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787 16TH ST - Building Permits
� Applicant to fill In all zpaess e:eept those wNhin heary Eortlar lines anG sign all aoVroo��ate Eoelantions. CITY OF COSTA MESA . � . _ � . -. _ - - - � . � --- , . i- .__ _. _ . .. . .. . , . _ . , , PERMIT NO. � � TRACT NO. LOT NO. : BLD . . . - . � CONSTRUCTION PERMIT ' . ' ' ' � �192 ' 7/QS/8�, �IQ�50, TL Applicent'S MBiling Addfess ` • T1�PE OF CONSTRUCTION . NEW DD . ALTERATION � REVAI R . ; � ' ' � , � PfOjBCtAddfeu �� I ❑ CONVERSION ❑ DEMOLISH '❑ OTHER � � " � ' � � � � , � , ' . OWnlfiNeme �� ' hone DESCRIPTIONOFWORK � . ZO I G E ULATI N' Addreu ,� 7 1� �' �� ��'' � . 7ypE OF PERMIT ORADING � FOVNDATION STRUCTURAL .� A. P'vW - '' 20NE AfCh/Eng. LiCenze NO.• ❑ TENANT �ELECTRICAL ❑ PLUMBING ❑ MECNANICAI ' ' ' PLNG. REF. �k 1 �- � -BUILDING ' � , � ❑ �OTHER : REAR VARD (TO P/L) �- Addf255 � � � PRO EILDVNLINE Contrecror'sNam one� PRaECTDESCRIPTION SQ.FT. � ' OCCUPANCV� - . . ,U � • LEFTSIDEVAqD RIGHTSIDEVARD ' Addfess�meiling) I � ' ' CONSTRUCTIONTYPE VALUATION$ ' . - . ZON$' GRA�INGCU.VOS. �ACRES �7KG.SPACE�REQ. . ' PROVIDED � ' licensa No. 2 � . � � � LICENSED CONTRACTOR DECLARATION � � r � � - - " � ' ' ' Remarks: � STREET WIDTH ' - PARK FEE $: I,heieby aifl�m that I am Ilcensatl untlar provislons of Charter 9(<ommen<ing : � . , wltn sectlon 7000) of Dlvislon 3 of the Businau anC Profedilons Cotla, anC ' • �. � � ;��, � , � ' SPECIAL CONDITIONS: � � ' • - � my�license Is ln fy /orce anE ff � � ' . , Licensa I 5' � e�No'-._�� 1 . _ . PLUMBING . ' . . . , . .I Date � ��� i�. �7 Slg at � '�- ? , � � , f'dKEpS'COMPENSATIONDEGLARATI N. � BefSiAk SeWefCep ' � ELECTRICAL ��by affirm that I have a cartlTiwte of tonsent to selfinsuGa or a certlflcate ' ' ' AutOmatic Washe� ! � Meter Over 10� amps ��.`Jorkers'' Compensatlon��lniurance,� or a certlfle , copy t�ereof (Sectlon . ' ^� BackflOw.P�eventer _. _ _ _ _ . SBwe� Conn2ctiOn . - ' _ . . _ . _ . _ 3800, laE. C.) � � �; " 9 Backflow Irrigation -"- i ' Construction Pole . . �Sub Panel� j Solar Collectors � ' Policy No. ��n 9OXO Company �� � - � ��- - � Cooking Unit a i Sub Pole i ' � � ' ' �Certifletl topy Is herbby furnishetl. s ' Bathtubs ' � Solar Piping � � . . � � : , rtlfie y 1 with the Uty ur v 5 0 Q , ' � � , ' oate_ ��TAppiiwnt ���j��C�.•iiC..�,� � :. Clarifiers � t � SolarTank Dishwasher j •Motors �0-iHP �1'h-8 i , ! f EXEMPTION;FROM WORKERS' COMPENSATION DECLARATION' � � DIShVYdsher � ( ' ' _SWimmin Pool w/Spe � � . - Dryers �GaS '�EleCtrit • ";" . ' (InC.5o18f'.'�9-15 HP-�16-05+" "� ' "'" (Thlssection neatl oot be completetl if the permit is tor. one �untlre0 (y300) or � 9 ' I certity,that in t�e performance of the work Tor which this permk is Issuetl I� 9 � � � � � �Microwave � � � iess): � ; Drinkin Fountairis i Urinal � '. Fan! � . i ! ' � ' � snall not employ any person In any manner so'as t m subjectto t�e � � i � F.A.U. � � Pale Li ht � i � Workers', Compensatian Laws of Californla� I �� -' ' Floor Drains � j Wat2r CIOSet� j . 9 � ' Date � . : ci9nature �•LL� ' ' . r � � � ! � � Fixtures � � ' � '� NOTICE:If, after_making this tleclaratlon, you.shoultl become.suGject to the 1 F,loor_Sinks _ ,: __,�____ _: _� _Wat2CHeat2�F. ,_ �... � . ., _ . ._ � � ' 1 ; ,Range ` � ' . I �.�Workers', Compensation provislon5 of the Labor Cotle, you must forthwlth � � comply with�. sucn provisions ornthls� permlt lsnau Da.tleemetl revoketl: GasService� . _Outlets �WaterService nC , t' i� ' � Device Boxes ' � • ;g�y�: � � ! I ' F i f . CONSTRUCTION�LENDING AGENCV�' ' � ' ' ' ' ' ' � OUtlets � ' I hereCy a�Tirm that there I5 a.con5trucHon lentling agency far the performance � ��tyrc2ptOr5 4 . -- � � � � . � ' '�Standing Sections ' � of the work tOr whiCh thi5 p¢rmi[' IS i55uetl (SeCtion 3097- CIV C� � -� � � � Lentler's Nama' � -- � z` ' �� - ' - �: i � � � � ' � Swimhes �. 'Trash Com actor t . . , ,., ' i. , ,� ; . : � . Ki4chen�Sink{ .l , ' I _ P � i � � < . P ' Lendors �Aadress � _ • • � - � I '. . _ . . . . , - . � , , j OWNER'BUILDER�DECLARATION � : � � f � ' LaVetorie5� "� � ' , ' ti Gef68geDisposal ' � � I hereDy affirm that I am exempt from t�e'Contiactor'i' Licanse Law Tor the: � -, - �� ,� - Generato� �0-5 KW �5�15 KW � � followiny reasom(Section 7031-.5 Business anA Professlonal Cotle: Any tlty or P—Trap �'„ ' . . ' i' � ' - county w�ich requires a permit.to cons[ruct, alter Improve, tlamolisn oi repair , �, .- -� � , TransfOrme� ' � 'any SGucture; prlor to Its issuance,.also requires t�e applicant toi such parmit � i Roof D�ain4; j� ,y i , i y�+ I�� ? � � i . ❑ 15-50 KW - � � . 1 k � to tlle a signetl statement that he/she Is licensetl pu�suant to [he provisions ot , ' � i �5U+KW ' � 'ReinS ction Fe0 �,� ��ontractor's'Licensa Law, (Chapter 9 (commencln9,with Sac/tion 7000) of - ' _, . ,, � ' � ' , • � - � � , � Pa , $15 `'Yrom antl � he, bas 5 for the allegeCiexe ptlon.�My, vlolatlon o( Sactlon � ShowErS ,,�. '. ReinSpectiomFee $15 _Meter ❑up to 100 amps ' ' �>I1.5 by .any',applicani for-ta,perml[.5ub�ect5'the.applicant �to a-civil ' ' � - � � - � 'Issue Fae- $ 3 � �enalty of not mora than tive huntlrea tlollars (y50o). . r. � I. ; Service Sink � ' �� laue Fee �� . �, $ 3 Zopi�9 qPProved By �� � ' �' Date I I;' as owner of� Ihe �property or my emo�oyaes witn .wages as their sole ' � . - , . I'. - ' ' ' � • , mmpensation wiu Co the work, antl Iha•structure�is not intantletl orof(eretl '• ' =� MECHANICAL � ' � � j ' } � . ' �• for sale (Secfion 7044, Buslne5s antl Vrofessional Gotle: Tne'Con[ractor'S • �Applinti0n Approred By at0 �� . Litense Law Coes not apply to.an owner of a property who builtls or impmves ' � Boj1ef •_ . � Refrigeration System ' � ,7 �� �.� t�ereon, antl who tloes such, wbrk himself/herself or tnrough his or her own , �`�- ��� ` ' Applieation laued By � ' �� ' � nate , emplo�ees, provitletl that such Improvamenes are'not intentletl or ofteretl for . ❑p-100,OOOBTU ❑100,OOOBTU . . ' sale. I nowever, the buiitlin9 or improvement Is soltl wi[hin one year ot com- ' ' Dutt - Untler�Ground , �� - � ' ' SUMMARV OF FEES . . pletion, t�e ownerlwill have the burtlen of proving he/she tlitl not builtl or Im- . �' � � � �eroveformepurposao(sale). , • � � Duct-Structural s� % ' SystemRepair/Alteretio'n . � BUILDINGPERMIT $' �� • SMIP ' + $ � ' � LJ I, as owner of the property, am exclusively contracting wlth�licensetl con- - t ' i - � ; �trattorsto construct the project (Section 7044, Business antl�Pwtessions Cotle: ' Duct - Ventilating • ,PLAN CHECK+ " $. � � PERMIT � : ' I -The�Contractor's l.icense Law does not apply to.an�owner of property'who . � -- ' . ' • � � , { � � � bulltls or im rova5 thereon, antl who wntracts for such �. . . $ , �SSUANCE �, $� � ' p pro�ects with a mn- , ' Exhaust System ❑ Multiple �' I . . � 'PLUMBING S � � , tracior(s) Iicense pursuant to tne Contractor's License law�: � . � ' 'P�qN CHECK� �' GRADING ' '$ � � ❑'I am ezempt untler Sectlon � i B:6 P. C. tor thls reason � , Fiiepl/Fxt. BIL ICBO # , , i . . ' ',. $ � 1 :. ' , � �� ' ' - � '-Heatin g � � � � k .ELECTflICAL. ' $�1Q•s� Data , owner g,System & Ductin ! � i � � i� � 1 MICROFILM �$ � � ' ' I hereby � certity,.that I,hava'�reatl this application antl state ttiat the above �_-�. ❑4700,000 BTU �100,OOOBT ,. _ 'PLAN CHECK , $' . � Informatlon is'co�rect. 1 agree to cOmp1Y '�'��h dll clty antl county o�AinanC¢5 � . . . ' � � '- �_ , �- ' Z � , � TOTALiFEE $ � � � ' and �stata laws ettn9 to ulltling constructi n, antl heraby autnorize reore- ' - � . �MECHANICA� $ . , �� 5entatives of n th bove-mentlonetl o rt Hood or Type I ❑•: �� � � • ' . Reinspection Fae $15 �� ' � � LESS � ' insoectlon ourpos . ' ' Cano ' T e 11 ❑� � � 'PLAN CHECK� $ �� qDVANCED PC $ ' � � ; Signature , Date � 1 � � • . � -� • ! i � ! ' � � • --�--�r � Drivers' Cicense ar'S5 � � ' � Register,s � Iswe Fee ' ' • $ 3 � ' ' � ' ? � �Q-�^_ I • i � FINAL F.EE'' r$, , /CMF 0865-46 rev. 12/82'—Wlilte - Bulltling; Gnary'- Appliwnh'Pink"= Accdunting; Goltlenrotl-- Assessor ` "' ` '' -- '- ' - ' " `� � ` ' - - ` ' " - - " ' ' ' ' - " '" - " ' - �- - -- . . . . � -- �-� - -. - � � �I ' �' CONSTRUCTION AND PLA NING o �. � � ' - . � -� � - - - POO' �� SPA - - � ` , � �? ' * ' ' t ' �,-,.�Dat�, •Inspeetor� . '� ` �' Date' Inspector •>APPROVALST' Permit# �� �9� � -'%pppqpVALS � � Pe�mit# v c- - m> G ' -'' i ��, r1.iTerriporary Electrical Service o[Pole` �u f '.9 f ,- ��'. j� `VO = ;52:=�Pool�&,Equipment Cocation� ' ' - � i t2. Soil Pipe;Und�gFnd. �• � � � .,;,,.-;'`� � � v�'� ",til '.y `. . :53' -.Steel R'einforcement � � ' � � � „ � � ,�' � .3.,Electrica,I�.Corid4it�lfYil�itv:UndrgrnA.�'�'`; : ��h� ? � � ' L. � ' � � =54:�Forms'= � � '.�4.�Electrical Conduit`-Undrgrnd.`- � . - � - � - . t � 55: �Electrical Bonding; �^ . - - ' � _ � (� ' . : ' _.,� • _ � �. _ o � n � ;' . - ' - . ' ,. _:, � :5.�Steel Reinforcemen't �,�; v � �; � ' , _ �� ° . 56. sRough.Plumbing &-Pressure�Test , - � . .t �6.�Electr'cel UQERrGrnd. �,$ °_�� � � � �:_ • '- � - � 57� �APPROVALTO�COVER-GUNIT.E _ _ �' � I� - � ,� �. � �:� `I 4. " 1 7.: Footings , _. " � � gm . 3 ; ` '. ; t . � � - - - ' :,58. �. Electriwl Conduit-Undramd: � - . �,'�'-" ' � . ' r . ,_-�."_� i . I . > _ y: �:� -.: ';�. : `� . � " _�-: i ..,� : 8. Foundation � •- 1 _ - -� 1 59. Gas Pipe, Q: Undrgmd., Test- � - ' , -� � � - l• -~ .� =- � - - - . �- 9. �Water Pipe-Undfgmd. ' � � � �s � � ' ' �t + � � � � �'�p. �.gackwash Lines, P-Trap, O Undrgrnd. ' . � ' { � 10.jSiiuctuial Floor System ; ��`: =C � : ;, '' ' t � " j .61. APPROVACTO DECK� � � 1 L`Properfy Sewer'Line & House 6onnec'tion � ' - ' " � ..� , x � . _ 1 � � ,• � .-�', . �� ,62.=6ackwash�& Receptor-Final - � 12.�Sewer CaP .j� ,� � : : i � _ . i ° . � ..� � . w. - � �„ , %t � „r ;' '63. Heatei &•Vent-Final . - . % . 13.' Roof Drains .. � ' �% i .' = � � � '64. Plum6ing SYstem: �Final : � . .. „ 14.'�Rough Plumbing r', � �- � � � f � - � � �65. Electrical-Final � � � � � � � � ' -� : 15-.,;Rough Electricat=Conduit "' -' �r n � �--� -,- -.' � "j"66: Solar�System-Final; - �- �� - �� �� -16.,� Rough Electric Wifing �, � t ' �i t� _ -� � � �, f � � � � - ;--., � � � � � t67� �Pencing & Access Approval . � - - �- ' . �' b7:I;Rougli Wir,ing Sign • ' r% � .. , �� -'� ( ' ' : i i � r I ° - � 468: �APPROVED FOR PLASTERING' � � � ' ' n.- r � �� � ' 18:�RougF.Elec[rical-T'Bar Ceiling i1 �; �; , � � � � ' � i �° �' 169 �POOL/SPA,SYSTEMS FINAL, ' - � �Y. i. rV �i' I i' s19`a Rough Heati �g & Air_Con'ditionirig �' I;� c� j �� � i j � FIRE DEPT. REQUIREMENT �- � � p ,i � , ��O.e Rough Factory Fireplace t � �� �i � I � I j � I � AP?ROVALS � Permit # _ .�" - i- ! •"21 'Ducts; in,Structure� ' � , i � , � ' ' � , � ; � t � �'. . � . �, i � i ,� � � f� � 70. Underground Hydro '„ � ��22., Ducts, Ventilating'� � i� � I; �� i' i I I i i � � �71t Product�Piping OGas ❑Oil . 23., Gas'Pipe-Rough & Test,.. ;�, �� y�i� ,r ; � � �� � i 7z� Underground FIusH � . � �:'24.'� Roof Framin9 i � �'� `% � ��`` i� � � '� � , i n• - � -, � - �.. .� 73� Undergrnd.�Storage,Tank O Gas ❑ Oil ! � ; i n i i L•m j'= -I .� 25 �'Roof Sheathing � - ��at�?�i. ; ��,� i., ' ' _ � � �7q, Operhead Hydro . , . ' � �� - �, i -�26.=T-Bar Ceiling (St�uctural)ij& MdnocOat � ! � ` ' ' � � ,� i , ;� � 75�. Dry Chemical ' - �- _ � � �: �. � 27. �Frame�and Flashing �� : , I� I' � : � ? � _ ; � � I 76� D'ry Standpipe' � � - 28.' Lathing & Siding ,j o' � i� i; I j j' I I 77� FIXED�SYSTEM FINAL � 29.` fnsulation� ` ' � � � ! ' ��� (� � � � � � � ' � 7gt FIRE PREV. FINAL • � J " °30:�Drywall Nailing � � . � �! �� ( � � � ' � � , Notes � ' ' . � . . � � 31. Plaster,Brown Coati i I �i ' 1 -�i l � .. -1 �I� ` - --. , '- - - -� ,- - ' - • - ' ' - -- - I + � f'� � � 32.� Electrical Power Meter-Fiinal !� ; � ' � � � � � � { . . , i . . 7� i 33.`.Final Electric � � i ' I I i; ' � ' I - I . � I I ', ' ; ' . ' . � � . 34. Final .Heatirig &,Air Conditioning i, �, � � ! � � ' , � i .. • , i , - 4 � .^ i. . j i �r 'r � � r. - ' . . . � 35. Final kGa's Pipe-Test n , � _ _ - , ^ � . - � � � 36. Hood��or�CanoOy.:�' •' � � �' ^; �� ! _ � - . ; i - . . � � - , . � ' m - ;it i � � . 37. Final Fa'cto,ry Fireplace` ''"-' � � - : IT �'; � , � � ! � ; - i, i - . � 38. Final Plumbing I f � ���. �� � '' � i. . I , ' � - - � � . .. s. i 39. Water Service-F,inal � i � '�� ' , i � � � � j ' � i � ��• - I i 40. Gas SerJice-Final � � '� , � � ' i i � , ' : - � . � � 41. Solar pomestic=Firial � j f � � � _ ; _ _ � _I. .� � � �_ � , � .. . � - _ � ._r--- � --+_ `+ 42. Backflow Preventei � � � •I�;' ` � j ' j . . - - h . -- - _ - . n I ". . i •r. 11. J ' 1' '1' ' I 1 43. Backflow Iriigation i � � • '+�i'� ( : � .; �-, i :,' - � `` -; i . ' �f.� � � �'' � �_ N I -� _ � • - 1 . 44. Landscape Irrigation�System� i ��,� � � ' _ , . ' .` _ . i = � 1 i .. � r._ . : C ' 4•i i . _ . .. � . ` • , 45. Sound'"Attenuation? � �' � � � � � � � j � �; I , = � � i � f , ' , _ �';� I *� - 46. Handica'p Regulations� � � � - ; i � s � ' � � ; � ` � � ' , .. _ � ' � 47.�FINALSTRUCTURE�&BUI�LDING-� �,.' � ��F�_;! �'� '�, I( I � . � 48. Special Requirements Completed ,� � �� � � �� i ; �� ' � �' � ' . . . .' I � �.:i � i 1. 49. Electric.Release tof Edisori i I ;` F _� _. i ! _L.. . J�� ._ �. __�_._t _ _ 1 - . . ' I . r � �� -�-- 50. Gas Release �to Southein California Gas Co � , � � � ; � � � � , - + � � � 51. CERT,IFICATE OF OCCUPANCY i� _ , ' _[ ..�`I__ , ' _ � 1 _ ___ .. ' , � � p �. � � t � � � 1 . � � �.. � No. �! ' � ' Date � � � . ' � s-, -�,.� �_:.� _� � � OF Address ApPlicant to fill in atl f 1 MESA PEf�6LT Ns . ON PERMIT L � 3 , i� witnin �eavy bo�tler li�s antl sign all approp�iate Eecla�atians� , _ TRACT NO. I LOT NO.' BLDG. NO. Y. TN Y761 TVPE OF C�O.yNSTRUCTION � Phone ❑ NEW p� AD� ❑ AITERATION V ��,� (' � ❑ REPAIR LJ CONVERSION ❑DEMOLISH � LicenSC No. ❑ OTHER � Addre55 ' ' OESCRIPTION OF WORK Contracror �,,.�N -' Phone �- TYPE OF PERMIT. �-� �- . AddfC55 � - ❑ GRADING '❑ FOUNDATION O STRUCTURAL LICENSED CONTNACTOR DECLARATION - -QTENANT�ELECTRICAL OPIUMBING ❑MECHAI I hereby aHi�m IM1:.t I am Iicansetl untler provisions o( C�ar[er 9(Com- � men<in9 with 5ettion 7000) of �IvlSion 3 of Ine Business antl ❑ OTHER Pratessions Cotle, and my II<ense is In full force antl eftect. pROJECT DESCRIPTION . Litense Clazs �icense No. Dale Signatur¢ � SQ. FT. � . WORKERS' COMPENSATION DECLARATION • OCCUPANCV_CONSTRVC710N TYPE I hereby atfirm that I hava a certifitale ot consont to self-Insure or a VA�UATION ZONE c¢rUflfatO 01 WOrk¢rs' Comp8n5dtlOn InSuranc0, Or' a Certilletl�copy . [hereof (Section 3800, Lab. C.). GRADING CV. YDS. ACRES A No. Company '- � tlfiGtl COpy I5 h¢rGby fUrnlsbetl.- � REMARKS: - � ' _ _ �J ..ertlfietl copy is tiletl with Ihe city Builtlin9 Dlvislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 1� '- (This soCtlon neetl not be complat¢tl if tho p¢rmlt.l5 focone huntlretl __. . 1E1001 or less). ' cert(ry that in the perfarmante ottha work for which.ihis permit is Issued, 1 shall not employ any Oarson in any manner so as to becom¢ PLUMBING PLAN CHECK sublec to��th�e,y��or,k�e�rs' Compensatlon Laws of/ II(o ia. , Date��irys.`�519nature � BATHTVBS SHOWERS ' NOTI : I(aftar making Ihis tle ration, you shoultl become ubjact TOILETS� � VRINALS � ' to t�e WO�kers' Compensation p� vlsions of [he Labor Cotle, you must � 10rlhwith compy with such provi51on5 Or thi5 p¢rmit Shall be tleemetl LAVATORIE$ DOUBIE lAV$ ' revOkatl.-• - .. . . .._ CONSTRUCTION LENDING AGENCV KIT. SINKS � DISHWASHER$ � - I h¢rlby aftirm tM1at IM1erC Is a Const�uctlon IGntling agenty for the perv SERVICESINK$ . SVMP$ � ' "" -' fbrmance ot the work for which this permit Is issuetl (SecUon 309] Civ. C.). � � � �� � FLOOR SINKS FLOOR �RAINS ' Lentler's Name Lentler's Atltlress DRINKING FOUNTAINS - -- OWNER BUILOER DECLARATION INTERCEPTORS CLARIFIERS I �eraby affirm tnat I am eaempt from the Contractor's License Law ior ' the following roason (SecHon ]03115 Business antl Profosslons Cotla: SWIMMING POOL � P TRAP Any city :or county which require5 a permit to conitruct, alt0r, Improvo, tlemoliifi or repalr any"structure; prior to Its Issuance,also re- y�qTER SERVICE ALTERATION � qui�es �be ap�.li�nl tor Such permit to fil¢ a Signetl statement that he � Is Iicensetl Oursuant to [he provisions of tbe"Contrattor'S License Law GAS SERV ICE OUTLETS � - 1Chaptm 9(<ommencing with Section 7000) of Division 3 of the 6uziness antl PrWessions Cotle) or that he 15 exompt'therefrom antl tne -yyqTEH�HEATERS � BTU OUTPUT - - b- " for the alle9etl exemp[ion. Any violallon o/ Section 7031.5 by d oplicant tor a permit 5ub�eCtS the appiicdnt to a clvil penalty SEWERCONNECTION$-�- ' c i more than IivC huntlretl tlollars (E500). i, as owner of the property, or my employees with�wage5 as Ipeir SOLAR TANK ��COLLECTORS sole�compensatlon, will tlo the wo�k,.antl the 5[�uctur¢ is not Inientletl or ofteretl for sale. (Settion ]044, Business antl Aoiessions Cotle: The SOLAR PIPING SVS. � Contractor's License law tloes not appty to an owner of a proPerty . . who builtls or impraves thereon, antl who tloes such wark himself or ISSUE FEE through M1is own employees,.provitlotl that such improvements a�e not. Intentletl or offeretl for sale. It, howeveq the builtling or improvement MECHANICAL PLAN CHECK Is soltl wiihin onc year oi tomplelion, thc owner will havelhe burtlen Ot Provinq he tlitl not Uuiltl or improve for the purpose of sale�. HEATING $VSTEM 0-100,000 BTV ' ❑'I',- as owner o/ tbe property, am exclusively con[ractin9� with qND DUCTING -�� � Iicensad rontractors to construc[ the prolect (Sectlon �044, Business 100,000+gTU� ' dI1C �PlOf¢551005 COtlC: TIIC COOtIdCSO�'S LlcenSe Law tloes nOt apply to an owner of property who builtls or improves thereon, antl who Con- REFRIGERATION 0-100,000 BTU traGts"irom-sucn projeGts-with a Contractor(5) Iicesnetl- pursvan[ to- SVSTEM ' tne ConVactor's �icense Law�. 300,000 + gTV � I am exempt untler Section � B. & P. C. for this gOILERS BTU reason - - ' SVSTEMREPAIR,ALTERATION � Oate - �Owner � I nereby certitythat I have reatl tnis appliwlion antl state that [he above EXHAVST SVSTEM MULTIPLE informallon is correct. I agree lo comply with all tity antl coun[y . o�tlinances antl slate laws roiating to con5truclion, antl hereby autM1oriie representatives of this uty tp en[er upon the above mentionetl Sl9nalure "`�'� � �� / � �SSV E FEE ' CMF 0865-46 White-Builtling; Canary-AOP��canl; Pink-Accounting: Goltlenrotl-Assessor 3945 3/30/82 - 13.75 i iL+. REGULATIONS A.P. � - 20NE PLNG.REF.� , . REAR VARD (TO P/l) _ PKG. SPACE REq. PROV IDED STREET WI�TH • PARK.FEE $ ' �ZONING APPROVED BV DATE ' , i SPECIAL CONDITIONS: . . . ELECTRICAL '" PL.an CHECK" " tiENERATOR '0-1KW_1-lOKW TRANSFORMER �APPLIANCE 10-SOKW_SO+KW �U MOTORS " 0-1 HP_1-10 HP , � (INC.SOLAR) 10�50HP_SO+HP - FIXTVRES TL SWITCHES " ,GAS TUBE SIGNS - . POCE LIGHT$ ' - ' ' 'PANELS " MAIN L �1�R �.� " !,' �SERVICE - - ' " ' "AMP ' ISSUE FEE - "- ' - ' - � p -APPCICATION APPROVED BV - - OATE� � ' SUMMARV OF FEES , � 'BVILD�NG - -� - - - - - � PERMIT 5 'r�SMIP.-� - $ - 'PLAN CHECK $ � PERMIT . .i�; � �P�UMBING g � ' �SSUANCE S � _ - - - �GRADING�E ! 'PLAN CHECK 5 - ' ELECTRICAL -$� $ . - PL"ANCFiECK g � � fu11CROFILM E .MECHANICAL $ __ TOTAL FEE 5 -� ' � LESSAD- ' PCAN CHECK $ ' - ' VANCE PC $ _ � . . . ." FINAL FEE § l �� � ' � i � CONSTRUCTION AND PLANNING � ) POOL & SPA � � �� l APPROVALS Permit# ��✓ �✓ Date Inspector qppROVALS Permit# - Date Inspector � 1. Temporary Electrical Service or Pole . 43. Pool & Equipment Location `' �� Soil ipe-Undrgrn 44. Steel Reinforcement ' � 3... Electrical Conduit Utility-Undrgrn 45. Forms ' 4. Electrical Conduit-Undrgrn 46. Electrical Bonding � � tee ein orce � 47. Rough Plumbin & Pressure Test � 6. Electrical UFER Grn � 48. APPROVAL�TO COVER-GUNITE�-- 7. Footings 49. Electrical Conduit-Undr rn 8.. Foundation � � 50. � Gas P.ipe, ❑ Undr rn, Test _ 9. Water Pipe-Undrgrn � � 51. Backwash Lines P-Tra ❑ ndr rn ' 10. Structural Floor System ' ' 52. APPROVALTO DECK � � - 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � 12._ Street Sewer Connection ' � 54. Heater & Vent-Final 13. Rough Plumbing - � � 14. Rough Electric�onduit � - � -56. Electrica6Final 15. Rougfi Electric-Wiring � - - 57. Solar System-Final ' - - ' � " 16: Rough Heating & Air Conditioning � - • encing & Access Approval 17. Ducts in Structure � • "' APPROVED FOR PLASTERING � � 16. Ducts,Ventilating _ '- ' . � -. " _ 19. Gas Pipe-Rough & Test � 60. POOL/SPA SYSTEMS FINAL •• � 20: Roof Framing ' - � �� 21. Roof Sheathin � ' - '- � . � � � � 22. Frameand Flashin NOTES: � ' 23! �Insulation � - ' ' ' - 24. lathing & Siding � � � 25. Drywall Nailing � � ' - 26.. . Plaster Brown. Coat . ' ' 27. Electrical Power MeterFinal ' � � � � 28. Final Electric _ /. 2 �� 29. Final Heating & Air Conditioning ' � 30. Final Gas Pipe-7est � 3L �Pinal Plumbing ' � � � � 32. •Water Service-Final - � ' ' 33. Gas Service-Final � ' 34. Solar pomestic�Final � ` � ' � ' � " ' 35. Landsca e S rinklin S stem ' ' � ' � � � 36. Sound Attenuation • � - � ' " � � - ' 37. Handicap Regulations � � -� ' 38. FINALSTRUCTURE&BUILDING � � 39. Special Requirements Completed - ' 40. Electric Release to Edison " � 41. Gas Release to Southern California Gas Co. � 42. CERTIFICATfl OF OCCUPANCY . � No Date - � . , NOTARIZED STATEMENT C �ESPONSIBILITY e f ��TO WHONi IT MAY CONCERN: .� ' ,7 � I �/ � 1�T1� S i'' . Svee[ Addres L L �( property, do hereby authorize: � JI tM Sw �A�.l l�i�a�►J Name vl � '7 F1 �% i/J • / �y++ � >• Sveen Add.ess Bldg. Permit # -J ` This Permit #� � ��� $ ' � AP Number as Owner in 7itle of the above referenced b�7- �1/9J Telephone No. ` %�i��'>d �? E's A �! � %� 7, 7 _ . " Ciry � ' State . . ZiP • to obtain permits in my behalf, as owner/builder, for the construction, alteration, moving, demolition or repair of the above referenced property. Should any person become an employee engaged in the improvement of the property, I shall immediately provide Worker's Compensa[ion Insurance coverage and cause a certfficate ot that coverage to 6e fi(ed witfi the Buifding Division of the Ciry of Costa Mesa, as required by Scate of Califomia laws. As owner/builder in fact, I undersiand and accept that my responsibilities do not transfer to any other person, company or �orporation. I agree to inqemnify and hold the City of Cosia Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties. � �_�` ��K�`�� Primed Name \ ` Signamre Notary's Statement: OFFICIAL SEAL ANNE M. MILLER NOTARY PUBUC - CALIFORNIq ORANGE COUN7Y My cdmm. �p(res AUG 4, 1982 CMF 0779�6 Date / � _� 2- CITY F COSTA MESA , CONSTRUCTION PE iplicant to fill in all sDace PERMS N�� IT c witnin heavy DorOer lines ane sign all approvrlate tleclarations. -TRACT NO. LOT NO'. BLDG. NO. � � rro7ectAtltlress � . TYPEOF�CONSTRUCTION OWnef' J '�d.%A � �� ne '�O NEW ❑ ADD O AITERATION ' 'Atldress ' -' •' - - - ❑REPAIF ❑CONVERSION ❑DEMOLISH ArCh/Eng. — ' '- ' ' LiCenSe No. - ❑ OTHER ' DESCRIPTION�OF WORK "Address - - - � - � � - 'Contractor ^J�Q Phone TVPE OF PEFMIT ' � ' � - Addte55 ' � ❑ GRADING�j ❑ FOUNDATION ❑ STRUCTURAI. LICENSED CONTRACT00. DEGLARATION ❑ TENANT QJ ELECTRICAL ❑PLUMBING ❑MECHANIi I h¢reby affirm thut I am IlcenSetl untler provi5lons of Charter 9�(Com= �\ menUng with section 7000) �ot Division 3 ot the Business antl -� OTHEii - Protessions Code, antl my Iicense Is in fu❑ torte antl etfect, pROJECT DESCRIPTION ._ .. License Class License No.� , " ' ! . . 54. FT. . ' _ Date Si9nature'- WORKERS'COMPENSATION�DECLARATION ... .:OCCUPANCV_CONSTRUCTIONTVPE I hereby affirm that 1 have a certificate of consent to self-insure or a�: VALUATION' ZONE certlficate ot Workers"Compensation Insurance, or a-certi/ied mpy � - thereof (Secfion 3800, Lab. C.). ' GRADING CU. YDS. ACRES ;�olicy No. - � Company - - - .fi� Certitled copy is hereby lumishetl. - - . . � pEMARKS: � - . . _ . 'i� Certifietl cOpy IS filed with the City Builtling Oivision. . �EXEMPTION FROM WORKERS' COMPENSATION DECLHRATION '- '- ' - " ' (This SeCtion neetl not be completetl i( th¢ p¢�rttit i5.(or one huntlred , . � _ ,_ ($10�) OI �255�. � .I certiry that in the pertormancepf the work for whlch this permit I5 issuetl, 1 shall not employ any p¢r5on in any manner 50 as 10 become PLUMBING -' PLAN CHECK .subjeCt to th Workers' Compensation Laws o GI' omia. ' . __, . - � _ . _ Dater�5lgnature �+/ ' � gP.THTUBS SHOWERS NOTICE: If after�making ihis aration, you shoultl be me subject -TOILETS r�, , �- URINALS to [h¢ WOrkers' CAmpensatlon ovlsions of the Labo� Cotle, you mus[ � � forthwitn comply,with such provi5ion5 or this permit shall be tleemetl LAVATORIES DOUBLE LAVS revOketl.. . _- " '_ _ _"_ _ _ __ - " CONSTRVCTION LENDING AGENCV � �KIT.SINKS- - � � DISHWASHERS - I hereby affirm that there is a constructlon lentling agency for [he per- SERVICE SINKS ! ' SUMPS - � ' - tormanC¢ of the work fo� which this permit is issuetl ($ection 3097 Civ. C.): _ _ ' ' " __'.._ , . � . �. . _... . _ _ .. . Lentler'S Name FLOOR SINKS FLOOR DRAINS l.entleYs Atltlress DRINKING FOUNTAIN$ �� -- - OWNER BUILDER DECLARATION " " ' - INTERCEPTORS CLARIFIERS � I hereby af(irm that I am exempt frbm.the Contra[tor'S License Law for tne following reason' (SecUon ]031:5 Business antl'ProfessionrCotle: "SWIMMING POOL � PTRAP -' ' Any city or munty which requires a permit to construct, alte�, Imp�ove, tlemollSM1 or repdir'any St�ucture, prior t0 it5 IsSuanC¢. also re- yyqTER SGRV ICE ALTERATION . . quires the apFlicant for such permit to � - is' IlCensetl'pursuant to the p�ovisions o1 (Chapter 9 (commencing with Sectior Business antl'Prdessions Cotle) or that basis for tne alleqetl exemption. Any e �y-appliCdnt for'a permit subjects tl ,,.,f( not mOrE than �ive huntlretl t1011ars y9,1, as owner of the property, p�m" netl statement that he rt�acto�'S'LicenSe Law GASSERVICE of Division 3 of the mpYtherefrOm antl the ' 'yyqTER HEATERS- of Sectlon 7031.5 by :ant to a'civil'penatty- 'SEWERCONNECTIONS- Conlractor'S LicehSe Law tloes no[.appty.to an ownet oi a O�ope�ry who builtls or improves lhereon, antl who tloes such work himself o/ tb�ough his own employees, p�ovid¢tl that such Improvements are not intentledor offe�ed for sale. If, however, the builtlinq or improvemen[ is soltl within ona yeariof complclioq, the owner will,have the bur0en of proving he tlitl not builtl or improve for the purpose ot sale). �Q I, as ownerrof-ttie=pro"pe'rly,�am exclusively conVactinq-with licensetl cOntractors to construct Ihe project ($ection 7044, Business antl P�ofessions' Cotle: The ContractoYS�LicenSe�Law-tloes not apply to an owner of property who builtls or improve5 thereon, antl who con- ttacts from such-projects with a contractor(s)-IicEsnetl pursuanbto the Contractor's License Law). ❑ I am exempt unGer $ection - � B. & P. C. (or tFiis Date � Owner - I hereby certify [ha[ 1 have reatl jhis application antl state that the above mformation is cmrecL�l a9ree to comply with all fiity antl Wunty ortlinances antl slate laws relating to construction, antl hereby authorize representatives of this city to enter u0on the above- mentionetl OUTPUT _ECTORS -'- SOL{iR PIPING SVS. ISSUE FEE MECHANICAL aLAN cNECK MEATING SVSTEM 0-300,000 BTU -'ANDDUCTING � 100,000+BTU REFRIGERATION 0-100,0006TU SVSTEM-' " ' 100,000+gTU BOILERS BTV SVSTEM REPAIR,ALTERATION ��, EXHAVSTSVSTEM MULTIPLE Siqnature +°^r�"^"^'�� Date L`/�cc•0/i o:��e,:• � r,:e or ss � , - ��ssue-Fee- . . - - - - - -- -- CMF 0865-46 White-Builtlinq; Canary-Applicant; Pink-Accountin9: Goldenrotl-Assessor '. . `.� 1J8q 2/OB/82 B.QO TL ZONING REGULATIONS . � A.P. � ' ZONE PLNG. REF. �, � a_____.. __ __ ' j'QBIZILDING_,_ „ REAR VARD (TO P/L) ' PKG. SPACE REQ. .PROVIDED STREET WIDTH . PARK FEE LONING APPROVED BY iPECIAL CONDITIONS: ELECTRICAL PLAN CHECK �. I�, SO. FL nvv " - 5[J_ FL � „ . _' _ _ GENERATOR- ' p-1 KW_ 1-10 KN/. - � TRANSFORMER APPLIANCE � 1'0-SOKW=50+KW i MOTORS ' 0=1 HP_1-1'O,HP ' i (ING SOLAR)- 30-50 HP 50 + HP_-- --- -- - FI%TURES -�OUTLETS' SWITCHES ' '� �-"'� i GAS TUBE SIGNS "` - ' ` " - ' - " POLE LIGHTS ' - ' - ' -' - - - _ . 'I -FWW6� MAIN ' .SUB -. - " SERVICE - -' - ' AMP "�" ' -'- ' ' _ ' ' ' " _ "' '_ . "'. ' ' _ ' ' _ ' ' ISSUE FEE � " ' --- - - - APVLICATION APPROVED-BV - ' ^ 'DATE� 'L SUMMARV OF FEES � � BVILDING ' ' ' - - � � ' PERMIT _._y . . . SMIP , 'r $..'__ PLANCHECK $ PERMIT9 P i1' PLUMBING g �SSUANCE $' _ � GRADING -�S PLANCHECK'.$� . '11,' ,� . ' �' _'$' EIECTRICAL $ .� .. PL'ANCHECK g '-" -_ MICROFILN:$ �� 'MECHHNICAC $ ' —TOTALFEE�B� - � PLAN CHECK S' " "' . � LE55 AD- '_" , _ VANCEPC $_ .� � �.:.�.. . , ^ , � . � . _ FINALFEE $� '� � CONSTRUCTION pND PLANNI�NG' POOL &�SPA � � � � �• APPROVALS �Permit #�11GL Date Inspector qppROVALS Permit # Date Inspector � 1. Temporary Electrical gervice or Pole �. 43. Pool & Equipment Location � � � 2. Soil ipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms � 4. Electrical ConduifUndrgrn 46. Electrical Bonding � -� i . tee em orce 47. Rough Plumbin & Pressure Test ` 6. Electrical UFER Grn 48. APPFOVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ Undr rn 10. Structural Floor System � 52. APPROVALTO DECK 11 . Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough ElectrioConduit - - �56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning � encing & Access Approval 17. Ducts, in Structure 9• APPROVED FOR PLASTERING � 18. Ducts, Ventilating . . . 19. Gas Pipe-Rough & Tast 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing 21. Roof Sheathin ' 22. Frame and Flashing NOTES: . , 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing ' 26. Plaster 8rown Coat � � 27. Electrical Power Meter-Final � L � 28-. Final Electric 29. Final Heating & Air �nditioning - 30. Final Gas Pipe-Test ' i . 31,.� Final Plumbing " ' ' ' "� �"'� ' � - ^-- ' � 32. Water Service:Final. ' � 33.', Gas Service-F.inal � ' 34. Solar pomestic-Finai ' 35. Landsca e S rinklin S stem 36. Sound Attenuation � 37. Handicap-Regulations � � 38. FINALSTRUCTURE&BUILDING � � 39. Special Requirements Completed � 40. Electric Release to pdison - � � '41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY . � No Date Variances: C. U. P.'s: Received by: ����� C�� v y I/t� F. C��O U c� Complainant TelepAone Number REPORT OF INVESTIGATION Assigned to: ❑ Building Division O Planning Division O Joint Investigation Case No.: Assigned to: R�c'� Date: 2 — 3 — � 3 787 w• l�rti sT— ComplaintAddress si j�� SVZp��N MrC Srue.v.r iiv4Tor/ 6tiap Name of Tenan (if applicable) Q• (l � llH v,cs L, A i./ Name of Property Owner Telephone I C / SdV ' S CM• Owner'sReside�tialAddres5 aGz Nature of Complaint: �rld'-! STi g i,rTi a:✓ o� s�"i� i �%'vrj-r /fT7�n� � � %4kl,IdK �iir_o_ n�ii�i.,�c /�S i0��%iii.✓ '� r�h.c�v�.. Ponesi"���7-io.� oF �2 oF�-i f.Ps i N i� F.fht.�-c ��r �S%'�/�i-i' ��Y'ti l�o�,�� �!-Pc j�Ci� c���i�s �'J�//�CS' Investigation by: Inspecror Building Permit Files Reviewed: Initial end Date Assessor's Parcel No. y� �f —�3� ` o� Violation of C.M,M.C. Section (sl: Time of Day (if applicable� Zoning Files Reviewed: Map No. initial and Date Findings: C�ekT•F'Y� l�Z�.-tic S-e...% 7b mw,y.�Ki'k�l �/sT-r' �—/-83 y-a�-s3 � 8=���y f��y ��-,�H����,z r�ti�.�i.�� c-,a-�.3 - io-g.3 � R— �y/l_ � , „ �- �a-83 � �- ���� ,. ,� �� i�/S-S3 (3- 7�/vG �,.�.y.G� 7- �s--�3 �_ ��i�r �-N�i..d ��L �o��3�Div9-5 �o�r�P�r� NOTICES: ist Given: Oate 2nd Notice: Time Allotted for Correction L° ./a s .� � � 8"/i �� �'�� maximum time Certified letter advising that if violations are not corrected, the compiaint and all supporting data will be forwarded to the City Attorney's office with request for prosecution. Daie Mailed Date Received 7�day recheck of site Filesforwarded to City Attorney's office with request: Initial and Date CMF 0829-30 . 19899 �� COSTA MESA BUILDING-SAFET/ DEPARTMENT P.O. BO%9/7 COSTA M6HA, CALIROpN1A For Applicant to Fill In Completefy TYPE OR PRINT ADDRESS / 'V �S� /F7 �/� COSTA MESA, CALIFORNIA � OWNER G. /v . AD RE58 �`� ! �'/' � /�'G G� �ir. � �, /�1G.f'4. No�46-9 ARCHITECT N O � � NOL� OR FNGINEER c� �EE RECEIVEU JUN 2 3 1963 � /�FIN/A�NC(�E(� TO�EPT[.�� A��L�I.A 1 �lJ� � V��CRMR BUILDING For Office Use Only ZONING rvo. or uo[ or ni runa Y OU�LDINO � � • � �U — �.i STATE �i/ � NEL. v 90' TO SIDE @ REAR p. L 6 BHALL BE LESS THAN LIC.NO.�S. �6-�� 2 EAVES 512E D �i I nO.OPe�Oae. /J ALLOWED (U.B.C.REOUIREMENT: OF LOT T NOW ON LAT l� � YAROSAPPROVED YARDSAPPROVED USE OF � MAIN BUILDIN� ACCESSORY BUILOING EXISTING BLOG. (FROM G/L STftEET) BETBACK LINE FROM _T` FRONT FT. PT. CENTER OP eTREET . V� REAR YAHO Z D . SIDEYARDI LEFT =� �RIOHT DESCRIPTION OF WORK ya tl OP i HEFEBY ACRNOWLBDOE THAT VR�VB pEAD ANO 6TAT8 TXAT TME ABOVH IS COHHBC PLY WITH ALL CITY ORDINANC88 ANO ATH BIIILO�NO CONSTRUCT SIGNATURE OF� PERMITTE AUTHORIZED AGENT VAR. # q 80. {�. � THE AMOUNT BHOWN UNDBP V�LUATION �8 POR THe = PURPOBE OF EHTABLISHINO A PBpM�T RH8 ONLY. � VALUATION � '' p PERMIT FEE $ � j � ��� m O LA CH C O �. 6 . TOTAL FEE $ �