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Home My WebLink About900 PEACE PL - Building Permits(714j 754-SD3 • Fayc (714) 754d856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT JobAddress: 900 PEACE PL Suite No Vicinity: Parcel Number: 41805251 Appliwnt: PATTEN,ANDREW Address: 19031 WOODLAND WAY PORTOIA HILLS Owner: DAUNCH, ALICE MARIE TR Address: 900 PEACE PL COSTA ME$A, CA Contractor. Address: Status: ISSUED Applied: 05/18/2004 Issued: 05/78I2004 ISSUED BY: Phone: 949-713-6990 Zip: 92679 Phone: 949-254-6070 Zip: 92626 PROGRESIVE HEATING AND AC 19031 WOODLAND WAY POR70lA HILLS Phone: 949-713-6990 Zip: 92679 License: 805263 SCOPE OF PERMIT REMOVE AND REPLACE FAU <100K BTU. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k B7U Re(rig Sys >700 k B7U Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < t00QOc(m Air Handiers > t00QOcfm Floor Furnace Floor or Suspend Heater 523.50 514.80 50.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 50.00 50.00 30.00 $0.00 $0.00 $0.00 Quantiry FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeretion Unit Ventillation System Evaporative Cooler Comme rcial I nci neralor Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750�BTU Boilers Uplo3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee ReinspecUon Fee Quantiry 50.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 50.00 TOTAL CALCULATED FEES $38.30 NOTICE: The work authorized by this permN shall compty with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No, g2•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 a6andoned 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 Inapeetlong and finel approvel must ba obtained. Failure to obtain inspections and final approval will result in the expiratlon ot this permit. FOR INSPECTIONS CALL: (714) 7545626 za+sae �a�oo� WORKEAS'COMPENSAnON DECLARAnON: I hereby effirtn under penalry o� Perjury ane ol the following declarations: ❑ I have antl wlll maintein e cartificate of consent lo sell-Insure for workers' mmpensetlon, es D��ded for by section 3700 0l Ihe Lebor Code, lor tha pertortnence ol ihe wark lar which Ihis pertnit Is luued. ❑/ I �ave antl wlll mairitaln workers' compensatlon Insurance, as reqWred �y soctlon 3700 oi ihe Lebor Cotle, lor the pedormance ol Iha work tor which Nis pertnit Is issuatl. // A/�y0uo/rkery('c mpe n Insurence carder end pallcy number ere: // �� v� `�� Polic�yGe.F l il (TTIs secNon nsed not be cwnplefed l! fhe perml( Is velued ef one hundre0 dW/ais ($100) or /e55J �I certify Ihal in the peAormance ol}qa work lor whi dic-yertnit Is IssueO, I s�all not employ eny person in any manner so es to become subject ro t�e workers' compensetion lews af Ca�ll � fiA e � i sh IQ become su��ect to Ihe workere' compensetlon provisions ot SecGop.�700 0l the Lebor Code, I shell torthwlN comP�Y wM these p/rpy�� //�p/ / L, Applicent Signature' /..�5� � - Date: �/ / O/ C� 7 WARNINO: FAILURE SECURE N'OHI(EFS' COMPENSATION COVERAGE IS UNUWFUL PND SHALL SOBIECT AN EMPLOYEP TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDREO TFKKISAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAN,4GE5 AS PFOVIDED FOR IN SEGTIIXJ 370fi OF THE UBOR CODE, IMEREST, AND ATTOFNEV'S FEES. LICENSED CONTRACTORS DECLAHATION: I hereby aHirm that I em Ilcensed u r provisic force and eHect. Lic. a Coniredols Signature: (commencing with Sectlon 7000) of Divisian 3 of Ihe Bi Class a Date: _ Cotle, flntl my license is in full CONSTRUCTON LENDINC AGENCV: ❑ I hereby attirm Ihet ihere is a consiruciion lontlinp eBenty lor the peAormance of ihe work lor w�ich �his pertnit is issued. (Sec. 3097, Civil Cotle). Landers Name: Signetura: _ Lenders Address: Daie: OWNER-BUILDER DECLARATIONS: I hereby eNirtn Ihat under pen9lry ol pehury thet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor �he lollowing reason (Sec. 7031.5, Busine55 end Professlons Cotle: Any ciry or counry whicn requires a permli to consiruct, alter, improve, tlemolish, or repeir eny structura, prior to Its Issuenco, also requires the epplicant for such permit to lile e signetl stetemant t�et he or she is Ilcensad pursuent to ihe pravisions oi the Contrectors License Law (Chapter 9(commenUng with Sectlon 7000) 01 Dlvlsion 3 ot Ihe Business end Prolessions Code) or that he or she Is exempi therefrom end the basis lor the elleged exemptlon. Any violetlon ol Section 7037.5 by any epplicant for e pertnit su6�ects tha applicant to a dvil penalry of not more then tive hundred dallaw (5500)J: ❑ I, as owner of Ihe praperry• or my employees wlth wages as their sde compenselion, WILL DO THE WORK, and ihe struqure is not intende0 or oHeretl for sale (Sec. 7044, Business antl Pmtessions Code: TTe Coniracrors License Law Eoes not eppty to an owner ot pmperty who builds or improves thereon, entl who does such work himself or herselt or through his or her own employees, provitletl Nat suU improvements are not imended or oHereA tor sale. If, however, the building or improvemem is sold within one year ot cOmpletion, the owner-builder will hava Ihe burden ol proving that he or she tlid not build or improve tor purpose ol ule.). ' ❑ I, as owner ol the propeAY, em E%CWSIVELV CONTRACTING WITM LICENSED CONTRACTORS to consimct the prol�� (Sec. 7044, Business end Protesslons Code: Tha contrattors Lf�ense law tloes noi epply to an ownar oi proDerry who buflds or impmves Ihereon, entl who coniracis for suc� project wlth e comractor(s) license pursuant to ihe Contracbrs Licensa Lews.). ❑ I em exempt untler sec. Business end Prolassions Code for Ihls reason: Signature: Dato: Owner ID verilied by drivefs liGense. ❑ Ves ❑ No Orivers License No. Expires: Vedticetlon of Ownership by (cype ol document, i.e. - property len bill ar tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby cetlify ihet no eX�evetion five (5) or more leet in depih Into which e person is requlretl to tlescend, will be made In connection with work euthorizetl by Ihis permil, antl Ihat no building sWcture, scaHolding, lalsework, or demolltlon or tlismaniling theraof, will 6e more than thirty-si: (36) leet high. (Chflp. 32, Grp 2, Art 2, Sec. 341, Title B, Calilomia Adminisirelive Code). ❑ As owner-bulltler, 1 will not employ enyone to do work w�ich woulA requlre e parmit from t�e DlWsion af Industrial Sefery, es nated ebove, unless Such pereon hes e permit to tlo such work Imm the division. Signature: Dete: Division ot Intlusinal Sefery PefmM1 Number. CEATIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRY: I cenily under penalry of perjury Ihel I heve read Ihls epplication and stete t�at tho inlormatlon given is correct. I egree to compy wit� ell state lews and ciry ortlinances relatlng lo bullding construction, end authorize representetives of t�e Gry ot Coste Mesa to enter upon I�e eDove-tlescribed properry for inspection purposes. I egree nof to occupy or ellow occupancy of eny building euthonzed Dy this permit until fnal insDection. i� / /Y/��i'��`�''� r�-�-�-��r<_,.,-r•:,..-_.,, - COOE �. INSPECTONTYPE 1616 Fixed System Final FIle Preventlon 126fi Pool Spa Finel 200 Final Re-Rool 201 Pinal Blxk/Reteining'Nall 202 Final Factory Fire PIaLe 203 Final Sign 20a Final Demolitlon � � 4oUE� INSPECTIONTY�E 20fi Final Mechanical 208 Flnal Plumbi�g 210 Final EleciriGal 212 Finel Fire PrevenNon 220 Final Planning Approval 222 250 Final Site Finel Building/Occupency � _ 1 1111' " r y \ � Aop�lcant to flll in a11 spaces exeeDi those witnin heavY Oortler ilnes antl slgn all avaroorlate tleclarations. CITY OF �:OSTfA� MESA ,GONSTR�ICTION PERMIT P�RMIT NO. TRACT NO. LOT NO. UNIT NU. Project esi -_\� ,�A« t��-'�E AppliCa Mailin� Address `� �� • ��' Owner's Name �C£ �• Phone Address q00 . Ef�CE L• Arch/Eng. Licensc No. Address Convacror'�NA�++a �i�`��Rk ooFiw• vti,.�„ '�\7 AdAreulmA'��gl �� T�A�i a. City License No. ��3� LICENSED CONTRACTOR DECLARATION I M1ereby aHirm that I am Iicansatl untler O�ovizlons oi Charter 9(commendn9 with 5¢c[ian 7000) of Dlvision 3 ot tha Business ana Vrofessions Code, antl my license iz in fyUI i9�^�.�ntl eitect. ��/� License sg ��i SL�(V `� � Date �Z ~ Si9nature `�p'�� WORKERS'COMVENSATION OECLARATION 1 nereby aHirm tnat I have a certi/icate ol wnsent to self-insure or a certiticate of Workers' Compenwtion InSuran<¢, Or a certifietl copy tnereo( (Section 3800, Lab. C.) Policy No. Company eCertifietl copy is hereby fu�niSheE. Certifietl [opy IS (ilea with t�e city Builtling DlviSion. Date APOlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Tnis section neetl not be completetl if the permit Is tor one huntlretl (5100) or less). I certify that in the performanca ot the work for wnicn this perm�t iz issuetl, 1 sM1all n0[ employ any per50n in any man e� so a5 bet e Subjett t Ihe Worke�pen5atlon Laws of Calitom �ate 2 Signature 'NOTICE: Ii, aRer makin9 tnis tleclaration, you sl la becomo suDject to the Wo�kers' Compensalion provi5ion5 O� Ihe La�o� Cotle, you must lorthwl[h comply witn sucn proWslons or this permit snall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby a�firm thal [hEre Is a construclion Ientlln9 a9¢ncy lor tho per/ormance ot the work br which tni5 permit is Iisuotl (SecNon 309] Civ. C.) Lentler's Name LentleYs HOtlress OWNER BUILDEH DECLARATION I horeby alfirm that I am oxompt irom tbe Contractor's Licensa Law for the following rcason (SocUon 7031.5 Buslnoss antl Prote55ional Code: Any clry or county whlch requires a Oermit to consVUCt, al[Or, ImOrove, tlem011sM1 o� �epair any scructuw, pdor to its issuance, also requlres tho appllcanl lor such permit to tile a SignOtl stalomenl Ihat h0/Sh0 I5 Iiconsatl Ou6uant to tlle pfOviSiOns o� lhe Contractor's License Law (Chapter 9(commoncin9.'�'��h SecUon 7000) o( Division 3 ot tba Business antl Prolesilons Cotle) or t�at he/sho is exempt thCrefrom antl lhC ba515 tor the allogotl ex¢mptlon. Any viOldtlon of $ection 7031.5 by any ap0��anl lor a permit subjecls the aPPlicanl to a civil �enalry ol nol more lban �Ivo nuntlrc0 tlollars (5500�. I, as owner of lha proporty or my a�nployeas with wag¢5 as their Sole comp¢nsalio0, will tlo the wo�k, antl the Tltuctur0 is nol IntenaeE or oiferetl lor sale (5lction 7044, Buslne55 antl Pr01855ional Cotle: Tho Cont�acto�'S Licenso Law tloes nol apply to an own¢r oi a proporry wno Guiltls or improves lhereon, antl who aoes Su<b work hlmsell/hurmH or through his or her own employees, prOvltletl that sucn ImprOvemenli arn nal In[antlatl or oiforotl for sale. I/, hOwevar, the builtling Or Im0/ovement IS Soltl within one year 01 <Om- pletlon, tne owner will have tha burtlon ol proving he/she tlltl not Dulla or Im- prOve lor the pu�posn ol sale). ❑ 1, as owne� ot the ProDerty, am ezclu5lvery contracling with IlcenSetl Wn- t/dC�0�5 f0 COnS�N<t th¢ P�Oj�Ct (SeCtlOn 7044, BUSiO055 dOtl PIOt¢SSIO�S COtle: � The Contractor's Litense Law does not dpply to an owner Ot P�opetty who builtlz or improves tnermn, antl who contracts for sucn pro�acts with a mn- tractor(s) Ocensa pursuant to the ConVactor'S License Law�. I am aware that proo( of lheir Worker's COmp¢nsalion Insurance Shoultl be provitletl t0 m¢. ❑ I am exempt untler SecllOn B. & P. C. lor lhis reason Date Owner 1 nereby certify that I have reatl tnis appli<atlon antl ztate that tne a0ove IntOrmatlon i5 wrrecL I agree to comply wilh all cHy antl coun[Y ortllnances antl state I ws relating to builtling construction, ana nereby authorize repre- sentatives [hi5 city�to e er u0on lhO�abOve-menlionetl p� Pq erty tor ins0e�tion poses. \ aA \p s� a� (�%A\!�1 `�o'� ` Date �2 \ � �— � TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DES IPTIO OF WORK/US OF BLDG. �� -�2ooF n�E2 EXS\Si 1 N TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL ❑ OTHER PROJEC7 DESCRIPTION Sa.(p�T�., � oCCUva v CONSTRVCTIONTVPE �"`-'�F VALUATION$ L%�� ZONE C.RADING GU. VDS. ACRES Remarki: � Sink Preventer Irrigation 7rinking Fountains Floor Drains Floor Sinks Gas Service Outlets IntefCeptOrS Kitchen Sink Lavatories Roof Orains Reinspection Fee � $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Ezhaust System ❑ Multiple Firepl/Fact BIL ICBO # Heating System & Ducting ❑ P7 00,000 BTU� � 100,000 Reinspection Fee � $15 ]0/BG White - 8ulltling; Gnary - ApPlicant; Plnk - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connettion Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Wnter Closet Water Hearer Water Service Auto-Wesh laue Fee Hood or Type I ❑ CanOpy Type I I ❑ Refrigeration System ❑aioo,000eru ❑ioo,000 System Repair/Alteration Fire Dampers Registers �ssue Fae FEES $ 3 S 3 A.P. ,iE S Main e� E T Front e Rear A C Right K left S Ping. Ref. # Automatic Washer Construction Pole Sub. Cooking Unit D ishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5 KW C 5489 12/09/95 Zona Accessory Building: Parking Req.IProvided ELECTRICAL � Transformer ❑ 75-50 KW ❑50+KW Meter LJup to 100 amps Meter ❑over 100amps Sub Panel Motors O0.7 HP O1'r5 � 8 Inc.Solar 09-15 HP �16-15* Microwave Pole Light Range ; Standing Sections 5�15 KW Trash Compactor g4o5C TL FEES Z O N I N G H E O M T S I Reinspection Fee �$15 I I Issue Fee I S 3 1 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approvad By �ata Building Approved By Date Appliption Issuad By Date � SU MARV OF�EES BUILDINGPEFMIT $ �� SMIP $ �.S�v PLAN CHECK $ - PERMIT PLUMBING $ ISSUANCE S PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $. GRADING S PLAN CHECK 50% $ MICROFILM § MECHANICAL $ TOTAL FEE $ •s� PLAN CHECK 25% $ � CONSTRUCTION AND PLANNING PG� _& SPA - APPROVALS Permit # Date Inspector AppROVAIS Permit # Date Inspector porary Electrical Service or Pole 52. Pool & Equipment Location 2r Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. �iec[rical Conduit Utility-Undrgmd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 5J. APPROVAL TO COVER�GUNITE �. 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 73. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 75. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17.'Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.'Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air.Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil ' 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof ShAathing . 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing&Siding 77. FIXEDSYSTEMFINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer ' 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ,. ,_ 48. Special Requirements Completed 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co � 51. CERTIFICATEOFOCGUPANCY , No Date �J , Aoplicant to fill in atl spaees exceot tnose within heavy ooraer lines anG sign ail appropriate aeclarations. rITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. T CT LOT NO. UN1T NO. Cac�� •9 - 22 �f9� Project Addr�ss 9��, /"�- ' ApplicanYs Mail('�ng �Ad�d� �l,(c�/�'_c � `5 ^1 � if -'1 St _ TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Ownef'S Name ��S��f)i1fS„JG-. PhonE - �is � CONVERSION ❑ DEMOLISH ❑ OTHER p. DESCRIPTION O,F WORK/USE OF BLDG. ��K f�� Address 7� ��AG6 p�i Arch/Eng. License No. Address n^.�. '1 ��[� Contractor's Nam¢�LLI� L Phonei�41a2 Addresslmal' g) .�Z� S (...�SG..1-� Sr �a'_,N�+-n�^-- Ciry LicenseNo. �a� k� LICENSED CONTRACTOR DECLARATION I he�eGy afti�m lbat I am licensetl untle� provisions of Charter 9(comm¢ncing with Sec[lon 7000) oi Divlsion 3 Of tho Bu51nCi5 antl Professlons Code, antl my license is in tull force antl efiecL ' License Class C'�' Lic se No. Q �� Date��z%��. Signa[ure WORKERS'COMPENSATION DECLARATION � 1 hereoy atflrm inat I have a certiticate'oi consent lo selLinsure or a certlticate o! Workers' Compensation Insurance, or a certifietl copy t�ereof (Sectlon 3800, Lab. C.) � . Policy No. • ^ Company eCertifietl copy is hereby turnishetl. •_ Certifietl copy is filetl with Ihe city Builtlin9 Division. , oaie Applicant E%EMPTION FROM WORKERS' COMPENSATION DECIARATION (Thissection neetl not be completetl if the.permit is for one nuntlretl (5100) or less). I cettify that in [he performdnce of the work fo� wM1ich this p¢rm�t i5 issuetl, I shall not employ any perzon In any m nner so as to become subjec[ to the . Workerj� C.prt� pen�y(Jon LawS of Calif n c.�_ Datao�-�G-b^- Signature �� 1��1„�^�� NOTICE: If, after making this tleclaration, you shoultl become sub�ec[ to tho. WOrkers' Compensation provisions of Ihe Labot Cotle, you must fortnwl[n <omply with SUGh provislOns or tnis permit sball be Oeematl revOketl. CONSTRUCTION LENDING AGENCV I herpby a(firm that tnere is a constructlon lentling agency for the periormance of tho work for whlch thi5 permit is issuetl (Settion 3097 Civ. CJ Lentler's Name Lentler's Atltlress OWNER BUILDER �ECLAHATION I here0y aftirm that I am exempt from the Contractor's License law tor tne lollowin9 reason (SeGtlon 7031.5 Business antl Professional Cotl¢: Any dty or counry which requires a permi[ [o construct, aller, improve, tlemolish or repair any structure, pdo� to its�iSsuance, also require5 lhe applicant for such permit to file a si9�etl statement tnat he/she is licenzetl pursuant to the orovisions of Ihe ContractoYs License Law (Chapter 9(commencing with Section 7000) of Division 3 of tM1e� Business antl Profession5 Cotle) or [hat ne/sne is exemp[ thmefrom antl the basis tor tite allegetl exemption. Any violation of SecHon 7031.5 by any aOP��cant for a permit subjects the applicant' to a civil �enalty of.not more Ihan five nuntlretl tlollars ($500). ' � U I, as owner oi the property or my employees with wages as their sole mmvansation, will ao the work, antl the structure is not intentletl or ofteretl ror sale (Section 7044, Business antl Professional Cotle: The Contractor's License Law tloes nOt apO�Y �u an owner ot a property wito builtls or improves thereOn, antl who tloes Such wotk nimselt/M1erself or [hrou9h his or her own employees, provltletl tnat sucn improvements are not Intentlea or otteretl for sale. If, howeveq th¢ builtlin9 or improvement is soltl within OnC Yea� of com- O�etion, tne owner will�have the burtlen oi proving hC/she Oitl not bulltl Or im- prOve for (he purpoie Of salo). , ❑ I, a5 ownC� of lhe property, am ezclusivery cont�acting wl[h licensetl con- Iractorsto conslruc[ lhe Oroject (Section 7044, Busine55 antl Pwlesslons Cotle: ThC Contractor's License Law tlOes nol aPPty lo an owner ot properry who builds or im0�ovez tM1ereon, an0 who conVac(5 for Such projects with a con- tractor(s1 license pursuant to [he�ConVactor'S Li<ense Law). I am awaro tha[ � proof o( [heir WOrker's CompenSatlon inwtance shoWa be provitletl to me. � 1 am exem0� untler Secllon B. & P. C. �Or thl5 r¢d50n Date Owner 1 hereby certi/y that 1 have reatl this application antl state that the above in(ormation is correcL I agree to comply with all city anC county ortlinances antl slate laws relating to builtling construction, and hereby authorize repre- 5entatives oi. this city to enter upon the above�mentione� property ior inspec[ion as s . . siqnature �-g 0- ��L1.f� �--� � oaceo/— 1z-Yb Orivers' License or 55 � � �-� - TVPE OF PERMIT LJ GRAOING ❑ TENANT ❑ ELECTRICAL ❑ OTHER PROJECT DESCRIPTION Sa.FT.� CONSTRUCTION TVPE VALUATION $ _ GRADINGCV.YDS. ACR 1 FOUNOHTION L�7 STRUCTURAL PLUMBING ❑ MECHANICAL Remarks: Bar Sink Backflow Preventer Backflow Irrigation Clarifiers � Dishwasher � Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets <itchen Sink ' Lavatories � ' '-Trap Roof Orains. Reinspec[ion-Fee S15 Duct - Under Ground Duct-Strucmral , Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepUFacL Blt. ICBO # Heating System & Ducting ' ❑ 0.100,000 BTU � 100,000 BT Hainspeaion Fee I $15 CMF 0865-66, rev. 30/84 White - Bulltling: Canary - Applicant; Pink - Acmun[ing; Goleenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection $olar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Weter Closet Water Heater water Service Auto-Wash Issue Fee Hood or Typel� ❑ Canopy TYPe II ❑ Refrigeration System � Oo-�oo,000eTu ❑ioo,000 System Repair/Alteration Fire Dampers , Registers 0 Issue Fee FEES A.P. # L S Main Bu E T Front B Rear A C Right K , Ping. Ref. # Planninq Notes: Automatic Washe Construction Pol� Cooking Unit Dishuvasher Dryers ❑Gas C fan ' F.A.U. Fixtures ' Device Boxes Outlets Switches Garbage Disposal Generamr �0-5 lectric 8024 I/24/86 Zone Accessory Building: ±a�i �� Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW. ❑ 50+KW Meter ❑up to 100 amps � Merer ❑over 100 amps Sub Panel Momrs �0�7 HP �1"F, 8 � Inc.Solar �9�7 5 HP 0 � 6-75+ Microwave Pole Light KW LJ5-15 KW $ 3 � Reinspection Fee $15 FEES , �DEVELOPMENT SERVICES REQUIR 2onin9 APPraved 6y Building Approved By , ,Applifation luued By Sign ' Standing Sections Trash Compactor Issue Fee Z O N I N G R E Q M T S FEES $ 3 ,� SUMMARV OF FEES BUILDINGPERMIT $ 2 00 SMIP $ D.SO PLANCHECK $ � �30 pERM1T � � PLUMBING $ ��SSUANCE $ � � PLAN CHECK 25% $ ENERGV P.C. ,$ EI.ECTFICAL . � $ GRADING $ � PLAN CHECK 50% $ ' MICROFILM $ 9� MECHANICAL � S' TOTAL FEE �$ ' J6, �O 5 3 PLAN CHECK 25% $ � � I � CONSTRUCTION AND PLANNING POt�� & SPA APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Ste?I Reinforcement 3. Electrical Conduit Utility-Undrgmd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement �' (� (�j/' 56. Rough Plumbing & Pressure Test 6. ElectricalUFER.Grnd, 57. APPROVALTOCOVER-GUNITE � 7. Footings ��` vL _: 5S. Electrical Conduit-Undrgrnd. ' 8. Foundation , 59. Gas Pipe, O Undrgmd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection i 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval � . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.� Rough Factory Fireplace APPROVALS Permit # � 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation � 78. FIRE PREV. FINAL I 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT :�t. Plaster Brown Coat . 79. FINAL INSPECTION 32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISS D 33. Final Elecvic Notes: ��6' E'/L�`�� £i�/ 34. Final Heating & Air Conditioning ��'/ �p ,`C /(��/r v� 35. Final Gas Pipe-Test - i 36. Hood or Canopy � ' 37. Final Factory Fireplace � 38. Final Plumbing � 39. Water Service-Final . 40. Gas Service-Final � 41. Solar pomestic-Final � 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING � � �� 48. Special Requirements Completed 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY , No. Date _ • y �• •!ti__iL}�11 'IHIS AQ2EF�1T, made ard entered intn this ��7"� day of u , 198�, by ard 6etween /�Li�-i MNlfi,< ,a, �N�/.� hereinafter referred tn as "LAND QddER", and /yI/,4QY ,ELL�,v f,lp�.y�,�f/l,� hereinafter referred to as "Aa7ACINP PROPERTY Q�iNER". It is hereby agreed that a party wall will be constructed on the property line in the City of C�ta Mesa, Coimty of Orange, State of California, as per map y p �- recorded in Book,�� .3 , PageS� of Miscellaneous Maps, in the office of the Coimty Recorder of said Coimty. Zhe party wall shall be permitted to encrxdi IN WITNESS YdiEREOF, the parties ha�e entered into this Agreement the day arcl year first abwe written. IAND CWNER / _ 1 1% r �/ ( gnature)" f��(C-� N//l?r� G`��1 tl.Yc� Name (Zyped or Printed) ,�� r� � viv �� A (Address) C�y .�a !_� � �� o�. i 9 3 c� r �� c�� c�� _Q�, � 3� / 98� (T � AATACENT PROPEFriY CWNER `� ^ � r'�.ul��G.�.� xY�h�,,.�,.�a.ls.( (Signature /�l/fK�/ ��P.v �� M ia .vs/li N�ne ( or Print ) �.SSI2 ��,.� G'- � (Address) -7�/,,y��,.,,L,,,�� 'ZG,�3 — c��i r.� Li? � F o f, �5--� 82 (NpTE: Please see reverse side for notacy's statement) 0 SD1TE Cf' CALIFOIBdIA ) ) ss. �[JN'IY Ck' OR.4NC� ) On before me, the imdersigned, a Notaty Public in and fnr the Coi.mty of Orange, State of California, personally appeared ]mown to me tn be the pers�n(s) whose name(s) is subscribed ta the within instrument and acknowledged to me that (he/she/they) executed the same. WI7TIES5 my hard and official seal. S ignat�e Name (typed or printed) STATE (F CALIFC)ISIIA ) ) ss. CYXJNRY OF ORAN(� ) (SEAL) On , before me, the imdersigned, a taotaty Public in and for the County of Orange, State of California, personally appeared Imown to me to be the person(s) whose name(s) is subscribed tt� the within instrument arci acknaaledged tn me that (he/she/they) executed the same. WI4NFSS my hard and official seal. ( S icptat�e ) Name (typed or printed) (SEAL) � 0 Cement Coping Optional � Chennel Block With Orre 3%Ou� Norizontal Top of �II • Fenoes � � Fo� Fences 5' or Leu Vert. Bars 3/8'� at 4' -0" O.C. For Fenees Higher Than 5' — Vert.Ban 3/8"� at 32" O.C. Fill Cells Solid With Grout — Where Steel Occurs Reinforcing Steel.Shall Conform to Sec.A•15-39 A.S.T.M. All Steel to be Lapped 16 " or to Code NATURALGRADE S7RUCTUFr,i�o TYPICAL 6�� CONCRETE BLOCK FENCE SErAFlr11 t YCnM1ii i �%i�� '�uv. fC; E:Ei:iRICAL. PLUfABING. �,�aTi,,s. �J.r:T�lATivG A"1J ��:i`itu:6A'!"i'; V'.��RK �_----- :�+ 2 � i.: , ...,:. , : . � n:,....,..,. .. ;:' ,.... ..:;itli: �i_QUESTS x � u w x z iu 0 � r� so � O. ° wio� � SEE CI o ee�ow Qi' �1 . .-�� ---_�_W i D T-H-�F-FbPT _ _,,yTHICKNE,S;S,fOF `` �`.,��;.: ,.DEQTH,TOF �EA`R i;!�'i�t�i. i�;,t- ,1 rfit �4+]:1 ,!i�.L�:•St3 PACENG��QF'„ E FOOTING REQUIREMENTS � -n NG 10�� ITH 24� f00TH 12' C-r`t�y.�-�C��a�J'1esa, California Building Department 7-�-84 � 14� 12 8" 16" I6' GENERAL- NOTES MORTAR: p�e parf Plastic Cemenf, and TAree Paris Sand GROUT: , One Port Cemenf Three o�d One Half Ports S�and COPING: One Part Cement, Three Parts Sand CONCRETE: We11 MiYed i: 2� : 3%2 MaY. of 7%2 Gallons ot Water Per Sack of Cement GROUT MAV BE POURED FROM 7HE TOP OFTHE FENCE CELLSANDAREASOF HORIZON7AL REIN� FORCEMENT SHALL BE CLEAR, CLEAN 8� fREE OF ALL MORTAR DEBRIS, ETC. 60NDS SHALL BE PROVIDED�BV LAVING BLOCKSINSTHETCHER COURSESSO THAT VERTICAlJO1NTSALTERNATEIN EACH COURSE. �'H OF E4RTHTCOTH V3 THE HEIG7H OF FENCE ��LOW BOTTOM OF FOOTIN�. SCALE: I/2"= I' �z„ 8" 12° 16' OWNERS NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ JOB ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ m -� C' [v f��z QC.�c Cs� � Q �:� a� �5�,.. �- ,=� =--- ,-- - 1� � A°PPR� � ED Ci1'y, of 4Qsta Mesa Building C-�' (� �/ ¢1' �i q`-'� DA7E.-_��J./�PCh. TMESE PLA�iS MUST BE CA! JC'6 Ai ALl T � MAKE NO CHANGES N'ITIiOUT PRIOR APPP"`� ' OF DEFT. THE ISSUO.�;CE CR CRA.`U�i:C 0� A P�RNti Oit hPP�Z OF PInNS A[dD SF�:�:CC6.�(�::5 $k:�Ll ttCi C: C0:11TP - TO Bf. A Idn:Y.li 7.R, CR h[: l.rf'&�G:L C:. .�tIY 1'�^.:h OF �NY Of iHE PRCt'!S(CY> C: TNI; COC�. (SJ f�'IAI( I c SUMING TO CI'JE L'uTHC31;Y TD 1':Gli+;`_ Cl C%V"EL . PROViSlGPCS GF THES CCDE StL;LL 6E C.::. `. IX:Cf( 1:7 i.. FAR /S 7HE HORK UR USE YM::d ITFLi.�C::�_3 L" Lilir. �-. TpE 1SSL'wy- i OF ; Ff".'i'i Si.�E7 C."C'! fi:.�:J A.r SPEG(ICnTtGNS SHl.L t�t,( (.i:Z�'( 7d- P••LC:.':: C: ":C3: ! fRCM Tk;E6G�,f7C8 tC�717t'.G T'. L� ;5�_T1v7 C- C::,.�.tF IN SAID F1AlS Ffi� S,*�C;F![�7:� '� C.^: F: .�: Y'�`.+_'1E::71N BUICDtRC �PCiu.T[0 SfiL..0 G:..t JC:: �!?t,'-�*-".�3.3:lD�i'...::.I IN 1'ICLATI�N�F 71 IS CG.,f 0,: C' �..:� u�e:..� ...� _._ OF THE CIiY. b ti W W R w N ! eniotru ---�-__� , /,�,,�� . � `n ► OF C�� fL4NNING DFPL '�'' — W�KT 70 BLOG. OEPT. Q� " I DlRK70Q O� DUMNINp —�'"u �`� ItU10[MC[ R[11D[NC[ 9�`� e �[UO[MC[ _ �_STREET S. �'�QG f' �=— - Tor Ir��s �� _ F -� �¢1 r� ' r a.r '�� .� � � AVD�ieant to fill in all spaces except lnosa within neavy EorEer Iines an0 sign all appropriate Eeclarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMITAIO._ _, „ TRACT NO. LOT NO. UNIT NU. Project Addrt:ss 900 Peace Place App1lcinYsMailingAddress 9�� Peace Place Owner's Name ��+� DeuilCh Phone 645-936$ Address 900 Peace PLace Arch/Eng. License No. Address convacco�'sNam A"8mes plum ing-Heatiny�no�e Address Imailing) 10422 Trask AVC Ciry License No. 6664 LICENSED CONTRACTOR DECLA0.ATION I hereby affirm that I am licensetl rt Orovis on Charte� 9(commencin9 with section 7000) ot Divisio of the Buziness a ess nz oae, anC my license is in fu11 torce antl ttect. �icense ci �icense 30 Date � Signat WOFKERS'COMPENSATION D LAR O I hereby aftirm tnal 1 hav¢ a Certilitate o co nt to 5¢Ittinsure or a cerllflwte of Workers' Compensation Insurant¢, a cettl�ietl copy ther¢Of ($ectlon 3aoo, uo. c.� q�gg32 Re bl' em ty Policy No. C pany �ertitieC copy iz hGreby tutniSheU // er[ifie��opY 15.tNetl with [he cit Bu � Oate 1/ O/ APPlicant EXEMPTION FROM WORKERS' CO ENSATI DECIARATION (This seclion neetl no[ be comDletetl it the plrmit i5 ior One huntlrea ($100) or less). I certity cnat in Ne performance of t�e work ior which Ihiz permk Is Bsuetl, I snall not employ any person in any manner so as to become subjeci to Ihe WarkerY Compensation l.aw5 of Califomia. Date Si9nature 'NOTICE: If, aflet making [hi5 tle[laration, you shoultl becom0 Subject t0 Iho Workers' Compensa[iOn pmvislons ot the LabOr Cotle, you mus[ Iorlhwl[It comply with such p�ovisions or thii p¢rmlt Shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby allirm lhat tnere is a[onstru<tion Ientling agoncy fo� [M1e pertormdnCO of Ihe work tor whith thiz permit is issuetl (SeCtion 3097 Civ. C.) Lentler's Name Lenae.'s aaaress � OWNER BUILDEH OECLARATION I herCby alli�m that I am oxempl frOm thc ConVaGtOr'S Licenso Law tOr [ho following reason (Section 7031.5 Buslness antl Protassional Cotlo: Any clty or county wnich requires a permit to construct, alter, Imorove, tlemollsh or ropalr any strucWre, o��or to i[s Issuance, also requlres the appli<ant tor such pormit to tile a sign¢tl Statemenl lbat hU/ShC Is IlconSBtl pursUant lo Ih8 prOviilons al tne ContractoYs License Law (Chapter 9.�commancing with SeGtlon 7000) of Oivision 3 Of Ihe Busine55 antl Plo�e55ion5 Cotlo) or that h¢/Sho I5 oxempt lhereirom and the baSiS tOr the alle9etl exempNon. Any violallon of Setllon 7031.5 by any applicanl for .a p¢rmit Subjett5 lhe ap0��ant l0 a civll �endlty ol not more Ihan fiv¢ huntltetl tlollars (§500). I, as owner ai Ine properly or my employee5 wilh wages as thair zola campenSdtiOn, will Co the wofk, antl tha SlruGtur¢ ii nOt Intendetl Or OHelatl for sale (Section �04a, Business antl Professional Cotlo: Tho Contractor•s Ucense Law aocz not apply to an owner oi a property wbo Dulltls or improves ihereon, antl who tloes such work himsell/nersult or tnrough his o. hor own employees, provitletl lnat sucn ImD�a�¢ments a�e nol Inientletl Or Offeretl tor sale. It, howevCq lne builtlin9 or Improvemenl IS Soltl within Ona yaar of <Om- o�etion, the owner will nave tne burtlen ol proving he/she altl noi bulltl or Im- p�ovt to� ttle purPOse oi sale). ❑ 1, as owner of Ihe prOPerry, am oxcluslvely Contracting wi[h Iicensetl con- tractors f0 construcf th¢ Project (Section ]044, BuSiness antl Prote551on5 Cotle: Tne Concractor's License Law tloes not apply to an owner o( properry who builtls or im0�ov¢5 mereon, antl wno conVacts for such pr0)ects wi[h d COn- tractor(51 Iicense pursuanl�to Ihe Contracioi's Llcenze Ldw). I am awam Ihat proof o( [h¢ir WorkeYs Compensalion in5uranc0 shOuld De prOvitletl to me. ❑ I am exempt untler Section B. & P. C. br tnis reason Date antl Owner m ana ztate tnat the abovo dry antl county orainances antl herebv authorize reore- TYPE OFCONSTRUCTION L1NEW U ADD LJ ALTERATION LJ REPAIR ❑ GONVERSION ❑ DEMOLISH ❑ OTHER q,p, �! DESCRIPTION OF WORK/USE OF BLDG. S Main Bui E TYPE OF PERMIT GRADING FOUNDATION STRVCTURAL T' Front ❑ TENANT ❑ ELECTf31CAL � PLUMBING ❑ MECHANICAL A Rear ❑ OTHER PROJECT DESCRIPTION 5�. FT, oCCVPANCv C Right K Left CONSTRUCTION TVPE VALUATION 5 S ZONE GRADING CU. VOS. ACRES Ping. ReL # Remarks: Planning Not Backflow Preventer Backflow Irrigation Bathtubs Clari(iers Dishwdsher Drinking Fountains Floor Drains Floor Sinks � Gas Service Outlets Interceprors Kitchen Sink Lavarories P—Trap Roo( Dreins Reinspection Foa §75 Boiler Duct • Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple � Firepl/Fact.6lt. ICBO # Heating System & Ducting ❑0100,000 BTU 0100,0008T' I��y��,�� I � RainsPaclion Fee — I $15 Drivers' Li nse ar 5 CMF 0865-46, rev. 30/84 White � Builtling; Canary - Applicanq Pink - Atcountinq; GolOenrod - Assassor Showen Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool wlSpe Urinal Water Close[ Water Heater Wacer Service Auto�Wash Wundry Troys Issue Fee Hood or Type 1 ❑ Canopy Type I I ❑ Refrigeration System ❑o-iao.000eru ❑ioo,000 System Repair/Alteration Fire Dampers Re9isters laue Fee FEES %] 5 3 FEES S 3 Automatic Washer Construction Pole Sub. Cooking Unit i Dishwasher + Dryets ❑Gas ❑Electric Fan - F.A.U. � Fixtures Device Boxes Outlets Switches Garbage Disposal Generaror �0.5 KW �f�yq 3-z� g� Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ SO+KW Meter ❑up to 100 amps Meter ❑over 100 amps Su6 Panel Motars �P7 HP O1'h - 6 Inc.Solar �9-15 HP 016-15+ Microwave Pole Light fiange I I; Standing Sectians 5�15 KW Trash Compactor I Reinspection Fee I$15 I I Issue Fee DEVELOPMENT SERVICES RE�UIREMENTS: Zoning Approved By Building Approved By Aoolicatian Issuad BY SUMMARY OF FEES BUILDINGPERMIT $ SMIP S PLAN CHECK $ PERMIT PWMBING $ �CD ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% 5 MICROFILM 5 MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ 5�� Z O N I N G R E Q M T S FEES S 3 '� 5.�0 CONSTRUCTION AND PLANNING � P�+�� & SPA f>PPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector -1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2,'�Soil Pipe-Undrgrnd. �a •� 53. Steel Reinforcement 3� Electqcal Conduit Utility�Undrgrnd. � 54. Forms 4: Electrical Condurt-llnd�grnd. 0 55. Electrical Bonding 5.`-iSteel^Reinforcement � 56. Rough Plumbing & Pressure Test 6..ElectricalUFER�Gind. . 57. APPROVALTOCOVER-GUNITE 7.�Foot�,ngs ' �, 58. Electrical Conduit-Undrgrnd. 8.,Foundation i'� � 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Und grnd. � 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural FloorSystem 61. APPROVAL TO DECK 11 . Property Sewer Line & House Connection ,, 62. Backwash & Receptor-Final 12. Sewer, Cap � _ 63. Heater & Vent-Final 13. Roof��Drains � � � 64. Plumbing System - Final • 74. Rough Plumbing�_ -, 65. Electrical-Final _ 15. Rough Electrical-Conduit 66. Solar System-Final „_' 16. Rough Electric Wiring 67. Fencing & Access Approval 17..Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling �Structura�) & Monocoat 75. Dry Chemical 27. FrameandFlashing 76. DryStandpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy , 37. Final Faaory Fireplace 3S. Final Plumbing L�-{�'Z (�,� 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final , 42. BackflowPreventer ir•: '+ 43. Backflow Irrigation � � � - �• 44. Landscape Irrigation Syster�:', 45. Sound Attenuation - 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Compleied 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY � � ' No. Date � � \ \ APo��ant to fill in al1 s0atts except tnase witnin neavy Eortler Ilnes ana sl9n a11 aDorovriate aeelarotions. a7Y OF cOSTA MeSA TR CTION PER IT Project Address Applicani's Mailing Address Owner's Name Phone Addreu Arch/Eng. License No. Address Convactor's Nam � , S Phon —� 5 Address (mailingl ' Ciry License No. LICENSED CONTR O CLARHTION I hereby affirm that I am licensetl untler provisions of Charter 9(Commencing with zection 7000) of ' islon 3 of the Business antl Protezsions� my Iicense is in tull forc antlljfpFL 1 �.ICC052 �IdSS �5�� License � Dat J(jJ��'] Signature 9R ER 'C MP6N4ATION DE L R 1 imeby affirm tnat I have a certitica[e o/ consent to sel sure or a certiftwte of Workers' Com ensation In urance, or a certlfle y thereof (Section 3800, Lab. C.) Policy No. / Comp�qy n� �rtifietl copy is hereby fumisnetl. � � rli ie cop�( il ith the ciry `sy�iain lon. Date �� `��fApplicant �� EXEMPTION FROM WORKERS' COMPENSATION DECLA TION (ThiS seclion neetl not be compl¢letl ii the permit iz for one tlretl ($300) o� Iess). I certity Ihat in lhe perfo�mance ot Ihe wOrk br which this erm�t is issuetl, I shall nol employ any per5on in any manner 50 as to Decome subjec[ to ttte Workers' Compen5ation Laws ot Calllomia. Date Signature ' 'NOTICE: It, atter makin9 this declaration, you shoultl become subject to the Workeri' Compensation provision5 OI Ih¢ Labor Cotle, you mus[ fortbwith comply wilM1 mcb provi5ions or this pe�ml[ shall be tleemetl revoketl. CONSTRVCTION LENDING AGENCV I hereby aftirm that lhere is a mnst�uction lentling agency fo� the performance of lM1e work tor which t�is Oermit is i55uetl (Settion 309] Civ. GJ Lentler's Name �entler's Aatlress OWNERBUILDER �ECLARHTION I hereby aifirm that I am exempt from the Contractor's License Law for the followin9 reason (Settion 7031.5 Business antl Professional Cotle: Any city or county which requires a permit lo construct, alter, improve, tlemolish or repair any sVUGtur¢, p�ior to Its i55uance, also requires the applicant for such pe�mit lo file a si9nea statement that he/sne is licensetl pursuant to che provisions of he Contractor'S License Law (Chapter 9(commencing with Section ]000) of )ivision 3 of th¢ BuSinesS antl Professlons Cotle) or [hat he/she is exempt [hmef�om antl th¢ Dasis tor th¢ alle9etl exempfion. Any violation ot Section 7031.5 by any applicant for a permit subjects the applicant to a civil' �enalty of not more lhan five nuntlretl tlollars (E500). I, a5 owne� of lhe pw0erty or my employees witit wages as Meir sole compensation, will tlo the work, antl the structure is not�. intentled or oiteretl tor sale (Sec[ion 7044, Business antl Professional Cotle: The Contractor's Licenze l.aw tloes not apply fo an owner oi a property who builtls or improves chereon, antl who does such work nlmself/herselt or tnrough his or her own employee5, prOvitletl t�at Such improvemenls are not In[entl¢tl o� off¢retl fo� 581¢. If, howeveq the builtling or imp�ovement is soltl within one year ot mm- pletion, the owner will have the burtlen ot oroving he/she tli0 not Duiltl or im- prove Por thc putpose of sale). ❑ I, a5 owne� ol the property, am exclu5ively cont�acting with lic¢nietl cOn- Vattors to consVuct the project (Section 70a4, Business antl Protessions Cotle: The Contractor's LicenSe Law tloes not apply to an owner of property who builtls or improves theteon, antl who cOnt�acts for Such p�ojec[s wI[h a con- tractor(sl license pursuant�to tne Contracror'i Lirense Law). I am aware that proo( of their Worke�'s Compensation insurance SM1oultl be provitletl to me. ❑ I am exempt untler Section B. 8 P. C. for this reason Date that Siqnature L Drivers' License or 55 q( CMF OB65-46, rev. 30/84 Owner this application antl state that the above� �m01y with dll City antl county ortlinance5 const�ction. an0 he�ebv authoriie �eo�e- TVPE OF C�NSTRUCTION L1 NEW� LJ ADD LJ ALTERATION IJ REPAIR- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � DESCR{PTIOALOF N10RK/USE OF BLDGy—; TVPEOFPERMIT GaaoiNG ❑ FOUNDATION S7RUCTURa� ❑ TENANT ❑ ELECTRICAI ❑ PLUMBING �ECHANICAL ❑ OTHER P`ROJECT DESCRIPTION 5�. F7. oCCUaarvCV_ — TON STRUCTION TVPE VALUATION 5 ZONE GRADINGCU.YDS. ACRES_ 0.emarks:, Bar Sink Backflow Preventer Backflow Irrigation 7rinking FOuntains Floor Drains Floor Sinks �as Service � Outlets Interceptors Kitchen $ink Lavarories - P—Trap Roof Drains , Reinspection Fee $15 Bol ler Duct - Under Ground Duct - Strucmral Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact BIL ICBO # Heating System & Oucting ❑ 0.100,000 BTU � 100,000 Reinspection Fee � $15 WM1it¢ - Builtlin9: Canary - APOlicanh Pink - Accounting; Goltlenrotl - Assesso� Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closec Water Heater Water Service Auw-Wesh laue Fee Hoodor Ty�el ❑ Canopy Type I I ❑ R�efrrigeration System kwe�100,0008TU ❑100,000 System Repair/Alteration Fire Dampers Registers luue Fae FEES A.P. # • S Main Building: E T Front A Rear C Right K Left $ Ping. Ref. # Planning Notes;' � --=-- � - Auromatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers �Gas ❑Elec Fan F.A.U. Fixtures Device 8oxes Outlets Switches Garbage Disposal Generator 00.5 KW � 41 E3 4/�0/2�; Zone Accessory Building: Parking Req./Provided ELECTRICAL TransfOrmer ❑ 15�50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Motars O0.1 HP X� 8 Inc.Solar �9-15 HP �1G75+ Microwave Pole Light Sign ; Standing Sections 5�15 KW Trash Compactor I`c�� TL FEES Z O N I N G H E Q M T S $ 3 I � Reinspection Fee $15 Issue Fee $' 3 FEES DEVELOPMENTSERVICESREDUIREMENTS: 2onin9 APProvod BY Date Building Approved By Date Appliotion laued By Date •� � - O SUMMARV OF FEES ' BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ � GFiADING $ PLAN CHECK 50% $ MICFiOFILM $ MECHANICAL $ � �TOTALFEE $ � $ 3 PLAN CHECK' 25% $ ' CONSTRUCTION AND PLANNING • P & SPA '- APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .2., S�il Pipe-Undrgmd. � 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd..�� ' � 54. Forms , 4. Electrical Conduit-Undrgrnd. �� - . 55. Electrical Bonding 5. Steel Reinforcement , -� ' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. '. 57. APPROVAL TO COVER-GUNITE Z Footings � ' .r• 58. Electrical Conduii�Undrgmd. '. 8' Foundation � ,. 59. Gas Pipe, � Undrgrnd., Test � 9. Water Pipe-Undrgrnd. , � 60. Backwash Lines, P�Trap, � Undrgrnd. 10. S;ructural Floor System -. 61. APPROVAL TO DECK 11.,Property Sewer Line�& House Connection �, 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final - 13. Roof Drains �, 64. Plumbing System - Final -f 14. Rough Plumbing .� 65. Electrical-Final � 15. Rough Electriral-Conduit 66. Solar System-Final . ' 16.. Rough Electric Wiring 67. Fencing & Access Approval _ �. 1-7� Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19._ Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21.. Ducts, in Structure 70. Underground Hydro � � 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil ' 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe � . 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80.' FOOD CERTIFICATE ISSUED � 33. Final Electric b-3-t�6 (./t1� Notes: ' 34. Final Heating & Air Conditioning L_7>-}ffr (,(Q 35. Final Gas Pipe-Test � � � 36. Hood or Canopy 37. Final Factory Fireplace . 38. final Plumbing 39. Water Service-Final 40. Gai Service-Final - 41. Solar pomestic-Final 42. Backflow Preventer ,� � 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handirap Regulations 47. FINALSTRUCTURE&BUILDING � . , 48. Special Requirements Completed � 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co , . � � 51. CERTIFICATE OF OCCUPANCY � ' � No. Date � � .°.VPiicant ta lill in all spaces exeept thasa within �eavY �orEer Iinas anG si9n all aDP�opriate tlecla�atlons. CI7Y oF COSTA Sa CONS�TR-UCTIQN PERMIT Proj¢ct AddreST �� / � Applicam'sMailing ddress �y � � �� Owner's Name_ I� GZ h G L phone Address �� Arch/Eng. � License No. Address ' Convacwr"sNam �� L' hon 73��y� Address (mailing) � � / �� Ciry License No 1 ,/� LICENSED CONTRACTOR DECLARATION I hereby affirm [hat I am Iicensetl untler provi5ions ot Chart¢r 9(commencing with seclion 7000) oi DiviSlon 3 ot BuSinezS antl P�ofe55�on5 Cotle, an❑ my license iz in 1W � ntl eHect. � Lice CI ' ' ens o.�r_2�� nat� Signature � �0.KE 5' OMPENSATION �ECLARATION meby aitirm that I have a certiticate of consent to It- zure or a certiflcate ot Workers' Compensa[ion Insurance, or a ertitietl copY thereof (SeFtion 3800, Lab. �^ `� I _- -- _ '/� PolicY No. o /lY/YI'��YU ❑ Cerlifietl py,iz hereby tumished. .��Cer'f'tl p �Iadwlththeci i5yo Date � APPlicant � � EXEMPTI N F OM WORKERS' COMPENSATION �E LARATION (Thissection nectl not be comple[etl if the permit is for n huntlretl ($300) or less). I cer[ify �M1at in the pe�to�manc0 0/ the wotk lo� wM1ich thls pe�m�t is issuetl, I shall not employ any oerson in any manner so as to become subject to the' Workers' Compensation Laws ot Calitornia. Date Si9na[ure 'NOTICE: If, aRer makin9 tnis tleclaration, you shoultl become subject to the Worke�s' Comp¢n5atlon provisiOnS Ot thC Labo� Cotle, you must forthwith mmply with such proWSlons o� this pe�mit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I nereby attirm thal there is a constructlon Ientling a9enty for the performance of the work for which t�is permit is issuetl (Sectian 309] Civ. C.) Lentler's Name LenOer's Htltlress OWNER BUIIDEN UECLF0.ATIOtJ 1 hereby affirm [bat I am oxempt irom lhe Contractor'S Licenre Law for the following reason (Settion 7031.5 BuSiness antl ProTessional Cotle: Any city or county whicM1 requires a pe�mit to cOnsl�uct, dlter, iTprove, tlemolizh o� �epair any structure, prior to its issuance, also requires the aDP�icant for such permit '� file a signetl statemen[ that ne/she IS Ilcensetl pur5udnt to the p�ovisions ot e Contractor's LicenSe Law (Chapter 9(commencinq witn Sec[ion ]000) of vision 3 0l tne Business antl Protesswns Cotle) or that he/she is exempt .ner¢from anp th2 basis for thC allegetl exemption. Any viOlation of Sec[ion 7031.5 �y any applicant for a permll 5ubject5 the aOP�icant to a civil �endlty ot not more Man live huntlr¢a tlolldr5 (E500). 1, as owne� oi ihG P/o0e�ty o� my ¢mployees wi[h wages as their Sole comoen3atlon, will tlo tne work, antl the sVucture is not Intentletl orofferetl �OI SdIC ($CL[I00 7044� B�Sif1055 dOd PlOi255I0OdI Cotle: The COOIldC�OI'S Licenze Law tloes not apply to an owner of a property wM10 builtls or imp�ove5 Nereon, ana who tloes such work himselt/herseli or tnrou9n his or M1er own employees, prOvitletl tba[ SUGh Improvements are not Intentletl or offeretl tor Sale. If, however, the bulltling or Improvement Is soltl within one year ot com- pletion, [he owner will have tha burtlen ot proving he/she tl10 not builtl or im- �rove tor the purposa of sale�. I, as owner of tha pro0erty, am ezclusively conlracting wi[h licensetl <an- tractors td consvuct tne proiect ISecNon 7044, Business antl Protessions Cotle: The ConVactor's License Law does not aPpIY to an owner ot property who builtls or improves lhereon, antl who contracts for such projects with a con- tractor(sl license pursuani to the Conlra<tor's License Law�. I am aware that proof 01 tneir Worker'S Compensation insurance Shoultl be prOvltletl to me. ❑ I am ezemD� untler Sectlon 8. & P. C. tor this reason Date Owner _ I hereby certly that J�qave reatl this a iniormalion Is correct; I z�9ree l0 tomply ISignature Drivers' �icense or 55 q/ CMF 0865�46, rav. 10/84 TYPE OFCONSTRUCTION U NEW U ADO �J ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISM ❑ OTHER DESCRI,P,yION OF WOFK/USE OF BLDG. TVPE OF PERMIT U GRADING Ll FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING/ "I�i ECHANICAL ❑ -OTHER 1 PRWECTDESCRIPTION SQ.F7. oCCUaANCv— CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VDS. ACRES— Remarks: Preventer Irri9ation Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Showers Service Sink� � Sewer Cap Sewer Connection Solar Collectors Solar.Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays Reinspection Fee I $15 I I Issue Fee I $ 3 I MECHANICAL fEES Duct - Under Ground Duct - Strucmral Duct - Ventilating Exhaust System ❑ MWtiple ❑ Firepl/FacL Blt. ICBO # HeaJ{ng System & Ducting J[i0,100,000 BTU 0100,OOOBT Reinspection Fee � $15 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlanrotl - Assassor Hood or Typel ❑ Canopy Type II ❑ Refrigeration Sys[em ❑6700,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers � Registers laue Fee $ 3 A.P. qW 5 Main Buildi E T Front B Rear A C Right K Left S Ping. Re(. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device eoxes Outlets Garbage Disposal Generator �0.5 KW �5-15 52I6 i�/03/85 Zona , , Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 700 amps Meter ❑over100amps Sub Panel Motors 00.1 HP O1 X- S Inc.Solar �9-15 HP �16�1 Microwave ' Pole Light Sign Standing Sections Trash Compactor I�oO'' TI. FEES Z O N I N G R E � M T S I Reinspection Fee I$15 I � Issue Fea I $ 3 I DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By �ate 8uilding Appravad By _ � Date Appliration laued By y nat SUMMARV OF FEES � ' BUILDING PERMIT $ SMIP $ � PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE ' $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAI $ GRADING $� PLANCHECK 50% $ MICROFILM $ ,hJ MECHANICAL $ � TOTAL FEE $ L� PLAN CHECK 25% $ ' - i CONSTRUCTION AND PLANNING P & SPA � - APPROVALS Pe�mit# Date Inspector AppROVALS Permit# Date� Inspector 1.'Tqmporary Electrical Service or Pole 52. Pool & Equipment Location .�.�$�il Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. 54. Forms � • 4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding 5. Steel Reinforcement� 56. Rough Plumbing & Pressure Test. , - 6. Electrical UFER Grnd. . . 57. APPROVAL TO COVER-GUNITE . 7. Footings � - ' S8. Electrical Conduit-Undrgrnd. . 8. Foundation . � 59. Gas Pipe, O Undrgrnd., Test . 9. Water Pipe-Undrgrnd. . _ 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System � � ' 61. APPROVAL TO DECK 1t. P�opertV Sewer Line & House Co�nection 62. Backwash & Receptor-Final 12. Sewer Cap . 63. Heater & Vent-Final 13. 'Roof Drains , 64. Plumbing System - Final 14. Rough Plumbing , 65. Electrical-Final - 15. Rough Electrical-Conduit . 66. Solar System-Final . , � 16. Rough Electric Wiring 67. Fencing & Access Approval 17. �Rough Wiring Sign , 68. APPROVED FOR PLASTERING 18. flough Electrical-T 6ar Ceiling , 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. DuCts, in Structure 70. Underground Hydro 22. Ducts, Ventilating ' 71 . Product Piping O Gas O Oil 23. Gas Pipe-Rough & Yest �� 72. Underground Flush - .} 24. Roof Framing , � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical " 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation ' 7S. FIRE PREV. FINAL 30. Drywall Nailing - ; . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79: FINAL INSPECTION 32.,Electriral Power Meter-Final � S0. FOOD CERTIFICATE ISSUED 33.�Final Electric � Notes: � � - 34. Final Heating & Air Conditioning rL/ � �n 35. Final Gas,Pipe-Test . " 36. Hood or Canopy _ 37. Final Factory Fireplace . . 38. Final Plumbing � � � 39. Water_Service-Final� � 40. Gas Service-Final � � 41. Solar pomestic-Final � - 42. Backflow Preventer ' . 43. Backflow Irrigation � . � . 44. Landscape Irrigation System ' .45. Sound Attenuation � � 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING, � 48. Special Requirements Completed - 49. Electric Releese to Edison : - ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Oate ' OWNtK JOB AC �EN ER AP No1 li ?C � s. �GAS W ATER LOT T �� PROP. $WR. LINE U MOUSE CON. U SPRINKLING SVSTEM MISCELLANEOUS 0.0UGH NEATING ANO AIR CONDITIONING TEMPORARV SERVICE OR POLE UNOERGROUNO � POWER � ROUGH WIRING TRENCHES � FORMS � STEEL pEINF. FLOOR SYSTEM BONo BEAM ❑ STEEL REINFOFCE n SHEATHING FRAME ANO FLASHING LATNING — IN [-J OUT ❑ PLASTER,BROWN COPT STPiiCTUFAL, FINAL H IG, VENT., REFftIG. ANO A.C., pINRL PL�...BING. FINAL AND GAS TEST � ELELTRIC, FINAL 6UILDING, FINAL _ _ DATE BUILDING PERMIT Ni FIRE ZONE VALUE GROUP TYPE SUBCONTRACTOR cover � _� COSTA MESA BUILDING-SAFEf'! DEPARTMENT P.O. BOX 7R00 � COSTA MESA, CALIFORNIA B28P8 1UN14 PA�OU.ti22 �*****3.00 �• 25442 : CITY OF C�STA MESA . COSTA MESA BUILDING-SAFETY DEPARTMENT I MAR. 23 1966 � P.O. BOX 12J0 � COSTA MESA, CALIFORNIA 92l26 •