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HomeMy WebLinkAbout2251 FOUNTAIN WAY - Building Permits� A MESn CONSTRUCTION PERMIT a2s7 r-�vN� IN cv�y E��t 's Owner's N�a1m,fe Addreu `�" AOP���ant to lill in all s0aces exeept lhose within heavy Eortler Iines an0 si9n all aporoprlata Oeclaralions. Address �/ ��� "� � � Contracmr's Nam hone Address (mailing) � Ciry License No. �ICENSED CONTRACTOR DECLARATION 1 hereby attirm that I am licensetl untler orovislons oi Charter 9(commencing with section ]000) oi Oivision 3 oi the Business antl Professions Cotle, antl my license is in full torce antl etfect. License Ciass License No. �ate " Si9nature WORKERS' COMGENSATION DECLA0.ATION � nereby atiirm that I have'a'certificate of consent to selt-insure or a certificate Norke�s' Compensatioh InSurance, or a certitietl mpy [hereot (Section ]. Lab. CJ . !�. ..ii<y No. ' Company eCertifietl coOY is h2ieby fumishetl. Certi/ietl copy is filetl with the city Builtling Division. oate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not�be completetl if the Oermit is for one huntlretl ($300) or less). . 1 certify that in Ihe�perforrtiance oi the wo�k to� which this pe�mit is issued I shall not employ any pe�son in any n nner so as to become 5ubjeCt [o t�e Worker' C ensati n'Lawsof Calif ia. �ate 1-P� R'� " Signature ' NOTICE: ((,—aftei m�king this tlecla ation, you shou tl become su je t o t Workers' Compensation provisions ot the Labor Cotle, you must f- hwi[h wmpty with SucM1 provisions or this p¢rmit shall be tleemetl �evokea. CONSTRUCTION LEN�ING AGENCV 1 hereby affirm thal lhere�is a ronstruction lentling agency for the pertormance of the work for which this Oermit is issuetl (Section 309] Civ. CJ Lentler's Name ' Lender's Atltlress OWNERBUILDER OECLARATION I hereby atfirrn that I am exemp[ from the Contrat[o�'s License L.aw for [he followinq reason (Section ']03L5 Business antl Professlonal Cotle: Any city or counry whicn requires a permit to construct, alter, improve, tlemolish or repair any 5[ructure, prior to its i55dance, also �equlres the applicant for such permit to file a Slgnetl staiemen[ that he/she i5licensetl pu�suant to the provislons of the ContractoCs License Law (Chapter 9(commencinq wi[M1 Sec[ion �000) of Division 3 of the Business antl. Professions Cotle) or that he/sM1e is exempt `=retrom antl the basis for the allegetl exemption. Any violalion ot Section 'LS by any ap0��cant fo� a pe�mit subjects the applicant to a civil flty of not more than five huntlretl dollars (E500�. . ._. 1, as owner of the� P/operty or my employees with wages as Ihelr Sole compensation,'will tlo the work, antl the StrUcture is nbt intentletl or ofteretl ior �saie (Section ]044, Business antl Professional Cotle: The Contractor'S License Law tloes not apply t0 an owner o( a property who bWltls or Improves prOv¢ rorthe put0ose 1 as ownev of the ' ractors to construc[ tl Tbe Contractor's Lin builtls or improves tM1 tlactol(z) Ilcense purz proof of Lb2iI WOYk¢ ❑ I am exempt untler Date ' � such work himseli/hersel/ or through his or her own at such improvements are not intentletl o� offeretl for uiltling or improvement is soltl witnin one year of com- have the burtlen of p�oving he/she tlitl not bulltl o� Im- f sale). noperty, am eicclusively contractin9 with licensetl con- � project (Section 7044, Busine55 antl Protessions CoEe: ne Law does not appty to an owner oi property _who reon, antl who coni�acts fo� such p�ojects witit a con- ant to the Cont�actor4 License Law). I am aware Ihat 's Compensation insurance shoultl be provitletl to me. Section—.,--� B. $, P.�. for this reason Signature Yl✓_il Drivers' License or 55 � CMF 0865-46, rev. 10/84 Owner have reai ntl r� a��3�i .�s-oi � i i �,s�3d,� TYPE OFCONSTRUCTION NEW �'ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHE D SCRIPTONOF,WO KUSEOFBLDG.7� i �,�_. � � �. �� TVPE OF PERMIT GRADING FOVNDATION STRUCTURAL ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING � MECHANICAL ❑ OTHEF PROJECT DESCRIPTION 50. FT. OCCVPANCV CONSTRUCTION.TYPE� VALUATION 5 / ydU' `� ZONE GRADWGCU.VDS. ACRES Remarks: �C-#, t ('� ^ p�i Bar Sink , Backflow Preventer - . Backflow Irrigation . . i, Drinking Pountains Floor Drains • Floor Sinks � Gas Service Outlets I nrerceptors Kitchen Sink � / P—Trap Roof Dra Showers Service Sink Sewer Cap Sewer Connection Solar Collec[ors Solar Pipin9 Solar Tank Swim ' g Po01 w/Spa Warer Closet Water Heater Water Service AutO�WeSh Laundrv Tra� FE ReinSpaMion Fea � $15 (�, I luue Fee I $ 3 Boiler Duct - Under Ground Duct-SVucmral ' �uct-Ventilating � ExhaustSystem_O �MWtiple ❑ Firepl/Fact BIL ICBO # Heating System & Ductin � ❑0�100,OOOBTU O,OOOBT Rainspection Fee _ � � $15 White - Builtlin9: Canary - Ap0licant; Pink - Accounting; Goltlenrotl,- Assessor fioad or Type I ❑ Canopy Type I I ❑ � Refrigcration System : ❑0-700,000 BT 100,000 BTU Syste epair/Alteration Fire Dampers ' . Registers� laua Fee . $ 3 A.P. � vs1� — �.�y' O % S Main Building: ' �� E f // T Front U O B Rear A C Fight �0/��/i%v %jl�� g Lef[ , Z.j � CJ�i 7' Ping. Ref. # Planning Notes: �Q ,,,,� , , Automatic Washer Cansttuction Pole Suh. Cooking Unit Dishwasher � Dryers ❑Gas ❑Elec1 Fan F.A.U. Fixtures Device Boxes . Outlets Garbage Disposal Generator �0-5 � Reinspection Fee � DEVELOPMENTSER Zoning Approved By_ Building Approved By Application luued BY. � U'17�1� � I/a3/B7 Accessory Building: Req./Provided ? 39e28 TL Zone — � ELECTRICAL - Trans(ormer ❑ 15�50 KW ❑ 50+KW Meter LJup to 100 amps � Meter �over100amps Sub Panel Motors00�li1-1 ❑1Yh-8 Inc. Solar�9�15 HP 016�15+ Range Sign Standing Sections 15 KW Trash Compactor $15 Issue Fae RE�UIREMEN7S: . FE $ 3 Z O N I N G R E Q M T S SUMMARV OF F�ES `� BUILDING PERMIT �$ 23• Sd SMIP �$ . SU PLAN CHECK $ � �� � � PERMIT ' PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C.. $ ' ` ELECTRICAL § GRADING $ - PLAN CHECK 50% $ � MICROFILM $ i �- MECHANICAL $ TOTAL FEE $ 3 ` - PLAN CHECK 25% $ � � �� CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE , 7. Footings . 58. Electrical Conduit-Undrgrnd. S. Foundation � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical�Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access ApproJal 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil ' 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. 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 Firepiace 38. Final Plumbing ; 39. Water Service-Final - 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigacion System 45. Sound Attenuation • � 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING �� �_ �J �G M./_ 4� 0� 48. Special Requirements Completed ' 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co , . 51. CERTIFICATE OF OCCUPANCY No. � Date . , � MV ) W 1 N � AOP�icant to fill in all spaces except those wit�in heavy GorOer linaz antl si9n all appro0riale tleelarationi. CITY OF COSTA MESA CONSTRUCTION PERMIT S/22S 2z 2 7 ee nin �� � Project Address a � Applicant's Mai-li�ng Address � Q � Owner's Name -��r ��� ^ � Phone Address Arch/Eng: License No. Address Convactor's Nam - Phone � � 1 Address (m '�' 1�O (��-{ l � Fi-[-�j \�_� L(Z City License No. ��� � �� ��� IICENSED CONTRACTOR DECLARATION I M1ereby affivm thal I am licensetl untler provi5ion5 of Charter 9(commencing with section ]000) ot Division 3 ot the Busine55 antl Protessions CoOe, antl my Iicense i5 in ful Orcc tl effect. � License'tC�la License o Dale� �— 5'9 t ,l�LL�-� n � WORKERS' COMPENSATION DEC ARATION . ' M1ere�y atfirm [hat I nave a certilicate of consent to Self-insure or a certlficate ' Workers' Compensation Insurance,�or a cer[ifietl coOY hereof (Section , d00. Lab. C.) �� r ( � � Policy No. � � Company �crti/ietl mpy is hereby furnishetl. rtit� co a filetl with the city �R�i$9 Divislon��./�c,G� Date� APPlicant �// '=.���eZ'� ��. EXEMPTI N FROM WORKERS' COMVENSATION DECL RATION (This sec[ion neetl mt be com0�etetl if the permit is tor one huntlretl (E100) or less). I[ertify that in lhe Performance of lh¢ work fo� wnlch this pe�m�t i5 issuetl, I shall not employ any person in any manner so as to become subject to the Workers' Comp¢nsatlon LawS ot California. Date Si9nature NOTICE: Ii, aiter making this tleclaration, you zhoultl become subject to the Workers' Compensation provisions of Ne Ldbor COCe, you must torthwith comply wiih' such orovlsions or this permit snall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV � 1 bereby afflrm Ihat lnere is a cons[ruction lentling a9ency tor the performance af the work tot whiCh thiz pe�mit i5 i55u¢tl (Sec[ion 309] Civ. C.) Lentler'S Name Lentler's Atldress _ _ OWNER BUILDER OECLARATION I he�eby af(Irm'that I am exempl lrom [he Con[�actor'S License Law (or the iollowin9 reason (Section ]031.5 Business antl Profe55ional Cotle: Any city or coun[y which r¢quires a perml[ to con5trucl, alter, iTprove, tlemolish m repolr any struclure, prlor to i[s issuance, also requires the applicant for such permit to �Ile a signe0 statement tha[ he/She I5 litensed pu�suant to lh¢ pwvi5ions ot the Contractor's Li<ense Law (Chapter 9(commencing wlth Sectlon ]000) ot „ DiviSion 3 of the Business antl Profe55ion5 Code) or that he/she is ex¢m0� '.'�;^�e�efrom antl the basis tor the allegetl exemplion. Any violation of Sectlon ,}�"gd31.5 by any applican[ �o� a p¢rmll SubjeGts llte aOP��cant to a civil .; ^�9enalty of not mor¢ lhan five huntlretl tlollar5 (E500j. ❑ I, as owner of tlte Droperty or my employees with wages as thCir sole Compensation, will tlo the wO�k, antl [he st�ucture i5 nOt Intentletl Or ol�eretl for sale (Section ]044, Business anE Pr0/¢ssional Cotle: Tho Contractor's License �aw tloes not appty to dn ownet ot a property who builtl5 Or implove5 thereon, antl who tloes su<h work himselt/nerseH orytnrougn his or ner own emplOyees, provltletl [hat sucb imProvements are no[ Intentletl or offeretl for sale. If, howev¢r, the builtling cr improvement IS soltl within one year of com- pletion, the Owner will have the burtlen of provfn9 he/5tte tlitl no[ builtl or im- .�rove fOr the purpoSe Of sale). LJ I, as owner of [he pro0erb, am exclusivery contracting with IicenSetl con- 'i [racto�s to consiruct the projeot (SCCllOf1 �/044. 6U51l1¢55 dOd PfO1Q551DO5 COGE: The Con[ractor's Licenze Law does not aPply to an ownet ot Ptope�ty who builtls o� imp�oves [hereon, antl who contract5 for such prOjects with a con- tracror(51 Ilcense pursuant�to the ConVaciOr'S Litense Law). I am aware that D�oOf o( th¢ir Wo�ke�'s Compensation Insurance Shoultl be provltletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date Owner I hereby certity that I have rea information is rorrecL I a9ree Io antl siate laws relatinq to builtlir senlatives of this city to en5e� insoection oyWoses.e+ /A_ / the above ortlinances , ���'� 31 Z I ....._. .._. I -- - I .,,�. TYPE OFCONSTRUCTION NEW ADD ALTERATION REPHIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRADING FOVNDATION STRVCTURAL ❑ TENANT ❑ ELECTRICAL �Pf;UMBL^ �N� 0 MECHANICAL ❑ �OTHER ���"h+"AK/ PROJECT DESCRIPTION SQ. FT. OCCUPANCV CONSTRVGTION TVPE VALUATION 5 ZONE GRAOINGCU.YDS. �ACRES Remarki: Bar Sink Backflow Preventer Backflow IrrigaLon Clarifiers Dishwasher Orinking Fountains Floor Drains ' Floor Sinks ' Gas Service Outlets <itchen Sink Lavatories 7—Trap Roof Drains Reinspection Fee . � $15 Boiler Duct - Under Ground Duct - Structurel Duct � Vantilating _ Exhaust System ❑ Mul[iple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑0�100,000 BTU 0700,000 Drivers' Lic nse or SS $ �— I I�einspection Fee I $15 CMF 0865-46, rev. 4/84 White - Builtling: Canary - Appliwnh Pink - ACmunting; Goltlenrotl - Asse55or $howers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal W2LCl C1052L Water Heater Water Service ...A Issue Fae Hoodor Typel ❑ Canopy Type I I ❑ Fiefrigeration System ❑aioo,000eru ❑ioo,000aT System Repair/Alteretion Issue Fee $ 3 $ 3 A.P. # S Main Building: E T Front B Rear A C Right K Left � $ Plne. Ref. # Plannina Notes: Auromatic Washer Construction Fole Sub. Cookin9 Unit , Dishwasher ' Dryers �Gas ❑Elec' Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW C 0660 4/04/85 Zone Accessory Building: Parking Req./Provided ELECTRICAL � Transformer ❑ 75-50 KW ❑ 50+KW Meter LJup to t00amps Meter ❑over]OOamps Sub Panel Motors �0.7 HP 01 %- 8 Inc.Solar �9-15 HP �76-15+ Microwave Pole Light Range 'Standing Sections 5 KW Trash Compacror \ !]e� � \ T� FEES 2 O N I N G R E Q M T 5. I Reinspection Fee I$15 � I Issue Fee I $ 3' DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Date Building Approved By Date � Application Issued By � � Dat� � SUMMARV OF FEES BUILDINGPERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ �. OC% ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRAOING 5 PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ � D� PLAN CHECK 25% $ CONSTRUCTION ANb PLANNING APPROVALS Permit # 1. Temporary Electrical $ervice or Pole 2. Soil Pipe-Undrgrnd. 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Untlrgrnd. 5. Steel Reinforcement 6. Electrical UFER Grnq, ' 7. Footings . 8. Foundation 9. Water Pipe-Undrgrnd: 10. Structural Floor System 11. Property Sewer Line & House Connection 12. Sewer Cap , 13. Roof Drains � 14. Rough Plumbing 15. Rough Electriral-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign , 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air �nditioning 20. Rough Factory Fireplace 27. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test � 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final i 33. Final Electric � 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test � 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation .. . . 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURF & BUILDING 48. Special Requiremen[s Completed 49. Electric Release to Eqison 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFQCCUPANCY Date Date POOL PA Inspector p�ppROVALS Permit# 52. Pool & Equipment Location. 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER�GUNITE 58. Electrical Conduit�Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. � 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar SYstem�Final � 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 0 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush - 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe � 77. FIXED SYS7EM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: Date � Inspector � .A ADp�icant lo fill in all ipaces except Ihose within heavy Eortler lines an0 sign all appropriate tleclarations. CITv oF coSTA MESA CONSTRUCTION PER^M`�IT ProjectAddress 22�/ �"�(%���1lt� �/�___y ���� Applicant's Mai�fig Address ''`�C,n,, Owner'sN�ame T�C r�-�:��i�� �i2—Phonep�T�� Address 2y�� i3.�(��i.� %ii�l% S�(li�� �0ti C(�i�AAI/�. Arch/Eng. _�� L /'�1 Q /L�iqense No. Address � Contractor'sName uA�? BRos. eLfsutl�,o�e S9S___._�_�__Att�? Addresslmailing) 2�6�2Q ACHc2A QOWL[•{�/0 N6�/jI' Ciry License No. �.Lq�� LICENSED CONTftACTOR DECLARATION I hereby af/irm Ihat I am lic¢nsetl untle� provision5 ot Charter 9(mmmencing witM1 sectlon ]000) of Division 3 Ot [he Businesg antl Professjp f�o�¢�tl my iicense is in ipu1 �force antl HectY� y i License Clas 1� �� `'-�� L'C n e No V�� Date��Iq Si9nature �b� wORKERS'COMPENSATION DECLARATION �e�e�y atflrm ihat I have a certificate of Wnsent (p seli-insure or a certifiCdte Workers' Compensation Insurance, or a certifiatl copy thereof ($ectlon _d00, Lab. CJ Policy No. Company eCer[ifietl coOY is hereby lumishetl. Cer[ifi¢tl mpy is filed with [he city Builtling DiViSiOn. Date APplicant EXEMPTION FROM WORKERS' COMGENSAT14N DECLARATION (Thisseciion neetl not be comD�etetl it the permit is for one huntlretl ($]00) or less). I certify [ha[ in the performance of tbe work fOr Whicn Ibis perm�t is ISiuetl, I zhall not em oy ny pe�son In any mdnne� o as lo beGome�subjeCt [o the Wo�ke�s' Q iQn Laws of Calitomia. /Ll I/ �' Date J��1.��..(1_Signature ��tjt J, Gi�TI^_v ✓ NOTIGE: It, �ter making this tleclaration, you sitoultl become sub�ect to the Worker5' Compensation provisions Oi [he Labot Cotle, you must forthwith romply with such provisions or tM1is Oe�mit shall be tleemetl revokeU. CONSTRUCTION LENDING AGENCV 1 hereby atiirm that there is a constrvction lentling a9ency tor the performance ot N¢ work for which thls permit is is5uetl (Sectian 309] Civ. C.) LenCer's Name Lentler's Atltlress OWNER BUILDER OECIARATION I hereby affirm that I am exempt from the Contractor's License Law tor the tollowin9 reason (Section �031.5 Business antl Professional Cotle: Any clry or munry which requires a permit lo construcq alter improve, tlemolisM1 or repair any siruGlure, p�ior [o its issuante, also requires the ap0��tant fo/ such permit to ti�¢ a siqnetl statemenl thdt he/she ii licensetl puRudnt to the provisiOns oi the Conlractor's License Law (Chapter 9(commeqcing with Sec[ion 7000) of Dlvision 3 ot Ihe Busin¢55 antl Pro(essions Cotle) o� tha[ he/she is exempt [nerefrom and the bazis for the allegetl exemptipn. Any violation of Sec[ion �I031.5 by any applicant for a permit Subjects the applicant lo a civil �enalty of not more than five nuntlretl tlollars (5500). 1, as owne� of the Droperly or my employpas wilh wa9es as their sole wmpensation, will tlo the work, antl [he Structuhe i5 not intentletl or o/(ered for sale ($ection 7044, Business antl Professiohal Cotle: The ConVactor'S LicenSe Law tloes not apply to an owner ot a property who builtls or improves thereon, antl who tloes such work nimzelt/herseli or througn his or her own employees, provltletl tbat such imprOvements are nOt Intentletl or offeretl tor zale. If, however, t�e builtlin9 or improvemen[ is soltl within one year ot com- pletioq Me owner will nave tha burtlen oi proving he/she tlitl not builtl or Im- prov! 10� ine purpose of sale). ❑ I, as ow r of llte property, am exclusively conl�actin9 with licensetl con- t�actoR [�struct Ihe p�oject (Section ]064, Bpsino55 antl Professions Cotle: The ConVactor's License Law tloes not apply to an owner of property who builtls or improve5 the�eon, antl who contracts for SucM1 0/ojects with a con- tractor(s�:;.cense pursuant to the Conlractor's Li�ense Law). I am aware that proof o� Worker'S Compensation insurance shoultl be Provitletl to me. ❑ I am ee [ untler Section B. & P. C. for this reason Date owner I hereby certity that I nave reai intormation is correct. I agree to and state laws relating to builtlir sentatives oi thi city [o en e inspeCtion purpo 5. Siqnature � Oriver5' License o� 55 � repre- y for = 32z S _. TYP^E OF CONSTRUCTION NEW P.DD ALTERATION REPAIR iJ CONVERSION ❑ DEMOLISH ❑ OTHER qp # DESCR PTIO WORK/USEp F BLDG. � G-�o,_y P� ,r _�� ` S Main Building: •s�z�_ E TVPEOFPERMIT�( GRnDING LJ FOUNDATION STRUCTVRAL T Front ❑ TENANT L^ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER %� PROJECT DESCRIP710N Sp. FT. OCCUPANCV — C Right K CONSTRUCTIONTVPE � VALUATION$ g Left 20NE GRADING CU. VDS. ACRES p�ng. Ret.�# Remarks: ,,,, � �, •� ���� ��� , � yd,� , �j Planning Notes: Bar Sink Preventer Irrigation Clarifiers Dishvrasher Drinking Fountains Floor Drains Floor Sinks Gas Service Kitchen Sink Lavamries Reinspection Fee � $15 Boiler Duct � Under Ground Duct - Structural Duct � Ventilating Exhaust System ❑ Multiple ❑ FirepVFact. BIL�ICBO # Heating System & Ducting 00.100,000 BTU O 100,000 BT Reinspection Fee • � $15 8{Ep 65-46, rev. 10/B4 White - Builtling: Canary . qpplicant: Pink - Accounting; Goltlenrotl - AssesSor Showers Service Sink � Sewer Cap Sewer Connection Solar Collectors Solar Piping � S r Tank Swimming Pool w/Spa Urindl Water Closet Water Heater Water Service Auto�Wash Laundry Trays Issue Fae Hootlor Typel � Canopy Typell ❑ Re(rigeration System ❑o- o oao aTu ❑ i oo,000 aru System Repair/Alteration Fire Dampers Regizters Issua Fee FEES $ 3 $ 3 Automatic Washer Construction Pale Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A.U. 5398 2/l9/8[I Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Met¢r ❑up to 100 amps � Merer �over100amps Device Boxes Outlets Switches Garbage Disposal Generator �65 KW �5-15 KW Sub Panel MotorsO0�1 HPOth-8 Inc.Solar �9�15 HP �i6-15+ Microwave Pole Light Range Standing Sections Trash Compacmr Fee �$15 � � luue Fee DEVELOPMENT SERVICES RE�UIREMENTS: 2oning Approved 8y Building Approved 6y Aoolifation Issued Bv � BUILDING PERMIT $ PLAN CHECK $ PLUMBING S PLAN CHECK 25% S ELECTRICAL $ �3'-Sb PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ 3:�0�:, 11 2 O N I N G R E Q M T S FEES SMIP $ PERMIT ISSUANCE $ - ENERGV P.C. S GRADING $ MICROFILM $ TOTAL FEE $ 33'S� CONSTRUCTION AND PLANNING APPROVALS Permit # ' 1. Temporary Electrical�.Service or Pole 2. Soil Pipe-Undrgrnd. � 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement' ,' 6. Electrical UFER Grnd. 7. Footings � � 8. Foundation � 9. Water Pipe-Undrgrnd� �. 10. Structural Floor SYstem 11. Property Sewer Line�& House Connaction 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electriral-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough FactorY Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and F.lashing 28. Lathing & Siding 29. Insulation � 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter�Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer � 43. Backflow Irrigation 44: Landscape Irrigation System 45. Sound Attenuation 46. liandirap flegulations 47. FINAL STRUCTURE & BUI LDING 48. Special Requirements Completed 49. Electric R se-to�dison 50. Gas Release to Southern California Gas Cn 51. CERTIFICATE OF OCCUPANCY Date Date ,_ POOL & SPA Inspector qppROVALS Permit# 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical8onding 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER-GUNITE 56. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. 61. APPROVAI TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL(SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT - APPROVALS Permit # - 70. Underground Hydro y 71. Produc[ Piping O Gas ❑ Oil 72. Underground Flush �., .`. 73. Undergrnd. Storage Tank O'Gas ❑ Oil 74. Overhead Hydro , 75. Dry Chemical � 76. Dry Standpipe 77. FIXED SYSTEM FINAL � � 78. FIRE PREV. FINAL � '� HEALTH DEPT'. REQUIREMENT � 79. FINAL INSPECTION � . � 80. FOOD CERTIFICATE ISSUED Notes: 0 Date �Inspector i.� � � �, I �i � � . . i . � -> �Btni DING SA.'''ETY DEPAR.TMENT NO �� O� � ; 'Boa No. 317 0 Costa Mesa, California Date y'- r C � CITY OF COSTA MESA , CERTIFICATE OF OCCUPANCY Building Permit No. Electrical Permit No y ,Plumbing Permit No. Use of Buildinp, Ll '�� r Y A PT �(/ i � h i v+ O Ttie 6uilding located ar `��-�,-�'�"''Q'�"'�'su� "� /� vP Legal Descrlptio� � (See reverse side tor Metes and Bounds) �has been inspected and found to comply�w1ith the provisious of all City of Costa Mesa Ordin- � applicable thereto for a Group /"� "�' T Occupancy. ' 'iED TO: � � City Building Official .�l_ r_-. �?og��rso✓ i� (Owner of Building) By � �+,�n- � I(4.{�./ti,R,i,�J7 . i CC: ❑ Original—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edison Co. ❑ 3rd cop�— ile Form 208 SB P 1M 1-60 s To ?dhon It t•fay Concern: . _ , --�--., �t .. i,u�us[ 9, 1978 7'his is to in,io�;:: ;on �.,a2 ..�., o•. :. , _ ' :i..;o�: :.�;:� ^r. :�naremcnts I am aware o[ the combination of copper an�l gal.vanized piping used in partial repipes in individual apartments. I am al&o aware of the possiUiiity of advanced corrosion due to Cliis combination. t_ T. Pol s, Owner — - - - _ .----- - - - - , - - - - - - . ., ' . � ..� ''_ _ . �M ��. ' GOSL95iME$A B'�11LDIN,.6lSAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA �i4, Y�de.i? �'v �-�M-• � p _ � �, � s-r� FINA�!CE DEPT. ��v FOR APP[/CANT TO F/[L /N COMPLfTELY APPLICATION;iFORxPERMIT TYPE OR PRINT ,��(/J� � 1 BUILDING Z.ZS/ SJ S 1 Y:J � (,Ol -�/ - ADDRE�ssG �2-2-SG-Atta�ltE-im-AVe[3uE � . ! COSTA MESA. CALIFORNIA fOR OfF/CE USE ONLY Paul S R�bertson Inc I FECEIPT NO. I�(P�RMi��_ OWNER V� MAIL ' ��1 We6t IIIC neceiVED 9Y OATE RECEIVED �qTE ISSIIED ADDRE55 1 �W! ' -6- /o-i� C08t8 M2B$ BUILDING CITY TNO. �1661 pODRESS ORCHITENEER Wa Jordan `,.',o: C-1449 COSTA MESA. CALIFORNIA ADDnc55 /71 WeBC 19th Costa �s8 FIRE ZONE TYPE� GROUP �/' CONTR��RE Roberteon IIIC �ICTNTp J�WOVO B?PROVED � DATE/O��" / ADDRE55 ��� we$t 19th Coata �B8 ZONING . IEGNL � - I LOT �10 I I �{[�� ZONE ., I NO. OF I O6E OF NEW DESCaIPiioN NO. 1O BLOCK / TRA� � PLANS BUILDING A.P. NO. By�'ROV ;� DATE ��—� J OF LOT 6% .64 X�.35 I rvOw Orv �OTS YARDS YE REOUIRED ALLOWEO USE OF (CENTEP LINE ST.1 EXISTING BLDG. FRONT � FT. IN. SETBACK LINE FFOM �p ' CENTER OF STREET aA S REAR YARD 6O R. SIDE FT, IN. SIDE YARO ILEFT LS.S3 IRIGHT �LO L.SIDE S �FT. IN. DESCRIPTION OF.WORK REAR S�� J �N. NEY I $IALTERATION I IIADOITION ( REPAiN I IIMOVING I IIDEMOLISH I BUILDING 32 % 55 NO.OF ({ 2 � SIZE ROOMS STORIES EXTERIORW��•I�.L.Q IROOF .Built u COVERING COVERING P VSE OF BUILDING AND WORK TO BE PERFORMED � �F U t ta � 1 HEREBY ACKNOWLEOGE THAT I HAVE R AD TMIS APPLICATION THE AMOUNT BHOWN UNDEH V�LU4TION IS FOR THE •ND STATE THFT THE ABOVE IS COR NND AGREE TO COM- pURP08E OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY OR�INqNCES qND TATE LAWS REGOLATING euLLDiNG coNslrsuciiorv. VALUATION SIGNATURE OF PERMIT FEE $ � ��� PERMITfEE �� /J /� j _ 7, PLAN CHECK S� y� AUTHORIZED AGEN TOTAL FEE $ � :� . - �' �.;�;�9 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPL/CANT TO F/LL /N COMPLE7E[Y TYPE OR PRINT nooR�s"s —Z256 Anah�Y� enue COSTA MESA. CALIFORNIA L �]49CP�.1 LIC. STATE LEGAL I LOT u I I ���1 o[scaivnorv NO. LO BLOCK TR A.P. NO. OF LOT 6/ . Vy x 135 I NO. OF BLOGS. NOW ON LOT USE OF EXISTING BLDG. SETBACH LINE FROM (� CENTER OF STFEET JO REAR YARD 2. SIDE YARD ILEFT V.G IRIGHT 19.14 DESCRIPTION OF WORK NEV I X IIALTERATIONI IIADOITION I REPAiH I II MOVING I II DEMOLISH I S Z�E DING .�,t X�O ROOMS STORIES j EXTERIOR WALL ROOF COVERING O COVERING USE OF BUILDING AND WORK TO BE PERFORMED oven caruort with closed storaee 1 HENEBY ACKNOWLEOGE THAT 1 HAVE REpO THIS APPLICFTION AND STRTE THAT THE ABOVE IS CORRECT AND RGREE TO COM- PLY WITH ALL CITY ORDINpNCES AND STATE LRWS FEGULqTING BUIL�ING CONSTRUCTION. SIGNATURE OF PERMITTEE 1' AUTHORIZED A NT � . . , �..�" _ .... (o-�R-s�1 ,-1� `,P:CE DEP1. � `� ,��.. nnnvt a4GCl1 APPLICATION FOR PERMIT �Q� BUILDING FOR OfF/CE USE ONLY � FECEIPT NO. �_ RERM�T : ISSUEU ..I G <j COSTA MESA. CALIFORNIA FIRE ZONE TYPE � GROUP APPROVED BY DATE / ' ZONING � ZONI� _i I I P ANS � I BUELDFNGEW /�] . (CENTER LINE ST.) FRONT REAR a� uce THE AMOUNT SHOWN UNUER VALl1AT10N IS FOR THE PURPOSE OF ESTqBLISHING A PERMIT FEE ONLY. VAWATION /� ^ /� �� PERMITFEE $ l{�• �� $ P' �G'O PLAN CHEGK $ v �� TOTAL FEE S /�S— . . I �_ 3.91:4�1; COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Comp/etely ADDRE55 /Ci �4 �� /'OU�T /i✓ W �A OWNER ��EO7J�E OG S MAIL CiS'C.'�1J'JA/✓A�rEl�'%E.vT Z ADDRESSoY �Z • G.e9N SUITE �� a U CITV �/fA/r/.} ry�/} NO�. S�7 S% Z2 Q CON5fRUCTION N O n/ L Q N LENDER am J � BRANCH J � a ��� ADDRESS a J ARCHITECT TEL. N OR ENGINEEfl U Q w 2 ADDRESS aW J O CONTRACTOF �„/SUQ I�C'[� EPAi.e �nG • m Z �-r � J Q ADDRESS � 3Q� G./ O/17CW/g' W w TEL. Z� Ci7v SANTA No. S,�S �/� w � STATE ] CITV j O LIQ NO. p� �p � LI0. NO SIZE NO.OF BLDGS. OF LOT NOW ON LOT USE OF / E%ISTING BLDG. . $� H SI2E OF NO. OF Z NEW BLDG. ROOMS STOFIES U EXTERIOF WALL ROOF COVERING COVERING J USE OF BUIIDING AND WORK TO BE PERFOFiMED aatu w ��u,: 1CT 23-74�M�.Q07007� 6b.Y,% APPLICATION FOR BUILDING PERMIT A.P. NO. �S —�p I�' ZQj r BUILDINGnn �a ADDflESq�� � TRACT �� LOT ^�I FIRE ZONE APPROVED NO. OF PLANS VAFOSAPPROVED VAR. � p F.2Am n/ .��u.n,s�.v E� cT ic9�- c.u.P.,w F � P.PPFOV ED1 � ` y Efltii✓ �,e Lu GL .��G • w L�Ii z 0 UI hereby acknowledge thet I hava reatl this application end stete = thet the ebova information is correct antl aBrea to comply with � all lews regulating builtlinp consttuction, and I shell not employ F any Oerson in vlolatlon of the workman's compensation lawa of y tha State ot Celifomie. ? I hereby certify that I am properly licensetl as a contractor untler SQ. FT. the State of California Business antl Profesz(ons Cotla, Dlvisicn 3, THE AMOVNT SHi Chapter 9, anC thet auch licenaes are in tull force antl eftect, or I TNE PURPOSE OF E am ezempt irom the provisions of the State of California Buslnacs VALUATION entl Professions Cotle, Division 3, Chapter 9. Si8^eture of / %� ��Fy^�=C.CYLCtthC/ � Pe�mlttae � 5 cI5'p0 n�mori:oe aaooc BIOC USE OF NEW '� 3'� BUILDIN�i�� VARDS APPROVED BEf. MAIN & �23� 9 STATE \ 1 TAX o F VA�UAT IS fOF ' 3 A PERMIT FEE ONLV: � ¢ n 'EE S � � 5CK S �� E =E $ ��� � �/ o LL