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PROJECT ADDRESS: 1775PLACENTIA AV
UNIT'CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 063894
OWNER'S NAME: BOYD ENT
ADDRESS: 1788 EDINGER AV PERMIT NO: P 063894 PLAN CHECK NO: N GOVT: N SUPP: N
S.A. , CA
CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: REP
ARCH/ENGINEER:
258-1177 gEC.NO.:
ADDRESS: UNIT:
JOB DESCRIPTION : INSTALL GAS LINE FOR DRYER SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
PERMITTEE PARKER PLUMBING 714 ) 646-0300
ADDRESS: 464 N NEWPORT EL COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
CM CA 92663
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.a y icen e is in full force and effect. SETBACKS
CITY uc.: 056 25 STATE uc.:64273cuss:
H..1Date: Signature: "AtiJ a MAIN BUILDING ACCESSORY BUILDING
WORKERS'C MP SAT ON DECLARATION: I hereby affirm that I have a certificate of consent to selllnsure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensa ion Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP. DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 42621302 ZNE: REF NO:
Certified copy is hereby furnished. Certified copy is filed with the city Building Division. PLANNING NOTES>
Dale: Applicant: C*.******iE********************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This se '. .ed not be co pitted if . lima is I one hundred WOO)or less). DEVELOPMENT S E R V•I• C E S _ REQUIREMENTS
I certify that in the performance of the work for which this permit is sued, all net ploy in ley manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE:
Date: t/t, 3 Signature: x
7 Code, :
If, Iter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY • m DATE
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: l0
which this permit is issued(Section 3097,Civ.C). JX.*.
LENDER: ADDRESS; LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 5 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SNIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 . 00
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING-D IV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS---->5 . 00 2 0 . 00 0 . 00 2 5. 00 25 . 00 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own
is
employees.provided
year
that ph improvementsme are not intendedheor offered for shee./
s a
hn,
orimprovementsoldwithinofprovingnotbuildor
improveg
for purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25,00
and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).lam aware *.*.***.*.****.****.*.**.***.****.******{(•**.**-*.N..)4*****************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
o I am exempt under Section:B.S P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: owner:
PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 00 5 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES25534andthatoranyfuturebuildingoccupantwill/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Au Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the a.• in•m ion is cor ct.I gree to comply with all city and county
ordinances and state laws relating to building construction and here. authorize a esentativ of tb citytoe ter upon the above-mentioned
propertyerfor inspe ion purposes. j
1
Dale'.1//G ey Signature: Z, _
5! SSS///
0100146644-00146644 TOT 25.00DriverLiceneorSocialSecurity4: DATE: 09/10/93 TINE: 12:19
1641.46 white—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
r LI
CONSTRUCTION AND PLANNING POOL ?A
APPROVALS Permit #
Date Inspector
APPROVALS Permit # Date Inspector
r
1. Temporary Electrical Service Or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
a Electrical ConduitiUtitity-Undrgrnd. 54. Forms
4, Electrical ConduitkUndrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test I+
6. E'ectrica OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings
I
58. Electrical Conduit-Undrgrnd.
8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15 Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
I j
H 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING j
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Robyn Fjctory Fir-e'piece i I , : : i aPPRQVALS- ' Perriiit# ,
21. Ducts,in Structure 70, tndergrb'und Hydro -
21. Duct;, Ventildung i .. i171. ProductPjning 0 Gas O.Oil
i
73. Gas Pipe-Rough & Test t 72. Underground Flush '
24_Root Framing 73.•M.lndergrndi.Storage Tank Gas ;a.
r
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceding IStrt'turall & Monocoat 75. Dry Chemical
27, Frame aro Flashing 76: Dry Standp;e
28. La±hind & Siding I 77:T,FIXED SYSTEM FINAL . . ,
29. insulttio-^ 781.FIRE PREY. FINAL
33. Drywall Nailing I I - HEALTH;DEPT..PEQUIR SIME NT
31. Paster Brio -n Coal •ia 79. FINAL INSPECTION •
32 E'cr-trical PoWer Mitar.F!na' ;I 80.• FOOD CERTIFICATE ISSUED
33. Firal Eiectric i I Notes:
I
34. Final Htatinbi& Al.-Conditioning
I
35, Final Gas Pipe-Test
I. •
9/4 VI D i _
36. Hood or Canopy i
37..FinalFactory Fireplace- ,
38. Finai Plumbing 0.7/ Ca - f_
39. Water ServiceFirial
40. Gas Service-Final
41, Solar Domestic-Final I
42. Backflow Preventer I
i
43. Backflow Irrigatio n
44. Landscape Irrigation System
45. Sound Attenpation
46. Handicap Regulations
i
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING I
49. Electric Release to Edison
I50.-Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No. Date
4,
PROJECTADDRESS: 1775 PLACENTIA AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT rtJM NO: M uDbly'.
OWNER'S NAME: BOYD ENTERPRISES
ADDRESS: 1946 E. EDINGER AVENUE PERMIT NO: M 056194 PLAN CHECK NO: N LjOV1 : N Suit': N
SANTA ANA, CA
CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH
258-1177
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : C/OUT DUCT ALTERATION/REPAIR SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: 4, 500. 00 CALC—VALUE: GROUP OCC: B-2 /
PERMITTEE: GRAHAM BROTHERS 714 ) 546-1653
ADDRESS: 2952 CENTURY COMMENTS : AN BUILDING ALTERNATION NOR T. I. WORK
COSTA MESA CA 92626 aE±FSE*AF***E*******E****#************* x+i****qtr**)6*******#*u-
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my Been a is in full force and eeect. SETBACKS
CITY LIC: 0 59 3 STATE LIC.:2486 Tum. —20
0 MAIN BUILDING ACCESSORY BUILDING
la e: Signature:.) FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
WORKERS' MPEN ATION DECLARATION:
1hI
hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT INCompensationlnsyranyc.gr a cOt e61 copy,
bereot(
Section 3800,Lab.0.8/0 1 /9 2POLICYNO.: _ EXP.DATE:
COMPANY: LIBERTY MUTUAL,
s
PARKING REO: PROV; PARCEL : 00000000 ZNE; REF NO;
1 Certified c y is reby furnished. LJ Certified copy fled with he city Building Di 'Sion. PLANNING NOTES>
a0]iE****iE***** '***************;c**x.**a0******************ft***iE***l0******ir*****Applicant.
DEVELOPMENT S E R=V I C E S REQUIREMENTSEXEMPTIONFROMWOKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1®(or less).
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE;
Date: Signature: BUILDING APPROVED BY •• DATE;NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
e
q'
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE• / /c 2
which this permit is issued(Section 3097,Civ.C). sr' K* *1r3fx";FzTSRk 3ei(
UNDER: Y.r.*****K*********1F**
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 18 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25t SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LANandProfessionsCode)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by y
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the
BUILDING—DIV—> PERMIT ISSUE PIAN—CHECK TOTAL PAID DUE
structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S----> 18 . 00 1 S . 0 0 0 . 00 3 3, O U 33 . 00 0 0
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS——> COLL EC TED: 33, 00 OVER/SHORT• 00
torptheepurrpose
ofMsaenin
one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 1 33 .00
and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *'**'*'*'*'*'*'**'*********+E'***'*****************************IE*If********************K***
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
1 am exempt under Section:B.8 P.C.
for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: Owner MEC 1 REFRIGERATION SYSTEM <= 100 K 3TU/H 9 . 00 9 . 00
I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and NEC 2 VENTILATION FAN CONN TO SINGLE DUCT 4 , 50 9 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEESpermitforconstructioncrmodificationfromtheAirDualityManagementDistrict.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above mf rmation is correct.I agree to comply with all city and county
r:
1211C7/Li- U 1 T:;b: i
ordinances and slate laws relating to building construction and her authori reprS$entativeso this city to enter upon the above-mentionedF f p
property far inspect lin purp a
1/
v'
I !
a7 . Il!/i_r TTj:'' 1 t•- '.
Dale: = Signature: 1
Driver's License lir Social rity 4:
1641-46 White—Building:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor
J
CONSTRUCTION AND
PLAf4NINGPOO WA
APPROVALS Permit#
Date Inspector
APPROVALS Permit #
Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd, 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System S Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank Gas 0 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 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 l Notes:2j1&1QZ f ess L04Ci[.o-G.£4
34. Final Heating & Air Conditioning 4fr(/r&&m
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 Domestic-Final
42. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co l
51. CERTIFICATE OF OCCUPANCY
No. Date
PROdECT11ODPE55: • 1775 PLACENTIA AV UNIT: t ,OF COSTA MESA — BUILDING PERMIT PERM NO: E u7D'3a'
OWNER'S NAME: BOYD PROPERTIES
ADDRESS: WILLIS BOYD PERMIT NO: E 05 A PLAN CHECK NO: N UOVd : N SOYr: N
1946 E. EDINGER
SANTA ANA, CA CONSTRUCTION TYT PERMIT TYPE: ELE PURPOSE: OTH
258-1177
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION SINGLE PHASE METER—SERVICE UPGRADE SQ FT;
ADDRESS: UNIT:
CLAIM VALUE: 1 , 500 . 00 CALC—VALUE: GROUP OCC: B-2 /
PERMITTEE: PM ELECTRIC 714 ) 590-7026
ADDRESS: 4821 LANIER CT COMMENTS: *
CHINO CA 91710 kr**+E********* ***sB******aE**I6*** ******************s6*****sE********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
clic tic.: 055145 STATE tic.: 5 3 6 3 7 2 C •CO
pate: /—Z7-12— Signature
MAIN BRIARING ACCESSORY EAILDING
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l ve a certificate of cortsen sell-insure or a certificate of Workers' LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT INCompensationInsurance.or a certified copy thereof(Section 38 Lab.C).
PCMY : EXP.DATE:
PARKING REO: PROV; PARCEL; 00000000 ZNE; REF NO:COMPANY: PLANNING NOTES>1 Certified copy is hereby furnished. Certified copy is filed with the city Building Division.
Date: Applicant: DEVELOPMENT - S E R V I C E S REQUIREMENTS
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Nis section need not be completed if the permit is for one hundred(5100)or less).
I certify that in the performance of the work for which this permit is issued,Ts II not e toy any person i ny manner so as to become
subject to the Workers'Compensation Laws of California. A// ZONING APPROVED BY G' DATE
i1e: /`27-4`L-5inawre: BUILDING APPROVED BY : DATE:NOTICE:H.alter making this declaration.you should become subject t the Workers' mpensati provisions of the Labor
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
e J
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE
which this permit is issued(Section 3097.Civ.C). E****) * **N*•• N****************SF *
LENDER: ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby allirm that l am exempt from the Contractors'Stale License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 18 50
repair any structure.prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed t 0 t SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLANandProfessionsCode)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not mare than five hundred dollars($500). ISSUE FEE 15 . 00
I. as owner of the property or my employees with wages as their sore compensation, will do the work, and the
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 18 , 50 1 S, 0 0 0 . 00 3 3 , 50 33 . 50 0 0
does not apply to an owner of a property who builds or improves thereon,and who does such work himsell/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale. II,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 33 , 50 OVER/SHORT• 00
improvement of sale).sold within one year of completion.the owner will have the burden of proving he/she did not build or improvefororthepurposese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting With licensed contractors to construct the project(Section 7044,Business
33 . 50
and Professions Cade: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *"N'***********************lE*****'x'****************N'******************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
I am exempt under Section:B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18. 50
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and slate laws relating to building construction and hereby authorizer it entative of this city to enter up in the alp e-mentioned
property for inspection purposes. n i
ate: (—
27r it— Signature: . ' , is " 'l" ir
Driver's License or Social Security v: 71yF7;e—finT517:4r —'2 -
164146 White—Building,Green—Code Enforcement:Canary—Aeolicant:Pink—Revenue:Goldenrod—Assessor Vl i..- N!.. 'V :. IL t,_` ,
CONSTRUCTION AND PLANNING 7 POO. , SPA
APPROVALS Permit#Date Inspector
APPROVALS Permit
Date Inspector
1. Temporary Electrical Service 4r Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Un&tgrnd. 54. Forms r,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
1
7. Footings 58. Electrical Conduit-Undrgrnd.on
8. Foundation rq4 59. Gas Pipe, Undrgrnd., Test i'ea
9. Water Pipe-Undrgrnd. ! 60. Backwash Lines,P-Trap, 0 Undrgrnd. Q
i
10. Structural Floor System ; 61. APPROVAL TO DECK i
11. Property Sewer Line & Houtr nnection 62. Backwash & Receptor-Final i
12. Sewer Cap j 63. Heater& Vent-Final
13. Roof Drains 1' V 64. Plumbing System - Final Jit+
14. Rough Plumbing
7
65. Electrical-Final r
15. Rough Electrical-Conduit9 66. Solar System-Final
16. Rough Electric Wiring9 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Aar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil
23. Gas Pipe-Rough & Test9 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas Oil
25. Roof Sheathing 74. Overhead Hydro
26. T- ig (Structural) & Monocoat 75. Dry Chemical
n- i Flashing 76. Dry Standpipe
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 Z 2p 9z d 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 Domestic-Final
42. Backf low Preventer
43. Backf low Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS:
10.
UNIT:
OWNER'SNAME: 1775 PLACENTIA AV CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05573E
ADDRESS: BOYD PROPERTIES
1946 EDINGEREAV PERMIT NO;
SAN
E 055735 PLAN CHECK NO; N GOVT; N SUPP : N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
RCHIENGINEER: 258'1177 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : 3 PHASE — METER UPGRADE SQ FT:
PERMITTEE: CLAIM VALUE: CALL—VALUE; GROUP OCC; B-2 /
ADDRESS: PM ELECTRIC 714 ) 590-7026
4821 LANIER RD COMMENTS• NO STRUCTURAL PERMIT ONLY METER UPGRADE
pj 77Uj E( CA 91710 e E********r Ex r****6 r****r+FSE*********F E****r r r 6***
LICENSED CONTRACTDAUECLARATION: I hereby affirm that I am licensed under provisions o7C peer 9(Commend g with Section
70001 of Division 3 of the Business and Professions Code,and my li s in lull force and effect.ZONING REQUIREMENTS
CITY LIC.:055 .45 STATE536372 s : SETBACKS
Date: ,— signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 42406105 ZNE: REF NO:
Certified copy is hereby furnished. Certified copy is lied with the city Building Division. PLANNING NOTES>
Date: Applicant:
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs sevum n rat be completed if the mitis for ,umred($too)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is a all not ploy an rson in a niter so as to become
subject to the Workers'
sCo
nation laws of California. ZONING APPROVED BY
Date: / —7—71/Signature:
DATE:
NOTICE:If,alter making this declaration,you should become subject tothe Workers'Compensation provisions of the Labor BUILDING APPROVED BY •DATE:
Code.you must forthwith comply with such provisions or Ills permit shall be deemed revoked.
E/,,///
q e/7CONSTRUCTIONLENDINGAGENCY: I hereby affirm that there is a construction lending agency for the pen ormance of the work for
A % 'sF 1F iP
which this permit is issued(Section 3097,Civ.CI APPLICATION ISSUED BY: 414-41k44:114DATE: Z,
LENDER: ADDRESS:
LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADINGSection7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or
PERMITTrepairanystructure,prim to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 29 . 50
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 1:)% SMIP/NON—RES
and Prolessions Code(or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 15 . 00
I. as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
structure is not intended or offered Sr sate(Section 7044,Busmess and Prolessional Code: The Contractors'State License Law TOTALS—--—> 29 . 50 15 . 00 0. 00 44 . 50 44 . 50 00doesnotapplytoanownerofapropertywhobuildsorimprovesthereon,and who does such work himself/herself or through
his or her own employees.provided that such imprOvements are not intended or offered for sate.II,however the building or
improvement is sold within one year of completion,the owner wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 44 . 50 OVER/SHORT- 00
lorthepurposeolsate). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner ul the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 44 . 50
and Professions Code: the Contractors'Sale License Law does not apply loan owner of propel who builds or improves thereonandwho
fonlrams
for such prompensawith aconlractpr(5)uld/wensbe provided the Contractors' License Law),I am aware *.*.***.**.***********,**********,******.***.***_***************************************
that proof of their Worker's Compensalion insurance should be provided to me.
I am exempt under Section:B.&P.C. INDIVIDUAL F E E BREAKDOWN
far nis mason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
Ido hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50
25534 and that I or any future building occupant MUSH not(Circle one)need to comply with said state codes and the requirements for a ELE 1 • SUB—PANEL 11 . 00 11 , 00
Permit for construction or modification Irom theAir ality Management District.Residential construction applications are exempt from END OF FEES
these provision.
Date: Applicant:
Ynereby cemly that I have read this application and state that the abov .tion is correct.I agree to comply w all cit and county
ordinances and state laws relating to building construction and mere( resenatives of this to entero ea mentioned
property for inspection purpo'ses.
Dale: q- //pI_ Signature
Driver's License or Social Security 4:
1641-46 White—Building:Geen—Code Enforcement:Canary—APPlirant:Pink—Revenue:Goldenrod—Assessor
CONSTR.-Al AND PLANNING
POOL & SPA
APPROVALS Permit#
Date Inspector
APPROVALS Permit #
Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. Lr 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
77-
10. Structural Floor System
4
61. APPROVAL TO DECK
i
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final t
15. Rough Electrical-Conduit I 66. Solar System-Final
16. Rough Electric Wiring . 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure. 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
a .
24. Roof Framing 73. Undergrnd:Storage Tank 0 Gas 0 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 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 1 iI 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 Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System -c
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co I ,
51. CERTIFICATE OF OCCUPANCY
No. Date
127•EPT. OF BUILDING an SAFETY'
2141100.70. BROADWAY
l
Na.g 3 6 0 2 9NTAANA, CALIFORNIA f
COUNTY OF ORANGE
CERTIFICATE OF USE AND OCCUPANCY
f
l/ ` 8/10/59
Bldg. Permit/No. 11.17 Elect. Permit No. 9914.00 Plumb. Permit No.
14
i(UseteBudng Office Group
Therbuilding located at 1775 Placentia, . Costa Mesa
W
Lot Block Trod
See Reverse Side_for Metes and Bounds)V
Has been inspected and found to comply with the provisions of all County of Orange Ordinances applicable
thereto. ' IT
ISSUED TO: C. W. DONOHUE
Superintendent of Building and Safety
Boyd Enterprises/
Owner of Building) By
Mail To:
4 4 • _ w -
THE CORY REGISTER COMPANY
FILE COPY 20M d•n
a
il1CATION FOR BUILDING !PERMIT COUNTYTOF CijAIPLICANTTOFILLINAREAWITHINHEAVYLINESONLY.ORANGE
B;)ILDING
S/
J"' DESCRIPTION OF WORK
ADDRESS 77 J ,/?,ems '4/'"(L( y I-
TOWN DR SCHOOL 1J /
J
NEV./LI ADD ALTER LI REPAIR DEMOLISH
DISTRICT SIZE NO.OF NO.OF
SO.FT. Z,y era STORIES FAMILIES
USE OF cJ.OWNER /
A3L.ESTRUCTURE ,y, - 4 / r
MAILING p g/Iir% i P'______ -/_ .:17,71('
ADDRESS r(/7 !O . /P ONE c t/JO35 1- /
29 Aa ye'7
i C i /
f
LEGAL LOT B ! K TRACT
CITY a r 0 LLif/ DESCRIPTION A L, G Y. faoa._.
ARCHITECT OR PLEASE ATTACH METES AND .OUNDS)
ENGINEER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI-
f-
r.Q
J `
ADDRESS S.--/ L.- 0 v VIDEOCATIONIS
CORRECT ANDTHATAND
STAE
AGREE TO COMPLY WITH ALL
COUNTYO
ORDINANCES AND STATE LAWS„REGULATING LDING CON-
ION.CONTRACTOR 1 SIGNATURESIGNATURE OF
A S$
PERMITTEE aZONING/ REGULATIONS Lry ? '/ ^
r// LL J _
AD RESS 1 /
I-1F/
6/
L-/
S-
rCHECKEDBY "1' DATE ' `TpATE CLEAfl ED-A"a-S
j... /
J,
Lr_ F..a/L- I p,(,-,
PLOT PLAN FULLY DIMENSIONED? YES v NO
FEE
B.PT.
ALL BUILDINGS SHOWN ON PLAN (PER APPLICANT)/ y4 S ( VALUATIONS . dao FEE $
MAIN USE ACC. USE ZONE /YJ / DIST, M. I`I.'/0 OCCUPANCY , TVPE
GROUP F — "L_CO 11 ,
REQUIRED BUILDING SITE FRONTAGE? ).ES NO
CONSTRUCTION Jy}
BUILDING HEIGHT? STORIES etAND FEET
INSPECTION RECORDN
APPROVALS OATS 1=S%CTOR SIGNATURE
REQUIRED LAND AREA/ YES NO
FOUNDATION( LOCATION T1/4-1VARIANCEREOUIRED? NG APPROVED ...
I
NO FORMS AND MATERIALS.
4-4 /, Arc (Teti. •AL ar/+STREET WIDTH...164U. CORNER LOT INT.LOT REINFORCED
Ji L c-•A MASONRY OR CONCRETE -../q/{PA w/BUILDING SETBACK CIL ST
IleyS S PROPERTY LINE HJ J•
Pt
SIDE YARD, RIGHT JLC !/ • EAVE PROJECTION BOND BEAM O
SIDE VAaQ, LEFT\/_/• EAVE PROJECTION • Co VU WN QA'vs
REAR YARD IAO P/LI / T O
to
OF ALLEYltr
L3 / Y
SEPARATION BETWEEN BUILDINGS D 0 ROOF SHEATHING
iMNEY IN REQUIRED SIDE YARD PROJECTS
H IN REQUIRED YARD PROJECTS
ROOFING
JJJ _
STAIRS IN REOUIRED YARD PROJECTS
5
FRAMING
PARKING AREA REQUIRED \//...--5 CAPACITY. CARS i/ fl LATH OR DRYWALL I
REMARKS:INTERIOR N u
LATH N( •
EXTERIOR t_'(l
PLASTER
FOR OFFICE USE ONLY iiipo BROWN COAT
RECEIVED BY PLAN ..4111V41:3,4110 at FINAL
AMER'SLANCHECKRECEIPTI. ROUTESi E• AT Y 2. OFFICE 3. STATISTICS FILE A. OWCOPY
NO.
TO INSPECTOR WORK COPY FOR COUNTER USE OF PERMIT
gP /G — /60 -
C. W. DONOHUE - SUPERINTENDENT 204 V/ N BROADWAY SANTA ANA. CALIF. KI 3-9341 HAROLD L. GOLDY IBJ.
DEPARTMENT OF BUILDING AND SAFETY VALIDATION ASSISTANT SUPERINTENDENT OF
A FEB 6'591 104 17 14.00 .1
BUILDING AND 5"`
14.00*
TELLER DATE PERMIT NO. PERMIT FEE CODE PLAN CHECK TOTAL
Selv-s 9 94-N G3_ 5-7"-C c s_ Q k . — vim 3/1-0 /s1
y