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HomeMy WebLinkAbout911 DARRELL ST - Building Permits(714)754-5273 • Faxpia»sa-aess • www.c�.�os�a-mesa.��MBWG PERMIT Job Address: 911 DARRELL ST Suile No Vicinity: GARAGE Parcel Nunmber: 42235312 npp�icant: YOKOTA, MALCOM Address: 17390 MT CLIFFWOOD . FOUNTAIN VALLEY Owner. tiK Address 911 � � irrigation Preventer Dental Umts ., �� Dishwasher ��;�•��' Drain Floor:. iz Drain Rainwater �'r. Drain Roof �� �" � Drinkmg Fountain Expansion Tank; Gas Earthquake Valve ,� Gas (1-0 outlefs)�.; . Gas (Over 4 outlets) _„ Gas Repipe Gas Service _.,� Interceptors (Grease, Oip,; Interceptors (Sand Auto j+�:: :� �� .:,� i , �� ?y �� : _..�eti.,.. ., -. g n ,.�.e n�"_ �_ _ . ' as' �'i}� JQTER PLUMBING HTG AND AC ,� �k- .IFFVJOOD �� Phone :7-14-241-1414 �ALLEY Zip ' 92708 License ;,529127 � „ � � � , , .. _ ��, ' , :'�:t . ... FEE SU ,rae. ; E r., y.� � 5. ..'.. i � - LaundryTub'/�Washe v�x, :,Landscape;lriigahon; P Trap Pressure Regulator "' Process Piping (per 1 .. Recepto�s; �,y -- - --'-SepUCTank-' � SewerCapforDemo ' SewerConnect Sewer Private Line Shower Sink bar ' �`Sink commeraal r �.d��n ��000 �:���� :S Y� . ;�,x;�$0 00 � :.0 .�r�,,.�,,,..:_: $000 0' $0.00 i0 9 ft)''":R�.� $0 00 � _�� g ,�. .;, �, $0.00 ;;.0 * � � �$0.00 - �0 �' . $000 0 "�$0y00 0 � A'$0.00�„ .:,0 $0.00 0 $0.00 0 '�$0 00 0 ��'� $0.00 0 «4�cnnn *1n....:... � 77 FAIR DRIVE, COSTA MESA, CA 92626 - � � , Status: ISSUED � Applied: 11/15/2005 Issued: 11/15/2005 0���,���V///'����f ISSUED BY: ___�� � r s. ;;- S � i. pAMT ��'� QTY �. q � ' i�.�� . Q iol °� '�i `�. �$0.00, �:: 0 �� �, `" $000��-. 0 ,�� $0 00 �' 0 Bkflow(14) r,$0.00'` 0 - Bkflow(5+j • $0.00 r . 0 � �':r�. $0.00 0 Set ::�� $0.00 � 0 ent System =�• $0 00 0 (Todei) "� $0.00 0 rlvent,"�" $12.30 1 (Inst or,Rep ) ; ,$0.00 0 ie � ��$0.00 0 e ±a$000 0 ier� � $0 00 0 f� $0.00 $0.00 K , $0.00 ION�-- $0.00 0 fED FEES: 535.80 NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord: No. 92-28, § 1, 12-27-92) � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 rc o law� WORKERS'COMPENSAnONDECLAFiAnON: — I heieby effirm untler penalry of perjury one of ihe following declarations: � _. . , . , ❑ I heve end will mainlein a certificate of consent to self-Insure far workers: compensation, es pravided for by sectlon 3700 of tha Labor Code, for ihe pertormence of the '�ork for which ihis permit is issuetl. ITha e�entl.vrtl4maintain workers' compensaiion insurence, as required by section 3700 of t�e Lebor Cotle, tor ihe peAortnance of the work for which this pertnit is issued. �My w'a��,r�j' �co.m�etnsat n AI s,,u�ran�ce car�n�j Nantl policy number ere: �7/_ �j�-/� ^ �j Carner "�i1f.L�M �WM�Q"1"1 PolicyN�' umtier�.`I�'!�I(J_�11..]VJd-DO7' �IssecNon neetl not be complete0 i/ the permitls velued at one hundred tlollars ($100) or less.) ❑_ I certify ihat in the pertormance of the work for which ihis permit Is Issued, I shall not amploy any person in eny manner so as to become sublect to the workers' . compens�lav/s of �alHp�ie„eptl agr e Ihet i� sh�come sublect to the workers' compensatlon provislons of Se;tlon 3700 of ihe Labor Code, I shall forthwith comply with ihas pm� slqfis/ // 1 ApplicanfSipnaWre: �1�u -yi���.A+ . Date: -11- � c-�� WAqtJINp!FAILURE TO S CURE E WORKERS' COlAPEN ION COVERPGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND GVIL FlNES lIP TOONE HUNDRED hqU$AND DOLLARE (5100,000), IN ADDIiION TO TME T OF COMPENSATION, DAMAGES AS PPOVIOEO FOq IN SECTION 3108OF THE 1A80F CADE, INTEFEST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I here6y aHirtn ihat I am,licensed:uAderRroy�sions of Chapter 9(commencing with Section 7000) of Division Code, antl my Iicense Is in full CONSTRUCTION LENDING AGENCVC - ' - � ❑ I hereby attirm that ihere is a construction lending agency for ihe Oertormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Siqnature: _ LendeYs AOdress: Date: I hereby aflirtn tfieC;under penelty ot perjury,ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Buslness antl Protessions Code: Any ciry Q_ counry whicli reqwre5;a:perinl4to constmct, alter, Improve, demolish, or repeir any simcNre, Orior lo its issuance, elso requires the epD�icant for such pertnit b tile a si9ned statement tliet'he or she�is licens`ed pursuant to ihe pravisions oi the Contrectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 of the Business end Protessions`Code) or thet`he'or'she is exempPti, relrom end tha basis for tha allaged exemption. Any violation of Section 7031.5 by any applicant for e permit subjects the epplicant to a civil penelry,8t"no{�ore than N've�hu��ed dollers ($500).): ❑ I, as owner of Ihe properry, or my emp�qees with,Evages�@5 iheir sole compensation, WILL DO 7HE WORK, and ihe swcture Is not Intendetl or oHered for sale (Sec. 7044, Business and Professions Code: The ContraCtors;L�cense Lew does no� apply to en owner of properiy who builds or improves Ihereon, and who tloes such work himself or herself or ihrough his or her own employees; piovitled that such improvemenis are not intentletl or oHered }or sale. N, however, ihe building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I, as owner of the pmperry, em E%CLUSIVELY GONTRACTING WITH LICENSED CONTRACTORS to construcl the prolect (SecJ044, Business antl Professions Cotle: The coniracrors Llcense Lew does nol epDty to an owner of property who builds or improves thereon, and who conireas for such project wit� a contractor(s) license pursuant to lhe Coniractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for ihis reason: Signature: Date: Owner ID veritied by drivers license. ❑ Ves ❑ No Driver's License No. Expires: Vedficatlon of Ownarship by (rype of daument, I.e. - property ta�c 6ill or deedJ: DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICA710N: ❑ I heraby certify that no excavation tive (5) or more faet in tlepth into w�ich e person is required to descend, wlll be made in connec�ion with work authorizetl by Ihis pertnit, end that no building strucWra, scaHolding, talsework, or demolition or dismantling thereof, will be more ihan ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title e, California Adminisirative Code). ' ❑ As owner-Duiltler, I will not employ anyone to tlo work which woultl require a permit irom the Division of Industriel Satety, es notetl above, unless such parson hes e pertnit to do such work from ihe division. Signature: Date: Division of Industrial Safery Permit Number: CER7IFICATE OF COMPLIANCE AND AIJfHORIZATON OF EMAY: I cenify under penaliy ot perjury ihat I have read this application end state thet ihe Iniormation given is wrrect. I agree to comply with ell state laws end city ordinances relating to building consiruction, and authorize representatives ot the Ciry of Costa Mesa to enter upon the ebove-described properry tor inspection puryases. I egree not to occupy or ellow occupancy of eny building authonzed by t�is permit until tinal inspection. GOOE t. INSPECTIONTYVE 1616 Fized System Final Fire Prevention 1266 Pool Spe Final 200 Finel Re-Roof 201 Finel BlocklRetaining Wall 202 Final Factory Fire Place , � 203 204 Finel Sign Finel Demolition , .. .. . OpTE Vi�96� _ �l- IS-a � COOEI INSPECPONTVPE 206 FinalMechanical -� 20B Final Plum6ing 210 Finai Electncal 212 Final Fire Prevention , 220 Final Planning Approval 222 Final Site . . , . , „ ,.: 250 ,.. Final Building/Occupancy � � II�IL—c�5 � � .; (71 a) �5a-5273 • Faz (�14) 75a-aess • www.ci.costa-mesa.ca.us 77 FAIH UHIVt, GU51 A MtSA, GA 82ti"Lti u Job Address: 911 DARRELL ST Suite No Vlcinity: Parcel Nunmber: 42235312 Applicanh BRUSSIN, Address: 911 DARREI PLUMBING PERMIT Status: ISSUED Appiied: 12/07/2007 Issued: 12/07/2001 ISSUED BY: B �''_ � n `� �'�. Phone: 949-645",1478, / � �` � Zi e92627 �.✓ _- P'� \ /�..�` ` ```�'_'-�'_vC`��c-"�`�-. �., . 1 jress �911 DARRECL'�ST r/ �`-'// ��j i �COSTA'M SA, CA � ��� �.., /1,��.. ---, 3ctor: J,OWNER-BUILDER ij ( �--� IArch /JE j j�LAddr �, , , -, \� �� _ � ��� 1R,EPLACEMENI � � 1`GAS REPIPE. � NO OTHER WO \ �\\ t\ ISSUE FEE � Backflow irrigation Backflow Preventer O Bathtub \ Clarifier System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 oullets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 0 0 0 0 0 0 0 1 0 0 0 Phone: Zi i '92627 s Y� � �P O <� a ,, a-v'� � .�o r.t�---�.� "� Phone: Zip: License: 0 (�`1r�7C� �1'il�" T1 °��I�' AI� �1'�' Phone: ��-�-'c¢ J .m/Z�P_ -ti ` �;2.,_,.._ __�:_..License:,_ �ti� i � SCOPE OF PEF = GAS LINES IN SLAB WITH NEW SI ,�,,. .' `i�^'g'�.�`' _. WITH THIS PE`RMIT. ��'.J �-'C:;.� � s�;�°�FEE�SUMMARY. � � � S�u a � ���,�, �.� AMT� Q' �� ° /r' c��0 Qa� � idry Tub7 Washer �i+ $0.00 � 0 Iscape� Irii9atiou � ° o $0:00 ' 0 aP<-.. . . �)�u' �. �$0.00,,-.0 '�.Nrocess•Plping�(per�10_ft)�'_$0.00"" 0 rJ Receptors_ $0.00�`0- � 1 .r'Septi �Tank�1 ('"���-" $Q00'-0�� V Sew'er Cap for Dema (_� �, $OAO v0, � SewerConnectJl��r"�} $0.00��' 0 _ Sink, bar��----- Sink, commercial Sink, Floor Sink, kitchen Sink, service/mop Spa (private) Spa (public) $0:00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 ATTICI � .. . V ��% � Wash-Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent WaterPiping Qnst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION O $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E33.30 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NO710E: The work authorized by this permit s a compy wi � -- -- equiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. , INSPECTIONS: In order for the work authorized under ihis permit to be considered, legal, such work must comply with all applicable codes, and all required Inspections and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 . � 2446<fi (N00) WORKERS'COMPENSAnON DECLARAnON: � � , I hereby aHirtn untler penalry oi perjury one oi the following declerations: ��' • „ � ❑ I have end will maintain a certificata of consent to seN-Insure for workers' compensation, es provided for by section 3700 oi the La6or Code, for the peAormance of the work tor which Ihis permit is issuad. .�. - ❑ I have antl will maintain workers' compensetion insurance, es requiretl by section 3700 of the Labor Code, for the peAortnance oi Ne work for which Ihis partnit is issued. My workers' compensation Insurance carrier antl policy number are: Cerrier. Policy Number: (This section need not be com0leted il the permit Is valued et one hundred dallers ($100) or less.) . ❑ I certity that in the pertormance oF ihe work tor which ihis permit is issued, I shall not employ eny person in any manner so es to 6ecome sublect to the workers' compensatlon laws ot CalHornie, entl agree that if I should become subfect to the workers' compensation provisions of Section 3700 oi the Labor Code, I s�all forthwith comply with t�ese provisions. Applicant Signature: Dete: WARNING: FAILUPE TO SECIIRE WORI�RS' CAMPENSATION COVERAGE IS UNLAWFUL ANO SHALL SU8IECT AN EMPLOYEP TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE MUNDRED TFIOUSAND DOLLARE ($100,000), IN ADdTION TO THE COST OF CAMPENSATION, DAMAGES AS PFOVIDED FOR IN SECTION 3]OG OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATON: I hereDy attirm that I em licensed undar provisions oi Chapter 9(commencing with Section 7000) of Division 3 of the Business and Protessions Cotle, and my license is in tull force end ettect Lla k Cless N ContractoYs Signeture: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm ihat ihere is e construction lending agency for the peAormance of �he work for which ihis permit is issue0. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Address: Signawre: Date: OWNER-BUILDER DECLARA710NS: I hereby aHirm Ihet under penelty of perjury ihat I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or county which requires a permil to consiruct, alter, improve, demolish, or repair eny sirucNre, prior to its issuanca, also requires the applicant for such partnit to tile a signetl statement that he or she is licensed pursuent to ihe provisions ol ihe Contrectors License Lew (Chapter 9(commencing with Section 7000) of Dlvision 3 of the Business and Professions Code) or that he or she is exempt Iherefrom and Ihe basis for the elleged eaemption. Any violation of Section 7031.5 by any applicent br a pem.. subjects ihe applicant ro a civil penalry of not more than five hundred tlollare ($500).): ❑ I, as owner of Ihe property, or my employees with wages es their sole compensation, WILL 00 THE WORK, and iha strucWre is not intended or oHeretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work himself or herself or ihrough his or her own employees, provitled that such improvemenis are not intended or oHered for sale. If, however, the building or improvement is �sold within one year of completion, tha owner-builder will have the burden of proving that �e or she ditl not build or improva tor purpose of sale.). I, as owner of lhe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the projecl (Sec. 7044, Business and Pmfessions Cotle: The contrectors License Law does not epply to an owner ot property who builds or Improves thereon, end who contracts tor such project wit� a contractor(s) license pursuent to the Conirectors License Laws.). ❑ I am exempt nder sec.��— Signature: � m .`7t Y'� w.c Owner ID verified by dnvers license. ❑ Vas No Business and Professions Code tor this reason: Dete: \'L�-1 — 0 \ Driver's ucense No. Expir85: S"� �"`O Z Verification of Ownership by (rype ot dwument, I.e. - property ta: hill or deed): —� DIVISION OF INDUS7HIAL SAFETY PERMR CER7IFICA710N: ❑ I hereby certity that no excevation five (5) or more fee� in dep�h inm which e person is requiretl m descend, will 6e made In connection with work authonzetl by ihis pertnit, and ihat no building siructure, scallolding, talsework, or demolition or dismantling thereof, wiil be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Celifomia Atlministrativa Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit irom the Division of Indusirial Sefaty, as notetl ebove, unless such person hes a pertnit to do such work irom ihe division. Signeture: Data: Division ot Industrial Safery Permit Number: CERi1FlCATE OF COMPLIANCE AND AllT}iORIZATION OF ENTRY: I certity under penalry of perjury ihat I have read this epplication and state Ihat �he infortnation given is correct. I egree to comply with all state laws antl ciry ordinances relating to building cons�ruction, and authonze representatives oi ihe Ciry of Costa Mesa to enter upon the above-described property tor inspection pu�es. I agree not to occupy or allow occupancy of eny building authorized by �his permit until final inspection. � 1 i..� �Yl ��^ �^�, SignaNre Of Legal O r s Date And/Or Authorized Applicani CODE I, MSPECTIONTYPE , 2pLE INTRIALS 1616 Fixed System Final Fire Prevention 7266 Pool Spa Final 200 Final Re�Roof 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition COUE 1 INSPECTION TYPE 206 20B 210 212 220 222 Final Mechanical Final Plum6ing Final Electrical Final Fire Prevention Final Planning Approval Final Site 250 Final euiltling/Occupancy Date onre INIRU�S loi -i/ - a/ � � � Applicant to fill in all sDaces exceot those within neavy bortler lines antl sign all appropriate tleclaratians. ' � . ' __. _ ' f .`' 1 PF� MIT NO � ; TRACT NO. ' + � LOT NO. . - � _�� ' � I ! s• � � �' � �6235 i8���;L7�Q� 7 -, ( 5��� =j'li. CiTY oF coS7a MESA I CONSTRUCTION PERMIT � (� ) } (] �;; ,„ r.; ., '•i UNIT NO.., �, a � � i, i�, 4, +•�,. , f _..! i n (� ' � ' I � \ `I" � -CJ�' , ' i - a.� i � �. .. _ _ i caz I , _.. ' � : . _ , �.i i i :- .S n i � f , i . = ; _ u a � Pro�ect Address � • '� �� p 11 �iriQ�' 1.� C i��� _ � } CJ . � . . i . . . ' ^ � `. � •• { . . � � ! �.. j � ' ' \1 -. � C `,l p S� � ' � TYPE OF CONSTRUCTION= � � NEW �' -� ADD 'ALTERATION : REPAIR� � � � ' r - r! � i„ � t, k � � ; � �� � - � � ^. .� 1 � Applitant'S Mailing Address �0 CONVERSION -❑ DEMOLISH � OTHER. ' � � 1 - ,� � - ' ' _ A p #� = � -' { � - i ' — � � ^ � ' r Zone � !'T Owner's Name "��N^ � b�- ���� � �'Plione � �� , DESCRIPTION OF WORK/USE OF,BLDG� ^' R4.ii OL- f`� G�'c' � Address I y�� �� i `)A0.0.C�.1^ S� ' �� %:.�' $-i�� 1u1� i � .. + n .S � [. � : i " � � ) � � � � � �: :_ iy_ _- � � ! .- i - � ._L ( E � S Mairi Bwldm9�l i � . ! .- . � AccessorV Buildin9i., ' I :' � Arch/Eng ' ' ' ' ' � : 'License No.i y I ~ � 1 - ! ' TVPE OF BERMIT 0 GRADING �FOUN�ATION, ❑�STRUCTURAL � " } , T, Frorit_r - i <� � ^ � ' � T � _ - i �, 1 . i ~ i ��� I � � � 3t< �O. '� � I � � ❑ TENANT ;O ELECTRICAL ,Q PLUMBING 0'MECHANICA'L' I C � F n � ' � ' Address i: i'{ 1" .;i � i ; i i� I'. i i } 1� � I t 1 r i:: � i ry �' q r � B Rear I: - i�r .'� ii _ i . � _('S' I f � ' ��R N � �..�-i � -�-�c ..a � ��,i�l-ti.i �� �: .❑�orHea, _., 3 . :. . . =1��1 i 4 ���� a' - _ , i Contracror s Name Phone i 1 � � , - � : - � ,. � C Right � e � � � � ., v ; _ � � � � ^ � �' �C N ! � • � -a + � , i p. �, � � � J I PROJECT DESCRIP710N� 5(l: FT. • � � � � 1oCCUPANCV� ' � ' � � - . ' Address (mailin9) • � ' . l � .' � u; � , v : .K � - c. � ' t I , � r � G � ) I CONSTRUCTION TVPE � - � VALUATION $ S Left I � , � �' j. , 1 �� � � _' � � ;C City Lice se No. I ;' � =' � . � , ! i � I � � �'� � I � ? 1 . . 1 3 � � I - � . � , _ R. � ZONE � GRADING CV. VDS. � �ACRES � ' , p :(' LICENSED-CONTRACTOR DECLARATION � i � I � � , � ' � � • � - 1 . � � � � � Ping. ReE # ) � � 1 Paikmg�REq./P�owd¢d G �_� � E� ( I�hereby�affi�in tnat�l am'licensetl untler provisions of �Chart¢i�9 (commencing I , qemarks: � �., � ; { i � i ; ; � � � � { { � Planning;NOt¢S: t ' + � ' t � ti � {�' M � with section 7000) of Division 3 of the Busmess antl Protessions Cotle, antl ' ' ' " � � ' � T , . t ' , � • . — � — : ' � mY I¢ense is io full Porce antl � t. , � � ' f � �. I � ( � � � i { � t' i � � � I i !� � � � ° l ' ! � � � � : . 1 ' �J f c, � }'- S. � Ucense Class � ' - - License No. `' � � ' - � • - - -- �Date � � ' � � '� Si9nature ^ E i . . I ' � ' i , 4 � - � � , ' PLUMBING' i. � i � f , � FEES 1 � j � ; . ' . :. � . � � • � ' i , !� WORKERS'COMPENSATION�ECLARATION�' : j � i � j Ba�$ink ' $hOW¢�S' � ' � � � � � � I I herebyatiirm lhat I have a certuicate o� consenl to seli-insure or a certiticate � . . : t � � � j/ . , � I• I 2 C�% • � � r � ELECTRICAL ( � ,! � � FEES i _of_Workers' Compensztion. InsurSnce,�or,_ a_certifietl copy theieof. (Section_� � � i � i i ; � . , � . . � 3800, Lab. C:) i � � , - � � - �' �` i" Backflow�Preventer� -_ -�---i - -Seivice Sink� --�--- - i-�--{ --•.1-- - - -Automatic WashertT'-� -- ,`Trerisformer��-15-50 KW—�- -�'--, - � -' , ' PolicY No. -� I �' � comPanY ' � � �I ' � � Backflowlrrigation SewerCaP ! : { � i . � T �'. � '� 50+KW 1 1^ � r �, . . � � � 1 � , j � , Construcbor Pole Sub. � j I � j . , � Certifietl copy is hereby fumishetl. � � {, I t f Cer[ifietl copy is (iletl with the city Builtlm9 Drvision. .� 1 I �� '{ B3thtub5 � � �� '� -y SCw¢� ConnectiOn � ! �'! COOk�pg Ullrt ���' � �Mete� ❑up t0 100�dTp5 � � � Date 1 �. ... . i APPlicant � � ' � , � ( .. . . + I i l ' � . i 1 .. . � A i � i" ! EXEMPTION�FROM WORKERSICOMPENSATION DECLARATION � ClanfieYs � � I � ; � � � - I , { � � . � � p - `Solar Colleccors. , � _ � . Disliwasher , �, •+� , � � � � , , Meter ❑over�700 amps� � � : �(Thissection neetl-not�be compleYedif�the permit"is for one huntlred($300)'or"{' . ' ' ' : less): � � J ? I ! � 1 � � � . � . � . � Dishwaiher j � j -� _- ? Solar Piping� � j � � ' ' - Dryers �Gasi DElectric � � �Su6�Panel - � • � � � �I cerLfy �that �in the performance oi tne work foLwhich this permit is issuetl, I � ' t � : shall�mt empioy any person in any manner so�as to becfine subject to �the i � Drinking Fountains E �� i Solar Tenk� � ! j� � �'. Fan �• ; � � � : � Worker�q ' Compeny; Ipn Laws of Cal�nia.1 � � � - - - � , �� , � . Motors OO-1 HP Oi %-�8� . i , � -Date `S^ � ��� `��\ I Si9nature { -' � \-..�-�� � Floor D�rains � 1 � Swimming Pool w/Spa � ' � � � - � � NOTICE:Ii,aflermakin thistleclaration, ' � - � - � � F�P''�U� '� � �InaSolar'09-�75HP016-15+ g you Shoultl b¢wme Subjett to the , _,' , � '� .Workers' Compen5ation. rovi5ions,ot.!the_Labor.Cotle,y0u.must forthwith � - L ' � ' � � � ` P Floor Sinks =_ �-. _ �. . _ ..Urinal-y � -- —.-�--_.__ � __� �� _ .Fixturesy--�-�_1--�- ! �Micr'owaJe � ' --�: ---- � romply with� such provizions or tnis pe�mit � shall be tleemetl �evoketl. �� ' , ' � . , � 7— . "'Y-'�--' �'"� � - % CONSTRUCTIONiLENO1NG)AGENCV.� 1 " � � 'C � ; i •_ i .' , ��� GasSer'vice �Outlets, :� � � � � � � �' � � �= � y' -� ' ' ' ' � i . ?, 1 f� - ' � � �Wate`r Closet � �� � Device Boxes 1 � 1 I- I � 7 I hereby affirm [ha[ Iheie is alconst�uction•lentling agency�to� the performance ' -'- �` �"��-� "' ' a I Pole.Light � � 1 � � ' of the �work �fo�I wMch_ t,hi� permit�is�iswe4.(SecLon�309Z Civ. C.) ti{ �� Inierceptorsi .° � ; � �� j � f n� � j OuLCtS � I � � � � Ran E ' ' � � - i -WateqHeater � r � . r �� - � . ` I i 'Lentler's Name � ' "� � 1 - - � � 9 � � , Lentler'srAdaress. 1 i .� '' o i r' ': I � i "` f ,�• . � n � ' - KitcheriSink �� % v t � 1 ' x „' � e ' � � � � � . : . t � � � , _, i - Water Service � � ! � ,,. � �'• Switches� � � Si n I � . OWNER BUILOER DECLARATION - -" • {- � !- rt_ � . �.r �� } � • �- -' ' • / � � 9 I � '{ � , I he�eb affirm'pthat I am exempt from.the Cantractor�s'License Law for the �� � .Lav3tOfi25 � T1 '•� F �`' � (] i �' U � ' !, f �o �i' �' ; - i v , 1 . . � , � Y . ( , <ti _ i � � i " � , � �' q _ � r. Garbage Disposal ' I' Standing�Sections � � � � -following'reason� (Section'7031�.5tBusiness antl Professional Cotle: Any aity or ( '- - - - � � ' � , � � _ � 2ounry wnicfi reqwres a permit,to,construct,ialter„improve, tlemolisli or,repair; ' � p �7�aP� a � :y � �. '7 ! �,� � _ t � i !, ^ ' 4 ! 1 _' � Y �, ,? . ,� 'Generato� DO-5 KW �5-15 KW � � � ' � � � �any it�ucture, p�wr [o �its;issuance; also'requi�es;the applicant (o� such permit t � � ' i . � � Trash Compacmr { � ' . k - � . . (to fiie aisignetl statemenGthat;he%she is licensetl�pursuant to�the provisions of � "' ' _ � -.� : � = i � � < < , ' ; - � Roof�Drains � *-' � , . � ,, t s: ; '�; j ' � , � �the Contractor's!�Icensc Ww (Chapter�9.(commencin9 with Section 7000)�of-�, � i � �� 1 fr ' i � � . 1 � � - E �`�� - ; � � ! � ' � '� , ' ' � ' � •Division( 3=of [he�Business antl' Protessions Gotle) o� that he/She_is exempt ! �- + � � � t L � � J, � �-' � • t � `_ - - . , r , .i _ _ ; :herefromi�antl the basi5 forithe alle9etl exemption.-Any violation;of Section +% � e'� ��; � r �% F � "`�• �� 1 � � , '7031.5 „by� any, applicant tor a permit, sub�ec[s.the- ap0licant±to a civil � - ' � �� ' r- . � � " - � . ' � ' � ' � ` � ' ' + � y nalty of,not more than five huntlretl tlollars�($500).� r. t' ' � t '� � . �� � � + ' r � , � ( L�' � i ! a � � � � ' � � � ' employees'with wa es as their sole j Reinspection Fee` � $15 - I � ISSue Fee' � { i� I $.3 ' _ � � 1, as owne� ot [he� property�or'my; 9 ( ' � �'co ensatron, will tlo the wo�k, anC thestructure is not intentletl or offeretl � ''�� �' - � ' '° -' R¢inip¢ction F¢e ' $15 � luue Fee � � �$ 3 for sale (Section i7044, Business antl Protessional� Cotle: The CanVactor's • � :; ��; � 'ti • r, �,� __ �MECHANICAL ' j � ! . - FEES� � � ' ' ' � � ' � License �Law tloes not apply t0 an.owner ot a property who builtls o� improves '� � '� • �' em�io�ees�providetl� nat sucF�: mkiovemeot eare not�intendetlhor offered fo� � � Bo�ler �^ f' �� Hood or Type I i ❑ i }'.�� ' %-+� ' DEVELOPMENT SERVICES REQUIREMENTS: J � � � �. 1 sale If however, tne tiuiltlin .cr imProvement is soltl�wlthin one eai of com- � ' ' P k� } + ; '; � ! r 2omng Approved By ' t � � Date � � g' Y i � i . . , � Canopy � Type I I ❑ f ; . � , . . . . � pletion,.the owner willihdvei Ihe bu�tle-n of proving'he/sh¢ tlid not builtl or, im- DuCt= Und¢� CirouOd � � ! � , ' Building App�OVed By � � � OB[e � �ova�for Ihe�purpo5e of sale). � � � � . , � � � ' ' . � , LI I,'a5�own¢r•of.the property, am ezclusively cont�acting with licensetl com � �� DuCt - St�uctutdl �� � � Refrigeration System �" Qpplic3tiOn ISSued By ' � � Ddt �J-� tractors to construct the project (Section ]044, Business antl Professions Cotle: ' ' ' � � 1. � - I o ' The Contractor's License law tloes not apply to an�owner of'property who • 1� Duct- Ventilating, i � _j. ❑0=100,000 BTU !�100,000 BTU � a � � '$UMMARV OF FEES � � � builtls or improves thereon; antl:who'cbntracts for such prOjects witn a'con-* � ' - • ' - � --�-- ^- ••- ^� ' - -- — ' ' j . , � � � 1 � ' tractor(sI license pursuant�to thej�Contracto�'s �itense Law). I am aware�that � Enhaust System ❑ MWtiple 01 System Repair/Alteration '�• 1 �� �, BUILDWGPERMIT ,$- � �! �' �'SMIP j '$�� ' proof of their Worker'S Compensation insu�ance shoultl be provitletl to' me.� . � . . . . ._ � f 1 � -� � � � � � . , , ' � �i . � ; � � � ��� PLAN CHECK � j $ f � �PERMIT � I ! ❑ rl,am �exempt under Section ' B. & p. C. tor this reason � � Firepl/Fact. Blt. ICBO # � � '� F i .. 1' + . ! 1 i , � : . � , � . I d , i i I ' � ,. PLUMBING � $ � �. E� . ' ISSUANCE � $ � ' � u nar '^1 - Owner� ��• -' � '- ' � -� ' � HeatingSys4em&Ducting! � f � � j ( � i pLqNCHECK �25%' $ � � � : �ENERGV,P.C.i $ '� �� I-hereby'certify�thatl have reaC�t is-applmatibn antl-state�tnat the above�,-�- �6.100;000BTU�100,000BT �• �GRADING $ intormation is wrrect. I a9ree to tompty with a11 city antllcounty ortlinances ` i � 1 � , ; -' �� �i , . 1 E,LECTRICAL � � $ ' � � , ! and'state laws �elating,to builtling construction; antl�he�eby authorize repre-'� • � p � �` • � ! I ' 'MICFOFILM '$ � ' � - sentatives ot� this� clty, to entert upon the above-mentionetl �proo,erty �tor �' � � � � � � ! � I , � , � ' � PLAN CHECK �50% $ � ' '� � ( * insPection P Poses. ! " � � ! . 1' � . ^� (1 .( � ' t i ; 1 . . � i i • ! t MECHANICAL • � $ � ' ' ,TOTAL FEE � $ � �• �a Signature ' � " Oate� k-.C�_l_ � t � � 7 i ( , � . X Drivers'�License or�55 � � ' � , � � � � : Reinspection Fee { $15 ' ( Issue Fee .� � $ 3 � � PLAN CHECK 25% � $ '. � � � � • � , � � \ CMF 0865-46, rev. 4/84 White - guiltling; Canary - Applicanq Pink - Accounting; Goltlenratl - Assessor ' "� ` " ----` "' ' "�-"' ` � -i^--� -' ,K , C r � ' " � . � � � POO. � SPA � . _. CONSTRUCTION�AND.PLANNING: �_� � � ' %� � - a- ir. � `: � ! � � �` ; ', T - - . Date �- Inspecfor � ` ,' � ' � �" � . - Date InspectoY �� APPROVALS. "permit #' ' " . ` ' APPROVALS _., `.Permit�# - 'S,A .r ',.. . .y t � � �1. Temporary Electric8l_Ser �ce or;Pole � . '52 'Pool &:Eqwpment'Location ``! . , ' - ;' O` � ' i t ry•. . . �.1:: � � 42.Soil Pipe.Undrgmd. "- � - J�; A j „ �� � � '� � � 53. Steel�Reinforcement � • - � Y � T �. .�,� ; ' . . � � . � - . �" .. - . . a3. Electrical Conduit,lltiliry;Undrgmd. �� �'� �, . 54. �Forms .- . � , � ' - . - _ � �: � �4.- Electrical Conduit-Undrgrnd. -.� . , . _ � - 55. Electrical Bonding - � - � ' ',p - _ i , 5. Steel�'Reinfo�cement _ � „. � �_ �' 56. Rough Plumbing�& Pressure Test. • - -� ' ��,� •"6: Electrical UFER Grnd ,`, .- � ^=� . � - . -57:IAPPROVALTO COVER GUNIT,E ; �-f ,. - � ''- � c7,. �'Footings' � � ;' ; ` : � � a . - _ 58' Electrical Conduif-Undrgrnd. ,,, • � r - � �, i _ �� 8.: Foundation' , ' . � ' `� ` � • � ? ' . i,:,� � - 59 -;Gas Pipe ❑,Undrgrnd 7est. .-+� .� -. - �. ; . F '�:9. Water Pipe-Undrgrnd: � � - . � � � ' ; �. _ 60.;BackwashpLines; P_Trap°O Undrgmd. � " - � ` - -. " F �,10. Structurel Floor System. �-'- 61�. APPROVAC TO DECK . . . , . - •. � j1�PropertySewer Line & House Connection � � ' `- � "62. Backwash & Receptor-Final =., c ` � _ � _ � 12. Sewer,CaP � � ' � � ' _. ' ' ' . .. - _ � •.�; " � � �63�. Heater & Vent-Final '' �� �,: � _ Y .- �' 13. Roof;Dra�ins . y ' , ' � � . �. - .` �. ` ' . . a� � � � 4 ; ,' �; . � . - - 64: Plumbing System - Final; . y � ; '!� t •; 14. Rough Plumbing� ! ' « � `' � � . �'�65. Electrical-Final �'e . . ;�°+'�. • . . i , .�" � Y - i � -'15: ;Rough flectrical-Conduit. � :_-� --j-- � � �-i � - t - . ` "66.' Solar System-Final'�� - - � � ^ ' , -- - " i16. ��Rough.ElectricWiri�ng� �� j,;-' - - 67�. Fencing &"Access-A proval `' t;- : - �-�' - '•• - br= •-' J � P - � `1J,:,,Rougfi Wiring�,Signf, � � � � �_ � "� � - � � 68. APFROVED FOR PLASTERING , . . • � � ,�18. Rough`Electrical�T Bar Ceiling �• I � - � - � �69. POOL/SPA SYSTEMS'FINAL ��� ,; ?' , , �, � . 19.'.RougR�Heating & Air Conditioning � � , � ; � � � ,FIRE DEPT. REQUIREMENT . � j - � -� � � , � � � 3 20.-IRough.Factory F�ir'eplace ' , " � � � � { � �. APPfiOVALS', Permit # � � ;� �� a � t; , ' - i ' i ' F 21; ?D`ucts,�in Sfructure� " , � �II' � � � z i. 70. Undeiground Hydro ���� • , � - : � _ � ; `-- '22.�Ducts,"Ventilating�' � 4 - ! . �� � ! ' � i ;71. �pr'oduct Piping �Gas�'�Oil � � � ' 1 J _ �+LL23. *Gas�.Pipe-Rough & Test ` i � �+� � I ,72. Underground Flush y ' . ��' , � ��� � j'.24,; Roof Framing . ' � �': '_ � i '��: �, ,. � , ! , .' _� , � ,� c � �73! Undergmd. Storage Tank �� Gas' O Oil � n �� � :25., Roof SFie}athing ' � F _', ,' _ ;,^ ! ' � ,; , - ,74. Overhead Hydro . - � . �-26 T-Bar;C�ilirig'IStructural) & Monocoat j � - � � �;� �, . 75. Dry.Chemical . � ' , - { ; ;,27. �F.rame�and Flashing' - � � � �( J, -'; � ; � � '. �76. Dry Standpipe � � � • -. �� i � � � '� �28.�Lathin'g &-Siding� : � � � � � ;� � � � � � -i� � � �77. FiIXED SYSTEM FINAL "��'; � ' - . { � � , »+ .� � . . . . � i � � . . , 29.�Insulaiion - - � � ?; '•' ! � j � 78. FIRE PREV. F�INA�L ' . ` � . � _ , = ;; ' . �30..Drywall Nailing , � �' ; �, ;�� �� ' � � ' ' �HEAL'TH DEP7. REQUIREMENT, � � � � � i � -_31.'.Plaster'Brown Coat � ' � ..�.� t r � � � • ,79. FINAL INSPECTION -� . - �� � �� i -+ _ � � .� i 32.,;'•Electrical Power Meter-Pinal � ��,'',�� � # � � i S0.' FOOD CERTIF.�CATE ISSUED ' ' � � _� - - . ..._. _ .. _ . ��:33.jFinalElectric � � � �� 4 � `� ', �Notesi _ , 1 � � ' , � � � � 34. Final Heatin � � � , �, ' ' � ; . -� g &'AirCondititoning "' t � � , i '. ' �� . .35: Fina�l Gas, Pipe-7est���� � ' ' �� ' �'n �� �'� ` ' t� • „ . � ' 36.' Hood or, CanoPY �- � ..' , G ' .. ,- � � , . . � , ' � . . . ., �. - , ., . ''. 37. Final Factor,y Fireplace ! ' � � - � � . � � � . '�' � _ �- _ - ' ' " � - � � 38, Final Plumbing : ' - ! � ° y �c.� L�k � � � ' . . . 'i � . • ' . ` .^ . 39. Water Service-Final� � � - � ' , . . � � � �- . � � ^- m 40. Gas Service-Final� � �� i � , � � � � � . �, ' � � . ;f •, � - . . 41.,Solar pomestiaFinal � ' � 3 � ' � - �� � � � � , '�' � ' � � •�3�� � � J � - ^ i - - -• . . . .. . . 42. Backflow Preventer`, , +� i , , �! f' � � � � � • '� - . ��' , � � � ��...; - 43.: Backflow.lrrigation -7:__. -y,e:,�.;,: �; .-- � � _ , - ' � ,'y . �; � � ' - : � ' . . � � _ � . . . ' 44. ,Landscape I�rigation System � ' _ ' j � ! ' � r; . ' � � � . ) ' � . . . . � . ' K ' '. " 45. Sound�,Attenuation . . - � _ (., � ! . . - � 46. Handicap Regulations , � � � ' ; � ' �` � I . , � .� �� � ' � �, i �'47. FINA`LSTRUCTURE&��BUILDING �'' � ' , � i . ' - . - • 1 } 3 �!' ' � . [1 48. Special Requirements Completed , j� . �, '. " r ;. � � � ' � ' ' � ; ; � �> � - ' :i 49. Electrie Release�to'Edison� j �_ • � • - - ' i ' -, • , � ' - �; � � }� � 50. Gas Release to Southem California Gas.Co � � ' ' . , � � � ' � � � � � ' �� 51: CERTIFICATE�OF,OCCUPANCY.' ,_ -. _.' ' } , ; ' , ' - , - _ . No. '^:�'. `Date,`- ' � u -, . : , f r,. . � . . _..,:.�_ ' - - �' AOP���ant to fill in all spaces exce0t ihose within heavY borEer Iines antl sign all appro0��ate Oeclarations. - �,�iTYryF,CO§TA,MESA CONSTRUCTION'PERMI.T t °E iTNo. S TRACTNO. i LOTNO. �UNITNO. ; ; ; �� ; � i ' � ,e6?9 � 9 � :i � 5.00� TL F,Ao�ectAddress ��� ��ARRG�-� ' S � ' � � - ' i . . � � . � i I � . i • Gn . ApplicanYsMailingAddress^� 'S�� E ' �. p� TYPEOFCONSTRUCTION • �NEW .nDD ALTERATION REPAIR � ` I "- ' T�� Owne�'sName' I�N� ll Q0.V1� �`�phone�S�l�o � CONVERSION� ❑�DEMOLISH ❑ OTHER _ ^ Ap '� -j h �, � ��� 1. _* Zone * _ '•• DESCRIPTION OF WORK/USE OF BLDG. � •� � Address �� 5��� ' ' ' ' ' � � � � � S Main Bwid�ng � - � ' Accessory Buildin9: ` ' , � � � . . . • .. . . E _ - � , Z Arch/Eng. • � ' ' Lic¢nse�NO. ' � TVPEOFPERMIT • GRADING ❑FOUNDATION ' ST�RVCTVRAL � j ,T Front;, ( � . ; ; � � S Q i ��. � Add/Q55 - � I : � � � TENANT� ❑ ELECTRICAL� 0 PLUMBING O MECHANICAL � B Rear . ' ' : � � ' � f � � i I � N , � ' ConbaCto!'s Name �. � � ! Phone ' . • , � �OTHER y , . r � . � ' Y . � . � �� Right- . _t'. ." ' ' - C' . —, — "` �. � ' � 4. N . �� Address (mailingl= �'�p ' � i � ' � PROJECT DESCRIPTION � SQ.�FT. • � OCCCIPANCY K � � , 'y � } � • G City'LicenseNb. OJl , � , {� ' CONSTRUGTIONTYPE ` VALUATIONt$ � �g Left?"' � • � , , � 1' � f 'R�� • � 2orvE � G RAOING CU. VDS. � - ACRES - ` p�n Ref. # , ' ' � ' Parkiri � Req./Provided � � . � t E . LICENSED CONTRACTOR DECLARATION � � , � • � ' 9'i � t• . . 9 � Q - I M1ereby atfirm that I am licensetl imder'provisions of Charter 9(commencing Remarks: ; u ',�_ � .� ' �'� .. , � �, ,Pldnni09 NOt¢5: � � j j� t � �_� �'y ; f � �; M with� section ]000)�. ot Division 3 ot tM1e Business antl'Professionz Cotle, antl ' ' • ` : my Ilcense is in full force antl effect • - . � � -ti . - . i • � : " � � " � � ' ' , - � ' I T� 1 i � ' - S License Class ' ' ' License No. ' ' � � � � - ' �� Oate� Slgnature � � ' ' -- j � PLUMBING y � - � ' ' ,fEES: � ' + � _ - ! � WORKERS' COMPENSATION DECCARATION � � ' • f ` - ~ ` " 5 I hereby aftirm thaC I have a certificate of consent to selhinsure or�a ceitificate � Bar Sink _ .�� r. _ i Showers. ,1� "-, ��, x • 1 ^� � Li ; i�. ECECTRICAL "' �� � ' � i FEES �. i � oi Workers' Compensation Insurance, or a �uertitietl copy tneriof (Section gackflow Prevenier, - Service Sink � � � � ' T � .�` ' . Automatic Washer ;. ' ' - � - Transformer�� 15 50 KW .X ' ^..�, � �. � ' .t 380Q Lab. CJ , � � � � , . ' - � _ ' . . . _ : . . . Policy No. = � Company � � ; Backflowirn ation . •^' � �� � � , . ' .,0 50+KW { � . e. , _ . , . . ; , 9 _ SewerCap � . . +. Construction.Pole.Sub . �':' � � .. I '- ' , ,;� . I _ � i ,:rJ . Certifietl copy is,her¢by furni5hetl. � Ceriifietl copy is tiletl with tne city Builtling Division. , Bathtubs , >� , � � Sewer Connection ; �. Cookmg Unit . _. Meter '�up to 100 amps ��" _ �ate � � � Applicant ' � ' - ' - - ' , EXEMPTION FROM WORKERS' COMPENSATION DECIARATION' ' . Cla�ifi2�Y �� . SOIa� COIICctO�s - { DlShwd5h2� . , � „ , � ' � Met2L OOv2/ 100 amps' f - � (Thissection neetl not be�completetl if the permit is for one huntlretl'($300) or � �„ � iess): � � i _ Dishwasher - . ` , Solar,Piping � � � % Dryers �❑Gas �Electtic ° � � • - Sub.Panel ( � • '� i `' � � I certily that in tbe.0e�formance of tM1e�work for whith this�pe�mi( is issuetl, 1 � - ' � • - shall�not employ any oerson in any manner so as to bemme subject to the Drinking Fountains �, - Solar Tank . � - �' � t Fan � '� • � � � Worke�5 ^or� ns p� taws'of Califq( nia�. � �. � ; � �- - • � _ ; ; _ Motois �O 1 HP �1� 8 �.,., : - Date -?. � \�—� I � Signature •�� •� ��-� � Ploor DFains � ' ' y' '' � '' Swiinmin Pool wIS a� • ' � � ' ` `- i - � " -NOTICE:df, atte�'�making this tlecla�ation, you�shoultl �become subject [o the�,- _ 9 P ~i F.A.0 � j � � Inc SOId� 09 15 HP,016 1$+1 �4 ` � Wo�ke�s' Comp¢nsation provision5 ot tlte �ubor,Cotle, you must torthwith � FIOO�SinkS . � , U/i0dl ��� � � t � � ' ' ^� • romply with such, provisions o� this p¢rmit shall,be tleemetl revoketl. n FixtU�¢5 MiC�ow3v¢ � � ' . ' CONSTRUCTION LENDING AGENCV ' G ' ' GaSSeNice • Outlets , � � , � � ' ' � � � �- ' ' Water Closet , � a� Device Boxes �, • Pole Li ht� I her¢by atfirm'that2bere is a consbuction lentling�agency for tM1e performance � ' i I , 9 . , I ' of -the wark foriwhicM1 this permiL is issuetl (Section 3097TCiv. C.) � ' � ; Outlets � - . - .. Rariye Lentler's Name { f� Interceptors � . � WlatyrvFleeeer' ' *� . ! -�entler's Atltlress_. .� . ' • _' ' � ! _ ` - KitchemSink ' -.-; - _ . Water�Service--- �'- .. ` .._ .._ _ � i OWNER BUILDER DECLARATION � j � ' � " — Switches -�- -- - . ' Signi "' '-' f" ` ' " ' _ I'heteby aftirm that I am ezempt;from�the Contractoi's License Law forthe � LavatO�ies ' , . AutO-W35h ' . .( . ' l - { . Garbage Disposal Standin Sections followin9 �easOn (Section ]031.5 Business antl Profe55ional Cotle:�Any City,or + 9 - 1� � - ";.county which requires a',permit to construcq alter, Improve, tlemolish or repair � P—Trap � � � Laundry Trays � � Generator �0-5 KW �5:15 KW Trash Com actor • i -��:any structu�e, prio� to its issuanc¢, also requires lhe applicant toYsuch pe�mit � � . � . P , :°to file a signetl statement that he/she is licensetl pursuant to the provisions ot - � � - ' - � the Cont�actoCs License'Law,(Chaptec 9 (commencing with Sectioni7000) ot i t RoOf Drains ; , ( • , p � ; ;' , ' . � t � � � i ' � .. ' ' M .�'_ 7_ .E � + Division 3'ot the Bu5InC55-antl Protessions Cotle) or,that�hE/She is.exernpt'— . . _ . ,- - , , - - _ , _ .. _ _ _ _ _ : - - ' - � [herefrom antl tM1e basis for the allegetl exemption. Any viola[ion of Sectlon . � � , � 1 , ' ' � ' I � . ' � -e ' , - , ' ' � � ' ]031.5 by any applicant for a pe�mit subjects the ap0��cant to. a civil � � �enalty,of not.more tnan five'�huntlretl tlollars (gW0 -. ' � : � � � � � :, � " ; ' ' ' ; � ' ' ,. L� I, as owner of�the property or my empioyeeB with wages as�tfieir sole ; 'Reinspection Fee, �$15 ' c. � , ' ISsue Fee � .$� 3 j• '� - ' ' ' ' � � ' � � � compen5ation, will tlo'the work, antl the st�uctu�e Is not int¢ntletl or offeretl � �- R9in5pectian F¢d $15 ISSUe�Fee � - � . 1$ 3 for sale (Section 7044;. Business�antl�,Protessional Cotle: The'Contractor's � �' , � - � . MECHANICAL' . �FEES� � ' t � � ; License Law tlo¢s not appty to an owner ot a prope�ry who builtls or improves ' ' , i � thereon, anG who tloes such'work himseli/nerseH'or tnrou9h hiz or her own y � • � ' DEVELOPMENT SERVICES REQUIREMENTS: ` , . � t 'employees, provitletl that sucn improvements are not intentletl or otferetl for i BOiI¢t . � � ' ��HOOd O� � Typ¢ I ❑ � 1 . ' , ._ .. '! f' � �. . sale. If;;howeve�,.the bullding or ImOrovement is soltl within one year of com- � .�CapOpy : Type I I i❑ �' � fZoning App�ov¢d By � � Date�� '� "pletion, ihe owner will' Itave the burtlen ot p�oving he/shetlitl not builtl or im- ; DUCt - UndC� Ground � '-. : . � � � j � ° ` - /f /� ��- I ,p�ve ror tne purpose ol sale). ._ � , �' � ` Building App�oved By � Date�J�j�j'�� I, as owner of the.prooerty, am ezclusively contractin9:with licensetl con- ' Duct - Sttuctural Refrigeration System " Appliption Issued By �Data=(LZ(11__�;� � Vactors to �onstruct the project (Section 7044, Business antl. Prote55ions-Cotle: "; - • YM1e�ConVactor's' License'Caw.does not apply,to an owner oPproperty wno Duct- Ventilating+ . ❑0-100,OOOBTU ❑100,000'BTU � �! .� ' - ' —' ' i � builas or improves thereon, antl who contracts forsuch.projects with a com '{� ' . �' � r SUMMARV OF; FEES ,; : _�_ -. �. � _ tractoT(s) i�cense�pursuantto'the ContractoCs �icerise Law). bam_aware £hat � � � - ,S �' BUILDING FERMIT_� �$• " ' � ��SMIPi � � 5 �$- ' proof,of'their Worker's Compensation insu�ance shoultl be prov�tletl to me. � ExhaustSystem�O _Multiple❑ SystemRepair/Alteration . _ � . , ,; � ., ., , - . �PLAN�CHECK ' $' PERMIT - ❑. i am exempt unaeCSection � B. & P' C.�for this reason � ' Firepl/Fact, 61t. ICBO # r �, Fire Dampers t� - � ' `� . - i . .c , . . •� .._ ISSUANCE l' I$a ^= � � _ ' � PLUMBING' � � �$- _ "' � o �-_s,- � � v : Heating System & Ducting� : � Registers 7 � �. � k ; p�,qN'CHECK' •25% $ •• ENERGV P.C. �$ - �? �� F - I hereby� certity that I havelreatl'Ihis apoliwuon �antl state.that the above '❑4100,000BTU �100,0006T - - - '~ � "- � c ` = intormation is.correct..l'a9ree to compry,with alPciry antl countyortlinances'� - i'�' �- ELECTRICAL- , �$. '=GRADING - i$ antl�sta[e�laws�rela[ing to builtling construction, antl hereby aut�orize repre-� � . . , . - � ` � `" ' �$: _. MICROFILM :$ � � }- sentatives��of� this �city, to enter upon the. above�menHonetl.Orope�ty„ tor' ~� �� �� �'� .^ ., p�r � y� X PLAN,CHECK - 50/ inspection p oses. (� (� C � � � - MECHANICAL , 'S . TOTAL FEE � '$� � Si9nature � � . _'`:� `�`.--- ' Dau`Z^ �q^D�.. . _ ' y . � �'' '-Drivers' License oi 55 � � ' � � � "' r- Reinspeetion Fae' ^ � $15 . . . laue Fee '�. . � $. 3 � � � PLAN CHECK �'�25% $ ' � � � � � . . . ._ ' _ .. _. _ __'_' .. "..... .. ., _ �, -. _ _, . ' CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goltlenrotl - Asse55or � . � � � ' r � �- � M� ; POO L & SPA - � ' � � CONSTRUCTION AND PLANNING t_ � ._� . � � _ I �, i,,, . ' ' - � . � .� APPROVALS ,Bermit�# '" � �'Date f ��Inspector ' � � � � �� i'� , ` � i� Date �i Inspector ` . , � � APPROVALS Peimrt # � 1..` Temporary Electrical;SerJice or Pole 4 ' � , 52. Pool &� Equipment Location� ' �., j � � , �, ,� 2. Soil_Pipe-Undrgrnd.�T ; i.� . � � � � ' � �'_53`�SteelReinforcement � ' ' � � � : �3. Electrical Conduit Utility�Undrgrnd'. � i � �� 54. �Forms� ; � , „j � , ! �� � , _ �" - : 4. Electrical Conduit-Undrgrnd. i ' . � 55. Electrical Bonding � , _ - � ., 5.,Steel�Reinfo'rcemeni� , � � r � I ,' ; � ' , ; • 56' Rough.Plu'mbing�,&.Pressure Test� t ; ' ' ' . ' ' � �� 57. APPROVALTOCOVER-GUNITE: . , . 6. Electrical UFER Gr'nd. � ' . , 7f Footin s -, �� , i � � - � ` , ' . g . - ,� . } 'ry�� y. . � � i , � 58. Electrical Conduit�Undrgrnd. . , , � . .J-�.:_... ;� . _. ____ . .8: Foundation . ' .. � .� - � �^ . � -r� - �- -, 59. Gas Pipe; 0� Undrgrnd., Test � - � ` 9�. Water Pipe-Undrgrnd.. 2 = ` .. .. � --- ..-t ...3�_ . -t _' • j � : �60r Backwash,Lines, P;Trap, O Undrgmd:' ' � � 10. Structural Floor SY4tem � '�'i :�- ' � � 61. APPROVALTO DECK � � , � ; � 11. Property Sewer Line. & Houge Connection � ' � g2, Backwash & ReceptorFinal� ' ' �. ' � � 1�2. Sewer Ca ' ' � . . .`.: , , • , P � ��� . .. � I � � . 63. Heater,& Vent-Final � � � . �- � 13 = Roof Drains % r� G.=' .,� �'= �.` `, ,� . ; '. � , , � � , i. . � r � ; , , , � 64. Plumbing System - Final � , , 14.� Rough:Plumbing , � " �:'' '_ - ' � - . . ! , , � ; ' �� � 65. Electrical-Final� � � 75:'Rough�Electrical-Conduit .' �� � ; � ` i . � i � �� ! - 66�. Solar System-Final � � , ' ` 16. Rough Electric Wiring - � �'"F' - � ' � .- � 67. � Fencing & Access'Approval � � "� � 17:"Rou`gh' Wiring'Sign � ' , ' � � "• "'� - ";'� � � ' 68. APPROVED FOR PLASTERING, •� � � � 18. Rougli Electrical-T Bar Ceiling�u;';- � �-, ��4 i��` 69. POOL/SPA SYST,EMS FINAL � 19. Rough Heating & Air Conditioning �' � � i � � � FIRE DEPT. R�EQUIREMENT � � - , . - ' • ' � . . - . .. . 20. Rough Factory Fireplace i . . ' + � � "' � APPROVALS - Permit # � � _ . - � , 21. Ducts, in �Structure �' � - �� � ' � � �, I 70. Underground Hydro - " , � 22 Ducts, Ventilafing,; � � , .�. � �,- �',• ', ,71. Product Piping O�Gas ❑ Oil � . 23: Gas Pipe-Rough & Test - � � � . ' ' 72. Undergiound Flu`sh . � . ' . 24.�RoofFramin � � :��.. � � �-' �. o ; � � � � g' , a, {. , �73. Undergrnd-.StorageTank ��Gas ❑Oil - 25: Roof Sheathing - � , - : � � , ' � * � 74. Ove�rhead Hydro . - . � , , 26.T-BarCeiling��StructuraQ&Monocoat �� •�'"'= ; 75daDryChemical� �. '��' �. � , ; ' , � `r .i' . ,. D: Frameand Flashing � - - ' �, - , 76. Dry:Standpipe • - ' � . �` � 28i Lathing & Sidirig � ' � . t � . ! , '. 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 CERTIFICA7E ISSUED ' . ' � ' 33: Finab�Electric : � � � - ' � ? ' � Notes: � ' � � � � � _ ' - .. . . ��.��. ' ;..;. . . .- . . � ' 34: Final Heating & Air Conditioning � • _� i , �'� � � � " � . . - _ , , _ 35. Final Gas Pipe-Test : . � � � � � � - 36. Hood.or Canopy _ _ . , � 37.�Final'�Factory,Fireplace•�: � 4 ,� � . . � �� � - � . � . 38. Final Plumbing . - � . � ` � '' ¢� � � ' . - � '�39:�Water'Service-Final �. - ; � { � � ' � , . I :40. Gas Service-Final . _ � � ' ' � , � � � . ' � ��41. Solar�Domestic-Final: - " . , � � _ • � � . � , � 42. Backflow, Pre'venter' - � - � � � .. ' � , � ' . � ' z .� 43. Backflow Irrigation,, , j; � � � , � • t� �� ' � � � � `c'' � • . • � � .44. Landscape Irriga'tion System - % , . � � � � � � .� - � - � 45. Sound "Attenuation � , - � � � • � ,� ; . - � -� 46. Handicap Regulations , - � - • � � � � ' • � . � • � ' . i 47.�FINALSTRUCTURE&-BUILDING ' - ' _ - ��+ � . . . � ,. ��, � , - 48. �Special� Requirements Completed =� � � - � ' , . � . - , � , �, -.49:` Eleciric Release to Edison� • -, � � � . �'� -� . � ' � , ' - � ' ` 50 `Gas Release to Southem_California Gas Co � � � � � . � � _ , . y. y . . � 57. CERT.IFICATE OF OCCUPANCY �� _ , �-' � � � � • , ' ' _ � �' r, ' No. � . , - � "-Date . . . . . _ . . . . . . ' - . . ._ . ' . �ti _ . c=.1 - . . . . . . _ _ . . . .. , . ,� _ . . . . . _ . . .... . . £. p...y.._ . .. .. OWNER gr15tOI E'St8L2S DATE l�-18-C6 � - JOBADDRES3 911 Uarrell $t. - � BUILDING PERMIT NO. 2823 - GENERAL CONTRACTOR $.�%.Hunsaker VALUE $ 8,856.�� LOT 50 BLOCK TRACT 28�3 Single Kes. W�att gar GROUP I & J INSPECTIONS Footing Trench �"' Foundation Forms and Grade Plumbi Plumbi Wiring, RougY Heating, Roug "Heatinq. Final St. or Lathing,ln Plasterinq Plumbing, Final, Fixtures Plumbing, Fin.al GasTest Wiring, Final Occupancy FORM 210 3M 10�•v0 � V SUBCONTRACTOR PERMITSISSUED DATE � NUMBER '_ Costa Mesa Bnilding Department;"" " ' APPLICATION FOR PERMIT ,���� :,� P. O. Box 3�, ���: � B U i L D 1 N G ' -� COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN ReceiPt rvo. Peprmit No. adaae� 9�� �A rzrLEC..C_ ST. - - o( 0 oZ-� Costa Mesa, Ci3��OPII13� Receiv y ate Rec'd. Date Issued -• . _. . : • � �,i �,sz., � �f,ifr.� Owner'AS'e (S Mail AddressQ�zCp ��tYTE�,, i. Architect or Engineer Address contractorS� �. Address SRh Size of Lot �00 � X � l�se of � Existina Blda. - „---- ' rk-'j"'E�S 'A��S ��J 2. Tel. No.Arl-'�-�ISI Lic. No. Cify Lic. No. ��f? � elock � INo. of E Now on INo. of Famille 1 Rear1 g � Addition Repair I I Moving � I Demolish � Building . �-/ No. of ) Size �� � 1 � Rooms � Stories } Exterior WaII Roof Costa Mesa, California rvo. ot Plans Covertng STJC-C...� I Covering QOGfL. E]PP$Q`7��' Use oi Ne L Building �� /�1 �� 1,q-MiLJ �u1�(�.� AJS Foundation Location Inspecto Forms, Materials, � {{��f}-��'�Q __� /L�� Under-Pinning � ' Frame: Fire Stops, ��-� Bracing,Bolts I hemby acknowledge that I have read this Application and state that the abme is correct and agree to comply Lath. Int. � with all City Ordinances and State Iaws regulating building construction. Lath. ExS. Signatureof ' Permittee Plaster,lnt � • � Authorized AgL. � Plaster. Ext Valuatlon Pe it Fee $ �Z z.O O Masonry Reinforced � Q Bond Beam 0 � Plan Check $ // •� p $ `�/ u � Total Fee ��. �4 I FINAL FM 209 10�55 D. P. 6 S. i —O � —� —Z " D —r �OWNER OVESEN, Mattie DATE 10- '� JOB ADDRESS 911 Darrell Street BUILDING P GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Pati � AP No.115- 83-]2 LOT TRACT FIRE ZONE VALUE $ � INSPECTIONS ' Si nature Date GROUP TYPE � soi� SUBCONTRACTOR �GAS � wniEa Plvmbin ROUGH PLUmBING NG AIR CONOITIONING UNOERGROUN� Lf POWER ROUGH WIRING N F. BON� BEAM ❑ STEEL REINFORCE SHEATHING FRAME AN� FLASHING LATHING — IN n OOT � PLASTER.BROWN COAT NEATING, VENT., REFRIG. ANO A.C., FINAL PWMBING. FINAL AN� GAS TEST �I - :,�. = ��� • 33731. Z . w w a U Z Q O.N am J � J � Q W p] J J m Q UN Z a W � aw wz J Q m Z J � W w � ZH W � N � 70 H z Q U J a a Q � F N Z O F U 7 � H Z , , , fiCT 13-71�p��00 716 0*�*�`+�S.r,Q COSTA MESA BUILDINGSAFETY DEPARTMENT - � . � � - � . . P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 .' . .�� - - . APPCICATION,FOR BUILDING PERMIT � For Applicant �to Fill in Completely - � . 'RE EIV BV DATEqECEIVED DATEISSVED BUILDING l � �P" �7� ADDRESS. � I Z Y�Y f...1 /O'�I�'� �II� ��� 3— I Z- PERMIT'9 i'] OWNER I��B. �'I `VCSY- ' A.P'.NO.. J !.J � MAIL d } �' -� BUILDING //- ' D� 1 r�' I�^ ADDPESS �1 � 1� Z�–'T� � \ ' • , � . �+ODRESS ." CITV CDS c' \<5 �; �' NOL TRACTGX�/�� � LOT S� BLOCK CONSTRUCTION '' , EW AD AL R P LENDER BqANCH . - OWNER � OV �S'Qm A�DRE55 � " ALUE �// � ARCHITECT � " ' � ' . TEL. � S S /�Y OR ENGINEER N . . ' � . . � ' . .. FIflE - _ ' ' �' , ADDFESS . ' ' - ZONE � TVPE `--�"GROUP . � APPROVED � CONTRACTOR �w. �y �Y �' " e�' �' DAT�U / ADDRESS S"Z„ L., � ZONE NO.OF USE OF,NEW�n.(� - -TEL ` / p�,qryg � gU1LDING C Ve/�� ' CITV - � �NO. � . STATE-' .. ' � � ' CITY_. ' . ' �'ARDSAPPflOVED VARDSAPPROVED , LIC. NO. � - LIC. NO. � - MAIN BUI�DING ACCESSORV BUI�DING SI2E ' � . ' -. NO.OF BLIX3S. � (FROM ,G�{}L 5T EET) . OFLOT ' NOWONLOT FROMUM �PiC • FT. - USE OF ,S, � EXISTING BLDG. ' Q ' ' ' �/ � FT. PL � - FT. ' �SIZEOF NO.OF �� � �� . ' ' NEW BLDG. ROOM$ STORIES L SIDE � FT. '/ FT. � " EXTERIOR WALL ' ROOF �' ' - � I / � ' ' COVERING COVEFING REAR' FT.�P ` FT. , USE OF BUILDING AND WORK TO.BE PERFORMED DISTANCE BET. � n BET. MAIN & � ' ' ' MAIN BLDGS. L ACCESS. BLD(e5. � " " - � VAR.# . �DATE . � `�.1,� � (�u. L,1/� ' C.U.P.# " ' APPROVED � . . , � , � . . � " • APPROVE IO�' '� , y .'. . . � . . . . � . ' � � ' - . I �ereby acknowletlBe chat I have teatl this aOPlication antl state `, � � � ' � ihat�the above information iswrrect and aBree to comply with __ all laws regulatin8 builtling construction, and I shall not amploy � � any person in violation �of Me workman's compensation laws ot � ffie State of Califomia. , „ . . � I hereby certify that I am properly licenutl as a conhector antler SQ. FT. ' o the State ot California Buciness antl Protessions Cotle, Divisicn 3; THE AMOUNT SHOWN UNDER VALUATION IS FOR ' Chapter 9, antl that such licenses are in full,force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m am exempt from the provisions of Me State of Calitornia Business � ¢�� antl Professions Cotle, Division 3, Chapter 9. . � ' VALUATION m . /� � . . . . - PERMIT-FEE $ � j . Signature ot . /�( � � O �� . . " , m Permiitee fr/ C. 't�r� ` $I/1//`JA /) � PLAN CHECK $ �— •. . E Q/ �/ I� I LL ^Authorizetl'Agent�- � � ' � ' . ' � � /� ,'�/ TOTALFEE $'�"�L tV`V � -