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Home My WebLink About3539 HOWARD WAY - Building Permitsi� ` 'f p Mf 4 � 0 , _ � J .,�,�,�o �. (714) 754-5273 • Fax (714) 754-4856 r CITY OF COSTA MESA BlIILD/NG DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 77 FAIR ELECTRICAL PERMIT 3539 JobAddress: 354A HOWARD WY Suite No � Vicinity: Parcel Nunmber: 41511218 App�icant: DUNN, MARY Address: 7470 SVL 80X VICTORVILLE, CA �-- Phone: 760-955-6806 Zip: 92392 E98-01157 I �' � Status: ISSUED Applied: 17/03/1998 Issued: 11/03/1998 ,�GK�i �� ic�C : , • �8/9�•�h�� A'�VE Ph Zip. •�9786� K 91.��- Z-S�3S Contraaor: ISLAND CONSTRUCTION & MAINTENANCE � Address: � 7470 SVL-BOX ISSUE FEE Temp service test Res. a/c package New Res (1-2 unit5) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole VICTORVILLE, CA Phone: 760-955-6806 Zip: 92392 License: 667042 SCOPE OF PERMIT REWORK ELECTRICAL W/IN EXIST CONDUIT AND UP-GRADE GAS MONITORING DEVICE TO CURRENT CODE. $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY -- Temp Dist System / Lighting Busway /100 ft � � Standing Section Misc Electrical Equipment Trensformers up�to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw .........'........over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckl � Misa Conduit - Misc.,Conductor ` Circus ( gen or ride) - Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electiical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $16.25 1 $0.00 0 $0.00 0 $o.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 538.25 COMMENTS / SPECIAL CONDITIONS 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 ol t80 days. . INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inapactions and Tinal epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSA710N DECLARATION: � I hereby attirm under penalry of p�ryury one ot the tdlowing deGaretions: ❑ I heve en0 will maintain a cprtitiwta of consent to setl-Insure for workers' compensation, as provided tor by section 3700 of t�e Labor Code, tor ihe peAormence ot t�e work tor which Ihis partnit is issued. � I have flntl vnll mflinlain workers' compensation InSufance, a5 required by Sec[ion 3700 of the Labor Code, tor Ihe pedortnance of ihe work for which thi5 pertnit is issued. My workars' wmpensation Insurence cartier end policy number are: / � ^�� Carrier. S"�AT� r�11� PalicyNumber: � 31�3�o S 5 (This section need nat be comp/e(ed il the permit is velued et one hundred dollers ($100) or less.) �� ❑ I certify that In the peAortnance of the work for which this pertnit is issued, I shall not employ any person in eny manner so as to become subject to the workers' compensation laws of Califqmia, end egree that Ii I 5hou10 becrome subject to the workers' compensation provisions ot Section 3700 of the Lehor Cotle, I shell lorthwith comply with thesa provisions.� o� `\` 3, �� ApplicentSignature: WI\Q1(�^ ��A�tir Data: t� WARNING: FAILURE TO SEWRE WOqKERS' COMPEN ODVERAGE IS UNUWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED THOUSAN� OOl1ARE (S10D,OW), IN ApDfTION TO TME ODST OF COIAPENSATION, DAMAGES AS PROVIDE� FOR IN SECfION 31O60F THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby effirtn that I am Iicensed under Orovisions of Chapter 9(commencing with Section 7000) oi Divislon 3 of Iha Business end Projessiurs Code, and my licensa is in tull torce and enect Uc. a loln'7 O LL.'a. c�ass a C l � Conirectors Signeture: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm Ihat Ihere is e construction lending aganty for t�e.qedortnance of the work tor w�ich this pertnit is issued. (Sec. 3097, Civil Code). Lendefs Name: Signature: OWNER-BUILDER DECLARATIpNS: � Address: Date: I hereby atfirtn that under penalty ot per�ury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor lhe tollowinq reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requires e permit ro conslrucL alter, improve, tlemolish, or �epair any structure, pnor to its issuance, elso requires ihe epplicant for suc� parmlt m illa e signed statamem thet he or she sed pursuant m the provisions oi the Contrectore License Law (Chapter 9(commencing with Section 7000) of Division 3 oi ihe Busineu antl Protessions Code) or that he or xempt therefrom antl the basis tor the elleged exemption. Any violation oi Section 7031.5 by any epplicant tor e pertnit subjecls ihe epplicant to e civ�l penalry ot not more then undred tlollars ($500).): . ❑ I, as owner ot the property, or my employees with wages eir sole wmpensation, WILL DO THE WORK, anC Ihe siructure is no� intentletl or oHeretl tor sale (Sec. 7044, Busineu and Protessions Code: The Contractors Licens w does not appty to an owner oi property who builds or improves theraon, end who tloes such work himself or herseN or through his or her own employees, proWded lha h Improvemenls ere nol intended or ofrereC for sale. If, however, the building or Improvement is sola within one year ot completion, the owner-builder will have the burden roving ihet he or she did not build or improve tor purpose oi sale.). ❑ I, es owner ot the propeny, am E%CLUSIVELV CON7RAC71NG WIT}i LICE D CONTRACTORS ta construct iha project (Sac. 7044, Business end Professions Code: The contractore Licbnse Lew does not epply to an owner ol property who � s or improves thereon, antl who contrects for such project with a contrecror(s) license pursuent to the Contractors License Laws.). ❑ I am exempt untler sec. Business and Professions Code fo 's reason: Signature: Owner ID veritietl Dy dnvers license. ❑ Yes ❑ No Drivers License No. Verification ot Ownership by (ryp@ oi document, i.e. - pmperry taz hill or tleed): DIVISION OF INDUS7RIAL SAFETY PERMR Date: Expires: ❑ I hereby certlly that no e:cavation tive (5) or more teet in dep ' to whlch a person Is requiretl to tlescen7, wlll be metle in connection wii� work euthonzetl Dy this pertnit, end t�et no building structure, scattolding, talsework, or demo � or tlismantling Ihereof, will 6e more than thirry-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Celifornla ACminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertni the Division ol Indusirial Sefery, es noted above, unless such person has e permit to tla such work trom tha division. Signelure: Division ot Industrial Safery Permit Number. Date: CERTIFlCATE OF COMPLIANCE qND AUTHORIZATION OF ENTRY: I certify under penalty ot perjury Ihat I have read this apPlication and state ihat ihe information given is wrrect. I agree,to,comply with all state laws and ciry ordinances relating to builCing wnsiruction, antl authorize representatives of the Ciry ot Costa Mese to enter upon ihe ebove-descnGed properry for inspection purposes. I agree not to occupy or allow occupancy of any building autMnzed by this pe�mit unti! f'inal inspection. GOpE I. INSPECTIOXTYVE �yJ�� 1616 Fixetl System Finel Fire Prevention 1266 Pool Spe Final 200 Final Ra-Root 201 Final BIocWRetaining Well 202 Final Factory Fire Plecb 203 Final Sign 204 Finel Demolition 2666d6 � I�� eooe� ixsvecnoxrrre 206 Final Mechaniwl 208 Final Plumbing 210 Final Elactncal 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy GeiE I[�llS PERMIT TYPE � CITY OF COSTA MESA � BYILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 MECH EX� DA'� � JOB ADDRESS: 3539 HOWARD V Vicinity: SQ. FT: . 0 � � - PERMIT NUMBER: M07-00407 _ �� ` L STATUS: ISSUED DATE ISSUED: 07/O6/2007 , �' �-� ��ISSUED BY: KJB � `.' ` „ :. :_, ,: � - - -.. CM_, - �� ?�Su�ite/Unit e;, � t=_ ;,. _ r , .:li SCOPE OF WORK: 1 CONDENSOR UNIT REPLACEMENT. (CHANGE OUT) ,, '� .1. �� ,wr� n, � . .ff;; r•� ,.7y.: t - :.} OWNER: HOWARD WAY LLC 1 y� i �-,,, Address �ATTN BRADCEY D HOWARD , UnitBURBANK, CA PHONE: ' . City/State2p �,�:-��1819 W OLIVE AVE APPLICANT: ARENAS, ERIK ;�� Address: ��'-^P:O BOX.1017 Umt � _ PHONE: 600-842-2637 , ;= City/Stale/zZip: GARDEN�-GROVE, CA � CONTRACTOR: A AMES PLUMBING HEAT�,;AC - " ':"„ , , -- .'Cicense No �:.; 250307 `�: - - Address: � 9911 LARSONAVEU�nit:�� PHONE:��.�.800-842-2637 . .__ ... _ � : , . �-, : : :._. ....:__ . �..-. - : . . _. .: y p �� 4 `- CELL: 714 530-2440 ;; Cit /State: GARDEN GROVE �CA ' Zi Code: 9264 �� ..�y ._. .. . -__'_ ., . MECHANICAL PERMIT FEE SUMMARY -" `` � 1� MECH ITEM FEE:� ' ' - =��538.20 � ' �� - PLAN CHECK FEE: '� � �.:=,$0.00 "'� � INVESTIGATIONFEE: - ,� �$0001 `ti . � �'r-� -� .�..i= REINSPECTIONFEE: "� M,�j ��$000 � z�o,.,, _��: �;� � �.. „� �. t" `. �`. F . . ... . _ .a �. .. . ::. -.- �� i ' " L -' TOTAL FEES: $38.20 �., : , ..: `.. , ; ,' . ., ';; . r• ', -� / � .. - ', � S �+ ( (� tj: �-�.1< � i, ... ..,� _.� , l a 3.' NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenls under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . - . , . EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all required inspeclions and final approval musl be obtained. Failure to oblain inspections and final approval will result in the expiration of this permit. cODEi, iNsvecnoxrvr¢ � � gelE iximn� �pp� wsveenoNttve � onrg L ixnnn�s 1616 Fixed System Final Fire�Prevention 206 Final Mechanical -a"� � lf �'J �L'\ i 7266 Pool Spa Final 200 Final Re-Roof ' 201 Final Block/ReWining Wall 202 Final Faclory Fire Place 203 FinalSign 204 Final Demolition � 208 Final Plumbing 210 Final Electnwl 212 Final Fire Prevention � 220 • Final Planning ADP�o�al 222 , Final Sile 250 Final BuildingiOccupancy WORKERS' COMPENSATION DECLARATIO� I hereby aKrm untler penalty of perjury one of Ih vnng declarations:' ❑ I have and vnll maintain a certifwte of consent to self-Insure for workers'- compensation, as provided (or by section 3700 of the Labor Code, for the performance of the work for which this permil is issuetl. ' . ave and will maintain workers' compensation insurance, as required by sectbn 3700 of the Labor Code, fw the peAormance of the vrork (or which this permit is issued. My workers' compensation Insurance wrrier and policy �nu becare: �7- 'j� Cartier-� �� l'i� �✓,NY in¢ seUian neeE raf De oon�p/efe� alhe perm4 a valued a1 me hundretl daNan (Sf 00) orless ) �r�YN.�=: aDoc�o 5��- Z�c�—] ❑ I ceAify thal in t e peAormance of the wnrk for which this permit is issued, I shall not e y any person in any manner so as to become subject to the vrorkers' co p nsation laws of Califomia, and agree that if I should bewme su�ject t workers' compensation provisions ot Section 3700 of the Labor Code sh orlhwith comply vrith these provi 'ons. AOGlitanl's'SignaWre OaY ! WAR G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S ($100,000), IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Code, and my license is in full force antl effect. �G� C3� I,ic�� lass . � — �sr -�_ ro _ NSTRUCTI LENDING AGENCY: ❑ I h y affum that there is a constmctbn lending agency for the peAortnance of the v.ork ta v.fiich this permit is issued. (Sec. 3097. Civil Code). Lentler's Name: Lentler's Address: �aie OWNER-BUILDER DECLARATIONS: I hereby a(firtn that untler penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. Business antl Professions Code: Any ciry or county which requires a permi� to consWct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to fle a signed statement that he or she is licensed pursuant to Ihe provisions of the Contrac[ors License Law (Chapter 9(commencing vrith Saction 7000) o( Division 3 0( Ihe Business and Pro(essions Code) or lha[ he or she is ezempt therefrom and the basis tor ihe alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects [he applicant ta a civil penalty of not more [han five hundred Collars ($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 offereG lor sale (Sec. 7044, Business antl Pro(essions Code: The Contrac[ors License Law does nol apply to an owner of property who builds or improves thereon, an0 who does such work himself or herself or through his or her own employees, provided Ihat such improvements are not intended or oHered for sale. If, hov+ever, the building or improvement is sold vrithin one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I, as.ovmer of the property, am EXCLUSIVELY. CONTRACTING WI7H LICENSED CONTRACTORS to construct Ihe project �(Sec. 7044, Business and Professbns Code: The contractors License Law dces not apply to an ovmer of rt wh b'Itl N r n and who contfacts (or such ro'ect with Owner ID verified by dr�se. ❑ Yes ❑ No �� Driver's License No. Expires: Venfication of Ownership by (rype of document, i.e. • property taa hill or deed): DIVISION OFiNDUSTRIAL SAFETV PERMIT CERTIFICATION: • � ❑ I hereby certify that no excavation frve (5) a more feet in depth into wfiich a person is required to descend, will be matle in connection with work authonzed by this permit, and that no builtling structure, scaftdding, (alsework, or demolition or dismantling thereof, will be more Ihan Ihirty-s� (36) (eet high. (Chap. 3.2, Grp 2, Art 2, Sea 347, Title 8, Califomia Administrative Code). ❑ As ovmer-builder, I will not employ anyone to tlo work which would require a permit from the Division of Intlustrial Safety, as noted above, unless such person has a permit lo do such work from the division. Fpplicanfs SignaWre Division of IndusMal Safety Pertnit Numbec HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and ceAify a Business Plan for emergency response to release or threalened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of [he Califomia Health and Sa(ety Code requires, with some exceptions, tha[ a Business Plan be (led with the Cosla Mesa Fire Department by every business which has at any one time during a reported year a quantily ot hazardous materials equal to or greater than a xreight of 500 pounds, or a volume of 55 gallons, or 200 cuhic feet of compressed gas at standard lemperature and pressure). 2. Does or vrill the applicant or present or future building occupant need to file a regislration fortn (or acutely hazardous ma[erials7 ❑ Yes � No (Section 25533 of the Cali(omia 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 quantiry of acutely hazardous materials equal to or greater than a vreight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl temperaNre and pressure). 3. Does or will the applicant or present or future building occupaM need to prepare an RMPP (Risk Management and Prevention Program for awtely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health antl Safery Code pmvides thal the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Departmen[ of an RMPP by businesses which are required to register acutely hazardous malerials with the Fire Department. 4. I( an RMPP is presently required, has Section 25534 0( lhe Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the appliwnt or present or future building occupant require for ihe work which is the subject of this applicalion a permi[ for such conslmc[ion or modification trom the South Coast Air �uality Management District or From any other air polWtion control tlisMc[ or agency? O Yes ❑ No (Section 658502 of ihe Califomia Govemment Cotle require5 that the requested in(ortnation be fumished on applications fa non-residential building pertnits). 6. Will any part of the facility to be constructed under this permil be wilhin 1000 feet (rom the outer boundanes of a school? ❑ Ves ❑ No (If "yes", the faciliry must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. I( a permit from the South Coast Air Qualiry Management DisMct or other air pollution contml district or agency is required for the v+ork which is the subject of this applicatioq have all of the disclosures prescribed by California Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. � Qf "yes", atlach certificate of compliance from the appropnate air polWtion contml oKcer). -�CERTIFICATE OF COMPLIANCE: I certify that under penalty oLperjury the information given above is wrzecL�l agree to comply with all state laws and city ordinances regarding HazardousMaterials and Emissions. � Signature prope y o w s or improves e eo , P 1, CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I a contractor(s) license pursuant to the Con[2ctors License Lav+s.). �ertif under enal[ of e�u that I have read this a lication and state lhat ❑ I am exempt under sec. Business and Pro�essions Code for [his reason: Signalure � � Oale 305]-a6�3/O]) Y P Y P��Y PP the information given is correct I agree to compty with all state laws and city ordinances relating to building wnsWclion, and authonze representatives of [he City of Cos[a Mesa to enter upon the above-described property (or inspection purposes. I agree not to occupy or albw occupancy of any builtling . authorized by Ihis pe � until fnal inspection. Signat e of egal Ovmer�s) �at G�o�fFut�wizeO�ApPliwnl' DM1te� "' � r� M � June 25, 2009 CITY OF COSTA MESA P.O. 80X 1200 • 77 FAIR DR1VE • CAUFORNIA 92628-120D DEVELOPMENTSERVICES DEPARTMENT BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION Howard Way LLC Attn: Bradley D. Howard 9911 Larson Avenue Garden Grove, CA 92644 PERMIT NUMBERS: PROJECT FOR: M07-00407 3539 Howard Way, Costa Mesa, CA Replace Condensor Unit Our records indicate the above listed permit(s) were obtained for propeRy improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days trom the date of such permit, or the date of the last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on July 6, 2009. Additional fees will be required to finalize expired permits. Requesting an insaection—If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. Requestina an extension—If you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-4871, between 8:00 a.m. and 430 p.m., and a staff member will assist you. The accuracy of records affecting your property is our goai and we appreciate your working with us to resolve this matter. Sincerely, ��Barbara J. wart OffiCe Specialist II cc: Aames Plumbing Heat, AC Builtling Division Q14) 754-5273 • Cotle Enforcement Q14) 754-5623 • Planning Division p14) 754-5245 FAXpt4�754-a856 • TDDp�a)754-52a4 • www.ci.wsta-mesaca.us f ; ! (774) 754-5273 • Fau (714) 754-4856 • wv+w.ci.costa•mesa.��LDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 ,lob Address: 3539 HOWARD WY Suite: Vicinity: Parcel Number: 41511213 Applicant: YOUNG CHO Address: 28345 N AGAJANIAN DR , �." SANTA CLARITA, CA � owner: HON/AiZD WAY LLC Address � ATTN: BRADLEY D HOWARD - ' � BURBANK, CA �� . �. _ ' - . 1819 W OLIVE AVE - Contractor. K H CONSTRUCTION Address: 5320 N BARCUS FRESNO,CA Zip: 93722 Zoning: MP MP Phone: 661-263-7041 Zip; 97390 Phone: Zip: 91506-2435 Phone: 559-277-0700 : License: 750819 , , Status: ISSUED Applied: 10/22/2003 Issued: 12/29/2003 � �� . �. � � � � � , �, • � �A� � V� �/' /� .��A � ,�� % '. � nrch : RICHARD SINNARD' - ' Eng: Address: 250 $ COLIEGE DR - � � _ Address: � � . , � - ' ' " . ` Phone: 801-860-0116 . � � , , .Phone: , . " SAIT LAKE CITY � . � '� Zip: 82702 ' , ' License: C26709 � License: � ' ' — - � �; . � SCOPE OF FERMIT � •- • , � � ' ADD 160 LF. OF CONCRETE MASONRY.UNIT WALLS AT�TRUCK WASH BAY AND INSTALL.NEW ROOF ACCESS LADDER AND HATCH FOR ` "RYDER" . . . . , � . � � . FEESUMMARY Plan Check: ` - Permit: SMIP Res: SMIP Com' Other: Inspection: Total: $937.14 $1,441.75 $0.00 $37.80 $0.00 $0.00 $2,416.69�� SETBACKS MAIN STRUCTURE Front 0-0 ACCESSORY Front� 0-0 PARKING Existinq: o . Calc Valuation. Siao,000.00 Claim Valuation: S�ao,000.00 • � . _ ✓_:. ,� - . . . ;,., ,�� - ' ' ; , - , r, -. : ., PLANNING & ZONING � ' Rear 0- 0 Rear 0-0 Left 0- 0 Left 0- 0 Required: 0 . Pfoposed: - 0 Right,� 0.0: ,�� - Right 0-0 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This pbrmit shail aufomaticalty expire and become void if work is not commenced within iB0 days, or if work is suspended or abandoned for a period of 180 dayS. INSPECTIONS: In ortler for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetions end final approval must be obtained. Failure to obtain inspections and final approval will result in �he expiration of �his pertni�. POR INSPECTIONS CpLL: (714) 7545626 2448d8 (8/00) WORKERS' COMPENSATION DECLARA710N: � � � I hereby eMirtn under penalry oi perjury one oi the following declarations: ❑ I have entl will maintain a certiticate of consem to self-Insure tor workers' compensation, es providad for by sedion 3700 of the LaDor Cotle, for the performence of the �work for which this permit Is issued. I have antl wiil maintein workers' compensaGon insurence, as required by section 3700 of the Labor Code, for the peAortnanca oi Iha work tor which this pertnit is Issuetl. My workers' compensaUon surance carder antl policy number are: ��( I Cartier: � Ti�/� � PolicyNumber. lV�f"¢66¢-2003 (lhis section need not be completed il the Oertnif Is veluetl at one hundred dollars ($100) ar /ess.J ❑ I ceniy that in Ihe pertortnance oi the work for which ihis permit is iuued, I shall not employ any person in any manner so es to �ewme subject to the workers' wmpensation laws oi Califomia, entl agre at If I shoultl become suDject to the workers' compensation provisions of Sectlo 3700 1 the La6or Code, I shell fort�with complywithihe Nsiong. Applicant Sionetur� A� Date: Z 7 B WAfiNING: FAILURE O SE W KERS' COlAPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMI PENAL ES AND GVIL FlNES UP TOONE MUNDRED hKK15lWD ,000), NDDRIONTOTHEC0.STOFCOMPENSATION,DAM4GESASPROVIDEDFORINSECTION3lWOFTHE ORCO E,IMEREST,ANDATfORNE1^SFEES. LICENSE� CONTRACTORS DECLAFiATON: I hereby eflirm Ihat I am licensed unde pmvisic rorce antl ettea. Lic. xp� Contractols Signaw/�i J CONSTRUCTION LENDING AGENCV: of Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Cotle, and my license is in iull Class a Date: / 2 �} ❑ I �ereby eHirtn that ihere is a construction lentling agency tor ihe pedormance of ihe work for which ihis permit is issuad. (Sec. 3097, Civil Code). Lendefs Name: LentleYs Adtlress: SignaWre: OWNER-BUILDER DECLARATONS: Date: I hereby atfirtn thet under penelry ol perjury thal I em EXEMPT FROM THE COMRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business antl Protessions Code: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair eny siructure, prior to its issuance, also requires the applicant tor such pertnit to tlle a signed atatement thet he or she is Ilcensed pursuant b Ihe provisions ot ihe Contractors License Ww (ChaD�er 9(commencing with Sectlon 7000) of Division 3 of the Business end Professions Cotle) or ihat he or she is e:empt therefrom and ihe basis for the ellegetl eaemption. Any violetion of Section 7031.5 by eny applicant for e pertnit subjects Ihe applicant to e civil penalry ol not more than five hundred dollars ($500).): ❑ I, es owner of t�e property, or my employees with wages es their sole compensation, WILL DO THE WORK, and the structure is not Intended or oHeretl for sala (Sec. 7044, Business and Professions Code: The Conirectors License Law does not apply to an owner of properry who builds or improves thereon, antl who does such work himself or herself or ihrough his or �er own employees, pmvided ihat such improvements ere not Intentletl or ofteretl for sale. tl, however, the building or improvement is so10 wi�hin one year ot wmpletion, the owner-builtler will have t�e burden ot proving that ha or she did not bui10 or improve tor purpose oi sale.). ' ❑ I, es owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The comractors License Lew does not appty to an awnar ol properry who builds or Impmves thereon, entl who coniracts tor such projea with a contrector(s) license pursuant to the Contractors License Laws.). ❑ I am e:empt under sec. Business and Professions Code lor this reason: Slgnaiure: Dale: Owner ID venfied by driver511cense. ❑ Y85 ❑ No Drivefs License No. Expires: Vedficetion af Ownership by (rype ol documem, I.e. - properry tau bill ar deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certity that no excavatlon tive (5) or mora teet in depth into which a person is required to descend, will be made in connection with work euthodzed by this pertnit, and that no building swcWre, scaflolding, talsework, or demolition or tlismantling thereof, will be more then thirty-si: (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Callfomie Adminisiretive Code�. ❑ As owner-builtler, 1 will not employ enyone to tlo work w�ich would require a permit from the Division of Industnal Sefery, es noted above, unless such person hes e permit ta do such work tram the division. Sipnature: Deta: Division of Indusirial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUiHORVA710N OF ENTRY: I certify under penalry ot perjury ihat I heve reatl �his epplication and stata that the infortnation given is correct. I egree to wmply with ell stete laws end ciry ordinances relating to builtling consWction, end euthorize representatives of Ihe Ciry ol Costa Mesa to enrer upon Ihe above-tlescnbed properly for inspection purpases. I egree not to occupy or allow occupancy of any building authonzed by this pertnii until tinal inspection. CQOE �. INSPECTONlYB! 1618 Fixed System Final Fire Prevention 1288 Pool Spe Final 200 Finel Re-Roof 207 FIne181ocWRelaining Wall 202 Final Fectory Fire Place Qa¢, f�$ �QQ�( INSPECTIONTYVE 206 Final Methanical 208 210 212 220 Final Plumbing Final Electncal Final Fire Prevention Final Planning Approval 203 Flnel Sign 222 Finel Sita 20E Final Demolition � 250 Final Building/Occupanty . . , %�� KH•CONSTRUCTION December 19, 2003 City of Costa Mesa Development Services Department Building and Safety Division P.O. Box 1200 Costa Mesa, California 92628 RE: Ryder Transportation Washbay Alterations — Costa Mesa Facility � This letter is to serve as authorization for CSHQA and their representatives to pull Construction Permits on behalf of KH Construction. Sincerely, KH Construction L/ � Dennis Prieto Project Manager CC: Jobfile #3843 NH•CONSTRdCT10N, a NEVOCAL Enterprises, Ine. campany r��:�:: eo. 750819 • 5310 North Barcus • Fresno, (alifornia 93R2 • iel (559) 211-0100 • fa� (SS9) 717-1410 • E-mail eta((C�cdi-kh.cam REPORT # CONTR. JOB # �� IIS��O� �c °� � SPECIAL DEPUTYINSPECTORS OBSERVATION REPORT Building Permit No. �p.�.Dl}� �{a-- Permit Date: Project Name/Address: Ri.y�� (�� Structural Engineer/Addres�_ S General Contractor/Address: ��Ei L'O�S 1'� Sub Contractor/Address: �} (�u-i A bpVr= TESTS MADE: C) D X '�t I APPROVED MIX DESIGN#: R ELECTRODE: Date of I of Building & Safety - City of: l'nSIG( /�GS? , �`-TYPE OF INSPECTIO : ❑Welding ❑Hi-Tensile Bolting ❑Reinfo!ced Concrete � OFireproofing lasonry DAnchors ❑Epo�cy ❑NDT ❑Other: Off-Site Fabricator Atldress: �IIS ection Summar • Location of Work, Detail & P Y� . Material Description - Type CERTIFICATE OF COMPLIANCE I hereby certity that I have inspected to the best of my knowledge, with the information provided, all of the above reported work unless otherwise noted. I have found this work to comply with the approved plans, specifications, and applic�ble sections of the governing building code. Registered Deputy Building Inspector's Certificate Signed by �d� r�,- Certification # ��aGi �t7-� 4 Type � 1i✓ DATE: HOUR � Inspectors Name: (Please Print) �IO IQ�rt dQ �Q, i�� NUMBER OF SAMPLES TAKEN: CONCRETE DENSITY PRISMS MORTAR GROUT LAB & HOURS SUMMqRY: REGULAR TIME HRS. PREMIUM TIME HRS. NDT HRS. All inspection is based on a 4 hour minimum, over 4 hours is an 8 hour minimum. In addition, any inspection erztending past noon will be an 8 hour minimum. All lab work necessary to complete inspections will be paid by owner, engineer or contractor. 4 hour minimum charge for jobs canceled without notification. Final reports shall be filed with the local building department on receipt ot final payment In recognition of the relative nsks of the Cliem and Metro Inspection on ihe project, Client agrees, to the extent per e by�Iaw, at etro Inspections liabiliry to the Client, in any way arising out of this agreement, shall be limited to 100% of ihe total fees and cost paid for that spe rfi o ac t tro nspection or $1,000.00. Whichever is greater. No warranry, expressed or implied is made by Metro Inspection Service, Inc. i\ Approved By: � Company: �� S�R�v�.Tlo.� TEflMS: DUE UPON HECEIPT� A lata charge o/ onc �al/ pertem Q 1@%) per mon��, p0%) per ennum) will be chargetl on the unpaitl balance hom �he da�e a� �ha invoica if paymant is no� receivetl in 9cwrtlance with the �erms harein. Should I( become necessary to enforce [he tarms 0� �his invoice, �easonable atlomeys fees antl cost s�all ba awartled �o Ihe p�evailin8 party. WHITE - Building Dept. CANARY/PINK - Office GOLDENROD - Job Site (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: $S�9 HOWARD WY Suite No Vicinity: Parcel Number: 41511213 Applicant: ROBERT GEBHARDT Address: 991y LARSONAVE GARDEN GROVE, CA MECHANICAL PERMIT Phone: 714-530-2440 � Zip: 92644 " Owner,,' HOWARD WAY,LLC ' - " _ _ ' Address: ' ATfN: BRADLEY D HOWARD- --� � Contrador. r �,Address: "�BURBANK,CA �� 181g W OLIVE AVE- AANIES PLUMBING, HEAT, AC 9911 LARSON AVE �, , � GARDEN GROVE, CA REPLACE HEAT.PUMP,IN SAME . � Quantity ISSUEFEE $23.50�., . - Inst FAU <100 k BTU $0.00 0 �� Inst FAU >100 k BTU $0.00 � 0 -� Repair I All Cooling/Heat $0.00 0 Inst / Rep. Recess Wall Htr $0.00 0 Re(rig Sys <100 k BTU $0.00 0'�. Refrig Sys >700 k BTU $0.00 . .0_ _ ,_ � Gas Piping $0.00 �..0 Factory Fireplace $0.00 0 Hood w/Mech Exhaust $0.00 0 VAV Box � � $0.00 0 Vent Fan FSingle Duct � $0.00 0 Appliance'. �. � � $0.00 0 Fire Dampers � � $0.00 0 Smoke Dampers ' ? $0.00 0 , Inst or Relocale Appl Vent �'. �, - $0.00 0 � �, _ Air Handlers < 10000c(m ,$0.00 t 0�-" - Air Handlers�.>`>�10000dm � "� �$0.00�- b� �`- Floor Furnece-;: , i�j- � \$0.00�" 0 , Floor or Suspedii Heatei, - , $0,00 _`.0' .. .� . , .' �, �- . � , Phone: Zip: 91506-2435 Phone: 714-530-2440 Zip: 92644 License: 250307 � - FEE SUMMARY Status: ISSUED Applied: 01/23/2006 Issued: Ot123/2006 �. Repair/AltAbsorbtionUnit - ,Repai[/AltRefrigerationUnit Ventillation System � Evaporative Cooler Commercia l I nci n e rator Domestic Incinerator ComDressors / Absomtion Svstems � Upto3hp/100kBTU 3 To'15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU .30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU " Boilers Upto3hp 3ToJ5hp -.15 to 30 hp. - �� 30 to 50 hp: � .. , � Over 50 hp � - ' ' � . ; . Other Mechanical Fee- � � Investigation Fee . , , Plan Check Fee Reinspeclion Fee TOTAL CALCULATED FEES Quantity $0:00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 � $0.00 0 $0.00 0 $0.00 0 $0.00 $27.15 $0.00 ` $0.00 � $0.00 � � $0.00 $0.00 $0.00 $50.65 ' � COMMENTS I SPECIAL CONDITIONS 0 1 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendetl or abandonetl for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectlona and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 [aaera lwuo� WORKERS'COMVBNSAnON DECLARAnON: � . � I hereby eflirm undar panalry of perjury one oi Ihe lollowing declarations: . , . ❑ 1 have end will maintain a cenificate of consent to selt-Insure for workers' compensation, as providetl for by section 3700 of the Lebor Code, tor Ihe pertormence oi the work tor which �his permit is issuetl. � I:�na wlll rt�intain workere' compensation insurence, as required by section 3700 of the Labor Cotle, for Ihe peAortnance ot the work for which thiS pertnit is issued. �workers' comp9nsatUm Insuraace carnu and oolicv num6er are: � �� u�� P�alioy NumDer: ` or /ess.) ❑ I certity that in t�e Dertortnanca oi the work lor which this Dertnit is issued, 1 5hall not employ any peroon in any manner so as to become subject to the workers' compensation laws ot Celifomia, antl agree Ihet i shoultl hecome subject to Ihe workers' compensation provisions of Section 3700 of the Le6or Code, I shell totlhwith comply with these provisio . ( /'� ��naWre: � : ae: (��`Y� �.'.y� �__ W FRICVRETO SECURE WOPKERS' COMP � ON COVEflAGE IS UNLAWF M1D SHALL SUBJECT AN EM ER TA O R IwLL PENALTIES AND CIVIL FlNE$ lIP TOONE HUNDRED SANDDOLL4RE(5100.0OO�,INADDIilONTO COuTOFfAMPENSATIqJ,DAMAGE5A5PROVI�EDFORINSECTION3lO60FTHELABORCODE,IMEREST,ANDATTORNEY'SFEES. UCENSED CON7RACTORS DECLARATION: of Chapter 9(commencing with Section 7000) of Division 3 of and my license is in full CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirm (hat thera is a consiruction lending agency for Ihe peAormance ol ihe work for which t�is permit is issued. (Sec. 3097, Civil Cotle�. Lendels Name: Lender's Adtlress: Signature: OWNER-BUILDER DECLARATIONS: oate: I hereby etfirtn Ihat untler Denelry of perjury that I am E%EMPT FROM THE CON7RACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professions Code: Any dry or coUnry which requiras a pertnit to co�struct, aiter, imprwa, demolish, or repair eny struclure, prior ro its Issuance, also requires t�e applicant ior such pertnit to file a signed stetement that he or she is licensetl pursuant to Ihe provisions ol the Contractors License Law (Chepter 9(commencing with Section 7000) of Division 3 of the Business end Prolessions Cotle) or that he or she is exempt iherefrom and the basis lor the alle9ed exemption. Any violation oi Section 7031.5 by eny applicent for e permit subjecis �he epplicanl to e civil penalry of not more than tive hundred dollars (5500).): � I, es owner ot tpe properry, or my employees with waqes as Iheir sola compensation, WILL DO THE WORK, entl ihe structure is not intentled or oXered tor sale (Sec. 7044, Business and Professions Code: The Conlractors License Law dces not apO�Y �o an owner ot properry who builtls or improves thereon, and who does such work himsell or hers9N or through his or her own emplayees, Drovided Ihat such improvements are not intendetl or oflered for sale. If, however, ihe buildin9 or improvement is wld wi�hin one year ot wmpletion, ihe owner�builtler will heve ihe burden of proving that �e or she did not Guild or improve for purpose ot sale.). � ❑ I, as owner of tne property, am E%CLUSIVELY CONTRACTNG WITM LICENSED CONTRACTORS to conslruct Ihe project (Sec. 7044, Business and Professions COEe: The com�actors License Law does not apply to an owner of properry who builds or Improves iheraoq antl who coniracts for such project with a coniractor(s) license pursuan� to the Contraciors License Laws.). ❑ I am exempt untler sec. Business antl Professions Code tor this reason: Signawre: Data: Owner ID venfied by G��er's license. ❑ Yes ❑ No Oriver's License No. Ventication ot OwnerS��p by (type of tlocument, i.e. - pwperty tax bill or deetl): DIVISION OF INDUSTRIAL SAFEN PERMI7 CERTIFICATION: Expires: ❑ I hereby cenity lhat no excavation tive (5) or more feat in depth into which a pereon is required to tlescentl, will be matle in connection with work euthonzed by t�is permiL and that no building swcwre, sraflolding, falsework, or tlemolition or dismantling thereot, will be more ihan thirty-siz (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title B, Califomia Administretive Cotle). ❑ As ownerDuild�r, I will not employ anyone to do work which would require a parmit from lhe Division of Indusirial Safety, as noted above, unless such person has e pertnit to tlo suc� work tmm the division. Signature: Date: Division ol Indusirial 5afery Permit Number: CEHTIFlCATE OF COMPLIANCE AND AUTMORIZA710N OF ENiRY: I certify untler penalry ot perjury ihat I have read �his appliwtion antl siate Ihat Ihe infortnation given is correct I agree to cor�ply with all sta�e laws antl ciry ordinances relating to builtling constmction, and authorize representatives of ihe Cily of Costa Mesa to enter upon t�e above-describetl propdhy Sor inspection purposes. I agree fwt to occupy or allow occupancy of any building authorixed by lhis permit uMiV tinel inspection. COOE t. INSPECTIONTYPE Q1iL �NTRIALS 1816 Fixea System Final Fire Prevention� 1266 200 201 202 203 204 Pool Spa Fina� Fin01 Re-Rod Final Block/Retaining Wall Final Factory Fire Place Final Sign Final Demolition COOE� INSVECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �1111. '. � � '�l\� 0 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: Suite: Viciniry: 3539 HOWARD WY OVER FUEL PUMPS Parcel Number: 41511213 Applicant: PERRAULT, TOM Address: Owner: Address Contractor: Address: Arch : Address: Zip: i'/"� f� � , HOWARD-WAY.LLC ,ATTN: BRADLEY D HOWARD BURBANK,CA "�� '1819 W OLIVE AVE �_r.� BONSALL,PETROLEUM P 0 BOX 969 � � BONSALL,CA Zip: 92006 � -, Phone: .-� License: Zaning: MP MP ISSUED BY: Status: ISSUED Applied: 02/01/2002 Issued: 04/09/2002 Phone: 760-631-0342-� ^ ' '� � Zip; � � r _ '�,\ � \ �/ \ , ' :��.�. . - -� _ .�� Phone: - . �.- "`� � Zip: 91506-2435 - ;. �'� . '� �'V' �� _, , , �/ �� `. �-' � ��'. . . AV�, j / ��. �, � � . / � -' � `. Phone: 760-631-0342 ^;�,A . �. �\ .,. � , .\\ "��,\ License: 682742 - - - �� : A�`�, �' � �� '' � �� , � :� , � - � i �' � •, Eng:• CHARLES MOSS/FREY=MOSS STRUCTURES , Address:`,-�1801 ROCKDALE INDUSTRIAC`BL ' � � _ ." � � ; ij�, Phone: 770-483-7543 CONYERS,GA%;`�." �V'� ; � � �. 30072 License: C49458 � '� �\ , , . .... . . n,.y,_. . Jl �� INSTALL NEW 1724SF CANOPY.OVER EXISTING FUEL ` Plan Check: Permit: ;, SMIP�Res: SMIP Com: Other: Inspection: ��=Total: F'tKMll.�, y.,,.,-. . � _ .�..�.,.._. � � FEE SUMMARY , � �. ; �- , '� $254.31 �- �'��-�- Calc Valuation: %'; � .'_ S25,000.00 � $39125 — � � �- -, % � � � � `Claim Valuation: ; -,`.�,� �. $25,000.00�� $0.00 � , � ,'-�,r <- � $5.25 !i>'. _ _ $0.00 ' ., o.; � _ , . . $0.00 �� j � � � i. � � - $650:81 � _ , � fi/ � : �A. . �io-,.. C_ " � . ��(i_ 4 � . - , .�� , 'i �� SETBACKS�� MAIN STRUCTURE Front '0= 0 , � Rear 0- 0 ACCESSORY Front 0- 0. ,� � Rear 0- 0 PARKING Existinq: o.; Required: o � NOTES: '�, '-_ NG&ZONING �,%" ��,�, i;.': � � ) ' % ; �' �/ \% , Left � 0-0-' � .��Right-:,'�0-0�> �� '�� ' / .� Left 0- 0 • Right, ,.0- 0' �� Proposed�- 0 � �� -i _— ;� __ . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abantloned for a period of 180 days. INSPECTIONS: �n order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable Codes, and all required Inspactlons and 11na1 approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 7545626 2446d6(N00) WORKERS' COMPENSATION DECLARATION: I hereby ettirm untler penalry oi perjury one ol the follor.ing declaretians: - � � , , I he antl will malntein a certiticete ot wnsent to sel4lnsure for workers' compensation, as provitled for by section 3700 ot iha Labor Code, for tha pertortnance oi the far which this permit is issued. I have entl will maintain orkers' com on insuran required by section 3700 of ihe Labor Code, for Ihe peAortnanca of Ne work for which Nis pefmit is issu My workere' comp§r(sati s cerrl end policy�ber are: � – •�� v Cartier. Policy Numbec (This sectlon n�comp/etetl i! (he pemJt is velued et one hundred ddlars ($f 00) or Ie55J ❑ I certify Ihat in Ihe pertorm oi the wolK for which this pertnit is issuetl, I shall not employ any person in eny manner so as to becoma suDject to tha workers' compensation laws o itomi and egre�+ �hn� �� I should become subiect to the workers' compensation provisions oi Section 3700 Ihe r Cotle, I shell forihwit� comply with the5e ovision -' a�'• -./ v�/1� Applicent Signature: Ri' �' U�-°�� __ Date: �� — _� / c WAPNING: FAILURE TO URE W RKERS' COMPENSATIIXJ WVERAGE IS UNLAW F�� AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO IXJE HUNDRED THOUSAND DOl1ARE (5100.000�. IN ADOITION TO THE COST OF COMPENSATION, OAMAGES 0.S PROVIDE� FOR IN SECTION 3�0fi OF iHE LABOR CODE, INiEflEST, AND ATTORNEI^$ FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm �hat I am licensee+ptler pmv' ion o Ch t r mencing with Section 7000) of Division 3 ot the Business and ProfeS�� s Code, and my license Is In full torce end ettect. Lic. a � A Class x /�1 Conirectofs SignaWre: � Llv�_, Date: CONSTRUC710N LENDING AGENCV: ❑ I hareby ettirtn that there is e wnstruction lentling agency for Ihe pertormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). lendei 5 Name: Lende(5 Address: SignaNre: � Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn that under penelry of perlury Ihet I am E%EMPT FROM 7HE CON7RAC70qS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professions Cotla: Any ciry or counry which requires a permit to wnstruct, alter, improve, tlemolish, or repair any siructure, prior to its issuance, also requires ihe applicant for such pertnil to file e signed statement thet he or sha is licensed pursuant to the provislons of the Contrectors License Lew (ChaO�er 9(commencing wiih Sectlon 7000) of Dlvision 3 of Ihe Business end Prafessians Code) or Ihat he or she is exempt therelrom and the basis for the allegetl evempiion. Any violation of Sedian 7031.5 by eny epplicant for e pertnit sublecis Ihe applicant to a civil penalry ot not more ihan five hundred dollars ($500).): ❑ I, es owner of Ihe proparty, or my employeas with wages as their sole compensation, WILL DO TIiE WORK, entl the sWcture Is not intentled or oHered for sale (Sec. 7044, Business antl Professions Code: Tha Contractors License Law dces not apply to an owner of properry who huilds or improves thereon, and who does such work himself or hersetl or through his or her own employees, providad Ihai such improvemenis ere not intended or oHered for sele. It, however, ihe building or improvement is soltl within one year ot completion, the owner-builder will have ihe burden ol proving Ihat he or she did not build or improve tor purpose of sale.). � ❑ I, es owner of the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Prolessions Cotle: The conirectors License Law tloes not apply to en owner ot propeny who bulltls or Improves ihereon, end who contracts tor such project with e contrector(s) licensa pursuant to ihe Contractors License Laws.). ❑ I em exempt under sec. Business and Professions Cotle for this reason: Signature: Date: Owner ID verified by dnvefs license. ❑ Yes ❑ No DnveYs License No. Eapires: Vedficailon ol Ownership by (rype ot tlocument, i.e. - property ta�c bill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: � I hereby certify thet no exwvetion five (5) or more feet in depth into which a person is requiretl to tlescend, will be made in connection wit� work euthodzed by t�is permit, and that no builCing structure, scaHdding, lalsework, or demolition or dismantling thereoi, will be more ihan �hirty-six (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Ttle B, Calitomia Adminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which would require e pertnit from the Division of Intlustriel Satery, as noted above, unless such person has e pertnit to da such work irom ihe division. SignaWre: Date: Division ot Industrial Sefety Pertnit Number: CERTiFlCATE OF COMPLJANCE ANO AUTHORVJ1T10N OF ENTAY: I certiy under penalry ol pe�ury that I have read ihis apD��on and stete tha� Ihe intortnetlon given is correct I egree to compty wlth all state laws end ciry ortlinances releting to building construction, antl authonze representatives of the Ciry of Casta Mesa to enter upon the ebove-descn6�dproperty tor inspection purposes. I agree not lo occupy or allow occupancy oi eny building authonzed 6y this permit until final ins0ection. GOOE 1. INSFEttIONTYPE QAIE IIi�LS 1618 Fixed System Final Fire Prevention 1288 Pool Spe Final 200 Finel Re-Rooi 207 Flnel Block/Retaining Wall 202 Final Fectory Fire Place 203 200 Final Sign Final Damolition � `7� %%��'C__._ Date COOE� INSPECTIONTYPE 206 Final Mechaniwl 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Plenning Approval 222 Final Site 250 Final BuiltlingiOccupency ��7\I JIII. saa-� S"NT 9V: BONSALL PETROLEUM CONST"'iCTION,; 760 631 0526; JAN-?^ '9 4:5BP�A; � PAQE 2/2 • - CITY "'° COSTA MESA, BUILD}NG SAFETY' _.SION � POSi IN Cb�`NSPICUOUS PLACE�`bPi THE JOB N0710E Schedule inspectlon one workday in advance. To schedule inspections, ca�l (714) 754•5626. Provide the following information: 1 � Permit number, 2) JOb adtlress, 3) InsDection item number, 4) Day and dete you need ihe inspedion. . . i � ewa�v�cx: l- IOCJ E�.iae�aa,� L-(,U co�v�nor. wu. Mcchaniral Pemul lY PlumAing Pertnit � Job De9cripllon �_ �_ � f n i�� ..�ti �1 Type: G�oup: �!�.��j Plan CMCc No. �Ssue Date: �-�' LS '--'� �•~"' ' � NEW ALiLR REGAIR MOVING DEAIOLISH PCRMITS EXPIRE 180 DAYS (6 MONTMS) FROM ISSUE OR LAST INSPECTION __ . . ... ._.. • • '• pemU STRUCTURAL Dace � h�mR POOI&SPA O�e Inspecwr 4 FooNngs L L 94 Pool & Equipment Location 6 Slab 96 Steel Reinforcement 8 Strucfural Floor 100 Electricat Bonding 7 7 Pre-lnspecf Root 102 Roug� Plumb & Pressure 7eat 12 Root Sheathing 104 Approval to Covflr - �unite 14 T-BarCeiling-Strudurel 106 ElecConduit-Underground 16 Shear Panel 108 Gas PipeNnderground Tesl 18 Frame 8 Flashing 110 88ckwesh line5, P-Trap, 20 Lathing 8 Siding Underground 22 Insulation 112 Approval to Deck 24 Drywall Nafling 176 Pool Plumbing System - Final I 26 Plaster Brown Coat 118 Pool Electncal - Final 30 pre-Grout 122 Fencing/AooesslNarms Approval 33 Disabled Aaess 124 Approval for Plastering f,� / 126 Pool/Spa Systems • Final � � 6Z csDe_ �o / 6 L ' f� f c � �� ' � '• e— l q B (f, - 161D Overhd HydrolOverhd Rough 1612 Dry Chemical 1614 Ory Standpipe j ELECTRICAI 1616 Final - Fixed System �� '�� 36 Ufer Ground 39 ElecConduit-Underground • 4a Rough Eiec • Wiring CaU (714) 7545626 for the following: oam m.�e�or 46 Rough Elec. Conduit 200 Final Re-Roof 48 Elec T-Bar Ceiling 201 final Blak/Rafeining Wall 50 ElecPowerFinal 203 finalSign 51 Temp Power Final 204 Final Demolition 206 Final Mechanical 208 Final Plumbing 210 final Elecfrical Q PLUMBMG & MECHANICAL Ca (714) 327-7400 for ihe following: Date Impector 52 Soil Pipe - Unaergrouna 212 Final Fke Prevenuon 54 Water Pipe - Undergroun0 Call (114) 754-5335 for tha lollowing: Da+e naoenor 55 Underground Gas 214 Final Transportalion Svs. 62 Rough Plumbing Call (714) 750.5671 forthe following: oa� �nsp�aor 64 Rough Mechanical 216 Final Engineering Approval 66 Rough - Fad«y Fireplace Call (71d) T545307 forthe followinp: o�n mipenor 6B Sewer System 27B Final CMSD Approval 72 �as Pipe - Rouah Test Call �714) 750-5245 for Me following: Dau Imp�Mr 90 Gas Pipe Test- Final 220 Final Planning Approval � 92 Walci 6c+ricc - Flnol Call (774) 75456i6 Nf the follOwingt aw in�p�aor 222 Final Site NOTES: SEE REVERSE 50 inal BuilainglOccupancy 9:i5i-OB �rov a.�+-) January 28, 2003 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT Howard Way LLC 1819 W. Olive Ave. Burbank, CA 91506 PERMIT NUMBER (S): FOR: PROJECT ADDRESS: BUILDING DIVISION NOTICE OF PERMIT EXPIRATION 602-00160 Canopy over fuel pumps 3539 Howard Way, Costa Mesa Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project and additional fees may be required to finalize expired permits. According to our records, the permit(s) listed above have not had an inspection for a period exceeding 180 days. If you have a signed inspection card indicating an inspection was conducted within 180 days from the date of this letter, please contact this office so we may correct our records. A time extension may be granted if you intend to commence work and complete the project. Requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you need to request an inspection please call our Inspection Request Line at 714.754.5626. If you do not contact this office within 10 days, your permits will expire on February 12, 2003. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, %��%� Mary Jane Weidenkeller Office Specialist II cc: Bonsail Petroleum P. O. Box 969 Bonsall, CA 92006 Building Division (714) 754-5273 • Cotle Enforcement (714) 754-5623 • Plenning Division (71a) 7545245 FAX (714) 75a-4856 • TDO (714) 754-5244 . www.d.costa-mese.ce.us PropeRy Profile Property Profile ' � 2003 DulaQuick CnCortnution Sys�ems This iNbrma[ion is compled from public dncuments anA is not guamn[ecd. Property Characteristics [3edrooms: Dathrooms: Total Rooms: Zoning: Heating/Cooling: Sale Bc Loa�a bafor�xatiou Transfer Date: 07-25-2000 Transfer Value: First Loan AmC Loan Type: Primarv Owner: HOWARD WAY LLC Sccondary Owncr: Mail Address: 1819 W OLIVE AVE BURBANK, CA 91506 Site Address: 3539 HOWARD WAY COSTA MESA, CA 92626 Telephone Number: APN: 415-112-13 Reference APN: Census'1'ract 639.079 Housing'1'ract Number: 155 Lot Numbcr: 16 Page Grid Old: 27-C2 Yage Grid New: 858-H3 Legal llescription: P BK 155 PG 11 PAR 16 Subdivision: Year Built 1981 Garage: Fireplace: PooUView: Seller: Cost/Sq Feet: $0.00 Lender. Interest Rate Type: Assessed & Tar lnfOY/)1q11011 Assessed Value: $1,058,659 Land Value: $151,177 Improvement Value: $907,482 Percent ImprovemenC SSJ2 'Pax Amount: $11,350 Tax Status:current Square Feet 12,623 Lo[ Size: Number of Units: Use Code: Industrial Miscellaneous Document 0000387�76 _ -- Title Co.: Last Trans W/O�: Last Trans W/O$ Doc: Homeowner Exemp[ion: Tax Ratc Area: 15052 [ Rep_o_rt Menu ] [ Select New Ta�e_t_Property ] Page 1 of 1 http://www.gotitle.com/cgi-bin/profi le.asp?rmt=TOPS&graphic=%2Faccounts%2FT07378%2Fcompan... 01 /17/2003 SENT 8Y: BONSALL PETAOLEUM CONST^"�TiON,; 760 631 0526; JAN-30 ^3 4:58PM; PAGE 1/2 January 28, 2003 CI'I'Y �F C4STA MESA �.0. BO% t200 • T7 FAIq ORIVE ' CAL1PORNIA 9i828-�200 OEVELOPMEM 9ENVICES DEPARTMENT Howard Way LLC 1819 W. Olive Ave. Burbank, CA 91506 BUILDING DIVISION NOTICE OF PERMIT EXPIRATION PERMIT NUMBER (S): B02-00160 FQl3:; --„ ,,—,--^._., Canopy over fuel pumps --.--, .., PROJECT ADDRESS: 3539 Howard Way, Costa Mesa Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permitg are valid for 18o days from the date of such permit, or the date of your last inspection for the project and additional fees may be required to finalize expired permits. According to our records, the permit(s) listed above have not had an inspection for a period exceeding 180 days. If you have a signed inspection card indicating an inspection was conducted within 180 days from the date of this letter, please contad this office so we may cortect our records. A time extension may be granted if you intend to commence work and complete the project. ftequests must be made in writing addressed to Ed Petros, Chief of Inspection, at the a6ove address, detailing circumstances and listing an estimated date of completion. If you need to request an inspection pleasa cali our Inspectio� Request Line at 714.754.5626. If you do not contad this oftice within 10 days, your permits wilt expire on February 12, 2003. If you have any questions, please contact the Buitding. Division at 714754�5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy ro assist you. The accuracy of records affecting your property is our goal and we appreWate your working with us to resolve this matter. Sincerely, �� Mary Jane Weidenkeller OKce 5pecialist II cc: Bonsall Petroleum P. O. 9ox 969 Bonsall, CA 92006 BUMGIrp DNbbn (71�) 7843P73 • Coflo Enlapme.rt (lta) 75a-682J • PlwJrq �Nlslan (71 Q 75652�6 FU( (T14) 75W85$ • 7DO (7i4) T94-S2N • wvw.G.weOrme.o.w (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: 3539 HOWARD WY 41511213 PERRAULT, 70M P O BOX 969 BONSALL,CA� HOWARD'WAY LLO Address ATTN: BRADLEY D HOWARD , BURBANK;CA ' 1819 W OLIVE qVE Contractor: BONSALL P�TROLEUM Address: P O BOX 969 ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches . Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to ihp Motors l0 10hp Motors to SOhp Motors to t00hp MOtorS over 100hp Communication drops Sub panel to 200a Pole Lighl Pkg Sign Circuils Temp Pwr Pole Intermed Pole BONSALL,CA ELECTRICAL PERMIT Phone: 760-631-0342 Zip: 92006 Phone: Zip: 91506-2435 Phone: 760-631-0342 Zip: 92006 License: 682742 SCOPE OF PERMIT � 8 CANOPY LIGHTS. "RYDER TRANSPORTATION" REF: 602-00160 $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $8.80 $0.00 §0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / Ligh6ng Busway/100ft Standing Section Misc Electrical Equipment Transformers up to 1 kvalkw ................up to 10 kva/kw .................up to 50 kva/kw .................up to'100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand � Other Electrical Pee Investigatlon Fee Plan Check Fee Reinspection Fee Siatus: ISSUED Applied: 05/21/2002 Issued: OS/21/2002 ISSUED BY: �.--`a--"� � Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $D.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $32.90 COMMENTS I SPECIAL CONDITIONS NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § t, 12-21-92) EXPIRATION: This permit shall automatiCally expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must compfy with all applicable codes, and all required inspeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permiL FOR INSPECTIONS CALL: (714) 7545626 . 26464fi (fJ00) WORKERS' COMPENSA710N DECLARA710N: - I hereby aHirtn under penalry of Derjury one oi ihe following tlaclarations: ❑ I hava end wlll maintain a ce�ificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of Ihe Lebor Cotla, for the pertormence of the wo lor whith l�is pertnit is issuetl. . �I�hava and will maintain workers' compensation insurance, es required by section 3700 of the Labor Code, for the peAormance ot the work for which this pertnit Is Lssued. My workers' wmpensatlan Insurence cerder and policy number are: !�,� �1 e7 Carrier7 �i IRTg_ ( e�-w�� Policy N`u _mher l4 [�' 0}' a O� (Tliis section need nof be comp/eted i! the permit is velued et ane hundreC dollars ($100J or less.) ❑ I ceNty that in the peAortnance he work for which t�is pertnit is issued, I shall not employ eny Dereon in any manner so as to bawme SuDject to ihe workers' compenution laws ot � m e, enE e ree that it I should become sub�ect to ihe workero' compensation provisions of Section 3700 ot the Lebor Cotle, I shall forihwith comply with ihese vi ons. '�_-'� �f-- ApPlkant:5lpneWie� � ��v �Da� 1 �� WARNING: FAILURE TO SECURE WO(iKERS' COMPENSNTION COVERAGE IS UNLAWFUL AND SHALL 50&IECT AN EMPLOYER TO CRIMINAI PENALTIES AND qVIL FlNES UP TOONE HUNDHED THOUSAND DOLLARE (5100,000), IN ADDRIIXJ TO THE WST OF CAMPENSATION, DAAMGES AS PROVIDED FOR IN SECTION 3]W OF THE LABOR COOE, IMEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I em licensed under pwvisions ot Chapter 9(wmmencing with Seciion 7000) of Division 3 ot t�e Business and Protessions Code, and my licensa is In tull torceand.eflecL.Lic..a, �C�ass:rt.� �� a/F�— C nVa` c� .Siyneture:� 1 4n �:✓�� r.Date:—. C�a /�li�-_ CONSTRUCTION LENDING AGENCV: ' ❑ I hereby aHirm that Ihere is a construction IenOing agency for the pertortnance of the work for which this pertnit is issued. (Sec. 3097, Civil Cotle). LenGers Neme: Lendefs Atldress: Signawre: Date: OWNER-BUILDER DECLAHATIONS: I hereby affirtn lhat untler penalry ot perjury Ihat I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business antl Professlons Code: Any ciry or wunry w�ic� requires a permit to construc4 alter, improve, demolish, or repair any strucWre, prior b its Issuance, also requires the applicant tor such pertnit to file e signed sWtement t�et he or she is Iicensed pursuant to the provisions of the Coniractors License Law (C�apter 9(commendng with Sectlon 7000) ot Divislon 3 of ihe Business end Protessions Code) or thet he or she is exempt therefmm entl the basis for the allegatl exemption. Any violation oi Section 7037.5 by any epplicant tor e permit sub�ecis the epplicent to a civil penalry of not more Ihen fve hundred dollars ($500).): ❑ I, as owner ol the property, or my employees with wages as iheir sole compensatlon, WILL DO TME WORK, and the structure is not intanded or oNeretl for sale (Sec. 7064, Busineu and Prolessions Code: The Contraclors License Law does nol apply to an owner of property who builds or improves thereon, end who does such work himselt or hereelf or Ihrough his or her own employees, provided tha� such improvemenis ere no� in�ended or oHered for sele. If, however, the building or improvement is sold within one year o1 completion, the owner-builder will heve tha burden of proving that ha or she did not build or imD�o�e for purpose of sale.). � I, as axner oi lhe D�oPerty. am EXCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct the pmjea (Sec. 7044, 6usiness antl Protessions Cotla: The conirectors License Law does not apply to an owner ol property who builds or Improves �hereon, end who coniracis for such project wilh a contrector(s) licensa pursuam to the Contracmrs License Laws.). � I am exempt under sec. Business antl Protessions Cotle for this reason: Siqneture: Date: Owner ID verified by drivefs license. ❑ Ves ❑ No Driver's License No. Vedficetion of 6wnership by (type of tlocument, i.e. - properry tax bill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETY PERMR CEPTFICATON: ❑ I hereby cetliry that no excavation five (5) or more feet in depih into which a person is required to descend, will be made in connaction with work authorized by Ihis pertnit, and that no builtling struciure, scattolding, falsework, or tlemolition or tlismantling thereot, will he more than thirty-sia (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Aaministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Intlustnal Safery, as notad above, uNess such person has a pertnit to do such work irom the division. SigneWre: Date: Division oi Intlusirial Safety Pertnii Number: CERTIFlCATE OF COMPLJANCE AND AUTHORIZATION OF ENfAY: I cehify untler penalry of perjury ihat I have read this application and state ihet ihe information given is correcL I agree to wmply wit� ell state laws entl ciry ordinances relating m building consiruction, and au�honza representatives of the Ciry of Costa Mesa to enter upon the ebove-descnbed property for inspection purposes. I agree not Io occupy or allow occupancy of any huilding authorized by this pertnit until finel inspection. COpE I. INSPECTONTYPE Q�TE INfRULS 1618 Fizatl System Final Fire Prevention 1288 200 201 202 203 204 Pool Spa Final Final RaRoot Finel BIocWRetaining Wall Final Faclory Fire Place Finel Sign Final Demolition COpE� INSPECTIONTYPE 206 Final Mec�anical 208 Finel Plumbing 210 Finel Elecirical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy �i � - _ � �1111.. _ V �ifl (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 3539 HOWARD WY 41511213 Applicant: TOM PERRAULT Address: % �" � Owner: , HOWARD WAY LLC Address'�ATTN:BRADLEY D HOWARD " BURBANK, CA"� - � � ' 1819 W OLIVE AVE ; � � ContrectOr: �� Address: BONSALLPETROLEUM P O-BOX 969� BONSALL,CA Phone: 760-631-0342 Zip: Phone: Zip: 91506-2435 - Phone: 760-631-0342 Zip: -92006. - License: 682742 Status: Applied: Issued: ISSUED BY: ISSUED 07/04/2002 01 /04/2002 s SCOPE OF.FERMIT . " � � '� � �. ' .`DISCONNECT AND'COONECT ELECT WORK TO INSTALL CONTAINMENT BOX UNDER 3FUEL�DISPENSERS � FOR "RYDER TRUCK"., REPLACE(0 CONDUITS. NO�OTHER WORK APPROVED BY THIS PERMIT. _ \ , �- ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches �- Non Res Appl � Res Appl Service to 200a � , Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 700hp Communication drops Sub panel to 20oa Pole Liqht Pkg Sign Circuit5 Temp Pwr Pole Intermed Pole $23.50 $0.00 $0.00 $0.00 $0.00 _ $0.00 $Q00 $0.00 . $OAO� �� $0.00 ,' � $OAO $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0:00 �Q.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY � - � �" ��, � � � __ _ ,', , • - -� Quantity '� ��,� � Temp Dist System / Lighting ' $Q00 0 �,.:' � ' . - Busway /100.ft , $0.00 0'. � ' _ Standing Section � $0.00 0'-� . � , . Misc Electrical Equipment $54.60 '� 3 ; � . Transfortners up to 1 kva/kw � $0.00 %;-0 � � � , ' � .._._...::_._uptol0kva/kw $0.00_,"r-0 _ ........._. ::c.up to 50 kva/kw $0.00 jj;� 0 __..........;.upto 700.kva/kw�„ _,�$0.00 ' 0 - � . � ' ..................over100'kva/kw�'?�.-$0.00 0�.. ,,.: -LowVoltageEquipment „-i$0:00/�� 0 :.�I � . "Low Volt Wiring System / Ckt;'!.'$0.00 -� � 0 � � Misc. Conduit . . " $182.00. 10 , r , Misc. Conductor- � ��. $0.00- - � 0 � �- ' % Cirws ( gen or ride) '$Q00'� 0. Circus (mech ride or lights) ��$0.00 ,'. 0- Christmas Tree Stand $0.00 % %�0 Firewoiks Stand � , � '$0.00-" 0 Other Electrical Fee - '� $0.00 „/l : Investigation,F,ee_ ' � `� $o.00 - � Plan CFieck Fee � 50.00 - Reinspection Fee $0.00 TOTAL CALCULATED FEES 8260.10 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 it work is not commenced within 180 days, or if work is suspended oi abandoned tor a period of 180 days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all requlrad Inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration o� this permit. �� FOR INSPECTIONS CALL: (714) 754-5626 2446a6 (N00) � � � WORKERS' COMPENSATION DECLARATION: . . ` I hereby aHirm under penalry of Derjury one ot the following tleclarations: � ❑ I hava entl wlil maintain a certiticate ot wnsent to self-Insure for workers' compensation, as providetl for by seciion 3700 ot the La6or Code, for ihe paAormence of the work br whiCh lhis pertnit is issuad. ❑ I have entl will maintain workers' compensation insurance, as requiretl by section 3700 ot the Labor Code, for tha peAormance ot lhe woAc for which this permit is issued. My�Cyp,rk�e� Carrier. \i � and policy nurt Policy Number: � (This section n9etl nat be comp/eted it the permif Is valuetl at one nundretl tlollers (S70o) or /ess.) ' ❑ I certity Ihet in Ihe pedo nce of the work for which this pertnit is issued, I shall not employ any person in any manner so es to bewma subjeq to iha workars' compensation law alifom' ntl agree Ihai if I should 6ecome sublect to ihe w9rkers' compansation provisions oi Section 3700 of Ihe labor Cotle, I shall torthwith comply wilh Ihe provision . ��/ ��I � / Appliwnt Signawre: ��%^ .Q�,L��lili 'C.'— Date: �� / WARNING: FAILURE TO UPE W RKERS' COMPENSATION CAVEMGE IS UNLAWFUL AND SHALL SUBJECT AN ENPLOVER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TOONE HUNDPE� THOUSAND DOLUAE ($100,000�, IN ApDITION TO THE WST OF COA9PENSATION, DPMAGE$ PS PFWIDEO FOR IN SECTION 31060F iHE L4BOR CAOE, IMEREST, AND ATfOfiNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm Ihat I am li ns und r pr �'sions of Chapter 9(commencing with Sectio 000) of Division 3 of Ihe Business nd Professions Code, antl my license is in full torce and ettect. Lic, a Class tt �- ld,A- Z. Contractors Signature: � Date: _ _ _ _Q —�� CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm that Ihere is a consiruction IenOing agency for Ihe pedormance of the work tor which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lentler's Atltlress: Signatura: OWNER-BUILDER DECLARA710N5: Data: I hereby aNirtn that under penalry of perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Protessions Coee: Any ciry or county which requires a Dertnit to construct, alter, improve, demolish, or repair any siructure, pnor to its issuance, also requires t�e ep0licant for such permit to flle e signed statament that he or she is licensed pursuant to the provisions ot ihe Contractors License Law (Ghapter 9(commencing with Section 7000) ot Divislon 3 of the Business end Professions Cotle) or that he or she is eaempt therefrom and the basis for the allegetl exemption. Any violation oi Section 7031.5 by eny epplicent tor e pertnit subjects the applicant to e civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner ol the property, or my employees with wages as Iheir sole compensation, WILL DO 7HE WORK, and Ihe siructure is not intentletl or oHeretl for sele (Sec. 7044, Business and Professions Code: The Coniractors License Law Oces not apply to an owner of proDerty who builds or improves ihereon, and who tloes such work himselt or herself or through his or her own employees, providetl that such improvements are not intended or offered for sale. If, however, the builtling or improvement is sold within one year of completioq the owner-builder will have the burden of proving Ihat he or she did not build or improve for purpase of sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professions Code: The contracrors License faw tloes not appty to en ownar of propeny who builtls or improves i�ereon, antl who contrects tor such pwject with a comractor(s) license pursuam to the Contractors License Laws.). � I am ezempi untler sec. SipnaWre: Owner ID verifietl by driver's license. ❑ Yes ❑ No Business and Professions Code for this reason: Venlicetion ol Ov.nership by (type af dwument, I.e. - properry ta: 6ill or deed): DIVISION OF INDUS7RIAL SAFETV PERMIT CERTiFICATION: Drivers License No. Date: Expires: ❑ I hereby cenify that no ezcavation five (5) or more feet in depih into which a person is required to descend, will be made in connection with work authonzed by Ihis pertnit, and ihat no building structure, scaflolding, falsework, or demolition or tlismantling thereof, wili be more than thirry-sia (36) teet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle 8, California AdmlNsiretive Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a partnit fmm the Division of Industnal Satery, as noted ebove, unless such person has e permit to Oo such work from the division. SignaWre: Date: Division of Intlusirial Satery Permit Number: CERTiFlCA7E OF COMPLJANCE AND AUTHORIZATION OF ENTTiV: 1 certiy untler penalty of perjury ihat I hava read ihis application and state Mat the intormation given is correct. I agree ro comply with all s;ate laws end ciry ordinances relating to 6uiltling wnstruction, antl authorize representatives of the City of Costa Mesa to enter upon the ebove-descnbed property tor inspection purposes. I agree no� to occupy or allow occupancy of eny building authorized by Ihis permit until final inspeqion. CODE 1. INSPECTIONttGE 1fi18 Fl:etl System Final Fire Prevention 1288 Pool Spa Finel 200 Final Re-Roof 201 Final BIocWReteining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolitian Applicant Q�/jg j[�S� COpE1 INSFECTIONTYPE - 206 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy � __ Appllcant to till in all sDaees axcept those within heavy Eartler Itnes anE si9n all aDVroprlate tleclaratlonz. � . . . . . ...._ . _ , ._. .�. _ ' '_ __ __ .' _" _ _ ' _ "' ` .. '�, _ .. .. . . _. �'. L CITY OF COSTA A CONSTRUCTION:PERM T � -PERMIT.NO. 'TRACT NO. , LOT O. UNIT N6. M1 � ' �, �� 3y �d�,��sl� �s�/ /�8�0, Og3• I�' � � � . biia ioi23ie4 . ` �5.57 TL Project Address ', �J � . � - � . � � - � , � Applicant'SMaiiingAddre55 ��f� �C��-'+yQ�' ( ��:."�, �TYPEOFCDNSTRUCTION� ' NEW ADD- LTERATION REPAIR � � ' " � ' . ❑ GONVERSION ❑ DEMOLISH ❑ OT�ER. �A�v��IP.O ii91 l� A.P. �h � Gj.__ I Zi� 3_' - Zone � p. Owner's Name ' ' � Phone � - DESCRIPTION OF WORK/USE OF BCDG � /�S{-1 �� Address : ' . , . � . . - �S � . :�--Af'G , :. • � . - � S'. . , . . ces ry Building.. , , . .Arch/Eng. - �LicenSe'No. -TVPEOFPERMIT" � _ GRADING FOUNDATION STRUCTURAL .. ; � T Front � �-o, b� /L � _ ra.�� o ❑ TENANT ❑ ELECTRICAL' ❑ PCUMBING ❑'MECHANICAL g � . - N Address - _ � . . , . Rear ��' ' . ' ' � � � ..� .I . . � . � � O��OTHER � . ' ' ' , '_ ' S , . iA � • Convactor's Name ' ° � ` Phone y � - � . '- - - . . . ' . � • PROJECT DESCRIPTION Sc�. FT. - oCCUPArvCv -- � C RigM � u. �. (L �G ,Address(mailing) �6i0 L�.G/,�-�� /lr/[. �•Swe.N' 'l7%.nr,,w'4, • • a, K- � . , � . . . p2, qiD - . CONSTRUCTIONTYPE VALUATION$ O� g' Left L��S ,�.� .L "_ ', ', R � City License N0. � � �+� ol af1/ , ' ZONE ' � � GRADING CU. VDS. ACR� ' , � LICENSED{CONTRACTOR DECLARATION ' � - - P�f!g.'R¢f. # Parking Req./Provided , 8 � E � I tiereby rffirm that I am Ilcensetl'untler provisions o! Charter 9(<ommencing Remarks: �'�= •� � _ B.¢ � . Planning Notes: '� - � i M wlth section 70007' ot DlWsion 3 of fhe Bu51ne55 antl P�otessions Cofl¢, dnd � '' lflY IIC205E IS �O ( OlC2 d!1 E11¢CS. .' ' � t � � � � 'i'l f S License las � � � � l.icen o. � � ' � � , v �� ' ; Date Si9nature � � � ' � � . PLUMBING ' FEES. , ') e�� ;%,,,�ORKEf15'F��SATION DEC ARATION '" . • . `=�ereby zftirm that, I have a certificate o� tonsent to self-insure or a certificate Bar Sink � . Showers . ' E CTR � FEES ��.� ._ Workers' Compensation. Insurance, or. a certifieG. mpy thereof.(Section gackflow Preventer' � , ' Servite'Sink ' - " " ' " � " ""�' - �-'3800, l.ab. c.) , . • � • Automa � asher � Transformer ❑ 15�50 KW , 4Policy No. ' ' ' Company ' ' � � Backflowlrrigation . SewerCap� , ConstructionPoleSub. ' � � , � 50+.KW� . � eCertitietl copy is bereby tumisM1etl. i . � . _ � � Certifietl copy is filetl with Ihe city Builtling Divislon. � � Bathtubs ', Sew¢r Connection , � � Cooking Unit Meter ❑up to 100 amps ��Da[e - ' APPlicant ' i � ' � . � , " ' �. EXEMPTIONFROMWORKERS'COMPENSATIONDECLARATION� � Clafifie�5 � ' $ola�COIICctofs ', ; - Di5hwa5hef � ' _ � Meter �over100amps ' _,�_,.,, , ..- .._. _ . . .. _. .. . .. .. - ' _ �(This section need nbt be�completetl it the permit is for one huntlretl ($300 or . iess).. �s -.. , �� ' �Dishuvasher SolarPiping ' � Dryers❑Gas.DElec[ric � SubPanel� � I certify thai in tne pertormance of tne work for which this permit is Issuetl, I � � � ' �' � �shall-not remi. I�on in anY m er so as to�b ome subiect to the Drinking Fountains ; . � Solar Tank ' � Fan 1 ' Morors �0-1 HP �1 %- 8 � Workers' o I en5 ti Laws:of•Ca' ' � ' ' �Datel'" Signature � FloorOrains' � �• � SwimmingPoolw/Spa i ' F,A,U. . NOTI E:Jf, att r m king this tleclaraHon; you shDultl become 5ubjeCt to Ihe� ' ' ' � �- Inc. SOIa� 09-1�5 HP 016-15+ I � 'Workers';Compensation,provisions of tne Labor.cCotle, you must torthwith-� � FIoo�Sinks� 1 -- � - �- Urinal � - "- -'� ' ' Fixtuies ' 't "- "' � � -'��- " ' " -- - -' � '�comply with suchi p�ovlsions o� thi5 pe�m`t shall. be tleemetl revoketl.,, ' � � Microwave� � � t �CONSTf3UCTlOfi LENDING HGENCV �'-� � - 1 1 � ;', , �� GasServiceT � Outlets � c ' WaterCloset �. � '� ° ' DeviceBoxes ' � ' � � I M1ereby affirm tliat there is a construction lentling agency tor the oerformance Pole Light � of the work' for whith. thi5. permit i5 i5suetl �(Section �309].Civ. C.),- Interc¢ptOrS � � Water.Heater, : -� Outlet5 ' ' �Lentler's Name � '� �� Range � � � � � Lentler's Aadress � �� , • � � ' ' - - ' � _ Kitchen Sink' � � WatervService , � � Switches � �Sign � ' � � OWNER'BUILDER DECLARATION" � � • �' � ' '- _ �- . ' ' � I hereby afflrm that I am exempt from the ConVacto�'s Llcense Law for ihe LBv2t0li25 • � AUtO-Wash " � � � ' following reason (Section-7031.5 Business antl Pcbfessional Cotle: Any ciry or ' Garbage Disposal ', Standinq Sections � ' county wblch requires a ermiqto!construct, alter, im rove, tlemolish orrepair .' �• . � � � a v , P=Trap � � '� L'aundry Trays " -� Generator DO-5 KW 05-15 KW � Trash Com acmr any s[ructure, prior to its issuance, also requires the applicant for such permit � i P i ! to fiie a signetl statement that he/she is licensetl pursuant to the provisions ot Roof Drains � • � T' �' - � • � ',Lhe Contractor's LlcenSe Law',(Chapter 9(commencin9 witM1 Section 7000) of L - ' " ' . . � `�p.','vision 3 ot the Busine55 antl Profe55ion5 Cotle) onthat he/she is;exempt � � i., � . _ . � � - � , ' lX';'erefrom antl the!basis fo� the allegetl ¢xemption. Any'violation�oT SectiOn � ' . � _ ' � . ' ' � � �`5031.5 by any'applicant for a permit subjects the applicant to� a clvll 1 � ' � � , �� enalty of noi more [han five�huntlretl tlo115r5 (5500). :- :' , � � ' - • , 3 � i ' , ' j �J I,�as,owner of'the property or'my'employees.with�wages!as theinsole Reinspeetion Fee' $15 I55ueFee • $ . ' ' compensation, will tlo the work, antl.the structure Is not intentletl or.offeretl � ' ° Reinspection fee $15 Issue'Fee �� '$ 3� i �or sale (Section �044, eusiness antl,Protessional Cotle:'The Contractor's' ' ,_ MECHANICAL� j FEESi ' ' � � �.Liwnse i.aw tloes not apply to an owner of a property who builtls or improves ' - thereon,.ana who does suchfwork himself/nerselt or through his or her own '- . , . i , DEVELOPMENT SERVICES REQUIREMEENN T � � � '� employees, provitletl tnat such improvements are not intentletl or ofteretl tor ' Boler, � �� 'Hood or ' Type I ❑ ' I ' . � sale. If, however, che builtlin9 oi Improvement is soltl wtthin one year oi com- ,. , ' , , Canopy Type I I ❑. � Zoning Approved By � �' �-'��W� ' Oate �� pletion, tne owner will have the bu�tlen of p�oving he/She tlitl not builtl o� im- � ' DuCt�- U�dE� i�i�OUnd� , . ' �� BUilding'App�OVEd By � Date � � ;� �Ova For the purpose oAsale). ': � � � i I, as owner oi the properry, am exclusively contractin9'with.licensetl con- ; Duct -Structural Refrigeracion Sysiem -' � Appliwtion Issued By � ^n'�� ' Dat � '� tractorsto cons[ruc[ the�project (Section ]044, 6usiness antl Professions Cotle: � � ' i � The ContracroYs License Law does not apply m an owner of property who . Duct - Ventilating .. � ..- ❑0-100,000 BTU_ �100,000 BTU _ � � , SUMMARV OF'FEES - � ' �bulltls or Improves,thereon,'antl who cantracts'toi'Such projects with'a con= - - ` � � • � � � '' � tractor(st'license pursuant'to;the contractor's License�Law). I am aware that � � Exfiaust�System ❑ Multiple ❑ System Repair/Alteration ' I BUILDING PERMIT '$ ��• S U� SMIP' 1$ .-�� . . ., proof of theii WorkeYs Compen5atiom insu�ance Shoultl be provitletl to me. . . . . ' � , � i - � � � � � PLAN CHECK �$ _ _��L'_i� � PERMIT ( 1 \ { � I4am exempt untler Section � � . B. & P. C. for this reason ; I FirepUFact. Blt. ICBO # � ' Fire�Dampers ! � : � ', ISSUANCE ,$ ' , � PL'UMBING � '$ ! ' .Date � ' ' owner � � � � � ' �' � ry Heating System & Ducting � Registers � � j � pl'qN CHECK 25% '$ � ENERGV P.C. �$ f EI' h¢r¢by�[ertity that'hhave�reatl�thi5'appllcation antl"state that the above ' �O-100,OOOBTU 0100,OOOBT' - ' - ' � - • - - ' ' GRADING� $ � j �informatlon is mnecL nagree to co ply with all city'antl <ounty ortlinantes f j ELECTRICAL � �$ 'antl state� laws rela g to builtlin nstruction, antl hereby authorize reore- � � � ; � • � ' � ` pLAN CHECK 50% '$ ' � M�CROFILM $ � � � •sentatives o ent on [he above-men[ionetl prop rry ior ' ' ' ' ' �-� Q �� inspectly� urp ; � i i '� ' � ' � � � MECHANICAL t �$ ; n TOTAL FEE '$ � 'S19naQL � Data�� , ' . � - ' i � Reinspection Fee $15 � � Issue Fee ,$ 3 : PLAN CHECK z5% $ Drivars' �icense or 55 �� . ' CMF 0865-46, rev. 10/84 W ite - Builtlin9: Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor 1' ,. CONSYRUCTION AND�PL'ANNING � � . PO. ,s� SPA � : . . '- Date ' �lospecfor � - ��' ' .- ^ Date Inspector APPROVALS� , Permit # _ � - - APPROVALS Permit # � = . �>i, 1. Temporary Electrical Service or Pole� . � :52. Pool & Equipment Location �� . , , � �2. Soil Pipe-Undrgrnd. ` f�",�� - � � 53: Steel Reinforcement - � � . � `„' 3. Electrical Conduit'Utility-Undrgrnd''�- ' -� ' 54. Forms � . � � - �, 4:,Electrical ConduiYUndrgrnd. - / ' - � � 155.. Electrical Bonding � � . � . � � � 5. S[eel Reinforcementr T'TbS, / �� ` 56. Rough Plumbing & Pressure Test � � �6. ElectricalUFER�Grnd.. �� ,.; 57. APPROVACTOCOVER-GUNITE _ - . 7. Footings �J ' � ' . � 3��Sc� �j. 58. �ElectricalConduit-Undrgrnd. ' .- , 8 � Foundation �; � " � j � . � 59. .Gas Pipe, O Undrgrnd., Test , � � 9. Wa[er Pipe-Undrg�nd: ,:�� , �60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System � �' - ��61�. APPROVAL TO DECK - 11:.Property Sewer Line & House Connection ' � 62:, Backwash & ReceptorFinal � , 12. $ewer Cap �',.� ��,!' , , '63. Heater & VenrFinal . ' ' � - ' ' 13. Rodf Drains ", �_ i� t � ' . 64. Plumbing System - Final , _ ', i 14. Rough Plumbing �: �' ' - 65. Electrical-Final � � 15�`yRougli Electrical=Coriduit � ' 66. Solar System-Final � ' .16. �Rough Electric Wiring � . � �67. Fencing & Access Approval ' ' . 17. Rough Wiring Sign - . �68. APFROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning � i. ' � . �FIRE DEPT. REQUIREMENT' 20. Rough Factory Fireplace APPROVALS Peimit # . , 21. DuCts, in Struaure � � � : 70. Underground Hydro . � . �22. �Ducts, Ventilating ' 71. Product Piping �Gas ❑Oil � � - 23. Gas Pipe-Rough &.Test � � 72. Underground Flush 24. Roof Framing � � ' - � 73. Undergrnd�.StorageTank OGas ❑Oil � � � 25. Roof Sheathing . � 74. OveFhead Hydro � � � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27. Freme and Flashing � 76. Dry Standpipe 28. lathing &�Siding . 77. FIXED SYSTEM FINAL � 29. Insulation ' '78. FIRE PREV. FINAL 30. Drywall Nailing ' ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � . � ' - 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Notes: � � 34. Final Heating & Air Conditioning; � ' . . 35. Final Gas Pipe-Test � � � ' . � - . 36. Hood or.Canopy ' � � ' ' . ' 37. Final Factory Fireplace � � � � ' � � � � 38. Final�Plumbing � � � , � � � ' . ' 39. Water Service' Final � � - ' ; i , � � � '. • '. 40. Gas Service-Final -� � � � , � . ,i ' ' � � - ' 41. Solar pomestio-Final i � � '. - - � � - � � ; • , ' �1 • 42. Backflow Preventer ; � ; - � . . - , , . . � ' � ' 43. Backflow Irrigation . � � � ' � �- � � , . �� . 44. .Landscape Irrigation System � ' . � - - � • � � � 45. Sound Attenuation � ' ; , � � � • ;, , � 46. Handicap Regulations , � , . - ' � � � � � - _ 47. F�NALSTRUCTURE & BUILDING; �1 � 8 � ' ��-, ', � ' ' 48. Special Requirements Completed � ' � � � , - � � 49. Electrie Release to Edison • r ; � � � � � � -, � - � -- `� ` - � . � ' � � 50. Gas Release to Southern California Gas Co � � . � '�� , 51. CERTIFICATE OF OCCUPANCY • - - No. Date � _' , � . . -. . � E 'pLICATION FOR A BUILDING PEP ` BUILDING PERMIT NO. E�ectrica� , r 9�SS� pp T�act Block Lot Permit No. '7'- C Builtling Plumbing a Atlaress 3 ,�3 Q� (� � �'ermit No. � � C�oss Mechanical C Area Street Permit No. ? m Owne� � � /1 �, A — � Type ot R'oj¢Ct: ❑ New ❑ Alte� ❑ Atltlition � � 'L /t Atltlre55 � � � �1-`/��,— ❑ epair ❑ Convert ❑ DemO ❑ Occupancy Pmt. /7` City �CLb Phone /� � ' S sp. A�rea/ Architect/ one Spl. Pmt. No. � Designer License No. ' tbacks P/� Front C/L St. Stree[ Witlth Atl0�es51� V rtls left Righ ear Clty Zlp Phone a ro�. e ig _ . . « Engineer �icense No. � Park n9 Require rov e overe p. Adtlress m Cit � Zip Phone Struct N.of No.ot Y i Height St ries Family � � LICENSED CONTRACTOR'S DECLARATION Park Fees ves Fee � I�ereby affirm that 1 am licensed under provi,ions ot Chapxer 9 Requiretl No �• � Receipt m t (co�nmencing with Section 7000 ot Division 3 ot 2he Business antl Zoning Approvetl By: Date Profossions Code, and my license is in tull torce antl affecH. � License CI s 0 License Number '1 ��- �� MiSt. T Date Cont.actor �! EL S EG r� /N� � E ndd.a:: / 1/f �'�r Lt� ES f .820 D d_ S Prapozed Vse jy City anA ZinO Alr-�(�O� C��phona %�3"i�/PL[-� of $Vucture CONSTRUCTION LENDING AGENCV . d ! her¢by af'irm that there is a consttuction lending aqency tor the a performance of the work for which this permi[ is issuetl ISec. 3097, ��a Type Cotle ' Civ. CJ. Class ConSL Vear y Lender's Name US /OCCUPANCV SIZE SQ. FT. � Lender's Address '� OWNER-BUILDER DECLARATION � I hereby atlirm that I am exempt from ffie Con[racmr's l.icense Law 1� �0 for the tollowing reason: � ❑ 1, as owner of the proporty, or my employeas with wa9es es iheir 2. sola compensatinn, will do the work�, antl the shucwre is m[ �t„ intentletl o: oftered forsaie. � ❑ I, xs owner of the proparty, am ezclusively conVaciing with 3' IicenseA contractors m consbuct the project. �v„ ❑ I am er,empt under Sec. , B$PC �or this reawn 4� v a Data Ownar E YYORKERS' COMPENSATION DECLARATION Total Valuation � I hereby attirm [hat I have a certificata ot consent to self-insure, Encroachment Vermit Requiretl ❑ es ❑ No Y or a certifica�e of Workers' Compensatlon Insurance, or u rertiti¢tl ryp copy thOf80f, Gratling Pmt. IdtllOg p POIICy No. COmpany R¢qUl!¢tl ❑ VCS ❑ NO PmL No. �a ❑ Certitieh copy is hereby furnishetl. ROu9h Gratling �p Q❑ Cartified copY is filed with Oranye Couniy, EMA. Approvetl by: Date 19 Ddte Applicent 3 CERTIFfCATE OF EXEMPTION �+ FROM WORKERS'COMPENSATIONINSURANCE — Z (This section need nof be completetl if permit is for $100 or less�. � C I cartity that in the pertormance ot ffie work tor which this permit is � issued, I shall not empby any person in any manner so as to become � �p subleci to ha Workers' Compenzation Laws of Calitornia. PERMIT F Dat APPlicant O�/[�ti C C.tC- i�l%N• , NOTIC TO APPLICANT: It, after making xhis Certificate of Structural 5 Plan Check § Examption, you should become subject to the Workers' Compensation provisions ot the Labor Code, you must forthwith comply with such EleCtrlcal SPecial provisions or t�is Oormic shall be deemeA .evoked. $ InvesL $ 1 CERTIFV THAT I HAVE REAO THIS APPIICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO Plumbinq $ COMPLV WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATWG TO BUI�DING CONSTRUCTION, AND HEREBV AUTH- Mechanital $ ORIZE REPFESENTATI��ES OF THIS COUNTV TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOF INSPECTION PUR- p�e-Gratle P �� ' � / Inspection $ i� Pre-Gratle Permit � Sgpa[ure of Applicant or Agent D te Re0. No. $ I55ue E �'�ci3L+2T �TOAIE/�11r�� E�•L Print P c IicanYs/AgenYs Name All spaces within this box must be completed to process Plan Issuance Check By: Approvetl: CMF 0335-46 (BU-28) rev. 6/80 1 ' - � Fnroea rwuctc raEnrne� onic. Area Code 714 738-3861 Suite 625 1400 N Harbor Blvd Fullerton Ca 92635 Mr. Victor Newton Assistant Building Safety Director City of Costa Mesa P. O. Box 1200 . Costa Mesa, CA 92626 Dear Victor, �� 1Q October 7, 1981 E /�a� ��ECEIVED CDSTA MESA CITY�'F,�,�r, I :'?T. aA� OCi -. q �98t� P�i � 1�345�+ �"bl$Jyt�l�lul 1 1 1 i 1 Ryder Truck Rental, Inc. requests temporary work with at the project located at 3539 Howard Way, Costa Mesa, California. The follow- ing is a list of items which require electricity to be tested. 1981. 1. 2. 3. 4. 5. 6. 7. Lights (interior and exterior) Air Compressors Fuel Pumps Air Conditioning Unit Heating Equipment Exhaust Fans Truck Washer We will need the temporary service from October 7 to November 15, Ryder Truck Rental, Inc. grant permission to the city and its agents and/or the utility and its agents to enter the oroperty between 8:00 AM and 8:00 PM of any day for the purpose of disconnecting the service should the requirements not be completed. The owner (Ryder Truck Rental, Inc.) understands that temporary approval will be withdrawn at any time without further notice should total completion and inspections not be accomplished within the time period stated above. Regards P. R TRUCK ]TA NC . �� v James A. Lunt, Authorized Agent & Field Engineer /pb cc: Dave Bojo - Jaska Building Systems Joe Leone - Ryder Truck Rental, Inc. attachement - notary information :J tl -' ' � STATE OF CALIFORNIA �' ` County of Orange ss. , ) Subscribed and sworn to before me this 7th day of October 1981. CARL L. KANE ///�� ' � � 9 NOTARY' PUBLIG • CAIIFORNU' ��' � 1) +`�...} �PRINCIPAL OFFICE ;IN I(..{t n�_ �? ORANGE COUN7Y Carl L. Kane ' , My Commission Expires Mey 24, 1985 � � P:ay 18, 1981 , david hutchison 4815 main street california 92686 architect yorba linda (714) 996-2902 City of Costa Mesa Denartment nf Rni.l.di.no S Saf_?ty _ Electrical Inspection Division ��jya� STQ�ceTuAL Post Office Box 1200 Costa Mesa, California ;?.; 3 9 /� �v:a � c� Re: Ryder Truck Faciltiy y� Underground electrical conduit � �-/,�/D1 � �— �(�/(.�� Schedule 40 PVC conduit in lieu of rigid steel conduit is approved by this office for installation of underground conduit�for the above project. If you have any questions, please contact me. Yours truly David Hutchison Architect DH/ls cc: Del's Electric Jim Lunt .: : i C i:� T�i' Ti � � � 21 1981 david hutchison 4815 main street california 92686 September 3, 1981 City of Costa Mesa 77 Fair Drive Costa Mesa, California Attn; Mr. Bob Cockron Re: Ryder Truck Rental, Inc. Howard Way, Costa Mesa Dear Mr. Cockron: architect yorba linda (714) 996-2902 This letter is to confirm our understanding of the job meeting with you and myself on Tuesday, September 1, 1981. We will enclose the electrical switch gear in the shop portion of the building, thereby eliminating your require- ment that the shop be mechanically ventilated. If you have any questions, please contact this office. 'ncer ly, David Hutchison � �`��2�� Architect DH/ls -/� y!.� i�/nl�' J//'f /J�''',� (,�" � Q �( City of Costa Mesa Building Safety Department P.O. eox 1200 Costa Meu, California CERTIFICATE OF OCCUPANCY ' =�'`�� + The Building located at 't�.�n r*-n..,„.-. ..�.: �.,. ��•v,�. .�-,.,+�1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group .--). x—' � Occupancy. Use of Building � a—,.-�Z:i-t' �7Fi' :� : 'ii'�x_ '; n^ - Legai Description_ Building Permit N n_ i r i.. �• � (See reverse side for Metes and Bounds) lectrical Permit No. � -�� '� �� Plumbing Permit No Number of apartments - and/or guest rooms - ISSUED T0: Building Official � . • . ., � _ . " .,; i. � i " i ey : r,.,�-� , , �r��-.: • _ T J�) � �C-CCOi: �. �.cfTf:0,1—D72�'C7i.u'C .i,...- --- ._ . Date :.'w��ntr';'2 �. .l �: 1 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 BU 34 Rav.11/70 ��-� P.vDlieant to fill in au spaces witnin heavy boraer lines ana sign all appropriate Geclaralion • CITY OF COSTA MESA � �- P(�$� NO.�� TRACT NO. LOT NO. BIOG. NO. ;CONSTRUCTIONPERMIT �� ' 9Z Addres'�,�- ' 1 . Arch/Eng.' -" � - - } Address - ' ' .',�° • " - License No: � � '(�iVrPE OF CONSTRUCTION �. U NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OT.HER � vI �l/ L J' IO TVPEOFWERMIT `/ Addre55 , V, ❑ GF3ADING ❑ FOUNDATION �O STRUCTURAL •' '� LICENSE� CONTRACTOR DECLAftAT10N - ❑ TENANT�� ELECTRICAL ❑PLUMBING ❑MECHANICF I h¢reby a(firrri th;.t I dm IicenSetl Untl¢r provislons ot Charter 9(com- . . mencing with section •7000)' of OlNsion 3-ot the Buziness-antl -Q�OTHER Rofessions Cotle, 3ntl license full torce antl eftect. ' -G % � J G �I __, I/�6� PROJECT SCRD��IPTION -- . License Class License Date '^ Signature � �i � 50' FT' �� WORKERS' COMPENSATION D ARATION � OCCUPANCV C[p.�NSTRUCTION TYPE I hereby a(firm [hat I M1ave a certificate of consant to salf-Insure or a V ALUHTION� `� ZONE rtiticate of Workers' Compensatlon Insurance, or a certilled coOY eoT (Se ion fl➢11.1.a�G). g�E �� / GRA�ING CU. VoS. ACRES cy No. �� Company �� - ' Certifietl wpy is hereby furnishetl. � �'�- REMARKS: .�' . . Certifietl copy is flletl with the city Builtlinq Dlvislon. , E MPTION FROM WORKERS'�COMPENSATION DECLARATION ' ' " (ThiS section.neetl not be complet¢tl if.the.petrtlit i5 fo� one huntl�etl . (EZ00� Ol IESSJ, - , � � I certify that in the perto�mance of the wo�k fo� whiGh this p¢rmit ii Issuetl, I shall not employ any person in any manner so as to Eecome P.LUMBING � P�AN CHECK subje<t to the Workers' Compensation l.aws of.California. . '' .. Date Signature� ' BATHTVBS SHOWERS- NOTICE: It atter making this tleclara[lon, you shoultl become zubject � TOILETS. ' � URINAl.S to the Workers' Compensation provisions of the Labor COEe, you must for[hwith comply with sucM1 provislons or thls permit shall be tleemetl LAVATORIES OOUBLE LAVS revoke0. . . . . CONSTRUCTION LENDING AGENCV KIT. SINKS - �ISHWASHERS ' I M1ereby af�irm that there is a construction lending agency for the per- SERVICE SINKS - SUMPS Q ' formance ot the work for which this permit is issued (Section 3097 ' G��' C'�' � FLOOR SINKS � FLOOR - C Lentler's Name Lentler's Atltlress DRINKING FOVNTAINS -' � �Q OWNER'BUILDERDECLARATION ' - �INTERCEPTORS CLA ERS I he�eby affirm that I am ezempt irom.the ContractoYS lic¢nsE Law for the following reason (Sectlon'7031.5 Business antl Professions CoOe: -'SWIMMING POOL � .P'TRAP" - Any city or county which requires a permit [o cons[ruct, alter, irtfprove, tlemolisM1 o� repair any struCtwC, prior to its issuante, also re- quires the ap;liwnt for such permit to file a si9netl 5tatement that he WATER SERVICE - A N . IS Iicensetl pursuant to the provisions of the Contractor's License Law GAS SERV ICE UTLETS hapter 9(commencinq with Sectlon ]000) of Division 3 of the ness antl Professions Cotle) or that he is exempYtherefrom antl'the yyqTER HEATERS BTU OVTPUT s for the allegetl exemption. Any violation of Section 7031.5 by appllcant for'a permit subjects the applicant to'a civll penalty SEWERCONNECTIONS � 'of not more than five huntlretl tlollars (E500). ❑ I, as owner o! the property, or my employees with wages as thelr SOLAR TANK � " 'COLLECTORS - SOIC cortip¢n5dtion, will tlo.the wo�k, antl the structu�e.i5 nol Intentletl or offeretl for sale. (Section ]044, Business antl Aofession5 Cotle: The SOLAR PIPING SYS. • Contractor's License Law tloes no[ apply. to an own¢r of a property wh0 builtls o� improves thereon, antl who tlOeS such work himself ov ISSUE FEE • � M�Ou9h hi5 own employees, provitletl that such imp�ovements a�e not , intentletl or of(eretl tor sale. It, however, the builtling or improvement MECHANICAL PLAN CHECK Is soltl,within one yearAi completion, the owner will have the buraen of proving he tlitl not builtl or improve for [he purpase of sale). HEATING SYSTEM 0-100,000 BTU ❑I,'as�owner�of the property, am ezclusivety-mntracting-with qryDDVCTING -""- "' �` - � ' IlpEnsetl cont�actors to consVuct the projeC[ (Section 7044, Business 1DO,OOO�+BTU antl'Prof¢ssions'Code: The ConGactor'S-Licanse�l.aw tloes not apply�[o ' an owner of prope�ty who builtls or improves thereon, dntl who con- REFRIGERATION 0-100,000 BTU � hacts from'such-projects-wi[h a-mnt�actor(5)-licesnetl-pursuant [o -•$YSTEM' � - - - � � - - � the Convactor's License LawJ. 300,000.+ gTU 4 I am exemp� untle� Section �' '- ' B. &�P. G. for"tfiis . BOILERS . � gTU i reason" - - - - - - - �� - Oate� - Owner - � SVSTEM REPAIR,ALTERATION I hereby cer[ity[hat I nave reatl this application antl state thaVthe above EXHAUST SVSTEM MULTIPLE information �5 mrrecL I agree [o compry with all c'�. - � ortlinances antl state laws relating to construction, antl h� representatives of.�this <it to enter upon ihe abi property f ' spection r se5. $Ignature Date Oriven' Li se or 55 � CMF 0865-46 Wnite-Builtling; Canary-Applicanl; Pinl ,^I ' ISSUE-FEE.. . - ... ... . . I 1 .. .. Goltlenrotl-Assessor '. I333 iiz�iaz - ZONING REGULATIONS A.R 9f ZONE � PLNTGp: gRUEF. � � � SEpTBACKC/LST. PROPE�RTVNLINE L$�EpFTVARD R�IGHTA REAR VARD (TO P/L) �- PKG.SPACE RE�. PROVIDED STREET WI�TH PARK FEE E ZONINGAGPROVE�BV_ . DATE SPECIAL CONDITIONS: ELECTRICAL' ' a�arvCHECK GENERATOR p-1 KW_1-SO KW _ •TRANSFORMER APPLIANCE 10-SOKW_SO+KW_ MOTORS ' ' 0-1 HP_1-10 HP _ QNC. SOLAR) - 10-50 HP �50 + HP _ FIXTURES OUTLETS SWITCHES �5:�5 TUBE SIGNS - POLE LIGHTS � ' �PANELS' � MAIN SUB - SERVICE AMP �... �.� / i .. . 1� (. � � ' 27.50 ;7L. - -ISSUE FEE' ' ' ' APPLICATIONAPPROVEDBY • � DATE�� ^l L SUMMARV OF FEES . , BUILDING PERMIT § O�OO � SMIP E D�SO ;PLAN CHECK $ PERMIT --- - �- ISSUANCE� b �PLUMBING $ . � . � GRAOI�NG f �PLAN CHECK S ' �� ' ,ELEGTRICAL $ ' S � � MICRORLM E ' PLAN'CFiECK- $ ' MECHANICHL S _ TOTP.L�FEE$ � LE55 AD- PLANCHECK y' '. VANCEPC S- � ^ . � _ ,- FINAL FEE $ `�`SO � "� . CONSTRUCTION.AND PLANNING � ... t . .�. ! POOL & SPA .� .-_ �-` v � .�. . .� -,." �, Date ; �Inspector = -' � �-' - " " ' � • �- - ' !�--Date..; Inspector - ;� APPROVALS � Permit# AP,PROVALS-• � •�j ' ��Permit#j � . ... . . - -- --- = -- - - ---� . 1. Temporery Electrical Service or Pole � '" �. " 43. Pool &�Equipment Location--�- � - ---- - - ---- - --- -� -� - - - ;4 .. .-.. . - --- - - - -- . _... . _ . _ ,. . . . . 2y Soil ipe-Un rgrn+'��•%• �^'�• � 44. Steel Reinforcement� --- ----------� - - --- - - � -� - -: -� � 3.._ElectricalCo^nduitUtility-Undrgrn,� ,_ : 45: Forms,,,�.1�� {----- --- -- - -- - - _4,.. Electrica! Conduii'-Undfgrn_ � � _46.. Elect[ical.Bonding_i-- �- ----- - - .�1' tee ein orce � ; � � . - . , � 47. Rough�Plu'mbin ".& P�essure Test--� � � - - - - - = -- - „_6. Electrical UFER Grn � " ' ' " 48: APPROVALTO CO,�/ER•GUNITE----- `- - - --' = 7. Footin s - - --- - -.. , , y, . _ .. . . - :- �'.,�� r:,-�a:, � � �, -_9_ ___� n � 49. � Elecirical Conduit-Undr m�� m �3^ • ' •- - ----- - - - -- r. , � ,-- - - - - - - - �8_ _Foundation.,. � �� 50.,..Gas Pipe�,.�,Undr �n,Tes[ " - � � � +� � - �' � �.9..YWater. Pipe_Und[gcn_ „�, ._ �- 51. Backwa h Lines .P.-Tra '�Q rn � ' � ' ' '--- -'-' - " ' ' ' ' �'! _ .: . . __._.. .�-'._'- - ' ..- -�-- •-- - . . :.LO._Sttucturai_Ftuo System,. �"' „� ,! 52. APPROVALTO.DECK"' '`"-""�"""' ''"' _ L _ . . �..1,?„_ Pr.nper,ty SEWer Llne & House Cornec2ion__'_� � + �� '� -• � � � ' �•'��- .• � .�� !' _ ^� .� _ 53. _. Beckwash,&�Rece tbr-Final .". ,.12.._S�eelSetver,(;pnnectl0n '`•" �. ".: y - ---- __54.- Heate�&"Vent-Rinal�. .. .� . �. � �� . ..;o: "i _I.3. _..FS7�9h Pluinhin�.- -- �- - - - - < .. <: �-_,. �� _ - --�- -' - -•_- • -' -- � . �._ ._ _�_._.ua , :�Y `f . _._ _ . _ . __, , .�. --.�. ,. 14. flaugh ElectrieConduit - � ';---- -�--- � � - - -- - -56.-Electrical-Final- ---t� � � � • �v�� - �� . , •:.: � r.a . .n � �.�,.: � :� � '� p . ,,..,..:, ��vc. v:�.... e„ .�nv,�u:.�n.-,.�,... . . . _ _�^ �.-�� ___ ___' .��_�" . '� _._ . , 15. RougiiElectric-P/inng '{---- • - � -�-�-----57.--Solar-SYstem�Final , .. . . .. �`.. ..... ....,,. '' ..... ............ .'.�' � � tFi.='?t=�ugiiHea4ing-&`AirConditiontng -c--:_.c_ `- - �� -- �._--. - • -_encing-&Access.Aqproval ,�„ , . .,, �;�' �- �"' ' �� .,_._ . . u _.17!_.Ducts'in.StEu'r.ture"_•', , `,_'_.1__�.. �-- --9. APPROVED'FORPLASTERING •'r � �•„ r� .,.. 18.---f��icth-VaMilatiag_ '. �' ' ' - ' '�.'3: l. ..�_ � - - ' :,� � � r��. , -'Y - -' '-. _ ... !, �.. . 19: G3s P(pe�ftougli &Test' -" - �� .r: 1. _ _ _ _ _:- "� 60 _ POOL/SPA'SYSTEMS�FINAL� "'' � + � ' , � �� , . �r . . �', i l-<^Ot�Roof'�, rain�flJ_ "!_"_ _ ' ._ . � _f . ..�A�' �A`/ J � .. � 'r u� � � . •q i��.� i�. vo: � w A � 21,� .RoofSh�€aihinc -----T,., ... .. �.^- --`-� --.,_ -- -- - ,:�� .y�� ! .�i:�,n:,�•�••n'si�.+�� _ '-f..__' ' ' " ' ' ' " 4 "_ ` 3 f�U.' ^t16_ . - NOTES�•.'�ou_�i�� n � � , c, , i ..n:• . ,or::t � , . r: , • : -22:- .Fram2 and'-Flashin - - - !- ., �� y?_ - - -_ � - -� --- � �," ., :� Z3:- I��SUI8t40n- �_." ' _- . ' 1_ � ..�•',�}? �'�'-_,c J. �n . _._-l1... `�,. �u ; �Z4: l �Fhi i(� F9-S°ding - .,.. _ -i.- � _ _ 9.iin . '�-bi.q " _`.�� :v � .�h �h. nn. � _ ___ "._ ' _ _ „i .� i+. � 25: .D�y'.iL!I-:.lailing_ '_ ' +.r-.�. � �_ ,il 'i � _' ' � t•tt._ _, __ _ i' r'�l �'� _��7 ,. i . � ' � , n . , ^� ': _ .�_ . no.�..� � - �... r -� ��i� �;. 26�--PlasteY-Brown.Cuat n� .v��.. � �. . , :" .�_.b � .`,i 'n•.�'�. �' !i 27: -�- Electi4cal.Fowei� iUleter-Final:- - -- . t -L-- T - - ` -'" . i;re._ _ � � _ _' _ a ��. • �m� �,;L ' . . � ' ,��,� f -"LB' -�F:<�aI,E{eotr�o � - -- - - ; - - - - �_ -- - - � �,�,a:, . . . . .� . . - �; p . . .' . �� _ _ ' 1' !R ).. .h �� (n�i:'� 4. ^ ) �.p � .... � � __ _ . '-28`. �Fiaal�He3tin .. . • � "...' . . . , ,•" � • - - . _ �r . .., . � ,- .,� , .. i 9�&-Air-Canditioning:_ � �; ..' .. .. . .. ... T �. .�, •.p„i. , , _ ._..._" . __` _ r _ _.. ' _..._ _' _ ' _ _ .. 1 __3U!_._Fanal'Ga�P.ipe•T.est _ . � _ 1 � . . , l ,.,. � � . � .. . . . .. � ., ,: . i: . . 1 _ _ _ __ _ . . .. � .� . __._ _, r� . �, • . > >�Y��,. in . . i. I_31!_ F..inal,Plumbin9-- -..--' --- --_ ..�..-'- ' ---- -. - . .e . . ' �� - 32. -Water Service-F'nal - . , . ,_�.. � - - -�'.• . �a�:. .�.. H - �.r, i. .. �• ,�� . .,, 1 --- -- - - '---- -- - - - - - -- .: . 33�:. Gas�Service EinaL. --. _ - - '_- -• `- " - � -- � - - ' �_ � . _.° � � •� � �' � . ^ ' � � � � 34. Solar pornes[ic•�'irial .."�. � , .. , ir:� r K ' + �. +`, r i 35: Landsca�2SprinklinaSYstem� *' � � I-..- _�, '" „ �:��rr� " . " � : •,� . . ,�„" .c^ . -. � vo , � i36. Sound A tenuation -- - - � i i- •,•r' C� ��,]-. .,•�. .••� n . .y . 1 .t . 1� ��o�, , :m.� � . Sr �n. � � j� � 37. � Handicap,Regulations - - . . � ... � � . ,H. ��.��.�c :��. .a»�:�. .t � - .. , :,-,;.r•-=. ':;�,. , '; e:,.�.:..� . . . �. ,..,. � , . .-- - -. . .� � •. - : • .. , ' 38. FINAL STFUCTURE & BUILDING � • ` > • ' 1 " ' �' � •i � . j - --. � , , I 39. Special Req�ir,ements ComPleted . . ". -' i � � � . ,., . n ,.., -_---.�. _._ .. .. ,�.... :,,,,. . �,,.. , , _-___..-- - -- _ . . _ _ � . _ . _ . � 4. � 40. Electric Release to Edison '� � ' "' � _ ' j • , • u� �: ,,,,�. . ��,'.•" ° �, . ., _. N 1 41. Gas Rele:�se to Southern California Gas Co. � � � ,,,� ... .._;r� . ..,. .... .�-� , .. . . . � . .- -- -- -'-' - . , _ . .. . � �.,.. r�. 42. CERTIFICATE OF OCCUPANCY . . _ _ _ ___ � j ' No._ '� �: � Date � - - -- i �� _._ _ �_. . _ - .'- - - � -- -` - - - -' -. .� '; - - ._ --�-- . �- �� _ �- �. , . � . � ��.. � . . . . • 1 . -/P— Z,L,gZ� SIGN PERMIT \ �� T CITY OF COSTA MESA Planning & Building Safety Departments � Q��, /� P. O. Box 7200 , y� Costa Mesa, CA 92626 (714) 754-5245 Building $ite Address � Name of Le • ,., Contractor 4 • Location Tag No. Type of Sign L�Q�- y�Electric 'p Non-elect�ic e r2L'l '�/�Ol`i License No. �� — ��n License No. Address ,�C2, �� % J�� GO/✓C � Cityi`�l��'.'�/� [ �LL�Li Zip /�✓ �� Legal Owner of Sign Addiess ��— �`d /'7�Y �/% City ❑ Gmund 1 � Wall y � � ❑ Roof ❑ Projecting ❑ Constmction ❑ Convenience ❑ Super Graphic �Planned Signing ' �N� � C.U.P.lVO. _ Descriptions ❑ Canopy ❑ Attraction Boacd ❑ Advertising Statuary ❑ O[her ❑ Tract Sign (Security & Right of En[ry Agxeement) ❑ Special Event (Request form submitted) ❑ Change of Copy�.(amo:tization) P`ograms ❑ ShoppingCen[er/In[egra[eddev. p By Owner/or ❑ by City (Date letter sent Phone IlWmination ❑ - - Nomiliumina[ed �DvecUy lighted. ❑ Indirectly lighted �Variance � `�'� —� `� � ) ❑ Minor Vaziance All applications mus[ be filled out by the Applicant, all foo4ng, f�aming, electiical and final lnspections shall be called. (714) �/-�/� �//�Q Valuation: Signature of Perrtii[[ee �X�GP _/.ui�-G� p�anning fe $ Building fee Authorized Agent Plan Check fee �� To[al Fee $ — Received by � Da[e Date Ap�oveQ, '� % C7 �"^ !�� ,H � o / L e,lii. Signature (Bldg. Staf� � � Signatute (Planning Staf� . Date ! (Appioval subjec[ m the condifion of Ord. 74-25 Sec.11l 3.d) _ CMF 006832 White - 6uiltling; Green - Customer; Canary - Planning; Pink - Finance; GOIEenrotl - Assessor / D [ e Y A i ia�z ii�7i62 OPfice Use Only 30.0❑ 7�; Property A.P. No. / � � � Zoning � �. Sign Dist. ' Date Received: � Received by: ' Street frontage: Front:�� ft. Sveet: �� Right: ft. Stxeet: � Left: ft. Sveet: Reer: ft Street: Building set back &om center line of street Ct. �iaster Plan Highways ultimate righhot-way ft. } Sign Loca[ion � Fiont� Right Left Between propertyJine & ultimate iighhof-way ' �� Ground Signs ❑ 7 fL & 15 sq. ft.for ❑ Table 2 Plantec Area= ,l /S�ign �(�, /�-� Area of Sign �. v in. x-d� ft �in. --�Lv 1� � /1 � ' � sq. Cf. Ground Clearance �� ' Overall heigh[ �� D `� � ' . Letterheight �r�� 3�� ' [tems of Infor a[io sp_Total Sy.Ft. of all Signage ` � Copy veibage ��%L! P�r'�� L�.` � � H � .' - . v pmortization . Subject to Amortiza[ion: ' yes ❑ no Expiration Date i OfPice Use Only � Insp.B Px B Px No. Fm..� Px A Px �o. (/�JJ��, , /J�T/+ Y{; �, I/ i/S //_ '{��Q� 3300 WEST OLIVE /A`/ENUE 9i505 I v�xa�u� i�, 1980 c.i,ty og coa.tn h4eaa 77 Fa,ilc Dn,i.ve Caa�n Me,�a, Cak.i,boan,in 92626 Re: LeLte�c o� Pe�un,i,s6�.on �on. Ryde�c Tnuefz Ren,ta.C, Inc. Gen.tPcinen: 6 843->650 049-2Y01 ..'/�,,,/�.,/; G;,/,/'„�«� A� .tl�� own�lc o6 .the rytopeh,tg eRown a,s Pahce,e 13 on unrtecohded Pcu�ceC Map, i'.S.T.951�, Ten,ta,t,i,ve PAap S-80-393, we heneb� g�.ve Ryde�c Tnueh Ren.taC., Inc. pe�cm.i�sa�.on #o en.teh upan owc pnopehty �to coiw.t�cuc.t cbccunnge �ac.i.Zi.t,ie� and �o di.ec{wnge �+aa.ten Unom Pance2 1G theneon. Tlu.a �Gw,i.nnge cLi,acluvcge .i,s .in conbonmance w.i.th .the apivtoverf Hydnokogy Ma� o�a b.i,2e a.t .the C.i.iy. S�.nce�ceCJ you�, JACKBILT INC � • _- -- -�----p-la�:-eti�_.i�- k_4gS6 - ( Ra�c:)ess;�r{owara W�• b� /Zn.. �''I�'1�%r� �!/- G — S o 0 17 ,�� n ii w�C, JDH/mno ec: fUaP�ten £ ASsoaia.te.s, I�ie: �3�P�#�ic�ZS david hutchison 4815 main street california 92686 November 5, 1980 Costa Mesa Building Department Post Office Box 1200 Costa Mesa, Califorilia 92626 - architect yorba linda (714) 996-2902 Enclosed is a letter granting permission for drainage for the Ryder Truck facility on Howard Sday.- Plan ck. �r44836. l�. t�•� �/4�8 I I /�VP��ant to fill in ali spaces within heavy bortler lines antl sign all appropriate tleclaration CITY OP COSTA MESA � � PERMIT NO. TRACT NO. LOT NO. �BLOG.NO. CONSTRUCTION PERMIT M i �� Address L_1 � /a ( ! Arch/Eng. - Address ' ' Contractor �,�/f�� Address ��y' LICENSEO CONTR. 1 hareby atfirm that mencing' wlth ' secHa Professions Code, ' License Class G Date ! � Z � WORKERS•COMPE 1 hereby affirm that L1 Wd� '. � TVPE OF CONSTAUCTION '/'pS PhO e � Z �NEW ❑ ADD ❑ ALTERATION �IO�/TG/d � ❑ REPAIR ❑ CONVERSION• ODEMOLISH License No. ❑ OTHER DESCRIPTION OF WORK �l/ (�yj 4� y�/y-�L '-' Yhone� J 3C TYPE OF PERMIT � - - �S MON�Z'V� �} ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ' TOR DEGLAR TION _ _ . " ❑ TENANT ❑ ELECTRICAL ❑PLUMBING �MECHANI m Iicensetl unCer provisions of Charter 9(com- �. 7000) �ot rDivislon 3 of tne Business and ❑ pTHER-- my Iicense is in tull torce an� eff�ct. pROJECT DESCRIPTION .. ZC ' e se�No ' Zd'Z . Signature �� - SQ. FT. � . ATIO LARATION �OCCUPANCY_CONSTRUCTIONTYPE hav ertiticate of consent to salf-insura or a VALUATION ZONE Compensatlon Insurance, or a certifietl copY � -a�p �j� �`�Z �J� �F�..�n RADING CU. VDS. ACRES .Y NoCL'�O/'(J`�i/�/ �omPanY �it�C.S%'�/�I`� —" 'Y �y LJ Certlfletl copy is hereby furnishetl. � REMARKS: � ' �Certlfietl cOpy is tiletl with t�e clty BUIltlinq �ivision. EXEMPTION FROM WORKERS' COMPENSATION DECLARRTION ' ' �� (Thls section need nat be completetl if the permit is tor one huntlretl fS100) or Iess1. f CBrtiry thdf ln tM1e performance of tne.work for which this permit is ISsuetl, 1 shall not BmplOy any pe�son In any mdnne� so as to becom¢ SUbjeGt t0 thC WOrkels' Compe05dtloh LawS ot CdptOrnia. ' . Date Signature � NOTICE: If atter making thls tleclaration, you shoultl bemme subject to thB WO�kets' CompenSatloO provl5ion5 Of th¢ Labo� Cotle, you mu5t torthwith comply with sucn provisions or this permlt shall be tleemetl revOketl. � - . - CONSTiiVCTION LENOING�AGENCV', I hereby affirm.that there Is a mns[ruction lentling agency for)he per- tormance of-the wo'rk forwhich this permit 15 Issuetl'(Section'3097 Civ. C.j. ' - ' - ' �entler's Name � Lentler's Atltlress OWNER BUILDE0. DECLARATION- - � ' I hereby atfirm tM1at 1 am exempt from the Contractor's License Law for the following reason'(Section 7031.5 Business antl Professions Cotle: qulle5 [be appuCant wl sucn pelmrt ro rue a IS IIC¢OS¢tl DIIISudOf SO ih¢ O�OVISIOIIS�Ot lhC ness antl P�ofession5 Cotl¢) or that'h¢ I5 exeropt ther2from antl the ; for [he alleqeG exemption. Any violatlon of Sectlon 7031.5 by _ y appliwnt for a permit sublects the applicant to a tivil penalty of not more than five huntlred tlollars ($500). ❑ I. ds owne� of the property, or my employ2es with waqes as thei� sole compensation, will tlo the.work, ana the structure is not intentleG or offetetl tor Sale. (Sectlon 7044, Bu5ine55 a0tl R'ote55ion5 Cotle: The Con[ractor's Lirense Law tloes not apply to an owner of a property who builtls o� improve5 Ih¢reon, antl ho tloes such work bimself o� tM1rough �his own employees, provitletl that such improvement5 are not intentletl or offeretl for sale. If, however, the builtling or improvement Is soltl withln one year of COmpl2tlon, tne owner will have tne burtlen of p�oving h¢ tlitl not build or improve for [he pu�po5e of sale). ❑ I, as owner of' itte' p�operty, am exclusiv¢ly con[racting with licensetl contractors to construc[ the prolec[ (Section ]044, Business antl Pro(¢sslons Cotle: The Cont�actor4 �.Icense Law tloes not apply�to an owner of prOperty wM10 builtl5 or imp�oves [hereon, antl who Wn- tracts from sUch p�o7ect5 with a'wntractor(5)'IiCCzn¢tl pu�suant'to Ihe ConVactor's license Law). � I am ¢xempt untler Section � B. $ 7. C; for this reason �ate '� Owner I hereby rertifytnat I nave read this applicafion antl state that the above PLUMBING��. BATHTU85 LAVATORIES KIT. SINKS SERVICE SINKS PLAN CNECK SHOWERS URINALS DOUBLE LAV 5 DISHWASHER$ SUMPS FLOOR DRAINS DRINKING FOUNTAINS � — INTERCEPTORS CLARIFIERS $WIMMINGPOOI� ' �PTRAG WHTERSERVICE ALTERATION GASSERVICE OUTLETS WATER HEATERS ' 'BTV OUTPUT� SEWER CONNECTIONS SOLARTANK� COL�ECTORS SOLAR PIPING SVS. ISSUE FEE MECHANICAL PLAN CHECK HEATING SVSTEM 0-100,000 BTU AND DUCTING 3 100,000.+ BTU � REFRIGERATION 0-100,000 BTU� SYSTEM � 100,000 t BTU �y BOILERS BTV SVSTEM REPAIR, AITE(3ATION EXHAUSTSVSTEM MULTIPLE Information is correct. I agree to compty with all City antl county ortlinance5 antl siate Idws r¢Iati09 to con5t�uction, antl hereby autho�Ize - represen[atives of thi5 city to enter upon the abOve mentlonetl property.for I pe o pur Q,S,. .. ..,_�_Y/ Si re Da[e d rivers ense r 55 � %� - ISSVE FEE '' CMF 0865-46 White-Building; Gnary-Applicant: Pink-Accounting; Goltlenrod-AsSessor �-� �. ...� 8261 .7/07/BI 36.�0 TL , �.. A.P. �' ZONE P�NG. REF. � REAR VARD (TO P/L) - PKG.SPACEREQ. PROVIDED STREETWIDTH � PARK�FEE$ ZONING APPROVE� BV SPECIAL CONDITIONS: ELECTRICAL � PLAN CHECK I . I�' GENERHTOR 0-1 KW_1-10 KW � .TRANSFORMER � APPLIANCE 30-SOKW_SO+KW MOTORS 0-1 HP_1-30 HP ' ' . ' �QNC.SOLAR) 30-50HP_SO+HP_ � -�� FIXTURES OUTLETS SWITCHES ' GAS TUBE SIGNS - ' POLE LIGHTS ' " - ' PANELS MAIN " - SUB ' SERVICE " ' - AMP — ' ISSUE FEE APPLICATION P.PPROVED BV DATE SUMMAHV OF FEES . BUILDING-' � � PERMIT $ � SMIP -S PLAN CHECK $ PERMIT•, . � - � ISSUANCE -$ � PLUMBING $ � � ' GRA�ING' S � PLAN CHECK $ � i ELECTRICAL $ -� � -� -� � $ PCANCHECK $ ' ' MICROFILM $�� (� `b .MECHANICAL' $�� TOTAL FEE $ � ' ^ � LE55 AD- PLAN'CHECK S VANCE PC $ _ - - \ � . � . � ' , � . FINAL FEE S CONSTRUCTION AND PLANNIN POOL & SPA' � APPROVqLS Permit# �� Date Inspector qppROVALS . Permit# .Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . Soii ipe-Undrgrn � 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn � 45. Forms 4. Electrical Conduit-Undrgm 46. Electrical Bonding - . tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 4g. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor SYstem 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � 12. Street Sewer Connection � 54. Heater & Vent-Final 13. Rough Plumbing � � 14. Rough ElectrioConduit � �56.� Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning `-�-� . • encing & Access Approval 17. Ducts in Structure ' APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathin - 22. Frameand Flashin NOTES: _y.y ^,3 �� 3 � 23. insulation - � /.9 24. Lathing & Siding � � 25. Drywall Nailing ' � 26. Plaster Brown�Coat - 27. � Elec[rical Power Meter-Final � - 28. Final Electric 29. Final Heating & Air Cqnditioning - 30. Final Gas Pipe-Test - 31. Final Plumbing ' 32. Water Service-Final - 33..� Gas Service-Final 34. Solar pomestic�Final 35. Landsca e S rinklin $ stem � ' � 36. Sound Attenuation .� � � 37. Handicap Regulations � � � 38. FINALSTRUCTURE&BUILDING � 39. Special Requirements Completed � � 40. Electric Release to Edison ' 47. Gas Release to Southern California Gas Co. � - 42. CERTIFICATE OF OCCUPANCY . No Date ApPlicanl to fill in all �CITY OF COSTA MESA . veamiT rvc ECOI�STRUCTION PERM within heavY bortler Iines antl sign all a ' ' TRACT NO. �Lp1 5�i ` : tleclaralions. BLDG. NO. �rro�ecci+aaress - - - . wa2� wd '• ' . TVPE OF CONSTRUCTION owner S ,S S Wt%�aS Phon -'L ,6�ryEw `,;O noo ❑.AITERATION n;� Addrea � - W ld ./'I�N`C(.. i/L ' '�REPAIR-�-CONVERSION-❑DEMOLISH �� . � •: Arch/Eng. "" - �' " - " 1 " 'Cicense No: - ❑ OTHEa- ,Addfe53�- . ' ' ^ ..- � . DESCRIPTIONOF_WORK G ��ContractorG2ow 4.,�� L /JPhone ' - Sd . TVFEOFPERMIT �. � - - Addr¢55 C S�UT Oil.%I�-�Vf� O GRADING ❑ FOUNDATION ❑ STRUCTURAL - � l-ICENSED'CONTRACTOR DECLAR TION �- � � � ❑ TENANT-O'ELECTRICAL OPl_VMBING ❑MECHANICAL 1 hereby affirm tM1at I am IlcenSeA untler provisions of Charter 9(com-' • ��.w , � fuencing wit�""section' �000) bf Division 3 oi' [he"Buslness antl• � � OTHER -- Professions Cotle, antl my lirense is in full force an ei,((p�t.�. - pROJECT'DESCRIPTION� License Class� L Z� ��%�}�� se N ��Z" Z ."' " ' Date��-^7�Q / c'��ar .c _lf -._.—' U� SQ. FT; " "' ' , WORKERS'COMPENSATIO LARATION -• "�OCCUPANCV_CONSTRUCTIONTYPE. I hereby affirm that I have ertifitate of conseni to self-insure or a' VALUATION ZONE '�}i�zte of Workers' Compensation Insurance', or a certifietl copy � - -�� .- � �of (Section 3800�I,.ab.�� /� GRAOING CU. VDS. ACRES .Y No l4tl/-O'lV/-l�rLromPanY-WCSIZ��J�%L/yQl�,ll� ' . . _ . . LJ Certifletl�copy�is hereby fumishetl: - � � � ' REMARKS: ' � - � - � - .�Certifietl topy is flletl with the city Builtling Division. E%EMPTION FROM WORKERS' COMPENSATION �ECLARATION ' ' �� -"� `� (This Section� neetl not be comple[etl if the permit i5 tot one huntlretl -_ . _ .. _ 1. _. (5300) or lezs�. •' - � � 6 C¢rt�fy that m thetperformance ot the work for which this permit is , ,. Issuetl, I shall no[ employ any person in any manner so as to'become PLUMBING - � �PLAN CHECK subject to the Workers' Compensation Laws of Calitornia. .- , _ oate Signature BATHTUBS- SHOWERS NOTICE: If aftet making this tleclaration, you shoultl become subject. TOILET$ ;,- URINALS - to th¢ Workers' Compensa[ion provisions of tM1e Labor Cotle, you must LAVATORIE$ pOUBLE lAVS torthwiih wrtlply with Such provi5ion5 or ihis perrtiit Shall be tleemetl �Cvoketl. - -- � . . � - . . - . - . CONSTRUCTIONLENDINGAGENCV� KIT.SINKS- DISHWASHERS� I hereby atfirm that tnere is a cons[ruction lentling agency for the per- SERVICE SINKS �' SUMPS � - Pormance of tM1e work for which, this permi[ is issuetl (Section 309] ' Civ. C.). � FLOOR SINKS FLOOR�DRAINS � Lentler's Name Lentler's Atltlress DRINKING FOUNT.qINS - � � j�'� - OWNER BVILDER OECLARATION � � INTERCEPTORS CLARIFIERS � � I hereby afiirm tnat I am exempt from tbe Cwtractor's License Law for th¢ following reason (SecUon �031'.5 Business'antl'Profes5lons Cotle: SWIMMING POOL PTRAP "" - Any city o� county wh¢h requires a pe�mit to mnstruct, alteq improve, tlemolish o� repair any'stvucture, prior to its issuance, also re- yyqTER SERV ICE ALTERATION � quires the applicant for such permit to file a si9netl statement tM1at he i= licensetl pu/suan[ to the provisions of the ConVactor's LicenSe Law GAS SERV ICE OUTLETS �pt¢r. 9, (commencinq witb Section ]000) of �ivision 3 of th¢ iess antl Prof¢ssions Code) �or that ne i5 eKempt Mereirom antl tM1e yyqTER HEATERS� - BTU OUTPUT for the allegetl exemption. Any violation of Section 7031.5 by , applicant for a'permit subjects the-appiicant to"a civil penalty SEWERCONNECTIONS � � � " '� of not more than five huntlretl doliars (5500). ❑ i, as owner of the property, or my employees with wages zs thelr SOLAR TANK �. COILECTORS ' ' sole compensa[ion, will tlo [he work,.antl the structure.is no[ Intentletl _ __. _ _ _ or offered for sale. (Sec[ion �044, Business antl R'ofessions Cotle: The SOLAR PIPING SVS. Contractor'S License Law tloes-not apply to an owner of a.properYy ,_ __, _ who builtls or improves thereon, ant] who tloes such work himself or ISSUE FEE through his own�employees, provitletl that SucM1 improvemenls.a�e not inlendetl or offeretl for sale. If, however, [he builtling or improvement MECHANICAL PLAN CHECK is soltl�within one year of comple[ion, Ihe owner will have the burtlen of proving he tlitl not builtl or improve for the purpose of sale). HEATING SVSTEM 0400,000 BTV ,�� J" ❑ I, as owner of' lhe property, am exclusively wntracting with qND DUCTING - e'u,b�(I) � licensetl contractors lo construtt tM1e project (Section 7044, Businezs 100,000 + gTU antl Professions Cotle: The Contractor'S licen5e Law tloes not apply to an owner of property who builtls or improves thereon, antl who con- REFRIGERATION 0-300,000 BTU [racls from sucM1 projects wiM a contractor(s) licesnetl Oursuant to ' SVSTEM ' - - - - [he Contractor's License Law�. SOO,OOO+BTU ❑ 1 am exempt untler Section 8. & P. C. for this - BOIlERS BTV ieason - ' ,_,___ _ , _„_____ _ __ _. _ . SVSTEMREPAIR,ALTEt3ATION CMF have reatl this application antl state that the aCove .L 1 agree to comply witM1 all city antl county aws relatinq to wnstruction, antl hereby authorize �i5 city to ente� upon [he above mentionetl �, P4�5. _ _ . O_ _F'I �6g�*� Date EXHAUSTSVSTEM MVLTIPLE r55�U/ -( � ISSUE'FEF ' - - Whi[e-Builtlin9; Canary-Applicanh, Pink-Accountin9: Goldenrod-Assessor `, �; U`�_.i;� . . .` � � -., - _ . 6722, 10/13/81 ZONING REGULATIONS • � A.P. $ � . ' ZONE PLNG. REF.��, � REARYARD PKG.SPACE STREET WID ,`,; j33.00 TL, IDED� .,� FEE $ -. . ZONING APPROV,ED BV . I DF SPECIAL CONDITIONS: - - . � . . � _ . ^ • :Y� . ELECTRICAL - ' ` PLAN CHECK - GENERATOR 0-I KW_1-30 KW � TRANSFOftMER • APPLIANCE � ' 30-50 KW_50 + KW ' ' MOTORS ' 0-1 HP_1-30 HP �(INC. SOLAR) - 10-50 HP_-50 + ryp FIXTURES- "-OUTLETS SWITCHES ' �GAS TUBE SIGNS ' ' - � - ' POLE LIGHTS ' - ' - PANELS ' - MAIN '- SUB' SERVICE "- " ' AMP - ISSUE FEE' ' ' �--- �" APPLICATION APPROV ED BV . DATE- ^ . t SUMMARV OF�FEES ��--J BUILDING PERMIT .$ ^ SMIP , $ �PLAN CHECK $ PERMIT - � ISSUANCE $ PLUMBING• $ - , - GRADING $ ,, � PLANCHECK $ �• • 'ELECTRICAL $ � - S � PLAN CHECK $ ' � � MICROFILNI $ � ' MECHANICAI'-$ �-3-- ' TOTAC FEE $ � . ' � PCAN CHECK' $- '�' VAN E PC' $_ I , 33� .� � FINAL FEE y CONSTRUCTION AND PLANNING � � POOL & SPA' , : �. , APPROVALS Permit �h ��.3 5 Date � Inspector , � � � ��'� - Date :.Inspectoi �� ' 1 � \ E I \.; I . ,..� � APPROVALS , Permit # � 1 Temporary Electrical Service or Pole '• t 43. Pool & Equipmerit Location � �' - � 2. Soil ipe-Undrgrn � - 44. Steel Reinforcement - - ' - �- �� 3.. Electricai Conduit Utility-Undrgrn 45. Porms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding �� . tee ein orce • 47. Rough Plumbin & Pressure Test,.. ' • 6. Electrical UFER Gm � 48. APPROVAL' TO COVER-GUNITE - � 7. Footin95 ' 49. Electrical Conduit-Undr rn • - 8. Foundation ' - � 50. Gas Pipe, ❑ Undr rn, Test � � � 9.. Water Pipe-Undrgm� 51. Backwash Lines P-Tra ❑ ndr rn 10., Structural Floor System, 52. APPROVAL TO DECK ' • 11. Property $ewer Line & House Co'nnection 53. Backwash & Rece tor-Final � 12. Street Sewer Connection • 54. Heater & Vent-Final � �� 13. Rough Plumbing _ -� � � � - � • - � � � 14. Rough Electric-Conduit � - -• .56. � Electrical-Final � � 15. Rough Electric-Wirin§ � ' � - ' � 57. Solar System-Final � � - - 16. Rough Heating & Air Conditioning _ - � encing & Access Approval � 17. Ducts in Structure. • � � APPROVED FOR PLASTERING 18. Ducts, Ventilating. . � 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL � 20. Roof Framing ' � ' � 21: Roof Sheathin ' - 22. Frame and Flashin NOTES: � 23. Insulation - . � 24. - Lathing & Siding � - ' 25. Drywall Nailing ' � � � 26. Plaster Brown Coat - - ' � 27. �Electrical Power MeterFinal . ' ' � � � 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 pomestic-Final � • 35. Landsca e S rinklin S stem � ' 36. Sound Attenuation • � ' 37. Handicap Regulations - ' � 36. FINAL STRUCTURE & BUILDING � ' 39. Special Requirements Completetl � ' � ' ' - 40. Electric Release to Edison ' � ' 41. Gas Release to Southern California Gas Co. ' �� 42. CERTIFICATE OF OCCUPANCY . " No Date �... f.iTV OF COSTA MESA ' CONSTRUCTION PER 'Address Address Address ApPiica�nt ta �fill in all PEI RMIT NC a within neavy Dortler linez ana s19� all aooropriale tleclarations. � - TRACT NO. LOT NO. �BLDG. NO. '� I hereby afflrm that I am Iicensetl untler provisions of Cnarter 9(com- mencing with sec[lon ]000) of Oivlsion 3 oi the Business and Professions Cotle, antl my Ilcense is in tull force antl ef(ect. License Class License No. Date Signa[ure � WORKERS' COMPENSATION �ECLARATION -- �I h¢r¢by affirm that I have a Cer[ificate of consent to self-in5ure Or a ^^•tificate of' Workerz' Compensatlon Insurance, or a certifletl coOY +.ot (Section 3800, Lab. CJ. � No. Company � � ertlfietl copy is nereby fumi5hed. � -� u Certifietl copy is filetl with the city Builtling Divisian. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl no[ be completetl if tne permit.is for one huntlretl ($300) or less). , I certify that in the performance ot the work.for which this permit is Issuetl, 1 snall not emplOy any pe�5on in any manner so as to become subj¢ct f0 the Work¢rs' Compen5ation �aws ot California. . Date $I9ndture NOTICE: If atter making this tleclaration, you shoultl become subject to the Workers' Compenzation provislons of the Labor Code, you mus[ (o�thwitn comply with such p�ovisions or Ihis pe�mi[ shall be tleemed revOk¢tl. • - � - - � - CONSTRUCTION LENDING AGENCV I M1ereby aftirm that th¢re i5 a cOnstruciion lentling agenCy for the per- formanCe of [he work for which [his permit is issuetl ($ection 3097 Civ. G.�. .Lentler's Name Lentler's Atltlress OWNER BUILOER DECLARATION- � � I hereby atfirm Ihat I am exempt from.the ConVacto�'s License Law for the following reason (Section 1031.5 Business antl Professions Cotle: Any city or county, which requires a pe�mit to construct, alter, irtfprove, tlemolish o� repair any strutture, prior [o ils issuance, also re- quires tne applicanl. far such permit to file a signetl statement that he iness antl �Prd¢ssions Cotle) or that he is exempt theretrom and the tor the alle9etl exemption. Any violation ot Section ]031.5 by appliCant fo� a permit subjects [he applicant to a civil penalty not more than five nuntlred tlollars ($500). ❑ I, as owne� of the p�o0erty, or my employee5 with wa9e5 as their sole compensation, will tlo the work, antl the s[ruc[ure is not intentletl or otfered for sale. (Section 7044, Business antl Professions Cotle: Tne Conlractor'S License-Law tloes not apply to an owner of a property wh0 builtls o� imp�oves the�eon, antl who tloe5 su<h work himself or throu9h� his own employee5, provitletl that such improvements are not Intentletl or otferetl for SaIE. If, however, [he builtlinq or improvement is soltl within one year of completion, the owner will have the burtlen of proving he tlitl not builtl or improve for the purpose of sale). � I, as owner of the property,-am exclu5ively mn[racting witM1 IiC¢nsetl contracWrs to wnstruti the project (Section 7044. Bu5ine55 antl Professions Cotle: TM1e ConGactor's License'Law tloes not apply to an owne� of property who builtls or improves tnereon, antl who mn- tracts from such -projects with a contractor(s) licesnetl pursuant�to [he Contrat[or's Litense Ldw). ❑ I am exempt untler Section B. & P. C. for this reason"' ' ' ' ' Date� •• � Owner � - - - - 1 hereGy certitytha[ I e reatl his ication antl state tM1at the above TVPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑�ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH O OTHER DESCRIPTION OF WORK TVPE OP PERMIT - ❑ GRADING . ❑ FOUNDATION ❑ STRUCTV RAL ❑ TENANT � ELECTRICAL OPLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION . ` - - SQ. FT. OCCUPANCV_CONSTRUCTIONTVPE VALUATION ZONE GRADING CU. VDS. AGRES -REMARKS: � �1 / _ - 9 ,P ... .. — PLUMBING, � � PLAN CHECK BATHTUB$ SHOWERS TOIl.ETS URINALS LAVATORIES DOUBLELAVS KIT. SINKS � DISHWASHERS � SERVICESINKS . SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS � INTERCEPTORS CLARIFIERS SWIMMING POOL - P TRAP WATERSERVICE � ALTERATION GASSERVICE OUTLETS WATER HEATERS BTU OUTPUT � SEWER CONNECTIONS SOLARTANK COLLECTORS-� SOLAR PIPING SVS. ISSUE FEE MECHANICAL a�Arv CHECK HEATING SYSTEM 0-100,000 BTU_ AND DUCTI NG 300,000 + gTV _ REFRIGERATION 0-300,000 BTU_ SVSTEM � 100,000 + BTV _ BOILERS BTV SVSTEMREPAIR,ALTERATION _. EXHAUSTSYSTEM MULTIPLE info�mation is cor ct. I agr to c mply with all city antl county ortlinanCes antl s e Idws rel ing t n5tr ction, antl heveby authorize rep�e5entativ oi this ci to [ the above n ionetl� property for inspe t'on s. . � SlgnaWre � Data� �- ISSUE FEE '' � Drivers' ice e or 55'$ � CMF 086 -46 While-Builtling; Canary-Applicanh Pink-Accountinq; Goltlenrotl-Asse55or >>s� �,�, _:� �, � _ . . - 4 A.P. ; ZONE REHR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BV SPECIAL CONDITIONS: ELECTRICAL 3 I0/07/81' - Tl REGULATIONS � " " ' " PLNTGp. RUEF. � - � 7ROPE�RTV LINE � ' L PROVIDED PARKFEES � � DATE PLAN CHECK I . � - GENERATOR p.l KW_ 1-30 KW _ TRHNSFORMER -APPLIANCE 30-50'KW_SO+�KW _ MOTORS ' 0-1 HP_1-30 HP _ (INC. SOI.AR) 30-50 HP SO+�HP _ FIXTURES OUTlETS SWITCHES GAS TUBE SIGNS ' POLE IIGHTS ' �PANECS � MAIN SERVICE ,/.t y/}/ A A�-I � ISSUE FEE � .APPLICATION APPROV EO BV SUB AMP p _ .. DATE � SUMMAfiV OF FEES , BUILDING ' ' - ' 'PERMIT $ SMIP. a $ � PLAN CHECK $ PERMIT . � � � � ISSUANCE� $ PIUMBING $ �- GRADWG S ' PLAN CHECK $ , � ' ,$ ELECTRICAL S� , PLAN CHECK �$ ' � �`�11CROFILM $ � � �� " � - ' TOTAL FEE $ � MECHANICAL.$ � �� LE55 AD- ' PLAN CHECK' $ VANCE PC 8_ - , • . ` 1 "'. ._ _ . , . { _ � FINALFEE S, a�_ CONSTRUCTION AND pLANNING �/ POOL & SPA -_ , -� APPROVALS Permit # --! o�y� Date Inspector APPROVALS Permit # � Date , .Inspecto'r � : _ , �Y •��,Temporary Electrical'Servicelor Pole � � 43. Pool & Equipment Location - - � ' � � - . Soil Pipe-Undrgm � . �- - 44. Steel Reinforcement - � � � ' � 3. Electrical Conduit Utility-Undrgrn 45. Forms � � � 4. Electrical Conduit-Undrgrn - � 46. Electrical Bonding ' � � . tee ein orce ` � 47. Rough Plumbin & Pressure Test ' 6. ElectricalUFERGrn " ' " ' 48; APPROVALTOCOVER-GUNITE• � ' ` ' � � 7. Footings - 49. Electrical Conduit-Undr rn � 8. Foundation � 50. Gas Bipe, ❑ Undr rn, Test 9. Water Pipe-Undrgm � 51.� Backwash Lines P-Tra ❑ ndr rn � � 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final 12. .Street Sewer Connection � ' 54. Heater & Vent-Final � 13. Rough Plumbing � � - � - �. . � � -� � - ' 14. Rough Electric-Conduit � � - - - � �56. Electrical-Final ' 15. Rough�Electric-Wring - - � �� 57. SolarSystem-Final: ' � � '� � � � ' '� i 6. Rough Heating & Air Conditioning. - � - � encing & Access Approval 17. Ducts, in St�ucture ' g• APPROVED FOR PLASTERING � � 18. Ducts, Ventilating _ 19. GasPipe-Rougfi&Test 60, POOL/SPASYSTEMSFINAL � 20. Roof�Framing - � � � � � 21. Roof Sheathin � � . � . 22. Frame and Flashin � NOTES: � � 23. Insulation � � 24: Lathing & Siding � ' " � � 25. Drywall Nailing � � ' � � 26. .Plaster Brown Coat � ' � ' 27. Electrical Power Meter-Final /u-cs-iq _ C_ 28: Final Electric�- � � � � 29. �Final Heating & Air Conditioning .. ' � - � 30.:.Final Gas Pipe-Test ' � � � �, 31. Final Plumbing ` � ' � ' ' 32. ' Water Service-Final ' ' 33. Gas Service-Final � � ` - � ' "' � 34. Solar pomesticFinal � ' ' � � 35. landsca e 5 rinklin -S stem � � - 36. Sound Attenuation � . 37. Handicap Regulations � � � 36. FINALSTRUCTURE&BUILDING " ' � � : 39. Special Requirements Completed � � 40. Electric Release to Edison � ' � � � � 41. Gas Release to Southern �Iifornia as � 42. CERTIFICATE OF OCCUPANCY - No Date � .ICATION FOR A BUILDING PERD' BUILDING PERMIT N0. Eiectrifai co T/act BIOck Lot Pe�mit No. � Builtlln9 Plumbing , a � Atltlress 35 3� NvvJP2� �Y / /�� Permil No. � Cross � f`O Mechanical 6 Ar¢a Street Permit No. n e m Owner 2��ZvZ "(Q,Jul` 2�J �/� � Type ot Roject: ❑ New ❑ Alter ❑ AtlUitlon � Atltlress �j(�j `� �, �, QjZM S � ❑ ReOa'r ❑ Conver[ ❑ Demo ❑ Occupancy Pmt. City �'` � AM I r'L.i� � Zlp PhOne A.P. Sup. OISt./ Insp. Area Architect/^- Desi9ne� '�Jy�1 n N\/ l �'k ��Lice�s¢ No. Zon¢ Spl. Pmt. NO. Atltlress �}JV� S �p��1 5-�, Setbac s P/L Front C/L SL Street Witlt❑ Vartls Left , Righ ear Gty\��y �I,J(�� ZIP Phone , ave rol. e 9. _ i` Engineer ��'j�,�/yU� (��S��.L�Icense No. � � Pa�k ng 5 e ire /ov e overe n Atltlresi G� �j �S �`N s( �4 ��3- Stru<t No.of No.of m Ciry �r��A. `�;J(�p. ZiP PhoneA22-(rSSS Height Scories Family � LICENSED CONTRACTOR'S DECLARATION Park Fees ves � Fee � ReqWretl No C.T. peceipt m I hereby atfirm that 1 am licensetl unAer {vovisions of Chapter 9 r (commencing with Section 7000 of Division 3 ot the Business antl Zoning Approvetl By: Date Profes^,ions Cotle, antl my licensa is in tull force antl fte�tl. � License Clas< <' - ��' License Number �� `-�� - > Data 4 - �" '� � Conirector �' v�� '`'m�3� Nlf� �+�V�� Misc. E Atldress3�6 a. �A�-��v.n a� Proposetl Use jy CityanC 2ip �`Nn��M � �i�- kuS ppo�e53i^i�� of 5trutture �v� CONSTRUCI'ION LENDING AGENCY � I hereby eflirm that there is a consvuction lending agency for the a perfo�mance ot the work for which this permit is issuetl ISec. 309], Occ. Type Cotle i Civ. CJ. Class Const. vear C Lender's Name USE/O CUPANCV SIZE SU. FT. Lentler's Adtlress '� OWNER-BUILDER DECLARATION y 1. I hareby attirm that I am exempt trom the Conttactor's License Law A for the following reason: � ❑ 1, as owner ot tho proparry, or my amployees with wages as their 2. � zole compensation, will do the work, antl the shucture is nat �L„ intentled or offered for sala. 3 � ❑ 1, as owner ot the property, am exdusively contracting with licensed conhactors to cunsVuct the project. w ❑ I am evempt untler Sec. __, 8&PC tor this reason 4' N a Date Owner E WORKERS' COMPENSATION DECLARATION Totai Valuation � 1 heraby affirm :hat I have a certiticate oY consenc to self-insure, Encroachment Permit Requlretl ❑ Ves ❑ No Y or e certifiwte of Workers' Compensation Insu�ance, or e certified C copy thereof. Gratling PmL Gratling � Policy No'�2-�5-gg Company ti'�M�S �NS Requlretl ❑Ves ❑No Pmt.No. �a �'}`Cartified copy is hereby furnish G ❑ Certitied copy is tiled with ang nt , q, Rough Gratlinq � Approvetl by: D e a Daxe 4-�v'1� APPlicanc 3 CERTIFICATE F EXE P7i N - FROM WORKERS'CO PENSATIONINSUHANCE Z (This sectlon nead mt be c mpleted if permit is tor $100 or less�. � I certify that in t�e pertormance of the work for which this parmi[ is 3 issuatl, 1 shall nOt xmploy any person in any manner so as m become A subje<t to the Workers' Compensa*ion Laws of Calitornia. PERMIT FEES Dat�_ Ap�licani � NOTICE TO APPIICANT: It, after making this Certiticate ot Structural $ Alan Check § Exemption, you shoulA become svbject to the Workers' Compensation " provisions of the Labor Cotle, you must forthwith comply with such SPecial Electrical y ��VeS� E provisions or this parmit shall be tleemeA revoked. I CERTIFV THAT I NAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORREGT. I AGREE TO P�umbin9 $ COM?LV WITH ALL COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTH- Mechanical S ORIZ PFESENTATIVES OF THIS COUNTY TO ENTEfl UPON T AB VE jjJ�� TIONE/p PROPERTV FOR INSPECTION PUR- p�y.Gratle $ OSE � ��% J-"'��' InSPection ? 9��L �� Pre-Gratle Permit Signa[ureot icantorAgent Print ApplicanYs/Agent's Name �° Pldn IsSuance _ All spaces within this box must be completed to process Cneck BY: Approvetl: CMF 0335-66 (BU-2B) rev. 6/80 ICATION FOR A BUILDING PER11' BUILDING PERMIT NO. Eiecnicai Go Tract Biock l.ot Permit No. � 6 Builtlln9 Plumbin9 Atltlress �jr'J' �S oi W6�/7 I1/6�/ Permit No. ,� Cross � / �� MechaMcal n Area Street �XEn/�C ��E , Permlt No. �- A Owner ,�/�Q �,�/��([ �,�ir'4L lNG TYPe of Project: New ❑ Alter ❑ Atltlition � Atltlress 3�� w g2 ,�rj �Vf , ❑ Repalr ❑ Convert ❑ Demo ❑ Ocwpancy Pmt. CitY �v1/.4M/ � j� . ZIP'3�j/r>Z Phone A.P. S sP. Al�ea Architect/ Zo�e Spl. PmL No. Deslqner �Y//'7 f//�icense No. Setbacks P/L Front C/L SL Street Witlth Atltlrezs /S �A��/ ST. / 7/ Vartls lett Right ear CitY ORR�4 UN��d Z�0.�%Z(e8(� PhOne •147� ave �o�. e ig . . En9ineer License No. C �7AM � Park ng SPaces Requ retl rov e overe a Atltlress �9 St�uct No, of No, of m Clty Zip Phone � HeiqM1t Stories Fdmily � LICENSED CONTRACTOR'S DECLARATION vark Fees Ves Fee �° Reyuiretl No C.T. Receipt m I hereby affirm thet I em licensed under provisions ot Chapter 9 L (commencing with Sectian 7000 of �ivision 3 of the Business antl Zoning Approvetl BY: Date Professions Cocle and my license is in full force antl effectl. �j Licens..e. C�la.s��n �� License Number 2(a�s� � > Date.�I21��—Controctor. A�-rK�+. �47'E.�� Misc. E Atldress 4�� AR2o`'� �oposetl Use jy CityandZip M�NTGCCIR Phone%Z(n'Z44G ofStructure v� - CONSTRUCTION LENDING AGENCV � I her¢by affirm ihat there is a construction lending agency for the a partormance of the wo�k for which this permi[ is issuetl (Sec. 3097, Occ Type Cotle ' Civ. CJ. Class Consi. vear y Lender's Namo ��'�� USE/OCCUPANCV S12E SQ. FT. � Lentler's Adtlress J OWNER-BUILDEH DECLARATION � I heraby aHirm that I am exempt hom the Conttactor's License Law 1� � for the follawing reason: ' C ❑ I, es owner ot the property, or my employees with wages es their 2. sole compensation, will do the work, and the sttuctura is noY Y intentletl or offeretl for sale. . � ❑ I, as owner of the property, am ezclusively conVac[ing with 3� licensetl conttactors to consVuct the project. d ❑ I am exempt untler Sec. , 8&PC for this reason 4• N a Dete Owner ' E WORKERS' COMPENSATION DECIARATION Total Valuation � I hereby atfirm thai 1 heve a certificate of ronsent to seH-insure Encroachmen[ Permit Requiretl ❑ Ves ❑ No or a certificate of Workeri Compensation Insurance, or a certifietl C copy thereotf�E Gratlinq Pmt. Gratling � Polic No. �%�%�En Company �G �>'�E��'�R'4'�C Requiretl ❑ Ves ❑ No Pmt. No. n Certifiotl copy is hareby fumishx E Gy Rou9h Gratling � 6 ❑ Certifi�a copy Is tilad with Or e C nty,.Ej.�1� qpprovetl by: Date � a Date 311'L�L Applicant� �L� d70 3 CERTIFICATE OF EXEMP710N FROM WORKERS'COMPENSATIONINSURANCE z (This saction need mt be compie2etl if permit is for $100 or lessl. � I certify that in the performance of the work tor which this permit is 3 issuatl, I shall not employ any person in any manner 50 as to become � subjett m the Workers' Compensation Laws of Calitornia. PERMIT FEES Oat Applicant_ NOTICE TO APPLICANT: If, after making this Certifiwte ot Structural S Plan Check § Exemption, you shoultl become subject to the Workers' Compensation provisions ot the Labor Code, you must forthwith comply wi<h such Electrical $ S�QCia1 S prOvisions or this permit shall be tleemeA revoketl. Inv¢St. I CERTIFV THAT 1 Hl1VE READ THIS APPLICATION ANO STATE THAT THE ABOVE INFORMATION IS CO(iRECT. I AGfiEE TO P�umbing S COMPLV WITH ALL COUNTY ORDINANCES AND STATE LAWS REIATING TO BUILDING CONSTFVCTION, AND HEREBV AUTH- Methanital 5 ORIZE REP SENTATIVES OF THIS COUNTV TO ENTER UPON THE AB E MENTIONED PROPERTV FOR INSPECTION PUR- Pre-Gratle POSE . 3 /3 /8/ ��5pection $ Pre-Gratle Permit S' nat�ra Applic�ajnt or Agent Date Rec. No. $ Issue $ ��.V/T� /ccaTe Print ApplicenYz/Age�nYs Name A17 s aces within this hox must he campleted to rocess P�an Issuance P P Check By: ApOrovetl: CMY 033�-46 (tlU-1tl) fCV. b/tlU J F C CW. Q � y .Z'i H G W F . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 �� For Applicant to Fill in Completely — Use Ink Only ADIDRESS �S. �-,�L'w��-� W T�E ANT�R ��,� T�2JG{L iZ�Ti�� . ADDRE S�I�{�7 N� VJ . ZJZN9, ST . CITV (V� � � CONSTRUCTION BRANCH ADDRESS ARCHITEf TEL. NO. L. APPLICATION FOR STRUCTURAL PERM[T 30� 20 7L' RECEIV DBj} PERMIT w , _ � A.P. NO. BUILDING ADDRE55 VNIT OR SPACE NO. R.NO. LOT NEW ADD ALTER OWNER USE A . ADDFESS <urve �` APPROVED CONTRACTOR � �fAS� �J.M 3�N Sc�.J, BY ADDRESS��(p pJ� /-�NA�"�`�/h TEL. CITV J�{��P, �-l.t�f/� NO.S�J�j- �_ L C NO. �I C3O�%L LICVNO. S12E I NO.OF BLDGS. OF LOT NOW ON LOT USE OF EXISTING BLDG. Separa[e permits are requued for electriq plumbing and heating work�. APPROVEDSETBACKS (FROM GL STREET) PLANNING ACTION VALUE 'p _ E DATE BLK. DEMOLISH DATE .�a � APPROVED � APPROVED r ..l � W Z aa I hereby acknowledBe that I have reatl this application antl state � that the above intormation is corract and agree to comply with U �+ all laws regulating builtling consvuc8on, antl I shall not employ � r 'z any permn in violation ot the wo�kman's compensation lews at d �. � che State of Califomie. SQ. FT. m 3 I hereby cenify that I am properly licensetl as a contractor untler � (� the State ot California Businass antl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VAIUATION IS FOR m X Chaptar 9, and that such licenses are in full forca antl atfect, or I THE PVRPC6E OF ESTABLISMING A PERMIT FEE ONLV: �� am exempt ir p�ovisions of She Siata of California Business VALUATION 4 antl Profe ons Cotle, ivisio , hap<ar 9. PERMIT FEE S 8, QO m J � PIAN CHECK 5 0 Signatur �� /�/ • LL Q Perm(ttae '` $ �/{ " TAX S 4:� � � Author@e Agent Oate 7�� I � TOTAL PAIO E, �{ n J.'n U ' `f . . `/ • . / � � � COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVILDING ADDRE55 �53�/ ��J "W.0 � OWNER OR �j`, TENANT /'�J��7� T�it' C �NC, ADDRE 5 '�(�C?� /tI�1/. �j�LAlb �.c� • TEL. CITY �� e�rj/� NO. CONSTRUCfION �a�E I FNfIFR BRANCH AODRESS AqCHITECT APPLICAT[ON FOR STRUC � RECEIVEDBI PERMIT ' . A.P.NO. `3 \�ULI BUIL�ING �� L� _ ADDRE55 1�� UNIT OR SPACE NO. R NO�Y[p� LOT I �J`C7U� I NEW ADD ALTER REPAIR OWNER R ��[�r T'r,u USE O{liK!_ L M1!J/. /sIAli ADDPESS L{S/S /{/(.p/N �Ti . rqAi3G CJNI�d ZONE � � APPROVED CONTRACTOR�.dE�A %jC-f�s• �� >TE�I� BV ADORESS �X'7�/ �$oW J`�`�'�/Y• ' TEL. ' ^ CITV M4�!%GGA/� NO.�p'LG7A4G �� _ F STATE CITV � P.P7ROVED'_ � LIC. NO. 'L(PloS�%O LIC. NO. SIZE NO.OF BLDGS. (FROM( C�S 6. OF lOT 3�jz£� NOW ON LOT v FROM`�� a USE OF '� EXI5TING BLDG. /�� y F.- Separate permits are required for � electric, plumbing and heating work: F USE OF BUILDING AND WORK TO BE PERFOfiMED Q a %QCiC.� r�E �JL �/G/ 9 N � z w I ACTIO�' Q�. r�� HOLD FOR SPECIAL fURALPERMIT ' " 90 TI.• �` 51428 _. _.. — t� :.W'� /� B�K. `P MOVING DEMOLISH � i4 e.KhYv vALUE $ 70 000 � _ DATE QI hereby acknowledge thet I have reatl this application and stete °i � \ that the above information is correct antl agree to comply with �+ all laws regulatin8 building construetion, antl I shall not employ � ,'L any person in violailon of Me workmen's compansation laws of d � the State of Californla. '� ' 3 I hereby cartify that I am properly licensetl as a contractor under SQ. FT. � OO� •r— w the State of California Businass and Ptofessions Cotla, Division J, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl that such licenses are In full farca and etfact, or I THE PURPpSE OF ESTABLISHING A PEf±M1T FEE ONLv: � am exampt from the provisions of the State of Callfornia Business V ALUATION d antl Professions Code, iv' on 3, hepter 9. PERMIT FEE $ 2�� N PLAN CHECK $ o Signature of � ' LL Permitt6e S Co7�� dd� TAX $ G' O f A�thorizetlAgent Date 3/��8� TOTALPAID $�Qa Q� U