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2569 SAN CLEMENTE DR - Building Permits
• • tar)M 9 CITY OF COSTA MESA w ," BUILDING DIVISION 4,.,.:. 4, DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER 1. 1 V. rite mit PERMIT + y. 802-00516 grow.(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2569 SAN CLEMENTE DR Status: ISSUED Suite: 11 Applied: 04/17/2002 • Vicinity: BUILDING 11 Issued: 04/18/2002 Parcel Number: 42005103 Zoning: Applicant: POWDERLY, PAUL ISSUED BY: Address: 135 W SANTA FE AVE 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 20 YR COMP SHINGLES.INSTALL 30 YR COMP SHINGLES BY GAF.7500 SF. 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)7545626 2446-48(WOO) =small= RKERS'COMPENSATION DECLARATION: I areby affirm under penalty of perjury one of the following declarations: I have and 1Yill 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. 71 have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the erformance of the work for which this P permit is issued. I My workers'compensation Insurance carder and polo number are: Carrier: d77Inrraf V X11 Policy Number: I j - %/y //7 7-ry to";-- (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify th in the pe •• ance of the rk for whi this permit is issued.I shall not employ any person in any manner so as to become subject to the workers' compensati•• laws of C:ifomia,a agr that i should beme subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the-e pr. ' ions. I f_ApPlcanL.Signatur s. €--•-t /\ Data: 1 `y - (--"C— 07—_WARNING:FAILURE TO SECURE WORKERS' ENSATION COVERAGE IS UN -AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed •der• • isionha•ter 9(commencing with Section 7000)of Division 3 of the Businessrpfessions Code,and my license Is in full :force•and.effect Licr, .� U {plass.] `-7 ractors.Signature:, t_ _ � T [Dater Lt —(c5— C.)22________ C 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). Lenders 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(5500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 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,Ad 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ......... ..................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes u No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 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 Abed property for inspection es.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. (l% Si lure eget Owner(s) s._._._..._ 4 _`� r nateh cAs, -Authorize Applicant) LDala_ NODE I INSPECTIONTYPE PAIS ItIMAL5 PDF I INSPECTION TYPE MI !Malo 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final r 208 Final Plumbing 200 Final Re-Roof 7 l5 02 Ces. ,r G 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 -8 r . itf 0CALIFORNIA 926281200 P. 4 q CITY UI' COSTA MESA JI ik DEVELOPMENT SERVICES DEPARTMENT %mic --,4) October 20, 1986 Tb: Building Safety Division Pacific Bell (2) Business License Division Police Department - Ping. & Research Camnunications 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 Cleni:nte Dr. , 101-108, 201-208 420-212-10 2566 San Clenente Dr. , 101-108, 201-208 2569 San Clenente Dr. , 101-108, 201-208 2575 San Clenente Dr. , 101-108, 201-208 2579 San Clenente Dr. , 101-108, 201-208 2551 Santa Barbara In. , 101-110, 201-210 2556 Santa Barbara In. , 101-110, 201-210 Carports: San Clemente Dr. , A-I Santa Barbara In. , A-D Bar your convenience ue 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, Ate, 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 • X 1 x vr-rekle . , . 1 a,c�vwr c.:, -. - M ram iii a•• --' u \ = i e] ' a i ' 0. ' v l'© 1I;-+_ Il ' A oh •fL{/a,,ay�- ro55 4U—sir;p . 1 ; 1 p ,•• , .. t , .�y�'1.4. - r`A'!r i' I ' N. f .- , fie'• J WOW ISM 1,3 il ' Z " vt‘gi if- • i_ —_ it illiV�ra � i i t6 6 '• � It _ r ► t. t ,trao �, -snip -at- - p� W A . sit N� iii �f ERRIM . . :000_________ ' 2 FAOI • • HARBOR VILLAGE aN V@W DEVELOPMENT COMPANY...•r..wu w..4 swam Ir 1II BURKE• LESTER d& ASSOCIATES /' ARCS tar sE AND PLANNING \iN p\ttll.inn. \IaM.A\t,tY•ONu\eau 11141 110.•MN - ELLS Acctiess . TYPCAL— -- -- _" , • y QB5Go5.tJTt 6.vReArc W .311 A� .. �U I� .iro/yL •. ..S io' 107 sA .`1T�I`,YM,C- 06 ' •IO I 102 . i �.� tea.- i�� IOPi 'i�l'�7 F —� • •� Vit` • • e ' • y • yP � ; S . .• �a , IeIj - I / HARBOR •* ' VILLAGE ' • VI M among. Ian mu,iYIWY II III 7 FAIRVIEW�DE�ELoL1Ey _MVANY . , / � C71571N6: I ^\` IL BURKE• LESTER & ASSOCIATES \ \\ ARCHITECTURE AND PLANNING \\ ` \ ans•Y W4 gam 1 "La U4SS YY Imo Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. P MIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA�MEtSA�j CONSTRUCTION PERMIT 3 7p9� - Project Address 4++107 S/„V ( ,4 ant5uTP. ! CI REPAIR 1'�D• ,C0X 967 s7g gTTR/ TYPE OF CONSTRUCTION CI NEW LI ADD ALTERATION Applicant's Mailing Address ❑ CONVERSION El DEMOLISH ❑ OTHER Owner's Name A".•67/.6///6612 /W/Ale17 • Phone S _ZS 27 A.P.# Zone DESCR PTN OF ORK/USE OF BLDG. Address 45/00 z)74//f/sr. 2/eUiiela IOS er ` c-e ✓ A .¢ S Main Building: Accessory Building: Arch/Eng. . License No. - ' - v TYPE OF PERMIT I. GRADING . FOUNDATION I♦ STRUCTURAL T Front ZO Address El TENANT ❑ ELECTRICAL RPLUMBING El MECHANICAL • B Rear N Contractor's Name AA1/JLf /Spd/ci QGPJ.phone ZaL-72/e ❑ OTHER A 1 Address(mailing) ,Q.is-it ��) PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N 9�7 Sr/QA/7`�xC/ -/ K G CONSTRUCTION TYPE'AJ VALUATION$ s Left City License No. O y 1Z`i O 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: • Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code,and M my license is in full force and effect. �A _ /3.6.�. T License Class - e-.�l License No. S NDate 29-29 Signature i/A�/� t� PLUMBING FEES W WORKERS'COMPENSATION DECLARATION o 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 ..d00, Lab. C.) Backflow Preventer Service Sink ' Automatic Washer Transformer 0 15.50 KW Policy No. 073,2 Y/a 3 - P7 Company S 7,97E /-ozi Backflow Irrigation Sewer Cap0 50+ KW a Construction Pole Sub.Certified copy Is hereby furnished. . % Certified copy,is 9,9.99,9 with the city ton.Division. // Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps Date •-4 -2 `7- !^7 Applicant /C.�[�Ge�!�L./� Lemli EXEMPTION FROM WORKERS'COMPENSATION DECLARATION J' Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred ($10 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 Di 4-8 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 09.15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. ALight ave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet I hereby affirm that there is a construction lending agency for the performance / 2 00 Device Boxes of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Healer OutletsLender's Name e 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-Wash Garbage Disposal 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 ❑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 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). I, as owner of the property or my employees with wages as their sole Reinspection Fee $15I Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Foe $ 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 ❑ ZoningApproved sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 pp roveBy Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By �'/ Date o I, for the purpose of sale). ��/S //� —� I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By a L v i_ Date s , 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 ❑ •000 BTU ❑100.000 BTU SUMMARY a F F' 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 thatExhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT S SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ ❑ I am exempt under Section B.8 P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLAN CHECK $ PERMIT PLUMBING $ sC 00 ISSUANCE $ Date Owner Heating System&Ductin Registers - PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100.000 BTU ❑10 •000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relati to building construction,and hereby authorize repre- sentatives of this y to enter upon the above-mentioned property for PLAN CHECK 50% $ Inspection purpys s. � 9�9 - MECHANICAL $ TOTAL FEE $ '� Signature /l i rut n o2�Date / I Drivers' License or SS# - Reinspection Fee 1 $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant: Pink -Accounting; Goldenrod - Assessor ...LLL 01 CD02V454-0029454 TOT .5.ao - t1aTGe O"1:n0Jon ..,.. . ........ 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-Uridrgrnd. 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, ❑ Undrgrnd.,Test 9. Water Pipe:Undrgrnd. , _ 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System / St 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 OH � 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 I - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1• i' 33. Final Electric Notes: t- 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test SA/d'% Lg. 36. Hood or Canopy 37. Final Factory Fireplace - • 38. Final Plumbing s/y/e( Ler? 39. Water Service-Einal_ . - _ • 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 • Nb Date P. `/(; _� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • PERMIT NO. TRACT NO. LOT NO. NIT NO, 1847683 TL CITY O.. COSTA MESA CONSTRUCTION PERMIy ^-r401 5' 9/29/86 eProjPechl�dd.:ss : s G 9 59� C«./t"lv'r 1�.�(i{o 4-� Rj Z J 5 3 /? 5.911 rr LI �G�li ¢ ' • '�� ../ TYPE OF CONSTRUCTION KNEW u ADD U ALTERATION REPAIR rAp�S, ,ant's Mailing Address �.�l�G/ /ti, Sy�Le,FJ�!efrL //Gj !-� Owner's Name FA/{21IIFLO / /11/30i/`/Fdrr4hone,l is-04 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#4�p- 0,C]—`/ Zonepag_iii/� /!,� �A/N DESC'IPTION OF WOR /USE OF BUIL. ri Address 57 zei✓/d// A4 y,?7////4- _ ��! S Main Building: Accessory Building: Arch/Eng. ea.eLF 4F1ff.�' License No. 0'G�< TYPE OF PERMIT II GRADING h FOUNDATION �( STRUCTURAL T ' N 45'" v. Z O Address -fl)a<///AL e'e,+1,,,,e P . !AAq-/L.rd /Li 5 ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL• B r 5 j O i _(_ N Contractor's Name4atel/Vii/1Y2Y✓P�a�/.04.fv` Phone 9/9-fd r 7 ❑ OTHER A t 69i ADi , PROJECT DESCRIPTION SQ. FT./',17' OCCUPANCY e—I £ (S L AD • - A G 64414-544c !) pSjy /J C O N ST RUCTION TYPE zeeAnzte iron-et VALUATION$✓�fI e S L'�+' /✓ /rf City License No. J l Ste! ZONE 'GRADING CU.YDS. -ACR$ �� R Ping. Ref.# • • _ Parking Req./Provided 2x 2� E LICENSED CONTRACTOR DECLARATION _ rrr--��� �/ < 0 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: !/G ti 3�� — Y! _ L___ Planning Notes'. eh^AQ �A / VIL MA/4e;� M with section 7000) of Division 3 of the Business and Professions Code, and - r 00 ��00r" o-"`� my license is in full fort ntl effectT License Class A - CO• Li.enie No S HOLD FOR SPECIAL REQUIREMENTS Date v Signatu • Agar ._ . ms. PLUMBING .FEES 7R KERS' COMPENSATION DEC LA RATIO ' Bar Sink , Showers - ELECTRICAL FEES ereby affirm that I have a certificate of consent to self-insure or a certificate - • ..r Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink Automatic Washer Transformer 0 15-50 KW 3800, Lab. C.) e� O/� �� C'/ / - Policy No.Cid SU 4914-9-66 Company i '.4'e a• '3 Backf low Irrigation Sewer Cap0 50+KW 8 Certified copy is hereby furnished. Construction POI¢$ub. — Certifie copy is filed with the city Building ivision. Bathtubs Sewer Connection CookingUnit 'Meter // ✓p`� Q ❑up to 100 amps Date_ 'FR KERSAppl'COMPEnt NSATION E✓� - 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 to the Drinking Fountains Solar Tank FanMotors❑0-1 HP ❑1%-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 09-15 HP 016-15+ 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 Pole Light I hereby affirm that there Is a construction tending agency for the performance 9 of the work for which this permit is issued (Section 3097 Cly C.) Interceptors Water Heater Lender's Name �leFdr .9.'7fr/ldwlL/er 6d✓MI/c Ud4/y _ Outlets Range'• . Lender's Address/D/J5--�ilAree Fbba/rA/al ALZC/ r1470g Kitchen Sink .-Wale?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 Code: Any city or • Garbage Disposal Standing Sections • county which requires a permit to construct,alter,Improve,demolish or repair P-Trap - Lalindry Trays any structure, prior to its issuance, also requires the applicant for such permit 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 - Pe Contractor's License Law(Chapter 9(commencing with Section 7000)of - ivision 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 . /031.5 by any applicant for a permit subjects the applicant to a civil - _ penalty of not more than five hundred dollars ($500). ' UI, 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 1 _ for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES Reinspection Fee $15 Issue Fee $ 3 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(RJE/tQ�UIREMENTS: // Q employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 ZoningApproved Bynl "� q //� Date ,,/Jrr� V sale. if, however,wn the will building improvement opro i sold within one year of com- Canopy Type II ❑ Iipp /r`�w /// plebe the owner se of have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By YU /L1J GL{. Data 6(1 prove for we purpose theoe). /G/// s ��, ❑ I, as owner tr the property, Se 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 001100,000 BTU 0100;000 BTU builds or improves thereon, and who contracts for such projects with a con- $ Uyy Y OF FEES AA� �f tractor(s) license pursuant to the Contractor's License Law). 1 am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ !MF BIP SMIP $ `�•2f proof oftheir Worker's Compensation Insurance should be provided to me: PLAN CHECK (/��� ���='� PERMIT 0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING M$ • ISSUANCE $ Date - Owner Heating System&Ducting Registers • PLAN CHECK 25% $'. ENERGY P.C. $ I hereby certify Chat I have read this application and state that the above • ❑0.100,000 BTU 0100,00067E 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- - - - • sentatives of this city to ente upon the above-mentioned property for • ' PLAN CHECK 50% $ MICROFILM $ Inspection purpos- . r / �/ MECHANICAL $ Signature ..e"a -i�.a e�-. -��.-a; Date,-71 L7 TOTAL FEE $ / _\ Drivers' License or SS of Reinspection Fee $15 Issue Fee $ 3 ' PLAN CHECK 25% $ ! 705 a n865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTIONAND 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-Undrgind. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. Oita po. 57. APPROVAL TO COVER-GUNITE 7. Footings //W , Die 58. Electrical Conduit-Undrgrnd. 8. Foundation ; ' LLL//// 59. Gas Pipe°O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System �� � Q/�" 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 0il 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing L 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25: Roof Sheathing 07 04C 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 5/0,f7 76. Dry Standpipe 28. Lathing & Siding / 77. FIXED SYSTEM FINAL 29. Insulation 3/61/67 04- 78. FIRE PREY. FINAL 30. Drywall Nailing ( HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat (20; ®� ' 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED p/� 33. Final Electric Notes: L707 ger S',Mt Y-om °giro ("UT ' 34. Final Heating & Air Conditioning __// !! G 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace © Age 38. Final Plumbing s/zc/f 7I , 39' Water Service-Final 40. Gas Service-Final Astes:asiijeer 41. Solar Domestic-Final - 42. Backf low Preventer '• 43. Backflow Irrigation -i -44. Landscape Irrigation System • 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ` � - ' - 48.•Special Requirements Completed '(J7/114'l M M • 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co .' ' ,. 51. CERTIFICATE OF OCCUPANCY No. Date - �' /-a .5/ City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division ,, 2569 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) 31 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) 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 //1 May 8, 1987 Signature and Title Date Red's Insulation 381933 Sub Contractor(Insulation Applicator) License Number . / J G ,_,C -••-••e May 8, 1987 Signature and Title Date CMF 1106-46 DCA Don Greek `. and flssooiotes 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 Q%OIESS4i q,, 4a pER M. �� 1;3Z UA N!ix0. 34559 m J * *i Orr Cly �1, Ng'or cAl.1 r 2428 N.GRAND AVE., • SUITE L • SANTA ANA,CA 92701 • (714)543.0990 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. ' • Project Address 2569 San Clemente Dr./Trash Encl.92fr2� A.? 7U 8 $ FI2SSch4 a j TYPE OF CONSTRUCTION •• [XI NEW 1_J ADD ❑ ALTERATION U REPAIR • 1330 I/29/67 .84.13 TL Applicant's Mailing Address 2510 N.Shelley Cr. nCOSta Mesa rs-3. I _ Owner's Name 9 COm Phone 714/863-15)0 ❑ CONVERSION ❑ DEMOLISH ❑ oT Trash Enclosure / - Fairview Management Compme A.P.# Q — Q[a zone —{+tom • DESCRIPTION OF WORK/USE OF BLDG. ' Address 2400 Main 9 .�_r'mina.__Ca._92714 _ • r-�/• / ,S Main Building: Accessory Building: Z Arch/Eng.Bllrkfl_LeRtPr & AaSDS_License No. C-6925 TYPE OF PERMIT El GRADING 0 FOUNDATION [ '<TRUCTURAL T FrontrQ / 'ID Sty/ (ppnayi. y Di—• 0 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL /� ¢ Address 23025 Mi 11 (:YPPIC—Dr. LdQ}]I')_d x111 S.4/972553 ❑ OTHER B Rear 2 ' _v . ,rp 5fxPe _ N - C:omhpan1' r`''_� _ Contractor's NamrFai rvi Pw neve'clpmpnt Pone 14/979-50 57 - - / C Ri ht /� /� N PROJECT DESCRIPTION SQ. FT. - OCCUPANCY 44'71 K . g Jv '�� L` / � Sc' • G Address(mailing) 2510 N.Shell Shelley Cr. ,Costa Mesa.Ca._92625 CONSTRUCTION TYPE -V� VALUATION$ a/00(7 ) s Left'f25 y ..4 r`� (2649 Sz... c -rn..3tc City License No. 395R2 ZONE GRADING CU.YDS. ACRES I R LICENSED CONTRACTOR DECLARATION • Ping. Ref.# • . Parking Req./Provided E 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: t e ` 3 s,•�g6 i_ Planning Notes:-'.7 d-S' ��Lf/ sA['U e.€ M with section 7000) of Division 3 of the Business and Professions Code, and per, �rte` M „„suer my license is in full force and effect. . _ - T License ass B ' LI en • N. 496901 s N Dale Signature �r moi,/er/� PLUMBING I FEES � 'OR KERS'COM ENSATION DE a• RATION Bar Sink - Showers - lereby affirm that I have a certificate of consent to self-insure or a certificate • ELECTRICAL FEES ..f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - 3800, Lab. C.) /^ Automatic Washer Transformer D 15-50 KW Policy NoUB-830F 944-9-86 Company The Travelers Ins.CO. Backflow Irrigation Sewer Cap /7 Construction Pale Sub. ❑ 50+ KW U Certified copy is hereby furnished. - / Certified cypp yea with the city B ild' g Divi p Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date /lO � Applican 2-Ce--1-&--rel ) • EXEMPTION FR WORKERS'COM SATION DECLARATION Clarifiers ' Solar Collectors Dishwasher Meter Dover 100 a ps (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 FanMotors 1 HP ❑1'rS-8 Workers' Compensation Laws of California. - _ Date Signature • Floor Drains • Swimm' Pool w/Spa F.A.U. - • NOTICE: If,after making this declaration,you should become subject to the _ In olar 09.15 HP 016.15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks U • al Fixtures Microwave comply with such -provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets • Water Closet Devic¢gOx¢5 ' I hereby affirm that there is a construction lending agency for the performance Pole Light of the work f0/ which this permit i£jssued (Section 3097 Civ. C.) Interceptors / Water Heater - Lender's Name blared} Amen an irgt Savings Bank Out Range Lender's Addfessl�5_.Siater Ave. .FOtlntain Valley.Ca. Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION 9228 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Dis O 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 ' P—Trap i LaundryTrays any structure, prior to Its issuance, also requires the applicant for such permit y General 0-5 KW❑5-15 KW Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of ROOjfor '• 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). • $ 3 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work, and the structure is not intended or offered tor sale (Section 7044, Business and Professional Code: The Contractor's MECHANICALReinspection Fee $15 Issue Fee S 3 ' License Law does not apply to an owner of a property who builds or improves FEES 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 . /-.247-.8"*-:DtrC sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ - Zoning Approved By Date pletion,.the owner will have the burden of proving he/she did not build or Im- prove for the purpose of sale). Building Approved By Date �`�� y 0 I, as owner of the property,am exclusively contracting with licensed con- . Duct-Structural Refrigeration Syst ) Application Issued By Lei /•e��..... - Date/—r4-9—R-7 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 ❑100,000 BTU builds or improves thereon, and who contracts for such projects with a•con- SUMMARY OF FE \tractor(s) license pursuant to the Contractor's License Law). I am aware that - Exhaust System 0 Multiple ❑' Syst epair/Alteration BUILDING PERMIT $ 3'2'5E' $MIP - $- • .5c, LIroof of their Worker's Compensation Insurance should be provided to me. a/'/3 PERMIT I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# ire Dampers . PLAN CHECK $ ISSUANCE $ - - - - • PLUMBING - $- - - - Date Owner Heating System& Ducting Registers • PLAN CHECK 25% $ ENERGY P.C: $ I hereb certify that I have read this application and state that the above • ❑o-100,000 BTU ❑i0 BTL GRADING $ information-4 correct. I agree to comply with all city and county ordinances' ELECTRICAL $ and state law3'celating to building construction, and hereby authorize repre- MICROFILM $ sentatives of this. ty' to enter u•• the above-mentioned property for -• 1 PLAN CHECK 50% $ inspection- • pun aq i MECHANICAL ' $ Signature Z/S nspection Fee $15' Issue Fee S 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 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 2/01 oa 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, ❑ 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 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 p30 t,77 ceirdp 48,. Special Requirements Completed • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date s� vacD 117uyyat, 368.63 TL • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. a�r�— PERMIT NO. TRAfT NO. LOT NO. UNIT 0. CIT • Y OF COSTA MESA Q-CONS RUCTION PERMIT `I `,2�/�rl - Project Address.-. •a 5I___A C I ' - r $ TYPE OF CONSTRUCTION yD EW LJ ADD LI ALTERATION LI REPAIR r - • APF ^grit's Mailing Address I&A08��=HPdrlp'/. S,F 5, v � ❑ CONVERSION ❑ DEMOLISH 111 OTHER q P •# Zone Owner's Name tCViOtJ ^I)[,V Shone DESCRIPTION OF WORK/USE OF BLDG. . Address aslo 14*511"%e-Ate,, CQ-S) . N 7 si-. tsq S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT LI GRADING LI FOUNDATION LI STRUCTURAL T Front p Address j� ��� ❑ TENANT ❑ ELECTRICAL ter-PLUMBING ❑ MECHANICAL BB Rear N OTHER Contractor's Name eo („ T �[1 `-irn,1 PPho�ne17�s+l PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right - rs �aQC; N Address(mailing)L3 P6'ur•L. f...-�AJTI _�ErSP�/ J CON ST RUCTION TYPE - VALUATIONS S Left �D \S 3 DG4 G City License No. 39 I�ft ZONE GRADING CU.YDS. ACRES cE.W 1'161 R LICENSED CONTRACTOR DECLARATION 111 Ping. Ref.4 RE Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing 'Old c��m c 4-th- Qs S 31 Planning Notes: RF' M Remarks: G I CEIVED ()IST with section 7000) of Division 3 of the Buslnest and Professions Code,and 1 r Lr to 2 7 s -_, my license is in full Iy ce end -fleet. '1 I - I sit T LJcens a `-" - Lic°Aso.l(}Z93L{ • S Date J�'-- A 7(4' Signature' -!lint .. UL PLUMBING I FEES •• - WORKERS'COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-Insure ora certificateELECTRICAL FEES of Workers' Compensation Insurance, or a c 'fled copy thereof (Section Backflow Preventer A Service Sink 3800, Lai a / I INb � Automatic Washer Transformer 00 50 15-50 KW Policy No. �(.� Company JD s(� Backflow Irrigation _ Sewer Cap — Construction Pole Sub. Certified copy is hereby furnished r)jI ecisey-jy filed with the a: - Divkle�.lr� ��. •Bathtubs Sewer Connection 1�.� Cooking Unit Meter Cup to 100 amps ate /Ud'[1''C l� Applic. -Nil 0; �L.`<.G(� 1— (� 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). lig Dishwasher,. Solar Piping 3a — Dryers ❑Gas ❑Electric Sub Panel 1 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''A.8 1 Workers' Compensation Laws of California. — ' I Date Signature I Floor Drains Swimming Pool w/Spa — F.A.U. Q ❑9-15 HP 016.15+ Workers' Compensation provisions of the Labor Code, you must forthwith —Floor Sinks Urinal Fixtures , comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets 1 i11 Water Closet ''11 L^ ' I hereby affirm that there Is a Construction lending agency for the performance I S �T Device Boxes Pole Light of the work for which this permit Is Issued (Section 3097- Civ. C.) Interceptors VA Water Heater ,- Outlets' Range ¢ Lender's Name g 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-Wash rr,,11 Garbage Disposal ' • following reason (Section 7031.5 Business and Professional Code: Any city or �' T 9. P Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P-Trap 4 Laundry Trays 8 --' Generator ❑0.5 KW❑5-15 KW ' any structure, prior to Its Issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains r the Contractor's License'Law(Chapter 9(commencing with Section,7000)of ». Division 3 of the Business and Professions Code) orthathe/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 J 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 provefor, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Alte /�11(�f rove the purpose of sale). �� /�/r/fl/d o I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date LJ 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 BTUSUMMARY OF FEES • builds or improves thereon, and who contracts /pr such.prOjects with aeon- tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o their Worker's Compensation insurance should be provided to me. ' PLAN CHECK - $& `aw*•So PERMIT sa�1i ❑'1 am exempt under Section B. P.P.C.G.for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBING $ fir' �Q�,( t/3ISSUANCE $ 7 Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ 7/'/3 ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU❑100,000BT ' - 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- sentative ity to enter u-on he above-mentioned roperty for - '516. p ^� inspet..npur.• . ��SP MECHANICAL $ TOTALFEE $ �'�✓ DSrivernet �`N�J __-. ,` Date Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS# - CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor J 'CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit Date Inspector APPROVALS Permit 4k_ Date Inspector 1..Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. f14:114 LEb 53. Steel Reinforcement a?• +.•J 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • r• 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •en . 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test •e_' 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE"" 7. Footings i 58. Electrical Conduit-Undrgrnd!} +,1 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,TestI4 E31 r 9. Water Pipe-Undrgrnd. /1-ci4L CEO 60. Backwash Lines, P-Trap, 0,l/pdrgl.d. 10. Structural Floor System 61. APPROVAL TO DECK ••1-• 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 a.-lists Z LIFO 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 ❑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 4,12310 6-0- • ' 36. Hood or Canopy • . 37. Final Factory Fireplace _ 38. Final Plumbing cki/v7 L(t0 r 39. Water Service-Final 12-3146 LEO . 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 1' , 1 No. Date _ . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ CITY OF COSTA MESA _ CONSTR U TION 'E- IT PERMIT NO. TRACT NO. LOT NO: UNIT NO. . ,2. _ 183.00 -TL Project Address ••1/45 a /�Lz _% I�`•`r TYPE F CONSTRU4) 2LeCO' CTION IEW Li ADD LI ALTERATION LI REPAIR #2308 • Applicant's Mailing Address 231 W. BLUERIDGE AV'^ . El CONVERSION ❑ DEMOLISH ❑ DTH A,P,# _ Zone Owner's Name FAIRVIEW DEV .' CO. Phone OTHER_ VENTIAL - 2510 N. SHELLEY CIRCLE DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: ' Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front t _9'� p�'�yj{.� Z ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ®XAECHANICAL B Rear ' "n`CEWEL Di:L 6 8 1988 N Address - ❑ OTHER A Contractor's Name SANTIAGO A/C Phone 998-1600 C Right • - - N 231 W. BLUERIDGE AVE . PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G Address(mailing) CON STRUCTION TYPE ' VALUATION$ • S Left R City License No. 015264 ZONE GRADING CU.YDS. ACRES. Ping. Ref.4 Parking Req./Provided E LICENSED CONTRACTOR DECLARATION ' 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(;prep: d effect. 9496 T License CLss "-" _ License 1 i . $ Date • • Signature -�r�r • v PLUMBING j FEES• . . WORKERS'COMPE ATIO • LARATION Bar$ink • Showers - ELECTRICAL I hereby affirm that I have a certificate of consent to self-insure or a certificate - FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink • 3800, Lab. - Automatic Washer Transformer 0 15-50 KW Policy ab `I�N878-5227 Company IND. INDEMNITY Backflow Irrigation Sewer Ca • ❑ 50+ KW rs.�rs P Construction-Pole Sub. fl ertified copy is hereby furnished. - Ater}-'If'tjd 7gs iled'with the city�{I),Id n9 vislpn Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date lam•/ J/ "� Applicant—(V Vr^•�'IMA�-../1/1�..--• .- 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 to the Drinking Fountains Solar Tank Fan Mptots❑0-i HP ❑i'/:-B • 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 rovisieclaration, 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 ' 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 HeaterOutlets Ran • e Lender's Name g • Lender's Address -- Kitchen Sink ' - Water Service - - ' -Switches . . •- -- - - - OWNER BUILDER DECLARATION Sign' 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 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator DO-5 KW 0515 KW • any structure, prior to its issuance,also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions-of Roof 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 of not more than five hundred dollars ($500). $ 3 LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee 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 goiter • Hootl or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not intended or offered for Zoning Approved By Date sale- If, however, the building or improvement is sold within one year of com- Canopy Type II 0 pl , !Motion, the owner will-have the burden of proving he/she did not build or im- Duct- Under Ground rove for the purpose of sale). Building Approved By Date LII,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 SUMMARYOF 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 0 Multiple 0 System Repair/Alteration • BUI LDING PERMIT $ SMIP ' $ proof of their Worker's Compensation insurance should be provided to me. _ • PLAN CHECK $ PER MIT. _ ❑ I am exempt under Section ' B.& P.C.for this reason - Firepl/Fact.Blt. ICBG 4 Fire Dampers ERMITISSUANCE $ PLUMBING $ _ Date Owner - Heating System-& Ducting %D Registers OQ t� PIAN CHECK - 25% $ ENERGY P.C. $ _ I hereby certify that I have read this application and state that the above *0 Dori BTU ❑100,000 BTL to 00,000 $ 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- PLAN CHECK 50% $ -MICROFILM $ sentatives of this:city to enter u n the above-mentioned property for G inon gurposes. ' Signature - Date )k12/3/86 MECHANICAL $ TOTAL FEE $ r.ar) Drivers'License or 55 - - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ •'�• L 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 r� 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement tit 3. Electrical Conduit Utility-Undrgrnd. 54.. Forms rte.• 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test t^. c 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ; 7. Footings 58. Electrical Conduit-Undrgrnd. :..r 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9: Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ 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 4-K47 ( 4-,) - 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. Backf low 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 �P MI NO. �y TRACT NO. LOT NO. • UNIT NO. ' . Project Address 2559 San Clemente ANN Dr• f,^�1{'1,. ' '.J_• r �+& 9 / r - 0789 1 /23/87 123.00 TL Applicant's Mailing Address 5380 E. Hunter. Ave, Anaheim - TYPE OF CONSTRUCTION Cx.I NEW CI ADD LI ALTERATION U REPAIR Fairview Management CO. ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# c I Zone Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. Address 2400 Main St, Irvine, CA 92714 Housing S Main Building: Accessory Building: Z Arch/Eng. Burke-Lester & Assoc License No. TYPE OF PERMIT ❑ GRADING LI FOUNDATION EllSTRUCTURAL E Front Q Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING p MECHANICAL BRear N IDB OTHER I Contractor's NameMission Sheet Metal Phone 970-5734 - C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCYK G Address(mailing) 5380 G. Hunter Ave, Anaheim 92807 CONSTRUCTION TYPE VALUATION $ S Left . City License No. ��°°YY99��yJ ZONE -i GRADING CU.YDS. ' ACRES E LICENSED CONTR7XTY6R DECLARATION /� - Ping. Ref.#- Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: }mss�1 C•5 3,/ Planning Notes: M 0 with section 7000) of Division 3 of the Business and Professions Code, and LVJOt�.1�./.-J Nmy license is in full force and effect. T License Class C2 Ucense No. �(,i�� - - - S Date 2'y R Signatur$. ���j/�i�-+�` PLUMBING FEES ' •• WORKE S CO/g(I7E NSATION DECLARATION Bar Sink Showers ELECTRICAL FEES ‘ I hereby affirm that I have a certificate of consent to self-insure'or a certificate - • of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer _ Service Sink - . , 3800• Lab. C.) - Automatic Washer Transformer 0 15-50 KW t Policy No. -470893 Company State Fund Backflow Irrigation Sewer Cip , (Construction Pole Sub. ' • 0 50+KW Certified copy is hereby furnished. Certified copy is filed with the cit�B�i Ing Division. J _ / / Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps [e k-(O� R�KERS'cp t_/ENSATI N - EXEM T OM WORKERS' dCO 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 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 00-1 HP 01%-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 AGENCVGas 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 Ran e Lender's Name _great Americ - Savings g Lender's AddressKitchen Sink Water Service Switches OWNER BUILOEW1k&AfiANtcat Ave, xMMtiKafX Fountain W-t7. .ay _ Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage DisposalStanding 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 00-5 KW 05-15 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 i / 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). LJ 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 1$1" 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 hlmsolf/herself or through his or her own Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered foryp j 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 / Drove for the purpose of sale). I,as owner of the property, em 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 con- tractos license pursuant to the Contractor's rLicenseLaw). I aaware that Exhaust System D Multiple❑ System Repair/Alteration BUILDING PERMIT $ - SMIP $ proof of) am aware Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section 8.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING $ ISSUANCE CE $ 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 ' ❑O-100,000 BTU 0100,000 BT , GRADING $ information is correct. I agree to comply with all city and county ordinances .._.c____ _ ,. ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- - --- - - .� - PLAN CHECK 50% $ ...MICROFILM $ sentatives of th city to enter u•on th-. above-mentioned property for •/ M inspection •un”es. - • Kitchen hood ' (�l�r MECHANICAL $ ,- �j �/`� Signatur ice.,/ i..et_- a . — / Date i_�_23-o_1-R7 TOTAL FEE $ /g.7.C iL� Drivers' icense or S5 c Reinspection Fee $15 Issue Fee PLAN CHECK 25% $ of 9 - ' CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor . 1 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: Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 642-Y7 tAfn 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 6-+2_o7 Gra) 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low Preventer 43. Backflow Irrigation 44.J,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 56. 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. - - 0Z�c�� c� 5979 10/27/86 572.70 TL Protect Address. $"(c`' flea +=A? Le•/'TS - - Applicant's Mailin Address //Q g' VAN 0vs.0(._J - 01 TYPE OF CONSTRUCTION Li NEW L) ADD ❑ ALTERATION U REPAIR s !- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name = ,�.7• // - l!'hone$G3.ISo° DESCRIPTION OF WORK/USE OF BLDG. Address 9-Vq0 te/ /c/4:<' St • �P 4,1,u<•.. _ . S Main Building: Accessory Building:• Z Arch/Eng. e/v`Ke' " 1 C5raA License N. O.- TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL T Front _ 0 Address 30 /J-5.a. • �;// JP to bra` ,'*� �i(•s/!1-j i% ❑ TENANT El ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Nama6tSo ci /j-T '�lac-r re-hon02 X- t ❑ OTHER C Right N ,v r t , PROJECT DESCRIPTION' SQ. FT. OCCUPANCY K G Address(mailing/ ✓- g C O N STRUCTI ON TYPE VALUATION $ S Left City License NO. ' 77f ZONE GRADING CU.YDS.- ACRES Ping. Ref.# Parking Req./Provided R LICENSED CONTRACTOR DECLARATION, ���••• ,,�.I++)77 E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �, a 4 Q PS--) 7/•f/b ' Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and 1CJ`YJA '/ „J my license is tophi force and effect. �1 T /� License Class L` /a Licens¢ .�72n 0 k S i \Dater —az)—5- Signature(a1 E�rl'•.tt0} af..C'�1 PLUMBING FEES 64% WORKERS'COMPENSATION DPCLARATIONBar Sink Showers ■ hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES ' d Workers' Compensation Insurance, or a certified copy thereof (Section ■,■ Labs �j,,,!� 1 / ■ s I KVV Policy No-�_l1'��d company /}/• 7i i -c �ui✓� ■ r Certified ropy is hereby furnishetl. �� D Certifiedgcopy Is fi d with the cit B :�g . Ilio/ / ♦ .c ■ . Cooking • 100 amps ' Date��-7-7 -s'& APPlica•;rs%S Vii- - _ EXE PTION FROM WORKERS'C• PENSATION DECLAR•� ION 11 Dishwasher•• Dover• as ' p/6.^ (This section need not be completed if the permit is for one hundred(5100)or ■Dishwasher 1 e�� • ■ ■ d J less). CD I certify that in the performance of the work for which this permit is issued, I ort ' employ anyperLson of any manner so as to become subject to the • 00-1 ■ Workers'lnoemploy Compensationrsonn Cnf ala. Date Signature , • - , ■, ■• • 016-15+ HII NOTICE: If,after making'this declaration, you should become subject to the ■ i�� Workers' Compensation provisions of th¢ Labor Code, you must forthwith rw �g �. comply with such previsions or this permit shall be deemed revoked. CONSTRUCTION LENDING iso AGENCY ' • 1hereby affirm that there t construction 0n lentlin9 cy for the performance Pole of the work 1 which t permit Is issup=Syt top 3 97 iInterceptors _Lentler's Name(/ { .tt` - .Jtt e/�<' 3 /� lets Range Light �� Lender's Address(' : / • r t 1 Switches illSign 1t. .p OWNER BUILD ROE LA RATION 11.1 II. :')�y' I hereby affirm that I am exempt from the Contractor's License Law for the •/ Garbage Disposalno following reason (Section 7031.5 Business and Professional Code: Any city or • • I Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays ■• ■ any structure, prior to its he/, also requires the applicant ant ler such permit II to file a signed statement Lnsethat pte is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencingCo ) r with Section 7x) of 'Division 3 of the basis and Professionseprion or that violationha/she is exempt - therefrom and the for the allegedderexemption. Any pp icant of Section 7031.5 by any applicant for a permit subjects the applicant to a civil ][molly of not more than five hundred dollars($500). LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure is not intended ed or offeredReinspection Fee $15 Issue Fee --$ 3, 7 *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 dies such work himself/herself or through his or her own Hood or Type I ❑ DEVELOPMENT employees, provided that such improvements are not Intended or offered for BoilerZoning sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 roved By • D' pletion,the owner will have the burden of proving he/she did not build or im- Duct- Under GroundBuilding Approved By Oat° ' prove for the purpose of sale).' - 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System 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 00100,000 BTU 0100,000 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 0 Multiple 0 System Repair/Alteration proof of 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.Blt. ICBG# Fire Dampers . .Date _ owner - Heating System& Ducting Registers I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BT ■Information is correc ' agree to comply with all city and county ordinances ELECTRICAL $ 2.and state laws rel. .• to building constr - I•n, and hereby authorize reprePLAN CHECK- sentatives o t city to enter ...di;•on - abo•e-mentioned property for . . a , inspection es. / / �/i �•/ , MECHANICAL Signoras .....,4/es. Da[g�G"27"$ "i ■ . TOTAL TO Drivers9F > -Applicant; Pink -Accounting; Goldenrod - Assessor IM ri 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. i:4 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 LI . /4,{ 67.. Fer)cing & Access Approval 17. Rough Wiring Sign !'r F'�• 4 68. APPNOVED 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 O'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 is 29. Insulation 78. FIRE PREY. FINAL ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 4 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 . 48. Special Requirements•Completed ;- ‘- 49. 49. Electric Release to Edison ti . 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. _ . 71114 r CITY OF COSTA MESA CONSTRUCTION PERMIT PER IT ..�� TRACT NO. 'LOT NO. UNIT NO. 4882 IA/09/86 23.00 • ,- -ProjecCAddress Z. SCI 5;,.. Cfri,jp C' re_ 'q� Applicant's Mailing Address /!O C 6. VAN twcad / 't(.'G (DA.•TYPE OF CONSTRUCTION LI NEW U ADO U ALTERATION U REPAIR 1 • Owner's Name Flt Ate' !" /1 ! ✓TCr - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone 'Phone DESCRIPTION OF WORK/USE OF BLDG. Address 01tee [- Al4l .• s� — rite ti e S Main Building: Accessory Building: Z Arch/Eng.Riolt.l E.Le Pei 4ASSe.License No.0 -6t/tl.5TYPE OF.PERMIT CIGRADING CIFOUNDATION CISTRUCTURAL T Front - _ D Address v13c>fi �/-S Ma /, ltip s'Lt O.o — Ln Cw'.tj.& lit//S CI TENANT CI ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ��,,..�� B Rear N Contractor's NameSSOC:A /P rcc Pho�Se 7 �— ❑ OTHER A I A ,-cd 132A`PROJECT DESCRIPTION SQ. FT. • OCCUPANCY C Right N Address lmailingl lug 7]�� .rr • ��Lsl Q/(Q.(zly eJn K Left • G r CON STRUCTION TYPE VALUATION$ $ City License No. 3 77 $ R O „ ZONE GRADING CU.YDS. ACRES Ping.,Ref.# - Parking Req./Provided E LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 3� J Planning Notes: O r". with section 7000) of Division 3 of the Business and Professions Code,and '��-�/ M Cpmy license is in full force and effect. T License Class - ,",I " ens�.No 172 o s I ` t s Date/l' g- (Sec Signatur- J r ,L.a PLUMBING FEES WORKERS'COMPENSATION D CLARATION - Bar Sink Showers ' C hereby affirm that I have a certificate of consent to self-Insure or a certificate - ELECTRICAL FEES Y -If Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Yransformer ❑ 15-50 KW 3800, Lab. C.) — / Q.•. Policy No. 7>S f�JIfr_ 1 Company£7 L •77f+j a Irks al .. Backflow Irrigation Sewer Cap0 50+KW /n 8 Certified copy is hereby furnished. Construction Pole Sub. (' Certified opy s filed with the cit Bu. ing DivlslorI „ Bathtubs Sewer Connection Cooking Unit Meter Dula to 100 amps . Date Applicant r�r// — tiff V ' - .EXE TIO FR WORKERS C O •RATIDA1 Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need of be completed if the permi Is for on i. ndr dl($100)or Dishwasher less). / tel,-"t i,a/uetl, I Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify t':t e • rformance of the •r f• .whlc• shall not ti JJ� . person in a m f -• a t. t -ct to the DrinkingFountains - {r y '•• /a. Solar Tank Fan Work 4-s'.„pile-n Laws of C • / / /V _ f Motors❑0.1 HP O1'h-8 Date .Q— I:. Signa /� { i CiG. _ Floor Drains Pool w/S a NOT C : If, .i er makingthis dee .r. ion, `T '"' Swimming p -- F.AU. Inc.Solar ❑9.15 HP ❑16-15+ y. show •e • .•le t to the Workers' Compensation provisions of the Labor Code, you must '• e h Floor Sinks Urinal comply with such provisions or this permit shall be deemed evoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole I hereby affirm that there is a construction lending agency for the performance - Light of the work for which tins permit Is issue (S tion, 097 Interceptors Water Heater Lender's NameC% 4 R• 6 rarity;tAAi 1 ,A✓• GS 11 p Outlets Range Lender's Address/•C/ 7Y' Sic sell ffy.iC—rs,[(Kr.aiJ 10161 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 Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P—Trap structure, priorapplicantpermitp Laundry Trays Generator ❑0.5 KW ❑5.15 KW Trash Compactor its issuance, also requires theto for such p to file a ractotl statement LLicense Law that(Chapter is licensed pursuant to the prov7isions foRoof Drains the Contractor's the ei Cause and r fe 9s ons Code) with Section x) of Division 3 of Business Professions or that he/she Is exempt '- - therefrom and the basis for the alleged exemption. Any violation of Section )O 7031. 7031.5 by any applicant for a permit subjects the applicant to a civil (G Sd4 Pile s �� Onalty.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 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL _ I FEES p $15 Issue Fee $ 3 -. Liereon,Law does not apply to an owner of a property who builds or improves _ i 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 -^ theowner 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 the oe). 1��irk D t as owner the property,roject exclusively contracting ing wrof licensedioncon- Duct-Structural • Refrigeration System Application Issued By / Date ` �(/ hetors t constructctors the project s(Section tBo o antl of property Code: The Contractor's License Law does not apply to an owner je who Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU •SUM RV 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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ .SMIP $ _ proof of 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.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date owner Heating System& Ducting Registers ENERGY P.C. $ PLAN CHECK 25% $I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT information is correct. l.agree to comply with city and county ordinances ELECTRICAL $ .��1t.l :W^ GRADING $ and state laws relati to building co ructi and hereby authorize repre- - MICROFILM $ PLAN CHECK 50% $ inspection of this yr to enter p t ova-mentioned property for MECHANICAL $ TOTAL FEE $ .92s.090 inspection p loos ��, e• / • ee4 Oateit`i. / Signatere 1 �• $ Drivers' Licens 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 /' r 1 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, 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) & Monocoat75. 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 / Ai 80. FOOD CERTIFICATE ISSUED 33. Final Electric /�/�'�/'I/�/. # Nates/O-l>-5 4 /'7ojan*cIra nA S G'k". 34. Final Heating & Air Conditioning / // /r/-2 o i7 7-c C o n C.4 S p 4,1902- / 35. Final Gas Pipe-Test whew. co:..,0r4aclj ii.o... a 0 ±h.r 36. Hood or Canopy 5 b re...ins w kka.4 Co...a 2 c +-or-j AS 37. Final Factory Fireplace 38. Final Plumbing j 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 • e 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING • • 48. Special Requirements Completed - .. • I 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date • v 01 �\ Page 1 of 2 .2,---------r 4, • . la.L.D.G._AIX-ft-rx: / \_ • I, - eirzwAy • • son -.Tyr -YYI -2r�0 N ---\ t lir r _ . . .i, , - -61• ,c wacky . / ?'�.• Iv -1 Igr•-to •I rrppX 95' I � _-- . N`• _\ 1 1 1 .eI Q 1 O, ; 1a 1 1 1 1 lO I I Ia 1 �I 11 1 1 :3 ' ;Q! 'sill : I--- 1 IFl-7� 1c— +� I I I 1 I I 11 I i : lilt BIZ 1 1 �1 I �r�5 r ! w, •. • ' IT /80191IQ1 1Y �L,I1 Ie Id I+ - t (( fll -� = i tbF/( r { AEMF • 1 { - I 1 ! / JI1I r�� P IIIIl t� .• I ' '''�t�, '-', I f �;rl . 1 ; ; 1 I .i l 112 z�` : _ .', 1 �� �v 1 I - \ .—t____ : .. •I : 1 25755/VJ y ' t ltn1/40 y • e+- 110 ' f I • 207 11 ° 5trActs i 1 CLENfENTE l 1 - 4EE h18 .� II a 108 . J _ '� _ ea. CRANI � I j - �/. �lrt - ,.— , tel/ �p ,0 a 204 tt 1 -I i f, � 23 9513. Cr 1 4_.-.4 • (— .1o2 103 104 n,n •P • • 20 • 1. � 'd = F=- • - d1 jO -5/LN� COs }1- ,- —" •fA. 1bl I I aE~ vff__J o3 205 sa • t: . 206 le 103 sn : - a 10, 105 . - • - 10G . . _. Fit_ C w A 202 -- -- _. : A Y 107 i ¢ '°� '2 -lilt 1M cLM 1"rxz - � MERR ; X01 . • Ia8 lol _ • N\' 1 • ‘5 • /'�i�/- HARBOR VILLAGE • U' •D[ 11711113017tAl 11111111 COM. Milk C4110 M14 , rO FAIRVIEW DEVELOPMENT COMPANY • IN *in . 1.4Y vial cam.(y (YIM.Y SCALE NO ® ' BURKE • LESTER & ASSOCIATES III ARCHITECTURE AND PLANNING I3023 MILL C•LL[ WOVE, L341ML HILLS. L•lWOY.IIL •2513 17141 710.11•11 • Page 2 12 - • (,o • sq,' _ TYPCAL. _� _. is. 25�5,4•11" sAR�RA L-N• gl • 7 -t 0 - i % 1 = m gra�Qo 2.: 207 206 205- D�. • I10 109' a 108 107 � • D - et1 201 202 Ey 203 • - i 101 102 103 10' ,,!7/. 2.91%,449-74I 0 • .. ■ �.- -LR _ .1i:' I e -EARA I-4* ' !' • . / 2\ 4 -I .2o7 •7 10• 0104-11 - 203 �m 0103 Y� -� .' + •, k V%, lip •f•1,•• e' lo=t 10 0P 2 • 2.1 'it• \: ,,j-7�'/ • W '40 • x / K HARBOR )! C ' VILLAGE ' n ,I, 406 •uIIMV• COM NM. C•LIVOIlitt ll FAIRVIEW DEVELOPMENT COMPANY • N l sews Gaga YN� � VM / \gegiN6 I I ' i�\ ■ I BURKE • LESTER & ASSOCIATES \ \ \ ,� ARCHITECTURE AND PLANNING \\ \ 33023 SILL OA [ 04611. LAGUNA Mint [.LWO'MIY pt[[ U/NI 7[o•.M[ '