HomeMy WebLinkAbout623 RHINE LN - Building Permits 42576 ..
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
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ADDRESS / !!�� ( o.1 p/��(CII TRACTa/0 LOT (r BLOCK
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BRANCH /e(4/41 �; OWNER EL/ e2
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CONTRACTOR 6E0 �P2E2� ; APPROVED ���^ DATE I' / --
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ADDRESS TE7 (NO.OF0 VI
USE OF NEW'3 .1rr
CITY NO. :� ci �—tPLANS C. . BUILDING CC4)P1-+
F+ STATE /� j� CITY YARDS APPROVED YARDS APPROVED
': LIC. NO. L 7'e,757: LIC. NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE 'NO.OF BLDGS. (FROM C/L STREET)
O. 1 OF LOT NOW ON LOT `. FRONT T. FT.
Q USE OF
EXISTING BLDG. R.SIDE putt/ FT.
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FSeparate permits are required for ; L.SIDE FT. FT.
- ?: electricrt : ,plumbing and heating work. ?, REAR FT. FT.
n] USE OF BUILDING AND WORK TO BE PERFORMED
'C ' AINDISTANCEO BET. BET.MAIN&
a0 �j rte- ///J °,' MAIN BLDGS�J ''/ ACCESS. BLDGS.
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APPROVED � /'
} � APPROVED/D. J DATEy. I /j•�V
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O I hereby acknowledge that I have read this application and state n
C$ : that the above information is correct and agree to comply with es
G. ' all laws regulating building construction, and I shall not employ i
Z LI any person in violation of the workman's compensation laws of d
the State of California. m
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I hereby certify that I am properly licensed as a contractor under 7
the State of California Business and Professions Code, Division 3„', THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE Sv
and Professions Code, Divislop 3, Chapter 9. ��/ O n
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PLAN CHECK E 20 / m
Signature of `/G‘..42-6/2---- 0 V //'J �) o
. Permittee ( /�7� fG� .(C $ /// OD!/. TAX S 11 U
Authorized Agent ( TOTAL PAID 85-23 gfr
CITY OF COSTA MESA
•
0y111/440 BUILDING DIVISION
f ._.r,.__.�J ,�I 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL:(714)754-5626
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PERMIT NUMBER: P10-00106
PERMIT TYPE PLUM STATUS: ISSUED
APN: 93405112 DATE ISSUED: 08/02/2010
ISSUED BY: KJB
JOB ADDRESS: 623 RHINE LN CM • - Suite/Unit:
Vicinity:
SCOPE OF WORK: WATER HEATER CHANGE OUT
OWNER: SANDELL,KEN Address: 623 RHINE LN
PHONE: 714-654-2711 City/State/Zip: COSTA MESA,CA
APPLICANT: SYKES,VON Address: PO BOX 1017 .
PHONE: 714-530-2440 City/State/zZip: GARDEN GROVE,CA
CONTRACTOR: A-AMES PLUMBING HEATING License No. 250307
Address: P O BOX 1017 PHONE: 714-530-2440
City/State: GARDEN GROVE,CA ZipCode: 92842 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL FEES: $35.80
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
CODEC INSPECTION TYPE DATE INTITIALS CODE! INSPECTION TYPE DATE INTITIALS
1618 Fixed System Final Fire Prevention 206 Final Mechanical ^� p,/
1266 Pool Spa Final _ 208 Final Plumbing g'I 2-/0 by t+V
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive a license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. • Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of tke work for which this permit is issued.
have and will maintain workers'compensation insurance, as required by
' n 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
are; person is required to descend.will be made in connection with work authorized
JCAVA/1 .f by this permit,and that no building structure,scaffolding.falsework,a demolition
r' • i or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section needdna be completed d the perms is valued at oneneh fired••tars($100)or less) 2,Art 2,Sec. 341,Title 8,California Administrative Code).
o y.Wumber. 02D i R M t2-0062 a p
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become ubject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
the Lab r Code,I sh orfhwith comply with these provision
Division of Industrial SafetyPermit Number:
want' alure U'; -i HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No
($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
isuCJI-�`.� V? CandiL G.b6 (Section 25533 of the California Health and Safety Code, with some
!ti exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
Slpnamra_ .-,r are— 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Dale
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
thereon,and who does such work himself or herself or through his or her own 8. (If"yes" attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
IDI, as owner of the property. am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code:The contractors License Law does not apply to an owner of signature Date
property who builds or improves thereon.and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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 .z:Owner(s) Da e
Signature Date
3057.4613/071
n.r or uthdnz ryApphwm r Daie b`�,
In
a Prescriptive Certificate o;Compliance: Residential
CP-ER-ALT
Residential Alterations Le (Page 1 of 5)
Project Name- , Climate Zone t! t •
Ir N of Stories
��y
General Information
Site Address: L2 2;3 iv, r\Q, -Enforcement Agency: Date: , ' O
Building Type pingle Family ❑Multi Family Circle the Front Orientation:N,E,S.W,or degrees r�_�
Conditioned Floor Area(CFA): Project Type: 0 Alterations Cl Envelope 0 Fe n O Roof ❑FFVAC
Replacement or Change Out 0 Duct Replacement ater Heater
NOTE:This form is not to be used for Newfy Constructed Buildings or Additions ,
Insulation Values For Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
❑Opening of framed cavity alone-Alterations that involve the opening of the framed cavity ofa wall,ceiling,orf nor must install the
mandatory minimum insulation value per§lSOfor the altered assembly.Fill in Columns A-C and enter mandatory insulation value in Column H
Cl Replacement of entire assembly-Replacement of an entire wall,ceiling,or floor assembly requires the installation of Component
Package-D insulation values in Table 151-C. Fill in Columns A-J
Opaque Surface-Details For the furred_portioned of Mass Walls see Furring Strips Construction Table below. _
A [ B ) c ) D _ E F I G ) Hill J
' Proposed s«N"" Standard Values From 1A4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tae) Assembly Name Material Spacing, U- 1A4 Table Cavity Insulation A. .... y Assembly
ID or'type' _ and Size2 - or Other factor Number' R-value° R-Value? alue° U-factor
•
Note:Forfurred assemblies,accountingfor Continuous Insulation R-value,see Page JA4-3 and Equation 4-I. F' calculatingfurred walls use the Mass and
Furring Construction table below.
1.For Tag/ID indicate the identification name that matches the building plans. .
Z Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs,Crawl Space, s..rs and etc...Indicate the Frame type and Size:For
Wood Metal,Metal Buildings,Mass,enter 2x4,2x6,or etc...see JA4 for other pas, .leframe type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members en•-•;16"or 24"0C;or Other for all other assembly description
such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel. etc....
' 4.Based on the Climate Zone;enter the Standard U-factor from Table 151- C or D for each different assembly Name or type.
S.Enter the Table number that closely resembles the proposed assembly
6. Enter the R-value that is being installed in the wall cavity or betw•.n the framing;otherwise,enter "0".
7. Enter the Continuous Insulation R-value for the proposed asse bly;otherwise,enter "0".
8.Enter the row and column of the U-factor value based on C. mn F Table Number and enter the Assembly U factor in Column)
9.The Proposed Assembly U-factor,Column.1,must be eq • to or less than the Standard U-factor in Column E to comply.
•
Furring Strips Construction Table for Mass Walls I ly
A i8 - C )_ D F ) G ) H ) I ) J F K _ L M
Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation
Walla From Reference in Furring Space from Reference
Joint Appendix Table 4.3.5,4.3.6,43.7 Joint Appendix Table 43.13
•v gI.t. iso u
Assembly ....------" I-. o,`o 1 IT o m'-Ni 1. .1,-d Filial
Mass Rime or 4 Table e u a u 8 'g 3 <i 1;3 Assembly
Thickness' ape' Number' -S,> _ 7,K 4> , w z U-factor^' Comment
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Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms August 2009
Prescriptive Certificate of Compliance: Residential CF-1R-AL T
Residential Alterations ))j(((pppage 4 of 5)
rProject Name: (6,2 3 t`__i Climate Zone# i llor Stories
I! I' \ s I
HVAC SYSTEMS-HEATING
Minimum Duct or Piping Configuration
Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split,
Type and Capacity t (AFUE or',SPE) Type and Location° R-Value T p vs: - P;. • or H droni c
!.Indicate Heating Type(Central Furnace, Wall Furnace, Heat pump, Boiler, Electric R- ' ance,etc.)
2 Electric resistance heating is allowed only in Component Package C.or except ere electric heating is supplemental(i.e.,i(total capacity
<2 KW or 7,000 BtWhr electric heating is controlled by a time-limiting a: -ice not exceeding 30 minutes). See c1.51(b)3 exception.
3.Refer to the HERS Verification section on Page 4 of the CF-1 R-ALT .rm for additional requirements and check alplicabk boxes.
4. Indicate Type or Location(Ducts,Hydronic in Floor,Radiators •tc.)
HVAC SYSTEMS-COOLING
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment (SEE'b ' ' or Distribution Insulation Thermostat (Central,Split,
Type and Capacity' OP) Type and Location R-Value Type Space,Package or Hydroni c)
I.Indicate Coot ; •- (A/C,Heal pump, Evap.Cooling,etc)
2 Refer to the ERSVeriftcation section on Page 4 of the CF-IR-ALT Form for additional requirements and check applicable boxes.
3.Indica!• .- or Location(Ducts,Hydronic in Floor,Radiators,etc.)
WATER HEATING
List water heaters and boilers for both domestic hot water(DEM)heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane ftred,;and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s)and on all underground
hot water pipes is required in all component packages in all climate zones.
External Tank
Water Heater Tyuel Distribution Type Number In Tank Energy Factor or Insulation
_ c tsndard, 0, ( g)' System C> ty(gal)_ Thermal)EfficiencyR Value'
Vh e LY
1.Indicate Type(Storage Gas,Heat Pump,Instantaneous,etc.)
2 Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§150(n). The Prescriptive requirements do
not allow the installation ofa recirculating water heating system for single dwelling units.
3. The external water)heating tank and pipes shall be insulated to meet the requirements of§1500).
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written justification and documentation and special verification.
NEW ROOF ASSEMBLY-Radiant Barrier
The radiant barrier requirement of§I51(02 does not apply to roof alterations.
Slab Edge(Perimeter)Insulation ❑YES ❑NO
YES:In Climate Zone 16 in Component Packages D,R-7 insulation is required.
Heated Slab Insulation 0 YES 0 NO
YES:Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation 0 YES 0 NO
YES:In Climate Zories 1,2,1 I, 13, 14&. 16,R-8 insulation is required;in Climate Zones 12& 15,R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass,use the Performance Approach.
Registration Number:, Registration Date/Time: HERS Provider: _
2008 Residential Compliance Forms August 2009
• i
• Prescriptive Certificate of,Compliance: Residential CF-1R-ALT
Residential Alterations age 5 of 5)
Project Name: I LI2et5 y) I ;� Climate Zone war Stories
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measure pecfed in this
checklist below. A conipleted and signed CF-4R Form for all the measures specified shall be submitted to the buildi _ inspector before final
inspection
Duct Sealing&TestingfHERS verification is required for this measure.
❑YES 0 NO YRS:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or rcpt. • . t ducts am installed in unconditioned
I space,the ducts are to be sealed per§152(6)1 Dii and the newly install.: .ucts am to be insulated per§1510)10.
O EXCEPTION:Existing duct systems that arc extended,which constructed,insulated or sealed with asbestos.
0 YES 0 NO VIES:In Climate Zones 2 and 9-16,if the existing space-conditioni : ystem(HVAC equipment and ducting)is replaced,the
ducts are to be sealed per§152(b)I Di.
❑YES El NO YES:In Climate Zones 2 and 9-16,if the existing HVAC ••ipment is replaced(including the replacement of the air handler,
I outdoor condensing unit of a split system,cooli : .r heating coil,or the furnace heat exchanger)the ducts are to be
I sealed per§152(b)IE.
P EXCEPTION:Duct systems that are : • umented to have been previously sealed confirmed through HERS
verification in accordance with pr . :ares in the Reference Residential Appendix RA3.
O EXCEPTION:Duct systems w' less than 40 linear feet in unconditioned space.
❑ EXCEPTION:Existing du systems constructed,insulated or sealed with asbestos.
Refrigerant Charge-Split System N. 'A verification is required for this measure. •
❑YES ❑NO YES:In Climate Zones : d 8-15,when the existing HVAC equipment is replaced(including the replacement of the air
handler,outd.• condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat
exchange : refrigerant charge measurement shall be verified per§152(6)1 F.
Central Fan Integrated • I)Ventilation System and Fan Watt Draw
The ventilation require nen. . §150(o)do not apply to existing residential homes.
Ducted Split Syste i -Air Conditioners and Heat Pumps: Airflow HERSverifecation is required for this measure.
❑YES Cl N 1 r S:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is
I replaced,the airflow and fan watt draw shall be verified per§152(b)1 Ci to meet the requirements of§151(07B.
Documentation Author's Declaration Statement
• I certify that thid Certificate of Compliance documentation is accurate and co etc.
Name 1 �r�J I •
I 1 0 Signature:
Company: Date:
- 4 i.un*Ms � l (cc p nJ 3O I I D
Address: � ` If Appli a 13 CEA or 1:1CEPE
. .%b,C, to 10 (Certification 0:
Cf tL i est (irate_1 l ° R- q 2S"T a- Phone: t /150 Yf o
Responsible Building Designer's Declaration Statement `fJ
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24,Parts I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the inform 'on provided to document this
building design oh the other applicable compliance forms,worksheets,calculations,plans and speciti :�. s submitted to the enforcement
agency for approval with this building permit ap lication. At
Name: c • Signature: - .—'
Now
/
Com ,I Date:
Ad ) License:
'max \b1 .
City/State/Zip: Phone: ^ /� 5 , ', !'\
l--CT-119-4 Tr&(=ChA-2 C' H 0I 210-1�- ' CI V
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:I-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Coliapliance Forms August 2009
e- s..,_,.fr.ni` City of Costa Mesa Planning Department
.r_ Post Office Box 1200
4 a 77 Fair Drive
ii;;�j�; g —'I����
Costa Mes556-5a,245California 92626`-i )
REQUEST FOR OCCUPANCY
(Single Family Residential or
Condominium Units)
Tract No. / / Z� Date Imo/ vZ � 977
Lot No. ///2—
Address 62,..g3
The developer of the above entitled tract desires to sell the above
set forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he, she, they) .-c/ l& (was or were) 'z1.4 advised that this tract has
•
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the
City at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless
from any claim resulting ,in damage or personal injury to the undersigned by
reason of the aforementioned uricompleted condition.
By �9Z st e J / (�tJ
Puichase -
i 4
•
By a
177:y 4 r
By . 9 6 Pe .�
17731 IrvinerBlvd.
Tustin, California 92680
CMF 0569-26