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3177 COUNTRY CLUB DR - Building Permits
i , i� CI AVV�icant to fill in all spaces excev< tnoze within heavY boraer Ifnes ana sign all apvroprfate aeclarations. ,1T�Y�?MCosTA nnESa .CONSTRUCTI'ON PERMIT r Project Address � 1� � G O U ��iR� � CLV g l�2 � Applicant'sMailingAddress SpMF—� � '� � Jwner's Name� �TF�RZ� V Rla�%r Phone S� G-YS� 4ddress S P �� � 4reh/Eng� �dN w ��'ST 2 UM License �No. � � � 4ddress ' �ISI1L �v�M� �-R.VZG/JIM $J C. � M} �onvactor's Nama m�r^�- ' ' Phone � 4ddress (mailing) � ' � � . i City License No. LICENSED CONTRACTOR DECLARATION � � . I hereby affirm that I am licensetl untler provisioni ot Charter 9(commencing HitM1 section ]000) of Division 3 nf the Business antl Professions Gotle, antl ny license is in full force'and etfect. � � , LicenSe CIa55 � License No. ]ate� ( Signat�ure � NORKERS'COMPENSATION DECLARATION ' ' ' hereby aftirm that'I have a certitiWte of consent to selt-insure or a certificate Workers' Compensation Insurance, or a��certifletl coOY thereot (Section 0, Lab. C.) . � -olicy No. ' � company ��Certifietl mpy is hereby (umishetl. ' � Certitietl copy is.filed with�the tity Builtlinq DiviSian. 7ate �- Applicant � � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � Thissection neetl not be mmpletetl if the permit is for one huntlretl ($100) or ess). I certity Ihat in [he Performance of ihe work fo� which his p¢rmjt i5 issuetl, I :hall noi employ any person in any manner so as o c me subject to the Norkers' Com sation Laws�of Califor�i�� �a[e Si9nature � \��� �— NOTICE: If,.after ma ing. this tleclaration, you shoultl.become subject to the Norkers' COmpensation provisions of the Labor Cotle, you must forthwith :omply witM1 sucn provisions or this permit sM1all be Ceemetl revoketl. CONSTRUCTION IENDING AGENCV � ' - � I hereby afFlrm�that there is a construction lentling agency tor the performance N the work I for uhich ([iic Qe�rpi'�is i55uetl (Section 309] Civ. CJ Lentler'z Name 1V l)TV _ Lentler'sACtlress_ � ' ' OWNER BUILDER OECLARATION � I hereby affirm that•I am exempt from the Contractor's License Law for the /ollowing reason (Section �031.5 Business antl Professional Cotle: Any tlry or counly which require5�a�pe�mit to const�uct, alter, imp/ove, tlemolish o� repair any structure, prio[ to Its issuance, also require5 tM1e applicant for such permit to file a signetl slatem¢nt that he/She is licensetl pursuant to the provision5 of [he Contractor•5 L'icense Law (ChaOter 9(commencin9 with Section 70�0) of Division -3 ot the Business antl� Protessions Cotle) or that he/she is-exempt =bom antl� the basis for the allegetl ex¢mption. Any violation o( Section .5 by any applicant tor d permit subjects the applicant [o a civil Ity of not more than five huntlretl tlolla�s ($500). � �1, as owner of �the property or my employees with wa9es as their sole compensalion, will tlo the work, and the structure is not intentletl orbfferetl for sale (Section 7044," Business antl Vrofessional Cotle: 'The Contractor's License� Law tloes noDapply to an owner of a property wno builtls or improves thereon, antl who tloes such work him5elf/herself ot th�ough hi5 or h¢r own employees, provi0etl that such impravemen[s are not intentletl or offeretl for sale. If,.however,¢he builtlinq o� imp�ovement is soltl wlthin one yea� of com- pletion, the'owner will have the burtlen of proving ne/she tlitl not builtl or im- prove torthe ourpose oisale). .' . ��' I; as owner of the property, am excluslvely cont�ac[ing with licensetl con- tracto�5to consttuct [he project ($ection ]044, Business antl�Profe55ion5 Cotle: The ContraCtor's Licanse Law tloes"not apply to an owner ot property'who builOs,or improv¢s•thereon, antl whb conGacts for such projects witM1 a con- / — G�� � �?J �. 1v� � , TYPE OF CONSTRUCTION NEW .ADD ALTERATION REPAIR � ❑ CpNVER510N ❑�.DEMOLISH � OTHER ' � '- � " DESCRIPTION OF WORK[USE OF BLDG. �<<%V ��' �' P�T � v--- �� A•P• #- i(Z(�� (��N���.� ' � ' � S MainBuildi TVPEOFPERMIT GRno1NG OVNoi1TION STRUCTURAL � T F,ronU 3 ' ��TENANT ❑ ELECTRICAL •❑ PLUMBING ❑ MECHANICAL B Rear � ❑ OTHER � � � � � ' �: PROJECT DESCRIPTION 5c]. FT. , � Z� oCCUPaN v - C- Right CONSTRUCTIONTVPE � � VALUATION'$ O i g Left' ZONE GRA�IfVG CU. VDS. ' � ACRES' � Ping. Ref. # � Remarks: � ' ' , � Planning Notes: /?C- `SZ/— c�P� S , ' Sink' ' <flow Preventer � ' � sflow I�rigation . Dishwasher ,• � ' ' Drinking Fountains . Floor Drains Floor Sinks { � I Gas Service � Outlets � Interceptors � KitchenSink,. . . � Lavatories ' P-TraP RoOf Drains � . ', ' � i Reinspec[ion Fee, $15 loiler _ � luct - Under Ground � )uct - Structurel � tracCor(s license �pursuarit tothe Contractor.'s License Law), f,am aware that Exhaust Systeni ❑ Multiple ❑ � proof o��their Worker'S COmpenSation in5urance.shoultl be provitletl [o me. _ ❑ I am exempt untler Section B: & P. C.,for this reason Firepl/Fact Blt. ICBO # ' oa�e' p �l.nl�w - Heating Syitem�& Ducting � � I nereby certify thatJ have reatl�this application ana state that me aDove� ' �0-100,OOOBTU �100,OOOBTI information is correct. I a9ree to comply with a11 city antl county ortlinances. ' . antl state laws�relating to builtlin9 construction, antl hereby authorize repre- � . ,, sentatives � of'. this cit enter i F a i above-mentionetl� qqrop ty for ., ', � inspection purposes. � I Q�/�� — Siqna[ure : . .,`4�16q at t F$�_ � � � - �, - ; OriJers'�Licenze o � 55 � � � ,)= , Reinspection Fae � $15�^ 9F 0865�46, rev. 10/84 VJnite - Builtling; Canary - Applicant; Pink - Acwunting; Goltlenrod - Assessor Showers Service Sink Sewer Cap ir , �� ��I ��I $Oldf COIICCIOfS ' Solar Piping , � - ' Solar Tank � � Swimming�Pool w/Spa' ' Urinat � Water Closet � Water Heater . ..Water Service' - �� -. � - � Auto-Wash LaundryTrays ' . 0 ' .' . " ". ; ` _ ' i 1 + ' Issue Fee $ 3 CAL, -FEE Hood or Typel ❑ , � Canopy Typell ❑ , Refrigeration System ' � � Oo-i'oo,000eru Oiao;000eri System Repair/Alteration _ FireDampers . � - Reaisters . � � . laue Fee t $. 3 � , � - , -. 6867 I I /07/86 i , . . , � � � Accessory Building• 41.75 7L . • � , Z � ' O N � 1 . __' _ .. . p _ . . ,N . � G . � Parking R E Q M r T S FEES � ' n . Automatic Washer� � � '� Transformer ❑ 15-50 KW �' 'z '. Construction.PoleSub. ��,50+KWi ` - � ; � Cooking Uni[ �� , Meter �up to 100 amps ' ' Dishwasher'.' ' _ ` Meter. �ober100amps � � Dryers ❑Gas �OElectric . Sub Panel ' � ' � � � Fan . - Motois �0-t HP 01X-,B ;, � F.A.U. �' ' '' - � Ina Sblar �9-15 HP 016-15+� Fixtu�es � Microwave ' i Device Boxes : Pole Light� � i � Outlets � Range � . .Switches-` ' i - -i' ' - Sign : -' -' . . .-' - Garbage Disposal ' I Standing Sections ' ' Generator �0-5 KW��5-15 KW Tresh Compactor ' � � f I 1 } ' I ' � 1 1 Reinspection Fee ,$15 Issue Fee i � �� $ 3 � DEVELOPMENTSERVICESR�/ �y�R� ENTS: � ; ' , � f' � Zoning Approved By ✓ � ` " ' Date // , v Building Approved By - _ — '� � Date Appliqtian Issued By ' �Dat . e_��L���lZ� � � ' � � ` SUMMARV OF,FEES : � �• � � � � � ' ' BUILDING PERMIT $ ��. �. -SMIP � _ ; _ $ D..��� PLAN-CHECK j �$. ,___L1'2iL.J— ' PERMIT�' _ . . .. ..., P.LUMBING � $ �� ISSUANCE � $: " ENERGYP.C. '$' � ' PLAN CHECK 25% $ � " ELECTRICAL �, - $ � ' �,GRADING� - �$ � � PLAN.CHECK 50% $ � �MICROFILM $ ' -' MECHANICAL, $ .TOTAL FEE , $ ' �_ /� � '` � � PLAN CHECK �25% $ ' ' � � � � ' � � POOL & SPA �' CONSTRUCTION AND PLANNING " � ��'�' Date � Inspector �- . Date Inspector \ :� APPROVALS ' Permit # � �' , APPROVALS Permit # � ` 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 � i . , �, 56. Rough Plumbing & PressureJest � � ' 6. Electrical UFER Grnd. � �- 57. APPROVAL TO COVER-GUNITE � 7. Footings � ' ' ' 58: Electrical ConduibUndrgmd. ,, y 8. Foundation � - , - 59. Gas Pipe, � Undrgmd., Test , 9, Water Pipe-Undrgrnd. � -. 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System �� , 61. APPROVAL TO DECK � � 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final ' 12. Sewer Cap � � � � 63. Heater & Vent-Final � • � � 13: �Roof Drains_ � 64. Plumbing System - Final'' - � ' 1,4.� Rough Plumbing - . � � � 65. Electrical-Final ' , 15. Rough Electrical-Conduit " ., � 66. Solar.System-Final � � i6. Rough Electric Wiring � ' � 67. Fe cing & 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 D,Gas ❑ Oil �• 23: Gas Pipe-Rough & Test � , ' ' . �72. Underground Flush � ' • ' 24. Roof Framing . . . ' 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing :. . � ' -�- 74. Ove'rhead Hydro � . �� � " 26. T-Bar Ceiling (Structural) & Monocoat �� +- � 75. Dry Chemical � ' � ' �i � 27.. Frame,and�Flashing � . � - 76. DryStandpipe � ' � 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 pomesticFinal - � . . , . �� 42. Backflow Preventer � ' � . � 43. Backflow Irrigation � � ti ; * •; � 44. Landscape Irrigation System _ , ` � • � = i' � 45. Sound Attenuation � - , . � � � � 46: Handicap Regulations � � ' , - � ' � _ 47. FINALSTRUCTURE&BUILDING ��� � . � � � � � .. �- ,���� i 48.,Special Requirements Completed , � � ' , . �•'' � r .49. Electrie Release to Edison � . • �,50. Gas Release to Southem California Gas Co � ' � ; 51.'CERTIFICATE-OF OCCUPANCY - � No. " ' Date � � 'i \ \ Aoolicant to till in all a a. e. nn� �e..0 W»n�.. nnavv boraer Iines antl a �u � ���. ne.m.»inna CITY OF. r STAIMES� C NSTR �CTION' ER IT , ' P MIT NO. (-� TRACT NO. ; LOT NO. � -UNIT NO. � ? ' ' � ' � ' , , , ( �...''�- ' �U' �� i ' � - . . I � , . . t . . -- , • Pr�jett Addre3s 3( 7 + ' ' , � � ; , i � 873� I 2/, j 5/86 � 44 50 ' 1 Applican�'S Mailing A dre55 I ' l TYPE OP CONSTRUCTION NEWI 'ADD A ER ION REPAIR ' - � /� � ❑ CONVERSION ❑,DEMOLISH O OTHER � A p. # � ' j � I Zone ' Owner's Namer � � Phone . �� ' DESCRIPTION OF WORK/USE OF BLDG�� � ' . � � � � � � i Address i 1 � ' � S Main Buildin9: , � � Accessory Buildingi t . Arch/Eng: icense No. � j TVPE OF PERMIT � GRADING FOUNDATION STRUCTURAL '. T Front� � � � � � ' ' , ���; p Addre55 � ' ❑ TENANT, ❑ ELECTRICAL. ❑ PLVMBING ❑ MECHP,NICAL � . B Reaf : ' � I ' 1 ' N � O OTHER � ' � � ' %� � • � Contractor's Nam ne pROJECT DESCRIPTION 5 . F � ' oCCUPa C C �Right' ' - - "" �' "" � " - � - �- ". j - ' - ' � 'G' Address (mailing) � � � K . � • ' . � � , . 'CONSTRUCTIONTVPE � VALUATION$ � S. Left' , . . � I , j City�License No. � � ZONE � � '" GRADING CU. VDS. ACRES � � ' . ' � ' R LICENSED CONTRACTOR DECLARATION . PIn9..R¢S. � ' P2/king.Req;/P�Ovided � �, E 1 hereby atfirm that I am licensetl untle� provision5 0( Charte� 9(commencinq Remarks: � � ' ' '' - t Pl3nning NOL¢5[ � j � ' ' � � M wifh Sectlon ]000) of Division 3 of the Business antl'Professions Cotle, antl � ' 1- � '� - ' my license is in JI e antl ettect. � , � � I ' ' • ' I ' � : � _ i � � � i •' • � , T License lass Lic 5e No ' ��J �� . • 5 oate� - Signature � PLUMBING �FEES " ' ' � ' � �1 ` WORKERS' COMPENSATION DECLARATION - - ' - . •� � - - � _ . ' , . ,� nereby afiirm that I have a oertificate oi wnsent co selt-insur or a certificate . Bar Sink � SM1owers , � -' � �� ELECTRICAL� ��• FEES '� � ," VJorkers' Compensation Insurance, or a�certifietl copY thereof (Section � gackflow Preventer '-. ' Service Sink - � • 1 ' • � � �o, Lao. �j <��/,, �� ' AummatiqWasher �� Transfor'mer-� 15-50 KW � ,' �' �'olicy No. ��I ���//�/ Companyl{S{�L{(1(�� Backflowlrrigation SewerCap . � ' • Constructiori:PoleSuh.. ' • -� 50+KW ' 8 Certifi¢tl Co y' hereby fumishetl. ce i_tl -tiletl�witn the city ivi � eathtubs . Sewer_Connection , ' .�- Cooking�Unit � . � Meter ❑up to 100 amps ,� Oate Applicant � , , . � - ' EXEMGTION FROM WORKERS' COMPENSATION DE A ATI rv� Clarifiers . �' � Solar�Collectors� -��� ' � Dishwasher . � Meter �Ove� 100 amps �" r (This section neetl not be complete0 if the permit is tor one hu r ($100 or ' ' - less). � Dishwasher ' � Solar'Piping _ Dryers •OGas OElectric ' � Sub Panel � ' I certify Ihat in the performance of thG work tor whith this pe�m�t is iSsuetl, I , ' ,' � shail �not employ any person in any manner so as to become subject to the Drinking Fountains ' Solar Tank • Fan � ' Motors �0-1 HP 01 %- B ' Workers' Compensation Laws of California. , . Date ' ' Si9nature � Roor Drains ' � Swimming Po01 w/Spa p,q U ' • . , � ' ' � � . NOTICE:Jf, after making this tleclaration, you_shoultl. become subject to the _ _ � Inc. Solar �9�15 HP 076-15+ Workers' Compensation provisions of the Labor'Cotle, you must torthwith • FloorSinks Urinal � Fixture5 � ' comply wilM1 such p�ovisions o� this pe�mit shall be tleemetl revoketl. Mic/Owdv2 , CONSTRUCTION LENpING AGENCV Gd55ErvicE . OuLICLS �Wate�C105¢t D¢vic¢BOx25 ' � - I M1e�eby affi�m tM1at Ihere is a constiuction lentling a9ency to� the petformance POIC Light of Ihe work for which thi5 permit is issuetl (Section 309] Civ. C.) ' . ' . , � Interceptors Water Heater Outlets � Ran Lentler's Name 9e ' � �entleCs Atlaress � � .�� Kitchen Sink � . � Water Service . � Switches . � � - ' Sign ' -' � ' " ' � ' OWNER BUILDER DECLARATION ' ' . I hereby affirm that'I am exempt irom the Contractor'S l.icense Law tor the LdvdtO�ieS � A�tO-Wdsh following reason (Section 7031.5 Business antl Professional Cotle: Any city or Garbage Disposal Standin9 Section5 county which requires a permit to construct, alter, improve, tlemolish or reoair p-Trap Laundry Trays Genera[or �0-5 KW ��5-75 KW Trash Com actor � � any struc[ure, prior to�its issuance, alzo requires the applicant for such permi[ P • t0 file a signetl statement that he/she is licensetl pursuant to the provisions of ROOi D�dinS ' the Contractor's License Law (Chapter 9(commencing with Section 7000) ot . � -Division 3 of ihe Business antl-Professions Cotle) or thab'he/she�is exempt - - - � � - - , ' _ :.i,efrom antl� the basis for the allegetl exemption. Any violation of Section . , � � � - . � , ' � � � �':y,:.5 by any applicant for a permit subjects the applicant to a civil ' ' - � iity ot not-more than tive hunared aollars (g500). - ' 3 , • , � LI� 1, as owne� of �[he, property o� my em0loyee5 with wa9es as [hei� sole ReinSpeitiOrl F¢e $15 ISSUe F¢e $� � _ , _ � compensation, wi11 tlo the work, antl the sVucture is not intentled or otteretl Reinspection Fee $15 ' luue Fee ' � . _� $ 3 , for sale (Sectiam 7044,� Business ane Protessional Gotle: The Contractor's MECHANICAL FEES License law tloes notappty to an owne� of a property wha builtls or imp�ove5 � � �, tbereon, antl who tloes sucn.work himselt/herself or throu9h nis or her own . � � �DEVELOPMENTSERVICESREQUIREMENTS: -' . - employees, provitletl that such improv¢ments are not intentletl or offeretl for BOiI¢r � HOOd O� Type I ❑ ' , ; . � ! ? sale!' If„however,:the builtlin9 or improvement is soltl within one.year of com- � Cdnopy Type I I ❑ '�Zoning Approved By . ' Date - pletion, the owner will have ine burtlen of provin9 he/she tlia not builtl or im- Duct - Under Ground � Building Appmved By - - • Dat� ���ove fo� lhe pu�pose of Sale). � _ � , -. � ) .I, as owner oi the property, am exclusivety mntracting wiM licensetl con- Duct - Structural . Re/rigeration System ' Applitation Issued By ' [� -• Dat � tractorsto construct the project (Section 7044, Business antl Profe55ions Code: �' _ The Contractor's License Law does mt apply to an owner ot property wha � Duct - Ventilating . ❑0-100,000 BTU ❑100,000 BT.0 .� '- 5 N1M aV�OF�FEES , �- - builtls or'improves thereon, antl wM10 contracts for sucb projects wlth a con- � - - - . '{ i 5'�, r tractor(s).ucense.pursu5nt to'the Contractor's License Law). I am aware that� - � � ,� BUILDING PERMIT ��$ -'SMIP ,- .$ proot of Iheir Worker'S Compensation insurance zhoultl be provitletl to me. � E%hduSt SySt¢m ❑ Multlpl¢ � ' Syitem Repair/AlteretiOn �_ . • C - ,_ � _ - - � PLAN CHECK ,: �$� PEFMIT � '� ' ❑ I am exempt untler�5ection B. & P. C. for this reason ' FirepVFact. BIL ICBO # � Fire Dampen � c � -• � pLUMBING :$ ` ISSUANCE $_ _ oate ' owne`r ' Heating System & Ducting Registers . . � . ' . � � . PLANCHECK �25% $-_ 'ENERGVP.C. $y � . i hereby certify mat i have read this appiicatlon antl state that the above ❑0.100,OOOBTU �100,OOOBT "- ELECTRICAL : GRADING ,'$ � ' ' infarmation.is mrrect. I agree to comply with all city and county ordinances ' ' � ,'$ ' ' ' , � antl state laws relating to builtling'construction, antl hereby authorize reDre-' . ' ' � pLAN CHECK ��50°.6 =� � ''MICROFILM $ ' sentatives ot his city t enter Pon C above-mentionetl p�ope� fpy � . $ ' - ,. .. inspection p s. `�(/_� ' ' - ' ' MECHANICAL $ � TOTAL FEE. $ ' •�S� - Signature � Date����'/� Reins ection Fee ��$75 , Issue Fee orivers' icense or 55 �F P � $ 3 • PLAN CHECK 25%. $. MF 0865-46, rev. 10/84 � Wnite - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor � CONSTRUCTION AND PLANNING . POOL & SPA .. . , APPROVALS Permit# � Date , �Inspector qppROVALS Permit# � � ; Date Inspector � 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . , ,' � 2. Soil Pipe-Undrgmd: • � 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. � t '' " � 8. Foundation' , 59. Gas Pipe, � Undrgrnii., Test .` . t . 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 & Vent-Final . - 13. Roof Drains �. 64. Plumbing System - Final . � 14. Rough Plumbing - ' � ' 65. Electrical-Final' � � � ' 15. Rough Electrical-Conduit .' 66. Solar System-Finel _ � � � 16. Rough Electric Wiring ' 67. Fencing & Access P,pproval � • 17. Rough Wiring Sign - - � 68. APP.ROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling � 69. FOOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough FactorY fi�eplace 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 Sheafhing 74. Overhead Hydro : 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - ' ' � 27. Frame arid 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. Pinal 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 Attenuation ' � ' • . t . 46. Handicap Regulations � � , � •- , - t • � ' 47. FINAL STRUCTURE & BUILDING b � p � ,,.-� . � . ' . 48..Special Requirements Completed - � ' , " 49. �Electric Release to Edison � ' �� � � � � 50. Gas Release to SoutFiem Califomia Gas Co � -•.+'. 51. �CERTIFICATE OF OCCUPANCY • • . , 'n No. Date . . \ \ Fy � Aoplicant to fill in all spaees exeept those within heavy bortler lines antl sign all aporopriate aeclarations. l CITY OF COSTA MESA CONSTRUCT/IOIN P(,,ER/'M)IT ' PERMIT NO. , `� TRACT NO. ' L T NO-. I UNIT NO! • ' � � , � � / Y ! / %� /'�� i � ! .r !' r,� :.L_ . . . � � . � � ' ' Pro'ectAddress ���� /i(e7�%�l���i/ 7[[� � '' S'F `� �� ' ' ' ! � ! ' , � - .�c//.� �( � � � f.�{J �C��J%�l� ' 7l.nr�� . ApplicanYSMailingAddress TYPEOFCONSTRUCTION NEW, �ADD ALTERATION REPAIR �/ SS iC� I iJ J'f(� y++A .NI.1�F� I'I -❑ DEMOLISH ❑ OTHER �n �{ i • / ❑ CONVERSION 7rrn ,� � Phone�C �j_ ��j6 A.P.#_�_ _i Zone � Owner's Name� �'�" V DESCRIPTION OF WORK/USE OF BLDG. � � —' Address 7ir .,,. .r1.., lli.G � Fr.I+n ��� PS� � ' , � � � ' S Main Building: ' . �' I Accessory Building: Arch/Eng.� �j !^,�*' �/� b ' License No. 7- /9 � TVPE OF PERMIT GaaoirvG FOUrvDATiOrv STRUCTURa� � 'T Front i � � 1 p Address I y �/�(./, ,V �/ � ❑ TENANT ❑ ELECTRICAL� � PLUMBING � MECHANICAL � A Rear ' ' � . � � � � N Contractor's Name % ���f�r�'Phone . `� ��� ; � ��THER ' _. � -. . . _ _ : , _.,� _ _ , � � PROJECT DESCRIPTION 5 F � oGCVPANCV C� Right. N Address (mailingl �v r �� �A� t� �P '�' � ' Q' (f �; . K = - G � /� , - � CONSTRUCTIONTYPE �P �� ' VALUATION$ �� r y' $ �eft , . _ ' R City License No. ZONE � GRADING CU. vDS. ACRES p�ng. Ref. # � � Parking Req./Provided + E LICENSED CONTRACTOR DECLARATION Q I hereby affirm Ihat I am licensetl untler provisio�s ot Cha�te� 9(commencing Remarks: - � - ' ' - Pl2nning Not25[ � � - � witb section �000) oi Division 3 of the Business antl Protessions Cotle, antl � 1 i M my license is in /(1,ILforce ana effecL .,, � `> , � . ' ' ' � i ' ' . . � , T License lass L S�� - • Liaense No: �� �9 ✓� - . , S Dare ��'� �n e��ae . K ni. 17- Unn7ni � - ' - PLUMBING . .FEES _ ` � � ' —�i�r,.TGy�� C� • WORKERS' COMPENSATION DECLARATION V � Bar $ink � Showers '� ' I hereby atfirm that 1 have a certiticate of consent to selt-insure�r a certiticate ' , . ELECTRICAL ,, FE of Workers' Compensation Insurance, or a cert�fietl copy thereof (Section , Backflow Pfeventef � ServiCe Sink � ' ' 3800, Lab. Cj�/� (� ,c�.�i�� � � � . � Automatic Washer - Trensformer ❑ 15-50 KW PolicY No.7lAI`Z'�e {1At� •'�,. ComPan ��� �f�.Vf� _ . . _ . , , - . , � y_ Backflowlrrigation �SewerCa ❑50+KW' eCertifietico / - P . Construction'PoleSub. � �. , py) s M1ereby furnishetl. ,nl . Ce tifiea RY'�5 tiletl wi[h�fhe city B�iltl�{ng Di��s�on. // ,� Bathtubs SewerConnection � Cooking Unit . Meter ❑up to 700 amps Oate���-1� � qpplicant ��XJ/21A /.1(��BHf ' . � EXEMPTION FROM WOHKERS' COMPENSATION DECLARAT,ION Clarifiers � Sola� Collectof5 ' ' Dishwasher . Meter ❑over 100 amp5 (Thissection neetl not be completetl i( the permit is fo� one huntlrveii ($300) or ' - ' _ less . Dishwasher Solar Pi in � ' Dr ers ❑Gas ❑Electric ' . � ) . P 9� Y .. Sub Panel 1 certify that in the per(ormance of the work for which tM1is perm�t is issuetl I - ' shall not employ any person in any manner so as to become subject to tf�e Drinking Fountains Solar Tank i Fan . Motors �0-1 HP 01'/: - 8 � Worke�s' Compensatian Laws of Califomia. , Date Signature Floor Drains ' Swimming Pool w/Spa � - � F.A.U. -' NOTICE: If, after making this tleclaration, you. shoultl become subject to tha Ina Solar �9-15 HP 016-15+. Worker5' Compensation provisions ot the Labo� Cotle, you mu5t forthwith FIOO�SinkS U�indl ' Fixtufes : � ' compty with such� provi5ion5 or thi5 pe�mit shall be tleemetl revoketl. � Microwave CONSTRUCTION LENDING AGENCV � GaSSefvice �OuUets WaterCbret DeviceBOxes � � poleLi ht ' � I hereby affirm that there is a Construc[ion lentling agency to� the perfo�mance 9 ot the work for whicM1 [his permit is issued (Section 309] Civ. C.) Inte�cepto�s . Water Heate� OuHets Lenaer•s Name � Range Lentler•s Aaaress Kitchen Sink � Water Service ' Switches � Sgn ""- OWNER BVILDEft DECLARATION � . � I hereby affirm that I am exempt from the Contractor's License, Law for the Lavato�ies ' � Auto-Wash Garba e Dis osal following reason (Section 7031.5 Business antl Vrofessional Cotle: Any city or 9 P Standing Sec[ions county which �equires a permit to constvuct, alte�, improve, tlemolish or �epair P-T�dp L2undf T�d 5 � any structure, prior to its issuance, also rEquire5 ihe applicant tor such permit � Y Generamr DO-5 KW �5-15 KW T�25h COTpdCtOf � to file a si9netl statement that he/she is licensetl Pursuant to tne provisions of � Roof Drains • � the Contractor's License Law (Chapter 9(commencinq with Section 7000) oi i Division 3 of t�e Busine55-and Prote55ion5 Cotle) or that he/she is ezempt -- theretrom antl the ba5i5 for the allegetl exemptiOn. Any violation of Section - • . ]031.5 by any applicant for a�permit subjec�s the applicant to a civil �enalty of not more tM1an five huntlretl tlollars ($500). � I, as owner of tlie oroperty or my employees with wages as their sole ReinspeMion Fae $15 ISSue Fee $ 3 compensation, will tlo the work, antl the struciure is not intentletl or otferetl Reinspeetion Fee $15 15sue Fee $ 3 - for•sale (Section �044, Business ana Professional Cotle: The Contractor's � MECHANICAL FEES, l.icense Law tloes not apply to an own¢r Of a proPerry wM10 builtls or improves - thereon, antl who tloes such work himselt/herselt or throu9h nis or her own DEVELOPMENT SERVICES REQUIREMENTS: . employees, prOvitletl that suGh improvements are not intentled or offeretl for BOil2� HOOd OI'- Typ¢ I ❑ � - sale. It, howevet, the builtling o� imOrovement is soltl within one yea� of com- C,3nOpy Typ2 II ❑ Zoning APProved By D2t@ pletion, the�owner will hav¢ the burtlen of provir9 he/she tlitl not builtl or im- Duct - Under Ground rove for the purpose of sale). Building Approved By - Date � 1, as owner of the property, am exdusivety contracting with licensetl con- Duct -Structural Retrigeration System Application Issued By 'a' Defe ��r � tractorstd constructthe project (Section 7044, Business antl Professions Cotle: , The Contraclor's License Ww tloes not apply to an owner ot property who Duct - Ventilating ❑4100,000 BTU ❑100,000 BTU SUMMARV OF FEES builtls or improves thereon, antl who cont�acts for such projetts with a con- � _ , tractor(sl ucense pursuant to the ConVactor's Li�ense Law). I am aware that Exhaust System ❑ Muliiple ❑ System RepaidAlteration BUILDING PEfiMIT $ ���- SMIP $ ' proot of their Worker's Compensation insurance should be provitletl to me. PLAN CHECK $ PERMIT . ❑ I am ezempt under Section B. & P. C. tor this reason Firepl/Fact. BIt. ICBO # Fire Dampers PLUMBING $ - ISSUANCE $ Date � Owner ' Heating System & Ducting' Registers pLqN CHECK 25% $ ENERGV P.C. $ I hereby certify that I have reatl this applicati0n antl state that the atiove� ❑0-t00,000BTU �100,0006T GRADING $ information is correct. I a9ree to compty with all city antl county ortlinances ELECTRICAL $ ana state laws relating to builtlin9 consiructlon, anG hereby authorize repre- � $ MICROFILM $ sentatives of�this city tp enter upon the abo�e-mentionetl property fon � PLAN CHECK 50% ` inspectian ourpos�s. Q� � /7_ //_ �{� MECHANICAL $ TOTAL FEE $ Signature �S/O✓.� ( ii ,iE J� /i Date � � �� Drivers' License�r 55 �� �✓-'� Reinspection Fee '$15 � Iwue Fee $ 3 PIAN CHECK 25% $ �nr naus_na .a� t nina wnuo . w��un�..,.. r�..�.., _ n��u.�..�. o�.,� _ o�.,.��,.��..,.. c,.ine...... .,...,...... � CONSTRUCTION AND PLANNING � � POO� '4 . . . � APPROVALS Permit# �Date Inspector � qppROVALS Pc # Date � Inspector 1. Temporary Electrical Service or'Pole � , 52. Pool & EquipmeM 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. ' �' S. 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. Elecfrical-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. REQUIFiEMENT � 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 � � - � 26. T-Bar Ceiling (Structuraq & Monocoat � 75. Dry Chemical� - ' � 27. Frame anil 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. Electriral 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. Backflow Preventer � - • 43. Backflow Irrigation - ' ' . _ , . � 44. .Landscape Irrigation System - � � � ' 45. Sound Attenuation � � ' _ ' . � ' � � 46. Handicap Regulations - � � . 47. FINAL STRUCTURE & BUILDING , - � - � 48. Special Requirements Completed : - ' _ . ' 49. Electrie Release to Edison � � . , � 50. Gas Release to Southern California Gas Co � . � • 51. CERTIFICATE OF OCCUPANCY ' . � No. Date ' - � ,�y Applicant to 1ii1 in all spacez except those within heavr Ooraer lines ana sign all aDoropriate tleclarations. ' CITY OF COS�A MESA �CONSTRUCTION�PERMIT,•�" � �T NO. TRACT N0. � � LOT NO. ; .UNIT N0. � ' �J -� . . � � j ' � . � �= � ; - 2ss�.7 33�3' , +gs . -- . , � . , � �4247 iai iie6 . � -�e �T;, Pro�ec[�Addcess ?i�'11� �(9vN �� �lv� ��. � . , � � , _ , , Q . , � I 46. { �y ' / t - ' t^ ,.TVPE OF CONSTRUCTION NEW ADD ALTERATON REPAI R � � � � ' � ' A(,p�l[anf'sMaiYfngAddre55 i 3� `1/ +4GV`n��2�A �iV�l�' - ❑CONVERSION DOTHER � p / �7 p ~�=—C21?. � � .\c�120.h1i- �i>-�5$,6 . .� .. ❑ DEMOLISH .. . . - A.P. # . ..I' ! -1�--/^Z `. �i� ._( _� . � Zone 1� I _ Owner's Name --� Phone , DESCR PTION OF K E OF BLDG. - � AdGress 3� 11 C�NTd''L G��u�J�/L L, M �� � . �plJ �� : � . ' . ' �S Main Building: " j ' Accessory Building: .. Z � � TVPE OF'PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL � E Fronf � � Arch/Eng: � License�No. . T i� I�� �E � O � � ' � � �,�'� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANIGAL , Rear : � � . Address ' '� ��/� � - 6 2�� � ' ' ' N �SELF E/!i�/ - , i�:� � :..� �OTHER, � . . . � . . , � Contractor's Name Phone � �. , : o � _ C Right -" -'� 5 % � � � � - � i- ' N- � Address (mailingl � � , 'PROJECT DESCRIPTION Sq. �FT. � occUVANCv K � r � G � � • � CONSTRUCTION TVPE � VALUATION $ ' g Left � � (,., �., . '� R City License No. - � ' ' ZONE �' GRA�ING CLL VDS: ACRES Ping. Ref. # ' � ' "' Parking Req./Provided E LICENSED CONTRACTOR DEGLARATION � . � �. � � p - � p � � � ' Q I hereby a/firm tM1at I am licensetl untle� provisionsof Charter 9(commencinq ''Remarks: � C� - �� lI�Z �� ,a ��6• : P�anning Notes: � ' � M with section 7000) of Division 3 of the Business antl,Professlons Cotle, and`_ . ' �` T my license is in full torGe antl eTfect. � • • , `/�. '["'A / � 1i/_ �+ $ License Class • �icense �`l0. �- J � a �� � , . , oate � Signature ' � ��- . � .PLUMBING - ' - FEES. � � ' ' ' � ' � s. WORKERS'COMPENSATIONDECLARATION- � ' �BarSink� ' " • ' Showers ' ' ' ' ' - " - ' ECECTRICAL � FEES '+� hereby afti�m that' I have a certificate of mnsent to sel4insure or, a certificate � � Workers' Compensation InSurance, o� a certitietl copy the�eof, (Section . - ' - . � � -i � � - � � � � , Backflow Preventer - Servire Sink � .. Automatic Washer � � �- Transformer ❑ 15-50 KW . " d00, Lab. CJ � ' � � • _ i r - - � � I Policy No. � � ' Company � Backflowlrn9ation ' , � � SewerCa -' � - . . . �. q� SO+KW� � ' , eCertifietl copy is heretiy iurnishea. � � . . ' P ' - ' , Construction'PoleSuh . . _ . . � . - Cerfifietl mpy is.filetl.with�the dty Builtling DrviSion. ' Bathtubs ' SeWe� COnnEctiOn ' � Cooking Unit Meter ❑up t0 1�03mp5 Date� � APPlicant - . n •• - . . . �- ' ' ' • • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � j ' J � Clarifie�s � - Solar Collecrors � Dishwasher � ! � ' _ Meter ❑over'700amp5 ` ' � (Thissection neetl mt be completetl i( the permit is for one huntl�etl ($300) or s ' - �"- ; � ' ' •�� less). � . . , � '?• DishwasFer� . " Solar�Piping ' - Dryers OGas �OElectric � � Sub Panel ' . � . I certify that in [he pe�fo�mance ot tlte wo�k to� which this perm�t is issuetl I ' '- � � }' ', h� shau�not employ any person in any manner so a5 t ecom-e s; bjecl to the .^,.� Drinking Fountains ' Solar Tank 1. � ' Fan � ' . Motors DO-7 HP �1 %: 6 � � Workers' Co nsation Laws of Calil�rtKa�_ \ �. ' ' - ' � - _ . . � �ate ' � Si nature �LK- U A�w�h " � ' ' - � Inc.Solar �9-15 HP��76-15+ , �/ � 9 �'`� � Floor Drains � . Swimming Pool vu/Spa • F.A.U.�" � � /\ NOTICE: If, atte� making this tlecla�ation, you shoultl become subject to fh¢.. . , � ' ; � Wo�ke�s' Compensation provisions of tne Labo� Cotle, you must forthwith � ROOf$inks Urinal FiXtu/25 comply with such' provisions or this perinit shall,be tleemetl revoketl. Microwave � f O CONSTRUCTION LENDING AGENCV ' � � . GaSService . « Outleti Water�CloSet � 'f � DeviceBoxes ' a I hereby affirm�that there is a[onstruction lentling �a9ency fo� tne pe�fo�mance � '� �' �°�� ,_ � Pole Light• � � j of the work � for �(n'c h' ermiH is i5suetl (Section �309] Civ:j C.) '�jnterieptors , ��- � WdtE��H¢dt¢t' '� � E � � � Lentler's �Name �-n�'�� . . . � � � �; Outl¢t5 �" R2nge , � ~, %`_ . Lenaerts Atltlress ' � � � ' v : Kitchen.Sink � . . Water Service �fp '(�/� �2 pQ 2 Switches • � - Sign , " ' - � - � O' OWNER BUILpEN �ECLARATION � ' - ' I hereby aHirm [hat 1 3m exempt frOm [he Contfactof's License Law (of th2 L'dvaLOIiCS . '�a � � " AutO-WdSh �� �' (�idlbd ¢ Di5 0521 � ' tollowing reason (Secfion ]o31.5 Business antl Pro�essional Cotle: Any city or - � - - �� 9 P Standing Sections . • count which �equires�al etmit [o const�uci, alter, im rove; tlemolish o� �e0ai� � �;!�; �- . � ' Y o P P-Trap Laundry Trays � Generator'DO-5 KW �5-15 KW Trash Com actor any sVucture,.prior to-its issuance, also requires tne applicant�for such permit P 1 to fiie a signetl statement that he/she is licereetl pursuant to the provisions of :'.ROOf DfdinS ' � • �� ' ' ' the Contractor's License �Law (Chapter 9 (commencing witb Section ]000) 01 ' ' i ' � � i , ivision'3 of the BuSiness�antl Professions Cotle) or that he/she is�exempt - -- , - - - - - ��'�„;ereirom antl the basisfor the allegetl exemption. Any violation of5ection .' ' . � ' I . , • , ' J31 5 by any applicant for a pe�mit subje[t5 th¢ applicant to a civil ' � , �' ��7epafty of not more than tive huntlretl tlollars ($500). , - ' � � ; � � , *�I, as owner ot�the D/oPerty or my employees witn wages'as their sole ReinSpBCtion Fee $15 � � ISSue Fee $� 3 , � �� �mpensation will tlo'the work, antl (he st�ucture is not intentletl or off¢r¢tl � RBinSpection F¢B �� $15 ISSue �F¢e i � � �$ 3 r'sale (Se<tionr�044, Business antl Professional Cotle: The'Gontracmr's � - ' � MECHANICAL' .FEES• - icense Ldw tloes not apply to an owner of a pro0erty who builtls or improves � ' , ,. , thereon, antl who tloes such work himself/herselt or through his or her own i . � � ,DEVELOPMENT SERVICES REQUIREMENTS: . � ' � employees, provitletl [hat such improvements are not Intentletl o� otte�etl for BOil2� . HoOd O� ' Typ¢ I f❑ ' � _+ 1 �V �� _. sale. If, nowever„tM1e builtling or improvement is soltl within one year ot com- ' � � Canopy . Type I I �❑ � � � Zoning Approved By �- ' Date pletion; the owner will have the burtlen of proving he/sM1e dltl mt builB or im- Duct - Undef Gfound . � j ' ' � � Building�Approv¢d By � Date Z '• prove for ttie purpose of sale). ' - , " i , . �' ❑ I, ai owner of tM1e property, am exclusively mntractlng with licensed con- � �ucl -Structural � � Refrigeration System � �/ GY9 Appli�tion Issued 6y � 1 _Datx [e /� T�actors [o construct the project (Section ]044, Busine55 antl Professions Cotle: The conVactor's License Law tloes not apply to an owner ot property who � Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU ' 7. . S�NJ[N@RV OF�FEES ��� � - � " builtls:or improves thereon, antl who contracts for Such projects wrth a con- - . .. tractor(s) I¢ense pursuant�to,the Contractor's License Law). I am aware that ' - ' - BUILDING PERMIT $ �L� � - SMIP � $- �� prooi ot.their Worker's Compensation insurance shoultl be providetl to me. Exhaust System ❑ Multiple ❑ System Repair/Alteration , . . - � PLAN CHECK - $. � PERMIT - L7 1 am exempt untler 5eccion '- � e P. C. tor this reason Firepl/Fact. BIG IC60 �f`- �% � Fire Dampers ' ' - �� ' � �- ISSUANCE �$: � � __- .� �A . � .. ' - PLUMBING . $_ , - S, 00 J _ ' Dare� � Owner �'�=J� �� Heating Systein & Ducting� � , Registers � � DO PLAN CHECK � 25% '$, � � • � � ENERG�' P.C. $: i hereby rertity that I have.read this application and state mat the above. ❑0�100,OOOBTU �100,OOOBT EI.ECTRICAL'� - L �� - GRADING ,$-' ' information is correct. I a9ree to comply with all tlty antl county ortlinances' ..: � '$ ��j . - antl state laws relating to builtling con5truction, antl hereby authorize r¢pre-:, �� ,�r , " , . _ r� Z�� ��.MICROFILM_ $ �- � zentatives,of Ihis city o�ienter upo the�abq�ve-mentionea_property tor , ' , , ���' `� .I' ' - - PLAN,CHECK .50% ,$ _ ��/� inzPection PurPoses. � � -f�J�'__^��� �� Reinspection fee $15! Issue Fee � $ 3 PLAN CHECK -,25% $ � CMF 0865-46, rev. 10/84 White - Builtling; Canary - APplicanq Pink - Accounting; Goldenrotl - Assessor , t CONSTRUCTION AIVD PLANNING � ` , POOL & SPA • Date � Inspector� Date ' Inspector APPROVALS '�Permit�# ' , APPROVALS Permit # � �, . � L�Temporary Electrical Se"r'vice or Pole � . 52. Pool & Equipment Location 2.. Soil Pipe-Undrgrnd. � . . -53. Steel Reinforcement � � � 3. Electrical Conduit Utility-Undrgrnd. . � 54. Forms , 4.�Electrical Conduit-Und�grnd. � � , � � �55. Electrical Bonding � � . ' . 5.-Steel Reinforcement � ' � 56. Rough Plumbing & Pressure Test -� � 6. ElectricalUFERGrnd. �' �p Q(f, 57. APPROVALTOCOVER-GUNITE � '7. Footings , { b �(}- 58. Electrical Conduit-Undrgrncl. , ' - 8.� Foundation� �,; � � y�� D� � 59. Gas Pipe, � Undrgrnd., Test � 9. Water Pipe-Und'rgrnd. � 60. Backwash,Lines, P-Trap, � Undrgrnd.' ' 10. Structural Floor System � y� �(, ,Q� 61. APPROVAL TO DECK ` 11. Property Sewer Line & Flouse 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 . ' � .��i J � 67. Fencing &�Access Approval 17. Rough Wiring Sign � � ' ' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling ,� n 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' , FIRE DEPT. REQUIREMENT . 20. Rough Factory Fireplace ' APPROVALS Permit # ��' -_ _ z'T-�F; ,L�: . 21. Ducts, in Struc[ure , 70. Undergiound Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil � 23. Gas Pipe-Rough & Test ' 72. Underground Flush � 24. Roof Framing ' � , � 73. Undergrnd; StorageTank OGas ❑Oil 25. Roof Sheathing ` � �� 74, Overhead Hydro ' ' -. 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . • ' 27. FrameandFlashing � � r�,.�� 76. Dry,Standpipe . ��"�'`J i i. � 28. a in 'Siding . : (Z �� 77. FIXED SYSTEM FINAL�� �� � 29. Insulation• ' � �� 78. FIRE PREV. FINAL .,, ' 30. Drywall Nailing - �y d HEALTH DEPT. REQUIREMENT ',. � T 'ioP ' 37. Plaster Brown Coat 79. FINAL INSPECTION �� + 32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED „+ 33. Final Electric (n'1(-�] �[.� Notes: � ��6 h,� � 34. Final Heating & Air Conditioning ���� . �� ! �d. �� � . J � .,�,a !/' 35. Final Gas Pipe-Test�- � , f� g(0 �'dy� 36. Hood or Canopy � � 37. Final Factory Fireplace - 'G_..��f� L� � 38.' Final Plumbing . ' � . � 39. WaterService-Final � �,�-1 L�O - � - • " . 40. Gas Service-Final . - � � • 41. Solar pomestic-Final � � ' ' � � .� 42. �Backflow Preventer � ` ' � ' 43.•Backflow Irrigation � � • v � " �44. .Landscape Irrigation SYstem � . � �45. Sound Attenuation . 46: Handicap Regulations - � • • • 47. FINALSTRUCTURE&BUILDING � � � , 48. Special,Requirements Completed � - . . � 49. Electric�Releaseto Edison ' - . - j 50. Gas Release to Southern Califomia Gas Co . c� - •' 51. CERTIFICATE OF OCCUPANCY ; i' . � /� No. � � � Date ' ,� '. � � ' ���� ��� E;- - - -- ---------- - _ __ �. _ - -- - - - - � . � - `��°-� - � - - - — � � �i _ `��� - : � -- �. _ _ _ - - � �� _ `�-�- � �� __�_ ���� - + - �`-e-('�.� �� -Q-� 9� - - �; -�,.�-v-.�.°s� � - � � - - +� , -�.��- --- � - -- -- ; ; - � �����1 . csZ,.�-- ��� _- , � . , � � C�"� _ - - - , r �-3 � �� 9->-� �k i � E� �=�- � ' � . : �� ��- 3 2�a-.� 8_ � - - - �,,�....-� - C�� � �� - - - - -'i ����-L-' - - � � � . z�:�:�� COSTA MESA BUILDING DEPARTMENT P. O. BO% 31] COSTA MESA, CALIFORNIA ,�. �. V�i €� t� � E'ti p` r_ . AUG k 1959 .rt,,r,�+� ,,.-�-: � � "V� '_ Li .. FOR APPLICANT TO FILL IN ' APPLICATION FOR PERMIT AooR'S5 177 Countr � BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. � py OWNER Newnort Homes nc ��� RECEWE� BY C�ATE FECEIVE� qT IS ADDRE55 1555 Placentia � � _ S� lfU 1�"f�59 TEL. BUILDING cirr Net oi't BeBch No nooaess nacr,iTECT ��C. COSTA MESA. CALIFORNIA - OR ENGINEER NO. FIRE ADDRE55 } - (� ZONE K• ��1. Koll Const• VV� 20NE NO.OF TVPE GROIIP CONTRACTOR Tv NIO. 1217 � 1 P�^rvs .r/ � _J1— � t TEL. APPROVED ADDRE55 'NE OPti BB8CL1 � NO.• BY DATE �EG"� ��� lgg 3363 CORRECTIONS OEScniPnON NO. BLOCK TRAGT A.P. NO. OF LOT 190 �±�p Zz� uo. oF e�ocs. O � �Now orv �or IJSE OF E%ISTING BLDG. SETBqCK LINE FROM j CO REAR YARD �I{yy CENTER OF STPEET J SIDE VARD 1 RIGHT LEFT 1 ' DESCRIPTION OF WORK NEW X ALTERATION I ApDITION ' REPAIR MOVING DEMOLISH ` SIU�IEDING I �tl ✓ ROOMS .1�� STORIES � E%TERIOR WALL t ROOF , " COVERING Bb71CCO COVERING 4l0 C� L15E OF NEW ' BUILDING dwellin T �-J 1 HEREBV nCNNOWLEOGE THiT i HnVE REwD iH15 APGLICATION AND STATE THAT THE ABOVE�I$ CORRECT ANO AGREE TO COMPLY W!TH ALL CITY OROINANCES f�ND STATE LaWS REGULATING BUILDING CONSTRVG iioN. VALUATION SIGNA E F /y �] � j PERMiT FEE S � -� PERM T /, �3 / y - � PLAN CHECK $ � J'-' � AUTHORI AGENT TOTAL FEE $ `J��-- ear