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Home My WebLink About1022 POPPY CIR - Building PermitsApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO, TRACT NoLOT NO. UNIT NO. 8421 /30/86 I I -q0 Tl. ct Address rOz� , �v�i c��i� �ass6 -�Ao. aa. scam's Mailing Address TYPE OF CONSTRUCTION NEYJ LJ ADD LJ ALTERATION LJ REPAIR )• —�-P .,@•,�� 1-1CONVERSION❑ DEMOLISH ❑ OTHER' A.P. # - - - zone s NameT��N /%tX3 Phoneme +' q .rjLf TA i T/L•n-1 DESCRIPTION OF WORK/USE OF BLDG. ss �G ZZ O c - e - (/m r S Main Building: ' Accessory'Building: - ang.� n - License Nu. ,/ TYPE OF PERMIT •GRACING I�^Q❑FOUNDATION STRUCTURAL T Front - I '' �I• Q fess %�C7 Z� /T>fl•+�',/-✓/� P,k LI ,✓ U l' ❑ TENANT ELECTRICAL Iq PLUMBING ❑ MECHANICAL.- B Reap, 1 Z " N ntractor's Name 5l�� Y //pt T/FS Phone 7�416 OTHER •% _ - C .Right - I N r Address (mailing) /' r b i PROJECT DESCRIPTION 50. FT. r OCCUPANCYOCXJ K .G ] p CONSTRUCTION TYPE VALUATION $ � S Left - R City License No. J d ' ZONE GRADING CU.YDS. ACRES S E LICENSEDONTRACTOR DECLARATION Ping. RefI Parking Req./Provided IherebY;afrm that 1amlicensetlunderPrevisionsofCharter9(commencn9 Remarks: Planning Nofes: Q _ M with section 7000) of Division 3' of the Business and Professions Code, and T my license is in full fort and-effect. G I Lic�fis glass '`� L'` Lice�s},No. ZL7 9— _ S .t..La /7zU (j ' " S'b t L „?if/ "`�. I , PLUMBING I i FEES I of-'Workers' Compensation Insurance or 6'ccertified' copy thereof' Section— Backflow Prevente Showers 1 ! 1 ELECTRICAL LFF Policy No.I hereby fum loaf I have a certificate of Poan ` Bar Sink _ r Service Sink ! i Automatic Washer Transformer 1550 KW WORKER COMPENSATION D LARATION consentto self-insure or a certificate I 3800, Lab. C.) sZb692� LT S �� ❑ 50 + Kw y Backflow Irngation I Sewer Cap I I Construction Pole Sub. , Certified copy is hereby furnished. I , wVl�- ®Certified cop 's [ilea with the city Bu i ltlin_g Divis�iyn. `� l Bathtubs I Sewer Connection j Cooking Unit Meier ❑up to 100 amps I Date I (7 Applicant 71Ll3U �. I 'EXEMP 10N&ROM WORKERS' COMPENSATION DECLARATION - —I - Clarifiers _ _._J . Solar Collectors. ., _ _. Dishwasher i._ IMete,r ❑over 100.amps (ThiSsection need not be completed if the permit is for,one hundred ($100) orI , less). , I Dishwasher Solar Piping , ❑ Dryers Gas! ❑Electric I Sub Panel certify that in the performance of the work for which this permit i5 issued, I - shall not employ any person in any manner so las to become subject to the Drinking Fountains Solar Tank I Fanri I Motors [10-1 HP �J 1'/x- 8 t Workers' Compensation Laws of California. i - Date SignatureFloor Drains! '9*1 J'/Spa F.A: U. 1 ( Inc. Solari139-15 HIP 'El16-15+ NOTICE: if, after making this declaration, you should become subject. to the _ _ _ _ _ _ _ _ Workers'. Compensation provisions of the Labor Code, you must forthwith — Fjpor Sinks Urinal 1 Fixtures ! Microwave comply with such provisions 'Or • this permit, shall be deemed revoked. CONSTRUCTION LENDING AGENCY- ! t'/- Gas Service' Outlets WateKCloset e-.� Device Boxes' j iPole.Light 1 hereby affirm that there is a conpt ruction lentlmg agency for the performance - of the work for which lois/permit iS: issued (Section 3097 Civ. 'C.)' Interceptors 1 Water•Heater ' - Lender's' Name 1 A' p , 1 Outlets: Range Lender's'Address/ ' Kitchen Sink1. - Water Service : i - ,.p �' Switches I Sign & 1 OWNER BUILDER DECLARATION .. � 1 - - _ r I hereby affirm that I am.exempt from the Contractor's License'6aw foi the Lavatories v " r; { Auto-Wash r +/ Garbage,Diiposal ;Standing Sections following reason (Section,7031:5'. Business and Professional Code: Any city or _ _ ' _county which requires a permit,to construct; alter, improve, demolish oc.repair P—Trap i - Laundry Trays + I any structure, prior to .its issuance, also requires the applicant for such permit P+ ' y y '. Generator ❑0-5 KW �5-15 KW Trash Compactor ^to file a� signed zlatement'that he/she is licensed, pursuant to the provisions of ROOf'DrainS r - ' �" �� '- the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ' i _ i • "1 t;, I Division 3 of the' Business and ProfeSsions Code), or that he/she is exempt! - j therefrom-and the basis for'the alleged exemption. Any vlolatioWOf Section t c . _ + �, I ! ,'".• I - I 7031:5 by. any applicant for a Permit subjects. the applicant'to 'a civil, �nalty of not more than five hundred tlollars .($500). _ Y. - I LJ 1, as owner of the! property;O1 my.employees with wages as their sole Reinspection 'Foe I & $15• Issue Fee•. $,3 /} l compensation, will do the work, and the-structure is not Intended or offered Reinspection Fee -$15 . 'Issue fee $ 3 for sale (Section 17044, Business 'And Professional Code: The Contractor's', _ r- - - ",MECHANICAL �_ FEES , License Law does not apply to an Owner of a property who builds or improves i - DEVELOPMENT SERVICES REQ EMEN thereon, and who does such work himself/herself or,through his Orlher own , .� ! : A 'y/q/—%/�t/C—%,�{ • [�'j�' employees, provided that such improvements are not,intended or offeredlfor Boiler -•, HOdd Or Type I ❑ - x+ sale. If, however, the building or improvement Is Sold within one year of core- Canopy Type II; ❑ - zoning Approved By - 1 Date pletion„the owner will; have the burden of proving he/she did not build or;im- Duct- Under Ground Building Approved By l Date Eve for the purpose of sale). ' l I j i - ,r n L I, aziowner of the property, am exclusively contracting with licensed con- t Duct -Structural Refrigeration System - AppliUtion Issued By I Data I A tractors to construct the project (Se�t1Pn 7044, Business and Professions Code: ' ' f 1 �, _ , The Contractor's License Law does- not.-apply 4o antowner, of property Who - - Duct - Ventilating =��'- 1- - 1 -- 00.'l 00,000 BTU 0100,000 BTU . t ,., - , ,SUMMARYQF FEES builds or'improves tM1ereon, and who c tracts for such,projects.wilh aeon- _ • ' �lh'D I'St/ l tractor(slrlicense pursuant to the Conti ctor_5•License-Law). Cam aware that Exhaust S stem ❑ Multiple ❑1 System Re air/Alteration '%+ I BUILDING PERMIT $ Jsi SMIP $ ' proof off their Worker's Compen--t'o surance should,.b. provided to me. arI” , & y Y, - p- p .. Lf PLAN CHECK i $ PERMIT ❑ yam exam B. untler Section ``/ ' B.'&:P. C. for this reason Firepl/Fact. Bit. ICBG # I Fire Dampers rs ISSUANCE i $ ' J - i PLUMBING $ i Date I - Owner; _ Heating System & Ducting Registers i ) '� i 'gyp PLAN CHECK Q5%. $ / S ENE RGV,P.C. $ I hereby certify that-I have read this application and state that the above ❑0100,000 BTU ❑100,00067 I i I I ELECTRICAL ' $ ' GRADING $ informal ion•is Corr t agree to comply with-all it aty antlicounty ordinances - an state 5la ws+rc ng%lo builtling'eon t coon antl hereby-authorize repre : , 1 S MICROFILM $ :emelt ion pf city, to en er' 4p he ;above-mentioned properly.,for I '"; - j ' , ' I PLAN CHECK 50% $ 1-I--s�-FG-- i I pu ses. /j1//'J�/j//j[�1 , I' i MECHANICAL i $ TOTAL FEE $ Signature -'�' WyC%Vsv'� Dale Z� O I Drivers'lLicense or SS # . _/�' Reinspection Fee $15' i Issue Fee i $ 3 PLAN CHECK i25% $ i CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor / I=.VD PLANNING ' -- APP �,..;_W.,,.: Permit # Date Inspector POOL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. 53. Seel 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 LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE Z� 7. Footings 58. - Electrical Conduit- ndrgrnd. (( .� w B. Foundation 59. Gas Pipe, ndrgrnd., Test OA-- �(o V(,� , 9. Water Pipe-Undrgrnd. 60. Backwash.Lines, P -Trap, O Undrgrnd. X70. Structural Floor System 61. APPROVAL TO DECK ` (/(/ y L. Property Sewer Line & House Connection •62. Backwash &Receptor -Final - 112. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final i 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 �p 19. Rough Heatinq.& Air Conditioning 4 FIRE DEPT. REQUIREMENT APPROVALS Permit +-.- ._21. 20. Rough Factory Fireplace 21. Ducts, in Structure 170. Underground Hydro 22. Ducts, Ventilating .. 71. Product Piping O Gas ❑ Oil 23, Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing r, 73. Undergrnd. Storage Tank ❑Gas ❑Oil 25. Roof Sheathing - 74. Overhead Hydro t - 26. T -Bar Ceiling (Structural) &'Monocoat 75. Dry Chemical I` '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 Notes: 0_//^ ,eQ l►�J,t/! C'f%LG F� 34. Final Heating & Air Conditioning /✓Cj� d"'- 135. 35.Final Gas Pipe -Test ��-(� , We AE5M e L('F_'t57 Hood or Canopy pT3736. )"7- 37. . Fina`I Factory Fireplace 38. Final Plumbing ' 39. Water Service -Final 40. Gas Service -Final - i 41. Solar Domestic -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 V 50. Gas Release to. Southern California Gas Q) 51. CERTIFICATE OF OCCUPANCY INo. Date ): t_ �Z \ Building Address U \ Owner ,_Contractor Address / Permit Date 050-5i —p Numb a r_Issued CITY OF COSTA MESA I OX DEPARTMENT OF BUILDING SAFETY Registered Deputy Building Inspector Certificate of Compliance Date of this Certificate To the Director of Building Safety: .I hereby certify that the following portions of work on the buildings at the above address which required continuous inspection and which I was employed to inspect, were inspected by me and comply with the provisions .of the Building Code applicable thereto. ) Concrete 3) Welding 5) Special Cases 2) Masonry 4) Reinforced Gypsum 9wimmi-rq-�P,prY Size _Gunite t� Hand Pack ✓ Sacks Cement Tons of Sand o Approximate % of water in aggregate n This report covers work completed during week ending Name i.. �Z�.•p Address RJ.,�T„-��'iDtil. l�l1E� Laboratory AD hjj'b . Telephone q�03-�S4 Form Bu 6 - •- • t•� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY 0 *STA MESA - PLAN 5 El ev.'�A - PERMIT NO. TRACT NO. LOT NO. CONSTR TION PERMIT LOT 22- (o ZO/ Z =.>r - 516.9 3/01''/®4 599.59 Th. Project Address: C . oppy 1•rC a .• - , -TYPE OF CONSTRUCTION NEW ADD ALTERATION ± REPAIR ApprpafR•s rNaaing Address 1565 W. MacArthur Blvd., C.M. _ 1:1 CON VER5I.ON . ❑ DEMOLISH ElO'iHER '� A p •# ,� 3-7 Owner's'Name Stan da rd' Paicffic COr�. hone 546-1161 DESCRIPTION OF WORK I -_ S - Main Build mg.• '% - AccessoryBuildmg 7 - _ q Address Same- T ,7 .Front 'LOQ - O N , 'TYPE OF PERMIT -GRADING , FOUNDATION 'STRUCTURAL 1 '1 Arch/En . AdamS/StrPetlErLicense No. - OR- 9❑'TENANT- - ❑,ELECTRICAL'❑ PLUMBING El - B ". - - ', 17g8l Sk,y Park' Circlet''1'rVl'Re` ❑'-OTHER a 1 - '- '- A. Reap 1 N , Address - r G Contractor's Name' SPP QWnPr "Phone' i .PROJECT DESCRIPTION SO: FT. �__ OCCUPANCY' '- K - - _ -. R - i - - Address (mailing) �' � I CONSTRUCTION TYPE I 'VALUATION$ 7l 1 ��-t-1',-,— S Left % �Jr. - = � - 1'^ ./� � E Ci - -^ City License No. '(- 7 - I ZONE r� GRADING CU.VDS. -ACRES Pln Ref. # g. 'ZF- -OS -Park. Fees $' / Z �'7 O ,� LICENSED CONTRACTOR DECLARATION Remarks: C .. O �. A ,Parking Req./Provided 2' �7%�z-' U p 1-herebyaffirm that I am licensed under provisions of,Charter.9 (commenclnq R with section 7000) of Division 3 of the -Business and Professions Code, and Use of Building: i ' _ , E - my license -is in full for (�e d,effedt. a -. PLUMBING Planning' Notes: i• 1 - M License Class -"-� ense p.'248042 FEES E nate ' 12'-15-23 Signature Bar Smk Showers HOLD FOR SPECIAL REQUIREMENTS ' N WORKERS' COMPENSATION OE ARATION •- I' T 1 hereby affirm that I have a certificate of consen{to self -insure or a certificate Backflow Pr¢v¢nter Service Sink $ J of -W orkers' Compensation- Insurance; or -a certifiedreopy-thereof (Section - - - - - - 3800, Lab. - f ' Fremont Indemni-y -84-225-8561 Backflow Irrigation .f Sewer Cap <':;,. - I -?' 'ELECTRICAL '�_;,. FEES. Po. rap. cpmpany ❑ Certified copy Is hereby furnished.'„ : , Bathtubs ° _ Sewer Connection S Automatic Washer - 'Transformer ❑ 15�50,KW ❑ Certif'e c i fed with the city ulldi g Di IsiQ n. i 9-1% 2 0 50 + kW- Date Applicant' -tan aro NaCI•f7C' I Clarifiers , Solar Collectors,,.. Construction Pole Sub.-'(-,� -EXEMPTION FROM WORKERS' COMPENSATION.DECLARATION -- - (Thissection need not be completed if the permit is for one hundred ($100) or Dishwasher"" - "• r' Solar Piping' - _ - Cooking Unit-; - "" - - - l - Meter' Oup to 100 amps " . llecartify that in the performance of the work for which this permit is issued I Drinking Fountains Solar Tank Dishwasher j •Meter ❑over 100 amps t - ' shall not employ any person in any manner so as to become subject to Idle Workers', Compensation taws of California.' i i Floor Drains • Swimming Podl w/Spa . Dryers ❑Gas- ❑Electric - -Sub Panel. •( Date Signature - NOTICE: If, after making this declaration, you should bec6me subject to the t Floor Sinks ' Urinal i i Pan. Motors 00-1 HP 01%- 8 Workers' Compensation provisions of the Labor Code, you must forthwith- _ - - - - - - 1 comply with' such provisions, or ,this permit shall be deemed revoked. Gas Service Outlets'. Water C OSet F,A:U. Inc. Solar ❑9-15 HP 01,6-15+ - CONSTRUCTION'LENDING:AGENCY - I I hereby •affirm that there is a;construction lending agency for the performance interceptors I 1 Water Heater Fixtures Microvvave i of the work .for which i this permit is issued '(Section 3097 Civ. 'C:)- - - - - - -� - Lender's Name. Kitchen Sink _ - Water.Service Device Boxes' Pole Light i Lender's Address OWNER BUILDER DECLARATION - - _ Lavatories , - - • Outlets 'Range I hereby: affirm that I am exempt from the Contractor's. License Law for the following reason -7031.5 Business Professional Code: P -Trap: - i - - Switches (Section and Any city or _ j.±" Sign ! county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit i - - Roof Drains' Garbag¢'D isposal - 1 'Standing Sections to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing) with Section 7000) of Dl vision. 3 -of the'Business and Professions Code) or that he/she is exempt - - - - - Generator KW ❑5-15 KW Trash Compactor, therefrom and the basis for the alleged exemption. Any,vmlat ion' of Section '7031'.5 - -_ •3 - , y, - , by -any applicant for; -a, permitlsubjects the .applicant to a civil " Reinspection Fee : i ($25, Issue Fee_ $ - •- - I Beaty of not more than five hundred dollars ($500). �- I, as owner of theproperty or my employees_witfi' wages' as their soleReinspection. - Fee P $25 Issue Fee $' 3 - compensation, will: do the work, and the.structure is not Intended or Offered - MECHANICAL- - FEES for sale (Section 7044, Business and Professional Code: The' Contractor's PUBLIC SERVICES REOUIRE License Law does not apply to an owner of a propertywho;builds or improves thereon, and'who,does such work himself/herself or through his or her own 1 BOII¢r -- '. HOOd Or Type ❑ Zoning Approved'By v' �/� /W Date Z Z7 ' employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year, of com- - Duct - Under. Ground ' Canopy Type If ❑ - -, _ ' f, gpplidation Approved By , / �'"^ Date i0 ' pletion, the owner will have the burden of proving he/she did not build or im- rove+for the purpose of sale). I, as owner of the am exclusively contracting with licensed con- , Duct - Structural Refrigeration System Application Issued.By Q I>"' r' Dat 3 c` property, tractors to construct the project (Section 7044, Business and Professions Code: Duct - Ventilating , ❑0-100,000 BTU ❑100,000 BTU � �' SUMMARY OF FEES The .Contractor%s License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- ' _ _ Exhaust System ❑ Multiple ❑ .. _ System Repair/Alteration - 1 BUILDING PERMIT $ - - SMIP $ _ n nn --50Qi:00— ��r- ) license pursuant to the'ContractoCz License Law). i tra-I ❑I Section B. P. for this - PLAN CHECK $ 82.55 PERMIT - am am exempt under & C. reason Firepl/Fact. Blt. ICBG # PLUMBING $ ,ISSUANCE $ •' Date -Owner. - Heating System & Ducting - PLAN CHECK $ ENERGY P.C. ' $ - I hereby certify that I have read this application and state that the above ❑0-100,000 BTU ❑100,DOOBT " - ELECTRICAL 1 GRADING $, information -is correct. -I agree to comply'wlth all city and -county ordinances - - - _ J $ and state laws relating,to building construction, and hereby authors a repro- 'enter - ,' - �: �; PLAN CHECK $ MICROFILM $ sentatives of this city t upon the above-mentioned ro rty r , inspectio �s@'e^.. 7p// Date �/� ,MECHANICAL $ TOTAL FEE $ - FOO fiO Signature Drivers' License or 55se Reinspection Fee $25. Issue Fee $ 3 PLAN CHECK $' . CMF 0865-46 rev. 7/83 Pink -Accounting; Goldenrod -Assessor- - - r •. GCONSTRUCTION AND PLANNING-. APPROVALS Permit # - � � - Date Inspector. - POOL & SPA _ APPROVALS .P . Permit Date Inspector �1: Temporary Electrica I -Service or Pole .. 52. -Pool & Equipment Location _ f2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement' - - '• 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55.� Electrical Bonding , 5. Steel Reinforcement 4' - 56.. Rough Plumbing & Pressure Test - 6. Electrical UF.ER Grnd. ' 57. APPROVAL TO COVER-GUNITE 7. Footings kPLIZI9i 58. Electrical Conduit-Undrgrnd. ' 8. Foundation _ 59.'Gas Pipe, 0 Undrgrnd.,, Test ' 9: Water Pipe-Undrgrnd. c - - 60. Backwash Lines, P -Trap, 0 Undrgrnd. 102 Structural. 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.E 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. -APPR0VED FOR PLASTERING 18. 'Rough Electrical -T - Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating &Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # - 20. .Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22': Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23: Gas Pipe -Rough & Test - ;� 72. Underground Flush 24: Roof Framing 73. Undergrnd. Storage Tarik EJ Gas 0Oil 25. Roof Sheathinget- AS 3 B 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat -' 75. Dry Chemical 27. Frame and Flashing ' f'� (/ 76. Dry,Standpipe , 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation j%L 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: &1-3A 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy - o 37. Final Factoryireplace- - -•y�,� - ' 38. Final Plumbing 39. Water Service -Final ' 40. Gas Service -Final y 41. Solar Domestic -Final - •'� - 42. Backflow Preventer - - 43. Backflow Irrigation j - 44..Landscape irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&,BUILDING 48. Special Requirements. Completed •, i19 6__ 'Cal 49. Electric Release to Edison - - - '- 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OFOCCUPANCY No. Date aU �-/�.� -Applicant to films- I in ail sPa c?s_exce�5,Q. whom heavy bord r lines ane_ si n all appropriate declarations. - CITY OF.COSTA MESA !� CONSTRUCTION RMIT ' ,-. PERM NO TRACT NO. LOT NO. UNIT NO. ProjectAddress•_/";Q2 -�9 /4 TYPE OF CONSTRUCTION NEW ADD ALTERATION- REPAIR ❑ CONVERSION - 1-1 OEM LISH ❑ OTHER _DESCRIPTION OF WORK/USE OF BLDG. - - - - Applicant's Mal�lin/q�A—ddres e - Owner's a Y �� .// / php� �� Address � -e / �7 /JI A.P. # .. - - Zone S Main Building: Accessory Building: _ -p E _ Z Arch/Eng. License No. � Address, = -❑ TYPE OF PERMIT GRADING -FOUNDATION %STRUCTURAL TENANT ❑ELECTRICAL PLUMBING )GOOD❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT.' 'OCCUPANCY CONSTRUCTION TYPE }VALUATION$ ' ZONE - GRADING CV.VDS. ,ACRES T Front - 1 - O BA Rear N I Contractor's Nam P p Address Imailingl - I _ City License No. LICENSED CONTRACTOR DECLARATION C Right - _ N G K $ Left 1 ' _ - R I Ping. Ref. $ ParkiOg'fleq./Provided-" - I _ E Remarks: 1 i I P.Iarin ing Notes: M affirm that I am licensed under provisions of Charter'9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and ,with my license is in full rce n effect. ` Licenj�jF�ass' ¢ens N (/ Lice 'Signal r �//L 7� - I 1 I ' i , T S.: PLUMBING G FEES - - - I- j Bar Sink Showers ' - ' ELECTRICAL FEES WORKERS'rCOMPENSATION DECLARATION'' - 1 I hereby affirm that I have a certificate of consent to self -insure or a certificate Of Workers' omp.nsation Insurance, or a. certified, opy thereof .(Section .. 3800, Lab. Policy No Company L�� sijgprtuied copy is hereby furnished. Cer ' d co y i fi d with the city�gyjI in I _ __ _ " Backflow Preventer _ , 'Service Sink' ' _ _ -Automatic Washer- Construction Pole'Sub. - Transformer ❑ 15-50 KW --' - ' 0 50+ KW Backflow Irrigation Sewer Cap 1 1 a Bathtubs Sewer Connection Cooking Unit , Meter• Oup to 100 amps Date Applican �� EXEMPTIO FROM.WORKERS' OMPENS PION DEC LARATI N - Charmers f _ _ Solar Collectors j _ Dishwasher - - - Meter Dover 100 amps, (Thissection need not be completed if the permit is for one hundred ($100) or Ilecertif that in the performance of the work for which this permit i y' p t iSiisSuetl, I shall not employ any person in any manner so l as to become subject to the Workers', Compensation, Laws of California.. Date Signature Dishwasher - Solar Piping, - Dryers (]GasOElectric Sub Panel 1 Drinking Fountains Solar Tank Fan " , Motors 00-1 HP 01%-8 Floor Drains Swimming Pool w/Spar I F.A.U. Inc Solar 09:15 HP 016-15+ NOTICE: If, after making this declaration, you should become subject to the Worker$• Compen Sation provisions of the labor Code, you must forthwith - comply `with such provisions or,this, permit shall be deemed revoked. - Floor Sinks - - ' Urinal -' ' ♦ - - - -Fixtures -Microwave - Gas Service _Outlets Water Closet - r1' Device BO%¢$ . POI¢ Light - , CONSTRUCTION LENDING AGENCY, ,. I hereby affirm that there is a -construction lending agency for the performance , Interceptors. �; - 'Water Heater i of the work for which; this, permit is issued (Section 3097 Civ. C.) -. Lender's Name Outlets Range _ Kitchen Sink - Water Service Switches; Garbage Disposal Sign 'Standing Sections' ' _ Lender's Address - OWNER BUILDER DECLARATION( - - - I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish Or repair. any structure, prior to'its-issuance, also requires the applicant for such permit - to file a'signed statement that he/She is licensed pursuant to the provisions of the Contractor'License Law (Chapter 9 (commencing with Section 7000) ofr s Division 3 of the Business and Professions Code) -or that he/She is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by, any applicant for a permit. subjects the applicant to a civil -enally of not more than five hundred dollars ($500). .� I, as owner of the property or' my employees with wages as their sole "compensation, will do the work, and the.structure isnot intended or offered for sale (Section '7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon; and who does such work himself/herseh-or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of conn- pletion, the owner will have the burden of proving -he/she did not build or im- Uve for the purpose of sale). Ie f owner r the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of,p,.Pe,ty who builds or improves thereon, and who contracts for Such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me., .0 1 am'exempt under Section e. & P. C. for this reason Lavatories - P -Trap _ - Generator 00-5 KW 05-15 KW Trash Compactor - Roof Drains I I , - -. 'Reinspection -Fee - l $15 Issue Fee " $ 3 1 - Reinspection Fee $15 Fee $ 3 MECHANICAL FEES IlIiliiliiil�ililssue DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date,��.--/-(1-�}�� Application Issued By Dat , - , Boiler k ( - Hood or Type 1 ❑ , Canopy Type II EJ: _ Duct - Under Ground Duct -Structural Refrigeration System ' 001100,000 BTU 0100,000 BTU - _ - _ Duct,- Ventilating _. - - - - BUILDING,PERMIT PLAN.CHECK i PLUMBING PLAN CHE 'ap%vl$'�, 1 SUMMARY OF FEES $ ,$MIP k $ , $ s ,PERMIT 1$ IS UANCE $ � f R`,.]/��'`' �$ R DIWtt� Exhaust System ❑ Multiple ❑ _ System Repair/Alteration ' Firepl/Fact. Blt. ICBO�# - Date ! Owned - - I hereby certify that 'l have read this application and state that the above Heating System & Ducting ❑Q100,000 BTU 0100,000 BT - information is correct. agree to comply with all city and county prtlinances and state law r ating to building co struction, and hereby auth rize repre- .Sentatives of, h i y to enter o th ab -me tioned'p oper y.for inspection pu s ELECTRICAL PLAN CHEC I50%I MECHANICAL' $ I $ MICROFILM $ TOTAL FEE $ I Reinspection Fee $15 ' - I Issue Fea s $ 3 Signature ' Date Drivers' License or 55 PLAN'CHECK • 25% I $se CMF 0865-46, rev. 4/84 - Accounting; Goldenrod - Assessor - " 'CONSTRUCTION AND PLANNING • , APPROVALS Permit # Date Inspector POOL & SPA APPROVALS • 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-Undirgtnd. ' - 55. Electrical Bonding. 5. Steel Reinforcement •j 56. Rough Plumbing-& Pressure Test ' !` 6. Electrical'UFER Grnd�_. 57. APPROVAL TO COVER-GUNITE - 7.Footings i .,� - 58. Electrical Conduit-Undrgrnd. -" 8. Foundation -�' 59. Gas Pipe, 0 Undrgrnd., Test' • 9. Water.Pipe-Undrgrnd. ^� ' 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System -.� 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final' 12. Sewer Cap .-1 .h 63. Heater & Vent -Final _ 13. Roof Drains 7' 64. Plumbing System - Final - 14. Rough'Plumbing. 65. Electrical -Final 15, Rough Electrical -Conduit 66. SolrSystem-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 APPROVALS Permit # _ ' 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating --, 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test - • - / 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 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 Notes: i 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. Ga's Service -Final 41. Solar Domestic -Final 42. Backflow Preventer s 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 -� [_4! _ .Applicant to fip.in an spaces except those within heavy border lines and sign.all appropriate. declarations. i •CITY OF COSTA MESA CONSTRUCTION PERMIT 5748 . 3%09/a4 ;i 38.00 PERMIT NO. - r , t ' TRACT NO: ,LOTiNO.I BLD Project Address c - Appl¢eot'S Melling AddfPr�s+. ' %= -. - TYPE.OF CONSTRUCTION- NEW LJ ADD - • ALTERATION Ll ❑CONVERSION ❑DEMO ISH ❑OTHER ' REPAIR- -' A.P. #; Zone'- , - L Owner's Name Phone, II(�I, Address 'I ��` JiLY-Tl'i. .' v �:-[TxJ-C.4_-y sxe�O.aL.� DESCRIPTION OF WORK - -• S Main:Building' Accessory Building,' ! z TYPE OF PERMIT GRADING ❑ TENANT ❑ ELECTRICAL -❑ COTHER PROJECT DESCRIPTION SQ. FT. CONSTRUCTION TYPE - - FOUNDATION STRUCTURAL LUMBING. ❑ MECHANICAL - - OCCUPANCY VALUATION$ E T Front - - - - ) O N Arch/Eng.. License NO., Address B A Rear 1 N contractor's Nam Pho li�lii� Address,Imaili,,,,1�1 I^�In'Q�Lrl C. Right - - G K ,S Left ` R E pt- City License No. GF 16 1`] LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business antl P, pfess Ions Code, and my Iicen se Is I t I force and effect. qq 4 Llcens:nClass License f .�1�T ZONE - GRADING CU.YDS. ACRES Ping. Ref.+ - Park.Fees$ - - O U Remarks: /57 Parking Req./Provided - 1 Use of Building: _ R E PLUMBING FEES 'Plannin Notes: g M Date Signature / WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I haves certificate of,consent to self -insure or a certificate- of Workers' Coiripensatlon Insurance, or a certified copy hereof (Section , Bar Sink Showers ! ' I N Backflow Preventer' 'Service Sink - - -- T S POIicY No. l,ty c%' -S (,OR L}7OCom Pany � Certified copy'is hereby furnished. -I ❑,Certl7r�lejf Backflow Irrigation - Sewer Cap -• - ELECTRICAL •FEES • Bathtubs Sewer Connection' Automatic Washer Transformer ❑ 15-50 KW coI)y fiJetl with the city ding D�(i7joa �dte ((�- b F `75� Applicant s =�-- v�—"'�1 ' Construction Pole Sub. ❑ 50+KW Clarifiers _ Solar Collectors EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or 11 certify, that in the performance of the work for,whlch this permit is Issued, I Dishwasher Solar Piping Cooking Unit I Meter ❑up to 100 amps Drinking Fountains Solar Tank Dishwasher Meter Cover 100 amps shall not employ any person In any manner so as to become subject to the Workers' Compensation' Laws of California., Date i Signature - Floor Drains I Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel - Floor Sinks - Urinal - Fan -. Motors ❑0.1 HP 011/. - 8 NOTICE: If.ofter making this declaration, you should become subject to the Workers' Compensatlon provisions of the Labor Code, you must forthwith comply with such provisionsor this permit. shall be deemed revoked. CONSTRUCTION LENDING AGENCY ' Gas Service Outlets Water Closet o00 F.A.U. Ina. Solar❑9-15 HP E16-15+ InterceptorsWater. " Heater; � Q Fixtures ' Microwave I hereby affirm that there Is a constructlondending agency for the performance of the work for which, this permit Is.Issued (Section 3097 CW. C.) Kitchen 'Sink _ Water Service O Device Boxes Pole Light Lender's Name Lende,Ii 'Address OWNER BUILDER DECLARATION I hereby affirm that I am'exempt from the -Contractor's License Law for the following reason (Section 7031.5 •Buslness antl Professional, Cotle: Any city or county which requires a permit to construct, alter, Improve', demolish or repair - i Lavatories. Outlets Range P—Trap ` P' Switches' 1 Sign, Roof Drains, - "' - Garbage Disposal Standing Sections ,any structure, prior to Its Issuance, also requires the applicantfor such permit to file a signed statement that he/she Is licensed pursuant to the provisions of _ I - Generator, E10.5 KW El 5-15 KW Trash Compactor the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3'of'the Business and Professions Cotle)`or that he/s he -.is exempt therefrom and the basis for the alleged exemption. Any violation of Section Reins ct= Fee PB $25' - Issue Fee s ' $ 3 1 .7031.5 by applicant for a permit subjects the, applicant to a civil rlenalty of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole co mpensatlon will do the work, and the'structure is not intended or offered for sale (Secilon. 7044, Business antl• Professional Cotle:. The Contractor's Ll cense Law does not apply to an owner of a property who builds or Improves thereon,; and who does -such work himself/herself or through his or her own - employees, provided that such Improvements are not Intended or offered for sale. If, however, the bulldin or Improvement is sold within one year of com- 9 d Y p ratio n, the owner. w111 have the burden of proving he/she dltl not build or im- ove for the purpose of sale). Econ- I, as owner tr the property, Se exclusively Business ng with Professions tractors to construct the project Section.7044, n Professions Cotle:...• Reinspection Fee $25 issue Fee ,-, MECHANICAL FEES, PUBLIC SERVICES REQUIREMENTS: {Zoning Approved By Date - Building By Date - - Application Issued ey Data _ Boiler' Hood Or • Type I ❑ Canopy Type If ❑ ^. Duct - Under Ground I Duct -Structural - Refrigeration System , ," t ❑0.100,000 BTU ❑100,000BiU _ .Duct -Ventilating ... SUMMARY OF FEES to owne The Contractor's License Law do hoc apply to r s owner je property wno apply builds or Improves thereon, and who contracts for such projects with acon- tractor(s) Ipursuant to the Contractor's License Law). • ❑ :I am exemptempt under Section } B. & P. C. for this reason BUILDING PERMIT ' PLAN CHECK PLUMBING' PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL .$ - PLAN CHECK 25% $ SMIP $ $ PERMIT $ ISSUANCE $ $ -7 NERGY P.C. $ GRADING $ $ $ MICROFILM '$ TOTAL FEE $ $ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBO+ I Date Owner' ' 1 -hereby -certify -that I have read this application arid state that the above '� Information is correct. I agree to comply with all city and county oromances and state laws relating to building construction„and hereby authorize repre- sentatives of'th IS: ci y� to enter; upon the above-mentioned property f Inspection u poses. // Signature - Date cense or 55 Drivers' Li'Yp Heating System & Ducting +, 00.100,000 BTU ❑100,0008T ' , Reinspection Fee x$25' -- Issue Fee $ 3 CMF 0865-46 rev. 12/83 White- Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor -. '.�CONSTRUCTION AND PL"ANNING- - �• .• .- ,POOL&SPA _•-•wc- - .--; p 1- .. -rJ r,, _;; ..: L' ' -• > =APPROVALS Permit #Y '• Date Inspector' _ ' - S " APPROVALS -Permit # -Date .1 -.inspector. 1: Temporar Electrical Service or Pole y. .? �' �� 52� Pool & Equipinent�Location'��- -- ' ,• ,` 2`Soil Pipe•-Undrgrnd..'�-:%/y� jcj . 53. Steel Reinforcement •, j' ' " ° i _ _ 3? Electrical Conduit-Utility-Undrgrnd� ri - - •54:-. Forms._. t 4C Electrical Conduit-Undrg'rnd.. , r - - 55.. Electrical Bond i ng _ 5` Steel Reinforcement (� i - ` J. - - - , 56., Rough Plumbing'& Pressure Test �` - `-`• '' 6. Electrical UFER Grnd" "- 57. APPROVAL TO COVER-GUNITE. .'2.= I Y• i -' 7. Footings n a •, 58.' Electrical ConduifUncirgrnd._;. - -� I I �• •I•ai _ r 8. Foundation', 59. Gas Pipe, O-Undrgrnd.-, Test`• �;', - •^ ,; 9. Water Pipe.Undrgrnd.- fjy; L� 60. Backwash Lines,'P-Trap, O Undrgrnd.=. i ' ' e V0 10. Structural Floor System "1 J ' 61. APPROVAL-.TO DECK 11. Property Sewer Line & House Connection 6/el�8y t.E� 62. Backwash:& Receptor_-Final= > - _ 12. Sewer-Cap, +'Heater.-, _CP`; i, - 63 &,Vent-Final -- i _ . ..;.- 13. Roof Drains A •7 [S 64. plumbing'System;- Final - 14. Rough Plumbing '65. Electrical-Final 15' 'Rough Electrical-Conduit . - - '- '66. Solas System-Final'- 1 i 16. Rough Electric Wiring .4 -'- 67,.' Fencing &Access Approval - -u 17. Rough Wiring Sign' - -. 68.' APPROVED FOR PLASTERING' 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ^ 1 19.".Rou6h Heating & Air Conditioning FIRE DEPT. REQUIREMENT„ " : APPROVALS l Permit 20. Rough.Factory Fireplace ' 21. D6cts, in Structure 90. Uriderground Hydro 22. Ventilating - 71., Product Piping O Gas .11] Oil- ,Ducts, 23. Gas Pipe-Rough & Test- - 72:'Underground Flush 24. Roof Framing - 73. Undergrnd. Storage Tank,0 Gas,D'Oil. 1 ,'25. Roof Sheathing 74., Overhead Hydro ,.:. =- 26. T-Bar Ceiling (Structural) & Monocoat 1 75.Dry,Cheritical 1 - � - � ,. i � ' I -5 . 1� 27. Frame and Flashing . 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL r 29. Insulation 78., FIRE PREV. FINAL y I ,30. Drywall Nailing , HEALTH DEPT. REQUIREMENT i ' 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' '. 80) FOOD.CERTIFICATE ISSUED I 33. Final Electric s ! Notes'. 34. Final Heating &'Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy i I - i `i` i ;. 37. Final Factory'Fireplace, 38. Final Plumbing r 39. Water Service-Final d 40. Gas Service-Final ' ' - .. `' • 1 i 41. Solar Domestic-Final 'I •; .v 42. Backflow Preventer 43. Backflow Irrigation ,'_' • - - •' 44. Landscape Irrigation System 45. Sound Attenuation; 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - , I .i i r tj ' 48. Special, Requirements Completed. ' r •1 " •' I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I • " ' • I ! 51. CERTIFICATE OF OCCUPANCY No. _Date Applicant to fill in all _spaces except those within heavy border lines and sign all appropriate declarations. I .0448 I0/I7/64 15.00 CITY OP COSTA MESA ON19RUCTION PERMIT Project Address (Ocam•3 i OP Pte) PER NO. 1 CT NO. � ( lbd LOT NO. UNIT NO. TYPE OF CONSTRUCTI N NEW ADD ALTERATION REPAIR -❑ CONVERSION ❑ DEMOLISH ❑ OTHER - • DESCRIPTION OF WORK/USE OF BLDG. - Applicant's Mailing Address 5;r - Owner's Name 57P Phone Address I A.P. # _ Zone, S' - Main Building: - Accessory Building: Arch/Eng. License No. Address - TYPEOF PERMIT 11 GRADING ❑ FOUNDATION ❑ STRUCTURAL '❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL • -0,OTHER _ PROJECT DESCRIPTION SO, FT.' OCCUPANCY' - CONSTRUCTION TYPE VALUATION$ ZONE ' GRADING CU.YDS. . ACRES - E T Front ' 1 - Z 'O B Rear. - N 1 Contractor's Nam Phone - I Address (rrlailingl +• City License No. - LICENSED CONTRACTOR DECLARATION - 1 hereby affirm that 1 -am licensed under provisions of Charter 9(commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. - License Class License No. - A K Right r r N S Left C' R Ping. Ref. # Parking Req./Provided E Remarks: Planning Notes: M - i T S PLUMBING, - FEES Date Signature I Bar Sink Showers ' ELECTRICAL ' FEES WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation -Insurance, or a certified: copy thereof (Section 3800, Lab. c.) ¢nter Backflow Pf¢v- Service Sink - - Automatic Washer.' A -- -- -- Transformer ❑ 15-50 KW - Backflow Irrigation Sewer Cap � Policy No. Company Certified copy is hereby furnished. I I I e Certified copy is filed with the city Building Division. ( Construction Pole Sub. - 1 El50+KW ' Bathtubs Sewer Connection Cooking Unit ( Meter ❑up to 100 amps Date ' Applicant I EXEMPTION FROM WORKERS':COMPENSATION DECLARATION _ Clarifiers Solar Collectors Dishwasher - - Meter ❑Over 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping ' Dryers ❑Gas ❑Electric Sub Panel I certify that in the performdnce of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California.. Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑l% - 8 Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar ❑9-15 HP 016 15+ Date i ' Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit' Shall be deemed revoked. CONSTRUCTION LENDING, AGENCY I el ' - I hereby affirm that there is a construction lending agency for the performance Floor Sinks- - Urinal - Fixtures Microwave - - - Gas Service Outlets' Water Closet Device Boxes Pole Light Interceptors -Water Heater- Outlets Range of the +work for which, this permit is issued_- (Section 3097 Civ. C.), Lender's Name Kitchen Sink Water Service Switches Sign Lender's Address - - OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor:s License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair, any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the Business and Professions Code) or that he/she is exempt Lavatories Garbage Disposal 'Standing Sections P -Trap - - Generator ❑0-$ KW F-15-15 KW Trash Compactor ROOF Drains - - _.-- therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Subjects the applicant to a civil enalty of not more than five hundred dollars ($500).; 1, as owner of the property or my employees with wages as their le compensation, will do the work, and the structure is not intended oro ered for sale (Section 7044, Business and Professional Code; The Contr ctor's License Law does not apply to an owner of a property who builds or imp thereon, and who does such work himself/herself or through his or her o employees, provided that such improvements are not Intended or offered for sale. If, however, the building Or improvement is sold within one year of com. pletlon, the owner will have the burden Of proving he/She did not build or. inn- rfor purpose of sale). I, as owner of,the property, am exclusively contracting with licensed con-'. 1, tractors to construct the project (Section 7044, Business antl Professions Cod a: The Contractor's License law does not apply to owner Of property who builds or Improves thereon, and who contracts forr such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that' Proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Seciion B. & P. C. for this reason Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHAN 1 Boiler Hood or Type I ❑ Canopy Type 11 ElZoning Duct - Under Ground FEES DEVELOPMENT SERVICES REQUIREMENTS: Approved By Date Building Approved By Date Application Issued By Dat r�-�- Duct -Structural Refrigeration System Duct -Ventilating E10-100,000BTU 01,00,00OBTU PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% (SUMMARY $ $ $ 1 IF-r)o $ OF FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ -BUILDING Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBO # Date Owner Heating System & Ducting I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City -and county ordinances and state laws relay to In construction, and hereby authorize re pre- sentativeS of thi y to enter up0 a above-mentionetl'propert y for inspection pure ,J f7.�_(� f Signature Date d_ Drivers' nse or 55 # — ❑O-100,000 BTU ❑100,00067 ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% $ $ $ $ GRADING $ MICROFILM $ TOTAL FEE $ ��-GJ Reinspection Fee $15 Issue Fee $ 3 CMF 65-46, rev. 4/84 White - Building: Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING - ;APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # :Date Inspector •1. Temporary Electrical Service or Pole ,• 52. Pool'& Equipment Location 2. Soil Pipe-Undrgrnd. - 53: Steel Reinforcement - j ,3. Electrical Conduit Utility-Undrgrnd. _ i_.: ',54. Forms 4. Electrical Conduit-Undrgrnd: - - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test _ 6. Electrical UFER Grnd. a 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 Lines, P -Trap, 0 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 ... 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure - 70. Underground Hydro 22: Ducts, Ventilating 71. Product Piping 0Gas .0Oil - 23. Gas Pipe -Rough & Test 72. Underground Flush - - 24. Roof Framing X73. Undergrnd. Storage Tank 0 Gas 0 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 Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test (O�S�dy l Eo 36. Hood or Canopy - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -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 ReleasetoEdison - - •- - - 50. Gas Release to Southern California Gas Cc 51. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations CLTY.-Of COSTA MESA; --- - -- -CONSTRUCTION PERMIT - �j��'+ .- , PERMITNO. : -, -' E TRACT'NO. LgqN Oti; BLD -- - - - 1--+' l '3012 -6/27/0G --"--� --8a.95 T{ ' Project AddressR.R Applicant's Mailing Address `' - ' r '- , - TYPE OF CONSTRUCTION , 'NEW ADD_ ,ALTERATION ❑CONVERSION DEMOLISH ❑ OTHER,- REPAIR + A• -p„# •- l , - ° I 'Zone, -` I i > Owner's Name • - hLo e Address. z/s' �// ////ice _❑ ' `OESC RIPT.ION'OF WORK _ ' - - 1 _ - . $_ Main Budding. _ Accessory Building. Z -+ - TYPE OF PERMIT GRADING 'FOUNDATION ST ROCTU RAL ❑ TENANT ❑' ELECTRICAL ❑PLUMBING CAL ` = - . , _ ❑1 OTHER - 'r ' PROJECT DESCRIPTIONr SO: FT. OCCUPANCY "CONSTRUCTION TYPE VALUATION $ ' + E T .Front' - s ., r 7 _ ` O N - /L —_may/ Arch/En ng. ` V ,/,P S License No , Address' - B A .Rear• ,- . - - 1 - - - N -_ Contractor's Nam a Address (mailing) � �• ` l/ C Right - - ,'.. G K $ Left• , r - ( c. i, E Pin . Ref. # 9 _ I - - Park. Fees $• d - Q U (• - 1 City. License Na. I LICENSED CONTRACTOR DECLARATION a , I hereby affirm that I am licensed under provisions of Charterj9'(commencing with section 7000) of Division 3 of the Business and Professions Code and my license is in full /grce a R{fect. (/,1 �` r_Icense,Clas� (/ ire se � �- t- ZONE GRADING CU.VDS. 'ACRES ' - 1 1. i ! , ' Remarks: a I .. ;o Parking Req./Provided t , + _ c IT 1 ”" ;' ' / G r - dJ Use of Building' , v R E - , .. ! PLUMBING /.: + FEES Planning Notes. 1 - I/ M E Dzte ((O§ - c g t �-q ' WORKERS' COMP( NSATION DECLARATION Bar Sink Showers T Backflow Preventer Service Sink 1 ( S 1 hereby affirm that I have a certificate of consent to self -insure or a certificate - of Workers' Compensation In so ra n ce,L or- a, certified copy -thereof (Section -. - - Backflow Irrigation Sewer Cap I t ELECTRICAL t -FEES •r_ , 3800, Lab. IC Policy No. y r��• Compil 'v� �� ®Certified copy is hereby furnished. Certified copy is tiled with the city -Bui "ng vi Date i Applicant 'Clarifiers Bathtubs Sewer Connection 1• - i 'Automatic Washer Construction Pole Sub. ,Transformer 0 15=50 KW ! 50+ KW Soiar Collectors , i EXEMPTION FROM.WO RKERS' COMPENSATION -DE LARAT.ION ) (This section need not be completed if the permit is for one hundred ($100 or ' Dishwasher"'' - 1- Solar Pi in Y """`' P 9 , - - / - - , Cooking Unit ' - -'- ;Meter -❑up t0 100 amps- r / a ' less): I certify that in the performance of the work for which this permit isissued, I Drinking' _ Fountains Solar Tank / Dishwasher 'Meter}6ver 100 amps 3 - ' shall not employ any person In any manner so as to become subject to the Workers' Compensation' Laws of Californ ia.l Date Signature NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation -provisions -of -'the Labor -Code; you must forthwith 4 comply •with' such provisions..or .this permit 'shall be, deemed revoked. 1 CONSTRUCTION LENDING -AGENCY. Floor Drains; Swimming Pool w/Spa . + 'Dryers ❑Gas ❑Electric ,Sub Panel 1 t Floor Sinks Urinal I - 3 FanMotors - 00-1 HP 01 % - 8 - -- - .' Gas Service, _Outlets - Water Closet - c F.A.U. : .Inc. Solar109-15 HP 016-15+ Interceptors - - _ Water Heatef - - Fixtures , - ^Microwave I hereby affirm that there is a construction lending agency for the performance' of the.,work •for which this permit As issued, (Section 3097 Civ. C.) Kitchen Sink v Water Service '- -' - Device Boxes - Pole Light Lentler's Name. - - Lender's 'Address] - N OWNER BUILDER DECLARATION :` y i ,' t Lavatories' _ • - _ i Outlets Range - I hereby affirm that I am exempt from the Confractor's: License Law for the following reason (Section 7031.5iBusiness and Professional; Code: Any city or. county which requires a permit to construct, alter, improve, demolish or repair :any structure, prior to Its Issuance, also requires the applicant for such permit ! to file a:signed statement'that he/she is licensed pursuant to the provisions of :the Contractor's License Law (Chapter 9 (commencing, with Section 7000) oi' Division -an thelBasis ess and Professions Code) or, that she is exempt therefrom -and ih¢ basis for the alleged examption'. Any -violation air Section 7031.5 by any -applicant for a. permit. subjects- the applicant to a' civil enatty of not more than five hundred dollars ($500). ) r - 1„ asi owner of the' property oi: nnyyennployees with wages as their sole -compensation, will do the work, and the -structure is not intended or offered for sale-(Sectlon 7044, Business antl• Professional Code:, The Contractor's ( License Law does not apply to an owner of a property who builds or improves thereon; and 'whe does such work himself/herself or through his or her own employees, provided that such. improvements are not intended or offered for sale. If, however, the buildingor improvement Is sold within one year of com- P pletion, the owner will have the burden of proving he/she did not build or im-M/�.��; rove,for the purpose of sale). ; ! I P -Trap. ! p, _ ` - Switches .. ', Sign ' ' 'Roof'Drains: - _ - '- Garbage Disposal 'Standing Sections _ ry ; .- - 41 , Generator 00;5 KW 05-15 KW (Trash Compactor ! I -_ ' --Reinspection=Fee - ? i $25 - Issue Fee'_- Reinspection Fee $25 • Issue Fee' 1 �" MECHANICAL - } : FEES PUBLICSERVICES REQUIREMENTS: Zoning Approved By 1 ,, Application Approved By Application IssI-ued By _ = Date - , , _ Date . CSI_ Date_ 2API _ Boiler, I , '� ' Hood or Type I ' ❑ -� Canopy' Type II ❑ ' sj ,• Dkt,j Under Ground Duct -Structural Refrigeration System + - ' ' 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project ((Section 7044, Business and Professions Cade: _The Contractor's License Law_does not apply toan,bwner of property who. builds or improves thereon,'and who contracts for'such projects with aeon- tractors) license pursuant totheContractor's License Law): : , O;I am exempt under Section B. & P.. C. for this reason 00100,000 BTU ❑100,000 BTU _ '_ Duct -Ventilating ` j BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ ,SUMMARY OF FEES 1 SMTP, $ ' PERMIT ' + - 11SSUANCE ' $ _ _ , Exhaust System ❑ Multiple 01 _ . �.- •- - System Repair/Alteration - i Firepl/Fact. BIL ICBO�# I ! Date ' - Owner: + I hereby certify that 1 have read this application and state that the above Infer mation Lis correct. I -agree -to comply with all- ity and county ordinances and -state laws relatin to wilding constr coon, nd hereb authorize repre- sentatives of this' c' t rl on a e-mentionetl grope y , r inspection purposes , /� Signature Heating System & Ductingt D O-10000 ,0BTU 0100,000 BTL• - - PLAN CHECK - i $ I ELECTRICAL $ PLAN CHECK $ MECHANICAL } $ PLAN CHECK $ �� ENERGY P.C. I $ r� 6 I —�� GRADING -$ , MICROFILM $ ' / _ TOTAL FEE $ r - - - - -r i - '� , Reinspection Fee $25• Issue Fee I. s $ 3 CMF0865-46 rev. 7/83 -White-'Building; Canary - Applicant; Oink - Accounting; Goldenrod - Assessor. - ' - ) -. _:_ •.- -- '_ - .^�--._ - ... -__ _�_ y.____ �.,,_ _-__,- ' ;,.'..'CONSTRUCTION � " CONSTRUCTION AND PLANNING _ APPROVALS • Permit # -. Date• Inspector - . : -POOL & SPA - - APPROVALS- Permit # Date Inspector f., t. Temporary Electrical Service.or Pole -q 1p ' 52. Pool & E ui ment 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. - B..Foundation 59. Gas Pipe, 0 Undrgrnd., Test - .9. Water Pipe-Undrgrnd. v . 60. Backwash Lines, P -Trap, El Undrgrnd. 10. Structural Floor System 161. APPROVAL TO DECK - 11. Property Sewer Line & House Connection �' '.62. Backwash & Receptor -Final 12. Sewer Cap r �•' •63. Heater & Vent -Final 13. 'Roof 64. PIumbing. System. - Final " 14. Rough Plumbing - 65. Electrical -Final - - - 15. Rough Electrical -Conduit- 66. -Solar System -Final - - .16. Rough Electric Wiring 3G , ° C� 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 APPROVALS Permit # _ 20. -Rough Factory Fireplace 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. Storage Tank. F1 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 _ 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 Domestic -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 - K - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations CITY QPCOSTA MESy C NSTR TI N PERMIT PERMIT 39 `� TRACTNO. L°T NO. UNIT NO. 36O% 7/p 6/84 B.Ep TL IUB 1 1 - Project Address " TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Applicants Mailin , dress ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Na eua� P on A.P. # Zone DESCRIPTION OF WORK/USE OF BLDG. Addressyl)v S Main Building: Accessory Building: Arch/Eng. License No. - TYPE OF PERMIT GRA DwG FOUNDATION STRUCTURAL T Front "" Z ��--yy O Address - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING & MECHANICAL B Hear - N Contractor's Nam Phone ❑ BOTHER - - A _ - I _ • PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N v) Address (mailing) KLeft O - � CONSTRUCTION TYPE VALUATION$ $ -r R City License NO. ZONE GRADING CU.YDS. ACRES E I LICENSED CONTRACTOR DECL RATION Ping. Ref. # Parking Req./Provided 1 herebyaffirm that tam licensed under visions of Charter 9 (commencing ° ( 9 Remarks: /� Planning Notes: M 1 with section 7000) of Divisione3 of th usiness and Professions Code, and T mY Itis Clais in f,d]I f e and effect nS LiceCla s� S. ice a o. Date Signature r PLUMBING FEES wI WORKERS C M NSAT16N DEC RATION Bar Sink Showers - ' 1 hereby affirm that I have a certificate of consent to "elf -I re or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a cert i ❑ copy tDpFeof (Section 3800, Lab. /l/ h yylp - - Backflow Preventer Service Sink Automatic Washer _ Transformer ❑ 15-50 KW Policy No. ✓ V ` Company O/7� Backflow Irrigation $ewer Ca ❑ 50+KW P Construction Pole Sub. 8 Cert toed o Is re furnished Carni fled with the city 'I 's' Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date Applicant r E%EMPTI ON"FROM ORKE RS' C )MPENSATIO DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less) Dishwasher -, , Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that In the performance Of the work for which this permit is issued, I ^� shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors ❑0-1 HP Ill '/x- 8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. ,Inc. Solar'09-15 HP❑16-15+ NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of thelabor, Code, you must forthwith Floor Sinks Urinal Fixtures .'comply with such provisions or this permit "Shall be deemed revoked. Microwave CONSTRUCTIONLENP PING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that t�¢ rQ _Is a construction lending agency for the performance of the work for WIY��¢q�j1 {t'1pi ermit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lander's Name T s/ Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION- - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code:'Any city or - county which requires a permit to construct, alter, Improve, demolish or repair P—Trap Generator ❑65 KW ❑5-15 KW' .any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed Statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the, Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a. permitsubjects the applicant to a Civil , enalty of not more than five hundred dollars ($500)._ 1, as owner of the property or mym eployees with wages as their sole Re inspection Fee $151 1 Issue Fee $ -3 compensation, will do the work, and the structure is not intended or offered Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code; The Contractor's - MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and. who does such work himself/herself or through his onner own 1 I DEVELOPMENT SERVICES REQUIREMENTS: employees, rovided that such improvements are not intended or offered for Boiler - Hood or Type I ElSale. If, however, the building or improvement is sold within one year of com- Canopy Type 11 El Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct - Under Ground Building Approved By Date rove for the purpose of sale). ^� I, as owner of the property, am exclusively contracting with licensed con- Duct -Structural Refrigeration System Application Issued By yq Dat tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct -Ventilating ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMTP ,$ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT C1 am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO #G $ ISSUANCE $ Date owner - Heating System & Ducting 'ENERGY P.C. $ PLAN CHECK 25%. $ hereby -certify that I have read this application and state that the above L�100,000 BTU 0100,00087 - ELECTRICAL $ GRADING $ infor matron is rrect. agree to comply with all city and county Ordinances and state laws elating to build struction, and hereby autho ize core MICROFILM 1 $ sentatives of s c ty to en up�&entionecl pr er to PLAN CHECK 50% $ sentatives pu ac ty t p Signature �'"""`� Pink.- Accounting; Goldenrod - Assessor - - - - - --- - - ' CONSTRUCTION AND PLANNING - APPROVALS Permit# Date - Inspector - POOL &.SPA ,APPROVALS 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. 65. -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, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines; P -Trap, 0 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 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 '�'��+tf. Lep I FIRE DEPT. REQUIREMENT APPROVALS Permit # 20.' Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping 0Gas.. 0Oil 23: Gas Pipe -Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd,StorageTank •OGas 0Oil 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 - Notes: 34. Final Heating & Air Conditioning AL/6y L" . 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 Domestic -Final 42. Backflow Preventer " 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation I _ 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING - 48. Special Requirements Completed 49r Electric Release to Edison 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy be lines and sign all appropriate declarations. OI 69 1 Q/ i2/04 .�-- ' CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. - TRACT NO. LOT NO. UNIT NO. ' Project Address 1022 Poppy Circle TYPE OF CONSTRUCTION NEW ADD ALTERATION -REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. - - 'W (( V Applicant's Mailing Address Owner's Name Standard-Parifir (`nr0_ 'Phooe 546=11'61 Address 1565 W MacArthur COS'ta (`'I psa 99696 ' A.P. # Zone. S Main Build ingr ' Accessory Building: Arch/Eng. _ I -License No. Address I r .. TYPE OF PERMIT 'GRADING FOUNDATION' .STRUCTURAL _ ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL O 'OTHER - 'PROJECT DESCRIPTION SG: FT. OCCU PArvCY CONSTRUCTION TYPE� VALUATION $ ZONE GRADINGCU.YDS: 'ACRES T Front - =p B Rear ) N Contractor's Name NowP1 U61blllg "'-Phone52R_114(1 Address (mailing) �l R9 'N Foc Ona Ana hcim City License No. '22871 - , LICENSED CONTRACTOR DECLARATION r I hereby affirm that I am licensed under pfovisiphs of hatter 9 (commencing with section ]000) of Division 3; of the Busin s a Professions Code, antl . my license is in full fo c¢ d off License Class �� i nse No 426109 C Right _ '_ - - _ - N K - S Left G R Ping. Ref. # Parking Req./Provided E Remarks: - I' �� 1 Q� I ` `�� Planning Notes: M I _ - _ T $. PLUMBING FEES - Date10/10/84 ' Signature 1 Bar Sink Showers r ELECTRICAL _ I FEES WORKERS' COMPENSATION DECLARA ON I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab: C:IC-1 JJJ141 Rollie Policy No, F'W Company - ❑ Certified copy is hereby furnished. L)d ,�CCpp��r(t ip�d {�-0pppy is filed with the city Building�ppivisig(� L D,221 nitff Applicant IVeW Y I UR)Ul ng EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION Backflow Preventer Service Sink Automatic Washer _ - Transformer_ ❑ 15-50 KW. ❑ 50+ KW Construction Pole Sub. I Backflow Irrigation Sewer Ca P Bathtubs Sewer Connection _ . Cooking Unit Meter ❑up to 100amps " - Clarifiers. Solar Collectors Dishwasher ,Meter El over 100 amps ' (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shallmot employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Dishwasher Solar Piping Dryers ❑Gas ❑Electric - 'Sub Panel 1 ' Drinking Fountains Solar Tank - Fan Motors E10-1 HP ❑1'h-8 Floor Drains- I Swimming Pool w/Spa F.A.U. Inc Solar 09-15 HP ❑16-15+ Date Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Urinal - - - - Fixtures Microwave Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions -or this permit shall be deemed revoked.-, Gas Service Outlets` Water Closet 1 6 - 2 50 Device Boxes Pole Light ` CONSTRUCTION LENDING'AGENCY_ ' - ' I hereby affirm that there is a.construction lentling agency for the' performance Interceptors Water Heater Outlets Range of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Kitchen Sink - - Water Service Switches Sign Lender's Address OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or Lavatories Garbage Disposal Standing Sections _ _ P—Trap - Generator ❑0-5 KW ❑5-15 KW Trash Compactor county which requires a permit to construct, alter, improve, demolish or repair' any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License law (Chapter 9(commencing with Section 7000) of Division 3 of the' Business and Professions Cotle) or that he/she is exempt ROOF -Drains - therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 'applicant to a civil t(_enalty of not more than five hundred dollars ($500). I, as owner of the property or, my employees with wages as their sole compensation, will do the work, and the.structure is not intended or offered for sale (Section .7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property, who builds or improves thereon, and who does such work himself/herselfror,through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or'im- Seve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- - tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). 1 am aware that Proof of their Worker's Compensation insurance should be provided to me. L2 am exempt under Section B. & P. C. for this reason r' , Reinspection -Fee - $15 Issue Fee $.3 Reinspection Fee $15 Issue Fee', $ 3 t MECHANICAL - FEES DEVELOPMENT SERVICES REQUIREMENTS: , _ Zoning Approved By Date Building Approved By Date Application Issued By ' Boiler -1 1 Hood Or Type I ❑ Canopy Type I I ❑ Duct- Under Ground Duct -Structural Refrigeration System ❑0.100,000 BTU ❑100,000 BTU Duct - Ventilating ,SUMMARY OF FEES BUILDING PERMIT $ $MIP $ PLAN CHECK $ PERMIT PLUMBING $ .�J rsl7 ISSUANCE $ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact.'Bit. ICBO # Date Owner - 1 hereby certify that I.have %ad thi application and state that the above information is correct. I agr to co Iy with all city and county ordinances and state laws relating to b ilding n5truction, and hereby authorize repre- sentatives of to enter/ Pon �the� above-mentioned property or inspection purpose . Lo ��D I Signature' Date Drivers' License or 55 _ Heating System & Ducting ❑0-100,000 BTU ❑100,000BT PLAN CHECK 25% $ ENERGY P.C.' $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ f $ TOTAL FEE $ S5o PLAN CHECK 25% $ I HMECHANICAL $15 Issue Fee $ 3 Reinspection Fee: I + `MF 0865-46, rev. 4/84 White - -Accounting; Goldenrod -Assessor - - - - POOL &SPA ' CONSTRUCTION'AND PLANNING APPROVALS Permit Date Inspector APPROVALS 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 r, 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement. 56. Rough Plumbing & Pressure Test = 6. Electrical UFER Grnd.I 57. APPROVAL TO COVER-GUNITE ` �'/ - 7. Footings, `` _' 58. Electrical Conduit-Undrgrnd. 4 U 8. Foundation '�• _ -59. Gas Pipe, 0 Undrgrnd., Test '! - 9. Water Pipe-Undrgrnd. Z _ 60. Backwash Lines, P -Trap, 0 Undrgrnd. le 10. Structural Floor System 'A61. APPROVAL TO DECK y 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final •v v 12. Sewer Cap 63. Heater & Vent -Final .� 13. Roof Drains 64. Plumbing System - Final •��. 14. Rough Plumbing 65. Electrical -Final 9 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, Veritilating 71. Product Piping 0 Gas. 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush ' 24. Roof Framing - 73. Undergrnd. Storage Tank ClGas 00iI_ 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 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 r 41. Solar Domestic -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. CERTIFICATEOF.000UPANCY No. Date " ,. \