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HomeMy WebLinkAbout725 CENTER ST - Building PermitsAPPLICATION FOR A BUILDING ��4MIT Tract q(� ' .exk k pp�OD $ �ot f S' BUILDING PERMIT NO. peemit No. W Bulltling Plumbing a Atltlress � 2 � G P�„ t-e r � t- ��—� �� Permit No. � ,. Cross Mechanical Q Area Street �.q;� � �!p,,.�� y�4 Permit No. � Owner TYpe ot Projett: � New ❑ Alter IJ Atltlitlon � M�. �- s,�. Nu Z�a, l� Atltlress S Ge � f ✓ r� ❑ Repalr ❑ Convert ❑ Demo ❑ Occupancy Pmt. GtY C� .�y7 . [, f� Z�P-I �6.1� Phone l) �'/�1� A.P. 5 sP. Alrea/ Archltect/ Zone Spl. Pmt. No. Designer License No. Setbacks P/l Front C/L SL Street Witlth Atlaress � Vartls Left Igh ear CitY ZiP Phon¢ � ave ro�. e g . . Y Engineer��L Z�,,.�p<� LlcenseNo.�/v�/ � Q � � ar ng SPaces epu re rov e overe p, Atltlress �q m City ' ZiP Phone Struct No.of No.ot Height Stories Family Y � LICENSED CONTRACTOR'S DECLARATION Park Fees ves Fee m 1 hereby atfirm xhat I am licensed under provisions of Chapter g ReqWretl No 0.T• Recelpt Z (commencing with Section 7000 ot �ivision 3 of the Business antl Zoning Approvetl BY: Date Professions Cotle, nd my license is in full forca antl etfe t). ?� license Clas= � icense Nu�nDer � T Dato'�"�""�L� Conttacmr � / �� Misc. E Atltlrazs =p'� "� p - Propose0 Use ot Structure jy City and Zlp Phone � CONSTRUCTION LENDING AGENCV � I hereby effirm thsf there is a mnsttuction lentling agoncy tor the a pertormanca of the work for which this permit is issued (Sec. 3097, Occ. Type Cotle ' Civ. C.). Class ConsL Year d Lender's Nama USE/OCCUPANCV SI2E SQ. PT. C Lentler'sAtltlress_ J OWNER-BUILDER DECIARATION r I hereby aitirm that I am ezempt from the Conttattor's Licanse Law 1� � for Jire following reason: � I�.YI, es owner of the property, or my employeas with wages es their Z. solo compensation, will do the work, and the sVucture is not L intended or offeretl for sale. � 3. � ❑ I, as owner ot the property, am exclusively contracting with licensetl contractors to cons[ruct the prOject. r ❑ I am ezempt under Sec , 8& C f r 1$ eason_ 4• m r a Dat ' '/6^�f/7 owner E NIQRKERS' COMPENSATION DECLARATI N Total Valuation � I hereby attirm that 1 have a certiticate of consan to self-insure, Entroathmeni Permic ReaWrea ❑ Ves ❑ No or a wrtificate of Workers' Compensation Insmance, or a, certifietl C cOpy thereof. Gratling Pmt. Gratling � Policy No. _ Company Reyuiretl ❑ Yes ❑ No Pmt. NO. �a ❑ Certified copy is nereby furnishetl. ROu9h Gratlinq V Q ❑ Cerxifiatl copy is filetl with Orange County, EMA. qpprovetl Oy: Date � Date Applicam 3 CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE Z c (This section nead nat be complefetl it permit is for $100 or lessl. 3 1 cer[ity that in the performence nf ffie work for which ffiis permit is � Issued, I shell mt employ any person in any mannar so as to bemme ry subjact to the Workers' Compensation Laws of Californie. PERMIT FEES Dat Applicant NOTICE TO APPLICANT: If, after making rhis Cerxiticate ot Struttural b Plan Check $ Exemption, you sho�ld becOme subject to the Workers' Compensation provisions ot the Labor Code, you must torthwith comply with such S�ecial provisions or this permit shall be deemed revoketl. Electrical b Invest. $ I CERTIFV THAT 1 HAVE READ THIS APPLICATION AND STATE p�umbin9 S THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLV WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEitEBY AUTH- Mechanical E ORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ABOVE MENTION ROPEFTV FpR INSPECTION PUR- Re-Graae PA� jS. D � Insoection $ y7n� K 7��%`Y/� Pre-Gratle Permit Signature ot Appli nt or ant Date ReC. No, s ISSU¢ E �%CGGCI L��Jp=MML�� Print ApplicanYs/Agent's Name All s ces within this boz must be completed to process Pian Issuance � Check BY: AOProvetl: �mr a�ao-vo �o�-za� rev. a/av . . ApDliant to 1111 in all spaees e:cept [�ose witMn �e,��^% er Ilnas anC slgn all aoVroDdata aadantlons. ♦ CITY QF COSTA�MiSA� � • • _ , � pE IT NO. TRACT NO. OT NO. , BL � � . � � ' . � �.... `� CONSTRUCTION PERMIT , � ' . . , ^ '6,3� ' ' - ,� -. ; , q,3t, ,/ i "/";� � � :; :I �, • �� � Appli:ent's Mailing Address a . TYPE OF CONSTRUCTION' NEW ADD AL7ERATION REPa1R _ : � ,, ' � % '� � G ' ' ❑'CONVERSION ❑ DEMOLISH ❑ OTHER � � -. ' � � ' t � ' - ' � Roject Addrev I , I I'L � , - - Owner'S Neme M/ LNQ�I L. NO'ZiYlAG K PhOt1B �T 8�P!�'� � DE RIVTION OF WORK _ ' 1 G A 5� � �nddress sp�p � ' , � TVPEO PERMIT �GRADING FOVNDATIO�-Ny STRUCTURAI '' A.P.qW. � S ZONE � '_ S�a�..�P •- r ;�:� Etr.rv. LicenseNo.� G 30704� � � . ' � . : 9. , �❑ TENANT ELECTRICAL PIUMBINO L10 MECHANICAL PLNG. REF.qW ..� BUIL ING �O�Oi� ,�� Addfess � ��� � � ' ' � �' ' O �OTHER . ' '' ' ' . TO BUILDING � REAR YARO (TO P/U IS�� V ' � Contrector's Nemr 5� �^ � rLZ1�PY � Phone� � PqOJECT DESCRIPTION Sq 3, � ';j ' OCCUPANCV M� PE V 1 E -T i�� , , LEFTSIDE YARD '�j �(�� RIGHT�SIDE VARD � � � ' � CONSTRUCTIONTVPE ✓� ' ' VALUATION$ ��' Addresslmailingl�Ja/,� � , � _ � _ . � . ZON� GRADINGCV.VDS. ACRES PKG.SPACEREQ. PROVIDED �/�. ; I Cicerise No. ' � � ' ' LICENSED CONTRACTOR DECCARATION � � ' Remarks: „� C 'L ' � STREET WIDTH � ' � PARK FEE S a� , S 1'tiere0y �af8rm tnat L•am Ilcensetl untler provislons ot Chartar.9 (commencing � � � , with sectlon 7000) of Olvislon 3� of the BuSinen antl ProTe551ons Cctle, antl ' �� ' � ! �-' - . SPECIAL CONDITIONS: � i� my Ilcanieds in full force anA aHect. • , � � - ' , � - , u�e�� c�a:� u�a��a No. � � , P�umsinc � HQLll. EOR SEECIAI. REQUIR T Oata � Si9nature � 1 ' . �. . :WRKERS'COMPENSATIONDECLARATION� . 1 � ����P : ' � E ECTRICAL � , � 88f Sink gsraby afllrm that.l have a certlfirate of consent to self-iniure or a cartitic2te ' � gg�kflow Preventer �- - �- SBw2r ConnEction'• .- � - ?utomatit Wazher �MBter ❑over 10� Bmps� ' � Workers' Compansatlon"Insurance, or_a,certifieE'copy theraof (Settlon � � - - . � ' Construction Pole' ' I Sub Panel; �=� 2 % �00. Lab. C.) � � ' i i . 1 � . - . ' _ " � ' r . . . O'0 � � , �. , j i � . . � � Backflow Irrigation � Solar Collectors " r ;; - ' ' � PoucY rvo. �. . ". ComPanY '.. � � . . �. . � - - �. � -� , Cooking Unit . � Sub Pole � � . • . , eCertifietl copy, is heraby fumishee. � .- � � , � ; � Bethtubs � SOIBYPipiOg � � ; � Q � � ' � Certifletl copy is filetl with the city Builtlinq Dlvision. Dishwashe� MOto�s �0•1 HP ❑1 X-8'� ' oate ' ' ' �Applicant . ' � '� ' ' , Clerifiers ' . So1ar Tenk • ' � � � � - . � � 0� EXEMPTIONFROMWORKERS'COMGENSATIONDECLARATION � / Dryers es ❑Electric-�� 'InaSolai`�945HP�O1645+ � `' (Tnls sactlon neetl noi be comvletea If the permlt is toY,one nuntlretl (Sloo) or. � Dishwasher : Swimming Pool W/Spa � ("; �� less) i � /. s . . . • . / I . . i , � .. . � �. Fan i � . ' � .Microweve • " • I certlry Mat In the performanca ot the work'Por whlch thls permR Is I5 uetl I � Drinking Fountains U�inel � � 5�� - s�all.not amploy any perwn in any - nerso z� o batome su07e to t�e • -. , n � „ w � F.'A.U. ���•� Pole Light � � Worker C mpeq� loml.aws o7 Callt r � , Floor Drains ' L Water Closet' _� O ' Date ��-�S-R� � c�g�ature � - � Fixtures , ' � ' 'Ran e -NOTICEe I(, after�making thistlaclaratlon,�you sn I ecome�sub)xt�to the-� ,� Floor�Sinks � - Wate� Heater - -. -2 pp . _ - 9 _ OO Workers'. Compenutlon D�ovisions of the Labor C , You mu5t forthwith, � � � 1 O¢vic2 Box¢5 � i Si n � comply with 5uch ;provlsion5'or [hi5, parmlt 5h II DB tleemed, revoketl. ' GeSS¢rviCe� •Outlets Wete�ServiCe ' . _ 2 �� 9 � � ` / CONSTRUCTION'�LENDING AGENCV � � - � ' ' Standing$BCtiOnS � ' , I (p � � , • Outlets � ' 1 hereby alfirm t�at thera Is a construc[ion IenCing agency.for the,perPormanca, Interceptois � . i: . _ �; � � � - of tha work tor 1 this• permit Is issuatl (SecNon .308] Civ. C.)� � � ;� . - - $ Switches • • � TraShCompactor ' � LenAer•s Nama �� ` : _ KitchBn�Sink - ' � �r � � l.enaer•s Atltlreu � � � Garhage Dispoial • � � ' � � OWNER BUILDER DECLARATION ' � � ' . � • �' . ! ' ' ''7. �'atories . . � ' . ' . S ' � ' ' I herabyafflrin that I am'exemp0.from ttie.Contractor's Liceuse Law fortM1e � . GenC�ato� �0-5 KW �5-15KW ' � • tollowing reason- (Saction 7W3.5 Business antl Protasslonal CaAe: Any city or' �'' P-T�Bp• - '� - 1 G' � - - munty which requires a Darmit to <onstruct, alter improve, tlemolis�•or repalr , , - ., i� :� TransfOrmEr � 15-50 KW � � �''* ' ' • D O any structura; p�lo� to its issuance, also requires tl�e'applicant for such parmit Foof DreinS to flle a signea itatement that he/zhe Is Iltensetl Dursuant to Ihe�provisions of • _ ,- � . I ❑5U+ KW , ' ' '' � � . ContYactor's"License Law.(C�apter 9 (commencing wlth.5ectiom7000j.of � ' � ' - ' � � ' � , . . I Reinspection Fee .�Kion,3 07 lhe'BuSiness an0 Professlons Cotle) or that he/she Is exempt � ShOw2�5 - - 1` , � Reinspection Fee �f°'J ' ,,y' � from antl the bazis tor the allegetl exemptlon: Any vlolatlon oLSecdon 4 - , " " � _ � Meter ❑up t0 100'emps IauB Fe9 � . � S 3 i.5 by any applicant for a' permit'SUDjectS the aDP����t to a civil � ' �, . �- L I • �� � ' . - . ��q�,Ity ot tnan flve nunarea aoliars (ESoo). ; �- � -. � , � . Serv^ce Sink, __ � ` laue Fee . S 3 Zoning ApOroved By � Date � � �'" � ! 6G1, as the�property;oFmy amployees with wages as thelr soie - � MECHANICAI: � ' ' ' ' - ' � � ' tompen�n w I. tlo the vrork, an0 thestructure Is not intendetl or ofteretl , :,� � _ � qpplicatiomApprOved By at0 '-- �� I for sale (Se<Eion 7064, Business, antl � ProfesSional Cotle:. The, Contractor's . � � ( � , Ucense Law tloes not aDD�Y to an owner of a property'who bulltls or Improves �, Boiler ' . REf�ig2retiOn Sy5t2rt1 ^� . '' � thereon, antl who'tloes sucn work'himsalf/hertelf or through his or her own . ,� • � ,�. Appliration ISiued By � � DatB employees, provitletl that such Improvements are not IntentleC or otferetl for ,� ❑0.100,OOOBTU ❑100,0008T.0 � r � ' sale. IT, �aweveq the bulltling or improvement Is soltl within one yoariot com- Duc{-' Under Ground � � , , .. SuMMARV OF FEES ' ' � � pletlon; [ha owner'will have the burtlan of provin9 he/she EiU not builtl or Im- , ' �JQp � . �rovetormepurposeofsaie): � , � . � _, ; � � Duct-Structural ' SystemRepair�Aiteiation � •BUILOINGPERMIT $ � � SMIP - $ 3•� �, as owner oT [he Omperry, am exclusivaly <ontracting�wllh'licansetl wn- � � ' � � � � ' tractors to construct the project (Section 7044, Business antl Protezsions Cotle:. '. � Ducj - Ventilating _� , � � � PLAN CHECK� $� � PERMIT ' � � The Contractor•5 Licensa Law does not apv�Y to an ownar ot property who � , � � �� � � � � � � IS$UANCE �` .$ builGs or improvas theraon, antl who contracts for such pro�ects with a con- , Exh2ust System ❑ Multipl2 �: {�� � PLUMBING . $ . tractor(s) Ilcense oursuant to tha Contractor's Licenze Law): . , I i � - � 'p�.,qN CHECK, $ 2 � GRADING ��� � � S ❑�I am ezemD� untler Sectlon ' ' ; B. 6 P. C. for thls r son ' , Fi�epl/FaCt. Blt. IC80 � ; � 1 � • � ' 'ELECTRICAL $ 2 • 2� ' � '' �� � $ ' Date � owner' •" � � He mg System & Ducting � MICROFICM �' $. -I hereby'certiry that'I�nave-reatl this applitation SnE st a tliat tlie above-.- -''- �100,000BTU �100;OOOBT• -� - � . �� P111N CHECK $� � • informatlon is corract. I agree to compiy with au tlty an county ortlinances ' ' ' y' ' � ' � TOTAL FEE�� $� -r antl-state laws relating to bullEing coretrucHon,.an0 hareby auMorize repre- - , ., , � , �MECHANICAL � $ �� �� 1 � . , , sentalives of'this�city to enter-upon the aDove- ntioneE property Jor � HOOdOr Typ2i ❑ ' RBinSpec[iOnFee 8}7 '� � ;L,pO . �ESS � � 'PLAN CHECK $ inspectlon oses. � � Ceno . T - e II ❑ � . I � ADVANCED PC $ � � � ' Si9nature ' • �_ Data�I'%�[�f3 ' . ' � , � , ' � � Registeiz � Issue Fee � S 3 ' FINAL FEE E�;�8/•39 I\ Drivar5' IJtense Or 55 $ � � i ■ CMF 0865-06 rev. 12/82 White - Bul tling; Canary - APplicant; Pink - Accountin9: GolCenrotl -Assessor � ' ' � � - ' � - - ' " � - '-- �� �� . � - - - - - -- - - - - -- ---- - - - _ _ . - � _. �1-,1CONgTRUC1ibN AND.PLANNING; ' ; � _� . _ :.0 : �z r �� • � : �' - � : POOI PA� - -� -. ,, ? . . . - �' , '., . � � �•��3'!R_ :oate ���nspector ` -- �Date �In'specwr ,i > ^APBROVALS ' Permif# _ __ _ Y - -: � _ �APPROVALS Permit# . , . n•� Temporary,Electrical Service oFPole ti' ` � e ' . 52� Pool &.Equipmenf Locanon, . ; � ' � � � . • _ , ',��:.'_ " _ �� ^_' '-._ '' . - �. �,� 2? Soil Pipe-Undrgrnd � �- � ? : � �-/f�'y,r- ��r 53' Steel Reinforcement .- � - � ' • � . ,� � , - 3: Electrical Conduit UtiliN Undrgrnd. . : _ -54.' Forins'. - _ � �� - � � , � - c'4: Ele tr;ica'I Contluit-Undr,gmd� - � - _ °,�l��& `e _ �'55= Electrical Bonding � - _ . � - m � C • 5: �; Reinforcement � � � W?, � ` , - ' " _ '5`6. Rough PlLmbing & Pressure�Test _ _ - - - � � 6. Electrical UFER �Grnd. • � ( � - `' � ` �- - ` 57.. APPROVAL�TO COVER-GUNITE � ; � , � _ 7. Pootin9; , I � � � .- l t i ° , . ,''� � �, 58: Electrical.fqnduit-Undrarnr{.- . . � � � . .8. �Foundation ' � • � j �_' i - - � _ �59. GasPipe,O.Undrgrnd.;Test� � � � 9. Water Pipe-Undrgrnd. � - � � /P-fY.7 ` !i �60. Backwash Lines, P-Trap, �� Undrgrnd.�- � ; ' 70. �Structural Floor System . " `' � ^- - . '61. APPROVAL TO.DECK " - _ - .- . � . , 11. Property Sewer Line &'�House:Connection' _ - � . 62. Backwash & Receptor-Final-. �� _ - � � - � 1 � - 12. Sewer Cap , • � ! ; ; � � _ � 63. Heater & Vent-Pinal - ' � ' - . o_ , � r 73. �Roof�Drain's� i i � � : ' � i -- � :64. Plumbing:System - Final'� ., �: � -� � •. 14. �Rough�Plumbing � � , � � �� � � / � ' � 65. Electrical•Final- •� - • ' - _ ' � � � � c v _ ; " �15` �Rough"Elect�ical=Conduit�'I'-''"' � `-�- � � "r `;- �„-� � -;�'-. - � � 66, Solar Sqstem-Final" �'� --" -'- �: -' � " .- "�' � , � : r a I . ' i 6. �.�Rough�Electric Wiring, , j � ; " �; _, �' ��� � �'Lo�'--' :67. �Eencing & Access Approval ", � � -' " - - • "` � = ,-17. R�ough Wiiirig'Sign" ;; ' ' �1 � ' ' ' � ' ; � � Q . • � ` .gg: APPROVED FOR'PLASTERING � ' � : � • � ' ": � ' ' � ' = y 78:.�RougkElectricaLT�Ba� Cei'ing, �, � � , � '69.� POOUSPA SYSTEMS F�INAL - � � 19.' Rough�HAating & AicConditioning ,' � '!f j� �� / � �, '.; FIRE DEPT, REQUIREMENT ' � ` � � � 20.,Rough Factory Fireplace, �-'; �. i � APPROVALS• ' Permit # � ' = � . ,; � � , 21. Ducts, in Structure . ' � � ..� �,� ,' ! � � � I � '70. Underground Hydro . � � � � -22.;Ducts, Ventilating �; .� ��, �''; ,� � i � � �' 71: Pr,oduct Piping O Gas � Oil � - , � • 23. _Gas�Pipe-Rough &yTest iP` � ��`_, �� _' � _ , � . ; ; "72. Underground Flush ' , � • ' ���24:'Roof Framing; . � ' '� i �': ' � � � :� , ,F �_ j . . � � ,73. Undergrnd. Storage Tank O�Gas .O Oil � � 5. �'Roof Sh@afhing ' � ' ,�� 4 � ��� J 74: Oyerhead Hydro , � ' ! � ' y� �26, T._Bar Cei�ing jStructuralh&'Monocoat � � � =,� - � 75: Dry Chemical . . - ', c � , � � 27.7Frameand-Flashin� ; Y ' • � !��/�.43 i76. DryStandpipe . .` ' ". . � . , �, 2b�. Lathing & Siding� ' . �. � ; i; + � ;77. F,IXED SYSTEM�F,INAL - � ' ! I ' , 29. Irisulation. �p,w.a� � � 8;i�� � 16�3 i �78: FIRE PREV. FINAL ;; , � ' ='30.�DrywallNailin9-�-���/j�� � � � I � � � •Notes: �j.yy� I��,3 - 31; Plaster�Brown Co � � � ; � � ;• � � � - . -- � � � -- - � - - ��-- - . . et i . .: � iI .. � i C',5 .,i' ' 7 . ; . - - - . . . '.--. � J� � 32. Electrical PowerMeter-Final � ' ;i R t ti " � 1-��: ; �� i i'! ) ; ` 'N �� ' : � . . ,� �" �T .. ' - - - .; ' . , - 33.�Final Electric � � Y � � �7i � ',:� �, . ' 34. FinalHeating-&,AirConditioning�. K ,! ��/b'� ;' �'�,,: ! - . .. - . 35. Fina�l Gai Pipe=Test ` ' " ! �'' � • .��3/ �S �,�' . .� � �� ' - - � � � . � � '� • - . S'� 36. Hood or CanoPY: ' ,�, i � ' . ?� � �' ! � � � a i i . . � -� " . ' - - . �-, �., �t 37. Final Factory F�ir'eplace , .: � '� ' � r � - ' � � , , - � � - ` � 38. Final Plumbin9: , ; '. � .! `I':. ! �' / Y/� ,��' i � . _ � - . . 39. Water Service-Efnal ' , � � � � '� i I `! �:, � i �' -f 40. Gas Service-Final , � - � ' � , � , �-�7 . � ' , i � 41. Solar pomesficFinal � � i�� . ; - . -_- . , _ _ � � �i . � r r -i' :^r 42. Backflow Preventer � � ` .i ` ' . , � � � --` • :C'� . .. n =,. ---.�._ . . . . _ _ � � 43. Backflow Irrigatiori � � � �� �, ' , - .' � � � ` - � . , % z.., � , . - i 44. Landscape Irrigation�System�' . : � � , - � ' � : �'� , � ` . I , ., - _. '�� ': . , _ . - 45. Sound �Attenuation'- � � � •� V { : � " ., � _. � � � � � ' - ' � I �( � . _. . ' . I ' 46. Handicap Regulations . ' � � � � �. . - � ,'i � 47. FINAL STRUCTURE &�BUILDING�i , `- .�.�' -� �� � � � ��� �� 48. Special RequirementSCompleted '' � l�tl (� Z]c� I�� rl ' ' � : � .� . � -� 49. Electricfie�easeto�Edison � . �-- _- - ,(3/� ��-1a,s_�,Q„1 - _ " � ' • ,� 50. Gas Release to Southein California Gas Co i ' � � , . ,, , ; ' � � . . 51. CERTIPICATE OF OCCUPANCY �� -, �. � __"_ '_.' __ . � �i. .^._ _ _ .._ _ " .:'� : �� � � ' No � Date � � ; ; „ ' � �� ' � ' ' J . '"Costa.?Me ,� _�,_........, � , , -- r,.'�11�7 EA9T 2pth STREET ' • , ��60STA MESA, CALIFORNIA '- FOR APPLICANT�O FILL IN Building, " rI^-� ,/!' �4a.27i;r3> ui:'!'c Addreas L�— Costa Mesa, California Nearest Q�g���, ,�j,'yfi'L"£'c Croas Si, owner f."�z`�'�ld? �2�T �'.2:2C�s ii0'�CII Ox C7=^a�e -rdress ______.�_'____. ' "sFO�:�iel'.`i � S�t _ontractor Address ��7� �:e 1���3 v'. Legal LOL I� Description No. 1 � B (Attach Metes and Bounds) size ot �ot �II x 324 Use of �.,m���o Existing Bldg. 3etback Line from fjf3a Center oT Street DESCRIPTION New I � I Afta'ation Rmair —.ILn I Movina %.a €t= +5EF3 I No. Addition � �fa�a��y d�+�e?.�.i� 33 PPLICATIOIV FOR PERMIT BUILD,�NG '� FOR Og'FICE USE ONLY Receipt No. Parmit No. �7�a 3�� ed by Date Rec'd. Date Issued � `2��d—�J' I ,7—� `-S7� Mesa, California � i ,.-� r. rr--. /Y;I �f I TyPe � I s APPROVALS Forms, Materfala Under-Pinnfng Frame: Fire 3tops, Bracinu. Bolts I hereby acknowledge that I have read this Application `a1O. 1O`. and state that the above Is rnrrect and agree to rnmply �ath. Ext. wfth al] City Ordinances and State L.aws regulating building construction. ' Signatureof Plaster, Int. Permittee � �j1�,,n`�'}� Plaste�, E� Authorized Agt. �1fJ(v%r�F \ �i�• �1 �LI tCi•\ Maunry Rt Valuation `P.ermit Fee $ L sb. C�, Plan Check $ L� Bond Beam $ VJSC�v Total ,7 �� Fee $ (D �— FINAL pQRM 2a4 G-H 2M 6-54 . e 0 9 � Z D r � r _ -T � . 'a�.r�9 •� , �' ., . �- , � „ , , J • � - • •a _. . J � - . . . .. . o p, � a, . . o a` • .� . 1 - - -- -- - - - ' . ' , .o: ' " - ' -- - - - —'--` — — - ` � � - — • _ , _ .. , ... . . `_. . ., n:'�r .. . Rn., "f ° A 1 y ��'�` .�'1 ^. «. � �' '_ ��yl 4,�. ,',�.�a,����. ��'n.��� F _ '_ _ . . tu. � .. . . . . - � � � . re . � ' . •' , ' __ ___ _ ' � ': b-' y��.k. � ,•i.,' • ..1 . j -- � Street � ., ' d'�. ., . M1..- , � - - � .r�� �i :� .. , . n,o�l. . . Ip- • • � ' - � PLOT PLAN — - . . '. � , .: : . : : -- . --- — — ' Show�oca Ionr��nd�dishncea f�o�m J . . ,. • ' • . - �- __ , property line and between butldings. , ,, , ' -' �' 'r'cl: , � - '• Ji '\' - � . . � ____ _—_ __ " _ _ ' _ . ' _ ' . . i� - ,.� _'_ _"_ _' ' .�_' ' " _' . . : ..... . . - , . .. . Y . �. , . .. . . .. ' �o. -. .. . . . ` " :.i ' . :, - i . ,. ' ' . . ._. . . . _. _ . ._" "'_._"" .. . . . .. . � , �,� t "'' .. .. . . ' ': . � i. � � � , • . . .. . , � ..i , � . . .. ' ' �, .i-.. ..:' ' . . { - ' . . . --.�. , � � , . �. . . i' - v ., . . , � - _ _ - - - - ' - . i a :� � F � W a a � y S F C R1 F � Q 7 � .J a w a O � 0. z w 'y' 3 2176 6/24/80 5�:a5C TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT n anv »nn rncrnseocn rni�[nosun eoeoe .._.____ ___' _"'"'_"__""'____ _.._""'_" RECEIVE BV PERMIT N° 5Q289 For Applicant to Fill in Completely — Use Ink Only ADIDRESS 7} S H PV Si. A P ND �f 6�Q ,� OWNER OR ADDRE55 • TENANT �L (� L. NG 2 �M L � MAILING UNIT OR ADDRESS ��J, S G(N �l' PY i- SPACE NO. TiNf)./ S� LOT / � BLK. TEL. ?f �p CITV � NO. -0 2 CONSTRUC.iION NEW ADD ALTER REPAIR MOV�NG DEMOLISH LENDER O N P BRANCH OWNER ((�C ADDRESS ' • VAWE ORENGINCR Dk/ Y TEL. L f USE /jK. G�� U�/� s A ADORESS ZONE Z— TVPE �N GFOUP R� 3 APPROVED CONTRACTOR Ow y( r BV DATE —� — (J ADDRESS � TEL. CITV NO. STATE CITV :�F7ROVEO SETBACKS LIC. NO. �J, LIC. NO. (FROM GL STREET) / OF LOT �Q J( NOW ON LO� OM .3 D FT. �P USE OF l� �� �� �P S C% EXI5fING BLIX'i. ' �n Separate permits are requi ed for L. SIDE 3V FT. � olecMc, plumbing and heating work: � REAR U E QF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION c/ .� ie.� DATE � C 4 N�" O � �ROVED '� I A7PROVED � .n� [�IO D / ♦ C�(.a I hareby ecknowledge that I heve reatl thls application antl stnte ° � thet ihe ebove informetion Is corract entl aBrea io comply wlth ell Iews reAuleting builtlin9 construction, end I shall not employ any person (n violatlon of the workman'a compensetion laws of ° the Stete oi California. O SQ. FT. � I hereby cBrtlty thet I am ptopetly Ilcansad as a contrector untler ° the Steta of Californla Business antl Professions Code, Dlvision 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR n Chapter 9, antl that such licensas ere in tull forca entl effect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: � am axempt from tha provisions ot tne State ot Celltornia Businass VALUATION PERMIT FEE � and Pro(ec4�ons Cotla, Divislon 3, ChaDter 9. $ u PLANCHECK 5 8, r.� � SlBneiure of � ��� _ Permlttee $ Tqx g �� ar llD C Authorized ABent Date a TOTAL PA�D S y, �� ,� , , COSTA MESA BUILDING•SAFETY DEPARTMENT onv »nn �onosiin noeoe � � F � L Q � y F C � F � a � i� .� x w a � 0�. 0. Z W .T. 3 ' 4929 7/16/80 �6a�_ TL APPLICATION FOR STRUCTURAL PERMIT .._'__""""' "'...."__".,—.._.._......"_"_ RECEIVED PERMIT For Applicant to Fill in Completely — Use Ink Only sU 3 BUILDING A,P. NO. — � ADDRESS % (y�� L. BVII_DING OWNER OR ADDRE55 TENANT L� 2 Li UNIT OR MAILING SPACE NO. AooaE55 G pr �-- TR LOT ,� BLK. TEL. CITV G O � NO. EW ADD ALT@R REPAIR MOVING DEMOLISN CANSTRUCTION LENDER BRANCH OWNER M� � S. G ADDRESS VALUE ARCMITECT )� TEL., USE � S s7 . OR ENGINEER i L, R'�K � ADDRESS N 20N � VPE ��� GROUP )� APPq VED CONTRACTOR L,� !j yyp p-p� BV DATE � � Q ADORESS � 6 G'¢ G TEL. CITV NO. 'r .r7 STATE CITV APPROVEDSETBACK� / LIC. NO. " LIC. NO. SIZE NO.OF BLDGS. (FROM C/L STREET) OF l0T j� NOW ON LOT � ONT O FT. � USE OF L-�/ ^ �� EX15fING BLIX'i. Q I.H�� V V i �j , Separate permits are required or �. sio Fr. electric, plumbing and heating work. REAA � USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROV � � � VED /% ��/ I hereby aeknowlatlge that I have reatl this application and ataie that the above informatlon is correct antl egrea to comply wlth ell lews repuleting b�iltling conrtruction, and I shall not amploy any penon in violation of the workman'a compensatlon lews of tha Stete of Californ�¢. �� I heraby ceriify thet I em p�operly Ilcensetl as e conbactor untler � SQ. FT� �� iha State of Californ�e gusinass entl Professions Cotla, Division 3, 7HE AMOUNT SHOWN UNDER VALVATION IS FOR Chapter 9, antl ihat sue� licenses era in full torce antl effect, or I TME PURPO6E OF ESTABLISHING A PERMfT FEE ONLV: am ezempt from Ma provisions ot the Sta2a of Celifornia.Business VALUATION PERMIT FEE E 2 antl Professions Code, Dlvision 3, Chapmr 9. �• PLAN CHECK $ SlBnaiura of • (� � Permittee �tf(' S�S�—/� � TAX S �� -- or I AuthorizedABani Date 7�`� ` TOTA�PAID S 6 n i m 7 m n 4 m m 0 f U APD���ant to iill in all spaces e:eapt t�ose wlt�in �eary EorUer Ilnes anG sign all apD�oorlata tleclantlons. CITY OF COSTA N1ESA � � ; , � _ : ' ' p�a CT NO� � • � TRACT �; LOT NO. LD `. : ' CONSTRUCTION PERMIT - ; ' [�� ' � " � ApplicenYs Meiling Addre55 ' - " C .' , TVPE OF CONSTRUCTIO , NEW ADD ALTERATION REPAIR �{//}�� . � 1 AojeCtAddlEss �2S L-nH J�C�Y j'I� • ' � ❑ CONVERSION ��DEMOLISH O OTHER: ' \/ r • ^ �'���.� � DES�C/p IPTION F WORK � LI a !I� l✓1�f[GPhO(IB . /`�O �I'�/!_ � �'. GGYI. O{^ l� i/ LH b���1Ai�i Owner i Nsme �'• � �� L • ^� ��qv . � Addf255 S4 M �C : ' . - � -" � 7ypE OF PERMIT � �GRADING .. � FO DATION ' STRDC Arch/En.=S+�++P � � . .. LicenseNo.G 3(J7d g� ,� O TENANT O ELECTRICAL ❑ PLUMBING ❑.MECHANIG Addre55 ' ' - ' ' � �❑�OTHER - .. Contrecfor'sNam ��✓tinv'� SitrHi� ` -vhone' ' PRQIECTDESCRIPTION� S�:FT.� oCCuanN - � � � - ' � ' ' CONSTRUCTIONTYPF � � VALUATION$_ Addresslmailing) � _ . 1 _ _ ZON$ ' GRAOINGGU.YDS.� �ACHI Licenm No. ' ' - IICENSED CONTRACT00. DECLARATION � � ' Remarks: -� . . 1 hereby�alfirm tnat �Pam IlcenseU, untler provislons of Charter 9(<ommencing _ , � � with ieetlon ]000) 01 DWlzlon 3. ot t�e Business nntl Profassions Cotle, an0 � . � - � ' my Ilcense Is in tull tor<e antl atiact. � � �te Class ? � � License No. _ , � - ' PLUMBING y • � ' Si9nature � i � . ....�KERS' COMPENSATION DECLA�RATION , ' �, � , • Bef Sink , � : • SewEf Cap � � , I.hereby'aiflrm tnat I have a.certlficata of conSenClo selNnwia or a,certificate _ _', ggpkflow PreventC/ -- ` � � - -�SBwer COnn2ctiOn�� � of Workeri' Compensation Insunnca, ar a certlfietllcoDY �hereof (Sectlon - -- • 1 3800, LaD. C:) ' - � , � � Beckflow Irrigation � ' $plar Collectors j � � Policy No. � � � Company - � � � � eCertl7letl copy I5 hereby furnls�eC. � i � i • � - , � Bathtubs . . • . SOlar Piping � . � Certi/ietl copy Is tlle0 with tne city Builtling Dlvislon. - . _ � .. . � ' Clarifiers ' ' SolarTenk � , . . ot tha work fOr CONSTRUCTION'IENDING AG I hereDy affirm that there is a tonst of th0 �work tor: whith. t015: p Lentlar'i: Name.� ' � Lentler'S�'AAGress' � � OWNE0.'BUILDER DECLARATIC =rvCY � ucNon Ientling agency for tha�per' �.rmlt •B lissuetl.(Sectiou �3097' 1� F . N �' ' ' . � 'rom ttie�ContracmrY Ucensa La '�usinezs antl ProteSsional;Catle: Ai :onstruct', alter improve; tlemolisl -also reqWres t�e:applicanhior sw he Is Ilcensetl pursuant to Ihe pro ter 9 (commencing'wit�'Sectlon � OT¢SSiOns COGe) of illat h¢/slle-i egetl axemptlon.�Anyylolation�a �armlt subJects the�aDP��cant t etl tlolla/T (E500j: � � �- r my employees with wagai'as' itl,tha•strudura I5 not IntanGetl � anC, Professlonal Cotle:' Tha� Co. wner ot a property who bulltls or himself/herself or through his or mvements are�no[ in[entled o� 01 saie, i*, nowavaq ma oww�ng or improvame pletion, t�a owner�will have the burtlen of p �fove tor lhe purpose of Shce). ; LI I, as owner of t�e property, am excluslvi tractors to coustruct [he'Droject.(Sactlon 704 The Contractor's �icenie Law Uoes noc apl builtls or Improves thereon, antl w�o contra tractor(s)Iicense pursuantto the Conlractor' ❑ I.dm exGmpt unEe! 52CSIOn � I . Date � Owner � I heraby cmt�ify that^I��are-reatl�thirappl informatlon is correct. 1 agree to comply wl antl state laws rela[ing to bullEin9 constru sentatives of.thls•d '[o enter upon e Inzpectlon o �, se j ; Signatura � � orivers' License or;55 � i � � Dishwasher � - Swimming Pool wl'� tloo) or — is uetl I�, � Drinkin9 Fountains ' . Urinal . � �mt�e � ' ; -'. . . Floor Drains � Water�Clout :bto tne-� � '� Floor Sinks_; . _.._ .__- . _ _Water Heater,_ -_ ? _ _ _ _ >rthwlth. � . � . , . , i., � revoketl. ' GasService� Outlets� �� ;WaterService :; � , - ' i " � ormance, � InterceP,tars. . i _ ' " - ' ' � � .� +. CI'v. CJ' � ' ' - ' - �� � KitchemSink �. � 1 ' � � '' 1 '' r � 1 ' � Lavatorier ' � � ' ' � . � !' ' ; '` � i v torthe � P-TreP� ' ' . 1 � ' ,' � . Roof'Drains' "• �' . . ' � ' ' . • ' ' �, Shav+eri - ! � '� j • • Service Sink j -� � � � i '-. . .. ... � � . , nr�� _ i ... r. �r , PLNG. REF. ;W '' TO BUILDING �y� V I //,r)(� �. �•+� LEFT SIDE VARD � r� ` PKG.SPACE REQ. � STREET WIDTH , a. IOB55 dfltl %Oi85510f15 COtlB:, I uucl - vemuauny t.� µ , an owner of property who � � , � . � � r such projacts wlth a con- ' Exheust SyStem ❑ Multipli ise Law). � - 9. & P. C. tor this reason ' � Firepl/Fxt. Blt. ICBO;� � � ' ! ` Heating�System & Ducting � i•antl-stata-tnat-ttie�above�-�� '-06100,OOOBTU�100;00( dty ana county ortlinances � ' � • ntl hereby aut�orize repre- Hoad or 7 ' e-mentlo�netl property �tor ( � , ype I ❑. � r i Cano T� e II ❑� � � oeoe2�—lS—Ff3 � � � � Registers , � � rav.12/82 �/hite-Builtling;Canary-ApDliwnt;Pink-Accountin9;Goltlenrotl-Assessor � - . Reinspection e ' , Issue Fee -� j ...,...y....,;�..�� ��...,.�. � . ❑0.,100,000BTU ❑100,000 I i System fiepair/Altefation ' ' _�__I..._.L � _ � � � � � � � i i i ' ' � � � � � � �� � � � Reinspection Fee� f � ' i�e F� , • $15 $ 3 _; I �. .: .. j. . ; _ .T_ i .. . .- ' , �: G535 2I16/B3 " � .,?3.G;' T! . � <' • ' , . , ' - � - CFTCAI`Y/`/1 CT� - REAR VARD (TO P/L) RIGHTSIDE VARD, , ' ' ' PROVIDED , '" . PARK FEE $ • • �YI/W ' � F � i Sub Pane � Sub Pola ; , i Mo[ors [ ��� � .� I � i h:� I � - � Dryers OGas ��OElectric ' � ---� -jlnc:5ola�,O9-75 HP-O 16-15+ "` ' " "" � Fan � � � Micr6wave � '� +�' F.A.U. � � ' �' �Pole Light � �'< � � 1 Fixtures . ' '. - �Fan e i � I ' � � ' ' . " _ ' ._ __.. ._._. . . . 9 ... . ___ _ ._._ .. _ .. .__ _ , Device Boxes ' ' Sign ' • � OuUets . ' ' • Standing Sectidns ; ' Switches ' i � � �Trash Compactor ! � � I � Garbage DiSposal ' ' . � ' � � ' Generaror 00�5 KW �5-15 KW � , � Trensformer �15-50KW ' � ' � 1 j f ' ' ' ❑5U+KW� � ' � � � � Reinipection fee $75 Meter ❑up to 100ampi ' �Issue Fea. � r' S 3 i Zoning Approred BY 'Data ' . • • � � Applintion Approved By � � ate Application laued By � Date � � ; � ' � SUMMARV OF FEES � � � � � �BUILDING PERMIT 5 / � �0 � I SMIP � � � $ ,� O•SC7 .PLAN CHECK� $ � � ' PERMIT ' . � 1 � ' ISSUANCE � ! $ I � PLUMBING � $ � � � � � . PLAN CHECK� $' � GRAOING � � S i � � i EIECTRICAL' � $ � � � � ' � � $ � - � � � � - 1 MICROFILM � $ � (PLAN CHECK' $ - . . 'MECHANICAL : $ � i TOTAL'FEE, • $ ; ; �PLAN CHECK. ; $� t � 1 I LESS ' � ' ' j i ; � � ` � i ADVANCED PC ; $ • � � � 23.00 ; , � { ! FINAI FEE � f $ • _ i ,- �' GCONSTRUCTION AND`PLANNWC � -� 4 �� : � . � "5P & SPA -_� , . , - _ - , ' ' �APPROVALS ,. Permit �h� '� `Date r : ,Inspecto � _ __ ApPROVALS,�.'�Permit # L- Date ;� Inspector . -, aa. _ . � i . < - - _ .. . �� t1- Temporary�Electr,ical Service orPole ; `' ' �� , o? ` ;2-� 52"'Pool &'Eguipmerif Location � • - � � _ - �? 2: �Soil Pipe Undrgrnd.� . � F: �� : � ` - � >:' � � �-.53� Steel Reinforcement ` _ - • . . ' � : �3'. �Electrical Coniiuit Utilitv-Undrgrnd: r - _ � ^ = yJ 54 � �Forms = ' ' c ' � ' '< ` � ! � _ _ , . � :.�. . .. �i ,' �4: Electrical Conduit-Undrgrnd.; -'-:' ' � . ��8 u^� � '55� �Electrical Boriding� � � = ; ' - ' •�� � .a - •. . � 5: Steel'Reinforcemenf ' ; � LL „� , - � - � 56. Rough�Plumbing & Pressure Test � � - � � � 6: �Electrical UFER Grnd. � � ` � ' � � . ' ��. _ - 57.' APPROVAL' TO COVER-GUNITE' � � . . � � = 7. Footings � ; `� - : _ _- �. 58r Electrical'Cpnduit-Undraro�l.� � � . .,� i i 6. 'Foundafiori � � � . ; ' - _ -. ' _ � � - � � � �. -� . ' � � . , � . �� . _ i� , _ _ '59. Gas Pi�pe, O'Undrgmd., Tesf, . �- �t. � : 9. .Water Pipe-Undrgrnd. , . �- . ' �' =' � � � _ . .gp, gackwash Lines,��P-Trap, O-Undrgind.- - _ • - i � � '�: 10. �Structur`al Floor System � � � � � I ^; - � � ;,61. APPROVAL TO DECK ' - - ', ' � � � - � 17. Property Sewer Line &�House�Connection : ' �� _. � � . � , � � _ -62. �Backwash &:Receptor-Final .: � - 12. �Sewei CaP � ' � , � ' '' � '. ', P,^ `6§. Heater &-Vent-Final . � - . ` i �� - 13. �RoofiDrains � . � � ' � �� ! c,� '- � ;64. Plumb`ing�_System - Final '. - � , � � . - 14. �Rough �lumbing� � � • ' - ' � � � . ! ° . . �-65. Electrical-Finaf � - - � � � ' - v o _ ,-15:- Rougfi ElectPicaf=CondniY'�" -'i" -� "-"'I- � i-` � �- ' 66.�-Solar',�System-Final � � "' ' u �" ' r " � :; �. c +n . �t �. � � , __� ._. ; t � ^ � � . , ' � • . ���16,;Rough;Electric�Wiring � ! " I, �`�,,-I'. �'s��,� ` =,'I'n �.^,: i6Y.� �Fencing &^Access App�oval�-'� �� ��i �- ' � `�� "" ' � ' r - �17.`Rough,WiringSign� "� � ` � � f�l , 1 . � �^ �:` �� �' �68! APPROVEDFOR:PLASTERING , ' � �:. _. ' ', ' � " - - � 16'�RougB`Electrical�-T�Ba`r Ceiling �j i ' � � ; � l i � � � � I ; �69J POOUSPA SYSTEMS'FINAL � � � : ' . . � � 79._�Rough�Heating &'Air:Conditioning �, � � - � i •, � ` �FIRE DEPTJREQUIREMENT- - � , • : ' 20.'.RoughcFacto^y Fireplace i � Ij I� �' � I I I APPROVALS, � Permit# � '� � �� . �. _ i 21. Ducts; in Struc[u�e� " � . '� � � � � I I 70. Unde�ground Hydro ' � � � ' ^ `,;22.�Ducts, �Ventilating "� ' � � ' �� { , i f i i71 � Product Piping O Gas ❑ Oii � � ' � � : ��23�Gas Pipe-Rough & Test � ; ' ��:;;.- •-� i � ' � � �72. Undergrountl Flush � , � , � ^ `24: Roof Frami.ng� ' � , , i ��a �I..o ! , � ^: � �: � ,; „ � -, ; _ - �73: Undergrnd. Storage Tank O.Gas ❑ Oil � � � 25.'�Roof Sheathing � ' � � i � � ' � �; ; � � � •� ' - � ^ ;74.� Overhead Hydro . - - � � � �.,�26..T-Bar Creiling (Stcucturalh & Monocoat � � i ° � s� �` + ' � �' ':75� D'ry Chemical � - ' � ._ � � � � =27..:Frame'and Flashing - � �� i j � " � � - ! ' '76; Ory Standpipe � •� , � � � ' . ' �28.�.L'athing &�Siding, (; � � ; � �� �; � I I ' = � ' � ,77+ FIXED SYSTEM F,INAL � � � 'T� • � �._29.�Insulation.�� � � i � �' � � i � � j � �78i FIRE PREV. FINAL � �: '30.�Drywall Nailing ' r- � � � � ! � I f �Noter � , • � . � � � �� �i � � �\31.f.P,laster�BrownCoat�� 1 � � i �I p � � , � - i' f � � � - � ---- .. _, ..... . . . . _ _ i � � , 1 � ', �'32.':Electrical�PowerMete�-Fioal 1 �; - �` ' � � � � � � , ' ' . • - ---� i -- - i_ � �' i 33.•Fi�al Electric � �. ��_�� r � ; ! � ' • ' + f � � , . � 34. Final �Heating�&�Air Gonditioning " ' � � ^, ' � ^ � ^� � , � •i. u �,- � a. i� 1 I " `.i 35. FinafGasPipe-Test' �=� �i� 41 :I � ��•_I� ".� -�,����i'r � �� '�� . .. ' _ . � `- - I , 36. Hoodior�GanoPY � " : w � : �• . r r I - � i -� � = T I � � ° _" i, - ' ' .. . i :i •� i, � i r i�i � I _� � -i 37. Final FactoriY.Fireplace � � � � �� " � i � � ' . � ! r � - , � <' .. � � 38. Final Plumbing� ' � • � - � � � � ; i ' �' �� �� � I�I i �.� �' .~� � 39. Water Service=Final � ' � �t � � � ' � : � � ; i t � ��, "_ - � " ' i � i � 40. Gas Serv,ice-Final ' � ' j -' � � � ' � � # '. _ ' :---r� 41. Solar porriestic;Final 1 " � �� � ! � � j ! ! � ' ' ' � . ' ' . , �• i � � � � � �. ,_ -1---� ' - --- �-� _ _ . 42. Backflow Preventer _ ' : j " �.r. � � , i ! � ' � � � � . . � � � ' � �: ,. � � ., . "� , - ' �' -` : �. -� . .--. - - - r -r `�-�-'- - r - ' - ! , 43. Backflow Iriigation�-1- � � ,'� �i '-'' �'� -�._''; �� � "� - ---�- , . : � . 44. Landscape'Irrigation�System� � ��'= � F' e� � � - . � ; � . � � _ - 45. Sound.�Attenuation'. i, `- . �- � � , -I ; j � I • � , � I I ' � { � - . _ .� _ _ � - 46. Handicap Regulations , � � � .. �."i � , `,- � � i � � I v I . . - . ,� . - �. 47.� FINAL STRUCTURE�& BUILD�ING'� j? a' ' � � r i P -� �-� -' � I I � I • - � � 48. Specia;l Requirements Completed '. , j � J � : ' � � ' � � � , • � ' _ � . . �- , . , 49. Electric Release toiEdison � ' � . �.. �f�l._i. _�_ �_ � _ � _ � '. �. ! . ' • � ' , I i f ; f 1 -� r �� 50. Gas Release;to Southem California Gas Co I � � ` � � � ' � - �. ; ' - C � . 51. CERTIF�ICATE OF OCCUPANCY :_ F.�. .'� _.L T� -1__ .ti._�._���,.-� _.i:.' :" ;,, ' � `"1' ' � ' ; No �� � � � Date � � � T ' ' � � , ' . . _ _�_ _ �_ � ' _l _ I PN0.IECT RDOHESB: '� Z S C GNT ER S T OWNER'SNRME: SHOING LIN nooeess: 4850 BARRANCA PKWY. IAVINE, CALIF. 92714 7l9/786-9162 , ■HCH/ENGINEER: aooxess: REO.NO.: uxn: uxrt: PEpMinEE: pR0—FORMANCE, INC. ( 714 ) 779-6868 � aooeess: q572 E. EISENHOWER CIR ANAHEIM CA 92807 "LICENSEO CONiMCTOfl OECIAMT10N:,,1 Aere�y atfirm tnat I am Iicense0 unAer O�o�isions ol'CAaD�er 9(commencinp wRh Section 70W) af mws�on.3'af Ihe 8us�ness an0 ,Pralessions CoEe.'and my license isio-�tul farce antl ettect .. ,ertvu%f,� '4t�'9n"2 �sr�tEwc 48�341 cusg"''��'�"'', � Date: " � � � _ SignaNre: ��L1� 1//' J((itif'L¢/ WOBKEBS' COMPEN511TION OECIAlUT10N: I Aerehq affirm that I have a certificate oi conunt to seli-insure or a uNlicate ol Workers' Compensatian Insurance, or a certilietl caDY �hereof (Section 3800, LaU. C). raucr no.: H WC 19 612 9 EXP. DATE: O 9 I 1 i/ 9 O �:HIGHLANDS i co0 is Aerehy fumiSAeA. � Cerlifie0 copy is fl M the cily Bu��iNsio/y`���� ��� ' O MDlicant IXEMPfION FNOM WORNERS' COMPENS�TION DECLAM710N: (iAis seclian nee0 nat he mmpleteE tl Ne permit is lor one Aurtl2A (f100� a lar�. '� I certity t�at in the De�ormance of Ihe vrork lor wAich tAis permit is issueC, I s�all not employ any Derson in any manner m as to became su01e�� �o ihe Workers' Campenution Laws ol Califomia. � oate: SignaNre: NOTICE: 1�, atter makinq �his declaration, you shoul0 Cecoma SUEject lo t�e Warkers' Compensation Drovisions o1 Ihe �ahor Code, you must fonAvnt� comDN ��h such DrovLsions or t�is permit shall Oe Ueemetl revoke0. CONSTBUCTION IFNUING �GFNCY: I �erehy atRrm ttut t�ere ¢ a consVuction IenOinp apency for tAe perlormance ol Ihe woA lor xTicA Nis permi�is i5sue0 (Sec�ion 3097, Civ. C�. IENDEfl: � 1DDPES3: OWNER BUIWEB OECIAMTION: I �ereby affirm Ihat I am exempt from the Cantractors' State Licensa Law for Ihe fallovnnp reason (Seclion 7031.5 Business anG Professional COUe: My ciry oi counry w�ich repuires a Dermfl to construct. alter, Improve, Uemolish, or reptir auy strucNre, D�or lo its issuance, also requiru tAe apDliwn[ for such Dermit ro Gle a siqneU statement tlwt �e/she Is IicenSeA pursuant ro the pmvisions oi Ihe Comactors State License Law (Chapter 9(commencinp with Section 7000) of DiNvon 3 of the Business antl Pmtessions Cotle) or t�at hUshe is exempt t�erehom and t�e Dazis lar tAe alleOeE exemp[ion. My dola�ion ol Section 7031.5 �y any applicant for a permR su0jecis t�e applicant to a ciNl penalry oi not mare than five �untlre0 dallars (5500). I, az awner oi ihe DroDerty or my employees wit� wa9es as their sole compensation, will Eo t�e work, antl t�e ❑ strucWa is not inten0e0 or oflere0lor sale (Secnan 7044, Business an0 Prolessional CoCe: Tne Contactors' State Liunse Law tices not appy to an owner at a property who Ouilds�or imDroves tAereon, anU who tloes suc� work himulf/herselt or throup� �is or her own employees, pmN0e0 [hat sucA improvemenGs are nol IntenUeO or offere0 /ar ule. I/, howaver Iha builEinp or imOrovemeni is sold within ane year ot comDle[ion, the awner will have t�e 6uNen at D�avin0 Ae/she Uitl nat build or impmve for [he purpose oi sale). I, az owner of the proDeM, am exclusiveN conlractin0 with Iicense0 coniroctors to consirucl the projecl (Sacnon 7044, Business �– "an0 Professlons CaUe: The Cantractors' SWte License Law Eces not apply to an owner ot Draperty who OUAds or imD�s t�e2on anG who wntracts tar such Dmjects ci�� a coniractor(s) license pursuant ro IAa Coniractars' State 4cense Law). I am aware �hat pmoi of iheir Worker's Compens:tmn insurance shoul0 be pmnAeJ to me. � I am exempt under Section: B. 8 P. C. �or IhiS rea5on: , Oate: Owner. I Ao herehy certity that I am aware of anE wEersunA IAe requiremenis of Califamia Health anE Salery COEe Sections 25505, 25533, and 25534 an0 that I ar any tuNre OuiltlinA occuDant will/will not (circle one) neetl to compty wR� sai0 state coUes antl the repui2ments for a permil Por consimctiomor modificauon from the Air Uualiry ManaOement Disinct. ResiAential constmctian apD�ications are exempt trom thesa pmvisions. . Oale: Applicani: I� I hereby certiry that I have read ihis aDPlicatian antl state [hat the aEove informatlon is correct. I a0ree ro comply wilA all ciry antl counry oNinances an0 state laws relatinq ro OuilEinp constructlon an0 h,ei�by aufhorize repmsentatives ol t�is ciry lo enter u0on the a�ove�mentianed Droperry� r'nspecti n puryoses. //i7"%'N� /� i Dah: SipnaNre: � onver's �icense oi Socia secunry x: 1fi41>6 Whita—Builtling; G�aen—Cotle Enbrcement; Canery—Applicenf, Pink—Ravenue: GolOenroE—Aasesaor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: EM 047868 PLAN CHECK NO: N CONSTRUCTION TYPE: JOH DESCRIPTION : ADD A/C CLAIM VALUE; PERMIT TYPE: ELE MEC CALC—VALDE: PEAM NO: EM 047868 GOVT: N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: / COMMENTS: *�x*�****�r�********�*�*****�****�rx*�r�*x*�r*�r�**�r��*�r��*�**�r�*****+�**�r�r*�******+�* ,r�rt, Z O N 2 N G R E Q U I R E M E N T S _;' � f, +� �a�„ �a 5 E T B A C K S , ..� ---'---- MASN HUILDING ---------- ------- ACCESSORY BUILDING ------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT ZN PARKING REQ: PROV; PARCEL: 92920405 ZNE: REF NO: PLANNING NOTES> ' > ' �e****�******��*�*��*�***�e*�r*****�**�x�*_i�*��x�r�***�e**�*��r*******xxx***��+r*****�** D E V E L O P M E N T 5 E•iR j I C E S R E Q U I R E M E N,T S ZONING APPROVED HY � DATE: HUILDING APPROVED BY : ' DATE: APPLICATION I'SSUED bY • ''�'� DATE • 7 3/ 9I� iEiF#iEifitikiEifititil�iEitit'kifif'kiEjEit ir iEifitiEfEif�lFiEiklE iEiE ik ik if iE iE it iE iE iE iE if iE iE iE # if iE 1E # it # iE iE 1E i(-iE iE iE iE iE iE±E iE iE iE �lE if �F iE'lE iE 3E iE iF if iE iE i! iE iE iEiE iE iE iE iE iE 1E if if iE iE if iE iE iE iE if iE iE if if it iE iE ik iE k ik LEGALIZATION;N F E E ,S U M M A R Y STRUCTURAL SEGMfiNT':N BLDG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT _ 7.50 9.00 j 50Y 25� SMIP/NON—RES PLAN ISSUE FEE ' .1�.00 15.00 � bUILDING—DIV—> PERMIT ISSUE PliAN—CHECK TOTAL PAID DUE TOTALS----> 16.�0 30,00 0,00, 46.50 46.50 .00 REVENUE DIVISION TOTALS--> COLLECTEU: 96.50 OI�ER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 22,50 % 24;00 iF iE iE iE iE iE fF iE if iE iE iE 1E iE iE iE 3F ik iE iF �E iE �)f iE jE'h� �E if iE 9E iE?f iE if 1E df if iE iE iE if * j! iE if iE iE 1E iF jE ik iE �l(� dt iE iE �k iP iE iE iE iE iE 1E if if 3E 1E iE iE iE iF iE iE iF iE iE if if I N D I V I D U A li� F E E B R E A K D O W N TYPE QTY D E 5 C R I F T I O.N UNIT COST TOTAL COST �' i ELE 1 MOTOR/POWR APPARATUS 1.1 — 10,0 HP 7,50 7.50 MEC 1 REFRIGERATION SYST�M <= 100 K BTU/H 9,00 9.00 END OF FEES _4 i i'' ., �I��OD665E4—U0066.`,b5 Tt7 T 4o.5U DATE� �713i/9[f iIiiE� i4:5q 0 / �� � • ' CONSTRUCTION AND PLANNING .. P��� APPROVALS Permit #' - �-. ate Inspector qppROVALS Permn # 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, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. . ' 60. Backwash Lines, P�Trap, O UndPgmd. • 10. Structural Floor System ..� , - 67. APPROVAL TO DECK � 11. Property Sewer Line & House�Connection �� 62. Backwash & Receptor-Final_ . 12. Sewer Cap .� - - 63. -Heater & Vent-Final 13. Roof Drains � - � 64. Pluinbing System - Firial 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 FOF? PLAS7ERING 16. Rough ElectricabT Bar Ceiling � 69. POOUSPA'SYSTEMS FINAL - 79. Rough Fleating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � � APPROVALS Permit # 21. Dutts, 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.StoregeTank OGas OOiI 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frameand Flashing 76. Dry Standpipe . 28. �athing & 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 �2�/y�lf l.1�� Notes: /7�Qp (`�DDIIF.:%dA%- EGTC�i2iJ, (.6� 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 pomesticFinal 42. Backflow Preventer , 43. Backflow Irrigation 44. Landscape Irriqation System � ' 45. Sound Attenuation , , 46. Handicap Regulations 47. FINALSTRUC7URE&BUILDING � 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to SOuthem California Gas Co � � 51. CERTIFICATE OF OCCUPANCY No. Date