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2950 Airway Ave - Building Permits
CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT J PERMIT PERMIT NUMBER E99-00184 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 2950 AIRWAY AV Suite No Vicinity: Parcel Nunmber: 42716406 Applicant: MILLER, KEVIN FEE SUMMARY Address: Quantity Phone: Quantity ISSUE FEE $22.00 Zip: _ Temp Dist System / Lighting Owner: WICKETT, GEOFF Temp service test $0.00 Address 2950 AIRWAY AV $0.00 0 Res. a/c package $0.00 Phone: Standing Section $0.00 COSTA MESA, CA Zip: 92663 Contractor: K R M ELECTRIC INC $0.00 0 Address: 933 RASHFORD DR 0 , $0.00 0 Phone:, (714)579-0952 - PLACENTIA, CA - Zip: 92870 Lighting Fixts $0.00 License: 473148 SCOPE OF PERMIT 100 AMP ELECTRICAL METER SERVICE CHANGE OUT. (E99-00166). Status: ISSUED Applied: 03/08/1999 Issued: 03/08/1999 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically explre 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) 7545625 FEE SUMMARY Quantity Quantity ISSUE FEE $22.00 _ Temp Dist System / Lighting $0.00 0 Temp service test $0.00 Busway /100 ft $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res (3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool / Spa $0.00 0 ................up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 ................. up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 ................. up to 100 kva/kw $0.00 0 Switches $0.00 0 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $27.25 1 - Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $0.00 0 Service over 1000a $0.00 0 Circus ( gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp - $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 - 0 Plan Check Fee - .' $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 ' Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $49.25 Intermed Pole $0.00 0 - COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically explre 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) 7545625 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: �I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. ❑ 1 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 workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit Is valued atone hundred dollars ($1370) or less.) ❑ 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 workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these proAsl�n Applicant Signature: Date: r WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Uc. N / `/)' Class N 'L� — /-V Contractors Signature: '/Z fY... , Date:<^S�-9fi CONSTRUCTION LENDING AGENCY: ❑ 1 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: Lenders 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 Cade: 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 ($5GO).): ❑ 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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, falsawork, or demolition or dismantling thereof, will be more than thirty-slx (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sac. 341, Title 8, California Administrative Cade). ❑ 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 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mese Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................................................................. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 o1 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). ....................................................................................................................... .....r'o.pa.r'e.............................-................................enti........rogr...............utel......................atelia.. ? 3 Does or will the applicant or present or future building occupant need to prepare fln RMPP (Risk Management antl 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. .....................................................................................................................................................................................I.......................... 4 If en RMPP Is presently required, has Section 25534 of the California Health and Safety Code been fully compiled with? ❑ Yes ❑ No .......... .......................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this as plication appo mit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ NO (Section 65850.2 of the California Goverment Code requires that the requested information be furnished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it "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 proscribed by California Health and Safety Code Section 42303 been made ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... 8 (if 'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Dete CODE-S, INSPECTIONTYPE DAIS I6ImAL5 CODE l INSPECTION TYPE DAIS ItiTm•ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 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 Bullding/Cccupancy 2"4 B City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 2950 Airwav Avenue, Unit A-1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. Use of Building Office/Research Lab Legal Description 427-164-05 (See reverse side for Metes and Bounds) Building Permit No B 49860 Electrical Permit No. F. 4cASg Plumbing Permit No. P 4gg4cl Mechanical Permit No. M 50186 Number of apartments and/or guest rooms ISSUED TO: Analytical Technoloqies Inc. 550 Morehouse Drive, San Djcego, CA 92121 Building Official Thnv C'De Baca by_ Date March 8, 1991 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 Building Safety Department CERTIFICATE OF OCCUPANCY P.D. Box 1200 Costa Mesa, California The Building located at has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group"_ Occupancy. Use of Building 't•:'r" -`•�- Legal Description (See reverse side for Metes and Bounds) Building Permit No Electrical Permit No. Plumbing Permit No, Number of apartments and/or guest rooms ISSUED TO: Building Official by '8 Date 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. 306 fei U.B.C. Form BU 34 Rev, 11/70 CITY OF COSTA MESA BUILDING DIVISION i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us 0°.r FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B07-00948 PERMIT TYPE B_ROOF2 STATUS: FINALED ' , DATE ISSUED: 09/28/2007 ` ISSUED BY: BJK z ; JOB ADDRESS: 2950 A001 AIRWAY AV CM ' Suite/U.nit:,.,,,�A001 Vicinity: BLDG A 1 ` ^�� y'�'""� a'•' .. _ ' Squares: 4600 - Valuation:_:- x'-$14,514.00 i.. •-`r. � ,.fit^, 2�.tt SCOPE OF WORK: REROOF COMMERCIAL BLDG: T/O EXISTING CAPSHEET ROOF AND INSTAWNEW TITLE 24 COOL ROOF ENERGY CAPSHEET B.U.R. 14,514SF Z15'. Y'. r£`-...' OWNER: DOANE, PHILIP S TR x �=`�,';^, �31,_�Address: r 1306 E BALBOAiBLVD4a, Unit: PHONE: ->1 rr City/State/Zap NEWPORT BEACH, CA - - ��.'. APPLICANT: MC FEGGAN, BILL ky-ptJi Address: 1007 WGROVE'AV.hi.Unit: :UNIT D {L ORANGE, RANGE CAPHONE: 714-997-9449 Glry/State/Zip NOW- CONTRACTOR:IFAIRATHER - ROOHNGINC 1:"-•7; i z License No. 770565 Address: 1007 W GRO AVUnit: I.`UN4 :�-.`.�.w PHONE: 714-997-9449 City/State/Zip.. ORANGE A� (t� 92865 i 'rw e= CELL: ARCHITECT '14� Licen3e No.. i PHONE: ENGINEER- /�' h41�� �` 'r4 License Noa T t PHONE: FEEf SUMMARY iof'Plan Check: )of 'Permit Fee: r' -Y-' -4 �spectionFee: 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval vdll result in the expiration of this permit. 444E - 6`-I "-_ ' P23E-• ",` INML3 Q—M.-IxsPernOx rme ; "- -- _ Z*v 18Il➢4LS - 1616 Feed System Final Fra Prevenaon; - '1 . 205 -_ Final Mechanical - • x ' �' - 1288„ Pool Spa Final ,--_^_, y i 208Final Plumbing � ;: 200 Final Re-Roof�� i r . ��� 210 -Final Eleclncel. - 4st j „201, Final Block/Retaining Wall 212 - Final Fire Preventlon t 2D2" ; Final Factory Fire Place ' t l - J 220, Final Plennirig Approval - - '-�F,inal Sig` - - - 1-"" -,'.J 222 Fnal Site " 204 Final Demoiltlon� - tt" � ^''�-',� 250. FinaLBuiltling/Occupanq -_ f ,Y WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the ., .ing declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code. for the performance of the work for which this permit is issued. ❑ 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 workers' compensation Insurance carrier and policy number are: Carrier: (i a sei need not ee compieted 0 the perrm u valued at one hundned"are(E 100) w Jess) Policy Number: ❑ I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applmanl's Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. # Class # Contractor s Signature Date CONSTRUCTION LENDING AGENCY: ❑ 1 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: 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 natngr nee. imp _ dpmnfchnany ctnghup nrinr in itc 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 safe.). ❑ 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 contraccii license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature Date 305746 (3107) Owner ID verified by drive rise. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into Mich a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, N demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applleant's Signature Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1, Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from C!her _ pcn,_6o.^. c_...._t a:�rrict a g .cy° ❑ Yes ❑ "... (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 feel from the outer boundaries of a school? ❑ Yes ❑ No (if "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No, B. (If "yes', attach certificate o1 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 stale laws and city ordinances regarding Hazardous Materials and Emissions. Signature Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by [his permit until final inspection. Signature of Legal Ownegs) Andlor Authonzed Appgram (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2950 AIRWAY AV Suite: A003 Vicinity: ROOF, UNITS A003 AND A004 Primary Occ: B Eat<501 Office/ Bar<50 Type of Construction: Parcel Number: 42716402 Zoning: Applicant: TIM MCCARL Address: 126 COMMERCIAL WY ISSUED BY: Status: ISSUED Phone: 949-548-5569 Issued: COSTA MESA, CA - Zip: 92627 i Owner: WICKETT, NEAR -TR OF - Calc Valuation: $9,140.00 Address CANWICK EXEMPTION TR. Claim Valuation: $9,140.00 SMIP Res: BALBOAISLAND,CA Phone: SMIP Com: .909 E BAY FRONT Zip: 92662 Contractor: G L R ENTERPRISES INC/DBA CRANK BROTHERS ROOFING Address: 126 COMMERCIAL WY _ Total: $183.17,: Phone: 949-548-5569 . COSTA MESA, CA _ Zip: 92627 ,,. • License: • 828379 Arch' - Eng: Address: -Lek 0-0 - - . Address:', Front , 0-0 Rear, 0-0 Phone: Right 0-0 PARKING Status: ISSUED Applied: 06/02/2005 Issued: 06/02/2005 Phone: Zip: - License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL HOT MOP WITH 72# CAPSHEET FOR COMMERCIAL BLDG. 40 SQUARES TO COVER UNITS A003 AND A004. 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 it 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 2446-46(6=) FEE SUMMARY ' Plan Check: $0.00 Calc Valuation: $9,140.00 Permit: $181.25 Claim Valuation: $9,140.00 SMIP Res: $0.00 SMIP Com: $1.92 . Other: $0.00 Inspection: $0.00 _ Total: $183.17,: PLANNING& ZONING ' SETBACKS ' MAIN STRUCTURE.Front 0-0,i ; Rear 0-0 -Lek 0-0 Right "0-0" ACCESSORY Front , 0-0 Rear, 0-0 - Lett - 0-0 Right 0-0 PARKING Existing: 0 Required: 0 01 - 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 it 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 2446-46(6=) DECLARATIONS Ile WORKERS' COMPENSATION DECLARATION: 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. 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 workers' mpensetlon Insuren terrier and policy number are: Cartier. eed���N N Policy Number. ii Z.. ti aG� — ZOO S sectlon need not completed It the permit is valued at one hundred donors ($100) or less.) ❑ 1 cerlity that in the peogrimance 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 workers' compensation laws o Ili r I. and a that If I sh Id become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these sf m ) _ Applicant Signature: Date: b' -2— WARNING: WARNING: FAILURE TO SE ORkERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHAH SUMECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLIARE(E100, , 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 Ilcensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Lic. N Class a C— 3 9 Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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: Lenders 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 seta. 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 coniractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Masa Fire Department by every business which has at any one time during a reTorted 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). .................._...........__...................ant or ........_..cupant.....................�......_.ation f...........__.__...__._....................................._............__......._._.......__.__._......� 2 Does or will the applicant or present or future building occupant need to file a registration forth for acutely hazartlous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mess 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 orbic feet of compressed gas at standard temperature and pressure). ....._.._...._.................................................................................__..................._.__......................_._.................__......................_._._..._.................._................._........................._..._..............._..__................. 3 Does or will the a plicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ t�0 (Section 25534 of the California Health and Safety Code provides that the Costs 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 en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No ........................ ............................................................................................................................. ............................... _........................._......................_____.............................................. .................................. _... _......................... _... _.......... 5 Dees or will the applicant or present or future building occupant require for the work which is the subject of this a pllcation ao mit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on application for non-residential building permits). 8 WIII any part of the facility to be constructed untler this permit be within 1000 feet from the outer boundaries of a school? N (if "yes', the f rdlity must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade). ......................................................................................................................................................................................................................................................................................................................................................................................... 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 applicatlon, have all of the disclosures prescribed by Calitorria Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ........................................................................................................................................................................................................................................................................................................................................................................................... 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that 1 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 Mese to enter upon the abov"escribad property for inspectlon purposes. I agree not to occupy or allow occupancy of any building authorized by this permit unfil final inspection. SI in--at Leglner(s) Pate 2 n S AM&Or Authorized Applicant I Date CODE L MSPECnON TYPE PAR MURALS CODE INSPECTION TYPE 2AM 11TDISL$ 1616 Fixed System Final Fire Prevention ''— 206 Final Mechanical fib Pad Spa Final / 208 Final Plumbing .. 200' Final Re-Roof 210 Final Electrical 2 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BulldlnyOccupancy, (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cg UILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 ,lob Address: 2950 AIRWAY AV Suite: A009 Vicinity: UNIT A009 Parcel Number: 42716417 1 Applicant: GALLA RINI, MILES Address: 346 E MEADOWBROOK ORANGE,CA" Owner: BRADESON, BRIAN J Address ,16445 WIMBLEDON LN A009). TEAR OFF EXISTING ROOFING & INSTALL NEW BUILT-UP ROOF SYSTEM (35 SO). - HUNTINGTON BEACH, CA Contractor: 'GALLARINI, MILES Address: 346 E MEADOWBROOK FEE SUMMARY ORANGE, CA . Zip: ` 92668- Arch Address: i Phone: a Status: ISSUED Applied: 11/13/2000 Issued: 11/13/2000 Zoning: ISSUED BY: Phone: (714)974-6424 - Zip: 92668 - Phone: Zip: 92649 - - - Phone: (714)974-6424 License: 663983 - i.�. Eng: Address: - - - Phone: - Zip: License: License: - SCOPE OF PERMIT- _ REROOF EXISTING COMMERCIAL, BUILDING FORT_ IME CLOCK SALES- (UNIT A009). TEAR OFF EXISTING ROOFING & INSTALL NEW BUILT-UP ROOF SYSTEM (35 SO). - - - FEE SUMMARY Plan Check: $0.00 -- -- = Calc Valuation: $6,000;00 Permit:. $153.25Claim Valuation:." $6,000.00 �. SMIP Res: $0.00 SMIP Com: $1.68 Other: • '10.00 .Inspection: Total: $154.93 �- PLANNING & ZONING �;.. SETBACKS�� -Rear. MAIN STRUCTUREFront-"�0-0 0-0 Left 0-0 = Right - 0--_0./ ACCESSORY Front 0-0 Rear- 0-0 Left , 0-0 t Right:' 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 (6100) .or DECLARATIONS WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the or for which this permit is issued. � 1—have and will maintain workers' co pensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. *My work rr ' pons Ito IIn,Is�urr a carder and policy number are: Carrier: - Policy Number:, -zi FSS I b S6 '(This section need not be plated i/ the Peri( is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the wor c for which thisilpermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of alifomia, and a r t H I sh tl become subject to the workers' compensation provisions of Sec on 3700 of the Labor Code, I shall forthwith comply with these p v (ion Ali-- I �D,- 11. 13tDD ignature:— WARNING: FAILURE TO SECAE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND S1 AIMINAI 6ENALAES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3108 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9( mmencing with Section 7000) of Division 3 o(ihe Business and Professions Code, and my license is in full force and effect. LIC N� Class'k—`"` Contractors Signa"" �D, - 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 ($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 property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code : The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, 1 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 t0 release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................................................................................................................................................................................................................................................................................................................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..............................................................................................................................................................................................................................................................................................................._....................... 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ................................................ .................................. ............ _...... -........................................ ....................................................-.................. .......................................................................................................................................... ......................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a aye" It a eil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Ves No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any par of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑Ves ❑ 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 [:1 No ........... .....................................................................-..........-.............................................................................. ................................... ................................... .... ......... ....................... ... ................................... .......-...................................................... e (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. n e Of Legal Owner(s) Date . it -13- n rAuthorizad Applicant�,- _ Lt -Date CODE 1. INSPECTION TYPE PdTE INTmALS CODEC INSPECTIONTYPE 2ATF Its 1616 Fixed System Final Fire Prevention - 206 Final Mechanical 1266 Pool Spa Final z �l 1-1 208 Final Plumbing 200 Final Re -Roof / �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 F C a PAIL i!1;490-77cn,.003044" **¢8019, t ' ';COSTL\ MESA BUILDING -SAFETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 �! APL ATION FO STRUCTURA PERMIT "'Nior Applicant to Fill in Completely — se 14 O RE ED V D E CEIVE TE I UE BUILDING ,�A. C. A4 ADDRESS 'Z77 PERMIT NO. OWNER ' A.P. MAIL $✓ !/ BUILDING ADDRESS; G - ADDRESS 72663 TEL - CITY NO. 1ff16 Fall. TRACT LOT J ', BLOCK W A AL R P CONSTRUCTION LENDER X1 A— BRANCH OWNER • ADDRESS VALU S Ah L. �. U &p/ dp ENGINEER NOrr ADDRESS ZONE VPE GROUP APPROVE �l/•a CONTRACTOR BY DATE ADDRESSSVig IVCW Agel Z 7 NOOF VUE OF - CITY' OL 10 LAN BLDI / STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF SLOGS. -. (FROM C/L E E T OF LOT NOW ON LOT RONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT Separate permits are required for L. SIDE F I FT. electric, plumbing and heating work. REAR T. T. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN MAIN SLOGS. ACCESS. BLDGS. __ �: CE' VAR .+ /J C.U.P. DATE APPROVED Q APPROVE .�v P.O• �ATI�D `2 �i ' � � \ I hereby acknowledge that I have read this application and state 'n that the above Information is correct and agree to comply with �% all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws%f J 0 's the State of California. - I hereby certif r that I am property licensed as a contractor under O. FT. ami THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, ON. on ,3, m� Chapter 9, ane that such licenses are in full force and effeci, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from the provisions of the State of California Business m a VALUATION PERMIT FEE $ and Professions Code v Ion 3, Chapter 9. �PLAN CHECK $ e Signature f i TAX $ �s Parmittee yv vV Mired Agunt D TOTAL PAID $ 94 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 2154 6/30/79 53.30 TL s - APPLICATION FOR STRUCTURAL PERMIT RE V PERMIT - I N2 — 48727 For.;,pplicant to Fill in Completely — Use Ink Only BUILDING ADDRESS P A.P. NO. ......' OWNER T`d fJs TENANT.J // (Y V yj tj �7 �` ADDRESS L J O f w 'A MAILING UNIT SPACE NO. ADDRESS ,�-�j. TR.NC_,d.,o9,1 OT ,—I BILK. CITY x1le Pjpj'-I P NO. L) NEW ADD LTER REPAIR MOVING DEMOLISH CONSTRUCTION / /� q LENDER %✓ /'�t� BRANCH OWNER ADDRESS V UE ' ARCHITECT /.AIC P0-" TEL. Sj VSE r . OR ENGINEER No. ADDRESS / B b"'q Q PodeT (a op ZONE TYPE GROUP COSTA ^e SA APPROVED CONTRACTOR r( i✓ BY DATE ADDRESS o CITY 6DS7—/9 74 /1eyNOL STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF BLOGS IF ROM C/L STR EET) OF LOT NOW ON LOT FRONT USE OF EXISTING BLDG. Separate permits are required for L. SIDE electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE �4 APPROVED 64 APPROVE (l IDATF u 7O1 I I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shell not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. the State of California Business and Profession, Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E �O end Professions Code, Oivlsi Ch/°{�Jter 9. • Signature of QC/ t 22n ©O PLAN CHECK E /JO �0 Permittee S / TAX Eor SQ Date 2 _ZTOTAL Authorized =111 PAID E s n 417 3 i — • COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 OCT 26-77i SA001424 .***332.50 Il� APL AT ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RE DATE RECEIVED DATE ISSUED BUILDING ADDRESS PE OWNER A.P. NO. MAIL BUILDING /A„' ADDRESS ADORE zCK� TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION AMOVING LENDER BRANCH A OWNER // ` . ADDRESS VALUE USE $ ARCHITECT TEL. OR ENGINEER N FIRE r% ADDRESS ZONE PE GROUP FL••� APPROVED CONTRACTOR BV DAT O' ADDRESS TEL. ZONE OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STR EET) SIZE NO. OF BLDGS. OF LOT NOW ON LOT FRONIT FT. FT. USE OF EXISTING BLDG. A. SIDE FT, FT Separate permits are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUI NG AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. SLOGS. VAR. 96 DATE C.U.P.+ APPROVED APPROVED DATE I hereby acknowledge that I have read this application and state 'n n that the above Information is correct and agree to comply with m \ all laws regulating building construction, and I shall not employ s any person in violation of the workman's compensation laws of m the State of California. - m/ I hereby certify that I am properly licensed as a contractor under SQ. FT. tv THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, DL ro V Chapter 9, and that such licenses are in full force and effect, or I Chapter THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business' a VALUATION PERMIT FEE $13921h antl Professions Code, Division 3, Chapter 9. PLAN CHECK § m o 0 Signature of TAXy Permittee $ & U TOTAL PAID 5 2 Authorized Agent / Il� --COSTA MESA BUILDING—SAFETY DEPARTMENT P.O. BOX 1200 Costa Mesa, California Address ity License No. 006303 N0. ITEM FAU, Wall, or Grav, Furn. Incl. Ducts and Vents Vent Ill not Incl. or Repl pliance 3 H.P. or # X I Alteration additional Fee Sub -Total Processing Fee TOTAL FEES CMF 0449.46 } 3698 TRACT N0. & SERVICE LOT N0. Parmlt'L 88 Circle COZ�CIAL c USE T/ ISSUE_I Zip code 92807 J 3 Class. C-20 BUILDING 2950 Airway Avenue, Suite # A. Tel, No, 630-6412 ADDRESS EACH FEES COSTA MESA, CALIFORNIA OWNER FWD SALES WEST, C'' MAIL ADDRESS 2950 Airway A e lue, Suite # A-12 E CITY COSta Mesa TEL. NO. I herebyalnwlledge that I have read this application and,steyeSthat the above is correct and agree to comply with tell City Ordinances and State Laws regulating Hea[- ring4Ventilating, Refrigeration and Air -Conditioning. I certify that I possess the above valid State of Calif- omia classification or I am the legal owner of the single family residential property described above. Signature f Permittee RalARKS: Ducts Underground Ducts in Structure 00 Ducts Ventilating Heating — Rough Hoods Refrigeration Lines Pressure Test AAir-Cond. Final Ventilating Final Heating Final 3 00 Refrigeration Final Final Gas Test Utility Co. Notified BLDG. PERMIT NO. R— DATE 41 A tj C09TA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only 0117906 APPLICATION FOR STRUCTURAL PERMIT BUILDISS �OZ`l15CL7 rzwaY�-CVn A.P. NO.ADDRE OWNER OR w)In1IC:) JtiTZ47=� J.JCi'VN� TOL BUILDING ADDRESS TENANT MAILING e2C1 D l,XJQLjWig, UNIT OR / SPACE NO. (� ADDRESS r'.—T' TEL. Cj51 T O LOT BLK. ^ _C _� _ ��Q CITY t..��L�.� NO. NEW I ADD ALTER IREPAIR IMOVINGIOEMOLISH CONSTRUCTION LENDER BRANCH T w OWNER ADDRESS I VALUE ARCHITECT— TEL. USE ce, _ OR ENGINEER ADDRESS ZONE 49 TYPE GROUP �((�� APPROVED sl 9O 7 BY DATE T G CONTRACTOR --yu hl. t ADDRESS ..., �� CITY �p'.,ti�1E� NO. STATE 3 S CITV �'l�,s APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF SLOGS (FROM C/L S_; -REE T OF LOT NOW ON LOT ONT FT USE OF (�"�{ G EXISTING BLDG. Separate permits are required for L. SIE FA I electric, plumbing and heating work: R E AV FT. USE OF BUILDING A Z %7r, TO B�PERFORMED PLANNING ACTION -QW DATE APPROVED 1...��f•-,tt A�_�!'] S yaacknowledge APPROV O II hereby that I havee read this app—plication and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E 07) and Professions Code, Division 3, Chapter 9. PLAN CHECK § �p VQ Signature of I s 1 ty M _ _ - Permittee �1J�.7��M �A'i �� c $ 2�p♦`�Q or TAX E Authorized Agent Date 47L=7 TOTAL PAID E Tll c r, k_. 3886 6/09/78 COSTA MESA BUILDIN -SA TY DEPARTMENT 1 4,0T80X 1200 COSTA MESA, CALIFORNIA 92626 / R16 0 0 AP L19ATION FOR STRUCTURAL PERMIT For Applicant to Fill in Comple y — Ink Only REC I DATE RECEIVED D !;UE B� A NG UILDING ADDRESS Cj d / {// /nGJA OWNER -3'� PLOP s-rms A.P. NO.-Ipc/-IILI�II P T MAIL �-n /��P�T C�Qp ADDRESS BUILDING / `/Gl 'tf ADDRESS O vG CITY /,,JP6 f'(— �� /� NO. C O / TRACT JI C LOT5J BLOCK CONSTRUCTION LENDER BRANCH OWNER T/(� ' .�... ADDR aSS ��Y4LUE /s/KL�I�i.% OR ENI INET . TEL. JL $ Il' fill ADDRESS 0� 1 � .4fi,4.Jfsr c O. lie l'j& FIRE L'.;% ZONE VPE GROUP r 7 `•-,�,�[-" APPROVED _ CONTRACTOR [.d(/ qJ 8V DATE ADDRaSS TEL. ZONE NO.OF USE OF NEW Znal JfOr CITY NO. %!�: PLANS BUILDINcya STATE CITY YARDS APPROVED YARDS APPROVED LIC, NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLOCS. (FROM C/L STREET) OF LOT I NOW ON FRONT FT FT. USE OP EXISTING BLDG Separate permits are required for L SI FT. electric, plumbing and heating work. REAR FT, FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLOCS. ACCESS. SLOGS. VAR.# DATE C.U.P. 4% APPROVED APPROVE �J l 4T I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that 1 am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, andffect, or I Chapter 9, and thegpleh licenses are iMofC THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from a ovisions of the BusinessVALUATION Professions division apJ PERMIT FEE S and Signature of 3, PLAN CHECK S TAX $ S J([�J�)") _ t/Permlttq TOTAL PAID S Authorised AgentV R16 0 0 1 4 7:4,0 � -754 - P2Z� `2! 4100 2/26/79 2266 COSTA MESA BUILDING -SAFETY DEPARTMENT ' 4100 -2/26/79 26�e.6C6KT S P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 61'00 00004475 62 IA _ A LIC TI N FOR STRUCTURAL P@ Fill in Completely — Use Ink Only RE El=d BY DATE RECEIVED DATE IS UE (y. oAi [AD7DRESSJ /�r -42 7-I/ PERMIT NO. ,e A.P. NO. // �/�ADDRESS Q ,� '• 1'� d A 7 TE � CIT 2 O. TRACT 7V0y LOT BLOCK CONSTRUCTION NEW A P LENDER BRANCH �tX, Gv OWNER GL,yc s U ADDRESS VALUE 2� �- ARCHITECT OR ENGINEE '^ ^-_ LLr ADDRES �'Tr W1 FIRE ZONE PE GROUP APPROVED CONTRACTOR(`j t �(: .� BV DATE ADDRESS �•�jt () .J AE„� ^ y• ••.. "' TEL �p ZONE M NO.OF PLANS 5Z USE OF NEW ) �1/ % BUILDING CITU F� \ NO r �j / <� STATE / � CITY LIC. NO / .�I��i' LIC. N YARDS APPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING SIZE NO. OF BL (FROM C/L STREET) OF LOT NOW ON LOT RONT FT. FT. USE OF EXISTING BLDG. p Separate permits are required for L. SIDE F L FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. SLOGS. G VAR.* DATE C� C.U.P.#s APPROVED APPROVED ewe I hereby acknowledge that I have read this application and state '^ n that the above Information Is correct and agree to comply with m all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of m the State of California. I hereby certify that I am properly cenwd as a contractor under SO. FT. v THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California 8usine an rofessions Code Division 3, m Chapter 9, and that such Iica s r In full force an effect, or I THE PURPOSE OF ESTABLISHING A PERMIT F ONLY; am exempt from the ovist sof State of Calif is Business a VALUATION PERMIT FEE E and Professlons Code i�llsl 3, h p r 9. m Signature of 1 LAN CHECK E A 57, 0 n Pe Permittee $32-, ✓ TAX E F u Authorized Agent TOTAL PAID E Applicant to fill to all Spaces except those within heavy bottler lines and Sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT H L Project Address - Zn o 41r_V4&"e 44� �7�,, Applicant's Mailing Address , Owner's Name tA��pPhone Address 7alZJC7 %_._r_=_...�`/t�:�'�.��. Arch/Eng, License No. Address G Contractor's Namo4l:?I li'V1 '1 Phone �.4� ((G1,J Address (mailing) S"' City License No, pLICENSED CONTRACTOR DECLARATION 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full forcg License lass: ✓�^}'�'F—S' License Nal c•+ DateSig at t WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sell -insure or a Certificate of Workers' Compensation Insurance, or a Certified copy thereof (Section ' a k y No�t�x.i/�s./y FJl7 C6mpanyentified copy is Hereby fufnish¢d.ertif'ed cc Is fie with the city lion, Division. Date Applicant E: MP ON FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed it the permit is for one hundred (8100) or Ier I certify that in the performance ofthe work too which this permit is issued, I shall not employ any R¢ i0 any manner so as to become subjatt to the Work@r4' Compensation Laws of California. Date SiSignature NOTICE: C after making provisions declaration, you r Cod become subject to the Workers' Compensation provisions this the Labor Code, you must forthwith Comply With such provisions Or thin permit Stall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there i5 arCw. ipn lending agency for the performance C.) Of the work for Which loisis permit is issued (Section 3097 CIV. C.) Lander's Name Lenders Address OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's license Law for the following reason (Fectlon 7031,5 BusmeS5 and Professional 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/she 15 licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotle) 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 Lila applicant to a civil ,naity, of not more than five hundred dollars 1000). I, as owner of the property or my employees with wages as their Sole .mpensation, will do the work, and the structure is not intended or Offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property Who boiW$ or improves thereon, and who tloes such work himself/herself Or through MS or her own employees, provided tnat such improvements are not intended Or offered for sale, if, however, the building or improvement is sold within one year of com, pi@Uon, the owner will have the burden of proving he/She did oat build or im- grOv¢ }Or the purpose Of Sale). LJ I as owner of the property, am exclusively contracting with licensed Con- 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 builds or Improves thereon, and who contracts for such projects with a Com tractor(5) ucen Se pursuant to the Contractor's License Law). 1 am aware that Pico f Ofi their Worker's Compensation insurance Should be Provided to me. 0 1 am exempt under Section 8, & P, C. for this reason Date Owner I hereby certify that I have rea informal ion is correct, I agree to and state laws relating to builQQn somatives of lb"_city to en Car Drivers' License or SS =. TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION U REPAIR Showers ❑ CONVERSION ❑ DEMOLISH 0 OTHER ELECTRICAL FEES A.P. .# DESCRIPTION OF WORK/USE OF BLDG. Service Sink Automatic Washer Transformer 0 15-50 KW Construction Pole Sub- 0 50 + KW Backflow Irrigation 5 Main Buildi Bathtubs Sewer Connection TYPE OF PERMIT GRADING FOUNDATIONy LJ STRUCTURAL T Front 0'a TENANT 0 ELECTRICAL 0 PLUMBING $ MECHANICAL B i— LJ OTHER A Rear PROJECT DESCRIPTION SO. FT. OCCUPANCY C KLeft Right CONSTRUCTION TYPE VAWATIONS S Swimming Pool w/Spa ZONE GRADING CU.YDS, ACRES Ping. Ref. Remarks: IA\la=-crAI L �:X 1 Urinals Planning Notes: 4148 Zone Accessory Building: Z O N N G R Parking ReOL/Provided E O M APR 2 9 1989 T S Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Construction Pole Sub- 0 50 + KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter Dula to 100 amps Clarifiers Solar Collectors Dishwasher Meter Cover 100 amps Dishwasher Solar Piping Dryers Gas OElectric Sub Panel Drinking Fountains Solar Tank Fan Motors 001 HP 01 %- B Floor Drains Swimming Pool w/Spa F,A,UInc. Solar 09.15 HP 016-15+ Floor Sinks - Urinals Fixtures Microwave Gas Service Outlets Water Closet Device Boxes Poll, Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal Standing Sections ` P --Trap Laundry Trays Generator 00-5 KW 115-15 KW Trash Compactor Roof Drains Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee I Issue Fee $ 3 MECHANICAL. FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By nate Building Approved By Dat Application Issued By Dat Boiler Hood ar Type 0 Canopy Type i 1 0 Duct , Under Ground Duct - Structural Refrigeration System 0-100,000 BTU 0100,000 BTU Duct - Ventilating SUMMARY OF FEES BUILDING PERMIT S SMTP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ - PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING S PLAN CHECK 50%�_rs ) MICROFILM $ 1,2 1 � MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ Exhaust System C -Multiple C _F_ System Repair/Alteration Firepl/Fact. Bit. ICBO #' Fire Dampers F�F_ Heating System & Ducting 00-100,000 STU (3100,0008TI. Registers FRoinspection Fee $15 Issue Fee $ 3 ,086546, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting: Goldenrod - Assessor CONSTRUCTION AND,PLANNING APPROVALS Permit '# Date Inspector POOL & SPA 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 V:0 ' 5. Steel Reinforcement 56. Rough Plumbing & PressureYT.est - 6. Electrical LIFER 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 Ondrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK V 1 U -11.+Property Sewer Line & House Connection 62. Backwash & Receptor -Finals 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 APPROVALS Permit # ' 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush , 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00iI - 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 �r1 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED ;cul 33. Final Electric Notes: _ 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37•• Final Factory Fireplace t -• 38. Final Plumbing •39. Water Service -Final ',40. Gas Service -Finial v 41. Solar Domestic -Final -42. Backflow Preventer - - 43. Backflow Irrigation '44. 'Landscape Irrigation System 45: Sound Attenuation - - t 46. -Handicap Regulations„ , 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed '• 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co -' - 51. CERTIFICATE OF OCCUPANCY No: Date i PROFOONESS: 2950 AIRWAY AV UNIT: n� Div, NAME: J D GANTES AIRPORT ss:PROPERTIES P O BOX 8147 NEWPORT BEACH,CA 92658 (619)458-9141 ARCHIENGINEER: BOWMAN S BOWMAN REG.No.: NONE ADDRESS: 750 THE CITY DR UNIT: 150 ORANGE CA 92668 PERMITTEE: ENTERPRISE RECONSTRUCTION (714)757-1884 ADDRESS: 1928 E DEARE 110 S.A. CA 92700 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Derision 3 UI the Business and Professions Code, and my license is in full force and ellecl.CITY / Date uc.0 17 9 STATE tic.: gni < G/'y,,,s B„G`'c/GEIR t— Date: 0 Signature:%a�'�— WOR%ERS' OMP NSATION DECLARATION: Ihereby alhrm hall have a certificate of consent to sell -insure or certificate of Workers' CampensaO Ls,ra4b1 a4cefl,L.0 r6py t,^jeryol (Section 380D. Lao. 8 4 / 2 1 / 91 POLICY NO.: W Y 7 9 7 b 1 E%P:9ATF: LCONPANY: FREMONT IN�}D/E�M 'eJI CenifledJy is/h/gJebnyfurnished. benilied copy 6 lied w lhyyy a city W g Dentin,Oa_ %_,( ApplicantEXEMP,/OR%ERS' COMPENSATION DECLARATION: (Tlds section need 1 be mmplered II illi pant is for one hundred ($100) or less). I Lenity that in the performance of the work for which this mumit is issued. I shall =1 employ any Person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: IL after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shah be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pedormance of the work for which This permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Stale License Law lot the following reason (Section 7031.5 Business and Professional Code; Any city of county which requires a permit to construct, alter, improve, demolish. or repair any structure. prior to its issuance. also requires the applicant lot such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9(commencing will Section 7000)at 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 Into live hundred dollars (5500). I. as owner of the property or my emppldynes with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Seclion 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/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 will have the burden at proving he/she did not build or improve for the purpose of sale). I, as owner of the propen. am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Slate License Law does not apply to an owner of properly who builds Or improves thereon and who contracts for such projects win a contractor(s) license pursuant to the Contractors' Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: 8. 8 P. C. for this reason: Dale: Owner I do hereby cenify that I am aware at and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that l or any future building occupant wilUwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Oualdy Management District. Residential construction applications are exempt from these provisions. Date: AD k,or: Ihereby certify that I have read this applicalio and slate that the above information is Correct. I agree to comply with all City and bunty ordinances and 51ale laws relating to building r nvruction and hereby aNhor¢e epresemativeso ' ity to en upon the above -m Boned property for etli purposes. Dale: Shgnalure: Driver's License. Social Securely nr 1641-46 While—Building; Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 049860 PLAN CHECK NO: 05760-90 S CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; INTERIOR ALT'S TO OFFICE/RSEARCH LAB SQ FT: 4,059 CLAIM VALUE: 19,000.00 CALC-VALUE: 33,490.00 GROUP OCC: B-2 / COMMENTS: THINK SAFETY! *+Fae9E*�E�E9E1Eif**96*iEriP*tE��Ar+E+tlekiPYP9EaE*�E*iE*iE+E*BPaP9e+k***rt*aF*�aE�t*a!9taF1Er�E�1F�E�*fE**9fiE9EAFa6iEiP�**9E�r Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42716405 ZNE: MP REF NO: PLANNING NOTES> 4059 SF INT ALT TO AN EXISTING INDUSTRIAL BLDG. > USE TO BE RESEARCH ORIENTED FACILITY. D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY GL DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY:DATE: k kit kit iE iEM***�E iF iF 3f iF if kiF iE iE 9P *iE*1E AF i!iF �E*ie AE at IP AE if**iE iP*ick*iE iE**kEe**iP aP iF*iE AE iE iE*iE 9E iE iE IE iE iE iE 1E 1EiF iElE#iE kEk It iEkkkiE4aEk**kkiE iF4 aE iF M iE iE AeiEiF aE tE iE )E iFie lF sit iE sit LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 310.50 SMIP/NON'-RES PLAN 201.83 5.02 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 315.52 0.00 201,83 517.35 517.35 .00 REVENUE DIVISION TOTALS—> COLLECTED: 315.52 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 310.50 5.02 iE iF 9Pk 3P IF IP aE***if iFk Mil*iE ifM*iE iE iEk le 9E if kiP**iE*iE*iE IEM�at*aE fP a[•aE 1E k aE*kIF IE tEk*te iE iFiE iP IPiEit k iE 3E*k9e fE at*iE iE**iP la I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 2786 OFF -INT, ALTER TYPE V -N -AVER 10x,12 28,194,32 SFC 1273 WAR -INT, ALTER TYPE II V -N -AVER 4,16 5,295.68 �_-END bF FEES 01 00073267-00073868 T CAT .5.5, DATE: 11/09/90 TIME: G?:01 S CONSTRUCTION AND PLANNING P & SPA 'APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector Temporary Electrical Servic-of Pole.; % 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. t.;;�, 53. Steel Reinforcement /. - r ,!� i. 3.'Electrical.Condu1t Ui:ilityUndrgrnd. ( 54. Forms ' .4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , Steel Reinforcelpi nt 56. Rough Plumbing & Pressure Test _..5, .6...,'Electrical UFER.Grnd. 1.. " '57. APPROVAL TO COVER-GUNITE ' 7. Fooirigi�'- 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test i 9. Water Pipe'Undigrnd. - 60. Backwash Lines, P -Trap, 0 Undrgrnd. i 10. Structural FloocSystem 61. APPROVAL TO DECK 11. Property Sevier -Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap '- L 63. Heater & Vent -Final �I 13. Roof Drains- �4ii 1 64. Plumbing System - Final 14. Rough Plumbing; i) 65. Electrical -Final 15. Rough Elecviral-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 'r"• +APPROVAL& 'Permit # •_- 20. -Rough Factory Fireplace 'x•^ • - .: v^., 21 :Ducts, in Structure, 21, '-t - - rt' -'70. IJndergrou`V�d Hydro • 22. Ducts, Ventilating;. ' _ y = • ;_ 71, Product7Plping O'Gas 00il 23:;Gas Pip's -"Rough &Test `, 72. Undergrountl Flush': 24...Ro6f Framing I Jr + : S73.-'Undergrrid.StorageTank'OGas 0Oil_ .. 25. Roof Sheathing'74;-Overhead�Flydro :" c 26:7 -Bar Ceiling (Structural) & Monocoat • - u' 75^Dry Chemical 27:. Frame and Flashing ;, a • �,; 'ter,, 76:"15ry Standpipe r,� .', 28. Lathing & Siding -• „y:, .r, t; �< .t 77. FIXED SYSTEM FINAL - 29. Insulation 78�,'FIRE PREV. FINAL 'r30. Drywall7Nailing ' .HEALTH�DEPT-. REQUIREMENT 31. Plaster Brown Coat` _79< FINAL INSPECTION _ -32 Electrical Power Meter -Final .. :$0.: FOOD CERTIFICATE ISSUED .33 Final Electric"Noses: '-34,- Final Heating & Aii Conditioning, 35.; Final Gas Pipe -Test •.-, , .,36. Hood or Canopy i i !. ��^ r, 37.=Final Factory Fireplace, _ ' " •� •" I r 38, Plumbing �v c, I -Final l I - 39'. Water Seivice�Final �� I �' - •r 40', Gas Ser34ce-`Final 41. -Solar Domestic -Final - -- - 47. Backflow Preventers 43. Backflow Irrigation "... S •i : - 44. Landscape i rigation System rl= : ," „ - �- i; , '" .-; � .�• .45.. Sound Attenuation > •-'. , r G 46. Handicap Regulations - _ �• 47. FINAL STRUCTURE & BUILDING /7-I3" - D'? ' 48. FINAL PLANNING 49. -Electric Release to Edison 50. Gas Release to Southern California Gas OD 51. CERTIFICATE OF. OCCUPANCY nc i No. Date IrBODDNESS: 2950 AIRWAY AV UNIT: A� 'a S M4ME: J D GANTES AIRPORT ADDRESS: PROPERTIES P O BOX 8147 NEWPORT BEACH,CA 92658 (619)458-9141 ARCM/ENGINEER: BOWMAN S BOWMAN REG.NO.; NONE ADDRESS: 750 THE CITY DR UNIT: 150 ORANGE CA 92668 PERMITTEE: R. C PHILLIPS (714)675-5599 ADDRESS: 31§ ONYX AVE, BALBOA ISLAND CA 92662 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7DOO) of Division 3 of the Business and Prolessions Code. and my license S in lull force and effect. CITY LIC.: 03 185 STATE LIC.(99555_ - Cess: — Date: I QQ signature: //�� O� WORKERS' COMPENiATION DECLARATION: I hereby affirm that I have a cedificale at consent to selhinSure or a certificate of Workers' Compensation Insurance. or a carolled copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need rwl be Completed if the pend[ S for one hundred (St OO) or less). I certify that in the performance of the work for which this permit is issued. I shag not em joy a r5on in am/ manner m as to become subject to the V rkers' one;sation La . California. n ^_y/� / Date: %� 0 Signature: e..- �l I NOTIC : I1. at, making this declaration, you should became subject to the Workers Cumpensztion provisions of the Labor Cotle. you must forthwith comply with such provisions or this permit Shan be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the performance of the work lot which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law tar the following reason (Section 7031.5 Business and Professional Cade: Any Gay of County which requires a perrnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to life a signed Statement that he/she is licensed pursuant to the provisions of the Contractors' State 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 two hundred dollars (5500). 1, as owner at the properly or my em pployees with wages as their sole compensation, will do the work, and the structure is nal intended or ollered tar safe (Seclbn 7044. Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/hersell or through his or her own employees, provided that such improvements are not intended or offered for safe. If, however the building or improvement is sold within one year of completion, the owner win have the burden of proving hulShe did not build or improve for the purpose of sale). "as owner of the property, am exclusively Contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors State Liberal Law does not apply to an owner of propefly who builds or improves thereon and tubo contracts for such projects with a contractans) license pursuant to the Contractors' $tate License Law). I am aware that prool of their Worker's Compensation insurance Shedd be provided to M. ❑ I am exempt under Section: B. 8 P. C. lot this reason: CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 049949 PLAN CHECK NO: N CON:iTHUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION ; INTERIOR ALT'S TO OFFICE/RSEARCH LAB SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: RE: B49860 PRIMARY BLDG, PERMIT, Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN LEFT: ppFT IN RIGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING RE(3�'ES> PROV: PARCEL: 42716405 ZNE: REF NO: *iFKk**ia**9e**iE it**iF BE iE*BEiE EE**Bt BEiE iF Bt***aE ie iF BE TEie*it BE BE*1E9EiE,iE aE 4e4E*iF*if*ie*iE***BPiP iE 9E if iE ie lF *3F as if***** D E V E L O P M E N T S E R V I C E S�— R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: I O if*BF iF iF*#M****lE*BPitit*iEiE*BeiFiFiF'iFBFBF'{F7FiF 3F'iFiFiFiEiF'aFiF iFiE7FiFif'£RFiFiF'fF w-***iF iE kE*** ** 8E*ie**MiP***M*#iE*MBP Ie 8F 8E*********af if**iE FP iE BF N•ie ie iE iek*iF*iN k3f 1F 8E M>E Be BF***iEie iFiF*Ra***if iE iE tE 7.t*iE it*9F*x LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMBINNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING 00 '5% SMIP/NON—RES PLAN ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 6,00 3,00 0,00 9,00 9,00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 9,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 9,00 aF*4MiFM%iF MBe iF iE BF if*ie*ie BE RP**iF 9E 3F*is iF BfM MBE iE ikK ksPBeiE BE IE**iP NE ie i( le iF ae iE***iE *eE lF*iE*>F*iE**iE if *IF 9f lest kit*iP** I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale: owner: P L U I do hereby verily that I am aware of and understand the requirements of California Health and Salety Code Sections 25505. 25533, and PL U 25534 and that I or any future building occupant wtlVwin not (Circle one) need to Comply with Mid State Codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is Correct. I agree to comply with all city and county ordinances and state laws relating to building y5astrachan and hereby authorize represenutnes of [his G y to enter upon the above-mentioned property for inspec 'On pure ses. f/ n Date: Signature: ` 9,i� Driver's License or Social Security N: 164146 While—Building; Green—Code Enforcement; Canary—ApplicanC Pink—Revenue: Goldenrod—Assessor 2 SIN 1 SINK§,SERVICE / MOP END OF FEES 2.00 4.00 2.00 2.00 01 00074213-00074217. TOT DATE: 11/14/90 TIME: 14:50 9,Or . CONSTRUCTION AND PLANNING P &SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Tzmporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. '. C( (�j -;L 53. Steel Reinforcement ' 3 "Electrical Condti t Utility-Undi rnd. 54. Forms `:4 Electrical:Conduit-Undrgrnd. 55. Electrical Bonding �Y5. Steel,Reinforcem ent 56. Rough Plumbing & Pressure Test _ .i .�6:.Electrical UFER-Grnd. u 57. APPROVAL TO COVER-GUNITE Footings-1 _ < _ - 58. Electrical Conduit-Undrgrnd. " 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water PipeLUndrgrnd. 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 CapIx 63. Heater & Vent-Final r 13. Roof Drains2 '• `, 64. Plumbing System - Final re 14. Rough Plumbing 14111f CW 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric-Wiring 67. Fencing & Access Approval 17. Rough Wiring$ign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling- 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 'APPROVALS J_-Permit # .1 - 20 ^Rough F.actogy Fireplace i a '• �."� r ^_ •`i ° 21, Ducts, in•Strgcttire. ... _ + 370. Underground Hydro _ 22. Ducts, Ventilating + ^ `- 1 "-' j71. product Piping OGas []Oil _ 23�;Ga`s PipelRo gh & Test i ,n 1 + y.72. Underground FIus,F, - 24t7`Ro6f FIemirjg 1::A' 1"H •IT + _ t y.73-VUndergrnd'.StorabeTank,:0 Gas 00il i� 25. Roof Sheathin �' 01 9 ,k r T ^_'1 _ 1,13 .1 u.; O r•: '} 74^,Overhead Hydro_ .1 267.7-Bar Ceiling (Structural) &.Monocoat f w l Iq? 757Dry Chemical 27tFrameandFlashing ' 76�Dry Standpipe -.:28- Lathing-& Siding^ i cj 7 : z , t: ;. / i 77,. FIXED SYSTEM'FINALI ''29. Insulation 140 ti .. .1 I i; :; 78-FIRE PR EV. FINAL X30. DrywalljNailing ❑ 1 } t . - ':�l _•,HEALTH'DEPT. REQUIREMENT I I '- 31. Plaster Brown Coat 3 i 4 a �t (1 f r-1 l i t F�NACIN$P,ECTI,QN ti I lrn• F r79. u1 U32.: Electrical PowertMeter-Final 1 a • i 80-.FOOD CERTIFICATE 19SUED 33. Final Electric I I `'No{es:l f- J �(Ai�rM -� _(460 I; ..q0 . ,. Q�( + 34, -Final Heating & Air Conditioning. ; •• ^ I is x -c; ,^.x _ .., n 35:'_'Firia'I Gars Pipe-Testy . X36'.` Hood or ;Canopy •;. •' + 1 ' `- -'37PFin5l Factory FireolaceT. �' `- I� ' r I I �; ' r! „1 -38. Final PI'umbing pl tr 39. Water Service-Final' n 1 r ^ 40. Gas Service-Final !: r , - '� I -'41. Solar Domestic-Finalr rl• CTS I :+ <•� r + 42.. Backflow Preventer, 43. Backflow Irrjgatior; _ 44. Landscape Irrigation System- = 45.. Sound Attenuation 46. Handicap Regulations 47.-.FINAL STRUCTURE & BUILDING I`- • _ - •• 48.`FINALPLANNING 49. Electric Release to Edison I " 150.. Gas_ Release to Southern California Gas Goj �, ,- �� �, i •• 51. CERTIFICATE OF. OCCUPANCY t No. Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER T N TRACT NO. LOT NO. BLDG. NO. a C7NST$UCTION PERMIT A /a, TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑REPAIR ❑ CONVERSION ❑DEMOLI 1:1 OTHER - - BS%O 112(. �,ZONING REGULATIONS '! �Je 4% Project Address —0l{'�1 VI Owner 00 ePhone Address A. - Address 29,5 'cIk rW A -0 Arch/Eng. �-. License No. DESCRIPTION OF WORK C40 A.P.:P Address — ZONE PLNG. REF. $ Contractor H•1 ON 1G0 Phone - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA SET AC 1 p 5I TO BUILDIrvG PROPERTY LINE Address 10 o� • t'YA'SN f(�n-)A Ned LICENSED CONTRACTOR DECLARATION 1 hereby that I am licensed under of Charter 9 affirm provisions (com- menti ng with section 7000) of Division 3 of the Business and ❑ OTHER RIGH Professions Cotle, and my license Is In full force and effect. REAR YARD (TO P/L) — 10 C PROJECT DESCRIPTION License Class yfansa N� PKC. SPACE REO. PROVIDED SignatureSD. Date't �, `/may(_ Fr. OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE E WORKERS' COMPENSATION DEC LA ION I hereby affirm that I have a certificate of consent to selfansure.or a �/ VALUATION=CO- ONE ZONING APPROVED BY DATE - 'Vicate of Workers' Compensation Insurance, or a certified copy of (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: No. Company REMARKS: - La Certified copy is hereby furnished. ertified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be completed if -the permit Is for one -hundred 1E1Utor less). cerify that in the Performance of the work for which this Permit is Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS KAUL Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW— 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW -50 + KW - revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there I5 a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 30-50 HP 50 + HP formance of the work for which this permit Is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS OUTLETS SWITCHES Civ. CJ• Civ.LenC..er's Name .FIXTURES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereb affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP the following reason (Section 7031.5 Business and Professions Code: Any city .or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior to its Issuance, also re- quires the applicant for such permit to file a Signed statement that he GASSERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law -`hapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT 1ness and Professions Code) or that he is exempt therefrom and the is for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS _ y applicant for a Permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ I, as owner o1 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES - Intended or offered for Sale. If, however, the building or improvement Is sold within one year of Completion, the owner will have the burden - of proving he did not build or Improve for the purpose of Sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT E1Ls�L SMIP $ ❑ I, as owner Of the property, exclusively B wets AND DUCTING n 7044, licensed contractors to the project (Section Business 100,000 +BTU PLAN CHECK f �. PERMIT he Contt sLicees not Code: The Law does not apply to and Profeweer of ISSUANCE E builds or I proveso owner of properly who or Improves thereon, and who con- p REFRIGERATION 0-100,000 BTU PLUMBING E with a tracts from such projects with a contractor(s) Ilcesnetl pursuant to tracts SYSTEM GRADING E the Contractor's License Law). 100,000 + BTU PLAN CHECK f ❑ 1 am exempt under Section B. 6 P. C. for this BOILERS BTU ELECTRICAL f $ reason PLAN CHECK - MICROFILM $. Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL S $ TOTAL -FEE E - LESS AD - I hereby certify that I have read this application and stale that the above Information it correc area to Comply with all cit and count 9 PY Y Y PLAN CHECK $ VANCEPC $ ordinances and state relatin to consir uctlon, antl herout rise - representatives of is y t enter upon the above an. d property for e on ser Signature Date ISSUE FEE FINAL FEE E Drivers' License or SS is CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # i POOL & SPA Date Inspector APPROVALS Permit # - - _ Date In3aector� 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. SoilPipe-undrgrn --4T. Steel Reinforcement --- - ' 3. Electrical Conduit Utility-Undrgrn - 45. Forms ' 4. Electrical Conduit-Undrgrn 46. Electrical Bonding -- i5. SteelReinforce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE - - 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation - - 50. . Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.❑ Undrqrn ' 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House•Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection - 54. Heater & Vent-Final - 13. Rough Plumbing - - -- - - - 14. Rough Electric-Conduit - :56.. Electrical-Final -r 15.- Rough Etectric-Wiring - -- 57. Solar System-Final 16.- Rough-Heating-& Air Conditioning - _ encing & Access Approval - 17. Ducts in Structure - APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough &Test Roof Framing -- 60. POOL/SPA-SYSTEMS FINAL o - 21. 22. Roof -Sheathing Frame and Flashing - _ _ -. •. - NOTES: 23. Insulation - 24. Lathing & Siding _ 25. Drywall Nailing 26. Plaster Brown Coat - 27. Electrical Power Meter-Final ' 28: Final Electric ' 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final- ' 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING L-- - I 39. Special Requirements Completed - 40. Electric Release to Edison - - - - - - 41. Gas Release to Southern California Gas Co. 42. ' CERTIFICATE OF OCCUPANCY No Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO.SLOG. NO. NSTRUCTIONPERMIT 288 %yg 3 — TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ALTERATION ❑ REPAIR ❑ CONVVERSION ❑DEMOLISH ❑ OTHER 0319 7/20%81 129.10 ZONING REGULATIONS jnt Address - Owner - Phone Address — Arch/Eng. License No DESC P71N RK A.P. — 3' Address ZONE PLNG. REF. 9F Contractor Phon TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC To g�1 Lp� SETBACKC PRO PE1f2TY LINE I YARD IJ Qr A I �L� SIpE Y ,f K7 nc Address LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (com• me neing with section 7000) of Division 3 of the Business and ❑ OTHER WIGHT Professions Code, my license Is in full force and effect. REAR YARD (TO P/L) C PROJECT DESCRIPTION License Class c PKG. SPACE REQ. PROVIDED Date %- - / SIg t ad� ^ SQ. FT. STREET WIDTH PARK FEE $ WORKERS' COM ENSATION DECLARATION OCCUPANCY ONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION 3D- eoZONE ZONING APPROVED BV DATEa s _.'20- Nlcate of Workers' Compensation Insurance, or a certified copy ,of (Section 800 b. C.). GRADING'CU. YDS. ACRES SPECIAL CONDITIONS: acy No. Company ❑ Certified copy Is hereby furnished. - REMARKS: ?� ❑ Certified copy Is flied with the city Building Division. _ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION T— - (This section need not be completed if the permit is for one hundred OOZ or less). 1$ cert fy that in the Performance of the work for which this permit is issued, I shall not employ any person net So a become _ PLUMBING PLAN -CHECK _ ELECTRICAL PLAN CHECK subject to the Wor ers' Compensatio s f Cal r BATHTUBS _ SHOWERS qQ FT Date Signature /(iC�L — NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS -APPLIANCE 10.50 KW -50 + KW - revoked. KIT. SINKS - DISHWASHERS MOTORS 0-1 HP -1-10 His - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lendingagency for the per. SERVICE SINKS- SUMPS - (INC. SOLAR) 10-50 HP 50-+ HP formance of the work forwhich this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES ,( - CIV.Len Lender's Name %���y / er' Londer'S'AddreBs - DRINKING FOUNTAINS GAS TUBE SIGNS ' OWNER BUILDER DECLARATION \l hareby'a Oirmdhata am exempLfroni Ino Contratto$s LIcense Law•for. ,INTERCEPTORS .. . CLARIFIERS POLE LIGHTS ' SWIMMING POOL P TRAP the fallowing. reason (Section 7031.5 Business and Professions. Code: Any city or county, which' requires 'b permit to construct; alter, POLES METERED SUB WATER SERVICE PANELS '- MAIN SUB Improve; demolish or repair any structure, prior to Its Issuance, also re- quires the appllcant.focsuch permit to file a signed statement that he - .•a -ALTERATION is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE., OUTLETS SERVICE AMP (C2hapter 9'(commencing with •Section•7000) of Division 3, of•the siness and Pro/essions.Code) or that he Is exempt therefrom and'the WATER HEATERS - - •• y BTU OUTPUT basis for.the.alleged exemption: Any ,vlolat tom of SectiOm703115 by any applicant for a permil.subjects the applicant to a civil -penalty SEWER CONNECTIONS of not more than five' hundred dollars•(E500):r , •- : - -SOLAR TANK COLLECTORS ❑ I. as owner of -the property, or my employees with wages as their sole compensation, will do the'wdrk, and the structure is not intended` 1_ ` or offered for sale. (Section 7044, Business ano Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a Property who�builcis,'oglmproves;thereon; antl who does such'work himself or, ISSUB FEE_ � I -� APPLICATION APPROVED BY DATE? =(j 't hrough-hiS'own employees, provitlso that'such imbr'ovements-are not intended MECHANICAL PLAN CHECK SUMMARY SUMMARY OF FEES or offered for sale\If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden of proving he Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU '�f _� PERMIT G o -o the pro rt exclusivelycontractingcontracting with ❑ I, as owner' the property, - s� SMIp, E�1Q_ rs construct the project Ilcensetl contractors AND DUCTING 100,000 +BTU PLAN CHECK S- PERMIT : Law does not apply to and Professions Code: The Contractor's Lce(Section es not apply ISSUANCE $ or Improves [hereon, and who owner of property who improves REFRIGERATION 0-100,000 BTU PLUMBING E tracts with a t to tracts from Such projects with a cont ractor(s) Ilcesned pursuant f0 SYSTEM U GRADING b the Contractor's License Law). 100,000 +BTU- Y• +)k Nit PLAN CHECK b - ❑ 1 am exempt under Section B. 8. P. C. for this BOILERS BTVS ELECTRICAL $ reasonMICROFILM SYSTEM REPAIR, ALTERATION $ PLAN CHECK b TOTAL FEE S Data Owner MECHANICAL E I hereby certify that I have read this application and state that the above EXHAVST SYSTEM MULTIPLE LESS AD - is correct. 1 agree to comply with all city and county PLAN PLAN CHECK $ VANCE PC 'S _ ordinances and st t relating to cc ction, and hereby authorize roprese It at i Nes h CI to n on the above mentioned properly. e % /�� � �[(�� /� sro 1Z �/ Signature Dat �sL1L ISSUE FEE ��+-f/`�� FINAL FEE $ / 7'e/ - 5 Drivers' License or SS 5-4 CMF 0865-46 White -Building; Canary -Applicant; Pink=Accounting; Goldenrod -Assessor f 7L CONSTRUCTION AND PLANNING APPROVALS Permit # .9 -2 -Ag Date Inspector POOL & SPA _ _" APPROVALS Permit # • ' ` Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -' _ 2. SoilPipe-Undrgrn 44. Steel Reinforcement �� •-� - 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding _ 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE •- ' 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test - .9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra " ❑ Undrcirn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13, Rough Plumbing _ Final 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 57. Solar -System -Final ' 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - - 60f POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing/ 7 - - S C //o 22. Frame and FlashingNOTES: 23. Insulation e.( 24. Lathing & Siding SS, 'fir d3 1` cuter C� 25. Drywall Nailing rc . b r s' 26. Plaster Brown Coat Zd - 4 t!-. Sr 27. Electrical Power Meter -Final (•,q,� a ter` F'.r I ! a 28. Final Electric L.�' 29. Final Heating & Air Conditioning S R ,$ rk Z ts('s bus i 30. Final Gas Pipe -Test ,Ct S 31. Final Plumbing I,.r ✓r Z ,,, C S ire✓ 32. Water Service -Final _ ' 33. ` Gas Service -Final 3 - 4 iri IdId c 43 0,4'K 34. Solar Domestic -Final 35. Landscape Sprinkling System - 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 3-1�-82 aur 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY NoDate J Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ' CITY.QF COSTA MLSA PERMIT NO. TRACT NO. LOT NO. BL CONSTRVCTION PERMIT 1 TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION .❑DEMOLISH ❑ OTHER 1352 7/24/81 .I 4a80 ZONING REGULATIONS Pfoject Address,:/ Q rr -/Z,rr Owner Phone . Address }' Arch/Eng. License No. , DESCRIPTION OF WORK Address ZONE PLNTGpp. Rg(E1F�. Contractor Phone - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SET Ac IO YARD p�� PgOPE1RTVLI NE Address /Z/r LICENSED CONTRACTOR DjrCLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA glEp -y 1 hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code and my license Is In full force and effect. REAR YARD (TO P/L) - PROJECT DESCRIPTION License C s5 Liven O. PKC. SPACE REO. PROVIDED �� y ��a+iAO�.�A It J Sq. FT. ' Date Sign toe STREET WIDTH PARK FEE $ WORKERS COMPENSATION DECLARATION OCCUPANCY_ CONST R UCT ION TYPE 1 hereby affirm that I have a certificate of consent to self -Insure Ora VALUATION ZONE ZONING APPROVED. BY DATE ' `Iflcate Of Workers' Compensation Ins ante, Or -a ort ietl COPY - - eof (Section 380 C.). Q, L,a� /4/ GRADING CU. YDS. ACRES SPECIAL CONDITIONS: ..cY No.0 E/%3 Sv4/ Company _ .� - .. ❑ Certified copy Is hereby furnished. REMARKS:' ❑ Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not be complltetl It the Permit is for one hungretl SE11 or less). cert00ify that In the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK " subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS NG- Date Signature NOTICE: If after making this declaration, You should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW - to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this Permit Shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW_50+KW - - revoked. KIT. SINKS DISHWASHERS- MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS -SUMPS - (INC. SOLAR) �10-50 HP 50 * HP i lormance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES ,& OUTLETSWITCHES Civ' C,). Lender's Name Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License taw for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL - PTRAP'POLES the following reason (Section 7031.5 Business and Profession% Code: Any city or county Which requires a permit to construct, alter, METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demollih or repair any structure, prior to Its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the' Contractor's License Law rChapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Nusiness and Professions Code) or that he Is exempt therefrom and. the basis for the alleged exemption. Any violation of Section 7031.by SEWER CONNECTIONS - any applicant for permit subjects the applicant to a civil penalty of not more than live hundred dollars (S500). SOLAR TANK -- COLLECTORS ❑ I, a5 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. (Section 7040, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply t0 an owner of a properly ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMIP E ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTV PLAN CHECK E PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E tracts from such projects with a contractor(s) Ilcesnetl pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 +BTV PLAN CHECK E ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL E� E reasonMICROFILM SYSTEM REPAI R, ALTERATION PLAN CHECK $ MECHANICAL E $ TOTAL FEE E Date Owner hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD - information is correct. I agree to comply with all tl[y and county .4 PLAN CHECK E E_ ordlnances antl s[ a laws relating construction, and hereby authorize representatives this City tvet!tges dpon the above nti ad property for actlow pu Signatur! / ate ISSUE FEE - - 7 -fl - - - FINAL FEE $ Drivers' License or SS 9pS' CMF 0865-46 White-Buikding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # g -_12L Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn - 44. Steel Reinforcement Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgm 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Line P-Trag, ❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11, .Property Sewer Line & House Connection 53. Backwash & Receptor -Final . 12. Street Sewer Connection 1 54. Heater & Vent -Final 13, Rough Plumbing 55, Plumb'na System - Final 14. Rough Electric -Conduit -.-56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final - 16. Rough Heating & Air Conditioning -b8. Fencing& Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60, POOL/SPA SYSTEMS FINAL , ' 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric $ 29. Final Heating & Air Conditioning ' 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36, Sound Attenuation 37, Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERP NO. r� TRACT NO. LOT NO. g G. jam. �ICIJ CONSTRUCTIO ERMIT /(! o^C OY 0674_ 7/22/61 9900 Project Address �Z TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ALTERATION 0 REPAIR 0 CONVERSION ❑DEMOLISH El OTHER -` G. ZONING REGULATIONS, Owner Phone Address - - '- DESCRIPTION OF WORK A.P. ZONE PLNG. REF. 50-' Arch/Eng. License No. Address - _ Contractor Ph6ne4 TYPE OF PERMIT 0 GRADING 0 FOUNDATION 0 STRUCTURAL ❑TENANT ❑ EL'ECTRICAL OPLUMBING CMECHANICA D SETBACK C L IDE YARD SIDEYAR ��OP IRTVNLINE - - ' _ _ _ Address -7 (� "� LICENSED CONTRACTOR DECLARATION- that I licensed Charter 9 I hereby affirm am under provisions of (com- me n cing with section 7000) of Division 3 of the Business and- - . 0 OTHER - RIGHT - Professions Cotle, a my lice se Is in full force and effect. REAR YARD (TO P/L) D cc -PROJECT DESCRIPTION LlcenseC ss —ti nse '�O Z , SQ. FT. - - PKG. SPACE REQ. PROVIDED Date Signature WORKE S' OMPENSATION DECLARATION -••-OCCUPANCV_CONSTRUCTION TV PE - STREET WIDTH PARK F.EE$ I hereby affirm that I have a certificate of consent to self -insure or a VALUATION ZONE ZONING APPROVED BY DATE 'ificate of Workers' Compensation Insurance, or a certified copy sof (Section 3800, Lab. C.). GRADING CU. YOS. ACRES SPECIAL CONDITIONS: •cy No. Company - _ - 0 Certified copy is hereby furnished. - - - REMARKS: 0 Certified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - ' (This section need not be completed if the permit is for one hundred S$100) or Iess1. 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 PLUMBING • , PLAN CHECK' (ELECTRICAL - - PLAN CHECK subject to the Workers' Compensation taws of California. - - BATHTUBS SHOWERSSQ - FT_ UARAUL_ qQ FT Dale —Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS - -GENERATOR 0-1 KW -1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW=50 + KW revoked. - - - - - - KIT. SINKS DISHWASHERS ' MOTORS -' 0=1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- -- SINK -SUMPS (INC. SOLAR) 10-50 HP 50 +HP- - formance of the work for which this permit is issued (Section 309.7_ FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - Civ. Lendeer'sr's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for POOL P TRAPKUUIIUN POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code:SWIMMING Any city or county which requires, a _ permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE ALTERATION• PANELS MAIN SUB ' quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS - SERVICE AMP - is licensed pursuant to the provisions of the Contractor's License Law -,Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT _ •+Nsiness and Professions Code) or that he is exempt therefrom and the :� asis for the alleged exemption. Any violation Of Section 7031.5 by SEWER CONNECTIONS ' - any applicant fnr a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK - COLLECTORS ❑ 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property - ISSUE FEE APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK _ SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale).BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT $ - SMTP $ 0 1, 'as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000.+ BTU PLAN CHECK $ PERMIT • . and The Contractor's License Law does not apply to ISSUANCE $ wn r of p pert: owner Of property who Or improves thereon, and who ton- REFRIGERATION 0-100,000 BTU PLUMBING $ with a tracts from such projects with a contractor(s) licesned pursuant to tracts SYSTEM - GRADING. $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ 0 I am exempt under Section B. & P. C. for this BOILERS BTV$ ELECTRICAL $ reasonMICROFILM SYSTEM REPAIR, ALTERATION PLAN CHECK $ MECHANICAL $ $ TOTAL FEE $ Date Owner I hereby certify that.I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- information is correct. agree to comply with all city and county PLAN CHECK $ VANCEPC $,_ ordinances and state laws relating to constructi n, and hereby authorise . - representatives of this�cit to ent up the above mentioned property r i b c n Irpose . �� Signature Date_ FINAL FEE § r Drivers' License or 55 ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING �fJ�POOL APPROVALS Permit # rte`3C�_ Date & SPA ' Inspector APPROVALS Permit 4# D-.. In'spector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -Soil2. Pipe -Un rgrn t 44. Steel Reinforcement ' 3. Electrical Conduit Ut lity-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test . 9. Water Pipe-Undrgrn _ 51. Backwash Lines P-Tra• .'❑ Adr rn ' 10. Structural Floor System 52. APPROVALTO DECK 11. Property -Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - i55. Plumbing System - Final 14. Rough Electric -Conduit - - ':56.. Electrical -Final 15. Rough Electric-Wrin - - 57"Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval - 17. Ducts in Structure - APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating ' Gas Pipe -Rough & Test Roof Framing _ 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning - 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final - 33. Gas Service -Final 34. Solar Domestic -Final ' 35. Landscape Sprinklinq System 36. Sound Attenuation _ 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. - - - � TRACT NO. LOT NO. G. N TYPE OF CONSTRUCTION ❑NEW El ❑ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH El OTHER DESCRIPTION OF WORK - - ' - /'. (]874 7�23�81 7eQu i ZONING REGULATIONS ) A.P. � ZONE PILING. REF.-:* , Pro")act Address J SUITE f Z Owner Oa W Phone - (lO Address s1+/Kr - - Arch/Eng. License No. - Address - - E Contractor's 'w\O n1\�,� Q/yV Phdne 3t-yi]il TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STIR ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑ OTHER _ CTURAL MECHANICA - SETBACK TTop 6g�L11ILpINC PROPE RTV LINE Address r� Q" WF%5 jjAim SID YARD LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com. mencing with section 7000) of Division 3 of the Business and SIEpE V RIGHT REAR YARD (TO P/L) Professions Code, .and my license Is In full force and effect. License �ClTajs t 'ZO License No. 30 Sly t .ice WORKER 'C MPENSATION DE ARATION 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 3800, lab. C.).- rNUA/Q PROJECT DESCRIPTION SQ. FT. OCCUPANCY -CONSTRUCTION TYPE - VACUATION ZONE GRADING CU. YDS. ACRES _ PKC. SPACE REQ. PROVIDED STREET WIDTH PARK FEE$ ZONING APPROVED BY DATE SPECIAL CONDITIONS: _ y No. Company � - - - REMARKS: artifieo copy Is hereby furnished. _ Pau Certified copy Is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATIONDECLARATION (This.sectlon need not be completed if the permit is for one hundred ($1001 or less). - -- - cart(fy that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of.California. PLUMBING PLAN CHECK - -ELECTRICAL- PLAN CHECK BATHTUB$ SHOWERS UWLLLINUSO, FT_ SQFT Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TOILETS _ URINALS GENERATOR 0.1 KW_ TRANSFORMER .APPLIANCE 10-50 KW_50+KW 1-10 KW LAVATORIES DOUBLE LAVS revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP -1-10 HP _ CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the par- formance of the work for which this permit Is issued (Section 3097 SERVICE SINKS SUMPS - - '(INC. SOLAR) 10-50 HP 50 + HP R FLOOR SINKS FLOODRAINS - FIXTURES OUTLETS SWITCHES Civ. .). - - Land Lender's Name _ _ Lender's Address DRINKING FOUNTAINS - .GAS TUBE SIGNS - OWNER BUILDER DECLARATION - 1 hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS POOL PTRAP .POLES KUU I 1UN METERED SUB the following reason (Section 7031.5 Business and " Professions Code:•SWIMMING Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB - Improve, demolish or repair any structure, prior to its Issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensedpursuantto the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Y5usiness and Professions Code) or -that he Is exempt therefrom and the O,Ps for the alleged exemption. Any violation of Section 7031.5 by isnot licemortt fore. dupermiit rsu jestsdollat e applicant to a civil penalty ❑ 1, as owner of the property, or my employees with wages as their SEWER CONNECTIONS SOLAR TANK COLLECTORS ' sole compensation, will do the work, and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who tloes such work himself or , ISSUE FEE APPLICATION APPROVED BY DATE through. his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY BUILDING PERMIT$ PLAN CHECK $ PLUMBING $ PLAN CHECK $ OF FEES - , SMIP $ PERMIT ISSUANCE $ GRADING $ ' Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ 1, as owner'of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who or Improves thereon, and who con- tracts from such projects withith a a contra ctor(s) Ilcesned pursuant to the Contractor's License Law). HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 +gTU REFRIGERATION 0-100,000 BTU SYSTEM - 100,000 +gTU ❑ 1 am exempt under Section B. & P. C. for this ELECTRICAL $ BOILERS BTU$ reasonMICROFILM PLAN CHECK $ /-- MECHANICAL $ PLAN CHECK $ $ TOTAL FEE $ LESS AD- - VANCE PC $ _ ✓��� / FINAL FEE $ Date Owner SYSTEM REPAIR, ALTERATION - I hereby cert ify that I have read this application and state that the above Information Is correct. 1 agree to comply with all city and county ordinances and slate laws relating to construction, and hereby authorize representatives of th city toRRRnter upon the above ment'oned property for-JaspeeTon gZrp Signature Date L Drivers' License or SS #r EXHAUST SYSTEM MULTIPL ISSUE FEE - CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # .Date- Irrspector„ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - '- 2. Soil Pipe -Un rgrn •- 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn _ 45. Forms_77. 4. Electrical Conduit-Undrgrn , _ 46. Electrical Bonding 5. 5teel Reinforce 47. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grn 48. APPROVALTOCOVER-GUNITE'-' �' r 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn; Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ ndr rn 10. Structural, Floor System 52. APPROVAL TO DECK 11. - Property Sewer Line & House Connection 53. . Backwash & Receptor -Final 12. Street Sewer Connection 54.. Heater & Vent -Final -13. Rough Plumbing 55, PlumbFna System - Final 14. Rough Electric -Conduit - - -56. Electrica kFinal - 15. Rough Electric-Wirind - -- 57. Solar System -Final 16. Rough Heating & Air Conditioning - _ encing;& Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. - Roof Sheathing NOTES: / 22. Frame and Flashing _ 23. Insulation - 24. - Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final - 28. Final Electric - 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final ' 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison, 41. Gas Release to Southern California Gas Co. 42.' CERTIFICATE OF OCCUPANCY No Date � � � ' � `-' �_- .,- - • 4G657 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 f U TL" APP CAI -FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEI D V DATE RECEIVED D TE ISSUED BUILDING �5d5G /1l�JttrA UN�T�i:� ADDRESS l�f KWR - +�-7 Z7- P I O. OWNER A.P. NO. MAIL �/ /, �� ADDRESS I �/� �/` i..trU,�' BUILDING 2 ADDRESS {SQ V /H "J / CITY NOLrj�'u5/( TRACT LOTp/ BLOCK CONSTRUCTION NEW I.ADD ALTER REPAIR MOVING n LENDER BRANCH OWNER ADDRESS VALUE S Ni. / LT $ ARCHITECT TEL. OR ENGINEER N FIRE L ADDRESS ZONE TYPE GROUP �Rq APPROVED G CONTRACTOR V G!/f(lF�(_ BY DATE ADDRESS TE TEL. ZONE NO. OF USE OF NEW CITY PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LC. NO. MAIN BUILDING ACCE SORV BUILDING SIZE NO- OFBLDGS. (FROM C/L STREET) OF LOT NOW ON LOTFRONT FT, FT. USE OF EXISTING BLDG. R. SIDE FT Separate permits are required for L. SIDE Nt FT. FT. electric, plumbing and heating work. REAR FT. FT. USE UILDI ;;,,AND WORK O PERFORME DISTANCE BET. BET. MAIN& Als MAIN BLDGS. ACCESS. BLOCS. VAR.+ DATE C.U.P.* APPROVED N APPROV6�/i C��� DATE ^J/• / I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and 1 shall not employ any person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE S and Professions Code, Divisio 3, Chapter 9. PLAN CHECK $ 50 Signatu/ TAX $ sV Permtte.L- Authorized Agent TOTAL PAID $ f U TL" CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-51!73 • Fax (714) 754-4856 Job Address: 2950 AIRWAY AV Suite No 0003 Vicinity: Parcel Nunmber: 42716406 Applicant: MILLER, KEVIN Address: ELECTRICAL PERMIT Phone: Zip: Phone: Zip: 92663 l Phone:lY'(714)579-0952 - Zip: - 92870 - 'License: 473148" , PERMIT E99-00166 77 FAIR DRIVE, COSTA MESA, CA 92626 status: of Applied: 03/03/1999 Owner: GEOF•WICKETT- " Address 2950AIRWAY ' FEE SUMMARY .''A003/ COSTA MESA, CA . i Quantity Quantity Contractor.'/ K R M ELECTRIC INC Address: '-'033 RASHFORD DR $0.00 PLACENTIA, CA i ELECTRICAL PERMIT Phone: Zip: Phone: Zip: 92663 l Phone:lY'(714)579-0952 - Zip: - 92870 - 'License: 473148" , PERMIT E99-00166 77 FAIR DRIVE, COSTA MESA, CA 92626 status: ISSUED Applied: 03/03/1999 Issued: 03/03/1999 COMMENTS I SPECIAL CONDITIONS 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 1 100 AMP ELECTRICAL SERVICE. SCOPE OF PERMIT - FEE SUMMARY Quantity Quantity ISSUE FEE - $22.00 - -Temp Dist System / Lighting $0.00 0 Temp service test . $0.00 = - Busway /100 ft, - _ $0.00 0 Res. a/c package $0.00 - - "- Standing Section' $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0' New Res (3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0. Pool / Spa $0.00 0 ...............:up to 10.kva/kw $0.00 -0 Lighting Fixts $0.00 0 ................. up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 .................up to 100 kva/kw $0.00 0 Switches `-"$0.00 0 :' ... ......over 100 kva/kw $0.00 - "•- 0 Non Res Appl ,- - $0.00 0 Low Voltage Equipment $0.00 0. Res Appl $0.00. 0.' ,. Low Volt Wiring' System / Ckt ,$0.00" 0" Service to 200a $27.25- 1" _ ` -Mise. Conduit- ; -$0.00 0 Service to 1000a' $0.00 0 " . Misc. Conductor . $0.00 0 Service over 1000a $0.00 01 Circus ( gen or ride), $0.00 0 Motors to lhp $0.00 0 Circus (meth ride or lights) $0.00 0. Motors to 10hp _ _ . $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 - Fireworks Stand $0.00 - 0" Motors to 1 00h $0.00 0 - Other Electrical Fee Motors over 100hp $0.00 .0 _"$0.00, Communication drops $0.00 0 Investigation Fee, $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 ,Reinspection Fee . $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $49.25 Intermed Pole $0.00 0 COMMENTS I SPECIAL CONDITIONS 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 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations:.. - r I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 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 workers' compensation Insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed if the permit is valued et one hundred dollars ($100) cr less.) > ❑ 1 cortity 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 became subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these pravl Ions. Applicant Signature: f4.— - Ai _ ;1.4 Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3r06 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. # Class # C yc Contractors Signature: Date: 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: Lenders 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 property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................................................................................................................................................................................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ...............................................................................................m. c"...........00d-.'to'pr,a,p......................................................................Ttio"....................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management end Prevention Progrflm for acutely hazartlous 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 partment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .................................................................................................................................................................................................................................................................................... 4 If en RMPP Is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... 5 Daes or will the applicant or present or future building occupant require for the work which is the subject of this a plication appannit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be Within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................... 7 If a Permit from the South Coast Air Quality Management District or other air pollution control district or agency Is re wired 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 matle? ❑Yes ❑ No .................................................................................................................................................................................................................................................................................... 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I cant N that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materiels antl Emiss ons. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S_ Ifint;ture Of Legal Owner(s) Date 14�1 -iz-3-4j' And/Or Authorized Applicant Date CODES. INSPECTION TYPE DATE INTITA CODE l INSPECTION TYPE DATE IWMA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 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 2446 06 p COSTAMESA BUILDING -SAFETY DEPARTMENT P.O."BOX 1200 COSTA MESA, CALIFORNIA 92626 44571 9ii.l/i8 �6T1: ff711'/78 1126x45 K4Y / / /1 to, e- t AP LI A ON Fdk55TfRU�tI6P1&IIT For Applicant to Fill in Completely — Use Ink Only RE D D :EI DA EI/5}1E LDING y yrnrs AQ a KISQ�I.�N Z• L_1 ADDRESSV ' / OWNER W Inl W RL7 S A.P. NO. o� �� P RMIT NO. ter-• MAIL h2,'2 i�%U•��� ` -SNI BUILDING � r'C) �CZWP � ADDRESS ADSS DREtitlL t�It4 Ali,TE1a.a� pp CITY �SZ l%I tv NOL L�33S�1I TRACT LOT BLOCK CONSTRUCTION W A\D.(D' ALTER P MOVING, QFMQI [SH BRANCH 1l OWNER tt\INOW&T(O ts�^'Vy*_-Sj —, ADDRESS VALUE USE $ ARCHITECT OR ENGINEER T G N �! �� r�� M�TIn ADDRESS 2 rr ZONE T PE GROUP '"� APPROVED CONTRACTOR DATE - ADDRESS TEL. ZONE OF USE OF NEW 11V�O CITY NO. PLANS BUILDING 1_7� I STATEl YARDS APPROVED LIC. NO. 1� LI CYN O. MAIN BUILDING ACCESSORY I DING SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT " NOW ON LOTFRONT FT. USE OF 4DF_st='-I C -1c• p A� EXISTING BLDG. T. Separate permits are required for L. SIDE FT T. electric, plumbing and heating Work. REAR FT. FT, USE OF BUILDING AND WORK TO BE PERFORMED l DISTANCE BET. BET. MAI & MAIN BLDGS. ACCESS, SLOGS. VAR.+ DATE C.U.P. gp APPROVED APPR //7 f� o I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I em properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FE O am exempt frorn the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Code, Division 3, Chapter 9. PLAN CHECK $V r Signature of r��s/./..��_��� TAX - $ � 0 Parmittre $ � VV 1 TOTAL PAID $ Authorlze/d A\Oiant / / /1 to, e- t d d ,y. 'S F L1 A 3 4 r a a w a O 0Y a Z W c7 COSTA MESA BUILDING -SAFETY DEPARTMENT • P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING ADDRESS OWNER MAIL ADDRESS BRANCH ARCHITECT CONTRACTOR ADDRESS St STATE LIC. NO. SIZE OF LOT USE OF LIC. NOTY s.AO`o NO. OF BLDGS. NOW ON LOT I Separate permits are required for electric, plumbing and heating work. I hereby acknowledge that 1 have read this application and ante that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from the provisions of the State of California Business and Professions Code, Division chapter 9. Fir1vr'ui4ft Authorized Agent 6535' 6/23/7B -lQih.7S TL APtLICATJON FOR STRUCTURAL PERMIT— FIRE ZONE APPROVED it -Wj I WE6 A GROUP C r • I +\ OF N ZUSE I SA t `` D YARDS APPROVED ACCESSORY BUILDING A l FIRE ZONE APPROVED it a ' THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMMIITTFFEEIE ONN7LYY /y VALUATION I PERMIT FEE S 16 $Sl I C. � TAX E l TOTAL PAID E t n m i m m N 0 F- Z PE GROUP C DATE +\ OF N ZUSE BUILDI SA t `` D YARDS APPROVED ACCESSORY BUILDING F a ' THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMMIITTFFEEIE ONN7LYY /y VALUATION I PERMIT FEE S 16 $Sl I C. � TAX E l TOTAL PAID E t n m i m m N 0 Applicant to fill in all spaces within 'Aeavy border lines and sign all appropriate declarations. CITY OF COSTA MESA '- CONSTRUCTION PERMIT - PERMIT NO. /��� �� TRACT NO, OT NO. BL G. - ' � TYPE OF CONSTRUCTION � NEW ❑-ADD IPHLTERATIO N' - ❑ REPAIR. O CONY/E RSION ❑DEMOLISH - U OTHER "' DESC RIPTION OF WORK - . 1 • . - •�' -- - -- . ` /54.00 ` 5/04/82", "' 6.00 - -- -- - -- __ __ ZONING REGULATIONS _ -- A.P. - - - - - ,,, r• - _ - -ZONE - PLNTGp-: REF:,#,T Project Address O /,C[C3.4y vB q. Owner - LgjU .,{ .Z/07oLS /Ajt Phone 966099 Address -Z -105'/f �u%7✓TCG tS. 6tl,UG /`.,%9000 ,-Arch/Eng.- -'- - -- j- - License No: 2Z6So ''Addre55 - _ "' -"' -- .. '� '-Contractor-CLCCCE 'C:' GyHePi.✓6, Phone dCb TYPEOF PERMIT "= - - '"-- "- ^ ❑GRADING FOUNDATION-'�STRVCTV RAL--- ' - 0'TE NANT ❑ EL-EDTR1.IGA 1.L•�PW MBING �MEGHANIGA ❑ OTHER. - -1-�- -' ISET BAC ST. •SIO 'YARD' --- --- F r, 1 1 E V RIGHT Address - .. �� -G[2o ln -CrLA% 404 '22 LICENSED CONTRACTOR DE ATION ._ .. ' I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with-secllon-7000)-of sDIVision 3 -of the-Buslness-and Professions Code. and ,QIy license is In full force and effect- -C-3 C- ,3$'yL SV` License Cla s - L,��e ryje No. PROJECT,DESCRIPTION SG. F.T. •, _R - - -000VPANCY s_� CONSTRUCTION TYPE VALUATION _ s ZONE REAR YARD (TO P/L) .. _ '� PKC. SPACE REQ. PROVIDED _ - STREET WIDTH PARK FEE E�„ ZONING -APPROVED BY 'DATE- - or.• Date •r - Signature ! D!9gfi !./•OA��- WORK R -CO that I have NcDECLcAR ION... _._ .. I'e,%eby affirm that I have a certificate Of consent to self -Insure ora -tale (Section3 00, LCompensation-Insurance,-or a -cert tried copy t' ".bf (Section 3800, Lab. C.). � _ _ y GRADING CU. YDS. ACRES _ .SPECIAL CONDITIONS- ONDITIONS , +• Policy Policy No. --_ _._ - _Company ❑.Certified copy -is hereby furnished. ._ -___ _ _. _ �.. ❑ Certifiedcopy filed with the city Building Division. EXEMPTION FROM'W00.KER5'"60MPENSATION OEC LAR ATION' (This -section need not,be completed,if_the.permit is for_one hundred- SS300)or leu). .certify that in the Performance of the work for which this permit is Issued, I shall not employ any person in any, manner o as to become Subject .to he.W kers' Compensatlon,Laws of o _ Date r e Signature io - -REMARKSiI _`' - -- _ - - - -- -- - r 41-�- --- - - - --- --- - - _ - - r ll' PLUMBING �y - .,PLAN -CHECK "- - ELECTRICAL _ --PLAN-CHECK.. �, -- , ' - - _ - BATHTUBS SHOWERS '- - - - FT- qQ FT NOTIC after making this declzration, you shot.16become,stiliject to the Workers' Compensation provisions of the Labor Code, you must comply with such provisions or this permit shall be tleemetl 1701 LETS, IURINALS- - - -- LAVATORIES DOVBCE LAV$ ,' -- - 'GENERATOR '0--1 'KW_1-30 KW !TRANSFORMERforthwith _u -ApPL-IANCE'--30-50 KW_SO+KW - - ---• revoked., revoked., - __ '._ -_ -,_ CONSTRUCTION LENDI_NG AG ENC�V � ,I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 KIT. SINKS DISHWASHERS SERVICE SINKS .1 : I ,SUMP$- MOTORS-' - '0-1 HP_1-10 HP' (INC. SOLAR 1 -d0-50 HP=50+HP---- - -- - FLOOR SINKS FLOOR DRAINS - - ,FIXTURES* OUTLETS' SWITCHES"' - CIV. C.)'. '-- - - - '- - - " --- -"- 'Lender's Name Lender's Address DRINKING FOUNTAINS ,� ""'-' 1" -' )GAS TUBE'SIGNS-- ---- -_ - - -- -- .. OWNER'BUILDER'DECLARATION�INTE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section -7031.5- Business and Professions Cotle:$WIMMING'PDDL Any city or county which requires a permit to construct, alter, Improve,- demol ish'or re Pair any structure, -prior to Its Issuance, also re- qh} 4} the ap,11cant for such permit to file a signed statement that he I ss�tsed'pursuant-to the provisions of the -Contractor's License Law er 9 (Commencing with Section 7000) of Division 3 of the S+ss antl: Professions Code) -or that he is,exempt therefrom and the D for the alleged exemption. Any violation of Section 7031.5 by RCEPTO RS -� CLARIFIERS ",PO LE LIGHTS' - I fir - "'P'TRAP- '-- - - - - - --- _ - I iPOLES METERED •.SVB -WATER-SERV ICE- -ALTERATION- -- 'PANEL'S' 'MAIN "'SUB- GAS SERVICE OUTLETS - "- - SERVICE-- " ^- _ qMP I -'WATER HEATERS-" -BTU OUTPUT =- �^ ONNECTIONS -- '_ -'_ SEWER CONNECTIONS.— -"! -•'--- - -- - - - - - a�n y� applicant-for-apermit subjects the -applicant- to a civil penalty- of of_ of more than five hundred dollars ($500). ❑ 1, as oWreT of the property, ormy employees with wages as their sole_Compertsatio.. will.do the work, and the structure Is not Intended _ " SOLAR TANK' -'" '- COLLECTORS- ' -r' '- - - --- ^ -- - ---�- - -- J.- r-- or offered for sale. (Section 7044, Business and Professions Code: The ContractoCs_Ucense ,Law does not apply. to an owner of a property who builds or improves thereon, and who tloes -such work himself or through his,own employees, -provided that.such Improvements are not _ _ _ _ _ _ _' _ SOLAR PIPING -Sys. - 1 - ' '' - ISSUE-FEE-:.�r,�' ISSUE FEE_ _ t- 0-fAPPL•ICATION APPROVED BY - --- - - --'DATE-•- --- - - " MECHANICAL PLAN CHECK - i HEATING SYSTEM 0-100,000 BTU AND DUCTING -' 100,000+BTU ( REFRIGERATION 0-100,000 BTU r SYSTEM: - --- - - --- ---• ---- _ _ _ _. 100,000+BTU ! - -' - -- - - BOILERS BTU r SYSTEM REPAIR, ALTERATION 1 EXHAUST SYSTEM MULTIPLE I - it r t - �- SUMMARY OF FEES ,.1, i ,1,o "BUIL-DING--- - - ---^- -- ---- - - PERMIT $ ,Smlpl ' f^ -' -- - - - - •- - - I - $-- ' 'PLAN CHECK $ PERMIT �, irr - - --ISSUANCE $ IPLU MBI NG E ••�O �1,� r I .._ _ _ ._.GRADING $ PLANCHECK $ - - - - - -- � I •-$ ,ELECTRICAL $ - r MICROFILM $' "PLAN CHECK $ - _ t -_TOTAL FEE $ = r -(MECHANICAL.-$ 'PL•AN•CHECK -$•- - _ LESS AD- T. r VANCE PC'-:$ -- - Intended or offered for sale. If, however, the building or Improvement Is.sold within one year, of completion, the owner wi_II have the burden of proving he did not build or improve for the have of-sale). ❑-b; as -owner -of the property, Y. e p exclusively n 7044, B with licensed contractors contractors to construct the project (Section ]044, Business and -Professions Code: The Contractor's License -Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such.projects with-a-contractor(s) licesned pursuant -to the Contractor's License Lawl• ❑ l am ex9mpt'untler Section' ' ' -' '_ 07& P. C. for this reason - - - - - - - -- - i tier Date _ `� have I her eo ce tily that I M1aO reatl this application and state that the above Informal] n Is correct. 1-5grea-to comply with all -city antl county' ordinances and state laws r latin to construction; antl hereby authorize representative5-of-lhi y - eStQ, upon the abovis rintionetl propeyty. for s e p self/ Signature (•� Date •. Drivers' license ar ss # ISSUE FEE r :. .FINAL FEE $ - -- CMF i 4 1 CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TU t •;,' CONSTRUCTION,AND PLANN APPROVALS Permit#3 Date Inspector POOL & SPA - Date Inspector APPROVALS Permit 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - - - _ 3. Electrical Conduit Utility-Undrgrn _ 45. Forms - - 4. Electrical, Conduit-Undrgrn 46. Electrical Bonding _5.,.-S.teel Reinforce _ - 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn _- 48. APPROVAL TO COVER-GUNITE- - - - 7. Footings 49. Electrical Conduit-Undr rn' - B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn. _ - 51. Backwash Lines P -Trap.❑ Undrqrn - 10._ StructuralFloor System 52. APPROVAL TO DECK - __11.. Property Sewer. Line & House -Connection' - 53. Backwash & Receptor -Final 12... Street.Sewer,Connection 54, Heater & Vent -Final. 1.3., Rough Plumbing - _ _ _ _ - - -- - - 14. Rough Electric -Conduit --- - - - - �56. - Electrical -Final 15. Rough Electric -Wiring - - - -- - - 57. - Solar System -Final - 16. -Rough Heating &Air Conditioning - - - - encing &,Access Approval '- 17. -Ducts, in Structure - �_ - _ - APPROVED FOR PLASTERING ' 18. - Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL •" 19. Gas Pipe -Rough & Test 20. Roof Framing - - - 21.` Roof 'Sheathing NOTES: 22. Frame and IFlashin 23.- Insulation-- - 24. Lathing & Siding --- - - - - - 25. Drywall Nailing... 26. Plaster Brown Coat - • • - 27. Electrical Power Meter -Final 28. Final Electric - 29 Final'Heating & Air Conditioning - - ' -30. F.inal'Gas Pipe -Test - -- i 31. Final Plumbing 32!- Water Service -Final I 33. Gas Service -Final _ 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation ' 37. Handicap Regulations -- 38. FINAL STRUCTURE & BUILDING - - 39. Special Requirements Completed - 40. Electric Release to Edison ' 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY -No: - - Date ' ADDAMMIIIIII. 9 ' ,29.50 _AIRWAY- AV _ uNT A5 OMNERSWEIFICN)w:ANGELO REGUSA _ Aoi;EI;iL2950 AIRWAY AV #45 C.M. CA 92626 AwL. MUIRdG WORM ARCNRECT 011 DdlaGll uc. N0.: no till, •a smxeo UMI: CONLRACron NAME: GALLA-RINI CONSTRUCTION (714)974-6424 CONTRACTORS MARINO 346 E MEADOWBROOK AVE AWRESS:ORANGE _ _ CA._ _�= 6 3983 92665 urn: LICENSED CONTRACTORS DECLARATION: I h«eby am ilia pemly of pwjuy tial 1 em Ikmeatl pnwi i Chep« B (avnmendnp with Section 70W) a Divbun 3 d tlhe Bminw era Pmlmtow Coda, and my 0mrue b in 1 en 11 CITY UC. NO.: cL"% C39 LIC 663 ,83 (P: Drum caampor LL%fj i nBUILDER DEC ATION: hweby of to i uncle, palelyof d peryry they I em emmp hom IM Cmtmot. liwme lea I. theI p laeaon (Section ] 15 and Phot Code: Any city or county which mquir" a Dwym to mmtM, am. hnprwe. bmd'eh, or nepair my stnldule: prim b m uausnm. abo MI Uu mPkmtt 1« such pwmi In Ne a signed debmea Ono h «eM OR 11c mod Mmomni to Inc p tvarto of 0n C«araoms License low (Chops 9 (oamlwhm, with Swain 70W) of Dwbion 3 of 0n otmoo m era Pro vvhp Cads) or thm M or she b soap Ithwahom wd IM bmb 1« the ~ memplbtt. A, violation of Section 7W 1.5 by at appf for a per .6i. Me Wpf to a dd pwu0y d nd mora Mm rwa hamar ddlen rMD. ❑ I, m owns d IM pOpeny«my wr0000s weh wapea m thi wM comp«mbcn.N do en work aM the etncnea is not int «dlarad lar sobmwmthram. Rumens era Pmlasc«u..Wor m or ft Bowe or IN,o nctapplyyamonmrtlhat .h Mho Wide « knpovm Timson, wd orf, Som such wean hinve0 or harvM a tivwajh his «her own mhpotam, pwided that s0dh 'unpwwnwm ra nal ibldea «dheed 1« actio. 0, howav, th With, «knppanwa u soM vdthl am Meer a compstion, Ohs awns. Wilder wT hove Ms codon d gait, M « eM iia Inot Wild «'vnprova 1« Me pvpwa d cob). ❑ I, m oma of the pa0eny, am awhuwly aoWeei, will, flamed ramew«v in comwm du project (Section 7 . &nines era Prolmeiom Code: The Canuacton Limns Lew ions res apply in an owls of popsy, whho bili is « improv® thwaon W who c«wects Eor each prcle6S with a co mact«(.) ricwmed peoowa to the Contmmon Uums Leh). ❑ 1 ml, eawnpt hada Section: B. a P.C.. for tlo roeem: Dale: Owner. I b hemby unity IM I ern ewer. of and udweWd the reauk.mwm of C sfif b Neemh and Safety Code Sections 25505. lWcl. end 2553/, era that I « env M. WiMb,amps. will / will not d (cb oiluNT veld mat ) to comply with e coc m wd IM muirsmenb b e pomt l« construction or modihmtion Into h it enpemem Diwrict. RaskonIW o«WlWion eppicamw am pt hom tMss I".. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I Mreby tolam udw pwnky of pmjuy ane d the 100.4, dedwatiom: ❑ 1have and ail me'vn.khaowdrobdaw:ato.eaumuabworken•.«Memtoion.m Woykidlerby Sepias37Wd MsLehr Cob. ler IM pedanmnc�a d d» work for tow this p na b e.1n L I hat. and ail mseaen+orkas' aompwwYion b omwow. m equo by Soctimt 3700 of in Lobar Cob. b 0w pedo mono. d tM work for which Nb pwmil is bsusd. My workws' compmnatln bmmce cmb era porky mmhbw era: Omtlw: EXPIRES Poky Nuob. HERRES07/01/98 (Thu Section nasi nd fes o«npmSd d dm pwml u b oat huh6M ao0an /51W1 «bwJ ❑ 1 Mm Mm in ttI pMormam:a d mo work iO which 1lhv psmm b bauaa. I sheO lip ampby w7f person 1 Y manrw so m to bw.dns subject to tM warhorse' dmpwnatin laws d CaMorn d apes 0hat 0 I SMWf scorns ap tM workers' ompanutb``n pa 'sum d S Sian 07W tl yM labor Coax, I wbh comp yNa f o Appr , l — 4 min9: F.H. SScrws ronl'sn'rorrpwnaetlon cow c N is uth"vU and.ha to 1scl en wntployw m cdraml pwnldss and civil Irma W 0 oat hundred Iho."ad "hr. ($104OW), M S ldan W In. cm1 of compwwllon, demepm m provided far In Secdan 3700 of Me Labor Coda• IntwL end efbmsy'it lase CONSTRUCTION LENDING AGENCY: I hereby Shrum udm pendy of pwamy thin these b a ®mon ction brdh, agency for 1M Ped«mace of mw work for which Mb pumil b band (Section 3 . Civ. C). LENDER'S NAME: LENDER'S ADDREW: I cMay that I have Imo thuapplcallon and atmn, the to. kd«mmianb«Intl.I.p.s in comply with el city evI coutl,«camas ami tom, Im rani, to budding mhancom era hwa y mnhores npemlumiw of tib ody W Saw cpnh 1M eb0n memiarrd popalty t« inspetlbn prpoma. MARK SCHMID 6 ,nstun d enV act« / (5151de.W P) A Se1mY Gann-Fda: Canry-Appicaa: Pink-Rwwwme: Golden l4chhh err CITY OF COSTA MESA--BUILDING-PERMIT— PERM NO: B 086201 PERMIT NO: B 086201 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/O ROOF 6 REROOF W/CAP SHEET SQ FT: 9,700 CLAIM VALUE: 9,700.00 CALC-VALUE: 9,700.00 GROUP OCC: R-1 / COMMENTS: X Z O N I N G R E Q U I R E M E N T S S E T B A C K S_. ------------ MAIN.BUILDING------------------- ACCESSORY BUILDING--------- FRNT: FT_ __IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT .-_.IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• _ .PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> _ _ > , f +r+r+t+r+E**+ESE**Sr�ar�rr�r�ar�s*�M+E�rar*�E+E*Mii'it'+r+rill'iaia�EiEx�Ss+E+s+E�ataiE**LE*�rSE*�rhEia*�E�S�p�s�ritSS M.*it�r�9�r*iL ��E D E V E;L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED'BY DATE: BUILDING APPROVED BY : DATE: Y APPLICATION ISSUED BY: DATE: MMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMM MM LEGALIZATION- F E E S U M M A R Y STRUCTURAL S GMENT.Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 162.25 .97 SMIP/NON-RES PLAN ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 163.22 0.00 0.00 163.22 163.22 .00 REVENUE DIVISION TOTALS--> COLLECTED: 163.22 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 162.25 .97 MMMMMMMMMMMMMMMMMMMMMMMMMilk ilk ilkMMMMMMMMMMMMMMMMMMit dfMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 9700 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 9,700.00 END OF FEES 12-16-1997/04:23 PHA163.22 RWT5:51-2516936 PERMIT:086201 .% CONSTRUCTION AND PLANNING- _JL & SPA APPROVALS Permit # Date Inspector APPROVALS Permit # - Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2: Soil Pipe•Undr rnd. 53. Steel Reinforcement ,,;. -,(•J Condu 54. Forms Q ' ,,-lectrical t„l .Iity-Undrgrnd. 0 4. Electrical Condtt+T4l5drgrnd. r 55. Electrical Bonding �. t zf. heel Reinforcej�ent 56. Rough Plumbing & Pressure Test '.2' ilectrical UFERsBtnd. 57. APPROVAL TO COVER•GUNITE _ 'J7 footings 58. Electrical Cono;Se;Undr rnd. . Foundation ; j :V s 59. Gas Pipe, 0 Ury"*'grnd., Test 9• Water Pipe-Undq�Rd. 60. Backwash Linel. P•Trap, 0 Undrgrnd.. 10. Structural FlootSYstem - 61. APPROVAL Y DECK 11. Property Sewer@t'ne-•& House -Connection 62. Backwash & Receptor•Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing ,o _ x 65. Electrical -Final 15. Rough Electrical-Cotjduit .. 66. Solar System-RTWAI 16. Rough ElectricU•/iririg y 67. Fencing & Acrw{gp,pproval 17. Rough Wiring Sign _ 68. APPROVED FOOT RPLASTERING 18. Rough Electric31',T Bar Ceiling - 69. POOL/SPA SYSRMS FINAL 19.,1io4gh Ijejtirtfg &;Aij Conditiogilud -NP M Mv* C F-tREtE*PTxREQUlfiIEMENT co n ra:j0 n x Y `^ W* 20.ToLfkh FxttoH Fh�eplace Si c * C APP O NS Permit # V m m 21. u ,r•�truT ri 151nod 1udllydro x 22.:0ut`, t%elttilHtingU x� =� * Ci CJ r,.: 71. Prod q',NPin as Oil 23. Gas ipe-_Bo � . & st S �' m s d 0 r •'� a: r1 :� 72. Underground l.iift,; ,.�T� .rT 0� x y S'k * >1 p 24. Roo Framing ; tj � > n 7' ti ndergrnhd. Std14t1c janl 0 Gas 0 Oil r 25.,-,oo&Sh tithing -At' VL 2 �f•�,~ TQ'.• verhead HYd * �x CQC .x _ 26.%-BaC' CeNing (Stuural) & rQt1iioat cal I-M+ry 27.ql1ra?eahM Ffia hing', Mit T b1 >' r 76. Dry Staa�21_••p''iper in x p �. G N F' 28. Latfing•& Siaing z: y 0ME- O t ' I 77,. F I X E 0 SYSTEK* IN C1 rXI 29. Insulati c a s x S 75. FIRE PREV. FITAL r ` 30. Drywall•Nail ng 4: '•+ F c aKEAL$H OERT. REQUIREMENT {: 31. Plaster B�owl'CoatsS ' ��', * - 79. FINALitP_PECl]ON 32. §Iectric&oWer Meter -Final r ` ` SBi FOOD CERTIFICATE *SUE& 33.�in6E1 ri * ' tt,, N^tes: O OS r sQ - xG k 4 d mn t f 34.:Fin$GHeottin Ai(Zft5Utioning m > I 35.CFinal Gasy�,Pipe•Test Ir " - �c O`'' x rI*' s. i 1 ••n m 36.!Vo or'Cano * o PY 1 iR: o ss I I .• m :Co 'K C: �iTl • 37. Pinal'Fa-'•cry Fireplace,^ 38. Final;Plumbing .y x -± o _ I n 39. Water Service -Final-' 2' •�'•� `fi i x Y '-ro n to m . t Y 6i 'G, t'r. j 1 40. Gas Service-F2pa1 x , 1 •J ., 1 41. Solar Domesttc•Finat t7 r * M o "- 42. Backflow Prwnter� x �r " m 43. Backflow Irr ationt >'__ - .ti _ A *, N tc3 Z) O 4.r�..andsca IrYlAatio , System= £ +'� Q•„y M < d a:k y 0- 146AIlound Atte iGatio K "iv: x i9 1 �y.. T a F 7 136. Haroicap•Retjulatio'is ; s_ O n L67. IPML STRU TURF & 8UI`LDING �� ( ' � X .1 r., y. 'rJ- -1O � F t Cu - 48.�RINfELP GANNING i K f' 49. $Ieciric Release to Edison 'f :k .^ •,^ x o 60. $asrrFtelCAe to Southern CalifnTyaia Gas Co % �� ` " t; c Cl •51. CERTIFICATE OF OCCUPANCY _, ' -' No. Date ADDRESS ZONE I I I TV E GROUP F APPROVED r ADDRESS TEL' ZONE/y� P Z • COSTA MESA BUILDING -SAFETY DEPARTMENT CITY NO.ij Sd52 " • P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 2776 2/01/79 20*1 A l_ A ON FW_§fRUbf(JW,'0 PERMIT 20.2 to Fill in Completely — Use Ink Only O A RE EI D Y DA R CEIVED 'DATE ISSUED OF LOT NOW ON LOT ��tsBUILDING c lilA% t:../J II- FT. USE OF M 4 •U y,27-I`I I PERMITq N%O�. Author zed Agent NO. PADDRESS RSIDE ILDING 4v"y *JDRESS�gS SO::��A�I��r t'�f!-WCJ n., 9"'it WA /T Separate permits are required for L. SIDE FT JA.P. '=rr No.�j�7-15TRACT —s��Q'T'e/V7 l 7V LOT BLOCK W ADREPAIR REAR F FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BRANCH MAIN SLOGS. ADDRESS ZONE I I I TV E GROUP F APPROVED r ADDRESS TEL' ZONE/y� P Z USE OF NEW / AJ CITY NO.ij Sd52 " • PLANS BUILDING Al -T STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING S12E NO. OF BLDGS. (FROM CIL STREET) VALUATION �• OF LOT NOW ON LOT FRONTFT. FT. USE OF M 4 •U s Author zed Agent EXISTING BLDG. RSIDE FT Separate permits are required for L. SIDE FT FT. electric, plumbing and heating work. REAR F FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLOGS. //11 ++ IL)I /21092 ALrOYKi11�tiS VAR.+ C.U.P_46 DATE APPROVFO P LF, I hereby acknowledge that I have read this application and state '^ n that the above Information Is correct and agree to comply with all laws regulating building conrtruction, end 1 shall not employ � any person In violation of the workman's compensation laws of a the State of California.- I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter ttt 9. I SO. FT. n m •' y' in THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT EE ONLY: VALUATION �• PERMIT FEE $ pLAN CHECK S // // /f •^� Signature of ��,••J(((,,,///j1/ /I/jf�(„/'��.' Permittee S M 4 •U TAX S .� Author zed Agent TOTAL PAID $ (7 C' � V t7 3 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 i', 43439/05/78 153:20 TLS >N S APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEI .DATE RECEIVED D EIS D BUILDING �7 A / I� ADDRESS Z SO ArirtvYA ,4Pw.r �/ _ tt'-'-�� Sitt•tS9uMtD OWNER 141L QoA-QC— S A.P. NO. �Z 7-�6/ PERMIT NO. BUILDING ADDRESS A MAIL I ST. ADDRESS a5'o G ` f TRACT (p LOT BLOCK C�fj'f/. TEL. CITU NO. CONSTRUCTION W ADD A PLISH LENDER BRANCH OWNE ItAj ADDRESS VALUE USE • S Or/(� ARCHITECT TEL. OR ENGINEER NO - FIRE ADDRESS �; ZONE TYPE GROUP �- A Tf7Uc.7�2 APPROVED CONTRACTOR BY DATE tY ADDRESS �OZ iL RU IZ TEL. ZONE NO. OF USE OF NEW j.VTCQf P CITY ZV t4L CA V71S NO. 8 3 � PLANS 2_ BUILDING LT6QRTl STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE I `` 3s NO. OF BLDGS, (FROM C/L STREET) OF LOT 7. X J e7 �• 7 NOW ON LOT FRONT FT: FT. USE OF EXISTING BLDG. F Separate permits are required for L SIDE FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR. bI• DATE C.U.P. sW APPROVED APPROVED6jq / �� DATE �i I hereby acknowledge that I have read this application and state Mat the above Information Is correct and agree to comply with all laws regulating building construction, and 1 shall not employ any person In violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Dlvislon 3, Chapter 9, and that such licenses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E and Professions Coop, Division 33/, Cha 11.9 / PLAN CHECK § Signature of TAX E Q Permittee OW K/ Authorized Agent TOTAL PAID E a 20 >N S PRQJEC�T ADDRESS: 2950 AIRWAY AV UNDIj OWNER'S NAME: J D GANTES AIRPORT ADDRESS: PROPERTIES P O BOX 8147 NEWPORT BEACH,CA 92658 (619)458-9141 ARCHIENGINEER: BOWMAN S BOWMAN REG.NO.: NONE ADDRESS: 750 THE CITY DR UNIT: 150 ORANGE CA 92668 ' PERMITTEE: RON OLSON ELECTRIC (213)493-1089 ADDRESS: 10391 LASSEN LOS ALAMITOS CA 90720 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.:0�51834q STATE LIC.:1366479 CLASS: C10 Date: _1 1 / � 10 _1I// Signature: _/�r'✓� _ (/ WORKERS' COMPENSATION DECLARATION: 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 3800, Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: I Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred (5100) or less). 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 �Workers' /Compensation Laws of California. Date: 1 L/ / J—` q J `Signature: _Aclii NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 70315 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that halshe 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 win wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her ownemployees. provided that such improvements are not intended or offered for sale. It. however the building or Improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. & P. C. ' for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that 1 or any future building occupant will/will not (circle one) need to comply with said stale codes and the requirements for a permit lar construction or modification from the Air Quality Management District Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have mad this application and stale that the above information is correct I agree to comply with all city and county ordinances and state laws relating to building cq struclion and hereby authorize representatives of this city to enter upon the above-mentioned property for i'nspecctton puurrrpposes, W ✓ v Dale'. � V—/7 0 Signature: _ Driver's License ar Social Security w: 164646 While—Building: Green—Code Enforcement Canary—Applicant: Plnk—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E PERMIT NO: E 049959 PLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION INTERIOR ALT'S TO OFFICE/RSEARCH LAB SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: REFER TO #tB49860 Z O N I N GS E R T E B Q A U C I K R 9 E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE&p PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING NfSTES> iF if iE iR Brit Bf 969f iE * it * iF 9t BL• Bl• BP 9E tE BE iE it Bt * iP * iE 9E it 9f Bt AE * * * 9E if * it >E * BE * aF 9t 9R * iP fF.� * * iF BE if * #f if Bt 9t 9E * k if it BE iF if 9t iF * it iP Of * k iF it D E V E L O P M E N T S E�R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: IE iFk kBF if kiE iP BtiE**iR it le AP 9t iR if BF k'iFif3fifSFif3iifiF�FiFTfiFiF'iF'3�3Fif'1FiF if7E if iflFiF7f�fif3FiFiFit if lE iE lE iE iE 1f 1E 1E if 1E k kiP k 9f 1f if iF Bf * 3P if BP iP )b iR iE• * iE k iP * iR iP k iP iF it iR 9P iE Bt 9t it Bt iP BE k BP 9t iE k iE iFBE LE 9E it iE k iP iP iF iF iR iE LF XEif iE iE * iE * BE at Be 9E iF 3E 9t iE iP iR 9E Lt * 9F LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES - GRADING PERMIT 12,00 50t SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 12.00 15,00 0.00 27,00 27.00 00 REVENUE DIVISION TOTALS--> COLLECTED: 27,00 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 i iE9PiFkBF*BEaE*9EkIE9PiE9t9tLRlkif*if*rt**IfiE**atitlEiEBEiFifiE*DEiE*9EaE-IE*kR9FfE*kEIe9FttiFBF***iEaFiE#RifiEififiEiF9E**ifiR*9FBf*9E9t I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 8 RECEFT/OUTLET 1 ST 20 EA. .75 6.00 ELE 2 MOTOR/POWR APPARATUS 0.0 — 1,0 HP 3.00 6.00 END OF FEES t' 01 00074261-00074261 T CET 27.01, DATE: 11/15/90 TIME: 10;22 a • P & SPA CONSTRUCTION AND PLANNING ' APPROVALS Permit # Date!spector APPROVALS Permit # Date Inspector �. 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 Steel Reinforcement 56. Rough Plumbing & Pressure Test .6.,Electrical UFER Grnd. +c 57. APPROVAL TO COVER-GUNITE 7. Fotitingf: - 58. Electrical Conduit-Undrgrnd. ,•�--• 8. Foundation ' , 59. Gas Pipe, ❑ 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 r -' I 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 `:77. 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 APPROVALS" Permit # _- 20� Rough Factory Fireplace _ 21. 21. Ducts, in Structure7. 1 • 70. Underground Hydro 22. Ducts, Ventilating - - { - 71, Product Piping O Gas ❑ Oil 23; Gas Pipe -Rough & 72. Underground Fluth F `. ,Test 24: Roof Framing �. C 73:' Undergrnd. Storage Tank D Gas OOil 25. Roof Sheathing-' ''• - '' ' 7qp Overhead'Hydr6- 26. T -Bar Ceiling (Structural) & Monocoat u - +' - - 75: Dry Chemical - 27. Frame and Flashing 76. Dry Standpipe v + r,'• _ 28. Lathing & Siding <. :.;}.• c + 77. FIXED SYSTEM'FINAL 29. Insulation 78r FIRE PREY. FINAL - 30. Drywall Nailing I (- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat _ `,' k' 79: FINAL INSPECTION 32. Electrical Power Meter -Final - :' I 80. FOOD CERTIFICATE ISSUED 33: Final Electric' 12'•13� 1 Notes: • '.34: Final Heating &Air Conditiohing- I I t 35f, Final Gas Pipe -Test I C, _ r 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing �- + - (_ �•. - - - 39. Water Service -Final ,• - - ' 3� 40. Gas Service -Final. - 41. Solar Domestic -Final-. c 42. Backflow Preventer 43. Backflow Irrigation 1 44. Landscape Irrigation System,. •i - -_ - e 45.. Sound Attenuation til r 'y --46., Handicap Regulations 47 -,FINAL STRUCTURE & BUILDING- 48..FINAL PLANNING - 49. Electric Release to"Edison 50. Gas Release to Southern California Gas Co j ' - - . - 51. CERTIFICATE OF OCCUPANCY �; r :• No Date •I.. CrsV OF COSTA MESA CONSTRUCTION PERMIT ' PrpjectAddress 2950 AIRWAY AVENUE ,c�J�'1-� A - Applicant's Mailing Address 1175 N. OSPREY CIRCL ., I Owner's Name Phone Address Arch/Eng. License No. Address Contractor's Name BLAKE A/C & SERV.CO.INCPhone M30-641 Address (mailing) 1175 N. OSPREY CIRCLE.,ANAHEIM,CA. City License No. 026026 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am IIC(mSed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is in full tprcgdno effect. 3 109 License Class ll.• 66 L ce e Date T7— ao Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure ora certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Polio, Lab. Policy No. �Company 00058100005 NATIONWIDE INS.CO. ' � Certified copy is hereby furnished. I / Cert1die opyds fi With the city Ing Division. 1 to IZ ✓�' Applicant ���ate_ ' A c EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for One hundred ($100) Or less). 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 Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become Subject to the Workers' Compensation Provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of 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 ($500). ❑ I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law doesnot apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove efor the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the Project (Section 7044, Business and Professions Code: The Contractor's License Law doe$ not apply to an owner of property who 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 proof p their Worker's Compensation Insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason 41 189 Applicant to fill in all spaces except those within heavy border lines and sign au appropriate declarations. Date Owner I hereby certify that I have read this application and state that the above information Is correct. 1 agree to comply wl h dll City and county Ordinances and state law relating to bui Ing con tru ion, antl hereby authorize repre. sentatives o is city [o a er a o e -mentioned property for inspection po s. k0z C7 /I_;> 2 n Signature Date Drivers' License or SS 5P ADD Lle ALTERATION 11 REPAIR CONVERSION LJ DEMOLISH LJ C 3CRIPTIQN QE WORK/USE OF -BLDG. TYPL" OF PERMIT LJ GRADING LJ FOUNDATI N LJ STRl1CTUl ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL ❑ ,OTHER PROJECT DESCRIPTION SO. FT. OCCUPANCY CONSTRUCTION TYPE VALUATIONS— ZONE— ALUATION$ZONE GRAOINGCU.YDS. ACRES— Remarks: FEES A.P. W sS Main Building: T Front A Rear C Right K Left Ping. Ref. + Plannina Notes: Accessory Building: Zone Z O N I N G R E Q M T S Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Dat Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50 + KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter El over 100 amps Dishwasher Solar Piping Dryers []Gas ❑Electric Sub Panel Drinking Fountains Solar Tank n Fan Motors ❑0-1 HP, ❑ 1'h - 8 Floor Drains Swimming Pool w/Spa F.A.U.Inc. Solar 09.15 HP 1116-15+ Floor Sinks Urinal Fixtures Microwave Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal Standing Sections P,=Trap Laundry Trays Generator ❑0-5 KW El 5.15 KW Trash Compactor Drains Reinspection Fee 1 $15 Bailer Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBG # eating System & Ducting Reinspection Fee 1 $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 00-100,000BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 FEES Reinspection Fae $15 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Dat SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ — .. ISSUANCE $ r5V 5u� 0(II/���' TUT 33.N PLAN CHECK 25% $ nwt +n rnc_ ENERGY. P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ 15ANy—TOTAL FEE $ E. be PLAN CHECK 25% $ 6 n CO $^ CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector ij."iTemporary 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 6:1 Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE rn 7.'�Footings 58. Electrical Conduit-Undrgrnd. 4�8.'.,'Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9'.+1Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10': Structural Floor System_. 61. APPROVALTO,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 ' 17r. Rough Wiring Sign 68. APPROVED FOR PLASTERING Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # r'1 7 - 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil C r 23. Gas'Pipe-Rough & Test 72. Underground Flush h' 24. Roof Framing 4 _ ' I 73.j Undergrnd. Storage Tank DGas .0Oil to 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 t, 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat 79. FINAL INSPECTION "U 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating &Air Conditioning uzi�> �J 35. Final Gas Pipe -Test -' 36: Hood or Canopy 37. Final Factory Fireplace a 38.^ Final Plumbing ' 39-WaterService- Fi�, rnalt � j \ r r: 40. Gas Service -Final - 417 Solar Domestic -Final .42 --Backflow Preventer 43 Backflow Irrigation 't rr -'44�Landscape Irrigation System co r:. -. ✓aJ .45 -Sound Attenuation i 46 Handicap Regulations _ v: 47:,FINAL STRUCTURE &BUILDING ... - :• 48! Special Requirements Completed t� 49=Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date \ v \ v. \. - - ' ' • �'• - . y, w 9r• i y_ j `{�f J - Applicant • `- l0 fill In all spaces except Inose within heavy borEer lines and sign ill apprppr(ate declarations. .. MESA .CONSTRUCTION PERMIT-' 'CITY OF COSTAAl l Prpject'Address ?:%GA- PERMIT NO. - ry TRACT NO. :LOT NO." UNIT NO. TYPE OF CONSTRUCTION _ NEW ADO 'ALTERATION REPAIR ❑CONVERSION.. ❑DEMOLISH ❑OTHER I Lr, DESCRIPTION OF WORK/USE OF BLDG. .+ *l 47 :� ! .r,-, ' . A licant's Mailing Address 1'i%'+ fi,--ti:v i:Y:•ax.t:.../-.,.:.:.1Y. ` Owner's Name Phone • Address - A P qW Zone - IS Main Building: Accessory Building: Y ' Arch/Eng. License No. Address �f TYPE OF PERMIT GRADING U FOUNDATISNt STq CTURAL - -]TENANT ❑'ELECTRICAL ❑ PLUMBING MECHANICAL 1:1 OTHER.' .. PROJECT DESCRIPTION SQ. FT. -'-OCCUPANCY CON STRUCTION TYPE 'n 1!VALUATION$ ZONE GRADING CU.YDS. - ACRES - T Front - O, 9 A Rear Nf I f:l C'(tr.:.//',• F.' 4_•�.!tl.iJ./.1.:!' (l Contractor's Name Phone Address (mailing) _ 9 �.%ri ;?•, i;".[S:r._}{ CYt;C,I_� .i:+'K�L1. 9 -- City License No. t=�'%•f� LICENSED CONTRACTOR DECLARATION - I I hereby affirm that I am licensed under provisions of Charte Y P with Section 7000) of a and of 3 of the Business antl Profe my license is in full force and effect. � License Class License Nol,',- JIM) 1. CA T 9 commencing ( shoes Code, and '/.- C Right - ' N K S Left'r - G R Ping. Ref. t. Parking Req./Provided E Remarks: , -�•�- _ Planning Notes: 0 M fl ' � � T Date ( '^ '-•- 1' 1 Signature r-�"^ ' "f' "' j — •'L - 'PLUMBING, $, FEES - - •I .t; N It V� • •', ORKERS' COMPENSATION DECLARATION -,hereby affirm that I have a certificate of consent to self{esu 'Qf•workers' Compensation Insurance, or a certified copy 3800,'Lab ..C.) iy"_U 5 16=05 lu.�Yd;a 'Policy No. Company • 8 Certified copy Is hereby furnished. C¢ftAf Intl Copy, is filetl with thecity Building DIVISion. te f,..3' r ft,.,• Applicant 'k'-.!_I�'n!'^—aI-Ate`-' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit IS for one hundred less). - 'LI I certify that In the performance of the work for which this Permit -shall, not 'employ any person in any manner so as to become Workers'-Compensation-Laws of California. Date Signature or a certific5te hereof.(Section � :I::S_Co. - ",' !`x • ($100) or is issued, I subject to the rr - - F - Bar Sink- ' - Showers,, y - ., j'. 'ELECTRICAL �' .,FEES Backflow Preventer -Service Sink + Automatic Washer - t'4 Transformer ❑ 15-50 KW _ ❑ 50+KW Construction Pole Sub. �d Backflow Irrigation Sewer �aP r. Bathtubs $ewer Cohnection _ "_ -� Cooking Unit Meter ❑Up to 100 amps z Clarifiers $Oler'COII¢c[ore - Dishwasher --I If+ Meter ❑Over 100amps - Dishwasher Solar Piping : ' 5 Dryers ❑Gas ❑Electric ' Sub Panel Drinking Fountains Solar Tank - % i Fan r• Motors00-1 HP 01 h- 8 - Floor Drains Swimming ing Poolw/Spa ',- �( F.A.U. 'Inc. Solar ❑9-15 HP El16-15+ •' f . I i ^' ;!, •' ” j:- ' _ _ ' •' - ' NOTICE: If, after making this declaration, you should become subject to the Workers' .Compensation provisions of the Labor Cotle, you;must forthwith comply with Such provisions Or this permit shall b¢' deemed revoked. •CONSTRUCTION LENDING AGENCY i 1 hereby worrti that there is a construction Issug agency i or.t 3097 fCIv. C..) of [he work for which this permit' Is Issuetl (Section 3097 Clv. CJ ,Lender's Name 1•. f 1' ' Lender's Address OWNER BUILDER DECLARATION _ i`. fl hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031:5 Business and Professional 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/she Is licensed pursuant 'to the provisions of 4'he Contractor's License Law(Chapter9 (commencing with Seetlon 7000) of -1...-salivision 3 of the Business and Professions Code) or that he/she is exempt `+herefrom and the basis for the alleged exemption. Any violation of Section ' 7031.5 by any applicant for a permit subjects the applicant to a civil enally of not more Than five hundred dollars ($500). j•V I, as owner of the property or my employees wllh wages as their Sole compensation, witl'do the work, and the structure Is not intended or offered for sato Section 7044, Business and Professional Code: The Contractor's (Section thereon Law does not apply to an owner if a property who builds or improves thereon, and who tloes such work himself/herself or through his or her own or offered for' 'employees, provided that such Improvements are not within sale. If, however, the building or improvement is Sold wlthln ono-Year of tom- pletion, the owner will have the burden of proving he/she did not build or Im. strove for the purpose of sale). . 1 - ,. LJ I, as owner of the property, am exclusively contracting with licensed con. 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 builds or Improves thereon, and who contracts for such projects with a con. tractors) license pursuant .to the Contractor's License Lawj � I am aware that Proof off their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. 6 P. C. for this reason ' •T'. l Floor Sinks - Urinal I' - - s ' [i Fixtures Microwave ,i . • ' w'- - Gas Service Outlets WaterCloset .- Device Boxes Pole Light ) i 9 - Interceptors Water Heater- .i _ ! Ran e Outlets s g Kitchen Sink Water Service - - - Switches ;; ; Sign Lavatories _ Auto-W"sti .._ '-- Garbage Disposal ,) . Standing Sections P—Trap 1:e Undr! Tfa s. - - y y Generator 00.5 KW 05415 KW Trash Compactor Roof Drains - Reinspection Fee C �- $15 �-� v - 1 Issue.Feo' §'3 {' - [ Reinspection Fee - $15 Issue Fee § 3- MECHANICAL FEES - DEVELOPMENT SERVICES REQUIREMENTS: I Zoning Approved By nate Building Approved By Date . Application Issued By - Date Boiler r Hood ort Type I ❑ Canopy Type II ❑ 5 dd Duct - Under Ground Duct :Structural b - Refrigeration System - ❑0-100000 BTU ❑100,000 BTU ' Duct - Ventilating _ - SUMMARY OF FEES BUILDING PERMIT"-. $ $MIP $ PLAN CHECK $' PERMIT _ PLUMBING .� $. -ISSUANCE. $ ,•J ' +' PLAN CHECK 25% $ .ENERGY P.C. $- - •' 'GRADING ELECTRICAL $ PLAN CHECK 50% ,5 MICROFILM $. MECHANICAL' $ f�^+���-� � f • . e .0 ' - TOTAL FEE $' ` PLAN CHECK 25%rf$ 0. Exhaust System ❑ Multiple ❑ System Repair/Alteration ,• �� Firepl/Fact. Blt. ICBO # Fire Dampers 1 ' Date Owner I — I hereby certify that .1 have read this application and State` that the above .Information is correct-. I agree to comply with all city and county ordinances and state laws,relating to building construe0on, and herebylauthonze rcore. Sentatives Off this city to enter upod the above-mentioned property for inspection purposes. f /' ` ( / P • I ` p j i Signature.-;.G^z. _�' f'..F :'- '✓tom•_-Daate i�it' -'11 - - y Drivers' License Or SiS Heating System & Ducting ❑U700,000 BTU ❑100,000 BT Registers' - -',t_. - —NY;- 1wYl -- lz- ^ •�- i- <c,r -- - - ----. /. _ - Reinspection Fee " $15 Issue'Fee $$$:3r - �. CMF 0865-46, rev. 30/84 - Wnite�, Building; Canary - APPlica of Pink -Accounting: Goltlenrotl.. Assesiort , �'�, ril }, Y 1 CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL & SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. i 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 LIFER 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 APPROVALS Permit # _ 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 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 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ' •r P.; City of Costa Mesa Building Safety Department CERTIFICATE O F OCCUPANCY P.O. Boz 1200 i T" M63 Costa Mesa, California The Building located at 24 i0 T.:irrr.^tr R.a,a. Ii—J has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group ccupancy. Use of Building Ytllln+ iter A1t•n:-^+,_inn Legal Description A ct. %C,97-1.'.F—iln (See reverse side for Metes and Bounds) Building Permit No —'47111 Electrical Permit No. TZ --111 rt Plumbing Permit No. --') Number of apartments —fl, and/or guest rooms _n_ ISSUED TO: Building Official by r. rl F: Sf,arIcs 17, C. Ne}at —Lu.t1d inrq Aiviuio:t Dr/xt' /962 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. 306 lel U.B.C. Form BU 34 Rev. 11/70 r (714) 754.5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT .lob Address: 2950 AIRWAY AV Status: ISSUED Suite: B001 Applied: 10/01/2004 Vicinity: INDUSTRIAL BLDG UNITS B1 8 B2 Issued: 10/01/2004 Parcel Number: 42716409 Zoning: Applicant: WILBER, SHARON ISSUED BY: Address: 10501 CLAUDIA CIR_ - -Phone: "(714) 827-0861 CYPRESS, CA - Zip: 90630 -- Owner: KEITH, SONJA Address 23 TERRAZA DR - - ,� Phone: • , NEWPORT BEACH, CA-- - Zip: 92657-1510 - -_ Contractor: WILBER ROOFIN( ZINC Address: 10501•CLAUDIA CIR - Phone: (714)827-0861 ' CYPRESS,CA ' Zip: - 90630 - License: 322179 - Arch-: .._Eng: Address: Address: ,Phone: ,.. - _ Phone: Zip: License: License: SCOPE OF PERMIT REROOF INDUSTRIAL BLDG WITH UNITS B1 AND 82: T/O EXISTING CAPSHEET ROOF AND_ INSTALL BASESHEET 3 PLY FELTS AND CAPSHEET NOT MOPPED. 4800 SO FT " -`' _ - FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6660.00 Permit: $167.25 _ _ __ "_ _ _ :. Claim Valuation: $8,650.00, SMIP Res: $0.00 SMIPCom: $1.80 Other: $0.00 Inspection: ' $0.00 - -' Total: $169.05 PLANNING & ZONING SETBACKS STRUCTURE\.Front 0'0 R_ ea_r, 0-0_ Left, 0-0 g 0 .i - ,�-0MAIN i ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right , 0-0 PARKING Existing; '0 Required:- , 0, Proposed: 0 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 2448-46(6[00) WORKERS' COMPENSATION DECLARATION: - - I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are- Carrier: 17• Carver: T,IOTTZ– —N.tl� Policy Number: _5 _!1 (This section need not eb completed if ?fie permit is veluetl at one hundred dollars ($100) or less.) ' ❑ 1 certify that in the pertornance of th work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califoml a agree that if I should subject to the workers' compensation provisions of Section700 the Labor Code, I shall forthwith comply with these provlslons // //3 d L/J Applicant Signature: �� Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions o�Chapter 9 (commencing with Section 7000) of Division 3 of the Businetis and erolfessions Code, and my license Is in full force and effect. Lia # 12 p7 d Classy# Contractor's Signature: Date: O a CONSTRUCTION LENDING AGENCY: ❑ 1 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: Lenders 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 ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor($) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Califomia 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: i' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and cenity a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................................................................................................................................................I........................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .........._............ .._............ ......................._........... -._................................................................ _..... _... _._................................................ _.__........................................ _..................... _........... ..... _................ _............ _............. _...................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .........................................................................................................................................................................................................................._.... ............................................................................... I ................. ............................... . ........................ 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .............................................. .................. ........... ............................................................... ..................................................... .........................................................._........................................................................................ ................ ................. ........ 5 Does or will the applicant or present or future building Occupant require for the work which Is the subject of this e a plication apmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? I) Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ....................................................................... ........................................................................................... .............................................................................................................................................................-..................-....................................... 6 Will any pan of the taciltry to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it 'yes". the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................................................................................................................................................................................................................................................................................................................ 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..................... ..............._............._...............................____............._._....___............................................................_...—__..................__..__........................ _........... _................. _............. __.......... __............ _..... yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I cenity that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. Si r Legal Ow r ) Data And/Or Authorized Applicant Date CODE.. INSPECTIONTYPE OATS INTITMLS CODE. INSPECTION TYPE DATE INTIDEL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof "l�'T 1'(30 210 Final Electrical 201 Final Block/Retaining Well 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 PROJECT ADDRESS: 2950 AIRWAY AV UNIT' B-3 OWNER'S NAME: SOUTH COAST COUNSELING ADDRESS: SAME ARCH/ENGINEER: 957-6904 REG.NO.: ADDRESS: UNIT: PERMITTEE: EARLS PLUMBING (714)772-3470 ADDRESS: 1533 W. LINCOLN ANANHEIM CA 92801 LICENSED CONTRACTOR DECLARATION: I hereby atlum that I am licensed under provisions of Chapter 9 (commencing with Section 7000) at Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY UC.j)05938 STATE LIC. :217657 CLASS: r-36 Data: Sig nature: Fj WOR S'C PENSATION DECIARATION: thereby affirm lh aveacenificale at consent to sett -insure oracenilicate of Workers' Compensation Insurance, or a cemfied copy thereof (Section W. Lab. C). PouCYNO.:1339225-93 EKP.DATE:03/01/94 4CDMPANY: S TATE ] Certified copy is hereby furnished. W Certified copy is filed with the city Building Division. Oat e. L Applicant:v EKEM N POM WORKERS' COMPENSATION OECLARATION: (T don need not be mmdched it the permh is for one hundred (31 W) or less). I cer iy 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 WorkersCompensation Laws of California. Date: Signature: NOTICE: It. atter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097. Gv. Q. LENDER: ADDRESS: OWNER BUILDER DECUBATION: I hereby affirm that I am exempt from the Contractors Slate License Law for the following reason (Section 7D31.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State 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 lice hundred dollars (55700). 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 fm cafe (Section 7044. Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and Who does such work himsel0herself or through his or her awn 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 will have the burden of proving he/she did not build or improve for the purpose of saleI. I, as owner of the property, am exclusive ty contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not appy to an owner of propefly who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' $tate License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: Date: Omer: I do hereby certify that I am aware of and understand the requirements at California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any lulure building occupant wilYwal� (tittle die) need to comply with said state codes and the requirements for a permit for construction or modification from the Au Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that have read this application and Slate that the above information is correct. l agree to comply with all city and county ordinances ana state laws relating to building construction and hereby authorize representatives of flus Gly to enter upon the above mentioned property for inspection purposes. Date: '? Signature' Driver's License or Social Security e: 1641.46 Whole—Bwld,ng: Green—Code Enforcement: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT FERM NO; P Ob1617_ PERMIT NO: P 061612 PLAN CHECK NO; N GOVT: N SUPP: AN CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE; OTH JOB DESCRIPTION : INSTALLED WATER HEATER SQ FT: CLAIM VALUE: CALL—VALUE; GROUP OCC: / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ; PROV; PARCEL: 00000000 ZNE; REF NO: PLANNING NOTES> > D E V E L O P M E N T S E R V I C E S.•• R E Q U I R E M E N T S ZONING APPROVED BY i DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: _ L� le####3F##iF#!E###IE#####k#iFiFxir xirxxxir iFFlFxae x-kiF x. Qf .xh'it•3tx#xx###awn #xx.rx xxxx x•#•?( LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7.00 25% SMIP/NON—RES PLAN ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 7.00 20.00 0.00 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR VENT 7.00 7.00 END OF FEES CJNSTRUCTION AND PLANNING -- APPROVALS Permit #T- Date Inspector - POC SPA APPROVALS Permit # Date Inspector' - 1. Temporary Electrical Service or:Pole 8. Foundation 52. Pool & Equipment Location 59. Gas Pipe, O Undrgrnd., Test " 2. Soil Pipe-Undrgrnd. 9. Water Pipe-Undrgrnd. 53. Steel Reinforcement 60. Backwash Lines, P -Trap, O Undrgrnd. 3. Electrical Conduit Utility-Undrgrnd. 10. Structural Floor System 54. Forms 61. APPROVAL TO DECK 4, Electrical Conduit-Undrgrnd. 11. Property Sewer Line & House Connection 55. Electrical Bonding 62. Backwash & Receptor -Final 5. Steel Reinforcement 12. Sewer Cap 56. Rough Plumbing & Pressure Test 63. Heater & Vent -Final 6. Electrical LIFER Grnd 13. Roof Drains 57. APPROVAL TO COVER•GUNITE 64. Plumbing System - Final 7. Footings 58. Electrical Conduit. Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 18, Rough Electrical -T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe -Rough & Test 24. Roof Framing 25, Roof Sheathing 26. T -Bar Ceding (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter -Final 33. Final Electric 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Date sm 1n In Is In in iN 68. APPROVED FOR PLASTERING 69. POOLISPA SYSTEIVS FINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping O Gas 0Oil 72. Underground Flush 73. Undergrnd. Storage Tank ❑ Gas 3 Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREY. FINAL HEALTH DEPT, REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED -}I- Notes: I I) PROJECT AODRESS&2 950 AIRWAY AV UNIT: B4 OWNER'S NAME, IUCE COB INE' ADDRESS: 682 ROCKHURST ,S. A. ► 957-6904 'ARCHIENGINEER: - REG.NO.: A)DRESS: UNTT: 14111iITTEE: BRUCE CORZINF. ( 714 ) 957-6904 ADDRESS: 10682 ROCKHURST ST S. A. CA 92704 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my,lica n e, is in full fora and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cenifcete of consent to sell -insure or a ceni/iczte i f Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Q. `UCY NO.: EXP. DATE: ,OMPANY: - ❑ Candied copy Is hereby fumished. ❑ Cernfied copy is filed with the city Building Division. - Date: Applicant: i - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one lftil 4{510)) or less): : I certify that in the performance of the work for which this permit is issued, I shall not em I n ers t in any manner 6Q as to become subject to the Workers' Compensation Laws f California.I .•" Date: Signature - G % NOTICE: I/, offer making This dedaratio you s oma subject the, Workers' Compen Ifon provisions of.li. Code, you must forthwith comply with Such provisions or this,permit s e deemed CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work fors which this permit is issued (Section 3097, Civ. Q. LENDER: - .. �' •. ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that•I am exempt from the Cormactors' State License Law foF the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, imocto Its issuance, aUgrequires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of the Contractors' Slate 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 7mi.5 by any applicant /or a permit subjects the applicant to a Civil penalty of not more than five hundred dollars ($500)7 - y, I, as owner of the property or my amy owes with wages as their sole.ampensalion, will do the work, -and the l structure is not intended or offered for axle (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who aces such work Nmself/herself or through • his or her own employees, provided that such improvements are not intended or offered for sale. 11, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the proplerty. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Gode: The Contractors State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such Projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. •- ❑ I am exempt under Section: B. 5 P. C. for this reason: q s Date: � � 3 � ( Owner / I do hereby cenity that I am aware of and understand the req uireme of C lilornia H all and Safety de S ns 25505, 25533, and 25534 and that I or any future building occupant will1will not (circle one) need to comp 'th sal and the requirements for a permit for construction or modification from the Art uality Management District. as cards construction applications are exempt from . these provisions. Date: Applicant: I hereby certify that I have read this application ��p���IIId slate that the above information is correct. I agree to amplywith all city and co ty ordinances and state laws relating to building co mcnon a re6Ywa orize ropmrsantatiliels4i city to enter upon the above -mend property for inspection purposes. / y/ Date:- I _ ignature: Dr'iver's License or Social Security e: 16,111 White—BuHdMn: Green—Code Erforcement; Canary—ADplicant: Pink—Revenue: Gold o—A..rrsao CITY OF COSTA MESA = BUILDING PERMIT PERM -NO: BE 04679r - PERMIT NO: BE 046798 PLAN CHECK NO: 63471-90 S GOVT: SUPP: td ,N CONSTRUCTION TYPE:•V-N PERMIT TYPE: ELE SIR PURPOSE: AtT .JOB DESCRIPTION OFFICE T.I. ,,ADD A DIVIDING WALL S.Q FT: 1,500.. CLAIM VALUE: 1•,500.00 CALC--VALUE: '1',500.00 GROUP OCC: B-2 '7 COMMENTS: ########N#####K#ef#ie#i/#i4"##########'iE######!k####4f#af###�41E 1E##)E i(####1(•#-####'%#fE#####iF## Z O N I G S E T B A C SR E Q U I.R E M E Al T S ' K ------------ MAIN BUILDING-- --- — ------ ACCESSORY BUILDING ----- FRNT: FT IN REAR: FIT IN FRNT: FT IN REAR: FTIN LEFT: FT IN FIGHT: FT IN LEFT; FT I IN RGHT: FI', IN PARKING REQ: PROV: PARCEL: 42716405 ZNE: MP REF NO: ` PLANNING NOTES> INTERIOR ALTERATION TO SUBDIVIDE•A COMPUTER REPAIR ROOM FROM > EXISTING WAREHOUSE AREA. #####ae########i<#?f#N.iF#####ieN;#M•####'###.##################iE##if####M'####X. #'##l4#,#"% D, E V E L O; P M E N:T S E.R V I C E S R E Q U I R E M E -N T_' S' ZONING APPROVED BY,'/ � DATE: BUILDING APPROVED BY : ! DATE: APPLICATION ISSUED BY: DATE:, ###################### u 7.k a�Fi�3F#####ef##ie% fit# iFaa ii## LEGALIZATION:N F E E S U,M M A R Y STRUCTURAL:'SEGMENT:Y BLDG PMT' PLUMBT.NG ELECTRIC MECHANIC FIRE SMTP/RES&• GRADING PERMIT 35.00. 6.00 508 SMIP/NON—RES' PIAN' 22.75 SU r.SSUE.FEE 15.00 BUILDING—DIV-> PERMIT ISSUE: PLAN—CHECK TOTAL PAID DUE TOTALS-----> 41:.50 15.00 2.2.75 79.25 79.25 .00 REVENUE.DIV.ISION TOTAJ.S---> COLLECTED: 79.25 OVER/SHORT: .00 BLDG PMT PLUMBING,ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK 35.00 21.00 .50 22.75 JE##dE 1F#7F if if##lE#7ear###############eFN#)Eklf#######1FiEJE#iE##########1E#####d(•########if###3E# I. N D I V I D U A L F E E B R E A K D O W N 'TYPE QTY D E S C R I P,T I O N UNIT COST TOTAI. COST SFC' 1.500 ALTER BY VALUE COMMERCIAL NOZONE 1.00 1,500,00 ELF. _; FIXTURES, liIGHT:ING . 1. ST 20 F.A. .75 3.75 F_LE 3 RECEPT/OUTLET I ST 20 EA. .75 2.25 LNI7 OF' FEES 0 01 00057721-00057724 I -OT 79,25 . DATE: 64/03/90 TIME: 14:49 CONSTRUCTION AND PLANNING APPRO.YALk. Permit# Date jInspector r .L & SPA APPROVALS Permit # Date Inspector-. 1. TeWporary Electrical Service or Pole 52. Pool & Equipment Location f Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' r .i 3. "ectrical Conduit Utility-Undrgrnd. ' �.. 54. Forms 4. Electrical Conduit-Undrgrnd. ,; 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test r -` - 6.. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE' 7. Footings - - 58. Electrical Conduit-Undrgrnd. 8. Foundation ; � � 59. Gas Pipe, ❑ Undrgrnd., Test i 9. Water Pipe-Undrgrnd. '" r 60. Backwash Lines, P-Trap, 0 Undrgrnd 10. Structural Floor System p j ` 61. APPROVAL TO DECK �Z 11. Property Sewer Line & House Connection 14 62. Backwash & Receptor-Final 12. Sewer Cap �j :- i 63. Heater &Vent-Final 13. Roof Drains ��.. / 64. Plumbing System - Final1. l 14. Rough Plumbing "i^�- 65. Electrical-Final 15. Rough Electrical-Conduit_ i 66. Solar System-Final re 16. Rough Electric Wiring /M-+ 1 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING !' / 18. Rough Electrical-T Bar Ceiling �7 d • 69. POOL/SPA SYSTEMS FINAL-- 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT APPROVALS - Permit # 20." Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 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 Flashintr [� 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 - Y 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date J i _-hSTA MESA BUILDING—SAFETY DEPARTMENT - P.O. BOX 1200 Costa Mesa, Calitomia BOg4 7/OI /81 ME 29.64 % a ' F a , a a ' MAN Andersen Electric TRACT NO. LOT NO RECD BYELECTRICIAN 4;DAFTE- IT NO. ISSUED 7 ADDRESS 47 Beach -Lido Park BUILDING USE CITY Newnmkt Beach TEL. N0675-3160 STATE LICENSE NO. 302502 CLASS C-10 ADDRESS 295a Airmay Suite B-1 CITY LICENSE NO. 6729 NO, ITEM EACH Ftas COSTA MESA, CALIFORNIA Dwelling,NEAREST Sq. Ft. S CROSS ST. _Kx \l 1 Garage, Sq. Ft.,% j. OWNER Morris & First 20 Outlets, each InnADDRESS 3176 _Pu1TI1dn�Suite 112 Outlet., Adai!i°"al17 IRA r CITY Costas Mesa TEL! NO.540-8846 jw First 20 Fisfures, eachI 79; Inn HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CATION AND�STATE THAT THE ABOVE IS CORRECT AND AGREE TO'{COMPLY�WITH AIL CITY ORDINANCES AND STATE LAWS REG- ELECTRICAL WRING. (I CERTIFY THAT 1 POSSESS THE ABOVE VALID STATE OF •" CALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF THE SINGLE FAN^ RESIDENTIAL PROPERTY DESCRIBED ABOVE. PERMITTslowtune. PERMITTEE i'sULATING Fixtures, Additional Dryer//pp _'l�.L FanA"_ Hearer 'l' t\ y T Oven, Domestic .( �� NO. ITEM EACH FEES Pole, ConaructionK:yk, Sign 6 1 Trans. 2.00 Rang, Deineitic) Transformers KW 2 ^!!'f-. ' A/C 2.0 4.00 1 Panel 5.00 Generators KW Motors (See Schedule] HP HP HP Sub -Total Fees ,(,Q, CFC=D C.& 7 -ie,—? APPROVALS ], Motors, e . _ _ y 5.00 INSPECTOR — DATE ' TEMP. POLE Permit Fee 3 DO UNDERGROUND CONDUIT ROUGH p✓,f:-4 Sub -Total Fees _ FIMURES _ POWER Total Fees $29 64 UTILITY CO. NOTIFIED FINAL CMF 0313.46,rev17j7e For items not listed refer to Fee Schedule BLDG. PERMIT NO. a i� C. COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 22 TL For P„pplicant to Fill in Completely — Use Ink Only BUILDING /) aSC AIRWAY 6_1 % 1 ADDRESSBUILDING RECE PERMIT S� 7 A.P. NG. ^ l D OWNER OR /� � R �/ / p TENANT' 1 N\t117 7�1��� ADDRESS 29s6 6E��2�aJa4 rJ �/ UNIT N SPACE NO. MAILING jt�t,C�I [� ADDRESS 3 I Z (� Pv L�-M A /�-� rt _ 1'cy/�V(-�r R. LOT LOTG / J BLK. Q CITyCL� A M05� NO. �171�-/� CONSTRUCTION A'� LENDER '�Y_ NEW ADD LTE REPAIR MOVING DEMOLISH BRANCH ADDRESS OWNER` �.�QL.ESS `A�fo2SJL USE !/..s /i/G[O� % VALUE$ H2O n nz G b'w ARCHITECT . r �nppl� TELFr L OR ENGINEERr�+C-'I J��^� ZONE MP /_� R TYPE `� _A)GROUP r8 r L 1 , ADDRESS ` "YJ f V W��^� '(T �' V tt��7•r���� � � It Srj/•R.vw� APPROVED (P/ro BY DATE �O Ap ADDRESS3 (j b V L-L--JL`(Ati '(N(21 *f p e CITY L' 10SM HOSI'1 NO. IrZI (7�1�i� LIC. NO. LIC. NSTATE CITY . 1 `� J J APPROVED SETS KSS SIZE OF LOT NO. OF BLOCS, NOW ON LOT (FROM C/L STREET) FRONT T. USE OF '' pp 1 ,� Vn4 /y EXISTING BLDG- ( PD �1� t t `� R -SIDE FT. Separate permits are required for electric, plumbing and heating work: L. SIDE FT. REAR FT. USE OF BUILDING AND OO TTOO/BE PERFORMED PLANNING ACTION /,W rR�K i r (/ j912_ Vr { 6 -OS DATE APPROVED Y lA 8l I hereby acknowledge that I have road this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or 1 =am exempt from the provisions of the State of California Business d Professions Code iv/7eIown 3, Chapter 9 Signature o�s/�Q/ Permittee III ---,,E I SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION $ / PERMIT FEE S O PLAN CHECK SL C TAX E • fgJ t 'b/ or Authorized Agent Date / TOTAL PAID $233. 2 _ 22 TL F/ PRWECT ADDRESS: 2950 AIRWAY AV UNIT: H-3 OWNER'S NAME: MICROAVIONICS ADDRESS: 3190 K AIRPORT LOOP DR COSTA MESA CA 92626 e ARCNIENGINEER: (714)957-6904 REG.NO.: ADDRESS: UNIT: PERMITTEE: GRAHAM BROS. (714)546-1653 ADDRESS: 2952 CENTURY PL COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am ficensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my averse is in Cue force and effect. CRY LIC.'0059G3 STATE UC.:248604 ss: 20 Date: �/ �j/y�do Signature: WORNE' 4OMPENSA 0 DECLARATION: I hereby alliin t a uNikate o I to sell -insure or a certi0wte of Workers' Compensation Insurance. ar a certified co thereof (section 3500. ab. C). POLICY NO.: WC2 1. 6 10 302 26019 ExP.DATE: 08/01/90 ',COMPANY: LIBERTY MUTUAL. a ] Certified copy is hereby furnished. ® Certified copy is Med with Ne city Bill g Onisi n. I Applicant: E%EMPnO FROM WORXbM' COMPEN&TION OECLAMTION: se feed not be compel 0 e Permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which Uds permit's nd, I shall not em any person in any manner co as to become subject to the Workers' Compensation Laws of California. Date: Signature: - NOTICE: If, alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or RIR permit stall be deemed revoked. , 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 (Section 3097, Civ. C). LENDER: , ADDRESS: - - - OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, Improve, denrolish, or ' repair any structure. prior to is Issuance, also requires the applicant for silch permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State 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 notation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty Of Prot more than live hundred dmtars (3500). 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 (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work hlmselUlrersetf or through ehis 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 will have the burden of proving he/she did not build or improve for the purpose of sale).' 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply loan comer of propem7 who builds or Improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. A P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupam WIVWll not (circle one) need to comply with said sure codes and the requirements for a permit for construction or modification from theATr ua�ery Management District. Residential construction apDlicalions are exempt from these provisions. Date: Applicant I hereby certify that I have read this application and state that the above information is correct. 1 agree to comply with Pty and county ordinances and state laws relating to building construction and hereby authorize representathres of this Wo enter up a Ove -mentioned property for inspection purposes. i Date:�Sipnatum: Driver's License or Social Security e: -164146 While—Buikekio: Green—Code Enforcement Canary—Applicant: Pink—Revenue: Goldenrod—Aseeseor CITY OF*COSTA MESA — BUILDING PERMIT PERM NO: M 045897 PERMIT NO: M 045897 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5 PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION ; CHANGE/OUT REFRIGERATION SYSTEM SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: NO "B" PERMIT TO REFERENCE: ***�-x--�a�dx-**>E**x->EaEeE•�ex+t*x*x-*+��tx�*�*w� �r**arm**-�a�d-�txarTraa�aar-x-arit�-�t�-aE*�txx*->t*ar*�t**x-�c-il-�xit�a�t�k* Z O N I N G R E Q U I R E M EN T S S E T B A C K S ---- ---- -- MAIN BUILDING ---------- --------- ACCESSORY BUILDING----•------ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV:' PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES'> > — klkk)FyEkiFK-aEk itkk kk kiEkkkkiE iEk7E iE kiEkkk�-kit iEit kiFkit iE iF kitkk kiFki4kk k#iEkiEk k�*kiF if iE kitkkkkiE iEkk kiE kiE I) E V E L 0 P M E N T S E R'V,I C E S R E Q U I.R E M E N T S ZONING APPROVED BY' _ DATE: BUILDING APPROVED BY :_ _ DATE: APPLICATION ISSUED BY: DATE: �0 k kkk kkkkk kkkk kkkkkkkkk � i }�iFk kk kit iE ltitkk• itk i(-iek iF ie ie iE lE ie kiE 3Eklekiekit#iE iE iE iE ]k lE if kit kiE if iE iF i( -ie iEkiFkk iE iF it ie lE iE iL iE iE le if ie ik iekif it iF it ie lEi(-ie %iF ie iEfElt iE ie-fEie iE iE el3E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 9.00 PLAN 253 SMTP/NON—RES ISSUE FEE ; 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL. PAID DUE TOTALS- --- > 9.00 15.00 0.00 24.00 24.00 .00 REVENUE DIVISION TOTALS— > . COLLECTED: 24.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT 'GRADING PLAN—CHECK 24.00 kkkkit k'f4 iEk kkkiE itkkkkkkkitkkkkkit iFkk kkitk iEkkkkk kitkkkkkkkkkkkiF k-#iFkkkkkk kitk kiE kifkkit itkkkk I N D I-V I D U A L F E E B R E A K D O W N I TYPE QTY 1) E S C R :I P T I 0 N UNIT COST- TOTAL COSI' MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/11 9.00 9.00 END OF FEES 01 00052950-00052950 TOT 24.00 DATE: 01/30/90 TIME: 11:11 CONSTRUCTION AND PLANNING_' PO. & 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-Und grnd-. - �' 54. Forms 4. Electrical Conduit-Undrgrnd. - i 55. Electrical Bonding -� 5 ,Steel Aeintorcement' - 56. Rough Plumbing & Pressure Test �, 6. -Electrical LIFER Grnd. -. _ 57. APPROVAL TO COVER-GUNITE T.; Footings 58. Electrical Conduit-Undrgrnd. = 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. -Water Pipe-Undrgrnd. /.-� '.'fes 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. Sevv'er Cap _ ; i ,• 'i /1 63. Heater & Vent -Final ' 13. Roof Drains -, 64., Plumbing System - Final 14. Rosgh Plumbing r = 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 APPROVALS .--'-Permit # _ 20;_ Factory Fireplace r. - - , a 21 Ducts, in Structures f - - i -70. Uhderground Hydro ' 22. Ducts, Ventilating,: X171, Product•Piping 0 G_as ❑Oil 23. Gas -Pipe -Rough & Test _ : 72, Underground Flush - _ 24: -Roof Framing _ :73.-Undergrnd.Storage Tank OGas ❑Oil 25. Roof Sheathing 74.- Overhead Hydro ' 26: T -Bar Ceiling (Structural) & Monocoat 75.. Dry Chemical _ 27: Frame and Flashirig 76. Dry Standpipe `"_`71 - - - -28. Lathing`& Siding:,.• -r. 77:.. FIXED SYSTEM FINAL - - 29. Insulation _ �. iii,: 78.- FIRE PREY. FINAL - _ 30. Drywall.Nailing i HEALTH DEPT. REQUIREMENT -:.31. Plaster Brown Coat ' . t - 79. FINAL INSPECTION ;'32r.Electri6al Power Meter -Final iy�; " 80.FOOD CERTIFICATE ISSUED . 33=Final Electric _ _ :. +' Notes: - 34: Final Heating & Ai ,Conditioning- 35. Final Gas Pipe -Test, .- 36. Hood of Canopy 37. Final Factory Fireplace. = . r ! �• n Final Plumbing -:38. ' 39. Water Service -Final, - 40. Gas Service -Final * •- - ' - r _ `41. Solar Domestic -Final' 42. Backflow Preventer 43. Backflow Irrigation. - ' 44. Landscape IPrigation System•- '_ 45. -,Sound Attenuation 46. Handicap Regulations - - .47. FINAL STRUCTURE & BUILDING' - 48. FINAL PLANNING. ;• -' : ; 49:- Electric Release to Edison > 50: Gas Release to Southern California Gas Co �e r - 51. CERTIFICATEOF•OCCUPANCY No. Date IT Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ',CITY OF COSTA MESA - P MIT NO. TRACT N - LOT NO. jPeSe. NO. 449I 4/12/82 ' ? 33.22 ;CONSTRUCTION PERMIT 3Z� S �' _ - " ' -' • ' • - _ _ . _ " TYPE OF CONSTRUCTION 2❑NEW ❑ADD IRALTERATION' ❑REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER r r,! •'; ; -- ZONING REGULATIONS "- . Project Address 2950 Airwa $- C.M. Owner Qrrl� -a' earle c� -Phone -92 Address295/,O Ili Wd B- C.M. - LArch/Eng. Ffank Morris License No. C - 3 1 DESCRIPTI A P ZOW 'Address2950-Airwa B- ZONE PLNG.REF.if ` Contractor R. B. Searles -- Phone - aYPE OF PERMIT - - - - -: ' ❑GRADING ❑FOUNDATION 9ISTRUCTURAL g] TENANT ❑ ELECTRICAL ❑PLUMBING -❑MECHANIC- •SETBACK C LST. IDE'YARD ^- SIEDFE-VA - Tpg I pINC PROP TY LINE .•.I/ - ,Address" 2950 Airway' B - 'LICENSED CONTRACTOR DECLARATION- - - 1 hereby affirm that I am licensed under provisions of Charter 9 (com- I _ .RIGHT mencing with section 7000) of'Division- 3 of the Business and Professions Co my license is In full force and a ect. ❑'DTH Efir- REARV-0 (TO P/LI - .... - land ZC PROJECT DESCRIPTION _ _ - - - as Lise Llcens Jc I - PKG. SPACE REQ. "' 'PROVIDED "'---" Date '�/ arch Signature ..SQ. F_T. _ ._.. .. .. t V _ WIDTH - _ - PARK -FEE'S "- ,WORKERS'-COMPENSATIONDECLARATION - _ it hereby affirm that I have a certificate of consent to self -Insure ora -N OCCUPANC- CONSTRVCTI ON T V_PE VALUATIONS•$2. n, non ZONE STREET .-ZONING'APPROVED BV /' DATE certificate of -Workers' Compensation •Insurance, or -a certified copy __ 0 SPECIAL - - -" - thereof (Section 3800, Lab. C.). GRADING CU. UOS. ACRES - CONDITIONS' y No. _ Company y. - - - - - - -- .ertlfied copy is -hereby furnished.. _ _ _ "Li '- REMARKS;- -i lilted copy istiled with the city Building Division. , EXEMPTIONFROMWORKERS' COMPENSATION DECLARATION (This section need not..be completed if the,permit is for one hundred - - - _ •• S$100) or less). _ - - - .certify that in the-performance.of the.work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING' ` - PLAN CHECK _ t - iELECTRICAL-`- - PLAN CHECK subject to.the Workers' Compensation Laws of California._ - 'BATHTUBS- S110WE0.5- - - ..-- Date Signature .NOTICE: If after making this declaratlon, you should become subject ,TOILETS ., URINALS "— '- - 'GENERATOR- 0-1'KW_1-10 KW - - to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS --' t --- ' ;APPLIANCE- 10-50 KW_50 + KW - - -- --- - revoked. __ .�_.-. _ ._ __ - - CONSTRUCTION LENDING AGENCY KIT.'SINKS` " -DISHWASHERS - MOTORS -- - - 0°1' HP -1-10 HP 'I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS , SUMPS '-:,, *('.1 ' '� ,y • '; -� - ' . .(INC. SOLAR) _1Qy50 HP " 'E 50 + HP" �• �_ _- 7- formance of the work for which this permit Is issued (Section 3097 _ ___�. FLPOR.SINKS WELDOR DRAINS' - f' -4v_ - FIXTURE$- +OUTLETS -SWITCHES- ,Civ. C.). .. __ .. _ ._._ -_ _ ._ .. __. - ..1 C +. .. •_c (Lender's Name' °•�' "'� �'•^ , \ _ (. t Lender's\AddreS{- 1 :: -�• sw -- DRINKING FOU NTAIfVS'--' — " - :GAS -TUBE SIGNS --- - - - -- -- OWNER gU1L"DERDECL`AR'AATION�' '"''^' %",-.x. -•v,n I hereby:affirm' that)( am exempt from the Contractor's License.L'aw for _ ' INTERCEPTORS r % CLARIFIERS POLE LIGHTS - - 'SWIMMING'POOL"•' P'TRAPJK •. • • ^•r. -.POLES METERED - .SUB the following reason (Section 7031:5 -Business and �Plof esjions'Coile:: Any city_orz.cagunty whlchl1equires,•a,'permit to;construct, salter, WATER SERVI�E i �R �''�%i LTERAPANELS--- - 'Is'licensed'Dursuant•to - MAIN- - SUBquires Improve, demolishZcr repair any structure, prior to"Its issuance, also re- the ap.lirant�(og5ucb permit PojfilO.R signed stat` men$ that he GASSERJIeE OUTLET -'-' 7Prof SERVICE-AMP(Chapter the'provislons-ch the'Contractii s'License Caw' 9 (commencing with Section 7000) of Division 3\of the ; yWATER-HEAFERS% -sBTUOU— ' -- -for. slicent-for'a asst ons'Cod e)eor thathe is exempt therefrom anBthe • the allegetl.exo I, n, ny violation ot_Se ctlon`7031.5-by•a permIt-subjects theappl¢ant-to a civil penalty 'SEWER' CONNECTIONS-- -t'more,than hve^hundred dollars,(5500).%,5N-s 90L'ARTANK-\ Y COLLEC-sole owner o(t he+,property;or my,employeeswilh wages;as tfieir tdmpensd tion; wilLdo the: work,'a ntl the'structure slnot-intendedt _or SOLAR,PIPING SV.S.-y 0, ""'ISSUE FEEContractor's offeretl for sa l .(Sectlon(70440 Bus loess and Pro feSslons.Code: The' License?Law•tlpes no applytto-anf Owner of: a`p roperty•APPLICATION ISSUe FEE ' "' APPROV ED BV- -- �pATi- /'1througli who builds o0improves thereon, antl who tloes such workhimself or own employees,.provided thatsuch improvements are not _ _intended PLAN C- SUMMARY OF FEESis or offeretl for sale. If, however, the building or improvement"MECHANICAL sold withln-one year of completion, the owner will have the burdenof proving he did not build or improve for the purpose of sale). - - - _ BUILDINGHEATING ❑-I,-as owner-of-4he property, am -exclusively contracting with 7044, eu5iners SYSTEM 0-100,000 BTPERMIT gryD DUCTING •-- - - 1lic¢nsetl E� SMIP $ contractors to construct the project (Section 100,000+BTpLANCHECK E PERMIT. and'Professions-Code:-The Contractor's License Law tloes-not apply to - _ ISSUANCEan owner of property who builds or Improves thereon, antl who con- REFRIGERATION 0-100,000 BTPLUMBING tracts from such projects with -a contracto((s) licesned-pursuant to •SYSTEM - - - ',GRADING $the Contractor's License Law). ' -- 100,000+BT- ,•\ ,PLAN CHECK 1❑ I am exemot under Section - —' B. & P. C. for'this BOILERS BTV'ELECTRICAL-'$ - ' - '-Sreason - - - _ _MICROFILM SYSTEM REPAIR, ALTERATIONPLAN EXHAUST SYSTEM MULTIP- - CHECK $ - MECHANICAL E r -$Date TOTAL FEE1 - -- - - - ' - - - AD- Owner hereby certif at I have read this app' tion and state that the above inform, correct: 'I a ree to c ply with all cit and county Y - 'PLAN CHECK $ VANLESS LANCE PC $ ortl inapt a stat laws r a[mg to struction, and hereby authorize — - - represe oil 5 o this - ty t a r upon the above entlo ed' Proper y t ec`io es ��� •s ' •- - �j, w� .pure /� /• Slgnat re • """' Date . _ _ _ .ISSUE FEE --� � - - ` l _ -' - '^' FINALa.FEE_$ L.i ,7 f. - - '-- - _ Drivers' License or 55 � - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod-AsSessor TU CONSTRUCTION AND PLAN NG APPROVALS Permit �' , _`_- •- Date Inspector - -�-` POOL & SPA - . Date _ Inspector APPROVALS Permit �t,� ' 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location2. Soil Soi ipe-.Undrgrn 44. Steel Reinforcement - - -• ''4� - -3.-_Electrical Conduit.Utility-Undrgrn _ _ _45: Forms--- - - -4. .ElectricalConduit-Undrgrn. _ ... 46.. Electrical Bonding- - - - "" - • " -'' - _ _ 5. Steel tee ein force, �� _ _ _ - _ .:_ � � , , 47. Rough Plumbin &Pressure Test - --- - .6._ Electriol UFER Grn - -, 48. APPROVALTO COVER-GUNITE 7. -Footings _ _ _ 49. Electrical Conduit-Undr rn' - -8. - Foundation. _� 50. Gas Pipe, ❑ Undr rn; Test __9. Water Pipe-Undrgrn.. 51. n Backwast Lines P -Trap', E] ndr en -- 70. Structural Floor System. ' ° 52. .APPROVAL TO DECK - ;.11.. Property Sewer. Line &: House . Connection__ 153:-Ba6kwash-&.Rete for -Final - -12. -Street-Sewer Connection - "' -- - ' 54-. Heater &Vent -Final •__13. Rough.Plumbing_ __ - ' " 14. Rough Electric -Conduit - - - 56. Electrical -Final -- 15. Rough Electric -Wiring - - - -- 57.- Solar System -Final 16.- Rough Heating & Air Conditioning 58. Fencing & Access Approval 17-.- Ducts in Structures - APPROVED'FOR PLASTERING 18: -Ducts,-Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test _ .__ ---20. -Roof Frami6g - - - 21. Roof -Sheathin- ' - • - - - -' ' 'NOTES: 22. Frame and Flashing - - 9 _ _ - 23. Insulation - -- -- - - -- .- .2 _ 2 _ O !v • 241 Lathing & Siding - - - - - - - - - - -- -- - - - 25: Drywall Nailing - - - - Y 1- 26. Plaster Brown Coat - -- ' 27. - Electrical Power Meter-Final664 - - 28. Final Electric - - --- -- -- 29:-- Final Heating & Air Conditioning --- - - i-- 2 _ -6 Oog e t cat 'A- JPLT 30. Final Gas Pipe -Test - o 31. Final Plumbing - 32. -Water Service -Final _ - "� 33. Gas Service -Final-- 34. Solar Domestic -Final "'� • "' 35. Landscape Sprinkling System • 36. Sound Attenuation •�- ! - - ' 37. Handicap Regulations - - - - 38. FINAL STRUCTURE &BUILDING - 39. Special Requirements Completed 40. Electric Release -to Edison - - 41. Gas Release to Southern California Gas Co. 42. CERT2IFI,C/ATE' OF OCCUPANCY Date L7 L C� 6 CITY OF COSTA MESA CONSTRUCTION PERMIT I PERMIT NO. TRACT NO. LOT NO. iaG. NO. - - - --- - - -- .331 TYPE OF CONSTRUCTION ❑ NEW El ADD ❑ ���NyrTrc2C0T1- YE ALTERATION Xk ❑DEMOLISH r 4782 :' _ �� � --, - - 4/19/82 20,.,44 - , Project Address f 2 O - _B'Z pP_�u.J Owner / C� IGJ�-ES Phone - 9 '-Address 2 X01+ wA _ - .El REPAIR CONVERSION ❑ OTHER - ZONING REGULATIONS 'y ' _ Arch/Eng. Ni k L W C License NO. - DESC RIPTION,OF WORK - - A.P. Address (ZONE PLN�-rGp. _ 7rry Contractor Wk) Cl_\GF6 -LPLCr Phone TYPE OF, PERMIT ❑ GRADING O I'D -I'D ELECTRICAL , i. -'- -- - FOUNDATION - O STRUCTURAL -(]PLUMBING ❑MECHANIC - - SETBACK C 1 YARD 51 YA f RIGHT gR(E/F. PROPEIRTL L1NF I - - - 'Address sPECT - L_.' 420101 " � R 'LICENSED CONTRACTOR DECLARATION __ -' " ,I hereby affirm thbt I am licensed under provisions of Charter 9.(com- mencing with section -7000) -o/' Dlvision..3 of the. Business and Professions Code, and my license Is In full force antl effect. _(].OTHER '. REAR YARD (TO P/L') ,Licenas{e�/C15ss �' - - se No. PROJECT DESCRIPTION , - '- 'II -- -- -- - - - PKG. SPACE REO" - - _ - - 'PROVIDED -_ �. Date+Llgi2_ crg..a.. .e -- Jw_' SO FTS ,_- ._ _ TYPE .._ -__ - `STREET WIDTH PARK FEE WORKERS'-COMPENSgT10 E ARATION OCCUPANCY_CO CONSTRUCTION - )'ZONING APPROVED By - DATE . - - - I hereby affirm that I have a ce tate of consent to self -insure, or a VALUATION ZONE s' - certificate of Workers' -Compensation Insurance, or. a certifietl:copy 'thereof (Section 3800, Lab. C.). GRADING CU. YDS. -;1- -- - -� ----- ACRES - 'SPECIAL CONDITIONS: 1cyNo. Certified copy ls'hereby,turnishetl. ., REMARKS:, -I q - -_ Ll Certified copy Is.filed with the city Building Division.�- 'FROM 'WORKERS' EXEMPTION COMPENSATION-13ECLARATION ((Thls section need not be completad_if the permit Is for one hundred or less). , S$100) certify that n the -performance of the work for which this Permit id issued.- I shall not employ any person in any manner so as "to Deco a subject to th Wo kers' mpensati o Qglpia."� - Signature PLUMBING PLAN CHECK- - - - - .ELECTRICAL " ^' - ' PLAN CHECK - - - - -- _DWELLINGGAR BATHTUBS -- SHOWERS' `-'- "`- -"' ;Date�'2 NOTICE: If after making this cla ation, you Should become bled ,to the Workers' Compensation p Ions of the Labor Code, you mush „forthwith comply with such provls ons or this permit shall be deemed .TOILETS.., - LAVATORIES �. URINALS- - - _ --- DOUBLE LAVS-- - -' -- +GENERATOR—0=1-KW=1-10 KW' '- -,TRANSFORMER .v 11 1 v.-• • -rAPPU ANCE 30-50 KW=50 + KW- - - revoketl...- ' •_ . - _... _ _ -�.-- ICONSTRUCTION LENDING AGENCY '1 hereby affirm that there is a construction lending agency for the per- of the work for which this permit is Issued (Section 3097 -KIT. SINKS-- •'-' '-" SERVICE SINKS ? -DISHWASHERS 1 ;,, (SUMPS-„ -' _ - .MOTORS--- ----0.1-HP_1-10-HP- - — -- - 1(INC.50 LA R).•-_30-SB.HP 50.+_HP_ '-- ,formance Civ CJ. - `•- -� ` - - —'- _ ,=77 Name 'FLOOR'SINKS,- - - -'-FLOOR DRAINS"'� j� -` ' rF.1XTURES OUTLETS SWITCHES -21 -- ILender_s •Lentler'sAddress - DRINKING FOUNTAINS'" _r; "--" - "� _ GASTUBESIGNS-- -----^-• - - - EPTO RS - - --CLARIFIERS` "- ""' rPOLE-LIGHTS-- -- - -- - •- -^- - - - - 'OWNER BUILDER DECLARATION ---INTERC I herebyy affirm that I am exempt from.the Contiactor'S.License Law for .the -following reason (Section 7031.5 Business and' Professio nsICotler- Any city or county Which requires a -permit to construct, alter, improve; demolish or-rebair any structure, prior to its issuance, also re- quires the apllicant for such permit to file a signed statement that he SWIMMING POOL' - PTRAP---- --- - -- - SIKL?Lul - METERED- -SUB`-'" -- - WATER SERVICE' - -"ALTERATION - -- -- -- !PANELS- - - MAIN - SUB - - -- - - -GAS SERVICE OUTLETS" -' 'SERVICE--- - --- - - - AMP •- - - - - - - - is licensed pursuant to•the -provisions of the Contractor's -License Law- 1Chapter 9 (commencing with Section 7000) of Division 3 of the 'WATER-HEATERS BTU OUTPUT •� f -- - �-- - -- - - -• - - - — P••ciness-antl Professions-Cotle) or that he ds exempt4herefrom and the ' for the alleged exemption. Any violation of Section 7031.5 by applicant fora Permit.subjects the applicant to.a. civil penalty � SEWER CONNECTIONS ' _ - n .iot more than five rundred dollars ($500). SOLAR TANK' - - COLLECTORS �-- - - - - --.•---- -• - - - --- -- -- --:� - - - ❑ I, as owner of the -property, or my employees with'wages' as't heir sole compensation,_ will do the work, and the structure Is not intended or offered for sale. (Section 7044; Business and Professions Code; The" SOLAR PIPING SYS. ' ISSUE FEE Contractor's License LaW does not apply to an owner of a property who builtls or impro Les thereon, and whodoessuch work himself or ISSUE FEE - - - '' f APPLICATION APPROVEPBY - .DATE -"' - - - through his. own employees, provided that such improvements are not intended or offered for sale. -If, however, the building or -Improvement sold within one year bf completion, the owner will have the burden of proving he did not 'build or improve for the`Purpose-of'sale). as -owner- of -the property, projectu(secti..co7044,ing_wiss Ilcensetl contractors to conztrutt the project (Section 7044, Business Professions Cotle: The•Contractor's License-Law.tloes.not apply to an owner of property who builtls or improves thereon, and who con- from such -projects -with. a. contractor(s) Iicesned-pursuant to Contractor's License law). I am exempt under Section 'B. &-P: C:for this MECHANICAL PLAN CHECK - -- - -- - HEATING SYSTEM 0.100000 BTU AND'DUCTfNG - - 100,000 + g7UPLAN _ - REFRIGERATION 0-100,000 BTU _ F.1 SYSTEM -.- - - - 100,000+BTU - - - -- - - -- - SYSTEM REPAIR, ALTERATION EXHAUST SY57 EM MULTIPLE - - I SUNIMARVOF IPERMIT § - - - BUILDING•I, CHECK $ _ _ ._ _ - PLUMBING - btracts - PLAN CHECKEl ELECTRICAL -BTU IDate .PLAN CHECK-$ - 'MECHANICAL-$ - - 'PLANCHECK S-- - I - • ,_ FEESis •SMIP. PERMITantl, _- :ISSUANCE .$ IGRADING Slthe 'MICROFILM($Data •TOTAL FEE $I - -�-VAN EPC b_ •- - - ' FINAL FEE S Q Owner hereby certify that I have read this application antl state that the above Information i5 correct. 'I agree to comply with all 'city and 'county' ordinances and state law; relating to constr ction, and hereby authorize- representat e - ty to to on• the' -above mentioned' properly f r i pe< ion_ purp �Z Signature Date L-��- Drivers e e or SS ISSUE FEE _ - - CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor TL; APPROVALS CONSTRUCTION AND PLANNING t'N• /- .�/� Permit 9:-:3314 Date Inspector _ POOL & SPA- J Date, Inspector APPROVALS Permit# - l 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location' - - O• 2. SoilPipe-.Undrgrn 44. Steel Reinforcement 3..- Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. ElectricalBonding Steel ein orce _ 47. Rough Plumbing & Pressure Test - 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7.. Footings 49. Electrical Conduit-Undr rn' 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test - -9. - -Water Pipe-Undrgrn 51. Backwash Lines P-Tra '❑ Undrdrn 10. Structural Floor System. 52. APPROVAL TO DECK 11. Property Sewer Line & House -Connection. 53. Backwash & Receptor -Final 12.- Street Sewer Connection "'- -- - -- 54. 'Heater & Vent -Final ..13.. Rough Plumbing _55. Plumbina System - Final 14. Rough Electric -Conduit -- - -- • :56: Electrical -Final 15. Rough Electric -Wiring 57.- Solar System -Final 16. Rough Heating & Air Conditioning" - -- - -b8. Fencing &Access Approval 17. -Ducts, in Structure 59. APPROVED FOR PLASTERING _ 18. Ducts, Ventilating - 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough &Test - 20. Roof Framing -- - _ - - 21. Roof Sheathing--*- ---- -- - -- -_ -•,'r - NOTES: 22. -Frame and Flashing 23.-- insulation 24. Lathing & Siding ---- -- - _ -MIA ' 25. Drywall Nailing' - 26. Plaster Brown Coat - - - - - 27. - Electrical Power Meter -Final - - 28.- Final Electric 29. Final. Heating & Air Conditioning - 30. Final Gas Pipe -Test - - - - i- 31:-, Final Plumbing 32.- Water Service -Final -- - - - 33. ' Gas Service -Final - - - ' 34. Solar Domestic -Final 35. Landscape Sprinkling System i 36. Sound Attenuation 37. Handicap Regulations - - - ' 38. FINAL STRUCTURE & BUILDING • - ' 39. Special Requirements Completed- ___ - _• 40. Electric Release to Edison - - 41. Gas Release to Southern California Gas Go. - 42. - - CERTIFICATE OF OCCUPANCY 'No Date a i� A22 sOCT 26-77PAi110011425* Crus ***506.00 COSTA MESA BUILDING -SAFETY DEPARTMENT • P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 tA.P. PPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only EIVED BV DATE RECEIVED DATE ISSUEC BUILDING /I/� C ADDRESS %t G n // PERMIT NO. OWNER NO. / /p LDING MAIL ORESS.L ADDRESS eow TEL.TRACT �l LOT BLOCK CITY NO. CONSTRUCTION W ADD ALTER REPAIR BRANCH OWNER Q ADDRESS VALU ARCHITECT TEL. USE $ OR ENGINEER NO FIRE CONTRACTOR L. SIDE 49 FT/2aZ ADDRESS REAR FT. TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. S12E NO. BLDGS. OF LOT NOW ON LOT USE OF APPROVED DATE O.OF Kn /r INUSE OF NE\/ ((Y PLANS BUILDIN I YARDS APPROVED YARDS APPROVED MAIN BUILDING I ACCESSORY BUILDING Separate permits are required for electric, plumbing and heating work. L. SIDE 49 FT/2aZ LC REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. MAIN BLDGS. BET. MAIN & ACCESS. BLDGS. VAR. # _ i /l � � , DATE . iris I hereby acknowledge that 1 have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I em properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I em exempt from the provisions of the State of California Business end Professions Code, Division 3, Chapter 9. Signature o Permittee Authorized Agent -2U- 7 THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ I% .44 PLAN CHECK E $ /M, (�a /i TAX b V(/ TOTAL PAID $ APPLICATION FOR A BUILDING PERMIT, Tract Block Lot BUILDING PERMIT NO. 77 Electrical Permit No. Bullringu �S ��O ����� �_ I Address ` Plmbing Plumb No. Cross Mechanical Area Street Permit No. Permit (� � Owner Co/ CT r G6../ 61 lit Type of project: ❑ New ❑ Alter ❑ Addition 11\V l fv l/ ��+%� �� Atltlress'' ❑ Rep it ❑ Convert ❑Demo ElOccupancyPmt. QQlf./ City VZip Phone �S 14v A.P. Sus. Dist Insp. Area Architect � p�( Designer / K �lW 7 License No. C— 7 I Q Z e Sol. Pmt. No. Address 311 V PO L,(,HA rP s E Se backs P/L Front C/L St. Street Width City Css rA H 05A Zip Phone Y rds Left Right ear a dol. a Ig . Engineer LIc0n5e No. Parking Spare< Reowre roy_a were_ Address City Zip Phone Struct Height No. of Stories No. of Family LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I em licensed antler provisions of Chapter 9 Park Fees Yes Required No C.T. Fee Receipt Zoning Approved By Date (commencing with Section 7000 of Division 3 of the Business and Professions C tla, ntl p license is in full force and aHacH. License Chas n License Number Date Contractor Rfl�j eo. S� Addr 11 ✓rLl'(ArN Pcl9c 5 I Proposed propoaed txe of Structure City and ZipPho Phone 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, Civ. CJ. OccType Class Const. Code Veer USE/OCCUPANCY SIZE SO. FT. Lender's Name 1�/ {� Lender's Address 1. OWNER -BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their 2. sole compensation, will do the work, and the structure is not 'intended or Offered for sale. as owner of the property, am exclusively contracting with 3 4. tensed contractors to construct the project. am exempt under Sac. , B&PC for this reason Total Valuation Date Owner WORKERS' COMPENSATION DECLARATION Encroachment Permit Requiretl Yes No I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Works,.' Compensation Insurance• or a certified copy thereof. // A n Policy NcCLL_Rg5� % Company(0S N Yp h�rM�1`lCs� Grading Pmt. Required ❑Yes ONO/ Grading Pmt. No. •VO`f Certifietl copy Is hereby furni ed. ❑ Cer>��s- d c is filed wit ange oun E 1/O Rough Grading Approved by: Date 'pay Date V APPII nt d A — &—t - CERTIFWATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit is for $100 or less). I certify that in the performance of the work for which this permit is PERMIT FEES issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Electrical $ ¢lel $ Invas . Plumbing $ I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELAT G TO BUILDING CONSTRUCTION, AND HEREBY AUTH. ORI REPRESENT AT..O ES OF THIS COUNTY TO ENTER UPON Mechanical $ Pre -Grade In specific. $ TH AB VE Js•[ENTI (t ED PROPERTY FOR INSP TIO PUP- POO, `/W///� n l (O s�a-s� natu(r�e of App scant or Agent Date Pre -Grade Permit Rec. No. $ Issue $ 2 Print Applicant's/Agent's Name All spaces within this box must be completed to process Plan Check By: Issuance Approved: CMF 0335-46 (BU -28) rev. 6/80 I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. a_QTAS, COSTA MESA PERMIT NO. TRACT NO. LOT NO. I BLDG. NO. BL95 7/09/81 20.50 TL CONSTRUCTION PERMIT M / _,0:TSl I — Address Address Contractor Address 7 Phone License No. under provisions of Charter 9 Division 3 of the Busines Its is in full force and I License !alss L.ic Nga(4*6(n0 c/ Date ? Signature WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self4nsure of a certificate of Workers' Compensation Insurance, or a certified copy thereof (Se tion 3800, Lab. C.). �ucy No. LK �� ��� "�'3t'^mpany�'T a/41AL EN rtified copy IS hereby furnished. Certified copy Is fifed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred (E300) or less). II ttrtlfy 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 Workers' Compensation Laws of California. Data Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY ..I hereby affirm tha Lthere, is a construction lending agency for the per- formance of'the work for which this permit Is- issued '(Section. 3097' Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION 1 I hereby affirm that 1 am exempt from.thWContractor's License Law for the following reason (Section 7031.5 Business.and Professions Code: Anycity or county which requires a permit to construct,'alter, improve, demolish or repair any structure, prior to its Issuance, also re- quires the applicant for such Permit to file a signed statement that he is licensed Pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 Of the Business and Professions Code) or that he Is exempt therefrom and the `ails for the alleged exemption. Any violation of Section 7031.5 by y applicant for a permit subjects the applicant to a civil penally not more than five hundred dollars ($500). _i 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an Owner of a property who builds or Improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑ 1, as owner Of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) Iicesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certifythat I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives of this city to enter upon the above memloned or SS aX < < White -Building; Canary-Appllcant Pink -Accounting; TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY_ CONSTRUCT ION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: A.P. $ ZONE PKG. SPACE REQ. STREET WIDTH SPECIAL CONDITIONS: PILING. REF. V� PROVIDED PARK FEE PLUMBING PLAN CHECK, ELECTRICAL PLAN CHECK BATHTUBS SHOWERS SYSTEM 100,000 + BTU PLAN CHECK TOILETS LAVATORIES URINALS DOUBLE LAVS GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW_50+KW 1-10 KW _ _ KIT. SINKS SERVICE SINKS DISHWASHERS SUMPS MOTORS (INC. SOLAR) 0-1 HP -1.10 10-50 HP HP _ 50+HP_ FLOOR SINKS t FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY MECHANICAL PLAN CHECK SUMMARY OF FEES HEATING SYSTEM 0-100,000 BTU sy r vv / AND DUCTING 100,000 + BTU REFRIGERATION 0-100,000 BTU7 SYSTEM 100,000 + BTU 1 BOILERS BTU I I 1 SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE -Assessor 3 BUILDING $ PERMIT S PLAN CHECK $ PLUMBING $ PLAN CHECK $ ELECTRICAL E PLAN CHECK $ �J MECHANICAL PLAN CHECK E DATE SMIP $ PERMIT ISSUANCE $ GRADING $ S MICROFILM IS TOTAL FEE $ LESS AD- VANCEPC $ FINAL FEE $� CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA _ APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn --4'-T. Steel Reinforcement k 3. Electrical Conduit Utility-Undrgrn ' - 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce - 47. Rough Plumbing & Pressure•Test "6: Electrical UFER Grn .. 48. APPROVAL TO COVER-GUNITE . 7. Footings 49. Electrical Conduit-Undr rn - - 8. Foundation - - - ' ' - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-TraI2. ❑ U6drqrn' 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection - _ - 53. Backwash & Receptor -Final -� 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - _ - -- - - •- 14: - Rough Electric -Conduit - _ -56. Electrical -Final "- -15. --Rough Electric -Wiring - - -- 57. Solar System -Final .16. Rough Heating & Air Conditioning 58. Fencing & Access Approval - 17. Ducts in Structure - - -i7- / /.mac. APPROVED,FOR PLASTERING - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing %J.f. _ 60. _ POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES -.,j_//.__,9`/ •�j ��A/ ' T.OQ O.✓ 23. Insulation i Q /w, 24. lathing & Siding 25. Drywall Nailing ' 9�ZG-3' 26. Plaster Brown Coat ' 27, Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning - 30. Final.Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final - - 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation ' 37. Handicap Regulations v - 38. FINAL STRUCTURE & BUILDING /• /y ' 39. Special Requirements Completed - 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co.- --- - 42. CERTIFICATE OF OCCUPANCY No Date 00 <�CITY d@ COSTA MESA P R I O. t TRACT NO. LOT NO. BLDG. NO. .CONSTRUCTION PERMIT � �� 1 1 r 8171 7/06/81' 14900 'Project AddressTYPE OF CONSTRUCTION ❑ NEW ❑ ADD JJ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER - ' - ZONING REGULATIONS Owner �s tlj'E Phqne Address Is P Al _ - Arch/Eng. License NO. - DESC RIPTION OF WORK A. P. ZONE PLNTGp. REF. 9,1 - ' Contractor Phone TYPE OF PERMIT ❑ GRADING - ,❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑MECHANICA BUILD SETBACK C ST. L DFE YARD VROPEIRT VNLrnE _ Address L= zr " - JJUL LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (com- YJFLUMBING SIDE VA RIRD GHT reenting with section 7000) of Divi Sion' 3 of the Business and ❑ OTHER Professions Code, nd my license is in full force and effect. REAR YARD TO P ( /L) S - PROJECT DESCRIPTION License Class License No PKG, SPACE REQ. PROVIDED '7-/9( n // Sq. FT. - Date Signature STREET WIDTH PARK FEE $ WORKERS' COMPENSATION' fi LARATION OCCUPANCY '_CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or 'a certified copy - thereof (Section 3800, Lab. C.). _ Policy No. Company GRADING CU. YDS. ACRES - SPECIAL CONDITIONS: - - ❑ Certified copy Is hereby furnished. - REMARKS: - r - r unified COPY Billed with the city Building Division. OPTION FROM WORKERS' COMPENSATION DECLARATION - . Section need not be completed if the permit is for one hundred _ S$ce" or lessl. e¢rtllfy that n the performance Of the.work for which [his permit Is issuetl, I shall not employ any person in a y manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK - subject to the Workers' Compensation La of California. THTUB$ SHOWERS �,�=1^±� ZV n !���(l Dale �� Signature NOTICE: If after making this q cl ration, you shosr�tl b c me.subject TOILETS 1 URINALS GENERATOR 0-1 KW_ 1-10 KW to the Workers' CompenEation provisions of [he Labor Cotle, you must TRANSFORMER forthwith comply with such provisions or this permit Shall be tleemetl LAVATORIES / DOUBLE LAYS APPLIANCE 10-50 KW_50 + KW revoked. - - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS �f MOTORS 0-1 HP -1-10 HP I hereby affirm that there is a construction lending agency for the per -SERVICE SINKS - SUMPS (INC. SOLAR) 10.50 HP 50 + HP formance Of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - Civ. C.). Uw NE1� Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS ' INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL PTRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, _ WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior t0 iii issuance, also re- quires the applicant for Such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP ' is licensed pursuant to the provisions of the Contractor's License Law 1 Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS 131SL03l'� Business and Professions Code) or that he is exempt therefrom and the basis 10, the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - - any applicant for a permit Subjects the applicant to a civil penalty' Of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS as Owner of the property, or my employees with wages az their ompensatlon, will do the work, and the structure is not intended _fered for Sale. (Section 7044, Business and Professions Code; The SOLAR PIPING SYS - ISSUE FEE ' Contractor's License Law does not apply to an owner of a Property - - who builds or Improves thereon, and who does such work himself or ISSUE FEE I APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for Sale. If, however, the building or Improvement is sold within one year Of completion, the owner will have the burden of proving he did not build or improve for the purpose of Sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ - SMTP $ El I, as owner of the -property, am exclusively contracting with AND DUCTING licensed contractors to Construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law tloes not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from Such Projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law)- 100,000 + BTU PLAN CHECK S ' ❑ 1 am exempt under Section B, & P. C. for this BOILERS BTU$ ELECTRICAL $ reasonMICROFILM SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ MECHANICAL $ $ - TOTAL FEE $ LESS AD - Elate Owner I hereby certifythat I have read this application and state that the above information is correct. I agree to comply with all eery and - PLAN CHECK $ VANCE PC $— — ordinances and State laws relating to thonry construction, and hereby authorize - representatives representatives oJ, this city to enter upon the above mentioned e property for 1 ettlon Pur ase J /n FINAL FEE $ / 'v� �d T< rZ SigOatur=%U��^nom- �/ / �Y �� ISSUE FEE - Drivers(- icenze or SS CMF 0865-46 While -Building; Canary-APPlicant; Pink -Accounting; Goldenrod-AsseSsor TL CONSTRUCTION AND PLANN,NG APPROVALS Permit# Y-R� Date Inspector POOL & SPA APPROVALS Permit # Date Inspector., 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms . 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn . 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test - 9. Water Pipe; 51. Backwash Lines P -Trap. ❑ ndr rn 10. Structural loor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing Cl -7 7•�j' - - 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring - - 57. Solar System -Final 16. -Rough Heating & Air Conditioning 5H. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test - 20. Roof Framing - ' 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation (. _ 24. Lathing & Siding 'M 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final ' 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing O 32. Water Service -Final - 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape SDrinklinq System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Aoolicant to fill in all spates within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA F PER MUT TRACT NO. LOT NO,,. BLDG. NO. CONSTRUCTION PERMIT 1. w�JLli6 v (3 7 I TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION' ❑REPAIR ❑-CONVERSION ❑.DEMOLISH ❑ OTHER I ,. 55598 5/07/82 14-50 - .., "ZONING REGULATIONS Project Address Owner on Address - 0E5C1,I1 TIONOFWORK -- - ;TYPE OF PERMIT ::" - - ` - ❑ GRADING' -O FOUNDATION O'STRUCTURAL ❑ TENANT 0 ELECTRICAL PLUMBING ZONE - PLNG. REF, 0' , - Tp Bt��Lp'NG - . - tWrt:SETBA,CARO T.. _ PROPERTY LINE• Arch/Eng. License No. Address - - - -- Contractor Phon - - Addre55 LICENSED CONTRACTOR DECLARATIO - - 1 hereby affirm that I am licensed under provisions of Charter 9 (tom-, -of MECHANIC ., I pip- •• ❑ g1 E -Y i RIGHT. ,mencing with section 7000) , Division' 3 of the Business and iprofesslons code, and my 1 Gens 15 In full force and effect. OTHER - 1 REAR YARD (TO P(L7 Licensee ss r ense PROJECT DESCRIPTION ._ _ _ _ -.. - . PKG: SPACE REO - 'PROVIDED.' ' -C -I Z E re SO ,. -''_ - -. _ _. Dateiz 5'gn _ -tiK�Q OCCUPANCY_ CONSTRUCTION TYPE , STREET WIDTH PARK FEE E WORKERS' COMPENSATION DECLARA ON ---• - - - a ,ZONING APPROVED'BY -DATE '- ;l hereby affirm that I have a certificate of consent t0 self -insure or VALUATION ZONE .,nrtiflcate of Workers' Compensation 1 surance,• -aeertiffed opy -- - -• -• - - - �, - _ _._ - _. +:¢of (Section 38 0 ). GRADING CV: ,`(O5. ACRES SPECIAL' CONDITIONS:' �cy NOL .REMARKS -+Y: •' '� v-Certlfied copy is hereby furnisPed.- - -- - - - -+i.'. :Certified copy Wiled with the city Building Division. "• ! - - --- - - - , -{ - - - FROM WORKERS' COMPENSATION DECLARATION - ,EXEMPTION JThis -section-need not -be completed Jf.thO permit IS.for One hundred ($100) or less). I -I certify -that in -the performance .Of the work tar which [his, permit is Issued, 1 shall not employ any person In any manner so asap become _ _ PLUMBING- . r tr. PLAN CHECK_", ', 1� ELECTRICAL` ' PLAN CHECK '-- subject to4he•Workers Compensation. Laws. of California.'_✓'tCG- -- BATHTUBS _ SHOWERS - '-' - :Date t Signature -' ' ;NOTICE: If after making this declaration,you Should becomb,subject, -;TOILETS,, . URINALS -• - f - GENERATOR - 0-1 KW Y-10'KW - - -' to the Workers' Compensation provisions OMI, Labor Code, you must TRANSFORMER -, I forthwith Comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS ' _ -' 'APPLIANCE '10.50 KW� 50. KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS - "-'-DISHWASHERS "'" -"" ''MOTORS-- '-0.1 HP'_ -1=10 HP - •1 hereby affirm that there is a construction lending agency far the pet-. SERVICE SINKS �; T )s, SVMPS' - _- _._ _ _ _.., (INC: SOLAR)- l0-50 HPC - - SO+.HP'-'r r • formance of the work far which this permit -is 135 bad (Section 3097 FLOOR SINKS - - FLOOR DRAINS' - - 'FIXTURESOUTLETS '--SWITCHES - - ^Civ• C')• t `, ,Lender_SNameLender's Address DRINKING -FOUNTAINS ,GAS TUBE 'SIGNS-'-^ ---- - - - 'INTERCEPTORS C - i.ARIFIE RS POLE NIGHTS' ''-' - - -- - - OWNER BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Conti actor's License Law for SWIMMING POOL -� "P TRAP' ' "" - POLES METER - - 'SU the following reason (Section'! 031.5-BuSlneSs and Professions Code: • Any city or county which requires a permit t0 construct, alter, E MATER SERVIC--ACTERATION" - PANELS -' MAIN - - SNB'- - - Improve, demolish -or repair any structure, prior to its Issuance, also re- quires the ap> licant for such permit to fila a signed Statement that he -GAS SERV ICE --OUTLETS - - •- ;SERVICE' ' - - - -' --- AMP -- Is-licensed"pursuant to'the provisions of the Contractor's License law -,>aptee 9 (commencing with Section 7000) of Division 3 of the HEATERS-- BTU OUTPUT �- - - _pzMass and Pra{essions-Code) or that he is exempt thorefrpm and the'WATER 7031.5 by Is for too alleged exemption. Any violation of Section ".,y applicant -for a permit subjects the -applicant to a civil -penalty SEW ER CONNECTIONS - ot not more than five If mired dollar$ ($500). SOLAWTANK-COLCECTORS 'Q 1, as owner of the property, or my employees with wages as thelr sole campensation,.w111 do.the work, and_tho-structure is not intended ` ' or offered for Sale. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SYS.)' - - - ' - _ ISSUE -FEE- 'Contractor's .Licensa..Law does not apply to, an owner. of property, builds Improves thereon, does himself or - ..)�.. .. ISSUE FEE l -APPL'ICATION-APPROV EO BY— -. - - pATE--- ,who or and who such work d hrough. his own.om PlOyees, provided that such improvements are not _ MECHANICAL PLAN CHECK SUMMARY OF FEES„ ' i mondeo or offered for sale. It, however, the building or improvement Is -sold within one year Of completion, the owner -will have the burden Of proving he did not build Cr Improve for the purpose of sale). HEATING SYSTEM HTU 'BUILDING- -, ---- PERMIT S - -- - = -- •.SMTP $ ' 0'1,'as^Owner of the property, am exclusively contracting -with 'licensed contractors to construct the project Section 7044, Business P i ( -0•]00,000 AND DUCTING 1 100,000; BTU PLAN CHECK E� - - PERMIT )$ and Professions -Code:- The'Contractor's License taw does not 2PPIY to - - - _- _. ISSUANCE ,an owner of property who builds or improve$ thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ $� tracts from such projects -with -a contractor(s) Ilcesned pursuant to SYSTEM-- ----- ' ' S --GRADING_ the Contractor's License Law).- IOO,ODO i* BTU PLAN CHECK E - - - ❑ 1 arrexempt under -Section- - -`B. & P. C: for this BOILERS BTU - ELECTRICAL $ reason'- - -,` - s SYSTEM REPAIR, ALTERATION -PIAN CHECK $ 'MECHANICAL r:TOTA FILM $ e TOTAL FEE b - - - - - Owner - ,Data 'I ner¢py. cert!/y,tnat 1 havaredd this application and state that the above EXHAUST SYSTEM MULTIPLE E - AD -• information is correct, I agree to comply with all city and county PLAN CHECK -E - VANCELESS - VANCE PC $'_ `- $ ordinances and stateJaws.relating to construction, and hereby authorize represe�tl1l1atives of this city to enter upon the above mentioned propeFy 6r in pe tion as s. �/ ((...11�eyy��]) - • A FINAL FEE A�_ Signa S Date Drivers' Li _ - ISSUE'FEE-- - - - - - - - CMF 0865.46 White -Building; Canary-APPlicant; Pink -Accounting: Goldenrod -Assessor :TL, CONSTRUCTION AND PLANNIN APPROVALS- Permit # �� Date di'spectorl POOL & SPA- PAAPPROVALS APPROVALS Permit_# Date . Inspector 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location' - - - - • •• 2. Soil Pipe-Undrgrn 44. Steel Reinforcement •- - 3. - Electrical Conduit Utility-Undrgrn 45. Forms i 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - 5. Steel ein orce 47. Rough Plumbing & Pressure -Test 6.. Electrical UFER Grn. ' 48. APPROVAL TO COVER-GUNITE - - - _ 7. Footings 49. Electrical Conduit-Undr rn - 8. Foundation 50. Gas Pipe, O Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,0' ndr�r'n I. 10. Structural Floor System • 52. APPROVAL TO DECK- . 11.. Property Sewer Line & House Connection 53. Backwash & Receptor -Final ' 12. Street Sewer Connection _ 54. Heater & Vent -Final - • 13. Rough Plumbing - 14. Rough Electric -Conduit -- - - - .-56.- Electrical -Final ' 15. Rough Electric -Wiring - 57. Solar System -Final - 16. Rough Heating & Air Conditioning - encing & Access Approval 17.- Ducts in Structure 2.L _59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough &Test - 20. N,,Roof Framing . - 21. \Roof Sheathing _ NOTES: 22. Frame and Flashing 23. Insulation - _ _ _ _ ! ' 24. Lathing & Siding -- 25. Drywall Nailing- 26. -Plaster Brown Coat 27. Electrical Power Meter -Final - 28. Final Electric - 29. Final Heating & Air Conditioning ' 30: Final Gas Pipe -Test - ..31. -Final Plumbing ✓ - 32. Water Service -Final - 33. Gas Service -Final 34. Solar Domestic -Final - '- 35. Landscape Srinklin System 36: Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed' 40. Electric Release to Edisoh' " ' 41. Gas Release to Southern Chlifornia Gas Co. - 42._: CERTIFICATE OF OCCUPANCY f�No Date - - �i 046985 CESA BUILDING -SAFETY DEPARTMENT O. BOX 1200 COSTA MESA, CALIFORNIA 92626 I f 8177 -I1/0-1./.78 8177 IV/ DIY78.. _ 81.77 "00004469 B4 H s AP LI A ON FOR STRUCTURAL PERMIT For Fill in Completely —Use Ink Only REC V D J DATE RECEIVED D E 1 SU TApplicant BUILDIADDREO I —PERMIT N06 OWNERG •Z � A.P. NO. — — MAIL BUILDING /) ADDRESS e G ADORES b TEL. TRACT T BLOCK CITY A. V NO. CONSTRUCTION W AD AL LENDER H O BRANCH OWNER N� ADDRESS S � va L w$ ARCHITECT TEL. OR ENGINEER N FIRE ADDRESS ZONEYPE GROUP (/ APPROVED / CONTRACTOR �V�/ BY DAT / ADDRESS TEL. ZON NO. OF USE OF NEW, CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FROM USE OF EXISTING BLDG R. SIDE FT Separate permits are required for L. SIDE FT. T. electric, plumbing and heating work. REAR F D USE OF BUILDING AND WORK TO BE PERlcontractor DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. SLOGS. VAR.+ DATE (9 C.U.P. sp APPROVED ED U /APP I hereby acknowledge that I have read This aion and state that the above information is correct and agcomply with all laws regulating building construction, andl not employ any person in violation of the workman's coation laws of the State of California. I hereby certify that I am properly licensed atractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professioe, Division 3, Chapter 9, antl that such licenses are in full ftl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State ofrnia Business VALUATION PERMIT FEE $ and Professions Code, Division 3, Chapter 9.Signatue CHECK $JP fPLAN PermittaT6/ $ /�"�� TAX $ ou Authorized Agent TOTAL PAID $ H s City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 0 O �u p 03 P. O. Box 1200 Costa Mesa, California The Building located at 29.50 Airs v Avanne. mite n_o has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. Use of Building Office/Warehouse Legal Description 427-161-170 (See reverse side for Metes and Bounds) Building Permit No. BPMF. 20537 Electrical Permit No. R;•1MR ',>nr'4'7 Plumbing Permit No.RPMR 2rKZ7 Mechanical Permit No. BPMF 20537 Number of apartments and/or guest rooms ISSUED TO: Lucas & Mercier Pronerties 2950 Airway Avenue rnaf-AWSawn.CY`A 92696 Building Official w;tt;�m by Date March 4, 1986 This.Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building (Pfficial 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 ER DATE 11-27-78 No.427-161-11 LOT TRACT FIRE ZONE VALUE$ 750.00 NSPECTIONS Si nature I Date TYPE v GROUP ZONE MP oILMI SUBCONTRACTOR 5I SSU ♦I— Date -EQ Number I Si nature ATER Plumbing R OUG H_ PLUMBING �I(—' 'PROP. SWR. LINE r] ;OUSE CON. Lj SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND [_] POWER 0 ROUGH WIRING Hgatina and Vent. TRENCHES IJ FORMS Lj STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING �. I .I .i� )HING LATHING — 1. OUT C . 161. PLASTER, BROWN COAT STRUCTURAL.FINAL HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING. FIN 4L AND GAS TEST D ELECTRIC. FINAL (714) 754-5273 • Fax (714) 7544856 • www.ci.costa-mesa.WLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2950 AIRWAY AV Suite: C003 Vicinity: ROOF Parcel Number: 42716411 Zoning: Applicant: ALBERTSON, NOEL Address: H0610208 Phone: Zip: Owner: MC KIBBIN, DONALD.H TR Permit: $251.25 Address 1112 PEMBROKE LN . SMIP Com: $2.98 Other: - Phone: $0.00 NEWPORT BEACH, CA Zip: 92660_. Contractor: DAVEY ROOFING INC Address: - 17182 ARMSTRONG AV 0-0 Left- 0-0 ACCESSORY Front- '0-0 -`, - - - Phone: (949) 852-9955 Existing:. 0 -. IRVINE, CA, 0 Proposed: 0 Zip: 92614 License:, 700710 ISSUED BY: Status: ISSUED Applied: 10/11/2002 Issued: 10/11/2002 Arch Eng: _ Address: Address: - Phone: ' Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING BUR CAP ROOF. REPLACE DAMAGED SHEATHING AND ALL ROOF RELATED MATERIAL WITH 26 GAGE, NEW BUR ROOF, ROSEN, 1 BASE AND 2 -PLY WHITE CAP SHEET. 4,100 S.F. BUILDING C-003 - - Plan Check: $0.00 Permit: $251.25 SMIP Res: $0.00 _ SMIP Com: $2.98 Other: $0.00 Inspection: $0.00 Total: $254.23 ` PLANNING & ZONING ^ SETBACKS MAIN STRUCTURE Front' 0-0' Rear - 0-0 Left- 0-0 ACCESSORY Front- '0-0 -`, �, Ream 0-0, - Left 0-0 PARKING Existing:. 0 -. �Re uired: 0 Proposed: 0 \ , Calc Valuation: $14,201.00 Claim Valuation: $14,201.00 Right 0-0 Right 0-0 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 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I herebVffirm under penalty of perjury one of the fallowing declarations: ❑ JJ, ,('eveend will maintain a certificate o1 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. m Illusive and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the.pedo_nnance of the work for which this permit Is Issued. _- My wo rs' compensP� n Insu^1ra`nce_` c�Iar'n,re'r andT°—°lie�v number are: (/� u� 70 Q Cl Carrier��l�f) � TLJ'L,� (10P4 Nu be,. v I (Riffs. n ed not be comprotedWrpormitis valued at one hundred dollers ($100) or less.) ❑ 1 certify that in the performance of the work to which is permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of aliform an r t t if I sl o Id become subject to the workers' compensation provisions of Section y/0 of (hDe Lez Code, I shall forthwith comply.wllhdhe59'prQ ions. /O%� / 0 Appllciiril'Signature:J �D'atei7 WARNING: FAILURE TO SECLAE ORK ' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EM�YER. CRIMI PE TIES DCIVIL FINES UP TO ONE HUNDRED THOUSAND DCUARE ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I It by aItimilbat I em tic sed under rovis sot Chapter 9 (commencing with Section 7000) of Division 3 of4he,Business and P fessions a -and my license is in full 4 fdree.and effect Linl�N 1/ C,lass If p 21 t_,- ¢3ignat1. ) : Date:: v O O CONSTRUCTION LENDING AGENCY: ❑ 1 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 ($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 property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or resent or future building occupant need to file a registration form for acute) hazardous materials? Yes N PP P 9 P 9 Y ❑ ❑ o (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). .......__............................... __..................... __.._................... ._............................... __.._........................... ___..................... __................................. __—_................................ __.__........................ _._....................... ... _...... Yes ❑ 3 Does or will the appNoplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, cerlificationand 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 Cade been fully complied with? ❑.Ves ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appertnit for such construction or modifiCaaon from the South Coast Air QualityManagement District or from any other air pollution control district or agency? Yes u No (Section 65650.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). f .........__........................_................cil.............. ..................................... .........._..._....................................____........................._.___............................_...................__.___............................_........__.___._.. .......... 6 Will any pert of the aity to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (It 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 applicatlon, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes El No ...................................................... ..... ...... __............ _....... ..................................._.......................................................... _.._.......................................................... __................ ....... _...................... _...... __.................... __............. e (If "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply With all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. tur L gal Owner(s) to onzegApP.11rantl' T D, Ib_, CODE t• INSPECTION TYPE pAIE INTMA CODE r INSPECTION TYPE MM Pim 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final � 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 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 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMITI r`A7Tly OWY"l &if - Applicant's Mailing Address / 14) ow0ers:J m� Lucas &Mercier ProoertpR9i,e 250-0193 Address Arch/Eng. License No. Address ( 714) Contractor's Name Luetts 250-0193 Address (mailing) - "LVlite. CA City License Nn/C LICENSED CONTRACTOR DECLARA ION I hereby affirm that I am licensed under provisions of Charter, 9 (commencing with section 7000) of Division 3 of the Biss'nd Professions Code, a d my license is in full force and effect. LicenseCla s s No. '�3fr5 Date Signature WORKER ' CO PENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure or a cer ficate ,f Workers' Compensation Insurance,. or a certified copy thereof (Section 3800, Lab. C.) ' Polley N Company -- 8 Certifie copy is hereby furnished. fled < Cer ied copy is filed with the cit�B ulltling Division. Dat Applicai'JIG__ EX MPTION FROM WORKERS' COMPENSATION DECLARAT ON - (Thissection need not be completed 4o - t 's to ne hundr d ($100) r; less). 1 certify that in the performance ofr hic t is perm t is issued, shall not employ any person in anto a me su ject to th Workers' CgmtRopsi4 on Laws of Ca.Date 7/J/OJ Signature NOTICE: If, after making this declashould become subject Workers' Compensation provisions of the Labor Code, you must forth i comply with such provisions or this permit shall be deemed rev 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 (Section 3097 Civ. C.) Lender'sName Lender's Address N/A OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the any stru to file a the Contractor's License law (Chapter 9 (commencing with Section /Uuu1 or �'Jivision 3 of the Business and Professions Code) or that he/she is exempt v herefrom 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 e nalty 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 (Section 17044, Business and Professional Code: The Contractor's 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 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- pletion, the owner will have the burden of proving he/she did not build Or inn - 6 t he the purpose of sale). L I, as owner of the property, am exclusively contracting with licensed con- 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 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 proof of their Worker's Compensation durance she al be provided to me. ❑ I am exempt under Section 11,, (� Bl/&&P. C. for this rgpson Date have read this application agree to comply with all i of thk scity, lJ enter\upon the a1 rumdu Signature'a- Driver, '.Llcense or SS YP tate that the above d county ordinances :by authorize repre- ioned ,property for Date 9/5/85 TYPE OF CONSTRUCTION LJ NEW L -J ADD `YJ ALTERATION L REPAIR — ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# 81ESCRI PI I08Ff. WOR KN/l E OF BLDG. enera ice arehouse S Main Building: TYPE OF PERMIT GRADING �11 FOUNDATIIO��''N1I TRUCTURAL T Front 11TENANTX0 ELECTRICALX61G PLUMBING X]7 MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION SQ. FT. Warehouse 1809 OCCUPANCY ?"I J� C Right CONSTRUCTION TYPE OffiCe 2292ALUATION $ 35 000.00 $ Left ^ ZONE GRADINGCU.YDS. ACRES Ping. Ref.+ Remarks: "'per+ /'Pezj Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink - Lavatories P—Trap Roof Drains Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spec"' -. Urinal Water Closet Water Heater Water Service Auto -Wash Fee $15 1 1 Issue Fee Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBG+ Heating System & Ducting ❑ o-100,000 BTU 1:1100,000 BTi Reinspection Fee 1 $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type 1 ❑ Canopy Type II ❑ Refrigeration System ❑o-1oo,000 BTU 0100,000 System Repair/Alteration Fire Dampers Registers I Issue Fee FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas QEIectric Fan F.A.U. 9771 9/06/85 Zone - Accessory Building: ELECTRICAL Transformer ❑ 15-50,KW ❑ 50+KW I Y Meter El up to 100 a'mp's d, Meter Dover 100 amps Sub Panel Motors ❑0-1 HP 01%)-8 Inc.Solar ❑9-15 HP 016-15+ a. Microwave Pole Light FEES O N I N G R E O M T S 1201 Switches I Sign :4 6 1 Garbage Disposal ; Standing Sections ' Generator 00-5 KW 05-15 KIN I Trash Compactor $ 3 SMIP . Reinspection Fee $15 FEES ISSUANCE DEVELOPMENTSER I FS Qi Zoning Approved By 'Building Approved By Application Issued By ENERGY P.C. $ GRADING $ %Ue BUILDING PERMIT $ I PLAN CHECK $ - PLUMBING $ PLAN CHECK 25% $ _ ELECTRICAL $ _ PLAN CHECK 50% $ _ MECHANICAL $ _ PLAN CHECK 25% $ _ $ OCi $ 3 Issue Fee $ 3 FM FEES SMIP a q� $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ CONSTRUCTION AND PLANNING PRO ALS Permit# Date Inspector POU._ .,� SPA APPROVALS Permit# Date Inspector . T'e mporary Electrical Service or Pole - 52. Pool & Equipment Location 2. iPPipe-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, ❑ 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 G{(�l�',� (�[n - 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 q (7 Y L� FIRE DEPT. REQUIREMENT APPROVALS Permit# 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil .23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas El 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 Conditioningl 35. Final Gas Pipe -Test ' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ("Co 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 v. -50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY tJo.�Date n .. 44` 2- COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING4q _ q n " A . _ A / _ S OCT 26-77CNSID001426* ***633.76 APPLICATION FOR STRUCTURAL PERMIT RECEIVED By I DATE RECEIVED ..ire i_— OWNER BY DATE / / / m a MAIL NO. OF TEL. VALUATION ADDRESS BUILDI G L m G PLAN CHECK $ G $/��(/(� STATE CITY YARDS APPROVED /�TEL.CT LIC. NO. LIC. NO. MAIN BUILDING NO.CONSTRUCTION S12E / y-' LOTCITY OF LOT D VL A PDVINQ USE OF LENDERBRANCH G G5,1_16.5- ADDRESS ADDRESS - VALUE ARCHITECT TEL. USE $ OR ENGINEER N III FIRE CONTRACTOR BY DATE ADDRESS SO, FT. m a Z NO. OF USE OF N TEL. VALUATION PLANS BUILDI G L CITY NO. m G PLAN CHECK $ G $/��(/(� STATE CITY YARDS APPROVED YARDS APPROVED i LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING S12E NO. OF SLOGS. (FROM C/ STR ET) OF LOT NOW ON LOT ONT USE OF /_ Separate permits are required for electric, plumbing and heating work. I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. Signature of Permittee Authorized Aoent BET. I BET. MAIN & VAR. qW C.U.P.; -2l -7 ut n m SO, FT. m a THE AMOUNT SHOWN UNDER VALUATION IS FOR D THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; VALUATION PERMIT FEE $ev e n m G PLAN CHECK $ G $/��(/(� TAX $ D / TOTAL PAID $0.3 fyF t r. o. J (714) 754.5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Job Address: 2950 AIRWAYAV Suite: Vicinity: 1 BUILDING WITH UNITS C-1 & C-2 Parcel Nunmber: Applicant: LEACH, ROY Address: Owner. KH PROPERTIES LLC Address 2950 AIRWAY AV Zoning: Phone: Zip: Phone: COSTA MESA, CA Zip: 92626 Contractor: LEACH & ASSOCIATES ROOFING Address: 3928 DOWNING Phone: 626-851-1427 BALDWIN PARK, CA Zip: 91706 License:' 691152 Arch _ Eng: Address: - Address: Phone: Zip: License: PERMIT NUMBER B99-00043 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUEDhtb Applied: 01/07/19198 Issued: 01/07/1999 Phone: License: SCOPE OF PERMIT T/O EXISTING ROOFING ON THE BUILDING AND REROOF WITH MODIFIED BITHUMEN ROOFING. BUILDING HAS UNITS C-1 & C-2. 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: r $10,200.00 $10,200.00 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 FEE SUMMARY Plan Check: $0.00 Calc Valuation: Permit: $174.75 Claim Valuation: SMIP Res: $0.00 SMIP Com: $2.14 Other: $0.00 Inspection: $0.00 Total: $176.89 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: r $10,200.00 $10,200.00 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 DECLARATIONS WORKERS' COMPENSATION DECLARATION:} I hereby affirm under penalty of perjury one of the following declarations: iL ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the" work for which this permit is issued. ❑ 1 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 workers' compensation Insurance carder and policy number are: Cartier: Policy Number. (This section need not be completed it the permit is valued at one hundred dollars (3100) or less.) ❑ 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 workers' compensation IlawsALCAI,fomia, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with the provisi Applicant Slgnatt / ' Lc/C Date: /�/ WARNING: FAILURE TO SECURKr_RSCOMPENSATIONI COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (SIOO.000rIN 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Uc. k Class p Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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 penallyof 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 permlt 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 o1 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 contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet In depth Into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a pemllt to do such work from the division. Signature: Date: Division of Industrial Safely Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 01 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 comprossed gas at standard temperature and pressure). ................................................................................................................................................. ....................................................... 2 Does or will Lha epDllcant qr present or future building ocapant need to lila a re9lsiretlon form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time hes 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 o1 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 F re Department. ................................................................................................................................................................................................................................................. 4 If an RMPP Is presently required, has Section 25534 of the Celifomia Health and Safety Code been fully complied with? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building Occupant require for the work which Is the subject of this a plication ao mit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residentlal building permits). ................................................................................................................................................................................................................................................................................. 6 Will any pen of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................... 7 If a Permit from the South Coast Air Quality Management District or other air pollution control district or agency is ISGulred for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... W (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I cerlily that under penalty of perjury the information given above is correct. I agree to comply with all state laws and dry ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHOR17ATION 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 Masa to enter upon the above-desc' roperry for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Lege[ Owners) And/Or Authorized Applicant ate OBE -L INSPECTION TYPE BATE II®ElS CODE 1 INSPECTION TYPE BATE IiQIMAL$ 1616 Fixed System Final Fire Prevention n 206 Final Mechanical 1286 Pool Spa Final 208 Final Plumbing 200 Final Re -Root � � L 210 Final Electrical 201 Final Block/Romining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final BuildingrOcoupancy 244646 { COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 +dor Applicant to Fill in Completely — Use Ink ORIr�� BUILDING D,is.. i.. i/1/i OWNER u 1 CITY AZJ/ _ / NOL 70' 179rcj ADDRESS TEL. ADDRESS CONTRACTOR Nfa 9"Q- bra. r ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE NQ OF BLOGS OF LOT NOW ON LOT USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED 1 hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shell not employ any person In violation of the workmen's compensation laws of the State of California. I hereby certify that I em properly licensed as a convector under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and affect, or I am exempt from the provisions of Stata,97 California Buslne and Professions Code, Dlviission 3, C Ater Signature of Permittee �// Authorized Agent Sl- ,4 R ECEIh/E /I tr -7 BET il4sIt; 5/c;;/7° FOR STRUCTURAL PERMIT DATE RECEIVEDOATTF IScuFP E9 LOT VALUE BET. MAIN & C N n m e T. m r THE AMOUNT SHOWN UNDER VALUATION IS FOR M THE PURPOSE OF ESTABLISHING A PERMIT FEE LY: e VALUATION PERMIT FEE $ 0 N m PLAN CHECK 3 1e O TAX 3 L'T $ /OV LL V u TOTALPAID 3/ �, II a — -- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA . CONSATR UCTION PER M`I�T PERMIT NO. I TRACT NO. LOT NO. 1 UNIT NO. Project Address h9� A h.ma_y (IA[I Applicant's Meiling Address li•e'1 p TYPE OF CONSTRUCTION LJ NEW LJ ADD MALTERATION I I REPAIR Owner's Phon Nome , - :>V I 2 - itL Spy ❑ CONVERSION ❑ DEMOLISH ❑ OTHER yk e _ DESC51PTION OF WORK/USE OF BLDG.S— Address L9 _ 139. Z9 dl v, N;. A9. 92660 - A +-VAO*� Arch/Eng. 'License�No. TYPE OF PERMIT RADING ^�OUN DATION- STRUCTURAL coW Address ❑ TENANT' 1:1 ELECTRICAL 1LJi PLUMBING ❑ MECHANICAL c ,? 'Contractor's Nam " s •ZN 'Phone ❑ OTHER I 6 ��6�y � - 1 Address(mailing)p—/--0-r OX L/ 3 5_5 "`PROJECT DESCRIPTION SO. FT. - OCCUPANCY -- CON STRUCTioN CCUPANCYCONSTRUCTION TYPE VALUATION $ �— City License No. - ZONE GRADING CU. YDS. (ACRES -1 LICENSED CONTRACTOR DECLARATION 1 - Remarks: - I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) o1 Division 3:of the Business and, Professions Code, and ' . my, license is in full forcistnteffect. q Licari C ss icensa'No. . Date 11 Signature I Duct -Structural "V$)RKERS' COMPENSATION DECLARATION . ereby affirm that I have a certificate of consent to self -insure or a certificate Bar Sink- Exhaust System ❑ Multiple ❑ Workers' Compansation Insurance, -or a certified copy thereof ,(Section ,J800, Lab. C.) - I ""Q Policy No. �`-' (Company , Backflow Preventer --- -- - Backflow Irrigation ❑ I'am exempt under Section B. d. P. C. for this reason ;rtified copy. is hereby turn shed. 19 Cer If ir'nt coo �11v5.�fi I d with the city ilding Riy�Stio�n. n D.1. Af Applicant Aga'd f(Z tom, / E%EM PTION (PROM WORKERS' COMPENSATION DECLARATION - Bathtubs ' Clarifiers (This section need not be completed if the permit is for one hundred ($100) or less). - Dishwasher _ _ _ Meter Dover 100 amps _ 1 certify that in :the performance of the work for which this permit is Issued, I t shall.not employ, any person In any manner so as to become subject to the Drinking Fountains 'Workers' Compensation Laws;of California. ' Date-- Signature Floor Drains 'NOTICE: 1f, after making this declaration, you should become subject to the Floor Sinks - - Motors 00-1 HP❑1K-B Workers': Compensatlon provisions of the Labor. Code, you must forthwith • comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets i Inc. Solar 09-15 HP 1:116-15+ "CONSTRUCTION LENDING 'AGENCY I hereby affirm that there is a construction lending agency for the performance - Interceptors of the work fort which this permit is Issued (Section 3097 Cls. C.) Under's I Name _ - _ Kitchen Sink _ Under's Address I i Pole Light OWNER BUILDER DECLARATION , n K,, ern. rhos I a... a..nmpt from the Contractor's License Law for the Lavatories. Cf 5 Business and Professional Code: Any city to construct, alter, Improve, demolish or rel ,C.. also rea.ires the applicant for such oerr Roof Drains error mn e,u s v.o a> .,, .031.5 by any applicant for a permit. subjects the applicant to a civil 1 enalty of not more than five hundred dollars ($500). I, as owner of the property or my employeas with wages as their sole compensation, will do the work, and the structure is not Intended or offeretl for sale .(Section 7044, Business and Professional Code: The Contractor's ' License Law doesnot apply to an owner of a property who builds or Improves thcreon, and whu does such work himself/herself or through his or her own 1 • 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- pletion, the owner will have the burden of proving he/she did not build or im- F" foLthe purpose of sale). I.as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves, thereon-, and -who contracts for such projects with a con- FEES' Reinspection Fee I $15 - - - Boiler I ". Duct - Under Ground ELECTRICAL Duct -Structural , Duct - Ventilating Automatic Washer "� -- Construction Pole Sub. Exhaust System ❑ Multiple ❑ tractor(s1 license pursuant to the Contractor's License Law). I am aware that i proof o1i, their Worker's Compensation insurance should be provided to me. Firepl/Fact. Bit. ICSO �k ❑ I'am exempt under Section B. d. P. C. for this reason 1 Date Owner � j I hereby certify ttiat I have read this -application antl state that the above information is correct I agree to comply with all city and county ordinances - Heating System &Ducting 00-100,000 BTU 0100,000671 and state laws relating to building construction, and hereby authorize repre- i sentatNes of Is at to enter upon the above-mentloned pr erty for inspection p ses- /-' %�� �� , n Signature C /d'vo�/•"'— Data %o 'Z D Reinspection Fee Drivers' License or SS IF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink -_ Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal - Water Closet Water. Heater ' Water Service Trays Issue Fee Hood or • Type 1 ❑ Canopy Type ll'❑ Refrigeration System 00.100,000BTU ❑100. Fire Dampers Registers Fee 0697 I0/2L/84_._ A.P. 0/26/84 .- A.P. + - S' Main Building: Accessory Building: E T Front A Rear C Right - - - gLeft Ping. Ref.,# Parking Req./Provided Planning Notes: ! Zone 10.50 TL Z O N I N G R E Q M T S FEES' ELECTRICAL FEES Automatic Washer "� -- Construction Pole Sub. - Tmnsformer ❑ 15-50 KW ❑ 50+KIN - f • Cooking Unit Meter ❑up to 100 amps, r Dishwasher _ _ _ Meter Dover 100 amps _ Dryers ❑Gas ❑Electric Sub Panel Fan Motors 00-1 HP❑1K-B • F.A.U. 1 i Inc. Solar 09-15 HP 1:116-15+ - Fixtures Device Boxes Pole Light Outlets Range f Switches Sign Garbage Disposal Standing Sections - Generator00-5 KW 05-15 KW Trash Compactor $ 3 Reinspection Fee $15 Issue Fee $ 3 FEES' DEVELOPMENT SERVICES REQUIREMENTS:. 'Zoning Approved By Date Building Approved By Date Application Issued By Dat '2'Z BTU BUILDING PERMIT PLAN CHECK PLUMBING( PLAN CHECK 25% ELECTRICAL , PLAN CHECK 50% MECHANICAL.S PLAN CHECK 25% SUMMARY OF FEES ;$ SMIP $ $ PERMIT $ ISSUANCE $ (,'S� ENERGY P.C. .$ ' $ t �$ GRADING: ,$ �$ MICROFILM $ ' TOTAL FEE $ $ — 1 $ 3 CONSTRUCTION AND PLANNING - Date APPROVALS Permit# Inspector POL <SPA APPROVALS Permit# -Date Inspector 1. Tempotary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. _ I�' G 53. Steel Reinforcement 3. Electrical Conduit Utility;Undrgrnd. 54. Forms 4. .Electrical ConduitiUndrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement - - 56. Rough Plumbing & Pressure Test 6.• Electrical LIFER Grind. - 57. APPROVAL TO COVER-GUNITE ' 7. Footings, ! 58. Electrical Conduit-Undrgrnd. 8.•F66ndation. i 9: Gas Pipe, 0 Undrgrnd.; Test -I 9.•Water Pipe-Undrgrnd: I ' 60. Backwash Lines, P -Trap, 0 Undrgrnd. - 10. Structural Floor System - "i 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection I 62. Backwash & Receptor -Final 12. Sewer Cap i 63. Heater & Vent -Final - 13. Roof Drains -• 64. Plumbing System - Final 14. Rough Plumbing 14j_WYYCE/l 65. Electrical -Final 15. Rough Electrical-Cona6it 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70.E Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 oil 23. Gas Pipe -Rough & Test 72. UndergroundFlush• 24. Roof Framing 73. Undergrnd.StorageTank OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame'and Flashing 76. Dry Standpipe 28. Lathing &Siding 77. FIXED SYSTEM FINAL 29. Insulation _. 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test, - - 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final - 41. Solar Domestic -Final - -• - - - - 42. Backflow Preventer' - 43. Backflow Irrigation 44, Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING , 48. Special Requirements Completed 49. Electric Release to Edison -- 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date - -- - 0471031 'CnT MESA BUILDING -SAFETY DEPARTMENT 9645 I I /2BY78 P.O: tlOX 1200 COSTA MESA, CALIFORNIA 92626 _ - 8.50 s s A L1AON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only REE D DATE RECEIVED qTE S ED BUILDING '1 / � k ADDRESS i v (� 7h r� 1 yOWNER �/Q�� PERMIT NO. /1, G L A.P. N MAIL BU IDR / ADDRESS /7 s� �s'i KCS ADDRE TEL. CITY Go / NO. TRACT LOT BLOCK CONSTRUCTION NEW ADD AL LENDER ATE il BRANCH OWNER ' ADDRESS VALUE SE / E ARCHITECT TEL. OR ENGINEER No. FIRE ADDRESS ZONE TY/E GROUP 1- Qr� ED CONTRACTOR - WinttfiC 4)- a ByPROV DATE ADDRESS 24V O r/�/Y TEL. ZON NO. OF USE OF NE U CITY pM C NO. PLANS BUILDING ,#7 // STATE CITY VAR DS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS (FROM C/L ST OF LOT NOW ON LOTFRONT FT. USE OF EXISTING BLDG. ,4 SIDE.J —VICER. / Separate permits ar required for L SIDE FT electric, plumbing and heating work. REAR FT. F/ USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. "!� )•s OfC�IC T'nO�s VAR. $`+ DATE C.U.P. 916APPROVED APPR E I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E and Professions Code, Division 3, Chapter 9. PLAN CHECK E Signature of Permittee /— r� E UTAX E l Authorize6aa,s TOTAL PAID E s s COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. 9OX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only APPLICATION FOR STRUCTURAL PERMIT RECEIM DATE RECEIVED SS}l BUILDING f / ADDRESS 1/ ,�5_E OWNER Q — ) A.P. NO. / PERMIT NO. MAILj� ADDRESS,. r� BUILDING DA Q ADDRESS _ 12W I t i CITY �• t NOL TRACT O� LOT BLOCK CONSTRUCIOW LENDER BRANCH OWNER15 jf2 ADDRESS VALUE $ D ef ARCHITECT TEL. OR ENGINgER FIRE ADDRESS ZONE TYPE GROUP APPROVED 01 CONTRACTOR .� 14 BY DATE ADDRESS TEL CITY NO. ZON NO.OF PLAN Z USE OF NE BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NG OF BLDG& (FROM C/L STREET) OF LOT NOW ON LOT FT. 4T. USE OF EXISTING BLDG Separate permits are required for L. SIDE FT FT. REAR FT. FT. electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS BLDGS. �� O VAR. 46 DATE °`/� / C7G� • C.U.P. ys APPROVED ADO ^WROYEIY C6 DATE I hereby acknowledge that I have reed this application and state that the apove information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any parson in violation of the workmen's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR Me State of California Business and Professions Coda, Division 3, Chapter 9, end that such licenses are In full f e end effect, or I an exempt from the provisions of /State Cellfornie end Professions Cotls, Dlvidon 3, teeter THE PURPOSE OF ESTABLISHING A PERMIT FEE NLY::t VALUATION PERMIT FEE S • V PLAN CHECK $ �, O Parrm lttaa Signature of aO S/2 51717 if TAX $ ° ti TOTAL PAID $ Authorl..d Agent �M COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 It:lb o7 i° ' I . APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEI .DATE RECEIVED DATE ISSUED 5 �Z BUILDING / ADDRESS !i (J �1 PERMIT OWNER A.P. NO. MAIL i� �— BUILDING - ADDRESS O' -B G' 6 ADDRES ti�4/l.(.iJ TEL. CITU TE TRACT74/Z LOT BLOCK .�. nFivIDLISH LENRECONSTRUCTION _ LEN ER BRANCH ni OWNER ADDRESS VALUE S ARCHITECT TEL. OR EDIGINEER FIRE ADDRESS ZONE TYPE GROUPqlz APPROVED CONTRACTOR ByDATE ADDRESS (/(/ TEL. ZO p IND. OF PLANS USE OF NE A� BUILDING CITY NO. (�(.&� STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF SLOGS (FROM CIL STREET) OF LOT NOW ON LOT FRONT FT FT. USE OF EXISTING BLDG Separate permits are required for L'SIDE FT. electric, plumbing and heating work. REAR Ky-FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLOGS. ACCESS, BLOCS. r VAR. # DATE C.U.P.# APPROVED rRO VVV D I hereby acknowledge that I have reed this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and 1 &hall not employ any Person In violation of the workman's compensation laws of the State of California. I hereby certify that I em properly licensed as a contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and affect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FE ONLY: am e%empt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Coda, Division 3, Che tar 9. i0 D o PLAN CHECK S 60 Signature of d 4�L TAX 3 Permittee $ J\ Z5-oO TOTAL PAID S DI A uthPrizatl Agent COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING *'YJL71/l,.n;. ,.w, l •,f, ,r n 'Zk OWNER Q Q S MAIL ADDRESS O /J CITY TEL. m i 0 CONSTRUCTION LENDER �' �• / rCC BRANCH DISTANCE BET. THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: ADDRESS VALUATION PERMIT FEE $ ARCHITECT ORE INEE TEL. ACCESS. BLDGS. ADDRESS /�� ^� VAR. 06 CONTRACTOR _ / /.1N 10 ✓ TAX CITY STATE LIC. NO. SIZE OF LOT TEL. NO. CITY LIC. NO. NO. OF BLOCS NOW ON LOT FOR STRUCTURAL PERMIT —/67/—// FIRE ZONE APPROVED DATE ' ZONF�„ ^ INO.OFr, I BUILDING OF �� EJ(� _44 D /JI APPROVED Separate permits are required for S V FT electric, plumbing and heating work. - REAR FT. m i 0 FT. USE OF BUILDING AND WORK TO BE PERFORMED THE AMOUNT SHOWN UNDER VALUATION IS FOR DISTANCE BET. THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: BET. MAIN & VALUATION PERMIT FEE $ MAIN BLOCS. ACCESS. BLDGS. lt/�`�/1l02 Lp�S /�� ^� VAR. 06 $ L V DATE TAX C.U.P.# U APPROVED I hereby acknowledge that 1 have read MIs application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any Person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under the State o1 California Business and Professions Coda, Division 3, Chapter 9, and that such license% are In full force and effect, or 1 am exempt from the provisions of the StatW California Business and Professions Code, Division 3 apter . Signature Of. Permittee Authorized Agent /n['�c�'� I TOTAL PAID S G ✓ % euz N n m i 0 SQ. FT. H THE AMOUNT SHOWN UNDER VALUATION IS FOR D THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: u VALUATION PERMIT FEE $ PLAN CHECK /�� ^� $ L V i TAX U Authorized Agent /n['�c�'� I TOTAL PAID S G ✓ % euz ADDRESS OF BUILDING: 2950 AIRWAY AV UNIL C-1 CITY OF COSTA MESA — BUILDING PERMIT ---------- ORNERSNMIEBIDIMN,M C KIBBIN SAILS ACCESSORY BUILDING--------- FRNT: PERM NO: E 080866 ADDRE%2950 AIRWAY FT IN FRNT: FT IN REAR: FT IN PERMIT NO: E 080866 PLAN CHECK NO: N GOVT: N SUPP: N APPL. MMUNG ADDRESS: CONSTRUCTION TYPE: I FR SP PERMIT TYPE: ELE PURPOSE: ALT ARCNDECT OR ENGINEER. MC NO.: JOB DESCRIPTION REPLACE MAIN ELECTRIC METER MAIN SQ FT: ARQL OR ENG•s ADDRESS: UNIT. REF NO: PLANNING NOTES> CLAIM VALUE: CALC—VALUE: GROUP OCC: B / cpfRRACTOSNOUIV SMALLCOMB WIRING (718)556-8591 :comACTORs11AnwD 136 E. GARRY AVENUE Ams%SANTA ANA CA gym: 145961 92707 UN': LICENSED CONTRACTORS DECLARATION: I hereby, affirm under penalty of perjury that I am licensed under prwiuona of Chaper B (Porrm ndrq wish Setlon ]000) d Division 3 d the Business end Prdessi«n Code, and my ltcanea is in lug lace end effect. UCNo.:011005 LIC.cuSS:C10 LIC, NO,:14 9 11 EXP; 08/97 Data: Cmbect«: EB BUILDER DECLARATION: I hereby affirm Incl« penely of perjury Ilea I am mu mot from the Contractors Licenew Lew for the towing reason (Section 7031.5 Bossiness and Prdmiom Code: Any city or county which requires a permit to construct, after, hnpro m, mulish, or repair any structure, prior to ie lesuanca, new newirm the applicant for such permit to file a wowl smlemea thel he «nd e licensed pursuant to the provisions d the Contractors License low (Chapter 9 (mmmeociag with Section ]000) d D"im 3 of the Business and Pramions Code) or Its! he or he is esemyr thaelrom and the besis for the alleged exemgion. Any violation of &action 7031.5 by any applicant for a permh subjects the mplicenl to a coil perafty, of not more then Me hundred clalere ❑ I. we own« of the progeny or my employees with wages as their sole mmpemtion, will M the work, and the amdure o no intended or offered for sale (Section 7034, Business and Professions Code: Tho Comecon, License Law dose not appy to on owners propMy who bull. or knproves Thereon, and who does such work himself or hersel or through his or her own employees, provided the each impovemonn are not intended or d rowl f« sae, ff, however. the buikliag «imlxovemeM Ls sad within one year of mmpklon, the owner-0uioer will have the budon of paving he or she did not build or improve for the purpese of sale). COMMENTS: X ############################################################################### Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING p°`1510ne PERMIT 27.25 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N D E V E L O P M E N T --S E:R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY 111.DATE: the pmts r rmton cion awl end with licensed a owner to prop" ❑ I, es ovmer d the popeM. tr eadueivdya Low close Lnenss Lew does not apply to th owner propend who Mhda «improves Thereon end wM Code: The Contin BUILDING APPROVED B Y : �yy - DATE. commions contrecle M eudm protects with a marector(a) I'cenaad persumt to the Contractors Limine Law). ac ct � v - I �/ ❑ lammempundarsecton: B.&P.C..fir this earn: APPLICATION ISSUED BY: ISSUE PLAN -CHECK DATE: �k-* DUE Dae: Chimer: # # # # ## ##### # # # # ##### # #�F 3F TFif7FiFTF3f7FiF;f7FfFiFiFiFiF'iF is iF7FTF;F7FiFiFiFiF # # ##### ## # .00 REVENUE DIVISION TOTALS--> LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SE ENT:N I M hereby cetgy that I am aw«e of and undennrd the raguirem urs of Cafforn a health and Safety Cade Sectiom?5505. 85533. end PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING eperroh eatonstructvmya mocificcidi toOm[heAAir Ila�yll.oe�ILaaeo%mmRoi dnae°a. IRaa ®tly m�a'aamapp nr aAr ptl�mmeAts for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING p°`1510ne PERMIT 27.25 Dae: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under pray of perjury one of the tollowiN cledereloro: ❑ I have end wit mainMn a unilicata d mnaont Io saffuwre b workri mmperemim, o paroled f« by Serrion 3]00 d the tele« cove. I« tit. pedonvma d the work I« wNan No perch o estnd. l have ud will mountain wakes• mmisensato^ imraro. ea reauimed by Section 3]DO ado Lab« Code. for the ped«menu of the 7 work for whidm this p now to lesued. My wakere' comiomeian'vnurance comer end Polk, number ere: Cartier: CA CARUALTV EXPIRES Pa'ry Numbe,Wr F.Q(10011109 10/01/97 nen rued rat be mnplrxW r rhe Perrot u /« «ms hundred dollars (SI001 «hit.) I cenly cine in Uma pedom«ca d IM work M wfioh thle parole b issued, I Nag mI amp oy am, parson in any mem« vo m to bacons wbjw/ to The workers' c«npemeton lewa d Cakfomle, and agree the Pat hadd be«ane subject to the wwmkers' D pemaionl 'e"oro d Setlicn 3]OD d The Lerma . I I' n mmPy wtlhAhmq PmNsiona. i _ 3 - )�1 (FII�Jb Y WemMp: Fagan fp cacao wodcere' mrrywnsetlon eovereya la unArwNl, andahsll auDJecN an employsy Lo edMnal perreltlu and pldl flora nos m aro herrIhouund dahn 00A M add/Mn m Na Prot of rorrparmsaUorm, Mnnpas m pnvldM b] In Ssctlon 3706 0l Ma Labor, Co COM, Interest, end emoneYMmey'a /Owe CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there at e construction lending agency for the performance of the work M which this pmt is ®wed (Section 3087. CN. C). LENDER'S NAME: LENDER'S ADDRESS: 1 caniy [het I here reed this application end Owe thel the above information re mrtact. I agree to comply with all city and county okimnoee and alae less retain to buiWng construction end hereby authorize representatives ofthis city to enter upon the above-mentioned property for imwpootion perpnm. KEVIN SCHELLIN (51514e.WP) WhheBuileiag&Safety: Dam: /I-+3-96 Pink-ptavenpe: Gddamad-A . 508 SMIP/NON—RES PLAN ISSUE FEE 22:00 BUILDING—DICT—> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 27.25 22.00 0.00 49.25 49.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 49.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 49.25 ############################################################################### I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V &' BELOW 201 AMP 27.25 27.25 END OF FEES 01 00221034-002210334 TOT DATE: 12/13/95 TIME: 15:27 49.25 CONSTRUCTION AND PLANNING APPROVALS ;Permit # -. - tor F POt .SPADate " APPROVALS Permit# Date Inspector 4 1.: Temporary.Electrical Service dr Pale' 1 - 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 - - 5& Rough Plumbing & Pressure Test 6. Electrical UFER Gr6d. - 57. APPROVAL TO COVER-GUNITE 7. Footings_ -. g , X58.. Electrical Conduit-Undrgrnd. 8. Foundation ^ ;59. Gas Pipe, O Undrgrnd:, Test 9. Water Pipe-Undrgrnd.: - - ,60. Backwash Lines, P -Trap, O qj drgrnd. 10. Structural Floor System f 61. APPROVALTO 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 APPROVALS Permit # - 20. Rough Factory Fireplace 21. Ducts, in Structure - 70. Underground Hydro 22. Ducts, Ventilating i 71. Product Piping 0Gas OOil 23. Gas Pipe -Rough & Test - - 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas ❑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 33. Final Electric _ 80. FOOD CERTIFICATE ISSUED Notes: 34. Final Heating & Air Conditioning q 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date q r'4 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000340 P. O. Boz 1200 Costa Mesa, California The Building located at 2950 Airway Drive #Dl has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building Intterior Alteration— Travel Agency Legal Description 427-X64-14 (See reverse side for Metes and Bounds) Building Per No 10504 Electrical Permit No E -y20606 Plumbing�Permit No. P-10653 Mechanical Permit No. M-10713 Number of apartments 0 and/or guest rooms 0 ISSUED TO: Building Official Beverly Hills Travel � by a 2050 Airway ODl, Costa Mesa, CA a (12 Date 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 ER WATER ROUGH PLUMBING POP. SWR. LINE E] HOUSE PRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR C01 TEMPORARY SERVICE OR POl UNDERGROUND POWER ROUGH WIRING DATE BUILDING PERMIT NO. , FIRE ZONE VA SUBCONTRACTOR TRENCHES FORMS STEEL REINF. nvarin vnv •an r. ` -1 - Q FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN F 1 OUT PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST El 11611111 111 ft ELECTRIC, FINAL City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 10an a:rwat: avcntth. unit D3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R2 Occupancy. Use of Building office/Warehouse Legal Description 427-164-05 (See reverse side for Metes and Bounds) Building Permit No B 53349 Electrical Permit No. E 53667 Plumbing Permit No. P 53668 Mechanical Permit No ISSUED TO: CatrmnnA HoFnor 2330 Vanguard Dr., G-203 rv,ar� m.oa. ra 09626 Number of apartments and/or guest rooms Building Officia—l/ Tnnv C'De Baca by / ; Date Cunt•omhar 1Q, 1991 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 X015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File (714) 754-5273 • Fax (714) 754-4656 " www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2950 AIRWAY AV Suite: D003 Vicinity: UNIT D3 (CONANT CAR STORAGE) Parcel Number: 42716415 Applicant: ROGERS, PAT Address: Zoning: ISSUED BY: Status: ISSUED Applied: 07/06/2004 Issued: 07/26/2004 —SCOPE OF PERMIT INSTALLATION OF ONE "INBAY TECHNOLOGY SL291 (400 SERIES)" ROTARY IN-GROUND•2-POST LIFT UP TO 9,000# CAPACITY INSIDE "CONANT CAR STORAGE" UNIT D3. PLNG. - NO WOMP REQUIREMENT. T.I. FOR STORAGE OF HIGH END VEHICLES FOR SALE. NO MAJOR AUTO WORK/SERVICE ALLOWED SEE APPLICANTS DESCRIPTION IN FILE. WS REF: B03-01870 FEE SUMMARY / , ,' Plan Check:" � $90.51 Calc Valuation: , . $7,000.00 Permit $139.25 Claim Valuation: $,090.00 SMIP, Res: $0.00 SMOCom: $1.47,, 'Other: $0.00 !d - Inspection $0.00 a/ 2 Total x$31.23%�,� ��. 2 SETBACKS MAIN STRUCTURE Front 0- 0 PLANNING&ZONING��V --Rear 0-0 Left " 0-0 - Right __�i0-0 I 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 1'none: /14-ti3Z-b3UU '- �;� - Zip: Owner: CONANT FAMILY TRUST Address X1381 GALAXY DR - - Phone: NEWPORT�BEACH CA.'Zip: 92660 -- ' Contractor: `AUTO "SHOWEQUIPMENT CO INC Address:_ 2840 E CORONADO ST - - Phone: 714-632-5300 ' ANAHEIM, CA Zip: 92806 r License: 472820 _ Arch- Eng: MAURICIO LOPEZ ' Address: Address:' Phone: - - ' ` - Phone: `Zip: License: License: SE36801 —SCOPE OF PERMIT INSTALLATION OF ONE "INBAY TECHNOLOGY SL291 (400 SERIES)" ROTARY IN-GROUND•2-POST LIFT UP TO 9,000# CAPACITY INSIDE "CONANT CAR STORAGE" UNIT D3. PLNG. - NO WOMP REQUIREMENT. T.I. FOR STORAGE OF HIGH END VEHICLES FOR SALE. NO MAJOR AUTO WORK/SERVICE ALLOWED SEE APPLICANTS DESCRIPTION IN FILE. WS REF: B03-01870 FEE SUMMARY / , ,' Plan Check:" � $90.51 Calc Valuation: , . $7,000.00 Permit $139.25 Claim Valuation: $,090.00 SMIP, Res: $0.00 SMOCom: $1.47,, 'Other: $0.00 !d - Inspection $0.00 a/ 2 Total x$31.23%�,� ��. 2 SETBACKS MAIN STRUCTURE Front 0- 0 PLANNING&ZONING��V --Rear 0-0 Left " 0-0 - Right __�i0-0 I 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 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the fallowing declarations: ❑ Ative and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this p rmit Is issued. I have and will m ,mar works comms on insurance, as quired by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' co i In ra ce card and policy nun er are: Carder: I Policy Number: (This section need n comp/eard /t the permith valued at one hundred dolfam ($100) or less.) ❑ 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 workers' compensation laws of Ca f a agree at if I s d become subject to the workers' compensation provisions o1 action 3790 0� Labor Code, I shall forthwith comply with the cosi r EI/ Applicant Signature: Date: 1 `-G WARNING: FAILURE TO SECURE WO ERS' COMPE ATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED A THOUSAND DOURE($100,000), IN ADDITION TO COST OF OOMPFNSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am Iicens der r isi s of Spier 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Lic. k Class a Contractors Signatur Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there Is a 9afistruction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders 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 property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Celifomia Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department Dy 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). future building occupant need to file a registration form for acutely hazardous materials?..�.. ......Yes .......... .....No_.................._..................... .................................................................................................................... 2 Does or will the applicant or resent or utu a building p g y ❑ ❑ (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 then 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 ❑ Yesr will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? 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 apartment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ........................................_......................._._—___._........_._..............................._._....................__..................._..........................................................................._......._............................_..........._......................_.................___. 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes a No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .........................................__.._............_........__...._.............._.._..............................._..........................._............................................................................................................... I..................................._.................__............... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...................................................................................................................................................................................................................................................................................................................._...........................___._...................__._.... 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Salary Code Section 42303 been made? ❑ Yes ❑ No ............................................................ ................................................... ..._................................................................................. ................................................... ............................ ....................................................................... ........................... ... 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SI tura egal er(s) OD le r Authorized Applicant D e CODE I, Q/!TE INIMAt^ CODE r INSP� fjcnONTYPE LIdTF. INTRIALS 1616 Fixed S m Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 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 Bullding/Occupancy (714) 754-5273 • Fax(714)764-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 2950 AIRWAY AV Suite No D003 Vicinity: Parcel Nunmber: 42716415 ISSUED BY: Applicant: WARD, DON Address: Phone: 714-321-3841 ' Zip: Owner:,%,CONANT. FAMILY TRUST Address - 1381 GALAXY DRQ Phone: NEWPORT, BEACH, CA Zip:- '92660 Contractor: MATSON, JOHNATHAN SCOPE OF PERMIT - INSTALL CLARIFIER SYSTEM BETWEEN FLOOR DRAIN AND SEWER SYSTEM. CLARIFIER FOR CAR WASHING - WASHING WILL BE ANCILLARY TO THE OWNER'S AUTO BROKER USE. WASHING AND DETAILING FOR'CUSTOMERS IS PROHIBITED. Address: .. 13271 SOUTH STREET" Phone: 562-402-9100 - ,CERRITOS; CA _- Zip: 90703 License: C15532 k Arch / Eng: Address: Status: ISSUED "Applied: 08/04/2004 Issued: 08/06/2004 `VAAA� MATSON, JOHNATHAN% 13271 SOUTH STREET - Phone: 562-402-9100 CERRITOS, CA -Zip: 90703 -'- License:' C15532 / - ` SCOPE OF PERMIT - INSTALL CLARIFIER SYSTEM BETWEEN FLOOR DRAIN AND SEWER SYSTEM. CLARIFIER FOR CAR WASHING - WASHING WILL BE ANCILLARY TO THE OWNER'S AUTO BROKER USE. WASHING AND DETAILING FOR'CUSTOMERS IS PROHIBITED. N.i - - ' AMT QTY - ., - AMT QTY / �� ,.AMT QTY ISSUE FEE t$23.50 Laundry Tub /;Washer, $0 00- 0 Sump Pump j� j, $0.00 0 Backflow in $0.00 ;; 0. ;� Landscape Irrigationv MATSON, JOHNATHAN% 13271 SOUTH STREET - Phone: 562-402-9100 CERRITOS, CA -Zip: 90703 -'- License:' C15532 / - ` SCOPE OF PERMIT - INSTALL CLARIFIER SYSTEM BETWEEN FLOOR DRAIN AND SEWER SYSTEM. CLARIFIER FOR CAR WASHING - WASHING WILL BE ANCILLARY TO THE OWNER'S AUTO BROKER USE. WASHING AND DETAILING FOR'CUSTOMERS IS PROHIBITED. AMT QTY - ., - AMT QTY / �� ,.AMT QTY ISSUE FEE t$23.50 Laundry Tub /;Washer, $0 00- 0 Sump Pump j� j, $0.00 0 Backflow in $0.00 ;; 0. ;� Landscape Irrigationv $0.00 0 ,�' / Swimming ;Pool /'( $0.00 0 Backflow Preventer \�\$0.00 ' i 0 P.-�,,�` " - $000-� 0= ;'%' iTrap'Priiner // $0.00 0 Bathtub ���$0.00 0 Pressure Regulator $0.00 --0`� \\Urinal �� ,� j/ $0.00 0 Clarifier System �S44.25 1 - Process Piping (per 10 ft) $0.00 0% \VacuumBrkr-Bkflow(1-4) $0.00 0 Connect (Ice,Soda,etc) $0.00 0 Receptors _ $0.00 0 , ' Vacuum B, r Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank - -$0.00 - 0 - , Wash'Basin $0.00 0 Dishwasher $0.00 0- " - Sewer Cap for Demo $0.00 l) `" „-Wash"Basin Set $0.00 0 Drain, Floor $9.80 1 Sewer Connect - $0.00 0 --,-,/Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 - Sewer Private Line $24.65, "-1- - " Water Closet (Toilet) $0.00 0 Drain, Roof $0.00 0 _- StPower" - ' - ' " '§o.00-- 0 Water Heater I vent $0.00 0 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 2448.46 tsrool DECLARATIONS WORKE S' COMPENSATION DECLARATION: I hereby ff.. Intl., penalty of perjury one 01 the following declarations: ❑eve and will maintain a certificate of Consent to sell -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the X for which this permit is issued. 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 penult is issued. M workers,`pG`mofa\ns'atio ,erica carder and II number are: CertieMy�� " Policy Policy Number. (This section need not be com leted if, the Permit is valued atone hundred dollars ($100) or less.) ❑ 1 certify that In the Dodo an of th work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C fomla, gree that If I should become subject to the workers' compensation provisions o1 Sec' n 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: - Date: WARNING: FAILURE TO SECURE WORK S. ENSATICN COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND CIVIL ES UP TO ONE HUNDRED THOUSANDDOLLARE($t OO,000),INADDI ONTO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE,INTEREST, ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am lice untler provi o CheQQ^te�r 9 (commencing with Section 7000) of Division 3 of the Business and P ofessions Code, and my license Is in full force and effect. Lic. 0 LSv Class q �Contraclor's Signature Date: CONSTRUCTION LENDING AGEN ❑ 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: Lenders 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 Professlons 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 property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not appy to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet In depth Into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Califomia 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 Solely Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, .or 200 cubic feet of compressed gas at %tenderd 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? ❑Ves ❑ 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 appplicants 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 Safely 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? ❑ Ves ❑ No ......................................................_......................................... ............................................ ...................... .............................................. ..................................................................... ...................................................... ......................... ...................... 5 Does or will the epPlicant or present or future building occupant require for the work which Is the subject of this a plication a gparmit 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 65650.2 of the California Government Cale requires that the requested information De furnished on applications for non-residential building permits). ..........................._........._........__..__.__._................................... __............................ __.............. _—---------------- _................................... ......................................____................................ _._............................. _ 8 WIII any pan of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a schod7 ❑Ves ❑ No (If -yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...................................................... _.................................................. _........................................_............................_............................. _...... .............................................................................................................. .._..................................... 7 II a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ........._._.__................................_..................................................................................................._........................._...............r)..._...................................................................................................................._....................................................... 6 (If yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-describroparty for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. \ Ig lure Of Legal Owner(s) Da In VAnd/ r Authorized Applicant pate CODE I, INSPECTION TYOE lid CODE# INSPECTION TYPE 1616 Fixed System Final Fire Prevention 206 Final Mechanical • / 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 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 (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us BUILDING PERMIT Jab Address: 2950 AIRWAY AV Suite: D003 Vicinity: 77 FAIR DRIVE, COSTA MESA, CA 92626 Parcel Number: 42716415 Zoning: Applicant: WARD, DON ISSUED BY: Address: Phone: 714-321-3841 Zip: Status: ISSUED Applied: 10/27/2003 Issued: 03/05/2004 Owner: CONANT FAMILY TRUST Permit: $1,469.75 Address .1381 GALAXY DR SMIP Com: $38.85 Other: $0.00 Phone: $0.00 Total: NEWPORT BEACH, CA Zip: 92660 Contractor: D & W CONSTRUCTION Address: 126 S REDWOOD Phone: 714-321-3841 BREA, CA Zip: 92821 License: 390650 Arch : Eng: MALI, DHIRU Address: Address: 1480 E ERIE ST Phone: Phone: 780-722-2022 GILBERT, AZ Zip: License: 85296 License: 2811 SCOPE OF ADD 2782SF NEW SECOND FLOOR (ATTIC STORAGE ONLY)INSIDE EX CHANGE MAJOR OCCUPANCY OF 4708 SF FIRST FLOOR TO S-3. ALSO rn 1 4708 SF TENANT SPACE OF MULTI -TENANT BUILDING. )ES INSTALLATION OF LIFT AND STAIR. PLNG. - NO WQMP REQUIREMENT. T.I. FOR STORAGE OF HIGH END VEHICLES FOR SALE. NO MAJOR AUTO WORK/SERVICE ALLOWED. SEE APPLICANT'S DESCRIPTION IN FILE.. WS. Plan Check: $955.34 Permit: $1,469.75 SMIP Res: $0.00 SMIP Com: $38.85 Other: $0.00 Inspection: $0.00 Total: $2,463.94 SETBACKS MAIN STRUCTURE Front 0-0 ACCESSORY Front 0-0 FEE SUMMARY ., Calc Valuation: $185,000.00 Claim Valuation: $185,000.00 PLANNING & ZONING Rear 6-0 Left 0-0 - Right 0-0 Rear ,0- 0 Left 0-0 Right 0-0 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 ?a (eroo) DECLARATIONS WORKERS' COMPENSATION DECLARATION: r I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for' -0y section 3700 of the Labor Code, for the performance of the w rk for which this permit Is Issued. I have and will maintain workers' corn sation Insurance, As required by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My workers' p tsatfloglnsurance ca er and policy bar are: Carder: ��71.. YY j Policy Number: J (This section of b o fed it the pe it is valued of one hundred dollars ($100) or less.) ❑ I certify that in the p Orman of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o C Ilfom a, and agree that if I should become subject to the workers' compensation provisions of Se¢¢¢tion 3700 of the Labor Code, I shall forthwith comply with these provis ns I ✓' t / Applicant Signature: \ - Date: f\�-1► �-j� WARNING: FAILURE TO SECURE W tERS' CO PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE f$t OD,Dco), IN AD TION T E 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 em licen a oder provlsl s p�e er 9 (commencing with Section 7000) at Dlvislon 3 of the Business and Pro ssions Code, end my license is in full force and effect. Lia N V/� Class N Contractor's Signature: Date: CONSTRUCTION LENDING AGE ❑ 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 em 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 property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Lew does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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: ❑ 1 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, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such Work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certity a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires. with some exceptions, that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reVorted 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 stantlard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materiels? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some excetions, requires registration with the Costa Mese Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equarto 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 Bor will th❑applicant plicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? (Section 25534 of the California Health and Safety Code provides that the Costa Mese 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. ................_..._._......................_.__....................._...._.._....................................__.........................___................__.........................___..................ith-......................_.........................�......................___..._................ 4 If an RMPP is presently required, hes Section 25534 of the Califomia He.... end Safety Code been fully ccmplietl with? ❑Yes [No 5 Does or will the Coattail or present or future building occupant require for the work which is the subject of This a plication epplermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ......_.................._................._........_....._____......................................__.............................._...................._......................._—___._........—_................._........................ ___..................._. 6 Will any part of the facility to be constructed under this peril be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (It `yes. the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..................................................._................. 7 It aperil from the South Coast Air Duality 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? ❑Ves ❑ No ...._.......... 8 (If ......._..__y ....................._............_._ pP....P............_._......................__..._....... ....................................._..__...._._..............._._..—_.....................____.........es', attach certificate of compliance from the a ro date air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this mi until final inspection. 1 Si azure f Legal Owners) Date And/ r Aut orized Applicant Date CODE t. INSPECTION TYPE 2LU INTITALS CODE INSPECTION TYPE 2AI9 INTITIdLB 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -. 200 Final Re -Roof 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 2950 AIRWAY AV Status: ISSUED Suite No D003 Applied: 03/12/2004 Vicinity: Issued: 03/12/2004 Parcel Nunmber: Applicant: 42716415 WARD, DON ` ISSUED BY: Address: 126 S REDWOOD AV Phone: 714-321-3841 BREA, CA Zip: 92821 owner: rCONANT FAMILY TRUST \ Address. "1381 GALAXY DR - .. r , ,. Phone: - NEWPORT BEACH, CA Zip: 92660 ' Contractor: D & W CONSTRUCTION Address: 126 S REDWOOD AV _-Phone: 714-321-3841 BREA. CA - - Zip: 92821 . - - - License: 392650 - „ SCOPE OF PERMIT , ADD 2782SF NEW SECOND FLOOR (ATTIC STORAGE ONLY) INSIDE EXISTING 4708 SF TENANT SPACE OF MULTI -TENANT BUILDING: CHANGE MAJOR OCCUPANCY OF 4708 SF FIRST FLOOR TO S-3. ALSO INCLUDES INSTALLATION OF LIFT AND STAIR. ' - 85 LIGHT FIXTURES, 40 OUTLETS, 10 SWITCHES, 1 SERVICE TO 1000A 1 MOTOR TO 1 HP, 5 MOTORS TO 50 HP. -REF: B03-01870 _,_�_ ____�_ _ -_, •- _ FEE SUMMARY Quantity - - Quantity ' ISSUE FEE,' ', $23.50' C ?:, Temp Dist System / Lighting $0.00 0,1 Temp service test ".' $0.00 -:�?,''; ' . • . Busway /100 ft $0.00 _• 0 Res. a/c package ,,•; $0.00 ""� Standing Section-,. $0.00 0 New Res (1-2 units) - $0.00 0 Misc Electrical Equipment. -;� . $0.00`"",' , 0 New Res (3+6nits)$0.00 , 10: Transformers up to 1`kva/kw •' $0.00 0 Pool / Spa $0.00 0 ., ...... .:...up to 10 kva/kw , $0.00 0 Lighting Fixts ; - • • '$69.45 _ 85'' - ,.................up to 50 kva/kw:"' ` $0.00 0- ' Recept Outlets ., ` " $36.60v 40'.;; c,;�• - . .up to 100 kva/kw' $0.00' \c,0 Switches � .; �, - $11.00 70 ........'..over 100 kva/kw ' "$0:00' 0 Non Res A I pp �\ ; \ $0.00 0 - - Low' Voltage Equipment $0 00- ; 0, " Res Appl ��� =�$0.00 ", 0 __ Low Volt Wiring System / Ckt ` . $0.00 -o Service to 200a $0.00 ',' 0-- -` , _1 . _Misc. Conduit --' '. $0.00 -',/,b Service to 1000a $62.15- 1" '•, Misc. Conductor -$0.00 0 Service over 1000a _ $0.00 0 , ,Circus (gen or ride) - $0.00 0 Motors to 1 hp $4.75 �' ,�-- 1_ - - - Circus (meth ride or lights)' ' $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand.. = `, - $0.00 0 , Motors to 50hp $123.00 5 -- - _ 'Fireworks Stand' $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 246646(6=) DLICLAbiATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the :ww,orkr which thispermit is Issued. ntl will maintain workers'compensation insurance, as required bysection 3700 of the LaborCode, for the performance of the work forwhich this permit is Issued. rkers' pe sation Ince carder and policy number are:Y /�a-�(A )I Polic mber. (�V nee no ba�edifthepermitis valued atane hundred dollars ($100)orless.) that in the erfo ance 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 workers' nsation laws 1all and agree that If I should become subject to the workers' compensation provisions of Section 3I700 of the Labor Code, I shall forthwith ith these pro'sions�I✓IJti lure: Dete� $ JLURE TO SECURE' O KE ' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), INA ION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I here t I am lice der l2rovisions of Chapter 9 (commencing with Section 7000) of Division iness an fessions Code, and my license is in full e e Contractors Signal ur . ate: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a corisiructioin_I ding agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders 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).): ❑ 1, 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 Cade: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous materiel? ❑ Yes ❑ No (Section 25505 of the Calitomia 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). li ant or resent n need to file a registration form for acute) hazardous materials? Yes No ..............................................................................9.......... ....... ..... 2 Does or will the app c p or future building occupant e t g y ❑ ❑ (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 Calitomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, cendication and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .......................................................................................................................................................................................-................................................................................................................................................................................................... 4 Ii en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a plication aggennit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Wiilany pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the Calitomia Health and . . . Safety Code). ..... ...................................................................................................................................................................................................................................................... .......................................................................................-..................................... 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ................................................................................................................................................................................................................................................................................................................................................................. 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above -describe operty for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 11`` Signature Of Legal Owner(s) .9 e 1d/Or licant b e CODE I. INSPEctioNTYPE QAiE INTTIALS CODE r INSPECTION TYPE PATE INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Pool Spa Final 208 Final Plumbing 1 n n 200 Final Re -Roof 210 Final Electrical 201 Final 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 2950 AIRWAY AV Suite No D003 Vicinity: Parcel Nunmber: 42716415 Applicant: WARD, DON Address: 126 S REDWOOD AV Phone: 714-321-3841 BREA, CA Zip: 92821 Owner: ' CONANT FAMILY TRUST Address 1381 GALAXY DR Phone: NEWPORT BEACH, CA Zip: 92660 Contractor: D & W CONSTRUCTION Address: 126 S REDWOOD AV Phone: 714-321-3841 BREA, CA Zip: 92821 License: 392650 ISSUED BY: Status: ISSUED Applied: 03/12/2004 Issued: 03/12/2004 SCOPE OF PERMIT ADD 2782SF NEW SECOND FLOOR (ATTIC STORAGE ONLY) INSIDE EXISTING 4708 SF TENANT SPACE OF MULTI -TENANT BUILDING. CHANGE MAJOR OCCUPANCY OF 4708 SF FIRST FLOOR TO S-3. ALSO INCLUDES INSTALLATION OF LIFT AND STAIR. 50 LIGHT FIXTURES, 40 OUTLETS, 10 SWITCHES, 1 SERVICE TO 1000A 1 MOTOR TO 1 HP, 5 MOTORS TO 50 HP REF: B03-01870 -- - 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 244646 (SM) FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 ..- Temp Dist System / Lighting $0.00 0 Temp service test $0.00 - Busway /100 ft $0.00 0 Res. a/c package $0.00 - Standing Section- $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment _ $0.00 0 New Res (3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool / Spa $0.00 0 ................up to 10 kva/kw $0.00 0 Lighting Fixts $43.90 50 .................up to 50 kva/kw $0.00 0 Recept Outlets $36.60 40 .................up to 100 kva/kw $0.00 0 Switches $11.00 10 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $0.00 0 Misc. Conduit $0.00 0 Service to 1000a $62.15 1 Misc. Conductor $0.00 0 Service over 1000a $0.00 0 Circus ( gen or ride) $0.00 0 Motors to 1hp $4.75 1 Circus (mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand - $0.00 0 Motors to 50hp $123.00 5 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. . 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 244646 (SM) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 4,1 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 workers' mpensatl°�'surce carrier and policy number are: Carrier: �� pan rW✓' Policy Number: (This section neeY not Mmpleted if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the erfo rice 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 workers' compensation laws f Califf ia, and agree that if I should become subject to the workers' compensation provisions of Section 370 of the Labor Code, I shall forthwith comply with these p visions. 11 _N10 `/�. Applicant Signature: Date: WARNING: FAILURE TO SECUR WOR" "COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PAN S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100.000),IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACT DECLARATION: I hereby affirm that I am titans r prov' ions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bustnes nd rofessions Code, and my license is in full force and effect. Lic. # Class # Contractors Signature: Date: ii 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: 1 hereby affirn 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).): ❑ 1, 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.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: - - Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ 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 forth for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia 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 complietl with? ❑ Yes ❑ No ......................................................................... -............................................. ................... ............................. ............................ ............................................................................... .... ........................... ............. ................................... ................... ....... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apemlit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency! Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ....................................................................................................................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (It "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and . Safety Code). ... ........................................................................................................................................................................................................................................................................................................................................................................................ 7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ........................................................................................................................................................................................................................................................................................................ _................................................................................. e (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply With all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described properly�f r inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sign I e Of Legal Owner(s) 3 'Z Date Or A thorized Applicant —� Date CODE #, INSPECTION TYPE 2AU INTmALS CODES INSPECDONTYPE 2g INTMAS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 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 (714) 754-5273 • Fax (714) 754.4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 2950 AIRWAY AV Suite No D003 Vicinity: Parcel Number: 42716415 Applicant: WARD, DON Address: 126 S REDWOOD AV Phone: 714-321-3841 BREA, CA Zip: 92821 Owner: CONANT FAMILY TRUST Address: 1381 GALAXY OR Phone: NEWPORT BEACH, CA Zip: 92660 Contractor: D & W CONSTRUCTION Address: 126 S REDWOOD AV Phone: 714-321-3841 BREA, CA Zip: 92821 License: 392650 ISSUED BY: Status: ISSUED Applied: 03/12/2004 Issued: 03/12/2004 SCOPE OF PERMIT ADD 2782SF NEW SECOND FLOOR (ATTIC STORAGE ONLY) INSIDE EXISTING 4708 SF TENANT SPACE OF MULTI -TENANT BUILDING. CHANGE MAJOR OCCUPANCY OF 4708 SF FIRST FLOOR TO S-3. ALSO INCLUDES INSTALLATION OF LIFT AND STAIR. 1 VENT FAN/SINGLE DUCT, 5 FIRE DAMPERS, 1 VENTILATION SYSTEM, 2 COMPRESSORS UP TO 3 HP/ 100K BTU, 2 INST FAU < 100K BTU (PKG UNITS) REF: B03-01870 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 FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/ Alt Absorbtion Unit $0.00 0 Inst FAU <100 k BTU $29.60 2 Repair / Alt Refrigeration Unit $0.00 0 Inst FAU >100 k BTU $0.00 0 Ventilation System $10.65 1 Repair/ Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst / Rep. Recess Wall Hlr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys X100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys x100 k BTU $0.00 0 Compressors / Absorption Systems Gas Piping $0.00 0 Up to 3 hp 1100 k BTU $29.40 2 Factory Fireplace $0.00 0 3 To 15 hp / 500 k BTU $0.00 0 Hood w/Meeh Exhaust $0.00 0 15 To 30 hp 11,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp / 1,750 k BTU $0.00 0 Vent Fan / Single Duct $7.25 1 Over 50 hp / Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $36.25 5 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers < 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers > 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. 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 workers' compo tion Insuranc�rder and policy number are: /�� Carder: �� \-N^n Policy Number: (This section need not be plated if, th permit is valued atone hundred dollars (SIOO) or less.) ❑ I certify that in the performa a 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 workers' compensation laws of Califon , and agree that If I should become subject to the workers' compensatlon provisions of Sec on 3700 of the Labor Code, I shall forthwith comply with these provisi ns. Applicant Signature: Data: J WARNING: FAILURE TO SECURE WC CE MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENJITIES AND CIVIL FINES UP TO ME HUNDRED THOUSAND DOLARE(5100,000), IN DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTOCLARATION: I hereby affirm that I am licensed ) pr$ isii Qs of Chapter 9 (commencing with Section 7000) of Division 3 of the Business d Professions Code, and my license is in full force and effect. Lia p d ' V Class N Contramofa Signature: Date: ^L CONSTRUCTION LENDING AGENCY: ❑ 1 hereby aflirn 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: Lenders 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 Loomis 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 Coda: 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.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feel 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, lalsework, or demolition or dismantling thereof, will be more than thlrty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, 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 Persil Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........__................................_..___............... ................... .............. ........................................................ _..... ..................... ....................... .............................. .............................. ................... .... ........ __........................_....... ......................... ............... 2 Does or will the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will theaeppplicant or present or future building occupant need to prepare en RMPP (Risk Management antl Prevention Program lar 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, codification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 It en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No 5 Does or will the oast Air or present or future building District occupant require for the work which is the subject c this a plication ePPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes LJ No (Section 65850.2 of the Califomle Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No . (it '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? ❑ Ves ❑ No .........___.............._..__........_....................................................................._................... __._......................... _............. ................... __—__—___._...........__.._....__._................... _......... B (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 AUTHORIZAT10N OF ENTRY: I conity, under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described proper inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. \\ ignau e f Legal Owners),. Date A- Or 2uth2dzed Applicant Date CODE 1. INSPECTION TYPE OAff. INTITALS CODE INSPECTION TYPE Jim VAJOIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Relaming Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 2G4 Final Demolition 250 Final Building/Occupancy (714) 754.5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2950 AIRWAY AV Suite No D003 Vicinity: STE D3 Parcel Nunmber: 42716415 Applicant: WARD, DON Address: 126 S REDWOOD AV BREA, CA Owner: CONANT FAMILY TRUST Address 1381 GALAXY DR NEWPORT BEACH, CA Contractor: D & W CONSTRUCTION Address: 126 S REDWOOD AV Arch / Eng : Address: BREA, CA PLUMBING PERMIT Phone: 714-321-3841 Zip: 92821 Phone: Zip: 92660 Phone: 714-321-3841 Zip: 92821 License: 392650 Phone: Zip: License: Status: ISSUED Applied: 03/12/2004 Issued: 03/12/2004 ISSUED BY: SCOPE OF PERMIT ADD 2782SF NEW SECOND FLOOR (ATTIC STORAGE ONLY) INSIDE EXISTING 4708 SF TENANT SPACE OF MULTI -TENANT BUILDING. CHANGE MAJOR OCCUPANCY OF 4708 SF FIRST FLOOR TO S-3. ALSO INCLUDES INSTALLATION OF LIFT AND STAIR. ' 1 GAS OUTLET (1-4), 1 SERVICE/MOP SINK, 1 WASH BASIN, 1 WATER CLOSET REF: B03-01870 QTY AMT FEE SUMMARY 0 AMT QTY 0 AMT ISSUE FEE $23.50 0 Laundry Tub / Washer $0.00 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 Backflow Preventer $0.00 0 P -Trap $0.00 Bathtub $0.00 0 Pressure Regulator $0.00 Clarifier System $0.00 0 Process Piping (per 10 ft) $0.00 Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 Dental Units $0.00 0 Septic Tank $0.00 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 Drain, Floor $0.00 0 Sewer Connect $0.00 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 QTY AMT QTY 0 Sump Pump $0.00 0 0 Swimming Pool $0.00 0 0 Trap Primer $0.00 0 0 Urinal $0.00 0 0 Vacuum Brkr Bkflow(1-4) $0.00 0 0 Vacuum Brkr Bkflow(5+) S0.00 0 0 Wash Basin 59.80 1 0 Wash Basin Set $0.00 0 0 Waste and Vent System $0.00 0 0 Water Closet (Toilet) 59.80 1 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 (8/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 at the Labor Code, for the performance of the work for which this peril is Issued. 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. M workers' co nse 'on Insu�Litow�cam .or and policynumber are: Carder: y� r ✓� r Policy Number: (This section need noMc Meted it he permit is valued at one hundred dollars IS 100) or lass.) ❑ I certify that in the ped an 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 workers' compensation laws at Califomia, tl e e that if I should become subject to the workers' compensation provisions of Section 37 of the Labor Catle, I shell forthwith comply with these provislc . Qn I Applicant Signature: Data: 'S I� 1 WARNING: FAILURE TO SECURE WO ERS' CO IS4TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CML PINES UP TO ONE HUNDRED THOUSAND OOLLARE ($100,0DO)). IN N AD I ONTO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 305 OF THE LABOR ODDE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTOR__CLARATION: I hereby affirm that I am Iicens r jrp� I no of Chapter 9 (commencing with Section 7000) of Division 3 of the Businse anY Professions Code. and my license is In full force and effect. U, e V Class p Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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: Lenders 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 live hundred dollars (5500).): ❑ 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 sets (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. It, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Data: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and cenity, a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to lila a registration form for acutely hazardous materials? [I Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mess Fire Department by each business which at any one time has on hand a quantity o1 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). .....�__.............willt o____ _._._.._......._.............._.is,k...................._.....................r-e-v,.......................____.—__�..—._ 3 Does es will th❑e applicant or present or Future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? (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 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? []Yes❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject age of this a8 Yes No apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Ves LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........................................................._.................................................................................__...................................................................................................................................................................................................................._............. 6 WIII any part of the facility to be constructed under this peril be within 1000 teat Irom the outer boundaries of a school? ❑ Yes ❑ No (It yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................... 11 ..... ...................................................................._.......____........................__........................_......................................................................................... .......................... __........ ... .............. _........ __......... 7 11 apemit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .__ ...............___....__........_ _.___.....__ ._........__......._....____..................__......_........................................._............._...__........ _......... —................ _.......... — 8 (ll 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 cenity 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 dry ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described p�np�M11 for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SI re OI Legal Owner(s) Date `; d/Or tuthortzed Applicant Date CODE INSPECTION TYPE gd¢, IBS CODEC INSPECTION TYPE gs¢. Imo$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 N (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.%MLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2950 AIRWAY AV Suite: D005 Vicinity: UNIT 0005 Parcel Number: 42716417 Applicant: GALLA RINI, MILES Address: 346 E MEADOWBROOK SMIP Res: ORANGE, CA " Owner: BRADESON, BRIAN J Address 164A5 WIMBLEDON LN Inspection: $0.00 Total: - HUNTINGTON BEACH, CA Contractor: GALLA RINI' MILES Address: 346 E MEADOWBROOK ORANGE, CA Zoning: Phone: (714)974-6424 Zip: 92668 Phone: Zip: 92649 Phone: (714) 974-6424 Status: ISSUED Applied: 11/13/2000 Issued: 11/13/2000 ISSUED BY: Zip: 92668, License: 663983 - - - Arch - Eng: Address: Address: Phone: Phone: Zip: License: License: ) SCOPE OF PERMIT REROOF EXISTING COMMERCIAL BUILDING FOR "TIME CLOCK SALES': (UNIT D005). TEAR OFF EXISTING ROOFING & INSTALL NEW BUILT-UP ROOF SYSTEM (30 SQ) Plan Check: $0.00 Permit: $139.25 SMIP Res: $0.00 SMIP Com: $1.47 Other: $0.00 Inspection: $0.00 Total: $140.72. SETBACKS MAIN STRUCTURE. Front - 0-0 Rear 0-0 ACCESSORY Front . 0-0 Rear 0-0 PARKING Existing: -0 - Required: 0 NOTES: FEE SUMMARY Calc Valuation: Claim Valuation: PLANNING & ZONING Left 0-0 Right 0-0 Left 0-0 Right 0-0 Proposed: 0 - . $7,000;00 $7,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 ux 6 (6W) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Lhave 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. �M y-workers/' cc�om ensation Insuran carrier and policy number are: / Cartier: do P fr'/�� Policy Number.---,. b�� �.�, S l") -(ibis sectlon need net be co leted if the permit is valued at one hundred dollars ($100) or less.)----_: ❑ 1 certify that in the performance of the work forZhis armil is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree theul b Qme subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these p�rov/ekII�ons. - /1 Applicant Signature:. R 3Date: "�-I 113 � 0 1 _ _ -WARNING: TO SECU EWORKERB'COM SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO cRumiNAi PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOt.IARE ($100,000), IN ADDmON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION WO6 OF THE IABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirn that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business nd Professions Code, and my license is in full force and effect-Llc. N �c1Sss N� - C Corltractor•s'Signal y('/ �--��a Date: CONSTRUCTION LENDING AGENCY: ' ❑ 1 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 ($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. It, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .............................................................................................................-............................................................................................................................................................................................................................................................................. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................................................................................................................. 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ................. ........................................................................................................................................................................................................................................................................................................................................................................... 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .................................... ............ ......... ............................................................................................. .................................................. ....................................... ................................................................... ................................................................. -....... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ....................................................................................................................................................................................................................................................................................... ...................... .................................................................- 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If 'yes". the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ......................................................................................................................................... .................................................................................. ............................................................................................................... ........................... I...................... 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..... ....................................................................................................................................................................................................................................................................... 8 (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ,f matupre eget Q ner(s) Date O A thodzedrApplicant - CODE If INSPECTION TYPE IAN IRTRMLS CODES INSPECTION TYPE IlAg It1IID$LS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof /pw 210 Final Electrical 201 Final Bloc /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 1 ADDRESSOFBUILDDM: 2950 AIRWAY AV 011NERSNAMEIFFUMI:CHUCK TILLBURY 6 DOUG oBilm- F I OR E S I SEBASTOPOL, CA95472 1090 COFFEE LANE AM. MMUNO ADORERS: ARCHRECT OR BROKER: ARCH. OR ENG.'S ADDREM: Uc. NO.: UNIT: D'1. CITY OF' COSTA MESA — BUILDING PERMIT PERMIT NO: B 081079 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: STR LINT: mNIRACTofrsxmm;ADAIR ROOFING INCORPORATE (714)637-0239 CONTRACTORSMNLING 2390 AMERICAN WAY ST ADDREssORANGE CA uc.ND.: 261221 92665 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby, affirm under party of perjury that I am licaued under prwiaions of Chapter 9 (nmommem; with Senior )000) of Division 3 of the Business and Pmlesalom Code, end my lon. a in full force and e6ed. CITY LIC, No.006536 LIc.cuLss:C 39 LIC.N0,26122y1l EXP—/09/97 (,.' Data: // � / % Cont OWNER BUILDER DECLARATION: I hereby affirm under penally d perjury that I amesemyy Irom IM mraxm License Law for the I011owiiq reason (Semon 7031.5 Bushs eand Prolamines Code : Any city a county a1r,, suns a Permit to canetruat, after, improye, damoleh, or rapes any structure, prior to is issumce. aso Imuim the wphomt for such permit to fib a signed swemem that M or she is Iicanaed moment to the prcwi aws of the Commoom License Lew [chapter 9 (canm ercinp with Smom 7000) d Dennion 3 of the Business and Profession Codel or Thal he or she is exempt Instanter and the beaus for the eloped exemption. AM ticlatort of Section 7031.5 by arty appliwd for a permit subjects the apploenl to a civil pmelry, of not orae than Bwe hundred dollars It50O1). ❑ 1.. unser of the ropet, or my employees whh wa9m as their sole mmparramon, will do the work, and the structure 6 net intended or Merest for sale (Section 7041, Business and Professions Cade: The Contrenws Lomse Lew does not apply to an ownerof property wino Wide a inprovae thereon, and who does soon work Herself or herself or I1mxs h his or her over emplorme, provided that such impmremams ere not intended or offered for ease. H, however, the buJdinq or inpm armed is soon wflhm one year of eacplelion, the owneriwioar will have to burden d priorm, he or she cid not buik or impmes for the purpose of sale). ❑ 1. air owner of the propend, am axduMaty wnlmdiN with licensed mntractm to construct the Project (Seton 7044, Bwireas rest Professions Code: The Contradm Lkmm Lew does not apply In an owner of property who Wide or improvers thereon and wlm comrade for won projects with a mmmdar(cl Ikereed pu suml to the Comradm license ❑ 1 art exempt under Section: B. A P.C., M this reason: Date: Ovmar: I do hereby candy that I an aware of mrd undmmnd the requirements o1 Caliomo Health and Safely Code Sections 45505, 2 MG. and 25531, and that I or any Mum Wioin9 omupanl will I will not (circle me) need to comply with eadd ante mdse and the nq m mann M a pamilamnstmniona modifimtionhmtMAi3i ysTi .asgemmt Oohs. presidential mmnrWon applications ere exempt from thine prmWdme. WORKER'S COMPENSATION DECLARATION: I herethy effim under peneby of perjury one of the Idlos , declensions: ❑ I have ad witmpeerman a certificate dm pwem to eeHimlar um womrs cam dpeael nlon, m provided for by Seton 37M d the Labor Code, for IM dororace of the wank for wNch thin Perch is esued. t] I hew and W$ maintain wodene' mmWwe n imur . m required by Season 3700 d IM Labor Code. M ton Mftmarm d the work for which this permit o issued. My worysns' mmpmaetka inwrace ismer and polity number aa: Cada: STATE FUND EXPIRES Policy Number — 04/01/97 phis nMion need nor be ooropletsd of rhe permt is for ere hundred collas IS1001 or lass.) ❑ 1 candy that in IM pedomenee d the work la whkh this perch is iwusd, I Moll nd employ ary peen In am manner w m Io thecae subjaG to the wokas' canpersatian laws of Caldmeia, and ai Ural h L/ehmM hemem abject to IM wankel' mrnparnakn pro es. of Sectom 37OD of the Labor Code, l shell foMwfth amply ori' one povokrs. Date:�� /- Wamlrr . Fel/un ro secure wo*We, coorpsnaedon cornu" Is ewMl, and ehall sul;*t an employs to cdMnsl yatallf" and 'Isyl Rroa up soons h mer d thouvnd n dolle(SfOGOPD/, N /tlon m the cost of eerry ermatlen, demWas u p oyh6sd for In Se bre 3706 ill ft=r Cods, IntmM4 end eMmey's I CONSTRUCTION LENDING AGENCY: I thereby alfine under Penally of perjury Lha them e e conamd'an bndirp Meaty for the pedorame of the work for whits the perm is issued (Sad'on 3097. Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I randy that I have reed this application and "a that IM above information is coned. I apes to comply with at my end omnty odimnms end state tears relating to wilding mnstrudlon and hereby aulhorrza repreaenlatives athis dry to enter upon the eboya-marooned property for inspection purposes Dater Whhe_Bui sty, A Slay: GreerrFse; Canary-Appfirenl; Pink-Rasnue; Go danrod-As. PERM NO: B 081079 GOVT: N SUPP: N PURPOSE: OTH JOB DESCRIPTION T/O OFF EXISTING ROOF, APPLY NEW BUR SQ FT: 7,000 CLAIM VALUE: 7,000.00 CALL—VALUE: 7,000.00 GROUP OCC: B / COMMENTS: NEW 20#dYBR#B1UER, FIBERGLASS, 1-28BASE, 2-11PLYBif75#CBiAfdPSHEiEEiEf*################ Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING NOTES> D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N TS . 1. ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: LEGALIZATION:'N F E E S U M M A Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES1 GRADING PERMIT 124.75 ; SMIP/NON—RES PLAN 1.47 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 126.22 0.00 0.00 126,22 126,22 .00 REVENUE DIVISION TOTALS--> COLLECTED: 126.22 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 124.75 1,47 ############################################################################### I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 7000 REROOF BY VALUE COMMERCIAL NOZONE 1.00 7,000.00 END OF FEES 01-09-1997/89:13 AN/ PERMITZ081079 CONSTRUCTION AND PLANNING. - APPROVALS Permit#" Date Inspector F .'& SPA 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 - T 4. Electrical Conduit-Undrgrnd. 551 Electrical Bonding i 5. Steel Reinforcement - - 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. - _ 57.. APPROVAL TO COVER -GUN ITE " 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - - 59. Gas Pipe,.0 Undrgrnd.,,Test ' r 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 -, - 1 63. Heater 8; Vent -Final 13. Roof Drains - -64. Plumbing System = Final 14. Rough Plumbing 1 - - -. 65. Electrical -Final 15. Rough Electrical -Conduit ', 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign . 687. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - - FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 000 25. Roof Sheathingf /�O 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75., Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29, Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning .. 35. Final Gas Pipe -Test 36. Hood or Canopy 37, Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43, Backflow Irrigation 44. Landscape Irriqation System 45, Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison �• . 50. Gas Release to Southern California Gas Co 1• 51. CERTIFICATE OF OCCUPANCY No. Date 8 dg�d ADDRESS OF BML110Kb 2950 AIRWAY AV OWNF S MEIFKNOMN: TIME CLOCK SALES mss 2950 AIRWAY #D-7 COSTA MESA, CA 92627 APDL. MUM ADDRESS: WHtTECT OR ENGINEER' ARCH. OR EN L's MORESS: UC NO.: Dla: D-7 UNIT. cONTRACTo,s NAME: COAST ROOTER AND PLUMBING (714)241-1414 CONTRAMA'SMMIMB 2737 S CRODDY ADDRESS: SANTA ANA CA uGND.: 529127 92704 LICENSED CONTRACTORS DECLARATION: I hereby affirm miter Minot (commendrq with Section ]ODD) d Division 3 of the Business ant Ptsmsk CIT, LIC. NO.: X�00\ 4 514/0�-�S/ uc. Cuss: C 3 6 LIC. Nt Doe: ✓ .1./C 7 fJ Contract. _ OWNER BUILDER DECLARATION: I hereby affirm under penally of perjui Aowip rectum (Section MIS Boosters and Profession; Code: Any city Jemdmh, or repair any structure, Poor to its oauano, abo require; the app is licensed pummnt to the provisions of the Contractors license Law LClu Busioem end Professions; Code) or Miss his or she is exemPl thershom and MIS by any applicant f« a permit subjects Mie applicant to a ci 1 Penalty ❑ I.mowPerdlM pmpelty«my employees wth wegeawithei sob« UHT: D - jury That I an licensedu gwisions a Chapter 9 e, told an lit is in t ma and sped. 2112 �n P; 06/97 Ihas I ....Of from the county whits require a ps ant for such permit to fib a or 9 (commenmq with St n feces far the alleged ex, I rust mon than Fwe hum. pmmlion, WI do Ma work cos Litems law for the mmnucl, arm, Imgoya, sesi nrem Met he or tits Intended owner-0uild« do hate the burden of ploym,; he «she clef not bold or imps , lar the impose; of wile). Profess❑ I, m awnsr d the. Th enY. aln mceeicaly s Low clue wits apply t art owner f property Me Proied (Section ]DN. atonia®! end commis for code: The Cs wish a e limns law dowi not apply to th orotr d puoPedy who beefs « inprovm Ihmean snit who coMracb ler uxA prapda wits a mnrect«(s) loenwid Peremm to the Contractors lipensa laws. ❑ I am exempt uMm Section: B. 8 P.C.. for Mu rmson: Dole: Owner: I do hereby cenlly that I am anyone of and uoderstaM the reyuiremmts of Celiomie IeMh end Safety Code Sw,ipns 25505, 25533. and 25531, and Mil I or my future building coarpent will I wit not (circle ons) need to com* with well mate codes end the repubemmb for is amt lot mrmtmctian«matlifimtion from the Ai uMy erugemem District. RmidemW construction applications we exempt from Male «aNsiam. Does: Applicant WORKER'S COMPENSATION DECLARATION: I Mrefy affirm uncler penny of Perjury ons of IM fdlowirp declensions: ❑ I have eM rip maMa'vn a cenifcme d cement to seBinsun ler woken' comPenWbn, m govefacl I« by Sectors 3]00 d tM lab« Cade. for the Pedonnmce of the work f« which this pem0 is issued. 1PI here mo wit maintain work«e' compensation insurance, as required by Section 3]00 of the labor Cots, ler the pM«mmoe of thisrL won 1« which the Pemh is Issued. My woken mmMmatbn insurance owner erd pdio, number are: CaMm: CALIF COMP EXPIRES Policy Number: UbI112H44 01/01/97 (This section need not be conpbnd i Me permit to lar on. hundred ddb. Isloof «Ins.) ❑ I only Ihat o the Mdomanwi d tM work for which this Mmk is isew I ahs} We Y mY 0 on/n my manner m m to beconse subject to the workers' mmpeneatim era of California, m(y nee d If rhe d fe n subpd to the workers' �omP�y p/rwiaom sun 3]00 a the Labor Cocle. I when th co N e Dme: 5 /J L7C Applicant: Washing: Failure m ester. warten' cenponwition coverage Is wk Lf, arc eMll j t en employer to «Irmnaf pm and CIWI 0nu up W untie huru nched Mosrtl delAcn 1111140400% M 10R00sal to Me roof of cerrAvmdensitiesu adon, deprovMsd AN In Section 3M at Ms Leber Code, InMeel, and mann s 1. CONSTRUCTION LENDING AGENCY: 1 Manby affirm uncles penalty a perjury that Inn is a construction larrdmg a,mery ler due perf. rce of the work ler whiufi the peat a caused (Sedim MEF, Ce. C). LENDER'S NAME: LENDER'S ADDRESS: 1 cantly that I heva read Mia application aoi stabs that IM above'udametion is coni l allies to campy with all cry and oavdy «dnencea and We Mrs refusing 0 Miliip conobudim snit hereby motivate relaemMmivea of this city to miss upon the above nremorrad property f« inspection PerPewie. R 13RRT H I S B Y rim Does: �CC Signs 0Om pPiondCoMrecto (5151.0.WP) Whh-Buildup 8 Safety; Green -RI.: Careq APPllom; Pink-Revmus; Oddmmd-Aseem« CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 080735 PERMIT NO: P . 080735 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION CHANGE OUT WATER HEATER / ELEC SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: ELECTRIC WATER HEATER( EIUAJ&G k� YEkS *iFiE it iF ib iF iF lE it ii iE iF lF tE*sF dE**ie iF SE it Ri*9S tf tE iF iF if if tE 1F iF*rt kiF 1F tE tt SF ti db 3E*TF iF ib iF iF*tk tE tE dE clE iFdEiF 11 di iE *df tf SE iE ib*db Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQQ• PROV; PARCEL; 00000000 ZNE: REF NO: PLANNING NC7TES> TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR VENT > 11.00 END OF FEES tE***iE 1E iF 1F tE SE tE iF***iEM***SE tE tf tE tE tE iE**M!b***tE ti iE*iE iEM**SE***SE*ib*tE iE tE*tE*iF tS*1F tE *tf iE BE iE iF iF lF iE iE**IF ♦E*IE iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY : APPLICATION ISSUED BY: G iE*1E**tE****iE iE tE*ik lF dE tE iF SF iE 11 LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 11.00 PLAN DATE; _ DATE: DATE: IZ- 3-962 F� i! iF iE 1E iF SE fE lE 1E iE 1t��F�F1E 4 STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES ISSUE FEE 22,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS--.-->__, 11,00 22.00 0.00 33.00 33.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33.00 . iEiF*iEiErtibtf*dttfttif*rt*iEiEiF1FBEibiEiFiEtEBE*db ifiEdFdtdF*if iftEiE1F1F1FtEiFrtitiE*iF*iElfdfdE*IEtEdEtFiEiEie*ibiE*dEiE1f1E*iE*iFiEiE1PiEBE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR VENT 11,00 11.00 END OF FEES EXPIR'E'DDATE I-12--I�jS 01 00220302-00220302 T13T 33.00 DATE: 12/03/95 TIME: 15:42 CONSTRUCTION AND PLANNING Date APPROVALS Permit# Inspector Pt & SPA - APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -. 53. Steel Reinforcement - 3. Efectrical Conduit Utility-Undrgrnd. - 54. Forms 4: Electrical Conduit-Undrgrnd. 55. Electrical Bonding 1 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, ❑ 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 ,' t 15. Rough Electrical' -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & AccessApproval 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 APPROVALS' Permit # 20. Rough Factory Fireplace - - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating .- 71. Product Pi in ❑-Gas 0Oil p' g 23. Gas'Pipe-Rough & Test 72. Underground Flush _ ;A 24. -Roof Framing _ _ 73. Undergrnd. Storage Tank O Gas Cl Oil V 25, Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - I 27. Frame and Flashing _ 76. Dry Standpipe. -- 28. Latfiing & Siding- - 77. FIXED SYSTEM FINAL 29. Insulation - - _. 78. FIRE PREY. FINAL - 30. Drywall Nailing -. - - _HEALTH DEPT: -REQUIREMENT 31. Plaster Brown Coat - 79. FINAL IJJ PECT;ION x - 32. Electrical, Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning a, 35. Final Gas Pipe -Test . 36. Hoon 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. FINAL PLANNING 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date ADDRESSOF wLDINO: 2950 AIRWAY AV EDYIR:BRIAN IGIDBRADESON NP� N AODRESA 2950 AIRWAY AV D-7 C.M. CA 92626 APPL."M ADORES& ARCNIMM OR ENGINEER: LIC. ND.: UNIT. D7 UNIT: coNwtAc7olrs NAME: GALLA RINI CONSTRUCTION (714)974-6424 CONMAClOWSMMIIND 346 E MEADOWBROOK aDOREss:ORANGE CA u itl 663983 92668 uwr: LICENSED CONTRACTORS DECLARATION: I Mraby of rat undr pway of perp, Mel l am Issas alder p wasio s of Chapter 9 (oommervV wuh Sxrtion 7000) d Division 3 d the Business wnd Prdeniom Cob. and mY kpraa k' hrl fora ryeffect. r�L� clo.:070512. /uCCLASS:C 39 uC.No._663( �EW'd 08/98 WNE BUILDER DECLARATION: I herehy allotd tm&e p.W a with, IoM I arm exempt from IM Contractors tisane Law for the rneem lssol— 7031.5 &rim end Prdsasi«w Code: Any cly or crwy w reuses a peas to commua. wr.'im ma. or rapsk wY structra, prior m b ewenca, aaa iwome, the awboaro for su N pains to file a siplyd sfetenmm Mat M «Mn 110H otmsuml to the Iromiary a 6e Comrad«a Licwae Law lChaplr 9 (mmmenLap ew section 7000) a Division 3 d the BiI I are Polesons Codal or tate or we is exempt Ihrafrom and IM bask for the alleged esrnplion. Am violation of S kxt 7031.5 by any appGrem lot a parmil subpcta IM epoium to a dW prlMy of rat more tan rwe MMred dollen rMOOD. ❑ 1, se, owner tithe property or my employees with wegm as their sole campertwast, will do the work. wd On etnrwrn is rel imeMed or offered for eek (SMion 7044, Business and Prdessiore Code: The Cm racton Limine ewbm rot appy tow bastard Popery wM Mie or knlwovae Gamin. text who does sue work Nosed or hen" or dvough he or Mr own empfoysaa, prme tet audl imr ata, se nd'ueaMed or dfend 1« eek, E, Noway. IM bdklirp «inpm oat k sold within we yar d complaion. Me ownrauiMer rill have IM burden of pnw'wq M or she did not bWd or inpmva for IM purpose of sale). ❑ I, ss Dame of IM properly. stn so1stway aram ti , wVh kcamae orreptcrs to wnmuct the reject (Section 7044. &einms end Pmkssions Code: TM Comma. L'cenea Lew time rpt appy to w ora of Popery wdm bullds or imrwaa Gerson end who mrdrave for auctl projede with a corwafor(el Rcemad punuem to IM Commosse Liowee Law). ❑ 1 em exempt uear Section: B. 8 P.C., for W. roeaon: Dole: Ow w I b hereby certify OW I not aware of noxi mdwmwd the roauiromenb a California Ikdlh ae Sisley Cade Swkws 25505. 25533. end 25534. and Mal I or my MUM eidN oxrpanl mll I will int (circle mel need to comply with said ere miles els the musslnenk M eermltl«aawtnclion«modifiwknhom the Ak ee v wwearnl0iriict. Raudruklmmortssm wollowwa. eumu 1. Mase Data Applicem: WORKER'S COMPENSATION DECLARATION: I hereby affirm uMer penalty of perjury we of the folbwirp detleretbns: j ❑ have end ail .airman a osrtiimta d inners Io.0-inwre for a«kero' c«nMmatiort, as Provided 1« by Ssdion 37M d 144 lobar Code, f« IM pMomwca of re aor for w h this Items is issued. .Il I eve rd ail mweaki ao a mnpwsetion ImsoommWir , to by liscm 37M d Me Mb« Code, b the mdthe ormraw d 7i work f« whirA Nb PerrM k ksued. MY war4rs' compenmtkn imurwcs ®Peke rd pdily number re: Coen STATE FUND EXPIRES Poky Numbw 07/01/98 (Thr asaicn mM nr ascan~ IMM pewit is for me hundred ddlre ISlool or tem.) n to � ❑ �Mrbmerliy tIW in Ne pedmmence d the wM for which thk permit u issued, I tlWI ml empty am PreoO !m m ao wbpn to )M work" oompenWicn kws of California. wed s0rss thin I I shook bacanM worker' hep: FaOum Seaun aro ir.'rorrpam.tlon eovr+p.la unlnMd, aM.MI.reJM.n wryoloyr ro erbrYml pruM.s and 10nu rpt to ns hrrdrM LMuswnd dopa (51040001 to WRbn W Ne cost of rorlp ruatbry dwisgea as piavWW for M 9sctlm 3706 at the Labor cob, /nMetl, wd.tlom.y. f. CONSTRUCTION LENDING AGENCY: I hemb, alf. uMr prmlty of paryay thin them is e conrru liar knbp agerey for 0e perlamirwe of the work M whits the parol is timed (&salon 3057. Ce. C). LENDER'S NAME LENDER'S ADDRESS: I cadly last I hew red this awksdm wd ask lel 0e ebwe id«melion is mnact. l agree toccmpty with a rby'rd ooumy ardrarm rd etre Was mkm lato Wdkp lloombWca ae hereby emleresrepemmrivee d INe sty to amr upon IM alp mwlioed pap"f«�mpeamn prpeeea. MARK SCHMIDT r 7`.Pd 1 Data: Spwuro tiered/ Appmro « (515146.WP) While-BuiMtrq Pink -Revenue: Goldanro«LAsseesnr CITY OF COSTA MESA - BUILDING PERMIT —00 PERM NO: B 087705 PERMIT NO: B 087705 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; T/OFF 6 REROOF W/HOT BUILT UP SQ FT: 7,677 CLAIM VALUE: 7,677.00 CALL -VALUE: 7,677.00 GROUP OCC: B / COMMENTS: REROOFING TO COVER UNIT D7 ONLY. N*+F�F�FSEM**��*a�*�*��SF*�r**��rsE�L*sF**SL SF*���*�•**�r�F�r���L*��F***�L�E�F+�*�sF**�F�*��**+tom*�F*�**** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR:FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42716417 ZNE: REF NO: PLANNING NOTES> 4iE♦E iE dE dE dE iE iE dF dE iE 3F iElF:iE dE iE iE l6 if dE iF iE dF**ii*iE dE iE df*1E df iE db dE iE is if iE if N-iE***dF 9f*9E 9F*9E dE 9E dE df ii if if dE if iE***iE dF it irk*9E IE dE aE iE D E V E_"L O P M E N T S E R V I C E S R E Q U I R E M E N.f S ZONING APPROVED BY DATE: BUILDING'APPROVED BY DATE: APPLICATION ISSUED BY: DATE: ***dt d�dE**d(-dt iE'di*di***iE dE 3t iF*TF dF3F3F iF3F3FiF iF iFiF3fiFiF'iFiF�F F3F :1'iF'iF'iF3Fi€iFi'FiFi�Fi=3F df df iE dt dE )f if iE dE* _*� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL 'EGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 137,25 SMIP/NON-RES PLAN 1.61 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID' DUE TOTALS ---- > 138.86 0,00 0.00 138.86 138.86 .00 REVENUE DIVISION TOTALS--> COLLECTED: 138,86 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 137.25 1.61 k*iE irk dE iE�iF**iE 1F iE dE iE iE iE iE 9E dE 3EiE iEdi it iE iE iE iE dt dE di iE***dF dE 9F**1r dE iE ii iF 9E iE df iF*if*iE iE iE iE dE dEk#iF iE*dE *dE iE dF dE dE iE iE ie 3E dE dE dE irk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 7677 REROOF BY VALUE COMMERCIAL NOZONE 1.00 7,677.00 END OF FEES 04-14-1998/04:07 W$138.86 REPT#:01-0322409 F'ERMITc087705 CONSTRUCTION AND PLANNING-- -1 APPROVALS Permit # Ii Date Inspector P0. 6 SPA APPROVALS Permit # Date Inspector 1. Temporary Electric;, Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrna. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER 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 r 62. Backwash & Receptor-Final' 12. Sewer Cap 63.-Heater & Vent-Final 13. Roof Drains - 64. Plumbing System -'Final r 14. Rough Plumbing 65. ElectricakFinal 15. Rough Electrical-Conduit I 66. Solar System-Final 16. Rough Electric Wiring 67' Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Elrctricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # '- 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas ❑Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe ;Test 36. Hood or Canopy 37. Final Factory Fireplace i 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 t, 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Releaie to Southern California Gas Co "- 51. CERTIFICATE OF OCCUPANCY No. Date DJVVrADDRESS: UNIT: OWNER'S NAME: 2950 AIRWAY AV D3 ADDRFr$S: RAYMOND HEFNER 2330 VANGUARD DR #G-203 COSTA MESA CA 92626 ARCNIENGINEER: REG.NO.: ADDRESS: ARC-IDCI UN 9. 8 18002 SKYPARK CR PERMITTEE: IRVINE CA 927 RAYMOND HEFNER (714)641-8101 14 ADDRESS: (((2��gq3300n VANGUARD WAY n 9 G-203 LICENSED CONTRACTOR DECTARAY 4 I'NE A aftirm that I am licensed undSAisi nAkliapt€r 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and elect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm mat I have a certificate of consent to self -insure or a candidate of Workers' rmpensation Insurance, or a certified copy thereof (Section 3800. Lab, Q. JLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. ..ale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This seCtlon need not be completed if the permit is for one hundred ($100) or less), I coolly 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 Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the WorkersCompensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be deemed revoked CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law lot the following reason (Section 7031,5 Business and Professional Code. Any city of county which requires a permit to construct, after, improve, demolish, or repair 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 the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel 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 at not more than live hundred dollars ($500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the -3 structure is not intended or offered Ior sale (Section 7044, Business and Professional Code: The Contractors' State License Law f does not apply to an owner of a properly who builds or improves thereon. and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve ter the purpose of sale). I, as owner of the property, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business ❑ antl Prolessions Code: The Contractors' Slate License Law does not ,Spry o,an ow r of propertyy who builds or improves thereon and who contracts for such projects with a contractors) license pursuant t tractors' Slate License Law). I am aware that proof of their Worker's Compensation insurance should th provided me. I am exempt under Section: B. A P. C. Q tern r anon: W044 NER7BUILDER Date: Ow r. do hereby/certify matOr am ware of and understand the requirements of Calilo Health and Safety Code ions 25505. 25533, and 25534 and that I or any luture building occupant will/will not (Circle one) need to comply with said slate c e ntlthe requiremenlsfor a permit for Construction or modification from the Air Ouallty Management District. Residential construction applications are exempt from these provisions. Date: Applicant I hereby certify that I have read this application and slate that the ordinances and state laws roaling to building construction and here' properly Ior touch purposes, / ale ✓At/�� Signature'. ( Driver's License or Social Security p: is Correct. I agree to co Icy with all city and ltatives of this city to enc upon the above -me 1641.46 White—Building'. Green—Code Enforcement; Canary—Appltcanl: Pink—Revenue: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05334.. PERMIT NO: B 053349 PLAN CHECK NO: 02798-91 L GOVT: N SUPP: N CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; COMN,ERCIAL T.I. (OFFICE S WAREHOUSE) SQ FT: 938 CLAIM VALUE: CALL -VALUE: 6,470.84 GROUP OCC: B-2 / COMMENTS: LEGALIZE OFFICE/WAREHOUSE EXPANSION. #kk#%ie####•kiF#kk###?fie#######!Fie##iF#kk##kk#kk#iE#k*##k#kkkk#kk#ie%#iekkkkk####%%kk#%•if Z O N I N G S E R T 3 A C K S E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL. 42716405 ZNE: MP REF NO: PLANNING NbOTES> TI TO AN EXISTING IND, FFICE SUITE TO ADD HANDICAP BATHS > AND STORAGE. 4920 SQ.FT, TOTAL, Rf iEk#%#%##wif########kk+##k###*kkk##*#f###if##k#ie###%kin##ie#kink kkkii-#kkk#ii•if>#%k##*%it D E V E L O P N, E N T S E R V I C C ES S R E Q U I R E M E N %T S ZONING APPROVED BY S� � —� DATE; Lob BUILDING APPROVED BY DATE: APPLICATION ISSUED DATE: ###+?##ie########kk#kif## v . r •F�£k#%k?e##k+'#ty. acr .. r :k# LEGALIZATION:Y F E E S M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELEC: IC MECHANIC FIRE SMIP/RES GRADING PERMIT 180,00 PLAN 117,00 SMZP1.3b-R o ISSUE FEE BUILDING -DIV-> PERMIT ISS £ PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 181.36 0 0 58.50 239,86 239,86 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 181.36 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 'SNIP/TOT GRADING PLAN -CHECK 180.00 1,36 #kkk##ifiFi6+ik##%'k######%#iE kiniek#ifkk#i!#kkk#####jE%#If%####k#k#kk#k#kkif iE'r: kkk 7t iE#kkkif iK iik I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 431 OFF -INT, ALTER TYPE V -N -AVER 10,12 4,361,72 SFC 507 WAR -INT, ALTER TYPE IIV-N -AVER 4,16 2•.109,12 END bF FEES J'( 01 000941,17-060„ 6,18 T CA DATE: 09/13/SI iIP:E: 13: S CONSTRUCTION AND PLANNII.-_ { APPROVALS Permit # Date 1 Inspector lot PA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrrid. 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 LIFER 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 kloor 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas El Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank CGas 00il 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 ! Nates: 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 fv 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date (kT ADDRESS: UNIT: OWNEN'S,NAME: 2950 AIRWAY AV - D3 ADDRESS: RAYMOND HEFNER 2330 VANGUARD DR #G-203 COSTA MESA CA 92626 ARCH/ENGINEER: REG.ki ADDRESS: ARC—ID Cla398 18002 SKYPARK CR PERMITTEE: IRVINE CA 92714 ADDRESS: (R(2(]G33''E3L��00n VAAAApN�^GGyUARD WAY ( y p9 HEFNER (7149641-8101 G-2 LICENSED CONTRACTOROEC[AIIRIIOM'T1tB A affirm that I am licensed under h&Sidfisbki 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is infull force and effect. CITY LIC.: STATE LIC.: CLASS: ;Ijate: Signature: ai/OflNERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to Sell -insure or a certificate of Workers' 'Compensation Insurance. or a certified copy thereof (Section 3000, Lab. C). POLICY NO.: EXP. DATE: COMPANY: Certilied copy is hereby tarnished. ❑ Certified copy is filed with the city Building Division. .,le: Applicant: EXEMPTION FROM WORXEBS' COMPENSATION DECLARATION: (This section need rot be completed if the punt is lar One hundred (Slog) or less). I family 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 Workers' Compensation Laws of California. Date: Signature: NOTICE: It. after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Cotle: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant far Such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState 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). 1, as owner of the property or my am pp joyous with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himsell/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 will have the burden of proving he/she did not build or improve for the purpose of sale). I, as Owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Slate License Law does not apply to an o I property who builds or improves thereon and who contracts for such projects wish a contractor(s) license pursuant to t o raclor5' $tale License Law). I am aware that proof of their Worker's Compensation insurance should be provided to e. 1 am exempt under Section: B. 8 P. C. for thisthisi�reason: /OWNB P 7 B U I LD E R Date: �l Ownec I do hereb(ccedilq 11, that I am aware of and understand the requirements of rnia alth and a Code Sections 25505. 25533, and 25534 and that l or any future building occupant viii not (circle an ee o co ly wit d to codes and the requirements for a permit for construction or modification from the Air Bush Mans ant strict. Resitle (ruction applications are exempt from these provisions. Date: Applicant: I hereby cernly that I have read this application and Slate that the above iformatio re L l agree to comply with all city and county ordinances and state laws relating to building construction and hereby 1 �ie representaliv pf this city to enter upon the above-mentioned properly for inspection purposes. Date:AVIII/W Signature: Driver's License or Social Security r6ar.46 Wbne—Bmldmg: Green—Cotle Enlprcemem; Canary—Applicant; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05366 PERMIT NO: P 053668 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION COMMERCIAL T.I. (OFFICE 6 WAREHOUSE) SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: B-2 / COMMENTS: REF:B53349 �*s�******IfeFikBtBEiFifiFk�fBfiEefikBFiFiFit+ERB**+ter*r**�E**�*�E*Sr+t****+E*x*��SE*��E�E*****�E�E*r�Er**�E�*�r Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING Ni D E V E L O P M E N T S E R V I C E S_; R E Q U I R E M E N T S t; ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: : DATE: M Mil MiE k�Fkk*IE****MBE**BE BF* if lE****M**iEi��+E* M ek Bf KIE IFBE*if iE**iEiE eE*BE*******BE*********iE iE M it kiFM *******iE k iF BE it iE*BEit iE iE 9t iF**BFkkkiF *1EM MiFifkkif LEGALIZATION:N F E E S U M M'A`R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING '51 SMIP/NON—RES PLAN 'ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 8,00 3.00 0.00 11.00 11.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 11,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 11.00 M iFMM*1Fiif iH*BEiP*BE Nf iE it BE***iE 9E*iE****BE*BE****±F*******iE*****BE*iF9E•iEiE RE***ikiEMit iF *BE itit BE*iF******* I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 2 WASH BASIN 2,00 4,00 PLU 2 WATER CLOSET (TOILET) 2.00 4,00 END OF FEES 1 5 LSc 1Y'' t'.w^SE :9A I 1.. OoTc: Q9/OJ/ai .rpt_• :`I.�,; CONSTRUCTION AND PLANNING - POO' PA Y a� -APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector T. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. So^^ipe-Undrgrnd.^ 53. Steel Reinforcement y3y �e`�f lcal �O@ity-Undrgrnd. 54. Forms c O le¢tcicalrfon :dnfJrgrnd." ti 55. Electrical Bonding S Itp einf certgr x 56. Rough Plumbing & Pressure T8VUZ eCtrical - E r ¢1�. 57. APPROVAL TO COVER-GUN 'x -j 0 >n otings uz S4 58. Electrical Conduit-Undrgrnd. h' r �EoundatiornQ 59. Gas Pipe, O Undrgrnd., Test cr 9. Water Pipe-Undrgrifd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. &operty Sewn Lin" House Connection 62. Backwash & Receptor-Final 12. Sewer Cap N lid 63. Heater & Vent-Final %! 7f.'' •' 13. Roof Drains V ro 64. Plumbing System - Final 14. Rough Plu=v 65. Electrical-Final 15. Rough Eke trica -Conduit 66. Solar System-Final + i 16. Rough Electric Wiring 67. Fencing & Access Approval i Rough(ring S;IP, 68. APPROVED FOR PLASTERING 18. Rough Electrica'PF ar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT LT V"W E- to k E C,•.,- 4 20. iflou• Fa3torg Fi®place I �E*; �C'� x O D tri Y#'PRONAL-&J=^(Dermit # x •-� z til T t9 :SH ^ JN Y 21. uc y ir>jtrE%ur�',, -10. I •• •• CJS i. S 0 , * sr r¢u • yr-o 22. Ducts,VP:ltilating-'* I CJS x S ¢x a 1. Productmn t7 } ❑ it r, 23. Qas P'pe- os,;gh & T`st I tz �_ Cr HJr x E� I i t7 +: n Undergr�i&1FIu�j0lzr .3E I MS x,r1 Cr Q Gk 1.42. x. h 24. 'Roo Framing. trI* Ih;' ^F xJ O t * 53. WJndergrnd?StorageQ'ank0Gas ❑Oil« r 7 r r 25. R000h�thing m» 8 Ev x M E11 O Nst . 514 �verhead If dro Oh 14 vvx t7 > NR. Y 26. rrBa+lCeiling (StriILLral) & 6oaoeoat x tV :. Mq x 75.tOry Chemical 11 .x r'. E7 33 r K . 27. ��rar ar Flashir� % to � * 76. try Stand�pq Opy x S t+; NE .x tr Ed '48. Tat4ng Siding .t ^y<= Lr E ••I ••t 77.UFIXED S1'S'DEM F'SG�Lx Im ti n •.u � K. y :29. Insulati x. O y •• •• ; x M r: p; 78. IRE PREY. FIN(Li; .r.7 b: I� MO. Drywall Failing x :1-EALTUEPT�EOLAReWNT 31. Plaster 8row� Coat x i e ` I�3�ECT1 G IT S _ t�9.'PF*L ; 2. electrical Pow_sr Mes*et final i x N ` 0. CE TIF IM'EE ISSUED EA EF,OOD ~• .. jingElectri I .i: I Cr .11trl �� . E",Ij ott�t: tY '7lx :f ^- .>33. -. - , m I < T, i '"] "ts1 :k "7 O 111 Ell 4. ,Fin Hea��ting- Air ontiitiogi�S :� uZr •* ` �. r e•,., .r. Or 35. E�indi-Gas PiperTest + `= .r: { f--; :l Cl Ell M to O t x tioo ort£anoPY 1 -(n tq .. i no n^ 0�6. x D I Er'_7 '. F "X M 7. (PinarFacmry FirepjdEP,,.. I Ste V * En 4/ i .) * trt ;38. Finah-PILUX) 9 M N I a Lu $ CL S � M W .39. Wat0Set'oice-Final '1 :r a ~ �0. Gas Serv" S -Final ih to to * M T. Ell .41. Solar Domestic-Final' S C) •• Os jd H M rn `42. backflow Preventer F D I r M >E * C tc 43. Backflow Irriptionw SS M ' - aE-+ O u:,+ 4. Landscape Irygatio4.Systemtpttt j 2 ,4: J � V, t7 0 0 tt; N N t,-_0 oC J X5. Sound Atten]ation.r -at to E H n ry r e tK< w e�6.�andicap`pe&latiog 'FW h: w� r , cr s d- S 47. RIAL STRUCTURE & BUDDING x 1'% I s x' . 1 1 :. C* A: I_ 48. WINKL PLATE KING; i FF toPj c49. itlegppic Release to Edison I M • i .. E tK 50. �as,Release to SoutEern Callf6rgia{Gas Co 'i: Ir " oal r p Fs �, 41. CEF?F n;moo No. Date PROJECTNER-S, AM 2950 AIRWAY AV ux1T. D3 owxg0's,Niane RAYMOND HEFNER ADORES! 2330 VANGUARD DR #G-203 COSTA MESA CA 92626 AACN/ENGINEER: REG.NO.: ADDRESS: ARC -ID CIa-h98 18002 SKYPARK CR PERMITTEE: IRVINE CA 92714 ADDRESS: RAYMOND HEFNER (714)641-8101 ((''((2}�33`''E3E'�00 �V�,{(ANGGyUARD WAY 99 G-203 LICENSED CONTRACTOff RUATIRTLOIf.'�Se3'y affirm that I am licensed undeC rAowsio�n �f�fiipfir 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in too force and effect. CITY LIC.: STATE LIC.: CLASS: `Ute: Signature: DRIERS' COMPENSATION DECLARATION: I hereby allirm Khat I have a cenifrcale of consent to sell -insure or a tenilicate of Workers' 1 .Ampensalion Insurance. or a Certified copy thereof (Section 3800. Lab. C). f POLICY NO.: EXP, DATE: I COMPANY: 1 Cenihed copy is hereby furnished. ❑ Certified Copy is fled with the City Building Division. r Date: Applicant: EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Tles section need not be mrre#ted it the perrrvl is for one hundred(SIOO) or less). I certify that in the perlarmence at Ino Mk fa which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should become subject m the Workers' Compensation provisions of the Labor Code. you must forthwith Comply with such provisions or Itis permit shag be deemed revoked. CONSTRUCTION LENDING AGENCY: 1 hereby affirm that mere is a Construction lending agency lot the performance of the work for which this permit is issued (Section 3097. Civ, G. LENDER: ADDRESS: IOWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law tot the following reason (Section 7031.5 Business and Professional Code: Any city of County which requires a permit to Construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant lot such permit to lila a signed statement that he/she is licensed pursuant to the mo rreions of the Contractors' State License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business antl Professions Code) or )hal he/she is exempt merelfom 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 penally of not more than live hundred dollars (5500). I I. as owner of the properly or my emyloy¢e5 with wages as their sale compensation, wN do me work, and the ❑ structure is not intended or offered for sale (Section 7044. Business and Professional Code: The Contractors' State License Law does not apply to an owner of a progeny who builds or improves thereon, and who does such work himselllherself or through his of her own employees, provided that such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion. the owner VAR have the burden at proving he/she did not build or improve for the purpose of sale). 1. as owner of the prap(Ony, am exclusively Contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law saes not apply to an owner of progeny who builds or improves thereon and who contracts lot such projects with a contractors) license pursuant to the Cc tors' state License Law),I am aware that pmol of their Worker's Compensation insurance should be provided to me. 1 am exempt under section: BP70 4 4 B. d P, C. for In reasonOWNER BUILDER Dale: __!' Dwner: I do hereby certify that I am aware of and understand the requirements of California HeXand ty Code Sections 25505, 25533, and 25534 and that I or any future building occupant mlVmll not (circle one) need to ry with said stat ones and the requirements for a permit to, construction of mdllrcaion noun the Arr Owhly Management Di t. sidemial =Sir Iron applications are exempt from these provisions Date: -V-41 Applicant: I hereby Cenity that I have read this application and state that the above inform ' is Cut. ree to comply with an city and County ordinances and state Laws relating to bvddM Comliuclion and hereby author . semdiw s City to Me, Upon)be above-memroned properly for in[DCfl�i0a purposes . Date: f Signature: Drives s License or Social Security r: 164146 Whue—Buil, ing; Green—Code Enlorcemem; Canary—Applicant; Pmk—Reve�� nue�pl=enroG—Asgessot CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 05366 PERMIT NO: E 053667 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION COMMERCIAL T,I, (OFFICE 6 WAREHOUSE) SQ FT: CLAIM VALUE: CALL -VALUE: GROUP OCC: B-2 / COMMENTS: REF:B53349 MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM Z O N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING NOTES> > r, M MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MrMMMMMMMMMMMMMMMMMMMMMMMMMit M BEMMMMMMMMMMMMMMMMM D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: q q APPLICATION ISSUED BY: DATE: MMMMMMMMMMMMMMMMMMMMMM i'£iFM MMMMMMMMM�'iFiF;F{FMM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM.MMMMMMMMM Mi fMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING PERMIT 10,50 S0* SMIP/NON-AES ISSUE FEE 15,00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 10.50 15,00 0,00 25,50 25.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 25.50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 25.50 M MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 2 FIXTURES LIGHTING 1 ST 20 EA, 75 150 .ELE 2 RECEPT/OGTLET 1 ST 20 EA. ,75 1,,50 ELE 2 RECEPT/SWITCH 1 ST 20 EA. 75 1.50 ELE 2 MOTOR/POWR APPARATUS 0,0 - 1,0 HP 3,00 6,00 END OF FEES CONSTRUCTION AND PLAN. _ ".G POO ,PA x ' Date i1PPROVALS Permit # Inspector APPROVALS Permit # Date Inspector Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement '�' •�. . sE1^tnca �rtlity-Undrgrnd. 54. Forms r' v 'Eley(s{cal;.�g�{v?ij-J[r�drgrnd.' 55. Electrical Bonding s �SJJea1-Reinficer %e 56, Rough Plumbing & Pressure Test, w 3 gj �ctrical l�EF 57. APPROVAL TO COVER•GUN,fNT c y\ISCP,00tings tS SS 58. Electrical Conduit-Undrgrnd. 17 rn .ate. FOundatiob Wu 59. Gas Pipe, CI Undrgrnd., Test t;t 9. Water Pipe•Undrg;Zd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. �tructural Floor System - 61. APPROVAL TO DECK 11. Wjoperty Sewer, Line-& House Connection 62. Backwash & Receptor -Final ✓ r(�V I n 12. Sewer Cap 63. Heater & Vent -Final J 7/� ` j a ,t� Ll 13. Roof Drains L_ ,rc 64. Plumbing System - Final ' h rr • 14. Rough Plumb;i ro 65. Electrical -Final 15. Rough E tric4t_Conduit 66. Solar System -Final 16. Rough ElectricZing 67. Fencing & Access Approval I �7. Rough Ning SSsr1 66. APPROVED FOR PLASTERING 18. Rough Electrica$,- bar Ceiling 69.• POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT }IPPR( IAK-Sil1S�eAt # t"" to • *tTftm 20. t oug� Fatoq Fi&place I Rtr1 �2'i * O D try: y 11 21.ucft,' inStr turL* Fr 7 S H �� x l derj t iy o * ts1 F' v t.* I .. .. HS x S �.«*.�0. 22. Duc'n, Vt*tilytingt* ; 0* _ \� 5 < r x 771. ProductlPiping OOiI 23,Z&sWipeigo WTI �^ .� H+r Undergi'tS't c� FI sR * Ca r i mS x tri c •E Oxy x .E,,�2. .t H 24.tAoo Framing. M ;F -H --lr WJ O tT **.'-73.td1ndergrnrbStorakank©Gas ❑Oily at�t 25. Roclf'Sh(3thing v M O O c7* * 5/4.2)verhead Hydro' l[' tnz r V. - 26. 84f1 Ceiling (Strc.Wral) & -momncoat * tv .. C t-7* * 75.L -Dry Chemical -3 x H � EV r.9 tC$ 27. rFrame and Flashin * my co* x to * ,~ 76.L Dry Stand,�551p� Oi: x S P7 a nEF v '7 7+ W* x s'K CT W A' ' Mr x H. �8."Latf�l'ng Siding * v.' ,t¢,••'c = [ x: � •• ,* •• ••� * H 77.t. -FIXED Si LEMfiNAL.t _ E= Q; X29. Insulati * O s > *� 511 78:yFIRE PREY. FIt A, tv NO a 0. Drywall Railing �y • 4. 41.EALiAi I?EPT•gPiEQUIREIyfEP�. ,*.• H P1. Plaster 13171%V Coat*i , I 1 ' * INAL If P�CTI u '� C c CJ =tr' rr r ;i rJ9. T ��1 r J2. lectrical✓ PowKr>;r Mety. Qrfinal * _ _ ^t gO.�OOD CE�FlgAaZ;ISSl O t w N. r+ rK ,s 3.`If inVElectric" F I c �jg I .x trNof�s: _iT 7S. t !� F tL44rFina�Heatin `k Air��djtio�� tK g. � � T I �o N [n cs; t ; ... x S \ . s •/ a •u •S rl tz 35.cP.ini1 Ga6rPipefTest:x : 1 *' I ' - i' 1.. Clo;+ on ir)5 t t* O _ n v iT `otr ,�6.�rHod''or�Ganopy * a� r tr n. * Cs w S iia �37.5inlf:Factbry Firep�ce� i S[r 'v * tr; fit; -:x (IF=j PIG-tll oGo r [*] Fina6Pl4bin9 ,38. \ 9. Water Sersvice-Final?' \ • i w -4 0. Gas Serv'ce-Final * .v. H`s is . ra -ttr'fr S * LTI • :} QN NN x' •T y11. Solar Doj;estic-Final S Ci - •• x D;11 cr 1'42.-Vackf low Preventer* ` N 43. backflow Irr* tion,* r';S5 :r. ? x lTF * O \+! :Y * 4. Landsca I x t"V gd[i°rr1 $y5ie filr�m s **F * V{it,0 Pg rj tC ». tri C C 57 Y. t: N ruxCJ * _ N NNNO 5 -hound AttenDatior : Its M * i F F^ i7_11 a C•. iti [TN K 4 r r-. x R6.EHandicap.Re'lati4sd S *th -' '•x'�� Y '" HN .." UZ H O * * x. tr ,S t -no S 47.;gIN561_ STRQCTURf & BU[tDING 48.CddI1\1L PLANNIN w I tr'tr :4, - It * cu o; ,.1 It + tudEl c,49.�Iectric Release to 9dison •" i * 17 u `r50. Gas pelease to Soern Calieeornia Gas Co a t: * S 0= :r �+ C` - "ro r , .5 7 ,- 0 • OM * O . • . 51. CERTE OF: CCUPAJIEW * r� S \j tac x r OOOU No. Date FA W00.1 PROJECT ADDRESS: 2950 AIRWAY AV UNIT' D3 OWNER'S NAME: OCEAN TECHNOLOGIES SYSTEM ADDRESS: 2950 AIRWAY AVENUE UNIT D — 3 CA 92626 754-7848, ARCNIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: PETE' S ELECTRIC (714)979-4234 ADDRESS: 2629 S. EVERGLADE SANTA ANA CA 92704 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in lull force and effect. CITY LIC.:01$ 59 STATE LIG.: 300908 Ss C-1 XP, 00/00 Date: gnature: — — _ WORKERS' COMPENSATE N DECLARATION: I hereby affirm chat f fav a o¢nifieate of consegt to sen -insure or dioate of Workers' Compensation Insurance. or a certified copy thereof (Section 3870, Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Criminal copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Dale. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thissectionneed pence feted it the mit is fora un red lS100) or less). I cenify that in the performance of the work for which this permit is issued, I shall I ¢ y any s n in any ann So as to become subject to the Workers' ompensation Laws of California. Date: Q� Signature: NOTICE. 11. aftef making this declaration, you should become Subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is i=sued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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 h¢Ishe is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 70001 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 lar 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 em loyees with wages as their sole compensation, will do the work, and the El structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State 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 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 will have the burden of proving he/she did not build or improve for the purpose of sale). L as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business EJ and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts lot such projects with a contraetm(s) license pursuant to the Contractors' $tate License Law), I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby cenify that I am aware of and understand the requirements of California Health and S 25534 and that I or any future building occupant wet will not (circle One) need Io Comply with said permit for construction or modification from the Air Oualily Management District. Residential con these provisions. Date: Applicant: I hereby certify that I have read this application and slate that the above information is Correct. I agr D omply with all city and county ordinances and state laws relating to building construction and hereby au e r presentaif this ty t nor upon the above-mentioned property fort insp°ctmn cur usesLL Date: �� J Signature: Driver's License or Social Security a: 1641-46 While—Building; Green—Code Enforcement; Canary—Applicant; Pink—Revenue; Gomenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 071074 PERMIT NO: E 071074 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION : MISC ELECTRICAL WORK SQ FT: CLAIM VALUE; CALC—VALUE; GROUP OCC; B-2 / COMMENTS; NO STRUCT PERMIT ON FILE, NO OTHER WORK AUTHORIZED BY THIS PERMIT xxxxx*xxxxxxxxxxxxxxx�Fxxxxxxxxxxxx+6xxxx*xxx*xxxxx,6,r•*xxxxxxx*+�xxxxxxx�.xxxx*.x�x* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING RE&p PROV: PARCEL; 42716405 ZNE: REF NO: PLANNING N(STES> xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxiExxxxx+Fxxxxxx+'xxxxxxxxakxxxxxxxxx D E V E L O P M E N T S ESR V I C E S R E Q U I R E M E N T S ZONING APPROVED BY l` DATE; BUILDING APPROVED BY DATE; APPLICATION ISSUED BY DATE: 21 (O ( q xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxaFxx+Pxx�a�xr�xxxxxxxx+Fx�TF�xx xxisxxxxxaExxxxxxxxxxxxxxxxxxxxxxx�x+txxxxxxxxxxxxxxrxxxxxx+sxxxxxxxxxxxxxxxxxxxxxx LEGALIZATION;N F E'E• S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 21,50 50% SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 21,50 15,00 0,00 36,50 36,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 36,50 OVER./SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 36,50 xxxxxxiFxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxaExxxxxxxxxxxx*xxxxxxBfVxxxxxxxxxx I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 4 ELE 10 ELE 1 FIXTURES, LIGHTING 1 ST 20 RECEPT/OUTLET 1 ST 20 SUB—PANEL END OF FEES EA, ,75 3.00 EA, ,75 7,50 11,00 11,00 01 00176474-00176474 T4 T 36.50 V DATE: 02/10/9; TVIE: 10:41 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PC & SPP' APPROVALS Permit # Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ',t, 53. Steel Reinforcement <• 3. Electrical Conduit Utilit Un r rnd. Y- 9 �• 54. Forms 4. Electrical Conduit-Undrgrndai 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER 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, ❑ Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & 116use7Connection - ' 62. Backwash & Receptor -Final 12. Sewer Cap - ,r 63. Heater & Vent -Final-' 13. Roof DrainsI 64. Plumbing System -Final 1 14. Rough Plumbing - 65. Electrical -Final ` 15. Rough Electrical -Conduit - t , 56. 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 APPROVALS Permit # 20. 'Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping ❑ Gas ❑ Oil ' 23. Gas Pipe -Rough & Test 72. Underground Flush. 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. 7Bar 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 FOOD CERTIFICATE ISSUED 33. Final Electric yj rNotes: 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 46. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date C PROJECTAD8RESs: 2950 AIRWAY AV UNIT:D3 OWNER'S NAME: OCEAN TECHNOLOGIES SYSTEM n110RESs: 2950 AIRWAY AVENUE UNIT D — 3 CA 92626 754-7848 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: PETE' S ELECTRIC (714)979-4234 ADDRESS: 2629 S. EVERGLADE SANTA ANA CA 92704 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed render provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: 0143 4 .5 9 STATE LIC.:3009DB S: C Signature: WORKERS'C MPENSATION DECLARATION: Iturebyaffirmthatlhav ac i uIC nsenn to Self -insure or a certificate of Wavers* Compensation Insurance. or a der hied copy thereof (Section 38011. Lab. Q. 'OLICY NO.: EXP. DATE: )COMPANY: ❑ Cendled copy is hereby furnished. ❑ Cedified copy is filed with the city Building Division. Dale: Applicant: EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thus S¢dlgrn .. Ixrnpdeleoi rhe punt i5 failure hundred (51DD)or less). I Coey that in the performance of the work for which this per is issued, al n employ y erwn manner so as to become sublet) to the W rkers Compensation Laws of California. -WIC: !0 / 9/ Signature: e� NOTICE: If. after making Nis Declaration, you should become sub. CI to the Workers Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there B a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of County which requires a permit to Construct, alter, improve, demolish, or repair any structure. prior to its issuance. also reignites the applicant lot such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' State 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 lot the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of rpt move than live hundred dollars (5500). —1 I. as owner of the property or my eir1�loyees with wages as their Sole compensation, will do the work, and the 1 structure is not Intended or offered for safe (�ection 7044. Business and Professional Code: The ContractorsSlate License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himsediherself or through his of her form employees, provided that such Improvements are not Intended of offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner 01 the property. am exclusive ry contracting with licensed contractors to construct the project (Section 7044, Business 1-1andProfessions Code: The Contractors' Slate License Law does not apply to an owner of propel who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' Stale License Law). I am aware that proal of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. lot this reason: Date: Owner: I do hereby cedity that 1 am aware of and understand the requirements of Cathartic, Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wiNwill not (circle one) need to comply with said slate codes and the requirements for a permit for construction or modification team theAIr Oualrly Management District. Residential construction applications are exempt Irom these provision. Date: Applicant: I hereby certify that I have read this application and state that the above information is corned Tgree to comply with all city and county ordinances and state laws relating to building construclion and hereby author' .pre ntative scity to r upon the above. mentioned properly toil mspe Ion pu/Doses. Signature: Driver's License ail Social Security 4: 1641.46 White—Building: Green—Golfe Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05420 PERMIT NO: E 054208 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION : UPGRADE SERVICE SQ FT: CLAIM VALUE: 2,000.00 CALC—VALUE: GROUP OCC: B-2 / COMMENTS: **iK�KT�3K�EaF+fr**+�TL�T�ykTt*�k*+F*+t�ET�*at-�L*+F**�Ex-TP TExTE+�aF�aF**itx�F**�*uTi•*x+fT�**aF*T�Et*�E�F+t�Fat*yF�6�E>E+c+t�* Z O N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT I•N LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REpp• PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING NOTES> > iE 9f ik ik*Myf if lF iE lE iE*iE*ie lE ifM*iF iF iE'iE iF#f*iE iE*if if*iF3(-if ie*1E 1F iF aE i'*ie*Mae iF**3E iErt*1F Ie iE****iE if ie 3F*k3F#*iF*Y.'YkiE ie i% D E V E L O P M E N T •S"c.R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : 1 11 1 DATE: APPLICATION ISSUED BY: DATE: SF aF iF*iF fE*1E c,4**1E iF iE iE*i6 ii 1t 1E IE IF3FRFlFiF fE%9F 1E*IE1f iERp ie {K iE 1F**ia iF fF lE****iE Tf fp ie iE iflE iFiEiE#Bf**3F aE 3E *ikif iE*M9E kBf iEiE IE*li iE*if 1E IF k9Flf iEk 3f MiFie Mi4 iE4f RE BF iE 4E 3f 3f iF iF RF lE iF if klF 3k?E LEGALIZATION:N F )r�E S U M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ,ELErCTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 48,50 PLAN 50% SMIP/NON—RES ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 48.50 15.00 0.00 63.50 63.50 •00 REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 63.50 iFlE*iF aE i43F iF IEif if**iFN kIE iE iE if*iE***if iF it 3FftlE1E#iF BEie 9c-if-if*it it♦E*3e aE**1k*1E ie ae iE se iE iE�*iE 3f iE BF 3Fk *1E ii aF**ie 3i 1r if iE iE 3E* I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V S 201— 1000 AMP 37.50 3750 END OF FEES ELE 1 SUB—PANEL 11.00 11..00 UTE: 10/01!4a T'rz: C9 CONSTRUCTION AND PLAIcrJING - APPROVALS Permit # Date Inspector _ & SPA APPROVALS Permit # Date Insp�ctor 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Uiility-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. Prr,perty Sewer Line & HousgConnection 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. POOLJSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace ," 21. Ducts, in Structure '- 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas 0Oil 23. Gai Pipe' -Rough & Test 72. Underground Flush - 24. Roof Framing - 73. Undergrnd.StorageTank 0Gas 00il 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 - 9. FINAL INSPECTION 32: Electrical Power Meter-Final�B�L� JQ , FOOD CERTIFICATE ISSUED 33. Final Electric /8-� 91 ^tes: - .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 r 40. Gas Service -Final 41. Solar Domestic -Finale 42. Backflow Preventer - 43. Backflow Irrigation 44, Landscape Irrigation System ' 45. Sound Attenuation 46. Handicap Regulations ' 47. FINALSTRUCTURE 81 BUILDING 48. FINAL PLANNING ' r.49. Electric Release to Edison r � 50.- Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date D AWRESSOPAULIIWO: 2950 AIRWAY AV. 9NE: A 01 IEITSMAMEIPIDMN: J D GANTES AIRPORT emm: PROPERTIES P 0 BOX 8147 0-3 JEWPORT BEACH,CA 92658(619)458-9141 APDL. MAIUNKI ADDNES4: ARCXIIECT 011 EN<)Q1FFF. IK N0. AROL OR LOIG'S ADDRESS: UNR: WxrR,,,Im Nu¢: GRAHAM BRO HEATING AND Al (714)546-1653 caRRAcroRS MNInID 2952 CENTURY PL AWRm. COSTA MESA CA ucraa 248604 92626 UMR. LICENSED CONTRACTORS DECLARATION: I hereby dim under penalty of prhpy Mat I ml Bain under prwmoru of Chapter 9 (conamelldng with Section ]OWI of Divskw 3 doe Euupu aal PNwdons Cob. anal ny korw is in frd brPo ral atlact. Cm LAC. NO: 0059633 uc. CLASS: C 20 uC.N 248604 EX ; 06/97 Oct.: ^7` % Caaectu: �V\ ANNER BUILDER DECLARATION: I hereby dEun under peruly d pajlh I am emamp from the Conirectan ucenae Low IN the fplowkg reaea (Section 7(O15 Bwkem and Prdwaiau Cob: Arty city «couuy which rePrn A Pane b awMm, ala. allow. dendish, a rapsi mY atndus, prior b b sownos. oleo ata sum the appkm lar Poch pa to Ma A stP "- am tl Met hem all I. liamaad pincers to the prwisims d this Cawrmaa Lioree I.Aw (Chapter 9 (avmammg with Section )000) of Division 3 of the Ruvlew all Prdeniun Cale] or that M is all's ewnlpl Oerah«n male the bass for the doped mompim. Any vslaicn of section 703, 5 by try spPksaat Its a Ports emieds the APPOnre b a da9 PwaOy of has nae Con Ewa h sh ioSr. jSSOOD ❑ I.AsownrdtM«Ppelymmyengbam with wa9nm hai da mmpweat on, wAb Oe walk most ue rnrdvs is Wasraltl or offered ler mW(Section T . Ilmmv all Pnlwsiau Code:TM Conrtla.liwma Law does not ep*Iom oriented prepay who bulb or inpo as Il asun, Pod who, does euch wok limeed or haad or Osou9h his a her own employees, probed that rbh bnPnwvmada w nd'saatled is dksad la sale. 1. howws. the bu0dbg or knpoarmra is aold within pre year of abnplerion. Or ownerWillor wi0 hew Ms budan a pmr'vy M a all did rnl bold a Mpow Io Ihe pnapwa d rola). ❑ I. n owes d ill aopely, am mchnstwly aoareuig orbit foeusd caracla. b combuct Du polect (Saa'vn )Dae, Rwbnen and Prtleuou Cede: The Cammm LiPoma law don m appy to th owes d proprty Poll ), « Mpwo thraon nal Poll contracts leurh r spolecta with a cpNrectoRm« s) fceod puuertl to the Caamrma Llowe lenwsS. ❑ I an saanpt u SMicn: S. A P.C., for this «moan: Das: Ower. I the hereby caddy Mat I as, ewae anal ualeawal the nwdmnem of CSOoua Neebh nal S tat, Code Sections 25505.255]]. ell 295]1. most also I or an, haus bidding ompsa wall I will na (oda one) ted to o..* wish said pate codes and Oe r e menelm b a penis 1«pomltction or moddnmMn non Oe A: Durso. RastdraWm ionmPScaiPnwasenptIlpnlOwer prwiabe. Data: AppfrW: WORKER'S COMPENSATION OECLARATICN: I hereby Allan uldr pemly of porptay ere of the bitewing bctratbm: ❑ 1henandelmand'nacoldrAudoaewl tosell u Ioeakriociame atkb,m probed la by Section ]100dthe labor Cob.la IM palmmce d IM wok ler nlidn dv pans'e is.uM. ] I hew all will maintain wakas'mnpwW ion ivaaaa, w raelmed by Section ]lW d the Labor Cob. to, the pebnnrow d IM wok Its which this neral s s.w. My vestment' rycortin mad Policy cumber P�LgaWm a.: EXPIRES dNanber 1610 08/01/96 (Ths sen m mA1 rot Is mnpMrM IOe prmf a Air one hundred doles ISI W1 m ass) ❑ I curly Gnat ie ill padomwee , the work lar Is. the pwm'e b al I s t na wnplvy rry prvn in rry mww w m to MCOnnN wL'ial le IM of Seal' mmwnW On leas. d de, I "a. h Agnso Nat ! I blas to the waryan' .War Prwis'�/d Sactipn ]]00 d the labor Cods, l I hwtlh campy nR'�0/ ivy. Data: / 1 !!� Apdum: F L)iJ/L)C=l! ==•��� W.n.,':Fd bun Bun n wodrrs' parpeeatlon covvsYa, la 4 and ehll aIJM At arnploya b edmbel prlptlm all PIVN flim W b ore hladnd MouaaM ddsn (SIOGOWA In o"do. b the coat o/ romprasfbq damp. mn pvAbd les In Section 3109 0l Me Ldor Cob, 1.1.4amid •Oonls% • 1. .CONSTRUCTION LENDING AGENCY: I hereby elRrm under penalty of prjvy that Oen is a pomn#bn lanbg Agency ler IM Podam. d the wok 1« which this pats s isws l (Section ]OHI, Civ. C). LENDER'S NAME LENDER'S AOORESS: I cerOly That I hew reed Otis appGraaan ell atats IM the ebovs vdormri isconact. l 4 to aanply with d dl' and aeady adnenona aal ase Mm rehab, to bis diher g construction on! eby ab oda dhabs npsawativea d this dly uppa on the obpn modionM pery lorinepen°ep°°°° ROGER GRAHAM 1111h , it Nemo p .� � sgmwn d ow.nAHmwnpvkanvcaurma Wlhaft uimm A Sdey: Gia : Cauy-Appicad: PnkJlewnaa; Gddennd-Asaeas« CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 078553 PERMIT NO: M 078553 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION : INSTALL INTAKE BLOWER 6 EXHAUST FAN SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: B / COMMENTS: NO BLDG, PERMIT ON FILE iF iE 1F i4 if iE iE dE dE dE dE iE 1F iE 1E 1E 14 dF if dE 1E 1E iE 1E i4 if 1E iF dE iF iE iF iF iF 1E iE iF dF iE 1E 1f dF i4 iE dE k 1E 1E 1E df 1E iE 1E 1E 1E1f iE dE 1E 1E dt k 1E iE 1E!!• * iE 1E iE 1E 1E it iE 1E iE k 1E iF Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING NOTES> > Ci 1E 1E 1E*1E dE 1E iE♦E iF dE lE if lE i4*iF i4*dE iE dE 1E 1EiE 1E if*dE 1E if lEiEiE*****iE iE iE 1E iE♦FdE*♦E*♦F♦E 1E 1E 1E♦E 1E 1E*****iE 1E 1E lE dE i4*1E iE iE*1E*♦E d4 iF 1E D E V E L O P M E N T S E RSV I C E S R E Q U I R E M E N T S ZONING APPROVED BY T DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: dE dE 1E 1f iE iE 1ElE 4 * 1E ♦E ♦f * iE * ♦f * * 1E 1E 1E3FiF3F is��3iiFiris�3F���e�iF'{F3FiF 3F iFiF7! ## #IF�F�FiF3F1FiFiFiF 1E iE *141! 1t * iE * iE�iFiFRE dE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 16,00 25E SMIP/NON—RES PLAN ISSUE FEE 22,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 16,00 22.00 i 0,00 38,00 38,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 38.00 OVER/SHOAT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 38,00 1E 141E 1E dE 1E 1E iE iE 141E 1E 1E if 1E 1E dE * iE dE 1E iE 1F ♦E 1E 1E iE 1E 14141E 1E * * iE 1E 141E 1E+t k 1E dE it 1E dF iE if dE 1E 1F iE * ♦E 141E 1E 1E 1E 1E 141E iE iE ♦E * 1E k if k 141f * dE 1E 1E k dE 4 I N D I V I D U A'L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O•N UNIT COST TOTAL COST Y MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 6,50 6,50 MEC 1 INST/REL NON—PORTABLE EVAP COOLER 9,50 9,50 END OF FEES CONSTRUCTION AND PLANNIM1 APPROVALS Permit # - Date Inspector )L & SPA 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-Undr9rnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61, APPROVAL TO DECK 11. Property Sewer Line & House Conhection 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: Aough 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 APPROVALS Permit =It -- 20. Rough Factory Fireplace 21. Ducts, in Structure 21. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank OGas 00il 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 Brawn Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating &Air Conditioning Notes: 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No Date If . ADMESSOFM I.011f: 2950 AIRWAY AV uNr: OWNMSMAMEWW J D GANTES AIRPORT AOORESM1 PROPERTIES O-3 P 0 BOX 8147 EWPORT BEACH,CA 92658(619)458-9141 APR. MmtaD ANDRE54 ARCXRECT 011 ENWIEFIF. JIM ON ENG.'S ANDREWS: UC NO: UNT: cofORACIarWNME: GRAHAM BRO HEATING AND AI (714)546-1653 cofflll lDesMmP1G 2952 CENTURY PL ADMIEss: COSTA MESA CA mw-. 248604 92626 UNIT: LICENSED CONTRACTORS DECLARATION: I MrsIq shim u Penalty d pwjury tlIm I am kwamd Ulla prwmu d Chapter S (wanwteq ON Seam 1000) of Ilii m 3 of tlN 9uevuq all Prof. Cab. mld M (hS luta aM ellact. Cm UC. NO.; 00596p3 uc.cLAss: C 20 UC.No: 248604 ,, nn E : 06/97 Dtlw /� ! GMkwa, rQ'� OWNER BUILDER OE IARATIOW I hereby af(um ureter pwWy of m 1 am amend from IM Cororww Liame law for the alloe'e1p reemn (Salm 7W t s Bum. N P olee-ipu Cade: AM city or meaty whLYI rMwes a perms 1, oaepw, alter, seprore, dwnolbh, or repair mW epuclWe. prior ro m beuence. ebo r,mvm tM apdisre for such palmi to Me a siyud stMemd tlm M or efte is liramed punuenl 1. IM pwekna of Ma Comrwae lioerue law ICMda 9 (..res, Wh Section 1000) of Dwlsmt 3 of IM fl a text "arsems Cadal o then M or she b amend thaahan all IM beau for du atlaead ee .plio.. Aw misi on of Section )W 1.5 by am eppimN la a pwml subieds 0u epdiuN to a dri pmatlr d and mere Dun (Ws hrvkled datlera Issoo➢. r. ❑ ordf. adlM prooerWa nrY ernpiarwm wihwaieam lMe wAa to rsct LerTb Lave •dors mld tluatom e0ndb pro," O,Maidhxrale(Radian7011,Bus"vwaall Profmsioea Cob:TMCaumfaellmus law ben nd eployta, o tWMit who WJds a enpmvee Ihero,n, all w110 dose ..11 sank h'vneetl a lde,; aro M li her own ampbYre, pmri rt p that soil impramneab to w ten ver a dMM to ems. tl, homarer. Uu bW or a for t natl b ren f ehbl au Yam d opmpMbn, tlIa owner-0uiUa ei0 Mve lM Wmen d prorinp M a mIe dk w butld a Mpova for tM PaPwe d ewe). ❑ L m,anal of IM properly. am e=drviralt, mntrweN wuh im umd cavactas t, anmud DIe project (Section 701x: &eines erld Profeeeiom Coda: The Cmtrmon lmenea law does w apply to ea owner of pr," e , Wilde or umprwr Ihaean ell who conlrace fa euctl projects eilh a cwrwa(s) Boomed pureuam to IM Conover. lioelua Ia.). •; ❑ I em emend under Semon: B. 8 P.C., for Nb reason: Dena: Ovaw: I do heroby Iftal I that 1 ern etyma d end uManroM OIs reawrwnems d Cmr W c me* arld SMety Code Swine raqu mm ell ]3531. ark tlW I a ave haws bWdvN 000mal sill / W m lash err) need ro awgly Wh stud meta cobs eM the nal 1. these kr apammfao,mWcdoea modifiWbnhamlMAkiy enepr�wa Dimrict. ReudertlW mMMion eppfretidreramemdlromthms aorieians. I Dme: APpliau: WORKER'S COMPENSATION DECLARATION: I Mreby m(arn older pwWly d pw'Pay au d tlu hNow'vN bdmelbm: ❑ Ihen endm ocrr of ft dmewIo mtlmms br Waken'mrnOelumion,m provkM la by lia[don ]700dtM labor Cob, la tM pMamenpa d tlu mos la etirJl IAie palmi is issued. iL] IM ser dmll rrw a moire s'oa rmmm beer aw.mna:.d bysw on ]700daw abo Cob. Au tM Padamm rdw w«tRaw:aloe,'am+b�.e.Wmatare L1HERTEXPIRES �rrmM 08/01/96 (Tib ssaion red naf M mnAwad r w pwml b b or haloed datln 1St W1 a MrJ ❑ I rnry min" pdormanca d Pu sank Por WIiUI Nb perrM b beard. I "nd wIWoy erry MrM H any mwv r m w Moon a dnect to IM wakes' am rvemmbn hem d ell syr tlod S I hyyuM baoo M mlbjw to tM earlen' 0 1 Inn prwbiNl d Swkn 3n1e d IM I Cob. I aNwuh oompy Dena: n I 1 �! 7/n App(uro: Wsml g: Face, w aacun wo&e,e, aerrywa0on cavaa9a la l srld shill u!/c(An wriplo7er ro W rdpnmOm and dW Onm w W ane hot~ fhor ddbn ISIOg000A m sddla n m Ma cowl of crnpsmaOOM1 dmrpas As Pro~ for In Soodw 3105 of tM Labor Cob, Irrtwaa4 Ad attorruya Ire. CONSTIIUC(ION LENDING AGENCY: I h.* ellen Iuldw welly d P.W then tiers b • oolonmio,, IakkN mwa.Y b the perlo a. d IM eork for a this Ixrmi b bored (Swion ]091. Cir. C). LENDER'S NAME LENDER'S ADDRESS: I c.* Ihm l hew reed Nb epp(icmim mk mete tW IM above Wormmion b conea.I syr M randy wtlh a oiy eM wetly ad"vrmlme v me Iawe raimm to b MComawlalell herebymaha¢a roproWae4rr of IN. toy W omaupon IM a rnemiora pmpalY f«impw,nmrpoaes. OGER GRAHAM Pea Nems Door:fip ! OZ Sgeaturo of OwnalApenVApdimrmCadrwa (5151 .wp) Mo.-SuMm A Selly; Greel,Fib: Cwuy-AppicM I; P.1,41 rwuw; Oakemod-Aesm CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 078554 PERMIT NO: E 078554 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE; ELE PURPOSE: OTH JOB DESCRIPTION INSTALL INTAKE BLOWER 6 EXHAUST FAN SQ FT: CLAIM VALUE; CALL—VALUE: GROUP OCC: B / COMMENTS: NO BLDG. PERMIT ON FILE ELECT WORK INCID. TO MECH PERMIT #M78553 �E+E�r�r�EitiE�E�E�EiE,E+r+rx�r�E�E�E�r�r+��r�E�E�E*�E*�rx�r�E1E�E�r�Exxxit�r�r��(�E�Eit��E�E�r���E�E*+rar�E�Ex+EiE+r�E�E�(�E�Ex���*���� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ------------------- ACCESSORY BUILDING--------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING N TES> > iE 1E iE 1E 1E iE if iE iE iF N: ♦E it iE 1E 1E it irk 1E 1E ii iE 1E it iE iE / dE 1E * 1E 1E * iF Rih')E * 1E 1E 1E iE iE iE * * iE iE iE * if 1E iE iE 1E 1E dE ♦E 1E iE iE iE k dE iE iE k irk iE dE iF ih iE irk 1E iE iE 1E 1E 1E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: 7 i2 tt� APPLICATION ISSUED BY: DATE: 1E 1E*1F♦E iE iE lE dE iE iE♦FN-if 1E****1E dE iE3F3FTf�F'iFTFi�-3F �F7FiF'iF3FiFiFiFif�F3Fiaif�FiF�F Tf7'FiF'iFiF�F iE 1ElEiE ♦f iE iE 141E iE'iFiFiF3F'3FiF1E iE LEGALIZATION:N F E•E';I S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 24.75 502 SMIP/NON—RES PLAN ISSUE FEE 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 24.75 22.00 0.00 46.75 46.75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 46.75 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 46.75 1E 1E*♦E4♦t 1E 1E 1E 1E 1E 1E 1E 1E 1E 1E♦E 1E 1E 1E 1E 14*iE iE♦f 1E 1E 41E dE iE iE*iE iE iE1F1E iE iE 1E#♦E 1E iF iE if lE lE fE 1E 1E iE 1E iE iE if♦E 1E iE 1E 1E 1E iE iE 1Ek*iE 1E iE 1F 1E*1E N -♦f iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 2 NON—RES APPLIANCE NOT OVER 1.0 HP 4.25 8.50 ELE 1 MISC CONDUIT NOT LISTED REQ PERMIT 16.25 16.25 END OF FEES CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector P & SPA APPROVALS Permit '# Date Insp-mtor 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit* Undrgrnd. B. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System + : 61. APPROVAL TO DECK } 11. Property Sewer Line & Housa Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13, Roof Drains 64. Plumbing System - Final - 1 14. Rough Plumbing 65. Electrical -Final ' 15. Rough Electrical -Conduit 16. Rough Electric Wiring 17•. Rough Wiring Sign ' C�S/_ - n- 66 Solar System -Final Fencing & Access Approval 68. APPROVED FOR PLASTERING 181. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS- Permit # ' 20. Rough Factory Fireplace - - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - - 71. Product Piping 0Gas 00d 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank OGas OOii 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 p:. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning r�0 otes_ l 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 2950 AIRWAY AV - UNIT: D 3 OWNER'S NAME: OCEAN TECHNOLOGIES SYSTEM ADDRESS: 2950 AIRWAY AVENUE UNIT D — 3 CA 92626 AflCHIENGINEER: 754-7848 REG.NO.: ADDRESS: UNIT: PERMITTEE: PETE' S ELECTRIC (714)979-4234 ADDRESS: 2629 S. EVERGLADE SANTA ANA CA 92704 LICENSED CONTRACTOR DECLARATION: I hereli ffirn that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Proles s Code. and m��licerise is�in lull force and effect. EJTV La C.: _Q 84 9 STATE UC.: 00908' `S: C 0 Date: Signature: WONNERS' COMPS SATION DECLARATION: Ihereby affiant ave a Can consent to self -insure or a certificate of Work rs' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. Cl. POLICY NO.: EXP. DATE: COMPANY: � Certified copy is hereby furnished. ❑ Confined copy is filed with the city Building Division. ,are Anagram EXEMPTION FROM WORKERS' COMPENSATION BE RATION: (This section need not be ole dii the q�ryI is for one h ad ($100) or less). I certify that asp fmmance of the work far mch this permit is issued, I shall t pl any pyr�W in any nn so as to become subject Ia the Wor s' Com/yeCreplilied Laws I California. Dale:fflI(_[� Signature'. NOTICE: II, alter ma mg this declaration wis you should become subject to e Workers' Compensation provisions of the Labor Cade. you must forthwith complyplywith such provisions or this permit shall.be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code. Any city of 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/she is licensed pursuant to the provisions of the ContractorsState 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 o1 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 sate compensation, will do the work, and the 1-1structureis not intended or offered for sale (Section 7044, Business and Professional Code : The Contractors' State 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 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 will have the burden of proving he/she did not build or improve ' for the purpose of sale). I. as owner of the property, am laidusivelp contracting with licensed contractors to construct the project (section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a conlractous) license pursuant to the Contractors' State License Law),I am aware mal Drool of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C., tar this reason: Date. Owner I do hereby really that I am aware of ane understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Godly Management District. Residential construction applications are exempt from these provisions. Dale: DDlicanL hereby certify that I have read this applicati n and state that I ove'nformatlon' Orrecl. agree.JgcomDIY v+iin all city and county ardmances and slate laws relating to builtling .onstrucllon and h reb auI rhe more rives of Ihis UGldenter upon the auove-mentioned property for inspection purpo as Dale/y// V r+//�ignalure: Driver's License or Social Security a: 164146 While—Building: Green—Code Enforcement; Canary—Applicant: Pink—Revenue: Goldenrod -Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 054414 PERMIT NO: E 054414 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION : UPGRADE SERVICE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: * 1E iF BP iFlF iF 5E iE BE BE BE RE S! iE iP BE * LE JF SE 9P BE BE k BE 1F BF BF BE BP 3E 3E iR if BP 1E iE JE Ik iE if k iF iF iE Jk k it. if Bt JF k iE Bt 1E 3F fF BF iE BERE 1E * RE BF fE iF JF Rf Rf if iE k iE iE iE 5F iE Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ---.--------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ• PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING N TES> > i! jfiE iE iE fE lE iE iE ik iE if ik iE if iF iF li iF 3E ik IE k if if iE if 1E iE M if IF if iFiF if !E iE if iE if 1F if if• iE lF iE if k if If it iE �f iE iF iF iF iE �E 1E iE 3E �E 3E iF iE lF iF iF ik iF if 1F iF iF if i(-iF / D E V E L O P M E N T S E'•R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY `" DATE: BUILDING APPROVED BY : "_, DATE: APPLICATION ISSUED BY: DATE: BF iF BElEk SE eE IE iE BEiF iE if•BE if SF iEiFie BEiE iP3F3FiFiFiFiFiFiFiFTF3F�E3FiF TfiFiFiFiF 3f 7F'iFiE3FBf7F iE *BF iF Bt BP Bf iF iE* * iE *')(' iE k JE if BE JE 9E Rk 46 SF If BE iF 3E iE * BE JE iE iE SE if iE JE M iF k BE 1E'ikif iE k iE BP if SE iE * BE it iN BF it iE iE * * BE BE iE 9F BE iE JE RE k BF * BE ikiE BP iE JF * iE RE iP iF iP.SE if if iE LEGALIZATION:N F.,E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 19.95 50% SMIP/NON—RES PLAN ISSUE FEE 4.50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 19,95 4,50 0.00 24.45 24,45 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 24,45 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24,45 ifiPiE*M*Rf*iEif**BEitilREitiEitiriEREBE*BtiEitBE*kBritlEiE*if*iFRERE itkia*it 4E BE******irRrRt**iEiE*iFkit9F**ieiEiE*RPStBP#9f SE St* I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O,N UNIT COST TOTAL COST ELE 20 RECEPT/OUTLET 1 ST 20 EA. ,75 15,00 ELE 11 RECEPT/OUTLET ADDITIONAL EA. .45 4.95 END OF FEES 0'. 0^^9952+-00099521 'I'l 1Y,T DATE: ID/1191_ TI1'it: 12;2c CONSTRUCTION AND PLANNING - POOL PA 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;,U ility-Undrgrnd. 54. Forms �n4 `Electrical Conduit<Uddrgrnd. 55. Electrical Bonding - 'q�S:USteel,Reinforcemen�.- 56. Rough Plumbing & Pressure Test''' ;;c.6;111ectricalUFER'lGrnd. 57. APPROVAL TO COVER-GUNITE "7-. Footings :^M '= 58. Electrical Conduit-Undrgrnd. - Z8 -::Foundation nL r -- 59. Gas Pipe, O Undrgrnd., Test ' - 9:; Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑Undrgrnd. 10: Structural Floor System 61. APPROVAL TO DECK td Property Sewer Line'& House Connection 62. Backwash &Receptor -Final _ - 12: Sewer Cap 1 ! 63. Heater & Vent -Final 13. Roof Drains :� 64. Plumbing System - Final - _ 14. Rough Plumbing - � 65. Electrical -Final i 15. Rough Electrical -Conduit -'' 66. Solar System -Final 16. Rough ElectrienWiring 67. Fencing & Access Approval Cj7. Rough Wiring Sjgn 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT - _ _ _ ._ .. -. _ _ A y ;tits 20.'Rough F.actocy Fireplace <'-. _ '•: r :APPROVALS: ��Permit # 21.'Ducts, in Structures, .70. Underground Hydro 22. Ducts, Ventilating: -r •:�^ ? s X71, product Pj:ping O -Gas O'Oil �_ _ 23' -Gas Pipe-Ro� h &'Test J2. Under Flikuh?' I n]� ground . 24:=Roof Framing >73:=UndergrndtStora 4eTank ®Gas C1 Oil- m ' w 25. Roof Sheathin9 a: :,, r p ,; ,- . ' " 74 ^Overhead Hydro - 2& T -Bar Ceiling (Structural) &,Monocoat -� - •r izra'}. 75.7Dry Chemical CJ > = 19x11-7 r 27."Frame and Flashing' r 76: Dry Standr "e J>' 284Lathin6'& Siding r. _ :+t c s 77.rFIXED SYSTEM_ -FINAL' '29. Insulation ..J �.' "" ;• I f 7$ FIRE PREV.FINAL =30. Drywall Nailing ti �R HEALTH:b EPTJ.REQUIREMENT oz •_31. Plaster Qrown Coat' ! I * FINAL INSPECTION' t r79 '.� ' , ` 32 Electrical Power Meter -Final, e f ,,. •. r .rFOOD CERTIFICATE ISSUED 33:SFinal Electric ` Notes:, _ `i,34.-Fin21 Heating:& Air.Conditioning,_ •_ _ 35. Gas Pipe-Testi * _Final ,,36.+Hood or Canopy r t , , t > ,•• 37. Final Factory Fireplace, �''-r r n ! k '' ;3• s `� �; .* 1=38. Final Plumbing ami, ..i .+. `� .-tF j = x •n - 39. Water Service -Finals '-' rr :. .n,ri .� r '40. Gas Service -Final , ; F '41. Solar Domestic-Final.5 -r + 'S•' , r I _ •J .r 42. Backflow Preventer` 43. Backflow Irrigation' r > k 44. Landscape Irrigation System;,r*,'j,=' „t - - �„y - K ,; <45: -Sound Attenuation Handicap Regulations _ '• ` „ '� '• ; _ 47.�FIr,TAL STRUCTURE & BULLDINGa- 48 "h NAL PLANNING it .-49' Electric Release to Edison i; •.K i x _ to Southern California Gas Co t ;. '' '-� •,50.,,,Gas-Release .••: ,51. CERTIFICATEOFtOCCUPANCY No. Date PROJECT ADDRESS: 2950 AIRWAY AV OWNER'S NAME: INSULATION SUPPLY CO TRUS ADDRESS: SAME ARCHIENGINEER: ADDRESS: UNIT: D-9 REG.NO.: UNIT: PERMITTEE: DAN PLASIER AIR (ense ND ADDRESS: 8743 MAYNE ST BELLFLOWER CA 907 LICENSED CONTRACTOR DECLARATION: I hereby affirm mal I am sed under provisions of Cl 7000) of Division 3 of the Business and Professions Code, and my is in full force andCITY uc.: 6 5 3 STATE LIC.:4uss: _ Date: 42 1 Signature: —� WORKERS' OMPENS 10N D LARON: I allirm that I have a certificate of consent to s( Compensation Insurance. or a cenifie copy thereof (Section 3800, Lab, C). POLICY NO.: EXP. DATE: COMPANY: Cenified copy is hereby furnished. ❑ Certified copy is filed with the ity Building Division. (310)633-4562 with Section or a certificate of Workers' Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section ad not be completed it the perny]IH I n, ndred (5100) or less). I Cenify that in me performance of the work for which this permit is issue . 1 shall not employ any p non nner so as become subject t m Workers' Com ' Ii n s of California. Date: Signature' NOTICE: 11, after making this declaration. you shobittlecome su ct to the Wor ers' Compensation p Ions of the Labor Code. you must forthwith Comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097. Cin. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State 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 (5500(. 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 (section 7044, Business and Professional Code: The Contractors' Slate License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the propen9, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' Btale License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Dale: I do hereby Cenify that I am aware of and understand the re 25534 and that I or any future building occupant willlwill not permit for construction or modification from the Air Duality these provisions. Dale: Applicant: _ I hereby certify than have read this application and stale that the ordinances and state laws relating to building construction ago heret property I in peclion rpo rs. Date: L Signature' Driver's License or Social Security a: and Safety Code Sections 25505. 25533, and h said state codes and the requirements for a ial construction applications are exempt from information is Correct. I agree to Comte with 164146 White—Building, Green—Code Enforcement: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 066659 PLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC JOB DESCRIPTION : REPLACE 2 A/C UNITS ON FLOOR CLAIM VALUE: CALL—VALUE: PERM NO: M 06665 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B-2 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT �E+t*xw*+t�E�Exxx�ir+Ew�E�ryr*�t�E�Ex���+t�Eir�E�E�E�E+t+t+t+tx�rt�E�Ex �E*�E*�E*�E*�L*�E�E�E�it�EyE�L+rx �r*�E*+t+E�r*kir�r*�Ex�Etr�r� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ; PROV: PARCEL: 42716405 ZNE: REF NO: PLANNING N TES> > kkk k k k k k k kkk k k k k k k k k k k kk k kkkkk kkk kk k k kkk k k k k k kk kk kk kk kkk k kkkk k k k k kk k k kkk kkkk k kk D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: 1 DATE: �CA, k k k k kk k kk kkkk k k k k k k kk k kkkk kk k k k k kit k kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 18,00 25t SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 18.00 15.00 0.00 33.00 33.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33.00 kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 2 REFRIGERATION SYSTEM <= 100 K BTU/H 9.00 18,00 END OF FEES 01 00158301-00158301 TOT 33.00 DATE: 04/04/94 TIME: 10:29 \\ CONSTRUCTION AND PLANNING POO SPA APPROVALS Permit #_ Date Inspector APPROVALS Permit * Date Inspector's 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;t Electrical Conduit:.Undrgrnd. 55. Electrical Bonding 5: Steel Reinforcement 56. Rough Plumbing & Pressure Test - H -'6. ElectricalUFER,Gnd. 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, O Undrgrnd. 1 Q Structural Floor'System 61, APPROVAL TO DECK 11. Property Sewer ling & 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=7 Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT r, ^ -zr APPROVAtfi_3.-,Yerm1t+ 20 -Rough Factory *eplace 'C _ 1 - :" 21. -Ducat, in_Strustur�, }0. Undergrrntnd-�HY`o 22. Ducts, Ventilating - t 71, Product-Ptflirlg Q`f1a ❑ 0o _ 23. Gas Pipe Rough &'Test ;.. '•` _ .. `72. UndergYti+jd(Flu-sft r. a. 24.-�? oof Framing- _ + 4• - � J �7 3.cUndergrnd.Storage'sank OGas ❑Oaf _- 25. Hoof Sheathing _ : •r -_ '74.;9verhead Hydro 26. -T-Bar• Ceiling (Structural) & Monocoat _ 75. C5ry Chemical '� e C � r 27.'Frame ago Flashing 76. Dry Standpipe h"; * ' '•' ; _ 28. "Lat�ng'g Siding r _ 77,•.FIXED SYSTEMyF1NAL* J 29. Insulation •� " " 'T 78. =FIRE PREV. FIN,hL• , G, 30. DrywallNailing - t - HE"ALTHrgEPT, REOWREMENT 31. Plaster Brown Coa4' I` ; ..29.'FINAL INSPECTION - -' r• „ ,32. Electrical Pow$r Meter -final .t, -3 r • 50. -FOOD CERTIFICATE ISSUED ?• 33. -FinarEl@ctric, J" ' TlVotes: `r, 34. Aii Corrlditioning ,' ` 5/�,� ,Final-Heatingl& _ _ _ , �•r: • Ems,= 1 S Cis:_ n (f�dThJ•% 35. Final•Gas Pipe -Tett - 5 �H�, •r- _ 36. Hood'or-Canopy n• _y _ r •, n`^ -_+t•• 4' 37. Final -Factory Fireplace' c-� ' '" J '1 1.1.T- • * to .38. Final,-Plumbing�" W t 39. WatePService-Final- - w • 40. Gas Service -Final - ,` - - - ' - �4.1. Sour Domestic -Finch �- •• t - - ` 42. Backflow Preventer _ r _ 43. Backflow Irrigation . x': _. * r, 1-• s - <t 4�4. Landscape Irrtgatioo System 45. Sound Attenuation• :•- - c . m E -•v 46. Ha nd ica p. Regulations rim• ,r 47. F_1NAL STRUCTURE & BUILDING r , 46. FINAL PLANNING' ' `-, a 'i 49. Electric Release to Edison - _ - ;x n 50. Gas Release to Soutl4ern California Gas Co 51. CERTIFICATE OF OCCUPANCY' No. Date t• - C E 7917, 5/02/75- �- �' 777g9q�1�7 �p5�//02pp/7999 qqq1� 61:20C_KTO_ COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR �RIICTUR L -PERMIT 'A P:O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVED BY PERMIT i For Applicant to Fill in Completely — Use Ink Only BUILDING So /Q�A ADDRESS A.P.NO. '9127-1&1-11 OWNER OR/' p /+ ADDES RS 2 �0 TENANT / (-: /r^�OJS UNIT OR D` MAILING^a ADDRESS 2,O (� �� SPACE NO. TR.N'O� � LOT 3 " BLK. TEL. / CITY GUN/�l 13�/QC1 NO. �O :l/Z �� NEW ADD ALTER REPAIR IMOVINGIDEMOLISH CONSTRUCTION / -9S LENDER BRANCH / OWNER all -L. G Qoss ADDRESS VALUE USE eZ % ARCHITECT/ NFL ytp Z2L OR INFER 2. //iGl M z� 7�T.�v �r ADDRESS �f ✓O!L-17� L�L �/T m��[ ZONE //Ir YP GROUP � p _ CONTRACTOR 4WA/t UM4t� A/2 APPROVED BY DATE ADDRESS -e/],- JQ a ✓ 7 TEL. CITYL-0 /Q L`L AI NO. C7J 3' STATE CITY APPROVED SETBACKS LIC. NO. 2 43 ,30 LIC. NO. SIZE NO. OF BLOGS (FROM CIL STREET) OF LOT NOW ON LOT FRONT FT. USE OF EXISTING BLDG./_' Separate permits are required for L SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK'TO BE PERFORMED PLANNING ACTION q (,./L0 r� 441 � G00 DATE APPROVED p / APPROVED CW ' o/ F7p -DA:EE JV % I hereby acknowledge that I have read Misapplication and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and offect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Code, Division 3, Chapter 9. PLAN CHECK E Signature of '��.s _ .� / 1 s!Etboo Permittee C77J""Uyy`77 CCC�/NN/ TAX E s �(/�V(/�/ 40 Authorized Agent ate �/- Z j- 7%' - / TOTAL PAID E6 2-D 6291 5/10/79 9_2.00 TU cos''A MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT ' P.b.BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVED BY PERMIT For Applicant to Fill in Conif letely — Use Ink Only BUILDING /i/� A.P. NO. ADDRESS W OWNER OR //G ��.sOip _ ADDRESS a TENANT UNIT MAILING SPACE NO. ADDRESS T R.NO. LOT BLK. TEL CITY NO. NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER BRANCH OWNER -41 ADDRESS III ALOE ARCHITECTTEL. USE-• OR ENGINEER N . ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. CITY NO. STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF BLDGS. I (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. USE OF EXISTING BLDG. Separate permits are required for L. SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APPROVED I DATE I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Profession$ Code, Division 9. VALUATION PERMIT FEE E �ptar PLAN CHECK E Signature of Permittee TAX E Authorized Agent Date TOTAL PAID E 046933; - • COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR'STRUCTURAL PERMIT Applicant to FBI in Completely — Use Ink Only VrA�j?� DATE RECEIVED DAJOE ISLDING ,v �}RECEI SS Z 7 •SO /9/yP U'9 - �jQ"�/� /(t (/.IJ LIC / //�IU�A CT�Is!E:fI� �U, _ P I A.P. NO.I��— _ Z A BUILDINGy/��SS ADDRESS sGlJ/ D—�121A So /] iLt//} RID, (/� t,J (%,f'�/} �%��ryOL )r/ -G a-6 F,NG,NEE. TRACT 7 p{O LOT BLOCKUCTION N W ADD A PR vH^ /^�OWNER JbQ �-O. SS V LUE $—DECT TEL. �/ng US $ VINEER N FIRE ADDRESS ZONE TYPE GROUP p CONTRACTOR /) Q OC/U'�/ zc'� APPROVED Oma` BY DAT G ,j ADDRESS 5'G �1 & '} D/k TEL. ZONE �/� n NO. OF USE OF NEW /A/ % - PLANS BUILDING p CITY CO„f 9 E 1 NO. 7V-614 Q // / / AI.T . STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF SLOGS. (FROM C/L STREET) OF LOT NOW FRONT FT. FT. nON,LOT USE OFI ,y�y�r� /, Q T EXISTING BLDG. TT. F r v // �/7 /`-' FT Separate permits are required for L. SIDE T FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLOBS. ACCESS. BLOCS. _ VAR. #s DATE C.U.P. 46 APPROVED APPROVED CWRI Z T� I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with a all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO SD. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Businessd VALUATION PERMIT FEE E261000 and Professions Code, Division 3, Chapter 9. u PLAN CHECK $ 131,90 Signature of / // TAX E 5o _ Permittee L%lt/-'--vJ� �% $ no u Authorized Agent C TOTAL PAID E e SO 7 ata COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 3917 8/28/78 115341 20. TL 4 1,9 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RECEIVED By DATE RECEIVED D TE E BUILDING l�Q ADDRESS t OWNER NIE I A.P. NO. `1z7- 10 — P= O MAILpp /� ,,^ ADDRESS ADDRESNG S y�Q r TIE 7/O `` CITU ��jyt, NOL S' TRACT K� LOT BL CONSTRUCTION W ADD ALTERREPAIR LENDER BRANCH ��//�� // �//JJ '/ OWNER �A^mL 6&CIG v4..YR0 R &c ADDRESS _ /) VALUE S V�J� ARCHITECT TEL. SAG 2 OR ENGINEER N FIRE /Th ADDRESS ZONE PE GROUP jj CONTRACTOR S'/ APPROVED BV DAT •�� ADDRESS V 1 TEL. ZONE n NO OF PLANS Z USE OF NEW NOKS7' BUILDING CITY VI G NO. ��q' Y ..�. pCAC ITA E LIC. NO. LIC. NO, l US I. •5 CITY I�O 50 YARDS APPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE 0EXISTINGBLDG. Qjrl1'lFrB.%ltxli FT Separate permits are required for L SIDE • FT. pf FT. electric, plumbing and heating work. REAR F FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & O Gi MAIN SLOGS. ACCESS. SLOGS. r! �✓JG , L) / G (/ VAR.* C.U.P.# DATE APPROVED p {� APPROVE[Lbw / t� DATE I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that 1 am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; am exempt from,the provisions of the State of California Business VALUATION PERMIT FEE ��s $ and Professions Code, Division 3, Chapter 9. e{/ PLAN CHECK $ s Q C_ Signature of Permittee �/Ki/-w`^ .�/1u�1 I� $ J/�' �/yt TAX $ f e Authorized Agent TOTAL PAID $ / 53 s Itl 4 1,9 4u496 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely - Use Ink Only rAODRESS pUr1R CRS/rvG �L rn6!G/ 1J 190$a Ct-RRK GIRDLE pc TEL.IRVIME NO.ION BRANCH ADDRESS ADDRESS IJo(ok-I�unpKgt/rS vF. L f CONTRACTOR (yI•�/r✓ ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LC. NO. SIZE ,1 WIND BLDGS. OF LOT i 5R S S/1. FT NOW ON LOT USE OF t EXISTING BLDG. ARGHI ff-:GT orrice Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED R/v S I hereby acknowledge that I have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full f a and affect, or 1 am exempt from the pro Islons of the State f elifornia Business and Professio ode, Di Ion 3, Chapter 9. Signature of Permittee Authorized 7�3€1r0i.476 ... j146: a�cK�r��' 1 i32A' -.Ef0004464 g6 -I A APPLICATION FDIC STRUCTURAL PERMIT / B' DATE RECEIVED DISS 0 A.P/NO. BUILDING ^^ ADDRESS K 9 S'd APPROVED BYk// / DATE ZONEm nIPLOANS ZI BUILDING EW WQ FFt G IE I 1\ YARDS APPROVED YARDS APPROVED \II MAIN BUILDING ACCESSORY BUILDING %FROM C/L STREET) REAR Fl`.' FT. DISTANCE BET. BET. MAIN 1 MAIN SLOGS. ACCESS. BLOGS. � VAR.# DATE C.U.P.# APPROVED N m m' SQ. FT. a THE AMOUNT SHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE S N Q<7 PLAN CHECK $ m / $/ f/wD !!! / TAX S Ioy TOTALPAID 6988 6/„7,/78 9g;8b,,. TL COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 P CA ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RE 1 E DATE RECEIVED D TESUED �7 BUILDING A ADDRESS L-2*D i OWNER - /JS J holctr Lia r A.P. NO. 27 16 — PERMIT NO. MAILAZ / BUILDING DDRESS E ADDRESS t / 7 Op� CITY lt#V NOTEL.. —_Z� TRACT LO BLOCK CONSTRUCTIONNEW D LENDER BRANCH / OWNER Qrv� _ / ADDRESS /�•s VALUE �f• L— ARCHITECT TEL. N J $ , R ENGINEER FIRE ADDRESS ZONE PE GR UP ' �•1 CONTRACTORK,/w�CZ'1- APPROVED BY _ DATE ADDRESS TEL. ZONE O.OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACC SORY BUILDING SIZE NO. OF BLOG6. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. nFTd USE OF �•% EXISTING BLDG. Separate permits are required for L. $ FT UV FT electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR.# DATE U/�K OIL L (fJ C.U.P.* APPROVED 5 X �J / • APPROVEATE / - ' o �y� I hereby acknowledge that I have read this application and state ,het the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of ASO. FT. the State of California. I hereby certify that I am properly licensed as a contractor under THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that su 11licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT EE ONLY: am exempt from the rovisfon. of the State of California Business VALUATION PERMIT FEE § o antl Professions Co , Division 3, Chapter 9. PLAN CHECK § Signature o TAX E Permittee $ �V/' Authorized A nt TOTAL PAID E COSTA MESA BUILDING -SAFETY DEPARTMENT .P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDINGRESS A 1n ADDRESS OWNER ,9/z MAIL J/rU`.� ADDRESS TEL. CITY '�''/¢ j�% NO. CONSTRUCTION LENDER BRANCH ADDRESS ARCHITECT TEL. A.P. NO 3234 6/07/78 40.10 TL FOR STRUCTURAL PERMIT DATE RECEIVED I DATE,I SU i��'m • J� 4 n m 'm m N a m SIZE NO.OF BLDGS. (FROM C/L STREET) d OF LOT ADDRESS FRONT YPE ' GROUP(� SIDE FT. CONTRACTOR c//(/ ^ DATEADDRESSTEL.F fSeparate O permits are required for electric, plumbing and heating work. L. SIDE FT.'40 F REAR F W F QMAIN USE F BUI ING A D WOR O BE PERFORMED VE BET. MAIN & ACCESS BLDGS. Q VAR. # C.U.P.# DATE APPROVED � OF USE OF NECITY APPROV } NO.S DATE ..1 BUILDINGSTATE a CITYED YARDS APPROVED w Q1 LIC. NO. - LIC. NO.G Q9 BUILDING 4 n m 'm m N a m SIZE NO.OF BLDGS. (FROM C/L STREET) d OF LOT NOW ON LOT FRONT Q USE OF Q EXISTING BLDG. —R. SIDE FT. F y fSeparate O permits are required for electric, plumbing and heating work. L. SIDE FT.'40 F REAR F W F QMAIN USE F BUI ING A D WOR O BE PERFORMED DISTANCE BET. BLDGS. BET. MAIN & ACCESS BLDGS. Q VAR. # C.U.P.# DATE APPROVED � APPROV } DATE ..1 a w Q1 hereby acknowledge that I have read this application and state Q9 that the above Information is correct and agree to comply with L all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of the State of California. 3 I hereby certify that I am properly licensed as a contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATI the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT am exempt from the provisions of the State of California Business and Professions Co Division 3, Chapter 9. VALUATION PERMIT FEE $ PLAN CHECK E Signature of Permittee / zr -/��� �/ ./A. n $ %r Y — ✓ TAX $ r TOTALPAID $ Authorized Agent 4 n m 'm m N a m �'�lvl�l3 _COSTA MESA BUILDM Y DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Only Applicant to Fill in Completely — Use RE BUILDING _'1�—. OWNER TEL. CITY t7Y1� 150.. (2 r "Ae- / NO. 7PSnvn� BRANCH FIRE CONTRACTOR UC<//ll/t ADDRESS CITY TE L. NO. STATE CITY LIC. NO. LIC. NO. SIZE NO. OF BLDGS. OF LOT NOW ON LOT USE OF TRACT ER 1961 6/3I/7B 163.20__TU 1'961' 6'/31 /78.. _ . 153:20CKTD !$I F�fR�J1PIE�tMIT �A . DATE RECEIVED DATE ISSUED _ PERMIT NO. O / LOT, BLOCK VALUE /Ir TJV E GROUP DATE )F it I USE OF NEWS /, DS APPROVED YARDS APPROVED Separate permits are required for L. SIM FT. electric, plumbing and heating work. REAR FT. F USE OF BUILDING AND WORK TO BE PERFORMED pISTANCE BET. BET. MAIN 8� MAIN SUGGS. ACCESS. B / A T LT VAR. •. _ C.U.P. 9 DATE APPROVED 1 hereby acknowledge that I have read this application and nate that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and th suc licenses era In full force antl effe t, or 1 am exempt fro Me pr Isfon. of the Stat. of Cal J.m is or and Profession Co , DI ision 3, Chapt Signature of Permittee Authorized Agent THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ON VALUATION PERMIT FEE $ /J PLAN CHECK $ TAX $ TOTAL PAID 5 CITY OF COSTA CONSTRUCT[i —r Project Address Applicant's Mailing. Owners N Address P i Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PE501T NO. - TRACT NO. - LOT NO.- 81D - Address 41— —W 11.V UC- C-ouB'` Contractor's Nam 1 fl �tU,U(�'/ 'Phone? Address (m 'ng? - n ICM A� U rZu& City License No. !zq,$0 ' LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter,9 (commencing with section 7000) of Division 3 of the Business and Professions Code. and ,my license is in tu11,R f�e.g ,qf fact., License Claasss -Ens Oate.u'._ 6}8? Signature Vry WORKERS' COMPENSATION DECLARATION 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 J 3800, Lab. �1 Z� S� 4ZZ� STr4TE_ 754 pig f Policy Nompany Certified copy is hereby furnished. Certified copy is filed withththe cite city Building Division. , its IApplicant ' JEXEMPTION•FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed If the permit is for one hundred ($100) or less). I certify that in the performance of the work for, which this permit is Issued, 1 shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature - NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation -provisions of the Labor Code, -you must forthwith comply with such provisions or ,this -permit shall be deemed revoked. CONSTRUCTIONLENDING' AGENCY ' I hereby affirm that there is a construction lending agency for the performance of the work ,for which therMit Is issued (Section 3097 Civ. C.) Lender's Name- - us O�(% Lender's Address OWNER.BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the p ;:_kollowing reason (Section 7031'.5 Business and Professional Code: Any city or 1 .-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. si 9 red statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of .Division 3 of the Business and Professions Code) or, that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any -applicant for a permit' subjects the applicant :to a -civil enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wagesl as their sole compensation, will. do the work, and the structure is not intended -or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an.owner of a property who builds or improves thereon. and who does such work,himself/herself or through his or her own employees, provided that such improvements are not Inter, ad or offered for sale. If, however, the building or Improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or IM. rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- t ractorsto construct the project (Section 7044, Business and Pro Iessl ons Code: The Contractor's License Law does not apply to an owner of property who .. builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). 0•1 am exempt under Section B. & P. C. for this reason Date Owner ' I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relati o b Iltling const Etion, and hereby authorize repre. sentatives of this I t ent t p6 the above-mentioned property for Inspection pur Signature Date /a.5 / TYPE OF CONSTRUCTION Ll N ❑ CONVERSION ❑ DEMO ISI D SCRIPTION OF WORK TYOE OF PERMIT GRADING ❑ TENANT ❑ ELECTRICAL ❑ OTHER PROJECT DESCRIPTION SG. FT.L CONSTRUCTION TYPE r' VALUATION$ ZONE GRADINGCU.YDS. A( Remarks: 0 /— - n n 7 Z /L ADD LJALTERATION LJ REPAIR I FOUNDATION &e STRUCTURAL PLUMBING ❑ MECHANICAL FEES ar Sink Showers - ackflow Preventer ackfl Irr:getion Service Sink Sewer Cap othtubs Sewer ConnEb ' larifiers Solar Colle or ishwasher - - Spier Piping - - rinking Fountains So r Ta k loor Drains: ' S m Pool /Spa loor Sinks - -I al as Service Outlets a 'Closet ' Iterceptors _ 1 Water ter. itchen Sink Water Servic - Fee Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multi Firepl/Fact. Blt. ICBO 5h Heating System & Ducting 00.100,000 BTU 0100,( Drivers' License or SS z* I I Reinspection Fee CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor S25 $25 Issue Fee -v I - $ 3 FEES Hood or Type ❑ Canopy Typell ❑ Refrigeration System ❑0-,,100,000 BTU 0100,000BTU System Repair/Alteration Issue Fee $ 3 2.169 1/10/64 A.P. 0.40-7-R04- Zone S Main Building: - Accessory Building: T Front B Rear C Right PLI S Left Ping. Ref. # - 3 - '74 Park. Fees $ Parking Req./Provided Use of Building: Thwe 4A f65 / 17 Planning No0,11 hQ if 208.7.5 T(. N 1 N G R E Q U I R E ME 1G N l l u r l er ELECTRICAL FEES Automatic Washer ,Construction PoleEl Sub. ' Transformer ❑ 15-50 KW 50'+ KW_ Cooking'Unit - - - - Meter -❑up to 100amps - -- - Dishwasher Meter ❑over 100 amps' Dryers ❑Gas ❑Electric Sub Panel Fan- Motors 130-1 HP ❑ 1 K - 8 F.A.U. Inc. Solar ❑9-15 HP 016-15+ L Fixtures Microwave Device Boxes ' Pole Light - j Outlets Range Switches Sign ' Garbage Disposal Standing Sections ' Generator ❑05 KW 115-15 KW Trash Compactor MICROFILM $ l - Reinspection Fee $25 Issue Fee • $ 3 e PUBLIC' SERVICES REQUIRE ENT : zoning Approved BY �/ UJ Application Approved By - natethol .- _ ' Data _ SUMMARY OF FEES BUILDING PERMIT $ 'JOG • SCi SMTP •, $ PLAN CHECK $ PERMIT ' - PLUMBING $y ISSUANCE I $ f PLAN CHECK $- ENERGY P.C. $_ ELECTRICAL $ GRADING $ . PLAN CHECK $ MICROFILM $ l MECHANICAL $ TOTAL FEE $ �rY' ✓ PLAN CHECK $ CONSTRUCTION AND PLANNING- ' APPROVALS Permit# A1050� Date Inspector POOL & SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole' i 52. Pool & Equipment Location 2. Soil,Pipe-Undrgrnd. - 53. Steel Reinforcement -.3.'Eler�rica6Cond uit Utility-Undrgrnd. 54. Forms -4..'Electrical'Conduit-Undrgrnd. 'L„ .. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UF,ER Grnd. - 57. APPROVAL TO COVER-GUNITE 7t- ;Footings 58. Electrical Conduit-Undrgrnd. 8.,Foundation.-' _ .t 59. Gas Pipe, ❑ Undrgrnd., Test 9:" Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. 10.; Structural Floor System 61. APPROVAL TO DECK 11.'Froperty Sewer Line & House Connection '.. 62. Backwash & Receptor -Final 12! Sewer'Cap - 63. Heater & Vent -Final 13, rRoof •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 & Accgss 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Du¢ts,Ventilating r., , r 71.. Product Piping 13Gas El Oil 23. Gas Pipe -Rough& Test • -�_ 72. Underground Flush 24. Roof Framing .- 73. Undergrnd. Storage Tank 0Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. r ' ing (Stru Lyral) & on oat , _ - 75. Dry Chemical 27. Frame and FlashinSAff -7-"),a 76. Dry Standpipe 28. Lathing &Siding art �� +R �, 77. I SYSTEM FI A 4 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing LS /--,X-> HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat- 79. FINAL INSPECTION 32. Electrical Power Meter -Final '. 80. F,OOQ'CERTIFICATE ISSUED 33. Final Electric •Notes:, D z, 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 +' r, 43. Backflow Irrigation r••^ .'9 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations r 47. FINAL STRUCTURE&BUILDING 48. Special Requirements Completed r �• 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCYNo. e- Y 35/6 Date 2�/�•C`-- yT n declarations. \` Applicant to fill in all spaces except those within heavy border lines and sign all appropriate /r 304 � ppp /84/7e '7?0 a 5o (• CNB+'.-' y`7 • CITYCOSTA MESA - ', ,' - - PERMIT NO. TRACT NO. LOT NO. BL - ' - - -. .OF I CONTRUCTION PERMIT I. Prftt Address; - TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR - ❑CONVERSION DEMOLISH ❑OTHER I - Zone ' ' A.ilicant'S Mailing. Alldre55 - A -P, # • - 0 _ 1 ' wner's Name �1--.—Phone DESCRIPTION OF WORK S Main Building: - Accessory Building: ' Z _ Address -3 r'I�Gii - TYPE OF PERMIT GRADING ❑FOV NDATIO STRUCTURAL E T I Front O N' Arch/Eng. - ' License No. � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B Rear - - / • ❑ BOTHER ` A N Address _ C Right Q _- Contractor's Name � '��� %� �� Phan e ?L PROJECT DESCRIPTION. SQ. FT. 'OCCUPANCY K - - Address(mailing) ,l• %?, c /'L ��_�i%� �"'•��`�7 -CONSTRUCTIONTYPE � +s VALUATION$` /. S Left E ` - ZONE GRADINGCV.VDS. ACRES Ping. Ref. # Park: Fees $ Q City License No. O LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - 1 I hereby affirm that I am licensed under provisions of Charteo9 (commencing - R with section 7000) of Division 3 of the Business and Professions Code. and _ Use of Building: - I , r - - E my license is in full for antl effect. M License lass Lice se No. - PLUMBING FEES Planning Notes: 1 - Date V' Signature ' Bar Sink Showers - (E.1 WORKERS' COMPENSATION D LARATION - - T I hereby affirm that I have a cert tate of consent to selfArzo or a certificate Backflow Preventer Service Sink ' S of Workers' Compensation Insurance, or -a certified copy thereof (Section 3800, Lab. C.) - Backflow Irrigation Sewer Cap I ELECTRICAL FEES Policy No. Company B Certified copy is hereby furnished. ; Bathtubs Sewer Connection ! Automatic Washer Transformer 1:115.50 KW Certified copy is filed with the city Building Division. 1 1 ❑ 50+ KW ,to Applicant Clarifiers Solar Collectors I Construction Pole Sub. - EXEMPTION,FROM WORKERS'ICOMPENSATION L DECLARATION ' - Digh Wa"sFief 1 - - $Olaf Pi in 9 Cooking Unit - Meter ❑up to " (Thissectl on need not be completed if the permit Is for one hundred ($100) or P l' less). - I certify that ;In the performance of the work for which this permit Is,Issued I Drinking Fountains 9 I Solar Tank Dishwasher Meter Dover 100 ampsI shall not employ any person in any manner so as to bec-g"SWUact to t workerp �.p ensatiom Laws of Cal' nia. �, Floor Drains Swimming Pool w/Spa Dryers ❑Gasp ❑Electric Sub Panel Date _L' LSigna ture �'ss.�•. I NOTICE: It,'after m kingdec tion, you should beco subject to the + Floor Sinks I Urinal Fan Motors 00-1 HP ❑i'/:- 8 ' pthis Workers' Compensation rovisio of the'Labor'Code, must forthwith _ I comply with such provisions or this, permit shall bel deemed revoked. Gas Service Outlets Water Closet. '- 1 F.A.U. Inc -Solar ❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY •. i - I hereby affirm that there Is a construction lending agency for the performance Interceptors' Water Heater Fixtures ( Microwave of the work for 'which this permit. is issued' (Section3097Civ. C.) - Lender's Namn _ KitcKen Sink Water•Service Device Boxes Pole Light Lender's Address QWNER BUILDER DECLARATION from for Lavatories I' - - - Outlets 'Range _ :r,ereby. affirm that I am exempt the, Contractor's License Law the lowing 031:5 Business Professional Code: Any P -Trap C. - - Switches . reason (SeclionJ and city or - ilunty which requires a permit to construct, alter, Improve, demolish or repair - Sign any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains Garbage Disposal Standing'Sec[ions to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Generator ❑0-5 KW ❑5-15 KW Trash Compactor Division 3 of the,Business and Professions Cotle). 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 ', 5enalty of not more than five huntlretl dollars ($500). r t o - Reihspaction Fee $25 1 Issue Fee $ 3 1 $25 In Fee $ 3 LJ 1, 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 - -MECHANICAL FEES for sale (Sec/lon 7044, Business and Professional, Code! The Contractor's - PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property, who builds or Improves Boiler - Hood or Type I El thereon; and'wholdoes such work himself/herself or through his or her own Canopy Type II ❑ Zoning Approved By Date employees, provided that such Improvements are not Intended or offered, for Duch Under Ground sale, If, however, the building Improvement di one year of tom- i l Application Approved By Date t e proving h she pletio.f rthe the owner. w111 have the burden of proving hC/she did not build or s�rova tar the purposo of sale). i I 1 Duct - Structural I � , Refrigeration Sysfem � � - Application Issued By ` / L / Dat O LJ I, as owner of the propertyam exclusively contracting with licensed con- ❑0-100,000 0100,000 tractors to construct the project (Section 7044, Business and Professions Code: Duct- Ventilating BTU BTU SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- Exhaust System El multiple 13 System System Repair/Alteration PERMIT I $ SMTP $ tractor(s) license pursuant to4he Contractor's License Law)'. PLAN CHECK $ PERMIT ElI'am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO # ✓ ISSUANCE $ PLUMBING $ Date Owner Heating System & Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 'information 13 0-100,000 BTU ❑100,000 BT - - ELECTRICAL $ I GRADING $ - is correct. I agree to comply with all city and county ordinances and -state laws relating to builtling construction, and hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives of is city, to enter, upon the above-mentioned property for Inspection pur se - MECHANICAL a0, 5 . Signature Oat - $ � TOTAL FEE $ ,� Drivers' • Se or SS yp Reinspection Fee P $25 Issue Fee $ 3 ' PLAN CHECK I $ 3, i i CMF 086 -46 rev. 7/83 - White - Building; Canary - Acolicanh Pink - Accounting; Goldenrod - Assessor 'L l �riUCTION AND PLANNING .��PROVALS- Permit# M12 -7i l Date Inspector POOL & SPA ', 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. APPROVALTO COVER-GUNITE - 7. Footings 58. Electrical Conduit-Undrgrnd. B.' 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 APPROVALS Permit # 20. Rough Factory Fireplace 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 CGas 0Oil 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 48. Special Requirements Completed , 49. E lectri c'Re lease 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!f COSTA MESA,'- IT NO. TRACT NO. LOT NO. BLDG. NO. -` 2844-1-1/N%84 8.00' TL COOTRUCTION PERM T D�, Prdct Addr¢5S; - TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR - q.plicenYs=Mailing d ray .. -❑ CONVERSION ❑ DEMOLISH- OTHER/A.P. Zone 9wner's Name DESCRIPTION OF WORK - - S Main Building' _ - Accessory Building: - Z I I Address Q r - TVPE OF PERMIT GRADING'���777III❑'FOUNDATION - STRUCTURAL E T Front „j - O N Arch/Erig. I I License No .. ❑ TENANT ❑ ELECTRICAL µ� PLUMBING ❑.MECHANICAL - B Rear _ ' 1 Address. '- - I i ❑ OTfiER -. '. / �_ \ - A ._ N Contractor's Name* hone PROJECT DESCRIPTION SQ. FT. f OCCUPANCY -K Right 9 R Address (mailing) -'- ' tCONST RUCTION TYPE VALUATION $ ' �$ Left, r _ E - 0 City'Licerise No. _ l ° ZONE GRADING CU. YDS! ,ACRES Ping. Ref. # "' r Park: Fees $• r _ - Q LICENSED CONTRACTOR DECLARATION I i Remarks: r _ O - ' I , Parking Req./Provided ' - U I hereby affirm that 1 am licensed untler provisions of Charter 9 (commencing 1 - - _ + R with section ]000) of Division 3 of the Business and Professions Cod no _ - - ( Use of Building: } I •_ E 'my license is in full f a an fT (��� M license a s I I is N -1 J - - i PLUMBING - FEES Planning Notes: > E Date Signature Bar Sink - F Showers - N i WOR S OM ENSATION D RATION ' T 1 here affi m that I have a Cert t [e of consent I. self -insure or a certificate ' r Backflow. Preventer_.„'- Service Sink I i S of W rkere"Compensation In rice, or"a 'certified copy thereof'(Settion,' _ _ _ _ 3800, Lab. CJBackflow lmgation Sewer Cap ELECTRICAL FEES Policy No, ' Company 4 - ' 8 Certified copy is hereby furnished. ' 1 1. . ; Bathtubs Sewer Connection Automatic Washer Transformer El 15-50 KW Certified copy is filed with the city Building Division. '' ❑ 50+ KW Date � Applicant Clarifiers Solar Collectors I Construction PO_I_e Sub. ' EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION" " --Piping,-;Meter- (This section need not be completed if the permit is for one hundred ($100) or' Dish wa5h¢r SOlaf Cooking Unit rr ❑uptb100 amps - -"" less). etl I-, I certify that in the performance of the work forlwh' 1lthis er 't ect i Drinking Fountains 9 Solar Tank r Dishwasher 7n - 'Meter ❑Over 100 amps • t shall note ploy /any person in any marine so o ec a bject t tie workers', Laws of C r r is Floor Drains• - , i - - - Swimming Pool w/Spa r i '" Dryers ❑Gas Electric 'Sub Panel Date 519natu NO IC f (alt r ma ing this tlepl Ion,,yo u_ oultl become subject to the Floor Sinks 1 _ TGas Urinals - _ _ - Fan HP 01'/z- R Worker Com ensation provisio ;the Labor Code, you must forthwith -comply 'with..such provisions a .this.,permit shall be, deemed revoked. I - ;_ Service l �Ouilets - Water Closet ' F.A:U. - .Motors,❑0-1 - - - - - �- Inc. Solar09-15 HP 1:116-15+ CONSTRUCTION: LENOING''AGENCVD f I ' `^ r -• l I herebylaffirm that there is a construction lending agency for the performance +. f'iis}issuetl u I Interceptors+ _ _ ' Water, Heater } , I Fixtures J t i Microwave of the work -for which; this permit (Section 3097- Civ. IC) •. - _ i ' Lenders Name'• l i s Kitchen Sink - ,� I :Water Service Device Boxes I Pole Light - I - Lend'e'r s Add ress "•' } l - - r OWNER BUILDER DECLARATION .. - tr 'y _t - C Lavatories 7 I. i - µ + S t { 1 -/ r 'Outlets t Range r hereby, affirm 4hat I am''exempt from the Contractpr's Lroensa Law for the _ r ' -, i 'llow, ng reason. (Sectionr]031:5•Business antl,Professional. Code: Any city or r P -Trap �.. } - _: : l ' - f Switches' i Sign I I .unty which req lilies a permit to construct, alter, improve, demolish oCrap.ir - _ r C3 - ' any structure, prior to Itsissuance, also requires the applicant such permit t BOOf Drains L 'S' } 1 - , Garbage Disposal ' c n$[aeding'$etilOrlS " l .t0 file a•5igned statement thatbe/she i5 licensed' pursuant to the provisions of ,the Contractor's License Law (Chapter 9 (commencing with Sectio ]0axe of "Division3 of the; Business and Professions Code) -or that he/she'is exempt - ( - -- - - :-' I ! Generator 065 KIN05-15KW Trash Com actor P .therefrom and the basis for the alleged exemption. Any.violation'of Section �I 7031.5 by any applicant for' a permit subjects -the applicant to a civil Reins etlon Fee f- 1 Pe $25 Issue Fee` - $;3 `penalty of.not more than five hundred dollars ($500). �, LLJJ i,- s owner of the, property !or my,employee`s-with wages as their sole 'i i `MECHANICAL p I Reinspection Fee ; $25 Issue Fee, r $ 3 ' compensatlon, will do the work, and the structure is not intended or offered ' r - '- - FEES _ for sale- (Section •7044, Business and. Professional Code: The Contractor's I 'PUBLIC SERVICES REQUIREMENTS:' - I License Law does not apply to.an'owner of a property whobuilds or Improves Boiler i - Hood or Type I : ❑ i ' thereon; and who does such work himself/herself or through his oriher Own- not I Canopy Type I ❑ Zoning Approved ey i Date ' employees, provided that such improvements are intended or offered for Duct; Under Ground - i - sale. If, however, the buildingor improvement is,sold within one year of com- v Application Approved By Date d pletion, the owner se of a le+the burden of proving he/she tlitl not build' orim- rove for the purpose of sale). prove ILI I, as owner of the property, am exclusively contracting with licensed' con- ' i Duct -Structural i - Refrigeration System t •� Applicatipn Issued By 1 � / i not _ n 8 tractors to construct the project (Section 7044, Business and Professions Code: Duct -Ventilating !- X0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES The -Contractor's- License- Law does not apply -to an owner- of -proper who builds or Improves thereon, and who contracts for such projects with a con- , Exhaust System ❑ Multiple ❑, System Repair/Alteration ''_ BUI LDING.PERMIT $ SMTP $ tractor(s) license pursuant tolthe Contractor's License Law). ❑•I am exempt under Section B. & P. C. for this reason Firepl/Fact!BIt. ICBOi# ` PLAN CHECK i $ PERMIT PLUMBING $ ISSUANCE $ Date owner` I Heating System & Ducting 'HECK'�' PLAN C/ $ GV'P. . $ , U V ENE C I -hereby -certify that I have read',this application antl state tAat_the above _, _, ❑0.100,000 BTU 0100,00067 - _- " ELECTRICAL $ GRADING GR $ information is correct. I agree to c y with all city and'county ordinances' , and state laws relating builtlm con ucti n, antl he eby author ze re e- sentatives this to'ente the bove-m lioned for PLAN CHECK - $ MICROFILM -$ of city u o pr rty Inspection r s r MECHANICAL -_ $ , Signature Date 1 TOTAL FEE $ _ Drivers or 55 Reinspection Fee P $25 Issue Fee $ 3 PLAN CHECK - $ `CMF -086546' v. 7/83' White -6uilaing; CanarPink Accounting "'Assessory-APplant; -Goldenrod • • CON`"RUCTION AND PLANNING flu"53: f.�t'PROVALS.- Permit # flu 53: Date - - Inspector POOL,& SPA - :APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52'. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement f 3. Electrical Conduit Utility-Undrgrna. 54. Forms - 4. Electrical Conduit-Undrgi'ncl_ 55. Electrical Bonding - .5..Steel Reinforcement _ 56. Rough -Plumbing & Pressure Test 6.' Electrical UFER Grnd..) - 57. APPROVAL TO COVER-GUNITE 7.'F6otings - 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 127 Sewer Cap, 63. Heater &Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 0 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. POOVSPA SYSTEMS FINAL 19. Rough Heating & Air'Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace r 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas El Oil ' 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing V 73. Undergrnd. Storage Tank OGas []Oil 25. Roof Sheathing 74. Overhead Hydra - 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 i HEALTH DEPT.'REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric I Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test , 36. Hood or Canopy 37. Final Factory Fireplace - - 38. Final Plumbing 0.44 / ' 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer ,;-43. Backflow Irrigation X44. ,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 CITY•OF..COSTA MESA " CONSTRUCTION PERMIT Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. BLD • -/OGD (o - , Project Addre35 ROOf.DralOS' - TYPE OF CONSTRUCTION LJ NEW LJ ADD 'ALTERATION LJ REPAIR Reins etion,Fee Pe S2'' Adplicam's Mailing Address Compensation will do the work, and the structure is not Intended or offered for sale (Sec/ion .7044, Business and Professional Cotle:' The Contractor's ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Boiler A.P. 911- s,.,/',� Owner's Name GT .;, Phone DESCRIP TION OF WORK pletion, the owner -will have the burden of proving he/she did not build or im- eve'for the purpose of sale). '- I, as owner of the property, am exclusively contracting with licensed con- t ract o rs to construct the project (Section 7044, Business and Professions Code: S Main Bt Outlets Address The- Contractor's -License- Law does not apply 'to'an owner of property who - builds or improves thereon, and who contracts for such projects with a con- TYPE OF PERMIT GRADING 'FOUNDATION STRUCTURAL T Front Generator ❑05 KW 05-15 KW Arch/Eng. License NO. ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B PLAN CHECK _ Address .3-Fr.tFO 1-1 OTHER $ A Rear Contractor's Nam honed f PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right � Address (mailing)I CIQNa// d'ZA7 � CONSTRUCTION TYPE VALUATION$ S Left City License No--liZ�L - ZONE GRADING CU.VDS. - ACRES Ping. Ref. LICENSED CONTRACTOR DECLARAT'IO'N I hereby affirm that I am licensed under provisions of Charter 9 (commencing with -.section 7000) of Division 3 of the Business and Professions Code, and P my license is in full force and effect. 0 Ucehse Class' - -cense N Date ' Signature WORKERS' COMPENSATION D ATION ' I hereby affirm that I have a certificate of conse t to self -I sure or a certificate of'Workers' Compensation -Insurance, -or a certified copy thereof (Section 3800, Lab. C sryl, �j P Ilcy No. �1 w "algCompany �I , Certified copy is hereby furnished. I Certified copy is file wiin the city Buil Applic Date KERS'ant EXEMPT ON F WORKERS'C R TIOM (This section need not be completed i the permit is one hu tlretl (§100) or less)- f I certify thatthe performance the work for'whthis permit is issued, I shall not employ an to any person in any manner so.as to become subject to the Workers' Compensation Laws California, . Date -Signature - - ' NOTICE: If, _mafter making this ions of the you LaborshouldCod become, subject to ith _ cWorkers' Compensation provisions this Labor Code, you must forthwith comply •with ON' LENDING ns G-ihis .permit shall be deemed revoked: ' CONST RVCTION' LENDIN constr NCV - . I hereby work that there is a construction lending agency for the performance of the .work for which, this permit Is Issued -(Section 3097 Civ. C.) Lender's Name; Lender's Address - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the; Contractor's License Law for the following reason (Section 7031.5,Business and ProfessionalCode: Any city or or Sink ackflow.Preventer 1. ackflow Irrigation athtubs - larifiers ishwasher rinking Fountains J loor Drains loor Sinks.- as inks-as Service ..Outlets iterceptors, Itchen Sink avatories�' -- ,any structure, prior to Its issuance, also requires the applicant for such permit ,to file a signed statemen L.thal he/she is licensed pursuant to the provisions of ROOf.DralOS' - _ the Contractor's License Law (Chapter 9 (commencing with,Section7'000) of 'Division,3 of the Business and Professions Cotle)'. or that he she is exempt :therefrom and the basis for the alleged exemption: Any vlolation'.of Section 7031:5 by., any applicant for -a permit' subjects the applicant t0 a civil ,1Lenalty of not more than five hundred dollars (§500). . I. LLJI I, as owner of the property or my employees with wages as their sole Reins etion,Fee Pe S2'' " Compensation will do the work, and the structure is not Intended or offered for sale (Sec/ion .7044, Business and Professional Cotle:' The Contractor's Sub Panel Boiler License taw 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 F :A:U. I Duct -Under Ground 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- pletion, the owner -will have the burden of proving he/she did not build or im- eve'for the purpose of sale). '- I, as owner of the property, am exclusively contracting with licensed con- t ract o rs to construct the project (Section 7044, Business and Professions Code: Device Boxes Duct - Structural Outlets Duct - Ventilating The- Contractor's -License- Law does not apply 'to'an owner of property who - builds or improves thereon, and who contracts for such projects with a con- $ign Exhaust System ❑ Multiple C tractor(s) license pursuant to the Contractor's License Law).' ❑ •I am exempt under Section B. & P. C. for this reason Generator ❑05 KW 05-15 KW . Trash Compactor $ Firepl/Fact. Bit. ICBG # Date I hereby certify that 1 Information is correct. I dntl SLd to laws n sentati yes ofith inspection purpo Signature Drivers' Llcefist =\ '0665.46rev. Owner _ ve read th Heating System & Ducting ❑0100,000 BTU 0100,000 - - 7 s 677/ ! I I Reinspection Fee I $25 �3a-s-r- 3 White- Building; Canary - Applicant; Pink - Accountingf GOldenrod -Assessor-* )MBING - .1 FEI Showers Service Sink ' Sewer Cap Sewer Connection Solar Collectors Solar Piping -- - Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater -Water_ Service - Issue Fee S 3 AANICAL - ' FEE Hood or Type ❑ Canopy . Type 11, ❑ - Refrigeration System 110.100,000 BTU 0100,000BTU System Repair/Alteration . t Issue Fee I_ $ 3 Planning Notes: 0547 1/17/64 Zone Accessory Building: Park.Fees $ i ELECTRICAL Automatic Washer Construction Pole Sub. Transformer ❑ 15,50 KW ❑ 50+KW Cooking Unit • I Meter ❑up to 100 -amps Dishwasher -Meter ❑over 100 amps I Dryers ❑Gas- ❑Electric Sub Panel .Fan .Motors 0&1.HP OVA & F :A:U. I ,inc.Sohr-09.15 HP 016-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range ' Switches $ign Garbage Disposal Standing Sections Generator ❑05 KW 05-15 KW . Trash Compactor $ I 1 Reinspection Fee 1 S25 1 Issue Fee PUBLIC SERVICES REOUIREMENTS: Zoning Approved By Application Approved By Aoplication Issued By - 69.70 TC $ 3 O N I N G R E 0 U I R E M E N t SUMMARY OF FEES BUILDING PERMIT $ SMIP $ . PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. • $ ELECTRICAL $ rad, 91J GRADING $ PLAN CHECK $ .3-Fr.tFO MICROFILM $ MECHANICAL $ TOTALFEE $�� PLAN CHECK $ t ,;. CONSTRUCTION AND PLANNING APPROVALS Permitbw)(� t Date Inspector POOL & SPA -APPROVALS Permit # Date Inspector I., TemFtorary. Electrical Service or Pole 52. Pool & Equipment Location 2., toi('Pipe;Undrgrnd. - _ 53. Steel Reinforcement / 3. Electrical Conduit Utility-Undrgrnd. V 54. Forms .� 4. LEIEctrlcalSonduit-Undrgmd. 7� 55. Electrical Bonding 5.; Seel ,Reinforcement,% •'? 56. Rough Plumbing & Pressure Test � • �' ,,, 6. Electrical-LIFER Grn_d: �• '�- � - 57. APPROVAL TO COVER-GUNITE 7.Fbotings 58. Electrical Conduit-Undrgrnd. 8. Foundation _ 59. Gas Pipe, 0 Undrgrnd., Test 9. Water-Pipe-Undrgr. nd5l 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.-StruciuFal Floor System 61. APPROVAL TO DECK .•- 11.%Property Sewer Line & House Gofiection j 62.; Backwash & Receptor-Final 12. Sewer Cap'.;" : �' 63. Heat er & Vent-Final 13. Roof brains `. 64. Plumbing System -Final ., 14. Rougl�,Plumbing J;;' �!7 65. Electrical-Final / 15. Rough Electrical-Conduit -- 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 - APPROVALS Permit # 20. Rough Factory Fireplace ° 21. Ducts, in Structure ��1• 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas Coil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas Coil 25. Roof Sheathing`s 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing ';v 76. Dry Standpipe 28. Lathing & Siding _ i, 77. FIXED SYSTEM FINAL :::4 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 y �" Notes: Q 34. Final Heating & Air Conditioning '--j 'ry Q 35. Final Gas Pipe-Test rt 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 ! ' an 51 s. } — — — 6640 11/15/79 5a50 �L s � ' COSTR MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT -_, .per. BOX 1200 COSTA MESA, CALIFORNIA 92626 REG PERMIT ' N" 49182 For Applic�asnt to Fill in Completely — Use Ink Only BUILDING ,/� 'rj �'(� ADDRESS Z CL iJ A.P. NO. 7— OWNER OR BU ADDRESSJA TENANT UNIT OR MAILING An SPACE NO. ADDRESS TR.NO. LOT BLK. CITY NOL r NEW ADD ALTER REPAIR MOVING DEMOLISH ,Z k ` CONSTRUCTION17-4k/ LENDER BRANCH s / OWNER A_ `�� ADDRESS VALUE �OOt ARCHITECT TEL. USE �.(/C • $ OR ENGINE R NO ZON TYPE N Fz. ADDRESS GROUP OVED DATE CONTRACTOR BYP ADDRESS TEL. CITY NO. STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF BLDGS. (FROM C/LSTR OF LOT NOW ON LOT FRONT FT. USE OF EXISTING BLDG. R. SIDE Separate permits are required for L. SIDE T electric, plumbing and heating work: REARFT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APP D I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any Person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. the State lifornia B iness and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, nd t su Icon full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt rom th r is" f the tate of California Business VALUATION PERMIT FEE $ and Profess i s Code, vi on Cha to 9. s OO PLAN CHECK $ w Signature of Permittee $ TAX $ or Authorized Agent Date TOTAL PAID $ Ss PAID it *** OCT 26 77cr1sa�01427 849.58 •COSTA MESA BUILDING -SAFETY DEPARTMENT P.O; BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BY DATE RECEIVED GATE ISSUED BUILDING DI ADDRESS E, PERMIT NO. OWNER A.P. NO. 1 MAIL BUILDING CC ADDRESS ADDRESS je TEL. CITY TE TRACT LOT, L BOCK CONSTRUCTION ADD A TER REPAIR LENDER BRANCH /` OWNER, �/i ADDRESS VALUE BE $ ARCHITECT TEL. OR ENGINEER N FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR By DATE ADDRESS TEL. ZO NO. OF USE OF N CITY NO. 10 PLANS BUILDI G STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM C/ T T) OF LOT NOW ON LOTFRONT T. ` USE OF EXISTING BLDG. (� Separate permits are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT 1`76411 - USE OF BUILDING AND WORK TO BE PERFORMED USE DISTANCE BE BET. M & MAIN BLDDGG.S. ACCESS. SLOGS /� DATE / — C.V.P. qk ���/ APP ROVEDTJ_�(�— APPROV�I' BY CC�'WW I hereby acknowledge that I have read this application and state n that the above Information is correct and agree to comply with � all laws regulating building construction, and I shall not employ any person In violation of the workmen's compensation laws of m Q the State of California. - 1 hereby certify that I am properly licensed as a contractor under SO. FT, smv THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, ro Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business y antl Professions Code, Division 3, Chapter 9. VALUATION PERMIT FEE E n . CHECK E Signature ofPLAN TAX $ 5 Parmittee $a45 Qco 1 t y U TOTAL PAID E Authorized Agent L9