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Home My WebLink About1792 HAWAII CIR - Building Permits1111 V/' Applicant to fill in all spaces except those within heavy border fines and sign all appropriate declarations. CITY OF COSTA MESA 'CONSTRUCTION PERMIT PERM T O. TRACT LOT NO. UNIT NG. �v��i -PER ��E��83 (cwt Project Address _ Applicant's Mailing Addressjj.. %h-�wJ t:/� Lt� p ..1sO TYPE OF CONSTRUCTION NEW ADD I ALTERATION REPAIR Owners Name �iLt LZ—a Y1- �•.Vtd" 'hone) (G ❑CONVERSION ❑DEMOLISH ❑ OTR fir/�C� OF WORK/USE OF BLDG., / 12!�Z_ 14-A,wo,k \ L( Imo, I �./��' Arch/Eng. .G 4�'l, "�'� License No �(cL g3 Address �m LIE— Contractor's Nam 2LV S rQ�S Phony Address (mailing) [�i�-k�Jg Lv3`j tSS+e City License No.Qp-1 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter.9 (commencing with section 7000) of Division 3 of the Business and Prof;Bions Code, and my license is in full force and effect. �I License Clays' L l [g—Liddse No.. �' Date? ✓ � � Signlure WORKERS' COMPENSATION DECLARATION " 1 hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or -a certified copy thereof (Section 3800, Lab.C. l�.v. � LI�C.. Policy No. 322 IOT�M,Company Certified copy is hereby furnished. Certified py, .s filed with the city ing Divi n. Date' N Applicant -^ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed if the permit is for one hundred ($100) or less). certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation'Laws of California. Date Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY,' I hereby oi f rm that there is a,construction lending agency for the performance of the work for which this permit is'issued (Section 3097 CIv. C,) Lender's Name _ Lender's Address - OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License .Law for the following reason (Section 7031.5 Business and Professional Code: Any City or county which requires a permit to construct, 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of )ivision 3 of the Business and Professions Code) or that he/she is exempt lerefrom and the basis for the alleged exemption. Any violation of Section ,031.5 by, any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). LJ I, as owner of the property or my employees with wages as their sole compensation, will do the work, and thestructure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law doesnotapply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rrove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: ' The Contractor's License Law (foes not apply to an owner of property who builds or improves thereon, and who: contracts for,such projects with a con- tractor(si license pursuant to the Contractor's License Law). I am aware that proof o t hei r_ Worker's' Co mpensation insurance shoultl be provided to, me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner' 1 hereby certify that '1 have react this application:and state that the above information is correct. I agree to compl with all city and county ordinances and state laws relating'to buil m9 co t uction; and hereby authorize repre- sentatives of this ity- to e r upo h¢, abdve-mentioned property. for inspection au 7_ �... Address �- TYPE OF PERMIT LJ ❑ TENANT I� ELE ❑ OTHER PROJECT DESCRIPTION CON ST RUCTION TV Remarks: DINGgLJ FOUNDATI 2f)l VYSTRUCTURAL CAL `PLUMBING IPI2 2 MECHANICAL - L -t r S , As ,5 FT.A+ OCCUPANC�V,,— VALUATION Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50+KW 1 - GRADING CU.YDS. NACRES A.P. # S S Main Building: E T Front B Rear A C Right g Left Ping. Ref. # Planning Notes: 6580 7/12/85 Parking Req./Provided Zone Ille7a �� Z O N I N G R E D M T S PLUMBING FEES ' BUILDING PERMIT Bar Sink I Showers ,5 ELECTRICAL FEES Backflow Preventer -- Service Sink - $ Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50+KW 1 - Backflow Irrigation Sewer Cap PLUMBING Bathtubs Sewer Connection to Cooking Unit •Meter ❑up to 100'amps ' Clarifiers Solar Collectors $ Dishwasher 'Meter ❑over 100 amps Dishwasher Solar Piping ELECTRICAL Dryers ❑Gas ❑Electric Sub Panel ' Drinking Fountains Solar Tank GRADING Fan' Motors ❑0-1 HP 1 % - 8 Floor Drains, Swimming Pool pa F.A.U. 7 Inc. Solar ❑9-15 HP ❑16-15+ Floor Sinks Urinal $ Fixtures Microwave Gas Service Outlets Water Closet - Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink - Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal Standing Sections P—Trap Laundry Trays - Generator 1:1115 KW ❑5-15 KW Trash Compactor Roof Drains Reinspection. Fee 1 $15,1 I Issue Fee I $ 31 Onder Ground Structural a,wa -, vciuna uuy Exhaust System ❑ Multiple ❑. Firepl/Fact. Bit. ICBG # Heating System & Ducting 011100,000 BTU 0100,000 BTL Hood or Type 1 ❑ Canopy Type I1 ❑ Refrigeration System I +, ` 00-100,000BTU ❑100,000BTU System Repair/Alteration Fire Dampers Registers Fee DEVELOPMENTSER Zoning Approved Bye Building Approved By $15 I I Issue Fee Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $ 3 $ $ $ $ 111.73 ��9namre •- Drivers' License or SS 'SUM ARV OF FEES BUILDING PERMIT $ ,5 SMIP , PLAN CHECK $ 'No, -7 PERMIT PLUMBING $ to ISSUANCE PLAN CHECK 25% $ ENERGY P.C. ELECTRICAL $ -L) GRADING PLAN CHECK 50%,$ MICROFILM MECHANICAL $ - . TOTAL FEE Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $ 3 $ $ $ $ 111.73 ��9namre •- Drivers' License or SS ' CONSTRUCTION AND PLANNING APPROVALS Permit# a Date - Inspector POL . SPA APPROVALS Permit # Date - Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location y 2. Soil Pipe-Undrgrnd. I 53. Steel Reinforcement - ' 3. Electrical Cend uit; Utility-Undrgrnd. 54: Forms 4. Electrical Conduit-Undrgrnd. j 55. 'Electrical Bonding ' . 5. Steel Reinforcement � - 56. Rough Plumbing & Pressure Test 'I 6.; Electrical UFER Grnld. 57. APPROVAL TO COVER-GUNITE 7: Footirigsl 58. Electrical Conduit-Undrgrnd. • 8., .Foundation 59. Gas Pipe, 9tTnc1rgrnd., Testes I 9. Water,Pipe-Undrgrnd. _ 60. Backwash Lines, P-Trap,`R1lndrgrnd. jY („Q'Q 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 3 12. Sevyer•Cap 63. Heater & Vent -Final 13. Roof Drains! 64. Plumbing System - Final i 14. Rough Plumbing,) 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # - 20. Rough Factory Fireplace 21. -Ducts, in Structure 70. Underground Hydro 22.}Ducts, Ventilating 71. Product Piping 0Gas ❑Oil - 23. Gas Pipe -Rough 8c Test 72. Underground Flush 24. Roof Framing 1 73. Undergrnd. Storage Tank OGas Coil 25. Roof Sheathing 74, Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical _ 27. FrameiandFlashing 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 Cdr Canopy - 37. Final Factory'Fireplace 38. Firia6Plumbirng 39. Water'Service-Final i v, 40. Gas S✓'rvice-Final i r 41. Solar Domestic -Final - 42. Backflow Preventer 43. Backflow'Irrigation� 44. ,Landscape Irrigation'System 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING. 48. Special Requirements Completed , 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date III inq Laboratories Of Do E.2 CaLifov2ia, 5�� 3310 Air Dort way / Marling Address P.O. Box 47 / Long Seacn, CA 90801 / (213) 426-33S5 / 12131 636.2386 / 17141 828.6432 TESTING BRANCH OFFICE. 15t.1-0 Nortn Susan Street I Santa Ana CA 92103 1 (714) 554-2545 August 16, 1985 Examination: SC85-6137 COMPRESSION TESTS ON GUNITE CYLINDERS Max Sitter P.O. Box 3454 Fullerton, California 92637 PROJECT SPA ADDRESS 1792 Hawaii Circle, Costa Mesa ARCHITECT CONTRACTOR Aquarius Pools Aquarius Pools ENGINEER SUBCONTRACTOR . B.C. Adams Arco Gunite SAMPLE FROM Main drain SPECIFIED MIX 4,2-1 STRENGTH DATE CAST 7-27-85 SLUMP SIZE DATE TESTED 8-6-85 8-16-85 SPECIMEN NO. 1 2 COMPRESSION 10 -Day 20 -Day TOTAL LOAD, LBS. 44,000 62,000 POUNDS PER SO. IN. 1,854 2,734 28 -DAY AVERAGE, PSI COMPLIANCE SPECIMENS DISTRIBUTION: Max Sitter - 3 Cdasta-Nesa Bldg 20 -Day test complies with specified strength. MADE BY Tom Dept./ Scott Priegel DELIVERED BY Max 2,000 psi 5V x 12-1/8" 3 "HELD IN FIELD" RECEIVED ON 8-1-85 LL Rick Hyden ALL REPORTg ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS.:UTNORCATION FOR PUBLICATION OF OUR REPORTS. CONCLUSIONS. OR EXTRACTS FROM OR PE3ARDING7HEM IS PESERVED PENDING OUR WRITTEN APORGVAL AS A MUTUAL AROTECTION TO CLIENTS, THE PUBLIC ANO OURSELVES -30..? Gunite (✓ ) Post -Ten. ,ned Concrete ( ) REPORT OF INSPECTION ON Masonry ( ) Fireproofing ( ) Concrete ( ) Reinforcing Steel ( ) BM TO: Address OWN ER:J't�i?i PROJECT: Report No. Address: PAA, a, �Lt,9 Perm t No. Architect: ( ,> nis ('.<2'< Contractor: Address: Address: Engineer: QJ,,�. "f1�Yi Subcontractor (Gunite) Address: Masonry or Concrete) Inspector: (Y'r-.t G ft;_, Address: f 3cx 3`( _ii Mix Used:tl•4,-1 Slump, inches: -<�- Admixture: -f.-I— Designed Strength, PSI :;I Q,�. The following inspection was performed in accordance with the approved drawings: Cu.Yds• No. of DATES Placed CYIs• Remarks ;1 l i Y J 1�q<,, 4i �::„ , P n t Copies of Reports to: (Indicate which Bldg. Dept. E furnish address of any not listed) CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. X694 DATE1� LOT NO. :Z=6 ADDRESS/7-92- The DDRESS,7-9Z The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he -she -they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. &__7�e=n=d_er Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 'CITY OF COSTA MESA P RW IT NO. - TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT Y--- 02/ -7 7 TYPE OF CONSTRUCTION '❑`NEW ❑ ADD ❑ ALTERATION - EJ REPAIR ❑CONVERSION ❑DEMOLISH- ❑OTHER' ,_. 0052 !a �30/6� 15.50 - _ _ - - ZONING REGULATIONS Project Address Z �lN.4 � Rif, , Owner � �( P q?l,-& Address I Z. t.UA-l1 L' -I pC Arch/Eng. ,License No. DESCRIPTION OF WORK A.P.4 ZONE PLNG. REF. =)P Address ' " - ' Contractor A _ rpi,,ff�o ' Phone "' - TYPE OF.PERMIT -- ❑ GRADING, El ElFOUNDATION EJ STRUCTURAL ❑ TENANT G ELECTRICAL, ELUMBI NG- ❑ MECHANICAL BUILDING SETBACK CIL ST. SIDE YARD Tp BUILDING PR OPERTV LINE - Address ) I - 1.7, Z /N [., '724Y q LICENSED CONTRACTOR DECLARATION- - I hereby affirm that I am licensed under provisions of Charter 9,(com- / ` RIGHTA - mencing with section 7000) -of Division 3, of the Business and ❑OTHER - - - - - Professions Code, and my license is In full force and effect. REAR YARD (TO P/L) $G-L/(� �� PROJECT DESCRIPTION.._ �;._ - _ _ - - Llcense Class'r3^I License - (t PKG. SPACE REQ.' .PROVIDED. r;go.4: �, Date) Z -Z4- S("I Signature C7- S ' �--�`� _ - SQ- FT. _ _ _ - _ - - _- 'PARK v WORKERS' COMPENSATION DECLARATION - - - - - OCCUPANCY -CONSTRUCTION TYPE .STREET WIDTH FEE $ I hereby affirm that I have a certificate of consent to self -insure ora VALUATION' ZONE iZONING APPROVED BY _ _ 1 .DATE 'certificate of Workers -Compensation Insurance, or a certified copy lcreof (Section 3800, Lab. CJ. GRADING CV.'IYOS. ACRES : .SPECIAL CONDITIONS- r lily No.�7'%�- 41 Company �TRTr F -U 117 - - - - - _J Certified copy is hereby furnished. - _... -_._ REMARKS: ❑ Certified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not.be completed if the permit is for one.huntlretl ($100) or less). - I certify that in thwperformance of the work for which this -permit is issued, 1 shall not employ any person in any manner so as to- become PLUMBING_ - _ PLAN CHECK - _ "ELECTRICAL PLAN CHECK - subject to the Workers' Compensatio ws of vCa l ifornia -UVVIELLINU BATHTUBS SHOWERS _ _ SO, - - Oateyz-2el-Y/ Signature ' , NOTICE: If after making this decixration, you should become subject TOILETS-, URINALS "" GENERATOR- 0-1 Kt - 1_1O 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 DOUBLELAA -,APPLIANCE '10-50 KW=50 "KW _ C/ revoked..-. CONSTRUCTION LENDING AGENCY KIT. SINKS -DISHWASH 5 - - ,MOTORS--' "0-1"HP_1-10 HP" I hereby affirm that there l5 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 FLOOR SINKS- FL O RAINS FIXTURES-' ' ' OUTLETS SWITCHES --' - - _ Civ: C.). - - '-- - '" - - Lender's Name _ Lender's Address DRINKING FOUNTAINS '. -A - - 'GAS TUBE SIGNS 'INTERCEPTORS ARIFI ERS - POLE LIGHTS OWNER BUILDER DECLARATION -" - -' - 1 hereby affirm that I am exempt from the Contractor's License Law for SWIMMING PO ,TRAP' --" - POLES METERED - - - SUB the following* (Section 7031.5 -Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to its -issuance, also re- ' WATER SERV f - ALTERATION' PANELS"" - -MAIN -- SUB quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS ,SERVICE - 'AMP - is licensed pursuant to the provisions of the License Law-' (rhapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATMIM BTU OUTPUTfor 'ness and Professions : Code) or that he is exempt therefrom -and the the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONSor 'applicant fora permit subjects the applicant to a -civil penalty not more than live hundred dollars ($500). _ SOLAR TANK"- / _ - 'COLLECTORS -..- ..- -V._ .__ .._ .. _ ❑ 1, as owner of the property, or my employees'with'wages as their will do the work, and the strProfes,ionot de; ded _ The or for sale. (Section 7044, Business and Professions Code; The or offered for sale. SOLAR PIPING SVS. __ _ _ - - ISSUE FEE- ntracttl Contractor's License Law does not apply to owner of a property ISSUE FEE - - 1'. + -- �-- -.APPLICATION APPROVED BV - _ ----DATE - es such work himself or who builds or improves thereon, and who does provided trot such improvements are not- own. employees, ot_ MECHANICAL PLAN CHECK _ _ SUMMARY OF'FEES, - for sale. If, however, bor improvement intethrodeed or for sale. intended is of completion, the owner will have the soldetl th n one -year -of s one.d _ - ✓ f sale). forwill not build improve for the purpose of sale). of proving he n o proving HEATING SYSTEM 0-100,000. BTU - BUILDING- - - - - 'PERMIT $ ' - - - - ---- -- -,:;SMTP, ), Iv $_ :- -o rt ❑ I, as owner --of -the property, am- exclusively contracting with AND DUCTING - "- -" '--"'-' -•-- r- - -- ._. licensed "contractors to construct the project (Section 7044, Business 100,000+BTU !PLAN CHECK $ 'PERMIT y 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 0-100,0110 BTU t PLUMBING $ tracts- fro m- such projects with a-contractor(s)-licesned pursuant -to -SYSTEM -- -- - - - - - - -t- - -- - - - - - ( - GRADING $. the Contractor's License Law). 100,000+BTU ,PLAN CHECK $ ❑ I am exe mpf under Section - B. &-P.'C. f6r this BOILERS BTV ELECTRICAL - $ '-S C/ reason --- - - - - - - - - - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ "MECHANIC1 "$ MICROFILM $ _ TOTAL FEE $' i - LESS AD - Date - - Owner - Ihereby cerci fy that 1 have this application and state that the above e to comply with all city and county information is correct. agree '!PLAN CHECK -$- - - VANCE PC' $, ordinances and state laws relating to construction, and hereby authorize representatives of this city to enter upon the above mentiOnetl t - 'Z7 property fo ms t. purposes. _ -_ \_- _ - f Z2 5I FINAL'FEE $ / Signature Date _ Drivers' License or SS - - ISSUE FEE - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TU CONSTRUCTION AND PLANNING APPROVALS Permit # �j1� Date Inspector POOL & SPA - -, APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pale 43. Pool &Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement- - 3. Electrical Conduit Utility-Undrgrn 45. Forms- .4. Electrical. Conduit=Un_drgrn _ 46. Electrical Bonding - -5. Steelein orce - - 47. Rougb Plumbing & Pressure Test _ 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE -- - - 7. Footings- 49. Electrical Conduit-Undr rn - .8.. Foundation- 50. Gas Pipe,.0,Undr rn,Test 9. -Water Pipe-Undrgrn 51. Backwash Lines P-Tra E Undr rn • 1,0. Structural F100 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 _ 14. Rough Electric -Conduit -- 56: Electrical -Final v. 15. Rough Electric -Wiring - - - 57. Solar System -Final - - 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval -17. Ducts -in Structure 9. APPROVED FOR PLASTERING - 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - 19, Gas Pipe -Rough &Test- - _ _ _ 20:- Roof Traming - 21. Roof Sheathin - > NOTES: ' 22. Frame and Flashing - 23. Insulation 24. Lathing & Siding - - - 25. Drywall Nailing 26. - Plaster Brown- Coat - - 27: Electrical Power Meter -Final 28. Final Electric• 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31.- Final Plumbing _ _ _ _ _ ' '•' 32. - Water Service -Final - 33. Gas Service=Final: 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap. Regulations ° `- 38. FINAL STRUCTURE & BUILDING --- - - 1 39. Special Requirements Completed - - - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - I 42. -CERTIFICATE OF OCCUPANCY - Nd-_ Date - - . APPROVED CITY OF COSTA MESA Mechanical Division Building Department Approved._-.-f..i--•C.--....Date/ , , , , Permit ## THIS NUMBER MUST ACCOMPANY ALi, 1NS'FCTION RFQUl-STS We -- - _.... —,.rAk� LAS IN 7-o IZ— L4C— {N'1-0 i ` 7 y. c.L p1pinlG ;Nc.LL L'E-%/q' -rYFIL5 M GCt'i I j I�kl�q: �LaT v LL Ll KI Lhcls �s�D lu-ro 5�1(3- Set -L F�I�Fi IiC�IR'�5. i I !Joffe„ je t?, P, [ F I-rs 17C.`II I-JiT60[r-LL 1j --171'P If2vIU� GA• 41-7q - 671f� , I , , , , Permit ## THIS NUMBER MUST ACCOMPANY ALi, 1NS'FCTION RFQUl-STS We -- - _.... —,.rAk� LAS IN 7-o IZ— L4C— {N'1-0 i ` 7 y. c.L p1pinlG ;Nc.LL L'E-%/q' -rYFIL5 M GCt'i I j I�kl�q: �LaT v LL Ll KI Lhcls �s�D lu-ro 5�1(3- Set -L F�I�Fi IiC�IR'�5. i I !Joffe„ je t?, P, [ F I-rs 17C.`II I-JiT60[r-LL 1j --171'P If2vIU� GA• 41-7q - 671f� INTERNATIONAL ASSOCIATION OF PLUMBING AND MECHANICAL OFFICIALS _ �._ .No.wvoa,ycua,oe.nae r RECOMMENDATION OF THE ®; ®•' RESEARCH COMMITTEE °&,,(o0 The product described herein has been reviewed, tested and recommended for acceptance by the Re- search Committee of the International Association of Plumbing and Mechanical Officials as meeting the requirements of the UNIFORM SOLAR ENERGYCODE. This recommendation is subject to the conditions set forth in the characteristics below and is. not to be construed as assurance or guarantee by the Association of product acceptance by local jurisdiction or authorities using the UNIFORM SOLAR ENERGY CODE or otherwise affiliated with the Association. Accepted August 1981 void offer August 1982 PRODUCT: Flat Plate Solar Panel . FILE NO. S-2257 APPLICANT: Urja Inc 3100 S.T MODEL: fi �aPm M1 -dan A ;(rat -,Mad App '-'40'. plate ne; 704:.`. 40 rrowiag-nam or tiadem Energy Co a logo.'`r.t . Itector pane s for swimmir zthe provisiogs_oPjhe Uniform'Sol`ar al and the manufacturer's instruc star 32.& Jantar 40 atg size: Length 97'kjor'Jantar 32 ' ,,ii hickneaq 3"t luminurny_px�usion Plate: Aluminum .05!thick: s/2" TTe=tvl,copperwa;r tube Temperedglas�' number oi, space or filled in actor- nergy Code W 121" for Jantar Insulation" -i 2" polyisg"gyanurate Weight: 146 lbs. dry and 154 lbs. full - Jantar 32 Weight: 185 lbs. dry and 192 lbs. full - Jantar 40 Pressure Drop: .25 psi at 4 gpm Operating pressure: 100 psi y This recommendation is lar the per`Si rt�cdredheremrarh!,aro d"arter'date shown above. Any change in materi without having first obtained the approval of the Research Committee or evidence of infenorworkmanship or failure service policy may be deemed as sufficient cause for revocation of this recommendation. Reproduction of or r_ advertising purposes may bemade only by specifi; written permission ofter tionaf Associalionol Pfumbmg� This auth�� ua� a USEC shield on Products wvered r the ertificale. •/ fY✓.+raul ntla�eOrGOweR[a (xKlrrrvl MO[OTO' Sponaora of Uniform Plumbing Code. Unlfwm Swimming Pool Code. Uniform Solar Energy Code, and Uniform Mechanical Code carrlsawnEs RACHEL GULLI V ER O V NNE n[1iol1VT MAURICE L MARTINEZ V IC[M USO{NT SHIRLEY JEAN SETTER MARCIA MARCUS TOSNIKAZU TERAEAWA CITY OF LOS ANGELES CALIFORNIA DEPARTMENT OR BUILDING AND SAFETY REPLY TO$ MgNANIC.L TWTINO LAIORATORT LOE A+O[Ly. CALVORRI. OO 31 TtL -ONC �jljl ♦E E.jj1R Tp JACK M. FRATT T O M BRADLEY OCNIR.L MA.AOER MAYOR URJA, Incorporated 3100 South Shannon Street Santa Ana, CA 92704 Mr. Brian E..Langston RESEARCH REPORT NO.: 4264 Date: July 31, 1981 GENERAL APPROVAL - Solar Collector, Models JANTAR-32, -40. The above product is approved until August 1, 1982. DETAILS This solar collector is made of metal and glass. The approvalhs subject to the fgllowing conditions: 1. This collector may be installed only in solar heating systems for swimming pool, potable water heating, space heating and spa applications. 2. Installation and approval shall conform to attached "General RequirementsFfor Solar Heating Systems." Installation need not_meet requirements for combustible collectors. NOTE: Wet weight shall be based on the following: MODEL NO. JANTAR-32 JANTAR-40 WET WEIGHT 154 lbs. 192.5 lbs. NOTE: Structural approval of supporting framework is not included in this approval. 3. Each collector shall be identified with a permanent label showing the name "URJA, Inc." and appropriate model number where visible for inspection purposes. Page 1 of 4 t. AN EQUAL EMPLOYMENT OPPORTUNITY'— AFFIRMATIVE ACTION EMPLOYER ,i" Hole Insert Copper ion Of Sensor Side Of Panel Solar Panel Sensor A.C. Power. Cord 115 V.A.C. To Bottom Of Panels 4 a Cold From Top Hot 6 Of Panels a _ ' Brass '/:" Butterbail Valve I _ 'A" Brass Spring toad \) Check Valve 01111MMIMII Tank —►+ rThermacel ISensor Insulation for Wire 1/2" Pipe Pressure and Temperature Drain Pipe Tank Sensor Mounting 314" Brass 112" Copoer Pipe 1/2" x 3/4" Copper M.I.P. Adapter .I 314" Brass Tee 14" Pressure - 150 P.S.1. Temperature - 210 F gehel Valve , 1/2" x 112" Copper M.I.P. Adapter 3/4" x 112' Copper FTGX Adapter 14" Union UM 25 - 18 SU n Grur.dtos Pump /I 75 Watt. 115 V.A.C. No. 10 Stainless Steel HOSe Clamp V2" Copper Pipe 12" x 3/4" Copper M.I.P. Adapter � w Tank —►+ rThermacel ISensor Insulation for Wire 1/2" Pipe Pressure and Temperature Drain Pipe Tank Sensor Mounting 314" Brass 112" Copoer Pipe 1/2" x 3/4" Copper M.I.P. Adapter .I 314" Brass Tee 14" Pressure - 150 P.S.1. Temperature - 210 F gehel Valve , 1/2" x 112" Copper M.I.P. Adapter 3/4" x 112' Copper FTGX Adapter 14" Union UM 25 - 18 SU n Grur.dtos Pump /I 75 Watt. 115 V.A.C. No. 10 Stainless Steel HOSe Clamp V2" Copper Pipe 12" x 3/4" Copper M.I.P. Adapter Air Vent 'y Return Line t Lag Bolt t � i - - y `4.. - Panel - Redwood Riser Sensor Inside +/•,- Mounting Hole I Insulate All Exposed Pipe Copper Pipe With Thermacel Pipe Insulatio r Qrz DznNPG Cooper Mounting Bracket - 4 Per Panel \ Redwood 2X412' Each) I ADDITIONAL MATERIALS - O Vz- Type -M Cop ater Pipe l{ vz- Coppe ows vz- C per Tees rmacel Pipe Insulation I Quantity Item Description 2 3" x 34" Brass Nipples 2 3/4" Brass Tee's 2 1/z" x 3/4" Copper M.I.P. Adapters 2 z/4" x 1/z" Copper FTGX Adapters 1' Grundfos Pump UM 25.18 SU IF- 1 '/z" Brass Swing Check Valve 1 1/z" Brass Spring Loaded Check Valve 2 1/z" Butteroall Valves 2 Pressure -Temperature Relief Valves - 210'F - 150 P.S.I. t Air Vent Valve IBraukmann) (Bell 3 Gossett) 1 1/z" No. 10 Stainless Clamo for Tank Sensor 1 1/z" x Y4" Female Copper Pipe Adapter (for P.T. Valve on Panel) ADDITIONAL MATERIALS - O Vz- Type -M Cop ater Pipe l{ vz- Coppe ows vz- C per Tees rmacel Pipe Insulation I .Applicant to fill in all spaces except those within.heavy border lines and sign all appropriate declarations. CITY OF COSTA MES(Cjj CO TRUCTIO ERMIT Project Address k ) `� .Applicant's Mailing. A dress • Owner's Namg`' Pho Address T^ • ` O Arch/Eng. License No. Address �y Contractor's N e �� Pho e�'r 17; Address (mailing) AZ1�-�VA+rl\ s� City License No. �( n_ LICENSED CONTRACTOR DECLARATION w 1 hereby affirm that.l am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full �i,C_M! effect. nom, A Date - %kiShci iA . Signature WORKERS' COMPENSATION DECLARATION 1 hereby affirm that.l,have a Certificate of consent to setins++re or a certificate of Workers' Compensation Insurance, Or d certifi Gi ther of (Section 3800, Laabe QP Policy �-'^-' ;tcopy I hereby furnished. eIth the city Ivl ate pY Applicant EXEMPTION FROM'wORKERS' COMPENSATION DECLA N (This section need not be completed if the permit is for one hue o ($100) or less). certify that in the performance of the work for which this per is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject t0 the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such, provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that.I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional, Code; Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed Statement that he/she is licensed pursuant to the provisions of the Contractor's license Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Subjects the applicant to a civil enalty 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for Sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im. prove for the purpose of sale). EJ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con. tractor(SI license pursuant to the Contractor's License Law). I am aware that proof of! their Worker's Compensation insurance should be provided to me. [] I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify tha h ve read, in, application and State that the above information is come I re to com ly with all city and county ordinances and state laws relaF o bdi loin struction. herebv authorize reore- Signature P Drivers' License o SS 17 TYPE OF. CONSTRUCTION LJ NEW U ADD LJ.ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH _❑_OTRjR _A_G;,, _ _ ,,,meg TYPE OF PERMIT L-3 GRADING IJ FOUNDATION LJ STRUCTURAL � /•t ❑ TENANT ❑ ELECTRICAL ❑ PLUMBL PLUMBING ❑ MECHANICAL Cls'( -5g ❑'OTHER PROJECT DESCRIPTION SO. FT. Aiy OCCUPAN�. CON STRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES Remarks: A.P. # S Main Building: E T Front A Rear C Right BLeft Ping. Ref. # Planning Notes: ( ellen 01 1Qiia Req./Provided Zone Z O N I N G R E Q M T S PLUMBING FEES Bar Sink Showers DEVELOPMENT SERVICES REQUIREMENTS: ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50+KIN Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter []over 100 amps Dishwasher Solar Piping Application Issued By Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Date Fan Motors []0.1 HP ❑l Ya - 8 Floor Drains Swimming Pool w/Spa SUMV JY�OFF FEES F.A.U. Inc. Solar ❑9-15 HP 1116-15+ Floor Sinks Urinal �0 Fixtures Microwave Gas Service Outlets Water Closet SMIP Device Boxes Pole Light Interceptors Water Heater PLAN CHECK Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash $ Garbage Disposal Standing Sections P—Trap Laundry Trays Generator 00.5 KW 05-15 KW I Trash Compactor Roof Drains ENERGY P.C. $ Reinspection Fee , $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICED # Heating System & Ducting ❑ 0100.000 BTU ❑ 100.000 BT Reinspection Fee , $15 CMF 0865-46, rev. 10/84 White - Buildirig;Aanarrr - Applicant; Pink - Accounting: Goldenrod - Assessor Issue Fee 1 $ 3 Hood or Type 1 ❑ Canopy Type I1 ❑ Refrigeration System 1:10100,000 BTU 0100,000BT System Repair/Alteration Fire Dampers Registers Issue Fee , $ 3 Reinspection Fee , $15 ' , Issue Fee , $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By �, . o Date SUMV JY�OFF FEES �0 BUILDING PERMIT $ _{ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ •,�-O PLAN CHECK 25% $ .CONSTRUCTION AND PLANNING APPROVALS , PJermit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1'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. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings _ 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # , 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush .' 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION , 32. Electrical Power Meter-Final 80. FOOD CERTIFI ATE ISSUED 33. Final Electric Notes: ' 34. Final Heating & Air Conditioning , 35. Final Gas Pipe-Test 36..Hood or Canopy , 37'. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final ; 42. Backflow Preventer - - 43. Backflow Irrigation • 44. Landscape Irrigation System 45. !Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE&BUILDING Z O W 48. Special Requirements Completed t I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: 1792 HAWAII CI OWNER'S AD RESS: VERMEULEA RAY aoDREss: 1792 HAWAYI CIRCLE COSTA MESA ARCH/ENGINEER: 779-6770 BEG.NO.: ADDRESS: UNIT: PERMITTEE. PETERSON ROOFING ( 714) 979-7111 ADDRESS: (((3��GG00�6�LL ENTERPRISE ffp q LICENSED CONTRACTOR DECl11NATIOlkMY1terr4 alfirm that I am licensed undeP"IfYdvisidhAhapet r 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: LLASS: Ok5,A1�45 607872 C-39 Ore: _ _�a—�' 41_ Signature: — WORKERS' COMPENSATION DECLARATION: [hereby affirm that I have a certificate of consent to self insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Q. POLICY NO: 1021355 EXP. DATE: 04/01/92 COMPANY: STATE FUND El Caroni copy is hereby fupmishetl. L3{ Compiled ropy is I of with the city /Building Division. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be tompleted it the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Dale: Signature: NOTICE: If. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (3500). I. as owner of the properly or my empDloyees with wages as their sole compensation, will do the work, and the 1:1 structure is not intended or offered for sale (Section 7D44, Business and Professional Code : The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon. and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 1-1andProfessions Cotle'. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts lot such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05546 PERMIT NO: B 055468 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: SIR PURPOSE: ALT JOB DESCRIPTION REROOF O/EXT SHAKE W/TILE ICBO#3409 SQ FT; 3,600 CLAIM VALUE: 3,600.00 CALC-VALUE: 3,600.00 GROUP OCC: R-3 / COMMENTS: REACTIVATE EXP, PERMIT #B32676 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 RECD• PROV; PARCEL: 00000000 ZNE; REF NO; PLANNING N TES> ################x-#�}ex-�If#* E##1fiE**K*S *E*R **V* f**C*iE**S** E#3f xI#xiFE IM iiif f(IFT NSlx1f-##ir# 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: 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 63,00 -50 SMIP/-NON-RES PLAN ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID' DUE TOTALS ---- > 63,50 0.00 0.00 63,50 63,50/ .00 REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT:'. ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 63.00 ,50 REx'######x###N-#N•##########RE###iF#################R6###RE RE RF#x#####RE####RE iik#######RE Ri# 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 Date: Owner: I do hereby comity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and SFR 25534 and that I or any future budding occupant will/will not (circle one) need to comply with said state codes and the requirements for a Air permit for construction or modification from the Ouakty Management District. Residential construction applications are exempt from these provisions. I Date. Applicant: I hereby certify that I have read this application and stale that the above information is correct. l agree to comply with all city and county ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Dale:_ � Signature:xhz_ Driver's License or Social Security •: 1641"46 White—Building', Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Golcomod—Assessor 3600 REROOF BY VALUE IESIDENT'IAL NOZONE 1.00 3,600.00 S END OF FEES z EXPIRED Incomplete Inspections Date f�� Sig / CONSTRUCTION AND PLANNING APPROVALS Permit # 11 !Date Inspector POOL & SPA APPROVALS Permit # Date ' Inspector 1. Temporary Electrical Service or Pole 4 52. Pool & Equipment Location l_ 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Urt rgrnd. P 54. Forms 4. Electrical Conduit-Undrgrnd;.�_, 55. Electrical Banding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test _ 9. Water Pipe-Undrgrnd.� I' 60. Backwash Lines, P -Trap, 0 Undrgrnd,------------ r� 1 10. Structural Floor System 61. APPROVAL TO DECK 11, Property Sewer Line & Hodse Connection 62. Backwash & Receptor -Final ' 12. Sewer Cap - 63.' Heater &Ven[ -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing i j 65. Electrical -Final 1 15. Rough Electrical -Conduit ,i 66. Solar System -Final •� 16. Rough Electric Wiring .• 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace - 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil ` 25. Roof Sheathing - 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe .28. Lathing & Siding 77. FIXED SYSTEM FINAL - 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing - ��i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: i 34. Finaf Heating & Air Conditioning 35. Final Gas'Pipe•Test 36. Hood or Canopy i \ 37. Final Factory Fireplace i 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 t E_XR-1_R-ED 45. Sound Attenuation Incomplete Inspections 46. Handicap Regulations y 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 >RddECTADDRESS: UNIT: OWNERr1' NAME: 1792 HAWAII CI ADDRESS: 1792 R AY HAWAII CIRCLE COSTA MESA ARCHIENGINEER: 779-6770 REG.NO.: ADDRESS: UNIT: PERMITTEE: PETERSON ROOFING (714)979-7111 ADDRESS: 3006 ENTERPRISE COSTA MESA CA92628 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter'9 (commen(ing with Sil[lion 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: .. 7945445 607872-39 WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a candidate of Workers' Compensation Insurance. or a certified copy thereof (Section 3804 Lab. Q. POLICY No.: 1021355 EXP. DATE: 04/01/92 COMPANY: STATE FUND n ❑ Certified copy is hereby �burnished. 1 `14 Certified copy is led with the city Building Division. Oa r /( L tApplicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($10() or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature, NOTICE: IL after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ, C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Cotle'. Any city of 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/she Is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my butlevees with wages as their sole compensation, will do the work, and the 11structure is not intended or offered for sale (flection 7044, Business and Professional Cotle'. The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for safe. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a con[ra6tor(s) license pursuant to the Contractors' Stale License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby cenify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that l or any future building occupant will/will not (circle one)need to comply with said state codes and the requirements fora permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date' Applicant: I hereby deputy that I have read this application and State that the above information is correct. l agree to comply with all city and county ordinances and state laws relating to building construction and her y authorize representatives of this city to enter upon the above-mentioned propertyforinspection purposes. Acte l4 -C" 1— Signature: Driver's License or Social Security a: ( 164146 White—Bmldmg: Green—Cotle Enlorcour Canary—Applicant, Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 05546] PERMIT NO: B 055467 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: SIR PURPOSE: ALT JOB DESCRIPTION T/OFF REROOF W/BUILT UP SQ FT: 2,500 CLAIM VALUE: 2,500,00 CALC-VALUE; 2,500.00 GROUP OCC: R-3 / COMMENTS: GARAGE & PART OF HOUSE FLAT AREA ONLY!! Z O N I N G S E T B A C K S R E Q U I R E 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: 00000000 ZNE: REF NO; PLANNING NOTES> UNIT COST TOTAL COST SFR 2500 REROOF BY VALUE RESIDENTIAL > 2,500,00 END OF FEES ###################•-)f########################4f-##%#############ab#####i¢JF-IfK##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 DATE: BUILDING APPROVED BY 4 DATE: APPLICATION ISSUED BY: DATE; a, LEGALIZATION;N F E E S U M W A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54,00 ,50 SMIP/NON-RES PLAN ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 54.50 0.00 0,00 54.50 54.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 54,00 .50 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 SFR 2500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,500,00 END OF FEES .a' CONSTRUCTION AND PLANNING - APPROVALS Permit # Date Inspector , POUL & SPA APPROVALS Permit # Date 1 Inspector �1. Temporary Electrical Service,pr Pole ^ 52. Pool & Equipment Location l� 2. Soil Pipe-Undrgrnd. r -. 53. Steel Reinforcement '7 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, 0 Undrgrnd., Test _ 9. Water Pipe-Undrgrnd. y 60. Backwash Lines, P -Trap, 0 Undrgrnd. ' >1 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House.Connection 62. Backwash & Receptor -Final 12. Sewer Cap 1 _ 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System -Final ` 14. Rough Plumbing t ` 65. Electrical -Final ' 15. Rough Electrical -Conduit 66. -Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating -• 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test - - 72. Underground Flush . 24. Roof Framing 73. "Undergrnd.StorageTank ❑Gas 0011 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 7 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat %"I' 79. FINAL INSPECTION 32. Electrical Power Meter, -Final .80. FOOD CERTIFICATE ISSUED 33. Final Electric ��. 'Notes: -' 34. Final Heating & Air Conditioning.. ? :i 35. Final Gas Pipe -Test ,36. Hood or Canopy 37. FinalFactory Fireplace - �, ''� p 38. Final Plumbing - I, 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 1 l q�A 48. FINAL PLANNING - r._ 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY I No. Date OWNER APOLLO DEVELOPMENT DATE 1-22-70 JOB ADDRESS 17Q? 14a...1 i Cirri n BUILDING PERMIT NO. zt 90� LVI LV It. cCTIONS SOIL GAS WATER ILL 7U ROUGH PLUMBING PROP. SWR. LINE OUSE CON. Le SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING TRENCHES ® FORMS STEEL REIN F. FLOOR SYSTE BOND BEAM STEEL REINFORCE SHEATHING --�� /J FRAME AND FLASHING '\ 7 I. ATHING — IN nl MIT r Date -1T PLASTER, BROWN COAT ,P f-J_T S_ TURAL, FINAL HL... ING, VENT., REFRIG. AND A.C., FINAL r PLUMBING, FINAL AND GAS TEST ELECTRIC. FINAL SUBCONTRACTOR Z . a LWj Z _Z F O rn am J � J � <W M J J m Q UN Z Q W m d W WZ JO mZ J m W Z_ )– w0 N m 70 31292 %Q/tl h `^"2f COSTA MESA BUILDING -SAFETY DEPARTMENT 0�-5°OO 733+ *** 159.75 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 - APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI /,g/t{ DAT F/j'q[�� V D `• / �� DATE ISSUED BUILDING •' 9 /I- / AW_ 70 ADDRESS cL�L�- �lr1iC r- PE71 OWNER Apollo Development Corp. A.P. NO. .j MAIL ADDRESS 1104 E. 17th Street ADDRESNG S/ /� L. CITY Santa Ana NNo. 547-9673 TRACT 6694 LOT 26 BLOCK CONSTRUCTION U. S. National Bank W ADD P LENDER R Main Office OWNER Apollo Development Corp. BRANCH 19O S. Broadway, San Diego Dwelling VALUS 17,700 ADDRESS --� TEL. ARCHITECT ORE NGINEER Kermit DOrlus N 675-1164 USE FIRE T�T ADDRESS 3111 2nd Ave., Corona Del Mar ZONE TYPE GROUP CONTRACTOR Apollo Development Corp. BYPRoveD DATE ADDRESS 1104 E. 17th Street TEL. ZONE NO. OF USE OF NFNy/ CITY Santa Ana No. 547-9673 <- PLANS BUILDING (C•(�/ E 2525STA49 1690 YARDAPPROVED YARDS LIC. . LICyN O. MA NS BUILDING ACCE SORY BUILDING SIZE NO. OF BLOCS. -- 58 101 (FROM C/LS EET) OF LOT X NOW ONLOT FRONT FT. FT. USE OF EXISTING BLDG. --- E FT, FT SIZE OF NO.OF 2100 S.P. 9 2 NEWBLOG. ROOMS STORIES L. SIDE FT. FT. EXTERIOR WALL Per ROOF Shin le COVERING COVERING REAR FT. — FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLOCS. ACCESS. BLOCS. Construct new dwelling with �.U. / gppgOV ED attached garage. APPROVED / I hereby acknowledge that I have read this application and state HOLD FOR SPECIAL REQUIREMENTS that the above informatioO is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of �• SQ. FT.7j the State of California. I hereby certify that I am properly licensed as a contractor and THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION and Professions Cod DivisY3,pierPERMITFEE _ SSignature ofL �//Permittee /V sn00'si S 3i / PLAN CHECK $ Authorized Agent TOTAL FEE $ 1 751–