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Home My WebLink About951 UNION ST - Building Permits! • : � � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 951 UNIONAV Suite: Vicinity: RESIDENCE & ATTAHCED GARAGE Parcel Number: 42244216 npplicant: SMITH, KEN Address: 11691 LUZON CYPRESS, CA Owner. KLEE, JANSEN �LQYD Address 951 UNION AVE Zoning: Phone: (714) 391-3754 Zip: 92630 Phone: COSTA MESA, CA Zip: 92627 Contracror: A OK REOVATION & ROOFING Address: 11691 LUZON CYPRESS,CA Zip: 92630 Arch : Address: Phane: (714) 391-3754 License: 639447 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 04/25/2001 Issued: 04/25/2001 Phone: Zip: License: License: SCOPE OF PERMIT REROOF PITCHED & FRONT FLAT AREA ONLY�(NOT BACK FLAT AF2EA): T/O EXISTING COMP ROOF, REPAIR SHTG AS NEEDED, 1 LAYER 30# ASTM FELT. APPLY 25-YEAR COMP SHINGLES TO PITCHED AREA. TORCH TO FRONT FLAT AREA.79SQUARES . FEE SUMMARY Plan Check: $0.00 Calc Valuation: S2,soo.00 Permit: $8325 . Claim Valuation: S2,5o0.00 SMIP Res: $0.50 SMIP Com: $0.00 Other $0.00 Inspection: $0.00 Total: $83.75 SETBACKS � MAIN STRUCTURE Front 0- 0' " Rear 0- 0 ACCESSORY Front 0-0 -� Rear 0-0 PARKING Existin : 0 Re uired: 0 NOTES: � PLANNING & ZONING LeR 0-0 Right 0-0 Left 0- 0 � Right :,0- 0 Proposed:. 0 . , INOTICE: The work authorizetl by Ihis permit shall comply with all applicable handicap access requirements under California statutes and related . �egulations. (Ord. No. 9248, § 1, 12-27-92). EXPIRA710N: This permit shall automatically expire antl become void if work is not commenced within 180 days, or iF work is suspended or abandoned for a period o( 180 days. INSPECTIONS: In order tor ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and flnal approval must be obtained. Failure to obtain inspections and final approval will resufl in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ?aae-s6la�oo) t WORKERS' COMVENSATION DECLARA710N: I hereby eHirtn under penalry of perjury one ol ihe following declarations: ❑ I have and will maintflin a certilicate ol consent to self-Insure tor workers' wmpensation, es provided tor by sedion 3700 0l the Lebor Code, Por Ihe pedortnence of the wOrk 1or which this pertnit is issued. ❑ I have entl will maintain workers' compensatbn insurance, as required Dy section 3700 of the Labor Cotle, for Ne peAortnance of the work for which this pertnit Is issuetl. My warkers' compensation Ins ance ` er and pollcy number ere: Carner. ♦ ��'� Policy Numbar: � (�Th/is'section need not be com0�eted il the permif Is va/ued et ane hundred dallers ($100) or /ess.) �' I certiy thet In tha pertormance of ihe work for which this pertnit is issue0, I shall not employ any person in any manner so es to become subject to the workers' ,/ �ompensatlon laws oi Ca fornia, and a that it I shou become sub�ect to the workers' compensetion proNsions of S§ctlon 3700 of the Labor Cpppddde, I shall torthwlth comply wilh the r isi �/ ��^ Q� � !"f"� C/ Applicam Signet e: Date: � � WARNIN(i: FAILUR 5 E WORNERS' NSATIqJ COVERAGE IS UNLAWFl1L AND SH�LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES M1D CIVIL FlNES UP TOIXJE HUNOREO THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES PS PHOVIDED f-0R IN SEGTIIXJ 3](K OF THE LABOF CODE, INrEREST, AND A7TORNEI^S FEES. LICENSED CON7RACTORS DECLARATION: I hareby aHirm that I am licensed untler provisions ol force entl eHect. Llc Je��X�� Conirectofs Slo eture: ` 9(commencing with SSction 7000) of Division 3 oi ihe Business and Pmfessions Code, and my license is in full qess q �. Date: �— � � �i CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirm that there is a construction lending egency for ihe pertormance ot Ihe work Por which this pertnit is issuetl. (Sec. 3097, Civil Code). LentleYs Name: LentleYs Atldress: Signeture: OWNER-BUILDER DECLARATONS: Data: I hereby eHirm that under penalry of perjury ihet I am El(EMPT FROM THE CON7RACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business antl Profeulons Cotle: Any ciry or counry which requires e permit to consiruc�, elter, Impmve, tlemolish, or repair any structure, pnor to its issuance, elso requiras ihe applicant tor such permit to tlle a signed s�etement t�et ha or she Is Iicensed pursuant to the provisions ol the Contrectors License Lew (Chapter 9(commencing with Sactlon 7000) of Division 3 ai the Business end Professians Code) or Ihet he or 5he Is exem0� �herefrom end the ba519 tor Ihe elleged exemption. Any vloleti0n oi Setlion 7031.5 by any epplicant lor e pertnil subjects ihe epplicant to a civil Denelry of not more then five huntlred tlollare ($500).): ❑ I, es owner oi Iha property, or my employees with wages es their sole compensetlon, WILL DO TME WORK, antl the sWcture Is not Intended or otteretl tor sele (Sec. 7044, Business and Professions Code: The ConUactors License law does noi epP�Y to an owner of property who 6uilds or improves Ihereon, and who does such work hlmself or herself or Ihrough his or her own emD�oyees, providetl that such improvemenis are not Intended o� oHered tor sele. If, however, the building or imDrovement is sold within one year oi completion, the owner-Ouilder will heve ihe burden of proving thet �e or s�e did not 6uild or improve for purpose ot sale.). ❑ I, es owner ot the propeM. em E%CLUSIVELY CONTRACTING WITi LICENSED CONTRACTORS to con5lruct the projeCt (SeCJ044, Business antl Profe55ion5 Cotla: The Coniradors License Law does not ep01y Io an owner of property who build5 or improves thereon, end who coniracls lor such projact with a cOntrector(s) license pursuent to the Contractors license Laws.). ❑ I am exempt under sec. Signature: Owner ID verifietl by dnvefs license. ❑ Yes ❑ No Business and Profeuions Cotle for this reason: Venfication ot Ownership by (rype oi daumeni, i.e. - properry taz bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTiFICATON: Drivefs License No. oate: Expires: ❑ I hereby certily thet no excavetion five (5) or more feet in depth into whic� e person is required lo descend, will be mede in connection wiih work authonzed by this permlt, and thet no building stmcNre, scattolding, felsework, or tlemoli�ion or dismentling ihereot, will be more then thirty-sla (36) fee� high. (Chap. 32, Gry 2, Art 2, Sec. 341, 71t1e B, Calitomle Administrative Code). ❑ As owner-bullder, I will not employ anyone to tlo work which would require e permit from the Division of Indusirial Salety, es notetl above, unless such person has e permit to do such work irom Ihe divislon. Signature: Date: Division ol Industrial Safery Permit Number: ICERTFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certity under penalry ol perjury that I have read this applicalion antl state Ihat the inlortnelion given is I correct. 1 egree to comply with all state laws end city ortlinances relatinq to 6ulltling consiruction, antl authorize representatives ol the City of Costa Mesa to enter upon tha above-descnUjfd property tor inspection puryoses. I egree not to occupy or ellow ocapency of eny building authorized 6y this permit until finel inspection. COpE �, INSPECTIONTYPE 1616 Fixetl System Final Fire Prevemion 7266 200 zoi 202 203 Pool Spa Final Finel Re-Roat Final BIxWRetaining Well Final Fectory Fire Place Final Sign 204 Final DemoOtion jl�g �NTIilALS �I TO-O/ � �� .. : - COOE I INSPECiION TYPE 206 Final Mechanical 20B Final Plumbing 210 Finel Electnwl 272 Final Fire Prevention 220 Final Planning ApprOval 222 Final Site 250 Finel Building/Occupancy onre ,t�ELi /�oo�icant to till in ali spaces ezcept ihose within heavy Doraer Ilnes ana sign a11 approoriate aeclarationz. VIVI 1 IVV. CI'BY OF COSTA MESA CONSTR UCTION R ��' y �Project Address _ �� U�� v� L�� r�'�`� /d � y �v � ' Applicant'sM��9Address �0,8. //.r3C� G'o,�. �Yes3 TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR �G�S(I'G! L � �F %ZZ- %�/ � CONVERSION ❑ DEMOLISH ❑ OTHER A•P•# ZZ— O�Jner's f�ame � Phone DESCRIPTION OF WORK/USE OF BLDG. Address ��?' 2d 4¢ S Main Building: Arch/Eng. License No. ' Address / Con[ractor'sNam '��0 'F �� h n �77 � Addr¢sslmailingl � �� ¢ ��'70� �rsiry License No. � `; r� ' LICENSED CONTRACTOR DECLARATION lereby attirm that I am Iicensetl untler provisions ot Charter 9(commencing th section 7000) of Dlvision 3 0( lhe Business a Pro lons Cotle, antl .iy license is in tull force anp ftecL /�.� �� +LJcanse la�c i nse ! � Date ��//— Si9nature — �' `AKERS'COMPENSATION DEC RATION eby afiirm tnat I have a certifl of consent to selt-insure or a certificate Norkers' Compensation Insur' ce, or a certifietl copy tnereo( (Section 3800, �ab. C.) Policy No. Company eGertlfletl copy is hereby fumishetl. Cmtitietl Copy i5 tiletl with the city Builtling Division. at¢ Applicant XEMPTION FROM WORKERS' COMPENSATION DECLARATION (TM1lssection neetl not be completetl if the permit is for one M1untlre 5100) ar Ie55). /7 I certi/y that in tlte�performance of the wopCfqt wlticpyhis p �t is issued, I Date � � / �Signature ' � K�'T NOTICE: If/ait r making [his Oeclaratio you shoultl become subject to the WorkCrS' �om ensation provisions of e Labor Cotle, you must forthwith comply with such prOvi5iOn5 or [h' permit shall bE tleemetl revoketl. CONSTRUCTION LENDING AGE V I nereby aHirm that there is a mnstr c[lon lentlin9 agency for the performance o� Iho work tor which tnis permit is issuetl (Section 309] Civ. C.) Lentler's Name �en0er's Atltlress OWNER BUILDEN bECIAftATION I hereby af/irm that I am ezempt from the Contractor's License Law for the tollowing reason (Section 7031.5 Buziness ana Professional Cotle: Any city or cOunty wM1iCh require5 a permit to consVuct, alter, improve, tlemolish or repair any struclur¢, priOr to its issuance, al5o requires ihe ap0��ant fOr sucb pe�mil l0 IIIB d 5�9f1Ed SIdL2fi1COL Ihdl hE/5112 IS IIC2OSCE p11I5UdOI IO IM1C pIOV1510lIS O1 "�e Contractor's License Law (Chapter 9(wmmencing wi(n Section ]000) ot visi011 3 O( the BuSin<ss antl Profe55ion5 Catle) ol that he/she is exempt erelrom antl the basis for the all¢getl exemption. Any violdtion of Section .J31.5 by any applicant for a permit subjects the applicant ro a civil �enalty of not more than five huntlretl tlollars (E500). 1, as owner of the property or my employees witb wages as Iheir sole compensation wili tlo the work, antl the sVucture is not intentletl orofteretl :Of SdIQ ($CC(100 �044. BUSIfIC55 dlld PI01255100d1 Cotle: The COII[fdCI01�5 License Law tloes nol appty to an owner ot a property who builtls or improves thereon, antl who tloes such work nimselt/herself or tnrough his or her own emO�oYeeS, provitletl that such imprOvements are nof int¢ndetl o� otferetl for al¢. 11, however, the builtling or im0/ovement is so1G withln one year of com- lotlon, Ihc owner will �avc tM10 bur0an of proving he/she tlitl not bwitl or im- �rOve tOr the purpose ot sale�. ❑ I, as owner of ihe property, am exclusivety contractinq with licensetl con- tractors lo cons[�uct the Orojecl `$eclion �044, Business an0 Protessions CoOe: TM1e ContraGtor's Litense Law does not aPpty to an owner ot property who builtls or imDroves tnereon, antl who conVacts tor sucn projects with a con- tractor(sl ncense pursuant to me ConVacmr's License Law). I am aware that proof of Iheir Worke�'s Compensation insu�ance shoultl be providetl to me. ❑ I am exempt untler Sectlon 8. & P. C. for Ihis reason Date pwn¢r `I Orivers' �iCense ^ 4 =MF 0865�46, rev.d this app�tion antl ztate that tne above E TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T FlOnt ❑ TENANT� ELECTRICAL ❑ PWMBING ❑ MECHANICAL A Rear ❑ OTHER C Right PROJECT DESCRIP710N SQ. FT.�,/�`� OCCUPANCV _ K CONSTRUCTION TYPE '" - VALUATION S g Left ZONE GRADING CU. VDS. ACRES p�ng. flef. # Remarks: i�. � P R C D '7 g� G�i _ Planninp Noces: Sink Preventer Irrigation Drinking Pountains Floor Drains Floor Sinks Gas Service OuUets Interceptors Kitchen Sink lavatories Roof Reinspection Fee FEES Showers Service Sink Sewer Cap Sewer Connection $012I COIICLLOfS Solar Pipin. imming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash laundry Trays $15 Issue Fee $ 3 Boiler Duct - Under Ground Duct - Svuctural Duct � Ventilating Exhaust System ❑ Multiple Firepl/Fact. BIL ICBO # Heating System & Ducti} ❑0.100,000 BTU �Lt40,000 Reinspection Fee � $15 Wnite - Builtling; Canary - APPlicanh Pink � ACrounting; Goltl¢nrotl - Asse55or Hood or Typel ❑ Canopy Type I I ❑ Refrigeratio�n '" � ❑aio s�osTu ❑ioo,aoo stem Repair/Alteration Fire Dampers Registers Iwue Fee $ 3 Automatic Washer Construction PoleSub. Coaking Unit D ishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fix[ures Device Boxes Outlets Switches Garbage Dispoul Generator DO-5 KW C 9ose� i i ioaie� f 2 .� �,� Zone � -- Accessory Building: Parking Req./Provided r!�/ Cs G� a•-�7 � ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW to 100amp5 �r 100 amUs Sub Panel Motors D0�1 HP �1 %- 8 InaSolar �9-15 HP �16�15+ Microwave . Pole Light Range Standing Sections 5 KW Trash Compactor � Reinspection Fee �$15 I I Issue Fee DEVELOPMENT SERVICES RE�UIREMENTS: Zaning Approved By Buildin9 Approved By � Bo0�1 TL FEES $ 3 Z O N I N G R E Q M T S SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT-� • PLUMBING $ �SSUANCE $ PLAN CHECK 25% 5 ENERGV P.C. $ ELECTRICAL g •C�O GRADING $ PLANCHECK 50% S MICROFILM 5 MECHANICAL $ TOTAL FEE 5 �� d0 PLAN CHECK 25% $ � CONSTRUCTION AND PLANNING POOL & SPA � APPROVALS Permit# Date Inspector qppROVALS 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. Elect�ical 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-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor SYstem 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & fieceptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electriral-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 # 27. D�cts, 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. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing , 74. Overhead Hydro . . , . .. 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical , , 27. Frameand 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 8rown Coai 79. FINAL INSPECTION �. 32. Electrical Power Meter-Final ��E 80. FOOD CERTIFICATE ISSUED i 33. Final Electric � - -- Notes: . 34. Final Heating & Air Conditioning . 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Faaory Fireplace 38. Final Plumbing 39. Water Service-Final -� 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Fegulations ' • 47. FINAL STRUCTURE & BUILDiNG 48. Special Requirements Completed . � 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co ti� 51. CERTIFICATE OF OCCUPANCY _ N0. ' . �%�,• � ; (�qZ HE� � .� �� 9' � — �•� � ( Lite1.' a - APPROVED ', City of Costa Meso Building De�pi I BY �--�—� '-� RATE � � �9 �I � k ; n, nt, u.t}cS g� r;*}.ii}? AT All TilhE$ h AKE �'r.u�.. ,��GT�."t � �'� � r ::s . .�� ;�R��a�.,z�v.a. �r c _Pr. , � � v � -:,�;,.,•.:,,: - :-CP : :4 ;, �T:n�r .^: .� c�R+:�S M nFCFOvn OF r, P!I.i�Sf.:;C�9h::Flf' -.,nSFiI�U.:..?iUEtO�+5TR6E.:•iQ.Eq �. !'il:md fi1F:, il( ..n: /'.iP",(,L't.l. Jr. GI<': V10laI10` Oi' 1N' Of �iH[ Fr^!1VI$iVP.J Cf I.^:S CV:i[. "JG �c.F.,NIi PQESUM1:VJG lO iIVE I ,�u5�0ar� :G ti;ou;} �):: :.oyiEi tNe r��ov�5ta�+5 uF �.us CUCf SN�IL 9! �A:i:>, FSCEPi ir: 50 FAR AS tHE wqtK (?R USE j tVHiCH li AU1HOd�_'ES I$ IAWFUL � TME ISSU4NCE OF A PER;AIt oAS'.D U?ON P�'.r'S .ND I SPECIFtCAiI^F:5 SHqI! NOT PHE•:Et�T ME 9i;IlD:N�= •,.1.� Int � : F=:.;.: T`:F�fAi'.%1: ?cv'.iin�NG iae .;iic..: � C.^. r t F;:.::: . IN K`yiNl hG � �' �L" �vG C°CCnlOVS BFING G�HRIED �.`r iHC.�cI: :UE: w i(r� � ' '.^, Fry�SCOD'cOROsn�.�Cinia'Oa ��r.,�.Oo r A. 1 . � . I ��I �� I" /G' � 1 /+�' 1-_ � /p� � , . ✓ —,=- -� t �/ ' , , i� . �%� �. � � � � � sd'� Ma�' � � �- = --- � _ , � fjN/�� c�p ST�2 /=� 7'— /�,� � /�3 , . �y�� /b�7�2 . pwti'E2: ,./.4N��N ,�L� � FL�v.�9-T/on/• 9'�a6o�� o�.,�'�' �;,a � s7�a � PLANNING DEPT. ilf�lfiCT TO 6lDCi. DE►T. �EO. ot �ue�Mllio nau/ �'fi �cr� pc,� s�S,g�S . � . .> � � _ 0 �1 J �2 HEIi�Z 2 � � - � � i � ,�-�v � ` /83 � .. x� � , :. .� . �� ' 1t ` !•� . �, , � �n � p.� �,. � 9 � � ✓ . ' j �' ' , �t , ,�+� � .r-- —� � O�oL f� ��. li�� l � — �„¢� � '� � _� ' Ej/V/ � /L � r0 ,9�17/ZH�s� c�.�/ G%V�c'J�j _ . i�i � /83 ��yr` a�r /6�7„2 pWN`EJ�: .,/�4N��N �L� �' ELFY�T/oN: q'�a6o�� c��' /:a¢ � sJ�¢ %' . �� : CITY OF COSTA MESA ` PlANN1NG DEPT. � �s��u:�ay ro eto�. oEet. �co. ' . [ �f'�"`�ATE.—�� '�b7 D�xectCs e► rukt+�+o STP_ /=� T �s�v �i�,o,� .�'�— f �5 � uN,onl `T . : ; . . p�� µ�D �l :: • . . = ' � � �20�0�? � . .. � d Oc� N �. � �, N \ . 512d � �� i / _ ' �.�� I.�y - �/Y'--rr, c: .� .. , ��" �� 2 /�S f ��K �-��"� : �/9 �� , � � . ,�o �,�wc�I"� . / !:'�� u. Av �=J�� V 1 ` � M i7 � (o�x6 �/o r��rs ru�s� . ` � , /�� eLX o �/f�".� " �� 3�% ;/� #� Q�", o.�, c,�x � � /6" � �r�cGZ�I ''�i � �r�a 6a�, �" �'"`� i ll��c101X/ iQ 3 `— �f ° � .r�o1� � //��•-,�° ,�r• s/,:(¢ � � �� _z� � s�o�¢ - �xh7�'!'m Y 9Lc. e u� N-. ��c e j� 4�+0 ��'� sI�I � � // / � x �/� C7�2o�,� 6 �Ci, �e�,' a2T '•.� f�i u-�x, �88 �,Il• = 4� Su F�, C fLc I1 � h c� � 1`� S �i �( ��.(, �� ppr: � � ,Q� 1 � or d t�ry � (/ 6z��m � /� ,;�,k�� .��"-6'� � r^y�>.1 ,=c;�7 u c � a� �. I �,z,,.�u�,�s�-�:, cK. rr� , .,,,/,y 21� �4 t,�i"�^'� % �; . .� / / / � �'/ / ; `II aa''ae : f ' � j' / �'� , " �� pf��l� '�L � wc�� .Ba (� �t'" �� I P��Z_ �� r' M � bloG�i��•� . d,,,,,6/� � -'��'// �/::fL �� H•l . , `� . ; i � . �. � � u 5 d . , � ,. , . :,_S� �4ta�?'��; . � , � � �-k `'�°�` � � � . =A �:,� .,. �L� ... . ' • �,�' . � _ ;� � � � � � . �� . � / : � . �� , �y� i � �� • �` - � ; . � - � ,� � ; � -tir'".°� _. �1 ��' n �, � . • �ii rr •�`o � � �� ' ' � � . I � ' o aa��q 1 ` . . � h` � � ' � � � , � - i °I Sr/ I °.� �� . i (�N/Orv �xlsf. r � " �'� °' ' ' ^� � � . � . � .. �.4 , � � k�, ` ` - ,� �' . � � . � � � �� -. ' � b ,� 3v 4-� �� r — , � Q * X/'s . 0� " ✓ J � hClL we/�S � , �g o��' - N � �N . S� �� ..�... . - - . - X- ' �� AOO�icant to fill in all spaces except thoze witnin neavY oortler iines ana sign a11 aoc�oVriate aeclarations. ' CITY O.F COSTfl MESA CONSTRUCTION PERM T PERMIT NO. TRACT NO. LOT NO. UNIT N6. P,oiee��ddress ��/o l�Div/0/Y �/�; ��i N¢�a �'P 29%%z �% Z /� Applicant'sMaiHngAdd�ess r•O,p• I�f�p �,Pfo- TVPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR " ✓'g.NS�N � �j� �� 72'�_7�8/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A P # /r� Owner's Name Phone T Address rj',rJ (iN/Qw �(�, L�nY�+- r/2fa DESCRIPTIONOFWORK/USEOFBLDG. S MainBuildi � E ArchlEng. LicenSeNo. TVPEOFPERMIT GRADING FOUNDATION ��STRUCTURAI. T Front Address • Contractor's Name �'� �`J � a+-- Pho% e'� _�1 �-�66 Address (mailing) �7�/ �/I'YJ � d� [.B"��G�a� City License No. f 23 LICENSED CONTRACTOR DECLARATION I hereby at(irm [hat I am licensetl untler provi5ion5 of Charter 9(commencing vith section 7000) of Division 3 of the Business a��]]d9''��ro�epsions Cotle, antl ny license is in iWI force antl tecL �//i , �� License C a ��pse F! 7, — Oate Signatu�e WORKERS' COMPENSATION DECL ATION '�ereby atfirm Ihat I have a certitica f mnsent to self-Insure or a<erHticate Workero' Compensa[ion Insuran , or a certifietl coOY [M1ereof ($ection J0, �ab. C.) Policy No. Company eCertitietl copY is hereby furnishetl. Certitietl mpy i5 filetl with the city Builtlinq Dlvision. Date APplicant EXEMPTION FROM WORKERS' COMPENSATION DEC�ARATION (This seciion neetl not be mmpletetl if the pe�ml[ is for one huntl (5300) or 1255). I certify tM1at in the performan<e of tM1e�� fo� wh' f Rhis mR is I55ueQ I shall not e plo any pe�son in any m n so�beco ubject to Ihe Wo�kers' n Laws of Califo � Oate Signature Ff NOTICE It, te� making tbis tleUarati0 you Shoultl become SUDject [o [ne Workers' Compensation provisions of Labor Cotle, you must forthwitn comply with such provisions or th' pe�mit shall be tleemetl revoketl. CONSTRVCTION LENDING AGE I nereby alflrm that there is a mnstru ion lending agency for the peAormance of the work for which this permit is i55ueU (SectiOn 309] Civ. C.) tPntler'S Name Lentler'S AOtlress OWNER BUILDER DECLARATION I hereby atfirm inald am exempt trom Ihe Contractor's Lit¢nse !2w tOr [he following reason (Section ]031.5 Buziness antl Professional COUe: Any city or county which requires a permit to construct, alter, improve, tlemolish or repair any structure, prior to its issuance, also requirez lhe applicant for such permit to tile a signetl zlatement that he/she is licensetl pu�suant to Ne provisions of the Gontractor's License Law (Chapter 9(commencing with Section ]000) of '�ivision 3 of the Business antl Professions Cotle) or lhat he/she is ¢zemp[ +.refrom antl tne basis for the allegetl exemption. Any violation of Section 31.5 by any applicant for a pe�mit suDjects Ihe ap0lican[ to a Civil nalty of no[ more than tive huntlretl tlollars (E500). � I, as�owner of the property or my employees with wages as [M1ei� sole mmpensation will tlo the work, antl [he st�ucture is not intentletl or olfer¢tl for sale (Section ]044, Business antl Professional Cotle: The Contractor's License I,dw tloes not apply to an owner ot a property wno builtls or improves thereon, and who tloes such work himself/herzelt or through his or her own employees, provitletl that such imp�ovements are no[ in[entletl o� offe�etl for Shce. If, howevm, fM1e builtling or improvement is soltl witllin one Year of cam- �Ietioq lM1e owner will have Ihe burtlen of proving he/she tlitl not bulltl or im- 'ove tor the purpose ot sale). � 1, as owner oi the property, am exUusively contractlng witb licensetl con- lrattorsto consVuct tbe project (Section 7044, Business antl Professioni Cotle: The Coneractor's License Ldw tloes mt apply to an owner of property who builtls or improves ihereon, antl who contracts for such projects witb a con- tractor�sl ucense pursuant to the Contractor's License Law�. I am aware that proof of their Worker's Compensation insurance shoultl be provitletl to me. � 1 am exempt untler Section B. b P. C. tor this reazon Date 1 her¢by certif� iniormation is c -antl state laws sentafives of tl inspection purp� Signature Drivers' License .� CMF 0865-46, rev. 1 �� L Owner _ that I have reatl [his �n antl stale that the above clty antl couniy ortlinanc¢s antl herebv autho�lie ren�e- ❑ TENANT �, ELECTRICAL � PLUMBING ❑ MECHANICAL 6 Rear ❑ OTHER A PROJECT DESCRIPTION 5q. F7. oCCuaArvcv — C Right CONSTRUCTION TVPE Y�� VALUATION $ �j� -¢Q� g Left � ZONE GRA�ING CU. VDS. ACRES Ping. Ref. # qemarks: Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Foun�ains Floor Drains Floor SinkS Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof�Drains Reinspection Fee §15 Boiler Ducl - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Pact Blt ICBO # Heating System & Ducting ❑0-100,000 BTU 0100,000 � �— I I Reinspection fee I $15 White - Buildin9; Canary - Applicanq Pink ' Accountin9; Goldenrod - Assessor Showers Service Sink SewerCap Sewer Connection Solar Collectors ' $olar Piping Solar Tank Swimmin9 Pool w/Spa Urinal Water Closet 'Water Heater Water Service Auto�Wash Laundry TraYs Isue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteretion Fire Dampers Registers Issue Fee FEES $ 3 FEES $ 3 Automatic Washer Construction PoleSub. Cooking Unit Di5hWd5h21 lettric Fan F.A,U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0�5 KW Fee 47. 2one � � � Accessory Building: P�ark�ing —Req./Provided 'L,/i B"�� ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Merer ❑up to 100 amps Meter �over t00amps Sub Panel Motors OO-1 HP O1'/:-8 Inc.Solar �9-15 HP �16�15+ Microwave Pole Light Range Standing Section: 15 KW Trash Compactor $15 Issue Fee DEVELOPMENTSEFVICESREQUIREMENTS: 2onin9 APProved By Building Approvetl By �ql FEES $ 3 Z O N I N G R E Q M T S .,/(�1(niQ�pi/�j�/LJ SUI.S� 00 FEES �iJILDING�PEFMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING 5 ISSUANCE $ PLAN CHECK 2596 $ ENERGY P.C. $ ELECTRICAL 5 GRADING 5 PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ _1S.ea PLAN CHECK 25% $ CONSTRUCTION AND�PLANNING POOL & SPA � ` Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# 1.; Temporary Electrital Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-UndrgrnU. �� • 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electncal Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. r�f 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. r/ 8. Foundation .' 59. Gas Pipe, O Undrgrnd., Test � � 9. Water Pipe-Unc(rgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. ' 70. Structural Floor Syst�em ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 72. Sewer Cap ,.*' 63. Heater & Vent-Final ' , 73. Roof Drains 64. Plumbing SYstem - Final 14. Rough Plumbing -�" 65. Electrical-Final 15. Rough Electrical;Conduit 66. Solar System-Final _,i 16. Rough Electric Wiring d � 67. Fencing & ACce55 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 # _ 27. 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 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 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 7$. 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 39. Water Service-Final � � ' � 40. Gas Service-Final � � 41. Solar pomestic-Final � 42. Backflow Preventer � • 43. Backflow Irrigation � . i�, � 44. Landscape Irrigation System � � 45. Sound Attenuation � ' `' 46. Handirap Regulations . � ' 47. FINALSTRUCTURE&BUILDING � � ' �' ' � • � 48. Special Requirements Completed � �• . 49. Electric Release to Edison �� 50. Gas Release to Southern California Gas Co . �f'� 51. CERTIFICATE OF OCCUPANCY . No. . ' ' � � � ; ✓�,E'�7/ .�4�E ,_ETTC,e .�rai� ��/�z ;ss �,�� c ��oro�� '�'o�c�1 . i� � � . . � � S �, 2 y��CG/ ��' �G/"//� � ��G1 Q� � Y -� �� 4 q !%sa a/�t1 C��s��i>� . ,/ �v�= LC� ,� -c*JiLu�r- / Gi� /� J �j779 .� /��7 ti ._,.�,—w,�m�v�, M.�.ro_o„�,ea,��s, _��s J City of Costa Mesa I N S U LAT I O N C E RTI F I CATI O N� auilding Safety Division C'j.("� (//(1/ p/L/ �FJS' � �Q S'�z � Number and Street City Counry Subdivision Lot Number DESCRIPTION OF INSTALLATION c�X �.�D �d/v^ ROOF / � /,{7� Material �� /T�� h2�/�c�/S`%7pl�ctcBrand Name � x ' / �H��r//Q Thickness (inches) � � � � T Thermal Resistance (R Value) ' � �y EXTERIOR WALL Material /'� /� �ii Thickness (inches) CEILING � � Batt or Blanket Type Thickness (inches) Loose Fill Type �/r Minimum Thickness (inches) Area Covered (ft2) ��%O S�f- FLOOR,ELEVATED , Material C-�� ii Thickness (inchesl � FLOOR,SLAB Material �-1�G� � r� � � ii Thickness (inches) Width (inchesl— FOUNDATION WALL Material Thickness (inches) Brand Name � /�'"�_�'"�l�Q Thermal Resistance (R Value) � �� Brand Name �%*�-�-�-�/i//G Thermal Resistance (R Value) � �� Brand Name _ Number of bags Weight per bag Ib. Thermal Resistance (R Value) Brand Name Thermal Resistance (R Brand Name Thermai Resistance (R Value) Brand Name Thermal Resistance (R Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code�. �//i/ �'O/V S T•2f/Gi T/ O/✓ Generel Contrec1o718uilder) � —o�trv�c Signature and Title Sub Contractor (lnsulation Applicator) Signature and Title CMF 1306-46 � �f7l77 9 License Number ii zi �� Date License Number Date . 1 • � , , � SUBCONTRACTOR LIST City of Costa Mesa — Planning Division P. O. Box 1200, Costa Mesa, CA 92628-1200 Builder Address Phone 1ob Site Date Pennit # Valuation TRADE SUBCONTR.4CTOR ADDRESS PHONF.. ASPHALT CABINETS CARPETS CARPENTRY CEMENT CONT. CEMENT TRANSIT � CLASSIFIED SPEC. CLEANUP/HAULING � DOORS (GARAGE) � � DRAPERIES � �� DRY WALL � ELECTRICAL � � � ELEVA'TOR � � � EXCA V ATI ON FENCING � FIRE EXTINGUISHER � . � FLOORING/DECKING FORMICA \ FOUNDATIONS � � GLAZING � HEATING \ INSULATION � � LANDSCAPING � LATHING LINOLEUM/ASPHALT � TILE/GUNITE � MASONRY � PAINTING � PLASTERING � PLUMBING POOL REFRIGERATION � ROOFING SANDBLASTING SEWER SHEET METAL SHOWER DOOR SOLAR SPRINKLERS STEEL REIA'FORC. STEEL STRUCT. STUCCO I TV ANTENNAS', WALL COVERINGS WEATHER STRIPPING OTHER SPECIALTY `d:0701�30 rev.30/BS � CITY OF COSTA MESA DEVELOPMENT SERVICES DEPARTMENT PLANnING DIVISION OWNER BUILDER CERTIFICATE OF EXEMPTION I am fully aware of the responsibilities as owner builder. The persons named below are my . employees and 1 agree to witiiltold the followin� required deductions: Federal and State Income Taxes, Social Security paymenis, and Wo�cmen's Compensation Insvrance Premiums. My employer's number is . Further, I hold no objection to a copy of this certificate being forwarded to any govemmental agency upon their request for same. Employee's Name Address .`Social Security No. Under penalty of perjury, 1 declare that the above statement is true and correct to the best of my knowledge and belief. Date Address t'_ _ ` ,1 `+ . i�1—',�� !. ��`�F C�STA N�9, CONSTRUCTION AOV��ant to fiil in all soaces except tMose wit�in heavy borCer Iines anC sign all Address ti�� ✓�v�viv i�v�-,� ��i� i ic�rr Arch/Eng. License No � . Address � Contracmr's Name '-7 S��G P io � I Address (ma"I�ngl� '/ r1 , �/�/G' E/�CH City Licensr No � /� Zg LICENSED CONTRACTOR DECLARATION I he�eby a�titm thai 1 am Ilcensetl untle� ptovl5ion5 of C�arter 9(commencing �ith Section 7000) Ot Divislon 3 of the BuSiness antl Profes5ion5 Cotla, antl iy license is in /uu (ort�a effect. �79 �� y". License C��''�'��s Licen N�� Oate��L'7 519 t � ��k/�� WORKERS'COMPENSATION DECIARATION . ^reby afiirm that I have a certificatrlof consent to selt-insure or a tertiiltato Wo�ke�s' Compan5ation Insuranc�y� o� a certlfietl copy tha�eof (Sec[ion- J0, Lab. CJ __ Policy No. Company 1 8 Certitietl copy i5 hereby tumishetl. A . � Certifie0 p f" etl wilh,the city Buil�Divisiopf/ Date � � ' � APplicant�/��j'1��' ' � • EXEMPTION�FROM WORKERS' COMPENSATION DECLARATION (This section ne¢tl not De cOmpletetl it the permit i5 for one huntl�etl (E100) or - less). �" � I cerlity tnat in the per/ormance of the work for which thls pefm�t Is Issuetl, I shall not emp oy any pe�son In any Tdf1O�5B d5 IO beco ubj¢Ct t0 [h! Workerj Co pon o Laws of Calitor ia. Date/ , ^�Signature - � � NOTICE: 1, aft r making this tleclaratlon, ou shoultl become subject to the Wo�kers' COmpenSation p�ovisions ot th L:abo� Code, you must forthwlth tomply with such p�ovisions or thi5 permit Shall be tleemetl revOketl. CONSTRUCTION LENDING AGENCV 1 nereby af(irm that tnere is a conztruction lentlin9 agency for the performance of tbe work far which this permit is Issuetl (Section 304� Civ. C.) Lentler's Name � Lentler's atltlress OWNER BUILDEH OECLARATION I hereby affirm lhat I am ezempt trom the Contractor's License Law tor the following reason (Section �031.5 Business antl Professional Cotle: Any cl[y or county which requires a permit to construct, aiter, improve, aemolisn or repair any itructure, prior to its issuance, also requires the applicant for such permit to file a signetl ztalement tha[ he/she is IicenSetl pu�suant [o the provisiOns of the Contractor's License Law (Chapter,9 (commencing wiN SecUon 7000) oi ��vi5ion 3 of [he Busin¢55 ana Protessions Cotle) or that he/She is exem0� ere(rom antl lne basis tor the alle9etl exempcion. Any violation of Section 31.5 by any applicant for a permi[ subjects the applicant to a clvll �ndlty of not more t�an five huntlretl COIlarS (5500). 1, as owner of the Oropetty or my employees with wages as their sole comp¢nSatiOn, will tl0 the wo�k, antl the st�ucture i5 no[ inientletl or otfe�etl tor sale (Section 7044, BuSinesS antl Pmfezsional Cotle: Th¢ ContrattoYs License Law Coes not apply to an owner ot a propercy who bulltls or imDroves thereon, ana who tloes sucb wo�k himself/M1erself or through hiz or ner own employee5, provitletl [bat such improvements a�e not inten�etl Or oife�etl for sale. It, hOwevet, lhe builtling or Improvement is Soltl wlthin one y¢ar of Com- letion, tne owner wiil nave the burtlen o( provin9 he/she tlla not builtl or Im- •ove tor the purpose of sale). .� 1, as owner o/ the prooerty, am exclusively contracting witn licensetl con- tractorz to con5i�uct lhe prOject ($ection 7044, Busine55 antl Professions CoOe: The Contractor's License Law tloes not appty to an owner of prup¢rty who builtls or Improves thermn, antl wno contracts tor such projects with a con- [ractor(5) Imense pu�suant to the ConVactor's License �aw). 1 am aware that proo( o( lheir Worker's Compensatlon insurance shoultl be provitletl to me. ❑ I am exempt unCer Section B. & P. C. for this reason Date Owner I M1ereby certify that 1 have rea information is mrrecL I.e9ree to �antl sta[e laws relaling'Co builtlir sentatives oy this,ci[f�o.enttr 'inspecUon p rposei� / tion antl state that tne above all city antl muniy ortlinances �, antl hereby authorize repre- oove-mentionetl /P�iop/'ty for) � Oai�/o P 'P/ i ��P �� s2 �/z 3 TVPE OFCONSTRUCTION NEW DD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH OTHER A p # DESCRIPTION OF WORK/USE OF BLDG. - ' ' S Main Building: E TVPE OF PERM�IT j GRADING�y FOUNDATION TRVCTURAL T Front ❑ TENANT 't+ELECTRICAL 6LPLVMBING ❑ MECHANICAL A Rear Q� �0 OTHER ' C Right � � PROJECT DESCRIPTION �54. FT. oCCUCAN v K CONSTRUGTION TVPE VALUATION $ _��Q,�= $ Left 20NE �;GRADINO GU.YpS. ACRES P�ng. Ref. # Remarks: - Planning Notes: Preventer I rri9ation 7rinking Fountains Floor Drains FloOr Sinks GasService Outlets I nt¢reeptors Kitchen Sink . Lavatories Roof Drains Reinspection Fee VLUMBING Service Sink Sewer Cap Sewer Connection $olar Collectors Solar Pipin9 Solar Tank Urinal Water C1052L � ' Water Heater Water Service • Auto-Wash Laundry Trays $15 laue Fae Boiler Duct � Under Ground Duct - Strucmral Duct - Ventilaring Exhaust System ❑ Multiple Firepl/Fact Bit. ICBO � Heating System & Ducting ❑0.100,000 BTU �10� I D� L' ' S5 � _ � � Reinspection Fee CMF 0865-46, rev. 10%89 White - BUIltlingY Canary - qpplicant; Pink - AC<ounlin9: Galtlen�Otl - Assesm� $15 Hood or Typel ❑ Canopy � Type I I ❑ Refrigeration System ❑0-100,000� U ❑100,OOOBTU Sys�•flepa ir/Alteretio n Fire Dampers Registers " � Issue Fee FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Oryers �Gas ❑Elecn Fan F.A.U. Fiztures Device eoxes OUNEtS • \_ � Zone Accessory Buildin9: 2 O N I N G R Parking Req./Provided E � M T S EIECTRICAL Transformer ❑ 75-50 KW ❑ 50+KW Meter �up to 100 amps Meter pover 100amps Sub Panel Momrs OO-1 HP O1'/, � 8 Inc. Solar �9�15 HP �16-15+ Microwave Pole Light - Range • Garhage Disposal I I Standing Sections Generator �0-5 KW �5-15 KW Trash Compactor FEES $ 3 I �— Reinspection Fee $15 Issue Fee $ 3 FEES DEVELOPMENTSERVICESREQUIREMENTS� 7i/1/. �.� 2oning APProved BY I��'�.� Date Building Approved By Date Application laued By Dat� SUMMARV OF FEES ' 'r BUI LDING PERMIT $ II D� S!7 SMIP $� PLANCHECK $ �I�- � PERMIT PLUMBING $ �(e. E�O ISSUANCE $ PLAN CHECK 25% S 3.15 ENEflGV P.C. $ . ELECTRICAI $ 6. Oo GRADING S PLAN CHECK 50% $ I. 5� MICROFILM $ MECHANICAL S TOTALFEE $ ��b .Iv $ 3 PLAN CHECK 25% $ CONSTRUCTION AND PLANNING � POOL & SPA APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 'f � 2. Soil Pipe-Undrgrnd. �Z (+lf•0 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. 8ackwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor Svstem 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection g�,� G�p 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing ��7 G� 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 79. 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 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro , 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe � � 28. Lathing & Siding �� 3 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINA� 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: �� Qy ra 34. Final Heating & Air Conditioning � h 1 �� 35. Final Gas Pipe-7est . 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing , ' � 39. Water Service-Final - 40. Gas Service-Final . 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation � � .1 44. Landscape Irrigation System ' � 45. Sound Attenuation 46. Handicap Regulations ' � ' 47. FINALSTRUCTURE&BUILDING � G. ,� 48. Special Requirements Completed � ' / 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY ` nio. y n CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT -� �7� . � � - ,..- . � ��.�., . ., .. ., Developer/Applicant: �i}"/�S,C/{/ GL/%�/%% •�L/�� / � �- Address: "T��f 1�/fi//i/(/• � i G/��%l4 �-FQA �� % '1'elephone Number: ��/ / �GZ' �7�� — Tract/Parcel and Lot Number(s): �7 �� , ^- Q �t(��- i � C�- J/ / Location of Project: ��%Y,-- o ,lr �%�P- v - .� Number of Square Feet of �,%Q ^ Residential Space v` a� x$1.50 Number of Square Feet of �__ Commercial and Industrial Space � x $0.25 Tota1 /-�� - -- - o Total The provisions of Government Code Section 53080 are not applicable. This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995. Checks are to be made payable to Newport-Mesa Unified School District. ��n� Business Manager Newport-Mesa Unified Sctiool District The above representation as to:�squ°are footage is true. Developer/Applicant agrees thaC if it is later determined that such representations are not true.then this certificate shall automatically terminate and the appropriate City/County shall be notified: (3 �� Date: � n eveloper/Applicant � / /I i�k�Cic�� . �..