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Home My WebLink About2292 CANYON DR - Building Permits� . �� COSTA MESA BUILDING-SAFETY DEPARTMENT �"P.O. BOX 1200 COSTA MESA, CAUFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING ^ ^ ADDRESS .( < � 'A ~ � N OWNERORC � ��AS� TENANT �J ADORE 5 aa 7k-N � w� o R\ C I T V ` O,S � A I ('Q S � r N OL� 7� CONSTRUCTION /✓'� N ,` i LENDER BFANCH � ADDRESS ARCHITECT L1 IlR GNf:INFFR �� e ' T S F � W a Q � y S F C � � :� Q � r .� C v� a. � �. 4 Z L[7 � 3 CONTRACTOR Se � � ADDFESS �( d��_�e w� J'I'� cirv �os % /� /V(e-��R No� % � STATE qT V LIC. NO. LIC. NO. SIZE NO.OF BLOGS. OF LOT NOW ON LOT VSE OF Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED STJ R A 9� �a r�o Y i— I hereby acknowleEBe that I have reatl this applicetion antl staie that the above information is correct and aB�ae to comply with ell �aws rOBulating builtling cOnstruction, and I shell n0[ employ any Oarson in violatian ot Ma workman's campanmtion laws of Me State of California. I hereby eerUty ffiet I am properly Ilcensetl m n<oniractor untlar the Stata of California Business antl Ptoteasione Cotla, Dlvlsion 3, Chapter 9, antl Mai such licensas are in fuil force entl affact, or I am ezempi from the prwisions oi Me Stete of California Business antl Professions Cod � rvision 3, Chapter 9. SiB�et�ra of Permittee m_ /�� G or !%C�%� � z l `7 O � Au[horized Agent � APPLICATION FOA'STRUCTUKAl. PERMIT �B'69 TL CEr'�C�V PERMIT N° � 51021 X A.P. NO. �- BUILDING /� (j ADDRE55 `Z-(Z GM.yON� VNIT OR SPACE NO. TR.NO. LOT NEW ADD ALTER REPAIR MOVIN( OWNER S�J • McNas VAIUE USE (J.I`� O '1—' $ ZONE TVP � GROUP APPROVED BV DATE �� PLANNING ACTION r � VALVATION 5 �� m �e � �_ .. m � m FT. � N 7 � SHOWN UNDER VALUATION I$ FOR m OF RTABLISHING A PERMIT FEE ONLV: � PERMIT FEE S S�, _ q n PLAN CHECK E 2 ^ . � O LL TAX S O� f u TOTALPAID S � . �O � . • Appllcant t0 till in all Sp9tef eaCeO� �hofe wit�in �aavy borEar Ilnes antl fi9n all appro0riate Geelaralions. CITY COSTA MESA CON RUCTION PERMIT Prn�nrt AAArxs � � � Applicant's Mailing Add�ess . V � Owner'sName M� N�S�� .�hone ' Addreu �M�� A�iD� ' ArchlEng. License No. , Address ��.� �c�� Contractor'sNama SLR,�1qM�P�IC. $b� ahone�S.d—�17� Addiess�lmailing) L' Ciry License No. ��666 ' LICENSED CONTRACTOR DE LARATION ' I hereby afllrm thai I am Ilcensatl untlar provisloni of Charter 9(commendng wlth sectlon 7000J of Dlvislon 3 of [ha Businau anO Profe55lons Cotle, and my Ilcense Is I ful force ana e/e �t. Llten e Class � � S�' ' LI<ense No. � O� Date �— � n"� Si9 at e �� G WORKERS'COM,ENSATION DECLARATION :' hereby affirm that I have a certifiwte of mnsent to SelLinsure or.a certi(Iwie '�"�� Workers' Compensation InSurance, Or a certi(latl COpy therlOT (SeGtlOn "�'�00, Lab. C.) p T Polity r,o. nsLK 9SFt 5 f g`Pfl mpany �•�'t � BCarHflatl copy Is nemby furNsnetl. Certi(latl toqy 1 flleC wit� the city B i tljng Division.� �^ Oate 1—��Y� APPliwnt �rU1.J v�y1M�� ' E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (Thls sectlon neatl nol be complete0 if the permit is for ana huntlretl (E100) or less). I certify that in tha pertormance of tne work /or'whi<h thls perm�t Ii Issuetl I shall not amploy any parson in any manner so as to become subject to t�e Workers' Compenzatlon Laws of Califomia. Date 519nature NOTICE: H,mfter mekinq thlz tleclnratlon, y0u ShOUItl become suEjact to tha� Workers' Compensatlon provislons of the Labor Cotle, you. must forthwlth comply wlth such provlsionz or this ,parmlt ihall be tleemeq revokatl: CONSTRUCTION LENDING FGENCV� . 1 �eroCy a/firm that there Is a constructlon lentling a9ency fonlha performance Of the wOrk tOr wnlCh thi5 Permlt IS Issuetl (SeCtiOn 3097 Civ. C.) LDntlB/'S Nama Lenaer's Atlaress OWNER BUILDER DECLARATION • I hereby a(firm that I am axamDt from the Contractor's Ucense Law for the followin9 reason (Saction 7031.5 Business antl Pro/essional Cotle: Any city or tounty which roqulrei a permit lo construci, alter improve, Eemolizn or rapair any itructura, prlor to Its Issuance,�alzo requlrez t�e applicant for such Oarmlt to /IIB a SIgnBC Statament t�at he/sne IS Iltensetl pursuan[ to lhe provisions o} the Contractor's Licanse Law (Chapter 9(tommencing wlth Sactlon 7000) of Dlvlsian 3 o} the Buslnesi antl Pro/esslons Cotla) or that he/she I5 exempt •erafrom anG t�e Gasis for the allegeO BxBmO��on. Any violatlon of Saction 131.5 by eny applicant for a pormlt subjects tha appllWnt to d Clvll . inalty o} not more than Ilve �unCretl tlollars (E500). ❑ 1. as owner ot the orooertv or mv emolovees witn waaes as t�elr sole empio eas, proviaea tna[ sutn imDrovemen[s are noc maenaea or o**aroa ror fale. 1, howevar, the bulltling or Improvament Is soltl wit�in ona year of com- platlon, t�e owner will have the burEen ot proving he/she tlitl not builtl or im- �rOve tor the purpose ot sale). 1, as awner of the DroOerty, am eacluilvely contracting wlth IlcenSeO con- tractoritd construct the Droject (Saction 7044, Busineis antl Professlons Cotla: The Contrattor'S Llcense l.nw tloas not apply to an owner ot property who bulltls or Improvet thereon, antl who contracts for suc� Oro�ects with a con- tractor(s) Ilcenie pursuant to tne Contm<tor's Ucense law): ❑ I am oxempt untlar Sactlon B. 6 P. C. far this reason Date Owner 1 hereby certiry tnat•1 have reatl this applicatlon antl stata that the�above In(ormatlon I5 corrett. I agree to comply with all city an0 county orGinances antl state laws relating to bulltling constructlon, antl heraby authori[e repre- santatives ol t�ls city to enter. upon 4he abova-mentlonetl property, (pr Slgnatura IJ1 Drivars' Licanu oC55 � CMF 0865-46 rev. 12/83 Whlte - Bulltling; Gnary ,_ ...,. ._. __..._. ,. , — !/ 3 c5 — n., • TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR .❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.p, �6 . � ' DESCRIPTION OF WORK �nL� } \� . S MainBuilding: � T.VPEOFPERMIT ,GRADING FOVNDATION STRVCTURAI T FfOnt ❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL B Re3r � . ❑ OTHER . . � � A . PRQIECT DESCRIPTION 5Q. FT. - OGCUPArvC C Right � K Left CONSTRUCTIONTYPE � VALUATION§ $ � ZONE GRAOING CU. VOS. ACRES ping, Ref. # Remark�: � �' Parking Req./Provided • , Uu of Building: ' PLUMBING FEES �PlanningNotes: Sink ShowMs cflow Preventer - � Service Sink' cflow Irrigation ' Sewer Cap Clarifiers ' ' Dishwasher . Drinking Fountains Flaar Drains Flaor Sinks . GasService ' Outleu Interceptors Kitchen Sink . . Levatories � � P—Trap Roof Drains Reinspection Fee $25 Boiler Duct - Under Ground Duct - Structurel Duct - Ventileting Exheust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO �/k Heating System & Ducting ❑ ai oo,oao eru 0� oo,aoo sr �� I I Reinspeccion Fae Plnk - Accounting; Goltlenrotl - Assessor �$25 Solar Col�ectors So�ar Piping Solar Tank Swimming Pool w�Spa Urinal Water Closet Water Heater Water Servite laue Fee Hood or Type 1 ❑ Canopy Typell ❑ Refrigeretian System 04700,OOOBTU ❑100,000 System Fiepeir/Alteration Isue Fee $ 3 E 3 Automatic Washer'; Construction Pole Su Cooking Unit ' Dishwasher Dryers �Gas ❑E6 Fan F.A.U. Fixwres Devica Boxes Outlets Switches i Garbage Disposal Generator �65 KW az�e 2/14/B4 Zone :sory Buildin9: I Park.Fees $ ELECTRICAL . Transformer ❑ 15-50 KW �. / ❑ 50+KW Meter ❑up to 700 smps Meter �over100amps 5-15 KW Sub Panel Motors�0.1 HP�1K-8 Inc. Solar �415 HP OtE15+ MiCrOwavB Pole Light Range Sign Standing Sections Trash Compecmr � Reinspaction Fae � � 525 ��ttue Foe PUBLIC SERVICES REOUIREMENTS: 2oning Approvod By Building ApProved 0y AODIIC8L1011 ISTIIB(� BV \ \ I I'.OL 7L � S 3 SUMMARV OF FEES BUILDING PERMIT $ • SMIP $ PLAN CHECK $ PERMIT PLUMBING • $ � ��UANCE $ PLAN CHECK 25%' $ ENERGV P.C. $ ELECTRICAL $ GRADING $ ' PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTAI FEE $ I/, n- d P�AN CHECK 25% $ _ _ . . Z O N I N G R E � U 1 R E E N T C7NSTRUCTION ANDPLANNING � _ POOL. A • . : -� _ � Date Inspector � Date � Inspecto� APPROVALS Permit# ' . _ ' �APPROVALS Permit# � Temporary Electrical Service or Pole � . 52. Pool &�Equipment Location _ , 2: Soil Pipe-Undrgrnd. �: - � . . 53. Steel Reinforcement ' , . - � 3: Electrical Conduit Utilify-Undrgmd: �.__ - . � . ,54. Forms , �, � 4. Elecvical Gonduit-Undrgrrid? -� _ • , �55: Electrical Bonding � � 5. Steel Reinforcemeni• , - � " 56. Rough Plumbing & Pressure Test � 6. Elecirical UFER G'rnd.. ' 57. APPROVAL TO COVER-GUNITE. � ' - 7. Footings .'- ' � 58. Electrical Cqnduit-Undrgrnd. , ' 8. Foundation • � • -59. Gas Pipe, O Undrgrnd., Test = � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgmd. - � ' 10. StruCtural Floor Systeih ' • 61. APPROVAL TO DECK ,� 11. Pro ert � Sewer Line & House Connection � � � • P Y , 62. Backwash & ReceptorFinal - 72. Sewer-CAp ' ' • � 63. Heater & Vent-Final ' ." 13. Roof Drains • 64. Plumbing, SYstem - Final � � � ' , 14. Rough �Plumbing � - + - ' 65. Electrical-Final � 15. Rough Electrical-Conduit � � ' ' 66. Solar System-Final � � - -- " �" i 1§. Rough Electric Wiring -. - ' 67. Fencing & Access Approval . ' 1�Rough Wiring Sign' - - � 68. APPROVED FOR PLASTERING ' � " 18. Rough Electrical-T Bar Ceiling 69.� POOL/SPA SYSTEMS FINAL 1�9.,. Rough Heating & Air Conditioning �. FIRE DEPT. REQUIREMENT� � � v 20. Rough Factory Fireplace APPROVALS Permii# '• ' ` � t �21. Ducts, in Structure. ' . 70. Uuderground Hydro � � � � 22. Ducts, Ventilating � � I 71. Product Piping 0 Gas� ❑ Oil � ' 23 �as Pipe-RougFi & Test � .�L9 72. Underground Flush ' �24. Roof Framing - . . 73. Undergrnd.StorageTank �Gas ❑Oil ; � 2�. Roof Sheathing � � � 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat ,75. Dry Chemical � 27. Frame and Flashing ' � 76. Dry $tandpipe ' ' � 28. Lathing & Siding ' 77. FIXED SYSTEM FINAL � 29. �Insulation _ ' �78. FIRE PREV. FINAL ' 30. Drywall Nailing -� , HEALTH DEPT. REQUIREMENT I 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final �� 80. FOOD CERTIFICATE ISSUED 33. Final Electric � � Notes: � i 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � ^ � -� � � � � - � . . . 36. Hood or Canopy � , � ' ,� . ` �i " 37. Final Factory Fireplace . � , j : ' � � �- 38. Final Plumbing ' �' (/� � ' 39. Water Service-Final . . 40. Gas Service-Fina� � ' � ' ' 41. Solar pomestic-F.inal . �( (�f� - � , � 42. Backflow Preventer i � � • , 43. Backflow Irrigation� j �,' , . . � - .� 44. .Landscape Irrigation System , � ' � �' 45. Sound Attenuation - ' � � � ` i ,. � 46. Handicap Regulations � -. , r� _ 47. FINAL STRUCTURE & BUILDING , � � � 48. Special Requirements Completed, � � 49. Electric Release to Edison � � � � � � . � � 50. Gas Release to Southern California Gas Co � ' ' ' i � 51. CERTIFICATE OFOCCUPANCY � - - � � -- - N0. �- . rDate � - . . _ . . . / � C' Y*OF�OSTA MESA �,'., � JiVSTRUCTION PERMIT � � AGP��eanl to fill in all ipaces axce0t thoze wlthin �eavy Eortler Iines and sign ail aoo�opriale eeclarations. Applicant'sMailing/�A/��ddreu �'`'"��t Owner's Name �'•C ��' Phone Address Arch/Eng. License NO. Address �,...� �1 Contractor'sNam E'h — PhoneLl�Gl� Addreulmailing) G� � City LicPnu No. • � � a ,Li� LICENSED CONTPACTOR DECI.ARATION I hereby atHrm tnat i am Ilcensetl unUor provislons of Charter 9(commancing wl[h sectlon 7000) of Division 3 a1 the Buslnass entl Professlonz CnOo, antl my Ilcense is in (ull tor�4 ana e(letl. UcenSeClass `�� LI N Sb Date�Z�-1� Signature WORKERS'COM7ENSATIOPo �ECLARATION I h¢reby aftirm that I hav¢ a cerHticate ol consent [o selNnsure or a certificate ot Wo�ke�s' CompenSdtlOn InSU/anGe, O� a cor0flea� cooY tnereof �Settlon 3800, ldb. CJ Policy No. Company Certifietl copy is hereby furnlshetl. Certifietl copy is flletl with the city Builtling �Ivision. Date Applicant E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section naetl not Ce completaG if tne permit Is�(or one huntlretl (E300) or less). I certify tbat (n [ha performance of tne work !or whlth this permR Is Isiuetl I shall not employ any person In any mannar at to become 5ubjocl to t{�a Worker Co pen I n Laws o! Califor,�11� Date �� Si9nature �L/� %��' �' NOTICE: It, atter making [hii tlaclaratlon, you snoultl �acoma subject to the WorkGrS' COmpunsatlOn provlslons of llte Labor Cotle, y0u mu5t forthwith comply with zuc� provisions or thls permit shall be tlaeme0 revoketl. CONSTRUCTION LENDING AGENCV - I hereby affirm t�at tnqw is a conSVuttlon lontling agoncy for tha performanco of the work to[ �Ihich this Ocrmit Is Issuntl (SecHon 3097 Civ. C.) Lnnaer's Nama V lxntlnr's Atltlress OWNER BUILDER DECLARATION I hereby aHirm Mat I am exempt from [he Contractor's Liconze L.aw for tne following reason (Section 7031.5 Busineis antl Professlonal Cotla: Any city or COunty whlGh rGqWr05 d p¢rTlt t0 ConStruct, alt¢r, Impfov8, tl<mOliilf Or fepair any struthre, pdor to its (ssuance, also requires the apPlicant for such permil to file a signed statement that ha/she is licensetl pursuant to the provisions of -the Con[ra<tor'S License taw (Cnapter 9(commencing wit� Sectlon 7000) of DiWsion 3 ot the'Business antl Professions Cotle) or that he/sha is exempt therefrom ana the �azis for t�e allegetl exemption. Any violation of Section 7031.5 by any apv�icant for a permit subjecls lhe applicant lo a civli �enalty of not mOr¢ than five huntlr¢tl t1011arS (E500). LJ I, as owner of the� property or my omployeez with wagez as their solo com0ensatlon, will tlo t�e work, antl the structure Is not intentletl or o(feretl tor sale ($ection 7044, Buslness antl Profeislonal Cotla: The Contractor's LicenTe Law tloes not apply to an owner ot a prooerty who builtls or impraves the�eon, antl who tloe5 Such work hlm5el(/hOr591f or thrOugh hIs or �e� own amployea5, provldetl that Suth ITprOvoments a�e no[ IntenEetl or oHeretl for sale. It. however. the builtlina or Imorovement is soltl wl[hin one vea� of com- n, tna owner wI fortho our0ose as owner ol tho �rs to construtt t Contratting Business antl orlm- Tna Cont�actot'S LICenSe law tl005 nOt npply to an owne� Of p�ope�ly wn0 builtls ot Improva5 thernOn, antl who contratts lor SU<� p�o�eClS wit� d COn- Vactor(5) II<anse pursuant to th0 ConlraCtof'S LICenSe Ldw). ❑ I am exempt untler Section B. 6 P. C. tor thls reason Date Owner I hereby certlty [�at I have reatl tnis application antl stato that tha above IMormation is mrrect. I agrao to compty wlth all dly antl <ounry ortlinancas antl 5[ate laws relatin9 to bulltling coni[ructlon, anC hareby autnorize rapre- sentatives of t is <ily to enter� upon t�e above-mentionatl proporty lor inspec[lon pur ses. . S�gnature . Da[a Driveri',License or 55 � CMF 0865-46 rev. ]/83' White -�Buliding; Canary - � - /O�/ 3 � ' � � TVPE OF CONSTRUCTION NEW �(iDD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH � OTHER �ESCRIPTION'OF WORK TVPE OF PERMIT` / GRADING FOUNDATION STRUCTURAL ❑ TENANT .�.,r^LECTI7ICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER � � PRQIECT DESCRIPTION 54. FT. oCCUPANGv � CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.YDS. ACRES Remark�: � f/�/'� — P Bar Sink Backilow Preventer_ Backflow Irrigation Bathtubs Clarifiers ' Dishwasher � Orinking Fountains Floor Dreins Floor Sinks . GesService Outlets Interceptors Kitchen Sink lavatories P—Trap, Rooi Drains _ - Reinspection Fee � '$25 Boiler - Duct • Under Ground . Dutt - Structural Duct - Ventilating Exheust System ❑ Multiple Firepl/Fact.8lt. ICBO # Heating System & Ducting �ai oo,000 sru � i oo,oao II Reinspeciion Fee Appliwnt; Plnk - Actounting; Goltlenrotl - Assessor $25 Showers Service Sink Sewer Cap Sewer Connection $olar Collec[oro Salar Pipin9 Solar Tank Swimming Pool w/Spa Urinat Water Closet Water Hea[er Water Service . Isue Fee IANICAL � Hood or Type I ❑ Canopy Type I I' ❑ 0 Retrigeration System ' �aioo,000eru ❑ioo,000 System Repair/Alteration Issue Fee � $ 3 S 3 A.P. # S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Perkin9 Feq./Pn Useof Building: Planning Notes: Automatic Washer Construction Pole Sub. Cookin9 Unit Dishvrasher Dryers OGa� Fan Zona Park.Fees $ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW F:A.U. Fixtures i Device�Boxes � Outl¢t5 Switches • Garbage Disposal ,• � Generator �0.5 KW �&15 KW PUBIIC SERVICES REUU 2oning Appravdd By_ Appliwtion APProved'BV J � . BUILDING PERMIT � gLAN CHECK - PLUMBING . PLAN CHECK.� � ELECTRICAL PLAN CHECK,. NIECHANICAL PLAN CHECK Meter Uup to 100 amps - Meter �over 1008mps Sub Panel Motors �P1 HP �1'F. - B Inc.Solar �9�15 HP �16�15+ Mivovrdve . Pole Light • Range Standing Sections Trash Compactor � $25 � IssuO Fee — REMENTS: 0 FEES / $ 3 2 O N I N � U � R E SUMMARV OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGV P.C. $ $ ,�a,� GRADING $ g . 9. �jD MICROFILM $ g , TOTALFEE $ ��, %� $ �, � � f I� ' ONSTRUCTION AND PLANNING POOL & Sr„ � , �4 APPROVALS Peimit # Date Inspector AppROVALS Permit # Date Illnspector w � 1. Temporary Electrical Service or Pole , � 52. Pool & Equipment �ocation � �i ' 2. Soil Pipe-Undrgrnd. �� 53. Steel Reinforcement I - 3. Electrical Conduit Utility-Undrgrnd. • 54. Forms. �_ � 4. Electrical Conduit-Undrgrnd. . ' ' 55. Electrical Bonding '�� .51Stee1 �Reinforcement . ' 56. Rough Plumbing & Pressure Test I 6..Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE I 7!Footings - 58. Electrical Conduit-Undrgrnd. � I' 8.'Foundation � . � 59. Gas Pipe, O Undrgrnd., Test I 9. Water Pipe-Undrgmd' - 60. Backwash Lines, P-Trap, � Undrgmd. �� 10. Structural Floor System 67. APPROVAL TO DECK I 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � . � 12. Sewer Cap . - . 63. Heater & Vent-Final � � � 13. Roof Drains , ' 64., Plumbing System - Final �i 14.' Rough Plumbing . 65. Electrical-Final 15. Rough Electrical-Conduit " 66. Solar System-Final � 16. Rough Electric Wiring � 67. Fencing & Access Approval . ' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' - i 18. Rough Electrical-T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace . APPROVALS Permit # , I. � 27. DuCts, in Structure 70. Underground Hydro I 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil �i 23. Gas Pipe�Rough & Test . 72. Underground Flush �, 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil � 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 'i 27._ Frame and Flashing 76. Dry Standpipe �� 28� Lathing & Siding !'� 77. FIXED SYSTEM FINAL f.�� i♦ : 29. Insulation 78. FIRE PREV. FINAL ;,;, ,. 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION I� 32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED �� 33. Final Electric Notes: L`= � I 34. Final Heating & Air Conditioning ` - _ � E 35. Final Gas Pipe-Test � 36. Hood or Canopy � . � 37. Final Factory Fireplace ' � gg�� 0 Q _ 38. Final.Plumbing �' G,� S� IP �i � i� � 39: Water Service-Final � N O 40. Gas Service-Final �i 41. Solar pomesticFinal � � � � 42. Backflow Preventer � 43. Backflow Irrigation , � � . 44. Landscape Irrigation System . � � 45. $ound Attenuation ' � 46. Handicap Regulations � - � 47. FINALST(tUCTURE&QUILDING � 48. Speciai Requirements Completed , ' ' 49. Electric Release to Edison - -. � 50. Gas Release to Southern Califomia Gas Co - , 51. CERTIF.ICATE OF OCCUPANCY • ' No. Date - I . '" � f;�(YpF COSTA MESA � �TRUCTION PERMIfi � � �' Applicant to lill In all s0acas exca0� �hose within heavy botEer Iinas anG sign all aOvroD��ate tleclaraliont. Yrojec�Address (ly2 C�N�D�/ !/A/[�� Applicant's Mailing Address � ow�er'srvarne S�n�(v✓ M� NttrL� ano�e /� Y?% nddreu .i192 r.n�vo.v O.pi✓�r r ArchlEng. Licenu No. Address � i Conttactor's Nam _ �• '� � hone Addreu (mailing) City Licnnse No. , LICENSED CONTRACTOR DECLARATION I n¢reby affirm t�at I am licenietl untler proviiions ot Charter 9(comTencing w'LLh section �000) of Division 3 0( the Business antl Protessions Cotle, anC my license is in tull lorce anA effect. License Ciass a License No. Dale Si9naWre 3^ �'- �4KER5' COMPENSATION DECLAR�.TI�ON . =�y affirm tnat I have a certifiwte of c�hsent to self-insure or a certlficate �orkers' Com ensat}on Insurance, or a tertitiee cop� �I�hereot Section 3800, Lab. C.) '�(N!J K -' �K$ CLNP�� Policy No. � Company _ �Certifietl copy (s here0y tumtshetl. ' �-_ . Ce� � ietl coOY is tiletl wiM the tlty tlIn I lo . Da[e� ApPI"��t � � ' EXEMPTION FROM WORKERS"CIJMP NSA ION DECLARATION (Thizsection neetl not Ee com0letetl if-tl{e permi[ is for one hunGretl (5100) or less). I certify that in the oer(ormance ot.4he work (or which this perm�t is issuea,l shall not employ,any person•�n any. manner so as to become subjec[ to�.the� VJorkers' Compensation I�ws'o( t(pli(ornia. Date � • Si9nature NOTICE: If, aTter making this�tletlaratton, you shoultl Decome suDJect to tha Workers'-Compensation proyislonsaf the Labor Cotle, you must forthwlth comD�Y �+'�th such provisloni or this permlt ihall ba tleemetl revokeU. CONSTRUCTION LENDING AGENCV ' I hereby affirm that there i5 a construttlon lentling a9ency for the performance of the work /or whic��thii permtt is issuatl �(SecNon 3097 Civ. CJ Lentler'i Name � ' Lender'S Atltlress � � OWNER BUILDER DECLARATION I her¢by afllrT that I aT lxeTpt f�om Ine Cont�acto�'s UcenSe Law f0/ [ho followina reazon (Sectlon 7031.5 9usinass antl Professlanal Cotle: Anv citv or � ��4eretrom antl tha bas '�031.5 Dy any aOP�� enaity of not mora th � I� d5 OW09I O� lhE <ompeniation, will Eo for sale' (Section 704 �icense Law aoes not ; thereon; antl who tloe employees, provitletl tt sale. If howeveq t�e C pletion, the Owner will �rove for the purpose c I, ds owner-Of the I tractorsto construct th The Contra<tOr's, Litai bulltls oi improves tn� tractor(s) Iicense pursu ❑ I'am exempt untler Ow Date ' ^ I nereby cerHfy that Information Is correct' antl ztate laws relati senta[ives of t�is� InSpection pur Si9nature Drivers' License or 5 CMF 0865-46 rev. 7/B3 t tor a permit subjects tne apolicant to a civil five hUntlr¢tl tlollar5 (E500). ' lope/ty or my emplOYees witn wages as thoir wle 3 work, dntl th¢ s[Nctule Is nOt IntOnCeA OI otfefed Business antl ProfeSsional Cotle: The Contrattor't ily to an owner of a property w�o bulltls or improves uCh work nlmseli/ner5elf or tnrough his or her own such'improvements aro not Inlentle0 or oflemtl (or itling or Improvement Is saltl'within ona year of com- 3ve tha burtlen o1 proving he/she tlitl not builtl or im- ale). �p¢rty, am exclusively contractlng wit� Iiconsetl con- �roject (Sectlon �044, Buslness antl Professions Cotle: Law does not aPply to an owner of Droperty who an, antl who contracts for such prajects witn a con- �. to the o t r's License taw). ctio� �� — B. & P. C. for thls reaion owner OF CONSTRUCTION CONVERSION ❑ I SCRIPTION OF WOR ER 1 ALTERATION U RE�AIq TVP2"OF PERMIT lJ GRAOING LJ FOUNDATIO�N yC9'STRUC7URAL ❑ TENANT ❑ ELECTRICAL �LVMBING L7 MECHANICAI ❑ OTHER PROJECT DESCRIPTION Sa. FT. OCCUPAN�C/V�� CONSTRUCTIONTYPE �' N VALUATION5�2L� ZONE GRADINGCV.YDS. ACRES_ Remarks: � Bar Sink Backtiow Preventer Backflow Irrigation Bathtubs Clarifiers - � � Floor Drains ' Floor Sinks • ( GasSer'vice z Outlets Interceptors � Kitchen Sink - - � Lavatories' ' P-Trap Root Drains Reinspection Pee- $25 Duct • Under Ground Duct-Structurel , , Duct - Ventilating � Exhaust SyStem'� MW[iple Firepl/Fact.8lt.ICBO�h � Heating System & Ducting I ❑0.100,0008TU�100,000 � enter upon the tiove-mentlonaC qpro�pe�r�ty� itor ; Date�_ � Reinspection Fee White - Builtling; Canary - Appliwnq Pink - Atcounting: GOltlenro0 -Assessor $25 Showers Servire Sink Sewer Cap Sewer Connectioi Solar Cotleclors• Solar Pipin9 Solar Tank � Swimming Pool v -U�ri—nal . ater CW lazet Water Heater Water ServicO � ' 1 K /J� �'c? M�/!{.rs laue Fee {qNICAL Hood or Type I ❑ Canopy Typell ❑ , ; Re(rigeration System � ❑0.100,000 BTU ❑100,000 Bl System Repair/Alteration Issue Fea ' $'3 FEES A.P. vW i '-G S Main Building: � E T Front ��' B Rear �- A C Right � K Left 1 S Ping. Ref. qk ��_ Parking Req./Provided Use of Building: Plenning Notes: ALtomatic Washer � Construction Pole Sub. - Cooking Unit - Dishwasher Dryers �Gas ❑Elec Fan F.A.U. . . Fixtures ' Device Boxes � Outlets- ' Sviitches ' � Garbege Disposel-,. Generator �0.5 KW � Reinspection-Fee PUBLIC SERVICES RE04 Zoning'Approved By_�� A'pplicetion Approred�y , 'T .:�.� .�.. , Zo�e a Attessory Building: Perk.Fees $ --� � ELECTRICAL ,- Transformer ❑ 15-50KW ❑ 50+KW Meter Oup to 100 amps' � ' Meter Oover 100 amps ' Sub Panal Motors � 0.1 HP � 1 X- 8 Inc.Solar•�315 HP �7E75+ - ' Miaowave � Range �. Sign Stending Sections KW Trash Compactor $25 laue Fee � �IENTS: � vr ` FEES $ 3 O N I N G R E Q U I R E N T � � � � SUMMARV OF FEES q �J BUILDING PERMIT n$ -� �•�%+ 00 SMIP $ 0.��✓ PLAN CHECK �A R $ �� PERMIT P1U6161NG 'ri�6L.- $ 3 9''—� ISSUANCE $ PLAN CHECK "$ IB •� ENERGV P.C. $ .ELECTRICAL '� $ � GRADING $ `PLANCHECK.• $ ' ' M�CROFILM $ ' MECHANICAL'�6� $ � 7'O0 TOTAL FEE $ -� �� PLANCHECK �. $ �'f'�O r _� _ .� r . � � ONSTRUCTION AND PLANNING �. ' , POl . SPA � . . 't; Date Inspector � Date Inspector , PPROVALS Permit # APPROVALS Permit # _. .1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Sqil Pipe-Undrgrnd. �/ � � 53. Steel Reinforcement _ . ' 3., Electrical Conduit Utility�Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reiriforcement 56. Rough Plumbing & Pressure Test ' :6• Electrical UFER Grnd. p g 4 Z 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 6. Foundation S. (�, 59. Gas Pipe, O Undrgmd., Test . 9. Water Pipe�Undrgrnd. , 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 'J,rjs�� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar SYstem-Final .'16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18: Rough Electricai-T Bar Ceiling . 69. POOUSPA SYSTEMS FINAL '79. Rough Heating & Air Conditioning a n FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # 7. Ducts, in Structure 70. Undergraund Hydro • 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil ' i3,. Gas Pipe-Rough�& Test 2-3-8k ti=( 72. Underground Flush ,24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 1„�d._ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 'i 27. Frame and Flashing �7 (� 76. Dry StandPipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � Z•Zg•B¢ G,(�� 78. FIRE PREV. FINAL . 30. Drywall Nailing ,3 � HEALTH DEPT. REQUIREMENT I 31. Plaster Brown Coat 79. FINAL INSPECTION , 32. Electriral Power Meter-Final . 60. FOOD CERTIFICAT.E ISSUED 33. Final Electric ( �o �� Notes: , 34. Final Heating & Air Conditioning ,jC�Bc� LFJ ;v -/9-g3 �pKS�l7k1TArJ /PE: �oo?'inr S 35. Final Gas Pipe-Test ��J %�( /�K �DfNT�N m �w �ieu+lK �^�� w�9 36. Hood or Canopy tJ8'J ;,� jp ��3 D� Tv c'eyar �a/�iil ��1 s7- 37. Final Factory Fireplace - yBaN v?lii�uf� 38. Final Plumbing 5j3�d1Y 4f% '�+l - 3 {t a� %p 39. Water Service-Final � _ � 40. GasService-Final 3 - �� ' - � 41. Solar pomestic-Final Z..�.g¢ L,u�, /a �3 S ,� =-.- s�� 42. BackflowPreventer �'�Q � so�:'�; .� S ` 43. Backflow Irrigation - p{J 445TQ57 oty Lo6C'G�KE2 2-3-3`( �4f7 44. �Landscape Irrigation System -(�µ5 TFS.T ok yy yly [ �•. 45. Sound Attenuation • 5►�WfiE2 Pqh OK ��f�Q�`%�0 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ! �o B� ' 48. Special Requirements Completed � 49. Electric Release to Edison �` I . 50. Gas Release to Southem California Ga�Co 4;• -✓ � 51. CERTIFICATE OF OCCUPANCY '1 ��' � • ..� � � . _ No. Date �� , ...._ • � �c' i � Gt'fYQF�COSTA'IC�SA .., ;e �ONSTRUCTIOIu,PERMIT � � Aop�lcant to illl In ali spaces exceDt those PrOject Address ,1++� Y'� � �- w'--^'� �%� ApplicanYs Mailing Address � �� Xe. � �h .>�'�=(' n Owner i Name � f� •�' "�� C�j �� PhOf12 3'�� Y�� Address -�'.� �/— -�! � � n � .� �J` C c;C l4' � /i��•{-iE . Arch/Eng. p�'�T��L•�� /1r� dicense No.'�S Address yc;_ �l/.� �••�...61- UT�✓Y�'�,�" Contracmr's NamP �"�'� �� -%�' � L�S" Phone Addreu (mailingl City �icense No. - LIGENSED CONTRACTOR E AT N � ' . 1 hereby affirm that 1 am li � er piovisions of �Charter 9(commencing with section 7000) of Division of the Business ane Protestion5 Cotle, antl my Iicense,ls in full force anqeffecL � License Class License No. ' Date ' Sl9nature WORKERS' COMPENSATION DECLARATION . 1 hereby affirm that I have a certlficate of mnsent to salf-insure or a<ortlficate ' .Ot Worker5' CompenSatiOn InSurdnt¢, OI �d tertitietl Copy theleo( (SeCtion 3800, Lab. C.) , ' _ Policy No. Company � 8' Certi(ietl copy is hereby fumishetl. � - . , Certifietl copy is flletl with the city Builtling Division. Date Applitant � EXEMPTION�F0.0M WORKERS' COMPENSAT�ION�OECLARATION (Tbiz section neetl not bo completetl If the permiYis for one huntlretl (g100) or � less). I ce�tlfy Ihat In th¢ pe�fO�mdnc¢ Of IhG work to� which [his p¢rT�t 72 i55ueE'I shall not employ any person In any manner so as to become subject to t{�e, Workers' ComDansation Laws ot California. ' � Date Si9natura NOTICE: H, after making this tleclara[iOn, you S�oWA become zub�¢Ct t0 lhB Workers' CompensaUon provl5ions oYt�e Labor Cotle,-you must fOrthwl[h , comply with tuch provlslons or - this permi[ 1 shall be tleemetl revoketl. CONSTRUCTION'LENDING.AGENCV � - -'• I hereby affirm that there li a construc[ion lentling agency'tor the per(ormance ot the work for which [his permit. is issued (SecHom 3097, Civ. C.) LEntler'S Nam¢ - L.enCeYs Atltlress' OWNER BUILDER DECLARATION � - � ' I har¢by d1(irm thdt I am exempt irom tfie Contractor's Lic¢nse L.aw (Or [he , croYs� License law (CM1ap[er 9(commencin9 with Section 7000) of 'of tho Business antl Professions Cotl¢) ov that he/she Is exempt antl the basis for the allegetl exemption. Any,vlolation of Sectlon any appliCant for d p¢rmit.5ubjeCts the ap0��ant�to a clvil not more than five nuntlretl tlollars ($500). , i . � License l.aw tloes not apply to an owner of a property who'builtls or improves thereon, antl who tloes such work himzelf/herselT or throu9n his or her own ¢mployea5, p�ovltl¢tl that such Imp�Ovements a�e not intehtletl or offe�etl�fo� sale. If, however, the builtling or improvement is soltl wlthln one year of com- pletlon, the owner wlll have lhe burtlen ot proving he/she tlitl not builtl or Im- �ovd(or the purpose oi sale). , - � LJ I, as owner o/ the prooerty, am exclusively contractin9, with Iitensetl con- traGtO/sto COnStruct t�a proj¢ct (Seclion ]044, Business antl Professlons Cotle: The Contractbr's License Law does not aOPly to an ownEr ot property who builtls o�VmprOv¢S thareon, dntl who wntracl5 fOr Such ploj¢Cts wlth a COO- trattor(s) II<ense pursuant to Ihe Gonlractor's License Law). ❑ I am Gzempt untler SecHon B. & P. C. for IhiS r¢a5on Date /nwner' [hat e reatl this application antl state that the above �rec . gree to comply wlth all c antl councy ortlinances lat ,�O buil 9 ConStruction, e�eby authorize rlpr¢- �ilyj �r,�u/po�n �thJeO ab e tionea property for �/ v/Z(/ ' Data//�S�aa \ Driverz' License or 55 CMF OBfiS-46 rev. 7/83 - Builtling; �k��. I TYPE OF CONSTRUCT^ION rvE ❑ COIVVERSION Li DEMOLISH DESCRIPTION OF WORK OTHER anG sign all appropriate tleclarations. ALTERATION LJ REPAIR TVPE OF PERMIT LI GRADING, � FOUNDATION IJ STRUCTURAL ❑ TENANT ❑ ELECTRIGAL �LVMBING ❑ MECHANICAL ❑,OTHER PROJECT DESCRIPTION SQ. FT. oCCUPANCY_ CONSTRUCTION TYPE VALUATION $ ZONE GRADINGGU.VDS. ACRES_ Remarks: �p �;/✓C L.20/'%%�w� l�..o_iJ � Sink Preventer Shawer5 Service Sink Sewer Cap Sewer Connection asher ' � ' Solar Piping ' ing Fountains Solar Tank Drains • � Swimming Pool w/Spa Sinks � Urinal ;rvice Outlets. Water Closet - eptors Water Heater �n Sink' . , Water $ervice . Lavatories Drains Reinspection Fee � Boiler ' � Duct - Under Ground Duct - Structural Duct - Ventilating Ezhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # Heating System & Ducting ❑4100,000 BTU 0100,0008T II Reinspection Fee Applicant: Pink - Accounting; Goltlenrotl • Assessor $25 Isue Fee Hoodor Typel ❑ Canopy Type I I ❑ fiefrigeration System ❑0.100,OOOBTU ❑100,OOOBTU System RepaidAlteration Issue Fee A.P. # S Main B� E T Front B Rear A C Right K Left S Ping. Ref. # Use of Building: - EES Planning Notes: 1. Automatic Washer ConStruction Polef - Cdoking Unit - _ Dishwasher _ Dryers �Ges �E Fan ` ; . F.A.U. ' $ 3 $ 3 9oeo ��ii�.i...: i:.o , e - � ZOne' ' 'l . ' ' � Accessory Building:' Z O N I N ' , _. G R E . � Park:Fees $ ' n U . R E M —� E D¢vice Boxes Outlets ' Switches �,. Garbage Disposal^ Gerierator �0.5 KW CLC41f�IVMI ' 1 Transformer � 15-50 KW � 50+KW ' � 'Met2r ❑up-to'100amps-- — 'Merer �over100amps � Sub Panel Motors �61 HP �1'f. - 8 � Inc. Solar �9�15 HP �16-15+ Mittowave ' Pole�Light � ^' ' Range � � Sign � � ' Standing�Sections � �5-75 KW � Trash Compactor . FEES � I Reinspection Fee • I$25 � Issue Fee ' $ 3 I PUBLICSERVICESREOUIREMENTS: � 2oning,APProved By 4 ' ' Date ' \ Application Appioved:By ' � Date Application Iwued By� � � ,y fi'�' Det� . . .. . , � SUMMARV OF FEES BUILDING PERMIT $ � SMIP $ � PLAIV CHECK $ PERMIT � ' . PLUMBING .. $ •� ISSUANCE $ ' PLAN CHECK . $ ENERGY P.C. $ .ELECTRICAL • $ • GRADING $ ' PI.ANCHECK �� $ ' MICROFILM $ � MECHANICAL • $ �_— TQTAL FEE $ ��S PLANCHECK - � ""'If�--^'�^"p�• • ,i 'n � �ONSTRUCTION AND PLANNING APPROVAL$ Permit# i. Temporary Electrical Service or Pole 2. Soil Pipe-UAdrgrncl. 3. Electrical Conduit Utility�Undrgrnd. P- ' 4� Electrical Conduit-Undrgrnd. 5. Steel Reinforcement . � ti 6. Elecrical UFER Grnd. "I . 7. Footin s � 9 .S-e-e':�a�`r s � 8. Foundation 9. Water Pipe-Undrgrnd. 10. Structural Floor System 11. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electrical-Conduit 16. Rough Electric Wirinq 17. Rough Wiring Sign • 18. Rough Elect�ical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace ' 21. Ducts, in Structure _ 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test `24. Roof Framing - � 75:, Roof Sheathing ' - 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding �� 29. Insulation „ � 30. Drywall Nailing `� � 31. Plaster Brown Coat • 32. Electrical Power Meter-Final 33. Final Electric r 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System � 45. Sound Attenuation 46. Handicap Regulations 47. F:INAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51.•CERTIFICATE OF OCCUPANCY No. Date Date Y Inspector POOL & SPA APPROVALS Permit# �Date �Inspector I 52. Pool & Equipment Location i 53. Steel Reinforcement - 54. Forms 55. Electrical Bonding � 56. Rough Plumbing & Pressure Test , 57. APPROVAL TO COVER-GUNITE � 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final � 63. Heater & Vent-Final i 64. Plumbing System - Final �i 65. Electrical-Final . 66. Solar System-Final" '� 67. Fencing & Access Approval ' 68. APPROVED FOR PLASTERING � 69. POOL/SPASYSTEMSFINAL I FIRE DEPT. REQUIREMENT '� I APPROVALS Permit # 70. Underground HYdro' � 71. Product Piping �Gas OOiI , 72. Underground Flush � 73. Undergrnd. Storage Tank O Gas ❑ Oil � 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe . � 77. FIXED SYSTEM FINAL i 78. FIRE PREV. FINAL � HEALTH DEPT. REQUIREMENT � 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED ' Notes: i l l �S � �t� %%aL1 i71✓L �ao�`"/.i �.s R-3-tTY Ko Gas �re57 oK �.r�.u�re 4✓t1�piJ' GA6 �SP'O}'-� a'� ' J ! i. i ��•Il9��iilf�7/. r7i7� • _ - , a J. owt