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HomeMy WebLinkAbout152 QUIET BAY LN - Building Permits ' - 1 i. . . • 163 r 16Z 160 J r 151 • 15-8 .. : Z. .; L H . 156 r r= . - Q « r m rsbc3 J 15Z • 1-_..ig • .. • „. 0 H.T.5. f ' - `LDECS . ' AVENUE Your cooperation in this matter is appreciated. Sincerely, GLEN S. ETHERINGTON Planning Intern GSE: j1 (ADDCHNGE. 23) cc: Neville Pearson 2666 Elden Avenue, Unit G Costa Mesa, CA 92626 Occupants 2666 Elden Avenue Units A-N Costa Mesa, CA 92626 . December 21, 1988 To: Building Safety Division Pacific Bell (2) Code Enforcement Police Dept. - Ping. & Research Communications Santa Ana Heights Water Company County Administration Office Sanitary District Engineer County Clerk/Bd. of Supervisors Southern California Edison Co. County Registrar of Voters Southern California Gas Co. County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Fire Prevention U.S. Post Office, Adams Avenue Manager, MIS U.S . Post Office, Santa Ana Mesa Consolidated Water Dist. Zip 4 - Santa Ana Newport-Mesa Un. School Dist. (2) File (2) The City of Costa Mesa wishes to advise you that the following addresses have been changed or added: OLD ADDRESS NEW ADDRESS A. P. NO. 2666 Elden Ave. , Unit A 151 Quiet Bay Lane 439-221-61 2666 Elden Ave. , Unit B 153 Quiet Bay Lane "_ 2666 Elden Ave. , Unit C 155 Quiet Bay Lane " 2666 Elden Ave. , Unit D 157 Quiet Bay Lane " • 2666 Elden Ave. , Unit E 159 Quiet Bay Lane " 2666 Elden Ave. , Unit F 161 Quiet Bay Lane " 2666 Elden Ave. , Unit G 163 Quiet Bay Lane of 2666 Elden Ave. , Unit H 162 Quiet Bay Lane 439-221-62 2666 Elden Ave. , Unit J 160 Quiet Bay Lane 2666 Elden Ave. , Unit K 158 Quiet Bay Lane " 2666 Elden Ave. , Unit L 156 Quiet Bay Lane " 2666 Elden Ave. , Unit M 154 Quiet Bay Lane " 2666 Elden Ave. , Unit N 152 Quiet Bay Lane For your convenience we are listing the agencies above that we have notified of the change. In addition to those listed, you are advised to notify your correspondents of the change in order to avoid any possible interruption of mail service. ' rift - CITY OF COSTA MESA 49 BUILDING DIVISION >:l DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER t. I tri.taatruirs'7/`" I PERMIT 4. B03-01802 likbePeRmfl Ifr (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.c3-t{s,ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 152 QUIET BAY LN BUILDING Status: ISSUED Suite: Applied: 10/15/2003 Vicinity: UNITS 152-154 Issued: 10/15/2003 • Parcel Number: TPN003179 Zoning: Applicant BATIOFF, JOHN _—_—_ ISSUED BY: c!'`y Address: 17182 ARMSTRONG AV • f_.- "-,--.. �\��oPhone:-714-381-7974 ----c--P *c.. Zr ///���������...,,, IRVINE,CA��i0p: 92614 1 � t U.' Owner: QUIETtBAY-HOAJULI / `� Address 163 QUIET BAY \ - — _ _ ,A cT>A �rj/n� �� 1 '�___=-`_-P.h e-949-253=4548-'\`1�J ���J\`\�. I'n /COSTA �,'C.AA /„2,-ij Zip: 92627-4670 -"' ',� \\ `/ \�\\ f/�� \ ��� /' �> ��� Contractor: DRI COMMERCIAL \���,�/> / /A/ddress`:: 17182 ARM TRONG AV \ ��\\/ \\�., • Phone: \ �('1// , IRVINE,-CA lig ` J Zip:,J 92614 / 1 License:3 818623 _-_ A' 2 /// 7 _-___ --2•2• J,-/-1"--, : T ,)'Arch/:..., r�� \t Eng: .,.� ; t 1"Address: /e?-)1� ' 0 a o ��9� Address:•- �, ',�)/, L�' I(li(��i E0�Fhone -�,�._ ,�-��) /"• Rhone: i '>v,i p tl]� o ?/i ---7 „ t -) I tl — _-SCOPEOF'PERMIT = ' I -,TEA OFF EXIST NG'ROOF. INSTALL SSA COMPOSITION SHINGLES.-37.34 SQUARES-FOR-‘CONDO UNITS. UNITS 152-154- i n Ill1.,f, l i )4,-,./4. _ii 1_ \L4' LL 31 .:t11..e A ._.sL., L_), I. FEE SUMMARY ' � ,c L Plan Check: ,----I ,s- $0.00 -t,.- f _,-F- '_' •� Cale Valuation 'i;,,j $7,39000 • t,, , t .‘ ) i •" r` �sP�� — `d' /!•�� i,. '''illi i r= ti.�. - � • ,Permit. t ti '$153.25 _� = - c! -Cialm Valuationi $7;39oA0 ��`S'MIP-Res:\ ° $0.74 W —���_/�_ -jI jlei�r l --C.,..J iii r, �SMIP Corn: \'� $0.00 � l t 1, 4 , /,,, / ��'. Other: $0.00 c 3;' /2 /� \Inspection $0.00 - a/ I. ;t'i VA \ �s�,� .0 • � I -i/ �Sotal: $153.99 • i , il �\ VA�e C�V \\‘‘,X.Alm -_. .,J,---.,5;:), -1...9.„ „,„„(i , `. ,.'f.''.::3°'S.�R77,-.h- (-2.5);‘,' cj , / \. _ . u' %PPLANNING &ZONING '—iv-.4"7-17/ ,i i SETBACKS . 6/421/7_,.,_ '�°a° l 0'4,, 3� VI/ (1,...?,, ' s it ,/y , . MAIN STRUCTURE'Front; 0-'O ',Rear "0�0' „i).„-,Lett, c0 0 c, Right - 0h0- .�,�i ACCESSORY NN Fronk 0.:•'0f // ,Rear 0'0-2Left 6--b Right j0' 0 -,;� - r PARKING Exisfinq 0� Required //0 l /',1 Proposed `-0, < NOTES: KENNE_S ;10115/2003-FEES-PAID; REF.: VOIDED PERMIT 1- • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under 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.com anced within`t180fdays,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 required 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)754.5626 2446-46(6/00) • WORKERS'COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'co enation Insurance carrier and policy number are: Carrier A Cc'.0Policy Number: LA JC'N 9 Z)6, 3$7 (This section need not be completed if the permit is valued at a hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Car mia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith with complythese provisi n . (° _ f _ LJ w,-3 t. lJ cApplicanl,Signature:- _ Date: WARNING:FAILURE TO SECURE OR RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADD ION 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 that I am licensed under�nerprovisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business.nd -rofess'.I Code,and my license is in full force and ettect..Lic..N_____� Z Class ft C. force . ,"s I " C- Contractors Signature:. 1 Date: II — 1 CONSTRUCTION LENDING AG NCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors 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 for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): . ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale,If,however,the building or improvement is sold within one year of completion,the owner-builder will have'the burden of proving 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 Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety 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 for emergency response to release or threatened 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 during a reported year a quantity of 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 standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration 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 of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes LI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control 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. • Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state taws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ig atu e Of Legal Owner(s) Da _ /(1— !s D - -An uthorized Applicant - j CODE r -INSPECTION TYPE • DAIS . ` INTIALS CODE r INSPECRON TYPE - '-DATE - INTRIALs 1616 Fixed System Final Fire Prevention • 206 Final Mechanical 1266 Pool Spa ) 208 Final Plumbing 200Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place • _ 220 Final Planning Approval 203 Final Sign . 222 Final Site 204 Final Demolition 250 Final Building/Occupancy - "PQOAECTADORESS• . "-,-fir*,,,1 "' :r"/S�"�jV� t- ' , Nir.M - t-�' F , CITY or COSTA` MESA—-2' BUIL`D ING 'PERMIT'• •4"."—i-`11-7- OWNERSNAME•JOANN:. BURGER - I • { J/ - 'r , - •i, .: + j " j '' : ; ' • I • 1r': ya ' • r ::: ; • ,2 • .y - i : i •t- • ' t °� 1e -et . , ADDRESS: SAME ,AS ABOVE ; • :j •y I PERMIT} NO: .E 044589 ~` PLAN .CHECK NO:- ; - t . f N ' GOVT: N SUPP !N i 7 1 t' ' i+ + .1' Cw 1 ; ,` 'r ,t_ . , •t 1 r' • .w r ':f I )'. .. _I • ' I r 1. , ,,. v : t T ,_ - n ),r f�, i - .i.'----7 �, I•�. CONSTRUCTION TYPE I PERM IT TYPE IELE • - - 'At 1 , _ , PURPOSE NEW • :..t • 'ARCH/ENGINEERy 7. t 1 - - ., •` I s - }. REGNO 1ri: , r t :JOB DESCRIPTION'„ OUTLET FOR. SPA , . S ' , i ,- 'SQ- FT '• • t ' 1+ .i ' ADDRESS a 0, ✓ •., i ,F� - a :. UNIT. L j " , •:..1 ? r'• - t a 1 '. '' , r 'y • t t•" • +00000 ' ' � I i x 1 CLAIM. VALUE, I . -. ' :'i } ' ; CALC-VALUE: 1 '' 1' ' " ,GROUP' OCG•" 2 -; ' %. 1 - I PERMITTEE: JOANN M,' BURGER • ' r ,t: . - ( 714,)'645;'6766 i ` t r . f� • 3 ; ,} . . t _ .i ', t •, , n ' ?• ` 1 I iii -p l'. .••1 --r ADDRESS .: 266`6 • ELDEN' AV j ; -1 '• -1 � . 'M''n i.s- ; CO -, I 1 � : , ,. •. ! •• a . . 1".: "' t • • ' •-• : ; 1 c - - : , .r ' COSTA:MESA.... y' CA:92627 p i *#########*##*#N##iE############**i1###X#*N`*###•##16iL**.**#######**#16•****I****#**##1�* , f 1 .LICENSED CONTRACTOR DECLARATION: hereby affirm that am licensed antler provisions of Chapter 9(commencing with Section ° c ' 12 O 1.111 N' !G R `.E 1. ., I L' t.. Q .`1U IfR. E, M E 'N'• T.. �i :.Y r i• - 7000)of Division 3 of the Business and Professions Code,and my.license is in full•force and effect'. I '"- '' "6_ 1 j , . 1 i . -S' E 'T-. B A C: K 'S • i - -' • x t t 1 ". 1 t-r' t CITY LIC.: ' > ' . •, STATE LRC,: I CLASS:i :' } 1 • I , I . . . r '- 't • i i • i , ' 1 ' I c t i' • ' j- _ Y .'u • . MAIN: BUILDING = - -- ------ 'ACCESSORY .BUILDING • • Date. - Signature: - s '. t FRNT, FT • ' IN REAR I • •; FT, . INS ' FRNT:, ;FT' IN ;REAR: " , FT IN `s • i ! , ' WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self insure or a certificate of Workers { 1 - 10'. , LEFT: FT TN RGHT FT ' IN ' 'LEFT:' t 'FT . IN.' RGHT: ''„cFT. , .,IN;• • •Compensation Insurance,or a certified, copy thereof(Section 3800;Lab C)^ 1 1 • . . 1 ' .POLICY NO.: ' I'' , .I. EXP.DATE: , e /•' 1. ; - , _1 1 :.,. . . , ., 1 •, I } 4 .1 ' ••t' 1 f d • ' I PARKING 'REQUIRES,:U• ' t PARKING' PROVIDED PARCEL: 00000000 ZONE .,' n ' Certified copy is hereby furnished_o ❑ Certified copy is filed with the city Building Division PLANNING t NOTES> 1 • : . • • . •. _ ! d i d } „ ' ;r .-1?. j. 1 1 , � __ 1• I . } I 1 • 1 . ######'lE####.IE#if##,1f#fE###3EN-#######-##########)E######IE####iE###########jf*###########X- r • Date: ' • Applicant o 1 1 , :D .E V E L .0 ;P M •E N' T.. S E R• V1I 'C E ,S • R 'E U Ii R tE- M . E• N: T•tS • ' EXEMPRON FROM WORKERS'COMPENSATION DECLARATION: 'pis section need not be completed K the permit is for one hundred(5100)or less). • r t I 1 Q 1 1 , I certify that in the performance of the work for which this permi issued.I shall not em toy ny person in any manner so as to become: I - 1 _ i } - ; t • , I I i -. . . ) I I II subject to the Workeep CCo/^pensla/hon.Laws of California. / �y�t ZONING APPROVED BY 1 , r DATE: i • Oates " _ '•/6/ ' 7/ /1. Signature:-l � `• „- -r, I. • 1 { ' f NOTICE:If;after making this declaration,you should become sublet[to the Workers"Compensation provisions of the Labor B U I LD I NG,�AP PROV ED- B Y { . - ' d'- • , +' " , ,DATE: .� , f .T• •� • +' .Code,you must forthwith comply.with such provisions or this permit shall.be deemed revoked.!. .-.4 . I. - , �• ' 1 J. '} • 71)I ' ' ' •j ^i ) i t • 1 CONSTRUCTION LENDING AGENCY:.I hereby affirm that there is'a construction lending agency.for the performance of the work fort APPL I CAT ION,`I S SUED 1 BY.: I -, - _* �-i • - 'DATE c, 1 I j which this permit is issued(Section 3157,Civ.C). , .t I - ! M:aL•�e'fF + , ' } 1' i ###1f•####3E######-######!E####-,####LF#3(-####### • aE####ik####iE# iE###-3F#####• • #iE -, ` LENDER: 1• j,. .i : I #######iE,iE##1(#e(##*#N##i####i(•############i **r#1(#.###,*3F####iF#i(#### (-****########IF,####* •,•, ADDRESS I ir—I• • LEGALIZATION N. ' ` ! 1F E E" - S1U M 14. A ••R Y`f:`- d • STRUCTURAL SEGMENT:N4- " i : t J . 1.;i , - ] . ••S ,.. r• .. 1"' t ..i. - OWNER BUILDER DECLARATION:':.i dereb;affirm that l am exempt from the Contractors'State License Law foi the following reason " _t ,•_ } x BLDG' PMTS PLUMBING:• ELECTRIC •`MECHANIC { FIRE1 - • SM1P/RES • „'GRADING • - (Section 7031.5 Business and Professional'Code:'-Any.city of county which requires a permit to construct,:jolter:improve,demolish,or . P ERM I T ,- r _ 1 • . r: 1:1. .1 i s 7 5' t' , i- . i I' j repair any structure,prior to its issuance,also requires the applicant for such permit to'file a signed statement that he/she is licensed • • - 1 - t �.' I i a ' ' '� • 50.% - , - 1•• t' • `. - - 1' )• ' , iSM'IP/NON-RES t .I ; 1 ' pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business• •PLAN n - " r i • 1 I and Professions Code)•or that he/she is exempt therefrom and the basis for the alleged exemption:Any violation of,Section 7031.5 by ' .- { .�' " l ry ?': I - I. any applicant for a permit subjects the appliaant to a avis penalty of not more than five hundred dollars.(5500): ) 1 - ISSUE FEE ' i'• t' I'' 1 •. :1.5:. 00 • 1 I • 1 ' -_ _ yr _a ` ` 1 I ' • I as'owner sof the property or'my.em Ioyees with wages 'as their sole'eempensation, will do'.the work;and the •BUILDING 1D`•IV > -? PERMIT ' ., 'ISSUE; 'I PLAN—CHECK + TOTAL !' • p,, ) PAIDd;~ 'DUE j ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code.'The Contractors'State License Law TOTALS-. 7-j-1? 0 .45 • 115 . 00: . 0 ” 00 .1;5 .75'i 31.•'5 0 : t .-715 .1.75 t^ does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through _ : i ' '- "� I' ' ' '4 a>.- L i 1', ( t, his or her own employees,provided tharsoch improvements are not intended or offered Or sale.l4 however the building or ‘REVNUE:.D I V I S IONt TOTAL S'-—> ' 'COLLECTED >• • I 15 ,;751 OVER/SHORT•"`1 1 - :improvement is sold within one year of complebon,.the owner v411 have the burden-of proving he/she did not build,or improve . - 0 0 '•' r' -tar the purpose of sale)- • ' ,-,•;? 1 '-: HLDG PMT PLUMBING 'ELECTRIC•z MECHANIC" FIRE SNIP/TOT GRADING PLAN-.PHI:CK •. ..I:as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business , , a, - .� :and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ( .. 1 ' • `- ) and who contracts for such projects with a contractor(s)license.pursuant to the Contractors'1State License Law)e l am aware •###*.####'########*#####iE####*#i4#*#****###%#*****it***########*######IE3E.*X######1E### • that proof of their Workers Compensation insurance should be provided tome! ' :1 4' • . . - • > ' 7 i r v9': t , - +. ' I N D1 I ,C •2D U A Lh P fi E B R E A'"K D. O W N ' i ❑ I am exempt under Section • i. I ' • B.8,P C s r' - t 'a 1 arr -.1 i 1 • .. _ • for this reason: I , . I •,1 // , a ' , 'TYPE t QTY ;, D E' S. 0 IR I'1P T, IO N I ' ) UNZT ' COST �• .t TOTAL COST. . i.7 Date.• - ',irel// _ill Owner. _ " a I ' r•. } r•-, ELE 1 r,. FIXTURES liIGHTING ;ST: 20 , t !.EA: 7;5 `• 7� • 'Ado 4 reWcer I ythatl am aware of and understand the.requirements of California Health and Safety Code Sections 25505,25533,and _ , , - 1 { ?. , FEES . E F.- OF ; ;' '.I 25534 andthator any future building occupant will/will not(circle one)need to comply with said,state codes and the requirements for a 1 -'.{ - _ qq -- -"'s'. i ; 1 p• ermit for construction or modification from the Air Quality Management DistrictResidential construction applications are exempt from - ' i '' L t ' 1 :. ' {' tt • I ' , these provicions., I ' - 4 I ! 1' 1- 1 p ' , i •• 1 } 1 EXPIRE.,. 4 4 • Date: Applicant: - - I 1 ( Incomplete InspectLons 1. } _ , ! j.. i # :.• 1 I , ,- I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ,f t 'i, t• "1 t } ' I f ' ! , I' r . -ordinances and state laws relating to building construction and here authorize representatives of ity to enter upon the above-mentioned, 1 _L._ _ :. 1:. • / 1. .4 9 - ' ' ' property tar,crisp¢ ioneepurpo sr.� j 1 P , • 1 - 1 date — _=L-'_ Stg H x- - - 1 :f i• 1 •;. 1 i 4 . Date l L / Si nature.` ' 1, - (] 000453/4000337 • • / DATE 10i19l39 II%E •12.1 Driver's License or Social SecurityN: ' t 1 .� t r 1 , !!! • _ 1 _ , k , ;160146 While=Building:Gratin=Cade Enforcement:'Canary—Applicant;Pink—Revenue:Goldenrod—Assessor' -- ' '1. _ ... Ir .l -. _,• ._.__' _ ... - • • ! . ONS±RUCTNAANtt ` a _ 4SPA,• . -Date Inspector • P - O: . ` .•Date ' Inspector I' . . V APPROVALS Permit#2 - _ - - '' ` - - APPROVALS• -_Permit# _ 1 1 Temporary Electrical Service or Pole ' 52. Pool'&•Equipment Location - s ,2:,;Soil Pipe-Undrgrndr, - . �' _ 53 - Steel Reinforcement - „ 'r i - 1'-3=Electrical •Conduit Utility-Undrgrnd.'. - 'r;; ', • 54,' Forms ., e . „---- ;, h 4,Electrical Conduit Undrgrnd T /Zit Y 4P-id 55 Electrical Bonding , • - �;1" 115••Steel.Reinforcement3 /J• '�V/ - 56.-RougI P,lumbing.& Pressure Test,,'' ' - ^ 1�, 4. a;6.gElectrical UFER G nd-. _ : '., - - ' 57.-APPROVAL TO-COVER•GUNITE�;.- • t 7`Footings. , 1:::Q.,.•,,•,..' • - , . • • _ 58 Electrical Conduit-Undrgrnd. - i ,; 8. ,Foundation ''� _ '• "+ ' <�;••. _ 59. %Gas,Pipe, 0•Undrgrnd:,Test - - /1 A: • , 9. Water Pipe Undrgrnd::t • ;w. - c • % Lines, rap;60.- Backwash P-T0 Undrgrnd. •;10.•Structural Floor System s_ - ,...,t. ., 61. :APPROVAL TO°DECK '1 /^, : : !'.4. /II '- 211.. Property Sewer Line'&'House Connection • -.- `• ' i • r , :� , _t •62 Backwash & Receptor.Final • ;, , y 12. Sewer Cap • ci _ ,` 63.,Heater & Vent-Final • �- 1': 213. Roof Drains�1.- • • . ,;: y; 64,..Plumbing System;= Fir-al 2xm 14. Rough Plubing .. ,• - ,, f' 65.. Electrical-Final- ✓`-\ _ 15. Rough Electrical-Conduit -• ' - - • 66:<<*Solar System-Final _ 4 ' 16. Rough Electric,Wiring' • _ 67. Fencing & Access Approval' +� . - 17.: Rough Wiring Sign - • •- • 68 -APPROVED'F.OR PLASTERING I ' 18. Rough Electrical-T Bar Ceilings: 69.'POOL/SPA`SYSTEMS FINAL _ , . -- "'19:yRougfi Re ting'&Air Co`nditioning"' _ ' ";'"tz; • „' .t" .. FIRE,DEPT.REQUIREMENT • " - • 20VRough Factory Fireplace _4:1 r=, tr t, , !APPROVALSZJPermit# • ' ! ;' 21^Ducts, in Structures• " " ' "" '' • • r ,., x_ e is i t t x .. .:70. Underground Hydro .. ' 22-Du`cts ,.Ventilatirig a�` V CD :i: 41; ri .1`.•' P C71. Product Piping ❑Gas ❑Oil 23:'Gas,Pipe?Rough &.Testt.' . ' . 1? '- 't>' - r . ,�x '; ,X72, Underground Fluh s : ' 24: Roof Framing _ r-t..1 • r:a. a •73:1 Undergrnd.Storage:Tank 0 Gas 00i1 - -. 25. Roof Sheathing • • '<'s,.., ' i-v'' ' , - L"' ,y74.`Overhead Hydro,. 26`,.,T-Bar Ceiling (Structural)'&-Monocoat Ci '-' `,c -s-: 75S:Dry Chemical = - , -is' 27 Frame and'Flashing r. M' • „ ^• -" tt 76. Dry Standpipe _ ` _�28. Lathing;& Siding .; ' 'j • . ' .t " . ••t¢ s: 77 FIXED SYSTEM FINAL - ^• - "29. Insulation S. ''y s 78 FIRE PREV- FINAL 1' c, v I -,:. r• I--, • ''-30. Drywall-Nailing ; .ti • t '4 F- . ; I 1." a - -HEALTH1DEPT. REQUIREMENT : oatY31. Plaster Brown C `-= •Y. l; 1 i ' ,t,..-,,,. ,,79. FINAL INSPECTION _ _ .32:'.ElectricalPower Meter;Final " x ' �, I . ,; •'80r FOOD CERTIFICATE ISSUED-: s ,� - .•33°=Final Electric' - 'l: n- + r� , 1' Nofes: "'-=' '.lL�: ' - 3 - c•: .. .. Y _.:-, r, 1: 'ti t I v l"5`. • n c' _ -- ._., ' x - •S t , , ti 34.Final Heating& Air.Conditioning . .,. ; k, .j j a; - •- • f-,;. -' • n352Final Gas Pipe-Test: r:: Y% H . I • ;. - :,. C. - "sir 36 .H `od or CanoPY • 1, ;••••“-.1- sr; t , : c:e y il 1a37`Final Factory Fireplace; ,-s' - ! 'I , +'s - '-" `< - - Y., ;Y ._ 1:t•.. 1: ^' . . i ..a. rt :- 38. Final Plumbing ,;,.f . '139. Water Service-Final: .: - Y r-- ' I I h: .;. . r + �� -s 40. Gas Service-Final O. , y T' , ` •. - `'' _. _ f tee- . . a•41. Solar Domestic-Fin-alO - . i:,' -E: ` I I p� '-::.r c- . ' - ' - - `42. Backflow Preventer ti t .1 s- ' _ _ " 43: Backflow Irrigation' - r t _ ' , 44.,Landscape Irrigation Systern-.; c " ,y E. j .- E XhE Ds' - 45 Sound !Attenuation r• =•, i .InCUlIlPIe; p 46:-Handicap Regulations '' _ {� Qate " ' - L.- - ' 477FINALLSTRUCTURE & BUILDING -t. !- - * r. '" :,- j 4B jFINAL',PLANNING - `} i 1* 's p ' 49":Ele-ric Release to Edison 1._ • ..is I 1,...---2.1 7_,..1*,:ir:1111slirgicti.4.,i_.:::.'.. _ c ;,, H . - 50='GasyRelease to-Southerri o ' Californiania Gas '•✓i : „ r ,: ; nom �' it • 51_. CERTIFICATE OF'OCCUPANCY • ' .w --'T , • • No. ` Date __ _ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . CITY OF COSTA MESA CO/N�STRUCTION'PERMIT PERUIT NO.���� TRACY NO ` LOT NO. I^N�T NO. • II • + _.' •y ��I �1� I T, Project Address 2l..o CO(O c'.D rT) ' • _N ' o� I KIT • 1• {. ` 'I ' Fla +.• L Applicanf�Nleiling'Address ) I - TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION REPAIR ) ' - I I I ' • I w I ❑ CONVERSION' ❑ DEMOLISH ❑ OTHER • A P # I t- I + I Zone Owner's Name' I �L:� Z • • , Phone ' DESCRIPTION OF WORK/USE OF BLDG. - (Oa -• - - - - - + — -- — , + Addr• ess • 4 I 4 4 S Main Building: • . I ;Accessory'Building: I- {' - l' Arch/Eng , '• , I License No. ' - • - • I TYPE OF PERMIT , ❑ GRADING ❑FOUNDATI IOTNy ❑ STRUCTURAL : E Front I I , o Address ) ''/ ; 4�7' ,/-� I 1 ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING L[{ MECHANICAL I 1 B Rear • r ) 1 • N ' 1 Contractors Name /e/C/e•S! ' •,/ eor14/c- Phone la � .l ( ❑ ,OTHER I '; ! I' r - I A 1 • I 1 f • I 7 . { C Right ) f. I - PROJECT DESCRIPTION 5D. FT. OCCUPANCY • Address(mailing/ 735', 14-4- /L •_4 - HB - _ K I G. , �/)��� + CONSTRUCTION TVPE . VALUATIONS : 1 • S Left i 'i City License No. '7 r ZONE - GRADING CV.YDS: ' I ACRES 1 _ + R ' LICENSED CONTRACTOR DECLARATION j j 1 1 1. , . Ping. Ref.# ' Parking Req./Provided ) ; E • • - I. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' II • •, n • 2�Q'Z....4- •r ' ` ! - t planning Notes: I , ' t.°, j ,. : M Ifs` with section 7000) of Division 3 of'the Business and,Professions Code, and - _ (J ` • my license is in full force and effect. 1 - y ) ' 1' t I •{ ; i - + i' ' • ; • - T ('•1t0 License C-�ss License No.J i ' c S • ` Date /' '7 •Signature *PLUMBING • :FEES' ' ! 1 i 't •- r -'ORKERS'COMPENSATION DECLARATION j 1 - - 4 _ - - _ ,- I Bar Sink , Showers a ? ereby affirm that)! have a certificate of consent to self-insure or a'certificate . . v Y ( - ,ELECTRICAL FEES' Workers' Compensation Insurance, or a icertified copy thereof•(Section I _ :�, , -- " _� / 3800, Lab, j� l + i f Backflow Preventer "-� i t Service Sink -s' • ,�I Automatic Washer 1 Transformer'❑ 15-50 KW ' � _ • Policy No. �(.lTJ3 803 i Company 57A 7r F!/b .• Backflow Irrigation Y I Sewer Ca ,• I �❑ 50+ KW' • Certified copy is hereby furnished. I , , II - p ' _ ; DOn$trUCtloq POI¢$Ub. , I'; _ I C' Cert ifie cQ�y ij f{hed with aha city Buil furs" : Bathtubs . Sewer Connection r V. .. Cooking Unit Meter, ❑up to 100 amps , • Date �' ZJ CJ/ Applicant I - - a' ... . , EXEMPTION FROM WORKERS'COMPENSATION/ 4RIEGC ATION ' Clarifiers ' u. Solar'Collectors - . . - y 4 r fifi -. - Dishwasher ._ 1 , Meter Dover 100 amps _ (This section need not be completed if the permit is for o e untlred ($100)or • less r e ? r' ' issued, • Dishwasher _ p .9 ` ;r .; , , , r. - Dryers ❑Gas -❑Electric .•i I Sub:Panel ' • _ , , , - 'I - )., r { + Solar Pi in certify that in they rmance of the work for which this permit Is Issued, , _ - • - - ' I , shall not employ any person pin any manner so as to become subject to the- '; ; Dririking,Fountains' • ' So lar Tank • 'i f' Fan I - ) 'Workers' Compensation Laws'of California. r I ' r - : - ' •_ •• .. - - -1 I •' Motors❑0-1 HP.❑1%-8 . Date: - - • Signature Floor Drains • Swimming Pool w/Spa I F.A',U _ ., I- • Pr.' ' -- - (]9-15 HP,❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith I Floor Sinks , -t Urinal '� ' - t .. comply with• such: provisions or, this permit shall be deemed revoked. I - - 'i' r _ w ' Fixtures � ' Microwave( + t 4 •, 'CONSTRUCTION LENDING AGENCY 4 ) i : Gas Service Outlets I i l I hereby affirm that thereris a construction lending agency for the performance • -- • I Water ClCIOs¢t j 'no Device Boxes 'I. , �, Pole Light • of the work 1 for which this permit: is issued (Section 3097 Civ- C.) Interceptors 1 •I , Water Heater i dr-FrOutlets • ; Lender's Name - - Range Lender,'s.Address - ' -_ t Kitchen,Sink - _, -, Water Service' _. _ i •_. .. .Switches .-�-,_ _ - _ _ ._.•. I OWNER BUILDER DECLARATION - a 1 - - • - , -- __ ..Sign I hereby affirm that I am exempt from;the Contractor's License Law for the ' - Lavatories i + 1 Auto-Wash I' Garbage Disposal 'Standing Sections r + following:reason (Section 7031.5 Business and Professional Code: Any city'or "' - ' r + ] i county which requires a permit to Construct;alter,improve, t for or-repair —• P-Trap-- • •I '. Laundr Tra s 1` - • + y V .'_' Generator.100-5 KW:, KW any structure;prior to its issuance;.also requires the applicant for such permit - I I. Trash Compactor ' I to file a signed statement that he/she is licensed pursuant to the provisions of "' ) I ) ' 'yI^. - - 'he-Contractor's License Law(Chapter 9(commencing with Section is7000)axe of I Roof Drains I , , 1 ivisiOn-3 -of the•Business and'Professions exe.Code) or that he/she-is exempt--, - -. — - - -T•- Y — - _ .. . . _..._.. .. - _.. _ .- erefrum ands the'basis for the alleged exemption:Any violation of Section 1 ' - • 1 { - • - penalt 'by any applicant for a -permit subjects the applicant to;a civil' -� _ '— penalty,of not more than five hundred dollars($500). t -{ - ' .. I ! I ;, I - i. I Reinspection Fee' ' i $, 3 '•' ' - l 0 I, as owner of'the property or-my employees with wages as their sole - 1 , Pfff $15 Issue Fee, - • cor sale t en:will do.the work, and the structure is not : The ed Contractor's red - - ` - ' - Reinspection Fee ' ! $15 Issue Fee I - $'3 - Lor ,sale (Section 7044, Business and ,Professional Code: The Contractor's , MECHANICAL; + -FEES - - ' • , License Law does not apply to an owner.of a property who builds or improves - - - thereon, and who does such such.work ovem himself/herself or through his or her own - , - , DEVELOPMENT SERVICES REQUIREMENTS: . ' __ employees, provided that such improvements are not intended or offered for - Boiler Hood or ' Type I ❑ II - I ,� .sale. If,.howownethe building burden eme tis sold within one year of com- _ -- Canopy ' Type II ❑ ' - 'j ,zoning Approved By Date • _? • - pletionor he owner will'have the of proving he/she did not build or ins- Duct=Under Ground - , Building Approved By 1 - Date - f--prove for the,purpose of sale): • : , - �yy�i• . -❑-I;as owner.of-the,property,am exclusively contracting with licensed-'con- ' Duct-Structural Refrigeration System • - I (Application Issued By • - 1 ' Dat: Attar tractors to construct the project (Section 7044,Business and,Professions Code: - r i - • The Contractor's. License Law does;not apply-to an owner.of property-who Duct-Ventilating r ' ❑0.100,000 BTU ❑100,000 BTU I "� SUMMARY OF FEES - builds or limproves'thereon, and who'contracts for such projects with a con- - - BT, •• - - r BUILDING PERMIT tractor(s) license pursuant'to the Contractor's License•Law). Ilam aware that' Exhaust System 0 Multiple❑ System.Repair/Alteration - I $ ' LSMIP - $ proof off their, under ectionpensation insurance should be provided to me: - - PLAN CHECK • '$ PERMIT I ❑;I am exempt under Section ' - B.& PtC.for this reason- Firepl/Fact.BIL9CB0# Fire Dampers • . PLUMBING ? _. _ , . Dater - ••-' • owner ' - ,• - ' - I Heating System & Ducting i ' Registers _ _ ' PLAN CHECK 25/ '$ - - ":ENERGY P.C' •$ • - .I hereby certify that I have read this application and state that the above'' : / 0.100:000 BTU ❑i00000B - _. GRADING - information is correct. I agree to comply with all city and county ordinances- • - -, - - 1 - - ELECTRICAL " $;" • • and state laws relating to building construction, and-hereby authorize repre-- . - - . - . - - • • - -' : • _MICROFILM •$. ' sentatives of.this city t enter' upon. the;above-mentioned property_for. , I . , , : r - - _ ' _ PLAN CHECK 50°.6 $- I , inspection purposes. ///�} J : 7-6-127 . - - - - 4 - - s :�•_ Signature' - `-!'� 9'�//� Reinspection'Fee. '. $15- . . i Issue Fee .' , ' $ 3, * PLAN-CHECK 25%.,$ / 0 - + ' j - ) CMF 0865:46,rev.10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor •� - "- - - _' l ' - 1 POOL&ZSPA•_ -- - '• - /1;11 ' ;: CONSTRUCTION AND PLANNING' _ __ _ _ - �.- . . - - ._ -'Date- I Inspector tom-• - i Date Inspector . APPROVALS Permit'# • APPROVALS Permit • _ • 1.'Temporary Electrical Service orPole ' _ i X LL 52. Pool & Equipment Location' ' i .;r 2, Soil Pip • e-Undrgrnd.',r I r53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd, , ' I '54. Forms: : . :; • ` i i ' 4, Electrical CoElectrical;Bonding' ' • : + . . • I' ' ' 5. :Steel Reinforcement ' ' j- :'I• I j. I :56,. Rough Plumbing & Pressure Test •i , : , 6. Electrical UFER Grnd, 1 - 1 157-'APPROVALTO COVER-GUNITE: • L. 7. Footings -i , r, ; _,: ; 58,; Electrical Conduit-Undrgrnd, - ' ' ' .! r 11 ;�B,r Foundation ' . ' -"-',- `L ",-- -- ' -' '59:--Gas'Pipe,'O-Undrgrnd„ Test , .-9:-.Water Pipe-Undrgrnd: 60. Backwash Lines,-P Trap, O Undrgrnd. v • - 10. Structural Floor System' .. • 61. APPROVAL TO DECK ' ' ,I it • •11. Property Sewer Line'& House_Connection " , ' • I i , 62. Backwash & Receptor-Final; I 4 ', r 12. Sewer Capt ' 63. Heater & Vent-Final 13,;Roof-Drains , E 64. Plumbing SystemL- Final I , i I 14. Rough Plumbing ja ' i � 65, Electrical-Final : - . 15..Rou h Electrical-Conduit - = " ' ' 9 ' ' r . .66, Solar System-Final ! .; I , 16, Rough Electric Wiring. • ' -} • -' 1 :67 Fencing & Acce'ss Approval , ' "_ _ • " 17,•, Rough,WiringSigh '--**""4' . 7RING ' _ i ' 68.`APPROVED FOR PLAS• TERING. ` . 18. Rough,Electrical-TBar-Ceiling;It:•7" ;, i : , , • 69. POOL/SPA SYSTEMS FINAL " - .19., Rough Heating & Air Conditioning " dA Vs-i a ` FIRE DEPT- REQUIREMENT , - _ 20. Rough Factory Fireplace , i , " ' ,APPROVALS Permit# _ ' 21, Ducts, in Structure. • i ` 70. Underground Hydro : - ' • A 22, DuctsVentilating= • . "I , ' x .71, Product Piping 0 Gas ,, O Oil , - i . - , ,, • , 23, Gas Pipe-Rough & Test i ; 1, t l 72. Underground Flush ' ' , , I - ;l c ; ' : 24„ Roof Framing ; I - ? . 73- Undergrnd:Storage Tank O GasC O Oil '' 25- Roof Sheathing ,--• C 74.-Overhead Hydro , ' Il : i K^ 26. T-Bar Ceiling (Structural) & Monocoat + . •• - 75i,Dry;Chemical , ,.1 . _ I',. - 27.' Frame and Flashing","..";-- ,: 7,,,.4" f i ' - ! 76. DryStandpipe- • „ I! 11I . 28. Lathing&Siding 77. FIXED SYSTEM'FINAL ' - , 29, Insulation 78, FIRE RREV. FINAL' I' Cyt• ' ` r 30. Drywall Nailing . I i " I HEALTH DEPT, REQUIREMENT ' _ 31. Plaster Brown Coat • . •" ' } ' . . 79._FINALINSPECTION ,. r�. I I 32. Electrical Power Meter-Final 1. _ 80.:FOOD CERTIFICATE ISSUED; ' .✓• : 33, Final Electric • '' - e , • Notes:^ ' .. y - 34. Fina bHeating & Air Conditioning �R f9/�•��/X7� - + _ - ; 35, Final•G5s Pipe-Test. r //` _. 36. Hood or Canopy c ''1 37i:4-Final Factory Fireplace • " : ' - r' - ,,r• ,ti' 38�iFinal Plumbing -' - . GJ , n I IL, 39. WaterlService-Final _ - _ •:'u�� • !ttilA. in li `t'" '' 'r40. Gas Service-Final` - - _ • - 41. Solar Domestic-Final ' �.- .S.:1--' ` , ;! , ]. - 4:. ?42. Backflow Preventer' - f " - •. ',f,- < °' -• „` .• :n "43tt, , Backflow Irrigation " - _ - �`- - %' ec :4,41,/-Landscape Irrigation System; _ - _ ' • 'Nu `` kg . 45f Sound Attenuation" _ _ ;, , (•/ 0 % ' ' ' 46' Handicap:Regulations - ! Q �I- - 4rt.- i . '• 4,.'FINALSTRUCTURE,& BUILDING , - - � ,' i11 _ - �t � .I • 48. Special Requirements Completed - - " i " k : 1,49-- 49, Electric Release to Edison • . - O. ' 50, Gas Release to Southern California Gas_ Co - , - '•'. ,� '51. CERTIFICATE OF OCCUPANCY - ' - - - 7 iF No. Date _ .. _ - - - - ,t, - - 1 -. • - - N. _-,, - E inspacesexcept those withinNOeavy border lines9 all appropriate declarations.-_• _ _ _ Applicant to fillall tl and.sign ppropria • CITY OF COSTA MESA CONSTRUCTION:fPERMIT P RK,JT N O ,, TRACT LOT NO. ( UN C T— 'i' •, {_as ; 7I):/.17 I { 6o' ; I p��/-� � rid; O 1 I { Project Address 7� IGl:i�lG� F /-, , { I rI U ALTERATION REPAIR 1 j + t - i I - 1 ` TYPE OF CONSTRUCTION NEW L ;'ADD f - Appl+cant'S Mailing Address , r t C I ' El ❑ DEMOLISH ❑ OTHER A.P,# _ _ I ).I Zone • + Own'er's Name • / `l-� �-^ Phone • • DESCRIPTION OF WORK/USE OF BLDG.' eDNbon +-- • - I-.. "'• - -- - - -- Address , I ' I I • ! • • + . 1 I S Main Building: •• '{ Accessory Building: ) ' vE ' t • ' Z Arch/Eng. • I License No.-' TYPE OF PERMIT ! ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL . ',T Front: �_ I ) G +' I t r { . , ❑ TEN ANTI ❑ ELECTRICAL' CI PLUMBING MECHANICAL 'g 'I N intAddress �5 ❑'OTHER ! , I ,A Rear i f l _ I /G/e.--- HT& 'rig.' Phone OL/Z chi / , • C Right ..r-. Contractor's Name - ' I 1 PROJECT DESCRIPTION , SQ, FT- " OCCUPANCY :K - G Address(mailing) !• 3SI NC► L. — K— �' { �/y�`/ 1 f CON ST RUCTION TYPE VALUATION$ $ Left • I R City,License No. `LL -?y + ZONE GRADING CU.YDS. • ACRES t ' t I _ Ping. Ref.# Parking Req,/Provided E LICENSED CONTRACTOR DECLARATION • • 1 - - - Q I hereby affirm that I-amlicensed under provisions of Charter 9 (commencing • Remarks: ' + •� OZ •' - ; t tc Planning Notes: M with section 7000):of Division 3 of the Business and.ProfessiOns Code, and - ! 7 T 1 my license is in full force a effect. • + - ` "` I • + I' License Class �� - Li' nse o ' ' I • • - - - - 4$ I I 1_ it Date Signature - .. 1 t -PLUMBING _• yFEES - -' 'ORKE RS'COMPENSATION DECLARATION ( • Bar Sink - ' r _ . Showers; t ' _ .ereby affirm that I have a certificate of consent to self-insure or a certificate f _ ELECTRICAL - - ! FEES Workers' Compensation Insurance, or a certified 'c py there f (Section �� - + ' Backflow Preventer Service Sink e I _) ' • J Automatic Washer ' Transformer=❑ 15.50 KW ' • I ' •3800, Lab. C.) (0 1 , • , - • _ _ Policy •No. -•�3SC�� Company -Backflow Irrigation Sewer.,Ca _ , '+ I t - ❑ 50+ KW _ Certified copy,is hereby turn fished, I J_—_ p • ' COnstruction'Pole Sub., ! i_ t Cert ifi�e�aatl��copy is fi`py}P�jd,wit hlthe city Building D slo ' Bathtubs Sewer Connection Cooking Unit • - i • Meter'Duo to 100 amps' • 1 Date —Y" 8M"7 Applicant 1 • /'J� I a • _ EXEMPTION FROM WORKERS'COMPENSATION DEC RA ION ' ' Clarifiers " 1 „ S r` SOIar Collectors. c { t 1 Dishwasher . I •a j -Meter ❑overt00 amps _ I -x • I (This section need not be completed if the permit Is for one hun ed ($100)nor , - .less .I I' • ! - , Dishwasher- L.: I - , ' Solar Pi m 1 ° - Dryers - ,. Sub Panel I ° I ' 'f ): t - p 9 :❑Gas :❑E lectnc h' i, I certify that in the performance of t manner for which this per u is issued,I ( - s all jnot employ any person.in any manner so as to become subject to the _ Dririking,Fountains + ' Solar Tank _ 4 ) "f - I , r ,..1 ' t Workers' Compensation Lawsjot California. - I '- : -- - -i n Fan l i , Motors❑0-1 HP O1'/x;R , ' + t a. . Date " • •I Signature !• 'f { ', Floor Drains $' - Swimming Pool w/Spa V-17': - a u. - - 4,. . NOT.ICE:..I f;,af ter making_th is declaration,yp u.sh oultl become.subject to the_: __ _._ _ _ ' • ------ I' of r 5 6 F Inc S a: ❑9-i HP ❑1 -15+ Workers' Compensation provisions of'the Labor Code, you must forthwith. , I FloorSinks , Urinal. - • i' - - I { comply with such; provisions or this permit shall'be deemed revoked, I - ( Fixtures ; { Microwave I' I I 1 CONSTRUCTION LENDING AGENCY • - Gas Service ' Outlets Water •Closet , ' - ' . I hereby affirmlthat there is a construction lending agency for the performance ' - - Device Boxes � Pole Light i 1 of the work•for,which this permit is issued (Section 3097 Civ, C,) - Interceptors i Water Heater , - I I Outlets t ' - ' Lender's Name I Range I1 { _ _Len NE Address... ,S Kitchen Sink . Water Service I. _ L _ _ _ _ r _.. . Switches ' OWNER BUILDER DECLARATION ' _ "-T"' Sign I hereby affirm that I am exempt from the Contractor's License Law for the , Lavatories ' Auto-Wash ' -� • Garbage Disposal Standing Sections i ' ' founty g:reas (Section 7031.5-Businessto and Professional Code: Any citwor , - ' : - • county which requires a permit to construct,alter,improve;demolish or repair • ` PcTra �. ' - , any structure, prior to its issuance, also requires the applicant for such permit ' r• p - Laundry Trays t �l , _ Generator'❑D-5 KW.❑5-,}5 KW ! to file a signed statement that he/she is licensed pursuant to the provisions of ' - I I Trash Compactor i 'he Contractor/5 License Law,(Chapter 9(commencing with Section 7000)of • ROOf Drains ' , tuition-3 of-thee Business-and Professions ons,Code) or:that,he/she-is exempt' --- -- - �-•- --- - •- - - --- -- -- - - - • .1. erefrom and the'basis for the alleged exemption. Any violation of;section • ` _ I 031.5:by anyapplicant for a applicant to: a civil L 1 i f pp permit subjects the a II ' • penalty,of nbtlm ore than five hundred dollars($500). ( -• . ; I . - I • l j. ' co I, as' owner of the property or my employees with inceWages as'their sole ' I Reinspection; Fee if $15 _ . ' Issue Fee - $ 3 • - _ _ compensation, will do.the work, and the structure is not intended or offered - - - Reinspection Fee I $15 ( Issue Fee •; $ 3 le (Section.-7044, Business,and Professional Code: The s or actor's " I • MECHANICAL FEES I ' ' License Law does not apply to an owner of a property who builds or improves , thereon, and who does such work himself/nerselfnot through his-or her own - - + 'DEVELOPMENT SERVICES'REQUIREMENTS: ' + - ; - 1 '.-employees, provided that such improvements are.not Intended or offered for ' Boiler . j , lCano or Type I !❑' I ' sale If;however;the building or improvement is sold within one year of com- n Canopy .Type I I ❑ .Zoning Approved By _ Date pletion:the owner will':have the burden of proving he/she did not build or im- - Duct-Under Ground i - - '+ -prove for the purpose p sale): - , I - - • • I - _ - f mprov .e; Approved By _Dated 1 ❑-n; as owner of:the property, am exclusively contracting with licensed con- ! Duct-Structural , ( Refrigeration System + '' �; Appliaition Issued By ' - - Date _Fr/ ' tractors-to construct the project (Section 7044, Business anessions•code � - ' j "The;Contractor's License Law does-not apply;to an ownerer,-of-.ofc property who ' , Duct-Ventilating t I • '❑0-100,000 BTU ❑1.06,000 BTU , "-1 ,r I ' - SUMMARY OF;FEES • - 'buildsior,improves,thereon, and'who Contra Cts:for-such projects with a•con- II_`- t • i tractor(s)n+cense pursuant to;the Contractors LicenserLaw), 1•am aware that' Exhaust Systerri•❑ Multiple 0 "; System Repair/Alteration l ( BUILDING PERMIT' $,\ '•SMIP • $ - • 'proof.off their, Worker's Compensation insurance should be.provided to me: .- - t ' 1— - i - PLAN CHECK $ •;PERMIT, 0 1 am exempt under-Section - B!& P.C_for this reason - Firepll Fact.BIG ICBG# • Fire;Dampers •>�+ = ISSUANCE . $_ i (, u • ' - -_ .• - - _ . Date' ' ` • 7 . Owner • '• ' ` • - - ? Heating System& Ducting -_ ., Registers I • PLAN CHECK' 25% $. ENERGY P C. S. I — , --I hereby 'certifycthat.I have'read this.application and state that the above' -/ 0100000 BTU ❑100000 BT - information is correct: I agree to comply•with all city and county ordinances ' - •E t - ' ELECTRICAL: ., '$- - GRADING _ '$ and,state laws relating-to building construction,and.hereby authorize repre-- MICROFILM $ 1 - sentatives of this city to-enter up he above-mentioned property:for - _ - t : f I PLAN CHECK;,50% $, -- inspection purposes. �y MECHANICAL '$" 0 p, A f. Signature • - , ��' - .� Reinspection Fee • ,$15' Issue Fee -$ 3" PLAN CHECK" 25%. $ 0 n - I Drivers' License or SS + t -__ .- .- __ ._ , __ • _- ___._.. ._ ._- _ -. _. _ _ __ _ - _ _ __ _ __ -_ __ .-- - - __ -CMF 0865-46,rev,30/84 White - Buildin Canary -Appll Cant; Pink -Accountin Goldenrod - - q; 9: A55e55gr CONSTRUCTION AND PLANNING _' _ ,__ . _.... ' POOL&SPA - - .. - : ! •.f � '. -•-i _. _. • Date Inspector i Date' t Inspector ' APPROVALS Permit# ' • 4 , ' APPROVALS Permit #` 1.:Temporary ElectricaliService or Pole 1 52. Pool &'Equipment,Location , : ! r 1 fj i ' 2. SoilPipe-Undrgrnd. - { • , 453. Steel Reinforcemlent; , 1 I ' • : ' I I, ' ' 3. Electrical Conduit Utility-Undrgrnd: ! ' •- • ' I . Forms ! I4 • I' 4. Electrical Conduit-Undrgrnd. t5 , I 1 1 55. Electrical.Bonding • ' , I ' 5 Steel Reinforcement ` ' ' ' . 56. Rough Plumbing'& Pressure Test ' ;d• i • i `( ,' 6.•Electrical UFER Grnd. ' ' c. , ' I r 1:. .'57.•'APPROVAL TO COVE• R'-GUNITE ' . ' 1, , y; • i 7. Footings , , :a ° i x• 1 If- I ; ,58. Electrical'Conduit.Undrgrnd, •),t r 1„ :i i� 8: Foundation ' - lr -I- - -' 59.-GasPipe; ❑'Undrgrn� Test , ' ,-- i r • ! 9_ Water Pipe-Undrgrnd. •! - '- 60: Backwash Lines, P_Trap, D Undrgrnd.: 1 = 10. Structural Floor,System t 61. APPROVAL TO DECK • * I ' 11. Property Sewer Line:& Hous&Connection '• 1 62. Backwash & Receptor-Final• r i ' 12. Sewer Cap ' " ' ' • 63. Heater & Vent-Final . ' i 1 ` • 13; Roof Drains - m : 1 ' 'S, - ' . ' . t 64. Plubing System.- Final i 14. Rough Plumbing ` .: - al-Final 65. Electric ' 1' e , • - • 15' Rough'Electrical-Conduit , l - . 66. Solar System-Final 4 I - `- 16.-Rough Electric Wiringr "' - 'j ` '6/ Fencing &Access Approval [ ' _ .; ' . " '17. -Rough Wiring Sign - i • � - 68. APPROVED FOR PLASTERING `•4 18. Rough Electrical-T Bar;CeilingP.,' , ;-' . 1- ' 69. POOL/SPA SYSTEMS FINAL ;4 i 19. Rough Heating & Air Conditioning r�/ 47 8� ' FIRE DEPT. REQUIREMENT - . • 20. Rough Factory Fireplace 14/1,7 ` APPROVALS • Permit - - _ - 21. Ducts, in Structure: • , ` I , - 't 70. Underground Hydro; i • . ` $ • 22. Ducts, Ventilating " . , 23. Gas Pipe-Rough & Test, - - - 1 72. Underground Flush . f 4.4,, I 24. Roof Framing ' ' „ " ' l ' • ,,i ' i. 73. Undergrnd.Storage Tnk❑Gas' 0 Oil 25: Roof Sheathing -., - . , , I ;' • ' 74. Overhead Hydro I .� •' ...el• ' - ' --' 26. T-Bar Ceiling.(Structural) & Monocoat 75:Dry�Chemical1 + : ."h 'l) i "1 - 1 27. Frame and Flashing _ - - 76. Dry Standpipe 4m ' !:; ",' , ' 28. Lathing &Siding ' 1 77, FIXED SYSTEM,FINAL pi : _ ti'; ' ' ' 29. Insulation • . ' . I 1 : ' , ; • 78. FIRE PREV. FINAL " ' 30: Drywall Nailing i ' ' ' HEALTH DEPT. REQUIREMENT ., . 31. Plaster Brown Coat ' ' ' I 79. FINAL INSPECTION 32.1 Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED , 33. Final Electric - - Notes: , ' > • " • "' 4.( / 34. Final:Hea•ting & Air Conditioning - ' - i 35. Final"Gas Pipe-Test ' _ . • 36. Hood or Canopy- -_..... r _ ._ .. _.__ . ___ ._ _-. _ t/ .T - r Via'- - .f .�: 37. oFinal Factory Fireplace Yr • 41 • < I,, 38"Final Plumbing . . • . .0 f t 39. Water•Service:Final. • y Lr .'Ib7. • s,3 • Il �, t, ego. Gas'Service=Final - ' .. '' j' Cl'„{'� •d , r1� ' ' ey •x'41. Solar Domestic-`Finala -- " - - An lfo S#t. r 7 c yr ;I .(•.;•r 42. Backflow,Preventer'' •- 143. Backflow Irrigation •' ; -...°.--' ' 1 a-. '• _ .1:I, L ,,, . ( 44'r,Landscape Irrigation System , t• . ,- - . - - 'it - - • i" ''L'--, .„' t-ii. E • 45.(Sound Attenuation- _ ' I G 46f Handicap Regulations ..• - - : . . -i' ui' = • _ I;!I:�. : ' ti - 47YFINAL STRUCTURE & BUILDING . - - " cA.- ' ICI: -- Lit •' ' 1 N ' .✓ - ' 'it. 48. Special RequirementsCompleted • . •. • .. c-,..-- .' ..- (c,,. _0 : t,; ' ' 49..Electric Release to Edison- i"-°' _ :_ _ ? - 1 - V- - _ • - ' 50. Gas Release-AO Southern California Gas Co '' - • .. . I - - - • ' 51. CERTIFICATE OF OCCUPANCY • - - - : '; " - : " ...7 -. - No. Date • ., 7 - ' - " -- _. / 7 I _ _ _ -Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - _ _J. _ _ _ _ . . _ _ _ _ _ _ en CITY OF COSTA,M�E�p,e �O T1 Ni ' �� PERMIT NO. 1 TRACT NO. .I LOT NO. 'UNIT NO: f ' j ' '*a�Dp tb I;i. fog -- --• ' I Project Address (5C/� l � ISG V l� E��•7 lo M N' 3392 •6/1'1/87 1 . r 96.60 TL A licant's ; TYPE OF CONSTRUCTION EW 117-ADD j(r�{I - - - ' ' - - pp moiling A•dress 1 ]- ' •� U ALTERATION LJ REPAIR Owner's Name �_M r 1••-ne - `33 7'y r ❑ CONVERSION, ❑,DE LISH ❑ OTHER ) •q p #.. _ - __ ......f_ - ` • DESCRIPTION OF WORK/USE OF BLDG. - I Address ' '-. I _ S Main Building: ' I ' Accessory Building; , • Arch/Eng' ' i Li• cense No. - • ' TYPE OF PERMIT ElGRADING• ❑ FOUNDATION CI STRUCTURAL T Front i 1 j • Address - s . - i •' ❑ TENANT LECTRICAL. ❑ PLUMBING El MECHANICAL j B + t ' N � //���� ❑ OTHER, •.; I q Rear I ' - Contractor's Name 7565 EL.E-d c te__ ' xPi�o a��333 Address(mailing) 5 3c mon N©lU i A`-" PROJECT DESCRIPTION 'SQ. FT. : - • • OCCUPANCY • K RigfiP"' ; N 3 t„1) ` I CONSTRUCTION T.V PE VALUATIONS S Left • R J City.License No. T`C Ll ZONE • • GRADING CU.YDS. ' ACRES - t • LICENSED CONTRACTOR DECLARATION I ( . - Ping.iRef.# , . I Parking Req,/Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' I - I Q wlthisection 7000) of Division 3 of the Business and•Professions Code,and - I - 41 •• - Planning Notes: , , I M • my license is in full f• ce .ntl effect. : I - •I� /1� Off - I _ - • I T • License 1 55 ♦ • Icen;N•�a Or, - °� ^E' y d- ` - S Date' • Signature ��-_� _ ._i - / - • •. , . 'PLUMBING • " ,FEES: - , - - _ s 'ORKERS'COMPENSATION DECLARATION - Bar Sink i; Showers • hereby affirm thatI have a certificate of consent to self-insure or-a certificate .+ 2 'ELECTRICAL' ' { ' FEES - of Workers', Compensation Insurance, or a certified Copy,thereof (Section Backflow Fret/enter' = J Service Sink r ' "' _ - - - - s _ 3800, Lab. s-),.li t••. .n + r•. - �Atitomatic Washer Transformer D 15 50 KW ;. -Policy No. WC..5'13/T 87• Company •rec-m-i .-t ' ' f Backflow Irrigation •f ' r Sewer Cap• ' ". _ _ Construction Po le Sub 1 a. 50+ KW` - �a ¢miffed copy is•hereby furnished. - - + , ertif"i@p cct filed,with'the city B II I'�_'/TDiv' 1 Bathtubs - - , Sewer Connection i/•y Cookin Umt /` Meter\�J�u to 100 dm s J Date' d 7 �• Applicant /fl .. f L/ 9 tC / v v s �a-O�i EXEMPTION FROM WORKERS'COMPENSATION DECLA ATION• • Clarifiers , _ Solar Collector{, , - 'jam Dishwasher _:a - ' 1 ' - Meter Oove,100 amps �jC (This section need not becompleted if the permit is for one hundred (8100) or ` ' - - - • ' - •• - p less). a Dishwasher:. ; - • - , Solar Piping I ' . Dryers�LE,,f,.(,,ias DElecti is - 2 Sub Panel f _ j �.r• OD I certify that in th • e performance of the work for which this permit is issued, I - - - _ - - �" ' •- - shall not employ any person'in any manner so as to become subject to the ,Drinking°Fountains I : , Solar Tank . S ) ' Fan Workers' Compensation Laws of California. , - • - _ - I , Motors DO-1.HP �1 Y=-8 ,. ' _ I y OQ Date' Signature ( Floor Drains . ' + Swimming Poo Spa ' F.A.U. ' ' 1 ' ' - ' Norkers 4f,after making th vision aration,you should become subject to the -- i _ I Ino.Solar 09 15 HP•❑1 B-15+ � Workers' Compensation provisions of the Labor Code, you must forthwith , Floor Sinks. I . Urinal . • ' I L Fixtures 1 i 1 /, comply with such. provisions or. this permit shall,be deemed revoked. i_ - - , Microwave (D_00 ' CONSTRUCTION LENDING AGENCY Gas Service Outlets - ' 1 hereby affirm that there is a construction lending agency for the performance er'Closet • up Device Boxes I i - , , Pole Light; s: ; of the work 'for'which this permit is issued (Section 3097 Civ. C.) f ; Interceptors / Water Heater: • ' Lo Outlets i -: ' Range I �� Lender's Name - - • •- .Lender's Address - - Kitchensink '__. .--I / - Water-Service — ' -- -- -'- Switches+ '»--I- _ - -,_r "_5 - i.� • OWNER BUILDEDECLARATION R . - ATION -- { - , Sigol yQ ' I hereby affirm that I am exempt from the Contractor's License,Law for the Lavatories l/ : Auto-Wash ; . Garba a Disposal 1 9 P 1 . •' Standing Sections • following:reazon (Section 7031.5 Business and Professional Code: Any city;or - ' - 20o county which requires a permit to construct;alter,improve,demolish or repair • P—TrapBy „ 1 • Laundry Trays ? 's1 G enerator DO-5 KW 05-15 KW any structure, prior to its issuance, also requires the applicant for such permit _ - - ;yt Trash Compactor ' to file a signed statement that he/she is licensed pursuant to the provisions of _ • - I __ ; • , 'he Contractor's License Law (Chapter 9 (commencing with Section 7000)of Roof Dr.... t : •,t, - _ i , • therefrom and of the-Business-ane-Profess;ons Coden.or•that he/she is exempt-- - -- . --. -- - 1�- �--- 1 - - - - . .• f • r' + therefrom antl the for the alleged exemption. Any violation of Section- • 7031.5,by any applicant for a :permit subjects the applicant to,•a civil ' I - -• - - t ' ' ¢pally of not.more than five hundred dollars ($500). , + I 1 Reinspection FeeI. , . $ 3 I • i : • ?. 9 I, as owner of the property or my employees with wages as their sole pet $15 . Issue Fee - compensation„will do.the work, and the structure is not intended,Contractor's `y Reinspection Fee ' $15 Issue Fee "'l $ 3'. - ' • le (Section'7044/ to an owner Professional Code:builds tor's , MECHANICAL, :FEES• I. ` License Law does not apply to an owner of a.property who builds or improves _ - , i ' thereon, and who does such-work himself/herself or through his or her own , 'Hood or Type •❑ 4-DEVELOPMENT SERVICES REQUIREMENTS: ' S • ,- e le, If, es, provided that such improvements are not intended or offered for Boiler , _ yp _ . , I • 3 '- sale. If, however, the building or improvement is sold within one year of com- - ,Canopy Type II ID 4 - Zoning Approved By Date ' .prove f, the—owner will'have the burden of proving he/she did not build or im- Duct- Under Ground ' r • - i y i prove for the purpose of sale): i - i - - Building Approved By • /� 0 i,as owner of thethe.property, am exclusively contracting with IicenseC con- . Duct-Structural , Refrigeration System 'Application(Sued By A �,�'_I s��� �w -Date � • tractors to construct the project.(Section 7044,Business and Professions Code: ' -• { / The'Contractar's License Law does-not apply to an owner of-property;who , Duct-Ventilating{ - _ DO-100,000 BTU' 0- 50,000 BTU • - I l - SUMMARY OFF rS I -• • . builds,or'improves thereon, and who contracts for such projects with a con- - - - - _ • _ .• , - ; M1 =,,Y tractor(s license"pursuant'to t lie Contractor's.Licerie:Law). Iain aware that; + ' ' BUILDING PERMIT $ ' : SMIP' - I $'t • i •' proof:of their, Worker's Compensation insurance should be provided to me. Exhaust System ❑ -Multiple❑ System = .air/Alteration - _ i , i : i „ _ - - - + PLAN CHECK $ - PERMIT D am exempt under Section B.&-P.C.for this reason• Firepl/Fact.WU ICBG+ re Dampers J I - ` I. r ' . . I PLUMBING , .•-** i$_ t ( .- ISSUANCE $ : - Date. - ' -' • Owner ' ` • ' ' = , ; , Heating System:& Ducting Registers •_ . - - i ,-41' PLAN CHECK: 25% 1$ - (-: ENERGY P C. $$:11." . ' I hereby 'certify that I have read this application and state that the above, ' ' D0-100.000 BTU D .,•OOBT , t ' GRADING '$--t information is correct'I agree to comply.with all;city and'countyordinances_ I • ,„ - - t 'ELECTRICAL V I $' and stateilaws re . to buildi c•• truction, and.hereby authorize repre - •- 1 --� �' 1 ~+ i '. sentatives of s c' to-en the abyve;mentioned propert for- ; - • g, ` + PLAN CHECK 50/ $, ' 3' .MICROFILM $-, .. 1 inspection pu p•.e / •/•x f I ® MECHANICAL $ •• r _r , s +'7 640 / fir.. , Signature •• • . .t/ ,J 1 1 Reinspection Fee 't $15- $i 3,- 1 I PLAN CHECK 125% $ • : r ''{ I ^ i _ CMF 0865-46,rev.10/84 White Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor r r ;CONSTRUCTION AND;PLANNING �,.i 's r::'u_ .f+ .1 i'' POOL& SPA ' ', APPROVALS Permit _ Date r 1lospectgr i ,,APPRO VALS1 Permit I Date Inspector ' 4 1.'Temporary Electrical Service or Pole - ' ' I. ; • ' 52. Pool & Equipment Location. ' t • •' . . i 2. Soil Pipe-Undrgrnd.'t z : ' ! . : ' } ; 1. • 53. Steel Reinforcement ! . ' 1 Ii s , • 3. Electrical Conduit Utility-Undrgrnd'. i ! 1 54. Forms) - , �' , 4.Electrical Conduit-Undrgrnd. ° • 1 „ :55. Electrical.Bonding 'or i k ' 5. Steel Reinforcement ', 1" , : , ' i. :567 Rough:Plombing& Pressure,Test;- • 1 ' `• I 57.'APPROVALTO COVER:GUNITE t 6. ElectricafUFER Grnd;,', - - ' 7. Footings , • , - • • cVU 58. Eleical Conduit- ndrgrnd. .: ,, I 8. Foundation ' - -.r--, - . -(- - 59.-Gas'Pipe,-0 Undrgr`nd., Test • I I , t 1 1 . , o•-.. Tr,. • 9. Water,Pipe-Undrgrnd:",- . -. _ ::-• L_. - - • - 60.-Backwash Lines, P-Trap, 0 Undrgrnd. I - 10.,Structural Floor System ,.--11; : ' • 61. APPROVAL TO DECK 1 , • , 11. Property Sewer Line 8i-House Connection - 62. Backwash& Receptor-Final : ' 12. Sewer Cap - . • ._ - ' 63. Heater,8,1_,Vent-Final ' " . 13.-Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing • ' t r • I • 65. Electrical-Final ' 15.-Rough Electrical-Conduit I ., 1 •66: Solar System-Final ' : ' ' 16. Rough Electric Wiring Set S 04.1.. , ^ ��6iti Fencing.$'Aceess Approval ' ; - :17. Rougli Wiring Sign - ' - • ' ' . ' 68: APPROVED FOR PLASTERING "" 18. Rough Electrical:T Bar Ceiling. • I I, -' - 69.. POOL/SPA SYSTEMS FINAL ' 1. r 19r Rough Heating& Air Conditioning - I i • FIRE DEPT. REQUIREMENT EMENT ' . , ; 20. Rough Factory Fireplace - APPROVALS Permit# • - 21: Ducts, in Structure . , •1 70. UndergFound Hydro' „ - • - • 22. Ducts, Ventilating.; I I ,•71, Product Piping.O,Gas 0 Oil + •' ., i, . 23: Gas Pipe-Rough & Test - 1 i i72. Underground Flush I •„ 124. Roof Framing-r` ;.. : _ t : ; ' I 73, Undergrnd.Storage Tank ❑Gas:❑Oil : 25. Roof Sheathing • - I . 74..Overhead'Hydro I ': , .4`! I c. I 4 ', 26. T Bair;Ceiling (Structural) &.Monocoat • • . r • ,75.:.Dry,Chemical' $.,j r t ;t, 27: Frame and'Flashing • ;, j ' 76. Dry Standpipe ' ., - , - ..-y.- ,I 28: Lathing & Siding • - 77. FIXED SYSTiEM. FINAL j t,1 29. Insulation - , , 7 ' e 78. FIRE PREY. FINAL i ,^- ; : • 30. Drywall Nailing ' _ : ' i ' ' • .' HEALTH DEPT:'REQUIREMENT : 3 31. Plaster Brown Coat 79..FINAL INSPECTION ' . . • ,X.4 - -, - 32. Electrical Power Meter-Final f • 80 .FOOD CERTIFICATE ISSUED• ��/ov/fQ� y0j�IL -i 33. Final Electric'. �._./"r Qv Notes: - i •r - C�+ecK' Meter rat p-k .> ficit: 1 34. Final Heating & Air Conditioning ' .. Sua�-f B�Ao' . -A , t . , • 35. Final Gas Pipe-Test ' J • . 36:36: Hood or Canopy c • - - - I a _ - I -'. - 37:r1Final Factory.Fireplace - - - )P i,; f, 1: ', 38. Final Plumbing, : - • - ..^s h -. e 397Water Service-Final- _ - - • - " _40. Gas'Service:Final y` - 7./ wr . .°� •.-. t41. Solar Domestic-Final - . ti c?� - ..:4' L t42. Backflow Preventer •" - - ' • - - - ! - -' • .43. Backflow Irrigation: - , - , . - • �• _ .- '! -. , , . ...4441/LandscapeIrrigation System , - . ::.f , 4 '45k :Sound Attenuation . _ . n • 46. Handicap Regulations .. ;• - 1 Ij i'4:1"..'• � 47 FINALSTRUCTURE &-BUILDING . . - - i.� -� .',. ' tq •.� 48": Special Requirements Completed,, _ - _• 1� �."1 49. Electric Release to Edison - ' ' • ' "`' - . 50:,Gas,Releaseto Southern California•Gas Co T: 1 - - ' 51:CERTIFICATE OF:OCCUPANCY - r. _ - .: Date - -. - r] I .. m. _J Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _„ I PERMIT NO. TRACT NO' LOT NO. UNIT NO. _ "•--t _ - T - - 1976't 7/��/27 'T cJ0.2t. , TL CITY OF•COSTA MESA CONSTRUCTION'PERMIT L [� ry / 1 • ;1/4 Project Address '/ /06C/ ZG 7_ �LQr=N ft F Z -1 O tli • ^' r. - 3 � ���� .+Lrl ! I I f I i r I , . ! 1 I • - p //�J �• , AA TYPE OF CONSTRUCTION $NEW ❑,ADD L &ALTERATION U REPAIR 4 Applicant's Malting Address I /bis e pT en-rA lOCr•- VpW?1,4V 1 q` / p , (+ t 5 ❑ CONVERSION ❑.DEMOLISH ❑ OTHE�'"' "n^ f'•.t I - - t , • Owner's Named .] .n't,�/�� iYL'it Cu Phone 1 _ __ _, A.P_#_. - - __ 1 _ _ , _I _( Zone f- •• _- _ / I DESCRIPTION OF WORK/USE'OF BLDG. _ C_D/(QrLN tKt'liti % - Address - I 1 - t 1 _, : "f ' . ! 1 S Main Building: . ! Accessory Building: 1 ! . 'r- • Arch/Eng: l License�No. ' TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION? LI STRUCTURAL .T Front - • t ZO Address • �^ ' : • ,•� q: : I. ❑A TENANT, ❑ ELEC7TIRICAL: ❑ PLUMBING ❑.MECHANICAL • B Rear f ! • I - N • �. G/lJ4y Fiver ;lOt'r;d CPhone '7Sy 777& : K�OTHER 'F/, c 'Cc PA.�1 b•c.t.e/c..-..r ' _� , C- Right"- ( _'_ _ ! .T N Contractor's Namf• // ROJECT DESCRIPTION I SQ..FT: ! OCCUPANCY 1 - i Address(mailing) /(,t' tC Sr,S2rP••f<dL A. ��A�/,�V-�IYI� -O� K - . G ' 1 y t,,� , / • ' CONSTRUCTION,TYPE I - ` VALUATION /Z OOO a '$ ,Left f �, I . . City'License No. / Y I • 1 LICENSED CONTRACTOR ODECLARATION I i • i I ZONE 1 t ' GRADING CU..YDS. ' ACRES,J - Ping. Ref.# ' '? ' : ' Parking Req./Provided • ' , 1- E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: t I Plannin Notes ! , ' .f Q ' with section 7000)'of Division 3 of he Business and-Professions Code, and ' I !-� • I trD 6Q' ,,i G L `,r, 1 Planning.Notes: I I M • my license is in full force'and effect. L -' ' t • I License CI•ss • I Lice /•Non .- 5117/5105 • • ) . I• ' •• ! - • _ ; T ' \I Date l W Signature i '' •/ •. . ..r/ i I • ! ^' 1 1 - -'=:'PLUMBING 1 I :FEES 1 i ) - _ • 1 "DRK RS COMPENSATION • •LARATION I. ' • I : Bar Sink: :"1 I • ,, $hpw¢fg ? f _ _I --- - p}• ' 0 '�ereby affirm that I have a cer f' ate of consent to self-insure or a certificate — 1 _ ! - -• +,"' ' ELECTRICAL - ' " ' FEES I ,•Workers' Compensation In - ante,• or•a'certified copyi thereof (Section 1 • • - 3800, Lab. 0.) o p �^• ' : Backflow Preventer r ,'Service Sink _ - - - - I ''j 1 ,; AutoinaUc WasheN I- '? � Transformer-❑ 15 50 KW '! Policy No. �• / " /J Company �5I Backflow Irrigation' ) • r - I ' ; I 9 - Sewer�Cap, I - I 1 Constructlon•Pole Sub -, '❑ 50+KW _ �] Certifietl copy IS hereby Turn ishetl. - ' - ' ' R4.Certifie cop filed with the city Bu ing Di Ion. I r Bathtubs !Sewer Connection ' i - I. Cooking Unit : -Meter pulp to 100 amps L -t I Date- ou F- ' Applicant 9"""TI • 1 c. - _ ., • • EXEMP I FROM WORKERS'CO NSATION D CLARATION ' Clarifiers ) I ( Solar Collectors, - _ - DlihWa$h¢r - - - i - Meter Dover 100 amps s I (This section need not be completed if permit is for one hundred($100) or . I - less). . 1 1 / Dishwashers T • •' 1 Solar,Pi ping - „ _ Dryers ,OGas ❑Electric •., Sub Panel ' I'certify that In the performance of e work for which this permit is issued, I - - - - - shall not employ any person in any manner so as to become subject to the Drinkin •Fountains - .. •j j Motors❑0-1 HP ❑1Y.-8 !' I - 9 Solar,Tank c ; , Fan ' 1 f.. Workers' Com Pensation Laws of California. + t •e - _ ' — • Date' - Signature • ' ` - j Floor Drams • I Swimming Pool w/Spa' • -! 1 '-' F.A.U. I I - 1 ! ' r -NOTICE:If,after,making this declaration„you.should become-subject to the -_ _ _ _ _ - . _ - - 1 Inc.SOlar ❑9-15 HP•D16-15+; Workers' Compensation provisions of the Labor Code, you must forthwith' . Floor Sinks ” • • Urinal - • ' ' r . i '� Fixtures Microwave = comply with such' provisions of this permit shall'be deemed revoked. 1 - _ - CONSTRUCTION LENDING AGENCY ( Gas�Service I . Outlets ! Water Closet ; ! • , I hereby affirm that there is a construction le itling agency for the performance _ t • - - _ __• >- _ Device BOx¢s• I I 1 I Pole Light' i ,v ' of the 'work ,for which this permit is issued. (Section 3097 Civ. C.) , Interceptors Water Heater ' f - Outlets ' Lender's Name - - t - Range - Lentler's Address„ - f - : ' Kitchen Sink.,'.„, I _ - + _ _ _ ._ ' •_. _ .- �. _ .Water Service: _... . 1 Switches ' OWNER BUILDER DECLARATION, j j + - - - - - - - - ' Sign ' I hereby affirm that I am exempt from the Contractor's License Law.for the Lavatories . I ' Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city'or ` , d Garbage Disposal Standing Sections countywhich requires apermit to construct,alter;improve,demolish or repair t . , , , - - , ) P—Trap 1 Laundry;Trays 1 Generator ❑0-5 KW DS-.15 KW ' any structure, prior to its issuance, also requires the applicant for such permit - i' Trash'Compactor ) to file a signed statement that he/she is licensed pursuant to the pro isionsof Roof Drains 4 a' t ' • • - - •he Contractor's License Law(Chapter 9(commencing with Section 7000)rof ' - I. i - ' ivision'-3-of!the Business•and Professions Code) or that-he/she is-exempt , - .__.__ _ «__. - _ __ _ .. _ ' - erefrom and the basis for the alleged exemption. Any violation of Section - - 'I j . ' 4. , /031.5' by any applicant for a permit subjects the applicant to.a civil `' r - - . ` _ i - ' 1' ' 1 . ' ' p¢nalty,of not more than five-hundrederdollars($500). -• ,� ' i -1 r . 1 ❑ I; as 'Anne} of the property or my'employees with wages as their sole Reinspection Fee' $15 ' • i Issue Fee ' $'3 _ • I ” I compensation, will do the work, and the structure is not intended.ntra feretl _ - Reinspection Fee ' I $15 i . Issue Fee , ▪ for sale (Section.7044,1 ly to an owner 'Professional Code: The .Contractor's 1 i I i - , " MECHANICAL I FEES - - License-Law does not-apply to an owner of a'property who builds or improves _ _ _ thereon, and who does such iwork himself/herself or through his or her own • • - I ,• _ • ,.DEVELOPMENT SERVICES REQUIREMENTS: , t ' - ' employees, provided that such improvements are not intended.orhin ofoffered for • Boiler , 'I • Hood or Type I ❑ . , • ,- A 1 , soleal; the q"the building or improvement is sold within one year of cam- Canopy j Type I ❑ �Zaning Approved By �p Date • •provefor the owner will have the burden of proving h¢/she did not build or Im- , Duct- Under Ground- , . Building Approved•By w• ' �` sE�/' • -Date 7 :1�6 Prove purpose of sale). < . - • - - - 5 N/1—�- (��J D I O.I, as owner of.theh property,am exclusively contracting with licensed con-„ ' Duct-Structural J Refrigeration System I . 'Application Issued By •-• - ' Date tractors to constructthe project (Section 7044,Business and Professions Code: - The :Contractor's:License Law does not tractsto an owner of property who -. , Duct-ventilating ❑0-100,000 BTU 100,000 BTU .. I • : • Sc •$ SUMMARY OF,FEES r builds or improves thereon, and who contracts,for such projects with a con- - ' - - - 9'..2 tractor(s)Jlcense-pursuant So,the Contractors License Law). Pam aware that I I Exhaust System_❑ Multiple D System•Repair/Alteration _ • BUILDING PERMIT' $ -- 7-2.7V SMTP I ' $-_ • -7 •'� ` proof f their Worketinder ctionpensation•insurance should.be provided to me' . • -_ I , ; PLAN,CHECK ' ' '$ -� PERMIT• i 0 Ilam exempt under Section _ -- _ B.&,P.c.-for this reason : Firepl/Fact.BICIC80 4 • Fire'Dampers - - - - "� - -PLUMBING ' . •$_ ISSUANCE : f$- • _ Date • - I ' owner ' f I • Heating System& Ducting • , Registers -q• ' • - ..• __ •, •: ENERGY P.C.' $4 1 - _ ' „� PLANCHECK 25% 1$ I hereby •certify that-1 have tead'this application and state that the ati ces 00.100,000 BTU ❑I100,0008T • - < in d stat ionLs ce -f in. I agree to amply with all'city and county ordinances r ' - - - ELECTRICAL.. } t$. , GRADING �$� I and-state laws re .l ing.to •uildl t•• action, ve and.hereby authorize repre-, - - - ' ^MICROFILM $ ' - sentatives of th' city t• fent., a above-mentioned pro ert for, • - i - I ; ' • • ' - ' PLAN CHECK' '' - •- inspection pure' s. - .I� Y ' • , - 1 - •� 1 Signature f i *AP l ' Date -7 9. 07' }.- • '0 _ I ,^ 1 1 i MECHANICAL { • $` TOTALFEE it /� • - >Drivers Lic or 55#; - �� � 1 •' ' t Reinspection Fee j'$15a i, ' , Issue-Fee - , ', ! $ 3 t PL'AN CHEC•K ,25%; $ '- • ' CMF 0865-41,117. W .10/84- bite- Building; Canary -Applicant; Goldenrod Pink -Accounting; Goenrod - Assessor -- """ " —• - ." - - - -• --^- __ "CONSTRUCTION AN PLANNING 7. . I«•-1 i , t •_ ,^_ .'_IPOOL"&SPAT,--.'r •• '' Date Inspector. 4•• ` ' Date ,Inspector ,t. APPROVALS .Permitlik -- P 1APPROVALS Permit#1 ° i. t : 1.,..Tiemporary Electrical Sefvice or P le , 1 . ' • ' ' 52. Pool & Equipment Location, . i '1 1 i ', 7 2. Soil Pipe-Undrgrnd. ' - 1: ' ' }53. Steel Reinforcement + I 1 r' ; i " 3. Electrical Conduit Utility-Undrgrnd. : ' r I.• 54. Forms 1 ' I :.- i 4.'•.Electrical Conduit-Undrgrnd. 55. Electrical Bonding 1 I i; 5._.Steel Reinforcement.' _ i . 56: Rough Plumbing& Pressure Nest., 4 1 4 ' • , , r 6. Electrical UFER Grad: ', s - "" . 57. APPROVAL TO COVER'GUNITEt : ' • 7. Footings ';� r r 58. Electrical Conduit Undrgrnd, ' • '� ' 8. Foundation- L ;.. • - - --j' -i - • '-JI^-- 59. Gas Pipe, 0 Undrgr'nd.,Test I T ' . i 9: Water Pipe-Undrgrnd - - '1,...,14 _ - .60--Backwash Lines,.P-Trap, P Undrgrnd.j ' _ y 10 Structural Floor System i : r I 61. APPROVAL TO DECK , i. , i I • - 71. Property Sewer Line & House:Connection ` , 62. Backwash & Receptoi i- Final 1 I 1 '• • i 12. Sewer Cap - • ; 63. Heater & Vent-Final • 13.-Roof'Drains • , : ;' - ' ' ; 64: Plumbing System- Final 1 ` .( 14. Rough Plumbing r_ 1 - i .65i Electrical-Final- , - f ;I ,•' 15.'Rough Electrical-Conduit '' •c'^;: ' t ; i ' ; + , 1 66:,Solar.System-Final • , •' '. 11t 16. Rough Electric Wiring; ; - 1.s' r - ' " , - - `' - '" "i _ . 67.-Fencing & Access Approval ; '17. Rough,Wiring Sign' -", :' - - . I' -' ' 68. APPIROED'FOR PLASTERING- , 1. - ' - " ' I 18. Rough,Electrical-T Bar Ceiling_ " 1 1, - 69, POOL/SPA SYSTEMS FINAL ' ;• 19.' Rough Heating 8,4 Air Conditioning i ; 1 FIRE DEPT. REQUIREMENT r 20. Rough.Factory Fireplace ` : ' I APPROVALS ; Permit# . ' f _ - • - 21. Ducts, in Structure ' I I a• „rl'5 �� st - 70. Underground Hydro y,1 I•� 22. Ducts, Ventilating-, i • '.77, Product Piping ❑Gas ❑Oih ' , 23. Gas Pipe-Rough & Test 'j _1 72. Under round Flush ' • ��,-�i `, 9 1rh89 V-"�TJ'1 24.: Roof Framing ; . , •i ,, ,_ • i.. 73. Undergrnd.Storage Tank'0 Gas 0 Oil; 4 4 25.• Roof Sheathing i . - I ' • 74. Overhead Hydro r • ' ' . g.12,� �'lr' "- ' 26. T-Bar Ceiling (Structural) &"Moriocoat 1 t , ' i 75: Dry Chemical ', F.;11'", ' - 427.• Frame and Flashing' c' • ' ' . 76. Dry,Standpipe i,.•„ _ 28. Lathing & Siding 77. FIXED SYSTEM, ' 1z Jr . ' 129. Insulation , ,: , .i F 1 ' . 'I 78. .FIRE PREV. FINAL' , .,r/ jp /1' 30.!Drywall Nailing ' . . . 1 '- ; ' HEALTH DEPT. REQUIREMENT_ 1 , 31. Plaster.Brown Coat ,;. - I i ' 79.,.FINALIINSP,ECTION , ., :1 ,a 32..Electrical Power Meter-Final t• 80. FOOD CERTIFICATE ISSUED - '',t , 33. Final Electric - Notes::' • I _ .; ' , r , - . 1� , 34. FihalHeafingl& Air Conditioning�, . 1ILLI ;� � ; 7 ' : • 71.1. i :�. ( ; .' i '( -' A. '111 ' ;r 35., Final Gas Pipe-Test • 1 ' r ' 1 I , 1 ' • , - --« 36. Hood or Canopy , -Y- i, + . c,.-, r• - • 37. Final Factory Fireplace i = >• 1•, 381..Final Plumbing " _ • h _ .f .t f 39. Water:Service-Final - - "rt , _ - _ . 40. Gas Service-Final' - + • • r <- : . ?i+ ', ;:y '_ ? b+ . 111. Solar Domestic Final - 7.':,-.7 i42. Backflow Preventer .• ') ' i 'J �` E^ '- ' _ -t-' .. �' 'f >n . :43.'.BackflowIrrigation'.� ,,1'; . - :r*'' . , •4•. 'it` '• ' :.. t .•e� 44.`,Landscape Irrigation System ` - F-,• :: 4, j - ° , ., 7 t i; , • • 45.. Sound Attenuation - - • - - - ' . - - . - - . _ - . , '•1 a,' • '146. Handicap Regulations _ _ '- • - - - I• _ _ { y i . ' 47. FINAL STRUCTURE &BUILDING . %• I ;,.• '3,; • 1- ' 48:`Special Requirements Completed - - - - ' • - ' 49. Electric Release to Edison, - ' ', - - - �' ' " ,. - ' 50. Gas Release to Southern California Gas Co -Y ' -✓11 ' 1. ' �.. ., Y -51-. CERTIFICATE OF OCCUPANCY - - ' No. : Date - - _ _ _ a _ _..,q' --cwt - r �. _ -i . .. • ^'-'-��ut.-- " _ � ' _ Applicant to fill in all spaces except those within heavy bborder lines and sign all appropriate declarations, . _, .. ._t, I - i P T N ,TRACT NO. I LOT NO: 1. !UNIT NO' I . I . •-I ) , . '- 1 _ I i . " j, L CITY OF CQSTA MESA TQNSTRUL.TION;PER�M�IT I-r47 o2/ 2 n0 , i V t 1 ' 1.'1 - PI ' 1 1 ' 1 )' 12.— . of .,�1-4201T4; /] i•!1 ,0930 L/26787 640:42 >TL Pro act Address ` } I I Applicant's j i ( 6- j ( i TYPE OF CONSTRUCTION 1 NEW' L ADD LI ALTERATION ' ' - Mailing.Address ❑ REPAIR Owner's Name+!' r <<'"1Z �'°�" `•'- -' /���I'- ❑ CONVERSION ❑IOEMOLI$H ❑.OTHER _ _ ` _ • f 7� 2� ' /J.° 1)-_-7_ .zone 'mss�.s� 4 , DES •IPT ;NOF WORD 1$ LDG. 1 Address''S � d �JY7 .1 i , • /L LQx(,J(J$' tor_ ��-' ! E Main Building: 1 ' ,Accessory Building: • - i Arch/En . '1 -STO License No. $7 car •e ._TYPE OF PERMIIT III GRADING , g CN IS ' 17 . )-7)9 CI B $TRUCTU RAL I T F.rontl ., ?3 G/ �)� /_JC3� I I 1, 1 s Y O '2.--a, �7 s.�. w r.+s' G x • ' ' ❑ TENANT'❑ ELECTRICAL •❑ PLUMBING ❑ MECHANICAL B - 1 i N Address ,�'�1J�r 1 •''� I ' irt 1❑ OTHER r i 1 I _ I A Rear- - l t/-5/ff'f• ff I • j , 1 Contractor's Name ' fN/'../ 1 • I Phone i ` `' - - /� - C RighT. �`` -c' • / L,' --' - - - - --- " N i ! i 1 l PROJECT DESCRIPTION 'SO..F 1'J 4 OCCUPANCN`: JVi �: ��� cI It� i } ; I t Address(mailing/ ' • ' ''y` V T K f G 1 1 I • ; ' I ' STTYPE ,-I •VALUATION'$ '•V ° `w ' s Left '/ 'c, ,6/ jO.5 1 • • - 1 ; I. i City License No, - - ' • 1 -t :V - r , R • J ; ZONE _ GRADING CU,YDS, 1 ACRES i , Pln Ret. # • Parkin Re /Provided EQ LICENSED CONTRACTOR OEC LA RATION r 1 nf /�� � y_.y�-� � � i - g'. D(z-8(o -3'-F g. q. 33 3 • I hereby affirm that I am licensed under,provisions of Charter 9 (commencing[»' V'Remarks: ! v 3'Vli 11'/ t ' -e:� . �/'L�/.q :-: 1 » Planning Notes: — _ -.FOR SPFC1A�. REQI71RF.h7Pi'lh'C i M with`section 7000) of Division 3 of the Business and:Professions Code, and, p� • rr my license is Inlfull force antl effect'. 1', - 1 - V -' /G')Q L� �'- E.'?O /O 3 U 1 i i i I i i I ' ' S. License Class - • License No. - I , - , - -, - t Date •' Siignature ' ' . ., '1.• 1 ,y 1 ; ;PLUMBING ' ..I :FEES •t-- 1 i '' I _ I- I � I 1> I WORKERS'COMPENSATION DECLARATION - �• �, -t- �- - - , Bar Sink, -, i " i : ,-I Showers' - 1 -- ' I I - _ i I hereby affirm that'I have a certificate of consent to self-insure or.a certificate- ' 1u , I ELECTRICAL i 1 -? .,� FEES Workers' Compensation Insurance, or a ''certified copy-thereof (Section% `� - 1- - + :00, Lab C.) 1 ' I 1 i ( ) i Backflow Preventer c I , Service Sink - - I - •_ 'r ; • ^.. I Policy No, • Company • !' `` - Backflow Irn anon ' �, ' ) ' - A nstruc i Washer ) : Transformer-❑,15 50 KW ;-t i' 1 / y , __ 9 I. _ .SewerCap - ICr ! t " Construction Pote Sub r - , I ' , , ❑;50+KW, • ` ` p ❑ Certified copy is hereby furnished. - • • _ _ i ❑ Certified copy'sped with the city Building Division, I "'` 1 Bathtubs ' 1 a, j .Sewer Connection , 1 1 1" Cooking Umt, 'Meter: Dug to 100 amps 1 [ Jt 1' l0 • % Date, 1 Applicant r J _ ) , .. , ! -- i 1 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ! 4 1'i .1 Clarifiers C i • •• I Solar Collector•s• • F , = •' - t 5 y Dishwasher - 1-:• ' •_ -.1 1 ,Meter Clover 100 amps H( 3 i :. , (This section need not be completed if the permit is for one hundred ($100) orf ` less).! f 1 t Dishwasher , _ I Solar Piping 1 ,_ , » i - : Dryers ❑Gas ❑Electric 9 Sub Panel I certify that in the:performance of the worklfor which:this permit is issued; Ir A - - - I I - ',;•.1' 1"..-rt.. r 1 Ft shall,not a ploy ny person in any manner,so as to become subject to the, Drinking'Founta ins I t Solar Tank _ ,$. - i Fan 1 ' Motors ❑01-HP ❑1'/:�B , ,n ' A•• 1 Workers' o ,en(/pa ws of California. $ 1 , -� I - X Date._ 9r. [_Signature " 1 L :it! 1':' Floor'Dreins I''• i Swimming Pool w/Spa ' 7; • 1 ' F A.0 , i ,•. l - 1 ✓.NOTIC If;aft making thisitleclaration,•you.5houltl-become-subject•to the-»-- .- ._,. ___ _ - _._. .. M1 - Inc.Solar 09 15 HP .. _ _- _- , i Workers' Compensation provisionslof the Labor Code; you must forthwith , Floor Sinks- • 1 !Urinal - •1 f I Microwave' t comply with sucht provisions ort this) permit shall 'be deemed revoked. - 1 , - ' Fixtures I , 1 CONSTRUCTION LENDING, AGENCY - i ( i - Gas`Servide i _r`Outlets -'I ' Water Closet t • I I ' - rDevice Boxes •• , t I t •Thereby affirm that the/els a construction lending agency for the performance } `. i - I .. Pole Light I - of the work ;for whi h this ermigql is is etl• t5¢ction 3097 Civ, C.) y -' • i j ' f ' 1 Lender's Name' r., T enlat77 A4e7C .9a1x� i i Interceptors 6 .. Water,Heater i i I Outlets ; I. I ,�,^ ' Range"` ! ' X .Lender's Address.' ' cf<b .Ci. �.S—f ti _�' fY r,JJUC-,r. - i.. _ _ _: Kitchen Sink ) -C- I. LWater Service --7-----' - 1 — -- — . - _. -_ 1 OWNER BUILDER'DECLARATION - I 1 - T -1Switches' r""I' 1. 1- I -t Sid ..;T. . , +. -- 1 I hereby affirm;that'i am exempt from;the Contractor,'s Licenser Law:for the ' Lavatories ( µ"I1 -'•9 .r: - -_' - ' - , , t „f - - . Auto Wash ! Garbage Disposal ' Standen Sections I followinghich requiresi on permit to Business and Professional Code: Any city or - �L , I 9 J , i- county which requires a to construct,-alter;a applicant forrlish or repair P-Trap ' t 1;. r w l „ ,- Laundf Tra 5 i any structure, prior/to its issuance; a is lequires the applicant such permit 'J'L, - ' Y. Y ) S Generator ❑0-5 KW ❑5 15,-KW Trash Compactor ' , • to file a signed statement that he/she is_Iicensetl pursuant to the provisions,of - $ • Roof Drains" ,....2 - r' „ - ;= ' - I the Contractor's.License Law(Chapter 9 (commencing with Section 7000) of .. .. G ''•'.' J. , - I ' I , » ' i »- Y.s, I I'1'% q! , L I L • '^'Divisionm3^oftthe Business and Professions'Code) or that •is exempt ^ I , , --- - - - - - --- - - - - j -bore S.m'and;the plica for the allegetl't subjeion, Any violation of Section I i , ' 1 I 1 I j i , , 13115. by any applicant for a permit subjects the applicant to.a civil • t • , I ! 1 I • I• _ I ,, i I 'Y I i i nalty_of not more thanpfive hundred dollars.loyees, I j i 1 S , i I • I - t 4 I , i - ) ) I - co 1; ass owner of jltiel property or my employees with wages as their sole • Reinspection'Fee' • $15 I =, . Issue'Fee $ 3 1` 1 • ror sal sat actio ill da't M1e work,and the structurescionis not intended or:offered Reinspection Fee -” jI p !;$15, Issue Fee,.I .$ •3 a , I for sale (Section.7044,'Business 'and Professional Code: The Contractor's 1 MECHANICAL[ I I $• ' FEES I - _. _ - - _ ! ' e:Law doesnot apply to an owner of a'preperty who builds or improves - . - - - thereon,• and who does such work himself/herself or through his or her own Type I f DEVELOPMENT SERVIC-S, LOUEO`RE i.T I I ,..;`,1 ) employees, provided that such improvements are not intended or offered for Boiler ! Hood or T e I ❑ - f,( '''rrR)))��I` n(� rsale: If;.however;'[he building or improvement is sold within one year of coin- Canopy s Type I I ❑ t ^ _ (Zoning Approved By /ate - �pletiOn,the owner will'have the burdenlof'p'oving he/she did not build or im- Duct-Under Ground i - i - , (/W.6_r %, -/ Dat¢ ' g.�pe for the:purpose of sale)? - • r 'Building Approved By '� Date •t - I'as owner of the property, am exclusively contracting With licensed-con- Duct-Structural I Refrigeration System' ° ' _ • Application Issued By 17 - Date__LL_<-L2_ t tractors,to construct the project (Section 7044,Business and'Professions Code: - __ ' : _ / ! ' 1 The)Contractor's'License Law does-not apply,to!an owner of'property who • Duct-Ventilating + ❑0100,000 BTU ❑100,000 BTU •• 1 - - I I ✓ • 1 I t builds,or'improves thereon;and-,who'contracts%for such projects with a;con- _ - 1 . - S A V OF FEES i • ,C ` 'tractor(s) license;pursuant to,t he Contractor's License:Law). am.aware that. - r • . BUILDING PERMIT 1$ , oe, rtSMIP =•! e. • I Z - i I proof of their'Worker%'Compensation insurance:should be ExhausiSystem ❑, Multiple❑. System Repair/Alteration ± $'. _ p'rovitletl me: _ I $"' -PERMIT 1 , i - : - _ I ;. PLAN/CHECK❑ 1 am exempt ondeC Section B.A. q for this reason Firepl/Fac[BItJICBO# Fire Dam ars 1 - - - U ! I I J- ; __ - P - r- PLUMBING i • $ 1 ' ISSUANCE ' $- Date' - 7.6' 7" Owner - r _ u i a c Heating System'& Ducting,. -Registers -' ••• i V I '1 t • .ENERGY P C� $ -i - • • I I _ •» /. , u' 1 _ ' PLAN CHECK 25%' $' I. , I hereby ertify 'I have tree his apple anon and state that the above[ ❑0100,000 BTU ❑100,000BT i c ' - i - : i- ' - 1 information,is correct. I agree•tolcomply with all city and-county ordinances. _ - I - 1 " ELECTRICAL I $`� :GRADING• - $ - - and,state laws relating to building construction; and-hereby authorize repro-, _ - I • MICROFILM.= $ " 1. sentatives'of'•this city to-enter on the above-mentioned or. , *, I C. 1 i'» ! , , _ I r. - PLAN'CHECK - 50,6 $ . • , L inspectionlpur.r. •/' 1 7 - I i - •- • MECHANICAL $• ' ' I !p�[�,. `L ' Signature• ! r /• At ,1 '- ' Date propertye x i TOTAL FEE : $, T a{ Drivers-License vers"License or SS# ' `- 1 • Reinspection Fee " .'i$15� I A . Issue Fee v ) j $13- ' . PLAN CHECK 25% $ ' ' ' 1 CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor iCONSTRUCTION AND PLANNING _' • , POOL&SPA. i i Date Inspector .i.APPROVALS 'Permit#i '• �-• '" ""Date. .Inspector APPROVALS Permit'#1 • i i Temporary ElectricaltService'or Pole • ' " ' I ' ' 52. Pool &.Equipment Location • ' I ( . - • 2. Soil Pipe-Undrgrnd.' - : . 53. Steel Reinforcement, ' ; re• , ' ' 3. Electrical Conduit Utility-Undrgrnd. I • 54. ,Foams. _ 1 4. Electrical Conduit-Undrgrnd. I `$5.' Electrical`Bonding ' I i /I . , I, 5. Steel Reinforcement.- , , ;56. 'Rough Plumbing & Pressure#Test- t ' r7 l I-:• r - 6. Electrical UFER Grnd. • ' .. I , t7-t fI$'. 57. APPROVAL TOCOVER-GUNITE ' I • 7. Footings. ' ! I'i'ptEc �.C( 7/431 TOA , • X58: 'Electrical,Conduit-Undrgrnd.; i i -y • I. C; '' 8. Foundation ' -':' 'U - `4--- , 59. Gas Pipe'f❑ Undrjrnd.,Test_ 1 • -i ' , , 9. Water Pipe"Ukdrgrnd. _ - _ ... 4. ,. .,!/_ _ . ' 60. ;BackwashLines„P-Trap, 0 Undrgrnd. I iy ' 10. Structural FloorSystem .•_" - . 61. 'APPROVALTO'DECK ^ ' ; 11. Property Sewer Line & House Connection 62. Backwashi& Receptor Final: . ' i 12. Sewer Cap - _• 7 63. Heater:& Vent Final I b= •' I "' I . I 'I 13.'Roof Drains - • ' , 64. Plumbing System - Final, ' , ; ' I ' .14.•. Rough-Plumbing % - - - ' 65. ,c____l-Final. ' • 15. Rough Electrical-Conduit _ ' : 66. Solar.System-Final • , . • I.: I 7 ; 16. Rough Electric Wiring ,, i- - . - - 67. Fencing&,Access Approval - ,"' •, , "17: Rough'Wiring Sign - - ' 68: APPROVED.FOR PLASTERING - , 18: Rough Electrical-T Bar Ceiling - " ' ' 'I ' • ` - 69. POOL/SPA SYSTEMS"FINAL , " " ' 19. Rough Heating 31. Air Conditioning , • FIRE DEPT. REQUIREMENT. . i _ _ _ • -. 20: Rough Factory Fireplace • • APPROVALS , Permit • l'I - 21i Ducts, in'Structure I 70. Underground Hydro!- -(Y • " - • 22. Ducts, Ventilating .. • 71. Product.Piping O ,1:1:011 Gas I 23. Gas Pipe-Rough &Test 72. Underground Flush (_ • 24: Roof Framing - , I '73. Undergrnd.StorageTanITIGas 0 Oil - 25. Roof Sheathing , • i/qiv G�. 74: Overhead Hydro 1 - 26. T-Bar Ceiling(Structural) & Monocoat / 7 -75:•Dry Chemical . : • - ' 27: Frame and Flashing' - • - " 2'/21 - cr�,,j 76_ Dry Standpipe • - , ; r I 28. Lathing & Siding 7/i0 87 6,9 I 77. FIXED SYSTEM FINAL I - , - 17 29: Insulation • : • Q 3 •v) . 78. FIRE'PREV. FINAL I, r' ,, ' ` • 30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT ' ' ' 31.' Plaster Brown Coat : Its i &/ 72_ FINAL INSPECTION .!' ''„ ,* 32. Electrical'Power Metei-,Final - ' ' !(1 !(.X 80:, FOOD CERTIFICATE ISSUED ` A, I _ . _ . 33. Final Electric i Notes ,f' C 5 • - . 'L°, - - 34. Final'Heating & Air Conditioning' • ' - • HOLD FOR SPECIAL RLQUIRL4Iialr - 35. Final Gas Pipe-Test • ?,/ft/t-t OK 1'D' 64,164 I�Y� -- 36..Hood or Canopy• . le 12,- .r^` an l'`� d�7�llj�/11 ' 37'Finel-Factory Fireplace . ' I 1 , • • 38^Final Plumbing- - • - •- ..:• " ; , , 39. Water Service-Final. . I , 1 fix. .. 40. Gas Service-Final - ' - - �? /41. Solar.Doomestic-Final. - - ' ' �14 • - : - • . .Y ¢ . . _ - _ . ' ' . . '42: Backflow)Preventer't 9,(p 7• se43• . Backflo v Irrigation _ - • • - ,. �;,,. .. _ ,9 3,44?ISandscape Irrigation System - • I - '45'I�SoundiAttenuation'- . : ' 46Handicap Regulations '-, _ ' _ 47. FINAL STRUCTURE&BUILDING fy`y3/� G N -tee `' , . 48•. Special Requirements Completed' /2/3, 8'7 A, t F , - • ' , .49.-Electric'ReleasetoEdison - . . 1 !`t /� . - r4 . . - - ' 50.'Gas Release to Southern California Gas Co - • •� - + - n 51.'CERTIFICATE OF'O.000PANCY - - No - :_ .:Date - - ' - ' • • INSULATION CERTIFICATION • This is to certify that, in conformance with the current energy regulations (California Adminis- trative (ode, Title 25, State of California') and approved plans, insulation has been installed in the building located at: • • COSTA MESA , CAr ORANGE City _ C• i.i 2666/2627 ELDEN AVE . Sheet No. (II Anll.bl.) ---- Shod • Lal Meeker Tnd Ma. DESCRIPTION OF INSTALLATION ROOFS • Type of Malerial._______________ Manuieclurer Thickness_ _R Value" • EXTERIOR WALLS Type el Material_ FIBER GLASS 43m;factnrer CERTAINTEED Thickness_ 3 'z S Value" R 1 1 (Or Inds Nome) CEILINGS • entts: CERTAINTEED Type of MaterialF IBERGLASS_ Manufacturer Thickness 64 R Value•• R 1 9 (Or Node Owns) • Sq. ft. Covered___.._____ MOWN: • Type of Material _ Manufacturer • Thickness No.Bags_ roc PIN Nsm.) WI./Bap Sq. Ft. Covered R Value"__ FLOORS Type of'Material_ Manufacturer Thickness R Velue••� (Or Trod* Moms) MAR ON GRADE Type of Material . — Manufacturer Thickness R Value"_ (Or Trott' Memel Width of Insulation _. Inches FOUNDATION WALLS (If required) .. Type of Materlaf __ __ __ Manufacturer Thickness. R Valu. •� (Or troth Memo) ' REMARKS (If desired)__.._...._ FLUTER DEVELOPMENT General,Contractor (Builder) _ License Number • By _ __ Title Date Sub-Contractor (Insulation Applicator) 1I/1TCll 1.11:il1LATIOI license Number..3526116 C-2 ' (Inmbnan, M•nery. (IC) (Slots "SAME' I1 aunt as Ownnl C.nlnrlw) By E _N1a�LE , {� ` ^ Title owner Date DECEMBER 14 , 1987 (•Cenlmnla Adminl,,nnv C.A., (..rpy in.ulanen Standard., declet•a WACUfl hem in. icue •1 ib. HnIM and Solely Cod• .1 net Stal. "Compliance. Upon romp.11en el lb. I,,tellolbn el Invlotion, an and N California. eOlfvIng AN M• Insularism. I,,., Are. In,taU•d In reelnrmant• with the rpubsm.nb or Ib... ,.vutallon, 'ball IN remel•bd and • .eul.d by N. nn Ne dlnreb .1 •crrpanor similar co,llNrell.n that a newly ton. the In,ulaflan nprllrnle, end by lb. balldm. lhl, !^nlnllen carepllente ,b.pd heal, m•Id, aparlmenl hw,., hem. - •M« nddm.Nsl cord ,ball K. roiledkronen el a rnn picueukronen within the dw•Iline...I dwelling It habitable 'ball be listed by tech • brlldlnt duntelNent tole.. lb* Iberian •I Unit •oU,nes Ids. mioinrm •n.rr1 I,..lellM •lt Vat.. I. the rneneeta el IN. ,.,I.lnno el reeNrintt sr bvlldln• standards abblbbd pungent h Mb .herb.." componEnt to Ole pn„nte el boot. Ite ,..l Aver. nary IRI of o.a utyre.Fell set Include any .eIe ...lee r ,JI•cllr. forint.) • INSULATION CERTIFICATION This is to certify that, in conformance with the current energy regulations (California Adminis- trative (ode, Title 25, State of California') and approved plans, insulation has been installed in the building located at: COSTA MESA , CA . ORANGE City tasty 2666/2627 ELDEN AVE . Sheet We. (If Anllable) Shoot Lot Phoebe Trod No. • DESCRIPTION OF INSTALLATION ROOFS Type of Material._____ _ _ _ Manufacturer Thickness R Value' • EXTERIORWALLS Type ci Material_ F I B E R GLASS u.mr1attrC E R T A I N T E E D ._ � Vatue " (o. uses Nemo/ R 1 1 CEILINGS NAM: CERTAINTEED Type of Material FIBERGLASS Manufacturer Thickness 64 R Value" R19 (Or Trade Mama) Sq. It. Covered_______ BLOWN: Type of Material —_ __ Manufacturer • Thickness No.Bags_ • Mt Traria Noma) Wt./Bag Sq. It. Covered R Value"._ FLOORS Type ofMaterial__._ __ ________ Manufacturer Thickness R Value" (o. Trade Name) SEAR ON GRADE Type of Malvial. Manufacturer Thickness _R Vatuaa•_ I0. T,ede Mama) Width of Insulation _. Inches FOUNDATION WALLS (if required) Type of Material Manufacturer ThICknefi._ R Value"'____ for tad. Nam.) REMARKS (IF desired)__._. .... . _.....__ _ General Contractor (Buildeq___FLUTER DEVELOPMENT License Number By _ title _ Date Sub-ContractorApplicator) IIA'CCII .1i18I11,A'I1OTT 38261 -- • (Insulation License Number. t6 C-2 hnculellen, Meront,, CIc) _ (Sola "Sane' 11 same o eenarol Cenlroatm) BY E . L . cv 2� Title_ owner DECEMBER 14 , 1987 I Cnnlerno Admhdroany. Cade. rn.,gy (niula¢en Pandora. dales, /KC(M hen Sea. 'fan .1 Ib. Health and Safety Code of the State "Camphoric*, Upon completion of Ih. Inrlellnllen at 'aviation, a cord e1 California. orlllylna ilial the Inolenae Far Fa.n In,tnll.d In cantonments .IIF his rwuh.manti el IF.o reaolenent shall be ramoletod and • auied by -He udlnc.la of .romance or similar certification that a early ere. Ib Inalallen annlloalnr and by IF* build.. IM. !•vu(mfen cemplIeece Jimmied hetet, omelet, apartment Foes*, hem. .r other nddanl(el `- enralveul locetle, within A. d ' Mrd shall be retial oI a welling. dovelike I. habnebis shall be lamed by ori a brlidlea department c — alien the .h.cl.a el ion° ..non., ib minima. anergy la..latl.a 1•91 Vole. Is Ili. el M. .,nems al a materiel or building ~dards.,tabnah.d prroant to Ibis chapter." mnensni to IM panan al haat. rho r.Jnnn,. .ni.a (al el n, n-iyp. Imulmlem •hell not Include any unto. ler uneclb. letting.) • ( DICkiln ryCCOU9 111M ©. •dYIV ENGINEERS 3840 EAST COAST HIGHWAY, CORONA DEL MAR, CA 92625 Ii TELEPHONE 7141675-4487 December 14 , 1987 I ' City of Costa Mesa 77 Fair Drive Costa Mesa, Ca. • Attention : Building Department Subject : Final Grade Certification Tract No. 12880 Gentlemen: This letter is our certification that the final grading has been completed in accordance with the approved grading plan for Tract No. 12880 . Should you need additional information please contact our office . Very truly yours , Duca-McCoy Inc. C td Pete J. Duca P.E. R.C.E. No. 24668 QROFESSj0N W No, 24668 rrf EXpla i 4 , `fT CIVIt �Q' 9rF°FCAL\Ea`�� • f• • • COSTA MESA SANITARY DISTRICT PERMIT VALIDATION P. O. BOX 1200 PERMIT NO./0 3 6' 9 COSTA MESA, CALIFORNIA 92626 • \ _Ct 7 • APPLICATION FOR SEWERAGE FACILITIES USE AND CONNECTION PERMIT Date Ordinance No.6 Effective 9-29-69 CONNECTION CHARGES Applicant to fill in this area only Building Address 7. ( ! o -- ? 6 7? I L L . ',- NUMBER - FIXTURE FEE/FIX. FEE I R Bathtub I - ;.i $ 15.00 . I fV j' f '' ( — : - Tract No. i Lot No. j,'> ; Laundry Tub or Washer • 15.00 /rig; � ^ shower ' 15.00 / 4/Cir.' Owner i;r '�' :_ ` ,- L_ s ' ,14;„ . Sink,bar 7.50 �� i-'L I 1 _ rl • - / �,{ Applicant ii I J Sink, Kitchen 15.00 /J 04*, , Wash Basin 7..so -. J2•`' 0 Address. ` / • '-.Wash Basin (Set) 15.00 - , - Y� " ' / A _t 'i- 1, 7 - `-i Water Closet(Toilet) 45.00 S'S I- - Telephone Number ' -� ' / :LS' • Bidet 15.00' `k. , 9 / f i. ' :Dental Units _ ' • 7.50 • PROCESSED BY •"'-;— �l'' Fountains 7.60 -,Drinking (' .. Floor Drains ' . 15.00 ' INDUSTRIAL USE''CHARGES Interceptors for Grease, Dili Solids. Etc. 22.50 (' s_ - - . Cu. Ft. per month per acre.in excess of 15,000. . • Interceptors for Sand,Auto Wash, Etc. 45.00 — .Rate is$0:50 per 1,000 cu.ft. per month per acre or•any ''.'it Laundry Tub or Washer(Self Service) 22.50 fraction thereof. Receptors 22.5o _ (non ad valorem"user--double above) ' $ - Shower, Gang— Per Head 7.50. • , J - - Sinks, Bar—Commercial 15.00 •'•I SPECIAL CONDITIONS - ;, ; , ' '�. - Sinks, Commercial or Industrial22.50 Sinks, Floor •,7.50' ` Sinks, Flushing Rim 45.00 . - Sinks,Service - 22.50 , • _ • • TOTAL CHARGES Swimming Pool 45.00 - .. .. I ' Urinals,Pedestal 45.00' .'� "•••Connection'Charge $--- - - , ' Urinals,Stall 15.00 I ';Use Chargee Urinals,Wall . 15.00 Tata! Permit Charge $. ' Urinals,Wall Trough 22.50 Penalties rr ., 1 n, 'l�O Total Due $ • , I _ Connection Charge $7A. I 0 r7 I - " ' I t—��3-' L'-! ;( i--L 1'C% ;i. rri p-:., Cj 3;34 ` enalties: Charges are double if connection is made prior to 1' V obtaining permit, plus$5.00 a day. '($25.00 a day for a NOTE( A sewer permit Is required at the time '" ' Sewer Hook-up. _._---- public corporation).'' - 1",y'll.ilit.-.j - 'y,.j _ CMF 0708-68 Rev.7-78 �Jl ' \ • O ° 5 i ll1- i,i 'S.GJ • - IUw -' G . • ' > -tt,'l - (S .- 13. O CITY OF COSTA MESA • PARK FEES Fee Payment Receipt 001063 0923 1 /26/87 15981 ;94 TL 1 Project Address .2( in(n E(.Ll rc.N MMC A /f2,C/ M e i r/c>/ NJ J, L )N ) U A.P.Number. 4 3`) — 22/ — 1(.0 ) 1 '7 Building Permit Number Owner's Name RUBS Fl..tl Mailing Address S/0 3&t` ST.. / 1�Y-co Po far 86Acf4 / Cf} 9zt to 3 FEE: Single Family * Number of Units 2-Bedrooms or Less - @ $ 861.76 = 3-Bedrooms @ 1,205.67 = 4-Bedrooms @ 1,545.62 = 5-Bedrooms+ @ 1,810.50 = Multiple Family " •Bachelor.or Studio @ 474.37 = 1-Bedroom - @ 573.18 = 2-Bedroom @ 881.51 = 3-Bedrooms+ 13 @ 1,229.38 = 15)73 • I Total Fee *** /5) 98/• 9q Planning Department ApprovalDate24- 87 By /IOC. / M✓Yl,- 141844-. Applicant's Signature , 'a#4 * City Ordinance 72-44 •• City Ordinance 72-45 ' City Resolution 78-116 IpM�1I ym�j� II'' (�' CMF 0174-30,rev.7/85 White—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant NMllJJC • -_ 'T -. _ _ Applicant to fill in all spaces except those within heavy border line;and sign all appropriate declarations. CITY OF,COSTA':MESA^'1 CON TRU, TIOVERMI, PERMIT NO. �'D 'TRACT NO. ' t LOT NO; • UNIT NO. ? f• j { j Project Address b b ' ' - t ! - 11---11-4, 1 • - •. OF CONSTRUC 'NEW ADD ALTERATION REPAIR • i Applicants Marlin• e.dress - _ .4/� �� i : �, i t — % ' TYPE❑ CONVERSIONT❑NDEMOLISH. OTHER • ' • ��. Owner's Name, ill' -..4.914...� � ' Phone _ I . - # i= _- DESCRIPTION OF.WORK/USE OF BLDG.' ' Address i t } rrr���---ttttII , , S Main Building: - ; Accessory Build s ' j Arch/Eng: ' License• lNo. • ' TYPE'OF PERMIT ❑ GRADINGFOUNDATION ❑ STRUCTURAL T Front j , ICOSTA ithCJf1 - O Address ? I ;• '' ❑ TENANT ❑ ELECTRICAL. LUMBING ❑ MECHANICAL { B Rear • - LII 1 , N I Contractor's Name ` et/424-2C, . l/�c�a?-7. ' Phone Qr7 6�Ic,7 ❑'OTHER ' - I �A - _ - _ _ I {' I ! I oC Ri lit I ' •`t `?- - , :N • r PROJECT DESCRIPTION SQ. FT. OCC UPANCV Address(mailing) / -j�/ � h'�"�r' I• :S L• eft I• ' I G • I CONSTRUCTION TYPE VALUATION$ R i City License No. / • • ' r ZONE - - •- • GRADING CU.YDS: ' ' ACRES ping.,Ref.# I Parking Req./Provid• ed I ' I E LICENSED CONTRACTOR DECLRRATION 1 I - 0 I hereby affirm that am licensed under provisions of Charter 9 (commencing Remarks: ' ?•n - , 1 r _ Planning Notes _ ' ' with,section 7000)'of Division 3'of the Business and Professions Code, and ( D✓l c27v 7 1) ' 7 - ' I M my license is in ful torte •Id -fleet. • e./ / Off- • _ T License Clgs /4 LIi se N�•� O b ; l ( - • I • $ Date QED 7ignature JJdi ]3` .. !!" - ? r' i PLUMBING j , FEES; � . .. 1 ' I _ , _• .WO ERS' MPENSATION D�A'ATION : - - - - I• •ereby affirm that I have a cert'�f•-te of consent to self-insure ora certificate • ` Bar Sink _ I / • Showers. __ ,• `-' UD ELECTRICAL - FEES c'• Workers' Compensation Insurance, 'or a certified copy;thereof (Section - _ + - Backflow Preventer . I Service Slnk i Automatic Washer ' Transformer'_D 15 50 KW .d00, Lab. C. ,��s��./� Policy No. �f C�`�"—�� Colmpany /•"" • Backf low Irrigation - Sewer1Ca ` * ' I i ^ ' ❑ 50+KW' - V'O P _ Construction Pole Sub ' •l . ❑ Certified copy is hereby furnished: j - - - ertifiefd oyppy is.filedd,gwith,the city ' di Oi / Bathtubs ' _"I • _ j Sewer Connection - _ Or::410 Cooking-Unit ' :.t Meter Dula to 100 amps, ., Dater J' J ! Applicant - I _ ...%/- h,1¢ //fd Clarifiers +.. -� Solar Collectors! 1 ' - - > ' EXE TION eFAed no WORKERS'C ENSATION DECLARATION I _ Dishwasher . `T I • Meter (]Over 100 amps • ( (This section.need not be complet the permit is for one hundred ($100)or /♦ - _ - - , . - _ ^ less): • . , Dishwasher. - , _ . Solar:Piping , _ �lm s Dryers DElectric .. `.. I certify that in the performance of the work for which this permit is issued, I ( _ y '/_- ySub Panel -� , `; shall not employ any person in any marine, so as to become subject to the Drinking Fountains ., 1 Solar—Tank - , - - I. _„ Fan 1 .1 - • _ Motors El ;1 HP_O1 Y 8 Worker • p cation Lawsbf California. • 1 Date --' Signature ' ( - Floor Drains f • '' Swimming-Pool w/Spa i Work :-I f;after-making this tleclarf the-yJu sh OUltl-become subject - • } F.A.0 I a Int_Solar 09/15 HP 016-15+ • Workers' Compensation provisions of Labor,Code, you must forthwith ' Floor Sinks I I Urinal ' ' j Fixtures . t 'comply with such provisions or this permit shall be deemed revoked. - - - - I f.. Micro v¢ t CONSTRUCTION LENDING AGENCY I E]h ; n.1 Gas Service Outlets 3 Water Closet ^N + - - '• - !Jai} r ,Q DeviceBoxes j� ' I hereby affirmithat there is a construction lending agency for the performance ` •✓ ) 'II?. "[' e Light �J of the work for.which this permit is issued (Section 3097" Civ. C) interceptors / Water Heater: , .2..-rt. Outlets �' z Ran e I Lender's .Name - - - $ / 9 , ,j2 , - -Lender'vAtltlress-{ -- - i- -- r /• Kitchen.Sink•- <- '- - • . / ' Water Service -• i�IJD Switches , - -I— ;�;.•t ''- 'Sign;' 't " "t`'"` I ' " OWNER BUILDER DECLARATION' I I , ^t hereby affirm that.1 am exempt from the Contractor's License'Law for the y Lavatories I I� Auto-Wash J,rs /t Garbage Olsposal -rp - jt Standing Sections • • , following reason (Section 7031.5 Business and Professional Code: Any city or !/ county which requires a-permit to construct,alter,improve,.demoilsh or repair 7- j Laundry Trays-. Generator OO-5 KW. - -15 KW r, ' ;/. . ' any structure,'prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the.provisions of ; Roof Drains + I 4-F ' /~ 1 the Contractor's License Law,(Chapter 9 (commencing with Section-7000) of . - _ v%1 _-i- . eli I LL .s.� 'vision 3-of'the Business-and Professions Code) or that he/she is exempt - . — - — - - - 1 trefrom and the'basis'for the alleged exemption. Any violation of:Section ; .31.5 'by any applicant for a permit subjects the applicant to, a civil • I - ' penalty of not more than five hundred dollars($500). tt , t Reinspection Feel I ` I $ 3 } - i - - t , . M. I ' i ❑ I, as owner will property or my employees with wages as their sole P - ,$15 IIssue Fee - - •fompensation,'will'do the work,and the structure is not intended or offered ' '- for sale (Section 7044, Business+antl Professional Code: The Contractor's , - _ ,Reinspection Fee $15 F Issue Fee $ 3 MECHANICAL :FEES- _ • , License Law does not apply to an owner of a property who builds or improves ' __ ' . , • , ,thereon; and who does such work ovem nts i 1 sold intended yearered for . Boiler '1,..r ■ _ • "sale. If, however,..the building or improvement is sold within one of com- - - ■ ,Zoning Approved By Date _ t pletion, it he p nen win have the burden of proving he/she did not builtl'or im- , ' Duct- Under Ground • - t• _ ,-,prove for the purpose of sale). ., . - - - Building Approved'By - Date /if ❑-I, as owner of the property, am exclusively contracting with licensed con- Duct-Structu nal ' • , 1 •Application Issued By - 6 Date r`•�� ��� tractors to construct the project (Section 7044, Business and'Professions'Code: ' -- _ TheiContractor's;License Law sloes-not apPlyvto an owner of property who ■I ,11 III : ■ 11 111 : - - builds-or improves;.thereon, and-who contracts for such projects with a con- _• Duct-Ventilating • , '-, SUMMARY OF FEES , . tractor(spucense pursuant to the Contractor's,License Law). I ani aware that; . ' Exhaust System'❑ .Multiple ❑ - BUILDING PERMIT I$- - SMIP b proof•of their Worker's;Compensation insurance should be provided to me. - - - '$. , p - - - ' fire /Fact.Blt"ICBG# - e,• PLAN CHECK , t$ f -:PERMIT.' .x • , I i01.1 am exempt under Section B:& P.C:for this reason p - _ Oa+ ISSUANCE •• '$' Date ' - ' I . Owner . Heating System& Ducting. .. II i . y PLAN CHECK '25% 'S 1..trD •. ENERGY P.C. $- - I hereby,certify:that I have read this application and state that•_the above ❑0-100;000 BTU 0101,100 BT • • GRADING! $ - information is correct.-I agree to comply with all'city and county ordinances' . - • ELECTRICAL- t •$ - ' and state laws relating to building construction, and hereby authorize repre-i - - - PLAN CHECK 'S0% $• MICROFILM -$- t • - sentatives of, HO city ant r upon th above-mentioned property for -. .- 1 - t ; u inspection pun 6 "--a7 r' - , , , ,• _ , MECHANICAL ,$- ' - TOTAL FEE •$ •40.S-4).- . Driverure, .G$ __ ; -;Date _ Reinspedtmn Fee $15 I ' Issue Fee ' i $ 3 ' PLAN CHECK •25% $r • - • I I "Dri vers' Li se or SS �� CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND.PLANNING. - - .... :-- 4" .i , POOL &SPA: ...f,-, ,-i • ' •'r Date! 'Inspector-.- : ' l1:1 I- I '"Date •f Inspector • APPROVALS Permit , APPROVALS Permit I ! 1.1Temporary Electrical Service or'Poie _ ' _ 52. Pool & Equipment Location r t i ' ; t, 2. Soil Pipe-Undrgrnd. 1. • is/,/f7; �f '' • 53. Steel Reinforcement' , 1 I. • 3. Electrical Conduit Utility-Undrgrnd. i i • 54. Forms: v - ' ' , - + , , , 4. Electrical Conduit-Undrgrnd. • •'55. Electrical Bonding t 5:Steel-Reinforcement •56. Rough.Plumbing & Pressure1Test 1 , '.! -• ("iii - -- 4 6. Electrical UFER Grnd. ' ,a. ' ' - ' 57. 'APPROVALTO,COVER-GUNITE ' •t 7. Footings r - t" , ' - ; J • 58: Electrical Conduit_Undrgrnd. . • . ' , 't• 1 -' i - • i 8. Foundation 59: Gas Pipe'0 Undrgrnd.,Test i i ', ' 9. Water Pipe-Undrgrnd. • - ' -+ Ver f 60. Backwash Lines;P-Trap, 0 Undrgrnd) _ ' , . 1 10. Structural Floor System , r • , l . 61. APPROVAL TOIDECK ' - ; , ' 1. - 11. Property Sewer Line'& House Connection 10-1- g o LSA 62. _Backwash & Receptor-Final i • . ' 12: Sewer Cap • . . ' i 1 ' 63. Heater1& VentrFinal' i . i ' ' 13. Roof Drains : '11 ' 1 1 64. Plumbing System - Final. i I i 1 1 , ; ' 14. Rough-Plumbing . ,744r ME 65. Electrical-Final + l ` • w• ,. 15. Rough.Electrical-Conduit ' - ' C • . 66: Solar.System-Final 1 ' 1, ' 16. Rough Electric Wiring: ?. '•;:a- i '" - 67:-Fencing-&Access Approval i r.. + " s 17. Rough Wiring Sign ' - "' "' - ' - 68 APPROVED FOR PLASTERING - t 18. Rough Electrical:I Bar.Ceilingi - .r ,,, -- 69, POOL/SPA SYSTEMS FINAL • '' 19: Rough Heating & Air Conditioning • . , FIRE DEPT. REQUIREMENT ' , 20' Rough Factory Fireplace ,• . APPROVALS , Permit# _ . 21: Ducts; in,Structure I ' 70. Underground 'Hydro) i . ' : .- , ^ - , 22. Ducts, Ventilating ' . i 71. Product Piping 0 Gas 0 Oil • I , 23 Gas Pipe-Rough & Test j 72. Underground Flush ' + • 24. Roof Framing' ' ' , , . , , ': ' • 73. Undergrnd.Storage Tank 0 Gas' 0 Oil 25: Roof Sheathing t,.:;:. ' 1:,..!:: , ' I !r ' , .. -74.•Overhead Hydro ; s.• • ' ' - ' 26. T-Bar Ceiling (Structural) &+Monocoat • ; - 75. Dry Chemical. - - • 27; Framan e d Flashing '! • - n 76. Dry Standpipe c- • ' • /.' - `. 28. Lathing & Siding • r 77. FIXED SYSTEM FINAL f, ' 29. Insulation ! - 78. FIRE P,REV. FINAL : - . • 30: Drywall,Nailirig ". - j - . . I HEALTH DEPT:REQUIREMENT. - - 31. Plaster Brown Coat ' - 79. FINAL'INSPECTION1. - - , ......, 32: ElectriEal.Power Meter-Final C 80. FOOD CERTIFICATE ISSUED . • - - 4 ' 33. Final Electric " „- Notes•../��-/e�-��� � ���� / 34.. Final Heating & Air Conditioning' ' �; - - , 35:• FinalGasPipe.Test " - //�' />Vi,,_ - '. •' - - I- _ • - . . .... . 36. Hood or Canopy... _ - e, .14 r . 37. Final Factory Fireplace - y I +• • ,�,'� ` 38. Final�Plumbing. . ' .. ' l�/'ylf� 1 •• i+ '1 !� .. ��"I I' ..• et 1/41' • • ri , '1,39. Water Service-Final ' - .. </OtS-�i (.ui . ', , - ' • ',� ` Y': . ' , :40. Gas-Service-Final - - - • 41. Solar Domestic-Final '• - - : . !. ,ii + + 42. Backf low Preventer+ ;Cr :"',. �T 43!Backflow Irrigation • _ ,.t: ' - i• '44. Landscape Irrigation System " ' - . ' • - • ' • _ •- ' i ' *�,}�• 45. Sound Attenuation - - ,1. - 46. Handicap Regulations ' - - / �• , 47. FINALSTRUCTURE & BUILDING- - - _ - _ - ••+;�� ` " ,� >. 48:.Special Requirements Completed ' , .- j �,'' .49. Electric Release to Edison - - • • - : t.. I.; 50. Gas Release to Southern California GasCo - ;,V., 51..,CERTIFICATE OF OCCUPANCY • r : ' .. - Date • . . 1 _ _ .. . . .. - - - - -^ _ r. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -� - - -� _ PERMIT NO. ' 1 TRACT NO. LOT NO. ,UNIT NO. -. - - I I _ - --- CITY OF COSTA,MES CONST RMIT in ; 2:2 3 v4,Gy . • �`'r���w�`a Project Address ¢ 1 1 / I • ( ,.JIl_ . ,-( , I /; 3'7 TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR ' - ' ' Applicant's Mailing Address & �/\�I ❑ •CONVERSION ❑�DEMOLIS_H IE OTHER �q p qp p7 Owner's Name. �i,v t • Phone Q•����0 - .. •_ .-- . A.P.# - : �.__ H Pt2 9-198( A_ • Zone y- 'i ' y • DESCRIPTION OF WORK/USE OF BLDG. ' Address ' 111------III��, • ' S Main Building: , , d ; Accessory Busl�1' I • • • Arch/Eng. • ` License'No. ' •TYPE OF PERMIT • ❑ GRADING FOUNDATION ❑ STRUCTURAL E Front 1 I I ,C)�• 1 1 0 i , - ❑ TENANT ❑ ELECTRICAL PLUMBIN•G ❑ MECHANICAL B ` - - l N • Address ,� il, iG ///',� ❑ OTHER _ .[ 1 . ,A Rear • - Addre ctor's Name e ! 9 • ! -• • K 9 " ; 1 G •�Qcc-e<s Phone • PROJECT DESCRIPTION -SG. FT. occuPANCY C Ri lit -' (• N ' Address lmailing) �f . CONSTRUCTION TVPE 1 VALUATION . . •S I ' ( �1/a'� ( Left ' , City License No. J/ - .. ` ZONE GRADING Cu.VYDS: ACRES •- Pln .Ref.# ' ParkingI R LICENSED CONTRACTOR DECLARATION ' ' 4 s ' 9' Req./Provided E hereby affirm that I am licensed under provisions of Charter 9 (commencing 0 Remarks: ; •� _-.a "7 .ca 7 1 f I t,' L. 'Planning Notes: I I . , • M withi section 7000).of Division 3 'of the Business andiProfessions Code,and VV ' . _ ' my license is in fuuyy tory a,pd effect. /, • • 1 •� , • ` : _ y • T • • License Class 'L -.i/+ ,ytc .^ No. "Y4ic2 7 , - j S • d .gate gnature d°- I :r!• _ i. PLUMBING , i :FEES ' •1 - pRK RS' CO PEN ATION DE ARATION - l • - _ / ` . , -. •ELECTRICAL FEES y Bar Sink, _ ' Showers 2 DJ ' U'O' O .ereby affirm that I have a certif to of consent to self-insure ora certificate .t -_ ' - . 1 ., r "3 Workers' Compensation Insurance, or a'certifietl opy thereof (Sec 'on • Backflow Preventer - Service Sink' = {'' ,• i 3800, Lati. C.L. f - - , - - Automatic Washer Transformer 0 15-50 KW ' Policy No. On 19^6 4 Company ' Backflow Irrigation : - i , Sewer Ca •❑ 50+ KW • P - _ l L' Cdnstructlon-Pole Sub ' , . _ ' 1 Certified copy is hereby furnished. , - •- ' • /C_1 Cued coe fll6edQw)it hit he city B ,I ing in.�. �� , 1 Bathtubs 1 ,. Sewer ConnecLon j' i ZOU Cooking'Unit 1 - Metes Rup to 100 amps; 1 Date' �ONF (IW KERS ant' s//�GO , _ - • \ Clarifiers E%EM ON F O WORKERS'C ENSATION DECLARATION. 1 1 - Solar Collectors= Dishwasher Meter ❑over 100 amps , • (This section need not be complete the permit Is for one hundred ($100) Or �I � - • less). • 1 1 / Dishwasher , . . - C I ' Solar Piping , 1 } 1 `' vVu i. Dryers ❑Gas ❑Electric , • I certify that in the performance of the work for which this permit is issued, I - , , ? Sub Panel • sham not employ any person:in any manner so as to become subject to the . Drinking Fountains i , Solar Tank , I Fan • Workers' Compensation Laws.of California. . I - Motors❑0-1 1'/x 8 1 Date_ - Signature , I Floor Grains ) '' Swimming Pool w/Spa : •' r` F.A.0 1 - ' • Inc.Solar %9-15 HP-;❑1615+ NOTICE: If;after making this•tleciaration,-you•sh OUltl become subject-to the '— — - - — - - -_-- -+----- - - -- . - Workers' Compensation provisions of the Labor Code, you must forthwith ' Floor Sinks / Urinal • i - comply with such' provisions or this Fixtures ••• Q Mic ave; - permit shall-be deemed revoked. s CONSTRUCTION LENDING AGENCY 4'. 4/• Gas Service Outlets , Water Closet OD Device�Bbxes �y)<Yr °d, ' I hereby afflrm'that there is a construction lending agency for-the performance - r �• 'ole Light. '.:'r ' of the work for which this permit is issued (Section•'3097r,'Civ. C.) "l.l Interceptors ; Water Heater I 2-6.1-O Outletst'� • • ` -I++ • OWNER BUILDER DECLARATION .� - _• _ ' 1 ,'' Range Lender's Name Lender's Address---t-- - --- - - - ' Kitchen Slnk- - tr J - r - � Water Service •-- -- 903 Switches - - - - , - •-_ „ Sigh I • • I, I hereby affirm that I am exempt from the Contractor's License,Law for the Lavatories I i - Auto-Wash • " i' i - following reason (Section ]031.13 Business and Professional Code: Any city or - - / _ ) - `{/ p\ Garbag¢,Disposa l�-' � /-. Standing Sections lie; I county which requires a permit to construct;alter,improve;demolish or repair : P—Trap i Laundry Trays 4 1 r any structure, prior to its issuance, also requires the applicant for such permit '' Y Generator ❑0.5 K ■5-15 KW Trash Compactor I, •o file a signed statement that he/she is licensed pursuant to the.provisions'of , :i ' Roof Drains : , , t ' 'r 1 �' re Contractor's License Law(Chapter 9(commencing with Section:7000)of . 41 , •!,/„ ' ivision'3"of the Business and'Professions Code)-or'that he/she Is exempt - , t- '"' _ '-' - -- - -" ' - --' . - - - / - herefrom and the'basis for the alleged exemption. Any violation of•Section l •• . - ' r I ' , ' t 1 • 7031.5 by any applicant for a permit subjects the applicant to a civil - ' • . _ 'l t - - penalty,of nottmore than five hundred dollars($500). : - , - i I - , • .E { ^ •' v II - l ❑ I; as owner of-the' property or my employees with wages as-their sole - -Reinspection Fee V ' $15 Issue Fee 5;3 . I compensation, will do:the work,and the structure is not-intended or offered. ' • - for, sale (Section 7044, Business and-Professional Code: The'Contractor's ' MECHANICAL , - Reinspection Fee ! $15 • Issue Fee $ 3 FEES, License Law does not apply to an owner of a property who builds or improves • - . . - _ - - , thereon, and who does such/work himself/herself or through his or her own - I - ' '--• , 'DEVELOPMENT SERVICES REQUIREMENTS: - - ' employees, ever,.ed'thai such improvements are not intended or offered for ' Boiler • Hood or . Type I ❑ sale. If, however,.the building or improvement is sold within one year of com- ',Canopy ; Type II ,❑ Zoning Approved By . Date ': . pf;the owner will have the burden of.proving he/she did not build or im- Duct-U •nder Ground • , Building Approved By 1 �� Date 3-t,,• ` ., prove for the purpose of sale). _ �, C ❑ I, as owner of the project (Section exclusively contracting;with licensed con- - Duct-Structural • Refrigeration System ( i �• - ,Application Issued By ' - - ' 'Date tractors to construct the project (Section 7044,Business and Professions Cade: - - ' - . The Contractor's,License Law does not applysto an owner of property who Duct-Ventilating ' DO-100,000 BTU. ❑100,000 BTU - - -• builds or improves-thereon,and who contracts for such-projects with a con- - - _ .- SUMMARY OF;FEES - tractor(s) license pursuant to the Contractor's Li cense,Law). I am aware.tnot, Exhaust System'0 Multiple 0 ; Sys `:Repair/Alteration ' A BU •I LDING PERMIT $ 1 SMTP ' $ - proof off their. Worker's Compensation insurance should.be provided to me-. _ • PLAN CHECK • :$ • PERMIT ❑%l am exempt antler-Sectien ' - B.&.P.C:for this reason ' Firepl/Fact.ell. IC80# llr Fire Dampers ' - - • PLUMBING I $ Hp) ISSUANCE $ Date '' • - - •Owner - - " Heating System& Ductin Registers . - ' I pLAN CHECK 25% �$: - '7ENERGY P C. '$:, - I hereby certify•that-I have'read•this'application and state that the above ❑o-100,000 BTU ❑ ,000 BTU : , . t .- _ • r --GRADING .$ ) Information is correct-I agree to comply,with all city and county ordinances, - r - ELECTRICAL - ,$ - _ and,state laws'relating to building construction,and hereby authorize repre-. - t - PLAN CHECK„ 50%',,$ -. • MICROFILM, •$y` -' sentatives of t is city t enc upon the above-mentioned property.for - i - _ - C. - - , i ., 1. - - //� �.�`` inspection ion p _ ' , •,' � J •- C. MECHANICAL_ ,$ - ,.TOTAL FEE ,- $, 7V• 7'V Signature ��. ' - _ -• , • , CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING .� , ` ! ) _ . ' POOL &SPA • APPROVALS Permit# Date ; 'Inspector - ' #, - � Dat "..; Inspector APPROVALS Permit 1 'Temporary Electrical Service or Pole ; ' ' + 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd . ' Wel •i4) 4( 53. Steel Reinforcement. ' , ' • • 3. Electrical Conduit Utility-Undrgrnd. ' ' ? • t . ' 54, :Forms; . ' ' 0 : } 4. Electrical Conduit-Undrgrnd. ' - I "55. Electrical Bonding - • 5. Steel'Reinforcement, .. .' , , I : ( 56. Rough Plumbing & Pressure Test . 1 6. Electrical UFER Grnd.' ; - 57. "APPROVAL TO'COVER-GUNITE • ; 7. Footings. '- : -58'. Electrical Conduit Undrgrnd. - , ' 8. Foundation "'` ' 59. Gas Pipe,'O'Undrgrnd.,Test • I _ ' 9. Water Pipe-Undrgrnd. ' ',-._• ''l7//44l 7/e '"-G60, Backwash:Lines,P-Trap, 0 Undrgrnd.: .' 10. Structural Floor System .. p ' 61. 'APPROVAL TO DECK 11. Property Sewer Line & HouseConnection, /0.4fre LEO 62. Backwash'& Receptor-Fit-tali ' , 12: Sewer Cap �\ 63. Heater,& Vent-Final ; . , : . " : 13: Roof Drains_ : - - : ` - 64. P}xl{bi ,ng System - Final, . + ' 14'. Rough Plumbing ;' ; - - '7/u 47 leo, 65. Electrical-Final ' '• Jf7T 15. Rough Electrical-Conduit ; ` 66. Solar,SYstem'Final 16. Rough Electric Wiring I_ ; - ;" "i -67; Fencing & Access Approval' • ' - 17: Rough Wiring Sign ' - • " 'r ' . 68.: APPROVED FOR PLASTERING ', : ' -18. Tc c Rou h Eletrial- Bar Ceilin f - • - 9 9; � . .r :. ci, ;y' ' •69. POOL/SPA SYSTEMS�F_INAL , 19. Rough Heating& Air Conditioning ' 7 i . FIRE DEPT. REQUIREMENT • j 20. Rough Factory Fireplace , ' APPROVALS 1 Permit# ' - • - 21: Ducts, in Structure - 70. Undergto ind Hydro • „ - - - - 22: Ducts, Ventilating' I ' ; '71. Product Piping 0 Ga's 0 Oil • V ' 23. Gas Pipe-Rough'&.Test , • ) 72. Underground Flush '; "� _ ' - : 24. Roof Framing - + 73; Undergrnd.Storage Tank 0 Gas 0 Oil 'i 25. Roof Sheathing 74: Overhead Hydro ' . 26; T-Bar Ceiling (Structural) & Monocoat , i, ,75: S Dry Chemical. . .: -.I' " " • s 27. Frame and Flashing - • ' :' , -'ty+ 76. Dry Standpipe ;..;--1' • -', •' ' 28: Lathing & Siding' •, ' ' ' . .' ' 77. FIXED SYSTEM FINAL : , : 4 . : • - ' 29. Insulation , 78 . FIRE PREY. FINAL ;; r: , . -, ' • 30) Drywall Nailing ; , - HEALTH DEPT. REQUIREMENT �• '31. Plaster Brown.Coat ' , '4 79. FIINA LINSPECTION • !1 32. Electrical Power. Meter-Final 80. FOOD CERTIFICATE ISSUED ` - - -. '33. Final Electric - -. -Notes: �' ` i ' ',= � �/ �' . /moi ki,3Y i in/- .-n -/., �. L �j. 34. Final Heating &,Air.Conditioning . : -,,.( :'_ , _ , - _ ., - -, 35: Final Gas Pipe-Test. , -. fhefe, , c _ ' -- _ -_ - _ .., _ •.. _ _. -. , .36. Hood or Canopy . - ���/ , -� i. - - • 37... Final Factory Fireplace - ": - ' 38. Final Plumbing .,;. - ' I! a , • j.39. Water Service;Final - 'OW47 `AO •,t :_ I • '-40. Gas Service-Final - ' , : - ,41. Solar Domestic-Final - . .. ' ,i_ ,, 42. Backflow Preventer ' • '43. Backflow Irrigation . 'i - - . ' - I - ,.44. Landscape Irrigation System. . - ' ) ' i45.'So'und Attenuation - i • v• 46. Handicap Regulations , .e - -' ' ' - -- - i, ' •.. ` '47. FINAL STRUCTURE & BUILDING `S ••' ;f, t 48. Special Requirements Completed ` . - - - - - - :::,(t., - i. :/i •.• . • 8 - • 9.- Electric Release to Edison • - 4 - . • ' - , • - 50. Gas'Release to Southern California-Gas Co ' - '1" ' ,. • ':51.tERTIFICATE OF OCCUPANCY T - - - ;, - • ��, _ _ • No.' Date.. . - - - . APplfcant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • • - - CITYOF,COSTA.MEgp, • 1CCOoNNggTq�CT1ON:P,ERMIS i,i- l,• i( PERMIT NO, 2931'A 'TRACT NO. • i LOT NO. (UNIT NO: -•T_-1 _ 4 :— 4.- .I, • t • '2f1��' ;]/_21/S] r 43.043Cel 'rl r 1666 EL�Efl ,AVENUE "��'' M N. t t ! Project Address - - _ .. I vL� , 1 - s Applicants Mallin Addres } • le 9 •' : • f Ck TYPE OF CONSTRUCTION NEW U1ADD U ALTERATION U REPAIR . ' ' I I " FLUTER DEVELOPMENT 637=3177 ' ❑ 'CONVERSION ❑IDEM LISH ❑ OTHER 1 _ f • ' Owner's Name: pion ' A.P.# i , ( - l 4 I Zone ;510 30TH ST' NEWPORT' 'HEAL LA DESCRIPTION OF WORK/USE'OF BLDG. •f Address . ' r r Lit { S Main Building ; , , ' Accessory Building. 1 i t ' Arch/Eng! I- I License No. ' •' TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ! • T Front_ •1 • i ` Address '�• i 1 I - ' ❑1TENANT ❑ ELECTRICAL; ❑ PLUMBING Z.MECHANICAL j B Rear Contracto'r's Name ' SIERRA FIREPLACE DIST :,:Ne, ' 83z 8,62 • ❑ OTHER { c ' . I J A _ 2 f 1 I ' • ' • • I • 1, 1 • •1V r CA.92083 PROJECT DESCRIPTION •SO. FT. F '• t .-. ' OCCUPANCY Kt Right - i— 1 -' G 1 Address(mailing) " - - ' ; , L� p,�-/ , , CONSTRUCTION TYPE ( VALUATION$ I s Left l • I , i R City;License NO. /�I/) • • I ZONE . •U GRADING CU.YDS. " ACRES' - i l� LICENSED CONTRACTOR DECLARATION I ' I - Fl ng. Ref.# i 'Parking Req,/Provided • f E I hereby affirm that I am licensed under provisions of Charter 9 (commencing , Remarks: .Q C[' •1� r • I - Planning Notes: 1 _ ! 0 with section 7000) of Division 3 of the Business and Professions Code, and " l-- �D -Z7 DZ-•�' i { i t 9 - 1 I - 1 M 1: my license is in'full d e and effect,. •I ) 1 1 440255 ' l - ' ! t 1 'i 1 ? , „- , i i _ � , I T ••' License Class • • • ' , Lit- se •. • ' •' - - , $ , '.,• Date- • • •gnature _i — ' -4 , 1'. I PLUMBING i 1, FEES. . , , , .1 ' • t i ' ' ' i , `�( WORKERS' COMPENSATION DE ARATION • ( I - Bar Sink. I -- - ' Showers, + s •" - f - l -I ' V 'ereby affirm,that I have a certificate'of consent to self-insure or,a certificate '•• .- - -- ' -t -' . 1 4 I ELECTRICAL = 1 0 i FEES - Workers' Compensation Insurance, tar.a'certified copy'thereof (Section - r • .1 _ _ I .,800, Lab. c.) f Backflow Preventers •i I ,'. ' Service Sink _ 1 $1 •'-.! .m 1 r , Automatic Washer I j 1 1 ' ' - Transformer•D -15 50 KW" - ' I Policy No. 73WC00389700Q�(npany •NATIONWIDE MUTUAL' Backflow Irrigation - ;a Sewer Cap _ • ` - ~ I .D 50+KW I 1 4;I Certified copy is'hereby furnished. i t - f . t - - - 1 I COnStruetiab POIe Sub, „- - �, _ J ,• • Certified copy i fileC with the city B lltling ivisi9q '/ , Bathtubs a. r I j Sewer Connection t ' 1 t Cooking Unit , ` I Meter Dup.to 100 amps •- . .Dale' - //16/ORKERcan '"t _ _ - f 1 t EXEMPTION FROM WORKERS'C PENSATION D LARA t Clarifiers I 1 ., - Solar ColleetorsC -3 Dishwasher -. ': 1"„ i Meter, Lover 100 amps ' - ; • -4 ! • { (This section need not be completed if the permit is for one hundred ($100)or ' ' less). .r i - . Dishwasher =5 : l = 1 Solar:P,ping ; ( _ !•,,,x ,a1 I = ' ti Dryers'OGas ,DElectric • `. Sub Panel 1 , (.certify that in the-performanceperson of the work for which this permit-is issued, I , _ - - --, - - - - r•. - ' shall not Compensation person in any manner so as to become subject to the Drinking Fountains .. ' i Solar Tank • 1 1 • Workers' Compensation Laws'of California. 1 - • - , , . - 1 .I • •9 , •Fan ' l Motors DO-1,HP.D1'R-8 t { Date 1 Signature '- s • I • Floor Drains Swimming Pool w/Spa e, t F,A,U `" " J a' ' .(. NOTICE:,If,after,making-this'declaration,you should become subject to the, __- ._ _ -•__ _ _ _ _ IncInc"Solar D9-15 HP,D16-15+- Workers' Compensation provisions bf,the Labor Code, you must forthwith - 1 Floor Sinks i ••I Urinal 4. - , �Y ( i Fixtures - comply with such' provisions or this permit shall be deemed revoked. . 4 - l i Microwave, 'r • -CONSTRUCTION LENDING- AGENCY • I 1 •t GaS'Servic 1 ,Outlets i ' 1 • c. 1 , 1 Water Closet 1 f Device Boxes ' I 1 hereby affirm that there,is a construction lending agency for the performance - i I i •. e I , Pole Light • ( of the work 'for ,which this permit; is issued' (Section 3097 Civ. C.) ! Interce tors s i ; Water Heater 1 I 1, � u I ' - - , Lender's Name - 1 ' t v. P _ r vii • 1 Outlets „. . I , Range i ; 1 „Lender's Address - ' • - _ - - • •I __� Kitchen Slnk 4_�-;__- •„__- ) Water,Servlce _,.---1.-- if,” ,. _ .1— Switches.1 . .. .. _ - 5 -- ;' • _ 1 OWNER BUILDER DECLARATION ;-- - - , .%t ) > -..f. I hereby affirm that I am exempt from.the Contractor's License Law f6r.the I Lavatories 1 ! Auto-Wash . Garbo a Dis osal^ 1� t _ " following reason (Section 7031,5 Business and Professional Code: Any,city!or ' r 9 P •Standing Sections 1 i county which requires a•permit to construct;alter{improve,demolish ocrepalr . . P-Trap ' 1- { t Laundry Trays .r Generator ❑O-5 KW D5-15 KW '- ' any_structure, prior to its issuance, also requires the applicant for such permit • 1 • Trash Compactor . I • to file a signed statement that he/she i5 licensed pursuant to the provislonsiof 'i I i • '� • Roof Drains • the'Contr3 of.1s License; ss (Chapter 9 (commencing with Section 7000) of i . r ,i - , ti . ' I . 'ivlsion 3 Oftithe Busintis5 ahe alleged exemptde) or,that„he/she.is exempt -: _ �.,.. _ - . . ✓_ __ _ _ �-_ ' erefrom1.5by and,the plicabasisifor the exemption. Any violation of Section •i t� I •'M .� I• ; i 4 - 1• f331.5 ay applicant for a .permit subjects the applicant to a civil - 1 - • • pendlty'ot not more prop hundred dollars . ^$ • , D i' as owner of the property or employeesmy' with wages tende*as their sole Reinspection Fee�'-- i15 • +� • ,Issue Fee- 1 $ ” • ' Fee L i.:..- iCompensation,:will do:the work, antl the structure is not intended ntractoroffered ' - " - -' far gale (Sections7044, Business(antl Professional Cotle:-.The sContract yes l ; 'MECHANICAL(. • -{ -FEES, ' _ Reinspection Fee - !'$15 Issue Fee {' , r' $ 3 11 , License Law doesn oes sly to an owner of a:property who builds or improves •• ' thereon, and who does t such ork himself/herself or through his or her own iDEVELOPMENT SERVICES REQUIREMENTS: , 1: ' • I t-.-:employees, provided that such improvements are not intended or earoffered for • '2.Obin A roved B • '' _sale.0f„however;the building or improvement is sold within one year of com- : g PP I Y - i J I '�y;-/y�-//� :'/y,r pletlon, the owner will.have the'burtlen of proving he/she tlitl not builtl or im- i 1 _lY�� ( frove for the purpose qi sale). - r ;Building Approved By I Date1; as owner tr cthese of sae): •Se exclusivly contracting 1wrofe cenied con- • . - - • ,Builiing A Issued By - / ' •�• Dete[rhe coto construct the project (Section 7044,Business aner of essions Cotle:The s'oris ctor's'License Law does'not apply._to an owner of property-who • uI •11 I11 : 11III - , ' f • '- • f .` SUMMARY OF:FEES - i . • builds or:improves thereon;and who contracts for such projects with a-con- tractor(s)'ncense•pursuant to the Contractor's License,Law). l•amProv aware,[hat' • • t ! •+"" BUILDING PERMIT- S. + 4-SMTP ' t { :. '$� - -- i proof .of their Worker's Compensatlons,nsurance;should'be provided'to me: aust 1 - t ; • ,P,LAN CHECK 4 ' ,$. ' 1 "PEMIT Dt•I am exempt under'Sectlon - ” ' 'B.& P:C.,for this season_ �, :•Multiple� •. 97, co f ;$ pi t• , ._ s• , _-• l ._ - j PLUMBING - 1 iq S. .- ISSUANCE %$, -1 Date ^- Owner - _ • - - l • PLAN CHECK_P 25% $; - • • / : c. ENERGY P C. •'$r' - 1 hereby certifythat' I hade'read this ao''cation and state'that•the above' 00-10b,000 : I1•III : -' information is crrect. 1 agree to Comply-with all city and county ordinances- 1 ^ ' .'ELECTRIC_AL - .$;: - ( GRADING, . I$ • and state laws relating.to building,construction,and hereby authorize repre . • 'MICROFILM !$ . '• I sentatives of,this city. to-enter upon' the'above-mentioned pro erty for:. ' • PLAN CHECK 50.4 _'$-• - inspection Pur ses. - ' . .t:' - Signature G1t-�O'� /�/� ' Dale, �"7`"_. ; • 'MECHANICAL�•i $ f ��1 5 TOTAL FEE ,$•.��3 ��+- Drivers'Liefnse or 55 • • Irte0: AN CHECK:-25%"$:. a-CYO• • • •CMF 4 OB65- 6,"rev. 10%B4 • White TBuilding; Canary Applicant; Pink -Accounting; Goldenrod - Assessor f ;CONSTRUCTION AND P.LANNINGF '. . I { ' _ . __ . _.• ..: ' POOL & SPA - t r Date ' Inspector ' 1 Date : Inspector ' •APPROVALS Permit#' " • IAPPROVALS Permit# 1. Temporary Electrical Service or Pole i ' 52. Pool &'Equipment Location, ' I , 2. Soil Pipe:Undrgrnd. `1' - , , I . - 153. •Steel Reinforcement a t , • ; 3. Electrical Conduit Utility-Undrgrnd! ' _ ;54. Formsii. ' • t 1 tI . • ��•.+ ' 4:.Electri`cal Conduit-Undrgrnd. ! i - I �.: I 55'1'. Electrical"Bonding • ,. I i : 5.Steel Reinforcement,. I 56. Rough Plumbing & Pressure Test.; I 1 • ,( 6. ElectricalUFERGrnd.: i, • ;1' i ; • 57' APPROVAL TOCOVsERGUNl1Et . I I 17.•Footings X' ' ' l ; ' ' • • 58: Electrical Conduit-Undrgrnd'. . , • - -• • •'81.. Foundation 1: - ---- • ' -.. !-- 1,- - 59. Gas'Pipe; ❑-Undrgrnd.,Test' 1 -, - ; '9.,Water Pipe-Undrgrnd "' . . _�__ .„' : ...,:.. -60.-Backwash Lines, P-Trap, O Undrgrnd. ' 1 • ; '1 I.:10..Structural Floor System. ci : . ' .l ��, { 61. APPROV• AL TO DECK 1 • +, 11. Property Sewer Line I& House,Connection i - , 62. Backwash & Receptor -Final ; ` • '` 12. Sewer Cap - 1 I ' 63. Heater & Vent -Final t • ?.13' Roof Drains.,, �' :, ;. +,. I ,i ! 64. Plumbing•Syste_my- Final i : I : 1 . I-, ' I'14. Rough Plumbing ,`:t 1. 1 `• 1 I ,t i + ' 7 r 65. Electrical-Final' ' - 1 i ' •i 15. Rough Electrical-Conduit - , : ' 66. Solar System-Final I; -1 : I; z S 16. Rough Electric Wiring- p -_ --y. . •` • "1 e-.:.... , . , ., t • , 1- ..1-. ,.. . ., • _ 67. Fencing& Access Approval Y , ti 17.; Rough Wiring'Sign -" p' • -' i"- .- i' -'y ' 1 ' 7 '.i ` ,•68. APPIROVED FOR PLASTERING`-• , - - ' - .• • ' : 18i Rough r Electrical-T-BaCeiling; ; ,.7..... t i- -'--1 '-j- ;- -I ' 1 69. POOL/SPA SYSTEMS•FINAL (. 1'19. Rough1Heating & Air Conditioning • I , • ! I 1 . ' FIRE' REQUIREMENT { ,, l:'20. Rough Factory Fireplace , • /11��H /0� APPROVALS , Permit# •r - : ' 121. Ducts,�in Structure' • , , /-J7I/C`, ' i 70. Underground Hydro - . i r - • 22. Ducts, Ventilating- , •• • 1 ; 71. Product Piping ❑Gas ❑Oil I . Q qi 23. Gas!Pipe-Rough & Test, c ; , '• 72. Underground Flush i ?` I • .• a . 124.' Roof Framing • i - • a i 1 - , . 1S Ir I 173. Undergrnd• .Sto•rage TankD Gas. O Oil,. � , , Sheathing ) 25, Roof ,r- I , 74 Overhead Hydro ` " , 126. T-Bar Ceiling r(Structural) &.Monocoat, • , l ..;j`; F I- 75.'DryChemical tyt c.f. - , ' - -1... - t_ _. _ Wit. ' 27.,Frame and Flashing . r 76. Dry Standpipe, 1 ;6I . , `, - •-r i • 28.' Lathing &`Siding .. !" i ' I j 77. FIXED SYSTEM;FINAL Bina t -` - , v c Vic" 0 - 29. Insulation,. ) t 1 - 78. FIRE PREV..FINAL ' ,'i . ` 30.,Drywall.Nailing ! ! • ) ' 4, ' i • , HEALTH DEPT. REQUIREMENT r.i , 31.;Plaster Brown Coati ; r `• 1 I ` i ' . ; 79..F,INAL INSPECTION - r % 4 r, . 32. Electrical Power Meter-Final : I ` '• 80. FOOD CERTIFICATE ISSUED. i 1.7. i 33. Final Electric „ - ! , i . r I ' Notes:= I 1 ! i , 1 , ` .. . - ' , :. r j'411. Final Heating•& Air Conditioning' 1 „ • , . .-° ; . ' - : I[ . :1.1 - ; 35. Final Gas Pipe Test f i ( 1 ' • t, - • t . ''1 ,, 36. Hood or Canopy ,,, _ - 4' 37, Final Factory Fireplace - ))/h y/ J �' ? ;_ i 38: Final Plumbing: `. . - r ' - - /`� :sir; , i . i 39. Water Service:Final, .. '' - r.; ,+ ' - • - - - ,' , 40. Gas Service-Finals - - i. tl. _ I's'- ' : 41. Solar Domestic-Final - • ,: - -, • `a _ ''- 4 •4 r •l, =,a, ;42. Backflow•Preventer . 14 4 - ., " . - • ' ,43. Backflow Irrigation , c: _ }, - 1 , .Y • 44. ,Landscape Irrigation System - ' - ; 1 • ' t 5' '4Sound Attenuation ,,'- •• . - • ; _ � " - - '• i l' 'r46:`Handicap Regulations -• ..4• . r ' 47. FINAL STRUCTURE& BUILDING c, "'F - - - ' :. - -_ . ;r .. a. . 48.Special'Requirements Completed ; ' .1-4.,•'• 4 , ' • - 1 ;- ' .- • : - !49.:Electric Release to•Edison ••:- , - ai - - , - _ . ',!. . f. 50. Gas Release to Southern California Gas.Co :- - -• -` " . •- ° , ''51'•CERTIFICATE-OF OCCUPANCY - - - . - - . - • G . No. - - + ' ' Date • -. -'` _ _ _ .. .- --- - --- -_�_ .. rim- T - 11 1 ..S j . • • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 002014 Building Safety Division P.0.Box 1200 • • Costa Mesa,California The Building located at /AAA t/aAan Ayanna, gni lai no M F N has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto t; Tfor a Group v'3 Occupancy. Use of Building flnnl ax Cnnrinmi ni.um Legal Description 4RQ-991 —IgF>17 r2yf ` (See reverse side for Metes and Bounds) f Building Permit No B 27027 Electrical Permit No. P. 9Q776 Plumbing Permit NoP28289, P28290 Mechanical Permit No. M29494, M29185, M29186 Number of apartments - and/or guest rooms ISSUED TO: Building Official at; 11 i am T_ Hnwa rd ? Fluter 'Development 510 30th Street byr -,711 i, '(\ Newport Beach, CA • Date January 4, 1987 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. , s.\ CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File