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Home My WebLink About3452 PLUMERIA PL - Building Permits� LJ � CITY OF COSTA MESA �� '�pMF'tq BIIILDING DIVISION �t�� 77 FAIR DRIVE. COSTA MESA, CA 92626 • 014) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us " � FOR INSPECTIONS CALL: (714) l54•5626 `�°�"°' PERMIT NUMBER: E11-00060 PERMIT TYP� ELEC APN: 41217807 JOB ADDRESS: c3452P_LUNIERI�4�PL:CM^"� Viciniry: STATUS: ISSUED DATE ISSUED: 03/31I2011 ISSUED BY: KJB Suite/Unit: SCOPE OF WORK: CHANGE OUT A/C UNIT, 1 FURNACE CHANGE OUT TO 110K BTU,'14 DUCTS, 1 COIL. OWNER: KESLER, HARVEY K Address: 3452 PLUMERIA PL Unit: PHONE: Ciry/State/Zip: COSTA MESA, CA APPLICANT: ZAMORA, CAftLOS PHONE: 949d53-8500 CONTRACTOR: KEMNITZ AC AND HEATING Address: 188 TECHNOLOGYUnit: SUITE C Ciry/State: IRVINE ZipCode: 92778 �:. ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $41.70 Reinspection Fee $0.00 TOTAL FEES $41.70 Address: 188 TECHNOLOGY UnitSU1TE C C i ty/S ta te/zZi p: I R V I N E License No. 695874 PHONE: 949-053-8500 CE�L: 9 .� � NOTICE: The work authodzed by this permit shall comply with all applicable handicap access requirements under Califomia sfatutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must wmply wilh all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COOE t. INSPEC110NTypE �pTE INTITIRLS CODEf INSPEG110NTYPE OAIE IN7171AL 1616 Fixed S}stem Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ^ 200 Final Re-Rpof 210 Final Electncal ��'�'— � 3' �� /�%>i %r ia r' 201 Final BIocWRe�aining Wall 212 Final Fire Prevention ` •L`� 202 Final Factory Fire Place 220 Final Planning Approval 203 FinalSign 222 FinalSite 204 Final Demolition 250 Final Building/Occupancy r... ,� � WORKERS' COMPENSATION DECLARATION: I hereby aKrm untler penalty of perjury one of the following tleclarations: ❑ I have antl will maintain a certificate of consent to selbinsure for workers' compensation, as providetl for by section 3700 of the Labor Cotle, for the p�ed/orm anCe o( ihe vrork (or whiCh fhis permit i5 issued. L�' I have and vrill maintain v.orkers' compensation insurance, as required by section 3700 of the Labor Code. fw the pedormance of the work tor which this pertnit is issuetl. My workers' compensation Insurance carner and policy number are: �,��--_. /-�l I ca�c-e �(?I^lriss-e_-C�onneedirolEecwn e(e/E�✓Iheperm4i5�vLi.W¢dula/n,e/�v,r,MiMdaN 51001a1ess) IPeIC�Number: �" I �� J��V lL� �� ❑ I certify that in the peAormance of the vrork !or which this permit is issued, I shall not employ any person in any manner so as to become subiect to Ne workers' compey sation laws o( Califomia, and agree ihat i( I should become subject to � i€ workers' compensation provisions o! Sec�ion 3700 ot the Labor Cotle, I s all foAhwit ply with these provisions. � YSignaW d �Date ,j V WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND A�ITORNEI^S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aKrm lhat I am licensed under provisions of Chapter 9(commencing with Section 7000) of�� ion 3 0( the Business and Pro(essions Code, and my license /is ,i,n (ull r6 ce and effect. 'icr#—' lY ..less.#— - C7i� � r ctor's i8^ re le-- CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that lhere is a construction lending agency fw the peAwmance of the v.ork for wfiich [his permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Atldress: SignaWre OWNER-BUILDER DECLARA710N5: I hereby affrm that under penalry of perjury that I am ExEMPi FROM THE CONTRACTORS LICENSE LAW for lhe (ollowing reason (Sec. 703t5, Business antl Professions Code: Any ciry or county which requires a permi� to constmct, alter, improve, demolish, or repair any sirucWre, prior to its issuanca, also requires the applicant for such permit to fle a signed statement thal he or she is licensed pursuant ro the provisions ol the Contracrors License Law (Chapter 9(commencing wilh Section 7000) o! Division 3 of the Business and Professions Code) or Ihat he or she is exempt Iherefrom and t�e basis (or the alleged exemp[ion. Any violation of Section 7031.5 by any applicant for a permi� subjects the applicant to a civil penally of not more than five hundred dollars (5500).): ❑ I, as owner of the property, or my employees vrith wages as their sole compensation, WILL DO THE WORK, and the struclure is not inlended or oftered for sale (Sec. 7044, Business and Professions Code: The CoNractors License Law does not apply to an owner of propeny who builds or improves lhereon, and vfio does such vrork himself or herself or through his or her own employees, provided that such improvemen[s are not intentled or offered For sale. If, however, Ihe building or improvement is sold within one year ot completion, the owner-builder will have the burden of provinq that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pmtessions Code:�The contractws License Law dces not apply�to an owner of property who builds or improves thereon, and who contracts for such project with a cont2cta(s) license pursuant [othe Con[ractors License laws.�. ❑ I am exempt under sec. Business and Professions Code for this reason: SignaWre JOS]-A6(9I01) i Owner ID veri(ied by driver's license. ❑ Yes ❑ No Dnver's License No. Expires: VeriScation of Ovmership by (rype of document, i.e. - property tax bill or deetl�: DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certily that no excavation !rve (5) or more teet in tlepth into wfiich a person is required lo tlescend, will be matle in connectbn with aork authorizetl by this permit, antl that no building structure, scaFfdding, falsewnrk, p tlemolition or dismantling thereof, will De more than thirty-soc (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 347, Ttle 8, Califomia Administ2tive Code). ❑ As owner-builder, I will not employ anyone lo do work which would require a permit (rom the Division of Industrial Safety, as noted above, unless such person has a permit t0 do such work from lhe division. AppllcanYs SignaWre Division of IndusVial Sa(ety Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan (or emergency response to release or Ihreatenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time tluring a reported year a quantiry o( hazardous matenals equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic leet of compressed gas at standard temperature and pressure). - 2. Does or will ihe applicant or present or future builtling occupant need ro file a registration (orm for aculely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Sa(ety Code, with some exceptions. requires regislration with the Costa Mesa Fire Depariment by each business which at any one time has on hand a quantity of acutely hazartlous materials equal to or greater than a vreight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standar0 temperaWre and pressure). 3. Does or vnll the applicanl or present or future builtling occupant neetl to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0! the California Health and Safery Cotle pmvides that the Cos[a Mesa Fire Department may require Ihe preparation, certificalion antl (ling with Ihe Fire Departmenl o/ an RMPP by businesses which are requiretl to register acutely hazardous materials with lhe Fire Department. 4. If an RMPP is presently requiretl, has Section 25534 0l the California Health and Safery Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require (or lhe work which is the subject of this application a permit tor such constmction or modifcalion fmm Ihe South Coasl Air �uality Management District or from any other air pollNion control tlislrict or agency? ❑ Ves ❑ No (Section 65850.2 of the Califomia Govemment Code requires Ihal ihe requested information be fumished on applications for rwn-residential building pertnits). 6. Will any part ol Ihe facility to be wnsWcred untler this permit be vrithin 1000 feet (rom t�e outer bountlaries o( a school? ❑ Yes ❑ No Qf'yes", Ihe (acility musl meet the requirement o( Sections 25534 and 42303 of the Cali(omia Health and Safety Code). 7. If a permi[ trom the South Coast Air Qualiry Management Dislrict or olher air polNtion coNrol disMct or aqency is required for the work which is the subject of Ihis application, have all of the disclosures prescribetl by Califomia Health an0 Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Q( yes", allach cetlifcate of compliance trom the appropdate air polWtion control offcer). CERTIFICATE OF COMPLIANCE: I certify that untler penalry of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Oa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penally of perjury that I have read this application and state thal the information given is correct. I agree to comply with all slate laws and city ordinances relating to building construction, and authonze representatives of the Ciry of Costa Mesa to enter upon the above-tlescribetl property for inspection purposes. 1 agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signawr ollega �s� �a�e �'i�� dAMlorAv��arzeE,A001iwm �9ab � � .. , � CITY OF COSTA MESA `�StaMgS BUILDING DIVISION i e 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us y Y� °f FOR INSPECTIONS CALL: (714) 754-5626 '�°"°°°^'�' PERMIT NUMBER: P11-00070 PERMIT TYPE PLUM APN: 41217807 JOB ADDRESS: �345�2�PLU,MERI� A�'� BL� Vicinity: CLOSET ' STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: ISSUED 04/06/2011 RMD SCOPE OF WORK: PLUMBING PERMIT FOR WATER HEATER CHANGE OUT LOCATED IN CLOSET FOR SFD. COMPLIANCE FORMS ATTACHED TO CITY PERMITAND JOB CARD. OWNER: PHONE: APPLICANT: PHONE: KESLER, HARVEY K JACOBY, ERIC 949-453-8500 Add255: 3452 PLUMERIA PL City/State/Zip: COSTA MESA, CA Address: City/State/z2ip: CONTRACTQR: KEMNITZ AC AND HEATING License No. 695$74 Address: 188TECHNOLOGY SUITEC PHONE: 949453-8500 CitylState: IRVINE ZipCode: 92718 . CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: PERMIT FEE: TOTAL FEES: $0.00 $35.80 $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relatetl regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTION$ In order for the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit. LOOE71. INSPEC110NTYPE OATE INTITIpLS CODEN INSPECPONTYPE DATE INTITIALS ifi16 Fixed System Final Fire Prevention 206 Final Mechanical 2 µ � 1266 Pool Spa Final 208 Final Plumbing ��'� �?�� I� 200 Final Re-Roof 210 Final Electrical 201 Final Blq�k/Retaining Wall 212 Final Fire Prevention 202 Final Fattory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 final Demalition 250 Final Building/Occupancy � WORKERS' COMPENSATION DECLARATION: I hereby af(irm under penalty o! perjury one of the following declaretions: ❑ I have and will maintain a ceAifcate of consen[ to selFlnsure for workers' compensation, as provided for by section 3700 0( Ihe Labor Cotle, for the perform of lhe work for which this permit is issued. I have and will main�ain workers' compensation insurance, as required by sectbn 3700 0( the Labor Code, for the perfortnance of the work fo� which this permif is issued. My workers' compensation Insurance carrier and policy number are: /� � /� /� Carrier: N��PI r. � ) �AC / I (��rssx(nnneedirol0e el�im rsvalueDpalorne--hGun�tlreCdoOars(5100)orlessJ Policy Number. K��L� b 6-7 / L� ❑ I ceAify that in the perfortnance of the vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject to Ihe workers' compensation laws of Califomia, and agree that if I should become subject to Ihe vrorkers' compensation provisions of Section 3700 of the labor C�C�, I shall fo hH i comply with these provision . �� Ap0licant'sSgn� u Oa�e WARNING: FAILURE TO CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm lhat I am Iicense0 under pmvisions of Chapter 9(commencing wi�h Section 7000) of Division 3 of [he Business antl Professions Cotle, antl my license is in (ull force and eHect. Lic. # _ i� Class # � Comroc�or'sSJ� na) re o e CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construclion lending agency tor the pedortnance of the v.ork f« which this permit is issued. (Sec. 3097, Civil Code�. Lender's Name: Lender's Atldress: OWNER•BUIIDER DECLARATIONS: I hereby affrm ihat under penalty of perjury tha� I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any city or county which requires a permil to constmcl, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit to file a siqned statement that he or she is licensetl pursuaN to the pmvisions of Ihe COMractors license Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis (or the alleged exemptioa Any violation of Section 7031.5 by any applicant for a permil subjects the applicant ro a civil penalry o( not more than five huntlred tlollars ($500).): ❑ I, as owner of the property, or my employees with vrages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Pro(essions Code: 7he Contracrors License Law does not apply to an owner of property who builtls or improves thereon, antl who does such work himself or herself or lhrough his or her own employees, provided tha[ such impmvements are not intended or offeied for sale. I(, however, the building or improvement is sold within one year of completion, the ownerbuilder will have the burden of proving thal he or she tlid not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro cons[ruct the project (Sea 7044, Business and Professions Code: 7he contrectors License Law does not apply to an owner of property who builds or improves thereon, and wfio contracts for such project with a contractw(s) license pursuant to the Coniractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for [his reason: SignaWre �a�e 3051-46 (3I0�) ' , Owner ID verifed by driver'Slicense. ❑ Yes ❑ No Driver's License No- Eapires: Verifcation of Ownership by pype of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cert'rfy that no excavation frve (5) or more feet in depth into which a person is required to descend, will be made in connection with vrork authonzed by Ihis permit, and that no building sWcture, scaffolding, falsevrork, or demolition or dismantling thereo(, will be mo�e ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Administrative Code). ❑ As owner-builder, I will nol employ anyone ro do work which vrould require a permit from the Division of Industrial Safety, as notetl above, unless such person has a permit to do such work (rom ihe tlivision. Applicanl's SgnaWre Division of.lndus[rial Safety Permit Number _ HAZAROOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or (uture building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Healih and Safety Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fire Department by every business which has al any one time during a reported year a quantity of hazardous materials equal to or greater [han a weight o( 500 pounds, or a volume of 55 qallons, or 200 cubic feet of compressetl gas at siandard IempereWre and pressure). 2. Does or will ihe applicant or present or (uture builtling occupant neetl to file a registration form (or aw�ely hazardous malerials? ❑ Yes ❑ No (Section 25533 of the Cali(omia Health and Safery Code, with some exceptions, requires regisiretion with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic feet o( compressed gas at stantlartl femperaNre and pressure). 3. Does or will the applicant or present or (utwe building occupant need to prepare an RMPP (Risk Management and Prevention Program /or acutely hazardous materials)? ❑ Ves ❑ No (Section 25534 of ihe Califomia Health and Safery Code provides that the Costa Mesa Fire Department may require the preparetion, certifcation and fling with �he Fire Depariment of an RMPP by businesses which are required !o register acutely hazardous materials with the Fire Department. 4. If an RMPP is presenUy required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will �he applicant or present or (uture building occupant require for Ihe vrork which is the subject of this application a permit for such constmction or modifcation from �he South Coast Air Quality Management Dislrict or from any other air polWtion control district or agency? ❑ Yes ❑ No (Sec�ion 658502 of [he Califomia Govemment Code requires �ha[ [he requestetl infortnation be fumishetl on applications tor non-residential building permits). 6. Will any part o( Ihe faciliry to De constructetl under this permit he wilhin 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No Qf'yes", Ihe (acility must meet ihe requirement of Sections 25534 and 42303 ot the Califomia Heal[h antl Safery Code�. 7. I( a permit fmm the South Coasl Air Qualiry Management DisMcl or other air pollution conUol district or aqency is requiretl for the vrork which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. (If'yes", attach certificate of compliance from the appmpriate air polWtion conVol officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalty o( perjury that I have reatl mis application and state that the information given is correct. I agree to comply vnth all state laws and city ordinances relating to builtling construction, and au[horize representatives of the Ciry of Costa Mesa to enter upon the above-described property �or inspection purposes. I agree not to occupy or allow occupancy of any builtling authorized by ihis pertnil until final inspec[ion. Si naWreotLe IOwner�s Dat �Jr�L i i�A Andlor Au�h n tl Appl ca ale PrescriPtivo Certificatc uf kv.��irlenTial filXerntta�rs P:oj�f •cl-]Vtitne: -' /� i/%% 1%� ��---' t-r� �,.�ce: Resid CP-lI2-ALT (Ya�e 1 ui5) Zune d �/ ' �� tl�of_Stui-ies �Si �- Gener.il Inlnrina tio�i . - Site Address: �"�� _� O . L � llate: � 6uildincTypc le Family ❑ ldulti F�unily Circle the Proni Orientatmn: N, P, S, W, tir deerees - Conditioned Ploor Areii (CP'A)�. _�_�� '�41ec� Type�. ❑ Alieratiuns ❑ Envelope O Feoesvution �toof O HVAC Replecement or G>anEe Gut ❑ Duel keplacemenl - �ter Heatei NOTE17'Li�� nnn ia� nn! tn Le u.sed 1nrNe�vli� Constrncled lSuildings orildditions .. . .. - _ Invdnlinu I!alueti Tn� Opuqu� Sw(ace.r (fm�.Fnn'nng nn�e thc �l4ns.s nncl Fazrring S�rtps Cmxsrre�ciiorriable below) .. :. ., �. '.. - �. . Aea�mbi��. Altc� �t�m� . � - . � . . . .. �� .�--" -� �' �O Openinp o1 ii �nShc �c'm7t1 done= ALer ations thn� n�nnlnrs d�e ope��ing a/Ove,framed ccn,itp"o/'o iaali,.ceihnb' or',/lom n�e�sl ti�sudl the "-`�� . . . inandnior��iaimmum n�sidniion i�nld�e pei� §I SO /or tire ahe+'ecl assenvblp; Fill irv Colxu�v�sA-C cmd en�er mwida�or'i� iusul4nrnYvuli�e in Cofunvi H. �' ,- ❑ Replxcemeni of eirtir'�:issembl)'-Replacepien! o/�qn entirerooall; ceiling, w:/loorassc��vb(�� reyuires�the Jnstb]lalion ofComjibi�enl " ' � ' ' ' Pimlenge='L7nsulutioit Jnh�es ii� Tutile ]51=C' . �Fi71 in Golnnnnv /J - li .' : ... � ~ , - " . . ....: � ., ; �.� � , : . _ .. .. �.,, . . .. . . . . . . - � nqOe�Sllt 1eCe I1Cta115 i�ur the twa'ed purtiuned uf IVluss w'alls seeFun�n;.5h�ips CunsCruction T abl'e'belon� -'"��'��- "'"'-"' -' "' - __- _ _.. �>. �: � p .',. .._� . 'li ..:.,.... I . :.r'= ."-h--.-71 ...... .......:J; ..... .. . .];:�.:.. . ., G . .._:��:.� .f7-..:.�_� ri�---` .-: _�;p.�. �---�-- P -.. Tag/ , Ass mbl� Name . ID� . � oi Tyae�.: - . �� . . I, . . , . Noie: For d ,`.-`�" �,.. � . ��Stmd��d Framing Thiclaiess, � Material Spucing, I U � � � - � Values Froin dH4 7'able `� - � - � � " Frame�cl � - � Continuous- J A'4 -.`- ' � 7A4Talile� Caviry ]nsulation AsaembJy � e '�=�Niimbeis:�� -$ value�� = R. Value' `�- Cell Valuea i �. I . -..; .. . ..... ,. ,. .. . ._. . a�ee Page Jd4-3 a�d Egiiarfwr 4-1. use rvpuseu �ssembl� ` � J-fact6r9 � Fmv�ing 6onru'ucliai lable belom ' � 1. For 7'crgqD iivdicale the identiJicaiimi r�ame thal mntehes (he buildingplans. � � �- � ?. Indicnte Ihe Assemblv Nume m� ,ryrye: Roof/Cei(ino, Wolls, Floora�, S1aba, Crawl Space, Dowa and etc...lndicate the Frame rype and Size: Fm� N�aod, Metal, Metd] Buildinga�, Nlass, ervter 2x4, 2zG, or ete... see JA4 for oihw� possible f�ame r��ye assemblies. - _ 3. Entei�'d�e 11eic/mess fm� mass� ire inches m� Spacnvg bet�reen fi�aming membe�a e�arer� 16 "or 29 "OC; ot� Ot7eer fo�� all oUrer assembl�� descrlptio» �_ .. . . . ..::. seich as Concr'ete Sand�xich Pane1, Spandre] Panel, Loga, Straii� Bale Pa�el and eic.... � � "-� -"�� 4. Bna�ec] m� the Clnnote Znne; e��ler Ihe Standarc! 0-jacior fronr Table ]51-D, C m� D for euch d�erei�I assem6lp Name or' t� pe. 5. Gnter the Table n2nnGer tha� r.lose(�� re.xe�nbles� d�e proposed asaembir. (. Lu�er Ihe J7-i�aluc !hn! Lv bemg installed fn 16c �mal1 cnniip m' between U�e {'anaing; oUiertivisc. e��ter "0„ .� � . . 7. Gnier tlie Cm�linaiousl�m�tdntiwi IZ-nnlue,jm� iheproposecl ass'embl��; olher'�visc, ertter''0". 8. Bnier' !]re rorr cnvcl cnlimm nf Ihv U fae�or i�nitie bascd on Colw�vn F TnGle Number and ente+' !he A.+•.xembh� U-fac�m� ua Cotmn�v J - ).77�e I'rnpnsed d.rsentblv U fiicior: Colzmn� J, rmes'� Gc egual lo m' les.v vhan ihe Slnndard U-fac�m' in Cnlumn E tu compl�'. Porring Strips Constnmtio�� Tuble for IViass W alls Onh� -- •� A ]i - C D �, F G Y7 7 .l K L � - M , 1'roposed 7'rupertien of'Mnsunry tm�l Cuncretc Added ]nterior ur Txterim�lnsululinn \�'��Iln� 7�rui» Iteferencc in Tw'ring Sp:ice from kclerencu � Juin1A>>endia7�ab1u4.3.5.A.3.G.9.3.7 3oinlA>>�udix'1�aL1c4.3.73 J VL � j 1 — V u. � L � .0 L.L, r u Asxembly �" � � o� F- F- ° m. ^ �.' _ T��n�l Ivinss Name oi .IH4lti61c � ' ' = E c o � - Q °' �� - ASSelnb�y � � < <: c E � Thicl;ncr.;� Typr' Num6cr I� � V�i = ,� c: .% � t ��` �� t l'-luCtol�.� Comnlenl � I I I � I � � I ! I I -� kegdr+rolimr 1Jennbcr: 17egr.rtra�imr Ua�e/Trme: NERS 1'rnvider: 200� liea'fderztitd Con�pficince For'rt�,t� /�ugu�.s� 7.(7pJ AC }lenting e CertiSicatc o1' Alleralirnas' T1NC EfGciency iUE m' }IS .�sidenti.il • ' � i��SGS_� lluci or Pipi Uistribuiion lusulntion Thermustai CR-1 R-ALT (Pa�e 4 oi'S1 (Central, Spli Pacicaee or H � iJ��Aicn�e Henling 7j��e_(Ce�urol Furnace,-N'ull F'an�nace, Hen/ pwirp, lloiler, Glecn'ic Rea�i�lunce, eic.) ; - - � -.- .-.. , 2. L•lec�ric resis�unec hea�in� i.v �dlmved nn(�� in Compnnenl Puclaigc C, ar czcepi n�here elcclric henling,is seryplemenla( (i.e., iflolal cupncily .. �< Z KN! nr 7;OOOI3iu/!v� elecu�ie hea�ing�is conirolled Ly p�ime-liniiting device.no� exceeding 30 minu�es). See �'I5J(G) i exceptiat: '', - 3. Re(er in the HERS Verifica�ioii.ceciimi ou Pnge 4, o(�hc CFJR-ALT Farm,(nr nddiiianal regz�iremen�s nnd �diecA np��licn6le bozes. ,� � � . . ,9.Jndicnie,��Tj�e orlocaiion (Ducis, Hydrnnic in!'loor', liadiamrs, e�c.) �� ' .,. . . _ . .. . . _HVAC SYSTEMS - COOLING :.. ... . .. . ... .. :. . .... _ . , .,._ ,., :,..,..,,.., ..�.. :; ;., . , _... . ., Minunuin . . . .. .... , _. . . ...._-.r � ... .- . .. _ . - ...,, � . .. ..._ .� . --� . ,..,.,., -� -- —. --� � - _ � "� ' .--'T..:..._ Hfficienc)'��' ' -,. — ---=::='Ductar.Piping:: - .:�....._.. � _..._ _ Configuration� � - - , .. -: - . .. _ .. . . . � __ .._ . _ . _ -' -. -'CciolingEquipmerii" ' ��:(SEbR/EER or . �_' �'�Disti'itwtion �. �::';. : �lnsulntion , .. ;Thermostaf , . , �, (Cent�al,-Splu -- . .. .,.. . -: ,., .: �. : ., _ .- . ; ; ..-. '��-TypeandCnpacity�:z-, �� . ••;: COP,)�� -� �Ty enndLocntion'�� - �R-Vnlue� � � --Ty e �� S ace;Packageo�Hydroriic) , . - _ . . ��;. � . � . - - --- - �:� .- . - �' . .. . � 1: Indicaie Coolang Tppe (A/C Hea� puinp; Eiap CoBling•�etc). ... -: � . -. ... � � . - — � �•. • --�_ ..- � . . � . - � 2. Re(er �o` Nie HE25' I�eriJicutron section�oii�Page 4 oJ/he CF-/P-ALTFornr for pdditioiip� reqamemerets aud chech 6yplica6le LoAes. � �� 3. hidicn�e Type or Locntimi (Duc�s, Hvdrmiic in Rloor, Radiamrs, etcJ �. � � � ' ' � � � � � � . . . � , . . . . - . . . . . . . � -- � l�'ATER H�ATING 'lisl rvtuer' henter's and boilers' for bolh domeslic hol waler (DHN')�heaters and hydronic space heatiig. lndividaal dme/ling �DHN' heaters nars7 t Igas orpropmie.fired, and ma1� nol esceed 50 gQllavs. Hol water pipe insiddtim� fr'om !he DFIGJ' heater to Oie hilchen(sJ and on all z�ndergrow�d � hnt walm� niues is renuired in all emm�mien! naclmees in nll climate znnes. - Vdater Heater Type/Fuel Disiributiou Type T...�..I . /C'r....l.....1 ➢o,.:.rid.,� Extemal Tank' Number ln 7nnL � Energy Factor or . Insulation Svstem Capacit�� (gal) Thermal Efficiency R-Value3 1 �-/n . s`�� / Z l. Lidicuie 7jye (Slornge Gast Heai Pump, Jnxianiuneaua', eic J .. . 2.Iiecirctdttling.�;Vslenta'.eerving nrtdliple dive!ling imils shnll meer Ihe recirculalion rey��irernenra o(§I50(n). The _Yre.xcrip�ivc-reyuiremerns do' »ol idlom tivc insTn[In�ian qfn reeirciduliiv�; rnuler bea�ing s.vs/eni �ar single divelling m�its. _ . �/ �TI e es(ernal ��,��er hemin7: mnlc and pipes .��hnll Lc insiJaierl �o n:ee� Ihe reqiiiremem.r nf .b750(j). . . - . . . .. sl'�CIAL f�ATUT��',S The en(orcemeru ngenc�� should pn1� a/�eciuLcmeivtion io (hc Sj�eciol Feo�urea� speci/ied in this checldisl LeloN�. Tl�ese ile+na' nvnl' requirc wrillen It�.�'lilicalimi and dncuuienlalinn cmd a�pecial i�er NCN' kOOr ASSGMISLY -Itudianf Il�u�rier The ridinm 6.in ier requiremem o1' G I 51(112 doex nm tipph' tu roof aller�tions. Sl:ib lidgc (PL'1'lillClL'1'� IIItiIIlaliun ❑ )'l5 ❑ NO )'L5: ln Climnte "Lune 1 G in Coinpuncni Ptickeges D, Il-7 inxulation is required. Hcnted Slab insnl:ition O 1'LS ❑ NO 1'L�S: Slnb edEc insulatinn rcquired for till he;iled sl�ibx iu all Cliinnlc Lones. See: details In Tablc 11f;-A of ihe st;mdards. RaisedSlnbinsulntlmi ❑Y�S ❑NO . Y�S: ]n Climale Zones I, 2, I I. 13, 14 & 1 G, It-8 insnlation is requircd: in Cliina�e'Lones 1'l & 15, Id-4 is required undei 'I'hcrm:d M:�ss � l'o nbuiin Compllance Credil fnr the install�tion of lhermul mass, use thc Perform�mce Ifegi.rn�n�ion lJumLer: 7fegia'U�ulinn Lule/7'iivie: _ 200b' Re.sidential Cbmplicmce T'orms HLIiS Prm�ider: ll. fiz�gcts'! 2GOJ , . I PrexcripLive Cta�t'iticate ui' Cumpli�uir.e: Residenti.il CF-] R-ALT liesidcnila! A[terali�ms� � (Yx��e 5 01' S) YrojecrlVn�r�e: I �+� I C7imate�'Lonct/ / I tl1n1'Si�rica . . �-l' L �� i S'—C /� lll 2- HEI:S V�RIIP7CATI01� SUMMAR]' The en(w'cemen� ngenei� should pq�� special nbcntimr �n Ihe HEItS Mem•urea speci/ied iir diis checklr.e� Lefmr. d ca�rpfered nied a'igixd CF-417 Fnnr+ jor n/I �br weastu'e.r e�pecijied.rhnU 6e subnoilled �a the Giiildiirg ins��ector Lefore- Jinal D�C{ SL'alitle & J�L'Stillb I�IL2Sneri/icn�inn is required/orlhis mensure. " ❑ YLS ❑ NO 1'�+5: ln Climntc Zones Z mul )-1 Q if more than 4D linenr feei of new or replaicemen� ducts �ve installed in unconditioned spnce, thc chic�s are to he sealed per § 152(b)IDii ;md Ihe newly inst�dicd ducts m'e w bc insultued per § I51(1) IU. , '.❑ lXCLI''190�: Lxisling ducl sYstonu th:d nrc ezteudeA; which :u'e cuustructed, insnluted or scaled �vilh :is6cslus. . ❑ Y�$ ❑.NO 1'LS: In Climatc `Lones 2 nnd 9-I G, if lhe exis�ing space-cqnditioning syslem (FIVAC equipmenl �nd ducting) is replaced, the • ducts arc �o be sealed per §152(b)IDi. . � � - , ❑ Y�S ❑ NO 1'Ls: In Climate Zones 2 and 9-I G, if the exisung HVAC equipmeni is repluced (iucludiug ihe replacement of' ihc air handler, - � . . outdoor condensing wiii oTsi splil system, cooling or henting coil, or the furnace lieni exchauger) the ducts are tn hc ..-.,.�.�: ... _... ..`sealed.per.§152(b)lL.,... ._. . . ... ._. ,.., . . . . ..,,... _.,. .. . .,.. .. . .... . . � . .❑�7:CL'1'7'IUN: Uuct systems tli i( ovc d�iuiinenled tu li �vc 6eeii pr�viimsly sesiled cunfirmed thrimgh tIL'IZS .�.... . . �- verifiailinn in :�ecurdunce with prucedw�es iir tlie Reference I2esidentinl Appendia lLA3�. � ... ... ... ,., ...... ....:.: ._-..-.. .p-�aCEP7'JUN:`IJ6cf zytilems with less fh�n 401inear feePin'unemiditiqned spxce. . . - -❑� ISCliP'PIpN: lzisliirv'duct srslems'constcucled, insul:LLed-or tuded��wikh�asLeslos. �-� ...:..-. �H°fi'IdL'7'�tlt C�I.IPeE'�=�5 Lf�S �S1EIA -tlERSveriJicmiai:isrertiiredfai�lhi.smeuswro: .... �..-. . . . .. " .. . ` . � P ) . / . ,_ . "'.. -. � .. . . .. ..3:.-..}.,,. .�'.. . i ❑]'iS ❑ NO YCS: In Climate Zones 2 und 5-15, when the exis[ing HVAC equipment is replaced(iiicluding t(7e,replacement of the�uir� �. . 7�andler; outdoor condensing uni! ofa split�system A/C a� heat pump, cooling or lienting coil, or tlte fumxce heat ,` ' �• ....... _.... . ,.. , . ; ..� �. .� . � . • � .. � exr.heneerl a re4}iverant charee mensurement shall be verifled oer �152(h11C � � � ��. � Central Tan Inieer�ted'(CFI} Venfilafion Spstem and I+un l�'atf Dran� ' ' ' ` ` "' ' ' : ` " ' � The�vrntilation requirements of ( I50(o) do not applv tn existine residential homes. �� ` �� Ducted Split SYstems - Air Conditioners uud Heal 7'umps: Airllow HLRS rerifcarion is reguired (or rhis measure. � -❑ Y�S ❑ NO YL+S: In Climnte Zones 10 lhrough I5, when the existing space-conditioning system (HVAC equipmenl and ducting) is � � renlaced, the ai�flow and fan watt drzw shall be veri5ed oer § I S2(b)ICi �o meet the requirements of &l51(1175_ 1I Address: I l Date: II'Applicai�le ❑ 'EA or (Cenificmion N): � � �_ � � � � �n�,��' �S'3 kS�v � `�F ltespuusible ]iuilding Desi�ner'ti Decla�'utiun Statciuent �<---1-t7m eligiblc under Division 3 of thc Cnliforniu Dusiness rmcl Professions Codc to aecepl responsibility for lh� building design idenlil'ied on- lhis CcrlificaLc uf Complinncc. � ' �� • I ceriify th.ii tlic eneryl' fcUures auel perfarm�meu speciGcations for the buildiug design identiGed ou this Cerliflcute nf Cmnpliance cunf'a-m �u lhe rcquircmenls ol�Tillc 24, Pm'Is 1 xnd 6 of tl�e Culifornia Codr. of Regulations. 'fhe building denign i�eaturuu iduntifiud on Ihis Certificn�c of Ci�mpJi�inee �ire consis�em wil6 lbe intormfuiun pr��vidul tn dueumem tliin bullding dosign on lhc olhcr appllcahic cumpliunuc formn, worl<shcot:;, ciJculu�ions, pl�ns und speciLca�iuna subniluod �u thu cnfurccmcnt ,iucncv 1'a�amanval wilb tliis buildinu ncnnil aunlicn�inn. Name. Company: Address: Ciry/Stntd"Lip: Signat�irc'. I'OI'l6Y.5'l.4Y(IItLC IA'!/1!L'SIIOl15'!'L'�lli'((!/i� the Enerb i' S[mrdm•d.s, cmrtacr 1/rc Lnerd i' fln/fiue ttC 1-80(1-772-i.40(f. Itegi.sinuiou NwnLer: /fegi.�vnnion Uaie/finac: 200b' lteaidenrinl Comp(iunce Fonns blLltl' I'rrmidcr: Aa�gus130/)J IVf xn �l�t(: Resideiitial 1`v�e�su�-es Starrnen Lntiircemenl Agm�c1': J��F-1�2 (i'ii�r ] 01'3) 71 a Lc: NOTE: Low-rise res•idemin! Guilding.r sut�ject tn the Sim�dcn�ds mvsl comp(t� witli n(1 npplicuble mnndutorp mensares lisicd, regurdless of 1he canplicume approudi v.�ed. More sirir7genr ener�� measures' lisled ai die Cei7ificu�e o%Compliance (CRIR, CF-IN-�fUlJ, nr CI'-IR-/�L% T'Ol'Ip� .l'I1L/N 5'!l�)L'YSL'LIL IIIL' /ICtl]S' O1G1'I(L'CI1VilIi GI] CLSICI'LSI; ("J be(ooi�. This 4lundu�a-1' Mcus�n e.r Summnrp a•holl Le incoi��m�n�ed imo the permi� documems nnd O�e upplicable fenlures shn/I Le cm�sitlered f�p oll purlies as minimxun C0177/J011C)1/�iL'l.f(Jl'p7LItlCC 1))L'ClJICCIIIOA.S' Whether lhep cu�c s•hown elsewhere in !he documenls a� indhi.+• .rummar��. Submi! ull. cWplicohle seclion.v nf rhe A9F-I li 6orm ri�ilh nlurts. . . Ti�scrsl��rie�N . .. .. . . ... . . . _ 9iuildin;,� �nvclupe Mcsisures: :§IJC(tQl: Dooctiandwindnws'he� ��.� 1 �I G( �i)4'Peneutalipn: pi iiduclti,(e 7:--.:Exlerior and tured tn liinii air leal<tige . .. . ...... . . .. . .. . . . �.eniGed U-Pactof �cenified Solar Hcni GaiEi Gaefficien� ' ;. . . , . .,.... .... :.. . � .. ... . ... .... . .. . � ,dkedund se�led .. ............. ..._........_. . ___. __.. .. . , � : . . .. � . ._ . . ._. , . ,. . . � �----- � .. . ... .. �fl'8(al'�' Insulnuo�i"sj�ecified or. msialled�meet.s' S�andards foPLisiilatiug Maiennl 'Indicnte type and-include.ou.CF; 6R �'oim.:� ... !§I-18(i): �The thermul�ertiitianee�and solar reflectance-values of the-cool roofing materi�l meeis the requirements ot'.,��' 11',8(I) when�the mstallaGa�i oi , - . . - .. .,. .- . . . • ,. . . . .:: � ..- . ..... � � � -a Conl Roof�.is s �ecifed on Ihe�CF-]R�Fonn - �.._ � �� - ' - . . . . .... - -;;, � . . . ., - . . .. ._ - .. ._ . . _.- _. . . . , _ . .. ... . . �"§I50(n};� Minimun� R-19�insulauon in rvond-frame'ceiling or equiLalent U-factor. '� ��` � �� ..�, �-.�... .. � ..... . ........... . ,. :.. §150(b): LoosefilLinsulationsliallconfortliwitlimanufacturer's�iiistalled`desi@nlabeledRValue �, ' � - �� - �§150(c): MinimumR-i3�insulationinwood-framewallorequivalentU-factor. � �� - � � � . *§I50(d): Minimum R-13 insulatioain raised wood-irame flom� or equivalent U-fnctor. �-- � . §15U(�: Air retarding wrap is tested, labeled, und instnlled according [o ASTM EI G77-')5(20DD) when speciGed ou the CF-1R Fomi. §15U(g): Mandatop� Vapor bnrrier installed in Climate Zones 14 oi� I G. � _ §150(I): W ater nbsorption rate for slab edge insulation material alone without facings is no greata� than 0.3%; water vapor yermeance rnte is uu � Freater than 2.0 permlinch and shall �be protecied from uhysical dama�e nnd UV li�hi deterioration. I'ireplaces, Pecorntive Gas Appliances and Gas Lo; Measures: �- . � . §150(e)IA: Masonry or factory-built fireplaces have a cbsable metnl or glass door covering q�e entire oj�ening of the firebox. -� � §150(e)IB: M�sonp� or Sectory�-built fu�eplaces have n combustion outside s�ir intalce, which is ai least six squnre inches in ama and is equipped with a with a readih� accessible, o er�ble, and ti hl-fittin � damper and or n combuslion-air convol device. § I SOIc)2: Continuous burning piloi lightx nnd the use of indonr air 1'or cuoling n fu'ebor. Illcket, when that indoor air is ��ented ln the outside of the buildin{;, nrc proliibited. � Suucc Cnuditiouiu�;'VJatcr Hc;�tiu{; aud Plumbiu� Svstem Ncas�u�es: . �� - . 10-§1 ] 3: HVAC equipnienl, waier he�ters, showerheuds, taucets and all olher re�;td�ued ;ipplianees are certiGed by [he Lnergy Conuriission. 13(c)Si Water he�uing rccirculatimi Inop:; serving multiple dwelling units and High-Rise residenti�l occupencies meei the air releane valve, 6ad<Ilow pievention �pmnp isat�tion vatve nnd recircuh�ion Inop connemiou requirements nf'§113(e)5. 15t Cuntlnuously burningpilol Ilgllls xre prohibitocli'oruauu�al gus�. lim-type cunu.il furuncen, household coulcing �ippliances (applinnces ��ith uu electric�d nuppll' vulixµe cnnnuclinn with piloi IiFh�a ihm cousumc less th�in I50 Uw/hr �u'c exempt), uncl pool �ind sp;i heaters. I SO(h): l�Jeniing smdlor cnoliug loads are calculatcd in �iccordance with ASlilt�l, SMACNA oi ACCA. 1:�1)(iJ�. l�lesiting sVstems are uquipped �vilh lhennus��us iha� meei lhc xel6�icl; rcquirements nf Seclinu I 12(c). I i0('�)I A�. Siurxge gas wuter haiters rued wilh un Lncr6P P�iclor no grcaler lhau ihe federul minimal stand;u'd are exlernulll' ��r�pped with /' insulution having nn ins�alled thermt�l resistancc o('R-12 or �rc�rier. ISOUJ)B: Ull�ll'L'[) SlO�ily'C Ii111IS3� SIICI] flti SLUI'i1�C 1811L'S OI' Il'JCI(LI�) Li111I:ti IOf ti0Ii11' \4i1lCf-I1CilLllly S1B1C111� or olher indircci hoi �rater tanlc;: havc H-12 cx�erual insulatiou or IlJ 6 internxl insula�ion wherc thc iniernui insulaiion R-valuc is indicated on thc exieriur of lhe �unl:. � I50(I)2: Pitsl 5 feel of hol �ind cold w�uer p�pes closesi to waier heuter tanL, nun-recircultiung systcins, and cn4rc leugth of recu�culxung sectiuns of hoi wa�er pipes ;ire insulate[I per Standards Tablc ] 50-f3. § I SUQ)2: Cnaling sys�em piping {suction, ehilled water, or brine lines),uncl piping insulumd bel�veen he�ling suw�ec and indireci hoi water tnnlc sliall bc insul;ued tu'Liblc 1 SO-B and �c im�icm I50-A. lj I SU(�)2t Plpe Insulelion 1'ur sleam hydrunic heutiug sys�cros or hoi waiier sys�ems'� 1; p;;i, meets thc requirements of S�nndard:; Tablc IZ?-H. � I SU(I)3A: Inxulation is prolecteA (i'om dNl➢L�.C, II1CIl1(IIII� lI1Jl (IIIC lll tiL111I16I11, muix�ure, equipmeni maimentmec, �md wlnd. §I511(I)3A: insidniiun fm� chilleJ water piping aucl reffigeranl suclion li»es includcti n v�ipur retardam or is euclosccl entirclp in condi�ioned space. 30087ie.rideiviul Complimvice (brma� �t�giesi 200.% � CITY OF COSTA MESA ��o�`""'F., BY/I,DIN� DIVISION =�� 7 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us � FOR INSPECTIONS CALL: (714) 754-5626 �°°^�°"° PERMIT NUMBER: M11-00050 PERMIT TYPE MECH STATUS: ISSUED APN: 41217807 DATE ISSUED: 03/31/2011 ISSUED BY: KJB ...�+`C�XnG"Y!T^'�'P�"T�/�n JOB ADDRESS: 34'S2=P-LUMERIA'.P_L`:GM� Suite/Unit: vicinity: SQ. FT: 0 SCOPE OF WORK: CHANGE OUT A/C UNIT, 1 FURNACE CHANGE OUT TO 110K BTU, 14 DUCTS, 1 COIL. OWNER: KESLER, HARVEY K Address: 3452 PLUMERIA PL Unit: PHONE: City/State/Zip: COSTA MESA, CA APPLICANT: ZAMORA, CARLOS Address: 188 TECHNOLOGY Unit:SUITE C PHONE: 949A53-8500 City/State/zZip: IRVINE � CONTRACTOR: KEMNITZ AC AND HEATING Address: 188 TECHNOLOGYUnit SUITE C City/State: IRVINE ZipCode: 92718 MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $70.10 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $70.10 License No. 695874 PHONE: 949-453-8500 CEIL: NOTICE: The work authorized by this permit shall comply vnlh all applicable handicap access requiremenls under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) �EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all required inspectiqns and final approval must be oblained. Failure to obtain inspeclions and fnal approval will result in the expiration of this permit. COOE R. INSPECiIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Fin�l 200 Final Re-Roo( 201 Final8locWR¢(aining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DaTE IN1111AL5 LOOE� INSPECTIONttPE 206 Final Mechanical 20B Final Plumhing 210 Final Electrical 212 Final Fire PrevenliOn 220 Final Planning Approval 222 Final Site 250 Final6uilding�Occupancy a DATE INiIilALS )� ji-1.3-11 �� WORKERS' COMPENSA710N DECLARATION: I hereby atfrm under penalty of perjury one o( the follovring declaretions: ❑ I haVe dntl vrill mainldin a certificate Of consent IO 5elf-InSure for workefs' compensation, as provided tor by section 3700 of Ihe Labor Cotle, for the pedormance of the work (or which this permit is issued. � I have antl will maintain workers' compensation insurance, as required by section 3700 of Ihe Labor Cotle, for Ihe peAormance of the vrork for which this permit is issued. My workers' compensation Insurance carrier and policy number are: �Carrier-- A � � ( (A ✓l CP (This sec(.on need no( be mmdefed Athe pemrrt is val�etl at one M1�ndretl �ollars (5100) oi less ) �Pdicy�Number. 2 � � �i O � � � O (O � CO � ❑ I certify that in the pedormance of Ihe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the wo�kers' compensa�ion laws ol Calilornia, and agree �hat i/ I should become subject m I�.vroAcers`compensation provisions of Seclion 3700 0l the Labor Code, I hall forthvrith comply with these prov7isions. /'3�" �! �' li�'an17�5ignilure �ab+1,. WARNING: FAILUR CURE WORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm �hat I am licensed under provisions of Chapter 9(commencing vnth Section 7000) of Division 3 0! Ihe Business and Professions Code, antl my license Ji �in full force and eftect. �—_ CIl � . Wss'#�. i�Z'l� 3-3/• // � nxan s nawre �' CONSTRUCTION LENDING AGENCV: ❑ I hereby affum that there is a constructbn lending agency fw the perfortnance o( the v.ork for wfiich this pertnit is ssued. (Sec. 3097, Civil Cotle�. Lender's Name: Lender's Address: SignaWre Oate OWNER-BUILDER DECLARATIONS: I hereby aHirm that under penalty ol perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or lhe following reason (Sec. 7031.5. Business antl Professions Code: Any cily or county which requires a pertnit to cdnstrucl, alter, improve, demolish, or repair any stmcture, pnor to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to Ihe provisions of the Contracrors License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code) or that he or she is exempl therefrom an0 the basis for lhe alleged exemption. Any violation of Seclion 7051.5 by any applican� (or a permit subjec[s the applicant to a civil penalty o( not more �han five hundred tlollars ($500).): ❑ I, as ovmer of the property, or my employees vnth vlages as their sole compensation, WILL DO THE WORK, and the struc[ure is not intende0 or offered for sale (Sec. 7044, Business antl Professions Cotle: The Contractors License Law does not apply to an owner of property who builds or improves thereon, antl who does such work himsel( or herself or thmugh his or her ovm employees, provided ihat such improvements are not intentlea or oHered tor sale. II, however, the building or improvement is sold within one year of completion, the owneo-builder will have the burtlen of proving that he or she did not build or impmve for purpose o( sale.). ❑ I, as owner of Ihe property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to consWct the project (Sec. 7044, Business antl Professions Code: The contractors License Law dces not appy to an ovmer of property who builds or improves thereon, and who contracts for such project vnth a contracta(s) license pursuant tothe Contractas License Lavrs.). � I am exempt under sec. Business antl Pro(essions Code !or this reason: ]057-46�]I07) � Owner ID venfied by driver's license. ❑ Yes ❑ No Dnver's License No. Expires: Verificalbn of Ownership by pype ot tlocument, i.e. - property tax bill or deed�: DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certify that no excavation frve (5) or more feet in depth into which a person is requiretl to descend, will be made in connection with v.nrk authorized by this pertnit, and that no building structure, scaftolding, (alsework, p demolition or dismanUing thereof, will be more than thirty-sia (36) fee[ high. (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, Califomia Administ2tive Code). ❑ As owner-builder, I will not employ anyone to do work which vrould require a permit from the Division o( Intlustrial Salety, as noted above, unless such person has a permit to do such work from I�e tlivision. Applitanfs SignaWre Da�e Division of IndusMal Satety Permit Number _ MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicaN or present or future building occupant neetl to fle and ceAify a Business Plan !or emergency response to release or threatenetl release oi a hazardous matenal? ❑ Yes ❑ No (Section 25505 ot [he Califomia Health and Safery Cotle requires, with some exceptions, that a Business Plan be filetl wilh the Costa Mesa Fire Departmenl by every business which has at any one time tluring a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl temperature and pressure). 2. Does or will Ihe applicant or present or (uture building occupant need to file a regisVation form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Heal[h antl Safety Cotle, with some ezceptions, requires registration with the Costa Mesa Fire Department hy each business which at any one time has on hand a quaniity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard temperature and pressure). 3. Does or will the applicant or present or future builtling occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardoUS materials)? ❑ Ye5 ❑ No (Section 25534 of the California Health and Safety Cotle provides Ihat the Costa Mesa Fire Depanment may require Ihe preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to regi5ter aCutely haZartlous materials vnlh the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Heal�h and Safe�y Code been fully complied with7 ❑ Yes ❑ No 5. Does or will the appliwnt or present or future building occupant require for the vrork which is the subject of this application a permit for such construction or motlifcation from Ihe SoWh Coast Air Quality Management Districi or irom any other air polWtion control district or agency? ❑ Yes ❑ No (Section 658502 0! the Califomia Govemment Code requires that Ihe requested information be fumished on applications fa rao-residential building pertnits). 6. Will any part o! the facility to be construc[ed under this pertnit be within 1000 feet from the outer bountlaries of a school? ❑ Ves ❑ No Q( "yes", the faciliry must meet the requirement o( Sections 25534 and 42303 of the Califomia Healih and Safe[y Cotle). 7. If a permit from the South Coast Air Qualiry Management District or other air polWtion coniml district or agency is required for the vrork which is the subject of this applicalion, have all oF the disclosures prescribed by California Health and Sa/ety Code Section 42303 been made7 ❑ Yes ❑ No 8. (If yes", atlach certificate of compliance from the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that untler penalry of perjury the information given above is correcl. I agree lo comply with all state laws and city ordinances regarding Hazartlous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AU7HORIZATION OF ENTRV: I certify untler penalty of perjury that I have read lhis application and state that the information given is correcl I agree to comply wilh all state lavrs and city ordinances relating to building constrnction, and authorize representatives o( ihe City of Costa Mesa to enter upon the above-described property tor inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this p 't until final inspection. Signa re ol Lega eqs) Date � 3/-/! Analor ppieE Appl¢anl Date Simplif'icd 7'rexcriptivr Ccrtific:: "Co�npli:�ucc: 21lUSIZen•ide�itird771 dCAli,. ,�iu�rs CF-7.it-Als7�-II�'AC Clinmlc'l,unus 7 aud 3- 7 f . ' linlorcmucur � V� � � U� Uurc: /'ernur t!: 3 3i�// Equipmem TV �^. � Lisi 1�41nimum Efitcicnc�% � Fforn Amn � rennimmen! 'I'hennuslal ❑ 1'�icl:n}cii {it�i� � Gvcr4U iy�(duc �� rre��,«•. druLt��% ocor .�u,:��i: � }� �? Served bp system .idded /reof�u. l m L:YindoorCail LdSGCR_[� OHSPF_ % � (//iminlrentirjn'csenl.muslhc �SO!% cG mc uditio�e?'Spnce CJ�ondensing Unii Q EER _ O Itesisuince �, R G(C`L /. ;-5) 'nnn(Ind) . . . ❑ Ulhu /. Lyuipment 9')'Pc: GYioose Ihe cquipme�i� being mstrilied; if mnrc thmi unc �-; tcm, use uuuther CF-112-AL'1'.t1VAC Sor.cacli.aVstem . . ._ .. . . , . . .. 2. Minimum II.qnipmm�t L'Tficienciest 13 SEEK, 9Y':L Ai�UF..7.7fiSPi� for.typical reaidenfinl sl'slem�. .. . .� .. _: .. Guntr:ictm' (I)uciunencaiiun AutLur''s /Itesponsiblr.11esi�uer's' 3)ecinratiou Squemunt) . _. � • 1 cenify ihal this CeruLcam o�Compliance documenm�ion is accuraie and complete. �- �� . .. � • 1 am eiigible wider Division 1 of ihe CaiiFomin Businesc and Ymfessiuns Cocie to accepi responsibiliq� tor ihe d�sibm idemiiied on ti�is . . CeniScate of Cmnpliance.. • . � .� . � •! cenity th, t tlic enerb�' features and performance speciiicationr, [or lhe: desi�,m i[lentificd on thi.^, GertiGcnteoLCompii:mce conCom� io �hi�. . � ; requiremr.nls o(Title 24, ]'ar4: I And 6 o(�he Cfilifornir� Code of 14cgula�imtG. � ' �. , - � • Tiie design feamres identified on this CertiLcam o(Compliance ure consisteni with tiie info tim documemed on other applicable � � ,. compliance forms; workshce¢, calculatiaie,,pl:ms and speci0ca�ions suomitted to thc enior menl a� p iorapproval witL the permii . . ....-. -.-_. n�oiication. .. . . . . . ...... . . . . . ... .._.. _. Namc: . ('�✓�0 2�(yvcU✓`i . I Si�mamrc: Com en •� � - - � � � � La�e� � P.>,. . . . .. ..... _. . _. _.. ... ,� -3�3,-zoy. P�� -.. -... tidd�.s_ �g 8 T � � L;�e„5.:� qs �� oro � . Cirv/5cai�ip: Tr�iiv�. .�/� a Zeo ! 9, I Piione: C'1 • RSOD �l1(Jii I(&SlGC11GGI C0111f)IiGACB FOI'q1.S I1�Gl'CII �OIO ENF'CJIIC�ML'TJT �1 GL•'N.Cd' CM��GUS'l uAUZE i�T�ITH L-'�77'ERIIEfi7J/SL'x1LJ 2011£; P,uifding �ner,�,y Ef.'fiiciency Stxudards €2esidentifil H1�AC Alteratione Cfimxt:e Zoues 7 and 3 thrmigh 7 �z-(� � �osr�,��s� RC7SiN�SS ANll ^ROP'LSSTONS C(1DE. S�C"190N 71](V . �� . Willt"ul or deiii�erate disregnrd and violation of'thr. huilding laws, including �lie Calif'ornia Eiuilding Codc, and local pennil requirements cons[ilutes a eause. for disciplinarp action fiom �he Contractors State License Board worldng in conjunclion wi�h Ihe local building departmenL This action may consisi of finec up to S:S,p00 per �� violation or suspension/rvwcaiio�i of a contractor's license. � - ' � � . WI:I��' IS A P�RMI7' I.linUI]t.GU', . . . '. . .. . . . . � . . ' A written construction permit shall be obtainul from the: en(orcemen� a�ency prior to thr, erection, conxtructioii, .� . .. � .. ...... . .. . . , . . .. ... . . .. . .. , .. .. - ,. , � reconstrucliou,.mstallation, relocauott, or alterauon of �my mechanic�l �ystem; except as p�rmitted �in Appendia ' . - � ' .. -.�Chupter 1, Section I t2 � of Ihe 2007 Cnlifomia Mechanical Cbde. Projects requiring permits iuclude, bu�'are not �-'- �� ' ' limited tn: - . . • New FNAC installation • .� ' � , � . . FIVA'GChnngeout -. .... . � . . ' � . � ,.�. �,"..: ..;..,. . , . . . . . . . , keplacomem of furnaee, ctiil, PAU, or concleuter . . .. � � � ' . . . � � - . . ' .. � ' .• 12elocation o(an,existing 3-NAC iinit . ' , . . . � . "-- - —__.._ .. .. .. � ..._..... . . . ... . . . _..__._ _ ._ - .. . - .: - - --- - ' �- - -� _._ . - . .. . . • Addino oi replacine� more than 40fi ducting in uncondiiioned soacr. . - . ' y ' . .. . . . .. . _ . . . . � . . .. _ . ._ 21111R RUILDING•�NCItG�' �T'rICI�NC]' STAPIIiA1,7TS.(Title 24, Parr GYI2�OiTII:�IV�NTS II�GLiJDE• = `�- �-. � -� -. -- . -. .�... ,. „. - 1. Hcating equipment mus� have.a�minimum 7R°/� APUE (Ezception: Wall�ti floor fumaces; room'heaters).� � �- � ' • • ' ' � � ' ' � .,..: ., _ . ._, , � � � � �_'. - Central air..conditioners � heat pumps)ess thau 65,000 Rtu/ni� must h�ive a aunimum 13 S�ER: ' ' ` � � �'� �"`� �� - � � - � - � �]J 1�' tlled eh ddut• t' v�.. ' 1 - I fR4� .,. ew � ms a or � u ace c s mus nu ., a mm�mum msu auon va ue o -._. 4.� A setbacl: type thermostat (24 iv� clucl: with iour set points) is required ior all alterations. -� . 5. New or repiacement duots must mee; the mandatory reauirements of Section li0(mj: � '�. � �• All joints and openings in ihe in the. HVAC system must be sealed, �� • Only UL 1 S1, UL 1&lA, or UL 1 R lA approved tapes, or mastic shall be used to seal ducf openings. � �• C�nneetions ot meeals ducts ¢nd the innec core of flex duets shall b� meci}anically iasieried. Fl�r, duets must be comiected using a metal sleevJcoupling. ' • rlax ducts that are susoended must be supponed every 4ft. mar. for iiorizoncal runs with no more fnan 2" of sag be[ween supnorts and G fi. ma>: ior venical runs. G. The Cr-6R-NIISCEI-114 mus� be completed and signed by thc installing contractor. The lnspector will collect thi, form and verif�� thai toe model numUers are the same as the installed equioment. � f �.Q Gp�l!(2 �n e�� S-{ a� /f � L V h I� ° , es'rs-�i��, f oc�.-�ro� , L� �- �'� �— � �K e� a�u<� o� �u,��, 3a� � ( ��Z' �I U Wtpvl A, �( G((� -! 5 •?• iJ• �� P�A��t�G �PPROVAL City of Costa Mesa Planning Div. Subject to Building Division Regs. A�n � Revision must be approved. Required Prior to Buildinq Final ❑YES I�� Zoning Inspection OYES L�1N0 Traffic/ Park Fees BY —.�L� Date� Q�. �2�Min,-� �li� Co�di+co�iny ��d ��«y. cs�� s 8� (a�+i 4S3 - es o0 s' G� ALLOW TO PROCEED WITH PLAN CHECK THIS DOES NOT CON9TITUTE NqLPIANNINOAPPHOVAL YGMP: �jq �Non�PtbrNy �Ptlorft, CITY �r COSTA MESA REQliEST FDR OCCUP� .�Y TRP.C'£ N0. � � � � DATE � ( �' ��7� �� The developer of the above eatitled tract desires to sell che above set forth lot prior to the iime thzt t'n.e tract has been completed aad its streets accepted by the City of Costa Mesa. The undersigned, by executing tnis ag:eement, acknowledges that (he-she-they) l,�,t. (was or were)�_A�civised that tnis t-.act has not been given final ir.spection nor has it been accepted by the City of Costa Mesa as having co:�:plied with the conditions of approval which were imposed by the City at tne time the final tract map c:as 2p�roved. The City assw:.es no liaoil_ty £or the enforcer,.ent of the conditio.^.s necessary- for epproval ot'r.er tnar. those con3itior.s protected by surety boad. The un3ersigned a&rees =o ir.der..nify ar.d hoid the City haz;�less from 2x+y c1a�-� resulting in da:.age or personal injury te the undersigned by reason of the afore„entioned uncomoleted con3it�on. REC_E4VED CIiY OF COSTA MESA PLPNNINt; OF.PT. � � p 2 ; ;97:s J:i A� A� �'i$��t&�-:4« i�tl;.$'..«3o�So5i�$ � BY � a �_. � iC O �!'i � Purchaser �, -� � / BY /� ��-( c"�::._ �' �/zl�% .�.-:=l�S<"��< Developer and/or autnorized represer.ta�ive sY ri :L�i�, ,l%�-,T�; Lender 2�' � _`�"� q"��. Twiniaq Laboratories of =Sou�E�,= c�a��fo�ta, �,�. ��"� , °ti 73�0 aimorc way / btaiiinq AaCress F.p. Bo+ a� / Long Beacrt Ca 9000� / 2� 31 �26-3355 / Rt316364386 / ptn� 82B�6a72 TESTING BPANCMOFfICE' �Sia�Orvpr�n5usan$IfPdl / Snn�a.lna.CA92]OJ � 1��415��-ZE��$ October 13, 1988 Examination: SC88-9433 COMPRESSION TESTS ON GUNITE CYLINDERS Willard Gannaway 1031 Laguna Street Anaheim, California 92801 PROJECT SWI�NG POOL aDDRESS 3452 lumeria, Costa :�fesa ARCHITECT CONTqq�TOR - - Blue Haven Pools ENGINEER SUBCONTRACTOR B.C. Adams Arco GuniCe SAMPLE FROM MIX DATE CAST DATETESTED SPECIMEN NO. COMPRESSION TOTAL LOAD. LBS. POUNDS PER SO. IN. 28-DAY AVERAGE, PSI COMpLlANCE SPEClMENS oisrniaunoN: `rlillard Ganaaway - 3 Cos sa Bldg. Dept. Floor 1-4 9-28-88 10-10-88 1 12-Day 45,000 2,120 SLUMP - - SPECIFIED STRENGTH SIZE 2 & 3 "HELD IN FIELD" 12-Day test complies with specified strength. MI1DE BY Tom DELIVEREO BY W. Gannaway �,000 psi 5.20" x 10.40" RECEIVEDON r' '�'� '� F��,.��! � Lloyd Suehiro ,:_......-- �,�.__„�. � - - -.._ -..___.�e::ireo.:s,:._::�r��oe�ri« . -- =•i;s�,:..��.:,�,.:-��rn-..: . . .....,,_, . . . ...._. .._.. _ -- -- .� __ _ . -�:. —. -_....oES"cP„cpoo�.Cr!hnu=c:Fi""E':=v . . .... ... ovr _ .:: a I.ulli.:., . .: r. . . . . . � . ..� .. .. •� . . . �— „, , Applicant to fi�l.in all spacas exce0t those wit�in hGavy GorOe� lines an0-si9n_ail a00�aD��ate tle[bralions. • , . . ,. �• -� � -• �e. CIT�Y OF COSTA Project Address �_ UCTION PERMIT Own� 's Name /� �L /�E-SLEX Phone7Sy�yy �Address Arch/Eng. 5 icense No. -��r' AddP�ss � � � .��//� e�.�� Convactor's Nam v `LPhone S.LLT=L1li �.Gddress' ( mai ling) S City License No. � � y LICENSED CONTRACTOR DECLARATION I hereby at/irm Ihat I am licensetl untler provi5ion5 of Charte� 9(commencin9 with section ]000) of Division 3 ot the Business and Profession5 Cotle, antl my Iicense is in fW force ntl eifect. ��(J Licens lass� h� - Licenye No.�`'� `—'� �� Date �/oi'Dt� � c'a�ar .a ey��,n�„ WORKERS' COMPENSATION DECLARATION ' heteby atfirm lhdl 1 hdve a certifica[e of con5ent t0 SCIt-I ufe or� J workers' Comoensation Insuran<e, or a certitietl/ c�o'py tnereof (Se<tion 3800, Lab. �^! ��B ComPanY�", ' ` �� / Policy No.,� �X� ❑ Cer[ifietl copy is hereby furnishetl. (yCertitiell,�� is t—��y wAPPhcantY Bui g�p/�v��^ //�/� Date Y E�� CSL /V reC( E%EMPTION FROM WORKERS' COMPENSATION OECLARATION (Thi55¢ction�noetl not be comple[etl ii the permil is for ona huntlretl ($100) or less). I certify lhat in the Perfo�mance of the wo�k tOr which tltis pe�m�t Is Issuetl, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Calitornia. Da[e Si9nature NOTICE: If, atter making this declaration, you shoultl becbme subject to the Workers' Compon5ation provisions Ot the Labo� Cotle, you mu5t forthwith comply wlth such provisions or tnis permit shall be tleemetl revokea. CONSTRVCTION LENOING AGENCV - 1 hereby ailirm that lhere is a construction lentling agen<y for the performance Of the work for whith this petmit is issuetl (Se<tion 3097 Civ. C.) Lender's �Name Lentler's AtltlreSs �ii OWNER BUIIDER DECLARATION I hereby afflrm lhat I am exempt irom che Contractor's Licenze Law tor Ne tollowing rea5on (Section 7031.5 Business antl Professlonal Cotle: Any <ity or county wnith r¢quires a permit to construct, alter, ImOrove, aemolish or re0air any ztructure, O��or to ils issuance, also requires tha applicani for such permit f0 lile d Signetl slatem¢nt that he/she i5 licensetl pursuant to the Provisions of tne Contractor'S LI<ense Law (Chap[er 9(commencing with Section 7000) of 'livision 3 of tne Buziness antl Pro(essions Cotle) or that he/she is exempt erefrom antl [he Dasis for the allegetl exemptlon. Any violation ot Section J31.5 by any applicant �or a permit subjects Ihe applicant to a civil �endlty of.not mOre than five huntlretl tlollars (§500). I, as owner of tne property or my employees with wa9es as their sole . compensation, will tlo the work, antl the strutture Is not intentletl or ot�eretl tor sale (Sectlon.7044, Business antl Professlonal Lotle: The Contrac[or's LicenS¢ I. w tloes not apply to an owne� ot a property who builtls Or im0/ove5 tnereon, antl who Coes Su[h wo�k himselt/�¢r5¢tl or th�0ugh hiz or he� own employccs, provitlotl [hat such improvements aru not intentl¢tl O� oHe�etl to� sale. If, however, [ne builtling or improvement is solU within one year of com- pletion, lhe owner will have the burtlen of proving ho/she tlitl not builtl or im- prOva for Ihe purpoze of sale). � ❑ I, as owner ol �the property, am exclusively contructing wlth Iicensetl con- tractor5to construcl [he proje[t ($ectiOn 7044, Bu5ine55 antl Prote55iOns Cotle: Th¢ ConVactor's �icense law tloes not apply to an owner of property who builtls or ImOroves Ihereon: antl who COM�acts to� Such oroiect5 with a ron- tractor(51 I�cense vunuan[ to ine Conttactor•s`License Law). I am aware thac ! prool o(�tnelr Worker's CompenvNon'insurante shoultl be provitletl to me. I❑ I am eaempt untler Sec[ion 'b � B. 3 P. C. for this reason Date - Owner I herebvi certiry thaL I have reai sentatives inspection Orivar5' Litense or 55 � above 7P�IT � SZ / S I HAI,� . WI I/ _ UNIT NO. A.P. � � S Main Buildi TYPEOFCONSTRUCTION• 'NEW ADD ALTERATION REPAIR E ❑ CONVERSION ❑ DEMOLISN ❑ OTHERp • T FrOnt DESCRIPTION OF WORK/USE OF BLDG. �/OOL SQA B�Rear �'T" a TYPE OF PERMIT�y GRADwG FOUNDATIOrv STRUCTuaA� ' C Right ❑ TENANT kU ELECTRICAL �PLUMBING ❑ MECHANICAL � . g� Lef[ ❑ OTHER \ Ping.�Ret. # PROJECT DESCRIPTION 5ci. FT. oCCUPANCv�—�� Planning Notes: CONSTRUCTION TVPE VAIUATION $ f�� ( / ZONE GRADING CU. VDS. ACRES Remarks: pG �� 1 P�� ssg=8� eovio� sr�.wc6 o•wat erSink �V /DUC � Backflow Preventer Backflow Irrigation Ba2htubs Clarifiers Dishwasher Drinking Fountains Floor Droins " Floor Sinks' GasService � OuUets Interceptors � Kiichen Sink Lavatories � P—Trap Roof Drains - Reinspection Fea $15 Boiler Duct - Under Ground � � Ouct-Strucmral ' Duct - Ventilating ' ExhauSt System ❑ Multiple ❑ . Firepl/Fact. BIL �CBO # Heating System & Ducting . ❑0.100,OOOBTUD700,OOOBTI Reinspection Fee �$15 0865-46, rev. 5/89 White - Builtling; Canary - Applicant; Plnk - Accouniing; Goldenrotl - Assessor Showers Service Sink Sewer (:ap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater WacerService- Auto-Wesh � Issue Fee Hood or Typel ❑. Canopy Typell ❑ Refrigeration System � ❑aioo,000eru ❑�oo,000 System Repair/Alteration Fire Dampers Registers laue Fee Z ��fl�— >v I /� � � ' ' � ,� � � — Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec' Fan F.A.U. Fixtures Device Boxes Outlets zone N i N G R E � M T S. ELECTRICAL Transformer �� 15-50 KW � 50+KW Meter Dup ro 100 amps - Meter ❑over100amps Sub Panel . Motors �0.1� HP � 1 X- 8 "Inc. Solar �9-15 HP 016-15+ Microwave Pole Light ; awiccnes gi9� Garbage Disposal Standing Sections Generator �0.5 KW �5-15 KW Trash Compactor � Reinspeaion Fee �$15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: $ 3' 2oning,Approved By � FEES Building Approved B� $ 3 FEES � ' 1. • � SUMMAR OF FEES o BUILDING PERMIT $ � �� SMIP $ ' 6`� PLAN CHECK � $� � PERMIT PLUMBING $ �S• uJ ��UANCE $ PLAN CHECK 25% $ �3. B' D ENERGV P.C. $ ELECTRICAL $ Yd. ve GRADING $ PLANCHECK 50% $ I(O-S✓ .MICROFILM $ MECHANICAL $� TOTALFEE $ Z'Z%.3,j PLAN CHECK 25% $ - , �i 1001»580-000145�4 T��T 221.3:, DATE: 09/16/$$ TI11E: 1?:42 � ' ' ' �\ CONST�it1CTIOfYATdDPLANNING -1 POC .SPA APPRQVALS� 'Permit#' - Date Inspector AppROVALS Permit# Date Inspector �i 1. � empor�ry Electrical Service or Po�e � �� 52. Pool & Equipment Location '�,� 1a lo 2. Soil Pipe-Undrgmd. y �� .� 53. Steel Reinforcement � Electrical Conduit UtilityUndrgrnd. !' ,�. 54. Forms ' 4� Elect"rical Conduit-Undrgrnd. •�� '� 55. Electrical Bonding � ,5� Steel�Reinforcement�.' 56. Rough Plumbing & Pressure Test . i � Electrical UFER Grnd' � 57. APPROVAL TO COVER-GUNITE ;�I �7,� Footings � �� . � 58. Electrical Conduit-Undrgrnd. /(J.y-jj}j G� �� i 8~ Fdundation - � � 59. Gas Pipe, O Undrgrnd., Test �.1,�_�j( (��iQ i n. ' .� 9� Water Pipe-Untlrgrnd. � .,; 60. Backwash Lines, P-Trap, O Undrgrnd. 7 10V Siructural Floor System �' � 61. APPROVAL TO DECK 17. Property Sewer Line & House Conn�ction i r; 62. Backwash & Receptor-Final ` ` gY �� 12. Sewef �P �� ' 63. Heater & Vent-Final (� 8j. O� 13. Roof�,Drain� �� ' 64. Plumbing System - Final � 6 pj� �(� 14. Rough Flumbing; 65. Electrical-Final �� 15. Rough Electrical-Conduit .�,� 66. Solar System-Final ��}6. Rough Electric Wiring �' < 67. Fencing & Access Approval f. � '1�7. Rough Wiring Sign .�f�, 66. APPROVED FOR PLASTERING �� p B'i/' j8. Rough Electrical-T Bar Ceiling � � ��; 69. POOL/SPA SYSTEMS FINAL �� B� .�1�. Rough Heating & Air Conditioning: "�i FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace �' •••��- j APPROVALS Permit# �21. Ducts, in Structure . ' 70. Underground Hydra 22. Ducts, Ventilating • i. '� M 71. Product Piping OGas ❑Oil 23:�Gas Pipe-Rough & Test � �� - �. 72. Underground Flush 24. Roof Framing �� ,� ' 73. Undergrnd.StorageTank �Gas ❑Oil � 25. Roof Sheathing .�'' . 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical l 27,. Frame and Flashing r 76. Dry Standpipe 28. Lathingl3�`.Siding r 77. FIXED SYSTEM FINAL 29. Insula4ion - 78. FIRE PREV. FINAL 30. Drywall Nailing .� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat"�� , i 79. FINAL INSPECTION ' 32. ElecYrical Power Meter-Final �,� �. S0. FOOD CERTIFICATE ISSUED 33. Final Electric � �' " ' Notes: - 34. Final Heating & Air Conditioning �1 y 35. Final Gas Pipe-Test ,36. Hood or Canopy .37. Final FactoryiFireplace ;38. Fin�l Plum�ing ,�.- . �39. WaterService-Final•,� ,.� "�40..GasServlce-Final �� 41. Solar pomesticFinal3 � 42. ��ackflow Preventery�� , ��. � i � � •' -� ' 43. Backflow Irrigation � � �� `� � � 44. Landscape Irripation.System '� � , � 45. Sound Attenuation • �� 46. Handicap Regulations_ "` ' 47. FINALSTRUCTURE&BUILDING � 4R. Snecial Requirement;.Cort�Pleted 49. Electric Release to Edison '�i %', r.j � 50. Gas�Release to Soufhern California Gas Co .' � 51. CERTIFICATEOFOCCUPANCY �- � � •rf "' ' • No. Date � '' • • r.l . , I .J � �� Aoplicant to till in all soaces except tnoze witnin heavy boraer Ilnes an0 zign all aoo/oV��ate tleclarations. CITY OF COSTA ME� �C+O�N UCT��-IO(�N� ♦PER IT PEHMIT NO. TRACT NO. LOT NO. I�NiT Nn Project P' �s � .pg_��T—N-'� ��— ApR�ILa��s lingAddress 2Z� 5.i.�Q�b�{1 S.A. Owner'sName � �-�Phone��'�yyy Atldreu ��JSZ LUMc�W L• Arch/Eng. Licenu No. Address ConVactor's Nam M!�_/ � Phone 2%� � Address (mailing) ZZ�./� S • i.��G!'�'� � • �' Ciry Licenu No. �j.33 �y� �. LICENSED CONTRACTOR DECLARATION � I hereby affi�m tbat I am licensetl untle� provisian5 of Charte� 9(comm¢ncing with section 7000) of Dlvision 3 of the Business antl Professions Cotle, antl my license is in full f rce aRtl eflect I License Class v Li�] se No. 43Zs �� Date /o�i � 519 t� • �LIi4�_ WORKERS' GOMPENSATION DECLA0.ATION �ereby a((irm that 1 have a certificate of consent to zelf-insure or a certlficate Workers' Compensation InSurancc, or a certilietl copy thereot (Section BOO..Izb. (�P�31�'( I U�I comoa�v �'-� S. 1.��5 Poli No. , ertified copy Is hereby furnisnetl. Certitietl o y 'letl with [he city Bulltli Divi "e Date�i�L�- APPlicant �� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be compleletl if th¢ permit i5 tor One huntl�etl ($300) or lezs). I certity tnat in the performance of the work for whicn this perm�t is issuetl, I 5M1a11 not employ a0y p¢rson in any manner so as to betome Subje<t to IhE workers' Compensation Laws of Califomia. Dale Si9natwC NOTICE: If, after makinq this tleclaratlon, you shoultl become subject to the Workers' Compensatlon provisions of the Labor Cotle, you must Por[hwith comO�Y N'��h such provisions or (his p¢rmit Shall be tleem¢tl revoketl. CONSTRUCTION LENDING AGENCV I he�eby affi�m lhat there i5 a Constructlon lentling agency for the perfOrmance ot [h¢ wOrk tor w�ich [his permil is is5ue0 (Section 3097 Civ. C.) LenEer's Name . Lentler's Atltlress OWNER BUILDEN OECLARATION I hereby altirm that I am exempt irom the Contractor's License Law for Ihe '� following reason (Section ]031.5 Business antl Professional Cotle: Any ci[y or I County whlch require5 a pe�mit to con5truct, alte�, im0�ove, tlemolislt o� �epair 'I any structure, prior to Its issuance, also requires the applicant tor such permil to tile a sign¢tl ztatement that he/she B licensetl pursuant to the provisions of �ne Contracror's LiCenS¢ Law (Cnap[er 9(commencing with Section 7000) ot �ision 3 of the Bu5in255 antl Prot¢STions Cotl¢) ol that ne/sh¢ i5 exempt retrom antl lhe ba5i5 to� lhe alle9¢tl exemption. Any violation ot $ection ,31.5 by any applicant tor a pe�mit 5ubject5 the applicani to a civil �enalty o( not more tM1an five hund�etl tlollars ($500). I, as owne� ot tha property or my employees with wa9es as theiv sole compensation, will tlo the work, antl [he sVucture is mt intenGetl or offeretl for sale (Section 7044, Business antl Professional Cotle: The Contractor's License Law tloes not appy to an owner of a property who builtls or improves thereon, antl who tloes such work himseli/herself or through his on c�r own emplovees, provitletl thal such improvements are not intentled or offerea for sale. If, however, tbe builtling or improvement is soltl within one year ot com- pletion, the owner will have the buraen o( proving he/she tlitl not buila or Im- �ove for tM1e purposn o/ sale�. LI I, as owner ol the o�operty, am exclusively mntracting with licensetl con- tractorsto cons[rucl Ihf prolect (SeCtlon 7044, Business antl Prote55ion5 Cotle: The ContractoYs License Law tloes not appry ro an owner of property who builtls or improvos thereon, antl who contracts for such projects with a mn- [rattor(5) htense pureuant to the ConVactor'S License Law). 1 am awa�e that pwot of tM1elr Wo�keYS Compen5a[ion insu�ance zhoultl be provitletl to me. ❑ I am exempt untler Sectlon B. G P. C. tor ihis reason CA Date I hereby certity that intormation is correct antl state Iaws relatin sentatives of this inspection purpos Signd[ure Drivers' License r 5 IF OB65-46, rev. 10/B4 Owner antl TVPE OF CONSTRUCTION LI NEW LJ ADD LI ALTERATION LJ RFtPAI R ❑ CONVERSION ❑ DEMOLISH �OTHER ��10E UPC'�Pa�- AP # DESCRIPTION OF WORK/USE OF BLDG. i � S Main Building: E TYPE OF PERMITq GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT I�l ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B qear � ❑ OTHER A PROJECT DESCRIPTION SQ. FT OCCUaANCv C Right K Left CONSTRUCTIONTVPE 9 —� VALUATIONS $ ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: �� _ _ � � ��- Planning Notes: Sink Preventer Irrigation rinking Fountains loor Drains loor Sinks P-Trap Roof D Reinspectian fee Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swi ing Pool w/Spa �U[IEIS VuBtEf CIOSCL Water Heater Water $ervice Auto-Wash Wundry Trays $15 luue Fee Boiler Duct � Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple FirepllFacL Blt. ICBO �I`- Heating System & Ducting � ❑ a i oo,000 eru O i oo,000 Reinspection Fee � $15 White - Builtling; Cana�y - APPlicani; Pink - Accouniing; Goltlenrotl - Assessot Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System C�-100,000 BTU ❑ 100,000 System Repair/Alteracion F ire Da mpers Registers laua Fee $ 3 FE $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dfshwasher Dryers ❑Gas ❑Elecvic Fan F.A.U. Fixtures Device Bozes Outlets $WItC�I¢5 Garbage Disposal Generator O65 KW O5-' Fee Zone Accessory Building: Parking Req./Provided ELECTftICAL Transformer ❑ 15�50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ■over 100 amps Suh Panel Morors �0.1 HP 018 - 8 Inc.Solar �9-15 HP 016-75+ Microwave Pole Light Range FEES Standing Sections 5 KW Trash Compactor $15 Issue Fee $ DEVELOPMENTSERVICESREQUIREMENTS: 2oning Approved By /� Building APProved BY eT� . f. 1 f Z O N I N G F E Q M T s SUMMARY OF FEES� BUILDING PERMIT S SMIP S PLAN CHECK S PERMI7 PLUMBING S ISSUANCE S PLAN CHECK 25% S ENERGV P.C. $ ELECTRICA� § �3 �� GRADING $ PLAN CHECK 50% $ MICFiOFILM $ �2 MECHANICAL S TOTALFEE $ `"—'�� PLAN CHECK 25% $ Of UOOS)453-0�017553 Tl i1ATG' i(1/10/Rff TTML� 7?t CONSTRUCTION AND PLANNING '�. �- POOL & SPA APPROVALS Permit# � Date Inspector APPg��ALS Permit# Date Inspector ' h: 1. Temporary Electrical;Serviceor Pole 52. Pool� 'Equipmen[ 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. $. Foundation ' � 59. Gas Pipe, O Undrgrnd., Tes[ 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 Drains. 64. Plumbing SYstem - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. �Fencing & Access Approval 17. Rough Wiring Sign 68. �APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace " APPROVALS Permit # - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 1 24. Roof Framing '73. Undergrnd. Storage Tank ��Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro < 26. T-Bar Ceiling (Svuctural) & Monocoat 75. Dry Chemical .�' / -� 27. Frame and Flashing ' 76. Dry Standpipe � � i 28. Lathing & Siding 77. FIXED SYSTEM FINAL ''�' , 29. Insulation 78. FIRE PREV. FINAL �Y> � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT •� 31. Plaster Brown Coat 79. FINAL INSPECTION " . " �� 32. Electrical Power Meter-Final �j� 80. FOOD CERTIFICATE ISSUED . 33. Final Electric Notes: � � .� 34. Final Heating & Air Conditioning � � I � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Faaory Fireplace 38. Final Plumbing 39. Water Service-Final ' 40. Gas Service-Final . 41. Solar pomesticFinal ' 42. Backflow Preventer 43. Backflow Irrigation ' - ^ �'-. 44. Landscape Irriqation System �-'" 45. Sound Attenuation �� i 46. Handicap Regulations '� � 47. FINALSTRUCTURE&BUILDING . ,ij? 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co „' 57. CERTIFICATE OF OCCUPANCY �' . } No. Date �� . . . .AVG��ant lo till in all soaees excevt tnose within heavy Daraer lines antl sign all appravriate aeclarations. CITY OF CQSTA MESA CONSTRUCTION PE MIT PERMIT � TRACT NO. LOT NO. UNIT NO. ProjPct Address ,��2 ��L��q-f�a-^ �l ' . Applicant's Mailing A dress� C�`�� Pi I TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR �,,/�' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p# Owner's Name /� Phone�� DESCRIPTION OF WORK/USE OF BLDG. Addreu ,ld�'� � S Main eu E Arch/Eng. -- . LicenseNo. TYPEOFPERMIT GRADING �FOUNDATION STRUCTURAL T Front� ❑ TENANT ❑ ELECTRICAL ua PLVMBING ❑ MECHANICAI g Address —. - Rear Contractor'SNam �� P one ❑ OTHER A �/ /� [[[''' ��,�} /`PRQIECT DESCRIPTION SQ. FT. OCCUPANCV C Right Address (mailin � / L.,{�lL��___L � / �L� K /�/ ( 7 CONSTRUCTIONTYPE VALUATION$ g left City LicenS¢ No l) 7� > ZONE GRADING Cll. VDS. ACRES LICENSED CONTRqCTOR OECLARATION Ping. R¢f. � I hereby atfirm that I am IlGensetl untle� 0/ovision5 of Charte� 9(commencing qemarks: � �. , Plannipy NO' with sectlon ]000) of Divis�on 3 ot the Bu5ine55 antl Protessions Cotl¢, antl ' my license is in tu Ffprc¢ and etfect. . � �. Licens .C'a i�n �n'�y /�L,icense��/f o. � ��'C�!/,;.P, � Date��/��r . 5'9 tt r=1.^% /�° � �G��`� .T�/� WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent ta self-insure or a certiiicate f Workers' Compensation Insurance, or a certifietl co�py tbefeof (Section Pal�'�oY No. � '� ' ComPanY��"`-'" ,��/�.IT/� ¢rti(ietl copy is nereby lumisnetl. D�ec� ieq ��SJjlea with the city,B�ltl py i s�n ,%/ ��•C-� ( � APPlicant6, .�� [1�-' � EXEMPTION FROM WORKERS' COMPENSATION DECLARFTION (Thiz zeotion ne<tl not be cor�P�etetl it the p¢rmit is fo� one huntl�¢tl (E100) or less). I cer[ify Ihal in Ihe psrformance of the wOrk tor whlch Ihls perT�t is ISSUGtl, I shall not employ any person in any manner so as to become suEject [o the Workers' Compan5ation LaWs ot California. Date 5�9nature NOTICE: If, alter making this tleclaratlon, you should become zubject to the Workers' Compensation provisions ot the Labor Code, you mus[ forthwith comply wlth such provisi0ns or this permi[ shall be Geemetl �evoketl. CONSTRUCTION LENOING AGENCV I hereby ailirm t�at [nere Is a construc[ion lentlinq agenty tor the Per/ormance ot the work fOr which lhi5 pe�mit is issuetl (SectlOn 3097 Civ. C.) Lentler's Name Lentler's Aatlress OWNER BUILOEH �ECLARATION ' I he�eby affl�m that I am eXempt trom the Cont�actor's License Law for [he �oilowing reason (Sectlon ]031.5 Busine5z antl Pro�esslonal Cotle: Any city or county which requiras a permit to wnstruct, alteq improve, tlemolish or repair any structure, prior to Its issuance, also requires the ap0�icant for such permit to fiie a slgnetl statement tnat he/she is licensetl pursuant to Ihe Provisions of the Con(raclor's License Law (Chapter 9(commencing wlth SecHon 7000) of IviSion 3 ot [h¢ Busine55 antl Profe55ion5 Cotle) or [hat Ite/she is ezempt ereTrom antl Ih¢ basis fOr Ihe alleqetl exemption. Any violation ot Section J31.5 by any applicant for a permit 5ubject5 tho applicant to a civil �enalty of not more lhan five huntlretl tlollars (550��. LJ I, as owner ot the proPerty or my employees witn wages as their sole compen5ation, will tlo the work, antl the sVucture is not intentletl or offeretl for sale (Section 7044, BUsiness antl Profezsional Cotle: The Contractor's License Law tloes not apply to an owner o( a property who builtls or improves thereon. antl who tloes such work himzeli/herself or throu9h hiz or M1er own pletion, tha owner will hav6 tne ouraen ot proving ne/sne aia noi oww or im- prOv¢ fo� [ha pu�pose ol 5a18�. ❑ I, as owner ot the property, am exclusively contractlng with Ilcensea com t�actorsto con5iruct Ne profect ($ection ]044, Bu5ine55 antl Profe55lon5 Cotle: The ConVactor's License W�+ tloes not apply to an owner oi property who builtls or improves thereon. antl who contracts for such projec[s with a con- tractor(s) ucense pursuanl ro tne. Contractor's License Law). I am aware that proof of tM1eir Worker's Compensation insu�ance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. ror this reason � Date O'+�ner 1 hereby certity that I nave reatl this application antl state that th¢ above iniormation is mrrect. 1 a9rRe to comply witn all Uty antl counlY ortlinances antl state laws �ela[in9 �o builtling const�uctiOn, antl her¢by authorize re0�e- Senta[ives ot�j hiS�.Gf(Y[o enter upOn [he above-menUonetl_Property for in5pectian pliypas45 ✓) � � Q � Signa[ure �� lli 0�� / __. Date� / / Bar Sink • Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Drinking Foun[ains Floor Drains Floor Sinks GasService �UfIEIS 1 nterceptors Kitchen Sink ' Lavatories P-Trap Roof Drains Reinspaction Fee $15 Duct- UnderGround Duct - Sttuctural Duct-Ventilating " Exhaust System ❑ MWtiple ❑ Firep1/Fact.8lt. ICBO # Heating System & Ducting ❑4100,000 BTU O100,0008T' Reinspection Fee � $75 r.. � CMF 0865-46, rev. 10/B4 White - Builtlin9: Canary - ApPlicant; Pink - Accounting; Goltlenrotl - A55ei5ar Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Pool w/Spa Urinal _ Water Closet Water Heater Water Service Auro-Wash Laundry Tra� Isue Fee Hood or Type I ❑ Canopy Type I I ❑ 4efrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration. Fire Dampers Regizterz Issue Fee FEES 5121 2one - Accessory Building: Parking Req./Provided ELECTRICAL Automatic Washer Transformer ❑ 15�50 KW ConstructionPoleSub. � 50+KW ' Cooking Unit Meter �up to 100 amps � Dishwasher - Meter ❑over 100 amps Dryers ❑Gas ❑Electric Sub Panel . Fan Motors 00.1 �HP 01 X- 8 F.A.U. Inc.Solar 09-15 HP �16-15+ Fixtures � Microwave . Device Boxes Pole Light Outlets Switches ' Garbage Disposal Generator �0-5 KW 05-15 KW Standing Sections Trash Compactor $ 3 Reinspection Fee $15 laue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Appraved By n Appliption Issuad By $ 3 5.Q0 TL Z O N I N G R E Q M T S FEES S 3 SUMMARY OF FEES _ BUILDING PERMIT $� SMIP $ PLAN CHECK $ �� PERMIT PLUMBING g � ISSUANCE $ PLAN CHECK 25%' $ ENERGV P.C. $- ELECTRICAL ' $ GFADING $ PLAN�CHECK 50%� $ MICROFILM $ � MECHANICAL $ TOTAL FEE $ � PLAN CHECK 25%- $ � CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms �, 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVFR�GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd.,;Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap; � 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 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe . 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIF�CATE ISSUED 33. Final Electric Notes: ��.9� �,4nG� �5 �,q, ZO�?u LlrG 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy , 37. Final Factory Fireplace " 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed _ 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co . ' 51. CERTIFICATE OF OCCUPANCY � ' No. Date OWN�R JOB ADI GEN�Rt AP No. INSPEC" 5� �— c. WATEry ROl1GH Pl PR��'� SWR. LINEIb HOUSE CON. �' SPRINKLING SYSTEM MISC�LLANEOUS ROUGH HEATING AND AIR CONOITIONING TEMPOftARV SERVICE OR POLE UN�ERGROUN� [� POWER � ROUGry W�RING TRENCHES �FORMS STEEI RE FLOOR SYSTEM BONO BEAM � STEEL REINFORCE [ SHEATHING FRAM� pND FLASHING/ LATHING - IN OUT PLASTER,BROWN COAT STRUCTURAL, FINAL HEAT(NG, VENT., AEFRIG. AND A.C., Ff P' ING, FINAL ANO GAS TEST �� UAIt BUILDING P SUBCONTRACTOR Z . W W a c� Z za Oci am J7 J � Q W 0� J m J Q U Q zQ aw WZ J Q m Z J � W W � z �- w� �� o ,1 ,�� ,�'�,�, 39� y ��.�; �� 3b`��Jv v veu ra�c ... aa � �-�, �.—,� 00 �� :: :: i ii.24 COSTA MESA BUILDING-SAFETY DEPARTMENT U1 � p,0. BOX 1200 COSTA MESA, CAL�FORNIA 92626 APPLICATION FOR BUILDING PERMIT ForApplicanrtoFillinCompletely RECEIVE ev DATEqECEIVED on eissu o BUILDING �/ � �_ �� /�jO _ ADOFESS I/ PER I,T d OWNER Larwin Southern California ^�P�NO� � � `'�� MAIL BUIIDING ADORESS 16255 Ventura BLVC1. ADDRESS GTV Encino, Calif, nrio��986-8890 TFACT ]SS%�B LOT ].],] BLOCK CANSTRUCTION W ADD A P LENDER Larwin Southern California BPANCH 16255 Ventura Blvd. /�� aooaess Encino, Cali£ornia �WNER lAa�a✓/N ,s� c...,pL VALUE G . AFCHITECT ��1R So. Calif rE`'. 273-4464 � $ � � � .g�� OF ENGINEER N . // ADORESS 9100 Wilshire Blvd. Bev. Hills ZONE rvPE / GROUP .� APPROVED CONTRACTOR I.dTWli1 Southern California B�' DATE �7 ADDRESS 16255 Ventura Blvd. TEL ZONE / PL4N5 � BUILDING EW S =E . ciTv Encino Ca1if. No 986-8890 / 6.0 STATE CITV �'AR�SAPPROVED VARDSAPPROVED uc. No. 1913ll �IC. NO. B-1 MAIN BUIIOING ACCESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/L S REET) OF LOT (]O X LOO NOW ON LOT O FRONT FT. FT. USE OF ExISTING BLDG. SI FT. FT. SIZE OF 'NO. OF NEW BIDG. Z3S�L ROOMS STOFIES Z L. SIDE FT. FT. EXTEFIOR WALL ROOF COVERING SCllCCO COVERING WOOCI shin 1 REAR� � FT. FT. USE OF BVILDING AND WORK TO BE PERFORMED DISfANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. Construction Single Family Residence c uRP � APPROVEO APPROVED • _ O �-7� `p�IOLD FOR PECI L E1dT5 I hereby acknowletlge ihat I have read this application and state that ffie above information is correct antl agree to cOmply with all laws regulating buiiding consvuciion, antl I shall not employ any person in violation of the workman's compensation laws of the Stare of California. /{�) / I hereby certify ffiai 1 am properly licensed as a conttacmr under S � SQ. FT. U! the Stace ot California Business antl Professions Code, Divisicn 3, THE AMOUNT S O N U ER VALUATION IS FOR Chapter 9, antl that such licenses are in full forca antl effect, or I THE PURPOSE OF TABLI HING A PERMIT FEE ONLV: am exempt from the provisions of the Stata of California Business � VALUATION 1],(7.SO and PFotessions Cotle, Division 3, Chapter 9, PERMIT FEE $ Signature Permitte(G��'II� D. Downs s 35,600 PLANCHECK$ 58.25 Authorized Agent 174. 75 TOTAL FEE $