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Home My WebLink About965 DAHLIA AVE - Building Permits_ � �� . �f .: '1 I �s'- ;. � � � � � , CITY OF COSTA MESA _ _ . , . . - BUILDING D/VIS/ON � ' • - F` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax p14) 754-4856'• www.ci.costa-mesa.ca.us � °.� � ,,, , , . � „ ':-:-.FOR INSPECTIONS CALLi (714) 754•5626 , - � � . .. , "� PERMIT NUMBER B07-01008 , ,. . PERMIT TYPE B_ROOF2 JOB ADDRESS: 965 DAHLIA AV�CM�* Vicinity: CRICKET ,,�''�. =�: r ` Squares: " 100 M'�;-' ;�w ' . . . �?��; � -��.i��'z� SCOPE OF WORK: REPAIRIREROOFCRICKET,'ARI , •� DOWN AND RESINGLED AREA.5I�SSQ=PITCH2:12`'�� OWNER: SCHMIDT, PHONE: APPLICANT: RAY, RO: PHONE: 949-646-8 CONTRACTOR: ALLV Address: ' 2192 AMERIC� City/State/Zip: COSTA ME ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspeclion Fee: TOTAL FEES �4 . v4i CA �:" � 9: i_ � � fii.i `- � ` "� �.=t� :�. � •� _ E � o i z4 5. �� ;74 �,.' ; r � , STATUS: ISSUED • DATE ISSUED: 1110512007 �� ISSUED BYi BJK OF AN EXISTING SFD ROOF. T/O o�';�, � � Address: �: 965 =� y,�� City/iState/Zip C( t "�J��.�''�' Address��:at 2192�� =°�"�� City/State/Zip: C f�'�'� SUITE%Arr--r - s =s. .. .t.,�.. �.. _. . '3..�",.�`�. �x License No. $50 95 r � "'+� ,n�'"'�.jy� ',�, t�� ! < �� . '$000 Ss�?! ; � "a�^Y�iw.z� �.,� � �e:'��. c '�•i. r L,�f�:S'� t"'Y --€` y ��'� �^� '� J5� 9rJ �: wRv � 'li �� z� y ; _.�:-s-.�:1: i�. C.=°':-+.. .. . e y.s:e : (�� OF FELT, TORCH ' Uniti � � � � ` Unit: :SUITE A � : . . � , ' - � . . . ' .. .. . .i . , - I , . NOTICE: The work authorized by this permit shall comply with all applicable handicap�access.requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) ' � • - � • � � � � . . - EXPIRATION: PERMIT EXPIRES 180 DAYS FROM�DATE OF ISSUE OR DATE OF LAST INSPECTION. ,' , � �� _� 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 final approval will result in the'expiration of this permit. , GODE/. INSPEC770NTYPE OAIE IN7RIAL5 CODEk' INSPEG110NTYPE � ' . DRTE IN11ML5 .1616 Fixed System Final Fire Prevention - � ' � . 206 �- Final Mechanical � 1266 Pool Spa Final :.. � � 208 Final Plumbing 200 Final Re-Roof � �� 210 Final Electncal 201 � Final Block/Retaining Wall � 212 - Firial Fire Prevention 202 Final Fac�ory Fire Place �� 220 ' Final Planning Approval ' 203 Final Sign � � �� , 222 Final Site 204 Final Demolition .' 250 Finzl Building/Occupancy ' � f - � WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penally of perjury one of �he following declarations: � ❑ I have antl will maintain a certifcate of consent to sel(-Insure for workers' compensation, as provided for by section 3700 of Ihe Labor Code, for Ihe p ormance of ihe work for which Ihis permit is issued. � . . .I have and will maintain workers' compensation insurance, as requiretl by ectbn 3700 of the Labor Cotle, for the perfortnance of ihe work for which this permi[ is issuad. My workers' compensation Insurance carrier and policy number areA: carrier: 7�/�'i`Yr �f J/l fb '(Thb section neetl iro!t b>e mm efe��the permrt is valuetl at one hvntlretl tlollars (8f00) orlessJ Policy Number: I Ti I�` � D �(� % ❑ I certify that in [he performance of the vrork for which [his permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o( Califomia, and agree that i/ I should become subject to the vrorkers' compensation provisions of Section 3700 of the or Code, I all forihwith comply with these provisions. J/-� 07 ACO��' =9�aWre] �Dale' � �� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. � LICENSED CONTRACTORS DECLARATION: I hereby aKrm thal I am licensed under provisions o( Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and eftect. � Li Class #' =�/ I/��D�z Conlratlor' ignalure J � —Da�e� - CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that there is a construclion lending agency !or the perfortnance of the �+ork fa �Mich this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Atltlress: SignaWre �r�Date F;a'f''' \ _�; OWNER-BUILDER DECLARATIONS: i^'' �" �":,'x?"'�`�-� p,,�.°i:;, . �..�,i I hereby affirm that under penalty of��perjury;tha[,Iram EXEMPT•-PROM THE CONTRACTORS LICENSE L'AW �fori the`following reason (Sec. 703L5, Business and Professions'Gotlei,Any(city or county which requires a permit to construct, alter, improJe<demolish,�or, repeir any structure, prior to its issuance;"als'o�requires the'applicant foi such permit to fle a signed statemen[ that heaoi she is licensed pursuant to the provisions of the Contrectors License Cadi (Chapter 9(commencing with Section 7000) of Division 3 of the Business4`end:Professions Code) or ihat he or she is exempt therefrom and the basis for the alleged exemption. Any violation ot Section 7037.5 by any applicant tor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and Ihe sUucture is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply lo an ovmer of property who builds or improves thereon, and who does such vrork himself or herself or through his or her ovm employees, provided that such improvements are not intended or�o((ered for sale. If, however, the building or improvement is sold within one year of completion, the ovmer-builtler will have Ihe burtlen of proving that he or she did not build or improve for purpose of sale.). �' - ❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH IICENSED CONTRACTORS to coustnict Ihe project (Sec. 7044, Business and Professbns Code: The contrectas License Law dces not apply to an ovmer of property who builds or improves Ihereon, and who contracts for such project with a contracta(s) license pursuant to Ihe Contractas License Laws.). � ❑ I am exempt under sec. Business and Professions Code for this reason: _ Siqnatore 305�L6 (3/0]) ' ( � Owner ID ven�etl by driv e. , � Yes ❑ No Driver's License No. Expires: Venfcation'of Ovmership by (rype o( document, i.e. - pmperty lax bill or deed): ' DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: -�� ❑ I hereby certrfy thal no excavation frve (5) or more feet in depth.in[o which a person is required to descend, will be made in connection with work authonzed by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling ihereo(, wiil be more ihan Ihirty-six (36) (eet high. (Chap. 32, Gry 2. Art 2, Sec. 341, Title 8, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone ro do vrork which vrould require a permit from [he Division of Industrial Safety, as noletl above, unless such person has a pertnit to do such work trom the division. . ApDliwm's SignaNre Division o( Industrial Safety Permit Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or future building occupant need to file antl certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filetl with the Costa Mesa Fire Department by every business which has at any one time tluring a reported year a quanlity of hazardous ma[erials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperaWre and pressure). 2. Does or will the applicant or present or tuture building occupant need lo fle a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires regisiration wi[h [he Costa Mesa Fire Department by each business which at any one time has on hand a quanti[y of acutely hazardous materials equal to or grea[er than a weight of 500 pounds, or a volume o/ 55 gallons, or 200 cubic feet o( compressed gas at stantlard temperature and pressure). 3. Does or will the applicant or present or fulure building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Sa/ery Code provitles lhat Ihe Costa Mesa Fire Departmen[ may require the preparation, certi(cation and fling with Ihe Fire Department of an RMPP 6y businesses which are required to register acutety hazardous materials with Ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Sa(ety Code been /ully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future builtling occupant require tor Ihe vrork which is Ihe subjec[ of this application a permi� for such construc�ion or modifcation from the South Coast Air Quality Management District or fmm any other aii polNtion control district or agency? ❑ Yes ❑ No (Seclion 658502 of Ihe Califomia Govemment Code requires that Ihe requestetl informalion he fumished on applications ta non-resitlential building pertnits�. 6. Will any part of the faciliry to be constructed under this permil be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No pt'yes". the faciliry must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7. If a permit from the South Coast Air Qualily Management District or other air polWtion control district or agency is required for the work which is the subject of t�is application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ,❑ No 8. Qt yes", attach certificate of compliance�from the appropnate air polWtion control oKcer). � � � . CERTIFICATE OF-�COMPLIANCE: I.certify that under penalty,of perjury Ihe information giJen above is codecL I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions.' � � , SignaWre � - Dale . CERTIFICATE OF COMPLIANCE AND AUTHORIZATION�,OF ENTRY:�I certify under penalty of perjury that I have read this application and state that the intormation given is correct I agree to comply with�all state laws antl city ordinances relating to building consiruction, and authorize representatives of the City of Cosla Mesa'to enter upon the above-described property (or inspection purposes, I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. � -`��SignaWr fLeBalOwner(s) Oate ' �/�5 =07 MdlorAuth��PCliwnt._.-.- Dale � ____ _ i' .- . •", '� � CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fa�c (714) 754-4856 Job Address: Suite: Viciniry: 965 DAHLIA AV HOUSE & ATTACHED GARAGE Parcel Number: 41218122 BUILDING PERMIT Zoning: R1 R1 ! ; =. : PE IT NUMBER 99-07376 77 FAIR DRIVE, COSTA MESA, CA 92626 npp�icant ALAJOKI, JOHN Address: 21045 LARCHMONT DR � ISSUED BY: CA /�Phon� 1283, LAKE FOREST „/�j� Zip-92630 Owner: SCHMI Address 965'DAN DR Status: ISSUED Applied: 08/27/1999 Issued: 08/27/1999 U � \� / �/�-BCh_ooe:= �'-"-�-.� i/�-'"�-"Zip: 92626 � O Phone: (714)830-1283 /� V / Zip: "'J// J ��"'�License: �5 tf1 � ��i��l v/�. iREROOF�EXISTING SINGLE FAMICY�RESIC SHINGLE�ROOF, INSTALI 1�lAYER�OF 30# SUBJECT TO'�PRE-ROOF INSPEC'fION.'� ,��ril � �--= � t1 � i Check: $0.00 � Permit�; $111.25 �=- �IP Res. $0.50 IP"Com: $0.00 Othe�: $0.00 \ cti,on: $0.00 �fi� . -� �1Total: ti$11;1:75 _.. ACCESSORY PARKING �1�7.- � = , D��/'/�� Front " 0� O Fron�O-0 �j, Existinq: Licens�� 735404 � i `�,�\ �. Eng: • •,,,1 � `Address: �, � 4f iJ0 ° 0 0� n o� 0 � Left 0- �rr�-�� } �n�1�C' oJ +�� Proposed: ' ��\\ � P,�\" �'` � License: � � yli,� L--. n ' 1 �'�III � ` OVER EXISTING WOOD, (--� AR COMPOSITION�SHINGCES. i I/�/III c Valuation: �/� �$a, n Valuation: Sa! NING a f� 0�� /��1�/ 0 Right��0.J0� � �/ ��C �� Righ� 0� 0 o��' '•/ if NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . EXPIRA710N: This permit shall automatically expire and become void if work is not'commenced withiri 180'days, or if work is suspended or abandoned for a penod of 1 BO days. - - ' . INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapectiona end flnal epproval must be obtained. Failure to obtain inspeclions end final approval will resuN in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARA710N: ' " I hereby a8irm untler penelry of perjury one of the iollowing declarations: -� � ' � - ❑ I have and will maintain a ceRificate of consent to self-Insure for workers' compensation, es provitled for by section 3700 of the Lebor Code, for ihe peAormance of the work for which ihis permit is issuetl. �I have and will maintain woAcers' compensa�ion insurance, as required by section 3700 of the Labor Cotle, for the performance oi the work for whicti this pertnit is issue0. ' My workers' compensation Insure e carrier entl policy number ere: �7� C Cerner. SrA�'�- �i Vv� -"Policy Numbec �_,CI' S— J S� � (This section need not be comp/eted li fhe pe it is velued et one huntlred tlollers ($f 00) or less.) "-` ' ' ' . ❑ I certity Ihat in�the peAormance of th wo�k for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws oi Calif ia, and gree that ii I should become subject to ihe workers' compensetion provisions of Seciion 3700 of ihe Labor Code, I shall forthwith comply with Ihese provisi c Applicant Signeture: . Date: o /�7/�79 [_. WARNING FAILURE TO SECU RK 5' PEN$�1TION COVERAGE IS UNIAWFUT AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FWES UP TOONE HUNDRED THOUSANODOLLARE(5100.000),I ADDITIONTOTHE.('�TOFCOMPENSATION,DNMAGESASPROVIDEDFORINSEGTIIXJ370fiOFTHELABORCODE,INiEREST,ANOATTORNEV'SFEES. LICENSED CONTHACTORS DECLAHATION: I hereby aHirm that I am forca end eRect. Lic.�N- Comractor's Signature: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that there is a construction Lenders Name: Signeture: Chaptar 9(commencing with Section 7000) of Division 3 of the Business and Protessions Cotle, and my license is in full Class #- � vDate:- �,�, 5''� agency for the pertormance of ihe work for which this permit is issued. (Sac. 3097, Civil Cade). Lenders Address: Date: OWNER-BUILDER DECLARATONS: � � I hereby aNirm iha� under penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7037.5, Business and Professions Code: Any city or counry which requires a permit �o construct, alter, improve, demolish, or repair any simcNre, prior to its issuance, also requires tha applicant tor such permit to file a signed stetement thet he or she is licensed pursuant �o Ihe provlsions of the Comractors Licensa Lew (Chapter 9(commencing wlth Section 7000) ot Division 3 of ihe Business and Protessions Code) or thet he or she is exempt iherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant tor a permit sublecis ihe applicant to e civll penelty ot not more than fiva hundretl dollars ($500).): � ❑ I, as owner oi ihe propetly, or my employeBs with wages as their sole compensation, WILL DO TME WORK, and the stmcture is not intended or oHered for sale (Sec. 7044, Business antl Professions Cotle: The Contractors License Law tloes not appty to en owner of pmperty who 6uild5 or improves thereon, and who does such work himself or hersetl or Ihrough his or her own employees, provitled that such improvements are not intentled or offered tor sale. If, however, ihe building or improvement is sold within one year of completion, the owner-builder will have the burden of pmving Ihat he or she tlitl not huild or improve for purpose ot sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WI7M LICENSED CONTRACTORS to consimct ihe projea (Sec. 7044, eusiness antl Pmfessons Cotle: The contractors License Lew does not appty to an owner of pmpeny who builtls or improves ihereon, and who contrecis for such project with a comractor(s) license pursuant to the Coniractors License Laws.). ❑ I am exempt under sec. _ Business and Professions Code for this reason: Signature: Date: Owner ID veritied by drivefs licensa. ❑ Yes ❑ No Dnver's License No. Venfication of Ownership by (type ot tlocument, i.B. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CffATIFICATION: Expires: ❑ I hereby cenify that no excavation five (5) or more teet in tlepth in�o which a person is required to descen0, will be mede in connaction with work authonzetl by Ihis , permit, antl ihat no huiltling stmcture, scattoltling, falsework, or tlemolition or dismantling thereof, will be more ihan thirty-six (36) fee� high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califarnia Administrative Code). - ❑ As owner-builder, I will not employ anyone IP tlo work which would require a permit irom ihe Division of Indusinal Safery, as notetl above, unless such person �as a permit to tlo such work from the division. Signawre: Date: Division af Industnal Satery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AllT}IOR171�nON OF ENTRY: I certity under penalry ot perjury ihat I hava read this application antl state ihat the intormation given is correct. I agree Io comply with all state laws a d ciry ordinances relating to builtling construc�ion, and authonze representatives ot ihe Ciry of Costa Mesa to enter upon ihe above-described propetly for inspection purpo�s. I agrea not to occupy o� ellow occupancy ol any building euthorizetl by this pertnit until finel inspection. CODE�. INSPECTIONTVPE �'� 1616 Fixetl System Final Fire Prevention 7266 Pool Spa Final 200 Final Re-Roof � 207 Fina1 BlocklRetaining Wall 202 Final Factory Fire Plece 203 Final Sign 204 Final Demolition 2666-48 �.�Z\I�Ci(II/1f: Date _� z�,L3`f Dete CODE♦- INSPECTONTYPE ' 206 Final Mechanical � 20B Final Plumbing 210 Final Elecirical 212 Final Fire Preventbn 220 Finel Planning Approval 222 Final Site 250 Final Building/Occupancy QdjE TRIA ' . AVolicant to fill in all spaces exeeot ��ose witnin neavy bortler lines antl.sign all apo�oDriate Oeclarations. - CITY OF COSTA MESA �`ONSTrtiUCTION PERMIT � PER IT NO. TRACT�NO. LOT NO. ! i UNIT N6. � t 4i �. ' � � � .�' P�oiect�4ddress ��OS 'U�/fU/% � � � 05� ' ' • , � , . . � . 2091 I I:/ 1 3/84 '� `' I J��t7 �',TL' � 2c��l7 E.�L#p^/�9� /}�� TYPEOFCONSTRUCTION ; _ NEW �AD� .ALTERATION �REPqIR r � ' � } A'pplicant's Mailina Address' ��1 . Owner's Name ��'� �UT�� •�Phone Sn"�ti`%�' � CONVERSION _❑ DEMOLISH '� OTHER. A P # ' _ � . , _ ' Za�e� ; � i_ `'DESCRIPTION OF WORK/USE OF BLDG. � � - - Address �� "Da'�L� ' � - � ' ' ' ' � " - S Main Building: � �. � Accessory.Bwlding: , � - _ Arch/En9. � � � `LicenseNo ' � , TYPEOFPERMIT. GanoiNG� FOVNDATION ,STRucTURAL ' T Front:' - i i ' ;.t: . :' i % �� p � Addres5 -- ' : , ❑ TENHNT'❑ ELECTRIC}iC �❑ PWMBING � MECHANICAL' � � gn qea� ' � � . � = � • � ' ; _ , i ' �•y N' 'Phone /�,,-1y -� �OTHER � . � ConvactoPSName ' t S^-� S[�Y—s.i_2� � - � � ' �� C Right � • ' ' ' ' ' " N� PROJECT DESCRIPTION 'Sa.F7.� - ' - oCCUPaNCv ' Address (mailing) Z� E: : . �' , . � � - � . � . . . K - : • . , � - � :' - G ' " � �O� � � _ , -CONSTRUCTIONTYPE : • VALUATION$ g Left : �' • • City'LicenSe.No: � • � � ' � � ZONE �'cRA�INGCV.vDS. ' +ACRES PIng.Ref # � � ' t Parkuig�Req./Provided.. ` E° ' LICENSEO CONTRACTOR DECLARATION' � � ' . � � � ' � � � - . � I:hereby affirm th5t.l am licensetJ untler prov�sions ofiCharter 9(commencin9 � Remarks: � " ' '� I �0 �O � i Planning Notes: . j � � .� ��. ` f��: M? with section �000) ot Division 3 ot the Busineis anG Professions Cotle, antl � ' ` ' ' " ' � T . mY license.is in fuu force antl eftect. � I . �� j . - �. I , . ; , � ' j ' ' � � ' ' • . + . • i . ' � i r} : " t � `. � .' S • License class'�'�� ' license No.� � . � , ' . r . i. : � 1 . . : PLUMBING. : FEES ' . ! . i -' � ^ j i `Y 1� � . ' Date -Signature WORKERS' COMPENSATION DEG�ARATION' ' ' ' • . � i , Bar Sink - � Showers ^ � i ' ELECTRICAL ( � i � � FEES ' � 1 hereDy affirm tnat I nave a cerLficate oi consent to selt-insure or a certit�cate ., ' r %� ' � � 1 � ' of Workers' Compensation Insu�ance, o� a certifietl'copy [hereot'(Section BackflowPreventer � $Efvic¢$ � � � ' + -3800, �i.ab. C:p • - � - - = '� - ` � ' ' - ' ' ' � ` • ' ' " �' ' � Automatic Washer . ' � - ;Transformer� 15 50 KW^"f' ` t ' mk � ... � i POImyNo. ' ` * ' Gompany � Backflowlrrigation - - • SewerCap : i � ' } ' � • ' ; 050+KW. 4 t Y �'. Ce�tifie0 copy is hereby furmshetl. ' � % � ' ' � ' � 'f /.. Construc{ion Pole Sub ; } � ; � ' i i e'Certifietl mpy is tiletl with the city Builtlmg Division. �' i Bathtubs j � ' .i Sewer Connection � � ' Cooking Unit � . , i � Mete� ❑up to 100�amp5 ' �� Date . � � APPlicant ' ' . ' - ' � ' • . , . ' ' � i � EXEMPTION;FROM WORKERS' COMPENSATION DECLARATION CI31ifi2R' { � � SOId! COII¢Ct0�5 � � � '� Dfstiwasher � ; - ' �. (Thissec[ionneetl�noLbemmpletetl�itthepermiDis�foqone�hundretl�($100jor�r� , { iMeter ❑over,t00amps� _ less . � � : - ' � ' . . � � � i � Dishwasher �i� ' ; Solar Piping! ! ' . Dr ers ❑Gasl OElectric : : � ) � . � . _ Y � ISub.Panel , , .J j � � I certify.thaf in the perio�mance of the work tor,which thi5 permk is�issuetl I . ., shall not employ any person in any manner so as to become subject to tf�e ; '! Onnking Fountains � -Solar Tank � � � Fan ' �Motors �0-1 HP �1 %-�8 ! Workers' Compensation�Laws of California.. '� � 1 � 1 ' ' - ' " ' . . : 1 � � . Date Signature � � - ' • � �. Flooi Drains� - Swimminq Pool w/Spa r � F.A'U. - • ' ' Jnc. Solac�09-15 HP �16-15+ ! t 'NOTICE: If, atter making this tleclaration, you shoultl become suGject to Ihe ' . ; ' . . � Workers' COmpensation provisions ot the Labor Cotle, you must forthwith ' i ' -- '-- - ' - � . . Floor Sinks , ;_„_� _. _ Unnal__ __ _. . Fixwres ' -- � — � —_ - — _:..j mmply -with such provision5 orthis' permitl'shall 'be {tleemetl revoketl:-"�' " ' - � ' " " �Mic�Ow2v¢- -. . . ---� �� - ' CONSTRVCTION�LENDING;AGENCV � �n' � '. .. � ' � - � ✓T ' , � � «• � - GasService� `'Outlets WateiCloset' ' � �'� f i • , i � - i � DeviceBoxes � �- � ,Pole�Li ht ' � I he�eby afflrm that there is a const�uction�lending agency �o� the pertormance � 9. f. I � of the work for whicn �nis permit i5 i55uetl (SectiOn 309� Grv. CJ . Interceptors' ' Water.Heatei 1 � � OuL12t5 • f • � ' � � � � Lenaer's' IVame�� '- '. . , i `- _ � 1 Ran9e i' .�' j f Lentler's Adarezs � • � Kitchen Sink ' Water Service " - - Switches 4 � � � $ign � 1 OWNER BUILDEH �ECLARATIOfJ-' � -� � � � � ' � � ' � � � I hereby afflim.that I am:ezempt from the Cont�actor'S License Caw for the -! l'avatO�iCs �, �' - i. .,, ' - . ' � followin9 reasom (Section.7031.58usiness antl Protessional Cotle:'Any city or � �� Auto-Wash Garbage Disposal '! Standin9 Sections , county whlCh re ui�es a permit to const�uct, alter, im �ove, tlemolish or repai�' ` - -� � _ . , I any structure, pr�"�or to its�issuance,;also requires the applicant for such�permit P-Trap� , -� f Laundry Trays ,' i _ Generetoi �0;5 KW �5-15 KW �Trash Compactor . •� � 'to file a signetl statement�tbabhe/she is licensetl',pursuant to the p�ovisions of ' � ' ' '" � . , � , ' 'the Contra<tor'S�License Law (Chapter 9 (commencing with Section.]000) of' �Roof�Drains� • , � �� - , ' � Division� 3 ot theBusiness antl Professions Cotle)�or that he/she is exemp[ � - � � � ` � � ' � � �lherefromtantl the basi5 (onthe allegetl ex¢mp[ion. Any. violation ot Section • - • i �� ' _ , : - ; + ' � , � y I •' ,� � - � ' ]031�.5 by any�applican[ for"a permit subjects the_�appllcant-to a civil - � ' � � � - � ' ' , � � penalty bf not more than tive hundred tlollars (5500). � , -., , ^ _ ' � � , ' � ; i . � - � • ; ; .0 I; as owner of tne� property or my;employees with waqes as their sole '�Reinspection Pee •'� $15; s� laue Fee � , '$.3 �, /' , . , •' � compensation, will do the wo�k, antl the structu�e`is not intentletl or Offeretl ; ' ReinSpettiOn Fe¢ $15 ¢ Fee' � . �$ 3 ' . for sale. (Section ,�044, Business antl Professional Gotle: The Contractor's'. r, i •<- _, � ,- , � ^ �MECHANICAC ' ' ' FEES � � - � iicense Law tloes not apply to aniowner of a property wno;builtls or improves ; �� -- � � - . . , � thereon, antl'wno tloes such work nimseli/herself or through his or�her own � .. -� - - � � � �� EVEIOPMENT SERVIC REMENTS:�- � � ! �' � � i � � employees, provitletl that such imorovements are not�intentletl or oiteretl,for � Boiler � . � Hood or Type I ❑� � , � . � sale. It, however, the builtling or improvement is spltl within one year of com- '.- " �' "�, Canopy '�Type 11 ❑ � - Zoning pprove By Date � � D�etion,�the owner will'have:ttle burtlen of proving-he/she tlitl not builtl or im- Duct - Under.Ground � � - ' ' ' , ' -� � prove for the Ourpose of sale). �^• , ' ; � . ' � i Building Approved By � - Date ❑ I, as�owner ot the o�operty, am exclusivery coniracting` witti licensetl con- . Duct -Structural i i� Refrigeration System , , S, . ' Appliption Issued By ��TDatP I I I � tractors to construct the project (Section 7044, 8usiness antl Professions Cotle: � � ' ` . � � The Contractor's License Law aoes not apply to an owner ot property who � Ddct - Ventilating . � ❑0-100,000 BTU ❑100,000 BTU , - : ' �SUMMARV OF FEES . � � � � �- .builtls, or improves [hereon, antl._who cont�acts.for sucM1 projects.with a.con- - ' � � � � ; ' tractor(s)'license pursuant to the Contractor's License Law). I am aware thaf � Exhaust System ❑ Multiple �' System Repair/Alteratwn ' � . BUILDING PERMIT $ ��1 '� �. SMIP� � �$ � + 3' proof of their Worker'S Compensation insutance shoultl be provitletl to me. � � � . � �4 , - � � ; � � � PLAN CHECK 1 $ PERMIT � : ' I. � � ❑ Pam exempt unGer Sec[ion � B. & P. C. for this reason � � Fi}epl/Fact. Blt. ICBO # Fire Dampers' ' � i - � i . ' ' e PL'UMBING ' , $ � ISSUANCE • $ ! Date ' Ownert � � , ' ' • � + � Heating System & Ducting � Registers � � ' � � ENERGV P.C. $ � � ' PtAN CHECK �25% $ � � I hereby certify_that, I nave reatl this application antl state.mak the above,_! . ❑P100,OOOBTU.�100,OOOBT _. ._. _. ._ ._. . ,,. _ ` ' � GRADING , $ �� intormation is mrrect. I a9ree to campl th all city ana county ordinances � , . ELECTRICAL � r$ ' ' , ' antl�state laws rei ng to build' cons ruc'on �and ner tiy authorize repre- � . � � � ? „ ' � � ' PLAN CHECK 50% $ ' � MICROFILM !$ � � i sentatives of.this!c y'to ent i on the bove- � ioned property for , � . , inspection purposes. � � � � '' ' � - � � ' MECHANICAL $ ' � � TOTAL FEE . $ _ �S �•� ' Si9na[ure � -- Reinspection Fee $15 ' � Issue Pee • . $ 3 PLAN CHECK 25%' $ ' ' � � � CMF 0865-46, �ev. 30/84 White - Builtling; Canary -Applicent; Pink - Accountin9: Goltlenrotl - AssesSor � � — `� 'CONSTRUCTION AND PLANNING - � � � ��` -�� ' - � P�OL & SPA � � � : . � � x' =" '.'�, . , ` ` ` � � ' . :�Date •. Inspector ` . � � . - . . � ... � ' . Date� ' Vlns pc*or��. APPROVALS - Permit # - � -APPROVACS -' Permit # - P" . i . ._r _ ��. 1.,Temporary Elect}ical Service or Pole� �� 52.: Pool & Equipment Location . -_ . •'a•_ `'2. -Soil Pipe-Undrgrnd. - - ' '' ' _ � ' 53. Steel Reinforcement � " � ; �i � �3.,Electrical Conduit Utility-Undrgrnd. �,: _ - � � � : 54.. Forms. � . - � ' ' - . � � ' a4:�Electcica.l Conduit-Undi9md�" j : - ' S5: ElectricahBonding•" � - - ; „ . , � py5��. Steel'Reinforcement -� ' : ,� 56.� Rough'Plumbing`& Pressure Test. "B:, Electric'al UFER�Grnd. . � - - . ' _ � 57.; APPROVAL�,TO COVER-GUNITE �'.� ' ' _ .� - • ' J� Footings � . ' • =' � - � . 58.- Electrical�Conduif-Undrgmd: . . . , -� � �" t')8f Foundation ' � '� . ' �' " .'' � 59.-Gas Pipe,:O'Undrgrnd.,'Test ,'� � .�%rt � ,-'�9. Water Pi e=Undr rnd. � � " � � P 9 . ,. � 60. Backwash� Lines, P-Trap, � Undrgrnd. _ c10. Structural Floor SYsfem . � � � "'. : 61. APPROVAL TO DECK :'�- �� _ • - � � ;c71. Property Sewer Line &�HouseConnection ? � ' 62.,Backwash &.Receptor„Final ' . � �'� - �� 4�12. Sewer� Cap � � "'• � � _ . _ , � ' 63. Heater�&�Vent-Firial - � . �' . _ , i ' -� - 13. Roof�Drains _, � � � � � - 64. Plumbing_System'- Final a: . � . - � ` ' � 14. Rou h Plumbin � � ' �� - 9 9,� . 65. Electrical-Final" . . . � � • � 15.� Rough Electrical-Conduit, - - , - ,' � - � 66. �Solar SYstem-F�inal"' �", "--' - � . _ , . _ __. "'16. Rough. Electric Wiring � ' . ' -- _ , � '� �.`67. Feucing'&-Access Approval ',' i - `�. � ' "� " �i7.�'Rougfi Wiring Sign. ' - � � ' � •+. i � � .- � 6g. �APPROVED �FOR PLASTERING ' � � 18.',RoughElectrical:T,BarCeiling ' � � - ' . � 69. POOUSPA-SYSTEMSFINAL� : _ � . , �' Y 19.�Rough Heating & Air Canditioning �� _� � , FIRE DEPT; REQUIREIVIENT . i . ' 20. RoughFactoryFireplaoe � �, �� f � APPROVALS. � Permit# � . �, ' 21. Ducts, in Structure . • � ' ' � � 70. Underground Hydro � , rc , 1 -22.�Ducts,Ventilating � f77. Pioduct�Piping�OGas,- ❑Oil . � � ' � 23.. Gas: Pipe-Rough & Test � !� � � . , 72, Underground Flush � � • , c24.. Roof Framing � � � � �, n � 73. Undergrnd.�Storage Tank� O Gas ❑ Oil � � i ,, 25. � Roof Sheathing � � ' , � , � , 74. Overhead Hydro . • 26. T-Bar Ceiling�l5tructural) �& Monocoat ' � 75. Dry Chemical _ �� -27.. Frame and Flashing , � • , � 76. Dry Standpipe � f - _ � 28.. Lathing & Siding ' , ' + � � ' � � � 77. FIXED�SYSTEM FINAL � �. ' 29.� Insulation: - �� i � � � 78. FIRE PREV. FINAL � � � 30.,�Drywall Nailing � '' � ' ' . HEALTH.DEPT. REQUIREMENT ' i � a31.,Plaster Brown Coat � �f ; � � � , j79' FINAL INSPECTION �� . � , ' ' f ,, - : 32. Electrical Power Meter-Final :"' � � �80. FOOD CERTIF.ICATE ISSUED � �•� i . � 33.�Final Electric � . _ ya �F c�' �� Notes: � ' , . ' - � , ' 34. Final Heating &�Air Conditioning � , ` • � � `� �+ - .�• -, ,. ;., 35. Final Gas Pipe-Test� , G � � • � � � T � - �' ' , � �`' - _ . �i 36. Hood o� CanoPY � . . . y - � � . � '„ ' 'I: -- . : ' _ . ,� �- i : � . - - ' � - • , r 37. Final Factory Fireplace � - -' � ' � • . � ; .p ' . - - - � , ; � , n 38. Final Plumbing � � t ' � . � , � ; r ` � ' - � � � � 39. Water�Service-Final; � '. " � I - � � ' ', � „ 40. Gas Service-Final � ' ' ' � ' " - - � � 41. So�larpomesticFinal � t � rc�,. ..�._` . ._ I . ...�,. ._�... :__i__r.�,_..��,j ` �' � � � . 42. Backflow� Preventer, ` � ' . j_ �_ � � � � - '� � � 43. Backflow Irrigation, � � � � �' ' - � ; � < • �. � , . � , � _ . i :. ' .� . - . ' : . 4'4. �Landscape Irrigation System , ; " , � _ ,� � � : ; � � . � � �� ;�,, ,: 45. Sound Attenuation � � � l , � :' ' ' j - � ' �- . - ; , � , ' . - ; � � � - 46. Handicap Regulations � '. � � r.: � ^ i ' � � ' � ' � �� _ " � . - 47. FINA� STRUCTURE & BUILD WG ;�` . '. . i i 1,, i� 1 r. .� _ t� � � . 48. Special Requirements 6ompleted �� ' I �' j . ' ? , � i< < , , �� h .. . � � � �i 49. Electric Release;to �Ediion, , � � - ----j - - - --- �-' - �i- -� r - --� .L_<,. 1 � � _ ' ' 1 . y 50. Gas Release to Southern California Gas Co i � � � ��i � � i� �:-� ' � i , 51. CERTIF.ICQTE.OF'OCCUPANCY. '"' - ,..--' -_.�_' '� I`- -�- �-,-.' •" i j` � ; N � � � � + � _ No. ' � Date' ' ' � , r- .L£ L. � " __ .�� "_' _ . � nno�NlpNO: , 9�]S DAHL�IA AV awriexswweic�,rnvx: SCHMIDT, ALVERA moness: 965 -DAHLIA AVE COSTA MESA,CA ' MY�. MAlIlNO �UDNE59: IAXCNRECTONFMtlNFER: urcx. on ��s �ooeEss; �CONTNACT011'SN/JIE: BGW FURNACE SERVICE ca�m�crom�uiwo 6015 STATE ST �ooeEss: HUNTINGTON PARK 90255 IJCENSEU COMRACTOqS DECLAPATION: I hereby eRxm under penMy of p (rommer�r n0 �h Seclion )000) of Orvision 3 d ihe Businw eiM Prolecdona C� �ic. No.: 0 6 6 6 0 uc. cuss: C 10 uc. No.: , ui� 4� _ �;��,. 92626 UNT: FLOOD: AH-38 26 I� uc. ra.: uNr: (213)582-7942 CA �G�, 3008%8 uxr: ihet I em licansed under pransione M Cheqar 9 M my limnae u in lull Iwcs eM Nlaa. .Q,�78 EXP: O1/97 �p1�NEP BUIIDEfl UECLAbATION: I hemby �rm vnEer pen ot pry lh I e empt from �M Comredae Licenae Lew lor �he lollow'xp reavon (�� )�t.5 Busiwea eM Prolwiom M' y a t ieyuiree e pemiu to mrown. allx. impwe. demdeh, a repei eiry etiucturo, prior io en ovueMe, abo �ui epplimnllor euch pe�mu Io fib e sprwE aletemenl ihel �e or eM ie liceneed W�*�ent m ihe poviaiona d IM Gomrenore,Licenee Lew �Ghepler 9(mmmendnp wilh Setlbn )OW) d DAnion 3IN the Buainaae eM Prdewons COEe] or ihet he u ehe ia azemp iherehom end the beais la �he dbped ezemqion. My v'detion al Sedian ]031.5 Ey enY eVD�we^I lw e permn auEpds IM epplieenl �o a evil penelry d na mae then fna hundred ddlaea �SSW�. � I. es avmer of tM proparly or my employeee wnh wepee as t�ai eole compeneetian, will do Ne vrork, end iha elrvcture u nal intended �or dlered lor sab (Seclion 10aa. Bwrev arM Prdeseiona Code: The Cantredwa Limnea Lew tloas not eppyto en owrord popa1ly wlw buida a inqovea iMrean, enE who doea auch xak NmcaX a MneL a Nraph hc or her own ampbyae�, qwked thm wc� improvemenis ere M imantleE a oHeretl lor cele. II, hawever, tha buiNiiq or impmvemeM is eok wnhin orre yaer d mmpinbn, ihe owner-WiNer xill heve ihe burAen o/0�'i�p ha or ehe EiC not builtl or improve lar ihe puryoee d We�. � I. ea oxmr d IM popeily. em extluarvely oonirediq xii� licensed contrec�pe �o wnqnM iM pojed (�� . �vi�e eM Vroleseione COEe: The Gonved«e liunee Lew Joea rwl eppty lo en owner d propeny who buiMe w impovea �hereon enE who - convecte lor wN prol�e wilh e mmrepor(a) licanaed punuent lo Ihe Coniretlan Licerua lew). � I em eaemq urder Sec�ion: B. 8 P C.. la �hn meaon: � Oem: � Ownec I tlo hereby cMiN �� I em ewera W end uManierd iM repuiromente A CalRomie Maellh enE Selery COEe SeGione 25505. 25533, and 255�1, entl Net I m eny Mura buildi�p oaupeM xill / wJl rw1 (dreb one) rieed io comply wih aaid nme codm vM iha �uiramenb br apertnnlaconetrw�bnwmodificetianhwn�MAi e�il�y anepamamDiqritl.Reaidenlielconqiudionxppfratiauueuemqlmmtheee pmWaone. � .. ' + , Dete: ' . ApqiceM: ' WONKEfl'S COMPENSATION DECLRN�TION: I Mraby elfirm unEer penelly M parjury me M Ne lolbwinp dedvetbne:' � Ihewvdvrilmainteneeend'eetedmnemitoaeMinwrolawaken'ewnpenaation,upovidedtaEySecVm3]OOdiMleEor Cade, for ihe peNormanu d tM xwk fa wlvch �hie permd is ieauetl. � � nmre d,a wiu meio�ein won�ers� oomcanmiia; m.�reMe. m,.Qutree W seaian a�ao a m. leb« coae. r« me w�� a in. .��a�.n�m�,w�a�,m.�,.e.Mr.«w��'"�a�.,.�ecwwv��mcau.:. EXPIRES c�a�: ' ' ,a,�N�m,,� — 10 /01 /96 (This aec(ion rroe0 r�a be rompbleJ d IAe pemid is M aie hvndied ddbie (J1W1 w lex.,.) � ❑ I ceMify Ihe� in �he paAarmence ol �ha woA br whkh ihia pe�mil ie ieeued, I ehell ml employ eny pareon in eny menrw eo q lo e eubje t lo Ih woi1�qra' campenWion kwe d Celibmu, end q�rae Uut A I wM come euEjed lo �M xwknre' mpanseiio rwieb a ol baion 3]00 M �M lebor Coda, I ehell fonhvAh campy ' I� e ieiona. oa�e� �vd��. �� em/np: Fellu ro��c ro warbri compau�Uon rovop� � unln q entl �h 1 f m �mp/oya to ctlMm/ p�m/Uq mtl C/YIl flMJ Yp b MI hYI1tlIH fMYHM COII!/� (S/0Q000f. 111 b tl1� C01 .rwnon a.m.p. u provm.d ror in xtlon 9]W ol Ms Le6or Cotls, /nt�nsf, entl ettomsy'� Iw. CONSiRUCT10N LENUING ROENCY: I hereby affirm untler penelry W perlury ihm then ie e mnalruaion brMinp eperwy br ihe perlortnence ol the wak br whidi Ihe permY e 6eued (�� . Cw. CI� . LENDEN'S NAME: , LENUER'S ADUflESS: I cerli/y ihm I heve read Ihia epplcelion end ete�e �hm �ha eCove inlormmion is mme. I ep�ae to mmpy vmh all ary eM counry mtlinenoee arM stele lewe relaling io buildnp wnaVueion erd heraby emlwr¢e reDrasenie�hes ot Ihis dly to enler upon IM ebove�meMoned 0 WM mrmo�e�w�ooae�. JONATHAN MOFFATT t Neme r�� .. X� / Dme: fi f / ( a �.,� a�� o� �,�, , CITY OF COSTA MESA — HUILDING PERMI.T " PERM NO: P 07700 • , PERMIT NO; P 077008 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PI,U PURPOSE: OTH JOB DESCRIPTION : GAS VALVE ON OWNERS SIDE OF METER SQ�FT: , CLAIM VALUE: CALC—VALUE: ' GROUP OCC: R-3 /U-1 COMMENTS: INSTALLATION OF GAS VALVE FOR EARTHQUAKE SAFETY� *x��tet***at�*********�at��atat�**�at**x*at+�*�t�*�atx**+e�+�***�c*�t***��*iF*rtet�at***+�it*rt*��* Z O N I N G R E Q U I R E M E N T S .S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ----=---- FRNT:. FT IN REAR: FT IN_ FRNT: FT - IN REAR: FT' IN LEFT: FT IN RGHT; FT IN� LEFT: FT IN RGHT: ' FT IN PARKING REQ: PROV: PARCEL: 41218122 ZNE: REF NO: PLANNING NOTES>� � • . � ik if iElE 1E 1E iE 1f fE fE iE 3E 3ElE �E iE 1E fE.fE iE �E 1E iE 1E iE iE 1E iElE iE if if if !E iF fF 1E fE 1E fE aE iE 1E jf iE iE iE.if * iE 1f �E iE iE fE iE iE �f iE if if iE if fE iElE 9E 1E �E if iE iE �E iE �)E ff iE jE fF , D E V E L O P M E N T S E R V I C E Sr� R E Q U I R E M E N T S ZONING APPROVED BY �� DATE: BUILDING APPROVED BY : APPLICATION ISSUED BY: (%�—.1 L / if !f iE 1E ff !E iE 1E if 3E �E fE 1E 3E 3E iE �E iE iE IElE iE i��; LEGALIZATION:N. F E E S U M M A R.Y- HLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 7,00 DATE: � DATE: �' 2/ ' � iF�3FjE�ElElE1EIE1E1fiEiE7FiF1F �1FiFiF��F1EiE STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING 258 � SMIP/NON—RES PLAN , � ISSUE FEE 20,00 ^ ' BUILDING—DIV—> PERMIT ISSUE Pli'AN—CHECK TOTAL PAID DUE TOTALS----> , 7.00 20.00 ��. 0.00 27.00 27.00 .00 n REVENUE DIVISION TOTALS-->., COliL'ECTED: 27,00 OVER/SHORT: 00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SM.IP/TOT GRADING PLAN—CHECK 27:00 (� 1f iE * aE if * 3E iE iE aE� iE'1EjE iE �E jF iE iE �E iE iF iElE 1ElE iElE 3E iE 1E 3Elk 1f iE 3E �ElE if 3ElE IElE iE iE iE 1E if if 1E �ElElE 1E 3E 1F IF �IE 1E 1F 3E iElElElE 9k �E iE iE 1E �E'lE 3E if iE 3ElE'� � I N D I V I D U A L�,` F E E B R E A K D O W N � TYPE QTY D E S C R I P T I O'�N UNIT COST TOTAL COST PLU 1 GAS SER��ICE. �-1 7, 00 7, 00 r�EyND OF FEES � t. /'i/ 0 01 OQ23363?–OQ243d37 "d'�:� T :?7,t�p DAiEc 04/QZf4` TIflt: p5:i3 CONSTRUCTION AND P�ANNING � �- ' • t - � APPROVALS Permit # � F';- �� 'Date .. Inspector . i L Temporary ElecErical Service or Pole, - '- -- � . �_, -�2: Soii Pipe-Undrgrnd: - '' ' � ' . _ �� 3:'Electrical Conduit Utility�fJndrgrnd.;_ ', � - . 1"4.�Electncal ConduiFUndrgrnd�. �� _ ' . ��'/ . . . .OL & SPA .- ..`� - .. . `- �' _. - �. : � � ;, 0 APPROVALS -Permit#'-'� ` t ' _ . : 52. Pooi & Equipment Locationf,-.. � 53. Steei Reinforcement `� _ 54. Forms -_ . � ' '�� `r ^ • 55. Eleciricai Bonding ,. ''+� � . " �� `�5. Steel Reinforcement- - y �- ' 56: Rough Plumbing & Pressure Test '- -� '': c 6`,-Electrical UFER,Gmd. . i�� .. . - i 5�,[, APPROV.AL TO COVER-GUNIiE� ^7. Pootings . • �` � � „_ � ' 58: Electrica� Condui[�Undrgmd. � 8: Foundation - •`- � ,r _ � • � r-�: ' - 59. Gas Pipe, � Undrgmd.; Test' r-j ; • ✓ 9. Water PIpe�Und?gmd._J �;�,,:/=. � ' ; 60i Backwash�Lines, P�Trap, � Und�rr.d. p �: ' lO.StructuralFloor-SYstem r ':,�,�t�. �` - G ' ' �.61: APPROVALTODEEKy-�{' _' i t. •Broperty Sewer line & House ConnectiDn� .. [ C� {�fi2c Backwash & Receptor-Final �� + `�" � ^ F 12..SewerCap ` „�", ' •} �: � �63. Heater&Vent•Finai �� , � -:.�r: r,..._.._•' 13. Roof Drains . L'! � - - � 84. Plum6ing Syster.i �.Fina4�� y%=�; �� 14. RoughPlumbing ,��,; �- `'? '�� 65.'Electrical�Pinai � ,� �� "-15. Rough Elecffical-Condwt ; � - �� . i '66 � Solar SYsterri: Final . ' t6. Rough Electric Wiring ; � " ". - - , • '`67 L Fencinc��& Access Approval � • '77. Rough Wiring Sign � • . �: ;68; APPROVED: FOR PLASTERI��NGK 18. Rough Electrical-7 Bar Ceiling "- ��` � 69. POOUSPA SYSTEMS FINAI 19. Rough Heating & Air Conditioning - ' FiRE DEPT. REQUIREMENT - - t - 20. �Rough Factory Fi�eplace ' ?a:=' , � - -' " APPROVALS� � Peimit # 27.'Ducts, in Structure ,•� . .• • - _ ' � - • " 70.� Underground Hydro 22. Ducts, Ventilating : � -- �. . � �� 71. Product Piping O Gas u Oil 23. -Gas Pipe�Rough &�Tes2 . - - � ; � _ 72. Underground Flush � 24.'Roof'Framing � �� - � �� 73. Undergrnd. Storac�e Tank O Gas ❑ Oil . 25. Roof. Sheathing A� :�� . i �, � %-� �, .� ` 74. Overhead Hydro ` 26. T-Bar Cei�ing (Structurel) & Monocoat ' C `= r 75. Dry Chemical � ` 27.:Frame and Plashing,� �� 76. Dry Standpipe' �, . - - 28. Lathing&Siding� : � _ � ?'' � • '- 7i. FIXED'SYSTEMP:INAL 29. Insulation -' t� � � y� . Z8, FIRE.PREV. FINAL � 30. Drywail Nai6ng � " � „� �,` ;, � � HEALTH DEPT�. REQUIREMENT 31. Plaster Brown Coat , y . a , 79:'FINAL INSPECTION . � 32. �.Eiectrical Power Nleter�Pinaf � ;• . "� ' 80. FOOD CERTIP.ICATE ISSUED • 33..Final Eleciric � � ,- � t,, T " - Notes: l ,�--�i � �� T_ c. -i� id'i�61 � 34. Final.Heating-& A�r Conditioning;'. . �- � r a. 35. �Final"Gas Pipe-Tes't ; ;• - � � � . . . r,. _� 36. �Hood or CanoPY �'' " ` �- : • �= F' • , - ,= � 37.'Final FacTory Fireplace . � " � " .� . - - 38. Fina�'Pfumbing � ' . . . .. -�� /G - �= 39. Water'Service-Fin81 � � , „ 40. Gas Service-Finai � r T .. *, a 4/. Solar pomesticFinaf `� ' ��'- � ' _ , � 42. Backfiow Preventer,�,i `� ' �� • �43. Backftow Irrigation' � -�� - . ��;44 � landscape IrrigatiomSYstem� ,t,i.� � M C. _ ��45�Sound Attanuation': � � � _ , , • `46.� Handicap Regu�ations ' � - �- 47. FINAL STRUCTURE & BUIGDING ` _ ��'` 48, fIN0.�PlANNING� . .� . `'�.. - �., "49. Electric Release to Edison � ' �-� > a ,. �, 50.� Gas Release to Southem Califomia Gas Co �. �r �_ Date r. _ Date Inspecror �'� �9t, �* . . ... ... . , . , ...� _ ,� �_�� . Applicant to fill in all spaces except tbose within�heavy bortler lines antl si9� all appropriate tleclarations. _ J �-� CITY OF � oSTA m �sa%."CO�ISTRUCTION PE�RMIT '� • PE IT N% ' � �TRACT N/O�. - t LOT N - ' UN1T NO. � Y� � i � /' ~p � �-� �' •'] (� - � / '� n � �� / � � � �' iJ � :.� . '_ 5�'-- • . . � ii . ' ' � '. .. � � ` � � C94�. �U��c�l:� � .�� r?II.riF{}'t 'T� Pro+±'.Ptidsess � 9/d`7 .YlaiiL%/� S%� . . . . 1 • ' `- i ' • L , . c' �q � TYPE OF CONSTRUCTION � ' NEW ADD ALTERATION- REPAIR • � � ' '�' Applican[ s Mailing Address �Z�1it.'� /� �'��f�ROOi I'�N/j�B�� . . : - . . , , . �, ��.CONVERSION ❑ DEMOLISH ❑ OTHER�� "- � • '!' O`wner'sName'A'I-VCI�A �c%rl/M'o7 ' PhoneSbJ-/'I'SO� " - " . A.P.�. ' L�-LZ � . �, � ��u� ' .:� .r ; • Zone� ��. - �JG 7 �/7FJL�/N T%�c�. LoS�rl/N�..�S'a . _oEs�CpIPTIgJVOFWORISjJJSEOF.BLDG. ��V �NTNef _Hf�+'_ ia _ , Address '/QI �/NG�Lu �'�'}Y�'/ /1.� �OWltrZ�%UG. ' " S' Main Building: . - - 'Accessory Building: Arch/Eng.-�E •��• �n�N -� � � � � License No. �� 7��c � TYBE OF PERMIT - � GRADwG�" 'FouivDATioN STRVC7V RaC . � ' _ T FFont #r � - . . _ - . -p � ' (GZS � W • �i4T�:*li.•1 ' . . �� , Atldress � ' ' p/� � ��!�+ e' , _/ � '❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear ' �p �' �� :. � t ' � _ , �� ,' : - � N � . ��L�SQ.V[^I�,' L; .CJtiIST r 1� ZI ��OOTHEft '� . . � ' 1 • . .- . , Contracmds Name Phone��r� ' � � - -7 � � - � - � � C Right � ; i ' � � N � ' { ' 2-�% . ��O�CONNOp=' Nt1Hl9��"': �ZJOG <PROJECTDESCRIPTION� Sq.F � /� � ' � ` ! K., Z� - � � G OCCUPAN Y Address (meiling) - � ^ ' � . u � ' � . � �' � ^j CONSTRUCTION�.TVPE •�^�% � � ;VAWATION$� DO� g� Left� -�I k � � � _ � �'. ,�. � I , � � � , � . . � ft I City License No.. � � ' • � � � /� (L� � �� x� � ^ � ZONE � � � • GRADING CV. VoS� � �% ACRES � � � � ' � -- L'ICENSED CONTRACTOR DECLARATION + T , � � ; � � � - i � � � I • - Ping: Ref. # � ' ' � � Parking�Req /Provided / �, ' ; E� � I�he�eby.a(firm Ihat'I am licensetl'�untler provisions of Chartei 9 (commencing � ,Remarks: I _ �G' � � � ` S',�" 77� �. � � � Planning Notes: � ;�j.� ' ",r , - M '� J with rettion 7000) of DrviSion 3� of the BuSin ss antl Protesyions Cotle, antl ' ' ' ` -' ' mY license is in fulfforcp.�an �etfect.. _!.. - � . { � ; -...�. - .:L.'. D =1 � � . : 1 . � , I ..+ 3 ! � - .---- - f � " � `} i � - ` f._- + T i , Cicense lass� � 47' f licenservo. �%��'O�"} ' 73 �Q.�' . . �e' � : � : : . . . .. . �.. ' S.� � oate �i: � ca�ai CtAt.1l♦ ' � � ' I i PLUMBING : :.' 1 ' I a FEES ' }� � 1 ' � � • � a + i . � i WORKERS' COMPENSATION DECLARATION � : �� j � ' � � � + � � - �� ' ` - 1 heretiy affirm that I have a certiticate of mnsent to self msure or a certlficate Bai Sink � '. I �� Showers - i � i , � : � �ELECTRICAL � '•� �� FEES �, �/1�_of Workers' Compensation Insurance,,or a certi(ietl mpy thereo( (Sec[iOn � � f , � . . �- �� 3800 LSb. C.j e ; �� , i;�1, ' � l- Backflow Preventer-- . _ _ __ Service Sink �— 1 - . . _ . ', _ Tt „ � r � � Automatic Washert--+— � Transformer• � 15 50�KW �- k � Pol�cy No. � -f"'• ��¢ ' Com any � � �� - �'JNn ' -� Backflow Irri ation � Sewer Ca • ' �" 7 ' ' � � � � � 50 + KW � � �P � . � .i. 9 . P •z, i 1 . � _ , r .:-� ConstructiorPoleSub. 1 I � . � , , l e Cerbfietl mpy,is hereby fumishetl. -' �J, - �� -� � /� \' CertuieQ copy s filetl with Ihe uty euil mg wis'o /� � /j�p� � - Bathtubs . � j Sewer'Connection j �' �.� Cooking Unit �!_ � � Meter ❑up to 100 amps ' �� Date /lUll �� APPIi<ant - A�`�—Q �u��lo� �SW�v'� ' . . . - . , f f _ i' 1 . � EXEMPTION FROM WORKERS' COMPENSATION'OECLARATION .� . Cldflfi¢iS� f, � � � $012� COII¢ctOR�� '� � � ' ^� Dishwasher " � � �Meter ❑Ov¢f 1002mp5i � � j� \ (Thissection neetl'not'be completetl if tne permit is for:one huntlretl'(5100) br 1 , . , , , ' ' ' less)- . � , ' ' � �. � , '! � � j Dishwasher . � ( Solar Piping, ;'! - , i �� Dryers OGas �Electric �F �Sub.Panel t � ' __� ( � i ' i 1 cert�fy that m tne per(ormance of tM1e woik•for wh�ch this peimit is i55uetl; li � , ..� , . - � � ' - ' ' - - ` ' � shall:not employ any person in any manner^so as to bewme subjeGt to [he � D�IOking FoUntein5 � 'i SOIa�'Tank ;!i; 'l�t� e' �I '�� . �-�.. F2n' � � f � � ' � Workers^Compensation'Laws ot Califomia.Y'I i�+- i i � " `- ' ' - ' ' " .,r �, 1,- � , ; Motors �0-i HP 01%',;16 � � t ' Date� � � � Si9nature � ' .�i FloorDrains, � �I SwimmingPool'w/$pa�' 'r � � FA�.U. �" i � i .IncSolar'�915HP�16-15+ � � � NOTICE! If, afte� making (hi5 tleclaratlOn, you slioultl become subject to tne � ' � ' � � - . • Warkers'4 Compensation .provisions.of the Labor Cotle, you must forthwith ;, ! �. F.loor Sinks � __ i _. .� _... _. } . _.Urinal a.. � � � � � ' + I � � ' -}J,. �7 ..' �,. ' " -, �4 .Fixtures,�� _ �,__ . . ,1..__ Microwave _ :-� '. _r_�2 k�. comply �w�th, such provisions o� tha permrt shall be tleemetl revoketl. �, � � i-'. _ .. �. T -^�:; .. CONSTRUCTION�LENDING AGENCV" �� (,J'+' '�� - ', ' GaSService,� .�Outlet5'� ' �Water,CloSet ' ' � - �" ' �''� � I M1ereby �af(irm tM1at there is a�con5t�uctioriJentlin a enc -for the' erformance � � - - • ` � � - . . ' � - � " 1 � � 0 Device Boxes t;'"� � 1' 'a P012 Li ht \•T Ft +S, _.�� O -� 9 9 Y P �/ .,� 9 d �,] ot tfie -work for. wnic �is poamit�is�issuetl�(SecLon'3097 Civ. CJ. . r i � � � : . . ,. . !' i.. , � u � „i � � , �' Interceptors�- . s Water:Heater I . Q Outlets 1 'i r ' , flan e-�-y ,y:, F�� `'.�� ' p• � � � Lentler's' Namer . . ' - � .. 1' '}..- li '� _ 9 �'t f�r ..� �2' Qt7 -: Lender'sAtltlress �� ' �^ T -� � � ' ' KitchenSink `t i - WaterService " � Switches� � �� ' � gj � �' " G� '�y� _ ? .�J - - OWNERBUILDERDECL-ARP.TION� � - � =- S S -- � � . i " i - - � � - � �� '� 9 � r �• N .L O I hereby aftirm�[hat I am exempt from the ConVactor's� License Ldw fo� the Ldvdtones � � - �� y � =1 j _ .. . F _ - y' '' " • .e . � following reason. (Section-�031.5 Business antl' Protessional Cotle:'Any uty or : ' ' •- ' ' � ' � � ' ' . Gar6age DispOsal'�' 2. C , ;' Standmg Section¢'' , �'��, � -, � county which requires a permiC.to construct, alter, improve, tlemolish or repair' �qyyp �g��7" ��, a' . = i� � �' � 2 Generator DO-5 KW �5 15 KW 'T � � t" •3' '�1 any structule, plior to..itYissuance; also requifes thE applicaflt for SUCh pelmlt r � ; - _� :: TfdSh CO�fIlpdCtOf� ,�; � �� N ss•;to file a'si9netl.statementrthat�he/she is licensetl pursuant to.the provisionz ot.� - ' Roof DraiOs` y- � ' � � ' + � � . ' � _ ---"he Contractor'S'License Law,(Chapter 9.(commencing with Section J000)bf" � f � �' � , � � ., y, ,� Yi `� � 'J .�� .�Y' ' i �?. � ••y, �.-� °YDivisionj 3. of the' Business antl Professions Cotle) or that M1e/she' i5 exempt � �_ � .+ � _ . - - the�efrom-antl the basis for.[he alleged exemption. Any.violation of Section ... �' � � : I ^ �� r : 703L-5 :by, any; applicant fo� a permit subjects tne applmant ^to a civil � - ` " � � ' • � ' •� � � � ' � � � � �` �v � t: � y � ' `. - :�enalty of.not more than five huntlretl tlollars ($500). r� , _ , . � ",. , r --�- »� � • �- , � � , � � a - � � l �� ' . ' -� c-. 5 •�..w ��) - °j LJ I, as owner of Ihe property�onmy employees�w�th wages as their sole •ReinspeGtiOn Fee " � $15 � ; Issue F¢B ; 1 � �1 ' $�3 �- - I t'"' I'� �� ^, • . ^°: ,� ` �'.'3' ' e . ' ?J!i�!" A' Fr rompensation, will tlo the work, antl the structure is not intendetl or offeretl ' - ' ' '' L t Reinspection Fae •,,,, $15 � Issue Fee,� M' y,,, �$�3,;� Y rj . for sale, (Section ,�044, Business antl Professional Cotle: �The Contractor's � ' - . -� , . �MECHANICAL • ' ' � FEES ' ' - � '` License Law tloes not apply t0 nm,owne� of a prope�ty who builtls or improves , - ' • - �- ,,,,,P, �,,,, � ..`. Ihereon; antl;wM1ofdoes such work bimself/herselt or�througM1 nis or her own ' f �t , �� - DEVELOPMENTSERVICESREQ11I E ENT c. � "�' . employees, provitled that such improvements are not intentletl or offeretl for , Boiler - v _ � Hood ort Type I� ❑ � �n , �.5 � F /'I � r,� . . 1 � _ .-. {J : �� ' r* ' . sale. It,'however, the buildin9'cr improvement is soltl�witnin one�year ot com- � - :' ' Canopy , Type I I ❑� t� 7' 2oning Approved By 1.� Date � � pletion,'the owner wilChave the burtlen ot proving_he/she tlitl not buila or Im- ` Du'cL- Unde�-Ground � - ! .. . � $uildm9 Approved Byz� �- � - �� '� bdt0�• � �� 'Y �roveifor the�PurPose of salel. . '.- , .� : � ' 1. ' . . . ' _ : � f� 4 _' r �. . . _ _ LJ I,�as�owner of the property, am exclusively contractin9 with licensetl ton- Duct- Structural Refrigeration System �..' � Application Iaued:By_ �Dat "� ' ttacto�sto mnstruct the project (Section �044, Business antl Profe55ion5 Cotle: � � � , The ContractoYs License Law tloes not appry to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100;000 BTU \� � ' + . ��S qRV OF FEE$'. ''r ' � � -builtls ot im0�oveSthereon, antl who'confractsto�-such Orojects'witRa mn-'� --- - � �- - - - - � . � � � �7, �� . ' �.` r�^ �� ; tractor(sl license pursuant�to tne Gontractor.'s License Law). I am aware that . ' ' ' d � BUIL'DING,PERMIT• $J �� J� -^SMIPr . .$ ; fr_2,73 w proof of their Worker'S Compensation insurance should be provitletl to' me.� Exhaust $ystem ❑ Multipl¢ ❑ SyStem R¢pdir/AlteratiOn � ?' � �� . .� p, _� ,� ,�, ,. ,. � , � • � - � PLAN CHECK $(�' �{^ - PERMIT;j Q, ^ y%i' ❑ I am exempt untler Section e. & P. C. for this reasou Fif¢pl/FdCt�Blt. ICBO # �'�s e5 : �' L�' � QQ ^ � � -' �.' �� ? .� � ? I , , . . . , 1 . -. ' . PLUMBING �' §�' ..y. ISShUANCE ;' $� �. Date � � '- - Owner ' - � - -� ' Heating System & Ducting � ' . � G' " ' ' %''1 � OO � ENERGYP.C:'� $ � �- � � ~ � PLANCHECK 25% $,�� / I hereby certify�that I ha've reatl-thii apolication anA state that.the above ❑0-700,OOO,BTU 0100,OOOBT � -. __ _- - .._ . „�,•- �,;, J � �pp � GRADING � $� � � " '� �" information is correct. I a9ree to comply with @u city antl.counry ortlinances . ' .. '. � - .• �' ELECTRICAL . �$ ,n. � antl state laws relatinglto builtling mnstruµpry antl hereby authorize repre- . � � � . ' r � MICflOFILM $'' �' a ^'" - sentatives o�,this'city� to enteri up th;e yoove-mentionetl •property for . r, .,Q�C+'��- ��"�SfoN� � j ' , , - �,� P�ANCHECK ,50% $ � Y,{ a �. +�• y �-�j__�� insPet[ion P Po 5. � � A�,(,� /1 \.��' ` �Ll L9f � :-. ' � ' ' � - ' MECHANICAL $:'' . . i OO jTOTAL FEEL" $`�"� �1 Signature tZ�tG.'� a 't�%J "' �i0' Date Q _ . �- '.,. � . n. i Dnvers' Licerise or:55 � � � � � ' � � Reinspec[ion Fee, ,$�5 � i� Issue Fee � $ 3 � �':� �PLAN'CHECK , 25%; $aa. � � � r' •1 ra8'�s,-" 6: ti . _.. _ � . _ - . : _ . CMFOB65-46,rev.�4/B4 White-Builtling;Canary-Applicant;Pink 'Accounting�Goltlenrotl Assessor;. � , , , � �� '�� ' ��` ., - - � � '� "-' " " " � ' -^ -r --- '� �A � ' _ . __ . . . .? .. _ . .i"_"_`_,_. _ ��! � ' ^� " � -. r � � ,> � �, _ � � � } . ._ '.7� >- 'c` . .. '; . P'"'�&SPA ' _ - r � CONSTRUCTION��AND.PLANNWG �*, - � ' u . • . ; . � � - _ . , • ' ' ' "� . ' - . - , • .� Date � ` �Inspector ' �' - � � �Date : Inspector . . �� A�P,ROVALS � Permit # � - - _ - - ,-. � APPROVALS � Peimit # y .. .i' �c. �-1. �"empora�y Electric8l Serviceor;Pole t .. .g' 'a1 ' S52 Pool &_Eqwpment��Locatiori: '. . "> .y i� - �. , �2."Soil Pipe-Undrgmd.�' °� �o : !,� �-; L/f%% � 53. Steel�Re`inforcement � � � `3. Electr,ical Condu t �Utility Undrgmdi f`' - � - �' - .54.'Forms�� - "'� ' -� � . '• V � _ . . ' , - �. .. . � " .�.'.,� � . _ _ - . , ._.. - .. � °4r Elect�'rical Conduit-Undrgr,nd�. � � � - '� ` . � '-55.`Electrical Bonding � _ • -� � " � � - 5s SteellRe�ntorc`eme�t -, � -.I � - , `'56 Rough�Poumbing & Pressure Test,� . r ' ; t„� : ,�:�6. tElectrical UFER�Gr`nd. , � �:-' ' �-;•' �. . - . 57 •�APPROVAL�TO COVER-GUNITE ' '` � '~� „ . ,. - -- y� .� , F . ,. . . . , �r .� 7'��Footings ' �' ' = �; }+ =.�� .�'' ' S8: Electrical Conduit-Undrgrnd. � � , - ? �8:: Foundafion �� ^; : j�'= S kfj/!�'l�c� -59. "Gas Pipe, � Undrgmd.,�Tes( � . , � � �'`_; •.��' � � <9�,Water Pipe-Undrgrnd�'�� _ �(j�5'��'�� '`/) ; �.60.�Backwash;Lines, P;Trap, �.Undrgmd.: � 1 • � - ' i. :.� �.10. Stiuctural Floor System. '- _ � �`, �: �; �! �.T, �', " ' '61�. 'APP,ROVA�L',TO DECK � _ . ` � � � ;1,1 7 PropeitY Sewer Lin`e &�Nouse:Connection. J�c� 'y � 'L2n ' 62. Backwash�& Receptor-Final ' � � � • :. � J��'. 12. Sew`er�CaP� { ! ' � �' � ` r �. . ' - � . . . � ..r, ,l � g� , . �� r' �-63: �Heater&YenbFinal , _ ' -"i 13. Roof-Drains' ,�,;^��,y . _ F;�. � 64. �Plumbing.System;-�Finil � ' - � �� y , 14. Rough Plumbing: �7 �' �� ` -. . . � - �� t� C�� 65.��Electrical-Final • - - � � ' , , � -15. Rough�Electrical-Conduit�� -,- �- � - --� �� '�.66:` Solar'System=Final'� ' ' � - -' ' � ' � • ��u16.`Rough Electric Wiring. . , j _- _ �� -�C� . 67:' Fencing &�,Access Approval`-'�. -, . . � ' � �`17. �Rough Wiring Sign"' � ' '. � � _ � � �68. APPROVED FOR PLASTERING � � x � �18: Rough Electrical-T Bar CeilingY, � - -� � ; 69� POOL/SPA SYSTEMS FINAL � , � - ` � _ r , �. � 19.aRough_ Heating & Air Conditioning ! �', � i � � ' �FIRE DEPT: REQUIREMENT- , � , � �i � ' - . .� � i ., j , 20:'Rough� Factory Fireplace ' � • � ; � APPROVALS`�� Permit # ' � ' ' � ; � I i n.- � � , + �� 1 i i 21:,Ducts,in.Structuie ' . ' ' . �70. Underground Hydro ' � � � � �v � � � � �22. Ducts, Ventilating,,. i '�i��_'`. ,�. , � �71. Product1Piping;�Gas �Oil � � $� � � � ":23: Gas.PiPe�Rough&Test.' :�„ ' �� ,y� ; � j .�. tZ2� UndergroundF�lush�':',--i,- .�_.. - -. .. � �-24:iRoof Framing .'� � �.•%" '��':�� ' . ,, � �73. Undergmd.Sto�ageTank�OGas' �Oil � � ' 25. Roof Sheathing � � 'f; ' -.!� ? : /O'. G '74. O�verhead Hydro ' ` - �� ' � 26.,T-Bar,Ceiling (Structural)'& Monocoat i -. - 75. Dry Chemical � , -�� „ . - ' .;27.'FrameandFlashin �'" � � � .. � � ' • 9 /' ^ t ! , �'' (/ ;, /. � 76. Dry Staridpipe, , :.,,'' i �. . 28. Lathing,&`Siding •i ; � � : � � � � -�}� �77�' FIX�ED'SYSTEM FINAL "' _ �f`�, ' � ' 29.� Insulation�, ` � ^ ��_ � :�� . �j ;) � � I �j�� ".7g, FIRE PREV. FINAL • ' � � • " "�30: Drywall Neiling :•� � �� '; �� . � i ; � 5' 1 i ' � � HEALTH�DEPT. REQUIREMENT� ' � � 31. Plaster.BrownCoat�(,"� ' . ' � 79? F�INALINSPE6TION ��_� ��4 .. ' • ,� / � �� 32. Electrical Power�Me4e�-Final � i' -�t`:'!� �� ' � � �80: FOOD-CERTIF.ICATE ISSUED' t�r�-� �� 1 1" Y ti 33.' Final Electric r ' �� '� ��'�' L� d,�( "5 ,��. � Notes: �' - � � . _ .. . - . .> 34. Final Heating & Air�Conditioning - � , G�+ t . � . � i7 , . � ' " � i � '• � f ' 35. Final Gas Pipe-Test � � . , - , � � � /�. ; �5,�� i Q�' 36. Hood or CanoPY ��•. �; ' ' � ,_ ' . S � p Q; '! �� ,� �9, - � 37. Final.�Facfory�Fi�eplace 1^! ' „�, ';'- ,' � � � � , `� �� f.•n (�' J:` 38. Final Plurritiing' . ` �• t' I. � - , � L�Y�y -(.�(� ;� � � �, ..� . ' , � � , 39. Water Service-Final � ' _ � ! � �-' , . ` �' � h • � ' 40. GasService-Final � • � � . � g ' ' � ' ' � ; 'f-1 a�}� S 41. Solar pom`esticFinal � � �" � - j _� ��_� �� ' ' - -�- SS$ �fc>fr� IS �`d ff ' .S'�' `, �o G•30 �' ' 42. Backflow Preventei ' ' . ;} , , �: • ; • ' ! � � r �� ,�(� �' � .. �J�t�e.l _ 5 A {t2 .1�A� ' y..'. ' ' i - : i �. I - ' " ' 6 43. Backflow Irrigation f r,. . i_, , I„ `�� 44. ,Landscape Irrigation System, � � • _' . � � �� 45. Sound AttenuationF ' ^ � � {- ." ' F � ' " � a f' . �. b:n. `" i c�, � , � , - 46. Handicap Regulati�ons � �, �! � � � � � . � ' �� , • G'a� J' �"a S� ; 47. FINALSTRUCTURE�&�BUI�LDING � s -�-��' ` ' � � � � ' 1 M.t � rt� 48. Special Requirements Completed �, ' � , " _ � �� s � " �,!� � � '� � � 49. Electrie�Release to'Edison ' ' - , -. ,-' � � � �'� �x � f k! o ! 1 50. Gas�Release to Southern California Gas Co � � ' � � � ' ' �� ` '�' � � � wJ - ',51. CERTIF.ICAT,EOFOCCUP.ANGY � ' ' ; • ' Qaq�',��1 .a�tQu��C`c�al�f �� " �p�� ' :.�i,sp' . ' No. • ' `Date� ' " � �'- -- �`:: Sha��,bsi C/t/[ ( �a.'h1!2¢h'�SLV} ��)%�` �-_ ' � �,.f^'-�. .._ . y r r -- - . , ' . � - . � I - Applicant to flll in all s0acas axcept those within heavY bortle� lines anG sign all appropnate tleelarotions. � _ i__ ' � . �� .. _ . _... " ' ' _ _`._ _ , .. . ._'' _ _. _. ' " .._ PERMIT NO.� t� i7RACT NO. LOT NO. � , ....� . ; .' . i ; ` 4 � �?._ ;. _ � "i i -� �' . ' _i'__'� � r � �- �-` i ' � , r r� ! t c UNIT N6 .d '..., . a � . 0 1.0 +• , - CITY OF, COSTA sA CQNSTRUC'iI�ON PERMIT,; ., � � . - / ,�c-�. 4 ^ , i •. '. � � •. ; ', t -� ' � . 1 ;, �. , � ,_� u . � W �j„ , � , # 1:667 � I h"/05/�4•. � _� � �� -1 �.25 'tT� 1�Pro�eit A&dress. �lv 5 `OA �F-/ L i %� I � . - i .. � '�CO�v; � � 1 � � • , � � �. I ,� ' t !, � r ( � �� n -.� t � � �r. �� ,� 'rpl -� .�� •� . . . �i •_ . _1-.Ylr4 .•IA1 ir..i-V.�Mi�� . f Applicant S Mailing Address 7 Z�'%�c+'�'7 CO)ZON��' �� ,A ��4� �'' TYPE OF. CONSTRUCTION ��, NEW ADD� , ALTERATION � REPAIR ' " � ' c � • �� ,c� ❑�CONVERSION ;�.DEMOLISH ❑:OTHER: 4' � � ` `}� AP #:.' t-. _ � ' � _ „�Z��e+= � - "� . ' Owner s Name r. J'�Cf-� wLi A-T � ' % ' • P.hone �v' � ' ' ' a. � . . . 7 ' � I _ - � . . � � ,T � . , ;� _ �� DESCRIPTIONbF WORK/USE OF BLDG.� � , � _ - � - � � � Address � .a .rA✓%'1 � ' � ' i w ! �= = ' f a '� " �' ' .'_ : . ' �' � .^ "' ' r. � - , L ': 'S'' Main Bwldmg > > � � � � Accessbry Building: p� i � p . , � � . .Aich/Eng.� � ' :, ' � : -, TLmense�No. �,: 4 -. � �� 1T+PEOP.PERMIT � caADiN� ❑ FOUNOATION, � STRVCTURAL � , T., Fran4 _ a `. Ir; � - � ' - ,� �'+ � ,`:�I "+ 1 J, ' �,O � Addres5 ' �� I �`� , � � . 1 � _ O TENANT ❑�ECECTRIC1AI, O PLVMBING� �,MECHANICAL- r r.,, ' ' �8-. Rear � s �'�; ' � V n � . . ; � '"` ' � �N ' .,r � � � ' -, � j•. � ' . ' - nl�CSc� ^ OYE � 'D � �' • r'O OTHER �� IM1 - ! i . d,.^-.i '.= f �. ,; � A. - ' � t'�' �1 f � . . �, i _Ta: . ... . C . Ri9ht ' . � � i, i � , - �, - N I Contractor's Name � Phone�3o OS�� c -� a� - m � c = G � � � - � � � .-PROJECT DESCRIPTION � Sa.�FT.; '- ocCuaaNcv ' �- � � � • - � � - -' ' � - � I� �Atldresslmailing) �/'� �Gc�o nAP=60 - ' ".� M�- - . K� , . .. , r ,T {? : y � i 'G � 1; ' �1 ('7� A : I`• � I � 1.CONSTRIICTIONT.VPE 1 ' �"' � . 'i VALUA710N$ �' %' +S" left'- �� 1 , i i.. � . i. - . � 1 Gty License No_� � ' /�.� �1 -` V � -.• I �- „ ZpNE � �' � � � GRADWG CU. VDS. ACRES ' ' � � - R` • �� 1 LICENSED�CONTRACTOR DECL'ARATION � , . �. � i. ' � ' ' ! � ! . , Ping.'Ref.�# � ,� , � t Parkmg Req./Provided � m. i, t � C; .i 'E' � � I M1ereby zffirm t�al I;am'Iicensetl.untl¢r'provislons of Charter.9 (comm¢ncing Remarks: '� � ��i.� --- J � �' ' � � ! - " � ' �n i :� , { •j i I' . + Planning Notes: . � . j � i' : . � � , 4-. � „`-, r� ,M I iwith secLon 7000)�of' Division �3fof the Businesi antllProfess�ons Cotle antl ' � � ' { � my, license Is in full force antl etfect. _i � ' � ' I. � � f ` � � � , '. � ' � ' _ � � j ' � � . ' :'� 1 � . 'T � Cic'ense clgss d .." i 1...: . �i - icense�rvo l %OEj O3 ' �{ �" _ 'c i - � � _ ., E { . � � i . , { . I � i , ' � •I � �: _ I w � - � ; :'+� . ..� PLUMBING � - � � �S � �Date Ll l 5 ,F�4 Si9nature , . .' �- � �. ._ S ...t ' � -i . f� . �' G-i � .] FEES; � F : � � ) �f;' i n � , r � i:• 1 - .� . ��W00.KER5'COMPENSATIONDECLAR TI '� ' � :' � . i�, + ' � � � � � � . � (- i - ' - - • � � • Bar'Sink' 'I �} Showen f .;�1 hereby affirm thaL I have a certificate of coris self-insure or,a certificate �� . 1 I� . ` . - . j�EIECTRICAL � j,` -Y - IPEES -f_ . of ,Workers'_Compensation..lnsuran al.certifietl 'copy..thereot_(Section ' ' .. - . . _ � . __� � _ ,n„ .� � r . � � . � ' " Backflow�PreJente�-- ' , - - �i Service Smk'%� ' �- `` � -'- � � ' ' qutomatic Washei � .�� 'Trensformer ❑ 15-50 KW � �� . � 3800. Lab. C.) ,( �� .. :. �� f i .F .. ,, .-. } . I �, j Poucy No. ' � Z!� ^'�� compariv � sTb FE ' �(7 N:J r ; gackflow Irrigatiori � iT Sewer Ca . � ' ' ' ' � ' . + ❑ 50 + KW; 4 A ' ' ' i�Certlfietl copy is hereby fumishetl. � r � f 4 : - , - � :P � ' � � .�'. Construction�Pole Sub. , � �L f , ,,. � � i Cert'fie co y is filetl with�.the clty Builtlin Di tOn: � ;� '� .i �� Baffitu65 •� � I' � Sewer Connection j (. � j'. • j�� t, ; Cook�ng Unit .� i i. {p Meter ❑up to �100 amps �- '� iDate- i 1 ..., APPlicant• • . J' � ' - � - . � . . . e i . � . '! . tt � E%EMPTION FNOM WORKER$' COMPENS ION CLARA , N� � Clanfiers � i '_; " I" __ • Soler Collectors �' ' � _ � - � _ Dishwaiher ' .� � .� 4_ . Meter ❑over 100 arilp5 i � �, I �j � ' 'j'(Thissection neetl no£be;completetl if.the-pe�- it is f one d,($100)'or�. � - � - , , . '. ' "" " � lessl'. �� t ' . . . � . . �' ' � Dahwasher �i � . Solar PiPin9.• , ; � ' ' � , f ' ' Dryers ❑Gas ;�Electric' � , ( ; Sub Panel' r � � I certity that in tne perto�mance of Ih¢�work (Or which thl5�pe�m t i5 i55uetl, I � ] � � . � - . . . ' ' ' � �^ ! �• . I !� � j 'shall=notiemploy any p¢r5on imany manne� so as to'become subject to the -� �, Drinking Fountains 4� • 6-Solar Tank. j ' � Fd❑ ,� 1 lWo�ke�s' Compenzafian t_aws�of Califo�nia. � � : � ; � � � � -' �. � - , _', �� ' .i � + '�- Motors O01.HP.O1Yh-8 / '. . , Date} _ � � + � Si9nature � � ' � ^�� '� � �� ! � j• Floor Droins � , j j !.`Swimming�Pool�w/Spa� ^ � � - � ( . , FAU i I 1 I r ❑ . F. � IncSoa 915HP�1�-1 + '.'NOTICEi If, att¢r making this tleclaration, you shoultl become subject to the ' ' ' ' � , . � ` - - �� ' ' - t `. � ' r ' o. .,: � �Workers:�Compensation:-provi51on5..of thelLabor.,Cotle,.you-must�forthwith lr _.,� FI00lSi0k5r�� -'-�-- �- -��--;1 f Unnal'; � - '�'*"l'- - '- � "'"�-,'� ""— '"'-'M - -6 � -�--,- -- l � , 1 . �' '� Fixtllf¢5 � � �T � - iCfoWdv¢ 5 ' � comply with�such, pro'visions.or this permit shall;be tleemed revoketl. .� ' � ' - � � � - � � - 4 - •1 . 1 1' . �� T,��1 , ; ' CONSTRUCTION., LENDING /\GENCV�' p r; r` ��T j. �:V '- • ;� � Gas Service` ' . �OutIEtS � -- GI I Wdt¢�-CIOSCt � Cv � i G� � ''] U Device Bozes 1 ' � �� °.Pole Li ht �� ' � r • � , .�' I hereby affirm tha[�there is a constiuctlon lentling'agency fo� the Oeifo�mance• • ' � - � � ^ � � . . . � , , 9 i . , , � ,of the workQ for�.which��thiS,..Permit is issaetl,(Section'�309�,_Crv.�CJ� � p. , Interceptors 1 �^; �'� � ..: 1 Water.Heate�� :�., rt � ' �� f i' � -� � ' - ' ' ' ' Lentler,'s�Name - -- � � � � � - � - - ^.+ - .' � Outlets � i ( I � Range � � � . � � I � Lentler.'s Atldress � '� � ' , �� ` � T' � ' '�' � ' � - Kitchen Sink' U � ., � � ;;, , Water Service� �,; i � � { Switches � � � { �Si n i � � � ' OWNER�BUILDER OECLARATIOIV� ' � . :. r ' ,- "-". � . � � � - � � ' � � • ' ' " � " � 9 ' � � � ! 1 hereby'affirm tha41 am exempt�irom the Contractor'S-License Law foi the', _�L Lavatones � r ��- - - � n� Auto�Weshz .� 1 �..; '} ' '� Garbage Di5po5aL (' � . �; Standing Sections i � (� - }following�reason'(SectionJ031:5BusinessantlProfeSsional-CODe:Anycity;or ; ' �' ' - ' - ' ' ' ^ ' � � • � • � . . . : : � � ' � county which�requires a permirtolconstruct alter, improva; Cemolish mirepatr ; � � py Trep . •S � :n r ., � 'L'auntlry Trays,: ' � ti �� '- ' GeneratorlO65 KW.O5-15 KW " � � � ' � any st�ucture; pno��to its Issuance, al5o reqWres the�applicant tor such pe�miC • � � � � ' ""� � �- � . T�25h COmp2cto� � � � } � • ! • ( t0 (ile a Slgnetl statement tnat he/she is licensetl pur5uant [o the�p�ov�sions of( � „ � ' "' {- � ' � ' 1 .? � � ' ^ - � � - . . � ' � Roof Drains . � ' ,� �- � ; .� the Contracfor's!License!Law�(ChaDter.9'(commencin9,witb Sectiom]000) of ' � � , . -� :� � .- . - r+ } .� . . 7' � • ; � -i Division�3�;oflthe Business antl�Professions'Cotle) m�Nat,he/she!isfexempt i _ . � „� - � ' s � - - - ' � ' � �' ` , tM1erefrom antl�the;basis'•for tbe`allegetl�exemption7'Any�violation^ot Section - t �- " � Y '� �� I ;-a 'C� � � j � i+ ' � ' I-;- - $ 1 � - � i 7031.5 by-..any�applican[ for,.a permib`isubjects�the,applicant'to� a, civil f � � y `� �" t ,• i � +:� 1 ' i '. 1 :�t, - � ': � � � � ' � I � - ' � � . � �enalty of noLmore than fivejhuntlretl tlollars ($500): {.(y i � - i '- ,�,... � i, " !, -' � .. - � � � ' _ � � , ' i � � � ' • '- F � � �' - t � - LJ I, as'owner.of:the `ProOerty or my employees.with�wages,5s tlien. sole � F7einspection Fee ��'•' $15 1; :�� Issue Fee ,,� $� 3" � � . . r ' - : . I ` - . � ` � compensation; will'tlo the work, antl"the sVucture is not intendetl or.offeretl � ' '' �' -- � Reinspection Pee � �$15 - Issue�Pee , � -� �� }� �$ 3 j � , � tor sale �(Section 7044; Business;antllProfessional'Cotle: �The;Contractor's' � 4'. ti�!„_ � � � � �,� MECHANICAL� �� ; FEES� �� ' License Law OoeS not apply to an�owne� ot a property who builtl5 or improves ' - • � 1 � �,� . 'thereon,antl who tloessuchlwork himselt/herself 6r tnrough his or her own ' . t ' ' 1 t�' �' - - +�, r yy; �. � DEVELOPMENT SERVICES REQUIREMENTS: � �' 1 em0�oyees, provitletl [bat such improvements arei�o� intenCetl or otferetl for �� Boiler_ I �� Hood or i Type I�❑ , r. i� �� - c � i � ! '! tj. � �- ' � ' wle. If,'however, tne bulltlin9 or Improvement is soltl within oneiyear ot com- ; . , �.._ � Canopy i Type II �❑ T {"; ' IZoning Approved By � , ' � � jl Date - - ' � � � pletion, the owner,will have the burtlen Of proving'he/sh¢ tlitl not builtl or Im-: DuCt�- UndecGrOund { ' '�� ' I ' Buildin 'A roved i ��' 4 ., � :� j � � 3 �.�� j ' � � rove tor the purpose of;sale): , � i �' �; {,,,- t ' i ' • 7 � , � , ' ' � ' ` � � - � "` � � 9 PP BY � �� 'Date } '� I, as owner, of the oroperty, am exclusively contractmg wim�licensetl con-' Y j Ducf - Structural ��<'� ; Refrigeration System i �+�'� �. i Applicatian Issued By -r ,/ �- � � Dat �� :S� '.f � t�actorsto construct the!project (Section ]044; BuSiness antliP�ofessions Cotla: 1 � ' ' � ' �� ` � i . 3 The Contractor's L'icense Law tloes not apply to an owner�of property who __ t Duct__Ventilating, _!�_�. � _DO 700,000 BTU 0100 000$TU � � .�, 4, - SUMMARV OF FEES � ' ��buiitls'o�. improves�thereon; antl'who contraCts'for such�projects'wlth'a'con � - � •' ' +- � ' -- ' � I � Y ' I ,{ . i . ' " � � �'tractor(s license pursuant�to;tne contracior's License' Law). I am aware tnat � � Exhaust�System � Multiple ❑ �System Repair/Alte�atiori � r" !'� ; � i' BUILDING PERMIT �$ � ' +� SMIP � i$' � � � praot o�`thei� Wo�ket'S Compensatiomin5uranW Shoultl be prOvitl¢tl to me. . - 1 � C I , � • - + � ' : : ! 4- PL'AN CHECK �� $ � r ' ' � PERMIT f i.' t ' ' ' I •L7 I%am exempt under Section ` � � B!.& P: C. for this'reason r � Firepl/Fact: BI[. IC80 # ' ,' Fire�Dam ers �� ' ' ' � � � r , � 'i ' ' ; -• , •. : ' 7 ' `. t � , ; ' : . � } . . � P � ' ! ' I PCUM8ING i I ' - � ISSUANCE,.. '$,. ' j, �Date . ' j owner � F � ��' '" ' �� ' + •.� y HeatingSyste.m&Ducting � j.Registers . �- ,j, � � � � ' � �� ENERGV�P.C. �$ 't� ''� � � i . , . . . � , �� .• � . ; � '! PCAN CHECK 25% {$ '- � , t _.., �I hereby�ce�tlfy-that-I�have�,reatl(this�appl¢atwn'antl'state'thaYth¢'above""'i "-"�' �O�lOO,000BTU'�IOO;OOOBT ' -" '-� -' ` "t�-' "' � -� �� '� �" � ' %information is c rrect. I agree to comply.with all�aty antl wunty ortlmances .� � ' � : �' • • �� ECECTRICAL � �$ l0'SO ' j- GRADING' I$ ' � ' � antl state, laws r latin9 t bulltlmg construcUon, antl hereby authorize repre- � . � } ' f ' + ' ' ' � PLAN CHECK 50% $, �� S � MICROFI6M ,$ �� - � � '-5¢ntabves of th s c� �to' eofer upOn the' above-mentionetl property fo� -� ; j 1 � � T' ; n } � ,. � i ( � 1 �� j � j r �inspection purpo . �. � . ' i � � f • ' � � MECHA�NICAL �$ - ' TOTA�L FEE' ,$ / .aS ' Si9nature : I � 3 oatelL��./��1 i ''' . � ' ' . ', � � � � , � � � � � i � ; � . , �� f � Reinspection Fee $15 j ' Issue Fee $� 3� � + PL'AN CHECK 25%� �$ t � i � � Drivers' L'Icense r 55 ( � /� CMF 0865-46, rev. 30/84 '- Whit¢ - Builtling; Canary - Applitdnt; Pink - Accounting; Goltlenrotl - Ass¢SSor � , . ' �� --; .- � - , -- R -- _ - _ , - - - - - CONSTRUCTION AND,PL'ANNING� =- � � -• � � : � � � ` � � �� ?OUC & SPA � ';' , ' � - �_ , �- Date `� �Inspector, . ' - �' - „- r.:Date " ,Inspectbr r ' . APPROVALS ; Permit #' � ' ' _ �� APPROVALS� � Permit # ' � " � - '1.�.Temporary ElectncalyService or Pole i ��' �."52: Pool & Equipment Location `•I � � � .., : .` Y �. ,1 ' . - - . _ � . - � 2. �So,il Pipe-Undrgmd. ` - - ,. � �� ` • � � - � '53. �Steel Reinforcement - � , t : -• .�3?'ElectricalConduit�Utility-Undrgrnd:�� • �P :54;.Forms � ��=� " � - ' . �,;.._ .� � � � `4: Electrical Conduit�Undrgrnd.� �'�� - - � . ° � ��`.55. Electrica,l Bonding" � � - - � . �� ' , � 5. Steel Reinforcement'• � n + ' �- ' a � '- j� ~56: �Rough Plumbing & .Pressure Test Ay � �� o � , � � �'��, ' I'. ' � a.. : � .. r � • �6.:Electrical UFER Grnd �` ' - j � ; - � � �,' � � �57� �APPROVAL TO.COVER-GUNITE ' . � ' �' :� �'7.`,Footings , � ,�� .� j. _ �y �� °� - _ � '� - . ;58� Electrical Conduit-Undrgmd• �� =' : � ' �' 8. Foundation: � ' �^ � ` , �• �' j'�`-' . � �59�'Gas Pipe, �� Undrgrnd., Test� `.;:' ��_' ' �� ^ ' ' ✓�f � � - e � - - 9.'Water Pipe-Undrgrnd�:� � � i � � = � � . � ' �60`.,,Backwash-Lines,-P-Trap, O-.Undrgrnd.` � � i ,�� 10. Structural Floor System ^ � � It� �` � � ;, 6L.�'APPROVAL TO�,DECK • - - �s ' - ,. ' j;�:"_'� - 11. Property Sewer�Line_& HauseConnection ��, �d ;' � � ' � �' ' - �- � ,� � , _ a. � , �s62�:.Backwash`& Receptor-Final �12. Sewer'�Cap � y, '..I! . . . � '-�' : ' � = '' „ . - . 63: Heater &:Vent, FinaP • . - - 7". , 13. Roof�Oreins ti`� - ,� � � i �.64.; Plumbing System',Finaf ' � ' tiq'� . ��-.� -,' 14. Rough Plumbing .'. � � � ` _ ' � �65. �Electrical-Fihal' � � - - � " . 15.��Rou h Electrical�Contluit�.`� '- "- - j -� '' .` `_. _.�_._ . . _ _ . . . ' '- - '-. -- ' - 9 . , i 66J So'lar System-Final � j' � .16.�Rough.Electric Wir�ing� �� % ��_�a -� i,7-' � 67.� Fe�ncing &�Access Approval- �j � � �17. Rough Wiring Sign,' " � ' . � �-, ^ " �, , . �68.' APP.ROVED FOR-PLASTERING � , � y ' � c, 18.'-Rough^Elecfrical-.T,Bar Ceiling ', !� ' � � " �69. POOUSPA SYSTEMS FINAL.'. 2 � ' `�' � � � _ 19. Rough Heating &�Air Conditioning .� � - ' ' ' i ' FIRE DEPT. REQUIREMENT � � �' t , . ' � � - 20. Rough Factory Fireplace � � :1 �: ; � i .� � � AP.PROVALS , Permit # � �� ' . � u 21�. �Ducts,'in Stiucture� � . !�. ;,, ,� i ' .' :.. ' f �70.� Underground Hydro � ' , ' .22.:Ducts,Ventilating,, � ,r � ; � i' � ' . �7L(ProductPipi�ngOGas� ❑Oil � � ' � . '-23. Gas Pipe-Rough & Test _ ' - .�" �� 7p_� Unde�ground Flush - - � ; � 24. .Roof Framing � ' �.; . � � ; ; r • . ti ; '� '' , 73.� Undergrn�d. Storage Tank O Ges. ��Oil : '_ � ' . � ,25. Roof,Sheathing � � , , .4�� , � � , � , ' _ , ' 74.' Overhead Hydro •��• � � . . . , . ; _ - .. . 26. T-Bar Ceiling (Structural) & Monocoat � - �� - � � � � , 75. Dr.y;Chemical ' . . � � , ' � 27. Frame and �Flashing � • ' � '� � � �= ' � � �' •76., Dry Standpipe . . � ' �� ' 28. L"athing & Siding` p �= : � ' j ; ; � � � r77.� FIXED SYSTEM FINAL ' -` � c �- ^ 29.. Insulation � � =� ` ' ' +i ` � � � ' JS. FIRE PREV.•FINAL � ! ' ' ' 30.'Dr,ywall Nailirig `� ' � � � � ' � i �HEALTH DEPT. REQUIREMENT i ' •31. Plaster Brown Coat ; � � ' 4 �' j ' � �79. FINAL INSFECTION . � � � 32. Electrical Power Meter;Final ;- �� ; � 80.� FOOD CERTIFICATE ISSUED ' � 33.,Final Electric _ � i `t� � � Notes:' ! � i £ � ' . ' ' ' ' " ' .i i' _' . ". __ ' ' '34. Final Heating�&�Air'Conditioningi ' � ' ' � ' � � � ' "� . � f. - .3 _i ' < . ; i � , 1 " • ' _ . . ' _ i _ f`_ _ - . 35. Final Gas,Pipe Test � � r .� � ! I ' �+ � i . � , � ' - � - � ��i 36. -Hood or Canopy. � { - ' � ' - ' � � � ' ` �� i , � 4 '. -• " � . 37'. Final Pactory Fi'replace� 'E �i ,t.`: ' ��. i ' , i � � � � -` �€ ' ... ,. � _ r �t' - i , � � - � - . .. _ 38. Final Plumbing � ' ; � � �� _ , . ' , " . '- 39. Water Service-Final � ` � � ;, ; '� � , ' � , i, � � ' ',t � , -- . ! � f 1 � , � .� . 40. Gas Seivice-Final � f I. I ,. . ` � � � ; r . , � � � _� " {. �a' `� ' •� , . . � � I '41. Solar pomestio �inal � . . ' ,� `P • .. Jr.. .l.:. rc._.,. _.��- . 1-! .� �. . ..,, . �- � !' ": . � - 42.'Backflow�Pre'venter,� , , ' a ,!._j �'�i,_..__1-; -�� . � -. - - • . , i. � , _i "l , i 43. Backflow�lrrigation� � ,� � , � � ! � �� `� � � �:{ , �� _ � � . F "� � � . I/ . ' � ' �44. ,Landscape Irrigation System � ' � - ,_ !" -' - . `` � .' � ' � ' ' • � �'^ _ � 45. Sound� Attenuatlon � `^' l �I � � f � �•,. � � F ' , ' � ' i� ' . - _ • � , � '" t" ; _' ;� . ; -j, ; _= _ 46. Handicap�Regulations { . . :, - 1'c> � , � � i ; ; � � � - I � ` - - 47.FINALSTRUC�URE&.BUICDING �-';� `rj' 1 ^ �-I (. .� � � � � � � ' r„riC�' ' ` � 1.+= 1 ci �i 48. Special Requirert�ents Completed! �� t, � � � � � i ;.:� � : � � ; � � .. � ' �- . _ ,. �. ` , . ,y ' � K`_'`.-`-_ ._..'� �__ � .._�._.�-.--� -.t--, -, .� . 49. Electric Release to Edison � � 4 i i `��' ��; � { i � , � � ., ,, , , , 50�. Gas Release to Southern Celifornia Gas Co � � ! � i � } � � ' � � } �� '' ' � � � ' ' i �- - r I � r� �. �' ,ri 51.-CERTIFICATE'OF;OrcGUPANGY i .. . �_•;-, �--�..-,..-}__, _�_.�_.'. _;� :.,, . ' ' ' ., .. No. .-� '- .y Date._ ._._�. .'- -•.�-+ -_._x.__• _.y.. .-" - - ' ,c �_ . - Aoplicant to fill in all soaces except thoze within heary bortler lines antl.sign all appraprlate tleclarations. � ' PE IT NO. ' TRACT NO. LOT NO. 2SI3� I I.I I i�B!1 ,' �� I-%�Ql� �T�� - CI.T-1:OF COSTA MESA ' CONSTRUCTION PERMIT � ._ + . . i UNIT NG. ' . _ .- � ' ProjectAddress 96 S-,Aah I�a, :�]U� � ' � 1 . �.. �� ' � ��'� . / � � .. . . ' � � T " r . . • " Applicant'S Maili❑g Address y/�.� �.. � � /�Q� I AUE - w � �' TYPE OF CONSTTRUCTION � NEW- ADD 'ALTERATION-; .REPA�R, ' � � � � � � - - � 9/ : S` r,-'. ,,,� � CONVERSION' ❑ DEMOLISH ❑ OTH R' � � q,p: # J � � 2,� � t ' Zone, - Owner'sName AUL'2.L.- �-ii'Mldn�" Phonev�LS� DESCRIPTIONOFWOftK/USEOFBLDG.�r� ��5 G��'i�'i � _ ' � ` _ _ Address' � 9�° � � Ie N �i Uf. .. (�S�a /%ICSt' � :��'/24tG � � .,S ']�-y�2 . 1 � " �q'TkGfE ' . ' : -E Main ewlding' - " Accessory euildin9..' 1 . . . Z . Arch/Eng. � LicenseNo.' � TYPEOFPERMIT � Gan�iNG 'FOuivDATiOnI .STRUCTVaaL��y T. Front: " ?' ' _ ' ' - _ "' " O ,� . Add�255� Y � ' ❑ TENANT ;O ELECTRICAL �❑ PLUMBING ❑ MECHANICAL ' A Redf ., . , , . � „ N � Contractor'S Name ' ' � Phone ' � . 0 �OTHER � ' � f. ' � � . - . . . _ , � ' ' � . � � PROJECT DESCRIPTION SQ. FT.' ' -' OCCUPANCV' - '- K Right ! •� ' � 3 +r G ; Atldresslmailin9) �� ' ' - . - � �7 . � � p • •CONSTRUCTIONTVPE � .VALUATION$ IC.O ' S Left �% ; � ' .�` r . � � � . CityLicen5eN0_ ' ZONE - GRAOINGCU.VDS: ,ACRES ^ R� , � , . . P,Ing. Ref. # ' � . � Parking,Req:/Provided; . � E� � LICENSEO CONT1iACTOR DECLARATI N ' . '= � � � Q. � I�hereby, alfirm that 1' am licensetl antle� provisions o(,Charte� 9(commenang � Remaiks: ' � � ' � , � � G� Planning',Notes: ' ) ' � �' ' __ � �{ M � with section �000) of oivision . ; t�e Business antl Professions Coae, zntl �, ' - ' _ _ � , , _ -" � my license: is in full force antl ef ct. � . ' ' � j . ; , � , .� i - , ' � i . , • ' � � S f � Cicen4e Class � � License No.� ( ' � ' � � - . . � � ' - Date � � - �Signature,� � - � _� ' i • ,� � �PLUMBING 1 � FEES � � � � ' � . � � WORKERS' COMPENSATION DECLARATION � , I � ! � gai Sink � � Showeri ` ' i ' � � � - � - - � � � � � I herebyaifirm that 1 have a certiticate of consent lo self-iniure or a certificate I 7 ' ' ELECTRICAL � j _1 �-- � FEES - �; of Workers' Compensation Insurance,� or a cerHfietl:' coOY tM1ereo� (Section � ^ gackflow P�eventer � Service S � ' � - , � ' • . , 3800. Lab. CJ'_.. . . .. � _ :.. . . _ . _._I_ . ' . . . - .. _ _ � _ ___ i . . ' mk. ' s � Automatic Washer ; ^�-' � Transformer-�-15 50-KW "'' ' � Policy No. � � - Compa�ny " � Backflow Irrigation Sewer Ca � ''� � ' t '� ❑ 50+.KW � � : P . ConstructionPoleSub. : � i { e�CerLfietl copy i5 hereby furnishetl. . . � ' � - : , ' ' ' � - ' ' ! Certifietl copy is filetl with the city euiltling Division. i Bathtubs � i Sewer Connec[ion , 4 Cooking Unit � i � Meter ❑up to 100�amp5 I � j Date � ' Applicant � ' � � ' � � � ' 1 Clatifiers � � • � � � � , ' ' � EXEMPTION FHOM WORKERS'�COMPENSATION DECLARATION � , , � � S012f COII¢Ct0l5 �� . . j . DISI1Wd5IlE� ; � � � �Meter ❑�OVE� 100dri1p5� ' . (Thi55ection neetl not.be rompletetl it the permit is for one huntl�etl.($100)�or� . - � - . ' " ' � ' � � less). � + , � � ' ' � ' � Dishwasher � i - 'Solar Pipin9 �Dr ers ❑Gas' �Electric : � I ceriifyithat'in the pertormance of the work (orJwhich this perm�t i5 is5uetl, I - � �. j �Sub Pd0¢I. � � �� ; i ; � 'shall_not employ any person in any manner m�a� become subject to the Drinking,Fountains Solar Tank j �' ; Fanf ' � ��Motors OO-1 HP �1'/x�-.8 f � Workers', ompens tion� Caws of Califq5� ia � � I � ' � � , ' - 1 � i } . Date �-5ignatdre 'v ��(,Ei�'� �-��J � ' ' � Floor Drains' � Swimming Pool �wYSpa � � F.A;U. ' � � � � ', i ! ' 'NOTICE: If, after aking this tleclaration, you shoultl become subjett to the � , ' ' ' ` � ` , � . Solar�09-15 HP 0�16-15+ ! � !' Inc Wofkels' ComPenSdtion plovisions of t11e Ldbor Cotle, y0u muzt fOrthwi[h FIOOf SinkS .� � � � Ullndl .� , ' _ - �comPlY with; such - ' ' -" - - . i _ -. Eixtu�25 � . . - - �Mic�Owav2-' V. ; . --. .� " � provisions � or thi5 -permit � shall be tleemetl �revoketl: ' � � CONSTRUCTION LENOING. AGENCV , �i_ . ,-. � .. n .. . .;, ' • - - . ! GysS¢rviCe :Outlet5� '�- � � '�Wat¢! CIOSet: � �'� � � �� ! ' � { � � � 1 hereby atfirm tliat there is a�construction lentlmg agency for the periormance' � �� - ' . Device Boxes i Pole, Light ��) ` � � of the 'wo�k for which �this permil I5 �issuetl (Section 3097 Crv. G.) Interceptors' ' _ _ Water Heater, ` � ; ,�� '" OUtlEti ' � � ' � ' ' �entler's Name'. - ' Range . i � Lenaer'siHaCress - � � � - �- � = ' ' �' � ' � ` Kitchen Sink c _ � ' Watei Service . � - , . ' ' ' � . � � ! OWNER BUIIDER UECLARATION � i �� - ' i r - „ Switches' . : gi9� � I hereby affirm;that I am exempt ffom the Contlactor;5 License Law tor the Lav2t0tl¢5 _ �_ �, � ' (�idfbd 2 DIS OSdI ' following:reason�(SecLon ]03LS;BuSiness antl Professional Cotle: Any city or - • ' ' 'AutO-,Wash ' ' , g p ! ; Standing Sections . � � , � county whicti re uires a pe�mlCto const�uct, alter, im /ove, tlemoli5h or'�epalr _ " � ] ' ' � � � any structure, pr9ior to itscissuance,`also requires,the applicant for such'permit • P Trap .Laundry Trays �� T�<�' Generator 065 KW �5-15 KW . : ' !Trash Compactor � a r .to file a.signetl statement�that'he/she Is licensedlpursuant to the provisions ot ' ' � � , .. ! ' r� , � Y - , , � r ,the Contractor's License Law (Chapter 9(commencing with Section 7000) ot' Roof.DrainS� �. - . _ Division; 3 of the�BuSinesS antl Professions Cotle)-�o�'that he/she i5 exempt :: c - � •.. . . tM1ere(rom and the basis for.the allegetl exemption. Any violation�ot Section - � . � � . = , , � � . . , ' 703L'S by any ap0licant tor`a� permit subjects the applitant'to a�civil - � eenalty bf not more than five huntlretl tlollars ($500). , � � ; ' ' . (, � - . i � x � � ; -� � ; ' ; � � or�my'emplo ees with wagei as their sole "Reinspection.Fee ��' $15 '- � Issue Fee ' 4' $.3 �" �" �.� I,� as� owne� of [he� p�operty � Y . . compensa[ion, will tlo the work, antl the structure is no[ �ntenGetl o� offeretl � � - ' . 'for sale� (Section �044, Business antl Professional Cotle:; The Contractor's' _. . '�MECHANICAL � Reinspection Fee $15 'Issue Fee� � _ � �$ 3 ; � . • . FEES. � . �� License Law tloes not appty to an owner of a properiy, who�Duiltlz or improves ' `� - � ' ` , , � ihereon, and,who'tloes such work�himselt/herseli.or�through his or��her own , ' � ,� .. . DEVELOPMENT SERVICES REQUIREM NTS' . ;� employees, provitletl that such improvements are not,intentletl or offeretl for-� �� Boile�, , ��, �l �, �" � Hood or+ Type I: �. ; ' t. . � } j sale. If, however, [M1e builtling or improvement Is soltl within one year of com- , � Canopy : Type II ❑� '+� � ,- Zoning Approved By � Date pletion, the owner will'have the burtlen of proving fie/shc tlitl not builtl onim- � Duct - Und2��Ground � � � ' j a� 8uilding Approvad By � Date�-�1� i prove for the purpose of sale). , :- � : ' � . � , . y = . , . . � ' ,� I, zs owner of the prooerty, am.extlusively contraciin9 with licensetl con- � � Duct-Structurel �� Refrigeration System ; �.,., � , Application laued By � � Dat L � ; tractorsto constructthe project (Section�7044, Business antl Professions Cotle: - � � I _ The Contractor's Liwnse Law tloes not apply to an owner ot property who � � Duct - Ven[ilating �! � . ❑0-700,000 BTU ❑100,000 BTU ( • �. , ' j SUMMA�V OF FEES '� '- � ' builtls or improves tM1ereon, antl who contracts fo�_such p�ojects wlth,a con- '� � - - � � . . . • • i tractor(s licenie pursuant to tnelContractor's License Law). I am aware that � j Exhaust Sys[em �•Mul[iple �i System Repair/Alteration . , gUILDING PERMIT i$ , �b �� SMIP� , j$ ' '�a i� proof o� Iheir Wo�ker'S Compeisa_ tjop insurance shoultl �e provitletl to me.' - � � • pF�r•p r ' � • � � � � PLAN CHECK $ � � PERMIT � ❑'I am exempt untler 5ection B. & P. C. for this reason , Firepl/FacL BIt. ICBO # Fire Dampers � w � . � � i � � � • - � � PLUMBING • �$ - � �ISSUANCE f$ , � 1 ' DatJ � � � owner' • � � � ' Heating�Sysiem & Ducting � � Registers , � • ' p�qN CHECK 25% � $ � ENERGV P.C. ; $ - I here y certi(y that I� have reatl thi5 applica[iOn and sta[e that the above _ ❑6100,000 BTU 0100,OOOBT� � ,y_ _• . � ' ' � - � ' GFADING '$ � � ELECTRICAL � intormation'is'correct. I agree to comply wrth all city antl munty ortlinances - � � ' � ' �$ � � . antl;state laws relatin9 to builtling construction,iantl hereby aumorize repre- � , , , + . . . i� pLAN CHECK 50%: $ '' � N��CROFILM f$ � � sentatives ot Ihis city, to enter upOn the above-mentlonetl p� perty for : � ' ' -/ inspection pur�poses. . p � � ' ' ' TOTAL FEE -, $ � 1 � I Signature4 L4 P� i � X7��-11` � Date � � � ' ' , � MECHANICAL ' $ ' ��Drivers' License or�55 �f � � Reinspection Fee $15 . IsSue Fee $ 3 PLAN CHECK 25%' $ y� � ' . � ' � • , .. . . . _ . _ _ .. _ .,.. __ . ... .. ..., ,._ �.. .. . 'e� ' ' ---�'�""-r•`-�:^4...qccoun[inq; Goltlenrotl - Assessor ' � � ' � � "� � � � ��ti _. �.. . cyr.. .� } r n v« .. ... ♦.e- ... .. . , t hr r` Y.la CC' e . ' M �.+. vaw .e r ..PW^? .. .. , • �'ar 1 1 � r+ CONSTRUCTION AND PLANNING - - � c� '.' x. : �> �' - - � NOOL &-SPA -� � � _ ,� � • i � �} APPROVAL`S - Permit-�r; � - Date ^;. �Ins�iector - ' �'' � ' � � � � � � Date- �. �Insper.ror - -> :APPROVALS - "Permrt # - � V� 1� Tempo�ry.'Electrical $ervice.or Pole� �' . - ' 2 ^. �52^ Pool°& Equipment Location °';� . • ��I � � 2. -Soi�Pirp�-Undrgrndi . � : - _ = " r.; _ .� ��. _ '53., Steel Reinforcement � . - � • ° � . � , �3: Elect'ricaiConduitUtility-Undrgrnd. . _ � '' -�54: Forms.'.- ' �`'� ` ^� ' < �� , ` � r, � ��, �� 4� Eleci ical Conduii-Undrgi nd; - _ _ _ ' - � �,55. ElectricaG6onding � � � ,'. � � ��... _ �y � • 5�SLeeI,R'einfarcement ` : ' �' •`--�"- ' 56.- Rough P.lumbing=&�Pressure Test � � . - � ��; _y _ j `�• 6.'. Electrical UFER Grnd. � - -- �'' �� _ "' 57..APP.ROVALTO�COVER�-GUNITE�'�� _ �'� �i �,,.i�. , o � _ ..,' �" - - � � n '3 2 i�. ` „7,�Foo�ings � , , , �- -_ i �- = , � _ � .'58. ElectricaGConduif-Undrgmd.�'; ` ' , .� _ {v� � � : .0 c' 8YF,oundation . � ' ' • � �,�� . 59r Gas Pipe ❑'Undrgrnd , Test . � � : , '�v � c . VA �.Yl(t3 I G - _ • , �fj '�9�Watei�ipe-Undrgmd. -- ` ' � � �„�",. , 60 Backwash Lines, P-Trap,'C7 Undigrnd. , � , _ . - .'�' ` , - � . . � 10: Structural �Floor System - .. � � =� ft ; � . 67. APPROVAL'TO'DECK �,� . � �!, ' �i l.'Proper[y Sewer Line & House Connection "'�� _ : �. 62. BackwasFi & Recepto�=Final : � � - ` � - � T - � b92. �Sewel ,2p � ' i � ' � ' � 63� Heater�& Vent-Final % , . �� a 13. lRoof�Drains � � � ' " � - 64. Plumbing System - Final . , '-t � "'- � . y..r � . 14.�Rough�lumbing � - - ' `� �� 65.-Electrical-Fihal�' � .. -' ' � ' - j � ° = 15. Rough�Electrical-Conduit - -- ' � ��' -" 66:-Solar System-Final- � � " --"-T ' � " � µ � - ` = 16.` Rough, Electric Wi�ing , � �, � , - -� � - _ � ' � '�� 67. :Fencing.&-Access App oval � � J ` ��" - ` _ - .. 17 `Rough Wiring Sign � _ . :� ,� , � ; - ', ' 68. APPROVED FOR PLASTERING - � ' '1�8� RougFi Electrical-T.Bar Ceiling � ' � _ � ; . V , 69. ~POOL/SPA SYSTEMS FINAL� � � - � " � 19:, Rough Heating &�Air,Conditioning . . - i FIRE'DEPT. REQUIREMENT . , � 20. Rough Factory Fireplace � ` � ' � APPROVALS. ' Permit# � � " � �- 2L�Ducts;.in Structure. . � � � - `; 70. Underground Nydro - �. � z t� ' � � i . '- 22.� Ducts, Ventilating . ' ' , , 71. Product.Piping � Gas ❑ Oil � � " '� 23 �� Gas-Pipe-Rough & Test �� , � � � i 72• Underground Flush � ' � �~ � �� 24. Roof Framing � � � �t , � _ ' 73.yUndergrnd.StorageTank OGas ❑Oil 25.� Roof Sheathing ' . �� - � _ � i 74�, '�Overheail Hydro `�' a� ` � , � ' � _.26. T-BarCeiling�(Structural)��&Monocoat � , � � 75.�DryChemical . -� � '-27 ��F,rame�and Flashing ' � � ' i � !{ � � � 76. Dry Standpipe . � i � � . � � ' � � 28.- Lathing & Siding ' _ _ � � { � � ' � i 77'. FIXED SYSTEM FINAL � . ' ' � � ` 29.� Insulation . ' Q - � ; ' ' ' 78. FIRE PREV. FINAL � �- ' ' 30.� Drywall Nailing � ' ' � � ' , - � � �, HEALTHiDEPT. REQUIREMENT � I ' 31.� Plaster Brown Coat' � ' �. � � � ' ' � 791 FINAL INSPECTION � Y ^ ,32. Electrical Power Meter-Final i r,''�� • � i �80: FOOD CERTIFICATE ISSUED ; .: i - 33. Final Electric � � ' � � Notes: , � � � 34. Final Heating�& Air Coridiiioning � � � i � � � ' - _ 1� 35. Final Gas Pipe,Test ^ � '. . ' . � j: ' • � . ' � � ' _ I 36. Hoodro'r Canopy � . - ' �r i ,� � ' . � " . - , , - . _ � . . _ i i i- 37. Final�Factory Fireplace � - : � . � � � � � � ; � � � - � � � - �` " „., 38. F'inal'Plu,mbi�ng � , � � . . . 1 ".' . - : � " . . - __ . � 39. WaterrService-Final! • - ' . � � ' � - . p 40. Gas Servi�ce-Final . ` � � ' . . , ' , . j �� . �. . � . . , . 41. Solar pomesticFinal i � ._ � _ i � � � r % - , '. � r . . .. _ -- i -', 42. Backflow Preventer� � � � • ' � ' . � � � . � •� ' � - 1-- -} - 43. Backf�ow Irrigation' � ~ • � : _ j - +� � ` � , � • � � � �_ '44. ,Landscape Isrigation System � � ; � � , � ' � � . � -- ' ' ' � ' � r, � i �. • � . i , . '� .. � i �. , � ' _ .- . 45. Sound� Attenuation .t ' , � . �„ � � _ • ! - � _ � ..� (" ' � 46. HandicaP Regulatio�s i -' � � , : � , � ' � ' ' , t . , �� _ ' 47. FINALSTRUCTURE&�6UILDING� ! � � � '� �� ! � � � ' � � � " �� '" � � � �% , D_' � � � i _ � �. 48. Special Requiremerits ComPleted . � . ' � + ' + � � � , � -� - - �L i i � � � . � 49. Electric Release�to'Edison; •-�1- `,- ---1-;•_,_ __. ' _.;..�'-_ !....�. _� : . - � , � � i• i "i . . , � "�' ,� �_ _ , � - ,. 50.� Gas Release to Southem California Gas�Co � � � � � � � 1, v � ' _�.- �� !• � � � ' �, 51. CERTIFICATE"OF:OCCUPANCY , `j _.__ 1_:._ �_!_.j.�. _�_ �_ �.,..i._ l _ f.,. " ' . � , � . � I No. � �Date - .. � • � � � � � . . . . _ C_ i :. _a. - . - . - .S.'_, ' ' � � . ,, . , . - �. .-._. _ � _. a: �, . d P J� � ,. :' , . ..� APP�OVE �`�. � City of Costa Mesa Building ep . ; � 8Y__..I(�,!__�L�N "= .�._.DAT I � \Qr0`I� - -- -- - - - � — - �THESE�-0UM�-MUST BE ON JOB A7 ALL TfMES I MAKE NO CHANGES WIThOUi PRIOR ��i?P �7Y.At! O OF DEPf. �, S al iHE I�SL�F,'dCE C{2 GRAATING�Of A PERMIi� ^ A�' VAL ' • � ,� ' OF 'LANS l,flD SFE�IFlGATIONS SHALL N0� RE COH T��ED O, � I!.)'.},i `_':;'1 -�' �. �I�� TO E A fE"nS�IT FOR, OR FN O�PPROVAL 0=. Af V VI� !7�f(ON ��,� G F� iv. CF TNS fRCVL;0ii3 0= TH6 CO�F. ND ERN T�'R E- ' r� , ,,, ,,,,,;,,;,,; , ; , ' �� 4r:: -' • ��1 '� • SIM 6�� CIVE AU7HORITY TO 1'IOLATE O4 CA•''.' T c � I� J"_ . �f�ni i{tqnA � _ o C ldio Cu�E SHHLL bc 1'N�ID. [t„E� SU I ._ �.L. _ � ._.._ _ . .__ � .. � �� ^. V :r�F-E-i5oh�(:5 : ,,,,_ ..''IC=F7 AU.-..� i��=- . � NFUL. ' � I �� I:,SU0.iuCE C'" ��- f�SV.ti BasED UNc: P�iiifiilhili;rrtn I �� I- ' �,'r� (1'-eT!�=�:"�B� � �__� ��f_I� _YE';L�1H° C:I! C h; OFFIC a F '�_. �fI`iznl; �`O(J,%�� jJ (R. 1F.CSL;;`1:R R;pUIRING TH� T -.71;'IiC: C:��.0 I � �.IN : JC1 !_.4��5 l::J Sf�CIFiCATI.^i:': i 6i=�1 4%rii'dE.�.t�ll�/t 911U• � 2(� G'��(`l� PL'I )INC GPEE'SI::."S EEb4G C/',�:RIE7 "i THE?E� ^lCfO R,y- � •��1 .V`�`, IN 1 'LfdlC � �. � . �� i,•_� E�, , ' _ � W31VN34FlAa q MOOA YJIh.tA� -� `�-=5�- =_= —=- L- � �� MpOfl438 R3T2AM S MOORJ38 .� MOC.�O�Ej i2AqY.A3F3� 3TIU2 "—�nre—:---�C�, � � STR�IGT�UR�L APPROVAL�ONLY -- -- - I —:��, � --- , SEPAR;'�TE;PiRt1(TS �1RE RE)UIRED � �a.s�.6 a. _..—.._._�nv �-S�;s.:`=`:::':':=.1.. PLUMB i\�, ! HEATING, 1�€ra�{L�;T!%,G ;.ND ..�. L_� , - �, ' .1"An,iFIO�ATfD�ji iNORk � fl3iZa�.1 � � S. "'�� MOOA c7NILll4 HI-MJA'/: HTAa Ii\ � m � r+'�� _.._.____._._...,...._' 'T32JJJ, � �I h s cA0i2p �HTt,fi � �} .,YV'�..."�. _ J / � -- - � ' �� 7T„_' �� VTINAV� .—. 4— � � �� p:6;:: =c� �"' — rnnru ��;;'iE'Y; "-' � ..; F;C�CN°ANY . , ..- — - -- ' — ��==�- _ n�cc:, --'—� i^Ge�cC;:,i.�;R� U-�STS -- � �r;n3.�� .,�...�:�.. �_Q � '--- ��..: .�_.__. , ._`-- t0' t PE;';Su;vS i;RE TO f; r �-�.�.._' .T, . s ; i'sE �., t 16 fST THR�T THE I PA !�rvi.. �: J,;,__u~J.,;ii� ilIVISI��Y OF � I ^ �i I �,:: CONSUL7ED FOR „n.,e7 -- uu=�= ;� ,! riEUUI�EMENTS. i � . � ti100A �!-11`JIJ�_—:' .--- -- � -; �!l�AF a(35TA MESq C�j�C� FiANNWG'DEPT. CJ u�au� ro swo. orfr. aca -; Fi7�__._�_..'AnF II� ... � x . o� w�rw�o '+�:. . .. . , . � o -o m.! _ �, /q L-I/�,�� SCfi'M II�T 9�s D�a�v� �.� �a �E . ; � 9�� - �, � �: k a OWNER JOB ADDRESS DATE _� � /.»/�q _ No. LOT q5 TRACT 7'�7$ FIRE ZONE VAWE $ 26,900.00 GAS W ATER ROIIGH PLUM6ING PROP. SWR. LINE SPRINKLING SYST MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING _TEMPORARKSE0.VICEOR.POLE- - - UNOERGROUN� � POWER � ftOUGH WIRING TRENCHES FORMS STEEL REIN FLOOR SVSTEM 90ND BEAM ❑ STEEL REINFORCE � SHEATHING FRAME AN� FLASH NG LATHING - IN. OUT � PLASTER, BROW COAT ' STRUCTURAL, FINAL � HEATING. VENT.. REFRIG. ANO A.C.. F SUBCONTRACTOR .� : J i v � ..-. .. ' . �ai . �- '� t. . . .. . .. • . . . . . :� . . _ , . . . — ' ss . � - 359.1 � ` ::� �,,�az5-73�,s��01193:'4 **'�i,42.c8 � � " COSTA MESA BUILDINGSAFETY DEPARTMENT� � . � ' � � . '�9' � �, ' �FOLCR P.O. BOX 1200 . COSTA MESA, CALIFORNIA 92626 " , ' � . ' �. ; � ; � � � • �- . � �.. PP'IC TION FOR BUILDING PERMIT . . . For Applican t fo: Fi!l iri; �Completely � . _ ; . � - .' ` . . . . , R CEI E V DATERECEIVED -DAT�EISSVED . aui�oiNc :� �� Dahlia;; Avenue 2 -u- —�a�7.� ' .ADDRESS . ' .� . . ' . •-.. PERMI7�IQ' A owNeA Larwin.$outhern'California lnc. "P•NO �_ "� 7 � `� • MAIL � BUILDING, � � �� i nooREss �6255 Ventura Boulevqrd. �j^:- aooRess ��' - a � ar� . � Encino,�'California;. No`986-8890 F TFACT,� / LO�S . BLOCK F" Z - - � "" . 1 .. � W iIDD AL �P� " Z Q CONSTRUCTION ' � � . . F LENDER � Q Ifl �SOUYhBRI alif � ia ��" - � . . . ' a'� BRANc,; . 16255 Ventura Boulevard . . /J,�P� �.� .`� �T/ - JtA. . . � . �. . . .OWNER� K�c✓ R/ C.•'./�N . a w � ADDRESS �' Ef1CIf1O CQIIPOff11Q� r /� VALUEQ/ m Q � ARCHITECT ' • ��." TEL USE �7 ' � // � R/? .$/'�/ �� ' � .. OR ENGINEER LAR N . . . � N ' W� nooaess :`�-9100 Wilshire„Boulevard � B.HIII$ ZONE '. TVPE GROUP ' a W . . .. _ . , : .. APPR ;.E , , : � . /J �% JO CONTRACTOR Larwin Southem California �nC. 'e�' '� DATE /��/' /� ' . a] Z' . : . .. a . ,- �.. ., . , . r ,. � , , ', . ' _ �� nooaess' 16255 Venturd Boulevard � =" ' v; - . W W -ZONE NO OP VSE OF NEW / ' °= cir�. Encino,.Califomia oio`986-8890' P�+� 0'2,�. e�i�owc'�/,� �/` z� � STATE �� ' CITV Y�.�'ARDSAPPPOVED_+i VARDSAPPROVED " . N�. ��. No. • 191311" -• LIC. NO. B�� MAIN BUILDING ACCESSORV BUILDING 7 O - �- (FROM G 5 EET).. �� 'OFLOT� ':',(S-9X'LOO � NOWONLOS O�' FFONT. '�FT:� ' � �LL.-FT. . ' USEOF . . -. . . • - . : 7''. . . ' EXISTING BLOG. 'FT."" � FT. . �H:� '$IZEOF 'NO.OF� �" . ...�� ,. .• . � � � Z NEWBLDG. �1784 '�I700M5 ' �STORIESL" LSIDE �'�FT. FT. . .U- �EXTERIORWALL'SI'UCCO.'R��F WoodShin�C �� r , ' � COVERING -�COVERING g REAR r,FT. � R FT. "J USE OF BVILDING AND WORK-TO BE PERFORMED . .- DISTANCE BET. . - BET. MAIN & - a . . " � .MAIN B�OGS.. ' ACCESS.BLDGS. . ,.a Q' ' ' . ' ` - . VAR # � . ' DATE ' • • ' ' ' � ' C.U.P. � • � , APPROVE , � 0. - ••. ' • .. . � . ' ' ~ Construct Single Family.Dwelling � A�Roveo �� a, /Z ? z .. N, p ."' � . ' �`NOLD FOR SPECI L R QU 5'` ~' I'hereby acknowledge that I have reatl this�application antl state.' '� . � T/V( � . :'� ' ffiai the above intormation is wrrect antl agree' co comply wiffi , � �� all laws regulating builtling construction, and I shall not employ. ' F_ � eny pe�son,in violation of,the� workman's'compensation laws of • _ � ' N the State ot.Califomia. . , ' � . _ ' : p �.. , ,. _ �' ' � � Z I hereby certity that I am properly licensetl as a contractor under SQ.�FT. �� p , ' the State of Calitomia Business antl Protessions Cotle, Divisicn 3, =THE AMOUNTSHOWN UNDER VA�UATION IS FOR ' ` Chapter 9,'and that�such licenses are in tull torce antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONIV: d , am exempt from ihe pravisions ot ffie 5[aSe ot Calitornia Business �' ¢ antl Professions Cotle, Division 3, Chapter 9. �- � ' VALVATION _ . . . ; +. .. ' - . . . . . . ' O.( . PERMIT FEE� $ � J - SiBnamreof �ww �, pOWnS ' �.,�J//�'u ' � m' . Permittee _��/r� . . . `$ !/V, I� . PLAN CHECK $ _ E - `o ' � Authorized Agent � ' � - '� � � TOTA6 FEE $ '�' LL