HomeMy WebLinkAbout2575 SAN CLEMENTE DR - Building Permits `p •F 9 CITY OF COSTA MESA
4
BUILDING DIVISION
Y :j arr____ , DEVELOPMENTSERVICES DEPARTMENT PERMIT NUMBER
t !ti (- PERMIT
Vogl" B02-00573
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.Bc IIILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2575 SAN CLEMENTE DR Status: ISSUED
Suite: Applied: 04/29/2002
Vicinity: HARBOR VILLAGE APARTMENTS Issued: 04/29/2002
Parcel Number: 42005103 Zoning:
Applicant: POWDERLY, PAUL ISSUED BY:
Address: 135 W SANTE FE AV
Phone: 714-981-3046
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 EXISITNG 20 YEAR COMP AND INSTALL 30 YEAR COMP'SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: r $9,600.00
Permit: $181.25 Claim Valuation: $9,600.00
SMIP Res: $0.96 / /
SMIP Com: $0.00 ,
Other: $0.00 - .
Inspection: $0.00
Total: $182.21 ' ' . -
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
244646(6'00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
Ili• I ave and will maintain a certificate of consent to self-Insure for workers'compensatigi,as provided for by section 3700 of the Labor Code,for the performance of the
Nk ork for which this permit is issued.
U1 I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
*, My workrs oo' 'on Insurance carrier and policy number are: (
Cartier: Policy Number 1,ln7 9 1 c ---i-2-0v
,-y<'7
'
(This section need not be completed if the permit is valued of one hundred dollars($100)or less.)
❑ I certify at in the pert rmance of the wo or w 'ch this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compens tion laws alifornia,and ogre=that i should beco e subject to the workers'compensation provisions of Section 00 of the Labor Code,I shall forthwith
comply witur!: provision�. r ( Zi iU�`
Applicant Signature: �+-'--'� c �j�J `�-Date: O
WARNING:FAILURE TO SECURE WORKERS' ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
' THOUSAND DOLLARE($100,000),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 hat I am lice sed under provis'ons•P 9(comme acing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.L .4 Class N
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Contractor's Signature: �A �/ (�'f/j �/
g � I�-C== � Date: ttt
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CONSTRUCTION LENDING AGENCY:
O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec.
7044,Business 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 properly,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 driver's license. 0 Yes 0 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,Gm 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? 0 Yes 0 No
(Section 25505 of the Califomia 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 ere 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 aaermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Govemment 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? 0 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 Cale Section 42303 been made? 0 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 cit ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
abo roperty for inspection pu es.I ag e not to occupy or allow occupancy of any building authorized by this permit until final inspection.
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�b\ � .fiignatu Of LeCal wner(s) \ ��� ;//j)q 1 ct¢?
C��.An—d1Orr`ut rized Applicant \ T G`� lDDatee
CODE* INSPECTION TYPE DATE =ALE CODEC ly$PECTION TYPE DAM MAU
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final208 Final Plumbing _
200 Final Re-Roof 5 i O2- 210 Final Electrical
201 Final BIock/Retalning Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval -
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203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
City of Costa Mesa
Development Services Department
CERTIFICATE OF OCCUPANCY No.
Building Safety Division 06 -4127
P.O.Box 1200
Costa Mesa,California
The Building located at 2569 San Clemente Drive
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group - of Occupancy.
Use of Building Aoartarant9
Legal Description 420-012-11
(See reverse side for Metes and Bounds)
Building Permit No R25531.B27088 Electrical Permit No.E25969,E25688 Plumbing Permit No.p 26169
Mechanical Permit No. P126671M26972 Number of apartments lA and/or guest rooms
ISSUED TO: Building Official William T. Howard
Fairview Management Company
•
1176 Main Street by r - a' .
Irvine, CA 92714
Date July 1, 1987
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C.
CMF 1015.46 rev.1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File
City of Costa Mesa _
Development Services Department CERTIFICATE OF OCCUPANCY No. 00 5 5 3
Building Safety Division
P.O.Box 1200
Costa Mesa,California
The Building located at n-in c.,.. tit..••••.•,. (n1A- not
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group 12-1 Occupancy.
Use of Building Anartmonf"
Legal Description 420-mi 2-11
(See reverse side for Metes and Bounds)
B27089 &
Building Permit No 147SS7Q Electrical Permit No.r) oc7 Plumbing Permit No. nnr171
Mechanical Permit No. Mflcnn Number of apartments /4 - and/or guest rooms
ISSUED TO: Building Official tt: 1 t _ T - -a
Fai rV1ow Mannnnmanf- rn -
1176 Main St. by j..
Trcri no - ('A Q771 &
Datee_,_oi
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink -Bldg. Permit File
V1
• 9
cEStp"'Fs9 CITY OF COSTA
°oit
CALIFORNIA BtP
V. +. DEVELOPMENT SERVICES DEPARTMENT
_ A
ORPORMEO\95.
October 20, 1986
To:
Building Safety Division - Pacific Bell (2)
Business License Division Police Department - Ping. & Research
Canunications 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 Dr. , 101-108, 201-208 420-212-10
2566 San Clemente Dr. , 101-108, 201-208
2569 San Clemente Dr. , 101-108, 201-208
2575 San Clemente Dr. , 101-108, 201-208
2579 San Clemente Dr. , 101-108, 201-208
2551 Santa Barbara Ln. , 101-110, 201-210
2556 Santa Barbara Ln. , 101-110, 201-210
Carports: San Clemente Dr. , A-I
Santa Barbara Ln. , A-D
For your convenience we are listing the agencies above that we have notified
of the charge. 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,
/de'
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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LW ot. Applicant to fill in all spaces ezcey. .n....wrttin heavy border lines and sign all appropriate declarations. 4013 9/29/86 2190. 11 Tl.
.;,t CITY OF COSTA MESA ,ONSSTRUCTI ON PER MITB4&o .2 - PERMIT NO. p TRACT NO
. LOT NO. {�UNIT^NQ
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• Project Address re 7X744/(:GF/7Fi1/TZ- pee/,. ' 6 2.S'52 / /VT?ST r� '7L(t 6 2
Applicant's Mailing Address --1670 Al�'weL-Cyt:, .. e,�//♦/ TYPE OF CONSTRUCTION of NEW ADD LJ ALTERATION LJ REPAIR 1 '
Owher's Name `A/>✓/F/*J/yA.✓.dTjL`/YE•J1eO Phone P4?-/.'�BQ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#4••x//'1` t —// Zone ��/
DESCRIPTION OF wORKJUSE QF BLDG. S Main Building: l/ r'�- AccessoryBuilding:Address //76 /JA/Asr.!! /2vA/< eA Q.2,17//� / %6;-U.�Lt. Amerit.UT
Arch/Eng- a/ '/AX " AeSrs-� License No. J" -‘91.5"--
7 TYPE OF PERMIT U GRADING FOUNDATION g STRUCTURAL T .6wn( A) 30 / C0 ( AQJ,a /./�Q( = Z
Address a2n.2. f//LL `leEEfL De 24 90A-44 .GLS ❑ TENANT ❑ ELECTRICAL PLUMBING LI MECHANICAL B Beer 5 �1 7/ r_ /4 N
Contractor's Name FA/.e✓/f_w DF✓ G.014-4, one 9fl-3 s7 ❑ OTHER A C d / RJ 1
i PROJECT DESCRIPTION SQ. FT. �A-¢RR OCCUPANCY ,e/ O B+RI+f G 9$' ><p tl(dpr / N
Address(mailing) 4 4 LtF - J A ,r K �� 7 / v- G
�3 a 5 ij CONSTRUCTION TYPE �A/yF'�1"!/GLO VALUATION$ • r `r"�j+� $ L[J 17 in �j^ • R
City License No. C G/ ZONE GRADING CU.YDS. AC PIS 0 7�J'
LICENSED CONTRACTOR DECLARATION ^ r. .J Ping. Ref.#pA_�_ /g3 4 Parking Req./Provided�J 7q//aZC/ E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:pc
L7-4.26 � Planning Notes: A 0 `7T A. v/Cf-/`/GF D
with section 7000) of Division 3 of the B i ess an Professions Code,and I- •-/ !// /' 1.1 M
my license is in full force a • of ect. Q,y0,Q Q� - S
License Class `- . Licen ',No/25-3/47•14-4 -� �p��p
Date - -. Signatur_ .-�._ - . . - -. PLUMBING FEES TFOR SPFr(nl REQUIDr?4tMTE
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
iereby 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
.,800, Lab- C- •_ Automatic Washer Transformer ❑ 15-50 KW
PolicyNo.;A s!?o 944-986 Company �.�'�✓f ere5. 9 Sewer Capfl 50+KW
P Y Backflow Irrigation Construction Pole Sub.
BCertified copy is hereby furnished.
Certified Copy is filed with the city Building Division Y� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date L -9— -, Applicant G6/E///F-�t/ De44 t6 -
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 Motors❑0-1 HP ❑1'h-8
Workers' Compensation Laws of California. _
Date Signature FloorDrains 'Swimming Pool w/Spa F.A.U.
NOTICE:If,after making this declaration, you should become subject to the _ _ Inc.Solar ❑9-15 HP ❑16-15+
•
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked. • Fixtures Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which tq is permit Is Issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets
Lender's Name ( .iir4ui.c /CLW Fiotr 4 uftc(4 AA..../
Range
Lender's Address/4/7C LA ff,P Ail, cEtJNT440 A/.r-.G/ 7Gg 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 Laundry Trays Generator 00-5 KW 05-15 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 • -
the Contractor's License Law(Chapter 9(commencing with Section 7000)of -
'vision 3 of the Business and Professions Code) or that he/she is exempt • - -
trefrom and the basis for the alleged.exemption. Any violation of Section
)31.5 by any applicant for a permit subjects the applicant to a civil _
LIenalty of not more than five hundred dollars($500).
I, as owner of the property or my employees with wages as their solo 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 1 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 R U MENTS:
employees, provided that such improvements are not Intended or offered for Boiler Hood or Type 1 0 1-)A
,LS.� �/�-Ir='
-sale. If, however,the building or Improvement is sold within one year of com- Canopy Type II ❑ • Zoning Approved By II�� f�� ,Date Iaisl'
pietion, 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 purpo5o of Salo). �y�
0'1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural- Refrigeration System Application Issued By • �. Dat+ ti!4jg
tractorsto construct the project (Section 7044,Business and Professions Code: •
The Contractor's License Law does not apply to'an property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU •• $ �U(v1aM RY OFFEES
450 SMIP $ 54•6
builds or improves thereon,and who contracts for such projects with a'con- e�D
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ • SystemRepair/Alteration BUILDING PERMIT
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 PLAN CHECK 25% $ ENERGY P.C. $ '
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,000BT 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- •
$ MICROFILM $
sentatives of this city to e/lter upon the .bove-mentioned property for PLAN CHECK 50% /� p r
inspection pur..ores. j - �_��/ MECHANICAL $ TOTAL FEE $ I LO. 1l
Signatur.. -e or � ii.i�' - Daf O Sa
Reinspection Fee $15 . Issue Fee
Drivers' License or SS# - p $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
'CONSTRUCTION-AND PLANNING POOL & SPA
APPROVALS r Permit# Date Inspector APPROVALS Permit# Date Inspector
h
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. • /,O/Se' 6 44'- 57. APPROVAL TO COVER-GUNITE
7. Footings /O 66 P4 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, E Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, E Undrgrnd.
10. Structural Floor System 0 0/r, LLQ 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 EGas EOil
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 'Alin li 01¢ 77. FIXED SYSTEM FINAL
29. Insulation ` 78. FIRE PREV. FINAL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 3191%104 79. FINAL INSPECTION •
•
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning /1/�1G 0/4n "
35. Final Gas Pipe-Test C�--ae��w
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing C\VIJA -
nit
39. Water Service-Final 0/7ilt�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 1p 87 .tel
48. Special Requirements Completed &a/0/€'i MM .
•
49.-Electric Release to Edison
50. Gas Release to Southern California Gas Co • •
51. CERTIFICATE OF OCCUPANCY
No. Date •
.Y
\ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. •I 1329 1 /29/87 54. 13 TL
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. L /a sq4 E-TR LOT NO. UNIT NO. •
Project Address .2575 San Clemente Dr./Trash Encl. Aa 7 O R 7 SA - q-,
Applicant's Mailing Addru+ss 2510 N.Shelle]{�5. �COSta Mesa 3 TYPE OF CONSTRUCTION NEW LI ADD LI ALTERATION U REPAIR - 11 r Y IZ-14D
�•""'YY ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner's Name Fair1(_i ew Management Phone 714/863-15)0 A.P.#4-,..0 - Zone
DESCRIPTION OF WORK/USE OF BLDG. Trash Enclosure
Address 2400 Main_Sts,_,T;LYsle, Ca. 92714 S Main Building: Accessory Building:
Arch/Eng Burke-Lester & AS SOC License No. C-6925 TYPE OF PERMIT Li GRADING Li FOUNDATION ❑ STRUCTURAL T Front ' ri nPp ,Q ( ZO
Address 23025 Mill Creek Dr. ,L c un� H lis r Ca.92653 ❑ TENANT El ELECTRICAL ❑ PLUMBING El MECHANICAL B Rear / r/ N
Om all Ell OTHER A d Pee.-.._-......... �/ I
Contractor's Name Fairview Developmer t phone //l4/979-5057 c Right "Zi '�y p r/ - N
PROJECT DESCRIPTION SQ. FT. - • OCCUPANCY Ogle,
Address Imailin )25.10_N-•ShelleyOr__ Costa MesaICa•92626 y- / /
g r CON ST RUCTION TYPE��/ VALUATIONS ).,000 ' $ Left & .110/74., Ll.. . '.r R
City:License No. 39582 ZONE GRADING CU.VpS. ACRES -^'• 7
LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /5 ` / /� PlanningNotes: 4/ T1s/ L c.Q/ E M
ct
with section 7000) of Division 3 of the Business and Professions Code,and '`� :557-f?-6
` /�0?5 'TieASfl -+`rG^�"'/�-•✓F M
s, my license is in full force and effect. I • T
`\ License Class License Ng. •11 •
S
Date ""-......12-Ver Signature .4_r, _ 0'. . . . i1. • - PLUMBING FEES
\ WORKERS' COMPENSATION DEC ' RATION Bar Sink ' Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-Insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer • Service Sink /
••.„,<,..., 800, ab. C.) Automatic Washer Transformer 0 15.50 KW
�\ 1 PolicyNaPB-830F944-9-86 compan4The Travelers Ins.CO. Backflow Irrigation •- • Sewer Ca / 0 50+KW /
,i\ Certified P Construction Pole Sub.
copy is hereby furnished.
Certifi d copy.,1,,filed with the city a ildi • bivii•s / Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps /
Date/ x-71 Applica
•
EXEMPTION FROM WORKERS'COMP SATION 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 T - Fan Motors❑9AiIP �1'/a-8
Workers' Compensation Laws of California.
Date Signature Floor brains - Sw' ming Pool w/Spa F.A.U. - Inc.S09-15 HP 01615+
NOTICE: If,after making this declaration,you should become subject to the — --
Workers' Compensation provisions of the tabor Code, you must forthwith Floor Sinks rivalFixtures
comply with such'provisions or, this permit shall be deemed revoked. rowave
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 foqrs which this permit is Issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets
Lender's Name b Amer,ran Fi rat Saul rigs Bonk Range
Lender's Address-l- 75 Slater Ave• rFountaln Valleya. Kitchen Sink • - . Water ServiceSwitches -.
OWNER BUILDER DECLARATION 7G/28 • Sign
I hereby affirm that I am exempt from the Contractor's License Law-for the Lavatories Auto-Wash • Disposal Garbage
following reason (Section 7031.5 Business and Professional Code: Any city-or Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundfy Tray s •
any structure, prior to its issuance, also requires the applicant for such permit - Generator ❑0-5 ❑5-15 KW Trash Compactor
to file a signed statement that he/she Is licensed pursuant to the provisions of '
Roof Ora.
the Contractor's License Law (Chapter 9(commencing with Section 7000) of t •
.Division 3. of the Business-and Professions Code) or that he/she Is exempt - - . - - .
' W�lerefrom and the basis for the alleged exemption. Any violation of Section
931.5 by any applicant for a permit subjects the applicant to a civil I _ l
"1`r-*enalty of not more than five hundred dollars($500). • : •
Li 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 - l '
, for sale (Section 7044,.Business and Professional Code: The Contractor's MECHANICAL FEES ReinspeMion 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 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 I I 0 Zoning Approved By / Date /-z9-
pietion, 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). - - - � r�I/� � XXX""+T
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration Syste : Application Issued By �• Date �7
tractors to construct the project (Section 7044, Business and Professions Code: f
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 . -0100,000 BTU , SUMMARY OF FEE' '
builds or improves thereon, and who contracts•for such projects with a con-
tractor($)license pursuant to the Contractor's License Law). I am aware that - Exhaust System 0 Multiple 0 Syst epair/Alteration - BUILDING PERMIT $ 32• lb SMTP $
proof of their Worker's.Compensation insurance should be provided to me. _ PLAN CHECK $ �• /3 PERMIT
❑ em exempt under Section B.& P.C.for this reason •
Firepl/Fact.Blt. ICBG# Fire Dampers • • PLUMBING • $ ISSUANCE $
Date- - Owner • Heating System Ducting Registers PLAN CHECK 25%. $ ENE RGYP.C. $
I hereby certify that I have read this application and state that the above ❑0100,000 BTU ❑ ,000 BT - - 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- PLAN CHECK 50% $ MICROFILM $ •
sentatives of this C y to e ter u••n the above-mentioned property for - •
inspection Pur...: / p /i-7 MECHANICAL $ TOTAL FEE $ 4- /3
Signature .i .1 4. tea_ DaL• O J /
Dri vers'•License .r 55# � • 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 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 - i(,/� o-$- 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) & 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 rr
47. FINAL STRUCTURE & BUILDING 1'/ /0'
48. Special Requirements Completed JI (" -
49. Electric Release to Edison
50. Gas Release to Southern California Gas CO
51. CERTIFICATE OF OCCUPANCY
No. Date
ROG . COVERING CERTIFII 1TION Bldg. 2
Permit No. B25529
•
Property address 2575 San Clemente Drive. Costa Mesa. Ca 7;402
Owner Fa' v'- M. ,..-u- r •u•• .
Contractor Fairview Development Company
State Contractor License Number 496001 Classification B
I hereby certify that I have installed,or caused to be installed, a minimum Class C roof covering at the
above address in conformance with Chapter 32, and Section 1704 of the 1979 Uniform Building Code, as
amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the
manufacturer.
% I further certify that I am the owner of the property. (Owner-Builder permittee only).
0 I further certify that I am:
❑ Owner of sole proprietorship company
❑ Full partner of the company
❑ Limited partner of the company
Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered tot
make this certification, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the
Building Division for acceptance.
Fairview Development Company
• Company or Corporate Name •
2510 N. Shelley Circle
Address
Costar,
taMesa, Ca 92A7
; May 7, 1987
Received by Building Division by: Signature J'� Date
5-=/C-Y7 F. E. Kindstrand, Vice-President
Initial Date Printed or Typed Name
Sbace for Notarial Statement for authorized officer or agent
•
CMP 0990-46 White-Building Div.;Canary-Contractor;Pink-Owner
DogDon Greek
and flssoc.iates
•
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
Qapf.ESSIpj
�0 pER At 9tr.\
rei
N0. 34559 m i
\,* *
\elf CAt4.
2428 N.GRAND AVE., • SUITE L • SANTA ANA,C4 92701 • (714)543.0990
•
•, Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 662B II /04/6s . 443.00 TL
^ ^ II PERMIT NO. TRACT NO. LOT NO.
CITY OF COSTAMESACONSTg, CTION PERMIT .[ rL/_/ y/ UNIT N
Project Address, 575 ax C I ti ,e_Y � '1 - r l� 77 'fir l _ _
l • t" 1'34pOeB G=, 17>G, S, •.0 TYPE OF CONSTRUCTION Sl NEW U ADD ❑ ALTERATION U REPAIR
Applicant's Maill2g Address R\P r sa .
•�•�fViCaa7 Phone ❑ CONVERSION ❑'DEMOLISH ❑ OTHER A.P.# - Zone -
Owner's Name DESCRIPTION OF WORK/USE OF BLDG. _ - •
Address ' S I• •Sk' W .,..w. V, ,4-. S Main Building: Accessory Building:
•
Arch/Eng. License No. _ TYPE OF PERMIT ❑ GRADING rr��I❑l FOUNDATION ❑ STRUCTURAL T Front Z0
Address D 111 TENANT ❑ ELECTRICAL ID PLUMBING ❑ MECHANICAL BA Rear J N
ID OTHER
Contractor's Name x(,'4$1 �, j�phon C Right - N
Address(mailing) 1g3(D1--s05 �f' rMT a"f'u•-ttL'�y / ROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left • G
o ]� lQ� l CON STRUCTION-TYPE VALUATION $ S• R
City License No. ] ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking Req./Provided 3 top • E
LICENSED CONTRACTOR DECLARATION �--s �L l .'l/ 77Q Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: S\A
_ 14 IE '-15 C R Planning Notes: cENED tie M
with section 7000) of Division 3 of the Business and Professions Code,and 1J I• ..JI G� P sr -
my license is in full •rc• . d effect. '���.I _ T
Ucense( - �' Lice y o. Y' • S
Date Cl ,d • Signature �/i�f ./A.411, PLUMBING FEES / . 1
WORKERS'COMPENSATION DECLARATION , Bar Sink • Showers ELECTRICAL •' FEES
ereby affirm that I have a certificate of consent to self-insure or a certificate
Workers' Compensation Insurance, or a fled copy thereof (Section Backflow Preventer Vs Service Sink �✓a Automatic Wa Transformer• ❑ 15-50 KW
1 6800, Lab. ®� p� L,/ 0_ }L(` '
"1 Policy No. ` LCL 4 aClia Comp 'y r�//L�-�/' U't Backflow Irrigation Sewer Cap ' ' _ Construction PyISy.EtvE� GUT 0 50+ KW;
Certified copy is hereby furnished • a
Wiz.;d co�v^h filed with the ci-s�'- Ing •Ivision.� R • ' Bathtubs Sewer Connection („QLI• , Cooking Unit - McTer 70145100 amps '
Date/V— —"C Applicant-'I7N La...? U - '•
^` EXEMPTION FROM WORKERS'COMPENSATION DECLARAT N ClarifiersSolar Collectors Dishwasher :. Meter Dover 100 amps \,.
. (This section need not be completed if the permit is for one hundred ($100) or '^ _ _ •
less). \I,,Q Dishwasher.. Solar Piping 3a Dryers ❑Gas ❑Electric Sub Panel J
` 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 1 Motors❑0.1 HP ❑1'h-B
Workers' Compensation Laws of California. ^ - �_ - - -
. Date Signature A Floor Drains ' - Swimming Pool w/Spa 14 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 Outlets5(Q 3'} Water Closet j
I hereby affirmthatthere is a construction lending agency for the performance ��a1. — Device Boxes Pole Light 1
of the work for which this permit is Issued (Section '3097Civ. C.) •Interceptors It Water Heater 31Q — Outlets • Range
•
Lender's Name - 'u:
-
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 32 Lavatories it, Auto-Wash nit tz.
following reason (Section 7031.5 Business and Professional Code: Any city or % • 14Q� Garbage Disposal Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays • �k. Generator (]0.5 KW ❑5-15 KW, I 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 _. _ - - _ ,
sivision a of.the Business and Professions•Code) or that he/she-Is exempt
terefrom 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). $ •3
IJ I, as owner of the property or my employees with wages as their sole Reinspection FeeI $15 Issue Fee '
•
•
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 ownBoiler Hood or Type I 0 - DEVELOPMENT SERVICES REQUIREMENTS: -
employees, provided that such improvements are not intended or offered for
•
' sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By / Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved ey r./ Date fl
prove for the purpose of sale). - j<__
0 1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural • i Refrigeration System Application Issued By_ Date
tractors to construct the project (Section 7044,Business and Professions Code:
The-Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU - SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a_con- .
tractor(s) license"pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ - SMTP - _ $
proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT'
0 lam exempt under Section - B.& P.C.for this reason . Firepl/Fact.Blt. ICBG# Fire Dampers LUMBING $ 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 0100,00067E .. - ELECTRICAL $ ' GRADING $ '
information is correct. I agree to comply with all city and county ordinances -
and state laws relating to buildingstruction, and hereby authorize repre- •
PLAN CHECK 50% $ MICROFILM $ "
sentativ- • iv city to enter •'�n the above-mentioned•property for _ 1
inspec o • 1 •
MECHANICAL $ TOTAL FEE $ 1-wl'3'D8
Signatu —St,�_�$��.
- • - Reinspection Fee .$15 Issue Fee $ 3 PLAN CHECK 25% $
a
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 ,
1. Temporary/Electrical Service or Pole 52. Pool.& Equipment Location
2. Soil Pipe-Undrgrnd: ��.w�( G@.D 53. Steel Reinforcement
tip
3. Electrical Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. ;Rough Plumbing & Pressure fest
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
•
7. Footing; 58. Electrical.Conduit-Undrgrnd;":
•
8. Foundation( - 59. Gas Pipe, O;Undrgrnd.,Test^,
9. Water Pipe-Undrgrnd. it+X76 LEO 60. Backwash t-14es, P-Trap, OUndrgrnd.
10. Structural Floor System 61. APPROVAL:TO DECK --
11. Property Sewer Line & House Connection 62. Backwash &IReceptor-Final
12. Sewer Cap 63. Heater & Vent-Final
r•
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing -11.-1i7 L•eD 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 ElectricalT 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 O 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 froth)? IAD
39. Water Service-Final J23fLES . . • -
40. Gas Service-Final •
41. Solar Domestic-Final .
42. Backflow Preventer •
43. Backflow Irrigation •
44.-..Landscape Irrigation System - -• •
45.. Sound Attenuation , •
46. Handicap Regulations •
47..FINALSTRUCTURE & BUILDING
48, Special Requirements Completed ;
49. Electric Release to Edison - j
• t
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 COSTA1 E CO TRU . ION P • MIT PERMITTRACT NO. LOT NO.
0� NO.m ���� uvio. 9135 12/22/86 213.00 TL
Project Address I - IrGE
•._�/ f U #2308 • '
Applicant's Mailing Address • . I • AVE. TYPE OF CONSTRUCTION LNEW U ADD U ALTERATION REPAIR
FAIRVIEW DEV. CO. Phone ❑ CONVERSION El DEMOLISH ❑ OTHE.PL. TIAL A•P•# Zone
Owner's Name DESCRIPTION OF WORK/USE OF BLDG. RE
Address 2510 N. SHELLEY CIRCLE • S Main Building: • Accessory Building:
E Z
Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front O
Address - ❑ THERT ❑ ELECTRICAL ❑ PLUMBING ®XSECHANICAL BB Rear ECEIVED DEC 0 8 1986 "
Contractor's Name SANTIAGO A/C Phone 998-1600 PROJECT DESCRIPTION SQ. FT. OCCUPANCYC
Address(mailing) 231 W. BLUERIDGE AVE . K RightaftG
015264 CONSTRUCTION TYPE VALUATION$ S R
City License No. ZONE GRADING CV.YDS. ACRES Ping. Ref.9k Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: Q
M
with section 7000) of Division 3 of the Business and Professions Code,and RI,DG PERM TT # 112552R thin R 95534 RECEIVED DEC t 9 ty8b
my license is in full rc d effect. T
Ucen3e CI s -�-�7.k-ZU _ - ce a No. 2 e 9 v 96 S
Datel2/ 0i OD ignature .I a _____ _ rt._ PLUMBING FEES
/
WORKERS' COMPEN • •• - CLARATION
Bar Sink Showers ELECTRICAL FEES
ereby affirm that I have a certificate of consent to self-insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
_400, Lab. `4N878-5227 IND. INDEMNITY Automatic"Washer Transformer 0 15-50 KW
Policy No. Company _ Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW
Fertified copy is hereby furnished.
ertJf ipp��d F$�py As,flied with the city$ut�ltl�ing- vii Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date 1%/3/�$f� Applicant VVIACJ �.L_ '
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 ($100)or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑Q7 HP❑i h-8
Workers' Compensation Laws-of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. •NOTICE:If,after making this declaration, you should become subject to the Ino.$Olar ❑g-15 HP 016-15+
Workers' Compensation provisions of the tabor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. _ Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
1 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
Lender's Name Outlets 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-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 Laundry Trays 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
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
`Ivislon 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 _• -
3nalty 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 I $15 Issue Fee S 3
. compensation, will do the work,and the structure Is not Intended or offered — - Reinspection Fee I $15 Issue Fee - $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or Improves
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for - Boiler Hood or Type I 0
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- Duct-Under Ground
rove for the purpose of sale). Building Approved By Date
1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that BUILDING PERMIT $ SMIP $
f Exhaust System ❑ Multiple❑ System Repair/Alteration
proof o 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 9F Fire Dampers • PLUMBING $ ISSUANCE • $
/ ,,l
Date Owner \, Heating System& Ducting A Registers /Qy Ute PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above \ DO-100,0MBTU 0100,000BTL GRADING $ '
information is correct. I agree to comply with all city and county ordinances 64 7 ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- MICROFILM $
sentatives of this city to enter upon the above-mentioned property for • PLAN CHECK 50% $ q Z �}
inspect ion,pims.�.4 �-7- 'Gl Date 12/3/86 MECHANICAL $ TOTAL FEE $ OC�3. (/(/
Signature or
vwu.-�
Drivers' License or SS Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ 2, /
•
CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1
r7
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# i�Date Inspector
tc
1. Temporary Electric& Service or Pole 52. Pool & Equipment Location rr
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement c-t
tc
3. Electrical Conduit Utility-Undrgrnd. 54. Forms '
.0
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE '�•I
7. Footings 58. Electrical Conduit-Undrgrnd. Lt
8. Foundation 59. Gas Pipe, ❑ Undrgrnd.,T st
`l.
9. Water Pipe-Undrgrnd. ,
60. Backwash Lines, P-Trap, C1'Undrgrnd.
n
10. Structural Floor System 61. APPROVAL TO DECK ^°I
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 Z-4-Y7 (,EP 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 ❑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 5/zq(g1 LEO
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 CO NST�U1 CTION PERMIT PERMIT-NO. TRACT NO. LOT NO. UNIT O.
Project Address � ,,y�Y'� C�C �(1 �r�,��,,��s/��r' a Sg6J 5980 10/27/86 623.• 10 TL
' Applicaryt's Mailing Address ' � �.(_ \JA_1r1 Qt1�11 CJIQ'15X OF CONSTRUCTION L I NEW U ADD U ALTERATION REPAIR - -"
•
Owner's Name• tPvJ G� •tgMk Ct PhoneW2o\ O JuTIONCONVERSION ❑ DEMOLISH El OTHER - q,p-# _ • (Zone ,
`! �.�•s[��` DESCRIPTION OF WORK/USE OF BLDG. •
Address � �es��,..._p ��asv��e S Main Building: Accessory Building:
Arch/Eng. C \LV. C.&R/�_License No..- 6 \ TYPEPEOF PERMIT ❑ GRADING L I FOUNDATION ❑ STRUCTURAL E Front ZO
Address 12�n25 KW l aQQ�► 1'�II TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's Nam=w',._ "i�sfl� �'POl_�ho e -.2.772.. LI 24
OTHER ` A • - I
1A��( '%X.,--J C Right N
Address(mailing)Fy7C 21-- Set 11& Q IQn 'I PROJECT DESCRIPTION SQ. FT. - OCCUPANCY K Left
G
G J /� C ON STRUCTI ON TYPE VALUATION$ $
City License No. 7O® 9$GY9i ZONE • GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION �\-711�.,['�� /� fl ���••• q - • Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed of provisions of Charter 9 (commencing Remarks: ✓). �--' B 2"�P52 1 I Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and t`--JJ _J
d/� my license is in full force d e fe t. J- T
rL- License Clas ' �� / Lice def o.� =— S
�s Date Yar C_ _ Signature .o-��.. a PLUMBING FEES p
WORKERS' COMPENSATION DEC ARATION ' '� r
1 hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES
)f Workers' Compensation Insurance, or a certified copy thereof (Sectio
Backflow Preventer Service Sink - Automatic Washer Transformer 0 15-50 KW
^. .3800, Lab. C. /� ..}.,� G� IIIII
♦ ` •
Policy No.�C�•�'!_s{1`>— Companso e\ PAP f V Backflow Irrigation Sewer Cap - 0 50+KW -
Construction Pole Sub.
Certified copy is hereby furnished. /
— Cert flied co y sfi}ied with the cl,l : ,::ing Dlvisio ♦ Bathtubs • Sewer Connection Cooking Unit 7 7 Meter up to 100 amps a Ob
•
Date�L, �^in Applica 152.. - J ,
EXEMPTION FROM WORKERS'CO•PENSATION •ECLA-ATION Clarifiers, Solar Collectors /6' Dishwasher - Meter,Oover 100 amps - G6 00
• (This section need not be completed if the permit is for one hundred ($100) or ,
less). - - Dishwasher Solar Piping . Dryers ❑Gas OElectric f 7 Sub Panel �S' OC
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 •s Fan 00
Workers' Compensation Laws of California. 3.y. Motors❑,0.1 HP O1'/x-8 - `3�i
Date Signature Floor Drains - ' Swimming Pool w/Spa - •F.A.U. Inc.Solar 09-15 HP 016-15+ l6 a0
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. , �—y�Vis- Microwave 41S.—
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet _ - '
I hereby affirm that there is a construction lentlin agency for the performance Device Boxes Pole Light
of the work •r 'which his •• i is issu ion 3097 Ci.. C.
Lender's Nam: 1 CP: ` •�' - • • , .. y\ Interceptors Water Heater 'X A.Outlers Range � YC
Lender!s Address p t. �• •�. stir=��i - " Kitchen Sink Water Service - - �—
OWNER BUILDER DELL•RATION, �Switche5 Sign 4/p —
• I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • ,Auto-Wash //_ CC
following reason (Section 7031.5 Business and Professional Code: Any city or I 1p Garbage Disposal • Standing Sections `y
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 ❑D-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 - •
therefrom and the basis for the alleged exemption. Any violation of Section '
7031.5 by any applicant for a permit subjects the applicant to a civil
. - penalty of not more than five hundred dollars ($500).
U I, as owner of the property or my employees with wages as their sole Reinspection Fee $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 `•
d or Type I sale. If, however, the building,or improvement is sold within one year of con- Canopy ■ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). Building Approved By Date
O I,as owner of the property, am exclusively contracting with licensed con- a Refrigeration Application Issued By 0 • - Dat j[L
' 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 e 00-100,000 : 0100,000 BSUMMARY 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 thataust •ystem ■ ■ BUILDING PERMIT $ SMIP $ ' •
on
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. ICBO# Fire • _PLUMBING $ ISSUANCE $
Date Owner - DuctingPLAN CHECK 25% $ LL,, c�. 'ENERGY P.C. $
I hereby certify that I haverread thismapplication all and state that the aboves - Do-100,000 : ■ I1111 : ® ELECTRICAL $ 47�kg. ID GRADING � $ - .
' information is correct. agree todi comply with all dy ande y county rite repres -and state laws rela ng to building constr coon, and hereby authorize repre- PLAN CHECK 50% $ 20.6 }'O MICROFILM $
sentatives of thi�ity to en er po /' a above-mentioned property for /
ignatinspection- /4 ,/ I 7 Date/ea'? tb MECHANICAL $ 6�,/0
SignaturTOTAL FEE $
Drivers'License or SS#
-Applicant; Pink -Accounting; Goldenrod -Assessor
•
CONSTRUCTION AND PLANNING POOL& SPA
APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms • '
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. - 1' 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 1 66. Solar System-Final
16. Rough Electric Wiring ;,.y), , 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
i
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 PREY. FINAL "
30. Drywall Nailing • HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION ! -
1
32. Electrical Power Meter-Final et:Z el/, 80. FOOD CERTIFICATE ISSUED
33. Final Electric e4ti247 ?22C Notes:
34. Final Heating & Air Conditioning / a�
35. Final Gas Pipe-Test • a
36. Hood or Canopy �.. _ ; L.,`
37. Final Factory Fireplace :A - : -
38. Final Plumbing .' - '•�a: ;t•,
39. Water Service-Final '. - i
40. Gas Service-Final .• - ° . '
41. Solar Domestic-Final -
42. Backflow Preventer r ' t ' 't '
'.l
.•43. Backflow Irrigation •'z. `:'; ( ; :•••
44. Landscape Irrigation System
45. Sound Attenuation • - _ t
46. Handicap Regulations - i' v:
10
47. FINAL STRUCTURE & BUILDING ro -
•
48. Special Requirements Completed � '
49. Electric Release to Edison .-, I I
1i
50. Gas Release to Southern California Gas Co ,... r •
51. CERTIFICATE OF OCCUPANCY
No. Date '