I COVVERIN6 BY 1jj, IA. DATE //`/ USE OF BUILDING AND WORK TO BE PERFFRMED R' 1 /t w,o// GOX/gob —.4. X3.2'0-- L. • - rt. X /7o 'o G /&ocf. I ext. I • ta _ h / 8 G N so FT. Y [ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE E AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION ,Q CFC0 m BUILDING CONSTRUCT! �(�// / N PSIGNATURE ERM ITTEF OFC3`St ��TAOCVC.. �vl PERMIT FEE 5 � �/ B 41 C .-I-Oa-c- ..Ara.-j-. bind PLAN CHECK $ V a AUTHORIZED AGENT / � 4 7 TOTAL FEE $ CI 20029 • FEE R" HIVED f COSTA MESA BUILDING-SA,_.Y DEPARTMENT AN I P.O.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT83 For Applicant to Fill In Completely OIPFLIgATOMACME tMIT TYPE OR PRINT • BUILDING : For Offiee Use Only BUILDING /S9e' go,Ani`. - --e#4'C I ADDRESS ✓ /7 s((/ RECEIPT NO. 1 - - PJI ct,COSTA MESA,-CALIFORNIA I. L !, - RECEIVED BY DATE R 81V6 TIS IS UeD OWNER /2e row k S e de.c%JCO4.E1,Ali� �t - DATE (Q' .�7!,� J ` • -BUILDING . 711 i//p ADDRESS J.I ./ ,e-Ax4 (/).a./ /Y, a - 'ADDRESS" _ '� ••!!RO H/L. /.. Jr/ /� TEL.., .. FIRE CITY ��'ff1 ''�/Ef,1, CA 40c# .•No.. .- ZONE' ! TYPE •/' ARCHITECT :-• - - tiAy��s`'OLI'r TEL[� �✓yy//�[.r BYPRC�V - DATE 7`/Q OR ENGINEER//tA2J O7a'c .NO.HV.2%'-02- .��!! .P/J /" ZONING • / ADDRESS 1052 L(/, hal S/✓. LOf.�1/ty,ELes =Ot{[J I I NO.OF I U86 OF N[W e6,' ��ii //++ C PLANS 6 _ BUILDING CONTRACTOR 70.(.114! Ave-, ate, . - a v' .%"1 • - 1 TiLEGAL 4 4 Loy: sc.) , ! DeBCBIRI x' ADDRESS /0/3- 4r./At.rN/TE' .6'.44,70,. I- .(I i6 CITY /ac A/rac ES iZ. 1 ..4�-/4 A.P.NO. I.i7- 3 /✓ ~-4 t/ J TEL. q NOTE: NO HAVE OVERHANG SHALL BE LESS THAN LLIIC...NO.ATE /Firm/70 NQ. �� y o752 90'TO SIDE&REAR P.L. EAVES SIZE ` NOO.OF FN LIAR ALLOWED (U.B.C.REQUIREMENT/ OF LOT?4rJX ✓��b ' YARDS APPROVED YARDS APPROVED EUSElNeNG BLDG. de 'r7- Q c MAI BUILDING ACCESSORY BUILDING (FROM -;aS, IREET SETBACK LINE FROM / FRONT -"'FT. I FT. CENTER OP STREET /.0.457REAR YARD -- SIDE YARD I LEFT 0 I RIGHT cc f R.SIDE FT. 4 FT. DESCRIPTION OF WORK L.SIDE :Sl FT. SO FT. NEW friALTERATIQN ADDITION REAR FT.C DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDG?. BUILDING / / NO.OF VAR.# DATE SIZE /PIC��)P''�/NJN�Oy;.Yy{ROOMS 4, STORIES / C.U.P.# APPROVED EXTERIOR WALL rear -'I=I ROOF �'�/ 'Cn� n� APPROVED/ / COVERING II COVERING/24 rCr- BY ll� DATE b 13 USE OF BUILDING AN E_PERFORMED l/!S. / OST onze itul V F(�OR� SP � IAL tap 7# r Q7.ysr, acr,'v ' olafi- •RJ ""eE-" A/ .7!-Jf 33.7 SO.F7. • N 0 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE • E AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY DINANCES AND STATE LAWS REGULATING VALUATION p BUILDING CONSTRU SIGNATURE OP �./f/�"�� PERMIT FEE $ 356.So; PERMITTEE �/ $ ayg1 43 PLAN CHZCK $ / /ay/' ] AUTHORIZED AGENT \ l TOTAL FEE $ S3 /' /'2 I i Left 1 ti. V 1.11* . .. cr, -. , .SPECIAL REQUIREMENTS: . ' .. . - • I. . That the height of:the wall at "the rear of the-property - -on Elm"Street, be. increased from five feet to .six feet; 2. That the westernmost dki'veway entrance to the"parking lot.from. Elm' Street be eliminated and the.eastern entry.repositioned to' offeithe least view of the interior of.the lot,.and widen to .'•.a"minimum of ,thirty (30) feet and maximum of thirty five (35' ) ' ` to provide, minimum interferencewith the,westbourid flow' of' • .,, ,1 traffic .on Elm Street; , , • . • 1 . . ; , 1. I-, I '-3.' — - .. .._ . ._ _. . . . _ { ,- •j_ ,,� F. That \the parking lot plan be:changed to conform•with•the +1. 's\ ` ' -recomm&ndation':of 'the-Planning Department. : • � 1 ' 1 e... . __ .$.-. _. _ . -- ,. __