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Home My WebLink About2767 DESOTO AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��s MBING PERMIT 77 FAIR DAIVE, COSTA MESA, CA 92626 Job Address: 2767 DESOTO AV Suite No Vicinily: GARAGE Parcel Nunmber: 14164202 Applicant NOCK, CANDY Address: 11612 KNOTT ST SUITE 217 GARDEN GROVE,�CA Owner: CAMPBELL, JAMES T Address 2767 DE SOTO AVE - ` COSTA MESA, CA;: - �� Phone: (714) 895-1246 Zip: 92841 Phone: Zip: 92626 Coniractor. NOCK PLUMBING Address: 11612 KNOiT ST SUITE 217 Phone: (714) 895-1246 GARDEN GROVE, CA Zip: 92841 � -� �� License: 7W775 SCOPE OF PERMIT � WATER HEATER CHANGE-OUT IN AN EXISTING SFD. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. ISSUE FEE Backflow irrigafion Backtlow Preventer Bathtub Claritier System Cbnnecl (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valva Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service fnterceptors (Grease, OII} Interceptors (Sand Auto ) AMT 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $D.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 QN 0 0 0` 0 0 0 0 0 0 0 0 0 0, 0 0 0 0 0 0 FEE SUMMARY AMT LaundryTub/Washer $0.00 Landscape Irrigation $0.00 P-Trap - $0.00 �.,PressureRegulator $0.00� Process Piping (per 10 ft) . $0.00 Receptors $0.00 SepticTank $0.00 SewerCapforDemo $0.00 Sewer Connecl - $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar - 50.00 Sink, commercial . $0.00 � Sink, Floor . , $0.00 � • :Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) 50.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ISSUED BY: Slatus: ISSUED Applied: 10/26/2005 Issued: 10/26/2005 ' A SumpPump , Swimming Pool ' . Trap Primer � Urinal . VacuumBrlirBkflow(1-4) Vacuum Brkr Bkflow(5+) . Wash Basin Wash Basin Set � � Waste and>Uent System WaterCloset(Toilel)` � Water Healer / vent Water Piping (Inst or Rep.) Water Re-pipe `� Water Service Waler Softener � OTHER VIOLATION PLAN CHECK �- REINSPECTION AMT QTY $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 SOAO � 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $12.30 1 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 0 - . TOTAL CALCULATED FEES: 535.80 - COMMENTS / SPECIAL CONDITIONS NO710E: 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 becane void if work is not commenced within 780 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inepeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of lhis permit. FOR INSPECTIONS CALL: (714) 7545626 2aas-ae (eiool WORKERS' COMPENSATION DECLARA710N: I hereDy ettirm under penelty oi perjury one of the following declara�ions: ❑ I heve end will maintain a cehificete ot consent to self-Insure for workers' compensation, as provided tor by sec�ion 3700 ot the Lebor CoOe, for the peMortnance of tha work lOr which thi5 permil is issued. �Mave end will maintain worKers' cnmpensation insurance, as req ired by section 3700 ot the Lahor Code, for ihe perfortnance of Ihe woAc for which this pertnit is issued. My wor sI m g/��s �tion„\In ura\nce ca[}�rier19/�'d� lic{y� �ynyyypbler YIere: � CeMer: 7� I��F'��„L�Y�I �'� 11 I1 Lq_ �__� P�dityNumtigr: ��,K�.G� (This�section nee�' nof b�com�(ad i! the OermR is valued at one hLntlred dollars ($100) or less.) L./` ❑ I certify Ihat in t�e peAormance of the work for which Ihis pertnit is issued, I shall not employ any person in any manner so as to become suDject to Ihe workers' compensation laws of Celifomia, end agrea thet it I should become subject to the workers' compensation provisions o� Section 3700 ot the Labor Code, I shall Fodhwith ��omply�with Ihese pmvisiong� jyI ApPlicenl-Signature�� -5� ✓ �'-� Date'i 1 � I "I )1 � WAqNINO: FAILURE SF9 ECURE WORKERS' iMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYE O CRIMINAL PENALTIES AND qVIL FINES UP TOONE HUNDPED hqU$ANO WLLARE (3100.000), IN APDfT10N TO THE C0.ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3�O60F THE IABOR CODE, INiEflEST, ANp ATTORNEI"$ FEES. LICENSED CONTRACTORS DECLARATION: I hereb aHirtn that I am lice%� e isions of Cha ter 9 commencin with Section 7000 of Division 3 of ihe force antl ettect L1� I�� P 9___ ) fCtass Catle, end my license is in full CONSTRUCTION LENDING AGENCV: ❑ I hereby attirtn ihat ihere is a conswction lending agency for iha pertormanca of iha work for which this pertnit is issoed. (Sec. 3097, Civil Code). Landers Name: Signature�. _ OWNER-BUILDER DECLARA710NS: Lenders Adtlress: Date. I hereby elfirtn ihat under penalry of periury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires e permit m construct, alter, improve, tlemolish, or repair any stmcWre, prior to its issuance, elso requires the epplicaN for such permit to file a signed stetement that he or she Is licensed pursuent to the provisions of the Coniractors License Law (Chepter 9(cammencing wiih Sectlon 7000) of Divislon 3 of Iha Business and Professions Cotle) or that he.or sfie, is exempt therefrom and the besis for the allegad exemption. Any violation of Section 7031.5 by any applicant for a permit subjecis the applicant to a civil penalry ot not more�han five hundred dollars ($500).): .4�4 � I, as awner af the property,.Or my employees wlih weges as Iheir sole compensation, WILL DO THE WORK, and ihe struc�ure is not intenaed or oHeretl for sale (Sec. 7044, Business an0 Froiessions Code: �The Cohiractors License Lew does not apply �o an owner of property who builds or improves ihereon, end who tloes such work himself or heiself optivough hls or her own employees, provitled ihat such improvements ere not Intended or oHereC 1or sale. If, however, Ihe builtling or improvement is sold within one year ol co,mpletion, the bwner-builder will have the burden of proving that he or she did not build or improve tor purpose ot sele.). � ❑ I, a5 ownef o�the prOpeity; Am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS b consiruct the pmject (Sec. 7044, Business and Profes5ions Cotle: The cqntrecrors 17cense Law does not apply to an owner ol property who builtls or impmves thereon, and who wNrects for such project with a contractor(s) '� license pursuant to the Contractore License Laws.). ��,$�m(gzempt undar sec. __ Business antl Professions Code tor ihis reason: _ Date: Owner ID verified by dnvefs license. ❑ Yes ❑ No Driver's License No. Expires: Venfication of Ownership by (rypa o� document, i.a. - property tax biil or tleetl): DIVISION OF INDUSTRIAL SAFff'rY PERMIT CER7IFICATION: ❑ I hereby certify thet no excaVation five (5) or more feet in depth into which a person is requiretl to descend, will be made in connection with work euthonzed by this permit, and that no 6uilding S�NcWre, sca8olding, falsework, or demoli�ion or tlismantling ihereof, will be more Ihan thirty-six (36) teet high. (Chap. 32, Gry 2, Ar12, Sec. 341, Ttle B, Califomia Atlministralive Code). ❑ As owner-builder, I will not employ anyone to do work which would raquire a permit from the �ivision of Intlustriel Sefety, es noted ebove, unless such person has e permit to tlo such work from the division. Signature: Date: Division of Intlusirial Safery Permil Number. CERTFlCATE OF COMPLIANCE AND AUTHORVA710N OF EMRV: I cenify under penalry of perjury that I have reaa thi5 applica�ion and state thai the infortnation given is correct I egree to comply with all state laws end city ordinances rela�ing to building construcUon, end authorize representatives ot the Ciry ot Costa Mesa to emer upon the ebove-descnbed property for inspection purposes. I egree not to occupy or allow occupancy of any building authorized by this permit until fnal inspection. CODEs, INSPECTION7YPE BeI& INTRIALS 1616 Fixed System Final Fire P�even�ion 1266 200 201 202 203 Pool Spa Final Finel RB-Roof Final BIocWRataining W all Final Factory Fire Place Final Sign 204 Final Demoliiion COpE I INSPEGTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finaleuilding/Occupancy Dp� I[�7JA4S L-2-o � �DOPESS OF BUItqNG: L/ b/ ll ES V 1 V A V oxr�exsrw�eiFa+wm: CAMPi"iELL. JM1t.5 'i' ADDRESS "l76'i 0�: SUTU AVE CIJS"lA MtSA,i:A AVFL. YAIIINfi AODNE55: NCNRECT OR EHIiNHIi: YKH ON ENO.'S ADUPES9: uxr: \ �lbL4 �� ` ua no: UNf: COMNACTORSWII�: NOCK FLuMb1NG (714)895-I[4o carm�cronswuuuc 11b12 RNUTT :�'! .noxEss l�A�if1EN GR(iVE CA uGw.: 707775 �za�i �N,: i i LICENSED CONfXACTONS OEClAP1TI0N: I hereby eflvm under panely d perjury NPo I em licemed uMx prwieima N Chapar 9 (mmmeridip wilh Sxtion ]000) of Diviaion 3 d Ihe Buaineas aM Pmleaeims COEe, eM my lieense o in /ull lace eeM oHeq. c uc.r,o.:O5G3&" uacuss: C-3o uc.No.: 7G�%,(75 r.'liP: G'L%5& �B' �iM115dIX: G��\LJ ��'J - OW R BUILDER OECUR4TION: I haeby effirm uMx perely d pmj�ry ihm I un examq hwn the Cam�aeas L'xneee law la Ne •T�9 �eeaon (Sedion )O�t.5 &niese vM Prolavsiore Coda: AnYW a ouuny wh'vA mQu'vaa e 0�!�! lo mmhud. eller. impo.e. dah, a repei vry sl'uetum. pia to ea oeueMe. eko reQuim Ihe epplimnt la vueh paemd to fib a epmd slmmwnt Mm M a eha IicemeE W rs�� o Ihe paisian d iM COMredas Liceme lew �Gheqar 9(commend�p xi�h Sedion ]000) d Divebn 3 d �he Jusinem end Prdaseiona Code� v ihet M m ehe ia enemq �heralmm eM ihe beare for the dbped exemqun. My vulmion d Seeion �)0]1.5 by eny ap0liranl for e permil vuDjeaa �ha epplicenl to e rnil penaly d iat moro Ihen fNe h�ibnE Edlen �5500�). � I, es ovmar of Ihe Oropeny or my ampbyees KRh weges m Ihe'v eob mmpanulbn, will tlo Na vroM, eM IM elrw.Mure e nd inteMetl a oMerad lor nele (Seeipn ]OId. Buwiwea end Prolasnur�a Codo: The Conlreeion Lieensa lew doee ew eppyto en owMr W popeily �' wM WJEs a vnproves Ihereon, end who Aoee such work Hmsell a Mnep ar Ihrwph hb ar her own employeee. povideE IIW wch impeovamenU era nd inlerMed w dlereE far sele. tl, lrowever, �ha buiki�p a'vnprovemenl ie saltl xilhin aw yeer d mmpbtion. the owror-buiNer xill heve the buken d proviiq M a sha d'M � Wik a imparo for tM WN�e d aeb�. � I, m ox�r d IM poparry, am utliavety contreeiq vmh licemed wmrecipe b consmxf Me popd (Sequn "lOU. Bue'vwa erd Vmleasians Coae: Tha Coniemae lieenee Lew dree ew� epply b en owror d p�openy who buitle a'vnpwr thxaan eM xfio wnvecta lar ax3� p�qee� wiN e wureuor�a) IcemeE WnueM lo iM Contreriora licwa lawl. � I em eaemq uMx Section: 8. d P.C., far thia reaeon: Dma: Ounx I Eo nereby cenity thet I em awere d arM urdsaiend the requiremams W CelAomie FVmhh enA Salety Cada Sedam 25.5D5. 2553�. eM us�s, e�a ind i a e�r nn�,a n��bmu �uoem �n i.ai �m la,�b �) �d m�maN .in ..�a n�a Wde. �d ine ba��remam. ro, e parmn IormnawciionormadRfation Fan ihaA'v�apament Oialnd. ReeiJentiel conMrudion eppYmtianeerevamW Imm theae oroviaiona. o�<: nnd�: WORKEN'SCOMPENSATONOECLAH�TION:IhxebyaffiemuMxpmuAydprjuyardNefdbwiiqdedWoro: ', � 1 hm eM Mil meinten e cenlwe d oomen� io aeMimuro for xpken' oompensq'vn. n prwided la by Seticn 3)00 of tM leba � coe.. i« ue c«i�a a ma �.o�x i« w:�n mm w� n�.�e. �] I hera enE wil meinten xvhse' mmpanevion ireureze. m npuireE Ey Sedim 9100 d Ne Lebor COEs. M IM pMamvKs d tM .axm,�.�n�mmva�n�».�e.Mr•�•VV�'UU��Y.A��°"��'m'""•. EXPIKES c�«: Golky Number: u J j� 1� 9 a ��is sedion neeE irot 6e rompleME! fhe perml ie bi one hundreJ EWlers (S100j w baeJ � I cently �het in iM pertormence d Ihe wak la vfich thia permG ia ivuad, I ehall � ampby e�ry paiwn In eny men�r eo n to /Gibme wbleM to the workera' rompenaelion lewe d CelHomie. en�egree Ihet il I ehp�d benome a0jed to tM woeke�e' Wamin : F�INn ro secun woAren'roniporustlon co✓emps li �Narlul, �ntl�lvll W!/sct an7lnpJbysr ro piMrW prultlu uM cnn up ro ax nu�area moua.m edrn (S�ao.000A �n ew�wn ro m. cwr o� mmoslwrnn d+m.w. u provxkd ro• In on 9)OS o/ ths Le6or Cods, Inf»�t, end ettomey i/ea. CONSTqUCTION LENDINO AOENC�: I Mroby elfirtn uMn penely d par'ryry ihel IMre u e consVudion bMi�q aparcy for the pOf�qTLlt! O� ��1G 1Wi�{ �Of W�1IC�11h6 VB�� 1f 69YBd ($B'ylJll :N3�/. CiM, ri�. LENOEfl'S NANE: � LENDER'S RDDPES4: I ceniy Ihe1 I have reaE Nis epplcmion eM mete ihel ihe above iniwmelion ia m'retl. I eprea lo campy xilh ell dly aM mumy wdirerimn aM eiete levn rele�ig ta buildvp conavupbn eM hereby eWhoriza repreeen�mivea M thia cry �a emer upon tM ebove�meMioneE p�ope�ly iw impearon pmpmes. :. �r. :.t. :i v oma: l � I i (5t51�48.WP) White-BuilEip85efaiy;Greer�-FleZenery-Appliram;Rnk-Revanue;Goldenmd-Naeamr CITY oF i;iis'rA Mr_�A - BiT.ii�D:iNG e�F;RM.f•f PERMI7 NU: P V851"/9 YLAN CHECK Nil: N CGNSIftUCTIGN TYYE: V-N PERMiI TYYE: rLU JUb DESCR3PTiUN : Wtaitk HtHTER CIiHNi,E GU'f rtRM N�; e u85:t"i' GOV'I: N SOrr: N PUiieUSr:: U`IH su rr: CLAIM JAL"UH; CALi:—VALUE: i;HVur i��i;: R-3 i CuMMENTS: NO i�THEtt WVRK ASSGCYAT�:L WI'rH TI�TS Y1s1tMII ie ie'rE ie w ie # ie ii ii ie ie i'r ir ie # if w iF w ie ie iF ii ii ie ie ir ie se # if ie if ii ie 3eie iF i'r # ii i4» aF iF �l'r ii w�w ie iE ;4 ie w# if �i'r ii iF ie�ie�k if ie've ir ie ie i'c K� ir iF ie i��iF iE w 7F Z U N I N G it E Q U I 12 E: M E N I' S 5 E 1 b A C K � ----------- MAIN 6UILUING ---------- --------- ACiESSuRz i3U1LuING --------- f'RNl'; FT IN REAIi: F'T IN F'kNT: r'1 IN ttEAit; F1 iiV LEF1': rT 1N h�Hi; F'i IN LErT': 'r'i IN it�i1'f; E'7 IiV PAFtKINv REQ: Pki�ti: PAkC�L: 14164202 2Tv�;: R�:t NU: PLANNIN� NuTES> i if i't ii i't iF if iF ie if ie iF ii ii if if ii if �� iF ie it if ii if ii� ii iF if if �iF ii� �k if iiiE it w� i6 ie i4 iE'sf w ii ie fi"w,ie i' if it iFif # iF ie iE i? iEir �:f if if �7r ie :r ie ii� ie ie i't ii-rt� w ie � ie ie # D B V 6 L i� P M E N T S E k V I i: E S, k �: u U i rc E M.r: N'f S ZuNIN� APPRGtiEL HY � L'A'ir:: Bi7ILLING APYkuVEL BY : � uAi�.: APF�LICAT3UN I55UcL bit; . � uA'i't;: �,� . i4irif'riffifif'sFifiiki'tifiFiEihiFiiifif+Fw%+'e'+F�r�+'ae se� wae xse �e �+Fx�itx�t'vF�'iFif�ii�ii��iiiwiFx�iF�e � w �x � LEGALIiATIGN:N F 6 �. S U M M H tt Y S'iRUC'iUii7iL S�ii, r_'!v'i:N nLLG PMT PLDMBING ELEi:'1RIC Mr:�fiANtC r'.[lir' SMIPil'tti5 i;tcAu1N� PERMIT 11.00 2 5 g SMi P i NON- 1tr;S FLAN ISSUB FEE 22."v0 ' BUILLING-LIV-> Y�;RMI'I ISSUE PLAN-i:H�:CA iUl'AL PAI� i�iiE TG7AL5----> 11.iiG 22."v0 O.Vv 33.Ov 33."vG ,Ou REVENiJE LIVISLuN TUTALS--� CuiLEC1EU: �.i.OG i�viiR/SHiitti: .GO bLU� PM'f PLUMHING ELEC"tRIC MECHANIC r':CRE 5M.L'Yi'1�Y1' GRAI:IiNG ei�AN -�iiECx 33.06 i4 �li ie it if # if if if ik ii� ii tiF i'r if ii'rf if if iF iF'vF i'r i'r if ie if if ie iE if ii ii ie ie iE iF iF ii iF iE if iF iE k iF iE �iie �ir ie si'rE'vf ir ie ii� if iE it iE iF i'r �if 'vE ii ie ie i'r i'r ie ii� ie iF ii ie ii �if i'r � I N L I V I D U A L F E t B R E A K Li U W N 'iYPE Q1'Y L E 5 C k I P T I O N iJNi'i' �Ci:;i iiYC�1L i;(is'i FLU 1 ivATnk ti�ATEk ANL/vK VENT ll,vv 11."vv �.NL GF rGL's 18-16-1997/81:55 PN/f33.88 RCATq:81-8813967 F'ERMIT:985179 CONSTRUCTION AND PLANNING �� P�� ,'PA ' APPROVALS Permit # Date inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pote 52. Pool & Equipment Location ' 2. Soil Pipe•Undr9rnd. ! . 53. Steel Reinforcement � � 3. Elecirical Conduit-Utiiity-Undrgrnd. 54. Forms � � � 4: Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5, •Steel Re�nforcement 56. Rough Piumbing & Pressure 7est - 6: Electrical UFER Grnd. 57. APPROVALTO COVEF-GUNITE :.7, .Footinqs - � 56. Electricai Cond�L�F�Undrgrnd. *8: Foundation �� - . 59. Gas Pipe, �7 Urit7rgrnd., Test r �. 9". Water Pipe-Undrgrnd.'� 60. Backwash LineT',_P.-Trap, � Undr9rnd. 10. Structura� F�oor System � 61. APPROVAL TO OECK 11. Proper[y Sewer Line & Houae Connection 62. Backwash & Receptor-Final 12. Sewer Cap ' , 63. Heater & Vent�Final 13. Roof Ora�ns 64. Plumbing System � Finai , 14. Rough Plumbing r, 65. Electrical-Final 15. Rough EVecvicaf-Conduit '. - 66. Solar System-Pjpa,l 16. Rough ElectricWiriKg� 67. Pencing & Accesf�Approvai 77. Rough Wiring Sign � �� 68. APPROVED FQR P�ASTERING 18. Rough Electrical-T Bar Ceiling - •89: POOL/SPA SYS�fMS FINA� 79. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT - - � -:ti = �: . 20. Rough F,a,cto� FQeplace �' � l r � ��, � APPF3pVA�S' � Ppyrmit #'�^ .� � 21. Duas, in�Strvcture i .. .. .r. -- � ,: -� 70.-Underground Ftydro �. �� 22. Qucts, V.PSntik�tin� � � �'- F .? � �- . J " ~ p y'�,;j.C,�s k70i1 � , �. ,� � " 77. ProducY�'i in 23..Gas��ipe�ough &�7est .r �� . •,� ; :.; ~: 72. Undergr6und FFush • 24.'Roa"C Framing• - F �- - ^ �' � r _� �'= 7g, Undergrpd. Sto7�age Tanf� � Gas ❑ bil 25. Roo}, Sheathing =;, �' , � �� _ " � �� ` 7�. Overhead Hydfg � � 26.'T•Bar Ceiling (StrOcturaq & Monocoat - 7�. Dr Ch � "� - I r c� ' t� '� '� } Y eq�lcal � 27. Frame and Flashiagt .�! y �.. w n+� 76. Dry Staadpipe� ��., �� 28.rLattting & Siding �' �-� ' _ A �' "� •'�K 7�, FIXED'_$�STEfvt EINqL � � 29. Insulatio q � " - �. • � � � 'a 2$.-FIRE.PREV. FIfV�AL �� '• � �� 30. DrywailNailing � � � j � �` _ ' -HEALTj'iDEf'T:REQUIF�EMENT , �< .� � I 31. Ptaster &own Coaf' - - � J � I tr . 79. FINAL tiV$PECT�jON i' � � 32.'Electrical Power NieteP3Final � �� i� I j �� SOl FOOD CERTIf�CATE �SS.UED � .. 33.'Findl EIc�Gtric. � t ,� T t r I i 4q � Nbtes: � jni ri. � � ��1 w 34. Finet Heatingi& Av�Conditionip'g5 ' � � I ,� _ '�' � . � � �a i a 35.:Finat Gas P�P?;�Test; n ,; � , ; k ' '. � ' � }, fk .� 7- � 36. �Hood or'Canopy r = ' r - _ . -� i ; �e � -, � , r� 37. finai;Factory fireptace _ ��'� - , ' �;� � � � 38. Final Plw'nbing " ` �. .. .. } ��c�'� � - �+ - _ ; �" .' '-' r_ . 39. Water Service�Fina!' _ ' ' � � '�' . '�'� . , i , . 40. Gas Service-Final ` - y ,- - g , ,� I j �. - a i � � 1 � 41. SolarpomesticFinal ' „ " I i , ?? , 42.'Backflow Preventer� � � �� ' -' � - • _ - 43. Batkflow Irri'gation� - � ' - ; . � 44. Landscaqe Iriipatiop System� = ; � . _ _ - " � - - � � "'45. Sound Attenuation � ' `- - �' "' : - ' T � l T � � • � � -46� ,Nandicap.Regulacions -, _ . _ , : _ R . � • ! 47;.FINAL STRUCTURE & BUfLDiNG r � i�. - - _ �. - _ � - - 48. FINYaL PLANNING� � • , , -� • . ' A9. Electric Pelease to Edison * ' � ;� � ; _ . 50'. Gas Release to Southern California Gas Co . _ - . > - . - - : ' ' - -, „ 51. CERTIFICATE OF OCCUPANCY . • � No. Date PflOJECTqDDPESS: ?•�C'�-I DESUT� AV owNEx�s NamE: CAN.PBELL, J'��S �I' RODflE55: �•76'I DE SOTU AC'E COSTA MESA,CA AflCH/EN0INEEH: '�4�-'�'7gII AODHESS: UNIT: 92625 flEG.NO.: UNIT: PEFMITTEE: �RE �-�!?�93�_��1 aooeess: 620 tJ ECKAOrF ST ORANGE CA 92664 UCENSEU CONTPACTOB OECLAPATION: I hereby a��irm Ihai I am IicenseA un0er pmvisions oi ChaO�er 9(commencing wiN Sec�ion 7000� o� Oivision 3 of I�e Business ane Pm�essions Cotle, an0 my license i5 in �ull �orce and elfec�. ciTruc.:0441e?6 sTareuc.:473042_ , �i"S��i � � Oate: �� A � 7 � SignaWre: ��_ L�AL�C. WOPREP$' COMPENSRTION DECIANRTION: I hereby a�firm Ihai I have a certilicaie ol con5enl io sell-insure or a certilica�e ot Workers' Compensalion Insurance, or a cenilied coDY Ihereo� (Seciion 3800. La�. C). POLICY NO.: RT✓jkTC i Z% g Q 2�} E%P. UATE: 1 S I O 1 I9 1 ' CaMPANY: �ATL UNlON F3RE -'] CeNhetl copy is hereby Iumi5�e0. ❑ Ceni�ied copy is �Aed with IAe ciry BuilOing Oivis/ion Oa�e: �7� r � - / l App6cant:��Rl66( E%EMPTION FflOM WONREBS' COMPENSATION OECLAPRTION: (This section nee0 not Ue campletetl il ihe permil is forone hunare0 ($100) ar less�. I cetlify ��ai in I�e peAormante ol Ihe work tor which this permit is issued, I shall not emplay any person in any manner so as to become subleci lo Ihe Workers' Compensa�ion Laws of Cab�ornia. Date: Signamre: NOTICE: II. afler making this tleclaratioq you shoultl 6ecome suble�� o ��e Warkers' Compensation pwvisions of ihe Labor Coae. yoU mus� �onhwilh Comply wi(h SUt� pmvisions or Ihis permi� shall be deeme0 fevoke0, CITY OF COSiA Mr.5A — B(1iLllTNC PEFt:KiT PEAN. i.0; i! UiJ4S< PER,`�IT NO: B G53459 PLAN CriECK NO: N GdV:': N SLFP; ,4 CONSTRliCTION TYPE; 5—\ PER�;Si TYPE; STR PIIRPOSE: ALT JOB DESCRIPTIOh ; INSTALL EXT. VZNYL SIDING (1CBUN 366]) S� FT; 4,3U0 CLAIM VAL�UE: 4,3U0.00 CALC—VAL�iE: 9,300,00 GkOUP GCC: R-3 / COMMENTS; �,^.OKE DETECTOR(S) kE�UIRED EN HOME. . if9E�Fi4#Elfii�lflF�lF�lFi:iFY:�iF;Fkii�3eiFdf�3'rff�i'raF3f#fiFiEif #IElE�fF%?{-ii-iFii�ie3E#iFMi'rii�3fY%i'r3F3flC�if�leiF?EiFii-if�iEiFiF3i�aci'ric3F?EY.-iEi:�i6''rYY Z O N I iV G R E�1 U I R E N: E N T S S � T 3 A C K S ------------ MAIN �UILDING ---------- --------- ACCESSORY �J2LDING --------- FRNT: rT 1N �iEAR• FT '1N FRNT: FT IN REAR: FT 1N LEFT; rT IN RGHT; FT ZN L�rT: FT IN r�Giii: FT I�i PARKZNG REQ: PROV: PARCEL; 42591500 ZA'E: REc NO; r�L�ANNTNG nai�s> i K� ah #� 1E-k i� IE w- iF if �lE%if af iF 3F k�e 3(� 3F 3'r IF i:� 3E ie If M-+�. ?E fE-Y.� 3E s{�� ih iE iE �IF 1{- i"r v-�it� ii� ih k id'i'r !f i4 ii 3F #4 iE #e iE �3F 3e 3E If � x� lE if Vi�lf ii�-k s�E 3f ic iE k# iE :�F lc 3E ah U E V E L O P M E N T S E R V 2 C c S R B Q[i I R E N, E�, .i 5 ZONING APPRUVED �tY DATE; •� BUILDING APPROVED 3Y : DAT�.; . ' CONSTflUCTION IEN�ING AGENCY: I hereby allirm that there i5 a cons�mc�ion lenaing agency lor �he De�ormance ot ��e work �or APPL I CATI UN I SS UED . -- nf�i 1 L• �U �-/ � whichihispermitisissuetl�5ection3097.Civ.C�. {p{F�(.y.{(.,p{p{p{(.{p{(.4p1c}}(�{��}}�{�.�r.� . �rrx�rirfrtrx�x Eici Ric P.i �r�� i� ri.i tfexr.il�i�36##-i'rN-ielciF , r rf �i!ii6 LENDEfl: ifdtifi�-3E#i'r##��iFi4ih?i�ii�}3f!(-1i�3F3i�)fY.�iEieiflE�f%3ei[�IfaF3fifihN-iEiE�CY ciEii�iFii�iEii�if%iEif�i!�i'�ikieiE%it?E-3i#�lEie3i�icA�RRiFii�34#iFitiif�iF±i aooaess: LEGALIZATION:N F E E S' M M A R Y STr2liCtJRAL SEGN.EA7T:Y OWNEflBUILDEBOECUINATION: Iherebyaffirm�hatlamexemp�imm��eContraclors'SIaleLicenSeLawforthefollowingreason BLDG PMT PLUM31hG ELECT' IC MECI-IANIC .�ZRE SMIP/RE_".' - GRAD'ihG �Seclion 703L5 Busine55 antl Pmfessional Cotle: Any ciiy of county which requires a permil b conslmct, alier, impmve, Aemolish, or pERN.I T % �. 0 � repair any slmcture. D�ior lo its issuance. also reQuires the applicani lor suc� permii �o �ile a signed siatemen� �hat he/she is licensed 7�� OYf5�3fII�0�ll¢pf0VI5i0�50�ihECOf11fdC10f55tateLicenseLaw�Chapler9lcommencingwit�Seclian7000)otDivision3oitheBusiness , S��lA�NON".�,`�...Jr and Pmlessfons Cotle� or tha� �e/she i5 exempt there�mm and Ihe Oasis �or lhe aliegetl eKempiion. Any violaiion ol S¢c�ion 7031.5 by PLAN � any aDPlitan� lOr a p¢rmil Sublecis lhe a0�licant �o a civil penal�y o� not mOre �han �ive AunAre� Oolla¢ (SSW). ISSUY. t�E ' i, as owner o� ine prapeny or my em loyees wim waoes as ineir soie comDensation, wiii oo tne work, and me HUILDTNG—DIV—> l�ERMIT 1SSPa PLAN—C$iCR ''OTAL PAlD j)(.iP. ❑ svucwre is no� Imenaen or onered ror saie lgectian 704a, Business anU Prolessional Code: T�e Coniractors' State License Law TOTALS----> 7 2, S Q �, U �, 0 0 � 2, S � �J Z. S Q -, 0 � tloes noi apO�Y lo an owner o� a pmperty who builes or impmves the�eon, antl who tloes suc� work himselfl�erself or Ihrough his or her own emDloyees, pmvitletl �hat such impwvemenls are nol in�en0etl or oliered lor sale. It, however Ihe building or impmvement is so�U wnhln one year o� comp�etion, the owner wil� have �ne burUen o� proving he�sne eid no� bui�0 or impwve Fi � V£N iJE D:i V I S IOh TO TALS --> COLIi �C TED ; �7.�. , � � UV: R/$HOR 1; U 0 mnneP�rPoseoisaieJ. Hi.DG PMT PZ,GMBING ELt.0 RIC N:E:CHANIC :IRE SMIP/TOT GRADING PLAN—C3ECR . I, as owner af Ihe pmperly, am excWsively contmcting with licensetl coniractors to consimct t�e prolecl (Sectian 70a4, Business 7 2. U Q . J � ❑ and Pmlessions Cotle: The Conlraclors' S�ate License Law �oes no� apPly �o an owne� of pmpehy who builtls or impmves �he�eon antlwhocanirac�siorsuchprole��swnhacomrac�or�s)IicenSepursuanl�o�heContractors'S�aleLicenSeLaw).lamaware .h.y{�.ap�(.�(.��(..ic.xjF#3E#)fi4#�JfiFififiFiflFififfE3Fii�ffiFlF�lEifiE?fii�3F##�#�(�3F�7e#iFN��1Pif�)flfiflr-3�143fiFi?�lFrfi{9i-�E�Y.-}=��tF}:�}�#IeiE?'tl��'k{(�?i�#lE mai prmi oi iheir Worker's Comoensa�ion insurance shoWe be omvieea m me. 1 N D Z V j p lJ A L F' .., tt � R� A F( D O i�7 !V � I am exempt und¢r SeC�ion: B. 8 P. C. mnnisreason. TYFE QTY D C. S C 3 I P T I O N UNIT CGST 1'OTA'L C'O5� Date: Ownec I do �ereDy cetlily Ihat I am aware ot an0 untlealand the requiremenl5 0l Cah�omia Heaith ana Sa�ery Code Sec�ions 25505. 25533, and S F ti 4 3 � U P.L 1: R � Y V7�L,Ut, RES ID Ei�T I AL NOZON ^ 1, 0 U Q� 3 U 0, U U 2553G ana Ihal I or any lulure 6uiltlmg occupant wilVwilt nol (circle one) need lo comply wilh said stale co0e5 antl ��e requiremenls far a EtiD Or :�.�5 permil br consimclion or moAiticalion irom ��e Air Ouahry Management �isVict. Fesitlential conslmciion aDDlicalions are exempt �mm I�ese pmvisions. oa�e: noPr�a�c I hereby ceitily inat I have reatl inis applicalion and stale ihat ihe above inbrma�ion is correcl. t agree to comply with ail ciry and caunty oramanceSanOSlalelaw5relatingia�uildingcons�mclionan�here�yauthorirerepresenlativesol��iscitytoenter antheabove�men�ionetl O�op2r�y �ot Inspecli0n purpa5¢s. �% / Dale'. _Q_L/ �� SignaNre' �/J'��q�;�` Oriver's License or Social Security u: �' t64ba6 Whna-Bwltling: Green-Coae EnforcemenL Canary-AppLcanP, Pink-Revenue', Goltlenmtl-Assessor �: Q�i,S`�Ss-G:i'5;;�� - - n/.I I_' i�� ISd /i 1 f 11�: ... `'L n' ��'C°:'.i`S-�'.ilUCSi�`.Y . 'iFzF+ ��:'s!_4''ii. 'j�.r. i-. '. / � � CONSTRUCTION AND PLANNING � P�� PA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. 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, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbinq � 65. Electrical-Final � 75. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPASYSTEMS FINAL 19�. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory FirePlace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe�Rough & Yest 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry $tandpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL _, 29. Insulation ' 78. fIRE PREV. FINAL .. ^ 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT `i.' � '- � 31. Plaster Brown Coat � 79. FINAL INSPECTION �, 32. Electrical Power Meter-Final f ;'i i 80. FOOD CERTIFICATE ISSUED 33. Final Electric i � � Notes: 34. Final Heating & F,ir Conditioning � ' 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing , 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer . 43. Backflow Irrigation � 44. Landscape Irriqation SYstem . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING �D 3 9'r 48. FINALPLANNING 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date � �I AOPlicant to fill in all spates except those wit�in heavy Oortler lines anG sign all appropriale Geclarations. CiTY OF COSTA MESA �jCO STR(��J` CTION PERMIT PERN�f'j NQ. �_� � TRACT NO. LOT NO. UNIT NO. � Project k�ddress �76 / �'f �+ � � � v � App�ant's Mailing Address 'Z 7�P 7�iF <TO ✓l� ' %�� Owner's Name f MP 'E�' LPho e � Address ��`'! �•f OT� %i'✓� � C"' /`i� • Areh/Eng. — License No. Address Contrector's Nam Phone Address (mailing) City License No. ' �� LICENSED CONTRACTOR DECLARATION ' I hereby atfirm Ihat I am licensetl untle� provislons of Cha�ter 9(mmmencing with section �000) of �ivision 3 ot the Business antl P�ofesslons Cotle, antl my license is in full (orce antl etfect, � License Clazs License No. Dale Siqnature WORKERS' COMPENSATION DECLARATION ' hereby aftirm that I have a certificat¢ of consen[ to self-insure or a certificate Workers' Compensation Insurance, or a certitietl copy thereof (Section :00, Lab. C.) Policy No. Company eCertifietl copy is hereby fumishetl. � Certifietl copy I5 filetl with the city Builtlinq Oivision. �ale � APplicant EXEMPTION FROM WORKERS' COMPENSATION DECIARATION (This section neetl not be completetl if [he p �mit is for one h �ntlretl (5300) o� less). I certity that in the performance ot the rk for which� � rm� is issuetl, I shall'not employ any person in any ner s me s ject Workers',sCop�peys`ati��s of Calif a. Date � V�� i9nature `"r" ' NOTICE: If, af[er makinq this tleclar tion, you shoultl b come subject to the ' Workers' Compensation Orovisions of the Labor Co , you must forthwith comply witn such provi5ion5 ar tbis p¢rmit shall be tle¢m¢tl /ewketl. CONSTRUCTION LENDING AGENCV I hereby aifirm that there is a mnstruction lentlin9 a9ency for the performance of the work for wnich this permit is issuetl (Section 3097 Civ. CJ Lentler's Name Lentler's Atltlress OWNER BUILDER �ECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followinq reason (Section ]031.5 Business antl Protessional Cotle: Any city or tOunty wM1ich requires a pe�mit to construct, alter, improve, tlemolish o� �epair any structure,'prior to its issuance, also reqWres the applicant for such permit to file a si9ned Statem¢nt that ne/she i5 Iicensetl pu�suant to the prbvisions o( the Contractor'S License Law (Chapter 9(commen[ing with SeGtion 7000) of Oivision 3 ot the Business antl Professions Cotle) or Mat he/sh¢'is exempt •erefrom antl the basis for [he alle9e0 exemption. Any viOlation ot Section 131.5 by any applitant to� a pe�mit Subjects the ap0��ant to a civil alty of not more lhan five huntlretl tlollars ($500�. I, as owner of tM1e proper[y o� my employees with wages as their sole � co pensation, will tlo Ihe wo�k, antl the Structure is not intentletl or offeretl for sale ($ection "]044, Business and Professionai Cotle: The Contractor's License Law tloes not apply to an owner of a property who builtls or Improves , lhereon, antl who tloes such work himself/herselt or through his or her own employees, provltletl that such Improvements are not intentletl or offeretl tor Sale. It,�M1owever, [he builtlinq o� improvemen[ is soltl wltnin one year of mm- �pletion, the owner will have the burtlen of p�oving he/she tlid mi builtl o� im- �rova for ihe purpose of sale). I, as owner of the property, am exUusively tont�acting with licensetl con- tractorsto wnsVuct the oro�ect (Sect'on 7044, Business antl Professlons Cotle: The Contractor's License Law tloe not appry to an owner of Oroperty who � builtls or improves �tnereon, antl contracts tor s h projetfs wlth a con- tlattor(5) I¢ense pursuant to tM1 ontrdCtor' ' aw). I m awar that prmf of thei� Wo�ke�'s,Comp ation in ce ho Itl be. ovitl tl me. ❑ 1 am exempt untler.5ec[ion ' '�' . ., his reas n oate FC owner A� L I hereby certify at-I have reatl this a plication antl state that the above information is ct. I agree to compl ith all city antl'county ortlinances antl'state law atin9�to b' ' ruc on, antl hereby au[horize repre- sentatives of t is city t e e u n t abo e- entionetl property for inspection p r oses. Signature Date�� Drivers' Li en e 0� 55 � — � � TYPE OF CONSTRUCTION ❑ NEW PS ADD ❑ ALTERATION ❑ REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p # DESCRIPTION OF WORK/USE OF BLDG. � ' - S Main Buildi TVPE OF PERMIT GRADING�q - FOUNDATION ❑ STRVCTURAL T F�Ont ❑ TENANT ❑ ELECTRICAL ,r� PLUMBING ❑ MECHANICAL B RCd/ ' O OTHER = C Right PROJECT DESCRIPTION 5�. Fr. � � oCCuvarvCv ,CONSTRVCTIONTVPE VALUATION$ g Ceft ZONE , GRADING CU. VDS. ACRES• , Ping. Fef. # Remarks: ` � � � ?S : Planning Notes: Bar Sink , Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains � Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap . Roof Drains � Reinspec[ion Fae Outlets ' Showers Service Sink Sewer Cap Sewer Connection Solar Collectois Solar Pipin9 Solar Tank � Swimming Pool wl$pa Urinal ' � Water Closet , Water Heater , Water Service Auto-Wash $15 Boiler Duct - Under Grourid Duct - Structural Duct - Ventilating � � Exhaust System ❑ -Multiple 0 FirepNFact._BILICBO# ^ Heating SYstem & Ducting � ❑0-100,000 BTU 0100,OOOBT Fieinspection Fee $75 CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicant; Pink - Attounting; Goltlenrotl - Assessor Issue Fee Hoodar Typel ❑ . Canopy Type I I � , Refrigeration System . 00-100,OOOBTU ❑100,0008T1 System Repair/Alteration Fire Dampers Registers � Issue Fee $ 3 $ 3 Automatic Washe� Construction PoleSi Cooking Unit Dishwasher Oryers ��Gas ❑EI Fan F.A.U. Fizwres Device Boxes . Outlets Switches Garbage Disposal Generator DO-5 KW 8749 12/16/86 � Zone Accessory Building: Parking Req./Provided ELECTRICAL , Transformer ❑ 15-50 KW ❑ 50+KW Meter LJup to 100 amps . Meter ❑over 100 amps Sub Panel Motors DO-1 HP O1 %- B Inc.Sotar 09-15 HP �16-15+ Microwave Pole Light Range I Standing Sections 5-15 KW Trash Compactor � Reinspection Fee �$15 �, � luue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Appliration Issuad By � � SUMMARV OF I BUI�DING PERMIT $ ' PLAN CHECK - $ PLUMBING � , $ PIAN CHECK 25% $ �� EIECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ 5050 TL Z O N I N G R E Q M T S FEES $ 3 ES � . SMIP $ � ' PERMIT • ISSUANCE _ $ ENERGV P.C:. $ GRADING � � $ MICROFI�M $ � � '� � TOTAL FEE $ J •_Z�L CONSTRUCTION AND PLANNING . � POOL & SPA APPROVALS Permit # ' Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement � � 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings � 58. Electrical Conduit-Undrgmd. �� 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgmd. 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 Si9� 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � ' APPROVALS Permit # - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilaiing 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing . 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar 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' - G-Z-i� � (�E� � . . 39:�Water Service:Final .� 40. Gas Service-Final , � 41., Solar pomestic-Final , 42. Backflow Preventer � 43. Backflow Irrigation ', 44. Landscape Irrigation System • • 45. Sound Attenuation ' . � . ' " 46.-Handicap Regulations " 47!FINALSTRUCTURE&BUILDING - � , 48. Special Requirements Completed � 49: -Electric Release to Edison � 50. Gas Release to Southern California Gas Co f i� 51. CERTIFICATE OF OCCUPANCY , No. Date ' / l ` �__�� Z 1 � ., _ AVGlicant to fill in all spaces exttpt those within neavy borOer lines anG sign all apDropriate tleclarations. CITY OF COSTA MEbA �-bNSTR1JCTION PERMIT PERMIT NO. � TFACT NO. LOT NO. UNIT NO. ProjecLAddress ��G7 ��-� S oTo �v�� — Applicant's Mrjling Address '1- Q+ 2� W�"'� l7F S Tf�/� �/�%% Owne'r's Name C GF M"!'i3G G G- Phone ~5 u� Address -Z 7 G 7� p�AL �OTD � U L=� Arch/Eng. C��— (�L` /� b n License No. ,�' �yD 9O3 r Address G � " Con[ractor's Nam ' � %G ��Phone Addresslmaiiingl � 2 /�K' � . K� � Ciiy License No. �`r D � LICENSED CONTRACTOR DECLARATION I bereDy aftitm that I am licensetl untle� provi5ion5 0! Cha�te� 9(commencing with section '/000) of Oivision 3 of the Business antl Professionz Cotle, antl my license is in lull torce antl effect. �{ LIC2052CId5S LI IIS O� D O+ �ale,.�Z� —�� Signature WORKERS'COMPENSATION DECIARATION ' hereby affirm that I have a certificate oi consent to self-insure or a certlflcate Workers' Compensation Insurance, or a certi(ietl copy thereof (Sectlon d00, Lab. C.) Policy No. Company Ce�tifietl copy is hereby furnishetl. Ce�tltietl copy is tiletl with the city iltl�i�n� iv]i �o Dal •/-+� �� / Applicant ��I/�Q�� Q'�,{ � EXEMVTION FROM WORKERS' COMPENSATION DECLARATION (Thls SeClion n¢etl not be com0�etetl it the permit is far One huntlretl ($100) or less). I certify tha[ in Ihe pe�foimance of the work tor whlch this permk is issUetl, I shall no[ employ any person in any manner so as to become subject to the Workers' Compensation Laws of Calitomia. . Da[e Signature NOTicE: Ii, atter makin9 this tleclaration, you shoultl become subject to the Workers' Compensation provisions of the Labor Cotle, you must fortnwith comply with such provisions or thi5 permit shall Ge tleemetl �evoketl. CONSTRUCTION LENDING AGENCV I hereby a�firm that tnere is a construction Ientling agency tor lhe perPormance of the work for which rois permit is issued (Settion. 309] Civ. CJ Lentler's Name Lentler's Htltlress OWNER BUILOER �ECLARATION I hereby affirm that I am ezempt irom the Cont�actor's License Law fo� the followin9 reason (Section ]031.5 eusiness and Protessional Cotle: Any <ity or county which requires'a permit to construct, alter, improve, tlemolish or repair any structure, prior to its issuance, also requires tne applicant tor such permit to fil¢ a Si9ne4 5tatemenEthai he/she is licensed pursuant to [he provi5ion5 0� the Contractor's License Law (Chapter 9(commencinq wltM1 Section �000) of 7ivision 3 of the Business antl Professions Cotle) or that he/she is exempt ereRom and [he basi5 tor [he allegetl exemption. Any violation of Section i31.5 by any applicant for a permit subjects the applicant to a civil analty of not more than five buntlretl tlollars ($500). � � I, as owner of che property or my: employees with wages as their sole compensation, will tlo the work, and the structure is not intentletl or offered ' for sale (Section 7044, Business antl Pwfessional Cotle: The Cmtrac[or's � License Law tloes not apply to an owner of a property who builtls o� Improve5 lhe�eon, an0 who Coes such work himself/herself or throu9h his o� her own � employee5, provitletl tM1at such improvements are not intentletl or offeretl for I Sale. If, however, the builtling o� improvement is soltl witnin one yea� of com- pletion, the owner wiil have the burtlen of proving he/she tlitl not builtl or im- �rovG fo� the purpose of sale). I, as owner of the property, am excWsively con��acting with licens¢tl con- tractors td construct tne project (Section 7044, Business antl Professions Cotle: The Conlracfor'S License Law tloes not apply to an owner of pro0erty who . builtls or improves ihereon, ana who contracts for such projects with a mn- Vacmr(sI ucense pursuant to the Contractor's �icenre l.aw). I am aware that proof of [heir Wotker's Compensation insurance shoultl be prOvitletl fo me. ❑ I am.exempt untler Section B. & P. C. for thls reason Date Owner I hereby certify that I have rea� � inPormation is mrrecL I ag�ee to antl-stale laws relating to builtlir � Sentatives of this ity ent in5pectlon pu�pS i Signature ____l�sn� �� Drivers' License or 55 � on antl state [hat the above 11 tity antl county ortlinances ; antl he�eby autho/iae rep�e- �av-e-�ml^entionetl/ �rop¢rty for �V Date[[_[�� TYPE OF CONSTRUCTION NEW 'ADD ALTERATIOfJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � OTHER PROJECT DESCRIPTION 5c3. FT. l oCCUaArv�vy_�,'.�G ;CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VOS. A( Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishovasher Drinking Fountains Floor Orains Floor Sinks � Gas Service ' Kitchen Sink ' Lavatories - � P—Trap � .- • RoofDrains �'��. � �. Reinspection Fee $15 Boiler - Duct- Under Ground � Duct - Strucwral Duct-Ventilating ' Exhaust System ❑ Multiple ❑ FirepVFact BIt. ICBO # Heating System & Ducting ' ❑0.700,000 BTU �100,OOOBT 0 Reinspection Fee � , $15 CMF OB65-46, rev. 30/84 Whiie - Builtlin9: Canary - Applicant Pink - Accountlnq; Goltlenrotl - Assessor ShOwers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimmin9 Pool w/Spa Urinal Water Closet Water Heater � Water Service Auto-Wash Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System . ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Regiseers laue Fee 0 $ 3 $ 3 A.P. #, S Main Buildinc E T Front B Rear A C Ri9ht K Left S — Ping. Ref. # P.lanning Notes: � Automatic Washer Construction PoleSub. ' Cooking Unit Dishwasher Dryers �Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets "� Switches � � Garbage Disposal Generator O0.5 KW O5-' Fee I 7413 11/18/86 I03.92 TL � O2 � Zone. . Accessory Buildin9: Z O N I N G R Parking Req./Provided . E ` Qi % M ' � cQ.,LtC2� 5 ELECTRICAL, . Transformer � 75-W KW ❑ 50+KW .Meter ❑up to 100amps Meter ❑over100amps . Sub'Panel Motors �0-7 HP � 1%� 8 . Inc.Solar 09-15 HP �16-15+ Microwave ' Pole Light . Range � ' � � _ Standing Section: 5 KW � Trash Compactor $15 Issue Fee DEVELOPMENT SEHVICES R Zoning Approvad By�� Building Approved By l�2 BUILDING PERMIT S PLAN CHECK 2'rJ�$ PLUMBING $. PLAN CHECK 25% $ ELECTRICA� $� PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK Z5% $ FEES $ 3 tS / ' SMIP $ • l0 PERMIT ISSUANCE $ ENERGV P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ ��' ! CONSTRUCTION AND PLANNING �. � POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � � 2. Soil Pipe-Undrgmd.' � �(Z�Z, �� 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement y 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. ._ 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit�Undrgrnd. , . 8. F.oundation� 59.� Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � ��2'� �J� 60. 8ackwash 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 ,2"�0�: (�L� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final � 16. Rough Electric Wiring 67. Fencing & Access Approval 2 -n-a�. 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,. 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test ` 72. Underground Flush , 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing, �� 74, Overhead Hydro . 2 �Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �` ', 27. rame and Flashing �S � 76. Dry Standpipe , " / 28 Lathin Siding L�i ! T� 77. FIXED SYSTEM FINAL /I 29 , nsulation . � 78. FIRE PREV. FINAL �-,I . Drywall Nailing � HEALTH DEPT. REQUIREMENT ' �, . PlasterBrown Coat� / y 7 79.. FINAL INSPECTION . Electrical Powe��_Meter-Final 80. FOOD CERTIPICATE ISSUED . Final Electric�� _ � �.� - Notes� � G.q$ �pry�2,� ��,�Q, L,�7 34. Final Heating & Air Conditioning �- �__ � _ ./ � �, T�.r`sn 35. inal Gas Pipe-Test �._.�,,,Dr� � . . Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � - 39. Water Service-Final 40. Gas Service-Final . � 41. Solar pomestic-Final ' - � 42. Backflow Preventer . ' 43. Backflow Irrigation : 44. �Landscape Irrigation System • . 45. Sound Attenuation �, � � 46. Handicap Regulations . � � 47. FINAL STRUCTURE & BUILDING L� � � . 48. Special Requirements Completed . . ' � 49. Electric Release to Edison . /� , 50. Gas Release to Southern California Gas Co ' � . 51. CERTIFICATE OF OCCUPANCY No. � Date ' • � � � � � � � r . , . , _( ` I � ... . . �. . .. v v � r� �� G J h � , �. -� �� -- I�_. ER OFFICE MEMORANDUti, NovemSer 15 19 �� ' ProFerty Owners, Contractors, Tenants, ` , � � TO Prcpe='tY [�ezs, 'Leasing Agents FROM �'isten Caspers, Plannirg Aide Re: ACCELEf2ATID PL4N QIECR AG2EEFII3�TP AUI730RIZID SI(i�]A'ITJRFS You may sic� this acgee�nt if - o You are the fee title proQerty owner. o Ya1 are the tenant for whid� the improvenents are bei� constructed. If the Ixoperty is aaned b� a mzporation or a partnezship, an afficer of that entity mist sign with their title. (i:e., partner, vice president, etc.) Furtheanore, if you are the oontractor, property manager or the leasing agent, you may sic� this acgeee�nt wt�en: o The imprwe7rents arn £or you a Frnspective tenant. o Yw ha,e a natarized copy of yois Pa.er of Attorriey or a notarized Letter of Auttnrization outlini the fact that �� si n this agreanent for the prop- �e owner: I�cpertyis cx�med a�r�ration or .a partneiship, an officer of that entity must sign with their title. (i.e., partner, vice �esi- dent, etc.) A1so, the te�an Developer as used in the agreer�ent refers tt> the apprcpriate entity as wtlined above. \ NOTICE: When submitting`this contract, a copy of the plans should be included. � This is for review by the Planning Division prior to recomnending that you pursue contracting with an outside plan checker. � F3chibit A • • (10-2r83 ) �C'�o�-0��4 ACCELERATID BUILDIN� PLAN RE�TIEW AGREII�TI' THIS PGREEMENfr dated -/�� c' C , is made ty the CI1Y OF COSTA �l�, S C� rl lo a L-'L, L MESA, a miumicipal cor�ration {CITY), V C,�../.F� (DEUII,OPER), arrj %� S� C O l�/ S C� �%A(�u�S ��INEER) in Costa Mesa, California. W I T N E S S E T H WHEREAS, the CIZY has establi.shed a procprlure whereby a DEVEIAPER m3y retain the services Qf a qualifzEd independent ENGZNEER to perform the buil.ding plan reviea nornially corc3ucted by the CZT� or its private �ntractors; arr3 Fi-IEREAS, DEVELOPER propcses to utili.ze the accelerated plan reviea pro- cess in connection with the proposed development of prc�perty located at 2�� ,E�n, � i.n the City of C�ta Mesa; and WHERF:AS, ENGINEER represents that he is duly licensed b� the State of California, a�r] that he shall �et all minimum qualificatioas arx9 resFonsibi.lities required tr� CITY as hereinafter stata9; arrl WIiERFAS, DEVEI.�ER undezstands azr] agrees that no building permit shall be issued imtil all rs3uireaents and conditions of this agreetrent ha�.e been satis- fied; and WHF.RFAS, ENGINEER represents that he has that degree of specialized exper- tise contenplated within California Government Code Section 37103 and holds all necessaiy licenses to practice azr3 perfozm the sezvices herein contelnplated; and 4�REAS, no official or enployee of CIT� has a financial interest in the subject matter of this a7reenent contanplated withi,n the prwisions of California Go.errvrent Code, Sections 1090-1092; and P W[IEREAS, E�IGINEER declares that he sha12 perEoun the secvices herei.n con- tanplated in cort�pliance with the Federal and California Laws related tn, minim�nn hours arY3 wages, (40 U.S.C. 27G A et seq ard Ca.lifornia l�bor Code Section 6300 et se3 and California Labor Code, Section 14I0 et seq), to the extent sarre are appli- cable herein. ida^I THEI2F�ORE, in consirleration of the mutual granises of the �rties, and other good and sufficient consideration, the p3rties agree tn the follaaing: I. BLIILDING PLAN REVIEFI SERVICFS A. CZTY does hereby agree tc� accept Et�INEER to perform buildi.ng plan review in accordance with the tenns and conditior� herein set forth. B. INGINEER shall review plans for oanpliance with pertirient City arr3 State regulations falling within the purview of the building officzal of the City of Costa Mesa. , II. FEES FOR BUILDING PLAN REUIEW SEKSICE. A. Fees for performing the building plan teviea shall be r�egotiated between DEVII,OPER and the EI�INEER arv3 said fees shall be paid to ENGINEER by DEVEI.CPER The CITI shall not be responsible to. ENGZNEER to any extent for the fee oc�d by DEVELOPER CITY shall not be called uFon tt� assimie acr� liability for the direct or iirlirect pay7rent of the fee aaed F� DEVELOPER or of arr3. salazy, wage, or ca�ensation to atr3 per�n trnployed by ENGINEER B. At the time the buildin� pennit is issued, an administrative fee e�ual to 25 �rcent of what c.vuld nornally have been the plan d�eck Eee, had the plans been checked l� the CITi', wi.11 be diarged and collected b3 the CITi'. Tnis fee wi.l.l be in addition to the bu9lding permit £ee. III. LIABILITY E}�OS[TRE AND COVERAGE A. All officers, agents, emplv�ees, ar� subcontractors, a� their agenrs, offi.cers, ard anployees who are hired by or engaged by ENGINEER in the perfozmance of the buildir� plan reviea, shall be deemed officeYs, agents, and anployees and subcontractozs of ENGINEER only and city shall not be liable for their acts or anissions nor res�.vnsible to than for arythirr� whatsoe .Er. • -z- B. FSJGINEER a� LIEVELc�ER shall each separately irr7armify arr] save harniless CITY, its officers, and its enployees, from and agairLst any arx3 all dam- ages tn property or i.njuries to, or death of any person or persons, in- cludi.ng property arr] enployees of QTY, and shall deferrl, save harniless, and indemiify CITi, its officers, and its anplo�ees, fran and against any ard all claims, deirends, liabi.lities, suits, actions, proceedings, or judcyrents therefore, resultirx� fran or arising out of .their oan negligent acts or omissxons or the negligent acts or omi.ssions of their respective emplo�ees or s�crontractors; except that neither ENGINEER nor I�.'VELpPER shall heret� incis any sucti obligation for the negligent acts or omissions of the other. C. ENGINEER shall obtain and imintain the follaai.ng i.nsisance cwerage: 1. CQ�IPRFIiENSIVE (�NERAL LIABILITY coverage with policy limits of not less than $1,000,000 �nbin� sirqle lzmit Lxr occurrence, with CITY as a9ditional ins�ed, and with an endorse�ent that the insurance prwided the CZZY as additi.onal ins�sed sha11 be dee�red primary and noncontrihuting wi.th any other i.nsisance of QTY. 2. PROF'ESSICI�L LIABILITY coverage for $1,000,000 with a contractual liability provisi.on sufficient tn insise Paragtaph IIZ.B. above. 3. WORKER'S QJt�ENSATZON It�URA[ICE in statutory amount. 4. 'Ihe general and professional liability ins�sance shall provide con- tinued o�era3e for at least 12 �ronths follavir� mnpletion of wn- struction of the project and shall not be cancelled, modified, or reduc� wzthout fitst giving CITY thirty (30) days written notice. D. F.NGINEER shall grovide CZTY certi.ficates of insisance acceptabie tn the City Attorney sh�wir� the alx�ve cwerage arr3 policy e�ors�nents prior tc� can�ncetrent of ary plan check servi.ces. IV. GENERAL �kIDITIONS A. The ENGINEER shall canply with all the provisions of the Worker's Caripen- sation Insisance and Safety Acts of the State of California, the appli- cable prwi.sions of Division 4 ard 5 of the Californi.a Labor Code, arrl all a�rendrrents thereto, ard regulations adcpted pursuant thereto tr� the State De�rtrc�ent of Lat�or arr] similar State or Federal acts or Iaws applicable. B. ENGINEER sha11 certify in a form and msnner acceptable to CI'TY that the plans he has diecked cc�ly wi.th all applicable codes, ordinances, and laws relating to the particular type of developirent proposed arrl that permits may be issued for the construction aE same. C. If anissions or errors in the plans �are discovered during the course of wnstructzon, correctiorLs shall be mac� at no ccst to CITY, and, all work perfotmed shall be required to canply with the codes and ordinances of CITY prior tD final building inspection. -3- V. D. T)EVEL,CPER shall, prior to or cona.trrently wi.th the buildirg plan reviea by Et�INEER, contact the Planni.ng Division, Fire Marshal, and/or P�lic Services DeparU�nt of CITi, the Casta Mesa Sanitary District arc3/or the Mesa Cons�lidated Water District to determine any conditi.or�s or special requirerents which may be administered by those departrrents. Failure to do so may dela� issuance of building permits. E. The licensed ardlitect, registered errjineer, or other authorized person, entity, or corporation who prepared or supervised preparation of the project plaas, sizcifications, an9/or erx3ineerirx3 calculations beirx3 revie�ed, shall not be assr�ciated in any way with II�INEER RESPCXdSZBIL2TIES OF ENGINEER ENGINEER shall revxea plarts for o�nplzance wi.th pertinent CITY arc3 State regulations falling wi.thin the purvi.ew of the bu9ldir� official of the CITY. More sFecifi.cally, the sezvices to be perfozmed b� ENGINEER sha11 consist of but not be limi.ted to: PL�AN CHECK b. d. e. f. Classify the buildirr� arx3 �erify canpliance for the followirx3: 1) OccuPan�Y 9r�P 2) Type of construction 3) Locatzon on property ' 4) Floor area 5) Hezght arrl nutrber of stnries 6) Occspsnt load Verify canpliance of the building with detailed ocai�ncy Verify ccmpli.ance of the building wi.th detailed type of requiranents. Verify canpliance of the tuzlding with e�cit requaranents. Verify cccnpliance of the building with detailed Code Verify compliance of buildirg with engineering regulations irents for �terials of construction. rec7uirenents. construction regulations. arc3 require- g. Verify ccmpliance with California Tit1e 24 b� . revie,�irx3 rrechanical and electrical plan schedules and �o�3c sheets for thermal insulation. h. Verify canpliance with California Title 25 and Section 13-144 of the Costa Mesa Mimicipal Ordinances by reviewirx� rtechani.cal, electrical, and plumbirrj plans, details, calculati.ons, and any requi.red Acwsti.cal IIigi.- neer's reFort. i. Prwide the Lvllv.ri�: 1) Coordinate with City Engineerirg personnel for grades dete�nination. 2) Provide drainage review by CITi Ordinance 3) Che�c draingage flva "Q" calculations. j. Revie�u plumbir�, electrical, and heatirx3 drawings. k. Prwi.de for reviea and verification of all of the above itens imtil all correctior�s are made arx� all data are�in compliance with all codes, ordi- nances, and State arrl Federal Iaws. _q... 1+t�i+� CERTIFICATION The follaairx� certification statenent shall appear on each page of the draw- ings submitted and shall be signed arci dated t� the registered arc3iitect or ENGINEER: ARCiiITECT OR E[IGINEER CF.£fCIFICATION I hereby certi.fy that the woric prop�sed to be done on these plans is in conformance wi.th all Codes and Ordinances of the City of Costa Mesa and f�ther, if anissions or errors are disco�,ered, I imderstand that the wvrk perfouned will be r�uired tt� can- ply with the Codes and Ordinances af the Ci.ty of Costa Mesa prior tn final bui.lding inspection. Sic�at�se PERPIIT ISSUANCE L�ate State License Building pennits shall be issued tr� CITY upon canpletion of all re3uirenents specified above and, up�n canpletion, of all requireirents of any other affected de�rtment of CITi' or other goverrmental agency. VIII. ACIQ��7L,E[UFMENIS DEVE[,OPER and INGINEER acknaaledge that they have read and undezstand the abo�e statetrent of conditions, requi.re�rents, and direction arr3 agree to per- form accordi.m�ly. FUrtherniore, they understand that no building permits shall be issued for any project imtil these requirements ha�e been satisfied, and they certify that no work has been �mdertaken b� the ENGINEER i.nvolvi.ng plan �eck services prior to submittal of the required certzficat2s of ins�ance an3 prior tc� apprc-nwal of s�ne 1� the Casta Mesa City Attl�rney. IX. SIC3�ANRES A. The Director of Development Services or his designee is authorized tn exeaate this agree7rent on behalf of the City of Ccsta Mesa c.fien the parties meet the conditi.ons listed herein. B. Zhe DEVE.LOPER is defined as the fee title property owner or the tenant for which the improvements are beirx3 mnstructed. If the fee title property owner or tenant is a crorp�ration or general partnership, an officer of the corporation or a yeneral partner shall execute this agree�nt. -5- C Zf the ENGIt�ER is a corporation or general_partnezship, an of£icer of the corporation or a general partner shall exeaite this agree�rent: IN WI''iT1ESS FaiERECF' the �rties have signed below. L�E,'VII.QPER BY , u°"a' � c�.r.,r -�•� TITLE (If Developer is�a oozporation, officer of corporation must sicyi; if Partner- sfiip, general partner must sign. } ;� z � ` � a.� �', a ,�., -� ��5 C..'� /� T�R �.��F�'ii �/ -Z � z {o /i?� �j S"-�- � - / 7 ��' TELEHiONE CI'IY OF NSTA MESA � a� �/G� ✓ j—eS //�P'�h / TITLE (If Engineer is a �rporation, officer of corporation must si.gn; iE Partner- ship, general partner must sign.} /4-�sJ.�, � �7 �� 4l�Tai hc�-c. C/� /. ��/�/ <��'1 �-$-� "_� �� L TELEFHONE `� �!ZG��✓C/!/ � 3I�`�I�'� � JOB ADDftFSS GENERAL C01 � AP No.l%F��I .i *�.LL}9ECTIONS t c!% ,Gas �y Water V Rnueh Com. Re DATE IGROUP A�, a 19W iGSCRIPTION OF WORK F TYPE V ZONE SUBCONTR.ACTOA . - - � �� COSTA MESA BUILDING-SAfEfY DEPARTMENT P. O. BOX 317 C09TA MCBA. CALIFORNIA For Applicanf fo Fill In Complately TYPE OR PRINT JRE59 � / (p / �F�%�J /7I�� COSTA MESA. CALIFORNIA MAIL ADDRE39 � CITY ARCHITEGT � SIZE ■ BETBACK LINH FNOM N6 FEE RECtIVEU qUG 4 1964 fINANCE DEPT. CITV OF COSTA MESA APPLICATION FOR PERMR BUILDINCi For Office Use Only BY I jJl �� 276 TEL.�� t�ne ♦ NO. / � ZONE GROUP APPROVED TEL. �_- BY DAT NO. ZONING � Z / NO. OF_ / U8E OI NHW ��` PLAN9�� OUILOINO I � � LEOAt � OESCRIRION L U �—' A. P. NO. I '�✓ �—V Y NOTE: NO EAVC OVHRHANO SHALL BE LE59 THAN 90' TO SIDE 8 REAR P. L. EAVES No.ORa�ca9. ALLOWED (U.B.C.REqUIREMbNTI NOW ON LOT YARDSAPPROVED YARDSAPPROVED i MAIN BUILDW6 ACGESSORV 6UILDIN6 DESCRIPTION OF WORK �� HEHEBY ACKNO AND BTATC THAT PLY WITH ALL CI eUILO1Na CONbTi ■ AUTMORIZEDAGENT oisrwn MAIN 6 V AR. SC f� eer.i AGGE �ATE N SQ. FT. � � 1 HAVB qGp TH 9 APPL�C�TION THE wMOUNT BXOWN UNDER VALUAT�ON IB POq TX8 g IB COqRECT ANO OqfiE TO COM� PURP09H OP ¢BTABLI9HIN6 A PERMIi FEH ONLY. Q 88 AND BTATH B REOULATI O pLUATION � / PERMITFEE S � j IG m g '? '7 c z J ., e LL ONNER CAMPBELL J. T. JOB ADDRESS 27 7 DeSoto Ave. GROUP J TYPE SUBCONTI2ACTOR DATE ^ I NUMBER F � • 2?_528 COSTA MESA BUILDING-SAFE7Y DEPARTMENT P.O. BOX /P00 � COSTA MESA, CALIFORNIA Y2626 � For Applicant fo Flll /n Complefoly TYPE OR PRINT ADDREBG � � G � / ^�F\Ll9'A ��%F COSTA MESA, CALIFORNIA :79.G -� OFLOT��' 3 / x �� nowON�� USE OF � EXI3TIN0 BLOO. O[TGACK L�Xi �ROY CHNTBR OP DT11[[f R[AR YA O SIOQYAPDI L[PT RI6XT DESCRIPTION OF WORK u'LL ro d��5�-%7 !� C_ B 7/.� /' 1 HlRSBY ACKNOW�[D06/TXAT 1 NAV[ AND BTATB THAT TNC AlOV6 It CORRI PLY WITH ALL CITY ORDINANCQ/ AND i BUILO�NOCONBTI1UCf10N. � SIONATUREOP� �NN�^ ! / P6RMITTHa �, � AUTHORIZiD AOHNT FEE RECEIVED JUN 3 0 1964 FINANCE DEPT. CITY Of COSTA MESA APPLICATION FOR PERMR BUILDIN(i for Offlce Use Only no. or _ ii uac or �° R�..�o„.-��. o'/� TK�'Ycso z5 A.P.NO. I'7/—�/ / �_ � HOT6: No GV6 OV[RHANO SHALL B6 Ll88 THAN 80' TO BIGB ! RBAR P. L BAVEH ALLOWBD (U.B.C.REOUIRHMfiNT1 YARGDMPROVHG YARG9MPROVfiD MAIN BUILDINO ACCESSORY BUILDINO %i owre 01 � TE � i a w � ao. Rr. � 0 THt AYOIIM OMOWN UNDBR VALUATION IB POR TN8 j ■YPPOOB OP BBTADLI/XINO A PBpMIT I88 ONLY. i VALUATION / P � � PERMIT FE8 k `�.-o 0 i `` TOTALFEH $ 3� ' 18872 COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBA. CALIFORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT aooaess 2767 De Soto Ave. COSTA MESA. CALIFORNIA G ■ STATE E. �oast c NO. OR 8ET6ACK LINE FROM 1� ceNTex on sTaeei µ� REAR YAROZ Z� SIOE YARD I LEFT 7� I RIGHT 6� DESCRIPTION OF WORK '" I II MOVING V�lii � YKn �_� n i� CO/I�IG shake & .,,Q_ �cosrr, w aasr�9�d.50 5-F" �. y.. 70s APPLICATION FOR PERMIT BUILDING For Offiee Use Only RECEIM NO. 'P�i$� L/l RELHIVED BY DATH NEG8IVE DATE K� �— G—�3 .;�1,� BUIL�ING ADDRESS COSTA MESA. CALIFORNIA FIRE ZONING ZON¢ f I NO. OF � I U8E OF e � PLANB BUILOR lEOAL _ _ LINB BTJ � Sin le familv res. w att, ar. Living Area: 1780 S. F, Plan �!� 0-C Garage Area: 1�60 S, F, I HEREBY ACKNOWLEDGE THAT 1 HAVE REAO TH19 APPLIWTION TH6 AMOUNT BHOWN UNDER VALUATION 19 POR TXE ANO 9TATE TMAT TH8 ABOV¢ 19 CORR¢GT AND AaREe TO COM- pURP08C OF E6TAfiLI6HIN� A vEqMIT FeE ONLY. PLY WITH ALL GITY ORDINANCE6 ANO BTATH lAWB fiE0U1.ATING emLolxa CONeTttUc�'iax. VALIIATION / SIGNATUBE OF V PERMIT FEE $ Y�c�' PERMITfE Mesa Uel P'far UeveloDment o [ - +� V {/� /O y / $ �.y�O6J �OO PLAN CHECK $ , `J//,� � AUTHORIZED A GNT ,4ri`(•7 � -[c TO AL FEE 0