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Home My WebLink About241 COSTA MESA ST - Building Permits,�(, v ApPlicant to fill in all spaces ¢xeept those within heavY �Ortler lines anO si9n all appropriate tleclarations. CITY OF COSTA MESA CONSTRUCTION PERMIT 7roject Address � �� OS�� i M�i9 Applicant'sMailningAddress ��]/-% �•��'L/1X� 1%�' �l/•i�. Owner's Name /Tti�ELL 0,]i. CQ/ S�Ci Phone �uZ--77Y3 Address 1 J/� �rA�xY +�K' �tJE�P.:�T' gr�, CA.9��[0 i Arch/Eng. License No. Address Contracror'sNam �nW��-ga�/�C-'4 Phone��`f2-%7f�� Addresslmailing) �.%�QAL.ata�/ �iL. 4/•s-C/L-�'sz[/.n City Licenze Na. LICENSED CONTRACTOR DECLARATION I hereby atfi�m that I am license� un�e� pro��5ion5 of ChartGr 9(commencing with SeCtlon.7000) oi Dlvision 3 of lhe BVSine55 antl Pwfesslons Co�e, antl - my li<enso is in full torte ana ef(ect. License Class License No. Date 519nature WORKERS' COMPENSATION DECLARATION, I nereby affirm ihat I have a certiflcate ot coPsent to self-insure or a certlilcatc ^� Worker5' Compen5a[iOn InSurante, Or a certl�ietl copY thereof (Saction 10, Lab. C.) � , ' ,ity No. CompanY L� Certlpetl copy Is �ereby furnishatl. . •� ❑ Certlfl cop I5 81etl wlth [he tlty�BIIsldi�9 Division„ n [.. � D��AP *m"dR1 ��iR�^'�"�-"'� .C.i� D � EXEMPTION F�ROM WORKERS' COMPENSATION DECLARATION (TM1iSsection neetl nOt b¢ CompletCtl if the permit i5 fol one huntlfetl ($100)'of less). I certify thal In the per/OrmanCe Ot the worK tor which this pe�mi[ is issuetl I Shall not emplOy any per5on in any ma9p er zo aS�to beco Subject to t�e workers' e9��atly n Laws ot Califo��y _ p� ��w -<' Da(g{� J�G_Siqnaturr,k �F�"��'� �� 'NOTICE It, alter making this tleclaration, you shoultl become suDject to the Workers' Compensation provisions ot Ine Labor Cotle, you must torl�witn comply with such provl5ions or titis pefmit Shall be tleemetl revoketl. CONSTHUCTION LENDING AGENCV � I h¢reby aftirm thal Ihe�e I5 a mnsVuctlon IePtling a9ency for Ihe performanGe Of lhe work for whicp lhi5 pa�mil is �ssuetl (Sectlon 3097 Clv. C.) LEntler'S Name . Lentl¢r's Atltlre55 ' OWNER BUILDER DECLARATION I nereby afflrm that I am exempt fwm the Cantrdcto�'s License Law for Ihe following reason (Section ]031.5 Business antl Professional Cotle: Any ci[y or cnunN wnicn reauires a cermlt to construct. alter, improve, Uemofish oi repair tnereirom antl the oasis tor tne allegeO exempuon, eany v�o auo� ��r . o � �1.5 by any applicant tor a permit subjects the applicant to a civll i,lty of no[ more tM1an five huntlretl tlollars (5500�. as owner of the propertY — � �' �' ' �� `� [�p�w�Mwrr, will tlo Iho wo�k, antl the st/ucture is not mlentletl or otf¢retl for sale (Settion 7044, Buziness antl Professionat Cotle: The Contractor'S �irense I.aw tloes not apply to an owner of a Property who builtls or improves thereon, antl who aoes such work himself/herself or tnrough his or he. own employees, provitletl [hal sucM1 improvaments are not intentle0 or offeretl for sdle. It, howevet, the bulltlin9 or improvemCnt is soltl within one year ot com- . plellon, lhe owner will bave lhe burtlen ot p�ovin9 he/she tlitl mt builtl o� Im- prova tor the purpose o/ sale). ❑ I, a5 owne� of the properly, am exclusiVery contracting with licensetl con- VaCtOrs l0 con5truct the praject (SMtion 70A4. Business antl Protession5 Cotle: The ConVactor's License Law tloes not apP�Y to.an owner ot property who . builtls or improves ther¢on, antl who con[racts for such projects with a con- � traclor(sl limnce pursuant�to tne Contrac[or's License Law). I am aware that proof a/ Ihel� Wo�ker's Compensalion insU�ance shoultl be prOvitletl Io me. ❑ I am exempt untic� $ection B. & P. C. for this r¢ason n � o I nereby ce lify that I have reatl this appl��ation antl state lhat the above intormation is correct. I aqree to comply wlth all city antl county ortlinances antl sla[e laws �elating to builtling con5l�uc��on, antl.hereby authoriie rep�o- sentatives o1 is' Uty to enter upon thC above-mentionetl prop rty for inspection po5e5. .. 5iqnaeure t' oate i 1 F Drivers' License or 55 � �� / � � - TVPE OF CONSTRUCTION LJ NEW LJ ADD QSJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � DESCRIPTIONp� WORK/USE OF BLOG. U%7Li�r �OGy— OPENi^�L- /3c: wr'c..� S,�'p��i1GF.Cea.y c-` oR Si✓�C.c TVPE OF PERMIT GRADINGp� FOLJ UNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL IJ PLVMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sp. FT.T.___ OCCUPANCY � CONSTRVCTIONTVPE �- VAWATIONS ZONE GftADINGCU.VDS. ACRES Remarks: �A�lI�N I�ITG��I�I� /�/\�i �� . lJ Sink Preventer Irrigation Clarifiers Dishwdsher Drinking Fountains Floor �rains Floor Sinks - Gas Service Outlets Interceptors - Kitchen Sink Lavatories , Roof Drains . � �Ff�vvo�e. '7'��.- Reinspection Fee $15 Duct-UnderGround Duct - Structural Duct - Ventilating � Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating SYsrem & Ducting ❑0.100,000 BTU � 700,000 BT Rainspection Fee � 515 CMF 0965-46, rev. 30/84 Wnite - Builtling; Canary - ApO��canp Pink - Accounting; Goltlenrotl - ASsesmr FEES Showers Service Sink Sewer Cap Sewer Connection Solar Coliectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Clout Water Heater Water Service Auto-Wash . C/�R�.✓ 6 E D u T �_ Issue Fae '- I $ 3 I , FEES •'" Hoodor Typel ❑ Canopy Typell ❑ � Refrigeration System � � 04100,000 BTU ❑100,000 BTU System Repair/A t Fire Dampers I� Fiegisters laue Fee S 3 / A.P. # ,z,�q ' S Main Buildin9: E T Front' � B Rear < A C Right S Left � Ping. Fef. # Planning Notes: Automatic Washer Construction Pole Cooking Unit Dishwasher Dryers �Gas O Fan F.A.U. Device Boxes Outlets . %/ — 6339 5%28%86 Accessory . � � . p�,50 1L 2one ii � ELECTRIC/YL Transformer ❑ 15-50 KW ❑ 50+KW Meter LJup to 100 amps � Meter ❑over 100 amps - lectric Sub Panel Mators �a7 HP O 1'/: - 8 InaSolar �9-15 HP �16-15+ Microwave Fole Light Garbage Oisposal Generator �65 KW Reinspection Fee � ✓ELOPMENTSERVI ing APProved BY-1 Iding Approved By dication 15sued Bv_ 15KW Han9e - $ign ' Standing Sections Trash Com�ector ' N FEES .. . o. $15 � Issue Fee'��`n $ 3 �.1 U�"RKIJ!' 3. ..... _ . i� =iQ. i Z O N I N G R E Q M T S �: SUM ARV OF FEES ' BUILDING PERMIT $ � SMIP $ 0• �O �' PLAN CHECK $ �� PEFMIT " /•' PLUMBING S �•�' ISSUANCE $ ' PLANCHECK 25% S D-SD ENERGV�P.C. S � ELECTRICAL $ GRADING $ " PLAN CHECK 50% $ MICROFILM 5 MECHANICAL S TOTAL FEE $ �� PLAN CHECK Y5% $ 2`2� Sb CONSTRUCTION AND PLANNING POOL 8� 9 APPROVALS Permit# vate Inspector AppROVALS Permic#' Date Inspector t 7. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. S[eel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Elecvical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undigrnd. 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. Rou h Plumbin ' g g b'3-� 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 Elearica�-T Bar Ceiling' 69. POOLISPASYSTEMS 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.StorageTank OGas OOiI 25. Roof Sheathin9 74. Overhead HYdro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frameand•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 - i�� •" 32. Electriral Power MeterFinal 80. FOOD CERTIFICATE ISSUED '� `-r° �. .a. . 33. Final Electric 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-Final . 41. Solar pomestic-Final 42. Backflow Preventer � 43�Backflow Irri�ation �s: 4�� Landscape lrrigation System 45;�Sound Attenuation 46nHandicap Regulations 47ijFINALSTRUCTURE & BUILDING 48. Special Requirements Completed 49. Elearic Release to Edison � 50nGas Release t0 Sou[hern California Gas Co d. 5M�CERTIFICATE OF OCCUPANCY No.� Date {� �. ; t°'`• For Inspect�m � C�ll 3 7 �� ,p°�j�'� CITY OF C�O5TA ESA PLANNING DFPT. suuecr ro e�oo. oer. �eo. jBYK�S-n�r-v�- DATE� � DOECfOR Or KANNINO 3�' � ;^ � A�P�R� Citj! of Costa Masa v•c�,. _ d N 't , �� •;. .;� :; � 0 v _ � �P.T sZ �q�6 1./A�(E NOPCHAN6E5 WITFi��' PRIOR APPROVAC OF.DePL � iF'.E ISSJAR'CE OR GRIl9TINC OF � PERMii CH APPROVAL OF PLANS A�JD cpQGf1:l.T!CtiS S�1AI� IVhi G� CO`l3TRUED S TO �,''L /{ UO rt TO BE A PERMIt fOR, OR A?� AFP��L i�F. A?�Y VIO:h�ION OFl,N; OF THE PROVIS!0?:$ OF Tfil� 0� NO fEF.NR PRE+ � . SUMIA'G fi0 CIVE AUTHORITY TO 1;.� CR Cf,VCEL iHE PROVISIO�S Of iHIS COOE SHALL(Bd V,�i^., EXCEPi IN SO �AR A$ iH� lh'OpK oR USE WHICH I A� T:�RIZES IS LA'NFUL ?HE ISSUANCE OF A PER.N!i Bip ED liPE'I PLAfli qN \ SPECIFICATfONS SHALL �Oi FREVC: T►!E L'CiLOC:� O(,";CI: �a �ROM THEFE:1fTCR REQUIRING T::� .::if.Cii;)! �: [;gr �� IN EAID !'LANS f.��D S; [61FICATi�: ,- Z��_�;, p�,r7-•� .� t'uuoircc CPC�Z^.T::.':S6GL�G C:�iu�ii) 7f;E?EU.'l.9�,? .�.i:_'+ � i, IN ;ic�aticu�� HIS co.:e c:� c, �: • `�, tl; ieeCiTv. __ �._ yr.��t c.: �;..,,;YB � `��^^—_---- _ -- zo' v� � � � Q � ��., 1 e �I - -, � .. . - �I _ � , x 'EP Aic�,.,�,.. • ',i -,.� l. ru�6 fl R Ek�l;� F,� ',��.��v ��:�. _- � H ATIK� LA'f1�T+1G AND � AEFAIGERA7IQN '�tiQ K j � a"�Gnt�c�93�, Yt./VL LS � 1; , ; ! Th'i�id!�"�"R(�+�:`!!Si�f,�OMPANY , q � f.'L i�':SP;;,T!;��i fttGUF ^ � :uii Ji!!S:IiS � �![:i= '�.FiCtd$ fli TO E � j r'��Nu�•.c.i.:;�: ;�Ji,f;L�YTi'.',J' ;R STATE �; i^Ai1��RNU� !;14'i5i::;i �� f�:�aJaiR l SAfET dE C(tNSIitTE6 fC9 AC ITIONA I fl`UUiflEM:NTS. N�u,o.onr ,. AOGlicant to fill in all spaces ezcept t�ose wit�in heavY �orOe� lines anE si9n all apPropriala Ceclaralions. ZITY OF COSTA MESA CONSTR UCTION PERMIT PERMIT NO. _ TRACT NO. LOT NO. UNIT NO. • ProjectAddress .2�/ L�GSi A M�SA- .S' � Applicant'sMailingAddress �7�a G-+ab�R+��/ ��. •b'• �1i.GL0 Owner's Name �NIE��a D.'�.P/3Gi � Phonerai 'L 77� Address � �� Y ��I/E�%+t� bC'9cr{ C�. 4tCGo Arch/Eng. License No. Address �Contrector's Name BGiiINZ-/SUitc7B.C. Phone�aS�z^7'�yj Addresslmailingl/'�/2 G'�/L.9xy lSr2 .(�d � �Y2t6o' City.License No. � LICENSE� CONTRACTOR DECLARATION I hereby affi�m that-I am licensetl untler provlslons of CM1arte� 9(commencing � witn section ]000) oi Division 3 of tho Business antl Profes5ions Cotla, antl � my license iz in full (orce antl effect. • License Qass Licanso No. Date ' Si9na[ure WORKERS' COMPENSATION �ECLAFATION I here0y attirm that 1 have a certllicate oi consent to self-insure or a certiticate ot Workers' Com0en5ation InSurance, o� a ce�Utietl copy [hereot (Section 3800, Lab. C.) Policy No. Company eCertifietl copy is hereby furnishetl. Cerfitie Cop a fil¢tl with [he City tliny Dlvlsio Dale '� 2 f1L APPlicant �� - � EXEMPTION FHOM W00.KER5' COMPENSATION DECLARHTION (This section neetl not be complotetl if the parmit I5 fo� One huntlretl ($300) or less). I CEr[ity that in the per/ormance of IM1e wo�k Por which this p¢rT�[ is lssuetl, I shall not employ any pe�son in any manner So as [o become subject [o the Workers' Compensation Laws ol Calitomla. Date Signalure 'NOTICE: If, after �makinq thls tlecla�a[IOn, you shoultl becom¢ Subject to the Workers' Compensation p�ovisions of lM1e Labo� Cotle, you must forthwi[h comO�Y with such provision5 Or thii p¢rmit Shall be tleemetl revoke0. CONSTRUCTION LENDING AGENCV I nereby atfirm that there is a construction lentlin9 a9enry tor tne pertormance o( the work (or .which this permit Is issuetl (Sec[ion 309] Civ. CJ Lentler's Name Lentler's Atltlress OWNER BUILDER �ECLARATION I nereby affirm that I am exempt from the Contraclor's License Caw tor the tollowin9 reason (Section 7031.5 Business antl Prafessional Cotle: Any City or county wnich requires a permit to construct, alter, improve, tlemolish or repair any struceure, prior to its issuance, also requires the applicant lor such permit to fiie a siqnetl statem¢n[ tnal he/she i5 licens¢tl pursuant to ttle p�ovi5ions o( [he Contractor's License Law (Chapter 9(mmmencing with Section ]000) of Division 3 of the Business antl Profesvons Cotle) or that he/she is exempt theretrom antl the basis for the alle9etl oxemption. Any v�olation of Section ]031.5 by any applitant for a pe�mil subjec[s the applicant to a civil .�e alty of.not more than five huntlretl tlollars (y500). I, as owner of the p�operty �rtqYwlnSalvilti '" ^"-'r^ ,�, will tlo the wOrk, antl the structu�e Is not intentletl or ofteretl for sate (Seclion ]044, Business antl Pro/essional Cotle: The Coniractor's License law tloes not apply to an owner o( a properry who builtls or improves thereon, antl who tloes zuch work nimsell/hersell or through his or her own employees, provitletl thai suctt imp�ovements arG nOl intentl¢tl o� ofleretl tor sale. If, however, Lhe builtling or improvemant is soltl wiNin one year of mm- pletion, tbe owner will have the burtlen Of Proving he/sM1e tlitl no[ builtl or im- �Ove for the pu�pose of sale). � I, as awner of the property, am ¢xclusively contracting with licen5etl con- tractors to construct the project ISectlon �044, Business anC Professions Coae: The CmVattor's License l2w does nOl apP�Y �o an owner ot p�operty wtto builtls or improves thereon; antl who conVacts for such projects wltM1 a con- tratlor(51 lic¢nse pursuant�[o�the Contrac[or'S Licanse Law). 1 am awa�e tM1at prooi of their Worker's Compensatlon insurance shoultl be O�ovitletl to me. �� ❑.I am exempt untler Sectlon B. & P. C. �or [his reason D t 1-� O ' I hereby certify that I have reatl this applicatlon antl state lhat the above information is conecL'I agree lo compty wilh all Uty antl county ottlinances antl s[ate laws relating to builtling constructlon, antl hereby autnorize re0re- sentatives this ciry to enter upon the above-mentionetl prooerty tor inspec[io oses. /� � , Signa[Ur rC.�%C, � Date Z� �� TYPE OF CONSTRUCTION LI NEW U AD� LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' A P # DESCRIPTION OF WORK/USE OF BLDG. S�� TE EL.CCT�4� -T .OR- i.+�./T . Oa S MainBuildi TVPE OF PERMIT GRADING FOUN�ATION STRUCTURAL T Front 'O TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ' ❑ OTHER A PROJECT DESCRIP710N 5[3. FT. OCCuaANCv C Flight K Left GONSTRUCTION.TVPE � VALUATION$ $ ZONE GRADING CU. VDS. ACRES p�ng. Ref. � Remarks: ' ��^ , .� ' �, L�� Planning NOtes: Sink Irrigation Drinking Fountains Floor Drains Floor Sinks ' � Gas Service . Outlets Interceptors Kitchen Sink Lavatories � P-Trap Roof Drains ' Reinspection Fee � $15 Boiler Duct-UnderGround Duct - Sttuctural Duct � Ventilating ExhaustSystem ❑ MWtiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0.100,000 BTU � 100,000 Drivers� License or 55 � � �.�� Reinspection Fee CMF o065-46, �ev. 10/84 White - Builtling; Canary - Applicant: Pink - Accoun[inq; Goltlenrotl - Assessor $15 Servite Sink Sewer Cap Sewer Connection _Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Clout ' Water Heater Water Service Auto-Wash . LaundryTrays � Issue Fee Hoodor Typel ❑ Canopy Typell ❑ Refrigeration System ❑0.700,OOOBTU ❑100,000 System Repair/Alteretion Fire Dampers Registers luue Fee i S 3 � - FEES 9695 2/HI/06 Zone � Accessory Building: � Parking Req./Provided' . Automatic Washer Construction Pole Sub. Cooking Unit . Dishwasher - - Dryers ❑Gas ❑Electric Fan F.A,U. Fixtures • Device Boxes Outlets ' Switche5 Gar6ape Disposal � Generator �0�5 KW �5-15 ELECTRICAL � Transformer ❑ 15-50 KW ❑ 50+KW � Meter �up to t00amps Meter ❑over 700 amps - Sub Panel Motors �47 HP �1'r5 - 8 IncSolar �9�15 HP �16�15+ Microwave Pole Light Range ! Standing Sections Trash Compuctor Fee �$15 � � Issue Fee �o� TL FEES $ 3 Z O N I N G R E � M T S DEVELOPMENTSERVICESREQUIREMENTS: � 2oning Approved By Date Building Approved By Date Applintion Issuad By Date .�. a� SUMMARV OF FEES , BUILDING.PERMIT $ SMIP S , PLAN CHECK $ PERMIT PLUMBING � ffi ISSUANCE S PLAN CHECK 25% $ ENERGV P.C. 5 ELECTRICAL $ � GRADING $ PLAN CHECK 50% $ MICFOFILM 5 MECHANICAL S TOTAL FEE $ R. D� $ 3 PLAN CHECK �25% $ ' CONSTRUCTION ANDPLANNING APPROVALS Permit # 1. Temporary Electric8l Service or Pole 2. Soil Pipe-Undrgrnd. � 3. Electrical,ConduitUtility-Undrgrnd. 4. Electrical Conduit�Undrgrnd. 5: Steel Reinforcement 6. Electrical UFER Grnd. � 7. Footings 8. Foundation 9. Water Pipe-Undrgrnd. 10. Structural Floor Syscem 11. Property Sewer Line & House Connection 12. Sewer'Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electriral-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heatin9 & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating � 23. Gas Pipe-Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Hea[ing & 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 pomestic-Final � 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 49. Special Requirements Completed 49. Electric Release to Edison '� 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Date POOL & SPA, Inspector qppROVALS Permit#� 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Und[grnd. 59. Gas Pipe, O Undrgrnd.�Test 60. Backwash Lines, P-Trap�, O Undrgrnd. 61. APPROVAL TO DECKi 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Fina! 65. Electrical-Final t 66. Solar System-Final - . � 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank � Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: � / �.- .O ctin.. !�n _ �e i Date �Inspector C� s e , � 7 ' � ApPlicant lo till in all Spaces exceDt those within neavy bortler lines anC si9n all appropriate Aeclaralions. (, � oF COSTa mESA CONSTRUCTION PERMIT - Proiect Atldress � `� � ��sT� 'h� � ST,. - ApplicanCs Mailing Address / % �� iC� L/1x.�/ .17�Z • - Owner's Name �t��F�-�- c %i i C GfSGi phoneG'%�--��V3 Address / 7/ i�...,4�R,�.� 1� 2. /j%EZ✓/D.c j YSE'7J�N , C9- ArchlEng: license No. Address. Contrecror'sName �'_ � . L — hone - Address (maiiing) � - City License No. � LICENSED CONTRACTOR DECLARATION 1 hereby alfirm that 1 am licensetl untl¢r provisions o/ Charter 9(commencing with section �000) of Dlvision 3 of the Business antl Professions Cotle, antl , my license is in ull force antl efiect. � License Class e No. � Date Signature WORKERS'COMPENSATION DECLARATION � ^.ereby aifirm that I have a certificate of consent to selt-insure or a certificate Workers' Compensalion Insurance, or a certifietl mpy ihereot ($ection .,800, Lab. C.) , - PoliGy No. Company eCertifietl mpy is he�eby fumishetl, i , Certifietl copy is flletl with tM1e'city Builtling Oivision. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION' (This seciion neetl not be mmpletetl if tne permit is for ane huntlretl ($100) or iezs). I certify that in the Oertormance of th¢ work for whicM1 this pe�mit is issued, I shall not employ any persan in any ner so as to become subject to the Worker m ensation Laws of Cali r4i, .. 6� r(�c/!,� � Date Signature , � � � 'NOTIC : 1, after making this tleclaration, you shoultl become subject,ro 1he . Workers' Gompensation provisions of Ihe Labor Gotle, You musi forthwith compty with Such provisions or .this permit sM1all be tleemetl ievoketl. CONSTRUCTION IENDING AGENCV. I hereby affirm that there is a mnstruction tentling agency tor the pertormance of Ihe work for which this permit is issuetl (Sectlon 3097 Civ. CJ Lenaer's Name Lender's Atltlress OWNER BUILDEH �ECIARATION I hereby affirm.that I am exempt from the ConlractoYs License -L•aw for the followin9 reason (Section 7031.5 Business antl Professlonal COCe: Any city or county which requires a permit to const�uct, alter, improve, tlemolish o� �epair "any sttuc[ure, priot to itSissuance, also requi�es the applican[ fo� such permi[ to file a signetl statement'tnat he/she is Iicensetl pursuant to the provisions of the Contraclor'S License Law (Chapter 9(rommencing with Section 7000) of �ivision 3 of the Business antl Protessions Cotle) ot that he/sh¢ is exempt erefvom antl the basis for the allegetl exemption. Any violation of Section J31.5 by any applicant tor a permlt subjects tne�-applicant to a civil pe alty of not mo�e Ihan tive huntlretl tlollars ($500). , I, as owner of the� property ' � ' will Oo the wo�k, antl ttte structur¢ is not intenCetl or offevetl . for sale (Section �044, Business antl Professional Cotle: The Contractor's Li<ense Law tloes not apply to an owner of a property who builtl5 or Improves thereon, antl wha tloes such work himseli/herself or throu9h his or ner own empioyee5, providetl that such improv¢ments a�e not,intentletl o� otteretl for SdIC. �f. bOWEVCI. (h2 builtling or imProvement IS SOItl Wllhlfl Of1C yCd1 Of COrtI- � . pletion, tM1e owner will have the bu�tlen of proving ne/she Oitl no[ builtl o� im- �, prOve for the pu�po5¢ ot sale). ; ❑ 1, az Owne� of the property, am exclusivety conVacting with licensetl con- tractorsto construct tM1e project (Section ]044, Business antl Protessions Cotle: � The Contractot's license Law'tloes mt apply to an owner of properiy who builtls or improves thereon, and who coniracts for such projects witn a com Vactor(sl license pursuant�[O ihe'Contractoi'i License Law). I am aware that proof ol thelr WorkeYs Compensation insurance shoultl be provitletl to me. ❑ I am'exempt unCer Section 8. & P. C. for ihis reason Date o � I he.eby certily that I have reatl ehis application antl state tnat the above information is correct. I agree to comply with all clty antl county ortlinances antl state laws relaling.to builtling cons[�uction, antl nereby authorize rep�e- sentatives o(�t,his city to enter upon the above-mentionea property (or i�5p¢CLIO� �Pt�5e5, ��/ ,�j • ' �� , Signature �f � �� "LC.° L �� - Date 55 //� �--- — -i' i __ __ CMF 0865-46, rev. 30/84 White - BUiltlinq: Canary licant; Pink - Accountin9; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collecfors � Solar Pipin9 Solar Tank � Swimming Pool w/Spa WdIEf CIOSCL Water Heater ' � Water Service � � � Auto-Wash LaundryTreys � • r Issue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-7 00,000 BTU �O 100, System Repair/Alteration Fire Dampers Registers � luue Fee r $ 3 -' FEES ` BTU $ 3 A.P. # . 5 Main 6uilding: E T Front A Rear C Right gLeft Ping. Ref. # Plannin9 Notes: 0 Automatic Washer Construction Pole Sub. CookingUnit' . ' Distiwasher � • Dryers ❑Gas. ❑Electric Fan F.A:U. Fixtures ' Device Boxes Outlets Switches • Gar6age Disposal Generator 00�5 KW �5�15 0378 3/04/86 Zone 'A ccessory-6 u i I d i ng: Parking qeq./Provided . ELECTRICAL .Transformer ❑ 15-50KW O SO+KW �Meter ❑uptot00amps Meter ❑over100amps• " Sub Panel Motors00-7 HP07'h-8 Inc. Sola� �9-15 HP 016-1'. Pole Light Fange Standing Sections Trash Compactor Fee �$15 � � luue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By_� Buildin8 APP�oved By . SUMMARYOFFEES BUILDING PERMIT $ � SMIP. � PLAN CHECK $ PERMIT PIUMBING $ ISSUANCE PLAN CHECK 25% $ � ENERGY P.C. ELECTFICAL $ � GRADING PLAN CHECK 50%� $ MICROFILM MECHANICAL -$ � � TOTALFEE PLAN CHECK 25%� $ $ �;,4G Tl FEES $ 3 Z O N I N G R E Q M T S ._� � ONSTRUCTION AND PLANNING POOI ,PA; . APPROVALS Permit# Date Inspector AppROVALS Permit#�� Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. . 53. StPel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE � 7. Footings � � 58. Electrical Conduit-Undrgrnd. 8. Foundation ' 59. Gas Pipe, O Undrgrnd.,,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap� O Undrgmd. 10. Structural Floor System ' 61. APPROVAL TO DECK f 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final I 13. Roof Drains 64. Plumbing System - Fina' 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 78. Rough Electrical-T Bar Ceiling 69. P00 VSPA 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 �• 77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � 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 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � �D Notes: �� N�j7- ��;/9-P C 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 47. Solar pomestic-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. Electric Release to Edison 50. Gas Release to Southern California Gas Co . - 51. CERTIFICATE OF OCCUPANCY ' � No. Date c + OWNER $jJ'j°j'$� DOI1811I g� v DATE S�u�� JOBADDRESS 24i COSt.82'IQSB S}.• BUILDINGPERMITNO. �35 GENERALCONTRACTOR BE� COI1St.TI1Cti10II VALUE $ 16f�� L/'"" �� 8-091�5 BLOCK TRACT �iplex GROUP H TVPE D ZONE R�4 FIRE DIS7RICT f%�3T PERMITS ISSUED INSPECTIONS �l DATE I SUBCONTRACTOR � . l�/_ _ /I _ A I DATE I NUMBER Plumbing, Rough to Slab /'wf' Plumbing, Rough Compl'et�e�/ Temporary Pole v�• Wiring, Rough ' � t Heating, Rough � Heating, Final % 1.��-, Sewer '� Septic Tank or Cesspool � � Lathing P ring �^- vi � Plumbing, Final, Fixtures Co lete Plumbing, Final GasTest�� Wiring,Final �� Occupancy �i � I�orm 110 GH 1M 12-68 ..�fiV. - Gosta 1liesa Buiiding Department i`� 111 EAST 20th STREET COSTA MESA, CALIFORNIA � FOR t1PPLICANT TO FILL IN Buiiding "� Address �y/ COSiij �S�S'..'�, Costa biesa, California Nearest Cross St. ��A�/G 6 or � (Attach Metesand Bounds Size of Lot � / p Use of Existing Bldg. Setback Line trom r........r s..... cTa / Building�y� _. � :erior Wall City Lie. N o. Block I Traet //8' �9/ — .c No, of Bldgs. �/ Nowon Lot /�Q�� INo.of No.of Familfes Rooms Rear Vard a G " Cid. V�nA ✓Ii. (" ig � � Demolish I No. of Rooms /c� Sferies / APPLICATION FOR PE$MI� ' ___ .BUILDI.NG. :� .,:'; ' FOR OFFICE USE ONLY � Receipt No. Permit No. ,� ,-� l� a �,2 3 s� ; eceive y Date ec' Date Iseued ' ��= � S �%%�s-��-s-� a'P� / _Ca J %R /l�l- Costa Mesa, California ��.Gt� � i No. o/� e kTType i u �T �v; � mrn� „overing_�y�� d I Coveriny CoMPa APPROVAI.S Use of New Foundation Lxation Inspecto Building . ��51��,�/��L /A/G6/K� Forms,Materials, Under-Pin�inp — L Frame: Fire Stops, Bracing, Bolts Lath.lnt. I hereby acknowledge that I have read this Application and st�te Ihat the above is correct and ngree to comply Lath. Ext with all City Ordinanms and S�ate Iaws regulating bu7lding cons�ruction. Signatureot /�� `� Plaster,lnt. Permittee o Plaster. Ext Valuatfon s /� O a� a nrm 2n� C- I51 1 Plan � Total 'ee � Bond B FINAL O a � z D r , . . :. .. . • : ,. , _ , , . . _ .. .. . " r ' . � � � " ` ; . . . . . - . P . . � : � r O � . L � a J � . w � . . - a � � . . . ' i . . 0. � a � , , � . , 4 . Street �i. . . . = PLOT PLAN - : ; .. -: Show location and distancea from property line and between buildingx ✓ ' ' . .,.. . . � .. �.i '. _ -_ .' . . , / _. _ . � : - . . .. ._. .. . �` .