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3195 HAITI CIR - Building Permits
,� PXOJECTADOflESS: 3195 HAITI C.� OWNEN'SNRME: �yERICAN a^AVINGS BANK aooness: 2429 SE BRZSTOL � COSTA MESA '�-.,A 9?,627 APCM/CNGMEEH: ' BEG.NO.: RDOflESS: UNIT: UNIT: rcemmee:FANCHER WILLIAM DAVIll (714)258-1808 aoosess: 13?.2 B�LL AV 1H TUSiZN CA 92680 IICENSEO CONTBACTOB OECIAHpTION: I hereby a�firm ��a� I am Iicen5e0 untler pmvisions of Chapter 9(commencing wit� Section 7000) ol �ivision 3 0l I�e Busmess antl Pwtessions Code, an0 my license is in tull force an0 effec�. ciTv uc.: 0� 12 51 $TATE UC.: S S �(j 4 4 cus` B Oa�e: � ,��� ��_ SignaNre: _��'�"" _ . WOBKEBS' COMPENSATION UECIAPATION: I �ereby a�firm Ihal I have a cerii�icate ol consen� to sel4insur¢ or a certifica[e o� Workers' ComDensa�ion Insurance. or a cetlified copy Uereaf (Senion 3800. Lab. C). POLICY NO.: E%P. OPTE: COMPANV: ."7 Cenilied copy is hereby fumished. ❑ Cetlified copy is fileA wilh Ihe city Builtling Division. Date: Npplicant E%EMPfION FpOM WONNEflS' LOMPENSIITION DECUMTION: (This sec�ion neetl nol be compleleG il �he permit is for one �unOreO (51 W) or less�. I wrtily I�al in Ihe pedormance ol ihe work lor which t�is perm is i55ueQ�chall noi employ any De� yy11 in any manner soy�to �ecome subject lo ��e �kers' ompensalion Laws of Califarnia� / �/ // . i.:=....�� `�� ii Oa�e: � �� Signature il/Vr .%O w��� NOTICE: I�. a��er making �his Oeclaraiion, you shoultl Decome sublec� ta �he Workers' C Densa�ion provisions ot �he Labor Code. you must �otlhwilh comDly wi�h such promsions or t�is permii shall be deemed revaked. CONSTNUCTION LENOING AGENCY: I hereby aHirm �hal lhere is a cons�mction IenOing agency �or Ihe pedormance oi ��e work for which this permi� is i=sued �Seciion 3W7. Civ. C�. LENDEN: RUOflESS: OWNEB BUILOEB �EClANA7lON: I nereey aflirm ihat I am exemDt tmm ihe Contractors' Stale License Law for ihe following reason (Seciion 7031.5 Business and Pmlessional Code: Any ci�y o� counry which requires a permi� lo constmc�, al�er, improve, tlemolish, or repair any stmciure, prior to its issuance. also requires the applicani �or such Dermi� �o file a signetl statement I�at �e/she is IicenseA Dursuant Io �Ae pmvisions of Ihe Comracmrs' Sla�e License Law (Chapler 9(commencing wi�� Seclion 70W) of Division 3 0l �he Business and Pmlessions Co�e� or Ihat he/she is exemp� �heretmm and Ihe �asis lor �he allege0 exemp�ion. My violation ol $eciion 7031.5 hy any aDolican� lor a De�mit sublects Ne aDVlicant m a ciWl penalry ol noi mare ihan five hundre0 Oallars (5500�. I. as owner of �he D�aDe�Y or my employees wii� wages'as Iheir sole compensation, will tlo �he work, antl Ihe ❑ stmctureis notinten0ed oroilered lorsale(Section 70a4, Business znd PmIe55ionalCoOe: The Contraclors' State License Law tloes no1 apply to an owner of a propeny who builds or impmves inereon. an0 who Ooes such work himselVherself or inmugn his or her own employees, pmvidea �hat such impmvemen�s are no� in�enAetl or oliered tor sale. I�, however �he building or impmvement is soltl witnin one year of completian, ihe owner will have ihe Uurden of proving he/she ditl not huiltl or impmve lor �ne o�rpose of sale). I, as owner of lhe propeny, am excNsively contratting wi�� licensetl contractors to consWct ihe pmlect (Section 7U44. Business '❑ ana Pmiessions Code: The Contracmrs' State Licenu Law Ooes not apply to an ovmer oi pmperry who hudAs or imDmves thereon , an0 who conVacls �or such prole��s wit� a contractoqs)license pursuan� to ��e Coni�aclors' State License Law�. I am awa�e ''�, iha� O�ool o� �heir Worker'S Compensation insurance shoWd �e pmvitled to me. I� I am exempt un0er Section: B, 8 P. C. for this reason: oate�. Ownec I tlo hereby ceridy Ihat I am aware o� antl untlers�antl Ihe reQuiremenis of Califomia Healt� antl Satery Cotle Sections 25505, 25533, antl 25534 ana Iha� 1 or any �uiure building occupani wilVwill not (cirtle ane) neea to comDty wiih said sta�e cotles antl Ihe reQuiremenis �or a permi� for consbuction or motli�ication Imm Ihe Pir Oualiry ManaAemen� �isVict PesiAemial cons�mction apDlications are exempt Imm IheS¢ provi5i0n5. Oate: NpplicanP. I hereby cetlily Ihatl have read Ihis aDPlication and sta�e�hai��e ahoveinforma�ionis correcl. I agreeto comply wi�� all ci�y and coun�y orUinantesan4slatelawsrela�ingtobwl4ingconstmc�ionandhere0yauthor¢erepresentativeso�thisciry�oenter � �heabove�memione0 pmpetly lor' SDeciion purposes. � �a�e�. 2 j' Si9nature:�'fll�nrv„ p' �river'S LicenSe or Soaal Secunty a: �� � I6nt-a6 White—Builtlina'. Green—CoOe EnlorcemenC Canarv—AoolicanC Pink—Revenue: Goldenrotl—Nssessor CITY OF CO5TA ME�A — BC7SLDING PERMIT PER,t NO: IB U5634: PERMIT NO: IB 056343 PLAN CHECR NO: N GOVT; tJ SUPP: Y CONSTRUCiIOtv TYPE: S—N PERN,IT TYFE: OTH STR FURPOSE; ADll JOB DHSCRIPTiON : kENEW EXPIRED RM ADD PERMIT SQ FT: CLAIM VALUE: 10,281.00 CALC—VALUE: GROUP OCC: R-3 / COM,�:E�lTS: REi��WS EXPIRED FERMIT H2553 & 33193 �*�x#�t**�rxx�x��r*�*��**��*x**#*���**�**��r*��*�*xx��**�r*�*�-�n*x**�***;�*��:k�*�**��� Z O N I N G R E Q U I R E M E,N T S S E T H A C K S ------------ MAIN BUZLDZNG ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR; FT IN FRNT; FT SN REAR: FT SN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: rT SN PARKING RE4� PROV: PARCEL: 13912239 ZNE: RF,F NO: PLANNING Nt3TES> > tN M� �k �IF it �IF �1E iF k� aF * ie �k iE �1E if dE 3E �)f iF �7F i4 3F 3"r 3F i'r if �f iF �lE ii- 3E 3F-7F �f-�}(� �)f iF it 3f� �E 3E 3'r iF it� iF 1E aE ih 3f ii� iE �f �7'r iF �F �iM1aF �� 1F }* �1E �lE �3!� ic iE �(� K{;li iP 1i� 14 3f 3'r 3e lE iF %� D E V E L O P M E N T S E R V 1 C � 5 R E�i U I R E M c N� S ZONING APPROVED BY DATE: �`, BiJ:iLDING APPROVED BY : DATE: :i APPLICATION I�SUED BY; DATE: "�'�� '%�3f'3fififiEif�iEiFifi43E-1FiF3E1'fi"1EifiEii'if +t ' it ftx'* :iF.-� " �iF.�f�.iEiF'1F3(�1f'3Fiei'riFiFi�''F ilFiF�l ifili'rlfif3E�Eir�M�iEiElE3EiElE4�Fii�3Ei'rifiFieifN�lk3Eif�FiFihi�' � iFif3Fi'riF#�ifif'1Ejix'.if3fiF3fiei'rifiE�i'rlEitififiE'�iPjFY�3E3F�ii9EiiiERi�icli�iFiflf LEGALIZATION:N , F" E E S U M M A R Y STRUCTURAL) SEGi�ENT:Y Bi,i7G PMT PLUMBING ELECTRTC MECAAUIC FIftE SMIP/RES�, GRADING PERMIT 30.00 PI,AN S�uIP/hOIJ� RES ISSuE FF'E '� Bf�.��DING—DIV—> PER��iIT ZSSUE PLAN—CHECK TOTAL PAID�� DtiB TOTALS----> 30.00 O.UO 0,00 3U.00 30.00 ;� ,00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: ,OU HLDG FN.'C PLUMBING ELECTt�IC NECHANIC FIRE SMIP/TOT GRADIN �LAD7—CHECK 30.00 if� ie ii- if%if-if %� ii• �3F )F }; lf� iF iE iF k if iE iE if 34 �7F 3F ff ah iE iP Ji� iE �lf )E iFlE if �lc 3E ie-1'r �)c if iF �)E if ik iE-lc 1E !F iF �1i iE 1F jE ii #� i�'-�1E iE ii�# l(� ih'�E 3c �1'r iE �fe 3elf �k iF �1!� �1'r � Y� iF ie iF I N D I V I D li A L F E E B R E A K D O W N � TYPB �TY D E S C R I P T I O N UNIT COST 1'OTAL COS'P SNS i BUILDING RE—I�SPECTION FEE 30.00 .�1 30,00 Er'D OF; r EES � /�, V �� r,i 4fl109345—C�71D9?;6 j9'•a �� ' �, t7r�TE: 02i:5/42 iI!1[:4h3:S� -J• /. -\ i � .. I. .i4�__ . _ _ . __ CONSTRUCTION AND PCANNING �.. ' . - - � POC SPA � . APPROVALS Permit# Date Inspector APpROVALS Permit# Date Inspector' i. Temporary Electrical Service or Pole _- . -- 52. Pool & Equipment Location � 2. SoiV`�ipe-Undrqrnd. � � - 53. SteeV Reinf'orcemeni ." 3. Electrical Conduit Utility-Undrgrnd. � _ 54._Porms . � 4. Electrical Conduit-Undrgrnd.-- 55. Electrical Bonding 5. Steel Reinforcement ' - 56.' Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE 7. �Footings � � ' � 58. Electrical Conduit-Undsgmd. * 6. Foundation i`�+ •�� } 59. Gas Pipe, O Undrgrnd., Test '•�;� 9. Water Pi e�Undr rnd. �� p 9 �p '�� s 60. Backwash Lines, P-Trap, Q Undrgmtl. �-� 10. Structural F�oor System k r'�% 61. APPROVAL TO DECK � 1 t. Property S¢wer Line & House Cbnriection 62.' Backwash & ReceptorFinal ^ 12. Sewer Cap - 63. Heater & Vent•Final ..s.,s 13. Roof Drains -'ti f�" 64. Plumbi�g System • Final r 14. Rough Plumbing � � 65. Electrical-Final � 1,: 15. Rough Electrical-Conduit � 66. Solar System-Final . 16. Rough EleGtric Wiring ' 67: Fencing & Access ApProval p 17. Rough Wiring Sign � 68. APPflOVED FOR PLASTERING - � 18. Rough EleGtrical-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 77. Product Piping OGas ❑Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Fram�ng 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceili�9 (StrUciural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAI 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. F000 CERTIFICATE ISSUED 33. Final Electric "�� Notes: � 34. Final Heating & Air Conditioning J 35. Final Gas pipe�Test � � 36. Nood or CanoPY � 37. Final FactOry Firepiace �. , � 38. Final Plumbing - - '' � i 39. Water Service�Final ' ;/� 40. Gas Service-Final . 41. Solar pomesticFinal ' 42. Backflow preventer � � 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - /�2 �W� _ f` w�`�G � � ��,[ f 48. FINAL PLANNING 49. Electric Release to Edison � /J ✓ 50. Gas Release to Southern California Gas Co ��� 51. CERTIFICATE OF OCCUPANCY No. Date - A�Ulicant to fill in all 5 .CITY OF COSTA MESA ve�mi�o�,. CONSTRUCTION PERMIT CJ AdAress ?ilq? Arch/Eng. -- Address AAdresS Phone License No. '� wh6in heavy bortler linr.o and s�.n all appr,:pri.rte �eclarations. TRqCT NO. LOT NO. BLOG.NO. 3 ���Co�� �� ._ .t:S�1 TYPE OF CONSTRUCTION ❑ NEW �ADD ❑ ALTERATION � �/� ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESC(31PTION OF WORK Phone TYPE OF PERMIT ❑ GRADING �FOUN�ATION �STqVC7URHL � I hCr¢by affi�m thot I am littns¢tl untler provi51on5 of Charte� 9(com� � TENANT ❑ ELECTRICAL ❑P�UMBING ❑MECMANIC mencing witM1 sectlon ]000) ot Division 3 of the Buslnasz antl ❑ OTHER. Professions Cotle, antl my Iicense is In fun fora antl efiecL , pROJECT DESCRIPTION � License Class 'Gc¢nse No. . ' � � �- � Date �'Si9nature' S4.FT. �a�d WORKERS' COMPENSATION DECLARATION OCCVPANCV CONSTRUCTION TVPE � 1 hereby affirm iM1at 1 have a ttrUficate of consent to selldnsure or a VAl_UATIO 1�8/.�ONE �ceriiflca[e Of Worke�s' Compansatlon Inzuranc¢, or a Certilletl coOY thc�^' (SecHon 3800, lab. C.). GRADWG CU. VDS. ACRES Pc i. Company G ietl copy Is h¢r¢by fumishGtl. REMARKS: , ❑ �...dfied copy is flletl with the city Builtling Divislon. EXEMPTION'FROM WORKERS' COMPENSATION �ECIHRATION �-� (Thls s¢Ction neetl not be completetl i! [he permit is for one huntl�etl � (E���) Of I¢55). � � '� ' � certlfy thal In the pertormance of lhe work for which this permit is Issuetl, I shall not employ any �p¢rson in any manner so a5 to become PLUMBING ' PLAN CHECK ' 5ubjeCt t0 fhe Worke�s' Compensation Laws of California, Dat¢ Slgnature ' BATHTVBS SHOWERS NOTICE: If a(ter making lhls tlecla�ation, you SM1ould become subjecl TOILETS VRINALS lo lhe Workers' Compensati0n provisions o/ Ihe Labor Cotle, you must forthwith comply wlth such provisions or this permit shall be tleemetl LAVATORIES DOUBLE LHVS - revoketl. CONSTRUCTION LENDING AGENCV - KIT. SINKS ' ' ' DISHWASHERS - I M1e�eby affirm that there is a conihut[ion IenOing agency for the per� $ERV IGE SINKS i� �SVMPS � formance ot thC work Por whiGh t�is permil is issuetl (Seclion 309] Civ. C.): � ' - -' FLOOR SINKS ' FLDOR DRAINS"' lentler'S Name- Lentler's Atltlress ORINKING FOUNTAINS - ' OWNER BVILDER DECLARqT10N INT[RCEP.TORS" CIARIFIERS I hereby affirm,that I am exempL/rom rne Contracror's License �aw for Ihe following reason (Sectlon �031.5 Business.antl Protesslons•Cotle' Any city o� counly wM1ich requires a p¢rmit jo construct, alte�, ?WIMMINGCOOL'�' PTRAP � � ImptOve, tlemolish O�'repair any SUucture, prlor Io Its�issuance, 8150 re• y./qTER 5[RVICE �' ''ALTERATION ' quires Ihe ap�.lican[ for such Oermit to file a Sign¢tl sta[em¢nl [hat he ' Is licensetl pu�SuanL[o"lbe�provisions of�th! Contractor's Llcense l.aw' ' GAS SERVI�E - OUTlETS � (Chapte. 9(commencing with Section ]000) ol oivision 3 of the Hosin�•= and�PrMeSs�bns Cotle)'or t�at he is�eKemOt the�efrom antl the yyqTER HE/1TER5 '' BTU OUTPVT basP lhe allegetl exemption. Any vlolalion of Sectlon 1031.5 by any ;ant lor a� Dermit su0)ects the applicant.to a clvll penalty� ,SEWER CONNECTIONS � '--- o�fJ ne [han five huntlretl tlollars (E500). 1111, a., OwnQr of tM1C p�operty,'Or my emplOy¢BS wltM1'wBgeS as thelr -SOLAR TANK —���---^COLLECTORS �' sole compensaUon, will tlo lM1e work, antl tM1e sVucture is not intentletl or offeretl for 5ale.��5ectlon �046, Business antl Professlons Cotle: The SOLAR PI�ING SVS: � ' COnlfdCtOl'S LiCQOSC Ldw tl0¢5 Oot dpply �p dn Own¢! Of d prop¢fly who bulltls or improves thereon,-�antl who Ooes such wOrk himsel( or ISSVE FEE "'' ' ""' �hrough his own employees, Orovitletl tM1a[ such Improvements are nol In�entletl or offered for sale. I/, howeveY, the Duiltling or improvement MECHANICAL PLAN CHECK � Is soltl within one year ot completion, the owner will have lhe burtlen � Drovin9 hC tlitl nOt Duiltl O/- imD�Ov¢ f01 [h¢ pUtp05¢ Of Shce). HEATING SVSTEM 0-300,000 BTV ❑ I, as .owner of Ihe -property, am exclusively mntraCting with IicenSetl conVaclors to construct the proj¢cl (Settion 7044, Business ANDOUCTING ' -�100,000+BTU antl�Professions Cocle: The Conlrattor's. License Law tloei no[ apPly lo an owner of property who builtls or improves thereon, antl who con- REFRI6ERATION 0-100,000 BTV iracts from such projects witM1 a cont�actor(s) licesnetl pur5uan[ to SVSTEM lhe Conlra[lorY Ucense Law). ' . 100�000+BTU ❑ I am exempt untler $ection - B. & P. G�or this - BOILERS BTV reazan Dat¢ Owne� 5`/STEM REPAIR,ALTERATION I ber¢by tertifytha� I have reatl ihis aOPlita�lon an0 stat¢ that [he above EHHAUST SVSTEM MULTIPLE Informatlon is cortecC 1 a9ree to' compry wltn all city antl county ortlinances antl state laws reia 'ng to construction, antl hereby authorize tepres¢ntatives f t iz cl Io Bnter upOn the above mentionetl properiy for pe. i ir ¢5. - ��� �q Slnnature� � - .'te iL_�L `L � � Drivers' Licensc iir ,^.5 � ' � " " "" •• ISSUE FEE . ........ . . .. . ._.. CMF OA65-��G N"�ile-BUiltlinq; Canary-ApplicanL Pink-Accountin9: Goltlenrotl-Assesso� �FJ�j r��U.)/iJc . . �'��.�4� �� A.P. � ZONEI RIGHTF,�u `,� y REHR VARD (TO P/l� PKG.SPACE REp. STREET WIDTH ZONING APPROVED B` SPEpAL CONDITIONS: ELECTRICAL REGULATIONS ' PLNG. REF, p PRO�'E�RT�Y�LINE c(`�'C�1 �v . t, �� RO DtD ' PARK FEE 5 �t'.r DHTE � 1 7 14 V .�) " L PLAN CHECK GENERATOR -'0�1 KW_1-0O.Kw� TRANSFORMER � , APPLIANCE '• 30-SOKW-_SO+KW_ MOTORS -- � 0�1 HP_1-]0 HP -_ (IN0.50LHR) 10-SOHP_SO+HP_ FIXTVRES OVTI_Ei5 SWITCHES GAS TUBE $IGNS - � POCE LIGHTS PNNELS 'MAIN SERVICE - �� ' ISSVEFEE- APPLICHTION />PPROVED ��� ��� —�� ��- —_- ��� •' � � 0 SUMMARY OF FEES . 7 �J CERMDING .. .S II��'v1 SM�P �" ~ f _r_L_OS+—" ' PLANCHECK E��� PERMIT _ . . -. ISSUANCE S �� � PIUMBING v§ � � . GRADING_ E PLANCHECK E �� � . � ELECTRICAL E � �" E �PLANCMECK �S - �MICROFILM E ' MECHANICqL E � TOTAI FEE E __ PLAN CHECK E _",�"LE55 AD� � ' VANCE �C E" . . y� ' FINqLFEE S�l���-1V � .�._-_ -- 19a�! _ ppv�{eant to fill in a11 zpac ! CITY OF COSTA MESA , PERMIT NO. �• CONSTRUCTION PERMIT — 3l � � PruiectAddress' f ' �l%� CI� i%� Owner iQ))r5 � VN �� rN � Phone Address I /J` �IFliTi—C�RC�t . (I I%I � A.�nlFnn' - ' - �- � LicenSe No. Adtlress - Contractor (j �� Atldresz � I bereby afplm lhLt I am Ilcensetl i mentlng with sec[lon 7000) ot Proinssions Coae, lantl my licen LlcenSe Class- � � � within �eavY �oracr lines nn0 �iyn ail appropriate tleclarations. �TRACT NO. LOT NO. BI.DG NO. �h:v(_F' �' I cl�� � • � . �C}r) TVPE OF CONSTRUCTION � ' ❑ NEW �i ADD ❑ ALTERATION �;�� ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER' DESCRIPTION OF WORK . � � Phone TVPE OF PERMIT ' ' " ' ❑ GRADING �• [�'�OUNDATION ��TRUCTURAI�� - 3ATION ' ❑ TENANT O ELECTRICAL OPLUMBING OMECHANIC jar provislons of Cnarter 9(com- ��p�� f IOM� vision .3 ot. tna Businass antl ❑ OTHER is in tuli force ana effact. pROJECTDESCRIPTION �_ License No.- 2y -- � �� � - � � �� - Date ' - Si9nature Sq. F7. � WORKERS' COMPENSATION DECLARATION � OCCUPANCV��CONSTRUCTION TVPE '�� N I nereby aftirm tnat 1 nave a certifica�e of consen[ [o ulf-inzure or a VALUATION�.�_�" ONE 'rerli(icate o� Workers'�CompensatiOn-Insurance, O� a Cer[itietl copy _ [hereof (SectiOn 3800, Lab. CJ. GRA�ING CU. VDS. AC0.E5 '^y No. CompanY �rtifietl cOpy is het¢DY tu�nishetl. . REMARKS: ertifietl capy is filea wi[h the city Builtling DivisiOn. ., EEEMPTION fROM WORKERS'-COMPENSATION DECLARATION ' (This settian neetl no[ be Wmple[etl it the permi[ is for one huntlred 1E300) or less). Car[ify thut In Ihe performance ot tpe work tor wbich this permil is IssucQ I shall not employ any person In'any manner so as to become PLUMBING subject to tne Workerz' Compensation I..aws oi California. � Da[e Signature � BATHTUBS " -�' � NOTICE: If a(ter making this tlecldratlon, you shoultl become suDjecl TOILETS lo l�e Worke�s' Compensation provislOnz ot the Labor Code, you mus[ 'to�lM1wiLt com0ly witb such provislon4 Or this permit shall be tleemetl LAVATORIE$ �evoketl. CONSTRUCTION LENDING AGENC�' � KIT. SINKS � 1 hereby a�tirm �na[ [hero I5 a consVu«lon lentling agency fo� [be perv SERV ICE SINKS formance ol lhe work �ot which tbis Permit is i55uetl (Section 309] Civ. C.�. -- - � FLOOR SINK$ ' - Lantlei's Nam¢ Lentle�'s Atldress .ORINKING FOUNTAINS OWNE0. 6UILDER DECLARATION - INTERCEPTORS I beieby afli�m lha[ I am exem0� trom.�he'Contratto�'S License Law for tne foilowing �eason (Section 7031.5 Busines5 antl Professions Cotle: � SWIMMING POOL Any nry Or munty whicM1 requires a, permit to consl�uct, alter, - im0�o�e, tlemolisn or repair any sV ucture, pnor to its issuance, a�so re� yyqTER SERV ICE quires [he ap�licant fo� sucM1 permit t0 file a Signetl slatement that,he Is licensetl pursuant to tbe p�ovisions of �[he Contractor's License Law GAS SERV ICE " (Chepte� 9(commencing .with $ecUOn' 7000) of pivision 3 01 lhe Business antl �PrWessions Cotle) or.lhat ne is e�empt therefrom antl lne yyqTER HEATERS ba��s for tne al�eyed exemption. Any vlolation o/ 5ection 703L5 by oplican[ tur a-permil subjetts Iha applicdnt to a�eivil pnnalty SEWERCONNECTIONS more thdn live nuntlretl aollar5 (ESoo). es owner of Ine"property, ' SOIAR TANK' - ' � '^ ^- �^n, will do lhe wotk Sntl the SVuc[ure is not intentletl or oHeretl lor sale. (Section ]044, Bu4iness antl Rofessions Cotle: The SOLAR PIPING SYS. CoNrattor's License l.ew tloe5 not aVPb' to an owner of a property who builtls o� improvef therean, antl �+ho tloes Such wo�k himself or ' ISSUE FEE � PLANCHECK SHOWERS URINALS DOUBLE LAV$ UISHWASHERS -- SUMPS ^' FLOOR DRAlIVS ' CLARIFIERS PTRAP • ALTERATION BTU OUTPUT COLLECTORS ihraugh his Own employees, provitletl tltat such imp�ovements are not inlentletl or o/leretl lor sale. If, however, IM1e builtling or improvemen[ MECHANICAL PLAN CHECK is wla witM1in one year o1 complatlon, tne owner will have tne Uurtlen ol provin9 he Oitl no� builtl or-improve tor the pu�pose ol sale). HEATING SVSTEM 0-100,000 BTU_ ❑ I, as uwner ul the proper[Y, ain. ez[lusively con[raclinq with qND DUCTING - licensed convactors to mnstruct tne oro�ea �Section �044, Business 100,000+BTU���_ antl Protessions Cotle: The Contrac[or's License.Law tlOes not apply to an owner ol pwperty who builtls or improves thereon, antl wno mn- REFRiGERATION 0-100,000 BTU_ Lacts !rom such projec�s with a coP�rdclo�(5) .licesnetl. pur5uant to SVSTEM the ConVactor's License L.aw). - . . � 100,000+BTU_ ❑ 1 am exempt untle�'Section " � B.'d�P. C. for this � �� ---� � BOILERS � BTU roawn Oate Z p e� SVSTEMREPAIR,ALTERATION I herebyterti/ytliat I have rea0 [his app��cal on ana ate lha[ Ihe above EXHAUST SVSTEM MULTIPLE intormation Is mrrect. I ag�ee to'comply wilh all clty-ana'county ortlinances antl s�ate laws rel ling to co05lruc[ion, antl M1ereby authorize representatives o tj�is' c� to en[er upon the above memionetl' - proVerly lor, � e lioo- r oses. �,��- i SiynaWre �� ��� � Date �l z_ - �� � Drivcrs' Liccnse or 55 - ' � •� �SSUE FEE CMF O86S-46 White�Builtling; CanaiY-Applicant; Pink-Acmunting; Goltlenrotl-Assessor �i4L�] i1�4�7�t1G A.P. 5 ZONE REAR VARO (TO P/L) PKG. SPACE REp. STREET WIDTH 20NING APPROVED B` SPECIAL CONOITIONS: ELECTRICAL REGULATIONS � 3� P�NTGp. R�EJF. � PROPE�RT�YNLINE � �/� :) �� P Vlp " PAf3K FEE $ /.�: I'� DATE lN , PLANCHECK I :34.;92 i 1�,; . . GENERATOR 0-1 KW� 1-10 KW TRANSFORMER � . APPLIANCE " 10-50KW�50+KW_�- MOTORS 0-1 HP�1-30 HP � (INC. SOLAR) 70-50 HP 50 * HP ... FIX'1'URES OUTLETS 'SWITCHES � �-� � GAS TUBE SIGNS - � POLE LIGNTS - ' � � PHNELS ' MAIN SUB SERVICE � - � AMP APPIICATION HPPROVED BV DATE � SUMMARY OF FEES . . - PERMIT G $ O•S yMIP, ., $��1Z PLAN CHECK E—�-�_3'Z- PERMIT - ISSUANCE E PLUMBING b GRAOING b. PLAN CHECK E . . � . ELECTRICAL $ S PLANCHECK $ "MICROFILM y ' i TOTAL'FEE$� MECHANICAL S LE55 AO- PLANCHECK�E vANCEPC S_ FINALFEE S��L.��i / , ` ., . � ,\ , a � / Pfl0.1tCTA00FES5: •j19c� HAITI C:I OWNEfl'SNAME: ��kTCAN SAVINGS BAhK - nooness: z424 SE HRISTOL COSTA MESA ..CA 92627 IIBCH/F,NGINEEfl: FOONE55: HEG.NO.: UNIT: UNIT: Pnoeess:FANCHER� WILLIAM DAVTD (714)258-1808 1322 BnLL AV iH TIiSTTN CA 92F�0 LICENSEO CONTHRCTOfl UECIAPATION: I hereDy aflirm Ihai I am licen5ed untler O�ovisions ol C apt¢r 9(commencing wii� S¢clion 7000) ol �irsion 3 0l �Ae Business and Pmlessions Cotle. antl my license is in lull �orce and e��ect. cirr uc.: 0 51 2 51 staTE uc.: � 5 I 9 4�' • ss: � oate: ��-��""q � Siqnamre: _ WOBNENS' COMPENSATIUN UECLANATION: I hereby a�firm �hal I have a certifica�e of tonsent �o sel4insure or a certi�icate o� Workers' Compensation Inwrance. or a ceriified copy t�ereol (Section 3800. La0 C). POLICY NO.: EXP. OATE: comvnxr: � Certitied capy is hereby �umishetl. ❑ Cetlilie0 capY is filed wi�h �he ci�y Builtling Division. �ate: ApPlicanL E%EMPTION FROM WOBHEPS' COMPENSATION OECLAflRTION: Qhis sedion neetl nol be completed ii the permi� is lor one hundred 5140) or less�. I ceriify Ihat in Ihe per�ormance o� Ihe work �or which ihis Dermi� is i55ue0. I shall not employ any pers�yin any manner s lo �ecome su�le�� �o the Wq�kers' Comp9ensation Laws oi Cali�omia. ` // Da1e: � _ z� / � Signature: f NOTICE: If. after making ��is tleclaration. you shoultl �ecome SuDlect lo the Workers' C Oensa�ion pmvisions ol Ihe LaDor Cotle. you musi fo�hwith compry wi�h such pmvision5 or �his permil s�all be Oeemetl revoketl. WNSTBOCTION LENDINC PGENCY: I �ere�y aitirm that there is a constmction lending agency lor �he perlormance ol the work for which �his permit is issuetl (Section 3097. Civ. C). LENDEX: RO�HESS: OWNEfl BUIWEB OECLABATION: I here0y af�irm �hat I am exempi (mm Ihe ConVac�ors' $�ale License Law �or the lollowing reason (Sec�mn 7031.5 Business ana Pmlessional COUe: Any ci�y oi counry which reQuires a permii Io con5tmc�, atle�, improve, tlemolish, or repair any simcmre. prior to its issuance, also reQuires the apPlicant for such Dermit to file a signed statement t�at he/she is IicenseJ pursuant to �he pmvisions ol the Comracmrs' State License Law (Chapter 9(commencing wnh Section 7000) oi Oivision 3 of Ihe Business antl Pmfessions Cotle) or �ha� �e/she is exempl �hereimm antl ihe �asis for the allege0 exemp�ion Hny viola�ion oi Sec�ion 7031.5 hy any applicam �or a permil su6lecis Ihe aDPlicant Io a civil penalry o� no� more than �ive hunAreO Aollars (5500�. I. as owner o� Ihe pmperiy or my employees wi�h wages as their sole compensation, will tlo ihe wo�k, antl ��e ❑ s�mc�ure is no� imentled or al�ere0 lor sale (Section 7044, Business antl Pmfessional Code: The Con�rac�ors' S�a�e License Law Does no� apply Io an awner o� a pmpetly who builds or improves �hereon, antl who does such work himseli/hersel� or ��mugh his or her own employees, pmvide0 �ha� such improvemenls are no� in�entled or oflered �or sale. Ii, Aowever lhe builtling or 'mpmvemeni is sald wi�hin one year oi completion, t�e owner will have the burtlen o� pmving �e/she ditl nol builtl or impmve �ar the purpose o� sale�. I, as owner oi �he property, am eeclusively contracting with licensed contractors to consimct the Drojeci (Section 7044, Business ❑ antl Pmlessmns Cotle'. The Con�rac�ors' S�ate License Law tloes no� appry ro an owner o� pmpeM who �uilOs ar impmves thereon and who coniracts tor sucA pmlecis with a contractor(s� license Dursuant ro the Contractors State License Law�. I am aware ihat pmol at iheir Worker's Compensation insurance s�ou10 be pmvi0ed to me. � I am e�empt untler Section: B. 8 P. C. br �his reason: Oate' Owner. I do hereby cetlify Iha� I am aware o� anC unC¢rS�anJ Ihe requiremeni5 0l Califomia Health an� Safe�y Code Sections 25505. 25533, antl 25534 ana�hal I or any�uture building ocaDaniwiil/will no� (circle one�nee0 to comply vnlh said 5la�e codes antl the reQuiremenis�or a permi� �or cons�mc�mn or moditica�ion imm ihe Air Oualily Managemeni �istnc�. Fesitlential constmc�ion applica�ions are exempt twm IAese pmvi5ion5. Date'. ApplicanP. � I hereby cerlitytha� I have reatlihis application ana 5tale��al the above informa�ion is correc�. I agree to comply wi�h all city and caun�y ortlinances antl sta�elawsrelaiinglo builtling con5imclion an�;� horizerepresen�a�ives at�hi ciryia en�eruponlhe ve-men�ione0 pmpetly for mspection purposes. t �aie: �" _ Signalum �� �river's License or Social Secunly p: t64b46 Whlte—Builtling: Green—Cotle Enlorcemem; Canary—Appl¢anf, Pink—Revenue: Goldanrod—Assessor CS.'iY OF COSTA N:ESA — BLJILDING FERMTT PERMIT NO: IE Q56344 PLAN CHECK NO; 1d CONSTR[3CTION TYPE; 5—N PBRMIT TYPE: ELE OTH JOB DESCRIPTION ; RENEW EXPIR�'D RM ADD PERMIT CLAIM VALUE: CALC—VALUE; PERM NO: ZE 05634� GOVT: N SIIPP: Y PURPOSE: OTH SQ FT: CROUP OCC: R-3 / COMMENTS• RE; IB56343 G RENLWJ EXPIRED E6479 ****+r*u�*��-***�r��*��***�x-x���*�*��r��r*�+�*x*�**�x*�*���*�*� **�K�+��**��*� ��*��t*�***� Z O i� I N G R E Q U L R E M E N T S 5 E T B A C K S ------------ MAIN BUILDING ---------- --------- P.CCESSO�Y BUILDING --------- rRNT: FT IN REAR; FT IN FRNT: FS IN REAR: FT IN LEFT; FT IN RGHT; rT IN LEFT; FT IN RGHT; F'T TN FARRING REQ • PROV; PARCEL: 1391?234 Z�E; REF NO: F�LANNI%IG Nf3TES> ) 1"r # tE #!F iF �lE �If It ih iE 1F fE iE 3f if iE 3k je �1F 3t iE iE i'r �JE ikiF'.E L� 3E iE Y.� iE �IFA ii� ic �IF ik iE iF If k 3E IE #� 3f iE iF 1e iF i! iE f'r'i.� �1(� �Yi k 3l� iE iE le ic�iF iE if ih N� #E �1E iF # 3b :i� �c ii� ib 3F �%� D E V E L O P M E N T S Fr�R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY . J�. DATE: BUZLDING APPROVED HY ; _ DATE: _ APFLICATION ISSUED BY• -�� r...� DATE: 2 �/Q c — — iE 3F'M if if' ' ii' iE N' if . Yc `.! ' h'3Fi�� tF i%�' d k'iF 9�3fiF3E�'t <iY )f iF if li' if R'Y.' if' if if'iF+�3Fie iF�';i� 3r �iE iF1FiflEifiEiF 1F lEifiEif K � i(� iF 3F 3F !E ie IE iE * li� fF if 3F if ih 1F 3F iF �1F 3E iE iF �f jf lE 3f i'r 3E if �k 3E 3t sF 3e�3E �lf 3F Y/� �: iF )f IE �IE if 1f 3E �lf if ii� )t ie 1E ih if iE i: #E ik �%3F ?i.3F i'r N� %� 3e i4 K� 3f 3� iE iE iF iF if LEGALIZASSON:N F E E S Ui5 M. A R Y STRUCTURAL SEGN:E,i�T:� ✓ BLDG PMT PLUMBING ELECTRIC MECiiANZC FIRE SMIP/RES GRAU�NG FER;�IT 30 �00 SA �, SN,I P /NON—RES UI,AN +r � `; ^, iSSiTE FEE �,. BUII,DING—DIV—> PEkMIT ISSliE PLTiN-CHECF( TOTAL PAIU Di7E TOTALS----> 30.00 0,00 '� 0,00 3U.U0 30,00 .00 �i .�.. REVENUE PIVISION TOTALS--> COLLECTEll: 30.00 OVER/SHORT: 00 HLDG PNT FLUMBTNG ELECTRIC MECHANI�C `.' FIRE S,y1P/TOT GRADING PLAR—C3ECK 30.00 ;, q # 3E�3E 3E 3E 3F iE i(� iF �iF 3F iE K� if 3E �(� �lf ii� iE 3E IF iE ik 3F iE lE �i(� aF � 3F iF iF 3f -IF iF ii� i� IF �'+1hK��AE 3(� iE * iE iE ii- 3e iF 3f iF�k' iE �k 3F Jf i'r �E �lE i't 1i� 3E fE 7f ii Y� 3h �F ii 1'r �1F 1E 3i iF 3e �!� if� I N D I V I D U A L��'F� E�sE B R E A N. D O W N � TYPE QTY D E S C R I P T I O N}� � �; i7NIT COST TOTAL COST ELE 1 ELECTRICAL RE—INSPECTION F'EE 30.00 30.00 END OF rcES _ i ^.' ( w �Y' � . �1 �� /t � ✓ /1' 9" Sj r? ��li�i93�47—D01093�; ?'a�7" z�,1� �—. • CATE: D?/25/92 TItiE: i3: i7 t'r �a.:/3L _ CONSTRUCTION AND�PIANNWG - . ' . P�� �PA- APPROVALS Permit#� Date Inspector APPROVALS Permit# Date Inspector . i. Temporary Electrical Service or Pole . �- 52. Pool & Equfpment Location � , � 2. Soil�pe�Undrgrnd. � ?� � . �53.�SteelReinforcement 3. Electrical Gonduit Utility-Undrgrnd. � 54. Forms . � � 4. Electrical Conduit-Undrgrnd. 55. Eiectrical Bonding 5. Steei Reinforcement - - 56. .Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. . 57. �APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Cqnduit-Undrgrnd. , y 8. Foundation ,� . �e �% 59. �Gas Pipe, � Undrgrnd., Test �,. �,' , ri. 9. Water Pipe�Undrgrnd. %� v- 60. Backwash Lines, P-Trap, O Undrgmd. �� 10. Str�ctural Floor System �- 61. APPROVAL TO DECK `� 11. Property Sewer Line & House1Connection � 62.• Backwash & Receptor�Final � 12. Sewer Cap - 63. Heater & Vent-Final !. 13. floof Drains �' 64. Plumbing System�• Final • i� 14. Rough Plumbing ^ + 65. Electrical-Final , 15. Rough ElectricabConduit � 66. �Solar Sysiem-Final •f' 76. Rough Electric Wiring ,�, % 67. Fencing & Access Approval � 17. Rough Wiring Sign � � 68. APPROVED FOR PLASTERING ; 18. Rough Electrical-T Bar Ceiling 69. POO�/SPA SYSTEMS FINAL � 19. Rough Heeting & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Fattory Fireplace APPROVALS Permit # 27. Dutts, in 5i�ucture � 70. Unde�g�ound Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Fram�ng � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceilin9�(Struciura4� & Monocoac 75. Dry Chemicaf 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FiNAL 29. Insulation 79. FIRE PREV. FINAL 30. Drywall Nailing �' . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' 79. FINAL INSPECTION 32. Electrical Power MeterFinal j- �. 80. FOOD CERTIFICATE ISSUED 33. Final Electric /� Q� _ Notes: 34. Final Heating & Air Conditioning ' 2 n'7 _ L72� �k J�L•1•, Q/� `;(�Q� . �"• L//-( (C (. 35. Final Gas PiPe-Test �- � � � � � � � � �� ��e �� ,p i. 36. Hood or Canopy •�� -IG�G��� l�L -�W�[ 37. Final Factory Fireptace �� . - � 38. Final Plumbing 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomestic-Final 42: Backflow Preventer � 43. Backflow Irrigation 44. Landscaps Irriqation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ��' 48. FINAL PLANNING 49. Electric Release to Edison � i 50. Gas Re{ea5e io Southem Califomia Gas Co ' ,'�.'� � 51. CERTIFICATE OF OCCUPANCY No. Date . .4VOIinn1 ta fill (n a11 spatts except thosa within �eavY GorGer Iines _( C:�iY OF COSTA MESA' � � ' i_ PER T NO _ TRACT NO. � LOT Po !: CONSTRUCTION PERMIT ,� , . ' - � jo �% � , ; � I. Applicant's Mailing Addrea �' TYPE OF CONSTRUCTION: � NEW ADD q � � ' �SI'���T - � CONVERSION ❑ OEMOLISH ❑ OTHER � . � Project P.ddrea -� � - . OWner'sName"�scl���"� y����Y��✓ Phaa2 � DESCRIPTIONOFWORK � � Address � 3/�3L=-�� n/� rlL�P (! M- 9�L.Z�e �:pE OF PERMIT � GRAOING FOUNOATION A�ch/Eng. 1� � U�N �n — - - LiCens2 NO. ^ � ❑ TENANT �ELECTRICAL ❑ PLUMB�NG ❑ � mC slgn all aCOroDNata Eeclarations. ). � BLD . . . , . •. .TERATION REPAIR � x�/ ���� (� / � � n- ICAL � AcSdPEu ❑ �OTHER " � : Contractor's Nam � hone � PqOJECT DESCRIPTION 5�. FT.' occuaANCv '�� Address�mailing) � - ' CONSTRUCTIONTVPE ' VqLUAYION$ � _ ' _ � ZON� GRAOINGCU.VDS. 'ACRES LiGense No. ' . LICENSEO CONTRACTOR OECLARATION -• - Remarks: - � 3 f I hereby affirm that 1 am Iicensed untler provisionz of Charter,9 (mmmenGng ' � �� �y��h sectlon 7000) of Dlvislon 3 of the BUsiness and Protesslons CoOe, anG ; �. , . .. my ��cense is In fuli torce antl effeCt. ' � • _ ' � Liceru Class License No. ' � PLUMBfNG Date - � Signatura -'^1RKE0.5'COMPENSATIONDECLARATION � ' . ! . BatSink . ' SewCfCap •eby aHirm tnat 1 nave a certiFlca[e of consenE to self-insure or a certiticate._, - Backflow Preventer SewE� Connection Vorkers' Compensatbn Insurance, or a certltietl. copy thereof (Sectlon �o, �ab. CJ � � Backflow Irrigation Solar Collecrors �� PoI�cY No. COmpaOy � � eCertifietl copy is hereby fumBneO. � ; ! ' Balhtubs � ' - Solar Piping . CertifieC copy iz filed with [M1e city Buildin9 Division. . oate Apa�icant ' Clarifiers ' SolarTank EXEMPTION FROM WORKERS' COM7ENSATION OEClARA710N Dishwa5he� ' Swimming Po01 w! (Ttlis section neea not 08 <ampleteG if the permlt is for ona hunOreE (5100) or ' — � less). , : � ' ' � I cCrti/y t�at in the periormance o/ the wOrk fo� w�ich Ih15 pe�mR ii i55uetl i i Drinking Fountains Urinal , sha�� �ot employ dny petzOp In Lny mannel So as to becOma SUEjecLto t�1a � - , Wo�ken' Compen5ation Lawi of Cafifom}a. � , �loOr Dr3in5, � Water Cioi¢t . Date ' qgnature � ' � ' - NOT�CE: 1/, aRer makin9 this tleclaratlon, you 5hou10 Decoma suDject to tM1e--� � Floo� Sinks� � �� � . �- Wat2r Heate� - . Workers' Compensation provisions of'tne Idbor. Cotle, you.must tortnwich '' corPP�Y with such provisions or tnis pefmlt shalY be CeemeO rewketl. . Gas Servite ' OuU2t5 Watef ServiC2 • 'CONSTRUGTION LENDING AGENCY - � � - � �. I nereby affirm that [here is a constructton lentling agency for the performanca , Intercepror5 _ ' . of the work to�, w�icn� thl5� pe�mit is issuetl (Section 3097 Clr. G)� , ' �entlers Name - Kimhen S�nk - . �ppaer•t' AtlGress � � ' - � ' � � � OWNER BUILDER OELLP.RATION - � � ' - " ��atOries �. . ' .- � , ' � 1 hCreEy alfbrtl that I aT exemOt frorti thC Contracto�'s License Lnw for tne � p_Tre � . followln9 �eazon (Sectlon 7031.5 Business anC Protessional COEe: AnY city or, P. ' - ' cou�tY whicn repWres a Permit to cons[rucf, alter, Improva, Uemolis� or repan . _ . _ _ ,� � anY stru<ture; prlor to tts issuance, aiso repWres t�e applicant to� such permit: � Roof.Orains' "' .' '�= � ' 2��`�;":5 bYaanYhaPolioanc �forea'IOermitxsu j cts theYaDPlc�ant to� a�c�ivl ' ' . ,- o.-:..:ity of not more lhan five hundretl dollars ($500�: - � Servic2 Sink !� I, as owner of che Property or� my emo�oyees wi[h wages as [heir sole , , tOMPensafiOn, will do tne woik, dntl the st�ucfUre is M1ot intentled of ottefeQ - '� ' tor sale ($ectian ]044, Business antl Pwf¢55ionai Cotle: The Contract0�'s Lic¢nse l.aw tloes nof aOPty to an owne� of a property wlto builds or improv¢s BOiI¢� Ne�eon, ana who tloes such work himself/nerseif or Nrou9� his or her own ' employees, provitletl t�at such imp�ovements are no[ intentletl or otferetl for sale. i�, however, t�e bu��ding or improvement is soltl within one year of com- ' Duct - Under Ground pletion, the owner wlll nave the burQen ot proving heJshe tlIC not bu11U or IT- ' . � ro�e for ehc purposa or sale). . ;.. ; � ' � Ducc - Structural � �, as owner of the property, am exclusivC�Y contrac[ing'wlth licenietl con- ' t�aGtors to tonzt�uc[ the Oro�ect (Section 7oaa, eusiness ane arofassions Coae: _: Duct_ Ventilating , ;',.; Th8 �ontractor's Citense Law does not appty to an 0`h'ner of pro0e�ty who i , Duiltls or ImOroves thareon, anE who contractt (or such projects with a cOn- � Ezhaust System ❑ MW[iple traGto�(s) licensa pursuant to the Gontractor•s Licenx Ww). �- e i ! � � ❑ i�am ezemOt untler Section B. & P. C. for this reason ' Fi�epl/FaCt. BIt. IC80 # ; Date ' Owner' � ' ' ' � Heating System & Ducting � � pereDy� certify that I�hare-rea6 t is application anC� state that the��above- ` -�❑P100,000 BTU �100.000 InfOrmatlon is correct. 1 a9ree to comply with ali dty antl county ordinances antl state laws relating to building construct�on, antl nereby autborize repro- Hood o� T E � �' sentativei of fhi5'city:to enter upo0 tna aboy e ¢ntiOnetl p�operty f0� YP Inspection outposes./• J� �� j/� ! !�?_ �� � Cano � T e II �' SlgPdture /./ /f Lf' � o5te J ' . ' .,.n».a �;.e.,m �. <c y. . _ � � Registers . � . . CMF 0865-46 iev. 12/82 Wnite - Builtling; Canary -ApPlican[; Pink -Accounting; Goldenrod -A55esso� ❑0,10' SYstem N Reinspection�Fea ', S15 laua Fee $ 3 in Sysrem , OBTU ❑100.0000TU � : I Reinspection'Fee Issue Fea i , S15 S 3 A. P. vF ' PLNG. REF. �- � . LEFTSIDE VARD PKG.SPACE REO. STREET WIOTH SPECIAL CONDITI Automatic Washe� Construction Pole Cookin9 Unit . Dishwasher Oryers ❑Gas C Fan F.A.U. Device Boxes ?!„7%tiJ : �z - l¢ -�8 .� HEAR VARD (TO P/L) RIGHTSIDE VARD � � PROVIDED ' PARK FEE $ Merer LJoverl0damps Sub Panel Su6 Pole , , . Motors 0-1 HP 1%-8 Inc.Solar �9-15HP �16-15+ Microwave � POIe Light � � Range _ . ._ . , Standing Sections Trash Compactor ' - h� 1/ ...�� },3% . I' - N Garbage0isposai � � � � Generetor �0-5 KW �5-15KW • � ' Transformer �75�50KW . � ❑5U+KW � ReinspectionFee � $75� Meter ❑up to 100 amps � Issue Fee �$ 3 Zonin9 Appraved By � Date Appliration Approved By R � Date -7 �Q� APPlitatian Issued BY �. " ' Oate � '� / 'l � . . , SUMMARV Of FEES ; � BUILDING PEFiM1T S� ' SMIV ' � $ PLAN CHECK� $ PERMIT PLUM8ING , $, � � , ISSUANCE ' $ � PLAN CHECK� � $ � ' GRADING S - ELECTRICAI, . $ �� � $ � , PLANCHECK $ O.�/O � MICROFILM $ � MECHANICAL , $. ' . TOTAL FEE $ ; PLAN CHECK` $ . LESS , ' ADVANCED,PC f; S ' � ' ' FINAI PEE � � $ � 3 . 3v A � '.i c.,.4? _ . . . . . . _ ._ _ ' " _ " " __' "" _ ' " '' `., CONSTRUCTION AND PLANNING ' _ POOL a. ,� � - " 'APPROVALS .: Permit# -� Date I�nspector : p�ppROVALS ' Permit# Date Inspector � 1. Temporary Electrical Service or Pole : . 52. Pool & Equipment Location �� 2. Soil Pipe�Undrgmd. -, . ..� 53. Steel Reinforcement - - 3. Electiical Condult Utilitv-Undrgrnd. � 54. Forms. � '.'4.ElectricalConduit-Undrgrnd.- ' ' � 55. Electrica6Bonding . � 5'. 5teel Reinforcement � , . 56. Rough Plurtibing & Pressure Test 6.,ElectricalUFER�Gmd: �_ � ' . � 57.APPROVALTOCOVER-GUNITE� � �� _ 7. doting3 . i ' ` �• ., � 58. Electrical Cp�duit-Undra���i. . � j� . R. �dundation ' � -- , � � . 59. Gas Pipe, �.Undrgrnd., Test . - 9., Water Pipe-Undrgmd. � 60. Backwash Lines, P-Trap, O Undrgrnd. , 70.'Sttuctural Floor System ' � � • - 61. APPROVALTO DECK . ' � 11. roperty Sewer Line & House Connection ' i. 62. Backwash &� Receptor�Final 12. Sewer Cap ; . � � � , � ' 63. Heater &�.Vent-Final . ' • , 13. Roof Drains � I � 64. Plumbing System - Final . , ' 14. RoughPlumbing�, ' ` � 65. Electrical�Final � � - "15:`Rough'Electrical-Conduit " ' .� ` ' • "' 66. Solar'System-Final � ��" ' - , ' '16.' Rough �Electric Wiring . 67. Fencing & Access Approval - . �- � � �' 17..Rotigh Wiiing Sign '�- ' 68. APPROVE� FOR PLASTERING �� � ' 78. Rough Electriral-T��Bai Ceiling ' . 69. POO�/SPA SYSTEMS FINAL � , 19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT � .' � 20. Rough Factory Fireplace � ' ' A7PROVALS � Permit # � � � � , 21. Ducts, in Structure . �, � 70. Underground Hydro , 22. Ducts, Ventilating ., � ' � 71, Product Piping O Gas ❑ Oil 23. Ges�Pipe-Rough & Test ' 72. Underground Flush -� 24. Roof Framing ' � . _ 73. Undergrnd.StorageTank OGas ❑Oil 25. Rooi Sheathing , .. - i,.� �: 7?,� Overhead Hydro � � 26. T-Bar Ceiling (Structurap & Monocoat . 75. Dry Chemical � � 27. Frame and Flashing 76. Dry Standpipe ' . . 28: :.Lathing & Siding• � 77. FIXED SYSTEM FINAL . � � ! 29._,Insulatiori �. • ' ' ' � • 78. FIRE PREV. F�NAL ' � ' . 30. Drywall Nailing � � � � ' , .Notes: � � � � � , ' i � '31. �Plaster Brown Coat � ' � i ' I ' ' i � i i 37.. �Elr.ct;iral'Power Mr.ir,r-Final . � � ' . � � � -' � i 33.�Final Electric i ; � ' '' � Z ad QL ' _ ' ,34. Final Heating &jAir Conditioning �, _ . r 35:.Final Gas Pipe-Test � " t; � . _ , � -, � � � 36. Nood or CanopY ' •� j �. � , ; i - � � `. -. � - ? � - - � � o, � . , � . , . - 37. Final Factory Fireplace �� . �� . � , � i i� _ . , j� . 38. Final Plumbing � � � , � ; ' � � � , , , -. " : 39. Water Service-Final ' ' • � � � 40: Gas Servite-Final �, � � � i . � � I. � , : , i 41. SoJar pomestic-Final ' ' � ' - --, - _ -- . . _, _. � . .. . " ' 1 42�..Ba.ckflow�Preventer; .. � � � !-� " .I ' . ' . : . . . ;���1 - 43. Backflow liriga[ion ;= ' '� _ �',- , , � ' -�� 44. .�andscape Irri9ation System i � _ ' � � i � , . � - , � -_ 45. •Sound �Attenua[ion ' � � ' ! ' � � �. , . . 46! Handicap.Regulations ! , � . � � !, : " • -- i 47.`�INALSTflUCTURE&BUILDING i � � � � ". 48. Special Requirements Completed . � � ; . � ' . -� . , �. .. -, 49. Elec4ric Release�to Edison� ' .I : . .. ' _ -. -. -. - _ . . - ' ' . • � 50.'-Gas%Release to Southern California Gai Co ' • � i . 51. CERTIFICATEOF OCCUPANCY ; _ � . _ '_ ' . , , i No. ' It ' � Date 4 . � •-'' . i ' . i .. Appliwnt !o fill in all s0aces e:cept those wit�in �eary DorGer Ilnes antl sign all aOGrooriate Eeclantions. " ' _' ' " "__.. ., r..__ .-. ..._�. . . . . _..._ . . _ . _ . . . _ ... . _ iY.OF}COSTA MESAi � 1 i. i. .� � � PER T NO, TRACT NO. � LOT NO. f BL . ' ` ~•� -_ . T . NSTRU6TION PERMIT �'� ?;� �,; . ' � � + . � , � �. � ; ; + � ; � ;' ;. `, . '; : 522� . 3/0�J183 , �33:38 � Tl � � '�'-9 � � ,, Cq�_ icanYs Mailing Addrea � - � . 'MPE OF. CONSTRUCTION � ; NEw �io� ALTERHTION � ' REPAI R ���. Y �� � ?'lZ � � U r�8 � �� � ' I 'Si��F ' ' � - = � CONVERSION'� DEMOLISH' ❑ OTHER'� ' � ' /� ; � � � i ett Addreu - . � � - - -�/ \�, • _ - - ' r '..T /Lii/� � ' � i �� . U ' ' I �DESCRIPTION OF WORK � � " � _ . L � . ;c ; ' . ner'sName 5�1/�M'� ��4G nDYAN °Phona �' . � . - _ - � � � r- � •. - . � . � e • . � . ` � ' � . - ZO I .R GULATI NS"> ' "�� � Addr855 3i9S �fl�/1 � P.JL�P� � Y�.M �' 9�L�le. ..n.pE�OFPERMIT GRAOING'-y - FOUNDATION - .STRUCTURAL ,� � �'� � A. P.•slt .. I 20NE 1 �' �' : 1 �ti. .1 ,� �Arch/Eng�T ' ��N�R � � � Ltcen58No- � � ' ❑�7ENANT;�ELECTRICAL ❑�.PL'UMBING ❑ MECHANICAb � ` i � , " ' BUILDING; �_ .. � I - - - ,PLNG.REF �.•� • ': � r+ a. , , i �� AAdreui - -� , � . � A � ' � 1 ' � � - ❑,'OTHER �' : '. ' � � ' ' ' � .TO BUILDING ' . .. ^ � . - 1 . _, � • . I � ' � � ~ I � � .. .. . . . P PE V INE � ;REAR VARD (TO P/U.= � ? Contractor's Nam - ' ' ^Phone • � PR0.IECT DESCRIPTION 5�. FT. - � � �' OCCUaANCV ' � _ . . ' � � � ` � °• � � � j CONSTRUCTIONTVPE � � `VALUATION$� LEFTSIOE VAqD i j RIGHTSIDE VARD� � � � Address (mailing) - � � ; ' ' � . , ; '. , � � - � � � - � '-'� I � � � � { ZON� GRADINGCU.VDS. ' fACRES � � �PKG.SPACEREQ. � , PROVIDED � � � � License No. � � � 1 � . LICENSED CONTRACTOR DECLAqAT10N � � ' � - • � � � Remarkz: � : � � � � ��3 , i ' - STREET WIDTH � � � � ,PARK FEE $ 1 � , . � Chereby afflrm th5t �I am IlcensaG untler provislonz oi-Cnarter�9 �(commancinq , ' -' ' ' ' witn secHon 7000) ot Division 3 of t�e BuSinaiS antl Professlons COCe, antl � ' � R F � - I /i,� '_ � ' . I ' ' •SPECIAL CONDITIONS: � �� {� ! �� '^, � � my Ilcense'�ii In tull force antl',etfeit. . . ' i ; • � 7 � { � : ' '. , Licansa Class ` ' ' � License No. � . . t . i ; 1 PLUMBING ' � � � . , � � ' � ' � � , � _�� I �� ,.. t i Date � ' ' � 519nature , � ' � �� i f � ' ' ' � • , '� . ' , ! HKERS'COMPENSATIONDECLARATION� � ;• j 1 ; I , BarSink -1 . � t ' SewerCap�' ' � .; •�_ ,' ; i ELECTRICAL � I . � �y 1 ` � � j aby at/irm that.Lllave.a.<eftlFlwte bf consent.to.selt-In5uY8 oLa Certlilfate�,;. . - ! ' ' _ _ • _ AutOmBt�C WaSher_b _.`., _ . �Metef �QOVef_7008Tp5, .. orkers' Compansatlon Insuranca,; or a cerUfiea� coov therem (Sectlon �� Beckflow�Pre'venter -j - �-SewerConnebhon�- � � - , � � � Construction Pole ' ;Sub PaneP ' ��. Lnb. C.) : ' . i i t ; ' Backflow Irri ation �� ' ..:_ _ � � ; ' ' I � ' � � � � ` 1 � ` , f . 9 - Sol'ar Collectore � � . � . , , . . . , . , ' . �. ' . Poncy No. ' Company � � - -� � - � Cooking Unit ; �i Sub Pole � � ` eCertitl¢tl�copy Is hereby furnishetl. � ' � ' I { 1 j 1 � ' BBthtubs ! � ; . Solar Piping � . ' � ; , , I _ r ; - � CartHietl copy is tlle0 wit� the Lity Builtling Dlvision. �. � i ' Clarifiers � Sotar Tank ; � ' � � DiShWasher �� Date � � � ' Applit2nt ' � � ' ( � ' . � �Motofs O-1 HP 1'/a B � �EXEMPTION�FROM WORKERS' COMYENSATION DECLARATION � � � , � � � � Dryers �OGas' OEIectlic �� ' . _ _ _ ; � _ __ ___ _ , _ _' _ ! - I ssjp5ection neetl not be completetl if the permit I5 for. ona huntlretl ($100) or �. I Dishwasher . � Swimming Pool w/Spa ; � ; . i ,Inc.Solar'•�9-15 NP �� 16-15+ i ' 1 Drinkin Fountains ` Urinal •' � ! � � Fan-� �, . �Microwave � � � ; 4 � I certify�that �in the performance of the work tor.which this perm�t is iisueE I 9 shall, mt employ any person in any manner zo �as to berome sub7ect. to the ' . � ; . p,q,U. Pole Li ht j _ . Workers•CompenSatlon:LdwsolCalHornla.� ( j . FloorOrains� � WaterCloset� - ' . f � � 9 . 1 ' I ( � I . � : � . ' . e . . �ate � • Si9na[ure � � ' � ' - " - - ' ' � . � � ' - " ' � �- � Water-Heater��•-�� ' � Fixtures � � 'Ran � NOTICE:df,after making t�is�tleclaration,�you�shoultl-becdme subject to the--,• �— Flao�-Sinks-, ���-� �, � - - - . -... -- - - ' - ._ - .. ..,_ ..�.. _.,,.. ,._ . , .. �._.. ge ._._�.. " � ;....,,i..,.. , , Workers'� Compen5ation provislous of'the Laboc COCe, you,must�fortnwith . � comply wlthf 5uc� provlsiOns or � thls 'permlt ;shall be �tleemetl. Yevoketl. ; � G85 ServiCO ' 'Outlets � _ 'Watei,Service " � ' Device Bazes ; ' ' giy� � � • �CONSTRVCTION=LENDING AGENCV� -• � ' � � �� - ' �• � - ' � ` � .� � I 1 hereby aTtirm that there Is a.constructiomlentling agency for the periormance :� Interceptors � i; i;. I y, ; - , � 1Q Outlets � � Standing Sections ! � � of tM1e work tor . which� this; permlt �s ;Izsuetl ^(Se<tion 3097' Civ: CJ� ' - � 'r � � ' ; � �' Kitchen Siuk� �� - � � - � i ' Trash Compactor � � � ( � Lentler'S' Name � • '� ^ '' - � -� � � ^ � Switches � ' � �Lentler'S� AtlErass � s � ' ; �' i -� : : =' 1 :� � .� - . �� ' - � -. . Garba e Dis osal : V ' ' ! . , , i ��, �OWNER BUILDER OECLARATION j, �� - � + `� � .. . - •': � �. � �+eVatOfieS . � � ' 1 9 P � ; ; � I harebyfaffirm that I am'exemptlfrom the•Contractor's;License Law for the �� - �, ��- - • Generator: �0=5 KW 05-15 KW � . . I � followin9 reasom(SactlonW 031'.5 Business anA-Protessional GOAe:�Any ary or P-T�eP. : � f ?' '� � ' . � ' � , � . rcaunty whlch'� requires a permit to'constru<t, alter, improve; tlemolish'or repair � ... � � �. � ,�� -�; � � Transformer p 75-50 KW � � � � 'any structure; prlor to its�issuanca,�also reqWres the applicanKtor such permib �'• i Roof'D�ains' ' i, i � ,� .� i � �I to flle a siqnetlsSatemenYthat he/s�e iz Iicensetl pursuant to the�provisions of { ''' ' '' � � �5U+ KW � � - ' the Contractor'S'Llcense.Law;(Chapter 9 (commencin9 w�th Saction,7000) ot ' ' r � ; i : . • i '- - _� i - �. { �� , � � 'Reinspee[ion Fee } §75�� : '�Ion �.3�of the Buslness' antl Prote551ons Cotle)','or� that, he/she is'exempt �-�j Show¢�5 �. ��� Reinspection�Fee ,' $15 , . ' 1 from�antl the, basis for the�alle9etl exeinption: Any"violation�of,Sectlon �� � '- � ' ' - Meter ❑up to 100 amps � , i Jssue Fee � ' ��$ 3 .5 by any appliwnt for-a.permiC'zub�e<ts the'applicant to a:civll ' "' ` - � ' - ` , t �enalty of not more t�an five huntlretl Coliars (E5o0). .� . ; a ; �rv�ce Smk � � , " • � Iaue Fee � , $ 3 - - � • � ; � - � -T ; � - • t . . . . Zoning dPProved BY Date J6� I,'•as�owner oT�the�property or�my employees�wi[h wages._as their sole ( � , ' 1 � compensaTt�on' wlll�tlo^h pwork� antl Thoztructure'is oot InteOtletl o�ofteretl 1; �,' MECHANICAL' i ' � ' � � „ � ..� � . e,.. , e .1.,.., . . .....�. .... • ._ _... _"' _ ' . '. '_ "' "' r .�. , . .- , . .. . . . � . ' MPlintion Approved BY . ; '� . Date � oate s '7 s N�. Owner I-hereby�-certify-thabltha+e��reai Information is correcL I agree to an0�state laws relating to builtlin sentatives of'�thls'citylto enter Insoection ou:poses. Signature ' Driver5' Licanse or 55 � fviF 0865-46 rev. 12/82 White - fr oi a properry wOo.bulltls or improves , iself/�er58iT o� through his Or hBr own finents are,not intentletl or otferetl for ' - wement I5 soltl within onelyear!o( com- , n of praving he/sne tlitl not builtl or Im- j � , C I i clusivery tontractlng�with�llcenietl com � � u 7044, Business antl.Professlons Cotle:_l. __ i at 5pply to an owner of pro0erty who � :ontracts for such proJects wit� a cOn- � actorY Llcense Law).� r j -� � B, & P. C. tor this reason i � - ._., , � i - Structural ( . 1 - Ventilatin9.., {y,;,,,,,:_ `. _ ust System ❑ Mui[iple ❑ d/FaCt. BIt. ICBO # � : � Heating�System & Ductin � �� Pink - Accounting; Goltlenrotl - Assessor 8 � r� m � I APPlicatibn Issued BY ' '' �� R i' f �+Date � J�� 7�� ❑ 100.000 BTU. . .� . . . � � � ' ' • � � f � : SUMMARV OF FEES ; � � 1 ; � �'ration � �! �BUILDINGPERMIT $' '� ' ' SMIP � i.$ � _�_�. : --`+--". t ' ` ,� � � f i , � ' ".� "''' ," _ 1 ' Reinspection Fea � $75 � � laua Fee C $� 3 N CHECKj� t $ i ' PERMIT � � ti � � MBING � � �$: � � � ISSUANCE f � $ • � � i i N CHECK? � $� ��� � : GRADING • ;' � $ � ; ; CTRICA� � $'�,SSJ•�v�4 : I � _ � $ ' ' ' NCHECK�� � $� �O.SIO. ( MICRO�ILM .l $�1 1. ') . 1HANICAI ; $t � t � TOTALFEE' ' $ ! ' � ' ' i ' ; LESS � 1 � � N CHECK �� $� ; � ` ADVANCED;PC � $ � ' �� � i l I j", ' i .� FINALFEE� �$�33.30 `6. �Electrical , i. . i 7. ootings 8. �Fountlafio -� � .� 9.,�, etei Pipe ,. � 7 0.• 5t� uctura I �� 11. ,�ropert'y S 12. Sewer Cap i. � � 13. ��Roof;Drair � 14.}Rough Flu � k'15=Rough'Ele e . i7 6. ; Rough�;Ele a,. p r.tc � �. i � g�t7. �Rough,Wv c • - '. � 18. fRou9h Ele� �:: 19.,Rough;He: � � 20. -Rough,Fai � _, . , , 2L �Ducts,'in' " .i i. , ._-_, ,iNU!'i y,__,__ - '; C ..-,y ���Gr'.�/in.�_ . F c�.. � ... .`U�l N�AND,PLANNING --. .. --- - �� Permit#� ' � G��Date � .Inspectori ;` APPROVALS�,� Per�m�'iC# � �. Date ^ Inspector' �� � :u .. - ..� : - - , � - - •' � � - :trical Service or�Pole ' i� c "J,;; • iii ; Q � ��52,i-Pool &_Equipme`nt Locafion; _ � '� _ �� z � - ' ' n �rnd.-'. , ! c' � ,`: F � � � ` ` - .- ` _� , . � �53.' Steel'Reinfoicement ' _ - � ;,: = . ` �.' - i r� =� uit Utilitv-Undrgrnd: � �_ - . ,54 Forms;n - _ - �� _ - � �' - � 1 . .� ' - uit-Undigrnd'.- � ` � _ � , = � � ' E" f55:� �Electrical�Bonding. ' . � '� = ' � n 1 � ''' r ' -'' � .^ ' -' ." i' �56. �Rou h�Plumbin?& Pressure,T.est; ' ' `•. ' _ `- � ^ ment � � �. , ; ° � - s :: s : � r 9 . .9. ,.. , .�� - � . R�Grnd.' � ' _'� , � r`- _ � ° •57 � APPROVALTO;COVER-GUNITE�- _ '. . . !;"- - -•;.�i' ; 1 i � < °" � � ` � • `=� ' � - i ' ; z� � ' ;: . :r � i j.ti _ • �:: i i58' �Eie�c�'��i cb�d��i-u�d�o,,,�:• -: « :c. �r`_ '� �. i . f. � . � , �, � i � . , - � �� , s i-�, c . .�59. �Gas.PiPe O�Und�gcnd.; Test i = •� '' � ' rgrnd. � , " ' : � ' ' ��60. Backwash Lines, P-Trap, ��Undrgrnd.(_� �' . I ' t � r System `.,' � � � - ` �'� = 61. ;APPROVAL TO�DECK �t ., ; -t `, Line &�House Connection _ ' ' ,62. 'Backwash &�.Receptor-Final� � - �� - i - - - �' , - , � ; � ^ � � ° � � .. '63. Heater' &;Vent-Final. " - _ " �1� �' � , � . �� � �- �64. Plumbing+SYstem ,F.inal = .1.• �� �� `. - . � � -' c v -- - -. " , � : �. � - - - g� � � ' ° • �� - • `65. Electrical-Final'�- � �"� - �` • � • d=COnduit `��-'�i -' � �"-.�-�.� � -_�' -� -:66i�Solar SYstem-Final-; '-�� -•'- "�-- - T - �-'� -� - --r--';, . � � l I �• , , Wiring. . i : �� ;iP 1--�.i ...- _ _ �-"i- . . . ' -.i._ ' - �--_�., ... _'I -7-- -? =--f--.-- �, ,; a � � , - ,67.�Fencing &�,Access,Approyal :. � _ _ ' T ,. +9�`- � �rt � ' ;� i � � > � ; � � r '„� ..: '68 APPROVED FOR PLASTE�RING � `! - ; � iI;J:Ba�,Ceiling' � ,��� � � 1 � •-� . � �' �69.� P,OOUSPASYSTEMSF,INAL. � � � ���� ., � . �� & AirConditioning � � - ;. � i � � � ; ;FIRE DEPT. REQUIREMENT � � ; �F ! t �.`_ " - �. �:. � •' � 1 i �� �k �'«-. � Fireplace, ! F i; �' 4 � � � � � � ' APPROVALS� ; Permit�# � � � ' �= i _ � � � . i . . . � ; � : .'_ :ure � � ' `� ,� ? � ' j . � 70.� Undeiground Hydro � . � � � y ' � 1 , ; 22. lDucts, Ventilating ,_ � � �� ; � � ' � 71., Product Piping � Gas O Oil � � � , • ; ; � , r � ' _� � ` n '.-T'-__i ' ;"_ _ .' __....'_ �"'_' ' _ ' '` i_' '__. _ _ � _*_ _ � ,�.=23. �Gas.Pipe-Rough & Test ; .'i, � i? ;� i � � 72.; Undeiground Flush; . �,�; , + . � -24. `Roof Framing�. , � � �, .a:;� ;, t i � . j:r � ,; � .c . > ; _, - 73. Undeigrnd. Storage Tank O�Gas ❑ Oif �� � �. ' 25. �Roof Sheathing , ' . '�'', � �., �' � , � ' 74.' Overhead Hydro - - � ' , _. ... :2 _ • . .. ., , . • � ',�26. iT-Ba'r Ceiling (Structural��& Monocoat= ; ' .'.�' ' - J5.' Dry Chemical , r t � . ,� S �� 27. �Frarrie and •Flashing� � ' i � ' i :� � r � � 76., D,`ry StandPiPe ' � � - - � . , . ^ � 28• cL'athing & Siding; � ; ' ' � � �i � i � � � ? ,77.� P�IXED SYSTEM`,FINAL k � � 1 ,¢ � � 1 � _ - _ � .' . [ - - x : , t 1% ' t 1 1 � � . - . . .. , � , � - _ � 2�Insulatiori � � � " �f �' i � ; j � � .78. FIRE PREV. FINAL . � � f ; , `� ! �` � 30. �Drywall Nailing � > � ,- ' ' :� �` I 1 i � i � �Notes:� � , r � ' i � • ( � � _ '3L �Plaster �Brown Coat . � � � '� i, � - -� - � - -r - � - -� . `- . - _ _, . . - , - .�-- - i . - i ! � I � i 1 l .� �. ' �32. �Electrical!Power Meter-Final i ; � � � i � � � � � ' � � � . , . � .. , - - � � � � � . � • � ,c33_�F�nal Electric � • 1 � ! ��_Ji__! �. ' � { ' ! � � . � � , - 34. Final Heatin- &�Air Conditionin I � �YV� V� ' ' '�' . • ` �Y � , ' � r. r 9- I- _ 9 �'. 1. 1 i ,�f.•.�'i`-.i�" . ��-�� 35.��F;inal Ga5'�Pipe=Teit' T i n. � l � �� i � Ir � - " � �✓;. � _ - . � � ,.� ' � t� r 36. HoOd or �CanoPY -� � � .. i n! �� i ' i . " t . � .. ' . . . r c . . - . b r ' ,: �_ .:i � ;.-� •�� - - 37. �Ffnal Fac[or,y Fiieplace� c' .i ' _ ' � ' ; � � ! " � ! , ; ' '- ' � �' '�' _ '= i - _ _ � G. � ` � �I-. � i . � i i � . � �i . <, . ., � . � � � • �_ ` - 38. Final P.lumbina � � , �t " �' � , - � - i ' . ,i 39. IMat 40. Ci85 41. Sol� . 43. �ackflow 44� �andsca� � i. 45.�Sound�Q � -< 46f klzndicaF 47.` h�INAL S 48. Spacial R 49.`�El�iic F i ti' � 50. Ga��ele� 51. CER�IFI , No. '� i 1 I .i ! � � � � - 'inali j � ;1 �� . ; ' � 1 � � i � j '' � 1� r o. � I ± � � 91 � I ' i N � � �. � . ' � 1_ � . . y .� , . , -Final � i' � ! r----� } ' -'.�' �-�_�z. -' � ,,� �. � ' ' , � � � �`i ' ; ' � 1� ` ,!' i� ' j ° i ' � � , , � � ' . � - f�Se��T.� 1 1 Tlf . � . . ' . I � y-� _ " _"' _ � : - � '. -f �'` 's -, , ,i tlon - , ! 1 <µ � I �_,' ' � � : i - c i � ' _ ' ' . . v' �,� , � . : � ; . _ � - _ . _� � � . • �,� jation`SYstem • r' . _ . � � . , F' ;a c ' - - , -t.. I i .l� T: � � � - � � : � _ ' i : � . � . � i p . . 3tlOf1 Q 1 . 1: i l � �, � � .� � ' ' ; � • •S _ �. 1. 1 1 �E F' f'" I 1 lation"s' I�..1 I �� �� � � � � i �� I ;� . . :� . . . 7TURE&BUILD�NG1. �� � , ; , ' - - . �ments Completed u � � ' �"' � � � � , ' - � . , , w , . . , ,o � � i � ;i f i i f + . ; ��to Edison{ I " � - --- i-.'_-. , -_.; - -- � .- _.;. _ _ � � I . t , ' . Southern CaliforniaGa`sCo ; ' ' � � . ' � � � -� � � � , � � - t� OF�OCCUPANCY �i I j"'i-�--{-i-�- � - � -' � -.- i '•ti � � � � ' I ' • ! Date � , _..__. . .1. � �--� � -'-- � � - -- - - -`- � - � - - - - �"� � �c .�--:�r .6 HANDCRAFfED AMERICAN-MADE ATHLETIC FOOTWEAR March 4, 1983 To Whom It P!ay Concern: I, James L. Van Doren, give William P. Belcher permission to pull the electrical permit for my residence, located at 3195 Haiti Circle, Costa Mesa, Ca7ifornia 92626. I certify that James L, Van Doren appeared before me and the above signature is his. . .� �!i..� .�� , OFFICIAL SEAL GORDON C LEE " � o - NO7aRY PUBUC - CALIFORNIA ' oeance counn � My comm. expires lAN 17, 1984 —,� Van Doren Rubber Co., Inc. 704 E. Broadway • Anaheim, CA 92805 •(714) 772-8270 \ � Applicant to fill in all spaces within heavy bortle� linei antl sign all apPropriate Ceela�ations. ' GL�G�FJ 4/06l82 �� 34� 32 i T�,i CIT'Y OF C STA MESA . PERMIT NO. "-' TRACT NO. LOT NO: BLOG.-NO. - -'- � - -�� � -� - •- ' CONSTRUCTION PERMIT - 3� 3 • • ' .�.-"��[p �a � � . � � •'� � , ,. _, , , . ,. ; Project Address i - ;�in c,�ecE . rr��.m /3 TVPE OF CONSTRUCTION �' � � . . . . . . , ' , , t Ownef - �� 1 �/(} D� Enf 'r- ' 'Prhaone � ^� ' O NEW �`ADD ❑ ALTERATION ' � � - • -•- � � ' - - -- -. � Add�e� i95 Ai7i �7QCLG /// n%� YI -0 REPAIR ❑,CONVERSION ❑DEMOLISH _ _ ;-Areh/Eng. - � - � � -- • . � � License No: - - . _ �0 o7HER""� � ' ZONING REGULATIONS' - ' � DES RIPTIONOFWORK� �' � �A•P•� I - I.ZZ �� - � .. - � �.'� � ' . ; AddresS . ..._., ' _..'"' ' " . l. _. , - . ._ . . _ �� . . .��) .KS/O' _ ' . ,ZONE'_' '' ' PLNG. REF. ge ' .. ' _' � Contractor Q ' _. _ . _. _.. . . -.Phone _' .."._ ., i '� . . , _ ' ' _ .e o N . _ _ . .. . � -, . � . � i � � TVPE;OF PERMIT �t ��� " • -T pgU I�DirvG (] ii - Addfess.' -'-' :. _ • -. .•.^'"--' ..-- • - ` . ���- I SETBACK LST. PROPERTV LINE 7'.�O . _ ,l�,GRADING,'-'�C�FOUNDATION �fTRUCTURAL-� �LIDFTVARD - - - -_ __ ' �LICENSED CONTRACTOR DECLARATION _ ' ' .=O TENANTr� ELECTRICAL ❑PLUMBING OMECHANIC 5Ep �. ___ . "' �1 hereby affirm thct I am Iicansetl �untler provisions of Char[er 9(com-, � �.: ,.,. �.. c_ � ! R�IGHT �O � � mencing with-section-7000)-.ot'�Division..3 o(_the--Business antl ..�OTHER"� " • ^^-t� ' 'Professions Cotle, �antl my Iicense Is In full force antl effec4 � ; REAR VAR� (TO P/Lj �� I ��- � - � 'i 1--- - - _ _ . {.. � ��PROJECT�DESCHIPT�ON � � ' + ,LicenseClasi -' - -LirenseNo:" - - - - "' -'- - " " '-'- ' `'PKG.SPACEREq.-- '"-" ";-P�2 VID � -'-' � 'Date "'" ' �' � "' Si9nature '. .. _ _ " "' _ ,�. __'S4. FT. +'� 7 ZI � ' �� . . . -�. � _ . . . _ � ' _ : IWORKERS'COMPENSATION.DECLARATION. � ��OCCUPANCV CONSTRUCTIONTVPE ^ ��STREETWIDTH ," .PARKFEE$.,.,- f,' ^ - - ' � -'" - "' -ZONING APPROV ED BV � �' "DATE /�, � �I hereby affirm that 1 have a certlfica[e of consent to self-insure or a VALUATION�•�—�ZONE � 'certificate of Workers'-Compensation--Insurance,.ou.a cer[itied'copy�� _ . _ �. _ _ `� �- ,thereof Section 3800, lab. C.). . '�SPECIAL CONDITIONS: - ' ' ' - ' - - ' ( GRADING'CV.�VDS. ACRES� - �� ,� ,;�Y"No:' " '"'_ ' ComPanY ' "'__ .. .::� - ' '__ " _ _ - - .. - . . .. _ . ,y� -�rtiti¢tl COpy,6 h¢reby.,fumish¢tl. __ . . �� ,' i �REMARKS: :4 �?' t ' � C' py;ertifietl copy'is.tiletl with the tity Builtlinq Divislon. � � � � � ---- � - -` �� � -'-'";' ���EMPTIONF0.0M'WORKERS"COMPENSATIONDECLARATION � -- � � + �. _ ' -" .. ' '(Thiz section._neetl nat be completetl if the permit is for one huntlretl -� - � -� � : - (5300) or 1e55). . : . _ .. . :_ '"_ . .' �'" _ t ' '_Z.SS-3 . '_ ' ' ' ' � _ " :I C¢/[ify'that in th¢ performanCe of the wo�k to� whith this permif Id V _ �, � 65uetl, I shall not employ any person in any manne� So as to�become :'PLUMBIN(�i ' " .PLAN CHECK" '- - ,ELECTRICAL'- -" ' -'PLAN CHECK : '' ' subject to the Wo�k¢rs' Compensation LawS of Calitornia."�• _ ''' ''� �� �"' � Date 519nature � � -BATHTUBS". ""' "-SHOWERS "' ` � -' - '-' -'�' - -� - - - - �NOTICE: If after making [his tletlarafion, you shoultl become subjec[ �-�TOILETS.... ,��� �� . VRINACS"- � '- ' • ;--' �- �.GENERATOR--- -Od'KW_110'KW' - "� � to the Workers' Compensation provisions of tne labor Cotle, you must � "� � 'TRANSFORMER � � - - - �torthwith compty with SUCM1 provi5ion5 or thi5 permit shall be tleemetl LAVATORIES OOVBLE�L-HV$' - ' -" YAPP�IANCE' --10-50 KW �_50�+ KW ----- revoketl. .S__ n �--.__ - ._ -._ - -KIT'SINKS' ' ' -"-DISHWASHERS - - - - MOTORS-- � �0-1 HP_1d0 HP�- �CONSTRUCTION LENDING AGENCV -` ' ' '+ ' I here0y affirm tbat there is a canstruction lentling agency for the per- SERVICE SINKS SVMPS' --� - - -� (�NC. SOLAR). .10-50.HP 50.*.HP '' _. formance o� the work for which this permit is issuetl (Sactlon 3097 ' � � - 'Civ:•C:)._ "._" ' �. _ . .' .- _" . __' " ' �FLOOR'SINKS.' ' ' ' ' '" _ ; iLentleKs Name' - _ �� � rFLOOR DRAINS' ' � �" ' •+PIXTURES- - -OUT�ETS -�•SWITCHES- �^ �Lentler'S Atltlress ' " " �.DRI�NKINGFOUNTA�NS^ - ^ - - --- - -�GASTUBE-SIGNS - ^ --- - - - - - - l OWNER�BUIL'DER-DEECARASION -� � " � V '� , ' � -`�NTE_RCEPTORS ' '- . -CLARIFIERS- - ' � POL'E'LIGHTS - ---- � - --- - - - - - - � '�,I hereby affirmthat I'am exempt from IM1e�Contractor's License•Law�for � - . . . . ' � - ` � the�Pollowin9�reason (Section-]031.S��Business-antl�ProfessionsCotle:: --SWIMMINGPOOL�-: .'�`PTRAP '" -'=-� � "" " � - � Any city or;wunty,.which reqwres,a,permit fo,consVuct, alteq � -- ^- � �� ' � � 'POLES ' �-- METERED �-`SUB" improve, tlemolish or rep5ir-any structure,-prior to its�issuance; also re=' yyqTER SERViCE''� �.�-ALTERAT�ON '-' - -. - - ' -,PANECS - � �- - MAIN- �- �-�SUB � - quires the ap�litant fo� such permit to�file a Signed�5tatement that,he�,,. - - - � is Ilcensetl�0ursuant to the•provisions of�4he.Contractor'S 6itense-[aw- ' � -- -- - - - - �}SERVICE- � � - � -- --� - - � -AMP�- —� - `� (Chapter 9(commencing Lwith Section•7000) ot Dwision.3 of tM1e� �GASSERVICE� �` '- OUT�ETS" i Business antl•Professions�Gotle)'or [hat�ne�is exempt therefrom�anG�the- '- yyqTER HEATERS��� � -BTV'OVTPUT • -- � �- -- - � � -� � -- -- - • - --- - - - - -- ---�=- ""' � h-•�s for the alleqetl exemp[ion. Any violation of Section 7031.5 by � , � ppliwnt (or:a•permit subjects the applicant to a-civil penalry- �-SEWER CONNECTIONS^^''� ' -� - ' � - � � � � �t more than five M1untlretl doliars ($500). ' � ' �� � - V � j . - � . _ ._ , r. ...." . .,'as'owner-ofthe'prop¢rty; "SOL-AR'�TANK"-- ""COLLECTORS � "'<- --.r--�� ---� �--- �-- �-----•---- -- -'� -:..., "� " -- �^n, will tlo the work, antl the struc[ure is no[ intentletl ' i or'ofteretl for sale. (Section 7044,-Business antl'R'ofessions Code: T�e-' "SOIAR PIPING SVS." -�;.- �' �' ' -' "}' ' '-- �SSUE FEE -- -- - - - - - -- - - - -- { Con[ractor'S ,License Law tloes not appty to an ownec of a property . ' ' � ^ '" ' { . wh6 builds or improves-Iheieon, aod who tloes such work-himself"or -' ISSUE'FEE`- """ ' �%:'-�--�"°` " "' �" '-' -�APPLICATION /�.PPROVED BV.- --��DAT•E � 'throu9h his_own employee5, provitletl that Such improvements a�e not " ' 'in[entletl or otte'retl fo� sale.-If,-however,-[he'builtling o� imp�ovem¢nY ' '-- ' "-"-- - '- '"-"' - " ' - "^ � -- -- -^- � m - -- =-�� MECHANICAI aLAN CHECK � SUMMARV OF FEES 'is sold within one year of compietion, the owner will have the burtlen ! � , .. t; .' �q�U. ' p ;. of provin9�he ditl not'builtl or'improve for-the'purpo5e'of sale):' - HEATING SVSTEM 0-100,000 BTU -'- 7'BUILDING--- �� � -- ❑�.I,-az_owner-of .Ihe_property,_amaexclusively._conVacting_with qND'DUCTING - � � � - ..� _�a „ _ �PERMIT §_+C_�+� i� SMIP`� .�$ h . 1� � 'IiC¢nsetl cont�actors to mnsGuct tM1e� project (Section 7044, Business ]00,000 + BTU i � PLAN CHECK E�_/�_��' � rPERMIT �.� i� � antl�ProteSsions-CoOe:The-Contractor's.License.Law.tloesnotappty[o. ' . /_l'.+.=_ 'ISSUANCE.§ .an owner of property who tiuiltls or improves thereon, antl who con- REFRIGERATION . Od00,000 BTU , � � PLUMBING E .� � :• trac[s-from-such.projec[s_with.a.contractor(s)_.liresnetl5pmsuant_to. _SVSTEM-- - � '- __ _- . �.. - "GRADING..E���'"' �^ ,theContractor4Licenselaw). -.+�� , � �.�' �� ,;;, 100,000A+gTU' '�; ,��,�, 'PLAN'CHECK.B �.t;;,-1�i ;•-: "4�: � �0'I'am-exemPt'untler'Section" - -�.e. _B�& P:0.(orthis' " " -"" ' " -- ' ' - . ' - . �S' t , BOILERS� �BTU ' ' � `�ELECTRICAL'-$' ,������ .,�MICROFILME � � 'reason• � �- --�SPbAN�CHECK- E • Z � SVSTEM REPAIR,ALTERATION � J 'ti �Date O ( - ' «».�TOTAL'FEES� - �7 - � MECHANICAL-E ' � ' -- - - I I hereby certifythat I have reatl this applica[ on antl ate [bat the above E%HAUST SVSTEM MULTIPLE j 1 "� � 7 ~ LE55 AD-h- �' • � information Is'corre<t.'I'aqree'to'comply'witn'alPciry.antl'county- . '; �PLANCHECK-E -- - VANCEPC-'S- ' '- � ortlinances antl state laws rel ting to construction, antl hereby authorize . .�'` �_.: , _ r� � �epre5entative5 t is"Ct�j- to ente�' upon'the above Tentionetl" -- - �� . ' � � � �- -. �" � property Por ' lo r oses. . ' il . _ _r'_' ' "_ " "_ __" ' .__. . /5 ,.Z,. . .. _ . _ _ ' _" � ' .FINAL FEE E7}?��Z< < 519nature Date �' � ' . - - . __ . . . _. Drivers'Licenseo'r55 '.y'�) _' '"' "."�• _ "`ISSUEFEE. . " '-'- `"'_ ' ' """'_"� ' ... ._. .. .. � � CMF 0865-46 White=Builtling; Canary-APPlicant; Pink-Accountinq; Goldenrotl-Assessor • � , ,, � • � � � CONSTRUCTION AND PLqNNING �� ' ` �� POOL & SPA ' � " � APPROVALS � Permit # ' Date Inspector pppROVALS . . Permit# � • .� Date Inspector � 1. Temporary Electrical Service or Pole . 43. Pool & Equipment Location ' . ' ' _ .Soi ipe-Undrgm � � 44. Steel Reinforcement - � • - � • 3. . Electrical Conduit Utility-Undrgrn - . 45.� � Forms � ' � - - - --� 4.-- Electrical Conduit-Undrgm � -` .:.46: _.Electrical Bonding ; - - - � - -- - - � _. .. . .. �. . _. . tee ein orce �� 47. RougR Plumbiu� & Pressure Test � � -- � � • 6.._ Electrical UFER Grn ' 48. APPROVALTO COVER-GUNITE- --- • - �, 7.. ,F09ting5�.. .. . - 49. Electrical Cooduit-Undr rn • � • � � � - • � 8: -�Foundaiion _. -. . � _ - . i. _ ' ' "' � 50. - Gas Pipe, 0 Undr rn, Test � � � � ' - ' -- - '- _ 9.,_.Water.Pi e-Undr rn -. . � " � " ' ' - � ' ' "' - ' P 9 -- --- - 51. Ba k ash Liner P-Tra�- ' ndF m� � p 10. .Structural.Floor System 52. APPROVALTO DECK � � �� " -- � ,� • �1.1... Pcopert � Sewer_Line & House Connection � '� 53.- -Backwash & Rece to�-Final "' ' ' t 12. - StreetSewer Connection ' ` " - - �- � � - -54.- �Heater &-Vent-Final � ' ' - - -- - . 13.. . Rough.Plumbing - - .- - . �- - - - _ . _ . _ - . '� 14. Rough ElectricConduit ' - "�- - - -�'r56: Electrical-Final- � � � "� .' �� � 15. Rough Electric-Wiring - ` ' ' ' "-�' ':` � '� �'57: -SolarSystem-Final , '� '�� "' ' �� " ' ' � ' � ' 16: �Rough�Heating & Air Gonditioning' � � �- - -- �- ,. Fencing:& Access�Approval . � � ' � 17. Ducts, in-Structure - " � � ' QPPflOVED FOR PLASTERING , ' ` ° *-- -• - - . _ , . . .. _- -- . .. . 18. � Duct4; Ventilating - -- ' -- - � -' '- � -. .. ' � ' ... � _ � . 19. GasPipe-Rough&Test' ' ' � - - ' - --. - - � _'_60.. POOUSPASYSTEMSFINAL,', . ., .� ' ,; � � r -20. -Roof'Framing. .. _ _ : . . , . i . r .. � . � , . � � . , , - �, 21. Roof Sheathin � - ' D,S.- - / '/--fis� . - - � . . . _ , ,. . . : ' . , ,- 22. Frame and �Flashin ._ _� _ ._. _ _ . . A- / -/-�,,. � "NOTES: . . . . . _. ,_ . .. , . _- . . � 23: -insulation - _ .. � .. �.- -- U1 . .;3�:. - - - ff--$3 - - o .�1 2'la,l �ia � /tid�•- cG�� . �24. Lathing & Siding ... . ..: . 3 �}i4Ch - . �.� �'. (,[/. .y . . .P,r � ,� � ..✓. � V�' 25: Drywall-Nailing� -� -� - -- � - - � � - - - ��S'' i" .ou"� " Ca- c .�Sv � � � 26: Plaster grown Coat � - - - � - - _ -- - (• �S - � � • 27. Electiical Power Meter-Final � - - � - - � �-- . �- ' ' � �Yfi �.v`vQ� �� �' �� S' . --e' 28�. � Final�Electric - -- -� - - - - - - - - --- - �� . '�Jb� ° o �-' iJ1�`. ` �c ,. , � � 29. � Final Heating & Air Conditioning - - - - • - - - »- � � "- - - � � � � • � � - ' 30: Final�Gas Pipe-Test - - - --- � � � - - - -- - � '�- �� � • � 31: � Final Plumbing . .. . �' ,.. ' � . . . � �; .. ......... •. .. � -- - , , w .,. . . .,,,,.. , � --- �- - -.._ . _ . .,., .. � .. � . - _... . ._ _.. ��32. Water Service-Final � '- ' " ' ' ' �� ' � -33.=��GasService-Final�-• - - ' ' " ��,' ' � � � � . 34. Solar pomesticFinal� ' ' � ' � ° ' " `' ' ' � , � � ' � � ' ' 35�. Landsca e S rinklin S�stem '�i � "� ' ' � • ' ' � � " � � � " " � ' - ' ' �� 36. Sound Attenuation � -- -, , �-' - - ' .. . ... . . � •z.' � . . • �. 37. Handicap Regulations � ' F -- - � ' ' ' ' , � 38. FINAL STRUCTURE & BUILDING $*?`;Ve _ �_ 03 �S �%$ ' � " � � • 'i ' ! 39. . Special Requirements CompleCed� � �._ . �'� ° � � � : 40.� �Electric Release �to Edison � ., • �' ' ' � � �� ' � ' i ; qi. Gas Release�to Southern California Gas Co.,. � � ' � - � . F • � ' � 42. CERTIKICATE OF OCCUPANCY � - - - -- - ' , "; �„ ' ' . ; ' , � ' ">� � ' No " " � Date -' - ' " - �: \ . _ . _ . . . ... . _ . . . , - ; - -. '. .. . -- . . . �� � i Applicant to fill in au sPaces witnin heavy bortle� lines antl sign all apOropriate Eectarations. � I E5J 2/D /p2_ , CITY OF COSTA� MESA- �- , Pe MIT NO. ' . 7RACT-NO. LOT NO. BLDG. NO. � - ��' - � - - -- - .. �-. a - �� - - -��9z�94-E?.�TL' , CONSTRUCTION PERMIT 'SS 3 ' ��J'JCD� q� 4. -' � , ',+,: .'• ,:..- : � . :t,•- , . � ProjectAddress ' J ' � ' � '-�� ' � - , ., , R5' 'AiT G .�CLE%�OSrA" CSA TVPE OF CONSTRUCTION � , , _ , � , ��•c OWnef f��'fES� � R�. E ' � PhOne `- ❑"NEW "�ADD ❑ ALTERATION � -� - = - . . .. . �'' ." '"'' ' - *�' . . . '. ; Addrea' ' %�J�T ' �C — sr -mESR � - � REPAIR_D.CONVERSION ❑DEMOLISH _ _ . �� � � •��' � � ���, .�„ . __ � ,�Arch/Eng.-' - �'- .-. ;- ..- License No.- - - _ _ ' _ _ '.O oTHea � � � � t � ' ZONING REGUL"ATIONS � ' Address " '" "� . .. .. �- ._.�.. . _. ._' "'"" ' �- _ DESCRIPTION OF WORK _ /� �' " .{- -_ 1'A.P: $ _'-_� Z _ . .._ ..__ . . _ "' , �'ZONE' � PLNG. REF':'��.�^ ' • �' 'I' j'Controcror 0 � - . - ' "' ' '--. Phone - . --- 'TVPE:OFPERMIT ' . . _ i-.. o . .i_ .. To B�JI LDING-. �y7 � p : ' Address' "- -�� -'------ - - - -- - :SETBACKC LST. '�PROPERTY�LINE�'Gt-1 O^ 'i" � 'OGRAOING ��FOVNDATION--�STRUCTVRAL� - SIOEVARD ` --- - 'ti, 'LICENSEO CONTRACTOR. DECL`ARATION._ '' - •� TENANT.O ELECTRIGAL' �PLUMBING. OMECNANICA L5EF '�, 'I hereby affirm that I am IicenSeC untler provivons of Charter 9��com- , , - IDE V -� � 1- - � �� _ _' mentin with section-7000 -of : ^•-' . . <y'-- -; ' RIGHT � g- ) DiviSion.3. o(. the _Businesz +antl: _.0 pTHER. . � . ♦ . � , Professions Cotle, lantl my Iirerise is In full.-force antl eftect. •�' -' ' s . ' REAR VARD (TO P/L) -- ` � ' � � - � ��PROJECT OESCRIPTION• ' � � � ` . . ...�. . - lUs� - `- �License qass"--� - � � - � ' -- Licensa No. " ' � � ' - " � ' """" , PKG. SPACE�REQ.- �� - " RO DE�; "_�i� '- "-"1 Date' ."' " 1r.519nature �T . � i.c SQ. FT. �.,eZ � � �, .. . ... � . . "- .... . .. ,WORKERSlCOMPEN5AT10N.DECLARALION_. _` - 'OCCUPANCV " CONSTRUCTION TVPE j ��STRE[T WIDTH"" - �"- .� PARK FEE y;,";� ., i n �I hereb affirm that I�have a, cerhti<ate of consent to selt-insure or a, '-" � �`� -- -'Z�NING APPROVEO BY' ' DATE p �certificzta��of WorkerS-�Compensa'ion_.Insurance, or..a certifletl_copy..�VALUATlO -.�ONE � �.�• ._ t G..3 ;thereof�5et[ion3800,Lab.CJ. , - GRADINGCU..VDS. ACRES � ' .SPECIALCONDITIONS:-'� �� , -'�-;'�-y-„��,-,.�' � '^Y No. '" ' "" 'ComPanY� _ ' ' '- ' ' ' ' ' _ ' ' _ ' ' " ' " _ "' 1 ' ' :rti(ietl copy is.hereby.furni5hetl._.._ _ ._ _ _ `. _ . ' ` REMARKS:� �';�-'_ _ .___. . . _ � _ __ _ _ ,ertitietl COpy is filed with the city Builtling DiviSion. ""' 1 '- -' '- - EXEMPTION-FROM WORKERS"EOMPENSATION'DECLqRATION� - - - • ^ - ^ � - - - - - � - ,�' `"�� '(This section neetl uot be completetl i! the permi[ is for one huntlred � �� .. .. '. ,,, . , ,�.��\.• C ;.q..}j _ ' '_.. _ "" - . . . .. . _ . ..f - ._ __ . i � � , • _ �. (5100) or.lessl. � . � ,. . . .. __' _.�*'. .. - . -.. . ._. . ._"';'. _' '.__ __'. _' . .. �... "_. > > f -..�'�. . _' " ' .1 certify that In the performance of the work tor which this peimit'ii _,„ ,, issuetl, I shall-not employ any'person'in any manner so as'to become , PLUM6ING '� ' r„ PCAN CHECK' �"�• ---^- -- �ELECTRICAC ` ^�'^-' PCAN'CHECK - '' � subjett to the Workerz' Compen5ation Laws ot Californ�a. ' '' ' � . •Date ' Signature � ' B%�THTUBS- "' SHOWERS - ' - i"' - -- " �- - - - - - - - NOTICE: If after�making this tleclaration, you shoultl become subjec[ 701LET5 . . URINALS ' - �- - 'GENERATOR�- ' ' � -'+-- • � i-�' ` ' "'04'KW"_1-IO.KW to tM1e Workers' Compensation provisions of the Labor Code, you'must � - �� ,TRANSFORMER �• '� � 1 � forthwith.wmply wi[h such provi5ion5 0� this pe�mit shall b¢ tle¢m¢tl LAVATORIES DOUBIE LAV$" -'--�-^- -� +qppL�qNCE "� 10-SO�KW_SO+�KW� ��- � revOk¢tl. � � - CONSTRUCTION LENDING AGENCV ' ' -KIT.SINKS" ' ' - -DISHWASHERS'� -�h -- �MOTORS� � -h;0-1'HP_1-10 HP--' - - - - - ; 1 hereby affirm that there is a construction lentlinq e9enty tor the per- �, _ ,�. �-_ _ __ �pNC.50LAR)_ .30-SO.NP_50�+ P� '�' SERVICESINKS.� �SVMPS `�� ^` H - ` - --J Jormante�of the.work.ior which this permit iriss�etl (Section{309] �� � -- . -: 1 . , . �. C Civ. C:1: �-- . .. � . . . . _ . ... ' _ . . _ . , r,� . . �' " � - - '" ' "� 1"' ` � "" - 4�"� `FLOOR SINKS ' :FCOOR'DRAINS"'� 1' -' t" " �FIXTURES- �-^c�OUTL-ETS-�'SWITCFIE$-'.,-Y � - -- - �Lentler'z Name--' - Lentler'sAddress '�� ""� DRINKING'FOVNTAINS-" ' - - --�_:-�'-- �i'�-'��.GAS�TUBE�SIGNS-- -- --i---- -.L---�- --�� OWNER BUILDER DEC�ARATION - ' ` INTERCEPTORS' � 'CLARIFIERS , "�POI-E�CIGHTS - - - -- - - � I herebya/firm,lhat I am exempLtrom,th¢ Contractoi'S License Law for � . �� �� �. .: �� the�following=reason-(Section 7031.5-Business.antl.7rofessions,Cotle!= .;SWIMMING POOL-�0r� ^=P�TRAP'-�� • - - - Any,'city or ,coun}y which requires a permi[ to �onst�uct, alter. - �` ' TPOLES --' ' METEREO �SUB"��r� � improve^tlemolisMor�r¢Pair'any�stN<ture,-prior to Its�issuance,�also're•� � yyATER SERVICE �"`"'� �ACTERATION-- � - { - - ,PANELS - - --MAIN � -5U8- - - - -- � quires.the.ap'�.licant for�such permit to file a si9�etl statemenbthat he� � -1 I - �� is-Iicensetl�pursuanDto'Ihe'provisions otithe�Contractor's�Cicense�L.aw! "GAS SERV ICE � " " � �OUTGETS""-" " ' ' � -- 15ERV ICE �- ---- -----�-- • AMP� , - -- - (Chapter 9(commencing with�Settfon ]000) o( P���Sion 3 of the Business antl.Professibns•Gode�[or�that he-is�exempt-�neretrom antl the- -yyATER HEATERS' `- 'BTU OUTPUT- - - � - - - ---- � -- - � b��is for the alle9etl exemption. Any�-violation of SeCtion ]031.5 by � � � �'- �. . . . . ... _ _ _ applicant4or a-�permit-subjects.the applicant-�o-a-civil �penalty� -SEWER CONNECTIONS�' - ''� -�%-�-� - -'--� - -� �-•- =� --�- -•-- . -«. _ - - - -. -- - _ .�_ . it mo�e than five hundretl�tlollars (5500). � '' ' _ - - � ;as'owner'of'Ihe'property�or'myemptoyees'With'wage5'as'their--'SOLARTANK-�-�-COLCECTORS - ��--• � sole compensation, will tlo the work, antl the sVuctdre is no[ intentletl '� T � �+ � - t or'offeretl for'z51e. (Section ]044, Business antl�R'ofessions Cotle: The' "SOLAR�PIPING'SVS- '��" ' -- "' ' ' - ' ' ' ' -�SSUE-FEE� -- - � �- - � --- - - - whortiuiltlrssor��mnrove9�htreon��antl�whottloes uchework'hiPm6elfror" -^.. _^ ��` • y • ... ' ^ " 'l ' , � P , -"ISSUEFEE"" -"- "'�-� -�- ' - "APPLICATION�P.PPROVEO-BV � - � --DFiTE� throu9h his own employ¢es, Provitletl that such Impfovements ar¢ no[ ` ' �"' intentletl or ofleredtor sale: If,-how¢veY, fhe�builtlin9�o� Imp�ovemeni MECHANICAL PLAN CHECK i � � � � is soltl within one yearbf completion, the owner wi�l have Ihe burtlen ' SUMMARY OF, FEES . �'�''� q . of proving he`tlitl mt'builtl'or'improve tor'tlte-Pu�pose'oYsal¢)^"HEATINGSVSTEM 0-100,000BTU � ��PERM�ITG $���� dq�„SMIP�� ,�S��QC,� , ❑-I, -as_owner_of the _property,_am exclusively..<OOtractin9_wi[h. .-AND DUCTING � -- - - ' - - - ' -�- - '` ' licensetl con[ractors [o cons[ruct the project (Set[i0n ]046, Business 100,000;+BTV � 7PLANCHECK E�Le��� ,�PERMIT � i and-Professions Cotle: The:Contractor's.License-Law tloes mt applyto _ __ __ _ _ _ _ _ - _ _ . ^ � _ _�_` , .. _ 'ISSIIANCE�-S ��' ' � an owner of properiy'who builtls or improves thereon, antl who con- REFRIGERATION 0-100,000 BTU �, }PLVMBING tracis..from.such .projects�with.a_contractor(s)_ licesnetl pursuant [o_ SVSTEM- _ _ __ " . . - � $ � ' GRAOING� E'� � the�Contractor'sLicenseLaw). ,•�.` � '•.� �. ` ' . �r 100,�000+BT,U' - `�-•�-T� iPCANCHECK $, � •�.�;`•���, . �. ' � I am'¢xempt'under Section = � Br& P: C �for [his - - - -� • -� - • � . - _ � __. .. . _ . ,. .-S BOILERS � BTV � iELECTRICAC E-� ' ' "' . ' reason ' "^- ' - "' ±PLAN�CHECK. .$_ -.-• ,� �� . •'MICROFILM E " • SVSTEM REPAIR,AL7ERATION •,.� - ` Date Owner � -- 'MECHANICHL�S - �TOTAC`'FEES��' I hereby certifythat 1 have reatl this application antl state that the above EXHAVST SVSTEM MULTIPLE � inPormation is mrrectCl a9ree'ta-comply'with all'city antl county .., t. ' _ �PLAN�CHECK��$- � - VANCEPC' .$-- � - � � brtlinances antl stale laws rela ng to construction, dnd hEreby authorize j .. � �„ representativer t is ci -to enter upon'the above mentionetl �- -� -- - - • � '��. p�ope�ty for pe i � e5. " . I�',� 519nature %�� �. -�$� L 2 3.8� _ _. . "_ "_ ' 1 _ . . .` � 11 FINAL FEE E �,/�O 1 �l\ Orivers'�License or 55 x � ` - ISSUE FEE '_'__ _ _ _ ' _ _ ' �" " ' _ � CMF 0865-ifi K'hite-Builtling; Canary-Applicanh pi�k-Acmunting; Goltlen�otl-Assessor _ =<:��Q! Mr. ,,'s�ues Van Doren 3195 Naiti Circle Costa Mesa, California 92626 � a i i 1'� Janutr � �28� 1975 Dear Sir; A building permit has been is ed to Irvine Pools to construct a private swi�ning pool on your p per[y. In order that your pool will be a safe �ne and for d�e purpose of advising you of y responsibility iegarding the requirements of [he Costa Mesa Muni al Code, we refer you to Section 8107, a copy of which is a[ta d. x. , ,_._..,.._._.. This letter is our ordinances area. RH:cb directed [o you in order that you wi11 be aware of and can make a complete safety check of your pool Sincerely yours, RICHARD HANHART Building Safety Dizector Laboratori�s �,f: �.,«<iz�:,: ��.�<<f�,,,.�.�. ,�„�. . =0 d^v_ �1 . ?]i0 Ai=opc:: ':Ln. . �C;![:� 9E:�.��. C°.i=. °:EJ! . 2ii; =?� 3Jii . . i;l o7:2iF: ,:�c� fi2E�6-'.'t c.x.:.— ':'r CES 51� o . , • . q.,. . .. . . 1 i..='C�a f � _a jj���ar..��`: -' [� �.• ..i .. _�.e_c • '���'`��" ��. February 14, 1975 Examination: SC7S-)13 GOMPRESSION TESTS ON GUNITE �YLINDERS Errol F. Heesch , 12921 Aspenwood Lane Garden Grove, Calffornta 92640 PRO�ECT Swimm�ng Pooi for Jim VanDoren ADpRE55 3195 Hatti Circle, Costa Mesa SAMPLE FROM GUf1ILC SWIrt6nIn9 POOI /JICNRE[T ENOINEEP MIX DATE CAST DATE TESTED CYLINDER NO. COMPRESSION TOTAI IOAD, LBS. POUNDS PER S�. IN 512E: COMPIIANCE CY�INDERS 4'1/2 CO 1 2-7-75 2-14-75 CONTP�[TOR Irvine Poois fUlCOHtYAROR Grove Gunite Co. SPECIFIED STRENGTH SLUMP 2-14-75 1 2 7-Day 7-Day 90,000 107,000 3,055 3,784 6-va�� x�2-va�� 6�� X ir� 26-day test canplies with specifieatlons. MADE 6Y Tom OltitltYtfON: ---CoEta Mesa Bidg. Dept. Grove Guntte Co. E. f. Heesch - 2 OEIIVFPED !Y E. Heesch 2,000 psi 2-14-75 4 "HOLD" 3 5 "HO�D" 6 "HOLD" 7-Day 81,000 2,865 6" x 12-1/8" t[c[rveo oN 2-8-75 ��iIL�fP�r SAFE7Y DEPY. TEB 181975 � ��-'-�--�-�1 �- �� p cpo'S �e, S.iBrniiiED �5 1ME CON�i�[Nti�l v90GEMi� Oc CLIENTS •VT„OA13�ilON fOP GVBL�C�IiON Of OIIP REGORTS, COMClVS10N5, OR EF iP�CiS �ROM pp 9EG�NOiNG IwEM IS R(SF4VED GEHOiMG OUN WwITiEN �>PHOV�L �5 � MUTV�I CFDiECTION t0 CIIENT5.T4f PVBIIC �MO OVRSELVES. 130.i2 �;,: . _ _- � C�diw"�..�erL��3e_'.d`...sr.•.•'w�a�s.�.hS�: - 1'v• . .�.�'��. ' .a_ L.� u'!'a'r�a_iJCn--vd .. _ LY����.� �. �s�� � . .i . _ .0.a. . .A ..��K.,�.�.� .��.�.. _.. - ,- . �:z::. . . '�/ _ j.'Qooy ��.�{-�,..�: • . :. , �,:�.' . STRUCTURAL APPROVAL ONLY • ,' �� :: - ` -''ws' �".� , ' SEPARATE PERMITS ARE REQINRED . ,:.' . :., . •fOR ELECTRICAL, P_U�+"E1P+G, , � :., l. - � � . : ' Y:'c - ;: NEATING, VEiJT1L�Tli•J'� A�lD. , ' . : RF�IGER,�/ %z.��,�/R2 � �N •�� � '� . ' .. . R o �. '� >, • • .. r � .. � .°a: '.� <. � . 1 � , � y` • e . , ' �' J- > ;,. f �n .. y, . ��' '�"yo . ;i �IiI � . _ 'E' : ,, , , � � � �� + . ,: _ ' i� ° ; .,, � cn rMNA�� -(�r/o �2X6 NG.I��.• , � N E� ND�Y .* � G' tP°(�.L' . CR N:DP �; �;�� �; y;�A � � i NK. �iRti KA���JG � �.n/� t� l�v �1�,�, �.V�� 1'���!\ � � �@0't!!I� �i=��.11--3-- THIS NIJMBER '.:`:�; ;��";iNPANY ALL .INSPFCT;D:� F`_�•JcSTS �fOF BllliD;� ;S :`:4= ;� ( S�WS ARf TD BE EMPLOYED, 11E S'S� `ST TF;hF TEt� S� T(QE OF CAuEu^�ziA DiVISIU'�`� �1F (F INDUSTRIA! SAFET'V SE COc�SULiEl1 FOR � � � �/.� /Z�%� / l�� 0 NOTARIZED 7ATEMENT OF RESPONSIB�LITY T MAY CONCERN: Bidg. Perm�it �F � OfS� J � � This Permii � 3145 Haiti ('irrla� ('ncta AAacg Sveet Add�ess AP Number James Van Doren property, do hereby authorize: " Karl Iiuy Name 2464 Coventrv Circle Street Address , as Owner in 7itie of the above referenced (i14') 650-4393- .' _ _ Telephone No. , Fullerton California 92633 City . ' State - , Zip to obtain permits in my behalf, as owner/builder, for the construction, alteration, moving, demolition or repair of . the above referenced property. Should any person become an employee engaged in the improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be fi(ed with the Buifding Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. I agree to indemnify and hold the City of Costa Mesa and its empioyees or officers harmless from any claim resulting in damage or personal injury to myself or any other partiet. � _ a/.�/8Z rintetl Name , Date . . ,, -S.AM�y uQI� liD�l� Signature Notary's Statement: m CMF 0]]9d6 � OWNER VAN DORIIV� JIM �JOB ADDRE55 3�95 Hait GENERAL CONTRACTOR Irvi� �'^ Nn139-122-3 �or ECTIONS Pool Location - Forms Main Drein Steel Reinforce Elec. Bond — Approval to Cover Underground Electric � Gas Piping Test Filtering System Lines _ Backwash Lines and Recep. Electrical Final Heater and Vent Final ' System Final ba�Kwash and Recep. Final Fencing Final DATE 1-27-75 BUILDING PERMIT SUBCONTRACTOR Electric Plumbing /'0?7_ 7 . S�' � /�e?9-Z 6 �79 / _ . - � 39534 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING-�� � � � �� :�� � . r.. Z wW aU Z Z � am J � J V1 Q W 0] J J m Q U � Za W � aW wZ J Q m Z J � W LL� O= Z F W � � 0 � z Q U J a a Q 0 F y Z O F <..i � � H N z PPAPIy:� I�, �-���t,�A � _��: CITV BRANCH AODRESS ARCHITECT '1(l ��r..�.-.�.�. 7'EL. CONTRACTOR � , � � Y X �..1 ADDRESS y3O l ta(�� �' �.� �. t` CITV �`P ����� NOLS,� L C NO. ��/ �� ! LICVNO.'� SI2E i NO. OF BLDGS. OF LOT NOW ON LOT USEOF ^��� ` `� EXI5TING BLDG. �� N SIZE OF NO. OF NEW BLDG. ROOMS STOflIE: EXTERIOR WALL ROOF COVERING COVEFING USE OF BUILDING AND WOFK TO BE PERFORMED I hereby acknowledga that I have reetl this application and state that the above intormation is corract and agree to comply with all lawz regulating builtling consvuction, antl I shall not employ any person in violation of the workman's compensation laws of t�e State of California. I hereby ceriify that I am proparly licensetl as a contractor untler the Siate ot California Business antl Protessions Code, Divisicn 3, Chapter 9, antl thec such licenses are in �tull torce antl affect, or I am ezempt from tlie provisions of theState of California Business and Professions Code, Division 3, Chapter 9. . ' Signamre of ( �`y ; „� � , ^^ ^ Permittee ��d��% C � 1/ 7W � � Authorizetl Agent PA�u ,t,ti 2�-�s�,�:: 00 ��y� ��: � :44:Oo APPLICATION FOR BUILDING PERMIT F�VEp�HV C�ATE3ECEIVED DATEISSUE %%" � Of / a� ; 17' _'2 PERMIT NO. A.P. N0.1 — BUILDING ADDRESS � TRACT W ADD x OWNER USE� FIRE ZONE VALUE � BLOCK � NO. OF � I USE OF N�,1 4� PLAN$ BUILDING - V VARDSAPPROVED VARDSAPRROVED MAIN BUILOING ACCESSORV BUILDING VAR. # C.U.P. # i � L DATE APPROVED & r�� ° FT, o THE AMOUNT SHOWN UNDER VALUATION IS FOR j THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m ¢ VA�VATION � /� � m PERMIT FEE $ % j /� m g / VDD.� p�,qN CHECK $ / . S D E . /—. ..._ _ `o . LL OWNER 11G ATER PROP. SWR. LINE LJ SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE I1N�ERGROUND � POWER � ROUGH WIRING TRENCHES FORMS STEEL REINF. BOND BEAM U STEEL REINFORCE SHEATHING FRAME AN� FLASHING LATHING - IN � OUT PLASTER. BROWN COAT HP S, VENT., REFRIG. AND A.C., FINAL P .JG, FINAL AND GAS TEST � ELt�iRIC, FINAL BUILDING, FINAL SPECIAL REOUIFEMENTS DATE �_��_ BUILDING PERMIT � of WORK SUBCONTRACTOR . •. _ Z . o- U z za � N am J � J � p] J • f11 J Q U Q Z � aw J p m Z J ¢ W w � _ Z F- W � � � F Z Q U J a a Q � H N Z O F- U � � �"' N Z ` 3b991 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Fo� Applicant to Fill in Completely ADORESS 3i9s ��%_� �rf. OWNER �jQ �� S N U E ADDRESS 31 �'J'"�TJ .�/ CITV Tj�J NOLSS%-6 0 5 FSi`1 CONSTRUGTION LENDEF ' BRANCH �� ADDFiE55 �� � ARCHITECT �� TEL. OR ENGINEER NO. ADORESS — CONTRACTOR �j(/7�J/' ��� ADORESS TEL. CITV ^ NO. STATE � CITV LIC. NO. LIC. NO. SI2E NO.OF BLDGS. OF LOT INOW ON lOT / USE OF �- EXISTING BLDG. � SIZE OF — NO. OF NEW BLDG. ROOMS —' STORIES EXTEflIOR WALL ROOF RMED ii BUIIOING ADDRESS � TRACT� OWNER FIRE ZONE APPROVED vaio � 1IIL 17_-73����,n001458�/A`^*** .50 , / /`r / � �N FOR BUILDING PERMI J DATE RECEIV D pATE ISSUED � 7- �Z- � Z..Z-3 �% R� LN q i LOT � `JI BLOCK NE NO.OF USE OF N W �I PLANS� BUILDING��+.�1�5-� VARDSAPPROVED ( YARDSAPPROVED MAIN BUILDING ACCESSORV BUILDING DISTANCE BET MAIN BLDGi. V AR. # I hereby acknowletlge that I have reatl this epplication antl state that the abova information is correct antl agree to comply with all laws regulating builtlin8 consttuction, and I shell not employ any person in violatiOn of the workman's compensation laws ot the State of California. I hereby certity that I am properly licensed as a contractar untler SQ. FT. the State ot California Business and Professions Cotle, Divisicn 3, THE AMOUNT SH Chap[er 9, antl that such licenses are in full foro �antl eifect, or 1 THE PURPOSE OF am exempi from tlie provisions of the State 4 alif�' ia Business VALUATION and Professions Coc�e, Division 3, Chapter 9 � sta�a<�.�"��/J%Z�i%� � �<p✓'� v t/ / Per tae � $� ( BET. MAIN ACCESS.BL DATE APPROVED ii /• — / T�` m 0 VALUATION IS FOR j A PERMIT FEE ONLY: m ¢ E $ j m K 5�-- E `o ' LL $ � . � � ����� COSTA MESA BUILDING DEPARTMENT P. O. 90X 31 � COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BUILDING 3195 Hait� Circle � ADDRE55 . COSTA MESA. CALIFORNIA OWNER Newport Homes, Inc. MAIL c�Tv Newport Beach ARCHITECT OR ENGINEER ADDRE55 No:� 6-3227 LIG. NO. �"'"� "�"�" CITV LIC. CONTRACTOR NO. ], aooaess NeWpOTt BeaCh• TNo: � � LEanL LOT OESCRIPTION NO. BLOCK TRACT A.P. NO. . S,zE irreg. � z�R; 3 �o. oF BLDGS. O oF �o'r S.rn i ir� n� riow orv �or $ETBACH LINE R'ROM I CENTEfl OF STAEET �[n � SI�EYARD RIGHT "�(p V� LEFT ��ZZ� � • DESCRIPTION OF WORK. NEW � ALTERATION AODITION REPAiR ' MOVING DEMOLiSH BUILDING ��Q NO.OF L SIZE �{���7� ROOMS V STORIES COVERIINGWALL `4tSCC00 COV�ERING �g�{m�O�B. • USE OF NEW dyjelllrj� x BUILDING /� IL1 � i- 1-7 . J - ��"��;;E_:�r;_r� AUG 4 ,1959 � ..,.,- -�.3;- -- -� .. APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY OATE ISSUEO COSTA MESA. CALIFORNIA FIRE 20NE APPROVED BY DATE CORRECTIONS ST4TE THAT TXE ABOVE IS COflRECT /�NO AGREE TO COMPLV WITH PLL CITY OR�ININCES TND $TATE LAWS REGUL�ITING BIIILOING CONSTRUC- T���� VALUATION P RMITU F j - /. � � � �. � a fl � . . � IAUI PERMIT FEE $ � �— PLAN GHECK � / j�— I� TOTAL FEE $ '� �-- VB�i! Z . d U � Z Z Q O v~i am J7 J � Q W ¢] J m J Q U N Za W � aW J Q m Z J Q W w 0 = 2 F- W� � 2 70 �i�� ...__.. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 / Z P ic '71IL 31-73 y5.;002848 ��*�*so.co A ATION FOR BUILDING PERMIT ForApplicant to Fi l in Completely RE ei e sv DATE RECEIVED DATE ISSUED BUILDING �.— �� ADDRESS ^� — PERMIT NO. OWNER A.P. NO. ' BUILDING �� � ' MAIL ADDRESS ADDRESS ' TEL. TRACT LOT BLOCK CITY NO. CONSTRUCTION W ADD ALT R P LENDER BRANCH n OWNER . 'C.,� ADDRESS VALUE ARCHITECT TEL. SE � " NE OR ENGINEER N . FIRE ADDRESS 20NE TVPE GROUP APPROVED CONTRACTOR BV DATE ADDRE55 TEL. �ONE NO.OF USE OF NEW CITV NO. PLANS BUILDING STATE CITV �'ARDSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT qONT FT. FT. USE OF ' EXISTING BLDG. SI FT. FT SI2E OF I k i NO. OF NEWBLDG. ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WOFiK TO BE PERFORME� DISTANCE BET. BET. MAIN & MAIN BLDGS. � ACCESS. BLDGS. � L �/� c"—PI,` VAR.� pATE c r��. .�tifl F.J C.U.P.# ' APPROVED APPROVED I heraby acknowledge that I have read Mis application antl state that the above information is corrett and agree to comply with . all laws regulating builtling construction, antl I shall not employ any person in violation ot ihe workman's compensation laws ot xhe Stare ot Calitornia. �� / � — � I hereby certify ffiat I am properly licensetl as a contractor untler SQ. FT. tha State of Calitornia Business antl Protessions Code, Divisicn 3, THE AMOUNT SH N UNDER VALUATION IS FOR Chapter 9, and that such licenses ate in tull torce and effect, ar I THE PVRPOSE OF ESTABLISHING A PERMIT FEE ONLV: am ezempt from [he provisions oi theState ot Califomia Business VAWATION antl Professions Cocie, Division 3, Chapter 9. PERMIT FEE 5. Signature of , Permittee $ PLAN CHEC� Authoriz¢tl ABent � TOTAL FEE $ •- - i 37053 �-- -� � - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ForApplicant to Fi!l�in Completely � AD'DRENS �I 1� 'CI�iTI ��FIIiL� Gil��r OWNER �/,t� MAIL .4 ADORESS `� CITV BRANCH ADDRESS ARCHITECT TEL. NO. ADDRESS v I S �, (�{� �-r h/JPyV CONTRACTOR ��NT�� ADOFE55 S �(/(/J� TE�. CITV NO. STATE pTV LIC. NO. LIC. NO. SIZE I NO. OF BLDGS. OF LOT NOW ON LOT USEOF (] r�C`���G.� EXISTING B�DG. � TL � �q 512E OF bP�QOT NO.OF yS NFWflLf](:. '1'30Gm ROOMSV STf1RIF'. COVEFING��� t,^L7(N ip I COVEFING 7�� ��� VSE OP BUILDING AND�WORK TO BE PERFORMED � A.P. NO. I � �%' BUILDING � ADDRESS �� PFIO lU! 7_S-73crisr.002510a �•**{�2�.82 FOR BUILDING PERMIT .TERE EIVED DATEISSVED ' 3 �- 30 - PERMIT NO. % /' � LOT BLOCK )NE NO.OF PLAPLS � VAfiDS APPflOVED MAIN BUILDING ROM Gl STFj�ETl VAR. # C.U.P. # � VALUE �ATE �' �Q " IllaL;r�1C [�2'y USE OF NEW BUILDING �9( %(O VARDSAPPROVED ACCESSORV BUIL�ING BET. MAIN & ACCESS. BLD DATE APPflOVED I hereb�'acknowledge that I have read'this a{lplication antl EYate that ihe above intorma[ion is correct antl agree to comply with � r all laws regulatin8 bvilding consVuction,, antl I shall not amploy any .person in violation of the workman's compenution laws of � � -�� ffie State ot Califomia. �D " � " � I hereby certity that I am properly licenutl as a contractor untler SQ. PT. o tha State ot Celifornia Business antl Protessions Cotle, Oivisicn 3, THE AMOUNT SHOWN UNOER VAIUATION IS FOFi Chapter 9, and thac such licenses are in tull torce and effact, or I THE PVRPOSE OF ESTABLISHING A PERMIT FEE ONLV: m em exempt from tt provisions of the St of Calitomia Business � VA�UATION antl Protessions Cr �e D' iei 3, Chapte 9 � � PERMIT FEE $ ] Signature ot � ///���� aw � �% � m Permittee $//• /�j i� PLAN CHECK $ LL E / (/ // `o Authorizetl Agent LL TOTAL FEE $