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2879 REGIS LN - Building Permits
-S- .. . CITY OF COSTA MESA :Y _ 4`A s BUILDING DIVISION ' F ,al DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER J • PERMIT aa,� /B02-00148 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2879 REGIS LN Status: ISSUED Suite: Applied: 01/30/2002 Vicinity: LEFT PROP LINE Issued: 01/30/2002 Parcel Number: 14156316 Zoning: Applicant: TUCKER, MIKE ISSUED BY: )411/40.,_ Address: , Phone: 714-593-3135 ' Zip: Owner STILLER,.DAVIDJTR �\ • Address 2879-,REGIS LN - Phone: , COSTA MESA,CA ' Zip: 92626 - - i \ \;•,,,,\ , Contractor: A J M-CONSTRUCTION Address: 9414 EL CAMINO AV 1. Phone: (714)593-3135 FOUNTAIN VALLEY,CA �V Zip: 92708 ' Licenser-. 562156 - - �•�� �" ��= �ti \ Arch : — Eng: Address: Address: .. , Phone: ' _ , 5,.5 A Phone: ' i v „ , `Zip: ' License: `License: SCOPE OF PERMIT - , CONSTRUCT 68 LINEAR FEET OF 6 FOOT HIGH BLOCK WALL ON THE LEFT PROPERTY LINE; INCLUDES-10 FEET OF RETURN WALL PER CITY STANDARDS.. f . FEE SUMMARY L _ Plan Check: $33.12 - - - - - =-. Calc Valuation: $1,360p:10 Permit: $50.95 - Claim Valuation: ,.'1 ' $o:oo SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0:00 __ ,,K, Total: $84.57. '" PLANNING'S.,ZONING , SETBACKS , ' . - MAINSTRUCTURE Front 0-0 Rear 0-0 Left 0-0 - Right 0\0 ACCESSORY Front 20-0 - - Rear -0-0 Left 0-0 Right ' 0-0 1,' PARKING Existing: 0 " Required: 0 Proposed: 0• " 1,-, NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. • INSPECTIONS: In order for the work authorized under this permit to be considered legal, suchwork must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARAT NS (Th �`j " WORKERV COMPE"SATION DECLARATION: . I hereby affirm under penalty of perjury one of the following declarations: - ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'comps aliop Inssjj rance carrier and policy number are: / /�/ Carrier: cY'S U PEND Policy Number: / 3 / 74o -0 (This section need not be completed i/the p valu at ne hundred dollars($100)or less.) ❑ I certify that in the performance of the ork or w ich his permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, n re that s uld become subject to the workers'compensation provisions of Se on 37 of the Labor Code,I shall forthwith comply with these provisions. / O Applicant Signature: Date: u/4/A/L WARNING:FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIM PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITIO TO THErfST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed un or,,EErovisior of Cha• =r f(commencing with Section 7000)of Division 3 of the Business an Professions Code,and my license is in full force and effect.Lic.a , d- are Class a --,z2 Contractor's Signature: Sins Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is-issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • • I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 more than five hundred dollars(5500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: _ Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation fNe(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Ttle 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No , (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? 0 Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described grope•r inspe •I purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ///IS;'•, re Of Legal Owner(s) j3a D A •Or Authorized Applicant ata CODE& . .11•., sr'' QSIC INTITULS CODES INSPECTION TYPE PATE IIMELS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall Z- (L .'ot. yJ7 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition . 250 Final Building/Occupancy /Z •THIS SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN Y6'k e IN HEIGHT SHALL ONLY, APPLICANT LS RESPONSIBLE FOR PROVIDING BE SETBACK A71FASf 10' FROM FROM PROPERTY LINE AN ACCURATE REPRESENTATION OF THERI PROPERTY IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WALLS/FENCES T C/FFNC6 SHALL NOT EXCEED Y b•IN HIICHT WITH THE INFORMATION PROVIDED ON THIS SHEET. WITHIN 1U OF THE FRONT PROPERTY LINE NOT CURB UNE). T3U 2 - 00 /Lig •VERIFY DISTANCE FROM CURB TO PROPERTY LINE VERIFICATION FROM THE CTIYS AND SEtOW. .�'1`P 7T�R(�R:IN� OON 6 REQUIRED. CALL(I34)734-.5343APPCITY.OF COSTA MESA gI) PLANNING DIV. y� • SUBJECT TO BLDG. DEPT. REG.• , ` IBY __DATE V30/0 1 I'J_SiC} i ;itstiAiii CITY F gOS I _.1:2;17:71.11. . ` _ A PIO ' ED By 7nisTxte!pernardspsciiicatl nsM�STlie t t.' n;xo^t a:��I�!� P ,this lob a18q fknes and B b . wlul.o • Y `ate` .ra.uratienc:sari bit,* I:: ,. ...• 1,3 r^:'rF I:a: T ;.•,,,, ,,;,vitt,;, ,,ai.Mj a. I a0-• "7.1° . Mtheos opineoDdiplany adso.�.f�:ry.nilhrLi40ibahel I .: At or tobean ap{aoval / -- -- . City a .isa Drdin: ce and/or Slate law. These an and pcc rr:tali es tire Ly Iimilaiien a_r„;buctvre null and void if the building or ll'O l iS' G^:n&f af and mai t:i.^.^.]aciv per UK§303(d)within IBC days of iSanco. , . 1 tA I. yy ; y y S i/ • ` < V is ;/ g a I NE9DEMCE RESIDENCE IE90EMCE RESIDENCE I N W te n111,4 RiDQt 'Kt, SET IAOt , .‘,..........‘\"•----- ----y • 7 qf STREET . BLOCK WALL LAYOUT FOR BUILDING PERMIT (VOTE ADDITIONS, DELETIONS, OR CORRECTn 'S SHALL BE APPROVED vv THr "I ^',Ia11I,h •,1V,^•r„ P_LANLVh1_ DI'VIS ON f , ._,_ .. .. TJ . 6I A. I - 1 a .l TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional s • GENE • RAL- NOTES Channel Block With 1.3/8 56 •�I . M,.�._ � Horizontal Top of all ease!! • Fences N' 1Ile' I MORTAR: One Part Plastic Cement, and fThrtt Parts Sand For Fences 5'or less la _Y� E r GROUT: One Port Cement Three and • vers.ear.3/8"¢at 4' 0"O.C. iii. • -• � I One Half Ports Srand a x • COPING: OnePartCement, Threeand For Fences Higher Than 5' !� WellPartisedvert.Ban 3/8"0 at 32" O.C. .> ' - CONCRETE: Wel I Mitld 1:2-I/2: 3-I/2 ! cc =; :, Mat of 7- 1/2 Gallons of Fill Cells Solid With Grout Mil . . > z - - I' Water Per Sack of Cement Where Steel Occurs I� I - - r - Rnnlnrcing Steel Shall !!II������,� 3 '� ' ' . GROUT MAY BE POURED FROM THE TOP 1 '.'I "- .y _'- OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A-15.39 • . w o A.S.T.M. - I OCCURS. I��I 2 ~ - --.' � CELLS AND AREASOF HORIZONTAL REIN All Steel to be Lapped - --_ — - _ FREE OF ALLT SHALL BE CLEAR,CLEAN& • IR I , - , _ I FREE OF MORTAR DEBRIS,ETC. 24"or to Code HH � NATURAL GRADE 111 v v - -- '1 ,I1 I T • • •„'h* ' r. o� •• ° • s�2 TWO LB"O BARS NEI • . . CONTINUOUS TOP Is • & BOTTOM -� III /.—W IOTH 10 16 0 C MAX , • e SEE CHART • HOQIZ.STEEL MUST BE TIED IN BELOW • DC 1,111 LI" C 4RTHTCOTH • PLACE AT TIME OF TRENCH I INSPECTION. 1 I/! TIIE HEIGTH or FENCE I r. BE-LOW BOTTOM OF FOOTING 1 � e� o' J� SCALE. I/2° = I' FOOTING REQUIREMENTS CHART I WALL HEIGHT 6 ' - 5 4' 3' WIDTH . 14" 14•• 12 . . . . 12" . THICKNESS . . 10" . . 10" 8 " 8 " DEPTH OF EARTHTOOTH I 24" 20" . . . 16" 12" • SPACING OF EARTHTOOTH 12' . 14' . 16' 16' . . . . car, I„-I • BUILDING DIVISION •;'� •- CITY OF COSTA MESA - 4y , �',, BUILDING DIVISION t•1 ^"J' ' DEVELOPMENT SERVICES DEPARTMENT M98-00252 PERMIT PERMIT NUMBER P (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2879 REGIS LN - Status: ISSUED Suite No Applied: 06/22/1998 Issued: 06/22/1998 Vicinity: Parcel Nunmber: 14156316 Applicant: MIRELES, HENRY Address: __ ,_ho '- Pne:-__"-` ,y---� _ � - 'r Owner: STILLER ,DAVID-J7TR �V �v ( 1 I 1 `j \A 4 • Address: 2879.REGIS LN CO MESA,CA �'f'--''zip: 926261 -2-. ��J J Contract/' PLAYA HEATING'& COOLING \t- \/\ \ Address: 6131•NORBROOKDR \ /J('�V�/J/�� V 7• Phone:: 1 \\.>,,N(,,,:.„ ,\ / ''HUNTINGTON BEACH,CA 9'Zip: 92646 . � • ., �/ \.'�.'/1 ' License'.714187 l 7 JC _�� �� Avrch/En ?f �� /f/ /c ! / )=Phone --7 ,. Y` , /�/y' \shi/ i 0-,\,, .., ..-- ��, 1 ��l !/ �'x..r� Zip.10 N N \(\.i;\f,`,‘,"-,-..--27---;� � �I '�//�� ff License: :41 �. I}1 it ' / __ _SGOPE.OF-PERMIT-- = i1 �` li(�)_,� Iii llilip ©,r`-CHANGE OUtHVACUNIT.') ,\(:r'11.t h , 1 N, 0� , 1 R ,, C . Li rv,1a;�.)(A\ -ti -,!nf ' ' \ - _) I'., I 'iy;f,),\ FEE SUMMARY St Irv' Oz u, antity , A'< 1l �,' 'f',; " Qua tit� 1 - n ISSUEFEE,3 ,\'.,`I $22001,x.. .. - 'tet-Repair/Alt Absorbtion Unit //' $0.00 01 .61i _ -----._. =�_r / 71 .J 1 Inst FAU•i 100 k BTU �\ � $13.25 ' ��Repair/AlhRefrigeration Unit �,J $0.00-� 0 �� Inst FAu; 100 k BTU \� $0.00 I Ventillation System ' (71/ $0.00 % 0 // Repair`/'Alt Cooling/Heat, 1 $0.00> 0 Evapoiative,Cooler L� :if/ /$0.90-7 cif,/ ` Inst/Rep Recess Wall Htr�l' $0.00 0 Commercial-Incinerator $0.00' 01! Refrig Sys` 700,k,BTU\ \\k $13.25 1 . Domestic Incinerator '$0.00 0'/ Refrig Sys>100 k BTU/ \"\\ $0.00 0 k1 p�q Compressors/Absorption Systems/3 / ` 7 j/ Gas PipingA\V "- �� $0.00 0 , 4,,li'ed GUp,to 3 hp/100 k BTU : /�--". $0.00 /0 Factory Fireplace ��'$0.00 0 tt"--(' Cf+a `3?0 15'hp/500 k BTU 1 /,i / $0.00\0 Hood w/Mech�Exhaust r.. \$0 00 0 )0u.),.....-;45c• Q y15 To 30 hp/1,000 k BTU%/ L ;> $0.00 0 VAV Box NAj\ / $0.0o 0- - - ��,y�, 30 To 50 hp'/.1 750 k BTU �/� $0.00 0 Vent Fan/Single Duct. //// 11 $6,00n9:7.„,• ' �Lover 50,11P 7 Over 1 750�BTU C/� $0.00 0 Appliance v , '/ /$0 00V 0 ' �'1>>- ".)., ti'ii Boilers '�N("��-C'' % .„ / • F Slmokke Dampers 10.00 .�„0~� S '- w'3 Too15 hp- - //<,\t C,\ . /t $0.00 0 Inst or Relocate Appl Vent N '$0 00 J;0 f __15 to 30 hp ••N. r r $0.00 0 Air Handlers< 10000dm ,..2`,::,.:>$0.00;90.,,- \j 30 to.50 hp' V v V v -- / $0.00 0 Air Handlers> 10000cfm C'$0 00 0( \\ /_,.-:�J/(v (-(7.-1 T-Over 50 h:1'.\�� i 71 p // $0.00 0 t Floor Furnace \'$OAO;;�0 ''K/ I f. /f; ? , � Other;Me6hanical Fee.--.,/,...-;,-- Floor -,---2.(--� Floor or Suspend Heater $6-.001„..--0,-' `-_,1 ;i\'\' Investigation Fee :':i' $0.00 • 1,...-3---kc!“--,,r,- r.5 -PlanCheck Fee .- $0.00 -- . --r. -Reinspection Fee $0.00 TOTAL CALCULATED FEES $48.50 COMMENTS/SPECIAL CONDITIONS I EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5826 DECLARATIONS f) WORKERS'COMPENSATION DECLARATION: -. I hereby affirm under penalty of perjury one of the following declarations:. . . ❑ I have and will maintain a certificate of consent to self-Insure for workers:compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Insurance carrier and policy number are: Cartier: - Policy Number._ (This section need not be completed it the permit is valued at one hundred dollars($100)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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions ApPllce gnature: y<3 A aaae-76r-99. WARNING NF LURE TO SECU ORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT NI EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100, ),IN ADOmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE,INTEREST,MID ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lia# Class# contractoras nature: �DatIe 2 9 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm tha there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Neme� Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK.and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes ❑No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation fNe(5)or more feet In depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit far such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Ley • ner(s) Date A ••Or Authoi :d Ap• cant 2, is Date- COOP I, INSPECTION TYPF DATE gl7IDAL5 LDDE2 INSPFN1ONTYPF --- QQ �. 1616 Fixed System Final Fire Prevention 206 Final Mechanical c,/Zc I e If 1266 Pool Spa Final ' ' - - � 208 " Final Plumbing • 200 Final Re-Roof 210 Final Electrical - • 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 (Final Planning Approval - 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy _ 2446.46 - t+�' CITY OF COSTA MESA F �.�I� BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT EqR-00601 PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2879 REGIS LN Status: ISSUED Suite No Applied: 06/22/1998 gLe7 • Vicinity: Issued: 06/22/1998 . Parcel Nunmber: 14156316 • , Applicant: MIRELES, HENRY Address: . Phone: _ ......----x-2:7- Y--...-a ...„„,a-----------e r! j i \7------; ....-, Owner STILLER • ,,,,-7-_ (TR \ \ \J_� I L104 �,c�� Address 2879 REGISLN �� • • COSTA.MESA,CA ,- „ - i 92626 ,--_ _�•,, /// 7;N...\K.\ dr(< ,z7t-- -;'--- Contractor: PLAYA/HEATING &COOLING _ \\\\, \"/\:\ tto a-.Address: 6131 NORBROOK DR - \ l/ T /J/ Phone: , C:::\-s ��A . 1,✓/ NUNTINGTON BEACH,CA �i.Zip:92648 �_ -- ` i"� \\.\ ��/jU/I/l/ 1,77 ••yL•i''ceenn'sse:•714187• ••1- 1 It f -"'( \, -'---\• --,r.' • 11COPE OF PERMIT�c:Cj : V I if CHA?G UTHVACUNIT. \r,, L, S ` 1.0 T I I � � _ 1 ill \, I lr'! �� ��� i /.` 11 , I k' �11Q J J 1 Tn ,�r: FEE SUMMARni-0 ai o)F- (a/_ / ,r {� © U�Ic ,._'jl quanNty� 1116_f ll�..l.�cl .1-110, -U1-> Quantity .: '. -/ h. 1 ISSUE FEE I1)11I I $22.00 \ Temp Dist System llightmg / $0.00 0 ;2 : , r ' )I Temp service test``\tit ; $0.00 ,^. Busway/100 ft X I $0.00 0 _ ' "� 1 Rest a/c packege\\\/)1` $0.00 !tom `'✓�F?t', Standmg.Section� ;^--•,,;I $0.00 0 I,t frt.-IN--1 t i New Res(112 units) ,)1t-'i $0.00 le.0_ - - l �MiScElectrical'Egmpment -, $0.00 0',77,•1 . J i' i New Res�(3+units) 1 ` {1p $0.00 i e-- -`--Transformers up to 1 kva/kw $0.00 ()ill/ / �I Pool%Spa, �r 1 1 a $0.00 I 0 -up toil0 kva/kw $0.00 01'/ \� ��. Lighting'Fixts \��` $0.00 0 •c'`up to 50 kva/kw .-"i$0.00 0;/ „--c? ` Recept Outlets \\ \k\ $0.00 ' 0 =`up.to'L100 kva/kw I$0.00 ,0 f "/ /(,Or / Switches,\ \ \,. $0.00 0 over 100 kva/kw $0.00 /1.0 rj r}1 Non Res Appl �� / \$0 00 1 0 � Low,Voltage Equipment `$0.00/%0 4./ Res Appl \\� �- \$0,00 0 'Low-Volt Wiring System/Ckt -$0.00 0 (f Service to 200a 1. $0.00 1 0 *.r�Jr,J MiscConduitt $0.011 0_A. i Service to 1000eA '1/4-1.--\1 $0.00 0 f()i QQ Misc:Condie,uctor '$0 00 0 f' Service over 1000a $0.00 `' .; 0- -,;(rIp- (i�Circus(gen or ride)�r $0.00 0 ,'J Motors to 1 h ' �" �o � i ,,;..:,29/' : 7- p G11.00� 1 •r+., a, n p Christen sTeedStandght- $0.00 ).0 ��� Motors to 10hp i$11.00 1�'^'`r""` (�j'r e � � %\ \ '..\ V V .w K M,i.. Motors to 50hp $0 00":.."N, 0��� - � l'Fneworks Stand,--i/% ....---4$600: 0!reu Motors to 100hp "-,11,44 $0.00 r���0 ' =\� -sOther Electrical Fee- co‘,..-)$0.00� ' Motors over 100hp �� � �>$0.00?(/J 0\ �- . __ _ ,".\ \\ �i /!fi' Communication drops N $6.00 `; / 0�-?/r1 _ Investigation,Fee \`- \J''$0.00,!' Sub panel to 200a $0:00"�� 10\ /f J)r j''3 �,=�Plan Check-Fee..3\\./ $0:00% Pole Light Pkg $0.00`�� ..-,0S� _ ' i I Reinspection Feel's �//$0:00 Sign Circuits $0.00 ------,0:5,:::. ,-i N L: `-J " • i,7y'/' ------ - Temp Pwr Pole $0.000......-.7.-5,.7:2--L.:-..*?!..,,_ -NOTAL CALCULATED.FEES $33.00 Intermed Pole $0.00 0 -r-�--.r Vie_.%•'- COMMENTS/SPECIAL CONDITIONS • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS ( ) WORKERS'COMPENSATION DECLARATION: _ ", • I hereby affirm under penalty of perjury one of the following declarations: . O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the - work for which this permit is Issued. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: - Cartier: _Policy Number. (This section need not be completed if the permit is valued at one hundred dollars($100)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,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith Comply with these sio s. ti p AppllcanfSignature: F DL atej G. Jr-2.-79 WARNING:FAILURE TO SE JR W COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOUARE($100000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractors Signature: CDate:= CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,Will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application&permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes LI No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building pecrnits). 6 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above Is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: • CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. / �ature f Le al Owner(s) Date G tie And/or A thorized Applicant �Date� COOLL INSPECTIONTYPE BATE ' =Ai5 COUEr INSPECTION TYPE DATE . INtmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final " ' "208 Final Plumbing ' '. . - 200 Final Re-Roof . ' 210 Final Electrical -?6-98 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Flre Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244646 _. 4O CITY OF COSTA MESA F . BUILDING DIVISION PERMIT N ER DEVELOPMENT SERVICES DEPARTMENT •• PERMIT PO 0126 • (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT • Job Address: 2879 REGIS LN Status: ISSUED Suite No Applied: 03/10/2000 Issued: 03/10/2000 Vicinity: Parcel Nunmber: 14156316 ISSUED BY: r Applicant: LORIE GLOVER Address: 2737 S CRODDY Phone: (714)241-1414 SANTA ANA,CA - Zip: 92704 Owner STILLER, DAVID J TR Address /2879 REGIS LN • Phone: COSTA MESA,CA Zip: 92626 Contractor COAST ROOTER PLUMING HEATING&AIR CONDITIONING Address: 2737 S CRODDY • Phone: (714)241-1414 SANTA ANA,CA Zip: 92704 License: 529127 Arch/Eng: Address: Phone: Zip: • • License:. • SCOPE OF PERMIT ' WATER HEATER CHANGE OUT. • FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 .0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 , Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen '$0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS U WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. T� I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. /— My wo ears'c pensation Insurance carrier and policy number are: p Carrier: �' `I C Policy Number: NDI D 8So (This secti ne d n l be corhpletedtia emit is valued et one hundred dollars($100)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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: r- Date: 3 _Ii�O0 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100.000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.4 5 a Sh Class 4 Contractor's Signature: c. Date: '3-.13 -0 0 CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,talsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency Yes S No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No B (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signal egal Owner(s) Date And/Or Authorized Applicant Date CODE I INSPECTION TYPE DATE INTmALS CODE# INSPECTION TYPE oATE INNS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing `ern`� 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 ADDRESS OF BUILDING: 2879 REGIS LN uMT: CITY OF COSTA MESA - BUILDING PERMIT - omen NUIEIrIaavNSTILLER DAVID J PERM NO: P 081937) • ADDS2879 REGIS LN COSTA MESA,CA 92626 PERMIT NO: P 081937 'PLAN CHECK NO: N GOVT: N SUPP : M APPL.MAI1lNO ADDRESS: 2 2_ L CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU PURPOSE: 0TH ARCKRECT OR DKANEER: UC.No.: JOB DESCRIPTION : DISHWASHER REPLACEMENT SQ FT: ARCH.OR EMI ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONTRACTORS NAME CaORACTORS MMURO COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT • ADDRESS: LUC NO.: ***************************************************************************¢*** WIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)d Division 3 of the Business and Professions Code,and my license is in lull force and effect. CITY LIC.NO.: UC.CLASS: LIC.NO.: EXP:. MAIN BUILDING ACCESSORY BUILDING --- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dale: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License law for the following reason(Section 7031.5 Buenas,and Professions Code:Any cly or county which requires a permit to construct.alter,improve, PARKING REQ• PRO V: PARCEL: 14156316 Z N E: REF NO: Wnofeh,or repair any structure,prior to as issuance,also requires the applicant for such permit to file a signed statement that he or she licensed pursuant To the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES> Jusiross and Professions Code)or that he Or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > ' 7031.5 by any applicant for a permitsubjects the applicant to civil penalty of not more than fee hundred dollars 1M5001). *******************************HE**************Rt,****************************N*** X❑ I.as owner ofthe properly or my employees with wages as then sole compensation,will do the work,and theetmcture is not intended DEVELOPMENT SER V I C E S t'- R EQUIREMENT S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of popery who buids or improves thereon,and who does such work himself or herself or through his or her own employees.provided that such improvements are not intended or offered for sale.R.however.the building or improvement is sold within one year of completion,the ZONING APPROVED By . DATE: owner-bulkier will have the burden of proving he or she did not build or improve for the propose of sale). ❑ I,as owner of the property,sat exclusively contracting with licensed contractor"to construct the project(Section 7044,Business and BUILDING APPROVED BY DATE: Professions Code:The Contractors License Law does not apply to an owner of property veto buiMs or improves(hereon and who contracts for such projects with a contredo(s)licensed pursuant to the Contractors License Law). 3 ❑ lam exempt under Section; 3 _6, P.C..for this reason: APPLICATION ISSUED BY: S ': DATE: 1S0if1 Catttyf� N $Itt.�Q1n *+EGALI TE:E:E**iEKEx:E RERERE:E:E:E KEtEtE�E:EtE�E aHKE**tE *if :E+EfE • STRUT:N °m °xrec LEGALIZATION:N F E E SUMMARY . STRUCTURAL SEGMENT:N I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533.and 2cc14,end that I or any future building occupant will/will not(circle one)need to comply wih said sums codes and the requirements ler anemia forconstructionormadificatwnhanthekk alarm,Management Distdd.Residential pru conctcn appiretiaerzem weeprlrom these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions- PERMIT 8 . 75 Date, Applicant: 25% • SMIP/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE 22 . 00 ❑ theandmaintainsfor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code.for the pedm aa mnnh euewokfawnantni.pei,iseaee. TOTALS----> 8 . 75 22 . 00 0 .00 30. 75 30 . 75 . 00 ❑ I have and win maintain worked'compensation insurance,as required by Section 3703 of the Labor Code.for the performance of the -_ work for which this permit is issued.My workers'compensation insurance carder and policy number are: Garner: REVENUE DIVISION TOTALS--> COLLECTED: 30. 75 OVER/SHORT: LOO Policy Number: • BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (his section need nor be cmnderad/the peark is for one hundred dollars MOO)or.ion) 30 . 75 X❑ I certify that in the performance of the work for which the permit is issued,I shall rot employ any person in any manner so as to become subject o the workers'compensation laws o California,and agree thin if I should become subject to the workers' *IE***************1E***4E*3E****1E******'*************lir********."*4t*****1('************* compensation provisions of Sedion 3700 of the Labor Code,I chat foforthwithcomply with those provisions. (� I N D I ' V I D U A L- F E E BREAKDOWN Date: 3 -4-'7 ApApplicant: `•i�eric.K�le M"S 4.02.�//�. I Warning:Fa9un to secure workers'compensation coverage Is unlawful,and shall sw/sd an employer to cdMn/',memos and_ . TYPE- _ _. QT.Y. _ D E S C R I P T I .O'N UNIT COST. COST civil fines up to one hundred thousand dollars 0104004 In adrift,'to the coal of conyte oaf On,damages as provided for Its " Section 3105 of the Labor cod,interest and etrornsyi fees. PLU •_ 1. _ DISHWASHER _ 8 , 75 8 . 75 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the " END OF FEES performance of the work for which the perml is issued(Section 3097,Civ.CI. I LENDER'S NAME LENDER'S ADDRESS: ' I certify that I have read this application and slate 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 authorize representatives of this city to enter upon the above-mentioned progeny fo`inepedian;,,purposepurcs STILLER_ 03-06-1997/01:89 PN/ Print Name RCPT#:81-033.66 )yL -51-I(/� .-9 PERMIT:981937 Sig ol�/Agent/AppicantlContradd Date: • 7 (5151 de WP) SiWhte-Buildig&Soley;Green-Fla;Canary-Appicant:Pink-Revenue;Goldenrod-Assessor " CONSTRUCTION AND PLANNING • )`' _ r POO SPA APPROVALS Permit# Date Inspector APPROVALS Permit #. Date Inspector APPROVALS Temporary Electrical Service or Pole f 52. Pool & Equipment Location ', , 2. Soil-Pipe-Undrgrnd. -. + 53. Steel Reinforcement . o , i'3:"Electrical Conduit Utility-Undrgrnd. - - '• 54. Forms , _ 4:'Electricat Conduit-Undrgrnd. - 55. Electrical Bonding • . _ ' -ix5-.Steel Reinforcement r - : 56. Rough Plumbing & Pressure Test • 6 :Electrical LIFER Grnd. ' -57. APPROVAL TO COVER-GUNITE - ' ;•7-:(Footings 58: Electrical Conduit-Undrgrnd. ' - f = 8. Foundation • 59. Gas Pipe, u 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.-a • 12..Sewer Cap - . 63: Heater & Vent-Final 13. Roof Drains - • 64. Plumbing Sy'steni -'Final, - 14. Rough Plumbing tT. : 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 Electrica6T Bar Ceiling - - • 69: POOUSPA SYSTEMS FINAL - 19. Rough Heating &Air Conditioning' cec_ FIRE DEPT_.REOUIREMENT 20. Rough Factof,Y F eplace ' ca ,. :* , APP.. ---S a Permit # - - , . 21.'Ducts, in=Strure:•ctu " " �,- :t ri �_N , 70.'.�Unde grounBy d dro _ 22.-Ducts, Ventirating• ,, - s n _ c 71. Product Piping D Gas D Oil 23. Gas Pipe-Rough & Test ^r al ::t*: 2. C 2: - 72• Underground bch 24. Roof Framing - • - ,I • 73, Undergrnd.Storatip Tank 0 Gas 0-oil y 25. RodFShi'athing x - -, ; -• - - 74-. Overhead Hydr�C, m • 26._T-Bar Ceiling (Structural) &'Monecoat r - - D- 75:. Dry Chemical r - - -- 27. Frame and Flashing, .J M r^ 3' '' a' 76.76. Dry Sta J*ipec r-'LI _ _ r 28. Lathing;& Siding F r" r4S (-; ; 7: .. ..i • ..` 7.7. FIXED'SYSTENI 1NAL- t y 29. Insulation Y * - i F¢.�.FIRE;-PREV. F;IIQ'AL : - 30. DrywalliNailing• - ._• I 4. x F ;,1. ,c ,LHEALTIH DEP,pf•. REQUIREMENT ,r 31. Plaster BrowniCott: = : rr•. $ tr. n 79. FINAL INSPECTION t 32..ElectricaLPower Merei;Final t r: ! rx r! 8Q FOOD CERTIFICATE tSSSUED. c I.' ' aN_ 33.final:Electric �' _ I K: Pfotes:'�_l3_Q 'l�r, FIN' 1�-•�z�^ � : 34.Final Heating`--& Aii`,CDnditioning` C"• I C. 35. Final Gas Pipe-Test, 0- it _, I tt• G .Ta ti,- 36._Hood or Canopy cu* = i rr•.7 - i i a 7- X - , - 37. Final•Factory Firel paces; ! F-;-• , , :4.0Final.Plumbing =''' rc - 3-.13-17-L NZ'rt t - ' 39. Water Service-Final, < * r ,i: > o- x t 40. Gas Service-Final - r7; n-''' - "� ' , M C o r CI c-- 1- i^ • N T X. C. i ; ' 41. Solar Domestic•FinSi ". ,, 1 r -;, = - 42. Backflow Preventerx ,t i 43. Backflow Irr7}ation,. = s A n - 44. Landscape lrfigatiofi Systeme+....1 cc >1 r - •_i c Cc)X `: r,. ".`' r. 45.-Sound AtterNatiorh -t •• • _ r r = C_ • t-C a 46. 'Handicap-Regulations :; _• '' N. i^ _ Cr... ` '. - s .. !c C ,r. I"- i. ( _ _ -47.-F INAL STRUCTURE & BUILDING c 48.-.FINAL PLANNING' -'E--' ` - I l' t': r' v Y. r. Cir G: t: C 49.'tlecic -ric Release to Edison " =J `^ - r. _ _ 50._Gas':Release to Southern California Gas Co I- 1 ti- 4-' =?' 51. CERTIFICATE OF OCCUPANCY - ,* -T t',A.. i. - • - No. Date I I !Cf*DDRESS. 411,`: "o W 66- - 773 2879 REGIS,LN H/GY377SST� UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; BEP 062830 NERD RESS: TILLER DAVID J ADDRESS: 2879 REGIS LN a- SS7 - 9375 PERMIT NO; BEP 062830 PLAN CHECK NO: 02348 93 S GOVT: N SUPP; N COSTA MESA,CA 92626 CONSTRUCTION TYPE; 5 N PERMIT TYPE; ELE PLU STR PURPOSE; OT'H H/ENGINEER: , BEG.NO.: JOB DESCRIPTION ; IN—GROUND FIBERGLASS SPA S FT; 7, 200 a00REss: uxlr: Q PERMITTEE: CLAIM VALUE: 7, 200 . 00 CALC VALUE; 7,200 . 00 GROUP OCC: R-3 / RAY S POOL & SPA ( 909 ) 899-2328 ADDRESS: 6924 BASSWOOD PL COMMENTS: FIBERGLASS IN—GROUND SPA / PROTECTIVE FENCING REQUIRED RANCHO CUCAMONGA CA 91739 • ***************>E****%****FE**srsF******s6X6 **********x**x*****TF*****x*XE**** ******* 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 license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.:4 9 2991 CLASS:C—5 3 Date: Signature: MAIN BUILDING ACCESSORY BUILDING ---- WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure ora 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.: t EXP.DATE: COMPANY: PARKING RE • PROV: ' PARCEL; 14156316 ZNE: R1 REF NO; ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> INSTALL UNDERGROUND SPA. > .% Date: Applicant: )t*************************)t***9 ****IE.*******************%********************)t** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(5100)or less). DEVELOPMENT S—E=R V I C E S R E Q U I R E M E''N�T•'S I certify that in the performance of the work for which this permit issued,I shall not employ any person in any manner so as to become ,r •' "'- subject to the yvorkpy4 Com nszation Laws of California. fir •• ZONING APPROVED BY (,Q Rr '••'i DATE; /(�;'�,301�I Dale•. fC l/Q�~73 Signature'. Ill//�Awr/�/ ' -711-1-4._ . _• /• •' NOTICE:It,after making this declaration,you should be ' ect to the workers'Compensation provisions of the Labor BUILDING APPROVED BY ; JV�Q QC(4j' I DATE: -r O Code.you must forthwith comply with such provisions or s permit shall be deemed revoked. `�— r A CONSTRUCTION LENDING AGENCY: hereby affirm that there a construction lending agency for the performance of the work for APPLICATION ISSUED BY• Vt.— DATE•1t_ r i! r r 30 "3 which this permit is issued(Section 3097.Civ.Cl. **********************.* [*9E * - *** **.*.%.* *******.*.***.****** -., -.. • - • . - •** LENDER: %*********************************************** *****************4iF********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y ' 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 SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 9 . 0 0 7,00 3 0, 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 25. % 50 SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 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 64 . 35 1 , 51 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 . 00 1 5• 0 0 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 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---.—> 137, 51 35. 00 64 . 35 236. 86 236 . 86 . 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 employees,provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 236, 86 OVER/SHORT• 0 0 for the 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 99 . 00 27. 00 45 . 00 1 • 51 64 . 35 ❑ 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 ContractorsState License Law),l am aware **************************************.***************** *********************.* that proof of their Worker's Compensation insurance should be provided to me.• INDIVIDUAL F E E BREA DOWN ❑ I am exempt under Section' B.&P.C. - orthisre ' r — ?0-93 •lirTYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: ,ii ee SFC 7200 SPA 1 . 00 7, 200 , 00 I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 1 SWIMMING POOL — IN GROUND — NEW EA, 30 , 00 30 . 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 PLU 1 SWIMMING POOL 7. 00 7, 0 0 permit for construction or modification Irom the Air Quality Management District.Residential construction applications are exempt from these provisions. :• e' i• END OF FEES Date: Applicant- , - - e I hereby certify that I have read this application and state that Pie'above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and authorize pre�entntives of this city to enter upon the above-mentioned property for inspection pppuyu�'�rrppp1oses�. ' ) Date: (0 Cpp /— 3 Signature./ 1 Ullk ' Driver's License or Social Security DATE: 06/30/93 TIME: 11:42 ,� 1641.46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor • - f ' i , PLANNING!IAPR! :• :Imit # • Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or.Pole 52. Pool & Equipment Location a 2. Soil Pipe-Undrgrnd. " - 53. Steel Reinforcement ‘ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steet Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 01,4S Pg 8. Foundation 59. Gas Pipe,X Undrgrnd.,Test /4 �'73 ( • 9-Water Pipe-Undrgrnd. I`!j 60. Backwash Lines,P-Trap, 0 Undrgrnd. rl n/Y3 10. Structural Floor System ' - 61. APPROVAL TO DECK • • 11. Property Sewer Line & House Connection '~ 62. Backwash & Receptor-Final 944/Pr rr - 12. Sewer Cap OCT" eater & Vent-Final < `1 . , 13. Roof Drains 64. Plumbing System - Final l x lee Cr 14. Rough Plumbing oh.. Electrical-Final „ / 15. Rough Electrical-Conduit • 66. Solai 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 ❑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 I I I 77. FIXED SYSTEM FINAL r I 29. Insulation 1 I -i -- 78. FIRE PREY. FINAL 30. Drywall Nailing - _' I-� - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i I f . i 79. FINAL INSPECTION • 32. Electrical Power{Neter-Final I i ' i 80. FOOD CERTIFICATE ISSUED 33. Final Electric /lie Q _ Notes: • 34. Final Heating & Air Conditioning - f I _ 35. Final Gas Pipe-Test I. - 36. Hood or Canopy L, . I - - 37. Final Factory Fireplace - . 38. Final Plumbing 39. Water Service-Final '-j 40. Gas Service-Final .I 41. Solar Domestic-Final ! i - . 42. Backflow Preventer . ^ - - 43. Backflow Irrigation . - 44. Landscape Irrigation System. 6 - 45. Sound Attenuation 4. 46. Handicap Regulations I I ,2 ' 47. FINAL STRUCTURE Si BUILDING /%// 1 - 48. FINALPLANNING ' j - 49. Electric Release to Edison , � `i - ' 50. Gas Release to Southern California Gas Co . • 4 • 51. CERTIFICATE OF OCCUPANCY No. _ Date I1 . T- - _ -e__ _ • , . _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - - .. - - - - - _ - _ - _.-. ._.-.^_ / P MIT O TRACT NO. LOT NO. UNIT NO. • , • 41003 C'/ti;�%�6 - oc CIT=Y OF COSTA MESA . CONSTRUCTION PERMIT ' " ' p .M ?, • T. .!�-Project Address o`1f/�9 L'g 1 S C'p` - Y�(�£Sq , - _ 'Applicant's Mailing Address d q /4 - 4r nMc' - TYPE OF CONSTRUCTION iii NEW' ADD U.ALTERATION U:REPAi R 1 `❑ CONVERSION,- ❑ DEMOLISH OTHER Owner's Name . �.0_il� �lL ' Phone 7�3.- A.P,# ' - ' (Zone. : , DESCRIPTION OF WORK/USE OF BLDG.71--A Ont.-CC/Snot J6/.4/1r Address '- _re C. - - • DT- Ssc '✓JLL p//a)te4',t`- -` &2 sS A-donrp. • • E Main Building: ; - I Accessory Building: , , - Z Arch/Eng. ' - ' —License No. ' ' - TYPE OF PERMIT .U GRADING- ❑ FOUNbATION ❑ STRUCTURAL T Front ' , - - - ❑.TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MEC NICAL - g - - - ' ''''r ?fsl,:, Address r� 7-7 j�7 �CpI( A E:j -_--- ___ii_ i. •Phone G�+tl �7�q PROJECT DESCRIPTION SQ. FT- �..1 a&aPA�8/ 7s VA $ g t , 1 •• City Lic • ense No. '• ZONE GRADING CU.VOSI ACRES , R LICENSED CONTRACTOR DECLARATION i Ping!. Ref.# Parking Req./Provided, '- E t 1 hereby affirm that I am licensed under provisions of Charter 9,(commencing . Remarks: - • Planning Notes: - c - M with section'7000) of Division 3 of the Business and Professions Code, and • . • my license is in full/llforce and effect. ' • • . T LI<ense lass__.�i ' Lice a No V.2 3� 0 • ' ' - S Date �a - Signature 7ta - �r�/�G' PLUMBING •- I 'FEES '� - :1 1_� WORKERS'COMPENSATION DECLARATION , Bar Sink - Showers I • ELECTRICAL I ' FEES hereby,affirm that have a certificate of consent to self-insure or a certificate I r , , .f Workers' Compensation Insurance, or a certified copy thereof.(Section-. - - - - \ Backflow Prevente� - - - Service Sink Automatic Washer Transformer ❑ 15-50 KW • p\,, ,f W Lab. CJ_ �]�/ - s2✓ Policy No. L J 3O 93 l- S'�Company ��r`� FLA Backflow Irrigation Sewer Cap Construction Pole Sub. ' - • ❑ 50+ KW , Certified copy is hereby furnished. I • - - - •' ertifl d co. • file• with the city iltlin Iv on_ /: Bathtubs I I Sewer—Connection Cooking Unit Meter Dup to 100 amps vat-. - Applicant 1 lC ' X MPTION FROM.WORKERS'COMPENSATION DECLARATION -, Clarifiers. . _ • - __ -Solar Collectors . _ _ -- _ • Dishwasher. _._. _- .. _ Meter Dover 100 amps: -. a-. ' (This section need not be completed if the permit is for one hundred($100) or less). Dishwasher SOlar_Piping Dryers ❑Gas OElectric Sub Panel I certify that in the performance of the work for which this permit is issued, ' • shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Fan ) Motors❑0-1 HP ❑1%-`8 Workers' Compensation Laws of California. - - �_ - _� _ Date Signature Floor Drains , Swimming Pool 1v/Spa - F.A'.U. Inc.Solar ❑9-15 HP ❑16-15+ 'NOTICE: If,after making this declaration,you should become subject to the • - 'Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal T I ._. .Fixttires • - ' comply with such provisions or this permit shall be• deemed revoked. - -- _ Microwave CONSTRUCTION LENDING1/4AG ENCV " - ' Gas Service I t,Outlets Water Closet . Device Boxes • Pole L t • - I hereby affirm that there is a construction lending agency for the performance , , Jse- pr.,may_: : of the -work for which, this permit is issued (Section 3097 Civ. C.) Interceptors - _ _ Water Heater Outlets Range ' Lender's Name - . ' • Lender's Address - Kitchen Sink4 rWater Service- , ' t ' OWNER BUILDER DECLARATION -- - , " Switches. 4 Sign 1 hereby affirm•that I am exempt from the Contractor's License Law for the 'Lavatories Iuto-Wash A following reason (Section 7031.5 Business and Professional Code: Any city or - - I Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap ,Laundry Trays- -- ` Generator ❑0.$KW❑5-15 KW -- - -any structure, prior to its issuance, also requires the applicant for such permit - Trash Compactor. �'_�' to file a signed•statement that he/she is licensed pursuant to the provisions of , ROOF DrdinS - - .'; �� Rahe Contractor's License Law (Chapter•9(commencing with Section 7000) of - ,T1 . `,ivislon 3 of the Business,and Professions Code) or that he/she is exempt l • .- - -- _ - - _ - ' • "i.erefrom and the basis for the alleged exemption. Any violation of Section - ' -� ;R . The% • '"031.5 by any applicant for a permit subjects the applicant to a civil . ' I - - - �- • - enalty of not more than five hundred-dollars_($500). I - . ' - t Ci .LJ I, as owner of the property or my employees with wages as their sole - -Reinspection Fee I ' $15 Issue Fee • - $'3 v , • "compensation, will do the work„and the structure is not intended or offered - • - Reinspection Fee ! $15 Issue Fee }._ . tU , $ 3 for sale (Section 7044, Business.and Professional Code: The Contractor's ' _- - MECHANICAL FEES .•. License,Law does'not apply to an owner of a property who builds or improves - - - - -' - - thereon, and who does such work himself/nerself or through his or her own , DEVELOPMENT SERVICES REQUIREMENTS: • °� - • employees, provided that such improvements are not intended or offered for • Boiler y• I Hood or Type I, 0 - . /, sale. If, however, the building or improvement is sold within one year of com- CanopyType II ❑, Zoning Approved By -,- --Elate pletion„the owner will have the burden of proving he/she did not build or im- • Duct- Under Ground - f ' . I - Building Approved By 'Date prove for the purpose of sale). , •- G // 0 I, as owner of the property,em exclusively contracting with licensed con- Duct-Structural 1 Refrigeration System i • Application Issued By ' �J Date -$'P tractors to construct the project (Section 7044,Business and Professions Code: I .The Contractor's,License-Law does not apply to an owner of property who Duct-Ventilating. . - - -. ❑0-100,000 BTU ❑100,000 BTU . _ SUM YQkFEES S builds or improves thereon, and:who contracts for such projects with a con- - (yrylq/R kE,I e� tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ . System Repair/Alteration - BUILDING PERMIT ; $ ' 4+'- aiLl MIP $ d sY� proof o// their Worker's Compensation insurance should be provided to me., -irony • PLAN CHECK $ PERMIT ❑ am•exempt under Section B.& P.C.for this reasonFirepl/Fact:31t. ICBO.# Fire DampersI ISSUANC•E ' $ i ' • • PLUMBING $ Date ' owner; - • Heating System& Ducting . Registers ENERGY P.C.; $ 4 ' • • l PLAN CHECK 25%; $ '1 hereby certify that'1-have-read this-application'a-bd. aco that the above- - ❑0100,000 BTU Di 00;000 BTU ELECTRICAL $ • ,GRADING $ - information is ceratin.-1 agree to'comply with all city and county ordinances , , and state laws relating,to building construction, and hereby authorize repre- - PLAN CHECK 50% $ ' MICROFILM $ : • sentztivez of; this city to enter upon t e above-mentioned property•for '���� inspection pure:nes. �7 v/ �f • a MECHANICAL $ I 4 TOTAL FEE $ ' Signature _--I/,GLr�..�, ' • Reinspection Fee ,$15, , Issue Fee .$ 3 PLAN CHECK 25%• $ , I • , CMF 0865-46,rev.10/84 White - Building; canary - Applicant; Pink -Accounting; Goldenrod - Assessor Ir CONSTRUCTION AND PLANNING . POC SPA h' % 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 UFER 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, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final 12. Sewer Cap • - 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final • 14. Rough Plumbing 65.: Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final- • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT 20r'Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. ,Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing •5_0_ae �4 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat r`� > 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 I - • 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 Domestic-Final • - 42. Backf low Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System E 45. Sound Attenuation - FF� EXPIRED• 46. Handicap Regulations Incompl a Inspections 47. FINAL STRUCTURE & BUILDING •- Yate / Sig BeT 48. Special Requirements Completed �P , 49. Electric Release to Edison - -•� - - ' 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date • - _ -- Applicant to fill in all spaces except those within he• avy border lines and sign all appropriate declarations. • CITY OF Cb STA• ES CO • • NS ,R TION PE' MIT PERM TRACT NO. LOT NO. .UNIT NO. ' STY t..- �" ys3 St • Project-Address 8TY A { • -1 ' • I TYPE OF CONSTRUCTION ❑ NEW H ADD U ALTERATION L I REPAIR I Applicant's Mailin. Address - fA , ❑ CONVERSION ❑,OEM DEMOLISH ❑ OTHER _ A.P.# Zone e Owner's Namel /nS r_ ` ,t /1 /'1 Phan: DESCRIPTION OF WORK/USE OF BLDG. S Main Building: AccessoryBuilding:Address 22 41 I e�b5 Ln-. ' • • • II-I E Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING 0 FOUNDATION ❑ STRUCTURAL T Front O Address - la ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N ���� � ���► (.��Q/�� '� ' ❑ OTHER A - I Contractor's Nam-:>�=!I'nadifi P<lm 117,..•hone. dL - - - - • C Right G" PROJECT•DESCRIPTION SQ. FT. OCCUPANCYK ' Address(mailing) �. _L:__.Maras CONSTRUCTION TYPE VALUATION$ s Left R City•Licen Se No. •'t � La '1 ZONE' GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E 0 LICENSED CONTRACTOR DECLARATIONF - - I hereby affirm that I am licensed under 'sion5 of Charter 9 (commencing Remarks:.. 1,s �y� �r l / - - �I^a� Planning Notes: M with section 7000) of Division 3 and Professions Code, and C/y sQ-s any CJf ASl - (AMS / y - - my license is in full f• ce a.: : f_ I_ • - U 1 . T Lice. . Cl.s LL—T License Sa ' • - - - `S Date •L Signatuitr ' - ��rr� • PLUMBING .FEES - • - • WORKERS'COMPENSATION D LA RA • Bar Sink • Showers ' • 'hereby affirm that I have a certificate of •sent to self-insure or.a certificate • ELECTRICAL - FEES ' Workers' Compensation Insurance, o a certified copy thereof (Section Backflow Preventer _, ' Service Sink ' 300, Lab. C.)��/� 2[{ s - - Automatic Washer - Transformer 0 15-50 KW • �) Policy No'i A.tV/1J�I,b 1 4 i i t • S. �1 Backflow Irrigation _ : Sewer Cap - - . 0 50+ KW IYIO, / Construction Pole Sqb. Certifie copy is hereby furni he.IyF�''�1Certi fed copy is fkI�1 with the .` a. , rrti Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps ' • • EXEMPTION FROM WORKERS' 0 PE NSATI• EC • R•TION Clarifiers Solar Collectors Dishwasher ' Meter Dover 100 amps - (This section need not be complet d if the permiti/or one hundred ($100)or less). Dishwasher .. Solar Piping - Dryers ❑Gas ❑Electric Sub Panel 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 Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑tY.-8 - Workers' Compensation Laws of California. - - - Date Signature Floor Drains • Swimming Pool w/Spa -• . F.A.U. - - — , - NOTICE: If,after making this declaration,-you should become subject to the ' _ . _ IOC Solar ❑0-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures ' comply with such provisions or this permit shall be deemed revoked. - Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there'is a construction lending Agency for the pe5formance _ • Pole Light: of the work fiat which this permit is issued (Section 3097 Civ. C.) ' Interceptors ! • Water Heater ' - app Outlets Range Lender's Name - Lender's Address - . - - - - - Kitchen Sink - • Water Service. •• - ' •• -- Switches • - -Sign - OWNER BUILDER DECLARATION I hereby affirm that I gfn exempt from the Contractor's License Law for the Lavatories Auto-Wash ' Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Cotle:+Any city or ' county which requires a permit to construct,alter,improve,demolish or repair P—Trap ' Laundry Trays f Generator 00-5'KW 05-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit P to file a signed statement that he/she is licensed pursuant to the provisions of i Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of • :.Division 3 of the Business and Professions Code) or'that he/she is exempt- - ' i'ir/..eretrom and the basis for the alleged exemption. Any violation of'Section I ;x1131.5 by any applicant for a permit subjectS the applicant to a civil • • • - - •nalty of not more than five hundred dollars($500). • ' ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee l •$15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered Reinspection Fee J $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The.Contractor's MECHANICAL I FEES - License Law 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 - T- DEVELOPMENT SERVICES REQUIREMENTS: - employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however, the building or improvement is sold within one year of com- - - Canopy Type II ❑ ,zoning Approved By • Date ' pletion, the owner will have the burden of proving he/she did not build or im- , Duct-Under Ground - Building Approved By Date rove for the purpose of sale).I, as owner of the property,am exclusively contracting with licensed con- • Duct-Structural Refrigeration System .Application Issued By �7 Date 7 c , tractors to construct the project (Section 7044,Business and Professions Code: ' • The Contractor's.License Law does not apply to an,owner of property who • Duct-Ventilating 00-100,000 BTU 0100,000 BTU - $UMMARV OF FEES builds or improves thereon,and who contracts for such projects with a con- __ tractor(s),license pursuant to the Contractor's.License Law). I am aware that . . BUILDING PERMIT $ ,SMIP $ _ (( Exhaust System '❑ Multiple 0 'System Repair/Alteration _ proof o their Worker's Compensation insurance shouldBbe provided to me. '_ - - PLAN CHECK $ 1/ �/� _• PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIC ICBG# Fire Dampers PLUMBING $ W.f N _ ISSUANCE $ • Date • ner ' • - - - Heating System& Ducting - Registers PLAN CHECK 25% •$ _ ENERGY P.C. $ _ I hereby cer•' . hat I have re.i this -..lie. •on and state that the above ❑o-100,000 BTU 0100,000 BTU— ELECTRICAL $ • GRADING $ _ - infor ration . correct. I agree • co -. y w city and county ordinances and s .to Iii relating to ding onstr l /and hereby authorize repre-- - MICROFILM $ _ - sentati -s ff this cit o enter •on ab.v'.. entioned property t- PLAN CHECK 5O% $ inspects. f urp. • - ��`I MECHANICAL $ _ TOTAL FEE $ t�i ULJ Signator- .—`•.- � _ - ��/ • Reinspection Fee $15 Issue Fee - $ 3 PLAN CHECK --25% $ CMF 0865.4 ,r- .10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 00009653-00009653 TOT 5.00 CONSTRUCTION AND/PLANNING POOL&SPA APPROVALS,/ Permit.* Inspector APPROVALS Permit# - Date Inspector 1. Temporary'rElectrical.Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement _ • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. • ••. 8. Foundatiori 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water PipiOndrgrnd. • 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 •17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling ty d 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 i 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil ' 1 23. Gas Pipe-Rough & Test 72. Underground Flush j 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0Oil 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 PREY. FINAL 1 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:7,27-88 tepr-Csieo Lac0 • 34. Final Heating & Air Conditioning • 35: Final Gas Pipe-Test 36. Hood or Canopy . 37. Final Factory Fireplace - • - - 38. Final Plumbing 7/j`s/ (, • ,I T; .'39.;Water Service-Final ti! `�Y'-[��) 40. Gas Service-Final - i ,41. Solar Domestic-Final . -,; a • 42JBackflow Preventer • , 7 1t-� YlI 43: Backf low Irrigation ( i ' 44. Landscape Irrigation System - 1. tig 45. Sound Attenuation DOi 46., Handicap Regulations ` '47. FINAL STRUCTURE & BUILDING, - �- 'i 48.;Special Requirements Completed . .• • 4• 9. Electric Release to Edison I - 50. Gas Release to Southern California Gas Co - '1. . 51. CERTIFICATE OF OCCUPANCY - - - , No. Date . - ' - - Applicant to fill In all spaces within heavy border lines and,sign all appropriate declarations. CiT-A OF COSTA MESA `• - PERMIT NO. " - TRACT NO. , 'BLDG:NO. ' " - - - -- ' .6.7'--^--? ;. CONSTRUCTION PERMIT ALA, 3/ t • Project Address, Q 7� J/FG,/'/,;� (n , • . ' c` TYPE OF CONSTRUCTION • .- -- ' i�fo(73_ I I/O4/BI 6.00 . _ IL • Owner C%)t'p GO ')--.- `,0t) PhOnss:SQ7-4775 '0 NEW O ADD 0 ALTERATION - - - T_qp,•,- - r' '.- ' , Address 79 . :-.. -4.„.. ID r /� /Jf-� - REPAIR 0 CONVERSION 0 DEMOLISH ZONING REGULATIONS -_ -Arch/Eng- - `J - License No. - ❑ OTHER • . . - ^ DESC RIPTION OF WORK _ - .- _ - ZONE PLNG. REF.$ Contract0T74 .4:4 6„rc 'p . aane fr'-4tj�J;i TYPE OF PERMIT • - BUILDING - —• To BUILDING' '^"� SETBACK CIL ST. PROPERTY LINE . Address 7�'•-// � lc-.•�J�+-�- F • 0 GRADING` -O FOUNDATION 0 STRUCTURAL ' � -SIDE YARD LICENSED-CONTRACTOR DECLARATIj!JN - - O TENANT O ELECTRICAL OPLUMBING OMECHANICAL LIFE YARD - - - ' • I hereby affirm that I am licensed under pi ovisions of Charter 9(corn- RIGHT mencing with'-section 7000) of Dlvisidn 3 of•the Business and 0 OTHER - - - • -- - Professions Code, /and my license is in full force and eft REAR YARD(TO P/L) - LLicense Class /� —/ c- e Nc,.. //r2p6 ' PROJECT DESCRIPTION _ . . . _ _ . -- __ -. . ...- icense • Date /' , - SG.FT, - ,. _ - PKC.SPACE REQ. - -,-QRO V,IDED / -Signature STREET WIDTH PARKFEE$ WORKERS'COMPENSATION-DECLARATION - -. OCCUPANCY_CONSTRUCTION TYPE _ I hereby affirm that I have a certificate oyy c' nsent to self-Insure or a VALUATION - ZONE ZONING APPROVED BY I DATE certificate of Workers' Compensation Ins&r ce, or a certified copy •- - - - . - - . - ---- - - ' SPECIAL CONDITIONS: thereof(Setup 800 b CJ. 1.+-741-C-74- /) / GRADING CU.,YDS. ACRES Icy No. (i`n07// Company I �. - lyyc-p.�/ _ _ - -. . .- _ __ .-. Certified copy Is hereby furnished. "REMARKS: Certified copy Is filed with the city Building Division.' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -'I . . - - - - ' - - ' (This section need not-be-completed if the permit is for one hundred _ _ ___ _ __ ,.'_ __ _ _ _ ($100) 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 PLUMBING r- PLAN CHECK - - ELECTRICAL - - _ PLAN CHECK - subject to the-Workers'Compensation Laws of California. UW -- ELLtNG - - -- GG AHHE - - Date 1 Signature • BATHTUBS - SHOWERS - -` SO FT SO FT - NOTICE: If after making this declaration, you should become subject TOILETS',. URINALS- - "'-' -" - ' GENERATOR ' 0-1 VCW_1-10 KW 4 to the Workers' Compensation provisions of the Labor Code,you mustTRANSFORMER . - • . . ' ..' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - 'APPLIANCE ' 10.50 KW_50+KW , revoked. -, . .- _. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS , . MOTORS ' ' 0-1 HP_1'-10 HP' - - - • I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS ` "SUMPS- ' -' - ' (INC.SOLAR) 10-50 HP 50-+HP -- - formance of the work for which this permit is issued (Section 3097 - Civ. - - FLOOR SINKS FLOOR DRAINS' ' - FIXTURES ' " OUTLETS'--SWITCHES - ' -" Lender's Name _ _ - Lender's Address DRINKING FOUNTAINS - - - - GAS TUBE SIGNS -- - - ' - - OWNER BUILDER DECLARATION - -- INTERCEPTORS CLARIFIERS - jPnl F'I IOHTS - - -- - I hereby affirm that 1 am exempt from the Contractor's License Law for _ the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL' 'PTRAP ' -'" - - LtLI I - Any clty or County which requires a permit to construct, alter, POI ME R CBImprove, demolish or repair any structure, prior to Its issuance,also re-' -WATER SERVICE ALTERATION ' P. ,A.'MA • .. quires theapplicant for such permit to file a signed statement that he _ - ( - is licensed pursuant to the provisions of the'Contractor's License'Law GAS SERV ICE OUTLETS ' (Chapter 9 (commencing with Section 7000) of Division 3 of the Y $[ A .•••>< . - -"iness and Professions Code) or that he is exempt therefrom'and the WATER HEATERS BTU OUTPUT - ' ' F2�AV -Q fQ�r/a`' for the alleged exemption. Any violation of Section 7031.5 by. _ applicant for a permit subjects the applicant to'a'civil penalty SEWER CONNECTIONS '-' . ' .ot more than five hundred dollars ($500). _ - Lu I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTOR -DA-EV/sic-9-4"SIG n/ sole compensation, will do the work, and the structure is not intended - or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. /i)d / IL/,.,/e;.L ) .6.100 , ISSI IF Contractor's License Law does not apply to an owner of a-property fi`- �r -- APPLICATION APPROVED BY. who builds or improves thereon, and who does such work himself or ISSUE FEE - - • DATE- through his own employees, provided that such improvements are not - - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the.owner will have the burden _ -- of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU _ BUILDING $ ' - SMIP • $ E-1,- as owner of the property, am exclusively contracting with -AND DUCTING - � licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT - OC) and Professions Code: The Contractor's License Law does not apply to- - - �-^� ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU _ PLUMBING $ tracts from such'projects with-a contractor(s) licesned pursuant to SYSTEM - - GRADING $ - the Contractor's License Law). 100,000+BTU _ PLAN CHECK $ ❑ I am exempt under Section • -- - B.& P..C.for this BOILERS BTU ELECTRICAL S S reason - ' PLAN CHECK $ • MICROFILM $ SYSTEM REPAIR,ALTERATION Date -- Owner - - - - TOTAL FEE$ MECHANICAL $ I hereby certify that I have read this appl ation and state that the above EXHAUST SYSTEM MULTIPLE ' , - LESS AD-. information is correct. I agree to co ply with all city and county PLAN CHECK $ -- VANCE PC $_ ordinances and state laws lacing to struction,and hereby author e representatives of is y r upon the above menti ed — / /�� property for Ins t urp , _ • _ _ / nM1/� Y '/ Signature I , ISSUE FEE -- • . . CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor .c.--- : ..-„---c1-..,. �� "- CONSTRUCTION AND PLANNING POOL&SPA • Date Inspector Date• - Inspector APPROVALS t f .` . Fermit,* APPROVALS Permit# 't ' " 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn - • 44. Steel Reinforcement - ' 3. Electrical Conduit Utility-Undrgrn 45. Forms - _4. Electrical Conduit-Undrgrn 46. Electrical Bonding . • - ' 5. Steel Reinforce _ 47. Rough Plumbing &Pressure Test " 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undrgrn r ' _ 8. Foundation , _ -.. - . I - - . 50. .Gas Pipe, ❑Undrqrn,Test - • 9. Water Pipe-Undrgrn • 51.• Backwash Lines, P-Trap. ❑Undrn n • 10. _ Structural Floor System _ 52. • APPROVAL TO DECK ' 11. Property Sewer Line & House Connection . - - 53. Backwash & Receptor-Final 12. Street Sewer Connection - - - . 54. 'Heater & Vent-Final 13. Rough Plumbing _55 Pbimhino System :Final • "' 14. Rough Electric-Conduit - - ...... - -56. Electrical-Final - • - . - 15. Rough Electric-Wiring - .. - - -- 57. Solar System-Final Kr''.. 16. Rough Heating &-Air Conditioning - . 56. Fencing&Access Approval 17. Ducts, in Structure . . - .. 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating , 19. Gas Pipe-Rough &Test • - 60. POOL/SPA SYSTEMS FINAL ' 20. Roof Framing . 21. Roof Sheathing - NOTES: • 22. Frame and Flashing - 23. Insulation . 24. Lathing & Siding _ - 25. ' Drywall:Nailing- • _ _. 26.; Plaster Brown Coat `, r, t -v : 27.: Electrical Power Meter-Final • . .-\ :, : • • 28. Final Electric " •• e f -y4: ; . , nr 29.1 Final Heating & Air Conditioning - ; _ f.,„'r^ 301 Final Gas Pipe-Test I - 31.: Final Plumbing ' 32. Watei Service-Final ...... . . -' . 33. Gas Service-Final • 34. Solar Domestic-Final 35. Landscape Sprinkling System 36: Sound Attenuation _ _ 37. Handicap Regulations • - - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison _ 41. Gas Release to Southern California Gas Co. . _ 42. CERTIFICATE OF OCCUPANCY No Date - , - - - PACIFIC INSTALLERS, INC. 7541 Anthony Avenue Garden Grove, California 92641 P.O.,.Box 728 Westminster, Calif. 92683 State Lie. # 44/tri' City Lie. # •.15/1t--5- Date //,0G - f/ Customer Name .,,C_c,-,_? Permit No's. J2')//6 ‘..5// T?oes of Permits City of ! (%/f _- Department of Building and Safety Gentlemen: Please be advised that as of /2/-.2/-1,/ all work by Pacific Installers, Incorporated, on the permit numbers listed above ' have been cancelled. Therefore, Pacific Installers, Incorporated, requests that the permits be cancelled and that all pre-paid fees be refunded. This cancellation notice is advice to you that Pacific Installers, Incorporated, has no responsibility for work accompliped under Permits noted at ,4,C 7% 4(2 *,_y7 cc is ti- • Very truly yours, PACIFIC INSTALLERS, INC. Manager PI-264 Rev. 3/74 1 Applicant to fill in all spates within heavy border lines and,sign all appropriate declarations, ' CITY OF COSTA-MESA ' — PERMIT NO. ' P TRACT NO. • LOT NO.•; -BLDG.NO.- - - -- • 1642—I2/ 1.3/9P . . - -.4.P5 ,TL CONSTRUCTION PERMIT 557?� II.. - , 1 l p .:F�.1�'n . '.,f 9 - Project Address /7O I •' ��p `7 }L� 9Y� �/a') . ' 1I . _TYPE OF CONSTRUCTION _ - ' Owner '1aas��1p Yq o A /� �j Phone.65•'7,�, O NEW ❑ ADD ❑ALTERATION ' . ••'1/l? • Address A(1 /q /CDAyi- g .., A• , .0 REPAIR O CONVERSION ❑DEMOLISH- " ,VV _ ` 'Arch/Eng. - - (/ - License No; -- if b•0 OTHER • ZONING REGULATIONS' _ , 'Address - . .--- .,, _ __ .DESCRIPTION OF WORK- A.p, ,. O ZONE" 'PLNG. REF. t - - :Contractor [" - •,vyPhone1337971U TYPE OF,PERMIT'- - -- ".1 - - - " - BUILDING_ . . ��BPUI LOING .,_ • I /� �-' �.,_,,�. •.� �• SETBACK C/LST. O RTV.LINE- *Addressisq-, ; (tn.,x•�"*•^•"`•"�• - G.LT" 't [ ❑ GRADING O FOUNDATION- 03TRUCTURAL - 41DETVARD - " • - ... _. _- _ _ '' LICENSED-CONTRACTOR DECLARATVV��N ' - -_ EFF Thereby,affirm that lam licensed under provisions of Chart •er 9(corn. TE-TENANT .ELECTRICAL i OPLUMBING ❑MECHANICAL -SIIGEYARD. - _.. -_ _ _ _ _ HT ' ' mencing with-section 7000) of. Dlvision••3-of the. Business and. ❑ OTHER '•54:?' REAR VARD'(TO P - r Professions Code, and • y license is in full force a tl f ot. - /U' I �f��' ' '.PROJECT DESCRIPTION - - LicenseCla s [[_ e No: " ` -' - - -PKG:SPACE REQ.'•' - " PROVIDED - _ -� - - Date" - - l• - Signature' .- °e - hs. ' . SO.FT.' ...,' . - . . - _ - r _yOCCUPANCV_CONSTRUCTION TYPE • STREET WIDTH' ._.PARK FEE $• WORKERS'-COMPENSATION DECLARATION - 'ZONING APPROVED'BY`•• 'DATE-hereby affirm that I have a certificate of consent to self-Insure ora •VALUATION ° -. ZONE s - - ••'• r' -- - ficafe of -Workers' Compensation-Insurance, or.a certi(led_copy ▪ ' " - - - =if(Septi[ �0p, Lab.CJ. I ,,GRADING CU.UOS; ACRES • I No. " W ler niched Y �Q.!' J V7W.(•.- ._REMARK§ . ,., - Lcipertified copY:is hereby furnished.:. __ - Certified copy is filed with the city Building Division. s ' .� . EXEMPTION'FROM'WORKERS' COMPENSATION DECLARATION -" •-" -: ' '-• - -"-- (This section need not be.completed if the permit Is for one hundred . , • ($100) or less). , -' - »_ .: . 'b ., ..- - '. - l - _ ._. . I certify that in-the performance of.the work for - which this permit'Is Issued, I shall not employ any person ini any mannerso as to-become PLUMBING.' " re LA IV CHECK-- -` - •-- 'ELECTRICAL ' -^ -'PLAN•CHEC:IE- - - , subject'to the Workers Compensatlen Laws of California. _ - UW ELLINb,_.� .AHRHtaE - Date Signature BATHTUBS' SHOWERS"' ' '* SO FT - SO FS - NOTICE: If after making this declaration, you should become subject TOILETS . ' . URINALS -• - - • • -(-•-- - • - GENERATOR• -- '0-1 to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER I forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS ^-- -':- _u -APPLIANCE' 10-50 KW=50+.KW' - _ _ • . ' __ .KIT.SINKS - • CONSTRUCTION LENDING AG ENCU '-.DISHWASHERS -• - MOTORS - - 0-1 HP�S' N•�-lO HP _ 1^hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - - SUMPS' '- - �•-- _ .(INC.SOL7.�L 1p�,0 /�� 0 P formaece..of the work for which this permit is issued (Section 3097 r (J�A.tLryL LI.G'P7--�'- �' "-Ol�' Civ. CJ. - •- - - ^+ •- • FLOOR SINKS ' ' FLOOR DRAINS- - - FFIXTURES • 0 TLETS S ITCHES - • Lender's Name - - _ ._. _.. Lender's Address - '- DRINKING'FOU NTAINS'- -�- •• - -" - - - GAS TUBE SIGNS. OWNER-BUILDER DECLARATION - - -- ---•• • - - -INTERCEPTORS ' t. - CLARIFIERS"-.- ' '•- • • POLE LIGHTS - '-- 4"„ " •- - - I,hereby affirm that I am exempt from the Contractor's License Law for - - _ the'following reason-(Section 7031.S.Business.and.Professions.Code:. •SWIMMING POOL CUNSI HUI-I ltN • Any city "or county which requires a permit to construct, alter, POLES 'METERED - SUB - improve,demolish or repair any structure,-prior to its-issuance,also re -WATER'SERVICE ' --• ALTERATION -s - quires the applicant for such permit to file a signed statement that he _ is Ilrensed.pursuant to the provisions of-the-Contractor's•License Law' . - r' 'er, 9 (commencing with Section 7000) of Division 3 of the GAS SERVICE" OUTLETS .. -- s and Professions-Code)•or-that he is-exempt-therefrom and the- WATER HEATERS - BTU-OUTPUT ^=-- - t- '- _ - •' - - - - -- ' ' " - '_.. - ,f the alleged exemption. Any violation of Section 7031.5 by - ' - pplicant-for-a permit-subjects •the applicant-to a civil penalty SEWER CONNECTIONS - . '- •----- - - -- - - - ••-- - - -- -- .. . of not more than five hundred dollars ($500). ' - ❑l; as owner'of the property;or'my employees with wages as their SOLAR TANK- -- COLLECTORS - - -• • --- -- •---- - - + • - -- .- _ sole compensation, will do the-work,and the structure is not intended • _ or offered for-sale. (Section-7044T Business'antl'Prbf essio ns Code: The ' SOLAR PIPING SVS. ' y - ISSUE FEE,- - -- - Contractor's License Law does not apply to an owner of a property rqp PLICATIONAPPROV ED BY.-_ _. - who builds or improves'thereon, and who does-such work himself or - -ISSUE FEE .• "'-' . through his own employees, provided that such improvements are not Intended or offered for sale. If, however:the building or improvement' MECHANICAL - . PLAN CHECK * . ' SUMMARY OF S' FEE , is-sold within one year of completion,the owner will have the burden • " of"proving he did'not build or Improve for the-purpose of sale): "' -- - 6:100,000 - - - • BUILDING -" HEATING SYSTEM BTU PERMIT $ SMIP - -..5 ❑a I,- as owner.of .the property, am_project (Section 7044,ing with. _: -_, ,: _ ._ •- _ - - �' o' - +' licensed contractors to construct theAND DUCTING- - - project (Section not Business 100,000;+BTU .. PLAN CHECK $ PERMIT a and Prof essions•Code:The build cto Cs License.Law does not apply to _ _ ISSUANCE a-E'r �" -' an owner of property who builds or improves thereon,and who con- REFRIGERATION - 0-100,000 BTU PLUMBING $v • tracts-fro projects with a contractor(s) licesnetl.pursuant to '.SYSTEM. - - - GRADING , 5 the Contractor's License Law). - 100,000+BTU - - " PLAN CHECK"5- 1' < - - ' - - ❑ 1 am exempt under Section - • --- --B.& P.-C.for this - - - --+ - - `t" �{ 5` BOILERS BTU' "ELECTRICAL- $-- IIOC�/ ' reason- - . _ - _ ,•_ - • MICROFILM 5' - I SYSTEM REPAIR,ALTERATION 'PLAN CHECK-$- Date Owner -- --MECHANICAL-$ - TOTAL FEE$ : .•,- _ l thereby certify that I have read this application and,state that the above EXHAUST SYSTEM MULTIPLE , l*= - I- LESS AD- information is-Correct-I-agree-to comply with all city and county' - - :PLAN-CHECK-§ VANCE PC- $: .ordinances and state laws relating to construction,and hereby authorize , . - " - _ . representatives-of this'city to-enter upon the above-mentioned - -- -- " - •• I property for Infpectio p_ sec./`- tali!O� ' FINAL rF-. O I • Signature - . �. . ' - - ' ISSUE-FEE _ .. -- .. ._.--'- y. . _ . . . - • CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING- POOL&SPA , - "'a c-1 'n( , I . APPROVALS. ' ;•. • Permit#- L/'..._7 76 Date 'Inipector '' O -' h ` - -- `1- ' --Date ,- , -Inspector. .• APPROVALS'? Ci. K:•t Permit# :'1. Electrical Service or Pole _ 43. . Pool & Equipment Lbcatio'n'' - - ' a 4:2,.: Soil.Pipe:Undrgrn_,,: :.- -___.- _ _ 44. Steel Reinforcement Y •37-Electrical Conduit.Utility-Undrgrn-,-_ . . ,,.-. r . :._ , ._ 45. Forms •-•--- __ • -- - - -- - - ' -- - --4: ,Electrical-Conduit-Undrgrn _ . . _ ' f -__ .- . - . _ __46. Electrical Bonding.. : - --- - - ---- : -- -- -. - - -- . t^.5. _Steel•Heinforce 47. Rough'Plumbing& Pressure-Test ` ' , r_6. - ElectricaLUFER.Grn. -- __,_. .. _ . ,. -. ..J • „48. APPROVAL TO COVER-GUNITE- -- , - • r-r - - L_7._Eootings_- -,., .,_-__ __ _ _ .__. , - ^, - ' 49. Electrical Conduit-Undrgrri .'-•':. 'i•.:• - - 8:- Foundation-,. . . _, ,- „4:::::12...t _�_-_ 50. Gas Pipe, ❑Undrgrn,Test - . 10'''' ' "' ` • I: t.• 9. -•Water Pipe-Undrgrn--.-- .:_.__._ ..._. . f 51. Backwash Lines.P-Trap O'Lliid rn„ ''-': ' -- --. -- . - -10.- _. Structural Floor System _ " __ r - ' r e: ' - ' 52 :,APPROVAL•TO DECK -- -- -- _- -7::::-.1 ` . , r11._.- Property.Sewer-Line.& House.Connection__ _ _ . -. . ___ ,_ . -53, -Backwash&•Receptor.•Final-9:---"-` . '- - • - - ' '•' " 1-12.- Street-Sewer Connection _ -- -„_ - .. . .- . • . .• -- . -54: Heater&•Vent-Final' - ' ' - -'�, 143.- Rough-Plumbing-- _ - _ __„_ -.,,,- _.._ -,•.., -- _.. __ - 55. PlumhinpSvktErn Final .•: it Rough Electric-Conduit ( - - - - '" -- •- -:56.' Electrical-Final n1 • ' - =^' ' '• • - 1 15. Rough Electric-Wring ---- --" - _.. - -57,`-Solar System-Final - - - -" ' " " "' 'I b8..- .Fencin &-Access-Appro - -� .n - .- `1.6.��'flough-Heating-&'Air Conditioning=--'• - - - :- " 1.- , � =- r=- ----Th.-. � - g � ,�� � . ,. ... '`; ' ;� t--17c!- Ducts;in-Structure -:,.--. --•-- •-• ._ -- ' I. _ . .59... APPROVED-FOR PLASTERING' Z.; 1 . : '. • • • . .. r18:` Ducts:Ventilating - -- - -L'. - +-- - - _.r. .-- _ • .- ----- - _ ,., .. _ ...-,-.- - -- -- -- .. . ..�ane_� _ . 19.1 Gas Pipe-Rough &Test I, •n- . i r• -60. POOL/SPA SYSTEMS FINAL'' '° "i' 4""'• c' -"='r , "`r't' •-'` c • • 20rt 'Roof Framing ._ ::ti- -- -' - --._: _, _I T.__. _ • ,r _., 21,1 Roof Sheathing :. a' `r:r . ,aa,s 3 ,a ?t, ,r ,=22:',- Frame and Flashing;- ,:_ _ _.-.- , _ _..._._-- _'NO. S J_ ._ I _ 2..-__... ` • - . r , „ , jf-23:. Insulation - -.- - - - --.... - _-.. b- --- - -- - .-._.. - �- -.._ - - -' _` - ---- -- --.... - - • - - - - •.r •a _ !-24.! -Lathing& Siding---- -- - I1 ' 25., Drywall-Nailing-- - - -- -�?•+,:. ,-.o• .--;-- - -^ - - - - -- - -- -- - -`---4 ,o' ,�� ,� n . . -i-i.,�:,,c;, -. •=n`.;;:+" , .. t 26.f-Plaster-Brown Coat- '-' ' - --- - --`; ' -; -_ _t'-- --'--• - -- --- - --• - -- -. ...:.._ l ' i .l ., ,, .i; - 27,r- Electrical Power-Meter-Final- . ,_..- __..:_ : . _. ,,,. ;t,u. •. r -: , -• ,,. , -,.-- .,. 28 Final Electric - - -_ .. - -mac 1� C •L - - r, . .. . ,, , • '-29:-- Final-Heating'&-Air - -- Conditioning - - -- -- - - --- - :__-_. �__ - ,_- ,__..._. .. _ , .., . . .. •i� -• l'i R Test --' _ __ - -- - -. ._...- - -- - . - - - . . • , , . ,I, . a ,-30., Final Gas Pe - ! ' > --- - - 1 31.. Final-Plumbing- - F 1 32: Water.Service-Final-----r; _-: -r-.. •-- -• i----._ - .-- ---- - • --- -'- - :'! "t.,- . • • ,.:r. • - q 34, Solar Domestic-Final n"y-'" i 35.- Landscape Sprinkling System -- '''- I -- - , . .r.:.--'' II . ' ' . ,_ .. .-- ." .. ' u ,. , 36, Sound Attenuation •- - , r - __ - _ t - -- __ ... t •' r- _ -. .. _!!_, 37. Handicap Regulations - - - - .,-,n- - -- . .. . „e , . 4c),•. �, ^ •, r. . . ' , , : 38. FINAL STRUCTURE&-BUILDING ' ' L_ L_ '_ - -- - _-'. - __ •z. - . r'= ' ' I. , 39. Special Requirements Completed '" I - _- - . _-. . _ . ' ' • : ,t 40. Electric Release to Edison - . .. . I ' :"t•.'' -'• : • ' - 1 41. Gas Release to Southern California Gas Co, • 7 142. CERTIFICATE OF OCCUPANCY - No_ - Date r _ .__._ .._ -. .. _ .._1:_:. ._ -. _ _ • • � � 2 r SEFf1EE3f RECEIVED Lott 81, Trac42Ob, Plan 3-D I,� COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. . P. O. BOX 317 COSTA MESA. CALIFORNIA CIIv OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 2879 Regis Lane . COSTA MESA. CALIFORNIA For Office Use Only p n I RECEIPT NO. 11 1T53Q owNERMesa Del Mar Development o. 16.1532 AMAIL DDRESS 3800 E. Coast Highway RECErv�.+ BY DA( �SiP- I St�B IBU 1.0v• CITY Corona del flat, Calif. NO..OR 314220 BUILDIN 7 Y G A `y..,,,EECT r�y, OF¢' 41INEER Macco Corporation ryD.aR 34220 COSTA MESA. CALIFORNIA FIRE ADDRESS 1800 F Coast Highway ZONE TYPE GROUP OYIK CONTRACTOR Macco Corporation APPROVED BY DATE ADDRESS 3800 E. Coast Highway ZONING `'�• CITY Corona del liar, Calif. zG" \ NO. 7 j�USE OF S,;�d2,1. '[� p PLANSO..OF 'USILDING %/ �j(/'- - LIC. STATE NO. 98808-SB-1 NOL.OR 314220 - DESCRIPTION �� ���1 I? t.-f {+O `• ! SIZE NO. OP BLDG 1 I OF LOT 6020 S F I NOW ON LOTI110ne A.P.NO. USE OF EXISTING BLDG. - APPROVED ALL none OWED SETBACK LINE FROM ')O 1 2 261 (CENTER LING ST.) �/ ^� CENTER OF STREET 39 `TI- REAR YARD FRONT 7 7 FT. IN. lit I I 61 SIDE YARD LEFT RIGHT R.SIDE 6 FT. IN. DESCRIPTION OF WORK L.SIDE /`/ FT. IN. NE 11XXII ALTERATION I 0 ADDITION I REAR Z C FT. -- IN. REPAIR I VI MOVING I 0 DEMOLISH I BP•PROVED /i DATE 1? -;/7/ BUILDING 10IX5h16U ,,,JJJROOMS 7 STORIES I -*/1CNO. OF /� 1? -;/7/EXTERIOR `WALL StuccdnoOF comp. COVERING COVERING Living Area 11167 S F USE OF BUILDING AND WORK TO BE PERFORMED Single family residence Garage Area 476 b F w/attached garage Covered Porch etc. 30 b l I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE_ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION SIGNATURE OF PERMIT FEE $ 6 PERMITTEE N a Del Ma Development Co p1 3 " B ���� // $16,O8µ.00 PLAN CHECK s /i — s AUTHORIZED AG ltie �H�C/+i/ 511.°0 K TOTAL FEE $ a _ 28391 NM 29=60)-838*. ****-18.00 l COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill In Completely APPLICATION FOR PERMIT �� TYPE OR PRINT BUILDING • �' For Office Use Only FLl UIDNG _Rsy/s L v/ DDRESSRECEIPT NO. ^PS3c/COSTA MESA, CALIFORNIA � /�Oi T�[�,/q��/ V/spy± C,�/�I/[y//][�.�3jC��y mRECI. DIED jaa<-IC'U 1J 11:1-6QWNER UI G7"'OR �l.4�Soiv ' r1 G BUILDING 79 ADDRESS F O 7d IZ G-9/< 'h. w, ADDRESS �(� �A f ,A(JJ / / TEL. ZONES TYPE GROUP CITY (� . Ad, NO. A7,'-.3 / p �,(�/ 9ITECT NGINEER A/0 Ai Sr TEL NOBBYPROVED /{ '7 DATE . y-/-4 . �I\ AZO/^NING Wcr�✓v IC • ADDRESS EO „ / IU.OSI BUUBEILODFINNGE CONTRACTOR /7M, EAT N47,4 / , / / ^R' )-0 7LEGDEDCRIFTION 7/ AL t ADDRESS /-..7 4...:7 MGNOGT../1 //IZ ' �. CITY i �i A.P.NO. l #!---- ---70 3— /_ / K/ NOTE: NO HAVE OVERHANG SHALL BE LESS THAN LIG..NO.ATE /.3077 NO. r yC -e yr- BO TO SIDE 8REAR P.L b EAVES SIZEOF LOT 7d I / I NO.OF SLOGS. ALLOWED (U.B.C.REQUIREMENT/ X NOW ON LOT / - YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. R E s/D ISN lP4' (FROM C/L STREET)/) SETBACK LINE FROM 1 FRONT J FT. Y/L-- FT. CENTER OF STREET REAR YARD Z O �y SIDE YARDI LEFT /3 12RIGHT c R.SIDE .6A7/!PT. .--0---70 PT. I DESCRIPTION OP WORK L.SIDE T•! " Irr. ALTERATION PM /i -REAR A20 FT. FT. DISTANCE BET. BET.MAIN B. REPAIR _MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGB. BUILDING NO.OF VAR.* DATE SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL ROOF Ar RW/D�I } 1 DATE 5 - f,64:5" COVERING ine,C.AC I COVERINGSA/LKG USE OF BUILDING AND WORK TO BE PERFORMED M ntharaziestwilititaiseetreg R 6A. /t• 4 6- E.t.aD T/�(J// // 'SQ.Q.FT. 1 I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COPE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 1A PLY WITH ALL.CITY ORDINANCES AND STATE LA S REGULATING VALUATION _�I 0 BUILDING CONSTRUCTION. U/L// SIGNATURE OP PERMIT FEE PERMITTEE ,�l a <.t_, - "J/ Z 12. $ 11 AUTHORIZED AGENT / /� (�(/}�� TOTAL FEE $ ..