The URL can be used to link to this page

Home My WebLink About827 PLUM PL - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 Job Address: 827 PLUM PL Suite No Vicinity: Parcel Nunmber: 42245412 Applicant: HERRINGTON,JERRY Address: 2737 S CRODDY STE D SANTA ANA, CA PLUMBING PERMIT Phone: (714)241-1414 Zip: 92704 Owner: O'SHEA, JEANNE TR Address 827 PLUM PL Phone: COSTA MESA, CA Zip: 92627 Contractor: COAST ROOTER PLUMBING HEATING & AIR CONDITIONING Address: 2737 S CRODDY STE D Arch / Eng : Address: SANTA ANA, CA INSTALL WATER HEATER. ISSUE FEE BackFlow irrigation BackFlow Preventer Bathtub Clarifier System Connect pce,Soda,etc) Dental Unils Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1� outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 SD.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY Phone: (714)241-1414 Zip: 92704 License: 529127 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY . AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 k) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Pnvate Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: 07/23/2002 Issued: 07/23/2002 ISSUED BY: SumpPump Swimming Pool Trap Primer Urinal Vacuum 8rkr BkFlow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Waler Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $35.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by Ihis permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced wiihin 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 _ zanses �sioo� WORKERS'COMPENSAnON DECLARAnON: � I hereby ettirm undar penalty oi perjury one oi the lollowing tleclarations: ❑ I have and will,�naintein e certiticete ot consent ro self-Insure for workers' compenseNon, es provided for by seclion 3700 oi the Labor Code, br Ihe peAormence ot the �. work tor which Ihis permit i5 i55uetl. . 1 heve enG vnll CBRIBf F J i�f (This section needr ❑ I canify that in Slgnatura: TMOUSAND DOLLARE (5100.000�, IN ADDITIIXJ TO THE LICENSED CONTRACTORS DECLARATION: CONSTRUCTION LENDING AGENCY: as required by sectlon 3700 oi ihe Lebor Catle, fw Uie peAortnance of Ihe work for which this pertnit is Lssuetl. amber are: Policy Numher: one hundred dollars ($100) or /ess.) .(or which thi ertnit is issueQ I s�all not employ eny peroon in eny manner so as ro becoma subject to ihe workers' �h�l s uld become sub�ect �o lhe workers' compensetion provisions ot Section 3700 0l �he Lebor Catle, I shall Iorthwiih �� Z.� —�� $Ail COVEMGE IS U SHALL SUBJECT AN EMPL YER CRIMINp1 PENALTIES AND GVIL FlNES UP TOONE MUNDiiED :AST ,OAMAGESASPROVI�EOFORINSECTION31080FTHELABOHCADE.INTEREST,AN�ATTORNEY'SFEES. 7000) ot Division 3 oi antl my license is in tull ❑ I hereby ettirtn thel there is a construction lending agency for ihe pedortnance of t�e work tor which ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: LenOer'S AAdress: Signature: Date: OWNEH-BUILDER DECLARATONS: I hereby aflirm that under penelry oi perjury lhat I am EXEMP7 FROM THE CONTRAC70R5 LICENSE LAW for the follovring reason (Sec. 7031.5, Business and Proteulons Cotle: Any ciry or counry which requires a pertnit to construcL alter, improve, tlemolish, or repair eny structure, prior to its issuance, also requires the epplicant for such pertnit ro lile a signed sletement thet he or she is Iicensed pureuant to t�e provislons of the Contrectors License Lew (Chapter 9(commencing with Section 7000) of Dlvision 3 oi the Business and Proteuions Cotle) or t�at he or she is exempt thereiram end ihe basis lor Ihe elleged axemption. Any violation of Section 7031.5 by eny epplicant far a permit sub�ecis the epplicant to a civll penalry of not more than frve hundred dollars (5500).): ❑ I, as owner ot Ihe property, or my employees with wages as thair sole compensatlon, WILL DO THE WORK, and the stmcWre Is not inlenGetl or ottered tor sale (Sac. 704d, Business antl Prolessions Cotle: TTe Contractors License Law tloes not apply to an owner ol property who builds or improves thereon, antl who tloes such work himself or hersetl or Ihrou9h his or her own employees, provided thet such improvements ere not Intended or oHered for sale. It, however, the builtling or improvement is sold within one year o1 complation, the owner-builder wiil have the burden of proving that he or she did not build or improve for purpase of sale.). ❑ I, es owner at the properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the pmject (Sec. 70a4, Business end Protessions Coda: The conirectors License Lew does not apply to an owner oi proDerty who builds or Impmves �hereon, and who comracts tor such project with e contrector(s) license pursuent to the Conirectors License Laws.). ❑ I am azempt under sec. Business entl Protessions Cotlo lor this reeson: Signature: Date: Owner ID verified by dnvefs license. ❑ Ves ❑ No Drivefs License No. Vetlficetlon ot Ownership by (type ot document, i.e. - property tan 6ill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I �ereby cetlity that no excavation fve (5) or more teet in dep�h into which e person Is required to descend, will be made in connection with work euthodzed by this pertni6 and Ihet no building sirucWre, scaffolding, talsework, or demolition or dismantling Ihereof, will be more �han thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle B, Calllomla AtlmlNSiretive Cotle). ❑ As owner-builder, I will not employ enyone to do work which would requira a pertnit from Ihe Division ol Industnal Safery, as notetl ebove, unleu such person hes e permit to tlo such work Irom the tliNsion. Signature: Date: Division ot Indusirial Sefety Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENfRY: I certify under penelty ol perjury ihat I heve read this epplication entl state Ihet ihe information given is correct. I agrae Io wmpty wlth all stete laws end ciry ordinances relating to building consiruction, end euthorize representatives of the Ciry of Costa Mesa to enter uDon Ihe ebova-tlescnbed oroDerd.tertl�ection,(>urposes. I eg�se not to occupy or allow occupency of eny building authorized by this permil until final inspection. COOE I. INSPECTIONTYPE 1616 Fiaed System Finel Fire Prevention 1266 Pool Spe Finel 200 Finel Re-Rool 201 Finel Block/Reteining Wall 202 Final Factory Fire Place 203 Flnel Sign 204 Final Demalition PAIF �$ y,QQ{1 INSPECTIONTYiE 206 Final Mechanical 200 Finel Plumbing 210 Final Electncal 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy � u�s • b � � 1 (714) 754-5273 • FaX (714) 754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626 Jobnddress: 827 PLUM PL Suite No Vicinity: FAU IN ATTIC Parcel Numbec 42245472 Applicant: BELL, RALPH Address: 11801 MAC ST - GARDEN GROVE; CA owner: O'SHEA, JEANNE TR Address: 827 PLUM PL COSTA MESA, CA Contracror. CRYSTAL AIR Address: 11801 MAC ST GARDEN GROVE, CA FURNACE CHANGEOUT Quantity ISSUE FEE Inst FAU <700 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater S23.50 514.80 $0.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 MECHANICAL PERMIT Status: Applied: Issued: ISSUED 11/02/2001 11 /02/2001 ISSUED BY: ' Phone: (714)534-2593 Zip: 92641 Phone: Zip: 92627 Phone: (774) 534-2593 Zip: 92641 License: 655036 SCOPE OF PERMIT FEE SUMMARY Repair I Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation Sysiem Evaporative Cooler Commercia l 1 ncinerator Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3 To 15 hp / SOO k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 7,750 k BTU Over 50 hp / Over 7,750 BTU Boilers Upro3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantiry 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 so.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 50.00 TOTAL CALCULATED FEES 538.30 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements undar California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such wo�k must comply with all applicable codes, and all requlred Inspections and final approval must be obtainetl. Failure to obtain inspections and tinal approval will result in tha expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2asae �aroo� WORKERS' COMPENSATION DECLARATION: I hereby ettirtn under panalry at parjury one oi t�e followinq daclerations: ❑ I have antl wlll maimain e certificate ot consem m selbinsure lor workers' compensetion, es provided tor by saction 3700 oi iha Labor Gode, lor the pedormance oi the work tar whlch this Oarmit is issued. ❑ I �ave and wlll maintain workere' canponsetion Insurance, as required by sectlon 3700 oi ihe Labor Code, for the pedortnance of the work for which this permit is Issued. My workars' compensatlan Insurence caMer end policy number ere: Carriec a( one hundred dollars Policy Number: '�c rtily thet In Ihe pertormance of Ihe work for which this permll Is issued, I shall not employ any person in eny mannar so es to 6ecome subject to the workers' mpensetlon laws ot Calllornie, entl egrae thet II I shoultl become su��ect to the workers' compensetion provislons of Sactlon 3700 oi the Lebor Cotla, I shell forthwil� comply with Ihese pro � I Appllcent Signeture:, � fDe�e: � � l —2 "D ( WARNING:'FAILURE TO SECURE WORKERS' COMPENSATION CQVERApE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FINES UP TOONE HUNDRED THOUSAND DOWIRE (5100,000). IN ADOITION TO TME COST OF WMPENSATION, DAMAGES A$ PFOVI�ED FOF W SECTION 3]O60F THE LABOR CODE, IMEPEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn thatl am licens�tl untler proNslons ol Chapter 9(commencing wit� Sectlon 7000) of Division 3 of t�e Business entl Professions Code, end my license Is in full force entl ettect�Lic. � 6� �y �Cless Aj �'--d'D Cantradofs Signeture:�� ,� �Date: + ( /—'Z'"st CONSTRUCTON LENDING AGENCY: ❑ 1 �ereby attirm ihat there is e consiruction lending egency for the peAormance oi Ihe work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). LentleYs Name: Lender's Address: SignaNre: OWNER-BUILDER DECLARATONS: Date: I hereby attirtn Ihet under penelry oi perjury Ihet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: My ciry or counry which requires e pertnit to construct, elter, improve, demolish, or repair any structure, prior to iis issuance, also requires the apDlicant for such pertnit to file a signed statement that he or she is Iicensed pursuent to Ihe proWsions oi the Contrectors License Lew (Ghepter 9(commencing with Seclion 7000) ot DlNsion 3 01 t�e Busineu and Professlons Code) or that he or she is axempt theralrom end tha besis for Ihe elleged exemption. Any violation of Section 7031.5 by eny applicant tor a pertr+l sublects Ihe applicant to e civll penalry of not more then live hundred dollars ($500).): ❑ I, as owner ol ihe property, or my employees wit� wages es their sole campensation, W ILL DO 7HE W ORK, and the structure is not intended or oNered for sale (Sec. 7044, eusineu antl Prolessions Code: The Contrectors lJcense Law does not appty lo an owner ot properry who builds or improves thereon, and who tloes such work himsetl or heroetl or �hrough his or her own employees, O�a�detl that such Improvements are not intended or ottered for sele. If, however, the builtling or improvement is soltl within one year ol completion, the owner-builtler wiil heve the burden ol proving thet he or she ditl not build or imprava tor purpose of sale.). � I, es owner of tha properry, em E%CLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS to construct the prolect (SecJ044, Business and Profeuions Code: The coniractors License Lew does not eppty to en owner of propeny who �uiltls or impmves ihereon, end who wNracts for such project with a comractor(s) licen5e pursuent to ihe Coniractors llCenSe LewS.). ❑ I em exempt under sec. Business entl Protessions Code for this reason: Signature: Date: Owner ID verifled Dy tlnvers license. ❑ Ves ❑ No Dnvefs License No. Expires: Veriticatlon of Ownership by (rype of document, i.e. � property tex blll or deed): DIVISION OF INDUSTRIAL SAFETV PEHMIT CERTIFICATON: ❑ I hereby cartlty ihat no excavetion tiva (5) or more feet In tlepth into which a person Is required to descend, will be made in connection with work euthorizetl by this permit, antl Ihat no building structure, sceflolding, lalsework, or demolition or dismantling ihereot will be more ihan thirry-six (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title B, Celllornia Adminisiretive Code). ❑ As owner-builder, I will not employ enyone to do work which would require e pertnit from the Division ol Industrial Selery, as notetl ebove, unleu such pereon hes e permit to tlo such work Irom tha division. Signature: Date: Divisian of Indusinal Safery Permi� Number: CEHTIFlCATE OF COMPLUWCE AND AUTliORQATON OF ENfAY: I certity under penelty of perjury ihat I have reatl this epplication antl state thet Ihe informetion given I5 correc�. I agree to comply with ell stete lews end ciry ordinences relating to bullding consiruction, and euthonze representatives of iha Ciry of Coste Mesa to amer upon the ebove-described praperry for inspection purpases. I agree not to occupy or ellow occupancy of eny building authonzed by ihis permit un�il tinel inspection. Of Legal COpE �. INSPECTONttPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Rooi 207 Flnal BIocWRetaining Well 202 Flnal FeCtory Fire Place 203 Finel Sign 204 Final Demolitlon �� $ CODE� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumhing 210 Final ElecMcal 212 220 Final Fite Prevention Final Planning Approval L(—'i D�d L � Data �, 222 Final Si�e 250 Final Builtling/Occupancy 11-a o� � (714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Jo6 Address: 827 PLUM PL Suite No Vicinity: FRONT OF HOUSE Parcel Nunmber: 42245412 Applicant: ALLEN, MARK Address: 3042 ENTERPRISE #F COSTA MESA, CA Owner: O'SHEA, JEANNE TR Address 827 PLUM PL COSTA MESA, CA Contractor: PROSERV PLUMBING Address: 3042 ENTERPRISE #F Arch / Eng : Address: COSTA MESA, CA PLUMBING PERMIT Phone: (774)540-2253 Zip: 92626 Phone: Zip: 92627 Phone: (714)540-2253 Zip: 92626 License: 467194 Phone: Zip: License: SCOPE OF PERMIT REPLACE 40' OF SEWER LINE FOR EXISTING SINGLE FAMILY RESIDENCE. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units � Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (7-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation � $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors � $0.00 SepticTank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $24.65 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen - $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: 09/20/2000 Issued: 09/20/2000 ISSUED 8Y: SumpPump Swimming Pool � - Trap Primer Urinal Vacuum 8rkr BkFlow(1-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E48.15 an 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 2448.48(fl�00) WORKERS' COMPENSATION DECLARATION: I hereby aftirm untler penalty of perjury one ol Ihe lollowing deUarations: ❑ I have antl wlll meintain a certificate oi consant to salt-Insure tor workers' compensation, es provitled for by sedion 3700 oi Ihe Lebor Cotle, tor the peAormance of the � for which this pertnit is issued. �— I �ave antl will malntaln woAcers' compensation insurence, as required by section 3700 ot tha Le6or Cotle, for ihe peAortnance of the work fw which this pertnit is iuuetl. My wo s' om s tlon�p,5urence cerner and poliry number are: %�/j� �Cartler: �(.'� �u�� PalicyNumber---�/�.�C[�C/� .(Ihis�sectlon need no be comp/eted il the permi( is velueO et ane hundred dollars ($100) or less.) ❑ I certify that in the performance of th work fgr which this pertnit is issued, I shall not employ any person in eny manner so as to Decome sublect to the workers' compensetlon laws of Celilornla e agr e`het If I should becoma subject to the workers' compensation provislons of Section 3700 of t e Lehor Code, I shall torthwith compty with these p/r%cv s. //'Jn AppliCanY5lgnaNre�J 1J/.�� -� �--Dele� �/ �L-/�� ,WARNINO.'FAILURE TQ CURE WORKERS' COMPENSATION COVEMGE IS UNLAWFLL AND SH4LL SUBJECT AN EMPCOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND OOLLARE �5100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3�O60F THE IABOR CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby aNirm that I am.lice d nd rAr v)'sic force end ettect L c. N ��inQ/ CONSTAUCTION LENDING AGENCY: Chepter 9(commencing with Sectian 7000) oi Division Code, end my license is In tull ❑ I hereby aflirtn that Ihere is a consiruction lending agency for ihe pertormance ot tha work for which this permit is issuetl. (Sec. 3097, Civil Cotle). LentleYs Nema: Lenders Address: Signeture: OWNEp-BUILDER DECLARATONS: Date: I hereby aHirtn thet under penelty of perjury Ihat I em EXEMPT FROM 7ME CON7fiACTORS LICENSE LAW far the following reeson (Sec. 7031.5, Business entl Professions Code: My ciry or counry which requires a permit to construct, elter, improve, tlemolish, or repair eny structure, pnor to its issuance, elso requires the applicant for such permit to tile a signed statement that he or she I5 Iicensed pursuant to the proNsions of Ne Contractors License Lew (Chapter 9(commenang wich Sectlon 7000) ol Division 3 ot the eusiness end Protessions Cotle) or that he or she is exempt Ihereirom antl the 6asis for tha alleged exemption. My vialatlon oi Sectlon 7031.5 by any epplicant tor e pertnit subjects the applicam ta e civil penalryof not more Ihan five hundred tlollars (5500)J: ❑ I, as owner ol the propeny, or my employees with weges as their sole compensation, WILL DO THE WORK, and Ihe siructure is not intentlea or oilered for sale (Sac. 7044, Business and Pmlessions Code: Tha Coniractors License law dces not apply to an owner ot property w�o builds or impmves thereon, antl who does such work himsell or herself or through his or her own employees, providad ihat such impwvemaNs are not Intantletl or oNered for sale. If, however, Ihe huiltling or impmvement is sold wi(hin one yeer of Compiation, ihe owner-builder will heve �he burden ot proving Ihat he ar she did not build or improve for purpose af sale.). ❑ I, as owner ol the property. am E%CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to consWct t�e pmject (Sac. 7044, Business an0 Profassions Code: Ttie coNreclors License Lew tloes not apPly Io an owner ol propeny who builtls or improves t�ereon, entl who con�recis lor such project wlth a contractor(s) licensa pursuant to the Contractors License Lews.). ❑ I am exemp� undar sec. Busine55 and ProfeSsionS Code for ihi5 reason: SignaWre: Date: Owner ID varitied by drivef5licen56. ❑ YBS ❑ No Dnver'S Licensa No. Expires: Ven�icalion of OwnerShip 6y (type ol daument, i.e. - properry tax Dill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify thet no excavetian five (5) or more feet in tlepth into which a person is required to tlescenq will be matle in wnnectlon with work authorized by Ihis pertnit, and thal no building sirucwre, scaflolding, talsework, or demoli�ion or dismantling ihereof, will be more than ihiry-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 347, Ttle 8, Celitomla Administrative Code). ❑ As ownerbuilder, I will not employ enyone to tlo work which would require a pertnit trom t�e Division of IndusMal Setery, as noted ebove, unless such person has a pertnit m tlo suc� work irom the division. Signature: Date: Divisian at Industrial Safety Permit Numbar. CEFi71FlCATE OF COMPLIANCE AND AUTHORIZATON OF EMHY: I certity under penalty ot perjury �hai I have read this epplication entl state that Ihe infortnation given is correcL I egree to wmply wilh ell stele laws end ciry ortlinances relating to building cons�ruction, and euthodze representetives of ihe Ciry ol Costa Mesa to emer upon Ihe ebove-described propeny for inspection purposes. I agrea not to occupy or allow occupancy ol eny building authorized by ihis permit until tinal insDection. [I77�J�CFiJi•Ti[�P.ii19� 1616 Fixetl System Final Fire Prevemion 1266 Pool Spe Finel 200 Final Re-Raot 201 Final BIocWRetaining Wall 202 Finel Factory Fire Place 203 Finel Sign 204 Final Demolition �� COUE 1 INSPELTION TYFE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Preven�ion 220 Final Planning Approval 222 Final Site 250 FinalBuiltling/Occupency Pd1E 1NImeLS . z �r> >3"rJ � � PflQ1ECT ROOHE55: B 2% PL UM PL OWNEP'S NRME:O' SHEAr JEANNE TR � AOOPE55: 8 z% pL JM PL � COSTA MESA,CA 642-8124 AflCH/ENGINEEN: AOOflE55: I1NIT: 92627 REG.NO.: UNIT: PEflMITTEE:LEE ROOFING OF' COSTA MESA (714)642-7223 nooeess: 1553 SUPERIOR COSTA MESA CA 92627 LICENSEO CONTRALTON UECIAflATION: I hereGy af�irm Ilut I am licensetl untler pmvivons ol ChaD�er B(�ommencing wil� Seciqn 7000� o� Division J ol �he eusiness antl Pmlessions Coee. and my license is in Iu0 �orce an0 e�feci. ciTruc.:022875q7 �sTaTeuc.349686 —� �ate'..s�� J J i-�J Signalure: __ ��w� �J WONKEflS'COMPENSPTIONOECLAMTION: I�er¢Uyatlirmlhatl�aveaceN�k o nsenimseu-insureor ceniliwteolWorkers' Compensalion In r%�nj� ry {ertil opY �hereol �5¢ciion 3800, LaD C �' PoLILYN0.:1�`�`��4"'�� EXP.DRTE:��f3OI93 comrnxv:STATE FONDy-, ❑ Ceni�ietl copy is M1ereby lurnishetl. CI Cerli�ietl co y is 11 � wi�� Ihe iry BuildinA 0' 'sion. �j2 � Oate: � � t J POD�icant: " �w� EXEMPTION FBOM WOPREHS' COMPENSATION OECIAMTION: �This s¢c�ion ne � be co DIefM ii Ne perrtnt 4 i one hun�reC (3100) or k55�. I cetlity Inai in I�e petlormance ol Ihe work �or whic� I�is permil is isSueA, I sh noI e ploy any person in any manner so a5 to �ecome sublecl Io Ihe Workers Compensation Laws oi Calilomia. oaie: Signamre: NOTICE: II. a�ter malting IAis Oeclaration. you 5houltl Uecome subjecl Io Ihe Workers' Compensation O�ovivons ol ihe Labor Code. you musl �orl�wilA campty vn�� Suc� D�ovisions or tN5 permii s�all be tleem¢G revokeG. CONSTflUCTION LENOING AGENCY: I hereDy aflirm t�at t�ere is a consimction lending agency br t�e pedormante of Itle work for w�ic� �his pe�mit is i=sued (Seciion 3�97. Civ. C�. LENDEN: ADOHESS: I —/I ,` OWNEfl BWlOEP OECUflFTION: I hereby aflirm Nat I am exempl Imm Ihe Conlractor5' State License Law for �he following reason �Seclion 7071.5 Business anG Pmfessional Cotle: Any ciiy of counly w�ich requires a permil to consimct, alier. impmve. tlemolish, or repair any simcture, prior lo its issuance, also requires �he applicani for such permi� Io file a signe0 s�a�ement that �e/she is licensed Oursuam �o I�e pmvisions ol Ihe Contracmrs' Slaie License law (C�apier 9 �commencing wi�h Sec�ion 7000� of Division 3 0l lhe Business an0 Pmlesvons Coee) ar Ihai �e/she is exempt Iher¢imm anA Ihe Oasis br I�e allegeA ¢xemption. Any vi0laiion oi Seciion 7031.5 by any apDlicant lor a permil SuUjects Ihe applicani Ia a civil penalry ol noi more Ihan live huntlretl dollar5 (f5110�. I, as owner oi me orooeny or my employe¢5 with wage5 as their sole compensation, will Ao Ihe woM, and Ihe ❑ slmcwre is not imenae0 or oileretl br saie (Section 7044, Busin¢ss anA Pmlessional Cotle: ihe COntracrors' Siate License Law tloes nol apply �o an owner ol a pmpetly who builAs or imD�o�es �hereon, and who Ooes such work himselll�ersel� or �hmugh his Or her Own em0�0yee5, D�ovidetl �hal Suc� impmvement5 are not intenEeA ar oiferetl for 5ale. I�, howCver Ihe builOinA Or impmv¢ment is sola vni�in one year of compietion. �he owner vnll �ave ihe GurGen ol Droving �e/s�e Eitl not Guild or imOmve tor Ine Durpose al sale). I, as owner of ihe O�openy. am exclusively contrac�ing vnt� IicenseU cantracmrs to construci the Dmlect (Section 7044, Business ❑ antl Pmlessions Cotle: The Coniraclors Slate License Law tloes nol apDty lo an owner of pmperty who builUs or impmve5 ihereon anA who conVacis lor SucA pmlec�s with a wntradoqs)license pur5uanlio Ihe Canlraciors' State License Law�.l am aware Ihat pwol ol Iheir Worker'S Compensalion insurance ShoWE Ee D�ovideA Io me. � I am edemp� untler Seclian: B. 8 P. C. lor Inis rea50n: Oaie: Ownec I Do here�y ceriily �ha� I am aware ol anA unders�and Ihe reQuiremenls ol California Heal�h antl Safely COAe Seclions 25505, 25533, and 25534 and Ihat I ar any iWure builtling occupani will/will no� (circle one) nee0 to comply wil� saitl s�a�e cotles and Ihe repuirements lor a permii lor consimctian ar moailicalion imm �he Air Ouality Managemen� OiSinc�. fleSiGeniial conSVuc�ion application5 are erempi imm IIICS¢ pfOViSi0�5. �ale: Applitanl: I hereby ceiiilythat I have read Ihis apDlicaiion and slale ihal Ihe above inlormation is carrecl. I agree�o comply with allciry anA county or0inancesan45ta�elawSBlatingtoouileingcan5lmctionanOM1ereOyaulta.�erepresenlativesa�thisotylo kru0oni�eabove�me ioned p�Op¢rly lot insp¢tlion pur005eS. Oaie: �� SignaWre: �\ oriver's license or Sacial Searily 164t�a6 wni�e—Builtlmg: Green—Coae EnlorcomenC Canary—AOOlicant Pmk—Revanue; Golaenrotl—Assessor CITY OF COSTA MESA - BUILDZNG PERMIT PERM NO; H 1� PERMIT NO: B 061226 PLAN CHcCH NO: N �VT; N—SUT�; N CONSTRUCTION TYPE: V-N PERMIT TYPE; STk PURPOSE; ALT JOB DESCRIPTION ; T/OFF RESHT, REROOF W/FIBcRGLASS SHINGLE SQ FT: 4,500 CLAIM VALUE; 4,500,00 CALC-VALUE; 4,500,00 GROUP OCC: R-3 /M-1 COMMENTS: SMOKE DETECTOR REQUIRED, REROOF 2400SF RESID S GARAGE *�***��*�rx��r*x�**�c-x� x�x�x***��c�*�-x�**x��c*#*�**x*�rw#�-x-*��#�x**x�x�c*��r*��*�#�r�xx** Z O N I N GS ERTEBQAUCIKRSE M E N T��.��KE DETECTOR MAIN BUILDZNG --------- ----�----- ACCESSORY B;��UC IF�ED . �. FkNT; FT IN REAR; FT IN FRNT; FT IN REr\n; r i�A�stsc�Ll LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING RE�• PROV; PARCEL: 42245412 ZNE; REF NO; PLANNING N T'ES> i it iF !f fE IE it IE iE if iE 3! iF iE iFif # iE iF if it iE 3F i! N� i4 iE 3f iP iF ih iE if� iFl4 it iE iF �1E if iE # iF iF if �11� iEiF 3f lf jE if -lE it # if if 1E �)t �)k iF iF iE # iE If 1l� IE #+E9FlE �1(' �]F �)t i! iE 3E 1F 3E D E V•E L O P M E N T S E R V 2 C E S R E Q U Z R E M E N�T• S ZONING APPROVED BY DATE: � BUILDING APPROVED BY ; DATE:.._,�, APPLICATION ISSUED BY• --��_ �� DATE: 3G3 �IE1FiElf3FiFfPlEifiEifiElFfEit7FiE!liF1FlEif3FiF�FiFiFiFi'tiF�riFiFiflfifiFitiF7FTtiFif� iF7Fiti3F7fiF3FiFltiFlfiF�FiEiEiEif#iE�1E - 9E3E IEiEiliFiElEiEiliElfafillFiEIEltiF1E-ItilfE�fff3(�iFitiElE�1f1E1fif3FlEif��1EiE1E1E1f1ElF1EiE3EfFIFiElflEfElElf�ll�lfkiElEiElfiFiE3f3EY�iFiF* iF3E3E11�iF1fiE3f-#if LEGALI2ATION;N F E E S U M M A R Y STRUCTURA.'SEGMENT;Y f: BLDG PMT PLUMBING ELECTRI•Ct"'MECHANIC ,� FIRE SMIP/RES GRADING PERMIT 72.00 Ir• � ,50 ` (/' , SMIP/NON-RES ISSUE F'EE 'a ' � BUILDING-DIV-> PERMIT ISSUE PLAN�CiiECK 1'OTAL PAID / DUE TOTALS----> 72.50 0.00 -� •0�;00 72,50 77,50 'r .00 REVENUE DIVISION TOTALS--> COLL�CT�D:�; 72,50 OVER/SHORT; � 00 BLDG PMT PLUMHZNG ELECTRIC MECHANSC� FIRE SMIP/TOT GRADING �LAN-CHECK 72 . 00 " ; � . 50 , . :;; � it it ik iliE k iE K� iE iE k it 3E iE iE if ih k iE i! lE iE it IE 3f iE if iF id iF iF 3F iE it K� K� 3E j(;�'7f� iE �E i!%iF # 1( 3E # iE iPik if ik IE itiE k 3E if 3F i(� iE x� if ii� ik iE iEjF iE 9E �f� Y� �K- N� IF K� iE I N D I V I D U A L� 'rF E: E B R E A K D O W N TYPE QTY D E S C R I P T Z O'N UNIT COST �TOTAL COST /. SFR 4500 REROOF BY VALUE RESr2DF�NTIAL NO'/.ONE 1,00 ." 4,500,00 E:ND�OF FEES , � ' f � I 'F+ J CONS7RUCTION ANDPLANNfNG APPROVALS Permii �`r �, Temporary Electrical Service'or Pole 2. Soil Pipe-Undrgrnd. 3. Electrical Conduit Ut�liry�Undrgrnd. 4, ElectriCal Condwt�Undrgrod. 5. Steei Reinforcemen' G. E�ectrical UFEi; Grnd. 7, footings g, Foundauon - 9. Water Pipe�Undr9md. 10. Strucmrai Floor System . 11, Property Sewer Line & HouseConnection 12, Sewer Cap . 13. floof Dra�ns 14. Rough Plumbing 75. Rough Electrical-Contluit _ 76. RoughElectricWiring 17, Rough 1Niring Sign 1$, Rough Electricai•T Bar Ceiling 19. Rough Heating & Av Condi:�oning 20. Rough Factory Fireplace 21. Dntts, in Structure 22. Ducts, Ventiiating 23. Gas Pipe•Rough & Tesc 24, Roo` Praming 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat Z7. Frame and Flashing 28. Laihing & Sidin9 29. Insulation 3p. Drywall Nalling 31, Plaster Brown Coat 32. Electrical Power �Ieter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. F�nai Gas Pipe-Test 36. Hood or Canopy 37. Finai Factory Fireplace 3$, Finai Plumbing 39. �vater Service�Final 40. Gas Service-Finaf 41. Solar pomestic-Final 42. Backtlow Preventer 43. Backtlow Irrigation 44. Landscape Irrigacion Syscem A5. Sound Attenuation • �;=� 46. Handicap Regulations ,� 47, FINALSTRUCTUREB&Bl�?•;DING 48. FINAL PLANNING • � � -'' i 49. Electric Release to Ed(son: -, 50. Gas Release to SouthecD California Gas Cc 51. CERTIFICATE OP tl UPANCY iSate Da[e 0 P� _ � & SPA Inspector aPPROVAL$ Permit;r Date 52. Pooi & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL7000VER�GUNiTE 58. Electrical Conduit�Undrgrntl. 59. Gas Pipe, O Untlrgrnd., Test 60. Backwash Lines, P�Trap,' � Ur.drg.nd. 61. APPROVAL TO DECK 62. Back�+ash & Receptcr-Fina� fi3. Heacer & Vent-Final _ 64. Plumbing Svstem - F�nal 65. Electrical�Final 66. Sofar System-Final 67. Fencing & Accest ApProval 68. APPROVED FOR PLASTEftING 69. PQOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydra 71. Product P�pin9 � Gas ❑ Oil 72. Undergrouad Ftust� 73. Undergmd. Storage Tank � Gas ❑ Oil /',X/ 74. Overhead Hytlro % !� 75. Dry Ghemical 76. Dry 5tandpipe � � 77. FIXED SYSTEA4 FINAL i 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT � ' 79. FINAL INSPECTION � 80. FOOD CERTIFICATE ISSUE�D � Notes: .1_ / . _,. � _ f�iJ _ /% . I nspecmr� � � i � l PflOJECT AUGHE55: �! 7 Pi.UM PL OWNEP'S NAME: �' SHEA JEANNE TR noosess: $8U6 Lfi,FORD AVE HESPERIA,CA y2395 AflCMIENGINEEfl: RUONESS: UNIT: NEG.NO.: UNIT: rexminee: RENAISSANCE ( 714 ) 380-9550 aoosess: 130 N, GILBERTST FULLERTON CA 26"a / UCENSED CONTBACTON �ECIABATION: I here�y a��irm �ha� I a 'censed un0e ' ions �Chap�er 9lcommencing wi�� Section 7000� ol Div im o Itr usiness antl Pmle�sipp e., aoA ¢en is in e effect. pTY LI ' � � � � � � STRTE LIC.: 4 y � / 7 �aie'. �� — �� i na�u WOBREBS' COMPENSATION OECNNATION: I hereDy alfirm t� a enificate of consenl to selLinsure or a certificate ol WOBers' compenution ms�ra�ge;w.af€]i�mmo�tqer&o jsection . �ae. tJ.7 � 31 / 9 3 roucv No.: uNICARE INS EX . ATE: COMPRNY: ❑ Ceni�(ie�a,c-opY is herehy fumis�ed. � Ceni�ietl capY is �ile w� 91 ci y' ' 0� g rvision. �ate: —L.__�� Ap ' E%EMPTIONFqOMWONREBS'COMPENSRTIONUECLNNATION: (This o e not�ecomplete0if�hepermitis�orone�undred(5100)aNess�. I cerlily Iha� in �he peAormance ot Ihe work for which Ihis permit i' sued I shall no� employ any person in any manne� so as lo become sublec� lo Ihe Workers' Campensalion Laws ot Calilomia. � �ate: SignaWre: NOTICE: IL aRer making �his OeClara�ion, y0U ShoUltl become Sublec� to (he Workefs' Compensalion pwvisions Of�Ih¢ labor Catle, you mus� Iorthwiih tomply wit� Suc� pwvisions or Ihis Dermit Shall be Oeemetl revoketl. "' CONSTPIICTION LEN�ING AGENLY: I here6y a��irm Iha� th¢re is a cons�mclion lenaing agenCy �or the De�o�mance o� Ihe wOrk �or which IhiS permi�is i55ued (Sedion 3097. Civ. C�. ' LENOEN: • aooaess: • . OWNEB BUILOEB OECLABRTION: I here�y aftirm Ihal I am evempt Iwm ihe Contrac�ors' Stale License Law �or �he �oliowing reason (Sec�ion 7031.5 Business and Pmlessional Gotle: Any ciry o� county which reQuires a Oe�mi� �o conslmc4 alter, impmve, tlemolish, or repair any S�mcWre, prior lo i�s issuance, also requires ��e applicant �or such permit ta file a signed statement [hat he/s�e is licensetl pur5uanilathe pmvisions of�he Coniractors' S�a�e License Law�Chapler9(commencing wi�h Sec�ion 7000�o10ivision 3 ot�he Business anA Pmlessions Cotle� or ihal he/she is exemp� Ihereimm antl �he basis br the alleged exemp�ion. Any nolation o� Section 7031.5 by any apPlicanl br a permii su0lects Ihe applicani to a civii penal�y ol no� more ihan �ive hundr¢a dollars �5500�. I, as owner ol the pmpeny or my employees with wages as Iheir sole compensation, will ao ihe work, and ihe ❑ slmc�u�e is no� inlentletl or al�ered for sale (Seclion 7044, Business and Prolessional Cotle: The ConVactors' S�a�e License Law does noi apDty to an owner o� a properly w�o �uilds or impmves thereon, ana who Aoes such work �imsel�/hersel� or �hrough nis or her own employees, provi0etl that such impmvements are not intentle0 or onered for sale. If, however the builtling or im0�ovemenl is soltl vn�hin one year of completioq Ihe owner will have IAe 6urden ol pmving �e/she Oitl not builtl or improve br Ihe purpose oI sale�. I. as owner ol I�e pmpeny, am e�clusively con�raciing with litensetl conVactors �o cons�mct the pmlec� �Sec�ion 704d, Business ❑ and Protessions CoOe'. T�e Contracmrs' SIa1e License Law tloes not apPly �o an owner ol pmperty who huilOs or imOmves thereon antl wha contracts �or such pmjec�s wi�� a[oniractor�s) license pu�suan� lo �he Contraciors' S�aie License Law). I am aware Ihal O�aoi ol their Worker's Compensation insurance should he pmvi�eA �o me. � � I am exempi unAer Sectmn: B. b P. C, lor this reason: Oa�e: Owner I tla hereby cenify Ihal I am aware ol ana understantl Ihe reQuiremems oi Calibmia Healih antl Safery Cotle Seclions 25505, 25533, antl 25534 antl thal I or any IUWre builtling occupanl willlwill nol (circle one) need ta comply with saitl stale cotles antl Ihe requiremenis tor a permn br consimc�ion ar modi�ication fmm the Fir Oualiry Managemeni DisUic�. flesiden�ial consimc�ion applicaiions are exempt �mm Ihese pmvisions. Date'. Applicant: _ I hereby cer�ity I�at I have rea0 ihis apDliw�ion and slate tha� Ihe oramances antl 9a�e laws relaiing lo builtlmg con5�m[tion antl herel properly lor inspetli0n purpOs¢s. � Date: � ` � ✓ Sig �ure Oriver's L¢ense or Sacial Searity p: is mrrect. Iggree �o mply with all city an0 county �ta�ivy9o�pisci�y, n�eruponiheahove�men�ioneA t6At�C6 W�i�e—Bviltling: Green—Cotle Enlorcement; Canary0.Applicam: Pink—Revenue: Goltlenrotl—Assessor CITY OF COST�1 MESA — HTJTLDING PERMIT �^:"." PERMIT �O: E 05844Q PLAN CY.ECK NO: N �� CONSTRUCTION TYPE: 5—N PERMTT TYPE; ELE PURPq5E: OTH JOB DESCRIPTIOh : WZNLOW CHANGE OUTS (INCL"JDES HAY) SQ FT: CLAIM Vr1LU'E: CALC—VALUE: GROUF� OCC: R-3 IM-1 C(JMMENTS: RE: HS8446 PRIMARY BLDG, FERMIT, �*�x-*�x***�*�r****�r**�*��xxx*x**��c*+��+c�tx��*�*+�**#�r�rr�r�� x*��*��*��*xt��:��* Z O iV Z N G R E f1 U I R E M E N T 3 sETsacxs ------- ---- MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAk; rT IN LEFT: FT IN RGHT: FT It�l LcFT: FT IN RGHT: FT IN PARKING REQ• PROV; PARCEL: 92245912 ZNE; REF NO; PLANNIrG iV15TE5> 7 if �1F iF �Y� �)f iE 3E iE 3E iE 1E 3F iF-%k �kiE -lE 3f if it iE 3E ff # ii� if )f iE df 3f if jF lE iE �J'r if 1F af 3F k�(� ?k 3E ii 1f �e 3F 3E 3f� }�lf iE 3: if iF �E ��f �f ie iE 3E-I(� 1E #� 3F ie fE iF 3F iFir iE �)f * i+.� iE D E V E L O P M n N 3' S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUII�DING APPROVED BY : _ _ _ , DATE • AFPLICATION 35SUED BY: �� DATE: �/y ly Z iE1FiFlEiE3ciE9FiFYiEif�M'ifi}if4FdEifiEiE'N'. .. PR .. t1 1E' )Fi�:�FiF�f�'iF iflEiflf9E9Eifii�ikiFSFFArI%i%S�3f'iFiF'IFiP9E � iE �ik iF3E iE iE iE 3E iF iE if it )c if af 1E if �)f �)f iE if !f iF 3E �6 �F Ik 3E �Ih �E �lE if iE iE iE if jf if if �)f- i( 3(� iE if 3E�iF ic if iE 1E � ik if f iE fF Ih iF if 3c ik } 3E i'r iE 3F !f 3E ±f � iE s�)c 3i� �I- LEGALIZATION:N F E Ej S U M M A R Y STRUCTURAL SrGME�3i:N BLDG PMT PLUMBING EI,ECTRIC A1ECtiANIC rZRE SMZP/RES GiADINC PERMZT 1,50 50& SMIP/NON—RES PI�AN ISSi7E FEE 15.00 BUILDING—DIV—> FERMIT ISSUE PLAN—CHECK TOiAL PAID D'JE TOTALS--�--> 1,50 15.00 0,00 16,50 16,50 ,UU REVENUE llIVISION TOTALS--> COLLECTED; 1b,50 OVER/SHORT: ,OU BLDG PMT PLUMHING ELECTRIC MECAANIC FIR� SMZP/TOT GRADING PiAN—CHECK 16.50 #� i4 ## iE � iE�)f 3! 3e iE iP #F iF iE if iE �1F 3E {. ii �3f �3'r # jF 84?4 �7E �1E iF 3F 7E iE 1e±F 3i ## 7t 3f ih iE ii� �F 3f iF 3e y. �f• 34 # if �1( 1t ie �1F N-1E �1F-k iF it 1F 3f iF 3F �le 3e #f k# ff iE if #�u iE'lf Y.� I N D I V I D U A L F E E b R E A K D U W N TYPE QTY D E S C R.I P T I O N UNIT CUST TOTAL COST ELE 2 RECEFT/OUTLHT 1 ST 20 EA, .75 1.50 END OF Fa:.5 n� ;UI1!' 'o _��1�_�'" _"'_ . " ''(�T[: , _tr,-_ �iJ�'., jf 'i CONSTRUCTION AND PLANNING . PG.. _& SPA APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector 7. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil`F4p�Undrgrnd. 53. Steel Reinforcemen[ � 3. Electrical Conduit Ut� � Y-llndrgrnd. 54. Forms 4. Electrical Conduit�Undrgr� 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electricai Conduit•Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. - �_ 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System ,:• � 61. APPROVAL TO DECK 71. Property Sewer Line & Flouse ConneMion 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & VenbFinal 73. Roof Drains 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final � 75. Rough Electrical-Conduit 66 " tar System-Finai 16. Rough Electric Wirin9 �.z�� /� . Fencing & Access Approvai .� 17. Rough Wiring Sign 68. APPROVED fOR P�ASTERING 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rou9h Heating & Air Conditfo�ing FIRE`DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Tes[ 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 011 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYS7EM FINAL 29. Insulation 78. FIRE PREV. FINA� 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Mete��Final � 8(�. OOD CERTIFICATE ISSUED 33. Final Electric ��1�.(j(%� � ot • c �l- 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy - 37. Final Factory Fireplate � 38. Final Plumbing - 39. Water Service�Final 40. Gas Service-Final 41. Sotar pomestirFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. FINALPLANNIfVG � 49. Electric Release to Ed�son . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PPOJEC�.AOOFiSS: $ � 7 PLUM PL owr+Ee�s xame:• WAGNER aooeess: SAME 64?.-8124 FPCHIENGINEEB: p00HE55: NEG.NO.: UNIT: I1NIT: Penmmee: CRYSTAL AIR ( 744 ) 630-5455 aooness: 11801 MAC STREET GARDEN GRCIVE CA 92641 ❑CENSEO CONTNACTOB OECIABATION: I hereby aifirm Ihat I am IicenSeU un0er D�ovisions o1 ChaO�e� 91�ommencing wi�h Section 7000) o� �ivismn 3 0l the Business an0 Pm�essions Code. anC my license is in lult lorce antl effect. �c�iTvuc.:04?006 srnreuc.:49392� cuss:20 Uate: / �� L Siqnaiure: _l� WOBKEPS' COMPENSATION UECIAflATION: I hereby allirm Ihat I have a certificate of consent to sell-insure or a certificate of Workers' Compensa�ion Jnturd?t& � dc¢fliGeE copy thereof (Section 3800, Lab. G1.7 � z S�� Z roucv r+o.: NAT I ONALF� EXP.OATE: U COMPANY: ,y, .� Cenilie0 copy is hereby fumishetl. L'] Cehifie0 coDY is lilea with ihe cily Builtling OiNsion. n � � ��-"Ql_ Applican�: �l ) 'LL� E%EMPTION FPOM WOflNENS' LOMPENSATION �ECUHRTION: Qhis s¢ttion neetl n0t Ee completetl i��he De�mi� i5 iorone huntlretl ($11p) Or less�. I ceriify Ihal in ��e pedormance o� Ihe work lor w�ich Ihis permit is i55ueQ I s�all not employ any person in any mann¢r so as to became subjed to ihe WorkerY Compensa�ion Laws oi Calitomia. �I Da1e' Signa�ure: NOTICE: If. after making Ihis declaration, you should Cecome 5ublec� to �he Workers' Compensation Dmvisions of ihe labor Cotle. you must �ort�with compty wi�h such pmvisions or I�is Oe�mi� shall �e OeemeG revoke0. CONSTBUCTION LENUING RGENCV: I �ereby aifirm Ihai �here is a con5imc�ion lending aAency �or ��e pedarmance o� �he work lor which Ihis permi� is i=suetl (Setlion 3097. Civ. C). LENOEfl: nooxess: OWNEfl BUILOEfl OECIABATION: I hereby a��irm �hai I am exempt �mm t�e CanVacmrs' S�a�e License Law tor the tollowinB reason �Seaion 7031.5 9usiness ana Pmtessional Code: Any ci�y of counry which requires a permit m cons�mc�, al�er, impwve, tlemolish, or repair any simcWre. prior lo its issuance. also reQuires t�e aDPlicant lor such permit to file a signe0 stalemenl ihat he/she is IicenseA pursuanl to �he pwvisians of the Cantracrors' State License Law (Chapter 9(commencing with Section 7000� o� Division 3 oi [he Business and Professions Coae) or iha� he/she is exemp� �herelmm and Ihe basis �or [he allege0 eKemD��on. Nny viola�ion ot Seclion 7031.5 hy any applicant for a permit subjects the applicant lo a ciNl penalty ot nol more than five hunOreU tlollars (E500�. I, as owner of ihe propeny ar my employees wilh wages as iheir sale com0ensation, will Ao the work, and ihe ❑ stmcmre is not intendetl or oileretl for sale (Section 7044, Business and Professional Code: The Contractors' State License Law tloes not apply to an owner ol a propeny who builAs or improves Ihereon, antl who does such work himsell/herself or ihwugh �is or Aer own employees. provitled �hat such impmvemen�s are not in�endea or offeretl br sale. I�, however Ihe builtling or impmvement is 5old wi�hin one year ol comple�ion, �he awner will have Ihe bur0en ot proving �e/she tlitl no� bui10 or imD�ove br Ihe purpose ol sale). I, as owner oi �he pwperty, am excWsively con�racling wilh licensetl contractors �a cons�mc� Ihe D�olec� (Sec�ion 7044, Business ❑ ana Pmiessions CoOe: T�e Contracbrs' S�ate License Law does not apply Io an owner o� D�operty who builtls or impmves Ihereon and w�o coNracls lor such pmjects wi�� a contracmr(5� license pursuant �o the Confracmrs' Sta�e License Law). I am awar¢ Iha� pmol o� Iheir Worker'S Compensation insurance s�ould be pmvide0 �o me. � I am exempl un0er Settion: B. 8 P. C. for inis reason: Dale: Ownec I tlo hereby ceni�y Iha� I am aware ol antl untlers�and Ihe reqwrements o� Calitomia HeaVh and Safery Code Sec�ions 25505, 25533, and 25534 antl �hatl orany�uWre �uilAing occupaniwill/will no� (ci�cle one� nee0�o comply wiih 5ai0 s�a�e co0e5 an4iherequiremen�sfora permit for cons�mc�ion or moeificaiion trom tne Air Ouality Management Oisinct. Hesitlential cons�mction apD�ications are eKempt from Ihese pmvisions. Oaie: Applicani: I here�y ceitify�hal I �ave reatl ��is applicatian ana s�ale Ihatthe above inlormalion is correcL I agreeio comDly wit� all city antl caunty ordinances and stalelawsrelaling�o �uil0ing consimdion and hereby aulhor¢erepresen�a�rves o�this ciryto enlerupon�he a6ove-men�ioned pmpetly lor inspeclian purposes. ,�7 lki� l �'^'` � `� Signature: (/�(J^`T 1�i Driver's �irense or Socia� Securiiy x: `.� I64LG6 Whi�e—Bwltling�, Green—Cotle Enlorcement; Ganary—Applicant Pmk—Revenue; Goltlenro0—Assessor CITY OF COSTA MESA — BUILDING PERMIT � Nu; � 5b PERMIT %10; E 056009 FLAN CHECK NO; N — �UGt; N S`UTY; N CONSTRUCTION TYPE: Cr—N PERMIT TYPE: ELE FURFOSE: OTH JOH DESCRIPTION ; INSTALL CENTRAL HEAT SQ FT; CLAZM VALUE: 2,900.00 CALC—VALUE; GRUUP OCC: R-3 / COMMENTS• SMOKE DETECTOR RE�UZRED IN THE HOME ��**�**xi�*��'*�***�**�r�tx�r*�* �**x*�x*�t****�x�r�*uu�*��r*�-***��****��**��r��*��+t�t�*�* 2 O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAZN HliILDING ---------- --------- ACCESSORY HUILllIA�G --------- FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN LEFT; F'l IN RGHT; FT IN LEFT; FT IN RGHT; rT IN PARKZNG RE • PROV; PARCEL: 42245412 ZNE; R�F NO; PLANNING N TES> i if �4 !6 iF if 1E iE %� if jE 3E if iF iE iE 3k iEl4 if iE iE IE iF iE � 3F 3E iF 1E iE iF if iF if 1E 3E iE iElF if af� 3E iE �If �lE # if if 1F if It 1E iF iE IE iE iE �iF 3f if 1E iF iE 1f %if jf iE iE 3F jf if ie iF iE iE iF iE �E D E V E L O P M E N T S E•R V I C E S R E Q U I R E M E N T S ZONING AFPROVED BY DATE: BUILDING APPROVED BY ; DATE; APPI�ICATION ISSLJED BY: �� ✓%t � DATE; � r�' � 4 iE3Eif3E3EiPiF3E�7F3E3FK3EjEiEiFif�lElE#iFiE i"� iF7F3F'if3f7F'i�'3F3FiF'TF3F'iF�3EiEiE�lFiEibitiFiEjE�F�,�.$iFiEj4 iE �lE 3f 3E if if iF iE if iE 3f aE iF if 3F iE iE 3F if 3F 9E iE 1f 1t �f 3E iE if 3E iE IF if� if -1f 3f iF fE 3F ff if if iFlF iE aE �E 1E iE iE iE iF if 3f if !k ik 1f 1ElE aE * if !e ie iE if i(� �F 3f ?E if iF 3F �Flf iF If iF �E LEGALIZATION:N F E E S tT M M A R Y STRUC'FURAL SEGNE:NT:N BLDG PMT PI.UN,BING ELEC,?RIC MECHANIC FIRE 5NIP/RES GRADING PERMIT 2.25 50: SMIP/NON—RES PI,AN ISS(JE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 2,25 15.00 0,00 REVENCIE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 1%,�rJ TOTAL PAID DUE 17.�°5 1%.25 ,UO 17.25 OVER/SHORT; .00 FIRE SMIP/TOT GRADING PiAN—CHECK :k 1f iE-Ie 3E-%IF if iE if 3E jf 1f iE * if aE 1E if iF 3E iE ik it lf N� if iE if iF iE iE �E iF iE iE iE �f 3F 3f iE IF !E iP?E!f N� lf iE if -IF iElF iE iE iF Y� iE iE iE 3f �f 3f iP iF iE 1E IF iF fE i(� 1E If iFiflE iF 3f if I N D I V I D tJ A I, F E E B R E A K D O W N ` TYPE QTY D E 5 C R I P T I O N UNIT COST TOTAL COST'�� ELE 1 rIXTURES LIGHTING 1 ST 20 EA, ,75 ,75 ELE 1 RECEFT/OiiTLET 1 ST 20 EA, ,75 ,75 ELE 1 RECEPT/SWITCH 1 ST 20 EA. .'15 .75 END OF FEES \� CONSTRUCTION AND PLANNING � PO y SPA w APPROVALS Permit# '� Date Inspector AppROVA�S Permit# Oate Inspector �.�1. Temporary Eiectrical Service or Pole �52. Pool & Equipment Location •2. Soil Pipe�Undrgrnd. �- 53. Steel Reinforcement r 3. Eiectrical Conduit Utility-Undrgrnd. 54. forms 4. Electrical Conduit-Undrgrnd. 55. Electriwl Bonding . 5. 5teel Reinforcement 56. Rough Plumbing & Pressure Teet 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Etectrical Conduit•Undrgrnd. 8. Poundation 59. Gas Pipe, � llndrgmd., Test 9. Water Pipe-Undrgmd. ' 60. Backwash Lines, P�Trap, �i Undrgmd. ?0. Structural Floor 5Ystem � 61. APPROVAL TO DECK 11. Properiy Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Finat 73. Roof Drains 64. Plumbing System � Final 74. Rough Plumbing 65. Electrical-Final 15. Rough Electrica6Conduit 66. Solar System-Finai 7 G. Rough Electric W��ng 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POO VSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fi�eplace APPROVALS Permit # 21. Ducts,in Structure � 70. Underground Hydro 22. DuMs, Ventilating 77. Product Piping O Gas OOiI 23. Gas Pipe�Rough & Test _ 72, Underground Flush 24. Roof Framing 73. Undergrnd. Srorage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structurai) & Monocoat � 75. Dry Chemical 27. FrameandFlashing 76. DryStandpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � ' 78. FIRE PREV. F�NAI 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 � [l'Z � Noces: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test 36. Hood or Canopy �`� � 37. Final Factory Fireplace ' � 38. Final Piumbing 39. Water Service�Final . 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer ! - 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulauons 47. FINAL STRUCTURE & BUILDING -, - 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . No. Date PNQIECTROOflESS: 877 PLUM PL OWNEfl'$ N�ME: O' SHEAL JEANNE iR nooxess: 8806 LtLFORD AVE H�SPERIA,CA 92345 � I ANCM/ENCINEEfl: ROORESS: �� PEpmiTTEE: RENAISSANCE aooness: 130 N, GILBERTST FULLERTON LICENSED CONTflAtTOfl UECIABFTION: I Aerehy alfirm tAat I am lice CITY'UCDiviziqp �oJ,�hF(�usin$TATE LIC.!C�ip�OCpQ¢ tl my lic t v� vcqio � � Oate: � � / � Sipwture: � POLICY NO.: UNIT: flEG.NO.: UNIT: (714)380-9550 CA 92633, o�anoop3¢p7.7/3;t/9 E%P. DR`fr . 9 (commencing wit� Section or a ceniliwte ol workers' 'LI CenilieU woY �s hereby lumishea. LJ Certified copy is fil p'vd 't it -Ui Q Nision. Date: � ' A E%EMPTION FpOM WONKEflS'LOM ENSATION OEClA9ATIUN: (This e on ne nolbecampleteAifthe permitis�orane huntlre4�E100�orless�. I cetlily Ihal in ihe pedormance af ��e work for whic� Ihis permi s� suetl, I shall no� employ any person in any manner so as �o become sublecl �o i�e Workers' Compensation Laws oi Calilomia. Si naiure: Da�e: A NOTICE:II, afler making Ihis tleclara�ion, you ShoulC Eecome suhle��o the Workefs' Comp¢nsation provisions of IAe La�or Code. you must fonnwiln comoly with such pmvisions or ihis Dermil shall he deemetl revoketl. CONSTNUCTION LENDINC RGENCY: I hereby aflirm Ihal ��ere is a cons�mc�ion lending agency for the pedormance ol Ihe work �or wnicA Inis oermil is issue0 I�clion 3097. Civ. CI. �exoen: RODNE55: OWNEfl BUILOEfl OECIAflRTION: I �ereby aflirm Iha� I am exem0� ��om �he Contraclors' State License Law �or I�e lollovnng reason (Section 7031.5 Business antl Pmleuional Cotle: Any city ol counly wM1ich requires a pefmit to canslfuCl. alteL imD�ove. Oemolish, or re0air any strutlwe. prior �a i�5 issuance. also requires I�e aOPlican� for such permit �0 61e a signed Slaiement that �e/she is licensed pursuam to ine pmvisions ol i�e Coniractors' Siate License Law (Clupter 9(commencinA �� Section 7000) al Division 3 al t�e Business antl Pwlessions CoOe) or ��al �e/she is erempllAertlmm antl Ihe Oasis lar ��e allegetl exem0�ion. Any violalion a� Section 7037.5 �y any applicanl lar a permit su0jecis Ihe apDlicanilo a civil Oenalty of noi more ihan �ive hunEreE dollars (E500�. I, as owner ol Ihe pmperiy or my employees wit� waAes as �heir sole compensa�ion, will Oo ��e work, anU �he ❑ Slrutlure is nolinlen0e0 Oro��ere0�or Sal¢ (SeClion 7044. Bu5ine55 an0 Prote55ionalCotle: The COnlrat�Ors' $laie Litense Law Coes nol apply to an owner o� a pmpe�y wtro �uild5 Or impmve5 Ihereon, antl who Oaes SUCh work �im5etf/herseli Or NmUp� nis oi ner own employees, o�ovitlee ihat sucn impmvemenis are not inlenaeA ar onere0 for Shce. II, howevet ihe Ouilding or improvement is soltl vnthm one year ol completion. t�e Owner will �ave Ne 6uraen o� pmvinp Ae/s�e Oitl no� builtl ar impmve Ior Ihe purpose o� Sale). I, as awne� ol Ihe pmDe�y. am exclusively conlracting wiN Iicense0 conVactors to cons�mci �he pmlecl (Seclion 70a4, Business ❑ an0 Pmleuions Code: The Coniractors' State Licenu Law Aoes not appry �o an owner of pmperry who �uilEs or impmves iherron anG w�0 Conlratis �or Such pmletis wilA a toniratlOr�s) litense pursuanl �o �he CqnlraCtOrs' $Iaie License Law�. I am aware Ilul pr0o1 af their worker's Campensation insurance snoWd Ue DmviAeO to me. � I am ecempt unaer Seaion: B. 8 P. C. tor I�is rea5on: oate: Ownec 1 ao nereoy cenily tnat I am aware ol ana unaerstana tne reQuirtmenls ol Califomia Health ane Salety CoUe Sections 25505, 25533, and 2553L anOlhat I or any �Nure DuilOing occupani will/wiil nol (ci¢le one) neetl �o comply with SaiA s�aie co0es antl ��e repuirements tor a permil lor conslmclian or modilication Imm ihe Air Ouabty Management Oistnct. Residenlial conSlmciion applicalions are exemp� irom IheSe provisions. Oate: Applicanl:_ I�ereby c¢tlily��at I�averea0t�is ap0�ication antl s�atet�at or�inances an0 sta�e lavrs reWling lo �uilJing con5lmciion and 1 pmDerly soecti n purposes. Da1e: � ` / iompty vnt� all ciiy anG counry enterupon�he above�mentionetl 16aL46 Whi1e—Bwltlmg: Gieen—CODe Enlorcemem: Canary—AOPlicanL Pink—Revenue; GolCanroO—Rssassar CZTY OF COSTA MESA - HUILDING PERMIT :-�:,.: ::�, ., „�„� , PERMIT NO: B 058446 PLAI� CHECK NO; 02q42-92 S ,,,,,.-. ., .,;;.-; .:. CONSTRUCTIO� TYPE; 5-N PERMIT TYPE: STR PURPOS�: AL'f JOE DESCRIPTION ; WINDOW CHANGE OUTS (ZNCLUDES BAY) SQ FT: 5,000 CLAIM VALUE: S,OOO,UO CALC-VALUE; S,OU0,00 GROUP OCC; R-3 /M-1 COMMENTS: SMOKE DETECTOR(S) RE�UIRED IN HOME, IfN�N�iFittf�FiF�;.if#�N�iflEiEiEil#ff#ifie#iEif��1F#lFiEif ii*iFi(�iE#�IFlhkiflEiFiF#fEifiEiFibif3fff!(•ifiEiEY.-iE1EiFiFiEiElf�?F�1FiE�!iiE3f3c1fiE3F3F1E3F?f�iF Z O N S N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BliILPI�IG ---------- --------- RCC_ESSORY BUILDING --------- FRNT; FT IN RcAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT 7N RGHT: FT IN PARKING REO• PROV• Pt1RCEL: 92245412 7.Nc• R1 REF NO: PLANNING 1�01'ES> REPLACE � WINDOWS. BAY WIhDOW IN FRONT TvILL NOT HAVE > FOUNDATZON; PROTR[JDES 18" - #�t#x�t*��t*x*it**�***#*#*x�'*##*ce*��*#�tx#x**�t�****�*�t*�*k�tx�ta»t+t*�t�t�*�t�**�*�****** D E V E L O'P M E/ N� �Tn S E R V I C E 5 R E Q U I R E M E N-r,�' S ZONING APPROVED PY_- : `�C//� � DATE: �/ _/'f�'2 �! BUILDING APPROVED BY ;� ,S� _ _ _ DATc; _J� ��'� �: APPLICATZON ISSliED-BY: S DATE; �d y�9'Z. If�fiFlEiFikiEifiFlEiPfO�hiEifiF3'rifMfEik3E � r��e - 3�: iFi�� 'iFir'iF�r �i«i(�iFiFifiFiij't3fieiE 'ir7�%irK�iE 1flE�1f�FIt�1EiF3E�FiF3cjfjEM�N��fkif�AFj(�ii�!E#itiFlEkiEiEtFiEk3Eifii� %iENk kl4ifiFi6?liF3Eilif�Ei!��E3kiEi'riEiFiFa:�{c�1f�1E#?F �3cY.��E#�'.FiFkif�ilf LEGALI2ATION;N �� F 5 E S U M M A R Y STRUCTURAL�SEGMENT:Y BI�DG PMT FLUMBING ELECTRIC MECHANIC .;TRE SMIP/RES GRADING PERMIT 72,00 ,50'. SMIP/NON-RES PI..AN 46. $0 ISS[7E FEE BUILDING-DIV-> PERMIT ISSUE PLAN-CHcCK TOTAL PRID L' DUE TOTALS----> 72.50 O,UO 46,fS0 119.30 119,30 ,,; .00 � . REVENUE DIVISION TOTALS--> COt,LECTED: 119,30 OVER/SAORT: r 00 BLDG PMT PLUN,BING ELECTRIC MEC9ANIC FIRE SMIP/TOT GRADiNG Pi,AN-CHECK 72,00 .SO 46.80 �k it 1E 3E If iE iF if iE �E ie if iE 1E iE iE if ie ## if iE 1E iF it iE iE if- # 3E iE #• iF if iE j! j't iE iE �Y #� �3F if 3f i(� �16iF 1F?e iEaE � 1F iE iE if iE ii� ii� �kif �F M� M� K if if �IF iF iF #� if 3i iE 1f f iE ie I N D I V I D U A L F E E B R E A K D O W N � TYPE QTY D E S C R I P T I O N UNZT COST "TOTAL C05T SFR 5000 ALTER HY VALGE R�SIDcNTIAt, NOZONE 1,00 n��,OOO,OU END OF ccES � /�� /' - -, _�. .,�,,., ._ .. , --, CONSTRUCTION AND PLANNING � PO. _& SPA APPROVALS Permit # Date Inspector AppROVAIS Permit # Date Inspector t. Temporary Electrical Service or Po�e 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement 3. Etectrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit•Undrgrnd. 55. Electrital Bonding 5. Steel Reinforcement - 56. Rough Piumbing & Pressure Test 6. Electrical UFER Grnd. - 57. APPROVAL TO COVER�GUNITE 7. Footings , 58. Electrical Conduit-Undrgrnd. 8. Fo�ndation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor Sysiem ' � 61. APPROVAL TO DECK 1 t. Property Sewer l.ine & I-Pouse ConnectioR 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drainz 64. Plumbing System - Final 14. Rough Piumbing 65. Eleclrical�Final 15. Rough Eleccrical�Conduh 66. Solar System-Final i 6. Rough Elearic Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign , 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Svucture 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping OGas ❑Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceilin9 ($vucturap & Monocoat 75. Dry Chemical 27. Frame and Flashing Z( �(y�- 76. Dry Standpipe 28. Lathing & Siding �,L cj� 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 MeterFinal -� 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 36. Final Plumbing � 39. Water Service�Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrlgation � 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING _� L� � U/b. s �b � �. � � - 48. FINALPLANNING � �o�� . 49. Electric Release to Edison �� '� 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date ` � AOp��ant to fill In all spaees ezce0� �hose witMin heavy EorEer lines antl si9n all a0Vro0/�a[e tleelarations. CITv oF COS7A MESA C I�STRUCT ON PERMIT Project Address __�� Applicant's Mailing /A�ddre s .p/� Owner's Name �(�.I �S��/�/i�J.c� ' - Phone Address �(CA-LI� � Arch/Eng. - License No. Address ContractoPs Nam Phone Address (mailing) City License No. � LICENSED CONTRACTOR DECLARATION 1 h¢r¢by attirm that 1 am licensetl untl¢r provi5iOn5 Of ChartC/ 9(commencing witn sattion ]000) of Division 3 ot the Business antl Professions Gotle, anC my license is in fylJjp/qe antl e/tecL �(/�/ /�� p, .Datc�'�_�_!_`��/� Signature'(,.�'LK/1�67.�L-/��/'�"�� WORKERS'COMPENSATION DECLARATION I�ncreby affirm that I have a certlficate oi consent to self�insure or a certificate ot Workers' Compensation Insurance, or a certffietl copy thereof (Section 3800, Lab. c,� _ ^, _ � / _, ,� , `/ � „ �'� �� Policy No. �d��.u��y_ Company !V� ��tit�tl <tqgy 1�(il¢tl wAPPhcantY 9 io� Date < � � y EXEM7TION FROM WORKERS' COM ENSATION DECL RATION (ThiS SCtlion nee� nol be completetl if the permit is fo� One huntlre0 ($300) Or less). I certi(y that in the oerformanca ot tne work for which this permR is issuetl, I shall not employ any person in any manner zo as to become 5ubjec[ to tne Workers' Compensation l.aws of California. � Da[e Si9nature 'NOTICE: If, af[er makin9 tltls tlecla�dtion, you shOultl become subject to the Worker5' Coro0en5ation provi51on5 Of th¢ l2bo� Cotle, you mu5t torthwith comply with such provisions or Inis permit shall be tleemea revokea. CONSTRUCTION LENDING AGENCV I hereby aftl�m thaf thGre i5 a tOns[�uctlon lentling a9anty for the perto�mance O/ lhe work for which Ihis permit iz i55uetl (Section 309] Clv. C.) lEntler's Name Lentler's AGtlress OWNER BUILOER �ECLHftATION I hereby aftirm [hat I am exempt from tbe Contractor's License Law for tbe tollowing reason (Section 7031.5 Businass and Professional Cotle: Any cify or county whlch requires a permit to construct, alter, imorova, tlemolish or repair anY struclure, priOr to it5 ISSuance, also �Equires Ne applitant tor Suth permit ' o tile a signCtl 5tatemenLthat he/Sh¢ is Ilcensetl pursuant to the provisions ot e Contractor's License Ww (Chapter 9(commencing wlth SecHon 7000) ot ,vision 3 of thf BuSinesS ar� tl Profession5 Cotl¢) o� lbat h¢/She is ezempt .be�efrom antl the basis for the alleged exemption. Any violation of Sec[ion 7031.5 by any appliCan[ tor a permit subjectt [h! aoo��anl [o a civil �enalty of not more Ihan tive nuntlred tlollars (E500). 1, as owher of Ihe p�o0e�ly ot my employees with wagCs a5 their Sole <ompensation, will do the work, antl the structure is no[ intentletl or ofieretl lol Sale (SCction J046, Busine55 dnd PrOf¢szional Cotle: The Conbactor'S Litense Law tloes noi apply t0 an owner Of a property wno Guiltls or imp�oves thereon, antl wno tloes such work himself/herself or throu9h his or ner own employees, O�ovitletl Ihat SucM1 improvements are not Intentlod or offeretl for sale. 11, nowaveq the Euiltlinq or improvement is soltl wltnln one year oi com- p10tlOn, the owne� will hav¢ Ihu bu�tlen of pwving he/Slte tlltl no[ builG o� Im- prOve /o� the pu�0ose ot sala). � ' ❑ I, as owner ot the property, am exclusively contratlinq with Ilcensetl con- t�actor5 to construct the O�oje[[ ($ection ]044, Business antl ProfeSsians Cotle: The ContraGt��'S LicenSe Law does nol apply to an own<r of Orop¢rty who builtli or Improves [hereon, antl wno contracts tor Such projecl5 with a con- tractor(s llcense pursuant�to lhe ContractoYs License L.aw). I am aware that proof o� their Worker's Compensatlon insurance shoultl be provlaetl to me. ❑ I am exempt untler Sec[ion B. & P. C. for this reason Date Owner I her¢by [ertify ihal I hav¢ rcatl lhls application anC state that the al in/ormacion is correct. I agree to compry with all city ana county oraina antl Slate laws relating to builtling construction, antl hereby authorize rc Sentdtives of�(niS�cJ�ty to ente� upon the above-mentionatl pro0erty Signature !.A// / IU Drivers' License or 55 � _ TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATIODYCJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER qp # DESCRIPTION OF WORK/USE OF BLOG. S Main Bu � E TVPE OF PERMIT � GRADING �❑ �FOUNDATION STRUCTVRAL T Front ❑ TENANT ❑ ELECTRICAL I{d'PLUM9ING ❑ MECHANICAL. A Rea� ❑ 9THER PROJECT�DESCRIPTION 5�. FT. oCCuaANCv C Right K Left CONSTRUCTIONTVPE VALUATION$ $ ZONE GRADING CU. VDS. ACRES ping. Ref. # Remarks: Planning No Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishvrasher Drinking Fountains Floor Orains Floor Sinks GasService Oudeis Kitchen Sink Lavatories P-Trap Roof Drains Reinspection Fae $15 Boiler Duct- Under Ground Duct -Structurel Duct-Ventilating� � Exhaust System ❑ Multiple ❑ Firepl/Fact Blt. ICBO # Hnating SyStem & Duc[in9 ❑ a� oo,000 aru O i oo,000 eT Reinspec[ion Fee , � S15 CMF 0865-46, rev. 10/84 White - Builtling; Canary � Applicant; Pink - Accounting; Goltlenrotl - Assessor ShOweri Service Sink Sewer Cap Sewer Conneaion Solar CAllectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet � Water Heater . Water Service Auto-Wash Laundry Trays Isue Fee Hood or Type I ❑ Canopy Type 11 ❑ Retrigeration System �, ❑aioo,000eru ❑�oo,000eT System Repair/Alteration Fire Dampers Issue Fea FEES Auromatic Washer Construction Po�e Suh. Cooking Unit " Dishwasher Dryers ❑Gas ��Electric Fan F.A.U. Fixtures Device Boxes Ouileis . Switches Garhage Disposal Generemr �0�5 KW ►46904 6%2B%96 .,-+r ._ _ _ .__ Zone Accessory Building: Parking Req./Provided ELECTRICAL Trans(ormer ❑ 15-50 KW ❑ 50+KW Meter �up to 100 amps Meter �over100amps Sub Panel Motors � 0-1 HP � 1 X- 8 Inc.Solar 09-15 HP �16�15+ Microwave Pole Light Sign ; Standing Sections 15 KW Trash Compactor 5.OD TL FEES Z O N I N G R E Q M T S $ 3 i' Reinspection Fee $15 Issue Fee $ 3 FEES .y DEVELOPMENTSERVICESREQUIREMENTS: � Zoning Approved By ' Date .'i Building Approved By Date��/(/J]��/�/ 1 Applintion Issued By Dats `�.�-�[_-a� SUMMARV OF FEES � BUILDING PERMIT $ SMIP $ PLAN CHECK 5 PEFiM1T PLUMBING 5 � � �ISSUANCE $ � PLAN CHECK 25% $ � ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ n MECHANICAL $ _ TOTALFEE $ v 0 v $ 3 PLAN CHECK Z5% $ �_ � CONSTRUCTION AND PLANNING �- P� 8' SP'4 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. Electriaal Conduit UtilitY-Undrgrnd. ' 54. Forms 4. Electrical�Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test 6• Electrital 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 Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 67. 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 SYS7EMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil 23. Gas Pip¢-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE �SSUED 33. Final Electric Notes: �-� �(� L,EpI'CiQQQ. �.,E�l 34. Final Heating & Air Conditioning 35. Final Gas Pipe=Test 36. Hood or Canopy 37. Final Factory Fireplace .r 38. Final Plumbing ("� -q-�6 GRi 39. Water Service-Final 40. Gas Service-Final �.'� t �� 41. Solar pomestic-Final E: 42. Backflow Preventer '" - » ,A3. Backflow trrigation i�. 4.4. LandscaPe Irrigation System ,4_5. Sound Attenuation 't' �6. Handirap Regulations 47. FINALSTRUCTURE & BUILDING 48. Special Fequirements Completed 49. Electric fielease to Edison �50. Gas Release to Southern California Gas Co 57. CERTIFICATEOF-OCCUPANCY - c No. Date PN0.IECT ROOflESS: H 2 % PLUM PL .awxex�s HAme: WAGNER nooness: SAME UNIT: 647.-8124 RRLM/ENGINEEfl: qEG.NO.: FOOflESS: UNIT: PERMITTEE: CRYSTFiL ASR (?14 ) 630-5455 aooeess: 118U1 MAC STREET GARDEN GROC�E CA 92641 LICENSED CONTpACTOB OELLFPF7ION: I hereGy atlirm tnat i am licensea unaer pmNsions al Cnapter 9(commencing wiN Section 7000) ol Uivision 3 0l tAe Business an0 Pmlessions Code, ana my littnse is in lull brce anA elletl. aTruc.:0 2006 sTnrcuc.:4939Z4 n/ C,� : 20 9af�- � Signature: / �'�1� WOPKEPS' COMPENSA7ION �EClANA710N: I hereby aflirm inat I nave a cenificate ol consent �o sell�insure ar a cenificate ot Workers' Comoensaiion ��w�T o� �celt�eacovv mereo� (section 3eoo, �ao. �1.� � 2 8� 9 z roucr xo.: NATIONAL exr. oaTe: LOMPRNY: ❑ Cenified- c-o/py �is eIler^eby Abmis�ed. � Certilie0 copY is li`letl vnih}� e city 9uiltling DivlSion. attle� L O�-V L'Z-� MDliwn�: /r`^�'IC lW E%EMPTION FFlOM WOPI(ENS' COMPENSNTION OELNMTION: (ilus SeGqn nee0 rot 0e plete0 iI Ne perml b Iw one muitlree 15100) or lusl. 1 certi�y Iha� in t�e periormance ol I�e work for wAich INs permii is i55ueG, I Shall n0� ¢mploy any per50n in any manner so as �o become SUElect to tlle Worker5' Compensation Laws ol Calilomia. Date: SignaWre: NOTILE: IL aiter makinp this Eeclaraiion, you s�ould become su�lecl to Ihe Workers' ComDensation pmvisions of ihe La�or CoDe. you mu5i forihwith comply wi�h such pmvisions or Ihis permil shall be tleemeA �evokeA. CONSTHUCTION IENDING AGENCY: I here�y affirm ihat Ihere is a conslmction lending aeency lor ihe peAormance of ihe work for which Ihis Dermit is issuetl (Section 3097, Civ. C). LENOEfl: aooxess: OWNEB BWLOEB OECLABRTION: I �ereEy attirm that I am exempllrom Ihe Comractors Slate License Law for the following reamn (Section 7031.5 Business an0 Pmle54onal CODe: Any ury oi counry w�ic� reQuirtS a permii to consiruct, aller, impmve, demolish, or reDair any SlmCiure, pri0r �a ils issuanCe. also require5 the applitanl tor SUth Oermii lo Iile a SigneU Sialement I�ai �e/She is Iiten5e0 purwanl �o Ihe provisions 01 Ihe COnlratmrs' Slaie LiCenSe Law (ChaD�er 9(tOmmenting w�lh SetliOn 7000) o� OiviSion 3 Ot ihe Busineu anU Professions CoOe) ar �hat �eh�e is eKempt ��erefmm and ihe Casis br Ihe allepetl eMemption. Any uiola�ion a� Section 703L5 Gy any ap0�i[ant lor a permii 5ubjecl5 ihe ap0licani Io a civil penalty o� n0t more Ihan live �undreE dallars (E500�. CITY OF COSTA MESA — BUILDING PERMIT k� :, 5 PERMIT NO: M 056009 PLAN CHECK NO; N t, i; u i�: COhSTRi7CTION 'PYPE; V—N PERMIT TYPE: MEC PURPOSE; OTH JOB DESCRIPTION ; INSTALL CENTRAL HEAT SQ FT: CLAIM VALUE; 2,500,00 CALC—VALUE; GROUP OCC; R-3 / COMNENTS: SMOKE DETECTOR RE�IUIRED IN THE HOME ��t**x�r�x*�x�**xx*�**�*�*�r�� **��x�*�x-��t*�t�*�*�*�****x�*�t*x*�*x�+t**�r�******��***x 7. 0 N I N G R E Q U I R E M E N T 5 5 E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING REp• PROV; PARCEL: 42245912 2NE; REF NO; PLANNING NfSTES> � :I IE �E iF if iE iE ft 1E IE fE �f iE �f k if if- 9t jf 1F 3E # if ik jF if iE iF 3f iE iE k## ik 3E iE iP'iE i(� i4 iE if iE iE iE iE �1E iE 3E ic it iF if 1E iF fElE * iF iE 3@ * jF IF iE if iF ib if �Y-#� Y� iE if jE if if iF iE D E V E L O F M E N T S E R'V I C E S R E Q U I R E M a N T 5 20NING APPROVED BY , 1 DATE: BUILDING APPROVED HY ; DATE: APPLICATION ISSUED BY: h" ` DATE: ��2�(-9 �—=— �IEih3F3EaF�EikiFi4jFiEifififififafiEiEiE3Fif . � ififiEif�aFiflPiEihiE7FiF��Sf�S�If1E iF if if iE if iE 3F if iE iP 3f iF if %?E iF 3E iF iE iE af 3E iE iE if iP jF 3F k �E iF it �f iE iE iE it jE 1f iE 3E 1E iE �IE 3F iE 3! aF Ik iF �E iE 1! iE * 3f iE 1f if ik k ik if it * iE iF �E iF �)f� 1E iF ic iF 3f �E i41E 1f LEGALIZATZON;N F E E S U M N, A R Y STRUCTURAL SEGMENT:N BLDG PMT PLDMBING ELECTRIC_ MECHANIC FIRE SMIP/RES GRADING PERMIT 9'LSR SMIP/NON—RES P 'L11N ISSUE FEE 15.00 �, as owner a� �he pmDeny or rtry employees with wapes as Iheir so�e compensation, wil� do �he work, and �he BUILDING—DIV—> PERtyIIT I$SUE PLAN—CHECK TOTAL PAID DUE ❑ SlrucWre is noi inlendeA or allered for sale (Section 70E4, Buune55 ana Pmlessional Cotle: ihe Canlractors' S�a�e License Law TOTAL S---> 9, � � 1 5, � 0 �, � � 2 4. 0 � Z 4. � � , � � Ooes n0i apPlyia an owner ol a pmperty wlw builGs or improves Ihereon. an0 wlq Oces 5uch woM1 �imSei�/herse�� or ��roUgh his ar �er own employees. OmNJea Iha� such impmvements are not inlen0etl or ottere0 for sale. II, �owever the buil0ing or REVENUE I) I V I S I ON TOTALS--> COL L ECTED • 2 4. 0 0 OVER /SHORT • 0 0 im0�ovemen� is 5dJ xilhin on¢ year o� comple�ion, Ihe owner will tuve �he Durtlen oi protinp hUslre tlitl no� �uiltl or imprwe mrmeo�rvoseoiu�e�. BLDG PMT PLUMBING ELECTRIC MECAANIC rIRE SMIP/TOT GRADING PLAN—CHECH` 29,00 I, as owner of t�e propeny, am exclusivery cantrac�ing wi�h licensea contractors �o mnstmct t�e prqect (Section 704a. Buvn¢ss ❑ antlProlessionsCaOe: t�eComraclors'3ta[eLicense�awdoesnotaDDN�oanownerofproperiy wlioDutldsorimprovesihereon *******.�*********�*�****�**************************************�***�*,***,i**,**#� anU w�o contrac�s lor suc� Omlecls with a coniracloqs�lit¢nse pur5uam Io ��e Conlraciors' Slate 4cense Lawp 1 am aware t�ai Dmof al t�eir Worker's Compensation insurance shoulE Ue provitle0 ta me. I N D I V I D U A L F G t. B il E A K D � W N � I am exempl unAer Seclion: B. 8 P. C. �ormisreason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Da�c', Owner: I M$C I Uo �ere7y cenily iha� I am aware oi anU untlerstan0lhe repuirements of Calitornia Healih and Safery COJe Sections 255Q5, 25533, an0 2559A anA I�a� Ioranyluiure UuilOinA ocapantwilVwillnot�circle one) neetlio comply vn�h 5ai0 Slate cotles aneihe reQuirements�ora p¢rmil lor conslmction or modilication Imm the Air Ouahry ManaAemen� Dis�ncl. PeSitleniial wnslmc�ian apDlica�ions are exemp� imm Ih¢5e prOvisions. Dale: FpplicanL I �ert0y cetli�ylhal I have reaCl�is applitalion antl Sta�eiha� Ihe ahovein�ormaiion is torr¢cl. I aqreeio tomDty wii� allti�y an0 counry o�0inances antl slaie laws relaiing to �uilaing consimc�ion antl hereby aWAoriie ieD�esenta�ives ol Ihis ciry Io en�er upon ��e above-mentionetl pmperly la speclian purposes. n U� L �- �ye: � � SignaWre: �� orrvers ucense oi sodai Security � t64��a6 W�ite-Bmltlina: Gre¢n-CaEe Enlorcemen�: Canarv-/oolitam; Pink-Revenue: Goltlanrotl-Assessor 1 INST FORC—AIR/GRAV FI7RN <= 100 K BTU 9,00 9.00 END OF FEES i7i;- �� ; - - - ii . 4 . �� l� . i, _ . li�.. 1��. l , CONSTRUCTION AND PLANJVING POOL & SPA � APPROVALS Permit # ' IDate Inspeetor qppROVALS Permit # Date Inspector 1. TemporerY Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. 54. Forms 4. Electriwl Conduit�Undrgrnd. 55. Electrical Bondmg 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Elecvical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. E�ectrical Conduit•Undrgrnd. 6. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System _ 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Dre�ns 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 $ign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOVSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Fectory Fireplace APPROVALS Permit # 21. DuCts, in $tructure 70. Underground Hydro 22. DuMs, Ventilating 71. Product Piping OGas OOiI 23. Gas Plpe•Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical 27. Frameand flashing 76. Ory 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. Electriwl Power Meter-Final 80. FOOD CER7IFICATE ISSUED 33. Final Electric ' Notes: 34. Final He2ting & Air Conditioning � 3 � G�� 35. Final Gas P�Pe•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 Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING . 48. FINALPLANNING 1 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date , ` � AOpPE550FBNlWG: S�% PT.,OM PT� OlMEFSN41EIFpqWN: (��SHEA, J6ANNP. TR �oo�ss 82� pL�UM Pt� �OSTA MESA,C.A 92677 �cv�. iuuuxc wonEss: uHt: APCXRECi OP ENf�l6A: 11C. NO.: ARCX.ON EN4'S1UDqE55: UNT: coNm�cTarsxu�e: THOMAS MEDANICH ( 714 ) 840-7595 c«rm�cToirs�uuxo 16881 HARKNESS CI �ooxcss: H,H. CA uc.ao.: 694386 9�549 uxr: 110EN5ED COMNACTOFS OECLANITION: 1 hareby eRim �Nx penely d pe�jury Nel I am licenaed i�Mx pwuimo d CMqm 9 ( ' g wilh Sacfwn'l000) �� a tlro Busmas ard Pmfeadms COEe. enE mY licenee o in lull force vM aHaq. ruc. .: uc.cuss: g uc.No.: 694385 EXP: /p� comreaw: AYN BUILDER DEttAH�T10N: I hereby dfirm urMer panely d perjury Ihe� I em mamq fmm iM WMim«e lioarue l.ew la tM �Idbxiq ieeson (`�� ]W1.5 Bus'vreea eed Roleaions Cotle: AnY cYY a mumy xAiM npuiree e paimn to mrebucl. eller. improve. 1 Eamdah, a repai eny eirucwre, p'v to p.v 6aerce, ebo reQuiref ihe epqimnt fa mc� pemN lo fib e spmE s�atemenl tlbl he a she ia licereed W�a^� to IM pm�ims d iM COMredon License Lew �Cheqm 9(�mendrp wilh Sedion ]OW) d Orvebn 3 d �ha Bu�inma eM Rdeaona Code� a Ihel ha a ehe u examq �haehan end ihe bavs fa Na dbped exemption. My volmon d Seqion J031.5 by em� ep0�icenl fa e permil aubpea tM epplicant to a crvil penely d� mwe Ihen Iwa huMred dolleis �5500��. � I, es owrrer d Iha vropeny «my amo�'�a �h wepes av Iher eob compenaatian, xill do �ha waA, arM Ne niunure e na imeMeE or oflered /or eele (Section )01d, Busirou eM Profensiona Cade: Tha Conlredon Limroe Lewtlo» ml eppty lo en ownerd propeily wha buJM or inD�� hereon, ard who daec eWi work Mmsetl or Mnetl «throuph ha w Mr ovm employees, O�dad thm euch imporemeMa ere nd inleMaC a dlared la aele. M, however, Ihe buidin0 «'vnpwemem u voN wnhin me ymr d mmplaun, the owiwrbuiidx xiil hew IM Wrden d qwiip M oe sM did ro� buik a impove far IM Wm�e ol ub). � 1. m ax�r d �M qW�Y. em ud�'eN oonirenn9 Miln licenaed convec�ara ro cmmua Me p4� (Smion IDU. Bw'vwe ard rw�a�s coee: rne com�a� �ca,se �aw eoas na ewN m en o�. a ww�r wno wua. « imwa� �ne�em d,e wno mnvazb Ia wdi o�M�� a coMtedor(a) licenaed Wn�1 to �M ConUedon License lew). � I em eFamq uMm Seclion: B. d P.C., br I�is �aeaon: Dme: Ownar: I do Mreby ceXity Nel I em eware d ard unEenlerM IM reyuimnenp d Celiana Heehh eM Selery Cads Setliana 15505. 2553�, enE 255�a, eM tl�et I a eny Mure Wikiip ocapeni wiil / wil rwt (aacb arw) need b wmply wih eeid pme mdm erd the �apuimnmm br e Ge�n laoomin�ctiona mod�tion homlM �i�—are0emanl Di%rid. fieakeMiel em9iutlian aGV�ime ve e�emq Iran Nme a��. Dele' APW�: WOHKEP'3 COMPENSATION DECLANAPON: I hereby alfiem uMer penel�y d perjury aro N tM lollowiip daduazbna: � IheveeMxilmeimenecenAceiedconeentloseli-iruureMworkeia'compensetion.mpwkeEfabySetlion3l00allhelabor COEe, in iM peAormenu d the wak la xlvch Ihe pdmn u iasued. ❑ i naw ene.� �men wnas• mmo�:M �nm,rence. � rea��roe M s.e� aiao d m. iem, cme. ro� me ro�am� a ine wwk la whiM Nie permn o esuad. MY workare wmpanmtbn i�numrce femx eM pdiry numGr va: c�.: Pdity Number: This secYion need nm be complxed'Y Ms peimAis bi one hvndred dollars (S1001 oi bsa.) cenly Uut in iha pMoimence d �he wwk br xfich thn permit u inued, I dWl �wl empby e�ry pe�aon in eny mennx eo ea to ' �o Ine xoiken' canpenm�ion lewe d cda�,e. ,�a �� mm a i.nwa nao� aqw m ms .�.8� wmox�setia; ofwuon. a seaion a�ao a in. �emr cme. �.w� �onn.mn mmoN wnn ume ommiom. � Duc AGdranl: W�mlrp: F�Ilun ro��cun woNcen'ron�v�rwtlon covn�p� ls unhwlul, �n0ah�ll �W/Ief �n wrploy�r ro<�/Mrol p�n�ltlw+nL elvll nM, ep ro on. ninerW thouaan0 eall,n lsloQaVoA �+��n ro M. ewt ol rompmutbry M� .. provWM ror In SxHon 9)06 0/ Me LMorCods, Intxuf, en0 erto�nsY�� Isu. CONSTPUCTION LENDINO 1GENCY: I heroby e1Frm uMer penely d per'ryry ihet iMm ia e meutrudion bMiip epem.y br ihe paAamence d Ihe xork �or whid� the peimi ie uvued (SeUon 3091. Cv. C�. LENDEH'S NMIE: LQ10EW5 �DDNE55: I cMity ihm 1 heve roed Nia epplicaiion W s1Ne I1� IM ebove inipmelion b corteq. I epree �o canply wnh ell ory ud munry ardirercea eM ete�e lews mlelin0lo Wik'up canArudion eld Mreby au1Mr¢e repeeenle�ivea d Ihe tily to enter upon IM ebae-menlo�wE paparly io,mao��w�o�a. SAME o�, 6 —i —9�' (St51J6WP) Whne-Buildiq85elely:or�Cerery-�ppirant:Pink-Revenue:�dEenmd-Rsaaeaor C.T.'1'Y OF CQS'.CA MESA — BUi7,D.T,N(; PFRMi'C PF,HM NO: E 077.6?� PERMST NO; F. 072629 PT,�AN CHECK Nn: N GQV"C; N;DPP; N CONSTRUCTiON 'CYPF.: PF,RM.T.T "CYPE: ET,F PtIRPOSF.: O'CN JOH DFSCRIPTIC7N : INSTAT,I, F..L�F.C. SF.RV7CE S REr1:PT .S'Q FT: CLAIM VA?,UB: CAt.,r,—VAJ.,UF.v GRqt)p n�r,; / COMMENT5: X 1E �lE �N� iE lE 3E 1E if iFlf 1E iE iE �lE �lE fE fF iElE iE �lE �K IElE-1E iF it iE iE iF�3E iE iE if i(� ik iF-%if if if �1P lE 3f iE ib 1( �� lE 3F lE1E iE IE-%K if %%df 1E �E iE 3F 1E 74 iF iF iF K�K iF �7F ��lf 3E 7E 3E iE 7, O N i N G R F. Q U:L R F. M F. N"P S S F. T B A C.K .S' ------------ MAIN BUILDIN.r, ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REO: PROV: PARCEL: 42245412 ZNE: REF NO: PLANNING NOTES> i lF i! 1E �E IE �lE if� i! !! 1E iE iE'll"1E j( jE iE # dE jf IF i!' 3E IE jE if ik �lE iF')E-1E If K-IE k ik IF iF iE ��% % iE # 1k 7E i(' iE iE iF if �7F-)E-%!F iElf'� � iE ��)E-0E iE iE �lE if'% iE If 3F K"K"M' 3E IF'lE iE iE D R V 6 T, O P M 1'. N T .S' F. ' R V T C F.. S R 1' Q f J .T R F.. M R N'C S 7,ONING APPROVSD AY , DATF.; BU7T�DING APPROVF.n AY : • DATF: APPLICATION .T.SS4RD AY; '.�.�a� # �_ DATE: � � �) iFikiEifkkih�lEik'k3kltiFlf�lElEif#lfkifiElf-�7Fififklt�kiFK-�]F%dEkk � k iF3fXihiE�X-iE%%k)fK�X)EiF�1E��9E�1Ek�lf�lEikiFiEifi(�3E7(� �k�lE ##lF1EiE I,EGAI�I7,A'tION;N F F.'F.. � S 0 M M A R Y STRi1Cl'I)RAf, SEG F,NT:N HI�DG PM'C PLUM5ING FI.�ECTRIC MECHAN:f.0 FIRF. SMIP/RES GRnDT,NG PF..RMIT 11 , 75 SOx SM.T,P/NON—RrS PLAN ISSOF. FEF. 7.5.00 AUIJ.�DING—DIV—> PERMJT ISSU6 PT,AN—CHECK TO'1'AL pAID DOR TOTAL.S'----> t1.75 15.00 0.00 26.75 7,f�.7S ,00 RF.VENUE DIVISION TOTAT,S--> COLI.,F.CTF:D: 26.75 nVER/SHORT; ,00 HI�DG PMT PLTIMHT.NG EL,FCTRTC MF.CHANTC I�INF SMT.P/'f0'C GRADTNr PT,AN—CH.F,CK %6.%1 1k ik 1E'X� jF 9E i@ i! ih k ik jf k K� �M iE * iE iF %# k lE k IE 1f iE �k 1f �lf if iF 3E'lE-k If if IE 3E iE iE iF 3E 16lE !F %9k iE'k IE 7E �X� IF %# %3E-X"lE'� �Ik 1E iE Ik �% X�K�lE # li% 3E 7E%�1E IE IE iE I N D I V I D T1 A T� F E E A R F A K fJ O W N TYPF Q'CV D F. S C R I P T I O N UN7T COST TnTAi� COST F.I�F, 1 RF,CRPT/OUTLF.T 1 ST 70 F,A, , 7 i , 7 i EI�F.. 1. SUA—PANF.L 1.1. , p0 9. t. 00 F.ND nF FEf:S �11 40if339�-OC13a298 Ti e-e' 26.75 DAT�: �Alt12/'i.`", TIf:E: }�tdq � �i. ��, CONSTRUCTION AND PLANNING�, POOI & SPA , APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Irt>p�ctor � 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe�Undrgmd. 53. Steel Reinforwment 3. Elecirical Conduit Uttlity-Undrgrnd. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electricai Bonding 5. Stee! Reinforcemen. 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings , 58. Electricai Conduit-Undremd. $. Foundation -. . 59. Gas Pipe, O Undrgrnd., Test 9. 4Vater Pfpe-Undrgtnd. . 60. Backwash Lines, P�Trap, � Undrgmd. 10. Structural Floor System 61. APPROVA� TO DECK � 11. Property Sewer �ine & House Connection 62. Backwast� & Receptor�Final 12. Sewer Cap 63. Heater & Veni-Final 13. Roof Drains 64. Plumbing System � Final 14. Rough Plumbing 65. Electrical-Final 75. Rough Electricai-Conduit 66. Solar System-Finai 76. Rough Electric Wiring 67. Fencing & Access Approval - 17. Ro�gh Wiring Sign - 68. APPROVED FOfl PLASTERING 1$. Rough Electricai-T Bar Ceiliny 69. PQOUSPA SYSTEMS FINAI 19. Rough Heating & Air Conditioni�g FIRE DEPT. REQUIREMENT 20. Rough Factory Pireplace � , ' , - __ APPROVALS Permit # , 21. Oucts, in StrUcture � �� •• '- 70. Underground Hydro 22. Ducts, Ventilating - ., 71. Product Pipin9 OGas OOiI ' 23. Gas Pipe-Rough & Test . " 72. Underground Flush 24. Roof Framing • '� . 73. Undergrnd.StorayeTank �Gas ❑Oi! 25. Root Sheathinc� + � 74. Overhead Hydro 26. T-Bar Ceiling (StructureU & Monocoat 75. Dry Chemicai 27. Frame and Flashing • 76. Dry Standpipe 28. Lathing & Siding , � � ' � ' 77. FIXED SYSTEM FINAL 29. Insulation �� 76. FIRE PREV. FINA� 30. Drywali Nailing � - HEAITH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED 33. F(nal Electric - f Notes: 34.. Final Heating & Air Conditioning • 35. finai Gas Pipe�Test . - 36. Hood or Canopy ' . � ' � 37. Finel Factory Fireplace • �. � 38. Pinai Plumbing � 39. Water Service�Final � 40. Gas Service�Final ' 41. Solar pomestic-Final �� . 42. Backflow Preventer 43. Backfiow Irrigation_ � 44. Landscape Irriqation System � �- . 45. Sound Attenuation � 46. Handicap Regulations � . - 47. FINAL STRUCTURE & BUILDING � ' ; 48. FINALPLANNING " , � 49. Eiectric Release to Edison 50. Gas Release to Southem Calitornia Gas Co � ' 51. CERTIFICATE OF OCCUPANCY ` � No. Da[e � L�.�ANGE COUNTY BUILDING DEPARTMENT . 636 North Broadway SANTA ANA, CALIFORNIA FOR APPLICANT TO FILL IN BUILDING NEAREST CROSS ST WIISH�RE BIVD. :�1�F1 "�DRE55 2jjO E. WAINUT ST.� PASADENA _�NTRACTOR NENPORT VISTA CO.io CR. F) AODRE55 6 WIISHIRE BLVD.� BEV. ILL DESCRIPTION I LOT NO. �O BLOCK �� (ATTACH METES @ BOUNDS) TRACT NO. OF �G. F�N.ILIES DESCRIPTION OF WORK NEW I Y I ALTERATION I REPAIR )I� I MOVING I BUILDI�O�4 SQ.FT ROOMS SIZE WALL ROOF COVERING STUCCO COVEI "�E OF NEW �_oiNc RESIDENCE .I� 6. OF � I HEREBY ACKNOWLE'JGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. O AUTHOHIZEO $ 483o.W �FEE $ � L VALUATION - s /i L FEE 7 APPLICATION FOR PERMIT YV'��I�V FOR OFFICE USE ONLY RECEIVEO BY DATE OF APPL. � DA' �-?3-J� �� BUILDING '� � U� ADDRE55 SCHOOLDIST. ^�„_ _ OR TOWN / /l.�/ NEAREST � � /�. CRO55 5T. �K/�A`�'�'�— ZONE NO. OF TY� I( /�/I I I PLANS ( iv� _� i SETBACK LINE FROM CENTER OF ST. REAR YARD 25ft � SIDE VARO 8 � 6 APPROVED BV OAI CORRECTIONS APPROVAL$ V�ATION: LOCATION INSPEC FORMS. MATERIALS. ��j_ BONO BEAM FINAL C � 0 � � 2 D r � " . _ _ _ ". .. . ' . ... .. . . ._'� .�2 si�sofoiV -.- •_.:I , :..' _.„ , •.._ � ;w�... ' j � .A��_ ._ L ._ _.�. _�. ..- '1''. _''�1.�:.':_'_..�� _ .:I:.,, _. � ' .:.� �.- _. . . .�� ., r' � . _ ...':1�. , l�"d=.. ' ' . �-'-I•.I.Y� � ..YJ ='71F,]_�'! � � � - X � � � "i -. . : . � -_. �;�I:.. ...-, � . � . � � i- :_. = I := . • � uwntK STUCKES JOB ADDRESS gZ7 GENERAL CONTRAC AP No. I I 5-424-OS INSPECTIONS so� -i c. WPicR ROUGN PWMBING PROP. SWA. LINE n HOI SPRINKLING SVSTEM MISCELLANEOUS ROUGX NERTING 4NU RIR UNOERGROUNO U POWER U ROUGH WIRING THENCHES � FOqMS STEEL REINF BONO BERM �] STEEL REINFORCE SHEnTHING FRRME AND FLASMING LPTHING — IN �] OUT PLRSTER. OROwN COnT STRUCTUR4L. FINRL HE�TING, VENT., REFflIG. PL'- 'iNG, FIN �L �ND GAS EL .IC, FINRL BUILOING, FIN4L DATE BUILDING PERMIT N0. , SUBCONTRACTOR __...5 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUI�DING �a� �«M ��,� ADOflESS OWNER�G/8/%�� T/%GC�'� MAIL �" CI T V �,,: . � CON5TRUCTION BRANCH ADORESS ARCHITECT ADDRESS CONTflACTOR ADDRESS CITV STATE LIC. NO. 512E OF lOT USE OF TEL. NO. TE L. TEL. NO. CITY LIC. NO. INO. OF LB�OGS. NOW ON LOT Separa[e permits are required for electric, plumbing and heating work. USE OF BUILDING AND WOFK TO BE PERFOFMED I hereby acknowlatlpe thet I have reatl this applicoiion end stete that the abova information is corract antl agree to comply wlth all laws repulotinB buildin0 �onrtruetion, entl I shell not employ any person In vialatlon ot th¢ workmen's compensation laws of the State of Californie. I hereby cartity that I am p�Ope�ly licensetl as a cOntracto� untle� tha State of Celifornia Businass antl Protassions Cotla, Dlvision 3, Chaptar 9, antl thet s�ch licenses are in full forca antl atfect, or I am exempi trom the provistons ot the Stete of Calitornle Businass entl Profas5ions Cotla, Division 3, Chaptar 9. Sipnatureat/�� (�� Permlttee r �� AvthoHzetl Agent � �i��r�—�-t�� PA1� # *�}'k 'x C rtB-5-76cn��,,00 154 6.�.50 APPLICATION FOR STRUCT'URAL PERM[T a�iv,�o ev °�iA. J�c7�� T� �� 7 �� A.P. NO. BUILDING ADDRES! TRACT / �/ I .7 I LOT OF _ I USE OF N VARDS APPROVED MAIN BUILDING ROM GL STPEET)� VAR �Jk DATE C.U.P.# AP7ROVED APPROVE��1/i ILIP�I ^ BLOCK APPROV THEAMOVNTSHOWNUNDERVALU THE PURPp$E OF ESTABLISHING A PERI VALUATION PERMITFEE E � PLAN CHECK E � //�.� .� (/ V TAX $ TOTALPAID E FT f N n m i m m N J m m a u� m n 0 LL :� U