HomeMy WebLinkAbout2566 SAN CLEMENTE DR - Building Permits ' 'F 9 CITY OF COSTA MESA ,
4 BUILDING DIVISION
F •',,,,,,�,,,.,,; �. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
b •PERMIT
itbeo•cmaTio`I'. B02-00528
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2566 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:
Address: 135 W SANTA FE AV . - .. - -
Phone: 714-449-7750 "
FULLERTON,IIA-- ' 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: $7,000.00
Permit: $139.25 - - Claim Valuation: $7,000.00
SMIP Res: $0.70 ,
,SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.95
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
2446-46(6/00)
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 i,sued. -•
I have and will maintai ••rke 'corn.;d,:'on in rst ante,as required by(action 3700 of the Labor Code,for the performance of the work for which this permit is issued.
y workers'compens- '.• - .rri: and policy number are: _r I / '7 '7/ Co 7 O
Carrier: (�\ Policy Number: !V,/,
(This section need not be completed i/the permit is valued et one hundred dollars($100)or less.)
❑ I certify t..: in the pe ormance of the -or o hich this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compen'=tion laws• California,pnd:gree •:t if I shoullbecome subject to the workers'compensation provisions of Sect/ion!370/P of the Labppr Code,I shall forthwith
comply wit e.,=•rov •O1�T - z / ^
Applicant Signatu :: " Cry— S. ' Date: t L L/ U
WARNING:FAILURE TO SECURE WORKS MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),INADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
C
S
LICENSED h I """`DECLARATION:
I crean affirmefe th am!icon d under provisi•� sof Ci apter 9(co mencing with Section 7000)of Division 3 of the Business and Profession S Code,and my license Is in full
force and effect.Li \ � Class 4 (7//'1/ � '7I/
Contractor's Signature: ��• •=tom Date: LLi 0 a
L�
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 properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No •
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? f�Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above- cribed property for inspecti I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
ignat Lega�I Owner"--- (s / 2 z /6
Date
Or Authorized Applicant Date
CODE# INSPECTION TYPC DALE INTRIALS CODEY INSPECTION TYPE Oil )NTf11AL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final208 Final Plumbing -.
200 Final Re-Roof re-if _ - b"H7` 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
St o 's
City of Costa Mesa INSULATION CERTIFICATION • Building Safety Division
2566 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 Fiber Glass Batt Brand Name Manville Gold Fiber Glass
Thickness (inches) 34 Thermal Resistance (R Value) 12-11
CEI LING
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 (inchesL 3 Thermal Resistance (R Value) R-11
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
// -!! rl anee----/ �'•,/D May 8, 1987
Signature and Title Date
Red's Insulation 381933
,Q Sub Contractor(Insulation Applicator) License Number
May 8,. 1987
Signature and Title Date
CMF 1106-46
OW
Don Greek
and 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
c4—tAdilTh
SURENDER DEWAN, P.E.
R.C.E. 34559
rtk
cc: Fairview Development, Attn: Mr. Frank Kindstrand
I-of ESS/0404
4O' Ir
c. �F
y N0. 55C �''�
�l!
OF.CA1-1e
2428 N.GRAND AVE., • SUITE L • SANTA ANA,CA 92701 • (714)543.0990
c' CITY OF COSTA MESA
IA92628.1200
P
> p. .
• ii;Z21
ii,a ft DEVELOPMENT SERVICES DEPARTMENT
October 20, 1986
To:
Building Safety Division ' Pacific Bell (2)
Business License Division Police Department - Plrg. & Research
Canmunications Santa Ana Heights Water Canpany
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 Zr. , 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 Ln. , 101-110, 201-210
Carports: San Clemente Dr. , A-I
Santa Barbara In. , 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
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ARCHITECTURE AND PLANNING
\ �`\ MM is.UM rn. LAMM rM.•«.IOM.MM I NM A•M1
/� /.1G% Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. . I
['L •
CITY OF COSTA MESA O(,,ON TRUCTION PER MITB.Lo#3 PE(��fs4IT NO. �j'� TRACT-sNO.S / LOT NO. UNIT N/[� 4! 4014 9/29/86 189048
Prolect4-4ress�-�V+co '^ 4./C4 /- ,w 'tJ_ e...,2 ,,,,e_ 13 /5550 i��p2,154`7 r� BLP ' 3 1
Applicant's Mailing Address 2-671041-Sf/fLLEYdt. easy-4 /yes-A TYPE OF CONSTRUCTION Ir l NEW U ADD ❑ ALTERATION U REPAIR I
S43^/sib ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner's Name FA//e1/LLJ/YAwi4calEtl/� Phone A.P.# 4120_0/2- // Zone k.Nr)
s� fA '/ DESCRIPTION OF WORK/ SE OF BLDG.
Address //76 / „ -ir ieedi/,E 44 917/¢ 1L;- 7- f� S Main Building:7 /_ �^,� .,,,w Accessory Building:
Arch/Eng.(/U4��E,,Ly✓fS1f�• �f License No. 6��/(p,^2� TYPE OF PERMIT GRA�ING FOUNDATION ILxSTRUCTURAL T Gaunt 4) 57/ •!6 C`^•'y'6s+r /l O
Address Q f/ Oa Ccyr.,Q Pe. 44c LWA H/LLS ' ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B �c 5 15r _/_. N
Contractor's Nam f•5c/,e✓lLk 2kJ1 CeeZet �O phone 779S0s7 AL
❑ OTHER A 7�'' I
�i /� // PROJECT DESCRIPTION SQ. FT. /3764 OCCUPANCY /!e/ C R«1ht`C 17/ �p b[dp '], N
Address(mailingl2�/0!"( �.Y�LL.E/C.Q dist /I�S.Q CON ST RUCTION TYPE C /1` .5/*C.O VALUATION$ < r4+ A $ LA{t• [.✓ 9r`j / —s' tr
City License No. YZ'Y"a ZONE GRADING CU.YDS. ACRYGJL'S7� O(�� R
LICENSED CONTRACTOR DECLARATION Ping. Ref.dk�A_�{C'-_ /8I/ Parking Req,/Provided i L� E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ,.1s��- ✓]� / PlanningNOII;S: .,/ ..SJ' •'f'T-/�/'I ,1 yl p�� , 1 N
with section 7000) of Division 3 of th /gpps ness a Professions Code,and CPC.. 3 C / — eta �-•-� - �' a0, -L/./7 IMKL�K V/�1/T M
my license is in full force an• of ect. C �s.O�q 3 HO+LJD FOR SPECIAL REOUr.REG?ENTS S
License Class A ' Y ice a N•
Date Signatur. rA r_ PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
`ereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a certified copy thereof (Section
JO, Lab..{C / �.t p� Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW
Policy No.`�Q�/�99" --9 %Company �/-'A'✓fLf..eS Backflow Ir7igation - Sewer Cap ,0 50+KW
Certified copy Construction Pole Sub.
is hereby furnished-
Cert'fietl cop is filed with the city Building Division. L Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date •-ON F Applicant Qri! G •
- 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 DElectric Sub Panel
I cerify 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 ID 0-1 HP 01%-8
Workers' Compensation Laws of California. .
Date Signature Floor Drains Swimming Pool w/Spa F.A,U. 9-15 HP ❑16.15+
NOTICE:If,after making this declaration,you should become subject to the Inc.IneSolar
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit 5ha11 be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Bo%es Pole Light
I hereby affirm that there is a construction lending agency for the performance9
of the work to which t Is permit_ is I sued (Section 3097Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name ,a 4 .0 ,
Lender's Address/O/7551-41-7-4.42-5 •% L.:4-P119 //War/9,77GP Kitchen Sink - Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash
following reason (Section 7031.5 Business and Professional Cede: 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 tre applicant for such permit _ Laundry Trays Generator 005 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
fivision 3 of the Business and Professions Code) or that he/she is exempt -
-
erefrom and the basis for the alleged exemption. Any violation of Section
131.5 by any applicant for a permit subjects the applicant to a civil _
' enalty of not more than five hundred dollars($500).
6 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee S 3
' compensation, will do the work,and the structure IS not Intended or offeredI
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee $15 Issue Fee $ 3
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 SE- I ES R •U • ENTS: _�
employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I ❑ ZoningApproved By % '- ' '
sale. If, however, the building or improvement is sold within one year of com- Canopy Type!! 0 pP �/ Date
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By / /,vva.L Date e
prove for the purpose of sale). , /l//G,
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By a Dat • h.
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 ❑0100,000 BTU ❑100,000 BTU _ SUMMA V OF FEES
builds or improves thereon, and who contracts IOr Such projects with a con- �
tractorExhaustSystemSystem Repair/Alteration s) license pursuant to the Contractor's License Law). I am aware that ❑ Multiple 0 Rir/ABUILDING PERMIT SM)P $ T4i 2.1
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ ..-PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $
HeatingSystemDucting g PLAN CHECK 25% $ ENERGY P.C. $
. Date Owner & Registers
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,0008 -
information is correct. 1 agree to comply with all city and county ordinances ' ELECTRICAL $ GRADING $
and state laws relating to building co truction,and hereby authorize repro- - MICROFILM $ o
sentatives of this city to ente p• the above- entioned property for PLAN CHECK 50% $ l�la
inspection purposes- - / t^/��/J MECHANICAL $ TOTAL FEE $ ele
Signature / .
-
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 UF ER Grnd. /' p:9 57. APPROVAL TO COVER-GUNITE
7. Footings • C g Px1 58. Electrical Conduit-Undrgrnd.
8. Foundations 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undi-grnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System {0/__/yb �,� 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 Ape-oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERINGI-
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. Root Sheathing 94ou- 74. Overhead Hydro •
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing v4176. Dry Standpipe
28. Lathing & Siding
yi(151
4,j87 04 77. FIXED SYSTEM FINAL •
29. Insulation 3/ 7 Pk 78. FIRE PREV. FINAL
30. Drywall Nailing 7/(p`/8? 09 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat / ',I 9- 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD "/"C��/�n� (90
CE TIFIC TE ISSUED //•
33. Final Electric Notes: (0.
0x be rec.2 c.
34. Final Heating& Air Conditioning / .
35. Final Gas Pipe-Test
36. Hood or Canopy ' (1 /) O�
37. Final Factory Fireplace S/Z4Ve ��
38. Final Plumbing /.
39. Water Service,Final C L
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. FINAL STRUCTURE & BUILDING 4 5 04
48. Special Requirements Completed ((��/r /n M MT .
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 OF COST/A'��ME/$/A CNST R CTION P RMIT PERMIT NO. TRACT NO. LOT NO.
P •
roject ASfaress G_._.J / �"� 7 ' 1 "�
Applicant's Mailing•Address -
a S. , Gm at i - TYPE OF CONSTRUCTION ❑ NEW ❑ ADD U ALTERATION U REPAIR r 5981 10/27/86 ' 572.70. TL
❑' CONVERSION ❑ DEMOLISH ❑ OTHER _ A.P.# • Zone
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG.
Address 24�`'�Mdl Yl __V•12-‘4 k ane /� G 1 S Main Building: Accessory Building:' •
Arch/Eng.Jr�M•Wq. 11LSR.� LicMense No. 1 67� ' 1TVPE OF PERMIT ❑ GRADING El FOUNDATION ID STRUCTURAL T Front • Z0
Address 7 07 ! (•(\L t'e°K Cr• vT hd `� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's NamrG 1 LC..p�r�_-_'l•'z��►• .CI
OTHER C Right N
mit- t \ `_, „,.PROJECT DESCRIPTION SQ. FT. OCCUPANCY
g
Address lmailingl�42r.� �` 1'14Ji �1,I IDd�Y1 •CONSTRUCTION TYPE VALUATION $ K Left G
City License No. _ *a, r gn •- - t ZONE • GRADING CU.YDS. ACRES $ R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
j� Q
affirm that I am licensed ofunder provisions of Charter 9 (commencing Remarks: ! ---. 43 Z .I / /`—+ ' Planning Notes: '
with •
section 7000) of Division 3 of the Business and Professions Code';and' — - M
my license�is in full force .nd effect. T
A !• • 5
Li cerf� ss Ltc—s- o. d al i• -
Date � _ Signature _ t �a •
�i/ . .� PLUMBING FEES
(44 WORKE S'C M•ENSATIO • 'LARA 10 Bar Sink Showers -
t i hereby affirm that I have a certificate of consent to self-insure or a certificate' ELECTRICAL- FEES
Workers' Compensation Insurance, or a certified copy thereof (5ect'on
�� ;, ;� Backflow Preventer • Service Sink
11 )0, Lab,,,,,,,������C//////}�..�r /' //''!� ro • Automatic Washer Transformer D 15-50 KW
1 policy No. ✓+T•T F,IORCI Company`s Backflow Irrigation • 'Sewer Cap ion ConstructPole Sub. 0,50+KW
s Certified pyyy is hereby furnished. _
- Certified copy is filed with the cit- B ?ding Division. , a Bathtubs • Sewer Connection Cooking Unit 17 Meter LYup t0 100 amps �'�CO
Date •- .�APplican• - - _
EXE P ION FROM WORKERS'C• PENSATION •EC R- ION Clarifiers - Solar Collectors l/ Dishwasher Meter Clover 100 amps /!_ - DO
(This section need not be completed if the permit is for one hundred($100) or 4• - t/
• less). I. 1' Dishwasher - Solar Piping• • - I Dryers ❑Gas DElectric � Sub Panel S C{}
I certify that in the performance of the work for which this permit is Issued, Iv /7 -
shall not employ any person in any manner so as to become subject to the: • Drinking Fountains Solar Tank II'' Fan Motors❑0-1 HP 01%-B 2f y eu
Workers' Compensation Laws of California. + - -4 /•
Date Signature !" • Plod,-brains" Swimming Pool w/Spa • /4 F.A.U. •
_,
NOTICE: If,after making this declaration, you should become subject to_the ' Inc,Solar 09-15 HP 016-15+ /6 '0
• Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixturea Microwave `3(/ -�
comply with such provisions or this permit shall be deemed revoked. - act- y
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet O - Device Boxes Pole Light
• I hereby affirm that there is a construction lending agency r the performance - 9
of the work r ic I •'-jt is su:•• ••ct 7-- 309 Civ, C. Interceptors Water Heater
Lender's Nam _�tL�-espc�-����� �• '1000utlets llgRange 5'} LM
Lender's Address •V{ st M-r• ' .e �' weft-Lk n lT' • Kitchen Sink Water-Service Liwt/$G.Switches -
OWNERBUILDERDECL• RATION Sign y�• Ijp�
• I hereby affirm that 1 am exempt from the Contractor's License Law fort Lavatories Auto-Wash - Garbage Disposal CO
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections
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 00-5 KW 05-15 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 - .- - - r
srefrom and the basis for the alleged exemption. Any violation of Section 4
ae.5 by any applicant for a permit subjects the applicant to a civil - _ ,.
•
natty of not more than five hundred dollars($500).
0 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 $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 E ZoningApproved
sale. If, however, the building or improvement is sold within one year of com- O PP By ' Date
Plotkin, the owner se of ale the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
prove for the purpose of sale). �7���r /
IDI, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration Application Issued By Dati ART A16
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 DO-100,000 BTU 0100,000 - 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 ❑ BUILDING PERMIT $ SMIP $
proof of their worker's Compensation insurance should be provided to me. PLAN $ PERMIT
❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers - PLUMBINGN CHECK $ 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 1:10-100,000 BTU 0100,000 BT . �Q GRADING $
information Is corre t- I agree to compl ith all city and county ordinances ELECTRICAL $
and state laws re ). g to building co�• ction, and hereby authorize repre- a
sentatives of t • ity to e'ty the.+above-mentioned property for PLAN CHECK 50% $- i i 0 MICROFILM $
inspection ,Ur•/.'f- AO el, Datel'D ''.2 7-2-re 2
MECHANICAL $ TOTAL FEE $ 5.7- ,
Signature Driver License or SS -%/� ' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
—
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING • POOL& SPA •
APPROVALS Permit# Date Inspector Date Inspector
APPROVALS Permit#
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, 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 $ wr✓T.f� 66. Solar System-Final
. 4.40516. Rough Electric Wiring /,3_nefe - 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 0 Oil
25. Roof Sheathing 74. Overhead Hydro • x
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 '1
30. Drywall Nailing HEALTH DEPT. REQUIREMENT "
•
31. Plaster Brown Coat 79. FINAL INSPECTION •
i
32. Electrical Power Meter-Final
/(D cc 80. FOOD CERTIFICATE ISSUED
33. Final Electric �J Notes: 7-11-k)
34. Final Heating & Air Conditioning
Firs .,a ..SOAd n-. no :4s lad .,.. 74-
35.
35. Final Gas Pipe-Test �t d _I
1-IP-P., OR /r^�.Qa7rcr., i� ,�X7.F�.S, aqo
36. Hood or Canopy
/ . of ce-..cJ„i'9 'son cold's `f#nct5),
37. Final Factory Fireplace � + ) i
7�a hc✓� . w.113/
38.-Final Plumbing i -
39.'Water Service-Final -
,
40. Gas Service-Final .' '
•
,, -
41. Solar Domestic-Final _
42. Backflow Preventer , - l`; • ` ,
4
43. Backflow Irrigation
1 44. Landscape Irrigation System -
45. Sound Attenuation
,• b ..
46. Handicap Regulations - 1 -
47. FINAL STRUCTURE & BUILDING '
48. Special Requirements Completed ..• Z. s, + +• r" r - I,
49. Electric Release to Edison
- `
4 - . .
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 OF COSTA MESA CONSTRUCTION,PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. y
p 1331 ♦/29/87 54013 T
Project Address 2566 San Clemente Dr./Trash Encl.9261 $ 70 $7 a 59 A : U
Applicapt's Mailing Address 2510 N.Rhell Cr. .Costa Mesa,C9 TYPE OF CONSTRUCTION NEW u ADD LIALTERATION U REPAIR
Fairview Management Company ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# 42-0 - 0/2 Zon
Owner's Name 4 Phone 714f863-15J0 DESCRIPTION OF WORK/USE OF BLDG. Trash Enclosure
- I �D�-� y
Address 2400 Main St Trvine. Ca. 92714 rte// s Main Building: • Accessory Building:
Arch/Eng.BnrkP-Tester & ASSOr. License No. C-6925 TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION L`1 STRUCTURAL E Front ,D`t_
o
Address 23025 Mill Creek Dr. ,Laguna Hills,Ca. 92653 CI TENANT ❑ ELECTRICAL Cl PLUMBING MECHANICAL • s Rear .F/[e' A �^Ls� -�.-, N
Contractor's NampFairview Development Phone X14/979 SOo7
2510 N.Shelley Cr- COm do PROJECT DESCRIPTION SQ. FT. OCCUPANCY �' C Right 7 ' j N
Address erase No. ,Costa Mesa,Ca.92625 f �p K - -" - / - G
CONSTRUCTION TYPE I VALUATION$ f7 OO' $ Left -'j
City License 39582 ZONE GRADING CU.YDS. ACRES Ping. Ret. # Parking Req.lProvided E
LICENSED CONTRACTOR DECLARATION '
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 2 Qt Planning Notes: ' aste.4 &y Q p - Q
with section 7000) of Division 3 of the Business and Professions Code, and J` �'S �- n`•' Ls�+-is-'c ' i•`r� �SL�12'� M
my license is in full force and effect. T
Licens CI s B ' Li ens- ' ••11 111 - S
Date -- Signatur- 417:.�.i PLUMBING ' FEES
—er
WORKERS' CO PENSATION DEC rr RATION Bar Sink Showers r ELECTRICAL
pI hereby affirm that I have a certificate of consent to self-insure or a certificate _ FEES
if workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink /
C,,,, 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW ,
\\ Policy NoUB=83OF944-9-R6 CompansThe Travel era ins .CO. Backflow Irrigation Sewer Cap _ 0 50+KW - •
__
\ Construction Pole Sub. i
I- Certified copy is hereby furnished.
`\\ M. Certified copy is filed with the city B ildi g Divi 'on Bathtubs Sewer Connection Cooking Unit Meter lap t0 100 amps
'� Date)- '-� APPlica - - '+
•• •••••. EXEMPTION FRO WORKERS'C MP SATION DECLARATI Clarifiers Solar Collectors Dishwasher Meter Dover 100 a s 11
(This section need not be completed if the permit is for One hundred($100) or
less). Dishwasher, , Soi r Piping - Dryers ❑Gas ❑Electric Sub Panel •
I certify that In the.performance of the work for which this permit is issued,II
shall'not employ any person in any manner so as to become subject to the Drinking Fountains ' Solar Tan. FanMotors 0-1 HP 01•A-8
Workers' Compensation Laws of California. _
Date signature Floor-Drains - ' • I Swi - ing Pool w/Spa - - F.A.U. Inc- pier 0915 HP ❑ie-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 - inalFixtures ierowave
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 lending agency for the performance Pole Light
of the work fp' which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets
Lender's Name urPFIt. BinPrl ran First Savings Rank _ Range
__Lender's Address102/5.slater' F]S1S'._,F_O3zn.tain_Val l P �d _ Kitchen Sink Water Service Switches Sieh
OWNER BUJLDER DECLARATION 7L/LG• - Disposal
I hereby affirm that I am exempt from the Contractor's License Law-for the Lavatories Auto-Wash Garbage
following reason (Section 7031.5 Business and Professional Code: Any city-or P Standing Sections _
county which requires a permit to construct,alter,improve,demolish or repair LaundryTrays
any structure, prior to its Issuance, also requires the applicant for such permit y Generator 9-5 KW❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of . '
Roof Dr ns - - /
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 - - _ -. --'herefrom and the basis for the alleged exemption. Any violation of Section
'031.5 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 S.3 —
compensation, will do.the work, and the structure is not Intended or offered --
• for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee $15 Issue Fee $ 3
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 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By _`" Date/-Z/ -
oletlon, the owner will have the burden Of proving he/she did not build or Im- Duct- Under Ground , q
.prove for the purpose of sale). Building Approved By �•SG/I/ Date /-n‘..2-9-7
0 I, as owner-of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By iner�/� Oat'
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 BT 100,000 BTU SUMMARY •OF FEE•`—
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$ stem ❑ Multiple❑ Syste . BUILDING PERMIT $ -z •'.S) SMIP •' •$ • 5°
f ypair/Alteration
proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ ?'t' `/3 PERMIT-
•
❑,I am exempt under Section • B.& P.C.for this reason Firepl/Fact.Blt. ICBG# ire 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 00-100,000 BTU 0 L 9,000 BTL - - 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-t - MICROFILM §
sentatives of this city to enter upon the above-mentioned property for PLAN CHECK 50% $
Inspection our-Os-.
Signatur -- .7/.e - .
.
CMF 0865.46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
POOL& SPA
CONSTRUCTION AND PLANNING - pate Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit
1. Temporary Electrical Service or Pole , 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
•
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. ,,,�,,,, JJJJ�}y��,�//// 57. APPROVAL TO COVER-GUNITE
7. Footings 2/ 58. Electrical Conduit-Undrgrnd. •
•
8. Foundation _t ,IJ 59. Gas Pipe, O 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 OGas ❑Oil
23. Gas Pipe-Rough&Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation • 78. FIRE PREY. 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 Domestic-Final
42. Backflow Preventer •
43. Backflow Irrigation •
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING b`3,k? os
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date •
i
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
'2 4,,/
CITY OSTA MESA CONS UCTI ON PERMIT PE R MI O. —f-^ TRACT NO: LOT NO. UNIT NO. / •
Project, •rens 5(eCIL _ ( . 1 _u 3r (` � ` (, 3 % 6629 11/04/86 33425 TL
Applicant's Mailing Address131-11Ot C•TJ&,I r ',- - S.Fag, TYPE OF CONSTRUCTION /ZI-NEW ❑ ADD U ALTERATION H REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# ' I I Zone
Owner's Name cC zit ^teiJ . a • Phone DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building:
Address - SID L 'S �� It w � I
Arch/Eng. • License No. TYPE OF PERMIT LI GRADING LI FOUNDATION ❑ STRUCTURAL T Front o
Address _ ❑ TENANT ❑ ELECTRICAL lAI PLUMBING ❑ MECHANICAL B Rear-... ."_ ��� • 0 OTHER A g l'iZ Contractor's Nam C' L-!iac� Phone -t3 C Ri ht Address(mailing)13(aOS C .. .n r-, •, , S. , ..t MAL ' �, PROJECT DESCRIPTION 50. FT. OCCUPANCYKLeft�y7 CONSTRUCTION TYPE VALUATION$ $City License No. 3R ig/ ZONE GRADING CU.YDS. ACRES -LICENSED CONTRACTOR DECLARATIONPing. Ref.# Parking Req./ProvidedI hereby affirm that am Ilcengetl under provisions of Charter 9 (commencing Remarks:"I L, p Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code, and Um's CJ �(SSw 1Lilt,� 3 �V��-my license is in ful��o--rCCzzee nd effect. 1'11 MM G� ,V� l3�Lic¢nz� las( License .I"td73 � 1E. C
Date d���tOJddO�����(�7��(7 Signature PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a Certificate '
.f Workers' Compensation Insurance, or a ce ified copy thereof (Sectio Backflow Preventer 11.. Service Sink 3 Rt C[ 1/sn fiICALf 0 15-50 KW
B00, Lab. z //11pp �••'' 11l[[ Automatic Washer CI r J fa i 2m¢/� fu
g+No. rl-.-1P Dei-05-1- Company lit.. +alt Backflow Irrigation Sewer Cap Construction Pole Sub. r fault+ KW
Certified copy is hereby furnished�sa��,
t`OO e e co filed with the c`7/�'i 'r• Derision a Bathtubs Sewer Connection I+8 — Cooking Unit Meter ❑up to 100 amps
1 Date I APPlican a�• �(�`�� •
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher - Meter :lover 100 amps
(This section need not be completed if the permit is for one hundred($100)or
less). ' ❑
Dishwasher Solar Piping - • 32. — Dryers Gas DElectric Sub Panel
I 4 certify that in the performance of the work for which this permit is issued I s.- - -
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP 01%.8
Workers' Compensation Laws of California. —�
Date Signature Floor Drains • Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16.15+
`
. NOTICE:If,after making this declaration,you should become subject to the -
•
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. -s s Microwave
CONSTRUCTION- LENDING AGENCY ' Gas Service Outletssp a(} 4
Water Closet I3 — Device Boxes ,
a Light =
Pole I hereby affirm that there is a construction lending agency for the performance ,
of the work for which thit permit is issued (Section 3097 Civ. C.) -'
• Lender's Name Interceptors �(R Water Heater 32. — Outlets 1 Range •
Lender's Address -- - - - - Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION ,'Q
I hereby affirm that I am exempt from the Contiactor'z License Law for the Lavatories Auto-Wash "!YJ — Garbage Disposal , Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or cello
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays •
any structure, prior to its Issuance, also requires the applicant for such permit Generator ❑0-5 KW_❑$-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 '
'031.5 by any applicant for a permit subjects the applicant to a civil
denalty of not more than five hundred dollars($500). '
th
LJ I, as owner of' e 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 properly who builds or Improves • DEVELOPMENT SERVICES REQUIREMENTS:
i thereon, and who does such work himself/herself or through his or her own Boiler Hood or T e I 0
employees, provided that such improvements are not intended or offered foryp Zoning Approved By Date
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground ,Building Approved By Data
prove for the purpose of sale). ,
❑ 5, 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 00-100,000 BTU 0100,000 BTU • SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a tractor(s) con-
license pursuant to the Contractor's License Law). I am aware that' Exhaust System 0 Multiple 0 System Repair/Alteration . BUILDING PERMIT $ SMIP $
proof of
their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ .7y�.pto ' PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ RR Q• '1/''�ZIkSSI ANCE $ -Sea+
Date Owner - Heating System& Ducting Registers - - pr ENERGY P.C. $
PLAN CHECK 25% $
I hereby certify that l have read this application and state that the above 0o-100,000 BTU ❑100,000BTL -
ELECTRICAL $ GRADING $
Information is correct. 1 agree to comply with all city and county Ordinances
and state laws relating to building construction,and hereby authorize repre-
sentative . .is city to ent-r upon the above-mentioned property for
inspect"•n pur.•.•s t. (4 MECHANICAL $ 334.25
Signatur��litq►! . r AD Date(L/ AriV' .. - TOTAL FEE $
Drivers' License or SS# Reinspection Fee $15 Issue Fee -$ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Plnk -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. ftc 4(. Leo 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-Undrgrod:
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe'-Undrgrnd. l.EO 60. Backwash Lirie�t P-Trap,l`JfUndrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK C.
11. Property Sewer Line & House Connection 62. Backwash & Raptor-Final
12. Sewer Cap .r?
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- a•
28. Lathing& Siding •
77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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 247 a • -
39. Water Service-Final jzi�O
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. 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 _ _ 4
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA// // CONST TION ER,MAIT I� PE/R,MMIIT NO. TRACT NO. LOT NO. UoNIIT/NO. 3 y 33 12/22/86•
Project Address . .6-04 t c7a..o 2 2 + LA. Ie)e� /� t7 z�� ^"'"{ �` 183.00 TL
Applicants Mailing'Address 231 W. BLUERIDGE AVE'?'VC, TYPE OF CONSTRUCTION EXEw LI ADD U ALTERATION U REPAIR r ,' Gnaro '
Owner's Name FAIRVIEW DEV . Co. Phone ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.# • Zone +
DESCRIPTION OF WORK/USE OF BLDG. RESIDENTIAL
Address 2510 N. SHELLEY CIRCLE S Main Building: Accessory Building: • $ �ppQ
Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATIONII,�I��'L I STRUCTURAL T Front RECEIVED DEC é V Y74V zO
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING LAIXAAECHANICAL B Rear N
Contractor's Name SANTIAGO A/C Phone 998-160C ID OTHER
PROJECT•DESCRIP710N SQ. FT. OCCUPANCY C Right I - N
Address(mailing) 2s3LW- RI,II l''.R Tnri F'', AVE. G
C ON ST RUCTION TYPE VALUATION$ S Left
City License No. 015264 ZONE GRADING CU.YDS. ACRES! R
LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided E
Q
I hereby affirm that I am licensedision3 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 RECEIVED DEC 1 9
my license is In IWhtprcp,• d effect. 2 9496 lib T
s•
De12/3 Lir nsef ,
Date PLUMBING FEES •
WORKERS'COMPS LARATION Bar Sink • Showers - .
'hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a certified copy thereof (Section —
Backflow Preventer Service Sink
100, Lab. Automatic Washer Transformer 0 15-50 KW
`K�N878-5227 IND. INDEMNITY ❑ 50+KW' •
Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub.
Es;ertified copy is hereby furnished.
er ftlgq T ss 77sled with the city�ulld ing Ivisiyn. ... y� Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps
Date 1L/J��0 ' Applicant in. I�IMI�.v—=
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors Dishwasher Meter Dover 100 amps •
(This section need not be completed if the permit is for ono hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel '
I certify that in the performance of the work for which this permit is issued, I -
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank __ • Fan Motors ❑0-1 HP ❑1'h-8
Workers' Compensation Laws of California. - —_
Date Signature Floor Drains Swimming Pool w/Spa' ' ' F.A.U. .
Inc.Solar ❑9-15 HP ❑16-15+
Workers' Compensation
makingnrov dions of
h, you should becomesubject to the pys' Com such ipr provisions the tr Code, you et forthwith h FIOpr Sinks Urinal Fixtures Microwave
. comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY . Gas Service Outlets , Water Closet • Device Boxes Pole Light
I hereby affIrm'that there is a construction lending agency for the performanceg
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 Switches ..Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-WashGarbage Disposal Standing ,
following reason (Section 7031.5 Business and Professional Code: Any city or Sections
, 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 ofRoof Drains •
the Contractor's License Law(Chapter 9(commencing with Section 7000) of .
flivision 3 of the Business and Professions Code) or that he/she is exempt- • —
erefrom and the basis for the alleged exemption. Any violation of Section ,
131.5 by any applicant for a permit subjects the applicant to a civil ,
Lienalty of not more than five hundred dollars($500). •
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 $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 iHood 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 nate
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 of sale).
U I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Data
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 eon-
tractor(s)'license pursuant to.the Contractor's License Law). I am aware that Exhaust System 1:1 Multiple El System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT,
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBINGN CHECK
$ RMIT,ISSUANCE $
Date Owner _ Heating System& Ducting !EL Registers 84 OD PLAN CHECK 25% $ ENERGY P.C. $ •
I hereby 'certify that I have read this application and state that the above \ ❑0.100,000 BTU ❑100,000 BTL ./�J GRADING $
information is correct. I agree to comply with all city and county ordinances' IPt ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter upgn the above-mentioned property for
inspection pyrposes. �-- 4^ ' 12/3/B6 MECHANICAL
Signature I/!/1 Date $ JYEa TOTAL FEE $ __221A9__221A9/L{f
Drivers' License or SS# • . Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% .$ 36.
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 c
3. Electrical Conduit Utility-Undrgrnd. 54. Forms rc. �1
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure.Test. t,_•
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-Gt(NITEr
7. Footings 58. Electrical Conduit-Undrgrnd
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test!
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, Elvndrgrnd.
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 CI 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 Vtilge (-fib
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. 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
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT O. TRACT NO. LOT NO. UNIT N
Project Address 7565 San Clemente Ds_ �.- =E OF CONSTRUCTION 9- �� ''ii - 0788 I /23/67 123p00 TL
.Applicant's MailinY.Address . S-Rf1 F' 11nnter-Ave Anaheim TYPE OF CONSTRUCTION L,q NEW. ADD 111 ALTERATION U REPAIR
Owner's Name Phone •
ID-CONVERSION ❑ DEMOLISH ❑ OTHER q,p-# _ I Zone .
F312-V-i—aw Manageffle 1C DESCRIPTION OF WORK/USE OF BLDG. HOn S1nb'
Address !! -- s S Main Building: Accessory Building:
Arch/Eng. —Burke Lester & Accoc License No. TYPE OF PERMIT El GRADING ❑ FOUNDATION�I ❑ STRUCTURAL E Front • . p
Address ❑ TENANT/u ELECTRICAL .0 PLUMBING y(a MECHANICAL B Rear N
Contractor's NamePhone 07n 9-571L ❑ 'OTHER
Micsen Sheet Metal C Right N
PROJECT DESCRIPTION $O. FT. - OCCUPANCY
Address(mailing) 5380 E. Hunter Ave, Anaheim, CA 9280' _ K Left -' ' ' - G
CON ST RUCTION TYPE VALUATION $
City License No. 0264-6-7 ZONE GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided - E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remark pas ✓] l� Planning Notes: - O
with section 7000) of Division 3 of the Business and Professions Code, and -Jl 7 • M
�
my license is in full force and effect.
/' . T
License Class C20 & License NO/ S
\ Date. 1 23 87-- Signature) / ��/ PLUMBING FEES
WORKERS'COMPENSATION DE LARATION Bar Sink Showers ELECTRICAL FEES
r hereby affirm that I have a certificate of consent to self-insure or a Certificate - '
f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - ---
.1800, Lab. C.)
Automatic Washer Transformer �❑ 15.50 KW
N Policy No. 470R93 Company XXXXX State Fund Backflow Irrigation Sewer Cap Inil Construction Pole Sub. • ,❑ 50+KW
Certified copy is hereby th the etl- - `
I Certified copy Is filed with the city ul g Division. Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps
Date_)=23-R-7--.KERS'antry.�gJWSATIONLanIXA /
EXEMPTION FROM WORKERS'C if the NSATION 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 to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 011S-8
Workers' Compensation Laws of California. -
Date _Signature Floor Drains Swimming Pool w/Spa F.A.U.
Inc.Solar 09-15 HP 016-15+
'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 '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 this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets Range
Lender's Name Croat Atnprjran cavingc 9
Lender's Address 'LIECC A' or Aye, FOtTRta-tn-- ley-e-y— Kitchen Sink Water Service • Switches Sign
OWNER BUILDERa TI
-
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or s 9 P ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0.5 KW ❑5-15 KW Trash Com ti or
any structure, prior to its issuance, also requires the applicant for such permit 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
herefrom and the basis for the alleged exemption. Any violation of Section .
.031.5 by any applicant for a permit subjects the applicant to a civil
___-
malty of not more than five hundred dollars($500).
U t, as owner of the property or my employees with,wages as their sole ReinspectionFee I $15 , Issue Fee $ 3
•
compensation, will do the work, and the structure is not intended or offered Reinspection Fee $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 Boiler Type I 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements aro not intended or offered forHoodor yp Zoning Approved By Date
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 -
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 of sale). -
❑ I, as owner of theiproperty, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System • Application Issued By al) 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 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon, and who contracts for such projects with a con- -
tractor(s) license pursuarjt'to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUI LDING PERMIT $ SMIP $
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. ICBO# Fire Dampers PLUMBING $ PERMIT
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 0o-100,000 BTU 0100,000BTL .0 4k /Z ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances f11Y i Ynjlm-gingla Aunt
and state laws relating to building construction,and hereby authorize repro- // �� MICROFILM $
sentatives of chit city to enter upon t e above-mentioned property for • /� Kitchen hood PLAN CHECK 50% $
inspection pyre • ( Yy�G, MECHANICAL $ ' TOTAL FEE $ Pig,(v1--/
Signature Date 1 23 87
Drivers' License or SS# Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ o2Sco
.
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor
CONSTRUCTION AND PLANNING POC 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, O 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'i'Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
1?.'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.tucts, 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 O Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 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 .51124e•7 0
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. 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 •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
IaEq`"��T p"^ TRACT NO. LOT NO. UNIT NO2 _ '
CITY OF COSTA MESA CONSTRUCTION PERMIT . .M ato9/H� . . _
Project Address __ _ -.._. _ - ! �0/' ,Ll ALTERATION LI REPAIR ' _
Applicant,'s Mailing Address TYPE OF CONSTRUCTION NEW U ADD 0787 I/Pa/A ^•^ T
5380 E. AUD LCL AVE, ADdheluf, CA CI CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name - .e Phone - DESCRIPTION OF WORK/USE OF BLDG. —1.104.1.8144-g
Address - - S Main Building: Accessory Building:
1_vine, CA 92714 E • - Z
Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front • - o
Burke-Lester & ASSOC" ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING EMECHANICAL B N
Address A Rear I
❑,OTHER
Contractor's Name *^+ ���� e1.esr nrt �r a'I phone 970-5734 C Right - N
Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY .
5380 B. HuilterAvF,lf Anaheim, CA CONSTRUCTION TYPE VALUATION$ S Left G
City License Na _3. da( 4c, / ZONE GRADING CU.YDS. ACRES E
LICENSED CONTRACTOR DECLARATION �a � tt _ Ping. Ref.# Parking Req./Provided -
I hereby affirm that I am licensed under provisions of charter 9 (commencing' Remarks`. 1J y1 5 ,Sy(-1 Planning Notes: -- M
with section 7000) of Division 3 of the Business and Professions Code,and ���LLL JJJ�C sXX 7r -
my license is in full force and effect. T
License class I • / License No 374-693 S
IN Date 1 23 87 Signatur . -a — PLUMBING FEES
WORKERS'COMPENSATION .•r CLARATION Bar Sink Showers
lereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
l Workers' Compensation Insurance, or a certified copy-thereof (Section
Backflow Preventer Service Sink
\ 3800, Lab. C.) l
Automatic Washer Transformer 0 15-50 KW
Policy No. 470893 Company State Fund Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
N Certified copy is hereby furnished.
Certified copy is filed with the city ui g Division. Bathtubs SewerConnectionCooking Unit Meter ❑up to 100 amps
Da e 1-23-87 KERS'e�A-g".-'D
EXEMPTION FROM WORKERS' PENSATION DE L RATION 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 to te Drinking Fountains Solar Tank - Fan Motors 00.1 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+
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
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 which this permit is issued (Section 3097' Civ. C.) Interceptors Water Heater Outlets '
Range
Lender's 'Name Great American Savings
Lender's Address Kitchen Sink ' Water Service
OWNER BUILDER DECLARATION 1(1 1755 Sl toT' Fountain 11�+y Switches Sign
I hereby affirm that I am exempt from tine Contractor's License Law for the tavu tOfies Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal :Standing Sections s
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
livision 3 of the Business and Professions Code) or that he/She is exempt '
,ierefrom and the basis for the alleged exemption. Any violation of Section . •
/031.5 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 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 Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for yp Zoning Approved By Date
sale. If, however,the building or improvement Is sold within one year of com- Canopy Type II 0
pletion, the owner will have the burden of proving he/she did not build or lm- Duct- Under Ground Building Approved By Date
trove for the purpose of sale).
I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 62tDat
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 eon-
tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. I PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# 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 00.100,000 BTU 0100,0008T //((// GRADING $
information is correct. I agree to comply with all city and county ordinances Bathroom-cingle dUCC Q'T -r ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ j,s� MICROFILM $
sentatives of thi- city to enter pon t above-mentioned property for kitchen hood
inspection es. /� Kitchen
1z^3-87 MECHANICAL $ •r TOTAL FEE • $ 11/3. 00
Signat urpuLa1�J'X(f� Date •. CC)
^^,,,, •
Drivers' License or SS : •
Reinspection Fee I $15 Issue Fee $ 3 LV PLAN CHECK 25% $ �w.l�
CMF 0865-46,rev.10/84 white - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
•
CONSTRUCTION AND PLANNINGPO :SPA
APPROVALS Permit#_. Dai 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. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating a-c- '7 £40 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 g/m/)lZ Or
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. 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