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Home My WebLink About186 DEL MAR AVE - Building PermitsE April 10, 1985 Yl� CITY OF COSTA MESA P"ECEIVED-MAY -1 7 -1985 CALIFORNIA 92628-1200 P. O. BOX 1200 DEVELOPMENT SERVICES DEPARTMENT Building Safety Division Business License Division Communications County Administration Office County Clerk/Board of Supervisors County Registrar of Voters County Tax Assessor Engineering Division (2) Finance, Revenue Division Fire Prevention Manager, MID Mesa Consolidated hbter District Newport -Mesa Unified School District (2) Pacific lblephone Company (2) Police Department - Ping. & Research Santa Ana Heights Water Company Sanitary District Engineer Southern California Edison Co. Southern California Gas Co. State Board of Equalization Street Division United States Post office, Adams Avenue United States Post Office, Santa Ana Zip 4 — Santa Ana File (2) The City of Costa Mesa wishes to advise you that in revising street addresses, the following addresses have been changed: OLD'ADDRESS NEW ADDRESS A.P. NO. 186 Del Mar \ 186 Del Mar 439-221-48 Units A, B, C 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. Si cerely, J. ONY PEREZ Planning Intern JAP:alm (F-3-29) Building Division (714) 754-5626 Code Enforcement/Business License (714) 754-5234 77 FAIR DRIVE Planning Division (714) 754-5245 C Applicant to fill in all spaces except those within heavy border lines and stgn all appropriate-dectarations. 91F COSTA MESA CONSTRUCTION PERMIT FProject�tddress �!1 � IJEG M19' Applicant's -Mailing Address Owner's Name 14F0Phone - Address1q.t.i,jif%.47IPir Arch/Eng. ��EN O.CA /•��j t7 License No'SE?2� _ Address .I�»8i John �Tr .n los Tsrt ryv 9zG.� Contractor's Name Phn�G�, Address (mailing) ' City License No. LICENSED CONTRACTOR DECLARATION I`hereby affirm that I•am licensed undef provisions of Charter.9 (commencing with section 7000) of Division j�f t e,Business and Professions Code, and my license is in full force and eftff I Y l License Class _ % License No. Date Signature r,ORKERS' COMPENSATION DECLARATION' 5e - ,reby affirm that I have a certificate of consent to self -insure or a certificate p Workers' Compensation Insurance, or a certified copy thereof (Section `x800, Lab. C.) - - - - Policy No. Company 'Certified copy is hereby furnished. Certified copy is filedwith the city BuildingDivision. , Date ' Applicant EXEMPTION FROM WORKERS'•COMPENSATION DECLARATION (Thissection need not be completedifthe permit is for one hundred ($100) or less). I cartify'that in the performance of the work r, ich chi er issued I shall not employ any person in any m s to be Ibject to the Workers' �orm�p nsat' n Laws of Calif Date zz Yr �5ignature NOTICE: If, after making this decl tion, you s uItl beton a subjec e Workers' Compensation provisions of the Labor Code, yo must hwitthh comply with such provisions or this permit shall be eemed ev0, CONSTRUCTION'LENDING AGENCY'- - I hereby affirm that there is a construction lending agency for the performance of the work for which this permit i5 issued _(Section 3097 Civ. ,C.) Lender's Name _ Lender's Address OWNER BUILDER DECLARATION - 1 hereby affirm that 1 am'exempt from the Contractor's -License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or ' county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of '•he Contractor's License Law (Chapter 9 (commencing with Section 7000).of bision 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 J31.5 by any applicant for a permit subjects the applicant to a civil enalty, of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole 'compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code; The Contractor's License .Law does not apply to an owner of a property who builds or improves . thereon, and who does such work himself/herself or through his or her own employees, Provided that such improvements are not intended or offered for . sale. It, however, the building or Improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of .the property, am exclusively contracting with licensed con. tractorsto 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(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 amiexempt under Section 8._&,P. C.,1or this reason 1hereby certify that I- have ree information is correct. I agree to and state laws relating to buildii sentatives of tIt o me,Inspection pur Signature TYPE OF CONSTRUCTIO LJ NEW IJ ADD El ALTERATION ❑ REPAIR - • inns I /PR/fah Application Issued BY ElCONVERSION DEMOLISH •❑ OTHER A.P. # ,` Q � 1710.1 — 49) Zone �i� StJMMARY OF FEES DESC IPTION OF WO K/USE OF B - S Main Building: r eW a-$17i'vl. PICC Accessory Building: $ TYPE OF PERMIT GRADING ❑ FOUN ATION LJ STRUCTU URAL T Front ,, I / /bq -fp exio, rl PLUM13ING O ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL; ' B Rear IS 4'OYl4[Lp N ❑ OTHER - A/ PLAN CHECK 50% $ MICROFILM I PROJECT DESCRIPTION SQ. ,FT. OCCU PANG'p CONSTRUCTION TYP 'V VALUATION$ 7749LiD- C S Right r� - - N R Left 40 - - • ZONE GRADING CU. YDS. ACRES Ping. Ref. # - Parking Req./Provided�/ - E Remarks: I 'C" z`k�•So Planning Notes: nGGJ a _S�Ut-c Lf�5,T/� M s. PLUMBING - FEES Sink Preventer ulsnwasner I Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection -Fee _ Service Sink Sewer, Cap Sewer Connection " Solar Collectors Solar,Piping Solar Tank v I Swimming Pool w/Spa' Urinal Outlets - . Water Closet Water Heater Water Service -- $15 Boiler Duct- Under Ground Duct -Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBG # Heating System & Ducting ❑0-100,000 BTU 11100,000 Issue Fee Hood or Type ❑ Canopy Type 11 ❑ I Refrigeration System ❑4,100,000 BTU 0100,0008 System Repair/Alteration Automatic Wi Construction Cooking Unit Dishwasher Dryers ❑Ga, Fan F.A.U. Fixtures Device Boxes ELECTRICAL Transformer ❑ 15-50 KW Sub. ❑ 50+KW r. Meter ❑up to 100 amps Meter ❑over 100 amps: Electric Sub.Panel Garbage Disposal, Generator ❑0-5 KW $ 3 Reinspection,Fee - FEES DEVELOPMENT SERVI - Zoning Approved BY'— D ' Lic SS -- I I Reinspection Fee I $15 I I Issue Fee I $ 3 CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod _Assessor Motors ❑0-1 HP 01W-8 - Inc. Solar. 09-15 HP.016-15+ -Microwave Pole Light ' Range ' I Standing Sections 15-15 KW Trash Compactor '$15 Issue Fee FEES $ 3 Building.Approved By /-/ I Date / • 7 3 Application Issued BY i � �` Dat I 2. ' StJMMARY OF FEES r -'BUILDING PERMIT $ 70 •0b SMTP $ 5 s ,,.PLAN CHECK � $ PERMIT PLUM13ING $ ISSUANCE $ PLAN CHECK- 25% $ ENERGY P.C. $ ELECTRICAL $ -GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ .� CONSTRUCTION ANDPLANNING � APPROVALS Permit_# Date Inspector POk SPA APPROVALS. Permit# Date: Inspector .,1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location, . .2. Soi6Pipe-Undrgrnd. -' 53. Steel Reinforcement - - 3 Electrical Conduit Utility-Undrgrnd. '54. Forms :4!Electrical Conduit-Undrgrnd. 55. Electrical Bonding - - S.,Steef Reinforcement}L 6 Y 56. Rough Plumbfrig &Pressure Test -6.r Electrial UFER Grnd. 57. APPROVALm COVER-GUNITE ,7.Footings, 58. Electrical Conduit-Undrgrnd. 59. Gas,Pipe, O Undrgrnd.; Test 9.:,Water'P,ipe-Unilrg'rnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK. '- 11. Property sewer Line & House Connection 62. Backwash &Receptor-Final 12. Sewer Cep,) - 63. Heater & Vent-Final 13. Roof brains" � ri• 64. PlumbingSystem- Final 14. RoughAumbing 65. Electrical-Final - - 15. Rough Electrical-Conduit - 66. Solar System-Final - - - 16. Rough Electric Wiring - - 67. Fencing & Access Approval - - 17. Rough Wiring Sign. - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T'Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - - 19. Rough, Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # ' 20. Rough Factory Fireplace 21. Ducts, in Structure r. 70. Underground Hydro 22. Ducts, Ventilating / ` • 71. Pioduct Piping 13 Gas ❑ Oil 23. Gas Pipe-Rough & Test • 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25.' Roof Sheathing %' .' ?/;,has- j6rhl 74. Overhead Hydro i 26. T-Bar Ceiling(Structural) '& Monocoat 75. Dry Chemical 22. Frame and Flashing � .76. Dry Standpipe 2✓� Lathing & Siding y.,,,� ,Clime 77. FIXED SYSTEM FINAL 29. Insulation rl,4-5� 78. FIRE PREV. FINAL 30. Drywall Nailing ` HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat / 79. FINAL INSPECTION - - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33.. Final Electric I Notes: S�p 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 3ry S� 36. Hood or Canopy Lvit 37. Final Factory Fireplace 0 38. Final Plumbing t 39. Water Service-Finalzt 40. Gas Service-Final 41. Solar Domestic-Final �f• 42. Backflow Preventer - 43. Backflow Irrigation 44. ,Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ' 48-Special Requirements Completed 49. Electric Release to Edison �- - 50. Gas•Release to Southern California Gas CD 51. CERT'I.FICATE OF OCCUPANCY No. •" Date - CITY OF COSTA MESA BUILDING DIVISION I q, OWNER -BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner -builder verification. Attention Property Owner: An 'owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. 1 personally plan to provide t major labor and materials for construction of the proposed property improvement. Yes ❑ No 2. 1 (have/have not) /- 44-'Prs signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone 1 1 Contractor's Lic. No 5 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work I hereby affirm that t have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my personal knowledge, in rQmpliance with�tbis State haw. C.D.L. #or S.S. # Ia4�', / � " 7545273 CMF 1042-46 ate: %/ _2__g g ROC COVERING CERTIFI .TION J � Permit No./ �� J Property address Ownerlil//GG ✓ HJR �- Contractor 2e1dz �s2 xL2 ef: Z;Z State Contractor License Number Classification I hereby certify that 1• have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the 1979 Uniform Building Code, as amended in Sect' 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufactur I further certify that•I am the owner of the property. (Owner -Builder permittee only). ❑ 1. further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division by:. /3/� Initial Date Space for Notarial Statement for authorized' officer or agent Company or Corporate Name Address CMF 0990-46 White - Building Div.; Canary - Contractor; Pink - Owner August 22, 1985 •. • CITY OF COSTA MESA, Buildiang Department, • ATTER: Burt Morgan: . INSPECTOR K ` 4 Pt ` REF: 0j186LDel Mar, Costa Mesa • .', •-• Permit •No, B16380 ' Please be advised that jgrading and drainage at the referred address is hereby, certified to, ,be.as originally shown on the grading plan,` and operatesas per-Zosta Mesa City - • requirements. - Sincerely, � � � weist-.1,44 ear. te William I. Rou ey, • Owner Builder, . • 1903 Yacht Truant, . Newport Beach, Calif, 92660 ` • . 759=1396 • RECEIVED AUG 2 3 1985 • • • & Z Bute 03A1333N • Ge{/ • • 2 • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 0582 -4/03/05 'T CITY OF COSTA MESA CONSTRUCTION PERMIT :. Project Address i� LCL MA_R, PERMIT NO. z TRACT NO. LOT NO. UNy�ND; TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION 11 DEMOLISH El OTHER DESCRIPTION OF WORK/USE OF Bila . �j(-IC-- -- TYPE OFPERMIT GRADING LJ FOUNDATIIONNLJ / STRUCTURAL ❑ TENANT ❑ ELECTRICAL _� PLU_IVIBING CJ MECHANICAL 'El OTHER 1\Jt-yip 1.�.�` / - PROJECT DESCRIPTION SO: FT. OCCUPANCY _ - CONSTRUCTION TYPE VALUATION$ ZONE GRADINGCU.YDS. ACRES nn _ Applicant's Mailing Address�� 1` W I �` 1�n ,r r� T.�r-�' Owner's Name ' Y\ IC Phone Address 4 F•'4• C �T• ' A.P. # Zone S Main Building: ! Accessory Building: Arch/Eng. -License NO.; Address- -p' f E T Front Z O B Rear _ N Contractor's NameCV--V�ItI� �"��7 Phone I Address (mailing) P��--� I—�MC�2 ' ' City Licerise No. LICENSED CONTRACTOR DECLARATION C Right - g N K S _ Left _ G R Ping. Ref. # Parking, E Remarks: AMC_ Planning'NOtes: - - M 1 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 license is in full'force and.effect. - RECE�JVED AM 0 - - T S License CJe s is n No. Date?" ' S"g t -/ 0 - 0 l PLUMBING' t FEES - , Bar Sink Showers 1 ELECTRICAL FEES WORKERS' COMPENSATION DECLARATION I hereby affirm that have a certificate of consent self -insure ora certificate ietl copy thereof (Section of Workers' Compensation Insurance, or a certified 3800; -Lab p -C.) +'-/� x G -, - "' - - - -- - - PolicyP7U! K3Igq:3S J Company rI��M ALT rtif ietl copy is hereby furnished. : I ertifienr.�coe filetl with the city �e� yity ir}q,Qi i�n� —.�• ' Backflow reventer t Service Sink Automatic Washer _ Transformer ❑..15-50 KW _ - ❑ 50+KW _" Construction Pole Sub. I Backflow Irrigation Sewer Ca - P Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date? -Z-1 Applicant HLY KI k"!S L H ll-") EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter ❑Over 100 amps '(ThiSsectiom need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date' 4 Signature ' Dishwasher ' Solar Piping - Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan. Motors 1:10-1 HP Ill 14 - 8 ' Floor Drains Swimming Pool w/Spa, F.A.U. IncSolar'❑9-15 HP 016-15+ . - NOTICE: If, after making this declaration, you should become subject to the I Floor.Sinks ' Urinal - _ Fixtures Microwave l _ Workers' Compensation provisions of the Labor Code, you must forthwith comply with., such provisions or this permit shall be deemed revoked'. Gas Service -Outlets Water Closet Device Boxes Pole Light CONSTRUCTION LENDING AGENCY" I I hereby affirm that there is a construction lending agency for performance Interceptors p Water Hater Outlets Range of the, work for which this permit is issued (Section 3097 Civ. C.) Lender's Name _ Lender's Address �') - - OWNER BUILDER DECLARATION-' - I hereby affirm that I am-e)iempt from the Contractor's License Law for the fallowing reason (Section 7031.5 Business and Professional Code: -Any city or Kitchen Sink 'Water Service Switches Sign Lavatories - Garbage Disposal ' Standing Sections - P -Trap' - G¢n¢ratOr ❑0-5 KW ❑5-15 KW Trash Compactor county which requires a permihto construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed,pursuant to the provisions of the. Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division' 3 of the Business and Professions Code) or that he/she is exempt , Roof Drains therefrom and the basis for the alleged exemption. Any violation.of Section ;7031.5 by any applicant for a permit subjects the applicant to a civil ;innalty of not more than five hundred dollars ($500). - - - LL I,�as owner of the property'or my employees with wages as their Sole compensation, win do the -work, and the structure'is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his Or her own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). 71 I, as owner of the property, am exclusively contracting with licensed con- - ' Reinspeetico"Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 - MECHANICAL - FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date�� Application Isaued By Dat Boiler Hood or Type I ❑ Canopy Type If C1- - Duct - Under Ground Duct -Structural Refrigeration System 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 buildsorimproves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided t0 me. I ❑ I am exempt under Section B. & P. C. for this reason 100,000 BTU ❑100,000 BTU Duct - Ventilating SUMMARY OF FEES BUILDING PERMIT $ SMIP - $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM '$ MECHANICAL $_ TOTAL FEE $ PLAN CHECK 25% L•�C� S $ �. Exhaust System ❑ Multiple ❑ System Repair/AlteratiOn Firepl/Fact. Bit. ICBG # Date Owner - 1 hereby certify .that I have read this application and state that the .above information is correct. I agree to comply with all city and county ordinances and state laws relating t uil ing construction, and hereby authorize repre- sentatives i5 ty o en r upon the above-mentioned Property for inspection ur ose - 7 Signature Dat.?� Drivers' License or 5 _ I Heating System & Ducting 100,000 BTU C1 100,000 BT - ' Reinspection Fee $15 Issue Fee !Sv 3 CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink Accounting; Goldenrod - Assessor - d;I 1 ',:3 r - S CONSTRUCTION AND PLANNING - APPROVALS Permit # ' Date Inspector •POOL & SPA _ - APPROVALS ' Permit # Date Inspector, 1. Temporary Electrical Service or Pole .1 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. • . 53. Steel Reinforcement - 3: Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit,-Undrgrnd. 55. Electrical Bonding- . 5. Steel ;Reinforcement - 56. Rough Plumbing .& Pressure,Test .'." 6. Electrical UFER.Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. 'Foundation _ , 59. Gas Pipe, 0 Undrgrnd., Test 9: Watefipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. x,10. Structural Floor.System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final- , 12. Sewer Cap - _ i - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing 65. Electrical -Final - - 15. Rough Electrical -Conduit . ' 66. Solar System -Final 16. Rough Electric Wiring - 67. Fencing & Access Approval - - - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T -Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE -DEPT' REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro . 22. Ducts, Ventilating Ci 71. Product Piping 0Gas 00il 23.` Gas Pipe -Rough & Test �; 72. Underground Flusti - •_. 24. Roof Framing C 73. Undergrnd.Storage Tank'OGas 00il. 25. Roof Sheathing ct,- rNlonocoat 74. Overhead Hydro ' 26. T -Bar Ceiling (Structural) & - 75. Dry Chemical 27. Frame and Flashing �•� 76. Dry Standpipe - 28. Lathing & Siding a`� 77. FIXED SYSTEM FINAL 29. Insulation ru 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning bs/ Sir 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System v' 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed 49.'.Electric Release to Edison •• ' 50. Gas Release to Southern California Gas Co 51. CERTI F ICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ _ _• _ - - __, CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT No. TRACT NO.. LOT NO. UNIT '�— Date ' Hood or Type I ❑ Canopy Type I I ❑ _ 1455.. 4/ 18Y05 1.3.00 . L �%�� Pro)ecDALldress S.. > rove the purpose of sale). as 0wner 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 tloes not apply to an owner of property who builds or- Improves thereon, and who contracts for such projects with a con- Date— � I , ITL ' SMIP� - r 1 a -t ' , • //' �y A licant's Mailin A dress PP 1 ,t 9 / 7 �� 1��iC�/ '�/�1�/i.✓� TYPE OF CONSTRUCTION NEW ADD. ALTERATION` REPAIR R. - Bit. ICBG #'440.1 ' ISSUANCE r' ( PLAN CHECK 25% 1:1 CONVERSION ❑ DEMOLISH 1:1 OTHER_ ' $ _ 1 Heating System &Ducting I$ Registers �i Qwner's Name Ge'L?1 ,97 DESCRIPTION OF'WORK/USE OF BLDG. A.P. - Zone - I Address' PLAN CHECK 25% EMain Bwid ing:• = - Accessary Building: - sentatives of enter is ab v - io eIf pr pertyP fo inspe ctlon p �w -� , Arch/Eng. License No. TYPE OF PERMIT GRADING, FOUNDATION STRUCTURAL' . T Front _. _ ( Z O Issue Fee $ 3 i , _ Address. '- ❑ TENANT ❑ ELECTRICA}} ❑PLUM ING Q - B - - N !Phone -MECHANICAL �� OTHER- fe I,6 f.OL /�:C��j:.''GaeT �Lr, A Rear I Contractor's Nam e' I C Right _ ,- - _ N I - Address (mailing) n ' - PROJECT DESCRIPTION 50. FT. OCCUPANCY K - _ G _ - CON STRUCTION TYPE VALUATION$ 1 S Left _ City License No. - ZONE GRADING CU. YDS. 'ACRES I r, ' Ping. Ref. # _ Parking Req./Provided R E- ' LICENSED CONTRACTOR DECLARATI N `' _ Q hereby affirm that am -licensed under provisions of ,Charter 9 (commencing Remarks: -' I I i Planning Notes: - _ 1 Professions Code, and with section 7000) of Division 3 of the Busm7-� - M my license is in full force and effect. ^•SLicense - L.J Class • ('No:' , Date - Signature i ' - PLUMBING - FEESWORKERS' r COMPENSATION DECLARATIONi I r Bar Sink Showers i ELECTRICAL ' I hereby affirm that I have a certificate of consent to self -insure or a certificate FEES of Workers' Compensation Insurance, or a certifietl copy thereof (Section 3800, Cab: 'C.) " - r - - --- -- - - - Backflow Preventer — - + _ _ Service Sink • ._. ,_.._ _ _. __ Automatic Washer _ .... - _ - - ". -"'" Transformer ❑ 15'50 KW '-- I Policy No. ' Company Backflow Irrigation -R- Sewer Ca p Construct Sub. 1 ❑ 50.+ KW ' I e Certified co Oy is hereby furnished. cit Certified copy is filed with the city Building Division.Bathtubs /� Sewer Connection i Cooking Unit-, Meter ❑up to 100 amps ) 1 to Applicant ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers Solar Collectors ) _ Dishwasher Meter_ ❑aver 100 amps (This section need not be completed if the permit is for one hundred ($100) or ' _ M less): ' Dishwasher Solar Piping Dryers ❑Gas~ ❑Electric .Sub Panels certify that in the performance of the work for which this permit i ued, shairnot' employ any person in any manner s las to beco s e to the Drinking FObntains r •i Solar Tank I Fan :Motors ' Workers"Com nsationi�.aws of California( Works 5,•_ Date Signature 'NOTI .g ',beco Floor Drains: •. i Swimming Pool w/$pa I F.A.U. Inc. Solar ❑9-15 HP El 16-15+ this decla i ,' esu ject t e i Workers' Compensation!t; provisions of the Labor; Code, you must forth lth --, Floor Sinks ! -.- - Urinal -I Fixtures ^' - - - T — ' comp) with such provisions or this permit ishall' be deemed revoked. i {- :Microwave i CONSTRUCTION LENDING AGENCYV; ' - •' '- I hereby affirm that there is a agency for is Gas Service' Outlets, Water Closet - - Device Boxes.'- Pole'Li h t ' issue _3097rfCiv. C.)g of the work for which this- permit is issued (Section 309]_ Civ. CJ is- permit Interceptors -- Water.Heater: Outlets f Lentler's, Name. Range Lender's Address - '- Kitchen Sink r i Water Service ^ Switches - Sign' OWNER BUILDER DECLARATION I hereby. affirmthat1 am;exempt from the. Contractor's•License Law for -the , Lavatories - Auto -Wash - Garbage Dispoal i Standing Sections following reason (Section_7031.5. Business and Professional Code: Any city or , county which requires a permittoconstruct, alter, improve, demolish or repair P -Trap 'Laundry Trays. Generator ❑0-5 KW ❑5-15 KW Trash Compactor ' any structure; prior to its:issuance, also requires the:applicanbfor such permit I to file a'slgnetl statement that he/she is licensed pursuant to.the provisions of ROOF Drains the Contractor's License Law (Chapter 9 (commencing with'Section 7000) of fn....,.,.... - ,.e �. i_. � ,.m«�...,� ., a ti.f CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor iRainspection Fee compensation, will, do the work, and the' -structure is not intended Or offered ' for sale (Section 7044, Business and Professional Code: The, Contractor's' License Law does not apply to an owner of a property who builds or improves , 1$ 3 DEVELOPMENT SERVICES REQUIREMENTS:' I MECHANICAL I FEE •' Boiler - Date ' Hood or Type I ❑ Canopy Type I I ❑ 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 ale. If, how er, the building 0r improvement is sold within one year of com- pletion, owner' will have the burden of proving he/she did not build or Im- Date Duct - Under Ground rove the purpose of sale). as 0wner 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 tloes not apply to an owner of property who builds or- Improves thereon, and who contracts for such projects with a con- Date— � Duct -Structural I I' ( Refrigeration System ' F10-100,000BTU 0100,000 BTU - •- - - - _Duct - Ventilating I - - - $ SMIP� Exhaust System ❑ Multiple ❑ PLAN CHECK ' System Repair/Alteration I I PERMIT Conactor's License Law). I am aware that I trattoi(s1 license pursuant t0 -the tr ' proof 011 their Worker's Compensation insurance should be provided to Ime. ' PLUMBING Bit. ICBG #'440.1 ' ISSUANCE Fire Dampers' ( PLAN CHECK 25% ❑ I -am exempt under Section e. this reasonFirepl/Fact. Date '� Owner' ' $ _ 1 Heating System &Ducting I$ Registers �i • 1 hereby. certify that I: have read this apps' n any state that above - information is correct. agree to com y II city ntl count dl nances - E1&100,000BTU X100,000 BT _ - //•AO TOTAL FEE$ repre- ' and -State laws re Y t b titling anhereby auth rize repre- PLAN CHECK 25% $'-is1T�C ,'lylo , - sentatives of enter is ab v - io eIf pr pertyP fo inspe ctlon p �w -� I ' Reinspection Fee $15 Issue Fee $ 3 i , Signature Date Drivers' License or SS � � CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor iRainspection Fee I $15 1 1 Issue Fee , 1$ 3 DEVELOPMENT SERVICES REQUIREMENTS:' I Zoning Approved By I Date ' Building Approved By - Date Application Issued By -l% Date— � j ( SUMMARY OF FEES ' BUI LDINGPERMIT $ SMIP� $ i PLAN CHECK $ I PERMIT ' PLUMBING 1$ ' ISSUANCE $ ( PLAN CHECK 25% $ ENERGY P.C. ' $ _ 1 ELECTRICAL I$ i GRADING $ ' PLAN CHECK 50% ;$ I I MICROFILM ($ i MECHANICAL $ //•AO TOTAL FEE$ 1 -`-� PLAN CHECK 25% $'-is1T�C ,'lylo , '.1 CONSTRUCTION AND PLANNING. - APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # - Date Inspector 'I 'Temporary Electrical Service or Pole - 52. Pool & Equipment Location - '2. Soil Pipe-Undrgrnd. •53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing &.Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings -58. Electrical Conduit-Undrgrnd. " 8. Foundation. 59: Gas Pipe, O Undrgrnd., Test - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System _61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor -Final .12. Sewer Cap '63. Heater & Vent -Final 13. Roof Drains ' 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18. Rough Electrical -T' Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit# 20. Rough Factory Fireplace --// 21. Ducts, in Structure 70. Underground Hydro '22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED`r� 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing `fr 7/jd £ 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventers 43. Backflow Irrigation ' 44. Landscape Irrigation System -21 45. Sound' Attenuation 1 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed , 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51'. CERTI F ICATE OF OCCUPANCY No. Date ti CITY OF COSTA MESA BUILDING DIVISION OWNER -BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall. attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner -builder verification. Attention Property Owner: An 'owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processi/taior (ng your building permit. No building permit will be issued until this verification is received 1 . I personally plan to providlabor and materials for construction of the proposed property improvement. No 2. 1 (have/have not) _,005�` signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address — Phone ( 1 Contractor's Lic. No City 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name — Address Phone ( 1 Contractor's Lic. City 5 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of State of California Health and Safety Co d h personal knowledge, �99Vp4aryce wit thi; lav Signed: Name: G / 057 information set forth in Section 19830 of the pleted the above information to the best of my (Printed or typed) / C.D.L. #or S.S. # > � 7545273 CMF 104246 Date: 4Z —%,,? a Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. "__ !,., OSTA MESA �' P M_'-fQTRACT NO: `"' LOT NO." BLDG. NO.'_NST.UCTION PERMIT �/-� _ - 8613 1WMA2' ' '' I I.00 Project Address TYPE OF CONSTRUCTION '' . -- - • - • Ouvner phone �, 'El NEW ❑ ADD-' ❑ ALTERATION'- - - - - - - i t •. '..` 4Lddress -- _ - -0'REPAIR ❑CONVERSION ❑DEMOLISH ❑OTHER ZONING REGULATIONS, - I . Arch/Eng. - " License No. - - - - i ,, _ DE CRIPTI.ONOF-WORK P _ - _ AP's -Address ZONE �•PLNG. REF. �0.. •. Contractor 'L(/ '_' r' -" - Ph6n -TYPE OF PERM ' -- .5Ep BACK C _ F{ PYI LDYNG _ -. _ _ - P O RT L NI' '- �Address. ? '"- -' •. -- -- - ❑GRADING { ❑ FOUNDATION STRUCTURAL- .'LEFE VARA LST. LICENSED CONTRACTOR DECLARATION - - - ❑ TENANT' 'ELECTRICAL 0*J UMBING ❑MECHANICA SI L VAR I hereby affirm that I am licensed under provisions of Charter 9'(COM- t {>, IG HT - mencing with section 7000) of Olvision-3 of the -Business 'and - ❑ OTHER - . -- - Professions Code, '•antl my license is in full force and effect. - - REAR YARD (TO P/L) - - - - -_ '-PROJECT DESCRIPTION- CicenseClassLicense No. f .PKG. SPACE REQ. -PROVIDED: ' Date..._ .. _Signature- .� _ - SQ. FT. .. :: :. s .. .. - ,_ - .WORKERS' COMPENSATION DECLARATION---- •• -- OCCUPANCY_'"` CONSTRUCTION TYPE j STREET WIDTH PARK FEES 1 hereby affirm that I have a certificate of consent to self Insure or a. •, VALUATION ZONE. 'ZONING ARPROV EOBV _}I DATE, certificate ofWorkers"Compensation -Insurance',,�or-a certified, copy, - - -- - thereof (Section 3800, Lab. C.). ,. GRADING'.CU..YDS. •) ACRES SPECIAL CONDITIONS: tr• Policy No. . ... _ CompanY -«... _ . _ - . .0 -Certified copy is hereby furnished. - -- - - - -�- - REMARKS:t' - +•-< -- -- - �....- ' Certified copy.is filed with the city Building Division. • f.' ' EXEMPTI6N:F0.0NI-WORKERS' COMPENSATIONDECLARATION ,.. .. ' --� '-"' ' •' "•"`- (This.section. .need not be completed Ifthepermit is forgone hundred. - 1 certify that.in the performance of,.the.work for -which this.perinit a ; y .-'PLAN CHECK �' - ' ELECTRICAL PLAN CHECK _ Issued; I shall not -employ any person in any manner so as to. become ". PLUMBING ;{ I subject LAihe W kers,Co mpensatio �,ws ofCalif :�lA� - _GARAUL Date ('�XSignature -(IJP- BATHTUBS - SHOWERS x ...'. -y NOTICE: If after making this decla ation, you should becomesubject.TOILETS', , I,',URINALS" � �- .f �_ GENERATOR - 0-1 KW_ 1-10 KW h to the Workers' Compensation provisions of the Labor Code, you must - - _ TRANSFORMER . - - - _ ,- forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs '.APPLIANCE 30-50 KW=50 '+ KW' revoked...- _ ._. -- __ _. _ _ ._ _ ._ _ _. - KIT. SINKS ''� DISHWASHERS - -- "- MOTORS""' _ CONSTRUCTION LENDING AGENCY � � •0-1 FIP_1-10 HP_ _ 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - ..SUMPS - -"" - :(INC. SOLAR) 10-50'HP_50 + HP' formance of the work for which this permit is issued (Section 3097 ' 'FLOOIN R SKS FLOOR DRAINS 'FIXTURES' - -OUTLETS`-_ SWITCHES Lender's Name Lender's 'Address DRINKING FOUNTAINS �� G AS TUBE SIGNS - S" . _ -• POLEL I hereby affirm that I am exempt from the Contractor's License Law for ;INTERCEPTORS, CLARIFIERS IGHTS'� the following reason -(Section' 7031.5 Business- and -Prof esslo nsCode:- - SWIMMING POOL' ' PTRAP - - RUC `•' �-' Any city or county which requires a permit to construct, alter, 'POLES METERED SUB - improve, demolish or repair any'structure, prior to its issuance, also re- - _ ,PANELS - MAIN SU9 - quires the aP, Iicant for such permit to file a signed statement that he WATER SERVICE ALTERATION y Is licensed pursuant' to'the-provisions of the Contractor's License Law - AS SERVICETS SERVICE - - -AMP ' _. (Chapter 9 (commencing with Section 7000) of Division 3 of the _nn _ ;z usiness and Professions'Code)'or that'he is exempt therefrom and the WATER HEATERS ji OUTPUT ,asis for the alleged exemption. Any violation of Section 7031.5 by _ _ - ny *applicant for a^permit subjects the applicant to a'civil penalty- SEWER CONNECTIONS of not more than five hundred dollars ($500). _ r I, as owner of the —pro- pariy', or my employees withwages their SOLAR TANK COLLECTRS• t s" - sole -compensation; witLdo.t he work,.antl the structure uct ure is not .int O endetl_ - - - - _ __ or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE j•_. - Contractor's.License. Law,does. not apply -to an.owner..of a property _ _ who builds or improves thereon, and who does such work himself or ISSUE FEE - - - --1APPLICATION-APPROVED'BV DAT through, his own employees,..provided that such.! mprovements are not intendedor offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF'F.EES' - Is sold within one year.of completion, the owner will, have the.burden �._.,, _ _ ,Y _ _..- of .c..^_. of proving he did not build or improve -for the purpose of sale). r BUILDING' 0,i - -as owner of-the"property; am exclusively -contracting with HEATING SYSTEM_ 0-300,0_00 BTU- _ _ _ .PERMIT_-„-_,$ r'f"M 0'I; V SSM IP .Y- °"$ ^_- '-AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000,+ BTU 'PLAN CHECK $ PERMIT and -Professions Code: The ' Contractor's- License'' Caw does not apply to - - -- ^' ISSUANCE - an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU 'PLUMBING - $LZ�QCL7h•' tracts -from such -projects with a"contractor(s)-Iicesned- pursuant to -SYSTEM -GRADING$— the Contractor's License Law). 100,000,+ BTU PLAN CHECK ❑.l am exem6t under Sectiori' B. & P:C. for this ' - .ELECTRICAL .$ $ _+ ti BOILERS BTU _ ,-- _ - MICROFILM $ '• reason' -. - __ .. .-- _ .. - _ __ _ - rPLAN CHECK $ ` SYSTEM REPAIR,ALTERATION _.� Date - - Owner - -- --- - -- - -- -- -- -- - - - - MECHANICHL'$ - -NOTA LFEE $ -hereby. certify that 1 have read th is,appliWtion and state that the above, _EXHAUST SYSTEM MULTIPL_E - .,- ,-, .- --_= - --' LAN CAD.:�l, c •, information is correct. I agree to comply with all City antl county •PLANCHECK $ V E C., AD - ordinances and state laws relating to construction, and hereby authorize •! r, E �( representatives - f this 'city to enter upon the above mentioned - roperty, for pact ion .- _p T Signature - 0 - - - -ISSUE FEE __.. --... _ _ _ _ _ _.. _ •__ ..._ - '.-. _ ._ . . _ .. .. .... �- .. Drivers' Lite se or SS - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit e5Date Inspectors r' POOL &SPA APPROVALS Permit # •Date InWector 1. Temporary Electrical Service or Pole '43. Pool & Equipment Focation 2. Soil Pipe-Undrgrn --- 4-4. -Steel Reinforcement 3. lectrical Conduit Utility-Undrgrn 45. Forms. 4. Electrical Conduit-Undrgrn 46. - ElecthrAl.Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure -Test -'• ressure-Test- 6. 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. ElectHdalConduit-Undrgrn- 8. Foundation 50. Gas Pipe, 0 Undrgrn, Test - 9. Water Pipe-Undrgrn 51. Backwash Lines, P -Trap, ED Undrarn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash .& Receptor -Final 12. Street Sewer Connection 54.. Heater &)Vent -Final 13. -Rough Plumbing-- -� - - tmnym- Final 14. Rough Electric -Conduit -:56. -Electrical-Final - 15. Rough Electric -Wiring" 57. -Solar System -Final 16: Rough Heating & Air Conditioning. W. Fencing &jAccess Approval ,170 Ducts, in Structure 59. APPROVED'FOR PLASTERING 18. Ducts, Ventilating .60.1 -POOL/SPA SYSTEMS FINAL - 190 Gas Pipe -Rough &Test • 20; Roof Framing 21. Roof Sheathing NOTES: 22 Frame and Flashing 23: Insulation 24: Lathing & Siding 254 Drywall Nailing - 26!_ Plaster Brown Coat. 27. Electrical Power Meter -Final .28. Final Electric ,29. Final Heating & Air Conditioning 30! Final Gas -Pipe -Test, 31. FinalPlumbing 32. Water Service -Final- 33.. 'Gas Service -Final. 34. Solar Domestic -Final" i r 4, 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap RigUlations 38. FI NAL STRUCTUR E & BUI LID I NG 39. Special Requirements Completed 1 40. Electric, Release,.to Edison I F W_ .1 41. Gas Release.to Southern California Gas Co. 4 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7676 2/15/85 a,a0 % - - ' - CITY OF L`OSTA ME C� nONSSMU?TICI 'MIT Project Address — // Applicant's M1?9iling d ks H - Owner's Name r Phone / Address / PERMIT NO. TRACT NO. LOT NO. UNfIT�NO� TYPE OF CONSTRUCTION NEW ADD ALTERATION -R EPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTH DESCRIPTION OF WORK /USE OF BLDG. J A.P. # Zone S Main Building: Accessory Building: Arch/Eng. License No. Address TYPE OF PERMIT EGRADINGOtPONDATION 0 STRUCTURAL ❑ El TENANT ❑ELECTRICAL LUM BING -1 MECHANICAL THER PROJECT DESCRIPTION 5O. FT. OCGVPArvCV CONSTRU CTION' TYPE VALUATION$ ZONE GRADING CU.YDS: ACRES - E T Front Z O A Contractor's Rear N Nam �• Phone l:L.1�Jv�.� Address (mailing) !�/ q �C�'rilJ /—�i City License No.2 el722 _ 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 license is in fullf rced ffect. License 'je No. f� C Right N S Left G R Ping. Ref. # Parking Req./Provided E / Remarks: - I gb Planning Notes: M T S. sI n Date Signature PLUMBING FEES - WORK RS' OMPENSATION DEC ATION I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink - Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. �y / //�n ,�[� Policy No. %0 0/��IEO�Compan /� �'�. C ietl copy is h eby furnished. ertifie p h the city B tlIng Of O Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer 1115-50 KW ' ❑50+KW Backflow Irrigation Sewer Ca P Bathtubs ' Sewer Connection Cooking Unit Meter ❑up to 100 amps Date App I!cant EXEMP ION F OM WORKERS' CO PENSATION DECLARATION (" Clarifiers Solar Collectors Dishwasher f" - Meter El IOD amps (This se tion need not be completed if the permit is for one hundred ($100) or less). IY I certify that in'!the performance of the work for which this permit is issuetl, Dishwasher . Solar Piping Dryers ❑Gas ❑Electric - Sub Panel Drinking FountainsSolar Tank Fan ' Motors ❑0.1 HP ❑1'/x- 8 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. - Floor Drains Swimming Pool w/Spa F.A.U. - Inc. Solar 09-15 HP E]16-15+ Date Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Urinal Fixtures Microwave Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet DeVICe Boxes POI¢ Light CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Interceptors - Water Heater Outlets Range 9 Lender's Address - _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or Kitchen SinkWater Service - Switches Sign 9 Lavatories filt.., ��, Garbage Disposal Standing Sections P—Trap p Generator ❑0-5 KW ❑5-15 KW Trash Compactor P county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 70 00)of Division 3of the Business and Professions Code) or that he/She is exempt Roof Drains therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil . �nalty of not more than five hundred dollars ($500). LJ I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended Or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to An owner of a property who builds or improves thereon, and who does such work himself/herself or through his or.her own employees, provided that such imp rove marts are not intended or offered for sale. If, however, the building or improvement is sold within one year of conn- pletion, the owner will have the burden Of proving he/She did not build or im- Eve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES Y DEVELOPMENT SERVICES Zoning Approved By Building Approved By Application Issued By REQUIREMENTS: Date Date --�•--- Date t—Z'J Boiler Hood or Type I ❑ Canopy Type II ❑ Duct - Under Ground Duct-Structural Refrigeration System 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. 00-100,000 BTU ❑100,000 BTU Duct - Ventilating - SUMMARY OF FEES Exhaust System ❑ Multiple ❑ System Repair/Alteration tractor(sl license pursuant to the Contractor's License Law). I am aware that proof o// their Worker's Compensation insurance should be provided t0' me. ❑ I am exempt under Section B. & P. C. for this reason BUILDING PERMIT " PLAN CHECK PLUMBING PLAN CHECK 25% %ELECTRICAL ' PLAN CHECK 50% MECHANICAL PLAN CHECK 25% $ SMIP $ $ PERMIT $ - ISSUANCE $ $ ENERGY P.C. $ GRADING $ $ $ MICROFILM $ $ TOTAL FEE $ $ Firepl/Fact. Bit. ICBO # Date owner -I hereby certif hat I hav re this application an a that the above information is rect. I a t co y with all county ortlina rtes and state la Iatin t i in struction eby authorize repre- serum ti o his cl ter on the tionetl pro arty r inspection ses Signature Date / �-'% Drivers' License or SS Heating System & Ducting CIO 100,000 BTU ❑100;000BT Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 4/84 White - Building: Canary - Applicant; Pink - Accounting; Goldenrod - Assessor �� r f CONSTRUCTION AND PLANNING APPROVALS ' Permit# Date - Inspector POOL & SPA ... APPROVALS Permit# Date- Inspector, 1. Temporary Electrical Service or Pole ,- - 52. Pool & Equipment Location 2. oil Pipe-Undrgrnd. - 7Al�J (,�Q 53. Steel Reinforcement ' - •3. i,lectrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Uhdrgrnd. t 55.'Electrical Bonding 5.'Steel Reinforcement _ - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. Z. 74 y" - L46CD 60. Backwash_Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - 11: Property Sewer Line & House Connection /1 �' 62. Backwash &.Receptor-Final 12. Sewer Cap '' 63.'Heater&-Vent-Final 13. Roof Drains 64. Plumbing-System - Final 14. Rough Plumbing ��/� �� 65. Electrical-Final 15. Rough Electrical-Conduit - . - 66. Solar System-Final - 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure .70. Underground Hydro 22. Ducts, Ventilating ^23. 71: Product Piping 0 Gas 0 Oil Gas Pipe-Rough &Testy/�� 72.-Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 25. Roof Sheathing 74. Overhead Hydro 26.'T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing • 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD 'CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' r x7l'r � r � T/_ n F•ii 35. Final Gas Pipe-Test �� a,-r� �/-'• 36. Hood or Canopy, 37. Final Factory Fireplace _ 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final I . 41. Solar Domestic-Final - 42. Backflow Preventer ' i 43. Backflow Irrigation f. - 44. Landscape Irrigation System - 45. Sound, Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - - 50. Gas Release to Southern California Gas'Co i 51. CERTIFICATE OF OCCUPANCY No. Date _ - - .• ?� AppappropriateIOP �1 licant to'Nu'In'a rrar.=ces'excr,�jwithin heavy border lines and sign all declarations. 6379 1;24/85 - i { I " 'bITY OF COSTA MESA CONSTRUCTION PERMIT Project Adr�ess �� Z%fG /'�:%� A g �lJCi3 y�(,y� r2r//J,Ci%' Applicant's Mailing ddress, - /9 Owner's Named -2 „r7if/! L: Phone "'�3 Address PERMIT NO. TRACT NO. LOT NO. UNIT NO. TYPE OF CONSTRUCTION' NEW AOD ALTERATION - REPAIR ❑ CONVERSION -❑ DEMOLISH ❑ OTHER - DESCRIPTION OF WORK/USE OF BLDG. A.P. # - - •• Zone f' S Main Building: Accessory Building: Arch/Eng." License No. Address - ` : - TYPE OF PERMIT GRADING ❑ FOUNDATION. ElStRUCTURAL ❑ TENANT PIELECTRICAL ❑ PLUMBING ❑ MECHANICALB' ❑ OTHER - PROJECT DESCRIPTION Sri: FT. - 'OCCUPANCY - CON STRUCTION TYPE - VALUATION$ ZONE - GRADING CU.YDS. - ACRES T Front - Z p Rear - r: - N Contractor's Name—�u%f�'65+' Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION � I •hereby affirm that I am licensed under provis ns of Charter 9 (commencing with section 7000) of Division 3 of the �si ess antl Professions Cotle, antl my license is in full,force and effect. O Right _ I - - N s, _ _ Lefts ' ' ' G R _ Ping. Ref. # Park R/Provided , ngeq. r 1 � E' Remarks: I - Planning NOL¢$: I r O• M r ' _ T License Class L er ,e No. I ' S I PLUMBING _ FEES Date - Signature I - WORKERS' COMPENSATION OECLARAT,ION I hereby affirm that I have a certificate of consent to self-insure or a certificate I Bar Sink Showers ELECTRICAL - ! FEES of Workers' Compensation Insurance, or a certified copy thereof Section 1 ( r 3800, Lab. C:) ... . " _ .• __. - _ r _ "... Backflow-Preventer - - - -- Service Sink ' ., ._ - --- -- - �A ufomatic Wash-er iansfoim ,er ❑ 15-50 KW ' Backflow Irrigation Sewer Cap- t Policy No..' ' - Company eCertifietl copy is hereby furnished. ❑ 50+ KW Construction POe Sub. 1 S 1 Bathtubs Sewer Connection I i Cooking Unit Meter ❑up to,100amps, Certiflea copy Is filed with the city Building Division. ' Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100) or less). 1 certify that in the performance of the work for which this per R is issued, shall-not. employ any person in any manner so as to o ubject to the Workers' Compensati Laws of Calif or i .' { ' Clarifiers Solar Collectors - Dishwasher :Meter ❑Over 100 amps — Dishwasher Solar Piping - Dryers ❑Gas❑Electric Sub Panel' Drinking Fountains I Solar Tank - Fan Motors ❑0-1 HP ❑1 % - B 1 , Floor Drains Swimming Pool w/S a 9 P I : 1 " F.A.U. Inc. Solar ❑9-15 HP ❑16-15+ - Date' /—' �✓ Signature �% 'NOTICE: If, after making this declaration, you oultl ec to the Workers'. Compensation provisions of the Labor Cod you m s forthwith comply with. such provisions or this permit shall be dee d revoked. CONSTRUCTION LENDING AGENCY_ -- I hereby affirm that there is a construction lending agency for the, performance. f Floor Sinks ., Urinal- - - - 'Fixtures '` -Microwave Gas Service Outlets - Water Closet - Device Boxes Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Interceptors Water Heater - - Outlets Range Lender's Address " '- OWNER BUILDER DECLARATION'. - � -J: I ' -- I herebylaffirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or 1 - KitcFren'Sink' Water Service - - Switches ;Sign' Lavatories Auto-Wash - G Garbage Disposal ;Standing Sections P-Trap, - Laundry Trays Generator ❑65 KW ❑5-15 KW Trash Compactor , county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file assigned statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of . Division 3�of the Business and, Professions Code)`or=that he/she- is exempt therefrom and the basis for the alleged exemption. Any violation of Section I Roof Drains - - 1 - 7031.5 by any -applicant for a permit subjects the applicant to a. civil f5nalty of not more than five hundred dollars ($500).t 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 ' 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 Sale. If, however, the building or improvement is sold within one year-of com- plelion, the owner will have the burden of proving he/she did not build or im- prove tar the purpose of sale).. r ❑ I, as owner of the property, am exclusively contracting with licensed con- r Reinspection-Fee $15 Issue Fee r - $ 3' - Reinspection Fee $15 Issue Fee $ 3' 1 MECHANICAL FEES Boiler Hood Or Type I El Canopy Type II ❑ I _ - , DEVELOPMENT SER VICES'R EDUIREME NTS: ' 1 , Zoning Approved By Date 1 r Building ApproVed,By - Dale /� - Application Issued By ! :,y�i �' Date I Z� _ Duct - Under Ground Duct -Structural Refrigeration System ' :1 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- tract (s) license pursuant to.the Contractor's License Law). I am aware that 1 pr f o their Worker's Compensation insurance should be provided to me. I am exempt under Section B. & P. C. for this reason BTU E1100,000BTU - ^• - 1 - Duct - Ventilating❑0-100,000 , t SUMMARY OF FEES , I $ BUILDING PERMIT 1$ SMIP. PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ Exhaust System 13 Multiple 1:1 System Repair/Alteration r Firepl/Fact. Bit. ICBO # Fire Dampers Data U • caner hereby certify that I have. read t pp cat sae- the above- information is correct. I agree to comply th a c y antl co 1 ordinances and state laws relating to ilding const i d hereb a horize repre- sentatives of 'this it r upon t ove-menti property for inspection puri Signature Date Drivers' License S # Heating System & DuctingI ❑0-100,000 BTU ❑100,000 BT Registers r ENERGY P.C. $ PLAN CHECK 25% ' $ ' GRADING :$ 1 ELECTRICAL .$ l�� r O ; MICROFILM '$ PLAN CHECK 50°� '$ Z•. 57 MECHANICAL $ TOTAL FEE $ 1 • S U PLAN CHECK 25%$ r - - -- '�•- ? -'r - ' f Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ' CONSTRUCTION AND PLANNING APPROVALS Permit # Date � Inspector .POOL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - - 53. Steel Reinforcement , �'. Eledt'rical Conduit Utility-Undrgrnd. r 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ..' 6.` Electrical UFER Grnd. �, -. 57. APPROVAL TO COVER-GUNITE 7. ,Footings 58. Electrical-Conduit-Undrgrnd. N ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9: Water Pipe-Undrgrnd. . • -60. Backwash Lines, P -Trap, 0 Undrgrnd. 10': Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer;Cap .r• 63. Heater & Vent -Final - - 13. Roof Drains 64. Plumbing'Sy-stem - Final - 14. Rough Plumbing 65. Electrical -Final ' 15. Rough Electrical -Conduit" 66. Solar System -Final - 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas L) Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank OGas 0Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T -Bar Ceiling (structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. -Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating'& Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer .- 43. Backflow'lrrigation -. 44. Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING:: - - 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE-OFOCCUPANCY . No. - .. Date . CITY OF COSTA MESA BUILDING DIVISION OWNER -BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall.attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of. an owner -builder verification. Attention Property Owner: An 'owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No o building permit will be issued until this verification is received. 1 1 personally plan to provide t major labor and materials for construction of the proposed property improvement. Er Yes ❑ No C2� I (have/have-Msigned an application for a building permit for the J� proposed work. UI have contracted w th the following rson (firm) to prgvide.the proposed construction: Name 1��¢�J �/i0�/ Address City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( 1 Contractor's Lic. No 5 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and_,q93w completed the above information to the best of my personal knowledge, in5,orce w}sh-[00I' e law. Signed: Name: . or C.D.L. #or S.S. # 7545273 CMF 104246 Date: /" —Z �^ 1 Al Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ 0774 ,4/08/fl5 SD.,,� TL - CITPOF COSTA MESA O STRUCTION PERMIT PERMI NQ. TRACT NO. LOT NO. UN " ht's ailing'Address ` - Own-ei'slName .- - Phonel - 7 Address —�GT—/ TYPE OF CONSTRUCTION NEW ' ADD ALTERATION- 'REPAIR ❑ CONVERSION'❑ DEMOLISH .❑ OTHER. - •'4 DESCRIPTION OF WORK/USE OF BLDG. - - - - - - _ A.P. , 1 _ Zone „ S Main Building:- - l_ Accessory,Bmiding jC , _ t Arch/Eng; - License No Address '� I� TYPE OF PERMIT ❑ GRADING' ❑ FOUNDATION ❑❑�, OCTURAL , - El TENANT '❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL -❑'OTHER'+ �.� - _ . PROJECT DESCRIPTION, SO. FT.' OCCUPANCY T , CONSTRUCTIONYPE -VALUATIONS + ZONE - GRADING Cii 1 ;ACRE i T Front I _ O B, R¢ar, { ' - i ✓t N Contractor's Name; Phonesr69u�1' Addresslmailingl -� City License No. _ -'�% a� LICENSED CONTRACTOR DECLARATION j - Irhereby affirm that lam licensed under vi5io of Charter 9 (commencing With section 7000) of Division 3 of th B si ss nd Pro sswris Cotle, antl my license is in full f rceM effect License las CC�� Li Date Signature C Right N K $ _ .Left , - G R ( Ping. R¢f. # Par king'Req./Provided , E Remarks: I Planning;NOtes: I - - 1 M _ _ .. _ .( I PLUMBING i I FEES - i • t WORKERS' COM ENSATION DECLARATION ' hereby affirm that I have a certificate of conee to self-insure or a certificate Bar Sink r Showers - i ELECTRICAL f Workers' Compensation Insurance, or a rtifietl copy thereof (Section _ .._ .i_ _.. __. .' _ _.... aBoO, Lab. C.)' -' " ' No. Company - copy is hereby th the citCertifletl copy is filetl with the city Builtling Division. I Applicant i ` {EXEMPTION•FROM WORKERS' COMPE TION DECLARATION ._.. Backflow Preventer -1 -' -_--- Service Sink-- - --- " - _. - - - >Automatic _ - .�.-...._. - - Washer {Transformer O 15-50 KWPolicy 0 50+ KW+ Construction Pole Sub.Certified Backflow Irrigation Sewer Ca ° P - Bathtubs Sewer Connection, i kF�E Cooking Unit .3•Meter ❑up to 100 ampsDate Clarifiers Solar Collectors Dishwashet Meter ❑over 100 ampsOU - (This section need not be completed if the a it Is for one hone red ($100) or' less). i t I certify ithat in the performance of the ori for Rj a Ipperh it is issued, I shat F,not employ 9y person in any n er so s £om ubject to the Worke dlionLaws of Calif Date. �7 Signature NOTICE' If, after making this declaration, you sh ecome subject to the Workers'Compensation provisions of [he Lab de, you must forthwith._'- comply with such provisions or this perm shall be tleemed revoked. Dishwasher Solar Piping j - Dryers ❑Gas. ❑Electric Sub Panel _ 00 Drinking Fountains Solar Tank I (+; Fan. 'Motors X0-1 HP �1% - 6 Floor Drains' ' t Swimming Pool w/Spa y F.A.U. !Inc. Solar,1:19-15 HP 016-15+ FI00r Sinks __ Urinal - ---- - 'FixtUres'I --'- - - -- - - 'MidlOway¢ Gas Servic :Outlets Water Closet Device Boxes P 9ht OI¢iLi CONSTRUCTION LENDING.AG ENCY - ' I hereby affirm that there is a construction' lending agency for theperformance' Interceptors - Water Heater Outlets i Range 00 Ic of the ,work for which this permit is issuetl (Section 3097 Civ. C.) Lencer's Name Kitchen'Sink -- _ Water Service Switches Sign ' Lender's Address - - -' I `- OWNER BUILDER DECLARATION ' :' - .• I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section-7031.5 Business and Professional Code: Any city or county which requires a permit,to construct, alter, improve, demolish or repair any structure, prior to Its issuance,�also requires the applicant for such permit to file a.signed statement that he/she is licensed pursuant to.the provisions of ' the Contractor's License law (Chapter 9 (commencing with Sectiow7000) of i -livislon 3 of the Business and Professions Code) or that he/she 'isexempt Lavatories- - ' Auto-Wash - - ; Garbage Disposal Standing Sections-2 IC10 - P-Trap - Laundry Trays. - Generator 00-5 KW ❑5-15 KW 'Trash Compact or ROOf.Drains. - - ' - - - - - erefrom -and the basis for the alleged exemption. Any violation of Section 131.5 by any applicant far a. permit subjects the applicant :;to a civil enalty of not more than five hundred dollars ($500). i rr.. +IJ I,' as owner of; the, property or my _employees.with wages, as their sole compensation, Will do the work, and the structure is not intended or offered for sale (Section ;7044, Business and Professional Cotle:. 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 - sale. If, however, the building or improvement Is'sold within one year of Com- pletion, the owner; will 'have ithe burden of proving he/she Gid not build or Ion prove,tor the purpose of sale). ,- ❑.I, as 'owner of the property, am exclusively contractingwith licensed con- tractors to construct the project (Section 7044, Business and Professions Code: i The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with a con- ' ' - . 'Reins Mion Fee ': Pe � , $16 Issue Fee' - - $'3 Reinspection Fee $15 lluue Fee $ 3 MECHANICAL ' FEES DEVELOPMENT SERVICES REQUIREMENTS:' j Zorsing Approved By Date t Building Approved By Date { Application Issued By Dat Boiler- - Hood or Type I ' ❑ Canopy Type 11, ❑ i - I - , Duct -'Under Ground I Duct -Structural 2 I i Refrigeration System I >•. ❑0-100,000 BTU ❑100,_000 BT.0 - - -- , _ Duct - Ventilating _' SUMMARY OF FEES _ Exhaust System ❑ Multiple ❑ - System Repair/Alteration i- _who tractor(s1 license pursuanttothe C -tractor's License Law). I am aware that proof o their Worker's Compens io insurance should be provided tome. ff I'am exempt untler Section B. & P. C. for this reason BUILDING PERMIT $ ! SMIP $ { _ PLAN CHECK $ PERMIT PLUMBING- i $ ISSUANCE $ ENERGY P.C. $ PLAN CHECK 25% $❑0.100,000 IIinformatione i ELECTRICAL $ ' i� 0� GRADING $ r CHECK50% $ -Z7• SO MICROFILM $inspection MECHANICAL I IS TOTAL FEE '$ s•�Jd i PLAN CHECK 25% $ pl/Fact. FireBIL ICBO # 1 Fire Dampers' Ow Date%that ' I hereby Ce r _this' a plication and state that the above- mplyith all city. antl county ordinances and estate la'I conit uction, and hereby author-.¢ omre- - sentatives oe o the aboe-mentioned ropert or p Signature Date , Drivers' License or SS Heating System & Ducting BTU ❑100,000BT Registers 1 iPLAN i I ' Reinspectign Fee f $15 Issue Fee FF1 CMF 0865-46, rev. 10/84 White - Bui tling; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1* 'VSTRUCTION AND PLANNING 'Date f OVALS Permit # - Inspector ; POC SPA APPROVALS Permit # Date Inspector 1. emporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - 3. Electrical Conduit. Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit-UnBrgrnd.' c - - 55. Electrical Bonding --- 5: ,Steel.Reinforcement ' 56. Rough -Plumbing & Pressure Test 6: ElectricalUFER-Grnd.. 57. APPROVAL TO COVER-GUNITE . 7Footing$- ,- - 58. Electrical Conduit-Undrgrnd. ' 8:^Foundation "-''+ �- : 59. Gas Pipe, O Undrgrnd., Test,. 9. Water Pipe-Undrgrrid. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System •%', - �." 61. APPROVAL TO DECK - 1.1. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap;'. - - 63. Heater &Vent -Final 13. Roof Drains ;.•� 64. Plumbing System -Final 14. Rough Plumbing;, 65. Electrical -Final = - 15. Rough Electrical -Conduit 66. Solar System -Final - - 16. Rough Electric Wiring yf (b eiCf 67. Fencing & Access Approval -, 17. Rough Wiring Sign - ' 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit =h6- 20. Rough Factory Fireplace 21. Ducts, in Structure 21. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping El Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas. ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final. Heating & Air Conditioning'1 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service,Final 41. Solar Domestic -Final 42! Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations - 47. FINALSTRUCTURE & BUILDING 48. Special Requirements Completed - 49. Electric Release to Edison �.. ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE-OF.000UPANCY Nz - Date CITY OF COSTA MESA BUILDING DIVISION OWNER -BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner -builder verification. Attention Property Owner: An 'owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. ❑ Yes ❑ No 2. 1 (have/ds l) ifJ C- signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone ( ) Contractor's Lic. No. -4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( i Contractor's Lic. No 5 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and�ha�e completed the above information to the best of my personal knowledgg ompJjance wjm cq�1ee law. Name: (Printed� or Typed) C.D.L. #or S.S. * `� / J CMF 1042-46 7545273 rn Date: '*4 ::- —O � 1,. \0 THESE PLANS MUST BE Otl JOB All ALL +THE ICSUA.NCE OR GRANTING OF A PERMIT OR APPROVAL CF FLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO EE A FERVIT FOR, OR AN APPROIWL CF, ANY VIOtAiION CF ANY CF THE FRCVIS'CNS OF THIS CODE. NO PERMIT PRE - SLIMING, TO CIVE AUTHORITY TO VIOLATE OR CANCEL THE PROV _IONS CF THIS CODE SHALL BE VALID, EXCEPT IN SO FAR AS THE WLLRK OR USE WHICH ITAUTHORIZLS IS LAWFUL. THE ISSUANCE CF A FERVIT BASED UPC`! PLANS AND SPECISCATIONS SHALL NOT PREVENT THE FUILDI.NS OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION CF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM .PREVENTING WILDING OPERATIONS BEING CARRIEOON THEREUNDER WHEN IN VIOLATION OE IRIS OWE OR OF ANY OTHER ORDLNAm f: f9 la m �- HEATING, Vi REFR! i:'`'` IRf RE,QiIlR�7 C - �" r=_ , ..•.� THIS N"FL Ai - EM� ��'BE 'CONSULTED FU{t1 ,Y„JiiiU'!n: ' fjCUUTAEMEPd75. 7 �o I I J�e W";,' ')' E'N Oil u,+c-i �,.li'T'f -•n4•. rLay 5 x % ��'�ryi I I k r` 1 I c F - -57- ?.9 .✓ �1a�2 �: G .,p?o.vC. Bloc /O,O'� G C. 1`'444, � _ ') ✓013 ��?�o G��G / el s i;.._-.... 7-YoOl TURAL�. I City of Costa Mesa 8uilding.Depf. SEPARATE PERI \0 THESE PLANS MUST BE Otl JOB All ALL +THE ICSUA.NCE OR GRANTING OF A PERMIT OR APPROVAL CF FLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO EE A FERVIT FOR, OR AN APPROIWL CF, ANY VIOtAiION CF ANY CF THE FRCVIS'CNS OF THIS CODE. NO PERMIT PRE - SLIMING, TO CIVE AUTHORITY TO VIOLATE OR CANCEL THE PROV _IONS CF THIS CODE SHALL BE VALID, EXCEPT IN SO FAR AS THE WLLRK OR USE WHICH ITAUTHORIZLS IS LAWFUL. THE ISSUANCE CF A FERVIT BASED UPC`! PLANS AND SPECISCATIONS SHALL NOT PREVENT THE FUILDI.NS OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION CF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM .PREVENTING WILDING OPERATIONS BEING CARRIEOON THEREUNDER WHEN IN VIOLATION OE IRIS OWE OR OF ANY OTHER ORDLNAm f: f9 la m �- HEATING, Vi REFR! i:'`'` IRf RE,QiIlR�7 C - �" r=_ , ..•.� THIS N"FL Ai - EM� ��'BE 'CONSULTED FU{t1 ,Y„JiiiU'!n: ' fjCUUTAEMEPd75. 7 �o I I J�e W";,' ')' E'N Oil u,+c-i �,.li'T'f -•n4•. rLay 5 x % ��'�ryi I I k r` 1 I c F - -57- ?.9 .✓ �1a�2 �: G .,p?o.vC. Bloc /O,O'� G C. 1`'444, � _ ') ✓013 ��?�o G��G / O N 4004: 1 xi R7 jr , 41 J co TYPICAL. 611 CONCRETE BLOCK FENCE Cement Coping Optional Channel Block With 1.3/8 Horizontal Top of all Fences For Fences 5' or Leu Vert. Ban 3/8" IS at 4' -0" O.C. For Fences Higher Than 5' Vert. Bars 3/8"0 at 32" O.C. Fill Cells Solid With Grout Where Steel Occurs Reinforcing Steel Shall Conform to Sec.A•15-39 A.S.T.M. All Steel to be Lapped 24" or to Code NATURALGRADE TWO 3/8-0 BARS n CONTINUOUS TOP . & BOTTOM e 110CM7-STEEL MUST BE TIED IN t PLACE AT TIME OF TRENCH INSPECTION. p' x u W x U —W'IOTP SEE CHI BELOW FOOTING REQUIREMENTS CHART GENERAL-- NOTES MORTAR: One Part Plastic Cement, and Three Parts Sand GROUT: One Part Cement Three and One Half Parts Srond COPING: One Part Cement, Three Parts Sand CONCRETE: Well Mixed 1:2-1/2:3-1/2 Max. of 7-1/2 Gallons of Wafer Per Sack of Cement GROUT MAY BE POURED FROM THE TOP OF THE FENCE IN CELLS WHERE STEEL OCCURS. CELLS AND AREAS OF HORIZONTAL REIN- FORCEMENT SHALL BE CLEAR, CLEAN & FREE OF ALL MORTAR DEBRIS, ETC. 'H OF EARTHTCOTH I/3 THE HEIGTH OF FENCE MOW BOTTOM OF FOOTING. SCALE: 1/2"= 1' WALL HEIGHT 6 5 - 4' 3 WIDTH . . . . . . . . . . . ..14" . . . . . . . . . . .14`. . . . . . . . . 12" 12� ' THICKNESS . . . . . . . . . ..10".. . . . .. . . .. .10" . . . . . . . ' . _ . 8". e" DEPTH OF EARTHTOOTH .. . 24" . . . . . . . . . . .20" . . . . .. . . . . . 16" . . . . . . . . : 12" SPACING OF EARTHTOOTH. . 12' .14' . . . . . . 16'. . .. . . 16' Cit of Costa Mesa California OWNERS NAME: _ _, JOB ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ _ _ _ Y 7 Building Department PERMIT NUMBER:_ SIGNATURE: _ _ I _ ^ STREET A CITY OF COSTA MESA BUILDING DIVISION RETAINING WALLS I GRADE OX BARS 1 CONCRETE MASONRYI I 1 WALL - ALL CELLS K 2 43 BARS— ." x CONCRETE MASONRY D FIRST COURSE AT t WALLA LL CELLS 32" O.C. FOR WEEP HOLE #I ' FILLED SO LID •.� I WITH GROUT GRADE OMIT HEAD 271114� T. I JOINT IN FIRST _ COURSE AT 32'• 1 t C.C. FOR WEEP UNDISTURBED - HOLE NATURALSOIL TYPICAL SECTION 3'-0•' MAX. 2 - GF 2 y4 BARS 1 ^�— • CONT. _J POUR FOOTING i� AGA:NST NST UNDISTURBED Ce NATURAL SOIL TYPICAL SECTION T-0" MAX GRADE ® BARS tO � c 2 *1 BARS 1 CONCRETE MASONRYI X: < WALL - ALL CELLS b". FILLED SOLIU o: WITH GROUT -II � OMIT HEAD JOINT IN I Nni D FIRST COURSE AT t 32" O.C. FOR WEEP HOLE #I 2. I GRADE ,•� 271114� T. I _ POUR FOOTING ,BI AGAINST UNDISTURBED - NATURALSOIL TYPICAL SECTION 3'-0•' MAX. 0 tO 1 Q I O BARS I Q BARS I MBARS I— b". t••—tn••I V3.-t24--o-C-1 •78t4e•'o.c. NOT ES: 1. Retaining wall shall be grouted solid. 2. Reinforcing splices in masonry shall be lapped not less than 15", in concrete not less than 12". 3. Omit mortar at head joints of first course at 32" O.C. 1. Mortar shall be no leaner than 3 to 1. - 5. Inspection required prior to grouting cells. 6. A 4" block fence with pilasters may be constructed on top of the retaining wall for an overall height of 42" high on the sidewalk side. SPECIFICATIONS: CONCRETE: 2000 psi at 28 days. BLOCK: Type "A" A.S.T.M. C-90 or C-145. REINFORCING: Grade 40 A.S.T.M. A615 or A617. t ... . fi 'alI spaces except rhos within heavy. border lines and sign all appropriate declarations. ) �( vItSH 'CONSTRUCTION 'PER MIT `cRMIT NO. TACT NO. • / LOT NO. I UNIT NO: I I I [4/ I/(jS I Q:1. '{.,� Add{ess pphcant's MalhngAddress-� TYPE OF CONSTRUCTION NEW _ DD - ALTERATION REPAIR - _ ,/ !-`- sY.,e -❑ CONVERSION .0 DEMOLISH OTH R 'Dl%TR11/Q1 IJG- tiI�TLL' —'— A.P: # Zone' ''� ' Owner's Name i / }//� j % -DESCRIPTION OF WORK/USE OF. BLDG. �� V '-�� •— � S Main B ilding:,.r _ - Accessory Building: ' /-•..C/F�st/ �o r�C----`_! -/ice/ Address 3 i CQj - '. - � _ 1 Arch-/Eng.License NO. TYPE OF PERMIT ❑ GRADING: -FOUNDATION ^ STRUCTURAL - T Front 1 101 - 0 Address' �� ! ❑ TENANT ❑ ELECTRICAL 'PLUMBING ❑ MECHANICAL B _ Rear_ j1 N - '-❑ OTHER. Contractor's Name Phone- - - = C Right _ �yU I _ N ` Address (mailing) - '�- PROJECT DESCRIPTION, SQ. FT. '- CONSTRUCTION TYPE_ }a"�� - OCCUPANCY .VALUATION $ Ci K S Left - n -- Y `• _ y•_ - G =- I I R Ci ty'Lic¢nsa No ZONE GRADING CU. YDS. ACRES Pln Ref.# 9' r Parkin R2 /Provided g g - E LICENSED CONTRACTOR DECLARATION O I hereby; affirm that I am licensed under provisions of.Charter 9 (commencing i Remarks: - - Bla hning Not¢$: /�, ��/b,1 • ,. 1 ms's ` - .. M with section 7000) of Division'3 of the Business and Professions Code, antl - my license�is in full force and effect. . - ) r ! I 1 ! T License Class L-i cense No. i o Date Signatture _ PLUMBING FEES (, I i ,u ; WORKERS' COMPENSATION'DEC LA RATIONBar hereby affirm that I have a cyrtificate of consent to self-insure or a certificate Sink " Showers - t i ELECTRICAL FEES _ of Workers' Compensation Insurance„ or a certified copy_ thereof (Section_. - - _ 3800, Lab.-C.)- gackflOw Preventer - -• - S¢iV ice Sink' - _ - l I '-'-- — ' - -Automatic Washei -"' - 'Transformer ❑ 15-50 KW 1 I Policy No. ) ' ComPan v, Backflow Irrigation Sewer Ca p Construction Pale Sub. ❑ 50+:KW eCertified copy is hereby furnished. I .- Certified copy is filed with the city BuIldin9 DiNislo.. Bathtubs Sewer Connectioni 1 Cooking Unit Meter ❑up to 100'amp5 Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ Clarifiers i Solar Collectors _ Dishwasher .V ❑bust 100 amps,. (This section need not be completed if the permit Js for one hundred ($100 or less). ) yin Dishwasher Solar Piping f Dryers ❑Gas ❑Electric Sub Panel . I certify that the performance of the work tor'whlch this rmi issued, I�•� I a shall; nN-employ any person in any -nn o bec sect to the Drinking Fountains Solar Tank i Fan - Motors ❑O-1 HP ❑1,% 8 - Work s' mqe atiol s of Cal r - - Dat- / Signatu 'N Floor Drains. Swimming Pool w/Spa F.A,U. Inc. Sola 109-15 HP ❑16-15+ ICE: If, after making this declarat ,you sho I econ a subject he . • - - W rkers' Compensation, provisions of the Labor Code, you must f t with comply-,with"'such provisions or this permit shall be r oked.- Floor Sinks - - --Urinal - -1` ` - Fixtures - - - --- (- Microwave ,tleemed CONSTRUCTION LENDING AGENCY . I hereby affirm that there is a construction lending agency for the Gas Service Outlets, Water Closet - ' Device Boxes.i - �' `. Pole'Li ht ' 9 performance. of the work for which, this permit i5 issued (Section 3097 Civ. CJ - -Lender's, Interceptors Water.Heater - i - - Outlets -, - Range r r Name'' _ _ _ -� F Lender's Aydress - - - - Kitchen Sink Water Service Switches Sign F' ' OWNER BUILDER DECLARATION - -•' ,e" hereby affirm that 1 amexempt from the -Can tractor's'License Law for the Lavatories 'Auto-Wash Garbo a Dis oral' 9 P y ' Standin Sections following reason (Section'•7031.5 Business and' Professional Code: Any city or county which requires a permiLto construct, alter, improve, demolish or repair the'applicant for P-Trap• - , •' - ' 'Laundry Trays ' Generator ❑O5 KW Q5-15 KW Trash Compactor any structure, prior to its issuance, also requires such permit rto file a'signed Statement that he/she is licensed pursuant to the provisions of ' ROOf Dfains' r' _ - - 'the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'or _ •_�''• - ' Division 3' of the Business and Professions Code) that he/she' is exempt 'therefrom and the basis for the alleged exemption. Any violation-of Section -to t, _ - 1 f `' { ;,• 17031.5 by any applicant for a permit subjects the'applicant a civil I - Penalty of not more than five hundred dollars ($500). : ' ❑ I,-as owner of they property or-my em plOyeeS with wages as their sole .R¢insp¢CtiOn :Fee ' $15' Issue Fee _ $ 3 ompensation, will do the work, and the structure is not intended or offered Re_inspedion Fee ?x$15. issue Fee • ✓~ $ 3 Ir sale, (Section 7044, Business and, Professional Code: The Contractor's - I I MECHANICAL FEE$ icense Low 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 - - '� Hood 1 ❑ DEV E�iOPMENT'SERVI ES REO ��t111 I E NTS: ` employees, rovided that such improvements are not intended or offered for P Boiler Or, Type I Zoni A roved'B 2— r79 pproved y r '—Date sato. If, ho eq the build lug or Improvement is sold within one year. of con- he/she did build im- - Duct Under Ground ' Canopy Type ❑ �. pterion a owner w111'have'the burden of proving not or - - Building Approved By ( Date LO or the purpose of Sale). I, as owner of the property, am exclusively contracting with licensed con- Duct - Structural Refrigeration System - , Application IssuedlBy_' - 'r %, Date 4 7Z 8� tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who - Duct - Ventilating 7 ❑0-100,000 BTU ❑100,000 BTU !SU' - MARV OF FEES T r builds or improves thereon, and who contracts for such projects with a con- tractors) license ;Contractor's License I that I -" -- - - • - - - r a . ' BUILDING PERMIT`1 $'. / 2 • O I �/ pursuant to the Law). am aware Exhaust System ❑ Multiple ❑' System Repair/Alteration - •� - r :,$MIP $';"I o "' proof off their Worker's Compensation insurance should be provided to me., ❑ Nam B. P, f is - I Firepl/Fact. y PLAN%CHECK '•-$=':4D.co PERMIT: •` I - exempt under Section & C. reason ' Bit. ICBO # Fire Dampers ! - iPLUMBING� .'' $'� - - - I - 'I f:,ISSUANbE $ i Date Owner _ - Heating System & Ducting ' Registers - f - PLAN 25%=`$'i _ -- /ENERGY—P.C. $.,. 1 hereby. certify that I have'read his applicatio and Sta that th bove • information ❑0100,000 BTU,E]iwo00 BT - ` - -- `Y - ELECTRICAL' $;_ Y r., r.. ' .'GRADING $: is correct. 1 agree to comply with all city and ounty o ances 'and.state laws relatin to building c nstr Syon, and hereby author repre- ! - - PLAN CHECK 50% $ ) '' (•' -MICROFILM $..' sentatives of .this o enter. a above-mentioned property for inspection pp i j , ! •'rjOy Signature �l-�S' MECHANICAL$: FEE $t / . Date Drivers' [CWS;or SS j Reinspection Fee $15 Issue Fee $.;3 PLAN CHECK 25% $ . `^TOTAL CMF 0865-46, rev. 10/84 - Accounting; Goltlenrotl - Assessor I " ION AND PLANNING Permit # lectrical Service or Pole rSoil Date Inspector POOL & SF. APPROVALS Permit # 52. Pool & Equipment Location Date Inspector drgrnd. 53. Steel Reinforcement nduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement- > 56. Rough Plumbing &Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings �. �(( ITIS 58. Electrical Conduit-Undrgrnd- ' 8. Foundation _ L 9 - 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. (.10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - - 62. Backwash &Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 4. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 3. Gas Pipe -Rough & Test 72. Underground Flush T:12. 4. Roof Framing 73. Undergrnd. Storage Tank ❑Gas ❑Oil 5. Roof Sheathing 74. Overhead Hydro 6. T -Bar Ceiling (Structural) &-Monocoat 75. Dry Chemical - /1 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding .- 77. FIXED SYSTEM FINAL 29. Insulation• 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown Coat 79, FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood Hood or Canopy 37. Final Factory Fireplace �-- 38. Final Plumbing L 39. Water Service -Final C'/_ _ 22_ 40. Gas Service -Final 41. Solar Domestic -Final -` o 42.• Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System ' 7 45. Sound Attenuation ' �J 46. Handicap Regulations SS 47. FINAL STRUCTURE & BUILDING 8' 48. Special Requirements Completed 49. Electric Release to Edison mk T' 50. Gas Release to Southern California Gas Co C- 3 8;r' # I Q'K P[tYpr 'A= ,�•��.. 51_�CERTIFICATE OF OCCUPANCY Nn. - Date