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Home My WebLink About156 QUIET BAY LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 156 QUIET BAY LN Status: ISSUED Suite: Applied: 10/15/2003 Vicinity: UNITS 156-158 Issued: 10/15/2003 Parcel Number: TPN003179 Zoning: Applicant: BATIOFF, JOHN ISSUED BY: Address: 17182 ARMSTRONG AV �6�1� �Phoge:�714-381-7974"�� IRVINE, C �� ` Zipi 92614 Owner: QUIET BAY'HOA ' ILJZ- � �� Address 163 QUIET BAY LN �(7�� L/ '`:P -hone: -94&253-0548 / / / ©0 COSTA MESA CA� �� Zip: 92627 � Contractor: vDRI COMMERCIAL (Address: 17782ARMSTRONG AV Phone: IRVINE .CA 1 ✓ Q,� �� 1 Zip: 92614 [ License':.818623 Eng` iAddress:J �� S( / °�°-�,o �'t,N� Address: Phone. = Phone: t Zip: ;� License: License: I it t + i — SCOPE'OF`PERMIT = r n r—r�.'_,. �r,:,t'cry _i,. v I I I TEAR OFF EXISTING ROOF. INSTALL CLASS A COMPOSITION SHINGCES:�37.34 SQUARES FORICONDO UNITS UNITS 156-158 ; U./il. SL f1 it.y � u 1Z 1L A.✓ , FEE SUMMARY ` Plan, Check $0.00 ry� k. _Calc Valuation ; S73s000 1t l Permit:,�1$153.25 _ - ___ =• / ' -Claim Valuation. $7;390.00( 1 �,SMIPRes:��,)° $0.74 i ISMIP Com: ,�\U $0.00 �, Other: -A$0.00 � In`spection� � \$0.00 �� tTotal: 1 /$153°99 m 1z a ;c PLANNING" &' Z_ONI= NG SETBA�KS .r..i MAIN STIR c- jO'Left 0Right. /0/=C-l/✓� / )� j/,j ' 'Front ! - �\� ACCESSORY VF,ront�0- 0' ��i Rear 0- 0�--�----_ �a LeR =0- 0 Right �0- 0 0 Existing: 0�ReerPPARKING :_ r�r000sedr}0 \^. NOTES: KENNE_S 10115/2003 -FEES PAID, REF.: VOIDED,PERMIT, 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 commenced with_in`1801days, 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: 1 hereby affirm under penalty of perjury one of the fallowing declarations: ❑ 1 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 far 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' compensation Insurance carder and policy number are: -7 Carder: 0 /Wx'lT-vLf ti OaA a6. -n Policy Number: (� `.1.� � if ie (This section need not be completed if the permit is valued at ox9hundred 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 California, and agree that if I should become subject to the workerscompensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisip�pys,�s-� I _ ""Applicant Signature: ! \ Q Date: WARNING: FAILURE TO SECURE W ERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($108000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionsfyoda, and my license is in full force and effect. Lic. f1 JQ to Z� Class» G3 Ci 1 `� ;Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Cade). Lenders Name: Lenders 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 Cade: 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 Cade) 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 contractors) license pursuant to the Contractors License Laws.). ❑ 1 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: ❑ 1 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 California 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 Cotle, 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 ...4..........I.f..Department. ........................................................................................................................................................................................................................................... ............................................................................................ anRM..PP s presently required, has Section ....I of the California Health and Safety Code been fully complied with? ❑Ves ❑ No ..................................................................................................................... ildi........................................................................................................................................................................................................................................... difi................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Uplication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ 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 ❑ No (If ryes", 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 ............................................................................................................................................................................................................................................................................................................................................................................................ B (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 laws 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. aturA Of Legal Owner(s) � _ l - 7� nd/ Authonzed Applicant Date T�— CODE 4. INSPECTIONTYPE DAL INTRIALS CODE. INSPECTION TYPE_.!LATE 1NTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical - 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 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 December 21, 1988 To: Building Safety Division Code Enforcement Communications County Administration Office County Clerk/Bd. of Supervisors County Registrar of Voters County Tax Assessor Engineering Division (2) Fire Prevention Manager, MIS Mesa Consolidated Water Dist. Newport -Mesa Un. School Dist. (2) Pacific Bell (2) Police Dept. - Ping. & Research Santa Ana Heights Water Company Sanitary District Engineer Southern California Edison Co. Southern California Gas Co. State Board of Equalization Street Division U.S. Post Office, Adams Avenue U.S. Post Office, Santa Ana Zip 4 - Santa Ana 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 " 2666 Elden Ave., Unit H 162 Quiet Bay Lane 439-221-62 2666 Elden Ave., Unit J 160 Quiet Bay Lane 11 2666 Elden Ave., Unit K 158 Quiet Bay Lane of 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. Your cooperation in this matter is appreciated. Sincerely, > i GLEN S. ETHERINGTON Planning Intern GSE:jl(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 nN-]AV, N-3(17- L J - _ ~ � Applicant to fill in all spaces except those within heavy border lines andsign a •- -V -~_ .. ♦ _ - -- _- -_ 1 7~•`_- - cITYGF.cOS7AM//Es/q-/ECC)NSTRUCTIONPERMI P IT ^N 7© IT TRACT NO. ' LOT NO ( ; Reinspection` Fee' 'Project AddressG-YL/i (// �I/C•a'�I' /�V 1 1. I 640.42 I• $' 3 TYPE OF CONSTRUCTION NEW. ADD ALTERATI ' ` - Applicani's Mailing Address j ! ! ' J t9, t I i ' ^j -r �_' �' ��'' ❑CONVERSION' ❑'DEMOLISH _0 OTHER 1 ' - - + Owners Name{��jj(("�-�� Phone Address /10 t � �C-� 4 + DESC,�+P)"I (J F. fO(p�1C/U$6.Q-F i S77 Arch/Eng��"Ua�- License No. l s7�iLi�ce�ns�e-sN.yo.s f,TYPE O,FF PERMIT ; LJ GRA FGUNDATIA� SrRl, F, ro tit. 5�'G �l Address i ��- ��t'`�— i r f ❑ TENANT; ❑ ELECTRICAL• ❑ PLUMBING ❑ MECHAN" i !.a i❑ OTHER I i p. 'n�`�-- WNc• r i' I t/ I ( CG t Contracto'r's Name'�L. Phone -- Duct - Ventilating ' •- ' Address (mailing) ( ( ' 1 t 3! { s _'tt �.t•,'CO PROJECT DESCRIPTION ! SD.'FT. oCCUP1 N STRUCTIONT-VP.E i I City;License No. - 1 ,VALUATION$ 'ZONE ,GRADING CU.YDS. AC System Repair/Alteration LICENSED CONTRACTOR DECLARATION , f ; I 1 t flRe marks: i'b0 r �V S j �'f-J�� " J ' ' 1 hereby affirm that I am licensed antler provisions of Charter 9 (commencing - Fire Dampers I f •; f ith,section 7000): of Division 3 of the Business and;Professions Code,and ", .< ' lU l.� Too• ' y license is in full forceland effect. I t % Planning Not s!a. License Class " License No. ? !PLUMBING. I +' r�386- Date! I I Signature t • WORKERS' COMPENSATION DECLARATION t '•' I k c 'hereby afform't M1at11 have a certificate of consent self -insure oris certificate - Bar Sink I ' `r i ' Showers. ' - f f Backflow Preventers j^ = i , ..- i Service Sink �) �. 1'.r _i fi I Workers' compensation Insurance, or a'certifietl coot; [Hereof (Section X800, Lab. C.)• i { i i t .� t� 1 ?„ ; Backflow Irrigation ' .: O - Sewer: Cap I - ' Polis No. I - compan 1 a Policy v ! I sl ryll Certified copy is hereby furnished.(� - IJ CertiLetl copy i5 filed-,withahe city Builtlln9 Division, f p`,.� 1/` } Baffitubs _ , " t".Y Sewer_Connection - • 1, -Date ' 1 - I Applicant ! - S EXEMPTION FROM WORKERS' COMPENSATION DECLARATION tr .'p _ - .. I Clarifiers i '- ` b' , r SOIar COilactor,s- (ssjssection need not becompleted if the permit Is for one hundred ($100) 'or• •� Dishwasher ' = ! - '!= " = SOlar'Piping -� I certifythat in the; performance of the work+for whlch'thls' ermj p permit i55Uetl(I -• 1 '1 Dryers-DGas 'DElectric • I shall Ino employ any person ion any manner so as to become. su bjectRo the { Dnnkipg1Fountains ! ' t Solar Tank ' "' HP D1% 8 ;., t' Workers' Compensation Laws of California. Datej ' Signature + ' ) t' ( r - !; 7J�7 FloorDrains' + i - t Swimming Pool w/Spa , .NOTICE: If, after making -t his.declaration,.you.shou Id. become. subjecttothe - 1 Floor Sinks Urinal I s' + MicrowaveY Workers' Compensation provisionsof the Labor Code, you must forthwith j i S comply with 'such! provisions or; .this 'permit shall' be deemed revoked. - j Gas Service \'1 Cutlets,; * �. I Water Closet CONSTRUCTION LENDING AGENCY I i 1 hereby affirmithat there'is a construction lending agency for the performance - 1 (Interceptors gyp. -�. . ,rte, r Wates Heater 1 ; ) i of the work i.for iw ich �h� perml'[ itJssuetl (Section -3097 Qv. C.) Lender's Name. = �"/ �" NA"IpI,- - + i i _ .y Kitchen Sink •-L f Wa[egService:-- - —+ - - . LendeCs. Address ! �'o'+ - d✓• r �2(�i14 � ( i OWNER BUILDERiDECLARATION i 'hate declarations. vision 3 of•the•BUSiness'antl'ProfessionS+Cotle) or,that',he/she-ir- ' erefrom antl'the ibasis •for the'alleged exemption. Any violation of Section 031.5 by any. applicant for a 'Permit subjects the applicant to' a civil enalty, of not more than.five, hundred dollars ($500). I I,' as owner of sth.' property or my employees with wages as their sole i compensatiogiwill do.the work, and the structure is not intended or(offered for .sale (Sections 7044,' Business 'and Professional Code: %The ;Contractor's License; Law does -not apply to an owner of a property who builds or improves thereon, and who does such !work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for osale:ilf„however,,the building or improvement is sold within one year of cnm- pictmn; the owner will have the burden of proving he/she did not build or Im- -pryr ve for the, or Of sale). 1 , ! I owned of; the ' Operty, am exclusively contracting with licensed con- �i r8clo rs to construct the project (Section 7044, Business and!Professians Code: The,Contractor's. Li cense Caw tloes not apply ,to an owner, of property'v, builtls or imp rovesA ereon, and .who contractsJor such. projects with a,con- tractors !h Ce ns e. pursuan t'to,the Contractor's Liceose,Law). I am aware,thai proof o� their. Wor kers, Compensation. insurance -should be p'fovidetl to me.' - o = •. - ' D •1 am exempt antler Section - -B.'&PIC for this reason ' r , e •, t r i ..'+ NO. i 0924: 'IL26/87 t - t t' , •5 I I Reinspection` Fee' ! 1. I 640.42 I• $' 3 REPAIR ! 1 .3 ' ` - t ,' 'D - ; A.P. # ; - — X22 t Zona _ + 'S Main Building: ' ' Accessory Building' 1 _ i _ T F, ro tit. 5�'G / ` 2 O Duct -Structural i R Rear 5. 5 ( f ) I r N Duct - Ventilating ' •- ' '� C Right- - / .' - I 1 _ i_ - N. System Repair/Alteration 'g Left 0, 5'1 ! - ' G R E Fire Dampers I f •; f ` PIng.IRef. ,# ® - — P r ,/Provided Vni 7 ' .Heating Planning Not s!a. - -+ + f 1 d M - r�386- l S. - _:FEES. - --t. f = �) �. 1'.r _i - -. - �i Remspettion Fee $15 it Goldenrod - Assessor ELECTRICAL t I - y FEES t' I ' _ - Suh +' Automatic'Washer' - "� jt�Su�,Pamel ormCr.E1 15 50 KW 'D 50+KW'CohstructionPole - I ;- -Cooking Unit " Dup to 100 ampsDishwashei -Dover, 100 amps Dryers-DGas 'DElectric ' Fan Is'DO-1 HP D1% 8 ;., t' d - t _ F.A._U. _ _.•lu_ - _ _Ina Solar5 gA-j HPjD 16-15+a - Fixtures ! .. MicrowaveY i S Device Boxes 11 s Pole Light: ' 1 j j Outlets 4-- _ Switches -j (- Signl - -. - ' • ' • 1! /"'ICMF vision 3 of•the•BUSiness'antl'ProfessionS+Cotle) or,that',he/she-ir- ' erefrom antl'the ibasis •for the'alleged exemption. Any violation of Section 031.5 by any. applicant for a 'Permit subjects the applicant to' a civil enalty, of not more than.five, hundred dollars ($500). I I,' as owner of sth.' property or my employees with wages as their sole i compensatiogiwill do.the work, and the structure is not intended or(offered for .sale (Sections 7044,' Business 'and Professional Code: %The ;Contractor's License; Law does -not apply to an owner of a property who builds or improves thereon, and who does such !work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for osale:ilf„however,,the building or improvement is sold within one year of cnm- pictmn; the owner will have the burden of proving he/she did not build or Im- -pryr ve for the, or Of sale). 1 , ! I owned of; the ' Operty, am exclusively contracting with licensed con- �i r8clo rs to construct the project (Section 7044, Business and!Professians Code: The,Contractor's. Li cense Caw tloes not apply ,to an owner, of property'v, builtls or imp rovesA ereon, and .who contractsJor such. projects with a,con- tractors !h Ce ns e. pursuan t'to,the Contractor's Liceose,Law). I am aware,thai proof o� their. Wor kers, Compensation. insurance -should be p'fovidetl to me.' - o = •. - ' D •1 am exempt antler Section - -B.'&PIC for this reason ' r , e •, t r i ..'+ s ' 1 t - t t' , •5 I I Reinspection` Fee' $15 f -: + Issue Fee + ' I• $' 3 t i ! i ' - ' •• Reinspection Fee - $15 Issue Fee - t• $ 3 - ` •' i - MECHANICAL! t ,' 'D -FEES ; , Boiler _ i S - �HOOd Or I Type I t Can Opy l Type I I ❑ I t i. _- i - l '! 1 - • '. t t ': i „ DEVELOPMENT SERVICES REQUIREMEN i zoning Approved By ! a44.titititi (illGJr's-' '^'/vfDate / Building Approved By '_� 1 'Dat¢ 'Application Issued By - , Duet - Under Ground -' ”- I Duct -Structural i Refrigeration' System D0-100,000 BTU 'D 100,000 BTU ' -- r, : 1 Duct - Ventilating ' •- ' '� ' t I , SU MA V OF FEES -' , j s , j "' BUI L'DING PERMIT. $' • �• SMTP •- $^ r &: .z - _ f i --Y :, PLANCHECK. ,$:' "PERMIT i - - 1 ^ PLUMBING , - $ L ISSUANCE ._ t I PLAN CHECK t25%r I$"• i F 1ENE RGV PC' �$�' GRADING' �,$ - ELECTRICAL t $: ,f - -• i -, - i 'r' .' PLAN CHECK .50%, $, _MICROFILM'[•$ - ' MECHANICAL $ r Z ._TOTAL FEE'. �$ yb - PLAN CHECK 25%- - z/ ' +Exhaust - System_ ❑ [Multiple D. System Repair/Alteration ,. Firepl/Fact Blt.'ICBO # 'v Fire Dampers I f •; f i Y _ ' _ ' i Date - 4 / Owner ! - < Hereby certify;tha -I have 'reatl ;tris application and state that the atiove. i information 'is correct: I agree to comply with all city and county ordinances ' antl;state laws relalm9?to buildin construction', and -hereby authorize re re-- sentativeslof,this, at to +enter9 span• he!above menhonetl_ property,Por inspection,purposej i ! 11' Signature ---///A:r/J�!' /J 11^ .. i Date:-�`.�i• ., Oriveri' �Ll cense or—�85- ' t' i I <•' I 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink , Accounting; .Heating System,& Ducting ❑0100,000 BTU D100,000 BT ,Registers '' + - _ ' - --t. f = �) �. 1'.r _i - -. - �i Remspettion Fee $15 it Goldenrod - Assessor p . i ^' j .. ( Issue Fee .- 1 I $j 3 ,CONSTRUCTION AND PLANNING '_. '-_ _ .. ;-_i .i POOL&SPAS :-.r_ �. -�c.�• APPROVALS �Perrt it # - Date (inspector, Permit to Date Inspector i 1 +_Temporary Electrical. Service or Pole I 'i -! h { _ i 52. 'Pool & Equipment Location - 2. Soil Pipe-Undrgrnd!• `-53. 'Steel Reinforcementt 3. Electrical Conduit Utilify-Undrgrnd. ' - 54. Forms', ' ' t _. " . _ s 4. Electrical Conduit-Undrgrnd. 55.`, Electrical Bonding 1 , .. 5. Steel Reinforcement, I ' I - 56. Rough Plumbing & Pfessure1Te`st, i 6. ElectricalUFERGrnd. 10j&1- 57.;•'APPROVALTO'COVER-GUNITE_ �..� 7. Footings 6�,;,•• - 7 e .0�- is 58'. Elecirical'ConduifUndrgrnd. l 8. Foundation 1 ' : - - - - ,"-' --� j 59. Gas Pipe, El-Undrgrnd., Test ^J i �• I j •' 9. Water Pipe-Undrgrnd. �' _ r-! ` -60;• Backwash -Lines,: Undrgrnd �, I a 10. Structural Floor System 0� 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash,& Receptor-Final' "t:: ' 12. Sewer Cap 63. Heater.& Vent-Final. 13.-Roof Drains: '"- - 64. Plumbing System - Final! ,. 14. Rough Plumbing 65. Electrical-Final 7 15. Rough Electrical-Conduit - 66: Solar System-Final 16. Rough Electric Wiring - - - 67. -Fencing &•Access Approval' ' 17. Rough Wiring Sigh` -""' "-'- ` -` •' '68 APPROVED FOR PLASTERING- LASTERING18' 18'Rough Electrical-T Bar,Ceiling"' ' 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning • , FIRE DEPT. REQUIREMENT _ APPROVALS-' Permit #-L,-'_ 20. Rougk Factory Fireplace ' 21. Ducts, in Structure I 7 70. Underground Hydro . 22. Ducts, Ventilating, .. +71. Product Piping OGas El Oil 23. Gas Pipe-Rough & Test- f I I I 72. Underground Flush •' .i i./ i ` �r- - 24. Roof Framing- 73. Unclergrnd. Storage Tank, El,Gas O Oil 25i Roof Sheathing 74: Overhead Hydro! 26% T-Bar Ceilirig (Structural) & Monocoaf Dry Chemical;- 274 Frame and Flashing S 76. Dry Standpipe i, ,: , 28. Lathing &Siding 77. FIXED SYSTEM FINAL 29: Insulation _ C!"'' 78. FIREPREV.FINAL 30. Drywall -Nailing ` i ' HEALTH.DEPT. REQUIREMENT - 31. PlasterBrown Coat + 79.-FINAUINSPECTION •'' ', - i �.Ve-. _' 32. Electiical'Power Meter-Final 80.-FOOD CERTIFICATE ISSUED 33. Final Electric_ Notes: -f W f 34. Final'Heating &Air Conditioning 35. Final Gas'Pipe-Test $ It OK w E7cT. G N- 36,,Hood or Canopy Of 3 'Final`Factory Fireplace ` .38f,'FinalPlumbing -- 39; Water Service-Final- 40. Gas Service-Final '.41. Solarrpomestic'Final , 42: Backflow Preventer 43. Backflow/Irrigation ;44 •Landscape Irrigation System: ' .45..Sound Attenuation` _ - •'- '; • t"` �'1' 46..Handicap Regulations 47. FINAL STRUCTURE'&BUILDING 48,`.SpecialiRequirements Completed t ' 49: Electrie,Release to Edison; - - - - - 50. Gas Release to Southern'California Gal Co , _ - .- ..• 51. CERTIFICATE OF OCCUPANCY No Date i. INSULATION CERTIFICATION This is to certify that, in conformance with the current energy regulations Kalifornia Adminis- trative (ode, Title 15, State of (alifornia') and approved plans, insulation has been installed in the building located at: COSTA MESA, CA. ORANGE clq c...b 2666/2627 ELDEN AVE. ffi..1 Ne. (11 b.11.bl.) --- ----`_ 'Sh.M LM NIeIb« Tied DESCRIPTION OF INSTALLATION ROOFS Type of Maier iaC_Manufacturer Thickness - R Value EXTERIOR WALLS _ uc, + NTEED Thickness Type nl ldaterial_ FIBER GLASS _.�._....____._ n•acturorCE .i—RTAI—3-2—RYelue•`R 1 ], CEILINGS BFI Tyypepe of Maleliat.__.._.__BERGLASS Manufacturer C E R T A I N T E E D Thltkness_ 6ALR Value"R19 (0, I•.e. n.Tal sq. ft. Covered___.._ -- BLOWN: Type of Material Manufacturer Thickness No. Bags_ la T,.d. M.w.) WL/Bag Sq. rt. Covered_ R Value""� FLOORS Type al+Material_.—.—_ Manufacturer Thltkness R Value"_ SLAB ON GRADE Type of Materiel._._..__— Manufacturer Thickness—It Value"_ 10, urea N.m.l Width of Insulation __. Inches FOUNDATION WALLS (if required) - Type of Material ___-_.____.___ Manufacturer Thickness. R Value". REMARKS (If desired)__._...._ General Contractor(nuildn)...__FLUTER DEVELOPMENT License Title Date SubContraclor (Insulation Applicator) �tA'l'CII l.fl:illLA'IIOM Ucense Number Mil 46 C-2 (I ... I.11ee, M.wnry, [I<.) / (11.1. •'SAME- It e',. a C..ol C.MneM) By E.L.HAJG`'� _Title o.WIL'r Data DECEMBER 14, 1987 1'CNlle.nle Ad-Ww.Itre Ced.. In..er Imoleuen Aendm A., d.<lana 1AC1R" hew La. 11175 d Ike Health and select Cade of the slate "Ce.an. ,.. Unen < wrNllen el IN. In.Iellnllen el Imvletlen. a[a.d .t C.Ill.nl., ulll,lna Ihm the Innlnllen Am Nem In.INLA In [enler•nmo .bAIN. .fn� Z11.—I. 11.—I. el Ihen r.avlNbm rFnI1 he < mvbbA enA ..•<ebA h. N. arthral. .1 .ccmwn « dwlle. [«II11c,11 a that a n.d, Ih. In,ulellen nrnllminr enA hr t1. bvudw,eIN" !•:ul Nle. ro•nelleno Mnq.d helal, wept. • brad..I hell.., hew. « eM« ntld.11.1 `-erA .Nell be ne.wA N e mnlnnv. Ie,nllen -1,%(, he A.NIIn..") d-.Illna 1. h.1,1141.l. .hall be 1.,..d b, ,I% It b.11dlea du,e ..l 1%. u..[I.n .1 1.a0 s0.0e the wlnlw.w ...,s, InplatlM I"R V.1.. I. IN. .n el IN, ..rLlvn.e al n «Int e. ballAln. .wnd«d..11.b11.AM a«nen! he phi, ml 1. IN. Doone. el brei Ih. r.rW eve .etre IRI er rn arbor Imolvtlen. ,Noll nal InrlvA. ant antra Iw n14a11.. bdn0.1 CITY OF COSTA MESA PARK FEES 0923 1 /26/87 Fee Payment Receipt 0010631. Project Address ZWz,(n G L tc.N ANI E A h 1C, y E '- Fi G� H J _Ki L ji M J N A.P. Number Building Permit Number Owner's Name K' Mailing Address _5J FEE: Fi.uTE/Z Urn Sr. W_ Single Family . 2 -Bedrooms or Less 3 -Bedrooms 4 -Bedrooms 5 -Bedrooms + Multiple Family " fzr 6EACN . u 3 Number of Units @ $ 861,76 = _ @ 1,205,67 = _ @ 1,545.62 = _ @ 1,810.50 = _ 15981.94 TL Bachelor or Studio @ 474.37 = ti 1 -Bedroom @ 573.18 = 2 -Bedroom @ 881.51 = 3 -Bedrooms+ @ 1,229.38 = IS q �• 7 - Total Fee "' /5 t �g�• %H Planning DepartmentApproval Date - - 26-91 By�, M✓h�u/8 Applicants Signatur'4 • City Ordinance 72-44 •• City Ordinance 72-45 *•• City Resolution 78-116 CMF 0174-30, rev. 7/85 White—Planning;Canary—Planning;Pink—Finance; Gold.h,00—APPllcant ,l • ti i CITY OFCOSTA:9n�A�CONSIRUC ION;PERMIT k Project Address_��..•(% Applicant's MaiAing Address � S I 'Q Phone %'a'� � Owner's Name' �' � 1 Address Arch/Eng. I � License No. Address Address Phone, Contractor's N e'' �4'"q'a x Yr /' � Address (rn 'I' !- I 5 3'/ i? - •3L ' Ai rye City; License No. I LICENSED CONTRACTOR DECLARATION ' I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000). of Division 3'of the Business and,Professions Code, and my he is in fW l^orp� a d effect. Z / License class LOQ J ense:No. % 16 Dat e9 t' S WOR ERS' CO PE NSATION D ARATION hereby affirm that I have a cert ate of consent t, self -insure or.a certificate �` � Workers' Compensation Insure b ce, or a Certifietl cop flier fn W .+800, Lab. CJ `( Policy No. �"lLoreg,2 'T� - CompadY. Certified copy is hereby furnished. Certifi co y is'f l ed'wlth the city Bui i09 at Applicant (��J EX PTION ROM ORKER S' CO SATION ECLARATION \� (Th section need not be completed " e permit is for one hundred ($100) or ee I certify that cin the performance of the wort: for which this permit is issued, I i shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ' Date Signature ' NOTICE: If, after makinq•this declaration, you should become subject to the j Workers' Compensation provisions of the Labor Code, you must forthwith comply with such, provisions or this permit shall,f be deemed.trevoked. CONSTRUCTION LENDING AGENCY 1 r I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section3097: Civ. C.) Lender's .Name - -Lender's Address--- - - - - - - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt -from the Contractor's License Law for the fallowing reason (Section 7031.5 Business and Professional Code' Any city or county which requires a permit to,eon5truct, alteq improve, demolish or regal any structure, prior to its issuance, also requires the applicantfor such permit to file a signed statement that 'he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section -7000) of livision 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 031.5 by any applicant for a permit subjects the applicant to a .civil penalty of not more. than five hundred dollars ($500). ; , ❑ 1, as owner of the property or my employees with wages'as their. sole compensation, will do.the work, and the structure is not intended or offered for -sale (Section 7044, Business and$professional Code: The , Contractor's I ir—P , aw dopa not annly to an owner of D property who builds or improves • prove for the purpose'of sale). El 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The. Contractor's License Law does. not apply to an owner of property who builds or improves' thereon, and who contracts for such projects with a con- tractor(s77 license pursuant.to the Contractor's License Law). I -am aware that Proof o(.t heir Worker's Compensation insurance should be provided to me. ❑-lam exempt under.Section B. & P. Cr for this reason _' Duct -Structural i ' Refrigeration System ,' ❑0-100,000 BTU ❑100,000'BTU - _ tt to fill in all spaces except those within heavy border lines and sign all appropriate declarations. e, .- Duct -Ventilating ' - - - - ' - r •- f { -_ SUMMARY OF, FEES BUILDING'P.ER MIT '$ -:'SMIP. - PLAN CHECK ,$ �`-' -- _PERMIT? - PLUMBING . ISSUANCE ' $ - R T NO TRACT NO. LOT NO'. - UNIT NO � . _ Firepl/Fact. Bit. ICBO # Fire Damp- - I c '. - Date 10wner - - - Information certify 'that I have read'ttns application antl state that,tha atiove information Is correct: I agree to comply with all`city and county ordinances i and state laws relating to building construction, and hereby authorize repre-:_ sentatives of this city �p a er upon [he' above-mentioned - property, for inspection pur ods. N Signature f1�1'l !� - :DateC=� ";Drivers' Li nse or 55 _ YPE OF CONSTRUCTION Ll NEW DIADy Ll ALTERATION LJ REPAIR tern -, a - ,$ 1 ,PLAN CHECK 25°% $ ,. �O ..-ENERGY P.C. $ -` ' r 1 j +GRADING $ _ '-• _ ELECTRICAL' t$• PLAN CHECK ,50% $, - MICROFILM $- - w _ i _� 1 S A MECHANICAL $ _ ...-TOTA;L FEE $, 1 PLAN CHECK ••25%' $- + r ' ❑CONVERSION ❑,DEMOLISH 1:1 OTHER .i, ' _ i i r -- t .r _ - _ �`�- . - A.P. #.-__. _ _ _ Q _ Zone, �_, Goldenrod - Assessor DESCRIPTION OF, WORK/USE OF BLDG.' ' - l ' s S Main Building: j I Acssory Bd ing: ce YPE OF PERMIT LJGRACING FOUNDATION LJ STRUCTURAL T Front, I ! ' 'j-- r,/ O ❑,TENANT ❑ELECTRICAL, .PLUMBING ❑ MECHANICAL 'B Rear T f VV. 1 .r -i _ N ❑ OTHER_-'- i .. ;.. i 1A ' ' ROJECT DESCRIPTION : SQ. FT. ' OCCUPANCY C __ Right," '+ "- - "-" '- -" ):` `•t 'N' CONSTRUCTION TYPE F VALUATION $ ,S Left ZONE + I I GRADING CU. YDS. ACRES - Ping. Ref. #' , Parking Req./Provided 1' I E emarkz: i'' ! + j t_ - Planning Notes: D M S - •FEES.s v 'PLUMBING i •. .t 1 I i• Bar Sink'- ;_ r Showers - _ 4 •` _ 0 '� ' t ELECTRICAL "r. ". FEES -- Backflow Preventer I I Service Sink -- • - _ _ Automatic Washer. Transformer ❑' 15-510 KW Backflow Irrigation .. Sewer Cap - -- •Bathtubs _�; Construction Pole Sub.-• ; I ' '❑ 50+ KW r t Sewer Connection - Cook i ng Unit I- - Meter ❑up to 100 amps :.� Clarifiers �, i Solar'Collectors Y' j i -- Dishwasher 1" -, f, Meter, Elover 100 amps + - ' •' 1 Dishwasher.' Solar Piping - - _i Diyers:LJGas 'E]Electnc - Sub Panel Drinking Fountains Solar Tank - - Fan Motors ❑0-1 HP ❑1 X; 8 Floor Drains - Swimmirig'Pool w/Spa ,; F_.A_. U. _ _- _ Ina Solar_09- HPi❑16-15+! + Floor Sinks'.Urinal I - -•) ' Fixtures> ; ' Micro t e Gas Service j - Outlets Water Closet Ir 06 t t Device,Boxes: is ' d = PPI<Light Interceptors Water Heater , f W Outlet' •., + Range Kitchen Sink- - - Water Service - - - -- • -- - o Switches - - -- j - '`Sign- / Lavatories , 1 Auto -Wash I, to 6u Garba?g bisposal �„ Standing Sections P -Trap Laundry Trays TGenerator 00.5 K '• 5-15 KW.' Trash Compactor Roof Drains !i Reinspection Feer $15 '." Issue Fee $ 3 + Reinspection Fee $15 - Issue Fee • $ 3 ' a a i -MECHANICAL: ( FEES• _ • prove for the purpose'of sale). El 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The. Contractor's License Law does. not apply to an owner of property who builds or improves' thereon, and who contracts for such projects with a con- tractor(s77 license pursuant.to the Contractor's License Law). I -am aware that Proof o(.t heir Worker's Compensation insurance should be provided to me. ❑-lam exempt under.Section B. & P. Cr for this reason _' Duct -Structural i ' Refrigeration System ,' ❑0-100,000 BTU ❑100,000'BTU - _ Application Issued By - Date e, .- Duct -Ventilating ' - - - - ' - r •- f { -_ SUMMARY OF, FEES BUILDING'P.ER MIT '$ -:'SMIP. - PLAN CHECK ,$ �`-' -- _PERMIT? - PLUMBING . ISSUANCE ' $ - Exhaust System Multiple 0 System Repair/Alteiavon ; _ Firepl/Fact. Bit. ICBO # Fire Damp- - I c '. - Date 10wner - - - Information certify 'that I have read'ttns application antl state that,tha atiove information Is correct: I agree to comply with all`city and county ordinances i and state laws relating to building construction, and hereby authorize repre-:_ sentatives of this city �p a er upon [he' above-mentioned - property, for inspection pur ods. N Signature f1�1'l !� - :DateC=� ";Drivers' Li nse or 55 _ - . Heating System & Ducting'. 9 Y 9 ❑0-100,000 BTU ❑100,000 BT tern -, a - ,$ 1 ,PLAN CHECK 25°% $ ,. �O ..-ENERGY P.C. $ -` ' r 1 j +GRADING $ _ '-• _ ELECTRICAL' t$• PLAN CHECK ,50% $, - MICROFILM $- - w _ i _� 1 S A MECHANICAL $ _ ...-TOTA;L FEE $, 1 PLAN CHECK ••25%' $- + r 1 I _ 1 _ ' , .i, ' _ i - $ _ .. Reinspection Fee $15' r 1 Issue Fee $ 3' CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND.PLANNING..'- , + ! POOL &SPA �+ -Dai •-r .r - + APPROVALS Permit•;# ^f .Date ;Inspector " - + APPROVALS -Permit# , Inspector 1 ,Temporary Electrical Service or, Pole y + 52. Pool &• Equipment Location j 2. Soil Pipe-Undrgrnd..' 3+ ,Sf� 1-53 Steel Reinforcement + 3. Electrical Conduit Uti litY-Undrgrnd: 1 'i ' 54. Forms. - ?' - f f ; ' !- + t 4. Electrical Conduit-Undrgrnd. + r -55. Elecfrical Bonding + - ip , 5: Steel Reinforcement . + 56. Rough,Plumbing& Pressure.Test , ' 6. Electrical LIFER Grnd�,' ' '`' 57. APPROVAL TO'COVER-GUNITE : q • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation _ - - + -' `- - 59. Gas Pipe, -0 Undrgrnd., Test F• 9. Water Pipe-Undrgrnd. -60.- Backwash Lines,P=::Trap, ❑,Undrgrnd.+ + f. 10. Structural Floor System `q,� 61. APPROVALTO'DECK ' 11. Property Sewer Line & House Connections 10.or-P cga, 62. Backwash & Receptor -Final - 12. Sewer Cap y`. 63. He'a'ter & Vent.Final ' 13"Roof Drains - ', ` '' 64. Plumbing System - Final ! '' = 14., Rough Plumbing -� I 65. Electrical -Final . 15. Rough Electrical -Conduit , 66. Solar. System -Final •-� - + �: 16. Rough Electric Wiring - •? itj6 , - f 67. Fencing & Access Approval`' - 17. Rough Wiring Sigri 68. APPROVED FOR,PLASTERING 18: Rough Electrical -7 Bar Ceiling ? .• + s 69. POOL/SPA SYSTEMS FINAL 19.- Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ._ APPROVALS ` Perm iti# _ 20. Rough Factory Fireplace + 21. Ducts, in Structure: + 70. Underground Hydro•:- 22-. Ducts, Ventilating'; '' + 71. Product Piping OGas ❑Oil 23. Gas Pipe -Rough & Test + ' + 72. Underground Fiush i 24. Roof Framing, - ' +' 73. Undergrnd. Storage Tank 0Gas Ll Oil -- 25. Roof Sheathing + 74. Overhead Hydro _ -- 26. T -Bar Ceiling (Structural) '& Monocoat 75?. Dry Chemical' •. , , ' 27: Frame and Flashing+ - - 76 Dry Stand , P�Pe -- '• _ 28. Lathing & Siding. •, .i ' I 77. !FIXED SYSTEM FINAL !'w - 29I Insulation78. FIRE PREV. FINAL ' 30. Drywall Nailing . + HEALTH DEPT. REQUIREMENT' ✓' 31. Plaster Brown Coat 79. FINAONSPECTjION {f ' ''` 32. Electrical Power, 80.. FOOD CERTIFICATE ISSUED- • 33. Final Electric !` - • . Notes:' 34. Final44e4ting&Air. Conditioning `•. _� 35' Final Gas Pipe -Test+' �/ /� • ' +� 36.' Hood or Canopy- 37,•Final Factory Fireplace - . - - i•'` ��`:- 38-. Final Plumbing 39. Water Service -Final' "+x' lo-RtY7 L60 • - '• '40. Gas Service -Final 41.' Solar'Domestic-Final,; 42. Backflow Preventei' 43: Backflow Irrigation. •- - ,'s: - j ` __ • -Landscape Irrigation System r 45. Sound Attenuation• - - �; .' E": 46' Handicap Regulations - - - •• nn, . -47 ."FINAL STRUCTURE & BUILDING .-• • 48.� Special Requirements Completed + ^ � -. r1 -.-��, t . •� '' . i . 49. Electric Release to' Edison. • - ° - ..: - • 50. :Gas Release to Southern California Gas Co a -- Y,'.,- •= i - ,. - - 51.,CERTIFICATEOFOCCUPANCY . - No. .. Date i _ .. ... I� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declare ions. - CITY OF,COSTAI ESA CONST/RJUCCTIONIPERMIT Z, PERPI NO ' TRACT NO. I ) 2U .LOT NO: ; UNIT NO + ) r "� { bra- J 1/ Q Pro)ect Address�� Applicant's Mailing Ad rens Phone �ri ? PE LJ Nwr LJ 1 ADD ALTERATION TY❑CONOERSNRONT❑NDEMOLISHE F-1 OTHER - REPAIR ' ..A. ' ' _, P...# 1.. _,__..._• ,..,,�� ..,. �.. .�_. t, �. _.}.,. Zone a; Owner's Name I I I DESCRIPTIOOF WOR K/U••SE OF BLDG.` I - S Main Building: -, — _ --Acc¢ssOfy Sint) I Address ` Arch/Eng: License No. TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL :E T Front ' I Y Ur 'v JI lava a Z O Address ' ❑ITENANT ❑ ELECTRICALS PLUMBING ❑ MECHANICAL B Rear ! ' N 1 ❑OTHER ._. . '• i. __ - _, -- A -, - - .t -- - - -- 'I - _•_ Contractor's Name Phone 1 t- ROJECT DESCRIPTION SQ. FT. _ ' OCCUPANCY - IC Right• } N r Address (mailing) ' CO N STRUCTION TYPE I i VALUATION$ S Left , I I G - Cit✓License No. X72 %73 - 1 ZONE GRADING CU.YDS. ACRES _ Ping.'Ref. �' Pln Ref. # I Parkin Re q./Provided R E LICENSEp CONTRACT--I-rOR DECLARATION {g 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: — Z Planning Notes: '. M with section 7000), of Division 3 of the Business and)Professions Code, - .I /and my license is in f�fOrc rid effect. - �,b '' i ,. { r I I - I I } 1 1 I J T S License Class _�._ Li=e L± I M1 _ t •' , \ ` Date �iy]nature C ) _ PLUMBING . FEES ,. .i WORKK RS ATION DE, RATION ! hereby affirm that I have a certif' to of consent to self -insure or a certificate Workers' Compensation Insurance, or a'certif ietl copy thereof (Sects Bar Sink I _ Showers ." , ', ELECTRICAL - FEES 4800, Lab. C.) ., /%{ _ Y — ( Backflow Preventer ".( - _ - Service Sink , , - •- i' Automatic Washer I. - Transformer_❑ 15 50 KW j ` 1' �y�.,'1 Policy No. ?1` ©�2 Co'mpariy v , Backflow Irrigation '. c� Sewer Cap " -n ( Construction Pole Sub, . '_❑ 50+ KW+ l 1 Cert if ietl copy is hereby furnished. tifi%d y is fit with the City e 'mi Dlv" n. Bathtubs _ - Sewer Connection Z(�D ' Cooking Unit Meter ❑up to 100 amps ; I Date Applicant E%EM TION F OM WORKERS' C PENSATION DECLARATION _ - Clarifiers '� _ Solar Collectors - r r 1 Dishwasher '- 1 - Meter ❑over 1 OO'amps r (This section need not be completed the permit is for one hundred ($100) or less), I Dishwasher. y Solar Piping ^- 'p 1 •, Dryers - ' • Suti Panel - certify that in the performance of the work for which this permit is issued,)I. _ shall not employ any person in any manner so as to _become subject to the' Drinking Fountains Solar Tank ' i - Fan ' Motors ❑O.1 HP /: 8 I - r - Workers' Compensation Laws'of California. 1 - )- Date ' Signatwe ! Floor`brains - Swimming Pool 'W/Spa i 4' F.A.U. Inc. SOlar'❑8-15,HP❑16-15+ } •NOTICE: If, after making this de6laration-you should become subject to the Workers' Compensation provisio Ps of the Labor Code, you must forthwith , Floor Sinks I Urinal , - - - - - •i Fixtures - comply with 'such' provisions or, this permit 'shall be deeni revoked. _ i �n rowave _ / CONSTRUCTION LENDING AGENCY+✓,,, I lending for(the performance J ;Gas Service Outlets ! Water Closet I r r r Device -Boxes •"s sa Pole Light J1' i I hereby affirm that there is's construction agency of the work for: which this Permit is issued (Section 3097, Civ. C.) -Name I , ' Interceptors , Water Heater s) u Outlets %, 1 Range I g .- Lender's r -Lender's Address ---' - -- - Kitchen Sink- 1- Water Service- — — --- M .i -- - - Switches }' Sign 'c OWNER BUILDER DECLARATION. - �. I hereby affirm that I am exempt from the Contractor's Lieense.L'aw for the Lavatories i 1 ! %Auto -Wash Garbo e;Dis 0521 '+ p 'p j - Standing Sections 0r i following reason (Section 7031.5 Business and Professional Code: Any city, or •: _ ,g, / , county which requires a permit to. construct; alter, improve; demolish or repair requires the applicant,for such permit { P -Trap I p l t Laundry Trays Generator'�0- KW. El 5-15 KW r Trash Compactor '!:j•�-� any structure, prior to its issuance, also to file a signed statement that he/she is licensed pursuant to the provisions of .' Roof Drains { a the Contractor's License Law (Chapter 9 (commencing with, Sectiow7000) of M n''- Code) or that he/she is exempt livision 3 of theBusinessand -Professions. "' - _ ierefrom and the basis for the alleged exemption. Any violation of Section' I I 031.5 by any applicant for a (permit subjects the applicant toa civil -penalty ,ot noCmo on than five; hundred dollars ($500). , ', or their ! R¢in5pection Feel $15 - j Issue Fee - $.3 - ' I i - ; - ❑ I; aS owner of , the property my employees with wages•as sole crmpensatio n, will tlo'the work, antl the Strutt ure'is not intended or offered Reinspection Fee $15 issue Fee $ 3 for sale (Section 7044; Business and Professional Code:'Th. Contractor's MECHANICAL -FEES' _ - License Law does not apply to an owner of a property who builds or improvesi thereon, and who does such work himself/herself or through his or her own } I Boiler - ;Hood or I ❑ .. DEVELOPMENTSERVICES'REQUIREMENTS:. - employees, provided that such irn_provements are not intended Or offered for sale. Ifohowever, the building or Improvement is sold within one year of com- : - .Type Canopy. Type I I ❑ 'Zoning Approved By 'Date %pletion, theownerwill have the burden of proving he/she did not build or tm- Duct 'Under Ground- ; _ Approved By t `-. prove for the purpo se of sale): -;,. ' _ - ! - ❑, 1, is owner, of the property, am exclusively contracting ,with licensed con- `• , Duct -Structural Refrigeration System •' _ ,Building - i Application Issued By -Dat . Dat% ' tractors to construct the project (Section 7044, Business and Professions Code: The, Con tractor's . License Law�doescnot apply to an owner of property who _ Duct - Ventilating ❑0.100,000 BTU 61100,000ETU -- . - - SUMMARY OF FEES - builds5or improve s )thereon', and who contracts for such projects with a con-, .' _ - •SMIP • T ' tractor(s)' license. pursuant to the Contractor's License Law). Lam aware that, Exhaust SySt¢m ❑ ;Multiple ❑ S SteT,R epalr/A Iteration BUILDING PERMIT -$- - $ - proof-of•their Worker's Compensation; insurance should be provided to me. PLAN CHECK '$ _ ❑ i am,exempt untler Section -'B. & P. C: for this reason' - f Eirepl/Fact BILI ICBG # - Fire, Da mpe(s •' ' -PERMIT' - 3.617 ISSUANCE $: .,f ' RLUMBING' $- I - - Date _Owner - Heating System, ' Registers i,. ) f PLAN CHECK'S 25% $ 7.� $�- ENERGY PC ;$` I heieby'certify _that .I have read this application antl state thzt.the above' 'I ❑0.100,000 BTU ❑100, BT - - ELECTRICAL $ GRADING $'� - '� information is correct.agree to comply with all city and county ordinances I and; state laws relating to buildiT19 construction, and hereby authorize repre-J. for. _ - _ PLAN CHECK 50% $.- MICROFILM $y sentatives of, this city t ..¢rite/upon the above-mentioned property inspection p } a Dat ��r'- �'"'� 'Signature. �i'" _r I 7 - _. �} -. ,. MECHANICAL $ OT L'FEE ±$ '. c 5J - / .. Reinspection Fie, "'$15- Is'sue'Feis ' I $ 3 t PLAN CHECK 25% $ -Drivers' -i enze or SS 1 , CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - /, 'CONSTRUCTION AND, PLANNING _ -'.Date ` ' _ j. POOL & SPAS -�- - f' _-Date •-• + APPROVALS Permit # `,I nsPectorl t r' APPROVALS ~ Per'mit # x - Inspector 1. ;Temporary Electrical Service or,, Pole + ' ! 52. Pool & Equipment Location ; • t 2: Soil Pipe-Undrgrnd.', f '53,'Steel Reinforcement}. ' 3. Electrical Conduit Utility-Undrgrnd. '. 54. Foams 4: Electrical Conduit-Undrgrnd. i 'S5.' Electrical Bonding 5. Steel Reinforcement+,•,•, �';56. Rough' Plumbing;& Pressure'Tesi, 1!n • 6. Electrical UFER'Grnd.' - • '57."APPROVALTO,COVER-GUNITE 7. Footings " • • 1. 58. Electrical Conduit'Undrgrnd. I 8. Foundation i - r' - -'59. Gas Pipe; O Undrgind., Test . I - • - ' 9. Water Pipe-Undrgrnd. 3 �� 60: Backwash Lines, P-Trap,T] Undrgrnc. 10. Structural Floor System 61. APPROVAL TO DECK + 11. Property Sewer Line &House -Connection ��S L6p g2. Backwash & Receptor-Finalj' 12. Sewer Cap - 63. Heater & Vent -Final 13.. Roof Drains I -' ! 64. Plumbing System - Final, i 14. Rough Plumbing - '.�� 65. Electrical -Final' 15. Rough Electrical -Conduit - _ ' ' 66. Solar System'Final 16. Rough Electric Wiring - - -, - •-67. Fencing & Access Approval I - '17. Rou h Wiring Sign' '' - - "-`•' 9 9 9,r R' 68. rAPPROVED FOR PLASTERING -" - ,1 8. Rough Electrical -T Bar Ceiling', j 'r V. 69. POOL/SRA SYSTEMS'FINAL 19. Rough Heating & Air Conditioning , F.IRE DEPT. REQUIREMENT �- APPROVALS Permit # - _ i 20. Rough Factory Fireplaces 1 - I 21. Ducts, in Structure i 70. Underground Hydro! - 22'. Ddcts� Ventilating 471. Product Piping ❑Gas 71 Oil , 23: Gas Pipe -Rough & Test 72. Underground Flush - 24. Roof "Framing -73. Undergrnd. Storage Tank Gas ❑Oil - 25. Roof Sheathing • r - i - .. `74. Overhead Hydro 26. T-Bar,Ceiling (Structural) & Monocoat ,75. Dry Chemical, 27: Frame and. Flashing -✓ trt: 76. Dry Standpipe^ 28. Lathing'& Siding- I' .r 77. 'FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREV. FINAL I 30..Drywall Nailing; HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat. i 79.t FINAU INSPECTION 32. Electrical Power Meter -Final - 80:. FOOD'CERTI F ICATE ISSUED - +, 33. Final -Electric. 'Notes: " 34'. Final Heating &IAir Conditioning"' ' ' " '-' , p 35'. Final Gas Pipe -Test", . �; • ' I 1- 36. Hood or Cano Pyi 37Y -Final Factory Fireplace 38.' Final Plumbing 39. Water Service -Final -- . t40. Gas'Service`-Final. -41. Solar Dome sfic-Final_ •• - �. „� _r; 42. Backflow Preventei t ., ' 43! Back`f low Irrigation - •' - • p � � j .t - . 44. Landscape Irrigation System - r45. Sound Attenuation 46. Handicap Regulations ," _, a �' , r• , ' . •, ..2 47.'FINAL STRUCTURE&.BUILDING' . '- �• - '"� ,. :( 48'"•Special Requirements Completed 46' Electric Release to Edison i .50.' Gas.Release to Sou{kern California Gas Co 51„CERTIFICATE OF OCCUPANCY .• No.= .Date •.. .. - .. -. - - .. - .. ti I - L 5�. CERTIFICATE Applicant to fill in all spaces except inose within heavy border lines and sign all appropriate declarations. ' CITY OF'COSTA MESA 'CONSTRUCTION:PERMIT PE T N 1 9%83 TRACT NO. j LOT NO. UNIT NO! ! r `� j, { r 1 S7/j z(o[p(p EZJ�FJI)' Project Address ' � 1 - ! ! +' �. j ;jig-[; l3"' a g-rr. r pJ r ! Applicant's MailjngrAddress -i r- I TYPE'OF CONSTRUCTION NEW: LJ ADD LJ ALTERATION 0 - 1-1CONVERSION! ❑-DEMOLISH ❑OTHER_ REPAIR - r I { • f '' 1 f - t �'yI j I Owner's, Name. /-�- V'T' Phone + DESCRIPTION OF WORK/USE OF BLDG.�� ._ A.P.# I - l Zone -• r Address ? ! t ; .I i. f - t i a. ! { ; S Main Building { 1 Accessory Building' Arch/Eng ` License No. + TYPE OF PERMIT '+ GRADING -]TENANT FOUNDATION ' STRUCTURAL { d Front 1- ! { '{ 1 j ' ❑ ELECTRICAL ❑ PLUMBING II�� MECHANICAL B - I + N 1 Address G A 2 ❑ - W ! A Rear,• I Contractor's Nam Z'Phone 7. ,OTHER. - _ _ C Right- - - _ _ .- _ _ - t —�-- - N- I�Ie Address (mailing) PROJECT DESCRIPTION SQ. FT.- _ I OCCUPANCY iS + li City,License No. p %p CONSTRUCTION'TYPE I' ' VALUATION`$ t Left .1fl ' I r "A DECLARATION ZONE ri GRADING CV.VDS ACRES' Ping. Ref. # I •: 'Parking Req./Provided E LICENSED CONTRACTORR • I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ( ) IT Ce 1 + ' ' =y Planning Notes' _ t with section 7000)'of Division 3 oT the Business, antl•Professions Code, and ,� ; my license is in full fore effect. I I 1 f i - _ �- , S ( i icense No. License Class '586 � C - ' w Date'"�1 '>?+%' p+% Signature /i'�� 't- _1 ;PLUMBING FEES! WORKERS' COMPENSATION DECLARATION hereby affirm that(1 have a certificate of consent to self -insure ona certificate - ... + ,Bar Sink - 'Showers T v ' - _ _. +• - ;ELECTRICAL ' -- + ! •� ') FEES , s Workers' Compensation' Insurance, or a -certified copy thereof (Section Lab. C) ^1 : gackflOw Pfev¢n[¢q i I • Service Sink -+ ' ' Automatic Washer' - ti. _ - Transformer.:❑ 15 50 KW •- 1.y. ,x700, ,, h'` Policy No._::0b6?i LCJ ) Company GuN� Backflow Irrigation s Sewer,;Cap s '' i` t Construction Poll x. " � 50+ KW, Certified copy is hereby furnishetl. - r 1 ' ', - - + r , - I Certifieda�off( IsJiled with the city Build tog Di io - Bathtubs .A I '+ I Sewer Connection ' { �. .. Cooking Unit _ Meteq ❑up to 100 amps' - Da[e�'1�•�7 � Applicant EXEMPTION FROM WORKERS COMPS N 5ATION DECL N• - +} � I _, Clarifiers _ I-� Solar CoilectOrs 1 .q Dishwasher - ' Meter ❑over 100 amps (This section need not be completed if the permit is for one hundred ($100) or less):I t • , DislV - Solar Piping ; 4 s Dryer ❑Gas ❑Electric - I in the, formance the'wOrk for which this t i5 issuetl, - _. ..rt - _ y - $u6 Pan¢I 4 i _ - - certifythat per of permit p 'shall;not employ any person;in any manner so .as to become subject to the DrinkingIFountains _ j Solar Tank _ + - ! Fan f } 1 Motors ❑0 1 HP ❑1 % 8 Workers' Compensation Laws of California. �- + _ - _- I _ Date' Si9nature - - Floor Drains + Swimming Pool'w/Spa' ) - F A•U ..^..`) 1 -n0. Solar ❑9=15 HP Ell 6-15+ 1 . NOTICE: It, after making this declaration, you should become,subject-to the_•_ Workers' Compensation provisions of the Labor Code, you must forthwith FIOOr Sinks ( _ _ I Urinal i— - Fixtures - - MIprOWdye' comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY is construction lending for the ) Outlets f : Gas ServiceWater " ' C loset : I Device Boxes i Pole Light' 1 hereby affirm that there a agency performance of the work' for which this permit' i5 issued (Section 3097 Civ. C.) -Interceptors I Water Heater I c ' Outlets. Lender's Name - ! Range f Lender's Address_ I' - z Kitchen Sink- _1 _ J._ - +`-'_ . Water Service: _ I _ .-_ .Switches., -i - - - --Sign' -•--- - ' i' OWNER BUILDER DECLARATION i' her that I exempt from -the Contractor's License Law for the r Lavatories Auto -Wash ` , '{ I affirm am Professional Code: Any !" I Garbage Disposal Standing Sections foliowing'reason (Section 7031.5 Business and city or county which requires a permit to construct; alter;- improve; demolish or repair + P,—Trap j, 1. j + Laundry Trays i +'! I Generator DO -5 KW ❑5-15 KW Trash Compactor any structure, prior, to its issuance, also requires the applicant for Such permit, -� r + to file a signetl statement that he/she is licensed pursuant to the provisionsiof 7000) Roof Drains { j the Contractor's License Law (Chapter 9 (commencing with Section of 7nvismn-3 of -the Business and Professions Code) Or.lhat,he/she is exempt J y ..Ifi r erefrom and, the basis for the alleged exemption- Any violation of Section { j }• - 1315', by any applicant for a .permit subjects the applicant to a civil .r _ ' eenalty,of not more than five hundred dollars ($500). ^1 Reinspection Fee $15 '• Issue Fee S: 3 j 0 I, as' owner'of the property or my employees with wages as their sole do=the and the Structure is not intended orloffered i - I, * compensation,'will work, 'sale Code: The Reinspection Fee' $15 - Issue Fee " r� $ 3 f i for (Section- 7044,. Business . and !Professional !Contractor License Law does not apply to an owner of a'property who builtls or improves I MECHANICAL FEES- _ thereon, and who does such'.work himself/herself or through his or her own , Boiler - Hood Or Type I ❑ -+ DEVELOPMENT SERVICES REQUIREMENTS: �• _ j employees, provided that such improvements are not intended or offered for sale- If;,however, the building or improvement is sold within one year of com- Canopy % Type I I T]Zoning Approved By - Date I'• - - _ fiction, the owner will have the burden of proving he/she did not build or im- Duct - Under Ground - ' Building Approved By 1 y I Data { - prove for the purpose of sale). - _' "❑=1, as owner of the property, am exclusively contracting with licensed:con- + Duct -Structural - Refrigeration System b (� I •-Application Issued By / Date tractors to construct the project (Section 7044, Business and Professions Code: who - S ❑0-100,000 BTU r9 _ The Contractor's License Law does not apply to an owner of property who contracts for such with a,con- Duct - Ventilating , - ;❑100,000 BTU - - SUMMARY - '� OF FEES y r " builds or improves thereon, and projects -Law). that _ - -• I =- f I - ' 1 - tractor (sl pursuant the Contractor's License I,am aware Exhaust System..❑ .Multiple ❑ System Repair/Alteration BUILDING PERMIT - � � S. SMTP r $ • + proof .o their Wor,kerJs Compensation insuranceshould be provided to me. ff •P: - _ 'F � � PLAN CHECK '$- i - PERMIT • ❑•I am exempt under Section _ + B. & C. for this reason-, irepi/Fact. Blt: ICBG # , Fire,Da mpers I u r - - - • - PLUMBING, t •$',� 1 ISSUANCE Date - '' " Owner --- - - Heating System & Ducting " ' Registers ° I ! PLAN -CHECK 25% $• ENERGY P C' $' I hereby certify that .I have reatl!th is app ucation antl State that the above / J!W 100,000 BTU ❑100,000 BT _ - - -. - - -,GRADING '$ _ information:iz correct. -I agree to comply with all,city and county ordinances •(' , ELECTRICAL $ _ .. and state (laws relating to building', construcif ,and hereby authorize repre - for.. - e - _ - i PLAN CHECK ' S0% $ - - MICROFILM '$ ' t v sentatiyes. of, this, city to -enter upon t e Ove -mentioned property ' J - - - /r� inspection purposes i ' b 'Signature' .. :NJ4 /i -pj'07^ ' • Remspection Fele' -$15- _ ) .+ r MECHANICAL $ SZ + i _ ._TOTAL FEE $ -'25%'t$ rr -CJ�. -brivers, License or SS;.- r Issue Fee $: 3-. PLAN CHECK t CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - - •-- - - —' _ "� —' ^""IPOOL&SPAS CONSTRUCTION PLANNING i [' _ - '_ .. _. .,� .s- •• _ �._.. .-.. ,..t _. • t,.„�,... � APPROVALS Permit Date Inspector , ! -,APPROVALS Permit #' Date i Inspector 1. Temporary Electrical Service or.Pole ' 52. Pool & Eg6ipment Location' [; 2. Soil Pipe-Undrgrnd. -53. Steel Reinforcement '1 i 3. Electrical Conduit Utility-Undrgrnd. . 54. Forms: 4. -Electrical Conduit-Undrgrnd. ' ;5P. 'Electrical Bonding - '5.Steel Reinforcemenf�56. Rough Plumbing &PressureTest x7•ai 6. Electrical UFERG_rnd. r' •' �:, 57. APPROVALTOCOVER'-GUNITE' 7..Footings 1 ' 0 :; ..1 '58r' Electrical Conduit-Undrgrnd. ., .: '8.' -Foundation ' � (•; �� - � ! • i " � 59. GavPipe,-171 Undrgrnd., Testi ' 9. Water Pipe-Undrgrnd. __ . - _ _ -60.•-Backwash-Lines, P -Trap, 0 Undrgrnd. F 10. Structural Floor System, 61. APPROVAL TO DECK - 11. Property Sewer Line'&, House Connection 62. Backwash & Receptor -Final i ,& • 12. Sewer Cap 3 .. ' i ; 63. Heater Vent -Final 1 '13. Roof Drains 64. Plumbing System:- Final.I i 14. ;Rough Plumbing 65. Electrical -Final: 15. Rough Electrical -Conduit `• ;• , '66: Solar System -Final t 16. Rough Electric Wiring -67. Fencing &'Access, 4rovlal . `,; •_ r t 177 RoughlWiring Sign- ' -. - „" ' ' ` •. ' - 68." APPROVED FOR PLASTERING 18. Rough.Electrical-T Bar'Ceiling� -f 69. POOL/SPA SYSTEMS FINAL ; 19. Rough Heating & Air Conditioning 1� '1` rp7l rj I ! FIRE DEPT. REQUIREMENTS + APPROVALS Permit # I -'I 20' Rough Factory Fireplace - 21. Ducts, in Strucwre. 70. Underground Hydro 22. Ducts, Ventilating '. 71. Product Piping ❑Gas OOiI. w ; 23.' Gas Pipe -Rough & Test - t ' 72. Underground Flush '- + 24. Roof Framing+ . �-' - � _i ; + t � 73.' UndeFgrnd: Storage Tang!❑Gas' ❑Oil. r r- = 25. Roof Sheathing - - ' �' I ' 74. Overhead Hydro - 26. T -Bar Ceiling (Structural) &.Monocoat ; 75. Dry Chemical' •! -' �. "' " ,;, , 27: Frame and Flashing - - - 76. DryiStandpipe 28., Lathing & Siding ,' 77. FIXED SYSTEM'FINAL it 29. Insulation! t 78. FIRE PREV. FINAL 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown Coat' 79.'_FINA1_!INSPECTION : ` ',.•i, ,� - 32., Electrical Powers Meter -Final - _• ' 80. FOOD CERTIFICATE ISSUED. -- , 33.Final Electric + Notes:' 34. FinalrHeatin & Air "Conditionin bt i 35.. Final'Gas Pipe -Test `. _ ! 1. I -� •` ''j r 36. Hood or Canopy - - 37."F.inal,Factory Fireplace` 38. Final Plumbing- •' /' I1 - y` X39. Water Service:.Final - _ , . -• .' - ,i ? j i (40. Gas Service :Final �41. Solarpomestic-Final ,. - - •,� "+'t _ f' 1' 'f42. Backflow Prevenier - • - _ t 43.`,Backf low Irrigation,' }�_•� - �• ? :. ° %" `'�r,'' •+J' , r i '44e Landscape Irrigation System - .. ', _ r •j=• �Z•; = ` � - . : 45'. Sound Attenuation - � " :�„ � (.,• �''° ' ' - �'' v ti{ �.jr 46: Handicap Regulations - _ -- C _ L• .,`., +•' y `47. FINAL STRUCTURE &-BUILDING z1 48. Special Requirements CorrSp•leted 49. Electric Release to, Edison - •'> ;;+ �: - - ,- -�50. Gas Release to Southern California Gas.Co 51.'.CERTIF.ICATE'OF OCCUPANCY 'No. -- Date:' __ .. .. ti_- ._ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations t i - CITY OF COSTA MESA CONSTRUCTION.PERM�"y PERM O - p TRACT NO. +' f ( LOT NO! (UNIT , { ! i f i S I {- •' 2te(o le 1 1 I � +•� i Project Address + I ) j^ j Applicant's NjailingAddress • < t TYPE OF CONSTRUCTION NEW •ADD ALTERATION r ❑CONVERSION ❑ ❑ OTHER ,REPAIR �7, 1 , f Owner'rNamel + /v ��- Phone Y DEMOLISH +---'- I DESCRIPTION OF WORK/USE OF BLDG. - -- = - ---- - - - A.P.#_ - -t-- - } f Zone I Address ( - ' ' ) I 1 ! ,S Main Building: 1 j Accessory Building; ] 1 ( Arch/Eng. LicenseNo. ' TYPE OF PERMIT 'GRADING FOUN DATIO}V 'l'• STRUCTURAL ❑ ❑ ❑PLUMBING I 'T Front i 1 t, j i ,j t '{ y`: O - Address TENANT' ELECTRICAL, Jf�Y'xM ECHANICAL Rear t ` Y ; N ✓ E'rs" �-Phone-SL.7�L/7 ❑ OTHrER + A , t Contractor's Nam i x'351 H L K-. }fB + Address lmailing)� PROJECT DESCRIPTION ; SQ. FT. ' ! _ OCCUPANCY C' - .- _, Right - I -_. _ - - - _ _-- - N G ' - i '- r t CON ST RUCTION TV PE + I VALUATIONS - ) I$ Left j ; i + ) { R City License No. /-� i ZONE GRADING + CU.YD5. ' ACRES 1 I Ping.,R¢f. ,# Pafkin9 Req./Provided ' 1 e E LICENSED CONTRACTOR DECLARATION r. , 1 hereby affirm that 1 am licensed under provisions of Charter 9 (commencing Remarks: I !6 i - ' :PlanoingNOt¢si 1 1 i i _ I .. -) } M with section 7000), of Division 3 of the Business and Professions Code, and ' my license is in full for a d effect. License Class i (e- ' • l Lic ' j `t i t z ^' ' ,i r i ' - , 7 + T S nse'.No. r Date 7 S'g L •- ePWMBING I +, FEES' I, WORKERS' COMPENSATION DECLARATION Bar Sink! .' r+ - Showers ! ( }ELECTRICAL -- FEES 11 hereby affirm that I have a certificate of consent to self -insure or a certificate - - - _ ,- f Workers' Compensation Insurance, or a.certified copy thereof (Section I `. +�- Backflow Preventer - (.. ) 'i Service Sink - y j -, -• f > _ Automatic Washer-' Transformer -❑ 15-50 KIN- • wc Lab o. C.y CoS 3 A03'' I ' Policy No. Company i •Backflow irrigation - {'v •- ISewer:Cap- ,' I 1 I -. ., + ': lj So + Kw _ • _ - Construction Pole Sub Certified copy Is'hereby furnished. , .1 Cert ltietl c y aliled twit h',the city Building Div' on. I t • f 'Bathtubs 1 ' .Sewer Connection , r ! l' i Cooking Unit ; Meter ❑upao.100 amps. 7` g7 Applicant - 1 _ EXEMPTION FROM WORKERS' COMPENSATION DECLARA ON Clarif rets _ ; Solar Collectors • , . 1 I. } Dishwasher c L + Meter Dover -100 amps (This section need not be completed if the perm ) it is for one hundred ($100 or _ less). I .1 1 : 1 'perm ; Dishwasher': ( - - pg i ? - `- i Solar PipiPiping❑ ° ' t ' - Dryersz❑Gas IElectric - Sub Panel i ' he performance of the work for which this t is Issuetl, 1 certify that in t' employ, any in any manner so as to become subject to the - i Drinking Fountains - t Solar.Tank - } '� - + shalknot person Workers' Compensation Lawslof California. ' Fan ; S �' Motors E161 HP ❑1 % B Date;' Signature - • FloorOrams ' t ' - SwimmingPool -w/Spa -+ - ' "� t u- F:A.0 -' - �' ` = - Inc.Solar 09-15 HPI❑16-15+ ! r _ NOTICE:.If,. after making_this declaration, you should become.subject to the Workers' Compensation of the Labor lCode, must forthwith Floor Sinks r _' `Urinal provisions you this be deemed .t' 1 ' Fixtures - I Microwave. + comply with suchi provisions or: permit shall I revoked. CONSTRUCTION LENDING, AGENCY ; - -' 1 Gas Service Outlets , ( Water Closet ' I ti- • Device Boxes , + Pole Light I I hereby affirm,that there is a construction lending agency foPthe performance of the work for which this permit is Issued (Section 3097 Civ. C.) 'Name t Intdree tors ' 1 p , Water Heater , i - I- Outlets I Range ' Lender's I j- I, t - Lenderjs. Add ress - ` ' _ Kitchen Smk_ _ _ _ Y Water Service. _ _ _ _ _ Switches - _ _ �. �_. �.. _ _ Sigo- -'-- -- -- - ' OWNER BUILDER DECLARATION . I hereby affirm that I am exempt from the Contractor's License Law for,the Lavatories - Auto -Wash Garbage Disposal '! Standing Sections t ' following, reason (Section 7031.5 Business and Professional Code: Any city or which requires a permit to construct; alter, improve; demolish or repair I Trap 4 - Trays ' i ,. 1 county any structure, to Its issuance, also requires the applicant for such permit M t - ,1, Laundry - Generator KW ❑5-15 1 KW Trash Compactor I " prior to file a signed statement that he/she is licensed pursuant to the provisions of _ 'f '' j_ ' Roof Drains ; t - �, , ., t - I the Contractor's License Law(Chapter9 (commencing with Section 7000) of t I -_ f- 'sivision-3-of'the•Business-antl- Professions -Code) -or thahhe/she is exempt- 7.- - -, - •-- - •refaom and the basis for the alleged exemption. Any violation of Section I ! t _ ' • % h .31.5 by any applicant .for a permit subjects the applicant to, a civil • . . enalty of not more than five hundred dollars ($500). I '4 1 *as r • Reinspection.Fee' $15 ! _r t ( Issue Fee $. S 1 1 1 I, as owner ofithe property or my employees with Wages their sole 7 ' I compensation; will too the work, and the structure is not intended or offered - ` Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044 Business and Professional Code:�The,Contractor's -- ,t MECHANICAL ( 1" -.:FEES{' - ' License Caw does no Lapply to an owner of a property who builds or improves' thereon, and who does such, work himself/herself or through his or her own Boiler - Hood or Type I. '❑i, DEVELOPMENT SERVICES REQUIREMENTS: ) ' I employees, provided that such improvements are not intended or offered for j I yp Ronin Approved B g PD y ?sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ _Date ( ;, letion, the owner will have the burden of proving he/she did not build or im- p ( Duct - Under Ground - "' ' Building Approved BY f Date ^prove for the purpose sale): + i. t i --❑.P, as owner; of; the property, am ekclusively contracting -with licensed con- Duct -Structural Refrigeration System t. �'! 1 �Applieation Issued By _ n. - 'Dat tractorsto construct the project -(Section 7044, Business and Professions Code: The Contractor's License law does not apply to an owner of property who `' 1 Duct - Ventilating ❑0-100,000 BTU❑100,000 BTU ! SUMMARY OF FEES buiIds,or improves thereon, antl wno contracts for such projects with a con- - -. tract or(sl Imense pursuan Lto the Contractor's License, Law). I am aware that Exhaust System ❑ Multiple System.Repair/Alteration , BUILDING PERMIT" '$- DSMIP �$ ' proof off, their Worker's Compensation insurance should•be provided to me. - -- PLANLCHECK $, _ :PERMIT ' C1.1 am exempt under Section I ' _ .B: & P. C. for this reason Firepl/Fact. Blt'rICBO # Fire'Da mpers' ,. - t o f 1 - PLUMBING ;, $ ISSUANCE - $ - - Date' `' .t - -- - hereby that I havelread'this antl state:that the above I Heating system & Doering , Sd0-100,000 BTU ❑100,000 BT Registers '+ - I PLAN' CHECK,, 25% $ ENERGY P.C.owner ' I certify application in is correct. I agree to comply with all city and county ortlinances / - I - $ GRADING ,$. -_ and state laws relating to building tan,, r ction, and hereby authorize repre _ELECTRICALS - PLAN CHECK 50% $ - MICROFILM $.. ^ - sentaLves of this aty t nt r up n I ave -mentioned, property for. inspection purposes. '� Signature Date_ - I L - _ 1 - MECHANICAL I $ ji+ �.1 TOTA L•F EE.�• $ / t - - - • r• :} Reinspection Fee, .•$15 , _ Issue,Fee 1 1 _ $ 3 PLAN CH ELK: 25% •$ , ,LJ`Vn C�L�— '' 1 I I Drivers"License or SS # I , 1 I CMF 0865-46, rev. 10)84 White - gullding; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor" - l1 .CONSTRUCTION AND.P.LANNING�- - II - �. -i. .._l ; ,'; ' POOL & SPA- - _ ' I " Date Inspector APPROVALS Permit # " Date Inspector , miti )v 'APPROVALS Per# ` I i 1.` Temporary Electrical Service or'Pole 1 52. Pool & Equipment Location; 1 K 'i - 21 Soil Pipe-Undrgrnd. i , I 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd' •I } ! ut -54,: Forms ! : f ' 4 -Electrical Cc, nduit-Undrgrnd. ' ' -`55. Electrical:Bonding '. 5. Steel'Reinforcement; . I -,56. Rough,Pluinbing & Pressure Test. l !. '• - t ,; ' 6. Electrical UFER Grnd. ! 57.- APPROVAL TO COVER'GUNITE' . 7. Footings �,�-f 1 ,58.i Electrics l'Conduit-Undrgrnd' ��"i - .�+ ,i` $.._Foundation 59. Gas Pipe,'O'Undrgrnd., Test 19.4ater Pipe-Undrgrnd. - �i-.+- - -60. -Backwash L-ines;-P-Trap, ❑ Undrgrnd. _ 10.. Structural Floor System.' -.j 61. APPROVAL TO DECK 11. Property Sewer Line& House Connection 62. Backwash &, Receptor -Final i t 12. Sewer "Capt 63. Heater & Vent -Final t ,13. Roof Drains- - '; Y t i'•, y- 64. Plumbing System,- Final 14. Rough Plumbing 65. Electrical Final ` ' 15. Rough Electrical -Conduit -66.; Solar;System-Final • ' +'' - 16. Rough Electric Wiring;. 67. Fencing &Access Approval ! ._ • "' -'17:'Rough;Wiring Sign - '' ,' ';' r ' ' - ' ' 68. APPROVED FORS PLASTERING 7. �" s' 18. Rough Electrical -T Bar Ceiling!;x t r 69. POOL/SPA SYSTEM$ FINAL i 19. Rough Heating & Air Conditioning I ,� fl Sv I i I FIRE�DEPT. REQUIREMENT. APPROVALS Permit#•''Si- 20. Rough Factory Fireplace i l i 21.Ducts, in Structu're'• y' f l 70. Underground Hydro . ° ,'. ` ,• ! -""'r� ! 1' 22. Ducts, Ventilating'- i 71. Product Piping O Gas El Oil 23.• Gas Pipe -Rough & Test' - I i 72" Underground Flush ,y h 24. Roof Framing, i' 73. Undergrr:d:Storage Tanki 11 Gas- 0 Oil; . 25. Roof Sheathing -'> _ `' " i 74. Ovefhead"Hydro 26. T -Bar Ceiling;(Structural) & Monocoat; ", 75., Dr"y Chemical' { 27. Frame and Flashing 76 Dry'Standpipe', 28. Lathing &Siding ; 77. F IXEQ SYSTEM- FINAL # ! 29. Insulation t 78. FIRE PREY. FINAL:* ' 30. Drywall Nailing HEALTH DEPT. REOUIREMENT'- 31.E Plaster Brown Coat ! 79. FINAL'INSPECTION 32. Electrical Power Meter -Final - 80.�jFOOD CERTIFICATE ISSUED - ? _ 33. Final Electric ' !- Notes: 34., Final,Heating & Air Conditioning ,- j s 35. FinaF Gas Pipe -Test A' i 36. Hood or Canopy- 3P, Final Factory Fireplace- - ! 38"Fi6al Plumbing, - .- .Fl.. 39. Water"Service-Fina l : .`2<f ;r✓�°' `,�-' " - ..»�. .ft- ' 40. Gas Service -Final - '-• - - ' �' ft- + t41. Solar -Domestic -Final _ :+ !� ;42. BackflowPreventer" - ,;:y : t; . . ,143.';Backflow Irrigation 44: ,Landscape Irrigation SystemrV ;"[''45. Sound Attenuation- f ' i• �L' 46:•Handicap Regulatioris. '47. FINAL STRUCTURE &BUILDING: 48. Special'Requirements Completed •" `' - - `" - _ ;� r :_ i." ,- i '49. Electric Release to_Edison. 50. Gas Release to Southern California Gas Co 51. CE RTI FICATE.OF,OCCUPANCY � No. � " Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. +TRACT NO. LOT NO: r .UNIT NO! CITY OF d,esgCO� pp��A� �OpL$T�iUCTJ ON.P CM`T s 1 , f L,� j I 3393 1B/ll/B7 96'60 'TL r Protect Addoess SIE' GL-!� L '• ( , t ,, Applicants Meiling Ad less TYPE OF CONSTRUCTION'NEW LJ'ADD. LJ ALTERATION 11 REPAIR ' •^7 ❑CONVERSION ❑DEM LISH OTHER• Owner's Name �� , hone `73 377 / DESCRIPTION OF WORK/USE OF BLDG. — ?"P'^# -:. _e -. i i --{^, _ f Zone . _ 1.,_.. -. - .- Address I - Ir' - S Main Building:' 1 ' Accessory Building: I Arch/Engi , License No. ' TYPE OF PE RM1 GRADING ❑ FOUNDATION s STRUCTURAL r T Front 1 - j r . ; Address " IIs �-, ``--ts ❑ TENANT%��`j ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear - ' ! N Contractor's Name �� 1� P one �tS0333 ( ❑•OTHER I c A - -.. __ - - _ _. -- - I �s PROJECT DESCRIPTION • SO. FT. ' OCCUPANCYC Right) N- T, (mailing) -�53� m� VL �' �J;1'4 ( - K - - I G Qf„' .L i CONSTRUCTION TYPE VALUATION $ " S Left { , R City�License No. J7Y t ZONE - GRADING CU. Y65, ACRES j Pln LICENSEDCONTRACTORDECLARATION. ' 'Ref. # - t 9•,, 1 � Parking'Req./Provided E I hereby affirm that am licensed under provisions of Charter 9 (commencim ng 'Rearks:"' ! 1 - Q withisection 7000)lof Division 3 of the Business and;Professiods Code, and I ? 1 1 1 Planning Notes: M I my license is in full for 'and ft ct.`y t ,n t , :� t - s 1 t 1 - T License �IpSS 'CEn Ml1 // I 1 I �' • $ Date 7i- Signature I - •i PLUMBING _ _FEES, I II { ? NORKERS' COMPENSATION DECLARATION Bar Sink !Showers. t I hereby affirm that I have a certificate of consent to self -insure or a certificate ELECTRICAL t - FEES 'b of Workers' Compensation Insurance, or a scertified copy thereof (Section -- ' r - " Backflow P�eventer - Service Smk Atitomavc.Washer I = Transformer' ❑ 15 50 KW : r 3800, Lati. ) - - I 'Policy No. I--g� Company '•`^^'�"'� ' Backflow l rrigation r - 1 I - - - _ Policy � r Sewei Cap,i l i - Construction Pole S_ub t r '❑ 50+KW' Q ,certified copy is hereby turnishetl. - _ - - - ertrjigtl c�yl�filetl wit h.[he city u/� iswR.a N _ Bathtubs 'Sewer Connection I Oking Unit �-s:, Meter ❑up t0 100 amps Oate' YY a ' APPlica nt / /I V� t . - - EXEMPTION FROM WORKERS' COMPENSATION DE LARATION - Clarifiers F j su Solar. Collector' ishwashe'r ; '- Meter ❑ovei, 100amps O(% (This section need not be completed if the permit is for one hundred ($100) p. - _ a, - 'I less) j - - 1 Dishwashers. , j. I : 1 Solar Plying Dryers as ❑Electric ub Panel I I certify that in the! performance of the'work for which this permit is issued', I _ „ :7! ' �� shall not employ any person'm any manner so as to become subject to the f Drinking;Fountains ' SOIar.Tank rr ' Fan 1 ! •, Workers' Compensation Laws bf California. ,- - - - - _ ., Motors ❑0-1, HP ❑1x -8' 0 Date Signature FI66r'Orams' 1 n ! Swiinmio 'Pool w/S a , "✓ - NOTICE:If, after -Makin .this: I • .9 p ^ t a• / '� F.A.U. ' Inc Solar'❑9-15 HP ❑16-15+ g declaration,-you-sh oultl. become-sdbjecLto-the - ! .. is Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Silks"1 'Urinal t I 1 Fixtures - - comply with such: provisions or this permit shall: be deemed revoked.' - ' - _ t j Microwave 1 , CONSTRUCTION LENDING AGENCY Gas Ser c¢a. Outlets , I Water Closet ` Device ! 1 I I hereby affirm that there is a Construction lending agency for the performance ! -✓. ! POI' Light) i of the work for which this permit' is issued (Section 3097 Civ. C.) Interce tors I . Water Heater - - Lender's Name p i t : I I Outlets - Range , D Lender+s Address _ 1 r - ' Kitchen,Smk:.. _. �_• _ ..Water. Service; _ --_ J . _-_ i Switches = - - -; _ _ _. _ _ ' _ i OWNER BUILDER DECLARATION . i 1 r r Sign i' , 1 hereby affirm that I am exempt from'the Contractor's License Law for the r Lavator eSl Auiomiish ( i 1 -Garbage Disposal 9Standing Sections 7 follnty which re (Section permit t Business and Professional Code: Any r repair ""- II _ I county which requires a permit to construct, alter, improve ;tlemolish or repair P -Trapp, Laundr Tra s I _ • any structure, . prior, to its issuance, also requires the applicant for such permit -•�y y I ... Generator❑0-5 KW ❑5.15 KW p - "v Trash Compactor t to file a signed statement that he/she is licensed pursuant to the provisions,of-1- - I the Contractors ' License Law (Chapter 9:(commencing with Section 7000) of { Roof'Drams 'Division 3 of line 'Business and Professions Code) or that she/she is exempt - - - - - - — --T- t- therefrom andthebasis:for the alleged exemption. Any violation of Section t ' I ( {. -1 1' - '_ 1, 7031.5 :by any applicant for a -permit subjects the applicant to a_ civil ( - 1 Menalty of not more than five hundred dollars ($500). - LJ 1, as owner of :the property or my employees with wages 'as their sole Reinspectlen' Fee: $15 I , Issue Fee l' $ 3 com pensathm, will do the work, and the structure is not intended or,offered I -t ! for sale (Section 7044,' Business '.and ;Professional Code: ,The Contractor's -' I MECHANICAL' 'FEES - Reinspection Fee $15 r Issue Fee $ 3r I License Law does not apply to an owner of a property who builds or improves _ r thereon, and who .does such work himself/herself or .tnro ugh his or her own I I .. I DEVELOPMENT SERVICES REQUIREMENTS: _ employees, provided that such improvements are not intended or offered for Boiler ,Hood or Type I ❑- .1 -sale If,.however; the building or improvement is aOltl within one year of com- - Canopy Type 11 ''❑ - 'ZOning Approved By Date pletio n, the owner will have the burden of proving he/she did not build or Im- Duct - Under Ground . _ ; 1 i Building Approved By • - Date , [ or for the Purpose Of sale),' ' � r , - - `�• p'J 1 LJ is as cwn6r,of.the.property, am exclusively contracting, with Iicensetl con- Duct -Structural 1 Refrigeration System ' - IApplicaYO I ed By 6 6�^•j_Date�,t -11,-177 tractorsto construct the project (Section 7044, Business and,Professions Code: , The, Contractor's, License 'Law does,not applylo'an owner of property who !Duct - Ventilating' y❑0100,000 BTU'❑100,000 BTU SUMMARY OF,FEE - - builds -or' improves) thereon, and who contracti,for' such,projects with a'con. j - ' ' - I L tractors) ucerise pursuan t'to the Co htractor(s License Law). I, aim aware that - ' BUILDING PERMITS $ + '. SMIP' ! Exhaust System-❑ Multiple ❑ System Repair/Alteration l j _. ,$. proof sof their Worker's Compensation' insurance should'be provided to me. _ _ - ,, .. I - ^ - - _ - - PLAN CHECK ) $._ '+'r ;PERMIT= 't ❑:I am exempt under Section e: &: P. C. for this reasonr Firepl/Fact Bit_ICBO # Fire Dampers I a -- + " ' - ' _ PLU MB�ING I ;,, $ - .' ISSUANCE Date owner- flHeating System & Ducting , ' Registers PLAN CHECK. •25% $ 1 "'ENERGY P.C. $' ' 1 hereby certit pp ' ❑0-100000 BTU - _ - 7� -" y that`I have reatl•this a lmation and state that the atiove ELECTRICAL %S�� GRADING'. - '$.J information'is correct.,l agree to comp) ith all city and county ordinances - I $ _ ti and state laws,, el 'n9 -to builtlin r tion, 6ntl hereby authorize repre-' PL'AN CHECK 50% $ - 3� '�� = MICROF.ILM' '$=; sentatives, of icy. to -enc on above entroned :p ope y _ ; ! — j s ; - Iv inspection p r ((JJ// ((JJ�� I ` MECHANICAL ) $ ^ i ! TOTAL FEE a$ �� Signature ate:_ + - -) - - r 5 i I - r t 1 r-�`-- r, Reinspection Fee. $15- I Issue Fee r L$_ 3 PLAN CHECK 25% $ Drivers"License Or SS - CMF 0865-46, rev: 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor L CONSTRUCTION AND PLANNING -..'_ _ L. ' �.?. .---;i. '1,. %, -..u- 'POOL &SPA • • '•' '- - ;, 'APPROVALS . I Perm #• ti 1 Date)t t, Inspectors �� r APPROVALS1 Permit # Date Inspector 11 -;Temporary Electrical'Se'rvice or, Pole i it (, 52. Pool &,Equipment location, ' t' r - 2y Soil Pipe-Undrgrnd. `h j ' '53. Steel Reinforcerrient . , ., .. t 1 3. Electrical Conduit Utility-Undrgrnd. i -5A. Forms, •, �- i. ' 4: Electrical Conduit-Undrgrnd. .55.Electrical Bonding 5. 'Steel Reinforcement'(. ; - • 56. Rough Plumbing & Pressure ,Test 6. Electrical UFER Grnd.•. 57. APPROVAL TO COVER-GUNITE I 7. Footings'+ f -58. Electrical Conduit-Undrgrnd. 8: Foundation '59. Gds Pipe' ,10 Undrgrnd., Test; 9: Wate ,Pipe-Undrgrnd ; k > 60. -Backwash Lines; P -Trap, L1 Undrgrnd. 10.: Structural Floor System -• ii; 61. APPROVAL TO DECK . 11. Property Sewer Line &House Connection 1 62. Backwa & Receptor -Final' _ •. 12. Sewer Cap 63. Heater &Went -Final 3 13.i Root Drairis 64. Plumbing System - Final ; ' 14. Rough Plumbing 65. Ele`ctiical-FinalF `- - '15.'Rou h Electrical -Conduit 9 z . ,. ` 7•66,, Solar'System Final 16, Rough Electric Wiring , 67Fcin9`&Acces� s Approval - ,' -' 17. Rough Wiring Sign •``" "r'' I' 68. APPROVED FOR -PLASTERING- •• ' 18 Rough, ElectricalT Bar Ceiling' '- " 69. POOL/SPA SYSTEMS FINAL ' 19. Rough He & Air Conditioning '. FIRE DEPT. REQUIREMENT, APPROVALS Permit# 20: Rough Factory Fireplace'• i 21. Ducts; in Structure' h 70. Underground Hydro;i 22.` Ducts, Ventilating'" 71. Product Piping El Gas' El Oil 23. Gas Pipe -Rough & Test l t I - 72. Underground Flush ' 24' Roof Framing ,. , I -73. Undergmd'. Storage Tank 0Gas ❑Oil - 25. Roof Sheathing•'� j -, -74. Overliead'Hydro_ ! el 26. T -Bar Ceiling (Structural)'& Monocoat _ - .75:•. Dry, Chemical 11 27. Frame and . Flashing ,' - 'r---'- ^;r 1-.--- 76. Dry`Standpipe . 28., Lathing & Siding - '., 77. FIXED SYSTEM FiNAY,, 1 , ,' ,�':• 29: Insulation 7$. FIRE PREY. FINAL'' '' . - . • 1 30. Drywall Nailing : ,. ` HEALTH DEP.T.'REOUIREMENT 31. Plaster Brown Coat I t '• 1 79*FINAL INSPECTION 32. Electrical'Power'Meter-FinalLL hVOU 80.. FOOD CERTIFICATE ISSUED. Y i . 33. Final Electric ' . Notes:., 34. Final,Heating & Air'Conditioning, 35. Final GdS,Pl pe -Test 36. Hood or Canopy 37. �FinaGFactory* Fireplace ', -- - � J ry ( 38yFinal Plumbing Water Service -Final - . , � � - _� . t„ -n ^ ii ,40: Gar Service -Final -. - - - _ ' •.-} .�; 41. Solar Domestic -Final. . '✓: $ - .t `r42,�BackflowPreventer :4i §ackflow Irrigation. .'44 ;Laddscape Irrigation System ,j45. Sound Attenuation ^.• - y. „ ' "� L_ ` 46. Handicap Regulations - - �47: FINAL -STRUCTURE & BUILDING . p,- - - - it ' ;'..i rS✓!'v `' ^' '..ri • .�" fit.' ,y ? 48.�Special Requirements Completed;- -` --�;" .-•�" ' 49: Electric Release to: Edison 50.`_Gas:Release to Southern:California Gas Co 51. CERTIFICATE OF OCCUPANCY,, No. Date - - T -CITYOF.COSTAIMEs4 .- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _, : -2025- J/iii 7- T- CONSTRUCTIONPERMLT PERMITNO.Jr(i43p7 ?TRACT NO. ;LOT NO, UNIT NO, i .-' I 'r '2666 ELDEN AVENUE - "-K" 1'L" ' ! `ALTERATION E I 1 '. Project Address ANEW , . Appl Mai 14173 CHAMBERS ROAD, TUSTIN,; CA• TYPE OF CONSTRUCTION IADO REPAIR icant's Address n9LUTER DEVELOPMENT i 637-3777 TtOwner's Na • - ! Phone ❑CONVERSION ❑IDEM LI$H ❑OTHER A.P. #_ zone'+ - L -' r - - ' 510 ST, NEWPORT BEACH, ,CA ; DESCRIPTION'OF WORK/USE OFBLDG:'-'- E � - - - 'S B Main Building: Accessory Building: Address _30TH _ Arch/Eng, t License No. I t , / ' l TYPE OF PERMIT h GRADING -'❑ TENANT ❑ ELECTRICAL FOUNDATION ._ STRUCTURAL i ❑PLUMBING MECHANICAL T BNRear Front ' - { - O` - ( Address ❑ I ' I A I Contractor's Name SIERRA FIREPLACE DIST' Phone 832-6862 .' OTHER 1417'1 CHAMBERS RD, TUSTIN CA 92683 Address (mailing) + PROJECT DESCRIPTION I SG.'FT. I _ _ OCCUPANCY C K Right; T N G ' { 1 I City License No. Y - ` �?r I ' { CONSTRUCTION TYPE •• VALUATION $ tS Left I - R /- LICENSED CONTRACTOR DECLARATION •' : ;ZONE ! + GRADING CU.YDS ACRES + -- Ping. Ref: # ! I ! Parking Req./Provided E , 1 hereby affirm that I am licensed untler provisions of Charter 9 (commenting i Remarks: %� (( ' ! RQ T. Z OZ6 I l ' - Planning Notes: ' 9 - ! `• Q M 1' with'section 7000) of Division 3 of the Business and Professions code, and my license is in full force'and effect. , '44 I 1 ' ' y Ll License crassse 440255 I ..,PLUMBING S Date ;gnat ure ' ' y '_F=EES .. I' •-ORKERS' COMPENSATION DE RATION f ereby affirm thab I have a cercificate of consent to self= insure certificate I Bar Sink' 1 " '+ ` Showers, 1:� u t - ELECTRICAL FEES l ' ere Workers' Compensation Insurance, or a certified copy thereof (Section I .I I - _ i Backflow Breventen Serve Sink- I •p _ , ' E I , od00, Lab: C.) - - ; - + Automatic Washer Transformer-11 15-50 KW ' Policy No--IZ-w�Company NATT(1NWTT)F MiI9'IiAT F Backflow lrngation 'i ' _ Sewer,Ca - '- p ' S .i + Construclwri Pole Sub - _❑ 50+KW. ; . Certified copy is!hereby furnished. E' 1 ' -- >, y , 1 Certified copy is"f iletl lwith't he city uiltl ing DI ""op/_ Bathtubs ( _• ( •t Sewer Connection Cooking Unit Meter ❑up'to 100 amps n ` at••fir_ APPlica� 'Clarifiers J ` ' EXEMPTION FROM WORKERS' MPENSATI DECLON I, l Solar'Collector5 ) - Dishwasher ". - Meter ❑over 100 amps ' (This section need not be complete If the permit i for one hundred ($100) or t 1 Dishwasher, -`• ' _ Solar Piping " .l - i Dryers -[]Electric 'L ( I certify that in the performance of the,work for which this permit is issued, L .. _ r' Y Sub Panel r - - t ' shall not employ any person in any'manner so as to become subject to the - - Drinking,FOu nta ins , Solar Tank 1 _ _ Fan } ' - Motors ❑0-1 HP ❑1'/: -8 ' Workers' Compensation Laws of California. , Date - Signature ' 1 •the I Floor-Drains { 1 ; ;Swimming POOI w/Spa ^ I f -? •• , F.N.U.- U. Inc. Solar ❑9-15 HP;❑16-15+ NOTICE: If, atter making this declaration, you should become subject to NOTICE: 'Workers' Compensation provisions of the'" L'abor"Code,'.you' must forto Ito-'1 _ _ _ _ ...., ° Floor Sin ks _ Urinal 4 Fixtures + Microwave! comply with such provisions or, this Permit Shall'be deemed revoked. i CONSTRVCTION LENDING AGENCY 1 ; -' I.iP -{ for Gas'Service Outlets { .{� Water Closet I 'I {>'p e ! Device Boxes ' 'Pole Light -. I hereby affirm that therel,is a Construction lending agency the performance of the work; for lwhich this permit is issued (Section 3097 Civ.z CJ Interceptors ' ' I p ,Water Heater 1 �ti Outlets ' Range I - iLentler's' Name Yom. i 'Lender's Address _ f __ _ �; _., - -OWNER Kitchen Sink- _ _ _ Water Service, i s• --'- i _ Switches .-., ._. r 3 g ) I - '—]-Sign n ---- -�--- BUILDER DECLARATION ' T ( - I hereby affirm that I am exempt from the Contractor's License Law; for the Lavatories ' c Auto-Wash +'3 ' - Garbage Disposal - f Standing Sections foll°wingireason (Section 7031.5 Business. and Professional Code: Any,city or - -,� , f county which requires a-permit to construct; alter, improve, demolish or'repair any structure, prior, toots issuance; also requires the applicant for such permit P-Trap i j Ladndry,Trays !✓. _ t Generator'❑O-5 KW:❑5-15 t 1 KW . Trash Compactor to file a signed statement that he/she is licensed pursuant to the or ovl sions,af _ Roof Drains ' •he Contractor's License Law (Chapter 9 (commencing with Section 7000)of - vision-3..oNthe_B.siness and. Professions;Cotle)., or that.he/she is.ezem pt,-_' L'f • r _l refrom and, thelbasis for the alleged exemption. Any violation of Section .31.5-'by any. applicant for a -permit subjects the applicant to a civil I ] t, - + E " Benalty of not more than five hundred dollars ($500). I ,' LJ I; as owner of 'the property Or my employees with wages as their sole ! ReinspeMionl Fee+ $15 •• I j ,.Issue Fee -I $i 3 v co m pensation,twill do: the work, and the structure is not intended or offered Reinspection, Fee i _7 $15 Issue Fee for sale (Section.7044,• Business and Professional Code: The Contractor's •I + - MECHANICAL. I. .I FEES - ` License Law does not apply to an owner of a property who builds or improves to.reon, and who does such work himself/herself or through his or her own " + - - - , - HOOd .DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for building or improvement is sold within one of coin- Boiler { _ , Or 'Type I ,!❑ f Canopy "Type ❑ - j, IZoning Approved By r - ` - Date I „ . sale.af, however„the year the-owner will have the burden Of proving he/she did not build or im- Duct -Under Ground II i - ( ! . pletion; 'prove for the purposepE sale)` ; ' + guild ing Approved By Date i - , ”❑-.I, as owner of the Property, am exclusively contracting with licomed'co n- Duct -Structural - Refrigeration System E Application Issued By • 'Date tractors to construct the project (Section 7044, Business and;Professions Code: The Contractor's. License Lav, does not apply to an owner of.property�who _ Duct -Ventilating.! Y ❑6 00,000 BTU ❑100,000 BTU 1 { •` SUMMARY OF!FE ES ' t bullds.cr'improves thereon, and who contracts for such projects with a con- - _ •- - - f •. I �$ I _ - tractor (sl. license pursuant tojthe Contractor's License!Law). 1 am aware that: ' Exhaust System ❑ -Multiple ❑ System Repair/Alteration 1 BUILDING PERMIT- - '$MIP . $� - proof o their Worker's Compensation insurance Should:be provided to me'. _ _ - PLA N,CH ECK s$. - t •- , - i� ❑ lam exempt untler. SectionO' ' -B. & P. C..f or this reason• Firepl/Fact, Bit. ICBG #� Fire Dampers - .-' a/�t.'i _.PERMIT " ' '- - -' PLUMBING $" ISSUANCE Date - -"Owner ' �^ ' _ t -' +- - ' I hereby certify'that+I have lread'this 'aPplcaLon and state that the above= Heating System:& Ducting ❑0-100,000 BTU 100,000BT - ' Registers - _ - t pLAN'CHECK y-25% �$: •,l +ENERGY P.C.' $ ''•' ` I •'G RA'DINGT '$'- L I . information'is correct. 1 agree to comply with all city antl county ordinances. - _ - - ELECTR ICAL +$ I _ and'state,lawVrelating,to building construction and hereby authorize repre-� -- i - • "; r PLAN CHECK 50% '$ - MICROFILM . ;$- = �: sentabves'of, his 'city, [ enc r upon the+-above-men boned •pr art for_ o,, f �' I inspection Pur ores: (/ �, - `/-/ Dater - + i ' - I '- I -+ '' i ;,' - ,. I MECHANICAL -'S 1 ' 00 ^TOTAL FEE .$ .� Signature - - Reinspectwri Fee $15 '• Issue Fee ' •-, ^$? 3 PLAN CHECK ;25%' 1 0' t%� • 1 ' 'ori vers•. LV nse or SS - r - • ;$�1.' CMF'0865-46,-rev. 10/84 - White rBuilding;-Canary - Applicant; Pink.- Accounting; Goldenrod - Assessor "'- I 'CONSTRUCTION AND -PLANNING ' POOL & SPA- „ t• v.: . c' APPROVALS , Permit # Paten j spector I ' a! .rAPrROVALS Permit #` Date r Inspector e 1 1.,Temporary Electrical Service or Pole i 52. Pool &Equipment Location; ! r . 2.�Soil Pipe-Undrgrnd.' - I '53. 'Steel Reinforcement ! ? I 3. Electrical Conduit Utility-Undrgrnd' ; 54: Forms 4"Electrical Conduit-Undrgrnd. ', - j 55., Electrical -Bonding ' y. �.� 5" Steel; Reinforcement' ` r .56. Rough Plumbing & Pressure Test_ i • 6. Electrical LIFERGrnd. r' i 57. APPROVAL TO COVER-GUNI.. 7. Footings •: �'' :� ; - , j , 1 .58..6ectricaLConduit-6ndrgr4 r . Foundation '^ • - - - -,- ' 59" Gas Pipe; O Undrgrnd., Test' i' 9. Water Pipe-Undrgrnd. i '� ', - -,f -: •• 60. -Backwash Lines; P -Trap, D Undrgrnd. ' . 10. Structural Floor System' t. -.. - 61.. APPROVAL TO DECK .11. Property Sewer Line'& House Connection •: ,� ! 62. Backwash & Receptor -Final 'i12. Sewer Cap 4 63. Heater &Vent -Final ! 'r 13. -Roof Drains - '. J . :�, " 64. Plumbing System,- Final 1 - �- ' 14. Rough Plumbing, 65. Electrical -Final, - C 15. -Rough Electrical -Conduit 9 f , r r 66. -Final =' 16. Rough Electric Wiring. 67. Fencing& Access. Approval - 17.; Rough Wiring Sign-' - " ' '- - '- t' 68. APPROVED FORPL'ASTERING ' 18.'. Rough�Electrical-T Bar Ceiling - + , 69. POOL/SPA'SYSTEMS'FINAL 19., Rough Heating 8• Air Conditioning FIREDEPT. REQUIREMENT: APPROVALS Permit # _ 20.' Rough:Factory Fireplace 21. Ducts, in Structure: 'i '' I 170. Underground Hydro ; ?; �' r ' 22.: Ducts, Ventilating'• 71:. Product Piping O Gas; 1) oil ' 23., Gas Pi a-Rou h&Test;' •• i P 9 72. Underground Flush - .24. Roof Framing'.73. Ondergrnd. Storage Tamk10 Gas, O Oil 25. Roof Sheathing - r ;" _~ ' 74r OJerhead'Hydro', , - r 26. T -Bar Ceiling (Structural) & Monocoati i r = 75. DryPhemical _I,".l '1 '. •- _ i 27.) Frame and 'Flashin'g' - - - ` - - -� - •-' 76. Dry Standpipe 28.' Lathing &,Siding177. FIXED SYSTEM FINAL 29., Insulation'," 78. FIRE PREY. FINAL; 30.;Dry'W lH Nailing, • ( , - HEALTH DEPT. REQUIREMENT;" - + 31. Plaster Brown Coat • 79. ;FINAL -_INSPECTION s l� I 32. Electrical Power Meter -Final - I • 80.:FOOD.6ERTIFICATE ISSUED, 33.. Final Electric' - c;Notes .34..dFinal Heating,&,Air Conditioning - `;� I ` l t } . ' .- l i , t. � : ' ,.r •' �' 35. Final Gas Pipe -Test , r -' - -- �� •-' - - - -- - 36. Hood or Canopy ' 37. Final Factory Fireplace - - ., ��%. !?• l 38. Final Plumbing • "-. _ - '+'. - s _ ' 39: Water Service -Final = •. I._ ; r -; - ., .. 40. Gas Service=Final , 41. Solar Domestic -Final 42.'Ba ckfIow Preventer « r43. Backflow Irrigation ,- -,, ,?; ' s.� - - " � 't; , Landscape Irrigation System. ,,44" 45.Sound Attenuation- - w , '•` `, r VHimdicap 46. Regulations; •&BUILDING 47: FINAL STRUCTURE 48! Special Requirements; Completed 49. Electric Release to Edison . r- - r _ 50. Gas Release to Southern California Gas Co 51: CERTIFICATE OF OCCUPANCY: No. Cate. City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 002022 P. O. Box 1200 Costa Mesa, California The Building located at 2666 F1Aen Avprinp, rTnitta K A T, v_ has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R3/Ml Occupancy. Use of Building Duplex Condominium Legal Description 439-221-16,17 (See reverse side for Metes and Bounds) Building Permit No R 27n2F Electrical Permit No. E 29725 Plumbing Permit No.P28287,P28288 Mechanical Permit No.M2Q1R'A,M2Q1R4 M29'AQ4 Number of apartments and/or guest rooms ISSUED TO: Steiner/Fluter 510 30th Street Newaort Beach, CA 92660 Building Official Wi 11111 am T. ROW;4rri by Date January 11, 1988 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 lel U.B.C. CMF 1015-46 rev. 1/83 White -Owner; C- , - Numerical File; Pink - Bldg. Permit File