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Home My WebLink About2302 ELDEN AVE - Building Permits (5)� (7ta) 750-5273 • Fax (7�4) 75a-a856 • www.ci.costa-mesa.g��LDING PERMIT �� rv,in unrvt, wa iH mwr, i.�+yzozo Job Address: 2302 ELDEN AV Suite: A Viciniry: BLDG A AT ELDEN 23RD Primary Occ: R-1 Hotels/Apts/Res >10 Occ Type of Consiruction: V-N Parcel Number: TPN006022 Zoning: Applicant: MOLLISE, DANIELLE Address: 1653 SUPERIOR AVE COSTA MESA, CA Owner: ELDEN 23RD HOA Address 2302 ELDEN AV COSTA MESA, CA Contrador: LEE ROOFING OF COSTA MESA Address: � 1653 SUPERIOR AVE COSTA MESA, CA Zip: 92627 Arth : Address: Zip: Phone: License: Phone: 949-642-7222 ISSUED BY: 2ip: 92627 Phone: Zip: 92627 Phone: 949b42-7222 License: 349686 Eng: Address: Status: ISSUED Applied: 02/03/2006 Issued: 02l03/2006 Phone: License: SCOPE OF PERMIT REROOF ELDEN 23RD CONDO BLDG A: T/O EXISTING CMP SHINGLES, REPAIR/REPLACE SHTG AS NEEDED, 2 LAYER 3Q# FELT, APPLY 30-YE� SHINGLES. 11SQUARES FEE SUMMARY Plan Check: $0.00 Permit: $8325 SMIP Res: $0.50 SMIP Com: $0.00 Other. $0.00 Inspection: $0.00 Total: $83.75 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY � Fronl -0-0 PARKING Existina: o Calc Valuation: $z,e25.00 Claim Valuation: $z,sz5.00 Rear 0-0 Left 0-0 Right 0-0 �' Rear 0- 0 Lett 0- 0 RigM 0- 0 Reauired: 0 Pr000sed: 0 NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 1 BO days, or ii work is suspended or abandoned tor a period of 780 days. �� INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all � required inspeetlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 imsas �siao� WORKERS' COMPENSATION DECLARATION: , � 1 hereby affirm untler penatiy of perjury one ot Ihe lollowing tleclara�ions: [] I have antl will maintain a certificate ol consent to selbinsure tor workers' compensation, as provitletl tor by section 3700 of Ihe Lebor Code, for ihe perfortnance of tha y� work tor which thi5 pertnli is issuBd. �(' I have antl will maintaln workars' compensation Insurance, as requiretl by section 3700 of the Labor Code, for Ihe peAormenca of the work Por which this pertnit is issued. ��'�My^w,orK\ pamp `�satlonJnsur� e�; rrier and policy number ere: ` J Certier. �-g C Uay�Number. 1g l� a n� /.0— �1�� (Th/s es cfion ne4tl not be comp/etetl i! (h ermit is valued e( one huntlred tlollers ($100) or /ess.) Q I certify that in the peAormence oi the wark for which this pertnit is issueQ I shall not employ eny pe�son in eny manner so as to become suDject ro the workers' compensatlon laws ol Califomla, antl egree thet If I shoultl 6ecome sub�ect to the workers' compensatlon provislons of Saction 3700 of ihe LeDor Cotle, I shell torthwith comply with these provl5'� Qns. , APP�Icen4Sigt�Bqlre: �i�y'�n %JY'YSI�"%t� ��•�� Cna�ei� � ! 3 "- U �O y/ARNWG FAILURE TO SECURE WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL ANO SHALL SIIBIECT AN EMPLO ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO qVE HUNDRED 7HOUSAND DOlL4RE (8100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAM4GE5 AS PROVIDED FOR IN SECiION 3]OB OF THE IABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm ihat I em licensed un r pmvisi ns ol Chapter 9(commencing with Section 7000) of Division 3 of �he Business en�rof��ions Gotla, and my license is in full ro�oe a�a atta��. uc.�p. i 51 � lo R� o cie3,.e-, � CaNSTRUCTION LENDING AGENCY: [] I hereby aHirtn t�at ihera is e construction lentling agency ior the peAormance oi t�e work tor which Mis pertnit is �ssuetl. (Sec. 3097, Civil Code). Lentlers Name: Lentlers Atltlress: Signeture: Date: ON�NER-BUILDER DECLARATIONS: I hereby ettirtn ihat under penelry ot perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe fo�lowing reasOn (Sec. 7031.5, Business and Protessions Code: Any ciry or counry which requires e permit to consiruct, alter, improve, tlemolish, or repair any siructure, pnor to its issuence, also raquire5 the applicant tor such permit to tile a signed stetement Ihet he or she is licensed pursuant to the provisions of the Coniractors License Ww (Chepter 9(commencing with Sactlon 7000) ol DfWsion 3 of the eusiness antl Pmfessions Code) or that he or she is eaempt lheaetrom anA tha basis tor the allegetl exemption. Any violation of Section 7031.5 by eny appliwnt br a pertnit subjects the applicant to a Clvil penalry ol not more Ihan five hundretl dollars (5500)J: Q I, es owner oi the pmpeny, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, antl ihe structure Is not intendetl or oMered for sale (Sec. 7044, Business and Protessions Code: The Coniractors License Law dces not apply to an owner ol propeny who 6uilds or improves Ihereon, and who tloes such work himselt or herself or Ihrough his or her own employees, provitled ihat such impmvemenis are not Imendetl or oMe�eO for sale. If, however, iha building or improvemeni is soltl within one year ol complelion, tt�e owner-builtlar wiil have the burtleo ol proving that he or she ditl nol buita or improre for pu�pose ot saleJ. [] I, as owner ot Ne property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the pmject (Sec. 704d, Business and Pmfessions Code: Tne coniractors License Law tloes not epply to en owner of propeny who 6uilds or improves t�ereon, entl who coniracts for such pmject wlih a contractor(s) licensa pursuant to the Comracbrs Licensa Laws.). ❑ I em exempl under sec. Signature: pwner ID verilied by tlnvers license. ❑ Yes ❑ No Business and Professions Cotle for ihis reason: Verilication of Ownership by (type of tlocument, i.e. - properry tax 6ill or deed): DI��SION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivers License No. Da�e: Expires: ❑ I hareby cenily that no excavation five (5) or more feet in Cepth into which e person is requiretl to descend wlll be matle in connection with work eutharized by this pertni�, and ihat no Duiltling s�ructure, scaHoltling, falsework, or demolition or disman�ling thereof, will be more than thiny-six (36) leet high. (Chap. 3.2, Grp 2, Atl 2, Sec. 341, Title 8, Celilomie Adminisirative Code). ❑ As owneo-builtler, I will nol employ enyone to do work which would require a permit trom the Division of Indusirial Selery, es noted above, unless such person has e permit to do such work irom Ihe tlivision. Sig�eture: Dale: Dihsion of Indusinal Safery Pertnit Number: CE�IFlCATE OF COMPLIANCE AND AUTMORIZATON OF ENTAY: I cenity untler penalry ot perjury ihat I heve reed Ihis epplication end state thet ihe infort�ation given is coRec�. I agree to comply wi�h all stale laws and ciry ordinances relating to building consiruction, antl authorize representatives oi lhe City of Costa Mesa lo enter upon the eb0�e-descnbed property tot inspection purposes. I a9ree not ro ocGupy or allow occupancy of any builtling authorizetl by this Oermit until finel inspection. �� Signature O� Legal Owner(s) -� _ LOtlE 1, INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 7266 Pool Spa Final 200 201 202 203 204 Final Re-Roof Flnal BloCk/Retaining Well Final Fectory Fire Place Final Sign Final Demolitlon OpTE CODE� INSPECTIONTYPE 206 Final Mechanicaf 208 Final Plumbing 210 Final Eleclncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildirnyOccupanry PAIE Irmn��S FEB-�2-06 11 :56 PM � '�. February 2, 2006 � .. _. � P.01 j �f%l( _ QO� —� LZ— 7 Elden 23�d HOA 2302 rlden Avenue Coste rilesa, CA 92627 i City ofCosta hlesa Building Division: ; Wc, the F,Iden ?3N Homeowners' Association, authonzo i,�e Roafng Company f'or tha re-roofing of our complex. Tha work is sc:heduled to begin today, February 2, 2006. Please call us to inform us that ��ou have r�,ceived this authonzation. ' RespecU�ully, �'✓'1.'r�..�-t.t... " �-�-�( lJuvid anQ.fennifer Lpng J I IOA Vicc Presidont und 5ecretary, respectively Owners of Unit C (949) 722-8677 0 \ \ � AOVlieant to fill In all spaees ezeev< <hose wlthln neavy �oraer Iines anG sign al1 approDrlata tleclaralions. •CITY dF COSTA MESA� CONSTRUCTION PERMIT Project Address 7 3 h Z ��--'�c /� Applicant's Mailing Address ;J-�A�K E' ✓✓) �1T H L"!� �66 Y�%Nt� Owner's Name�, �� <' /23 RD ��°R�`�✓r��o�e 6S�oC-/2v Address - � ' Arch/Eng. License No. Address ��O ��5/✓�///b' ' Contiactor'sName -��" M+Ti-`E�L Phone CiaT/9/ Address (mailing) �3e 4 I'hA.¢L��/3 � City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm thdt I am licenzetl untle� p�ovi5ion5 of C�arter 9(comm¢ncing with sectlon 7000) ot Divlsion 3 of thn Business antl Professlons Cotla, antl my license is in full rce antl eftect. License Clan � icense N 2 Z y Date Si9nat � , 1�YORKERS' COMPENSATION D ARATION � :, ��eby a(firm thdt I have a certificate of con5ent [o sel - nsu�e o� a ce�tlficate �„,,. Workers' Compensation Insurance, or a certlfietl coOY �hereof (Section � :`v`00, LaD. �.) n Q'� PolicY No. `-��-7> /� �"�-� ComPanY STAT� ��D �Certifietl copY Is hereby furnis . Cer ie co0 is filetl with th city viV ' i' DatenM1P� AOPIIc ' EXE I FR M WORKERS' C MPENSATION DECL ATION (This secti n neetl not be complete0 if the pe�mlt IS tor one untlretl (S300j o� less). I certify�that in the performance of the work �or which ehis perm�t is issuetl, I Shall not employ any pe�son in any manner so as to become 5ubjett [o the Workers' Compensatlon Lawz of Califomia. Date Si9nature -NOTICE: If,iafter making this tleclaration, you shoultl become subj¢ct to [he Workers' Compensa[ion Orovisions oi the Labor Cotle, you must fortnwith com0ly with Suc� provizions or thi5 permit snall be deemetl revoketl. CONSTRUCTION LENDING AGENCY I hereby aHirm that there is a<onstruction lenaing agency for the performance of the work tor which [his perm_�T i i Su¢tl (Section 309] Civ. C.) Lentler's Name _�d�, - ^-� d � `"' �� Lentler'S Atltlress � �=�o�+ � �'L-�^) OWNER BUIIDER DECIARATION I hereby affi�m l�at 1 am exampt trom [he Cont�actor's LlcenSe Law IOr th< tollowing reason (SeCtion ]031.5 Business and Professional Cotle: Any city or munty which requires a pe�mit to construct, alt¢r, imp�ove, tlemolish or repair any structure, prlor to its issuance, also requlres the applicant tor such permlt to til¢ a signetl 5[atemeM tM1at he/she IS licensetl pu�suant to the O�ovi5ion5 0( the Contractor's License Law (Chapter 9(commencing with Se<fion 7000) of ��vision 3 of the Business antl Protessions Cotle) or that he/she is exempt �refrom antl.the basis for the allegetl exemption. Any violation of Section 31.5 by any applicant for a permit su�jects the �appllcant t0 a civil enalty of not more than tive huntlretl tlollars ($500). � I, as owner of the property or my employees with wa9es as thelr sole compen5a[ion, will tlo the work, an0 the st�uctura is not Intentletl O� oHe�etl for sale (Section 7044, Bu5ine55 antl Pro(e55iOna1 CotlC: The Conlra<tOr'S LicenS¢ Ldw tl0¢5 not apply t0 an owner of a properfy who builtls o� Improve5 iheteon, antl who tloes Such work himself/herself o� through his or her own employees, provitletl that su<n improvements are not intentletl or oReretl for Shce. If, however, [ne bulltling o� imp�ovement IS Soltl within one year oi com- pletiOn, tne owner will have tne burtlen of p�ovinq he/she tlitl not builtl o� Im- �rove forthe purpose of sale). I, as owner ot the property, am extlusively contraccing wlth licensetl con- tractorstb construct the project ISection 7044, Business an0 Professions Cotle: The Contrattor•s License Law does not apply f0 an owne� of property who builtls or imvroves tnereon, ana who contracts for 5uch projects with a con- tra<Sor(5) Ilcense OurSuanf to the Contra<tor's License Lswl. ❑ I am exempt untler SecHon B. & P. C. for Nis reason Date Orivers�cens¢ or 55 3 CMF 0865-46 rev. 12/8 Owner _ have rea0 this TVPE OF CONSTRUCTION LJ NEW U ADD Ll ALTERATION LJ REPAIR ❑ CONVERSION ❑ �EMOLISH ❑ OTHER � q.p, �b - DESCRIPTION�OF WORK �(KG9��C6 +'I� �T ' �O6 �Z� . � S Main Building: � TVPEOFPEflM1T �GRADING FOUNDATI N STRUCTURAL T Front �� TENANT ❑ ELECTRIGAL ❑ PLVMBING � MECHANICAL A Reaf � ❑ �OTHER ' � � PROJECT DESCRIPTION Sq. FT, oCCUPANCv � C Right . K Left � CONSTRUCTIONTVPE VALUATION$ $' ZONE GRAOING CU.YDS. ACRES PIOy. R¢1. `/k Remarks: . - O �.- Parkin9 Req./Provided - �Use of Building: PLUMBING ' FEES Planning Notes: Irrigation Dishwasher Drinking Founroins Floor Drains Floor Sinks Gas Service Outlets Citchen Sink ' Lavatories ?-Trap Roof Drains Reinspection Fee $25 Boiler Duc[ - Under Ground Duct - Struc W ral Duct - Ventilating Exhausi System ❑ Multiple ❑ F irepl/Fact. Blt. I CBO # 31 Q'� Heating System & Ducting ❑0-100,000 BTU 0100,000 BT -_�- I I peinspeaion Fee I $25 BUIltling; Canary - Appliwnp Pink - Accountlng; Goltlenrotl - As5e55or Showers Servite Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heacer Water Service laue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑aioo,000eTu ❑�oo,000 System Repair/Alteration Issue Fee $ 3 $ 3 Auromatic Washer Construction Pole Su Cooking Unit Dishwasher Dryers �Gas ❑Eli Fan F.A.U. Fi%tuf¢5 Device Bozes Outlets Switches Garbage Disposal Generator �0.5 KW fi 8169 4/06/84• 8p0� TL Accessory Building:. Park.Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter poveri00amps 5-15 KW Sub Panel Motors�0.1 HP �1'h-8 Inc. Solar �9�15 HP 016-15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor FEES O N I N G R E � R E N E N T � Reinspection Fee I$25 � �uue Fee I $ 3 I PUBLIC SERVICES REDUIREMENTS: Zoning Approvetl By Date BuildinB APV�oved By ,',� Date�-��/�{�-�� Appliption laued By �`, Dat9_[.L.(CL� SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ —p--�7-/�7- MECHANICAL $ TOTAL FEE $ �� ' �� PLAN CHECK 25% $ � � 'CONSTRUCTION AND'PLANNING POOL 'A � . - APP.ROVALS Permit # -�S a' Date Inspector p�ppROVALS Permit # Date'� Inspector . 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . l•2. Soil Pipe-Undrgrnd.� 53. Steel Reinforcement - - 3: Electrical Conduit Utility-Undrgmd. 54. Forms � 4: Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcemen[ 56. Rough Plumbing & Pressure Test - 6: Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings ' ' S8. Electrical Conduit-Undrgmd. '. 8. Foundation � 59. Gas Pipe,:O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgmd. � 10. Structural Floor System 61. APPROVAL TO DECK 17. 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�ElecCric Wiring , " 67. Fencing & Access Approval - � ,`17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ' APPROVALS Permit # � 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 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 Ceilinj (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 � ' / �Y � 38. Final Plumbing � � � � � 39. Water Service-Final , � 40. Gas Service-Final � . 41, Solar pomestic-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 ; � i � 49. Electric Release to Edison . � � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY � - -' No. -� ' `D'ate � , . � 0 PERMIT AOP��cant to flll In all svaees except ihosa within �eavy PERMIT N !'� - TRACT NO. , t .. 9n %�n�f J Project Address �-�'t�1 Z �L�'@/� Applicant's Mailing Addr ss - /'/., !_! Owner'sName �3 °�"'�� Phone!¢Y�-21% Address Arch/Eng. License No. Address Contrector's Nam U S Phone s� / r � Address�mailingl �� L'��dN�f• '�• l)'. J. City License No. �� aa LICENSED CONTRACTOR DECIAqATION 1 h¢r2by affi�m that I am licensetl untle� p�ovi510n5 of Chdttet 9(commencing with �section 7000) of Division 3 of the Busine55 antl Professions Cotle, antl my Iicense is In fuJl �force ntl effect. �1 Licens Class v— �� o�� ry�Q� a�� Date Signature� �� /'� ��—� KERS'COMPENSATION DECLARATION :reby attirm that I have a certificate of consent to self-Insure or a certiilcate Workers' Compensation Insurance, or a certifietl copY thereof (Section 3800, Lab.�C.) Policy No. Company e Certifietl copy is hereby furnlsM1etl: $ co is ille ith the city ii ivl�n.Sp ..y,0 Oate� Applfcant � � EX PTION F OM W RKERS' COMPENSFTION DECLARATION (T issec[ionroeetl not be completed if the permit is for one huntlretl ($100) or less). 1 c¢rNfy tM1at in the Oe�fo�mance ot the wo�k tor which thi5 pe�m�t i5 i55uetl I sitall r�pt em0loy any person in any ryartpeqso as to qe�orr�Lbject.ro [�e � NOJ/CE: If,�aftE� making this tleclaratlon, you shoultl become subject to tM1e Workers' Compenwtion provislons of the Labor Cotle, you must torthwlth comply with such orovisions or this permit shall be tleemetl revoked. CONSTRUCTION LENDING AGENCV � I hereby affirm that there is a construction lentling agency for the performance af the work tor wnlch tnis permit is issuetl (Sectlon 3097 Civ. C.) Lentler's Name Lentler's Atltlress � OWNER BUILDER DECLARATION ' � � I hereby. aflirm that I am ezempt from the Contractor's License L.aw Tor the follOwing rea5on (Section 7031.5 Buslne55 antl Protessional Cotle: Any city or Lounty whlch requires a permit to construct, alter, improve, tlemolish or repair nMrom antl the . J31.5 by any a� �enalty of not mor I, as owner of mmoensation. will owner � w ; purpose as rt fol-a permlt Sub�ect5 the applicant to a, clvll five huntlretl tlollars ($500). . . . �roperty or my employees with wages as their sole � work, antl the structure is not intentletl or offeretl ' Business and Professional Cotle: The Contractor's �ty to an owner of a property who builds or improves , �uch work himself/herselt or through his or M1er own such Improvements are not In[entled or offeretl for IGing or improvement is soltl within one year of <Om- aie the burtlen of proving he/she tlitl not builtl or im- . ale). �perty, am extlusively contracting with Ilcense0 con- voject (Sectlon 7044, Business antl Professions Cotle: �. Law does not apply to an owner of property who . on_ antl who mnVacts tor such oroiects with a con- � LJ I am exempt untler Section B. & P. C. tor thi5 reason Date Owner I hereby certify'that 1 have reatl ihls appllcation antl state that the above Info�mdtl0n Is m�rect. I agree to COmply with all tlty antl county ortlinances antl state laws relating to builCing <onstructlon, antl hereby authorize repre- sentatives of t cl y to enter u�Q n th$ above-mentionetl Rroperty tor Inspectlon p�s� Q1 �Q //l .�1i� // � � i0� Ilnes anE sign all aOVropriate tleclarations. TVPE OF CONSTRUCTION LI NEW U ADD LI ALTERATION LI REPAIR ' .O CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT �ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCV CONSTRVCTIONTVPE VALUATION 5 ZONE GRADINGCU.VDS. ACRES Remarks: Sink <flow Preventer eflow Irrigation Dishwasher Drinking Fountains Floor Dreins Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap �Roof Drains Reinspection Fee Outlets $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. IC80 # Heating System & Ducting �0-100;000 BTU �100,000 ��y��a�� - ' _ '_ __ _ i Drivarz' License or 55 � Reinspec[ion Fee $25 CMF0865�46 rev.12/83 Whlte-Builtling;Canaty-Appllcant;Pink-Accounting;Goltlenrotl-ASSe55o� Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee 1ANICAL Hood or Typel ❑ � Canopy � Type I I ❑ Refrigeration System � ❑0.100,000 BTU ❑100,000 BTU System Repair/Alteration Issue Fea FEES A.P. # $ Main Buildi E T Front B Rear A C Right K Lett S Ping. Ref. # Parking Req./Pn Use of Building: Planning Notes: Automatic Washer Consvuction Pole Sub. Coaking Unit Dishwasher Dryers ❑Gas ❑Elec' Fan F.A.U. Fixtures Device Boxes Outle[s Switches Garbage Disposal ' Generator �0.5 KW C 3201 I/27/84 Zone Park.Fees ELECTRICAL Transformer ❑ 15-50 KW ❑ 50 + KW Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel Motors�0-i HP �1'f.-8 Inc.Solar 09-15 HP �i6-15+ Microwave Pole Li9ht Range Standing Sections 5 KW Trash Compactor $y� Reinspection Fee ' $Z5 Issue FEES PUBLIC SERVICES HEQUIREMENTS: � Zoning Appraved By Buildin8 />PProved By $ 3 10.50 T�. 2 O N I N G R E Q U R E M E T $ 3 SUMMARV OF FEES . � BUILDING PERMIT �$ SMIP $ ' PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% S ENERGV P.C. $ ELECTRICAL �$ .00 GRADING $ PLANCHECK 50% $ rS�D MICROFILM $ MECHANICAL ' $ TOTALFEE $ �D•SO PLAN CHECK 25% $ ONSTRUCTION AND PLANNING ° ROVALS Permit# F(01� �.mporary Electrical Service or Pole i � .;oil Pipe-Undrgrnd. , . Electrical Conduit Util ty-Undrgrnd. 4. EleFtrical Conduit-Undrgrnd. i 5. Steel Reinforcement' � 6. Electrical UFER Grnd. � � 7. Footings � , ��' � 8.�Froundation � � � 9. Water Pipe-Undrgrnd. ' 10. Structural Floor Systern ' 11. Property Sewer Line & House Connecti'on 12.'�Sewer Cap � � 13. ,Foof Drains i i ' ! 14. Rough Blumbing . 15. Rough Electrical-Conduit i6.;Rough ElectricWiring 17�. Rough Wiring Sign 18.; Rough Electrical-T Bar Ceiling 19. Rough Heating,& Air Conditioning 20. Rough Factory'Fireplace , . , 21. Ducts, in Structure ' , 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test .� 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structuraq & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation � 30. Drywall Nailing 31 . Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. �Handicap Regulations 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc 51. CERTfFICATE OF OCCUPANCY Date POOI PA Date .Inspector AppROVALS Permit# Date Inspector -I ' 6 0 � : 52. Pool & Equipment Location : 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER-GUNITE . ' 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test ,' 60. Backwash Lines, P-Trap, � Undrgrnd. 61. APPROVAL TO DECK � 62. Backwash & Receptor-Final '� 63. Heater & Vent-Final � 64. Plumbing System � Final � 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT � APPROVALS Permit # 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank 0 Gas ❑ Oil � 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe • 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: i' . 0 A Applieant to fill in all spaces except t�ose within hcavy Oortler Ilnes anE sign all aoo�opriata tlaclarotions. CITY OF COSTA MESA - CONSTRUCTION PERMIT Project Address —�_%`' � %��N Applicant'S Mailin9 Address Owner's Name C%n'1 /� )i C UWS � Phone Address � ��% �nfL/'MZATE �A/I�.Y;� /V /-S Arch/Eng. License No. _ Address Contractor'sName�TONI`� /�/7i1 C �3 Phone y��-�YkS Address (mailingl - � � R " S f City LicPnse No. 7 � LICENSED CONTRACTOR DECLARATION . ' I`hereDy affirm that I am Iicensetl undar provisions of Charter 9(commencing with section ]000) ot Division 3 of the Business and Professlons Cotle, antl my license is In (W fo�jc antl etfect. O License Class � `� Lic se � � Date `� Signature • . WO KER�SATION DECIARATION �ereby affirm that I have a<ertlficate of consent to self-insure or a<ertifiwte Workers' Compensation Insuran<e, or a certifletl copy thereof (Settion a800, Lab. C.) /•r� Po cY No. �Yvo .a 3- �i5� OmPanY �T / rr%� �U17�0 , Certifietl copy is hereby furnishetl. � ertitieC cop is filetl with the ci[y B iltli Dlvisi n. �� a e � Applicant ' �" EXEM ION�RKERS' CO ENSATION DECLARATION (Thissection neetl not be <ompletetl it e Oermit I5 (or one huntlred,(E300) or 1¢ss)'. ' •.. I certity that in the performance of the work for whlch this perm�Lis issuetl I sha16 not employ any person in any manner so az to become sublect to t{�e Wo�ke�s' Compensation Laws ot CdlifOrnia. Date Si9nature NOTICE: If, atte� mdkln9 this Oecla�alion. You Shoultl becom0 Subjeci to the Workers' COmpenzation provisions of the Labor COtle, you must fort�witn comply witn suc� provlsions or this permit shall be tleemetl revok¢tl. CONSTRVCTIOM LENDING AGENCV I hereby affbm that there i5 a�mnsVuction lentling agency for the performanCC o( the work for whlch this permit is iszuetl (Section 3097 Civ. CJ Lentlet'S Name Lentler's Atltltess � OWNER BVILDER DECLARATION 1 hereby a(firm that I am exempt from the Contra<tor's License Law for [he following reason (Section 7031.5 BuSiness antl Professional Cotle: Any city or a 1, as antl the Gasis tor the allegetl exemption. Any violation of Section any ap0��ant tor_ a permit zubjects [ne applitant to d civil not more than five huntlrotl tlollars (E500). an owner or a properry wno owms or vork hlmselt/hersell or throu9� his o� improvements are not intenCetl or o�� saie. Ii, nowever, tne owiamq or improvement is soitl wimin one year of com- pletion, the owner� will have the burtlen Of provin9 he/she tl10 not builtl o� im- �rove tor fhe purpose of sale). 1, as owner of the property, am exclusively contractin9 �'��h Iicense0 con- tractors to construct t�e project (Section ]044, Business ana Professlons Cotla: The Contrattor's License taw does not appry to an owner of property �who builtls or Improves thereon, antl who contracts for such pro)ects wlth a con- tractor(s) li<ense pursuant to the Contractor's License Law). ❑ I am exemOt untler Sec[ion B. & P. C. tor this reason Date Owner 1 hereby certify that I have reatl thls applicaYi intormation is wrrect. I agree to complY �+�� a antl state laws relating to builtling tonstruction sentatives ot this� ppp�ty (o enter up tn a inspection purposey / . /� S�gnature�T � 9�1!/LL L.. Drivers' License M 55 � I I Aeinspeetion Fee — /O/ �� I ` TYPE OF CONSTRUCTrI�ON IJ NEW L1 ADD lJ ALTERATION LJ REPAIR ❑ CONVERSION p�DEMOLISH ❑ OTHER p�p .M, DESCRIPTION OF WORK �F�w4Ol-JII .0 rO � 5 Main Building: TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT O ELECTRICAL ❑ PLUMBING ❑ MECHANICAL , A Rear ❑ �OTHER - � C Right PROJECT DESCRIPTION 5�. FT. oCCUParvCV CONSTRUCTIONTYPE VALUATION$_,� �aG�— g Left � ZONE GRADING GU. VDS. ACRES p�ng. Ref. # Remarks: . � ' Parking Req./Provi< Sink Preventer Irriyation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee � $25 Boiler Duct- Under Ground DUG[ - $tNCtuf81 Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ai oo,000 eTu 0 i oo,000 CMF 0865-46 rev. 7/83 White - Buildin9: Canaiy - APpliwnp Pink - Accounting; Goltlenrotl - Assessor $25 ShOwers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service laue Fee Hood or Type I � Canopy Typell ❑ Refrigeretion System � ❑4100,OOOBTU ❑100,000 System Repair/Alreration Issue Fee Use of Building: FEES Planning Notes: E Automatic Washer � Construction Pole Sub. � Cooking Unit � $ 3 $ 3 Dishwasher Dryers ❑Gas ❑Eb Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �65 KW 5�15 KW 2639 'I/IB/B4 Za�a Accessory Building: Park.Fees $ Transformer ❑ 15�50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors �0.1 HP � 1 Yh - 8. Inc. Solar 09-15 HP �16�75+ Microwave Pole Light Range Standing Sections Trash Compacror 34.37 7L 2 O N I N G R E Q U I R E E T � Reinspaction Fea I$25I �ssue Fea I $ 3 I PUBLICSEHVICESREOUIREMENTS: � 2aning Approvad By Date Application Approved By Date ApO��tion Issued By / Dat ' SUMMARV F FEES J� BUILDING PERMIT $ � SMIP $ - ..5 // PLAN CHECK $ �� PERMIT PLUMBING $ S/D ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ 7 MECHANICAL $ TOTAL FEE $ �J P�AN CHECK $ CONSTRUCTION AND PLANNING ' • POO, ;PA • APPROVALS Permit # 5�'(�w 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, O Undrgrnd., Test 9. VJater Pipe-Undrgrnd. .� 60. Backwash, Lines, P-Trap, O Undrgrnd. 10.�Structural Floor System 61. APPROVAL TO DECK i t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final t2. sewe� caP �_�y_yy � 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. POOUSPA 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.StorageTank �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 . 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 48. Special Requirements Completed - 49. Electric Release to Edison � 50. Gas Release to Southern Califomia Gas Co � ' 51. CERTIFICATE OF OCCUPANCY ' No. Date _ - � ,_ . , Appllcanl to fill in ail ipaces ezcept tnose within heavy GorEer Ilnes antl sign all.appropriata tleclaratians. .�CIT�' OF COSTA MESA P MIT NO. TRACI CONSTRUCTION PERMIT ' �— ( O—T 3 � Project Address r e i1 � TYPE OF CONSTRUCTION NE AppliCent'S Mailing Address , � ❑ CONVERSION ❑ DEMOLISH < �Lsc� ' . DESCRIPTION OF WORK J noo LJ ALTERATION IJ REPAIR OTHER Owner's Name 'T �.' Phone Addreu TVPE OF PERMIT GRADING �❑Y FOUNDATION ❑ STRUCTURAL ArchJEng. ' Lic2n5¢ No. ❑ TENANT ❑ E�ECTRICAL O aLUMBING ❑ MECHANICAL Address ' ❑ �o7HER � ' � ' Contractor's Name ��""�'S u" Phone�PYb �� PROJECT DESCRIPTION 5c�. FT. oCCUaANCv_ Addresslmailing� �S3q��`�`��'�L�'" Z' CONSTRUCTIONTVPE VALUATION$ ' CityllC¢OS¢NO. F%I�/�� ' ZONE GRADINGCU.VDS. ACRES LICENSED CONTRACTOR DECLARATION Remarks: (%fj� �/5�n�-r J I hereDy affirm that I am Ilcen58tl untler provi5iOn5 oi Chart¢r 9(COmm¢ncing with sectlon 7000) of Dlvislon 3 of the Business antl Proty�s�vn 9tle, and my Iicense is in ful orce antl effect. � � LiCBOSC CId55 �� a�-�-� �- �� 050 . Date �'--rNO-� c9nar �•n {�/W�'�I Zt — — -- --'ORKERS' COMPENSATION DECLARATION Ba rreby atfirm that I have a certiticate ot consent to self-inzure or a certificate ge, Workers' Goinpensation Insurance, or a certlfletl copy thereof (Sectlon � 3800, Lab. C.)�� QQn ( ! , _ � � ?^ , _ � Be� PolicY No. �[�� ComPanY -�T �� 1�� ifletl copy Is hereby furnisnetl. • � Ba ertifietl ca I5 filetl with the city Builtling DiviSiOn Irrigation PY • Oate APPllcdnt CId�i1i¢�s EXEMVTION F0.0M WORKERS' COMPENSATION DECLARATION Dishwasher (Thissectlon neetl nat be completetl If the permit is.tor one huntlretl ($100) or less). -• I C¢rtify tM1at in the pertormance of the work (or which Ihls permk is issuetl, I Drlflking FOu. shall not employ any pe�son In dny manne� so as'[o become SubjeCt to the Workers' Compensation Laws ot California. � Floor D�ains Date Signatura ' NOTICE: If,iafter making this tleUaraHon, you shoultl become subject to [he Floor Sinks Workers' Compensation provlsions of the Labor Cotle, you must forthwith comply with such provisions or this.permit sM1all be tleemetl revokeG. GaSService CONSTRUCTION LENDING AGENCV ' 1 hereby afilrm that there Is a construction lentling agency for tne performance Intercepto�s ot the work for which thls permit is issuetl (Sectlon 309� Civ. C.) Lantler's Name j Kitchen Sink l.entler's Atltlress . /� Lavatories OWNER BUIL�ER DECLARATION ' I I nerebv a�firm that I am exemot trom the Contractor4 Lirense Law tor the „_ dlty of not mo�e than fi� I, as owner of the pro ipensation, will� Oo the � sale (Settion ]044, Bi �nse Law tloes not apply �eon, antl who tlo¢5 suc �loyees, p�ovitletl that s� �_ If, however, the builtll :ion, tne owner will haei va for the purpose of sali 1. as owner ot the o�oot to construct, alter, Ii me. also reouires the ior a� permrt suo�ecu [ne appucan[ m a crvu a huntlretl tlollars ($500).' �erty Or my employees with wag¢5 as their sole �ork, anC the structure is not Incentle0 or offeretl siness antl Protessionab Cotle: TM1e Contractor's to an owner of a property wno bulltls or improves i wOrk nlmself/her5elt or through his or her own ch ImProvements are not intentletl or offeretl for ig or improvement is soltl wl[hln one year of com- the bu�tlen Oi proving h¢/She tlitl not build or irt�- �. i rty, am exUusively contracHng wi[h Ilcansetl con- ect (Sec[lon 7044, Business antl Protessions Catle: aw does not apply to an owner ot property who antl who cont�acts for SUth profect5 wl[h a con- the Contractor's License Law): I am axempi untler Sectlon B. & P. C. for this reason Date Owner _ have reatl this above iances repre- v for Outlets Roof Orains Reinspection Fee $25 Boiler Duct - Under Ground Duct - Structural Duct - Veniilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating Sysrem & Ducting ❑0.100,000 BTU 0100,OOOBT Slgnature - - - �- — uaca � -' � Drivers' License or 55 � Reinspee[ion Fee $25 CMF 0865-46 rev. 12/83 White - Bulltlin9; Canary -Applicant: Pink -Accountin9; Goltlenrotl -Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors ' � Solar Pipin9 . Solar Tank Swimming Pool w/Spa Urinal Water Closet � Water Heater / Water Service Isue Fee FEES $ 3 A.P. # S Main'Buildi E T Front B Rear A C Right K S Left Ping. Ref. �}- Parking Req./Pn Use of Building: Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit D ishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes OUtlets Switches Garbage Disposal Generator �0-5 KW C . , 3I25 I/26�Q4 Zone ' � Accessory Building: Park.Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter LJup to 100 amps Meter pover100amps Sub Panel. Motors �0-1 HP �1 %- 8 Inc.Solar �9-15 HP �i6-15+ Microwave Pole Light Range Standing Sections 5-15 KW Trash Compactor Reinspection Fee $y5 Issue Fee IANICAL FEES PUBLIC SERVICES RE�UIREMENTS: Hood or Type I ❑, � Zoning Approvad By Canopy Type I I ❑ � Building Approved By Refrigeration System � ❑aioa,000sTu ❑ioo, System Repair/Alteration Issue Fee $ 3 J5•b0 TL Z O N I N G R E � U I R E M E N T S FEES $ 3 � SUMMARV OF FEES . - BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ 2A_OL� �SSUANCE $ � PLAN CHECK 25% $ �vi Z7 ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ � PLAN CHECK 25% $ CONSTRUCTION AND PLANNING � 1 POOL PA � � APPROVALS Permit # Dat j� Inspector pppROVALS Permit # Date � Inspector `� 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � ' 2. Soil Pipe-Undrgrnd. �%.r�� 53. Steel Reinforcement �a3. Electrical Conduit Utility-Undrgrnd:, � 54. Forms � .'4. Electrical Conduit-Undrgrntl. �. � 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. �' //a7/d� � 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System � 61. APPROVAL TO DECK 11. Property Sewer Line & House Conn� ction � 62. Backwash & Receptor-Final 12. Sewer Cap , � 63. Heater & Vent-Final � 73. Roof Drains -��•. -i 64. Plumbing System - Final 14. Rough Plumbing Z/Z 8 65. Electrical-Final 15. Rough Electrical-Conduit 66... Solar System-Final 1��6. Rough Electric Wiring 6Z Fencing &�Access Approval -• 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18.�Rough Electrical-T Bar Ceiling 69. POOUSPASYSTEMS FINAL - 1.9. Rough Heating & Air Conditioning � 8�/ 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 Q�Z�/� � 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. D'ry 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 Lf(/L��°/ (,E� 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � _3 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 � 48. Special Requirements Completed � ' 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY � No. Date � . P�oVilont to fill in all spaces ezeeot tnose witnin heavY Oortler �ines ane sign all approoNata Oeclarations. '. CIT�J OF COSTA MESA • � p MIT NO.. TRACT NO. LOT.NO. � BLD . . � � • CONSTRUCTION PERM17 ' -��V�'�� ProjectAddress Z TYPEOFCONSTRUCTION NEW %�DD ALTERATION REPAIR � � �'�� - AppliCanYs Mailing Addre55 . � �/�,�,% /A�� Z' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � A p # 2on8 . Owner's Name �- b.1 - 2-3P-o i/l�`%1�P�'� Phone 0 L�% DESCRIPTION OF WORK �K��"��~ � . � M,,� S Main Building: Accessory Building: 2O ilddreu � 2. ��D��°.il`� �rl47 l�l � � .- - E. TVPE OF PERMIT GRADING FOUNDATION STRVCTURAL . T Ffont � � N Arch/Eng. License Na. � - - ' I ❑ TENANT ❑ ELECTRICAL PWMBING ❑ MECHANICAL � B Rear " AddfC55 �{�- � � � .�' �,�Cy"� ❑ �OTHER � . ' A N Contrector's Nam 1NC-K- MR�'pA�F'C�- Phone �¢1�--11ti FAOJECT DESCRIPTION St;. F7. � oCCUaAnCY C Right - G Addre55�1mailingl �-�D�O � 1-��ks CONSTRUCTIONTVPE VAIUATION$ S Left ' E CityLicen52No. ZONE � � GRADINGCU.VDS. ACRES ping.Ref.# Park.Fees$ � �� LICENSED CONTRACTOR DECLARATION ' Remarks: — a � - Parking Req./ProVided ' R ( herGby a�li�m that 1 am ticensetl untle� p�ov(s(ons o( Charter 9(commenc(ng - . with Section 7000) ot DivlSion 3 of the Busine55 antl Profe55lons Cotle, antl ' U520( BUiIdIOy: ' � E my Iicense iz tn iyF� (orce ana effect. /� ' M License C as 1"�! � — �• ice��sej`1 o. 2 2 r L � PLUMBING - FEES Planning Notes: � � \�Date� Sig t !�/lt'� - ' ' WORYCEE35' C6MPENSATION DEELqRFTION Bd/ Sink $hOw2�s \. LhereDy affirm that I have a certificat¢ of consen[ [o selLinsure or a certificate [ . . -- - of Workers' Compensation Insurance, or a certifiea copy tnereof (Section Backflow Preventer Service Sink S 3800, Lab. C„LS ��d. �� 7 u� ByCkfIOW Ifli at�on � Policy No. � � Company �`�� 1� 0 9 Sewer Cap �- ELECTRICAL FEES � Certifietl copy is M1e�eby tu�nishep, B2thtub5 $ew¢� COnn¢cti0❑ -Cer 'ii-a p is fnea wirn tne � Automatic Washer Transformer ❑ 15-50 KW q D siu�. ❑ SO+KW Date qppiic Clarifiers Solar Collectors Construction Pole Sub. EXE TI FRO WORKERS'CO ENSATIONOEC ARATION (This section neetl not be complete the permlt Is tor on huntlretl (E100) or Dishwasher Solar Piping Cookin9 Unit ' Meter ❑up to 100 amps less). I c¢r8fy that in the perfo�mance of the work tor which this pe�m�t is Issuetl, I Drinking Fountains $Oldf TdOk DishwBSh¢f Meter ❑Ov¢� 100 amps snall not employ any person in any manne� so�as to betome Subj¢Cf [o the Workers' Compensatlon Laws of Cal�fornia. . Floor Drains � Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Date Signature NOTICE: If,iaf[er making this tlecla�ation, you ihoultl b¢coma Subject [o [he FI00� SinkS Ufinel � F2n Motors Oa1 HP O1X-8 Workers' Compen5a[iOn provisions ot the Labor Cotle, you must tor[hwitn wmply with suc» provislons or tbis permlt shall be tleemetl revoked. GasService Outlets' Water Closet F.A.U. Inc,Solar �9-15 HP Q76-75+ CONSTRUCTION LENDING AGENCY I hereby affllm that there is a mnztry�tion Ientling agency for Ne peftotmance IOt¢!C¢PtOfS Wdt¢! H¢3L¢f � FixLuf25 MiCfOW3v¢ af tM1e work (or which this permit is i55uetl (Section 309] Clv. CJ Lender'z Name Kitchen Sink Water Service Device Boxes Pole Light LPntler's AtltlreSs OWNER BVILDER DECLARATIOry LavatOries putlets Range I hereby a(tirm that I am ezempt (rom the Contractor's Llcense �aw for Iha following reason (Section 7031.5 BUsiness antl Professional Cotle: Any city or 7-Trap Switches Sign coUnty w�lch �eqW�es a p¢rmit to Cbnstruct, alteq im0�ove, tlemolish or repai� any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains Garbage DispoShc Standin9 Sections to tile a signetl statement that he/sh¢ is Iicensetl pursuant to the provislons of tne Contractor's License Law (Chapter 9(tommencing with Sectlon 7000) o( Trash Com actOr Dlvision 3 of the Business antl Profeszions Cotle) or that he/she is exempt Generator DO-5 KW �5-15 KW p theretrom antl the basiz for the allegetl exemption. Any violation o� Section 7031.5 �y any applicant fo� a Permlt subjects the applicant t0 a civil 3 �enalty of no[ more than five huntlrgtl tlollars (g500�. Reinspee[ion Fee $25 IAue Fee $ I, as owner of tne property or my emv�oYees with wa9ez as ehair sole Reinspectian Fee $25 Isue Fee i 3 compensatlon, will ao the work, antl the structure is not IntentleC or ofteretl MECHANICAL FEES for sale (Section ]044, Business a�tl Professional Cotle: Tbe Contractor's - License Law tloes not apply to an oW�er ot a propercy who bulltls or improves PUBLIC SERVICES RE�UIHEMENTS: theraOn, anE who tlOes such work himsGlf he�self ot tNou h his o� Iter own BOiI¢� HOOd O� TypE I ❑ - ' n / 9 ZoninB APVroved BY ata employee5, provitletl that Such imprbvemen[5 are not intentletl or oHaretl tor CanOpy Typ¢ 11 ❑ sale. I/, how<ver, th< bulltling or Improvem¢nt is soltl wifhin one year of com- DuCt - Und2r GfOund Building Approved By DetB pletlon, the ownar wlll have the burtlen oi p�oving he/she tlitl nol bulltl or Im- �� L �rove (or tho purpose of sale). Duct - Structural Refrigeration System Appliwtion luued By Dat I, as owner o( the property, am excluzively contracting with Iicensetl con- ❑0.100,000 BTU ❑100,000 BTU Iractorstb construct the project (Saqion 70aa, eusiness antl Profeszions Cotla: Duct - Ventilating SUMMARY OF PEES The Contractor's License Law dOes �O[ apply to an owner of property who builtls or improves thereon, antl who contracts for such projects with a con- ExhauSt System ❑ Multiple ❑ Sys[em Repair/Altera[ion BUILDING PERMIT $ SMIP $ tractor(s) Iicense pursuant to tne Coq(racror's License Lawl. p�AN CHECK $ PERMIT � I am exempt untler Settion B. & P. C. for this reason Firepl/Fact. Blt. ICBO dk PLUMBING $� ISSUANCE $ Date owner Heating System & Ducting PLAN CHECK 25% $ .S ENEFiGV P.C. $ 1 her¢Dy ce�tify thdt 1 have reatl fhi5 applicatlOn antl state [hat tha abova ❑0.100,000 BTU 0100,0008T � GRADING $ iniormatlon is corract. 1 a9ree to comply with all tlty antl county ortlinances ELECTRICAL • $ antl state laws relatin o builtling Construction, antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatl to enter u on above-menUonee proper y tor , � Inspec on purp s. MECHANICAL $ TOTAL FEE $ s/S� Signalu � . Date Drivors' License or 55 � � Reinspaction Fee $25 Issue Fee $ 3 PLAN CHECK 25% $ - CMF 0865-46 rev. 12/83 hite Builtlinc: Canarv - Aooiicant Pink - Accountlno: Goltlenrotl - Aszessor ' �CONSTRUCTION AND PLANNING � POOL & SPA � - -_ � � � APPROVALS Permit # Date Inspector qppROVALS Permit # - ' �Date Inspectoi � ' „ 1. Temporary Elecirical Service or�Pole - 52. Pool & Equipment Location . � ;; . `. •� 2�. Soil Pipe-:Undrgmd: • , 53. Steel Reinforcement � � , _ � 3. Electrical ConduitUtility-Undrgrnd. " 54. Forms - ' 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding .� �; 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Efectrical UFER Grnd: � 57. APPROVAL TO COVER-GUNITE 7. Footings . � � 58. Electrical Conduit-Undrgrnd. � 8. Foundation � ' 59. Gas Pipe, O Undrgmd., Test � � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final - 12. Sewer Cap , � 63. Heater & Vent-Final - 13. Roof Drains _ . 64. Plumbing System - Final -. 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrica�-Co�duit 66. Solar System-Final - "- ' ,� �'16. Rough Electric Wiring . 67. Fencing & Access Approval '17.�Rough Wiring Sign � � 68. APPROVED FOR PLASTERING . , 18. Rough Electrical-T Bar� Ceiling 69. POOL/SPA SYSTEMS FINAL - � ' � 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace - APPROVALS Permit # '� 21. Ducts, in Structure � 70. Underground Hydro - .�22. Ducts, Ventilating . � . 77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test � 72. Underground Flush V 24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil � 25. Roof Sheathing 74. Overhead Hydro ' � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' . n 27. Prame 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 i 79. FINAL INSPECTION ' - 32. Electrical Power MeterFinal 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 pomestio-Final � ' � 42. Backflow Preventer � � 43. Backflow Irrigation - . 44. .Landscape Irrigation System , 45. Sound P,ttenuation 46. Handicap Regulations ` � . � ' 47. FINALSTRUCTURE&BUILDING , 48. Special Requirements Completed� � - 49. Electric Release to Edison � ' " ' � " � 50. Gas Release to Southern California Gas Co . �� 51. CERTIFICAT�E OF OCCUPANCY - - • - No. - Date � � � Insula 2131 17:763 W4•.�imin��rr Arn #C Gard��n Grore. CA 9Y6�d3 714-530-9530 license #i 384692 THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: 4 UN�ZCONDQ �ora A Er. 2302 ELDON_AVE, ciTv�TA_M��A EXTERIOR WALLS� R- MANUFACTURER MANVILLE THICKNESS/TVPE 3� VALUE_].L CEILINGS: BATTS R_ MANUFACTURER M�NVILLF THICKNESS/TYPE 6 VALUE ZJ BLOWN IN; MINIMUM R- MANUFACTURER THICKNESS VALUE _ SQUARE FOOTAGE COVERED NUMBER OF BAGS USED _ FLOORS; MANUFACTURER THICKNESS/TVPE SLAB ON GRADE: MANUFACTURER TFiICKNESS/TYFE TH OF INSULATION INCHES FUUNDATION WALLS: MANUFACTURER_ THICKNESS/TYPE GENERAL CONTRACTOR – – __ - _ _- _ _ —_ _ _ CALIFORNIA CONTRACTORS LICENSE N SIGNA INSULATION CONTRACTOR CALIFORNIA CONTRACTORS LICENSE # --=��IV E R- VALUE R- VALUE R- VALUE DATE Yi�1�1 DATE Z�l�+�B�+ —PRES_ TITLE 2131 7/.763 iF"r�tnrin.crrr Arn. Af. (:ardrrs Grnra. C.! 9°hJ.7 7/4-530-9530 license # 384692 THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLEp IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS. CALIFORNIA ADMINISTRqTIVE CODE, TITLE 25, STATE '��.. OF CALIFORNIA, IN THE BUILDING IOCATEO AT: 4 UNIT �ONDQ �ora � rRacra _ET�2302 ELDON AVE. cirvCOSTA MESA EXTERIOR WALLS; R- MANUFACTURER MANVILLE 7HICKNESS/TYPE 32 VALUE 11 CEILINGS: BATTS: p_ MANUFACTURER �1NVILLE THICKNESS/TYPE 6 VALUE 19 BLOWN IN; MINIMUM R- MANUFACTURER THICKNESS VALUE SQUARE FOOTAGE COVERED NUMBER OF BAGS USED FLOORS; R- MANUFACTURER THICKNESS/TYPF VAWE SLAB ON GRADE: R_ MANUFACTURER TF:ICKNESS/TYFE VALUE 'TH OF INSULATION � INCHES . �NDATION WALlS: R_ MANUFACTUFiER THICKNESS/TVPE VALUE GENERALCONTRACTOR. CALIFORNIA CONTRACTORS LICENSE p DATE SIGNATURE INSULATION CONTRACTOR � _ CALIFORNIA CONTRACTORS LICENSE p DATE 2�14/84 I pRES..._.— AT RE TITLE � 2131 ll3fi2 fY'rs�mins�rr Arr. #C GarJvn Grm•�. Cd 9T643 7/4-530-9530 license # 384692 THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, T�TLE 25, STATE . OF CALIFORNIA, IN THE BUILDING LOCATED AT: 4_UNIT_CQNDD �oTa D rancra .er 2302 E_LDON AVE. aTv_CQSTA�ES� EXTERIOR WALLS: R- MANUFACTURER MANVILLE THICKNESS/TYPE��—VAWE 11 CEILINGS: � BATTS q_ MANUFACTURER MANVILLE THICKNESS/TVPE 6 VALUE 19 BLOWN IN; MINIMUM R- MANUFACTURER 7HICKNESS VALUE _ S�UAREFOOTAGECOVERED NUMBER OF BAGS USED Fl00RS; MANUFACTURER THICKNESS/TYPE SLAB ON GRADE: MANUFACTURER TFiICKNESS/TVFE "H OF WSULATIO� F..JNDATION WALLS: MANUPACTURER— GENERALCONTRACTOR CALIFORNIA CONTRACTORS LICENSE p SIGNATURE INSULATION CONTRACTOR CA�IFORNIA CONTRACTORS LICENSE d �� N INCHES THICKNESS/TYPE R- VALUE R- VALUE R- VALUE 2131 11:76? fl°�•Fimina��v Arn. pG Gardrn Crnrr. C.1 436�l.Z 714-530-9530 licerase # 384692 THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANGE WITH CURRENT ENEFGY REGU�ATIONS, CALIFOPNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE QUILDING LOCATED AT: 4 UNIT COND.O LOTp R TRACTp =er�2302 ELDQN AV�. cirvS�STL�MESA EXTERIOR WALLS: R- MANUFACTURER MANVILLE THICKNESS/TYPE�_y_VAWE 11 CEILINGS: BATTS q_ MANUPACTURER �NVILLE THICKNESS/TYPE 6 VALUE 19 BLOWN IN; MINIMUM R- MANUFACTURER . THICKNESS_ __ .. VALUE SQUARE FOOTAGE COVERED NUMBER CF BAGS USED FLOORS; MANUFACTURER THICKNESS/TVPE SLAB ONGRADE: MANUPACTURER Th;ICKNESS/TYFE 7H OF INSULATION h..JNDAT10N WALLS: MANUFACTURER__ GENERALCONTRACTOR. CALIFORNIA CONTRACTORS LICENSE p SIGNATURE INSULATION CONTRACTOR CALIFORNIA CONTRACTOpS LICENSE k �� INCHES THICKNESS/TYPE R- VALUE R- VALUE R- VALUE DATE onre2/14/84 TITLE City of Costa Mes2 �� Development Services Department Building Safety Divis�on P.O.Box 1200 Costa Meu, Califom�a CERTIFICATE OF OCCUPANCY .� No. 0�(1�l�� The Building located at 23l12 '6:lc�lan [init. A has been inspected 2nd found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group p_1 Occupancy. ”` Use of Buildin Legal Description A.P. �#439-261—01 .e ' ` (See reverse side for Metes and Bounds) ' Building Permit No �B-10642 Electrical Permit No.E-10'd45 Plumbing Permit NoP13�36�P12524 Mechanical Permit NoM� 1 ddf1.M1 �S�l Number of apartments and/or guest rooms ISSUED 70: Building Official �/- G. ��%✓�c'ti- RlArn/23RD Pari-nershio / . �2 Corporate Plaza ;1290. New�rt i�ach bY ��,/� T�� Date � � %��"" This Certificate of Qccupancy SHALL BE posted in a conspicuous place on tfie premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner, Canary - Numerical File; Pink - Bldg. Permit File . �� _ , . .. _. . AOD�icant to tili in al1 spaces exeept those within heavy bortler lines antl sign all approvriate tleclarations. � �'CITY OF COSTA MESA � ' ••� � � PERMIT NO. �� ' TRACT NO. LOT:NO. BLDG. N. CONSTRUCTION PERMIT ' �— j/�$j y� Project Address ' �A�pplicant's Mailingg AcJdress . � /—�/� " M ' �f ' �one Owner's Name �r1(!3' Address ArchlEng. License No. Address Contracior's Nam � Phone �7 4 Addresslr^ ,� �� C ��`P-f' ��' r§ � City License No. ��d LICENSED CONTRACTOR DECLARATION I hereby aftirm that I am licensetl untler provisions ot CM1arter 9(commencin9 wlth section �000) of Division 3 of the Business antl Professions Cotle, antl my Iicense is in tull t ce antl ettect. Lice ryC/�,yss �:/, l� ' �i ense No Dat9��C�y%'�'�/��i Si9nature -ORKERS' COMPENSATION DECLARATION ;reby affirm tnat P have a certificate of consent to self-insure or a certiticate WorkerY Compensation Insurance, or a certifietl copY thereot (Section 3800, Lab. C.) Policy No. Company eCertifietl copy is hereby furnishetl. . Certifietl copy iz filetl witn tne city Builtling Division. Oate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thi55ection neetl not be completetl if the permit is tor one huntlretl ($100) o� less) I certify that in the performance ot the work tor which this perm�t i5 issuetl, I sM1all no employ any person in an� rtla�to beco subject to the Wor mpB s i � ws ot Cal'�Q ✓/ -�� ate Signatur .�y dC w�.7/�L.ei.a� NOTICE: If,�,after making'this tleclaration, you shoultl become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith compty witM1 such provisions,. or this permit sliall be tleemed revoketl. CONSTRUCTION LENDING AGENCV I hereby afilrm that there is a construction lentling agency for the performance of the work for which this permit is issuetl (Section 309] Civ. C.) Lender's Name _ Lentler's Atltlress OWNER BUILDER DECLARATION ' ' � � nn.rnnv-a(firm ihat 1 am exemot trom the Cant�actor's Llcense Law forttie �-j�retrom antl the basis for the allegetl ezempt�on. Any vioianon or secuon �:b31.5 by any applicant for a permit subjects the applicant to a civil �enalty ot not more than five huntlretl tlollars ($500). - I, a5�owner of the.property or my�employees wltM1 wage5 a5 thei� sole c6mpensation will tlo the work, antl the structure is not intentled or offeretl tor saie (SecFlon ]044, Business antl Professional Cotle: The Contractor's License Law tloes not applY to an owner of a property who builtls or improvez thereon, antl who tloes such work himself/herself or through his or her own employee5, prOvitletl tM1at SUCh Improvements are not intendetl or offeretl for sale. If, howeveq the building ar improvement is soltl within one year ot mm- pletion, the owner wiil have the burtlen of proving he/she tlitl not builtl or im- �iova fo� tM1e pu�po5e of saie). - ' i U I, as owne� of the property, am exCluslvely cont�acting with Iicensetl con- tractors tb construct the oroject(Section 7044, Business and Professions Cotle: The Contractor's License Law does not apply to an owner of property who builtls or improves tM1e�eon,'antl who contracts for such pwject5 wiYh a con- tractor(s)license pursuant to the Contractor's License Law). ❑ I am ezempt untler Section B. & P. C. tor this reason Date Owner I hereby ceriity that-I have reatl this application antl state that ttie above information is correct. I aqree to comply with all city antl county ortlinances antl state laws relating to builtlin9 construction,.antl hereby authorize repre- sentatives ofit}rys�city to enter yppn tFje_above-mentionetlMpjpperty for TYPE OFCONSTRUCTION -�.NEW LJ ADD LJ ALTERATION�.LJ REPAIR ' ❑ CONVERSION ❑ DEMOLISH O OTHER � q.p.# DESCRIPTION OF WORK � � ' S Main Bu TVPE OF PERMIT GRADING ❑ FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ EIECTRICAL ❑ PLUMBING; � MECHANICAL . A Reaf ❑ OTHER PROJECT DESCRIPTION 5a. FT. occUaANGv C Right K Left CONSTRUCTIONTVPE VALUATION$ ,$ ZONE GRADING CU. VDS. ACRES Ping. Ref. # Remarks: Parkin9 Req. 8ar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Dreins Floor Sinks � � Gas Service Outlets Interceptors Kitchen Sink Cavatories ' � - P—Trap; Roof Drains ' Reinspeciiun'Fea � $25 Boiler Duct-UnderGround Duct - Structural �Duct- Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ o-i oo,000 aTu O i oo,000 sT pignacur ---�y D ' �e ' L' ense or 55 �f � � -• /�� " Reinspec[ion Fee $25 CMF0865-46 rev.12/83 Whife-Builtlinq;Canary-ApPlicant;Pink-Accounting;Goltlenrotl-Assessor Service Sink Sewer Cap Sewer Connection Solar Collectore Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water C1052t Water Heater � - Issue Fee 1ANICAL Hood or Type I ❑ . Canopy Type II ❑ ' _ Refrigeration System � ❑0-100,000 BTU ❑ 100,000 BT. System Repair/Alteretion Issue Fee FEES Use of Building: Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers .BGas . DElec Fan F.A.U. Fixtures Device Boxes Outlets Switches , Garbage Dispoul Generator��0-5 KW � 3558 2/Q2/84 Zone Accessory Building: Park. Fees $ ' ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Momrs �0-1 HP O1 %- 8 Inc.Solar �9-15 HP �16-15+' Microwave Poie Light ' Range Standing Sections 5 KW Trash Compactor $�� Reinspection Fee � � $25 Issue Fee FEES �PUBLIC SERVICES REQUIREMENTS: 2oning Approved By Building Approved By ' �� $ 3 SUMMARV OF FEES , BUILDING PERMIT $ SMIP PLAN CHECK $ ' PERMIT PLUMBING $ �SSUANCE PLAN CHECK 25% $ ENERGV P.C, ELECTFICAL $ Q GRADING PLAN CHECK 50% $ / Q MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ $ 37.5� TL FEES $ 3 O N I N G R E O U R E M E n � CONSTRUCTION ANDPLANNING POOI �PA - ' ' Date Ins ector � � -, APPROVALS Permit# P � 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. Fq�tings � � ` _ I- .i' 58. Electrical Conduit-Undrgmd. , , ;.� 8. Foundation �• 59. Gas Pipe, � Undrgrnd., Test � . � j; 9. Water Pipe-Undrgrnd. ! ' 60. Backwash Lines, P-Trap, O Undrgrnd. � � I 10. Structural.Floor System � � � 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final � � 12. Sewer Cap �, � 63. Heater & VenbFinal � � 13. Roof Drains � ' � 64. Plumbing System - Final - 't� 14. Rough Plumbing _ 65. Electrical-Final � 15. Rough Electriral-Conduit 66. Solar System-Final ' - 16, +Rough Electric Wiring s a g (y0 67. Fencing & Access Approval � �17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � - 18. Rough Electriral-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 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 i _ 37. Final Factory Fireplace 38. Final Plumbing ' � 39. Water Service-Final 40. Gas Service-Final - 41. Solar pomestio-Final . ' .'�� 42. Backflow Preventer . . � 43. Backflow Irrigation � � �� 44. �Landscape Irrigatiori System . 45. Sound Attenuation . ,. � - 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed � � � � 49. Electric Release to Edison � 50. Gas Release to Southem California Gas Co �� . , �. 51. CERTYFICATEOFOCCUPANCY � . - , . No. Date' � � ' �� - ' \ CITY 0� COSTA MESA CONSTRUCTION PERMIT AOP��eant to fill in all spaces except tM1ose within heavY �orEer linas an0 sign all apGroO�iata Oeclarotions. PERMIT N% � x TRA= CT NO. LOT NO. ' BLD . . CJ � Ja PfojectAddre55 ��J� �L�F�� ST �fr TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH n OTHER q,p,# Applicant's Mailing A�dyd�re.s�s :� �µ/ �� OWnE�'S Nam2 �`�r'"� "�' � /•J �/ �<"PhonB�/f�n/�-�� DESCRIPTION OF WORK ,� �7/��L�i'� �I"��7 /��/J. ' ` E Main Bu Address TVPE OF PEflM1T GRADING ❑ FOUNDAT ON STRUCTURAL T Front ArCh/Eng. LiCense No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING�MECHANICAL B Reaf AddlEss � ❑ �OTHER � p' - S�SIF� Z-Sri J PROJECT DESCRIPTION SQ. FT. OCCUPANCV C Right Contractor's Nam Phone K Left Addre551meiling�� CONSTRUCTIONTVPE VALUATION$ S ' �Gi`Q� ZONE GRAOING CU.vDS. ACRES p�ng. Ref. # City License No. f LICENSED CONTRACTOR DECLARATION I hBr¢by affirm that I am Ilcensetl untler prOvision5 0( Charter 9(coTmencing with sectlon ]000) of Dlvislon 3 of tne BuSinesS antl ProfeSsions Cotle, antl my Iicensa9s in full force ayq e,Lfpcj.� � � License Class �% `�-� nsa Date " — Slgnatura ,.".20RKER5' COMPENSATION DECLARATION �+ �sF;,3rebypfflrm chat I have a certlflcate of conEent to self-Insure or a certlticate �-"Workers' Compensatlon Insuranca, or a certlfletl copY thereof (Section 800, Lab. C.) . �zt �/ Polity No. �� Company r�� Certi(letl copy Is nereby tumishetl. Cart(fietl�o,qy�/11eG wApp icantY Bulltling Data�% < <� E%EMPTION FROM WORKERS' COMPENSq7 N OECLARATION (Tnis sectlan neatl not be campletetl It tne perMlt is for one huntlred ($300) ar less). I cerUfy that in [ne performante of the work tor which this permit is issuetl I shalb not employ any person in any manner so'az to become subject to t�e Workers' Compen5ation Laws o} CaliTornia. Date - Signature � - NOTICE: If,iafter making this tlaclaration, you shoultl become sub7e<t to the Workers'. Compenutlon provisions of the L2bar Catle, you must forthwith comply 'wlth- such provislons or thls� perMlt � shall ba tleemetl revoketl. CONSTRUCTION LENDING AGENCV � I hereby afflrm that there is a�construction Ientling agency for the performanca ot tne work for which thi5 permi[ is issuetl .(Sectlon 3097" Civ. C.) L.entler's Name I�naer's Atltlress OWNER BUILDER OECLARATION � I hereby, afTirm that I am exempt irom the Contractor'S.License �aw for tne tollowing reason (Sectlon 7031�.5 Business antl Protesslonal Cotle: Any city or county whlch reqWras a permit to construct, alter, improve, tlemolisM1 or repalr any strutture; p�ior to its issuanta, also requires the applican[ for such parmlt , tinw��nnbaet�r��sSiJceose iaw fChaoter�9 fmmsmAncina wltn Sectlon ]V0001 of t� ��nalry oi not more man nve nunorea aonars (g500). i • ' LJ I, as owner ot tha Oroperty or my employees with wa9es as their sole <OmpenSdtioll wlll tl0 t11e wolk, dntl the st14ctu/¢ i5 ffOt In[entl¢tl olOff¢I¢tl for sale (Secfion 7044, BuSiness antl Protessional Cotle: The Contractor'S Llcanse Law tloes not apply to an'owner of a property wno'bullds or improves thareon, antl who •tloes su<h work �himselt/herself or throu9h his or her own employ ees, provitlea that such Improvements ara not Intentletl or offeretl for - sale. I(, however, Ihe bulltling or improveme�t is soltl withln one year of com- pletlon, tne ownerwlll have the burtlen of provin9 he/sha tlitl not builtl or im- 1 ��ove for the purpose af sale). ' ' 1, as owner o/ the property, am extlusive�y contracting with Iicensetl con- tractontb construct the Oroject ISection 704d, Businass anG Profe55ioni Code: The Contrattor'S Llcense I�w does not apply to an owner of Proparty who builtls o� Improves thereon,.antl who contracts for such pro�ects wlth a con- .tractor(5) Ilcense pursuant to the Contractor's �Icense Lawl: � ❑ I am enempt untlar Section B. & P. C. for this reason � Date Ownerf � I hereby certify that I have reatl thls appli�atlon antl state that the above Information is corract. I agree to <omDly wifh all city antl <ounty ortlinances � antl stata laws relating tqbullaing constructlon, antl hereby authorlxe repre- Signature ��'" Drivers' Llcense or 55 � 0865-46 rav.12/83 W�ite-BuilCing;Canary-Appllwnt;Pink Remarks: Preventer Irrigation Clarifiers - Dishwasher Drinking Fountains Floor Dreins Floar Sinks Gas Service Kitchen Sink . Cavataries Service Sink Sewer Cap Sewer Connection � $Oldf COIIECtOIi Solar Pipin9 Solar Tank Swimming Pool w/Spa -- Urinal Outlets - WaterCloset' � Water Heater � ' - Weter Service � Roof Drains �Reinspec[ion.Fae " ' Boiler Duct = Under Dutt - StrutP Duct - Ventil�, �■— �� ■� ExheustSystem ❑ Multiple❑ Firepl/Fact, Blt. ICBO # �He ting System & Ducting ' 6100,OOO,BTU �100,OOOBT Ve n �,, peinspection Fee Goltlenrotl - AssesSor $25 � Hootl or. Typel ❑ ' Csnopy Type I I � ❑ � Refrigeration System ❑aioo,aoosru ❑�oo,oac System Repair/Alteration Issue Fee FEES , I ., FEE $ 3 Use of Building Planning Notes: Automatic Washer Construction Pole Su �Coaking Unit Dishwasher Dryers ❑Gas ' �EI Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator, �0.5 KW e 4697 2l22/84 IZone Accessory Building: , Park.Fees $ ELECTRICAL , Transformer ❑ 15-50 KW ❑ 50+KW � Meter ❑ up to 100 amps Meter ❑over 100 amps Sub Panel,� , � MotorsO0-1HPO,1'/:-8' : Inc.Solar �9-15 HP 016-15+ � Microwave ' Pole Light Range , 5�9� Standing Sections � 5 KW Trash Compactor . 1a.25 TL O N I N G R E Q U I R E FEES i Reinspection Fee � $y5 luue Fee � $ 3� PUBLICSERVICESREOUIREMENTS: � ' I Zoning Approved By Date Buildin9 APP�e`Rd By Date ' Appliption Issued By— ( ' Dat � 2�" ' SUMMAQV OF FEES . BUILDING PERMI7 $ SMIP $ ' PLAN CHECK � $ ' PERMIT PLUMBING $ ISSUANCE •$ � PLAN CHECK 25% $ � ' ENERGV P.C. $ � ELECTRICA� $ GRADING .$ PLAN CHECK 50% $ MICROFILM $ '// q ��— MECHANICAL ' $ � TOTA� FEE $ ,/�.4'� PLAN CHECK 25% $ �"� � �" S � � CONSTRUCTION AND PLANNWG � � - - P��'��'��A - � � - Date� Ins ector �� ' � . .APPROVALS Permit#m-�� P , APPROVALS��,-Permity# : � ' �Date' Inspecto� `, � -7. Temporary Electrical Service or Pole 52. Pool &�Equipment Location ' - '� - � ' 2. Soil Pipe-Undrgrnd. � . � 53. Steel Reinforcement't ' - .. � ' '- �� ; 3. €lectrical Conduit Utility-Undrgrnd. '� � ,� � � 54. Forms - " -, � _ - ' - � _ � - � ` 4. Electrical Conduit-Undrgmd. , ' �55: Electrical,Bonding. ,� ^ : • j � ` ._ i _ � ; � 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= - ' � � � . � =r' 9. Water Pipe-Undrgmd. t� : ! � � 60. Backwash Lines, P-Trap,�O Undrgrnd...� �'' � . , �� ' 1 10. Structural Floor System �� 61. APPROVAC TO DECK - � �^ - 11. Property Sewer Line & House Connection '' ' 62. Backwash &� Receptor-Final - - �. � � - ' �. 12. Sewer Cap � . ' . 63. Neater &•Vent-Final -� . -� � � � 13. Roof Drains . � '64. Plumbing,System; Final� �' . ' � ` �.. 14. Rough Plumbing 65. Electrical-Final' �� - • - . - � 15. Rough Electriral-Conduit � 66. Solar�System-Final-� �- ' � -- � '- "-, -�- " - ' 16. �Rough Electric Wiring 67. Fencing & Access Approval'-."�t - -S i ;,. ; > � �� ' � h , 17. Rough Wiring Sign 68, APPROVED FOR PL9STERING � s�. � 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ��- };: ,•, ' �,� 19. Rough Heating & Air Conditioning � �e� � FIRE DEPT. REQUIREIVIENT. � - � ! , � ` 20. Rough Factory Fireplace ; APPROVALS Permit # '� ' � � ' - , . ! , 21. Ducts, in Structure � ' 70. Underground Hydro ' � � . - ' { 22. Ducts, Ventilating , ' � .71.' Product Piping O Gasz: � Oil �� + � � � 23. Gas Pipe-Rough & Test 72. Underground Flush � � 24. Roof Framing � . • � ; • 73.' Undergmd.StorageTank O�Gas3�0i1 � : � i • ; 25. Roof Sheathing . . . 74.- 0'verhead Hydro � � ' . � ,' 26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical � � � - � _ �; 27. Frame and Flashing � ;76. Dry Standpipe � � ' ' ' ' 28. ,Lathing & Siding ' � 77. F�IXED SYSTEM FINAL t . �, � � � ' ' � 29. Insulation � �78. FIRE PREV. FdNAL � � i � 30. Drywall Nailing - � HEALTH DEPT. REQUIREMENT ' � � 31. Plaster Brown Coat �79.� FINAL INSPECTION � � ' 1 32. Electrical Power Meter-Final ' . . 80. FOOD CERTIFICATE ISSUED' � +, ' � 33. Final Electric ' Notes: � ' � � 34. Final Heating & Air Conditioning ' ��/�!f � ' ' ' � ' � _ , v �, 35. Final Gas Pipe-Test . ' • ' - � . � . - - _ ' i 36. Hood or Canopy ' • . . � � � � � � _ _ � 37. Final Factory Fireplace . � � � . � . � � � � _ , � - ; � � 38. Final Plumbing . � � � � �;;* �� , � � - 39. Water Service-Final � � ' � ` ' . • ' 40. Gas Service-Final � � i � � � � � ' ' � ' ' "' 41. Solar pomesticFinal - - - � � � ._ . _ ' : -� � , � � -f- � � .�.Y . 42. Backflow,Preventer . _ � _ �__ _ � - � 43. Backflow Irrigation• , . � � , � - - ` 44. ,Landscape Irrigation System . ' ' . , 45. Sound Attenuation ' � � � ' � ' i,. ^ , � � �. 46. Handicap Regulations . ' � ; y ' . � � � ' .- � � 47. FINALSTRUCTURE&BUICDING� � - � �, � ' , � � ' ' 48. Special Requirements Completed - ' � I ' . ' � � j 49. Electric Release to Edison � � � - - - - •� � .- -'` ' �� ' � � c 50. Gas Release to Southem California Gas Co � ; ' � , � I I � � . � ' � - 51. CERTIFICATE OF OCCUPANCY � - . - --- . ; -?-- . - ' � No. • Date " ' . � � . • � � � _ � ,. �• A�pliwnt to fill In all sDaeas axeept t�ou wll�in heavY �orAer Ilnes antl si9n ell approDriata Eeclantions. 'J CITV aF COSTA MESA �� PE MIT NO. TRACT NO. LOT NO. BLD . .. � � , � ��-(;� C!�JSTRUCTION PERMIT . � ' - O(q !��- ' /? /Jt, ' ' ; • : 2786 I /20/8A � r..3. 7- TL ApplicanYs Mailing Addreu O ��'�'��L {yy� r G DM ' TVpE OF CONSTHUCTION NEW ADD ALTERATION FEPAIR - ' �, . I: . ' ' PfOjectAddrMS Z OZ �t.�.(i U ❑ CONVERSION ❑ DEMOLISH ❑ OTNER _ : � _ ' ' � . ' ' � � �� i hone �flG�� DESCRIPTION OF WORK � . � Owner i Name —� - � � - � - � � UL I S' . , qdd�ett {'� Z'(A{�'-(�O{C(YLE 'PI.�YZ<F Q� Z-iO N-�3. 9a�6o TrpE OF PERMIT GRAOING . �FOUNDATION STRUCTURAL � . _ A. P. �Y'+ � � 7� — I ZONE � � � Arch�Eng. �ON YrzO KP,1.� �U-I. LicenmNo. L-3S67 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � ' BUILDING � !'/ � • . ,P,LNG.REF.� ;� ^. O- J � AddfMS �500 �I�}3�jLA/� %VE + �Q1=LJfJ� �L- � . ❑ UTHER .. - ' '. � . . . -� TO BUILDING / - Contracmr's NamP —,'r✓ ��^�'f'v�� Pph 0 PAWECT DESCRIPTION 50. FL � ' OCCVPAN�Cya�_ PR PE Y LINE ��O - REAR VARD (TO P/U C ~'t Addresslmeilingl3�� -= �-�� /��j��S9��f. CONSTRVCTIONTVPF �N' • VALUATION$y�j[�, /'�� LEFTSIDEYARD 5�I RIGHTSIDEVAflD . , /' •. _ License No. > G K9 /7 IO�� 20NE .:�—Z _ Gf3ADING CU. VOS. ACREs ?KG.SPACE REQ. A� s PROVIDED a• S" . LICENSEO CONTNACTOR DECLARATtON ' � Remarks: , � ��G��3 STREET WIDTH PARK FEE S �� '�, . I�haraby affirm that I am Ilcensatl untler provislons of C�artar 9(commencing � , � with sectlon 7000� o} Dlvislon 3 of t�e Business anG Rofessions coaa, a�a � ' - SS3 47 ` � . ' ✓� /� .�'� SPEGIAL CONDITIONS: � � my Ilcenm Is In full rte a E eHect. � ' � � ' � -. i u�e��Q -�—% �� v u�a�� No�� /1 ; • vwnneiNc � HOLD FOR SPECIAL REQUfAE1j9ENTS. ;'" DatBJ'�Ta'o—T a��..�.. � /7J��.f+ _ r . . � . ;�ARI(ERSYCOMPENSATIONDE LARATION ' , � � BarSink . SewerCep- ; ELECTRICAL ��areDy atfirm that I Oave a Certlilwte ot consent to �IHnsure or a certlfit5te Automatic Wazher �Meter ❑over 10� amps �3 . c::=., � BackflowPreventer ._ - SewerConnection'_. .i;� � Workers' Compansation Inzurance, oi�a certlfletl copy -theraof (Section _ ' _ . . . Construction Pole � - � 3800, tae. CJ ' 6 •�-� ' Backflow Irrigation SolarCollecmrs . � Sub Panel �,,, Pollcy Nc� r-�y�7Z " �r �� Company �'�%� YU/%U � , , ' - � � - -, COoking Unit • ' Sub POIe � � [,� Certitietl copy Is hereby furnl � . ' ' , � " - Bathtubs ! � , Soler Piping � ' ' • ` t / � " • � {�CeriH tl opy I filetl witb t e<ity Bulltl D �°i '� , � . � Date � ADO� Clarifiers , . SotarTank _ , � Dishwasher Motors ❑0-1 HP ❑1X-8'� "EXE ION, ROM WORKERS"C PENSATION'�ECL ATION � Di5hWe5ha� . • � I Swimming Pool W/Spe . .4 �'" DryefS ❑Ga5 �Electlic • � -.- � - .(Tnlsse<tion neeE not be Como�etetl f the oermit Is for.one unarod (Sloo)'or . � _. ;InFSolar'09--15 HP 01645+• -' lessl . � - , .• _ -• . '� . - ' • • • Fan � � � . 'Microwave ' I CBrtlfy t�at in the pertO�TGnte OT thB WOrk /Oi,Whlth this p0/T�t is issuetl I: Orinking Fountains Urinal . i . . + r�, � s�all�no[ employ any person In any manner so as to become subject. to the I . , , � - - � , F.A.U. ! � � �Pole Light ' '�� I � � Workars'-Compans3tlon,Laws ot�Callfornla., , .., � Floar Diains� Weter Closar . i� � - � � �{ Data � Signature -' � � � , � . ' . � - , Fixtures , Ran e ' NOTICE: H, after maklnq lhis.tletlarallon, you SnoulC EecOma suoJect to the .� �. Flaor Sinks _�. _ ' _,_ _ _ _ Water Heater _� _,_ _ _ _ _ _ � B Workers' CompensaHon provislons of tha Labor Gotle, you muit Torthwi[h ' � Device Box¢5 � - � � �� '. Comply wlth�. 5uc� provlslons��or^thli DeYmit Shall be tleemetl revoketl.. t GasService� � '-0ut18t5, ' WetePServlCe �, " �Sign� , • � 11- CONSTRUCTION�CENDING"AGENCV - ' ' _.��tle[5-' 1 ' I nereby affirm tnat there is a<onstructlon IenUing agency tor tha� ertarman<e Int2rcCptots � _ - . 'Slanding $ectians [ � of tha �work tor whic�_this permlt-is �Iisuatl (Section 30�] Clv C:). � � . � � ' ! LenCer's� Name � ' � � ' ` � - " � ^ '. Kitctien S�nk � . � � M1' Switches,, � . ,Trash Compactor � ' 1 L.enaer's Atltlress' ' . - �: • I , r t � . la'vatories . .` /� � . , . • ' . Gartiage�Dispoal ' . ' . � � OWNER BUILDER OECLARATION' � � � � � •- ti, � � � � ' - " ' ' I hereGy�a(firm tnat 1 am axempP trom Ma�,Contractor's' Licanse �aw for the � .�- . , . ' GeneratOr 00�5 KW �5-15KW � � i - tollowinq reason (Settlon J031.5'Business antl Professional!Cotle: Any city or P-Trap, ': �, � f� _ � � -.,county which requires a permit to construct, alter ImD�o�e; tlemolish or,re0air : - , . , � , ; , - Trensfarmer ❑�5-50 KW.� . � ' � � any struchre, prior to its Isivance, also roquiros l�e"applicanl for such parmit • � Roof D�ami j. � � '� t0 flle a-Slgn¢fl Std�¢m8nt thdt he/ihe Is IlcenS�tl pulSudOt to th0 prOVISIOns 01 �� . �� . �� ❑$U+ KW� ' ' � �e Contractor's License law (ChaDtar 9 (commencing wlth�5ectlon,7000) of � .- i '.- ' ' � � . . • . , . � .Rainzpaction Fea §7$�' , -„qislon 3,ot the Businesi anE Protesslons COUe) or, tnnY ne she Is� exemo� � Showe�$ �, ;' ' �' Reinspection�FeB � ,, $15 -_ , . '.�}refrom.antl tha ba5i5 for the a11e9eC exemptlon. Any viola�lon �ot.sectbn , � � . ' , � Meter ❑up t0100,ampa � IauB FeB. -S 3 >�31.5 Dy any applicant for a permit 5ubjett5 the aDP�(Cant to a civll � ' SefViCe Sink 1 . ' . r Issue Fee -.. ; S 3 -' -- - ' '�' f �-�enalty of not more than five.huntlretl Oollars (5500): � � . . � •_ . � Zpning'App�oved By : Date _ � LJ I,' as �owner oh Ihe�proparty or"my ertiplayaes �wlth wages.as their sole ; MECHANICAL � . • � ' � com0en5atlon' wlll'tlo [�e work, anG t�e'itrucWre'is no[ IntenCetl or offeretl . • :� �;; � � • . . . . ' Appliration Approved By - ' �atB ' for wle:(Secfion 7044, Buslne55�anA'Protesslonal Cotle: Tha Conlra<tor'S � , . . . - • � • Ucense Law tloas not appty tman owner of a property w�o bulltls or im�roves BO11e�. ' ' _� Refrigeretion System i ' � ' t � • ' � ' thereon,7antl w�o tloes such worklhimself/harself or tnraugh his or har own ._. .�� +' : � . � � � APP��tion lauad By ' � ,Data � emD�oyeez, provitletl thet su<n improvaments are'not Intentletl or offeretl for � - ' ❑0-100,OOOBTU ❑10U,000HTU � . - . � , - - • � � Duct=Under,Ground � , . � � ss1e. If, nowever, tne bulltlin9 or Irtiprovement Is'soltl wlthin one year'of com- : I , � , �: ' ; • � SU1�MARV OF FEES � . � Oletlon, the owner wlll have the burtlen of proving he/she tlitl not builtl or im- : � � � q �'/ •, ' . �rovafortnepurposeofsale). f � ! ' . � � ' Duct-Strucfurol � SystemR�epair/Alteration :BUILDINGPERMIT '$ �� SMIP j • $ , �- � � L! I, 55 owner o/ (he pioDarty, am exclusively contractlng�with�licansatl con- ; � ; l � � tractorsto construct tha project (Sectlon 7044, Business antl Professlons Cotle: , Duct - Ventilatin9 � � . { 'PLAN CHECK • $ PERMIT � � -� � Tne�Contractor'S'FJcenie Law tloes'not app�y to an ownel'of property who".' . � . � ` � � I ISSUANCE � �$' �,� . builtls or Improves t�areon,'antl who contracls tor such oro)eUs with a cBn- ' Exhausl System �•Multiple �� . • � iPLUM8ING � $ ; � tractor(s) Ilcense pursuant to ine Contraclor's License Law): I � � � . � �p�qN CHECK' � ' GRADING . $ � ❑'I am exempt untler Section B. 6 P. C. for thls reason � FiiepVFxt. Blt. ICBO il� � • • . $ � � ' ' � � � 1ELECTRICAI � � �$ � j � � ' $ • ;� . , . . . , ' Heatin 5 stem & Ductin � ' . , . ' . Date ' � � O'wnar � • � 9 Y 9 ' . ' ' - � . � - . ! . � MICROFILM � $ �, . Lhereby, certify that P �ave reatl thls apD�icatlon antl state [hat the above.L . �PLAN CFECK' , Oo-ioo.000sTu�ioo.000ar' . � - --... �� _. .� $ $ � in(ormation Is correct. 1 agree to comply with all Uty anE county ortllnances � . � � • � � ' - � . ( TOTAL�FEE: � �MECHANICAL antl state laws retating o builtling constructlon,�antl hereby authorize repra- Hood or ' ' ' � ' ' �$ • ' � � � sentatl , to nter� upon the o-menUo�netl Drope ty .f r� TYPe � �. Reinspection Feel � •$15 �p�qN CHECK� . I $ � � � LESS t Cano . .T' e II ❑ � � r ADVANCED PC ' $ ' inspact n ourpose , � - ! ' Signature ' � I Data � � � � , � ' ' � � ' ' • .�59' 7 � onvers• Lic sa or155 � Registers , • � Iswe Fee • i S 3 ,� � � ! � , '-,4 - � . � FINAI FEE � . $ � �� CMF 0865-06 rev:'72/02 ' tte - iltlin9: �nary - APOIIwnq�Pink - Accountin9� Goltleurotl = Assassor ' ' . '' - � " � '' " � - - �-�` _ . � . . . .'.. . " . . . _.. . _ '...- � .. . - .- - . -. -. . - .r. . .. . , ~`.. � - ,.�,�! � J �� . 1 - - - -- --- : • CONSTRUCTION AND PLANNING � ;' ' ' ,. , �� SPA �� - . = � _ � . _ ' � - fDate- � �Inspector �� . - • � % � Date' �Inspeetoi , : •�APPROVACS,r Permit �h �`��=6�'�' � - �APP.ROVALS'."`�Permit � . m � = a - . . . . . d.'Temporary Electrical Service•or Pole , -� ` ' ` n .` � : _ �-52. Pool & Equipment Location � " '_ 2. , Soif Pipe-Undrgrndt � • . � �" - , . - - . - 53: -$teel Reinforcement ' _ . � � :, �3. iElectrical Gonduit Utilitv-Undrgrnd. = � `'� � - � 54. Forms ; _ - � � . . : �4.;Electrical Conduit-Undr9rntl.=-_ ' _ _ _ � "o � � • -55. Electrical Bonding � � ` �5.�Steel Reinforcement � I v ' - �- ' r-, g;y° ; �� ''56. Rough'Plumbing & Pressure TesY• ��' � � ''6.�Electrical UFER�Grnd: ::. �`J � 1;^ _ - -57. APPFOVALTO'COVER-GUNITE� • < ' 7.IFootings � � � � �� *:' � �� A, �, --�� 58. Electrical Cpnduit-Un`ddror�d:� . � , B.;Foundation '� � ' � � - � � ° � t -59.-Gas Pipe� O Undrgmd.,l'est :- - . � _, , : � � . . SN _ �' �'1, 9.!Water Pipe-Undrgrnd. ' � '; �`•;,60. gackwash'Lines, P-Trap, O Undrgmd: . - 10.,Structural Floor System ' ��p,�j. ,_ a. 3• [� �,(P� , 61. APPROVAL�TO��DECK- - . � . .. 11. Property Sewer Line & House Connec[iod : ,' ""62.'Backwash.& Receptor-Final - 12. Sewer Cap � � -' F - , ' 63. Heater & Vent-Final - � . _ � 13.� Roof Drains � � � `� � - ' 64. �Plumbing SYstem�- Final � - ` • � I A 1 14.�Rough Plumbing � � � ' � � 65. Electrical-Final �� "15: Rough"Electrical=Condui4;"_�� ."y -' � "'t"� - "� -: -'� �66.�SolarSystem-Final ' � � -- - � -16.�� Rough Elearic Wiring � ; ° � �, _, � � �'� �'�'„- -` , 87.--Fencing &-Access Approval - " � ' ,- , - - - 17. Rough Wiring Sign -`, ', '� : � I t ; � ' '- � •. � �� I , gg, APPROVED'FOR PLASTERING � . , - 16.' RougFi Electrical-T'Bar Ceiling �' � �� 69'. iP00USPA SYSTEMS FINAL ' �' ' 19r Rough Heating & Air�Conditioning � I : � , � > i . � ' FIRE DEPT! REQUIREMENT � _, . 20.�,RoughFactoryFireplace , �i i� � � , ', ; � APPROVALS I Permit# _ i 21. Ducts; in�Structure '� � - � � . � � � � � ( 70. Underground Hydro :22. Ducts,Ventiiating: n � � � � ( , i j71, PinduaPiping�OGas ❑Oil � � :'23. Gas Pipe-Rough & Test' ; �,� ti � � . ! � � 72. Underground Flush � • ' "24. Roof Framing ` '�.. ; � � �g.�� ,g. 73; Undergmd.StoregeTank �Gas ❑Oil � 25. Roof Sheathing ' � . . , y�, I' �' � _ ;��gf/. ��' � 74. Overhead Hydro ' - 26. �T, Bar Ceiliug (Structuraq� & Monocoat ' � , . � , � - 75. Dry Chemical . . � � . �,27: Frameand�Flashing :' " il ��. .B � 76. DryStandpipe' - 28:' lathing & Siding �; ; . � � � �� I , , 77'. FIXED SYSTEM FINAI � ' � 29. Insulation• ? '"� 1 ' �'' � 78. FIRE PREV. FINAL � � a„ 1 .1. f' 4 A�--- I =30. Drywall Nailing ,.+s' ��-t;� � 3.('�.g t I, Notes: N � � •1� �4 i . r I . ' ' � 31. Plaster Biown Coaf �'� � � �r t 32., Electrical Power MeterFinal'� � � �I � ! � ' � � ` i � � 33� F.inal E�ectric � ' T� ' ' � i � � � '� �.v.� • ` �34. Final'Hesting & Air Conditioning ,' � ' , , ' � � : �- i 35. Final Gas Pipe-Test�_ ��; , `_'I i' a ��o „ , �� ' 36. Hood or CanoPY ' � � "�' .. � - " � � � .- . . i, �i- - �l �_ �- 37. Final'Factory Fireplace: ' �� , � ` � , �� - r - 38. Final"P�umbing � , i � ' � . ! � � , " ar� 39. Water Service-FinaF I 1 '� , , ' � � � � i � i �' � 40. Gas Service-Final ' " � � - � � ; � � � , ' , i i � � � • ., I � . , . ' 41. Solarpomestioo-Final � I , �� _. _ ,_ � y • - - � . � I i �r , �� - . _ . . _ _ .... . r. ...- - � 42. Backflow Pieventer,- ' ' � � � �� ' � ' ' � � - � i I t I .�}'- - - '�- -� - - r . . - - i�. ... 1 T I i i I . Y. I r ... � . ' i t 43. Backflow Irrigation_ i � . � � _ 3 � . - � . . �.: .__� �.� , 44. Landscape'Irrigation System j ,- �� ~ ' ° -- � - , , � - � . . � �� .,, _ ' ��: 45. Sound Attenuation', � ° i ' - � " � ' { � � ' � � . . . ' f ' li: 1 46. Hand�icap Regu,latioris i � � . - � ' � � � � . ' � - `. � i 1 - � 47.FINALSTRUCTURE&BUILDING �- �1�-1 ' , 48. Special Requirements.Completed n /�$'/ � ' � � � � � � . 49. Electric'Release to Edison � �j j � __ __. . . - . _ ._. _ _... � • � � r-- • 50. Gas Release to,Southem California Gas'Co � � � ' . . ' , , ,� 51. CERTIF,ICATE OF OCCUPANCY `' '_ � _ _ _ . - , , . ' T. No. fTJO.O L/ 1S�/� � � �Date ' 3s" � �i-% 1 g 1 . � � . :_-.+� � _r..._„ . / ' - ` e �ROBIN B. HAMERS 6 ASSOCIATES, INC. CIVIL ENGINEER$ • PLANNEFiS � SURVEYOIaS May 3, 1984 City o£ Costa Mesa Building and Safety Division 77 Fair Drive Costa Mesa, CA � RE: FINISHED GRADING COMPLIANCE 2302 ELDEN AVENUE � GRADING PERMIT B10642-B16645 Gentlemen: 23a E. t7TH ST.. SInTE 2O5 COSTq MESA. CA 926E7 �,a� �„e2 Subject property is graded substantially in conformance with the the approved gradinq plan. There is positive drainage away from the building and the minimum required rates of grades on ground and pave"cl surfaces are met or exceeded. Sincerely, G��•%�� '�/�� Robin B. Hamers R.C.E. 3I720 ;; �� ! , ; tiS��.. , `' . ,_ f. _-_ -- - - --- ---, :,� �-=_ _ _ � �: r ;TA.'�. I I � � M_ �` '� -�. , " ,� -, . N Febtvary 24, 1984 To: Buildirx� Safety Division 5usiness License Division Ccmmunications Co�mty Administration Office County Clerk County Registrar of Voters County Tax Assessor F.ngineering Division (2) Finance, Revenue Division Fire Prevention Manager, MID Mesa Consolidated Water District Newport-P9esa Unified School District Pacific Telephone Can�ny (2) R�lice Department - Ping. & Research Santa Ana Fleights Plater Ccmpany Sanitaty District Engineer Southern California Edison Co. Southern California Gas Co. State Board of Equalization Street Division United States Post office, Adaris Avenue United 5tates Pe�st Office, Santa Ana Zip 4 - Santa Ana File (2) (2) The City of Costa Mesa wishes tn advise;you that, in conjunction with a neca project, the following addresses have been changed: OLD AUDRESS NEW ADDRESS A.P. N0. 2302 Elden Avenue 2302 Elden Avenue, Unit ?� 439-261-01 2302 Elden Avenue 2302 Elden Avenue, Unit B 439-261-01 2302 Elden Avenue 2302 F.lden Avenue, Unit C 439-261-01 2302 Elden Avenue 2302 Elden Avenue, Unit D 439-261-01 For yo� convenience � are listing the agencies above that�,e have notified of the charr3e. In addition tr� those listed, you are �vised to notify your corres�ndents of the d�ange in order to awid any pc�ssible interruption of mail service. Your coq�eration in this matter is appreciated. Sincerely, � �_ �� l�'i ��=�-' ` RORER?' Z. DUENAS Planning Intern RZD:hwn (F-1-25) l ��! ��:-� ��.� � cc: James Griset/Jack htather 2 Corporate Plaza, Suite #z90 NciuErort Beach, California 92663 t�. � . �_� .�� 1, �_ S ��Y �J CERYIFICATE OF y,`��TE OF ilMet,9 _ �o �A�T�= A C �__'—_"'_�--.��. "__ R r: a3 0 2� i�P�e h P�.rw�; �s B �r�C�Y�,�13,4�/d �l.s CONFORMANCE /HE UNDERSIGNED MANUFACTURER HEREBY CERTIfIES that the producu identified below and on attached sheets Nos. are marked with the Coliective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC) and were manufactured in contormance with applicable provisions of American National Standard ANSI/AITC A190.7-1983, Structural Glued Laminated Timber, and that such manufacture has been at our plant in Saginaw, Oregon ,�„�hich plant has a quality control system approved by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION and inspected periodically by such Bureau. The manufacture of these members complies with the manufacturing and fabricating provisions of Chapter 25 of the Uniform Building Code. �r- �-. �o JOBNAME: JOB LOCATI � CUSTOMEF'$OF�ERNO. �V51 DATE 10/25/83 MFGR'SOFDERNO. W. P C, Director ` pDORE55 Saginaw, Oregon DPTE Fii��`�i��v Load Wr AITC HEREB Y CERTIFIES that the said company at its said plant is licensed by the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect of products which comply with applicable provisions of said Standard, that the adequacy of the quality control system in effect at said plant is periodically inspected and verified by the Inspec;ion Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of AITC, said company is capable of complying with applicable manufacturing and testing provisions of said Standard in respect of products manufactured at said plant. Conformance with the Standard in respect of any specific or particular product is the sole responsibility of the manufacturer; AITC's guarantee hereunder being that the said company is qualified to produce a product meeting the said Standard and that its plant is periodically inspected and verified by the AITC Inspection Bureau. AITC FORM IBCA AITC_ Certi(icafe /Vo. Q! j� l � fa AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (�c 1983AMERICANINSTITUTEOFTIMBERCONSTRVGTION � � Co�ta Mesa Building Departmen,�o 171 EAST 26th STREET COSTA MESA, CALIFORNIA Q� 0 FOR APPLICANT TO FILL.;IN 8ullaing '1— 1U /%� `� Address C.�(� 4 �/��=1J� Costa Mesa, California Nearost � 3 � J,,.� . Cross St. �di/ Mail �}p � Addross City � � . Architect or Engineer Address ntractor /'� Address LC9a1 Lot r� DeseNptio� I No. � ( (Attach Metesand Boundpyl / Size of Lot //� (�j/,( use or Existing Bldg. � ' Setback Line from r^X Cenkerof Street Z � .QI I Tract 3i "OS%— / of Bldga � ,..... � ... Atlditlon �PPLICATION FOR PERMIT BUILD,�NG '� FOR OFFIGE USE ONLY ' �`^ Receipt No. Permlt N9 . � 3 ��j� �O 1�� % (O 'ved by Date Rec'd. Date Issued ' 3-/i_J-l� .�—li �_ g / 3 .2i0 �� o ./�a,,.� Costa Mesa, alifornia Storits � APPROVALS � Foundation Loeation Inspector "'—�'--- Forms,Materials, I I hereby acknowledge that I have read Uus Application and sta[e that the above is rnrrect and agree to comply with all City Ordinances and 5[ate I.aws regulating building constructlon. Signature of Permittee Valu.atfon , / 3 U � � � cnwu �nA G-H 2M R-54 0 O gond Beam d a FINAL Gf I 2 D r Show locatlon and distancea Trom property line and between buildings. � e 9 t (714) %$4-5273 • Fa:c (714) 754-4856 • www.ci.costa-mesa.��DING PERMIT 77 hAIH UHNt, GUJ I A MtA'A, GA BLtilb Job Address: 2$O2 ELDEN AV Suite: D Vicinity: BLDG D AT ELDEN 23RD Primary Occ: R-1 Hotels/Apts/Res >10 Occ Type of Constmdion: V-N Parcel Number: TPN006022 Zoning: Applicant: MOLLISE, DANIELLE Address: 1653 SUPERIOR AVE COSTA MESA, CA Owner: ELDEN 23RD HOA Address 2302 ELDEN AV COSTA MESA, CA _ �. Contractor: ".LEE ROOFING OF COSTA MESA Address: � 1653 SUPERIOR AVE . COSTA MESA, CA Zip: 92627 � A�ch : Address: Zip: Phone: 949-642-7222 Zip: 92627 Phane: � Zip: 92627 Phone: 949-642-7222 License: 349686 Eng: Address: Phone: License: ISSUED BY: Status: ISSUED Applied: 02/03/2006 Issued: 02/03/2006 Phone: License: SCOPE OF PERMIT REROOF ELDEN 23RD CONDO BLDG D: T/O EXISTING CMP SHINGLES, REPAIR/REPLACE SHTG AS NEEDED, 2 LAYER 30# FELT, APPLY 30-YE, SHINGLES. � 11SQUARES Plan Check: $�.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING ezistina: o � ��Rear 0-0 Rear 0-0 FEE SUMMARY PLANNING 8 ZONING Lefl 0- 0 Left 0- 0 Reauired: 0 �Pr000sed: 0 Calc Valuation: Claim Va�uation: Right 0-0 Right 0-0 s2,szs.00 $z,szs.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such woik must comply with all applicable codes, and all requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446d8 (B/00) WORKERS' COMPENSATION DECLARATION: I hereDy aHirm under penalry of perjury one of the following declarations: , . [] I heve end will maintain a cetlificate of consem to self-Insure Por workers' compensation, as provitled for by section 3700 ot the Lebor Code, for the paAormance of ihe work for which ihis permit is issued. �I have end will maintain workers' compensation insurance, as requiretl Dy section 3700 of the Labor Code, Por the perfortnance of the work forwhich Ihis pertnit is issued. �_My.workers' co�° e1n–sa�ion Insura a carnar a tl policy number are: �---�--� Garrier:�'–."'� )'T�'�Q � � �PolicY.' {yumber;l � �«0� 1�Q– �'l�� (�fhis section need nof be complefed il (he permit is valued at one hundied dollars ($100) o� less.) Q I certily t�at in the pertormanca of the work for which this pertnit is issuatl, I shall not employ any person in any manner so as to become subject to the workers' compensation laws ol Califomia, end agree that if I should become subject to Ihe workers' compensatlon provisions of Seclion 3700 ot the Lebor Code, I shall forthwilh � omply.wit�b se D�ov' 'ons. '�tioenFSlgnat`ure: D�a� �' 3 — (� `p WARNING: FAILUPE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HLINDi1ED THOUSAND WLLpRE ($100,000), IN A�DITION TO THE CAST OF CAMPENSATIIXJ, DAMAGE$ AS PROVIDED FOR IN SECTION 37060f THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. UCENSED CONTRACTOKS DECLARATION: I he�eby aNirm ihat I am licensetl unde�r.Provisio7s�of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Pmfessions Cotle, and my license is in full f0«e entl BtteCt?Li� c. Ni �i ��'1 �2 �'W �CI9�S5� � 3GI C04UeGOf5.Si9l�d B: _�G'� � /Yl/� ��_ � 1 _�r-,_ Orat�e'. �i � i^Cl C., CONSTRUC710N LENDING AGENCY: q I hereby attirm that there is a cons�mciion lending agency for ihe pedormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lantler's Name: Lender's Atldress: Signatura�. Date: OWNER-BUILDER DECLARA710NS: I hereby etfirm that untler penalry of perjury that I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor ihe following reasan (SecJ031.5, Business antl Protessions CQde: Any ciry ar counry which requires a pertnit to consbuct, alter, improve, tlamolish, or repair any stwcture, prior b its issuance, also requires �he applicant tw such permit �o file a signed statement that he or she is licensed pursuant to the provisions oi ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) oi Division 3 ot �he B�siness ana Piofessions Code) or that he or she is exempt therefrom and the basis br the alleged ezemption. Any violetion of Section 7031.5 by any applicant for a permit s�hjects the applicant to a civil penalty of noi more than five hundred tlollars ($500).): [j I, as owner of ihe property, or my employees with wages as iheir sole compensation, WILL DO 7HE WORK, and the siructure is not intendetl or offaretl for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law tloes not appty to an owne� of propetly who builds or improves thereon, and who does such work himself or herseH or thmugh his or her own employees, providad that such improvements are not intended or oNered for sale. tl, however, Ihe builtling or improvement is sold within one year of cOmpletioq Ihe owner-builder will have ihe Curden of proving ihat he or she ditl not build or improve tor purpose of sale.�. ❑ I, as ownel of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cons�ruct ihe prolec� (Sec. 7044, Business antl Professions Cotle: The coniractors License Law doas not apply to an ownar ol propehy who builds or improves ihereon, and who con�racts for such project with a contractor(s) license pursuant to the Contrectors Licanse Laws.). ❑ I am exempt under sec. Business and Professions Code for �his reason: SignaWre: Date: Ow�er ID venfied by driver's license. ❑ Ves ❑ No Drivers License No. Expires: VB�iication ot Ownarship by Qype of document, i.e. - property tae bill or deed): DI��SION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby ceniy ihat no excavetion five (5) or more feet in tlepih in�o which a person is required to tlescend, will be made in connection with work authorized by this permit, and Iha� no building structure, scaftolding, fal5ework, or demolition or dismanNing thereof, will be more ihan Ihirty-six (36) feet high. (Chap. 32, Orp 2, Atl 2, Sec. 341, Title 9, Celitocnia Administ[ative Cotle�. � As owner-builder, I will not employ enyone to do work which would require e permit from Ihe Division of Industrial Safery, as noted aDove, unless suCh person has e permit to do such work from the division. Signawre: Date: Division of Induslrial Safery Permit Numbec ICER7IFICATE OF COMPLIANCE AND AUiHORIZATION OF ENTRY: I cenity under penalry of perjury that I have read this application and state that the information given is I corted. I egree to comply with ell state lews entl city ordinances relating to building consimction, and authorize representatives ot ihe City of Gosta Mesa to enter upon Ihe ebo�e-tlescribed property for inspection puryoses. I agree not to ocapy or allow occupancy of any building au�horizetl by this permit until final inspection. � _ Signature �egal Owneqs) �^ � ^� �Qpf,1, INSPECTIONTVPE ' 1fi1fi Fixed System Final Fire Prevenlion 1266 Pool Spa Final 200 201 Fioal Re-Roof Final BIxWRelaining Wall 202 final Factory Fire Place 203 FinalSign 204 Final Demolition W_TE It�18L5 40DE11 1115PECT10NTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Finel Fire Prevantion 220 Final Planning Approval 222 Final Site 250 Final Buildina/OccuOani QdIE �N�111AL5 FEB-02-06 11:56 PM February 2, 20�)6 .. y , 'r_.: . P_ a� j��l�_ pd� —p�zZ Eldee� 23rd HOA 230Z Tlden Avenue Costa rilesa, CA 92627 City ofCosta R1esa Eiuilding Division: W�, the F.Iden'3N Homeowners' Associatian, auihonza I.�e Roofinb Company f'or chz re-roofing of our comple�. The work is scheduled to begin today, February 2, 2006. Please call us to inform uy that yCu have �eceived this authonzation. Respectfully, ��ti ry�.�..,_,_ .�,r� U�vid and.fennifer Long I IpA Vice Presid�nt and Secretary, respee�tively Qwners of Unit C (949) 722-8677 � � Bl.._DING AND SAFETY DIVIS��N FIRE DAMAGE INSPECTION REPORT (Required Prior To Permit Issuance) r�/: t�' Address: 2�� Z r lG� �/N C�' % Z61 7 Unit: � Owner: �ChHi�]�'Cv' Lt�tGN �S�i ` G!��'/� %ZZ` ��,% Owner's Address (if different from above): �Y' �� y� Gi ��— 3G7�� e i Street Q Structural permit required. Q� Repair or replace as necessary. ❑ Plans required. Comments: — � �� 0� oa'�� ri� � �> t�. /, /. CI(Y �j.� �- � 2S t� State / 'Q' Electrical permit required. � Repair or replace as necessary. � � n/u � .� w � v , t� � , ti- ' � l P -c �c, Comments: s � � f � � Q Plumbing permit required. � Repair or replace as neoessary. Comments: Y C/�k , j� Q� Mechanical permit required. � Repair or replace as necessary. Comments � t � /`i ei-l� �� . /�/� �� • �.� � y �,. �fOoi< �z-i-o� � �y- �sy- S�/� Inspector Date Phone 1612-46 Tri0liwte: Originel-Owner, Vellow-Cqnlra�or, Pink-BuilEing Division Appliwnt to fill in all spacas exeept t�ow wHhin haavy DorEer Iinez anE zlgn all aDP�ooriate Ceelarotians. , CITY OF COSTA MESA , - �. � � pE MIT NO. TRp,CT NO. ' , LOT NO. BL . 2%BS ��2OIB4 'I BS• �6 TI� CONSTRUCTION PERMIT ' =/BG �<.S�` ?j 4'' - . � ' ' �x,¢" laee"�w��' �°ti`'G" , .- . _ - � ' �(�� ..cS� . AppliCBriT'SMeilingAddfB55SOOO7�'SMNJEJ:yL�,GOY�fiMA�' TypEOFCONSTRUCTION • NEw ADD 'ALTERATION REPAIR ' , � _ ��, ,� '- ProjectAddress ��'2 EI-'�-N �VE�- : � O CONVERSION �� DEMOLISH ❑ OTHER� ' +' � � ' ' .� ' ' � DESCRIPTION OF WORK 'Z ING REG TI Owner'sName �-'�L� �3je{�' PPY��M£K-``�''%�Phone� 0-E�� . . . - � - � . - . � i , . . . Addfea ��j �z'� �� AZA #L%U � N��._ ��( O � nrPE OFPERMIT' GRADING. FOUNDATION. STRUCTURAL . ' A.P..qW — --07 -20NE � 2.• • AICh/Eng. !� �—� FA'�'Q' A�Lt��t�YtSicense No.� C`� �6�' ❑ TENANT ❑ ELECTRICAI �� PLUMBING. ❑ MECHANICAL � ' _pLNG. RE . � 3� , BUILDING =? , '-�— ' � Address �06'(j%�S�yll�� RVE� GnFeoNR DF_� Mft{� �,�pTHER - : . � : . � . . . . '. � TO BUILDING COMfeCtOf'S Neme ..IP m�L c I11 ,n rqSL� vhona-� 7� ry��/� PAaECT DESCRIPTION� Sa. FT. �S 3a � oCCUPANCv2 � '� �� P PE Y INE S� ' REAR VARD (TO P/U -: i' j I� '�� Add�eA (meilin9) `�-s�� M 4¢r+ � A i ?%J{w�c �b.i�- , CONSTRUCTION TVPE -�N yqLUATION $� �7c�,/ r�i� � LEFT SIDE VAqD �� RIGHT SI_DE YARD ./, : " ZON� '2'Z- ' GRADINGCU.YDS: �' IqCHEs -' PKG.SPACEREQ. � t PROVIDED a 5.. licenseNo. 2429.i7� � �ery"77i� ' . � � �4j , LICENSED CONTRACTOR DEC�ARATION Ramarks: _ � � � �� . �G � STREET WIDTH ' � � � ' ,PqRK FEE $ : r Phareby a111rm that 1 am Iicensetl untler provislons o7 Charter 9(commencing - , wit� uction 7000) ot Diviilon 3 of t�e Bu5ine35 antl Profeisioni Cotle, antl ' � � � � . �- � �SPECIAL CONDITIONS: ' ' - ' my Iltense is In f folce antl etfect. � . . - , ' � - i � : , � LJcensa cla �—� I � ' -- .License o. . 2 � L 1 � • . • � PLUMBING . . • . ` � . � � � � , , .. . 'g0� F�R SPE%IA� ! fir c'necnrre .� i Date -l� z i+ / cio�at��. ��__� �' � �!�!i�T . . , � . . , . WORKERS' MP NSATIONDE �RATGCA ION ( � � � ; 88�Sink SewB�Cap �. � . , ELECTRICAL : ; I '`ereoy'atflrm that 1 hava a Cartlilrate of consent to selNnsure or a cerU/iWte � gg�ktloN/ Preventer . .. -. _ SBV.Rr ConnECtion . . � AutomaTic Washer � Meter ❑over tOb amps � � Workers' Coinpensatlan Ins�rance; �or a cerSitietl copy theraof (Sectlon � Construction Pole ; ' � t� ' � J0. Lab. C.) � �� ` 1 . ��^ � ' . ' � . - � . : . T I Sub Panel' ; Poilcy No..3-f�171� ��3 .SsorS� �rei.JD � � Backflowirrigation 'SolarCollectors � � . • ��.; Company � ' � � Cooking Unit � ( � 'Su6 Pole . � � �� ' . � �Certltletl copy is hereby fumishetl. ' -• . � .� � � . Bathtubs - $ola� Piping ' � , � , Cert tl co is ilatl with t ��r1 vi n. � � i � � � Dishwasher � j - MotOrs �04 HP ❑ 1:4$ ' Date �o qppjk'��/ ��✓J��; � Clarifiers ' Sofar�Tank , � I , , ' EXEMPTIO FR MWORKERS'C PENSATIONDE ARA71oN' 'i' � - - �� -' Dryers-OGas��OElectric � 'Inc:Solar'09-15'HP 016-15+ -'�� ' (Thlzsectlon neetl not be completetl f Ihe Dermit is for o e �untlratl (5300) or Dithwdihe� � � Swirtlmi�ng Po01 w/Spa 1 . I �i ce�rtlfy�that.in the perTormance ot the wor�k tor which this permk is�lssuetl I ' Drinking Fountains ' � �Urinai , .. � v � Fan; � � �Microwave � ' shall not employ any persoo in any manner zo'�ai to become SUDject to ti�e � � . � -. F.A.U. ' , � ,Pol¢',Li ht � Workers'.Compensatlon'Lawsaf Calliornia.. �,� � � . , , � FloorDiains� � � � . Water(7oset� j� � ' ' � 9 i Date ' . ' � 519nature � ' '- - - i � � " ' i . . , I Fixtures � � . � '� ` . t . NOT.ICE: If, after makin9 this tlaClaratian, you Shoultl betoma.SubJect to.the_ , Flool Sinks ' _ Wat¢r H¢etei . Range WO�ke�i' CompensatlOn prod57op5 ot th0 LdDo� Cotle, you muzt fOrthwith , � • DCvicC BOx25 �' <ompty with such �provisionsaor `this permit shall be tlaemetl revbketlJ Gas $ervice � :Outleti � � �;. -Wate� Servic2 ' _� • '�Sign -' ' '� '� ��.-. ' CONSTRUCT,ION LENDING AGENCV "" � " � � � - " ' ' ' '^ ' ' � ! . 1 heleby afflfT that fhBre IS a;cOnslrUctiOn IenGing dg9ncy fOr th8'pCrfOrTdnCB. � � Int¢fC¢ptOfS -' ' - � t �Utl¢t5 ' ' 'St3nding $CCtiOnS •� i - ot the 'work �tor w�lcti, this; permit "Is �issuetl � (Sectlon'S30B7- dv. C.)• � � � . . � . , Lentler's Name' � ' � � �. 1 '� i . ; '^ -' � ( ! � Switches': ' ,� - -- ' ' ', ` ' - ' Kitchen Sink; : . � , . � � �Tresh Compactor .� Lentler's Atltlress' � � - � ' ' ` � � ' � � � OWNER'BUILDEA DECLARATION� -` = j j �_ j � ' - � � ��atOfies iµ , � Gafbage DispOsal, `i �., .• � + I hereby(affir'm that I am'exertipY Twm tha+Contractor'S"License Law Tor the � s. �- �, �- ,�. Gene�atoi 00-5 KW 05-15 KW� - ' ' �� following reason. (Saction,J031.5 �Buslness and Prbfezslonal:Cotla: Any city or P-TrOp; � •r , � , � , � , • • • • . �county whlch, �¢qWreS a pG�mlt to const�uct, alta�, IrtlP�ove; Eemolish.o� repai� � . , -. � „ . � . . � � Transfoimer i � '� 1 ' • � any 5tructure, prlor to its issuance, alzo requims the'applicant.for such ermit � 015 50 KW , -' ,. ., ; � p ,� � Roof Drains� t- �+�- 1 � M I to file a si netl statement that he s�e is Iicenutl ursuant to the rovisions a1 � ' ' , the Contractor4 License Law (Chapter 9 (commen<ing.with SeCUOnJ000) of ' - ' � ' ` . - ' - � '- ,. � ❑5U+KW� � � ' j� �Re�nspaetion Fee ' - $75� � �ly�slon'32At the �Buslne55�2ntl. PrOfe55ions COtl¢):or thdt h¢/Sh¢ i5'�ex¢mpt ' i$hOw¢IS . 1 R01115pBCtiOp FBe I $7�j. __' _ - � f,jefrom.antl t�e basis for the allegetl exemptlon. Any.violatioKof SecHon ' , ' ; .' � _ , ' " ' Meter ❑up to 100ampb ' � ' � '�', � IlssueFee '$ 3 i ?,�J3:5 Ey- any -applican[ Tor a t permit subjects the. aOPI(cant to a civll • � �Y '- �' � � ' ' �nalty of not more than five huntlretl tlollars (5500). • �, , �= Service Smk' � , � . ; laue Fea - ; � �a 3 -' ' . i �� - � � d I, as owner of Ihe' � + �qi^9 APP�oved By �: Date ! Oroperty prLmy emO�oYees viith�wages•as thelr sole - . , , � � � ' V.j^ � � comoensation will tlo the work, antl Ihe;sVucture Is not intentletl or otferetl - ..T 1,' MECHANICAL � ' f� :� � ' � � Appliotion Approved By � Dat'd for sale (Sec�ion 7044, Buslness znG!Protesslonal'Cotle:.The'Contractor's � � . � . f , . li<ense Law tloes not apply to an owner of a property ��who builtls or improves � , Boile� � '� �� ' � . R¢frigeration System , p ��p4ion Issued,B - r� ' � tnereon, antl,who;tloessuch work �imself/herselt or throu9h his or her own , � y• � � ' ' PP. . Y ' ' � ' '`', Date � em0�oY ¢e5, provlGotl that such9mprovements ara�not Inientled or offeretl fo� , � ❑0-100,OOOBTU ❑10�,�OOBTIJ � sale. If, however, the builtlin or im iovament Is sold wichin one' ear of com- 3 Duct = Unde�,Ground ; I ., , , � . ' ,'..• ' � - - -.r .,- e P v , . 1 : �� ' . , "; �ti SUMfJIARY OF FEES.� � � pletion, the ownarwill have the burtlen of proving he�she tlitl not Duiltl or Im- ' - . � . � p , ' ) �rova for the ur ose of sale'. , , �. � . . • : Duct - Structural System Re air/Alteretion l I, as owner oPthe property, am ezelusively wntracting+with�,licensetl con- - � . ' P � %` �BUILDING PERMIT $' � o '�!- ± , $M�p t�• ' `($ - /�9G tractorsto mustruct tne'oroject (Sectlon 7044, eusiness antl Professions COGe: � Duct- Ventilating �,� 1 ; ; j � 'PLAN CHECK� + � � �`' Tne Contra<tor's Gcense'Caw' does'not apply to an owner of"property who'-� � - - - ' ' - � , . ' ' � $ ,n � ISSUANCE � �� $ � � � builtls or Improves thereon, antl who contract5 Tor such proje<ts with a cbn- j � ExhaustSystem ❑ Multiple �� . � � � L� . � 'PLUMBING: } � $� . �� r tractor(s) Iicensa pursuant to the Contractor's Llcense Law): � � - i j ! - . � . � � . + ' ' ' . - i i � � ;PLAN CHECK: ' $ : GFADING, " � $�' • ! ❑ I�am exempt un0er Sectlon � � B, & P; C. for tnis reason FirepVFact. Blt. ICBO # " , V � � � ' j $ � i �• i � � . � � : . i � . . � . " � � � . Date ' ' � Owner: � . . � � 9 Y 9 � ' ' � . ' ;ELECTRICAL�� $ ' . . : . 1 Heatin �S stem & Ductin ' � � �•�' !,Lhereb certif that I�have reatl_this.apo�ication antl state that_tha above 2 � � PLAN CHECK. - •i � i ,. � MICROFILM i-$,' v Y. 00.700,OOO�BTUD100,OOOB ' " ,..+. y S i � in�ormatlon Is correct. I agree to comoty with all city antl county ortlinances , . � � �� "- . t" i� i � ,� � 1 '' . .! ' TOTAL�FEE ��$�� . antl, 5tate laws relating �to builtling constructlon, an0 hereby authorize repre- • Hood or ' � � � . .MECHANICAL ' $� . ; , , ' sentptives of'tnls ' y. So enter upon the above-mentionea property f r' , T�PB � � ' Reins ectian Fee' 7 '� . � ' . i . ' � insoecti - r � - ; � f • � � Cano ' T e II ❑' � P � �15 ,PLAN CHECK' - $ - ' /� LESS� � , T . . � , � . .. ' ADVANCED PC� : $ • . � Slgnatur ' - Oate � • • . � � � � : � Drivers' LI nu or:55 � Registers � Iswe Fee . ! ' y 3 ' ; ' - , � . ' � , /gs�.y�p 9f i FINAL'FEE, , $ L_. CMF 0865-46'rev: 12/82 hite Bulltling;'Canary -Appliwnq Pink -�Accounting; Goltlentdtl =Assesdor ` "" � " - """ ' ' - -' ' "�' � � - ' � � -' ' " - ' ' -• � ^- ' -' - -- - . ._ . . . . . - . Y . . . _ _ ' _ . _' '.__ ' _ " _ ' __ _ _ ' _ : =; CONSTRUCTION AND PLANNING ` L = - - - , ; �� 'A = �: ' � � APPROVALS - �Peimit # g� �'�645 ��-Date�. - �Inspectorf . r+��pPROVALS- Permit.;f`- - ' .Date � .Inspector . ' - ' ' N r ' - '" :1, �Terriporary Electrical Service�oi Pole � "' �� _.' ' _ -� '52. Pool &'Equipment Location - � "`' � � - � - - +"2•.�Soil�Pi e-Undr rndE . ', -<, � �� ..�. ..,;� i:.;; �=r --�� - _ -. _ _ . � . ° P , 9 � _ , _' c > '-, - � � �53. =SteelcReinforcemenY ` - 3. iElectrical Conduit Utilitv-Undrgrnd'. � .� ' ' - � :54: �-Forms- - � . -_ , � � - • : � � o `� �4. �Electrical ConBuit-Undrgrnd. , i � � � �` '" =�= C 55� Electrical Bonding - - ... . - I. IL �5. �Steel Reinforcement , ; � �; �' , �, � ' : - - ° ;,� Q ��f : 56. `Rough'Plumbing & Pressure Test � - - - 6.1ElectricalUFERGrnd: �y'= e;; � ' 57'APPROVALTOCOVER-GUNITE ,. . 7.'Footings ` � � � , � t , =','�.�. ',.� ; 'i`' `'58. Electricai Cpnduit-Undrar�d:.'�' ' '� � E: 8. Foundation � , � ,' j -� � � � � ,; � , �. Q _�. Y' '59. Gas Pipe ❑ Undrgrnd.,;Test � - � .' ' . ' 9.'Wate� Pipe'Uridrgrnd. ! � � - . � ' s- _ � .60, -8ackwash ;Cines; P-Trep,'O�Undrgrnd. ' . � �' i 10.'Sfructural Floor Sy'stem ' ' °- _. J, , " . `61. �APPROVAL TQDECK- - - � - . - ' � 1 L .Property Sewer Line & House Connection� �; i � , - 62. Backwashf& ReceptorFinal � � -` � � � , '�. 12.'Sewer Cap � � � � �� _ � � + � : 5-•� --�� , �63. ��Heater &�Vent-Final . � - - " - , 13. Roof Drains : � -, � _ ' � � %, - -64.'Plumbing SYstem -�Fina1 � � - - • ' ; 14.•Rough Plumbing � � - I ' � ' �� • 65. -Electrical-Final � � � �, - � ' _ ''15[,Rough Electrical-Conduit�-'^ .�"' '�" r I � I '-',` �66[ SolarSystem-Firiaf "� " � - - -- " ' " , : i . ,_ � , -=-t _; ---- F � ' . .. - ;. 16. Rough Electric Wi�ing � � � .: {il: � � � , . - � - ., -� � ; -I-7�` - � o . � ' 67: .Fencing & Access Approval ; , 17 •�Rougfi Wiring Sign - , '. � �� j; ' � � � t � ' � � ' � ° �68. APPROVED.FOR PLASTERING . `- � �' I ( � I �78.��Rough Elecfrical-T;�Bar Cei,ling �� ^ ' �J � . �' � � � . �69: POO�L%SPA'SYSTEMS FINAL' �� " � � - - ;� 19.� Rough� Heating & Air`,�Conditioning ?i �� f �. , I I � FIRE DEPT. REQUIREMENT � � I ' ' - , � _� . �0. Rough Faaory Fireplace � � �� : � � � I � � � � APPROVALS t Permit # � _ , _ _. Z1.� D�ucts�, in�Structure, ., i � �I �� ; � � � � 70. Underground Hydro ; . -, �� ,. Q2.: Ducts, Venfilatin9. , , ; �I �,; � ' � � . ' . . . � z- ,� . f i j � � i � 77, ProductPiping��Gas ❑Oil �, � 23:?Gas�Pipe-Rough & Test ', � �;;- �; � � T � r� �7z: Underground Flush' �� '24.;,Roof Fra'ming ' � ^• { � ;�T i� n ; . `fr�. ;� . �73� Undergrnd. Storege,Tank � Gas� ��Oil � �� ; . , . , . , . � 25. Roof Sheathing I � .� � � ��:, i' � � % �j, � ` ��j,�� 74. Overhead Hydro � ' � � � :� � .., . � � �- � s � . i - . . 26. T-Bar Ceiling (StructuraDi & Monocoaf �� ; , ; � � � ; � 75. Dry Chemical � . - , �:27J�Frame.and°�Flashing � �(G ,�, ' � �� ;76. DryStandpipe � - - � ' � 28. L•athing & Siding �� '� � ! ;� , �� i ? i � t�77: FIXED SYSTEM FINAL ' i' � 29: Insulation � : ` . � � a ;, • � �:2,•.8�' �'� � 78. FIRE PREV. F,INAI ' � ' i � � i 30. Drywall Nailing � !; �� 3.�y�.�� e N--� ! Notesi j �� - - ': . �- , , - - -- ,. -.-- - - - - "31..,Plaster 8rown Coat� � ( , �f --j � �� - `f - 06 �a� � � . � � . � i , I � 1 i I goa; �-. 1 32.�'Electrical Power Meter-Final t � � �. i - 33.�,Final Electric - � � � ��_r I � � � � � 34. Pinal Heating &:Ai'r Conditiouing �, I � , � � � � � g��6 t .l. � P� 35. Final Gas Pipe-Test ` � � i � '� � �� ' - � � ' � � � ` � '-' I =. - - i - f ` 4 /,� g 36. �Hood;orCanoPv'�: � � r: � .: j �. ::':. � . i + i � _ � ` � - , :,. 37. Final Factory F,ireplace� � ,- � F. � : ' � , :. i , , � F ' 38.. Final Plumbin9' I i i "� ' ' i` � � � . ' . � t I < t ,i �. . � , i � , � , 39� WaterService-Final � ;� i � � � I � s� i _ : . i � ; . , ,,.., 40. Gas Service-Final i � � � , . � � , , ' ' ' - I , i � � � _ 41. SolarpomestioFinal , � � � � _ _ _ ___ •�C-- � � c�%�er; 42. Backflow Preventer �.' ' � :: �:R,I_ _ '`�. -� _ -- - -� I _ ��- , �' i 43. Backflow Iriigation r � ! ( "� - ' ; � _ - .l � � ' � . a �'44. LandscaPe �Irr.igation;SYstemE ' _-�°^_;-. � ' - � ' � �r; .. �� ' � �. �.. ._ :. _ ';.'-. , "; . .. �_ � _45. Sound"cAttenuationi �,R, ' �+' • � � ` ;� � � - �_�u; � �� i- � �io 46. Handicap Fiegulations � � , � ' .,� �o �� I �' j ; , � ; . �'. � � � � - 47.�FINALSTRUCTURE&BUIILDING�� I '�� •- �� ,, � i �- 48. Special Require'ments Completed I �, C' '� 49. Electric Release tolEdisori ' � � � � __ �. _ _ � � ____ � _ Gy . � � _� � 0 � � � � � i 50. Gas Release�to Soothem Galifornia Gas Co ; � j � I �'�--3 g�/, +' •/� � ' V 1 51. CERT,IP;ICATEOFOCCUPANC �..;. � . _� __ � � _ �� -,� ��"„fJ � No ��qDO �:O � Date :S � S8 r��$ � `�'l � - • �� k � . �. - . . ' � ' _ _ AOP��ant ta flll in all spaces axcept t�ote witNn �eavY �ortler Iines anE ti9n all apOropriale tleclarotions. , CITY OF COSTA MESA . � . _ pE IT N—� TRACT NO. LOT NO. • BLDG. . • CONSTRUCSION PERMIT • �— P �U�'3 Q PfojeCt Addre55 �" �� TVPE OF CONSTRUCTION W ADD ALTERATION REPAIR � �Applitent'S Melling/A`ddre55 , ❑ CONVERSION ❑ DEMOLISH ❑ OTHER� p� p# Owner'S Nama Yn�'S'S � Phon2 OESCRIPTION OF WORK Address Arch/Eng. License No. Address COntt2Cto�'� tinmo ��h-rs^^ u°'V� • Phnnw � Adtlresslmailingl �� •r`p�� ^ Z— Ciry Licensc No. � �� LICENSED CONTRACTOR OECLARATION 1 hereby aftlrm that 1 am Iicensetl untler provisions of Cnarter 9(commencing wltn sectlon 7000) of Dlvislon 3 of tha Business antl Profess s+ ,� tl my Ilcense is in f�fprce an ffe ucense Fia: b �s o. Da[¢ / SI9 t WORKERS'COMPENSATION DEGLARATION � hareby afflrm that I have a tertificate of consent to self-Insure or a certificate �t Warkers' Compensation Insuranca, or a certNletl topy thareof (Sec[lon 3800, Lab. C.1`r/ Q �` ^ r,\ n 1 POIICY No. Tn� I� ` ComPanY �-�. ru CJ\ ��yi C�� tl coOY �s neraby furnishetl. IlYCartlfletl COOY �s flletl with the city Builtling DlviSion. Date A�Pllcant , EXEMPTION FROM WORKERS' COMPENSATION OECLARATION (Thls section neotl not be comple[etl if tne permlt I5 for one huntlretl ($100) or iess). I certlry tha[ In the performance of the work for whlch thls permR is issuetl L� shall not omploy any person In any manner so as to becoma subject to the Workers' Compensatlon Laws ot Californla. � Dato Si9nature NOTICE: It,iatter makin9 this tleclaratlon, you shoultl become sub�ect to the ' i Workers' Compensation provlsions ot the Labor Cotle, You must fortnwith comply with such proviiions or thls oermlt shall be tleemetl revoketl. CONSTRUCTION IENDING AGENCV " I har0by affirm that thBre is a'con5tructiOn lentling agenCy tor th0 performance ' of ine work tor whlch thl5 Permit is issuetl (Sectlon 309] Civ. C.) Lentler's Name Lentler's Atltlress OWNER BVILOER DECCARATION i ' 1 heleby dHIrT that I am exempt flOm [h¢ COntlactol'S LICen50 Law fOr the followin9 reason (Sectlon 7031.5 Buzinass antl Pro(es5ional Cotle: Any city or coun[y wnich requiret a permit to conslru<t, altar, improve, tlemollsh ar repair any structure, prbr to Its issuance, also requires tha appli<ant for such permlt to Ble a slgnotl itatemant that ne/she Is IlcenseG pursuan[ ro tne provisions of the Contrattor'S License Law (Chapter 9(commencin9 with'Sectlon 7000) ot 7lvlsion 3 Of tne'Buslne55 antl Profe55ions Cotle) or that he/Sne is exempt . iare(rom antl lhe ba5i5 for the allegetl axemption. Any violation of Section 031.5 by any appllcant for a permlt subjects tha applicant ro a civil �enalty of mt more than five huntlretl tlollars ($500). I, as ownar of the property or my �employees wlth wage5 as their sole compensatlon, wlll do the work, and the structure iz not Intentletl or otferetl for sale (Sattion ]044, Business antl Protesslonal Cotle: Tha Con[ractor's Llcense Law tloes not appty to an owner of a property who builtls or improves the�eon, dntl wM10 tloes such work himseli/he�5elf or through hls or M1e� own amploy ces, provltlatl fhat such Improvements are not In[¢ntletl o� otte�etl tor ule. I/, howaver, the builtling or improvement Is soltl wllhin one year of com- pletion, the owner will have the burtlen of proving he/sne Citl nol bu�ltl or im- ��oveforthe purpose o/sale). I, a5 owner of the pro0erty, am exclu5iv¢ly COntraCting with IlcanSetl Con- tractors to construct the project (Section 7044, Business antl Professlons Cotle: T�e Contractor's License l.aw does not apply to an owner of property who bulltls or Improva5 thlreon, antl who COnttacts tor such project5 witn a con- VaCtOr(5) Ilcense puf5uant t0 the ContfdCtOr'S Litenze Ldw1. : � ❑ I am exempt untler Section B. & P. 0.(or th6 reason Date Owner _ I herGby carUty that I have r¢da�this Informatlon I5 correcf. I agree to comp antl state laws ralating to bu Itlin con sentatives of tnls dty to t yrp_or Inspection s. �� above TVPE OF PERMIT U GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL MBING ❑ MECHANICAL � ❑ OTHER PRQIECT DESCRIPTION SQ. FT. OCCVPANCV_ CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VDS. ACRES_ Remarks: r(�' — l.fl/l11-S Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifieri Dishwasher Orinking Fountains Floor Drains Ploor Sinks � Gas Service Outlets Kitchen Sink Lavatories P—Trap Root Drains Reinspection Fee $25 Boiler Duct - Under Ground Duct - Structural Duct � Ventilating Ezhaust System ❑ Multiple � Firepl/Fact.8lt. ICBO # Heating System & Ducting ❑0.700,000 BTU �100,OOOBT � Slgnature � Drlvers' Llcense or SS � �--� I I Reinspec[ion Fee I $25 CMFOB65-46 rev.12/83 White-Builtling;Canary-APpllcant;Pink-Accountlng;Goldenrotl-Assessor ShOwers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Typel ❑ Canopy Type II ❑ Refrigeration System . ❑aioo,000eru ❑iao,000 System Repair/Alteration Issue Fee FEES $ 3 $ 3 S Main Building: E T Front B Rear A C Right K Left S Ping. Ref. # Parking Req./Provided Use Of Building: Planning Notes: Automatic Washer. Construction Pole: Cooking Unit , Dryers lJGas L1Electric Fan F.A,U, Fixtures Device Boxes Outlets Swicches Garbage Disposal Generator �0.5 KW �5-15 3127 I/26/84 2one Accessory Building: Park.Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Mocors �0.1 HP �1 %- 8 Inc.Solar �9-15 HP �16-75+ Microwave Pole Light Range Si9n Standing Sections V Trash COmpactor I Reinspection Fee I$25 � luue Fee ' PUBLIC SERVICES REQUIREMEN7S: Zoning Approvetl 8y Building Approved By APolimtion Issued Bv !�%�� 25.50 TL FEES $ 3 2 O N I N G R E U U R E SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ ^rrr�� PERMIT PLUMBING $ � ISSUANCE $ — — PLAN CHECK 25% 3 �'�'. D ENERGY P.C. Q ELECTRICAL $ GRt+DiNG $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ �•� PLAN CHECK 25% $ �CONSTRUCTION AND PLANNING . POOL .r'A �•APPROVALS Permit# Oate� Inspector qppROVALS Permit# Date Inspector � � 1. Temporary ElectricBl Service or Pole 52. Pool & Equipment Location ��2. Soil Pipe-Undrgrnd. �/17�f� � 53. Steel Reinforcement �� 3. Electrical Conduid Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding � 5. 9'teel Reinforcement �' 56. Rough Plumbing & Pressure Test � j 6. ElectricalUFERGrnd. �� 57. APPROVALTOCOVER-GUNITE �; �• 7. Footings ' 58. Electrical Conduii-Undrgrnd. '� 8. Foundation ' .; i 59. Gas Pipe, � Undrgrnd., Test '� , 9. Water Pi e-Undr rnd,. - �� P 9 l�l7�i1� � 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 ' �� 63. Heater & Vent-Final 13. Roof Drains � •� 64. Plumbing System - Final � 14. Rough Plumbing � ��/�ty, 65. Electrical-Final � • 15. Rough Electrical-Conduit 66., Sol�System-Final �, i6 �Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APFROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # � 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test �/� 72: Undeiground Flush 24. Roof Framing� 73. Undergrnd,StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Strucwral) & Monocoat � 75. Dry Chemical - 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FtNAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final � 80...FOOD CER�TIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test t�,jt,��t+� L�(� 36. Hood or Canopy � 37. Final Factory Fireplace � 38. Final Plumbing .�-S.// 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 48. Special Requirements Completed � 49. Electric Release to Edison '.. 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • '^ Applieant to fill In ali spaces except tnose within �eavY Dortler I(nes anE sign ail aoPropriate tleclantions. CITY OF COSTA MESA � ' CONSTRUCTION PERMIT Project Address� � , -� Applicant's Mailing Address ' Owner'sName£L�''� .�� fr�/�T?�'2'��ho e�%.� " � Address �. L�--da2� �f i`�' i Arch/Eng. �icenu No. Address f Contracmr's Nam t � KPhone 'E''�75 Address�(mailin9) 11� �"��'��T�� City License No. �9n � LICENSED CONTRACTOR DECLARATION � 1 hereby atfirm that I am Iicensetl untler provisions of Charter 9(commencing witM1 iection �000) of Dlvision 3 of the Business antl Professions Code, antl my Ilcense is in full fo�ceyqp effect. � Z LJcense Clazs �- I nse o. Date �2 Sl9natu/e WORKERS'COMPENSATION DECLARATION :'-1 hereby at/irm that I have a certlfi<a[e of consent to self-Insure or a certificate �`2f Workers' Compensatlon Insurance, or a certifietl copy thereof (Sectlon 3800, Lab. CJ �//� �� 4e�Q AA��U� Policy No. 7�-�'�`" �� Company G�1�r /v( �ertifietl copy is here0y turnlshetl. '1,/� Date�er(j'��co y i tlletl wlth the clty Bull .��,� APPlicant EXEMPTION PROM WORKERS' COMPENSATION DECLARATION (ThliSection need not be completetl it the p¢rmit I5 for Ona huntlretl ($300) or less). I certlfy that in fhe performanca ot the work for;which this perm�t Is issuetl, I shall not employ any person In any manner so as to become 5ubje<t to tne Workers' Compensation laws of California. - • Date Signature � NOTICE: If,�atter making this tleclaration, you shoultl bacome subject'to�the Workers' Compensation provlslons of the Labor Cotle, you must forthwith comply with such provisions or this'permit'snall be deemetl revokea.. CONSTRUGTION LENDING-�AGENCV � I hereby'affirm tnat there is a constructlon Ientlin9 a9ency for tne pertormance � of the 'work for whlcn this permit is issued �(Section 309� Civ: CJ ILentler's Name _ , Lentler's Atltlress � � the Contractor'S �Llcense Law for the herefrom antl the �asls tor tne alle9etl eaemp[Ion.�Any v101a[wn or section � .J031.5 by' any appllcant for a permit subjects Ine applicant to a civll , : enalty ot not more tM1an tive huntlretl tlollars ($500). � I, as� ownar of t�e. property �or' my amployees with wages as their sole compansation, will tlo the work, anC the structure is not intentletl or otferetl for sala (Section 7044, Bu5lness and Profe55ional Cotle: The Contraccor's ' LJcensa Law tloes not apply to an,owner ot a property who builtls or improves thereOn; antl'who tloes sucn wOrk M1fmself/herself or tbrough his or her own employ ees, provitletl that sucn Improvements are not Intentletl or offeretl for sale. If, however, t�e buildln9 or Improvament is soltl within one year of com- pletlon, the ownar will bave the burtlan of proving he/she tlid not builtl or Im- ' �rove tor the purpoze ot sale). 1, as owner of the property, am exclu5ively contracting witM1 Ilcensetl ton- � [ractorsto tonstruct Ihe project.(Sectlon 7044, Business antl Profes5lons Cotle: TM1e Contractor's License Law does not apply to an owner of Property who bulltl5 0� imp�ova5 tM1e�eon, antl who con[�act5 TOr 511ch p�ojecti wlth a con- [ractor(s) Iicense pursuant to the Concractor's License Law). , , ❑ I,am exempt unCer Seetlon B. & G. C. for this reason Date Owner I hereby -certHy tha[ I have reaE thls applicatlon antl state that the above information I5 correc[. I agree to comply with all clty antl county ortlinances ' antl state laws relatin9�to b iltling construction, anG heraby au[horiza repre- zentatives of this city r on va-mentioneC property fo/r � inspection Durposes. ��L �` ZZj�i ' v( —//[{S / � D TYPE OFCONSTRUCTION NEW ADD ALTERATION RE7AIR ❑ CONVERSION ❑ DE OLISH ❑ OTHER q.p, # DESCRIPTION OF WORK � � S Main Building: TVPE OF PERMIT � GRADING FOUNDATI� -STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ P�UMBING MECHANICAL . A Rear ❑ �OTHER ' . (�` Right PROJECT DESCRIPTION 5�. FT, oCCUv.aNCY K CONSTRUCT�ONTVPE VALUATION$ �S Left. ZONE GRAOING CU. VDS. ACRES Ping, Ref. # Remarkr. �'� / � / iJ�� Parkin9 Req./Piovi� 3ar Sink 3ackfiow Preventer - 3ackflow Irrigation 3athtubs • � �laritiers �ishwdsher �rinking Fountains � � FloorDrains� � . Floor Sinks -- -- 3as Service Outiets Interceptors .� � Kitchen Sink Lava{ories, � � P—Trap Roof Drains r" � � Reinspaction Fee � $25 Boiler � Duct - Under Ground Duct-Structural ' � Duct - Ventilating _ . Exhaust System ❑ Multiple Firepl/Fact.Blt.IC80# � ,,H,er�a"ting System & Ducting �v,1t100,000 BTU 0100,000 Signature Date Drlvers' Licerise or 55 # - ReinSpeetian Fee ,$25 CMFO865-46 rev.12/83 White-Builtling;Canary-ApO��wnt;Pink-A<countin9:Goltlenrod-Assessor no�rvo Showers ' ServiceSink ' Sewer Cap Sewer Connection� Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal - - ' •� We[er CIOSet Water'Heater -" ' Water Service i , ' ' ' � Issue Fee � � � $ 3, Hood or� Typel Canopy ' Typelli . � Refrigeration System � ❑0-100,000 BTU ❑ 100,000 87 System Repair/Alteration Issue Fee � $ 3 Use of Building: Planning Notes: . Automatic Washer Cooking Uni[ Dishwasher .. Dryers ❑Gas ❑Electrit Fan ' " F.A.U. F i xtures Device Boxes � Outlets $witches Gartiage Disposal 'Generator �65 KW 05-15 � � Reinspection Fae � PUBLIC SERVICES REQUIREM 4 2aning APProved BY . Building Approved By _ 4696 2/22/84 Zone Park. Fees $ 14e.25: TL Z O N 1 N G R E Q U I R E � E T ELECTRICAL � Transformer ❑ 15-50 KW ❑ 50+KW Meter �up to 100 amps � Meter �over100amps � Sub Panel ' Motors �0-1 HP O1 %- 8 ' Inc.Solar �9�15 HP �16-15+ � Microwave ' ' Pole Light . Standing Sections Tresh Compactor $25 � luue Fee �� Application laued By � ',�� %� i Data �Lsy��y SUMMARV OF FEES � � BUILDING PERMIT $ � SMIP. .$ � PLAN CHECK $ � PERMIT • , � PLUMBWG � $ �SSUANCE $ ' PLAN CHECK 25% $ � ENERGY P.C. $ � ELECTRICAL $ � � GRADING �$ PLANCHECK 50% $ � MICPOFICM $ MECHANICAL $ � TOTALFEE $ -��`5 ' PLAN CHECK 25% $ .� �� :�.i� � i `CONSTRUCTIONANDPLANNING. \ 'S - POOL_pPA .- . - �.., , , � APPROVALS Permii# Date Inspector = ApPROVALS Permit# ' Date Inspector 1. Temporary Electric8l 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 �� r ' 7. Footingr , � ' � 58. Electrical Conduit,Undrgrnd. , � � 8. Founda[ion � �', ', , 59. Gas Pipe, 0 �Undrgrnd., Test , � _ � .. 9. Water Pipe�Undrgr�d. . �" • 60. Backwash Lines, P-T[ap, O Und�gmd.; -, � 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. Rou9h Plumbing - � 65. Electrical-Final- � - - � . 15. Rough Electriral-Conduit � � � 66. Solar'System-Final'� - � -� " -� -' ' 16:-Rough Electric Wiring . � � - 67. Fencing & Access Approval � � ' �- . T - � 77. Rough Wiring Sign � ", �.. � 68. APPROVED FOR PLASTERfNG� �'' � '. � . 18�.. Rough Electrical-T Bar,Ceiling � 69. POOUSPA SYSTEMS�F.INAL '� ' �� ', . 19: Rough Heating & Air Conditioning �/��y �� ,FIRE DEPT. REQUIREMENT �` ' � � � i I T' 20. Rough Factory Fireplace � � APPROVALS � Permit;# ' I �' , '� , 21. Ducts, in Structure ' , . 70.. Underground Hydro � � - ; � , � 22. Ducts, Ventilating 71. Product Piping �Gas;'OOiI ' � , , 23. Gas Pipe-Rough & Test ' 72. Underground Flush � � � 24. Roof Framing .�73.� Undergmd. Storage Tank O Gas . � Oil �' �� 25. Roof Sheathing 74.' Overhead Hydro ? � 26. T-Bar Ceiling (Structura�) & Monocoat ' ` 75. Dry Chemical � � � - • , - i � 27. Frame and Flashing � 76. Dry Standpipe , .' . - - 28. Wthing & Siding .77. FIXED SYSTEM FINAL � 29. Insulation � '78. FIRE PREV. FINAL ' + i HEALTH DEPT. REQUIREMENT � 30. Drywall Nailing � ' . � ' � ' 37. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Power MeterFinal � ' � 80. FOOD CERTIFICATE ISSUED � i' � 33. Final Electric �Notes:' ' ' , � ' 34. Final"Heating & Air Conditioning �� ` ' � ' ` • 35. Final Gas Pipe-Test� , .. . �- � �, � . , _ � ' 36. Hood or CanopV � � ' � ' � , - ; 37. Final Factory Fireplace � � � , � � ' . ' .� r ' ' • 38. Final Plumbing � ' ' � • - � � , 39. Water Service-Final � � � �� ' 40. Gas Service-Final • . � � � � � ' � i , 41. Solar pomestioFinal . � � . - - - ' � ' � • i 42. Backflow Preventer ' _ . ' _ . �. _. '. •' . . 43. Backflow Irrigation . � . � � 44. �Landscape Irrigation System ' � _ � � � .- 45. Sound Attenuation � ' : .' i � � � � . - � �- 46. Handicap Regulations � � � � � -� - i - 47. FINAL STRUCTURE & BUILDING, - ' �� . �� 48. Special Requirements Completed ' � • . ' ` � ' � ' i 49. Electric Release to Edison "" � `• , ' - � � . �- . � 50. Gas Release to Southern California Gas Co � � - • , ; ��. 51. CERTIFICATE OF OCCUPANCY . - - ' - � � --'- -, - '-� !- -= - - - �� ' - ; ! : , �� No. � Date - - . - - . - - - _ . • . Applicanl to flll In all spaees excap! l�ose wit�in �eavY �ortler Iines antl sign all appropriate tleclaratlons. ' � CITY QF COSTA MESA. � �CONSTRUCTION PERMIT Prolect AdtlreSs � Applicant's Mail�Ci��/A/��>c� � Owner's Name �a� �3 ��=��`/�'h � u� �� Addreu Arch/Eng. Licenu No. Address /7�� Contractor's Nam� kC.G�f' �SBs}�' e�arp�ho7ne U� Addresslmeilin9l ��31 ��/f�Ow/d•-r�a. U. ti-[�v�+ City License No. �� LICENSEO CONTRACTOR DECLARATION I hereby affirm that I am Iicensetl untler provislons of Charter 9(commencin9 with section 7000) of DIvlSion 3 of [he Business antl Prote55ions Cotla, antl my Iicense Is in full torce antl effect. Licen a55 I sa o. Date[��{Si9natur WORKER$' COMFENSATION DECLARATION ' I hereby afflrm that 1 M1ave a certificate ot consent to self-insura or a cartlBtate of Workers' Compansatlon Insurance, or a certifietl copy tnereof (Sectlon 3000, La�. C.) Policy No. Company BCertitletl copy is hereby furnlshetl. Ce�tiffetl copy IS tiletl wlth the clty BUIItlin9 DIvISiOn. Date Applicant EXEMPTION PROM W00.KER5' COMPENSATION �ECLARATION (This secilon neetl nof be completetl if tha permit is tor ane huntlretl (E300) or less). I<er[ity that in the performance of the work tor wnlch this perm�t is issuatl I Shall not amploy any p¢�son in a0y�e��o�Omesubjec� Wor mp ns F1 ws of Cali /.l Date Si9nature �J� NOTICE: If,�aHer makin this tleclaratl n, you 5�oultl become subject [o tne Workers' Compensation provisions ot the Labor Cotle, you must forthwilh comply wlth such provisions or IhiS permit shall be tleemetl r¢voketl: CONSTRUCTION LENDING AGENCV 1 n0reby attlrm thdt there Is a construction lentling agenty for the performance of tne work tor which this permit Is issuetl (Section 3097 Civ. C.) Lentler's Name I..entler's Atltlress OWNERBUILDER DECLARATION � I hereby affirm that I am exemp[ from the Contractar's License Law !or the following reason (Sectlon 7031.5 BuSiness antl.Professlonal Cotla: Any clty or cOunty which reQuires d Oermit to construct, alter, imprOva, tl¢mOlish Or repalr any structure, prlor [o its Issuance, also requires tM1e appllcant for such Oermil to flle a signea statement that he/zhe is Iicensetl pursuant lo tne provisions of the Contractor's LI<ense Law (Chapter 9(commencin9 with Section 7000) o� �ivision 3 of the Business antl Professlons Cotla) or that ha/she Is exempt .heretrom antl the bazis for the alle9etl exemptlon. Any violation of Section 7031.5 by any applicant for a permit sub�ects the applicant to a civil � enalty Of nOt mo�e than flve huntl�etl t1011a�S ($500j. � I, ds owner Ot the p�ope�ty O� my employ¢e5 with wa9es as th01� sole compenSaHon, wlll tlo tha work, antl th¢ structure is not intentled or oHeretl for sale (Saction ]044, Business and Professional Cotla: The Contractor'S Lic¢nse law tloes not apply to an owner of a property who butltls or Improves thereon, antl who tloes such work hiTselt/�e�5elf or througn liis or har own <Tployees, p�ovlCetl thdt suGh Imp�ovemGnts a�e not Intentletl o� ofter¢tl fOr sale. If, however, [�e bulltling or Improvement is soltl within one Year of com- pletion, the owner will have tha burtlen of proving he/she tlitl not build or im- �rova tor the purpose of sale). I, a5 own¢r of the pioperty, am exCIUSiJely contracting wi[h Iic¢nSetl <On- �. [ractorsto construtt the project (Sectlon 7044, Business and Professions Cotle: �ilT�e Contrattor•s License Law does not apply to an owner of property who ' bulltls o� Improv¢5 thereon, antl who contract5 for suGh 0/ojeClS with a con- Vactor(5) Iicensa pursuant t0 th¢ COntractor's LIC¢nse Lawl. ❑ I am exempt untler Sectlon B. 6 P. C. �or fhis reason Date Owner m and state t�at tha a�ove clty antl county ortlinance5 antl hereev authorize reore- F' ��S TVPE OF CONSTRUCTION NEW P.DD ALTERATION REPAI R - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � q.p, � DESCRIPTION OF WORK S Main Bu TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Reaf ❑ OTHER PROJECT DESCRIPTION Sq. FT. oCCUaArvCv C Right K Left CONSTRVCTION TYPE VALUATION $ $ ZONE GRADiNG CU.YDS. ACRES Ping. Ref. # Remarks: Sink Preventer Irrigation Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Intercepiors Kitchen Sink Roof Drains Rainspection Fee ,� $25 BOiI¢r Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ��0.100,000 BTU � 100,000 BT' a�Y��a�u�o - ---T—� �rivers' License or�55 $ einspee[ion Fee $25 CMF 0865-46 rev. 12/B3 Wnite - Builtling; Canary - Appliwnt; Pink - Actountinq; Goltlenrotl - Asu55or Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal WdtCf CIOSEI Wa2er Hea�er Water Service laue Fea Hood or Typel � Canopy Type I I ❑ Refrigeration System 00.100,000 BTU ❑ 100,000 System Repair/Alteretion Issue Fee FEES $ 3 $ 3 Use of Building Planning Notes: Automatic Washer Construction Pole Sub. Cooking Uni[ Dishwasher Dryers�,as �Elec Fan f.A.U. Fixtures Device 8oxes Outl¢t5 Switches Garbage Disposal Generator O0.5 KW C 3560 2/02/84 I Zane Accessory Building:� Park.Fees ELEC7RICAL Transformer ❑ 15-50 KW ❑ 50+KW � Meter ❑up to 100 amps Meter �over 100 amps Sub Panel Motors�0-1 HP O1'h-8 I na Solar � 9-15 HP � i 6-15+ Microwave Pale Light Range Standing Sections 5-15 KW Tresh Compactor � Reinspection Fee � 525 � Issue Fee PUBLIC SERVICES REQUIREMENTS: 2aning Approved By Buildine APProved By Anolication Issued ev � SUMMARV OF FEES BUIIDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING 5 �SSUANCE $ PLAN CHECK 25% 5 ENERGY P.C. $ ELECTRICAL § �OO GRADING $ PLANCHECK 50% $ �� MICROFILM $ MECHANICAL $ TOTALFEE PLAN CHECK 25% $ 37.50 �TL :. FEES G' $ 3 O N I N G R E R E N E N T -�. C?NSTRUCTION AND PLANNING POOL ��PA , ; ' APPROVALS Permit # � Date Inspector AppROVALS Permit # Date Inspector , 5� 1; Temporery Electrical Service or Pole . " 52. Pool & Equipment Location : � 2. Soil Pipe-Undrgrnd. . , 53. Steel Reinforcement ' � i �� 3. Electrical Conduit Utility-Undrgrnd. �- ;'� 54. Forms � ' , 4. Electrical Conduit-Undrgrnd. � � 55. Electrical Bonding � 5. Steel Reinforcement � � 56. Rough Plumbing & Pressure Test ��• 6. €lectnical UFER Grnd. , : � . 57. APPROVAL TO COVER-GUNITE �_ �,� 7. Eootings� �' ., i 58. Electrical Conduit-Undrgrnd. 8. Foundatinn � , ,' � 59. Gas Pipe, O Undrgrnd., Test ' � 9. Water Pipe-Undrgrnd. � �• ' 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System •� ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ,� 62. Backwash & Receptor-Final � 12. Sewyr�Cap , 63. Heater & Vent-Final �r, 1 . 13. fRoof Drains � 64. Plumbing System - Final ' 14. Rough Plumbing . 65. Electrical-Final • . 15. Rough Electriral-Conduit 66. Solar System-Final 16.rRough Electric Wiring 3� CC 6J. Fencing & Access Approval 17�. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18.'Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Duc[s, in Structure � ' 70. Underground Hydro 22. Ducts, Ventilating , 77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test ,� 72. Underground Flush . 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. pverhead 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 •' _� -' �� i�� i 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final , t 40. Gas Service-Final . i 41. Solar pomesticFinal � � � .� i 42. Backflow Preventer � � ,�� 43. Backflow Irrigation � �' r' 44. Landscape Irripation System �� 45. Sound Attenuation - 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed ; r,1'' . ' ' ,� 49. Electrie Release to Edison ' ��;,�, � 50. Gas Release to Southern California Gas Co '" ,i 51. CERTIFICATE OF OCCUPANCY -- , i No. Date ' • • �, � � CIT;Y OF COSTy MESA� - EONSTRUCTION PERMIT ,, � TS p.CDlieant to fill in all spaces except those within �eavy bortler lines anC sign all appropriate tleclarations. , PERMIT NO: - _ � : � TRACT NO. •LOT NO. � BLDG. N . • G- �u a 7 ProjeCtAddre55 �SOZ' C/Q�vt TVPEOFCONSTRUCTION. NEW LJADD LJALTERATION LJREPAIR AppliCant'sMailingAddre55 `��`',� ,,�, ,, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � A�� Phonel�IL�(P(L� . DESCRIPTIO OF WORK Owner's Name � �� ET`C� ��r[E7-S Address . . TVPEOFPERM�T GRAOING FOUNDQTION STRUCTURAL Arch/Eng. - � License No. ❑ TENANT ❑ ELECTftICAL ❑ PLUMBING ❑ MEGHANICAL Address �7� �rl� �^ ❑ �OTHER ' Contractor's Name.�tTl�l d/' r.,BN S A Ph/Q;ne///`��I G�� PROJECT DESCRIPTION 54. FT. ocCUCANCv AddIe55lmailing) �OIn'�� O(�/%�i /V7/P• L4•l'b� • CONSTRUCTIONTVPE VALUATION$ �� - ZONE GRADINGCU.YDS. ACRES City LicenSe No. / LICENSEDCONTRACTORDECLARATION Remarks: ��/jl�`J -�n%Cj.T R-�Ii/ �L�L 1 h¢reby affirm that I am licensetl untler provislons of Charter 9(commencin9 with section 7000) of Division 3 of the Business antl Professions Cotle, antl my license is in full fprce antl effect. License Class �=� icen No Date �'�✓ T�-��u�ignature Bar Sink WORKERS'COMPENSATION DECLAFATION `�ereby affirm that I have a certificate of consent to zelf-insure or a certificate ackflov Workers' Compensation Insurance, or a certifietl copy thereof (Section s00, �ab. C.) .- Backflov Policy No. Company ' � eCertified copy is hereby furnished. . Bathtub! Certifietl copy i5 tiletl with the city Builtling Division. Date Applicant Clarifier: EXEMPTION FROM WORKERS'.COMPENSATION DECLARATION DiShWas1 (Tbis section neetl not be completetl if the permit is for one huntlred ($100) or Preventer Irrigation less). Drinkin Fountains I certify that in the performance of the work for which this perm�t is issuetl, I 9 shall not empioy any person in any m er o as to �F o/�// sub'e ro the , . Wor � nbmp�nSD�iopr ws of Cality.i/i� {/ t'T� FIOOf Dfdi05 Date � � Signature� �� NOTICE: If,iatt r making this tleclarati n, you shoultl b¢come subject to tne FI00� Si0k5 Workers' Compensation provisions of the Labar Cotle, you must torthwith comply with such provisions or this permlt shall be Oeemed revosetl5 GasService �utlets CONSTRUCTION LENDING AGENCV � , I hereby afFirm tnat there is a consiruction lentling agency for the pertormance Interceptors of the wo�k tor which this permit is lssuetl (Section 309] Civ. C.) Lentler'S Name � Kitchen Sink � L.entler's Atltlress , OWNER BUILDER DECLARATION ' Lavatolie5 -- ' I hereby affirm that I am exempt from the Contractar's License Law for the p_Tra � tollowing reason (Section 7031.5 Business antl Professlonal Code: Any city or P county which requires a perifiibto construct, alte�, improve, tlemolish o� repai� , , any 5tructure, prior to its'issuance, also requires the.applicant for Such permit ROOf'DfdinS. ' to file a signea statement that he/she is Iicensetl pursuant to the provisions of the Contractor's License Law (Chepter 9(commencing wfrh Section 7000) of ��- _ . rom antl tne basis for the alle9etl exempUon. Any vlolaUon ot, Se 5 by any applicant for a' permit subjects the applicant to a y of not more than five huntlretl tlollars ($500). . as owner of the• property'or my employees with wages as theii �ncatinn. will tln tnz work. antl the structure is not intendetl or o1 �0, the owner 'for the purpc �as owner of t bulltls or lmproves th� tractor(s) license oursu ❑ �I am exempt untler oa�e '.o an owner of a property who builtls or improves wo�k M1imself/herself or through his o� her own � :M1'improvements are not intentletl or ofteretl,for g or improvement is Soltl within one year ot com- the burtlen of proving he/she tlitl not builtl or im- � ty, am exclu5ively mntracting with licensetl con- • =.ct (Section ]044, Business and Professions Cotle: .w tloes not apply to an owner of property who antl who contracts for such projects with a con- the Cwtractor's License Law). � n B. & P. C. for this reasan Owner7 ve reatl-this applicatl ree to'comply with a builtlin9 construction tate that the above tl countY ortlinances :by authorize repre- ione`tl r perty� pfo�qr[ Da�7��'�'�fL-L° ( Reinspection Fee �I - $25 Boiler Duct - Under Ground Duct - Structural Duct; Ventilating ExhaustSystem ❑ Multiple❑ Firepl/Fact.Blt.IC80�# � Heating System & Ducting ❑0-100,000 BTU 0100,000BT �i9na�urK�-i,r ..-.. L':�{.� ^ - Orivers' License or 55 � peinspectian Fee $25 CMF0865-46 rev.12/83 Wnite-Builtling;Canary-ApPlicant;Pink-Accounting;Goltlenrotl-Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal WaYe! CIOSei Water�Heatec - Water Service tl EES luue Fee ' _ � 3 fANICAL � FEES Hood or Typel. ❑ - Canopy Type II ❑ Refrigeretion System ❑0-100,OOOBTU ❑100,OOOBTU System Repair/Alteration Issue Fee � $ 3 A.P. # S Main Building: E T Front B Rear A C Right SLeft Ping. Ref. # Parking fleq./Provided Use of Building: Planning Notes: - 3556 .2/02/84 ; Zone•_ . Accessory Building: ark. Fees $ E Automatic Washer , Construction Pole Sub. Cooking Unit Dishwasher Dryers OGas ❑Electric Fan F.A.U. Fixtures • Device 8oxes Outlets Switches Garbage Disposal Generator �0.5 KW �5-15 KW Transformer LJ 15-50 KW � ❑ 50+KW Meter ❑up to 700amps Meter ❑over 100 amps Sub Panel Motors �0-1 HP 01 %- 8 Inc.Solar 09-15 HP �i6-15+ Microwave Pole Light Range Sign Standing Sections Trash Compacmr I Reinspection Fee � I$25 I �ssue Fee � PUBLIC SERVICES REQUIREMENTS: Zoning APProved BY . Building Approved By , APoliwtion Issued Bv 21.OQ TI. FEES $ 3 O N I N G R E R E N E N T � � SUMMARV Of FEES � � BUILDING PERMIT $ SMIP • $ PLAN CHECK ' $ - PERMIT . PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. �$ � ELECTRICAL � $ � JS�a GRADING $ PLANCHECK 50% $ `�Q MICROFILM '$ _� MECHANICAL $ TOTAL FEE $ �/• PLAN CHECK 25% $ , , i • 't 'CONSTRUCTION AND. PLANNING POOL A , '' APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector ' ' 7. Temporary Electrical Service or Pole ; - 52. Pool & Equipment Location - � Z. Soil Pipe-Undrgrnd. . i , 53. Steel Reinforcement � ' � � �'3.. Ele�ctrical Conduit Utility-Undrgrnd. ' ' 54. Forms � � i �4.�Electrica� Conduit-Undrgmd. � � � 55. Electrical Bonding � _ ; 5:� Steel Reinforcement i:�� 56. Rough Plumbing & Pressure Test � �l � � 6. Electr,ical UFER Grnd. r • � 57. APPROVAL TO COVER-GUNITE , �' ; 7.-Footings' !' , , , _ - 58. Electrical Conduit-Undrgmd. � -' 8: �Foundation , � � 59. Gas Pipe, � Undrgmd., Test � 9.tWater Pipe-Undrgmd. � ' 60. Backwash Lines, P-Trap, O Undrgrnd. 1�0. 3tructural Floor System c 61. APPROVAL TO DECK 11;. Property Sewer Line�& House ConneCtion , 62. Backwash & Recepior-Final . 12. Sewer Cap �� , . 63. Heater & Vent-Final 13.1 Roof Drains , � 64. Plumbing SYstem - Final , }4. �Rough Plumbing ; 65. Elecirical-Final 15.� Rough Electrical-Conduit 66. Solar System-Final '-b6. 'Rbugh Electric Wiring . 3 67. Fencing & Access Approval 17: Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18.'Rough Electrical-T Bar Ceiling 69. POOUSPASYSTEMS FINAL � 19:� Rough Fleating & Air Conditloning FIRE DEPT. REQUIREMENT� � � 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in�Structure � 70.� Underground Hydro � 22.Dacts,VQntilating �',' 71.ProductPipingOGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing . � 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing � " 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frameand 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: S0. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: • 34. Final Heating & Air Conditioning � � 35. Final Gas Pipe-Test � � - � 36. Hood or Canopy � � 37. Final Faaory Fireplace � . 38. Final Plumbing - 39. Water Service-Final � 40. Gas Service-Final � • � 41. Solar pomestic-Final ' , ( 42. Backflow Preventer . ' � �-�' i, 43. Backflow Irrigation � . ' ' � � � � � 44. ,Landscape Irrigation SYstem . "� 45. Sound Attenuatiod . - v � � ' 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed � . 49. Electric Release to Edison ' ' 50. Gas Release to Southern California Gas Co . . � ' 51. CERTIFICATE OF OCCUPANCY • No, Date CITV OF COSTA MESA � � ~ PARK FEES Fee Payment Receipt e Ai- 2�e5 ii2aie4 s2iy.7� ?�• � 924 Project Address �'�a ��v� A.P. Number — — Park Area Building Permit Number Owner's Name � Mailing Address FEE: � Single'Family " 2-Betlrooms or Less 3-Bedrooms 4-Bedrooms 5-Bedrooms + Multiple Family "" Bachelor or Studio 1-Bedroom 2-Bedroom 3-Bedrooms + Number of Units ' @ @ @ @ $ 861.76 1,205.67 1,545.62 1,810.50 474.37 573J8 881.51 1,229.38 �/2�c�o _ �g = 2(o1J ,53 '/�% Total Fee �" a �' � � Planning Department Approval Date ��_�R� . By�:..J-e>#'ha.— ApplicanYs Signature �� v ' City Ortlinance 72-44 +* Clty Ortlinance ]2-65 "` City Resolutlon 78-116 CMF 017432 Rev, 6/79 Wnita—Planning; Canary—Planning; Pink—Finance; Goltlanrotl—Applicant CO'G �1 S