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Home My WebLink About3472 SAN RAFAEL CIR - Building Permits. (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3472 SAN RAFAEL CI Suite No Vicinity: Parcel Number: 41205117 ,4pp�icant: COOTER, LYLE Address: 1327 S LEWIS - ANAHEIM, CA Owner: CURET, LUIS B Address: 601 BANDERA DR ALLEN,TX Contracror: PACIFIC AIR COMFORT Address: 1327 S LEWIS ANAHEIM,CA Arch / Eng : . " Address: MECHANICAL PERMIT ISSUED BY: Phone: (714)937-1333 Zip: 92807 Status: ISSUED Applied: 08/07/2000 Issued: OB/07/2000 Phone: �� Zip: 75013 � � 94'� Phone: (714)937-1333 Zip: 92807 License: 500236 Phone: Zip: License: SCOPE OF PERMIT REMOVE & REPLACE EXISTING�FAU WITH NEW 80K BTU UNIT, AND ADD NEW A/C CONDENSING UNIL ISSUE FEE Inst FAU�<100 k BTU Inst FAU >100 k.BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler . Commerciallncinerator , Domestic Incinerator . - � Compressors ! Absorption Syslems Upto3hp/100kBTU � " ' 3To15hp/SOOkBTU - 15 To 30 hp / 1,000 k BTU " - - 30 To 50 hp / 1,750 k BTU ' � Over 50 hp / Over 1,750 BTU Boilers Up l0 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00�� 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $1470 1 $0.00 0 $o.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 E53.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1. 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. '� � �NSPecTloNs: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspettions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALI: (714) 7545626 2446-46(N00) WORKERS' COMPENSATION DECLARATION: � ` I hereby affirm under penalry ot perjury one ot the following tleUarations: ❑ I have entl will maintain a ceR�M1cate ot consent to seli-Insure for workers' compensation, as provided for by section 3700 of the Labor Cotle, tor the pedormance of the work for which Ihis permit is iSsued. —� I have flntl wlll maintain workers' compensation insurance, as required by sectlon 3700 oi ihe Labor Cotle, for tha perfortnance of ihe work for w�ich ihis pertnit is issuetl. —�My'workers' compensation Insurance carner and policy number are: j�n—� � camer:-�d6WG�1' �5•-ltl3i PolicyNumber.'�/��T�,V`��fT (This secNon neetl not be completed il the permit is velued at one huntlred dollars ($f 00) or Iess.J `�� ❑ I certity that in the peAormanGe of the work for which this pertnit is issued, I shall not employ any person in eny manner so es to become subject to ihe workere' compensation laws of Califort�la, end agree that it I should become suDject to the workers' compensatlon pmvisions oi Section 3700 of the Labor Cotla, I shall forthwith comply with ihese provisions. [y^ ��/ j Applicent Signeture: � D� ata: ._. /}-r/ � 0�J WARNING.'FAILURE TO SECURE WOHKERS' GTMiPENSATION COVERAGE IS UNLAWFUL AND SHALL 5061ECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED hKKISPND DOILARE (5100,000�, IN ADP�iION TO iHE COST OF CqMPENSATION, DAAMGES AS PfiOViDED FOF IN SECTION 31O60F THE LABOR CODE, IMEREST, AND ATfORNEV'S FEES. LICENSED CONTRACTORS DECLAAA7�ON: I hereby attirm�ihatJ.am� nsed under prohsions of Chapter 9(commencing with Section 7000) of Division 3 of ihe,Business and Professions Cotle, and my license Is in full force and eHect-Lic'H �� Z: G Cla�ss e~rr (�_ � Cont`racto[�e:' <-- Date:_ � ��1 on CONSTRUCTION LENDING AGENCY: ❑ I hereby aftirm that there is a consiruction lentling agency for ihe peAormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER•BUILDER DECLAAATIONS: I here6y aHirm that under penalty o� Perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7037.5, Business antl Professions Cotle: Any ciry or counry which requires e permit m construci, alter, improve, tlemolish, or repair any stmcWre, prior to its issuanca, also requires the applicant tor such permit to file a signad statement that he o! she is licensea pursuani to the provisions ot the Contrectors License Lew (Chapter 9(commencing wit� Section 7000) of Division 3 ot the Business end Professions Code) o� Ihat he or she is enempt therefrom and ihe basis for tha alleged eaemption. Any violation of Section 7031.5 by any epplicant for e permit subjects the applicant,to�a'civil penalty of not more than five huntlretl dollars (5500).): (S J/�> ❑ I, as owner of theproperty,�or my.employees with wages as i�eir sola compensation, WILL DO 7ME WORK, antl the structure is not imende0 oi oflered for sale (Sec. 7044, Business and PmfeSsiOns Cotle: The Comraciors License Law does not apply to an owner of pmperry who builds or improves thereon, and who tloes such work himseli or herseN or through'.h�s oihei own employees, provided that such improvemenis are not intentled or ottered for sele. It, howevar, tha 6uilding or improvemeN is sold within one yea\oi completion;.ihe owner;builder will heve the burtlen of proving ihat he or she ditl not build or improve for purpose ot sale.). ❑ I, as owner of the prdperty, ar� E%CLUSIVELY CONTRACTING WITH LICENSED CONTAACTORS to coretmct the project (Sec. 7044, Business and Protessions Cotle: The wnirectors License Law does not'apply to an owner oi property who buiitls or improves thereon, antl who coniracis for such pmject with a coniractor(s) license pursuam to tha CONrectors License Laws.). ❑ I am exempt untler sec. —_�__ Signa�ure: Owner ID verifie0 by tlnver's IicensB. ❑ Ves ❑ No Business antl Professions Code for this reason: Venfication of Ownership by (type oi documem, i.a. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFEY�' PERMR CERTIFICATION: Drivers License No. Oate: Ezpires: ❑ I hereby cenity that no excavation five (5) or more feet in depth into which a person is required to tlescentl, will be mede in connection with work euthonzed by ihls permit, and that no building swcture, scaMolding, falsework, or tlemoli�ion or dismamling thereoi, will be more than t�irry-six (36) feet �igh. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, California Adminisirative Code). ❑ As ownerbuiltlar, I will not employ anyone to tlo work which would require a permit imm ihe Division ot Indusirial Satety, as notetl a6ove, unless such person hes e permit to do such work fwm tda division. Signature: Date: Division of IndusMal Safety Permit Number: CERTIFlCA7E OF COMPLIANCE AND AllTHORIZA710N OF ENTFiY: I cenity under penalty of perjury iha� I have read ihis application and state iha� �he information given is correct. I agree to wmply with ell 4�a�e laws and ciry ordinances relating to builtling consWction, and authorize representatives ol the Ciry ot Coste Mesa lo enter upon the above-descn6ed property for inspeG�ion purpwes. I agree not to occupy or allow occupancy of eny builtling authonzed by this permit until final inspection. Of Legal O ner(s rthori icant'— --- _ '_'__ , COOE t. INSVECTIONTYPE 1616 Fized System Final Fi�e Pfeveniion 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 203 Final Factory Fire Place Final Sign 204 Final Demolition f7��cuwl�y CODE! UISPECIIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final EIeCMCaI 212 Final Fire PrevaNion 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy !�! : Jf�. �" e �' 1 O � � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: 3472 SAN RAFAEL CI 41205117 COOTER,LYLE 1327 S LEWIS ANAHEIM, CA CURET. LUIS B Address 601 BANDERA DR ALLEN,TX Contracior: PACIFIC AIR COMFORT Address: 1327 S LEWIS ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Switches Non Res Appl Res Appl Service l0 200a Service to 1000a Service over 1000a � Motors to ihp Motors to 10hp Motors to 50hp Motors to 100hp Mators over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circui[s Temp Pwr Pole Intermed Pole ANAHEIM.CA Phone: (714) 937-1333 Zip: 92807 Phone: 2ip: 75013 Phone: (714)937-1333 Zip: 92807 License: 500236 SCOPE OF PERMIT ELECTRICAL FOR NEW A!C UNIT. $23.50 So.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0:00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighling Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low VOIt Wiring System / Ckt- Misa Conduit Misa Conductor Circus ( gen or ride) Circus (mech ride or lights)� " Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee ReinSpection Fee Status: ISSUED Applied: 08/07/2000 Issued: 08/07/2000 ISSUED BY: Quantity $0.00 0 $o.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 , 0 $0.00 0 $0.00 0 $0.00 ' 0, $0.00 - 0 $0.00 0 $0.00 0 $0:00 0 $0.00 � ��0 , $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 535.80 COMMENTS / SPECIAL CONDITIONS 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, 72-21-92) EXPIRA710N: 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 ortler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetions 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 2446-48(6/00� WORKERS'COMPENSAnON DECLARAnON: — � I �ereby attirm under penalry ot pery'ury one of the tollowing tleclarations: ❑ I have and will maintain a ced�iicale of consent to sell-Insure tor workers' crompensation, as pmvided for by section 3700 of the Labor Code, br iha peAortnance ot Ihe work for which �his permit is i5suetl. �,Lhave and will maintain worke�s' compensation insurance, as required by section 3700 oi the Labor Code, for the peAortnance Of Ihe work for which this pertnit is Issued. My workers' compensatlon Insurance carner and policy number are: GPolicy Number: �i'j-FkY1�-S ti�°c� one hund�ed dollars ($100) or IessJ ❑ I certify that in the paAormanGe ot the work for whi h-this pertnit is issued, I shall not employ any person in any manner so es to become subject to Ihe workers' compensation laws of Califomia, end agree i I shoultl hecome subject to Ihe workere' compensation provisions of Section 3700 ot the Lebor Code, I shall iorthwith comply with ihese provisions. / Applican�SignaWre:� Date: � QPi WARNING: F ULAI flE TO SECURE WORKERS' NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P� TIES AND CIVIL FlNES UP TOONE HUNDRED THOUSMID DOLLARE (5100,000�, IN ADDR�� TO THE COST OF COMPENSATION, DAMAGES 0.5 PROVI�ED FOR IN SEC710N 3]O60F THE UBOP COOE, INTEREST, ANO ATTORNEVS FEES. LICENSED CON7RAC70RS DECLAFiAT10N: I hereby attirm thaLl.am.licensed under provisions of ChaO�er 9(commencing with Section 7000) of DiNsion i tom�andetlecl_Lic:N. —1... -� L contractoY.sBignamre:l � � Profeuions Cotle, and my license is in full CONSTRUCTION LENDING AGENCV: ❑ I hereby aMirtn that ihere is a consiruction lentling agency for ihe pertormance of ihe work for whic� Ihis permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby effirtn Ihat untler penalry of perjury ihat I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professlons Code: Any ciry or wunry which req�ires e permii to construct, alter, improve, tlemolish, or rapair any strucWre, pnor to its issuance, also requires the applicant for such permit lo file a signetl slatement Ihat he or she Is licensetl pureuent m the provisions of ihe Contrectors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of the Business and Professions Code) o� that he or she is exempt therefrom and the besis tor Ihe alleged exemption. Any violation oi Section 7031.5 by any appliwnt for a permit subjects the applicant to a civil penalty oi nm mora than five hundred dollars (5500).): ❑ I, as owner of tlie property, or my employees with wages as their sole compensation, WILL DO 7ME WORK, and the sWCWre is not intentletl or ofleretl tor sale (Sec. 7044, Busiriess'end Prolessitlns Cotle: The Contractors License law tloes not apply to an owner of property who builtls or improves thereon, and who tloes such work himsetl or herselt o�ihro'ugh.p�s or her own employees, provided that such impmvements are not imended or oRered for sale. If, however, ihe building or improvement is sold wit�in one yeacof complbtion, ihe owner-builtler wiil have the burden of proving that he or she did not �uiitl or improve tor purpose ol sale.). �.i e: ❑ I, as owner.ot the properry�aT E%CWSIVELY CONTRACTING WITH LICENSED CONTRACTORS m construct the project (Sec. 7044, Business antl Protessions Cotle: The contractors License�Lew tloes'not apply to an owner oi property who builtls or improves thereon, antl who coniracts tor such project with a contractor(s) licen5e pur5uant t0 th9 ConlrActoiS�License Lews.J. ❑ I am exempt under sec. '- ^- � Business and Pmfessions Code for this reason: Y��\� Signaiure: Date: Owner ID verified by dnvers licensa. ❑ �es ❑ No Drivefs License No. Ezpires: Venfication of Ownership by (type oi tlocument, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hareby cenity that no excav2tion five (5) or more feet in depth imo which a person is required to descenq will be mada in connection with work authonzetl by Ihis permit, and ihat no building sWcture, scattolding, falsework, or demolition or tlismantling thereot, will be more ihan Ihirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Calitomia Atlminisirative Code). ❑ As owneo-builtler, I will not emp�oy anyone to do work which would require a permit imm ihe Division oi Industrial Sefery, as notetl above, unless such person hes e pertnit ta do such work from ide tlivision. SignaNre: Date: Division of IntlusMal Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE IWD AUTHORVATION OF ENTAY: I cenity under penalry of perjury ihat I have read �his application and state ihat the information given is cortect I agraa to comply with ell 5tate laws end ciry ordinances relating to building consimction, and au�honze represematives of the Ciry of Costa Mesa to enter upon the aDove-descdbed property for inspedion purposes. I e9rea not to occupy or allow occupanry of any building authorized by this pertnit until finel inspection. Signalure SQQE t' INSPECTIONttPE � 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition Q�ijF� INfIfIALS COpE� INSPECTONTYPE 206 Final Mechanical � 200 Final Plum6ing 210 Final EleCtnCal 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Builtlinq/Occupancy {�1�1�:111��? . •- .� L. /..� CITY OF COSTA MESA � BUILDING DIVISION i `� 77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • �wvw.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 r PERMIT NUMBER: B08-00329 PERMITTYPE 8 ROOF2 STATUS: ISSUED APN: 41205117 DATE ISSUED: 1 210112 0 0 8 _ , _ . ISSUED BY: KJB JOB ADDRESS: 3472 SAN RAFAEL CI CM�, . , Suite/Unit �: viciniry: «'.' � . - . - Squares: 0 � - � � �� .�� ,-Valuation�: � � ,�. $4,000.00 ` j z: - SCOPE OF WORK: TEqR OFF EXISTING ROOFAND INSTALL NEW HOTMOP CAP SHEET: INCCUDESTHE�'FLAT PORTION OF THE �' RESIDENCEANOTHEATTACHEDGAR.QGE.,='��`�� '�b'��--� ` "'� ,r � OWNER: CURET, LUIS B" Address: � 601 BANDERA DR �.', Unit: PHONE: !i , City/State2ip: ALLEN, TX `�-, r<�, - � i '', APPLICANT: CUELLAR, UqVIER '� �� Address: ' 13781 NEWHOPEST>. ,�;;, Unit: : PHONE: 714-534-63g8 w;�,.{ �' - � City/State/Zip: GARDEN�GROVE,-CA � ,� nn+�r5 iv - - � .. .:1 CONTRACTOR: DALES ROOFING � License No ' �906333 „ -- .,'... .'.` , Address: 13781 NEWHOPE STUnit: . " ' � . � � , PHONE: - `^- 714-534•63Q8 � � . City/State/Zip: GARDEN GROVE, CA �.-� 92843 -� � � � - � � CELL:_ � '� �i � ; . ,_ . . . . . . , , . .: . .. . ARCHITECT: � '� �� - � License.No. � - -7�PHONE ;'�.' �,+`,.. _ . .. ENGINEER: � � " License No. . � PHONE �"�'- FEE SUMMARY • , , Reroof Plan Check: . $0.00� � , -, �, � � -. Reroof Permit Fee: $9725 � Reinspection Fee: $0.00 � � � � . � - . TOTAL FEES $97 25 '- ' R �R 1� P NOTICE: The work authbrized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 7241-92) 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 anq final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. OC DEp. INSPEC710NTYPE 1616 � Fixetl System Final Fire Prevention 126fi Pool Spa Final . 200 Final Re-Roof 201 202 203 Final Block/Re�aining Wall Final Factory Fire Place Final Sign 204 Final Demolition DRTE NTI� 11RL5 1�' J � CODE� INSPELTIONTYPE 206 Final Mechanical 208 Final Plumbing 270 Final ElechiCal 212 Final Fire Prevention 220 Finai Planning Approval 222 Final Site 250 Final Building/Occupancy ORTE INTI71RL5 WORKERS' COMPENSA710N DECLARATION� I hereDy affirm under pena�� of per�'ury one of the following declarations: ❑ I have and will mainta �i a certiRcate of consent [o selt-Insure for vrorkers' compensalion, as provided for by section 3700 of the Labor Code, for the peRortnance o� Ihe work (or which thi5 permit is issued. ❑ I have and will maintain wnrkers' compensation insurance, as required by seclion 3700 of ihe La6or Code, fw the performance of the work for which this permit is issued. My vrorkers' compensation Insurance carrier and policy number are: //-�� Cartier �� i- C� l � w� (This sectbn nee0 mrpt be mnplepte0�d7Ihe pem+uf �u valuetl at ane nundmd Oollars (5100) orless ) Policy Number: C J� —('� T y.0 � �� ❑ I certify that in the peAormance of the v.ork tor which this permit is issued, I shall not employ any person in any manner so as to become subject to the vrorkers' compensation laws of Califomia, and agree that if I shoultl become subject to the vrorkers' compensation provisions of Section 3700 0( the La r Code, I shall fodhwith comply with these provisions. � —��.— /�— OP—O�' A7d��'s S�gnaWre Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALI SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN A�DRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LA80R CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn Ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle, antl my license is in tun (orce and eRect. �ic. n O 3 ciass u C 3� ' /2� O/—DY ConVaclor'S SignaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that there is a constructbn lentling agency tor the peAormance of the v.oAe for which tNs pertnit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lentler's Atldress: Date OWNER-BUILDER DECLARATIONS: I hereDy aKrtn ihat under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Pro(essions Code: Any city or counry which requires a pertnit to wnsWct, al[er, improve, demolish, or repair any struc[ure, pdor to its issuance, also requires ihe applicant for such permit to file a signed statement [hal he or she is licensed pursuant ro the provisions of the Contractors License Law (Chapter 9(wmmencing with Section 7000) o( Division 3 0( [he Business and Professions Code) or [hat he or she is exempt Iherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit subjects lhe applican[ to a civil penalry of not more Ihan five huntlred dollars ($500).): ❑ I, as ovmer of the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, anC the swcture is not intended or oftered for sale (Sec. 7044, Business and Pmfessions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves lhereon, and who dces such work himself or herself or through his or her own employees, provided that such improvements are not intendetl or offeretl for sale. If, however, [he building or improvemen[ is soltl wilhin 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 ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe projec[ (Sec. 7044, Business and Professbns Code: The contractors License Law dces not apply to an ovmer of property who builds or improves thereon, and v.ho contracts fw such project with a wntractor(s) license pursuant to the Coniractors License Wws.). ❑ I am exemp[ under sec. Business antl Professions Code for lhis reason: SignaWre 3051-G6(3/0]) Owner ID verified by tlne �cE ,] Yes ❑ No Driver's License No. Expires: ' ' � � berification ot Ownership by (rype of document, i.e. - property tax bill or daed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: � ❑ I hereby certily that no excavation frve (5) w more feet in depth into wfiic� a person is required to descend, will be made in connection with work authorized by this permit, and that no builtling strucWre, scaRdding, falsev.ork, or tlemolition or dismantling thereof, vnll be more than ihiRy-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 311, Title 8, Califomia Atlministra�ive Code). ❑ As ovmer-builder, I will not employ anyone to tlo vrork which would require a permit from [he Division of Industrial Safety, as noled above, unless such person has a permit to do such work from the division. Applicanfs SignaWre Dale Division of IndusMal Safety Permi[ Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant need to file antl certify a Business Plan for emergency response to release or threalened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the California Health and Sa(ety 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 lime during a reportetl year a quantiry of hazardous materials equal to or greater than a vreignt of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard temperature and pressure). 2. Does or will the applicant or presen[ or (uture building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with the Cosla Mesa Fire Depariment by each business which at any one time has on hantl a quantity of acutely hazardous malerials equal [o or greater ihan 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 [he appliwnt or present or future builtling occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Heal[h and Safety Cotle provitles that lhe Costa Mesa Fire Departmen[ may require the preparation, certification and filinq with lhe 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 Seclion 25534 of the Cali(omia Health antl Safety Code been fully complied wi[h? ❑ Ves ❑ No 5. Does or will ihe appliwnt or present or fuNre builtling occupaN require tor ihe work which is the suhject o( this application a permit for such construction or modification from the South Coast Air Qualiry Management District or (mm any other air polWtion contml disMct or agency? ❑ Yes ❑ No (Section 65850.2 of Ihe Califomia Govemment Code requires lhat the reques�e0 � infortnation be tumished on applications (a ran-resitlential builtlinq pertnits). 6. Will any paA of the facility to be constmctetl under this permit be wilhin 1000 (ee[ from ihe ou[er bountlaries of a school? ❑ Yes ❑ No (If yes", the faciliry must meet the requiremen[ of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permil fmm the South Coast Air Quality Management District or other air polNtiOn con�rol tlistrict or agency is required for Ihe work which is the subject of this application, have all of the disclosures prescribetl Dy Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If yes", attach certificate of compliance (rom the appropnale air pollution control officer). - ' CERTIFICATE OF COMPLIANCE: I certi(y that under penalty of perjury the � information given above is correct. I agree�to comply with all state lavis and city ordinances regartling Hazardous Materials and Emissions. � SignaWre Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: 1 certi(y under penalty of perjury that I have read [his application and 5tate lhat the information given is correct I agree to comply with all state laws and ciry ordinances relating to building consWction, and authonze,representalives of the Ciry o( CosW Mesa to enter upon the above-described property for inspec[ion purposes. I agree not to occupy or allow occupancy o( any builtling author d by this permit ^until final inspection. Et-t,c-` C �_ � � �l — Q � SgnaWre of Legal pwner�s) Date Applicanl Dale �. �i .-- � - _ _ _ � . _ _� �� __ , _AOD��ant to fi11 in all spaces except.tnose within heavr eortler PER No: �8a TRACTNO. �L ,/ Cit�ti�.k COSTA MESA CONSTRUCTION PERMIT • ' �?rojectAddress 347? Srif1 Rdfr� 1 11"CIP � � , r�+/ PE OF CONSTRUCTION . New i+oo Applicant'sMailingAddress . P_O_S�ZJ Pasadpna�: rnq� l// anE,sign all appropriate tleclarations._ ��' � UNIT N0.- . � • TERATION � REPAIR. �{J'_(�2� -❑ CONVERSION' ❑ DEMOLISH_ ❑ OTHER ' Owner's Name �rle S�le ' � Phone . � � : �� A.P. # - -� . 3472 San Rafael Circle'Costa N�sa, CA•�2� DESCRIPTION OF WOR,K/USE OF BLDG. Address � � . � � i S Main Buildir ; . . , E Arch/Eng. LicenSeNa � TYPEOFPERMIT � GRADING FOUNDATION STRUCTVRAL T Front, . � AAdreis ' ��}�� ' � , 70 OTHERT ❑ ELECTRIGAL �0 PLUMBING ❑ MECHANICAL _ A Reaf ' Contractoi s Naml�"w�-t%llVre.y YWf CA..'IiIC. phone 714 630-14 - . ' � - PROJECT DESCRIPTION 5i1. . "�• OCCUa v C Right ; � A¢dress (muiling) P-O.k30X 53'L7 PdSddel'td. CA 91107 � � � - . . K � , � • ' CONSTRUCTIONTVPE VALUATION$ O S L2FL � �iry LicenSC No. i7r%�0 ;ZONE GRADING GU. VDS. ACRES LICENSED CONTRACTOR DECLARATION � ( - Ping. Ref. # I M1ereby allirm that I am licensetl untler�provision5 ot Charter 9(commencing Remarki: Q �� 5!� n �ES .l.�w'( 55 ,,`��' Planning Notes:' wit� section ]000) of Division 3 of the Buslness antl Profe55ions Code, antl my license.is in fuiYfmrce an ftect. ' ' - , n� I , p � . ' � � - . � ; License CIa� - W7 C� N � � �� e I� '�' (� � .� ' � PLUMBING . \ �RKERS' COMPENSA OE LARATION BarSink ' � � ;Showers � � • .�ereDy attirm that 1 have a ceriificate oi consent to seli-insu e or a certificate �oi workers' Compensation Insurance, or a certifietl copy thereof (Section gackflowPreventer ' �ServiceSink. , � ' 3800; Lab. C.)' . Policy No. �,� , ompany �V i If1S. gackflow�lrrigation � � ;$¢wer Cap � " }n�{�Certitietl copY is hereby fumishe . �P Certifietl co is filetl with [he ity B� " eathtubs -� Sewer Connection ' Date ��_ A . � � EXEMPTION FROM WORKE 5' COM7ENSATIO D' ARATI N CIa�iFi0�5' ' � $ola� COIIEct0�5 i (This se<tion neetl not be completetl if the permit is tor e huntlr tl( 00) or less). Dishwasher' �Solar Pipinq' I certify that in the performan[e of the wO�k tor which tM1is pe�m�t is issuetl, I � � shall not employ any person in any manner`so as to become subject to the Drinking Fountains ' �Solar Tank - Workers' Compensation Laws ot Califomia. , - Date Si9riature Floor DrainY • ' ' Swimming Pool w/Spa ' NOTICE:'If, after making;tnis tleclaia[ion, you sM1oultl become sublect to the' '" - " " . - " Workers' Compensation provisionsbf tne Labor Cotle; you must Porthwith FloorSfnks � ' Urinal ' comply with such �provi5ion5 or thi5 pe�mit shall pe tleeme� revoketl. 1� CONSTRUCTION CENDING AGENCV � } GasService �Outle[5 WaLErClOse[ I M1e�eby aHi�m that there is a construc[ion lentling a9ency fo�'the pe�fo�mance of [he work for'wtii�h this permit is issuetl (Settion 309� Civ. CJ Lentler's Name InterceptOrs Water Heater 'Lentler'S HEdre55 - � ' ' Kitchen $ink ' � - ' Water Serviw " � OWNER BUILDER OECLARATION � J " 1 he�eby aftirm that�l.am exempt irom the Contracto�'s^L'icense'Law �for the LavaLO�ieS � • AutO-W25h following reasOn (SectionJ031.5 Businessantl Pwtessional CotledAny,city or _ county which requires a permit to construct, alteq improve, tlemolish or repair P-Trap Laundry Trays ' any structure, prior to its�issuance, also requires the applicant for such�permit i file a signetl statement that he/sne is licensetl pursuant to the provisions ot Roof Drains � ' ie Contractor's Licenze Law (Chapter 9(commencing with Section ]000) of ' Jivisiom 3 of the Business antl Profes5ion5 Cotle) or Ihat be/she is exempt , � - Ihe�etrom and �the basis for [he allegetl exemption. Any violation of SectiOn ' �- �]031.5 by any appiicant tor a permlt suCjects the applicant ta a civll � _' � eenalty�of noi more than five hundretl tlollars ($500). � LJ I, a{ owner of the property or my employees with wa9es as tneir soie ReinspBction Fee , '$15 ,ISsue Fee mmpensation will Go the work, antl th¢ Structure is not Intentled o� ofteretl for sale (Section ;�044, eusiness antl Protessional Cotle: The Contracmr's MECHANICAL � . License Law tloes not apply to an owner of a properry who builtls or improves A h s u h wark hi self herself o� throu M1 hi5 or her own . ' � tbereon, antl w o tloe s< m / 9 Boiler Hood or T employees, provitletl that such ImO�ovements are not intentletl or offeretl tor YPe � � � � sale. It; however, the builtling or improvement is soltl wlthin one year of com- , Cenopy Type II ❑ . ' pletion, the owne� will nave the burtlen ot p�ovinq he/sM1e tlitl not builtl or im- Duct - Unde(GroUnd prove for the purpose of sale). ' ' ❑ I, as�owner ot the property, am exclusively contracting witn licensetl'con- Duct -Structural Refrigeration Sys[em � . tractorsto construct the'project (Section']044, Business antl Professlons COtle: ' ' � The Contractor's License Law does not appry to an o'wner of property who Duct � Ventilating , . �0.100,000 BTU ❑100,000 B ' � builtls or improves thereon, antl who wntraCts for such projects with�a con- - ' ' � tractor(s) license'pursuant to the contracfor's License Law). I am aware ttiat Exhaust System ❑ MWtiple ❑ System Repair/Alteretion ' � proof of thei� Worker's Compensation insu�ance shoultl'be provitletl�[o me. - i - '� L� I'am exempE untler Section', '� ,� B. & P. C. for this�reason' Fir¢pl/Pact. BIt. ICBO # � Fire Dampers , � }Date' -- Owner ' Heating System & Ductiri9�� Registers � - , I nereby certity that I have reatl this apolication antl�state that the�aboJe' ❑0-100,OOOBTU �100,0006T � . , � info}mation is correct.' I agree to comply with al1 city antl wunty ortlinances • � ' � antliState laws relating to builtlin con tion; itl hereby�aut�orize repre- • � - .� , , feq(atives of [h' ci[ u t -mentionetl proq� rty j�or � - � '� . lpspe ion pu zes. /,C�Y�J�J�'.,�/ i, ' . ig � ✓ , DateL��L _ ` ' , . . � ` Reinspection Fee ' $15 � ' �� Issue Fee. "'n , er5' Lic nse or 55 � . �\ I, CMF 0865-46, rev. 30/84 Wnite - - Applicant; P�nk - Acmunting; Goltlenrotl - Hssesm� _ 0 . . - - 758Z -I,i /2D/86 , � . � � ' • ' Accessory Building: FEES _ AUi0IO3iIC iNd511Pf , ' Construction PoleSut � Cooking Unit� : Dishwasher� ; ' Dryers �Gas- �Ele Fan. , . � F.A.U. Fixtures Device Boxes • ; � Outlets ' ' I . ie.5a .r� � � � - Parking Req./Provided . . .. .. ` I ELECTRICAL , � Transformer � 15-50 KW , y . - :0'50+,KW Meter ❑up to 100 amps � -Meter ❑over-100amps• - Sub Panel � ' Motors �0-1 .HP O1 % -'6- Inc Solar �9-15 HP 016-' � Microwave . � Pole Light ° Range ' Switches � - � � Garbage Disposal � • Generator �0-5,KW �5-15 KW �s�� Standing Sections irash Compactor � . . _' . ... , . 1 , Reinspectian Fee � $15 Issue Fee FEES �DEVELOPMENTSERVICESREQUIREMEN7S: � ' 2oning Approved By i . � uildin A raved 6 ' B 9 PP Y — Aooliration Issued Bv- _ _ . � 5+ I FEES 2 O N i N G R E Q M T S ' . SU� MCARV^O�F FEES . � �\ , � BUILDING PERMIT $;� 'SMIP � - $ ' SV ', PLAN CHECK , $ � _PERMIT _ � PLUMBING � � - � $ � � " ��UANCE $ . _ � P�AN CHECK 25% $' , - - ; ENERGV.P.C. $ � ` � ELECTRICAL �- $ ' GRADING $ � '� PLAN�CHECK -50%- $,. ' ' MICROFILM $ - =� T" , MECHANICAL� _ $, � , � TOTALF,EE' $ S•Sv . PCAN CHECK 25% $ " � ' � . , � . f CONSTRUCTION AND PLANNING , � POOL &%SPA - � �„ ' APPROVALS Permit # Date Inspector pppROVALS 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 ConduitrUndrgrnd. � 8. Foundation ., . 59.,Gas Pipe, O Undrgrnd., Test � , � 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & 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. POOUSPA 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 � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush �� ' � 24. Roof -Framing - , 73. U�dergrnd. Storage Ta�k � Gas Q Dil � 25. Roof Sheathing .74. Overhead Hydro ' . �- 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical .� . -27. Frame and Plashing 76. Dry Standpipe � ' � . 28. Lathing & Siding � 77. FIXED SYSTEM FINAL - 29. Insulation - 78. FIRE PREV. FINAL � ' - ". 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . 79. FINAL INSPECTION �' 32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED � � �33. Final Electric - - Notes: �, " � � , 34. Final Heating & Air Conditioning - ' - ' . - • � ' ' 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace , � 38. Final Plumbing � � " 39. Water Service-Final � ' - . 40. Gas Service-Final � � ' , . . 41. Solar pomestic-Final • . 42. Backfiow Preventer � � , ' � 43. Backflow Irrigation . � " � 44. L.andscape Irrigation System � 45. Sound Attenuation � . ' � 46. 1-landicap Regulations � � , , 47. FINAL STRUCTURE & BUILDING .) � . 48. Special Requirements Completed . , � 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co � , �� . 51. CERTIFICATE OF OCCUPANCY - / � �a� � No. � Date - � � _ AVo��cant to fill in all sDa<es exeept thou within �eary eortler Ilnes anG si9n all apvrooriate Geclantlans. � �� CITY�OP COSTA MESA � PERMIT N TRACT NO. ' LOT. NO. - . 7 BL .. . � , , . } . ' , . ' .r-..,.a � � - ' CONSTRUCTION PERMIT . � ' . - � � � ' , - � , � • AppliCenYSMeilingP�ddfass � 7 ' �r e� � TVPEOFCO�VSTHUCTION � NEW ADD. ' ALTERATION' �REVAIR - , : '- �, JG,rJ2 4/22/83, , . '�23��J0� {TL. 05 � (�'ILS[�. �- . ' �' ProjeitAddreu ��"�Q- � - � �y � ��CONVERSION +Q DEMOLISH O OTHER_ , ' _. , ' . � , ' .- owneisrvame � �' �-� �'�— = ' o��" ��4a� DESGRIPTIONOFV�ORK A��EST/'L �. OG A�? � :34"1 a � � �1 � � � C� � • i , NING EGULATI Addr255 TVPEOFPERMIT' . GRADING �FOUNDATION TR CTURAL A.P.qIE = " ' ZONE 1 . , + ' • 'a Aroh/Engr CoS� �� ' �LicenSE � a. ❑ TENANT� ❑ ELECTRIGAL �PLUMBING ❑-MECHANICAI _ �pLNG. REF. y�� ' � . . "BUILDING' - ' Addreu� ' � � �' ' " �� "�,�OTHER ` ' . � � - • � I ' � TO BUILDING. ' � , �qEAR VARD (TO P/U � ' ,Contfe[tof=SNem �-' e- honebLl�� PROJECTDESCRIPTION SQ.FT.�--� OCCUPANCV' � �PR PE TV INE _ �• ' - ' �LEFTSIDEYAPD � RIGHTSIDEVARD � Y Addreu�meifng)'��^�e- ' ' � CONSTRUCTIONTVPE � ' VALUATION$' �1��'� . . �•� ' � _ ' � � ' - i' � ZON� � �-GRADINGCU.VDS. ACRES PKG.SPACEREQ. � � PROVIDED ' i ' - L•icense Na. ' �- � � ' � L�CENSEO CONTRACTOR DECLARATION � ' � ' • ' Remarks: S . U�L � � �C - STREET WIDTH � � ' � �PqRK FEE�$ - .- ' 1 harebylaHirm that I am Ilcensetl untler provl5ions ot Charter 9(commencin9 � wlt�,section 7000) of Divislon 3 of the Builness antl Professlons COGe, antl � . . � , � � � �� ' . SPECIAL CONDITIONS: � � �. `� .c�� my'Ilcen4e�i5 in full farte antl effect. t ' � , 1 �ensa CISss License No. ' � ' t ' � ' PLUMBING ' � ' . � � � i � � 4 � / . . . ' • , . � � �, . �.e' � Signature . - � , BarSiak � . � SeuverCap � .� ' � � � ELECTRICAL � i � ;�RKERS'COMPENSATION DECLARATION . i � - i - i"haraby afflrm.that I'have a CartlfiWte of.conSenLto seli-Insure or.a <eftliicate - ' ' ., ' . - _ AUtOmatiC WaShe! !Met2f ❑bve� 10b amp5,� � � i ' of Workers' Compensatlon Insurance,:�or a certifletl coOY theraof (Saction BackflOw Preven[er� � � -Seyu2t COnn¢ctiOn� - . . - - - - - - . , 3800, Lnb. C.) . • ' ' � � ' ' • -' '- � Construction Pole � �Sub Panel �� ' i Backflow Irrigation b Solar Collectors � . � � � � � � � � • �.: ' . � ' Po�Ity No. � ' � ' Company � ' -"' ' � � ; Cooking Unit � Sub Pole • � �� , eCertltietl copy is �ereby furnishetl. • { � � i Bathtubs� � $pl0f Piping . , �-. � • � �� '.,. , � Cartiiletl copy IS flilO with [he city Builaing Dlvlsion. +'� �. Date + apo�iwnt ' Clarifiers. - SolarTank : . ' � • _ Dishwasher 'Moiors �0-1 HP ❑1X-8 � � I EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � ; Di5hN25h2� .' ' SWimnlin POOI W/Spe � ' � DfyelS ��Gas ❑Elec[riC �u��. �� pC.SolarO9-15 HP 01645+ i ' '(This sectton neeG not be completetl it[he Oermit is for,one huntlretl (5100) or . , ' 9 , , � iessl: • . i � ; 7 . . � �. - Fan . t ; Microwave '�' � i j � 1 certify ithat In the performance of the work tor whlch t�is perm�t i5 issuetl I � Drinking FOunt0in5 .t Urin21 : ; . � . s i . � shall not amploy any person In any manner so as to become sub�ect. to t�e ' � � � F.A.U. � � Pole Li ht ' ' Workers'�Com0en5atlonlLawSaTGalifmniaJ � : , � � FIUo�Diains{ � � WaterClosetj ' ' 9 �� ' � � ' Date ' ' � ci9nature � � ' � - . ' . _ ' ' �� . . . � � NOTICE:�If; atter makiug thl5�tlatlaratlon', you�sfioultl�-be<ome 5ubje<t to [he- � - - FIOo4Sink5 �, � - - - - •. WetEr HeeteJ� � � � - . _ _ �,�xtures_ �:� ,Renge„',� _1, ! i Workers', Compensation provi5ions.of the Labor Cotle, you must.forthwith ' '' - � � � ' comD�Y '��+�th� such provlsions...or this"permit ihall be �tleemea; revokeaJ ; � � Gas SerJice� . �Outlets' "� •Water.Service , ' �. � � !'� Device Boxes �� Sign � ' I CONSTRUCTION LENDING AGENCV" � 1 � � � � � � ' ' , � �,. I Outlets � ' i ' I hereby xHirm that there I5 a,constructlon lentlin9 a9en<y�for the pertormance� ' � Interceptors . - _. ; r.'� � � �' - ' Standing Sections � '. af the work for . which�. this permit � is issuetl -.(Section 309T Civ: C.) � � - - � •- � . . . , L.entlers� Name: - ' � �' ^ � � � ' Kitchen'Sink . �� ' ' - � . Switches ; Trash Compacmr � • � . 'tantler's'� Atltlrau ; =� ' ' ��, � � � - . - . � � ); � - � . , i j � '� OWNERIBVILDER DECLARATION: � ry Y� . J�' Garba e Dis osal � � � � - � - � . Lavatories.. c." ' s ' r 9 P . � . , f I . I hereby atflrm that I am exempt from the ConSraccor's �Licensa Law for the • �� , t •� Gene�atoi �0-5 KW �545 KW ' ' following reason'(Section 7031�.5 Buslness antl Profasslonal Cotle. Any tlty or '? TFap' _ � . j � � .rounty which'requiros a permit'to ton5trucY, alter, improve, tlemolish or repair �- `. . � � - . - TransfOrme� 015-50 KW � � � -� ��;,y structure; prior to Its'Issuance,�also requires the appllcant�tor such permit RoOf.D�ains � � i i: , 1 ''j' p • �"-tile a slgneC 5talemenTthat he/she I5licensetl pursuan[ to the provisions of � -' . � T � � � ❑5U+KW� � � `"'e Cont�a<tor's IJcense taw (ChaOter.9 (coinmencing with'SecHon 7000) of � : � ' - , - � `,�' , i �Reinspec[ion Fee $75'�. j "i5ivl5ion.3'oT tbe Buslne55 antl ProTe55ion5 Cotle)"or:that he/She�is�exempt � ShOW¢fz �, � ' � � '; ^� � � Reinspection FeB � _$155 �� . ' � Iherefrom anG Ihe basis for t�e allege0 exemDtion:�Any vlolationTof Sectlon '� ,- ' _ � , , ': � Meter ❑up to 100 emps ; 'Issue Fee ' '$ 3 - J031.5 by.any applicant tor� a permit .suEjects the --apPllcant to a: civll , - . � � t ! .- . . k enalty of not more than tive huntlretl tlollars (E500). �• - • -' j Service Sink � ' �." � � Issue Fee t' ' a 3+ Zoning Approvad By ' � ' Date � 1, as,owner ofithe�property ormy employees wlth wages�as their sole � , ' i - . . wmpensatlon wilLtlo the work, antl�,the structure is not intentletl or oftereA :•, �: - MECHANICAL' ' • qpp�i��an Approved By � Date ' � � � tor salet(Secflon 7044; Business antl'Professional.Cotle:�The Contra<[or'S � .� �/J�M �f ' . � License law 7oe5 not apply to an owner ot a property wno bullds or improves .' � gOil2r '' j� Fefrigeration Systerim . , qpplication Isivad By / �LL�J ` � Date aZ � � i thareon,ldntl who 40¢5 SUCh wOrk him5elf/h¢r5elf or t�rough hi5 or her own • -� �-� '� � � ' � - � 1 • ; employees, provltletl thzt such-imorovements are noc Intentled or of(eretl tor � --� �� 0-100,OOOBTU ❑t00,000BTU� f . , , sale. If, however, the builaing or improvement Is soltl within one year,of com- � ' Duct = UndenGround • 1 _ � . +' �. ' . . � � SUMMARV OF FEES � , � � pletion, the owner wlll have the burtlen of proving he/she tlitl not builtl or im- . � , � �' � • �' �/� �� ' �.yy ,ppr va for the purposa ot sale). ; t ._ , � Duct-Structural , System Repair/Alteration � , BUILDING PERMIT $�SL.[.�L . SMIP $; 'i xl g�I, as ownar of tha property, am exclusivaly tontracting�with•Ilcensetl com � � � L9rattorsto construct tne project (5ection 7044, Business antl,Protessions.Cotla: _ Duct - Ventilating '_ . _ . ' . � � ' _ ' � ; ;y -, PLAN CHECK� $ '� � � PERMIT ' � ' The Contractor•s Llcanse l.aw does not apply to an owner of property who . � ; • bulltls or Improves thereon, antl who wntracts for su<h projects with a con- � Ezheus{Syitem ❑ Multiple O� � � � � � , PLUMBING : $� � ISSUANCE ,' �$• tractor(s) Ilcense oursuant to the Contractor's Licanse Law). � � ' - ' � � p�qN CHECK $� � GRADING � $� � ', O I am exempt unGar Section e, & P. C. for this reason � Fiiepl/FaCt. BIt. IC80 i�k • �� - � �) � i , ' , ,$! ' - � � � - - � �.ELECTRICAL' $ � ' ,Date ' � ' ' Owner ' �' � � • ` ' � HeatingSystem&Ducting � i � � � :y � • � '.MICROFILM � $ i ' '�PLAN CHECK $ -I�hereby certliy� thaC�l. hava� reaC�this appllcation antl state-that the above ❑P700,000 BTU 0100,OOOBT - � � � - �• . - . . � � ' IntormaHon is mrrect. I agree to comply with all tlty antl county ordlnances � . : .� ' . i/' ' TOTAL�FEE� $' � ' ' antl+state laws relaling to bulltling constructlon, and hereby authorize repre- j , �, MECHANICAL $ ' . � . � � sentatives of � this'G ty.,to entar upon che above-mentlonetl property for � HOod or Type I ❑' � Reinspectian Fee • ''$15' '%; pLAN CHECK $ � � , LESS ' j ' ! , : InsOettlon pu � os ; ; 1 Ceno ' T e II ❑ � ' ADVANCED PC � $ ` ' � � Signafure Date �-8� ' ; . . , ' , � � i . Drivers' License or 55 � � � Registers • . � Iswe Fee $�3� � ' � � : FINAL FEE � �� $ 'a.� �Q CMF 0865-46 rav. 12/ffi White - Builtling; Canary - APpliwnt; Plnk - Accounting; GOltlenroC - Assessor ' . . � ✓.`_-�t.'�,. , ' ��t, ` ` .. ? �� ? , . . . ^ � � .� ' , , ,- - , '�, ' .' a � *su�,,;� m�g �� : �M��., 4�-r� :. � � .9 . ' . � . . ., . .. �}�r-Cs,�b� 4�x �f�x./ao : � � ' - . ,� � il , , - -. . � , r : ,S�e. "I-'arik s��.e, lyx3ox/ao J � . �.�cl�es� -+ a� � � �- � : �� ; �� .. _ _ _ .. � J � _ _ . . . .�� 0'�`� � �`� �,�-d�� . _ �'` — — — — — � P�� . �aof � . �scree.nec�.1 - _...._ , - , ,;� J : .. " I O .1�ar�i �'x iO' e�.c1� �fx-17J�qe. � � �oo � Jo�ar O�.n��s .. ... .._.a......_. _... . ` . _ ..... .. . ' _." ��. . . . I � . � � ��+. �. �.. ' ... = +:. . . ' �i� KKt � �'. �:; .. r I . So o..r rY. a. c� ��. "'.. I ^ „ U�a..�e.r. }�ec�� ., ,. . : , „ . , ., , ,,, .,. k.. .:. ._..> - _ � . .. .. . .. . .. - , . � � .� - .� .. ' . _ . . . . : . . . .. __ ., :. _ ... ,- .. .. . . . . . .. . i. .. .. _. ' . . - -,. . `r.. . ° . . . . - , - -- . -. - - , -- .. � ' . . - - ' � - �. � .f;� - _ � � � , . � ' � - ' � : • ' � . . .� . . . .. . 3' � �_� , . ., . _ . . . . - . . � _ . - - . - . - ' . �. . .. � .. � �. ,. � • ' ' - . -. . , -.. .� . . .. . , '. � .. � - . ...- . . --� . . .. ' . , � � , . . . _ . . , � . , . � � . • , - : - b�� - . . . � . .. � y, - ; . .. � .. . ` _ .. - .. ' . , .. ' May 29, � 1973'`„ : . '. ' - ' _ , -- � - • : -�<' � r. . ' . - . • .. _ � - � . ' . . , � x.. ' , - . . . . _-- " _ _r� - ' .�': ,'.r . - � � � Mr. Darrell`Steele � ' _ ' - ' , - ' 3472 San Rafael Circle , • < .' ' . '.' _ . Costu.Mesa, Calffornia :, 92626 , , � , . , Dear'Sirs � _ • , -, . A building.permic hasYb � .issuad'[o.Madrid Pools [o:constiuc[ :: . - . . � „ _ _ ' _ a.pzivaie scai�oingf,pool o our-property .�_..s�.. , , .. . �' In'order thet yous pool c.ill be a safo ona and for tlie purpose. " ,; of advis'ing yon of youi reaponsibility regaiding�the_requirements �� :of�the Cos[a Me Municipal.Code� we�refar:you to Section"8107,'a � .. � copy of which ds tached ' ' ,- , ; . � •This letter is direc ed to'you in,order tkiat�you will be aware - , � of our.ordinances and can make•a complete safety check'.of.youi'�'�, -' � ' ' pool area. " . . _ , � ' . ' ` Slncerely�yoars�' ` . . , . , . ' t ' , . _ RICfiARD HANHART � . .. . ' ' � „ . . ' , . . . , _ ' - � , Building Sefety Director � RHtcb ' • , . '.. f, _ .r . � ,. , .. • ti . . _ .. ' �. ' ' . . , .: ... . . . , ' • _ _ ; - � . � . . . . , ` . _ - , - . . . ' , . �` , . ' . . . -. .. � . � - . , , . _ - ' - . = .. . .- V .. .. .. : , : - ' '; ` . . , - ;„ - _ } ' , , .. . , . . . ti . . ' . , , . � , ` . :, . - . . , . '� _ : . ' . .' - ' ., �� : Z 2s �� F � �,_� ' ,� °ti � TESTING June 21, 1973 0 Tvrininq Laboratories ��f ��,«t�=�=,= c«�'�t�z,�«�, �,r�. °A. BOY. +7 .'?IO 4W�0'� '+;',' , LC::G BE'+Gra CALIF. 90'001 . �:13� <2od355 . �217f 636-2366 . �11a� e28�6432 9=...G. p:f�GS ,.. . .. .. s..e � '—x.: :.-, o�, �� .. �. -4 s,,. . � ,,::;� ,. :>:s� .��n.a �c eo.., i��. ;��id; `; ., ,�n Cei� voaa Ix�3; ole.x±eo %,::jj �, At Examination: SC73-425) COMPRESSION TESTS Ok GUaITE CYLINDERS Mr. L. E. Sprague 5041 Roanoke Avenue Irvine, Cal(fornia 92705 PROJECT SNimmTng Pool for MR, b MRS. STEEIE ADDREss 3472 San Raefel, Costa Mesa SAMPLE FROM Gunl te Pool qRCNI1FCT ENOINFER MIX DATF CAS7 DATE TESTED CYLINDER NO. COMPRESSION TOTAL LOAD, LBS. ➢OUNDS PER SQ. 1N. SiZE: COMPLIANCE CYLINDERS Gunite CONIRAQOA Madrtd Custom Pools $UBCONIGq�TOF Coast Cunite Co. SPECIFIEO STRENGTH 6-19-73 SIUMP 6-26-73 6-26-73 1 2 7-Day 7-Day 89,000 80,$00 3.150 2,850 6" x 12-3/8" 6" x t2-1/4" 7-day test complies wtth specifications. MADE 6T DFtIVE0.EO BY - . Dave ouraieunoN: -�Costs Mesa Bldg. Dept. Madrid Pools Coast Gunite Co. ��e�/b y 2,000 psi 6-26-73 4 "HOLD" 3 5 "HOLD" 6 "HOLD" 7-Day 86,000 3.172 5-7/8" x 12-1/4" RECEIVFD ON 6-2I-73 1�C�ILbIl�4G S��'EYY �,�: JUl1 � u 1973 L. E. Sprague - 2 - ' •` ` '� a��-.m..��•` . . ..�...--sJ"': _.. �. .. � NEGON}5 �FL SUBMITI[O �5 TwE CONFIOFNTI�� PROPERiV U� CLItM1TS, �UTNO4II�LION GOR GVB4�C�TION O�- OVR XE�Oq�S. CONC�USIONS, OH E1.� TRaCIS ipOM Ow PGG�9DIHG iMEM IS REYa'flVfD Pl.NOING OVP WPItTF.M �FPRpI'�L /�5 � MVTV�I PAOiECT�ON TO CIIENTS, TME PVBLIC .�NO OVRSELVES, 330-13 ,� � 29�42 � � COSTA MESA BUILDING-SAFETY DEPARTMEM' P.O. BOX 7200 - COSTA MESA; CALIFORNIA 92E26 For Appllcan/ to F((1 In Campletely TYPE OR PRINT BUILDINO ADDRE55 COSTA MEBA. CALIFORNI 90036 201098 NO. OI �LGOO. USE OF EXISTIN6 BLDO. GETpACK LIX[ IIIOtl 20 � cenTCn o� oTn[R RGR YARD BID6 YARD I L[IR ].8 � I R16XT S� DESCRIPTION OF WORK BUILDINO NO.OP 81ZE ROOMB IITORI[t 1 EXTERIOR WALL I ROOP _ _ OL 1 Y18i1 4VGL ) HFREBY ACRNOWL6DOE TXAT 1 HAVe R@AD TMIe APPLICATION AND 8TAT6 TNAT TX6 AGOV6 1/ CORP6G1' �ANO AOREB TO COM- PLY WITH ALL CITY OpDINANCG� ANO /TATi LAWY R[OUTATINO BYILDINOCONBTRYQION. � AVTHORIZiD rato �. traaf� 1AN -7-69cMst00 177_ 99.0(; APPLICATION FOR PERMR BUILDINC; For Office Use Only ncc�irt xo. I J � ZONING I. , ZOX� NO.O� UYtO�N[W • Rl �uws 2- su��o�noAttach.Garat� teawt _ , NOTE: NOHAVlOV6RNAN68HALLBELE88THAN 80' TO 81D6 ! RBAR P. L EAVEe ALLOWfiD fUrB..C.REQUIREMENT) YARDBAPPROVED YARD8MPROVED MAIN BUILDING ACCE960RY BUILDINO vnte. # owre p„ "_ / / W Ol � � �//lD so. Pr. S�S� � 0 TNE ANOUNT BN N UNOHR V�LUI1ilON IB POR TX8 j PURPOB6 OP HBTABLI8NIN0 A P6RMIT FEB ONLY. �J�. VALUATIOq. � � ' S � ' PERMIT FE8 p �o�Q�%/C� �3- w �y � TOTALFEE S OWNER JOB AC �INSPECTIONS Pool Location . Forms Main Drain _ Steel Reinforce Elec. Bond _ Approval to Cover Underground Electric _ Gas Piping Test Filtering System Lines — Backwash Lines and Recep. Electrical Final Heater and Vent Final _ Filter System Final Backwaslr and R�e� ep. inal � . _ _ � .,Yn .�4 i �'17'�� ' `S�)iJ DATE SUBCONTRACTOR Electric Plumbing Z . w w o. U Z ZQ � N am J 7 J N Q W p7 J J m a U N Za W ¢ aw W Z J Q m Z J � W W � Z H w� 70 � z Q U J a a Q � �"' N z � H U � � H N Z 36�0� WSTA MESA BUILDING-SAFETY DEPARTMENT- P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUIIDING �` 1 ^'�'� /� � I �/� � ADDRESS � �j' 1 7'-1- r•t OWNER ��Z�Z��,� _VTF--. 4.—l.i� MAIL � /� M f� ADDRESS J�1 L TE L. �� CITV C� M` ' NO. ( 38 � CONSTRUCiION �— A� r.— r� BRANCH J_,r4�� ADDRESS ^ ARCHITECT `1"�'.� � /y ADDRESS J� � �; �S�/�/ +l� CONTFACTOR M,4.p►2,ih 1'Vi_1� AD�RE55 � � S �( �Y�-��ii N�.� CITV �- � G � NO��y` STATE �� 1 CITY LIC. NO. V LIC. NO. SIZE � �NO.OFBLDGS. OF LOT � Q �C � 7jO � I NOW ON LOT EX nING BIDG. �j�. S ��IV �� SIZE OF NO. OF NEWBLDG. ROOMS STORIE'. EXTERIOR WALL ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED I hereby acknowledBe [hax 1 have reatl this application antl state that ffie above information is rorrect antl agree to comply wiffi ell laws regulating building co^struction, antl I shall not employ any person in violation of the workman's compensation laws ot , the Stete of California. ' I hereby certify that I am properly licensed asacontrectoYuntler� [he State o� California Business and Professions Cotle, Divisicn 3, Chapter 9, and 2hai such licenses are in full force and ettect, or 1� am exempt from U:e provlsionsp theState ot Calitornia Business antl Profeszion oue,'Division �, C apter 9. � Signature ot Permittee Authorized Agani '�1Y;5-;3�F�.u(?��13y5i :a��t:44.ic APPLICATION FOR BUILDING PERMIT EIVFO�V aOA��CE��D DATAI3SUI �� OWNE FIRE 20NE APPqOVED r�� n� ' 7 � �'v /� � �� LOT I � DATE G ZONE NO.OF USE OF NEW SW(i PLAN$ � BUILDING YARDSAPPqOVED YARDSAPPROVEO MAIN BUILDING ACCESSORV BUILDI (FROMGLSTREETj� � �, BET. VAR. # C.U.P.� APPROVED FT & DATE APPROVED ne-rc J —�5'73 STATE THE AMOUNTSHOWN UNDER VALUATI THE PURPOSE OF E5TABLISHING A PERMIT � VALUATION // r PERMIT FEE $ �C $ / �� PLAN CHECK $ � Q� TOTAL FEE $ �. m ( o ' FOii � ONIV: Q � m ] � m �O E � LL