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Home My WebLink About626 CENTER ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 626 CENTER ST Suite No Status: ISSUED Applied: 04/OS/2002 Issued: 04/05/2002 Vicinity: Parcel Number. 42421230 . ---- - . ISSUED 8Y: /;:,_-�i"�ii'i,._. � _. '�'� Applicant CLARK, DAVE/i %� �-� � " _ , � �� . , Address: 6892 CARNELIAN ' ' - "� . ' � � ' ` ? � ; \, � � ; /.! / ' � -'� \ %� � Phone. 909-944-1340 � I ��' �, � .' ti � � � c�\� ACTA L�OMA,�CA �' � Zip - 91701- �% � � . � / �� '� � / %' � � � - �� - ��- /,'-,�i" A � __ - - - _ �� . �� %�\�� Ow�e� �- �HOL'LAND,�LESLIE A TR —� � � �� ' '� � � _� � � . .A Address:� 626.CENTER $Ti � � �'\ � ' �� / � � �; ` � � \/.!!��j"� VVA`V' � ,..i � ��A / � : � � /��: � Phona: � ��A`� � � \. ��. / / /: � � � �� ; : C09TA,ME9A�CA Zip: 92627 �\��L✓ �'��`� , � � �.. . � /,�iJ� � �, � A � �. ' �/i>/ �-:��. _..� ,�iA ',Contractor �'SOCOA�RCONDITIONING . . � '-��,�.:� ��- �'�`'. � �. � ,� � Address 6892 CARNELIAN- ` � - A ; � � ` . , , � -, � _ , . , � ; , - / - Phone �(909) 944 1340 � -' i � - �� -, � ., � ACTA LOMA ,CA� _ � :i _ Zip � 91701- � ; . ' . , - A. � , i � � .�'� �1 � , " - — License:333239 - _ . • �i i � � I / �A\ .- _ . . , . ; . � � ,.. _. / _. . ' . �', i / � , , �REPLACE 35,0( , �_ � SCOPE OF PERMIT � � ' � WALLFURNACE: _ - . .. _ - � � , ��' \ - --.,-� ,� :;� �-:--,; ,-� r , ;.,-,r; ,,, ; ; � l � � "". . '' "`FEE SUMMA'RY "' : -_ `' ` � � � - � � � Quantity `,'`� � ' Quantity'� ISSUE FEE . � - $23.50 � ; -� ., Repair/.AllAbsorbtion Unit �, $0.00 '0 . -' Inst FAU <100 k BTU .. $0.00 0 = '^� ' i. -�\ ,Repair / AICRefngeretion'Unit : � � $0.00. ` 0� �i � Inst FAU.>100 k BTU �.. $0.00` --0 .-__ -' � , Venhllahon System � ; y$0.00 0� )r',•� f RepaiF/Alt Co`oling/Heat� $0.00 �0 �� ' ` EvaporahveCooler � , .�j��$0.00_ �0 i., � Insl%�Rep: Recess WaII�Hh $0.00 0 Commercial Incinerator ��. ;$0.00, 0' �, ,1 Refrig�Sys <100 k.BTU $0.00 0 � Domestic Incinerator �- i��"r� $0.00�';�0 '� Refrig Sys >100 k BTU $0 ;00 0 Compressors / Absorption Svstems - , Gas P.iping ' _ -�,� '� $0.00 0 y � _ Up to 3 hp / 100 k BTU ,� ,; �' � ; '$0.00� 0 � � Faclo Fire lace � ! $0.00 0 - �' �� ry p „�: -3 To 15 hp / 500 k BTU !, '' `_ $0.00 , 0 ' Hood w/Mech Exhaust � . �� $0.00 0 .� �=f�::'- 15�To�30,hp / 1,000 k BTU '- ' �� $0.00 ; �� 0 � v, � VAV Box " �� ` � -� � $0.00 0 � � 30 To 50 fip /.1 750 k BTU �' �' $0.00' � 0 Vent Fan / Single Duct� � �$0.00:., 0 F °";� , � - ' Over 50 hp'/ Over,1�750 BTU � � � ) %' $0.00 '0 Appliance �\.� / �'$OAO 0 � � � ", J ' B011ers ' � _. ��% � i �� Fire Dampers �` .� /�� $0 00�` 0 �,=, �` - `:Up to 3 hp � . , ,% �i� - $0.00� 0 Smoke Dampers�� -� $0 00` �0 � °'- _ �� , ' " 3 To 15 hp � �i �� !� � �$0.00 0 Inst or Relocate AppPVent �� /�$0:00 0 �.,� � � -15 to 30 hp ,� � , � ` � ' ; �$0.00 0 Air Handlers < 70000cfm �� $0:00A 0 �� _ _ , 30 to 50 hp==/ � ,�; ^ � � % /� .�i j�$0.00 0 Air Handlers > t0000cfrri � � , �,$0.00� j 0� � - _ " - Over 50 hp , A i� '� , � .i� J i $0.00 0 Floor Fumace � �� $0.00/i0�_. � '�, � Other MechanicaLFee `�, A� ' � = j FloororSuspend Heater A �-� $0.00 :�0 � � -� l -� � - - � - Investlgatlon�Fee � � ;�-�/ �� $0.00 '_ �._._� �,, _ , �-' , Plan Check Fee-! $0.00 ,..-_ , � � . . � , `\. "� �`�--.. �" - � i- \ `.. . � Reinspection Feei:', i,%''".: � � / $0.00 �..,�"�;,� -__ ' � i„�� _ '� ''�`______ _ '_ - _" _ ' . , "_ - _ ., -,�� ,-� ,- . ="TOTAL CALCULATED FEES $34.15 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This pe�mit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 1 BO days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all require[I lnapectlona antl final approval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of this permit. FOR INSPECTION5 CALL: (714) 7545626 C3 FS:i(?iA: WORKE S'COMPENSATONUECLARATON: � � � I hereby ttirm under penel�y ot Derjury one of �he following declaratlons: � ❑ I eve and will�mainlein a certificate oi consent to selt-Insure tor workers' compen5ation, a5 provided for by section 3700 ot the Labor Cotle, for lhe peAortnance of lhe ork tor which lhi5 permi115 i5sued. I heve flnd will maintain workers' Compensation insurance, a5 required by section 3700 of the Lebor Cotle, for Ihe pedortnance of Ihe work for which Ihis pertnit is issued. My workers' compensation Insurence carder and pollcy number ere: Carder: PoliCy Number: (Thls section need not be comple(ed I/ tbe permif is valued ef one hundred dollars ($100) or Iess.J ❑ I certiTy that in the peAormence oi the work for which this pertnit is issueQ I s�all not amploy eny person in eny menner so es to hecome subject to the workers' compensation laws of Celifomia, end egree that II I shoultl become suD�eci to the workers' compensetion provl51on5 ot Seclion 3700 0l Ihe Lebor Cotle, I shall forthwith wmply with these pmv�isi � �^ y= �_�� Applicant Signeture: � �/ / � / ��7 . Data: WARNING: FAILUPE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SNALL SU6IECT AN EMPLOYER TO CRIMINN. PENALTIES PND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLL4RE ($t00,000�.IN ADDfTION TO THE COST OF COMFENSATION. DAMAGES AS PHOVIOED FOR IN SECiION 3/W OF THE LABOR CODE, INTEREST, AND ATTORNEI^S FEES. LICENSED CON7RACTORS UECLAFiAT10N: I hereby etlirm �hat 1 am licen undar provisio%� ot Chapter 9(commencing with Section 7000) of Division 3 of tha Busines antl Professions Code, entl my license is in tull force ana eHecL Lic. 8 �� j��i Class B �" � ContractoYs Signature:/ -i � �� Date: - `) � CONSTRUCTION LENDING AGENCY: ❑ I hereby alfirm ihat there is e construction lentling agency tor Ihe pertortnance of the work tor which this pertnit is issuad. (Sec. 3097, Civil Code). Lenders Name: Lentler's Atltlress: Signature: � Date: OWNER-BUILDER DECLARATIONS: 1 hereby atfirtn ihat under penalry ol perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business end Professions Code: Any ciry or counry w�ic� requires a permit to conswct, elter, improve, demWish, or repeir eny structure, pnor to its issuance, elso requires the flpplicant for such permit to tile e signea statement t�et he ar she is licensed pursuant to the proNsions o1 Ihe Contractors Ucense Law (Chepter 9(commendng with Sectlon 7000) of Division 3 of the Business and Professions Code) or ihat he or she is eaempt t�eretrom enA t�e besis tor the ellepetl eaemption. Any vialation oi Section 7031.5 by any applicant far a pertnit subjecis Ihe applicant to e civil penelry ot not more than fiva hundred dollere ($500).): ❑ I, as owner of the properry, or my employees with wages es Iheir sola compensation, WILL DO THE WORK, antl Ihe siructure is not inlended or offered tor sale (Sec. 7044, Business antl Professions Cotle: The Comractors License Lew does not appty to en owner of properry who Duilds or improves thereon, and who does such work himself or hersalf or through his ar her own employees, provided that such improvemenis ere not In�entletl or oHereO tor sele. If, however, Ihe building or improvement is soltl within one year of completion, ihe owner-builder will have ihe burtlen of proving ihat �e or she did not build or improve for purpose of sale.). ❑ I, as owner of Ihe property. em E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Profeuions Code: 7�e contrectors License Lew tloes not epply to an owner of pmpeny who builds or Improves thereon, and who contracts for such project wit� a contracbr(s) license pursuent to the Conirectors License Lews.). ❑ I am ezempl under sec. Business end Prolession5 COda for thl9 r8a5on: Signaiure: Date: Owner ID verified by drivefs licen5e. ❑ Ye5 ❑ No Dnvefs License No. E:pires: VedOcation at Ownership by (typa of daument, Le. - pmperty tea blll ar tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certity ihat no axcevetlon five (5) or more feet In depth Imo which a person Is raqulretl to descend, will be made In cannection wit� work euthorized by ihis permit, entl ihat no builtling strucWre, scaflolding, telsework, or tlemolition or tlismantling thereof, will be more than ihirty-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Ttle e, Celifornia Adminislrative Cotle). ❑ As owner-builder, I will not employ enyone to tlo work which would require e permit Irom t�e Division ot Industnel Safety, es noted ebove, unleu such person hes e pertnit m tlo such work fmm the division. Signature: Date: Division ol Industnal Safery Permit Number. CERTIFlCATE OF COMPLIANCE AND AllT}i0RVA710N OF ENfAY: I cenity under penalry oi perjury that I have reatl this application and state thaf the information given is correct. I egree to comply with ell stete lews end ciry ordinances releting to building construction, end authonze represenWtives oF Ihe Ciry of Costa Mesa to enter upon the ebove-described property for inspectlon purpases. 1 egree not to occupy or allow occupency of eny building auihorized by this permi� until final inspection. �^ � Sign re Of Legal Owner(s) ,�� 4,.�� —`'� An Or uthorizetl Applicanl Date CODE I. INSPECTONTYPE PdIE 1616 FixeO System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Finel Re-Roof Final Block/Retaining W ell Finel Factory Fira Place Final Sign 204 Final Demolilion � �Qp[! INSPECTIONTYGE 208 Flnal Mechanical 20B Final Plumbing 210 Final Electdcel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency �Ilo2 � I � AVDlicant to fill in all spaces exceDt inose witnin neavy eorder Iines antl sign a�� aoorooriate eeelarations. CI7Y oF coSTA M� a_ �O�STRU�c[ TION PER IT j� ProjectAddress 6f/_/�LL�� r�✓� S� C/�l Applicant's Mailing//q� dd� s��SL�� i�U��-7 �� 1 Owner's Nam/g j��+. �Q ��N^ Phone.�"�1�.L�7 Address (�a��•�'�� l �n� � �� Arch/Eng. License No. Address / �+�/;� CAniractor's Nam `� ��/ ,/� n �^'� ' Phone �3Li.��.Sl� Addresslm�'��_:..7�2K=_—lf� �1[J�v• S�� City License No. �.(Q�21� LICENSED CONTRACYOR DECLARATION 1 M1e�eby aHi�m Ihat I am Iiwnsetl untler provislons of Cnarter 9(commencinq with section 7000) of D��Sion 3 of the Business antl Professions Cotle, antl my license is in fup tor�e antl ettect. ^ License CIa55 �� Li N . '7 Da[e_1�r�%��j� 5�9nature WORK 5' C �TPENSPTION DECLARATION ` �ereby atfirm that I haV¢ a certifitdte of [on5¢nt to elf-insure o� a cmtlflCate Workerz' Compen5ation InSurance, Or a certifietl cOPY thereof (SeCtion 3800, Lab. CJ - Policy No. Company 8 Certifietl copY is M1erebY �urnishetl. Gertifietl copy 6 filetl witn the city Builtlin9 Division. Date Applicant E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be �ompletetl if the permit i5 for one huntlretl ($300) or less). 1 certify that in the performance ot the work for which tnis �t is IssueQ I shall not employ any person in any mann��yyss o as to bec ubject to the Worker5' C mpensat'pn Laws of Cali '�.� Date r�—Si9nature NOTI : f, f r makinQ this tleclara[i n, you shoultl e subjnct t0 the Wo�ke�s' ComDensation P/ovlsions of the Labor Cotle, Y u must �orthwi[h Comp�y with SUGh pro�isions o� Ihis pe�mit sltall b deemeC �evoketl. CONSTRUCTION LENP�NG HGENCV I hereby afflrm [hat ther8 is a conStruclion lentling agency for the performance af the work for which this permif is issuetl (Section 3097 Civ. C.) Lentler'S Ndme � Lentler'S Atltlre55 OWNER BUILDEN �EGLARATION I hereby aifirm Ihat I am ezempt from tne Contractor's License Law for the followin9 reason (Section 7031.5 Business antl Prof¢55ional Cotle: Any city or county wnicn requires a Permit to construct, alter, Improve, tlemolisn or repair any sirutture, prior to i�s iszuance, also requires the applicant for such permit lo file a signetl s[ateme�� that �e/she is licensetl pur5uant to thE PrOvi5iOn5 of [he Contraclor's License �w (Chapter 9.(mmmencing with Section 7000) of livision 3 of the BusiNe55 antl ProfeSsionS Cotle) o� fnat he/she is ezempt ierefrom and the basi5 for the alleqetl'exemption. Any violation of SecHon �031.5 by any applicant for a pe�mit subject5 the applicant to a civil �enalty of not more Ihan five hundretl tlollars (5500�. I, as owner of the Property or my employees wltn wages as [hei� sole comoen5ation, will tlo tne work, antl the structure is not intentletl or o(feretl tor sale ($ection 7044, Business antl Pmfezsional Cotle: The Contrac[or's License l. w tl0¢s nol ap01y to an owner ot a property wno bui105 Or Improves thereon, antl wno tloes such work himselt/herself or througn his or her own employees, prnvitletl tM1a� such Improvements a�e not Intentletl or offer¢d for sale. If, however, the bu��tling or Improvement is soltl wl[M1in one year of com� Oletion, the owne� will Pave the burtlen of proving h¢/sM1¢ tliG not bulltl or im- �rove tor the purpo5e of sale). U I, a5 owner of Ihe property, am exclusively cont�actlng witM1 IlcCns¢tl Con- itactors to cOnstruct the D/oject (Section ]044, Bu5ine55 antl Professlons Cotle: The ConVactor's Liten4e Law dOes not aOPb to an owner of property who builtls or Imoroves thereon, antl who contracts for such projects wltn a con- iractor(s ucense pursuant to the Contractor's License Law). 1 am aware (hat proof o� lh¢ir Worker's CompeniatiOn insurance Should be provitletl to me. ❑ I am exempt untler SC�t�on B. & P. C. tor this reason Date Owner I hereCy certlly that I have reatl this application antl state that Ihe above in(ormation is correcL I agree to comply with all tlly antl county ortllnances and state laws relating Co builtling co Vuction, antl her¢by authoNze r¢pre- sentatives of this cityyy�� to ente the above-mentionetl proy ertj/ tor Inspectionpurppc�p! / /j�/�/r.� Signatur¢ t f wAM Data �_�,�_� S_ Drivers' Li 55 � _ r v v ,� � TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR Q CONVERSION ❑ DEMOLISH ❑ OT ER DESCRIPTION OF WORK/USE OF BLDG. ��lT'+C c U( �3S � J TYPEOFPERMIT GRADING FOUNDATION STRVGTURA� ❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5a. F7. oCCucArvCv CONSTRUCTION TVPE VALUATION 5 20NE GRA�INGCU.VDS. ACRES Preventer Irriqation Drinking Fountains Floor Drains Floor Sinks GasService . OuUets Interceptors Kitchen Sink Lavatories P—Trap ' Roof Drains Reinspection Fae , � $15 Boiler Duct - Under Ground Duct - Struc�ural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting O ai oo,000 eTu O i ao,000� Reinspection Fee � $15 CMF OB65-46, rev. 30/84 White - Builtlinq; Canary - Applicant; Pink - qccounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Close[ Water Hearer Water Service Auro-Wash Issue Fea Hood or Type I ❑ Canopy Type I I ❑ Refrigeration System ❑aioo,000eru ao, System R r/Alteration Issue Fee $ 3 $ 3 A.P. $` S Main Buildin9: E T Front A Rear C Ri9ht SLeft Ping. Ref. # ' Planning Notes: Automatic Washer Consuuction Pole Sub. Cooking Unit � Dishwasher Dryers �Gas ❑Elec Fan . F.A.U. Fixtures Device Boxes Outlets Garba9e ❑ Generator 8196 10/26/87 , _ Zane ' Accessory Building: � i � ELEC7RICAL � � I Transformer ❑ 15-50 KW , ��1 ❑ 50+KW Meter ❑up to 100 amps Meter ❑overi00am � ' Sub Panel Motors -1 HP O1 X� 8 In olar 09-15 HP �16-15+ Pole Li9hI Sign Standing Sections KW �5-15 KW Trash Compactor d � Reinspection Fee �$15 � � Issue Fee DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Buildin9 App�oved By Application luued By � 7000 TL FEES S 3 SUMMARY OF FEES � BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PWMBING $ %• OO ISSUANCE $ - PLAN CHECK 25% $ " ENERGY P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50% $ � MICROFILM $ MECHANICAL S TOTALFEE $ � �� PLAN CHECK 25% $ Z O N I N G R E � M T 5 CONSTRUCTION AND PLANNING POOL & SPA . . , : APPROVALS Permit# � Date Inspector AppROVALS Permit# Date Inspector - � 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . . 2. Soil Pipe-Undrgrnd. � � 53. Steel Reinforcement � � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � � 4. Electrical Conduit-Undrgmd. � 55. Electrical Bonding . 5. Steel Reinforcement �� . 56. Rough Plumbing & Pressure Test ' � � 6. Electrical UFER Grnd.' - � � 57. APPROVAL TO COVER-GUNITE ' - , 7. Footings ,. • � , 58. Electrical Conduit-.Undrgrnd. � � ' - 8. Foundation - � 59. Gas Pipe, O Undrgrnd., Test i 9. Water Pipe-Undrgmd. . 60. Backwash Lines, P-Trap,;� Undrgmd. 10. Structural Floor System � 61. APPROVAL TO DECK ' � • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final� • , , � 12. Sewer Cap ' 63. Heater & Vent-Final � � � 13. Roof Drains � 64. Plumbing System - Final � � 14. Rough Plumbing - � 65. Elecirical-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 Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �' 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in Structure 70. Underground Hydro � . �- 22. Ducts, Ventilating 71. Product Piping O.Gas ❑ Oil 23. Gas Pipe-Rough & Test ,� 72. Underground Flush � . �. 24. Roof Framing � i 73. Undergmd.StorageTank OGas ❑Oil . i 25. Roof Sheathing ii 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat �- ' 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe - 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �, 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � ' 33. Final Electric . Notes: ' - 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � � � � 36. Hood or Canopy - 37�. Final Factory Fireplace ' - �' �. �=' 38. Final Plumbing � � �. ; y: 39. Water Service-Final ' � • � '+' ' � � ' L^ _40. Gas Service-Final `� E , ; � � ' ,' '41. Solar pomestio-Final � ' , ' �.' � � � � • + ' 42. Backflow Preventer , � ' - ' � �43. Backflow Irrigation � �' � • , - . � - � � , . 4'4. L'andscape Irrigation System � � �' � � � , � , � i' �45. Sound Attenuation � � �. � �� - . •'r. , ' .r. " 46. Handicap Regulations - � � � , '�.^� +��. 47-. FINALSTRUCTURE&BUILDING . - - i � f' �� :i' 48:jSpecial Requirements Completed . � � : ' � 49. Elearic Release to Edison -} �� „• 50. Gas Release to Southern California Gas Co '-� � � -. 51. CERTIFICATE OF OCCUPANCY ' � I - No. Date � � � . � . - ' ' � i� �-� Applicant to till in all spaces CI�'Y OF COSTA nnE�� CON��le N P��IT � Project Address � G Applicant's Mailing Address Owner's Name °� S �� Phone � ��; Atldreu -5 M E Arch/Eng. Licenu No. Address ��p��p Contractot's Name D G 6C � phone.LT�� Addresslmailingl ��'r� ��G� � Ciry License No. �-�9�. UCENSEU CONTRACTOR OECLARATION f nereby a7tirtP that 1 am Ucenutl unGer provi5iOn5 Ot Chart¢r 9(commencing with zection 7000) of �ivision 3 ot the Buiiness antl Protessions Cotle, antl myllcenseisitlfWlto�ceantleftect. j?�/�4q LicenseC ss ' Ucens No.�� d Date 6 Signature �_ �vORKERS' OMPENSATION DECLARAT O iereby afiirm that I nave a certitita�e ot mnsent to self-inzure or a certificate � Workers' Compensstion Inzurance, or a certifietl copy tnereot (Section 3800, Lab. C.) Policy No. Company Certifi¢tl cdyY is hereby turnishetl. Certlti tl d i f le wi[h the city Bi' D slon. D Applica - �� EXEMPTI N F M WORKERS' COMPENSATION DECLARATION (ThissectiOn nietl no[ be completetl if the pe�mit is for One M1untl�¢tl (E100) or iess). I certlfy that in the performance o1 the work or whi<h this p rm�t is issuetl, I shall not e p1oY y person in any ma so a o beco e sub� Workers' m e L.aws Ot GalifOr ' l Date Si9nature NOTIC : If, af r ma ing [his tleclaration, you 5 u tl beco e subject to Ihe Workers' COmP¢nsdtion O�ovisians Ot tlle LdbOr Cotle, you must fOrthwi[h comoly witn such provisions or this oermit shall be tleemetl revoketl. CONSTRVCTION LENDING AGENCV I nereby atfirm that tnere is a consVuction lentling a9ency for the performance of tha work tor wnicn this permi[ is issuetl (Section 309� Civ. C.) Lenaer'z Name , Lentler's Atltlr655 OWNER BUILOEH OECLARATION � I hereby attir�n [ha[ I am exempt from the Con[ractor's License Law for tne followin9 reasPn (Sectlon 7031.5 Business antl Protessional Cotle: Any city or county wnich requires a permlt to co�struct, alter, improve, tlemolish or repair any structure, Prior to its issuance, alzo requires the applicant tor such permit to tile a zigneJ statement tnat ne/sne is licensetl pursuant to the provisions o( (he ContractoY's LicenSe Law (Chapter 9(cOmmenting with SettiOn ]000) of 7ivision 3 0( tbe Business antl Profes5ion5 Cotle) or [hat he/she ii ezempt inerefrom antl �he baziz for the alle9etl exemption. Any violation of Sec[ion 7031.5 by anY applicant for a permit subjects tne ap0licant to a civil �enalty of not more [han five nundretl tlollars ($500�. I, as owne� of Ihe prope�ty or my employee5 with wag¢5 as their Sole . compensation,,`Nill tlo the work, autl the struCtu/e is not i�tentletl o� ofteretl lor sale (Sect�on 7044,' Business anG Professional Code: Th¢ Contractor'S License Law tloes no[ apply to an owner of a property who builtls or improves thereon, antl who tloes such work nimself/herselt or throu9h his or her own employees, p�Jvitletl that such improvement5 are nOt intenaea or Off¢retl for sale. If, however, [be bulltling or �mprovement is soltl with(n one year of com- pletion, the owner will have tha burtlen of proving he/she tl�tl not build or im- p�ov0 tOr the durpose ot sale). . � ❑ I, ds owner of the properly. am exclusively contractlnq with Iic¢n5etl con- trattorsto construct lhe project (Section ]044, Business and Professions Cotle: The Con[ractOr's License Law tloes not apply to an owner ot property who builds or imofo�es tnereon, antl who mntra<ts for such projects wltn a con- tractor(s) imense pursuant to the Contrac[or's License L.aw). I am aware that prool p( theiY Wo�ker's'Comp¢nsation in5uranGe shoultl be provltletl to me. ❑ 1 am exemp� untlet Section B. & P. C. for thi5 rea5on Date Owner I hereby cer[ifY that 1 have reatl information is �orrect. 1 a9ree ro� antl state laws relating to b'Itlina 5¢nlatives of [his it to ter Inspec(ion purpas . Signature Drivers' LitenSe Or 5 � _� ation antl state that the above i all Uty antl <ounty ortlinances on, antl he�ebY authoriz¢ r¢pre- above-mentio�etl p per for � oa�� !S T7 - Accountin9: Goltlenrod - Asie55or PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar T Swi ming Pool w/Spa ' rinal Water Closet Water Heater ' ' Water,Service -- Au[o-Wash Laundry.Trays - Issue Fee $ 3 IANICAL FEESi Hoodor Typel ❑ Canopy Type I I ❑ �.efrigeretion System 70-700,OOOBTU ❑100,000 stem Repair/Alteration Fire Dampers Registers laue Fee I $� 3' Automatic Washer Construction Pole Sub. Cooking Unit ' Dryers �Gas ❑EI Fan ' . F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �0.5 KW Fee 9E4C =/�=/_% Zone ' Accessory Build+ng: Parking Req./Provided 1 ELECTRICAL Transformer ❑ 15-50 KW o so+Kw Meter ❑up to 100 amps Merer ❑over100amps . Sub Panel Motors 00.1 HP i'h - 8 Inc.Solar 09-15 HP �16-15+ Microwave- � Pole Light Range Standing Sections 5 KW Trash Compactor $15 Issue Fae DEVELOPMENTSERVICESREOUIREMENTS: 2oning Approved By Building Approved By ' Appliption Issued By ' 17�.^": 'i' FEES $ 3 Z O N I N G R E Q M T S 0 � SUMMARV OF FEES BUILDING PERMIT $ SMIP' $ PLAN CHECK ' $ PERMIT - PLUMBING . $ �SSUANCE - $ PLAN CHECK 25% �$ ENERG� P.C. $. � - E�ECTRICAL � $ �'�.O'� ' GRADING $ PLANCHECK 50% $ � MICROFILM '$ ' MECHANICAL $ TOTALFEE $ ��.Q � PLAN CHECK 25% $ ' CONSTRUCTION AND PLANNING %. .� POOL & SPA APPROVALS Permit # Date ,� Inspector � p�ppROVALS Permit # Date Inspector 1•-•Temporary Electrical Service or Pole 52. Pool & Equipment Location ' ' 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation •� , 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgmd. ' �,'. � 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System 61. APPROVAL TO'DECK 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final � 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains . 64. Plumbing System - Final 14. 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 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 # _ 21. Duc[s, in Structure 70. Underground Hydro � ' 22. Ducts, Ventilating � 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test � 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil ' 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat . 75. Dr.y Chemical 27. Frame and Flashing _ 76. Dry Stendpipe 28. Lathing & Siding ' ' 77. 'FIXED SYSTEM FINAL 29. Insulation ' 78. FIRE�PREV. FINAL � 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat 79. FINAL INSPECTION . . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � 33. Final Electric C� Notes: ' i. 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final � 40. Gas Service-Final � 47. Solar pomestic-Final ' 42. Backflow Preventer ' -43. Backflow Irrigation � . ' � . 44. Landscape Irrigation SYstem � � 45. Sound Attenuation 46. Handicap Regulations - ' 47. FINAL STRUCTURE & BUILDING . 48. Special Requirements Completed 49. Electric Release to Edison . , 50. Gas Release to Southern California Gas Co . 57. CERTIFICATE OF OCCUPANCY No. Date � . � ,: / �Q� �-'F�l E��LL'Pa�D Applicant to fill in all ipaees except t�ose wilhin heavy bortler lines antl sign all apPropriale tleclaratians. On I O r� V � E�C3�C% CITY OF'COSTA MESA CONSTRUCTION PERMIT PER I NO. TRACT NO. LOT NO. UNIT N6. ��- TI . ProjattAddress �-6 C-ENTtrZ. ST C�SrA. HCKP ��/� � TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R Applicant's Mailing Address �ZG C�NZCP t OwnefSName `-FS�G %'��.L-�A� 1� Phone��9�91 � CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# • . 2on8 DESCRIPTION OP WORK/USE OF BLDG. �G ��E"}�G Address 6� �µT�� sr C�ST7� MC<A � CA ' S Main Buildin9: . Accessory Building: Arch/Eng. License No. TVPE OF PERMIT GRA�Irvc FOUrvDATIOrv S7RUCTV RAL T Front - � � p Address ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING MECHANICAL B Rear � N Convactor'sName G��Ar41 BR.�H�cfS phoneSK-�653 ��OTHER %� � PROJECT DESCRIPTION 5Q. FT. OCCUPANCv C Right � N Addresslmailing) �95ZCErtT�1��P1..� oc-rAn.�F �Q>,c,�S K Left G bo5963 CONSTRUCTIONTYPE � ALUATIONS S R City Licenie NO. ZONE GRADING CU. VDS. ACRE$ LICENSED CONTRHCTOR DECLHRATION Plny. R¢f. # P3�king REq./PfOvidEd E I hereby aifirm that I am licensetl untl<r provisions of Cha�te� 9(commencing Remarks: �A U Planning Notes: M wlth section ]000) ot Division 3 0( [he Business antl Professlons Cotle, antl my Iicense is in tu11 force antl eftect. T LicenseCiass -ZO Licen No?Q"g6o4 . . S �a�e G��7�— Siqnature PLUMBING � FEES ' ' WORKERS' COMPENSATION OECLARA ON ' Bdr Sink ShOw¢r5 �^�f.I hereby a(firm that I have a certiticate of consent ro seH-insure or a certificate . ELECTRICAL FEES `,:. : wjN Workers' Compensation Insurance, Or a cmtltietl cOpy the�eot (Section gackflowPreventer S¢Nic¢Sink� 'i .3800,' �ab. C. - - Automatic Washer Transformer ❑ 15-50 KW � -� 1� Polic No.'ik� 48t��3 ' Com an 2EPu6L(C SNDEaqN�-j-y 9 SewerCa � • : ' ❑ 50 v P v Backflow Irri ation + KW P , , Cans[ruction Pole Su6. D�ertifietl copY �5 hereby furni5hetl. • Cert'y{ i�e copy is ilietl with tne city �I 'ng Ivi io ^ Bathtubs Sewer Conneclion • G " Cooking Unit Meter ❑up to 100 amps .�c(n�$� APPlicant�. Qii�C�� - ' � E%EMPTION FROM WORKERS' GOMPENSA ION OECI�ARATION � Clarifiers Solar Collectors . " Dishwasher Meter ❑over 100 amps � � (Thisseclion neetl not be completetl if tM1e permi[ is for one huntlretl ($300) or ' less). . . Dishwasher ' Solar Piping ,: Dryers ❑Gns ❑Electric Sub Panel � 1 certlfy tha[ in tM1e periormance of Ihe wo�k fo� which this perrOR i5:i55Uetl, 1 '� shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank "r � Fan Motors DO-1 HP 01'h - 8 WOrkers' Compensation LawS of CalitOrnia. Dafe Si9nature Floor Orains� Swimmin9 Pool w/Spa F.A,U. �NOTICE: If, after making this tleclaralion, you 5hOU10 beGome subject m the , Inc Solar09-15 HP 016�15+ Workers' Compensation provisions ot the Labor Cotle, you must forthwitb FIoo�Sinks Urinal - � Fixtures Microwave Comply with such provisions or this pe�mit � shall be tleemetl revOketl. - - - CONSTRUGTION LENDING.AGENCV � GaSServic¢ 'ODUets �WaterCloset D¢vic280x¢5 I here�y afflrm that there is a copztruction lentling agency tor the performance � Pole Light 01 the work tp r' �wh�ich this permit is issuetl ($ection 3097 Civ. C.) Interceptors ' Water Heater Outlets Lentlerz rvamec�l�_� nF r1'in'h MESA. � Range � I„CfIG2f'S ACGI¢55 �•'V� �X IZpQ..�_[QQA MESI� q2(�ZS—�ZO� Kitchen Sink • � Water Service OWNER BUILDER OECLARATION � Swltch25 Si9� . I he�eby affirm that 1 am ezempt t�om the Conlractot's License Law /or the La'vatories , Auto-Wash Garba C Di5 0521 � � following reasom (Section 7031.5 Busines5 antl Professional Cotle: Any city or 9 P Standing Sections county which requires a permit to construct, alrer, improve, tlemolish or reoair P-Trep Laundry Trays ' Generator OP5 KW �5-15 KW any sVucture, prior to its.i55uance, blso repWreSlhe applicant for such permit Trash Compactof to tiie a si9netl statement that he/she I5 licensetl pursuant to Me provisions ot ROOf DrainS ' the Contracror's License Law (Chapter 9(commencing with Section 7000) of Divisiom 3 ot the Business antl Professlons Cotle) or that he/Sh¢ is exempt � , '� ',��herotrom antl tM1e basis �or [he allegetl exemption. Any violation of Section ' _ �,�ry,7031.5 by any. applicant fo� a permi[ subjec[5 the applicanf to a civil ' ' ' penalty of not more than five nuntlretl tlollars (E500). - � LJ I, az ownev o( tM1e property or my employee5 with waqes as their Sole RBinSpettiOn Pee $15 IsuB Fee $ 3 compensation, will tlo the work, antl the structure�is not intendetl or offeretl Reinspection Fea $15 Issue Fee '$ 3 for sale (Section 7044, Business antl Professional Cotle:�The Coniractor's MECHANICAL � FEES � License Law tloes nof apply to an owner of a property who builtls or improves i thcreon, antl who aoes such work himself/herself or through his or her own goiler , Hood or T e I ❑ - DEVELOPMENT $ERVICES REQUIREMENTS: � employees, proviEetl tnat such imProvement5 aro not Intentletl or otferetl fov r YP � j � � sdle. Ir, noweveq tne builaing or improvement is soltl within one year of com- � Canopy Type I I ❑� Zoning {lpproved By Date oletlon, tbe owner will have tne burtl¢n of proving he/she ditl no[ builtl or Im- ' DuC[ - Und¢� GrouOd Buildirig Approvad By DBtO ptove for lhe pu�poze of sale). . . � �� y1'/� ❑ I, as owner of the property, am exclusively contractin9 with licensetl con- Duct - Structural . Refrigeration System Application Issued By � DatB�qya(. lraCtorsto cons[ru[tthe project (Sec[ion 7044, Busines5 antl Proiessionz Cotle: Tno Cmtractor's License Law tloes not apply to an owner ot property who Duct - VeMilating �0.100,000 BTU ❑100,000 BTU . SUMMARV OF FEES builtlz or improves lhereon,'antl who con[racts for Such p�ojecls with a con- trattor(s1 licenze pursuant�m tne ConVatmi'i Licenze �aw). I am aware that Exhaust System ❑ MWtiple ❑ Sys[em Repair/Alteration pBUILDING PERMIT S SMIP • $ proot o( Iheir Wo�ker'S Compensation inswance shoultl be provitletl to�me. � • � � ,PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P. C. for this reason FirepVFact 61t. ICBO �I`- Fire Dampers � ISSUANCE $ � : PLUMBING $ Date Owner He tin9.System & Ducting Registers � PLAN CHECK 25% S ENERGV P.C. $ I hereby certify that I have reatl this aoP�icatlon antl state tnat the above � �6100,OOOBTU 0100,OOOBT GRADING $ information is correct. I agree to comply with all clty antl county ortllnances ' ' ELECTRICAL $ , antl 5tate laws relating to builtlinq constructlon, an0 hereby authorize repre- � MICROFI LM $ sentdtives of •this city to enfer upon th¢ abov¢-mentionetl property �tor PLAN CHECK $U96 $� y�1r�� inspectiong� pp� s. O - MECHANICAL $ ��_�f_ TOTAL FEE $ �� 5ignature y_4/.�L.' /iA6_� ' ' Reinspection Fee $15 Issue Fea $ 3 .PLAN CHECK 25% $ CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goltlenrod - Assessor ' � '^ - r..., CQNSTRUCTION AND PLANNING P��" �` S�A Date Inspector Date Inspector /yPPROVALS - Permit# APPROVALS Permit# � d. Temporary Elecvical Service or Pole . 52. Pool & Equipment Location . •� 2. .Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement '6 3; Electrical ConduSt �Utility-Undrgrnd. 54. �Forms . - 4. Elec4rical Conduit�-Undrgmd. . 55. Electrical Bonding ��,� 5; Steef Reinforcement�`; 56. Rough Plumbing & Pressure Test �;'� 6, ElectricalUFEFj,Gind. 57.•qPPROVALTOCOVER-GUNITE _ .k�� 7�. Footings '� . � 58.:;Electrical Conduif-Undrgrnd. . 8.' Found'ation ' 59. Gas Pipe, O Undrgrnd., Test � 9:' Water Pipe-Undrt rnii. . 60. Backwash Lines, P-Trap, � Undrgrnd. 10'StructuralFloorSysfem ' • ' 67. APPROVALTODECK 71, Property Sewer Line & House Connection .: : 62. Baikwash & Receptor-Final . 12, Sewer Cap . 63. Heater & Vent-Final ' 73. Roof Drains � .; � - 64. Plumbing SYstem - Final . } � 74; Rough Plumbing� : � 65. Electrical-Final 15. Rough Electrical,Conduit 66. Solar System-Final . � 76. Rough Electric Wiring � 67. Fencing & Access Approval 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 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 # 21. DuCts,in Structure 70. Underground HYdro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush ' 24. Roof Framing 73. Undergrnd.S[orageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar�Ceiling (StructuraQ & Monocoat 75. Dry Chemical ' 27. Frame and Flashing 76. Dry Standpipe 28. Lath'ing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric f/'�•9Z �� Notes: /� �J �- %/-/ �% //p 7?i2✓P� - a:.d/ c�ra'! 34. Final Heating & Air Conditioning �.�� L� �% � 35. Final Gas Pipe-Test �- � 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service-Final f ' 40. Gas Service-Final (Y�i 41. Solar pomestic-Final ?'• � � 42. Backflow Preventer j-;•� 43. Backflow Irrigation � � , � 44. Landscape Irrigation System: 45. Sound Attenuation �- - 46. Handicap Regulations ' 47. FINAL STRUCTURE & Bl�}LDING 48. Special Requirements Completed 49. Electric Release to Edison �� 50. Gas Release to Southern California Gas Co ." � '- 51. CERTIFICATE OF OCCUPANCY � No. Date Costa Mesa Building DeparLment :�PPLICATION FOR PERMIT P.O.Bo:3�� ,'��5 BUILDING � COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. PermiL N Buildin /� ndares�i26 Center Street. v7?J �iOS%& MCS$� California Received by Date Rec'd.' Date Issui Nearest .�iv� ��- C j� � 0-t Cross St. 1�i18}iCjIIl Building Address Owner ma�� . � Costa Mesa, California add�P« fi29 Pl�er nlearest a.ontrector Metes and Setback Linefn Center oi Strcet DES� New I Repafr I i Building Tel. N o. acy No. of Bidgs Now on Lot No.oi I No.oT Cross St, �tion I I Atldition I 9 I I Demolish I No. of Rooms Stories Roof Covering Re 1 Fou F � U Fra B I hereby acknowledge ihat I have read this Application and state that the above is correct and agree to comply with all City Ordinances and State Iaws regulating building construction. Signature of /�� RO � � •L Permittee �� + � ./C AuthoHzed Agt. PreS. Valuatlon �5,� Permit Fee $ 2,QQ Ptan Check $ '�" $ Total Fee � ,oM zna �o.es o. r. e s. NAL Plans I G� CORRECTIONS APPROVALS �n Location Inspector Materials, �inning re Stoos. Ini Ext. Date O � � 2 D r O I � Bhow Iocatlon and distances from ��• property Iine and between buildings � t�: c i V. O O ' � . tn � 0 0 �O � .;,, �'. , ,, 0