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Home My WebLink About619 BROOKVIEW WAY - Building PermitsPACIFIC INSTALLERS, INC. r- � � 751�1 9nthony Avenue Gardea Grove, Californi.a 926lt9 P,O. Box 728 Westmineter, Calif. 92683 State Lic. # � � City iic. # � Date �'�� Customer Name r��`f�_C�%Q�-�J�'�-� Pexmit No's. �� Types of Permite P.(..Q 4�� t� of r� � .� � � Department of Bvilding aad Safety Gentlemen: Please be adviaed that as of �' a"�6 '�� all rrork by Pacific Installers, Incorporated, on the peffii.t numbere listed above have been cancelled. There£ore, Pa.cific Inatallers, Incorporated, requesta that the pe�ita be caacelled and that all pre-paid fees be reflanded. Thia cancellation notiae is advice to you that PaciYic Installers, Incorporated, has no resBonei}�ilit�or wo�k a&�lished vnder Permite aoted at LO I�j � .@t4•�A� 4ery truly youra, PACIE'IC INSTAI,LERS, INC. � , � ` � :.-•- PI-26k Hev. 3�74 AVP��eant to fill in all soaces ezcevt �hose within neavY bortler Iines ana sign all aporooNate tleclarotions. CITY OF COSTA MESA CONSTRUCTION PERMIT G7LiGflT.•TJ7C:irYtt�s�� ._........._. ..---� �--- a� �i ._ . TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R — Applicant'S Malling Ad �ess � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' A,p. # / DESCRIPTION OF WORK Owner's Na�m�e� —C�� /'I ', n' ., eOPJ�o��,� � E Main Building: Address 1�LZ_% "C_.�u_i ('� TVPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL T Front AfCh/Eng. LiCenSe No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Address ❑ �o7HER A Rear Contractor's Nam Phone ^ Address (mal' g) I �� '�'� S � City Licnnse No. ��%� � � R`�� LICENSED CONTRACTOR OECLARATION 1 hereby aftirm [hat I am Ilcensetl untler provisions of Charter 9(commencing with section �000) o( Division 3 ot roe BuSiness antl Professions Code, antl my Iicense is in (ull tor antl !i t. �� O b License ass - Lic N'o'. �y� Date ��+-� 1_ Si9 t �� v�—� WORKE 5' COMPENSATION DECLARATION ' � 1 hereby affirm that I have a certificate ot consent to selT-Insure or a tertificate of Workers' Compensation Insurance, or a certifletl copY tM1ereof (Section 3800, l.ab. C.) Poli<y No. Company � BCerti(ietl mpy Is hereby (umishetl. Certi(ietl copy is tiletl with the city Builtling Division. Date APplicant EXEMPTION FROM WORKERS• COMPENSATION DEGLARATION (Thiz section neetl not be completetl if the perml[ is for one hunUretl (5300) or less) I certity that in tne pertormance oi the work for whlch this perm�t is issuetl, I snall not employ any person in any manner so as to become 5ubjec to the Workers' C' en io l.aws of California. Date Si9na[ure _ � - NOTICE: If after mak ng this tleclaration, you shoultl become subject the Workers' Compensation Orovisions of [he Labor Cotle, you-must tor with comD�Y H'�th Such 0/ovisions o� this pe�mlt shall be tleemetl rewketl. CONSTRUCTION LENDING AGENCV I ne�eby affirm tha[ [here is a mn5t�uction lentling agency fo� the pertormance o( the work tor which th15 permit i5 i55u¢tl (Section 3097 Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUIIDER DECLARATION I hereby aftirm that I am exempt from fhe Contractor'S License Law for the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which �equi�es a Oe�mit to const�uct, alte�, Imp�ove, tlemolish o� �epai� any structure, prior to its issuance, alzo requires the applicant tor such permie to (ile a signetl statement that he/she Is licensetl pursuant to the provisions ot the Contractor's License Law (Chapter 9(commencing witb Sectlon 7000) of Division 3 of lhe Business antl Professions Cotle) or that he/she is exempt 'he�ef�om antl the ba5i5 tor the allegetl exemptiOn. Any violation ot SeCtion �31.5 by any applicant tor a permit subjects [M1e applicant to a civil .nalty of not more than tive huntlretl tlollars ($500j. - � I, as owne� of the O�operty o�� my empl0yee5 with wage5 as their Sol¢ compensation, wi11 tlo the work, antl the structure is not intentletl or offeretl �or sale (Section 7044, Business antl Protessional Cotle: The Contractor'S License Law tloes not apply to an owner of a property who builtls or improves thereon, antl who tloes sucM1 wo�k nimself/he�sel( o� thrOu9h his o� he� own employees, provitletl that such Improvements are not intentletl or otteretl for sale. It, howeveq the builtlin9 or improvement is solU within one year of com- pletion, the owner will.have the burtlen o( proving he/she tlitl not builtl or im- �rove'for tM1e purpose of sale�. I, as owner ot the property, am exclusively contracting with licensetl con- tractorsto con5tructthe prOject (Section 7044, Business antl PrOtessions Cotle: The Contractor's license Law tloes not apply to an owner of property who builtls or improves Iherean, antl who cont�act5 fo� such p�ojeGts with a con- tracror(s) license pursuant to the Contractor'S License Law). ❑ I am exempt untler Section B. & P. C. to� thi5 rea5on Date Owner I hereby certity that I have rea into'rmation is correct. I agr¢e to antl state laws relating to builtlir sentatives of this city co entE r inspection purposes /Y •/�' Signature �.� �� Drivers' �License or 55 � he [ion antl state that the above ; all clty'antl counfy ortlinances �. antl he�ebv authorize reore- PROJECT DESCRIPTION 5a. FT. oCcuPANCv � C Right K Left CONSTRUCTIONTVPE VALUATION$ $ ZONE GRA�ING CU. VDS. ACRES Ping. Ref. # pemarks: � Parking Feq./Prv Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Dishovesher � � Orinking Fountains Floor Drains Floor Sinks Gas Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee � $p5 Boiler Duct- Under Ground Duct - Sttuctural Duct - Ventilating � Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU � 100,000 BTi Reinspection Fee � ' $25 $hoWers 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 I I ❑ Refrigeration System ' ❑0-100,OOOBTU ❑100,000 System Repair/Alteration CMF 0865-46 rev. ]/83 ' White - Builtling; Canary - ApplicanQ Pink - Accounting; Goltlenrotl - Assessor � -- � Issue Fee FEES $ 3 FEES $ 3 Use of Buildin9: Planning Notes: Automatic Washer Construction PoleSub. Cookin9 Unit . Dishwasher Dryers ❑Gas ❑Elec� Fan F.A.U. Fixtures Device Boxes Outlecs Switches Garbage Dispoul Generator �65 KW C IZone Accessory Building: Park.Fees $ ELECTRICAL , � Transformer ❑ 15-50 KW ❑ 50+KW Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel Momrs00.7 HP�1%-8 Inc. Solar �9-15 HP 016-15+ Microwave Pole Light Fiange Standing Sections 15 KW Trash Compactor FEES O N I N G E � U I R E M E — Reinspection Fee $25 Issue Fee $ 3 � � PUBLIC SERVICES RE�UIREMENTS: ' Zoning Approved By Date � Application Approved By e , Date �, Appliption Issued By Lv Date� .`�--' `� ��> �• SUMMARV OF FEES BUILDING PERMIT $ SMIP $ � PLAN CHECK ' $ � PERMIT — PLUMBING $ ,� �� UANCE $ PLAN CHECK $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK $ MICROFILM $ , MECHANICAL $ TOTAL FEE $ 5�� PLAN CHECK $ ' CONSTRUCTION AND PLANNWG ' POOL � A - APPROVALS Permit # �P ��s�/ 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. Water Pipe-Undrgmd. , - 60.' Backwash Lines, P-Trap, � Undrgmd. , 10. Structural Floor System , 61. APPROVALTO DECK 11. Property Sewer Line & House Corinection 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 � � 1.6.� Rough Electric Wiring ' 67.� Fencing & Access Approval ' 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electricat-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 OGas ❑Oil 23: Gas Pipe-Rough & Test � 72. Underground Flush � 24�..Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywali Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final' 80. FOOD CERTIFICATE ISSUED . 33, Final Electric � � Notes:L�� 0� �t.�(,,�� 34. Final Heating & Air Conditioning ,��-�- C92,�_ y 9� 35. Final Gas Pipe-Test 36. Hood or Canopy ' � 37. Final Factory Fireplace � , 38. Final Plumbing ' . S' �� LF,p, 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 Southem California Gas Co �• � 51. CERTIFICATE OF OCCUPANCY ; No. Date CITY OF COSTA MESA CONSTRUCTION PERIMIT ADo�leant to fill in all soaees except'those within neavy bortler Ilnes ana sign all apvropriata tleclarations. %J /J O y� 9 PERt�plj � N N� TRACT NO. LOT NO. BLDG. . f'" JC/ Ziurs� Project Address �j.� Y � A /f'A�l(�/1/�LQi�+`� Applicant's Mailing A r ss . Owner's Name hone ' Address �� Arch/Eng. License No. Address p Convacror's Nam c�— � (/ honN — �O Address(mailingl o; �r�Q ��..O�c� f7 " City Licensc No. v'�� LICENSED CONTRACTOR DECLARATION I hereDy aHirm that I am Iicensetl untler ptovisions ot Charter 9(commendng with SeC[ion 7000) Of Dlvision 3 ot the Busin¢sz an0 Profe55iOns Gotle, an0 my license is in full force antl eftect. C �icense CJ as — Li e No. 0 Date ignature WOR� M Ey SATION DECLARATION 1 hereby afflrm tnat 1 have a certifiWte ot mnsent to sel(tinsure or a certiflcate . of Workers' Compensation Insurance, or a cerU(ietl wpy thereot (Sectlon 3800, Lab. C.) PoliCy NO. Company 8 Certifi¢tl Copy is hereby turnishetl. ' Certitietl copy is tiletl with the city Builtling Division. Date AOP��t EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl no[ be completetl if the permit is tor one huntlretl ($300) or less). I certi(y that in the performance ot the work for which tM1is perm�t is issuea I shall not emp oy any person in any manne� 5 5 ta e ma sub' ct tp t{j9 Workers' �nsat' w9ot Califor�� < `� �� Date i nature Vr NOTIC : f,i ter a i thiz tlecla�a lon, you shoultl bewme subject [o [he Workers' Compen5ation provisions of the Ldbo� Cotle,youu must torthwith comply wlth Such O�ovisions or this permit shall .be tleemetl revok¢tl. CONSTRUCTION LENDING AGENCV ' I hereby aT1i�m that there is a conztruction lentling ag¢ncy fo� the perto�mance of the work for whith this permit is Issuetl (Section 3097 Civ. CJ Lentler's Name LPntler•s Aatlrezs OWNER BUILDER OECLARATION I he�eby a(fl�m that I am exempt from the Contractor's Licenze Law fOr the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which �eQui�es a pe�mit to const�uct, alter, improve, tlemolish or �¢palr any stru<fure, prior to its issuance, also requires the applicant for such oermit [o file a sign¢tl statement that he/she Is licensetl pu�suant to the provision5 of the Contractor's License Law (Chap[er 9.(commencing with Sec[ion ]000) of Division 3 of the Business antl Profezsions Cotle) or thac he/she is exempt therefrom antl the ba5iz fOr the allegetl ezemption. Any violation o( Section 131.5 by any applicant for a permit subjects the applicant to a civil nalty of not more than five huntlretl tlollars (g500). �. .J I, as owner of the property or my employees with wages as their sole compensatlon, will Ao the work, antl the structure iz not intentletl or ofteretl t0/ sale (Sectlon ]044, Business antl PmfezSional Cotle: The Contractor'S License Law tloes not aoP�Y �o an owner of a property who bulltls or improves thereon, antl who tloes s�ch work himselt/herselt or tnrough his or her own am0loyees, provi0etl [bat such improvements arc not intentle0 or oHeretl tor Shc¢. I/, howevet, the bulltlinq o� improvement i5 Soltl within one yea� of com- O�etlon, Ihe owner wlll nave the burtlen of proving he/she tlitl not builtl or Im- ��ova fO�the pu�pose of sale). I, az owner of the property, am extlusively tontracting with licensetl <on- tlactofs to cOnStruct tlle projeci f$¢ction 7064, Bu5ine55 antl Prote55ion5 Cotle: The Contractor's License Law does nOt apply to an owne� o( property who builtls or Improves thereon, antl who contracts for such projects witn a con- tractor(s) Iicense pursuant to the Contra<tor's License Lawt. ❑ I am exempt un0er Section B. & P. C. ior this reason Date Owner 1 hereby c¢�Ufy that I have tead this applicatb� Intormation I5 correct. I agree to comply with all antl.state laws relatin9 to builtling construction, a 59n[ative5 of [his t to ente� upon h¢ a�oo inspeGtlon pur Signature Drivers' LI ense or 55 � ]MF0865-46 rev.12/83 white-BWItlin9:Canary TVPE OFCONSTRUCTION LJ NEW LJ ADD U ALTERATION IJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TVPE OF PERMIT LJ GRADING �LJ �FOUNDATION lJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL I(yPLUMBING ❑ MECHANICAL ❑ OTHER PRQIECT DESCRIPTION Sq. F7. OCCUPArvCY— C O N ST RUCTION TYPE V ALUATI ON $ ZONE GRADING CU. VDS. CRES— Remarks: � r i— Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service DUt12L5 Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Rainspection Fee � $p5 Duct - Under Ground DuCt - $tfuCtuf81 Duct - Ventilating Exhaust System ❑ Multiple Fiiepl/FacL Blt. ICBO # Heating System & Ducting ❑6100,000 BTU �100,000 Rainspection Fee � $25 Pink - Accounting; Goltlenrotl - Assessor Service Sink Sewer Cep Sewer Connection Solar Collectors Solar Piping � Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Wa[er Service Issue Fee Hood or Type I ❑ Canopy Typell ❑ ❑a�oc System $ySLCT BTU ❑100,OOOBT laue Fee � FEES $ 3 A.P. # S MaimBuilding: E T Front A Rear C Right g Left Ping. Ref. # Parkin9 Req./Provided Use of Building: Planning Notes: 9`185 5/07/84 Zone Park.Fees $ ELECTRICAC Automatic Washer Transtormer ❑ 15�50 KW Construction Pole Sub. ❑ 50+ KW Cooking Unit Meter ❑up to 100amps Dishwasher � Mecer ❑overi00amps Dryers �Gas ❑Electric Sub Panel Fan - Motors061 HP�1X-8 F.A.U. Inc.Solar �9-15 HP �16- Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator 065 KW �5-15 KW Trash Compactor 5,0'� T� FEES I Reinspection Fee I$25I Issue Fee I $ 3 I PUBLIC SERVICES RE�UIREMENTS: Zonine APProved By Date Building APProved By Data p Appliqtion luued By Data S' 7 0 SUMMARV OF FEES BUIIDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � PLUMBING $ � ISSUANCE $ PLAN CHECK 25% $ ENEfiGV P.C. $ ELECTRICAL $ GRADING .$ PLAN CHECK 50% $ MICROR�M $ � MECHANICAL $ TOTAL FEE $ � 6� PLAN CHECK 25% $ Z O N I N G R E I R E N E N T CONSTRUCTION ANDPLANNING . , - POOL& . , -APPROVALS � Permit# Date Inspector p�ppROVALS Permit# Date� Inspector _ 1. Temporary Electrical Service or Pole ' ' 52. Pool & Equipment Location � � 2: Soil Pipe-Undrgrnd. '' 53. Steel Reinforcement 3. ElecVical Conduit,Utility-Undrgrnd(r y " �54. Forms • � i 4. Eiectrical Conduit-Undrgrnd: � '� 55. Electrical Bonding ' � 5: Steel Reinforcement �� ' ° 56. Rough Plumbing & Pressure Test . � � 6. Electrical UFER Grnd. .- + - � 57. APPROVAL TO COVER-GUNITE . 7. Fbotings , � , �'' 58. Electrical Conduit-Undrgrnd. � �� S. Foundation .�� - . . 59. Gas Pipe, 0 Undrgrnd., Test - . 9. Water Pipe-Undrgrnd,• � ' ��60. Backwash Lines, P-Trap, � Undrgrnd. �� r 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. RoughPlumbing . '�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 ' 1, JRough Heating & Air Conditioning PIRE DEPT. REQUI.REMENT � - 20. Rough Factory Fireplace ' � , � APPROVALS Permit# � i 21. Ducts, in Structure • ' � 70.. Underground Hydro ' 22. Ducts, Ventilating � % ' 71. Product Piping O Gas ❑ Oil ' i 23. Gas Pipe-Rough & Test � 72. Underground Flush ' . 24. Roof Framing 73. Underyrod.StorageTank OGas ❑Oil -. 25. Roof Sheatliing �� •�� j � 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 � � i 78. FIRE PREV. FINAL •' � 30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT I 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�GasPipe-Test � � - � . 36. Hood or Canopy • - � 37. Final Factory Fireplace , ' � . - 38. Final Plumbing ' ' S �d1y [�p , � - � 39. Water Service-Final � . 40. Gas Service-Final • � - 41. Solar pomesticFinal � .. ' . - 1 l. � 42. Backflow Preventer , 43. Backflow �Irrigation � ' . � � 44. �Landscape Irrigation System ' ' 45. Sound Attenuation , ' � , � � , ' 46. Handicap Regulations ' � � , i � � 47. FINALSTRUCTURE&BUILDING ' � 48. Special Requirements Completed� � � � ' 49. Electric Release to Edison � - - ' , ' • ' . • 50. Gas Release to Southern Califomia Gas Co � • � � 51. CERTIFICATEOFOCCUPANCY ' - � - ; No. ' Date _ . �