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Home My WebLink About959 PAULARINO AVE - Building Permits;j' ' . � I ADPlican[ to fiil in all s0aces except those within heavy Eortler lines anE sign all appropriate Eeclarations. •' CIT�Y'�i7F.CbSTA MESq(� C(Q7�Ny�S�T��R,�U�CTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. �-ProjecT'Address �.'r�-1 � �-"�`i�%-� � �u% P'A�CCNT�� Applicant'S Mailin9 Address i� 7'�✓ /J.PANC-E%lro,P/'t` '/';_v''''�, � Owner's Name, S.QQ ��---.---�—Kl�.l�l�A) Phone�aG �add ess �$��[}C�L�1-.P/�/C� Arch%�ng. License No. w' P�tlress /�"��`�y Cuntractor'sNam � fPhone.LSL{..�� Address (mailing) w — � �'Z � � ! City License No. LICENSED CONTRHCTOR DECLARATION I OereDy aftirm that 1 am licensetl untler'provislons of C�arter 9(commencing with section ]000) ot Division 3 of the Business anU Professions Cotle, antl my license is in full force ana efiect. ' License Class � Licens� No. . Dale — Signature �j ��f� WOR ERS'�O�SATION DEC RATION 1 hereby afflrm that I have a certitica e ot consent to sel/-insure or a certiticate of Workers' Compensation Insurance, or a certifietl copy'thereof (Section 3800, Lab. C.) ' (/� AT /� '' PolicY No. /ti� ti��_� �%�'�� ComPdnYT�'r/E� ; —(L%J� 8 Certifie� wpy is hereby iurnishetl. � — _ Certifietl copy is fi etl with tne city Bu' �tling Divisio . Date �- Applicant ' EXE PTION F OM WORKERS' C PENSATId DECLARATION (Thissection neetl not be completetl i the permit Is for one huntlred ($300) or less). I cxrtify thaY in the performance of the work Por which this perm�t is i55uetl, I snall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ;. I � Date Signature- NOTICE: If, after making this tledaration, you shoultl become subject to the I Workers' Compensation provisions ot the Labor Cotle, you must torthwith comply with such provisions or tM1is permit shall be deemetl revoketl. � � CONSTRUGTION LEN�ING AGENCV 1 hereby a(firm that there iz a conztrucBon lentling agency for the per/ormance oi the work for which this permlt is issuetl (Seccion 309] Civ. CJ �, Lentler's Name Lentler's Atltlress OWNER BUILDER DECLARATION 1 hereby atfirm ihat I am ezempt from the Contractor's License Law for the following reason (Section 7031.5 BuSiness antl Vrotessional Cotle: Any city or county wM1iM r¢quires a permit [o Const�uct, alte�, improve, tlemolish o� repair any struc[ure, prior to itz issuance, also requires Ihe applicant for such permit to flle a siqnea statement that he/she is licensetl pursuant to the provisions of the Contractor's License Law (ChaO�er 9(commencing with Seccion 7000) of Division 3 of tne Business antl Profe55iOn5 Cotle) or that he/she is exempt therefrom antl the bazis for the allegetl exemption. Any violation ot Section -]031.5 by any applicant for a permit subjects tne .applicant to_ a civil �nalty of.not more tnan tive huntlree tlollars ($500). . LJ I, as owner of ine property or my employees with wa9es as meir sole compensation, will tlo the work, antl the structure is not intentletl or offeretl for sale (Section ]044, Business antl Pro/essional Cotle: The ContractoYs License Law tloes nol apply to an owner of a property who builtls or improves lhereon, antl who tloes such work nimselt/herself o� through his or hEr own employee5, prOvitletl tM1al such Improvements a�e not intentletl or oife�etl to� saie. If, however, tne builtling or improvement is soltl within one year of com- oletion, the owner will have the burtlen of proving he/she d10 not builtl or im- p�ov¢ fo�the purpo5e ot sale). , ❑ I, as owne� of the pro0erty, am eztlu5ivery cont�acting with lic¢nsetl con- tractors to consirutt the projeCt (SecHOn 7044, Business antl Protessions Cotle: The Cwtractor's License law does not apply to an owne� of property who � bpiltls or improves thereon. antl wno contracts for such oroiects with a con- tractor(s1 I�cense pursuan[ ro me Contractor�s License Law). I am aware that proot of tM1ei� Worke�'S Compensation insurance Shoultl be p�ovitletl to me. � I am exempt untler Section B. & P. C. for this reason Date Owner I'�hereby certify Ihat 1 have reatl this application antl state that the above irPormation is mrrect. I agree to Wmply with all <ity antl munty ortlinances a�tlstate laws relatinq to builtling construction, antl hereby authorize repre- sentatives of this city to enter pOn the above-m¢ntionetl p�operty for inspection purposes �� Signature �� w i��/ rL _ Date f�-25 —�8� ! , � �Drivers' License o G� %t _� � �S�c 6� rr T�. � � Li' � A.P.9W � TYPE OF CONSTRUCTION NE /�DD ALTERATION REPAIR S Main Building: E ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T Front a3 � �ESCRIPTION OF WORK/USE OF BLDG. ,p Rear C Right '� � TVPEOFPERMIT GRADING FOUNDATION ❑ STRVCTVRAL K. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' g� Left � ❑ �OTHER 2 S Ping. Ref. # PROJECT DESCRIPTION 5. FT. oCCUPANCY Z � � �� anning Notes: CONSTRVCTIONTYPE �� VALUATION$ ZONE GRADINGCU.VDS. ACRES Remarks: �j � rn .� ` �,(j�� Bar Sink Backflow Preventer eackflow Irrigation Bafhtubs Clarifiers Dishwasher Drinking Fountains Floor Drains � Floor Sinks Gas Service Interceptors Kitchen Sink - ' Lavatories • P-Trep Roof DrainS Reinspection Fee Showers Service Sink Sewer Cap ',� � Sewer Connection Solar Collectors � Solar Piping So,lar Tank ' Swimming Pool w/Spa Urinal Outlets Z Water Closet � Water Heater Water Service � Auto-Wash $15 Boiler Duct- Under Ground DpCt - $tfuCtUfdl Duct-Ventilating � Exhaust System ❑ Multiple ❑ Firepl/Fact. BIt �CBO dk Heating System & Duc[ing �10-100,000 BTU 0100,0006T Reinspection Fee � $15 ^6, rev. 5/ 8 White - 8uiltling; Canary - Applicant; Pink - Accountin9; Goltlenrotl - Assessor Issue Fee Hood or Typel ❑; CanoPY TYPe I I ❑ . Refrigeratfon Sysiem . ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers ' Issue Fee $ 3 v��e�� Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher ;'- Drvers4 �Gas ❑Elec Zone Building: Req./Provided ELECTRICAL Trensformer ❑ 15-50 KW - � 50+KW Meter ❑up to 100 amps Meter ❑over100amps Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5�.KW �5-15 KW . l'� Reinsoection Fee . $75 Sub Panel �� Motors D O-1 HP O1 F, - 8 Inc.Solar �9-15 HP �76-15+ Microwave . Pole Light Range ' Sign Standing Sections Tresh Compacmr - Issue Fee FEES O N i N G R E• Q M T S. oEVELOPMENT SERVICES REQUIREMEN(7�y �% Zoning Approved By �d`-' � Date •� Building ApproVed By� � _ Date 9 z, �. ' - SU �EES � �BUI�LDING PERMIT.- $ SMIP $ � PLAN CHECK• ��'� $ �-�� 3 pERpAIT PWMBING - $ II�S� ISSOANCE $ PLAN CHECK 25% $ ENERGY P.C. $� -ELECTRICAL t� ' $�� GRADING $ �PLAN CHECK 50% $ � , MICROFI LM $ �/�y�y—�'¢�`�� MECHANICAL $ � TOTALFEE � $ Sf�Vy� PLAN CHECK 25% $ � o: 000iso.i�-000ise�z �rc�r, oas.a,; Dr+TE= D4/231£s� 7II1E: 12;2% y.. , . . � . . ,� . . . . ... s t . �� (j - � - � • : . � � 1 CONSTRUCTI�N AN4.PLANNING POOL & SPA ` •� •- .� ' • : Date Inspector 'Date' Inspector ApRROVA�S � Permit # APPROVALS Permit # '� � •� ;7! Temporary Electrical Service or Pole � .` 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � ,� � 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd� '� � 54. Forms , ' i 4.�Electrical Conduit-Undrgrnd,. % �� 55. Electrical Bonding . 5. Steel:Reinforcement � �. 56. Rough Plumbing & Pressure Test ,.:-' 6. EI'ectrical UFER Gr,'nd� ll '?� r � 57. APPROVAL TO COVER-GUNITE f-- �• � . 7. Footings � S��P-�.L ,' (c 7 ��i% 58. ElectricalConduit-Undrgrnd. , 8. Foundation '% � � _ - 59. Gas Pipe, � Undrgrnd., Test ,,� ,� i 9. Wate"r Pipe-Undrgrnd. /;� 60. Backwash Lines, P-Trap, 0 Undrgmd. r 10. Structural Floor'.System ; •({: $`a 61. APPROVALTO DECK 11. Property Sewer Line,& House Connection � � 62. Backwash & Receptor-Final 12.� Sewer Cap ' � . - •� - �, . - � ' i � � ' /�; 63. Heater & Vent-Final , � i 73: Roof Drains i, „ �� ,• 'j � y 64. Plumbing System - Final - � � � � 74' Rough Plumbing� ' � � 65. Electrical-Final , 15.�Rough Electrical-Conduit Solar System-Final - n L& Rough Electric Wiring . Fencing & Access Approval � � i17;. Rough Wiring Sign - 68. APPROVED FOR PLASTERWG �.78. Rough Electrical-T.Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � �+1_9. �Rough Heating & Air Conditioning �Z•S'�� L�� FIRE DEPT. REQUIREMENT , -20. Rough Factory Fireplace �� ' APPROVALS Permit # . , 21. Ducts, in Structure . 70. Underground Hydro - n . . 22. Ducts, Ventilating � ,- 71, Product Piping O Gas ❑ Oil - .23. Gas P,ipe-Rough` & Test '„ ' 72. Underground Flush ' �; � 24 Roof Framing .5 1`� 73. Undergmd. Storage Tank O Gas ❑ Oil , 25. Roof Sheathingl � �' . ' � B� 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 �� . y� � 78. FIRE PREV. FINAL 30. Drywall Nailing �;'L HEALTH DEPT. REQUIREMENT � 31'. Plaster Brown Coat-� 6 y� � L�� 79. FINAL INSPECTION i �32. Electrical Power Meier-Final . FOOD'CERTIFICATE ISSUED --� �, -r ' �. ,� �_ 33. Final Electric �"'� '� Z �� 30 � D� Ga (..� l + 34. Final Heating & Aie Conditioning si ZY��.t' Ld� � fl.�, � V 35. Final Gas Pipe-Test '-j��.g q L�p �' 8 � 36. Hood or Canopy �(p 8`� �w�y.� � L.�4p�k} ,a � P�,n!'O�C� ,3i. Final Factory�Fireplace.• .� �� 38. Final Plumbing "' � �jl2�l�Q' �G�l 3 � MO tjh�, H��y6 � CX� 39. Water Service-Final �� - - LC 40. Gas Service-Final ' ' 41. Solar pomesticFinali i 42. Backflow Preventer � ;�� a � ;'1 ,�. �;,� 43. Backflow Irrigation ' -4 r'' ,'��' 1 �1� t -. . � 44. Landscape IrrigatiomSystem • l .: � 1 �• � ,i 45. Sound Attenuation 46. Handicap Regulations. . ' 47. FINALSTRUCTURE&BUILDING 3 48. Soenial Requirements Completed � . 49. Electric Release to Edison '-' � ,l .50. Gas Release to,Southerl.California Gas Co - , � j : �,�� ,� '!' � 51. CERTIFICATEOF.00CUPANCY t� ' ' � '-. � +--� � , �s, `.I No. ' - Date _7 , , f �. i� � Aoolicant to fill in al1 soaces ezceot tnose witnin neavr EorGer Iines anC sign all aoVroDriate Ceclarations. MIT NO. TRACT NO. LOT O. NIT NO. .•� CI7vAF coS'fA MESA "CONSTRUCTION PERMIT a n.P. # zona • Project Address p � �y� U.1 S Main Building: Acceuory Building: AppliCa�Tt�s Mailing Addfe5sl0 �� M R � TYPE OF CONSTRUCTION NE ADD ALTERATION REPAIR E Front Z ❑ CONVE0.510N ❑ DEMOLISH ❑ OTHER �T O Owner'sName` �u5 K-�� li(� Phone��%�i� DESCRIPTIONOFWORK/USEOFBLDG. A Rear N AdBress'� 97� DQ✓��NO Arch/Eng. LicenSE No. TVPE OF PERMIT GRADING ❑ FOUNDATION STRUCTURAL I K Right N ❑ TENANT ❑ E}�J RIGAL ❑ PLUM8ING ❑ Mp� HANICAL i g� Left G Address 7Wi G+{��i� � �ip�.7 R �� ❑ OTHER � yf�_ T L%✓�L.1(i 7�'�– Pln9. Ref. # Parking Req./Provided E Contractor's Nam Phone�� —•� Q p PROJECT DESCRIPTION SQ.FT. OCCUPANCV Address (m 'I' gl �0 �� 2–�'� • . Planning Notes: ry� T CONSTRUCTION TVPE VALVATION $ '1 T Ci(y License No. ��3� ZONE GRADING CU. VDS. ACRE$ $, LICENSEO CONTRHCTOR DECLARATION I hereby aflirm inat I am licensetl untle� provi5ion5 ot Charte� 9(commencin9 Remarks: � with seclion 7000) of Division 3 of [he Business antl Profe55ions Code, antl my Iicense is in full lo e a tl eftect. 9 ELECTRICAL FEES Lice e 1 5s_ � L nse No.�� Date Signature PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW WORKERS'COMPENSATIONDE RATION BerSink Showefs ConStruCtionPo125Ub. ❑50+KW � I hereby alti�m lhat I have a certifica e of consent to sel�-insu�e o� a ce�titicat¢ of Workers' Compensation Insurance, or a certitietl cooY thereot (Section Backflow Preventer Service Sink �oking Unit Meter Qup to 100 amps �3800, LaO. G.y./ �� ^ y� � r�\ P po�i�y ryo, 1OYeC e �ompany� �r�� Backflowlrrigation SewerCap Dishwasher Meter ❑over100am s 8 Certilietl copy is ner by turnizhetl. ' � Oryers ❑Gas ❑Elec[ric Sub Panel Cer �e py tl with [he city i 9 vi5ion. BdthtUbS Sewer Connection Date_�:.�� APP��cant Fan Motors �0.1 HP �1 X- 8 EXEMPTION FROM WORKERS' COMP A N DECLARATION Clarifiers Solar Collectors (Thissection neetl mt be comoietetl it me rmit is for one huntlretl (5100) or Dishwdsher Solar Piping F�P'�U� Ina Solar �9-15 HP 016-15+ less). I t¢rtily [hat in th¢ Per/o�mance ot the wOrk f0/ which this pe�m�t i5 i55u¢tl 1 Fi%tU�22 � shall not emo�oy any person in any manner so as to become subje<t to tf�a Drinking Fountains Solar Tank Microwave Wo�ke�s' Compensation Laws ot CalifOmia. �. DCviC¢ BOx¢5 - Date Si9nature Floor Drains Swimming Pool w/Spa Pole Light NOTICE: H, after making this tleclaration, you shoultl become subject to the OutlEts Workers' Compensatlon O�ovi5ion5 ot the Labor Cotle, you must forthwith Floor Sinks Urinal Range comply with such O�ovi5ion5 or this Oe�mit Shall be tleemetl rOVOketl. CONSTRUCTION IENDING AGENCV GaSService Outl2t5 WatefClos¢[ SwitChes Sign I hereby affirm Ihat the�e i5 a Const�uction lentling a9ency fo� the pe�fo�mdnCE - of tno work for whicn tnis permit is issuetl (Section 309� Civ. G.) Interceptors Water Heater Garbage Disposal Standing Sections Lentl¢r's Name Lentler's Adtlress Kitchen Sink Water Service Generator �0-5 KW �5-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby afiirT Lhat I am exempt f�om lhe Cont�actor'S Llcense Law to� the Lavatories AutO-W25h lollowing reason (Section 7031.5 Business antl Professlonal Cotle: Any city or county which requirez a vermit to construct, alter, improve, tlemolish or reoair P–Trap Laundry Trays any Slructu�e, pNo� to It5 issuance, also requires tne applicant for such permlt 10 file a signetl statement that he/she is IicenSetl pursuant to the p�ovisions oT ROOi D�dinS the Contractor's License Law (Chapter 9(commencing witb SecUon 7000) of Division 3 ot the Business antl Professions Cotle) or that ne/she is exempt Reinspection Fee $75 Issue Fee $ 3 thetefrom antl tne ba5i5 to� Ihe allegetl exeTP[ion. Any violaliOn o1 $GctiOn 7031.5 by any aOPlicant for a permit subjects [he apP��cant [o a civil �enalty ot not more tnan tive nuntlretl tlouars (5500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: �J I, a5 owner ol [he prOp¢rty or my employees with wages a5 [heir sol¢ ReinSpection Fee $15 laue Fa0 compen5ation, will tlo lhe wo�k, antl the StrUcture is nOt Intentletl o� otfer¢tl ZOning App�oved 8y DatBT for sale (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES Building Approwd By Date—/� .+ License Ldw tloe5 nOt apply lo an owner ot a Oroperty who bulltl5 Or Improv¢5 //Y 7S'Y/bC tnereon, antl who does such work himself/nerself or [hrough his or her own Boiler Hood or Type I ❑ APP��tion Issued By Date_�E= employees, D�a�itlotl that such improvements ara not intentletl or o(faretl tor ule. Ii, nowever, the bulltling or improvement Is soltl within one year of com- Cynopy Type 11 ❑ SUM RV OF FEES pleti0n, lhe owner will have the bu�tlen of proving hC/she tlitl nol builtl o� Im- DUct - Uf1dE� GIOU�d prove tor the purpose oi saie). � UI LDIN PERMIT � SMIP $ ❑ I, az owner of the oroperty, am exclusively contracting with Iicensetl con- Duct-Structurel Refrigeration Sysiem PLAN CHECK $ PERMIT tractors to cons[ruct tne project (Section 7044, Business antl Professions Coee: 7he Convactor's License Law does not apply to an owner ot property who puct - Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $ builtls or Imoroves thereon. antl who contract5 for such oroiec(5 with a con- tractor(s1 Imense pursuan� m me Conttactors License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGV P.C. $ proof o( their Worker's Compensation insurance shoultl be provitletl to me. ELECTRICAL $ GRADING $ ❑ I am exempt untler Section B. 6 P. C. for tnis reason Firepl/Fact. BIt. ICBO � Fire Dampers MICROFILM $ PLAN CHECK 50% $ ^�/� Dace owner Heating System & Ducting Registers MECHANICAL S � I hereby certi(y that I aa this apo�ication antl state tnat lhe above ❑4100,000 BTU �100.0006 TOTAL FEE $�`� Information Is correc a9ree o �ly with al1 cily antl county ortlinances PLAN CHECK 25% $ dntl s�a�e laws rela � to builtling < st�uction, antl hereby authOrize rep�e- 5¢ntdtivei OI lhii t t [er upo [he above-menlionetl Prop¢r[y fqr Inspec[lon pur0ose5. �"16 �� , (� Signature Dat �D ReinspeRion Fee $15 Issue Fea $ 3 �l Q��1$Q9,Z,–QQQ1$Q9J "rQ� fl^ Orivers' License or 55 �U. �u OATE: 1G/23/&3 TI17E: 11:33 OB65-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Ac<ounting; Goltlenrotl - Assessor i ? ' " � u-�-1 . ,. � C�ONSFRUCTIQN AND PLANNING POOL & SPA ' �' ��' Date Inspector Date Inspector ,�-,AVP,�lOVALS .Permit�� - APPROVALS Permit# -.` � - � 7'. �j-emporary Electric8l Se�vice or Pol� 52. Pool & Equipment Location `• 2. �Soil Pipe-Undrgrnd. ' � • 53. Steel Reinforcement '�'�3.-Electrical Conduit Utiliiy-Undr.grnd. 54. Forms - r � 4.'ElectSical Conduit Undrgrnd. _,_ -- 55. Electrical Bonding + 1 � 5: Steel•Reinforceme�t•�., � 56. RoughPlumbing&PressurejTest ' �� 6: Electrical UFER Grnd. : 57. APPROVAL TO COVER-GUNITE � � 7. F.00tings ..� s ':�i �� • 58. Electrical Conduit-Undrgrnd. 8: Fouridation I ,�.;�� 59. Gas Pipe, O Undrgrnd., Test �i"� 9. WBter Pipe-Undrgrnd. �� 6p. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ' � 61. APPROVAL TO DECK 11. Pr`operty Sewer Line & House Connection . � 62. Backwash & Receptor-Final e - 12. Sewer Cap ; t -� 63. Heater & Vent-Final 13. Roof. Drains � � 64. Plumbing System - Final � - 74. Rough Plumbing;. � Z-([/� L�y� 65. Electrical-final � ]5. Rough Electrical�Conduit 66. Solar System-Final ' �:1`6L Rough Electric Wiring 67. Fencing & Access Approval � 17` Rough Wiring Sign 68. APPROVED FOR PLASTERING �18t Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19, Rough Heatinq & Air Conditioning FIRE DEPT. REQUIREMENT . � � 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts,'Ventilating 71. ProductPip'ingOGas OOiI 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 (S;ructural) & Monocoat 75. Dry Chemical 27. Frame and FlasFiing 76. Dry Standpipe . � '28. Lathing & Si{ling 77. FIXED SYSTEM FINAL 29. Insulation • 78, FIRE PREV. F�NAL :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 r • � 37. Final Factory Fireplace � 38. Final Plumbing �: 39. Water Service-Pinab •F:; � 40. Gas Service-Final � � U 41. Solar pomesticFinal � , 42. Backflow Preventer . i�� -,.� 43. Backflow Irrigation � -; � 44. .Landscape Irrigation SYstem 45. Sound Attenuation� 46. Handicap Regulations � ' 47. FINAL STRUCTURE & BUILDING 3 � 48. Special Requirements Completed 49. Electric Release to Edison ,'� ,�� 50. �,as Release to Southern California Gas Co �.r '�� i 51. CERTIFICATE OF OCCUPANCY � i; : . No.�� Dath � .� , • � •� , /� � � . _ CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT Developer/Applicant: 'j'f�Rkis 1�/D/K/<J��/ Address: 9J`�� 1iLlL�R//�%� �%� 7'elephone Number: 7�� %�6i0 �.,, io.._,._, .� -`- 'S): Location of Project: ✓�� /1/�� ' %�I Number of Square Feet of /'�.� Residential Space � x$1.50 Total �� O Number of Square Feet of Commercial and Industrial Space _ x $0.25 Total The provisions of Government Code Section 53080 are not applicable. This certifies that the above-named Deveioper/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995. Checks are to be made payable District. to Newport-Mesa Unified School �'d� /C. �?�`�� Busi ess Manager � Newport-Mesa Unified School District The above representation as to square footage is true. Developer/Applicant agrees that if. it is later determined that such representations are not true then this certificate�shall automatically terminate and the appropriate City/County�'�.shall be notified. Da t e: 9� q�0 .- Q O U veloper/Applicant � CITY OF CUSTA MESA CALIFORNIA 92628-1200 P.O. BOX 1200 Insulation Certificate 95'i /��'1v��o C'x»r, �t i��- N�,�,� �a sa�c csry I�-c - County Subdivisian LotNumber Description of Installation ROOF Material Bcand Name lhidmess (inches) 'Ihern�al Resistance (R-Value) EXTERIOR WALL Material �!}'iP�Gd-ix BraudName i9�Jt�nJ'� �.�i�✓G 'Ihickness (inches) '� � �z" 'ILertnal Resisrance (R-Value) Q - ! 1 CEII,ING Batt or BlanketType ✓ Brand Name �� NIuG 'Ihiclrness (inches) 'll�ermal Resistance (R-Value) r2- 3b Loose Fill Type Brand Name Contracar's minimum insralled weighVft Ib Minimum thickness inches Manufact�er's installed weight per square foot to acheive Thermal Resistance (R-Value) RAISED FLOOR Material 11�ickness (inches) SLAB FLOOR Ma[ecial 'Ihiclrness (inches) Wid�h (inches) FOUNDATION WALL Material 'Ihiclrness (inches) — Brand Name 'ILermal Resistance (R-Value) Brand Name 'Ihertnal Resistance (R-Value) Brand Name 'Ihermal Resistance (R-Value) Declaration I heneby certify that the above insulation was installed in the building at the above locadon in confoimance wi[h the cunent Building Energy Efficiency Standazds for new residential buildings contai�d in Title 24 of the Califomia Administrazive Code. �w ��a,� �/�'7 69� � Generel Cantractor (Builder) License Number 7� . S� /��i Signanae ud Tide Date SubContracwr (Insulazion Signanve md TiAe License Nwnber Applicant to fill in all ipaees except those witM1in �eavy borEer lines antl sign all apP/opriate Eeelarations. r� CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NU. Project Address �%S9 OAU1_A2�1�� 31g�� 3331 I/IB/p0 p2o75 1 TYPE OFCONSTRUCTION NEW A�D ALTERATION REPAIR Applicant'S Mailing AddteSs .�r,�'' ,�/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, � Zone Owner'sName qK��IK�R� Phonel..iY1L2� DESCRIPTIONOPWORKNSEOFBLDG. Address �� I DAULi4 K i N J S Main Building: Accessory euilding: E Z Arch/Eng. Lic¢nse No. TYPE OF PERMIT GRADING FOUNDATION STRVCTURAL T Front p Addre55 ❑ pTHERT � EIECTRICAL ❑ PLUMBING ❑ MECHANICAI A Rear N Contractor'sNam Phone C Right � N Addreu (ma i'�g� PRaECT DESCRIPTION 5�. FT. OCCUPANCv K G CONSTRVCTION TVPE VALVATION S g Left City LiCense No. ZONE GRADING GU. VDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided E 1 hereby afti�m that I am li[¢nsetl untler provi510ns Of Cha�ter 9(commentln9 Remarks: PldflninJ NOt¢5: M with section 7000) of Division 3 of the Busfness antl Professions CoCe, antl T my Iicense is in full lorce antl eHect. LicenSe Class License No. S Dace Si9nature PLUMBING FEES WORKERS' COMPENSATION DECLARATION Bd/Sink ShOw¢�s ELECTRICAL FEES I he�eby affirm that I �ave a certificdta Of <On5¢nt [o sell-Insu�e o� a certlficate ot Workels' Compen5dtion InSurance, or d Certifi¢tl cOpy thefeof (Sectlon BdCkflOw Pf¢v¢Ot2! S¢rviC¢ $ink 3800, Lao. c.) Automatic Washer Transformer ❑ 15-50 KW Poiicyrva. Comoany BackBowlrrigation SewerCap ConstructionPoleSub. ❑50+KW BCertitietl copy is hereby furnishetl. I Certitietl <opy is filetl with the city Builtlin9 Divlsion. Bathtubs Sewer Connection Cooking Unit Meter �up to 100 amps Date APPlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers Sola� ColleCtorS Di5hwa5her Meter �over 100amps (This section neetl not be completeG it �h¢ permit 75 for On¢ huntlretl (E300) O� less). Dishwasher Solar Pipin9 Dryers �Gas ❑Electric Sub Panel I certify [hat In [he perfo�mance of tbe wo�k for whith thi5 perm�t i5 iSSu¢tl, I zhall not employ any oerson in any mann so az too bacome suDject to the Drinking Fountains Solar Tank Fan Motors 00.1 HP 01'/x- 8 Workers' Com e sation Laws oi Califor q / oate �— P� ^�.'7 Signature �{�( �� %`rL./ac1 Floor Drains �� Swimming Pool w/Spa F.A.U. Inc Solar �9-15 HP �16�15+ NOTICE: I(, after making this tleclaratlon, you shoultl become subject to the — Workers' COmp¢nSatiOn provi5ions ot the Labo� Cotle, you mu5t torthwl[h FIOOf $i�k5 Urinal comply with suc� provlsion5 or thi5 p¢rmit Shall b< tleemetl �evokeU. FixLu�CS MiC�Owdv¢ CONSTRUCTION LENDING AGENCV GasService �utlCtS Wdt2�ClOset D¢viCCBOx25 1 M1ereby afflrm tM1at there is a cons(ructlon lentling agency lor the performance POIe Light of lhe work for which this permit is issuetl (Sectlon 3097 Clv. C.) �nterceptors Wate� Heater Outlets Ran e Lentler'z Name 9 �entler'z Atltlress Kitchen Sink Water Service Switches Si9n OWNER BUILOEH UECLARATION I M1ereby affirm that I am exempt irom the Gontractor's LI<ense Law for Ihe Lavatofies Auto-Wash following reazon (Sectlon ]031.5 Business antl Professional Cotla: Any clty or Garbage Disposal Standing Sections munty whicn requires a permit to construcf, alter, ImDrove, tlemolish or repair P—Trap Laundry Trays Generetor 00.5 KW �5-15 KW Trash Com actor any sVucture, prior IO its issuance, alm reqUires Ne appliGant fOr such permit P to file a signetl statement thdt he/she is licensetl pursuant to the provi5ions of ROOf D�ains the Contractor's License Law (CnaOter 9,(rommoncing with Section 7000) ot Division 3 of l�e 6usiness antl Professions Cotle) or iha[ he/she is exompt the�eftom antl the ba5i5 fo� the allegetl ex¢mptlon. Any violation ot $ectlon 7031.5 by any applicant for a permlt subjects the applicanl to a civll �enalty of not more tM1an five huntlretl tlollars ($500). 3 I, as owner of the proper[y or my employees wilh wages as [helr sole Reinspection Fee $15 Issue Fea $ compensation, will tlo lhe work, antl the struc[ure is not intentletl or offeretl Rainspection Fee $15 Issue Fee ^-7 for sale (Section 7044, Business an0 Professional Cotle: The Contractor's MECHANICAL FEES License Ldw tloes not apply lo an owne� of a proper[y who builtls or improv¢z tM1ereon, antl who tloes such work nlmseit/herself or tnrougn his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, proviCetl that sucll Improv8ment5 are not intentletl oY offered fof 60112I HOOd Of TypO I ❑ sale. If, however, the Duiltling or improvement is soltl wlt�in one year of com- Canopy Type I I ❑ Zoning Approved 6y Date pbHon, the owner wlll have ll�e burtlen of pruving he/sito tlla nof bulltl or im- Duct - U�dC� G�OUnd Buildin8 APP�OVBd By DdtO p�ove for the Outpose o/ Sale�. �--�^ � ❑ 1, as owner of the property, am exclusively contrattlng wi[h IlcenSetl con- Duct-$tfuCtU�al R¢f�igB�dti011 SYst¢m Appliwtion luuad By � )• _ DBt � t�actorz to construct [he project ($ection 7044, Business antl Prota55ion5 COtle: , The Contracror's License Law does mt apply to an owner of prooerty wno Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FEES builtls or improves tM1ereon, antl who contraCts br sucb projects with a<on- tractor(s) imense pursuant to the Contractor's LlcansA Law). I am aware tnat Exhaust System ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ p�oof of their Worke�'s Compensatlon insurance shoultl be provltletl to me. _ PLAN CHECK $ PEflMIT ❑ 1 am exempt untler Section e. & P. C. for this reason Firepl/Fact.81L ICBO # Fire Dampers PLUMBING $ ��UANCE $ Dace � - owner • Heating System & Ducting Fiegisters PLAN CHECK 25% $=� ENERGV P.C. $ i nereby certify mat i have reaa tnis appiication and state that tne above ❑0�100,OOOBTU �100,0000T ELECTRICAL $ GRADING $ information is mrrecL I agree to comply wifh all tlty antl county ortlinances antl state laws relating to builtling consVuction, antl hereDy au[horize repre- PLAN CHECK 50% § 9L MICROFILM $ s e n t a t i v e s o/ t h i s C i l y t o e n t e r u p o n t h¢ a b o v e- m e n l i o n e tl p r o p e r l y t o r � inspection purposes. MECHANICAL $ TOTAL FEE $ Signature Date� Drivers' License ar 55 � Reinspection fea $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 096�-46, �¢v, lU/tl4 Whlte - BWltling; Canary - Applicanh Pink - ACCountlrl9; GOItl¢nrotl - Assesso� CONSTFUCTION AND PLANNING � POOL & SPA APPROVALS Permit # �'' Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash �ines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 17. Property Sewer Line & House Connection 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 79. 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 1Structural) & Monocqat 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 S0. FOOD CERTIFICATE ISSUED 33. Final Electric Z 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 pomestic-Final � 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System , 45. Sound Attenuation � 46. liandicap Regulations 47. FINALSTRUCTURE&BUILDING . 46. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern Californfa Gas Co 51. CERTIFICATE OF OCCUPANCY No._�: _ Date CITY OF COSTA MESA BUILDING DIVISION OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this veritication is received. I personally plan to provide the major labor and materials for construction of the pro- posed property improvement. O Yes ❑ No 2. I (have/have not) proposed work. signed an application for a building permit for the / 3.� I have contracted with the following person (firm) to provide the proposed construction: l/ Name �R/�i/��/-EGT�Z/r_ r� Address �'�� R�,tirr-Q si cnyG.��i,�Df�,,�!//�S Phone (�/d' )$9 4 7(�LCF Contractor's Lic. No. j/g�/ CY� " - 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: 1� -_ ��fTii� Address Phone ( City Contractor's Lic. No. _ 5. I will provide some of the work but I have contracted (hired) the following persons to pro- vide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy ot the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my per- sonal knowledge ompJ�l'a�nce with t��his S�ta/te law. Signed: ��'i%"/U� /"/,/r'��,f.r��/ Date: �` ��' b�� Name: �1 D/ ,(�/i4 N Sf��K/ S (Printed or Typed) C.D.L. # or S.S. N 754-5273