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Home My WebLink About287 CAREFREE LN - Building PermitsAVP��ant to fill in all soaces exceD� inoze within heavy DorOer lines ana sign all aoPropriate aeclarations. CITY P� rncrn�nccn CClN.4TRlICTInN PERMIT Projec� �,..��. - 28� Carefree Ln. 1 App4icant;s in Address �� , J� z_.� � Own:r'S �N�y/m Phone AddressP` �n� • ArcN/Eng. C' � "�� l�2License No. S . Address aJ W � b��— � � � ( Coniracmr's Nam n Phone �-0�.� Addiess (mailingl—.—,c� � v City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensetl untle� provi51on5 01 Chart¢t 9(commencin9 wi[h section ]000) ot DivislOn 3 of the Business antl Profe5510n5 Cotle, antl my license is in full force antl e(tect. License Class License No. Date Si9nature WORKERS' COMPENSATION DECLARATION I hereby atfirm that I have a ce�tilicate ot ConS¢nt [O 5eH-Inw�e o� a ce�tlticat¢ o/ Workers' Compen5alion InSurance, o� a certltietl Copy Iher¢O( ($ectlon 3800, Lab. C.) � Policy No. Company . 8 Certifietl copy ii hereby tumisnetl. Certitietl copy is filetl with the city Builtling Division. , Date Appli[dnt E%EMVTION FROM WORKERS' COMPENSATION DEGLAR'ATION (This section neea not be completed if the permit is tor one nundretl (E100) or less). " I certify tnal in the performance of the work for which Ihis perm�t is issuetl I shall not employ any per5an ip any manne� so a5 tq Decome subje lo t�e Workers' Compensatio Laws of Calitomia. / . Date Z �.�.(_Si9nature %�� .t �' � NOTICE�� mak�ng this tlaClaraHon, you ou10 b me 5 j¢Ct t0 Ihe Workers' Compensation provizions of tne Labor Coae, You must forthwith complY w��h sucn prov�sions o� thi5 pCrmlt shall be tle0m¢tl �evoketl. CONSTRUCTION LENDING AGENCV 1 nereby a/Brm that there is a construction IenGing agency for the performance of tne work for which tnis permit iz issuetl (Section 3097 Civ. C.) Lentler's Name Lentler's Atlaress OWNER BUILDER DECLARATION I hereby affirm lhat I am exempt from tne Contractor's Lltense �aw tor the following reason (Sec[lon ]031.5 Business antl Protessional Code: Any city or munty which �equires a p¢rmit to const�uct, dlt¢r, improv¢, tlemoliSh o� �e0alr any Slructu�e, prlo� to its issuanc¢, also �equitCs the applicant for Such permit '�, to file a signetl statement tnat he/sne is licensetl pursuant to the provisions of (ne Contraclor's Li<ense Law (Cbapter 9(commencing with Section 7000) of Division 3 of the Business antl ProteSsions Cotle) or that he/she is exemp[ therefrom antl the ba5is fo� Ihe alleg¢tl exemption. Any vloldtlon of Section 703L5 by any applicant tOr a petmll subjects the dpplicant t0 a civll �enalty o( not more than fiv¢ huntlretl tlolldrs (E500). LJ I, as owner o( the property or my employees witn wages as ineir sola compensation, will tlo the wo�k, antl tne structure is not intantletl or o(feretl for sale (Section 7044, Business antl Profezsional Cotle: The Contractor's License Law tloes not apply [o an owner of a property who builtls or Improves lhereon, antl who tloes such work himself/her5elt o� [hrough hi5 0� h¢r Own employees, provitletl tnat such Imorovemenis arn not intentletl or oftorea tor sale. I/, however, ihe builtling or improvement is soltl wlthin one year ot com- pletion, the owner will have the buraen ot proving he/sne tlltl not bulltl or im- wprove for the purpose of sale). 0 I, az owner of the property, am ezclusively contracting with Iicansetl con- tlactors to constfucl Ihe projet[ ($ectiOn 7044. Bu5ine55 antl PfOfe55ion5 COtle: The ConVac[or's License Law does nol appry lo an owner ot Oroperry wno builtls or improves tnereon. antl wno mneracls �or such oroiects wltn a r.on- .�rac[or(s) Lcense pursuan[ to me Contrattor'S Licensa Law). i am aware tha[ proof oi tneir Worker's Compensation Inzurance shoula be provitlotl to me. ❑ I am ex¢mpt untler Sec[ion B. 3 P. C. f0/ thi5 reason �ate � nT. —� �_ Owner � I hereby certity that I have reaa t is application antl state tnaf the above InPormation is wrrecL I agree to comply wi[h all city antl counry ortlinances dntl state laws velating to builtling constructlOn, and he�eby authoriie �eprB- sentatives of this city to en[er upon the above-mentionetl property tor inspection purposes. ./ V y Signature !G Date /O �—O N Drivars' Ucense or 55 �f 0865-46, rev. 5/BB Wbite - Builtling; Canary -�APPlicanh Pink - Accountinq; Golaenrotl - Assessor a 4 b 3�t -1 I 5/ �E OF CONSTRUCSION � NE ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WOF71Cfti9E{lY J ADD L1 ALTERATION LJ REPAIR OTHER TV E OF PERMIT LJ GRADING LJ FOUNDATION LJ STRVCTURAL ❑ TENANT ,L�ECTIRI L❑ PLUMBING ❑ MECHANICAL � ❑ �OTHER ��ry �(�(.J • PROJECT DESCRIPTION Sq. FT. � � �� OCGUPANCV' CONSTRVCTION TVPE � ALUATION $ � I �e^I '3 %� 20NE GRADINGCU.YDS. ACRES Remarks: � ^ �- '� Bar Sink Backflow Preventer Backflow Irrigation � � Bathtubs ' _ Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets I nterceprors Kitchen Sink Lavatories P-Trap Roof Oreins Reinspection Fee � $15 Dutt - Under Ground Duct � Svuctural Duct - Ventilating 3 Exhaust System ❑ Multiple ❑ FirepUFact. Blt. �CBO # 3 r IHealing System & Ducting C �10-100,000 BTU O 100,000 6T1 Reinspeaion Fee � $15 ShoWerS Service Sink Sewer Cap � � Sewer Connection - Solar Collectors Solar.Piping Solar Tank . � Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Leundry Trays Isue Fee { I Hood or Type I I$ � Canopy Type II ❑ Fefrigeration System ❑aioo,000aru ❑ioo,000 System Repair/Alteration f ire Dampers Registers laue Fea A.P. # S `, S Main Buildi E � T Front ARear Q � C Right J K Left S Ping. Ref. # Planning No[es: Automatic Washer Construction Pole Sub. Cooking Unit ''7 q 0009�8 �a4� .-�' Zona � Accessory Building: � O N 1 N G R � Parking Req./Provided '� 3Q E � ��r M T S. ELECTRICAL Transformer ❑ 75�50 KW ❑ 50+KW Dryers �7Gas ❑Electric Fan F.A.U. Fixtures i .��' Device Boxes o�uec: ('ran<{e I Switches �� I Garbage Disposal Generator �0.5 KW �5-15 KW Meter `ypup to 100 amps Meter ❑over100amp5 Sub Panel Motors�41 HP �1h-8 InaSolar �9-75 HP �16-15+ Microwave Pole Light Range Standing Sections Trash Compacror FEES 0 Reinspection Fee $15 Issue Fee $ $ 3 DEVELOPMENTSERVICESREQUIREMENTS: ^ 2oning Approved By _ C/p Date �(' ' 3' � FEES Building Approved By Date �� Applintion Iuued By ' u�,�(.�i � Date: � � SUM�TA�FEES _ � _.. BUILDING PERMIT SMIP $ �� PLAN CHECK $ � PERMIT PLUMBING g �(,J_� ISSUANCE $ �G} � PLAN CHECK 25% $ ENERGV P.C. $ � � ELECTRICAL $ � GRADING $ PLANCHECK 50% $ �� MICROFILM $ � MECHANICAL $ �� TOTAL FEE $ �� _ t- PLAN CHECK 25% $ n� , ' . �.�.�� . _ " . . .�, � �,n�f�,` t1� .. . � . ... . 1 �-_\ . . ' ' � . CONSTRUCTION AND PLANNING POOL & SPA �' .'APPR¢�VALS �Pe'rmit # Date Inspector AppROVALS Permit # " Date Inspector 1. Te'mpo�ary�F �ctrical Service or Pole ; 52. Pool & Equipment Location , � , � $oi�y�Pipe �ndrgrnd. �d �'L•jyq L�(�.�_ 53. Steel Reinforcement � - . . �+ '1✓ ;3t Electr1ical;�onduit Utility-Undrgrnd. � 54. Forms _ - . . �4� ElecCric�al �onduit-Undrgrnd. 55. Electrical Bonding �T 5. STe`-�Rfi��oicement,_, 56. Rough Plumbing & Pressure Test � /s^E• � 0 57. APPROVALTOCOVER�GUNITE � �I,ectrical�UFERGrnd. � ��v� 0' ,� ,7�F.00tings �'�� - SC'L�L �A �b � � 58. Electrical Conduit-Undrgrnd. _ t� � � �8. Foundatlon� �^ 59. GasPipe,O Undrgrnd.,Test v �: . - '9��ater P�pe-U�drgrnd. ' %O /�{ LFi�� 60. Backwash Lines, P-Trap, O Undrgrnd. � 10�� Sfrucwial Floor System �o � gq pjg- � 61. APPROVAL TO DECK - � l�dp Pr perty Sei;ver Line�& House Connection � �� • 1�� , e v Y/ �Jp („� .� 62. Backwash & Receptor-Final � � 72. Sew�r Cap��%�•�.�' ' 63. Heater & Vent-Final � t�. � t�..r:;� �� 13 RooflDrai� ��.' '� .� � r' 64. Plumbing System - Final - �' � � /.. T n �14'�Rougt� Plumbing-�^ , ff� (�� 65. Electrical-Final ' '15. R�pu� Elect � I-Conduit . - 66. Solar System�Final � � 18. Rough Electric Wiring �- -9Q 67. Fencing & Access Approval v ,17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18i Rough Electrical-T 8ar Ce�l�^ . 69. POOI(SPA SYSTEMS FINAI 19. Rough Heating & Air Cond�Hing I C10 (iED FIRE DEPT. REQUIREMENT , 20. FjoughFactory�Fireplace �� O �� APPROVALS Permit# 21. Ducts; ii� St�ucture � 70. Underground Hydro. 22. Ducts;�Ventilati�g ^�� 91. ProductPipingOGas ❑Oil . � � �V.. Gas Pipe-Roug �& Test � �� _. 72: Underground Flush �-.` -24�. Roof Framing ��_r; h ' - 73. Undergmd.StorageTank �Gas ❑Oil 25. Roof Sheathing .�r � �x � �� 74. Ovenc�ad Hydro 26. T-Bar Ceiling��Structuraq &�Monocoat 75. Dry Chemical � � .- 27.. Frame�and Flashing" %P :�' i w �� 76. Dry Standpipe "28` Lathi g:& Siding �� :�• GJb 77. FIX�D SYSTEM FINAL �, � 29. Insulation '� 78. RE PREV. FINAL � 30. Drywall Nailing -. p HEALTH DEPT. REQUIREMENT �3,1? Plaster Brown Coat � � � y p 79. FINAL INSPECTION �32. Electrical Power.Meter�Final ),. 80. FOOD CERTIFICATE ISSUED � � _, � 33. Final Electric '�� i . ' Notes�Z.(-j�9 ((/��V�Gp�Qi�.. (i�•� ,. � ' 34. Final Heating & Air Conditioning %'l% �"'�� ; � /. �� (,�f��} p� 35. Final Gas Pipe-Test 7� L�i .-36. Hood_or�Canopy i , - '.37. Final�Facfory'Fireplace � L� �. L38. Final Flumbing,' � %/ �f(� (� �39. Water Service-Final ! � [,/LQ - s , �� 40. Gas Service�Final: � , j Solar D6mesticFinal " � _. . Backflow Preventer _ • . . • ' ' 43. Backflow Irrigation� ' ' � 44. Landscape I �igation' System , 45. Sound Attenuation�-' ' 46. Handicap Regulatioris � 47.FNALSTRUCTURE&BUILDING / � 48. ' ompleted , � 49. Electric Release to Edison � " :. a � �50. Gar Release to Southern California Gas Co � ,� � 51. CERTIFICATE OF OCCUPANCY ' � � � - �- No. � Date ' � ', . - � PN0.IECT ROUflE35:� �t,r,—��—ps;d� �ti' OWNEN'SNRMF:ICVST P.SS�C. ' noosess:125 HAKER#269.—E . , CM CA92'6?.6 714)668-9016 �BCN/ENGMEEfl: � RDONESS: BEG.NO.: uxiT: J uniT: PEBMRTEE: (':HARLFS SANDERS INK . ( 714 ) 630-191 J nooxess: 1441 RED GUM ST J ANAHEIM CA 92806 LICENSEU CON7NAC70B oECIAMTiON: I hereby afiirm t�at 1 am IicenseA under pmvisions oi Chapter 9(commencinA w�� Section . 7000� o� DiNsion 3 o�ihe Business antl Pmfessions Cotle, and m lice e is in �ulltorce anG e/lec r an uc.: q 7 8. 4 sTnre uc.:J 3 2 7 9 8 cuss:fff��______''' z ' Date: 1- Sipnature: � � � ��j(� IWOqKEB3' OMPEISATIONUEClAH11110N: IhereCyaffirmt�atlhaveacenificatealcansenttoself-insurearacertilicateaiWarkers POUCY NO.n$ ur ncp„�qr�r,�rqtiei Lopylhe,�eof (Section 3800, Lab Cy� ' y/ U3 1lS.�a EXP.�RTE: O7/Z8�9O COMPFNY:OHZO CASULTY. ❑ Certifie0 copy is here6y fumisheU. � Cenifietl copy is filetl wrt tAe ciry BuiltlinA D' io Dare: � � ApplicanC ��q �S� IXEMPfION POM HNEflS' fAMPENSNTION OECUMTION: (This sec�ion need nN he comD��e01t Ne pertni� is br ane hunArad (5100) or less�. I cetliy that in t�e pedormance ol the work for wAich t�is Oermit is issued, I s�all not employ any Derson in any manner so as ta become suGjeci ro the Warkers' Compensation Laws oi Califomla. Wte: SipnaNm: NOTICE: If, afler makinp this declaration, you shaultl become su6ject to the Workers' Campensation D�o�sions of the Labar CoUe, you must brt�with compty wRh such provisions or this permit shall he AeemeA revoke0. CONSTBUCTION LENOINQ FGENCY: I hereEy aifirm tAat Nere is a consVuction lentling agency lor the pertormance ot Ne work for which ihis permii is issuetl (Section 3W7, Civ. C�. LENOEN: FOOHESS: ' ' � - OWNEB BUILDEB OEClAM7I0N: I heaby aflirm ihat I am e�empt imm t�e Camracmrs' State License Law for ihe follovnnp reason (Section 7031.5 Busineu an0 Pmtessional Code: Any ciry oi counry which reQuires a Dermit to constmct, alter, imOmve, demolish, or reDaif any S�mCtUre, Driof �0 h5 i55uance, also feqUires Ihe applitant for SUCh permi� �0 �ile a Si0ne0 S�a�¢ment \hat he/She is licensetl pursuant ro the pmvisions of the Cantracrors' Stare Licensa Law (Chapter 9(cummencinp wit� Section 7000) of DNision 3 oi the Business and Pmieuions Cotle) or ihat he/s�e is exempt theretrom and tha basis for t�e allepea exemptian. My vialation of Section 7031.5 Oy any applicant for a permit subjects t�e apDlicant ta a civil Denalry oi no� more than five hunare0 Oollars (5500). I, az owner ol Ihe pmpeM or my emyloyees wit� wages as their sole compensation,-will Uo t�a woh, and the ❑ stmcWre is no� inientled oroflea0 �or sale (Sec�ion 7044, Business an0 PmhSsional CoOe: The Canfractors' State License Law aoes not apDry to an ownerof a pmperty who builOs orimprovest�ereon, and who Aoes such wark himseif/herselt or t�roup� his or her own employees, provideA that suc� improvements are not imendetl or oifered tor sale. Ii, however ihe builtlinA or impmvemeni is sa10 withm one year oi completion, the awner will have the Curtlen oi pmvinA he/s�e Oi0 not 6uiltl or imD�ove tor tne puryose ol sale�. I, as owner oi t�e praperty. am exclusivelp contracting with licensetl coniroctors ta constmct ihe prolect (Sectlon 7044, Business ❑ anA Professions Cotle: The Cont2ctors' State license Law Goes not appty ro an owner al DroDerry w�o bmlEs or imOroves Ihereon and who contracis for suc� prol�u w�ih a contractor(s)license Dursuant to t�e Contractors' State License Law).1 am aware tAat pmof oi tAeir WOM1er's Compensation insurance shoul0 Oe OroviAetl ro me. - � I am eKempt unAer Sec[ion: B. 8 P. C. (ar Inis /easOn: Wte: ' Owner: I EO Aere6y cetliry tha� l am aware Of an0 UnOelSlanO ihe requirtment5 0� Califomia HeaIIA an0 Salery CaOe SeCtions 25505, 25533, and 25534 anOl�al I or any futua Uuiltlinp occupant wiNwill not (circle ane) neeG to comply vnth saia state codes and tAe requiremenis for a permit for wnstmcl'wn or modification imm the Air Oualiry ManaAement District. HesiOential consimction aDPlications are exempf fmm inese provisions. Uate'. ADPlicant I hereby cenity that I �ave reaG t�is application an0 state that the above inlormation is correct I aAree to comply wit� all ciry ana counry oraina�es anC state laws rela�inp to Ouildinq conslruclian anG hereby authonze rtOresenta�ives of t�is ciry Io enler upon Ihe above-menlioneE pmperry forinspection purposes. Date: � SignaNre: Driver's License or Sociai Seariry x: 16alie W�ite—BuilEing;�Green—Code Enlorcamant; Canary—Applicent; Pink—Revenue; Goltlenrotl—Assessor CITY OF COSTA MESA — IIUILDING PERMIT PERMIT NO: M 045219 PLAN CHECK NO; N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC JOA DESCRIPTION : AIR COND, ADD TO G40377 PERM NU: M A45119 GOVT: N SUPP: Y SQ FT: PORPOSE: NEW CLAIM VALUE: Ff00.0.0 CAL�C—t)ALO£: GROUP OCC: R-3 /M-1 COMMENTS: ADD AIR COND TO #G4037% � �***��i�*�t**�*r�xr**�--��xx�**�t*�-*�t*x�*******�x�*�**�r*********�x-**f�*�t*x-*-��t**�*�*x-*�x�***��x� Z O N I N G R E Q U I R E M F. N T S S E T H A C K S � ---------- MAIN DUTLDING ---------- ---------- ACCESSORY AUILDI:NG ---------- FRNT: FT IN RCAR: FT IN FRNT: FT IN REAR: FT IN � LEFT: FT IN'RGHT: PT IN LEFT: FT IN RGHT:, FT IN PARKING REQ: PROV: PARCEI�: 9392012$ ZNE: REF NO: PLANNING NOTES> ' ? 1E �)E ff fE # 1E 1E 1E iElf # 1E iE 1E it iE iE iF 1E iE iE it if iE jf iE iE iE iF 3E 3E iE jE fE fE iE �1f'�lE�1E if 1E ik if jE # iE 1k k-IE iE iE fE iE 1k 1E if iE 1E iF �1E �1E �lE �1E �1F iE iE 1f� 1E iF iF iE * if jE �k-0E iE 3E iE D E V E L O P M E N T S E R iC� I C E S R E Q U I R E M E N'T S ZONING APPROVED BY - DATE: AUILDING APPRUC�Ep BY. : ,_ DATEo _ APPLSCATION ISSUED BY:_�—. DATE: �Z�Q �1f1(-iEfEiF3EiflEiFiF�ElEiflEihih�ItitiEifiElf�E ��iF �E �'�S�iEiFiEifiF�lEiEifikiE��fiE�fi(3F�1E iEitlElEiE1ElEiE�EfEiE3ElfifiEiFiFMiElEl4iffEiEfEitiEiEiFlFiF3E1E kfE�fiEiEiF iE3EiF9EiFififitik�EiE�F�EiElEifitiFitiFiEiEiEiE�EiEiE�EiEifiFiFiEiFifiE3k LEGALIZATION:N F E E S U� M A R Y STRUCTCIRAL SEGMENT:N HLDG PMT PLUMBING ELECTRIC MECHANIC FIRF SMIP/RES GRADING PERMIT 9.00 25� SMIP/NON—RES PLAN ISSUE FEE 4.50 AUILDiNG—DIV—> PERMIT . ISSUF�' PLAN—CHECK TUTAL PAID DUE TOTALS----> 9.00 -4.50' 0.00, 13,50 13.50 .00 REVENUE DIVI5ION TOTALi--> COLLECTED: 13.50 OVER/SHORT; .00 BLDG PMT PLUMBING EL�ECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 13,50 0 �1E iE 3E # 3E if 3E iF iE 9f iE iE jE � iE iE if it iE iE 3E it �F �E iE if iE iE iE iE iF �f if iE it it iE if 1f if if 1f iE iE iF iF �1F 1F iE if iE iE �! iE iE 3E 3E if iE fF 9F iE iF if 1E iE iE �E iE �E iE iE �E �1F # 1E iE 3E iE I N D I V I U U A L F E E FJ R E A K D O W N � TYPE Q'TY D E S C R I P T I O N fINIT COST TOTAL COST MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/ti 9.00 9.00 END OF FFES 01 U0048796-00043796 T O T 13.50 DATEt !2/01/$9 T1NE% 1b::Q CONSTRUCTION AND PLANNING POOI & SPA ��APFROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole . � 52. Pool & Equipmen[ Location � 2. .Soil Pipe-Undr,grnd., � ' 53. Steel Reinforcement ' 3: Elec[rical Conduit�Utility-Undrgrnd. • . 54. Forms � 4. Electrical Conduit�Undrgrnd. ,-, . 55. Electrical Bonding . 5. Steel Reinforcertient -• 56. Rough Plumbing & Pressure Test 6.' Electrical UFER Gmd. �' S7. APPROVAL TO COVEF�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 Elecvical-Conduit . ' 66. Solar System-Final 16. Rough Electric Wiring � _ 67. Fencing & Access ApProval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � . FIRE,DEPT. REQUIREMENT � - 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 ,- _ �'' ,'7y, Underground Flush . 24."Roof Framing .� , � - �. �73: Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing ` _ '' 74, Overhead Hydro: 26._T-Bar Ceiling �Structural) & Monocoat � 75:-Dry Chemical 27. Frame and Flashing - ' ' �' 76. Dry Standpipe _ 28. Lathing & Siding -- �«. 77.. FIXED SYSTEM FINAL � - 29. Insulation ' - ��;•'_ � 78.� FIRE PREV. FINAL ' 30. Drywall Nailing - ''. � . FiEALTH 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 . 7��`!q� �D , - 35. Final Gas Pipe-Test _ • � � �. - : � , : � � . 36. Hood or Canopy - � . � � ' _ �37. Final Factory Fireplace ' � � ' - - .38. Final Plumbing . . • � _ - � � _ � 39. Water Service�Final �� - - , . 40. Gas Service-Pinal � r � ' . � ; � � 41. Solar pomesticFinal � � • - � . 42. Backflow Preventer ' � � ' 4 43. Backflow Irrigation . � � � i 44. Landscape lirigation Sysrem, ' ~ . ; . • � ' � �45: Sound Attenuation . : , � ;� �� 46. Handicap Regulations � _ � _':'� 47: FINAL STRUCTURE & BUILDING .• ;', . � � � 48. FINALPLANNING ,. . , ' � 49. Electric Release to Edison . ', -. � � 50. Gas Release to Southern California Gas Co ' - • : 51. CERTIFICATE OF OCCUPANCY No. Date r PWj!RCT ROORESB: � �+ . �TrJ�'f�a�Fi�— OWNEH'S N�ME: RTCHARD FLOCIC . nooeess: ; 479 ORANGE AVE COSTA.MESA � CP. 92627 99999999 �PCXIENGINEER: NEO.NO.: � RUORESS: ' uxir: J UNIT: PEHMITTEE: ATLAS PIRE PROTGCT'IO ( 818 ) 767-5775 nooxess: ��64 SAN I'ERNANDO 10 SUN VALLF:Y CA 91752 110EN5E0 CONTMCTOR OECIAMTION: I here�y attirm Ihat I am li nse nAer Dmvisions of CAaO�er 9(ca encinp witA Saction 7000� of Divisian 3 of the Business an0 Pmlessions Catle, antl my f se in fullforce anG efiect. CITY LIC.: O 4) 9 4 3' STATE LIC.: S EJ % O S S $�� C•-16 Date: — Sipnamre: W08KEBS' W PENSIITIOH OECUM7ION: I herehy affirm ttut I Aave ' te al consen[ -insure or a ceniticate of Workers' Campenution Insurance, ar a certifieU caDY ��eof (Section 38W, La . roucr xo.: 1 12'7 8 4 2- II 9 exv. onre: / 01 / 9 0 cornrnxr: STATE FUND 0 Certi/ie0 copY is �ereDy fumis�etl. ❑ Cenifie0 copy is fle0 ' t�e ciry Bui ' on. .o O Date: a 0 / Applicant IXEMPfION FflOM WOBNEfl3' fAMPENSN710N OFCWMTION: Qhis secti eeA n be IeleA if ihe permit is for one hundrM (E100) or leu�. I cenity IAat in Ihe pedormance af �he work far wAich this permi� is iss 0, I s�al employ any person in any manner so a5 �a Uecome suhleci �o �he Workers' ComOensatian Laws oi Calitomia. Oaie: Siqnam2: NOTICE: It, atler maldng tAis aeUaration, you shoul0 become suhject lo tAe Workers' Compensation pmvisions ol the La6or CoGe, you must forthwith comply wit� suc� Orovisions or tNs permit shall Ce tleeme0 revoke0. LONSTHUCt10M LENOING �GFNCY: 1 AereUy atlirm Itut thea is a wnstruction IenOirip apency for tAe Oetlarmance ol t�e work tar whicA t�is permii i5 iSsueE (Section 3097, Gv. C�. lENOEH: RODPESS: . ' OWNEP BUILUEfl UECLAMTION: I here0y aflirm Ihatl am exemD��mm the ConVac�ors' Sta(e license Law brihe I011owin0 reason (Section 7031.5 Business an0 Professional CoOe: My ciry of wunry w�ic� repuires a Oermit ro consimct, aller, impwve, tlemolish, or repair any strudure, pnor ro tts issuance, also requires Ihe aDD�iwnt far such permit ro file a signeG statemeni tAat �Ns�e is Iicense0 pursuant to tne provisions ol tne Contractors' State License Law (Cnapter 9(cammencing wit� Section 700U) al Oivivon 3 0l Ine Busness anG Pmfessians CoOe) ar that MJshe is exempt t�eretrom an0 the Uasa lar I�e allepe0 exemption. My violation at Section 7031.5 hy any applicant for a pemut suhjects t�e aDPlicant to a civil penalry ol nat mare than five hunCreO dalWrs (5500). I, as owner oi t�e D�DartY or my employees xith wapes as Iheir sale compensatian, will Uo tAe waM, �anU tha ❑ stmcwre is not intenAM ar afleretl lar sale (Seciion 7094, Business an0 Professional Cotle: T�e Contractors' State License Law Uces not appry �o an owner ol a pmpeM who �uiltls or impmves Iher¢on, anA who Aaes such waB �imself/�erself or [hmup� his or �er own employees, proviGeE that sucA improvemenls are not intenAM or oifereA far sale. If, liowever t�e 6uiltling or improvement is sold wit�in one year of completion, the owner vnll have the GurG¢n of OmanA ��s�e Uitl not builtl or imprwe Por ihe purpose ot sale). I, as owner ot Ne pmperry. am exclusively contracting wiN Iicense0 coniractars to constmct the prolect (Sectian 70A4, Business ❑ antl Professions Code: The Contractors State License Law does not apply to an awner of Droperty w�o Ewlas ar imD�oves therean an0 wtw contraclsforsucn pmjects vrith a conVacmr(s)license Oursuant to ihe Cantractars' State licensa Law�. I am aware t�at proot of [heir Worker's ComDensation insurance s�oulE Ee D�4eE to me. � I am exempt unGer Seciian: B. 8 P. C. _ for t�is reason: . Date: Qwner. I Eo Aereby certiry ttw[ I am aware of anJ understan0 t�e requiremenis al Catilomia Heatt� antl Safery CoGe Seciions 25505, 25533, antl 25534 an0 that I ar any fNu2 huilEinp occupant wilUwill nat (cirUe one) neeG m compty with sai0 state co0es an0 t�e requirements for a permit tor consimctwn or moEi�ication imm I�e Nr Uualiry Managemeni OisMct. flesitlential constmciion apDliwiions are eeempi fmm Ihese D�ovisions. ' Oate: ApDlicanC I A¢rt�y Cefiily lhai I have r¢aU 1�i5 appliWiion an0 S�ale lhat Ih¢ aE0v8 � fmaGon R COrretL I aprp�f to tamDly wiill all tlry anE munTy or0inances aM state laws reWnnq Io DuilOinp consiNcvon arM Irere�y a iepresent � t'! ry to emer upon tne above�mentione0 pmpeM for i�ape tion Ip'utposes. � Date:� v �� SA�Wre: Dri.er's License ar Social Secunry x: 1fi41J6 W�ite—Builtlinp; Green—Cotle EnlorcamanL Canan—AnolicanK Pink—Revenue: GaltlanroE—Nssessor . CITY OE COS'fA MESA - BOILD'I�1G PERMIT PERt-0 1�0: F U4'S4 75 PERMZT NO: F 045475 PLAN CHECK NO: 01695�-tJ9 S GOVT: N SUPP: IJ CONSTRUCTION TYPE: - L�ERMIT TYPL: FIR PORPUSE: AUU JOD DESCRZPTZON : FIRE SPRINKLERS SQ I'T: CLAIM VALUE: 1,200.00 CALC-VALUE: GROUF OCC: R-3 / COMMBNTS: PROVIUE WORKMENS COMP AND AUTFIORIZATION�� /�7RpV�,Q�j� �b- ��*�x��****�**#�*��*+r�+��*+r�***��***x�*�*��*��.y(�illklP)EMMIfYthtEh�cTlt�E�fn"JEIEit .IF'it 'L U N I N G R E Q U I R E�M F N T F, S F. T B A C K 5 -------�-- MAT.N I3UILDING --------, --------- ACCESSORY BUILI7ING ------- FRNT: T'T IN REAR: FT IN FRNT: F'T IN RP.AR: FT . IN LEFT: FT IN RGHT: PT IN I�EFT: FT IN RGfiT: FT IN PARKING REQ: PROV: FARCEL: 43920128 ZNE: REF NO: PLANNING NOTES> � dE i(� iF ik iE iFlE -0F �K iE if iE iF iE �lE iE ik iE iE ik ih �F �1F �)E iE if iE 1E if iE ff i4 iE if iE iE if if iE # it iE iE R iE If �E 3E i(� it if 1f if iE iF fk if �Ik iE if i:� iE K� iE ?f i(� IE iE # iE iE iE �iE iE �1E c if if if D E V E L O P M B N 7' S E R V I C E S N E Q U I R E M E N T S 'LONING APPROVE:U BY DATE: BUILDING APPROVED BY : ___ DATE: APPLICATION ISSUED BY:_F-�- ikiE'iE'1f'IEiFlfIl"IE)EiEIF'IE1F�fR'N"II'iE'IF1EIFfE;F1l3F� s'Y 1E iE iE iF it if iE iF ik k iE iE iE if if k if iE If iE iEit dE �JE iE iE fk iE iE if iE iE M iE k 1E iE iE LEGALI7.ATTQN:N F E E 5 if iE 1! �! ik IEif fE �E ik!! M M A R Y BLUG PMT PLUMBING ELECTRIC MECHANIC PEI2MIT 29.00 65t SMIP/NON-RES PLAN 1II.fi5 I.�"iSUG FF'fi • BUILDING-DIC�-> PERMIT ISSU£ PLAN-CIIECK TOTAL PAID DUE TOTALS--- > 29.00 0,00 18.85 47.85 47,85 .00 REVENUE LIVISION TOTALS--> COLLECTED: 29.00 OVER/SHORT: .00 BLDG PMT' PLUMAING ELECTRIC MErHANIC FIRE SMIP/TOT GRADING PLAN-CFIECK 29.00 1e 3f iFlE 3f iE iE dE � iE if ik iE iFlE �f �k-ik �%it iE iE iE iE fE if 3E if jf �:E ft �f �! i! iE jE iE �E f! �F iE ft� iE iejE jf iE �ElE it i� iE 16 if �t if iE ih 3E iE tE 1f ff iE �K�1E 1k it jf fE tt iFlE 3t 1E if �f iE iF I N D T V I D 0 A L F E E R R E A K D O W N TYPG QTY D G S C R I P T I O N UNIT COST TOTAL COST ['IR 29 FIRE BQUIP FEE (PROM BLDG VAL TAHLE) 1.00 29.00 END OP FEF.S DATE : �Z• ZQ 1F'iF7Fat+eitit��titet**aFiF'3F*#+F ��rt� iE iF±E # jEl� 1!-iE iE if if i6 it if i! �k !k itlk iE �1E iE �F iElf STRUCTURAL SCGMENT�:N FIRE SMIP/RES GRADING A 07 U�050244—OODSp244 T C�T 29.00 DATE: 12/20/89 TIME: iS:09 � �:� 17i �. i CONSTRUCTION AND PLANNING POOL & SPA � APPROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector 1. Temporary Electrical Service'or-Pole �"" 52. Pool & Equipment Location � • 2. Soil Pipe-Undrgrnd. ✓ „ 53. Steel Reinforcement � � � 3. Electrical Conduit Utiliry�Undrgrnd. �., 54. Forms �; , � 4. Electrical Condui[-Undrgrnd/� 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPAOVALTO COVER�GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test �' � i 9. Water Pipe-Undrgrnd. _ - 60. Backwash Lines, P-Trap, � Undrgrnd. �• , , "� ,10. Structural Floor System ` ' 67. APPROVAL TO DECK � 11. Property Sewer Line & House Connection ,' 62. Backwash & Receptor-Final 12. Sewer Cap �' 63. Heater & Vent-Final . 13. Roof Drains �� " 64. Plumbing System - Final 14. Rough Plumbing -� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling ` � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT 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 O Gas ❑ Oil 25. Roof Sheathing • 74. Overhead Hydro '. �-sr� w�M 26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing � 76. Dry Standpipe 28. Lathing & Siding i � 77. � FIXED SYSTEM FINAL .�-c�0 �y„p 29. Insulation �� `' 78. FIRE PREV. FINAL &.2Jjy Ip 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 �• �T Notes: 34. Final Heating & Air Conditioning �,i� 35. Final Gas Pipe-Test � � � .� 36. Hood or Canopy . . 37. Final FactorY Fireplace � 38. Final Plumbing ' - 39. Water Service-Final � 40. Gas Service-Finel� � i 4�. Solar Oomestic�Final , 42. Backflow Preventei � • 43. Backflow Irrigatio`n � 44. Landscape Irripation System ' . , 45. Sound Attenualion - 46. Handicap Regulat{ons __ 47. FINAL STRUCTURE & BUILDING '" � , 48. FINAL PLANNIt�G .-. � 49. Electric Release to�Edison A� 50. Gas Release to Southern California Gas Cu �'-� • 51. CERTIFICATE OF OCCUPANCY No. Date ICiry of Costa Mesa '�""`�� oe�e�oPrriem ser�ices �epartme�t C E R T I F I C A T E O F O C C U P A N C Y Building Safety Division P.O.Box 1200 Costa Mesa, Calitornia The Building located at 287 CdCc3fCf0 WnB '� ^ ! No.0��1,�, a has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group �� Occupancy. Use of Building ��1111d1UII19 � Legal Description 43s-2oi-aa,29 � (See reverse side for Metes and Bounds) Building Permit No �0377- Electrical Permit No. G40377 Plumbing Permit No. l'.8f1a77 Mechanical Permit Na C�377 _ Number of apartments and/or guest rooms ISSUED T0: KVST Associ$te 125 Baker Street, Suite 261E Costa Mesa, CA 9262m6 Building Official Tonfa C'De Baca by � , Date Auqust 16. 1990 . This Certificate of Occupancy SHAIL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. ]/B3 - White -Owner, Canary - Numerical File; Pink - Bldg. Permit File