HomeMy WebLinkAbout2685 PALA MESA CT - Building Permits� .,
Job Address: 2685 PALA MESA CT
Suite:
Viciniry:
Primary Occ: R3
Parce� Number: TPN050002
Applicant: ZUNDEL,CHAP
Address: 2136 CARTWHEEL CI
Owner:
Address
Contrector
Address:
Status: ISSUED
Applied: 09/22/2005
Issued: 09/22/2005
Type of Construction: V-N
Zoning:
Phone: 951-893-7805 ISSUED BY: ���
CORONO Zip: 92880
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PALA MESA COURL.HOA��: '� � `''"�`""�
,u �
PAS CO INC �°` �-•?� ` '�
COSTA MESA;°CA �� �- i � Plione 714-641-D593 ��
H..,w
PO BOX 2968 OR 2953 RANDOLPH> �` ��Zip 92628� � � �; �:
, , . , �.. , �r .
DIVERSIFIED CONSTRUCTION=AND DEVELOPMENT� ' � �*
�, �„ � �.. = n
213fi'CARTWHEELCI � ..
� Phone: 951--893-7805�: ��. „�,.
CORONO . �-�P � `�
92880 �� � . License: 558203 �' � ��
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ACCESSORY
PARKING
Eng:
, ,g Address:
Phone:
?�.e ,
License: ��;,��y _, �+;
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SCOPE OF PERMIT� -
ID REUSE REPLACE WITH SAME TILE ICBO# 2656
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LL 2-30LB'FELT. 2685y2687 AND
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�z � � PLANNING & ZONING ��,� `�+-�,'.
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Front 0 0 �� �`Rear 0�6 . � Lek `� 0 0 ' - Righl � 0 OV
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Front 0 0- ����`��+'�.Rear 0 0 ' �°�� lefl 0 0 '�s� "Right� 0 0'� ��
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7,320:00
7,320.00
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calitornia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period o( 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, end all
required Inspeetiona and final approval must be obtained. Failure to obtain inspections,and final approval will result in the expiratlon of ihis pertnit.
FOR INSPECTIONS CALL: (714) 7545826
2446-46 (fl�W)
WORKERS' COMPENSATION DECLARATION: • ,
I hereby aHirm under Denely of perjury one ot ihe following declarations: �
❑ have entl wlll meinlain e certificete oi wnsent to selt-Insure for workers' compensation, es proNdetl for by section 3700 of the Lebor Coae, for ihe peAormence o1 the
-�work for whiCh lhis parmit is iuuetl.
wlll
n insurance, es requlretl by section 3700 of Ihe Labor Cotle, for ihe perfortnance ot the work for whicli this permit is issuetl.
end policy number are:
Carrier. � /L�✓�J .—. �\� ef: � 0 Z F 3'i C
(Th/s ion ne ot be completetl U the Oerm/t is valued et one hundred dollars ($100) or less.)
.❑ I cenify that in the peAormence of the w or which ihis pertnit is Issued, I shall not employ any person i nar so as to become subject to tha workers'
compensation laws of Calif and r ihat if I ahould become subject to ihe workere' compensatlon pmvisions ot Section 3700 ot ihe Labor Cotle, I shall fotlhwlt�
i e provisi
" ntSignatur Dete: -ni/?Z Os
W INO: F E TO SECURE WOfiK ' CqMPENSFTION COVEMOE IS UNLHWFUL AND SHALL SUBJECT EMPLOVER TO IMI PENALTI AND CIVIL FlNES UP TOONE HUNDFED
DOLLFRE (5100,000), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR II+ DE. F TME LABOR COOE, INTEREST, M!D ATTORNEI"S FEES.
LICENSED C ACTORS DELLARATON:
I hereby Irm e Ilcensad under proNslons ot Chapter 9(commencinq with Section 7000) ot D� � on 3 ot the Busine�s entl�rofessions Code, and my license Is in full
IorcB an et . Cles V3
Contractor igneture� ate: �d �
CONS7RUCTION LENDING AGENCY:
❑ I hereby aHirtn lhat thera is a construction lending agency tor ihe peAortnance of ihe work For which ihis pertnit is issued. (Sec. 3097, Civll Code).
Lenders Neme: _ Lendafs Address: __
Signeture:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby eHlrtn thet under penalry of perjury Ihet I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business end Protessions
Code: Any ciry or counry which requires e pertnit to construct, alter, improve, demolis�, or repeir eny structure, prior ro its issuance, elso.requires the epplicant for such partnit
b tile e slgnatl stetement that he or she Is Iicensetl pursuant to Ne provislons of the Contraqors License Lew (Chapter 9(commencing wflh Section 7000) of Divislon 3 of ihe
Business and Protessions Gode) or ihat he or she is e:empt tharefrom end the basis for 1he allaged exemption. Any violation o1 Section 7031.5 by any epplicant tor e pertnit
sublects the applicant to a civil penalry of not more ihen tive hundred dollars ($500).):
❑ I, es owner of Ihe properry, or my employees with wages as iheir sole compensetion, WILL DO THE WORK, flnd the siructure is not IntenCed or oHeretl tor sele (Sec.
7044, Business antl Professions CoCe: The Coniraclors License Law tloes not apply to an owner of property who builtls or imprwes t�ereon, and who does such work
himsetl or hersetl or Ihrough his or her own employees, provided ihat such improvemenis are not inientletl or oflered for sale. It, however, ihe building or impmvement is
sold within one year of completion, the owner-builder will have the burden of proving that �a or sha did not builtl or improva for purpase ot sale.). '
❑ I, es ov.ner ot the propery, em E%CLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to wnsiruct t�e project (Sec. 7044, Busineu and Professions
Cotle: The contractors License Law does not appty to an owner of properry who builds or improves Ihereon, and who contracts for such project with a contractor(s)
license pursuent to the Contractors License Laws.).
❑ I em e:empt under sec. Busineu an0 Professions Code for this reason:
Signature: Date:
Owner ID verified by drivefs licensa. ❑ Yes ❑ No Drivefs License No.
Vedfication oi Ownership by Qype oi document, i.e. - pmperty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Expires:
❑ I hereby cenity ihat no excavation ilve (5) or mora feet in depih into which e person Is required �o tlescend, will be made in connaction with work authorized by this
pertnit, and Ihai no building structure, scaHolding, telsework, or tlemolition or dismantling Iheraof, will be more than thirty-six (36) faet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Celitomia Administrative Code).
❑ As owner-builder, I will not employ enyone to do work which would requlre a pertnit from the Division ot Intlustnal Safery, as notad ebove, unless such person has e
pertnit to Oo such work trom tha division.
Signawra: Date:
Division ot Induslnal Satery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AIJT}IORIZATON OF EMAY: I certify under penalry ot perjury Ihat I have read this appliwtion and state tha� �he information given is
wrrect. I egree to comply with ell stata laws antl city orOlnances relating 10 building consWction, antl au�honze representatives of ihe Ciry ot Coste Mesa Io enter upon Ihe
ebove-descnbetl property tor inspection purposes. I agree not to occupy or allow occupancy of eny building authorized by this pertnit until final inspection.
LODE �. INSPECTIONTYPE
1616 Fized System Final Fire Prevention
1288 Paol Spe Final
200 Final Re-Root
207 FInaI Block/Retaining Well
202 Final Fectory Fira Place
203 Final Sign
204 Final Demolition .
Q� It1�Ak5
COOE 1 INSPECTION TYPE
206 Final Mechanical
20B Final PlumDing
210 Final Elecirlcal
272 Final Fire Prevention
220 Final Planninq Approval
222 Final Site
250 Final Building/Occupancy
09/22/2005 15:55 71464,,,?g ...
FROM :Cf7Y OF CCtSTA MESFl
PASCO
fNN.� fJLI. � : 714 '7_`-4 :856
bEGLARATION 4F AUTHORITY
FOR AOENT$ OF PRqpERTY OWNER
Td APPLY FOR PERMITS
i'�1 c-`s�4 U2iuc= ft,�.,r} .
PAGE 02
SeP. 22 2L�l�S r2: gaF�9 Pl
Bldg. Pertnit #
rr�s o.rm;� a _________�,._
SheSt Addrlss� �,�� �— .,r2 %�� !?f-��-A M� S�i AP Nvmber:
�;+� /f}5SOG��oT�o.✓ yyl,a��a.n<C-x
1. I(we1. ,�jJ02� < t-�op� ....._... _.__.._v_, deGare that I am the{�rwec-a4-TiYa ot the abova
ratenncetl ro�l pfep�hy. aed thaf 1(we) hereby authorize: '
Neme: .� i �!_25�� D.,..,.� �"s-'T����"�'.�? 7ebphottie NumbBr. g S^� S� S 7�U �
Sheet Addrssa: � / �'�3 (Q_ �W L'r 2_.--�-.--�._�_.
c�N: �'�'e�•.✓A s�ra: _...�t' __ ___.._.._... ._. z+c .... y� k SC3
CUt,k r `J
lu obbin permiM In my behelf, es ownerlbuitder, tor �� �/ ��ff� _%-���iG _,.�-�'"�'.�Z�.�
at me abova referoneed property. —�---��
2. 8hould any Val�on 6ecome an �mploy�s enpaged in the imOrovement o� tMe property. I Iwe) shall immeAiatery provide Worker's
Compensatlon Innurance coveraB� and cause a ceRAicate ol ;hnl coveraqe W be filed witl� the Buildin9 Di�sion ef the City at Costa
Mesa, as repuired by State o1 CaNtomia lawa.
3. M ownerlhullder in Inct, I understend and accept thaf my reeponalbilUies da not lransfa m any other person, campany or
co�wretbn.
4. I a(�ree Io IndemnNy and hold the City o/ Coeta Meea and its employeea pr oHlcere harmleas from any claim resuHinq in damage or
pMson�! in)ury to myssH o� �ny other peniee as a reauh o} work ouihorized by Me permRs hom Ne Ciry of Coala Mesa.
4. 1 detbrE ur.der the penaNy of pe�JUry d+nt the faepolnq Is ttue ano r�nect.
e�mcutea tMa ��`_Zday of Se�l>,�c�e� zo r��, at ��.�q�ye�i.� , C811fornlH.
�; �'hc=.s� Auut- hF�G.R
C3oiar�o Q� /7jn�'ci'utiS
Pr�n� Neme. rl'�� �i(,i2 — Dor�! 5 /.� �,ot-'
_�.--��jr Slgneture: �.cr/Y��... �_�_,
Date: .,__....�...y �i-,'i./i�S'.
�7
rJde�. Tnb e,9}w,izatlon tloes roe gram airt�w'ca9on ro verfam n,e wak ss o�s�er,
it afflely povitle! for IimitEtl D�� ot ettPrl'IeY to sepuR thla AdYn'll� h arry nnttpl(.
o�Ta+e ux�.nmal
�
09I22/2005 15:55 7146a" '59 PASCO PAGE 01
FRfJM :fITY OF i�OSTA MESA
FPX N0. :714 i54 4A56
�5�1. St 73
�7r�P. 22 �CtC�� C�2:13F'f�i P2
� "D" C�OQ� i/G�¢a �44�P.e�Kg' L/UK¢CQaL
owrrER-BUILDER �.�
VERIFiCATtON
Tddreav: � S/ 7(ojO Prrmit Nc
n ciry or counry, whi¢h ia n:yuired W give notite pursuant to Scetion 19y3Q ehall attnch to sucl� notict, and, ns
;i condition precedrnt �o issuin� . huildinq pernut, nquire Ihe complc�ion and require the mtum of, an owner-
builJer verilicmion.
nhention Properiy Owner.
M bwner-bnildei building penmt has been npplied }ur in pour namc a��d be�rjnti ynur siplmttne.
plense ca�lete and retum th�s informacion in tl�e envrinpe prmided at your earliest opportmiity to avoid
t�nnectasary deluy in prnce+.tin�; mid issuia�g your bnilding permit. Np buildinu nexmit w•ill be issued unUl_�h»
� e: ificaliutt is rccei��ud.
1. 1 per,onnlly 1>lan io provide die mnjor labor :�nd tnaterials ftx rnnstn�ction of the proposed
proEx�ty improvrmi+nt. � Yc� � No
2. i(lraver'have notl_._..{��iQ_. ,rJ��Y signed an �pplicetion for a huilAinq pcnnit for
du propose<9 wurk.
3
4.
1 hAve [OnICAGted witlx tl�e following persun (fim71 to provldt tlte ptopnc¢d cunulructinn:
I\'anu.._�r1� fl�.�.e�.,b, r'G�/5"''il4i��'i7.�..1
Addtess .. ��—C'a�2'f'c�l�..di� ..L��. .. ,. (;ily' --��"irl-es.vd
phnne(9�� 4$jj�('Oi`� Contractor'sLic.Na , �S-Q�?tl�
.�-_—_,.... .
I plan to pmvide portions of ihe w�ork, b�d I huve I�ired the followiug perion I�� coordin�lc.
suptrvise nnd provide Ihe major w�ork:
Vame
. .., ._ ...__
Addrevs _ Ciry._._...
_ _... ---
Phnne ( ) _._ lbntrnctor's I.ic. No.
5. I will piovide some nf the wrnk bul I bave couhuted (l!ired) tlm f'ollowiag persons tn
provide the work indicatcJ:
Namc Address Phune Typc of Work
7o4}n6lrnv iswl
CITY OF COSTA MESA
CALIFORNIA 92628-7200 P.O. BO% 1200
DEVELOPMENT SERVICES DEPAR7MENT
September 17, 1990
To:
Building Safety Division
Code Enfurce;�ent
Communications
Copley-Colony of Costa Mesa
County Administration Office
County Clerk/Bd. of Supervisors
County Registrar of Voters
County Tax Assessor
Engineering Division (2)
Fire Administration
Fire Prevention
Manager, MIS
Mesa Consolidated Water Dist.
Newport-Mesa Un. School Dst. (2)
PdC1f1C Bt'.11
Police Dept. - Ping. & Research
Santa Ana Heights Water Company
Sanitary District Engineer
Southern California Edison Co.
Southern California Gas Co.
State Board of Equalization
Street Division
U.S. Post Office - AIS
U.S. Post Office, Adams Avenue
File (2)
The City of Costa Mesa wishes to advise you that the following
addresses have been changed or added:
OI1D ADDRESS
``� � 1161 "A" Mesa Drive
t� °J 3 161 "" Mesa Drive
L161 "C" Mesa Drive
�� 161 " " Mesa Drive
�, 161 '�E" Mesa Drive
NEW ADDRESS
2689 Pala Mesa Court
2687 Pala Mesa Court
2685 Pala Mesa CouYt
2683 Pala Mesa Court
2501 Pala Mesa Cc.:rt
�-} �' 165 Mesa Drive 2682 Pala Mesa Court
I�� b5_Mesa Drive 2684 Pala Mesa Court
165 Mesa Driv-e --�-2686 Pala Mesa Court
��, 165 Mesa Drive '2688 Pala Mesa Court
3 165 Mesa Drive -2690 Pala Mesa Court T
� c�}'�z, �t.�c�,
A.P. NO.
439-221-64
439-221-23
For your convenience we are listing the agencies above that we have
notified of the change. In addition to those listed, you are
advised to notify your correspondents of the change in order to
avoid any possible interruption of mail service.
77 FAIR DRIVE
VR�ianwcc i Imr
U
�
G � 2 �ngS�
�
PALA MESA COURT
2ses
MESA ORIVE
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2690
2sss � �
2686
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l (
2sa2 � �ssa
-- �
AVGlicant to fiil in all spaces excepl t�ose wit�in �eavY �orEer lines antl sign atl approDriate Ceclarations. �1 � '' --
r • • � � �
cirY qF COS7A MESA CONSTRUCTION PERMITq
Project P!drBss I�� ��� A � 2 Q lOC- �� ') a!L(
Applicantk Mailing Address r n N� �' a� �Vqi"� 4�71
Owner'sName wss �eVS1D/�^"`'� Phone SSj'A�a`�0
Address
Arch/Eng. Licenu No.
Address —
Connactor's Name FVRvS O/„3 [r Phone 6��5
Address (maili�g) 1! i wk rr7i�.0 fT Crv,,
City License No. �3 � 2> f�
IICENSED CONTRACTOR DECLARATION
I bereDy afti�ln thdt 1 am licensetl untler provisions of Charte� 9(Comm¢nGipg
wit0 section 7000) ot Division 3 ot the 8usines5 anU Vrofes5ions Cotle, antl
my license iz in f WI force ana effect.
License Clasz 3 License No.
Date y-/ 4;�� Si9nature �Z — q
WORKEFS'COMVENSATION DECLARATION `
I hereby affirm that 1 have a certlficate of consent to ulf-insure or a certificate
' Workerz' Compensation Insurance, or a certi(ietl coDY thereof (5ection
�o. uo. c.tP 9% Y57 r
olicY No. W 8300 /ComPanY I e� �1 0wT
8 Cer�ifietl tPpY is hereby fumishetl.
Certy'�ied cPPY��5�letl wiih [he city Buil D�'v �sioy!
Date�1�lq-P� Applicant ��"Y%
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION
(This section neetl not be <ompletetl if t�e permit is far one �untlrcC (E700) or
less).
I certity that in lhe pe�fo�mdnce o� the work for whith this pe�mR is i55uetl I
snall not em0loy any perzon in any manner so as to become suDject to t{�e
Workers' ComPensation Laws o( California.
Date Sl9nature
NOTICE: If, af[e� making this tl¢Clardtion, You s�0ultl bGCOme Subject to [�¢
Workeri' ComPensa[ion prorisions of t�e la0or Cotle, yau must torthwith
comply wit� suc� provi5ion5 Or this pe�mlt Shall be tleemetl �evokltl.
CONSTRUCT�ON LENDING AGENCV '
I nereby afiirm �hat there is a construction lending agenry for [he performance
of the work for which this permit is �ssuetl (Section 309] Clv. C.)
Lenaer'S Nart�e
lentler's Aaaress
OWNER BUIMDER DECLARATION
I hereby af/irm lhat I am exempt Trom the Contractor's License Law for the
fouowing reason (Sec[ion 7W3.5 Business antl Proiessional Cotle: Any ciry or
munty wbiGh tequi�es a pe�mit to const�uCt, alter, im0/ove, Gemolish o� re0air
any structute, P/io� [o ils issuance, also requi�es l�e applicant for Su<h pe�mit
to file a si9ne4 statement that �e/sne is litensetl pursuant to the provisions of
t�e Contracto�'s License Law (Ghapter 9(commencinq wiM Seclion 7000) ot
Division 3 0� the Busine55 antl Protessions Cotle) or that he/sne is exempt
•herefrom and tne basis for the allegetl exemption. Any violation of 5ection
131.5 Ey aPY applicant (or a permi[ SUDjectS Ihe ap0licant to d civil
�nalty ot not more than five huntlretl tlollars (E500�.
L� I, as own¢r o} tne pro0erty or my ¢mployees with wd9es a5 t�ei� sole
compensation. win ao tne work, antl the structure is not intentletl or of�ereC
for sale (Section 7044, Business antl Protessional Cotle: The ConVactor's
License l2w does not apply to an owner of a property who builtls or imp�oves
t�ereon, antl who tloes such wOrk him5elt/herself or tNougn his or her own
em0loyees, provitled Shal Such improvements a�e not intentletl o� ofteretl for
sale. If, howe�Er, the builtling or improvemenl is soltl wil�in One year Of mm-
pletion, the O�+'ne� will have the Durtlen o/ proving he/s�e tlitl not builtl o� im-
p�Ov! �orthe purpOse otsdle).
❑ I, as owne� 01 the property, am exclusivery wntractin9 with licenzetl com
tractorsto consiruct the project (Section 7044, Business antl Professions Cotle:
The Convattor'S Lic¢nse Law tloe5 nOt aPPty to an owner of property who
builtls or improves Ihereon. antl who ton[racts for suth oroieGts with a con-
tractor(s) hcense pursuant to [ne ConVactor's Licenze Law). I am aware tnat
prooi of thei* woike�'s Compensation insurance shoula be provitletl to me.
❑ I am exempt untler Section 8. 6 P. C. for Ihis reason
Date Owner
1 hereby certi�Y that I have reatl tnis app!ication antl state that tne aoove
intormation is mrrect. I a9ree to como�Y wrth all city antl county ortlinances
antl state IawS r¢lating to builtling conztruction, an0 hereby authoriae rep�e-
xntatives of tnis <�itY-, to nt u on tne above-mentioneA property for
InSDeGtionpwPOjql. / p � y�pp
Signature U� Date /- O 0
Drivers' License or SS �
_ ___ _ _..._.
3s3 s � . � A.P.#
d.- �,
S Main Building:
T E OF CDNSTRUCTION NEW ADD qLTERATION REPAIR E
❑ CONVERSION ❑ OEMOLISH ❑ OTHER T FrOnt
DESCRIPTIONOFWORK/USEOFBLDG. A qear
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL C Right
�y� K
❑ TENANT ❑ ELECTRICAL �o.LYLUMBING ❑ MECHANICAL 5` � Left
❑ o7HER Ping, Ref.;l`-
PRQIECT DESCRIPTION Sq. F7. OCCUPANCV � Planning Notez:
CONSTRUCTION TYPE VALUATION $
ZONE GRADINGCV.�'D5. ACRES
Remarks: .`7.C7 iZ
Sink
Preventer
Irrigation
j Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
3 Gas Servic.e Outlets
Interceptors
3 Kitchen Sink
Z Lavatories
P-Trap
Roof Drains
Reinspectian Fee � §15
Boiler
Dutt- Under Ground
DuCt - StruCtUral
Duct - Ventilating
Exhaust SYstem ❑ Multiple
Firepl/Fact. Blt. ICBO �
Heating System & Ductinq
❑ai oo,000 eru � � oo.000
Reinspection Fee � S15
0865-46, rev. i/88 White - Builtling; �anary - qppiican[; Pink - qccounting; Goltlenrotl - Asse55or
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collector5
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinaf
Water Closet 'R
Water Heater
Water Service
Auto-Wash - (,p`^'
Laundry Trays
Issue Fee
Hoodor Typel ❑
Canopy Type 11 �
ES Automatic Washer
Construction Pole Suh.
Cooking Unit
Dishwasher ;
7 Dryers ❑Gas DElectric
Fan �
� F.A.U.
Fixtures
Device Bozes
Outlets
�.r �^ n Switches
T
Garbage Disposal
t _. Generamr �65 KW �5-1
Hefrigeracion System
❑0.7DO,OOOBTU ❑100,OOOBTU
System Repair(Alteration
Fire Dampers
Registers
Issue Fee
Fee
Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
� SO+KW
Me[er L]up to 100amps
Meter ❑over100amps
Sub Panel
Motors OPt HP �1'/:-8
IncSolar �9-15 HP �16-15+
Microwave
Pole Light
Range
$ign
Standing Sections
Trash Compactor
$15 � � Issue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By
FEES Buildine APProved By �
�� Appliration laued By
$ 3
n
I
h
G
R
E
Q
N
T
S
FEES
S 3
SUMMARV OF FEES
BUILDING PERMIT $ SMIP S
PLAN CHECK $ PERMIT
PLUMBING $ __�—i ISSUANCE S
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
P�AN CHECK 50% $ MICROFILM 5_.�T_
MECHANICAL $ TOTALFEE $ �=_
PLAN CHECK 25% $
I
u
Applicant to fill in all ipaces <xcept tltose wit�in �eavy Cortler lines antl si9n all appro0�iate tleclaratians.
CITYOF COSTA E�A CONSTRUCTION nPERpMIT 3uN;�S P MIT NO. TRACT N0. LOT NO. UNIT N0.
i Projn,ctA�'r¢ss � � ��.i�J'C /Y �J, -.
Applicant's PAailing Address ���! � �! �>f`�Ti�� �� �Q
OwBer's Name Phone
Address
Arch/Eng. License No.
Address
Contractor's Nam�'��� ���%i2i'� Phon�Z� �s��{�.•
iAddresslmailing) �567 �, �T '�+F� i �N�F'��
City Licenu No. 2 �� �Z�
� LICENSED CONTRACTOR DECLARATION
hereby affirm that 1 am IlrenSetl untler provision5 0f Charter 9(Commindng
with zection ]000) ol Division 3 of tne Business antl vrofessions Cotle, anC
my license is in full forcy.pn� �SecL �/ 7
License Class �' v Li
Dale % � � j� � Si9nature t"�9 ' `"
WORKERS' COMPENSATION DECLARATION
I hereoy atfirm that I have a certiticate o1 conunt to self-insure or a certlfitate
Workers' Comp<nsation Insurance, or a certifietl wpY �h¢rlof (SeCtiOn
J0. lnb. CJ
Policy No. Company
eCertitietl copY is hereby turnisbetl.
Certitietl copY is filetl with t�e city Builtling Division.
EXEMPTION FROM WORKERS' COMGENSATION OECIARATION
(ThiS section n¢etl not be completetl if the pe�mit i5 fo� One hunCr<O (E300) o�
iess).
1 c¢rlify [hat in th¢ pertormdnce of Ih¢ wOrk (o/ whlCh thjype�m�t is IsSUW I
shall not emv�oy any person in any manne Eo e 5 D� t to t{�
Workery�Cpp�per�5y(ipn LawS of Cali/ ��
Date }' c73 LX Signatu "��" �
NOTICE: If, atter making this tleclaration, you shoultl become subjett to the
Workers' Compensation provision5 ot the Labor Cotle, you must fort�wilh
comply wilh su[h prOvi5iOn5 .Or t�is p¢rmit s�all Ee Ceemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 nereby aHirm that there is a construction lentling agency tor the pertormantt
of the work tor w�ich this permit is issuetl (Section 309] Civ. C.)
LPntler's Name
Lentler'z AOtlress
OWNER BUILDER DECLARATION
I hereby affirm lhal I am exemD� from tne Contrattor's License Law /or tne
iollowing reason (Section 7031.5 Businezs antl Protessional Cotle: Any clty or
county which requires a p¢/mi[ to con5truct, alter, improve, tl<rTOlish o� �epai�
any structwe, prior to its issuance, also requires the apo���ant for such permit
to lile a signeU statement tlfat ne/she is licensetl pursuant to the provisions oT
the Contractor's License Law (Chapter 9(commencing with Section 7000) of
Division 3 of the Business antl Professions Cotle) or that he/5he is ezemo�
•refrom antl the bazis tor the allegetl exemption. Any violation ot Sectlon
31.5 by any appliwnt tor a permit suDjects the ap0licanl to a civil
G-,nalty of not more than five huntlretl tlollars (E5�0).
LJ I, as owner of the OrOp¢/ty or my em0�0yG¢z with wagl5 a5 their SOIe
compensation, will tlo the work, antl Ihe structure is not intenGetl or offeretl
for sale (Section 7044, Business antl Protessional Cotle: The Contractor's
License Law tloes not applY �o an owner ot a proPerty who builCs or improves
�hereon, antl who tloes such wo�k himself/herz¢H Or thwugh his or ner own
employees, provitletl that such imDrovements are not intendetl or offeretl for
Shce. H, nowever, the ouiltlin9 or improvement is soltl wit�in one year ot com-
pletion, lhe owner will have the burtlen ol proving he/she Uitl not bu�ltl or iT-
prove for the purpose of Sale).
❑ I, as owner of the pro0erty, am exclusively mn[racting with IiCensetl con-
traCto�sto const�uct Ihe 0/oject ($ection 7044, Business and Pro(es5ion5 Cotle:
The Contractor's License Law Doez not appty to an owner o/ pro�erry who
�uiltls or imOroves thereon. and who conVacts for such oroitG[s wrth a con-
iracror(s) Lcense pursuan[ to [ne Convacror's Littnse Law). I am aware that
proof ot their Wo�ke�'s Compensation insuranc¢ Shoultl b¢ provitleG to me.
❑ I am ¢xemOt untler 5¢C[ion B. & P. C. f0� thi5 reason
Date
I her¢by artify thal I
InPormation is correct. I
antl Stdte laws �elating 1
Sentative5 ot this
InsOection pu�
Signature
Drivers' License or 55
Owner _
have r¢atl thi5
a9/ee to comp
aGove
nances
Ddt¢� ~ � s�
/
35 3
TYPE OF CONSTR C
❑ CONVERSION
DE�CRIPTION OF
I � NEW U ADD U ALTERATION LJ REPAIR
DEMOLISH ❑ OT ER
'��C/^USEOFBLDG.�L iT�/C �_
TVPE OF PERMI� LJ GRADING LJ FOUNDATION lJ STRUCTURAL
❑ TENANT ELECTRICAL ❑ PLUM1IBING ❑ MECHANICAL
❑ OTHER
PROJECTDESCRIPTION S�.FT. OCCUPANCV_
CONSTRUCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES__
Remarks: $ � f' 1
J
� l I V�A
P
Bar Sink
. Backilow Preventer
Backflow Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Dreins
Reinspection Fea � $75
Duct- Under Ground
Duct � Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑P700,000 BTU 0100,0008T
Reinspection Fee I E75
Showers
Service Sink
Sewer Cap
Sewer Connectian
$olar Collec[ors
Solar PiO�ng
Solar Tank �
$wimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service
Auto-lVash
laue Fee
Hood or Type I �
Canopy Type II ❑
Refrigeration System
❑a�oo,000sru ❑100,OOOBTU
System Repair/AI[eration
Pire Dampers
Registers
Iswe ee
A.P. #
S Main Builtli
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
FEES Automatic Washer
Construction Pole Sub.
Cooking Unit �
Dishwasher
jDryers ❑Gas Electric
Fan
F.A,U.
/ Fiztures
� / Device Boxes
2one
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
'j Meter ❑up to 100 amps
Mecer ❑over 100 amps
Garhage Dispoul
Generator OP5 KW 05�15 KW
Sub Panel
Mo[ors O0.1 HP �i'f. - B
InaSolar 09�15 HP �16�15�
Microwave
Pole Light
Range
Sign
Standing Sxtions
Trash Compactor
Fee �$15 � � Issue Fee
FEES
E3
S 3 DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
FEES Building Approved By Date�—�y�
Application laued By Date�[��
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ J�?� GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ ��
PLAN CHECK 25% $
s� 44�Ko.o3 . _.. ._ .._. �. ..' -._.
`�
r��-� � 9
ADD�leant to Iili in all soaces exeeot lhose witnin neavy bortler lines anG si9n all appropriale tleclarations.
ION PERM PERMIT NO. TRACT NO. LOT NO. UNIT N0. AP #
, �.1 f.3 3524-� 3�L-� a4 4�
-' � S Main Build�ng:
,�zM3ilingAddres5 �(.f TYPEOFCONSTRUCTION MEW ADD ALTERATION RE AIR E �
❑ CONVERSION ❑ DEMOLISH ❑ OTHER �� T Ffon� ,
„er'sNas � Phone.�i�p DESCRIPTIONOFWORK/USEOFBLDG. � A Rear �
nddress
o . C Fi9h[ i
ApEh/Eng. icen5e No ��7� 7Y�E OF PERMIT GRADING FOUNDATION STRUCTURAL
�s K
Addre55 T� � ❑ TENANT ❑ EIECTRIC l.❑ P UMBIN ❑ MECIjANI AL ' g L¢ft r.
Cqntractor's Nam Phone ❑ O7MER U�d Ping. Ref. #
PRWECT DE IPTION SQ. F, ocCuaA
Addreu Imailing) � . Planning Notes: ,
J City License No. -
LICENSEO CONTRACTOR DECLARATION
1 neie�y afiirm lhat 1 am 1ice�isetl unCer proviiions of Chaite� 9(<oTmOnCfng
1 wiib section 7000) ot Dlvision 3 0/ the Business antl Pro(essloni Code, antl
my license is in tull /orGe antl etfect. '
License Class License No.
Date Signature
WORKERS' COMPENSATION DECLARATION
hereby a(firm Ihat t �ave a terWiwte o} conzent to selbinsure or a certlfiote
= Workeri' ComDensation Iniurance, or a certitietl coOY thareof (Sectlon
00, LaD. CJ - ' -
PoIicY No. ' '� Company
eCertitietl coOY Ii �ereEy (umishe4 . �
Cevtifietl copy Iz filetl with t�e cily ButltlinB Division: .
Date AOP�1Wnf"
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(T�is section neetl no[ De tomD�atetl ii t�e Dermit is for one buntlroE (S300J or
less)
� I certi}y [hat in t�e peffOrmdnce Of,lhe Wo�k tOr whiU IhiS Pe� � i5 (SSU@ I
zhall not'emolov anv oerson in anv manner so as to become ubjatt Iq e
�
'1 �
ol
NOi1GE: IY, attef rtiaking tNs ECCIarStlon, You s�OWU become suoject to t�e
Worke�s' Compensatinn pro.v�'sbni of [he Labor CoOe, you must fort�wittl
co�/nply with such OrovlsiotK or t�is Oermit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV �
I herebY afflrm thal theYe IS d Cons[ruGtlon lentling agency /or the perf0/mdnte
of Ih¢ work tor which -Mis permit I5 issuetl (Section 3097 Civ. C.)
tentler's Name
l.entler's AtlCrefs
OWNER BVILOER DECLARA710N
1 �er¢Dy alfirT thdt I dm exemPt hom t�< COntractor'S Ucense Law for the
toNowing reason (Settlan 7031.5 Bu:iness aaG Professiaoal CoOe: Any tlty oi
County whith �equirei d plfMft lo ConStNct, alter, improve, tlemOli50 0� mpdi
anv struc[ure. o��ar to �ts izsuanca, a�so requires the applicant for su[h perml'
-Oivisian 3 nt t�e Businesi anG ✓�o�essions coae) or mat ne/sne is axemv�
neretrom antl the basis iqt. t�e allegeE ¢xemption. Any violation ot Sectlon
G031.5 by any appliW^t 40r i Oarmlt suDjeclS t�e aDO�itant to d CIVII
�enalty o/ not more [ha� fiva �untlretl tlollars (E500).
I, ai ownar oi iha Oroperty or my em0�oyees with wagez as ��elr sole
comDe�satlon, will Co t�e vrork, anG t�a :tmcture ii �ol iatentlea OnottereG
/or sa�e (Sectlon 7044, Businau antl Profeszional Cotle: The Contractor'i
License law tloes not aPPly to an owner ot a property wno builtls or improws
tnereo�, antl who Goes fuc� wO�k Nms¢Ii/hlrself or throu9h hi5 O/ �er own
employees, p�oviCGtl t�at such Improvamen[5 are nol intentl2tl or offe�l0 for
sa�e. 1(, however, Ue Oullding or fmprovement is soltl within oae yea� of com-
pletio0, Ih! ownar will hav! lll! Du�tlen OI proving M1e/sM1e tlitl not builE o� im-
�ve �or t�e purpOSe of Sale).
I, as owner oi lha p�oparty, em excluslvely contracting with licensed Wn-
t�attolst0 COnit�uct thC pro�ect f5eclion 70G4, Business antl ProleSsionS CoOe:
The Cont*actoi's License lew dnes nol apply to an owner ot property w�o
Euiltls or Imorores Mereon. an0 w�o contracts for such oroiect5 with a con-
tractor(s1 Lanse Pursuam m tM ConVactor�s License Law). I am a�'are t�at
proof O( lhei� Worker's COmpe�faUon insurance shoultl be proviCetl t0 me.
❑ 1 am exempt unGar Sectlon B. 6 P, C. for tbis reason
Oate Y Ownar �
I hereby c ti/y at 1 Dav� reM thls �PClication antl sta[e tbat the abom•
Intormation is correct �_+9r�_t0 <omO�Y "/��h all city antl countv ofEindnCBS
InSpeCtiOn Dur0om5.
Signa W �e
Drlvers' Llcenu or SS
na6536. rev. 5/BB
CONSTRUGTIONTVP�—w! VALUATI
ZONE GRADINGCV.VDS.
Remarks: p(' � Z4'7 _ gQ, i.LJe e
Sink
Preventer
Irrigation
Floor Dreins
FlourSinks� � -
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trep
Roof Droins
R�inspection Fn 515
Boiler
Duct - Under Ground
DuGt - $trUCturel
Duct - Ventileting
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt iC80 �
Heatinp System & Ducting
❑ P700.000 BTU O 100.000 BT
Date�1��
¢ �. ] � ,� � painsp�etion Fw
Whlte • Bulltlin9: Gnary . qooi���..�. n�..4 _ wccountin9: GolOanrotl • Assassor
S76
Showers
Service Sink
Sewer Cap
Sewer Connection �'
Solar Collectors
Solac Piping '
Solar Tank
Swimming Pool w/Spa �
Urinal
Water Cbset
Water Heater /
Water Service
Auto�Wash
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
�a�oo,000aTu ❑�oo,
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES Automatic Washer
CAnstruction POIe Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fi#ures
Device Boxes
OuUets
Slvitche5
Garbage Dispoul
Generator �65 KW
Building:
Parking Req./Provided
�
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps �
Sub Panel
Motors �P 1 HP � 1 Yh - 8
Inc. Solar '�]9-15 HP �76-15+
Mitrowave _
Pole Light
15KW
Reinsyectio� Fee ' $t5
s 3 DEVELOPMENTSERVICESR �I
Zoning Approved By�
FEES BuildingApprovedBy
Sign
Stantling $ections �
Trash Compactor
Isue Fee
N
I
N
G
R
E
Q
M
T
S.
FEES
$ 3
8-(�
_l7 3-SA�
� SUMMARY OF FEES �j
BUILDINGPERMIT $ �2�0�•'JJ SMIP $ I %•SZ
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE e �
PLAN CHECK 25% 5 ENERG�'
ELECTRICAL $ ��
PLAN CHECK 50% $
MECHANICAL $ _
PLAN CHECK 25% ' _ __
S3� � �
. , ' " _';i"� . ..
4
�
2��� ,' `�^,JAppli[ant to lill in all ipaces exceDt t�ose wit�in heavY �or0er linei anC si9n an avorovriale aeclarations.
� I I �
CITV Or COSTA MESA CONSTRUCTION PERMI
ProjectAddress ��� �'eSG.�T ��a�� ,
Ap�licant's Mailing Address ��%� �� L�1'�� �r� G:'Cj r
Owrier't Name �Ai.�.� �Ev �Cv m en� Phone
�, Address �� ��G -o. � � �Ct� �f v .
I Arch/Eng.�Qa�`4`�"'d�iSt� LicenseNo. C\13.�3
Address � 3 3 �N `�
Contractor's Nama ���'���r��'��L PhOne 1" Ooi�
' Addressfmatltngl ��b`�' L-11'1[-6`n ��'4v�c���Cq �,..1.��
City License No. �"� Y'�
LICEfJSED CONTRACTOR DECLARATION
I nereoy atfirm tnaf f am lic¢nsetl untle� provi5ions Of Cbart¢r 9(commencing
with section �000) of Divizlon 3 O( [he Bu5ine55 antl 7rot¢ssions Coae, antl
my licenze is in ull force antl e/fect. ' `
Liceni¢ Ia55 � L EqSeNo."���AL�
Date��._ $i9ndture
ORKERS'COMPENSATION DECLARATION
'•eDy afiirm tnal I have a certificate of con5¢nt to seli-insure or a certificate
orkers' Cornpen5a[ion Insurance, or a certifietl copY t�ereot (Seclion
. J. �, Lab.
PolicY No. ��V'a3��50G�'£�'�omaa�r'�C����'<n\Gi Z�1S
erti�ietl covY is hereby turnisnea.
Certi ietl copY i5 filed with the c' y ilUi i is ��
Date 1 ?. qpolican �
EXEMPTION FROM WORKERS` COMPENSATION DECLARATION
(T�is section neetl not be completetl if the permit is for one �untlretl (E100) or
less).
I certi/y that in the Oeriormance ot the work for whicM1 this perm�t Is itsuetl, I
snall n0l employ any per5on in any manner so aS t0 be<ome Subject to tne
Workers' Compensation l.aws of California.
�ate Signature
NOTICE: If, aft¢r making this tletlaration, you ShOUItl become TubjEtt to thB
Workers' CompenSaHon prov(sfons of the Ldbor Cotle, you muzt (orthwith
tomply witM1 Suc� proViSiOns or tM1is p¢�mit Shall be tleem¢tl rlvoked.
CONSTRUCTION LENDING AGENCV
I hereby aHirm that there is a consVuction lentlin9 agency for the pertormance
oi the work tOr whiGh tnis permit is issuetl (5ectiOn 3097 Civ. C.)
Ixntler•s Name
iLentlet's Atltlress
OWNEq BUILDER DECLARATION
I hereby aHirm lhat I am eaempt (rom the Gontractor's license Law for tne
' foliowin9 reason (Section 7031.5 Busine5s antl Professional Coae: Any city or
' county w�ich �equires a pe�mit to conStrUct, alter, improve, tlemolish o� �epdir
I any structure, prior to itz issuance, also requires [he applicant ior sucn permit
to tile a signea statEment tnat he/she Is IicenS¢tl Du�sudnt to [ne provisionz of
tbe Coobactor's License Law (GhaDter 9(commencing with Sectlon 7000) of
^'•�ision 3 of ihe Business antl Professionz Cotle) or Mat ne/she is exempt
'ef�om antl th¢ ba5is for tne dlleg¢tl ¢x¢mpti0n. Any violation ot $ection
� 4.5 by any applitant fo� a Permit Subjecl5 lhe applicant l0 a civil
�enalty of not more than five nuntlretl tlollars (E500).
1, as owner of the oroperty or my emo�aYees with wages as iheir sole
wmpensation, will do the work, antl the structure is not intentleE or offeretl
I for sale (Section 7044, Business antl Profe55ional Cotle: The Contraclor's
� Li<ense Law tlOes nol appty to an Owner Of a property who builtls or imPrOves
thereon, antl who tloes sucn work himself/herre�f or tnrough his or ner own
employees, Provrtletl that such imp�oveTents a�e nof inte0tletl o/ otteretl fm
' sale. It, nowever, the builtlin9 or improvement is soltl wiihin one Year ot com-
Ipletion, the owner will have thC burtlen of proving he/sM1e tlitl not Duiltl or im-
nrove tor lne ourpose ot sale).
❑ I, ds own¢r o/ Ihe proPerty, am ez[IUsively conlracting with licensetl com
i iractors to construci tne project (Section 7044. Business antl Professions Gotle:
The ConVactor's License Law tloes not appry to an owner of ProPerty who
builtls or improves Ihereon. antl who mntracts for wch oroiects with a��n-
tractor(s1 license Oursuant to ine ConVactor•s License Law). I am aware ihat
prooi o1 llteir Worker's Compensation in5urance shoultl be p�ovitlea to me.
❑ I am exemot untler Section B. & P. C. for this reason
Date Owner
I hereby certify that 1 nave rea0 tnis aDP���ation antl state tnat tne aDove
inlormation is correcL I agree to comDly with all city antl county ortlinances
dntl state laws relating t0 iltlin9 construction, antl hereby authOrize repre�
sentatives o nis <' er upon tne above-mentionetl Orop erty fpr
inspection u z. � � \�, $
Signature �,_ � D t 1J.Y??C6
Drivers' l.icense or 55 qF �
�E OF CONSTRUCTION LKNEW U ADD LJ ALTERATION U REPAI R
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. ����'
TVPE OF PERMIT LI GRADING LJ FOUNDATIOyN�LI STRUGTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 11MECHANICAL
❑ OTHER
PR0.IECT DESCRIPTION SO. F7. OCCuvaNcv
C O N ST RUGTION TV VE V ALUATI ON $
ZONE GRADINGCU.YDS. ACRES
Remarks: � 'jr 1ui�
Backtlow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Kitchen Sink �
Lavatories
?—Trap
Roof Drains
Reinspaction Fee $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
f irepVFact. Blt. iC60 �k
Heating System & Ducting �
Q�100,000 BTU 0100,000 BT
Reinspection Fee � 515
. _ .. _ '_ ""_"__'. ..._�, _ e��..��„uo�. r �no�.nn . nawsaor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/$pa
Urinal
Warer Closet
Warer Heater
Water Service
Aum�Wash
laue Fee
Hood or Type I ❑
Canopy Type 11 ❑
RefrigeraLon System
❑0-100,000 BTU ❑100,000 BTU
System Repair/Alteration
Flre Dampers
�ssue Fee
A.P. �
S Main Builtli
E
T Front
B Rear
A
C Right
K
g left
Ping. Fef. #
Planning Notes:
Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixiures
Device Boxes
Outlets
Switches
Garbage Disposal
Generaror �P5 KW 05�15
zo�e
Accessory Building'.
Parking
ELECTRICAL
Transformer ❑ 75-SOKW
❑50+KW
Meter ❑up Lo 100 amps
Meter ❑over 100 amps
Sub Panel
M rs�0.1HP�7%-8
Inc.Solar �9-15 HP �i6-15+
Microwave
Pole Light
Sign
Standing Sections
Trash COmpacmr
Reinspection Fee �$15 � � luue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Zonin9 APA�oved BY—
FEES Building Approved By
��' Apuliration Issued Bv
ISUMMARY OF
BUILDINGPERMIT 5 �
PLAN CHECK $
PLUMBING S
PLAN CHECK 25% S
ELECTRICAL S
PLAN CHECK 50% S �'�e..�� �nnn
MECHANICAI S �
PLAN CHECK 25% $
IZ
O
N
1
N
G
H
E
�
M
T
S.
FEES
$ 3
SMIP $
PERMIT
ISSUANCE $
ENERGY P.C. $
GRADING $
MICFiOFILM $
TOTAL FEE $ _�i[�
" �
.�
ir
Ci7Y OF cpS7n MESA CONSTR{JCTI N PERMIT
' I G� M�s �
Project Addcess
ApplicanYs Mailing Address "
Owner's Name -S Phonrg�-A6'S
Address
�
Applicant (p fjll In all spaces eacept thase within heavY bortler Ilnes antl sign all appropriale Eeclaralion
PERMIT NO. r- � � TRACT NO. � LOT NO. UNI7 NO.
TYPE OF CONSTRUCTION LI NEW' U ADD LI ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WOFK/USE OF BLDG.
Arch/Eng. LicenSe No TVPE OF PERMIT IJ GRADING LI FOUNOATIOrv Ll STRUCTURAL
Addr¢ss � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
Contractor's Name RS%�"fd�� Pho S 3
.g°9n ❑ -OTHER
Address Imailing) �A= -'-�-� PROJECT DESCRIPTION SGi. FT. OCCUPANCv—
, /S3 �_� CONSTRUCTION TVPE VALUATION 5
Ciry License No. �F ZONE GRADING CU.YDS. ACRES—
LICENSED CONTRACTOR DEGLARATION '
1 hereby atfirm that I am licensetl untler provisions of Charter 9(commencim
with settion ]000) of Division 3 of tne Business antl Profes5iOn5 Cotl¢, anc
my license is in tull for antl etfect. � �Z
License Class i� psa-.
`ate - Si9nature
DRKERS'COMPENSATION DECLA
nereby atfirm that I have a certificat o consent to selM1i ure or a certificat[
ot Workers' Compensa[ion Insuranc or a certi(ietl c py thereo� (Sectior
3800, Lab. C. /�' �/
�icY No. ��% , ��Z-�1Sr ��Wa' � �i�.f-a.f.�
}�Certifietl�mpy is hereby furnisheq(�;uu�/ 1/i A
�LJ Zertrfietl copv isfNetl with the citv ilise�i6i��� // �l�
"(TM1lssec[lon ne¢tl no[ be complete the pefmit is lor One 7$(Iptl ($100) or
less).
I certify Iha[ in Ihe perfo�manG the wo�k }o� which t 5 perm�t is ISsuetl, I
shall noc employ any person i ny manner so as to come subject to the
Workers' Compensation Ldws o Califomia. '
Date $ignature
NOTICE: If, after making this tletlaration, you shoultl become subject to the
Workers' Compensation provisions o� the Labor Cotle, you must forthwi[h
comply .with such provisions or thi5 permit Shall be tleemetl �evoketl.
CONSTRUCTION IENDING'AGENCV
I hereby affirm Ihat there is a wnstruction lending agency tor the oerformance
Of th¢ work tor which this permit i5 issuetl (Sectlon 309] Civ. C.)
Lenaer's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION
I hereDy affirm Lhat I am exempt from the Contractor's License Law for the
following r¢asOn ($ectlon ]031.5 BuSiness antl P�o(e55ional Cotle: Any city or
county which �equiras a pe�mit to const�uct, alter, improve, tlemolish o� �epai�
any siructure, prior to it5 i55uance, al5o requires the applicant for Suth perml[
i file a si9netl statemenithat he/she isJicensetl pursuant to the prOvisions oi
ie Contractor's License iaw (Chapter 9(commencing with Section 7000) of
�ivision 3 Of the Business antl ProfE55ion5 Cotl¢) o� that h¢/she is exempt
tnere(rom antl ihe basis for the allegetl ezemption. Any violatlon oi Section �
7031.5 by any applicant for a permi[ subjects.the applicant to a civil �
�enalty oi not more than five huntlretl tlollars ($SOOj: ' '
LJ I, as owner of ine property or my employees with wages as their sole
comoensation, will tlo tne work, antl the structure is not intentletl or of�eretl
lor sale (Section 7044, Business.antl Protessional Cotle: The Contractor's
License Law tloes no[ apply�to an owner o( a property who builtls or improves,
thereon, antl who tloes such wo�k himself/he�selt o� th�ough his or he� own'
employees, provitletl Ihal SUCh Improv¢ments are not inteptletl o� offeretl tor
sale. If, however, the builaing or improvement is soltl withln one year o� com-
pletioq the owner will have [he bu�tlen of provin9 he/she tlitl not builtl o� im-
prove forthe purpose of sale).
❑ I, as owner o/ the pro0erty, am exclusivety contractinq with licens¢tl con-
tractorsto constru<t [he O�o�ect (Section ]044, Business antl Professions Cotle:
The Contractor's License l.aw doe5 not apply to an owner ot proper[y who
builtls or improvei thereon, antl who cont�act5 for Such oroiects with a con-
tractor�s Lcense pursvan[ W rne ContractoPs l_icense Law). 1 am aware thax
p�oo( o their Worker'S Compensation insuran<e shoultl be provltletl to me.
❑ I am ezempt untler SecHon--�`�. & P. C. for this reason
Oate
Owner —(�
have reatl this
j( Signature /� V�vv
X Drivers' Lic ns or 55 �f _
0865-46, rev. 5/BB White - Bui
oate/'l3`
Remarks: �
Bar Sink
Backflow Preventer
Backflow Irrigation��i
Bathtubs
Clarifiers
Dishuvasher' .
Drinking Fountains�
oi,.... n.�:..� -
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
FirepVFacc BIL ICBO �k�s
Heating System & Ducting
❑0-100,000 BTU 0100,000
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank �
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service '
� A uto-W ash
Laundry Tra'ys
laue Fee
Hood or Typel ❑
CanOpy Typell ❑
Refrigeration System
❑o-ioo,000aTu ❑ioo,oao
❑ Sysfem Repair/Alteretion
9 Fire Dampers
Registers •
Reinspection Fee � $ib � � laue Fee
: Canary - Appllcant Pink - Accoun[inq; Goltlenrotl - A55essor
$ 3
FEES
A.P. #
S Main Building:
E
T Front
B Rear
A
C Ri9ht
K Left
S
Ping. Ref. #
Planning Notes:
Accessory Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transtormer ❑ 15-50 KW
Canstruction Pole Sub. � 50 + KW
Cooking Unit '
Dishwasher' �
Dryers ❑Gas ❑Electric
Fan •
F.A.U.
Fixtu�es.� .'
Device Boxes
Ou[lets '
Switche5
Garbage Disposal
Generator �65 KW 05�15 KW
2one
Meter LJup [0 100 amps
Meter �over100amps
Sub Panel
Motors OO-1 HP O1'F. - 8
Inc.Solar �9-75 HP �16-15+'
Microwave
Pole Light
Range
Si9n
Standing Sections
Trash Compactor
� Reinspection Fee �$15 � � luue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zaning Approved 8y
Building Approved 6y '
Appliration Issued By
FEES
$ 3
SUMMARY OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ �PERMIT , �
PLUMBING $ ISSUANCE $
PIAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADWG $
PLAN CHECK 50°.6 $ MICROFILM $
MECHANICAL ' $ �3•J v � TOTALFEE $ �3•SO
PLAN CHECK 25% $ �
N
1
N
G
R
E
�
M
T
S.
al OOp24358-Q�02435E TE�T I3.5J
DATE: 01/ib/89 TIME: i1:46 ,
�
` CONSTRUCTION AND PLANNING � � - & SPA
�APPROVALS Permit# Date Inspector AppROVALS Permit# Date I�spector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
r .
' 2. Soil PiPe-Undrgrnd. � � 53. Steel Reinforcement � j
1 �3..,Electrical Conduit U[ility-Undrgmd.. .. 54. Forms ''
�
� 4. ,Electrical Conduit-Undrgrnd. � , 55. Electrical Bonding -
5. Steel Rei'nforcement ,�� . 56. Rough Plumbing & Pressure Test -.
z6. Elec$ical UFER.Grnd: ^ ��- 57. APPROVAL TO COVER-GUNITE
i i
.=Z:� Footings • � �" � " � ? � 58. Electrical ConduibUndrgrnd. �F'� 'i ,
8;.�oiindation -' �: � � ".�,. 59. Gas Aipe, O Undrgrnd., Test , .
.�
i9.' Water Pipe-Undrgrnd. '� ; � � � 60. Backwash Lines, P-Trap, O Undrgrnd. �� .
�v � �
10. Structural Floor System f' ��� 61. APPROVAL TO DECK _ �
11. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final �
i� i :
12. Sewer Capl " �.�. ' 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
1�6: 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. Duc[s, in Structure %� � � ' 70. Underground Hydro �
.n
22.' Ducts, Ventilating '�� 71. Product Piping OGas ❑Oil ',�
23. Gas Pipe-Rough & Test � 72. Underground Flush f�
24. Roof Framing ^ 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathin . �
9 �! 74. Oyerhead 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. lnsulation 78. FfRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED '
�� .�
33. Final Electric Notes: ��� �
34. Final Heating & Air Conditioning - �
35. Final Gas Pipe-Test ,
36. Hood or Canopy �
37. Final Factory Fireplace � �
1 38. Final Plumbing ._
39. Water Service-Final
40. Gas Service-Final •
41. Solar pomestic-Final
42. Backflow Preventer ' ''
I43. Backflow Irrigation �•�
� 44. �Landscape Irrigation System � �
� 45. Sound Attenuation �
�46. Handicap Regulations .
`47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
19. Elec[rie Release to Edison •
i0. Gas Release to Southern Catifornia Gas Co . ' `
�I1. CERTIFICATE OF OCCUPANCY
Date
� �.
�
�u
I
�
DPI
OFBNLpNG: 2fjSS PALA MESA CT
AEIFIWMRF. WEATHERHEAD, LEE D. TR
"°OPE� 2685 PALA MESA CT
COSTA MESA,CA 92627
wuwic woxess
AXCHRECT ON FIMiNFEq:
fx
u�cx on e+x+.�s woncss:
uc. ra.:
°M° Q� CITY OF COSTA MESA — BUILDING PERMIT
� 3 o�R,c�
2� PERMIT NO: P 083920 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
JOB DESCRIPTION ; DISHWASHER CHANGE OUT
uxT:
/ ��"�"^CT01'SN""� NOCK PLUMBING ( 714 ) 895-1246
nc
ca+m�cronsw,uuxo 1161Z KNOTT ST
�^"�� GARDEN GROVE CA �G� 707775
92841 �NT 17
LICENSED COHfPACTONS OECLAflRTON: I hereby eflim u�Mer per�eYy d pajury tM� I em 4cereetl uMu prwiewu W Cheqer 9
(mmmendrq wnM1 6ection 1000) m prviaon � d Ihe Budnaea enE Profeasions Code, eM my lioenm u in tull lace ud eHaq.
P'fi�"o OS0386 ��c.cuss: C-36 uc.No.: �07775 „ EXP: 02/98
�'yEN BUILDEP DECLAPAiION: I he�aby dfi'm uMer penely d perj�ry thel I em uamq tmm Ihe Canlredaa Licenae Lew la ihe �i
"MbwmB reewn lSeeion )03�.5 Busiresa eM Prdassions Code: RnY uY a mun1Y xfiitli nQuirea a V�n �o oonaleuel. eXx. imMwa.
imWsh, or repei any sVunun, qia lo ila saue�we, ebo reQuiren the epplirant Irn euch pamil b file e eg�wE eletemenl Mel M a ehe �
. limnaed pureuent to tM qw�iore d Ihe Caniredon Lioanu Law jChaqm 91�mene�q vrith Setlion )000) d pweqn J d ihe
Buairea eM Prdmsiom CaAal a ihet he a ehe is aremq thselewn eM ihe baw /a Ne dbged uemqion. MY vidmnn d Seaian
�mi s M enr enoi��� �or e o«mu wbjxv me aoWicem io e �vii oanelN d na m«o �hen r«e nurM�od ed4n [350oU.
� I.avowrerd�haPmDenYormYemPbV�ewilhwe9esasiMieoleromPemetion.vrilldoHrexwlt.mMiMelnwWne�wliMeiMaE
. ordlaredfaselel��]OII.BimroaeMPMesaionaCode:ThaCanlretlasLicenfelewEoeenotepplyloenownerdpopeny
who WiEs a inprwes thereon. eM Ma doea such wik IvmaeM or Mnatl w throuph he or her oxn emplvyeee, piovideE ihet auc�
imOrovemame ere nol inieMed a oilma� la aele. tt, however, tM Wikieq a inpwemem w edd wnhin wp yaar d eompletion, IM
owmrbuilder hill heve tM biiden d poviiq M a sha Eid nd build «imqove la IM WN^ee d aele).
� I. a� ovmer d the pWaN. em utluervdY mntreaiq xnh lioensad wnVeclas lo canebutl ihe V�I� (SeUion 101�. Bus'u�m� e�M
Groleseiona Code: TM Contrafon Licenae Lew daae nw epply �o en owiwr d qopeM ��iks a impwea Iheiawi end xla
comrecb br wM prqeds v.i�h e oonlratlor�a) IicenxE pursuent to tM Convmon livnea lewl.
� I am axamq uM« S«iion: B. 8 P.C., tor Uua �mson:
Deta�. 6Nnec
I do Mreby cerliry tIW I am aware d ud uMeratend tha requiremanb d Geliomie Heellh enE Seley CoEe SeUbm Y5505, 255�3, erd
2553e, end ihm I a e�ry Mura Wikiip ocapenl will / wil rw� (dreb me� rieeA �o cwnply w�h eeN mla mdee eM tM repuiremrm tor
ePermillawvvirtionamodifrationhantMAi�y eiu9amaniDimna.RmkeMieloonetrudionWN�iomueexemqhomlheae
a����,a.
Dele: � /DW��
WONKEfl'S COMPENSATION DECIAli�T10N: I heraby elfirm under pmdiy d perjury arw d ihs blloxi�p de�lere�ione:
� I hew arM vril meimen e cMGkate d m�ueni to aellinwn M xorken'rnnpenWbn. m w�� 1« by Sed"an �]00 d IM lebor
coea. �« ma oeno�oa w ub .� i�.n��n m�. va�u �. �a�,a.
QI heva eM witl mamen wMart mmpenseiion inaureewe. u rx�uirad by Sepim 3]00 d ihe Lebor Code. br �ha pe�lamerae M tM
wwk la whid� ihie peimn o iseued. My wvMen' cwnpenxtion inwrarica mrt'w ud pdiry numbar ve:
c�.: GOLDEN EAGL+py.� EXPIRES
PdiryNumber: NWf' �ii � i d�7 09 /O1 /97
(TM1(a mcfion rreeC nd be canplereEY tM pemiR is la are hvnEred ddlae /$�DJJ a bseJ
� I cMAy Nei in ihe pMormeire d the xroM fa whbh I�is pa�mn ia iasued, I ehdl eny pa�aon in eny manmr n m to
bawme subjo/� io tM xprkm' cwnpenaetun lexs ol Cd' eprae tlel�k bettvne aEp�f to iM xvrken'
��w �arr�wuuirep s«abn aloo d �na letor .nel� on � n mmW .mn � o�ovieime. �
We InO� Fsllun ro ixun woMen'rompxuetlon rownPo �� unlarNl, entlWll ub/�c! en w�nplyw to ufMiu/�I�ssd�
I flnu �q ro wro huidnd thouuM tlell�n /JIOQPOOA M eAlltlon b M� ewt ol eomp.wNOR demeW uVrovMM br In
Sxtlon 9)OS of Ms LMorCoM, Inten�S and aflomsyl les1.
CONSTAUCiION LENDINO �OENCY: I hereby eifiim uMer perol�y d perlNrY �� Ihen u e connrvdion bMi�q epaM.y tor tM
peAwmence W �he wwk fw whlM �hu %im1 in ee�wd (Sad'on 308J. CiN. CI.
LENDEF'S NAME:
LENOEH'S A�DHE55:
I ceniy ihet I heve reeE �hia ep0lcelian eM eteb Ihe� iha ebwa inl«metion ia cviad. I epree to comply xilh M dry aM camry oNinenoee
eM sima kxs rale�iq m buiM'vq canatruqion erd hereby euthonze repreaenletives d �hu dryw amer upon iM ebwe�mantioned vmpeny
lorirupeeion purposea. �
(5151d8.WP) Whilo-Buildinp
oma: �rD
Fnk-Reven�e: Oddm�o�A+aeeeor
PERM NO; P 08392
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS; NO OTHER WORK ASSOCIATED WITH THIS PERMIT
�**��****�*x**��r*x��r��r*�e�r�e**rr**x*�r�r*�e*�+r�r*+r******�r**�r�*�r***�r+r�r�r�c***�c���*���***
Z O N I N G R E Q U I R E M E N T S
S E? H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IA1
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 93794079 ZNE: REF NO:
PLANNING NOTES> ,�w
� r /
M M i! iF if if it if M M if if ik M iflF if if iF M i! ik if iF K!F iF if �lf %k if if iF if if iE iF iF iE ik �F iE if iE iFiF M M iF if M il iF iF �1E 1f it �F iE iE M aF iE aF ik iF ip i1 il if iF iE if if 1E it 3F 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
-�y
ZONING APPROVED BY "
�.
BUILDING APPROVED BY : /_:' �4R
Y��i;�I1F �I�] . i �'3-9i1 �! ��:)1
DATE:
DATE:
DATE:
LEGALIZATION:N F E E S U M M A�R Y STRUCTURAL SBGMENT:N
I
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 8.75
25Y SMIP/NON—RES
PLAN
ISSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 8.75 22.00 0.00 30.75 30.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 30.75 OVER/SHORT; .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30.75
if i! if if iF if �f if 1k ik iF if it k M'k'1F iF 1t 1F 1f iF If i! iF iF if iF iFlf iF 3k 1k ik ik'k'M i! k ik jf M if M it iF iF M iE it M ik iF if'1E iF M iE iE it M ik 1F if ik iF it iE fE iF if if iF 1E k* i f{E {E
I N D I V I D U A L F E E H R E A K D O W N
�PE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 DISHWASHER 8.75 8,75
END OF FEES
. ,'A, .,
07-30-1997/10:�6 pp/f36.7;;
RCGTN:A�-0089915
F'ERMIT:083920
PO� • SPA
►� - CONSTRUCTION AND PLANNING') , i � . _ � � , _
APPROVALS �Permit # � � Date �Inspector AppROVALS Permit #! Date Inspector�
. i
1. Temporary Electricat Service or Pole 52:� Pool & Equipment Location�', -
�, .
2. Soil Pipe-Undrgrnd. �� �. -53. Sieel Reinforcement X-i � . �
,� .
s;'.`-3,�.�Electrical Cond�Ft.UL�litV-Und�grn8. �. 54. Forms . � . �/� ' • �..
�:!-4t�Electrical Condiiit•tiridrgrnd. � • 55. Electricai Bonding � ��
��r .
.CS�Steel Reinforcements � � � 56` Rough Plumbing & Prezsure 7est � . � � , '� ;.
J..a:p
yr6=;Electrical UFERiG�rtd. . � 57,. APPROVA�TOCOVEP�GUNITE ,�: j
. �.,. ..� r.
'_-`/�F�ootings y-':n n 58. Electrical Conctui�Undrgrnd., �, �„
" .�:� ..� . Ji� � � -
. �J -&; �'oundation r-. cu �.. . � . 59. Gas Pipe�, O U rgrnd.; Test , � -�? ,
- , �HWater Pipe-Undrgrnd. a' ; - � 60. Backwash LinesSPyTrap,O Ui��irgrnd. _ �
,� _;
r 10. Structurai Ftoor Svstem , - "61. APPROVAL TO;H.ECK`� ' �.
�7:1. 6roperty Sewer Une & 4ouse:Connection � , 62. Backwash & Re�:�eptor-Final�
� 12. Sewer Cap `` � � ; � .,63. Heater & Vent�Final n; � .
73. Roof Drains ...� � , - � ' s64. Plumbing Syst'em - Final' -, � � � �
14. RoughPlum6ing� -� � °65. Electrical�Final � , r � � i +
� , 15. Rough Electriwl.Coriduit ;-; y' : _ " + 66. Solar�SYstem-Fi^nai ' ' ' ; �
�
16. Rough E�ectric �ring � ,� %; ' ' - � `67. Fencing & Acce'_ss�ApProvai `• - _ �
r
17. Rough Wiring Sign ,'�� ^� _S � � - '68. APPROVED Ff3R�PLASTERIf�G � - �
• �.
19. Rough ElectricakT Bar Ceiling- '" � � +J 69. POOL/SPA SYSTEMS'FINAI ` .
L'
'19�. Rough Heating & Air Coniiitioning � " ' � FIRE DEPT. REQUIREMENT �� -' '
- ,m �� t+'r: E. ;r .t F r
, 20.'Fougii Fa¢tor�Fi��Slace t^iT.� 4�. =� O.".J a"t t'APP�QV7SIL�J P mit��_
� :a .. i �r• }: s .� �,.: : � � .,�- �4
^ C F+ F '``;-� G. D _ � ��.
21. i]uCts, inr§tit�tufaj.� t.. .. �:S s: S O �-+.� ' 70. �UndergtoL'rtti �dro •:
, 22. �Ducty�? Ve�ttilating-' � � , � � � S `� �, 77, produCt;�l�ing"�ias l�0il
,-, , -^ � � ; . ' ,
23. Cias �pe ou &`1� st x �� � ''�
� � � t I*.S iT7 .7' �t O.� �� 72. UnderqrtiLrnd FluSb i: F+
24. Roofi.Fra_ming^ O�. � i-'F' ^F- >> O A � 4 73� Undergrr�. Stoi�LQ Tanl�� Gas � 0'Oii
'1 rl.i. 2 ,e s, r-7 U C�. .
, 25. Roo��$heathing f, Y � v v a: � � :;:�� 74.� Overhead Hydrd e
26. �-BarCelling (StruTtural) & �oaoat * � '� � ��� 7'�" Dry Che�7ica1 �� r " �a y
27. �f ame and Flashi Y x � �" �.� `� ' � `'� -. _' "� :�
..{ ^8 a a;�,^ ,� rn �, �k 76. Dry Sta�piOeF•�p
� 28. Lathing BJSidinq x i' ✓' ":� � � « � �..« 7y� FIXED'S'Y'ST�1f� A1. � :' �
r r -c. ri ••� ••I '^"� ti... ��N �.a "1 :i5
t O ry.... � tY � 't � � ...
+ 29. Insulatio'� ��+: •• « � I €s 7� FIRE:AREV. FINd.�1L Y::• x r*7
' 30. Drywall t�ailing Nr- L ✓ ��" r ; i "'' '�� '�+EALT�1 DEPT!RE�UIREMENT
f (�:J O 3�A � X
�l lw I .K J I 1 ')n.ac )�i e:� �.
. 37. Plaster B�dwn-Co�a• S i�„- a� i �: 79. FINAL f,fjI�PECl�fE7N y .
� 32. �IectricaRPow2r hdeter'Final . � �� n3 � � {t ,' gp-f FOOD CERT �ATE I�SQl1ED
- 33. �inal�.,Elec�ric� r�r �r i c .i � � , K N'o�Fes: y .�-_,M �.� ,� �-;
�„� 34. F,inar,}ieaiing-� A a onditionirlgS :'; i� ~ ! � �-^, Y>" !':x .K 5 'J
� m c� � 1 t
� 35. ��.'�inat'Ga�iP?''TeST:R O'� .: k I ' C% �'� IT7:� * f* t.,
s: '-� I t 2 U 7�-. 7.
�.
� 36. Hood�or CanoPY �. � �p � � �^ ^� �. � �� I 1: � tx � , n n :n
�
_ 37. Finai`�actory Firepl�ce x i YC � *''� i � « " * 1
� . ..., .... . �-_
38. FinatPlumbing n7+� :v � o�D-�3V � � -- .;.�.� � Y h.+
! 39. bVater"�Service�Fina'T�* � ^-� y I -i< ;� w:*� .x cC
i-i K f: i i' r.'. r� 4c .� ::>
; 40. Gas Service-Final ��. i-; ¢;�;r � v, rrf I` �;��c p,� t�fu i: ��
1 z•c
= 41. Solar pomestic•Pina�� s � ^ +` '-� "'- •FT _ - • �� `"'' '
.0 I I�I fx +N T } X
� 42. �Sackflow Preventer ,� r �, � � • ki a; ; ;-. ±' 7 �=
M �;-1!1 4
-43. Backflo�v Irrigatipn �{ y�5 Y � a .• x� �.i �J � � �
�
� 1 �� .� . ._ .
r,
44. Landscape Irr�qatior�System�.p-;� �� �� �r7 7 7+ N� !U �7 �.e � v
4b. Sound Attendation� `�SF •t*' a S i-� h+ 4x C. :-+ -+ •�.� x�t F!
_, �. . .y .. K± m a�., •r r a; � : 7 :
�6. �liandicap'�ie}ulations � �� 4' r ¢: S nrti; S M
i i n �� r
47�, F1NA'L STPUETURE & BUIGOING !�, �', v� `F
� �* ;r x �-
I 48.:,,INA_/. PLANNINGy � ��,_. ;; 1. ' �'- �,; i =i k; 'y Y� ,
� •49, 'ElecMic Release to Edison . i �, ,,,�r ' x + t
� #. i � .c t '6 •t`l .� �
� �;�'0�. Gas Release to Southem California,GzsCo :- ��'� -�� F� �+ c•,�:�7 * O • '
I. . . . _ . _ . .-. :� . � r �t ,
� �1'. CER:T.IFICATE OF OCCUPAN^ _ � ��.K _ • i'� ;*; : x �: �-+ v
No. Date i_