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2498 PARMLEY LN - Building Permits
(714) 754-5273 • Fax (714) 754-4856 • www.d.COsta-me58.Ce.u3 77 FAIR DRIVE, WSTA MESA, GA 926Le BUILDING PERMIT �. ._ . � Job Address: 249$ PARMLEY LN Suite: Vicinity: ROOF Primary Occ: R3 Parcel Number: 43933326 Applicant: SHOBE, DAVID Address: 2498 PARMLEY LN COSTA MESA, CA Owner: SHOBE, DAVID Address 2498 PARMLEY LN ' . COSTA MESA, CA Type of Canstruction: V-N Zoning: Contractor: O W N E R-B U I LD E R Address' Zip: . ArCh : ` � - - , .�� .. _ .. � Address: Phone: Phone: 7�4-646-8158 Zip: 92627 Phone: 714-646-8158 Zip: 92627 Phone: License: 000000 ' Eng: "' Address: Status: ISSUED Applied: O6/28/2005 Issued: 06/28/2005 ISSUED BY: �PCSCL/ Phone: Zip: License: . License: , SCOPE OF PERMIT ; TEAR OFF EXISTING WOOD SHAKE AND INSTALL WOOD SHAKE, CLASS�C ON�ATI'ACHED HOSUE AND GARAGE. REPAIR AND REPLACE SHEATHING AS NEEDED. " Plan Check: Permit: SMIP Res: SMIP Com: Other. Inspection: Total: $90.51 $13925 $o.�o $0.00 $0.00 $0.00 $230.46 SETBACKS� MAWSTRUCTURE�Front., 0-0� �- \. 4. ACCESSORY Fronh.� 0-0� . PARKING Existin : 0 Rear /' Rear FEE SUMMARY Calc Valuation: Claim Valuation: : %�. . - � PLANNING & ZONING 0.0 -� : tek 0-0 � Right �- 0-0 . 0-�0 '-Lek � 0- 0` - - Right 0- 0 Required: 0 Proposed: 0 s�,000.00 s�,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all �.. required Inspections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. IFOR INSPECTIONS CALL: (714) 7545626 2446-0fi (8�00) WORKERS' COMPENSATION DECLARATION: � � I hereby aHirm under penaHy of perjury one ot the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, es providetl tor 6y section 3700 0� the Labor Code, for ihe perfortnance of ihe work for which this Dermit is issued. ❑ I have antl will maintain workere' compansatlon Insurence, es requiretl by section 3700 of ihe labor Cotle, tor the pertortnance of the work for which ihis pertnit is issuetl. My workers' compensation Insurance carrier antl policy num6er are: Carrier: Policy Number: bThis section neetl not be comp/eted il the permit is valued at one hundred dollars ($100J or less.) r�%�a I c rtity ihat in ihe pertorman ihe work for which this permit is issued, I shall not amploy any person in eny manner so as to become subject to the workers' compensation laws of Calif and agree . t if I ecome su�ject to ihe workers' compensation provislons of Section 3700 ot Ihe Labor Code, I shall forihwith comply with thesa prov / ?EP�re: _� (�!i{C_." -oa�e:, � /> -a � - o � WARNING FAILURE TO SECURE WORKERS' COMPENSNTION COVERAGE IS ONLAWFUL ANp SHALL SUBJECT AN EMPLOYER TO CRIMINqL PENALTIES AND qVIL FlNES UP TOINJE HUNDRED THOUSAND WLLARE (5100,ODD), IN A�DITION TO THE COST OF COMPENSATiON, DAMAGES AS PROVIDED FOq IN SECTION 3]O60F THE LABOR WDE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hareby aHirtn that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Professions Code, antl my license is in full force entl effect Lia q Class # Contrectofs SignaWre: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirm that there is a consiruction lending egency for ihe performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: LentleYs Atldress: Signature: Date: OWNEF-BUILDER DECLARATIONS: I hereby alfirtn that under penelry of perjury ihet I am EXEMPT FROM THE CONTRACTOHS LICENSE LAW for ihe following reason (Sec. 7031.5, 8usiness end Professions Code: Any city or counry which requires a permit lo construct alter, improve, demolish, or repair any structure, prior to its iuuance, also requires ihe applicant for such permit to file a signetl statement that he or she is licensed pursuant to Ma proNsions W Ihe Conirectors License Lew (Chapter 9(commencing with Section 7000) of Divislon 3 ot ihe Business and Professions Code) or that he or she is ezempt therefrom and the basis for the alleqed exemption. Any violation of Section 7031.5 by eny epplicant for e permit subjeds the applicant to a civil penalry o� not more than five hundred dollers ($500).): ❑ I, as owner of �he property, or my employees with wages es �helr sole compensation, WILL DO THE WORK, antl tha structure is not Intended or ofteretl for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply to en owner of property who builds or improves thereon, and who does such work himsalf or herself or ihrough his or her own employees, provided ihat such improvements are not intentlatl or oNeretl for sale. If, however, ihe building or improvement is ���,,,nnn sold within one year of completion, Ihe owner-builder will have ihe burden of proving that he or she did not 6uild or improve for purpose of sale.). • ;�g / 1, �s owner oi the property, am EXCLUSNELY CONTRACTING WITH LICENSED CONTRACTORS to consWct ihe project (Sec. 7044, Business end Protessions � Cotle: The contractors License Law tloes not epply to en owner of propeny w�o builtls or improves thereon, and who contracts for such project with a contrecmr(s) license pursuant to j{�e Contractors License Laws.). ❑ I am azempt u e ___/��r'�t� Business and Professions Code for this reason: ��'�;Slgnaj "`l` �� ,,, ilf✓1/c-c_ venfi ydrivefslicense. es ❑No Orvers,LicenseNo. �/ Verificatian of Ownership by (type of document, i.e. - property ten bill or deed): DIVISION OF INDUSTRIAL SAFETY PEtiM1T CERTIFICATION: ❑ I hereby certify thet no excavetion five (5) or more feet in depth into which e person is required to descand, will be made in connection with work authorized by this permit, and that no building simcNre, scaHoltling, falsework, or demolition or tlismantling thereof, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Title 8, Califomia Adminis[rative Code). ❑ As owner-builder, 1 will not employ anyone to do work which would require a permit irom ihe Division of Indusirial Safery, as notetl ebove, unless such person hes e permit to tlo such work irom the tlivision. Signature: Data: Division o� Industrial Safety Permit Number: COOE t. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Fedory Fire Plece 203 Flnel Slpn 204 Flnel Demolltlon 1�9IE INTRIALS r , s�„' COUEt INSPEC110NTYGE 206 Final Mechanicel 208 Finel Plumbing 210 Final Eledricel 212 Finel Fire Prevention 220 Finel Planning Approval 222 finel Site 260 Finel BulldlnplOccupancy PA7E ItQID9Lfl PflOJECT PO�XE55: 2 4 9 8 PARMLEY LN OWNEfl'SNAME: pASHLEY LAURA F RDDflESS: S F) 9 LOU'iS IANA LEXINGTON,KY 642-4168 AflCHIENGINEEB: ROONESS: 40502 uNiT: flEG.NO.: UNIT: PEHMITTEE: NOCK PLUMBING ( 714 ) 895-1246 aooness: 11610 SEABOARD CIR STANTON CA 90680 LICENSEO LONTPACTOP UECLAflATION: I here�y alfirm ihai I am license� unGer pmvisions o� C�apter 9(commencing with Seciion 7000� ol Oi i e usiness antl Prof i n ntl i nse is in � i ntl ��°��b� "Sssf��°"7� �� �P: 02/95 CITY LIC.: STFT IC.: CLASS: �ale' _/� SignaWre: —is���—+ � L` REHS' COMPENS ION OECLAflATION: I hereby aflirm �hal I �ave a cetlilicaie ol consent Io selbinsure or a certitica�e ot Workeis' Comocnsa�ion msQr$ce7 t� 9c$�titi� tppy �nereo� ISeaion 3800, Lab.Al.3 / O 1/ 9 S roucr no.: gTATE E%P. ORTE: � COMPANY: ❑ Cetli�ieU cODY, 5 �¢re �umished. � Certiliea coDY i Ae0 wi=�ity BuiltlinB ivisio� a�r ApDlicanc � � � E%EMP110N FPOM WOBKE S' COMPENSATION OECUflRTION: (TAis sec�ion nee� iwl �e complel¢G i� Ihe p¢rmii is tar one huntlrttl (5100) or less�. � I cetlity thai in the perbrman[e oi Ihe work far whic� I�is permii i5 6sue0. I shall no� employ any Derson in any manner so as to Uecome su�l�� �o I�e Workeri fAmp¢n5aiian Laws oi Califamia. Oale: SignaWre: NOTICE: II. alter making this Aeclara�ion, you 5hou10 Oecome suhle�� �o �he Workers' Compensafion pmvisions o� �he Labor CoOe. yrou mu51 forilrxil� campty wi10 5uch O�ovisions ar IN5 Dermi� shall be aeemeA revokeE. CONSTNUCTION LENOING AGENCY: I �ere�y affirm ��at t�ere is a canstmctian IenEinp agency lor I�e pertormance ot ihe wark for whicn Ihis permit is issue0 �Section 3097. Civ. C�. LENDEP: AUONF55: OWNEN 60110Efl UECl4XATI0N: I hereby aflirm �hal I am exempl irom Ihe ConVaciors' S�a�e License Law tor �he following reason (Sec�ion 7031.5 Business anJ Pmtessional Cotle: Fny city of counly w�ich requires a permit m constmct, al�er, impmve, �emolisA, or �Qoair any simclure, o�ior �o ils issuance, also requires the applicant for sucn permil lo lile a signe0 statement IAat he/she is Iitense0 pursuam to Ihe piovisions of i�e Contractors' State License Law �C�apter 9(commencinp with Section 7000) ot Division 3 of ihe Business antl Prolessions CoOe) or I�at �e/she is exempt �herelrom ana Ihe �asis lor t�e allege0 exemp�ion. Fny violaiion o� Sec�ion 7031.5 �y any a0olicant Im a oermit suejects ine avPlicant to a Givil penalry of not more inan five Auntlretl Ootlars (�`�1. 1. as owner ol ��e pmperty or my employees vntll wdges as I�eir sole campensaiion, vnll tlo ihe xroA, an0 t�e �❑ stmcmre is no� intenCed or allerea lor sale �Section 70aa, Business anG Pmlessianal Cotle: The Contracrors' State License Law tloes noi aDVly Io an owner o� a pmpeny w�0 OuilGs ar imD�oveS ��er¢on, anU w�0 tices SUCh work himseltlherseti ar NroUg� �is or �er own em0�oyees, pmvitletl that such impmvements are not intenAetl or offeretl for sale. II, �owever t�e OuilOing or improvement is 5010 vni�in one year ot compleiion, Ihe owner vnll tuv¢ t�e bur0en ot provinp �e/she GiG noi 6uilA ar improve lor Ihe pUrpoSe o� sa�e�. I, as owner ol �he piopetly, am extlUsively conVacling wilh Iicen5e0 conVaclors lo can5�mci ��e prolecf (S¢ction 70Ed. Business ❑ antl Pml¢55ion5 CoOe: T�e Comraciors' S�ate License Law Gaes not apply Io an axner oi pmperry wtw OWGs ar improves Nereon an0 w�o mntracls lar suc� pwle��s with a coniractoqs) litense Oursuam lo I�e Contratmrs' State License law�. I am aware Ihai O�oo� of ihei� Worker'S Compensation insurance SMUIE be pmntled �a me. � I am exempt untler $ec�ion: 8. 8 P. C. �Of INS �Cd50�: Date: Owner, � I Do hereby cenily ihat I am aware ol ana untlerstand �he requiremenis oi Calilomia Heallh antl Salety Code Sections 25505, 25533, ana 25594 an0lhat I or any INure builAing occupant vnll/will no� (cirtle one) neetl to comply witb 5did stale codes ana Ihe requirements lor a permit lor conslmc�ion or moailicalion �mm Ihe Air Oualiry ManaBemenl Oistricl. Resiaential conSimciion aOPlication5 a�e exem0� �{om these pmvi5i0n5. ' I ' . Dale: NpplicanL I nere�y cer�i�yt�al Ihave reaa Ihis aDDlication antl state I�ati�e a6oveinlormalio is corr¢ct.lagree lo comply vnlh all city an0 county or0inances antl Ialelaw5relatingio �uiltlmg conS�Nclion anE her u orizerepres�l lives oti�is ci�y�o enteruponihe abOve�mentione0 pmpeny for � peclion urposes/ ' � Daie: VL� % V . Signamre: �� — � Oiiver's license oi Social Securiry a: I6CI�46 WM1ile—BwlAing; GrEen—COE¢ EnlotCemen�: Can2ry—AO����ang Pink—Revenue: GoIC¢nr04—P55¢smr CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; P 070669 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE; PLU JOB DESCRIPTION ; C/ OF DISHWASHER CLAIM VALUE: CALC—VALUE: . � . . . • �Q�IZZ� — e�• . ,�. . •• • SQ FT: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED HY THIS PERMIT **rrrr**r****�r*�r***�r�r**�**�r*+rir*****r*�rr*****�r*�r*r*rw*rx�***rr**�rr+rr******�*r�**�w- Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDItJG --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGiiT: FT IN PARKING REQ: PROV: PARCEL; 43933326 ZNE; REF NO; PLANNING NOTES> i 4 if 1f M 1f �f if k ff �F M ih 1f iF if M M ff if if M if iF 1t 1f if ft ik if ff 1F ik fk 1f if ih if 1f iE ff iF %if 1f 1f M'if �F i! �f M M if iF i4 iF if if M iflf if k If if k if !f 1F if iF M if if k iF if 1f af D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY; DATE; J P�� lfikifiFitififMlfif4Mitil4ifffifilMlFif �fififiE1f1f1fM1f4 ffif ilihftMftMlFitititMllitif4lFffilitMiEilif4if41tikiElflf%lfifititififiEifififitifiEltkiFillfrlfilMitlfkitifffiFiFiF!llfMitiliFlFiF**{Ei:iFitifiF LEGALIZATION:N F E E S U M M A R Y STROCTURAL SEGMENT:N PERMIT BLDG PMT PLUM�IN�G� ELECTRIC MECHANIC FIRE SMIP/KES GRADING 25Y SMIP/NON—RES PLAN ISSOE EEE 20.00 BUILDING—DIV—> PEAMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 7.00 20.00 0.00 27.00 27,00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 2%,�� %ifM1f if if Yif if if if itif ik ifi! itifitlfMiflf if if if 1f M if 1F ff M if M jf iklf �f ifM 1f if M if M Mik ifif %M 1f iF Mif 4 1: if if ifif ff If lfif if if Mif if�)f iF If ft1f�)f if M ff I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 DISHWASHER 7,00 7,00 ' END OF FEES 0 _t i ai coiz,-:�-;;e��4�ss re�-r ��.no Dq7E: 01l1i;7S TI�E: 11:2E CONS�KUCT40M AND PtANNING �' APPROVALS Permit # Date t. Temporary Electrical Service or Poae , 2. Soii Pipe�Undrgrnd. "w. _ � . <_. _ , .__. � -�4..Elecaical r, �, •� ; "�:�5ceel:Reinforcecrene " -=-r 6r �Electrical UPER�Grnd. �� ' -'7r'Pootings -� a: '. i "g, Foundation � 9. Water Pipe-Undr�rnd, _� 14. Stsacmrat Ftoor Svscem ,., � �. Broperty Sewer Line & Hbuse Coniaection 72. Sewer Cap ., 73. Roof Drains �� " 0 74. Rough Piumbing " :, 75. Rough Electrica6ConduiL � 16. Rough Eleciric Wi�ing �; 17. Rough WiringSign � 78. Rough ElectriL�1�7 Bar Ceiling }9. flough Hea2ing & Air Condvoninq 2Q�.� Ro�?gh-Factory Fireplace ' T `� � "? ? 1: i . �m 2L. Oucts,ln Stiuctv�s � - •• - - 22. Ducts,'9'eni�acing' � � �� � ,� ` 23.. Gas PIpe�Rough &;Test � �# p� - 24.� Roof F.reming � r . :: �� f✓ `i �n . 25. Ropf Sheathing _;' �; ; � �'` - 26: T-Bar Ceiling (Structural) 8i=0.1bnocoat ' 'D i , : �+ 27:; Fra�ne apd Flashing z��;.,�, ;, � 28✓ L2thing & Sidin�; i � • -�'��'.tF'. ' s; .. -) • , .. .. � ' 29. Insuiation � . ' .. � `�� '' 30. Dry�valPNailing �; � .31. Plaster�arown Cqat �• j p•�r �� 32;' Electrical Poh2rMeterFinai � �'% ,�. - 33. Fina1 E�ectric � -7 � � �' u � .Y �:34: Fin3l Heatirtg &�Air ConditiotFl� � i V :� �:i , 35:;FiriAI Gas Pi'�p,e-TesC •" �' ,.� , 36 � Hood or Canopy ) � : � - • i � PG, _ & SPA � Inspector qppROVALS Permit # 52. Pool & Equipmen; Location _�- 53. Steel Reiniorcement 54. Forms 55. Eiectrical Bonding 56. Rough Piumbing & Pressure Test 57. APPROVALTOCOVER�GUN17E 58. Electrical Cpnduit�Undrgrnd. 59. Gas P�pe, �7 Untlrgrn�., Test 60. 3ackwash Lines, P�Trap, � Unclrgrnd. 61. APPROVALTOOECK 62. Backwash & Recepmr�Final 63. Heater & Vent�Final 64. Plumh�ng Sysiem - Final 65. Elecaical�Final 66. Solar SYstem-Final 67. Fencing & Access Approval 68. APPROVED FOR PLP.STERING 69. POOL/SPASYSTEMSFINAL ( FIRE DEPT. REQUPREMENT -, •c 'i; i ..., L' c � � '�APP�OVJjC�,-. Per}nit #��-r_ :i , ' 70.�Under9toUNi F�L�idro ' ,�y F ° 71. ProduSi�Pi�ing!:1a'`as 40i1 ,., ~ C. r 72. UndergrQ�imd FIusM � �. _„ ;` 73� Undergmd. Stor,��,e Tank O Gas ❑�ii e . • ��� * + 74: Overhead HVdro � ?? ` � 75: Dry Cheq7ical -' ` �' . � ;- - :� -. x �_ � �. _. � v+. � 76. Dry S[an�ipipe � -u�. .t' "# � 77'y FIXED�5l'.STE(i1`FtNA(. _^ I � 78� FIREPREV. FINAL ' �' I • ' �' ��� •�HEALTH DEPT.'REQUIREMENT i a :�^7• �:.:liJ � � i . • � 7'�. �FI�NAL hWSPECTION . ' + J f � -_-�,j,.�.�.�__ - . I ' > i . 80t� FOOD CERTIFiCATE iSSUED . I t r a � � �. , � Notes: '��fS�� �� � A 4V ,� 1 (+ _f ! '-"'�! �G7�'�� .r, . . _ � . /1/ I. • � a' m i �ti r �^ . r.i � c Cr' q. i hi ;37,.Firt�l Factory Fiteplace,• .... � i 38. Final Plumbin9 :- * � . � + _2�' S �39. Waier Service�Finai _ ' .' • � � )� .;40. GasService-Final r �. Cn�n� : � n� .1 I � 41. Soiar pomesticFi�al= �^ " ' ' � „ e �42. Backflow Prevente� � �i � a �.. 43. 8ackflow lriigation '� "' ; �: q44, landscapetrrigation$Ystem'nici n: +,� :' r Sound ; Atterivatioh ' T'-' "� " .45.:, ; .. .. ,.� � 46. •Handicap Reg�lations �� 47: �FIN;4L STRUCTU:RE & BUI'IDWG , . 48. �FINAL PLANNING � �r� -�49: Electric Release to'Edison � �.50. Gas,Release to Southern California Gas Co � 51. CEATIFICATEOFOCCUPANCY Dace I �! R � F� � 5 5 � ' ` i �;4 � . ,. --� -J T } - . . p� r i e � ,4 : i i. .. i j' I '4 T �, �. .� C : '� � i' � ' ni ,'i � �: . c . , ,- a rr Ti i`5 ��i , .� , ., • •J Date � � . � —� P�oDi�Unt to fi11 in au s0aees wl�hin heavy boreer lines ana sign a11 aDorooriale eeclaralions. .—.}/p�/ •^� �_��? �ok)'- � � � GTYOFCOSTAMESA PERMITNO. TRACTNO. LOTNO. �BLDG.NO. 'Y�.Y � i '2�J'�� �/�/I�U� S�'L��ia::l - CONSTRUCTION PERMIT $- l�0 �I II ��� f�5 Arch/Eng. ��C/',�crj �,2 ��'�J ' Licenu No. Address / 7�l (i^/ Cc��u,o�/. /�v//✓F_ Addr�s I haraGy aftirm that I mencing wit� sectio FYo/essions e, LJcense Clazs � consent to selttinsura or a ance, or a certifietl copy �+Ilty No./U��`• ��'' —CAmpan�/�'//Gc /A/JICXLHHK:k CertiTietl copy IS �e�eDy TutnlShGtl. �CertiTietl cOpy IS flleA wi[h the City Builtling Dlviiion. EXEMPTION FROM WORKERS' COMPENSATION DECIAHATION (This section neetl nol be completeA it t�e permit is for one nunarea �51001 or less�. ' ' cerUfy that n t�a pe�torrtWnce of the work /o� whith [�iz p¢rmit is iuuad, i snaii not emPioy any oerson �n any manner so as to oecome SUGjG<t to t�e Wo�ke�s Compe��[ion Laws of �alHornia. Dale SIgnB�ure NOTICE: If diter makin9 �h�s tleclaratlon, you ihoWG Oncome subject to l�e Workers' CompenSatiOn O�ovisions ot the labor Cotle, you must fo�l�wlt� Comply wit� such P/oviSiOns Or thi5 pe�mit s�all be tleemetl revoketl. CONSTRUGTION LENDING AGENCV ' "' - 1 �ere0y aftirm that t�ere is a cons[ruttion lentling agency for ihe per- formance o/ the wor�k f9r ,Wr��c� xt�(Ts ^p�e,rmit is �1jsuetl ($ection 3097 Civ. C.1. ��4/'�N /�/�/ /� ' •t Lentler's Name Lentler's Atleras OWNER BUILDER DECLARATION I �ereDy atflrm t�at I am exempt /rom.the Contrattor's License I�w for Me following reason (Sectiu� 7031.5'Bus(neu antl Profes51on5.Cotle: Any ci[y or munly wTic� reQuires a permit [o consiruct,.alter, irtlpwve, tl8molish oI ropair any'strutture,'prbf lo ils issuanGe. d120 re- qWrGs the dp0�ifdnt for such Pe/mit lo file a sign9tl statement Mal �¢ or Y ' fo� tne alleg¢tl exempt�on. Any NolatiOn of Section 703L5 Dy ipplit'vnt }o� a permit suDjects t�e aOPlicanl to a. civil penalty .t mOr¢ than fiee huntl�etl tlollari (f500). �J I, as ownCr ot l�e prop6�ly, or my ¢mployees with waqes a5 t�Gir solG compensation, will tlo l�e v/o�k, antl t�e strutture is not inlentleO or offereA.for sale. (Soction 7044,� Business anU Aofezsionz Coae: The Conbattor's lJcenze Law tlPes nOt apply to an owner Of a property w�o Ouiltls Or Impw�e5 lnefeon, antl wh0 tloM such wo�k himSeH or throug� �is own employees, Orovitletl tnat suc� improvements a�e not intentletl or of(eretl br sale. ��. howeveq t�e builtlin9 or improvemen[ is sola witnin one year ot cOmpletion, the owner will have tne eurtlen Of p�ovinq �e tlitl no� �ui�tl or improve �o� t�e purpase of Sale). ❑ I, as owne� of �he property, am exclusively coniracting wit� IicensuC contmctors to mnsVuct tlte project ($ectlon 7044,-Busineu antl Professioni Cotle: T�e CA�tractor4 Licenie Law tloes not apply to an Owner of ptoperty who Ouiltls or improves thereon. antl wh0 con- tracts trom such prOjectz W��h a contra<tor(5) Iiceznetl pw5uant to_ lhe Contractor's Li<ense Law). ' ❑ I am exem0� untlei 5¢ctio� B. S P. C. fOr IhiS reason Date n6� i nereoy y� t 1 a reH ���s applifation antl itate that tbe above into�ma on is or�e ! ag e to comply with all city antl wu/1ty o�tlina 5 a ilat , ela���9 to coRStru�jbin„Cntl hereby aul��iie � , Dale or TVPE OF CONSTRUCTION � �NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER OESCRIPTION OF WORK _ _ � .. TVPE OF PERMIT ' ❑ GRADING �FOUNDATION �STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHFWD ❑ OTHER PROJECT DESCRIPTIO S4. �. ��l� �. M-/ OCCVPANCY CONSTRVCTION TVPE —� VALVATION 99, a�ZONE GRA�ING CU. VOS. ACRES REMARKS: PLUMBING PLANCHECK � BATHTUBS " SHOWERS - TOILETS URINALS LAVATORIES DOUBIE'LAVS KIT.SINKS -' DISHWASHERS SERVICESINKS . SVMPS �FLOOR SINKS - FLOOR DRAINS ORINKING FOUNTAINS " ' � INTERCEPTORS. � CLARIFIERS SWIMMING POOL' : . P TRAP -' " WATERSERVICE ALTERATION GASSERVICE � OUTLETS WHTER HEATERS BTU OUTPUT SEWERCONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SVS. ISSUE FEE � � MECHANICAL a�.qrv CHECK HEATING SVSTEM 0-]00,000 BTU AND�DUCTING 100,000+BTU REFRIGERATION 0-300,000 BTU SYSTEM - ' ]00,000+gTV ' BOILERS . BTU ._. SVSTEM REPAIR,ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE CMF 0865-06 VJ6ite-Build��9: Canary-Applican[; P"ink-Accou�ting; GolOmrotl-Assezsor i A.P. iF { � �1 ZONE �—� SETBACK ST:+ � SIDE YARD i L5EpF �" R�IGHT � {y REAR VARD (TO P/L� PKG.SPACE REQ. STREET W IDTH (� r� f, ZONING APPRO ED B1 SPECIAL CONDITIONS: � ELECTRICAL PLNG.REF. PROVIDEDi PARK FEE E PLAN CHECK GENERATOR 0-1 KW_ 1-]0 KW _ TRANSFORMER APPLIANCE 30-50 KW_50 + KW _ MOTORS 0-1 HP_1-10 HP _ (INGSOCAR)- -10-SOHP_SO�+HP_ FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS ?OLE LIGHTS POLES METERE� SVB PANELS MAIN $UB SERVICE AMP APPROVED PERMIT G $ y 3•3 PLAN CHECK b PIUMBING E PLANCHECK $� ELECTRICHL $ PLAN CHECK § MECHANICAL $ PLAN CHECK $ m _... .�o OF FEES � 4 � SMIP $ PERMIT ISSUANCE 5 - GRADING E . . . _.a � �.. . MICROFILM S ' TOTAL FEE S LE55 AD- • VANCEPC E FINAL FEE 5 T� I CONSTRUCTION AND PLANNIN����y� 1 POOL & SPA,-� • •' • � ' APPROVALS Permit#-�.L�L� Date Inspector APPROVALS � -Permit# ` . Date �. Inspector' . i. Temporary Electrical Service or Pole �- 43. Pool & Equipment Location - - - ' p� � 2. Soil ipe-Undrgm . . 44. Steel Reinforcement � � � � 3. - ElectricafConduit Utility-Undrgrn . 45. Forms � ' '-" ' " ' 4. - Electrical Conduit-Undrgrn 46. Electrical Bonding � - � � - - .' � . tee ein orce 47. Rough Plumbin & Pressure Test � - 6.` Electrical UFER Grn � � ' �,7..a� � 5 � 48. APPROVALTO COVER-GUNITE • � � - ' � - 7. FootingY . 3•7•i� .i� 49. Electrical Conduit-Undr rn ` '� - �a ' 6. Foundation� . • 50. Gas Pipe, ❑ Undr rn, Test + 9. Wate� Pipe-Undrgrn � " 5l. Backwash Lines P-Tra ❑ ndr rn � � � 70. Structural Floo� System -� 52. RPPROVAL TO DECK ' �� it. Property Sewer Line & House Connection' � 53. 'Backwash & Rece tor•Final � � � 12. Street Sewer Connection _ _ 54. - Heater & Vent-Final : � ' _. •�* -'13. Rough Plumbing' • � � �.�tr.�--,.�, � �, ��, 14. Rough Elect�icConduit � � � ' � 56. 'Electrical-Final ' 15. Rough Electric-Wiring -� � - 57. Solar System-Final� � 16. Rough Heating & Air Conditioning � - • encing & Access Approval �.� . 17. Ducts in Structure APPROVED�FOR PLASTERING � - � 18. Ducts, Ventilating � - � � - ' . � ' � � 19. Gas Pipe-Rough & Test � 60. POOL/SPA SYSTEMS FINAL � , 20. Roof Framing � 21. Roof Sheathin � � - � � �,['„ NOTES: C�,�S - Z- � � 22. Frameand-Flashin � � 23. Insulation Se-P A!>7�P S ,+-�L.�- � " -- 24. Lathin & Siding _ � ' - � ' ' � � " " i 25.' Drywall Nailing ' • ' �Cdiu%( 1��5T�4 TC� .$K,�. !c /�ni-R [D.t� a�2 Ri � 26. Plaster Brown Coat -27 -g 3� k5�+lp� . e'n.�- o< A,dl.✓ � K /.v �� 27. Electrical Power Meter-Final � ' ' 28. Final Electric � - - - ' 29. � Final Heating & Air Conditioning ' �� � 30. Final Gas Pipe-Test - � A 31. Final Plumbing ` ' � 32.-' Water Service-Final _ ' ' :33: �`Gas Service-Final ` '� � 34. �Solar pomestic-Final ' � 35: ' ndsca e S rinklin S stem� � � � a b 36. Sound Attenuation �� 37. Handicap Regulations � � - 38. FINAL STRUCTURE & BUILDING S ' +; . i 39. Special Requirements Completed ' �/ GcS 40. Electric Release to Edison ' - ' � 47. Gas Release to Southern California Gas Co: - 42. CERTIFICATE OF OCCUPANCY � ,_ - .No'�' Date - . '" . + ADV��<ant to /III In all spaeef ezcepl t�ose wit�in �aary GorCer Iines anG �Ign all ap0�oorlata tlaelaratlons. CITY OF COSTA MESA � CONSTRUCTION PERMIT Applicant's Meiling Address / �Y/s/ C!7N/.9�+�/� /O ✓/A/r ProjectAddreu Z'�9f� P�,¢.�[_t/. L� � �(_�� Owner's Name ��� ���� �hona��.76 ZS� Addreu � G Arch/Eng. 'gQMES ��� License No C ���a � Address �Zf���/Lf/__ //J✓/n/!i " d Contrector's nlam ��p�G ��� Phone7.�.ri Addrosslmailing) M9�� ��j.°''��� /,�✓!� LicanseNo. ����d LICENSEO CONTRACTOR DECLARATION 6 heroby allirm t�at I am Ilconsetl untlar provlslons ot Cherter 9(<Ommendnq with uction 7000) of Divizlon 3 of tn Busln ntl Profeulons Cotle, an0 my II<ense Is In full /orce a a affect. �„/d�b Ucen Cla s � e s �ora�a Dala Si9nalure G� ' `WORKERS' COMPENSATION DEClANATION I hereby affirm tnal 1 hava a cartHiwte of consent to zelf-insure ar a certl/iwta of Workers' Campensstlon Insuranca, or a certi/ieE copY t�ereo/ (Sectlon 3800, LaD. C.) ' �f�v PoIIty NO.��Z�s�� � Compd��/�•� /�� �� �Certlfietl CODY is hereDy hrnisnetl. Car e0 <opy Is 11eE with t�e city Bu tling Divislon i Data � �2 �� Ap0liwnt ��%�� � ��%�• E%EMPTION FROM WORKERS' COMPENSATION OECLARATION �. (This section neatl not be complela0 if the permit is for ona �untlretl (E300) or less), I certify thal in the DerTormance of the work /or which thls perm�t is ISsueO 1 zhall not employ any person in any manner so as to become suD7ect to the Nlorkers' Compensatlon, Laws o! Ca171ornia. � Date �iqnature NOTICE: If, aflar making this tleclaratlon, you shoul0 bacome sub7ecl to Ihe Workers' Compensation Orovizlons ot the Labor Cooa, you must forthwith compty wllh suc� provislons or this� Darmlt s�all be Geametl revokatl. CONSTRUCTION LENDING AGENCV 1 hereby aftirm that thera IS a tOnstructbn lentling a9ency for tha per}ormante o! [he wOrk tOt �1� t��perml IS ISsu¢tl CtlO� 097 Civ. C.) LonGar's Nama � I.enaer•s Ae7.ef� /�/C]�i.._��1i'�. ST. S. .4 - OWNER BUILOER OECIARATION - 1 I nereDy dfflrm thdt I am eaBmpt !rom tha COOtrdtt0/'S LI<GnTO Ldw 70/ �ho followinq reason (Sectlon 7031.5 Builnosi anC Profaszlonal Cotla: Any city or tounty w�ich. reaWres a permit to construcl, altar improve, Eemollih Or rOpalr any ztructure, Orlor to ils Issuance, also requires l�e aOD����l /or suc� permit lo file a 51gneE ilaleTent thdt �0/ShB Is II anseU pu�sUant lo ttle:provliloni of ha Contrattor's License Law (Chaplar 9(c mmoncing with 5ec[lon 7000) o/ �ivl5lon 3 of the Business antl Profeislo s Cotle) or that ha sha Is oxompt t�eref�Om an4 the ba511 for th0 allOgnO exnmpUon, Any vlola�iOn of SOCtlon �031.5 by any appli<ant /ar a permll subjectt the applicant to a civll �enalty of not more tnan tive huntlreO tlollars (5500). 1. az owner of [ha orooertv or mv amolovaes with waaes as lhelr sole . n, noweveq ma Oullaing o� Imp�ovemo0i i5 So�a w�in�n One yea� oi Com- lon, tha owner wlll have the burtlan o/ provinq ha/sha tlitl nol bulltl or im- ve !or tha purpose of salo). ' • ' ' I, as owner ot tha pioperty, am ezcluilvely contrac[Ing witn Ilcensetl con• torsto conitruct.tha projact (Sactlon 7044, Buslness antl Profassions COAe: � Gontractor's License l.aw does not apPy to an ownor of proporty w�o � tls or improves thereon, antl who <onlracts for 5uch projects with a con- tor(s) Ilcanse vursuant to t�e Contractor't Ucensa Law�: I am axempt unUer Section B. 6 P: C. for t�ls reason Date Owner I�hereDy cartlfy tnaY I hava'rea InfOfTailon IS cOrfEtt 1 dgr¢9 and ziate lawt relat to b tllr sentatives o! ¢nls �y .to enter _ Date,�� . Drivers' Llcanu or SS ��c9/Z TVPE OFCONSTRUCTION �I NEW LJ ADD LI ALTERATION LJ REPAIR ❑ CONVERSION �O DEMOLISH ❑ OTHER OESCRIPTION OF WORK S!f �— -� - � �� 1 TVPE OF PERMIT LJ GRADING U FOUNDATIO U STRUCTURAL ❑ TENANT ❑ ELECTRICAI ��LUMBING �MECHANICAL ❑ �OTHER � / PROJECTDESCRIPTION $p.FT. Z�0 - OCCUPANGVJG ' CONSTRVCTIONTVP ' VALUATION$� ZON$ GRADINGGU.YDS. ' ACqE� Remirks: � � .4 i �� Preventet Irrigation asher ' ing Fountains Dreins � Sinks - arvica Outlets Kitchen Sink � � lsvatories. P—Trep Roof Drains anowers � Servica Sink Boiier ' ' � Duct- Under'Ground • Duct-Struttu�el � Duct - Ventilating . ' �� Exheust System �` Multiple ❑ Fiiepl/Fact. Blt ICBO dk �� �ating,System & Ducting 6100,OOOBTU�l00,000BT' or Type I CMF 0865-46 rev. 12/82 White - Builtling; Canary - AOP���Ent; Plnk - Accounting; Goltlenrotl - Assossor Sewer Cap Sewer Connection- Solar ColiectOrs . Solar Piping - � Solar Tank Swimming Pool w/Spe Urinal Water Go:et ' Water Heater - Water $ervice � Reinspection Fee Isue Fee Refrigeration System , ❑0-t00,000BTU ❑100,0008TU System Repair/Alteration PLNG.REF.;M TO BUILDING PROPERTV LINE LEFT SIDE VARD PKG.SPACE REO. STREET WIDTH SPECIAL CONDITIONS: Automatic Washer Construction Pole.'' 8793 5/16/�;3 57.0:7 TL REAR VARO (T0 P/U RIGHTSIDE VARD PROVIDED PARK FEE $ Meter lJover 100amps Cooking Unit Sub Pole Dishwasher , � � Motors OO-1 HP ❑1X$ - Dryers �Gas ❑Electric Inc.Solar �9-15 HP �16-15+ Fan " � • Microwave F.A.U. ' � � Pole Ligh[ Boxes Generator DO-5 KW �5� Transformer ��5•50KW ❑5U+KW $15 Meter ❑up to 700ampe S 3 Zoning Approvad ey Application APProved BY _ Appliption laued By — � Reinspection Fea $15 : laue Fee . ' E 3 Trash Compactor SKW � Reinspection Fee S75 Issue Fee E 3 Data Data `�'� ' oa„ S-/3-�3 � � SUMMARV OF FEES � � ' � � 'BUILDINGPERMIT $ SMIP $ PLAN CHECK $ PERMIT � PLUMBING � �L9 ISSUANCE $ PLANCHECK ; �$ �_��' GRADING $ ELECTflICAI � $ � E ' MICROFILM $ P�AN CHECK' ' $ ' � MECHANICAC �� ✓$ o� ' TOTAL FEE $ � PLAN CHECK " �$ � � LESS � � ' ADVANCED PC ' $ ��y�� � - � , i FINAL FEE � S �3� - r CONSTRUCTION AND PLAN ING. :� - :' - > .: � '• ',� �O� a SPA . _ .. - -' � � _ -- Date - Inspector . � Date �, InspecMr � -APPROVALS ,, Permit�#� , _ �AP.PROVALS �Permit# ''�It, Temporary Electrical Service or Pole.'- . , � � � �_ 52 Pool & Equipment Location ' � - ., i - - - �� 2' Soil Pipe-Undrgrnd. � �,� ; /�9 j�. �` 53. Steel Reinforcement �-. �. _ � • 1 3i Elect;rical Conduit lhilitv-Undrgmd.� ♦ ��- . 54:, Forfns' � ' '' 4'. ElectFical'Conduit-Undrgrnd� _ . . - Y-� � � �� �< , 55:- Electrical Bonding � - • 5, S(ee�,Reinfor�men[ ' - � `�� ; � 56. Rough Flumbing & Pressure Test � � � 6: Electrical UF.,ER'Gind�` - ,• z - 57. APPROVAL TO COVER-GUNITE ` ,� w .,. 7. Footing� � • � : �! �' '� � . _ , � 58: Electiical..Cptiduit-Undramd, ' 8. Fouridation �� ' " _ �•U _ _ - - 59. Gas,Pipe,_O Undrgrnd., Test . . 9. Wate� Pipe-Untlrgrnd..-' �-� , -� : �'' 60. Backwash Lines, P•Trap, O Undrgrnd. , � 10. Structural Floor.$ystem �' . � r� _ � 61. APPROVALT.O DECK � 11. Property Sewer Line & House�Connection ��l�%/p? � -�62. Back�Nash &-Recepmr-Final . i, r7 �' 72. S,ewer CaP.' ", ' ' - �':; ' � . -- 63. Heatey & Vent-Final � � � 13. Roof�Drainr�,. � �� � � . ' �� �. - '64. Plumbing System - Final � ' � 14. Rough-Plumbing : ' �• (•j� f�' 65. Electrical-Final � �r ' ; T5, Rough Electrical-ConduiY�"y-' "' " - - , ' ;"�: '�'- i � Solar,System-Final - J - � � - ;:d6. Rough Electric Wiring, � � 4 ' ' ' � I :. � - " 69,'� Fencin �&�Access A roval - ' - .� i r . � i i ' �_ �: � � 9 _ PP - °i17. Rough�Wiring'Sign� ' ;r j : � �I ' " ' �-� - : �, 68.;APP.RO.VED FOR PLASTERING � , - _ � 16. �Rou§h�Electrical=T;Bar Ceiling� � � -= i � _ � � ; - 69. POOGSPA SY,STEMS FINAL . .' 19. �Rough Heating & Air Conditio;ning ' � / Y3 ', � �FIRE DEPT. REQUIREMENT . 20. ,Rough� Factory Fireplace ' � i ' . APPROVALS � � PermiY# �� . �. x ' " � � 21. Ducts, in Structure�^ ` � � � . ' � � � ; . 70.'� UndePground Hydro n22. Ducts, Ventila[in � � � ' �+ � � � � 9 , ,, i � � ' ' I 7-1 �' Product Piping O Gas ❑ Oil 23r Gas Pipe-Rough &�Test �. � ' p:� � J� 72. Undergiound FIu�Vi�� :��24. Roof Framing '� �� � -' Z3. Undergrnd.Storage Tank � Gas ❑ Oil � . 25. 'Roof Sheathing .'� �� �� ''- - ' � ' - - 74. Oyerhead Hydro � ' _ � 26. T-Bar Ceiling (Structurall & Monocoat� � _ . � - - , - � 75.' Dry Chemical ' . i i ' 2. Frame and Flashing , �' � . � 76. Dry Standpipe � . �„29;j Lathing & Siding � - ' ' ; � . - �77.� FIXED SYSTEM.FINAL - . ; . 29_ Insulation �' ` I - , � ' � � 1 .78. FIRE PREV. FINAL _ ' � �30. Drywall Nailing � , •%' �' � � i � � f � Notes:�, ' � . � �.� . � �- i- . . . . . 31. Plastek�Brown Coat;, ; ; ' � � ; � , , � ' . . �32. �Electrical Power MeterFinal � '� t � ,�,� "� � � f'' � • i � � �� � � i • � I � , � � 33. Final Electric ' � � ' � , � � , � � �� 34. FinalHeating&�AirConditioning' � 8.�.�3� i ' � � - " � 35. Final Gas Pipe-TesY " �., � t `� � . � �f ,�i " - � , . � � ' ' � c 36. Hood or Canopy �- i _ � , � _� ` � 37. Final Factory Fireplace � � : - ' � � � � � � � - � i 38. Final Plumbi"g , i � � ��3' � � . - ' � . 39. Water Service-Final �� � i �� • ' ' � • : � � � � i 1 40. Gas Seivice-Final . � ' � - � 41. Solar pomesticFinal � . ' � � .. . � . -. _ � - . - , .� __ - - - r � + , ,` 42. Backflow Preventer� ' � � � � � . - - + � --+ -� - ,, - ; � , , 43. Backflow trrigatiod � - - ' � 44. Landscape Irrigation�System � , - - ' - � � � � . - i 45. Sound �Attenuation •. ; -' ' � � i ' � ' , - � -' . � . - � 46. Handicap� Regulations � -� � . , . u � � � � � 47. FINAL' STRUCTURE & BUILDING " �, � � ' . ' ' � � � 48. Special_ Requirements Completed � � ' , � � � � ; ' � 49. Electric Felease�to Edison� , � � � _i _�_.�. . � _' � ___� ' � � ', , . . 50. Gas Release to Soujhem California Gas Co � � � ' � � � � � � 51. CERTIFICATE OF�OCCUPANCY • . ,_. � _-. -_. __ . � __� .-'. _,-. _�- 1 � , , No n � � Date ' , I i i ' � _ �_ , ��q� �������� Aool¢ant to fill in a s0aees witn{n neavy boraer lines antl sign al� avv�oorjate aeclarations. CITY OF G.�JSTA MESA � PERMIT NO. TiEACT NO. LOT NO. BLDG. NO. . CONaTRUC,TION °ERMIT /�� �3�d ' Project Address ' , � � ' �pE OF CONSTRUCTION ' Ownely� j%fkYF� % C'Y�fS -' 7/f�GIECLL�Pnon ��-3�_) � NEW ❑ ADD ❑ ALTERATION (��p Addr¢ss ���(p � ��J('C��N ❑ REPAIR ❑ CONVERSION' ODEMOLISH 1 � ArCh/Eng /-J�5 �'.�' N LiCense Na (,���f� ❑ OTHER �^ Address ] � �C��li � L� /I (E � � - DESC P7ypN OF.y���R ; �( ' 'U ' F ' �, Contrecmr �%�� � �(��-(')�,y � - Phone �'S/-��[I TVPE OF VERMIT � O ' Address /%�j�/1 / � ( T/ - � � ❑ GRADING ❑ FOUNDATION �O STRUCTURAL � IICENSED CONTRACTOR OECLARATION ' '- ❑ TENANT �ELECTRICAL�PLUMBING ❑MECHANI I h¢reby aftirm th:.t I aT Iicensetl untler provlsioni of Cnarter 9(com- TBn<in9 wit� sectiOn ]000) O/ Dlvlsion 3 Of the Bu5ine55 antl ❑ OTHER Rotessions Cotle, my- Iicens i Irv tu� 1 /for a tl eifecL� � Liteny. CISss ��v � ,Lic¢'ns€ No� �- " �Y PROJECTD€SCRj�T,oN� , yy� �,_ , _ . Date,t�Z, .i' i • �<�,,.,�.��.e // � -i� I%� 54. FT. �� - -� i- - � WORKE0.5"GOMPENSATION'DEC�ARA 10 • OCCUPANCV �'_/YCONSTRUCTIONSYPE � I hereby affirm tM1at I have a certiifcate of bOnsent fo self-Insure or a' VALUATION /' -��� ZONE uorHfiwte o( Workers^COMpenSation InSUrant¢,-Or a cer/ti�fi�entl copy , ,y�reot(Seq}OpfaSQ,;CZ�C.). � �UCf�/N,�CFCN GRADINGCU.VDS._ . . ACRES "����CyNo.��b< Company� �E:x'Certifietico0Yi5hereby�fumlShGtl. -- -- � ' REMARKS: � �CerUfietl copy is flletl with the city Builtlin9 Division. _ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � � (This soction neetl noLbe completatl if Ih0 permit �Is tor one.huntlretl . - - - _ . . _ �E1001 or less). . ' � ' <ert(ty that �in the. performanGe OL Ihe wo�k for whlch this permil. is Issuetl, I shall not employ any person in any manner so as to"Oecome PLUMBING . �� : PLAN CHECK SUDjetl to Ihe Work¢rs' CAmpensatlon Laws ot-Califomia. Date Signature BATHTUBS SHOWERS � NOTICE: If after making tnis tleclaration, you shoultl become subj¢ct TOILETS 'V FEINALS t0 th8 WOIkeIs' Compen5dtio� provlSiOns O( Ihe Ldbor Cotle, you must � forthwith compty wllb sucM1 provlsion5 or this permil Shall be tle¢metl LAVATORIE$ DOUBLE LAVS j f9vOk¢tl. - -- 1 - � . _ CONSTRUCTIONLENDINGAGENCV ' KIT.SINKS - 0151-1WASHERS • I nereby affirm tbat [here h a constructlon-lentling agenty tor the per- SERVICE SINKS � �.' SUMPS formanca of-the_wor toi�'which this.permi[ is�issuetll(Section.3097 l - Civ. C.1... � F�y%. r/NJ� �! drT.'\�,�. //, \.,. : FIOOR SINKS, '_ FLOOR DRAINS lentleYs Name /C=y��/.c /V�L LCnCer's Atltlres����) �� ���� -77 S�NA� Aa/n CA DRINKING FOUNTAINS OWNER BUILDER DECLARHTION �� -�. � � INTERCEPTORS C�ARIFIERS ' a to the oroviSlons of [ o( DlviSion 3 af tlte Xxyappucant tor a Oermrt SUDIecIS Ine appucdnt to a crvu pena�ry d"�"nol more than five huntltetl tlollars (5500). ❑ I, as owner of lh¢ prope�ty, or my employees witb wages as lheir Sole compensation, will tlo tne-wo�k, antldhestructure is�not intentletl or oHeretl for sale. (Section �044, Businesz antl Protessions Cotle: The Conbattor's License Law tloes.not appty [o an owner.ot a prop¢rty who builtls ar imprOves lhe�eon, antl wno tlOes zu<h wo�k himself o� lb�ouqh bis�own employees, provitlatl that sucb im0/ovement5 are not Inlentled or offeretl lor Shce. If, however, the builtling or improvemEnl is�soltl wi[hin.one year of completion, lhe owner will.have tne.buttlan oi proving- he altl no[ builtl or improva for the purpose ot sale). ❑ I, as owner of the'properry, am ezclusively'contractin9 vdth Iicensed mntractors to construct the praject (Section ]044, Business antl'Protessions�Cotle:'Th¢'ConGaCtoYs Gcense Law'tlo¢s noYapply to dn Owner of property wM10 builtls o� improves Ihereon, antl who Con- traG[s trom such profects with-a mnt�dttOr(5) 'liCesnetl pu�suant to the Contractor's License Law). ' ❑ I am exempt untl¢r Settion � B. 8 P.�C. �or Ihis reason " - Date — - Owner --- - - I h¢reby certi� t t I have,(ead Phis applicatlon anG stale that the.above Inbrmalion rs rrQGl. yagreE to compry with all city dntl county orPlnan< ana (ate lawf relY4in9 �O ConStruC jon, antl h¢reby.aifthOriFe re resen atives f thi <jt to "enf�� u n the above n(en�t/ioff etl SI9 celrtfe _ cti 0��'y�� 7! Dat� /���� 9� Le_�G SWIMMINGPOOL PTRAP WATERSERVICE AITERATION � GASSERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIOIVS � SOLAR TANK COLLECTORS SOLAR PIPING SVS. ISSVE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0_100,000 BTU_ ANDDUCTING 100,000�+BTU_ REFRIGERATION 0-100,000 BTU_ S`YSTEM � 300,000 + BTU _ BOILERS BTU SYSTEM REPAIR,AITERATION E%HAUSTSVSTEM_ _ _MVCTIPLE _ Drivers' Lice�n�se 0��S�S��f '� � � I ISSUE FEE , � =AF 0865-46 WM1ite-Builtling; Canary-Applicanp Pink-Accounting; Goltlenrotl-Assessor A.P. � 4727 2/2;�/83 16.50 TI ZONING REGULATIONS PLNG. REF. � REAR VARD (TO P/L) ' PKG.SPACEREQ. PROVIDE� � STREET WIDTH PARKIFEE S 20NING APPROVED BV,. - DATE , SPECIq� CONDITIONS: ' • .. � • 7 PLAN CHECK.' . I . I I� TRANSFORMER 0-1 KW_1-10 KW ' � APVLIANCE 30-50 KW_501 KW � MOTORS p-1 HP_1-10 HP �- ' � (INC:'SOLAR)' ]0-SO HP=50 i HP" " ' � FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS - � � POLELIGHTS � � . ICE MAIN ..SUB - I�� �- . _ . .. - .1 ,� . �-� . _ ISSUE FEE � � � APPLICliTION APPROVED BV �, � DATE �� 3 � SUMMARV OF FEES � � BUILDING � � - ` � — PERMIT_..__ .S `��' �_ SMIP�'' E �� ,PLHNCHECK � 'PERMIT ' �' ISSUANCE .S •PI.VMBING $�_ • , • �PLANCHECK §� GRADING� 8 � - � ;ELECTRICAL S g' � E . � PLAIVCHECK E .S(� - ' MICROFII.M E i� �MECHANICAL E - TOTAL FEE E - . . LE55 AD- �� ' PLAN CHECK E , VANCE PC S_ [p� � FINAL FEE S /v T �. l�� . � CONSTRUCTION AND PLANNING � POOL & SPA . ;� ,• APPROVALS Permit # 3� Date Inspector AppROVALS Permit�# 1��A�`�"�'K • Dafe,`„`� '- Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location � 2. Soi ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce � � 47. Rough Piumbin & Pressure Test 6. Electrical UFER Grn . ' 48. APPROVALTO COVER-GUNITE 7. Footings 49: 'Electrical Conduit-Undr rn - 8. Foundation - - � 50. Gas Pipe, � Undr rn, Test �- - 9. Water Pipe-Undrgrn � 51. Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor System . 52. APPROVALTO DECK -- ' 17. Property Sewer Line & House Connection � 53. Backwash & Rece tor-Final �� � 12. Street Sewer Connection ' � � 54. Heater & Vent-Final - 13. Rough Plumbing � - - -- --- � 14. Rough Electric-Conduit ' - ' 'S6. Electrical-Final - � 15. Rough Electric-Wiring - � -� �Sf � • 57. Solar SYstem-Final ' • ' � ' � i 6. Rough Heating & Air Conditioning � . encing & Access Approval . 17. Ducts in Structure - ' � APPROVED FOR PLASTERING ' -• � 18. Ducts, Ventilating _ • . 19. Gas Pipe-Rough &�Test ' 60. POOL/SPA SYSTEMS FINAL . 20. Roof Framing � ' � ' : 21. Roof Sheathin ' � � 22. Frameand'Flashin ' NOTES: Q - �L `]-' 23. Insulation ' . T 24. Lathing & Siding ' � 25: Drywall Nailing � ' � � � ' - � 26. Plaster Brown Coat ' � � ' 27. Electrical Power Meter-Final - � � - - � - � ' '� " ' � ' 28. Final Electric � ' � � ' � 29.. Pinal Heating & Air Conditioning _ � � � ' � � � 30: Final Gas_Pipe-Test ' - 31. Final Plumbing $ ' � 32. Water Service-Final ' � � ' � 33._ Gas Service-Final � - � � 34. Solar pomesticFinal - • ' ' � ' ' � 35. Landsca e S rinklin S stem � � � . 36. Sound Attenuation � ' ' ' ' � 37. Handicap Regulations � � � 38. FINALSTRUCTURE&�BUILDING • � � � 39. Special Requirements Completed ' ' "- " ' 40. Electric Release to Edison ' ' 41. Gas Release to Southern California Gas Co. � � 42. CERTIFICATE OF OCCUPANCY � . � No_- Date - , � Applieant to Iill In all ipaces except thosa wlt�in �eavy Dortlar Ilnes anC sign all apO�oDriate tlaclarations. . CIYY vF COSTA MESA , . PER IT O. TRACT NO. .LOT NO. BL . . , . .. , � �432. 4/ � 9/B,� I�9.SO � TI CONSTR�JCTION PERMIT �7 � /IBY� . ! . , , Q 1 App�lcant'SM2ilin-Addf855 ne TY OFCONSTRUCTION NEW ADD ALTERATION� "REPAIR ' - -' � � � � ProjectAddreu, � � N 'p �/� �- � �CONVERSION,-O DE O 5l4. � p �{ • � � '• � ' � _ � . � - � � ' .- �-J � DESCRIPTION�OF WORK ��� ' ��� FN� �� • - � ^ Owner's Name ^' � hon ���// � . ; . . , . . . . - � - . Z I G G 1 �Addf855 �� I � p$Q� ) �iv� ' - ' � TVPE OP PERMIT GRADING FOVNDATION ' STRUCTURAL A. P. �W, � � � 20NE Alth/Eng:`Je' G,C`�^`� � LiC¢nzeNO._ � ❑TENANT''�ELECTRICAL OPLUMBIN6-❑MECHANICAL, " BUILDING' � ' I /���� 'l . _ PLNG. REF.'qk - � AddfESi �� `^�'-" � Vl �� � C�,�OTHER ' TO BUILDWG - � -REAR VAqD (TO P/U �� ' � COntteCtoliNem � � / One 75� - PRaECT DESCRIPTION, SQ. FT.�� , oCCUPANCV LEFTSIDE VARD � � flIGHTSIDE VARD ' '' ♦ , Addrezslmeiling) �9 � (y� �7� ' CONSTRUCTIOfJTVPF • ✓ � VALUqTIONS 95"�'Q�� - _ 3� � 20NE ' GRADING CU. VDS. ACRFS PKG.SPACE REQ. � PROVIDED � � _ � li[enu NO. UCENSED CON7RACTOH DECLARATIOPI � Remarks: _ � � / ; STiiEET WIDTH � PARK FEE $ I.hereby aftirm that I am IlcanseE untler provizioni of Charter 9(commencing ' �� . . � wit� zectlon 7000) ot Dlvlslon 3 of the Busine� an Protessions Cotl , anC � ,( r �. � � ' SPECIAL CONDITIONS: ' my Iicense Is In full fort nE ef ect. /�7 (/�J �/ u /j� � utanse C,�;� �— I / � J/" ,✓�Ee a o � ( �'�1 . . PLUMBING � ' � Date �f no�.���.. . I , . . . 'VORKERS'COMPENSATIONDECLARA 10 ' BeiSink SeWefCep � ELECTRICAL hereCy aifltm tOat 1 nave a certlflcate ai mnslnt to SelNnsure or a certlfiUte._ . _ __ .. . Automatit Wather-. .-.- Metel over 10� amps • . _ �f Workars' ComOensatlon Insurance, or a certlfletl copy t�erao! (Settlon ` Batkflow Preventer - '�SeWer Connection' ' � 3Bao, LnG. C.Z � �G V�r/1/Y// /NS, [��/li / Backflow Irrigation � Solar Collectors � Construction Pole .Sub Panel � PoIICY No. U ComDan, rCu_Cl c� l.�- .. -� -- , . , �Cartifla -copy i's heraby furnishetl. • � Bethtubs i . I $pler PipinB Cooking Unit Sub Pole cer( i eC wlth tha city ByN ��'�✓y�q j� �y� �// Dishurasher Motors �04 HP ❑ 1'h-8 Date � ' ADonwnt /�"""��,�'�v�-�'(���J"� Clarifiers � So�arTank � E%EMPT ONq ROM WORKERS' COMPENSATION DECIARATION r Dishwashef SWimming Po01 W/Spe ' DryerS ❑Gas ❑Electric . InC.Solaf �9-15 HP �16-15+ � (ThitSadion ude0 not Ge comDletetl If the permlt 6 for one huntlretl (S100f or ' . , iess) � . � • � • � � � Fen j � Microwave � , 1 cartlfy.tnat in the PB/formance oi the work fOr whith this Derm�t IS 155uetl I � D�inking FOuntain5 � Ufinel � � shall not employ any parzon In eny manner so as [o become zuojec[. to t�e , , . , � .i � F.A.U. � � Pole Light . � _ � workers', ComDensatlon Laws of CalHornla., V ' • � ; Floor Drains � Water CIoSCt . _ � t � Date � � ' �iqnature ' � ; NOTICE: If,�alter making this�tleclaratlon, you ihoultl become subje<t to the � � Floo� Sinks ' ^- - � ; � �-� � � -Weter HEatei � -- ^ � -+ � �� ._ . Fixtures ' _ _ __ ;_,. Rang2 - .!.. .._ -_ __ - Workers' Compenzation Orovlslons,at tha Lnbor Cotla, you mus[.forthwith � � Device Boxes ' � � ' ' comply 'wlt�' Suth OrovlSionS' or � this permlt shall be tleemetl revoketl.� S ' Gas S¢rvice� �OutlCts � �- � � WOte( $ervtCe , � � � �, ' Sign ' � ' �CONSTRUCT,ION-�LENDING�AGENCY � ' ' - ' { � ' � I he�eby a1Fl�T tha[ thB/e IS alconst�uctlon IenCin9 aganCy fo� th�a�� p�erfo�md�ce� � Ipt¢�C¢pt0�5 . ' � � ^'� ' _ I ,i � , � �UtlCtS � � � .Standing Sections � � ' � of the �work for. I ,p�/q�,�y-r��p�} SecjfQ�.�yw� Civ. C.; � - � , t �entler'r Name ����iv/������ //'�"'^-� � Switches � Trash Com actor � ' � Kitchen Sink ' � � ' ' 7 P , tantler's AtlCrest �/ l � ` � � � ' � , • ' OWNER BUILDER OECLARATION - �� ' ' ` ' ` - � • �`/atolie5� � � ' ' � , � Gefbege Dispo581 � �, , � � � � i � 1 hereby�attlrm tnat I am exempt' from tne Contractor's Licanse Law for tne� �� �, � Generetor �0-5 KW 05-15 KW ' � , ^ ', following reason. (Sactlom 7031:5 Businass antl Profasslonal'Cotle: Any city or �_� P T�ep�� � 1 � • � . county which, repuiras a Oarmit:to <onstruct, alter Improve; tlemollsh�or:iapair � ,.-. , . _ �.. I 1 TransfOrmer � 75-50 KW � � ' � any structure, prior to I[s Isivance,.alzo reqWres t�e applicant for such permi[ i Roof Drems ��'" ;' • .� �,• . � - • ' to flle a signatl statemant that he/she is Ilcensatl pursuant to the provisioni a7 � ❑5U+ KW. - • Contractor's'License Law'(Cnapter 9(commenNnqlwith Section l000) of '' i' � ' . Reinspection Fee $15 ,�:'islon'3roi tne Businesrantl Professlons, Cotle)'onthat he/sha`is!exempt - Showers �� � , ReinspeCtion�Fae � S75 '#veTrom antl the' Dasis for the allegetl exemptlon. Any� violationbf.5ectlon ' . ' � i - Meter ❑up to 100 amps � laue Fee .-� 3 ' fti31.5 oy any apD��cant for - a permit� suDlects tne appllcant to' a civll Seivice Sink � � • Issue Fee ,' � � 3 - � -�- � � ' �enalty of not more tnan (ive huntlretl tlollars (5500). � : • ; �� , ' •�. ' : , � Zoning APP�o�d By ; Data � Ll I, �as �owner of: the �Oroperry or' my ertiploYaes with wages as their sole . compensation will.tlo Me work, antl�tha sVucture is not IntenCetl or offeretl �'� i- '- - , MECHANICAL � . � � .(or sale.�5eclion 7044�, BuSiness antl'Professlonal Cotle:'The•Contractor's - ' � ' APPhcationApprovedBy - Date � Licenie Law Ooas not apply to.an owner ot a property:wno bulltls or Improves � ' Boile�. �� ' � . Refrigeration System � ' ' � � � � � ' � . ; thereon, �antl who tloes,suth work himsetl/harself or lhrough his or her own - �� !� . • App�ifatiOn Isiued By � �! �Date emv�oYeas, provlEea tnat such Improvaments are not intentletl or offeretl for - � . ❑0.�100,OOOBTU ❑100,OOOBTU� . . sale. N nowaver, tne bulltlln9 or ImDrovament Is sola within ono yoar oi com- • Duct = Under�Ground , , � ', SUMMAflV OF FEES ' ' � ; pletion, the owner �wlll have the Durtlen o/ proving he/she tlIU not bui�tl or im- . , - . . ' : I . • � �rove for the purpose ot sale). . , ; '. . Duct - Strucmral ' System Repeir/Alteration ' BUILDING PERMIT $ � � SMIP j ' $ LJ I, as owner o( the property, am excluslvely contracting,wit� Ilcensetl con- ' ' � ' tra<torsm constru<t the proiact,(Saction 7.044, Business antl_Pro(essions Cotle:_., _ Duct- Ventilatin9.�' .,, :. .. _ � . . , _ ',PLAN CHECK� $, � PERMIT ' f The Conlraclor's Licansa Law doas not apply to an owner of property who , � � ' � ISSUANCE ' '$� f � builtls or Improves'thereon, antl who contracts (or such pra)etts witn a con- ' � ExhauSt Syztem ❑ Multiple 0� ' ' � ' PLUMBING $� � � tra<tor(s) Iicense pursuant to the Contractor's License Lawj.� . . � ' � GRADING $ � - � ' - ' 1 � . - - PLAN CHECK , $ ; �, � I am exempt untler Sectlon B. 6 P: C. tor thls reason . Fi�¢pl/Fact. Bit. iC80 # � i . . , � I � : � . $, � ' . � ' � . ' , ' r ' . � � . • � � � � ELECTRI�CAL - $ � , Date � � � �Ow/�er. � � � ' • ' HeatingSystem & Ducting ; � � , j MICROFILM � $ . � b �ereby certJ n 1/� arp� reaa this, applicatlon-antl state-that the above� �0.100;000 BTU-�t00,0008T �-- —' - • - PLAN CHECK. , $', � . fnformatloryfs r Yagr,le to comply wit� all clty antl county ortllnances � � ' t � ' �MECHANICAL' � $; • : TOTAL'.FEE $ ; ana�state�lawz a n9 topuiltlinq constr on, anGpq reby autnorjza r pre- , . sentativ of clt , O anter • on e abov a tioneC pr er r' . Hood oi Typ2 I ❑. � � � , ' � LESS ' � . . � }�f� -'� qP ; . ReinsPection Fee; 515 � �PLAN CHECK $� . • ADVANCED PC $ � . .Inspecti n o d ��i- , '/ � Cano T e II ❑_ � , . ; Signature - Date 7 � � • . . . ' . orivers' u or 55�yE � Registers ; � , � Icwe Fee � S 3 . ' : FINAL FEE � $ � � ' CMF�0865-46 rev. 12%82 White - Bulitlin9: Canary - Applicant: Pink - Accountin9; Goltlenrod - Assessor . .. . i• "� �'_ .� � . . , �` CONSTRUCT �ON AND�PL'AN NG �• _ ' - � ° �-- .• � • r . � ---� - �O SPA _ . - r ' �' , �-- . Aate � Inspector ' - � ';,`Date InspeeMr �APPROVALS Permit'�WW� i : i , ' APPRO,VALS:: � Permit y!� ' - . , 7 , 'i o ° '_ '�i. Temporary•Electr,ical Serviceor;Pole I _-: ; ° ' - - ; 4; .' �. 52. Pool &`Eguipment Location - � ..: 2: �Soil Pi e-U.ndi md., w � � `` - ,- c : '' ' - - - - . . • • F P 9 , i.; z�- -4• I,v�� � 53' Steel Reinforcement �- �' 3: Electrical Conduit U�tilitv-Undrgrnd. - � , i ..;� " � 54: Forms � - . ' .. -. - ��� �4. Electrical Conduit-�Jndrgrnd'. -' �" � ! � � I � ' ' - 55. Electrical�Bonding " ' - � � �� 6: Steel Reinforcemerit � ; ; ;; ;.- . ; �� % : . � ,� " � �.56.� Rougfi Plumbing & Pressure Test � � - 6.ElectricalUFERGrnd. `;�' �i , � � `� - 57:APPROVALTO.COVER-GUNITE 7. Footings i � � �: � � � ;: : . - �58:�,Electrical ��duit-Undramd" ' , r .� ' - 8. �Foundation �, ;�� , . , �� �• - _� `,_ " ��� _ ; � �.59. Gas Pipe,;� Undrgrnd:, Test . ' - 9. Water Pi�pe-UndrgfFld. ,' � �_ _, 60. Backwash Lines, P-Trap,�O Undrgmd. - •n 10. Siructural Floor S�rStem � j'o ,, � c 61. APPROVAL TO �DECK ._ - 11. Property Sewer Li e& House, Connectiorr -'� � 62. Backwasfi & Receptor•Final 12. Sewer Cap , ` • ,' - 63. Heater &-Vent-Final . ' - � � 4 13. Roof Drains � ' � ' i _ � � I f � � 64. Plumbing SYstem - Final . � 14. Rough Plumbing � i � � ` � . ' - ���65. Electrical=Final� � ' � � �-- .� 15.-Rough Electrical-Conduit- -'-- �� " �'" - � ; j � ,� � � � I , � � � , 66. �Solar System-Final - ' � � � � ' , ^ . �1$�1Rough Elecfric Wiring, . i ; �;' - � ' - - � � �67.. Fencing & Access Approval " - � � - 1. � :/ ,,$3 .L. -17.,; Rough-Wiring,Sign; � r'- � `' ; ' � . � : ; . _ ` ; - . , ,' � 68. APPROVED FOR PLASTERING , ��iRough�Elec[�ica1;T,Ba�Ceiling� 1 � �• "� � 69.�POOUSPASYSTEMSFINAL � ' - .� 19.';Rough�Heating & Air Conditioning I� � � , ; � FIRE DEPT.�REQUIREMENT � �. •I;� i i , V"�10,.,,Rough^Factory Fireplace; �': �� . � � � � APPROVALS � Permit # � . r. � . - ' 21. Ducts,:in St�uctu�e`+ �' I. j �� � � � , 70.� Underground Hydro � , �•_22. Ducts, Ventilating " -� � 1' � � ! � I 71. Product Piping O Gas ❑ Oil � . - ,"23. �Gas Pipe-Rough & Test c '.�; �;� r!� � � � i72.' Underground Flush� ' � �� ��24. .Roof Framing� . ! � ' l� ��`. � .� , � • � � i �: ; �, � �• � , .• : 73. Undergrnd. Storage Tank O Gas ❑ Oil� , • •� �' 25. �Roof Sheitfiing � , � � � �� �'', i� � � � a ; �- � � : � -. � 74.� Overhead Hydro ' _ � . � . . � � � : � � ' -26. T-Bar Ceiling (Struciurai)� & Monocoat' � � ;, � � � 75.' Dr�y Chemical _ - • ' ' ' i � `,.27. �Frameand Flashin9� ' � � ' � ! �+ ^' � I ��- � � 76.1 Dry StandPipe � � ' , � . 'I e I` � 28. I:athing & Siding! � -`, i ; 'i � i ' � ; ' ,77.� FIXED SYSTEM-FINAL. ' � � 78. FIRE PREV.. FINAL � 29. Insulati.on �] . � � �'� �� ; � � , � - � I : 30. D'rywall Nailing , �_ � �, � � 1 i � ( � j Notes:� • ; � ; t � � � �� - � - . • - -i -i -.� _ , . _ -� 31. Plaster Brown Coat � � j � � ' -32. Electrical Power Meier�Final � �� � � i � ' � . ' ' • " � - � if . � . . i � � � . � 33. �Final Electric ' � i� � ' �_ ' � � � Z � � � ' � 34. FinalHesting&�AicConditioning �1 � � � � ' I � �."" �� i � � , � � � . • - i^ - �r - � • i . - � � 35. Final GarPipe.Test' - _ _, � - � - � 36.HoodorGnopY`.��; ^ ����'.�-I� ; �-I��:. �. . . . . . _ ' _. e n - 37. Final Factory Fi�eplace•� _ � p _ ;�-' . ' ' � �- _ _ . � � � 38. Final Pluinbing � i i ' , o� . 4� � : I � � � � ' ! - - . -- , - 39. Water $er„vice-Finai� � � i �� � � • , ' , . � � � � 40. Gas Service-Final : � � � ; � i ' ' I � I � ' � - " �� :c 41. Solar pomesticFinal � � ' ' � ' � � � �' � � � ' - - _ - ..t-' - . " � U 42. Backflow'Preventer� � , n' • � '� � :� ! .. i: ' � .. .i --' -' - , . � 43. Backflow Irrigation' - . � � � � : � ' �� , � . . 44. Landscape Irrigation��System ' � _ � � - . � ^ • - - - a �. � i : � 45. Sound Attenuation '' , . � �-. , ' � i . i � � � � � . `- � � .. ��� � . , 46. Handicap'Reguletions� � � .. t � � �' � ' �� � � 1 � , � � � I , - . � � , 47.FINALSTRUCTURE&BUICDING� � � I�.!�,.�� � , ; I I � ' � e s i � i � � 48. Special Requirements Comple'ted� ' ' " '•! ; j � � � ' � �- + y i � � t � 49. Electric Release.to Edison � � r � � _ .. � _ � _ . � . I -'r-- - - -r--t - -�-+ 50. Gas Release to Sou{hem California Gas Co � � � ' ' � , , .i � � - � � . , 51. CERTIFICATE OF�OCCUPANCY ; _ _ _ _�_ �;_ _�. , ;` : � _ __� � ,�� No. ' Date • � .., ADD��cant [o till in all spacas axcapl thosa wlthin heavy Eortler Ilnes antl slgn all aDP�oorlate Eeelantions. cr_ .. . .. _ . . .. ._' _ ". . _.. _. .. ._. . . . _ ._ .. _._ �• �CITY OF ^^STA MESA ' � ' P R IT NO.. TRACT NO. lOT NO. B . , CONSi�CTION PERMIT ' '7G ' AppliCent'SMellingAddte � TYPEOFCONST CTION NEW ADD p.LTERATION REPAIR � � - , � �I2GI 'F]�E3Ia� ���i]l� TL P�OI�t Addfezs �'Qu � HGE y • ❑ CONVERSION '❑ DEMOLISH ❑ OTHER � ' ' . Owner's NHmO �T�60�2�[ Dt �• ' Phone '�>>Z DESCRIa710N OF WORK . 2 I G EGUL I S � Address� � �46i COWNAJ -1.RU/AJE ' TVPEOFPERMIT 'GRADINGp' �' FOUNDATION ' STRVGTURAL �A.P.qW \. 20NE - . - M Afth/En . LiCCn50 NO. � SC 3 IO.PLUMBING ❑"MECNANICAL PLNG. REF.9W ' BUILDING. ' ' 9 � ❑ TENANT ❑ ELECTRICAL' AddIe35I � - - O,�OTHER . TO BUILDING qEAR VARO (T0 P/U ' �� ' �� SUn:L.lG�{r6uF�P'r ahone�%�4�%�-�' .PRQIECTDESCRIPTION SQ.FT.� OCCUPANCV PR PE Y I � Contrector'SNama } � .LEFTSIDE VARD . RIGHTSIDE VARD '^9'.A •, �� Addresslmeiling) ��!4l� �'l%W�� �`�V��� � CONSTRUCTIONT.YPE VALUATION$ �' � ZONE �GRADINGCV.VDS. ACRES � PKG.SPACERE�. PROVIDED � � �icensa No; � ' II UCENSED CONTRACTOR DECLARATION � �` Ramarkr _ � i -� STREET WIDTH PARK FEE $�' � I �ereGy�a//Irin that I am Ilcensetl untler provislons of Charter 9(commencing _, � _ � , �with satllon 7000) ot Divlslon 3 of the Buslnau anC Pro(essloni Cotle, antl ' . � �, . SPECIAL CONDITIONS: ' ' _ - my Ilcanse Is In lull force antl�afTact. � � \ LJunie� qaS,s �,� �-� � � Licens� - Pfo.. � �SB�� � � I ; � PLUMBING • � . � ' . � . Date� Signature: BarSink ' � SewerCap . ' � ELECTRICAL � WORKERS'COMPENSATION DECLA0.AT10 I hereGy at/irm that 1 hava a<ertifiWte of con5ent to SelfansureAr a CertliiWte ' � • Automatic Washer � Met2r over 70� amps ot Workars' comGenSatlon Insurance, � or a cerU/letl- coDv thareot (Se tlon � Backflow Preventer -- . $BWer CAMettion '- -- - ' ' - 3800, Lab. C: � � - - i Conitruction Pole , Sub Panel i ' o C. ' BaekflOw Irrigation , Solar Coilectors � � Policy No. � � 3 6 � S �w Company '- � � COoking Unit � ' . � �Sub PoIB ' � ❑ CertifleC coOY �i hereEy tumiztiee. ' : � � • � Bathtu6s � � Soler Piping ' • •Y` ; � � . C� Cer Itlea cooY Is filea wlth tha clty 8 la ng Dlvlslonp /} DishWash2r �Motors ❑0-1 HP ❑ 1'h$ . �, Date �--1R"'h_3 - qppli<ant K+-t�n=TL-�� Clerifiers SolarTank , , � . . ' EXEMPTION FROM WORKERS'�COMPENSATI DECLARATION . . • � Dryers �OGas OElect�ic �� Inc.Solar,09-15 HP 016-15+ ' � (This sectlon neStl� not be Com01e[BU if the p�or one huntlretl (§100) or Di5hwa5hef � SWimming Pool w/Spa � � less) ' � ' � ' ; � . i Fan � � i '� ' Microwave i ' � I certify �that In�tne performance ot the work for whlch this permlt is IssueO I . Drinking Fountains � � U�inal ' j • � � shallinot 9m010y.dny penon In any manner So'd5 to b¢cOma subj¢ct to t�t¢ - , i F.A.U. � , �P012 Li ht � � Workers'. Compensatlon Laws of Californla.� � , � Floor Drains. 1. { Water ClosCt' I ' � 9• � � Oate � Si9nature ' � � � - i - ' ' • ` Fixtures . Ren e ' NOTICE:�If, after-making this Oeclaratlon, you shaWG bacome suEject to tha � FIoa�Sinks � ---� - — Wat2r�Heater � - - - - --- - 9 _ }. Workers'� Compensation provisjons of tha Labor Cotla, you must�forthwith � � i � '. - - Device BoxCs ' � � ' `! i comply wltn such,provisions�or'this Oermit shall be.0eemed revokaG.. �./. GaSServic¢ �Outl2ts' �� Wa[¢�S2rvic2 �! 5�9�� CONSTRUCTION LENDING AGENCV - - ' ' ' � � - � Standin Sections I hereby aHirm that there is a�constructlon lentling agancy�for t�e performance Interceptors ' �� � • ' �-. � . � Outlets , 9 � ' � of the work tor whlch: this" De�mit' is ,issuetl (Se<tion 30B� civ: cJ ' ' � , . Swiiches � ' �Trash Com actor ' � ' l.anCer•s� rvame - � Kitchen.Sink � � . P � � l.end"er•s Atltlress, ' � -' - � ' � � � �- • � GarbageDispoml ' ' � � � OWNER BUILDER DECLARATION . � , - - � • LevetOfieS� � - , �. � r . ' : . I hareby�affirm t�at I am exemppirom [he Contractor'S'Licansa Law Tor lhe ' • - . �, i Gene�a[o�, �0�5 KW �5-15 KW � � • � ' � Tollowing reason'(Section 7031:5 Business antl Protesslonal Cotle: Any city or_ ��, P-T�ep • i � ' !' 1 county w�lcti raquiros a permiLto construct', aller Improve, tlemolishar repair ' Y �-. �, r . , � TransfO�mer Q 15-50 KW � � � 'any struttura, p�lor to Its'Issuance, also reqWres tl�o applican4foi such parmi[ • ROOf'D�ams' � �� ,., ' , , ; to flle a signee statemanl that he/sha Is Ilcensetl pursuant to the'provisions of ; ;� _ ., ❑5U + KW � � ' �pein c[ion Fee the Conlractoi's License Law (Chapter 9(commencing with Section;�000J of ' f �-. - � � , a15 Dlvision,3� of. the Business xntl Profe55ion5. Cotle) oY that he/she is�exempt Showe�s i• r Reinspection Fee _ $15 . tnerefrom antl the.0asi5 for the alle9etl esemptlon. Any, violatiod�oi,secdon _ � , Meter ❑up to 100ampi Issua Fae � ' '$ 3 7031.5 �y.any aOG��cant for a permlLsubjacts tha •apP��cant to a' civil -' � � - - �enalty ot not more tnan tive,huntlretl tlonars fE5o0�. � .. • . - , � /� Service Sink ; : ' laue Fee � a 3 Zoning Approved By � ; 'Date , ' LJ I,'as�owner oP the.property oi my employees with wa9es�as their sole � . _. �� MECHANICAL � , s. � � ' ' compenSaUon wllt�tl0 the woik, anU tne st�ucture'� IS not In[en0etl o� oft¢�etl � ' � /�ppliGtiOn /�pfOYBd By � et9 tor sale.(Secfion 7044, Business antl Vrofettional Cotle: The Contractor's , � � � ' . � � IJtanse law tloes not aOP�Y to an owner of a property who bulltls or improves ' Boiler � �' R2f�ige�ation System � • qpP��mtion Issued By � - ' nate ' t�ereon,iantl who tloes such work hlmselt/herself or Ihroug� his or her own � � employees, provitletl Ihat zuth improvements are,not Intentletl or oftereG tor ❑0.100,OOOBTU ❑100,OOOBTU � ' � � ' ! wle. If, �owever, the bullCin or improvemenl is soltl wlthin onn Year of com- � Duc[ - Under Ground � , i' , � , { 9 , � � SUMMARV OF FEES , . • pletlon, the owner will have the burtlen of proving ho/sbe tlitl not builtl or im- � , ,, ' ' , � �rove for t�a purpose ot�sale). ; , � � Duct -Structural . � System RepairlAlteration BUILDING PERMIT $ � � SMIP � $ - ` LJ I, 8s ownar o( the property, am axclusively tontrattlng witn'licensetl con- � ' � ' tractorsto construct the Droiect (SecUon 7oa4,.Business anC arateszions_Coae: Duct - Ventilating, ._ � ;_ _! PLAN CHECK , $ ' • PERMIT � � Tha Contra<tor'i L•icenie Law does not appty to an owner o� property who � . - ' �' � ISSUANCE I $ � �• bulltls or Improves thereon, anC who contracts for such pro7ects with a con- � � Exhaust System ❑ MW[iple �; ' ' , j • 'PLUMBING ' � $ � . . [ractor(s) Iicenso pur5uant to the Contractor'S Licensa Law): . ' � � I � � �. ; � GRADING , $ � ' � � I am exempt untler Sectlon B. & P. C. for this reason � Fiiepl/FaCt. BIt. ICBO � j � � ' ' y ' �� �PLAN CHECKI $- �_ .$, � � 1 � , � ;ELECTRICAL $ Date ' � � Oavner' ' � � � � � HeatinglSyStem & Ducting � � � i � , MICROFILM � $ ' I he�eby�ce�tlty t�al-U�aoe-�eatl thi5'dppllCetlOO antl-stata�that the�a00ve , � ❑o-1�,���BTl1'�100,000 - � � � � 'PLANCHECK $� Inlormatlon I5 correct. I agree to complY N'�th all city antl county ortlinanros • . . 1 � � ' � � ' � � � TOTAL FEE, �$ � � anO,stata laws relating to bdiltling construction, antl hereby authorize repre- � • � - � � • ,MECHANICAL' � $ � sentativas of this clt to ent Hood or T 8 I ❑% � i � . , LESS , ;$' � ; 1 ! y, �upo the abo mentionetl property tor � YP a � � peinspectionFee� •$15 pLANCHECK' $ ADVAf�CEDPC ; insvectlon pur o � : Ceno . T e I I ❑ . + : . � ' Signature �� � � Date ��� � � � • : : . ' ' + ( ' � . � . . i I Re isters � � , � ? laue Fee � ' S�3 , . Drivers' Ucense or 55 � ' 9 i � � ' FINAL FEE' , E CMF 0865-06 rev. 12/82 White - BUIltling; Canary - Appliwnt; Plnk - Acmunting; GOIGBnrOE - Asse55or - � � `:CONSTRUCTION AND PLANyp� -N�G� �'t� `-' . � � - � � . � � �,- �OL & SPA � _ - . -� � > 574PP�ROVALS Permit #� � Date � Inspector - " ,. Date � Inspector �, I ,h r. ; . ,. _ ,. , �, � APPROVALS' Pe'rmit# - - ' �: Temp'orary~Electrical SerJice orPole � _ " � �'5T,: Poot &-Equipment Location � - - n - - ,J 2. Soil Pipe=Undrgmd:- �__� F r ' =-�i �Q � � 53� Steel Reinforcement � .. - , " _ ` - . Y . -u - S'. �Elec[ric'al Conduit UtilitwUndrgrnd.,' "^ ' ; � _ -� ' 54:: Forms.i �- � � � � _ - - �- `,' '? 4. Electrical Conduit-Undrgrnd� `, n , ' .' � - . - ` �,�� - '55; �Electrical Bonding ^"-. . � � � , - �� � 5. Steeh Reinforcement � i �; ^. ' - � � . a . -� � 56. Rough Plumbing & Pressure Test ' � . � , - •, `' � 6: .Electrical UFER Gmd` - � ��.- 57! APPROVAL TO COVER-GUNITE ' 7. Footings .; � . � �- � , -�t �- ' .:� 58` Electrical:Cqnduit-Undrar�d. - � - : , � �. . � ' �r 8. 1F.ounda;ion i � � � - � � ' ' C ; ' 59. Gas Pipe; O Undrgmd., Test. ' � _ '� 9. Water Pipe,Undrgrnd. � - � = . - ��60. Backwash Lines, P-Tra ❑ Und� rnd. � � - � �. - _ P, 9 10. Structural Floor Sys4em : ; _ � .;� • � ' � 61. APPROVAL' TO.DECK - � ' J 11. Property Sewer Cine &�'House Conneciion� - �= : 62. Backwash & RecepEor-Final � - 12. Sewer Cap � � ` 63. Heater & Vent-Final - - , . f . . 13. Roof.Drains `: , i :. -� _ , ��64. PlumbingSystem-Final � � '� 74. Rough.Plumbing . � � � " � 65. Electrical-Fina� � ' � - L' �' � 15"1Rough Electrical-Conduit-� � �-�, "'� - 'r - �' , -- �'� !-' 66 i Solar System-Final , � � - - ` " � ' ` ' - ,� .. �.� � I. � �-- �� � � I..- I � ` �'•16.:Rough Electric Wiring� , - �� ;�i �" � !�J' � - -' ,67�.� Fencing & Access Approval �.� - ` - ,�`:1J. `Rough'Wi�in9 Sign: ' -.. . � � y I � 7 i ` � - _ i ' ' : �. - - ��' =1 „ •� 66;APPROVEDFORPLASTERING `78.`jRough Electrical;T;Bai Ceiling� �� = r � ' '69.' POOUSPA SYSTEMS P.INAL ' • ' - � 79.'Rough Heating &�Air Conditioning ' � � � _ ! � FIRE DEVT. REQUIREMENT _ ' � " - 20.'Rough Facto'ry Fireplace , � � . � APPROVALS, � Peimit # ' � ' � .� � i ,� i 3 . � • 21. Ducts,--in Structure, ' ' '� 1' ! . ' � ; � � � , . . � � � . . , ,70.� Undeiground Hydro . - �22. Ducts, Ventilating'. � � ; � � 71.� Product Piping OGas .00iI , - ' � _23.,Gas'Pipe-Rough & Test _ �. i ��' �. � � �' � ! ' ,7�Q,1 Undeiground Flush:. � � . � ? � �24. �Roof Framing � ..' �I = � � � � •� -- � . �- 73. Undergmd. Storage Tank O�Gas �� Oil ' � ti 0 25. Roof Sheatliing � , ' �i �, -; f ,� - 74. Overhead Hydro , � . � i 26. T-6ar Ceiling (Structurall,& Monocoat' j ,, 1-� .'` � � 75.i D,ry Chemical � - � � , ��:27. Frome and �Flashing � � , ' i � � , �76. Dry Standpipe � ` ', 28. Lathing & Siding � , � � ' ;� � i � :� i ` I �77.- FIXED SYSTEM,FINAL .. - � � � . _ �_29. Insulation - � ' ' � � � � � � j78. FIRE PREV. F�INAL . �30. Drywall Nailing � � ' . ' ' ; � Notes:. � �� � � . . ,'31. Plaster Brown Coat � � � � � i � - � 32. �Electrical•Power Meter-Final ' . ` � � � � 33. Final Electric � � (� ' ' � ' � � ; i � I � 34. Final Heating &.Air Gonditioning , � . � � � � � � . � ' i � . � i 35. Final Gas Pipe=Test � �� ' � - � ��" ��� � . � • - " ,- �' -i i' 36. Hood or Canopy -�: .., i . . , I' - . I ' � � . . ' ,.. _ �.. � . . _ - . - � 37. Final Factory Fireplac'e. � � ,� , ' _. , � , � . " 't � 38. Pinal Plumbing � ' . .� � .�� •. 39. Water�Service-Finai. � j �i � ' -. � I 40. Gas SeFvice-Final I ' � � ' ' � ' � � . , ' � •� � � , � 41. Solar pomesticFinal { � � , � � � _�_ ' I ' 1 ;_._ . i'''�,___ . . ' ; 42. Backflow Preventer . � � � � � � � . . ' � : i ,- ' . - - .. 43. Backflow Irtigation - ' - � ' ' - � �� ' , �� �- f � i" i .. �', i - I''' - I i ' . - . ' 44. Landscape Irrigation�System, `� � = _ . � • � � ' 45. Sound Atteauation �, � T � �' , .� ' ' , � : ; " � � � � � • - � 46. Handicap Regulitions � � , ; i � j' � � � ', j � , � �' , � - ' . � , i i .� 47. FINAL STRUCTURE & BUILDING i � � � � ' ' � , � � i � � 48. Special Requirements Completed � � � ', _ � ' � � ; ; � � . � ' � _ � ,+ 49. Electric Release4o �Edison� �, ' ,_ _:_ . _. ._� ._.'- �--; •_ _ ..- ---� . • � . � : ' � . . �� � � 50. Gas Release to Southem California Gas Co ' � ' � ' � .. � - �� ; � � I 51. CERTIFICATE OF 9GCUPANCY ' ' ' ' . _ �. .. _ . } �--� i � � i � , ' i'�-, - -� i - , "� . , I. . . No. �� Date • j OWENS-CORNING Fit�e'rglas Building Insulation The contractor named below certifies that the Owens-Corning Fiberglas Building Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance and that the Building Insulation is installed in conformance with current energy conservation regulations, California Administrative Code, Title 24, State of California, in the building located at: O.ti7E .�15/ia (.OST�7 ��1 .GOT `i / Address Ciry 7ract Number Exterior Walls Owens-CorninQ Fiberqlas Type�S_ Insulation _/ �i_ ,� /� Thickness R-Value Ceilin s Owens-�orninq Fiberqlas Type�.� Insulation 61,� a_/9_ Thickness R-Value Floors Owens-Corninq Fiberplas Type Insulation Thickness R-Value Foundation Walls General Contractor By Manufacturer Type Thickness R-Value Title No. Insulation Contrayctoyr�,'S��P��'�'�� s—�� � License No. .30 B 030 By U/�1 (/�/'✓�-Q�-+ Title �..1u�f Date S�Z B� is�yo. ,.� �— Homeowner Copy (White) � Slete Copy (Yellow) Builder Copy (Pink) OWENS-CORNING FIBERGLAS CORP. v�,e. Ho. io-e��sne Insulation Operetinq Division Li��o In U.S.A., Jen., 19BY cocr.�vm e�eax o.�,�,-co,�;,q F;e„o4• ��o. Fiberglas Tower, Toletlo, Ohio a3659 �