Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2565 SAN CLEMENTE DR - Building Permits
• City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 00207k Building Safety Division P.O.Box 1200 Costa Mesa,California it The Building located at 2565 San Clemente Drive has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Rl. Occupancy. Use of Building Aoartmants Legal Description 420-012311 (See reverse side for Metes and Bounds) Building Permit No B 25532 Electrical Permit No. P 7cC1711 Plumbing Permit No. P 26172 Mechanical Permit No. N126973, M26669 Number of apartments 16 • and/or guest rooms - ISSUED TO: Building Official William T. Hnwarr3 Fairview Martaaement Company • 1176 Main Street by Irvine, CA 92714 Date July 1, 1987 -This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File 44,4011n 41 1 MF 9 CITY OF COSTA MESA BUILDING DIVISION F4111 a IA'41 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER ./ti ° PERMIT 4'q !� �1 /02-00527 ` oaurN"4 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2565 SAN CLEMENTE DR Status: ISSUED Suite: Applied: 04/22/2002 Vicinity: HARBOR VILLAGE APTS Issued: 04/22/2002 Parcel Number: 42005103 Zoning: Applicant: POWDERLY, PAUL ISSUED BY: f�� Address: 135 W SANTA FE AV Phone: 714-449-7750 - FULLERTON,CA ; Zip: 92832 Owner: STATE OF CALIFORNIA%CONTINENTAL WINGATE Address ASSOCINC ' 63 KENDRICK STREET Phone: ' ONE CHARLES RIVER PLACE Zip: 2494 Contractor: ROYAL ROOFING CO Address:, 135 W SANTA FE AVE Phone:, .(714)449-7750 FULLERTON,CA Zip: 92832 License: _ 678705 Arch : - - Eng. Address: Address* • Phone: Phone: Zip: License: License: . , SCOPE OF PERMIT TEAR OFF EXISTING ROOF.AND APPLY 30 YEAR COMP SHINGLE ROOFING.MULTI-UNIT APT. BLDG. FEE SUMMARY • Plan Check: $0.00 Calc Valuation: $9,000.00 Permit: $167.25Claim Valuation: $9,000.00 SMIP Res: $0.90 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.15 - PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 - Rear 0-0 Left , 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 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, 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 2446443(Woo) DECLARATIONS 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.them -� ave and will maintain workers'corn natio .nsuraneeras required by s c n 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation I ra c card olicy nurP�ber' I are: n t Carrier: {/1� Policy Number: '(-0---PI (..in —al- (This ,1(This section need not be completed it the permit is valued et one hundred dollars($100)or less.) ❑ I certify tha in the p• ormanco of the wy• hich this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensat.n law •1 California, d a. If I should be subject to the workers'compensation provisions of Section 3700 pi t11e Labor Code,I shall forthwith comply wit n4.:provisi gib .`•-li/I I �7 Applicant Signature:‘, 14`. � Date: VI, Ll9- / WARNING:FAILURE TO SECURE WORKE ' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE 15100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTH Rrert CLARATION: I hereby affirm t I I am licensed oder provisi.ns o Chapt. 9(comm: cing with Section 7000)of Division 3 of the Business and Professions Code, rid my license is In full force and effect.Llc. \ Class x - y/ i Contractors Signatur , c .\ Date: -1 (7, 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: 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 end 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 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 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: 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? ❑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 a plication apermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? j�Yes DI 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 0 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 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 e�va.�ascribed property for inspection purposes.pu) I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. � /) '1gna e�fLegal IOwner(skp 4 )it /` tte d/Or Authorized Applicant / (/(� Date SOH E, INSPECTION TYPE RAE Ifs CODE! INSPECTION TYPE QM ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final '- 208 Final Plumbing -. l'•92i 200 Final Re-Roof ‘cg-017 210 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 .4' ". - `o5tn-MFsq CITY OF COSTA MESA O.Q ., CALIFORNIA 92629-1200 P.O.BOX 1200 1 DEVELOPMENT SERVICES DEPARTMENT 0RPORGfEO\ October 20, 1986 Tb: Building Safety Division `' Pacific Bell (2) Business License Division Police Department - Ping. & Research Ccngnunications Santa Ana Heights Water Company County Administration Office Sanitary District Engineer County Clerk/Board of Supervisors Southern California Edison Co. County Registrar of Voters Southern California Gas Co. County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Finance, Revenue Division United States Post Office, Adams Avenue Fire Prevention United States Post Office, Santa Ana Manager, MID Zip 4 - Santa Ana Mesa Consolidated Water District File (2) Newport-Mesa Unified School District (2) The City of Costa Mesa wishes to advise you that in revising street addresses, the following addresses have been added: OLD ADDRESS NEW ADDRESS A.P. NO. None Dwellings: 2565 San Clemente Dr. , 101-108, 201-208 420-212-10 2566 San Clemente Dr. , 101-108, 201-208 2569 San Clemente Dr. , 101-108, 201-208 2575 San Clemente Dr. , 101-108, 201-208 2579 San Clemente Dr. , 101-108, 201-208 2551 Santa Barbara Ln. , 101-110, 201-210 2556 Santa Barbara In. , 101-110, 201-210 Carports: San Clemente Dr. , A-I Santa Barbara Ln. , A-D For your convenience we are listing the agencies above that we have notified of the change. In addition to those listed, you are advised to notify your correspondents of the change in order to avoid any possible interruption of mail service. Your cooperation in this matter is appreciated. Sincerely, MEL E. LEE Planning Intern ML:alm (F-1-56) cc: Sharon F. Mills Village Investments 1176 Main St. Irvine, CA 92714 Code Enforcement/Business License (714) 754-5234 Building Division (714) 754-5626 Planning Division (714) 754-5245 77 FAIR DRIVE 1 Al. r , X 5 . 1t d S t .cehre . \ GtcVMY miumasamma -, r [_ r i a . a 4 io vJ' I IMEEME I IIMPME r HUM= I 111111101111: 11 'I,'-.':ms's', IES (( —yl .' ids \- °; f �r%f' tr_ to1. • v,�tt� 0440 4. M. Jr5Z ie.'�.lD' Ib=s� • ' N' ' - b'-bra " , I 1\ GGnn�� '- 105 T ' IbC..}-� _ I K/a _ ��j t 1 , _ ':li d . ' a rv� t...11± '; 11- I I 1 1 im �p1�'1' 1 {rO �`� i I I' J 1 ��.. �t Stub. � 11 •_ - 6EE/A1D b p �'� 5. 4� �viz '- ice 774 . .. = :-- 71•rVi© t (I. i•Spillk �vili . miiir dgt r-4, ov o v� �.�a , -t MERBIMpC W A I • 101'.. .. \\ 1 / � OVLAGE. .YlI. W.G.tMWi;iLu11 p-" / ;� BURKE LEST ER & ASSOCIATES �' / ARR. ECII AND VL TES ono•n. o.n. 'LAWS wa c•4.0.-mo 111.11110••••• f . T1 TYPK aL= _ iv E2Sra'o engin 6AR&s.R�l lN• �I ' • ' rya i� . 5 _ - - ��.' — o� ` DiD 4 0 I 202010e, l^ . Op I 10203 �p=0= f / BOJ was • 1 "(� 4P dt11111 Xtal-dr -4 . • a. . am:o o3• _ ��t: • 4�' �tx . _aft. Z1 , -:/'.itivie.*: , • :\lark 411to.,, . 1, 1:N.reu— 1 x % 7444( HARBOR ' VILLAGE ' I,11i r .•• 1111111101.11111•Lu..s cc.su Win. tunas / FAIRVIEW DEVELOPMENT COMPANY • . ... w. Y 4 , .•. seta `\V N\, ,FEIN I. I• BURKE • LESTER & ASSOCIATES ARCHITECTURE AND PLANNING \\ \ , .L.. •Ill Coll Y.L Wain. *IA CYIar•OM I.NI.A•.a. ' 11/4#4002 44 L Aft Fiber Glass • , • _.- Asphalt Shingles - --- rig 7a.5-74 • • . 1 . . . . . . . • . . . .• . . . . . . . . .... • . .. •... - , . . . •. . . . - . ..;1,;#4,tt.L,-/c.:4-:4::i., 41-0-4,,.!--/e•47,1:4,&74-:,-,:sit-aikAliathAo,,-04,744.f.;141-,..i-. 0.•iyikkvery.4v.writwirtit.-kritii. ,tigOrt", ".,“-A,.14e m ajAri:*%Vo.1t Migt-fr41,1MetAlacMrc45.2t4,:ktcc: 41....cial.,or,ti,A.plove44:tt-?-ir gi-z;i1Iv.e- :'i,tP;4':fg:.t:g'AY'Pith:71'4:::,Wt:Sif'i4'g;' :03toPaP::114.0/Pi/Wylfla0;1;eitti%. rit::::visitgetifi.k.L.,43,4•5:;,;if.::;,2;73:op,54-3 ,,.??..,y.areAtiSl?rafrg.,Fg?"Mr:-%Vit;-t ...:44,itliiS:AvicNcia,..40:207-..7441Aertit ir: (3,-::C)--ft':'•-''k*,)itt';iC‘,:'''-,'.';3'"iVS'?43':-;K1''F•F':4W- t'f '1.'"i.r.4?i1a.,i'1;''1:" .-‘ ''''rA/.k,.',.1•.-.' re ..frrztSift.a...est4-4;ilk., 1'V A,(.,441,21i..--t,::,4.0--.47 2,...",'vs% ,,J.V.,:-•,. ti:-.,. i"..P•t:.,...-4. :::.,;( 'es...,:.-in.,,FSge,%.1..”«.:”.,..f: c,t....,..C.:ot,a.,,,.t7.7..,..2c..•-ec,,,.;:-..,.:,..:•c.,,,,..1..,tg.,,,3.:.. }24SISi.ki.::?":C.-i.!?tilii.Pht::•i=41ttilr.A. •t.k.::attt.'r.:11, I Fiber Glass Asphalt fl 5" 3 80 74350 ASTM D 3018-82 Shingle/20.12'x 36";3- ASTM D 3161-81 - tab;sett-sealing.UL Wind- • ASTM 03462-76 / Resistant,Class"A"LFed SS-S-294a abel. Limited Warranty(20 yrs.), . • ...`.` available upon request. ---.. 121/4"x 36"at III 514" 3 78 . ' --- Perth Amboy A 1 Big Onl Fiber Glass 534" 3 66 74348 ASTM 0 3018-82 Asphalt Shingle/20 1314"x ASTM D 3161-81 . ,:.-.11 , 3934"at Fremont:3-tab; ASTM D 3462-76 I' I self-sealing.UL Wind- Fed SS-S-294a • i \\ ,.,.. .,....___„ r . ,,,... ,.: lif 1 N :. : . ,...-.,...ii -.).... -..,,,,:.:.,:...,,...._ Resistant Class"A"Label. Limited Warranty(20 yrs.), • ::.-::::---,-::::'''''.. ''' V.i';:, att`•:.:':,-.::, ._ . available upon request. A -tC Big D Standard Hip and Ridge Shingle II 53i" 41 lin. 88 71924 ft.per per :;*. --S-a.. 931"x 1331" bdl. bd. - •-•'''' ',..:::"--S•roi-e-SP11:4-1ti744•3-t2:43''‘'2:--•-•-.,..-,-;--.^."-SVS7vei-V•i--..C..tv- •".c-r, Fiber Glass Asphalt S* 3 80 74351 ASTM D 3018-82 iz-irt;s.- .^:-..‘--i•-• .7-'., ••:-•-•!:- .i.-3--:-.;-- . -v..", Shingle/25 12"x36"3-tab ASTM D 3161-81 . ... . .. self sealing UL Wind- ASTM D 3462-76 rt< Silt-'.g.;,.-1:.1.--go•::.;•(>7..--.:;.3:'-' ....:>, ••;' •.: .: • ••Ij7i.•i.•''''' • Resistant Class"A"Label. Fed SS-S-294a 0Z::::c•-•.:",,,dt.C.; .:•• • • - . ., .. Limited Warranty(25 yrs.), .21;,,„:"---iltal;;;';;;.il:-.-;..2.,'-1.. . ' . ..,-.... ,-C.'- - • , - • . •3::','.'.1‘ available upon request • aisir ...'7f.‘":',c...•• "..• ;Yr.C.:3:-1,...7,---• ,, • 4:; - . ., 4::1•13,1 i3 _ Big 0"1 Fiber Glass 5% 4 66 74349 ASTM D 3018-82 are•rat.1 7..;k1.21:').&;.-. . ....=' ."-.' . 7 ., .1 ',1.1•4 ' ' ' .4...: 1 Asphalt Shingle/25 131/4"x ASTM D 3161-81 aurallaXC :j; ;;:'tr i. '•,'••- ;17 . ,- '4. , ', 'yszt„Iv\ 393?at Fremont.3-tab; ASTMFecis sC)..s342634-7a6 .7 '' ' ! ' •..' -Ii' '.24. -.44a11r iar A.-al-le.%.. 111:'-:.''•.,":S.).:7i..,t"-;7i..'.-'i3'.l.4ti."f.-:-::k".'.-S'"":Fe:. •;:••-`.'.*$.':"•-.rp..1.',ye!.0.,/.v.„.,,&.:1 i .'-,.T“,,:i?1;.4V-r.;:;fi:.:,:..•:,;.;1;;?I.4 .”2:-... ; l III 30 lin. 64 73198 None . :. - .- ..”.Tr • c:;,.!...c....si - • ...f/A,...Z:,, . • ja'A' Hip and Ridge Shingle ft per per 9Wx 1314' bdI WI • i 4#41.40,40')1" /..,' ' • • ‘1 ". \ ' V.;t1litftS53 0'..4tst.74'.;%!4e1VE '4-4.-11-ialls. v-4.11.34W ..Is... • -int- .. re.%:::•:;77,P,';'5, Availability :•-,1 I.: ..,..! -; .. ,,t .. -•,:.:4-:! s., \ill %.41.4.61. am. i . . , . . . . . _ .Q;,.i...:,;,,,,..),, -,:i4t.,v;i1 . .-titi,-,--i: \,4; . /..;?..c. k .. ._• :- ,orAiit . ' 1 i i ;47;;;J:t•t;•-z. ..,5.-i>efillIANNe_ _. \ \ C•:-- f . f Yi---.-- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT/re/1° 1 PEaMIT NO. TRACT NO. LOT NO. NIT NO. 4016 9/29/86 Project Address zc-154A/C<r_r/f a re / 2/!/tom S) '✓ 5�'�2 / 59�/ LIZ1 562.56 TL Applicadt's Mailing Address ,7670 Ai.5eO"Zt_e/ EH- d•/y, TYPE OF CONSTRUCTION KNEW U ADD Li ALTERATION LI REPAIR Owner's Name ��//�L /YMU�L/1tA/s'�t Phone�G��'�A LE CONVERSION El DEMOLISH El OTHER A'13' •p #400_,O/2 _/ / I Zon_PT�� /f • DESCRIPTION OF WORK/USE OF BLDG. 1 °/ L/ /7U Address //7 /@A/A/ T• /,el4/NE LFL q„2 d S Main Building: Accessory Building: G Z// l(/ -u vrr I�PA�TT M ,J— Arch/Eng.nn not.1ee c L,1fret?License No. @-6 ' :,..C. TYPE OF PERMIT IJ GRADING❑129 FOUNDATION ILY STRUCTURAL T Sssat A) /p0/7V' b& 4 o Address K2 //LL def _ /,i /• / ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL BA 7t2a1 5 //j`/ ./_ ,.�.,`(/s'— N Fle✓/t u /7 C ,faq 0 OTHER // 7Ve/TVL QL � Contractor's Name f✓ A Phone 979- c Rigtu G ✓ /LJ N /�t1EY �/2 A'> MES/} PROJECT DESCRIPTION SCI.FT. 744 OCCUPANCY K G Address(mailing) .217e)�� 5G Q CON STRUCTION TYPEFe-4,7/7 Jfv"La VALUATIONS 54 JJ/1cn $ L' IS/ t 2 City License No. 64-t•a-9 39.J ZONE GRADING CU.YDS. ACROlY.Q 3 R LICENSED CONTRACTOR DECLARATION Ping. Ref.#�Jfj— -/�3A Parking Req./Provided /' /� E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • / -/� /- PlanningNOtos: ]jam 11yfn�^ f /` D with section 7000) of Division 3 of the Business and Professions Code, and �C �� - �I�J - •+s•, v r � ✓/�/•K7O M gmy license is in full force and attach, �iA 1"3' T License Class L A•9000 LIC nse No. -"'r 3 HOLD I vQ Sf l:l,lj�L �iL ( $ Date a-9-.51G Signatur _'�) • , ._ _ _ PLUMBING FEES QU.REfJENTS WORKERS'COMPENSATION DECLARATIO Bar Sink Showers ' 'eby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL • FEES Yorkers' Compensation Insurance, or a certified Copy thereof (Section Backflow Preventer Service Sink ' ,ou), Lab. C. Automatic Washer Transformer 0 15-50 KW Policy No.d,�fi3/i<444-v'�L• Company re4✓Ze'F'es Backflow Irrigation, Sewer Cap - Construction Pole Sub. 0 50+ KW 8 Certified copy is hereby furnished. Certified�co[�p[y is filed with the city Building Division // Bathtubs Sewer Connection - Cooking Unit Meter Dula to 100 amps Date L J G Applicant itatec/LLC' //7E✓r enc _ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for 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 toy the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1'h-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 _ Inc.Solar ❑9.15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal comply with such provisions or this permit shall be deemed revoked. - Fi%lures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there Is a construction lending agency for the performance Pole Light of the work for which thi permit Is I •d (Sects n 3097 Civ. C. Interceptors . , Water Heater Outlets Range' Lender's Name-_E " - . = - - 9 Lender's Address /t/7C 54As/P Av< ~U41r414t .,/<19/7'g Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the Lavatories - Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap any structure, prior to Its issuance, also requires the applicant for such permit Laundry Trays Generator❑0-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's,License Law (Chapter 9(commencing with Section 7000)of vision 3 of the Business and Professions Code) or that he/she is exempt - refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). • I - U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 • compensation, will do the work,and the structure is not intended or offered - 1 Reinspection Fee I $15 Issue Fee $ 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/herself or through his or her own DEVELOPMENT SER ICES REG I'EMENTS: employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I ❑ �� -n 4 I „� sale. If, however, the building or Improvement is sold within one year of cum- Canopy Type II 0 Zoning Approved By L �f / Date S pletion,-the owner will have the burden of proving he/she did not build or im- Duct- Under Ground // prove for the purpose of sale). Building Approved By . .� ei Date a 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By /• - Dat= 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 ❑0-100,000 BTU ❑100,000 BTU SU gq['' OFF ES builds or improves thereon,sttoand who contractsac 'sfor such wprojects with a a- - BUILDING PERMIT $ --_ ] SMIP $ 26 43 proof of license their Worker's othe tionaInsura License Law). I ov aware that Exhaust System 0 Multiple❑ System Repair/Alteration 1=(Q proof their Worker's Co mode soften Insurance should be provided to me. - PLAN CHECK $ 3 PERMIT 0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ ISSUANCE $ HeatingSystemPLAN CHECK 25% $ ENERGY P.C. $ Date Owner & Ducting Registers • I hereby certify that I have read this application and state that the above I 00.100,000 BTU D100.000 BT $ GRADING $ information is correct. I agree to comply with all city and county ordinances -. ELECTRICAL and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter ••on the above-mentioned property for .I inspection purposes. -S /,J MECHANICAL $ TOTAL FEE $ ��� Signature - .. _ . Ie. - CMF 0865-46,rev.10/84 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND.PLANNING POOL& SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1: Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ' /175/16 oh' 57. APPROVAL TO COVER-GUNITE 7. Footings 1((((/3/8 Qd 58. Electrical Conduit-Undrgrnd. 8. Foundation .. , 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System IVS/$6 Qe- 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 1 . Rough Electrical-Conduit 66. Solar System-Final 16.Bough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING!.- 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . , 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT•- 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas OOil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing '/,/Y7 00 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical s-------- • 27. Frame and Flashing 3/S187 P - 76. Dry Standpipe 28. Lathing & Siding Bl /$Z (S� 77. FIXED SYSTEM FINAL 29. Insulation i ib 7 9&4 78. FIRE PREV. FINAL 30. Drywall Nailing 3 Vt 181,01kHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: / a/4 87 lsrcut . t cc po 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace C.-Ssie41v 38. Final Plumbing yet 39'. Water Service-Final (Z 40. Gas Service-Final �' 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation !- I. 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 7/) /g? m M r� 49. Electric Release to Edison ! ( +' 1 50. Gas Release to Southern California Gas Co ". 51. CERTIFICATE OF OCCUPANCY .- No. Date ' . . • . LOADI,NG FORCES REACTIONS A . 234 G 74 R-9 739 R-C -701 B-G -1326 C-J 413 G -1517 CL E97 SPAN = i T- 1 -'1; I 8. 412 M 76 8-C -1288 G-H -710 8-H 1942 E-K -1010 K -940 IC IL . E1 C 424 I 75 C-0 -1440 H-I 1239 C-H -518 F-K -210 TC MEAD! = 12 . 0 PSE ' 0 420 J 75 D-E -892 I-J 1385 C-I 152 BC = 10 . 0 PSF - E 420 K 38 E-F 0 J-K 858 0-1 5 n5 PSF REO. FOR i" D.W. CEILIn,;;I F 210 D-J -578 SPACING = 27. 0 " Maras CSI = 25 . 0 7. I') 5c-is Top CRoc2a on/E." 510E F2o,..A J'VTs . g ro p TC = 2 X 4 NO. 1 OF 1 EXCEPT r//zN 4 NO. / DF :c /lo =O" .1 A/A 'L. .r '/6 eft BC = 2 X 4 NO . 2 OF r ...;, i WEB= 2 X 4 STD. OF 1 C..001.44 . ivy X E.5 0 G' v . c _IDE nares '.=) 'MuS $ TO cu.pportr 'It OF 4"o.C. OIJC SLOE: 4- '/Z or ,o"o. c. oppos '-rs S/0£, / 6-3-8 / 6-9-8 6-8-0 6-8-0 / 6-8-0 / /12 4. C7' F -3 E 35 e -' 34Stt 0 35 <1-/\(22 Ate.; 35 /�e�//1 n_s /�/moi it 35 •r G 8 3 G /�e ' POFESS/04 y'/'�"�f, ii1J3z3A 3 5 2004EI . �?� se�Q ,/r+ FI 36 see Z3 23 "' 37122 % Mr" G 'S6 its" •• 1 6,1-0" U1Nr, .....:=2.1 12 r Q� 33-1-0 /lF OF Cato XVV XXX ' 11/16 OPTIONAL CAMBER UNLESS NOTED DIMENSIONS GIVEN RS FT-IN-16 RESIGN' SHOWS MINIMUM LUMBER AND PLATE SIZES TO MEET STRUCTURAL CODES' ICBG 2878. HUD 42.00' OR L.R. RR 23827. ABOUTCJOINT UNLESSFORM TO UBC DIMENSIONED.STANDARDRFCIAN BRACIN25. 1738 G DETAILS ERECTOR. SUGGESTJOINTS PROFESSIONALFITTING ADVICE.R!lRomKID PLATES ING ARACING, NOTEDOAL N FRl2 v/C v,/ I ; PLAN RS REO'D. QERMRNFNT RRAFING, BY BLDG. ENGINEER INCLUDING BUCKLING BRACE SUPPORTS. GEHEBAL CONTRAFTOR• FURNISH THIS PLAN TO BUILDING ENGINEER FOR REVIEW. RESPONSIBILITT• THIS DESIGN FOR TRUSS FABRICATION ONLY. XANAX, XANRX ENGINEERS OR TRUSS FABRICATOR NOT RESPONSIBLE FOR JOB CONSTRUCTION. BUILDING DESIGN, TRUSS ERECTION, ROOF SYSTEM OR ANT RELATED STSTEM. REVIEWED FOR TP178 ' DATE1 1/22/87 DRAWING NUMBERS 96917 t'''XANAX INDUSTRIES NATIONAL CORPORATE OFFICE 5690 SCHAEFER AVE. .CHINO,CR.91710 714-627-7411 X A N A X gt0 d./. J City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division , • 2565 San Clemente Drive Costa Mesa Orange Number and Street City County Tract 12594 Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material N/A Brand Name Thickness (inches) Thermal Resistance (R Value) EXTERIOR WALL Material Fiver Glass Batt Brand Name Manville Gold Fiber Glass Thickness (inches) 3} Thermal Resistance (R Value) R-11 CEILING Batt or Blanket Type Fiber Glass Batt Brand Name Manville Gold Fiber Glass Thickness (inches) 6 Thermal Resistance (R Value) R-19 Loose Fill Type N/A Brand Name Minimum Thickness (inches) N/A Number of bags Weight per bag lb. Area Covered (ft2) N/A Thermal Resistance (R Value) FLOOR, ELEVATED Material Fiber Glass Batt Brand Name Manville Gold Fiber Glass Thickness (inches) 34 Thermal Resistance (R Value) FLOOR,SLAB • Material N/A Brand Name Thickness (inches) _ Thermal Resistance (R Value) Width (inches)_ FOUNDATION WALL Material N/A Brand Name Thickness (inches) -- _. Thermal Resistance (R Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). Fairview Development Company B 496001 General Contractor(Builder) License Number May 8, 1987 Signature and Title Date Red's Insulation 381933 Sub Contractor(Insulation Applicator) License Number Cl:7410rp le May 8, 1987 Signature and Title Date Date CMF1106-46 • DciiDon Greek onci Cissooiotes CONSULTING CIVIL ENGINEERS ENVIRONMENTAL ENGINEERS SURVEYORS May 18, 1987 CITY OF COSTA MESA Department of Public Works 77 Fair Drive Costa Mesa, CA 92626 Attention: Mr. Gary Conlon SUBJECT: TRACT 12594, GRADING CERTIFICATION (FILE 1250) Dear Mr. Conlon: This is to certify that the final grading for Buildings 1 through 5 for the above-referenced tract has been completed in substantial conformance with the grades shown on the approved grading plan. Very truly yours, DON GREEK AND ASSOCIATES SURENDER DEWAN, P.E. R.C.E. 34559 rtk cc: Fairview Development, Attn: Mr. Frank Kindstrand 0. ESS/040,- e 40 pERM 402 coy � \ CJ Z IAA NO. 34559 m * - qlf OFCA1i�a'`. 2428 N.GRAND AVE., • SUITE I. • SANTA ANA,CA 92701 • (714)543-0990 Sr Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY'OF.COSTA MESA CONSTRUCTION PERMIT 5- PERMIT No..�-I TRACT NO. LOT NO. UNIT LD, 6627 14. TL • Project Address?SLAS Sean eft 2 v pI' LI b " . Applicant's Mailing Address13le0a �'•=ryQ6'2a Ss F.s , TYPE OF CONSTRUCTION ir NEW L I ADD U ALTERATION LI REPAIR , ❑ CONVERSION C7 DEMOLISH CI OTHER Owner's Name rQ.1f VI • Address Asko u ' • CPhone A.P.# Zone (I I DESCRIPTION OF WORK/USE OF BLDG. A C ""`�T— S Main Building: Accessory Building: • Arch/Eng: License No. TYPE OF PERMIT U GRADING ❑ FOUNDATION U STRUCTURAL E Front 0 Address ❑ TENANT ❑ ELECTRICAL Y--PLUMBING Cl MECHANICAL B Rear N ❑ OTHER - A I Contractor's Names I -- • - 41-'' -� �•t1\ion -�3 C Right N Address(mailing113LrttO•vR FI,rM e" �n%�A)5a r, G pct (-ethee PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left �` �['Et(1FtJ. �� G ^�n1 1r 1 - T CONSTRUCTION TYPE VALUATION$ $ City License No. 3 1 -1 ZONE - -- GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION • Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks I `nt --Bass 3'�" Planning Notes: RECEIVEDQ 7 M with section 7000) of Division 3 of the Business and Professions Code, and �I- Thr .. C L 2 7 '''q T my license is in ft fOepntl effect. 3 ,.A.TP $ Dater- sates � LLRR /l' "ce No � - PLUMBING ( FEES ' Dater" Signature WORKERS'COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a ' 'ed copy thereof (Section Backflow Preventer $ Service Sink ` 3800, Lab{�jJ /� ''1� ,/ 1l� — Automatic,Washer Transformer 15-50 KW ♦Jo Policy No.f e -g13&c�L' Company LC/ ut Backflow Irrigation • Sewer Cap ❑ 50+KW• ' Construction Pole Sub. Certified copy is hereby furnishes \ Da Cer(j,(ie co Is filed with the ler i •'ng pivisio ,Q(.1..Bathtubs Sewer Connection 48 — Cooking Unit Meter ❑up to 100 amps ' I Date /O . APplican '•.• EXEMPTION FROM WORKERS'COMPENSATION DECLA TION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps • (This section need not be completed If the permit is for one hundred($100) or - less). \Dishwasher Solar Piping 3a_— Dryers ❑Gas DElectric Sub Panel Q 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 te Drinking Fountains Solar Tank • Motors 00-1 HP 011/2-B N. Workers' Compensation Laws of California. _ Date • Signature Floor Drains Swimming Pool w/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 Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY t Gas Service Outlets 50 at11 Water Closet 93 Device Boxes 9 I hereby affirm that there Is a construction lending agency for the performance Pole Light of the work for which this permit is Issued (Section 3097.'Civ. C.) Interceptors /. Water Heater �j Outlets - Lender's Name - V' a Range . Lender's Address -. - - - - - Kitchen Sink - Water Service - SwitchesSign ' OWNER BUILDER DECLARATION ��Q I hereby affirm that I am exempt from the Contractor's License Law for the a4 Lavatories Auto-Wash "Its �' ' following reason (Section 7031.5 Business and Professional Code: Any city or rbage Disposal Standing Sections county which requires aermit to construct; P-Trap alter,improve,demolish or re air ' any structure, prior to its issuance,, also requires the aplicant or such permit Laundry Trays fenerator ❑0-5 KW ❑5-15 KW • Trash Compactor + to file a signed statement that he/she is licensed pursuant to the provisions of 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 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). - U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 / compensation, will do the work,and the structure is not intended or offered (1 Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES • License Law dons 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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler - Hood or Type I 0 , • sale. If, however,'the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date plebe for the owner sewillof have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved ByU I, Date ���� II rove the r of theproperty,oe). {1y�/sem YL// s owner of thet roject exclusively contracting ing with Ilsionsd con- Duct-Structural Refrigeration System Application Issued By / _ Date tractors tactors the project (Section 7044,Business and Professions rt Code: - - buil Contractor's License Law does notoraapply to an owner je property who Duct-Ventilating ..� 00-100,000 BTU 0100,000 BTU builds or improves thereon,and who contracts for such projects with a con- SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance'should be provided to me. _ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact Bit.ICBG�kPLAN CHECK $ SZ'�Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting I. Registers PLAN CHECK 25% $ 4a•as ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county Ordinances and state laws relating to building construction, and hereby authorize nrepre- sentatives PLAN CHECK 50% $ MICROFILM $ sentatives _this city to ,enter upon the above-mentioned property for • inspecti.n Pur.-es. L ,P j0 531 MECHANICAL $ TOTAL FEE $ 314.25 SiDrivers' ��s1 . .- _ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor • CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. (N4-V4 Leo 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Presst{re':Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE s'" 7. 7. Footings 58. Electrical Conduit-Undrgrnd. I;, 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Tes4 bt, 9. Water Pipe-Undrgrnd. s1 t/-‘d� L� 60. Backwash Lines, P-Trap, d-Undrgrnd:L, 10. Structural Floor System 61. APPROVAL TO DECK C. 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final':) 12. Sewer Cap 63. Heater & Vent-Final tkaa v, 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing L4(•(2 La 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing &Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ • 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough&Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • 27. Frame and Flashing • 76. Dry Standpipe •• • 28. Lathing & Siding • 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 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 1 'r 38. Final Plumbing &-V-V7 (,fes • 39. Water Service-Final jt-31•d6 Lit) ' 40. Gas Service-Final • • 41. Solar Domestic-Final - 42. Backflow Preventer - 43. Backflow Irrigation I , • 44. Landscape Irrigation System - • 45. Sound Attenuation - ' 46. Handicap Regulations • ' • 47. FINAL STRUCTURE & BUILDING - ' • 48. Special Requirements Completed t 49. Electric Release to Edison j 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - '1 No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT - - !?NO- TRACT NO. LOT NO. •UNIT NO., - -, • 1�1 a6973 i23eoo TL Project Address 7565' •San Clemente Dr. ---- I,,I r � LI 11 ,, x 0790 ( /23/87 Applicant's Mailing Address 1 1 • - _ - e_ s - l TYPE OF CONSTRUCTION h NEW LI ADO ALTERATION u REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# . Zone Owner's Name _Pain'ew Man_gfmant Cn Phone DESCRIPTION OF WORK/USE OF BLDG. Address _2.4.00_Mai-.,—S �i•• Ct, Irvine, ('4 9271L llousing $ Main Building: Accessory Building: Arch/Eng. urke-Tester f. eSSOC License No. TYPE OF PERMIT U GRADING ❑ FOUNDATION Li STRUCTURAL T Front Z BO Address ❑ TENANT LI ELECTRICAL ❑ PLUMBING p MECHANICAL B Rear N A Contractor's Name Nis cien Sheet—Me-L.a_l_Pnone 970-5734 ❑OTHER - C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address(mailing/ 5380 E. Hunter Ave, Anaheim, CA 9280' K' G CO N ST RUCTION TYPE VALUATION$ S Left - City License No. .026467 ZONE - GRADING CV.UDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. R¢(.# Parking R¢q./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks1- C.53a Planning Notes: . M with section 7000) of Division 3 of the Business and Professions Code, and +--r w T •my license is in fulltorte foes andffect. 37 '693 ( ul -License Class UU C43 / License No. S ' Date 1 23 87 signet ,#. If/4t -- 71/.1_:7» PLUMBING FEES i . \ WORKERS'COMPENSATIO •ECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate or Workers' Compensation Insurance, or a certified copy thereof (Section . Badkflow Preventer Service Sink r is 3800, Lab. C.) - Automatic Washer Transformer 0 15.50 KW Policy No. Company • Backflow Irrigation Sewer Cap _ Construction Pole Sub. 0 50+KW iCertifled co i y furnished. S'dtHe Fund Certified copy is filed with the cit B.i .ing Division. / Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 1-73-87 Applica- .. At at_4.m • EXEMPTION FROM WORKERS' OMPENSATION D CLARATION Clarifiers Solar Collectors • Dishwasher Meter Dover 100 amps ' (Thissection need not be completed if the permit is for one hundred($100)or l less). Dishwasher Solar PipingDryers OGas DElectric 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 004 HP ❑1 X-8 Workers' Compensation Laws of California. L-- Date Signature Floor Drains Swimming Pool w/SpaF.A.U. Inc.Solar ❑9-15 HP ❑16-15+ NOTICE:if,after making this declaration, you should become subject to the - - I ' 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 I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light of the work for,,y+hich this perrnit isued (section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name (,real American ma37ingS Range •Lender's Address 4_7{—G-IKitchen Sink ' Water Service Switches Sign OWNER BUILDER R • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash . Garbage Disposal ;Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or - county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW Os-15 KW Trash Compactor any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of 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 - . ' therefrom and the basis for the alleged exemptioh. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil • _ • enalty of not more than five hundred dollars ($500). U I, as owner of the property or my employees with wages as their sole Reinspection Fee, $15 . Issue Fee $ 3 - compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 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/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: i • 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 corn- .. 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 BYDatO prove for the purpose of sale). U I. as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 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 SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ • System Repair/Alteration BUILDING PERMIT, $ _ SMTP $ proof o�their Worker's Compensation insurance should be provided to me. PLAN CHECK • $ _ PERMIT ❑ I am exempt under Section —B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ _ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00100,000 BTU ❑100,0008 LAY Cr ELECTRICAL $ GRADING $ information is correct: I agree to comply with au qty and county ordinances m ' Ra thrnO -Si ngl P duet. and state laws relating to building construction.and hereby authorize repro- `/O PLAN CHECK 50% $ 1 MICROFILM $ •inspection of t city to enter e�on'f'he above-mentioned property for Kitchen hood .)i ea. /�O inspection our ,' \ �`�' - MECHANICAL $ areas. TOTAL FEE $ C. Signature 7 Date 1-7'i-R7 P Drivers' License or$5# Reinspection Fee $15 Issue Fee ' $ 3 PLAN CHECK 25% $ i -00 CMF 0865-46,rev.10/84 White - Building; Canary . Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 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 20.; Rough Factory Fireplace APPROVALS Permit# 21.1 Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas C Oil 23. Gas Pipe-Rough&Test 72. Underground Flush • - 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL ' 29. Insulation - 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: • 34. Final Heating& Air Conditioning `41.1 CIO 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations 47..FINALSTRUCTURE & BUILDING 48. Special Requirements Completed 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 heavy border lines and sign all appropriate declarations. CITY Ot COSTA MESA CQNSS'T TION ER MIT - PER IT NO TRACT NO. LOT NO. UNIT NO. Project.)ddress "-tiJ LJ�o�' 2 ' t' - I - _ 'z , 5978 10/27/96 531 .90 11 Applicants Mailing ddres�� dW \ TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION L I REPAIR 1O ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A-P,# ' - Zone _ Owners Name \EL) �`,.�s� s-�-,` •� Phon DESCRIPTION OF WORK/USE OF BLDG. • Address mf�l`[� �jc ?+wl n`FS Main Building: Accessory Building:• , • Arch/Eng. 'P�Cn _ L Lice e No. s%� ac TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front ZO Addresse1 a�► v �• :=�1►� �. ��J El TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear N Contractor's Nam- x11 -+-�+ "hone' • tZa ❑ OTHER C Right N" Address(mailing)114"2- 72 �� Auh e�Q PROJECT DESCRIPTION SQ. FT. OCCUPANCY K g G CON ST RUCTION TYPE VALUATION$ S Left • R City License No. •'�J��0 ZONE GRADING CU.YDS. ACRES ' (� LICENSED CONTRACTOR DECLARATION A� r` �s-a • Ping. R¢f.# Parking Req./Provided E I hereby affirm that am licensed under provisions of Charter 9 (commencing Remarks: r11 A� .}]� �.,� R��/�i-aZ Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code, and �-+�^ 41 ,J ' / - M my license is in f ore d effect. T LICense ass LICen Se� I $ Da Signature •�?j,�<///� A. PLUMBINGI FEES ' • VI WOR RS' OMPENSATION EGL RATION Bar Sink • Showers I I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES - , of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink • 3800, Lab. C. Automatic Washer Transformer 0 15-50 KW PolicyNo. `"3�c(p 4D Compan `1f•_ • a 0.' Backflow Irrigation Sewer Cap0 50+ KW - 9 Construction Pole Sub. 8 Certified copy is hereby furnished. Cer Wed copy s iled with the cit /B �i Bathtubs • Sewer Connection GL7 Gt Cooking Uri it • 1� Meterp to 100 amps �� EXEMPTIONFROM AEica / a 1 EXEMPTION n FROM WORKERS'C f the NSATION •one A Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps // - (]O (This section need not be completed f the permit is for one hundred ($100) or • - - less). Dishwasher • Solar Piping - Dryers ❑Gas ❑Electric 0 Sub Panel ' - it W I certify that in the performance of the work for which this permit is issued, I 1 shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan - 2uCID Workers' Compensation Laws of California. - Motors❑0-1 HP ❑1'/:-SI / _ Date Signature Floor Drains Swimming Pool w/Spa i j6 !F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ /h a° 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 Fixtures Microwave �9 CO ' comply with such provisions or this permit shall be deemed revoked. • CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes • I hereby affirm that there is a construction lentli g agen for he performance POI¢ light of the work h- •- i is i55 nn X97 Civ. .) Interceptors- Water Heater n�1/1 Lender's Name e'� L1t� -.l .t= I Outlets • - •�lil1��� Range r/ Lender's Address . eel .'� Kitchen Sink Water Service l�,q - b - OWNERBUILDERDECLA-ATION e/iC _ _ tit Switches Sign '�; I hereby affirm that I am exempt from the Contractor's License Law for th Lavatories • Auto-WashIYp_J following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections /6 7N7 county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays any structure, prior to its issuance, also requires the applicant for such permit - y Generator ❑0-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000)of 1 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 any applicant for a permit subjects the applicant to ,a civil ' penalty of not more than five hundred dollars($500). _ L I I, as owner of the property or my employees with wages as their sole Reinspection Fee I 111 $15 Issue Fee $ 3 , compensation, will do the work, and the structure is not intended or offered - Reinspection Fee 1;$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 - DEVELOPMENT SERVICES REQUIREMENTS: •• employees, provided that such improvements are not intended or offered for Boiler Hood or Type I D sale. II, however, the building or improvement Is sold within one year of com- - Canopy Type 11 0 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 prove for the purpose tee p sale).. �j ❑ t as owner construct tee project Se tion 7 44, contracting Ing wrof licensedionscon- Duct-Structural Refrigeration System • Application Issued By Dat hetors Contractor's License-Law the a- (oes ]044,Btos inessond Pf pro ert Cotle: • - - - . The s ontrmpros shern, a does notoraapply to an owner je is with who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU • SUMMARY OF FEES builds or improves thereon, ane'who contracts for such projects with aeon- tractor(s) ucense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $. Proof off their Worker's Compensation insurance should be provided to me.. PLAN CHECK $ . PERMIT-, 'I: I am exempt under Section B.& P.C.for this reason- Firepl/Fact.Bit. ICBG 4 Fire Dampers PLUMBING $ •. ISSUANCE $ Date' Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C., $ - I hereby certify that I,✓ve read this application and state that the above 00-100,000 BTU 0100,000 BTI, . ELECTRICAL $ j mss'6v GRADING $ Information is correct agree to comply with al •ty and county ordinances and state I. s rela • to building cons ctio• .nd hereby authorize repre- sentatives .f is ity-to enter .•ove-mentione ppr err for Inspection . p/ [T 2-i MECHANICAL $ 4D Signal ��./�/" .i Date TOTAL FEE $ �� �� Drivers' Li ase or SS 7? � Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ n • CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor /' CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date' Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 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 s .j 59. Gas Pipe, D Undrgrnd.,Test ' 9. Water Pipe-Undrgrnd. 1;1 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 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 r 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 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. DrylStandpipe , 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 /�J/," #./ 80.80. FOOD CERTIFICATE ISSUED, 33. Final Electric "' 9 �fC�jv Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37: Final Factory Fireplace ' _ ..... . r, , 38. Final Plumbing -. 39.'Water Service-Final ':' - ° 40. Gas Service-Final . • 41. Solar Domestic-Final - • v -• --a, 42. Backflow Preventer ' _ _ �' ' - - `43. 'Backflow Irrigation '44. Landscape Irrigation System . 45. Sound Attenuation ' ' '\ `45. Handicap Regulations 47. FINAL STRUCTURE & BUILDING _� •,- , . « � . a- w. ' 48.-Special Requirements Completed 49. Electric Release to Edison .. '-. , 50. Gas Release to Southern California Gas Co r • r •. 51. CERTIFICATE OF OCCUPANCY No. Date 1 • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY QF-COSTA MESA rCONSTRU ION PERMIT PERMIT NOin 4. • TRACT NO. LOT NO. UNIT NO. R e6,J� I .ject Address . ��zu -- - sZ & ' Applicant's Mailing Address 231 W. BLUERIDGE AVE , TYPE OF CONSTRUCTION I x4EW LI ADD Li ALTERATION U REPAIR 34921152 qI ' D I7/OD/LIC ' .^ - Ti Owner's Name FAIRVIEW DEV . CO. Phone ❑ CONVERSION CIDEMOLISH 1:11OTHER A.P.# • Zone , • DESCRIPTION OF WORK/USEOF BLDG. RESIDENTIAL Address 2510 N. SHELLEY CIRCLE S Main Building: Accessory Building: TYPE OF PERMIT U GRADING ❑ FOUNDATION 0 STRUCTURAL E Front ��1� Z Arch/Eng.ddress License No. [SD/MECHANICAL , REGEI�1E� : SST 0 Address L ❑ OTHER TENANT ❑ ELECTRICAL ❑ PLUMBING EXIXAECHANICAL A Rear f� v.--6' N Contractor's Name SANTIAGO A/C Phone 998-160C Address(mailing) 231 W. BLUERIDGE AVE . PROJECT DESCRIPTION SO. FT. OCCUPANCY CK Right G G 01526)4 CONSTRUCTION TYPE VALUATION$ S Left City License No. - ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping- Ref.# •Parking Req./Provided . E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: • BLDG. PERMIT # B25528 thru B 25534 - Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and my license is in full�horc d effect. License Class — T g7.� Li a se o. 269496 S Date12/386 PLUMBING _FEES WORKERS' COMPEN CLARATION Bar Sink - • Showers ---..x I hereby affirm that I have a certificate of consent to self-Insure or a certificate - ELECTRICAL - FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15.50 KW 3800, Lab. C. ,� IND. INDEMNITY •O so+KW Policy No. _ — 2 7 Company Backflow Irrigation Sewer Cap Construction Pole Sub. DFerti tied copy is hereby futhehed. • Cooking Unit Meter Our,to 100 amps {{Swart fieri c py,`s led with the cit Ildi sg visio^1 �J Bathtubs Sewer Connection Date 1L/ / so Applicant (/W�-(iL,.� EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (Thissection need not be completed if the permit is for one hundred ($100) or - less). Dishwasher Solar Piping Dryers ❑Gas ❑ElectricSub Panel , I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank - FanMotors❑Qi HP ❑1'f.-.8 ' Workers' Compensation Laws California. _ Date Signature m Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:IF,after making this s ddeclaration, you should become subject to the - Inc.Solar 09.15 HP 018.15+ Workers' Compensation provisions of the Labor.Code, you must forthwith Floor Sinks Urinal • Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance 9 of the work for which this permit is issued (Section 3097 Civ. C.) interceptors ' Water Heater Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service 'Switch¢$ • OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the ,Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or - county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permitY Generator 00-5 KW❑5.15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of 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 - 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 enalty of not more than five hundred dollars($500). U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee ' $ 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/herself or through his or her own 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 pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 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 ❑0-100,000 BTU ❑100,000 BTU SUMMARY 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 - Exhaust System ❑ Multiple 0 System Repair/Alteration - BUILDING PERMIT $ • SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT O I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers • • PLUMBING $ ISSUANCE $ HeatingSystem& DuctingIl Registers /_l� j Date Owner �1 9 IL�(17 �i PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above \� 00-100,000 BTU 0100,000BTL �l ELECTRICAL $. GRADING $ information is correct. I agree to comply with all city and county ordinances , and state laws relating to building construction, and hereby authorize repre- MICROFILM $ sentatives of this city to enter•upon the above-mentioned property for PLAN CHECK 50% $ • ingnatuon,IlyrpQses.,/ /. "71.4....4.2._ 12/3/86 MECHANICALSi $ --=�y TOTAL FEE $ �48: 00 Drivers' V✓�rrsSS+# � Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ (7 Drivers' License or SS� CMF 0865-46,rev:10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing&Pressure Test 17. . 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE i1J 7. Footings 58. Electrical Conduit-Undrgrnd. �t1 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains. 64. Plumbing System - Final • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval • 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 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning .qf CSO 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing • 39. Water Service-Final 40. Gas Service-Final y 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap 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 No. Date _ _