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2180 ELDEN AVE - Building Permits
AOC���ant to till in all spacet cept:ivose wit�in �eavy borEer Iines anG sign all approoriate Ee<lantions. ' "_ .. . . . _��' _ "'.r_. . . . ._. . _ .. _ . . . . _ _ _ _ . . . . _. ..' "'. . . CITY OF-COSTFf MESA� ' � ' . PERMIT N . - TRAf�T ,LOT NO.� , BL , � . , . ' � ' . , , „' COM1}STRUCTION RERMIT ' • ; _ � , � ' •� , — � ' '" , AppliCent's Mailin8 Addre55 ' . �PE OF CONSTflUCTION . � NEW ADD ALTERATION REPAIR . . , ' ' ` _ ' - ' ' � � � ' � PrOl�t Addrea �^ r � •• � � � CONVERSION . ❑ DEMOLISH ❑ OTHER ' � � � ' ' � - . - � � - � �i�-1� Cr�� DESCRIP710N OF WORK GQN�OM / Al � UrN � LJ /T Owner'sName , hone-�3t-a-�t7 � ' ' � I G ^ U TI ' � Addre55 OD `2 c� � TVpE OF PERM�T � GRADING � FOUNDATION TRUCTURAL � A. P:'9Y�' �'7 '� �` D� ZONE � � Arch/Eng. ^ LiC2 B NO. � D � � � ❑ TENANT � � � ❑ ELECTRICAL - PLUMBING ❑ MECHANICAL PLNG. REF.qW� -3a � BUILDING ' 4 t / � AddfB55 �a' � �� W ���9THER � I - � . � - �= TO BUILDING . /' ' J Contrector's Nem hone � �Z 6� PRQIECT DESCRIPTION� 5�. � �' •' •OCCUPANCv P PE V INE �� �REAR YARD (70 P/U - _ � � � � 'CONSTRUCTIONTVP ' VlaLUATION$-� LEFTSIDEVARD � FIGHTSIDEVARD S' Address (meiling) . . , . , - ' Q , . ' ' ZON$ ' GFADINGCU.VDS. 'ACRFc PKG.SPACE REQ. � . PROVIDED (�� _ Licenza No. � i LICENSED CONT ACTOR DECLARATION � ' Remark�: �� � i STREET WIDTH . ' � 'PARK FEE S' �� I'hereby attirm t�at I am Ilcensetl unEer provislons of Charter 9(commencinq ' , . � i � � wlth Sattion 7000) o} Dlvlslon 3 of t�e Bu5lneu antl Profe541ons Coae, Sna � . � SPECIAL CONDITIONS � ' � ' ' �'i � mY Ilcbnse I5 in full force antl efTect. ' � - � . ' � . • ♦ • � � � uunse ci6ss ' ' u'�e�se r�o. � � i � � PLUMBING , N, " � � HOLD FOR SP.ECIAL REQUIREMENTS • �; 1 t Date ' � � � ' Signaturo � ' � ' � Ba� Siak � ( ' ! Sewar Cap • � • � ' 1 , • � . ELECTRICAL � � ! " � ORKERS COMPENSATION DECLARATION I � � .� ' � , +� � ' � - - - . i ; I �eby aftlrm thaLl..have a �artlfltAte.of con5ent to Self-Insure.or a CerUfltate L � - •- „.1Automatic Washef .�,., . � � MOtet ov21 10b amp5' � .' Backflow Preventer .. SewerConnect�on' � . . .-� �-�-.+ Workers• Compensaqon Insuran<e,� o� a certHieO. coDY Shareot (Se<tlon..: ConStructiOn POIE „,�`Jo, Lab. C.l .I ! : . � 1 i �� � ; � , t Backflowlrrigation ! . � SolerCollectors:�''"� � `. . . ' � SubPanel, ; ` , �'t i _ i Polky No. ' Company . � - ,-�, 1 Cooking Unit � � � � `Su6 Pole ' � " � 8 CerHTletl copy li hereby furnlslietl. . � i � � � i ' Bethtubi � � Solar P.ipmg � �. � .} ••� , . � , � . � � � � Certitletl copy Is flletl wltn the city Bulltling Divislon. � � �� � , � � Dish'weshfr j �Motars ❑04 HP ❑ 1 h-8':'� 4 �' Date ' � Applicdnt � ' ' � � � '� � qerifiers � � So1er Tank , � � • � .. , i i iEXEMPTION�FROMWORKERS'COMPENSATIONDECLARATION � � ' - Dryers❑GaS�OElectr�c�- InC.So18I'09-15HP,O16-05+ .'r- '(TnissecUon neea not be com0�atea H me permit Is tor,one hun0retl (5100) or ' Dishwdsher ; �� I ' Swimmiug Pool w/Spa : ��� " � � i s ; lesslc ' � � 1 - • ' . � . � � .- - � �, g. t Fan , � :Micrawave ' j � ; ^ � � I CertNy(that In t�e pertormance ot t�e work for�which Mis permR is issuetl 1 Drinkln9 FOUntein5 Ufinel. � !;y ; . � . � � ' s�alP not� amploy any parson In any manner 5o�as to bacoma subje<t. to ti�e , . � - � , ._ F.A,U. , � � ' 'Pale'Lighi � � � � Workers'�ComDensdtlon'Lnws oT CallrorNa.. { � FIUOr Dfains . Water_GoSet•, �'M r�; i ' f - � � Date ' ' �ignahre • ' ' - ' , � � � � Fixtures • ' � ' � � � r.,� � .-NOTICE:�H,after making-this OeUaratlon,-you Shaultl become�iubjeEtto�the^- �- - FloofSinks ' � = - 1 .�- ' �._ _ Water-Heater - •, -'i �.'� _ �;,. ,._ : _� � _ _ _ _ . Range, w _ � Workars'• Compansatlon provizlons.of tha Labor, Cotle,.you. mu5L/orMwitb � ' � Device Boxes � � � compiy �wltn; sucn;orovislons';or mis�' � ' �-. Ga'sService. =0uilets � '� ; iWate�Service � � ; � � � Sign� pe�mlt shall be'Aeemetl� revokatl: , , -. , ' CONSTRUCTION�IENDING AGENCV � " � , �' t -' i ' . - - ' _ • � ' � � I neraCy afflrm tbat t�ere Is a conitru<tlon Ientling agency4ortha pertormance � Interceptors � �7 , - ; �; - ; _ � _ OuUets , . Standing Sections � • ' ' � , of tna work Tor. which this' Oermit �is �IaueE (Settion _3097. Civ. CJ � _ ' � ' ' � . - y - � �enaer's Name � " • ^ ' - � Kitchen Sink ' � �' � - � , � ' � Switches �Trazh Compactor � . � � �enaer's Aatlrei's �� : • � .� % � • ` • � .' ' ' ' 1 . � - Garbage Disporal � � � ' i ' �� OWNE0.;BUILDEq OECLARATION ; ' , � " + � � - Levatofies • �. • � : ' � , ' I hereoy�difirm th5t I am exempt trom the Contractor's License Caw for tne �- - ,� . �. Generator DO-5 KW �5-15KW � ' ' � ! � , following reason�(Sectlon.7W1.5 Businassantl Prote551ona1,Cotle: Any Nty or • ?-T�ap � ' �' �.county which repulrai a Dermit to construct, al[er, Improve, tlemollsh:or repair �. � _ _, y .,. T�ansfO�m2r �15-50 KW � - � � � i � any structure; prlor [o its izsuance,also reqWres the'apPlicant for such parmit : Roof Drains : - -r ; � •} . � �' � ' • • i.to iile a signetl itatemenl that he/she ii 11<ensetl pursuant to the.provislons ot ; ' "��` �- - �5U+KW�- ' � the Contractor's License Law.(Chaptar 9 (commentlngiwith.5actlon-7000) of .t� - � ` • � ' � '" � . ' � •ReinSpeMion FeB � $15 � �Ision�3 of the Business'an0'Pro/assions Cotlej-on�that he/she"is exempt � � ShOw2�5 : � r ,�.� � - , ReinSpection�Fea I $15 _ • °�.:eirom antl the� basis for lhe allegetl axemption.-Any vlolation' of Sectlon j -, . ''' ' '' Meter ❑up to 100 ampi �� 'Istue Fae �' � 1 ''� 3 � r��' ��7.5 by � any appllcant fon a� permit'subjects t[he � aOP���ant to a. civll " � � � ! '• 1 f-��,`'i'alty of not more [han five.huntlrea Oollars (E500). , , � . _ � � .Service Sink � _ r ,''_ Issue Fee ,6 � 1 � $ 3 zaning APProvad By ' �' � - Date ' ? lJ I;/5s;owner of� the property or my emo�oyees�.with wages!as tlieir sole r -,i '�MECHANICAL '' � ' ' � � i " ' � wmpensatlon wlll tlo the work, an0�t�e �i[ructure Is not Intentle0 or ofieretl � ' . � � . , . � ppp�imtion Approved By - . Date ¢ ' � tor sale�(Seclion 7044; Business antli��rofeulonal Cotle:l�The:Contraccor'S �� � , , , � i , � , � � License Law tloes nol aDV�Y to'an'owner of a property,who bulltls or Improves � goiler. '�.�,^.f (�� ' Retrigeration System 1 . � qpp�ication Isivad By � ! • , Date � I �' [hereon, antl who tloes such work hlmself/herself or throu9h his or her own . . .. . . ' ' . . . . � ' employ ees, provitletl thal such•Improvements are ntlt Intentletl or offeretl for � v ❑o-100,000BTU ❑100,0008TU • � - - � ` sale. 1(, however, the GUIlAln9 or Improvament Is soltl within one'year of com- � Duct - UnderiGround �: ' � i ' SUMMARV OF FEES i� .� � � 1 ' pletlon, tne owner�will have the burtlen of proving he/she tlitl no[ bulltl or Im- � � � , � - � � � ' ' ' � i � Qr,gvefor.meourposeo/sale)'�. � � .' � �• ; � • ' Duct-Structural �- ; SystemRepair/Alteration �. � BUILDINGPERMIT $, . � SMIP � !�$ � Q�I, as owner ot the property, am eaclusively contractln9 with Ilcensetl con- � � .iractorsto,construct tha oro)ect (Secuon 7044, eusiness antl.Professlons Cotle:__.. _ Duct- Ventilating__' „_ ; , _' _ _ ' _ _ � __ 1 _ t PLAN CHECK� . $ � • PERMIT ' '' � l� � The Contractor's License Law daes not apPly to an owner of proper[y who . , . ' - , � ' builas or imoroves thereon, ana who contmcts for suth O�o�etts with a con- ' , Ezhaust$ystem ❑ MulLple �� � �. 1 � � : �PWMBING $ ' SSUANCE' �$, bdtto�(5� IlcenSa pU�Sudnt l0 t�e Con[�acto�'S LlcenSe Law). � . � � - . : , PLAN CHECK. � $ i RADING $� � ❑ 1'am Bxempt untler SeCtlOn ' B, d P. C. fo� th15 reaSon ,. � Fiiepl/Fact BIt. ICBO ;1� ' � � � � � " , � � � � � � 'ELECTRICAU $� ��� � 1 �`E � �Date • ` ' Owner' ' � � � � � � HeatingSystem&Ducting j � � ' � ' ' � - '�MICROFILM .�$ � � '� I-hereby cartily that P �am reaE lhis ao01 tion arie state�ttiat-tha abow�. - ❑6100,OOOBTU��t00,000B � . - -- � � �PLAN CHECK . $� '� • ' informatlon Is m rect I 9ree to comply wl n all city antl county ortlinances ; '. • �� ^ t :' . ' ' ' TOTAL FEE $• I _'antl"stam laws r atl ing construc n,.antl hereby aulhorize raore- . Hoad or Type I ❑f I � ' ' � �. � � IMECHANICAL $.. � • , � � . sentatives ot;thl ;U ter uDon the ove-mantionatl roperty tor �. �, � . ' ReintpeQionFee $15� � � • LESS i • � � . , inspectlon p s s � ; • � . � Cano T e 11 ❑. : � . � 'PLAN CHECK, $ � I . - ��- �7 ' � , � , , . A�VANCED PC �� $ � Signature ' Date . . j� . , j. ( . � Registers ' , - Issiwe Fee , S 3 � � , � � ; Driv¢rs' LI o�55 � 7 � � FINAL FEE $� CMF 0865-06 rev. 12/82 WM1ite - Builtlin9: CanarY - APPlicant: Pink .- "' �.. _. � " -' � -"-' ' . �. .. .. . '. . 1 . - - . . . � . AccounUn9: GolAenrotl - Assessor � ' - � ` ri '� �1CO.NSTRUCTION AND.PLANNING! `. ; , ' . ,'- � . � .:�: �' .- < - - �OL `A � ,� . . . , � � , �_ •� - - ' ' • •: ,' - 'A . Date ��Inspector .. � - ` . : .- � - ' Date �� Inspector - � :,APPROVALS ,`- Permit-#�= " . _ _ �y - APPROVALS. . � Permrt�� .�us r�, - � ' - - � -_ " t. Temporary,Electrical Service or'Pole � N: : f ; r _ . � - 52s Po'ol &'Equipment Locaiion ' , " -� .- � - _ :e 2t iSoil�Pipe-Undrgmd.. _ Y ��' i � � E !>`. I,��p' ` ,- ��53' Steel Reinforcement '- ' . ' � "� 3: Electrical Conduit Utilitv-Undrgrnd! � "; � _ �a -,54: �Forms _ . _ . � - � ' `� . 1 fi J � - ' ' � � . � ' .� ' O t ... - - �' . _ �. 4: Electrical Conduit-Uhdrgrridt'_':�: � �, Y, � , , �c -g, '55.� Electrical Bonding ' � = � _ . _ . 5. Steel �Reinfbrcement � � � ` ` , ? ;._ ; � �_ `}': [ . � � 56. Rougfi Plumbing & Pressure Test � _ � 6. .Electrica� UFER G�od.i , ' '� ' ' ' -�i ` ' ." c: : �= 57:'- APPROVAL-•SO COVER-GUNITE: ' L' ' i i i a =- i ' � � � i i ; r �: i I a: : „ _' ; . . _. . 7. Footings � : � i I ' � = a I <, � � � � -58. Electrical-Cpnduit-Undrorn.{. _ - � - ' 8. �Foundation �j 1 � � ' � � � � :' � ; Y ' � � t � ' •59. Gas;Pipe,�O� Undrgmd.; Test' _. _ .. , � _ �� � d � o '� t p i_ C � o .,. � _ . ,. .� -,v . 9.•W�terPipe-Undrgrnd. � � � � � n � .'y - �-�� ,.�;6p, Backwash�Lines,-P-Trap;O'Undrgrnd.-E ' . _ �... 10. tiuctural Floor SYstem i _ ,t�,F3 I `� � � ; �61. `APPROVAL'-TO DECK " .- . . ; ' � - 11. operty Sewer Line & House Connec[ioo � ' - � 62. Backwash & Receptor-Final. - _ � '- . - � �. •� ' � � - -' 12. Sewer Cap � ; , � . � � o , , �� � � 63. Heater & Vent-Final ' - � � � 13. Roof�DiBins ' � , - � � � � � . ' i - � -64. Plumbing��System'-Final=: . 14. Rough Wumbing , ' � ' ^ a � � � '65. Electrical=Final" � ` ' - �� 15.'Rough Electrical=Conduit?-- - �� "'�' -'--�-� - r -� -��- �,66.� Solar System-Final � ;' , �' � -'- .- '�'- � " , - � � 16;.;Rough,Elearic Wiring• � I y �;_?I �+ � � � � � � � r t� ' �� �- �67:� F.encing &-A6'sess_ADPioval : �� ""-' � �- '- � _ ' 17.';RoughAWiring'Sign,'. ,:� � I ` "!� � � ( ; (:; ; � � : ; � 68., APPROVED FOR PLASTERING . ' i �':; . r - `_' ��78.'�RougFi_Electiical:'i;Bai Ceiling� ` �� � � : � _ ' ' '' � , , . � '69.� POOUSPA SYSTEMS FINAL A ..,.� � 19. yRough Heyting &�Air',Conditioning y � � ? � ' ; � � ,FIRE DEPT. REQUIREMENT. _ . � I _ �' 20.��Rough.Factory Firep�ace j ^ '��I �� � ; � � � � ; APPROVALS� � Permit�p , _ �. i .� I ! ,�; 21.��Ducts;�in Structure;� l' � i �� �� ' � i � � � � 70.' Underground Hydro ,� ' "�22. �Dmcts„Vel�tilating ,_ . .. ! ,� �� i� � i I � � �7�,� Produc[ Piping O Gas ❑ Oil � � � � i, _ � i'•i u � i I i � ^F3. �Gas��Pipe�Rough & Test _ � 1 , 'i � I T � � � � , � j2,� Underground Flushi ^ � ' ': I f2� ;4:� Roof,Frarping� � , � � ',"' �, � Iv � 4ti � I ,73 Undergrnd.Storage7ank,O;Gas ❑Oil �' � - 25 IRoof Sheathing ' � � ' `-' � � s 74. Overhead Hydro � � ' � : � �� � - -26. T-6ar Ceiling (Structural�i & Monocoat� � ; � ; . : I � � � �. �75. Dry Chemical � . - - , 27. hFrame and'Flashing � �� � � ' ` j� y t � � � � , .S 76. Dry Standpipe � ,r - ' � � � , , . _ ,_ " 28. ;�Lathing & Sidingl � � ; � ,1 � � � :4 i � rj � ,77. FIXED SYSTEM F�INAL. - - . � � j �,- � • i � 29.,Insulation' `- � Q � �, � '� �� �! i �!) � (�, .b � �78� FIRE Pf7EV. F�INA�L � - • . � i � 30. �Drywall Nailing � : � ' '�' �, ;� i j � � iNotes: � � � � � ; �37.IPIaster.�Brown Coat' . . I � ;- - - -� +� - � -. , _ ' _ ...... .__ . . ^ - - � � �• i � � � , � � � � . . , - 32. �Electrical�Power Meter-final•' I7 � � ' � � � 33.,Final Electric ' � " � � ' ' , � ' � � � _1 _ _t_ _ � - � � � � 34. Final Heating &;Air Conditioning i � i � � , � , � ' � . � � . 35. Final Gas Pi,pe-Test , � �� ; , ° �; � i� � - � I �^_ � � � ' � � ' � � - ' -, � I 36. Hood or �CanoPY- • -; � . ' r i ; � . ' ' � . i � � ,. , . . ; � � ,� � - �� � � i . . ; r ' -: .' . i_ o i ; ; . � . 37. Final Factory �Fireplace . �' 3', � _ ; � - � : � '� � ; . . 38. Final Plumbing :� ( � � `� �� i ' �! � � ' i � . � 39. Water�Service-Final� . ' � -'U � � � 1 � ' 1 . ' I � . i i �;t 40. Gas Service-Final ' ' � i ��` i � � � � �• f I� i i ci� I i i� � � i � � r,.. 41. Solar pomestic-Final . � � ,.�; �� � ' ; � � , � " ,-"� � I- +-- ' . + -- - - f F-' -'r - --.. . . ... � . . ' : . � ' , � , - ' � t 42. Backflow_Preventer � ! I ':�.:,i � i I , � ' . � ''? _-.-, _i ,��.�_. _}_ _ .. .- -- ---- - •.� _ �.;. _ . 43. Backflow Irrigation� � � � y C��'_ � � � , _ ; � j , ' . , ' 44. Landscape Irrigation System ; ��- � ' - �''� � .. -. - . �' . z. _, 46. Sound � �Aitenuatiori -� �� � ; � � . � ,j � � ; i ; � � � � . , � � ' � _ - � 1 �• � 46. Handicap.Regulations I �� I •,� � I T, ; � ' 1 ' �� ' - � 47.' FINAC STRUCTURE & B,UILDIN6 � � c � � � � ; � � � � � � , � , � :b �� �g, �t { � , . 48. Special Requirements Completed� � � ` � �- ' 'g I ; ' , � �� � � ' � . . , ,� , 49. Electric Release'4o Edisonj i � � � . ' � ' � __,'._��_'._ _ . ' , '' � -� �--- - - t- r_ 50. Gas Release to Southe�n Califomia Gas 60 � � j � � � ' � � i I ! � .� � ' . . � 51. CERTIFICATE;OFOCCUPANCY �� ' __�! � ' '. +_'_: __'.__�. _ _: " ' . - No � ' Date t t� ' I , ; `�T� ! � � ^. • ; , ' . �r AODlipnt to flll In all spaeas azwpt thom wit�in �aary EorEer Iinet anU tlgn all aoorooriate Aeebntions. • - - --f � - ' , - . , __ . .- — -. . _ . CITY OF COSTA MESA' � E MIT. NO. - . TRACT NO. � : LOT NO.. - B . : � � ' ' � , CONSTRUCTION PERMIT , . - � i � , . . , 3 i' � �' , � . . " , ' ,� : � � , = . - • ; 73'43 '4% I d/d$„� 45o0iJ ' il AppliCenYS Meiling AddfBSs ' � . � � ' TVPE OF CONSTRUCTION�" � NEW � ADD ALTERATION REPAIR . � . � � • _ - - � PrajectAddfea O �i�'��� � � ' ❑ CONVERSION •O DEMOLISH ❑�OTHER � - ' 1 ' ' - ' � � - � DESCRIPTION OF WORK ; Owner's�Neme � �, , G� ' hone � . _ . � . ' � . � ' I E UL TI Add�Bif, � �7VPEOFPEflM1T GRA�ING � FOUNDATION STRUCTURAL A.P.'1W ZONE _! o' . � �AlCh/Eng � ~ . : . _ LiC2nSBN0.� � ❑TENAIVT ❑ELECTRICAL PLUMBIN6 ❑'MECNANICAL PLNG.REF.#'' • BUILDING' •-� _ S i AddfBss ! �' ' O �OTHER �• � � � TO BUILDING. , ' ,REAR VARD�ITO P/U � � - ; Ctintractor.s Nam '�r�� ��U� �- A � � o6e���//s� PHOJECT DESCRIPTION 50. F7. f � oCCUrANCv � R i E ,� Addfesslm816ngi�crcl✓���������� ��`�� "�-" - � CONSTRUCTiONTVPF • '' , ' VAWATIONS � 'LEPTSIDEYARD ' RIGHTSIDEYARD. +-� y:. - � i- r� n �. � ' , � � � � ZON� � GRADING CU. VDS. ACRE� PKG. SPACE RE�. PROV�IDED � � � . � Cicense No. --YT- � ' � � ' � - ' _ LICENSED CONTRACTOR DECLARATION � � ' � � Remarks: • � - STREET WIDTH i ' � ' � .PARK FEE$ � - • � 1 �ereby.afflrm Ihat P am Ilcensetl unAer pravislons ot Chartar,9 (commencing I � ' . , . - � . wlth 5ectlon 7000) of DIvISIon 3 of the Business antl Proteislons Cotla, antl � � �' � . i ' ' ' SPECIAL CONDITIONS: ' � .�� � my Ilcen58ls in /u11 f ca antl tfact. . ' ' � - - Llcense �lass• � � �I ens' .'�S.�A�LfJ� . � � ; � ' PLUMBING ! ' ' , . . 1 ; � ' � � i � `/ r . Date� Signature � � � , . , WORKERS'COMPENSATIONDECLARATION p ' � � BerSink � Sew2�Cep � � ELECTRICAL ' ereEy afflrm.that.l nave a tertiflrate o1 consant to.5eif sure or a certHiwta. � BaCkfiow Preventer -' - SewC� ConnEction' -- - �lutometic WaSher �,` �Meter ❑over tOb amp5 - Workers• Compensatlon Ins nce,lor a cert co y t�ereof Sec � ' � • - � � . -� Coristruction Pole>' � Su6 Panef .a0o, Ldb. 6:)._. � ' ' ' � ' � ' � kflow Irrigation . Solar Collectors PoucY No. ' . � � pany � . . . .. . _ . ' Cooking Unit � Sub Pole � � e Certl cavY �s hareby f ea. , � � Bathtubs Solar Piping � — - � � � '. � . � f1eG to Y I h the City f ; ' e � � � AOPlicant � ' Clarifiers , ; : '� SotarTank � 1 � � shwasher . Mo[ors DO-1 HP ❑IX$ Di • � EXEM ION�FROM WORKERS'�C MPENSATION DECLARATION I � , Dishwasher� � ' Swimming Pool wISpA � � a _ - � Dryeis�-OGad'� �Electric� " �InaSolar �9,15 HP��16-05+ � � ,(T�is sectlon neatl not De com0�eteG it tha Dermit is foqone �untlreA ({300) ar —' i � Fau � ' ��,:.� � .Microwave � . ' � less): � �- � ' � ; Drinkin Fountains � Urinal � � 1 certl/y that.in the Derformdnce of the work for'wliich t�is perm�t ii Iisuatl� �1}• 9 1 � � '' ' ' ' , � s�all not employ any permn In any ma9q er s as ty' q�D�e`dubject to%� . , : -. . . F.A.U. �iA � �Po1C Light ' � � ' Worker Cor�jlensM+q� Laws of Canlory? � (/ % ,� ������/ � Floor Drains' Water Closet� � • � ' ' Data ��/(l � � r � S�g�ature ��� /�N ' ��-�"r^-���� � . Fiztur25 � i ' ' NOTICEi If,after making thls tle<Iaration,you shOUIC become sue7ect to the , Floor-Sinks - - - - - �- --Water.Heater �- -. - _ .Range, ' _ _ � _ Workers' Compensatlon proviilons o/ the Labor Cotle, you must forNwith I � � �` �. � _ Device Boxes I • ' � complY �+�[h• Suth OrodsIOnSFor thi5"D�rmit 5hall De �Eeemetl revoketly � :�� Ges$erViCe: , ( 'Out@ts � : _WetefServiC@ .- , - ' $ign CONSTRUCTION.IENDING AGENCV' ' �'� � ' ' . . ' - . I hereby afflrm [hat there Is a con5tructlOndentling agency for tha parformance� � Interceptors '_ � - _� . . OutlEts Standing Sections of the work Por whith this- permit IS ;issuetl .(Se<Uon 3087� qv: C.;i i . , _ _ . � Switches � ' � ' , Lenaer•s Name - � ' ' ' _ i KitchemSink - - ' _ . : Tresh Compactor � Lenaar•s �AaGross' � ' - ' /, 6a'vatories„ GarbageDisposal ' ' ' { � � ' OWNER BUIIOER OECLARATION ' ' . :' � ' " 1 . ' : � 7 . � i ` � ' ' . ' � i � i �erebyreftirm that i am exemptfrom tha Contiactoi's License Law for the - • � - � -�. . ! Generator, 00;5 KW �5-15 KW � � ' � following reason (Saclion 7031.5 Business antl Protessional Cotle: Any city or ' ' I P-Tiapi • r � - - � � � � county which mqWms a permit to construct, alter improve, aemolisn or,repair � ��. . _.. ,_ ., f f � Trensformer �75-50 KW � � ' ' � ,"any structure' prlor to Its Issuance,'also reqWres t�e'applicant for such parmi[ • Roof'D�ains G " � ' t0 fl10 a slqneC statemlOt thdi he/she IS IICenSetl purS�dOt IO the'prOvisions of � ' ,_� , , : ,�� I 1 ❑SU+KW� � � � ' ((�e Contiactor's,LJcense Law,(Chapter 9 (commentlng witn Sectlon-7000) ot � , f , . ' . , ; : , �Reinspeetion Fee � §75'� +-'�Islon 3 of the;BuSiness antl Professions CodeJ"or�t�at;he/she•Is'exampt � ShOw2�5 ,l r _ � - Reinspection Pae $15 , . . � � ��efrom anA the basli for the allegetl exemption Any violatlon'o/�5ectlon ; - ' y ' ' . ' Meter ❑up to 100�ampf � i � .IssuB Fee � 1'$ 3 . "'J1.5 by any aDD��wnt for a.permit'-subjects'the`.applicant'to a.tivll ` ; � ' I nalty of not more tnan (Ive hunGreE Aollars (5500). i.,. . �•, Servica Sink � �� � ' � Issua Fee � s 3 �ning Approved By � � ' Date � � { ���I�'dS,Owne� of'the pmperty or�my emD�oyees with wa9es�as their sole � . , i � � � � � ; � � compensatlon wlll Co lha work', anC,tha structure'is oot Intentletl or ofleretl _ , S- ' MECHANICAL � Appli�ation Approved By � - Date : for sale:(Sec4ion 7044-, Business; antl Professlonal Cotle:I The, ContractOr's • � �^^ , � License Law Coes not apDly to�an owner of a property who bulltls or ImOroves ` BDi�e� � , � �! i'" Refrigeration System • ' � j ' Y� ( � � i ' , APPliption Issued BY l . . Date '�� theraon, antl who tloes�, such work himself/herieli or through his or her own � � 1 . . em layees, provltlAtl that such Im rovements are�nbt Intenaetl or ottemtl tor . ; � • � � O,6,100,000BTU �100,0008TU. ' � . � � P P Duct'= Under Ground �� , �� . i � � I ' sale. If, however, the bulltling or Improvement 15 5o1G withlu one year�of com- i i , . . � , f 1 � � � � SUMMARV OF FEES � pletion, t�e owner,wlll have the Eurtlen of proving he/she tlIG not Euiltl or Im- • � , • i ' rovator.thapurposeofsaie�. I � � � - I 1 , � I Duct-Svucmrel + ' � SystemRepeirlAlteiation � � IBUILDINGPERMIT $ SMIP � . $ , - � I, as Bwnei of the property, am axclusively conlmcting.witNlicenietl con- � � � � , . • ' ' � � ' • � � _ tractors3o construct the D�oject(Section 7034, Business antl_Prote551on5.COEe: � Duct - Ventiieting _ _ _ _ � _ _ _, j __: _ _ PLAN CHECK� $, PERMIT � , � � The Contractor'S License Law does not apply to an owner of prOPerty who. � � . : � ISSUANCE' $' I Guiltls or Improm5 thareon, anA who tOntractz for sucb projeGts wlth a<om � ' Exhautt SyStEm O MWciple O' I i i ' ' �PLUMBING � $ , � va<tor(s1 �Icense pursuant to tne Contractor's License Law). , , ' � - � � . ' � � GRADING � � E � ❑ liam exem0� untler SecUon ' B. & P. C. (or this reason i � Fi�epl/Fact. Bit. ICBO � ! j � . � PLAN CHECK� � $� � � : � I � 1 � � . ' �ELECTRICAL � $ . � ' $ �� Date • � ' - Owner� ' � �- ' � � � Heabng�System & Duc{ing � ;. ' . � 1 i , ; . MICROFILM ' $ � P �eroby-certlfy �that I�have-reaC lhis apDlicatlon-ariA stdte that tKa abom-� -- OP700,000 BTU•0100,000 ---- � -- - E �PLAN CHECK � $� � � ,Into(mation Is wrmcL 1 agree to comply wim all city.antl county orAinancas � • � ' - . � ' � ^ � � � • 'MECHANICAL � $ � � ! TOTAL'FEE. $ ' antl'itate laws relating to builtlin n5tructlon,lanA hereby aulhorize ropre- i HOOd Of Type I �� !, . ' ' � � � I ' � : I ' ; LESS � ' 1 ' untaUves ofli s; y�to .upon Me ova-mentlonetl o�operty for I ReinSpbC[ion Fe9 $15 I ' � • inspectlon p f ze � , � 1 � '• ���o T e II ❑I i . iPLAN CHECK� 4 5 � qDVANCED PC �$• � 519nature � ./ ( Date • � �� � � � • � ' . . � � ' 1 � . , � . Drivers• �lJcense or'S5 $ '' +� ' Regiscers � � � � laue Fee S 3 i � 1. � ! � � FINAL FEE � � $ �� . . . _ . . . . . . � , _' __. ._ _. _........'"_"_.. _"_...' "'_"'_' " _' .. ......'_ '_. ..__. ._—_-�.._' __._'_ . .'_ . .._ __ . . .. _. .. .. .__" "'. _ ._ ._ . _ _ . CMF 0865-46 rev. 12/82 White - Bulltling; Canary - ApPlicant; Pink - Accountin9: GoleenroC - Azsessor � � "' _ ___ __ ,. AOC��unf to flll In ail soaeN axcaDt those wlMin neavy eortler Iines ana s19� ��I aoo�ovrbta -' CITY OF COSTA MESA' � ' � ' , . pERN]IT NO.. 3 � TRACT NO. � : LOT NO:. B CONSTRUCTION PERMIF ' J�/ ' Applicant's Nlailing Address �/ TVPE OF CONSTRUCTION NEW ADD • ALTERATION pEP FfojeCtAddfe55� �� rJp� '� � �� ❑ CONVERSION ❑ DEMO SH OTMER OwnmiNeme ' ��r�� hone� �ESCRIP.710NOFWORK ����A � � Address' ��� Q��� �� . '`�� �� ' TVPE OF PERMIT � GRADING FOUNDATION STRVCTURAI AIChIEng. , LiCenSB NO. ❑ TENANT ❑ ELECTRICAL �0 PLVMBINC.' �'MECHANICAL �, Addre55 " ' �,�OTHER � - ' Contrector's Nem c ��n�-f hone � VRQIECT DESCRIPTION SQ. FT. OCCUPANCV_ Add�e5elmA�'�g��Q���� Y ����An��� , CONSTRUCTIONTVPE �VALUATIONS ' ,,t��� � . , ZON� � GRADING CU. VDS: ACRFS� L'icense No. UCENSED CONTRACTOR DECLARATION � Ramarks: I'��ereby a}firm that 1 am Ilcensetl untler provisions of Chartar 9(commancin9 � . With section 7000) O} DlviSiOn 3 01 [he BUSInBss antl Profazslon5 Cotle, entl �, , . ' my Iicensa IS In full ! rte antl effett. ' Llcenie GI is - �d Ucan No. �-3� ' PLUMBING ' Date Signatura � ""ORKERS'COMPENSATIONDEC ATION � ' BtfSink SewerCOp , ereby attirm tnat 1 have a cartlilwta t conSenPto SelNnsure or a cmtiflfate - Beckflow Pr2venter - ' ' SBWer CorineCtion "-- " " Workers' CompensatlOn Insurance, or d certlfietl. cOpy thareOf (SeClion - 3800, Lae. C � � ��J ` ' ' ' By�kflow Irrigatian $olar Collectws � - POIicY No.���"��.3�[� ComPanY LUL-I�OLI ' . . -.._ "' '- [ �Certitiea copy Is nereDy hmisnea. ' � Bathtu6s $Olar Piping ' ' Cert i tl c py IS fileE wit� the tlty B fltlin • vislry1, � Data t1�j�1� . ADO����t ������ m�7�A��-- � Clarifiers _ SolarTank � EXEMPTION FROM WORKERS' COMPENSATION D IARATION DiShNAShef �` SWimming POOI W/Sp2 ' (Thls secUon need not ba complataE H the parmit it for one hunOreO (5300) or — ! ' - A. P. �W • PING. REF. vW ; � TO BUILDING PPOPERTV LINE LEFTSIDE YARD PKG. SPACE, REQ. i STREET WIDTH � SPECIAL CONDITIONS: Automatic Wazher - � Construction Pole ;' CqokingUnit ' .961C .oL;l/'.::; . --•';,e�; T: ` , CONE ; 9UILDING . ' REAR VARD (TO P/U '. � RIGHTSIDE VARD - PROVIDED { ' . _ . " - �PARK PEE $ ' I 9LECTRICAL Meter pover�700emps ---. - Sub Penel - � Sub Pole • Momrs O0.1 HP 'O1:S-8 . � Int.Solar 09-15 HP �i6-15+ iezs) ' . - • . - , ran � � � Microwave - I terUry �that In t�e performance ot the work tor'which this permR I: izsuea I Drinkiny Fountains Urinal ' shall not employ any person in any manner so as to become zub�att.lo tRe � - ' (r� F.A.U. ' � � � ' Ppl¢ Light � � Warkers' CamDensatlon Ldws o1 CalHornla. , L � ! Floor Dreins Water qo52t ' Date • �19�aturo Fixtures. ' NOTICE: If, after making this tletlaratlon, you snoWa bocomo'sue�ect to tne� Floor Sinks ,' • - Water Meater� ' - ' - -' �Range � �- - WOfklls' COmpanSdtlon DrOVISIOnS•ot the Ld�o! CoCe, y0u must fofthwlth� , DBviCE BO%¢5 ^ � ' comply'wlth•euc� provislons or.this;parmil shall be tleemetl rovokee: , GasService : Outlets' �WacerService - ' � 5�9�; - . � - CONSTRUCTION � I.ENDIIJG AGENCV " � ' . • i - � � 1 beroby z}firm that there Is a constructlon IenEing aqency for tlte performance� InterCeptOrs .� _ . Outlets Slanding Sections � ' of the �work for' whicn this• permit Is �isiuetl (Saction 3097 Clv. C.;- - , . Switches Lantler�s rvame � � Kitchen Sink' � � . � .Trash Compactar � ' LenCer•s' AtlCross � � ' ' � �� � _ � � _.. .. ' . � OWNE0. BUILDER DECLARATION ' � • - LevOtOriCS., ' , � . , . . . Gerbege Disposal i �� I hBroDy�affl�T that 1 am exempt�l�orti tfie Cont�atto�'S-LlCensa Lnw Tor the � -. . . . �.�. Generator DO-5 KW 05-15KW ' foilowln9 reason (Secllon 7031.5 Businass antl Protesslonal.COUe: Any city or .�- P-Trap. • ', . �'county whlch'reqWros a permlt to conztruct-, alter improve, tlemolish or rapalr . _ , . Transfarmer 075-50 KW . : any ztructuro, prlor to Its luuanca, also raqulras t�a applicant tar such Dermit- � T� ROOf D�ains ' ' � • , to flle a slgnetl Stalemant lha[ �e/Slte IS II<ensoE pu/Suant lo Ue provislons of '- ❑5U+ KW � ' 'b_r�COM�aclor's Ucense l.aw (Chaptar 9(commencing wllh Sattion 7000) of �Reinsyaetion Fae §75 9sion 3 bf tho Buslnest antl Vrofesslons CoGa) or that he/zhe Is exampt �' � Shbwers � • � . Reinspection�Fae $15 , , �..: �o/rom antl l�e basls lor t�e alle9eC exemDl�on. My vlolaiion o/ Settlon '` ' - � - M¢t2r ❑up ta 100 ampa Jssua Fee � ' S 3 -'%31.5 D �any aDG����� for'.a permit-subjects tne appliwnt to a clvll ' � ` ' � � � � - _ ��nalty o%not moro tnan tiva huntlratl tlollars (SSoo). .,• . Service Siuk . ; laue Fee � ' ' � I� S 3 ZoninB /�PProved BY � Date LJ 1, ai �owner oY [he O�operty a�'my employeas wllh wages az t�eir sole _� � MECHANICAL � � j � ' � wmpansallon wlll Eo tha work, antl.the structure'�is not IntenOOE or of/ered = r, , qpp�iotion Approved By ate ' ,lor salo'(Sectlon 7064, Business'anE�Proteulanal Catla: The Contractor's � . , Llcense l.aw aoes not avD�Y to an owner of a proparry wno bWmz or Imoroves Bailer f ' Refrigeration System � qpplieation Isued By � 1 � Date �'� Nereon,'anE wbo tloes such work �Imself/�arielf or through his or har own : . , � � s� . � emo�oyees, vrovitlatl tnat such Improvements are�not Intontlea or offeratl tor ❑0.100,OOOBTU ❑100,OOOBTU � . - ' sale. It, �owemr, the Oullaln or Im rovement Is soltl wR�in ona yaar of com- Dutt - Under Ground • ' , . . 9 P . . SUM ARV OF FEES , . � D�etlon, the oWner�wlll have lha burtlen of proving he/iho OIC not builtl or Im- . � r • . � ' �roveforma0�rposaoisa�e). � • . Duct-Structurel SystemflepaidAlteiation BUILDINGPERMIT $ � . SMIP $ � � I, as ownei of tno pro0erty, am axclusWely tontracting with Ilcansetl con- � - � � , � ' ' � ' • � � tractorsta construct lha Drojact (Section,7044„Business anG.Ro/ossions Cotle: � � Duct-.Ventilating..:_ ... � � �__.._ PLAN CHECK' ' $I PERMIT i � • � T�e Contra[tor's GcanSe Law does not applY to an Owner ot pro0erty who , � , � � 1 � ISSUANCE ($' � bWltls or Improvas therean, antl who contracts for such pro�ecls with a com Exhaust SyStEm ❑ Multiple ❑ � • ; ' �PLUMBING . � $ � tractor(t) Ilcansa pursuant to lhe Contra<torY License Law). � , - ' ' $ �� GRADING $� , � I,am exampt untler Sactlon B. & P. C. /or this reason ' Firepl/FaCt. BIt. ICBO 5W ; � PLAN CHECK� � ' ,$, � ' � � � . . . . ' _. .. � .ELECTRICAI' $ � � • . � �,Date � ' � owner' � � ' ' � ' Heating�System&Ducting . � ' ' ' � - - j MICROFILM . $ � I heraby.-certlly'that I hava'reatl tnls appl(wtlon an0'state'that the abova' 'I� qV100,0008TU'0100,000 ' �PLAN CHECK; � $ � � � , . '� Informatlon Is correct. I agrea lo com0ly witn a11 Uty antl county ortlinances . � ' ' ' ' � ' � '�Qv � ' TOTAL�FEE . S� antl state lawi relatlng lo builtling construction, antl nareEy authorize re0ro- � � . ; �MECHANICA� . $ � sentativei ol tnis'Nt �to enter�up n the above-mantionetl pr per tor HOOdoi TypOI ❑' � � , . i �� . � � : Heinspection Fee � $15 'PLAN CHECK 1 $ j�� LESS � . Inspectlon o oses. Y, 4. . . Cano T' e 11 ❑. • � , � 7 � � , . , ADVANCEDPC ' S ' Slgnature Date ' � � . /� ' DrWers' lJcen o 55 � - � � Re9isters � � lave Fae . S 3 • ' ' FINAL FEE � • E � `�'Od � CMF 0865<6 rev. 12/82 W�ItG - BuilEing; Cana�y - Applitanl; Plnk - ACCOunting; GOICenroE - A55l550r � c. C7CONSTRUCTION:AND�PLA NING . .' �.'' - •� . . �---POOL- -PA . - -- - ------ _ --- �- � F� � ' ` � ' ' � '�� � ' Date �Inspector �;APPROVALS �PermiT�h - - � ' Date � inspector � ;� ��APP.ROVALS :• Permit#� • n: i ., - - . . . ?� �: Te'mporeryM1Ele`ctrical SerJice or.Pole � '• �� -' . _ 52:� Pool & Equipment Location ' ' : - _ �_ - �- 2? Soii Pipe-Undrgrnd.. _ � � - ' " ;' � � ' b3 ; Steel Reinfoicement ; . � _ �. ; . � � 3i Electr,ical Conduit Utilitv-Undrgrnd. ��� r` ' 54. Forms : - � - - -, ��4c Electrical Conduit�Undr md', - _ : �',, `� .' - - -- � n , 9 � 55.-ElectricabBonding 5' Steel ReinforcemAnt, -�- „' �' 56. Rough Plumbing�& Pressure Test ��- , _6r �Electrical UFER Grnd.l - � � � � �-. �' ; � 57.;APPROVALTOCOVER-GUNITE _ 1 � 7. Footings � � � � � - ; �. - � �58. ElectricaG('qnduit•Und�ar�d.. - ' _ 8. Foundation � � _ - ` 59. Gas Pipe,;O Undrgrnd., Test ;� � _ � - • • 9. Water, Pipe-Undrgmd. � . - � t ' 60, Backwash:Lines, P,Trap, O Undrgmd. .� . �.' 10. Structurel Floor System ' �, �- _ � � 61. APPROVAL_TO DECK � - _ 11. Propeity;Sewer Line &.HouseConnection . �;. �, ' 62. Backwash &'Receptor�-Final� _. - � . i � i � �,. 12. $ewer Cap ' � ' � , - � �. 63. Heater & Vent-Final � ' i � r ,- 13. Roof Drains � .: � � - � g4. Plumbing System -:Final � • � _ > 14. Rough Plumbing . : � ' - � � -�.65. Electrical-FinaL - - � ' - � _` �T75PRough-Electrical=Conduit-�^- ' "'� - �-"'" "66.!�SoIa�SYsiem-Final - �� - ��� n. ,.i I ' 1�c76. Rough�Elec[ric Wiri}g . � _ '� {= f'; � 'i , - 6Z. �Fencing &�Access Approval •. . , � • � � � -.� ' �' 17. RoughiWiring Sign F' ^ t � •' ' � , "�-' � •.' ` i ' _ � ` gg.'APPROVED FOR PLASTERING _ • ' . � � w> � � -� _ ,.�• : o. . .. . _ � � � , � . � . . - � . . . _ �r ^ 1; 18. Rough_Elecirical'T Bar;Ceiling� � � - � ,_ ; . � i�� � , , 69.�POOUSPASYSTEMS�FINAL � � � s �' 19. ,Rough�Heating & Air Conditioning ,� � -��, _ ' y� � � , � FIRE DEPT. REQUIREMENT�� ' - � _ = � > � 20.';Rough.Factory, Fireptace � � . � ' � ; � APPROVALS j �Pe'rmit # - � • = -. � . ; � ' ,�, 21. Ducts,:in Stiucture = . , � I t� � � � ! i � 70. � Underground Hydro � . � � ���22. Ductg,Ventilaiing ,'� � � I , q � � � � � ; 71.�ProductPipingOGas ❑Oil � � • i _ �;23. Gas Pipe-Rough & Test '� ;� ` �^� � , � � 72.' Underground Flush , ' ; � �24. Roof; Framing"� � , ; � ` � .� ::'�, , � o �, �. . � I , � 73.' Undergrnd. Storage Tank� O Gas .O Oil ' � - r 25. Roof�SFieathing � � ' �,: �� -� � . � .'' . E � � 74. � Ov,erhead� Hydro ' ! ' I � � ��Q6. � Bar Ceiling (Structurel); & Monocoat' ; .-' i , ' ' � I = 75.' Dry Chemical 1 � ' . . ' � . - ` :��27. Frame and Flashirig � � � � ' � � ; � i 76. �. Dry Standpipe - . , � ' �_ � N 28. iLathing & Siding � .' �_, � � • '� . , . . . , , � : � �, � ;� � � I i �� 1 , 77.j FIXED SYSTEM�FINAL � ,�29._�tnsulatioo :� . � � � ,, �� ' � � � � � 78.�FIRE�PR�EV: FINAL ' ' � � � � � �30.�DrYwallNailing � ' �y � � �� '; � � � � �Notes:- � � � . � � � � F-. ' . . _ . _ . . -�- - --- � - � - - � � �'31. Plaster Brown Coat ; j I � :' �"� !' I" T_" � ."i � '� '� ' i i � '"�� � , � � . � . �� . .. , , � - ,i � � i , � ' ' i ' f � , , � � 32. Electrical Power Meter-Final � � � - " . � ! � � '�' • � - . � � I � i � � , ; � ' _ . �33. Final E�ectric � � ' i ' � � 34. Final Heatin � & Air�Conditionin ./ ,/� �I ;, 9 9 f %�Y �l .��/ � I, . . ' :, _ 35. Final Gas Pipe-TesT� � �, , j � � ��l ' i' , . , � ' . ; - � . � ' . �. ; ��. � 36. Hood or CanoP,Y���'� ° _ � �,� ' �.i . . � ,� . . . . - ' �. . ^ ;� i -- � � � -� � � , � � '� i' ` - - 37. Final Factory Fireplace'` � . � o i � � . ' r _ . _ - _ _ . 38. Final P.lumbing � � � ^ ' �, i j�- � � � � � �= i � . ' .. � ' 39. Water-Service-Final� j I ; J j i ' � � �� ` , � � i � 1 ' .: t � � , � 40. Gas Service-Final • � � � ' � � � ; . ' , � 41. Solar pomesticFinal � � ' ' � � - .' _ ' ' � ,.� i 1 i 1 ii r ---�- --� t - , -�--�- .-T- - . 42. BackflowiPreventer� _ � ' I !�. �- -�- - � - .4 - . - - _- -�--� ��:. �i - - 43. Backflow Irrigationi -_ � � ' �' � ' � t . `� _ � - � • • � � i - 44. Landsc"ape Ir�igatian System � � .; �� ' - ; � � ' � � ' � - �� _ �. ,.� - . �; . I;.. . - 45. Sound�-,¢ttenuation' � � ". - ' � '� ' � � i . . ' � - . � r r ' ` � � 46. Handicap��Regulations � � . � �: i . �'. ' � ^ � ' j i • ,. � - - . � . '; 47. FINALSTRUCTURE&BUILDING �, � , � � � , � � ,�' �� � 48. Specia6Requirements Completed� � � � � � � ' � � � � � � � � � • � n 1 :I 1 49. Electric Release to Edison � ' � � � i � � � _' . � - ' ' � � ! � � i � '! -i--i-- -i- ��- , � ; . � , . 50. Gas Release to Southern California Gas Cv i j ; � I I � �' �� , l � . � i. � i 51. CERTI'FICATE OF OCCUPANCY `_ _;. _ __' _ l- ,- y- J--T. Y,l ' No '� �� � � i Date; � ' '! 1 � � , I � , , -:.-' 1--L ' L � -�-- •` - ADPlieant to 1111 in all sDaces e:cept t�ott within �eary borGar Iinas anG sign all aoprooAate Geelantionz. CITY OF COSTA MESA � PERMIT O. TRACT NO. LOT NO. BL . ' � ' COI�STRUCTIbNPERMIT " ��7 . - 7176 '4/I4/B3• � ;9eJ� TL AppliCenYS Meiling Addf855 1 � W . TVPE Of CONSTRUCTION NEW � ADD ALTERATION REVAIR , • ProjectAddless au �ISO F_I0.Gn �V�C Q ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � � � - � Ownef's Neme 17T--r��< < �- �� � �hone DESCRIP710N OF WORK �-""`^ �7 �� � NI GRE ULA I N' � Add�ess �k00 �In.�.�I S�'I�� N l`� TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL A.P.� � �ZONE ' !� AfCh/Eng:�T�-( �"��•�� LiC2n58N0. - ❑TENANT �ELECTRICAL ❑PLUMBING ❑MECHANICAL PLNG.REF.� � � BUILDING � ' .' '(�,� ����'J N�wDo�� �c-.�[� �%� ��IOt7 ❑,'OTHER . . . . . - . . Addreu� TO 9UILDING" 0 � n r P PE V IN .REAR VARD (TO P/L). ' � Contrector'sNam1'�*���---� �<«���� Phonea'Q/-3`-�4% �PRQIECTDESCHIPTION S�.F7. � OCCUPANCV , . Addreulmailin9) ��?�/��oa�L.� /2e� LJ<�Sl�".._ CONSTRUCTIONTVPE ' ' ' VALUATION$�• LEFTSIDEVARD RIGHTSIDEVARD 1' ; �� �.LZ�� ' � � ZON� - GRADINGCU.VDS. ,ACRE$ , PKG.SPACEqEQ. PqOVIDED - Licenu Na � ' . LICENSED CONTRACTOR DECLARATION ' ' Remarks: " � STREET WIDTH PARK FEE $ ' � I„neieby affirm thzt 1 am Ilcensetl untler provislons of �Charter 9(commencing . . ��_, with sectlon 7000) of Dlvision 3 of t�e Business anA Professlons Cotle, and � � � , � ' � � SPECIAL CONDITIONS: � �' Ty'li<¢nse�is in tull fOrCB dntl BftBct. � , � . . Llcense Clzss � C l� � Licens�q No.� � r2 �� PLUMBING � � ' •� . � . � � . , . � Dale � ' Si9naturo �1 -"�—< i' ,LS / - —A , , , 1RKER5' COMPENSATION DECLARATION �— Bef Siok S0w2f Cap � ELECTRICAL .ereby aHirm that I have a.cartlilwta ot consent to self-Insura or a certlficata ' ' � - - J - Automatic Wazher . . � _ �Met2� ❑over.l0b amps _ � _ . �- � _ �f Workers' Compensatlon. Insurance, or a certltietl topy thereof (Settlon � BackflOW P�2v2nt2f SewC� COnnEctiOn� 3800, iab. C.)Q pn�j [� Backflow Irrigation � Solar Collectors ' Construction Pole Sub Panel� . s — POIICy No. � ^ ` Z< J' -1 � ComDdny FQi/`�n.� L.-.J �o. ; - -� - - . Cooking Unit Sub Pole � �ertitietl�copy Is haraby fumishetl. : � { ,� Bathtubs � Solar Piping ' � � . � • • , � ; � Cart tlatl copy Is flle0 wlth the'tlty B Iltlj ng p�vislon. �� ' � Clarifiers ' Sotar Tank Dishwasher 'Motors DO-1 HP ❑ 1X-8 � Date �' / � -X 2 ADOlicant� (- L� � , . ^ �� — EXEMPTION{FROM WORKERS' COMPENSATION DEGLARATION ' , Dryers ❑Ges ❑EleCtric InC.Solaf 09-15 HP 016-15+ � . Dishvuesher . • Swimmin Pool w/Spa ; (ThiSsection neetl not be completeA,if the permit Is tor one huntlretl (E100j or , � — 9 IBcerHfy�tnat In tne performan<e ot Sne work for'wnlcn this vermR is IssueG I Drinking Fountains � ' Urinal . ' . i Fan' ' ' 'Microweve ' � ' / � shall not amploy any person In any manner so as to become subjecGto t{�e . . ,.. � -� � F.A.U. � � , Pole�Light � ' � Workers' Compensatlon Ldws oi Calitornla.' � • , ! ploor Drains; '�� „ �. Water CloseY � y "' Oate � Si9nature � ' - ' � - - - . NOTICE: If, after making thisCeclaration, you�sfioultl bacome subjeci ta t�a , , F�OOr Sinks - - . -- � - WB[e� HeetCq - - - . Fiztures _ �Range.. . � .. Workers' Compensation Drov"isiont of the Labor Cotle, yau must forthwith - � � � � Device Boxes ' ' i ' � '� comply with, such provislons. or thistrpermit'Shail be tleemetl,.revoketl. � GaiServiC2` 'Outlets- WeterServiCE �. � - , Sign � 3�Q CONSTRVCTION LENDING AGENCV � ' ' � Outlets I hereby aftirm that Ihere I5 a constructlomlentling agency for tne'performance� � Interceptors ��' ����„ � Standing Secti6ns � Q . of the work for whi<h: thls� permil I5 �issuetl (Section 30H7 Civ. Q} . ' Lentler•s� Name.� � � •.• � Kitchen;Sink. " ' , . � ' ' - ;;Z Switches � � �Trash Compactor t ,s I �Lentler's Atltlresi ' ` Y - � ' -. . . . ' OWNER�BUILDER DECLARATION � ' - " � - � CaVatories � '. � •� _ . ' ' . ; . Garbage Disposal � . ' I hereby�affirin that 1 am' exempETrorti the ConVactor'S Licanse Law Tor tha� : � P T a � � � . � GBneratOr �0-5 KW 05-15 KW � . � � ' � tollowing reason:(Section 7031.5 Business antl Professional�Cotle: Any city or P � �• ' - i- ' �� county wnlc� �eqWres a pe�Tit t0 con5tluCt, dlter ilnp�ove; tlemolish or, rapalr - ,. � � � any itruchra, Orlor [o its Issuance,:also requires t�e appliwnt for su<h permlG , Roof Drains � ' ,=� � � Trensfo�mEr Q 75-50 KW . . fp file a signed statament that he/she is Iicensetl pursuant to the provl5lons of ' ❑5U+KW� � ` � - ' » Contractor'S Licenze Law,(Chapter 9 (commencing�with Sectlon 7000) of ,. i� � � � ' '- ' ' , . , � � Reinspec[ion Fee � $75' ' il5ion 3-of the'Businass anU, profeisions COAeJ"or that he/she.is exempt �-' ShoW¢�5 - " Remspection Fee $15 2�reirom anC tbe� basis for the allegetl exemption. Any,violation=of.5action � _ ' ' , - Mete� ❑up ta 100amps �x�e Fee� :�$ 3, ]�031.5 by any applicant for_a permit: sub�ects'tha applican[ to a civll �rvice5mk • , . IaueFea,, i � 3 --- '- • -- , � enLlty of not more than five huntlretl tlollars (E500). !. ; � �,, 7- �-. ` , ZoninB APP�oVed By ' Deta � : � I,�as owner of the property or�my employeas.with wages'as their sole , . _ , � � ! " . . ; . ; - � mmpensaUon wi11 tlo the work, anC the �sSructure is not tntantletl or offeratl ...- � MECHANICAC ' ; qpplintion Approwd B ' � ; tor sale (Secfion 7044, Business antl Professlonal Cotle: � The. Contractor's � � � Llcense Law tloes not apply to an ownei ot a property who bulltls or improves . Boile� '� �'. .- �FiEfrige�0ti0n Systeril � , q liwtion Issued B �Q � � � � ' thereon,.antl who tloes such' work himself/hertelf or through his or her own � PP � Y Y �'�l � . ' Date � � . employees, provltlBtl that SUCh improvements are:noi Int¢ntlatl o� oiteretl for ❑0-1�0,(�087U ❑i�O,U�BTU � . . SaIB. If however, the bulltling or Improvement Is soltl wlthin one year�of com- � Duct - Under Ground SUMMARV OF FEES i pletlon, tha ownBr,will �ave tha bUrtlen ot proving h¢/She tlitl not builtl or iT- ' . , � .eroverortnepurpaseoTsaie�. , � f Duct-Structural � SystemRepair/Alteration � �BUIL�INGPERMIT $ SMIP . � $ � LJ I, as owner of Ihe property, am exclusively tontratting with Iicensetl <on- ' � , � . tractorsto construct the oro�ect.(Section.7.044, Business antl Pro(assions Cotle: _� � Duct - Ventilating , _ -_ PLAN CHECK $ PERMIT � � . Tha Con[rattor'S License law does not apply to an owner ot property who ' , , ISSUANCE :$ bulltls or improves'thereon, anC who contractz for such projects with a con- � - Exhaust System ❑ Multiple ❑ � ' . PLUMBING $ � � tractor(s) Ilcense pursuant to the Contractor's Llcanu Law): PLAN CHECK $ � GRADING ,$' � ' ❑ I am ezempt unGer Sectlon B. & P. C. tor this reason Fi�epl/Fact. BIG ICBO # • . ' . . ELECT(iICA� $ • ' $ �Date owner ' � � HeatingSystem&Ducting � � � � .� MICROFILM � $ I-hereby ce tify� hat I�have reatl this application antl state that [he above ❑P700,000 BTU �100,0008 •' -� � �' ' PLAN CHECK $ , informatlon is <orrect. I agree to complv �+��h all city antl county orAinances . . ' TOTAL FEE .$' . antl state laws relatinq to builtling constructlon, anA hereby authorize repre- Hood or � �MECHANICAL $ � � . 5entative5 ot'this'tlty to anter upon the above-g�antlonetl pro� TYPQ � � � Reinspection Fae $15 LESS � � InsOection ourposes. �. �q, / ) // Cano T e II ❑ � � ;PLAN CHECK $ ADVANCED PC ' $ ' ' � Siqnbture � ���_ �.�a�...�_��-�_,_�r Date� �'-3 + • � ; . , Drivers' Ucense or 55 qf � �� . Registers ' Issue Fee . § 3 . , � ' ' (,� � FINALFEE ' $,�. CMF 0865-46 rev, 12/B2 White - Builtlin9: Canary - Applicant; Pink - Accounting; Goltlenrotl - Azsessor 2 -�CONS7RUCTION AND�PLA �- I,NrG�'� " � � . ` - - -- � � ,• .��C SPA - - - > . . �� � _ ° - n c � . �; APPROVALS ' Permit.#��:-3,¢OL�.'- 2Date -Inspector .APPROVALS Permit # � Date • InspectoY � R. _ .:, i +5 i t � N . �.. - - ' - �> "'u Temporary Electr,ical Service or-Pole � ' ` � o _ . o ' �.'52� Pool &:Equipment Location' • - � o. � n-' tY �^. .s. � F 2� ISoil PiPe-Undrgrndr- ,. : � �o' � . � � n� : i Y r` - R � . 53� Steel R'einforcement ,. - : '' ' ,I -� 1 - `'3. Electrical Conduit Utilitv-Undrgrnd: J ( .: `` - �'54.� Forms? ' - = . � ; - . ' �. :.;. "� ' ' 4: Electrical Conduit-Undrgmd: - _ "� . ' ,Zs_ ' v`C� � 55= Electricel.Bonding , � � � _ : � � �5: Steel �Reinforcement ", �� `' `� � -, � - ' - - � _ � . �56.' Rough Plumbing;& PiessureTest ' ` ' ' � - 6: �EI'ectrical UFER Grnd. � a �- -' -- 57.; APP,ROVAL TO.COVER-GUNITE�� . , - 7. �Footings , � ' '� �' ' `• . _ . 58�.� Electricalf Cqnduit=Undror�d: � � . - _ . � . � 8. Fountlation � i j • � G � • �' " i� ' � _f � ��59. Gas�Pipe,�O Undrgrnd., Test - � - � _ Jh 9. Watei Pipe-Undrgrnd. � o;• �� � _ i'60. Backwasti LinesjP-Trap,'O Und[grnd. ; 10. Stiuctur,al FloorSystem � „'� > �' '' � � _ ' � 61. APPROVALTO.DECK' ' '. -- = 11. Property Sewer Line &IHouse�Cqnnection� , � _ �62. BackwasFi'& Receptor-Final ! � ' ` . �' ' ' 12. Sewer Cap � � ' . f ' , ; • n'' , ,_63. Heater &;Vent-Fihal ' - � � 13. Roof Drains ! j : i � � � ; � , , � ; �64. Plumbing_System.- Final � ' ' � i 14. Rough Plumbing . ' , • � - - ��65. Electrical-Final' ��� � � � � - -'15: Rough�E�ectriral=Conduit i--'• ',"� -'� -�-'!'--+�-' '-"- 7 ' 66.` Solai System-Final-' � � � -� � - - � ^.16. 'Rough.Electric Wiring� � = ; ' --'� ' �- " - 'f- -67�. F.encing &�'Access.Approval � � �� -, �- _ � 12.. 1 ;':� 7. �Rough.Wiring Sign*. - � � ` � . - � � � - gg,' APPROVED FOR PLASTERING � � _ - " � : 18. �Rough'Electrical�T;Ba%Ceiling� •� ;� i- ; ' . 69. POOUSPASYSTEMS FINAL � � � 19: cRough�Heating & Air4Eonditioning I � � � � : ; �FIRE DEPT. REQUIREMENT ' � ' ' . - '; ' 20. ;Rough-Factory Fireplace � � �j ; � � ' APPROVA'LS � � Peimit # � •. � i i � "�' 21. �D'ucts,�in�Sfr'ucture� �' ' i � �1 il I � ; ' � ' � � ' ' � i � .� ; .�. i �. � ( i �' � 70. Underground Hydro " ��;22. �Duct�s, Ventil9ting � j - } i �i Jy { . � �71.� Product Biping O Gas ❑ Oil � ' � . � ,'; 23. 1Gas�Pipe-Rough & Test ° ; I,_ � � ' � � 72,' Unde�ground Flush - , ` `24. �Roof Framing; � � �� � � lim'' � � � � ' � �r; � _, �73. Undeigrnd.StorageTank OGas ❑Oil � � 25. �Roof Sheathing , � ; ,� � ' �� � � , : � ' � � ' . 1 n � ,� � � � ' � 74. OJerhead Hydro { � � =' �26. �T-Ba�r Ceiling (Structurall. & Monocoat= � `' - - i_'; ' � ; 75.� Dry Chemical � ' - .n - � u .I..1- ^�.27. �Frame and Fla'shing , ; j Ij �, ; - - � 76. Dry Standpipe � ' ' , � 28. Cathing & Siding � i„ � � I !� , �, �� � ! 77. FIXED SYSTEM"FINAL `_ i�29.'Insulatiori - r i� � 1i � , � I' � �78� FIRE PREV. FINAL � ' �,-'30. ��Drywall Nailing � ' ' � � � � � � �� � � �Notes:� , . . � ' � :>.�_ . .._ . ' .- - - � -- -- -�-- - • --- -- .._. . � .. -- �� ,'31. _Plaster Bro�Jn Coat � � ! I � �i f1 � � � � I � I � - � ' . -� •. ' ,� _ �� rj.32.,Elecfrical�Power Meter,-Final �� ' ; � � � j � � � , � � ' . � - ' -� ; � ' -: � � � . ' , � . ; � ; . . � . 33. Final Electric j t � � S j � � � � . 34. Final Heating &IAir Conditioniog �; I ' � � ' I ' ` •� � '� � ~ � � ~ 35. Final Gai Pipe=Te'st' � � " : m r'. ; � _ � - ' � � . �,� ; �, . . � � ; _ . : , :J- �' ' O)' M1 I ` � N . 1 ( 1 .. > 1 � � Q 36. HoodorCanopY:� "�r !;� , � � ; `� . ,• � � �7' � �, ` 1• c � � � ' �. 1. 37. Final Fac[ory Fireplacer ': � c� n � � " � _ � ' � ' ' "� � -;'� ' � - � 38. Final Plumbin9 j � ' ' � � � � � P I � ! � I .� , . ' - . -. e. � � i. 39. Water Service-Final; � i � ' � 'i , � � � � ' - � i .. 40. Gas Senrice-Final ' � ' � ' , � � �� � � ' j � � � � � - � I � 41. Solar pornesticFinal � � � ; , ' � 1 _ '_ � � � � � - o -� � i i i � - t - - - --" +-' - - - -- - i i ; � � , � i a , � , v i , � . � 42. Backflow;Preventer, � i .,,� i . - t , i ,, _ . .,-_ - - - -- - � .,�;' �,r' � .�':� ". '�:: i ; � . ,. 43. Backflow Irrigat�ion� ? i � � r,. ` `.� �'-� ; . . � � , � , - .. � 44. Landscape Irr.igation�System � � :1�_ � � �' I. � � � ' ' �--� I i � ' ' ' ' � - r.� = 45. Sound A[tenua4ion � �'- � z � � � i � � - ' � � . _ .' . � � � � . � � i i 46. HandicaP Reguletions ; � T i _ �i �� � 'r ' .'� � ' ' : � - ,-' � • . .. �+ .i . 47. FINAL STRUCTURE & BU,ILDING � � � ! � � � , , � � . � � . . 48. Special Requirements Completed ' i i � i � ; ' � , � , 49. Electric Releaseto Edi'son� � I_ � ' . _ ' _'• ' � ' ' � , � ' - t--'-- - � - - - - 50. Gas Release to Southem California Gas Co � I � i : t ! � • � '' . � � � 51. CERTIFICATE OF,OCCUPANCY '� I�_y ' � � • _ . _ _ _ ._ , � � -: - --� -i - -r- - -� - - . . No. � � , � Date . ' � , - � '-- � : _,_.�..._ - - ---�-----'------ ' -- - .. _. _ _ : , _ _ Appllean} to fill in all spacea e:cept thou wit�in �eavy DorEar Iinas anU sign all aDVrooNate aeelantions. _ _ ._ ___ . _ ,_, , � CITY OF COSTA MESA ' � � � � '� � „ p � , N . TRACT NO. � LOT NO. . B . • i � • ! ' � . )3y4, - G% f B�zi$� _ fI.�7,O�' �TL � CONSTRUCTION P.ERMIT � �4 � � � ; : ' � ,- � ' . . ' . ' I . . . , '' Applicent's Mailing AHdress /'� � ~ TVPE OF CONSTRUCTION-. � NEW ADD ALTERATION REVAIR , • ' � � � , , ' ; ' �' • ' ProjectAddress- ' z "� �V� ' ' _ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � � � - � - ' . ' - ' - � Owne� i Name U �'� �C� ' hone DESCRIPTION OF WORK � - , � . � � ' b - AddIeSS � , , , Ti/PE OF PERMIT GRADING • FOUNDATION STRUCTURAL ' A. P. � ZONE - � . z� Afch/Eng. � LicenSe No. . ❑ TENANT ❑ ELECTRICAL LUMBING ❑ MECHANICAL 'PLNG. REF. � � ' • BUILDING ' - . � ' ' -. AddlBss � ^ - � � ^ , � �O.�OTHEN . ' � . • _ 70 BVILDING - � O S ' ' ' '- PR PE V INE �= REAR VARD (TO P/L)- '- :� Cunfrector's Nam�'q� '��V/77AR+���SX/Ffw���e �Yc/�G� -. PROJECT DESCRIPTION SQ. FT.' ` � OCCUPANGV . ,.. �qo� ✓r_-.o�Ysifiy,� Li� CONSTRUCTIONTVPE VALUATION§ LEFTSIDEVARD RIGHTSIDEYARD . _ Address (meiling) [.4 . , - � � . . rt� . . �-�J��/J�,.� .. � ' ' ' ZON� � � GRADINGCU.VDSr .ACRE� �PKG.SPACEREQ. . � , PROVIDED ' ' Cicenze No. �r cT�`�'r - � CICENSED CONTRACTOR DECWRATION ' Ramarks: � � - � STREET WIDTH � � � ' PARK FEE $ � .k ' I hereby attirm that 1 am II<enietl untler provislons of �Chartar 9(tommencing " . , . � with zectlon 7000� of Dlvlsion 3 of the Buslness antl Professionz COGe, antl , , . ' � SPECIAL CONDITIONS: _ ' - mY Iicense.iz In tull torc an a fect. � � ' ' . . . . ' , �' � � ' Gcense � ass� -�/ I< a6No.• � ' ' PLUMBING • � � ! . � . � � � Date � Signature � , , , _ WORKERS' COMVENSATION DECLARATI N � ' ' ; Be� Sink . SeW2f Cep : I ELECTRICAL � iraby afflrm that I �ave a certlfiwte oi consent to self-insure or a certitifate .- � -. • Automatic WazhEr ___ ' Mete� ❑OVEc 10� amps � Workers' Compensatlon urance,� or a certlflea, copy tnereof (Sactlon Backflow Preventer ' Sewer Conn¢Ction • „a00, ub. CJ: � . , • ' •�� � ; � I Backflow Irrigation ' ' Solar Cullectors . Cbnstruction Pole' ;Suh Panel � PoIICY No. ' C Y � . ' "' " � � . � B Cerqfl opy Is hareby fur . Bethtu6s . i � • $olar Piping . � Cooking Unit �.�� , Sub Pole � eC c DY la [ha tlty B In9 v� �� , , Dishwdsher MotorS �0-1 HP �1X$ e � � .ADulicant � � ' Clarifiers . S�1ar Tenk �•� � • � � � EXEMPTIO FROM WORKERS' C PENSATION DE LARATION ' � -' � - � DryefS ❑Ga5' OElectric ' 'InaSole� 09-15 HP�O1645+ (This sacllon neaE no[ be com0letetl If tha permit is for ona huntlratl (S100j or ; � DiSh�+ashe� 1 ' � Swimming Pool w�Spa - - . { iess). . - • ' • � � • I ; � • . ' � i � � Fa`n. � �' � t Microwave i I tarti/y Iha[ In�t�e per/ormance ot the work for�which this pe it is Issuatl 'I , ' Drinking Fountains . Urinal � � snall'not employany person In any ma Per o as tq/ suDiect tn tf�e; . - . � F:A.U. , /� ' � �Pole'Light • Workars' CompM w�1p�p uws of Caufo e.� y , ? � Floor Oreins Water�Closet� �p � + • ' � � Date 'S' ' /A_'Y C Signature ^ � � _ Fixtufe5,' � � ' NOTICE: If, aftermakin9 this tlaclaratlon, you'shoul becoma'sub�ect to t�e ` FIOor SinkS �' • -- - ' � ( ' Wat2� Heat2�, - �. ' "a' - - - -� �- - Renga ... - _ - .._ _ _ _ . _ _ � Workers• Compenzatlon provlsioni of the Labor COOe,�you�mu5t.forthwiN. � � Devic2 BoxEs , � ' ' comply �with'such prodsions or.this "permit;shatl be deematl revoketl. , ;;/ GesSeryice�• / 'Outlets's �•WatecSer'vice . • . . � Sign . CONSTRUCTION LENDINC AGENCV ' ' ' ' ' OUtlets � � ' ' ' � 1 �ere�y afiirm tnat t�era is a ConStrutUon IenCing a9anty tor t�e.parformanta InterCCDtUfs .- . . �.' - .• � ' ' __ Stending S2CtiOnS . ' ' followin9 reason'(Sactlon-7031[5 Business antl Protessional�Cotle: Any dty or Y�irap ` • � tounty which reqWres a permit to construct, al[er, improve, tlemolish or repalr - - .. �any structure, prlor to Its Issuance, also raquires lhe applicant tor su<h parmit ROof�D�eins �'� ' � ' ,�to flle a siqnatl statement;that ne/sne Is IlcenSetl purzuant to tne.provisions of ' _ t0e Contractor's Ucensa Law'(Chaptar 9(commencing,with SactlonJ000) oi ' . . r'�-:�On'3'Of [he�Buslne55 Entl ProTe55Ion5 Cotle) of that he/she Is exampt � ,$hOWCfS R � � �rom anC the ba5I5 b� jhe allege0 exempUon. My vlolaUon ot Se<Non - .. .' 5 by any aDP����t for.a permit subjectsithe zpplicant to a�civll - ' ' ��Ity of not more than 1Iv8 hunaretl tloliars (E5oo): , ' Service Sink I,�as owner oP lha Oroparty�ortmy employees�with,wa9es�as thelr sote � 1 � compensatlon will tlo [ne work, antl tha structura�is not intentletl or otferatl � •�, �-��� . I �_ �(or sale (Sac4lon 7044, Business� antl i Protesslonal Cotle: � The� Contractor•s � , �y . � License Law tloes nol apply to�an uwner of a property who builtl3 or Improve5 Bollef. � � thereon,'antl who'tlaeslsuch wO�k hlmself/he�i0lf o� tnrough h15 ot he� Own I 1 �• '- • � employees, provltletl that such`Improvements are not Intended or oTTemtl Tor � -' Dutt - UndecGfOund � ! sale. II howeveq the bulltling or Improvement I5 soltl wlthin one�year'of com- � , ' pbtion, the owner will have the bur0en of proving he/she tlid not �uiltl or Im- I �rove for the purpose a( sale). � � � ,- � � � � �� Duct - Structur2l �' ' I, as�owne� 01 the property, am exclusivety <ontratting;with111cense0 con- � .; '_tractorsto.construct the D�o)ect(SectlonJ044,.Bu5inessanE Ro/e551on5.Cotla: � _ Duct- V2ntilating _, � .� _ _� ._ - The Contractor'S Citansa Law does nOt applY to a� owne� of property who � . � EuilCs or improves t�ereon, and who contra<ts for such projects with a con- j EzheuSt System ❑ Multiple ❑ � tra<tor(s) Iicense pursuant to lha Contractor•s License Law): � • � ❑ 5�am exempt unGer Sectlon � � � - 8, & P, C. f0� [hls reaSon � � Fiiepl/Fact Blt. IC80-;I� � - � i � � : 1 ' � . . 'Data � � � �'owneri ' ' � � � � .� i Heating'System&Ducting� - I'hereby� cartity-thai�l,have•reaA'SM1is'appllwtlon�anC's[ate�tfiat the'aGove • '-�'�a100;000'BTU'�100,0008T . In/ormatlon IS correct. I agrea lo comp�y with all city antl county ortlinances � ' i ' i � antl state laws ralating�to GuIIGi rtstruction„an0 nereby authorize repre- � Hood of Type I ❑. ' sentatives of t cl y to e! pon the ove-mantlonetl property for � �gn0 ..T � e II ❑; 1 � InsDettlon pu � s I p - I ' Signature �C ,/ • 1 Date - ��O � � � ' � Drimrs' Utensa or55 � 1 t Registers S i . CMF 0865-06 rev. 12/82 White - BuilGing: Gnary - Appliwnt; Pink - Actounting; Goltlenrotl - Azsesior < - ,� , - . . • r Transformer 015-50KW � ' ' . � ' � _ � �� . � ! . I i � � � ReinsPection�Fee' $15 � � ❑5U+KW, � �ReinspectionFee � $15'' • Meter ❑u to t00em s � � � � I ; � . - P P ' .laue Fee: ' $ 3 � � laue Fee „� , S 3 Zoning APProved By � � � ' ' Date � � i t � JICAL , ! , ' ApPlimtibn ApProred BY ' ' � � Date ' � � � 'rigeration System � . ; A ' � � � �i , � � ' �� � • . ppli'ation laued By ; • � Date __�_.� � 1,100,OOOBTU ❑100,0008TU . , : , � i . � � � � ' SUMMARV OF FEES �} � � � ' � � � tem Repair/Alteiation �BUILDING PERMIT $ � ' � � SMIP f � $ � I 1 ( , ..�_.�.�,- � _ � ' i .PLAN CHECK 7 $ ' I I ' PERMtT • . .� ' . - � $ �- ; ' ISSUANCE � ; $ ; � . I ;PLUMBING • i � � , •PLAN CHECK� j $� . GRADING � ; S� � � - � , � � ,ELECTRICAL � � $ ' .i ( � ' $ . � ' ' - .PLAN CHECK $ � � MICROFILM ' E i ' �_..f.�'i -��—�i i � � � I TOTAL'FEE� .� $ � ' ` �MECHANICAL $ � : Reinspection Fee' I 515 IPLAN CHECK� $ � I � � LESS ^ ' � j � � � � , , - , ADVANCEDPC • $ �� � � � � 1 � . Isue Fee E 3 J i i � ' . ; FINAL FEE( '$ � ADP�Iwnt ta fill in all ipaeas eztapt t�ON Wit�in heavy EorCar IIneS anE sign all apO�oDriate EaclantiOns. CITY OF COSTA MESA CONSTRUCTfbN PERMIT Applicant's Meiling Address 1 �� (y� Project Addrese �< < � � , � Ownm's Name � �'�'�� � �� ���} ohone � Address' /`�u� � �/ S� �Q � �(•�� ArchlEng. �Tc--�C- 1'�'�a �-Oi Licenm No. � "' Address —Ca��.�—ie....�- ( ...,�c.. '�/' � e� p.J � Contractor'sName� � � d f—� �� Phone �� 33�j Addrezs (mailing) /•.� 7 � ��a • �� License No. ��� 3G / 2 LY � � LICENSED CONTNACTOR DECIARATION � - I hereby alfirm Ihat 1 am IlcanseG untlar provlilons of Ghartar 9(commencing ' wlth sectlon 7000) of Dlvlsion 3 of tne Business antl Vrofessions CoAe, antl : my 11<Bnse Is In lull lOfGa anC e11B<t. , ' , LJcensa class � cenTe �� � � � oate '�'� �3 p35ignature' � WORKERS' COMPENSATION DECLARATION ' � ;'�qraby aitlrm that 1 have a certlficata o! consent to self-insu�e or a certlfiwte �'�:Workers' Compensatlon Insurance, or a tertliletl'copy thareof (Section '. ��CIO. Lab. CJ// ���' p ' .,� f' t...� �� Po11cY No. _LC^L� ComPanY :r�-a i r Nv.�. �� ��iy.�,ertHletl copy Is hareby turnishetl. LJ Certliletl copy I5 tllatl with the cltY Builtling Division. Date Applicant � EXEMGTION FROM WORKERS' COMPENSATION DECLARATION (This sectlon neetl not bo completetl If tM10 Dermit Is for.one huntlreG ($300) or Iess): • � ' � 1 Certlry'tM1at in the per/OrTanGa Of th0 wOrk fOr Whlc� this p¢rmR is issuetl I' snall�not employ any Oersan in any manner so as to becoma sub7ect to t{�e • Workars'-Compensatlon laws of Call7ornla. Date � ' Signatura ' � • i NOTICE: If,�a7ter making this tleclaratlon, you shoultl become sub�ect to the Workars' ComDensatlon Drodslons.oi lhe Labor Cotla, you.must.forthwi[h comD�Y w�t�� suc� provlsions or t�is permlt s�all be OeemaC revokeA. ' ,CONSTRUCTION IENDING AGENCV - ' ' I hereby afflrm that thera is a constructlomlentling agency tor tha erforman<e. � � ot the work for wbicn t�ls• oermit Is issuetl _(SecUon 30�7. Civ. C:)' lenEer•s Name l2�EBl'S Atltlf855 OWNER BUILDER OECLARATION � ' � � � ' I hereGy affirm that 1 am exampt irom tne'Controctor's Llcense l�w foi the- tollowing reason (Sectlon 7031.5 Businezs antl Professlonal Cotle: Any city or � county whic� requlres a permit to con5trutt, alter ImOrova, tlemolish.or reDair any structure, prlor to its issuance, also requires t{�e'applicant tor such parmit to tile a signe0 statament tnat ne/she Is Iicensatl pursuant to the orovisions of the Contractor's Ucense Lnw (ChaOte� 9(commencin9 with Section 7000) oi � D�^'�lon 3 of the Businaw an0' Professions COEe) or that he/she is exempt _ 'rom anE lhe basis for the allegeC exemptlon: Any. vlolation oT Sectlon 5 Dy any aDP��cant for a Dermit "SUDJacti the appliwnt to a civil - .� _�ty of not maro than five �unUreC tlollars (E500). - I, as ownar oi' the proparty or my amv�oyeas �with wages as Iheir z'ole comoenzation' wlll ao tna woik, antl tne structure is not intentletl or ofierea for sale'(Sac4lon ]044, Buzinoss anC Vrotessional Gotle: The.Contractor'S � - License Law tloes no[ apply to an owner ot a property who builtls or improves ' therGOn, antl w110 tloe5 Sut� w0/k hiTsolf/he�self o� th�0ugh hI5 0� he� own . employ ea5, p�avlCatl t�at such Imp�ovament5 dra�not Intantletl o� oft¢re0 tOr � ' sale. If, nowavar, the bulltlin9 or Improvement Is soltl within one year of com- pletion, the ownar wlll have tne burtlen of proving he/sha tlitl not bu110 or im- . �rove for the purpose of sale). ' I, as owner ot th¢ properly, am exclusively contracting'wtth Ilcensetl con- � tractorsto construct.the Droject (Section 7044, Business antl Rofes5lonz.COUe: The Contractor's Licenso Law does not apP�Y to an owner of D�operty who bulltlt or ImD�a�es thereon, antl who contracts /or such Drojects wlth a con- tractor(s)Iicensa pursuant to the Contra<lor'S Llcense Law). - ❑ lem eaemv� untler 5actlon � B. 6 P. C. for this reason Date � Owner I heraby certify that 1•hava reatl thls applicatlon antl state that Ihe above . Information is correct. 1 a9rea to comply with all city-antl <ounty ortlinances antl�state laws relatlng to builtlin9 �onstructlon, antl hereby authorize repre- sentatives of t�ii dty to enter!upon the above-mentloneG Oroperty for . �InsOectlon purpo,5es. � / , / � signaturo AX 'C, L3 t.�/c�G:-�p✓�_ oaca ��i-�<3 �Y3 Flo ��lp � - TVPE OP CONSTRUCTION Nt ❑ CONVERSION O DEMOLISH DESCRIPTION OF WORK J ADD U ALTERATION LJ REPAIR OTHER' TYPE OF PERMIT LI GRAOING U FOUNDATION LJ STRUCTURAL • ❑ TENANT � ELECTRICAL ❑ PLVMBING ❑ MECHANICAL ❑ �OTHER PROJECT DESCRIPTION SQ.FT.� occUaaNcv �CONSTRUGTION TVPF - VALUATION$� ' ZONE GRADINGCU.VDS. - ACRF� Ramarks: Sink Preventer Irrigetian Drinking Fountains � Flaar Drains� � � Floor Sinks � � � � Gas Service OuNets InterCeptors Kitchen Sink " Lavatories; - Raof D�ains Showers � � � � � Service Sink � " �oner _ Duct - Under Ground Duct-Structural � Duct - Ventileting Exheust System ❑ Multi Firepl/Fatt. Blt. ICBO dh Heating System & Ducting ❑a100,000 BTU �100,C Hood or Type 1 ❑ �, Dnvers' License or 55 5¢ �- � � I I Registers CMF 0865-46 rev. 12/82 Whita - BUIltling; Canary - AOP���ant; Pink - Accountin9; Goltlenrotl - Assessor Sewer Gonnectlon� �- So181 Collecrofs � , Soler Piping ' ' So1ar Tank i � Swimming Pool w/Spa ; Weter ClOzet Water Heeter� ' � Water Service � � � ' Reinspection Fea � laue Fee . • IANICAL ' Refrigeretion System ❑aiooAoos4u �ioo,000sru $15 $ 3 a � Reinspection Fea $15 . Issue Fee $ 3 PLNG.REF.qW LEFT SIDE YARD PKG.SPACE REQ. STREET WIDTH Washer Unit Dryers ❑Gas Fan F.A.U. Fiztures Device Boxes 7177 4/14/93 ZONING HEGULATIONS 20NE � . � � BUILDING - �Berr r/L ST REAR YARD (TO P/U RIGHTSIDE VARD ' PROVIDED ,� � PARK FEE $ 0 ���ie�-. Tl :Meter LJover100amps . . � -- Sub Panel S — Sub Pole � - � ,� .Momrs OO-1 HP ❑1%E � ! , Inc.Solar �9-15HP �16-15+ � IMicrowave �. ; _ �• Pole Light � , Range _ � � _. s�e� � / 3 StandingSections . ! �j � 2 Switcnes Trash Compactor Garbage Disposal ' . Generacor OO-5 KW �5-15 KW ' - Transformer �15�50 KW � ❑5U+KWi ' peinspecti Meter up to 100 amps ' Issue Fee Zoning ApProved BY Date Applintion Approved By \�[�7 �ate Application Issued By —J � �� , ,Date BUILDING PERMIT PLAN CHECK' PLUMBING P�AN CHECK ' ELECTRICAL PLAN CHECK� MECHANICAL PLAN CHECK OF FEES � SMIP � PERMIT ISSUANCE , GRADING � MICROFILM TOTALjFEE LESS , ADVANCED PC FINAL FEE nf;. . ____ . r i' t... n - -_ t ' . __c- FOOLP °A •-r • - �' - �: CONSTRUGTION,AND.PLANNING i i ' �:� o -� ' �� - �� ' n ^ = i '.;Date '' Inspector -p � ' ' J ' - ' -� Date � Inspector . > > .;_APPROVALS ,` PermiC#=�' � � - APPROVALS � - �Bern... # ��- � •, .. m a� ;; o. . � _ ` � � �,� _ . . - - - v ' `; �1.. TemRorary Electrical Service or�Pole ' " � - � `-�; ' ."52.' Pool & �Eguipment�Location . � ` � � ' - � F2! �Soil Pipe-Undrgrnd: .`� � r - ° I - ' = ' :i� ._ ° -. . �53' Steel Reinforcement � � • � - . _ , - - r31 Electrical Conduit Utiliiv-Undrgrnd! . `= �� � .54:' Forms - � -- _ " =- ' -� � - �'� 4'. Electrical Conduif-Undr, md� - : .: ✓� � � - � 'c+_ � ' - ' .� , � � � g , -ysjf3 �,;'C;t;,, 155: Electrical Bondin9 : - , , � '._ ' ." : . - ' � . ' _ - 5. Steel Reinforcemenf � ' . � � �= ,: i� � - - ' `'•` _ 56. Rough Pluinbing�& Pressure Test � � '. � R'' "'� `. y 57., APP;ROVAL TO..COVER-GUNITE 6� IElec[iical UFER Grnd.;- ! w� . o�- - , 7. Footings � ' ! � , u �-� , I ' � ; � � U :_ :58.� Electrical:�pnduit-Und_rar�d. � _,. -' ; � , . '. i .�;- . . �. - �_ - -: '- . �. 8. Founiiation � � � � ' ° i '�59 Gas�,Pipe,-O=Undrgrnd.; Test ` � � . � - 9. Water Pipe-Undrgrnd. i � .+ c �' y �, �4 ? ! 60. Backwash Lines, P-Trap,;O Undrgrnd. �. =�'• 10. Structu�al Floor Sysiem - � � - � �` � �'� � , 61. APPROVALTO.DECK � ,, - � J ` 11. Property Sewei Line &�House Connection - c� ° ' ' - ' ' - i , - i ' ,62. Backwash &� Receptor-Final_ _ 72. Sewer Cap � • ; j , I � � . ` �"63. Heater & Vent-Final'. - " _ � 13. Roof�Drain's � j � � �� � � _ - , �. 64. Plumbin9 System,- Final'' . - � ' � 74. ,Rough Plumbing � � ' i =� � ' % - `65. Electrical-Final � '"�� � ' - '- ,. : ; � 15` RougFfEleGtrical-Conduit�i"'T'^- �-- - T�'- ---- - - �' - -.-`--� - - ---. ._. . �.. � � � �, , � 66. SolarSystem-Final` ,. r � �16. ;Rou h-Elec[ric Wirin - � � '6'-- -r - ' ' �- ' - -' - - � . � w. �r� 9 - ; n, .� .> 9� '" , ` + I! ` ' ts'z � i'C ' - i J67. Fencing &�Access APP�oval � . . . r '1 - 17. �Aough`.Wiring_$ijn;? ; ` . " ��" � -. ( �'' ' = � ' . 68. APPfiOVED FOR'PLASTERING ' � � >I� _ � = ii 18. �Rough`-Electrical'T:Bar..Ceiling! � � � i � I - � � �'-' � �c �� �69. POOUSPA SYSTEMS FINAL � � � 19..Rough.Heating&'Air�Conditionin9 ' � : � � ' � � : FIREDEPT.:REQUIREMEN7, � - � �. . i �` 20. jRough,Facto'ry, Fireplace . � � � � � � 1 ��' � APPRO�VALS� PeFmit# � . . � �. . � . . . . . ' ; - . � � 21. D�uct's, in Sfructure�; ; � �� � � � � ; � , 70. Undeiground Hydro ����,22.'�Ducts, Ven2ilaiing '' �; i �� �' � ' I � �71.� Product Piping �Gas OOiI � t _ �;23. ,Gas�Pipe-Rough & Test `; f . �r � T �l �'� _' ; �- I^r ; 7Q, Under round Flush �' � � � �� i � ��� � I 1 i I I � ,9 I � . . . , ,._ ° 24. �Roof FFaming, � � �� � � �, ' ; I � . � . I _ I -. i .. '7_3.: Undergrnd. Storage Tank O Gas ❑ Oil - � � 25.�Roof Sheathing � � �^ `� � ��, i �.. � . f ;: I _ � ' 74.� Overhead. Hydro � - �_ ' � r � -i� -, � . - . .r . ". .. , - 26. T-Bar Ceiling (Structural) & Mono�coat' � � _�. � � � �� �.; � �` � ' 75.; Dry Chemical � ��, � ' � ' � • .� 7. �Frame and �Flashin � ! � " " • ' � ' � _2 9' ? � �� � i.: " � , � ; �76.� Dry Stanilpipe � - , . � � ,', � 28.',L'athing & Siding; � � I� � i' ;� 1 4 � I�; j � 77. FIXED SYSTEM'FINAL � � . � . _ �� 29 �I�sulation � = ; ;, `� � , '� ' � ! �78, FIRE PREV. FINAL ., . - „ ' � i ".'30. jDrywall Nailing � �� � ` � 1 �� i, i j , � i '. � �Notes:! � . . , ° .�31. Plaster Brown Coat f � ! i �� -� �...�. � � _ �..-- -� � �--� �--�- � - � - - - -. -- � �� - � i - i i � . . . � � - t � - � - � � . _ ' 32: 'Electrical Power Meter=Final �� � � + , � . - ' '� . ' ' � - � :; j�33. ,Fin�l Electric • � � � _', � i� l ' � . . � � 34. Final Heating &�Air. Conditioning �, �/ �- � � � � � ' - �+ ' _ ' - - T 35.FinaIGaSP;pe-Tesf'�i..�r�' � :.I �� '�,4�' �" =�-_� , �, . _ , - - - -_ 36. Hood or �CanopY - - .+' � � I . � � y I . � - � , � � � . � - _ � . . . ' -' ' ' _ � 37. Final Fac'tory Fiiaplace" � - �;j ��' i � '' � ' � '- i ' � 1 • . , . '' , � . , . , ' _ ' , , _ 36. Final Plu�mbi'ng f ' � � � ' �' t " T ' I ' � � � i � ! t.'. �- - . � • i � � .:� i . � r ; . 1 , � i . . 39. Water Se'rvice-Final' � � � �, ;, . � �� 40. Gas Se�vice-Final � � '� I ( , � , � � ' ; � � � , • 41. Solar D'omestirFinal � � � i ' _ � _'_ � ' =_ �._ ___ . . � ,, � � -'i, � 42. Backflow Preventer� ,. � ' _ 1__ '_ � ' �m_ n� _i. - -- '- - _ -. . 43. Backflow' Iriigafion - � + ' _ ' � � ' � �. � �.., � i i : �. � f _... . 1''' � 1 � ' �' �I�'�� :� �' � F�;1 44. Landscape Ir,rig�tion;System � i' . � ! �: - : i , .' , ' , . - - - 45. Sound��Attenuatiori �'.; , � � � ��. ' `' � , �. ' � � • .. �, - , . , �� • I' � I . �� I� I �'i l � 1�` i � � _ � � 46. HandicaP Regu�etions �'. I ,r � I ' - �". ; ' i ' � � � � ' � ! � , . ' , � � � '. , 47. FINALSTRUCTURE & BUILDING . �' I I � - � � � , � � .. . � i � I`.,I i; � i' i� � 48. Special Requirements Completed �� ' j i . � . � , r , , �� � i i i i I 49. Electrie Release�to Edison;� � � '' � _�--!-' --�- ' �-- -.�-,. ---� `Y-_.i.- ' � i r � r 50. Gas Release to Southern California Gas Co ; � � � . � � � � ' w � � i � � ..� � � . 51. CERTI,FICATE OF'OCCUPANCY � ___�i_^ ' :'_ �. _ L ..,__,_� �" _. � -�-- : � No. � � � i Date � ' ' � ' ' y 1 + , � i _.y-. -. AG . • CITY OF COSTA MESA ' � ' _ � CONSTRUCT,ION PERMIT '; ` " - ApPliwnYsMailingAddress _ _ �_. _ ^..� ,.. _ ,.V ^ . Project Addrese . � Ownar e� Name ACdress �� Arch/Eng. _ Addrezs _ Contracto�'s Nert AAdrezs (mailing) Licenm No. _ LICENSED CON' I hereby affirm ti with sectlon 700 In ful enm No. ' , �d'iC.(3 6 ' TOR DECLARATION � im Ilcensetl untler D�ovlilons of Chartar.9 (commencing Dlvision 3 oT the Busineu anE Vrofesslons COCe, antl e antl aTfect. ' � . �3�6 ' LICeQSa No c�ana�, �/� (,Y�'J � ATION DEC RATION � `eraDy aTlirm lhat 1..11ave a CertlfiW[e b/ con5ent to Selt-Iniure or a certlilwte� . Workers' �C)om�pqensatlon Insurance,�o� a certlfletl�cop/y thaieoi (Sactlon � J0� Ldb. `✓P 6J ��%�� i 'L.lili,i'��GLi . Policy No. COmpany �Certlfletl copy Is heraby furnlihatl. 9�y�'� ' '�ry,r -�/� � Ce,t(}IeC;°py �s ���ed w��h �he ���YKG'rr(SOY;S�o/NV "f�/�/� ' Oate �S 't K� ADO���anl EXEMPTION FROM WORKERS'�COMPENSATION O LARATION � 1 ss)55e<tlon neetl not De com0letatl if the p,rmlt Is for one huntlietl (5300) or � I<ertity�that In Ne perfotmance of the work for.wM1ic� [�le permit Is�issuetl 1 shalP not employ any parson In any manner so;as to bacoma sub7ect. to tRe Wo�kers' ComDensatlon'Laws of Califomla.. . � • � , Oate' Signature NOTICE:��If; aiter makin9 Mis'Geciaratlon,-you�shouttl-Gecome sub7ect to tne ' Workers' Compensatlon provlsions of the Labor Cotla, you•must forthwith � compry 'with' Suth O�oviilon5,-ior t�is ,Oermit'Shall be tleemeQ revoke0i. CONSTRUCTION'LENDING AGENCV'� 'i . � j ' I nereby aHirm tnat there Is a constructlon �entling agency forthe performance� o! the iwork for which this parmit -is � iuuetl .(Section 309] Civ. C.;; LenEe�'s Nama�� � ' uocers aaa�ess � • • � � � � � OWNER BUILDER DECLARATION � �' � � ?' � y ' ' ' ' - I hereby aftirm t�at I am enempLfrom tbe�Contractor'S Licensa Law Tor tha ant to fill In all spitn e:cept thom wlthin heavy GorUer Ilms anA sign_all appraorlate Geel: PERMIT NO. - TRACT NO. '• -LOT NO._ � • B D , /'�1=733 �7 .� � . � �� TVPEOFCONSTHUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMO�,�L,I�S,H`'�� OTHER � �' �DESGRIPTION OF WORK ���Y , � Q �+ � � TVPEOFPERMIT ORADING- FOUNDATION STRUGTVRAL ❑ TENANT ❑ ELECTRICAL ;O PLUMBING � MECHANICAL . • O,4THER � � ' ' - � PROJECT DESCqIPTION, 50. FT.� — OCCUPANGv � CONSTRVGTIONTVPF � VALUATION$ • ZON€ GRADING CU. VDS. ACRES � � Remarkf: . ' � � / ^ f R'g � _ . ' . Sink - ' � ' �� � Sewer CaP : � Solar Piping . � ' : _ Solar Tank , king Fountalns ' � Urinal � � � irD�ains ' � Water�Goser ' ' rtSinks � - - • 7 - WaterHeater, -:- � --� - � -�- - - Service � Outlets � WatecService � � ', rceptors ' C _ ' � ' C' � � ' � � hen Sink: — . � _ , _ ,�, • � . ' tollowing reason'(Se<tlon"7031:5 Business antl Professlonal.Cotle: Any city or - - P—T�ap ' �:county which requiros a Dermit4o construct, alter Ilnprove, tlemolish or,repalr ' .. . any struttur0; prior lo Its'luuanta, also requlres t�8�aD0��<ant for Suth parmit , Roof Dfeins, � � to iile a signaE itatament that he/she Is Ilcensatl pursuant to theiprovisions of -' - the COntrattor'S LJtenze Law�(Chaptef 9(tommeoting'withi5ettion.]000) o( t r- i'� � , �_ . qS�Rion 3 01 the �Bu51ne55 anC Prote55ion5 Cotlej or that he/she 15�examDt ShowCfS . ��'�;fom and the� basls /or the allagetl exemptlon. My violatlod ot SecHon -,._ ..e '`5 by -any appliwnt Tor'a � permlt sub7eet5 tha -applieant to' a- eivll � Service Sink � � ;'��y of not more than live hunOroO tlollars (E500). �' -. � i' i� � � I, `as ownor of tne iproperty 'or my 6mployeas with wages:az their sole , 'i compensation wlll tlo lhe work, an0� Ihe structu�a Is not Intentl¢C o� otte�etl .' , � tor sa)e (5edion 7oaa, ausiness ana � Proteulonai coae: � The. eontractor•s � . � Llcense Law Coes not applY �o'an'owner of a property who bullAi or impmvas ; � goiler' �" �� '. tnereon,.antl who.tloessuch work himielf/herself or tnrough his or her own , ' ; employ ees, provitlee tnat sucn Improvements are•not Intendetl or olferetl tor � Duct -'Under Ground ' ; sale. If, �owever, the GUIltling or improvement I5 solG wlthin one year of com- ' � platlon, tne owner will have the burtlen of proving he/she tlIE not builtl or Im- � � '� rova ror the purposa oi u�e). 1 ; ��- 1 � � � � Duct - Structurel I, as owner of the pioperty, am exclusively contracting.with�licensetl con- � � � _t�acto�sto const�u[t Ihe�p�o7ect (Section 7o44,.Businesz antl arotessionz eoHe:_ ..� Duct -.Ventileting .:.��. ' T�e Contractor'z License Law tloes not apply to an owner of praperty who • I builtlz or improves thereon, antl who contracts tor suc� pro�ects with a con- � Eahaust System ❑ Multipl� ' Iractor(s)Ilcense pursuant to the Contraclor's Licanse lzw): . � - ' � Cam exempt untler Sectlon � � B. & P. C. for thls reason � � Fi�epl/FaCt. Blt. ICBO � I � Date � � � ' Owner� - ' � ' � ' ' Heating System & Ducting � ' I�hefeby Certi/y tlla[ Ghave'reaE'thls applicatlon'antl-state`ttiat �the'above-� J' �aioo;000'eru Oioo;oa ; informatlon is correct. I agree to comply wlth all tliy,antl county ortlinances ' � �� antl itata laws relating to builtllnp con5truction, anG hereby authorize repre- f ; Hood Or T e I ❑ . 5BOt2tIv85 Otithls'City to entel up00 thG dbOva-TaOBonotl pfopGr y 1DI YP 1 � '� InspecUon oufggg oseS. � \� � 1 � � ; ' Cano . T ' e II ❑t ' y 519ri5ture�QLA <--iNi11QVY�� ' oate ' . 1 " i �Drlv0�5'Llcen50 r 5g{5 '��� ��-�� � � Registers � � CMF 0865-06 rev. 12/82 White - Builtling: Canary - APplicant; Pink - Ac<ountin9: Goltlenro0 - AsseSsor , ,. , � - Y _ .. � ' = f '' � ' , . Reinspaction.Fee' ; �' ; � Issue Fee �' - MECHANICAL � � � Refrigeration System � ❑o-ioo,000sTu ❑�oo.000 � ; : ;.�� � i � i � Reinspection ' . Issiie Fee 515 S 3 n 3 ns.. . , � • � , _ 96�1 I � 5/3T%d3; ' �;� �y.U�t. TL -. - . � � ' , ' - / • �' � - • ' � .. . , . _ � . PLNG. REF. qW' TO BUILDING PROPERTV LINE LEFTSIDE VARD PKG.SPACE�RE4. STREET WIDTN , BUILDING GFTGIf!`Y I`� REAR YARD (701 RIGHTSIDE VARI PROVIDED � � PARK AutomaticWazher - .�Meter.LJover.100amps'..-...; Conitruction Pole i , Sub Panel � � Cooking Unit � , Sub Pole , � " � Dishwasher ' � ,Motors OO-1 HP ❑1'/:$ Dryers ❑Gas ❑Electric �� t InaSolar �9-15 HP �i6-15� Fa� ' . -M. , ' . icrowave � ; � � ' Pole Light � ' l 's __ . . . _ _ _ .Renge . _ . .� _ � � .Y -I Boxes �. s;��' ' ; Stantl ing Sections I swncnes � Trash Compactor � 1 Garbage Disposal . � � ! . � • ' ' Generator 00�5 KW �5-75 KW ' � Transformer ��5-SOKW • � i 1 ❑5U+KW. � � peinspeMionFea � ,� f15 � Meter ❑up to 100empi � ,Isue Fee ' � . �$ 3 � Zonin9 APProved BY � ' Date ' • Appliption Approved By � ate ' � � � _� � f `�' � Appl'ration Isued BY p J � � Date � T-� �� %�� � i � , ; ' SUMMARV OF FEES � � � � , , BUILDING PERMIT $ � � SMIP � ; $ ' i •PLAN CHECK� � $ ' " - PERMIT � ; ; � � ,PLUMBING ' $ � � � ISSUANCE ; : $ ` 1� i 1 ,PLAN CHECK� � $ � � i i GRADING 1 � $ ' ' ELECTRICAL $ � ' � , ' '� � t 1 1 !PIAN CHECK� � $ - � � MICROFILM � $ � � I � ; TOTALiFEEi I $ � ' IMECHANICAL $ ��'1�C1 � �PIAN CHECK� ' $� .�i_�— � qDVANCED PC t $ � n' ' ? � , , i , � , FINAL FEE � i $ , 7.�00 i -- � . � - - - � - POOC F- "4A y _ - - -- --- � `� ��CONSTRUC;fION�AND;PL?ANNING� � -- � -- i � - � �: , . ; . ' - - `�� _� ` ;; _' r i � � i " � J7 Aate - ,Inspector ` ;, „ , ��, Da[e - �Ins,ector - � � �APPROVALS T PermiY#� , _ c . . � � APPROVALS Pen�...;#"., p , n: � r .� i �'1. >o - - - � � • '� �t� Temporary�Electrical Service or,Pole �+: � '• `' � � c' ;'r' , ;(52? Pool &�Equipment Location� � � ' _ �_` c �• � � .; [�G'^1- e �- n. �' ��- ..F i ��' w 2i �Soil Pipe-Undrgrrid � s �' ' , �; = � �" a� '�53,Steel Reinforcement � � �`_ ' c-t_ i c i � � � .��` i_ = n >�-. ' � 31 Electrical Conduit Utilitv-Undrgrnd. . r, � - % , � ' '.: � �� •54 Forms c - . - _ - � � ' _ ' ` - �v' �•� k � 9: Electrical Conduit-Undr rnd? Eu - i .. �. '' �_. .�%-< , � , � -� �. �" �`�' _ . ,� � ,g _ _ r = > �. � � � . � 55 : Electrical Bonding. , , , 5: Steel �Reinforcemenf , -� ��' ` = � � _ - �� - � 56,. Rou ti Plumbin & Pressure Test • ' � `1 , , i � a , e - ' <. �: n:_ � 9 9. ,. . 6: Electrical UFER Grnd., , a � '�;=�� � ' 1 �; `=' 57; APPROVAL TO;COVER-GUNITE - i � � � _ 7. Foot�ngs j ' � � = o'' � _ ., _ � �, ;t: .�58'�.Electrical'Cqnduit-Undram'r1. � �� � 8. Foundation � : � ; , � � . ? � : r - . ' 59. Gas Pipe; �'Undr'g'rnd Test � - ' ' - =, 9. Water� Pipe-Undrgrnd.� I o � ; I • � � ' ' - _ � ;'60. Backwash��Lines, P-Trap, �'Undigmd. - _ - � -� .� � � � ' � � � �61. APPROVAL".TO_DECK � � �' 10. Struciu�al Floor Sy,stem � � . � � - � � � � _ � 11. Property Sewer Line & House Connection� z: �' _. _ � � i � .� � _ � 62. Backwash & Receptor-Final.- � ` `, 12. Sewer Cap-I � � , I '� � - � o' ' : ` 63. Heater'&�Vent-Final �':•' - _ 13. Roof�Drains ; ' � ` � < ' `� �� 64. Plumbing'System •�Final .. - - � --' � � , � � > d 14. Rough Plumbing � . , ' a�� i ' ' ^ - ! ' 65. Electrical-Final' � �- - ����' � � � ` - � ' e ='�15.-Rough-Electrical=Conduit-^-�"�',--' 'T""-- -•�� - , - .- 's �'.r I ,. I � i i � � i � 66.i Solar SYstein-Firial� ,�- . ' - ' '--- - --- , �� � , ° �� z � '.-1"--.- ' � _ , o ;,=16. ,R'ough; Eleciric, Winng, r I � i, -�: � ; I ;; � �.. �-: � c � o i ., � 6T..� Fencing &%Access Approyal � . -, ' . - . _ r . � i ' � - _17. RoughiWiring Sign;_' � � ! . � 'N � ' � � � � �',!. `�; 68. APP.ROVED FOR PLP,STERING ' ' ' , �' r ' ' 16.'tiRough Elect�ical-T,Bai °iling� � i � _ � � � � � � ; : =' ' �69.� POOUSPA SYSTEMS FINAL �. � ' ' '� � � ^, 19. Rough4Heating & Air Cond,itioning � � '%S �� � i FIRE DEPT,.REQUIREMENT _ ' � � � . _, t i � j 20. �Rough Pactory Fireplace� ��• �, . � . i � � 1' APPROVALS� Permit# � , i,; �; �� 21. �D�ucts,iin St�ucture' ' i ti . ' � � ' � � � � 70.� Urideiground Hydro � ' - � � � Ci •1 J I L.. � ' r��22. Duc[s,:Ven4ilaiing T�❑ � � ': ' , � : i i � � 71,' product Piping O Gas ❑ Oil ' � � : . - . � , ._ . � . , . . � � � �_ �- - � - �- -' -� - - -- - - -- � --' -' - -- - � ay23. G&s�Pipe-Rough & Test �� � , �� i � i r� I qp•' Underground Flush � ' i I � � � �•.-�24. ,�Roof Framing' , � " I � ��"r., �;^, I ' � � , �� i � �" ' = i �; ,. �3.� Uridergmd. Storage Tank�,O Gas ❑ Oil � . ' ' G '�, 25. Roof, Sheathing � . ' ; � I � ^ ; > � � o _� � .- �. � - �74.� OverNead Hydro , - �- , - ' , . ' ��-26. T_Bai Ceiling (Sauc4ural),, &�Monocoat-' � � � ; � ` � ' �; � � � � - 75. Dry Chemical � � . � ' � , - � E � 27. Frame and Flashing' �' � � I �� � 1 - � ' I f ` i � I �76.� Dr�y Standpipe � � . - ; � : i � � ' � �i 26. �Lathing &�Siding � � o � f � �, � � � � I �,: � f I 77.�. FIXED SY$TEM �FINAC . � j ? ! � . ` jl 29. ?Insulation = ; i `i � � 1 (i � � I � I � � j �78 � FIRE PREV. FINAL . , i � � � � .` '30. Drywall Nailing � � � ' � � � , � � � � � � � �No4es: � � �� , � . � � �- � t i " � - - , . _ � , � , . � � p _ .r . 1 � , -� r -I -- - - , - � - r � - - . . '. . . - " .. . - _ ' '31. Plaster Brown Coat � � � ; � � � � -�--�-- - -� -'-� � � - � �. ^ ' � k 32. Electrical Power Meter=Final � (; + , � � � � ; � � ( ' � � � �� . � • - � ' � � � - ' .; 33. �Final Electric ' I _J _ I-- y � �-. )-. ' �.-�(. ( i � 34. Final Hea[iny &'Air Conditioning � j~ ���� d j� ���, i , ' ' , - . 35. Final Gas'PiPe-Test� i, � � � : �; ' t ;r r ` , i � -� � �rc . ' - � . . ' .. " . _ - " � • ] � i � 1 ' � < � - 36. Hood or CanoPY� �� ;.. � � . '; ' i'- � - ' I '• � � • � ' I •' � -- - ' i ! . _ ' , , " � . a h �-' i� r• �. I i' 37. Finai �actory' Fi�eplace � i = � . i � j '_ � � � � � % � � j - � ' , , rt • � � , 38. Final Plumbing � � � � � H � '� � � - � � I ' � � _�'. '� - ' I I I •_� � t' i I � � � r. 39. Water Service-Finall � � I �i a � i � I f -;: ,� ; � � ' • � i . _ � , : � • L 1 i r �� � � ' I - i '' I i ' , ' ! 1 + I ' ' I ' ' ,� I 40. Gas Seivice-Final � � � i �• 41. Solar pomesfio-Final ` I + j � +- � -i - } -_'t �� -1- =---�- � -i +'- � -r --,1 . . o.r. i i -�� � � ; � � ; � � , � ' i � � :� ; 42. Backflow'Preventer, � J . � � � _ . • p<. i : i ' - `i ,'i , � --�'-- - -�--�' - '�-i-- " I - � ' , , i _ - _ � . � . ' . . � i 43. Backflow�lriigation' � _ i � � � � � � � 44. Landscape Irtigation,System i ! ��- - � �'' ` � a � , ' I ��' : ' � ' . , , _ - . - , 45. Soundr. Fl`ttenuation �, � � e � � � � ; i � "� „�' � � I ' ` � i � _ - ' . . - _ .� , � � t - ..i. _ i i i : � 46. Handicap Regulations� � � ,- � ' �; ; � � �•�, � ; � � - � � y o _ � . , . . 47. FINALSTRUCTURE&BUILDING = ' �_ ; ; � � . ' � ' , • :i i -i i 1% - i. � . i i 48. Specia( Requirements Completed� ; j � f ' I � � � � � I � ' � ' � � 49. Electric Release to Edison I i � , � ' -�-!_- --L-�. - I _ :. _.�. � .:..� _� ._ . . , � . � i. � t 50. Gas Release to Southern California Gas Co � i I 4 �� i�,,; � ! 51. CERTIFICATE OFIOCCUPANCY ' � ' _ � _ � _ _ � I _�_ '� _ ' _ __ ,.-'_ _. . _ , , - . , � No '� �' � � Date i .. i � 1 ; I I f � ' � � , , � � . �' �--`-- - � Applieant !o fili In all spaees exeept lhosa wit�in heavy GorOer Iines anG tl9n all apOrooriata 0<clarations. � CITYQFCOSTAMESA.. ' - � _� ; �" '�. _ ..�PE IaNO—.� . 'TRACT Q.. LOTNO. � BLD -.. �.. ^ . .. _. .. •-� ,_ CO�ISTRUCTION PERMIT - - �; y '% ' . - •� � . , AppliCent'SMBIIingAddr855 � . � , ,TiPEOFCONSTRUCTION' . NEW' ADD �FILTERATION' �REPAIR�f. � . . � ~ � - - t , , , '�'� � ` ' �� '� , � ' i PlojeCtAddless '��&rO1� G� � ' � " � ❑CONVERSION _❑DEMOLISH ❑OTHER � ' -' _ � � ' '�'�~ . '� � - • � ' d+/.X - • hone �� 6'� � DESCRIP710N OF WORK - Owner'sNeme � . . .' r � . , �� , . .. - ' i � � . : ' . , . , -- -, . I G T . . � . . Address � `'i�OO . � 1�1.� .. . . - ' - ' . . . _ . ' . � . ¢ 3 . . � . � , r --7� C �7C/ + �TYPE'OPPERMIT , GRADING OUNDATION STRUCTURAC �A.P. ✓�D:J ZONE , p� ' r : . , Arch/Eng." ���y../� •.-��-LicenSBNo. n Z � ' ❑TENANT OELECTRICAL• ,PCVMBINO ❑'MECHANICAL /�a-2 � � "�BUILDING ' p�//Si Addreu a� '�cAca/1 e-q/.t%.C: �1`� . . , •� • . � � r . .P.LNG. REF.9k. i }�/ �/ �7 U �-�. . � n.- I � '� 'D,�OTHER � � � ! `� • -TO BUILDING �^ -. . .> ` ' a'�.6aZ( ' ' � ' -Pfl PE TY INE �`�/� ' ' REAR VARD(TOP/U_` ^ COntfett0_SNem �=Phnne ___ . :PAWECTDESCRIPTION SQ.FT ' � OCCUPANCV � � �LEPTSIDE VARD I PIGHTSIDE VARD � ` � � � ' � ' � � ' � � " CONSTRVCTION TVPE � � �VALUIITION $� ' � • � y . . �S V � I •• Address (mailing) � . . - i _ . . . � � . , � � � ! /� ' , - j ' ZON� ' GRADINGCU.VDS. ,ACRES ' "�' PKG.SPACE'REQ. l� � PROVIDED ' , C �y' License No. � �ICENSED CONTRACT R DECLARATION � � � : �• � � � Remarks: � S C.. . ' ' STREET WIDTH , • � .- �PARK FEE $ i � � I;hereby afTl�m that 1 am Iiceniatl untler prdvlslons of'Charter 9(commencing ; - -, - - � �� �� with saction 7000) of Dlvlsion 3 oT the Bus�neis antl Profeszions Cotle, anG � f � ;.�. _� � ! ; 1 ' , SPECIAL CONDITIONS: ' ' � ��� i-�� my IlcenSa IS In full force antl BffBct. � � f i ' � 1 � ', ' ' ' - ' � � . , - ( � . � y ,y Licenie Class � - � • ' • llcensa Na.� ` � � : � ; � f ' j PLUMBING � ; j � ! ' � ; � . � � ' ..� ; Date . . ! ' Si9naturo � i } , t ! � 7 1 �. . , . 1 . ` �. RKEHS' COMPENSATION OECLARATION j � � � � ' � � Bef Sink . ? i � SBNRf Cep � } � j ' � ELECTRICAL ; ' ' I ; � - = . . � + � , --._ . SewerConneit�on � � � � • Construction Pole � � M , � ' : �ireoy'affllm.that 1 nave a CerUflcate of conSent toselfdnsure.oi.a certlficate...l geckflow�Pr2venter- ,�..�_...._ _ Automatic Washer._, _ IMeter��over t0�amps' _,` . i �Workbri' Compensatlon Insurance, o� d certiflatl c6py thereoT (Sectlon ; '`�a'bo, Lab. CJ � ' � ! � � I i • f � 4 , � Backflow Irn tion Solar Collectors ", ^ � ' , , !Sub Panel, � � -, � � V PoIICY IVo. ' ' � � � GomPany • i � � � 1 ' ; � � : . . . � Cooking Unit I � ; ' 'Sub Pole � � �d ! i � BCertifietl copY is hereby furMshetl. ! � � ! � s ! ; Bathtubs y , � Soler Piping � � t ; . . . � . ' j Cartlflatl copy is flletl with tha dty.Bulltlin9 Divislon!' � , � Dishwasher ' � � �Moto�S 004 HP ❑ 16$: �� � � ." � I f � � � Clarifie�s t �iar Tank . ; � � � r � � � � ' ' . Date ' . ' AOOlicant � ' _. . . . . . . " . . , "" " _ " _':.. ' .. . . ,. I i EXEMPTION.FROM WORKERS' COMPENSATION DECLARATION T ' , DIShWeshef � SWimmin PoOI�avJSp2 ,k /'�i rt D�yers -❑Gas��Elect�ic -' f,'" �`Inc.Sola�;O9�15 HP 016-15+ j � ,(Thls sectlon neetl not be wmpbtetl if the perfnH �s for� one huntl�etl (5100) or 1 � � + _.. g . � - � � � , lass)^ , . i : I � � i � . t i f � , . , Fan! ; � � 'Microwave � i . � ."1 � : ' 1 certlfy¢hat In the perlormante of the work �or�WhichShis pe�m�t i5155ued I• { Orinking Fountairis j , Urinal� + ;,.�h ._. �,�! ��, , I' . � , � ,, , i , S shall. not employ any Oerion in an� manner so'as to berome subject. to t{�e i , - . � � + ' ' �; r-_' ; ' , Workers' Comoensatlon•Laws oi Califoinla. � ' � Floor Diains� � ��� 'r�� b F.A.U. � j �-Pole�Light '� � � . i , { . �' � � � � . . � I ; Water Closet, �: ; : ., ;+I � . �� � � . I � f y Date' ' � . . clBnature . . : ' t � . r _.� �� .Weter. • ` � 'r, Fixtures �, . . :Ran a � i . 1 �.�i �, � !�NOTICE:�If,after making�this�tleclaratlon, you shoulC be<ome subjechto�the- ;� --- FloouSinks --- ' •- � �-- Heate�� � � •, i � �-�� � �� -- - � -- ���- �' --� �� -' 9 , _ � Workers'- Compensatlon provislons of the Labor Cotle, you.must.forthwith ; _ � _ , ' " ' . � � ! � • : - - ^ Device Boxes ; � ' t i , I 1 : compry iwitn' such provlslons`,or � tnis'.'�perm�t I shall be •aeameU, revokea.y �,�. Gas Service'� j nOutlets �: v �Water Selvice � � r �„ I 'i � . '� '�Sign. , 1 , � 1 ; ,CONSTRUCTION�LENDING�AGENCY�� ' �' � '�� '� � ' ' ' ' � I hareby afflrm that there I5 alconstructlon Ientling agency,for the performance� { Y. � Int2rcEpt0�5' ,� � a� � � �,r � �. • Out�ets � � Standing Sections � ( � of the work tor which thls� permit is ISsuatl c(Section x3097 Civ. CJ� � -' - ' : � � - Lentler's� Namer � "' � - ' � ' �- - - '� � i - Ki4chenSink' _ ? � . � � :,' :� . � - Switches, � � . TrasfiCompactor � � � ! . Lentler's Aatlress � ' � � � _ . � ' � •- i ' ; `^ . ' � : .' � � ' � � " -i � � . . ��. i Gartia e Dis osal � � ' i ' ' � . OWNER�BUIIDER DECLARATION' -� : i', � '' - - . � " I z • . y �Vetolies � ' :Ji ,U i .� , '_ �'_ � � . 9 . P . � � i � : � � . 1 heraby�aNirm thEt I am exempNfrom the'Contracto�'S'License Law for tha �. � -� � i � � � Gene�ato�� �Ov5 KW �5-15KW I • I ' � � tollowin9 reasan:($ectidn•7U31:5 Businass and Proteszlonal Catle: Any city or ! �- � ? T�aP�� �. , ° �_ � � .� � � ' � � � � � � � d � '.county which reqWres a pe�mlLto construct�, 91ter, improve; tlemolish,or repair . � ' .: . � . Transfa�me� • � ' , � ' any St�uttuie' pfio� to ItS:lssuanc9, also �eqUil85 thB'dDP���ant ta� Such pa�mit. � R001-Dfet05 �y 'i � '� I �' 15-50 KW . ; � ' ; , � to file a 5I9neG statement that ha/she is IlcenSeA pursuant to the provisions of -' ' - � ' � � I � � t���g Contractor's'Ucense Law.(Chapte� 9 (commencing�with'Section 7000) of � r . - C ' Y I ' ' ' - � � �5U+ KW � ,RBinSpaction Fee ; � $75' ; [�,wJ?pn.3' oi the'Busine5s antl: ProfeSsions Goae)�on thatl he/she-is exempt 7� ShUw2�5 > ^ .. � Reinspettion�Fea $75 , ° �om �an0 tha' baSiT for the allegetl exemPtion: Auy,violationbf�5ection � " ._ _ ' � � � ° '� ', � ' . - Metef ❑�Up to 1008mps I ���UB FBB! t � $ 3 ��„5 bypany applicant for:�a permit: sutllects tha appliwnt to as uvil - �'y � '' ..-. , _ � e It of not more than five hunOretl Aollars (E500 � ' , �; �.• � Se�vice Sink .� � �- ' �yyue Fae' i � $ 3 , � � Y ). ' �. � r .,� . � . � 2onine APProved BY ' ' Oate � � I,� as �ownar of: [ha:property or- my amp�oyees �wilh wa9es as [heir sole 1 � . � ' ' � � � � � . compensalion wll4tlo the work, antl•the,stru<ture,is not IntenOeC or offeretl : � �; - �. : MECHANICAL' ; � � � qppl�cation Approved By � • � ' � atB 4 �� , ' (or 5aie.(Secilon 7044', Business, anE � Prote55�onal Cotle: � Tha Contracior'S ' � �� � - � • . � ; � �� Llcense Law tloes not aDV�Y to an owner ot a property who builtls or improves i ' Boj�e� • 'r `• i '' Refrigeretion Sys2ein � . � � ' ' � � p � � � � 8 1 , the�Bon„antl'who'COGs�Sutn�wO�k hlmself/h6�self o� thrOu9h his o� h¢� Own ` � - ''� • ' - � j APplimtion Isued By , ' �petB employees, provitletl that tuch•Improvements are�not intentletl or ofteretl for " ' '• ' ❑0-100,000BTU ❑100,0008TU' � - � 1 sate. It, however, the builEln or im rovement Is soltl within one earbf com- ` : Duct - Und¢r�Gtound � � . � • � , ; � , � � � 9 v Y . j � � � 1 . . . , . , • SUMMARV OF FEES ; pletlon, the owner,wlll hava the burtlen of pr0���9 he/she tlitl not builA or im- . I � � , ( r atorthepurpaseof�sale). i � ., '+I , , ; � ' Duct-Strucmtal � , j SystemRepair/Alteration � � ' 'BUILDINGPERMIT $'� � � � SMIP { � $ ` � � i I, ai ownei of the property, am exclusivelY contracting with�licenied <on- . . , , � � � ' . ' ' � i ' ra orstoconstruct the project,f5ection 7044..Businassantl..Professions,Coae:_ � , Dutt: Ventilating„ � ;, � , , � � i_„ .! � � � ,PLAN CHECK� $. � IT � I � I � The Contractor'S Gcanse Law does nof SppIY t0 an owner of property who � . - ; . ° � SUANCE ;$ � � builtls or Improves thereon, antl who mntracts Tor suc� projec[5 with a con- �+i Exhau5tSy5tem ❑ MWtiple �. ^ � � � ,PIUMBING � $; � � � tractor(5) Iicense pursuant to tha Contractor's Llcense Law): � ( ' ADING $� � � i 0 ��am exempt untler Sectlon ` e. 6 P. 0.(or ihis reaion � j Fiiepl/Faet. Blt. IC80 # � � ' �PLAN CHECK• $'. � , � • � � � r � � , , , ELECTRICAL $ � i ! � $ � � � Date � ' � own r � � ' � ' ' ` � � Heating'System & Ducting � ; � � ; ) � , � � � � t � I� hereby-cer8fy that�-I,hava-r atl thls appli aUom antl state-that �the�above ' �•� 06100,000 BTU 0100,0008T' � - �- �- 1 - . {PLAN CHECK. � , . . OFILM ` $ � � informatlon Is c rr . comply wll all city. antl county ortllnancas � a � � ; ' i •1 ! i � I ' ' TOTAL�FEE; $ i ' � antljstate laws r la g b il inq constru<} on,'antl hereby authoriie repre- . HoOd Or 1 � �� ' + � ,MECHANICAL ! $� t , � sentaUves ot �th s• I 1 en r� upon th e-mentionetl t}rooerty for , � TVpe I ❑� � � f i Reinspeetion Fee $75 � � � � " IESS 1 • j 1 � ; inspectlan rp • � ' /� % /� ' Cano i T' e II ❑` �. ( � ' t I ` �PLAN CHECK $ . , ADVANCED�PC $ ' 519n5ture �' 1 � Date -/'�/-7�3 - � ' � : � ; � Registero � F ; � Issue Fee � 5� 3 � , � � � j FINAL FEE j � $ ! Drivers' L 55 � � � ( � CMF 0865-46 rev. 1/82 White - Builtling; Canary - APPlicanh, P�nk - Accounting; Goltlenrotl -Assessor �� AVD����1 to flll In all �Dacaf a:capl t�osa wNMn �eavy EorGer Iinas anC dqn all aooroDriata Eeelantlanf. CITY OF COSTA MESA CONSTRUCTfUN PERMIT Applicant's Mailing Address 7 Prolect Addren � Owner'sName f��:-M,� erin>«... hone Address /N t'f ^� ��. .. •� /U � A'rchlEng. �� K � -� �-�' Licenm No. Address 2(� O /L�,c r. �nn ../— i .. � — � Con[mcto,r•sNxmn_. L�+tit � ._� �c: Phnnw Y9i-339� Arldresslmeilingl �•7� �-� �� 41..c��r_ licanse No. '� G r 2 2Y LICENSED CONTRACTOR DECLARATION 1 hereby_aftirm that I am IlcenSeE unEe� OroWslonz of C�arter 9(commenclnq � wlt�"settion 7000) of Divlslon 3 oi lhe Business an0 PrOfeSsionz CUCe, anE rtiy Iicenie Is in full /orce antl affact. ' � Llcense Class 4- Licen N. Date �� �� p�5iqnature WORKERS' COMPENSATION DECLARATION -'ereby atflrm that 1 �ava a cartlfirate o1 consent to.zalfansura.or a cartifiwta Worker5' CompanutlOn InSUrdnce, or a certltleE copy thereof (Sattlon oo, �ao. ca D 1 Policy No. M1� Company r� }�`� �• �,` �Certl�t]l�etl mpy 15 IIBG withrthe city Bu Itling D ion. , / � / Date "� �-; p-5.A001iwnt � � ��Ld� � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This seCtion neetl not OB ComO�eteG it tha permit IS for ona huntlratl (5300) or less). I certify that In the performance o} the work for which this perml� Is IstueC I s�all not employ any permn in any manner so as to become sub7ect. to t�e ' Workars' ComDensatlon laws of Calitornla., � • Oate �19naturo • NOTICE: If, atter making this tlatlaratlon, you s�oulC become sub7ect to the . Workers' Gompenulio� provislons.of [�e LaGar Cotle.•You must fort�wllh comO�Y .N'��h zuch provisions .or thls permlt ihall be tleemetl revokoC. CONSTRUCTION LENDING AGENCV • I hereby a/firm thal l�are Is a conitrucUon IenCing agency for the par/ormanw o/ _the_work for which tNs permit is IssmE (Sectlon .3097 Clv. C.) Lentler's Name' ' ' ' - ' - - �Lantler'S AaGress - - OWNER BUILDER OECLARATION � - - I �ereDy attirm t�at 1 am exempt trom l�e Contraclor's Licensa L.aw for lhe folloWing reamn (Sactlon 7031.5 Businesiantl Pro/esslonal COEo: Any cl[y or countv which reouires a oermlt to construct. alter. Imorave. tlemolish or raoair antl a d5 OwpBI Oi [00 propBlry of an owner ot a proparty wno out�as or �ork himielf/�erself or t�rough his oi Imorovements are not intentlotl or o' ever, the Cuiltling or Improvament Ii soltl wil�in one year o/ com- owner will have lhe burden of provinq he/she tliC not Duiltl or Im- rove I. The Contractor'z IJcanse Law tloas nol apply lo an ownar of property who . bulltls or improves t�ereon, anE w�o con[racts far such pro7ects with a con• tfattof(s) IlcenSB puftudnt t0 [h8 COntrdttOr'S LIc8n58 Ldw). ❑ I.am exempt untler Sectlon , B. 6 P. 0.�or this reason Date Owner anE sta[e lawi relating , untatives of'tnis cit �inspac[lon ourp5�ei�. � Signature �[_ Driveri' Litense or 55 5 CMF 0865-46 rev. 12/82 1 have rea0 Mis appllration antl state thaY[�e aDom 1 agree to <om01y wi[h all city antl county orOinances to builGin9 �onStrutUOn, antl hereCy authoriia r8Dr8- y to enter,upon the abova-mentlone0 Groperty for L� ;, O _ � oate 'Y /.3 2'3. TVPE OF CONSTRUCTION I.J NEW U ADD U ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTNER DESCRIMION OF WORK TVPEOFPERMITy� GRAOING FOUNDATION STRUCTURAL - , ❑ TENANT 1?ELECTRICAI ❑ PLVMBING ❑ MECHANICAL ❑,OTHER PRQIECT DESCRIPTION SO.FT. OCCUPANCV CON STRUCTION TVPF VALUATION $ ZON� GRADING CU. VDS. ACRF� Ramarku ', JQ � �%� 9 n Sink Preventer Drinking Fountains Floor Drains � Floor Sinks Ges Service Interceptors Kitchen'Sink P—Trep Roof Drains Showers �. Servite Sink ' Boiler ' � Duct - Under Ground SewerCap $BwEt (�,Onn2ttlOn Solar Collectars Solar Piping Solar Tenk Swimming Pool wlSpa UrinBl Water qoset Water Heater - Water Servica - ' , � Rainspeetion Fee . $15 ' laue Fee $ 3 � MECHANICAL - RefrigerationSystem � ❑0.100,OOOBTU 0100.00OBTU System Repeir/Alteration Exheust System � MWtiple � Firepl/Fact. Bit. ICBO dh Heating System & Ducting � ❑6100,000'BTU 0100,OOOBT a. Type 1 u � I IRegisters White - BuilOin9: Canary - Appliwnt: Pink - Accounting; Goltlenrotl - Aisessor � Reinspection Fee laue Fee $15 E3 fiEF LEFT SIDE VARD PKG.SPACE REQ. STREET WIDTH SPECIAL CONDITi utamatic Wazher onstruction Pole ooking Unit ishwasher ' ryers ❑Gas fT�Electri� en A.U. ixtures evice Boxes 7178 4/14/63 REAR YARD (T0 P/U � RIGHTSIDEYARD � PROVIOED PARK FEE S Meter LJover70Damps. Sub Poie ' Motors ❑0-1 HP ❑1X$ � Inc.Solar 09-15 HP 01615+ Microwave � . Pole Light � Range Sion • Stand ing Sections Trazh Compactor n�. , T; Generetor 00�5 KW 05-15 KW- --- —_. __ Transtormer 075-50KW � . ❑5U+KW ReinspettionFee 515 � Meter �up to 100 amps Issue Fee t'$ 3 2oninp Approwd By � pate ' ApPlirotion Approved By 1 . � � . ate '/ p Appli�tion Issued By �ate ��""��a� • ' ' SUMMARV OP FEES � � BUILDING PERMIT $ � SMIP � $ • �PLAN CHECK $ PERMIT PLUMBING $ ��UANCE � $ PLAN CHECK ' $ GRADING $� ELECTRICAL $ � � $ �PLAN CHECK' � $ �= MICROFILM $ � MECHANICAL $ TOTALFEE $ PLAN CHECK' $ LESS ' � . . ADVANCEDPC $ FINAL FEE � $ � � ^ i:CONSTRUCTIONAND'PCANNING - , .�- .- • -- . ' - -- ,-;. �OL -� A. --� � -�� - - ,_ � ti' ' -' - �j�c� a �� -:'Date � - ;Inspector ' � '� Date �n`speetoi ' �"APPROVALS ,,- Permit�#�.II� ! - � c - �• • ''APPROVALS� -!�Permit #� � � � .- 6, � ,+ . � . - . . � 1: Temporary Electrical Servic� or Pole ; �%' ; ' `' ! ' - � •� ,'52' Pool &�Equipment Location' ; � - , .v ' .. _ ' _ � _' . �" " . - _ . _ . . ' _ � Ft Soil Pipe-Undrgrnd' i� � ` � i - � - .- , � a� : - ;53`.' Steel R'einforcement � ' - � � � ' a `t Elect�ical Conduii Uiilitv•Undrqrnd: _ � - �54:: Forms � � . ' �''� �� � " �' 4y Electrical Conduit-Undrgrnd� -- - _ t�,�s - '� CC. � � 55� Electrical Bonding : , � - - - � 5' Steel Reinforcement ' :' �r : - � " � , '� _ - 56. Rough �?lumbing & Pressure Test � - 8' 'Electrical UFER Grnd. • � " . � " 57. APP.ROVAL.TO COVER-GLINITE�. ` ' ' � • 7. Footings � , •. ' � � �� .. -' 1� . - 58. Electrical �nduit-Undror�d.: � . - . � r,' � 8. Foundation � ' : � � ' � . ` h ` 59. Gas Pipe; O�. Undrgrnd:; Test -. 9. Wate � Pipe iUndrgrnd. . � ,, ', _+'-� � 60. Backwash Lines,°P-Trap, O Undrgmd.. _ , . 10. Structural Flobr System � . �' 61. APPROVAL TO DECK � �� � 11. PropertySewei Lin�'&,Ho'useCo�neafon' � , . 62. Backwash'& Receptor-FinaF � .� 12. Sewer Cap ' � � � - . , :63. Heater &.Vent-Final , 13. Roof,Drains � � �' ' � = 64. Flumbing'SYstem - Final -, ,,'� � � ., 14. �Rough Plumbing � ` � � - - ' - ' �65. Electrical-Final � � ' ' :�15: Rough Electrical=Conduit'1'"t' ' j;'' �" �� � - "-� - 66. Solar"System-Final � - � � ,- � � � , �:�.76.^Rough:Elect}ic Wiring, .• ' = � ' ! - -; ��2,� - (':CC'�" 67.' Fencing & Access Approval' �. - � ' -� - '17.,'�RoughiWiringSig'n� � � �� , �,'. i _ � {' , � - ., 68. ARPROVED FOR PLASTERING � . . , _. � 78. Rough'�Elec[rical;T'Bar Cei�ing! � . � _ � i � � ; ' 69. POOUSPA SYSTEMS FINAL � - � � �' 79. ���Rough,Heating &;Air�Conditioning ; � � ' 1 � � FIRE DEPT. REQUIREMENT - t: � - . �.: � 20. ,Rough,Pac[ory Fireplace , , , . , i � , � APPROVALS � Permit # ' • - � � -� rt 21. DLcts, in Struaure� ' ' � ' � ' 70. Underground Hydro � � . ,22. �Ducts, Ventilating � �- � � � ; � 71. Product Piping O Gas ❑ Oit ' 23. Gas�Pipe-Rough & Test � � �:' � � . ? 72.� Underground Flush � � � '24. RoofFraming� i � ' ;; � �. � • �.. . 73. Undergmd.StorageTankOGas ❑Oil _,1 25. Roof Sheathing , ; �.. j ��; r, ♦ i,. ' ; 74. Overhead Hydro . 26. T-Bar Ceiling (Structural). & Monocoat � .; � = � � ' � ' ;75. Dry Chemical � � . . '�.27. 'F��me and Fiashing ? ' � �� - ' . � ; i ,76. Dr,y Standpipe - � _ �• 26. Lathing & Siding' �., , I � i �� � � i' i� � ; 77.� FIXED SYSTEM FINAL - �. . B 29. !Ihsulation ; '� ' ' ' � � � � � � .78. FIRE PREV,. FINAL � � � _ ,�` `-30. Diywall Nailing -� � �� ;' � � , ; � ' i Notes:, ' � - � 31. ;Plaster Brown Coat � � � .i '� -�� � � � � � , - �- � - � , � � . � - -. � � � •^ ��32.:Electrical�Power MeterFinal � !� ' � � � ' ' � ' � � � � , i. 33.'Final Electric � 1 " � ' � ' ' � � 34. Final Heating & Air Conditioni�g y � �' -' ' ,� �_ • • ' . 35. Final Gas Pipe-Test, � , � `" ' - . ' � ' - � � - 1� . 36. Hood or Canopy�_ - ; � �. - - : , 3 - • . , n 37. Finai Factory Fireplece`� ' _ • - - � ' � i ' . � � " 38. Final Plumbing � t , ' . � : � v � j � � ' � - � � � . 39. Water Service-Final� � ; , � � � � I � { , - , , t � ;� ' � . i I ., � �i i . , , � � � � � i � 40. Gas Service-Final , . � , , . 1 ii i � 41. Solar pomestic-Final � � � � h � � _� �__� � . _� _ ___ _ _ � _. � � � 42. BackflowlPreventer, ,: � , . - - � � _ ' � - - _- i _ ' . . 43. Backflow Irrigation, �T � i � ' � : � , � - � � '' � � � n � r . � i = ! a � � � . - � . 44. Landscape Irrigatio`n Sy3tem � � . - � i �..I '� � ' - 45. Sound- Attenuatiori ', ` � _ j + ' . � . � � � , ' , - i 46. Handicap Regulations! �'i � �. ' � � � , ' � ' , ' � ' 47. FINACSTRUCTURE & BUILDING � ' � � ' ' � � ' � i� �� � ' � ' � � 48. Special Requirements Completed � '� � ' � ' ' � � . � � I � 49. Electric Release�to Edison� � � � .. . r. � �.. _ J .. . _ _ ' _ ' ' i 50. Gas Release to Southem California Gas Co � � � ' ' ; i 51. CERTIFICASEOFOCCUPANCY ;� ,_ _. :_+ . : ; _ .__ . ' _, _ No ' Date ' � ' � i � � � , � �� .. �- �_ .�� Applleant to fill in all spaees exeaD< <�ase wlt�in heavy borEar Iines anC sign all aOD�opriate Caelarations. r__ ' CITV O��COSTA MESA' �, � ' � . _ ; � � ' p R IT NO. _ � TRACT NO. LOT NO. L . ' � � _ . � � t ' ' • � � CONSTRUCT,ION PERMIT ' " , - , " , ' � � °. , , _ ' �' ' . , . ! .,. . , ApplicanYsMeilingAddress • - " TVPEOFCONSTRUCTION � NEW ADD ALTEg/ATION REPAIR ���_ ', - ' I '`Y ��612: �,5jJIIII3 f" r 9pOQ, TL PfojeClAddfeSS ��5� ���Qn, AL.4'�� ���'f ' ❑ CONVERSION .❑ DEMOLIS OTMER � / • � � � , � � • � � � � ,�J � . 4 Owner s Name � �ul. n� � G� ho/jppp�9/J,'� ' - � DESCRIP710N OF WORK . . ���� ' � . . . .�. . . : Addt933 1���' QUQ�/ ,�� ���"^-`^�� ' �'TrpE�OFPERMIT � � ORADING FOUNDATION ' STRUCTURAL A.P.9W � _' � �ZONE :':: . t � � ; � A�Ch/Eng. ' �: - L'IC@n52N0. � Q;TENANT, � ELECTRICAL ❑ PLUMBING ❑ MECHANIGAL �, PLNG. REF.9Y+_ � ' BUILDING� AHdrBR ' - ` . ' .❑,�OTHER � . - . . . . : �C - .G � �� . PRQIECT DESCRIPTION 5a. FT. OCCUPANCY - TO BUILDING . . fiEAR VARD (T0 P/U . ' ' . ContractorsNam r�^ h ne P V INE AddI953ImA��g���`� '�� �• l��%� A✓�'� �CONSTRUCTIONTVVF VALUATION$� � LEFTSIDEYARD RIGHTSIDEYARD � °_�'6 . ZON�' GRADINGCV.VDS. �ACRFS PKG.SPACEREQ. PROVIDED - License No. � � ' LICENSED CONTRACTOR DECLARATION ' Ramarks: ., � � � � STREET WIDTH . � ' � PARK FEE $ � ' I hereCy:attirm lhat I am Iicensetl under pravislons af �Charter 9(commencing � � ,, with de<tion 7000) of Divlslon 3 oi the 8usiness antl Rofesslons COGe, an0 ' . � � SPECIAL CONDITIONS: �� - my.license I5 In (ull !y rca an �eL tect. : ' ' � , ;�S" � �" ' ��d ' • . PLUMBING ' '.� ' . . Llcense Cla �"� ' Licen No. - � ' ' ' � ' ' � ` oa�e� �<-�3.�ic'�, c�.,.���.. C y o., Q•,�,._. � ; - . � WORKERS' COMYENSATION OEC qTl� � Bef Siak S2NEf Cep ' ' ELECTRICAL ' � � ' ' hereby a/(irrif that I have a�certlfira[e�of�<onsent lo selt-Insura oi a tertififate � , � - ' - - - - - - • — - � � Automa[ic�WazhE/ ! � - tMeter.O'over.100 amps.�_ _ _ _ . i. f . _ Workers' Comvensatlon Insurance,'or a cartifletl-covY thereof (Sactlon � B�kflowPreven;er $2WerCOnnActian'- i ,00, Lzb. c:7 , , �"" "� ' " - - � ,Sub Panef ' � . Pollcy No. <✓� ���%��{� ' L1J[U�Ql✓� : � i Backflow Irrigation $plar Collectors ; Construction Pole ' � ; � ��. �Certifletl copy ts hereby NrnishetlCompany , ; � Bathtuhs ' - $plar Rpmg � . • ,' �oking Unit , . ' �Sub Pole . Cert op isfllatlwlththacity iltliny pIy��on � Dishwasher � Motors �0-1 HP ❑1:5$ � Date . ADGliwnt �C//�/.]O71 .�i'�i 9L�/f� � Clarifiers � Solar Tank , � ' � . ' EXEMPTIO-_ e�RKERS'COMPENSATIONDEC ARATION r � � ' lOryers ❑Gas ❑Electfit ;InaSOlef��945HP �16-05+ i(7nissectlon neetl not De como�etea Ii tne oermlt Is ior one huntlrea (E100) or ' DishW3sher . , Swlmmmg Pool w/Spa ' . less): i � � � � � . ' i � � � , . - Pan j ' ;Microwave ' ' I certlty'that in the Oerforman<e oi tne work for which thls permR is IssueC I � Drinking Fountains Urinal � � . ' ' � s�all not employ any person In any manner so'as to become SUDjec[ to t�e � � - - � F.A.U. � ' � , Pol2 Li ht � �Workers'�Comvensatlon;Lawsofcalirornia. � . ; FloarDrainsj,'�i � Waterqoset' � 9 � Date ^ Signatura � � � � � � Fixtu�es .- _� ._ __ ' ��Ran e ' NOTICE:'If; a/termaking'th6 Eeclaraifon, you's�oulC'Decome 5uD7ect to tlla'• '� Floo� Sinks � � " - ' ' . Wat2r'Heater, '^ � " ' � ' 9 " ^ - - � �' - � Workers'. Compensation proWslons oi the Labor CoCe, you must tort�wi[h� � comply ,wlth, 5uth 0/Gvislons- or � tM1iS; Dermlt . Shall be tlaematl ievoketl. G85 SerViCe � :OUtlets .Water Service �� ��� Device Boxes � ' Sign. • � � CONSTRUCTION LENDING AGENCV � ' ' ' ' ' � , ' I hereby affirm tnat t�ere is a'construciion'IenCiny a9ency tor thmp ertormante. � : IoterCeptOrs � ; � - ' _ �; � �' � :� � I OutIBtS . � Standing SeCtiOns ' � • _ . of_the .work_tor �Ich th6; permit is ,IzzuaC ��(SecHon '3097 CIS C � � - ' � ' � � � - , . � LenGar s'-Nama^`T � ^��_'--= - — � _ KitchemSink - � '.` � ' , ' ; Switches � ; , � i � •Trash Compactbr ' • . � �� LenGer'S' Atltlress I ' � � � � � — _ _ - � � v , - �� � Lavatories ' : ' � r�- - ^_�' _ ' _-_. — — - -= Garbege Disposal ' � I � � ! ' OWNER�BVILDERDECLARATION ' - ^ � � �- I I - � � I hereby�afflrm that I am exempt from the�Contractor's License taw torthe �,- � p_Tre � '� - ' Generetor �0-5 KW �545KW - � '- ��- _�- �/altowin9 reason.(SecNon 7031'.5 Business antl Prolaisional Cotla: Any city or i _ , P' �� �� ' ' � � • ''county whlch requlres a oermlt to construct, aner Improve; tlemoiish or reDalr � , .� � Transformer � � 5-50 KW - � 1 ; �any stru<ture; prlor to Its Issuante,.also repulres l�a applican£tor suc� permit � Roof DreinS - o, : , " �- � • � : , i . � ' � � I ito /110 a Slgnetl ztatement that ho/5he is IlcenseG purivant to tha'prov151on5 oi I ❑5U+ KW � t�e Contractor's Licansa Law,(Chaptar 9 (commendng�with�$ectionJ000) of , , , �, • ��� - _ _ -� : ' 1 . � ; . ReinSpection Fee � §j5� Ivislon 3 bf, the'Business antl Prote55ions� Cotle) or that he/she I5•exempt Showen �.� � - . Reinspeetion•.Pee � $15 ' ; ' �y�"�efrom antl the ba5i5 tor tha allega0 exemDUon. Any violatlon of�5actlon � � " ' � , , � ''- Meter ❑up to 100'ampi ' - 'Issua Fee �. ' � S 3 '�'1.5 by��any aCP���nt for a:permlt subjects t�e appliwn[ to a�dvil � 7_ �$alty of n'ot, mom tnan tive �unOreO tlollars (5500). � � . , � Service Sink r„ ' _� Issue Fee �• ' S 3 Za�ing Approved By ' ' � Date :� I'as'owner ot the!property or my employeas,wil� wages•as thelr sole ; � ' ' � : ; compenutlon wlll�tlo the work, antl.the structura Is not Intentletl ocofferea , ` �•, ' � , - � , , MECHANICAC � ' � . ' � � ( + : � � � for wle'(Secfion 7044, Busineu and�ProfeSzionai Cotle: The,Contractor'S � � %�PP���tionAppravedBy ' , ata ! Llcense Law tloes not apply tman owner of a property who builtls or improves � �' � Refri e�atiOn S stein ' i � �'' � � ' thereon, anE wh0 00lsI5uCh wOtk hlTsel//�ercel! o� through �is or �er own i Boiler. �` i, I i � 9 ,� , � � qppli�ation IAUBd By � ��'9 _ DetB �� �� em0�oy eas, provitletl that sucn'Imorovaments are,not Intentletl or offeretl lor ❑6100,OOOBTU 0100,OOOBTU 1 sale. If, �awever, the DuilEln or Im rovement Is soltl wlthin one ear'o/ com- � Duc[ �- Under Ground � � ' ' 1 . � 1 � 9 P Y . � . i � ; ' • r� SUM ARV OF FEES � Oletion, the owner wlll have the burtlen of provin9 ha/she tlitl not builtl or im- . . . . ' � : � ; • � • : �romforthapurposaotuie�, . . • • , , Duct-Structurel i f � SystemRepair/Alteration BUILDINGPERMIT $ � SMIP � $ � I, as owner of t�a property, am ezclusively contractlng.with'llcensetl con- � � � - � ' � ' � � }.t�acto�5to const�uct tha project (Section.7044, Buslnau ana. Rofezsions Catle: -�. .- Duct - Ventilsting _ � . }, ._. . _� _ ;._ _ � . � ,P�AN CHECK, � $� 1 PERMIT ' i � � The ContractoPs Llcen3e law doez not appty to an owner of property who ' - � � ' ' ' � ' builtls or Improves thereon, antl who contratts for 5uch projetts with a com 1 Exh2ust Syst¢m ❑ Multiple � � I � ' ' � •PLUMBING � � $', , I�UANCE � .$� � . tractor(s) Ilcense pursuant to the Contractor's Ucense tawJ: � � � ' I � . � ' � i � i � � GRADING . S ' ❑ 1 am exempt unaer Sactlon � ' � e. & P. 0.(or mis reazon ! Firepl/Fact. BIL IC80 � � , � � 1 PLAN CHECK� � $, ; ' - j ' � I , $ ` � . . . . : , � � . i � � � i � � � EIECTRICAL $ . � � Date ' � � owner. - � / Heating�System & Ducting � ' � MICROFILM § ' � I"hereby:•certify^that'I.have'reaE'tbis'apD���atlonantl'state'ttiat'theabove.' / �6100,000'BTU"0100:OOOBT' - ' - - - -� 'PLP�NCHECK; : $' � � , � � � infmmatlon Is correct. 1 agree to tomplY N'��h all tlty�antl county ortlinancez � ' � � : . i �. . � . � i ! /�� � TOTAL� � ' i antl ztate laws relaiing to bullainq constructlon,�antl hereby authorize repra- � � . , - , . MECHANICAL ! $—/+� . . FEE $' � � ;sentaiives o(;this:clty;to enter�upon t�e above-mentioneE property for ; ; Hoodoi Typel ❑� � ; ' i � • T t � ; insoecuan ourposes. � 1 _ pa�a ) 7� e �� �j � � � ; Re�nspection Fee 515 � ;p�q�N CHECK. � t $' 1�7 . , LESS � , � j . Sigriature � � D-te�l,3� i � : t ' ! � ! � � , • . - + � . � ADVANCED PC I S � i — � t Registers ' 1 ; ' � Issue Fea � S 3 � � � � FINAL FEE � � E,,'� . Orivers' License or S � � CMF 086546 rav. 12/82 WNte - Bulltling; Gnary - Applicant: Pink - Accountin9: GbltlenroC - Assessor � � ' - - - - - - ,, ?��CONSTRUCTIONAND•PLANNING�.`a � � l� �� �-' -- -`� �OLf 4.�- � _ .- ,:-G � - " n - 733g:, oate � Inspector � ,,r 'L - Date Inspe'ctor > =APPROVALS , Permit #� _ . -APPROVALS - Peimit # - \� ' .� A T ' • , s" 1y': TemporaryyElectrica`I Serviceor?Pole �,+� - • ��� ., ; ,�52 Pool & Equipment.Location � � c- " , , - c - . :- ' - . - , v 2t Soil Pipe-Undrgrrid.- � �� `" . - � �. 53.;Steel Reinforcement . . � ' � ��. - . - � - . , _. , . �; 3i Electrical Conduit Utilitv-Undrgmd. ti'. ' � ' �. 54; Forms � - „ . � ' � � i. - ' , ' .�,. . ' � _ . - � 4� Electrical Conduiti-Undrgrnd�. -.: : ' .- ;� - ti � � 55:: Eiearical Bonding � ' ; ' - � 5:� Steel ,Reinforcement ' � � (, �•: ' �-. � ��'` � [ ` .` 56 Z Rougti Rlumbing'& Pressure Test . r_. i � • 8. Electrical UFER Grnd.' � F '= � , � - � �� � � 57...APPROVAL TO COVER-GUNITE � . , 7. Footings� �� j . � � �' ��� � � i' - . - . : - 58' Electrical.�nduit�Undrarod.,: ' - � � 8. Fo,undation� � � � � t, � ' � `_` • , � 59. Gas Pipe, O�UndrgFnd.; Test . 9. Wa[er, Pipe•Undrgrnd. " � � � � `�- � � ' 60. Backwash: Lines, P-Trap, � Undrgmd. � � -' 10. Str,uctural Floor System �` `� � ; � 67. APPROVAL'TO DECK " - 11. Prope�ty�Sewei Line'& House Connection , S - 62. Backwash�& Receptor-Final � -� 12. Sewer Cap.' . , . � � I e - �; 63. Heater;& Vent-Final . , ,'; � 13. Roof Drains � ' - � `� • , - .'64. Plumbing�SYstem`- Final�-� _: . - � _ 14. Rough Plumbing I � � % � - � ' 65. Electrical-Final � • � � " � - i ` 15. �Rou h'Electrical-Conduir'-T- �-�- '�T' � �- "'- " ' - : � g � r -- , � � } - ��- --66.' Sola� SYstem-Final . - . . -" �016. Rough;Electric Wiring � �t i , � : � ' _''� - - - i � � - � - 1 . - ' - ' -' , „ ., _ _ = 67.rtFencing &-Access Approval �" . _ , � . " %17. �Rough�Wiring�Sign,' ` �. , = , �� :� � - =; � �� .` I � � ' � 68.�APPROVED, FOR PLASTERING '. _ - ` � 16. Rough;Electrical-T Bai�Ceiling' � -- � ' - ! ". , � " " � " � , ' n,, _ , � '� � ' 1 69.�POOC/SPASYSTEMS'FINAL � 19. Rou h�Heatin & Air Conditionin �' ' � � ' ' ' � � „ � 9 � .9� � 9 , G � Q� I�� �� �. FIRE DEPT. REQUIREMENT. : . ' . _ � . . r . : : ' i i � . r ` N 20. RbughcFactory Fireplace� ' ; M �� ; � � � j � � � AppROVA'LS' �Permit# � ' ' . i ,L21. Ducts,�in Structure_� ! ' � � ' � ' { � 70.� Underground Hydro � ' i i '� � 'y22. Ducts, Ventilating _ i , ' � , ' � � ' ' ' i i � 71. � Product Piping O Gas ❑ Oil � _ �;23. Gas Pipe-Rough & Test � • 1 ! � j T � . i 72, - Underground Flush � -' ' � � ;��24. �800f� Framing`- i , � � � �� � _ � � , - .� � 1 . 73. Undergrnd. Storage Tank O Gas ❑ Oil �, 25.^Roof_ Sheathin8 , � 1 � . � ' � .. - � V � � � � 74. Overhead Hydro � ' : ' . I; 26. T•Bar Ceiling (Structural)� &�Monocoat - I � - - � � ' ; � 75.' Dry Chemical l . , ' _ , � . : ��27. Frame and Flashing' ' j � �� '� i , i � � ' � 76. � Dry Standpipe ; � . ' � � ' � -� ,� 26. �Lathing &�Siding � � ' � �� � ' � +.� � � 77., FIXED SYSTEM�FINAL - _ _ �29. ;Insulation ` _ � - ° ; ' . � � � 78. FIREIPREV. FINAL t 4�30.'Drywall Naili g� s .'� � � �'� � i Notes:, ' � . �� _ - , - --. � - - - �- � '. 31. Plaster Brown Coat : i • � �i �j � � i ' � I � ' I � . � ii , � + : . I L . � h 32. �Electrical �Power Meter;Final i 4 � E � � � � � � � �, �� � � � •. i _ " ; ' , . , f ! ' � M 33. Final�Electric ' t ' i L ,� � ; ' ' _ }_ � I ! i I � . ' � M34. Final Heating &'Air�Conditioning' i � � ' ' �, %���FT � ,%Q�� i 35. Final Gas`Pipe=Test� - f�. , ��' , � = _ ._ �' � ' ` �. . - - . '- t - _ ' 36. Hood or CanoPY�• = n� . � _ . � � ` , - � " . .. � - . - . � . - c i - ' 37. Final Factory Fiieplace - . . �',� � ' � . • . � � . ;. _ - " - . , - 38. Final Plumbing ' � � � ' �- � ' � � � � ' . � I, � . _ , u. � � 1 , I� - ' 39. Water Seryice-Final� � � "�, ; , . ;:, ; I � i � � {: 40. Gas Se�vice-Final � � ; ' �� i ! i ! � � � i .,' � � , � , 41. Solar pomesticFinal ' • � � �� ' � � _ , _ _ ,_.� _ _ �j � _ i � __ _ � ' � , 42. Backflow'�Preventer r ; � , -_- , _._'_ � � .�. J� � c: �! 1 - -- ' - -"_. "..._. 43. Backflow�lriigation � � � �{'� _ - - .� � �' � ' � '� . I . - . .. -i �� _ . :- - . 44. Landscape Irrigation'Sysiem i - - - , � � . � � . - r �_ � -� 45. Sound.Attenuafion ;.�,; t '' .�' i � , . � - � ' - - � �. - 46. Handicap�.Regulationi � j:: • ,i �- � , � � , � � • ,�� i � � .,' " - • �� ` ' 47. FINA � S� RUCTURE & BUILDING � I � I ! � I ' � � � ' � � , 48. Special�RequirementsCompleteti� � ; '� � . � � � I . - . � . 49. Etectric Release to Edieon � � �i � ' � ! ' ' � ' � � � _ _ _ � � i i - -'*- -+- � - - i - - -� - --� - � - ' ' ' � I � 50. Gas Rele�se to Southem California Gas Co ; � 1 � ;• � � i � � � I I 51. CERTIFfCATE OF�OCCUPANCY ' ) _ . __ _ _ � _ � � _ _ : : _ _ - � , • No. u ' I � Date � -� ' --� �� � j � . � , � . . . � _1._-' - -�' �-- -� �-- � i AVD���:+nt to fill In all,zpans exca0� t�asa_wit�in heavy DorGer Iines an0 sign all appropriate Caelantlo�s. _ _ __. _ . , _ , _ . _ _ , �. _ _ _ . .._ _ _ . CITY OF COSTA MESA � ' ' � , � i , ' � pEqMiT No._ � i . ; , TRACT NO. LOT NO. , BLD . � � ' I . . � � CONSTRUCTION PERMIT , � � - � ' ; ' ' " i � � � � � A7345 '`4/ f 8/83 ('' a�..00 .TL ApplicenYS Meilingg dd�RR � • TYPE OF CONSTRUCTION ' NEW ' ADD - ALTERATION-., REPAIR � • , ~ ' � � � � -r , � . y ' :L �J��' .lL / �v- - . , � � � � FfOj2Ct Addf05i' - - f � �❑ CONVERSION�❑ DEMOLISH ❑ OTMER . ' � r . : i �� , �U� f/)���/C'/�t .' � p ' � - DESCRIPTION.OF WORK ' Owner's Neme ' hone - - , _. - , . - � ' Z NI G � L' I ' AddfEss� � � � �- - — , ; TYPE,OF,PEflM1T 'GRADING . FOUNDATION .STRVCTURAL � A.P�`tiW 1 � , � ` ZONE : � t ArCh/Eng � L¢BnSC NO. ❑ TENANT. � ELECTRICAL PLUMBING � MECHANICAL.' PLNG. REF.#' � � � BUILDING � � ' , 'Q��OSHEft'� . , ' qEARVARD(TOP/U . Addt255 - '. .� . .: ': • .. '; � ' � ' . ', ` ' - ' ' ' , TO BUILDING. ' ' . . 69/}��(%/+1-%%/iI«�Ski�+ �h�dK'vs����fOi�' � PROJECT DESCRIPTION� SQ. FT.� �' OCCU7ANCV � P P RTV INE '- Contractar.'s Nam� e , - Addresslmailingl!��� �� �s!X��'�� �� �� � � CONSTHUCTIONTVPE �� � ' ' VALUATION$� � �LEFTSIDEVqqD RIGHTSIDEYARD' ' � ' - � ' � ' 20N$ GRAD�NGGU.VDS. � ACRES PKG.SPACEREQ. � PROVIDED ' Licanse No. � , � , CICENSED CONTRACYOR DECLARATION � ' Remarks: � I ` ' , _ - , STREET WIDTH � ' i ,PqRK FEE-$ � ' - I:hereGyaifirm t�at 1 al� ��censetl untler provislons of Charter-9 (<ommencing . � � with sectlon 7000) of P���slon 3 oi the Busineis an0 Professlons Cotle, anC ' ` , , � . ' , ' SPECIAL CONDITIONS � � -� � �- � j my Iicensa Is ln full torcP �� ff -t. ' I �;�� ' ' ' . 17cense lai - ' � � Uce se. . � • � PLUMBING � � • �. ' Date ' � " � ' yi9nature � � ' 1 1 I � d"� BarSink • � SewerCap ' ; ELECTRICAL WORKERS' COMPENSATION LARATION t � , . i � - - � - `ereby aitirm that.l.�av ertlfiwte ot.wn self-Indure�or�a certifi te �^ - -- � - - - - - � � - - - � � � � BackflowPreventer SewerConnection- � AutomaticWasher��- •Meter.�overlWamps_�.- . Workare' Compfl e� ��surance, oi � certifietl'coOY Ihareo c on� ' CoostructionPol2�.� ;oo, tso. C.)-" ' � ( � � , i I � Backflow Irrigation � . Solar Collectors � � � � Sub Panel . � } PoIICY No. '� � ' CompanY ' � . " -- - '- - � 1 . Cooking Unit , j".� � Suh Pole . • . ; 8 Cer ea copy Is nereD rnizhatl. � ' � � Bathtubs � Solar Piping ' - ; f. — . . ; ' ' ' fitlea co y I with tha city tll 5� �... � Dishirdshef �• MotofS ❑0-1 HP ❑ 1 h-8 ' � e� - Applicant - - . Clarifiers , SofarTank , i � , ' .� • _ . . i ; `. EXEMPTION FROM WORKERS',C MPENSATI N, ECLARATION / - � - 4 � ' � Dr ef5 ❑Gas ❑EleCttiC : � �(Thiisectlon neetl not be comD�eteO If the Oermit is for one �unGretl (EI00) or .' ,( Dishw2ih2r ; � Swimming POOI wlSpa ' Y �InaSOlar �9-15 HP � i6-75+ , . ' iess):� i � '. I : ..� ' : , � . t , - . � , f ' ' � Fan� , . •Microwave � � � I I certlty�Nat In the perlorman<e of the work for whlcn tnis p it is Issue 1`� � Drinking Fountairis ; : Urinal : � .� � -' ` • shall:not ampplo!yT,any Oerson In any manqer s'as t e subject �le'��, - � . � � � . F.A�.U. , � � iPole�Light ' � � Wo keCE: �tompensatio'n P a'vi5io sa ot'the Laboh Co�ou,ms � � Floor Drains - � • � � Date 5' � / s �♦--5i9nature � ( . , �' • ' ' . Fixtur s . - . . : � � • i � Water Goset i ublect to�the.. • Floor Sinks...r ' ` I � / - WaterHeateq , - � . . .. . ^ _ - .. .- . . Range. .. . �-�-'.•._ ' ' i _ e. � ust forthwith ' comply wlth' Suth pro��sians'.or:thts_Oermlt �S�all be iUBemeG� revbketl. ./� Ges$ervICB � � 'Outlets I �j' � �Water.Service � � • Device Boxes , ' Sign � ' ' ' � , . CONSTRUCTION :lENO1f.IG AGENCY • � � ' G -� � ' ( ' � '.I ' ' OUtlets ' I hereby afiirm that IherO is,a conitructlon lentling agency tor the performance: � ' Interceptois � �- � � ' Stantling Sections ', � ---�of�tne_work_for.�whlah__this_permit I5'IssueC�,(Section 3097� Clv. C.), � • - ' ^' ' - ' � ' ' . , Lendar's. Nama �T--- � -" r '��- " -- — Kitclien`Sink------- ' ' � �,� �.�__. ���' � - Switches � �Trash Compacror ' . . . -�' �_' .� Lentler's AaGress, � ' � ' .,L� • . . - . r .- . - . � . T - ' - - ' OWNER;BUIIDER OECLARATION' - - 7 �=�'atories� t � _ • Garhage Dispo5al—� '�- � - �-=- --� I heraby:aifirm that I ain-exempifrvm tne Contractor's �License Law Tor the � � � GeneretOr �0-5 KW �5-15 KW � � following reasom(Section� 7W1'.5 Business antl Profe55lonal�Cotle: Any city or ' � ?-Tiap' ' . � �- . � � ; ' county w�ich requires a Permit to <onstrutt, alter, improva, tlemolish or iepalr � �-� . Transfo�m2r 015-50 KW ' � any structure; prior to Its 9ssuance,'also requires the apPlicanbior such Dermlt RoOf,Dreihs � ` � �: � � � � to tile a si9ned ztatement'that he/she Is Ilcensetl pursuant to the v�ovisions oi ' � ' ❑5U+ KW � � � - the Conlractor's.LJcense Lzv+ (C�apter 9 (<ommencing�wit� Section ]000) of . - ' • � - , . . �ReinSpeetion Fae , $15' ,���51on �3 oi the Business antl� Professlons; Cotlej or thac, he/she is axempt .- Showers ! ReinSpection Fea $75 .�„�from antl the basis Tor the� allegetl axemptlon. Any violatlon`of SecHon .' � `_ , . . _� - Meter ❑up to 100,amps � Issue Fee i'$ 3 z'S by�any aOP���ant foL'a permit-SUEjects tn¢ dDplicant to a civil + � ' � ' ��°alty of not moro tnan tive'nuntlretl tlollars (y500): ?� . ,; _ ; . . � Service Sink - � � , laue Fee � � a 3 joning ApP�oired By ' ' � : � pate � ' i;'as ownar of't�e �Grooerty or my employees with wages,as ihatr soie � .- MECHANICAL' � • � ' ' � � � compensaFion will}Qo tne work, antl' Ihe structure' is not Intentletl or offeretl -.� - ' . , Appliption Approved By - Date � for saler(Secfion 7044; Business'anC ProfesSional Cotle:sThe•Contractor'S .. Iv .1./ • �/�' � License law tloes not apPty to an owner of a proparty who builtli or improves gpiler � RBfrig2ration Systertf + , ppp�imtion Inued By /�� � � Data ' thereon, antl who'tloes.such work himself/herSeH or throu9h his or her own � � � � ` � ' ' � ' , . emoloy ees, provitletl tha< such9mprovements areinot Intentletl or otferetl tor i � Duct - Under'Ground ' ❑0-100,OOOBTU ❑100,OOOBTU�� � � sale. If, howevar, t�e bu��tling or Improvemant is soltl within one yeanof com- • �_ : � i '� � � ! � � . SUMMARV OF FEES � ' ; ! pletion, t�e owner,will pave tha burtlen of proving �e/Sne tlitl not builtl or im- 3 . . . , � � ., . , ! � � , -� rova tor the purpose of sale). . ; � - - ' ; Duct - Structural � � .: System Repair/Alteiation BUI LDING PERMIT $; ' SMIP ' ' $ ' � I, as owner o1 the property, am excluslvery contrabting.wtfti�llcensed con- '�• - . � � � � � , � ' � , ' � '� tractorsto.construct.tha'P�ojact (Sectlon 7044, Buslness antl.Profasslons.Gotle:..- �. Duc[_ Ventilating_ _'._y., �t. _._�.. ' �.. � ...� _+_ . .{ � •PLAN CHECK: $; . PERMIT ` � The Contractor'S Gcen3a Law does no[ apply to an owner of property who � ' � � � � � ; $ 3; � ISSUANCE � ;$� � builtls or Improvesithereon, antl who contracts for su<n oro)ects witn a con- .� { ExhauSt,Syst2m ❑ Multiple �� i � � : ., :PLUMBING ' � ' tractor(5) license pursuant to'the Contractor's LI<enze Law). � � 1 � ' - '� '� I � ' � ' � � ' � ' ! . 'PLAN CHECKt $ ( GRADING ' + $ � ; � �(am'enempt unEer 56<tion B. & P. C. for this reSson � � Firepl/Fact. Blt. ICBO � ! � � � ' ' � Oata � '• ' i Ov.ner � • � ! � � - � � HeanngSystem & Ductin , � � ELECTRICALi -� $; ' ' f ; � � ; $ � . , , i-hereby' certity-tAat lihave-reatl thli aoVlication-antl��state'that'ttie above�: '1 06100;OOO�BTU��t00000BT� -T- �T- - �PLAN CHECK • $� � ' j MICROPILM, j$' t � � intormatlon li'mrrect. 1 agroa to comply. with all city�antl county orCinances : < < . . ! � 1 . : , � � � � TOTAL�FEE' � $ � j � � antl;state Iaws relating to builtlin9 onstruction,'antl hereby authorize repre- i � . : 'MECHANICAL $ � sentatives of :th' tl to i on the a Ove-mentlonetl ro ert tor' ; } HOOd Oi TypE I ❑ '. � 1 ' � � � , � �i f ' � i '•I 1 j F t t f p ? 7 Y � ( ReinSpection Fee � 515 � , , -) I LESS ' InSpection Our 9e5./ � � j t � ' : Canop .T e II ❑' � � r � . , . PLAN CHECK $. � ! : � � 5ign5ture � � � Date '�lf � .; � . � • .; . . .1 , � � ; ADVANCED�PC $ � i ! � Registeis �� laua Fee I $ 3 . � � � � �- Drivers' Ucensa or 55 qf, ' ' � � t • i j ! i � � FINAL FEE ( .$ j�_ ' CMF 0865�46 rev. 12/82 White -,Bulltling; Canary • ApPlicant; Pink - Accounting; Goltlenrotl - Assessor � � , �? y�CONSTRUCTION_AND:PL'ANNING- �, � " � � , � '. , .� - � POOL 'A . ", . ; � ' : � " '- � �.Date • � �Inspector � � � - ` � �Date � •Inspeiwr. �APP.ROVALS , Permit # � � - ` 'c APPROVALS - Permit # �' ' . , t � � � . ,' i . " � - - ' . o-� - � � �� `emporary;Electncal $erJice orEPole • -u � � .,52b Pool &'Equipment Location : - - _ � � � �p w � ro 3` Soil Pipe-Undrgrnd - �� _ `a' , � �. � /9�S'3 �� ' _53i Steel Reinfo�cement ; ,' � ` � ;7 " 31 Electrical Conduit Utilitv;Undrgrnd.i > � �� �`� � 54:� Forms -' - . " =:- ' " � - � ' � . � u� c '� 4C Electrical Conduit-Undrgr'ndi = � � � ` � �� � �� ' : 55:' Electrical Bondin � ' ? - � '° .r. . ' ' '1' �' i!. - . � . 9 . . . , r. � Y 57 Steel Reintorcement� � � ;• ~:� ,4 ' � : •.�. z.`-' ^: •, _ �56. Rough Plumbing 8& Pressure Test �� - � ' - I i �� • ; Je': ; • I � o '• - � r • ��v 6: Electrical UFER Grnd. . -� � ; � • � � _ - i�57�' APPROV:4'L'TO COVER-GUNITE" _ ', � • 7. Fo'otiogs � � � � '� : � ' " � : =•�� � : 58.' Electrical Gonduit=Und�ar.,d, ' _ � - 8. Foundation � ' „ . � . . . . ... ..' ', - - �` -� , �� i � i i , � ' � � � � � ° , , `, ��. << � 59. Gas Pipe, � Undrgrnd., Test , _ .- , 9. Water, Pipe-Undrgind. I , < < < � '/�,� .�lj : � 60. Backwasti, Cines, P,Trap,:� Undigrnd.'- �� � i � - � ` , � 10. Structural Floor Sys[em � � � � . �� ��� -�� � ;.61. APPROVAL TO�DECK .' ` • 11. Property.SeweF Line��&�Ho�useConne'ction : ' 1 � � 62. Backwash'& Receptor-Final � _� 12. Sewer, Cap �, ' ! � � , - � �, �63. Heater, & VenbFinal � - � - - i I ' ' 'o � - - ' 13. Roof �DrainS � � i . i ,'� . ,' '_ - • g4, Plumbing;System:,=�,Final °r_ �° - � � ' � � 14. Rough Plumbing ' � � ' ... � � � ! ,�3 � 65. Electrical=Final- �= - � • - ' ` '` ' � -75?'Rough-ElecTriC31-COnduiY� ' "-'��'�i -� "t.T '-- �'- i - � 66:�$ola� SYstem-Final � - - - --"- ' - � '-� " "i�76:�rRouyh�Eleci�ic Wiring, ^ , � �, �:�-.-�� -�� r•,�'f'�; � .-� 'i r'� 67. Fencing & Access:Approval , _ � � � -. - � �.' � �� . �-. m! I � . i G Y"�"%:.�OU9FIG iring'Sign`? ,. ; � �. t. �' ' _ �'; I =. �- i � " .;, . � 68.:APPROVED FOR�P�.qSTERING ; , - � _ °�i �: � �'`�16.`�Rough:Electiical-T�BahCeiling� �I � ; i: f '' � -� �'69.�POOUSPASVSTEMS�FINAL � . ` � - ' - ; � 19" �Rough;Heating.& Air Gonditioning �' � � ; �` � � � � ' � FIRE DEPT. REQUIREMENT � - ' ' _.. ; .r..= . , . 'i.;. � � � ,, � 20. AoughiFactory Fireplace' � I �, ' ' � � � - � APPROVALS' ' Permit # . _ � . , i i ' q 21. Ducts,'�in Structure�� �' '� � I! '� I' ( i � 70. Underground Hydro � ' - � i � � � �22. Ducts, Ventilaiing ' j � � i � .' �I � � ' I ' 71,: Product Piping O Gas OOiI . � • ' � � � '�;23. �Gas Pipe-Rough'& Test `� �� �; ���� �� 1 ' � ' 72.( Underground Flush � � � � � � 4 �. �. -.e.� i .� � � i �� � ' ' � a'24. Roof. Fiaming :� , � ^� j I ' . j ;� , , � : � � . � --, - . 7_3.1 Undergrnd. Storage Tank'� Gas ❑ Oil �fr I - � ` 25. Roof Sheathing � ` , � � p - � � i � � ' � _ � � I 74.:Overhead Hydro � ., � ' ' � p•26. 7'-Ba� Ceiling (Structural��, &.Monocoat- , � r; ; � � � _ , i r ' 75. � Dry Chemical c �. - . . . � �r- _ � � i _ ' �'��7. Frame and Flashing � � � � j! •� � i � � � � � � � � ! 76. � Dry Standpipe � -, i ; . , ' : � `� � . , , �. , . . . . . . - 28. �`Lithing &"Sidyng , � ; ; � _,J ' �, I � � , ' 77,� FIXED SYSTEM�FINAL � � � � _ � 29�jlnsulation� s .� . ' � I � !� ., � � � j � � i !78.� FIRE PREV. FINAL � , ; •` � 30. Drywall Nailin9 ' i I `i ; � ' � j I � �Notes:� . , � � • -� � . � � :� i � "31. Plaster Brown Coat I � � j ' i� ,� � I - � � �- i- -i �� � � -. - - , � - - - -- - , - � - � �`32� Electiical Power Meter-Final , � ' � ; ��''� ���, � lh-,'�r� ,�.� :`�� ; • • - • � � ( � , r � 33. Final Electric ' � I � � � �� I ; I ' I � � _ �� ' I ,�._i. ` �� i � ' ' i = 34. FinalHeati�g&�Air'Conditioning '� �� � j � � � � � � ' " � .� -�i�:-- � � � . � 35. Final GarPipe-Tes�i � ,�, ' ` .��/�3 �' �• �� � . ' ' - ` ' • - :� � ., R' 36. Hood or CanoPY'=C� ; I�: . -,. q , i,' � : - � � ��, � = � � ; t' � . ,- , - ' 37. Final Factory Fireplace � � - - ' t - ? ; � � � ' . ' � - " '- ' ' � . h �. � � 1- � , . . . 38. Final P,lumbing i � � ' = I + 8i�'�Fi � ' � i � � ' � � ' � 39. Water Service-Final� � � ' � ' � ! , � ' ' � � - 40. Gas Service-Final � ; , � j „ ' I ) � , i � � 11 � 1 1 1 f � � l 41. Solar pomesticFinal , � � " � � � � ' ' - - - , � � d- � 1 � r� -�'-�- --- - -i- - -'r- 42. Backflow;,Preventew; ,; � � . . � � ; '_ _!. _ � �' � � � �-i,_ .�. . -4 � - - - -- ._ _ . . 43. Backflow.�lrrigation� � ' j � _ : i ; ; - � � TJ ` . �:: , � - a •�, i'��. i � �� - � � . �. - : ;�� ' � . 44. Landscape Irngation System � �� - � � • � � � � � ' c1 -�, 1 � � � ' „. � 45. Sound �Atterivation, ; �' � � � � � � � I ' ' � _' . , . � . . - - '-: . � . �� ��- ' ' � ' `= 46. HandicaP��Regulations � � . ' i; ;. � � �' '; . � �� , I i ' . :,-'=- - - , � -_ _ 47. FINAC STRUCTURE & BUILDING � � i�.^ i � � � � � ' , - ' •'+ i � 48.SpecialiRequirementsCqmpleted� �! , � ,�� �! � � � ' I � i � � , - • � +��� + , �� 49. Electric Release to Edison{ { � � , 1 __.� _1�.._�_.� � _ �_ _ � �-_ ___. _ � � , • 50. Gas Relesse fo Southern California Gas ('v � � � ' � 1 � � � ' � - . a•- � ' � � � -� 51. CERTIFICATEOF'OCCUPANCY � � � � � � � .�_'.��` .�� . � � � --- -t � '--, -'-- - , , , r �, � i No � � Date � , i � � � ' � , �� " ' - ADOliont to till In all spaeea e:eapt tho��lthirTlfea✓y GorEer Ilnes anE zlgn all aOV�ooriate tleclantiont. � CITYO�_COSTRMESA' • •�- , - - _ � PERMITNO� TRA(TNO. . �Ll,S?NQ. IBLD � . _ , .__ - ._ . 4_1 _ ,' , CONSTRUCTION PERMIT ' " - E �9 ' ` • ' ; ` �'' ' ApplicenYs Mailing Address ' . � � T,YPE OF CONSTRUCTION' NEW AOD ` ALTERATION REPAIR ' : . � . ; � � _ � �� ; � � PfojKt Addfeis- ' G ' ���� �� .� � � CONVERSION ❑ DEMOLa15H ❑ OTHER_ U _ _ ' , ' ` . � : � , � .. Owner's,Name honedlC�b ' �Jj�--}.-��,� , `W�� , x ' - � � . . . � � . - JSLG r �i-r�i Ql�i.%�rF _- . . - � . Address _ ' - " ' . - � ,rypE OP PERMIT GRADING OUNDATIO STRUGTURAC . A. P..9�+ 3 -D 3 °�oNE� � • , � A?ch/Eng. � � - LicenseNo.G� 7 �TENANT O�ELECTRICAI �PLUMBING; �MECHANICAL PLNG.FEF.�W + -�Z��� BUILDING '�' /, ' //; AddllSS �6O � � �O" ' ' O.UTHER + ' .. ' ' ' - . TO BUILDING ( - . • - 1 -> . . . . P V I E REAH VARD (70 P/U .-' , ' � r � Contrecror's Nam � hone ��� 6Z� G PRQIECT DESCRIPTION SQ: FT.' � ' OCCUPANCV ,, CONSTRUGTIONTVPF VALUATIONS� •LEFTSIDE VARD � � RIGHTSIDE VARD �� ��' Addrea (inailing) � .� � � . 1 ' - - - r ZONp � GRADINGCU.VOS. � ,�ACRFS � ' PKG.SPACEREQ. ' � � � PROVIDED ;� � - � _ ' .• Licenm No. ' . UCENSED CONTRACTOR DECLAfiAT10N , ` � . Ramarks: � i ' ' ' � � � STREET WIDTH � ' � - �PARK FEE S � ��5.�- , 1 hereby afilrm thdt 1 am Iicenietl untler DroNslons o} Charter.9 (commanGng � � , - - _ '� wit� sectlon 7000) 07 Dlvislon 3 af tha Busineis anE Prafessionz Cotle, anA . � � � . • ' , 1 � SiECIAL CONDITIONS: �� ' rt1y Iitense Is In full fOrce anE'eHedt. ' � � - - ' • . . Ucensa Clais � Licenu No. - � � � PLUMBING ' ' � ' � � . ' . � . , Date ' Signature � ' - Bar Siok � � ' � Seuuer Cap , � . � - ELECTRICAL � ' �-'ORKERS' COMPENSATION DECLARATION ' `+ ' ' - - " ' �reby afOrm.tnat.l nave a.EerqfiUte Ut GOnsent to zelf-Inzure � a.t8rtlfit2te �- - ' - _ � ,. - _ _ _- _- Automatic.Wesher ' . •Metel Over 10�,ampz � , 4_'= „1. � i Workers' Compenutlon InsurSn<e,.or a certlilea�cooY thereoi (5ectlon � �� BackflowPra'venter- - -T' ' SewerConnectjon'-' � , Y� . , . 3800, LdE. C.) ' � , � ' ' ' -- ' . ! ^ t, ; • Cons[ruc[ion Pole ' . .Sub Panel � i { , Backflow Irrigetion Solar Collectors� � � � Pollcy No. � ' ComDany ' ' ' . � ��� COOkin Unit � � , � ' ' ' ' . Bcartlfiatl�wov Is herebr fumistiea. � : ' '.'_ i � i : Bathtubs ! . � �' Solar PiPing ' j , 9 'Sub Pole ' ; ., i . . i Certltietl covY Is fliea with the dty.BWlding Divislon. • � - � � � � � i DishWaSher ;Moton �41 HP ❑ 1 Ya�B .;,. � Date ' . . AOPlicant ' � ' - . � : ' : 1Clarifiers � _. i . _; .J _ ��rTenk : , . . i , E%EMPTION FROM WORKEqS' COMPENSATION �ECLARATION I � �� � -- � � � � � � - � �^� `- . _ ._ - - '(Tnis section neee not be como�etea if the permk Is mr.one huntlmtl (S100j or ; � Dishrvazher � � ' ! Swimming PooPw/Spa �-; '> Dryers '�Gas i �Electric ^� 71naSolar_ 09;15 HP �1645+ � ! ^ ! lass) � • e : � � � -, i � . . . � . • � .. i Fan , � � � 'Microwave � � • i. � I certlfy �tba� In the Perlofmante of t�e work tor�whlch thls pefm�t is 155u80 I � Dfinking FounTdinS , Ufinel ` , , p � . ! .. �� � t ; ihall not employ dny p0rmn in an manner So a5 ta bacoTe suC)ect to t�e . . � . _' ,.- ' - • � ' ' ' ' workers',Comvensatlon Lawsof Ca�ifornia.� ' . ' I ' FlaorDrains : ' � 1 , FA,U. 1 'Pote,Light ! Date' � . . • ci9nature ' . � � ' � � � . . Water pOSBt ;;1 , t . i f � c ' �-NOTICE: If; after-making this tleclaratbn,�you sfioultl'�become 5u0ject to�t�e � - Floor�Sinks -�- - - - -- - - -- - Wete�,H28te� - - - ._ _ Fiztures '. , „F �,_r _ _ _��_ ROnge _ ' _ ..S__ -.'.1L_�• _ .,h ' Workers', Compensatlon Orovislons ot the �aDar, Catle,'.you,,musL fort�with +' - ' " ' i � i - � - � - - ' ' comO�Y M'I�h� Such provlslonS�or.NiS>Dermit 5M1ai1 be tleemeEl rovokeG.. '. �, t � t ' ' ' _ DeviCe 6ox05 9 � �, t 1 GasService�' Outlets! �Water.Servme , � �• , �- , . � t : Si n, � ' . I CONSTRUCTION LENDING �AGENCV ' : I % � ' � ' � ' ' � � I hereby affirm that t�era is a'constructtondentliny agency for She performance '•i � Interceptorz � . - J' �' G j.. i,- Outle[5 , ' Standing Sections � ' ' - - Fol=the-�work� for,_whiUpthiS�permit�i5� szuatlr(Sectionl30B7 Civ. GJ� g- - ' , � � , I � _ . . . T r-�--F=. �- - r K - - - Switches � , Lentler•s rvame � � •' - - itchen'Sink -�-� � T - - :- 1 - _�� -- - . � Trash Compactor . i � . ' Lenaer•s 'Aaaress' ` _ t' . � � _.- - E ,- . - . . . - . . - _ . ' _ -' T_.- _ ' _ -_ OWNER�BUILDERDECLARATION' },} ( '� ' � . LevatOrieS� nt � ' � '- � GafbegeDispoml i ; � I hereEy attlrin th5t 1 am'exempt.irorti [hB:Contractor'S �LlcenSe Law tor tha' = • P 'T �e - . � � _ � ,� . . GenBfetol 00�5 KW �5-15 KW � � � , ' • I � � � iollowing reamn: (Section 9031.5 basiness antl Profeulonal•Catle: Any city oi: � , P; 1 =� i, - �.;' i�county which, raqulres a DermltYo constru2t, alter, improve, tlemolish oYiepalr � ' . . _ . �-; � TransfOrrtier 015-50 KW � � � � ' f � ' any structure; p�io� [o its issuance, also reqWros the'applican[lor suth parmit • � Roaf'Drains' ' �. - � - � „- � � ' �- . ' � � � . to tile a signetl statement that ha/she is Ilcensetl pursuant to the�provizions o1 ` ' � '�' 1 � �5U+ KW' � , ' ' 7 a Contractor'S License Law.(Chapter 9 (commencin9�w(th'SectlonJ000) of ' - � ' ,� : ' " • - "' ' � ' �Reinspection Fea $15' $ton'3' oT the ;Businesi antl! Brofessions Cotlej br'thaY. he/she is.exampt � Showers � �,� P f. . Reinspectian'Fee , $15 . � .� ' � �, �efrom�antl the basis tar the allegetl exemptlon: My violatlon��bi.SecHon - -',- ' 1 , ,- Meter ❑up t0 100�emps .d1.5 by�any applitant for-a�permit-subjects the applicant to a tivil � '�;, .'c r` � Y � i � �� $ 3 _ , IaueFee '$ 3 . enalty of not mora than flve huntlretl tlollars (y500)�. � • • ;- 1 ! . Seiv¢e Sink , � ' � � , ( , lam Fee ;' ' - ' (, . . . i . i . . 1 i 2onin9 APProwd BY . ; , , ' Date � � I;'d5!ownBr Ot.the�p�OpBriy Of`�my emplOy¢¢s with Way¢S�dS [h8I! Sola � � � compensafion wilPAo the work, antl tha structure� is not in[enEetl or offeretl ' � n �( '� ! - MECHANICAL • � � � � � qpp�iwtion Approved By � � �Date 4�� ' for sale •(Sac�lon 7044, Bu5ine55� antl: Professlonal.,Cotle:: The� Contractor'S � , , , � , _ , . . , � � • � . i � Licenie law tloes not apply to an owner oi a Omperty wha builtls or improyes i � �� ' RCfrigeretiOn SyStem ' ' NeteOn,�dnE wh0 GO¢5{SUCh w0/k himself/he�s¢If o� through h15 or he� own 1 Boiler � � �°�°: j� . � , , � ' Appliqtion laued By � ' ' � �Date � - � : � emplo�eos, provitled Mat such improvemants are;not Intentlea or oHerea tor �� -- - � ❑0.100,OOOBTU �100,OOOBTU ' - - � , . . ; ' ule. I however, the bulltlin or im rovement Is soltl within ona earrof com- j Duct =' Under Ground 4 � � , ' � � � � � 9 D v , , 1 i SUMM RV OP FEES I ; ! - plat n, tne owner�will have t�e burtlen oT proving he/she tl10 not bulltl or Im- � � � ' � � 7 � ' � � ' r eforthepurposeatsale)} � � � ( ' Ouct-Strucmral � � ' SystemRepair�Alteratian :BUILDINGPERMIT $ � SMIP � ' ; $ I as ownei of the property, am excluslvely contracting!with;licensetl con- � � � � � � � � � � � ' : ' � f ' ' _ racto sto construct the.project,(SectionJ04a, Busineu an0.protecsions.Coae:. � .._ Dutt, Ventilating _ . _ �� _.{ _._ „. . 1 _ _; .( .__� ,�PLAN CHECKi � � � , PERMIT ' ' ' Tne Contractor'S Licen3a Law does not apply to an ownai o( Oroperty who � ' , - � ' � � ISSUANCE � � $ � � � � . builtls or, Improves'tbereon, antl who contracti for such projects with a con- " Exhaust System ❑ Multipl8 ❑ � � j � . PLUMBING � � � tractor(s) Iicense pursuanc to the Contractor'S Licenze tawJ. , : � � ' - � � � � ' � � '. � � G DING � - $ � � � � ;PIAN CHECK, ' + � � � ��iam exempt un8er Section , � � e, & P: C. tor tnis reason � Firepl/FaCt.81t. IC80 # • ' � � � � , } t • : : e . . . { f . . � � I i � :ELECTRICALI , � �IL� i $ E i � Date ' t � owner � ' • - - ' � ' Heating�System & Ducting � • , ; � i ��� � -i �ereby.-certHy-that��l� hava reaE•this �avV��ca n -antl stata tnat-the-above-'� - � 06100,OOO�BTU 0100,000 - - - - -- � � - IPLAN CHECK • • � � � Information Is correct. I a rea comply wit all clty,antl tounty ortllnances � . �. . . . . ' � f 1 ' i � ' ' ( AI,FEE� '$� � antl:state laws ralatl il' ing construct n�na hereby authorize repre- , � - , � � . � ;MECHANICAL : I^ �, , � j � � � � sen[atives of�thi � y, ' 't r�u on the ab ve-mentloneG roDerty for - Hoodoi Typ21 ❑; � , , � � I Inspectlon pose . ' p . ' � Cano 1 T� e I I ❑: I I 1� � Re,inspection Fee � $15 ;pLAN CHECK� $, � IF/, LESS � � ' Slgnature � � Date �/��G—�3 j . - � � � ' ' - � � � � � � � ADVANCERPC � $' � • � Drlvers' LI n'or 55 qp � � Registers . � � � . Issue Fea j ' S 3 � I � , ' � FINAL FEE � $, ' � �. CMF 0865-46 rav. 2/82 Whlta - Bulltlin9: Gnary - ApPliwnt; Pink - Accountin9; Goltlenrotl -ASsessor �»a> �sa-s2�a • Fax (�ia> �sa-aess Job Address: 2180 ELDEN AV Suite No Vicinity: Parcel Nunmber: 93603024 Applicant: NOCK, RON Address: 11612 KNOTT ST GARDEN GROVE, CA CITY OF COSTA MESA �`� BUILDING D/VIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT Owner: GALVEZ, THERESA R Address 2180 ELDEN AVE #A A COSTA MESA, CA Contractor: NOCK PLUMBING Address: 11612 KNOTT ST GARDEN GROVE, CA Arch / Eng : Address: PLUMBING PERMIT Phone: (714)895-1246 Zip: 92841 Phone: Zip: 92627 Phone: (714)895-1246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT i WATER HEATER CHANGE-OUT. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drein, Roof Drinking Fountain Expansion Tank Gas EaAhquake Valve Gas (1-4 outleis) Gas (Over 4 outlets) Gas Repipe Gas Service Inierceptors (Grease, Oil) Interceplors (Sand Auto ) AMT $23.50 $0.00 $0.00 50.00 30.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, wmmercial $0.00 Sink, Floor , $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 aN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS PERMIT NUMBER �� OD3%� 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07/17/2000 Issued: 07/17/2000 ISSUED BY: Sump Pump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) , Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $12.30 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $35.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 .�7 NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced vnthin 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vrith all applicable codes, and all required Inepectlone and final epproval must be ob�ained. Failure �o obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: "� I hereby eflirm untler penalry of perjury one of �he following tleclaretions: ❑ I heve end will maintain a certificate ot consent to self-Insure lor workers' compensation, es provitled for by sedlon 3700 of tha Labor Code, for the pertormance of tha rk lor Which ihis pertnit is issued. I have and will maintain workers' compensation insurance, as requlred by seciion 3700 of the Lebor Code, for fhe peAormance oi the work for which this permit is issued. My workers' compensation Insurence carner end policy number era: � 9 ��/�7p 'r Carrier �i��E7\� �'6�� PolicyNumbeuS/�`"f / l 3 'T �d �_ (This secflon nBed nof be comp/etetl il fhe Oermi( is velued af one hund�ed dallars ($100) or less.) ❑ 1 certify that in the pertormance ot ihe work tor which this permit is issuetl, I shell not employ any person in any manner so as to become subjact to Ihe workers' compensa�ion laws ol California, entl agree ihat if I should become sublect to the workers' compensation provisions of Sectlon 3700 of the Lebor Code, I shall fonhwith comply wi�h ihese pra �si ^/� C, /J� \1 Applicent Signa�ure: Dete: �! �// � — �J WARNINO: FAILURE TO SECURE ORKERS' C NSATION CAVERAGE IS LAWFUL LL SUBIEC� AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDFED THOUSANODOLIARE($100,000),INADDITIONT0111ECQSTOFCOMPENSATION, AMAGESASPROVIDE�FORINSECTION3]O60FTMEL�IBOFCODE,INrEREST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby eNirm that I am licensed� r pr�siQns ry[C�r 9(commencing with Section 7000) of Division 3 of the Business and force antl eHect. Lic. # O 7 J ciess n Contrectofs Signawra: � / Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aMirm ihat there is a construction lentlinq aqency for ihe pedormance of ihe work for which this permit Is issued. (Sec. 3097, qvil Code). Le�tlers Name�. lentlefs Adtlress'. SignaNre: Date: and my license is in full OWNER•BUILOER DECLARATONS: I hereby eHirtn t�at under penalry ot perjury thai I am EXEMPT FROM TME COMRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry m counry which requires a pertnit to conswct, alter, improve, demolish, or repair any strucWre, prior to its issuance, also requires tha applicam br such permit to file e signed 5�atament ihat ha or she is licensed pursuant to Ihe provisions of the Contrectors Licensa Law (Chepter 9(commencing with Sectlon 7000) ol Division 3 of Ihe Business and P�o�essions Code) or ihat he or she is exempt therefrom antl the besis for the allegetl exemptlon. Any vlolation ol Section 7031.5 by eny epplicam tor a permit subjacts the applicant to a civil penalry o1 not more then Ilve huntlretl tlollars (5500).): ❑ I, as aw�e� ot the pmperty, or my employees wit� wagas as their sole compensation, WILI DO 7HE WORK, arW the svucture is not intentletl or oflaretl tor sale (Sec. 7044, Business and Professions Code: The Contrectors License Lew does nol apply to an owner of propeny who Duilds or improves ihereon, entl who does such work himself or herself or through his or her own employees, provided Ihet such Impmvements are not Intendetl or oRered for 5ale. If, however, the builtling or improvement is soltl within one yeer of completlon, ihe owner-buildar will have the hurden of pmving �hat he or she tlid not 6uiltl or improve for purpose of sale.). ❑ I, as own�r of ihe property, am E%CLUSIVELV CONTRACTINO WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business antl Pmtessions Cotle: Th9 comractors License Lew does not eppty m an owner of property who builtls or improves thereon, and who contwds tor such project wi�h a contrectoqs) license pufsuant to the Coniractors License LawsJ. ❑ I em ezemp� under sac. Business antl Professions Code for Ihis reason: Signaiure: Date: Owner ID verifietl by tlrivers license. ❑ Ves ❑ No Dnvafs license No. Expires: Verificafion of Ownership by irype of dacument, i.e. - property tav bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify tha� no excavatlon ilve (5) or more feet in tlepth Into which e person is requlred to descend, wlll be matle in connection wlih work authorizetl by Ihis permit, end ihat no building stmcWre, scaflolding, falsework, or demolition or tlismantling thereot, will be more ihan Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sac. 341, Ti�le 6, California Administrative Code). ❑ As owner-Duilder, I will not employ enyone to tlo work which would require a permii from the Division of Industnal Safery, as notetl above, unless such person has a permit Io do such work from Ihe tlivision. Signature: Date: Division ot Intlus�rial Safery Pertnit NumDer: CER7IFICA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certi(y under penalty oi perjury that I have read this application antl state that the information given is correcl I egree to comply with all stata laws and ciry ordinances relaNng to building construction, antl authonze represematives of the Ciry ot Coste Mesa to entar upon the ebove-descnbed p�operty lor inspaction purpases. I agrae not to occupy or allow occupancy of any buildinq authorizetl Oy t�is permit until tinel inspaction. 400E �. ItlSPECIlR�PE D9IE 1ti�19L5 1616 Fized System Final Fire Prevemion 1266 200 201 202 203 204 2aa6-a6 Pool Spa Final Final RB-Root Final BIO�k�Retaining Wall Flnal Faclory Fire Place Final Sign Final Demolition COOE 1 INSVECTION TYPE 206 Final Mechenical 208 Finel Plumbing 210 Final Electrical 272 Final Flre Prevention 220 Final Plenning Approval 222 Final Site 250 FinelBuildingiOccupancy Q�jf, NI TITIpLS ' �. G � _ _, _. ADG���int to /ill In all spaeas exeeD� [hoze wltnln �eavy bo�Ee� Iinas anE sign all approDriate Eeelantions. _ CITY OF COSTA MESA• � � ' � PE IT O. TRACT NO. LOT NO. BLD . � ' 734Z k� I�Y`! J , CONSTRUCTION PERMIT " ' ' � � ��, " • ' • 4�.J;:' T .i Applicent'S Mailing ddr�es.s/� - /%/� , . � � ' � �� TVPE OF CONSTRUC710N NEW ADD � ALTERATJON REPAIR . . . ' ; . ' - - � : PfOjeCt Addf853 e' �� . �•" ` - ❑ CONVERSION _ ❑ DEMOLISH ❑ OTHER � . , . . • � , , Ownar'S Name � ��� ��A��� K �h^^.a DESCRIaTION OF VJOPK _ , - �N E I S - - AddfBss ,_ TVPEOFPERMIT GRADING' FOUNOATION ' STRUCTURAL A.P..$ ' ' -ZONE ' A�Ch/Eng. - - LiCBnSB No. . ❑ TENANT �� ELECTRICAL :O PLVMBING ❑'MECHANICAL PLNG. REF.�9W' . � ' - � BUILDING � . Addr255 .� - . � � ' � D,�OTHER . ' � TO BUILDING . ' . - � - Contractor's Nam �� y�l A� oneZs 6v� ' PRQIECT DESCRIPTION 5q. FT. oCGUPANCv PE V INE � REAq VARD (T0 P/U � ' ���J���I�/ff/5/�/1'� -L;/f%� CONSTRUCTIONTVPF VALUATION$ LEFTSIDEVAqD RIGHTSIDEVARD � Addre55�metling) ' PKG.SPACE RE�, pROVIDED � 1GL.rrr , ZON� GRADINGGU.YDS. :ACRES - . CiceriseNo. .-c� �-F�� , LICENSED CONTRACTOR OECLARATION Remarks: �' STREET WIDTH . PARK FEE $, " I�hare0y afflrm Ihat 1 am Iicensetl untlar pwWzlons ot Charter 9(commencinq . , , . , wR� section 7000) 01 Dlvlzion 3 0/ the Builnett antl Profaisloni Cotle, an0 � , . . SPECIAL CONDITIONS: � �� my Iicensa is In tutl }orc n / ecL � . LlcensaCt �� ce � o. -�%� . PLUMBING . � � . � ' � ' Date�_ Signaturo -' , Bar Sink ' Sewer Cap ' ELECTNICAL WORKERS COMiEN5ATl0 �� AT�ON - - r¢D affirm tnat I Oav ert�f��ta of conse setf-Insure�or a certNiwte ' ' - - - Automatic Washer �- ' __ •Meter ❑over 100 amps >:7y�° Y Backfiow Preventer Sewer Connection .. . � ' v Workars' Compe on InSUrance, or ertitletl [o0Y ��ereot � . , :'�. ,�'lv o, Lab. CJ � , • ackflow Irrigation . Splar Collectors � Construction Pole • Sub Panel � Policy No. ' � Company �` ' � '- � ' � e Cert a coqy Is nereey nishetl. �� Bethtubs ' ' . � Solar Piping � Cooking Unit . ; � Sub Pole . � ifiea c y I itn tbe city B I v s Dishwa5her Morors �04 HP ❑1 X-8 e ' .AbPll�nt � ' Clarifiers � SolarTank � . EXEMVTION FROM WORKERS' COMPENSATION DECLARATION �. . DryCrs ❑Gas OElectric .(7nissection neea not be completea If tne oermit Is for one huntlratl (S1oo) or ' Diihwdsher Swimming Pool w/Spa Inc.Solar �9-15 HP � i6-75+ 1ess� . � , � Fan. Microwave 1 ceitlty.Nat in�[he DerTormance ot t�e work tor which this perm�t Iz IssueE I- D�Inking FOunteins i Ufinal .. . shall'not employ any parson in any ma ner o as jo D� me sub7ec to t�e� . . - . - • , F.A'.U. � � � �Pol2'Light � WorkariL' Compa(� satbry Lawi o1 Glifoj 9�la.• /�/ � � Floor Diainsi � yVater Closet ' — - - � . Date ! � ��*'•/J {_ Signature ��/��«�� ��� - � � Fixtures ' � _ tRan B . NOTICE: If, aiter making this Getlaratlon, you srioWtl become sublect to-the • Floor Sinkr -� • -�� Water Heater -- � -- -- � 8 � � --� - � Workers' Compensatlon DrovisiPns o/ the Labor COEe, you mus[ fort�wi[h- - Oevice Boxes comply with such provislons-or this parmit shall be tleemeC revokea: GasService�,� "Ouilets �j �.wateiservice �: •�. � Sign ' ' � CONSTRUCTION LENDING AGENCV � ` Outlet5 - I nereby aftirm that t�ere ii a coPstructlon IenOin9 agency !or tha performanca Interoeptol5 , - � � • ' $t2nding SettiOns of t�e work for whicn-this �ermit Is issuetl (SecHon 3097 Civ. C.) � � ' - ' Lenaer's Name. �' Kitchen Sink � ' ' : - ' ' ` ' . - � Switchez 'Trash Compac{or � LenOer•z �AtlGress ' ' Garba e Ois osal � OWNER BUIIDER UECCARA7�ON� • � �/' CevatOfiES ' � �-. _ . ,,,, . 9 P ' � ' I hereEy atiirm that I am anempt irom tha�Contractor's License L.aw for the � �. . , _ GeneretOr �0�5 KW 0545 KW ' . tollowing reason (SecHon 7031.5 Business antl Protesslonal Cotla: Any city or ' P-Trep � .�. - . 'county whicH reqWres a parmit to construct, alter, improve, Oemolish,o�reDalr - - � � . - _ • Transformer ❑ 75-50 KW � ' ' ' �, � any zt�ucture, pdOr t0 It5 ISSparYtO, LI50 �equir¢5 tha appllcant !O� such a�mil Roof Drains to fila a signetl slatement that „e/she is Iicensea pursuant to Ihe'provit ons o! 05U+ KW � me Contractor's Ucense Law (ChaOter 9(commenNn9�witn Saction�7000� of ' . . �� _ - , Reinspection FeB � $15 q�;l,!an-3bf the Businazs antl Professlons Cotle) or that he/she Isiexempt Showers ' � �, • Reinspection'Fee' $15 _ h �Y,��om antl the basis lor tne allegeC ezemptlon. Any vlolatiod of Section ' . . . _ - Mete� ❑up io 100 amps IssuO FeO. ��$ 3 ��f by`any appllcant tor a.permlt subjects the applicant to a clvll y af not more Ihan (ive hu�tlre0 Oollars (5500). ' � � , Service Sink - ' ' , laue Fee .% : . S 3 Zoning Approved By • � � Date ' � I, as owner of th0 prop¢rty or' my employ0es with wdgBs�ds thB�r Sola ' , , t � ' ' � tompansation' will tlo tha work, antl� the.struttura is not Intentletl or offeretl ' - I MECHANICAL � qppliption Approved By � � Date � tor saie,(Sec4ion 7044, BuSinesS anG�Professlonal Cotle: The Contractor's . ' - •-� Licanse Law tloat not aDP�Y to a� aH'�er ot a Droperty �who bulltls or imProves BoilEr . Refrigeration System ' I/j�] � ', thereOn,'antl wh0 CaeS SUCh w0�k hIT581f/he�sel! o� thrOugh h15 Or h0r own � ���� � � � ApPliUtia� ISSUed By � /� ' Date employ eas, provlEetl that such'Improvements are not Intentletl or offerea for . � ❑p-100,0008TU �100,OOOBTU . zale. If, howavaq the bulltling or Improvament is soltl witbip one year o1 com- Duct - Under.Ground , , , � , • � r � pletlon, the ownBnwill hdv¢ thB bWCen o/ proving he/she GIO nOt bulltl Or Irtl- , , � SUMMARV �F FEES , � �rovaforthepurposem,sale). '� ' � � � , Duct-Structurel � SystemRepair/Alteiation � � ;gUIL�INGPERMIT $ ' � SMIP � � I, as owner of t�e property, am excluslvely contracting�with:llcensetl com � � ; � � � , , � � ' , � $ . I tractorsto constru<t the project (Sectlon.7064,.Buslness anA Protesslons Cotla: _ Duct - Ven[ilatin8. . .. -. - -- PLAN CHECK: $ • , PERMIT ' ' � � T�e Contractor'S License Law tloes not appty [o an owner of property who , � � � � � $ 3 �=� � ISSUANCE � $ ` bu1105 or improves thereon, and �+ho <ontracts for such projects wlth a con- • � ExheuSt System ❑ Multiple ❑. ' � � � - PLUMBING � • . . tractor(s) Iicense O�rsuant to tne Coniractor's License Law)! ° � � p�qN CHECK $. � GRAOING j$' ❑ I am exempt unCar Sectlon � I B, 6 P. C. tor this �eason i Firepl/Fatt. BIC ICBO �V � � � � � , � � � - � Date OwnOrj - � � � � Heating System & Ducting t j � i � � � ELECTRICAL $ � � � • � $ � � PLANCHECK ' I , , MICROFILM $ , I'nereby 'ce�tlfy tnat•i�naae reaE'tnis applicatlon antl state'that the'a�ove ^' -'� 'Oa100,000BTU'�100;0006T� �� - -- � �- ; -� ^-� . , $. � � i Information is wrrect. I agree to compty with all Uty antl county ortlinances ' t . 1 ' I . i . � � � TOTAL�FEE' $ � � sent�ative5'o��thBlatclt tobe�Co/� �Ot�heiabae-rt1B0Uonetlutho�rleereproef ; } HOOdOr Typel ❑�� � f ' � � � - �MECHANICAL � $ � � � ` � Ceno . T � e II ❑ - � � • -PLAN CHECK $ � � ADVANCED PC $ � � y�� 9�' p c Y � Reinspec[ion Fea $15 � LESS ( , ' inspectlon ouro s. / ' . t� �y - ' � 519nature _ � �{� �[...,c��Jr/ oate �Y-/il -O> ' . , , , : � � • . . , � . , . � t ��. Re aters � I�e Fae M � $ 3 , ' V FINAL FEE: '$ � Drivers• Licensa or55 � 9 i � CMF 086546 rev. 12/g2 White - Bulltling; Canary - Appllcanh Pink - A«ountin9; GolUenroa - AsseSsor � � t �-CONSTRUCTION�AND�PLAN I -' � - ' ' ` � ' -. � ���'P- �A - ' � �r. '�- U PPROVALS Permm#' ;"y�� �. �Date . Inspectoi :- � ' - .. � . . . Date Inspector, A � � : ij�AP,PROVALS-'- Pei,. # . � ', - '� �1� Temporary Electrical SerJice or�:Pol`e� �,' , • `� i , � �? , . � � � ` _ - _ ', � • - _ �- � _ ,� _ s '� �'� -.52. Pool &�Equipmeot L•ocation ' . �� 2. �Soil Pipe-Undrgrnd., " ; _ � ' _-� �! %/�.75 -�ylR�. 53� Steel Reinfoicertient ` ' ' � i .� . � - _ .. � 3. Electrical Conduit Utilitv''-Undrgrnd., � v' -'� - ;' � 54c� Forms ^ ." ' - � � ' - - . . � . � rJ , ; . . : . �� . �^ 4 Electrical Conduit-Undrgmd. ,'; f � �' _ _ � - 3 � + ' �. 55.- Electrical•Bootling . � i ¢ o'� � i- � . F�, . T. i 5^. Steel Reinforcement� , �! • � � .� '` ' _ v � -P � � 56., Rough Plumbing-& �Pressure Test � � ' 6� Electrical UFER Grnd. ' .' -� 57 �APPROVALTO COVER-GUNITE�' � - 7. Footings� ' ; i ' � ��' a '� _ � :�58: Electrical-ConHnit-Undrar�ri.: - - - . . � ��. � 8. Foundation� '. � j , ' � _ ,' � � � - � `59. Gas Pipe; O' Undrgrnd.; l`est � - • ' ' i I , i - 9. WaterPipe-Undrgind. ; i _ . ! ��f�� ��jP-'� , _•gp, Backwash,Lines,P-Trap,O�Undrgmd.� � � 10. Str,uctural Flo`or System � �� � . � ' ��� ' , ;.67. APPROVA_L.TO�DECK , " - � 11. Property Sewer Line:& House.Cqnnection �._ i ��� �;.62. Backwash�.&;,ReceptorFinal- � . _ 12. Sewer Cap j � ; � � � � � � _r , , ? 63. lieater.&.Vent-Final . . . � , � 13. Roof Drains � . `_� � � , � - :. �64. Plumbing System,-�Final'- ' 14. Rou h Plumbin � . � � ' � ` ' � ' g 9 � '� �3 �- 85. Electrical=Final` � = �T5: �Rough�Electricat-Conduit � T T N � i ', %. � 1 f �"-' 66.� SoIaF�System-Final - � �"�' " � � ' , ' - "-" ^� T . . . _. , � ,_. . ' . _.1 �+'Rough'Ele mric Wiring.. _ i E � �' �-C' � � a rr .. , "� , � T � i � 67.' Fencing & Access-APProval . - , '- ` - - -,. � -` - �'�17'.:Rough:Wiririg Sign°' � � � . � ', � �� _ , �' � � ' '� • ' 68.� APPROVED FOR PLASTERING " - . _ � . , , , i_ • ,' � 18: �Rough�Electrical=T.Bar�Ceiling� � � : � ; � j !' I'-. ' � � ) 69.� POOL/SPA SYSTEMSFINAL - ' ; �- � 19.%Rough �Heating:&'Air Conditionin'g' ' ' � � '� ' � � FIRE DEPT. REQUIREMENT- � � ., . _ ' I - �- �1 � ^ 20'� Rough Factory Fireplace � � �� � ' i . � � � ' APPROVALS � Peimit # • � � 21. Ducts,�in St�ucture�� ' i � � '� it i , i � � � � � 70.' Underground Hyd% ' � i � - ' �"22. �Ducts, Ven4{lating F. ' : � ;; ( 'I ;� � � � � � I , � 71., Product Pip ng O Gas OOiI . , ' . :.�_ --� . ` ,.. . --� -;- - �--- -- ---- � ---' - - - - -' - -- - •- ±'23. Gas P.ipe-Rough &' Test ' i �R �� ; ' � � ' ' ' 72. � Underground Flush � ' : � �24. �Roof Framing", � ` ' •' �: � � � �. 73. Undergrnd.StorageTank OGas ❑Oil ' . � I 25. Roof Sheathing � � ; �� ��� ° � P ; � ' _ � � 74.� OJerhead Hydro . • � � � � � : a-26 T-Bai Ceiling (Siructural), &�Monocoat` �� � � r'; � ` 75.� Dry Chemical � , . . _ ; ' . , 27. Frame and Flashing � � , ,; �� � � `� � � 76.i Dry Standpipe ' � � � � �. - i i � �' i i ' k28. �L;athing&�'$iding' � .� , � � � i � I i . ; 77.' FIXEDSYSTEM�FINAL � � � ' � r 29. ,Insulation j � � Q " � r �� � � j ' � , � j j 78. FIRE PREV. FINAL � ' � ' � _'_ �' S � - . � . � . . - . . ; �, 30. �rywall Nailing . ' ' , �: ., � ; ; � Notes: - . . � . � - ,. . . � � �. .;. ..- - - . _ . .. ------ -- �� , i � �- - � - - � `_ ;�31: Plaster Brown Coat ,, '� r I � i i � ; �-. ���. , , � ' -.�;.. . . � I , ' �.! � �. " h � V �!j• � � , ' � ' � .��32. Electricsl Power Meter;Final '• � � ,�" %I �s'{' �l� . . �.� � • � � , � � - .i i �� � � � � � � � � 33. Final Electric ' , �! �� I � - ! f � � : ' + i ' ' ' - 34. Final�Heating &�Air Gonditioning � I j � � � � : � ' t � � ,. . � t , , ;; _ . . � . , � - 35. Final Gas'Pipe-Tesf� : ; `= ' ��/y�; . - �. -. � - � .. - � - . u i. �_ � � �. , k � . 36. Hood or Canbpy��; � • � � I ' ' . ' � - �" , - 1 � .i. - o� + ' � . ' . ' .� • - - , . . � - . _ 37. Final Factory' Firep�lace:.� �' , n• i,; , � �. . - . � � : a i. i i. -i . �. 38. Final P.hlumbing 1 r� � � � � � ��9�9�•3 . %j� c � ; � - . , • ; . 39. WaterSe�vice-Final� , � ! �:� ' i i � � _� � � � ' ' _ � ., � . 40. Gas Service-Finel � � � � � � � � • n '� � � � . , ' � 41. Solar pomesticFinal � I ' � � _ _ � � � -� . - � �� •• - � - l.. __. t --- r 42. Backflow''Preventer � , i ,:, � �' - _ F_ � - _- � -� I - -�- ,-- ' .. . , `` , � . 43. Backflow�lr�igation' �' ' ' � '.�`� ��� i ° c � � . � � � 44. Landscape Ir,cigation.System � •��� � , � � � � � � � _ � _ . �. , _. -'�, ..� � � i � � ; ' . . 45. Sound"Attenua4io_n r �; � T � � � � � � ! . ' - - . ��.�� i • -� --' -. � �-, � ; , � i i . _ - 46. Handirap;Regulation9 j � - i � , , � - , _ 47. FINA � STRUCTURE & BUILDING � � � � � � � � � - . � - `i � 48. Specia� Requirements Completed� �� � � � � '-' � , � ' � � • � ' , .� . . I I ': 49. Electric Release i o Edison � � � t _ . iL.'_ _. ' .�_.j_..,.._ �._� _ ._;_ _i_ _� -., ! , � : , ' , : �,. 50. Gas Release to Southern California Gas Co � ' � I i � � , • , � ' . � � • ' n r t i:-' 51. CERTIFICATE OF�OCCUPANCY � ; _ _ � ; _ ' _ _ ' �_ . ' ' ' No � � � Date � M1 �- - --� . ; - -, : � , `I`, . , � , � _i. ' J AYpliwnt lo !il In dltipaee� ee0�hose within heavy borGer Iines antl sign all aDProoriata tleelantlons. � CITY OFCOSTA'MESA �• -- ' ' ., � PERMI NO `� TRACT NO LOT NO. 8 . ' ' b�J�i'� 4/ I I� F� i � J � 7�e ] j f GONSTRUCTION PERMIT � � j���' /�y ' ' - � • AppliCenYs Meiling Addrea � �� ^ TYPE OF CONSTRUC710N ' NEW ADD� ALTERATION � REPAI R , . • " � � . - � ' . ' - , � PfOj2CtAddfe59 �/�� �L�i�/-4-4�F y�-� � �� ❑ CONVERSION �❑ DEMOLISH ❑ OTHER • - . ' , Owner's Nama pqLLpL H�L.�G%C ohoneSA7.Lla2K . DESCRiP710 OF W RK ' 1 G REGUCATI ' - Addreu S RU-�-IIF n nS�Q 7VPEOFPERMIT(�/ GRADING' OUNDATION STRUCTURAL A.P.� ��O` ZONE �� Arch/Eng. LicenseNo. �%� A ❑7ENANT J66ELECTRIGAL :�PLUMBING ❑MECHANICAL . PLNG.REF.9W � BUI DING , 2 � / / / � AddreA � � e � oe.¢.T �/� ���'L� ' ❑ 9THER � '� TO BUILDING `� COnttetto• � Nwma � Phone • PRQIECT DESCRIPTION' SQ. F , � OCCUPANCV E TV � I E �' REAR VARD (TO P/U ' LEFTSIDE VAqD � RIGHTSIDE VARD S� AddfeislmBiling) - � CONSTRUCTIONTYP VALUATION Q O' � � . ZON� � GRADINGCU.VDS: �ACRES ' PKG.SPACEREQ. PROVIDED � � Licenx No. ' LICENSED CONTRACTOR DECLARATION ' ' � Remarkt: � �� g S � � STREET WIDTH � � _ PAR�K FEE $� �a I-hereby affirm t�at-1 am Iicansetl untler Dravlilons of Chartar 9(<ommencing - . with 5attiOn 7000� of Divlslon 3 of t�e Buziness antl Prolesslons Code, antl . ' � SPECIAL CONOITIONS: � �-' my Iicense IS in full forCe an0 elfect. . � . ucense Ciass' u<enx rao.' ' : PLUMBING HOLD FOR SPECIAL REQUIREN(EI�TS' '. Dat¢ ' ' S19naturo � ' � � . . . WORKERS' COMPENSATION DECLARATION � ' r ! � • ' Bef Sink SeJ.Cf Cap . ELECTRICAL ' - � ' � =:;`�ereey.afflrm that.l nave.a CertiflWte.of consent to selfanwro or a tBrtNiWte gg�kflow'Preventer- - -- ' - - SBwEr COnnCCtion -- - - • - Automatic W85her � �Metef over 10i) amps _ , � WO�ke�s' CompenSdtlOn InSurdnCG, O! a certi/leC�<o0Y �Oaieof (SecUon : �:'oo, Lab. C.) • . � � Beckflow Irrigation � Solar Collectors � ' � Construction Pole � Sub Panel � � � " :!� aolicy No. ` � Company � . � - - � , Cooking Unit � � ',Sub Pole � '� �� � �i 8 Certifle0 <oDY �s hereby furnlihetl. � . . , Bathtubs . { � I � $Ola� Piping . ; . ✓' Cortifiatl cuDY is tlletl with the city Bulltling Dlvislon. Dishwasher ;Motors ❑0-1 HP ❑ 1 h$ ;� � .Date � .AOP���nt_ � ' ' � , Clarifiers . � SolarTank . � _ , _._ . . . —_. .__ ' . ' _ . . EXEMPTION FROM WONKERS' COMPENSATION OECLARATION , - DryerS Ges Elet[�id� � � "'" - Dishwasher � � SwimmingPoolw/Spa� InaSolar,09-15HP��1645+� (This saction neeE no[ be comD�eted I} phe permlt is !or one huntlretl (5300) or � --_ �� t • I¢ss): , . • � • � . i �, ., Fen. ' Microwave i 1 car[Hy;tha[ in [he performance oi tha work tor which this permk is Issuetl I � Drinking Fountains Urinal -; �.:., I � . i' � � shall not employ any Darson In any manner so as to become sub7ect [o [{�e � . � , - � � F.A.U. . � PoIE�Light � ' workers' companSatlon Laws of Glifomla. �� � � Floor Diains � Water poset' . � ' . Date � - ��9nature - ' - - - Fixhres ! � ' � ' � " � � 'NOTICErlf,afler making this tleclaratlon, you shoultl bacome sub�ecbto�the� ' F�OorSinks �-- — ��W2te� HeateJ � � � - � .Rang2 Workers' ComOensatlon proviSlons.of the Labor Cotla,.you musLforthwlth D2viceBoxeS ' comply wllh' Suclf'p�ovlsioni'o� .thls pe�Tit sball be-tleemetl roGOkaG. � GasServire "Outlets .Water±5ervice � . ' � �Sign, � I CONSTRUCTION LENDING AGENCY ' . ' ' ' - - ' OUtlets � � � � ' � I hereby aHirm that t�ere I5 a conitruction Ientling agency for the.0erformanco. ' �. Int2rc2pto�s � � !• �� t ` Standing Sections ' ' � - of [he 'work tor, whith lhi5: perml[ Is isSueE (Sectlon .3097 Gv. CJ; � - $Wi[Ches � � �enders riame. - Kifchen Sink' - � � � - � � ' ' � iTrash Compacror � � ' • LenGer's AAUress � - � � � � , � , � . . Garba e Di5 o5al ' � � OWNER,BUILDER DECLARATION � � � ' . � � . . I " Levaiories�� �, , _ ; , `. f 9 . P ' i ' 1 � I hereby�affirm S�at I am exempt from the�Contractor'S,Llcense Law tor the . - _ - � - Gen2retoo �0�5 KW 05-15 KW ' ' . ; following reason (Settlan�7031:5 �Bu5Ine55 an0 ProTeSzlonal Cotle: Any Nty o( ' ' P-Tf9p� •� � . � ' - : �, � - � ' � ' ' � county which, requires a permit to construct, altai, Improve, Cemollsh�or reoalr . � -, . _ . .. - .,� Transformer � 15$0 KW � ' ' ' - 'any ztructure, prlor to Ils Isivance, also raqWres the aDP��cant for suth permit ' j ROof'Dr0in5 ' �^ �. , . � • � � , to (ile a'si9natl statement� that he/sne Is Ilcenzea pursuanc to the�provisions ot - ''� -' � ' ❑5U+ KW ' - ' I the Contractor's Licensa Law (Chapter 9 (commencing,with;5ectlon ]000) ot � - 1 : V n; � � � . - " I • , ! . Reinspection Fee � � §�5� � t��ivision 3'of the ,Bu51ne55 and Protesslons Cotle) or. tha0 he/sha is exempt - Shawe�s • ' .� . � Reinspection.Fea $15 � ;^refrom antl [he basis /or the allegeC exemptlon: Any_violatlod�oLSectlon ' ,' '� � i' ' . , - Meter ❑up t0100'ampb I Issue Fee� �$ 3 31.5 �y any applicant for'a•permlt subJects the-applicant to a clvll ' � t � � . ' � �w �nalty ot not more than five huntlratl tlollare (E500). �• �, • ; S2rvicE Sink l :- . ' � ` . - - , � � Iaue Fee t ? 3 2oning Approved By � pate i b I' as,owner of, the property or m'y ertiployees with wages as thelr sole , . � � ' ; �<ompensation will�Ao the work, antl the structure is not Intentletl or o(faratl t �. MECHANICAC . � qpplintion Appraved By � � Date ¢�� for sale�(Sac�lon 7044, Bu51ne55 antl Professlonal Cotle:�Tbe Contractor's ' �� � - � ' Llcense law tloes not apply to an owner Of a propertylwho bulltls or IinOrovos ' Boiler _ � � RefrigeratiOn SyStEm ' ' ' ! thefeon,;antl who tloe5 Such wOrk hlTself/Ilelsel7 01 ttlfO�gh h15 or h!f own ' '-�. ' r � , i � ' ApplitBtiOfl ISiuBt� By � ; DBtB emD�oyees, provitletl that sucn Improvamants are'not Intentletl or offeretl;for ' ' ❑0-100 OBTU ❑100,OOOBTU � � � � - � . sale. If, howevar, the bulltline or improvamant Is soltl wlthin ono yoar of com- � Duc[- Under Ground ! ;. '� , . ; . , ! • I SUM ARV OF FEES ' . � ' ple lon, the owner'wlll have the burtlen of proving he/she tlltl not builC or Im- 1 � . ' , j r vato�tnapurposeoisale)�. : , , , . � ; Duct-Strucmral � �� ' SystemRepatr/Alteiatioo �'� ' BUI�DW�GPERMIT $, �! SMIP . � $ � � • ��+ 1, az owner of the pioperty, am exclusively contractin9�wlth'licensed con- � , . . ra ors to construct the project `Sectlon 70A4, Buslness anE Prolossions Cotla: � Duct - Ventilating � . ' ' ' 'PLAN CHECK� � $ � ' PERMIT � � The ontractor'S License Law doe5 not apply to an owner of O�operty who � . ' � ; ' $ � ISSUANCE � '$: , bulltls or Improves thereon, an0 w�o tontracts for such pro�ects with a con- Ezheust System ❑ MWtiple �; � � � . � ��, j 'PLUMBING � � � � , Utra<tor(s) II<ense pursuant toahe Contractor's License Law). � � ' ,P�qN CHECK' � $ ' � GRADING $ : ' ❑ 11am exempt untler Sectlon < < B. 6 P. C. lor thls reaion � Fi�epl/Fa[t. Blt. IC80 # 1 ' � - � � I � 1 p� �' . , • � ' ' l�. � ' ' 1 � ' . ' ' ! Heatin'System&Ductin � � • • ELECTRICAL � $ _p= � ; � $� �Date O er 9 9. � � MICROFILM •$ I hereby mrt y�,tnat I nave reatl thls ap Iication antl state that the above ' ❑p100,000BTU-�100,000 -. PLAN CHECK $ , Information i �c rect, to comply th all clty antl county ortlinances � � ' � � TOTAL,FEE •$ (�� antl=state law ' o u Iding constru I n,•antl heratiy autnorize repre- � - � . �MECHANICAL $, , '1.� sentat�� � tM �. t I t e ter. upon the bove-montionea property ,tor HUod or Type I ❑ • ReinsOection Fee $15 � � � LESS � � ' PLAN CHECK $ + Inspec on ou s • � , . Ceno T- e II ❑' i ;�� � sq`a re ' � � Date � � . � . , - , ' ' , . . ADVANCED PC ! $ �—//–Fi �' Driver n or5s qF -� � , Registers , laue Fee , � S 3 � � . FINAL FEE� $ CMF 0865-46 re . 12/82 WM1ite - BuIl0lnq; Canary - Appliwnh Pink - Actountln9: Goltlenrotl - ASsessor . -- -'' / ' ;CONSTRUCTION�AND•PL'A N :� " � . �- -� = ,:. ,• POOL, A � . , ` � � . , � • �APPROVALS R, Permity#- _- ���1�ate! � �,Inspector � APPROVALS ' Permit� � Date Inspector � �' ' - ,. �1.:_ Temporary Elec[rical Service or Pole � . � y � RG ; 52.'� Pool & Eguipment Location - . . - . � 2) Soil Pipe-Ondrgmd:: _ `' _ �. , � '' . - 53. Steel Reinforcement � - , ' - � - � ' 31 Electr.ical Conduit Utilitv-UridrgrnA: � 54: 'Forms : -. " . � ' �- � - ,� 4: Electrica,l Cpnduit-Undrgrnd: � - _ � �55.� Elec[rical Bonding : � - _ � 5: Steel, R'einforcerrmentl � � � : -� � �; y' ` - , .. 56. Rough Plumbing & Pressure Te`st � , . � .i 6. Electiical UFER Grnd. � - „' `. 57: APPROVAL TO COVER-GUNITE. � � 7. FooSi�9s , c � �. �- �: " : - 58: Electrical Cqnduit-Undrarnd. - _ 8. Foundation � i �� �., "� - � � 59. Gas Pipe, O_Undrgrnd., Test � 9. Water Pipe-Uriiirgrnd. � � - " i .'60, Backwash Lines, P-Trap, O Undrgrnd. � � � 10. Sttuctural Floor System ',:° ��� - ; 61. APPROVAL•TO'DECK : i 11. �Prbperty Sewer,Line &'House-Connection. �(��,�Y3 �jy�-� ;62. Backwash & Receptor-Final '' 12. �SelverCap �-�„ •�� I ' ' '63. Heater & Vent-Final, - - 13. Roof'D�ains ; } ( ' � � ' - �` c n 84. Plumbing�System • Final � � . � N . 14. Rough Plumbing � � -�- . . � - � 65. Electrical�-Final - � 15. Rougtf Electrical-ConduiY;'" 7 . ' � �'' f �� i`-.-"��� �66.{ Solar System-Final • ' � � - ' ,18. �Rough Elec[ric Wiring • 1 �< ' �� ; - � -; r t=; � - , ,, r- - �67:� Fencing'& Access Appioval " - �� ,- " � - 17. Rough Winng Sign;_ ', ':; i: i � _ ��� � � i' gg,' APPROVED FOR P.LASTERING - 18: .Rough Electrical=T Bar Ceiling � ;! � - ; . ' � ." � 69i POOVSPA SYSTEMS FINAL �9. Rough Heati�q�& Air Conditioning �, � '� �' FIRE DEPT. REQUIREMENT . �$0.' Rough Pactory Fireplace " � (; i ' ' . ' ' APPROVALS� Permit # • � 21. �Duc[s, in Structure, " � � , � C; i. � � ; � p0. Underground Hydro ' 22. �DucfS, Ventilating' � "_ �� � ;� � � � , 71. Product Piping �Gas ❑Oil � - ' 2f'r..:Gas Pipe-Rough & �esf 'Y ' � � ,i� �i I ' � 72. Underground Flush " � , ' � � � . 4. Roof �Framing- ;, � "�i � � , ( ; I ;r , �` • - 73. Undergrnd. Storage'fank O Gas ❑�Oil 2�. Roof Stieathing � � �.'-, � • � � � � 5,,,� . �74.� Overhead Hydro . . � ' � �� 26. T-Bar �eiling (Structuralh& Monocoat'' ` �75r Dry Chemical � - ' �. � . 27.'Frame 8nd Flashing �.1 , ,, 76. Dry Standpipe ' � � ' . . 26. "Lathing &�3iding; � � i t� �' � � � � (�,'� ' _ 77, FIXED SYSTEM FINAL 29. Insulation ; `� ;� . 'I , D S � �y^ �,,a 78: FIRE PREV. FINAL . � ' � ' 9 � ! Notes: � -. � � � 30. Drywall Nailing , �,� � � : � i , � , � 31:.-PlasteF.Brown Coaz� � � �l �; I � � . ; . � - . . ._ i 3 32. Electrical Power Meter-Final ,. ' � � -� � � � I . 33. Final Electric i ' ' �` � � . � I ' , 34. Final Heating &'Air Conditiooing' � ^ , ' . ' ' � 35. Final Gas Pipe-Test � � �� � � � � � ,�� - i � �'� � . - � ' � , � ' . �� . 36. Hood or �CanoPY'�' ' I .- - i � . . i =. _ - . 37. Final Factory Fireplace� � • , : ,� ' - - � . . � . � " � � � 38. Final Plumbing; •T i ' ' o; ,-�, �� i - � � � . ' � - 39. Water Se'rvice-Firia,l . � ' j � � I ' p. � 40. Gas Service-Fina� �� � � �� ' 1 � : � , �, i I � - 41. Solar pomestic-Final ' i � - - I i i � ' i ' ' � � ' .�; , • � � - 42. Backflow Preventer � � � �� �.., � � � , � � " ' � . �' r� - - ---- - - -- V ' � _ • 43. Backflow Irrigation ' , ' � .�� �" �; � ' i _ - � ' � . 44. Landscape IrrigationSystem � � � ?�, � _ . - � � � � � � 45. Sound Attenuation ; � � � '� _ � . • - � � . � 46. Handicap Regulations , "' � I ,�� i , • � � , 47. FINALSTRUCTURE�&BUILDING- '�� :�� �• �P�,IrI � � � � ' � n � � �. 48. Special Requirements Completed � � ' g�$ 8 � � � � � 49. Electric Release to'Edison' � � � _ �.-.j �� . _ � _ ._ _ . � � . . � • - � 50. Gas Release to 9outhern California Gas Co ;�� i �' � � �v - � � j�' - 51. CERTIFICATE'OF, OCCUPANCY ^ � _ _ : ; � - i No 1� ' . . Date i „ I f � . . . � , . . - - - - - - - - - � pLM. ADO��eant to Till in all s0aces a:cept t�ase within �eavy borAar Iines antl sign ill dDG�ODfIatO GlCldliti0�f. CITV OF COSTA MESA COaSTRUCT10N PERMIT ApplicenYsMailingAddress /�=Z7/ � �. /CoI_ /�/i<.�.T Project Addreu � � N l% £l� � OwneriName ��'�r� k ��.'/'y2-`i"'-=fPnone Address � Arch/Eng. f �� ��"s✓'�� LicenmNa. Address /Ucw v.� ��c # O Contractor's Nem � L� � s� � �hone �L3�� Address (meiling) 3 License No. LICENSED CONTRACTOR DECLARATION � I nerlby a(firT that�l am IlcenSetl unAer provlsions of ChdrtBr 9(comTBncing wlth sectlon 7000) ot Dlvislon 3 of the Business antl Protesslons CoUe, antl my Ilcenie Is in full for<e an0 effect. . Lltenu p s '�� Lice 8 No. � Z Oate $I9ndtur0 J.�Li�+k��"— WORKE S'COMPENSATION DECLARATION �,I here�y affirm that I hava a ttrtifl<a[e o1 tonunt to ���-��sure or a Certitfw[0 '-,�'f Workers' Compensatlon Insurance,��or a certifiRtl copY thereof (Se<tlon ��'�B00� Lnb. C.�q q3 � . �)r�n-...,� .�..c �o Polity No. Company— �ce.u+iaa <oor is nereey i�roi:naa. • Certiflatl op i/iletl wit� the city Bulltlin O 4�on. Data ApPliwnt��� �(v -�-� EXEMPTI N---��RKERS' COMVENSATION DECLARATION (Tnis section neeA nat ba camD�eted if the permit Is far one huntlreE (E100) ar less). . I certi/y tnat In the performanca ot the work tor wnlc� t�is perm�t is Issuatl 1 shall not amploy any person In any manner so as to become sub7ett to t�e Workers' Com�ensalion Laws of Callfornia. . Date �Ignatura NOTICE: I(, after making thls tleclara[lon, you sho��tl Gecome sub7ect [o the Workers' ComDenSaUon provisions ot tha Labor Wtle, you must forlhwith comply with such provi5ion5 'or Ihis 'permlt snall be EeemeO revoke0. CONSTRUCTION IENDING AGENCV I bereby alfirm that there Is a cons[ructlon �enCing agency for tbe performanca of the work !or w�ich lhis permit is:issuatl (�ction 3087 Civ. C.) LenEer's Name . t�entleYS Atltlress � OWNER BUILOER DECLARATION ' ' I nerebv af(irm tnat I am exemot trom Ma Contractor's l.Icense Law tor the )0315 by any appllCant tor a permit sub�acts ��a appucani co a uvu , ' enelty o/ not morB than flv0 huntlf¢tl tlOIIdrS ($500)• � I, as owner of-tha property br�my employees �+�Ih wages as their sole compen5ation wlll tlo tha work, antl tha struc[ure is not intantleE or oT/¢r¢tl • for wle (Secllon 7044, Business anG' Professionai Cotle:. The Contractor's ' License Law tloes not aDP�Y to an owner ot a proper�Y `�o bulltls or improves thereon, antl who Aoes such work �Imself/h¢rS01t Or througn h15 or �er own employ¢as, provitletl that such improvemants a�e nP< �ntentletl or otfer<tl for sale. If, however, the buil0ing or improvement is soltl within ona year o7 com- - � 0�etlon, the owner wlll have the burAen oi provin9l?¢/She tlitl not builtl or Im- '� rove for the purpose of 5ale). 1, as owner of tha property, am excluslvely contracting with Iicensetl con- tractorsto construct the project (Sectlon 7044,.Bu5iPess antl Protesslons Cotla: The Contractor'S License Law does not apply to an owner oi property who Guiltls or improves tnereon, anA who contractz Tor such pro)acts wlth a con- tractot(5)IICBniO Durivant t0 th¢ Contractor's LICBn4C Law). ❑ I am exempt untler Section B. & P. C. tor this reason Date Ownar I hereby cartlfy that I have reatl thi5 a0��i InfOrmation ii COrracL I a9ree to com0ly wil antl stata laws relating to builAing construct 5antatives o/ [his city, to enter upon the inspection ourpases. Si9natura ��;/�. -L-1 TYPE OFCONSTRUCTION LI NEW LI AOD IJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � DESCRIPTION OF WORK TVPEOFPERMITp��� GRADING FOUNDATION STRUCTURAL ❑ TENANT Ja�GLECTRICAL ❑ PLUMBINC. ❑ MECHANICAL ❑,OTNER PHQIECT DESCRIPTION Sq.F7. oCCUPANCv CONSTRUCTIONTVPF VALUATION$ � ZON� � GRADING CV. VDS. ACRES Remarks: �% % -�J JJQ � ' Ber Sink Backflow Preventer ' Beckflaw Irrigation Bathtubs Clerifieis � Dishwasher � Drinking Fountains ' Floor Drains • Floor Sinks � � Gas Service� Outleu IntelCeptOfs � Kitchen Sink . . Lavatories � . P-Trep Roof Drains Shawers � Service Sink .. Duct- Under Ground Duct-S[ructural ' Duct - Ventilating . Exhaun System ❑ Multiple Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑6100,000 BTU 0100,000 Hood or Tvoe I ❑ Drivers' Liconsa or 55 qp �� ?/��"'� - T�— I I Registers CMF0865-46rev.12/82 Whlte-BUIltling;Canary-APP����t;Pink-Accounting;Goltlenrotl-Assessor Sewe� Cap Solar Collec[ors Solar Piping Solar Tank � Swimming Pool w/Spa Urinal Water Goxt Weter Heater � Water Service Reinspection�Fae � laue Fee iANICAL Refrigeretian System ❑0�100,OOOBTU ❑100,OOOBTU System Repair/AI[eration A. P. qW PLNG. REF. qW LEFTSIDE VARD PKG.SPACE REQ. STREET WIDTH SPECIAL CONDITIONS: Automatic W asher Construction Pole Cooking Unit ' Dishwasher Dryers �Gas ❑Electric Fan F.A.U. � F ix tures Device Boxes J175 4/14/N3 REAR VARD (TO P/U RIGHTSIDE VARD PROVIDED PARK FEE $ Metef LJO�er 1 W emp3 Sub Panei Sub Pole � Morors DO-1 HP ❑7Xa Inc.Solar �9-75 HP 01 ,Pole�Light Range Sign Standing Sections Trash ComDatror GeneratorLJO-SKW LJ5-15KW Transformer 015�SOKW ❑5U+ KW Reinspaccion fee $15 Meter ❑up to 100 a Iaue Fee $ 3 Zonin9 APProved BY Date — Appliration Approved By f ,�, Uate Applintion Issued By `''//� �Date � Reinspection Fee $15 laue Fee � $ 3 BUILDING PERMIT PLAN CHECK � PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK , MECHANICAL �PLAN CHECK OF FEES SMIP i PERMIT ISSUANCE GRADING MICROFILM TOTALFEE � LESS � ADVANCED PC FINAL FEE 5+ $ �.<J i� �� , -- - - -_- , -..roo�a��a - ' ?�CON$TRUCTION�AND PLAN ING � � . � � �,� � � ' : � . ` ' . �� �� � �Date- � Inspector ' � � ' ' Date � Inspector >�.nAPPROVALS .; ReriniC#�IILw; _-` � � � �^ � APPROVALS �Permit#� ''� 1e Temporary Electrica'I Service or Pole ", � �. �. � 52; Poo� & Equipment Location '�� ' n ^ �}„ 2'. 1Soil Pipe-Undrgrnd. � ' " � <<r , •. - � 53:� Steel Reinforcement _ � � ' ' I-. '3i Electrical Conduit Utilitv-Undrgind. ' - - . . _ ' 54: Forms �. -. . � . . _ ' ' ;'' 4. Efec4rical Conduit-Undr9md: ' ' . � � ;���3 ..,-C' .'55: Electrical Bonding - - � ' �,� . . 5t Steel �Reinforcement � � � � II � . �{ , ' _ � i � .� � 56. Rough Plumbing & Pressure Test . _ 6. Electrical UFER �Grnd. ,,'., • . 57, APPROVAL TO COVER-GUNITE ' � 7. Footings ' ' , � . `' . . 58. Electrical �nduit-Undior�d; � � 6. Foundation � ' -�' ' . " _ . :59. Gas Pipe, � Undrg[nd., Test 9. Water Pipe-Undrgrnd. � ��-_ 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structurel Floor System i �' : �; 61. APPROVAL TO=DECK 11. Property Sewer Line & House Conneciion. , ,- - 62. Backwash & Receptor-Final . �• �. 12. Se'werCap ° � � � � n _ ��63. Heater&�Vent-Final 13. ,Roof'Drains � ' - �. � � - -.64. Plumbing System - Final -' � - � 74. Rough Plumbing . � � 65. Electrical-Final - �� - � � ; �-15. Rough Electrical=Conduit-,': � '� ""'��" i --- '-' "" 66.� $61ai System-Finaf � � - - "- -' �� � ,'16. ,Rough-Elecfric Wiring, . � � -- � b,z, �'�-' �o �- � 67. Fencing &� Access Approval � "- ,� �-�17. Rough'Wiring`Sig'n'. - ' � � 1 ' � - � �-� 68. APPROVED FOR PLASTERING � ' - - - -�78. +Rough�Electrical„T'8ar� Ceiling� i � ' � 69i POOL/SPA SYSTEMS FINAL � . � 19. Rough Heating &,Air Conditi9ning ' �' � � • FIRE DEPT. REQUIREMENT� � 20. Rough Factory Fireplace � � i ' � i APPROVALS Permit # � � 21.,Ducts,�inSiructure•, � - � � � � 70. Underground Hydro � ,a22 'Ducts, Venfilating ' r � � � ' � ' � � �71. Product Piping � Gas ❑ Oil ' T' "`.23. �Gas Pipe-Rough & Test �, � s�� : i I 72. Unde�yround Flush � � �'24. Roof Framing�� ' � ' . � � • ;: 73. Undergrnd. Storage Tank D Gas ❑ Oil ' > r _ ' 25. ,Roof Sheatfiing , %a ' - - 74. Overhead Hydro - � -26. �T-Bar Ceiling �Structuraq. & Monocoaf I � � � � 75. Dry Chemical ' , - (27. Frarrie and Flashing _ � � � � � ' � � � � �76. Dry Standpipe ' . � i ' � 26. Lath�ing & Siding ' i �! , � , i � 77. FIXED SYSTEM'FINAL 29.' insulation `-` - ' ' � � � „ �. ' � � j � �78. FIRE PREV. FINAL 30. Drywall Nai�ing � j '� � � � �Notes: � , - �,.. ;• � .' _ . .. - -- _ � �31. Plaster Brown Coat � � i � ; ' ' ' � '� 32. tElectrical Power Meter.-Final � � � � ! � � ' . • . . � - - � - � , r � � . ' 33.•Final Electric � ' � ' � ' 34. Final Heating &,Rir Gonditioning •'` � � � � 35. Final Gas Pipe;Te;t ` - � � � � � i ^ . - , �� - � � - � � ' . � , � . _ • . 36. Hood or CanoPY��, `� � � : � . . - ' � ' . . ' � �. . - . .. I !� 37. Final Factory Fireplace , i c�. :_ i- ;�._ � � I '', I,� i � � ' _ � ' :-' i , • � - � � - . 36. Final Plumbing � � i ' i � ' 39. Water Seivice-FinaP '� , � � ' _ � , ' ' � ' ' 40. Gas Service-Final � � I � - ' � ' � � ' � 41. Solar pomestio-Final i , ' � ' ' _ � ' � � i . . . _ , � , 42. Backflow P.revente � ,. � i .,i - - -- . � " . � , 43. Backflow Irrigation F � ' � � � 1 � : � ' , '-' �,_ . � � _ . . 44. landscape Irtigation S,ystem . � �? , � - ' - � � - � �- 45. Sound -Attenuation *' ' j � � ' � ' ' ' � - � - 3 '� 46. Handirap Regulations � � , , � � ` � . � ' . ' , � , � 47. FINAL STRUCTURE & BUILDING - �=� � ' � � , �� :i i i i � i. i 48. Specia) Requirements Completed ' � � ' � ' ' . .. + • � �� 49. ElectricRelease,to�Edi'son� � ' ' 1 �_ _' _ _ ' ' � e i 1 I_. '+-- ��l � � � . i4. 50. Gas Release to Southern California Gas Co i i , I . � � � . � , . � � � � ' 51. CERT,IFICATE�OF.OGCUPANCY ,: j _ �_ 1 _ -� _' � _ i , _ _' r' No � � � Date � � , . ' , , `: - - ,� --- - - - - --- -- - - , �j�;I y _ ^� �GTY OF WSTA MESA ' � � CONSTRUCTION PERMIT ""APVllcant to flll In all spues exeaPt �� . . ' . PERMIT.NO. . . _ .. _ � Applicent's Mailing Addreu �yd �et�i7Ho /' LQA,Qi' Project Addreu a/�L] �d�2n .ry • • �A/( i Owner i Name �.H�/�l C�� ' '�oh jne � Address ��%�� Q � •J � � 1%it/�. �7V�� Arch/Eng. � License No.. . . Address � � Contractor's Nam ���-�� - � ' hone q30 /�73 Address (rrmeiling) �� B��O� �� , ���M Q�.�fYs' � License No: � , LICENSED CONTRACTOR OECLARATION � 1 hereby al/irm that 1 am IlcenseE untlar provislons of Chartar 9(commencing with sacllon 7000) of Dlvision 3 01 the Business anC Roiaislons Cotla, antl my'licansa.is In full f r e a d effect. � ' . License_CI� s� � Icense S dS 6 ' Date S/3! ci��»��... ' A 4 me. WORKERS'COMPENSATION DEC R TION ' � 1 hereDy atfirm tnat I have a cerHilcata o consent to seli-Insum or e certiilwte � Workars' Compensation Insurance, or a carti/latl copY �hereof (Sectlon 10, Lab. C. 4c� IICY No.����y�W� ComPanY � /a� . � CertSlflEp.�GpqY i5 II80bwithrth8 <tY Bplltl r}g,pSl� ��./n ./, A�Y ' Date �"Y/06 APPlicant lYGt/// /'f/ Y�V , EXEMPTION FROM WORKERS' COMPENSATION DECLh ATION (Thissectlon neeE not bo complate0 it the Oermit is lor one hunOretl (5300) or Iess) • 1 certify �t�at In tne perto�manc0 Of [h0 wO�k f0� whlch this p0/T�t is ISSUetl I shall: not employ any pBriOn In any manne� so as to become su�lect. to the Workars' ComOensatlon Laws of Californla. ' � Date �ignature � NOTICE: If,-after making t�is Oeclaratlon; you shOultl become sub�ett to l�e Workers'• Compen5ation provislons of tha Labor Catle, you: must forthwith comply ,wit� sucn provislons,oi �t�is Dermit s�all be tlaemetl revokeG. ' CONSTRUCTION'LENDING AGENCV " I hereby aHirm that Ihara Isa <onstruction'lentlln9 agency:for Me�per/ormance' ' � of the 'work for which' this permit is Issuetl (Sectlon 3087 Civ. C:J � LPnGer's Name ' _ LenGer•s ACtlress - � OWNER BUILDE0. DECLARATION � • � ' I hereby:afflrm that I am azemp[ fiom the Contractor'S License I�w tor the LI CONVERSION LJ DI DESCRIPTION OF WORK OorOer Ilnas an0 sign all aoPraDrlate Eeclantions. _ . LOT NO.. BLD , i . , , ADD ALTERATION� �REPAIR f - � � TVPE OF PERMIT U GRADING � LJ FOUNDATION LJSTRUCTV RAL A. P. qW - - ❑ TENANT ❑ EIECTRICAL ❑ PLUMBING ��MECHANICAL. ,_ PLNG. REF.�9p O.�OTMER � ' ' TO BUILDING PRQIECT DESCRIPTION 5�. FT. - OCCUPANCV � P PERTV LINE CONSTRVCTION TVPE VALUATION 8 LEFT SIDE VqRD ZON� � GRADING CV. VDS. � ,ACRES PKG.SPACE REQ. qamarks: �' � STREET WIDTH � . . i � SPECIAL CONDITI � � - PLUMBING , � � Bar Sink , Sewer Cap ' Preventer Irriaation Drinking Founteins , Floor Drains ' Floor Sinks - GasService ; -Outlets Interceptare _ Kitchen Sink - , P—Trap, Division 3 ot the'Business antf Professlons�Coaej�or fbxl,ha/she Is exempt Showers ' • �r.refrom anE [he. basis lor the allagetl exemptlon. My. violatlon ot Section ;• `3�s$.5 by .any appliwnt tor- a• permit sub�ects tha . applitanl to a civll � • � :ti'Slty Oi no[ more thdn tivB huntlr¢C t1011an (ESOOj. i, SErViCe $ink .� ��.''I, as'owner of the property or�my amployaes with wages as thelr sole . compenSatiOn will tlo the work, dnA the-Struetur0 IS no[ int0ntlatl Or Of/<retl � � for sale (Secfion 7044, Business antl Vrotessianal Cotle: The Contrattor's , �icense Law Goes not apply to an awner of a property who bullCs or improvez . ' gOil2r ' thereon, antl who Ooes sucn work hirtiself/herself ar through hiz or har own , employeez, proviaetl that such improvemen[s are'no[ Inten4eG or offeretl for Duct - Under'Ground . � � salG. It, howeve�, tne bulltling or Improvement Is soltl wi[hin one�year of com- • _ . O�etlon, tha owner wlll hava the burtlen of proving he/she tlitl not bulltl or Im- ��rove tor the purpose ot sale). � ' . Duct - Struc[ural I, Ss owner of the property, am exclusivaly tonlractin9 with Iicensetl con- • tractors to construcbthe project ISectlon 7044, Butiness antl� Professlons Cotle:� - Duct -.Ventileting _ ' T�e Contractor's Licenie Law does not apply to an owner of property who builtl5 0� Imp�oves ther¢On, antl who cont/acts for sUch projlCtS wlfh a con- ' ExheuSt $y5t¢T ❑ MWtiplB ❑ tractor(s) II<ensa pursuant to the Contra<tor'S Llcensa Lzw7. ' � , 0 I,-am exempt untlar SacUon 8. 6 P. C. for this r¢ason i Firepl/Fact. Blt. ICBO •# � Date � ' Owner� � � ' � Heating System & Dutting �� — . I hereby certliy Ihat I� have reatl"tMs applicatlon antl itate ttiat tlie abova"I- I �U700,000'BTU �100,0006T informatlon I5 correct. I agree to comply with all dty antl county orElnances � � • � antl state laws relating lo builtling <onstruction„-anG hereby autnorize repre- i HOOd Or T e 1 ❑� sentatives of�this�city;to entar.upon tbe abova-mentloneG property lor , YP � Inspection [ ozei. ; Cano . T e II ❑� Slgnature ' Data�_ ! , . , ' . Orivers' Licen o�55 # � Registers ' ^ CMF 0865-46 rev. 12/82 Wnite - Builtling; Canary - ApO��cant; Plnk - Accounting; Goltlenrotl - Asussor \� Solar Piping Solar Tank Water qoset Water Heater' � -- Water Service . Reinspection Fee Issue Fee - , Refrigeratian System ' ❑0.100,OOOBTU ❑t00,0008TU n 0 $15 $ 3 I Rainspection Fee� $15 � Iswe Fee ' ' $ 3 Wazher Unit " . � , - •_ ' . ,,_ . ' 96^'i. .`7/,', I /F i • ' � �e., : . f 1 ' ZONE ' � .BUILDING ��To„�� ,-, �r ' REAR VARD (TO P/L) RIGHTSIDE VARD � ' PROVIDED PARK FEE $ EIECTRICA , Meter ❑ Su6 Panel Sub Pole Motors C F.A.U. Fixtures Device Boxes ' Garbage Disposal Generator �0-5 KW OS-15 KW Transformer �75�50KW � �5U+KW ' Meter ❑up to 100 amps Zoning Approved By � Applimtion Approved B� Appliption laued By • SU MA �BUILDING PERMIT $� .PLAN CHECK� . $ PLUMBING $ .PLAN CHECK: � $. ELECTRICAL $ �PLAN CHECK $ T A7� �7�i �� �MECHANICAL � $ �� � ���� PLAN CHECK� � $ �_C`X�. i , . �ver � w amps 0-1 HP ❑1X-8 ❑9-15 HP �16- Pole Light � � � Range Sign . Standing Sections � Trash Compac[or 1 '. Reinspec[ion Fee $15 V OF FEES i � � � , � SMIP . '� $ ' ' PERMIT � . • ISSUANCE , . $ � GRADING � , $ ' , $ MICROFILM � $ � TOTALFEE' � $ � ; LESS ' � ' ' ' ADVANCED PC � $ � FINAL FEE� $ � � e �. , .. .. ,� !� =�CONSTRUCTION AND_PLA NING � >' ' ' "� "� - �, ' �OL ffi � _ . - 0 / 3 �APP,ROVALS ,., Perrtiit.#;1�-7335' , Date �Inspector -, -APPROVALS � �'�Permit�# ,:Date � lospector .. N " a , rr j:; Temporary Electrical. Service�o'r�Pole, '� ' " 52. � Pooi & Equipment Location - - � - ri ^ � - n ' n. .. i� 2: Soil Pipe-Undrgrnd.- _ _ ' � . `-' � m : - 53, Steel Reinfo�cement � - - - - _ ,_. . _ - . � ; 3) Electrical Conduit Utilitv-Un�rgrnd. `� : _ 1` ��� • 54. Forms t � ' � . � -_ � - _ c• , ' , - ^:,��4� Electr�ical Conduit-Undrgrnd.: - ' ' � '� � � : -_ ; - � t `,, • 55; Electrical Bonding ' ' - , . � . 5., Steel Reinforcementi � .:� :. ' ` ; ` � ` 4 - ` - ` . . � . .� - � ' -, ; � � � . � � � ', ; , ,� ` S ' �.56.,,Rough�Plumbing�&'Pressure'Test-.- � � .6: ElectricalUFERGrnd.` ' ' i" � 57._,APPROVALTOCOVER-GUNITE` ' ' � ' 7. Footings '' � ; ^ ;� � . � % � ' ;7 _ .58. Electrical.Conduit-Undror�d. � - . � 8. Foundation _ , � -. , ' � '� _ : _ ��59. Gas Pipe;;�;Undrgrnd.;Test �- --� 9. Water� Pipe-Undrgrnd. � • - � ' - � 60. Backwash Lines, P-Trap, O Undrgrnd. . ,. - - i 10. Structu�al Fldor System , - � � . �� �: : 61. APPROVAL�TO-DECK � � - . 11. Property.Sewei Line�& House Connection �„ � � Q�_ - � 62. Backwash�& Receptor-Final � . - - " . � 12. Sewer Cap , ' � � �• � _ 63. Heater & Vent-Final � - . i 13. Roof �Drains � i � � , . � - , ''64. Plumbing?System�: Final � � ' � . 14. Rough Plumbing � - - ' - - � 65. Electrical=Firial � ' � � � � `, M 15.'-Rough'Electrical=Conduit-j -'� - - " -� 'i � ' �-' r--, �'r' �- �'66. Solar Sysfem-Final - - �, �"' � � '�16. Rough �Elecrric Wiring , .. � ��, '�> ; � i"-� s ��-• �, _-�""=", 6Z. Fencing &�Access Approval . � . - �`1 �. Rough�Wiring Sign:: ' S - ' �" - •_ � � � � � I , 68..APP,ROVED FOR PLASTERING� - �. s� � 18.',Rough�Electrical-S Ba'r`,Ceiling� � ' � �� � r ( ; ' � .� 69.�POOG/SPA SYSTEMS FINAL '� � � ' � v - i r �. 19. �Rough Heating & Air Conditioning � ,� G��'3 ( I � FIRE DEPT. REQUIREMENT � ' �: 20. Rough Factory Fireplace i � I � � � � � � i � � APPROVALS � Permit # - ' ' � 21. ,Ducts, in Structure � ` � � � �� � - � � � � 70. Underground Hydro � � . ���22.Ducts,Ven{ilating _ ' � , � i , 71.�productPipingOGas ❑Oil ' � ~ � 23. Gas Bipe-Rough & Test ,; � � �I � �' � �, , 72 ' Underground Flush ' � ' '� 24. Roof Framing = ' '� � � �• �,� ., - � � � � o � , � . 73. � Undergmd. Storage Tank� O Gar O Oil� ' �s a 25. ,R9of Sheatfiing � -' I ' ';,i_ ,�^ , - � ., ' � � ` - ,�-, j . 74.; Overhead� Hydro ' � . '-26. �T-Bar Ceiling (Structural)� & Monocoat � ' I ,' � " � ' � � �� 75.� Dry Chemicsl � �- � . . � ` 27. Frame and Fla'shing ' � i � , � � . i � 76. � Dry Standpipe � . - ' � � �� 28. ,Lathing & Siding' �' ; � i �� i � � i��: � 77.� FIXED SYSTEM FINAL . ' _ �• 29._�Insulation ; -. ` � ,� � � � � ; � ' 78. FIRE PREV. FINAL � . .'30. Drywall Nailing ` ' � , ' ' ' � 'Notes: , � , .. . . �" - , , -- - - �- � -. -_ . .,. � ... . _ �.�31. Plaster Brown Coat � � ' � � � � : � ; � � � � � � . . ' , ' , � . . `� 32.'Electrical Power Meter'Final � � � � � . � � � � � '; 33.,Final Electric i i' ' wj � �' ' � � . � = 34. Final Heating &!Ai,r; Conditioning � �� j/�'J� ,�� � � � � � ' ' ' � � 35. Final GasiPipe-Test - � � ' °� ' � � ; - . � - . . . . � . i 36. Hood or CanoPY.'f , . r • ', ! ' , , ' � ' -�� � _ ' - � c . .. o 37. Final F.actory Fireplace` � : � �, � � � ' , � � �� � ' � 38. Final Plumbing � �� j' � � � '� I � i � , . -. � . 39. Water Service-Fi�nal � �1 � ' � ' . � � � - � i , 40. Gas Seivice-Final � ' ' � � � ' � i =' � � � � . 41. Solar D`omestic-Final � � � � ' • ' - , � � ' � . 'r"'�._ . _. ..- . " - - • -� I i i � 42. BackflowiPreventer � , _ _ � , II i��. �� • . 1 ' I . 43. Backflow Irrigation -� I � �_ = . � - � ; . � �. .,.' � . � -'. . .. _ . '' ; ' . . , . 44. Landscape Irrigation�System ' . � � � ' 45. Sound�Attenuation '��. • ' '� ' � ' _ - � . , �, 46. Handicap�Regulations� , � � '� I; � � � ti' I � � � - , � ;, - - � � � i. �' i � I � i t �� 47.�FINALSTRUCTURE&BUILD�NG i;, � �V � � � ' � , �= � 48. Special Requirements Completed, ' � � � ' , � 4 � I ' 49. Electric Releese�to Edi3on� ' � � _ __�__ �J. _. - _�_. _ .__ . � 50. Gas Release 4o Southern California Gas Co � � � � , � � � i 51. CERTIFICATE OF'OCCUPANCY ; � � _ ; i _ , __ . . ' �I f � - .- I . No Date V:�a-.-' - J AYO�Iwnt to fill in all sWcas ecca0� CITY OF COSTA MESA , ' CONSTRUCTION PERMIT ' ' Applicant's Mailin Adcdfress �'� ProjectAddreu � a � £�' %� ST � . • �• �, i � � �- t� 2L Owner's Name n 1.L- � r r i hone Address � 00 0.( 5 w �-� � O Arch/En8• Q `� Licanse No. - Address � g �11' C 5 . N F �`' i �j Contractor's Nem ' S hon@'y�-� Z&� AAdress (mailin � q y �� �2�-F n LicenuNo. a 5�3 LICENSED CONTRACTOR DECLARATION ' 1 hereby afflrm that I am Iicensetl untler provi5ions af Charter 9(commencing with sectlon 7000) af Divlilon 3 0! the Busineu anC Professlonz Cotle, zntl my Ilcense Ii In full lorceJ� ntl aTfact. ' ,/ f� LJcan �� ^ � Licensa No.'7' a l� �.� oate 3-„?�S- qs,:.���._ WORKERS'COMVENSATION DECLARATION� � ' ' ' hereDy aftirm t�at I have a certifi�ate of consent to self-Insura or a certlticata - �t Workars' ComDansatlon Insurance, or a certliietl <opy lhareof (Sactlon 3800. Lab.,C�.� ^ ,� ComPanY����CG'1.� ��OC�S ' Polity No. �- L� 8�rtifletl cop� IS Iletlbwith�thahcitY. IEIn ivisJ9n. 1 � Data � ��- �� ADClicznt ��� (b A� . ExEMPTION FROM WORKERS' COMPENSATION DECLARA— TI�— (This section neetl not be comDletetl if the permit It tor one huntlretl'(5700) or less). 1 , � . I certity,thal In lhe partormance oT the work tor which this perm�t is Izsuetl I ihall� not amplOy any Oerson In any manner so as lo betoma suCject. to t{�e WorkGfS' COTOenShciOn Ldws Of CdllfOrnla.; . Date ' �Ignature ' � � NOTICE: If, after makin9 �his tleclaratlan, you 5houltl became suDject-to the Workers' ComDensatlon Drovlsions of tha Labor Cotle, you must lorthwith. comply wit�' zucn provlsions.or this�•permit s�ail �e tleemea revokeA. CONSTRVCTION'LENDING AGENCV ' , I he�eby a}tl�m that t�a�0 i5 a con5t�u<tlon�lentling agency fo� t�e perlormance of the work for whith thls permit i5 i55u00 ,(SeCtion 3097 Civ. CJ Lentler's' Name A/crnri' Lentler's� Atltlress � ' � OWNER�BUILDER OECLARATION ' I hereby affirm that 1 am exempt from t�e Contractor's License L.aw tor the a within TVPE OF CON57HUCTIO LJ NEW � LI ADD ' ❑ CONVERSION OEM LISN ❑ OTHER DESCRIPTIDNOFN/ORK f� F1-l1l7 CAY Iines antl si9n all aDp�oO�late tlecla�ations. DT-NO. BL . ALTERATION_ LJ REPAIR TVPEOFPERMIT LYGRADING.LJFOUNDATION IJSTRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING. ❑ MECHANICAL � ❑ QTHER � ' ' ' � PROJECT DESCRIPTION 5�. FT. " oCCUPqNCv� - CONSTRUCTIONTYPF ' VALUATION$�%OO ZON� GRADING CU. VOS. �ACqES_ Remarks: . ' ' ib5 � ers asher ing Fountains Drains Sinks lrJice C eptors � :n'Sink - )ries _ P-Trap� � �- Roof DrainS � ' - ' Showers - � ' �,Y031.5 by, any applicant for.a'permit suDjects [he pDP���ant to a civll � " � ' �enalty o7 not more than five huntlretl Collars (y500). ' SErvic¢ Sink � I, as�owner of tha property ormy employee5 wi[h wages as thalr sole compensatlon' will Oo the work, antl [be structure' is not In[enCeO or offeretl ' ' for ule (Sac{lon 7044, Business antl Profeulonal Cotla: The Contractor's . . LJcense Law Eoes not apply to an awner ot a property who bullEs or Improves Boiler ; tharaon, antl who tloes suc� work himself/herself or through �Is or �er own - '� employ ees, provitletl that su<h improvements are not Intentletl or of/eretl (or Duct - Under Ground � sale. I/, �oweve/, Ihe �Uliaing or improvement Is soltl within ona year of com- ' pletlon, lha owner,will hava tha Durtlen of proving �e/s�e tlitl nol bulltl or im- ' � , �rove /or, the puroose of,uieP. �� � � • Duct - Structural I, as owner of the property, am axclu5lvely tontracting wIN'llcensatl con- � � tfactof5 to constluct the p(oject.(SGCtion ]044, BuSinesS antl Profa5510n5 COGB: � DUCt -.V¢Otlldtip9, , � �._ T�e Conlra<tor's License Law does not aoo�Y to an owner of property w�o . . �builtls or Improves tneraon, antl who <ontrocts for such pro7ecl5 with a con- Exhaust System ❑ Multipl8 ❑ tractor(s) Iicense Oursuant to the Contraclor'S License Law): . - ❑ I am exempt untler Settlon B. & P; C. /or lhis reaion � Fi�2pl/Fact. Blt. ICBO � � Date Owner' � H¢ating System & Ducting P hareby'cartlty that L have.roatl^thls-applicatlon-antl-siate that the above ' �Q100,OOOBTU �100,OOOBT Information I5 correct. I agree to comply with all city antl county ortlinances . .. � anE StalB laws relating l0 EUIltling conslruction,�antl h¢r¢by autho�ii¢ /ep�e- HUOd Oi T e I ❑ sentatives of t�ls clty, to a er � u on the above-mentlonetl property for . YP � InspecUan oury s s. 1 i Cano ' T' e I I ❑� ' . Sl9nature G Date 3� as � 83 •� �� '� Drlvers• Llcense or 55 � - RegiSters . � � CMF 086546 rav. 12/82 Whlta - Buildin9: ��ary - AO�Iiwnt; Pink - Accounting; GOltlenroC - Asussor Sewer Cap ' . Sewer Cannection ' � Solar Collectars Solar Piping .- . Sotar Tank � � Swimming Pool w/Spa Urinel � Water Gaset -Water Heater - � � .Water Service ' � _ Reinspection Fee . i Issue Fee - IANICAL Refrigeration System ❑6100,OOOBTU ❑100,OOOBTU System Repair/Alteration i � Reinspeetion Fea� � � . ' Iswa Fee , PLNG. REF. slE � ' LEFTSIDE VARD P KG. SPAC E R E Q. .' . . � � 6359 3i_:�/.�3' • � '�, ��J� T: , i � ; REGULATIONS' - ' ME ' - BUILOING - - � ' REAR VAHD (TO P/U � � ' RIGHTSIDE VARD � PROVIDEO � ' 'PARK FEE:$ I5: _ Automatic Wazher Constructian Pole Cooking Unit ' Dishwdsher • Dryers ❑Gas OElectric A.U. ixtures evice Boxes L 0 Meter LJover t00.amps- Sub Panel Sub Pole , � � Motors LJO-1 HP LJ1XE ' Inc.Solar 09-15HP �16-15+ � � Microwave � � ' ,Pole Ligh[ � ' . Range .. . ,._ ,_ _. . - Sections 0 � t Generator LJO-5 KW LJ5-15 KW - Transformer �15-50 KW . � • � . ❑5U+ KW • Reinspeetion Fee S75'. $15 ' Meter ❑up to 100 ampa laue Fea �$ 3 $ 3 2oninq Approved BY ' Data Ap0liption Approved By � Date � ' Application IzSued By ' � Date � ' ' SUMMARV OF FEES � + i ,BUILDING PERMIT $ � 3��� SMIP � $ , 5 � �PLAN CHECK $ ' PERMIT ' � • � ,PLUMBING , ! $ �'��� � �SSUANCE' $ � � �PLAN CHECK $ � ' GRADING ' $ � ELECTRICAL, , $ � . ' ' $ � , ' 'PLANCHECK� $ ' ' j MICROFILM $ � �MECHANICA� $ � TOTAL FEE� � $ t $15 PLAN CHECK. $� � ; LESS � i ' ' � � ' ADVANCEDPC � $'��/�/�� $ 3 ' . '' ; ' :' FINAL FEE� � $ �� ? � �CONSTRUCTION.AND,PLANN�NG� . - - � `� '.:- �,_ � = _ �-: �OC a uPA - ..� ; v - �Date � - �Inspectbr � ` - - Date ' Irispector :APPROVALS ; Permit�#� - , � . APPROVALS P.eimit# � � . -� _ - . . . . - . . � 1. Temporary Electrical.Service or�Pole ,. v: = � ��' -- �' �, 52.� Pool &�Equipment Location . �- � - - a� . �^� 2' Soil Pipe-Undrgmdi `�� � _ , • c� °�: � : 53,.'-,Steel Reinforc'ement � ' . �. . - � 3i Elec[r,ical Conduif Utilitv-Undrgrnd' � = - ro _'� 5_4•i Forms � . _ � _ q . _ � � � - r,y 1 4. Electr,ical�Conduit-Undrgrtid�: =_'- , - � - ' � ' �-' : 55� ElectricafBonding` � � • . ' � �_ 5: Steel� Reinforcement `� r, ; ''. � . � _ �� : - ' `- � 56, Rough Plumbing & Pressure-T.est � � r• 6: Electrical UFER Grnd. � ;� r�� ':" ' ' - ' � 57:'APP�ROV7�LT0'COVER-GUNITE � - ' � _'= 7. Fo, iings . � '�� � � ' . ., _ ��r - � �,.58.' Electrical�,Conduit-Undram�{. - - . . _ , , '� " _ ^ ' '; . . . . 8. Foundation, _ _ ' ' - _ ' �59. Gas Pipe, O Und,grnd:; Test ; 9. Waier Pipe-Undrgrnd. ' � 1 ` _ � ^ �� �- � �`60. Backwash�Cines, P-Trap, 0 Undigrnd. . , � c rJ • 10. Structural�FloorSystem ' ' l:,` 61. APP.ROVACTO.DECK ` • 11. Property Sewer Line & House Connection -• �.62. Backwash'&��RecepforFinal �� - � 1 , , 12., Sewer CaP . ' � , . �. � ' �'�f�%7 � . � . . V , ; ='63. Heater & Vent-Final . .� �. 13. Roof Drains � _ � � � ; 64. Plumbing;SYstem.-.Final ^- ' ` - 14. Rough Plumbing � � -` � ' � `- � 65. Electrical=Finel ` � - - " � ' ' i 15.-Rough Electrical�-ConduirT -r --' - � •-' " - ' - � "I' 66. Solar Sysierri-Final .� -�; - � - , " -- - - � 16. �Rough Electric Wiring�, ,� � �• I �� � '-� � �= � � � �' j'-� �� i _ � !�6Z.. Feneing & Access Approval - � �;i� - . " * - 17. Rough Wiiirig Sign ��, i: � ��'.: j � z � _ i_ , 68.� APPROVED FOR P�ASTERING ��` � _ 16. RougKEleccrical=T:Bar Ceiling �� ' �, �_ � i'''' �� v 69.. POOC/SPA SYSTEMS FINAL � � -- 19. Rough Heating & Air Conditioning �. � � _" ' � � � FIRE DEPT. REQUIREMENT. � ' ' � 20. Rough�Factory Fireplace � � j� � ; , � i � � � � APPROVALS ' Permit�# � ' ._. ,i � 21. D'ucts,:in Structure•. -. ' ' '� � � � � , . ' � �� 1 , - . , � , . � 70.' Underground Hydro � � '22. Ducts, Ventilating _� r , I �� a � I � � � i 4 71,' product Piping OGas �Oil � � � � . , c . . f � �' -i ` --f'- --1 ----1. ; . . ' ' _ .. -- _- - - � 23. Gas�Pipe-Rough & T,est � ! P I, � , � � � 72., Underground Flush _ � � • , � �; ,; I ' 1 y' , . , . 24. Roof Framing-. � � �. ,� • I • � � ��, : _ � ; � � Z3. Undergmd. Storege Tank O Gas ❑�Oil � �� 25. Roof Sheathing ' ' ! ' = j - � : F ; _ , - : � �7q,� Overhead Hydro ' � � � 26.' T-Bar Ceiling (Structural)� & Monocoat� � � � � ' ' ^ � � � ; 75.. Dry Chemical � � - ' - � ;�27. Frame and Flashing � � -� i ; � � ' ��: � � �76.� Dr,y Standpipe � ' . ; � � . 28f �Lathirig & Siding' �� ' � i �� ;� � � + i - i ' � �77.� FIXED SYSTEM�FINAL � _ . , - • � 29. Insulation � ' ' ' ' � f � � , � � ; 7g � FI'RE PREV. FINAL ' - 30. Drywall Nailing ' � , � � � I � � � � 'Notes:i � � , ; - . 31. Plaster Brown Coat' � ' `. ' -- , � - � --- � � 1 T . -� � - - -- �� - f i � 32. Electrical Power Meter;Final � � ' � � �! � � . � � - , � � _ � p d � � i� I � i i � � i 33. Final Electric i � � � �� � � i � � � ' ., � � � 34. Final Heating &�Air Conditioning �' I ' �� , � �� - i � I I I ; i � 35. Final Gas Pipe-Test' I 1 � ' ' _ i ` - ' I i . I ' . � - - . _ - i. L ' �c - `. 36. Hood or CanoPYC . , ' � � � n I I ' _ l' . � �. I - _ . _. . . ' � 37. Final Pactory Fireplaie.' 4 � - ' � � i + i i � ' � � , � - , - . . 36. Final Plumbin9 � � I � � v i - � V , � - � � I I � - .� �,r.� � .. 39. Water Service-Fi�nal� ' , � � I ' ' I , � `_� � � � � ' � � I � 40. Gas Service-Final � ' . � . i: � � � I , ! ' ' � . ' � 41. Solar pomesticFinal � � � • ' i � ' ' ' , ' ' ? , � � ' � � - �*--� -* - --'- - - �--- � --- 42. Backfiow Preventer . . . ;�� • � t i ; _ � .. � � � . , . ( � y �� � I � 4 l J� 1 1.. � : I � 1 � I ` � � . 43. Backflow Irrigatiorn �i �' ' ' �� I � '�1 I � � - � ' , _I 'IZ. .:" .. t �' ' � 1 i. _j l � � 44. Landscape Ircigation�System ` ' "�' - ; � � � � � ,; � � � , ' � �- �. ... : . ' � � - � � - :i - � � , � 45. Sound" Atterivation • ` � ; i i , ; j , ! _ - � � , , - . . 46. Handicap;Regulations ; 1 . . � _, � . � ' � � 47. FINAL STRUCTURE & BUILDING �� � � � • _- � � � ' � � � ! � • � -� � I 48. Special Requirements Completedi � � �� � i ^_ 1 � � � � � t ' ' � . � � ., �� 49. Electric Re�ease.to Edison� ' , � � � ' ..� � � ' _�_.__1 J._ . � . ' . � ,� . I - -- r- -� - ` +- � - � . 50. Gas Release to Southem California Gas Cn � • I i , ' ! � • � � " � � i i 51.CERTIFI.CATEOF,OCCUPANCY � ,.�_.i __ _I___i ,Y�-L-�-, v' --, ' ' i ' i ' No Date ' i � � � � ' a- - - 1- - - 1-==-- � Appliwnt to /111 in all sDaeez e:cept thosa CITY OF COSTA MESA CONSTRUCTION PERMIT ApplicanYs Mailing Addressaf� � ��a � Project Address ' �j - Owner's Nama hon� Address � Arch/Eng. , License No. Addrea Contiacto�'<NA�e � ' Phone " � Address Imailing) �icenw No. �� LICENSED CONTRACTOR DECLARATION I hereby affirm Ihat 1 am Iitansatl untler provisloni o1 Cha�ter 9(commancing with section 7000) af Divlslon 3 of the Business antl Profaislons Cotle, anG my Iicense is in full ce effect, /`�[',� Licen Clau � ��• No. / ��7�" Date ��L � 57g [u • �-+W� WORKERS'COMVENSATION DECLARATION 1 hereby affirm that I �ave a certifiwte ot consent to selfansure or a<ertlficate >f Workers' Campansatlon Insurance,_oI a certltietl coOY.ttiereof (Sectlon 3800, LaD. C. A Pol�icY No. ��3�O8�SoZ CompanY ����U�L/ ' JA Ce�tl/iep _opYis /JI,eEbwithrthe city Bul tli gDlvisjp�q.� �� Date 6r_ � �h �7 APPlicant � � � � f'�nM� • . " E%EMPTION F0.0M WORKERS' GOMPENSATION DECLARATION (This sectlon neeE not be completetl if tha permlt I5 Tor one huntlretl (§300) or ' IB55�. ' f_� I certHy that in the performanca o1 the work tor which thts parmR is Issuatl I shall not employ any pBrion In dny mann<r 50 a5 to becomB'sUbje<t.to t�e . Workers'•Compenzation Laws of Californla.' Date � Signature ' NOTICE: If,aftermaking this tletlara[ion, you shoultl bacoma subje<t to the . Workers' Compensation provis�ons of the L2bor Cotle, you must torinwith ' comply with such provision5- or thi5 permit !shall be tleemetl r¢wketl: . CONSTRUCTION IENDING �AGENCV - ' ' ' ' I hereEy afflrm that there is a constru<tion Ientling agency,for2he performance ot the wofk fOr wh(ch -[Ns permit is �65uetl (Sectlon 3097 Gv. CJ, LenEer's Name l.en0er's Atltlrass ( - OWNER BUILDER DECLARATION' ' ' �� � ' I hereEy affirm that I am exampt from Ihe Contractor'S lltense I..aw tor tha � e/sne Is Iicensetl pursuant to the provisions oT • �apter 9(<ommen<in9 wkh Section 7000) of � ProTesslons Cotla) or that he/she Is'exampt ! allegeG exemptlon. Any violatiodot Sectlon � a permit subjacts�tha apo��cant to a civil ntlretl tlollars (55001. � ' � ' i as'owner ot !nsation, will LICCO50 Law aoes mt appiy io an owner or a properry wno nwias or improves ' thereon, antl who tloas-such work himselt/herselt or throu9h his or ner own employeas, provitletl tM1at such�improvements are not Intentletl or oiteretl for sale. If, �Owever, the builtlin9 or ImprOvement I5 soltl within one year Of cOm- pletlon, the ownar will have the burGen of proving he/she tlitl not bulltl or im- �rove.torthe purpose of.salej. ' � I, as owner of the property, am exclusively contracting�with Iicensetl con- tractors So construct the pro�ect (Section 7044, Business anC Professlons Cotle: ' TM1e Contractor's License Law does not apply to an owner of proDerty who ' builtls or improves thereon, antl who <ontra<ts for such pro�ects with a con- tractor(s) Iicense pursuant to tne Contractor's License Law). � ❑ I am axempt untler Section B, & P. C. for this reason ' Date Owner 1 hereby certlfy that I hare reatl�this application antl state that the above Information is correct. 1 agree to tomply wtth ali clty antl county ortlinantes antl state laws ralating to builtlin con5truction, antl hereEy authorize repre- 5entatives of Ihis city to ✓n ."pon the above-mentionatl property for Inspection purposes. ' � �.��Q L $igndtur! ^� Date '�( �6 � TVPE OF CONSTRUCTION LiiN[ ❑ CONVERSION ❑ DEMOLISH �ESCRIPTION OF WORK �c. .r� vy bO�Ce� Ilnes inG fi9n all app�oDriata Oeela�ations. LOT NO. B D -�'C �� ADD 'ALTERATION REPAIR . OTNER TYPE OF PERMIT� LI GRADING � LI FOUNDATION LI STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBINO ❑ MECHANICAL ❑,OTHER PHQIECT DESCRIPTION Sq. F7. oCCUPANC�v ' CONSTRUCTIONTVPF VALUATION$' 7.C7S ZON£ GRA�INGCV.VDS. ACRES— Ramarks: Bef Sink Backflow Preventar � Backflow Irrigation ' Bathtubs Ciarifien Dishrvasher Drinking Fountains Floor Drains FloonSinks - - Gas Service Outlets �. IntefCeptors ° ' ' Kitchen Sink � � ' Lavafories . ' � P—Trap � RoofDreins� - ' - $hOW¢IS Service Sink - , � � .. Boiler ' � . � Duct - Under Graund � Duct-Struciural � ' Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # � Heating System & Ducting ❑ a� oo,000 eru O i oo,000 Hood or Tvoe I ❑� D I 5' LI �5e �55 � � I I flegisters CMF 0865-46 rev. 12/82 W�ice - Builtling; Canary - Appliwnt; Pink - Accounting; Goltlenrotl - Aszezsor Sewer Cap - � Sewer Connection' . Solar Collectors Soiar PiPing ;_ � Sotar Tank � Swimming Pool w/Spa • Urinal Water�Closet Water Heater• -- ' Water Service - peinspection� ' laue Fea _ PLNG. REP. yp LEFTSIDE VARD PKG.SPACE REQ. STREET WIDTH� Automatic Wazher , Construction Pole Cooking Unit � , � Dishwdsher - ' Dryers ❑Gas ❑Electric Pan. F.A.U. Fixtures ' Device Boxes � � Outl¢ts � ❑o-.ioo,000sTu ❑ioo,oaosru � System Repair/Alteration Reinspection Fee. $15 laue Fee $ 3 i4ai dr�-9/�a ' BUILDING �gerir ri cr REAR VAqD (TO P/L) RIGHTSIDEYARD � PROVIDED PARK FEE $ Sub Panel Sub Pole s A 'Motors LJO-7 HP LJ7'h$ IncSolar �945HP �i6-05+ Microwave . ' Pole Light � � Range � Sign ' StandingSections , � ' Trash Compactor � ..� i� •� i .9e TL Generator LJO-5 KW LI5-15 KW � • Trensformer �75-50KW � . ' � • ❑5U+ KW 'peinspection Fee $15� . Meter ❑up to 100 amps laue Fea� '$ 3 i Zoning Approved By Date ApPliption Approved BY � ^ate Appliration Issued By � Date � . SUMMARV OF FEES ' ' � �� ,BUILDING PERMIT $, �,� !T � SMIP ; $ ' �-5 PLAN CHECK $ LY� PERMIT � ' � � PLUMBING $ ,j �— �SSUANCE , $ � P�AN CHECK, $ GRADING $ � ; " EIECTRICAL $ $ � . .PLAN CHECK $ MICROFILM $ � MECHANICAL $ TOTAL FEE $ -P�AN CHECK $ � LE55 , � � , . � ADVANCED PC � $ . � � • • � ' FINAL FEE � $ '3/. �� �� . � ; . :, , . -� _' "�CONSTRUCTION�AND�PL'ANNING, �'` ''' r� � �;�w . - ' : - � POOL iY.,r'A � . ^ _ �- � i F � _ .`Date' = ;Inspeetor ' - � t Date � Inspectoi > `'APPROVALS ;, Fermit#- -� ^ ' - � i„ � , cAPPROVALS�• =Permit•.# . �i• � � r � r ' r. ' _ . �•' ,1. Temporary'Electcical Service or�Pole � _ ' `� ' _ '. �•� ; ; ,�; 52i�Pool &.Eguipment Location � - - - • � - � . - - � � - : . .. c � � G r ' ' - . ' - - - . : : : - ;:2liSoilPipe-Undrgmd;. ^ �_., .: _ �>�'� :�. _'= �53: SteelReinforoement� ' � . -. _ ; ; ., . � . . . ; ; _ � . - 3: Electrical Conduit U,tilitv-Uqdrgrridi " i� : � -`_�' �'� � � 54. Forms' � • - � � � • � • i - .� � .4� Elec`"r.ical Conduit-Undrgrnd: -.. ����; � '- ` - � r = � � ; � � _ z. 55�. �Electrical Bonding ' � ' � � " ' 5; Steel�Reinforcemen4 , %:� � `%- ' ., �: � � - � ,;:� ; � `56., Rough Plurimbing.& Pressure Test � � � • I � �<� " � t ' i 1 ] � . 1 i � .. . . r � .. �. � 6: �Elect�ical UFER Grnd., , e, s� u, „ �= • 57: APPROVALTO'COVER-GUNITE . �r � i i r I>i.. �� - 7..Pootings �i . �; � � i .-, c� i � ; ' = i/? "�'. : .'58.' �Electrical:�pnduit-Undrar�d. � . � - 8. Fou�da[ion � � � ' " ! : � � ; ' � �' t f i 59. .Gas�Pipe,�O Undrgmd., Test � � ' . � 9. Water Pipe;�Uodrgrnd. � � - � ' 4 � .�- � `? �- r' � �60. Backwash' Line;, P-Trap, O Undrgrnd. � � � � i , a. 10. Structural floor S stem ' , � � .�� � � � Y y � t� . ' ��61. APP,ROVALTO�DECK 11. Propertq Sewer Line &�House`Co anectiod /, f.?' `} � 62. Backwash & Receptor-FinaF -_ _ , 72. Sewer Cap:; . , ' t;� , , - ."63. Heater &-Vent-Final - ' . � 13. Roof'Drains � n-'� � °. •' ' . j j �'64. Plumbing"SYstem - Final � � Q 14. �Rough.Plumbing' ,� � = � ° - - � -65. �Electrical`-Final - � � ' � , C �-15: �Rou`gh'Electric8l=ConduiY �-'-" , - - - - - : 4 _ �! li �' � � I I � I 66.j So'lar System-Final , �,18,�',;,Fiough,Eleciric Wir,ing•, . � i. ' � �' � ' � ; ; z �-� � !'- t , .- � � -�69 � Fencin`g & Access Approval h`1,7S��Rough N/i�ing:Sign:': ;� � �" � � I� , ; I� I� `�' I� 1.� �� 68 j APPROVED FOR PLASTERING � ' �' 78:+Rough�Electrical-T'Bar Ceiling �) �� � � . � ;, i � � � j `y 1 � + j69.' POOUSPA SYSTEMS FINAL � � : 19. �Rough'Heating & Air;Conditioning �. I�. `- �. I = � i � � FIRE DEPT.fREQUIREMENT. � ' � _. . ;. . : , i � � . ,�, �i ZO'Rough Factory Fireplace� � � :, i: ` � � �i � � � APPROVALS � permit # � ' , � � 29: Ducts, in�St�ucture� �' ' ' � ' � � ' i �70 �� Underground Hydro � , ' � � �22.'D.ucts, Ven'tilating ". �; � j � � � � i , � 71. Product Piping O Gas ❑ Oil ' = �F23.,Gas Pipe-Rough & Test � � � , ��' � � i � � -r. �-. - -.-- - -., _ . . . ,- - --�-� - � � 72. Underground Flush� '��24. RoofFraming� . ' , j �!L,'.�1,��- !.�� �?��� .,:. ;7.3.'Undergrnd.StorageTankO�Gas.❑Oil � � . _ i.c . � o , I �Z _ I : I . 25. Roof Sheathing � , �' � � �' ' ' � ;F � � - : � � �74. Overhead Hydro . ,^26.'T-Bai Ceiling �Structurall & Monocoat � ; � : � � i �` � � � � ' � . �75; Dry Chemical . � - - .� � - :: �=27. �F�ame and�Flashing, : � ' I I� �1 j.' , . � � � � � � '76: Dry StandPiPe { . . . _��28. �;Wtliing'& 3iding; �� '� i � i �1 ,, I � i� 4 � � ��77.j F,IXED $YSTEM�FINAL _ , 29, �Insulation j i Q " n � � �'� �� i ' I � � � �7g! FIRE PREV. FINAL . � � � � i �� � �i � � i 1 � l ' I Notesi ^ u. =30."Drywall Nailing � � �-1- - ; � . . . � • i . I � T� i._...- - � � � i - �-- � � r - �� , � - ,�31.: Plaster �Brown Coat �. � i i' I� 1 I t� I � �' � i 3' � ' ,� NJ32�LElectrical�Power Meter-Fir�al' � � li'� � ' � � � � ' ' � ' 1 ' '� , °, , � , • , ' � � � 1 ` � ' i � I 33.'Final Electric , � i � �, � � , j - .y. c 34. Finai Heating &IAir Goaditioning � � � � �p � � ' ' � � , , ��n, -�m .i� I ' � � �� , , � �` t', � it i -r �_ • � � � - �.. , . . - . . 35. Final Gai Pipe=Tesf �- � ' ., � _' I� - � i c _ _ ' . . � 36. Hood �or�Canopy��! . � t._ � i � � i �� I � �.. � . � I J � -. � � � - _ , . . _ . . . > 'i �ii I� - - � - - � - � 37. Final Factory Fireplace�� �� 1 � ri� . f .' � � i . I ' ' � � � , ' .- " , ' , _ � 38. Final Rluinbing � � i ' �� �i � � � � i i - i � ' � � ' � - - . � ' .; . - � 1 , i � - . 39. Water Service-Final , � ; �; ; � i I � . 40. Gas Service-�inal � � � . �', � � ' i ' � ' � - - „ . % 41. Solar D"o'mesticFinal � , � � � � , � ,�, t� + i , .� � ' ,-- n-_ �i � � il � ' � � I I I - ' ' - ' 42. Backflow Preventer ^ � ! , _� : � � � I �6� -' L-'' -r --i�� _ � . - - � - -- - 43. Backfiow Irriga�ion '� � _ i � � i �,i�i: , "�;-� ! ^, � �-.� .' � .. � ' � , „ � �� � _1 �. . _; '-' . _� � 44. LandscaPe Irri9ation"$Ystem � � . �T. . � '`` j �� , � , � : ' � � a' � . . � i,. � ��ir I 45. Sound �Attenua ion �. � � ' ' � � � �.:� � i ` ' I : ; • ' 46. Handicap Reguietion's � � ,. � � ��� I ; � I � �_ � � � � � . ' ! I = ' , - � �� �� i 47. FINALSTR�UCTURE&BUILDINGII ' �� I �. , � i I � � _ � t i i i i I? i I:.� i i 48. Speciai Requirements Completed '� � F �� � �; � � � ' � � , 49. Electric Re�ease;tolEdison � � ° ' _ � � � � - �- - . � _ _ • � '� � --( - - `-. , i , . � � - � : .� . � I 50. Gas Release �to Southem Califomia Gas Co � ( � I �; � ; � i! i , � 51. CERTjIFICATE OF� OCCUP,4NCY :� � j � t � .._;__ ; _ '. _� _ - ; _. �, . �� '� � � 1 � I � il � � �� � � � , � � � � � ' � � , No. � Date i �' ' • F-.- � - >w,.�%-,,.-. _ ._ � l � _.:--�. i. -�- - - - � ' - AVClieant to flll In all iDaces e:capt those wit�in �eavy borCer Iinas antl sign all approoriate Geelarations. GTY �F_-CQSTA MESA CONSTRUGTfON PERMIT ApplicanYs Mailing Addreu �• 77%�Ln� - 4 /� � �.-�nt�_, Project Addrea �-.��� � f � � � �" •� c � OwneriName �'" � k � �hone�%��7��( Address � �'� � ArchlEng. �'�< License No. Address '�� Cantroctor i Nam 1 � hone ��/ �3 9 Addrezs�m3ilingl �a3%% �an.i�. /2.� Lc/r.��.t � License No. ��' LICENSED CONTRACTOR DECLARATION � • I heraby aftirm that 1 am Iicensetl untler provislons ot Charter 9(commencing wlth section 7000) of Divlslon 3. o/ the Buslness antl Prolesslons Cotle, antl my IlcenSe�is in full torca antl aftect. LICRn58 C/�lass C^ LJ Bn50 NO � Date �( � ? �919natura W00.KER5' COMPENSATION DECLARATION ' . I here�y affirm [�a[ I have a wrtlfltdta oT <onSent to satt-Insura or a cartlflCdte of Workers' Compensatlon Insuranee, or a eerilfiea eopy ehereoi (Saetlon - 3800. Ldb. C.) n� e 3 l] CompanY ��h :"'^—�� PoIICY No. (K � 7 �qw�,,� rtifletl coDY is hereby furnishetl. . �f LJ Certlfietl copy IS flIBG with the cily Bulitliny D� n. �_ .// Oate AOG���ant (2,( �- �� El(EMPTION FNOM WORKEHS' COMPENSATION DEGLAXATION (This sacllon neetl nol be comple[eC If the permit Is for one hunEretl (E100j or iess). � • �� � � I certify that In t�e performance of the work for which this perm�t is Issuetl I shall not employ any person In any manner so as to become sub7ect to t�e � Workari' Compensatlon Lawi of Califomla. � Date Slgnature ' NOTICE: If, aTter �making this tleclaratlon, you inoultl become sub7ect to the Workers' ComOensatlon provislons ot the Labor Gotle, you mu5t torthwi[h comply wilh sucn ,orowsions or this parmit shall be tlaemed revoketl: CONSTRUCTION I.ENDING AGENCV ' I hereby affirm that thara Is a constructlon lentling agoncy for the parformance of the work for which this permlt Is IssueC (Sectlon �309� Civ. C.) LanGer's Name,� Lentler'i AaEress , OWNERBUILDER DECLARATION ' '� ' ° I hereby affi��ff ihat I am exampl f�om tha ContrattOr'S Ucense Law fo� tne ' enalty o/ not more th I, a5 owner o( Ih� compensation wlll ao for wle (Sec{lon 704 Llcanse Law Aoes not . thereon, antl who Ooe oTploy805� OtOvltlBtl �I sa1e. I/, �owevar, the t pletion, the owner wll �rovB for the pu�pose � I, dz owne� of the tractorsto construette The Contractor's Llce builtls or improvez t�i tractor(s) Ilcensa pursu ❑ I am ezempt untler tha aOP��cant to a �. wlth wdae5 d5 th¢7 or lo an owner oi a proparry wno owms or improves w0/k hlmsel//hBrs0lf Or thrOUgh h15 0� he� own :h improvements are not Intentlea or o((erea tor g or Improvement I5 sottl witnin one year of com- t�e burtlan ot Proving ha/she ditl not bulltl or Im- ty, am excluslvely contmcting with Ilcansetl con- lc[ (Saction 7044, Business antl.ProfesslonS.Code: w does not appry to an owner of Droperty who antl who contracts for such pro7ects wlth a con- t�e Contractor's License Law). n 8, 6 P. C. for this reason Date Owner I hBrGby certlfy that I have rea0 informatlon is correcL 1 agrea to < antl state laws rela[ing to builtlin< sentativef of Ihis tlty to enter Inspectlon OurPos . SI n5ture � u a above TVPE OF CONSTRUCTION LJ NEW LJ ADD �-1 ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � DESCRIPTION OF WORK _ TYPEOFPERMIT��y GRADING FOUNDATION STRUCTURAL ❑,TENANT f� ELEGTRICAL � PLUMBING ❑ MECHANICAL ❑.�OTHER , ' PRQIECT DESCRIPTION 5�. F7. OCCUPANCv CONSTRVCTIONTYPF' VALUATION$ ' ZON� GRADINGCU.VDS. ACRFc Remarks: U/I /l C C AA r-rG � � Bar Sink Backflow Preventer Batkflow Irrigation �rinking Fountains Floor Drains' Floor Sinks • - uas Service OuUets Interceptors Kiichen Sink Lavatories P—Trap Roof Drains �I�,�IShowers � II Service Sink, Boiler • � Duct - Under Ground Duci - Structurel Duct - Ventilating � Exhaun System ❑ Multiple ❑ Firep�/Fact. Blt. IC80 �f`- Heating System.& Ducting ❑ 0.100,000 BTU � 100,000 BT Hood or Type I ❑ 9 Driveri' License or 55 qp Register5 � CMF 0865-46 rav. 12/82 Wnite - BUIItlin9: Canary - APPlicant; Plnk - Accounting; Goltlenrotl - Assessor Solar Piping Solar Tank ' Swimming Pool w/Spa Urinal Water Closet Water Heater � Water Service ' � Reinspection Fee laue Fee IANICAI Refrigeration System � � ❑a�oo,000sTu ❑ioo,000aru System Repair/Alteration ' Reimpection Fee laue Fee PLNG. REF. � TO BUILDING PROPERTV LINE 'IEFTSIDE VARD PKG.SPACE qEQ. STREET WIDTH SPECIAL CONDITIONS: Automatic Washer ConStruction Pole ' Cooking Unit . Dishwasher � Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures / Device Boxes ' 71/9 4/Ik/.13 IG REGULATIONS ZONE BUILDING cornnrv r�i er REAR VARD (TO P/U RIGHTSIDE VAflD . PROVIDED PARK FEE $ � MBter LJOver 1 W emp5 Sub Panel Sub Pole Motors OO-1 HP OtY,$ �Inc.Solar �9-15 HP �16-1�5+ Microware Pole Light , � Range i Sign Standing Sections Trash Compactor i rio,ru TL Generemr 00-5 KW 05-15 KW � � Transformer ��5-50KW ' • ❑5U+ KW. � 'Reinspectian Fee $15� $15 Merer ❑up co 1 ' � laua Fee '$ 3 a 3 2oning APProvad BY - Data Appliotion Approved 6y 9� Date Appliption Issued BY �`� � ' Date �'�� �� SUMMARV OF FEES � BUILDING PERMIT $ SMIP $ ' PLAN CHECK $ PERM�T � PLUMBING $ ; ISSUANCE' $ ' PLAN CHECK $ . GRADING . $ 515 53 ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK $ 1��77L $ $ S".� MICROFILM $ $ TOTA�FEE $ $ LESS ADVANCED PC : $ � �, FINAL FEE $ �'� , . _ � ... ,. . ' .;CONSTRUCTION AND PL'ANIy1NG - - -,. _ ' �- -' .` - ��"-; POOL 6..,�A .. �. � Dzte -` �Inspector - - � ' Date ' �I�nspector > �,.APPROVALS Permit.#� r � - =APPROVALS Permit # : + _ � - X 1���Temporary Electrical Servic� or=Pole i � ... �- - :�52" Pool & Equipment Location .� - `"�_,; . _ � ' _: �_ ' - - ;� �, Soil Pipe-Undrgrnd: _• V - " �> - �- � 53: Steel Reinforcement - -. � � � , �: �3,: Elect�ical Conduii Utiliiv-Undrgrrid. �j. , - r � 54.� Formi - ' F - � - _ . - - � � "� 4 Electrical Conduit-Undr rnd: �. � � ' '�� �� ' 55:� Electrical-Bonding.; � � � � .,; � 9 �2'S-& -c�:= 5: Steel,Reinforcement ' ; �.{ � " ' ' ! �- = �T `. ° ' � � 56.• RougH Plumbing & Pressure iest . � 6. Electrical UFER Grnd:, , i'-` � .,' � � -�� - � 57. APPROVALTO,COVER-GUNITE. :. , 7. Footings ' � � � ; _� , . � �. � � �- 58: Electrical Conduit=Undramd. . - 8. Foundation _ . • - , ' • _ _ �- 59. Gas Pipe, O Undrgrnd., Test ' 9. VJater Pipe-Undrgmd. '� - _ � .� � 60. Backwash Lines�, P-Trap, O Undrgrnd.. . ' 10.StructuralFloorSystem F° <, � � ' :67.APPROVALTODECK - - - � 11. Property' Sewer Line &'House Connection � � ` - " � � i , , ,� � 62. Backwash &" Receptor-Final 12. Sewer Cap , � � ; ' �� - "�. , �63. Heater & Vent-Final � � - -, 13. Roof•Drains � ", � � - ' � � •'gq. Plumbing System - Final � � � � 14. Rough Plumbing �� ' • � � � - 65. Electrical=Fina�`� -' -�� � ' . = 15 �Rough'Electrical-Conduit-, � - -" '�" - .' -� ' " - "' 66.� Solar,System-Final�, -� � � '-- � ' � ' - ' 16. �Rough Electric Wiring�. . ' ,� � G ` - 67. Fencin & Access A � '� • - ,., _ _ � -Z �v' _ ��e 9 PProval _ . - �`17. �Rou9h�Wiring'Sign} � � � � ; - . � i ;' � �- I ° . � i M �- ,_� � 68. APPROVED FOR PLASTERING •, 18. �Rough'�Electrical;,T,Ba� Ceiling� � � � � ; �`= ' �69.' POOUSPA SYSTEMS FINAL � � �,-� '� 19. IR�ugh'�Heati rg &�Air Conditioning +� � ' � : , � � , FIRE DEPT. REQUIREMENT- • - ' � ��0. Rough'Facto'ry Fireplace� ' •:I I � APPROVALS' , Permit# ,. , i • i i i � �: 21. Ducts, in Structure , � � � • 70.� Underground Hydro � -� , �-22. Ducts, Ventila4in � � `_ ❑ 9., � � � � � i 77. Produc[Piping�Gas ❑Oil - - .23. Gas.Pipe-Rough & Test - � � ,'� � , � 72.' UndeFground Flush � ',�24. Roof F'ramingi ., � j� .; � i � j�, �., ' -, : � 73. Undergrnd. Storage Tank O Gas ❑ Oil ' �' �f 25. Roof Sheatfiing � � , �� ' � , i j • �74. Overhead Hydro � , : -26. T-BaF Ceiling (Structurall. & Monocoat�� j _ j � 1 `'� � ' 75. Dry Chemical ' � ' .27. 'Frame and'flashing . � ; ' � � � � �'; � , �76. Dry Standpipe . - � . , 28. LatHin & Sidin ;,� ' � ' � i. , g g , 'i � i �� 77. FIXED SY$TEM FINAL � ; � 29. insulation _� � .' " � i ' � �' i � �78. FIRE PREV. FINAL - 30. ,Drywall Nailing � � � � � � �Notes: , i� . , -- - -t . - - �- - - - - .. ' b'31. Plaster Brown Coat � i ' � � ' ' ' I I � � �,�, �.- ' , : � � . � ; ; . , , . . . ; 32. Electrical�Power MeterFinal � � � � 1 � ' . , _ ;, 33. Final Electric � i� ' :� � i � � � � � . � � � � � 34. Final Heating &�Air Conditioning , � , � � � �- - �< 35. Final Gai Pipe-Tesf ` . - � ,. ' " � �- . � 1�, � � ' , 1 - 36. Hood or�Cariovv �_ . " ,• . � ' ' � . - , � . � .. , � . . r .. 37. Final Factory Fi�eplaceh � ' c � ! . � - . - . 38. Final Flumbing i � � . , . - , : ; , ' _ 39. Water Service-Final i ; ' � � , - • � j- , 40. Gas Service-Final � � ' � � ' i � � � , ' 41. Solar pomes'tic-,Final � ' � � �. �� _ � _ ' _ , 42. Backflow P.reventer _ i � , � � ' � '' , y - -' -1 � - - 43. Backflow Irrigation . ' . � �� ` �•� � � � . . . ' - - 44. Landscape Irrigation SYstem � � - ' , , ' , - 45. Sound' Attenuation' ' i � ' ; � . ' • - ' i . i � �= 46. Handicap Regulations � � � � ��. � � _ � ' � '. � '' � 47. FINALSTRUCTURE&BUILDING � ��i � i • �' � �i i i I � I � 48. Special flequirements Completed ' � � � � - . i 49. Electric Release to Edison� ' ._ _ ' ` ._ , .� _ . _ , • -- - -� 50. Gas Release to Southern Califorriia Gas Co � , ' ' � � � . �. ' 51. CERTIFICATE OF� OCCUPANCY ' _� '__1 _ _.. _ '_ __ .. . No - Date ' � ! � , ' � ' ' •. �_ ADoi��ant [o fii� in atl soaces wilnin neavy Oortler lines anC slgn all appropriale tletlarations. 9I 5� 5/23/83 c�7�0� TL'' �CITY OF�COSTA MESA , PER+i1T NO. TRACT NO. LOT NO. BLOG. NO. - , ICONSTRUCTION PERMIT M `7�,3 r% • � � rroiecc v.aaress � � TYPE OF CONSTRUCTION , (Owner /' PhOna �}'NEW ❑ ADD Q ALTERATION. �Addrest � � Q REPAIR ❑CONVERSION ❑DEMOLISH IArch/Eng. - License No. OTHER ' � AddfEss '- ' - - � DESCRIPTION OF WORK � Contractor Phone TVPE OP PERMIT �� .AddfeSs � '❑GRADING , ❑ FOVNDATION "�STRUCTURAL GCENSE � ONTNACTOR DECLARATION - �� Q TENANT O'ELECTRICAL ❑PLUMBING�ECHANIC I neraby afilrm th:t I am Iicansetl untler provislons ot Charter 9(com- mendng' with section'7000) of Oivislon 3 of tne ouziness- antl -❑ OTHER - - 1 Professlons Cotla, an y' Ilcense is In (un force antl pjt cL PROJECT DESCRIP.T.ION.� _, _ . _ Llcans�p�_ ..� ��n ��cen No , SQ. FT. � � ' . .. . Date �� ��^^���� � WORKERS'COMPENSATIONDEC RATION� - - -OCCUPANCV_CONSTRUCTIONTVPE 'I hereby aHirm that I have a certiflcate ot consenl to selt-Insure or a VAWATION ZONE Certifltdte of Wolker5"COmpCnsatlOn InSufanCe, Or' a C¢rtlfietl copy � --- thereoi (5¢ ctio� r� 0Q��l,;p ). GRADING CV. YDS. � ACRES 'cyNouPX lYY'1��Company �C�1aiV °�'%�$p�.". ' ' - ertifieC copy is hereby furnishetl. - - - - ' REMARKS: - ' ' - - . - - .ertifietl copy is 111ed witn the ci[y Builtling Divlzion. EXEMGTION FROM WORKERS' COMPENSATION DECLARATION � - ' � -' ' " "' (This section neltl no4be completetl it the permit i5 fo� one hund�etl (E100) or Iess). - � � �� � I Certity that in the pCrfOrmance o� Ihe.work for which this pe�mit Is ISsuetl, 1 ihall not employ any p¢r50n in any manne� so a5 t0 Oecom¢ P.LUMBING� � �� �PLAN CHECK subject to thE Workers'-�Compensatlon LawS o1 Cdlifornia. .. . ' Dale $Ignature BATHTVB$ $HOWER$ NOTICE: II atter making tnls tleclaration, you zhoultl become'subjecb � TOIlETS� i URINALS � to the Wolkeli' Com0en5dtio0 prOvlsiOns Ot the Labor CoOe, you must � _ forthwith comply wlth sucn provisions or this permit shall be tleemetl LAVATORIES , DO �.�VS �� �TaONSTRUCTION LENDING AGENCV KIT.SINKS � I WA�(jF+HS �-� �I hereby aflirm that thera is a constructlon lentling agenty tor the per- SERV ICE SINKS � �i1MP5' � � � � forman<¢ o/ th¢ work for which tnls permit is i55uatl (SecUon 3097 ' • c��. c:t. - F�ooa gwtcs' ^'� '- dgooa)oakirvs Lentler's Name �Lentler'SAtltlres5 � INKIN F�UN'1'A1T� �' � � OWNEfi BUILDE0. DECLARATION ' � IN�T�2CEf�fqR$ CLARIF. I �¢r¢by aHirm [hat 1 am exempt irom tha Contractor'S License l.nw for tlemollsh'or'n e apFIIWn[ lor tl�pursuanl to aPPliCvnt tOi ol more than �. I� d5 OWOE! O� Sole compensalion, as a cWre to fi ns of the Contractor's License ldw ction 7000) of Division 3 0l tne bat ne IS OxOrtlpt thCrefrOm-dntl [hC ny Wolatlon at Section 7031.5 by t5 lne appliWpi to a"<Ivll'p¢ndlty lar5 (5500). �my amplOy¢¢s wlth wagez az [hGl� SERVICE U OUTPUT or oHeretl for sale. �xcuo�� .v ., �� � �., o � ��..��» �� ..�..�: ���o av�..r. r .. a.a. Contractor'S Licenza Law tloes�not apply�to�dn Own¢r Ol�a prOp¢rty wh0 builtls o� imOroves lhereon, antl who tloes sucn work himselt or ISSUE FEE ' IbrougM1 bis own employe¢S, provitletl that such improvements ale.nOt . Intentletl or oHeretl lor sale. Ii, howeveq ihe builaing or Improvement MECHANICAI PLAN CHECK is Soltl.within.ane y0ar ot completion, the Owne� will have.tne burtlen. of. provin9 he Oitl not builtl or im0/ove for the purpose oi salo). HEATING SYSTEM 0-100,000 BTV � ❑ I, ds Owner oi tne-property, am Oz<luzivery contrdtting with qND DUCT�NG IiCenzetl cOntractors ro conSVUCI [he project (Section 7044, Business ]00,000't BTU _ 5ntl' R'ofessio�5 CAtl¢: Th¢ COntractor's Licens¢ law tlOes not apply to an owner ot propetty wh0 builtl5 or ImprOv¢s lhereon, antl who cOn- REFRIGERATION 0-300,000 BTU_ traCtS trom sucb-p�o)ects wlth a-[ontraGtor(5) IlceSnetl pursudnt to� SVSTEM ' ' . -- the Contractor'S License Law). 100,000 + BTU _ ❑ I am ezempt untler Section � B. d P. C. tor this BOI LERS BTU f ICd50l1 Date Owner SVSTEMREPAIR,ALTERATION 1 h¢reby certity.that I have reatl Ihis appliWtion antl SLaiG [hat the aDovG EXHAUST SVSTEM MULTIPLE fnformation i5 correcl. 1 agree to compty with all City antl wunty o�tlinance5 antl,stdte laws relating to ConSt�ucliorl, antl �ereby auihoriie r¢pr¢5¢ntatives o( this city to ente� upOn Ihe abOve men[ion¢tl prope�ty fo� � spe ion p se5. ' Siqnature Date S�-L� Drivers' Licen � ss � =� � ISSUE FEE CMF 0865-36 Whi[e�Builtling; Unary-Appliwnt: Pink-Accouniing; Golaenrod-AsSessor ZONE , )NING REGULATIONS - PLNTGp. gR�E1FL. pryp . PROPE,RTV LGNE I REAR VARD (TO P/L) PKG. SPAGE RE�. PROV STREET WIDTH - PARK ZONING APPROVED BV iPECIALCONDIT10N5: � ELECTRICAL � -� PLAN CHECK I � Ro0F1 I IR]_ CE4IICF _ GENERATOR ' 0-1 KW_1-301(W TRANSFORMER APPLIANCE 10-SOKW=50+KW MOTORS - 0-1 HP'_1-]0 HP (INC.SOIAR)- 10-SOHP SO+HP �FIXTURES � OUTCETS SWITCH GAS TUBE SIGNS -' ' ' POLE LIGFITS ' � I' ' PANELS " ' SERVICE - 3 MAIN $UB AMP � ISSUE FEE - ' - ' APPLICATION FPPROVED BV pqT � SUMMARV OF , ES � , BUILDING ' . ' -- PERMIT S ' SMIP S PLAN CHECK S PERMIT ISSUANCE �S ,PLUMBING E GRAOING S PLAN CHECK E ELECTRIC%iL 5 � � s PLAN CHECK E MICROFILM S MECHANICAL -b OO TOTAL FEE §�' PIAN CHECK § � LE55 AD- �bd— VANCEPC $_ FINALFEE b� ._1 CONSTRUCTION AND PLANNING POOL & SPA - � ' , � :_ APPROVALS Permit # Date Inspector qppROVALS Permit # ' - Date Inspector 1. Temporary Electrical Service or Pole ' 43. Pool & Equipment Location •� � Soil ipe-Undrgrn 44• Steel Reinforcement � � � ' ' � � ' 3. Electrical Conduit Utility-Undrgrn 45. Forms , 4. Electrical Conduit-Undrgrn 46. Electrical Bondin tee ein orce. . 47. Rough Plumbin & Pressure Test �� 6. Electrical UFER Grn ' 46. APPROVALTO COVER-GUNITE- �• • �' ^ 7. ootings - 49. Electrical ConduifUndr rn � . 8. Foundation � 50. Gas Pipe ❑ Undr rn, Test " . 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn � 10. §tructural Floor SYstem 52. APPROVAL TO DECK � - 5 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final . 12. Street Sewer Connection_ 54. Heater & Vent-Final 13. Rough Plumbing � � � "��. �14. Rough ElectricConduit - � � �56. Electrical•Final � � f';n 15. Rough Electric-Wiring � � - 57. - Solar System-Final ' - ' �76. Rough Heating & Air Conditioning � encing,& Access Approval 17.' Ducts in Structure APPROVED FOR PLASTERING ' 18. Ducts, Ventilating. � - _ , 19. Gas Pipe-Rougfi & Test 60. POOL/SPA SYSTENIS FINAL � 20: Roof Framing _ � � � 21. Roof Sheathin � ' � � 22. Frame and Flashin � NOTES: • •' 23. insulation � � 24. Lathing & Siding ' ' � 25. Drywall Nailiog - � � � � ' ' � " 26. Plaster Brown Coat - 27. Electrical Power Meter-Final 28: Final Electric • 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing ' 32. Water Service-Final ' � ' � � ' �33.� �Gas Service-Final � � � � � ' : 34. Solar pomestic-Final ' ' ' 35. Landsca e S rinklin S stem � - 36. Sound Attenuation • 37. Handicap Regulations � 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed � � 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - , 42. CERTIFICATE OF OCCUPANCY _ , No Date , . %. r;, E � ENVIRONMENT/.�� STt2UCTUR�S Sheet: Date : 5� 3�g3 JN: �8 9Z 1_nkr7� 2/f�O �ld�,-� AVi. AG; r co��,; rrr�sp:, � OG�Ec/ or ��.✓�- ... 13���,,., C C4 �. ,B � C � y3" �'4-5" �-/D�'c r�. Cf'`' `J`Z c�' l, /�: �', = �7 ��� -j i I—=1- I�_ w: Roof =(= Psf.) ( _ d Wall = ( psf)( - 1�� F1oor= � psf) ( � D.L. of beam ................. _ r— - -� A Y :T� -�- `�' - 3"1Jcr�� I � a � a c� : r7. y-'� � � U. �" O8�i� ��-�� /ylA�bE /�arc� �� D 4v� Lo�r� - 3" D��r O . plf , , � ��- +� _ ��}; --� . mca = G u7 (z� - 4) (¢) f 'z ; ,-r. r"-� 25°7 �4� = 2`i'`�� . Z 5� Z;�y 3L/ 2 � 7<sp, cl. :�. ��� rJ�Z 1350 � oi� �" .VAIt S�?,�7.5��!Y�5��o5) �N.�\, _ �i0�l�o� � 3 (r i.,l l ' �- . Va�.� = �� � �o-� x (2��:, -i� c) _ ��89 z ,v � ' w: Roof = (_ psf) ( Wdll � ( pSf) ( Floor= (_ psf) ( . � -,.-u, n.?:_ ef �e�m .:............... � W � C{TY O 1STA MESA PAhn FEES Fee Payment Receipt Project Address a� �� ����-R--�'l, �'`e-^ A.P. Number .�� —� 3 3— a� Park Area Building Permit Number Owner's Name �1 Mailing Address � FEE: Planning Department ApplicanYs Signature + aty o,a�nanca �z-aa CMF 017432 Rav. 6/79 � Single Family ` 2-Bedrooms or Less 3-8edrooms 4-Bedrooms 5-Bedrooms + Multiple Family "' Bachelor or Studio 1-Bedroom � 2-Bedroom � 3-Bedrooms + - � n N-• � 894 Number of Units @ $ 861.76 = �° 1,205.67 = @ 1,545.62 = �° 1,810.50 = @ 474.37 = @ 573.18 = @ 881.51 = @ 1.229.38 = Total Fee "' "• CISy R85olution 78-11b— �1+Inp; Pink—Finan<e; Goltlenrotl—ApPlicant 6991 4/II/83 g��6o �S 2. 4917.52 TL cos�a��cs�