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Home My WebLink About484 CABRILLO ST - Building Permits� � • ADP��ant ta fill in all spaces except those within heavy ooraer lines ana sign a11 aooropriate aeclantions. CiTv,OF-�.oSTA M'E�SA �';CO ST UCT ON P RMIT T�� T �� Project,Add�ess ��r p r � �t Applicant's Mail' ddress O rl � � Owner'sName � w � Phoneb a�5� (�A� Address r � q I Arch/Eng. � License N�� a� � � Address � � S`�' e � \ Contractor's Nam Phone �Addresslmailing) n � Ciry License No. LICENSED CONTRACTOR DECLARATION I he�eby affirm that I am licensetl untler provi5ion5 ot Charte� 9(commencing with section �000) ot Divlsion 3 ot the Business antl Professions Cotle, antl my license is in tull force ana eftect. . License Class License No. Oate ^ Si9na[ure WORKEHS' COMPENSATION DECLARATION ' I hereby afiirm that I nave a certificate oi consent to self-Insure or a certificate o} Workers' Compensa[ion Insurance, o� a certitietl coOY thereof ($ectlon 3800, Lab. CJ o , >olicY No. �O�`'��'y� ComPanY ��• �_• 8 Certifietl copy is hereby furnishetl. Ger[ifi tl copy iz fil 0 with Ihe city uiltlin9 Division. oate �UNE � qppiicant �RA-TRNTI�R(�i " EXEMPTtON FROM WORKERS' COMPENSATION DECIARATION (Thissection neetl not be completetl if the permit is tor one huntlretl ($300) or less). � I certity that in the performance ot the work tor wnich this perm�t is issuetl, F shall not employ any per5on in any manne� so as to become 5ubjeC[ to [he Workers'�Compensation Laws of California.� , Dale S�9�ature NOTICE: It, atte� maklnq [his tlecla�ation, you Shoultl beCome subject [o the Workers' Compensalion provisions o( the Labor Cotle, you must fortnwlth comply with sucn O�ovisions or (his perml[ shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby afflrm that the�e is a mnstruction Ientling agency (or the perPormance of the work for whi[h this permit is issuetl (SectiOn 3097 Civ. C.) Lantler's Name Lentler's Atltlress OWNER BUILDEP DECIARATION I herCby a(flrm tM1at I am exemPt trom th¢ Cont�acto�'s License l2w for (he tollowing reasOn ($ectlon �OJS.S BU51l1E55 dOd PfO�C55I011dl COdC: AOy NLY O! county which requlres a permlt to construct, alter, improve, tlemolish or repalr any slruc[ure, prior [o i[s issuance, also requires the appliwnt for such permit to file a siqnc0 statement tnal hC/she I5 IicenSetl pursuan[ to lhn Orovisions ot thC Conlractor'S License Law (Chapter 9(commenung wilh Seclion ]000) of Division 3 of the Business antl Proiessions Cotle) or that ne/she is exempt [hCrefrom antl lhe ba5i5 tor t�e all¢getl exemption. Hny violation of Secllon 7031.5 by any applican[ tor a pe�mit subjects [he aOPliCant to a civil �endlty of not mor¢ Ihan (ive huntlretl tlollars (§500). I, ds Owner of Ibe propCrty or my employees with wages as their Solo compensation, will tlo tne work, ana the structure is no[ intentletl or offeretl for sale (Section ]044, Buzlness anC ProfeSslonal Cotle: The Gontractor'S License Law tloes not apply to an owner 01 a Oroperty wha builtl5 or imprOves thereon, antl who tloes such work himselt/nersell,or througn his or her own employecz, provltled tl�at such improvements are not intentlea or otteretl (or salC. If, howeveq ihe bulltlin9 or Improvement is soltl witttin One year of com- Oletion, tne owner will have [he burtlen Ot Provin9 hC/she tlIG not builtl or Im- , p�ove for the pu�po5¢ D1 sale). � ❑ I, az own¢r of Ihe property, am exclusively tonttattinq with licensetl con- IldClOI5l0 COOS[IUCL [bE p(OjCCI (S2CLIOf1 iO44. BUSIO255 dOE Professlon5 COtle: The Con[racto�'s License Law �loez mt appty to an owner of property who builtls or imOwves thereon, antl wno confracts to� such p�ojects with a con- tractor(sl license pursuant'to the Contractor'i License Law). I am aware inat proof of their Wo�ke�'s Compensation insurance shOuld be provitletl to me. � I am ezempt untle� Section B. & P. C. �or this reason o � uniE s/9 . 1f��r, ✓�u av, ari� I M1ereby cer[ify fhat I'have read thi5 application antl sta[e tnat fhe above informatlon is mrrect. I agree to como�Y �+��h a11 city anC counry ortlinances antl state laws relating to builtling construction, antl Oereby authorize reore- sentatives ot this city to enter uyon the above-mentioned o�crt tor inspecfion�p��Ooses. �/ --,l -j-� ,/ Signature /I�,f �/�_'�2A1 Mn U.c.�W �ate � � r ,�� Drivers' License or 55 � ._�31'�' i 3531 I 71�.�9�I 153 � V..�� .., � TVPE OF CONSTRUCTION NEW .4DD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF W RK/�iFj OF BIDG. ' � � TVPEOFPERMIT GRADING �FOUNOATION STRUCTURAL ❑ TENANT ELECTRICAL �PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sa..EL �� OCCVaA Cv CONSTRUCTIONTVPE � VALUATIONS�L/a�. � ZONE GRADINGCU.VDS. ACRES ftema�ks: Sink cflow Preventer <flow Irrigation Drinking FouMains Floor Drains Floor Sinks Gas Service Ouilets If1tEIC¢jltOfS Kitchen Sink Lavarories P=Trap • Rooi Drains Fee $15 Duct � Under Ground Duct - SVuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepUFact. Blt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU O 100,000 BTi Reinspection Fee � $15 _"� MF 0865-46, rev. 9/84 Whi[e - Builtlin9: Canar Pink -Actountin Goltlenrotl - Assesmr Y - APPlicant: 9: '�:— �jl� 5 �BING Showers Service Sink SewenCap Sewer Connection � SolarCollectors _ - Solar Piping Solar Tank � / Swimming POoI w/Spa Urinal Water Closet Water Heater Water Service laue Fea Hood or Typel ❑ Canopy Typell ❑ P Refrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteretion Issue Fee $ 3 $ 3 A.P. � S Main Buildi TFront yQ-� B Rear � A C Right � K Lefl S Ping. Ref. # Planning Notes: ✓ / 1656 6/05/84 Iha,l�. �7 �—�{ �7 2one g: Accessory Building: 'I Z ('�!Y � /� 0 > /,_ O �� N � /_ �// N _ Q /. ' G R Parking Req./Provided E Q M T S. Automatic W� Construction Cooking Unit Dishwasher Dryers ❑Ga�, Fan F.A.U. Fixtures Device Boxes Outle[s Sub. lectric Garbage Disposal Generator DO-5 KW ' � fleinspectian Fee — DEVELOPMEN7SER Zoning Appraved By� BuildinB APProved By Appliption luued By_ ELECTRICAL Transformer ❑ 15-50 KW O SO+KW Meter LJup to 100 amps �� Me[er ❑over100amps� Sub Panel MotorsO0�7 HPOtY,-B Inc.Solar,09-15 HP �16-75+ Microwave Pole Light Range % Standing Sections IS KW Trash Compactor $15 ,Issue Fee . REQ jIR � ENTS: /I BUILDINGPERMIT $ PLAN CHECK 5 'PLUMBING 5 •�� PLAN CHECK 25% 5 , ELECTRICAL /\ $ PLAN CHECK � 50% $ _ MECHANICAL �� . , PLAN CHECK 25% $ FEES $ 3 FEES SMIP $ .� PERMIT ISSUANCE , S ENERG� P.C. $ ffiRADING $ ,(�AICROFILM 5 TOTAL FEE $ � � CONSTRUCTION AND PLANNING ' POOL &�SPA ' APPROVALS Petmit # 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-Undrqmd. 55. Electric8l Bonding � ( 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 7�/� � � � �t,,�_ , 57. APPROVAL TO COVER-GUNITE 7. Footirigs' � � '"� 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd.' . 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 61. APPROVAL TO DECK 17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final . � 14. Rough Plumbing � 7�(�/b7C� G,L/) 65. Electrical-Final � 15. Rough Electrical-C,onduit 66. Solar System-Final 16. Rough Electric Wiring % J, r> 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. ProductPipingOGas ❑Oil �3. Gas Pipe-Rough & Test 72. Underground Flush , � 24. Roof Framfng S 1 �� 73. Undergrnd. Storage Tank O Gas ❑ Oil �5� .�'.�o (fl �c� D '74. Overhead Hydro 26., T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27.� Frame and Flashing 7 q 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing 7,�� j �� n�� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION 32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: L% r 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood�or CanopY 37. Final Factory Firepiace � � 38. Final Plumbing , L� , 39. Water Service-Final 40. Gas Service-Final � 47. Solar pomesticFinal � � . 42. Backflow Preventer � I 43. Backflow Irrigation � 44. .Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING I . '48. Special Requirements Completed , - 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co � 51.CERTIFICATEOFOCCUPANCY � .. ' - N0. Date � October 30,1485 To:The city of Costa Mesa From: Edward Fratantaro BPE 13537 Re: Drainage and grad3ng All excess dirt has been removed from the property. The room addition did not disturb the existing landscaping. All grading has been pro- perTy completed and water run-off. is to the sides of the property. ��Ti44.'��'� �/l�� m' �� 7 AVC��ant to fill in all soaces except tnose witnin neavy Doraer lines antl sign all approv��ate tleclaratlons. f CITY OF COSTA MESA 7�(�J(� NS R UC71.ON PE IT PFRMIS Nfl _ TRACT NO. I.OT NO. � iniir nin ProjectAddress �" � c, ��a �� Applicant's Mailin Address 7 BZ'�«d - , _ Owner's Na,mef,p �F^��N �� Phone y�% Address `T�n �-�T��l � Arch/Eng.�^�"' �s�/�,'�`f� 2 License No. e I20 Co � Address ^��L rt� ��yS n�� Contractor's Nam � Phone Addreu (mailing) �2 City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm thdt I am Iicensetl untler provi5iont of Charte� 9(commencing with section 7000) of Divizion 3 of tne Business antl Protesslons Cotle, antl my Iicenze is in tull torce antl eliect. License Class LicenSe No. Date Si9nature WORKERS'COMPENSATION DECLARATION 1 hereby atfirm tnat I have a certiticate of consent to sell-insur¢ or a certiticate ;..�nt Workers' Compensation Inw�ance, or a certlfle� .c�/o�OY �he/�reo'tI (Se-ction �9,+�00. Lab.� ComPanY ��/7. 'YT/"`-� �:='roliq Na. � :.:8 Ce��Ji/1�i¢tl �OPY 15 f letlbwitbr[hehc �lY B 9 iv'si Date ✓�/U� � APPlicant �� '. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl ii the p¢rmit is fOr One huntl�etl (E300) or less) . I certify that in the perfo�mance of Ihe wOrk for which this permlt I5 Issuetl,�l shall not employ any person In any manner so as to becoma subject to the Wo�kers' Com0en5ation ldws of Califomia.' Date Signahre NOTICE: If, aiter makin9 inis tleclaration, you shoultl become subject to lhe Worker5' COmpenzatlon provision5 01 (he Labor Cotle, you must torthwith Compty witn such provi5ion5 or thls permit shall be tleemetl revoketl. CONSTRVCTION LENDING AGENCV . I hereby afflrm tnat there is a Wnstructlon lentling agency for tM1e performance Of Ihe work for which this permit is issuetl (SecNon 3097 Clv. C.) Lentler's Name �. �entler's Atltlress , OWNER BUILDER DECLARATION - I hereby aftirm that I am exempt trom the Contractor's License Law for'the following reason (Section ]031.5' Business antl Profe55ional Cotle: Any city or . counTy which �equires a p¢rmit to construct, alter, impvovo, tlemolish or repai� any structure, prbr to its issuance, also requires the applicanl tor such permit to file a signetl statement that he/sne Is IIC¢nsetl pu�suant [o [h¢ Provision5 of the Con[ractor's License Law (Chapter 9(commencing witn Section �000) of pivision 3 of the. Bu5ine55 antl Profe55ion5 Cotla) or tha[ he/She is exempt therefrom antl the basis for the alleqetl exemption. Any violation of Section ]03L5 by any applicant for a permlt subfeC[s the applicant to a clvil oenalty of not more than five huntlretl tlollars ($500). ❑ I, as owne� ot thE 0/ope�ty o� my emplOyees wllli wages as thcir sole -compensation, will do the work, antl the struc[ure is not intentle0 or offeretl for sale (Sec[ion 7044, Business antl Professional Gotle: The Contrac[or's License ldw tloes not appty to an owner ot a prooerty who builtls or improves thereon, antl who tloes such work nlmselt/hcrselt or tnrou9h his or her own employees, provitletl that zuGh imp�ovements are nOt int¢ntled or ofte�etl for sale. If, however, the builtling cr improvoment is soltl wi[hin one yea� of Com- pletioq lhe owner will have the burtlen oi proving he/she tlitl not buila or Im- �ove tor the purpose of sale). I, as own¢� ot [he property, am ¢xcluSlvely cont�ac[ing with IlcenSetl COn- tractorsto constructthe project (Section 7044, Businezs antl Protessions Cotle: The Contra<tor's License law doe5 m[ apply to an owner of property who builtls or improves thereon, ana who mnVacts for such projects with a mn- tractor(s license pursuant�to the Contractor's License �aw). 1 am aware that proof o� their WOrker's CompensaUon InSurance shoultl be ptovitletl f0 me. ❑. I am exempt unaer Section B. ¢ P. C, fpr this reason Dafe Signature t Owner have rea TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p_�b �DESCRIPTION OF WOfiK/US�jOE,gyD�O O � b �C� 5 Main Buildi E TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PI.UMBING ❑ MECHANICAL A R¢dr ❑ OTHER PROJECT DESCRIPTION 5�. FT. oCCUPANCv C Right K Left CONSTRUCTIONTVPE VALUATION$ ' $ ZONE GRADING CU. VDS. ACRES Ping. Ref. # Remarks: - �-�ii � � ?� � ,� % � Plannin9 Notes: Sink <flow Preventer <flow Irrigatibn nubs �i ifiers �ua<I�wr � ' Drinking Foun[ains Floor Drains Floor Sinks GasService Outlets I nterceprors Kitchen Sink Lavatories - P—Trap ' Roof Drains � Reinspection Fee � $15 Boiler � Duct - Under Ground Duct - SVuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑6100,000 BTU �100,0008T Reinspection Fee ^��-�,nn.-,qssessor $15 PLUMBING Showers Service Sink Sewer Cap Sewer Cannection Solar Collecrors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration Sys[em ❑o-ioo,000eru ❑ioo,000 SVstem Repair/Alteration laue Fae FEES 3430 7/05/94 Zone Parking Req./Provided ELECTRICAL Automatic Washer - Transformer ❑ 15-50 KW Constructior Pole Sub. � 50 + KW Cooking Unit Meter ❑up to 100 amps � Dishwasher Meter ❑over100amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors DO-1 HP 01 h- 8 F,A.U. Inc.Solar.�9-15 HP �16-15+ Fixtures - - Microwave Device Boxes Pole light ' . Outlets Range Switches Sign Garbage Disposal � Standing Sections Generamr �0.5 KW �5-15 KW Trash Compactor $ 3 flainspection Fee $15 FEES DEVELOPMENT SERVICES REQi 2oning Approved By Building Approved By $ 3 BUILDING PERMIT $ PLAN CHECK $ PLUMBING 5 PLAN CHECK 25% S ELECTRICAL 5 PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ Issue Fee 4e2�i '� FEES $ 3 Z O N 1 N G R E Q M T S. SUMMARV OF FEES ' SMIP $ PERMIT ' ISSUANCE $ ENERGV P.C. $ GRADING $ MICROFI�M $ �` 7 ` �� TOTAL FEE $ � � CONSTRUCTION AND PLANNING - ' POOL �_�A 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 Utility-Undrgrnd: 54. Forms - 4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding ' � 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ' 57. APPROVALTO COVER-GUNITE 7. Footings . , y' ' 58. Electrical ConduirUndrgrnd. ' � • 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 72. 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 't'6. 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 7 FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. DuCts,in Structure � 70. Underground Hydro 22. Ducts, Ventilating L �(� 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� Frame and Flashing 76. Dry Standpipe' 28.� Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. F�NAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning L 35. Final Gas Pipe-Test � 36. Hood or Canopy � 37. Final Factory Fireplace � � 38. Final Plumbing � 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final . 42. Backflow Preventer ' � 43. Backflow Irrigation . _ 44. Landscape Irrigation System 45. Sound Attenuation � 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed � 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . N0. Date � ' ,) Aop��cant to fill in all svatts excev< <�ose within neavy portler Ilnas ana sign all aooropriate eectantions. CITV pF COSTA MwE�S..,A,� CONSTRUCTION PERMIT �Project Add:ess �+`�' �A�-�4�..�1-�w` �! ApplicanYs Mailing Address Zaf7},2�� liG�v��c�l �� Owner's Nnme �� .��!'9��A�Z� Phon� '�Z(fj Address � L'��"�Z�L-:ri% -=f� Arch/Eng. License No. Address ,L�F-ldwl �tfi �FS� Coniractor's Nam Phon Address (mailingl'If.-��5� ��-Y� �_ CityLicenseNo. dOSG[[d'� LICENSED CONTRACTOR DECIARATION I he�eby affirm thal I am Ilcensetl untle� provislons ot Char[Cr 9(commencing with sec[ion 7000) ol Division 3 of the Business antl Professions Cotle, antl my license Is in lull torce an etiect. lJ<ense dass �� i �'Q G��` ZO Date �- 1—/�_Q i a��a��`p� _�_� ��if��7�� WORKERS' COMPENSATION OECLARHTION I hereby affirm that I have a certi/icate o( consent to self-insure or a certiiicate of Workers' Compen5ation Insurance, o� d certitietl copY tM1ereot (SecNon 3800, La . �7 �as�f.�,1^�' ( �IicY No fr_'�a�J'� ComPanY �\-�,�a.�� y�/�,�,�(.�,QF rtiti¢tl copy ii hereby furni5hetl. Da Cert'fye�c�py ijfi�pA �yAPPI � itY � ivisi� � �� EXEMPTION FROM WORKERS' CO SATION DECLARATION (ThiSzection neetl not be completetl if the permit is for one huntlratl (5100) or less). I cer0fy thal In Ih¢ perl0rmante o/ Ih¢ work fOr which this perm�t is iisuetl, I shall nol employ any pe�son in any manne� so as [o bemme subje<t [o thC Workers' Companwtion l.aws ot California. Date Si9nature `NOTICE: It, after making this tleciaration, you shoultl become subiect to tho Workers' Compensalion pwvisions ot [he Labo� Cotle, you must tOrtbwilh camply with Such proviiions or this p¢rmit shall be tleematl�revok¢tl. CONSTRUCTION LENDING AGENCY I nereby a/lirm ihat thero is a ConsVuttiomlen0ing a9ency tor th¢ perbrmanto Ot th¢ work iOr wNch Ihis permit is issuetl (Sectlon 3097 Civ. CJ Lenaer's Name Luntler's Atltlress - ' OWNER BUILDEH DECIARATION I heroby aiflrm lhat 1 am axempt froT Ihe Conlractor'S LICenSC Law br llte ' tollowin9 rcason (Section �7031.5 Business antl Protessional Cotlo: Any tlty or county wNch requiras a permit to construct, alter, Improve, aomolish or rupair anv cnurlu.n nrim In Its Icswnce_ also reoWres [he aoolicanl for sucYl o�rmlt Dlvislon 3 o1 tne Buslness antl vrotessions Coae7 or ma� ne/sne is oxamp� lhcro/rom antl Iho basis fo� lhe all¢g¢tl exemption. Any viOldtion ot $ec[Ion ]031.5 by any aOP�iCant for a pe�mlt subject5 tha applicanl lo a<ivil oenalty o/ nol morc lhan five huntl�etl dolla�5 ($500). � I, a5 owner ol lhe p�ope�ty o� my employees with wdg05 as Ihak sole Compensalion, will do the wo�k, antl the st�ucture IS not In[enUotl o� o/leretl tor sab (SeGtlOn 7044, Buslness anU Pro/essional Cotle: The Contraclor's license Law tloes not appty to an owner Of a proparty wlto builds o� Improws theroon, antl who tloes such work himself/herself or throu9h hls or her own employees, proviaotl thal Such improvements are no[ InlCntlatl or Ol/oreU for sale. It, howavor, tho builtling or Improvament Is soltl within one year of <om- ple[lon, ine owncr wlll have tha burtl¢n of provin9 he/5hC �itl not builtl or Im- p�Ove torlhu purposo oisale). • ❑ I, as owna� oi tM1e OroP¢rty, am ex�luslvely Conlratting wlth IICCn504 Con- tractors t0 con5lruct lhe project (SectlOn 7044, BuSiness antl Pro/p55ions Cotle: The ConVactor•s License Lzw does not apply to an owner of prop<rty who builtls or Improves thereon, antl who contracts tor such pmjlClz wlth a con- tracto/(5) licenze pursuant Io the�Con[�acior'S LlcenSe L.aw). I am aware Iha[ prool of lheir Worker's Compensation insurance zhoultl ba provitletl lo me. ❑ I am exCmpl untle� Section B. 6 P. C. fOr lhis reaion Date Owner I nereby certiry tnat I have rea iNormation Is correct. i agree to antl state lawz relating to builtlir sentntiv�waf--[h1i citv to entA Drivers' License or'S5 � � ][his application antl State thal Ihe abova comply wi[h all Nty antl county o�tlinancos .g conslruction, antl hereby authorize repra- po the abOve-m¢ntionetl proDerty �for f •« � �/ � TYPE OFCONSTRUCTION LJ NEW LJ ADD LJ ALTERATION IJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. - �.��`�� S� G TVPE OF PERMIT LI GRAOING LJ FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MEGHANICAL ❑ OTHER PROJECT DESCRIPTION SQ.FT. OCCUPANCV_ CONSTRUCI'ION TVPE VALVATION 5 ZONE GRADING CV. VDS. ACRES— Remarks: Sink Preventer Irrigation Drinking FOuntains Floor Dreins Floor Sinks Gas Service Outlets Intercepmrs Kitchen Sink � Lavarories P—Trap Roof Drains IReinspaction Fee I $15 Boiler Duct, Under Ground Duct - Structural . Duct - Ventilating Exhaust System � Multiple ❑ Fi}epl/Fact.Blc ICBO# � Heat g System & Ducting 100,000 BTU 0100,000 BTi Reinspection Fee � $15 CMF OB65-46, rev. 10/B4 White - Bulltling; Canary - Applicani; Plnk - Accounting; GOltlenroC - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collxtors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Warer Heater Water Service Auto�Wash IaUe Fea Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑o-ioo,000eTu ❑ioo,000sru System Repair/Alteration Fire Dampers Registers Iss�e Fee FEES 5 3 S 3 A.P. qW S Main Buildi E 7 Front B Rear A C Right K Left S Ping. Ref. 4p Planning Notes: Aummatic Washer Construciion Pole Suh. Cooking Unit Dishwasher - Dryers ❑Gas �Elec Fan F,A.U. Fixtures Device Boxes OuUets Switches Garbage Disposal Genereror �0-5 KW C 0164 II/24/87 Zone Accessory Building: ELECTRICAL Transformer ❑ 15-50 KW ❑ SO+ KW Meter ❑up ro 100 amps Meter ❑over 100 amps Sub Panel Motors�0.1HP�1X�8 ' Inc.Solar �9-15 HP �76-15+ Microwave Pole Light Sign ' Standing Sections 15 KW Trash Compactor � Rainspeclion Foe �$15 � � Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning APProved BV . Building Approved By AppliWtion ��ad BY n BUILDING PERMIT $ PLAN CHECK $ PLUMBING 5 PLAN CHECK 25% S ELECTRICAL $ PLAN CHECK 50°6 $ MECHANICAL �y P�� $ 7,OU TL Z O N I N G R E Q M T S FEES S 3 SUMMARV OF FEES SMIP $ PERMIT � ISSUANCE S ENERG� P.C. $ GRADING $ MICROFILM 5 TOTALFEE $ � � na .. i�� •,\,;- �CONSTRUCTION AND PLANNING � POOL b� _.-A APPROVALS - Permit# Date Inspector AppROVALS Permit# Date Inspecmr i. TemporarY Electrical Service or Pole 52. Pool & Equipment Location � 2. -Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Elec[rical Conduit Utility-Undrgrnd. 54. Forms 4. Elec[rical Conduit�Undrgmd. � 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 7. Footings � 58. Electrical Conduif-Undrgrnd. . 8: Foundation 59. Gas Pipe, O Undrgmd., Test 9. Water Pipe�Undrgrnd. . ' 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 67. APPROVAL TO DECK 71. Property Sewer Line & House Connectiqn 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 Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ;19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . �Q. Rough Factory Fireplace APPROVALS. Permit # �27. Ducts, in 5tructure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Under9rnd. 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 Neiling 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 �V � / 35. Final Gas PiPe-Test 36. Hood or C.inopy � � 1� 37. Final Factory Fireplace r I 38. Final Plumbing � 39. Water Service-Final 40. Gas Service-Final \ 41 . Solar pomBstic-Final � �� i' �� 42. Backflow Preventer �.� �'! ,� ;' 43. Backflow Irrigation �� "_I ' 44. Landscape Irrigation System 45. Sound Attenuation � � � 46. Handicap Regulations ;n 47. FINALSTRUCTURESi�BUILDING 46. Special Requirements Completed 49. Electric Release to Edison = !� 50. Gas Release [o Southem Califomia Gas Co �"� � i:� 51. CERTIFICATEOFOCCUPANCY .� No. Date � , ' Costa Mesa Biiilding Department 1Q58 APP IpCATION FOR PERMIT ' „ 111 EAST 20th STREET p U I L D i� N G � �� COSTA MESA. CALIFORNIA " FOR APPLICANT TO FILL IN FOR OF'FICE USE ONLY I. Receipt No. Permit N Building � �� ,� si� �� Address Costa Mesa, Cia�OI'I118� Reeeived by Date Rec'd. Date Issu Nearest �T /� , CrossSt. �/�V//V! �1YE Building mau p Address () / Z t�l/ � y T ,S T Tel. cicy Cds rR /Jc ts+ No.li 8/�L Architect or Lio. Engineer/' E( 'lERN .OfIAFY/A/LNo. Address City Lic. Contractor��t%F_.SA fi/il�OEPf No. /E // Addrew ��Z y / r'� / Cv ' Leaal I LOt I I ��/.'06 ISize of Lot e Use ot Existing Bidg Set6ack Line � n ■ Bui No. ot Bldga � Y/3�'"� Now on Lot O INo.of No.oi Familles Rooms m � Rear Vartl y9 S 0 Sidw Vard f� r. Oemolfsh ress Costa Mesa, California Frame: Fire Bracing, E I hereby acknowledge that I have read Uus Applicatton Lath. Int. and state that the above is rnrrect and agree to rnmply �ath. Ext. with ull City Ordinances and State Iaws regulating building constcuction. Signature of �� L Plaster,lnt Permittee ,ejt��/%f7��i..r�/!!— —7—�� t Plaster, Ext Authorized Ngt. S Date CORRECTIONS �PRovAr.s Masonry Reinforoed Valu,ation Permit Fee $ < Plan Cheek $ j� Bond Beam $ /� � O D Fee I S,3 / FINAL cnwu �Da [a-w 2M 5-54 Date O � Q Z a r PL(Yr Pi. A N Show laeatlon and disYances from ' � property Iine and between buildinga 0 . .'•41 f�•55POcosra � 'r NESA 1�7a ir.r:iG37.00 0 c