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HomeMy WebLinkAbout1021 EL CAMINO DR - Building PermitsADDRESS OF BDILDWG: 1021 OWNER'S NAIIE IF KNOYfI: CAP I T ADDREss: 1017 COSTA }t APPL. "UW ADDRESS: I ARCHITECT OR ENGINEER: ARCH. OR ENG.'S ADDRESS: AMINO DR UNIT: NANCIAL CONSULT MINO DR ,CA 92626 UC. No: CONTRACTOR'S NAME: CONTRACTOR'S MMUNG ADDRESS: I.C. No.: UHT: DHT: LICENSED CONTRACTORS DECLARATION: I hereby earn under penally d perjury that I am Actinium! under provleions M Chapter 9 (commencing with Section 7oDD) of Division 3 of the Business and Professions Code. all my hosnse is in full forte eat aRea. Cm LIC. NO.: LIC. CUSS: LIC. NO, EXP: Date: Contractor, OWNER BUILDER DECUARATION: I hereby affirm under penalty of perjury that I am warnie from the Contractors Liome a Raw for the folbwing ransom (Section 7031.5 Business rat professions Code: Any city or oouMy which requtrea a permit to comtmd, war. improv, •nmol sh, of repair arty sbucture. prior to its Issuance, ateo requires the applioam for such perch to file a aipmd elatement that he or eat . licensed pursuant to the provisions of the ComraMors Lki ma law (Chapter 9 (commencing wth Section 7000) of Dion 3 of the Business and Professions Codel or that he or she is exempt therefrom eat the basis he the!aged asempimn. My violation of Section 7031.5 by airy applicant for a permit subjects the applicant to a dell pawaty of not more than Okra hundred !dare X] 1, as Decor!the properly err my employees with welfare as their able co rperemion, will do the hrak. and the almclure a not intended or offered for sale (Section 7044, B..i. rhd Pmfsesions Code: The ConVeaae License Lew does rot appy to an owner of properly vita boos or anpreves thereon. arta who noes such Work himself or henel or through his or her own employees, plo ieee thus such impnsi menta we nor Mterwed or dared for sale. 9, hoeevr, the Wileinlf or hnpmvemem a edit within ore year of completion, the owmrbuiMwr wig bans IM burden of pwirq he or she did not build or improv for the vpose of eels). I, as 0. d the property, am exdueively mmasis, with li irua l contractor, ro construct the papa (Section 7011. Business east Professions Code: The CoMmdas Lnama law dose not apply to an owner of property wlho Willa or impm+ee thereon and whe contacts for such pnojecs with a now a sonts) licemed punuanl to IM Conlradare License I an exempt under Section:S. 8 P.Cf jgJOjE_ma,m: Date: I no hereby owdy that 1 am aware of arhd h.,aehataaa the newimanerYa of calmmi. NeaMh .nd safatr cad. loco uses, ?5533. mad 25531. eat that I or sus future Wiwi, om+pant will / will nut (dole au) need to canply wlh esid Meta and and tat repuiernema for a prmhlmmrwtmctionormodifualbnhamthe Ar"uBTe "I.�anagrmnt DiMrid.Ressweraiel mmwion appLratiru Me eaemq from thea. prmdsfona. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm order penalty of prjary ort of to following declamations: IhensratwiltcoalmanacerModctmeenttosetlinwmforwwkm'corpmm icn,mpolledforby Sectfon3700dIralabor Came, for the pedomence of the work for wldch this permit a e.uad. hens rat wilt this per woM1ea' al, My aation tat rinpar es required by Section 3 And d the labor Cade, for the pMmmerea d tat work for whkyh this pert is eehed. My workere' componsetion inwrmue carder end pdirry number we: Caller: Policy Number This section naef not her oomrNded y the permx is fs. ort hundred odes 1$1011 or less./ I redly that je tat pa a %sort ca d the woM fa witch this pemrh a land a I se that employ tiny penton in tiny meow sa la s' become aubpa to the wf Saidi cor7M of the acs C Cdilamla, end agree That ir hoseM become wbjw to the Nedlene compensation pmvaae of Section 3)00 d the labor Code, l shall /odhwth amply with Ilmese pmvieione. DM.: Appinant: dyllft :Fallonm busby workers•campen as($1covsn9s aufidon , Me .at 1r, orcfanamo/oymfocr/m/rlalrovide Osnit c/vll Brea up m aro ab., CGI l 1.1 rat dollen (5100,000fa M etltlltlon ro Ms coat of rompenaafbry GrrNNAsa tie provided for In 9ectlon 37(AS of Me Labor Code, Inferes0 end atromey'� less. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury, that (here is a cons ruction lending agency for the performance of the Wank for which the permit is issued (Section 3097. CN. CI. LENDER'S NAME: LENDER'S ADDRESS: 1 certify that A hens reed this application all Mate that the above information is coned. I agree to comply with dl city and courtly on inmmces and wist.l.we renting to buildig const ucion eat hereby authorize representatives olthis my to enter upon the above-mentioned pr tioneoperty forinspealon pur=-1 JIM CARPENTER A R Data: / 20 - 9� (515148.WP) White-Butldng A Safety; Gre in -191a; Canary-Applranl; Pink -Revenue: Goldnmd-Amwaxr CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 086649 CONSTRUCTION TYPE: PLAN CHECK NO: 00243-98 S PERMIT TYPE: STR 3 e? — 13 PERM NO: B 086649 GOVT: N SUPP: N PURPOSE: ALT JOB DESCRIPTION MISC ALTERATION TO EXISTING BAKERY SQ FT: 1,094 CLAIM VALUE: 1,094.00 CALL -VALUE: 1,094,00 GROUP OCC: B / COMMENTS: "MC CARP CAKE'S" INSTALL DOOR HEADERS & ENCROACH INTO OTHE STE SE iEdE iE dE 1E 3E 1E AE dE dl*iE dE*dE if**/E**SE dE 9EiE*9E �F DE yE dE*iE Rf �E dE iE*dE iEiE iE*yE*dE�iE dEdE*iE iE*�*N•*SE dE dE RE***iE RE 1E 9E iE*9E 9E lE Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN.BUILDING------------------- ACCESSORY BUILDING '--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41267117 ZNE: C1 REF NO: PLANNING NOTES> REPLACE EXTERIOR DOOR WITH A ROLL -UP DOOR; INTERIOR AL-TER'ATI > ONS FOR A BAKERY. / *iE dE**dE iE dE dE dE dE***iE iE*fE dE 3(-jEN-dF dE iE*iE iE lF iE iE if-*iE if iE*iEif dE?E*dE♦E*fEdE dE*1E iE'1E?'E)E1EiE dE 9E RE dF**dE 1E*dE iE i�E*iE;dE*,*dE 1E iF 1E iE iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E!N T%S ZONING APPROVED BY DATE: , tcC$ BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: ' DATE• '1440 E E E iE dE E E E**E******idi**FlFiF*FFFFF dEi si,, dEE dE RE R LEGALIZATION:N F E E S U M M A R Y STRUCTUAL''SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 37,50 SMIP/NON-RES PLAN 24.38 % .50 ISSUE FEE :v BUILDING -DIV-> PERMIT ISSUE PLAN -,CHECK TOTAL PAID DUE TOTALS ---- > 38,00 0.00 CL 12 4.38 62,38 62.38 00 ;Y REVENUE DIVISION TOTALS--> COLLECTED: 62,38 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 37.50 ` ,50 24,38 * dF dE dE iE dE iE iE iE dE dE dF dE NE 1E 1E iE NE dE if dE * iE iE * 1E iE iE * iE if 9E yE d(' iE * iE RFiE iE dE iE dE 1E iE dE dE iE yE iE iE * * dE iE * RE iE dE,'1f dE iE dE dE iE iE if * iE 9E dE dE iE * 1F 3E iF dE 9E I N D- I V I D U A mL' 'F E E B R E A K D O W N TYPE QTY D E S C R I P T I O"N',/ UNIT COST TOTAL COST SFC 1094 ALTER BY VALUE COMkRC"SAL NOZONE 1.00 1,094,00 END)OF FEES / ami I! N r 81-26-1998/11:13 AR162.38 RCPTY:81-8818464 r PERMIT:086649 CONSTRUCTION AND PLANNING - APPROVALS Permit # Date Inspector PO(. . SPA 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 I 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line &House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing -65. Electrical -Final '. 15. Rough Electrical -Conduit 66., Solar.System-Final , 16. Rough Electric Wiring _ 67. Fencing & Access Approval ' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18. Rough Electrical -T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ! 19. Rough Heating & Air Conditioning FIRE'DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas OOil 23. Gas Pipe -Rough & Test ,. 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26., T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing •, ., 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation -' - 78. FIRE PREY. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ._ - Notes: 34. Final Heating & Air Conditioning -� • 35. Final Gas Pipe -Test 36. Hood or Canopy - 37. Final Factory Fireplace 38. Final Plumbing - 39. Water Service -Final ; 40. Gas Service -Final 41. Solar Domestic -Final 42, Backftow Preventer. 43. Backflow Irrigation - 44. Landscape Irriqation System 45. Sound Attenuation - - -•' *' rr 46. Handicap Regulations oo t r 47. FINAL STRUCTURE&BUILDING- Ov 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co n© 51. CERTIFICATE OF OCCUPANCY No. Date 1 �I . 'bECLARATION OF. _ oTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS loll— IOW5_ FL,CiomNc) DC. Bldg. Permit # This Permit # IL1!- (0 1-7 AP Number 1. I (we), LU -,So l'u'sts r T,4G _ declare that I am the Owner of Title of the above referenced real property, and that I (we) hereby authorize: .l � iw. Cud der rr UILO 54b-oI33 Name �� Telephone No. 1017— IOzI EL. C4mfKz f�r_ 0 city to obtain permits in my behalf, as owner/builder, for at the above referenced property. M_ Zip 2. Should any person become an employee engaged in the improvement of the property, I (we) shall im- mediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. 4. 1 agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. 1 declare under the penalty of perjury that the foregoing is true and correct. Executed this 1 ( ti.. day of — 19 l 1, at S"°) 60;Skb,�(? California. uAMGS A . Con�rtiYL �I.P.2en 4 t%>� S2totces l I r laq I Printed NameFA— Date bignature NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. 0779-46 (flee. 2191) NOTARIZATION REQUIRED %CALIFORNIA ALL-PURPOSENCKNOWLEDGMENT State of o�G County of On before me, (L- y DATE NAME, TITLE OF OFFICER - E.G., 'JANE D E, NO RY PUBLIC' personally appeared NAMES) OF SIGNERS) personally known to me - OR - Elproved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and ac- knowledged to me that he/she/they executed ANNE nNDEIao►� the same in his/her/their authorized Cominhonm capacity(ies), and that by his/her/their NotC" wblc — Oro„0gcoun+v signature(s) on the instrument the person(s), MY comm. ExWr01 t"�ts� or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. SIGNATURE OF NOTARY OPTIONAL No, 5907 Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER �1lc.a �'l`eralc�n,.R rITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: //NrtA��ME OF PERSON(S)�OpR ENTITY(I\ES`), p �.5� Qtl.� ry\QAr V\1�d1 S� DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPt OF DOCUMENT l NUMBER OF PAGES `j — l l' ('t -- DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 01993 NATIONAL NOTARY ASSOCIATION - 8236 Remmet Ave., P.O. Box 7184 -Canoga Park, CA 91309-7184 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO.. LOT NO., UNIT NO.' • ' CITY OF COSTA MESA CO ST �C•TION PERUT Project Address 2 t-iTy • h i ReinepaMipn Fee Applicant's Mailing Ad ress Re �LjI TYPE OF CONSTRUCTION ,' NEW ADD, .ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑'O`THE�g I • ' Owner's Name • \ Y/ • Phone _ DESCRIPTION OF WORK/USE OF BLDG:C;.' p'q p # ('� Address jyI'YI = 1S TYPE OF PERMIT GRADING' 1FO-UNDATION ❑ STRUCTURT Main Building: FrontAddress Arch/Eng. License No. - _ Backflow Irrigation' _ I I Sewer Cap - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER_. �1 r'ti— : t�i'r<-t!'L' h�l"� rw� I B Rear A/t� • 'r Q Contractor's Nam Pon Cooking Unit •a erti; cow is�C(l with thecity Bu q Address (mailing) s : ,in I' + C / aS PROJECT DESCRIPTION 50. FT. I OCCUPANCYCRight CONST RUCTION 1 K Left City License No TYPE VALUATION$$ _ Dishwasher Solar Piping - LICENSED CONTRACTOR DECLARATION ,ZONE GRADING CU. YDS. Ping. Ref.# g' 1 hereby affirm that I am licensetl under provislons.of Charter 9 (commencing th Re ks: v Planning Notes:, ' wi sect, on 000) of Dl vision 3 of the Business and Professions Code, and my license is in full once 5 tl effect. .S� ,PLUMBING SUMMARY OFFEES - BUILDING PERMIT $1T� SMTP $ •`J '�' .31.5 by any applicant for a permit subjects theapplicant to a civil enalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property or my employees with wages as their Sole License I ss - ice N C i ReinepaMipn Fee $15 .Date' Signature WORKERS' COMPENSATION D A TION ' ereby affirm that I have a cerlif to consent to self -insure or x certificate Bar Sink Showers • _ _ - F Workers' Compensation •7lnsu /nce, or a certified c0007the[j�of (Section 100, Lab. C.1.� `G 7� J -8b' ,j /' I Policy No: ✓ Company �' rtifietl copy is hereby furnished. J Backflow Preventer •Service Sink j forsale (Section 7044, Business and Professional Code: The Contractor's License" Law does not apply to an owner of a property who builds or improves Automatic Washer' - _ Backflow Irrigation' _ I I Sewer Cap - - Construction Pole Sub. , Bathtubs, -� ,Sewer Connection sale. If, however, the building or improvement is sold within one year of Com- the owner wlll'have the burden of proving he/she did not build or im- Cooking Unit •a erti; cow is�C(l with thecity Bu Date , ` /-rte Applicant Clarifiers _ 1 - Solar Collectors - prove for the purpose of sale)., - - , _ Dishwasher: EXEMPTION FROM WORKERS' COVY(ENAATION DECLARATION (This section need not be completed•i a permit is for one hundred ($100) or less). _ Dishwasher Solar Piping - '- Dryers OGas ❑Electric ' I certify that in the performance of the work for which this Hermit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. , Date i Signature NOTICE: If, after making.this declaration, you should become subject to the Workers' Compensation provisions 'of the Labor Code, you must forthwith comply with such provisions or,this permit shall be deemed revoked. Drinking Fountains - Solar Tank -� Fan Floor Drains - 'Swimming Pool vii/Spa F,.A. U. - Floor SinksUrinal i ❑ I am, exam pt under Section B. & P. C. for this reason Fixtures Gas Service Outlets 1 .Water Closet I I Device Boxes i CONSTRUCTION LENDING AGENCY I I herebyaffirm that there is a construction lending agency for�the e 9 Y Performance of the work for which this permit is issued (Section 3097 Civ. CJ LenName Interceptors Water Heater k Heating System &'Ducting Outlets I - Kitchen Sink- - -- Water Service - I hereby certify that I have read this application addstatethat the above Switches -' der's Lender'sAtldress- - - - - - OWNER BUILDER DECLARATION Lavatories . Auto -Wash Garbage Disposal I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or P -Trap Laundry Trays Generator 00-5 KW 05-15 KW I county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance,�also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Cnntrartor's I cense I aw (Chanter 9 (commencino with Section 70001 of Roof Drains •refrom and the basis for the alleged exemption. Any violation of Section SUMMARY OFFEES - BUILDING PERMIT $1T� SMTP $ •`J '�' .31.5 by any applicant for a permit subjects theapplicant to a civil enalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property or my employees with wages as their Sole ReinepaMipn Fee $15 Issue Fe¢, compensation, will do the work, and the structure is not intended or offered PLUMBING $ ISSUANCE, - $ MECHANICAL forsale (Section 7044, Business and Professional Code: The Contractor's License" Law does not apply to an owner of a property who builds or improves Boiler ' Hood or Type I ❑ thereon, and who does such work himself/herself'or through his or her own employees, Provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of Com- the owner wlll'have the burden of proving he/she did not build or im- Canopy Type II EJ.pletlon, Duct - Under Ground prove for the purpose of sale)., - - , $ 3 Duct -Structural PLAN CHECK 25% $ Refrigeration System 00-'100,000BTU E1100,0001 . ❑ " as owner of the property, am exclusively contracting with licensed con- tractors to construct', the project (Section 7044, Business and Professions Code: The Contractor's .License Law does not apply to an owner of -property who builtls or improves thereon, and who contracts for such projects with a con- Duct - Ventilating Exhaust System ❑ Multiple L1 System Repair/Alteration . tractors) ilcense pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should�be provided to me. ❑ I am, exam pt under Section B. & P. C. for this reason _ Firepl/Fact. Bit. ICBG # Fire Dampers DateOwner Heating System &'Ducting R isters - I hereby certify that I have read this application addstatethat the above ❑0-100,000 BTU E3 100,000 BT information itnorrect.'I agree to comply with all city, and county ord finances , - Signature Drivers' L CMF 0865-46 Date 2 ' Reinspection Fee $15Issue Fee White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $ 3 Reinspection Fee FEES Zoning pBy_ Buildingg Approved ed By Application Issued By - 2235 12/28/87 Zone Accessory Building:, ' Parking 'Req./Pr LECT,RICAL 19;50 ' TL Z O N I N G R Q M S. Transformer' ❑.15-50 KW 0'50 +,KW .Meter ❑up to 100 amps .Meter' Dover 100 amps Sub Panel' Motors ❑ 0-1 HP ❑ 1 % - 8 Inc.Solar ❑9-15 HP ❑161 Microwave Pole Light ' Range Standing Sections Trash Compactor $15 I Issue Fee EQUIREMENTS: , SUMMARY OFFEES - BUILDING PERMIT $1T� SMTP $ •`J '�' PLAN CHECK $ PERMIT I PLUMBING $ ISSUANCE, - $ ' PLAN CHECK -25% $ - '-ENERGY'IP.C. $ ' - ' G - $ I - ELECTRICAL $ :GRADIN -. - PLAN CHECK '50% $. MICROFILM $ - MECHANICAL $, TOTAL FEE $ $ 3 PLAN CHECK 25% $ CONSTRUCTION AND PLANNING APPROVALS Permit # - Date Inspector POOL & SPA . APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding " 5. Steel Reinforcement- 56. Rough Plumbing-& Pressure Test 6. Electrical UFER Grnd_. 57. ;APPROVAL TO,COVER-GUNITE 7. Footings -; 58. Electrical Conduit-Undrgrnd. 8. Foundation - - 59." Gas Pipe-, O Undrgrnd., Test 9. Water Pipe-Undrgrnd-: 1 _ 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 Electrical -Conduit - 66. Solar System7Final 16. Rough Electric Wiring - - - 67. Fencing'& Access Approval _ ^ 17. Rough Wiring Sign 68. APPROVED•FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS.FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit# 20. Rough Factory Fireplace - 21. Ducts, in Structure 70. Underground Hydro 22. D+!3s, Ventilating- 71. Product Piping 0Gas 0Oil 23. Gas' Pipe -Rough & Test 72. Underground Flush , 24. Rood" Framing - rr' 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. RoofSheathing 74. Overhead Hydro 26. T-BWCeiling (Structural) & Monocoat 75. Dry Chemical - Y 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL R 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 :t 35. Final Gas Pipe -Test 36. Hood or Canopy 37'. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final _ - - . 40. Gas Service-Fyinal l 41. Solar Domestic -Final , 42. Backflow Preventer f �•, 43.' Backflow Irrigation 44" Landscape Irrigation System - - •r '45. Sound Attenuation ,46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING X48. Special Requirements, Completed ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas CC) 51. CERTIFICATE OF OCCUPANCY No. Date ' ;J u \ � NOTARIZED STATEMENT OF RESPONSIBILITY TO WHOM IT MAY CONCERN: t � 1021 E1 Camino, Costa Mesa Calif. Street Address O i n /Bldg. Permit # \.This Permit # AP Number I, Id rrihnrc,,/n b1 Trlrpstnrs Tnr _ , as Owner in Title of the above referenced property, do hereby authorize: Luis Barragan , Chiappe's Catering (714) 540-2303 Name Telephone No. 1023 El Camino Drive, Costa Mesa California Street Address Costa Mesa California City State Zip to obtain permits in my behalf, as owner/builder, for the construction, alteration, moving, demolition or repair of the above referenced property. Should any person become an employee engaged in the improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and Cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties. I,indborg/Dahl Investors Inc. Patrick Fortune, agent March 17, 1981 Printed Name Date Notary's Statement: On February 2, 1981 before me, the undersigned, a Nortary Public in and for said State of California, personally appeared Patrick Fortune to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same. Witness my and official CMF 077946 OiFlCIAI SEAL LESLEY METSCHERNOTARY -- PUBLICCALIFORNIAPRINCIPAL 10 OFFICE IN OMNGE COUNTY My Commission Exp. Sig tur Notary's Statement: On February 2, 1981 before me, the undersigned, a Nortary Public in and for said State of California, personally appeared Patrick Fortune to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same. Witness my and official CMF 077946 Jun 15, 1984 OiFlCIAI SEAL LESLEY METSCHERNOTARY -- PUBLICCALIFORNIAPRINCIPAL 10 OFFICE IN OMNGE COUNTY My Commission Exp. Jun 15, 1984 11111111119 t3 70 COSTA MESA BUILDING -SAFETY DEPARTMENT 811.44 7/06/81 X29:37 TL' P O_ BOX 1200 C06TA MFSA CGI IFORNIA 92626 r to �M APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only R CEIVED BY DATE RECEIVE ��! DATE ISSUE % 4 / BUILDING /1 �j ADDRESS V7— EI.. L�li�t 1 /J , �..� —PJ (p U y OWNER ct-AP", Tc�I�L/ A.P. NO: ' �!' PER i?^^ MAIL BUILDING I ADDRESS ADDRESS CITY COSTtN, V�Y /� t ,p, S i NO` TRACT LOT BLOCK CONSTRUCTION W ADD ALT R I REPAIR LENDER 'OWNER /5 0 % L BRANCH ADDRESS ,r VALUE 40 C $ ARCHITECT TEL, OR ENGINEER N FIRE ADDRESS ZONE TYPE GROUP CONTRACTOR QD AI'lE (1 APPROVED BY DATE ADDRESS I Qila S 6.W TEL. ZONE NO. OF USE OF NEW A CITU 'CO NO. PLANS BUILDING STATE CITY /I o �I YARDS APPROVED YARDS APPROVED LIC. NO.?,`L (� LIC. N(r p� MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. AFT. FT. Separate permitS are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED, DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. SLOGS. VAR.# DATE C.U.P.# APPROVED APPROVED BY DATE I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with , ' all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of Ylifornia Business VALUATION PERMIT FEE $ Q and Professions tl ,Division 3, tar 9. '^ . PLAN CHECK $ 37 • �v / Signature of ,S { TAX $ � Permittee � $ 'I7 t Authorized Agent G/ �eue/ TOTAL PAID $ 9 r to �M • -- - PAID 35204 aur, 17 7z�pSAOO�s6z COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPJJCTION FOR BUILDING PERMIT R CEI E V DATE RECEIVED OR ENGINEER U N For Applicant to Fill in Completely ' BUILDIN(J BUILDADDRESTRACT �b(J ADDRESS1k r.r W � ADD A POWNERVALUS ZONE T PE GROUP MAIL APPROV D ADDRESS -t_y J O Z W W BY DAT TEL. tL U CITY 2 NO. J mZ ZZ Q CONSTRUCTION J M N LENDER ZONE U USE OF'NEYV / TEL. CITY NO. am PLAN$ � BRANCH Z_ H n STATE CITY YARDS APPROVED J ADDRESS W ARCHITECT TE L. J co Z) 0 R CEI E V DATE RECEIVED OR ENGINEER U N NO.�V/ �/ BUILDADDRESTRACT �b(J LOTW J1ED0A.P. W � ADD A POWNERVALUS ZONE T PE GROUP APPROV D Z Q FIREn W � ADDRESS ZONE T PE GROUP APPROV D a W J O CONTRACTOR BY DAT mZ J M ADDRESS S ZONE NO. OF USE OF'NEYV / TEL. CITY NO. WW 2 PLAN$ BUILDING - C • Q Z_ H STATE CITY YARDS APPROVED YARDS APPROVED W0 W fL LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING Z) 0 (FROM C/L ST EET) SIZE NO. OF BLDGS. OF LOT NOW ON LOT FRONT FT. T. USE OF"517 EXISTING BLDG. T. - FT. N SIZE OF "r /r NO. OF Z NEW BLDG 'L ROOMS STO IES L. SIDE FT. V EXTERIOR WALL ROO COVE NG COV RING. REAR FT. FT. 'J SE OF BUI NDIWORK T B PE F RMED ISTANCE BET. BET. MAIN & CL CL /t. _t,40, MAIN SLOGS. ACCESS. SLOGS. Q VAR.# DATE O Q C.U.P. * APPROVED F APPROVE fABY Z O, (Ptd I hereby acknowledge that I have read this application and state ' U L) that the above information is correct and agreetocomply with Cr all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of y the State of California. z I hereby certify that I am properly licensed as a contractor under SO. FT. o THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, 'm Chapter 9, and that such licenses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business 'N VALUATION 02.E ' and Professions Cotle, 'sion 3, Ch r 9. p))\pvvtrtggqJ��, Q�(J PERMIT FEE $ - m PLAN CHECK $ Signatu of Permittee n \ ` _ C/ �"I $ 4 / E VVV `o u_ Authorize Agent ' TOTAL FEE $ ! COSTA"MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BULDING ADIDRESS Wa61 CiL�GA ��.t/1rr-O OWNER OR J Vt.Us OJ4 ,v,�w TENANT T(�1'-r,(L MAILING ADDRESS CITY N0.L040 '�''3 CONSTRUCTION LENDER .N A— BRANCH /- ADDRESS ARCHITECT --ll TEL. OR ENGINEER ""Iv ✓�' NO. ADDRESS CONTRACTOR ADDRESS r{{I✓'I' F9785 3/30/81 5.50 TU M •- APPLICATION FOR STRUCTURAL PERMIT _-* v Y5V PERMIT hl�51529 A.P. NO.A/L� �' , AD13 IDRESS ([/q'3 �L UNIT OR SPACE NO. TR.NO. ILOT2D NEW I ADD IALTER IREPAIR IMOVI OWN APPROVED DATE VALUE 8 LK. } CITY r) I hereby acknowledge that I have read this application and state -STATE LIC. NO.LICWSIZE CITPROVED_fETB 0. all laws regulating building construction, and I shall not employ 1 NOROM C/L STREET G. OF LOT N NOONT FT. 3 1 hereby certify that I am properly licensed as a contractor under SO. FT. ry AN THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect, or I USE OF EXISTING BLDG. fJR. SIDE FT - 0 and Profs Sion 3, apter 9. VALUATION„ PERMIT FEE $ FSeparate (/� permits are required forSIDE FT. PLAN CHECK $ c Signatur of -- Permittee electric, plumbing and heating wAR $ i/ ?1). TAX $ LL -.5T v or FT. I.W. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE VALUE 8 LK. } W I hereby acknowledge that I have read this application and state n that the above information is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of a W the State of California. ' 3 1 hereby certify that I am properly licensed as a contractor under SO. FT. ry the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provi the State of Californ Business and Profs Sion 3, apter 9. VALUATION„ PERMIT FEE $ ,Div (/� _ m 1 PLAN CHECK $ c Signatur of -- Permittee $ i/ ?1). TAX $ LL -.5T v or Authorized/ nt Date �Tlt TOTALPAID $ _.Sn W COSTA MESA 'BUILDING COSTA APPLICATION FUR.S2RUC7MALPERMIT 5.50 TL P n RraX t9nn Cr1STA MRSA CAI IFORNIA R9R9R J ED d R CEIVBV PERMIT 41 <• For Applicant to Fill in Completely — Use Ink Only BUILDING ADDRESS OZ E CAm«(6 A.P. NO. /J �� (/ 07 /' ! BUILD I NG ADDRESS / t P n L. I � TOWNER ENANT L L I� / UNIT OR SPACE NO. MAILING�� ADDRESS S - TR.NO. L OT BLK. n TEL. O CITY CST—n NO. NEW ADD ALTER REPAIR IMOVING DEMOLISH CONSTRUCTION LENDER BRANCHJ OWNER G�s.y ADDRESS L VALUE USE Q �` $ QO[Y ARCHITECT TEL. It R OR ENGINEER ZONE TYPE GROUP UP CONTRACTOR �� APPROVED PROV ED ` p y DATE ADDRESS QO CITY NOL�t{SCO) STATE CITY q� LIC. NO. �Z�j �s �. LIC. NO� \I�Z APPROVED SETBACKS SIZE NO. OF BLDGS (FROM C/L STREET) OF,LOT NOW ON LOT FRONT FT. USE OF EXISTING BLDG R. SIDE Separate permits are required for L. SIDE FT. electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED • APPROVEDBY I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person •in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $. and Professions Code, Division 3, Chopt ` PLAN CHECK $ le Signature c TAX $ Permittee $ o TOTAL PAID $ SSV Authorized Agent Date