HomeMy WebLinkAbout2732 GANNET DR - Building Permitsao{Essaewtw,c: 2?32 G1PIP]ET Dft uxr:
o.xensnweiva+am+: ERIDGMAPI, BRUCE C FLGOD: AE-46
�o�u BRIDGMAN, VICY;IE
539 FULLERTOTI AC'E
dEi-IPOP.T BEAC?i,:A 92E63714) 69—^.-8889
�vv�. �uuxo �oowEss:
IIPCNRECTONENCd�EEX:
NMH.Ofl FlIG.'S AU�NE55:
CONfR/iLTqYB NAYE:
caxin�crorcs wuimo
ADDHE55:
11G NO.:
uc no.:
UNT:
UNT:
LICENSED COMFACTOHS UECLAHATION: I MreEy eAtm uMm panely d peryury Net I am licensed uMm prwieiona d Cheqm g
(commend'p wilh Senion )OW) d Divisun 3 d Na Busrieu end PMessbm Cade, enE my 4cenae e in lull lace end elled.
CRY IJC. NO.: 11Q C1A55: LIC. NO.: x' }( IJ �
Daie: Convmm
OWNEN BUILDEfl DECIANATION: I hereby dfirm uMar penely d perjury thm I em evmp Irom tM COMretlae license law /a ihe
'bwm0 �mvm (Satlion ]031.5 &ninaa ard Proleeebna CaEe: Any [iY a couMY wfiitli nQuiret e Gertnil �o cannhucl. eller. impow.
moloh, a rapei e�ry sVua�re, prior m us uauarim. ebo reQuime IM epolimM im wch permd m file a eymd ateiemeni the� M a aM
. licenaed punuent lo Iha protisiona d the ConVeWon Limnse Lew �Cheqx 9(mmmmdip wGh Sed'on ]000) d Di+uim ] d tM
Buvinev eM PrMeea'ana Code� a thel he a ehe ia usmq therelrom end the beais 1« tha ellepeE ntemqion. My voletion d Sedian
)o31.5 by eny eppliuni for e permn eWjada ihe epplicen� to e civil penelry d nd moro ihen 1've h�Mretl ddlen �350�7).
� I, m ownar d tM propaity or my empbyeae xilh wepea es ihe'r eda mmpammion, will do tM wwk, end �M eiiucture e ml inlenEeE
a oilareE Im eeb (Sacpon ]014. Bueineas eM Prdeaebne Cotle: The ConlreUon Liceree Lew Eoea � epplyto en ownerd propaity
wM builds or imOrovea Ihereon. arM wfio Eoee euch wark himmll a hanap w throuph hi or her own empbyeee, proviEeE Ihel euch
impravemenls are not in�eeded a diereE lor eab. H. however, the buiNirp w vnpiwemem ie eoN wnhin one ymr d mmplMian, IM
owner.Wildar xill have ihe burAan d pmvieq M or eM Ek rml WiIE a imprare lar iM W�e d eabl.
❑ I. m oxner d IM v�W�Y. vn e.du+rvNY oonlreq4q xith liceneed conVeclae ro wnatruf iha wui� (swion )01�. Bwi�ms eM
r,dm.�. coee: rne comreaa. ucense iew aoee na woN �o e� o�,w d uwenv wa w�w «��wd+., �nxeon ene wno
irena lor wch prqeas with a mNredar�e) Icenaed Wnuem lo �!n Conveaas Lioaree lawl.
^^.-i�e.�w��«s«��:BP�094 e,s"r.c..i«�mn�: •in'./3UILUER
� '�C�i �'r`f�' ��...��. �
canM thet I em ewere d ud
IIW I a eny Mure Wikirq a
Cal/«nu Heellh eM Sele�Y Code Satlbne 25505.25593. enE
neeE to mmpy wIh aeM alda eodee uM �he eaqu'vamams tor
nrie. Redd«uiel cam�uaion ePV�'diomers ezemq Imm Ihme
Dete: ApplicenL
WONKEN'S COMPENSATION DECURATION: I MreEy elfirm uMer peneXy d pvjury aro W Ihe bllowieq dederetona:
❑ I have end xil meintein e cerliliceta d mnsenl to vell-inwre la Mwkae' wmperealbn, sv provided Iw by Seqion 3'l00 d iha Labor
Cade, fa tM pallormenca W iM xwk la whic� Ihis permA is imued.
❑ i naw �e �;� mdm.m won�• �w��� �v�,�. m�aw�ae nv sea� s�oo d ma �no� com. ror me oe�to��� a m.
wwk lor whiM Ihia pe�mn is muad. My wakers' mmpemmion imurenee �amar aeM pdiry number ere:
Cemx:
� vdwr��mn«
(This senion neeC mt be can0�ed % Ne Pe^^i rs lw are hurMreE ddlas IS'1001 w ho.)
❑ i oenh uw m m. c«io��za a ma ..«� i« wnKn ma o�*n a�,aa. i�n m�,dw em o� �� .m m."�, .o e m
becoms wM� !o �na xvrlmra• com0��ion levn a celitanie. erd earea Uut il I ehwM Exwna wbjeU Io �M xorken'
wmVenaetion P�iom ot Sedion 3J00 d tM Lebor Code. I ehell /wthxnh mmdi ��a M��+.
Dme: ApplceN:
Waminp: Fellun ro�xun worker�'romps�ustlon rovsrep� l� unNwNl, anCahsl/ wbject en smployx b eNMnel penaMa entl
c/v/l flro� up ro ons huntlretl fMuaeM Collen (Sf00,000), M eWltlan ro M� coaf ol rompm�eHon, Wmepu sa provldsrl br In
SwOan 9lOS ol fM Lffior Corb, InM1ro�( entl ettomsy9 Ma
CONSTflUCT10N LENDINO AGENCY: 1 hereby �im under peneMy o/ perryry thei ihere ie e oonqruaion kMinp epency fa the
panorme�ce w ine woM ro, wnid, mm verml b oa�ea (seaoo ws�. cw. cl.
LENDEF'S NAME:
LENUEH'S RDDPES3:
I cenity Ihm I Mva ned Ihb applicetbn ard aele ihel iM eDa+e iM«metirn ia canM. I epree lo wmply xilh dl cuy ud caunN �inenoer
eM etve kws rek�iq to buiW'vq eans.rudm vd MreEy eu�Mrixe �epeesantelrvea otthu ary �o anter upon tM eboue�meMiaied peopeery
'"`"'"'°""°"'°°'°' Joxra EnMor�nsor�
Pnm Name
om. S �s • 9S
(St51deWP) Whn�85afaiy;Greeo-Fle;Cenery-Appicen�;Rnk-Revenua;GokenroE-beevaor
CITY OF COSTA t4ESA — HUILDING PEBMIT
PERM r10; P Oi234�
PERMIT NO: 3 072342 PLAA! CHECY. Nu; 01780-95 L GOL�T: N SUPP: N
CONSTRUCTI03� TYPE; nERMIT TYPE: STP. FURPUSE: OTF.
JOH DESCRIPTI6td , CONST, 48',2' HIGH BLC Wt�LL L tn10GD FENCE SQ FT: 98
CLAZM VALUE; 938,00 CALC—VALUE; °n0.0U GROUP OCC: R-3 /
C049MENTS: CONST, 2' HIGH BLO:'A 41AiL 6 4' HIGH TdOOD rENCE
if Y' iE �1F jf if'N' 1f iE?E iF if'Y if' if ##' #`"R i 1�'+f.'1f' iF'H--1F i'. if i'�'lf iE 3F i�' iE jl' 1(' Y- �F i4 } Ai #�lf if 1�' -ti iF i:# iF iFY.Y-iF iL +F iF iF �l ')('-y Y-Jf Y Y�1L �Y Y iL �K M- a("M'>f if +Y. i'- i4
Z O N I D7 G P, E Q U I R E M E N T S
J L T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------
FRNT; FT IP] P.EAF?; FT IN FRNT: rT IN REe?R: FT IT3
LEFT; FT IN RGHT; FT IN LEFT; FT IP7 P.GHT; FT IN
PARY,ING REQ• PRO�': FARCEL: 13947307 ZNE• R1 REF NO:
PLANNING NUTES> REPLACE h'OOD FEA7CE T�IITH COMBINATION SLOCF: ?dALL; WOUL` FENCE, 5
>' HIGH ALONG ST. SIDE FL
�YxM�14aF�iE<ii�iEif-jfaFifrr4ici4xx{e:iF{daL�MifiFifacY�3FitaiaF7k�F:aFii+fi:iF+hi�-'+aca:#iFjF#�rFiEx�faGy4�i3Fxi:iFx##aLici:iLicii�:.-Y-x.if. _.K.�]:i6#'�
D E V E L O P A1 E N T S E R V I C E S R E Q U I R E P9 E N T S
ZUNING APPROC�EU BY ,�'7✓�� DAT£: J 2
HUILDING AF�I'ROC*ED BY ; �- S' �
��� PAT�. ��_
APPLICATIOId TSSUED BY: DATE: � )
�7E+FMifVaFi�-iE4iE-iE�lkiFiEiEiF�'s�iE�lei:�ifififM��.+! ♦?�'f riF+t +EiEsiEft< 1Efr if� if�Faf+Fitif�%+F�1Fa:�?ta:+f +f +rii 9:Y�
LEGALIZATIOAl;P1 F E E S U P9 M A R Y STRUCTURAL SEGMENT::
BLUG PMT FLUMHING ELECTRIC A9ECHADIIC FIRE 5M2F;RES GRADIAIG
PERMIT 25,U0 .50
' • � .'SMIP/NON—P.ES
PLAN 16.25
ISSUE FEE
BUILDING—DIL'—: PERP9IT ISSUE PLAN—CHECR TOTAL PPIU DUE
TOTALS----> 25,50 0,00 ' 16.25 41,75 . 41,75 ,p0
REL'ENUE UIi'ISI��N TOTALS--> CULLECTED,; K1,75 OVEP,!SHURT; ,p0
BLDC PMT PLOP7BING ELECT'P.IC MEC:iAD]ZC FIP,E SMIP/TOT G?elDZh1G PLAPI—CHEC'f.
25,00 .50 15.25
'1f +f #�4 i�'V'-1f 1F M iF'k-1F #-1F t# �f -1E 4 iE 1F 4'k' iE if Y--k'R Yi'iF w u�74 if �f aG'Ff # Y jF i4 Y�i x 4Y iF l� # ik if #�' �f' 1E iM1 At 1F'Y' jl' t!'Y+E Y�1�- # if r+' if Y i!� 1'Y ff if T� i�' il. if
I N D I V I D U A L F E E B R E A K D� U 41 N
TYF'E QTY D E 5 C R I P T I U N UNIT Ct]6T TOTr1L C6ST
SFA 48 RES—CGDICRETE BLOCY. WALL / FT, "20,Q0 950,60
END OF FEES
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u �{
MAY 121995
��n pF COSTA MESA
��
CONSTRUCTION AND PI.ANNING . � �'O S SPA i
Date inspector Date Inspecto�
APPROVAL5 PermiT � APPR4VALS . Permit #
1. TemDorary Electrical Service or Poie � 52. Pooi & Equlpment Location E '
2. Soil Pipe-U�drgrnd. , 53. Steei Reinforcement '
3. Elec[ricai COnduit UtilitY-Undrgrnd. 54. Forms � '
4. Electrical Conduit�Undrgrnd. 55. Elect.icai Bonding
5. Steel Reinforcement 6�?-9 'Jr �(,d� 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAi� TO COVER�GUNITE �
7. Footings �p-7 G,� ���G 58, Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgmd. ! 60. Backwash Lines, P-Trap, O Und�gmd.
10. Structural Floor System 67. APPROVAL 70 �ECK
t t. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent�Final
13. Roof Drains 64. Plum6ing System � Final
74. Rough Plumbing 65. Electricai-Final �
15. Rough Electrical-Conduit 66. Solar System-Final � �
,
16. Rough Electrlc Wiring 67. Fencing & Access ApProval ' (
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ��
78. Pough Electrical-T Bar Ceiling 69. POOIISPA SYSTEMS FINAL
19. Rough Heating & Air Condixioning FIRE DEPT, REQUIREMENT
20. Rough FacturY Fireplace APPRQVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Vent��a2ing 77. Product Pipin� O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
2A. Roof Framing 73. Undergrnd. Srorage Tank O Gas ❑ Oii ��
25. Roof Sheatt�ing 74. Overhead Hydro �� '%
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ��' �
27. Frame and Flashiny . 76. Dry Standpipe �� i
28. Lathin9 & Siding 77. FIXEfl SYSTEM FINAL '
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nai��ng , HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat� 79. FINAL INSPECTION
32. Electrical POWer Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: I
34. Fina1 Heating & Air Conditioning �-/E� ,!�'S" _ �"�_ S� ! � f�� 1
[v (
35. Final Gas Pipe-Test WOG�� -��6�
36. Hood or Canopy
37. Final Factorv F�repiace
38. Final Piumbing
39. Water Service�Fi�al
40. Gas Service�F�nal
41. Solar pomestic-Final
42. Backtlow Preventer �/ L8- L'C',� C _/ !�G
�Q � �r�
43. Backflow Irrigation ,/j� j,�-�
f��G-7-Yl� � �d� v ,�. ?r
44. Landscape Irripation System � � " '":
•}.
45. Sound Attenuat(on _ �-
46. Handicap Regulations �
47. FINALSTi�UCTURE & BUILDING � ��
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
L�
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builder verification.
Ariention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building pertnit will be issued
untii this verification is received.
1. I personally plan to provide the major labor and materials (or construction of the pro-
posed property improvement. � Yes ❑ No
2. I(hav �— /���_ signed an application for a building permit tor the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
Phone (
Ciry
Contractor's Lic. No..
4. I plan to provide portions oi the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name _
Address
Phone (
City
Contractor's Lic. No. _
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name
�
Address Phone Type of Work
I hereby affirm that I have received a copy of the intormat
of California Health and Safety Code and have completed the
sonal knowledge, in compliance with this State law. /
I ^. � .
Signed: �
.
Name: � G� i
C.D.L. # or S.S. N � �
r�
or
754-5273
forth in Section 19830 of the State
information to the best oi my per-
S
Date: � �SS
�C��r1 �_���1N�'�'�1�
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e.."�'n� "^''�La�r°r^'�� ��
� C3fdiWNVid d0 OOL7�7U10
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'QL0 'lLaO 'lM70 OS L'�Ip1 Ji
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1�� �� � 1�� ;.i ��� ��i \.
3�M701t7Y
DMSION
]ON701f1tl
OF COSTA M SA
IThis set oi plans and specifications MUS7 ' J ��
and if is �unlawlui to make any changes or alte ation on same
Ge,�r.issior hom ibe Division of Buifding and Safety, Ci ol ��b at al1(¢pgq
wrthom wmt�,
Q4e hismp;r;, ;,, rh�s plan and specifications SHkLL NOT be�� M�
�n acprc".,i o( the violation of any provisions of a held to pp,�mk
Mosa OM�nn,;::� ,,,;Uar State iaw. �Y City of Costa
�ase �. _-: ::.:o a. .:u �ha!I exPue by limitation and becbme nWl and void i1
Ne outla�,-,�� cr ::, •",a :e. n�
(d) Nii^�� ;d,� ,,� � ��mR'e'"'c�'� 3ny maintained active
y ` '! :s;i�+�ce, per UBC §303
I P��'��� # % 2 3 4 2
THIS NU ^FR MUST qCCO
_ _ a� -^TION MPANY
- REQ(�;, STS
Cement Coping Outional —'
Channel Block With 1-3/8�
Ho�izontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8"yS at 4' -0" O.C.
For Fences Higher Than 5'
Vert.Bars 3/8"� at 32" O.C.
Fill Cells Solid With Grout
WhereSteelOccurs . .
Reinforcing Steel Shall'
Conform to Sec.A-15-39
A.S.T.M.. �
All Steel to be Lapped
24" or to Code
NATURALGRADE
TWO 3/8"d BARS �
CONTINUOUSTOo �
& BOTTOM
HORIZ.STEEL MUST BE TIED IN
PLACE AT TIME Of TRENCH
INSPECTION.
TYPICAL 6�� CONCRETE BLOCK FENCE
s =
��
�
> w
¢ _
c
>Z
a
i �
w o
c� r
z
w n
� �
Dn �
F►—WIDTH
� SEE CHl
9 BELOW
ol�.
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR; p�e pa�t Plasfic Cement, and
Three Paris Sand
GROUT; One Part Cement Three and
One Half Parts S�and
COPING: O�e Part Cement, Three
Parts Sond
CONCRETE: Well Mixed 1:2-I/2:3-I/2
Max. of 7-I/2 Gal�ens of
YVater Pei Sack of Cement
__„ i
GROUT�MAY BE POUREDaFROM THE TOP
OF THE FENCE IN CEI:LS WHERE STEEL
occuas., ; ''
CELLSAND AREASOf�HORIZONTAL REIN-
FORCEMEN7 SHALL 06ECLEAR, CLEAN &
FREE OF,ALL�MORTAR'DEBRIS, ETC.
, . ,. <� -- � �
-- r
_ �a
, - _._._'��
H GF E4RTHTCOTH
V; iNE NEIGTH OF FENCE
�LOW BOTTOM OF FOGTiNG
WIOTH . 14" 14" . 12". .
THICKNESS . . 10". . 10° . . . . . . . . . 8°.
DEPTH OF EARTHTOOTH . . . 24�� . . . . 20�� . . . . 16". . . .
SPACING OF EARTHTOOTH. . 12' 14' .. 16'. .
City of Costa Mesa, California
Building Department
SCALE: I/2" = I'
12"
8 .,
i2„
16'
::.F':.�hED NOV.B:. I
.
`
\
�
ADolicant to till in all sDaces exeeo� those within heavy eoraer lines ana siqn ail aoorovriate tleclarattons.
�i7Y oF Cosrn MESA CONS{T��RU"�CTION P RMIT ,
! Project Address a� �,- 1 /CA/[•
� Applicant's Mailing Address �
Owner's Name /• �� � Phone�50 _�b�j
Address a��l�- N7 .MM4� '
i
Arch/Eng. � License No.
Address — [}(� ��q
'Contractor's Nam Pnho/�ne J.._I -� ✓/�+�/
'Address (m� I'nnl � n(n /� i YXQ.(`LI� , -/ag
, City'Licen� No �) �7 l/f / �
LICENSED CONTRACTOR OECIARATION � '
I hereby affirm thai I am licensetl untler provislons of Charter 9(commencin9
with sectlon �000) of Division 3 of the Bu5ine55 antl Protesslons Cotle, antl .
my licenze is in o ce antl Q}{ �t, ���� �
LJcense Class � � Llcense No.� �
Date Signat�re
.,,WORKERS'COMPENSATION DECLAR%iTION '
""'I hereby aifirm that I nave a ce,rtificate of consent to self-inzure or a certlflcate
�"bf Workers' Compensation Insurance, or a certl(ietl�, copY thereOf (Sectlon
3800, Lab. C.) " "
Porcr r+o.io�r—�I'Od�sS-10�1�3comaa�r�A
Certifietl copy i5 her¢by fuYnishetl.
Cer i�tl � Y I i� with the city B I iSi � �/f� ' �
Date Applicanl �5��`�
EXEMPTION FROM WORKEqS' COM ENSATION OECLARATION
�(Thi55ection neetl not be mmbletetl i/ Ine pe�mit i5 fo� one huntlretl (5300) or
less). � •
I ceri7ty that 1n ihe oerforman�e ol the work tor wMch this oerm�t is issuetl, 1
zhall not employ any person in any manner so as to become subject to the
Woikers' Compensalion Laws o( California. , '
Date Sig�ature
'NOTICE: It, after makinq lhis tleclaratiOn, you shoultl beCome {ubjecl [o lhe
Workers' Compensation provi5ion5 Ot Ihe Labor Cotle, you must torthwith
comply witn sucn provisio�s or thls permit' shall' be . tleemetl revoketl.
CONSTRUCTION LERDINCn qGENCV.
I hereby atfirm that [here-is a tonstruttion lentling agency for the performance
of the work for whicM1 thi5 permit is issuetl (Sectlon 3097 Civ. C.)
LenOer's Name
�entler's AOtlress �
OWNER BUILOEH �ECLARATION "
I bereby affirm that I am exympt trom the Contractor's �icense Law for the ,
��, followinq reason (Section �031.5 Businezs antl Professional Cotle: Any city or
�'� County which requires a petmit to const�uct, al[¢q improve, tlemolish or �epai�
iany Slructure, prbr to its i55Uance, also r¢qWres the applicant (or Such permit
to IiIC a slgnatl slatement thdt he/she is Iicensetl pu�suant to lhe provisions Of
lhe ConlraCto�'s License Law (Chapte� 9(commencing with Section 7000) of
Divizion 3 of the Business dntl Professions COEe) or Ihat ne/she is ezempt
thereirom antl the basis tor (he allagetl exemptlon. Any violation of Section
7031.5 by any applicant fo� a permi[ subject5 Ihe applicant to a civll
�enalty oi not more lhan tive puntlr¢tl t1011ars (E500). � '
I, as owner ot th¢ Prop¢rty or my�employee5 with wages as Ihei� sol¢ '
fompenzation, will tlo tne wbrk, antl the structure Is not intentletl or otteretl �
for sale (Sec[ion 7044, Business ana Professional Cotle: The Contractor'S
License Ldw tloes mt apply lo an owne� of a property who builAs or ImprOves
th¢reOn, antl wM10 doe5 sucM1 work �imsel//he�self or thrOugh hls or he� Own
em0loyae5, p�ovitletl that suCh improvCments ara not intentletl or o}ter¢tl for
sale. If, however, the builtling or improvement Is soltl within one year Of com-
pletlon, the owner wiu�nave �I�e burtlen of proving he/she tlitl not bulltl or�irn-
prova for the purpose of sale), �
❑ I, as owner of tne property, am exclusively contracting witFi Ilcensetl con-
trac[ors to mnstruct the Proje�t (Section 7044, Business antl Professions Cotle:
The ConVacloYs License l.dw does noI apply to an owner of property who
builtls or ImOwves.thereon, antl who conVacts fo� suclt projects wltn a mm .
tractor(sl license pursuant to the Contractor's License Law). I am aware [hat
proOt o( thelt Worker's CompenSation Insurance shoultl be provitl0� [o m¢.
❑�I�am exempt untler Section B. & P. C�or this reason
Date Owner
I he�eby C¢rtify tnat I have red0 lhis aOP�icatlon and state tM1at the above-
)nformaflon Is ro�sect. 1 auree to comolv with all citv ana muntv ortllnanres
Signature V VI�
Drivers' Lice ze or,55 �
[o e�rR¢r upon
�YPE OF CONSTRUCTION LJ NEW IJ ADD LJ ALTERATION IJ REPAIR
❑ CONVERSION ❑ DEMOLISH ,O OTHE q,p, #
DESCRIPTION OF WORK/USE OF BLDG. ��� '- 2
S Main Buildi
E
TVPE OF PERMIT - GRADING� FOUNDATION STRUCTVRA� T FrOnt
❑ TENANT -❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A'Rear
'��OTHER - - C Right
PROJECT DESCRIPTION SQ.FT.� OCCUPANCV � K
, CONSTRUCTION7VPE ' - VALVATION$_������- g Left
20NE � GRADING CV.YDS. ACRES � p�ng. Ref. #
Remarks: Plannind NOtES:
Bar Sink
Back(low Preventer
Backflow Irri9ation .
Bathtubs
Clarifiers �
Dishwasher �
Drinking Fountains �
Floor Drains
Floor Sinks
Gas Service Outlets'
Interceptors '
Kitchen Sink
Lavatories �
P-Trap
Roof Drains
Reinspection Fee $15
Boiler � ,
Duct- UnderGround
DuCt - StrUcturdl
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFacL Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 eTu C] i oo,000 aT
Reinspaction Fee � $15
CMF OB65-46, rev. 30/84 White - Builtling; Canary - Applicanp Pink - Accountlng; Goltl¢nrotl - ASSGSSor
Showers
Service Sink'
Sewer Cap- '
Sewer Connection
Solar Collecrors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Cbset
Water Heater
WaterService �
Auto-Wash � .
Issue Fee
FEES
J
FEES
HOod or� Type I ' ❑ ,
Canopy Type I I ❑ ' ''
Refrigeration System
❑aioo,000sru ❑iao,000eTu
SVstem Repair/Alteration �
Fire Dampers
fiegisters
, Issue Fee , $ 3
Automatic Washer
Construction PoleSub.
Cookin9 Unit '
Dishwasher
Dryers �Gas ❑Electric
Fan
F.A.U.
Device eoxes
Outlets
ae6i 6/I3/Bu ��,',
- , zo�e
Accessory Buildin9:
Z
' O
N
I
. N
� G
R
Parking Feq./Provided E
Q
M
T
S
ELECTRICAL �
Transformer ❑-15-50 KW
❑ 50,+KW
Meter ❑up to 700�amps
Meter ❑over 100 amp�.
Sub Panel
Motors �0-1 HP OLh
Inc.Solar 09-15 HP ❑
- Microwave �
Pole Light '
Range
Garbage Disposal '
Generator 00.5 KW 05-15 KW
; Standing Sections
Trash Compactor
Fee �$15 � � luue Fea
�� DEVELOPMENTSERVICESREQUIHEMENTS:
Zouing;qpprovedBy �
Building Approved By
.; � _
Aaolication Issuad Bv
� . SUMMARV OF FEES
�BUILDING PERMIT ' $ 3G� 00 SMIP, �
.PLAN CHECK $ PEPMIT
PLUMBING $ �SSUANCE
PLAN CHECK 25% 5 ENERGV P.C.
ELECTRICAL $ GRADING
PLAN CHECK 50%. $ ' MICROFILM
MECHANICAL � $ TOTAL FEE
PLAN CHECK 25%' $ � � ' �
B
6-15+
$
FEES
$ 3
5
$
$
$
g .30�n0
.y
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
. 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
i
2. Soil Pipe-Undrgrnd. ,�' • 53. Steel Reinforcement " ;
3. Electrical Conduit Utility-Undrgrhd. - "' 54. Forms � �.
i
4. Electrical Conduit-Undrgrnd. , 55. Electrical Bonding
5. �Steel ,Reinforcement ' 56. Rough Plumbing & Pressure Test .
i
�6• �Electiical UFER Grrid.. 57. APPROVALTO COVER-GUNITE � ,
7. iFootings, ,' - 58. Electrical Conduit-Undrgrnd. �
S. �Foundation � ' �"� 59. Gas Pipe, � Undrgrnd., Test ,
9. �Water Pipe-Undrgmd. - .� '� � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. 5tructural Floor System : � 61. APPROVAL TO DECK ''
17. Property Sewer Line & House Connection . ' - 62. Backwash & Recep[or-Final
12. Sewer. Cap � � � 63. Heater & Vent-Final ,
�
� 13. ,Roof Drains •� ' ' 64. Plumbing System - Final
14. Rough Plumbing � 65. Electrical-Final �. '
15. Rough Electriwl-Conduit 66. Solar System-Final " '
16 � Rough Electric Wiring 67. Fencing & Access Approval
17., Rough Wiring Sign- - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T".Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19., Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Fough Factory Fireplace APPROVALS Permit#
21. Ducts,in StruGture 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing .. . 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing ', S.e { N o�e i 74. Overhead Hydro
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical �
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation - 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREIVIENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Mete}-Final �80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �p � /. �� T ��T
34. Final Heating�& Air Conditioning �
� w �
35. Final Gas Pipe-Test � �� �� d� �.Q � �o�/
36. Hood or Canopy
37. Fi�al Factory Fireplace ,
38. Final Plumbinq
39. Water Service-Final � � �
40. Gas Service-Fir�al �
41. Solar pomestic-Final '
I
42. Backflow Preventer �
A3. Backflow Irrigation
44. ,Landscape Irri9ation System �
45. Sound Attenuation � � �
46. Handicap Regulations , � � ,
47. FINAL STRUCTURE & BUILDING (y � �
48. Special Requiraments Completed � '
49. Electric Release to Edison � - �� �
50. Gas Release to Southern California Gas Co � ,
51. CERTIFICATE OF OCCUPANCY ' ' �
No. Date
AOP��cant to fill in all spaces axcept those within neavY eortler Ilnes ana sign all a0oroorlate aeelaratlons.
Y"'oF COS7 es C STR C 10 ERMIT
ProlectAddress�7�� ��'�� ��
Applicant's Maili Addr ss
Owner's Name ��/ �PM ❑n��,.7•iU O�
Address ��'�'E-
Arch/Eng. License No.
Address /—
Convactor'sName ��- �/Ll.��' aJ, G (F�hnn,o�%CO�n�W!
Addresslmailingl�Ql--l�/t'��� �+��–'��Z
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby attirm tha[ I am Ilcensetl untle� provi5iOn5 0/ Charte� 9(commencing
wit� section ]000) of Division 3 Of the Bu5ine5t antl PrOteSsioni COtle, antl
my license is in ull.jo e antl e e. �.i ./i / r
—J �/Mi(O J
Licen a License N iar_� �
oate' S1g t =
WOR R ' COMPENSATION ARATION
iereDy af/irm that I �ave a certificate of consen[ to self-insure or a certlfiwte
. Wo�kers' CompensatiOn Inzuranre, Or a c¢rtlfietl copy [h¢reol ($ectlon
3800, l.ab. C.)
Policy No. Company
BCcrtifietl copy is M1ereby furnishetl.
Certifietl copy I5 filetl witn [he ci[y Builtlin9 Division.
Date Applican[
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl nol be compleletl I7 the parmit is lor one huntl�etl (E300) or
iess).
I certlfy tM1 t in the p¢rtormance ot [be f hich Lhis pe�m�t is i55uetl, 1
snall not P y any petson In any m nne o betome Subj¢Cf to th¢
Worke n lion LawS of CdlifOr f.. r
Date Si9nature /
NOTICE If, tter making this tleUaraOon, you shoultl become suoject to the
Workers' Comp¢nsdtion prOvisions ot t�e Labo� Cotle, you must fortbwith
comply with su[h ptovislons o� this permit Shall b¢ tleemBtl revOk¢tl.
CONSTRUCTION IENDING AGENCV
1 hereby atflrm that t�ere is a constructlon lentlin9 a9ency tor the performanca
ot [he wark tor which thit p¢rmit is issuetl (Sectlon 3097 Clv. C.)
Lentler's Name
Lentler's AtlOress
OWNER BUILDEH �ECLARATION
I hereby afflrm t�at I am ¢xampt trom Ihe Contrattor's License Law for Ihe
tollowing reason (Section 7031.5 Busineis antl Professional Cotle: Any city or
county whlcn r¢quires a pe�mit to ConStrucl, alteq Improve, tlemolish o� �apair
any structwe, pdar to its issuan<e, also requires the applicant tor suth pnrmit
f0 tile a signatl statemenl thdt he/slle i5 IiCon5C0 pufsuant to th¢ prOviSlons of
the Convactor's UC¢n5¢ law (Chapter 9.(tommencln9 with Settlon 7000) of
?,'Jlvision 3 OI the Busine55 antl Protes5ron5 Code) o� that hC/She is axemo�
; neretrom antl lne bazis ior.lhe a11e9eC examption. Any viOlation o( $¢cliOn
"%031.5 by any appllcant fOr a Oermll Subjetlz the appllcant to a clvll
�enalty ol not more than five huntlretl tloltars (E500).
I, as owner of the prope�ty or my employ¢¢T with wagas as [heir sola
compenSaUOn, will tlo Ih¢ work, antl tne strutlure I5 nol intentlCd Or oHeretl
lor sale (SeUion 7044, Business antl Professional Cotla: Tne Contractor'S
License law does not apply to an owner ot a properly who bulltls or improves
[�ereon, antl who tloes such work himsetl/herielf or through his or har own
em0�oyces, provitletl tha[ sucM1 improvementz aro not IntenUetl or olfore� �or
sale. tl, however, Ne builtling or Improvament is soltl witMn one yoar of com-
pletioq ihe owner will have thu burtlen of oroving he/shc tlitl not bulltl or im-
prove forthe puroosa o/sale).
❑ 1 as own¢r Of t�e prope�ty, am exclu5ively conttacting wilh Ilcensn0 con-
tractors to mnstruct the D�oject (Section 7044, Business antl Protes9ons Cotlo:
T�e Contractor's License Law does not apply to an owner ol property who
builtls or improves ther¢on, antl who conbacts for such prOjects wllh a Con-
IfdC[OI(5 ��CCf158 PURud�t�t0 tb¢ COnL�aC[O�'S Licanse Law�. I am 3Wd�C Ihd[
proot o� their Worker'S Comp¢nsation insu�ance Shoultl be Provitletl t0 m¢.
❑ I am ex¢mpt un0e� $ec[iOn B. & P. C. fo� this reason
Date ' Owner �
1 hereby certify tna[ I have reaa this application antl state that tne above
inbrmation is correct. ree to comD�Y �+'��h all city antl county ortlinances
antl Stale laws t builtling cons[ruGtiOn, antl �ereby authot@e rep�e-
zentatives of t i enter upon tne above-menttonea�rppejty for
Signature �! /
Drivers' License or 55 3t
TVPE OF CONSTRUCTION IJ NEW� ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISM OTHER A p �y
DESCRIPTION OF WORK/USE OF BLDG.
S Main Buildi
E
TVPE OF PERMIT GRADING FOVNDATION STRUCTURAI. T FrOnl
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear
❑ OTHER %�
PROJECT DESCRIPTION 54. F7. OCCVanrvcV C Right
CONSTRVCTIONTYPE VALUATIONS S Lefi
ZONE GRA�ING CU. YDS. ACRES Ping. Ref. �h
Remarks: N A n.v� 0 O .�l 1 Planning Notes:
Sink
kflow Preventer
kflow Irrigation
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Roof �rains
Reinspec[ion Fee S15
Boiler
Duct - Under Ground
Duct - Strutturel
Duct � Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact.8lt. ICBO #
Heating System & Ducting
❑ai oo,000 eru O i oo,000 er�
Reinspection Fee 575
-- — __.—._.__.—
CMF 0865-46, rev. 10/84 White - Builtling; Canary - Applicant; Pink � Accountin9: Goltlenrotl - A55052or
Showers
Service Sink
Sewer Cap
Sewer Connection
Soiar Collectors
Solar Piping
Solar Tank
Swimming Pool w�Spa
Urinal
Warer Closet
Water Heacer
Water Service
Auto-Wash
Laundry Trays
laue Foe
Hood or Typel �
Canopy Type l l �
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alterotion
FireDampers �
Registers '
Isue Fee
§ 3
FEES
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit �
Dishwasher
Oryers ❑Gas ❑Elec
Fan
F.A,U.
Fixtures
Device Bozes
OuUets
Switches
Garbage Disposal
Generator �0.5 KW C
Fee
3/OB/,,�
Zone
Parking Req.IProvided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ SO + KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors � P 7 HP � 1 h� 8
Inc.Solar �9-15 HP �76-15+
Microwave
Pole Li9ht
Range
; Standing Sec[ions
5 KW Trash Compactor
$15 Issue Fee
UOJ .
FEES
5 3
Z
O
N
I
N
G
R
E
Q
M
T
S
DEVELOPMENT SERVICES REDUIREMENTS:
Zoning APProved BV � Data
Building Approvad By Date—�
Appliption Issued By - Daea J�
SUMMARV OF FEES
BUILDINGPERMIT $ � � SMIP S
PLAN CHECK • $ PERMIT �
PLUMBING $ -� ISSUANCE 3
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ �'�O
PLAN CHECK 25% $ .
�CONSTRUCTION AND PLANNING PO�� & SPA �
' APPROVALS Permit# - Date Inspector qppROVALS Permit# Date Inspector
r
7. Temporary Electrical Service or Pole . � -... 52. Pool & Equipment Location �
- 2. So jPipe-Undrgrnd. •- '� 53. Steel Reinforcement �
3`.�Electrical Conduit Utility-Undrgrnd. 54. Forms ,
4. Electrical Conduit-Undrgrnd. 55. Elec[riWl Bonding � s
�5. Stee��Reinforcemerit 56. Rough Plumbing & Pressure Test �'
�6:,ElectricalUFER'Grnd. �, • 57. APPROVALTOCOVER-GUNITE :;-
7�. Footings � � ' 58. Electrical Conduit-Undrgrnd. �
8. Foundation ' �„ � 1„� ' 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undr9rnd. � 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 "
t
� 14. Rough Plumbing ` 65. Electrical-Pinal
15. Rough Electrical-Condui[ 66. Solar SYstem-Final
� 16. Rough Electric Wiring ' 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning' FIRE DEPT. REQUIREMENT
20.�RoughFactoryFireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas PiPe-Rough & 7est 72. Underground Flush �
24. Roof Framing � 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. DryWall Nailing HEALTH DEPT. REQUIREMENT
31. Plastcr Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric Nntes:
34. Final Heating & Air Conditioning
35. Final Gas-Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace '
38. Final Plumbing , 7 �f �/J
39. Water Service-Final •
40. Gas 5ervice-Final
41. Solar pomestic-Final
42. Backflow Preventer '
43. Backflow�Irrigation �
44. Landscape Irrigation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed . '
49. Electric Release to Edison -
- 50. Gas Felease to Southem California Gas�Co �
51. CER7IFICATE OF OCCUPANCY - ' .. .
No Date
Gunite �(�� Post-Tens�oned Concrete ( )
REPORT OF IPISPECTION ON Masonry () Fireproofing ()
Concrete ( ) Reinforcing Steel ( ) '
� T0: ���'�:a �eSA
Address:
CNNER:
PROJECT:
Address:
Report No.
Permit No.(� �($(oV
Architect: 1'7p�,� (}�.(,� Lontractor: '(_��,� I����C ._
Address
Address:
Engineer: �, � , ,�y-�q-r� 1, Subcontractor: (��U (_�„��
(Gunite)
Address: Masonry or
Concre[e)
Inspector: (»nk �;�2 Address:
f7u. . x''�-i,j4 FJI1a2rCtv
14ix Used: �-a (
Slump, inches:�-
Admixture: -6---
Designed Strength, PSI : '�,�a�,�
The Following inspection was performed in acc�rdance wi[h the approved drawings:
Cu.Yds. No. of ,
DATES Placed Cyls• Remarks
1! � � �-17 �_ �stc� t�,. n�_ fqT-i�a 4k�P t C l o�e ��u�, .
�-�."iLV.� �.��+-�i; :, �,.�j.1_,.,ri�7 RC'�.;.tiC - ---- -----
Copicc. of Reports to: (Indicate which Bldg. Dept. L furnish addr�55 of any not listed)
�
• � Applicant to fili in all spaces except those within heavy bo�eer lines ana sign all apvropriate tleeiarations.
F COSTA MESA , - -� � ,. PERMIT NO. t T
C7iUCTION PERMIT,� n. ', [3��' —9SG O\.
Proj¢ct AddreSs '� �� �• � TYPE OF CONSTRUCTION I)Q NEW LJ AO� LJ ALTERATION- LJ REPF
I ApplicanYsMailing dress � GLl�Lt/ � c � ❑ CONVERSION ❑ oEM6usH_ ❑ OTHER
Ownef'S Name ����""''� Phone y5�'� DESCRIPTION OF WORK �� `�'"�""'�e �
Address• ' �,�J�� -TYPEOFPERMIT GRADING ❑�FOVNDATION STRUCTURAI.'
Arch/Eng. � � � Licens o. ���`� " ❑ TENANT ❑ ELECT.RICAL ❑ PLUMBING ❑ MECHANICAL
�'� Addre55 S3 '� � I���_��� ❑ �OTHER
Contractor's Name c� y Pho- .l.�r�s � PROJECT DESCRIPTION Scl. F7. oCCUvarvcV
�I Addi¢ss�mailing) 7/� ���"� CONSTRUCTIONTYPE VALUATION$ ��_.�rV`�•�
� (� gO ZONE GRADING CU. VOS. ACRES
'i City License No. /�
� uCEN5E0 CONTRACTOR DECLARATION Remarks: � �'�� i��
' I hereby affi�m tnat I am licensetl untle� provisions of;Cha�te�.9 (commencing � .
with uction 7000) ot Dlvislon 3 of tM1e Business antl Professions Gotle, antl I '
my license iz in fu�l force antl fe t��/ _ � •
License Class— �z-' —'"S3 ��/7 "�`G License No.� ' PLUMBING ' . FEE
Date //-�- O � c'��ar .a � L. i LiJ-a-cPdRic/ , . . , .
WORKERS' COMPENSATION DECIA'RATION � - Ba� Sink ', ShOwC�s ,�
1
I hereby affirm that 1 havea certlficate ot cOnsenC to self-Insure o� a certificate BaCkflOw Preventer S2rvice Sink ' �
of Workers' Compensation Insurance, or a cerUtletl�wpy ihereot (Section
3800, Lab. C.) pr BaCkflow IrrigatiOn Sewef Ca
Policy No, �7 �i��0 0 3 Company ��� �� P �
�Certifietl copy is hereby fumishetl. � � , , � Bathtubs � ; Sewer Connection � �
Cerfi(ietl wpy is tiled with the city Builtlin9 DiviSion.
Oa[e Applicant Clarifiers Solar Collecmrs
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION. � -� ' DiShWash¢�' ' " - - '- ' "
(Thissection need not be completetl if the pe�mlt is for one huntl�etl (E300) o� t S013f"Pipi�g"' '-
less). . � . ' � . 1 � ' - .
I ce�tify tha[ in the pCrto�mance of th¢ work fo� which this pe�m�t is issuetl, I f D�Inking FOUntairi5 �. $oldl Td�k � �
shall' not employ any person in any manner so as to become subject to the
Workers' Comoensation Laws of Caliiornia.: , ' -1 Floor Orains' Swimming Pool w(Spa' .
Da[e � Signature � � , , ,
NOTICE: If, after making this tleclaration, you shoultl become subject to the FIOof Sinks ' � Urinal
Workers'- Compensation provisions oi the Labor Cotle, you �must �torthwith� ,
comply with sucn pravislons or this permit shall be�tleemetl revoketl. � GasSeNice Outlets� , ,WaterCloset + �.
CONSTRUCTION LENOING AGENCV � � .... ._ -
I nereby affirm tha[ there is a constructlon lentling agency for the pertormance Interceptors ' Water Heate�
of the work ��or which. this permit-is issuetl-,(Sectlon �309] Civ. 'GJ, , .
Lentler's Name � . _ ' , ' Kitchen Sink . ' � Water Service - ' '_
Lentler's Atltlress� � . . , . .
OWNER BUILDER DECLARATION � - ' • LavatOries' f: - ', � • � .
I nereby affirm that,l am.exempt trom the Contracto�'s�License'Law for the � � , , � ,
toilawina reason f5ection �D31:5 Businessantl Protessional'Cotle: Anv citv or P-Trap' ' i �' ' • �' .'
county which r¢quires a pe�mltto conSVuct, alteq imOrove, tlemoliSM1�o�;�epalr
"any struchre, prlor to its issuance, also requiresthe.appllcant for such permit
�to tile a sign¢tl statement'that he/she Is licensetl�pu�suant to the O�ovisions ot
the Contractor's�License Law (Chapter 9(commencing with Section ]000) ot�
�Oivislon 3 of the-Business antl Pro(essions Cotle) oc that he/she�is exempt
.therefrom`antl tbe basis for'the alle9etl exemption. Any violatian�.of Section
7031:5 by-any_applicant tor a permit'subjects the applicant [o a civil ,
��nalty ot not more than five huntlretl tlollars' ($500). � - � , _ �
LJ I, as owner oP the: property or my �employees with wages'-as meir sale
mmp¢nsation, will tlo the work, antl the str�ctu�e is not intentletl o� o(feretl
fot sale. (Section ]044, Business antl Prote55ional' Cotle: The Contractor'S
License �aw tloes not appiy to an�owner ot a property who builtls or improves
thereon; antl�who tloes such work himself/herself or through his or her own '
employees, provitletl tnat su<h'improvements are not �intentletl or otferetl'for
sale. If, however, the builtling or improvement is soltl within one year of com-
pletion, the owner will have the burdan of provinq he/sM1e tlltl not builtl or im-
�rove for the purpOse of sale).
I, as owner ot the property, am exclusively contractin9 with licensetl con-
tractors to construct the oroject (Section 7044, Business antl Protessions cotle:
.The ConVactor's.License Ldw aoes not apply to an,owner ot property who .
builtls o� imp�oves tnereon"antl who'contrattsfo�-such�p�oject5 with a con-
tractor(s) license pursuant'to the Contractor's-License Law)l '� '
❑.I,am exempt untler Section 'B. & P. C. tor (his reasonr �
_ �.-
Date � Owner,_
•Reinspec[ion FeeT
�
��
� A.P. # ,,
S Main Buiiding:
� Front
Reer
- C �i�9ht
- K Left
- S
- Ping. fief. #
Parking Req./Provided
Useof Building:
Planning Notes:
' ' i, �
$25' ' Issua Fee:- �� , • : $'3 '
Boiler
Duct - Under Ground .
Duct - Structural �
Duct-Ventilating , '
Ezhaust System ❑ Multiple
FirepVFact. Blt. ICBO #
Heating System & Ducting
I h5ve rea0 ttils application'antl `state that tne above ❑0.100,000 BTU 0100,000
I agree to comply with all city antl counry orainances � � -
to builtlin9 construction, antl, hereby authorize repre-,
�o, enter� �upon tFe -above-mentlonetl ,property fov _ _ ' i
�h� : Date //� ._ ��� ,� , ..
Reinspection Fee
White�--Builtling; CanarY - ApP���anp Pink - Accounting; Goltlenrotl -Assessor
Signature . -� /�/�
Drivers' License or 55 �
'CMF 0865-46 rev. 7/q3
IHNIGAL
Hood or TYPe l' �' �-�
Canopy Type I I ❑ :
3efrigeration System � �
�0-100,000 BTU ❑100,000 BTU
System Repair/Alteration _
$25 I I luue Fee
. `�-%/�i������i :.
� !�
Zone
Accessory Building:
Park.Fees $
Automatic Washer '� •
Construction PoleSub.
Cooking Unit , ' ' --
Dishwasher �
Dryers OGaS ❑Electric
Fan '
F.A.U. � � .., _ � i. .-�
Fixtures' �
�eviceBoxes� . • �
Outlets �� „
Switche5. � �= - ,,,
v'
sposal �1,,.. �
❑0.5KW OSm15`N
t."_ ; ;
on�ee•-' . ,
2oning (lpproved By—
Appl;cation APProved;By
' ..
;ICAL
�Transformer � 75-50 KW �
� ❑ 50.+KW
Meter Dup to 100 amps -
Meter ❑over100amps �
Su6 Panel
,Mowrs DO-1 HP O1'/:-8
InaSolar,�9-15 HP �16-15+
`Pole Light � ��
Range � � •
� � Sign �
.
StandingSections . � . '
1
� Tresh Compacmr • �
��
$25 laua Fee' . ' $ 3
�S: �
- � - � � SUMMARV OF FEES O
' � BUILDING:PERMIT $ � d;- a' SMIP � $ �
. •�� �PLAN.CHECK -, `, $�:; PERMIT '
-� �PLUMBIf�iG ; $: '�/, n a �ISSUANCE $ ;
'PLAN;CHECK,! � $ ��� S • O O ENERGV P.C. . $ �
- � �ELECTRICAL'- _ $�. �I �— O_ D GRADING , $ �
' PLAN�CFECK $ � � S C> MICROFILM $ � ,,,��..�.�-
� ;•MECHANICAL�, $ ' � TOTALPEE � $ ��-��
$ 3 � PLAN'CHECK � $ � Y�/�% �QS
� �CONSTRUCTION AND PLANNING POOL & SPA .
�APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
%i � Temporary Electrical Service or Pole 52. Pool & Equipment Location ' I�1_ �
2. Soil Pipe-Undrgrnd. , , 53. Steel Reinforcemen
'3. "Electrical ConduifUtility-Undrgrnd. � � 54. Forms�
4��Electrical Conduit�-Undrgrnd. � . 55. Electrical Bonding ��_Z2_
� 5. Steel Reinforcement � � , 56. Rough Plumbing'& Pressure Test �J_2Z_� .�/ .p
6. Electrical UFER Grnd. . 57.� APPROVALTO COVER-GUNITE �) _-Z�.� ��]
7. �Footings •, � 58. Electrical Conduit-Undrgrnd. j�2�Z-Qj
8. Foundation � . 59. Gas Pi e, L� Undrgrnd., Test �� 30-ii3 ,Gi,�
9. Water Pipe-Undrgrnd. 60. Backwash� Lines,�P�Trap, L�Undrgrnd, j.�-��
10' Structural Floor System . 67. APPROVAL TO DECK a
�Z-
11�. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ��� � f� �
12. Sewer Cap � 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final �., Z �_
14. Rough.Plumbing; 65. Electrical-Final ��3-�y
15. Rough Electrical-Conduit 66. Solar System-Final .
16. Rough Electric Wiring � 67. Fencing & Access Approval j_k ^�� .p
17. Rough Wiring Sign � :, . 68. APPROVED FOR PLASTERING I��
18. Rough Electrical-T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL
�-1- 9
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
�20. Rough FactorY Fireplace APPROVALS Permit #
�Y
21. Ducts, in Structure � 70. Underground Hydro
� 22. Ducts, Ventilating ' . 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � , 72. Underground Flush '
24. Roof Framing , , 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing ' . . 74. Overhead Hydro
i
26. T-Bar Ceiling (Structural) & Monocoat 75. DrY Chemical .
27. Frame and Flashing � 76. Dry Standpipe
28. Lathing & Siding f 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: � a z Z^ 8'� I S�QQ ( -1
34. Final Heating,& Air Conditioning. ' �� ,��� ' 4 d 2�r
'35. Final Gas Pipe-Test �P O OC
36. Hood or Canopy / �,
37. Final Factory Fireplace S �! ,,�[ `� � � C �i
38. Final Plumbing ' I .S f0f�' Y' ��b i C�
39. Water Service-Final ��-
40. Gas Service-Final 1'Z EFO -t --
41. Solar pomesticFinal - � p � _ }' L E 2
42. Backflow Preventer '� , �_ L�
t 43. Backflow Irrigation - � ' ,
� 44. �Landscape Irrigation System �
45. Sound Attenuation • .
46. Handicap Regulations .
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison � .
50. Gas Release to Southern California Gas Co �� .
51. CERTIFICATE OF OCCUPANCY . '
No. Date
nt to ti11 in all spaces excao< <�ose wit�in neavy OorEar Iinas anE sign all aDDropriate tleclantions.
CITY OF COSTA MESA
CONSTRUCT,ION PERMIT - 7� _ �
Applicent'SMailingAddrea � NPEOFCONSTRUCTION ' NEW ADD , ALTERATION' REVAIR
ProjBCtAddless ❑ CONVERSION ❑ DEMOLISM �OTH R '
yt1_�,js� DESCRI�TION OF WORK �'° ��T
Owner's Name '� ��+'Q � ��ho� �� T- . / .
Addreu �� � � r1' /-Y � L yl � TVPE OF PEHMIT GRADING FOVNDATION STRUCTURAL
Arch/Eng. LicenSC NO. ❑ TENANT ❑ ELECTRICAL ❑� PLUMBING ❑ MECHANICAL
Addrew ' - ' ��p �,? ❑ �oTHER ' : . � . - : � .
h"Hi�T � '1' 'pppJECTOESCRIPTION� 5(i.FT,��/ occuPANcv
Contractor's Nem hone7 �0 77� �_
CONSTRVCTIONTVPE �- ' VALUATION$ O�
Address (ma'I' gl �U� � �
�p� J� � . ZON� GRADINGCU.VOS. ' ACRE$_
license IVo. 1a .�
��ICENSED CONT0.ACT00. DECIARATION ' Ramarks: .
1 hereby aftirm that 1 am Iicensea untler provisloni of C�artar 9(�om�mencing
�wlth sectlon 7000) oi Olvislon 3 ot [he Businass AnE Protesslons Code, antl , .
my Ilcense Is In ru11 t ca antl afre<t.
' LJcenu lass � Ice o. PLUMBING .
` Date Sl9nature Ba� Sink Sewer Cap
QKERS'COMVENSATION DE LA ION - -
' 'eCy afflrm.[hat 1 have a certiflra[e obconsanT to seN-Insura or a tertH{cate gackflouv Preventer -' Sewer ConnEttion -
. Workars' Compensatlon Insurance, or a certlfletl copy t�ereoT Sectlon - -
3Eoo, Lab. C.y __� ��— Backflow Irrigation ' Solar Collectors ,'
� Po,�fII y NO. _�� Company - -"' -- �
IG Certifletl copy is nereby tumishatl. , � � Bathtubs ' ' $plar Pipin9 �
LJ Cer fletl co rs fifeG wit� the city I n � 51 , �
Date�.�__ Appncant ' � � Clarifiers Solar Tank _ ' �
EXEMPTION,FROM WORKERS'CO P TION DECL RAT � - �
(Thissectlon neetl not be complatetl if th p rmlt Is far ane �unU� (S100j or DiShWdshe� Swimming Paol w/Spe
iess).. . . . . Drinkin Fountains . Urinal
I certlfy that in the pertormance ot tha work for wP��h t�ls permi[ is issuetl I 9 _ '
� shall not employ any perzon in any manner so as to becoma subject to t�e . ' -
Workers' Compensatlon Laws o7 California.�. • � � Floor Orains ' . Water CIo52t
' Date <ignature � ' ' -
MOTICE: If, atter making t�is detlaratlon; you shoUltl become su�ject [o'the - �- FIOor Sinks : --- WatEr Heat¢� � �
Workers' Com08nutlon O�o��slons ot the Labor Cotla,.you must forthwitb '
�comply wlM�such provisions or this permi[:spall ba tleematl revokatl: , GasSerJice OutIBtS� - WatC�S2rvice ' '.
CONSTRVCTION LENDING AGENCV
I heraby affirm that there is a�conslruttlon le
� of the wofk 1or whlcYth6 permil I5
'� LenCer's Name � ���� '� -
LenCer•s Atltlress '
OWNER,BUILDER DECLARATION �
I haraby atflrm that I am exempt�from the
' following reason (Settlon 7031�.5 Buslness a
, county whicn requlres a permit to construct
any strutture; prlor to Its Issuance,�also raq
�_ tfl (IIB a Sl9n¢tl Stdtam0ilt thdl �8/Sha IS IICB
l.Contractor•s Licensa Law,(Chapter 9 (co
�'-:i:-{slon �3 of t�e Business antl Protesslons
''r�'iafrom antl the� ba515 for the all8getl exe
t�v;d31.5 by'any aOV����� for a permlt s
� enalty ot not more t�an five nuntlre0 tlollai
1�� I, as �owner of� the property or my ert
compansatlon wlll tlo tne work, antl the sti
� tor sale:(Sec�lon 7044, Businais antl Pro1
; Llcens0 Law tlo05 not apply to'an ownor o/ �
theraon, anA who tloes such work himself/
. employ e85, provitletl t�dt SUCh Improvamen'
� sale. If, however, the bu1101ng or Improvem�
� pletlOn the owner wlll have the burtlen Of F
a9ency tof [he peffOfmanCB. �
I �(�«�on 3087 Civ. C.).
;oi's License Law for the
islonal'Cotle: Any city or
iprove, tlemolish or repalr
appliwnt tor such permit ,
suant lo the provislons of
g with Sectlon ]000) of .
>r thet he/5ha IS eaempt
Any violatiodo/,5ection •
:he apb���nt lo a dvll �
�with wages'as thelr sole
� not Intentletl or oiferetl
Gatle:' The Contractor•s •
y wno builas or Improves ,
� throu9h hii Or hBr own
[IntantleC or offeretl for �
1 within One year ot com- �
,_._.�.8/ShetllEnolbuiitlorim- � DuGt-StrUCtural �
�rove for the purp6se of sale)'. ' �
I, ds ownar of the property, am ax<lusivaly con<racting?with IlcenseU con- �
tractorsto consV uci the.project (Sectlon 7044, Busl�ess antl Profe55ions Code: Duct - Ventilating _ •
Tha COMrattor't LJcensa law does not apply to 2� owner of prooerty viho ' . � �
builtls or Improves thereon, antl who contract5 for such pro)acts with a con- ExhauSt System ❑ Multiple 0 i
tractor(5)Iicense pursuantto t�e Contractor's Licen4e Lzw): : •
❑ 1 am exempt undar Saction B. & P. C. 1or this reason Fi�epl/Fact. Blt. ICBO # �
�, ate Owner Heating System & Ducting , i
�I�hereby certlfy that-I��haae reatl tnii application ana state that tne above -. ❑6100,OOOBTU �100,OOOBTI'
,intormatlon Is corract. 1 a9ree to comply with all c�ty antl countY ortllnancas
�antl state laws relating to builtlinq nstruction, artl �ereDy authorlxe repre- • HOOd or •
Sentative5 of�thls�tlty't0 q!r o the dbOvtl-menUonetl O�o08rty 1or . TypOI ❑� i
- InSpettiOn Durp� ' ��O T e I I ❑i
' Slgnature i6.1Ji'F�� il �5��..� Date G �li-.�% • - • �
V � � .. -_ - � Registers . .
' Drivers' Llcense or 55 � �
CMF086$�jev. 3 W ite-Builtl��C��a�,�P��^n[^PInOkU�cg��in' Itlenrotl-Assessor
�� l/ � `J9 S L �
Lavatories •
P-Trap
Roof'D�ains ' ' �
Showers . ' � �
Service Sink ' '
Reinspection Fee §15
laue Fee �: ' $ 3
❑0.100,OOOBTU ❑100,OOOBTU �
System Repair/Alteration ' '
� . .
� . .
, , 1 �
, ' Reinspection Fee. $75
' � laue Fee � $ 3
� PLNG. REF. yk' ,
TO BUILDING -
P PE V I E
� LEFTSIDE VARD
PKG. SPACE REQ.
STREET WIDTH
SPECIAL CONDITION :
- . Automatic Washer-- -.
Construction Pole
Cooking Uni[
Dryers LJGas LJElectric
Fan �
F.A.U.
Fixtures_, j , , '
Device Boxes �
OuUets '
Switches . '
GarhageDisposal i
Ganerator, OO-5 KW �5-15 KW
Transformer ❑15-SOKW
❑5U + KW �
Meter ❑up to 100'ampi '
ZoninB APVrored By
�
ApPlication APVroved BY
APPliration laued BY � �
0563 6/17l3:J _ . �i..�i
LONE � �
BUILDING � .
ccT�nCr rri eT
REAR �'AFD (TO P/U �-
RIGHT SIDE YARD
PROV ED
ARK FEE $ ',
ELECTRICAL
Meter. Dover 1 W amps -
Sub Panel - ��
Sub Pole
,Motors L104 HP LJ1X$
Inc.Solar �9-15 HP,�16-15+
'Microwave
Pole Light • ,
Range . . . . . _ _
Sign
Standing Sections
Trash Compector ' �
, Reinspection Fee $75�
� .IK��e Cee � � . S 3 i
� ; �. �7 SUMMrARV OF FEES ' �
BUILDINGPEFiMIT $� � SMIP ; $ . ��5�
•PLAN CHECK � $ �� PERMIT � �
PLUMBING $; ' . ISSUANCE' � $ '
�PLAN CHECK� � $ � GRADING • , $ ; '
�ELECTRICAL' , $ ' � � � $ .
'PLAN CHECK � $ " MICROfILM $ i
MECHANICAL $ � TOTAL'FEE� $ .
� �
,PLAN CHECK� � $ � qDVANCED PC ; $
. , � � � � � � : FINAL FEE $ , 3. . 27
_t..:
. CONSTRUCTION AND PLANNING ' � � - � � � ` -�� 'PA - T� .� ' -
�Date - � �Inspector � � - - ' �"- �� � . Date Inspector
�_APPROVALS - Permit#� - �� APPROVALS-�. Permit�# .
� 1 Temporary Electrical Service or�Pote � � � _ 52.-; Pool &�Equipment Location
2. Soil Pipe-Undrgrnd: • +�. " - � - 53._ Steel Reinforcement '
� 3i Electrical'Cbnduit Utilitv-Undrgrnd. : _ � 54: �Forms . . � . � ' �
- �
4: Electrical'Conduit-Undrgrnd� _:: ' - ' � . 55.� Electrical�8onding� - . - ,
5. Steel Reinforcement; � � � - � ;-, � - 56. Rough Ptumbing-& Pressura Test - � `
6: �Electrical UFER Grrid. I, ' 57.' APPROVAL'TO COVER-GUNITE .
7. Footings • `� � - __ 58. Elec[ricaly�nduit•Undrarod. , � � �
6. Foundation �� ' , 59. Gas Pipe, �� U�drgrnd., Test - �. '� �
� 9. Water Pipe-Undrgrnd. � . � 60. BackwasFi� Lines, P-Trap, O Undrgrnd. .�
10. Structural Floor System 67. APPROV.AL TO DECK .
11. Properry.Sewer Line & House Connection, - 62. Backwash�&-Receptor-Final
12. Sewer'Cap � ' . 63. Heater & Vent-Final . " ' �.
�,.
13. Roof Drains ' � � _ ; 64. P.Iumbing,System - Final � . �
14. Rough Plumbing . � �^ 65. E�lectrical-Final �
15. Rough Electrical-Conduit" -"� - ' - � - " � -66.� Solar System-Final � - � � -� '
•16.� Rough Electiic Wiring- � ; � � ' - ' � �� � - �- � 67. Fencing & Acceis Approval -� � _
_ 77. Rough Wiring Sign ' � 68.� APPROVED FOR PLASTERING � -
� ' 1�8.-;RoughElectrical-TBar`Ceiling� � � ' � 69. POOL/SP:ASYSTEMSFINAL � � -
� � 19:. Rough_Heating & Air Conditioning' FIRE DEPT. REQUIREMENT ��
20't`Rough. Factory Fireplace, � � � APPROVALS �. Permit # - � � �
21 � Ducts,�in Structure� � � 70.� Underground Hydro �
� •
�22��Ducts, Ventilating'. , � . � � 71.� Product Biping OGas ❑Oil ' , �
23. Gas Pipe-Rough & T,esf _ � � - � � � � ' 72.� Uriderground Flush '
, "24. Roof Framing � . ^ : � � � � � . 93. � Unde�gmd. Storage Tank O Gas ❑ Oil i
25. Roof Sheathing : .. � 74. Overhead Hydro � .
26. T-Bir Ceiling (Struciurall.& Monocoat - � 75. Dry Chemical '. -"
27.�FrameandFlashirig � (o..��. 3 76. DryStandpipe• �
28. Wthing & $iding ��- ' � � � 77. F�XED SYSTEM FINAL -
_ 29._ Insulation � � � � .78. FIRE PREV,. FINAL
30. Drywall Nailing �� i ' � � Notes: Ld � ,� � � � a�
` 31. Plas[er Brown Coaty,' ' � � � i � )J
' O�� P�. O` L ZI-
32. Electrical Power MeterFinal � • � � � ' �
33: Final Electric , ` � j , I � .
34. Final',Heating & Air Conditioning � � . ' • ; ' � ',
35. Final�Gas,Pipe-Test " , � '� � . . ' � ' �
,
36. Hood or Canopy . - � - � . ' -
37. Final Factory Fireplace � � . " ' _ � '
�
38. Final Plumbing , ' . - , � � ' ' - .. � •
i
39. Water Service-Final . � '
40. Gas Service-Final ' � . . � � . ' � _ .
i i
41. Solar D'omesticFinal .. � � - � / '�
� � i - - - - - - - -
42. Backflow Preventer . , ' . ' _ � ' � � ' `! •
, , . , , ,
43. Backflow Irrigation �- _ • � " '
�
44. Landscape �Irrigation�System _ ' ' � . . � � � � , . �
45. Sound Attenuation ' � � � � ', � � � � '
46. Handicap Regulations , � - . ' - �
47. FINALSTRUCTURE& BUILDING ' $, �N• ' � ; I � ' ,
48. Special Requirements Completed , , � � � •' ' � ': , �
49. Electric Release,to Edison� I , _' _ ._ �_ . ' ' . � •
50. Gas Release to Southem Califomia Gas Co ' I � � , � . , � . ' "
�
51. CERTIFICATE OF OCCUPANCY ' , , ' � ' � •
No � � Date � i � � '� ;
Aoo�icant to fill In all spaces except those witnin �eavY borOer lines ana sign all aDDroD/�ate aeclarations.
�COSTAMESA CONST6UCTIONPERMIT
. Project Addr¢ss D 3 2 G a n n e t
Applicant's Mailing Address ��.�RI r h f i P �,(� P 1 a ce n t i a
Owner's Nam� —B-f-I.-d�-9.fAd ^�� Phon$ S o_ 0 4 6�
C
Address
Arch/Eng. License No.
Address
Con{recror'sName Davey fi00flflq ^phone99 -9550
Address (mailing) 6� R i dti f i e 1 d P 1 a c e n t i a
Ciry License No. ' a ��
LICENSED CONTRACTOR DECLARATION
1 hereby affirm that 1 am Iicensetl untler pravisio s oi Cnarter 9(commencing
wifh iectioa 7�OOj of DiviSion 3 of [h¢�Busine S a tl P t¢ssioos Cotle, antl
my license is in full torce an�e3fpct. (/ 3 83 0 3 9
Licenze Class � '�1 � e se
Date � - � n -��ature �"� • �� �
WORKERS' COMPENSATION DECLARATION
✓
1 hereby atiirm �hat I have a certiticate ol mnsent to seltdnsure or a certificate
of Workers' Compensation Insurance„or a certifietl copy'thereoi (Section
3800, lab. C,) �� p� � ���p /'4fe � L'e -,E m � O
Policy No. �-5+-�-�-1�_L]_St_ COTpany /
eCertifietl�cop is hereby furnishetl. '
Certifiedc P iY(�tl with Ihe city Bulitlln�lvisl
Date /• S � Applicant �� • .
EXEMPTION F, OM WORKERS' COMPENSATION DEGLARAT,ION
(This sectibn neetl not be comple[etl if the permit is for one huntlre0 (SI00) or
less). /
1 certity tM1at �n tM1e pertormance of the work fOr which this pe�m�t s ISSuetl, I
Shall nof employ any persOn in any manne� 50 as to becoTe iu ec[ [o the
Workers^ComPensatlon Laws ot California. .
. Date� Siqnature
'NOTICE: It, after makin9 tnis tleciaratlon, you shoultl become zubject to the
Workers' Cort�Pensalion' provisions of the Labor Cotle, you must forthwith
comply with such provisions or this permlt shall be deemetl revoketl.
CONSTRUCT�ON LENDING AGENCV '-
I hereby atfirrtt that there i5 a const�u�tion lentling agency for the p<r(ormance
Of the wark fOr which [his permit is i55uetl (Section 3097 Civ. C.)
Lentler's� Name ,
Lenaer's Atltlress - _
; OWNER BUILDEN �ECLAHATION '
� I he�eby affirm Iha[ I am exemp[ (�om [he Cont�acto�'s UGense Law for the
, tollowing rea4on (Section 7031.5 Business antl Professlonal,Cotle: Any city or
cOuniy which requires a permit �to cOnStruCt, alter, improve, tlemoli5h o� repair
any slructurer Prior to Its Issuance, also requires tne applicant for such permit
to file a siqn¢tl itatement that he/she is Ilcensetl pu�suant to the p�ovisions of '
4he Cont�acto�'S LiCense Law (Chapte� 9.(commencinq with $ection 7000) of �
Divi5lon 3 0/ tM1e Business antl Prote55ions Cotle) or that he/Sh¢ i5 exempt
•[herefrom �and lhe basis br [he allegetl exemption. Any vi0lation of Sectlon
7031.5 by a�Y applicant for a permit 5ubject5. the applicant to a civil
�ndl[y of not more than flve huntlretl tlollars (E500).
1, as'owner of the property or my employees with wa9e5 as [heir sole
Compensation, N'�II tlo lhe work, and the SVucture is not intentletl or offeretl
Por sate (Sedlon ]044, Business antl Professional Cotle: The Con[ractor'S
License Law does not apply to an oW�¢r of d property who�bulltls or improves
thereon, ana wbo aoes sucn work nimself/herseH or throu9h his or her own
employees, pYovitletl that such ImprOvements are no[ intendetl or o(feretl fo�
sdle. 1f, howe�e�, the builtling or improvemeni is Soltl within one yea� of com-
pletion, tne o'H�er will M1ave the buraen ot provin9 h¢/She tlitl no[ builtl or i�n-
p�ova for [he Pu�pose o( Sale).
❑ I, as owne/ of the property, am exUu5lvely cont�actlnq with Ilcensed con-
l�acto�s to mAStruGt the projec[ (Section 7066, Busine55 antl Pro(e55ion5 Cotle:
The Gontractor'S License Law tloes not apply to an owner of pwperty who
builds or improves thereon, antl who contracts for such projetts with a con-
Vacto�(s1 fice�se pursuant�to the Contractor's Licensu Law). � am aware that
proof ol thel/ Wo�ker's Compen5atlon Insurance Shoultl bC P�ovitletl to me.
❑ I am exempt untler Se<tion , B. & P. C. tor this reason
Date Owner
I hareby certlfY tha['I have�rea tbls a
intormation is correct. I'1�agre to afi ly
antl state lawf relating l�o bGiltli
5entative5 0f ihis city to ente �
inspection ourPoses. �
Signature —
Orivers' License or 55 � �
CMF 0865-46, rev. 10/84 White - Builtlln9:
n' antl stare '
tlty antl cou
antl herebV a
Date
TYPE OF CONSTRUCTION LJ NEW 'U ADD LJ ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER� � _ A,p.�6
DESCRIPTION OF WORK/USE OF BLDG. Re�r00 P
' . S Main Buildi
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAI T Front _
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B,Rear '
�O �OTHER � A
PROJECT DESCRIPTION Sq. F7. G C Right
OCCVPANCV
CONSTRVCTION TVPE VALUATION S'`� .�b (] g Left
ZONE GRADING CU. VDS. ACR 5 Ping. R2f. #
Remarks: Planning Notes:
i � �
Sink
<flow Preventer
cflow Irrigation
nubs
ifiers
Drinking Fountains
Floor D�ains
Floor Sinks -, - �
3asService 'OuNets
Intereeptors
Kitchen Sink � �
Lavatories . - '
P-Trap '
Roof Dreins �
Reinspection Fee $15
Duct- UnderGround
Duct - Structural
Duct-Ventilating �
Exhaust System O Multiple
Firepl/Fact. Blt. ICBO #
Heating�System & Ducting
❑0-100,000'BTU 0100,000
Reinspection Fee I $15
APPlicanp P��k - Accounting; Goltlenrotl - Assezsor
SeiviceSink -
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Pipin9
Solar Tank �
Swimming Pool w/Spa i
Urinal
Water Closet
Water Heater -
Water Service '
Auto�Wash
I er...Nr.r T.n..e . .
I
Issue Fee . .
IANICAL
Hoodor Typel ❑
Canopy Type I I ❑
FEES
Auromatic Washer '
ConStruc[ion Pole Sub.
Cooking Unit
Dishwasher .
Dry¢rs ❑Gas ❑Elec'
Fan �
F.A.U. �
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �0.5 KW C
5210 4/19/85
Accessory Building:
' � .
Parking Req./Provided
,
� �Go: i_
Zone i
�
ELECTRICAL .
.'
Transformer ❑ 15-50,KW
� ❑ 50+KVy. �
KW
Meter LJup to'100:
Meter ❑over�700ai
Sub Panel�� -
Motors �0.1'HP ❑
Inc.Solar �9-15 HP
Microwave � 7
Pole�Ligf7t . •
Range
$ign . '
: Standing Sections
Trash Compactor
$ 3
Reinspection Fee $15 Issue Fee
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
� Zaning Approved By
" __ Building APVroved By
Refrigeration System
❑o-ioa,000eru ❑io6,000aru
System Repair/Alteration
Fire Dampers
Registers
Iwue Fea
$ 3
� � ' SUMMARVOF.
BUILDINGPERMIT $ ��'0�
PLAN CHECK $ �
PLUMBING � '$ -
PLAN CHECK 25% �$ �
ELECTFICAL $ �
PIAN CHECK 50% §
MECHANICAL 5
PLAN CHECK 25% $ �
8
�i
$ 3
Z
O
N
I
N
G
R
E'
Q
M
T
S
$MIP ' $ . si�
PERMIT '
ISSUANCE $
ENEFGV P.C. $
GRADING �$
MICROFILM 8
TOTAL FEE $ �� S� ,
• �
�
I
� CONSTRUCTION AND PLANNING
APPROVALS Permit #
1. Temporary ElectricBl Service or Pole
2. Soii Pipe-Undrgrnd.
3. Electrical Conduit UtilitY-Undrgr�d.
4. Electrical ConduiDUndrgrnd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation
9. Water Pipe-Undrgrnd.
70. Structural Floor System
11. Property Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains
14. Rough Plumbing
15. Rough Electrical-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 Flashing
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 pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation '
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison '
, 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANC'�'
� No. Date
Date
POOL & SPA
Inspector AppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrica6Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit # -
70. Underground Hydro
71. Product Piping �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:
4
Date � Inspecror
. W2(� y�A
�2�,=W �.� Twiniaq La�or�torie: �f ��u�e2,t euc� fo2,�u�, �,�.
� 9910 Airport Way / Meiliny Atldress P,O. Box 4'! / long Beach, CA 90801 /(213� 426�3955 / �21J� 636�2386 / p 14) 821t��n31
TESTING BRANGIIOI'1"ICf: 1519�ONotlliSus:m5M1uu1 / Sanla�nn.CAJ2/UJ / I/191++�'PG�f
December 2, 1983
Examination: SC83-6785
COMPRESSION TESTS ON GUNITE CYLIND$RS
Max Sitter
P.O. Box 3454
Fullerton, California 92637
PROJECT SWIMMING POOL & SPA
aDbRESS 2732 Gannet, Costa Mesa
ARCHITECT CONTflACTOR
Dean Pools Dean Pools
ENUINEER SUBCONTRACTOP
B. C. Adame Arco Gunite
SAMPLE FROM Main drain - transition - ahallow end
SPECIFIED
MiX 4, z _ ], STRENGTH
DA7E CAST 11-22-83 SLUMP SIZE
DATE TESTED 12-2-83 12-2-83
SPECIMEN NO. 1 z
COMPRESSION 10-Day 10-Day
TOTALLOAD,LBS. $O,OOO S2,OOO
POUNDSPERSQ.IN. ' 3�ZZp � � 3,300
28•DAVAVERAGE, PSI � 3,180
COMPLIANCE 10-Day tests comply with specifications.
CYLINDERS 4,5 & 6"HELD IN FIELD"
MADE BY OELIVERED BV
SPECIMENS HowarJ Max
DISTPIBUTION: '
Max Sitter - 3
�ata Mesa Hldg. Dept.
2,000 psi
5-5/8" x 12"
12-2-83
3
10-Day
75,000
3,02�
flECEIVED ON
11-'L3-83
/ ��J
.,'�i,4.C:, . � �Gtu t'C�-,w�
Neale R.�Zuidema
ALL R�PORTS �fiE SUBM17LED AS THE. CONFIDF.NTIAL PROPF.RiY Of CLIENTS AUf110111lNION fOfl VUULIGAIIUN Of Ullli NI:I'OHIS. CONCLUSIONS.OR E%iflACT3 FROM
OB Rf(:Afl�ING f11CM IS RESEfIVlU PENOING UUB WRII IEN APPHWpL /lti A MU WAl 1'HUIIiC IION i0 CLIEN75, i11E VUULIC ANII UUHSE WES.
J90 ty
\.
� �' 24+ 2 ! 843
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 60X 91] C09TA MHBA, CALIFORNIA
for Applicaef �o Fill !a Completely .
TYPE OR PRINT
1 AD RE'SS 2732 Gannet Drive
' COSTA MESA, CALIFORNIA
2850 Mesa Verde Drive
� E. G. Kaltenbach No �5478(
1833 E. 17th St., Santa Ana
� F7 �� ��JNNf�oW on LOT� �
�C /03� .� �x�� _g� ,c
'.'�� JrO� REARYARD .���
EF7'S' I RIQNT ,O'
DESCRIPTION OF WORK
X I er rweer�nv I I enn�rrnu I
eui�oiNa2 �� NO.OP cj Z
SIZE / ROOMB 8TOR168
E%TERIOR WALL � �n9 ROOP d�e
COVERING StLLCLO COVER�NO 5 iingle
US6 OF BUIIDIfYp AND WORK TO B6 PERFORMED
wi h attached ara e.
House 2 030 s .ft.
Garage 451 sq.ft. Plan 54-CR
1 XEqEBY ACKNOW�,QpGH TNAT 1 HAVH pp.AO TMIB APPLICATION
♦ND BTATB THAT THC ABOVE 8 CORflECT ANO AOREB TO COM-
PLY WITH ALL CITy OROINA EB ANO BT�T{ LA RHOULATINO
BUILDINO CONSTq4CTION. /
f/
SIGNATUREOF �
P6RMITTE
AUTHORIZE� AG
FIR[
FEE RECEIVED
ypfl 31 19E;4
FINANCE DEPT.
CITY OF COSTA MESA
APPUCATION FOR PERMR
BUILDING
For Offica Use Only
DAT8ISSUEO
,.o � .i 196'�
ZONING
NO.O� USE
�l PLANO 2 BUII
SHALL BE LH89 THAN
VAROSAPPROVED I YARDSAPPROVED
MAIN 6UILDING AGGESSORY BUILDING
VAR. #
DATE
�3�-C
D H
- ..�%D 3 a. Fr '2 �
��
THE �MOUNT 9NOWN UNOER V�LUATION �8 POq TMQ �
PUHP09H OP 88TABLIBH�NO A PfiHMiT FHe ONLY,
VALUATION ��— m
PERMIT FEE S j
8 �/, �s� � 3y.�-d o