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Home My WebLink About3111 GINGER AVE - Building Permits,_;• t CITY OF COSTA MESA � BUILDING DIVISION � -- ; DEVELOPMENT SERVICES DEPARTMENT �• � PERMIT ERMITNUMBER �� P98-00748 (714) 754-5273 • Faz (714) 754•4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 3111 GINGERAV Suite No Vicinity: INSIDE LAUNDRY ROOM Parcel Nunmber: 13949402 Applicant: RUSSELL, WILLIAM W TR Address: 3711 GINGER AVE #A COSTA MESA,CA Owner: RUSSELL, WILLIAM W TR Address 3171 GINGER AVE #A Contractor: Address: ArchlEng: Address: COSTA MESA,CA PLUMBING PERMIT Fhone: Zip: 92626 Phone: Zip: 92626 Phone: . Zip: License: Phone: Zip: License: SCOPE OF PERMIT Replace existing water heater in the laundry room. _ . ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT 522.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 � 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank . $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 Qn 0 0 0 0 0 . 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED �.?� V� Applied: 09/30/1998 Issued: 09/30/1998 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr BkFlow(1-0) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $11.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $33.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetions and flnal approval must be obtained. Failure to obtain inspections and final app�oval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSA710N DECLARATION: � _ I hereby etfirtn under penalry of per�ury one ot the fallowing deGaretions: ❑ I heve entl will maintain e cenificate ot consent to setl-Insure for workere' compenSeUon, es provitled tor by section 3700 ot the Labor Cotle, tor ihe pertortnance of the work for which this pertnil is IssueC. ❑ 1 �ave and will mainWin workers' compensation insurence, as requireA by section 3700 af ihe Lebor Code, for the peAortnance of the work tor wNch this pertnit is issued. My workers' compensation Insurance cartier end policy number are: Cartiec Policy Number: (This section need nat be completed i/ the peimit is velued et are hundred dollars ($100) ar less.) ❑ I certity Ihat in tha pertortnance oi the work lor which t�is permit is issued, 1 shall not employ any person in any manner so as to become sub�ect to the workers' compensation laws of Celilomia, antl egree that if I should become suDject to ihe workers' compensation pmvisions oi Section 3700 of the Labor CoCe, I shell fonhwith compty wit� ihese provisions. Applicani Signeture: Date: WAHNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWRIL AND SHALL SUBIEGT AN EMPLOVER TO CRIAUNAL PENALilES AND qN� FINES UP TOONE HUNDRED Tl10USAND DOLLARE (5100,000), IN ADOITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOH IN SECiION 3/W OF THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTHACTORS DEGLARATION: I hereby eHirm that I am licensed untler provisions of Chepter 9(commencing with Section 7000) ot Division 3 of the Business and Protessions Code, and my license Is in full force and ettecl Lic. N Class x Contrector's Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby alfrm that there is a consiruction lending agency for Ihe pertortnence ot the work for which ihis permit is issuetl. (Sec. 3097, Civil Coda). Lenders Name: Lentler's Address: Signature: Date: OWNER-BUILDER DECLAfiATIONS: I hereby eMirtn thet under penalry oi perJury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reeson (Sec. 7037.5, Business entl Professlans Code: Any ciry or counry which requires a pertnit to construct, aller, Improve, demolish, or repair eny siructure, pno� to its issuance, also requires ihe epplicent for such pertnit ro file e signed statemem that he or she Is Ilcansetl pursuent to ihe proWslons of iha Contrectore License Lew (Chapter 9(commencing with Sectlon 7000) ol Divisian 3 of the Business end Pmtessions Code) or ihat he or she is e:empt therefrom antl the basis br the ellaged e:emption. Any violation of Section 7031.5 by any epplicant for e pertnit suJQecls the aDD�icant to e civil penelry of not more than five huntlretl Aollars (5500)J: � 1, as owner ot the pmperty, or my employees with wages as their sole wmpensation, WILL DO THE WORK, antl Ihe siructure is not inten0etl or oflered tor sale (Sec. 7044, eusiness antl Prolessions Code: The Contractors License Law does not epply to an owner of property who builas or improves thereon, end who tloes such work hlmself or hereelf or through his or her own employees, provltled Ihet such improvements ere not intended or ottered for sale. If, however, ihe bullding or Improvement Is sold within ona year ol completion, the owner-builtler will have ihe burden ot proving ihat he or s�e tlitl not build or improve for purpase oF sale.). ❑ I, es owner ot the proparty, em EXCLU5IVELY CONTRACTING WIiH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business ana Professions Code: The conirectors License Lew does not apply lo en owner of pmperty who bulltls or Improves Ihereon, antl who contrects tor such pmject wlt� e coniractor(s) licensa pursuant to the Conirectors License Lews.). ❑ I am ex9m�u�� Busines d Pmtessions Code tor this reason: Signeture: J ./,cLw. Date: !J � Oaner ID veritied by drivefs license. ❑ Ves ❑ No Drivels License No. Expires: Venfication of Ownership by (rype ol document, i.e. - properry tex bill ar deed): DIVISION OF INDUSTRIAL SAFE7Y PERMR CER7IFICATON: ❑ I hereby certify t�at no ezcavetlon tive (5) or more leat In tlept� into which e person Is requiretl to tlescenQ will ba matle In connection with work authorized Dy lhis permit, entl tha� no Culltling strucNre, scafFoltling, falsework, or demolition or dismantling thereot, will be more ihan Ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, lltle B, Califomia Adminislrative Code). ❑ As owner-builder, I will not employ enyone to do wark which would require a pertnit irom Na Division of Industrial Safery, es noted above, unless such person has e pertnit to do such work from Ihe tlivision. � Signeiure: Date: Division of Indusinal Satery Parmit Number. CERTIFlCATE OF COMPLIANCE AND AllTHORVATON OF ENTAY: I certify untler penalry of perjury that I have read this application and state thet the intortnetion given is wrrect. I egree to comply with ell stete laws and ciry ordinences releting to builtling construction, flntl authonze representaWes ot the Ciry ot Cwle Mese lo enter upan the abova-Oescrib,eQyr �-�r inspec�ion purpos� I agrea no� t�upy or allow occupancy of any 6uilding auNonzeOd Dy this pertnit un�il final�eIXion. / / / rJ / � i Cj � Ki �ii .Gt� 'V i 3d Signeture0f egalOwner(s) �Date AndOr Authorized Applicant Date wae �. iusveenoxnve pAiE It�l�s 1616 Fixetl System Finel Fire Preventian 1266 Pool Spe Final 200 Finel Re-Raof 201 Finel BIocWRe�eining Well 202 Flnal Facrory Fire Plece 203 Finel Sign � 20a Final Demolitlon 2a4&68 CAOEt INSPECf10NTYVE 206 Finfll Mechanicel 208 Final PlumCing 210 Final Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupan�y �g �� SN City of Costa Mesa Building Safety Deparfinent P. O. Box 317 Costv Mesa, Cali4ornio CERTIFICATE OF OCCUPANCY N� 2461 C The Building located at_��jy'�y ��r' �yt?�y A� has been inspected and found to comply with ihe provisions of all CiTy of Costa Mesa Ordinances applicable thereto for a Group � �y�p Occupancy. Use of BUilding— _ __ Legal Description j�; iAE '� (Sea revarse side for Metes and Bounda) Building Permit No.�� Electrical Permit No. �� plumbing Permit No. �`�'� Floor Load Signs have been installed as Room Capaci}y Signs have been instaled as required under Sec. 2308 U. B. C. . required under Sec. 3301 (1) U. B. C. — 17050. GERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging hovse shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by ihe enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion ihereof 2) The number of aparfinents or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required �nder Sec. 17050.1 (d), California Administrative Code, Title S, Chapter 9, Article 8. ' N�mber of aparTments—�._ andfor guest rooms_ ISSUED TO: Building Offi 'al / �a��,�� . b � Date This Certificaie of Occupancy SHALL BE posted in a conspicuous piace on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Forn, svaa-im—»-e3—s_s r �,�Y ': ADO��ant to fill in all spatts except those within heavy Eortler lines anE sign ali aDDropiiate Geclaralions. CiTY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. � TRACT NO. LOT NO. UNIT NO. ProjectAddress -��1, ��-'2 � . ApplicanYs Mailing Address ZC�Zin N�'�"�h'`�r n Owner's Name �� SS�`u- Phone 5`�C'17y5 Address ��,� ��- Arch/Eng. License No. Address Contracror's Name� ' ��0�9' /�ho�n�e ��¢''�'E`l. 9. Addresslmailing) �� Z��-�� 3W0 ��` m"-� City License No. �/�"� �% � LICENSED CONTRACTOR �ECLARATION I hereby afti�m [hat I am licensetl untler provisions of Cha�te� 9(commencing with section 7000) of Divislon 3 of the Business antl �rofesslons Cotle, antl my license is in tuC lorce ana etfect. 41G0'i� License Clazs i e o. Date �'"Z`}-8�3 Signature - WORKERS' COMPENSATION DECLARAT ON I hereby aftirm that I have a certificate of consent to selt-in5ure or a cer[iiicate � of Workers' Compensation Insurance, or a certifietl copy thereof (Section 3800, Lab. C.) � (, coiicv rvo. 10 ��94 g I^89 Co anv �� `''� ertifietl copy is hereby fumishetl. Cev£g1ryietl copy I5 filetl with the city B il n9 ivisi Date V-2�'�� AppliCant EXEMPTION FROM WORKERS' COMPENSATI N DECLARATION (Thissection neetl not be complet¢tl it the permit Is for one huntlr¢tl ($100) or less). I certity tha� in the performance of ihe work Por whicn ihis pe�m�t i5 iSsuetl, I sha11 mt employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature � NOTICE: If, att¢r making tnis tleclaration, you shoultl b¢Come Subject to the �Workers' Comp¢n5ation provision5 of the Ldbo� Cotle, y0u must to�thwith mmply with sucn provisions or this permit shali De tleemed revoked. CONSTRUCTION IENDING AGENCV I I hereby aHirm that there is a mnstruction lentling agency for the performance 1 of ihe work to� whiCh this permit is issu¢tl (Section 3097 Civ. CJ �. Lentler's Name . � LentleYs Atltlress �� OWNER BUILDER DECLARATION I nereby affirm that I am exempt trom the Contractor's License Law for the followin9 reason (Section 7031.5 Business antl Protessional Cotle: Any city or 1 wunty which requi�e5 a pe�mi[ to construct, alter, imprOve, tlemolisb o� repdir any struclure, prior to its issuance, also requires the applicant for such permit to /ile a signetl Statemenf Ihat Ite/sbe is IicenSCtl pu�suant to the p�ovi5ion5 of the Contractor'S License law (Chapter.9.(commencing with Saction ]000) of „rpivision 3 of the Business antl Professwns Cotle) or that he/she is exempt _^erefrom antl the basis for the alleqetl exemption. Any violation of Section �`,'."z13L5 by any applicant (or a permit Subjects [he applicant to a civil szr>��nalty of not more than five huntlretl tlollars ($500). LJ I, as owner of the property or my employees with wages as their sole compensation, will tlo the work, antl the structure is not intende0 or oHerea fo. saie (Section 7044, Business antl Protessionai Cotle: The Contractor's LicenSe Law tloes not apply to an owner Of a properry who builtls or improves thereon, antl who tloes 5uclt work himself/herself or Ihrough his o� he� own employees, provitletl that such improvements are not intentletl o� offeretl for sale. If, howeveq the builtlin9 or improvement iz soltl within one year oi wm- Oletion, tnp owner will have ttle bu�tlen Of proving ne/Sh¢ tlitl no[ builtl o� im- p�ove tor icie purpose of sale). ❑ I, as owner of the proDerty, am ezclusively contracting with IicenseC con- tractors to construct the project (Section 7044, Business antl Professions Cotle: The eonVactor's License Law tloes nol apply to an owner of oroperty who builds or �mproves tnereon. antl who contracts for such oroiects with a con- trattor(i�M��ense pursuant ro me contractor•s License LawJ. I am aware that O�ooi of theit Worker'S Compen5ation Insu�ance shoultl be prvvitl¢tl to me. ❑ I am exemp[ untler Section B. & P. C. for this reason Date Owner I nereby certify tnat I have reatl this application antl state [nat the above information is correct. I agree to comply with all city antl county ortlinances antl state laws ating to builtling construction, antl hereby authorize repre- sentatives of hi city t e pon the above-mentionetl property for InZp¢ction pur o . -Z�,. Signdture Date� Drivers' License or 55 � �'� � TVPE OFCONSTRUCTION LJ NEW U ADD LIALTERATION LJ REPAIR �CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIONOPWORK/USEOF's LDG.--�-x^''�P�5�0 �"�F ��K4Ti�� FCcI� C�-v-��- hi��'�'1 �'d0 4x'E-F'�QSA-�'G�c- K�ZQ.�'r�.P TVPEOFPERMIT GRAOING FOUNDATION STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ �OTHER �.�c' �'t-�^-�o n PROJECT DESCRIP710N 5q. F7.� OCCUa.crvCv CONSTRVCTIONTYPE � VALUATION$ �� 20NE GRADINGCU.VDS. ACRES Remarks: 8ar Sink Backflow Preventer Backflow Irrigation Bathtubs Ciarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Servic.e Outlets Kitchen Sink Lavatories P-Trap Roof Drains Reinspec[ion Fee $15 Boiler Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # Heating System & Ducting ❑0.100,000 BTU 0100,OOOBTI Reinspection Fee � $15 0865-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor $howeri Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Lsundry Treys Issue Fae Hood or Typel ❑ Canopy Type I I ❑ Refrigeretion Sys[em ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee A.P. i� S Main Building: E T Front A Rear C Right SLeft Ping. Ref. # Planninq Notes: FEES Automatic Washer Construction PoleSub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A:U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �0-5 KW � Zane Accessory Building: Parking Req./Provitled O N 1 N G R E Q M T 5. ELECTRICAL Transformer � 15-50 KW ❑ SO+KW Meter L"Jup to 100 amps Meter ❑over100amps Sub Panel Motors �0-i HP �1'h- 8 Ina Solar �9-15 HP 016�15+ Microwave � Pole Light � Fange I I Standing Sections 5 KW I Trash Compactor I Reinspection Fee '$15 I I Issue Fee $ 3 DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By FEES Building Appraved By - - $ 3 SUMM V�f FEES ' BUILDING PERMIT $ � SMIP PLAN CHECK $ PERMIT ' - PLUMBING $ ISSUANCE PIAN CHECK 25% $ ENERGY P.C. .ELECTRICAL $ GRADING - PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTALFEE� PLAN CHECK 25% $ FEES $ 3 $ O� �, � , �'i .i1�::. �.. ' ' i : . , rJ T[ " ' ' �,y , i,,,r�a;DS�.,_`1 1'. i h POOI ;PA ' CONSTRUCTION AND PLANNING 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. Raugh Plum6i�g & PretSure Test 6. ElectricalUFER"Grnd' 57. APPROVALTOCOVER-GUNITE 7. Footings . 58. Electrical Conduit-Undrgrnd. 8. Foundation . � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. , . 60. Backwash Lines, P-Trap, O Undrgmd. �10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 12. Sewzr Cap 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing � - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System�Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heati�g & Air Conditioning FIRE DEPT. REQUIREMENT '20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test . 72. Underground Flush� 24. Roof Framing �� 73. Undergrnd. 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. FIXE� SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final 80. FOOD CERTIFICA7E ISSUED 33. Final�Electric ' • Notes:a S` i"70 Q L 34. Final Heating & Air Conditioning L�. y,�� 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 i 43. Backflow Irrigation . . 44. Landscape Irrigation System � � 45. Sound At[enuation �� 46. Handicap Regulations � . 47. FINALSTRUCTURE&BUILDING � SMO(L� O6'- a(L - 48. Special Requirements Completed ' 49. Electric'Release to Edison � 50. Gas Release to Southern Califomia Gas Co _ ' �_, 57. CERTIFICATE OF OCCUPANCY "" .' i No. Date , � i � � A ciTY OF COS7A MESA CONSTRUCTION PERMIT � a Project A�dress ��1 V 6NGE`(Z _ Applicant's Mailing Addr@ss �"/�/t� Owner'sName ��E Pn�t`{�VlSSEI.L Phone5S6�9s Address SkME Arch/Eng. License No. Address / Convactor's Name_ �(^%�� Phone Address (mailing) City License No. LICENSED CONTRACT00. DECLARATION I hereby aifirm tha[ I am licons@tl untler provisions of GM1arter 9(commencing witb section 7000) ot Olvislon 3 0l the Business antl Pro(essions Cotle, antl my license is in tull torce and eil¢�(. Licen{e Class LicenSe No. Da�e Si9naturQ WORKERS' COMPENSATION qECLARATION I hereby aifirm that 1 have a cerqficate of consent to seli-insure or a certiflcate of Workers' Compensation Insqrance, or a certifietl copy thereof (Se<tion 3800, LaD. C.) Policy No. Company 8 Certifietl copy is hereby furnisbetl. Certiiietl copy is flled with the city Builtling Division. pate APPli�dnt E%EMPTION FROM WORKER$' �pMPENSATION DECLARATION (This zeclion neetl mt be como�e(¢tl if the permit i5 (or One buntlretl ($100) o� Icss). I certify Ihat in the pertormance of (pe'watk fo� which thi;p¢rm�[ysissuetl, I snau Wor4 Date NOTI�E: 1(, after mak(ng IhiS tleclara[ion, you sh4�q�come subject to'tne Workers' Compensation o�ovisibns ot the Labor CotleJyou must forthwith comply wilh Such provislOns or lltis permit shall be tleemetl revoked. CONSTRUCTION LENDING 4GENCV I nereby afflrm lhat there is a torystructlon lentlin9 a9ency for the pertormance o� tho work t0/ whith this permit i5 issuetl (Section 309] Civ. CJ Lentler's Name Lentler's Atltlrezs OWNER BUILDER DECLARAYION I hereby alfi�m lhat I am axertlpt irom the Contractor'S License Law for the lollowin9 reason (Section 7031.5 Business antl Professional Cotle: Any city or county which r¢quire5 a Oermit to construct, alteq improve, tlemOlish o� �¢pai� any svucture, prior [o its i55uance, also requires the applicant for such permit lo tile a si9netl slat¢ment Ihat he/She Is licensetl pursuant to the p�ovi5ions of Ne Contracror's License law (Qhapter 9,(commencing with $ection �000) of ��-,?livision 3 of the Business antl Professions Cotle) or that ne/sne is exempt '�w erefrom antl thE ba5is fo� thC allegetl exemptiOn. Any violdtlon ot Section ?�"'131.5 by any applicant for a permit subjec[s the applicant [o a civil �-�� e alty of not more lhan five n�ntlretl tlollars (5500). ��I, as owner ot the Property or my employees with wages as their sale compensation, will tlo the wo�k, antl [he structure is not in[entletl o� off¢tetl lor sa�e (Section �044, Busin¢5s antl 7wfessional Cotle: The Contractor'S License Law Ooes nOt apply [o an owne� of a property who builtls or improves Iheteon, and who tloe5 such wo�k himself/herself or thrOugh his o� he� own employees, provitletl lhat suCh Improvemen[s a�e not In[entled o� oft¢retl t0/ sale. If, nowever, the builtling pr improvement is soltl within one year of com- pletion, the owner will have the burtlen of proving he/she tlid not build or im- �rove lor the purpose ol sale). I, a5 owner ot [Ite property, am exclusively contrac[ing with IicenSetl Con- Gactors lo const�uct the projact (Sec[ion ]044, BuSinesS antl Profession5 Cotle: The Contractor's License �aw tloes no[ apply to an owner of Property who builtls or improves thereon. aqtl who contracts for such oroiects witp a con- Vactor(51 I¢ense pursuam to [he Cont�actor'S Licens¢ Law). I am awa�e thac proot of their Worker'S Compensa�[i qinsutance sltoultl be provitletl to me. ❑ I arn.exemot untler Sec[ion _„/ ) B. d�. C. �i nis reason I have �eatl thls applica4ie�(an state tnat the above 1 a9ree to comply witb all clry ntl county ortlinances to builtlino cnnshuc[ion. antl h¢rebv authorize reore- � ISigna[urel-�� Driverz' Licenze or SS �f � ant to fill in all spatts exce0� those witnin heavY OorEer Iines antl sign all aoGropriala Eeclarotions. PER IT NO. TRACT NO. LOT NO. UNI7 NO. ,� - 4`0�4� �a�a aa A.P.# TYPE OF CONSTRUCTION rvEW /aDD LjGi3p7l rv� R S Main Buildi E ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _��v' � r ' 7 Froni DESCRIPTION OF WORK/USE OF BLDG. L LIG A Rear O TVPE OF PERMIT GRAOING ❑ FOUNDATION STRUCTURAL � C Right ❑�p TENANT ❑ ELECTRICAL ❑ PI.UMBING ❑ MECHANICAL S Le t Scv OTHER . $ L 5 Y L� S � Ping. Ref. # PROJECT DESCRIPTION 5�. FT. OCCVPANG Planning Notes: CONSTRVCTIONTYPE—� - VALUATION$ �� 20NE GRADIMG CU. YDS. ACRES Remarks: Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Dreins Floor Sinks GasService Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct-UnderGround Duc[ - Strucmrel Duct � Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL iCBO dk Heating System & Ducting 00.100,000 BTU 0700,0006T Reinspection Fee I $15 0865-46, rev. 5/98 White • Builtling: Canary - Appllcant; Pink - Accountlng; Goltlenrotl - Assezror ShoWers Service Sink Sewer (;ap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Hood or Typel ❑ Canopy Type II ❑ Refrigeretion System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers laue Fee $ 3 $ 3 zo�e ELECTRICAL Aummatic Washer Transformer � 15�50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over100amps Dryers �Gas ❑Electric Sub Panel Fan Motors �0-1 HP � 1 h- 8 F.A.U. Inc.Solar �9-15 HP �16�15+ F ix W res Microwave Device Boxes Pole Light Outlets Range ' $witChes Sign Garbage Disposal Standing Sections �. Generator 00.5 KW 05-15 KW Trash Compactor _ Fee �$15 � � luue Fee DEVELOPMENTSERVICESREQUIREMENTS: 2oning qpproved By Building Approved By FEES $ 3 N I N G a E � M T S. S M�M 'V_ O�F FEES ' Ors� BUILDING PERMIT'�`EkF;� SMIP � $ PI,AN CHECK $ z PERMIT � PIUMBING $ ISSUANCE $ P�.4N CHECK 25% $ ENERGV P.C. $ E�ECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ � PLAN CHECK 25% $ G�'_ ']�' r��e: c��=�s;��:.9�:� ...-:s- . CONSTRUCTION ANDPLANNING POO oPA APPROVALS Permit # Date Inspect� ,qppROVALS Permit # Date Inspector � o : 1� Temporary Electrical Service or Pole �� 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement � � �. Electrical Condui4 Utility-Undrgmd. " 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 51 Steel•Reinforcement 56. Rough Plumbing & Pressure Test �� ,. 6.� Electrical UFEfi Grnd. ' 57. APPROVAL TO COVER-GUNITE � � . � ��7. Footings , 'l•� 58. Electrical Conduit-Undrgrnd. � � . 8. Foundation 59. Gas Plpe, 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 � . r� 63. HeateF & Vent-Final . t.' . 13. Roof Drains , 64. Plumbing System - Final � i 14. Rough Plumbing � 65. Electrical-Final ' 75. Rough Electrical-Conduit 66. Solar System�Final �' .16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing �' 73. Undergrnd. 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. In'sulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat�. 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric �i Notes: 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test , 36. Hood or Canopy 37. Final Factory Fireplace �38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final i. 41. Solar pomestic-Final 42. Backflow Preventer , , 43. Backflow Irrigation �• � 44. Landscape Irrigation SYstem � � � 45. Sound Attenuation 46. Handicap Regulations � � h7. FINALSTRUCTURE&BUILDING �q�(� ry�� - O/L v�� 48. Special Requirements Completed 49. Electric Release to Edison -.� . 50. Gas Release to Southern California Gas Co . 51. CERTIFICATEOFOCCUPANCY . , , � No. Date � • ADP�i�ant lo fill in all spaces except t�ose wit�in �eavy bortler iines antl sign all aDO�op�iate tlecla�a�ions. CiTv oF coS7n MESA CONSTRUCTION PERMIT • rploject Address � � /'v ! f ��'ApplicanYs Maili�g Add c s M L Owner'sName W/�l�/.fM l.vi /4VSS�.�.�phone55�-�1q.� Address -3/%/ �i/.v�/C/Q. S%• ��'1' � Arch/Eng. Licenu No. Address Contractor's Nam � Phone Address Im�'�'�� City License No. � UCENSED CONTRACTOR OECLARNTION 1 herCby afti�m thdt I am licensetl untle� provi5ion5 ot Charter 9(commentln9 with section 7000) ot Divizion 3 ot tbe Business antl Professions Cotle, anA my license is in full force antl effec[. License Class license No. Date Signature ' WORKEHS'COMVENSATION DECLARATION I hereby affirm tnac I have a certificate of consen[ to seli-insure or a certificate f Workers' Compensation Insurante, or a certitietl copY �hereot (Sec[ion 800, Lab. C.) Policy No. Company ❑ Certifietl capy is hereby fvmisbetl. ❑ Certifietl coDY Is tiled with the tlty Builtling �ivision. Date Applicant E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (Thi55ection neetl nat be com0�etetl if the permit is for one huntlretl ($300) or less). I cer[ify that in [he perfo�mance of the wOrk fOr which [his p¢rm�t is issued, I shall not employ any Oe�son in any manne� so as to become subje to Ihe Work rs' Compensatio Laws ot Call orni A� �__ ;, / Date��i—Si9nature � Lti� 'NOT CE: H, atter makin9 this tleclaratlon, you shoultl become ubject to the Wo�kers' Compensatlon provisions of Ihe Labo� Gotle, you mus[ forthwith comply with suc� p�ovi5ion5 or this pe�mit snall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV I hereby af/lrm Ihat Ihere is a consl�uclion lentling aqency for the pe�formance of [he work tor which this permit is Issuetl (Seciion 309] Civ. C.) Lentler's Name LenOer'S AtlEresz OWNER 9UILDER �ECLARHTION I hereby affirm that I am ezempt from the GonHactor's License L.aw for tne following reason (Sectlon 7031.5 Business antl Prof¢55ional Cotle: Any city or county which requires a Oe�mit t0 cOnst�uct, alter, imp�ove, tlemollsh or r¢pair any st�uCture, prio� to Il5 i55uance, also reqWres lhe applican[ tor Such pe�mlt to file a siqnetl statement [hat he/she Iz Iicensetl purzuant to [�e Provlsions of the Cont�actOr's Ucense Law (Chapter 9(commencing wilh SecHon ]000) ot Division 3 of tho Business antl Profes5ion5 Cotle) ot Ndt h¢/she i5 exeTpt 'heretrom antl th¢ Dasis for [�e allegetl ¢xem0��o�� A�Y ��olallon O7 Section 031.5 by any applican[ for a permit subjects the appllcanl to a civil ,$nalty of not more than five hunUretl tlollart (E500). �LR I, as owner ot [ne property or my ¢mployea5 with wd9e5 a5 [h¢i� sole com0en5ation, will tlo the work, antl IM10 structur¢ is not in[enEetl o� otfe�etl for sale (Se<[ion ]044, Busin¢zs antl Professio0al Cotle: The Contraclor's �i[ense Law tlo¢5 not appty to an own¢r Of a p�operty who builtls or improves tbereon, antl who tloes such work hlmself/ner5ell or [M1rough nis or her own employaes, proviaetl that such Improvements are not Intentletl or(ofteretl for sale. If, howeveq [M1e builtling or improvoment Is Soltl wilhln One year Of com- pletlon, tne owner w111 have the burtlen ot proving he/she tlia not bulltl or im- �rove Por the purpose ot sale). I, as own¢r oi the Oroperty, am eatlusively contra[tlng with li<ensetl con- Vaclors to cons[ruct lhe project (SectiOn ]044, BuSiness antl Professions Cotl¢: The Contractor's License Law tloes not apply to an owner ot property who buildz or improves thereon, antl who contracts tor such pro�ecls witn a con- tra<tor�sj license pursuant'to the Contractor's License Law). I am aware that ,proof of their Wo�ker's Compen5ation inzu�ance Shoultl be provitletl to me. ❑ I am exempt untler Section B. 6 P. C. for this reason Ot S O 1 he�eby certify that 1 have reatl this application antl state that the aoove information is correct. I agree to comply wiih all city ana county ortlinances antl state laws relatin9 to builtling construction, and hereby autnorize repre- sentatives of this city to enter u tM1e above-men[ionea property for ins ection ur Ses. P P P� / r�r Signature �� 1 L d+L�� Oate%.Z"30^CiJ Drivers' License or 55 ��' � _. �oZ.� fi > �oLJ olot � TVPE OFCONSTR�/�[� TION NEW ADD ALTERATION REPAIR ❑ CONVERSIPN ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. P��f�� Cev[.c w� �o:w,�zn TVPE OF PERMIT LJ G ❑ TENANT ❑ LEC ❑ OTHER PROJECT DESCRIPTIO CON STRUCTION TYPE ZONE Remarks: Bar Sink Backflow Preventer Backflow Irrigation d(inking Fountains Floor Drains Floo Sinks�. Gas Se vice Outlets Interce Of5 Kitchen ink P—Trap — Roof Drains Reinspection Fee G RADI NG §15 Duct-UnderGround Duct - SVuctural Duct - Ventilating Exhaust System ❑ MWtiple ❑ Firepl/Fact. BIt ICBO # Heating System & Ducting ❑0.100,000 BTU 0100,OOOBTi Reinspec[ion Fee � 515 �— --cMF.0865-46, rev. 30/84 WM1i[e - Building; Canary - Applicani; Pink - Acwuntin9: Goltlenrotl - Assessor JATION LJ STRUCTURAL NG ❑ MECHANICAI OCCUPANCV VALUATION $ � C( Showers Service Sink Sewer Cap Sewer,Connection Solar Collectori` Solar Piping -� Solar Tank Swimming Pool w/Spa Urinal WdtCf CI052L Water Heater Water Service Auto-Wash laue Fee Hood or Type I ❑ Canopy Typell ❑ Refrigeretion System ❑0-100,0006TU ❑700,000 System Repair/Alteretion Fire Dampers Registers Issue Fee FEES $ 3 A.P. # ��` .� S Main Building' E T Front � B Rear � A C Right K Left S Pln9. Ref. # Planninq Notes: Automatic Washer Constructian PoleSub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A,U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generamr �0-5 KW � Fee Zoning Approved By _ Building Approvad By 8056 1/24/GG Req./Provided �:.Oi �:. Zone R 3 ELECTRICAL Transformer ❑ 15-50 KW ❑ 50 + I<W Meter ❑up to 100 amps Merer ❑over100amps Sub Panel - � Momrs�Pl HP01X�-8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Li9ht Range ! Standing Settions 5-15 KW Trash Compactor $15 luue Fee FEES S 3 Z O N I N G R E Q M T S BUILDINGPERMIT $ SUfy1�RV11EFEs�IP $ e� i �x� PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE 5 PLAN CHECK 25% $ ENERGV P.C. S ELECTRICA� $ GRADING $ PLAN CHECK 50% $ MICROFILM S MECHANICAL $ TOTAL FEE $ _�� PLAN CHECK 25% $ , / • . . . . . . . � . CJNSTRUCTION AND PLANNING POOL �PA • ! Date Inspector � Date Inspector APPROVALS Permit # APPROVALS Permit # 7. 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 a 2- � 58. Electrical Conduit-Undrgrnd. - � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. �. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62.� Backwash & Receptor-Final 72. 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 i 6. Rough Electric Wiring 67. Fencinc� & 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. Rough Factory Fireplace - APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - •- 77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas � Oil 25. Roof Sheathing �� G 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing p� 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: p - 34. Final Heating & Air Conditioning � � � Q S 3 2 G 35. Final Gas Pipe-Test ' 36. Hood or Canopy ,.3�7. 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. Eleatric Release to Edison .50. Gas Release to Southern California Gas Co ' • 51:- CERTIFICATE OF OCCUPANCY � � No. Date ' � � ,� •. � . . . � , . '. .- �I� PqOJECT p00flE55: ] I 1�. G I NGER AV OWNEfl'S NAME: R(7CJ'SELL nooness: SAME 719 556-1796 AflCHIENGINEEP: AUOXESS: NEG.NO.: uxrt: p� IIN1T: PEpMITTEE: EARLS PLUMHING ( 719 ) 772-3470 nooxess: 1533 W, I,INCOiN ANANHEIM CA 92801 UCENSEO CONTPACTOfl DECLABATION: I hereby allirm �hal I am licensed untler pmvisions o� Chap�er 9(commencing wiih Section 7000) of Oivision 3 ai Ine Business antl Pmlession5 Cotle, ana my license is in �ull �ome and etlect. ciTv uc.: 00 9 3�pTE LIC.: z S 7[ S cuss: C=3 6 oate: � �' � � SignaWre�. — � WOflKEflS'C PENSRTI OECIABATION: Ihere�yaHirmlhallhaveacertificateolcon5entiosell-in5ureoracertilica�eolWorker5' Compensaiion Insuran�e or a cerlihe0 copy Ihereol (Seclion 3800, Lab. ) POUCY NO.: O�} S Q O EXP. UpiE: 3� O S I 9 S comvnxr: BEAVER � Cendied copy s hereby h nishea. � Cenilied copy is filetl with IAe cily Building �ivision. , �ale: � �a ppplitant E%EMPTION F M WOHN S' CUMPENSATION OECLANATION: Qhis section n¢etl not be tompletetl if the permil is tar one hunOreO (5100) or less�. I cetldy Ihat in Ihe petlormance of Ihe work �ar which �his permil is issued I shall not employ any person in any manner so as to become subject Io Ne WorkeR' Compensation Laws ol Cabbmia. Da�e: Slgna�ure' NOTICE: I1. alter making Ihis Aeclara�ion. yau should become sublec� ta ��e Workers' ComDensation Orovisions of �he La6or Code. you mus� Ionhwiih comply wiln such provisions or this permi� shail be aeemed revoked. CONSTflOCTION LENOING AGENCY: I hereby aftirm Ihat Ihere is a tonSVuttion lentling agenCy fOt Ihe performance at the work for which Ihis permll is issued [Seciion 3097. Civ. C�. LENOEH: AUOflESS: OWNEP BUILOEB �ECLAflA710N: i hereGy aflirm ihat i am exempt imm t�e Comramors' Stale License law for ihe following reason (Section 7031.5 Business and Pmtessional Coae: Any ci�y ol counry which requires a permi� lo conslmci, alter, improv¢, demolish, or repair any s�mclure. priar lo its issuance, also requires the applican� for such permil �o file a signetl s[atement that he/she is licensetl pursuanuo Ihe Omvisions of the Conirac�ors' State License Law (Chapter 9(commencing wi�� Section 7000) ol �ivisian 3 of �he Business anU Pmfessions Code) or Iha� he/s�e is exempi Iherelrom and ��e basis lor Ihe alleged exemption. Any vinlation o� Section 7031.5 by any applmanl lor a Dermii sublecis the applicant �o a civil penally oi noi more �han hve hunaretl dolle¢ ($600). I. as owner of Ihe property or my employees wi�h wages as �heir sole compensation, will tlo �he work, antl the ❑ stmclure is no� in�endetl or oHeretl lor sa@ (Section 7044, Business and Pmlessional Cotle: The Conlractors' S�ate License Law � tlaes no� apply Io an owner of a property who bui105 or improves lhereon, antl who does such wo�k himsell/herselt or �hmugh hi5 or her own employees, provitleU ��ai such improvemenis are not in�entled or aflered �o� sale. If, �oweverthe huiltling or impmvement is sola wilhin one year o� completion. Ihe owner will have �he Uurden o� pmving he/she tlitl noi builtl or impmve �or t�e purpose ol sale�. ., I, as awner oi Ihe pwper�y, am excWsively coniracting wiU licensed conUac�ors �o conslmc� �he pwlect (Section 7044, Business ❑ antl Pmfessions CoOe: The Comrac�ors' State License Law tloes not appty to an owner oi pmDehY w�o builOs or impmves ihereon and w�o conira[ts for such pwle��s wiN a contractor(s� license Oursuan� to t�e Coniractor5' Slate License Law�. I am aware ��al pmol ol Iheir Worker's Compensation insurance shoultl be provitled lo me. � I am exemp� untler Seclion'. B. 8 P. C. lor Ihis reason: Date- Ownec I tlo hereDy cenity ��at I am aware ol ana unAers�an0 Ihe requirements ol Califomia Health antl Satery Cotle Sections 25505, 25533, anU 2553a antl Ihai I or any lulure builtling occupant will/will noI (cirde one) neetl ro tomply with said sla�e co0e5 an0 Ihe requiremen�s �or a permit �or cons�mc�ian or modifica�ion irom Ihe Nir Ouahry Management �istrict. Fesitlential cOnstmction applications are exempt �mm Ih¢se prOvi5i0n5. pA�e: Applicanl: 1 �ereby cetldy ihat I �ave reatl Ihis applicaiion ana s�ale ihal Ihe above in�ormalion is correcL I agree to comply wi�h all ciiy and counry orainances antl slaie laws relaling Io building constmclion antl hereby au�horize represenlalives of I�is ciry to enier upon ��e above-men�ioneU uroperry lor insp/eStion purposr ////�//� � ie:/=/ �� SignaWre: �� ` ��"'�`��^`�� DriversLf��seo�so��a�se��vn� I6aLafi Wh�ie—Builtlmg: Green—Cotle Eniorcement; Canary—Applmanl Pink—Revenue: Goldenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05024 PERMIT NO; P 050296 PLAN CHECR NO: . N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION ; REPLACE WATER HEATER SQ fiT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / COMMENTS: REPLACE WATER HEATER *�**+�*�********x **��r*+�*�**+�*�*�a�*�*****�****�r�r*�*****�r�*******�**�******�e**�**�r Z O N I N GS ERTEB�AUCIKASE M E N T S ------------ MAIN HUILDING ---------- --------- ACCESSORY HDILDING --------- FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING RE • PROV; PARCEL; 13949902 ZNE; REF NO: PLANNING N 'PES> % ' 1f ik 1F IF iE if it IF IE if if if if 1F IE iE IF iE if 1E if iE 1!!F 3E iE iE iF 1E If If IF 1F 1k if iF �Fif ff if iE if if !F if 1kik�lf 1f If lkif il� iF i(� 1E 1E 1E if iF 1f iE iF if iE iE iE iF 1F 3E if iE �!F iF 3F iE 3f lE iF D E V E L O P M E N T S E R V I C E S; R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPRQVED HY : = DA'tH; �,, \1 ***�****w�*�r**�*�D*B*i� �� t�t��x��r�**D***�*��t�** �fKkaFikiF#IEIFif�lfiE*iFil�3E1E�EififMlElEiliElElEIf�EiFlFafiFififiF3EiEiFiFiFik f3EiFif3FififMiE3EiEififkif�lEiEiflEffaflEiFifiEiE3fif1EklEiFiFiEiE�fif� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT HLDG PMT PLUM�I�N�G ELECTRIC MECHANIC FIRE SMIP/RES GRADING 15Y SMIP/NON—RES PLAN ISSUE FEE 3,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 2.00 3.00 0.00 5.00 5.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 5.00 OVER/SAORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 5,�0 IF iF iF �k af K�E iF iF iE jF k iF If if �klE 1F 1E jf if iF iF'iF k iF iF 3F iE �E iF iF iE if iF 1f iF iF if iF if if af �E fE iE af fE 1F iE jf iE iF if 1E iF if iE �)FiE k iF iF if iE iF iF )f aF jE �E ik if iE iF iF 3E af �f I N D'I� V I D U A L F E E H R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR VENT 2,00 2.00 END OF FEES Di QOQ7b7{�—�it07br4? u :n �?' r CrATE: 22�3{./9D TIl1c: 1�J:l�J :.�0 / CONSTRUCTION AND PLANNING - P�� aPA � APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Servi�'e�or Pole-, , . 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd., ��. 53. Steel Reinforcement ;: 3;;Electrical Conduit Utility-Undrgmd��' y, 54. Forms 4. Electrical Conduit-Undrgrnd.,�• • 55. Electrical Bonding . �"5: Steel Reinforcemeh� _ 56. Rough Plumbing & Pressure Test '� „6. Electrical UFER'Grnd. 57. APPflOVAL TO COVER�GUNITE �, �'� 7. Footings �`, 58. Electrical Conduit-Undrgrnd. ' : 8. Foundation - ��• 59. Gas Pipe, O Undrgmd., Test '!� � . 9. Water Pipe�Undrgrnd. �t .�� 60. Backwash Lines, P�Trap, O Undrgrnd. ' 70. Structural Floor System � � � 67. APPROVAL TO DECK � 11. Property Sewer Line'& House�Connection 62. Backwash & Receptor-Final 12. Sewer Cap _ �r ,' ;i. � 63. Heater & Vent-Final � 13. Roof Drains �; ' � 64. Plumbing System - Final 14. Rough Plumbing`, � �� 65. Electrical-Final 15. Rough Electricat-Condult .. � 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 79. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT - - - - - 'r " - _ 20. Rough Pactory Fireplace � �`�� °' � - - _ - � � APPROVALS�.,=Permit # ' '" �r . � <,�:. �r,.J: -� _1 ,y t.'Y � ' . � • ` ' .. n `�'.� .' ' • . 21.'Ducfs, in,Stri�ctu�e, , .- .. �,: • ,: ,7 � r r70. Undergrwnd:Hydro .< 22. _Ducts, VentilAting� X _ ._ _ '= x_� J7, producTPiping QGas ❑ Oil 23.';Gas�Pipe�Rough & Test � ;: � , ,�� ,, � ,. 7p. Undergroupd Flush� . '' 24. iRoof Framing�� *'� . .- •" � - �, � ' ` �73. •Undergrnd: Storage�T'ank O Gas'O Oil c � -> s .•� � . �� ni; �. , � ' ' _ . 25. Roof�SH2athing .r , � ; t � ti :,�� ., 74, ,Overhead Hydro �` � 26.��T-8ar Ceiling (Structural) & Monc oat �� _ 1� - T` t� 75.yDry Chemical �'"� - " k� 27.�FrameandFlashing� _�`� ; �;, �,; 76. DryStandpipe `'; _, � S ` , 28. �Lathing.& Siding�: •. t'4 �3- * � ��y � 77,-FIXED SYS$TEM=F�FJ;AL'` ,., '29. Insulation �.,. ^ �� ;. t '� I � f ' 78.�fIRE PREV. FINAi � - � '�30. Drywall Nailing �i � ' i � •�" �HEALTFi�OEPT: REQUIREMENT • ^. n•.. ; i c 1-31. Plaster B�own,Coat; - � ,., . ' I ,\ �� : J9."F-fNAL`�VSPECTION -' ' � '�32. Electrical�Power MecerFinal; r..�• I '�� 50. •FOOD CERTIFICATE ISSUED - 533..iFin�l� Electric. � fn ' � - "� � `Notes: ' --'' r •.; �. 1 -: . , ... '* -. , _ ,34. Final' Heating,& Air•Conditio�ing�, � x � � j.. * ,r, ,^, � � � - i � i n, i ,r e 35.�Final Ga's Pipe-Test} ,_ r - `} ; t '�t,\�f� ' _ ,.� -� ;� ` ` '� ,�36. �Hood or CanoPY � �: �- �• - i -u , �' - ..` :. � . � �n ,:-. ,,. � 37.�Fina7'Factory Fireplace �_ � ;' '� ` "' � � �� ;,. ` ' r.. u. � � �. .. u . , - �38. Final Plumbing . n, ( Zp � , L�(� '. - . .. ".39. Watei Service�Final � � ' : ,�. � � � � � � 'r T � z. • `,40. Gas Service-Final � ,-, m: , � � , :'. � ,�r, :�r � �� :47. Solar pomestioFinal � ' ' '-` 'L'= ` ` �n i •� � 7c "42. �Backflow Preventer., ''' �� j, ` � �'' � � ,� . _ 43. Backflow Irrigation` �}� `-•'� " " `�� '' J .''44. Landscape IrFigation Systemx„� ^ rF . �- - ;� � ' � _ -45. �Sound Attewation� ��'l�•- '' � ' " ^ "- ''t • r �' ' �r � S � �_ �:46.`Handicap,Regulations ; � 'y ' � � � i,, '. ;�; � , �47.�EINAL STRUCTURE & BUILDING • � . .; �> �� - «- � � ; ;� �t � � 48.`'FINALPLANNING,� i r�� , � `?i. :.'.rt`�, `� -i : 49.'JElectric Release to Edison � + �; _� � `50.,Gas flelease to Southem Cali�ornia Gas Co .`'"''" , ". l I � f: �� ;51. CERTIFICATE OF,OCCUPA,NCY' -'- ,; - , � r .. > . � - No. Date � 26,s21 COSTA MESA BUILDING-SAFETY DEPARTMEM P.O. BOX 12M COSTA MESA, CALIFORNIA 9M2E For Appllcanf 'fo F01 In ComplNdy TYpE OR PRINT woo e'as° 3111 Gin er Ave . ' COSTA ME6A, CALIFORNIA ownee Ka1-South Devei�. Corp. Mwa 14 2 S. Euc � ADDR �,n. Fullerton o�871-82 ARCHITECT TRL ADDRE9i 1442 S. Euclid C�T,• �i� No. B102641 � 871-8233 612E _� � .,� ��r �� I No. or eLDot. Hi U9EOP ____ W�j CXIST�NO BLDO. YiA BETBACI( LINB OPON �s�. _ � 18� I gt ecr rt�axr DESCRIPTIAN OF WORK eui�ciNo 4b � �d no.0� 13 s�ze nooMe eronu HXTERIOR WA ROOP COVERINO �uCC� COV2RIN0 Rock UY¢ O� BUI LDINY AND WORK TO Bt P[H�ORM�D 4 unit residettce plus 5 car garages 1 H[F[GY ACRNOWL[DO� TMAT.1 MAY6 11tI�D iN�� A��4 ANO 9TI1T6 TryAT iXi AOOV[.10 COpR[CT ANO AO11�[ 7 PLT WITM ALI.'CIT' O1{OtNAXCO ANG RAiE tA�[C� OYILDINOCOHDTqY OGNM/ � AUTHORIZ[D AO[N'[ � OCT 31-66 001323# **�z10.75 11rPLiCATION FOR PERMR 6UILDIN6 For Offln Us� On1y YARDH APPROVH MAIN BUILDINO DIBTANCC BQT. MAIN BLD66. VAR•# ZONING 2� ,u�earxrx � �uuo�Ho � (�,�5,� �ia..��r '.HANO SHALL eB L688 TNAN >. L fU.B.C.NlOUIHlMHNTI D YARD9APPROVHD AGCH880RYBUILDINO DAT6 `hJ/`I DATi O oC D ' �l 4 W Kl/55384. M. 9�6�? a.�r,. 7do � i TM[ IIMOYM �MOWN UHO61i VALUATON IG IOR TN[ � •YP/OOl O► ilTAOLIGMINO A PHpYIT I[6 ONLY. � VALUATION PBRMIT FE8 . 5 �7 � s y9�9�1 w � .. _ .